hospital_name,last_updated_on,version,location_name,hospital_address,type_2_npi,license_number|WA,attester_name,"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."
"Astria Toppenish Hospital",4/15/2026,3.0.0,"Astria Toppenish Hospital","502 W 4th AVE Toppenish WA 98948-1616",,814670687,,TRUE
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age,standard_charge|LI_PLAN|COMMERCIAL|negotiated_algorithm,median_amount|LI_PLAN|COMMERCIAL,10th_percentile|LI_PLAN|COMMERCIAL,90th_percentile|LI_PLAN|COMMERCIAL,count|LI_PLAN|COMMERCIAL,standard_charge|LI_PLAN|COMMERCIAL|methodology,additional_payer_notes|LI_PLAN|COMMERCIAL,standard_charge|MEDICAID_PLAN|MEDICAID|negotiated_dollar,standard_charge|MEDICAID_PLAN|MEDICAID|negotiated_percentage,standard_charge|MEDICAID_PLAN|MEDICAID|negotiated_algorithm,median_amount|MEDICAID_PLAN|MEDICAID,10th_percentile|MEDICAID_PLAN|MEDICAID,90th_percentile|MEDICAID_PLAN|MEDICAID,count|MEDICAID_PLAN|MEDICAID,standard_charge|MEDICAID_PLAN|MEDICAID|methodology,additional_payer_notes|MEDICAID_PLAN|MEDICAID,standard_charge|MEDICARE_PLAN|MEDICARE|negotiated_dollar,standard_charge|MEDICARE_PLAN|MEDICARE|negotiated_percentage,standard_charge|MEDICARE_PLAN|MEDICARE|negotiated_algorithm,median_amount|MEDICARE_PLAN|MEDICARE,10th_percentile|MEDICARE_PLAN|MEDICARE,90th_percentile|MEDICARE_PLAN|MEDICARE,count|MEDICARE_PLAN|MEDICARE,standard_charge|MEDICARE_PLAN|MEDICARE|methodology,additional_payer_notes|MEDICARE_PLAN|MEDICARE,standard_charge|MOLINA_PLAN|MEDICAID|negotiated_dollar,standard_charge|MOLINA_PLAN|MEDICAID|negotiated_percentage,standard_charge|MOLINA_PLAN|MEDICAID|negotiated_algorithm,median_amount|MOLINA_PLAN|MEDICAID,10th_percentile|MOLINA_PLAN|MEDICAID,90th_percentile|MOLINA_PLAN|MEDICAID,count|MOLINA_PLAN|MEDICAID,standard_charge|MOLINA_PLAN|MEDICAID|methodology,additional_payer_notes|MOLINA_PLAN|MEDICAID,standard_charge|MOLINA_EXCHANGE_PLAN|MEDICAID|negotiated_dollar,standard_charge|MOLINA_EXCHANGE_PLAN|MEDICAID|negotiated_percentage,standard_charge|MOLINA_EXCHANGE_PLAN|MEDICAID|negotiated_algorithm,median_amount|MOLINA_EXCHANGE_PLAN|MEDICAID,10th_percentile|MOLINA_EXCHANGE_PLAN|MEDICAID,90th_percentile|MOLINA_EXCHANGE_PLAN|MEDICAID,count|MOLINA_EXCHANGE_PLAN|MEDICAID,standard_charge|MOLINA_EXCHANGE_PLAN|MEDICAID|methodology,additional_payer_notes|MOLINA_EXCHANGE_PLAN|MEDICAID,standard_charge|MOLINA_MEDICARE_PLAN|MEDICARE|negotiated_dollar,standard_charge|MOLINA_MEDICARE_PLAN|MEDICARE|negotiated_percentage,standard_charge|MOLINA_MEDICARE_PLAN|MEDICARE|negotiated_algorithm,median_amount|MOLINA_MEDICARE_PLAN|MEDICARE,10th_percentile|MOLINA_MEDICARE_PLAN|MEDICARE,90th_percentile|MOLINA_MEDICARE_PLAN|MEDICARE,count|MOLINA_MEDICARE_PLAN|MEDICARE,standard_charge|MOLINA_MEDICARE_PLAN|MEDICARE|methodology,additional_payer_notes|MOLINA_MEDICARE_PLAN|MEDICARE,standard_charge|PREMERA_PLAN|COMMERCIAL|negotiated_dollar,standard_charge|PREMERA_PLAN|COMMERCIAL|negotiated_percentage,standard_charge|PREMERA_PLAN|COMMERCIAL|negotiated_algorithm,median_amount|PREMERA_PLAN|COMMERCIAL,10th_percentile|PREMERA_PLAN|COMMERCIAL,90th_percentile|PREMERA_PLAN|COMMERCIAL,count|PREMERA_PLAN|COMMERCIAL,standard_charge|PREMERA_PLAN|COMMERCIAL|methodology,additional_payer_notes|PREMERA_PLAN|COMMERCIAL,standard_charge|PREMERA_AFFORDABLE_CARE_PLAN|COMMERCIAL|negotiated_dollar,standard_charge|PREMERA_AFFORDABLE_CARE_PLAN|COMMERCIAL|negotiated_percentage,standard_charge|PREMERA_AFFORDABLE_CARE_PLAN|COMMERCIAL|negotiated_algorithm,median_amount|PREMERA_AFFORDABLE_CARE_PLAN|COMMERCIAL,10th_percentile|PREMERA_AFFORDABLE_CARE_PLAN|COMMERCIAL,90th_percentile|PREMERA_AFFORDABLE_CARE_PLAN|COMMERCIAL,count|PREMERA_AFFORDABLE_CARE_PLAN|COMMERCIAL,standard_charge|PREMERA_AFFORDABLE_CARE_PLAN|COMMERCIAL|methodology,additional_payer_notes|PREMERA_AFFORDABLE_CARE_PLAN|COMMERCIAL,standard_charge|PREMERA_MEDICARE_ADVANTAGE_PLAN|MEDICARE|negotiated_dollar,standard_charge|PREMERA_MEDICARE_ADVANTAGE_PLAN|MEDICARE|negotiated_percentage,standard_charge|PREMERA_MEDICARE_ADVANTAGE_PLAN|MEDICARE|negotiated_algorithm,median_amount|PREMERA_MEDICARE_ADVANTAGE_PLAN|MEDICARE,10th_percentile|PREMERA_MEDICARE_ADVANTAGE_PLAN|MEDICARE,90th_percentile|PREMERA_MEDICARE_ADVANTAGE_PLAN|MEDICARE,count|PREMERA_MEDICARE_ADVANTAGE_PLAN|MEDICARE,standard_charge|PREMERA_MEDICARE_ADVANTAGE_PLAN|MEDICARE|methodology,additional_payer_notes|PREMERA_MEDICARE_ADVANTAGE_PLAN|MEDICARE,standard_charge|REGENCE_PLAN|COMMERCIAL|negotiated_dollar,standard_charge|REGENCE_PLAN|COMMERCIAL|negotiated_percentage,standard_charge|REGENCE_PLAN|COMMERCIAL|negotiated_algorithm,median_amount|REGENCE_PLAN|COMMERCIAL,10th_percentile|REGENCE_PLAN|COMMERCIAL,90th_percentile|REGENCE_PLAN|COMMERCIAL,count|REGENCE_PLAN|COMMERCIAL,standard_charge|REGENCE_PLAN|COMMERCIAL|methodology,additional_payer_notes|REGENCE_PLAN|COMMERCIAL,standard_charge|REGENCE_MEDICARE_PLAN|MEDICARE|negotiated_dollar,standard_charge|REGENCE_MEDICARE_PLAN|MEDICARE|negotiated_percentage,standard_charge|REGENCE_MEDICARE_PLAN|MEDICARE|negotiated_algorithm,median_amount|REGENCE_MEDICARE_PLAN|MEDICARE,10th_percentile|REGENCE_MEDICARE_PLAN|MEDICARE,90th_percentile|REGENCE_MEDICARE_PLAN|MEDICARE,count|REGENCE_MEDICARE_PLAN|MEDICARE,standard_charge|REGENCE_MEDICARE_PLAN|MEDICARE|methodology,additional_payer_notes|REGENCE_MEDICARE_PLAN|MEDICARE,standard_charge|TPSC_PLAN|COMMERCIAL|negotiated_dollar,standard_charge|TPSC_PLAN|COMMERCIAL|negotiated_percentage,standard_charge|TPSC_PLAN|COMMERCIAL|negotiated_algorithm,median_amount|TPSC_PLAN|COMMERCIAL,10th_percentile|TPSC_PLAN|COMMERCIAL,90th_percentile|TPSC_PLAN|COMMERCIAL,count|TPSC_PLAN|COMMERCIAL,standard_charge|TPSC_PLAN|COMMERCIAL|methodology,additional_payer_notes|TPSC_PLAN|COMMERCIAL,standard_charge|ZENITH_PLAN|COMMERCIAL|negotiated_dollar,standard_charge|ZENITH_PLAN|COMMERCIAL|negotiated_percentage,standard_charge|ZENITH_PLAN|COMMERCIAL|negotiated_algorithm,median_amount|ZENITH_PLAN|COMMERCIAL,10th_percentile|ZENITH_PLAN|COMMERCIAL,90th_percentile|ZENITH_PLAN|COMMERCIAL,count|ZENITH_PLAN|COMMERCIAL,standard_charge|ZENITH_PLAN|COMMERCIAL|methodology,additional_payer_notes|ZENITH_PLAN|COMMERCIAL,standard_charge|UMR_PLAN|COMMERCIAL|negotiated_dollar,standard_charge|UMR_PLAN|COMMERCIAL|negotiated_percentage,standard_charge|UMR_PLAN|COMMERCIAL|negotiated_algorithm,median_amount|UMR_PLAN|COMMERCIAL,10th_percentile|UMR_PLAN|COMMERCIAL,90th_percentile|UMR_PLAN|COMMERCIAL,count|UMR_PLAN|COMMERCIAL,standard_charge|UMR_PLAN|COMMERCIAL|methodology,additional_payer_notes|UMR_PLAN|COMMERCIAL,standard_charge|UHC_PLAN|COMMERCIAL|negotiated_dollar,standard_charge|UHC_PLAN|COMMERCIAL|negotiated_percentage,standard_charge|UHC_PLAN|COMMERCIAL|negotiated_algorithm,median_amount|UHC_PLAN|COMMERCIAL,10th_percentile|UHC_PLAN|COMMERCIAL,90th_percentile|UHC_PLAN|COMMERCIAL,count|UHC_PLAN|COMMERCIAL,standard_charge|UHC_PLAN|COMMERCIAL|methodology,additional_payer_notes|UHC_PLAN|COMMERCIAL,standard_charge|UHC_MEDICAID_PLAN|MEDICAID|negotiated_dollar,standard_charge|UHC_MEDICAID_PLAN|MEDICAID|negotiated_percentage,standard_charge|UHC_MEDICAID_PLAN|MEDICAID|negotiated_algorithm,median_amount|UHC_MEDICAID_PLAN|MEDICAID,10th_percentile|UHC_MEDICAID_PLAN|MEDICAID,90th_percentile|UHC_MEDICAID_PLAN|MEDICAID,count|UHC_MEDICAID_PLAN|MEDICAID,standard_charge|UHC_MEDICAID_PLAN|MEDICAID|methodology,additional_payer_notes|UHC_MEDICAID_PLAN|MEDICAID,standard_charge|UHC_MEDICARE_PLAN|MEDICARE|negotiated_dollar,standard_charge|UHC_MEDICARE_PLAN|MEDICARE|negotiated_percentage,standard_charge|UHC_MEDICARE_PLAN|MEDICARE|negotiated_algorithm,median_amount|UHC_MEDICARE_PLAN|MEDICARE,10th_percentile|UHC_MEDICARE_PLAN|MEDICARE,90th_percentile|UHC_MEDICARE_PLAN|MEDICARE,count|UHC_MEDICARE_PLAN|MEDICARE,standard_charge|UHC_MEDICARE_PLAN|MEDICARE|methodology,additional_payer_notes|UHC_MEDICARE_PLAN|MEDICARE,standard_charge|TRICARE_PLAN|MEDICARE|negotiated_dollar,standard_charge|TRICARE_PLAN|MEDICARE|negotiated_percentage,standard_charge|TRICARE_PLAN|MEDICARE|negotiated_algorithm,median_amount|TRICARE_PLAN|MEDICARE,10th_percentile|TRICARE_PLAN|MEDICARE,90th_percentile|TRICARE_PLAN|MEDICARE,count|TRICARE_PLAN|MEDICARE,standard_charge|TRICARE_PLAN|MEDICARE|methodology,additional_payer_notes|TRICARE_PLAN|MEDICARE,standard_charge|VA_PLAN|MEDICARE|negotiated_dollar,standard_charge|VA_PLAN|MEDICARE|negotiated_percentage,standard_charge|VA_PLAN|MEDICARE|negotiated_algorithm,median_amount|VA_PLAN|MEDICARE,10th_percentile|VA_PLAN|MEDICARE,90th_percentile|VA_PLAN|MEDICARE,count|VA_PLAN|MEDICARE,standard_charge|VA_PLAN|MEDICARE|methodology,additional_payer_notes|VA_PLAN|MEDICARE,standard_charge|WASHINGTON_STATE_HCA_PLAN|MEDICAID|negotiated_dollar,standard_charge|WASHINGTON_STATE_HCA_PLAN|MEDICAID|negotiated_percentage,standard_charge|WASHINGTON_STATE_HCA_PLAN|MEDICAID|negotiated_algorithm,median_amount|WASHINGTON_STATE_HCA_PLAN|MEDICAID,10th_percentile|WASHINGTON_STATE_HCA_PLAN|MEDICAID,90th_percentile|WASHINGTON_STATE_HCA_PLAN|MEDICAID,count|WASHINGTON_STATE_HCA_PLAN|MEDICAID,standard_charge|WASHINGTON_STATE_HCA_PLAN|MEDICAID|methodology,additional_payer_notes|WASHINGTON_STATE_HCA_PLAN|MEDICAID,standard_charge|min,standard_charge|max,additional_generic_notes
"ANTIDPRS TRIC MS 6PL",30180337,CDM,301,RC,80337,CPT,OUTPATIENT,,,411,267.15,,361.68,88,,289.34,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",411,100,,328.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",258.93,63,,207.14,,,0,"percent of total billed charges","63% of total billed charges",62.88,15.3,,50.30,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",283.59,69,,,,,0,"fee schedule","69% of total billed charges",411,100,,328.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",411,100,,328.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",411,100,,328.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",154.95,37.7,,123.96,,,0,"percent of total billed charges","37.7% of total billed charges",154.95,37.7,,123.96,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",139.33,33.9,,111.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",320.58,78,,256.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",339.49,82.6,,271.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",339.49,82.6,,271.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.05,16.8,,55.24,,,0,"percent of total billed charges","16.8% of total billed charges",411,100,,328.80,,,0,"percent of total billed charges","100% of total billed charges",62.88,411,
MDMA,30180359,CDM,301,RC,80359,CPT,OUTPATIENT,,,37,24.05,,32.56,88,,26.05,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.31,63,,18.65,,,0,"percent of total billed charges","63% of total billed charges",5.66,15.3,,4.53,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.53,69,,,,,0,"fee schedule","69% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.95,37.7,,11.16,,,0,"percent of total billed charges","37.7% of total billed charges",13.95,37.7,,11.16,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.54,33.9,,10.03,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.86,78,,23.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",5.66,37,
"80356 .Opiates,MS,WB/S/P Rfx LC",30180356,CDM,301,RC,80356,CPT,OUTPATIENT,,,101,65.65,,88.88,88,,71.10,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",63.63,63,,50.90,,,0,"percent of total billed charges","63% of total billed charges",15.45,15.3,,12.36,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.69,69,,,,,0,"fee schedule","69% of total billed charges",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.08,37.7,,30.46,,,0,"percent of total billed charges","37.7% of total billed charges",38.08,37.7,,30.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.24,33.9,,27.39,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.78,78,,63.02,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",83.43,82.6,,66.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",83.43,82.6,,66.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.97,16.8,,13.58,,,0,"percent of total billed charges","16.8% of total billed charges",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",15.45,101,
"80356 Heroin Metab (LC)",30180356,CDM,301,RC,80356,CPT,OUTPATIENT,,,105,68.25,,92.4,88,,73.92,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",105,100,,84.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",66.15,63,,52.92,,,0,"percent of total billed charges","63% of total billed charges",16.07,15.3,,12.86,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",72.45,69,,,,,0,"fee schedule","69% of total billed charges",105,100,,84.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",105,100,,84.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",105,100,,84.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39.59,37.7,,31.67,,,0,"percent of total billed charges","37.7% of total billed charges",39.59,37.7,,31.67,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.6,33.9,,28.48,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.9,78,,65.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.73,82.6,,69.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",86.73,82.6,,69.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.64,16.8,,14.11,,,0,"percent of total billed charges","16.8% of total billed charges",105,100,,84.00,,,0,"percent of total billed charges","100% of total billed charges",16.07,105,
"80359 Ext Amphetamine Conf LC 910990",30180359,CDM,301,RC,80359,CPT,OUTPATIENT,,,239,155.35,,210.32,88,,168.26,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",150.57,63,,120.46,,,0,"percent of total billed charges","63% of total billed charges",36.57,15.3,,29.26,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",164.91,69,,,,,0,"fee schedule","69% of total billed charges",239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",90.1,37.7,,72.08,,,0,"percent of total billed charges","37.7% of total billed charges",90.1,37.7,,72.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.02,33.9,,64.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",186.42,78,,149.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",197.41,82.6,,157.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",197.41,82.6,,157.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.15,16.8,,32.12,,,0,"percent of total billed charges","16.8% of total billed charges",239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",36.57,239,
"80361 Codeine (LC)",30180361,CDM,301,RC,80361,CPT,OUTPATIENT,,,105,68.25,,92.4,88,,73.92,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",105,100,,84.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",66.15,63,,52.92,,,0,"percent of total billed charges","63% of total billed charges",16.07,15.3,,12.86,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",72.45,69,,,,,0,"fee schedule","69% of total billed charges",105,100,,84.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",105,100,,84.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",105,100,,84.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39.59,37.7,,31.67,,,0,"percent of total billed charges","37.7% of total billed charges",39.59,37.7,,31.67,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.6,33.9,,28.48,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.9,78,,65.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.73,82.6,,69.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",86.73,82.6,,69.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.64,16.8,,14.11,,,0,"percent of total billed charges","16.8% of total billed charges",105,100,,84.00,,,0,"percent of total billed charges","100% of total billed charges",16.07,105,
"80365 Oxycodone (LC)",30180365,CDM,301,RC,80365,CPT,OUTPATIENT,,,142,92.3,,124.96,88,,99.97,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",89.46,63,,71.57,,,0,"percent of total billed charges","63% of total billed charges",21.73,15.3,,17.38,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.98,69,,,,,0,"fee schedule","69% of total billed charges",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",53.53,37.7,,42.82,,,0,"percent of total billed charges","37.7% of total billed charges",53.53,37.7,,42.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.14,33.9,,38.51,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.76,78,,88.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",117.29,82.6,,93.83,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",117.29,82.6,,93.83,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.86,16.8,,19.09,,,0,"percent of total billed charges","16.8% of total billed charges",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",21.73,142,
"81001 Urinalysis, Routine RLC",30781001,CDM,307,RC,81001,CPT,OUTPATIENT,,,69,44.85,,60.72,88,,48.58,,,0,"percent of total billed charges","88% of total billed charges",3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",5.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2.55,100,,,,,0,"fee schedule",EAPG,3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.47,63,,34.78,,,0,"percent of total billed charges","63% of total billed charges",10.56,15.3,,8.45,,,0,"percent of total billed charges","15.3% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,47.61,69,,,,,0,"fee schedule","69% of total billed charges",69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.12,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.17,100,,,,,0,"fee schedule","100% of LI fee schedule",1.83,100,,,,,0,"fee schedule",EAPG,3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.52,100,,,,,0,"fee schedule",EAPG,3.22,100,,,,,0,"fee schedule",EAPG,3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.01,37.7,,20.81,,,0,"percent of total billed charges","37.7% of total billed charges",26.01,37.7,,20.81,,,0,"percent of total billed charges","37.70% of total billed charges",3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.39,33.9,,18.71,,,0,"percent of total billed charges","33.9% of total billed charges",3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.82,78,,43.06,,,0,"percent of total billed charges","78% of total billed charges",3.2,101,,,,,0,"fee schedule","101% of CMS fee schedule ",56.99,82.6,,45.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.99,82.6,,45.59,,,0,"percent of total billed charges","82.6% of total billed charges",3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",1.83,69,
"BCR-ABL1, CML/ALL, PCR, Qnt LC 480481",30081207,CDM,301,RC,81207,CPT,OUTPATIENT,,,780,507,,686.4,88,,549.12,,,0,"percent of total billed charges","88% of total billed charges",144.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,780,100,,624.00,,,0,"percent of total billed charges","100% of total billed charges",253.47,175,,,,,0,"fee schedule","175% of CMS fee schedule",110.23,100,,,,,0,"fee schedule",EAPG,144.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",491.4,63,,393.12,,,0,"percent of total billed charges","63% of total billed charges",119.34,15.3,,95.47,,,0,"percent of total billed charges","15.3% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,538.2,69,,,,,0,"fee schedule","69% of total billed charges",780,100,,624.00,,,0,"percent of total billed charges","100% of total billed charges",144.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",780,100,,624.00,,,0,"percent of total billed charges","100% of total billed charges",144.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",780,100,,624.00,,,0,"percent of total billed charges","100% of total billed charges",144.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",554.01,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,144.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.84,100,,,,,0,"fee schedule","100% of LI fee schedule",79.27,100,,,,,0,"fee schedule",EAPG,144.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.16,100,,,,,0,"fee schedule",EAPG,139.13,100,,,,,0,"fee schedule",EAPG,144.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",294.06,37.7,,235.25,,,0,"percent of total billed charges","37.7% of total billed charges",294.06,37.7,,235.25,,,0,"percent of total billed charges","37.70% of total billed charges",144.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",264.42,33.9,,211.54,,,0,"percent of total billed charges","33.9% of total billed charges",144.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",608.4,78,,486.72,,,0,"percent of total billed charges","78% of total billed charges",146.28,101,,,,,0,"fee schedule","101% of CMS fee schedule ",644.28,82.6,,515.42,,,0,"percent of total billed charges","82.6% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,144.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",644.28,82.6,,515.42,,,0,"percent of total billed charges","82.6% of total billed charges",144.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,780,100,,624.00,,,0,"percent of total billed charges","100% of total billed charges",79.27,780,
"Reflex Exons 12-15 LC",31081279,CDM,310,RC,81279,CPT,OUTPATIENT,,,1461,949.65,,1285.68,88,,1028.54,,,0,"percent of total billed charges","88% of total billed charges",185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",324.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",110.23,100,,,,,0,"fee schedule",EAPG,185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",920.43,63,,736.34,,,0,"percent of total billed charges","63% of total billed charges",277.8,150,,,,,0,"fee schedule","150% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,1008.09,69,,,,,0,"fee schedule","69% of total billed charges",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",708.39,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",185.2,100,,,,,0,"fee schedule","100% of LI fee schedule",79.27,100,,,,,0,"fee schedule",EAPG,185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.16,100,,,,,0,"fee schedule",EAPG,139.13,100,,,,,0,"fee schedule",EAPG,185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",550.8,37.7,,440.64,,,0,"percent of total billed charges","37.7% of total billed charges",550.8,37.7,,440.64,,,0,"percent of total billed charges","37.70% of total billed charges",185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",495.28,33.9,,396.22,,,0,"percent of total billed charges","33.9% of total billed charges",185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",1139.58,78,,911.66,,,0,"percent of total billed charges","78% of total billed charges",187.05,101,,,,,0,"fee schedule","101% of CMS fee schedule ",1206.79,82.6,,965.43,,,0,"percent of total billed charges","82.6% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",1206.79,82.6,,965.43,,,0,"percent of total billed charges","82.6% of total billed charges",185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",79.27,1461,
"81338 Myeloproliferative Leukemia (MPL) Mutation Analysis LC",31081338,CDM,310,RC,81338,CPT,OUTPATIENT,,,687,446.55,,604.56,88,,483.65,,,0,"percent of total billed charges","88% of total billed charges",150.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,687,100,,549.60,,,0,"percent of total billed charges","100% of total billed charges",263.07,175,,,,,0,"fee schedule","175% of CMS fee schedule",110.23,100,,,,,0,"fee schedule",EAPG,150.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",432.81,63,,346.25,,,0,"percent of total billed charges","63% of total billed charges",225.5,150,,,,,0,"fee schedule","150% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,474.03,69,,,,,0,"fee schedule","69% of total billed charges",687,100,,549.60,,,0,"percent of total billed charges","100% of total billed charges",150.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",687,100,,549.60,,,0,"percent of total billed charges","100% of total billed charges",150.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",687,100,,549.60,,,0,"percent of total billed charges","100% of total billed charges",150.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",575.01,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,150.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.33,100,,,,,0,"fee schedule","100% of LI fee schedule",79.27,100,,,,,0,"fee schedule",EAPG,150.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.16,100,,,,,0,"fee schedule",EAPG,139.13,100,,,,,0,"fee schedule",EAPG,150.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",259,37.7,,207.20,,,0,"percent of total billed charges","37.7% of total billed charges",259,37.7,,207.20,,,0,"percent of total billed charges","37.70% of total billed charges",150.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",232.89,33.9,,186.31,,,0,"percent of total billed charges","33.9% of total billed charges",150.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",535.86,78,,428.69,,,0,"percent of total billed charges","78% of total billed charges",151.83,101,,,,,0,"fee schedule","101% of CMS fee schedule ",567.46,82.6,,453.97,,,0,"percent of total billed charges","82.6% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,150.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",567.46,82.6,,453.97,,,0,"percent of total billed charges","82.6% of total billed charges",150.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,687,100,,549.60,,,0,"percent of total billed charges","100% of total billed charges",79.27,687,
"Celiac HLA CLass II typing",31081377,CDM,310,RC,81377,CPT,OUTPATIENT,,,553,359.45,,486.64,88,,389.31,,,0,"percent of total billed charges","88% of total billed charges",94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,553,100,,442.40,,,0,"percent of total billed charges","100% of total billed charges",165.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.2,100,,,,,0,"fee schedule",EAPG,94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",348.39,63,,278.71,,,0,"percent of total billed charges","63% of total billed charges",142.11,150,,,,,0,"fee schedule","150% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,381.57,69,,,,,0,"fee schedule","69% of total billed charges",553,100,,442.40,,,0,"percent of total billed charges","100% of total billed charges",94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",553,100,,442.40,,,0,"percent of total billed charges","100% of total billed charges",94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",553,100,,442.40,,,0,"percent of total billed charges","100% of total billed charges",94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",362.38,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",94.74,100,,,,,0,"fee schedule","100% of LI fee schedule",28.91,100,,,,,0,"fee schedule",EAPG,94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.81,100,,,,,0,"fee schedule",EAPG,50.73,100,,,,,0,"fee schedule",EAPG,94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",208.48,37.7,,166.78,,,0,"percent of total billed charges","37.7% of total billed charges",208.48,37.7,,166.78,,,0,"percent of total billed charges","37.70% of total billed charges",94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",187.47,33.9,,149.98,,,0,"percent of total billed charges","33.9% of total billed charges",94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",431.34,78,,345.07,,,0,"percent of total billed charges","78% of total billed charges",95.68,101,,,,,0,"fee schedule","101% of CMS fee schedule ",456.78,82.6,,365.42,,,0,"percent of total billed charges","82.6% of total billed charges",39.02,100,,,,,0,"fee schedule","100% of WA fee schedule",94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",456.78,82.6,,365.42,,,0,"percent of total billed charges","82.6% of total billed charges",94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,553,100,,442.40,,,0,"percent of total billed charges","100% of total billed charges",28.91,553,
"81377 Celiac HLAClass II Typing",31081377,CDM,310,RC,81377,CPT,OUTPATIENT,,,537,349.05,,472.56,88,,378.05,,,0,"percent of total billed charges","88% of total billed charges",94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",165.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.2,100,,,,,0,"fee schedule",EAPG,94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",338.31,63,,270.65,,,0,"percent of total billed charges","63% of total billed charges",142.11,150,,,,,0,"fee schedule","150% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,370.53,69,,,,,0,"fee schedule","69% of total billed charges",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",362.38,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",94.74,100,,,,,0,"fee schedule","100% of LI fee schedule",28.91,100,,,,,0,"fee schedule",EAPG,94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.81,100,,,,,0,"fee schedule",EAPG,50.73,100,,,,,0,"fee schedule",EAPG,94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.45,37.7,,161.96,,,0,"percent of total billed charges","37.7% of total billed charges",202.45,37.7,,161.96,,,0,"percent of total billed charges","37.70% of total billed charges",94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",182.04,33.9,,145.63,,,0,"percent of total billed charges","33.9% of total billed charges",94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",418.86,78,,335.09,,,0,"percent of total billed charges","78% of total billed charges",95.68,101,,,,,0,"fee schedule","101% of CMS fee schedule ",443.56,82.6,,354.85,,,0,"percent of total billed charges","82.6% of total billed charges",39.02,100,,,,,0,"fee schedule","100% of WA fee schedule",94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",443.56,82.6,,354.85,,,0,"percent of total billed charges","82.6% of total billed charges",94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",28.91,537,
"ALBUMIN SERUM",30182040,CDM,301,RC,82040,CPT,OUTPATIENT,,,130,84.5,,114.4,88,,91.52,,,0,"percent of total billed charges","88% of total billed charges",4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",8.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.9,63,,65.52,,,0,"percent of total billed charges","63% of total billed charges",19.89,15.3,,15.91,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,89.7,69,,,,,0,"fee schedule","69% of total billed charges",130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.93,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.95,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.01,37.7,,39.21,,,0,"percent of total billed charges","37.7% of total billed charges",49.01,37.7,,39.21,,,0,"percent of total billed charges","37.70% of total billed charges",4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.07,33.9,,35.26,,,0,"percent of total billed charges","33.9% of total billed charges",4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.4,78,,81.12,,,0,"percent of total billed charges","78% of total billed charges",4.99,101,,,,,0,"fee schedule","101% of CMS fee schedule ",107.38,82.6,,85.90,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.38,82.6,,85.90,,,0,"percent of total billed charges","82.6% of total billed charges",4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",3.25,130,
"ALDOSTERONE,24 HR URINE",30182088,CDM,301,RC,82088,CPT,OUTPATIENT,,,81,52.65,,71.28,88,,57.02,,,0,"percent of total billed charges","88% of total billed charges",40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",71.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",30.04,100,,,,,0,"fee schedule",EAPG,40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.03,63,,40.82,,,0,"percent of total billed charges","63% of total billed charges",12.39,15.3,,9.91,,,0,"percent of total billed charges","15.3% of total billed charges",29.16,100,,,,,0,"fee schedule",EAPG,55.89,69,,,,,0,"fee schedule","69% of total billed charges",81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",155.86,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.75,100,,,,,0,"fee schedule","100% of LI fee schedule",21.6,100,,,,,0,"fee schedule",EAPG,40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.74,100,,,,,0,"fee schedule",EAPG,37.91,100,,,,,0,"fee schedule",EAPG,40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.54,37.7,,24.43,,,0,"percent of total billed charges","37.7% of total billed charges",30.54,37.7,,24.43,,,0,"percent of total billed charges","37.70% of total billed charges",40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.46,33.9,,21.97,,,0,"percent of total billed charges","33.9% of total billed charges",40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.18,78,,50.54,,,0,"percent of total billed charges","78% of total billed charges",41.15,101,,,,,0,"fee schedule","101% of CMS fee schedule ",66.91,82.6,,53.53,,,0,"percent of total billed charges","82.6% of total billed charges",29.16,100,,,,,0,"fee schedule",EAPG,40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.91,82.6,,53.53,,,0,"percent of total billed charges","82.6% of total billed charges",40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",12.39,155.86,
"ALPHA-FETO PROTEIN (NON-MAT)",30182105,CDM,301,RC,82105,CPT,OUTPATIENT,,,368,239.2,,323.84,88,,259.07,,,0,"percent of total billed charges","88% of total billed charges",16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,368,100,,294.40,,,0,"percent of total billed charges","100% of total billed charges",29.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",231.84,63,,185.47,,,0,"percent of total billed charges","63% of total billed charges",56.3,15.3,,45.04,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,253.92,69,,,,,0,"fee schedule","69% of total billed charges",368,100,,294.40,,,0,"percent of total billed charges","100% of total billed charges",16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",368,100,,294.40,,,0,"percent of total billed charges","100% of total billed charges",16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",368,100,,294.40,,,0,"percent of total billed charges","100% of total billed charges",16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.14,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.77,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",138.74,37.7,,110.99,,,0,"percent of total billed charges","37.7% of total billed charges",138.74,37.7,,110.99,,,0,"percent of total billed charges","37.70% of total billed charges",16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.75,33.9,,99.80,,,0,"percent of total billed charges","33.9% of total billed charges",16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",287.04,78,,229.63,,,0,"percent of total billed charges","78% of total billed charges",16.93,101,,,,,0,"fee schedule","101% of CMS fee schedule ",303.97,82.6,,243.18,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",303.97,82.6,,243.18,,,0,"percent of total billed charges","82.6% of total billed charges",16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,368,100,,294.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,368,
"Alpha Fetoprotein Amnio LC",30082106,CDM,300,RC,82106,CPT,OUTPATIENT,,,74,48.1,,65.12,88,,52.10,,,0,"percent of total billed charges","88% of total billed charges",17,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",29.75,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,17,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.62,63,,37.30,,,0,"percent of total billed charges","63% of total billed charges",11.32,15.3,,9.06,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,51.06,69,,,,,0,"fee schedule","69% of total billed charges",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",17,100,,,,,0,"fee schedule","100% of CMS fee schedule",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",17,100,,,,,0,"fee schedule","100% of CMS fee schedule",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",17,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.02,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,17,100,,,,,0,"fee schedule","100% of CMS fee schedule",17,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,17,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,17,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.9,37.7,,22.32,,,0,"percent of total billed charges","37.7% of total billed charges",27.9,37.7,,22.32,,,0,"percent of total billed charges","37.70% of total billed charges",17,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.09,33.9,,20.07,,,0,"percent of total billed charges","33.9% of total billed charges",17,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.72,78,,46.18,,,0,"percent of total billed charges","78% of total billed charges",17.17,101,,,,,0,"fee schedule","101% of CMS fee schedule ",61.12,82.6,,48.90,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,17,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.12,82.6,,48.90,,,0,"percent of total billed charges","82.6% of total billed charges",17,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",8.11,74,
"ALPHA-FETO PROTEIN (NON-MAT)",30182105,CDM,301,RC,82105,CPT,OUTPATIENT,,,308,200.2,,271.04,88,,216.83,,,0,"percent of total billed charges","88% of total billed charges",16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,308,100,,246.40,,,0,"percent of total billed charges","100% of total billed charges",29.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",194.04,63,,155.23,,,0,"percent of total billed charges","63% of total billed charges",47.12,15.3,,37.70,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,212.52,69,,,,,0,"fee schedule","69% of total billed charges",308,100,,246.40,,,0,"percent of total billed charges","100% of total billed charges",16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",308,100,,246.40,,,0,"percent of total billed charges","100% of total billed charges",16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",308,100,,246.40,,,0,"percent of total billed charges","100% of total billed charges",16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.14,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.77,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",116.12,37.7,,92.90,,,0,"percent of total billed charges","37.7% of total billed charges",116.12,37.7,,92.90,,,0,"percent of total billed charges","37.70% of total billed charges",16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",104.41,33.9,,83.53,,,0,"percent of total billed charges","33.9% of total billed charges",16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",240.24,78,,192.19,,,0,"percent of total billed charges","78% of total billed charges",16.93,101,,,,,0,"fee schedule","101% of CMS fee schedule ",254.41,82.6,,203.53,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",254.41,82.6,,203.53,,,0,"percent of total billed charges","82.6% of total billed charges",16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,308,100,,246.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,308,
"ARSENIC ANY SOURCE",30182175,CDM,301,RC,82175,CPT,OUTPATIENT,,,304,197.6,,267.52,88,,214.02,,,0,"percent of total billed charges","88% of total billed charges",18.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",33.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",10.18,100,,,,,0,"fee schedule",EAPG,18.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",191.52,63,,153.22,,,0,"percent of total billed charges","63% of total billed charges",46.51,15.3,,37.21,,,0,"percent of total billed charges","15.3% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,209.76,69,,,,,0,"fee schedule","69% of total billed charges",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",18.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",18.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",18.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.56,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,18.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.97,100,,,,,0,"fee schedule","100% of LI fee schedule",7.32,100,,,,,0,"fee schedule",EAPG,18.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.08,100,,,,,0,"fee schedule",EAPG,12.85,100,,,,,0,"fee schedule",EAPG,18.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",114.61,37.7,,91.69,,,0,"percent of total billed charges","37.7% of total billed charges",114.61,37.7,,91.69,,,0,"percent of total billed charges","37.70% of total billed charges",18.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",103.06,33.9,,82.45,,,0,"percent of total billed charges","33.9% of total billed charges",18.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",237.12,78,,189.70,,,0,"percent of total billed charges","78% of total billed charges",19.15,101,,,,,0,"fee schedule","101% of CMS fee schedule ",251.1,82.6,,200.88,,,0,"percent of total billed charges","82.6% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,18.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.1,82.6,,200.88,,,0,"percent of total billed charges","82.6% of total billed charges",18.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",7.32,304,
"APOLIPOPROTEIN A",30182172,CDM,301,RC,82172,CPT,OUTPATIENT,,,238,154.7,,209.44,88,,167.55,,,0,"percent of total billed charges","88% of total billed charges",21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",36.9,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",149.94,63,,119.95,,,0,"percent of total billed charges","63% of total billed charges",36.41,15.3,,29.13,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,164.22,69,,,,,0,"fee schedule","69% of total billed charges",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.66,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.09,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.73,37.7,,71.78,,,0,"percent of total billed charges","37.7% of total billed charges",89.73,37.7,,71.78,,,0,"percent of total billed charges","37.70% of total billed charges",21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.68,33.9,,64.54,,,0,"percent of total billed charges","33.9% of total billed charges",21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",185.64,78,,148.51,,,0,"percent of total billed charges","78% of total billed charges",21.3,101,,,,,0,"fee schedule","101% of CMS fee schedule ",196.59,82.6,,157.27,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",196.59,82.6,,157.27,,,0,"percent of total billed charges","82.6% of total billed charges",21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,238,
"APOLIPOPROTEIN A",30182172,CDM,301,RC,82172,CPT,OUTPATIENT,,,238,154.7,,209.44,88,,167.55,,,0,"percent of total billed charges","88% of total billed charges",21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",36.9,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",149.94,63,,119.95,,,0,"percent of total billed charges","63% of total billed charges",36.41,15.3,,29.13,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,164.22,69,,,,,0,"fee schedule","69% of total billed charges",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.66,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.09,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.73,37.7,,71.78,,,0,"percent of total billed charges","37.7% of total billed charges",89.73,37.7,,71.78,,,0,"percent of total billed charges","37.70% of total billed charges",21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.68,33.9,,64.54,,,0,"percent of total billed charges","33.9% of total billed charges",21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",185.64,78,,148.51,,,0,"percent of total billed charges","78% of total billed charges",21.3,101,,,,,0,"fee schedule","101% of CMS fee schedule ",196.59,82.6,,157.27,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",196.59,82.6,,157.27,,,0,"percent of total billed charges","82.6% of total billed charges",21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,238,
"Bilirubin Direct",30182248,CDM,301,RC,82248,CPT,OUTPATIENT,,,69,44.85,,60.72,88,,48.58,,,0,"percent of total billed charges","88% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",8.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.47,63,,34.78,,,0,"percent of total billed charges","63% of total billed charges",10.56,15.3,,8.45,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,47.61,69,,,,,0,"fee schedule","69% of total billed charges",69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.2,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.01,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.01,37.7,,20.81,,,0,"percent of total billed charges","37.7% of total billed charges",26.01,37.7,,20.81,,,0,"percent of total billed charges","37.70% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.39,33.9,,18.71,,,0,"percent of total billed charges","33.9% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.82,78,,43.06,,,0,"percent of total billed charges","78% of total billed charges",5.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",56.99,82.6,,45.59,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.99,82.6,,45.59,,,0,"percent of total billed charges","82.6% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",3.25,69,
"BILIRUBIN TOTAL",30182247,CDM,301,RC,82247,CPT,OUTPATIENT,,,68,44.2,,59.84,88,,47.87,,,0,"percent of total billed charges","88% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,68,100,,54.40,,,0,"percent of total billed charges","100% of total billed charges",8.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.84,63,,34.27,,,0,"percent of total billed charges","63% of total billed charges",10.4,15.3,,8.32,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,46.92,69,,,,,0,"fee schedule","69% of total billed charges",68,100,,54.40,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",68,100,,54.40,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",68,100,,54.40,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.2,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.01,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.64,37.7,,20.51,,,0,"percent of total billed charges","37.7% of total billed charges",25.64,37.7,,20.51,,,0,"percent of total billed charges","37.70% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.05,33.9,,18.44,,,0,"percent of total billed charges","33.9% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.04,78,,42.43,,,0,"percent of total billed charges","78% of total billed charges",5.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",56.17,82.6,,44.94,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.17,82.6,,44.94,,,0,"percent of total billed charges","82.6% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,68,100,,54.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,68,
"82248 Bilirubin Fractionated, Neonatal RLC",30182248,CDM,301,RC,82248,CPT,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",8.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.2,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.01,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.7% of total billed charges",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",0.34,33.9,,0.27,,,0,"percent of total billed charges","33.9% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",5.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,19.2,
"CHOLESTEROL FLUID",30182465,CDM,301,RC,82465,CPT,OUTPATIENT,,,88,57.2,,77.44,88,,61.95,,,0,"percent of total billed charges","88% of total billed charges",4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",7.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.44,63,,44.35,,,0,"percent of total billed charges","63% of total billed charges",13.46,15.3,,10.77,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,60.72,69,,,,,0,"fee schedule","69% of total billed charges",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.63,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.34,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.18,37.7,,26.54,,,0,"percent of total billed charges","37.7% of total billed charges",33.18,37.7,,26.54,,,0,"percent of total billed charges","37.70% of total billed charges",4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.83,33.9,,23.86,,,0,"percent of total billed charges","33.9% of total billed charges",4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.64,78,,54.91,,,0,"percent of total billed charges","78% of total billed charges",4.39,101,,,,,0,"fee schedule","101% of CMS fee schedule ",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,88,
PSEUDOCHOLINESTERASE,30182480,CDM,301,RC,82480,CPT,OUTPATIENT,,,193,125.45,,169.84,88,,135.87,,,0,"percent of total billed charges","88% of total billed charges",7.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",13.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,7.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",121.59,63,,97.27,,,0,"percent of total billed charges","63% of total billed charges",29.53,15.3,,23.62,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,133.17,69,,,,,0,"fee schedule","69% of total billed charges",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",7.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",7.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",7.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,7.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.87,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,7.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,7.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.76,37.7,,58.21,,,0,"percent of total billed charges","37.7% of total billed charges",72.76,37.7,,58.21,,,0,"percent of total billed charges","37.70% of total billed charges",7.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.43,33.9,,52.34,,,0,"percent of total billed charges","33.9% of total billed charges",7.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.54,78,,120.43,,,0,"percent of total billed charges","78% of total billed charges",7.94,101,,,,,0,"fee schedule","101% of CMS fee schedule ",159.42,82.6,,127.54,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,7.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",159.42,82.6,,127.54,,,0,"percent of total billed charges","82.6% of total billed charges",7.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,193,
"CPK TOTAL",30182550,CDM,301,RC,82550,CPT,OUTPATIENT,,,130,84.5,,114.4,88,,91.52,,,0,"percent of total billed charges","88% of total billed charges",6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",11.39,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.9,63,,65.52,,,0,"percent of total billed charges","63% of total billed charges",19.89,15.3,,15.91,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,89.7,69,,,,,0,"fee schedule","69% of total billed charges",130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.9,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.51,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.01,37.7,,39.21,,,0,"percent of total billed charges","37.7% of total billed charges",49.01,37.7,,39.21,,,0,"percent of total billed charges","37.70% of total billed charges",6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.07,33.9,,35.26,,,0,"percent of total billed charges","33.9% of total billed charges",6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.4,78,,81.12,,,0,"percent of total billed charges","78% of total billed charges",6.57,101,,,,,0,"fee schedule","101% of CMS fee schedule ",107.38,82.6,,85.90,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.38,82.6,,85.90,,,0,"percent of total billed charges","82.6% of total billed charges",6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",3.25,130,
"Creatine Kinase (CK) LC",30182550,CDM,301,RC,82550,CPT,OUTPATIENT,,,151,98.15,,132.88,88,,106.30,,,0,"percent of total billed charges","88% of total billed charges",6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",11.39,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.13,63,,76.10,,,0,"percent of total billed charges","63% of total billed charges",23.1,15.3,,18.48,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,104.19,69,,,,,0,"fee schedule","69% of total billed charges",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.9,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.51,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.93,37.7,,45.54,,,0,"percent of total billed charges","37.7% of total billed charges",56.93,37.7,,45.54,,,0,"percent of total billed charges","37.70% of total billed charges",6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.19,33.9,,40.95,,,0,"percent of total billed charges","33.9% of total billed charges",6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",117.78,78,,94.22,,,0,"percent of total billed charges","78% of total billed charges",6.57,101,,,,,0,"fee schedule","101% of CMS fee schedule ",124.73,82.6,,99.78,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.73,82.6,,99.78,,,0,"percent of total billed charges","82.6% of total billed charges",6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",3.25,151,
"CREATININE URINE RANDOM",30182570,CDM,301,RC,82570,CPT,OUTPATIENT,,,75,48.75,,66,88,,52.80,,,0,"percent of total billed charges","88% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",9.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.25,63,,37.80,,,0,"percent of total billed charges","63% of total billed charges",11.48,15.3,,9.18,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,51.75,69,,,,,0,"fee schedule","69% of total billed charges",75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.81,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.28,37.7,,22.62,,,0,"percent of total billed charges","37.7% of total billed charges",28.28,37.7,,22.62,,,0,"percent of total billed charges","37.70% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.43,33.9,,20.34,,,0,"percent of total billed charges","33.9% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.5,78,,46.80,,,0,"percent of total billed charges","78% of total billed charges",5.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",61.95,82.6,,49.56,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.95,82.6,,49.56,,,0,"percent of total billed charges","82.6% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",3.25,75,
"CREATININE URINE RANDOM",30182570,CDM,301,RC,82570,CPT,OUTPATIENT,,,75,48.75,,66,88,,52.80,,,0,"percent of total billed charges","88% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",9.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.25,63,,37.80,,,0,"percent of total billed charges","63% of total billed charges",11.48,15.3,,9.18,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,51.75,69,,,,,0,"fee schedule","69% of total billed charges",75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.81,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.28,37.7,,22.62,,,0,"percent of total billed charges","37.7% of total billed charges",28.28,37.7,,22.62,,,0,"percent of total billed charges","37.70% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.43,33.9,,20.34,,,0,"percent of total billed charges","33.9% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.5,78,,46.80,,,0,"percent of total billed charges","78% of total billed charges",5.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",61.95,82.6,,49.56,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.95,82.6,,49.56,,,0,"percent of total billed charges","82.6% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",3.25,75,
ESTRIOL,30182677,CDM,301,RC,82677,CPT,OUTPATIENT,,,182,118.3,,160.16,88,,128.13,,,0,"percent of total billed charges","88% of total billed charges",24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",42.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",27.85,15.3,,22.28,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,125.58,69,,,,,0,"fee schedule","69% of total billed charges",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.48,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.18,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.61,37.7,,54.89,,,0,"percent of total billed charges","37.7% of total billed charges",68.61,37.7,,54.89,,,0,"percent of total billed charges","37.70% of total billed charges",24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.7,33.9,,49.36,,,0,"percent of total billed charges","33.9% of total billed charges",24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",141.96,78,,113.57,,,0,"percent of total billed charges","78% of total billed charges",24.42,101,,,,,0,"fee schedule","101% of CMS fee schedule ",150.33,82.6,,120.26,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.33,82.6,,120.26,,,0,"percent of total billed charges","82.6% of total billed charges",24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",8.39,182,
ESTRIOL,30182677,CDM,301,RC,82677,CPT,OUTPATIENT,,,492,319.8,,432.96,88,,346.37,,,0,"percent of total billed charges","88% of total billed charges",24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",42.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",75.28,15.3,,60.22,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,339.48,69,,,,,0,"fee schedule","69% of total billed charges",492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.48,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.18,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",185.48,37.7,,148.38,,,0,"percent of total billed charges","37.7% of total billed charges",185.48,37.7,,148.38,,,0,"percent of total billed charges","37.70% of total billed charges",24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",166.79,33.9,,133.43,,,0,"percent of total billed charges","33.9% of total billed charges",24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",383.76,78,,307.01,,,0,"percent of total billed charges","78% of total billed charges",24.42,101,,,,,0,"fee schedule","101% of CMS fee schedule ",406.39,82.6,,325.11,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",406.39,82.6,,325.11,,,0,"percent of total billed charges","82.6% of total billed charges",24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",8.39,492,
"Estradiol Level",30182670,CDM,310,RC,82670,CPT,OUTPATIENT,,,148,96.2,,130.24,88,,104.19,,,0,"percent of total billed charges","88% of total billed charges",27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,148,100,,118.40,,,0,"percent of total billed charges","100% of total billed charges",48.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",93.24,63,,74.59,,,0,"percent of total billed charges","63% of total billed charges",41.91,150,,,,,0,"fee schedule","150% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,102.12,69,,,,,0,"fee schedule","69% of total billed charges",148,100,,118.40,,,0,"percent of total billed charges","100% of total billed charges",27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",148,100,,118.40,,,0,"percent of total billed charges","100% of total billed charges",27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",148,100,,118.40,,,0,"percent of total billed charges","100% of total billed charges",27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.87,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.94,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.8,37.7,,44.64,,,0,"percent of total billed charges","37.7% of total billed charges",55.8,37.7,,44.64,,,0,"percent of total billed charges","37.70% of total billed charges",27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.17,33.9,,40.14,,,0,"percent of total billed charges","33.9% of total billed charges",27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",115.44,78,,92.35,,,0,"percent of total billed charges","78% of total billed charges",28.21,101,,,,,0,"fee schedule","101% of CMS fee schedule ",122.25,82.6,,97.80,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",122.25,82.6,,97.80,,,0,"percent of total billed charges","82.6% of total billed charges",27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,148,100,,118.40,,,0,"percent of total billed charges","100% of total billed charges",8.39,148,
"Follicle Stimulating Hormone Level",30182728,CDM,301,RC,82728,CPT,OUTPATIENT,,,23,14.95,,20.24,88,,16.19,,,0,"percent of total billed charges","88% of total billed charges",13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",23.85,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.49,63,,11.59,,,0,"percent of total billed charges","63% of total billed charges",3.52,15.3,,2.82,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,15.87,69,,,,,0,"fee schedule","69% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.13,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.63,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.7% of total billed charges",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.70% of total billed charges",13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.8,33.9,,6.24,,,0,"percent of total billed charges","33.9% of total billed charges",13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.94,78,,14.35,,,0,"percent of total billed charges","78% of total billed charges",13.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",3.52,52.13,
"Pathology Billing Gyn Cyto Image Guided Thin Prep",30182784,CDM,301,RC,82784,CPT,OUTPATIENT,,,163,105.95,,143.44,88,,114.75,,,0,"percent of total billed charges","88% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",16.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",102.69,63,,82.15,,,0,"percent of total billed charges","63% of total billed charges",24.94,15.3,,19.95,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,112.47,69,,,,,0,"fee schedule","69% of total billed charges",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.57,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.3,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.45,37.7,,49.16,,,0,"percent of total billed charges","37.7% of total billed charges",61.45,37.7,,49.16,,,0,"percent of total billed charges","37.70% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.26,33.9,,44.21,,,0,"percent of total billed charges","33.9% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",127.14,78,,101.71,,,0,"percent of total billed charges","78% of total billed charges",9.39,101,,,,,0,"fee schedule","101% of CMS fee schedule ",134.64,82.6,,107.71,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.64,82.6,,107.71,,,0,"percent of total billed charges","82.6% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,163,
N/A,30182784,CDM,301,RC,82784,CPT,OUTPATIENT,,,191,124.15,,168.08,88,,134.46,,,0,"percent of total billed charges","88% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",16.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",120.33,63,,96.26,,,0,"percent of total billed charges","63% of total billed charges",29.22,15.3,,23.38,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,131.79,69,,,,,0,"fee schedule","69% of total billed charges",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.57,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.3,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.01,37.7,,57.61,,,0,"percent of total billed charges","37.7% of total billed charges",72.01,37.7,,57.61,,,0,"percent of total billed charges","37.70% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.75,33.9,,51.80,,,0,"percent of total billed charges","33.9% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",148.98,78,,119.18,,,0,"percent of total billed charges","78% of total billed charges",9.39,101,,,,,0,"fee schedule","101% of CMS fee schedule ",157.77,82.6,,126.22,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",157.77,82.6,,126.22,,,0,"percent of total billed charges","82.6% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",3.25,191,
N/A,30182947,CDM,301,RC,82947,CPT,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",6.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.03,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.93,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.7% of total billed charges",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.93,33.9,,12.74,,,0,"percent of total billed charges","33.9% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",3.96,101,,,,,0,"fee schedule","101% of CMS fee schedule ",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,47,
N/A,30182952,CDM,301,RC,82952,CPT,OUTPATIENT,,,37,24.05,,32.56,88,,26.05,,,0,"percent of total billed charges","88% of total billed charges",3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",6.86,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.31,63,,18.65,,,0,"percent of total billed charges","63% of total billed charges",5.66,15.3,,4.53,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,25.53,69,,,,,0,"fee schedule","69% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.92,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.95,37.7,,11.16,,,0,"percent of total billed charges","37.7% of total billed charges",13.95,37.7,,11.16,,,0,"percent of total billed charges","37.70% of total billed charges",3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.54,33.9,,10.03,,,0,"percent of total billed charges","33.9% of total billed charges",3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.86,78,,23.09,,,0,"percent of total billed charges","78% of total billed charges",3.95,101,,,,,0,"fee schedule","101% of CMS fee schedule ",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,37,
N/A,30182977,CDM,301,RC,82977,CPT,OUTPATIENT,,,126,81.9,,110.88,88,,88.70,,,0,"percent of total billed charges","88% of total billed charges",7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",12.6,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.38,63,,63.50,,,0,"percent of total billed charges","63% of total billed charges",19.28,15.3,,15.42,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,86.94,69,,,,,0,"fee schedule","69% of total billed charges",126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.54,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.2,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.5,37.7,,38.00,,,0,"percent of total billed charges","37.7% of total billed charges",47.5,37.7,,38.00,,,0,"percent of total billed charges","37.70% of total billed charges",7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.71,33.9,,34.17,,,0,"percent of total billed charges","33.9% of total billed charges",7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.28,78,,78.62,,,0,"percent of total billed charges","78% of total billed charges",7.27,101,,,,,0,"fee schedule","101% of CMS fee schedule ",104.08,82.6,,83.26,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",104.08,82.6,,83.26,,,0,"percent of total billed charges","82.6% of total billed charges",7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",3.25,126,
"Pathology Billing Gyn Cytology Thin Prep",30182977,CDM,301,RC,82977,CPT,OUTPATIENT,,,126,81.9,,110.88,88,,88.70,,,0,"percent of total billed charges","88% of total billed charges",7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",12.6,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.38,63,,63.50,,,0,"percent of total billed charges","63% of total billed charges",19.28,15.3,,15.42,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,86.94,69,,,,,0,"fee schedule","69% of total billed charges",126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.54,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.2,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.5,37.7,,38.00,,,0,"percent of total billed charges","37.7% of total billed charges",47.5,37.7,,38.00,,,0,"percent of total billed charges","37.70% of total billed charges",7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.71,33.9,,34.17,,,0,"percent of total billed charges","33.9% of total billed charges",7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.28,78,,78.62,,,0,"percent of total billed charges","78% of total billed charges",7.27,101,,,,,0,"fee schedule","101% of CMS fee schedule ",104.08,82.6,,83.26,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",104.08,82.6,,83.26,,,0,"percent of total billed charges","82.6% of total billed charges",7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",3.25,126,
N/A,30183002,CDM,301,RC,83002,CPT,OUTPATIENT,,,380,247,,334.4,88,,267.52,,,0,"percent of total billed charges","88% of total billed charges",18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,380,100,,304.00,,,0,"percent of total billed charges","100% of total billed charges",32.41,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",239.4,63,,191.52,,,0,"percent of total billed charges","63% of total billed charges",58.14,15.3,,46.51,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,262.2,69,,,,,0,"fee schedule","69% of total billed charges",380,100,,304.00,,,0,"percent of total billed charges","100% of total billed charges",18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",380,100,,304.00,,,0,"percent of total billed charges","100% of total billed charges",18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",380,100,,304.00,,,0,"percent of total billed charges","100% of total billed charges",18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.83,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.52,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",143.26,37.7,,114.61,,,0,"percent of total billed charges","37.7% of total billed charges",143.26,37.7,,114.61,,,0,"percent of total billed charges","37.70% of total billed charges",18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",128.82,33.9,,103.06,,,0,"percent of total billed charges","33.9% of total billed charges",18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",296.4,78,,237.12,,,0,"percent of total billed charges","78% of total billed charges",18.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",313.88,82.6,,251.10,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",313.88,82.6,,251.10,,,0,"percent of total billed charges","82.6% of total billed charges",18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,380,100,,304.00,,,0,"percent of total billed charges","100% of total billed charges",8.39,380,
"Follicle Stimulating Hormone Level",30183001,CDM,301,RC,83001,CPT,OUTPATIENT,,,106,68.9,,93.28,88,,74.62,,,0,"percent of total billed charges","88% of total billed charges",18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",32.51,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.78,63,,53.42,,,0,"percent of total billed charges","63% of total billed charges",16.22,15.3,,12.98,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,73.14,69,,,,,0,"fee schedule","69% of total billed charges",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.06,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.57,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.96,37.7,,31.97,,,0,"percent of total billed charges","37.7% of total billed charges",39.96,37.7,,31.97,,,0,"percent of total billed charges","37.70% of total billed charges",18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.93,33.9,,28.74,,,0,"percent of total billed charges","33.9% of total billed charges",18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.68,78,,66.14,,,0,"percent of total billed charges","78% of total billed charges",18.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",87.56,82.6,,70.05,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.56,82.6,,70.05,,,0,"percent of total billed charges","82.6% of total billed charges",18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",8.39,106,
"GC by Nucleic Acid Amplification",30183010,CDM,301,RC,83010,CPT,OUTPATIENT,,,219,142.35,,192.72,88,,154.18,,,0,"percent of total billed charges","88% of total billed charges",12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",22.01,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.97,63,,110.38,,,0,"percent of total billed charges","63% of total billed charges",33.51,15.3,,26.81,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,151.11,69,,,,,0,"fee schedule","69% of total billed charges",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.11,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.58,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.56,37.7,,66.05,,,0,"percent of total billed charges","37.7% of total billed charges",82.56,37.7,,66.05,,,0,"percent of total billed charges","37.70% of total billed charges",12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.24,33.9,,59.39,,,0,"percent of total billed charges","33.9% of total billed charges",12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.82,78,,136.66,,,0,"percent of total billed charges","78% of total billed charges",12.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",180.89,82.6,,144.71,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",180.89,82.6,,144.71,,,0,"percent of total billed charges","82.6% of total billed charges",12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",8.11,219,
"GC by Nucleic Acid Amplification",30183010,CDM,301,RC,83010,CPT,OUTPATIENT,,,219,142.35,,192.72,88,,154.18,,,0,"percent of total billed charges","88% of total billed charges",12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",22.01,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.97,63,,110.38,,,0,"percent of total billed charges","63% of total billed charges",33.51,15.3,,26.81,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,151.11,69,,,,,0,"fee schedule","69% of total billed charges",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.11,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.58,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.56,37.7,,66.05,,,0,"percent of total billed charges","37.7% of total billed charges",82.56,37.7,,66.05,,,0,"percent of total billed charges","37.70% of total billed charges",12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.24,33.9,,59.39,,,0,"percent of total billed charges","33.9% of total billed charges",12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.82,78,,136.66,,,0,"percent of total billed charges","78% of total billed charges",12.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",180.89,82.6,,144.71,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",180.89,82.6,,144.71,,,0,"percent of total billed charges","82.6% of total billed charges",12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",8.11,219,
N/A,30183018,CDM,301,RC,83018,CPT,OUTPATIENT,,,79,51.35,,69.52,88,,55.62,,,0,"percent of total billed charges","88% of total billed charges",21.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",38.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",10.18,100,,,,,0,"fee schedule",EAPG,21.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.77,63,,39.82,,,0,"percent of total billed charges","63% of total billed charges",12.09,15.3,,9.67,,,0,"percent of total billed charges","15.3% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,54.51,69,,,,,0,"fee schedule","69% of total billed charges",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",21.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",21.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",21.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",83.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,21.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.96,100,,,,,0,"fee schedule","100% of LI fee schedule",7.32,100,,,,,0,"fee schedule",EAPG,21.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.08,100,,,,,0,"fee schedule",EAPG,12.85,100,,,,,0,"fee schedule",EAPG,21.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.78,37.7,,23.82,,,0,"percent of total billed charges","37.7% of total billed charges",29.78,37.7,,23.82,,,0,"percent of total billed charges","37.70% of total billed charges",21.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.78,33.9,,21.42,,,0,"percent of total billed charges","33.9% of total billed charges",21.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.62,78,,49.30,,,0,"percent of total billed charges","78% of total billed charges",22.17,101,,,,,0,"fee schedule","101% of CMS fee schedule ",65.25,82.6,,52.20,,,0,"percent of total billed charges","82.6% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,21.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.25,82.6,,52.20,,,0,"percent of total billed charges","82.6% of total billed charges",21.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",7.32,83.99,
"HBV DNA RealTime Abbott LC",30183497,CDM,301,RC,83497,CPT,OUTPATIENT,,,280,182,,246.4,88,,197.12,,,0,"percent of total billed charges","88% of total billed charges",12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",22.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",176.4,63,,141.12,,,0,"percent of total billed charges","63% of total billed charges",42.84,15.3,,34.27,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,193.2,69,,,,,0,"fee schedule","69% of total billed charges",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.9,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",105.56,37.7,,84.45,,,0,"percent of total billed charges","37.7% of total billed charges",105.56,37.7,,84.45,,,0,"percent of total billed charges","37.70% of total billed charges",12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",94.92,33.9,,75.94,,,0,"percent of total billed charges","33.9% of total billed charges",12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",218.4,78,,174.72,,,0,"percent of total billed charges","78% of total billed charges",13.02,101,,,,,0,"fee schedule","101% of CMS fee schedule ",231.28,82.6,,185.02,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",231.28,82.6,,185.02,,,0,"percent of total billed charges","82.6% of total billed charges",12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",8.39,280,
"HBV DNA RealTime Abbott LC",30183497,CDM,301,RC,83497,CPT,OUTPATIENT,,,280,182,,246.4,88,,197.12,,,0,"percent of total billed charges","88% of total billed charges",12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",22.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",176.4,63,,141.12,,,0,"percent of total billed charges","63% of total billed charges",42.84,15.3,,34.27,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,193.2,69,,,,,0,"fee schedule","69% of total billed charges",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.9,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",105.56,37.7,,84.45,,,0,"percent of total billed charges","37.7% of total billed charges",105.56,37.7,,84.45,,,0,"percent of total billed charges","37.70% of total billed charges",12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",94.92,33.9,,75.94,,,0,"percent of total billed charges","33.9% of total billed charges",12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",218.4,78,,174.72,,,0,"percent of total billed charges","78% of total billed charges",13.02,101,,,,,0,"fee schedule","101% of CMS fee schedule ",231.28,82.6,,185.02,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",231.28,82.6,,185.02,,,0,"percent of total billed charges","82.6% of total billed charges",12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",8.39,280,
"Cortisol 24 Hour Urine",30585306,CDM,305,RC,85306,CPT,OUTPATIENT,,,526,341.9,,462.88,88,,370.30,,,0,"percent of total billed charges","88% of total billed charges",15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,526,100,,420.80,,,0,"percent of total billed charges","100% of total billed charges",26.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",331.38,63,,265.10,,,0,"percent of total billed charges","63% of total billed charges",80.48,15.3,,64.38,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,362.94,69,,,,,0,"fee schedule","69% of total billed charges",526,100,,420.80,,,0,"percent of total billed charges","100% of total billed charges",15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",526,100,,420.80,,,0,"percent of total billed charges","100% of total billed charges",15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",526,100,,420.80,,,0,"percent of total billed charges","100% of total billed charges",15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.59,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.32,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",198.3,37.7,,158.64,,,0,"percent of total billed charges","37.7% of total billed charges",198.3,37.7,,158.64,,,0,"percent of total billed charges","37.70% of total billed charges",15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",178.31,33.9,,142.65,,,0,"percent of total billed charges","33.9% of total billed charges",15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",410.28,78,,328.22,,,0,"percent of total billed charges","78% of total billed charges",15.47,101,,,,,0,"fee schedule","101% of CMS fee schedule ",434.48,82.6,,347.58,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",434.48,82.6,,347.58,,,0,"percent of total billed charges","82.6% of total billed charges",15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,526,100,,420.80,,,0,"percent of total billed charges","100% of total billed charges",2.48,526,
"Pathology Billing Gyn Cyto Image Guided Thin Prep",30183516,CDM,301,RC,83516,CPT,OUTPATIENT,,,37,24.05,,32.56,88,,26.05,,,0,"percent of total billed charges","88% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",20.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",5.66,15.3,,4.53,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,25.53,69,,,,,0,"fee schedule","69% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.53,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.95,37.7,,11.16,,,0,"percent of total billed charges","37.7% of total billed charges",13.95,37.7,,11.16,,,0,"percent of total billed charges","37.70% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.54,33.9,,10.03,,,0,"percent of total billed charges","33.9% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.86,78,,23.09,,,0,"percent of total billed charges","78% of total billed charges",11.64,101,,,,,0,"fee schedule","101% of CMS fee schedule ",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",5.66,44.1,
"Pathology Billing Gyn Cyto Image Guided Thin Prep",30183516,CDM,301,RC,83516,CPT,OUTPATIENT,,,88,57.2,,77.44,88,,61.95,,,0,"percent of total billed charges","88% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",20.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",13.46,15.3,,10.77,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,60.72,69,,,,,0,"fee schedule","69% of total billed charges",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.53,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.18,37.7,,26.54,,,0,"percent of total billed charges","37.7% of total billed charges",33.18,37.7,,26.54,,,0,"percent of total billed charges","37.70% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.83,33.9,,23.86,,,0,"percent of total billed charges","33.9% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.64,78,,54.91,,,0,"percent of total billed charges","78% of total billed charges",11.64,101,,,,,0,"fee schedule","101% of CMS fee schedule ",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,88,
"Pathology Billing Gyn Cyto Image Guided Thin Prep",30183520,CDM,301,RC,83520,CPT,OUTPATIENT,,,55,35.75,,48.4,88,,38.72,,,0,"percent of total billed charges","88% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,55,100,,44.00,,,0,"percent of total billed charges","100% of total billed charges",30.22,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",8.42,15.3,,6.74,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,37.95,69,,,,,0,"fee schedule","69% of total billed charges",55,100,,44.00,,,0,"percent of total billed charges","100% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",55,100,,44.00,,,0,"percent of total billed charges","100% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",55,100,,44.00,,,0,"percent of total billed charges","100% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.05,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.27,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.74,37.7,,16.59,,,0,"percent of total billed charges","37.7% of total billed charges",20.74,37.7,,16.59,,,0,"percent of total billed charges","37.70% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.65,33.9,,14.92,,,0,"percent of total billed charges","33.9% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.9,78,,34.32,,,0,"percent of total billed charges","78% of total billed charges",17.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",45.43,82.6,,36.34,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.43,82.6,,36.34,,,0,"percent of total billed charges","82.6% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,55,100,,44.00,,,0,"percent of total billed charges","100% of total billed charges",8.11,66.05,
"Pathology Billing Gyn Cyto Image Guided Thin Prep",30183521,CDM,301,RC,83521,CPT,OUTPATIENT,,,167,108.55,,146.96,88,,117.57,,,0,"percent of total billed charges","88% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,167,100,,133.60,,,0,"percent of total billed charges","100% of total billed charges",30.22,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",105.21,63,,84.17,,,0,"percent of total billed charges","63% of total billed charges",25.55,15.3,,20.44,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,115.23,69,,,,,0,"fee schedule","69% of total billed charges",167,100,,133.60,,,0,"percent of total billed charges","100% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",167,100,,133.60,,,0,"percent of total billed charges","100% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",167,100,,133.60,,,0,"percent of total billed charges","100% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",10.95,100,,,,,0,"fee schedule",EAPG,17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.27,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.96,37.7,,50.37,,,0,"percent of total billed charges","37.7% of total billed charges",62.96,37.7,,50.37,,,0,"percent of total billed charges","37.70% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.61,33.9,,45.29,,,0,"percent of total billed charges","33.9% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",130.26,78,,104.21,,,0,"percent of total billed charges","78% of total billed charges",17.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",137.94,82.6,,110.35,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.94,82.6,,110.35,,,0,"percent of total billed charges","82.6% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,167,100,,133.60,,,0,"percent of total billed charges","100% of total billed charges",8.11,167,
"Pathology Billing Gyn Cyto Image Guided Thin Prep",30183550,CDM,301,RC,83550,CPT,OUTPATIENT,,,29,18.85,,25.52,88,,20.42,,,0,"percent of total billed charges","88% of total billed charges",8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",15.29,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.27,63,,14.62,,,0,"percent of total billed charges","63% of total billed charges",4.44,15.3,,3.55,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,20.01,69,,,,,0,"fee schedule","69% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.43,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.74,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.93,37.7,,8.74,,,0,"percent of total billed charges","37.7% of total billed charges",10.93,37.7,,8.74,,,0,"percent of total billed charges","37.70% of total billed charges",8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.83,33.9,,7.86,,,0,"percent of total billed charges","33.9% of total billed charges",8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.62,78,,18.10,,,0,"percent of total billed charges","78% of total billed charges",8.82,101,,,,,0,"fee schedule","101% of CMS fee schedule ",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",3.25,33.43,
"JAK2 V617 Mutation LC",30183605,CDM,301,RC,83605,CPT,OUTPATIENT,,,32,20.8,,28.16,88,,22.53,,,0,"percent of total billed charges","88% of total billed charges",11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",20.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.16,63,,16.13,,,0,"percent of total billed charges","63% of total billed charges",4.9,15.3,,3.92,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,22.08,69,,,,,0,"fee schedule","69% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.25,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.57,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.7% of total billed charges",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.70% of total billed charges",11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.85,33.9,,8.68,,,0,"percent of total billed charges","33.9% of total billed charges",11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.96,78,,19.97,,,0,"percent of total billed charges","78% of total billed charges",11.68,101,,,,,0,"fee schedule","101% of CMS fee schedule ",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",4.9,44.25,
N/A,30083655,CDM,300,RC,83655,CPT,OUTPATIENT,,,119,77.35,,104.72,88,,83.78,,,0,"percent of total billed charges","88% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",21.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",10.18,100,,,,,0,"fee schedule",EAPG,12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.97,63,,59.98,,,0,"percent of total billed charges","63% of total billed charges",18.21,15.3,,14.57,,,0,"percent of total billed charges","15.3% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,82.11,69,,,,,0,"fee schedule","69% of total billed charges",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.32,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.11,100,,,,,0,"fee schedule","100% of LI fee schedule",7.32,100,,,,,0,"fee schedule",EAPG,12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.08,100,,,,,0,"fee schedule",EAPG,12.85,100,,,,,0,"fee schedule",EAPG,12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.7% of total billed charges",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.70% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.34,33.9,,32.27,,,0,"percent of total billed charges","33.9% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.82,78,,74.26,,,0,"percent of total billed charges","78% of total billed charges",12.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",7.32,119,
"Pathology Billing Cytopathology NG Thin Prep, with interpretation, except cervical or vaginal",30183700,CDM,301,RC,83700,CPT,OUTPATIENT,,,39,25.35,,34.32,88,,27.46,,,0,"percent of total billed charges","88% of total billed charges",11.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",19.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,11.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.57,63,,19.66,,,0,"percent of total billed charges","63% of total billed charges",5.97,15.3,,4.78,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,26.91,69,,,,,0,"fee schedule","69% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",11.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",11.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",11.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.06,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,11.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.26,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,11.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,11.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.7% of total billed charges",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.70% of total billed charges",11.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.22,33.9,,10.58,,,0,"percent of total billed charges","33.9% of total billed charges",11.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.42,78,,24.34,,,0,"percent of total billed charges","78% of total billed charges",11.37,101,,,,,0,"fee schedule","101% of CMS fee schedule ",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,11.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",11.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",5.97,43.06,
"C albicans + C glabrata, NAA LC",30183704,CDM,301,RC,83704,CPT,OUTPATIENT,,,80,52,,70.4,88,,56.32,,,0,"percent of total billed charges","88% of total billed charges",34.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",59.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",29.67,100,,,,,0,"fee schedule",EAPG,34.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.4,63,,40.32,,,0,"percent of total billed charges","63% of total billed charges",12.24,15.3,,9.79,,,0,"percent of total billed charges","15.3% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,55.2,69,,,,,0,"fee schedule","69% of total billed charges",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",34.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",34.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",34.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",130.77,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,34.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.19,100,,,,,0,"fee schedule","100% of LI fee schedule",21.33,100,,,,,0,"fee schedule",EAPG,34.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.38,100,,,,,0,"fee schedule",EAPG,37.44,100,,,,,0,"fee schedule",EAPG,34.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.16,37.7,,24.13,,,0,"percent of total billed charges","37.7% of total billed charges",30.16,37.7,,24.13,,,0,"percent of total billed charges","37.70% of total billed charges",34.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.12,33.9,,21.70,,,0,"percent of total billed charges","33.9% of total billed charges",34.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.4,78,,49.92,,,0,"percent of total billed charges","78% of total billed charges",34.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",66.08,82.6,,52.86,,,0,"percent of total billed charges","82.6% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,34.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.08,82.6,,52.86,,,0,"percent of total billed charges","82.6% of total billed charges",34.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",12.24,130.77,
"C albicans + C glabrata, NAA LC",30183883,CDM,301,RC,83883,CPT,OUTPATIENT,,,576,374.4,,506.88,88,,405.50,,,0,"percent of total billed charges","88% of total billed charges",13.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,576,100,,460.80,,,0,"percent of total billed charges","100% of total billed charges",23.8,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,13.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",362.88,63,,290.30,,,0,"percent of total billed charges","63% of total billed charges",88.13,15.3,,70.50,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,397.44,69,,,,,0,"fee schedule","69% of total billed charges",576,100,,460.80,,,0,"percent of total billed charges","100% of total billed charges",13.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",576,100,,460.80,,,0,"percent of total billed charges","100% of total billed charges",13.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",576,100,,460.80,,,0,"percent of total billed charges","100% of total billed charges",13.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.02,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,13.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.6,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,13.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,13.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",217.15,37.7,,173.72,,,0,"percent of total billed charges","37.7% of total billed charges",217.15,37.7,,173.72,,,0,"percent of total billed charges","37.70% of total billed charges",13.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",195.26,33.9,,156.21,,,0,"percent of total billed charges","33.9% of total billed charges",13.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",449.28,78,,359.42,,,0,"percent of total billed charges","78% of total billed charges",13.73,101,,,,,0,"fee schedule","101% of CMS fee schedule ",475.78,82.6,,380.62,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,13.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",475.78,82.6,,380.62,,,0,"percent of total billed charges","82.6% of total billed charges",13.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,576,100,,460.80,,,0,"percent of total billed charges","100% of total billed charges",6.96,576,
"Pathology Billing Gyn Cyto Image Guided Thin Prep",30183883,CDM,301,RC,83883,CPT,OUTPATIENT,,,130,84.5,,114.4,88,,91.52,,,0,"percent of total billed charges","88% of total billed charges",13.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",23.8,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,13.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.9,63,,65.52,,,0,"percent of total billed charges","63% of total billed charges",19.89,15.3,,15.91,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,89.7,69,,,,,0,"fee schedule","69% of total billed charges",130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",13.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",13.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",13.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.02,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,13.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.6,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,13.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,13.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.01,37.7,,39.21,,,0,"percent of total billed charges","37.7% of total billed charges",49.01,37.7,,39.21,,,0,"percent of total billed charges","37.70% of total billed charges",13.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.07,33.9,,35.26,,,0,"percent of total billed charges","33.9% of total billed charges",13.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.4,78,,81.12,,,0,"percent of total billed charges","78% of total billed charges",13.73,101,,,,,0,"fee schedule","101% of CMS fee schedule ",107.38,82.6,,85.90,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,13.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.38,82.6,,85.90,,,0,"percent of total billed charges","82.6% of total billed charges",13.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,130,
"Pathology Billing Gyn Cyto Image Guided Thin Prep",30183970,CDM,301,RC,83970,CPT,OUTPATIENT,,,241,156.65,,212.08,88,,169.66,,,0,"percent of total billed charges","88% of total billed charges",41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",72.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",30.04,100,,,,,0,"fee schedule",EAPG,41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.83,63,,121.46,,,0,"percent of total billed charges","63% of total billed charges",36.87,15.3,,29.50,,,0,"percent of total billed charges","15.3% of total billed charges",29.16,100,,,,,0,"fee schedule",EAPG,166.29,69,,,,,0,"fee schedule","69% of total billed charges",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",157.89,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.28,100,,,,,0,"fee schedule","100% of LI fee schedule",21.6,100,,,,,0,"fee schedule",EAPG,41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.74,100,,,,,0,"fee schedule",EAPG,37.91,100,,,,,0,"fee schedule",EAPG,41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.86,37.7,,72.69,,,0,"percent of total billed charges","37.7% of total billed charges",90.86,37.7,,72.69,,,0,"percent of total billed charges","37.70% of total billed charges",41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.7,33.9,,65.36,,,0,"percent of total billed charges","33.9% of total billed charges",41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",187.98,78,,150.38,,,0,"percent of total billed charges","78% of total billed charges",41.69,101,,,,,0,"fee schedule","101% of CMS fee schedule ",199.07,82.6,,159.26,,,0,"percent of total billed charges","82.6% of total billed charges",29.16,100,,,,,0,"fee schedule",EAPG,41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",199.07,82.6,,159.26,,,0,"percent of total billed charges","82.6% of total billed charges",41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",21.6,241,
"Pathology Billing Gyn Cyto Image Guided Thin Prep",30184080,CDM,301,RC,84080,CPT,OUTPATIENT,,,274,178.1,,241.12,88,,192.90,,,0,"percent of total billed charges","88% of total billed charges",14.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,274,100,,219.20,,,0,"percent of total billed charges","100% of total billed charges",25.86,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,14.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",172.62,63,,138.10,,,0,"percent of total billed charges","63% of total billed charges",41.92,15.3,,33.54,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,189.06,69,,,,,0,"fee schedule","69% of total billed charges",274,100,,219.20,,,0,"percent of total billed charges","100% of total billed charges",14.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",274,100,,219.20,,,0,"percent of total billed charges","100% of total billed charges",14.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",274,100,,219.20,,,0,"percent of total billed charges","100% of total billed charges",14.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.53,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,14.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.78,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,14.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,14.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",103.3,37.7,,82.64,,,0,"percent of total billed charges","37.7% of total billed charges",103.3,37.7,,82.64,,,0,"percent of total billed charges","37.70% of total billed charges",14.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.89,33.9,,74.31,,,0,"percent of total billed charges","33.9% of total billed charges",14.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",213.72,78,,170.98,,,0,"percent of total billed charges","78% of total billed charges",14.92,101,,,,,0,"fee schedule","101% of CMS fee schedule ",226.32,82.6,,181.06,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,14.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.32,82.6,,181.06,,,0,"percent of total billed charges","82.6% of total billed charges",14.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,274,100,,219.20,,,0,"percent of total billed charges","100% of total billed charges",8.11,274,
"Pathology Billing Gyn Cytology Thin Prep",30184156,CDM,301,RC,84156,CPT,OUTPATIENT,,,418,271.7,,367.84,88,,294.27,,,0,"percent of total billed charges","88% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",6.42,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",263.34,63,,210.67,,,0,"percent of total billed charges","63% of total billed charges",63.95,15.3,,51.16,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,288.42,69,,,,,0,"fee schedule","69% of total billed charges",418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.03,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.67,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",157.59,37.7,,126.07,,,0,"percent of total billed charges","37.7% of total billed charges",157.59,37.7,,126.07,,,0,"percent of total billed charges","37.70% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",141.7,33.9,,113.36,,,0,"percent of total billed charges","33.9% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",326.04,78,,260.83,,,0,"percent of total billed charges","78% of total billed charges",3.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",345.27,82.6,,276.22,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",345.27,82.6,,276.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,418,
"Pathology Billing Gyn Cytology without Pathologist Interpretation",30184155,CDM,301,RC,84155,CPT,OUTPATIENT,,,98,63.7,,86.24,88,,68.99,,,0,"percent of total billed charges","88% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",6.42,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.74,63,,49.39,,,0,"percent of total billed charges","63% of total billed charges",14.99,15.3,,11.99,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,67.62,69,,,,,0,"fee schedule","69% of total billed charges",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.03,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.67,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.95,37.7,,29.56,,,0,"percent of total billed charges","37.7% of total billed charges",36.95,37.7,,29.56,,,0,"percent of total billed charges","37.70% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.22,33.9,,26.58,,,0,"percent of total billed charges","33.9% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.44,78,,61.15,,,0,"percent of total billed charges","78% of total billed charges",3.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",80.95,82.6,,64.76,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.95,82.6,,64.76,,,0,"percent of total billed charges","82.6% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,98,
"Pathology Billing Gyn Cytology without Pathologist Interpretation",30184154,CDM,301,RC,84154,CPT,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",32.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.39,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.7% of total billed charges",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.55,33.9,,42.04,,,0,"percent of total billed charges","33.9% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",18.57,101,,,,,0,"fee schedule","101% of CMS fee schedule ",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",8.11,155,
"Rapid Plasma Reagin Titer",30184155,CDM,301,RC,84155,CPT,OUTPATIENT,,,98,63.7,,86.24,88,,68.99,,,0,"percent of total billed charges","88% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",6.42,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.74,63,,49.39,,,0,"percent of total billed charges","63% of total billed charges",14.99,15.3,,11.99,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,67.62,69,,,,,0,"fee schedule","69% of total billed charges",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.03,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.67,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.95,37.7,,29.56,,,0,"percent of total billed charges","37.7% of total billed charges",36.95,37.7,,29.56,,,0,"percent of total billed charges","37.70% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.22,33.9,,26.58,,,0,"percent of total billed charges","33.9% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.44,78,,61.15,,,0,"percent of total billed charges","78% of total billed charges",3.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",80.95,82.6,,64.76,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.95,82.6,,64.76,,,0,"percent of total billed charges","82.6% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,98,
"ELECTROPHORESIS URINE QUANT 24",30184166,CDM,301,RC,84166,CPT,OUTPATIENT,,,594,386.1,,522.72,88,,418.18,,,0,"percent of total billed charges","88% of total billed charges",17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,594,100,,475.20,,,0,"percent of total billed charges","100% of total billed charges",31.2,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",374.22,63,,299.38,,,0,"percent of total billed charges","63% of total billed charges",90.88,15.3,,72.70,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,409.86,69,,,,,0,"fee schedule","69% of total billed charges",594,100,,475.20,,,0,"percent of total billed charges","100% of total billed charges",17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",594,100,,475.20,,,0,"percent of total billed charges","100% of total billed charges",17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",594,100,,475.20,,,0,"percent of total billed charges","100% of total billed charges",17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.19,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.82,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",223.94,37.7,,179.15,,,0,"percent of total billed charges","37.7% of total billed charges",223.94,37.7,,179.15,,,0,"percent of total billed charges","37.70% of total billed charges",17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",201.37,33.9,,161.10,,,0,"percent of total billed charges","33.9% of total billed charges",17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",463.32,78,,370.66,,,0,"percent of total billed charges","78% of total billed charges",18,101,,,,,0,"fee schedule","101% of CMS fee schedule ",490.64,82.6,,392.51,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",490.64,82.6,,392.51,,,0,"percent of total billed charges","82.6% of total billed charges",17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,594,100,,475.20,,,0,"percent of total billed charges","100% of total billed charges",8.11,594,
"ELECTROPHORESIS URINE QUANT 24",30184166,CDM,301,RC,84166,CPT,OUTPATIENT,,,565,367.25,,497.2,88,,397.76,,,0,"percent of total billed charges","88% of total billed charges",17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,565,100,,452.00,,,0,"percent of total billed charges","100% of total billed charges",31.2,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",355.95,63,,284.76,,,0,"percent of total billed charges","63% of total billed charges",86.45,15.3,,69.16,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,389.85,69,,,,,0,"fee schedule","69% of total billed charges",565,100,,452.00,,,0,"percent of total billed charges","100% of total billed charges",17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",565,100,,452.00,,,0,"percent of total billed charges","100% of total billed charges",17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",565,100,,452.00,,,0,"percent of total billed charges","100% of total billed charges",17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.19,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.82,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",213.01,37.7,,170.41,,,0,"percent of total billed charges","37.7% of total billed charges",213.01,37.7,,170.41,,,0,"percent of total billed charges","37.70% of total billed charges",17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",191.54,33.9,,153.23,,,0,"percent of total billed charges","33.9% of total billed charges",17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",440.7,78,,352.56,,,0,"percent of total billed charges","78% of total billed charges",18,101,,,,,0,"fee schedule","101% of CMS fee schedule ",466.69,82.6,,373.35,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",466.69,82.6,,373.35,,,0,"percent of total billed charges","82.6% of total billed charges",17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,565,100,,452.00,,,0,"percent of total billed charges","100% of total billed charges",8.11,565,
"PROTEIN PHORESIS SERUM",30184165,CDM,301,RC,84165,CPT,OUTPATIENT,,,479,311.35,,421.52,88,,337.22,,,0,"percent of total billed charges","88% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,479,100,,383.20,,,0,"percent of total billed charges","100% of total billed charges",18.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",301.77,63,,241.42,,,0,"percent of total billed charges","63% of total billed charges",73.29,15.3,,58.63,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,330.51,69,,,,,0,"fee schedule","69% of total billed charges",479,100,,383.20,,,0,"percent of total billed charges","100% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",479,100,,383.20,,,0,"percent of total billed charges","100% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",479,100,,383.20,,,0,"percent of total billed charges","100% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.08,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.74,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",180.58,37.7,,144.46,,,0,"percent of total billed charges","37.7% of total billed charges",180.58,37.7,,144.46,,,0,"percent of total billed charges","37.70% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.38,33.9,,129.90,,,0,"percent of total billed charges","33.9% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",373.62,78,,298.90,,,0,"percent of total billed charges","78% of total billed charges",10.84,101,,,,,0,"fee schedule","101% of CMS fee schedule ",395.65,82.6,,316.52,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",395.65,82.6,,316.52,,,0,"percent of total billed charges","82.6% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,479,100,,383.20,,,0,"percent of total billed charges","100% of total billed charges",3.25,479,
"Protein Electro, Random Ur LC",30184166,CDM,301,RC,84166,CPT,OUTPATIENT,,,683,443.95,,601.04,88,,480.83,,,0,"percent of total billed charges","88% of total billed charges",17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,683,100,,546.40,,,0,"percent of total billed charges","100% of total billed charges",31.2,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",430.29,63,,344.23,,,0,"percent of total billed charges","63% of total billed charges",104.5,15.3,,83.60,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,471.27,69,,,,,0,"fee schedule","69% of total billed charges",683,100,,546.40,,,0,"percent of total billed charges","100% of total billed charges",17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",683,100,,546.40,,,0,"percent of total billed charges","100% of total billed charges",17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",683,100,,546.40,,,0,"percent of total billed charges","100% of total billed charges",17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.19,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.82,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",257.49,37.7,,205.99,,,0,"percent of total billed charges","37.7% of total billed charges",257.49,37.7,,205.99,,,0,"percent of total billed charges","37.70% of total billed charges",17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",231.54,33.9,,185.23,,,0,"percent of total billed charges","33.9% of total billed charges",17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",532.74,78,,426.19,,,0,"percent of total billed charges","78% of total billed charges",18,101,,,,,0,"fee schedule","101% of CMS fee schedule ",564.16,82.6,,451.33,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",564.16,82.6,,451.33,,,0,"percent of total billed charges","82.6% of total billed charges",17.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,683,100,,546.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,683,
"Protein, Electrophoresis Frac Qaunt LC",30184165,CDM,301,RC,84165,CPT,OUTPATIENT,,,563,365.95,,495.44,88,,396.35,,,0,"percent of total billed charges","88% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,563,100,,450.40,,,0,"percent of total billed charges","100% of total billed charges",18.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",354.69,63,,283.75,,,0,"percent of total billed charges","63% of total billed charges",86.14,15.3,,68.91,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,388.47,69,,,,,0,"fee schedule","69% of total billed charges",563,100,,450.40,,,0,"percent of total billed charges","100% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",563,100,,450.40,,,0,"percent of total billed charges","100% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",563,100,,450.40,,,0,"percent of total billed charges","100% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.08,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.74,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",212.25,37.7,,169.80,,,0,"percent of total billed charges","37.7% of total billed charges",212.25,37.7,,169.80,,,0,"percent of total billed charges","37.70% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",190.86,33.9,,152.69,,,0,"percent of total billed charges","33.9% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",439.14,78,,351.31,,,0,"percent of total billed charges","78% of total billed charges",10.84,101,,,,,0,"fee schedule","101% of CMS fee schedule ",465.04,82.6,,372.03,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",465.04,82.6,,372.03,,,0,"percent of total billed charges","82.6% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,563,100,,450.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,563,
"Testosterone Total LC",30184403,CDM,301,RC,84403,CPT,OUTPATIENT,,,504,327.6,,443.52,88,,354.82,,,0,"percent of total billed charges","88% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,504,100,,403.20,,,0,"percent of total billed charges","100% of total billed charges",45.16,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",317.52,63,,254.02,,,0,"percent of total billed charges","63% of total billed charges",77.11,15.3,,61.69,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,347.76,69,,,,,0,"fee schedule","69% of total billed charges",504,100,,403.20,,,0,"percent of total billed charges","100% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",504,100,,403.20,,,0,"percent of total billed charges","100% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",504,100,,403.20,,,0,"percent of total billed charges","100% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.72,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.81,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",190.01,37.7,,152.01,,,0,"percent of total billed charges","37.7% of total billed charges",190.01,37.7,,152.01,,,0,"percent of total billed charges","37.70% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.86,33.9,,136.69,,,0,"percent of total billed charges","33.9% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",393.12,78,,314.50,,,0,"percent of total billed charges","78% of total billed charges",26.06,101,,,,,0,"fee schedule","101% of CMS fee schedule ",416.3,82.6,,333.04,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",416.3,82.6,,333.04,,,0,"percent of total billed charges","82.6% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,504,100,,403.20,,,0,"percent of total billed charges","100% of total billed charges",8.39,504,
"Testosterone Total LC",30184403,CDM,301,RC,84403,CPT,OUTPATIENT,,,481,312.65,,423.28,88,,338.62,,,0,"percent of total billed charges","88% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,481,100,,384.80,,,0,"percent of total billed charges","100% of total billed charges",45.16,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",303.03,63,,242.42,,,0,"percent of total billed charges","63% of total billed charges",73.59,15.3,,58.87,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,331.89,69,,,,,0,"fee schedule","69% of total billed charges",481,100,,384.80,,,0,"percent of total billed charges","100% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",481,100,,384.80,,,0,"percent of total billed charges","100% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",481,100,,384.80,,,0,"percent of total billed charges","100% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.72,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.81,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",181.34,37.7,,145.07,,,0,"percent of total billed charges","37.7% of total billed charges",181.34,37.7,,145.07,,,0,"percent of total billed charges","37.70% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.06,33.9,,130.45,,,0,"percent of total billed charges","33.9% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",375.18,78,,300.14,,,0,"percent of total billed charges","78% of total billed charges",26.06,101,,,,,0,"fee schedule","101% of CMS fee schedule ",397.31,82.6,,317.85,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",397.31,82.6,,317.85,,,0,"percent of total billed charges","82.6% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,481,100,,384.80,,,0,"percent of total billed charges","100% of total billed charges",8.39,481,
"TestT+SHBG+TestFW LC",30184410,CDM,301,RC,84410,CPT,OUTPATIENT,,,106,68.9,,93.28,88,,74.62,,,0,"percent of total billed charges","88% of total billed charges",51.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",89.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",30.04,100,,,,,0,"fee schedule",EAPG,51.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.78,63,,53.42,,,0,"percent of total billed charges","63% of total billed charges",16.22,15.3,,12.98,,,0,"percent of total billed charges","15.3% of total billed charges",29.16,100,,,,,0,"fee schedule",EAPG,73.14,69,,,,,0,"fee schedule","69% of total billed charges",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",51.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",51.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",51.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",196.14,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,51.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.28,100,,,,,0,"fee schedule","100% of LI fee schedule",21.6,100,,,,,0,"fee schedule",EAPG,51.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.74,100,,,,,0,"fee schedule",EAPG,37.91,100,,,,,0,"fee schedule",EAPG,51.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.96,37.7,,31.97,,,0,"percent of total billed charges","37.7% of total billed charges",39.96,37.7,,31.97,,,0,"percent of total billed charges","37.70% of total billed charges",51.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.93,33.9,,28.74,,,0,"percent of total billed charges","33.9% of total billed charges",51.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.68,78,,66.14,,,0,"percent of total billed charges","78% of total billed charges",51.79,101,,,,,0,"fee schedule","101% of CMS fee schedule ",87.56,82.6,,70.05,,,0,"percent of total billed charges","82.6% of total billed charges",29.16,100,,,,,0,"fee schedule",EAPG,51.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.56,82.6,,70.05,,,0,"percent of total billed charges","82.6% of total billed charges",51.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",16.22,196.14,
"84439 Thyroxine, free (FT4) LC",30184439,CDM,301,RC,84439,CPT,OUTPATIENT,,,39,25.35,,34.32,88,,27.46,,,0,"percent of total billed charges","88% of total billed charges",9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",15.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.57,63,,19.66,,,0,"percent of total billed charges","63% of total billed charges",5.97,15.3,,4.78,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,26.91,69,,,,,0,"fee schedule","69% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.5,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.02,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.7% of total billed charges",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.70% of total billed charges",9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.22,33.9,,10.58,,,0,"percent of total billed charges","33.9% of total billed charges",9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.42,78,,24.34,,,0,"percent of total billed charges","78% of total billed charges",9.11,101,,,,,0,"fee schedule","101% of CMS fee schedule ",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",5.97,39,
"SGPT OR ALT",30184460,CDM,301,RC,84460,CPT,OUTPATIENT,,,117,76.05,,102.96,88,,82.37,,,0,"percent of total billed charges","88% of total billed charges",5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",9.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.71,63,,58.97,,,0,"percent of total billed charges","63% of total billed charges",17.9,15.3,,14.32,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,80.73,69,,,,,0,"fee schedule","69% of total billed charges",117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.27,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.3,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.11,37.7,,35.29,,,0,"percent of total billed charges","37.7% of total billed charges",44.11,37.7,,35.29,,,0,"percent of total billed charges","37.70% of total billed charges",5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.66,33.9,,31.73,,,0,"percent of total billed charges","33.9% of total billed charges",5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.26,78,,73.01,,,0,"percent of total billed charges","78% of total billed charges",5.35,101,,,,,0,"fee schedule","101% of CMS fee schedule ",96.64,82.6,,77.31,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",96.64,82.6,,77.31,,,0,"percent of total billed charges","82.6% of total billed charges",5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,117,
"SGPT OR ALT",30184460,CDM,301,RC,84460,CPT,OUTPATIENT,,,117,76.05,,102.96,88,,82.37,,,0,"percent of total billed charges","88% of total billed charges",5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",9.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.71,63,,58.97,,,0,"percent of total billed charges","63% of total billed charges",17.9,15.3,,14.32,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,80.73,69,,,,,0,"fee schedule","69% of total billed charges",117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.27,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.3,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.11,37.7,,35.29,,,0,"percent of total billed charges","37.7% of total billed charges",44.11,37.7,,35.29,,,0,"percent of total billed charges","37.70% of total billed charges",5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.66,33.9,,31.73,,,0,"percent of total billed charges","33.9% of total billed charges",5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.26,78,,73.01,,,0,"percent of total billed charges","78% of total billed charges",5.35,101,,,,,0,"fee schedule","101% of CMS fee schedule ",96.64,82.6,,77.31,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",96.64,82.6,,77.31,,,0,"percent of total billed charges","82.6% of total billed charges",5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,117,
"TRIGLYCERIDES BODY FLUID",30184478,CDM,301,RC,84478,CPT,OUTPATIENT,,,100,65,,88,88,,70.40,,,0,"percent of total billed charges","88% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",10.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",63,63,,50.40,,,0,"percent of total billed charges","63% of total billed charges",15.3,15.3,,12.24,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,69,69,,,,,0,"fee schedule","69% of total billed charges",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.95,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.74,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.7% of total billed charges",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.70% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.9,33.9,,27.12,,,0,"percent of total billed charges","33.9% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,78,,62.40,,,0,"percent of total billed charges","78% of total billed charges",5.79,101,,,,,0,"fee schedule","101% of CMS fee schedule ",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",3.25,100,
"Uric Acid A+ANA LC",30184550,CDM,301,RC,84550,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",7.9,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.28,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.51,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",4.56,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",3.25,95,
"BETA HCG QUANT SERUM",30184702,CDM,301,RC,84702,CPT,OUTPATIENT,,,431,280.15,,379.28,88,,303.42,,,0,"percent of total billed charges","88% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,431,100,,344.80,,,0,"percent of total billed charges","100% of total billed charges",26.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",271.53,63,,217.22,,,0,"percent of total billed charges","63% of total billed charges",65.94,15.3,,52.75,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,297.39,69,,,,,0,"fee schedule","69% of total billed charges",431,100,,344.80,,,0,"percent of total billed charges","100% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",431,100,,344.80,,,0,"percent of total billed charges","100% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",431,100,,344.80,,,0,"percent of total billed charges","100% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.56,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.05,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.49,37.7,,129.99,,,0,"percent of total billed charges","37.7% of total billed charges",162.49,37.7,,129.99,,,0,"percent of total billed charges","37.70% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",146.11,33.9,,116.89,,,0,"percent of total billed charges","33.9% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",336.18,78,,268.94,,,0,"percent of total billed charges","78% of total billed charges",15.2,101,,,,,0,"fee schedule","101% of CMS fee schedule ",356.01,82.6,,284.81,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",356.01,82.6,,284.81,,,0,"percent of total billed charges","82.6% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,431,100,,344.80,,,0,"percent of total billed charges","100% of total billed charges",8.39,431,
"BETA HCG QUANT SERUM",30184702,CDM,301,RC,84702,CPT,OUTPATIENT,,,454,295.1,,399.52,88,,319.62,,,0,"percent of total billed charges","88% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",26.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",286.02,63,,228.82,,,0,"percent of total billed charges","63% of total billed charges",69.46,15.3,,55.57,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,313.26,69,,,,,0,"fee schedule","69% of total billed charges",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.56,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.05,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",171.16,37.7,,136.93,,,0,"percent of total billed charges","37.7% of total billed charges",171.16,37.7,,136.93,,,0,"percent of total billed charges","37.70% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",153.91,33.9,,123.13,,,0,"percent of total billed charges","33.9% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",354.12,78,,283.30,,,0,"percent of total billed charges","78% of total billed charges",15.2,101,,,,,0,"fee schedule","101% of CMS fee schedule ",375,82.6,,300.00,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",375,82.6,,300.00,,,0,"percent of total billed charges","82.6% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",8.39,454,
Hemoglobin,30585018,CDM,305,RC,85018,CPT,OUTPATIENT,,,58,37.7,,51.04,88,,40.83,,,0,"percent of total billed charges","88% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",4.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.23,100,,,,,0,"fee schedule",EAPG,2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.54,63,,29.23,,,0,"percent of total billed charges","63% of total billed charges",8.87,15.3,,7.10,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,40.02,69,,,,,0,"fee schedule","69% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.06,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.37,100,,,,,0,"fee schedule","100% of LI fee schedule",3.76,100,,,,,0,"fee schedule",EAPG,2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.87,37.7,,17.50,,,0,"percent of total billed charges","37.7% of total billed charges",21.87,37.7,,17.50,,,0,"percent of total billed charges","37.70% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.66,33.9,,15.73,,,0,"percent of total billed charges","33.9% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.24,78,,36.19,,,0,"percent of total billed charges","78% of total billed charges",2.39,101,,,,,0,"fee schedule","101% of CMS fee schedule ",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",2.37,58,
"iSTAT Blood count; hematocrit (Hct)",30585014,CDM,305,RC,85014,CPT,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",4.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.23,100,,,,,0,"fee schedule",EAPG,2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.06,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.37,100,,,,,0,"fee schedule","100% of LI fee schedule",3.76,100,,,,,0,"fee schedule",EAPG,2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.7% of total billed charges",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.03,33.9,,1.62,,,0,"percent of total billed charges","33.9% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",2.39,101,,,,,0,"fee schedule","101% of CMS fee schedule ",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,9.06,
"Blood count; complete (CBC) LC",30585027,CDM,305,RC,85027,CPT,OUTPATIENT,,,182,118.3,,160.16,88,,128.13,,,0,"percent of total billed charges","88% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",11.32,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.23,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",114.66,63,,91.73,,,0,"percent of total billed charges","63% of total billed charges",27.85,15.3,,22.28,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,125.58,69,,,,,0,"fee schedule","69% of total billed charges",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.74,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.47,100,,,,,0,"fee schedule","100% of LI fee schedule",3.76,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.61,37.7,,54.89,,,0,"percent of total billed charges","37.7% of total billed charges",68.61,37.7,,54.89,,,0,"percent of total billed charges","37.70% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.7,33.9,,49.36,,,0,"percent of total billed charges","33.9% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",141.96,78,,113.57,,,0,"percent of total billed charges","78% of total billed charges",6.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",150.33,82.6,,120.26,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.33,82.6,,120.26,,,0,"percent of total billed charges","82.6% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",3.76,182,
"CBC LC",30585025,CDM,305,RC,85025,CPT,OUTPATIENT,,,198,128.7,,174.24,88,,139.39,,,0,"percent of total billed charges","88% of total billed charges",7.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",13.59,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.23,100,,,,,0,"fee schedule",EAPG,7.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.74,63,,99.79,,,0,"percent of total billed charges","63% of total billed charges",30.29,15.3,,24.23,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,136.62,69,,,,,0,"fee schedule","69% of total billed charges",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",7.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",7.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",7.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.72,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,7.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.77,100,,,,,0,"fee schedule","100% of LI fee schedule",3.76,100,,,,,0,"fee schedule",EAPG,7.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,7.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.65,37.7,,59.72,,,0,"percent of total billed charges","37.7% of total billed charges",74.65,37.7,,59.72,,,0,"percent of total billed charges","37.70% of total billed charges",7.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.12,33.9,,53.70,,,0,"percent of total billed charges","33.9% of total billed charges",7.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",154.44,78,,123.55,,,0,"percent of total billed charges","78% of total billed charges",7.84,101,,,,,0,"fee schedule","101% of CMS fee schedule ",163.55,82.6,,130.84,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,7.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.55,82.6,,130.84,,,0,"percent of total billed charges","82.6% of total billed charges",7.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",3.76,198,
"RBC COUNT ONLY",30585041,CDM,305,RC,85041,CPT,OUTPATIENT,,,56,36.4,,49.28,88,,39.42,,,0,"percent of total billed charges","88% of total billed charges",3.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",5.28,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.23,100,,,,,0,"fee schedule",EAPG,3.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.28,63,,28.22,,,0,"percent of total billed charges","63% of total billed charges",8.57,15.3,,6.86,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,38.64,69,,,,,0,"fee schedule","69% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",3.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",3.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",3.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.55,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,3.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.02,100,,,,,0,"fee schedule","100% of LI fee schedule",3.76,100,,,,,0,"fee schedule",EAPG,3.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,3.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.11,37.7,,16.89,,,0,"percent of total billed charges","37.7% of total billed charges",21.11,37.7,,16.89,,,0,"percent of total billed charges","37.70% of total billed charges",3.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.98,33.9,,15.18,,,0,"percent of total billed charges","33.9% of total billed charges",3.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.68,78,,34.94,,,0,"percent of total billed charges","78% of total billed charges",3.05,101,,,,,0,"fee schedule","101% of CMS fee schedule ",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,3.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",3.02,56,
"Platelet Count LC",30585049,CDM,305,RC,85049,CPT,OUTPATIENT,,,28,18.2,,24.64,88,,19.71,,,0,"percent of total billed charges","88% of total billed charges",4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",7.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.23,100,,,,,0,"fee schedule",EAPG,4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.64,63,,14.11,,,0,"percent of total billed charges","63% of total billed charges",4.28,15.3,,3.42,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,19.32,69,,,,,0,"fee schedule","69% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.13,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule","100% of LI fee schedule",3.76,100,,,,,0,"fee schedule",EAPG,4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.56,37.7,,8.45,,,0,"percent of total billed charges","37.7% of total billed charges",10.56,37.7,,8.45,,,0,"percent of total billed charges","37.70% of total billed charges",4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.49,33.9,,7.59,,,0,"percent of total billed charges","33.9% of total billed charges",4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.84,78,,17.47,,,0,"percent of total billed charges","78% of total billed charges",4.52,101,,,,,0,"fee schedule","101% of CMS fee schedule ",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",3.76,28,
"FACTOR VIII ACTIVITY",30585240,CDM,305,RC,85240,CPT,OUTPATIENT,,,222,144.3,,195.36,88,,156.29,,,0,"percent of total billed charges","88% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,222,100,,177.60,,,0,"percent of total billed charges","100% of total billed charges",31.32,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",139.86,63,,111.89,,,0,"percent of total billed charges","63% of total billed charges",33.97,15.3,,27.18,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,153.18,69,,,,,0,"fee schedule","69% of total billed charges",222,100,,177.60,,,0,"percent of total billed charges","100% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",222,100,,177.60,,,0,"percent of total billed charges","100% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",222,100,,177.60,,,0,"percent of total billed charges","100% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.46,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.89,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",83.69,37.7,,66.95,,,0,"percent of total billed charges","37.7% of total billed charges",83.69,37.7,,66.95,,,0,"percent of total billed charges","37.70% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",75.26,33.9,,60.21,,,0,"percent of total billed charges","33.9% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",173.16,78,,138.53,,,0,"percent of total billed charges","78% of total billed charges",18.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",183.37,82.6,,146.70,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",183.37,82.6,,146.70,,,0,"percent of total billed charges","82.6% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,222,100,,177.60,,,0,"percent of total billed charges","100% of total billed charges",2.48,222,
"Factor VIII Activity LC",30585240,CDM,305,RC,85240,CPT,OUTPATIENT,,,262,170.3,,230.56,88,,184.45,,,0,"percent of total billed charges","88% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",31.32,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",165.06,63,,132.05,,,0,"percent of total billed charges","63% of total billed charges",40.09,15.3,,32.07,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,180.78,69,,,,,0,"fee schedule","69% of total billed charges",262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.46,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.89,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.77,37.7,,79.02,,,0,"percent of total billed charges","37.7% of total billed charges",98.77,37.7,,79.02,,,0,"percent of total billed charges","37.70% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.82,33.9,,71.06,,,0,"percent of total billed charges","33.9% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",204.36,78,,163.49,,,0,"percent of total billed charges","78% of total billed charges",18.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",216.41,82.6,,173.13,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",216.41,82.6,,173.13,,,0,"percent of total billed charges","82.6% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",2.48,262,
"Factor VIII Antigen LC",30585246,CDM,305,RC,85246,CPT,OUTPATIENT,,,549,356.85,,483.12,88,,386.50,,,0,"percent of total billed charges","88% of total billed charges",22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.29,100,,,,,0,"fee schedule",EAPG,549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",40.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.78,100,,,,,0,"fee schedule",EAPG,22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",345.87,63,,276.70,,,0,"percent of total billed charges","63% of total billed charges",84,15.3,,67.20,,,0,"percent of total billed charges","15.3% of total billed charges",16.29,100,,,,,0,"fee schedule",EAPG,378.81,69,,,,,0,"fee schedule","69% of total billed charges",549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.74,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",16.29,100,,,,,0,"fee schedule",EAPG,22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.94,100,,,,,0,"fee schedule","100% of LI fee schedule",12.07,100,,,,,0,"fee schedule",EAPG,22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.62,100,,,,,0,"fee schedule",EAPG,21.18,100,,,,,0,"fee schedule",EAPG,22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",206.97,37.7,,165.58,,,0,"percent of total billed charges","37.7% of total billed charges",206.97,37.7,,165.58,,,0,"percent of total billed charges","37.70% of total billed charges",22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",186.11,33.9,,148.89,,,0,"percent of total billed charges","33.9% of total billed charges",22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",428.22,78,,342.58,,,0,"percent of total billed charges","78% of total billed charges",23.16,101,,,,,0,"fee schedule","101% of CMS fee schedule ",453.47,82.6,,362.78,,,0,"percent of total billed charges","82.6% of total billed charges",16.29,100,,,,,0,"fee schedule",EAPG,22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",453.47,82.6,,362.78,,,0,"percent of total billed charges","82.6% of total billed charges",22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.29,100,,,,,0,"fee schedule",EAPG,549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",12.07,549,
"PROTEIN S TOTAL",30585305,CDM,305,RC,85305,CPT,OUTPATIENT,,,62,40.3,,54.56,88,,43.65,,,0,"percent of total billed charges","88% of total billed charges",11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",20.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.06,63,,31.25,,,0,"percent of total billed charges","63% of total billed charges",9.49,15.3,,7.59,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,42.78,69,,,,,0,"fee schedule","69% of total billed charges",62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.4,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.61,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.37,37.7,,18.70,,,0,"percent of total billed charges","37.7% of total billed charges",23.37,37.7,,18.70,,,0,"percent of total billed charges","37.70% of total billed charges",11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.02,33.9,,16.82,,,0,"percent of total billed charges","33.9% of total billed charges",11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.36,78,,38.69,,,0,"percent of total billed charges","78% of total billed charges",11.72,101,,,,,0,"fee schedule","101% of CMS fee schedule ",51.21,82.6,,40.97,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.21,82.6,,40.97,,,0,"percent of total billed charges","82.6% of total billed charges",11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",2.48,62,
"zHEXAGONAL PHASE PHOSPHOLIPID",30585598,CDM,305,RC,85598,CPT,OUTPATIENT,,,88,57.2,,77.44,88,,61.95,,,0,"percent of total billed charges","88% of total billed charges",17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",31.46,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.44,63,,44.35,,,0,"percent of total billed charges","63% of total billed charges",13.46,15.3,,10.77,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,60.72,69,,,,,0,"fee schedule","69% of total billed charges",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.77,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.98,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.18,37.7,,26.54,,,0,"percent of total billed charges","37.7% of total billed charges",33.18,37.7,,26.54,,,0,"percent of total billed charges","37.70% of total billed charges",17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.83,33.9,,23.86,,,0,"percent of total billed charges","33.9% of total billed charges",17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.64,78,,54.91,,,0,"percent of total billed charges","78% of total billed charges",18.15,101,,,,,0,"fee schedule","101% of CMS fee schedule ",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule","100% of WA fee schedule",17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",2.48,88,
"PT 1:NP LC 241426",30585611,CDM,305,RC,85611,CPT,OUTPATIENT,,,107,69.55,,94.16,88,,75.33,,,0,"percent of total billed charges","88% of total billed charges",3.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",6.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,3.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.41,63,,53.93,,,0,"percent of total billed charges","63% of total billed charges",16.37,15.3,,13.10,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,73.83,69,,,,,0,"fee schedule","69% of total billed charges",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",3.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",3.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",3.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.07,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,3.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.94,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,3.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,3.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.34,37.7,,32.27,,,0,"percent of total billed charges","37.7% of total billed charges",40.34,37.7,,32.27,,,0,"percent of total billed charges","37.70% of total billed charges",3.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.27,33.9,,29.02,,,0,"percent of total billed charges","33.9% of total billed charges",3.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",83.46,78,,66.77,,,0,"percent of total billed charges","78% of total billed charges",3.97,101,,,,,0,"fee schedule","101% of CMS fee schedule ",88.38,82.6,,70.70,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,3.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.38,82.6,,70.70,,,0,"percent of total billed charges","82.6% of total billed charges",3.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",2.48,107,
"PT LC 241426",30085610,CDM,300,RC,85610,CPT,OUTPATIENT,,,107,69.55,,94.16,88,,75.33,,,0,"percent of total billed charges","88% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",7.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.41,63,,53.93,,,0,"percent of total billed charges","63% of total billed charges",16.37,15.3,,13.10,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,73.83,69,,,,,0,"fee schedule","69% of total billed charges",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.4,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.29,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.34,37.7,,32.27,,,0,"percent of total billed charges","37.7% of total billed charges",40.34,37.7,,32.27,,,0,"percent of total billed charges","37.70% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.27,33.9,,29.02,,,0,"percent of total billed charges","33.9% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",83.46,78,,66.77,,,0,"percent of total billed charges","78% of total billed charges",4.33,101,,,,,0,"fee schedule","101% of CMS fee schedule ",88.38,82.6,,70.70,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.38,82.6,,70.70,,,0,"percent of total billed charges","82.6% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",2.48,107,
"DRVTT LC 241426",30585613,CDM,305,RC,85613,CPT,OUTPATIENT,,,287,186.55,,252.56,88,,202.05,,,0,"percent of total billed charges","88% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",16.76,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",180.81,63,,144.65,,,0,"percent of total billed charges","63% of total billed charges",43.91,15.3,,35.13,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,198.03,69,,,,,0,"fee schedule","69% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.64,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.7% of total billed charges",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.70% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.29,33.9,,77.83,,,0,"percent of total billed charges","33.9% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",223.86,78,,179.09,,,0,"percent of total billed charges","78% of total billed charges",9.67,101,,,,,0,"fee schedule","101% of CMS fee schedule ",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",2.48,287,
"PT, Prothrombin Time (LC #117079 APS)",AFC30585610,CDM,305,RC,85610,CPT,OUTPATIENT,,,30,19.5,,26.4,88,,21.12,,,0,"percent of total billed charges","88% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",7.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.9,63,,15.12,,,0,"percent of total billed charges","63% of total billed charges",4.59,15.3,,3.67,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,20.7,69,,,,,0,"fee schedule","69% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.4,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.29,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.31,37.7,,9.05,,,0,"percent of total billed charges","37.7% of total billed charges",11.31,37.7,,9.05,,,0,"percent of total billed charges","37.70% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.17,33.9,,8.14,,,0,"percent of total billed charges","33.9% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.4,78,,18.72,,,0,"percent of total billed charges","78% of total billed charges",4.33,101,,,,,0,"fee schedule","101% of CMS fee schedule ",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",2.48,30,
"dRVVT  (LC #117079 APS)",AFC30585613,CDM,305,RC,85613,CPT,OUTPATIENT,,,65,42.25,,57.2,88,,45.76,,,0,"percent of total billed charges","88% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",16.76,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.95,63,,32.76,,,0,"percent of total billed charges","63% of total billed charges",9.95,15.3,,7.96,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,44.85,69,,,,,0,"fee schedule","69% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.64,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.51,37.7,,19.61,,,0,"percent of total billed charges","37.7% of total billed charges",24.51,37.7,,19.61,,,0,"percent of total billed charges","37.70% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.04,33.9,,17.63,,,0,"percent of total billed charges","33.9% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.7,78,,40.56,,,0,"percent of total billed charges","78% of total billed charges",9.67,101,,,,,0,"fee schedule","101% of CMS fee schedule ",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",2.48,65,
"RBC SICKLE CELL TEST",30585660,CDM,305,RC,85660,CPT,OUTPATIENT,,,102,66.3,,89.76,88,,71.81,,,0,"percent of total billed charges","88% of total billed charges",5.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",9.64,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.23,100,,,,,0,"fee schedule",EAPG,5.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.26,63,,51.41,,,0,"percent of total billed charges","63% of total billed charges",15.61,15.3,,12.49,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,70.38,69,,,,,0,"fee schedule","69% of total billed charges",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",5.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",5.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",5.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.07,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,5.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.51,100,,,,,0,"fee schedule","100% of LI fee schedule",3.76,100,,,,,0,"fee schedule",EAPG,5.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,5.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.45,37.7,,30.76,,,0,"percent of total billed charges","37.7% of total billed charges",38.45,37.7,,30.76,,,0,"percent of total billed charges","37.70% of total billed charges",5.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.58,33.9,,27.66,,,0,"percent of total billed charges","33.9% of total billed charges",5.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.56,78,,63.65,,,0,"percent of total billed charges","78% of total billed charges",5.56,101,,,,,0,"fee schedule","101% of CMS fee schedule ",84.25,82.6,,67.40,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,5.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",84.25,82.6,,67.40,,,0,"percent of total billed charges","82.6% of total billed charges",5.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",3.76,102,
"zTHROMBIN TIME",30585670,CDM,305,RC,85670,CPT,OUTPATIENT,,,107,69.55,,94.16,88,,75.33,,,0,"percent of total billed charges","88% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",10.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.41,63,,53.93,,,0,"percent of total billed charges","63% of total billed charges",16.37,15.3,,13.10,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,73.83,69,,,,,0,"fee schedule","69% of total billed charges",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.07,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.77,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.34,37.7,,32.27,,,0,"percent of total billed charges","37.7% of total billed charges",40.34,37.7,,32.27,,,0,"percent of total billed charges","37.70% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.27,33.9,,29.02,,,0,"percent of total billed charges","33.9% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",83.46,78,,66.77,,,0,"percent of total billed charges","78% of total billed charges",5.82,101,,,,,0,"fee schedule","101% of CMS fee schedule ",88.38,82.6,,70.70,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.38,82.6,,70.70,,,0,"percent of total billed charges","82.6% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",2.48,107,
"Thrombin Time (LC #117079 APS)",AFC30585670,CDM,305,RC,85670,CPT,OUTPATIENT,,,39,25.35,,34.32,88,,27.46,,,0,"percent of total billed charges","88% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",10.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.57,63,,19.66,,,0,"percent of total billed charges","63% of total billed charges",5.97,15.3,,4.78,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,26.91,69,,,,,0,"fee schedule","69% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.07,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.77,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.7% of total billed charges",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.70% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.22,33.9,,10.58,,,0,"percent of total billed charges","33.9% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.42,78,,24.34,,,0,"percent of total billed charges","78% of total billed charges",5.82,101,,,,,0,"fee schedule","101% of CMS fee schedule ",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",2.48,39,
"PTT-LA LC 241426",30585732,CDM,305,RC,85732,CPT,OUTPATIENT,,,137,89.05,,120.56,88,,96.45,,,0,"percent of total billed charges","88% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,137,100,,109.60,,,0,"percent of total billed charges","100% of total billed charges",11.32,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",86.31,63,,69.05,,,0,"percent of total billed charges","63% of total billed charges",20.96,15.3,,16.77,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,94.53,69,,,,,0,"fee schedule","69% of total billed charges",137,100,,109.60,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",137,100,,109.60,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",137,100,,109.60,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.74,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.47,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.65,37.7,,41.32,,,0,"percent of total billed charges","37.7% of total billed charges",51.65,37.7,,41.32,,,0,"percent of total billed charges","37.70% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.44,33.9,,37.15,,,0,"percent of total billed charges","33.9% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.86,78,,85.49,,,0,"percent of total billed charges","78% of total billed charges",6.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",113.16,82.6,,90.53,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.16,82.6,,90.53,,,0,"percent of total billed charges","82.6% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,137,100,,109.60,,,0,"percent of total billed charges","100% of total billed charges",2.48,137,
"PTT  (LC #117079 APS)",AFC30585730,CDM,305,RC,85730,CPT,OUTPATIENT,,,41,26.65,,36.08,88,,28.86,,,0,"percent of total billed charges","88% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",10.51,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.83,63,,20.66,,,0,"percent of total billed charges","63% of total billed charges",6.27,15.3,,5.02,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,28.29,69,,,,,0,"fee schedule","69% of total billed charges",41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.98,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.01,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.46,37.7,,12.37,,,0,"percent of total billed charges","37.7% of total billed charges",15.46,37.7,,12.37,,,0,"percent of total billed charges","37.70% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.9,33.9,,11.12,,,0,"percent of total billed charges","33.9% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.98,78,,25.58,,,0,"percent of total billed charges","78% of total billed charges",6.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",33.87,82.6,,27.10,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.87,82.6,,27.10,,,0,"percent of total billed charges","82.6% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",2.48,41,
"CENTROMERE ANTIBODY",30286038,CDM,302,RC,86038,CPT,OUTPATIENT,,,58,37.7,,51.04,88,,40.83,,,0,"percent of total billed charges","88% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",21.15,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.54,63,,29.23,,,0,"percent of total billed charges","63% of total billed charges",8.87,15.3,,7.10,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,40.02,69,,,,,0,"fee schedule","69% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.24,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.09,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.87,37.7,,17.50,,,0,"percent of total billed charges","37.7% of total billed charges",21.87,37.7,,17.50,,,0,"percent of total billed charges","37.70% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.66,33.9,,15.73,,,0,"percent of total billed charges","33.9% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.24,78,,36.19,,,0,"percent of total billed charges","78% of total billed charges",12.21,101,,,,,0,"fee schedule","101% of CMS fee schedule ",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",6.96,58,
"CENTROMERE ANTIBODY",30286038,CDM,302,RC,86038,CPT,OUTPATIENT,,,58,37.7,,51.04,88,,40.83,,,0,"percent of total billed charges","88% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",21.15,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.54,63,,29.23,,,0,"percent of total billed charges","63% of total billed charges",8.87,15.3,,7.10,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,40.02,69,,,,,0,"fee schedule","69% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.24,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.09,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.87,37.7,,17.50,,,0,"percent of total billed charges","37.7% of total billed charges",21.87,37.7,,17.50,,,0,"percent of total billed charges","37.70% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.66,33.9,,15.73,,,0,"percent of total billed charges","33.9% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.24,78,,36.19,,,0,"percent of total billed charges","78% of total billed charges",12.21,101,,,,,0,"fee schedule","101% of CMS fee schedule ",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",6.96,58,
"ANCA Profile LC",30286037,CDM,302,RC,86037,CPT,OUTPATIENT,,,38,24.7,,33.44,88,,26.75,,,0,"percent of total billed charges","88% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",21.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.94,63,,19.15,,,0,"percent of total billed charges","63% of total billed charges",5.81,15.3,,4.65,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,26.22,69,,,,,0,"fee schedule","69% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",9.39,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.05,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.33,37.7,,11.46,,,0,"percent of total billed charges","37.7% of total billed charges",14.33,37.7,,11.46,,,0,"percent of total billed charges","37.70% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.88,33.9,,10.30,,,0,"percent of total billed charges","33.9% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.64,78,,23.71,,,0,"percent of total billed charges","78% of total billed charges",12.17,101,,,,,0,"fee schedule","101% of CMS fee schedule ",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",5.81,38,
"C-Reactive Protein, Quant LC",30286140,CDM,302,RC,86140,CPT,OUTPATIENT,,,38,24.7,,33.44,88,,26.75,,,0,"percent of total billed charges","88% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",9.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.94,63,,19.15,,,0,"percent of total billed charges","63% of total billed charges",5.81,15.3,,4.65,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,26.22,69,,,,,0,"fee schedule","69% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.81,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.33,37.7,,11.46,,,0,"percent of total billed charges","37.7% of total billed charges",14.33,37.7,,11.46,,,0,"percent of total billed charges","37.70% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.88,33.9,,10.30,,,0,"percent of total billed charges","33.9% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.64,78,,23.71,,,0,"percent of total billed charges","78% of total billed charges",5.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",5.18,38,
"Cardiolipin Ab  (LC #117079 APS)",AFC30286147,CDM,302,RC,86147,CPT,OUTPATIENT,,,172,111.8,,151.36,88,,121.09,,,0,"percent of total billed charges","88% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",44.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.36,63,,86.69,,,0,"percent of total billed charges","63% of total billed charges",26.32,15.3,,21.06,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,118.68,69,,,,,0,"fee schedule","69% of total billed charges",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.45,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.84,37.7,,51.87,,,0,"percent of total billed charges","37.7% of total billed charges",64.84,37.7,,51.87,,,0,"percent of total billed charges","37.70% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.31,33.9,,46.65,,,0,"percent of total billed charges","33.9% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.16,78,,107.33,,,0,"percent of total billed charges","78% of total billed charges",25.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",142.07,82.6,,113.66,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.07,82.6,,113.66,,,0,"percent of total billed charges","82.6% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",6.96,172,
"Beta 2 Glyco 1 Ab  (LC #117079 APS)",AFC30286146,CDM,302,RC,86146,CPT,OUTPATIENT,,,172,111.8,,151.36,88,,121.09,,,0,"percent of total billed charges","88% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",44.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.36,63,,86.69,,,0,"percent of total billed charges","63% of total billed charges",26.32,15.3,,21.06,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,118.68,69,,,,,0,"fee schedule","69% of total billed charges",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.45,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.84,37.7,,51.87,,,0,"percent of total billed charges","37.7% of total billed charges",64.84,37.7,,51.87,,,0,"percent of total billed charges","37.70% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.31,33.9,,46.65,,,0,"percent of total billed charges","33.9% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.16,78,,107.33,,,0,"percent of total billed charges","78% of total billed charges",25.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",142.07,82.6,,113.66,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.07,82.6,,113.66,,,0,"percent of total billed charges","82.6% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",6.96,172,
"CCP Antibodies IgG/IgA LC",30286200,CDM,302,RC,86200,CPT,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",22.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.53,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.95,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.7% of total billed charges",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.92,33.9,,27.94,,,0,"percent of total billed charges","33.9% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",13.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",6.96,103,
"CYCLIC CITRULL PEPTIDE AB IGG",30286200,CDM,302,RC,86200,CPT,OUTPATIENT,,,87,56.55,,76.56,88,,61.25,,,0,"percent of total billed charges","88% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",22.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.81,63,,43.85,,,0,"percent of total billed charges","63% of total billed charges",13.31,15.3,,10.65,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,60.03,69,,,,,0,"fee schedule","69% of total billed charges",87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.53,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.95,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.8,37.7,,26.24,,,0,"percent of total billed charges","37.7% of total billed charges",32.8,37.7,,26.24,,,0,"percent of total billed charges","37.70% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.49,33.9,,23.59,,,0,"percent of total billed charges","33.9% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.86,78,,54.29,,,0,"percent of total billed charges","78% of total billed charges",13.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",71.86,82.6,,57.49,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.86,82.6,,57.49,,,0,"percent of total billed charges","82.6% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",6.96,87,
"ANTI DNA DBL STRAND",30286225,CDM,302,RC,86225,CPT,OUTPATIENT,,,65,42.25,,57.2,88,,45.76,,,0,"percent of total billed charges","88% of total billed charges",13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",24.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.95,63,,32.76,,,0,"percent of total billed charges","63% of total billed charges",9.95,15.3,,7.96,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,44.85,69,,,,,0,"fee schedule","69% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.55,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.74,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.51,37.7,,19.61,,,0,"percent of total billed charges","37.7% of total billed charges",24.51,37.7,,19.61,,,0,"percent of total billed charges","37.70% of total billed charges",13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.04,33.9,,17.63,,,0,"percent of total billed charges","33.9% of total billed charges",13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.7,78,,40.56,,,0,"percent of total billed charges","78% of total billed charges",13.87,101,,,,,0,"fee schedule","101% of CMS fee schedule ",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,65,
"ANTI DNA DBL STRAND",30286225,CDM,302,RC,86225,CPT,OUTPATIENT,,,65,42.25,,57.2,88,,45.76,,,0,"percent of total billed charges","88% of total billed charges",13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",24.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.95,63,,32.76,,,0,"percent of total billed charges","63% of total billed charges",9.95,15.3,,7.96,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,44.85,69,,,,,0,"fee schedule","69% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.55,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.74,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.51,37.7,,19.61,,,0,"percent of total billed charges","37.7% of total billed charges",24.51,37.7,,19.61,,,0,"percent of total billed charges","37.70% of total billed charges",13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.04,33.9,,17.63,,,0,"percent of total billed charges","33.9% of total billed charges",13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.7,78,,40.56,,,0,"percent of total billed charges","78% of total billed charges",13.87,101,,,,,0,"fee schedule","101% of CMS fee schedule ",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,65,
"86235 .ANA Comprehensive Plus Profile LC",30286235,CDM,302,RC,86235,CPT,OUTPATIENT,,,100,65,91,88,88,,70.40,,,0,"percent of total billed charges","88% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",31.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",63,63,,50.40,,,0,"percent of total billed charges","63% of total billed charges",15.3,15.3,,12.24,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,69,69,,,,,0,"fee schedule","69% of total billed charges",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.58,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.93,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.7% of total billed charges",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.70% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.9,33.9,,27.12,,,0,"percent of total billed charges","33.9% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,78,,62.40,,,0,"percent of total billed charges","78% of total billed charges",18.1,101,,,,,0,"fee schedule","101% of CMS fee schedule ",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,100,
"86235 .ENA+DNA/DS+Antich+Centro+FA... LC",30286235,CDM,302,RC,86235,CPT,OUTPATIENT,,,100,65,91,88,88,,70.40,,,0,"percent of total billed charges","88% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",31.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",63,63,,50.40,,,0,"percent of total billed charges","63% of total billed charges",15.3,15.3,,12.24,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,69,69,,,,,0,"fee schedule","69% of total billed charges",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.58,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.93,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.7% of total billed charges",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.70% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.9,33.9,,27.12,,,0,"percent of total billed charges","33.9% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,78,,62.40,,,0,"percent of total billed charges","78% of total billed charges",18.1,101,,,,,0,"fee schedule","101% of CMS fee schedule ",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,100,
"Sjogren's Ab, SS-B LC",30286235,CDM,302,RC,86235,CPT,OUTPATIENT,,,100,65,91,88,88,,70.40,,,0,"percent of total billed charges","88% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",31.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",63,63,,50.40,,,0,"percent of total billed charges","63% of total billed charges",15.3,15.3,,12.24,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,69,69,,,,,0,"fee schedule","69% of total billed charges",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.58,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.93,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.7% of total billed charges",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.70% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.9,33.9,,27.12,,,0,"percent of total billed charges","33.9% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,78,,62.40,,,0,"percent of total billed charges","78% of total billed charges",18.1,101,,,,,0,"fee schedule","101% of CMS fee schedule ",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,100,
"ANNA TYPE 1",30286256,CDM,302,RC,86256,CPT,OUTPATIENT,,,57,37.05,,50.16,88,,40.13,,,0,"percent of total billed charges","88% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",21.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.91,63,,28.73,,,0,"percent of total billed charges","63% of total billed charges",8.72,15.3,,6.98,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,39.33,69,,,,,0,"fee schedule","69% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.09,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.05,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.49,37.7,,17.19,,,0,"percent of total billed charges","37.7% of total billed charges",21.49,37.7,,17.19,,,0,"percent of total billed charges","37.70% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.32,33.9,,15.46,,,0,"percent of total billed charges","33.9% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.46,78,,35.57,,,0,"percent of total billed charges","78% of total billed charges",12.17,101,,,,,0,"fee schedule","101% of CMS fee schedule ",47.08,82.6,,37.66,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.08,82.6,,37.66,,,0,"percent of total billed charges","82.6% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",6.96,57,
"BETA-2 TRANSFERRIN BODY FLUID",30286335,CDM,302,RC,86335,CPT,OUTPATIENT,,,192,124.8,,168.96,88,,135.17,,,0,"percent of total billed charges","88% of total billed charges",29.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.28,100,,,,,0,"fee schedule",EAPG,192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",51.36,175,,,,,0,"fee schedule","175% of CMS fee schedule",28.1,100,,,,,0,"fee schedule",EAPG,29.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",120.96,63,,96.77,,,0,"percent of total billed charges","63% of total billed charges",29.38,15.3,,23.50,,,0,"percent of total billed charges","15.3% of total billed charges",27.28,100,,,,,0,"fee schedule",EAPG,132.48,69,,,,,0,"fee schedule","69% of total billed charges",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",29.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",29.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",29.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",112.26,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",27.28,100,,,,,0,"fee schedule",EAPG,29.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.35,100,,,,,0,"fee schedule","100% of LI fee schedule",20.21,100,,,,,0,"fee schedule",EAPG,29.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.83,100,,,,,0,"fee schedule",EAPG,35.47,100,,,,,0,"fee schedule",EAPG,29.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.38,37.7,,57.90,,,0,"percent of total billed charges","37.7% of total billed charges",72.38,37.7,,57.90,,,0,"percent of total billed charges","37.70% of total billed charges",29.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.09,33.9,,52.07,,,0,"percent of total billed charges","33.9% of total billed charges",29.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",149.76,78,,119.81,,,0,"percent of total billed charges","78% of total billed charges",29.64,101,,,,,0,"fee schedule","101% of CMS fee schedule ",158.59,82.6,,126.87,,,0,"percent of total billed charges","82.6% of total billed charges",27.28,100,,,,,0,"fee schedule",EAPG,29.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",158.59,82.6,,126.87,,,0,"percent of total billed charges","82.6% of total billed charges",29.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.28,100,,,,,0,"fee schedule",EAPG,192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",20.21,192,
"HYPERSENSITIVITY PNEUMONITIS",30286331,CDM,302,RC,86331,CPT,OUTPATIENT,,,62,40.3,,54.56,88,,43.65,,,0,"percent of total billed charges","88% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",20.96,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.06,63,,31.25,,,0,"percent of total billed charges","63% of total billed charges",9.49,15.3,,7.59,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,42.78,69,,,,,0,"fee schedule","69% of total billed charges",62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.82,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.98,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.37,37.7,,18.70,,,0,"percent of total billed charges","37.7% of total billed charges",23.37,37.7,,18.70,,,0,"percent of total billed charges","37.70% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.02,33.9,,16.82,,,0,"percent of total billed charges","33.9% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.36,78,,38.69,,,0,"percent of total billed charges","78% of total billed charges",12.09,101,,,,,0,"fee schedule","101% of CMS fee schedule ",51.21,82.6,,40.97,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.21,82.6,,40.97,,,0,"percent of total billed charges","82.6% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",6.96,62,
"T Cell Total Count LC",30286359,CDM,302,RC,86359,CPT,OUTPATIENT,,,216,140.4,,190.08,88,,152.06,,,0,"percent of total billed charges","88% of total billed charges",37.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.28,100,,,,,0,"fee schedule",EAPG,216,100,,172.80,,,0,"percent of total billed charges","100% of total billed charges",66.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",28.1,100,,,,,0,"fee schedule",EAPG,37.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.08,63,,108.86,,,0,"percent of total billed charges","63% of total billed charges",33.05,15.3,,26.44,,,0,"percent of total billed charges","15.3% of total billed charges",27.28,100,,,,,0,"fee schedule",EAPG,149.04,69,,,,,0,"fee schedule","69% of total billed charges",216,100,,172.80,,,0,"percent of total billed charges","100% of total billed charges",37.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",216,100,,172.80,,,0,"percent of total billed charges","100% of total billed charges",37.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",216,100,,172.80,,,0,"percent of total billed charges","100% of total billed charges",37.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.31,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",27.28,100,,,,,0,"fee schedule",EAPG,37.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.72,100,,,,,0,"fee schedule","100% of LI fee schedule",20.21,100,,,,,0,"fee schedule",EAPG,37.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.83,100,,,,,0,"fee schedule",EAPG,35.47,100,,,,,0,"fee schedule",EAPG,37.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.43,37.7,,65.14,,,0,"percent of total billed charges","37.7% of total billed charges",81.43,37.7,,65.14,,,0,"percent of total billed charges","37.70% of total billed charges",37.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.22,33.9,,58.58,,,0,"percent of total billed charges","33.9% of total billed charges",37.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",168.48,78,,134.78,,,0,"percent of total billed charges","78% of total billed charges",38.1,101,,,,,0,"fee schedule","101% of CMS fee schedule ",178.42,82.6,,142.74,,,0,"percent of total billed charges","82.6% of total billed charges",27.28,100,,,,,0,"fee schedule",EAPG,37.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",178.42,82.6,,142.74,,,0,"percent of total billed charges","82.6% of total billed charges",37.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.28,100,,,,,0,"fee schedule",EAPG,216,100,,172.80,,,0,"percent of total billed charges","100% of total billed charges",20.21,216,
"Rheumatoid Factor (RA) LC",30286431,CDM,302,RC,86431,CPT,OUTPATIENT,,,38,24.7,,33.44,88,,26.75,,,0,"percent of total billed charges","88% of total billed charges",5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",9.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.94,63,,19.15,,,0,"percent of total billed charges","63% of total billed charges",5.81,15.3,,4.65,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,26.22,69,,,,,0,"fee schedule","69% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.68,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.67,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.33,37.7,,11.46,,,0,"percent of total billed charges","37.7% of total billed charges",14.33,37.7,,11.46,,,0,"percent of total billed charges","37.70% of total billed charges",5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.88,33.9,,10.30,,,0,"percent of total billed charges","33.9% of total billed charges",5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.64,78,,23.71,,,0,"percent of total billed charges","78% of total billed charges",5.72,101,,,,,0,"fee schedule","101% of CMS fee schedule ",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",5.67,38,
"RA Latex Turbid, LC",30286431,CDM,302,RC,86431,CPT,OUTPATIENT,,,38,24.7,,33.44,88,,26.75,,,0,"percent of total billed charges","88% of total billed charges",5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",9.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.94,63,,19.15,,,0,"percent of total billed charges","63% of total billed charges",5.81,15.3,,4.65,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,26.22,69,,,,,0,"fee schedule","69% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.68,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.67,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.33,37.7,,11.46,,,0,"percent of total billed charges","37.7% of total billed charges",14.33,37.7,,11.46,,,0,"percent of total billed charges","37.70% of total billed charges",5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.88,33.9,,10.30,,,0,"percent of total billed charges","33.9% of total billed charges",5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.64,78,,23.71,,,0,"percent of total billed charges","78% of total billed charges",5.72,101,,,,,0,"fee schedule","101% of CMS fee schedule ",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",5.67,38,
"RA TITER",30286431,CDM,302,RC,86431,CPT,OUTPATIENT,,,33,21.45,,29.04,88,,23.23,,,0,"percent of total billed charges","88% of total billed charges",5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",9.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.79,63,,16.63,,,0,"percent of total billed charges","63% of total billed charges",5.05,15.3,,4.04,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,22.77,69,,,,,0,"fee schedule","69% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.68,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.67,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.44,37.7,,9.95,,,0,"percent of total billed charges","37.7% of total billed charges",12.44,37.7,,9.95,,,0,"percent of total billed charges","37.70% of total billed charges",5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.19,33.9,,8.95,,,0,"percent of total billed charges","33.9% of total billed charges",5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.74,78,,20.59,,,0,"percent of total billed charges","78% of total billed charges",5.72,101,,,,,0,"fee schedule","101% of CMS fee schedule ",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",5.05,33,
"86602 Hypersensitivity Pneumonitis",30286602,CDM,302,RC,86602,CPT,OUTPATIENT,,,32,20.8,,28.16,88,,22.53,,,0,"percent of total billed charges","88% of total billed charges",10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",17.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.16,63,,16.13,,,0,"percent of total billed charges","63% of total billed charges",4.9,15.3,,3.92,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,22.08,69,,,,,0,"fee schedule","69% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.93,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.18,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.7% of total billed charges",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.70% of total billed charges",10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.85,33.9,,8.68,,,0,"percent of total billed charges","33.9% of total billed charges",10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.96,78,,19.97,,,0,"percent of total billed charges","78% of total billed charges",10.28,101,,,,,0,"fee schedule","101% of CMS fee schedule ",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",4.9,38.93,
"ANTIBODY BACTERIUM",30286609,CDM,302,RC,86609,CPT,OUTPATIENT,,,302,196.3,,265.76,88,,212.61,,,0,"percent of total billed charges","88% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",22.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",190.26,63,,152.21,,,0,"percent of total billed charges","63% of total billed charges",46.21,15.3,,36.97,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,208.38,69,,,,,0,"fee schedule","69% of total billed charges",302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.26,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.88,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.85,37.7,,91.08,,,0,"percent of total billed charges","37.7% of total billed charges",113.85,37.7,,91.08,,,0,"percent of total billed charges","37.70% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",102.38,33.9,,81.90,,,0,"percent of total billed charges","33.9% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",235.56,78,,188.45,,,0,"percent of total billed charges","78% of total billed charges",13,101,,,,,0,"fee schedule","101% of CMS fee schedule ",249.45,82.6,,199.56,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",249.45,82.6,,199.56,,,0,"percent of total billed charges","82.6% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",6.96,302,
"ANTIBODY ASPERGILLUS",30286606,CDM,302,RC,86606,CPT,OUTPATIENT,,,92,59.8,,80.96,88,,64.77,,,0,"percent of total billed charges","88% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,92,100,,73.60,,,0,"percent of total billed charges","100% of total billed charges",26.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.96,63,,46.37,,,0,"percent of total billed charges","63% of total billed charges",14.08,15.3,,11.26,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,63.48,69,,,,,0,"fee schedule","69% of total billed charges",92,100,,73.60,,,0,"percent of total billed charges","100% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",92,100,,73.60,,,0,"percent of total billed charges","100% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",92,100,,73.60,,,0,"percent of total billed charges","100% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.56,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.05,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.68,37.7,,27.74,,,0,"percent of total billed charges","37.7% of total billed charges",34.68,37.7,,27.74,,,0,"percent of total billed charges","37.70% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.19,33.9,,24.95,,,0,"percent of total billed charges","33.9% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.76,78,,57.41,,,0,"percent of total billed charges","78% of total billed charges",15.2,101,,,,,0,"fee schedule","101% of CMS fee schedule ",75.99,82.6,,60.79,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",75.99,82.6,,60.79,,,0,"percent of total billed charges","82.6% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,92,100,,73.60,,,0,"percent of total billed charges","100% of total billed charges",6.96,92,
"ANTIBODY CYTOMEGALOVIRUS IGM",30286645,CDM,302,RC,86645,CPT,OUTPATIENT,,,327,212.55,,287.76,88,,230.21,,,0,"percent of total billed charges","88% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",29.48,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",206.01,63,,164.81,,,0,"percent of total billed charges","63% of total billed charges",50.03,15.3,,40.02,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,225.63,69,,,,,0,"fee schedule","69% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.45,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.85,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.7% of total billed charges",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.70% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",110.85,33.9,,88.68,,,0,"percent of total billed charges","33.9% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",255.06,78,,204.05,,,0,"percent of total billed charges","78% of total billed charges",17.01,101,,,,,0,"fee schedule","101% of CMS fee schedule ",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",6.96,327,
"EPSTEIN BARR (EA)",30286663,CDM,302,RC,86663,CPT,OUTPATIENT,,,210,136.5,,184.8,88,,147.84,,,0,"percent of total billed charges","88% of total billed charges",13.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",22.96,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,13.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",132.3,63,,105.84,,,0,"percent of total billed charges","63% of total billed charges",32.13,15.3,,25.70,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,144.9,69,,,,,0,"fee schedule","69% of total billed charges",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",13.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",13.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",13.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.18,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,13.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.12,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,13.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,13.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.17,37.7,,63.34,,,0,"percent of total billed charges","37.7% of total billed charges",79.17,37.7,,63.34,,,0,"percent of total billed charges","37.70% of total billed charges",13.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.19,33.9,,56.95,,,0,"percent of total billed charges","33.9% of total billed charges",13.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.8,78,,131.04,,,0,"percent of total billed charges","78% of total billed charges",13.25,101,,,,,0,"fee schedule","101% of CMS fee schedule ",173.46,82.6,,138.77,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,13.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",173.46,82.6,,138.77,,,0,"percent of total billed charges","82.6% of total billed charges",13.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,210,
"EPSTEIN-BARR VIRAL CAP IGG",30286665,CDM,302,RC,86665,CPT,OUTPATIENT,,,162,105.3,,142.56,88,,114.05,,,0,"percent of total billed charges","88% of total billed charges",18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,162,100,,129.60,,,0,"percent of total billed charges","100% of total billed charges",31.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",102.06,63,,81.65,,,0,"percent of total billed charges","63% of total billed charges",24.79,15.3,,19.83,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,111.78,69,,,,,0,"fee schedule","69% of total billed charges",162,100,,129.60,,,0,"percent of total billed charges","100% of total billed charges",18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",162,100,,129.60,,,0,"percent of total billed charges","100% of total billed charges",18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",162,100,,129.60,,,0,"percent of total billed charges","100% of total billed charges",18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.38,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.14,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.07,37.7,,48.86,,,0,"percent of total billed charges","37.7% of total billed charges",61.07,37.7,,48.86,,,0,"percent of total billed charges","37.70% of total billed charges",18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.92,33.9,,43.94,,,0,"percent of total billed charges","33.9% of total billed charges",18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",126.36,78,,101.09,,,0,"percent of total billed charges","78% of total billed charges",18.32,101,,,,,0,"fee schedule","101% of CMS fee schedule ",133.81,82.6,,107.05,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",133.81,82.6,,107.05,,,0,"percent of total billed charges","82.6% of total billed charges",18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,162,100,,129.60,,,0,"percent of total billed charges","100% of total billed charges",6.96,162,
"HSV 1 IgG, Type Spec LC",30286695,CDM,302,RC,86695,CPT,OUTPATIENT,,,73,47.45,,64.24,88,,51.39,,,0,"percent of total billed charges","88% of total billed charges",13.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",23.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,13.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.99,63,,36.79,,,0,"percent of total billed charges","63% of total billed charges",11.17,15.3,,8.94,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,50.37,69,,,,,0,"fee schedule","69% of total billed charges",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",13.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",13.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",13.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.45,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,13.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.19,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,13.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,13.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.52,37.7,,22.02,,,0,"percent of total billed charges","37.7% of total billed charges",27.52,37.7,,22.02,,,0,"percent of total billed charges","37.70% of total billed charges",13.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,33.9,,19.80,,,0,"percent of total billed charges","33.9% of total billed charges",13.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.94,78,,45.55,,,0,"percent of total billed charges","78% of total billed charges",13.32,101,,,,,0,"fee schedule","101% of CMS fee schedule ",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,13.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",13.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",6.96,73,
"HERPES SIMPLEX TYPE 2 IGG",30286696,CDM,302,RC,86696,CPT,OUTPATIENT,,,97,63.05,,85.36,88,,68.29,,,0,"percent of total billed charges","88% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",33.86,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.11,63,,48.89,,,0,"percent of total billed charges","63% of total billed charges",14.84,15.3,,11.87,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,66.93,69,,,,,0,"fee schedule","69% of total billed charges",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.01,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.35,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.57,37.7,,29.26,,,0,"percent of total billed charges","37.7% of total billed charges",36.57,37.7,,29.26,,,0,"percent of total billed charges","37.70% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.88,33.9,,26.30,,,0,"percent of total billed charges","33.9% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",75.66,78,,60.53,,,0,"percent of total billed charges","78% of total billed charges",19.54,101,,,,,0,"fee schedule","101% of CMS fee schedule ",80.12,82.6,,64.10,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.12,82.6,,64.10,,,0,"percent of total billed charges","82.6% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",6.96,97,
"HERPES SIMPLEX TYPE I IGG",30286695,CDM,302,RC,86695,CPT,OUTPATIENT,,,65,42.25,,57.2,88,,45.76,,,0,"percent of total billed charges","88% of total billed charges",13.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",23.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,13.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.95,63,,32.76,,,0,"percent of total billed charges","63% of total billed charges",9.95,15.3,,7.96,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,44.85,69,,,,,0,"fee schedule","69% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",13.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",13.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",13.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.45,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,13.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.19,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,13.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,13.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.51,37.7,,19.61,,,0,"percent of total billed charges","37.7% of total billed charges",24.51,37.7,,19.61,,,0,"percent of total billed charges","37.70% of total billed charges",13.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.04,33.9,,17.63,,,0,"percent of total billed charges","33.9% of total billed charges",13.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.7,78,,40.56,,,0,"percent of total billed charges","78% of total billed charges",13.32,101,,,,,0,"fee schedule","101% of CMS fee schedule ",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,13.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",13.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,65,
"Panel 083904 (HIV-1) LC",30286701,CDM,302,RC,86701,CPT,OUTPATIENT,,,79,51.35,,69.52,88,,55.62,,,0,"percent of total billed charges","88% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",15.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.77,63,,39.82,,,0,"percent of total billed charges","63% of total billed charges",12.09,15.3,,9.67,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,54.51,69,,,,,0,"fee schedule","69% of total billed charges",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.89,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.78,37.7,,23.82,,,0,"percent of total billed charges","37.7% of total billed charges",29.78,37.7,,23.82,,,0,"percent of total billed charges","37.70% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.78,33.9,,21.42,,,0,"percent of total billed charges","33.9% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.62,78,,49.30,,,0,"percent of total billed charges","78% of total billed charges",8.97,101,,,,,0,"fee schedule","101% of CMS fee schedule ",65.25,82.6,,52.20,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.25,82.6,,52.20,,,0,"percent of total billed charges","82.6% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,79,
"HIV-1 ANTIBODY",30286701,CDM,302,RC,86701,CPT,OUTPATIENT,,,68,44.2,,59.84,88,,47.87,,,0,"percent of total billed charges","88% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,68,100,,54.40,,,0,"percent of total billed charges","100% of total billed charges",15.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.84,63,,34.27,,,0,"percent of total billed charges","63% of total billed charges",10.4,15.3,,8.32,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,46.92,69,,,,,0,"fee schedule","69% of total billed charges",68,100,,54.40,,,0,"percent of total billed charges","100% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",68,100,,54.40,,,0,"percent of total billed charges","100% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",68,100,,54.40,,,0,"percent of total billed charges","100% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.89,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.64,37.7,,20.51,,,0,"percent of total billed charges","37.7% of total billed charges",25.64,37.7,,20.51,,,0,"percent of total billed charges","37.70% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.05,33.9,,18.44,,,0,"percent of total billed charges","33.9% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.04,78,,42.43,,,0,"percent of total billed charges","78% of total billed charges",8.97,101,,,,,0,"fee schedule","101% of CMS fee schedule ",56.17,82.6,,44.94,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.17,82.6,,44.94,,,0,"percent of total billed charges","82.6% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,68,100,,54.40,,,0,"percent of total billed charges","100% of total billed charges",6.96,68,
"Hep A Ab, Total LC",30286708,CDM,302,RC,86708,CPT,OUTPATIENT,,,99,64.35,,87.12,88,,69.70,,,0,"percent of total billed charges","88% of total billed charges",12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",21.68,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.37,63,,49.90,,,0,"percent of total billed charges","63% of total billed charges",15.15,15.3,,12.12,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,68.31,69,,,,,0,"fee schedule","69% of total billed charges",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.39,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.39,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.32,37.7,,29.86,,,0,"percent of total billed charges","37.7% of total billed charges",37.32,37.7,,29.86,,,0,"percent of total billed charges","37.70% of total billed charges",12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.56,33.9,,26.85,,,0,"percent of total billed charges","33.9% of total billed charges",12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.22,78,,61.78,,,0,"percent of total billed charges","78% of total billed charges",12.51,101,,,,,0,"fee schedule","101% of CMS fee schedule ",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,99,
"Hep B Surface Ab, Qual LC",30286706,CDM,302,RC,86706,CPT,OUTPATIENT,,,165,107.25,,145.2,88,,116.16,,,0,"percent of total billed charges","88% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",18.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",103.95,63,,83.16,,,0,"percent of total billed charges","63% of total billed charges",25.25,15.3,,20.20,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,113.85,69,,,,,0,"fee schedule","69% of total billed charges",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.08,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.74,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.21,37.7,,49.77,,,0,"percent of total billed charges","37.7% of total billed charges",62.21,37.7,,49.77,,,0,"percent of total billed charges","37.70% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.94,33.9,,44.75,,,0,"percent of total billed charges","33.9% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",128.7,78,,102.96,,,0,"percent of total billed charges","78% of total billed charges",10.84,101,,,,,0,"fee schedule","101% of CMS fee schedule ",136.29,82.6,,109.03,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.29,82.6,,109.03,,,0,"percent of total billed charges","82.6% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,165,
"HIV2; Panel 083955 LC",30286702,CDM,302,RC,86702,CPT,OUTPATIENT,,,316,205.4,,278.08,88,,222.46,,,0,"percent of total billed charges","88% of total billed charges",13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",23.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",199.08,63,,159.26,,,0,"percent of total billed charges","63% of total billed charges",48.35,15.3,,38.68,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,218.04,69,,,,,0,"fee schedule","69% of total billed charges",316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.71,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.52,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",119.13,37.7,,95.30,,,0,"percent of total billed charges","37.7% of total billed charges",119.13,37.7,,95.30,,,0,"percent of total billed charges","37.70% of total billed charges",13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.12,33.9,,85.70,,,0,"percent of total billed charges","33.9% of total billed charges",13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",246.48,78,,197.18,,,0,"percent of total billed charges","78% of total billed charges",13.65,101,,,,,0,"fee schedule","101% of CMS fee schedule ",261.02,82.6,,208.82,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",261.02,82.6,,208.82,,,0,"percent of total billed charges","82.6% of total billed charges",13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",6.96,316,
"MUMPS IGG",30286735,CDM,302,RC,86735,CPT,OUTPATIENT,,,216,140.4,,190.08,88,,152.06,,,0,"percent of total billed charges","88% of total billed charges",13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,216,100,,172.80,,,0,"percent of total billed charges","100% of total billed charges",22.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.08,63,,108.86,,,0,"percent of total billed charges","63% of total billed charges",33.05,15.3,,26.44,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,149.04,69,,,,,0,"fee schedule","69% of total billed charges",216,100,,172.80,,,0,"percent of total billed charges","100% of total billed charges",13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",216,100,,172.80,,,0,"percent of total billed charges","100% of total billed charges",13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",216,100,,172.80,,,0,"percent of total billed charges","100% of total billed charges",13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.91,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.05,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.43,37.7,,65.14,,,0,"percent of total billed charges","37.7% of total billed charges",81.43,37.7,,65.14,,,0,"percent of total billed charges","37.70% of total billed charges",13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.22,33.9,,58.58,,,0,"percent of total billed charges","33.9% of total billed charges",13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",168.48,78,,134.78,,,0,"percent of total billed charges","78% of total billed charges",13.18,101,,,,,0,"fee schedule","101% of CMS fee schedule ",178.42,82.6,,142.74,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",178.42,82.6,,142.74,,,0,"percent of total billed charges","82.6% of total billed charges",13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,216,100,,172.80,,,0,"percent of total billed charges","100% of total billed charges",6.96,216,
"Parvo B19 IgM LC",30286747,CDM,302,RC,86747,CPT,OUTPATIENT,,,67,43.55,,58.96,88,,47.17,,,0,"percent of total billed charges","88% of total billed charges",15.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",26.3,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,15.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.21,63,,33.77,,,0,"percent of total billed charges","63% of total billed charges",10.25,15.3,,8.20,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,46.23,69,,,,,0,"fee schedule","69% of total billed charges",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",15.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",15.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",15.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.48,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,15.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.03,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,15.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,15.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.26,37.7,,20.21,,,0,"percent of total billed charges","37.7% of total billed charges",25.26,37.7,,20.21,,,0,"percent of total billed charges","37.70% of total billed charges",15.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.71,33.9,,18.17,,,0,"percent of total billed charges","33.9% of total billed charges",15.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.26,78,,41.81,,,0,"percent of total billed charges","78% of total billed charges",15.18,101,,,,,0,"fee schedule","101% of CMS fee schedule ",55.34,82.6,,44.27,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,15.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.34,82.6,,44.27,,,0,"percent of total billed charges","82.6% of total billed charges",15.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",6.96,67,
"Rickettsia Antibody LC",30286757,CDM,302,RC,86757,CPT,OUTPATIENT,,,404,262.6,,355.52,88,,284.42,,,0,"percent of total billed charges","88% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,404,100,,323.20,,,0,"percent of total billed charges","100% of total billed charges",33.86,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",254.52,63,,203.62,,,0,"percent of total billed charges","63% of total billed charges",61.81,15.3,,49.45,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,278.76,69,,,,,0,"fee schedule","69% of total billed charges",404,100,,323.20,,,0,"percent of total billed charges","100% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",404,100,,323.20,,,0,"percent of total billed charges","100% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",404,100,,323.20,,,0,"percent of total billed charges","100% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.01,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.35,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",152.31,37.7,,121.85,,,0,"percent of total billed charges","37.7% of total billed charges",152.31,37.7,,121.85,,,0,"percent of total billed charges","37.70% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.96,33.9,,109.57,,,0,"percent of total billed charges","33.9% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",315.12,78,,252.10,,,0,"percent of total billed charges","78% of total billed charges",19.54,101,,,,,0,"fee schedule","101% of CMS fee schedule ",333.7,82.6,,266.96,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",333.7,82.6,,266.96,,,0,"percent of total billed charges","82.6% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,404,100,,323.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,404,
"RUBELLA VIRUS AB IGM EIA",30086762,CDM,300,RC,86762,CPT,OUTPATIENT,,,262,170.3,,230.56,88,,184.45,,,0,"percent of total billed charges","88% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",25.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",165.06,63,,132.05,,,0,"percent of total billed charges","63% of total billed charges",40.09,15.3,,32.07,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,180.78,69,,,,,0,"fee schedule","69% of total billed charges",262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.04,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.39,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.77,37.7,,79.02,,,0,"percent of total billed charges","37.7% of total billed charges",98.77,37.7,,79.02,,,0,"percent of total billed charges","37.70% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.82,33.9,,71.06,,,0,"percent of total billed charges","33.9% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",204.36,78,,163.49,,,0,"percent of total billed charges","78% of total billed charges",14.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",216.41,82.6,,173.13,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",216.41,82.6,,173.13,,,0,"percent of total billed charges","82.6% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",6.96,262,
"Toxoplasma Abs IgM LC",30286778,CDM,302,RC,86778,CPT,OUTPATIENT,,,328,213.2,,288.64,88,,230.91,,,0,"percent of total billed charges","88% of total billed charges",14.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",25.21,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,14.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",206.64,63,,165.31,,,0,"percent of total billed charges","63% of total billed charges",50.18,15.3,,40.14,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,226.32,69,,,,,0,"fee schedule","69% of total billed charges",328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",14.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",14.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",14.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.11,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.41,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,14.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,14.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",123.66,37.7,,98.93,,,0,"percent of total billed charges","37.7% of total billed charges",123.66,37.7,,98.93,,,0,"percent of total billed charges","37.70% of total billed charges",14.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",111.19,33.9,,88.95,,,0,"percent of total billed charges","33.9% of total billed charges",14.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",255.84,78,,204.67,,,0,"percent of total billed charges","78% of total billed charges",14.55,101,,,,,0,"fee schedule","101% of CMS fee schedule ",270.93,82.6,,216.74,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,14.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",270.93,82.6,,216.74,,,0,"percent of total billed charges","82.6% of total billed charges",14.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",6.96,328,
"West Nile Virus Antibody, CSF LC",30286789,CDM,302,RC,86789,CPT,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",25.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.04,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.39,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.7% of total billed charges",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.55,33.9,,42.04,,,0,"percent of total billed charges","33.9% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",14.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,155,
"Thyroglobulin Anttibody LC",30286800,CDM,302,RC,86800,CPT,OUTPATIENT,,,385,250.25,,338.8,88,,271.04,,,0,"percent of total billed charges","88% of total billed charges",15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",27.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",242.55,63,,194.04,,,0,"percent of total billed charges","63% of total billed charges",58.91,15.3,,47.13,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,265.65,69,,,,,0,"fee schedule","69% of total billed charges",385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.85,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.91,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",145.15,37.7,,116.12,,,0,"percent of total billed charges","37.7% of total billed charges",145.15,37.7,,116.12,,,0,"percent of total billed charges","37.70% of total billed charges",15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",130.52,33.9,,104.42,,,0,"percent of total billed charges","33.9% of total billed charges",15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",300.3,78,,240.24,,,0,"percent of total billed charges","78% of total billed charges",16.06,101,,,,,0,"fee schedule","101% of CMS fee schedule ",318.01,82.6,,254.41,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",318.01,82.6,,254.41,,,0,"percent of total billed charges","82.6% of total billed charges",15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,385,
"Hep C Virus AB LC",30286803,CDM,302,RC,86803,CPT,OUTPATIENT,,,184,119.6,,161.92,88,,129.54,,,0,"percent of total billed charges","88% of total billed charges",14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",24.97,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",115.92,63,,92.74,,,0,"percent of total billed charges","63% of total billed charges",28.15,15.3,,22.52,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,126.96,69,,,,,0,"fee schedule","69% of total billed charges",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.58,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.27,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.37,37.7,,55.50,,,0,"percent of total billed charges","37.7% of total billed charges",69.37,37.7,,55.50,,,0,"percent of total billed charges","37.70% of total billed charges",14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.38,33.9,,49.90,,,0,"percent of total billed charges","33.9% of total billed charges",14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",143.52,78,,114.82,,,0,"percent of total billed charges","78% of total billed charges",14.41,101,,,,,0,"fee schedule","101% of CMS fee schedule ",151.98,82.6,,121.58,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.98,82.6,,121.58,,,0,"percent of total billed charges","82.6% of total billed charges",14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,184,
"Antibody Screen LC",30086850,CDM,300,RC,86850,CPT,OUTPATIENT,,,200,130,,176,88,,140.80,,,0,"percent of total billed charges","88% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",96.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",126,63,,100.80,,,0,"percent of total billed charges","63% of total billed charges",30.6,15.3,,24.48,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,138,69,,,,,0,"fee schedule","69% of total billed charges",200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.15,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75.4,37.7,,60.32,,,0,"percent of total billed charges","37.7% of total billed charges",75.4,37.7,,60.32,,,0,"percent of total billed charges","37.70% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",67.8,33.9,,54.24,,,0,"percent of total billed charges","33.9% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",156,78,,124.80,,,0,"percent of total billed charges","78% of total billed charges",55.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",165.2,82.6,,132.16,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",165.2,82.6,,132.16,,,0,"percent of total billed charges","82.6% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",2.86,202.15,
"Rh Only",30086901,CDM,300,RC,86901,CPT,OUTPATIENT,,,278,180.7,,244.64,88,,195.71,,,0,"percent of total billed charges","88% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",71.58,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",175.14,63,,140.11,,,0,"percent of total billed charges","63% of total billed charges",42.53,15.3,,34.02,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,191.82,69,,,,,0,"fee schedule","69% of total billed charges",278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",104.81,37.7,,83.85,,,0,"percent of total billed charges","37.7% of total billed charges",104.81,37.7,,83.85,,,0,"percent of total billed charges","37.70% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",94.24,33.9,,75.39,,,0,"percent of total billed charges","33.9% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.84,78,,173.47,,,0,"percent of total billed charges","78% of total billed charges",41.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.63,82.6,,183.70,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.63,82.6,,183.70,,,0,"percent of total billed charges","82.6% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",2.86,278,
"ABO LC",30086900,CDM,300,RC,86900,CPT,OUTPATIENT,,,327,212.55,,287.76,88,,230.21,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206.01,63,,164.81,,,0,"percent of total billed charges","63% of total billed charges",50.03,15.3,,40.02,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,225.63,69,,,,,0,"fee schedule","69% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.7% of total billed charges",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.85,33.9,,88.68,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.06,78,,204.05,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",2.86,454.8,
"Urine CUL LC",30687086,CDM,306,RC,87086,CPT,OUTPATIENT,,,176,114.4,,154.88,88,,123.90,,,0,"percent of total billed charges","88% of total billed charges",8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",14.12,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",110.88,63,,88.70,,,0,"percent of total billed charges","63% of total billed charges",26.93,15.3,,21.54,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,121.44,69,,,,,0,"fee schedule","69% of total billed charges",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.86,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.07,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.35,37.7,,53.08,,,0,"percent of total billed charges","37.7% of total billed charges",66.35,37.7,,53.08,,,0,"percent of total billed charges","37.70% of total billed charges",8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.66,33.9,,47.73,,,0,"percent of total billed charges","33.9% of total billed charges",8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.28,78,,109.82,,,0,"percent of total billed charges","78% of total billed charges",8.15,101,,,,,0,"fee schedule","101% of CMS fee schedule ",145.38,82.6,,116.30,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",145.38,82.6,,116.30,,,0,"percent of total billed charges","82.6% of total billed charges",8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",4.81,176,
"Chlamydia Culture LC",30687110,CDM,306,RC,87110,CPT,OUTPATIENT,,,401,260.65,,352.88,88,,282.30,,,0,"percent of total billed charges","88% of total billed charges",19.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,401,100,,320.80,,,0,"percent of total billed charges","100% of total billed charges",34.3,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,19.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",252.63,63,,202.10,,,0,"percent of total billed charges","63% of total billed charges",61.35,15.3,,49.08,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,276.69,69,,,,,0,"fee schedule","69% of total billed charges",401,100,,320.80,,,0,"percent of total billed charges","100% of total billed charges",19.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",401,100,,320.80,,,0,"percent of total billed charges","100% of total billed charges",19.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",401,100,,320.80,,,0,"percent of total billed charges","100% of total billed charges",19.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.97,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,19.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.6,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,19.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,19.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.18,37.7,,120.94,,,0,"percent of total billed charges","37.7% of total billed charges",151.18,37.7,,120.94,,,0,"percent of total billed charges","37.70% of total billed charges",19.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",135.94,33.9,,108.75,,,0,"percent of total billed charges","33.9% of total billed charges",19.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",312.78,78,,250.22,,,0,"percent of total billed charges","78% of total billed charges",19.79,101,,,,,0,"fee schedule","101% of CMS fee schedule ",331.23,82.6,,264.98,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,19.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",331.23,82.6,,264.98,,,0,"percent of total billed charges","82.6% of total billed charges",19.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,401,100,,320.80,,,0,"percent of total billed charges","100% of total billed charges",4.81,401,
"Smear, Primary Src w/Interp LC",30687209,CDM,306,RC,87209,CPT,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",31.46,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.77,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.98,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.7% of total billed charges",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.92,33.9,,27.94,,,0,"percent of total billed charges","33.9% of total billed charges",17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",18.15,101,,,,,0,"fee schedule","101% of CMS fee schedule ",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",4.81,103,
"ACID FAST SMEAR",30687206,CDM,306,RC,87206,CPT,OUTPATIENT,,,94,61.1,,82.72,88,,66.18,,,0,"percent of total billed charges","88% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",9.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,63,,47.38,,,0,"percent of total billed charges","63% of total billed charges",14.38,15.3,,11.50,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,64.86,69,,,,,0,"fee schedule","69% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.61,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.39,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.44,37.7,,28.35,,,0,"percent of total billed charges","37.7% of total billed charges",35.44,37.7,,28.35,,,0,"percent of total billed charges","37.70% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.87,33.9,,25.50,,,0,"percent of total billed charges","33.9% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.32,78,,58.66,,,0,"percent of total billed charges","78% of total billed charges",5.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,94,
"VIRAL CULTURE SHELL",30687254,CDM,306,RC,87254,CPT,OUTPATIENT,,,94,61.1,,82.72,88,,66.18,,,0,"percent of total billed charges","88% of total billed charges",19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",34.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,63,,47.38,,,0,"percent of total billed charges","63% of total billed charges",14.38,15.3,,11.50,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,64.86,69,,,,,0,"fee schedule","69% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.81,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.55,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.44,37.7,,28.35,,,0,"percent of total billed charges","37.7% of total billed charges",35.44,37.7,,28.35,,,0,"percent of total billed charges","37.70% of total billed charges",19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.87,33.9,,25.50,,,0,"percent of total billed charges","33.9% of total billed charges",19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.32,78,,58.66,,,0,"percent of total billed charges","78% of total billed charges",19.75,101,,,,,0,"fee schedule","101% of CMS fee schedule ",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,94,
"ADENOVIRUS ANTIGEN",30087260,CDM,300,RC,87260,CPT,OUTPATIENT,,,266,172.9,,234.08,88,,187.26,,,0,"percent of total billed charges","88% of total billed charges",14.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",25.25,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,14.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",167.58,63,,134.06,,,0,"percent of total billed charges","63% of total billed charges",40.7,15.3,,32.56,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,183.54,69,,,,,0,"fee schedule","69% of total billed charges",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",14.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",14.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",14.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.19,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,14.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.43,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,14.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,14.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.28,37.7,,80.22,,,0,"percent of total billed charges","37.7% of total billed charges",100.28,37.7,,80.22,,,0,"percent of total billed charges","37.70% of total billed charges",14.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.17,33.9,,72.14,,,0,"percent of total billed charges","33.9% of total billed charges",14.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",207.48,78,,165.98,,,0,"percent of total billed charges","78% of total billed charges",14.57,101,,,,,0,"fee schedule","101% of CMS fee schedule ",219.72,82.6,,175.78,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,14.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",219.72,82.6,,175.78,,,0,"percent of total billed charges","82.6% of total billed charges",14.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",4.81,266,
"INFLUENZA AB AG BY DFA",30687276,CDM,306,RC,87276,CPT,OUTPATIENT,,,59,38.35,,51.92,88,,41.54,,,0,"percent of total billed charges","88% of total billed charges",16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",28.12,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.17,63,,29.74,,,0,"percent of total billed charges","63% of total billed charges",9.03,15.3,,7.22,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,40.71,69,,,,,0,"fee schedule","69% of total billed charges",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.46,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.07,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.24,37.7,,17.79,,,0,"percent of total billed charges","37.7% of total billed charges",22.24,37.7,,17.79,,,0,"percent of total billed charges","37.70% of total billed charges",16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20,33.9,,16.00,,,0,"percent of total billed charges","33.9% of total billed charges",16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.02,78,,36.82,,,0,"percent of total billed charges","78% of total billed charges",16.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",48.73,82.6,,38.98,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.73,82.6,,38.98,,,0,"percent of total billed charges","82.6% of total billed charges",16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,61.46,
"PARAINFLUENZA BY DFA",30687279,CDM,306,RC,87279,CPT,OUTPATIENT,,,65,42.25,,57.2,88,,45.76,,,0,"percent of total billed charges","88% of total billed charges",16.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",28.75,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,16.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.95,63,,32.76,,,0,"percent of total billed charges","63% of total billed charges",9.95,15.3,,7.96,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,44.85,69,,,,,0,"fee schedule","69% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",16.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",16.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",16.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.84,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,16.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.43,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,16.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,16.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.51,37.7,,19.61,,,0,"percent of total billed charges","37.7% of total billed charges",24.51,37.7,,19.61,,,0,"percent of total billed charges","37.70% of total billed charges",16.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.04,33.9,,17.63,,,0,"percent of total billed charges","33.9% of total billed charges",16.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.7,78,,40.56,,,0,"percent of total billed charges","78% of total billed charges",16.59,101,,,,,0,"fee schedule","101% of CMS fee schedule ",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,16.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",16.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",4.81,65,
"INFLUENZA B AG BY DFA",30687275,CDM,306,RC,87275,CPT,OUTPATIENT,,,102,66.3,,89.76,88,,71.81,,,0,"percent of total billed charges","88% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",21.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.26,63,,51.41,,,0,"percent of total billed charges","63% of total billed charges",15.61,15.3,,12.49,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,70.38,69,,,,,0,"fee schedule","69% of total billed charges",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.85,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.25,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.45,37.7,,30.76,,,0,"percent of total billed charges","37.7% of total billed charges",38.45,37.7,,30.76,,,0,"percent of total billed charges","37.70% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.58,33.9,,27.66,,,0,"percent of total billed charges","33.9% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.56,78,,63.65,,,0,"percent of total billed charges","78% of total billed charges",12.37,101,,,,,0,"fee schedule","101% of CMS fee schedule ",84.25,82.6,,67.40,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",84.25,82.6,,67.40,,,0,"percent of total billed charges","82.6% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",4.81,102,
"VIRAL RESP SCREEN BY DFA",30087299,CDM,300,RC,87299,CPT,OUTPATIENT,,,58,37.7,,51.04,88,,40.83,,,0,"percent of total billed charges","88% of total billed charges",16.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",28.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,16.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.54,63,,29.23,,,0,"percent of total billed charges","63% of total billed charges",8.87,15.3,,7.10,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,40.02,69,,,,,0,"fee schedule","69% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",16.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",16.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",16.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.58,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,16.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.1,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,16.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,16.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.87,37.7,,17.50,,,0,"percent of total billed charges","37.7% of total billed charges",21.87,37.7,,17.50,,,0,"percent of total billed charges","37.70% of total billed charges",16.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.66,33.9,,15.73,,,0,"percent of total billed charges","33.9% of total billed charges",16.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.24,78,,36.19,,,0,"percent of total billed charges","78% of total billed charges",16.26,101,,,,,0,"fee schedule","101% of CMS fee schedule ",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,16.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",16.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",4.81,61.58,
"87328 cryptosporidium LC",30687328,CDM,306,RC,87328,CPT,OUTPATIENT,,,119,77.35,,104.72,88,,83.78,,,0,"percent of total billed charges","88% of total billed charges",13.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",24.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,13.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.97,63,,59.98,,,0,"percent of total billed charges","63% of total billed charges",18.21,15.3,,14.57,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,82.11,69,,,,,0,"fee schedule","69% of total billed charges",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",13.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",13.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",13.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.86,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,13.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.82,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,13.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,13.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.7% of total billed charges",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.70% of total billed charges",13.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.34,33.9,,32.27,,,0,"percent of total billed charges","33.9% of total billed charges",13.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.82,78,,74.26,,,0,"percent of total billed charges","78% of total billed charges",13.95,101,,,,,0,"fee schedule","101% of CMS fee schedule ",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,13.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",13.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,119,
"HBsAG Screen LC",30687340,CDM,306,RC,87340,CPT,OUTPATIENT,,,169,109.85,,148.72,88,,118.98,,,0,"percent of total billed charges","88% of total billed charges",10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",18.07,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.47,63,,85.18,,,0,"percent of total billed charges","63% of total billed charges",25.86,15.3,,20.69,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,116.61,69,,,,,0,"fee schedule","69% of total billed charges",169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.33,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.71,37.7,,50.97,,,0,"percent of total billed charges","37.7% of total billed charges",63.71,37.7,,50.97,,,0,"percent of total billed charges","37.70% of total billed charges",10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.29,33.9,,45.83,,,0,"percent of total billed charges","33.9% of total billed charges",10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",131.82,78,,105.46,,,0,"percent of total billed charges","78% of total billed charges",10.43,101,,,,,0,"fee schedule","101% of CMS fee schedule ",139.59,82.6,,111.67,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",139.59,82.6,,111.67,,,0,"percent of total billed charges","82.6% of total billed charges",10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,169,
"HIV 1 and2 LC",30087389,CDM,300,RC,87389,CPT,OUTPATIENT,,,61,39.65,,53.68,88,,42.94,,,0,"percent of total billed charges","88% of total billed charges",24.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",42.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,24.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.43,63,,30.74,,,0,"percent of total billed charges","63% of total billed charges",9.33,15.3,,7.46,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,42.09,69,,,,,0,"fee schedule","69% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",24.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",24.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",24.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,24.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.08,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,24.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,24.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",23,37.7,,18.40,,,0,"percent of total billed charges","37.7% of total billed charges",23,37.7,,18.40,,,0,"percent of total billed charges","37.70% of total billed charges",24.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.68,33.9,,16.54,,,0,"percent of total billed charges","33.9% of total billed charges",24.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.58,78,,38.06,,,0,"percent of total billed charges","78% of total billed charges",24.32,101,,,,,0,"fee schedule","101% of CMS fee schedule ",50.39,82.6,,40.31,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,24.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.39,82.6,,40.31,,,0,"percent of total billed charges","82.6% of total billed charges",24.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",4.81,92.1,
"Clostridium difficile Quik Chek Complete",30687449,CDM,306,RC,87449,CPT,OUTPATIENT,,,197,128.05,,173.36,88,,138.69,,,0,"percent of total billed charges","88% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,197,100,,157.60,,,0,"percent of total billed charges","100% of total billed charges",20.96,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.11,63,,99.29,,,0,"percent of total billed charges","63% of total billed charges",30.14,15.3,,24.11,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,135.93,69,,,,,0,"fee schedule","69% of total billed charges",197,100,,157.60,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",197,100,,157.60,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",197,100,,157.60,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.82,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.98,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.27,37.7,,59.42,,,0,"percent of total billed charges","37.7% of total billed charges",74.27,37.7,,59.42,,,0,"percent of total billed charges","37.70% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.78,33.9,,53.42,,,0,"percent of total billed charges","33.9% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",153.66,78,,122.93,,,0,"percent of total billed charges","78% of total billed charges",12.09,101,,,,,0,"fee schedule","101% of CMS fee schedule ",162.72,82.6,,130.18,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.72,82.6,,130.18,,,0,"percent of total billed charges","82.6% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,197,100,,157.60,,,0,"percent of total billed charges","100% of total billed charges",4.81,197,
"CHLAMYDIA PNEUMONIAE PCR",30687486,CDM,306,RC,87486,CPT,OUTPATIENT,,,88,57.2,,77.44,88,,61.95,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.44,63,,44.35,,,0,"percent of total billed charges","63% of total billed charges",13.46,15.3,,10.77,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,60.72,69,,,,,0,"fee schedule","69% of total billed charges",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.18,37.7,,26.54,,,0,"percent of total billed charges","37.7% of total billed charges",33.18,37.7,,26.54,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.83,33.9,,23.86,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.64,78,,54.91,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",13.46,134.21,
"87481 Candidiasis Panel AVR",30687481,CDM,306,RC,87481,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"87481 Vaginosis/Vaginitis Panel AVR",30687481,CDM,306,RC,87481,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"87481 Cervicitis/Vaginitis Panel AVR",30687481,CDM,306,RC,87481,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"87481 Vaginosis/Vaginitis Extended Panel AVR",30687481,CDM,306,RC,87481,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"87481 Standard Panel AVR",30687481,CDM,306,RC,87481,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"87481 Comprehensive UTI Panel AVR",30687481,CDM,306,RC,87481,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"87491 Leukorrhea Panel - Extended AVR",30180185,CDM,306,RC,87491,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"CHLAMYDIA TRACH AMP PROBE",30687491,CDM,306,RC,87491,CPT,OUTPATIENT,,,226,146.9,,198.88,88,,159.10,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.38,63,,113.90,,,0,"percent of total billed charges","63% of total billed charges",34.58,15.3,,27.66,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,155.94,69,,,,,0,"fee schedule","69% of total billed charges",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.2,37.7,,68.16,,,0,"percent of total billed charges","37.7% of total billed charges",85.2,37.7,,68.16,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.61,33.9,,61.29,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",176.28,78,,141.02,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",186.68,82.6,,149.34,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",186.68,82.6,,149.34,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",18.33,226,
"87510 GardnVerella vaginalis by DNA Prb LC 180026",30687510,CDM,306,RC,87510,CPT,OUTPATIENT,,,99,64.35,,87.12,88,,69.70,,,0,"percent of total billed charges","88% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",35.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",15.15,15.3,,12.12,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,68.31,69,,,,,0,"fee schedule","69% of total billed charges",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.69,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.05,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.32,37.7,,29.86,,,0,"percent of total billed charges","37.7% of total billed charges",37.32,37.7,,29.86,,,0,"percent of total billed charges","37.70% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.56,33.9,,26.85,,,0,"percent of total billed charges","33.9% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.22,78,,61.78,,,0,"percent of total billed charges","78% of total billed charges",20.25,101,,,,,0,"fee schedule","101% of CMS fee schedule ",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,99,
"87511 Cervicitis/Vaginitis Panel AVR",30687511,CDM,306,RC,87511,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"87511 PID/Infertility Panel AVR",30687511,CDM,306,RC,87511,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"87511 Vaginosis/Vaginitis Extended Panel AVR",30687511,CDM,306,RC,87511,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"Herpes Simplex Virus (HSV) Types 1 and 2, NAA LC",30687529,CDM,306,RC,87529,CPT,OUTPATIENT,,,128,83.2,,112.64,88,,90.11,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.64,63,,64.51,,,0,"percent of total billed charges","63% of total billed charges",19.58,15.3,,15.66,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,88.32,69,,,,,0,"fee schedule","69% of total billed charges",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.26,37.7,,38.61,,,0,"percent of total billed charges","37.7% of total billed charges",48.26,37.7,,38.61,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.39,33.9,,34.71,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.84,78,,79.87,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",105.73,82.6,,84.58,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",105.73,82.6,,84.58,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",18.33,134.21,
"87529 HSV1 and HSV2 AVR",30687529,CDM,306,RC,87529,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"87529 Genital Ulcer Panel AVR",30687529,CDM,306,RC,87529,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"87538 HIV-2 Qual RNA LC",30687538,CDM,306,RC,87538,CPT,OUTPATIENT,,,131,85.15,,115.28,88,,92.22,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.53,63,,66.02,,,0,"percent of total billed charges","63% of total billed charges",20.04,15.3,,16.03,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,90.39,69,,,,,0,"fee schedule","69% of total billed charges",131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.39,37.7,,39.51,,,0,"percent of total billed charges","37.7% of total billed charges",49.39,37.7,,39.51,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.41,33.9,,35.53,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",102.18,78,,81.74,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",108.21,82.6,,86.57,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.21,82.6,,86.57,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",18.33,134.21,
"87556 MTB detection by DNA or RNA",30687556,CDM,306,RC,87556,CPT,OUTPATIENT,,,113,73.45,,99.44,88,,79.55,,,0,"percent of total billed charges","88% of total billed charges",41.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,113,100,,90.40,,,0,"percent of total billed charges","100% of total billed charges",72.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,41.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.19,63,,56.95,,,0,"percent of total billed charges","63% of total billed charges",17.29,15.3,,13.83,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,77.97,69,,,,,0,"fee schedule","69% of total billed charges",113,100,,90.40,,,0,"percent of total billed charges","100% of total billed charges",41.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",113,100,,90.40,,,0,"percent of total billed charges","100% of total billed charges",41.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",113,100,,90.40,,,0,"percent of total billed charges","100% of total billed charges",41.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",159.42,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,41.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.68,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,41.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,41.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.6,37.7,,34.08,,,0,"percent of total billed charges","37.7% of total billed charges",42.6,37.7,,34.08,,,0,"percent of total billed charges","37.70% of total billed charges",41.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.31,33.9,,30.65,,,0,"percent of total billed charges","33.9% of total billed charges",41.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.14,78,,70.51,,,0,"percent of total billed charges","78% of total billed charges",42.09,101,,,,,0,"fee schedule","101% of CMS fee schedule ",93.34,82.6,,74.67,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,41.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",93.34,82.6,,74.67,,,0,"percent of total billed charges","82.6% of total billed charges",41.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,113,100,,90.40,,,0,"percent of total billed charges","100% of total billed charges",17.29,159.42,
"Infectious Agent Detection (IAD); MTB Rifampin Resistance LC",30187564,CDM,301,RC,87564,CPT,OUTPATIENT,,,1372,891.8,,1207.36,88,,965.89,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",230.5,16.8,,184.40,,,0,"percent of total billed charges","16.8% of total billed charges",1372,100,,1097.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",237.41,17.304,,189.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",864.36,63,,691.49,,,0,"percent of total billed charges","63% of total billed charges",209.92,15.3,,167.94,,,0,"percent of total billed charges","15.3% of total billed charges",230.5,16.8,,184.40,,,0,"percent of total billed charges","16.8% of total billed charges",946.68,69,,,,,0,"fee schedule","69% of total billed charges",1372,100,,1097.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1372,100,,1097.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1372,100,,1097.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",230.5,16.8,,184.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",230.5,16.8,,184.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",235.11,17.136,,188.09,,,0,"percent of total billed charges","17.136% of total billed charges",299.64,21.84,,239.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",517.24,37.7,,413.79,,,0,"percent of total billed charges","37.7% of total billed charges",517.24,37.7,,413.79,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",465.11,33.9,,372.09,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1070.16,78,,856.13,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1133.27,82.6,,906.62,,,0,"percent of total billed charges","82.6% of total billed charges",230.5,16.8,,184.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1133.27,82.6,,906.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",230.5,16.8,,184.40,,,0,"percent of total billed charges","16.8% of total billed charges",1372,100,,1097.60,,,0,"percent of total billed charges","100% of total billed charges",209.92,1372,
"NEISSERIA GONORR AMP PROBE",30687591,CDM,306,RC,87591,CPT,OUTPATIENT,,,226,146.9,,198.88,88,,159.10,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.38,63,,113.90,,,0,"percent of total billed charges","63% of total billed charges",34.58,15.3,,27.66,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,155.94,69,,,,,0,"fee schedule","69% of total billed charges",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.2,37.7,,68.16,,,0,"percent of total billed charges","37.7% of total billed charges",85.2,37.7,,68.16,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.61,33.9,,61.29,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",176.28,78,,141.02,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",186.68,82.6,,149.34,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",186.68,82.6,,149.34,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",18.33,226,
"Neisseria gonorrhoeae, NAA LC",30687591,CDM,306,RC,87591,CPT,OUTPATIENT,,,267,173.55,,234.96,88,,187.97,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",168.21,63,,134.57,,,0,"percent of total billed charges","63% of total billed charges",40.85,15.3,,32.68,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,184.23,69,,,,,0,"fee schedule","69% of total billed charges",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.66,37.7,,80.53,,,0,"percent of total billed charges","37.7% of total billed charges",100.66,37.7,,80.53,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.51,33.9,,72.41,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",208.26,78,,166.61,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",220.54,82.6,,176.43,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",220.54,82.6,,176.43,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",18.33,267,
"NEISSERIA GONORR AMP PROBE",30687591,CDM,306,RC,87591,CPT,OUTPATIENT,,,175,113.75,,154,88,,123.20,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",110.25,63,,88.20,,,0,"percent of total billed charges","63% of total billed charges",26.78,15.3,,21.42,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,120.75,69,,,,,0,"fee schedule","69% of total billed charges",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.98,37.7,,52.78,,,0,"percent of total billed charges","37.7% of total billed charges",65.98,37.7,,52.78,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.33,33.9,,47.46,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.5,78,,109.20,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",144.55,82.6,,115.64,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.55,82.6,,115.64,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",18.33,175,
"87591 N.Gonorrhea (GeneXpert)",30687591,CDM,306,RC,87591,CPT,OUTPATIENT,,,128,83.2,,112.64,88,,90.11,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.64,63,,64.51,,,0,"percent of total billed charges","63% of total billed charges",19.58,15.3,,15.66,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,88.32,69,,,,,0,"fee schedule","69% of total billed charges",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.26,37.7,,38.61,,,0,"percent of total billed charges","37.7% of total billed charges",48.26,37.7,,38.61,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.39,33.9,,34.71,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.84,78,,79.87,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",105.73,82.6,,84.58,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",105.73,82.6,,84.58,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",18.33,134.21,
"87591 N.Gonorrhea (GeneXpert)",30687591,CDM,306,RC,87591,CPT,OUTPATIENT,,,128,83.2,,112.64,88,,90.11,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.64,63,,64.51,,,0,"percent of total billed charges","63% of total billed charges",19.58,15.3,,15.66,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,88.32,69,,,,,0,"fee schedule","69% of total billed charges",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.26,37.7,,38.61,,,0,"percent of total billed charges","37.7% of total billed charges",48.26,37.7,,38.61,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.39,33.9,,34.71,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.84,78,,79.87,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",105.73,82.6,,84.58,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",105.73,82.6,,84.58,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",18.33,134.21,
"87591 Cervicitis/Vaginitis Panel AVR",30687591,CDM,306,RC,87591,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"87591 Chlamydia/Gonorrhea Panel AVR",30687591,CDM,306,RC,87591,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"87591 PID/Infertility Panel AVR",30687591,CDM,306,RC,87591,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"87591 Leukorrhea Panel AVR",30687591,CDM,306,RC,87591,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"87591 Vaginosis/Vaginitis Extended Panel AVR",30687591,CDM,306,RC,87591,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"87591 Leukorrhea Panel - Extended AVR",30687591,CDM,306,RC,87591,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"87624 HPV Aptima LC",30687624,CDM,306,RC,87624,CPT,OUTPATIENT,,,153,99.45,,134.64,88,,107.71,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",96.39,63,,77.11,,,0,"percent of total billed charges","63% of total billed charges",23.41,15.3,,18.73,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,105.57,69,,,,,0,"fee schedule","69% of total billed charges",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.68,37.7,,46.14,,,0,"percent of total billed charges","37.7% of total billed charges",57.68,37.7,,46.14,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.87,33.9,,41.50,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",119.34,78,,95.47,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",126.38,82.6,,101.10,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",126.38,82.6,,101.10,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",18.33,153,
"RESP VIRUS 12-25 TARGETS",30687633,CDM,306,RC,87633,CPT,OUTPATIENT,,,881,572.65,,775.28,88,,620.22,,,0,"percent of total billed charges","88% of total billed charges",416.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.61,100,,,,,0,"fee schedule",EAPG,881,100,,704.80,,,0,"percent of total billed charges","100% of total billed charges",729.36,175,,,,,0,"fee schedule","175% of CMS fee schedule",100.54,100,,,,,0,"fee schedule",EAPG,416.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",555.03,63,,444.02,,,0,"percent of total billed charges","63% of total billed charges",134.79,15.3,,107.83,,,0,"percent of total billed charges","15.3% of total billed charges",97.61,100,,,,,0,"fee schedule",EAPG,607.89,69,,,,,0,"fee schedule","69% of total billed charges",881,100,,704.80,,,0,"percent of total billed charges","100% of total billed charges",416.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",881,100,,704.80,,,0,"percent of total billed charges","100% of total billed charges",416.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",881,100,,704.80,,,0,"percent of total billed charges","100% of total billed charges",416.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",1594.18,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",97.61,100,,,,,0,"fee schedule",EAPG,416.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",416.78,100,,,,,0,"fee schedule","100% of LI fee schedule",72.3,100,,,,,0,"fee schedule",EAPG,416.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.56,100,,,,,0,"fee schedule",EAPG,126.89,100,,,,,0,"fee schedule",EAPG,416.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",332.14,37.7,,265.71,,,0,"percent of total billed charges","37.7% of total billed charges",332.14,37.7,,265.71,,,0,"percent of total billed charges","37.70% of total billed charges",416.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",298.66,33.9,,238.93,,,0,"percent of total billed charges","33.9% of total billed charges",416.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",687.18,78,,549.74,,,0,"percent of total billed charges","78% of total billed charges",420.94,101,,,,,0,"fee schedule","101% of CMS fee schedule ",727.71,82.6,,582.17,,,0,"percent of total billed charges","82.6% of total billed charges",97.61,100,,,,,0,"fee schedule",EAPG,416.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",727.71,82.6,,582.17,,,0,"percent of total billed charges","82.6% of total billed charges",416.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.61,100,,,,,0,"fee schedule",EAPG,881,100,,704.80,,,0,"percent of total billed charges","100% of total billed charges",72.3,1594.18,
"87634 RSV (GeneXpert)",30684634,CDM,306,RC,87634,CPT,OUTPATIENT,,,190,123.5,,167.2,88,,133.76,,,0,"percent of total billed charges","88% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",122.85,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",119.7,63,,95.76,,,0,"percent of total billed charges","63% of total billed charges",29.07,15.3,,23.26,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,131.1,69,,,,,0,"fee schedule","69% of total billed charges",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",268.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.2,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.63,37.7,,57.30,,,0,"percent of total billed charges","37.7% of total billed charges",71.63,37.7,,57.30,,,0,"percent of total billed charges","37.70% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.41,33.9,,51.53,,,0,"percent of total billed charges","33.9% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",148.2,78,,118.56,,,0,"percent of total billed charges","78% of total billed charges",70.9,101,,,,,0,"fee schedule","101% of CMS fee schedule ",156.94,82.6,,125.55,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",156.94,82.6,,125.55,,,0,"percent of total billed charges","82.6% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",18.33,268.51,
"87653 Aerobic Vaginitis Panel AVR",30687563,CDM,306,RC,87653,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"87653 Comprehensive UTI Panel AVR",30687653,CDM,306,RC,87653,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"TRICHOMONAS VAGIN DIR PROBE",30687661,CDM,306,RC,87661,CPT,OUTPATIENT,,,190,123.5,,167.2,88,,133.76,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",119.7,63,,95.76,,,0,"percent of total billed charges","63% of total billed charges",29.07,15.3,,23.26,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,131.1,69,,,,,0,"fee schedule","69% of total billed charges",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.63,37.7,,57.30,,,0,"percent of total billed charges","37.7% of total billed charges",71.63,37.7,,57.30,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.41,33.9,,51.53,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",148.2,78,,118.56,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",156.94,82.6,,125.55,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",156.94,82.6,,125.55,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",18.33,190,
"87510 GardnVerella vaginalis by DNA Prb LC 180026",30687660,CDM,306,RC,87660,CPT,OUTPATIENT,,,99,64.35,,87.12,88,,69.70,,,0,"percent of total billed charges","88% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",35.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",15.15,15.3,,12.12,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,68.31,69,,,,,0,"fee schedule","69% of total billed charges",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.69,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.05,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.32,37.7,,29.86,,,0,"percent of total billed charges","37.7% of total billed charges",37.32,37.7,,29.86,,,0,"percent of total billed charges","37.70% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.56,33.9,,26.85,,,0,"percent of total billed charges","33.9% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.22,78,,61.78,,,0,"percent of total billed charges","78% of total billed charges",20.25,101,,,,,0,"fee schedule","101% of CMS fee schedule ",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,99,
"87661 Cervicitis/Vaginitis Panel AVR",30687661,CDM,306,RC,87661,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"87661 Leukorrhea Panel AVR",30687661,CDM,306,RC,87661,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"87661 Vaginosis/Vaginitis Panel AVR",30687661,CDM,306,RC,87661,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"87661 PID/Infertility Panel AVR",30687661,CDM,306,RC,87661,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"87661 Vaginosis/Vaginitis Extended Panel AVR",30687661,CDM,306,RC,87661,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"Respiratory Profile, PCR LC",30687798,CDM,306,RC,87798,CPT,OUTPATIENT,,,761,494.65,,669.68,88,,535.74,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,761,100,,608.80,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",479.43,63,,383.54,,,0,"percent of total billed charges","63% of total billed charges",116.43,15.3,,93.14,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,525.09,69,,,,,0,"fee schedule","69% of total billed charges",761,100,,608.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",761,100,,608.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",761,100,,608.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",286.9,37.7,,229.52,,,0,"percent of total billed charges","37.7% of total billed charges",286.9,37.7,,229.52,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",257.98,33.9,,206.38,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",593.58,78,,474.86,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",628.59,82.6,,502.87,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",628.59,82.6,,502.87,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,761,100,,608.80,,,0,"percent of total billed charges","100% of total billed charges",18.33,761,
"Bacterial Vaginosis NAA LC",30687798,CDM,306,RC,87798,CPT,OUTPATIENT,,,175,113.75,,154,88,,123.20,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",110.25,63,,88.20,,,0,"percent of total billed charges","63% of total billed charges",26.78,15.3,,21.42,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,120.75,69,,,,,0,"fee schedule","69% of total billed charges",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.98,37.7,,52.78,,,0,"percent of total billed charges","37.7% of total billed charges",65.98,37.7,,52.78,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.33,33.9,,47.46,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.5,78,,109.20,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",144.55,82.6,,115.64,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.55,82.6,,115.64,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",18.33,175,
"87798 Standard Panel AVR",30687798,CDM,306,RC,87798,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"87798 Vaginosis/Vaginitis Extended Panel AVR",30687798,CDM,306,RC,87798,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"87798 Vaginosis/Vaginitis Panel AVR",30687798,CDM,306,RC,87798,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"87798 Cervicitis/Vaginitis Panel AVR",30687798,CDM,306,RC,87798,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"87798 Mycoplasma Panel AVR",30687798,CDM,306,RC,87798,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"87798 Aerobic Vaginitis Panel AVR",30687798,CDM,306,RC,87798,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"87798 PID/Infertility Panel AVR",30687798,CDM,306,RC,87798,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"87798 Bacterial Vaginosis Panel AVR",30687798,CDM,306,RC,87798,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"87798 Comprehensive UTI Panel AVR",30687798,CDM,306,RC,87798,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"87798 Genital Ulcer Panel A",30687798,CDM,306,RC,87798,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"B.PertussisB.Parapertussis PCR LC",30687798,CDM,306,RC,87798,CPT,OUTPATIENT,,,188,122.2,,165.44,88,,132.35,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,188,100,,150.40,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",118.44,63,,94.75,,,0,"percent of total billed charges","63% of total billed charges",28.76,15.3,,23.01,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,129.72,69,,,,,0,"fee schedule","69% of total billed charges",188,100,,150.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",188,100,,150.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",188,100,,150.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.88,37.7,,56.70,,,0,"percent of total billed charges","37.7% of total billed charges",70.88,37.7,,56.70,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.73,33.9,,50.98,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",146.64,78,,117.31,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",155.29,82.6,,124.23,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",155.29,82.6,,124.23,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,188,100,,150.40,,,0,"percent of total billed charges","100% of total billed charges",18.33,188,
"87804 Sofia Flu A, B",30687804,CDM,306,RC,87804,CPT,OUTPATIENT,,,106,68.9,,93.28,88,,74.62,,,0,"percent of total billed charges","88% of total billed charges",16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",28.96,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.78,63,,53.42,,,0,"percent of total billed charges","63% of total billed charges",16.22,15.3,,12.98,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,73.14,69,,,,,0,"fee schedule","69% of total billed charges",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.3,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.55,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.96,37.7,,31.97,,,0,"percent of total billed charges","37.7% of total billed charges",39.96,37.7,,31.97,,,0,"percent of total billed charges","37.70% of total billed charges",16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.93,33.9,,28.74,,,0,"percent of total billed charges","33.9% of total billed charges",16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.68,78,,66.14,,,0,"percent of total billed charges","78% of total billed charges",16.71,101,,,,,0,"fee schedule","101% of CMS fee schedule ",87.56,82.6,,70.05,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.56,82.6,,70.05,,,0,"percent of total billed charges","82.6% of total billed charges",16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",4.81,106,
"BV+CG+TRICH(NAA)+YstCUL LC",30687905,CDM,306,RC,87905,CPT,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",12.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",21.38,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,12.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",12.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",12.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",12.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.74,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,12.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.22,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,12.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,12.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.7% of total billed charges",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",12.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.78,33.9,,5.42,,,0,"percent of total billed charges","33.9% of total billed charges",12.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",12.34,101,,,,,0,"fee schedule","101% of CMS fee schedule ",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule","100% of WA fee schedule",12.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",12.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,46.74,
"88173 Cytopathology Interpretation and Report",31188173,CDM,311,RC,88173,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",33.17,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.17,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",33.17,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",33.17,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.57,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",33.84,100,,,,,0,"fee schedule",EAPG,43.13,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",33.17,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",33.17,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",24.57,43.13,
"Pathology Billing Gyn Cyto Image Guided Thin Prep",31188175,CDM,311,RC,88175,CPT,OUTPATIENT,,,116,75.4,,102.08,88,,81.66,,,0,"percent of total billed charges","88% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",46.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.03,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.08,63,,58.46,,,0,"percent of total billed charges","63% of total billed charges",39.92,150,,,,,0,"fee schedule","150% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,80.04,69,,,,,0,"fee schedule","69% of total billed charges",116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.78,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.61,100,,,,,0,"fee schedule","100% of LI fee schedule",11.53,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.87,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.73,37.7,,34.98,,,0,"percent of total billed charges","37.7% of total billed charges",43.73,37.7,,34.98,,,0,"percent of total billed charges","37.70% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.32,33.9,,31.46,,,0,"percent of total billed charges","33.9% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.48,78,,72.38,,,0,"percent of total billed charges","78% of total billed charges",26.87,101,,,,,0,"fee schedule","101% of CMS fee schedule ",95.82,82.6,,76.66,,,0,"percent of total billed charges","82.6% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.82,82.6,,76.66,,,0,"percent of total billed charges","82.6% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",11.53,116,
"88185 Flow cytometry",31188185,CDM,311,RC,88185,CPT,OUTPATIENT,,,184,119.6,,161.92,88,,129.54,,,0,"percent of total billed charges","88% of total billed charges",92,50,,73.60,,,0,"percent of total billed charges","50% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.78,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",115.92,63,,92.74,,,0,"percent of total billed charges","63% of total billed charges",28.15,15.3,,22.52,,,0,"percent of total billed charges","15.3% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,126.96,69,,,,,0,"fee schedule","69% of total billed charges",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.8,61.85,,91.04,,,0,"percent of total billed charges","61.5% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,92,50,,73.60,,,0,"percent of total billed charges","50% of total billed charges",59.25,32.2,,47.40,,,0,"percent of total billed charges","32.2% of total billed charges",19.26,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",26.52,100,,,,,0,"fee schedule",EAPG,33.8,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",69.37,37.7,,55.50,,,0,"percent of total billed charges","37.7% of total billed charges",69.37,37.7,,55.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.38,33.9,,49.90,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",143.52,78,,114.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.98,82.6,,121.58,,,0,"percent of total billed charges","82.6% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,92,50,,73.60,,,0,"percent of total billed charges","50% of total billed charges",151.98,82.6,,121.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,,,,0,"fee schedule",EAPG,184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",19.26,184,
"88305 Surgical Pathology- 1st Site LC",31088305,CDM,310,RC,88305,CPT,OUTPATIENT,,,372,241.8,,327.36,88,,261.89,,,0,"percent of total billed charges","88% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.92,100,,,,,0,"fee schedule",EAPG,372,100,,297.60,,,0,"percent of total billed charges","100% of total billed charges",96.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",20.52,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.36,63,,187.49,,,0,"percent of total billed charges","63% of total billed charges",56.92,15.3,,45.54,,,0,"percent of total billed charges","15.3% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,256.68,69,,,,,0,"fee schedule","69% of total billed charges",372,100,,297.60,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",372,100,,297.60,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",372,100,,297.60,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.15,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.92,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14.76,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",20.32,100,,,,,0,"fee schedule",EAPG,25.9,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",140.24,37.7,,112.19,,,0,"percent of total billed charges","37.7% of total billed charges",140.24,37.7,,112.19,,,0,"percent of total billed charges","37.70% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",126.11,33.9,,100.89,,,0,"percent of total billed charges","33.9% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.16,78,,232.13,,,0,"percent of total billed charges","78% of total billed charges",55.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.27,82.6,,245.82,,,0,"percent of total billed charges","82.6% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.27,82.6,,245.82,,,0,"percent of total billed charges","82.6% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.92,100,,,,,0,"fee schedule",EAPG,372,100,,297.60,,,0,"percent of total billed charges","100% of total billed charges",14.76,372,
"Immunohistochemical Staining Program LC",31088341,CDM,310,RC,88341,CPT,OUTPATIENT,,,210,136.5,,184.8,88,,147.84,,,0,"percent of total billed charges","88% of total billed charges",105,50,,84.00,,,0,"percent of total billed charges","50% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",132.3,63,,105.84,,,0,"percent of total billed charges","63% of total billed charges",32.13,15.3,,25.70,,,0,"percent of total billed charges","15.3% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,144.9,69,,,,,0,"fee schedule","69% of total billed charges",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.89,61.85,,103.91,,,0,"percent of total billed charges","61.5% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,105,50,,84.00,,,0,"percent of total billed charges","50% of total billed charges",67.62,32.2,,54.10,,,0,"percent of total billed charges","32.2% of total billed charges",14.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",20.32,100,,,,,0,"fee schedule",EAPG,25.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",79.17,37.7,,63.34,,,0,"percent of total billed charges","37.7% of total billed charges",79.17,37.7,,63.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.19,33.9,,56.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",163.8,78,,131.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.46,82.6,,138.77,,,0,"percent of total billed charges","82.6% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,105,50,,84.00,,,0,"percent of total billed charges","50% of total billed charges",173.46,82.6,,138.77,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",14.76,210,
"88381 Manual Microdissection",30188381,CDM,301,RC,88381,CPT,OUTPATIENT,,,383,248.95,,337.04,88,,269.63,,,0,"percent of total billed charges","88% of total billed charges",191.5,50,,153.20,,,0,"percent of total billed charges","50% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,383,100,,306.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",241.29,63,,193.03,,,0,"percent of total billed charges","63% of total billed charges",58.6,15.3,,46.88,,,0,"percent of total billed charges","15.3% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,264.27,69,,,,,0,"fee schedule","69% of total billed charges",383,100,,306.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",383,100,,306.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",383,100,,306.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",236.89,61.85,,189.51,,,0,"percent of total billed charges","61.5% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,191.5,50,,153.20,,,0,"percent of total billed charges","50% of total billed charges",123.33,32.2,,98.66,,,0,"percent of total billed charges","32.2% of total billed charges",14.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",20.32,100,,,,,0,"fee schedule",EAPG,25.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",144.39,37.7,,115.51,,,0,"percent of total billed charges","37.7% of total billed charges",144.39,37.7,,115.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.84,33.9,,103.87,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.74,78,,238.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",316.36,82.6,,253.09,,,0,"percent of total billed charges","82.6% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,191.5,50,,153.20,,,0,"percent of total billed charges","50% of total billed charges",316.36,82.6,,253.09,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,383,100,,306.40,,,0,"percent of total billed charges","100% of total billed charges",14.76,383,
"Small Bowel follow through",32074248,CDM,320,RC,74248,CPT,OUTPATIENT,,,2467,1603.55,TC,2170.96,88,,1736.77,,,0,"percent of total billed charges","88% of total billed charges",1233.5,50,,986.80,,,0,"percent of total billed charges","50% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,2467,100,,1973.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.02,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1554.21,63,,1243.37,,,0,"percent of total billed charges","63% of total billed charges",377.45,15.3,,301.96,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,1702.23,69,,,,,0,"fee schedule","69% of total billed charges",2467,100,,1973.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2467,100,,1973.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2467,100,,1973.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1525.84,61.85,,1220.67,,,0,"percent of total billed charges","61.5% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,1233.5,50,,986.80,,,0,"percent of total billed charges","50% of total billed charges",794.37,32.2,,635.50,,,0,"percent of total billed charges","32.2% of total billed charges",80.56,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",930.06,37.7,,744.05,,,0,"percent of total billed charges","37.7% of total billed charges",930.06,37.7,,744.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",836.31,33.9,,669.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1924.26,78,,1539.41,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2037.74,82.6,,1630.19,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,1233.5,50,,986.80,,,0,"percent of total billed charges","50% of total billed charges",2037.74,82.6,,1630.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",108.76,100,,,,,0,"fee schedule",EAPG,2467,100,,1973.60,,,0,"percent of total billed charges","100% of total billed charges",80.56,2467,
"ALLERGEN INDIVIDUAL",30286003,CDM,302,RC,86003,CPT,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",9.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.96,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.22,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.7% of total billed charges",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.07,33.9,,3.26,,,0,"percent of total billed charges","33.9% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",5.27,101,,,,,0,"fee schedule","101% of CMS fee schedule ",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,19.96,
"Anaerobic Culture",30687075,CDM,306,RC,87075,CPT,OUTPATIENT,,,225,146.25,,198,88,,158.40,,,0,"percent of total billed charges","88% of total billed charges",9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,225,100,,180.00,,,0,"percent of total billed charges","100% of total billed charges",16.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",141.75,63,,113.40,,,0,"percent of total billed charges","63% of total billed charges",34.43,15.3,,27.54,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,155.25,69,,,,,0,"fee schedule","69% of total billed charges",225,100,,180.00,,,0,"percent of total billed charges","100% of total billed charges",9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",225,100,,180.00,,,0,"percent of total billed charges","100% of total billed charges",9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",225,100,,180.00,,,0,"percent of total billed charges","100% of total billed charges",9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.22,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.47,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",84.83,37.7,,67.86,,,0,"percent of total billed charges","37.7% of total billed charges",84.83,37.7,,67.86,,,0,"percent of total billed charges","37.70% of total billed charges",9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.28,33.9,,61.02,,,0,"percent of total billed charges","33.9% of total billed charges",9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",175.5,78,,140.40,,,0,"percent of total billed charges","78% of total billed charges",9.56,101,,,,,0,"fee schedule","101% of CMS fee schedule ",185.85,82.6,,148.68,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",185.85,82.6,,148.68,,,0,"percent of total billed charges","82.6% of total billed charges",9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,225,100,,180.00,,,0,"percent of total billed charges","100% of total billed charges",4.81,225,
"CORTISOL STIM ADD",30082533,CDM,300,RC,82533,CPT,OUTPATIENT,,,388,252.2,,341.44,88,,273.15,,,0,"percent of total billed charges","88% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",28.52,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",244.44,63,,195.55,,,0,"percent of total billed charges","63% of total billed charges",59.36,15.3,,47.49,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,267.72,69,,,,,0,"fee schedule","69% of total billed charges",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.3,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",146.28,37.7,,117.02,,,0,"percent of total billed charges","37.7% of total billed charges",146.28,37.7,,117.02,,,0,"percent of total billed charges","37.70% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",131.53,33.9,,105.22,,,0,"percent of total billed charges","33.9% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",302.64,78,,242.11,,,0,"percent of total billed charges","78% of total billed charges",16.46,101,,,,,0,"fee schedule","101% of CMS fee schedule ",320.49,82.6,,256.39,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",320.49,82.6,,256.39,,,0,"percent of total billed charges","82.6% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",8.39,388,
"CT ABDOMEN W/W/O CONT",35274170,CDM,352,RC,74170,CPT,OUTPATIENT,,,5754,3740.1,TC,5063.52,88,,4050.82,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3625.02,63,,2900.02,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,3970.26,69,,,,,0,"fee schedule","69% of total billed charges",5754,100,,4603.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5754,100,,4603.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5754,100,,4603.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2169.26,37.7,,1735.41,,,0,"percent of total billed charges","37.7% of total billed charges",2169.26,37.7,,1735.41,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1950.61,33.9,,1560.49,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4488.12,78,,3590.50,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4752.8,82.6,,3802.24,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4752.8,82.6,,3802.24,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,5754,100,,4603.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,5754,
"CT ABDOMEN W/CONTRAST",35274160,CDM,352,RC,74160,CPT,OUTPATIENT,,,4846,3149.9,TC,4264.48,88,,3411.58,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3052.98,63,,2442.38,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,3343.74,69,,,,,0,"fee schedule","69% of total billed charges",4846,100,,3876.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4846,100,,3876.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4846,100,,3876.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1826.94,37.7,,1461.55,,,0,"percent of total billed charges","37.7% of total billed charges",1826.94,37.7,,1461.55,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1642.79,33.9,,1314.23,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3779.88,78,,3023.90,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4002.8,82.6,,3202.24,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4002.8,82.6,,3202.24,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4846,100,,3876.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,4846,
"CT ABDOMEN W/O CONTRAST",35274150,CDM,352,RC,74150,CPT,OUTPATIENT,,,3375,2193.75,TC,2970,88,,2376.00,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,3375,100,,2700.00,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",108.24,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2126.25,63,,1701.00,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",105.09,100,,,,,0,"fee schedule",EAPG,2328.75,69,,,,,0,"fee schedule","69% of total billed charges",3375,100,,2700.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3375,100,,2700.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3375,100,,2700.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.84,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.19,100,,,,,0,"fee schedule",EAPG,136.62,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1272.38,37.7,,1017.90,,,0,"percent of total billed charges","37.7% of total billed charges",1272.38,37.7,,1017.90,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1144.13,33.9,,915.30,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2632.5,78,,2106.00,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2787.75,82.6,,2230.20,,,0,"percent of total billed charges","82.6% of total billed charges",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2787.75,82.6,,2230.20,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,3375,100,,2700.00,,,0,"percent of total billed charges","100% of total billed charges",77.84,3375,
"CT Abdomen/Pelvis w/ + w/o Contrast",35274178,CDM,352,RC,74178,CPT,OUTPATIENT,,,9200,5980,TC,8096,88,,6476.80,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5796,63,,4636.80,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,6348,69,,,,,0,"fee schedule","69% of total billed charges",9200,100,,7360.00,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9200,100,,7360.00,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9200,100,,7360.00,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3468.4,37.7,,2774.72,,,0,"percent of total billed charges","37.7% of total billed charges",3468.4,37.7,,2774.72,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3118.8,33.9,,2495.04,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7176,78,,5740.80,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7599.2,82.6,,6079.36,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7599.2,82.6,,6079.36,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,9200,100,,7360.00,,,0,"percent of total billed charges","100% of total billed charges",210.9,9200,
"CT ABD  PELVIS W/CONTRAST",35274177,CDM,352,RC,74177,CPT,OUTPATIENT,,,8590,5583.5,TC,7559.2,88,,6047.36,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5411.7,63,,4329.36,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,5927.1,69,,,,,0,"fee schedule","69% of total billed charges",8590,100,,6872.00,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8590,100,,6872.00,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8590,100,,6872.00,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3238.43,37.7,,2590.74,,,0,"percent of total billed charges","37.7% of total billed charges",3238.43,37.7,,2590.74,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2912.01,33.9,,2329.61,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6700.2,78,,5360.16,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7095.34,82.6,,5676.27,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7095.34,82.6,,5676.27,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,8590,100,,6872.00,,,0,"percent of total billed charges","100% of total billed charges",210.9,8590,
"CT ABD  PELVIS W/O CONTRAST",35274176,CDM,352,RC,74176,CPT,OUTPATIENT,,,5953,3869.45,TC,5238.64,88,,4190.91,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3750.39,63,,3000.31,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,4107.57,69,,,,,0,"fee schedule","69% of total billed charges",5953,100,,4762.40,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5953,100,,4762.40,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5953,100,,4762.40,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2244.28,37.7,,1795.42,,,0,"percent of total billed charges","37.7% of total billed charges",2244.28,37.7,,1795.42,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2018.07,33.9,,1614.46,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4643.34,78,,3714.67,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4917.18,82.6,,3933.74,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4917.18,82.6,,3933.74,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,5953,100,,4762.40,,,0,"percent of total billed charges","100% of total billed charges",210.9,5953,
"CTA AORTA W/RUNOFFS WW/O CONT",35275635,CDM,352,RC,75635,CPT,OUTPATIENT,,,8438,5484.7,TC,7425.44,88,,5940.35,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.95,175,,,,,0,"fee schedule","175% of CMS fee schedule",359.04,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5315.94,63,,4252.75,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",348.58,100,,,,,0,"fee schedule",EAPG,5822.22,69,,,,,0,"fee schedule","69% of total billed charges",8438,100,,6750.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8438,100,,6750.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8438,100,,6750.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",258.21,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.55,100,,,,,0,"fee schedule",EAPG,453.15,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3181.13,37.7,,2544.90,,,0,"percent of total billed charges","37.7% of total billed charges",3181.13,37.7,,2544.90,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2860.48,33.9,,2288.38,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6581.64,78,,5265.31,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6969.79,82.6,,5575.83,,,0,"percent of total billed charges","82.6% of total billed charges",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6969.79,82.6,,5575.83,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,8438,100,,6750.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,8438,
"CTA NECK WW/O CONTRAST",35170498,CDM,351,RC,70498,CPT,OUTPATIENT,,,5530,3594.5,TC,4866.4,88,,3893.12,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",359.04,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3483.9,63,,2787.12,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",348.58,100,,,,,0,"fee schedule",EAPG,3815.7,69,,,,,0,"fee schedule","69% of total billed charges",5530,100,,4424.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5530,100,,4424.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5530,100,,4424.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",258.21,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.55,100,,,,,0,"fee schedule",EAPG,453.15,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2084.81,37.7,,1667.85,,,0,"percent of total billed charges","37.7% of total billed charges",2084.81,37.7,,1667.85,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1874.67,33.9,,1499.74,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4313.4,78,,3450.72,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4567.78,82.6,,3654.22,,,0,"percent of total billed charges","82.6% of total billed charges",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4567.78,82.6,,3654.22,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,5530,100,,4424.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,5530,
"CT Angio Abdomen and Pelvis",35274174,CDM,352,RC,74174,CPT,OUTPATIENT,,,4062,2640.3,TC,3574.56,88,,2859.65,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,4062,100,,3249.60,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",359.04,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2559.06,63,,2047.25,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",348.58,100,,,,,0,"fee schedule",EAPG,2802.78,69,,,,,0,"fee schedule","69% of total billed charges",4062,100,,3249.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4062,100,,3249.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4062,100,,3249.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",258.21,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.55,100,,,,,0,"fee schedule",EAPG,453.15,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1531.37,37.7,,1225.10,,,0,"percent of total billed charges","37.7% of total billed charges",1531.37,37.7,,1225.10,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1377.02,33.9,,1101.62,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3168.36,78,,2534.69,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3355.21,82.6,,2684.17,,,0,"percent of total billed charges","82.6% of total billed charges",348.58,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3355.21,82.6,,2684.17,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,4062,100,,3249.60,,,0,"percent of total billed charges","100% of total billed charges",258.21,4062,
"CT CHEST WW/O CONTRAST",35271270,CDM,352,RC,71270,CPT,OUTPATIENT,,,6287,4086.55,TC,5532.56,88,,4426.05,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3960.81,63,,3168.65,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,4338.03,69,,,,,0,"fee schedule","69% of total billed charges",6287,100,,5029.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6287,100,,5029.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6287,100,,5029.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2370.2,37.7,,1896.16,,,0,"percent of total billed charges","37.7% of total billed charges",2370.2,37.7,,1896.16,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2131.29,33.9,,1705.03,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4903.86,78,,3923.09,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5193.06,82.6,,4154.45,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5193.06,82.6,,4154.45,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,6287,100,,5029.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,6287,
"CT CHEST W CONTRAST",35271260,CDM,352,RC,71260,CPT,OUTPATIENT,,,4964,3226.6,TC,4368.32,88,,3494.66,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3127.32,63,,2501.86,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,3425.16,69,,,,,0,"fee schedule","69% of total billed charges",4964,100,,3971.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4964,100,,3971.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4964,100,,3971.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1871.43,37.7,,1497.14,,,0,"percent of total billed charges","37.7% of total billed charges",1871.43,37.7,,1497.14,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1682.8,33.9,,1346.24,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3871.92,78,,3097.54,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.26,82.6,,3280.21,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.26,82.6,,3280.21,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4964,100,,3971.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,4964,
"CT CHEST WO CONTRAST",35271250,CDM,352,RC,71250,CPT,OUTPATIENT,,,3547,2305.55,TC,3121.36,88,,2497.09,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,3547,100,,2837.60,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",108.24,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2234.61,63,,1787.69,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",105.09,100,,,,,0,"fee schedule",EAPG,2447.43,69,,,,,0,"fee schedule","69% of total billed charges",3547,100,,2837.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3547,100,,2837.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3547,100,,2837.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.84,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.19,100,,,,,0,"fee schedule",EAPG,136.62,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1337.22,37.7,,1069.78,,,0,"percent of total billed charges","37.7% of total billed charges",1337.22,37.7,,1069.78,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1202.43,33.9,,961.94,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2766.66,78,,2213.33,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2929.82,82.6,,2343.86,,,0,"percent of total billed charges","82.6% of total billed charges",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2929.82,82.6,,2343.86,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,3547,100,,2837.60,,,0,"percent of total billed charges","100% of total billed charges",77.84,3547,
"CT MAXILLOFACIAL W/W/O CO",35170488,CDM,351,RC,70488,CPT,OUTPATIENT,,,2898,1883.7,TC,2550.24,88,,2040.19,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,2898,100,,2318.40,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1825.74,63,,1460.59,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,1999.62,69,,,,,0,"fee schedule","69% of total billed charges",2898,100,,2318.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2898,100,,2318.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2898,100,,2318.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1092.55,37.7,,874.04,,,0,"percent of total billed charges","37.7% of total billed charges",1092.55,37.7,,874.04,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",982.42,33.9,,785.94,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2260.44,78,,1808.35,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2393.75,82.6,,1915.00,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2393.75,82.6,,1915.00,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,2898,100,,2318.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,2898,
"CT MAXILLOFACIAL W/CONT",35170487,CDM,351,RC,70487,CPT,OUTPATIENT,,,2731,1775.15,TC,2403.28,88,,1922.62,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,2731,100,,2184.80,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1720.53,63,,1376.42,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,1884.39,69,,,,,0,"fee schedule","69% of total billed charges",2731,100,,2184.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2731,100,,2184.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2731,100,,2184.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1029.59,37.7,,823.67,,,0,"percent of total billed charges","37.7% of total billed charges",1029.59,37.7,,823.67,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",925.81,33.9,,740.65,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2130.18,78,,1704.14,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2255.81,82.6,,1804.65,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2255.81,82.6,,1804.65,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,2731,100,,2184.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,2731,
"CT MAXILLOFACIAL W/O CONT",35170480,CDM,351,RC,70480,CPT,OUTPATIENT,,,4021,2613.65,TC,3538.48,88,,2830.78,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,4021,100,,3216.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",108.24,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2533.23,63,,2026.58,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",105.09,100,,,,,0,"fee schedule",EAPG,2774.49,69,,,,,0,"fee schedule","69% of total billed charges",4021,100,,3216.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4021,100,,3216.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4021,100,,3216.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.84,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.19,100,,,,,0,"fee schedule",EAPG,136.62,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1515.92,37.7,,1212.74,,,0,"percent of total billed charges","37.7% of total billed charges",1515.92,37.7,,1212.74,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1363.12,33.9,,1090.50,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3136.38,78,,2509.10,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3321.35,82.6,,2657.08,,,0,"percent of total billed charges","82.6% of total billed charges",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3321.35,82.6,,2657.08,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,4021,100,,3216.80,,,0,"percent of total billed charges","100% of total billed charges",77.84,4021,
"CT NECK W/W/O CONTRAST",35170492,CDM,351,RC,70492,CPT,OUTPATIENT,,,4490,2918.5,TC,3951.2,88,,3160.96,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4490,100,,3592.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2828.7,63,,2262.96,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,3098.1,69,,,,,0,"fee schedule","69% of total billed charges",4490,100,,3592.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4490,100,,3592.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4490,100,,3592.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1692.73,37.7,,1354.18,,,0,"percent of total billed charges","37.7% of total billed charges",1692.73,37.7,,1354.18,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1522.11,33.9,,1217.69,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3502.2,78,,2801.76,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3708.74,82.6,,2966.99,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3708.74,82.6,,2966.99,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4490,100,,3592.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,4490,
"CT NECK W/CONTRAST",35170491,CDM,351,RC,70491,CPT,OUTPATIENT,,,4214,2739.1,TC,3708.32,88,,2966.66,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4214,100,,3371.20,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2654.82,63,,2123.86,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,2907.66,69,,,,,0,"fee schedule","69% of total billed charges",4214,100,,3371.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4214,100,,3371.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4214,100,,3371.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1588.68,37.7,,1270.94,,,0,"percent of total billed charges","37.7% of total billed charges",1588.68,37.7,,1270.94,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1428.55,33.9,,1142.84,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.92,78,,2629.54,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3480.76,82.6,,2784.61,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3480.76,82.6,,2784.61,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4214,100,,3371.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,4214,
"CT NECK W/O CONTRAST",35170490,CDM,351,RC,70490,CPT,OUTPATIENT,,,3245,2109.25,TC,2855.6,88,,2284.48,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,3245,100,,2596.00,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",108.24,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2044.35,63,,1635.48,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",105.09,100,,,,,0,"fee schedule",EAPG,2239.05,69,,,,,0,"fee schedule","69% of total billed charges",3245,100,,2596.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3245,100,,2596.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3245,100,,2596.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.84,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.19,100,,,,,0,"fee schedule",EAPG,136.62,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1223.37,37.7,,978.70,,,0,"percent of total billed charges","37.7% of total billed charges",1223.37,37.7,,978.70,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1100.06,33.9,,880.05,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2531.1,78,,2024.88,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2680.37,82.6,,2144.30,,,0,"percent of total billed charges","82.6% of total billed charges",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2680.37,82.6,,2144.30,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,3245,100,,2596.00,,,0,"percent of total billed charges","100% of total billed charges",77.84,3245,
Calcium,30082310,CDM,300,RC,82310,CPT,OUTPATIENT,,,88,57.2,,77.44,88,,61.95,,,0,"percent of total billed charges","88% of total billed charges",5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",9.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.44,63,,44.35,,,0,"percent of total billed charges","63% of total billed charges",13.46,15.3,,10.77,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,60.72,69,,,,,0,"fee schedule","69% of total billed charges",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.73,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.16,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.18,37.7,,26.54,,,0,"percent of total billed charges","37.7% of total billed charges",33.18,37.7,,26.54,,,0,"percent of total billed charges","37.70% of total billed charges",5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.83,33.9,,23.86,,,0,"percent of total billed charges","33.9% of total billed charges",5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.64,78,,54.91,,,0,"percent of total billed charges","78% of total billed charges",5.21,101,,,,,0,"fee schedule","101% of CMS fee schedule ",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,88,
"Creatinine Urine",30082570,CDM,300,RC,82570,CPT,OUTPATIENT,,,78,50.7,,68.64,88,,54.91,,,0,"percent of total billed charges","88% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",9.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.14,63,,39.31,,,0,"percent of total billed charges","63% of total billed charges",11.93,15.3,,9.54,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,53.82,69,,,,,0,"fee schedule","69% of total billed charges",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.81,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.41,37.7,,23.53,,,0,"percent of total billed charges","37.7% of total billed charges",29.41,37.7,,23.53,,,0,"percent of total billed charges","37.70% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.44,33.9,,21.15,,,0,"percent of total billed charges","33.9% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.84,78,,48.67,,,0,"percent of total billed charges","78% of total billed charges",5.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,78,
"E5621 Pooled Cryo",390P9012,CDM,390,RC,,,OUTPATIENT,,,200,130,,176,88,,140.80,,,0,"percent of total billed charges","88% of total billed charges",100,50,,80.00,,,0,"percent of total billed charges","50% of total billed charges",33.6,16.8,,26.88,,,0,"percent of total billed charges","16.8% of total billed charges",200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,17.304,,27.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126,63,,100.80,,,0,"percent of total billed charges","63% of total billed charges",30.6,15.3,,24.48,,,0,"percent of total billed charges","15.3% of total billed charges",33.6,16.8,,26.88,,,0,"percent of total billed charges","16.8% of total billed charges",138,69,,,,,0,"fee schedule","69% of total billed charges",200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",123.7,61.85,,98.96,,,0,"percent of total billed charges","61.5% of total billed charges",33.6,16.8,,26.88,,,0,"percent of total billed charges","16.8% of total billed charges",100,50,,80.00,,,0,"percent of total billed charges","50% of total billed charges",64.4,32.2,,51.52,,,0,"percent of total billed charges","32.2% of total billed charges",33.6,16.8,,26.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.27,17.136,,27.42,,,0,"percent of total billed charges","17.136% of total billed charges",43.68,21.84,,34.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.4,37.7,,60.32,,,0,"percent of total billed charges","37.7% of total billed charges",75.4,37.7,,60.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.8,33.9,,54.24,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",156,78,,124.80,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.2,82.6,,132.16,,,0,"percent of total billed charges","82.6% of total billed charges",33.6,16.8,,26.88,,,0,"percent of total billed charges","16.8% of total billed charges",100,50,,80.00,,,0,"percent of total billed charges","50% of total billed charges",165.2,82.6,,132.16,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.6,16.8,,26.88,,,0,"percent of total billed charges","16.8% of total billed charges",200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",30.6,200,
"IgG LC",30083516,CDM,300,RC,83516,CPT,OUTPATIENT,,,246,159.9,,216.48,88,,173.18,,,0,"percent of total billed charges","88% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",20.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",37.64,15.3,,30.11,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,169.74,69,,,,,0,"fee schedule","69% of total billed charges",246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.53,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.74,37.7,,74.19,,,0,"percent of total billed charges","37.7% of total billed charges",92.74,37.7,,74.19,,,0,"percent of total billed charges","37.70% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",83.39,33.9,,66.71,,,0,"percent of total billed charges","33.9% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",191.88,78,,153.50,,,0,"percent of total billed charges","78% of total billed charges",11.64,101,,,,,0,"fee schedule","101% of CMS fee schedule ",203.2,82.6,,162.56,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",203.2,82.6,,162.56,,,0,"percent of total billed charges","82.6% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",8.11,246,
"Influenza B",30087804,CDM,300,RC,87804,CPT,OUTPATIENT,,,142,92.3,59,124.96,88,,99.97,,,0,"percent of total billed charges","88% of total billed charges",16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",28.96,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.46,63,,71.57,,,0,"percent of total billed charges","63% of total billed charges",21.73,15.3,,17.38,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,97.98,69,,,,,0,"fee schedule","69% of total billed charges",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.3,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.55,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.53,37.7,,42.82,,,0,"percent of total billed charges","37.7% of total billed charges",53.53,37.7,,42.82,,,0,"percent of total billed charges","37.70% of total billed charges",16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.14,33.9,,38.51,,,0,"percent of total billed charges","33.9% of total billed charges",16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",110.76,78,,88.61,,,0,"percent of total billed charges","78% of total billed charges",16.71,101,,,,,0,"fee schedule","101% of CMS fee schedule ",117.29,82.6,,93.83,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",117.29,82.6,,93.83,,,0,"percent of total billed charges","82.6% of total billed charges",16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",4.81,142,
Iron,30083540,CDM,300,RC,83540,CPT,OUTPATIENT,,,136,88.4,,119.68,88,,95.74,,,0,"percent of total billed charges","88% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",11.32,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.68,63,,68.54,,,0,"percent of total billed charges","63% of total billed charges",20.81,15.3,,16.65,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,93.84,69,,,,,0,"fee schedule","69% of total billed charges",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.74,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.47,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.27,37.7,,41.02,,,0,"percent of total billed charges","37.7% of total billed charges",51.27,37.7,,41.02,,,0,"percent of total billed charges","37.70% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.1,33.9,,36.88,,,0,"percent of total billed charges","33.9% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.08,78,,84.86,,,0,"percent of total billed charges","78% of total billed charges",6.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",112.34,82.6,,89.87,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",112.34,82.6,,89.87,,,0,"percent of total billed charges","82.6% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",3.25,136,
"MG Tomo Diagnostic Bilat",40177062,CDM,401,RC,77062,CPT,OUTPATIENT,,,147,95.55,TC,129.36,88,,103.49,,,0,"percent of total billed charges","88% of total billed charges",73.5,50,,58.80,,,0,"percent of total billed charges","50% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",92.61,63,,74.09,,,0,"percent of total billed charges","63% of total billed charges",22.49,15.3,,17.99,,,0,"percent of total billed charges","15.3% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,101.43,69,,,,,0,"fee schedule","69% of total billed charges",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.92,61.85,,72.74,,,0,"percent of total billed charges","61.5% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,73.5,50,,58.80,,,0,"percent of total billed charges","50% of total billed charges",47.33,32.2,,37.86,,,0,"percent of total billed charges","32.2% of total billed charges",33.79,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",46.53,100,,,,,0,"fee schedule",EAPG,59.31,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",55.42,37.7,,44.34,,,0,"percent of total billed charges","37.7% of total billed charges",55.42,37.7,,44.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.83,33.9,,39.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.66,78,,91.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",121.42,82.6,,97.14,,,0,"percent of total billed charges","82.6% of total billed charges",45.62,100,,,,,0,"fee schedule","100% of WA fee schedule",73.5,50,,58.80,,,0,"percent of total billed charges","50% of total billed charges",121.42,82.6,,97.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.62,100,,,,,0,"fee schedule",EAPG,147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",22.49,147,
"MG Tomo Diagnostic Unilat",40177061,CDM,401,RC,77061,CPT,OUTPATIENT,,,147,95.55,TC,129.36,88,,103.49,,,0,"percent of total billed charges","88% of total billed charges",73.5,50,,58.80,,,0,"percent of total billed charges","50% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",92.61,63,,74.09,,,0,"percent of total billed charges","63% of total billed charges",22.49,15.3,,17.99,,,0,"percent of total billed charges","15.3% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,101.43,69,,,,,0,"fee schedule","69% of total billed charges",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.92,61.85,,72.74,,,0,"percent of total billed charges","61.5% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,73.5,50,,58.80,,,0,"percent of total billed charges","50% of total billed charges",47.33,32.2,,37.86,,,0,"percent of total billed charges","32.2% of total billed charges",33.79,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",46.53,100,,,,,0,"fee schedule",EAPG,59.31,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",55.42,37.7,,44.34,,,0,"percent of total billed charges","37.7% of total billed charges",55.42,37.7,,44.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.83,33.9,,39.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.66,78,,91.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",121.42,82.6,,97.14,,,0,"percent of total billed charges","82.6% of total billed charges",45.62,100,,,,,0,"fee schedule","100% of WA fee schedule",73.5,50,,58.80,,,0,"percent of total billed charges","50% of total billed charges",121.42,82.6,,97.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.62,100,,,,,0,"fee schedule",EAPG,147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",22.49,147,
"MG Tomo Screening",40377063,CDM,403,RC,77063,CPT,OUTPATIENT,,,216,140.4,TC,190.08,88,,152.06,,,0,"percent of total billed charges","88% of total billed charges",24.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,216,100,,172.80,,,0,"percent of total billed charges","100% of total billed charges",43.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",46.99,100,,,,,0,"fee schedule",EAPG,24.92,100,,,,,0,"fee schedule","100% of CMS fee sv",136.08,63,,108.86,,,0,"percent of total billed charges","63% of total billed charges",33.05,15.3,,26.44,,,0,"percent of total billed charges","15.3% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,149.04,69,,,,,0,"fee schedule","69% of total billed charges",216,100,,172.80,,,0,"percent of total billed charges","100% of total billed charges",24.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",216,100,,172.80,,,0,"percent of total billed charges","100% of total billed charges",24.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",216,100,,172.80,,,0,"percent of total billed charges","100% of total billed charges",24.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.76,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,24.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.3,100,,,,,0,"fee schedule","100% of LI fee schedule",33.79,100,,,,,0,"fee schedule",EAPG,24.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.53,100,,,,,0,"fee schedule",EAPG,59.31,100,,,,,0,"fee schedule",EAPG,24.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.43,37.7,,65.14,,,0,"percent of total billed charges","37.7% of total billed charges",81.43,37.7,,65.14,,,0,"percent of total billed charges","37.70% of total billed charges",24.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.22,33.9,,58.58,,,0,"percent of total billed charges","33.9% of total billed charges",24.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",168.48,78,,134.78,,,0,"percent of total billed charges","78% of total billed charges",25.17,101,,,,,0,"fee schedule","101% of CMS fee schedule ",178.42,82.6,,142.74,,,0,"percent of total billed charges","82.6% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,24.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",178.42,82.6,,142.74,,,0,"percent of total billed charges","82.6% of total billed charges",24.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,216,100,,172.80,,,0,"percent of total billed charges","100% of total billed charges",24.3,216,
"WBC Diff Only",30585007,CDM,305,RC,85007,CPT,OUTPATIENT,,,62,40.3,,54.56,88,,43.65,,,0,"percent of total billed charges","88% of total billed charges",3.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",6.65,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.23,100,,,,,0,"fee schedule",EAPG,3.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.06,63,,31.25,,,0,"percent of total billed charges","63% of total billed charges",9.49,15.3,,7.59,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,42.78,69,,,,,0,"fee schedule","69% of total billed charges",62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",3.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",3.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",3.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.53,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,3.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.8,100,,,,,0,"fee schedule","100% of LI fee schedule",3.76,100,,,,,0,"fee schedule",EAPG,3.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,3.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.37,37.7,,18.70,,,0,"percent of total billed charges","37.7% of total billed charges",23.37,37.7,,18.70,,,0,"percent of total billed charges","37.70% of total billed charges",3.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.02,33.9,,16.82,,,0,"percent of total billed charges","33.9% of total billed charges",3.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.36,78,,38.69,,,0,"percent of total billed charges","78% of total billed charges",3.83,101,,,,,0,"fee schedule","101% of CMS fee schedule ",51.21,82.6,,40.97,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,3.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.21,82.6,,40.97,,,0,"percent of total billed charges","82.6% of total billed charges",3.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",3.76,62,
"Protoporphyrin (FEP/ZPP)",30184202,CDM,301,RC,84202,CPT,OUTPATIENT,,,234,152.1,,205.92,88,,164.74,,,0,"percent of total billed charges","88% of total billed charges",14.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",25.11,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,14.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",147.42,63,,117.94,,,0,"percent of total billed charges","63% of total billed charges",35.8,15.3,,28.64,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,161.46,69,,,,,0,"fee schedule","69% of total billed charges",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",14.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",14.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",14.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.88,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,14.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.35,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,14.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,14.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.22,37.7,,70.58,,,0,"percent of total billed charges","37.7% of total billed charges",88.22,37.7,,70.58,,,0,"percent of total billed charges","37.70% of total billed charges",14.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.33,33.9,,63.46,,,0,"percent of total billed charges","33.9% of total billed charges",14.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",182.52,78,,146.02,,,0,"percent of total billed charges","78% of total billed charges",14.49,101,,,,,0,"fee schedule","101% of CMS fee schedule ",193.28,82.6,,154.62,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,14.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",193.28,82.6,,154.62,,,0,"percent of total billed charges","82.6% of total billed charges",14.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",8.11,234,
"SHIGA TOXIN 2",30687899,CDM,306,RC,87899,CPT,OUTPATIENT,,,65,42.25,,57.2,88,,45.76,,,0,"percent of total billed charges","88% of total billed charges",16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",28.12,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.95,63,,32.76,,,0,"percent of total billed charges","63% of total billed charges",9.95,15.3,,7.96,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,44.85,69,,,,,0,"fee schedule","69% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.46,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.07,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.51,37.7,,19.61,,,0,"percent of total billed charges","37.7% of total billed charges",24.51,37.7,,19.61,,,0,"percent of total billed charges","37.70% of total billed charges",16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.04,33.9,,17.63,,,0,"percent of total billed charges","33.9% of total billed charges",16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.7,78,,40.56,,,0,"percent of total billed charges","78% of total billed charges",16.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",4.81,65,
"Testosterone Total",30084403,CDM,300,RC,84403,CPT,OUTPATIENT,,,428,278.2,,376.64,88,,301.31,,,0,"percent of total billed charges","88% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,428,100,,342.40,,,0,"percent of total billed charges","100% of total billed charges",45.16,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",269.64,63,,215.71,,,0,"percent of total billed charges","63% of total billed charges",65.48,15.3,,52.38,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,295.32,69,,,,,0,"fee schedule","69% of total billed charges",428,100,,342.40,,,0,"percent of total billed charges","100% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",428,100,,342.40,,,0,"percent of total billed charges","100% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",428,100,,342.40,,,0,"percent of total billed charges","100% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.72,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.81,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",161.36,37.7,,129.09,,,0,"percent of total billed charges","37.7% of total billed charges",161.36,37.7,,129.09,,,0,"percent of total billed charges","37.70% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",145.09,33.9,,116.07,,,0,"percent of total billed charges","33.9% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",333.84,78,,267.07,,,0,"percent of total billed charges","78% of total billed charges",26.06,101,,,,,0,"fee schedule","101% of CMS fee schedule ",353.53,82.6,,282.82,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",353.53,82.6,,282.82,,,0,"percent of total billed charges","82.6% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,428,100,,342.40,,,0,"percent of total billed charges","100% of total billed charges",8.39,428,
"Total Iron Binding Capacity",30083550,CDM,300,RC,83550,CPT,OUTPATIENT,,,182,118.3,,160.16,88,,128.13,,,0,"percent of total billed charges","88% of total billed charges",8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",15.29,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",114.66,63,,91.73,,,0,"percent of total billed charges","63% of total billed charges",27.85,15.3,,22.28,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,125.58,69,,,,,0,"fee schedule","69% of total billed charges",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.43,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.74,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.61,37.7,,54.89,,,0,"percent of total billed charges","37.7% of total billed charges",68.61,37.7,,54.89,,,0,"percent of total billed charges","37.70% of total billed charges",8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.7,33.9,,49.36,,,0,"percent of total billed charges","33.9% of total billed charges",8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",141.96,78,,113.57,,,0,"percent of total billed charges","78% of total billed charges",8.82,101,,,,,0,"fee schedule","101% of CMS fee schedule ",150.33,82.6,,120.26,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.33,82.6,,120.26,,,0,"percent of total billed charges","82.6% of total billed charges",8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,182,
"US ABDOMEN LIMITED",40276705,CDM,402,RC,76705,CPT,OUTPATIENT,,,594,386.1,TC,522.72,88,,418.18,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,594,100,,475.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",374.22,63,,299.38,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,409.86,69,,,,,0,"fee schedule","69% of total billed charges",594,100,,475.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",594,100,,475.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",594,100,,475.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",223.94,37.7,,179.15,,,0,"percent of total billed charges","37.7% of total billed charges",223.94,37.7,,179.15,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",201.37,33.9,,161.10,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",463.32,78,,370.66,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",490.64,82.6,,392.51,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",490.64,82.6,,392.51,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,594,100,,475.20,,,0,"percent of total billed charges","100% of total billed charges",73.81,594,
"ULTRASOUND BIOPHYSICAL PROFILE",40276818,CDM,402,RC,76818,CPT,OUTPATIENT,,,551,358.15,TC,484.88,88,,387.90,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.6,100,,,,,0,"fee schedule",EAPG,551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",94.35,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",347.13,63,,277.70,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",91.6,100,,,,,0,"fee schedule",EAPG,380.19,69,,,,,0,"fee schedule","69% of total billed charges",551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.6,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",67.85,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",93.43,100,,,,,0,"fee schedule",EAPG,119.08,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",207.73,37.7,,166.18,,,0,"percent of total billed charges","37.7% of total billed charges",207.73,37.7,,166.18,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",186.79,33.9,,149.43,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",429.78,78,,343.82,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",455.13,82.6,,364.10,,,0,"percent of total billed charges","82.6% of total billed charges",91.6,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",455.13,82.6,,364.10,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.6,100,,,,,0,"fee schedule",EAPG,551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",67.85,551,
"Urine Creatinine",30182570,CDM,301,RC,82570,CPT,OUTPATIENT,,,78,50.7,,68.64,88,,54.91,,,0,"percent of total billed charges","88% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",9.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.14,63,,39.31,,,0,"percent of total billed charges","63% of total billed charges",11.93,15.3,,9.54,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,53.82,69,,,,,0,"fee schedule","69% of total billed charges",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.81,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.41,37.7,,23.53,,,0,"percent of total billed charges","37.7% of total billed charges",29.41,37.7,,23.53,,,0,"percent of total billed charges","37.70% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.44,33.9,,21.15,,,0,"percent of total billed charges","33.9% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.84,78,,48.67,,,0,"percent of total billed charges","78% of total billed charges",5.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,78,
"West Nile Virus EIA IgM LC",30286788,CDM,302,RC,86788,CPT,OUTPATIENT,,,163,105.95,,143.44,88,,114.75,,,0,"percent of total billed charges","88% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",29.48,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",102.69,63,,82.15,,,0,"percent of total billed charges","63% of total billed charges",24.94,15.3,,19.95,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,112.47,69,,,,,0,"fee schedule","69% of total billed charges",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.45,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.85,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.45,37.7,,49.16,,,0,"percent of total billed charges","37.7% of total billed charges",61.45,37.7,,49.16,,,0,"percent of total billed charges","37.70% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.26,33.9,,44.21,,,0,"percent of total billed charges","33.9% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",127.14,78,,101.71,,,0,"percent of total billed charges","78% of total billed charges",17.01,101,,,,,0,"fee schedule","101% of CMS fee schedule ",134.64,82.6,,107.71,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.64,82.6,,107.71,,,0,"percent of total billed charges","82.6% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",6.96,163,
"XR Hysterosalpingogram S and I",74740,CDM,320,RC,74740,CPT,OUTPATIENT,,,871,566.15,TC,766.48,88,,613.18,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,871,100,,696.80,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",548.73,63,,438.98,,,0,"percent of total billed charges","63% of total billed charges",133.26,15.3,,106.61,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,600.99,69,,,,,0,"fee schedule","69% of total billed charges",871,100,,696.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",871,100,,696.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",871,100,,696.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",328.37,37.7,,262.70,,,0,"percent of total billed charges","37.7% of total billed charges",328.37,37.7,,262.70,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",295.27,33.9,,236.22,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",679.38,78,,543.50,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",719.45,82.6,,575.56,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",719.45,82.6,,575.56,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,871,100,,696.80,,,0,"percent of total billed charges","100% of total billed charges",80.56,934.91,
"THER/PROPH/DIAG INJ IV PUSH",96374,CDM,940,RC,96374,CPT,OUTPATIENT,,,167,108.55,,146.96,88,,117.57,,,0,"percent of total billed charges","88% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,167,100,,133.60,,,0,"percent of total billed charges","100% of total billed charges",382.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",25.55,15.3,,20.44,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,115.23,69,,,,,0,"fee schedule","69% of total billed charges",167,100,,133.60,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",167,100,,133.60,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",167,100,,133.60,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",826.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.48,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",62.96,37.7,,50.37,,,0,"percent of total billed charges","37.7% of total billed charges",62.96,37.7,,50.37,,,0,"percent of total billed charges","37.70% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",56.61,33.9,,45.29,,,0,"percent of total billed charges","33.9% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",130.26,78,,104.21,,,0,"percent of total billed charges","78% of total billed charges",220.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",137.94,82.6,,110.35,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",137.94,82.6,,110.35,,,0,"percent of total billed charges","82.6% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,167,100,,133.60,,,0,"percent of total billed charges","100% of total billed charges",25.55,826.71,
"AQUATIC EXER/15MIN/-GP",42097113,CDM,420,RC,97113,CPT,OUTPATIENT,,,266,172.9,GP,234.08,88,,187.26,,,0,"percent of total billed charges","88% of total billed charges",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.83,100,,,,,0,"fee schedule","100% of WA fee schedule",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",65.28,175,,,,,0,"fee schedule","175% of CMS fee schedule",21.83,100,,,,,0,"fee schedule","100% of WA fee schedule",37.47,100,,,,,0,"fee schedule","100% of CMS fee sv",167.58,63,,134.06,,,0,"percent of total billed charges","63% of total billed charges",40.7,15.3,,32.56,,,0,"percent of total billed charges","15.3% of total billed charges",21.83,100,,,,,0,"fee schedule","100% of WA fee schedule",183.54,69,,,,,0,"fee schedule","69% of total billed charges",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",37.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",147.22,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",21.83,100,,,,,0,"fee schedule","100% of WA fee schedule",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.81,100,,,,,0,"fee schedule","100% of LI fee schedule",21.83,100,,,,,0,"fee schedule","100% of WA fee schedule",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.27,102,,,,,0,"fee schedule","102% of WA fee schedule",28.38,130,,,,,0,"fee schedule","130% of WA fee schedule",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.28,37.7,,80.22,,,0,"percent of total billed charges","37.7% of total billed charges",100.28,37.7,,80.22,,,0,"percent of total billed charges","37.70% of total billed charges",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.17,33.9,,72.14,,,0,"percent of total billed charges","33.9% of total billed charges",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",207.48,78,,165.98,,,0,"percent of total billed charges","78% of total billed charges",37.84,101,,,,,0,"fee schedule","101% of CMS fee schedule ",219.72,82.6,,175.78,,,0,"percent of total billed charges","82.6% of total billed charges",21.83,100,,,,,0,"fee schedule","100% of WA fee schedule",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",219.72,82.6,,175.78,,,0,"percent of total billed charges","82.6% of total billed charges",37.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.83,100,,,,,0,"fee schedule","100% of WA fee schedule",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",21.83,266,
ELECTROCARDIOGRAM,93005,CDM,730,RC,93005,CPT,OUTPATIENT,,,509,330.85,,447.92,88,,358.34,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",24.47,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320.67,63,,256.54,,,0,"percent of total billed charges","63% of total billed charges",77.88,15.3,,62.30,,,0,"percent of total billed charges","15.3% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,351.21,69,,,,,0,"fee schedule","69% of total billed charges",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17.6,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.23,100,,,,,0,"fee schedule",EAPG,30.89,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191.89,37.7,,153.51,,,0,"percent of total billed charges","37.7% of total billed charges",191.89,37.7,,153.51,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",172.55,33.9,,138.04,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397.02,78,,317.62,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.43,82.6,,336.34,,,0,"percent of total billed charges","82.6% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.43,82.6,,336.34,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",17.6,509,
"81479 Bill Molec Unlisted Procedure (81206 +81207) ZB3RV",31081479,CDM,310,RC,81479,CPT,OUTPATIENT,,,1647,1070.55,,1449.36,88,,1159.49,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.02,100,,,,,0,"fee schedule",EAPG,1647,100,,1317.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.2,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1037.61,63,,830.09,,,0,"percent of total billed charges","63% of total billed charges",251.99,15.3,,201.59,,,0,"percent of total billed charges","15.3% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,1136.43,69,,,,,0,"fee schedule","69% of total billed charges",1647,100,,1317.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1647,100,,1317.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1647,100,,1317.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39.02,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.91,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",39.81,100,,,,,0,"fee schedule",EAPG,50.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",620.92,37.7,,496.74,,,0,"percent of total billed charges","37.7% of total billed charges",620.92,37.7,,496.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",558.33,33.9,,446.66,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1284.66,78,,1027.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1360.42,82.6,,1088.34,,,0,"percent of total billed charges","82.6% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1360.42,82.6,,1088.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.02,100,,,,,0,"fee schedule",EAPG,1647,100,,1317.60,,,0,"percent of total billed charges","100% of total billed charges",28.91,1647,
"88108 Bill Cyto Non-Gyn Conc Tech Avero",31188108,CDM,311,RC,88108,CPT,OUTPATIENT,,,182,118.3,,160.16,88,,128.13,,,0,"percent of total billed charges","88% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",71.58,175,,,,,0,"fee schedule","175% of CMS fee schedule",26.78,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",114.66,63,,91.73,,,0,"percent of total billed charges","63% of total billed charges",27.85,15.3,,22.28,,,0,"percent of total billed charges","15.3% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,125.58,69,,,,,0,"fee schedule","69% of total billed charges",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.26,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.52,100,,,,,0,"fee schedule",EAPG,33.8,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",68.61,37.7,,54.89,,,0,"percent of total billed charges","37.7% of total billed charges",68.61,37.7,,54.89,,,0,"percent of total billed charges","37.70% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.7,33.9,,49.36,,,0,"percent of total billed charges","33.9% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",141.96,78,,113.57,,,0,"percent of total billed charges","78% of total billed charges",41.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.33,82.6,,120.26,,,0,"percent of total billed charges","82.6% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.33,82.6,,120.26,,,0,"percent of total billed charges","82.6% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",19.26,182,
"Gyn Cytology - Pathologist Interpretation",31188141,CDM,311,RC,88141,CPT,OUTPATIENT,,,171,111.15,,150.48,88,,120.38,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.56,100,,,,,0,"fee schedule",EAPG,171,100,,136.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.03,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",107.73,63,,86.18,,,0,"percent of total billed charges","63% of total billed charges",26.16,15.3,,20.93,,,0,"percent of total billed charges","15.3% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,117.99,69,,,,,0,"fee schedule","69% of total billed charges",171,100,,136.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",171,100,,136.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",171,100,,136.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.56,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",15.87,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",64.47,37.7,,51.58,,,0,"percent of total billed charges","37.7% of total billed charges",64.47,37.7,,51.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,33.9,,46.38,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",133.38,78,,106.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",141.25,82.6,,113.00,,,0,"percent of total billed charges","82.6% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",141.25,82.6,,113.00,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.56,100,,,,,0,"fee schedule",EAPG,171,100,,136.80,,,0,"percent of total billed charges","100% of total billed charges",11.53,171,
"88142 AP Bill Gyn Cytology Liquid Prep",31188142,CDM,311,RC,88142,CPT,OUTPATIENT,,,70,45.5,,61.6,88,,49.28,,,0,"percent of total billed charges","88% of total billed charges",20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",35.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.03,100,,,,,0,"fee schedule",EAPG,20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.1,63,,35.28,,,0,"percent of total billed charges","63% of total billed charges",30.39,150,,,,,0,"fee schedule","150% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,48.3,69,,,,,0,"fee schedule","69% of total billed charges",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.49,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.26,100,,,,,0,"fee schedule","100% of LI fee schedule",11.53,100,,,,,0,"fee schedule",EAPG,20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.87,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule",EAPG,20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.39,37.7,,21.11,,,0,"percent of total billed charges","37.7% of total billed charges",26.39,37.7,,21.11,,,0,"percent of total billed charges","37.70% of total billed charges",20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.73,33.9,,18.98,,,0,"percent of total billed charges","33.9% of total billed charges",20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.6,78,,43.68,,,0,"percent of total billed charges","78% of total billed charges",20.46,101,,,,,0,"fee schedule","101% of CMS fee schedule ",57.82,82.6,,46.26,,,0,"percent of total billed charges","82.6% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.82,82.6,,46.26,,,0,"percent of total billed charges","82.6% of total billed charges",20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",11.53,77.49,
"Labcorp 88274 Molecular Cytogenetics ISH 25-99",31088274,CDM,310,RC,88274,CPT,OUTPATIENT,,,1069,694.85,,940.72,88,,752.58,,,0,"percent of total billed charges","88% of total billed charges",42.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,1069,100,,855.20,,,0,"percent of total billed charges","100% of total billed charges",74.16,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.2,100,,,,,0,"fee schedule",EAPG,42.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",673.47,63,,538.78,,,0,"percent of total billed charges","63% of total billed charges",63.57,150,,,,,0,"fee schedule","150% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,737.61,69,,,,,0,"fee schedule","69% of total billed charges",1069,100,,855.20,,,0,"percent of total billed charges","100% of total billed charges",42.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",1069,100,,855.20,,,0,"percent of total billed charges","100% of total billed charges",42.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",1069,100,,855.20,,,0,"percent of total billed charges","100% of total billed charges",42.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,42.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.38,100,,,,,0,"fee schedule","100% of LI fee schedule",28.91,100,,,,,0,"fee schedule",EAPG,42.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.81,100,,,,,0,"fee schedule",EAPG,50.73,100,,,,,0,"fee schedule",EAPG,42.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",403.01,37.7,,322.41,,,0,"percent of total billed charges","37.7% of total billed charges",403.01,37.7,,322.41,,,0,"percent of total billed charges","37.70% of total billed charges",42.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",362.39,33.9,,289.91,,,0,"percent of total billed charges","33.9% of total billed charges",42.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",833.82,78,,667.06,,,0,"percent of total billed charges","78% of total billed charges",42.8,101,,,,,0,"fee schedule","101% of CMS fee schedule ",882.99,82.6,,706.39,,,0,"percent of total billed charges","82.6% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,42.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",882.99,82.6,,706.39,,,0,"percent of total billed charges","82.6% of total billed charges",42.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,1069,100,,855.20,,,0,"percent of total billed charges","100% of total billed charges",28.91,1069,
"iSTAT CG4 Blood Gases POCT",30182803,CDM,301,RC,82803,CPT,OUTPATIENT,,,70,45.5,,61.6,88,,49.28,,,0,"percent of total billed charges","88% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",45.62,175,,,,,0,"fee schedule","175% of CMS fee schedule",29.67,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.1,63,,35.28,,,0,"percent of total billed charges","63% of total billed charges",10.71,15.3,,8.57,,,0,"percent of total billed charges","15.3% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,48.3,69,,,,,0,"fee schedule","69% of total billed charges",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.71,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.07,100,,,,,0,"fee schedule","100% of LI fee schedule",21.33,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.38,100,,,,,0,"fee schedule",EAPG,37.44,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.39,37.7,,21.11,,,0,"percent of total billed charges","37.7% of total billed charges",26.39,37.7,,21.11,,,0,"percent of total billed charges","37.70% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.73,33.9,,18.98,,,0,"percent of total billed charges","33.9% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.6,78,,43.68,,,0,"percent of total billed charges","78% of total billed charges",26.33,101,,,,,0,"fee schedule","101% of CMS fee schedule ",57.82,82.6,,46.26,,,0,"percent of total billed charges","82.6% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.82,82.6,,46.26,,,0,"percent of total billed charges","82.6% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",10.71,99.71,
"iSTAT Basic metabolic panel (Calcium, ionized) Chem8+",30180047,CDM,301,RC,80047,CPT,OUTPATIENT,,,43,27.95,,37.84,88,,30.27,,,0,"percent of total billed charges","88% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",24.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",7.68,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.09,63,,21.67,,,0,"percent of total billed charges","63% of total billed charges",6.58,15.3,,5.26,,,0,"percent of total billed charges","15.3% of total billed charges",7.45,100,,,,,0,"fee schedule",EAPG,29.67,69,,,,,0,"fee schedule","69% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.73,100,,,,,0,"fee schedule","100% of LI fee schedule",5.52,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.6,100,,,,,0,"fee schedule",EAPG,9.69,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.21,37.7,,12.97,,,0,"percent of total billed charges","37.7% of total billed charges",16.21,37.7,,12.97,,,0,"percent of total billed charges","37.70% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.58,33.9,,11.66,,,0,"percent of total billed charges","33.9% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.54,78,,26.83,,,0,"percent of total billed charges","78% of total billed charges",13.86,101,,,,,0,"fee schedule","101% of CMS fee schedule ",35.52,82.6,,28.42,,,0,"percent of total billed charges","82.6% of total billed charges",7.45,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.52,82.6,,28.42,,,0,"percent of total billed charges","82.6% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",5.52,52.51,
"59051 FETAL MONITOR  NON OB Charge",72059051,CDM,720,RC,59051,CPT,OUTPATIENT,,,248,161.2,,218.24,88,,174.59,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.24,63,,124.99,,,0,"percent of total billed charges","63% of total billed charges",37.94,15.3,,30.35,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",171.12,69,,,,,0,"fee schedule","69% of total billed charges",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",93.5,37.7,,74.80,,,0,"percent of total billed charges","37.7% of total billed charges",93.5,37.7,,74.80,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.07,33.9,,67.26,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",193.44,78,,154.75,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.85,82.6,,163.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",204.85,82.6,,163.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.66,16.8,,33.33,,,0,"percent of total billed charges","16.8% of total billed charges",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",37.94,248,
"Fetal Nonstress Test",76159025,CDM,761,RC,59025,CPT,OUTPATIENT,,,561,364.65,,493.68,88,,394.94,,,0,"percent of total billed charges","88% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",165.98,100,,,,,0,"fee schedule",EAPG,561,100,,448.80,,,0,"percent of total billed charges","100% of total billed charges",355.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",170.96,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",353.43,63,,282.74,,,0,"percent of total billed charges","63% of total billed charges",85.83,15.3,,68.66,,,0,"percent of total billed charges","15.3% of total billed charges",165.98,100,,,,,0,"fee schedule",EAPG,387.09,69,,,,,0,"fee schedule","69% of total billed charges",561,100,,448.80,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561,100,,448.80,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561,100,,448.80,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",691.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",165.98,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.94,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.3,100,,,,,0,"fee schedule",EAPG,215.77,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",211.5,37.7,,169.20,,,0,"percent of total billed charges","37.7% of total billed charges",211.5,37.7,,169.20,,,0,"percent of total billed charges","37.70% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.18,33.9,,152.14,,,0,"percent of total billed charges","33.9% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",437.58,78,,350.06,,,0,"percent of total billed charges","78% of total billed charges",205.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",463.39,82.6,,370.71,,,0,"percent of total billed charges","82.6% of total billed charges",165.98,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",463.39,82.6,,370.71,,,0,"percent of total billed charges","82.6% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",165.98,100,,,,,0,"fee schedule",EAPG,561,100,,448.80,,,0,"percent of total billed charges","100% of total billed charges",85.83,691.92,
"Antibody Screen Gel",30086850,CDM,300,RC,86850,CPT,OUTPATIENT,,,327,212.55,,287.76,88,,230.21,,,0,"percent of total billed charges","88% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",96.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206.01,63,,164.81,,,0,"percent of total billed charges","63% of total billed charges",50.03,15.3,,40.02,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,225.63,69,,,,,0,"fee schedule","69% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.15,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.7% of total billed charges",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.70% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.85,33.9,,88.68,,,0,"percent of total billed charges","33.9% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.06,78,,204.05,,,0,"percent of total billed charges","78% of total billed charges",55.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",2.86,327,
ABO/Rh.,30086900,CDM,300,RC,86900,CPT,OUTPATIENT,,,327,212.55,,287.76,88,,230.21,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206.01,63,,164.81,,,0,"percent of total billed charges","63% of total billed charges",50.03,15.3,,40.02,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,225.63,69,,,,,0,"fee schedule","69% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.7% of total billed charges",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.85,33.9,,88.68,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.06,78,,204.05,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",2.86,454.8,
"Antibody Screen Gel",30086850,CDM,300,RC,86850,CPT,OUTPATIENT,,,327,212.55,,287.76,88,,230.21,,,0,"percent of total billed charges","88% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",96.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206.01,63,,164.81,,,0,"percent of total billed charges","63% of total billed charges",50.03,15.3,,40.02,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,225.63,69,,,,,0,"fee schedule","69% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.15,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.7% of total billed charges",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.70% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.85,33.9,,88.68,,,0,"percent of total billed charges","33.9% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.06,78,,204.05,,,0,"percent of total billed charges","78% of total billed charges",55.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",2.86,327,
"DAT Poly Tube",30086880,CDM,300,RC,86880,CPT,OUTPATIENT,,,537,349.05,,472.56,88,,378.05,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.31,63,,270.65,,,0,"percent of total billed charges","63% of total billed charges",82.16,15.3,,65.73,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,370.53,69,,,,,0,"fee schedule","69% of total billed charges",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.45,37.7,,161.96,,,0,"percent of total billed charges","37.7% of total billed charges",202.45,37.7,,161.96,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",182.04,33.9,,145.63,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.86,78,,335.09,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.56,82.6,,354.85,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.56,82.6,,354.85,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",2.86,537,
"DAT IgG Tube",30086880,CDM,300,RC,86880,CPT,OUTPATIENT,,,537,349.05,,472.56,88,,378.05,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.31,63,,270.65,,,0,"percent of total billed charges","63% of total billed charges",82.16,15.3,,65.73,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,370.53,69,,,,,0,"fee schedule","69% of total billed charges",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.45,37.7,,161.96,,,0,"percent of total billed charges","37.7% of total billed charges",202.45,37.7,,161.96,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",182.04,33.9,,145.63,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.86,78,,335.09,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.56,82.6,,354.85,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.56,82.6,,354.85,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",2.86,537,
ABO/Rh.,30086900,CDM,300,RC,86900,CPT,OUTPATIENT,,,327,212.55,,287.76,88,,230.21,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206.01,63,,164.81,,,0,"percent of total billed charges","63% of total billed charges",50.03,15.3,,40.02,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,225.63,69,,,,,0,"fee schedule","69% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.7% of total billed charges",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.85,33.9,,88.68,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.06,78,,204.05,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",2.86,454.8,
"ABO Only",30086900,CDM,300,RC,86900,CPT,OUTPATIENT,,,327,212.55,,287.76,88,,230.21,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206.01,63,,164.81,,,0,"percent of total billed charges","63% of total billed charges",50.03,15.3,,40.02,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,225.63,69,,,,,0,"fee schedule","69% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.7% of total billed charges",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.85,33.9,,88.68,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.06,78,,204.05,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",2.86,454.8,
"ABO Only",30086900,CDM,300,RC,86900,CPT,OUTPATIENT,,,327,212.55,,287.76,88,,230.21,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206.01,63,,164.81,,,0,"percent of total billed charges","63% of total billed charges",50.03,15.3,,40.02,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,225.63,69,,,,,0,"fee schedule","69% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.7% of total billed charges",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.85,33.9,,88.68,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.06,78,,204.05,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",2.86,454.8,
ABO,30086900,CDM,300,RC,86900,CPT,OUTPATIENT,,,327,212.55,,287.76,88,,230.21,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206.01,63,,164.81,,,0,"percent of total billed charges","63% of total billed charges",50.03,15.3,,40.02,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,225.63,69,,,,,0,"fee schedule","69% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.7% of total billed charges",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.85,33.9,,88.68,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.06,78,,204.05,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",2.86,454.8,
"Antibody Screen Gel",30086850,CDM,300,RC,86850,CPT,OUTPATIENT,,,327,212.55,,287.76,88,,230.21,,,0,"percent of total billed charges","88% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",96.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206.01,63,,164.81,,,0,"percent of total billed charges","63% of total billed charges",50.03,15.3,,40.02,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,225.63,69,,,,,0,"fee schedule","69% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.15,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.7% of total billed charges",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.70% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.85,33.9,,88.68,,,0,"percent of total billed charges","33.9% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.06,78,,204.05,,,0,"percent of total billed charges","78% of total billed charges",55.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",2.86,327,
"Antigen Type",3098905,CDM,309,RC,86905,CPT,OUTPATIENT,,,327,212.55,,287.76,88,,230.21,,,0,"percent of total billed charges","88% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",641.59,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206.01,63,,164.81,,,0,"percent of total billed charges","63% of total billed charges",50.03,15.3,,40.02,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,225.63,69,,,,,0,"fee schedule","69% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",1183.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.7% of total billed charges",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.70% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.85,33.9,,88.68,,,0,"percent of total billed charges","33.9% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.06,78,,204.05,,,0,"percent of total billed charges","78% of total billed charges",370.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",2.86,1183.25,
"Antibody Screen Tube",30086850,CDM,300,RC,86850,CPT,OUTPATIENT,,,327,212.55,,287.76,88,,230.21,,,0,"percent of total billed charges","88% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",96.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206.01,63,,164.81,,,0,"percent of total billed charges","63% of total billed charges",50.03,15.3,,40.02,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,225.63,69,,,,,0,"fee schedule","69% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.15,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.7% of total billed charges",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.70% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.85,33.9,,88.68,,,0,"percent of total billed charges","33.9% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.06,78,,204.05,,,0,"percent of total billed charges","78% of total billed charges",55.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",2.86,327,
"Antibody ID",30086870,CDM,300,RC,86870,CPT,OUTPATIENT,,,310,201.5,,272.8,88,,218.24,,,0,"percent of total billed charges","88% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.08,16.8,,41.66,,,0,"percent of total billed charges","16.8% of total billed charges",310,100,,248.00,,,0,"percent of total billed charges","100% of total billed charges",641.59,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.64,17.304,,42.91,,,0,"percent of total billed charges","17.304% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",195.3,63,,156.24,,,0,"percent of total billed charges","63% of total billed charges",47.43,15.3,,37.94,,,0,"percent of total billed charges","15.3% of total billed charges",52.08,16.8,,41.66,,,0,"percent of total billed charges","16.8% of total billed charges",213.9,69,,,,,0,"fee schedule","69% of total billed charges",310,100,,248.00,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",310,100,,248.00,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",310,100,,248.00,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",1183.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.08,16.8,,41.66,,,0,"percent of total billed charges","16.8% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.08,16.8,,41.66,,,0,"percent of total billed charges","16.8% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",53.12,17.136,,42.50,,,0,"percent of total billed charges","17.136% of total billed charges",67.7,21.84,,54.16,,,0,"percent of total billed charges","21.84% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",116.87,37.7,,93.50,,,0,"percent of total billed charges","37.7% of total billed charges",116.87,37.7,,93.50,,,0,"percent of total billed charges","37.70% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,33.9,,84.07,,,0,"percent of total billed charges","33.9% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",241.8,78,,193.44,,,0,"percent of total billed charges","78% of total billed charges",370.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.06,82.6,,204.85,,,0,"percent of total billed charges","82.6% of total billed charges",52.08,16.8,,41.66,,,0,"percent of total billed charges","16.8% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.06,82.6,,204.85,,,0,"percent of total billed charges","82.6% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.08,16.8,,41.66,,,0,"percent of total billed charges","16.8% of total billed charges",310,100,,248.00,,,0,"percent of total billed charges","100% of total billed charges",47.43,1183.25,
"Antibody ID",30086870,CDM,300,RC,86870,CPT,OUTPATIENT,,,788,512.2,,693.44,88,,554.75,,,0,"percent of total billed charges","88% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.38,16.8,,105.90,,,0,"percent of total billed charges","16.8% of total billed charges",788,100,,630.40,,,0,"percent of total billed charges","100% of total billed charges",641.59,175,,,,,0,"fee schedule","175% of CMS fee schedule",136.36,17.304,,109.09,,,0,"percent of total billed charges","17.304% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",496.44,63,,397.15,,,0,"percent of total billed charges","63% of total billed charges",120.56,15.3,,96.45,,,0,"percent of total billed charges","15.3% of total billed charges",132.38,16.8,,105.90,,,0,"percent of total billed charges","16.8% of total billed charges",543.72,69,,,,,0,"fee schedule","69% of total billed charges",788,100,,630.40,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",788,100,,630.40,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",788,100,,630.40,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",1183.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.38,16.8,,105.90,,,0,"percent of total billed charges","16.8% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.38,16.8,,105.90,,,0,"percent of total billed charges","16.8% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",135.03,17.136,,108.02,,,0,"percent of total billed charges","17.136% of total billed charges",172.1,21.84,,137.68,,,0,"percent of total billed charges","21.84% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.08,37.7,,237.66,,,0,"percent of total billed charges","37.7% of total billed charges",297.08,37.7,,237.66,,,0,"percent of total billed charges","37.70% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.13,33.9,,213.70,,,0,"percent of total billed charges","33.9% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",614.64,78,,491.71,,,0,"percent of total billed charges","78% of total billed charges",370.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",650.89,82.6,,520.71,,,0,"percent of total billed charges","82.6% of total billed charges",132.38,16.8,,105.90,,,0,"percent of total billed charges","16.8% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",650.89,82.6,,520.71,,,0,"percent of total billed charges","82.6% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.38,16.8,,105.90,,,0,"percent of total billed charges","16.8% of total billed charges",788,100,,630.40,,,0,"percent of total billed charges","100% of total billed charges",120.56,1183.25,
"Bill ABO",30086900,CDM,300,RC,86900,CPT,OUTPATIENT,,,327,212.55,,287.76,88,,230.21,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206.01,63,,164.81,,,0,"percent of total billed charges","63% of total billed charges",50.03,15.3,,40.02,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,225.63,69,,,,,0,"fee schedule","69% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.7% of total billed charges",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.85,33.9,,88.68,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.06,78,,204.05,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",2.86,454.8,
"BILL RH",30086901,CDM,300,RC,86901,CPT,OUTPATIENT,,,327,212.55,,287.76,88,,230.21,,,0,"percent of total billed charges","88% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",71.58,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206.01,63,,164.81,,,0,"percent of total billed charges","63% of total billed charges",50.03,15.3,,40.02,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,225.63,69,,,,,0,"fee schedule","69% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.7% of total billed charges",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.70% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.85,33.9,,88.68,,,0,"percent of total billed charges","33.9% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.06,78,,204.05,,,0,"percent of total billed charges","78% of total billed charges",41.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",2.86,327,
"Bill Only Rh Phenotyping",30986906,CDM,309,RC,86906,CPT,OUTPATIENT,,,111,72.15,,97.68,88,,78.14,,,0,"percent of total billed charges","88% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",71.58,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",69.93,63,,55.94,,,0,"percent of total billed charges","63% of total billed charges",16.98,15.3,,13.58,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,76.59,69,,,,,0,"fee schedule","69% of total billed charges",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",41.85,37.7,,33.48,,,0,"percent of total billed charges","37.7% of total billed charges",41.85,37.7,,33.48,,,0,"percent of total billed charges","37.70% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37.63,33.9,,30.10,,,0,"percent of total billed charges","33.9% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",86.58,78,,69.26,,,0,"percent of total billed charges","78% of total billed charges",41.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.69,82.6,,73.35,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.69,82.6,,73.35,,,0,"percent of total billed charges","82.6% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",2.86,137.47,
"BILL DAT",30086880,CDM,300,RC,86880,CPT,OUTPATIENT,,,537,349.05,,472.56,88,,378.05,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.31,63,,270.65,,,0,"percent of total billed charges","63% of total billed charges",82.16,15.3,,65.73,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,370.53,69,,,,,0,"fee schedule","69% of total billed charges",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.45,37.7,,161.96,,,0,"percent of total billed charges","37.7% of total billed charges",202.45,37.7,,161.96,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",182.04,33.9,,145.63,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.86,78,,335.09,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.56,82.6,,354.85,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.56,82.6,,354.85,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",2.86,537,
"Bill Only ABID Panel",30086870,CDM,300,RC,86870,CPT,OUTPATIENT,,,788,512.2,,693.44,88,,554.75,,,0,"percent of total billed charges","88% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.38,16.8,,105.90,,,0,"percent of total billed charges","16.8% of total billed charges",788,100,,630.40,,,0,"percent of total billed charges","100% of total billed charges",641.59,175,,,,,0,"fee schedule","175% of CMS fee schedule",136.36,17.304,,109.09,,,0,"percent of total billed charges","17.304% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",496.44,63,,397.15,,,0,"percent of total billed charges","63% of total billed charges",120.56,15.3,,96.45,,,0,"percent of total billed charges","15.3% of total billed charges",132.38,16.8,,105.90,,,0,"percent of total billed charges","16.8% of total billed charges",543.72,69,,,,,0,"fee schedule","69% of total billed charges",788,100,,630.40,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",788,100,,630.40,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",788,100,,630.40,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",1183.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.38,16.8,,105.90,,,0,"percent of total billed charges","16.8% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.38,16.8,,105.90,,,0,"percent of total billed charges","16.8% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",135.03,17.136,,108.02,,,0,"percent of total billed charges","17.136% of total billed charges",172.1,21.84,,137.68,,,0,"percent of total billed charges","21.84% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.08,37.7,,237.66,,,0,"percent of total billed charges","37.7% of total billed charges",297.08,37.7,,237.66,,,0,"percent of total billed charges","37.70% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.13,33.9,,213.70,,,0,"percent of total billed charges","33.9% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",614.64,78,,491.71,,,0,"percent of total billed charges","78% of total billed charges",370.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",650.89,82.6,,520.71,,,0,"percent of total billed charges","82.6% of total billed charges",132.38,16.8,,105.90,,,0,"percent of total billed charges","16.8% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",650.89,82.6,,520.71,,,0,"percent of total billed charges","82.6% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.38,16.8,,105.90,,,0,"percent of total billed charges","16.8% of total billed charges",788,100,,630.40,,,0,"percent of total billed charges","100% of total billed charges",120.56,1183.25,
"BILL Antibody ID",30086870,CDM,300,RC,86870,CPT,OUTPATIENT,,,537,349.05,,472.56,88,,378.05,,,0,"percent of total billed charges","88% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",90.22,16.8,,72.18,,,0,"percent of total billed charges","16.8% of total billed charges",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",641.59,175,,,,,0,"fee schedule","175% of CMS fee schedule",92.92,17.304,,74.34,,,0,"percent of total billed charges","17.304% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.31,63,,270.65,,,0,"percent of total billed charges","63% of total billed charges",82.16,15.3,,65.73,,,0,"percent of total billed charges","15.3% of total billed charges",90.22,16.8,,72.18,,,0,"percent of total billed charges","16.8% of total billed charges",370.53,69,,,,,0,"fee schedule","69% of total billed charges",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",1183.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",90.22,16.8,,72.18,,,0,"percent of total billed charges","16.8% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",90.22,16.8,,72.18,,,0,"percent of total billed charges","16.8% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.02,17.136,,73.62,,,0,"percent of total billed charges","17.136% of total billed charges",117.28,21.84,,93.82,,,0,"percent of total billed charges","21.84% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.45,37.7,,161.96,,,0,"percent of total billed charges","37.7% of total billed charges",202.45,37.7,,161.96,,,0,"percent of total billed charges","37.70% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",182.04,33.9,,145.63,,,0,"percent of total billed charges","33.9% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.86,78,,335.09,,,0,"percent of total billed charges","78% of total billed charges",370.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.56,82.6,,354.85,,,0,"percent of total billed charges","82.6% of total billed charges",90.22,16.8,,72.18,,,0,"percent of total billed charges","16.8% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.56,82.6,,354.85,,,0,"percent of total billed charges","82.6% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",90.22,16.8,,72.18,,,0,"percent of total billed charges","16.8% of total billed charges",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",82.16,1183.25,
"RBC Pretreatment",39086972,CDM,390,RC,86972,CPT,OUTPATIENT,,,147,95.55,,129.36,88,,103.49,,,0,"percent of total billed charges","88% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.96,100,,,,,0,"fee schedule",EAPG,147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",304.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",24.68,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.61,63,,74.09,,,0,"percent of total billed charges","63% of total billed charges",22.49,15.3,,17.99,,,0,"percent of total billed charges","15.3% of total billed charges",23.96,100,,,,,0,"fee schedule",EAPG,101.43,69,,,,,0,"fee schedule","69% of total billed charges",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",605.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.96,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17.74,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.44,100,,,,,0,"fee schedule",EAPG,31.14,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",55.42,37.7,,44.34,,,0,"percent of total billed charges","37.7% of total billed charges",55.42,37.7,,44.34,,,0,"percent of total billed charges","37.70% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",49.83,33.9,,39.86,,,0,"percent of total billed charges","33.9% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",114.66,78,,91.73,,,0,"percent of total billed charges","78% of total billed charges",175.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",121.42,82.6,,97.14,,,0,"percent of total billed charges","82.6% of total billed charges",23.96,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",121.42,82.6,,97.14,,,0,"percent of total billed charges","82.6% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.96,100,,,,,0,"fee schedule",EAPG,147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",17.74,605.96,
"Pretreatment of serum for use in RBC antibody identification",30086976,CDM,300,RC,86976,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.68,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.74,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",24.44,100,,,,,0,"fee schedule",EAPG,31.14,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",17.74,31.14,
"Bill Only Thawing",30086927,CDM,300,RC,86927,CPT,OUTPATIENT,,,345,224.25,,303.6,88,,242.88,,,0,"percent of total billed charges","88% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.96,100,,,,,0,"fee schedule",EAPG,345,100,,276.00,,,0,"percent of total billed charges","100% of total billed charges",304.86,175,,,,,0,"fee schedule","175% of CMS fee schedule",24.68,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",217.35,63,,173.88,,,0,"percent of total billed charges","63% of total billed charges",52.79,15.3,,42.23,,,0,"percent of total billed charges","15.3% of total billed charges",23.96,100,,,,,0,"fee schedule",EAPG,238.05,69,,,,,0,"fee schedule","69% of total billed charges",345,100,,276.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345,100,,276.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345,100,,276.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",605.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.96,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17.74,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.44,100,,,,,0,"fee schedule",EAPG,31.14,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",130.07,37.7,,104.06,,,0,"percent of total billed charges","37.7% of total billed charges",130.07,37.7,,104.06,,,0,"percent of total billed charges","37.70% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",116.96,33.9,,93.57,,,0,"percent of total billed charges","33.9% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",269.1,78,,215.28,,,0,"percent of total billed charges","78% of total billed charges",175.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.97,82.6,,227.98,,,0,"percent of total billed charges","82.6% of total billed charges",23.96,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.97,82.6,,227.98,,,0,"percent of total billed charges","82.6% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.96,100,,,,,0,"fee schedule",EAPG,345,100,,276.00,,,0,"percent of total billed charges","100% of total billed charges",17.74,605.95,
"Bill Only Antigen Typing",30986902,CDM,309,RC,86902,CPT,OUTPATIENT,,,327,212.55,,287.76,88,,230.21,,,0,"percent of total billed charges","88% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",641.59,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206.01,63,,164.81,,,0,"percent of total billed charges","63% of total billed charges",50.03,15.3,,40.02,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,225.63,69,,,,,0,"fee schedule","69% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",1183.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.7% of total billed charges",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.70% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.85,33.9,,88.68,,,0,"percent of total billed charges","33.9% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.06,78,,204.05,,,0,"percent of total billed charges","78% of total billed charges",370.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",2.86,1183.25,
"Bill Only RBC Ag",30986905,CDM,309,RC,86905,CPT,OUTPATIENT,,,327,212.55,,287.76,88,,230.21,,,0,"percent of total billed charges","88% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",641.59,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206.01,63,,164.81,,,0,"percent of total billed charges","63% of total billed charges",50.03,15.3,,40.02,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,225.63,69,,,,,0,"fee schedule","69% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",1183.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.7% of total billed charges",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.70% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.85,33.9,,88.68,,,0,"percent of total billed charges","33.9% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.06,78,,204.05,,,0,"percent of total billed charges","78% of total billed charges",370.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",2.86,1183.25,
"Bill Only Absorption",30286978,CDM,302,RC,86978,CPT,OUTPATIENT,,,107,69.55,,94.16,88,,75.33,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.96,100,,,,,0,"fee schedule",EAPG,107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",24.68,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",67.41,63,,53.93,,,0,"percent of total billed charges","63% of total billed charges",16.37,15.3,,13.10,,,0,"percent of total billed charges","15.3% of total billed charges",23.96,100,,,,,0,"fee schedule",EAPG,73.83,69,,,,,0,"fee schedule","69% of total billed charges",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.96,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17.74,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.44,100,,,,,0,"fee schedule",EAPG,31.14,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.34,37.7,,32.27,,,0,"percent of total billed charges","37.7% of total billed charges",40.34,37.7,,32.27,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.27,33.9,,29.02,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",83.46,78,,66.77,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",88.38,82.6,,70.70,,,0,"percent of total billed charges","82.6% of total billed charges",23.96,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",88.38,82.6,,70.70,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.96,100,,,,,0,"fee schedule",EAPG,107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",16.37,137.47,
"Bill Only REF ABID Panel",30086870,CDM,300,RC,86870,CPT,OUTPATIENT,,,788,512.2,,693.44,88,,554.75,,,0,"percent of total billed charges","88% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.38,16.8,,105.90,,,0,"percent of total billed charges","16.8% of total billed charges",788,100,,630.40,,,0,"percent of total billed charges","100% of total billed charges",641.59,175,,,,,0,"fee schedule","175% of CMS fee schedule",136.36,17.304,,109.09,,,0,"percent of total billed charges","17.304% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",496.44,63,,397.15,,,0,"percent of total billed charges","63% of total billed charges",120.56,15.3,,96.45,,,0,"percent of total billed charges","15.3% of total billed charges",132.38,16.8,,105.90,,,0,"percent of total billed charges","16.8% of total billed charges",543.72,69,,,,,0,"fee schedule","69% of total billed charges",788,100,,630.40,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",788,100,,630.40,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",788,100,,630.40,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",1183.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.38,16.8,,105.90,,,0,"percent of total billed charges","16.8% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.38,16.8,,105.90,,,0,"percent of total billed charges","16.8% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",135.03,17.136,,108.02,,,0,"percent of total billed charges","17.136% of total billed charges",172.1,21.84,,137.68,,,0,"percent of total billed charges","21.84% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.08,37.7,,237.66,,,0,"percent of total billed charges","37.7% of total billed charges",297.08,37.7,,237.66,,,0,"percent of total billed charges","37.70% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.13,33.9,,213.70,,,0,"percent of total billed charges","33.9% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",614.64,78,,491.71,,,0,"percent of total billed charges","78% of total billed charges",370.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",650.89,82.6,,520.71,,,0,"percent of total billed charges","82.6% of total billed charges",132.38,16.8,,105.90,,,0,"percent of total billed charges","16.8% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",650.89,82.6,,520.71,,,0,"percent of total billed charges","82.6% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.38,16.8,,105.90,,,0,"percent of total billed charges","16.8% of total billed charges",788,100,,630.40,,,0,"percent of total billed charges","100% of total billed charges",120.56,1183.25,
"Bill Only Electronic Crossmatch",30086923,CDM,300,RC,86923,CPT,OUTPATIENT,,,204,132.6,,179.52,88,,143.62,,,0,"percent of total billed charges","88% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.27,16.8,,27.42,,,0,"percent of total billed charges","16.8% of total billed charges",204,100,,163.20,,,0,"percent of total billed charges","100% of total billed charges",304.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.3,17.304,,28.24,,,0,"percent of total billed charges","17.304% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",128.52,63,,102.82,,,0,"percent of total billed charges","63% of total billed charges",31.21,15.3,,24.97,,,0,"percent of total billed charges","15.3% of total billed charges",34.27,16.8,,27.42,,,0,"percent of total billed charges","16.8% of total billed charges",140.76,69,,,,,0,"fee schedule","69% of total billed charges",204,100,,163.20,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",204,100,,163.20,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",204,100,,163.20,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",605.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.27,16.8,,27.42,,,0,"percent of total billed charges","16.8% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.27,16.8,,27.42,,,0,"percent of total billed charges","16.8% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.96,17.136,,27.97,,,0,"percent of total billed charges","17.136% of total billed charges",44.55,21.84,,35.64,,,0,"percent of total billed charges","21.84% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",76.91,37.7,,61.53,,,0,"percent of total billed charges","37.7% of total billed charges",76.91,37.7,,61.53,,,0,"percent of total billed charges","37.70% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",69.16,33.9,,55.33,,,0,"percent of total billed charges","33.9% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",159.12,78,,127.30,,,0,"percent of total billed charges","78% of total billed charges",175.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.5,82.6,,134.80,,,0,"percent of total billed charges","82.6% of total billed charges",34.27,16.8,,27.42,,,0,"percent of total billed charges","16.8% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.5,82.6,,134.80,,,0,"percent of total billed charges","82.6% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.27,16.8,,27.42,,,0,"percent of total billed charges","16.8% of total billed charges",204,100,,163.20,,,0,"percent of total billed charges","100% of total billed charges",31.21,605.96,
"Cold agglutinin; screen",30286156,CDM,302,RC,86156,CPT,OUTPATIENT,,,35,22.75,,30.8,88,,24.64,,,0,"percent of total billed charges","88% of total billed charges",8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",14.12,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.05,63,,17.64,,,0,"percent of total billed charges","63% of total billed charges",5.36,15.3,,4.29,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,24.15,69,,,,,0,"fee schedule","69% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.86,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.07,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.2,37.7,,10.56,,,0,"percent of total billed charges","37.7% of total billed charges",13.2,37.7,,10.56,,,0,"percent of total billed charges","37.70% of total billed charges",8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.87,33.9,,9.50,,,0,"percent of total billed charges","33.9% of total billed charges",8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.3,78,,21.84,,,0,"percent of total billed charges","78% of total billed charges",8.15,101,,,,,0,"fee schedule","101% of CMS fee schedule ",28.91,82.6,,23.13,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.91,82.6,,23.13,,,0,"percent of total billed charges","82.6% of total billed charges",8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",5.36,35,
"IAT Coombs ARC",30086885,CDM,300,RC,86885,CPT,OUTPATIENT,,,485,315.25,,426.8,88,,341.44,,,0,"percent of total billed charges","88% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,485,100,,388.00,,,0,"percent of total billed charges","100% of total billed charges",304.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",305.55,63,,244.44,,,0,"percent of total billed charges","63% of total billed charges",74.21,15.3,,59.37,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,334.65,69,,,,,0,"fee schedule","69% of total billed charges",485,100,,388.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",485,100,,388.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",485,100,,388.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",605.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",182.85,37.7,,146.28,,,0,"percent of total billed charges","37.7% of total billed charges",182.85,37.7,,146.28,,,0,"percent of total billed charges","37.70% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",164.42,33.9,,131.54,,,0,"percent of total billed charges","33.9% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",378.3,78,,302.64,,,0,"percent of total billed charges","78% of total billed charges",175.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.61,82.6,,320.49,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.61,82.6,,320.49,,,0,"percent of total billed charges","82.6% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,485,100,,388.00,,,0,"percent of total billed charges","100% of total billed charges",2.86,605.96,
"Pretreatment of RBCs for use in RBC antibody detection, iden",30086970,CDM,300,RC,86970,CPT,OUTPATIENT,,,110,71.5,,96.8,88,,77.44,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.96,100,,,,,0,"fee schedule",EAPG,110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",24.68,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",69.3,63,,55.44,,,0,"percent of total billed charges","63% of total billed charges",16.83,15.3,,13.46,,,0,"percent of total billed charges","15.3% of total billed charges",23.96,100,,,,,0,"fee schedule",EAPG,75.9,69,,,,,0,"fee schedule","69% of total billed charges",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.96,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17.74,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.44,100,,,,,0,"fee schedule",EAPG,31.14,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",41.47,37.7,,33.18,,,0,"percent of total billed charges","37.7% of total billed charges",41.47,37.7,,33.18,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37.29,33.9,,29.83,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.8,78,,68.64,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",90.86,82.6,,72.69,,,0,"percent of total billed charges","82.6% of total billed charges",23.96,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",90.86,82.6,,72.69,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.96,100,,,,,0,"fee schedule",EAPG,110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",16.83,137.47,
"Pretreatment of RBCs for use in RBC antibody detection, iden",30086971,CDM,300,RC,86971,CPT,OUTPATIENT,,,44,28.6,,38.72,88,,30.98,,,0,"percent of total billed charges","88% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.96,100,,,,,0,"fee schedule",EAPG,44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",304.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",24.68,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",27.72,63,,22.18,,,0,"percent of total billed charges","63% of total billed charges",6.73,15.3,,5.38,,,0,"percent of total billed charges","15.3% of total billed charges",23.96,100,,,,,0,"fee schedule",EAPG,30.36,69,,,,,0,"fee schedule","69% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",1183.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.96,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17.74,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.44,100,,,,,0,"fee schedule",EAPG,31.14,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16.59,37.7,,13.27,,,0,"percent of total billed charges","37.7% of total billed charges",16.59,37.7,,13.27,,,0,"percent of total billed charges","37.70% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14.92,33.9,,11.94,,,0,"percent of total billed charges","33.9% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.32,78,,27.46,,,0,"percent of total billed charges","78% of total billed charges",175.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",23.96,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.96,100,,,,,0,"fee schedule",EAPG,44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",6.73,1183.25,
ABO/Rh,30086900,CDM,300,RC,86900,CPT,OUTPATIENT,,,327,212.55,,287.76,88,,230.21,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206.01,63,,164.81,,,0,"percent of total billed charges","63% of total billed charges",50.03,15.3,,40.02,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,225.63,69,,,,,0,"fee schedule","69% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.7% of total billed charges",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.85,33.9,,88.68,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.06,78,,204.05,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",2.86,454.8,
"XM AHG Gel Interp:Compatible",30086922,CDM,300,RC,86922,CPT,OUTPATIENT,,,510,331.5,,448.8,88,,359.04,,,0,"percent of total billed charges","88% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",304.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",88.25,17.304,,70.60,,,0,"percent of total billed charges","17.304% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",321.3,63,,257.04,,,0,"percent of total billed charges","63% of total billed charges",78.03,15.3,,62.42,,,0,"percent of total billed charges","15.3% of total billed charges",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",351.9,69,,,,,0,"fee schedule","69% of total billed charges",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",605.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",87.39,17.136,,69.91,,,0,"percent of total billed charges","17.136% of total billed charges",111.38,21.84,,89.10,,,0,"percent of total billed charges","21.84% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",192.27,37.7,,153.82,,,0,"percent of total billed charges","37.7% of total billed charges",192.27,37.7,,153.82,,,0,"percent of total billed charges","37.70% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",172.89,33.9,,138.31,,,0,"percent of total billed charges","33.9% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397.8,78,,318.24,,,0,"percent of total billed charges","78% of total billed charges",175.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",421.26,82.6,,337.01,,,0,"percent of total billed charges","82.6% of total billed charges",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",421.26,82.6,,337.01,,,0,"percent of total billed charges","82.6% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",78.03,605.96,
"XM AHG Tube Interp:Compatible",30086921,CDM,300,RC,86921,CPT,OUTPATIENT,,,510,331.5,,448.8,88,,359.04,,,0,"percent of total billed charges","88% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",304.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",88.25,17.304,,70.60,,,0,"percent of total billed charges","17.304% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",321.3,63,,257.04,,,0,"percent of total billed charges","63% of total billed charges",78.03,15.3,,62.42,,,0,"percent of total billed charges","15.3% of total billed charges",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",351.9,69,,,,,0,"fee schedule","69% of total billed charges",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",605.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",87.39,17.136,,69.91,,,0,"percent of total billed charges","17.136% of total billed charges",111.38,21.84,,89.10,,,0,"percent of total billed charges","21.84% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",192.27,37.7,,153.82,,,0,"percent of total billed charges","37.7% of total billed charges",192.27,37.7,,153.82,,,0,"percent of total billed charges","37.70% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",172.89,33.9,,138.31,,,0,"percent of total billed charges","33.9% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397.8,78,,318.24,,,0,"percent of total billed charges","78% of total billed charges",175.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",421.26,82.6,,337.01,,,0,"percent of total billed charges","82.6% of total billed charges",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",421.26,82.6,,337.01,,,0,"percent of total billed charges","82.6% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",78.03,605.96,
"XM IS Interp:Compatible",30086920,CDM,300,RC,86920,CPT,OUTPATIENT,,,510,331.5,,448.8,88,,359.04,,,0,"percent of total billed charges","88% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",304.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",88.25,17.304,,70.60,,,0,"percent of total billed charges","17.304% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",321.3,63,,257.04,,,0,"percent of total billed charges","63% of total billed charges",78.03,15.3,,62.42,,,0,"percent of total billed charges","15.3% of total billed charges",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",351.9,69,,,,,0,"fee schedule","69% of total billed charges",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",605.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",87.39,17.136,,69.91,,,0,"percent of total billed charges","17.136% of total billed charges",111.38,21.84,,89.10,,,0,"percent of total billed charges","21.84% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",192.27,37.7,,153.82,,,0,"percent of total billed charges","37.7% of total billed charges",192.27,37.7,,153.82,,,0,"percent of total billed charges","37.70% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",172.89,33.9,,138.31,,,0,"percent of total billed charges","33.9% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397.8,78,,318.24,,,0,"percent of total billed charges","78% of total billed charges",175.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",421.26,82.6,,337.01,,,0,"percent of total billed charges","82.6% of total billed charges",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",421.26,82.6,,337.01,,,0,"percent of total billed charges","82.6% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",78.03,605.96,
"Computer XM OK",30086923,CDM,300,RC,86923,CPT,OUTPATIENT,,,204,132.6,,179.52,88,,143.62,,,0,"percent of total billed charges","88% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.27,16.8,,27.42,,,0,"percent of total billed charges","16.8% of total billed charges",204,100,,163.20,,,0,"percent of total billed charges","100% of total billed charges",304.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.3,17.304,,28.24,,,0,"percent of total billed charges","17.304% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",128.52,63,,102.82,,,0,"percent of total billed charges","63% of total billed charges",31.21,15.3,,24.97,,,0,"percent of total billed charges","15.3% of total billed charges",34.27,16.8,,27.42,,,0,"percent of total billed charges","16.8% of total billed charges",140.76,69,,,,,0,"fee schedule","69% of total billed charges",204,100,,163.20,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",204,100,,163.20,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",204,100,,163.20,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",605.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.27,16.8,,27.42,,,0,"percent of total billed charges","16.8% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.27,16.8,,27.42,,,0,"percent of total billed charges","16.8% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.96,17.136,,27.97,,,0,"percent of total billed charges","17.136% of total billed charges",44.55,21.84,,35.64,,,0,"percent of total billed charges","21.84% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",76.91,37.7,,61.53,,,0,"percent of total billed charges","37.7% of total billed charges",76.91,37.7,,61.53,,,0,"percent of total billed charges","37.70% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",69.16,33.9,,55.33,,,0,"percent of total billed charges","33.9% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",159.12,78,,127.30,,,0,"percent of total billed charges","78% of total billed charges",175.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.5,82.6,,134.80,,,0,"percent of total billed charges","82.6% of total billed charges",34.27,16.8,,27.42,,,0,"percent of total billed charges","16.8% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.5,82.6,,134.80,,,0,"percent of total billed charges","82.6% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.27,16.8,,27.42,,,0,"percent of total billed charges","16.8% of total billed charges",204,100,,163.20,,,0,"percent of total billed charges","100% of total billed charges",31.21,605.96,
"Cord DAT",30086927,CDM,300,RC,86927,CPT,OUTPATIENT,,,345,224.25,,303.6,88,,242.88,,,0,"percent of total billed charges","88% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.96,100,,,,,0,"fee schedule",EAPG,345,100,,276.00,,,0,"percent of total billed charges","100% of total billed charges",304.86,175,,,,,0,"fee schedule","175% of CMS fee schedule",24.68,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",217.35,63,,173.88,,,0,"percent of total billed charges","63% of total billed charges",52.79,15.3,,42.23,,,0,"percent of total billed charges","15.3% of total billed charges",23.96,100,,,,,0,"fee schedule",EAPG,238.05,69,,,,,0,"fee schedule","69% of total billed charges",345,100,,276.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345,100,,276.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345,100,,276.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",605.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.96,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17.74,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.44,100,,,,,0,"fee schedule",EAPG,31.14,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",130.07,37.7,,104.06,,,0,"percent of total billed charges","37.7% of total billed charges",130.07,37.7,,104.06,,,0,"percent of total billed charges","37.70% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",116.96,33.9,,93.57,,,0,"percent of total billed charges","33.9% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",269.1,78,,215.28,,,0,"percent of total billed charges","78% of total billed charges",175.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.97,82.6,,227.98,,,0,"percent of total billed charges","82.6% of total billed charges",23.96,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.97,82.6,,227.98,,,0,"percent of total billed charges","82.6% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.96,100,,,,,0,"fee schedule",EAPG,345,100,,276.00,,,0,"percent of total billed charges","100% of total billed charges",17.74,605.95,
"Cord ABO/Rh.",30086906,CDM,300,RC,86906,CPT,OUTPATIENT,,,111,72.15,,97.68,88,,78.14,,,0,"percent of total billed charges","88% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",71.58,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",69.93,63,,55.94,,,0,"percent of total billed charges","63% of total billed charges",16.98,15.3,,13.58,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,76.59,69,,,,,0,"fee schedule","69% of total billed charges",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",41.85,37.7,,33.48,,,0,"percent of total billed charges","37.7% of total billed charges",41.85,37.7,,33.48,,,0,"percent of total billed charges","37.70% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37.63,33.9,,30.10,,,0,"percent of total billed charges","33.9% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",86.58,78,,69.26,,,0,"percent of total billed charges","78% of total billed charges",41.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.69,82.6,,73.35,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.69,82.6,,73.35,,,0,"percent of total billed charges","82.6% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",2.86,137.47,
"Cord ABORh",30086900,CDM,300,RC,86900,CPT,OUTPATIENT,,,327,212.55,,287.76,88,,230.21,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206.01,63,,164.81,,,0,"percent of total billed charges","63% of total billed charges",50.03,15.3,,40.02,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,225.63,69,,,,,0,"fee schedule","69% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.7% of total billed charges",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.85,33.9,,88.68,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.06,78,,204.05,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",2.86,454.8,
"Cord ABORh.",30086900,CDM,300,RC,86900,CPT,OUTPATIENT,,,327,212.55,,287.76,88,,230.21,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206.01,63,,164.81,,,0,"percent of total billed charges","63% of total billed charges",50.03,15.3,,40.02,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,225.63,69,,,,,0,"fee schedule","69% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.7% of total billed charges",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.85,33.9,,88.68,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.06,78,,204.05,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",2.86,454.8,
"DAT Poly Tube",30086880,CDM,300,RC,86880,CPT,OUTPATIENT,,,537,349.05,,472.56,88,,378.05,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.31,63,,270.65,,,0,"percent of total billed charges","63% of total billed charges",82.16,15.3,,65.73,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,370.53,69,,,,,0,"fee schedule","69% of total billed charges",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.45,37.7,,161.96,,,0,"percent of total billed charges","37.7% of total billed charges",202.45,37.7,,161.96,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",182.04,33.9,,145.63,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.86,78,,335.09,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.56,82.6,,354.85,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.56,82.6,,354.85,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",2.86,537,
"DAT IgG Tube",30086880,CDM,300,RC,86880,CPT,OUTPATIENT,,,537,349.05,,472.56,88,,378.05,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.31,63,,270.65,,,0,"percent of total billed charges","63% of total billed charges",82.16,15.3,,65.73,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,370.53,69,,,,,0,"fee schedule","69% of total billed charges",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.45,37.7,,161.96,,,0,"percent of total billed charges","37.7% of total billed charges",202.45,37.7,,161.96,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",182.04,33.9,,145.63,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.86,78,,335.09,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.56,82.6,,354.85,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.56,82.6,,354.85,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",2.86,537,
"DAT IgG Gel",30086880,CDM,300,RC,86880,CPT,OUTPATIENT,,,537,349.05,,472.56,88,,378.05,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.31,63,,270.65,,,0,"percent of total billed charges","63% of total billed charges",82.16,15.3,,65.73,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,370.53,69,,,,,0,"fee schedule","69% of total billed charges",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.45,37.7,,161.96,,,0,"percent of total billed charges","37.7% of total billed charges",202.45,37.7,,161.96,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",182.04,33.9,,145.63,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.86,78,,335.09,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.56,82.6,,354.85,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.56,82.6,,354.85,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",2.86,537,
"E0167 RBC CPD 500",390P9016,CDM,390,RC,,,OUTPATIENT,,,577,375.05,,507.76,88,,406.21,,,0,"percent of total billed charges","88% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",99.84,17.304,,79.87,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.51,63,,290.81,,,0,"percent of total billed charges","63% of total billed charges",88.28,15.3,,70.62,,,0,"percent of total billed charges","15.3% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",398.13,69,,,,,0,"fee schedule","69% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",185.79,32.2,,148.63,,,0,"percent of total billed charges","32.2% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.87,17.136,,79.10,,,0,"percent of total billed charges","17.136% of total billed charges",126.02,21.84,,100.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",217.53,37.7,,174.02,,,0,"percent of total billed charges","37.7% of total billed charges",217.53,37.7,,174.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",195.6,33.9,,156.48,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",450.06,78,,360.05,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",476.6,82.6,,381.28,,,0,"percent of total billed charges","82.6% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",476.6,82.6,,381.28,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",88.28,577,
"E0178 RBC CPD 500 Irr",390P9040,CDM,390,RC,,,OUTPATIENT,,,829,538.85,,729.52,88,,583.62,,,0,"percent of total billed charges","88% of total billed charges",414.5,50,,331.60,,,0,"percent of total billed charges","50% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",143.45,17.304,,114.76,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.27,63,,417.82,,,0,"percent of total billed charges","63% of total billed charges",126.84,15.3,,101.47,,,0,"percent of total billed charges","15.3% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",572.01,69,,,,,0,"fee schedule","69% of total billed charges",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",414.5,50,,331.60,,,0,"percent of total billed charges","50% of total billed charges",266.94,32.2,,213.55,,,0,"percent of total billed charges","32.2% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.06,17.136,,113.65,,,0,"percent of total billed charges","17.136% of total billed charges",181.05,21.84,,144.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",312.53,37.7,,250.02,,,0,"percent of total billed charges","37.7% of total billed charges",312.53,37.7,,250.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.03,33.9,,224.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",646.62,78,,517.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",684.75,82.6,,547.80,,,0,"percent of total billed charges","82.6% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",414.5,50,,331.60,,,0,"percent of total billed charges","50% of total billed charges",684.75,82.6,,547.80,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",126.84,829,
"E0332 RBC CPD AS1 500 LR Irr",390P9040,CDM,390,RC,,,OUTPATIENT,,,829,538.85,,729.52,88,,583.62,,,0,"percent of total billed charges","88% of total billed charges",414.5,50,,331.60,,,0,"percent of total billed charges","50% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",143.45,17.304,,114.76,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.27,63,,417.82,,,0,"percent of total billed charges","63% of total billed charges",126.84,15.3,,101.47,,,0,"percent of total billed charges","15.3% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",572.01,69,,,,,0,"fee schedule","69% of total billed charges",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",414.5,50,,331.60,,,0,"percent of total billed charges","50% of total billed charges",266.94,32.2,,213.55,,,0,"percent of total billed charges","32.2% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.06,17.136,,113.65,,,0,"percent of total billed charges","17.136% of total billed charges",181.05,21.84,,144.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",312.53,37.7,,250.02,,,0,"percent of total billed charges","37.7% of total billed charges",312.53,37.7,,250.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.03,33.9,,224.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",646.62,78,,517.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",684.75,82.6,,547.80,,,0,"percent of total billed charges","82.6% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",414.5,50,,331.60,,,0,"percent of total billed charges","50% of total billed charges",684.75,82.6,,547.80,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",126.84,829,
"E0336 RBC CPD AS1 500 LR",390P9016,CDM,390,RC,,,OUTPATIENT,,,577,375.05,,507.76,88,,406.21,,,0,"percent of total billed charges","88% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",99.84,17.304,,79.87,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.51,63,,290.81,,,0,"percent of total billed charges","63% of total billed charges",88.28,15.3,,70.62,,,0,"percent of total billed charges","15.3% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",398.13,69,,,,,0,"fee schedule","69% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",185.79,32.2,,148.63,,,0,"percent of total billed charges","32.2% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.87,17.136,,79.10,,,0,"percent of total billed charges","17.136% of total billed charges",126.02,21.84,,100.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",217.53,37.7,,174.02,,,0,"percent of total billed charges","37.7% of total billed charges",217.53,37.7,,174.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",195.6,33.9,,156.48,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",450.06,78,,360.05,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",476.6,82.6,,381.28,,,0,"percent of total billed charges","82.6% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",476.6,82.6,,381.28,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",88.28,577,
"E0336 Dv RBC CPD AS1 500 LR",390P9016,CDM,390,RC,,,OUTPATIENT,,,577,375.05,,507.76,88,,406.21,,,0,"percent of total billed charges","88% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",99.84,17.304,,79.87,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.51,63,,290.81,,,0,"percent of total billed charges","63% of total billed charges",88.28,15.3,,70.62,,,0,"percent of total billed charges","15.3% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",398.13,69,,,,,0,"fee schedule","69% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",185.79,32.2,,148.63,,,0,"percent of total billed charges","32.2% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.87,17.136,,79.10,,,0,"percent of total billed charges","17.136% of total billed charges",126.02,21.84,,100.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",217.53,37.7,,174.02,,,0,"percent of total billed charges","37.7% of total billed charges",217.53,37.7,,174.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",195.6,33.9,,156.48,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",450.06,78,,360.05,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",476.6,82.6,,381.28,,,0,"percent of total billed charges","82.6% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",476.6,82.6,,381.28,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",88.28,577,
"E0385 RBC CPD AS5 450",390P9016,CDM,390,RC,,,OUTPATIENT,,,577,375.05,,507.76,88,,406.21,,,0,"percent of total billed charges","88% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",99.84,17.304,,79.87,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.51,63,,290.81,,,0,"percent of total billed charges","63% of total billed charges",88.28,15.3,,70.62,,,0,"percent of total billed charges","15.3% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",398.13,69,,,,,0,"fee schedule","69% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",185.79,32.2,,148.63,,,0,"percent of total billed charges","32.2% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.87,17.136,,79.10,,,0,"percent of total billed charges","17.136% of total billed charges",126.02,21.84,,100.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",217.53,37.7,,174.02,,,0,"percent of total billed charges","37.7% of total billed charges",217.53,37.7,,174.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",195.6,33.9,,156.48,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",450.06,78,,360.05,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",476.6,82.6,,381.28,,,0,"percent of total billed charges","82.6% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",476.6,82.6,,381.28,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",88.28,577,
"E0661 Aph RBC CP2D AS3 LR Irr",390P9040,CDM,390,RC,,,OUTPATIENT,,,829,538.85,,729.52,88,,583.62,,,0,"percent of total billed charges","88% of total billed charges",414.5,50,,331.60,,,0,"percent of total billed charges","50% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",143.45,17.304,,114.76,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.27,63,,417.82,,,0,"percent of total billed charges","63% of total billed charges",126.84,15.3,,101.47,,,0,"percent of total billed charges","15.3% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",572.01,69,,,,,0,"fee schedule","69% of total billed charges",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",414.5,50,,331.60,,,0,"percent of total billed charges","50% of total billed charges",266.94,32.2,,213.55,,,0,"percent of total billed charges","32.2% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.06,17.136,,113.65,,,0,"percent of total billed charges","17.136% of total billed charges",181.05,21.84,,144.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",312.53,37.7,,250.02,,,0,"percent of total billed charges","37.7% of total billed charges",312.53,37.7,,250.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.03,33.9,,224.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",646.62,78,,517.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",684.75,82.6,,547.80,,,0,"percent of total billed charges","82.6% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",414.5,50,,331.60,,,0,"percent of total billed charges","50% of total billed charges",684.75,82.6,,547.80,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",126.84,829,
"E0668 Aph RBC CP2D AS3 LR Irr 1",390P9040,CDM,390,RC,,,OUTPATIENT,,,829,538.85,,729.52,88,,583.62,,,0,"percent of total billed charges","88% of total billed charges",414.5,50,,331.60,,,0,"percent of total billed charges","50% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",143.45,17.304,,114.76,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.27,63,,417.82,,,0,"percent of total billed charges","63% of total billed charges",126.84,15.3,,101.47,,,0,"percent of total billed charges","15.3% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",572.01,69,,,,,0,"fee schedule","69% of total billed charges",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",414.5,50,,331.60,,,0,"percent of total billed charges","50% of total billed charges",266.94,32.2,,213.55,,,0,"percent of total billed charges","32.2% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.06,17.136,,113.65,,,0,"percent of total billed charges","17.136% of total billed charges",181.05,21.84,,144.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",312.53,37.7,,250.02,,,0,"percent of total billed charges","37.7% of total billed charges",312.53,37.7,,250.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.03,33.9,,224.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",646.62,78,,517.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",684.75,82.6,,547.80,,,0,"percent of total billed charges","82.6% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",414.5,50,,331.60,,,0,"percent of total billed charges","50% of total billed charges",684.75,82.6,,547.80,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",126.84,829,
"E0669 Aph RBC CP2D AS3 LR Irr 2",390P9040,CDM,390,RC,,,OUTPATIENT,,,829,538.85,,729.52,88,,583.62,,,0,"percent of total billed charges","88% of total billed charges",414.5,50,,331.60,,,0,"percent of total billed charges","50% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",143.45,17.304,,114.76,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.27,63,,417.82,,,0,"percent of total billed charges","63% of total billed charges",126.84,15.3,,101.47,,,0,"percent of total billed charges","15.3% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",572.01,69,,,,,0,"fee schedule","69% of total billed charges",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",414.5,50,,331.60,,,0,"percent of total billed charges","50% of total billed charges",266.94,32.2,,213.55,,,0,"percent of total billed charges","32.2% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.06,17.136,,113.65,,,0,"percent of total billed charges","17.136% of total billed charges",181.05,21.84,,144.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",312.53,37.7,,250.02,,,0,"percent of total billed charges","37.7% of total billed charges",312.53,37.7,,250.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.03,33.9,,224.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",646.62,78,,517.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",684.75,82.6,,547.80,,,0,"percent of total billed charges","82.6% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",414.5,50,,331.60,,,0,"percent of total billed charges","50% of total billed charges",684.75,82.6,,547.80,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",126.84,829,
"E0676 Aph RBC CP2D AS3 Irr 1",390P9040,CDM,390,RC,,,OUTPATIENT,,,829,538.85,,729.52,88,,583.62,,,0,"percent of total billed charges","88% of total billed charges",414.5,50,,331.60,,,0,"percent of total billed charges","50% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",143.45,17.304,,114.76,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.27,63,,417.82,,,0,"percent of total billed charges","63% of total billed charges",126.84,15.3,,101.47,,,0,"percent of total billed charges","15.3% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",572.01,69,,,,,0,"fee schedule","69% of total billed charges",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",414.5,50,,331.60,,,0,"percent of total billed charges","50% of total billed charges",266.94,32.2,,213.55,,,0,"percent of total billed charges","32.2% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.06,17.136,,113.65,,,0,"percent of total billed charges","17.136% of total billed charges",181.05,21.84,,144.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",312.53,37.7,,250.02,,,0,"percent of total billed charges","37.7% of total billed charges",312.53,37.7,,250.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.03,33.9,,224.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",646.62,78,,517.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",684.75,82.6,,547.80,,,0,"percent of total billed charges","82.6% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",414.5,50,,331.60,,,0,"percent of total billed charges","50% of total billed charges",684.75,82.6,,547.80,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",126.84,829,
"E0677 Aph RBC CP2D AS3 Irr 2",390P9040,CDM,390,RC,,,OUTPATIENT,,,829,538.85,,729.52,88,,583.62,,,0,"percent of total billed charges","88% of total billed charges",414.5,50,,331.60,,,0,"percent of total billed charges","50% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",143.45,17.304,,114.76,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.27,63,,417.82,,,0,"percent of total billed charges","63% of total billed charges",126.84,15.3,,101.47,,,0,"percent of total billed charges","15.3% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",572.01,69,,,,,0,"fee schedule","69% of total billed charges",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",414.5,50,,331.60,,,0,"percent of total billed charges","50% of total billed charges",266.94,32.2,,213.55,,,0,"percent of total billed charges","32.2% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.06,17.136,,113.65,,,0,"percent of total billed charges","17.136% of total billed charges",181.05,21.84,,144.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",312.53,37.7,,250.02,,,0,"percent of total billed charges","37.7% of total billed charges",312.53,37.7,,250.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.03,33.9,,224.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",646.62,78,,517.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",684.75,82.6,,547.80,,,0,"percent of total billed charges","82.6% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",414.5,50,,331.60,,,0,"percent of total billed charges","50% of total billed charges",684.75,82.6,,547.80,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",126.84,829,
"E0678 Aph RBC CP2D AS3 LR",390P9016,CDM,390,RC,,,OUTPATIENT,,,577,375.05,,507.76,88,,406.21,,,0,"percent of total billed charges","88% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",99.84,17.304,,79.87,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.51,63,,290.81,,,0,"percent of total billed charges","63% of total billed charges",88.28,15.3,,70.62,,,0,"percent of total billed charges","15.3% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",398.13,69,,,,,0,"fee schedule","69% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",185.79,32.2,,148.63,,,0,"percent of total billed charges","32.2% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.87,17.136,,79.10,,,0,"percent of total billed charges","17.136% of total billed charges",126.02,21.84,,100.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",217.53,37.7,,174.02,,,0,"percent of total billed charges","37.7% of total billed charges",217.53,37.7,,174.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",195.6,33.9,,156.48,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",450.06,78,,360.05,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",476.6,82.6,,381.28,,,0,"percent of total billed charges","82.6% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",476.6,82.6,,381.28,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",88.28,577,
"E0685 Aph RBC CP2D AS3 LR 1",390P9016,CDM,390,RC,,,OUTPATIENT,,,577,375.05,,507.76,88,,406.21,,,0,"percent of total billed charges","88% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",99.84,17.304,,79.87,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.51,63,,290.81,,,0,"percent of total billed charges","63% of total billed charges",88.28,15.3,,70.62,,,0,"percent of total billed charges","15.3% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",398.13,69,,,,,0,"fee schedule","69% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",185.79,32.2,,148.63,,,0,"percent of total billed charges","32.2% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.87,17.136,,79.10,,,0,"percent of total billed charges","17.136% of total billed charges",126.02,21.84,,100.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",217.53,37.7,,174.02,,,0,"percent of total billed charges","37.7% of total billed charges",217.53,37.7,,174.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",195.6,33.9,,156.48,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",450.06,78,,360.05,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",476.6,82.6,,381.28,,,0,"percent of total billed charges","82.6% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",476.6,82.6,,381.28,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",88.28,577,
"E0686 Aph RBC CP2D AS3 LR 2",390P9016,CDM,390,RC,,,OUTPATIENT,,,577,375.05,,507.76,88,,406.21,,,0,"percent of total billed charges","88% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",99.84,17.304,,79.87,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.51,63,,290.81,,,0,"percent of total billed charges","63% of total billed charges",88.28,15.3,,70.62,,,0,"percent of total billed charges","15.3% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",398.13,69,,,,,0,"fee schedule","69% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",185.79,32.2,,148.63,,,0,"percent of total billed charges","32.2% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.87,17.136,,79.10,,,0,"percent of total billed charges","17.136% of total billed charges",126.02,21.84,,100.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",217.53,37.7,,174.02,,,0,"percent of total billed charges","37.7% of total billed charges",217.53,37.7,,174.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",195.6,33.9,,156.48,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",450.06,78,,360.05,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",476.6,82.6,,381.28,,,0,"percent of total billed charges","82.6% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",476.6,82.6,,381.28,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",88.28,577,
"E0686 Aph Dv RBC CP2D AS3 LR 2",390P9016,CDM,390,RC,,,OUTPATIENT,,,577,375.05,,507.76,88,,406.21,,,0,"percent of total billed charges","88% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",99.84,17.304,,79.87,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.51,63,,290.81,,,0,"percent of total billed charges","63% of total billed charges",88.28,15.3,,70.62,,,0,"percent of total billed charges","15.3% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",398.13,69,,,,,0,"fee schedule","69% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",185.79,32.2,,148.63,,,0,"percent of total billed charges","32.2% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.87,17.136,,79.10,,,0,"percent of total billed charges","17.136% of total billed charges",126.02,21.84,,100.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",217.53,37.7,,174.02,,,0,"percent of total billed charges","37.7% of total billed charges",217.53,37.7,,174.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",195.6,33.9,,156.48,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",450.06,78,,360.05,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",476.6,82.6,,381.28,,,0,"percent of total billed charges","82.6% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",476.6,82.6,,381.28,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",88.28,577,
"E0869 Aph FFP ACDA",390P9059,CDM,390,RC,,,OUTPATIENT,,,287,186.55,,252.56,88,,202.05,,,0,"percent of total billed charges","88% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.66,17.304,,39.73,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",180.81,63,,144.65,,,0,"percent of total billed charges","63% of total billed charges",43.91,15.3,,35.13,,,0,"percent of total billed charges","15.3% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",198.03,69,,,,,0,"fee schedule","69% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",92.41,32.2,,73.93,,,0,"percent of total billed charges","32.2% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.18,17.136,,39.34,,,0,"percent of total billed charges","17.136% of total billed charges",62.68,21.84,,50.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.7% of total billed charges",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.29,33.9,,77.83,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.86,78,,179.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",43.91,287,
"E2121 Thawed Aph Plasma ACDA",390P9059,CDM,390,RC,,,OUTPATIENT,,,441,286.65,,388.08,88,,310.46,,,0,"percent of total billed charges","88% of total billed charges",220.5,50,,176.40,,,0,"percent of total billed charges","50% of total billed charges",74.09,16.8,,59.27,,,0,"percent of total billed charges","16.8% of total billed charges",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.31,17.304,,61.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",277.83,63,,222.26,,,0,"percent of total billed charges","63% of total billed charges",67.47,15.3,,53.98,,,0,"percent of total billed charges","15.3% of total billed charges",74.09,16.8,,59.27,,,0,"percent of total billed charges","16.8% of total billed charges",304.29,69,,,,,0,"fee schedule","69% of total billed charges",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",74.09,16.8,,59.27,,,0,"percent of total billed charges","16.8% of total billed charges",220.5,50,,176.40,,,0,"percent of total billed charges","50% of total billed charges",142,32.2,,113.60,,,0,"percent of total billed charges","32.2% of total billed charges",74.09,16.8,,59.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.57,17.136,,60.46,,,0,"percent of total billed charges","17.136% of total billed charges",96.31,21.84,,77.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.26,37.7,,133.01,,,0,"percent of total billed charges","37.7% of total billed charges",166.26,37.7,,133.01,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",149.5,33.9,,119.60,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",343.98,78,,275.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",364.27,82.6,,291.42,,,0,"percent of total billed charges","82.6% of total billed charges",74.09,16.8,,59.27,,,0,"percent of total billed charges","16.8% of total billed charges",220.5,50,,176.40,,,0,"percent of total billed charges","50% of total billed charges",364.27,82.6,,291.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.09,16.8,,59.27,,,0,"percent of total billed charges","16.8% of total billed charges",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",67.47,441,
"E2684 Thawed Plasma CPD",390P9059,CDM,390,RC,,,OUTPATIENT,,,441,286.65,,388.08,88,,310.46,,,0,"percent of total billed charges","88% of total billed charges",220.5,50,,176.40,,,0,"percent of total billed charges","50% of total billed charges",74.09,16.8,,59.27,,,0,"percent of total billed charges","16.8% of total billed charges",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.31,17.304,,61.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",277.83,63,,222.26,,,0,"percent of total billed charges","63% of total billed charges",67.47,15.3,,53.98,,,0,"percent of total billed charges","15.3% of total billed charges",74.09,16.8,,59.27,,,0,"percent of total billed charges","16.8% of total billed charges",304.29,69,,,,,0,"fee schedule","69% of total billed charges",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",74.09,16.8,,59.27,,,0,"percent of total billed charges","16.8% of total billed charges",220.5,50,,176.40,,,0,"percent of total billed charges","50% of total billed charges",142,32.2,,113.60,,,0,"percent of total billed charges","32.2% of total billed charges",74.09,16.8,,59.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.57,17.136,,60.46,,,0,"percent of total billed charges","17.136% of total billed charges",96.31,21.84,,77.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.26,37.7,,133.01,,,0,"percent of total billed charges","37.7% of total billed charges",166.26,37.7,,133.01,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",149.5,33.9,,119.60,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",343.98,78,,275.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",364.27,82.6,,291.42,,,0,"percent of total billed charges","82.6% of total billed charges",74.09,16.8,,59.27,,,0,"percent of total billed charges","16.8% of total billed charges",220.5,50,,176.40,,,0,"percent of total billed charges","50% of total billed charges",364.27,82.6,,291.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.09,16.8,,59.27,,,0,"percent of total billed charges","16.8% of total billed charges",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",67.47,441,
"E2701 Thawed Plasma CPD <24h",390P9059,CDM,390,RC,,,OUTPATIENT,,,287,186.55,,252.56,88,,202.05,,,0,"percent of total billed charges","88% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.66,17.304,,39.73,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",180.81,63,,144.65,,,0,"percent of total billed charges","63% of total billed charges",43.91,15.3,,35.13,,,0,"percent of total billed charges","15.3% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",198.03,69,,,,,0,"fee schedule","69% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",92.41,32.2,,73.93,,,0,"percent of total billed charges","32.2% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.18,17.136,,39.34,,,0,"percent of total billed charges","17.136% of total billed charges",62.68,21.84,,50.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.7% of total billed charges",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.29,33.9,,77.83,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.86,78,,179.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",43.91,287,
"E2719 Thawed Plasma CPDA1 <24h",390P9059,CDM,390,RC,,,OUTPATIENT,,,287,186.55,,252.56,88,,202.05,,,0,"percent of total billed charges","88% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.66,17.304,,39.73,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",180.81,63,,144.65,,,0,"percent of total billed charges","63% of total billed charges",43.91,15.3,,35.13,,,0,"percent of total billed charges","15.3% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",198.03,69,,,,,0,"fee schedule","69% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",92.41,32.2,,73.93,,,0,"percent of total billed charges","32.2% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.18,17.136,,39.34,,,0,"percent of total billed charges","17.136% of total billed charges",62.68,21.84,,50.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.7% of total billed charges",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.29,33.9,,77.83,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.86,78,,179.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",43.91,287,
"E3046 Aph Plt ACDA LR Irr",390P9037,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"E3056 Aph Plt ACDA LR Irr 1",390P9037,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"E3057 Aph Plt ACDA LR Irr 2",390P9037,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"E3058 Aph Plt ACDA LR Irr 3",390P9037,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"E3077 Aph Plt ACDA LR",390P9035,CDM,390,RC,,,OUTPATIENT,,,1524,990.6,,1341.12,88,,1072.90,,,0,"percent of total billed charges","88% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.71,17.304,,210.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",960.12,63,,768.10,,,0,"percent of total billed charges","63% of total billed charges",233.17,15.3,,186.54,,,0,"percent of total billed charges","15.3% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1051.56,69,,,,,0,"fee schedule","69% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",490.73,32.2,,392.58,,,0,"percent of total billed charges","32.2% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.15,17.136,,208.92,,,0,"percent of total billed charges","17.136% of total billed charges",332.84,21.84,,266.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",574.55,37.7,,459.64,,,0,"percent of total billed charges","37.7% of total billed charges",574.55,37.7,,459.64,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",516.64,33.9,,413.31,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1188.72,78,,950.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1258.82,82.6,,1007.06,,,0,"percent of total billed charges","82.6% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",1258.82,82.6,,1007.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",233.17,1524,
"E3087 Aph Plt ACDA LR 1",390P9035,CDM,390,RC,,,OUTPATIENT,,,1524,990.6,,1341.12,88,,1072.90,,,0,"percent of total billed charges","88% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.71,17.304,,210.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",960.12,63,,768.10,,,0,"percent of total billed charges","63% of total billed charges",233.17,15.3,,186.54,,,0,"percent of total billed charges","15.3% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1051.56,69,,,,,0,"fee schedule","69% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",490.73,32.2,,392.58,,,0,"percent of total billed charges","32.2% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.15,17.136,,208.92,,,0,"percent of total billed charges","17.136% of total billed charges",332.84,21.84,,266.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",574.55,37.7,,459.64,,,0,"percent of total billed charges","37.7% of total billed charges",574.55,37.7,,459.64,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",516.64,33.9,,413.31,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1188.72,78,,950.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1258.82,82.6,,1007.06,,,0,"percent of total billed charges","82.6% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",1258.82,82.6,,1007.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",233.17,1524,
"E3088 Aph Plt ACDA LR 2",390P9035,CDM,390,RC,,,OUTPATIENT,,,1524,990.6,,1341.12,88,,1072.90,,,0,"percent of total billed charges","88% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.71,17.304,,210.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",960.12,63,,768.10,,,0,"percent of total billed charges","63% of total billed charges",233.17,15.3,,186.54,,,0,"percent of total billed charges","15.3% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1051.56,69,,,,,0,"fee schedule","69% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",490.73,32.2,,392.58,,,0,"percent of total billed charges","32.2% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.15,17.136,,208.92,,,0,"percent of total billed charges","17.136% of total billed charges",332.84,21.84,,266.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",574.55,37.7,,459.64,,,0,"percent of total billed charges","37.7% of total billed charges",574.55,37.7,,459.64,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",516.64,33.9,,413.31,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1188.72,78,,950.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1258.82,82.6,,1007.06,,,0,"percent of total billed charges","82.6% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",1258.82,82.6,,1007.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",233.17,1524,
"E3089 Aph Plt ACDA LR 3",390P9035,CDM,390,RC,,,OUTPATIENT,,,1524,990.6,,1341.12,88,,1072.90,,,0,"percent of total billed charges","88% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.71,17.304,,210.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",960.12,63,,768.10,,,0,"percent of total billed charges","63% of total billed charges",233.17,15.3,,186.54,,,0,"percent of total billed charges","15.3% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1051.56,69,,,,,0,"fee schedule","69% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",490.73,32.2,,392.58,,,0,"percent of total billed charges","32.2% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.15,17.136,,208.92,,,0,"percent of total billed charges","17.136% of total billed charges",332.84,21.84,,266.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",574.55,37.7,,459.64,,,0,"percent of total billed charges","37.7% of total billed charges",574.55,37.7,,459.64,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",516.64,33.9,,413.31,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1188.72,78,,950.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1258.82,82.6,,1007.06,,,0,"percent of total billed charges","82.6% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",1258.82,82.6,,1007.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",233.17,1524,
"E3591 Thawed Pooled Cryto",390P9012,CDM,390,RC,,,OUTPATIENT,,,1173,762.45,,1032.24,88,,825.79,,,0,"percent of total billed charges","88% of total billed charges",586.5,50,,469.20,,,0,"percent of total billed charges","50% of total billed charges",197.06,16.8,,157.65,,,0,"percent of total billed charges","16.8% of total billed charges",1173,100,,938.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.98,17.304,,162.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",738.99,63,,591.19,,,0,"percent of total billed charges","63% of total billed charges",179.47,15.3,,143.58,,,0,"percent of total billed charges","15.3% of total billed charges",197.06,16.8,,157.65,,,0,"percent of total billed charges","16.8% of total billed charges",809.37,69,,,,,0,"fee schedule","69% of total billed charges",1173,100,,938.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1173,100,,938.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1173,100,,938.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",197.06,16.8,,157.65,,,0,"percent of total billed charges","16.8% of total billed charges",586.5,50,,469.20,,,0,"percent of total billed charges","50% of total billed charges",377.71,32.2,,302.17,,,0,"percent of total billed charges","32.2% of total billed charges",197.06,16.8,,157.65,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",201.01,17.136,,160.81,,,0,"percent of total billed charges","17.136% of total billed charges",256.18,21.84,,204.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.22,37.7,,353.78,,,0,"percent of total billed charges","37.7% of total billed charges",442.22,37.7,,353.78,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",397.65,33.9,,318.12,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",914.94,78,,731.95,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",968.9,82.6,,775.12,,,0,"percent of total billed charges","82.6% of total billed charges",197.06,16.8,,157.65,,,0,"percent of total billed charges","16.8% of total billed charges",586.5,50,,469.20,,,0,"percent of total billed charges","50% of total billed charges",968.9,82.6,,775.12,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",197.06,16.8,,157.65,,,0,"percent of total billed charges","16.8% of total billed charges",1173,100,,938.40,,,0,"percent of total billed charges","100% of total billed charges",179.47,1173,
"E4154 RBC CPDA1 LV Acadj",390P9016,CDM,390,RC,,,OUTPATIENT,,,577,375.05,,507.76,88,,406.21,,,0,"percent of total billed charges","88% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",99.84,17.304,,79.87,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.51,63,,290.81,,,0,"percent of total billed charges","63% of total billed charges",88.28,15.3,,70.62,,,0,"percent of total billed charges","15.3% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",398.13,69,,,,,0,"fee schedule","69% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",185.79,32.2,,148.63,,,0,"percent of total billed charges","32.2% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.87,17.136,,79.10,,,0,"percent of total billed charges","17.136% of total billed charges",126.02,21.84,,100.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",217.53,37.7,,174.02,,,0,"percent of total billed charges","37.7% of total billed charges",217.53,37.7,,174.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",195.6,33.9,,156.48,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",450.06,78,,360.05,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",476.6,82.6,,381.28,,,0,"percent of total billed charges","82.6% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",476.6,82.6,,381.28,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",88.28,577,
"E4156 RBC CPD AS1 LV Acadj",390P9016,CDM,390,RC,,,OUTPATIENT,,,577,375.05,,507.76,88,,406.21,,,0,"percent of total billed charges","88% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",99.84,17.304,,79.87,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.51,63,,290.81,,,0,"percent of total billed charges","63% of total billed charges",88.28,15.3,,70.62,,,0,"percent of total billed charges","15.3% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",398.13,69,,,,,0,"fee schedule","69% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",185.79,32.2,,148.63,,,0,"percent of total billed charges","32.2% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.87,17.136,,79.10,,,0,"percent of total billed charges","17.136% of total billed charges",126.02,21.84,,100.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",217.53,37.7,,174.02,,,0,"percent of total billed charges","37.7% of total billed charges",217.53,37.7,,174.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",195.6,33.9,,156.48,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",450.06,78,,360.05,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",476.6,82.6,,381.28,,,0,"percent of total billed charges","82.6% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",476.6,82.6,,381.28,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",88.28,577,
"E4157 RBC CP2D AS3 LV Acadj",390P9016,CDM,390,RC,,,OUTPATIENT,,,577,375.05,,507.76,88,,406.21,,,0,"percent of total billed charges","88% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",99.84,17.304,,79.87,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.51,63,,290.81,,,0,"percent of total billed charges","63% of total billed charges",88.28,15.3,,70.62,,,0,"percent of total billed charges","15.3% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",398.13,69,,,,,0,"fee schedule","69% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",185.79,32.2,,148.63,,,0,"percent of total billed charges","32.2% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.87,17.136,,79.10,,,0,"percent of total billed charges","17.136% of total billed charges",126.02,21.84,,100.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",217.53,37.7,,174.02,,,0,"percent of total billed charges","37.7% of total billed charges",217.53,37.7,,174.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",195.6,33.9,,156.48,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",450.06,78,,360.05,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",476.6,82.6,,381.28,,,0,"percent of total billed charges","82.6% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",476.6,82.6,,381.28,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",88.28,577,
"E5017 RBC CPD LV",390P9016,CDM,390,RC,,,OUTPATIENT,,,577,375.05,,507.76,88,,406.21,,,0,"percent of total billed charges","88% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",99.84,17.304,,79.87,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.51,63,,290.81,,,0,"percent of total billed charges","63% of total billed charges",88.28,15.3,,70.62,,,0,"percent of total billed charges","15.3% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",398.13,69,,,,,0,"fee schedule","69% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",185.79,32.2,,148.63,,,0,"percent of total billed charges","32.2% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.87,17.136,,79.10,,,0,"percent of total billed charges","17.136% of total billed charges",126.02,21.84,,100.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",217.53,37.7,,174.02,,,0,"percent of total billed charges","37.7% of total billed charges",217.53,37.7,,174.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",195.6,33.9,,156.48,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",450.06,78,,360.05,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",476.6,82.6,,381.28,,,0,"percent of total billed charges","82.6% of total billed charges",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",288.5,50,,230.80,,,0,"percent of total billed charges","50% of total billed charges",476.6,82.6,,381.28,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",96.94,16.8,,77.55,,,0,"percent of total billed charges","16.8% of total billed charges",577,100,,461.60,,,0,"percent of total billed charges","100% of total billed charges",88.28,577,
"E5115 Aph RBC CPDA1 LR Irr 1",390P9040,CDM,390,RC,,,OUTPATIENT,,,829,538.85,,729.52,88,,583.62,,,0,"percent of total billed charges","88% of total billed charges",414.5,50,,331.60,,,0,"percent of total billed charges","50% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",143.45,17.304,,114.76,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.27,63,,417.82,,,0,"percent of total billed charges","63% of total billed charges",126.84,15.3,,101.47,,,0,"percent of total billed charges","15.3% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",572.01,69,,,,,0,"fee schedule","69% of total billed charges",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",414.5,50,,331.60,,,0,"percent of total billed charges","50% of total billed charges",266.94,32.2,,213.55,,,0,"percent of total billed charges","32.2% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.06,17.136,,113.65,,,0,"percent of total billed charges","17.136% of total billed charges",181.05,21.84,,144.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",312.53,37.7,,250.02,,,0,"percent of total billed charges","37.7% of total billed charges",312.53,37.7,,250.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.03,33.9,,224.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",646.62,78,,517.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",684.75,82.6,,547.80,,,0,"percent of total billed charges","82.6% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",414.5,50,,331.60,,,0,"percent of total billed charges","50% of total billed charges",684.75,82.6,,547.80,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",126.84,829,
"E5548 Thawed Aph Plasma ACDA 1",390P9059,CDM,390,RC,,,OUTPATIENT,,,441,286.65,,388.08,88,,310.46,,,0,"percent of total billed charges","88% of total billed charges",220.5,50,,176.40,,,0,"percent of total billed charges","50% of total billed charges",74.09,16.8,,59.27,,,0,"percent of total billed charges","16.8% of total billed charges",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.31,17.304,,61.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",277.83,63,,222.26,,,0,"percent of total billed charges","63% of total billed charges",67.47,15.3,,53.98,,,0,"percent of total billed charges","15.3% of total billed charges",74.09,16.8,,59.27,,,0,"percent of total billed charges","16.8% of total billed charges",304.29,69,,,,,0,"fee schedule","69% of total billed charges",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",74.09,16.8,,59.27,,,0,"percent of total billed charges","16.8% of total billed charges",220.5,50,,176.40,,,0,"percent of total billed charges","50% of total billed charges",142,32.2,,113.60,,,0,"percent of total billed charges","32.2% of total billed charges",74.09,16.8,,59.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.57,17.136,,60.46,,,0,"percent of total billed charges","17.136% of total billed charges",96.31,21.84,,77.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.26,37.7,,133.01,,,0,"percent of total billed charges","37.7% of total billed charges",166.26,37.7,,133.01,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",149.5,33.9,,119.60,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",343.98,78,,275.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",364.27,82.6,,291.42,,,0,"percent of total billed charges","82.6% of total billed charges",74.09,16.8,,59.27,,,0,"percent of total billed charges","16.8% of total billed charges",220.5,50,,176.40,,,0,"percent of total billed charges","50% of total billed charges",364.27,82.6,,291.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.09,16.8,,59.27,,,0,"percent of total billed charges","16.8% of total billed charges",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",67.47,441,
"E5549 Thawed Aph Plasma ACDA 2",390P0959,CDM,390,RC,,,OUTPATIENT,,,441,286.65,,388.08,88,,310.46,,,0,"percent of total billed charges","88% of total billed charges",220.5,50,,176.40,,,0,"percent of total billed charges","50% of total billed charges",74.09,16.8,,59.27,,,0,"percent of total billed charges","16.8% of total billed charges",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.31,17.304,,61.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",277.83,63,,222.26,,,0,"percent of total billed charges","63% of total billed charges",67.47,15.3,,53.98,,,0,"percent of total billed charges","15.3% of total billed charges",74.09,16.8,,59.27,,,0,"percent of total billed charges","16.8% of total billed charges",304.29,69,,,,,0,"fee schedule","69% of total billed charges",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",74.09,16.8,,59.27,,,0,"percent of total billed charges","16.8% of total billed charges",220.5,50,,176.40,,,0,"percent of total billed charges","50% of total billed charges",142,32.2,,113.60,,,0,"percent of total billed charges","32.2% of total billed charges",74.09,16.8,,59.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.57,17.136,,60.46,,,0,"percent of total billed charges","17.136% of total billed charges",96.31,21.84,,77.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.26,37.7,,133.01,,,0,"percent of total billed charges","37.7% of total billed charges",166.26,37.7,,133.01,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",149.5,33.9,,119.60,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",343.98,78,,275.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",364.27,82.6,,291.42,,,0,"percent of total billed charges","82.6% of total billed charges",74.09,16.8,,59.27,,,0,"percent of total billed charges","16.8% of total billed charges",220.5,50,,176.40,,,0,"percent of total billed charges","50% of total billed charges",364.27,82.6,,291.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.09,16.8,,59.27,,,0,"percent of total billed charges","16.8% of total billed charges",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",67.47,441,
"E5621 Pooled Cryo 5 Units",390P9012,CDM,390,RC,,,OUTPATIENT,,,235,152.75,,206.8,88,,165.44,,,0,"percent of total billed charges","88% of total billed charges",117.5,50,,94.00,,,0,"percent of total billed charges","50% of total billed charges",39.48,16.8,,31.58,,,0,"percent of total billed charges","16.8% of total billed charges",235,100,,188.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.66,17.304,,32.53,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",148.05,63,,118.44,,,0,"percent of total billed charges","63% of total billed charges",35.96,15.3,,28.77,,,0,"percent of total billed charges","15.3% of total billed charges",39.48,16.8,,31.58,,,0,"percent of total billed charges","16.8% of total billed charges",162.15,69,,,,,0,"fee schedule","69% of total billed charges",235,100,,188.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",235,100,,188.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",235,100,,188.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39.48,16.8,,31.58,,,0,"percent of total billed charges","16.8% of total billed charges",117.5,50,,94.00,,,0,"percent of total billed charges","50% of total billed charges",75.67,32.2,,60.54,,,0,"percent of total billed charges","32.2% of total billed charges",39.48,16.8,,31.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.27,17.136,,32.22,,,0,"percent of total billed charges","17.136% of total billed charges",51.32,21.84,,41.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.6,37.7,,70.88,,,0,"percent of total billed charges","37.7% of total billed charges",88.6,37.7,,70.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.67,33.9,,63.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.3,78,,146.64,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.11,82.6,,155.29,,,0,"percent of total billed charges","82.6% of total billed charges",39.48,16.8,,31.58,,,0,"percent of total billed charges","16.8% of total billed charges",117.5,50,,94.00,,,0,"percent of total billed charges","50% of total billed charges",194.11,82.6,,155.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.48,16.8,,31.58,,,0,"percent of total billed charges","16.8% of total billed charges",235,100,,188.00,,,0,"percent of total billed charges","100% of total billed charges",35.96,235,
"E7001 Aph Plt ACDA PASC LR",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"E7002 Aph Plt ACDA PASC LR 1",390P9035,CDM,390,RC,,,OUTPATIENT,,,1524,990.6,,1341.12,88,,1072.90,,,0,"percent of total billed charges","88% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.71,17.304,,210.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",960.12,63,,768.10,,,0,"percent of total billed charges","63% of total billed charges",233.17,15.3,,186.54,,,0,"percent of total billed charges","15.3% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1051.56,69,,,,,0,"fee schedule","69% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",490.73,32.2,,392.58,,,0,"percent of total billed charges","32.2% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.15,17.136,,208.92,,,0,"percent of total billed charges","17.136% of total billed charges",332.84,21.84,,266.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",574.55,37.7,,459.64,,,0,"percent of total billed charges","37.7% of total billed charges",574.55,37.7,,459.64,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",516.64,33.9,,413.31,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1188.72,78,,950.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1258.82,82.6,,1007.06,,,0,"percent of total billed charges","82.6% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",1258.82,82.6,,1007.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",233.17,1524,
"E7003 Aph Plt ACDA PASC LR 2",390P9035,CDM,390,RC,,,OUTPATIENT,,,1524,990.6,,1341.12,88,,1072.90,,,0,"percent of total billed charges","88% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.71,17.304,,210.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",960.12,63,,768.10,,,0,"percent of total billed charges","63% of total billed charges",233.17,15.3,,186.54,,,0,"percent of total billed charges","15.3% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1051.56,69,,,,,0,"fee schedule","69% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",490.73,32.2,,392.58,,,0,"percent of total billed charges","32.2% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.15,17.136,,208.92,,,0,"percent of total billed charges","17.136% of total billed charges",332.84,21.84,,266.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",574.55,37.7,,459.64,,,0,"percent of total billed charges","37.7% of total billed charges",574.55,37.7,,459.64,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",516.64,33.9,,413.31,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1188.72,78,,950.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1258.82,82.6,,1007.06,,,0,"percent of total billed charges","82.6% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",1258.82,82.6,,1007.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",233.17,1524,
"E7004 Aph Plt ACDA PASC LR 3",390P9035,CDM,390,RC,,,OUTPATIENT,,,1524,990.6,,1341.12,88,,1072.90,,,0,"percent of total billed charges","88% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.71,17.304,,210.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",960.12,63,,768.10,,,0,"percent of total billed charges","63% of total billed charges",233.17,15.3,,186.54,,,0,"percent of total billed charges","15.3% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1051.56,69,,,,,0,"fee schedule","69% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",490.73,32.2,,392.58,,,0,"percent of total billed charges","32.2% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.15,17.136,,208.92,,,0,"percent of total billed charges","17.136% of total billed charges",332.84,21.84,,266.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",574.55,37.7,,459.64,,,0,"percent of total billed charges","37.7% of total billed charges",574.55,37.7,,459.64,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",516.64,33.9,,413.31,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1188.72,78,,950.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1258.82,82.6,,1007.06,,,0,"percent of total billed charges","82.6% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",1258.82,82.6,,1007.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",233.17,1524,
"E7005 Aph Plt ACDA PASC LR Irr",390P9037,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"E7006 Aph Plt ACDA PASC LR Irr 1",390P9037,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"E7007 Aph Plt ACDA PASC LR Irr 2",390P9037,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"E7008 Aph Plt ACDA PASC LR Irr 3",390P9037,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"E7607 Aph Aplasma ACDA RT<=24 Frz<=24 4",390P9012,CDM,390,RC,,,OUTPATIENT,,,287,186.55,,252.56,88,,202.05,,,0,"percent of total billed charges","88% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.66,17.304,,39.73,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",180.81,63,,144.65,,,0,"percent of total billed charges","63% of total billed charges",43.91,15.3,,35.13,,,0,"percent of total billed charges","15.3% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",198.03,69,,,,,0,"fee schedule","69% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",92.41,32.2,,73.93,,,0,"percent of total billed charges","32.2% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.18,17.136,,39.34,,,0,"percent of total billed charges","17.136% of total billed charges",62.68,21.84,,50.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.7% of total billed charges",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.29,33.9,,77.83,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.86,78,,179.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",43.91,287,
"E7644 Aph Plasma RT<=24 Frz<=24 Dv",390P9012,CDM,390,RC,,,OUTPATIENT,,,287,186.55,,252.56,88,,202.05,,,0,"percent of total billed charges","88% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.66,17.304,,39.73,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",180.81,63,,144.65,,,0,"percent of total billed charges","63% of total billed charges",43.91,15.3,,35.13,,,0,"percent of total billed charges","15.3% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",198.03,69,,,,,0,"fee schedule","69% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",92.41,32.2,,73.93,,,0,"percent of total billed charges","32.2% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.18,17.136,,39.34,,,0,"percent of total billed charges","17.136% of total billed charges",62.68,21.84,,50.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.7% of total billed charges",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.29,33.9,,77.83,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.86,78,,179.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",43.91,287,
"E7648 Aph APlasma ACDA RT<=24 Frz<=24 2",390P9012,CDM,390,RC,,,OUTPATIENT,,,287,186.55,,252.56,88,,202.05,,,0,"percent of total billed charges","88% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.66,17.304,,39.73,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",180.81,63,,144.65,,,0,"percent of total billed charges","63% of total billed charges",43.91,15.3,,35.13,,,0,"percent of total billed charges","15.3% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",198.03,69,,,,,0,"fee schedule","69% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",92.41,32.2,,73.93,,,0,"percent of total billed charges","32.2% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.18,17.136,,39.34,,,0,"percent of total billed charges","17.136% of total billed charges",62.68,21.84,,50.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.7% of total billed charges",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.29,33.9,,77.83,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.86,78,,179.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",43.91,287,
"E7646 Aph APlasma ACDA RT<=24 Frz<=24 1",390P9012,CDM,390,RC,,,OUTPATIENT,,,287,186.55,,252.56,88,,202.05,,,0,"percent of total billed charges","88% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.66,17.304,,39.73,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",180.81,63,,144.65,,,0,"percent of total billed charges","63% of total billed charges",43.91,15.3,,35.13,,,0,"percent of total billed charges","15.3% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",198.03,69,,,,,0,"fee schedule","69% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",92.41,32.2,,73.93,,,0,"percent of total billed charges","32.2% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.18,17.136,,39.34,,,0,"percent of total billed charges","17.136% of total billed charges",62.68,21.84,,50.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.7% of total billed charges",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.29,33.9,,77.83,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.86,78,,179.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",43.91,287,
"E7650 Aph Aplasma ACDA RT<=24 Frz<=24 3",390P9012,CDM,390,RC,,,OUTPATIENT,,,287,186.55,,252.56,88,,202.05,,,0,"percent of total billed charges","88% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.66,17.304,,39.73,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",180.81,63,,144.65,,,0,"percent of total billed charges","63% of total billed charges",43.91,15.3,,35.13,,,0,"percent of total billed charges","15.3% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",198.03,69,,,,,0,"fee schedule","69% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",92.41,32.2,,73.93,,,0,"percent of total billed charges","32.2% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.18,17.136,,39.34,,,0,"percent of total billed charges","17.136% of total billed charges",62.68,21.84,,50.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.7% of total billed charges",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.29,33.9,,77.83,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.86,78,,179.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",43.91,287,
"E7731Thawed Aph Plasma ACDA RT<24Fr<24",390P9059,CDM,390,RC,,,OUTPATIENT,,,287,186.55,,252.56,88,,202.05,,,0,"percent of total billed charges","88% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.66,17.304,,39.73,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",180.81,63,,144.65,,,0,"percent of total billed charges","63% of total billed charges",43.91,15.3,,35.13,,,0,"percent of total billed charges","15.3% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",198.03,69,,,,,0,"fee schedule","69% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",92.41,32.2,,73.93,,,0,"percent of total billed charges","32.2% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.18,17.136,,39.34,,,0,"percent of total billed charges","17.136% of total billed charges",62.68,21.84,,50.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.7% of total billed charges",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.29,33.9,,77.83,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.86,78,,179.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",43.91,287,
"E7731 Thawed Aph Plas ACDA RT<24Fr<24 Dv",390P9059,CDM,390,RC,,,OUTPATIENT,,,287,186.55,,252.56,88,,202.05,,,0,"percent of total billed charges","88% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.66,17.304,,39.73,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",180.81,63,,144.65,,,0,"percent of total billed charges","63% of total billed charges",43.91,15.3,,35.13,,,0,"percent of total billed charges","15.3% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",198.03,69,,,,,0,"fee schedule","69% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",92.41,32.2,,73.93,,,0,"percent of total billed charges","32.2% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.18,17.136,,39.34,,,0,"percent of total billed charges","17.136% of total billed charges",62.68,21.84,,50.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.7% of total billed charges",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.29,33.9,,77.83,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.86,78,,179.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",43.91,287,
"E7753 Thawed Aph Plas ACDA RT<24Fr<24 4",390P9059,CDM,390,RC,,,OUTPATIENT,,,287,186.55,,252.56,88,,202.05,,,0,"percent of total billed charges","88% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.66,17.304,,39.73,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",180.81,63,,144.65,,,0,"percent of total billed charges","63% of total billed charges",43.91,15.3,,35.13,,,0,"percent of total billed charges","15.3% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",198.03,69,,,,,0,"fee schedule","69% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",92.41,32.2,,73.93,,,0,"percent of total billed charges","32.2% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.18,17.136,,39.34,,,0,"percent of total billed charges","17.136% of total billed charges",62.68,21.84,,50.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.7% of total billed charges",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.29,33.9,,77.83,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.86,78,,179.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",43.91,287,
"E7750 Thawed Aph Plas ACDA RT<24Frz<24 1",390P9059,CDM,390,RC,,,OUTPATIENT,,,287,186.55,,252.56,88,,202.05,,,0,"percent of total billed charges","88% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.66,17.304,,39.73,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",180.81,63,,144.65,,,0,"percent of total billed charges","63% of total billed charges",43.91,15.3,,35.13,,,0,"percent of total billed charges","15.3% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",198.03,69,,,,,0,"fee schedule","69% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",92.41,32.2,,73.93,,,0,"percent of total billed charges","32.2% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.18,17.136,,39.34,,,0,"percent of total billed charges","17.136% of total billed charges",62.68,21.84,,50.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.7% of total billed charges",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.29,33.9,,77.83,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.86,78,,179.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",43.91,287,
"E7751 Thawed Aph PlasACDART<24Frz<24 2Dv",390P9059,CDM,390,RC,,,OUTPATIENT,,,235,152.75,,206.8,88,,165.44,,,0,"percent of total billed charges","88% of total billed charges",117.5,50,,94.00,,,0,"percent of total billed charges","50% of total billed charges",39.48,16.8,,31.58,,,0,"percent of total billed charges","16.8% of total billed charges",235,100,,188.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.66,17.304,,32.53,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",148.05,63,,118.44,,,0,"percent of total billed charges","63% of total billed charges",35.96,15.3,,28.77,,,0,"percent of total billed charges","15.3% of total billed charges",39.48,16.8,,31.58,,,0,"percent of total billed charges","16.8% of total billed charges",162.15,69,,,,,0,"fee schedule","69% of total billed charges",235,100,,188.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",235,100,,188.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",235,100,,188.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39.48,16.8,,31.58,,,0,"percent of total billed charges","16.8% of total billed charges",117.5,50,,94.00,,,0,"percent of total billed charges","50% of total billed charges",75.67,32.2,,60.54,,,0,"percent of total billed charges","32.2% of total billed charges",39.48,16.8,,31.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.27,17.136,,32.22,,,0,"percent of total billed charges","17.136% of total billed charges",51.32,21.84,,41.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.6,37.7,,70.88,,,0,"percent of total billed charges","37.7% of total billed charges",88.6,37.7,,70.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.67,33.9,,63.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.3,78,,146.64,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.11,82.6,,155.29,,,0,"percent of total billed charges","82.6% of total billed charges",39.48,16.8,,31.58,,,0,"percent of total billed charges","16.8% of total billed charges",117.5,50,,94.00,,,0,"percent of total billed charges","50% of total billed charges",194.11,82.6,,155.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.48,16.8,,31.58,,,0,"percent of total billed charges","16.8% of total billed charges",235,100,,188.00,,,0,"percent of total billed charges","100% of total billed charges",35.96,235,
"E7751 Thawed Aph Plas ACDA RT<24Frz<24 2",390P9059,CDM,390,RC,,,OUTPATIENT,,,287,186.55,,252.56,88,,202.05,,,0,"percent of total billed charges","88% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.66,17.304,,39.73,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",180.81,63,,144.65,,,0,"percent of total billed charges","63% of total billed charges",43.91,15.3,,35.13,,,0,"percent of total billed charges","15.3% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",198.03,69,,,,,0,"fee schedule","69% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",92.41,32.2,,73.93,,,0,"percent of total billed charges","32.2% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.18,17.136,,39.34,,,0,"percent of total billed charges","17.136% of total billed charges",62.68,21.84,,50.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.7% of total billed charges",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.29,33.9,,77.83,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.86,78,,179.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",43.91,287,
"E8340 Aph Plt ACDA>PASC LR Psoralen",390P9016,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"E8342 Aph Plr ACDA>PASC LR Psoralen 2",390P9016,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"E8344 Aph Plt ACDA>PASC LR<3E11Psoralen",390P9016,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"E8343 Aph Plt ACDA>PASC LR Psoralen 3",390P9016,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"E8341 Aph Plt ACDA>PASC LR Psoralen 1",390P9016,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"E8343 Aph Plt ACDA>PASC LR Pso 3 Dv",390P9016,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EA007 Aph Platelets ACDA LR BM>=36h",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EA008 Aph Platelets ACDA LR BM>=36h 1",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EA009 Aph Platelets ACDA LR BM>=36h 2",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EA019 Aph Plts ACDA Irr LR <3e11 BM>=36h",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EA017 Aph Plts ACDA Irr LR BM>=36h 2",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EA018 Aph Plts ACDA Irr LR BM>=36h 3",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EA015 Aph Platelets ACDA Irr LR BM>=36h",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EA016 Aph Plts ACDA Irr LR BM>=36h 1",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EA010 Aph Platelets ACDA LR BM>=36h 3",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EA011 Aph Plts ACDA LR <3e11 BM>=36h",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1246.9,61.85,,997.52,,,0,"percent of total billed charges","61.5% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EA013 Aph Plts ACDA LR <3e11 BM>=36h 2",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1246.9,61.85,,997.52,,,0,"percent of total billed charges","61.5% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EA014 Aph Plts ACDA LR <3e11 BM>=36h 3",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1246.9,61.85,,997.52,,,0,"percent of total billed charges","61.5% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EA012 Aph Plts ACDA LR <3e11 BM>=36h 1",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1246.9,61.85,,997.52,,,0,"percent of total billed charges","61.5% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EA022 AphPlt ACDA Irr LR <3e11 BM>=36h 3",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1246.9,61.85,,997.52,,,0,"percent of total billed charges","61.5% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EA020 AphPlt ACDA Irr LR <3e11 BM>=36h 1",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1246.9,61.85,,997.52,,,0,"percent of total billed charges","61.5% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EA021 AphPlt ACDA Irr LR <3e11 BM>=36h 2",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1246.9,61.85,,997.52,,,0,"percent of total billed charges","61.5% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EA138 Aph Plts ACDA>PASC LR BM>=36h 2",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1246.9,61.85,,997.52,,,0,"percent of total billed charges","61.5% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EA137 Aph Plts ACDA>PASC LR BM>=36h 1",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1246.9,61.85,,997.52,,,0,"percent of total billed charges","61.5% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EA139 Aph Plts ACDA>PASC LR BM>=36h 3",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1246.9,61.85,,997.52,,,0,"percent of total billed charges","61.5% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EA136 Aph Platelets ACDA>PASC LR BM>=36h",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1246.9,61.85,,997.52,,,0,"percent of total billed charges","61.5% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EA140 Aph Plts ACDAPASC LR <3e11 BM>=36h",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1246.9,61.85,,997.52,,,0,"percent of total billed charges","61.5% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EA143 AphPlt ACDAPASC LR <3e11 BM>=36h 3",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1246.9,61.85,,997.52,,,0,"percent of total billed charges","61.5% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EA141 AphPlt ACDAPASC LR <3e11 BM>=36h 1",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1246.9,61.85,,997.52,,,0,"percent of total billed charges","61.5% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EA142 AphPlt ACDAPASC LR <3e11 BM>=36h 2",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1246.9,61.85,,997.52,,,0,"percent of total billed charges","61.5% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EA156 AphPlt ACDA>PASC IrrLR <3e11 BM>36",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1246.9,61.85,,997.52,,,0,"percent of total billed charges","61.5% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EA155 Aph Plts ACDA>PASC IrrLR BM>=36h 3",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1246.9,61.85,,997.52,,,0,"percent of total billed charges","61.5% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EA154 Aph Plts ACDA>PASC IrrLR BM>=36h 2",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1246.9,61.85,,997.52,,,0,"percent of total billed charges","61.5% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EA153 Aph Plts ACDA>PASC IrrLR BM>=36h 1",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1246.9,61.85,,997.52,,,0,"percent of total billed charges","61.5% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EA152 Aph Plts ACDA>PASC Irr LR BM>=36h",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1246.9,61.85,,997.52,,,0,"percent of total billed charges","61.5% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EA158 AphPltACDAPASC IrrLR <3e11 BM>36 2",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1246.9,61.85,,997.52,,,0,"percent of total billed charges","61.5% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EA159 AphPltACDAPASC IrrLR <3e11 BM>36 3",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1246.9,61.85,,997.52,,,0,"percent of total billed charges","61.5% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EA157 AphPltACDAPASC IrrLR <3e11 BM>36 1",390P9035,CDM,390,RC,,,OUTPATIENT,,,2016,1310.4,,1774.08,88,,1419.26,,,0,"percent of total billed charges","88% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.85,17.304,,279.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.08,63,,1016.06,,,0,"percent of total billed charges","63% of total billed charges",308.45,15.3,,246.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1391.04,69,,,,,0,"fee schedule","69% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1246.9,61.85,,997.52,,,0,"percent of total billed charges","61.5% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",649.15,32.2,,519.32,,,0,"percent of total billed charges","32.2% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.46,17.136,,276.37,,,0,"percent of total billed charges","17.136% of total billed charges",440.29,21.84,,352.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.7% of total billed charges",760.03,37.7,,608.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",683.42,33.9,,546.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1572.48,78,,1257.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",1008,50,,806.40,,,0,"percent of total billed charges","50% of total billed charges",1665.22,82.6,,1332.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.69,16.8,,270.95,,,0,"percent of total billed charges","16.8% of total billed charges",2016,100,,1612.80,,,0,"percent of total billed charges","100% of total billed charges",308.45,2016,
"EB309 Aph Plt ACDA LR Psoralen 4",390P9035,CDM,390,RC,,,OUTPATIENT,,,1524,990.6,,1341.12,88,,1072.90,,,0,"percent of total billed charges","88% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.71,17.304,,210.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",960.12,63,,768.10,,,0,"percent of total billed charges","63% of total billed charges",233.17,15.3,,186.54,,,0,"percent of total billed charges","15.3% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1051.56,69,,,,,0,"fee schedule","69% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",942.59,61.85,,754.07,,,0,"percent of total billed charges","61.5% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",490.73,32.2,,392.58,,,0,"percent of total billed charges","32.2% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.15,17.136,,208.92,,,0,"percent of total billed charges","17.136% of total billed charges",332.84,21.84,,266.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",574.55,37.7,,459.64,,,0,"percent of total billed charges","37.7% of total billed charges",574.55,37.7,,459.64,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",516.64,33.9,,413.31,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1188.72,78,,950.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1258.82,82.6,,1007.06,,,0,"percent of total billed charges","82.6% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",1258.82,82.6,,1007.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",233.17,1524,
"EB309 Aph Plt ACDA LR Psoralen 4",390P9035,CDM,390,RC,,,OUTPATIENT,,,1524,990.6,,1341.12,88,,1072.90,,,0,"percent of total billed charges","88% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.71,17.304,,210.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",960.12,63,,768.10,,,0,"percent of total billed charges","63% of total billed charges",233.17,15.3,,186.54,,,0,"percent of total billed charges","15.3% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1051.56,69,,,,,0,"fee schedule","69% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",942.59,61.85,,754.07,,,0,"percent of total billed charges","61.5% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",490.73,32.2,,392.58,,,0,"percent of total billed charges","32.2% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.15,17.136,,208.92,,,0,"percent of total billed charges","17.136% of total billed charges",332.84,21.84,,266.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",574.55,37.7,,459.64,,,0,"percent of total billed charges","37.7% of total billed charges",574.55,37.7,,459.64,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",516.64,33.9,,413.31,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1188.72,78,,950.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1258.82,82.6,,1007.06,,,0,"percent of total billed charges","82.6% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",1258.82,82.6,,1007.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",233.17,1524,
"EB309 Aph Plt ACDA LR Psoralen 4",390P9035,CDM,390,RC,,,OUTPATIENT,,,1524,990.6,,1341.12,88,,1072.90,,,0,"percent of total billed charges","88% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.71,17.304,,210.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",960.12,63,,768.10,,,0,"percent of total billed charges","63% of total billed charges",233.17,15.3,,186.54,,,0,"percent of total billed charges","15.3% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1051.56,69,,,,,0,"fee schedule","69% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",942.59,61.85,,754.07,,,0,"percent of total billed charges","61.5% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",490.73,32.2,,392.58,,,0,"percent of total billed charges","32.2% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.15,17.136,,208.92,,,0,"percent of total billed charges","17.136% of total billed charges",332.84,21.84,,266.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",574.55,37.7,,459.64,,,0,"percent of total billed charges","37.7% of total billed charges",574.55,37.7,,459.64,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",516.64,33.9,,413.31,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1188.72,78,,950.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1258.82,82.6,,1007.06,,,0,"percent of total billed charges","82.6% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",1258.82,82.6,,1007.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",233.17,1524,
"EB309 Aph Plt ACDA LR Psoralen 4",390P9035,CDM,390,RC,,,OUTPATIENT,,,1524,990.6,,1341.12,88,,1072.90,,,0,"percent of total billed charges","88% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.71,17.304,,210.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",960.12,63,,768.10,,,0,"percent of total billed charges","63% of total billed charges",233.17,15.3,,186.54,,,0,"percent of total billed charges","15.3% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1051.56,69,,,,,0,"fee schedule","69% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",942.59,61.85,,754.07,,,0,"percent of total billed charges","61.5% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",490.73,32.2,,392.58,,,0,"percent of total billed charges","32.2% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.15,17.136,,208.92,,,0,"percent of total billed charges","17.136% of total billed charges",332.84,21.84,,266.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",574.55,37.7,,459.64,,,0,"percent of total billed charges","37.7% of total billed charges",574.55,37.7,,459.64,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",516.64,33.9,,413.31,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1188.72,78,,950.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1258.82,82.6,,1007.06,,,0,"percent of total billed charges","82.6% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",1258.82,82.6,,1007.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",233.17,1524,
"EB309 Aph Plt ACDA LR Psoralen 4",390P9035,CDM,390,RC,,,OUTPATIENT,,,1524,990.6,,1341.12,88,,1072.90,,,0,"percent of total billed charges","88% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.71,17.304,,210.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",960.12,63,,768.10,,,0,"percent of total billed charges","63% of total billed charges",233.17,15.3,,186.54,,,0,"percent of total billed charges","15.3% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1051.56,69,,,,,0,"fee schedule","69% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",942.59,61.85,,754.07,,,0,"percent of total billed charges","61.5% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",490.73,32.2,,392.58,,,0,"percent of total billed charges","32.2% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.15,17.136,,208.92,,,0,"percent of total billed charges","17.136% of total billed charges",332.84,21.84,,266.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",574.55,37.7,,459.64,,,0,"percent of total billed charges","37.7% of total billed charges",574.55,37.7,,459.64,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",516.64,33.9,,413.31,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1188.72,78,,950.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1258.82,82.6,,1007.06,,,0,"percent of total billed charges","82.6% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",1258.82,82.6,,1007.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",233.17,1524,
"EB309 Aph Plt ACDA LR Psoralen 4",390P9035,CDM,390,RC,,,OUTPATIENT,,,1524,990.6,,1341.12,88,,1072.90,,,0,"percent of total billed charges","88% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.71,17.304,,210.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",960.12,63,,768.10,,,0,"percent of total billed charges","63% of total billed charges",233.17,15.3,,186.54,,,0,"percent of total billed charges","15.3% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1051.56,69,,,,,0,"fee schedule","69% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",942.59,61.85,,754.07,,,0,"percent of total billed charges","61.5% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",490.73,32.2,,392.58,,,0,"percent of total billed charges","32.2% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.15,17.136,,208.92,,,0,"percent of total billed charges","17.136% of total billed charges",332.84,21.84,,266.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",574.55,37.7,,459.64,,,0,"percent of total billed charges","37.7% of total billed charges",574.55,37.7,,459.64,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",516.64,33.9,,413.31,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1188.72,78,,950.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1258.82,82.6,,1007.06,,,0,"percent of total billed charges","82.6% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",1258.82,82.6,,1007.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",233.17,1524,
"EB309 Aph Plt ACDA LR Psoralen 4",390P9035,CDM,390,RC,,,OUTPATIENT,,,1524,990.6,,1341.12,88,,1072.90,,,0,"percent of total billed charges","88% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.71,17.304,,210.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",960.12,63,,768.10,,,0,"percent of total billed charges","63% of total billed charges",233.17,15.3,,186.54,,,0,"percent of total billed charges","15.3% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1051.56,69,,,,,0,"fee schedule","69% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",942.59,61.85,,754.07,,,0,"percent of total billed charges","61.5% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",490.73,32.2,,392.58,,,0,"percent of total billed charges","32.2% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.15,17.136,,208.92,,,0,"percent of total billed charges","17.136% of total billed charges",332.84,21.84,,266.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",574.55,37.7,,459.64,,,0,"percent of total billed charges","37.7% of total billed charges",574.55,37.7,,459.64,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",516.64,33.9,,413.31,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1188.72,78,,950.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1258.82,82.6,,1007.06,,,0,"percent of total billed charges","82.6% of total billed charges",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",762,50,,609.60,,,0,"percent of total billed charges","50% of total billed charges",1258.82,82.6,,1007.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",256.03,16.8,,204.82,,,0,"percent of total billed charges","16.8% of total billed charges",1524,100,,1219.20,,,0,"percent of total billed charges","100% of total billed charges",233.17,1524,
Elution,30986860,CDM,309,RC,86860,CPT,OUTPATIENT,,,537,349.05,,472.56,88,,378.05,,,0,"percent of total billed charges","88% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",90.22,16.8,,72.18,,,0,"percent of total billed charges","16.8% of total billed charges",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",304.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",92.92,17.304,,74.34,,,0,"percent of total billed charges","17.304% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.31,63,,270.65,,,0,"percent of total billed charges","63% of total billed charges",82.16,15.3,,65.73,,,0,"percent of total billed charges","15.3% of total billed charges",90.22,16.8,,72.18,,,0,"percent of total billed charges","16.8% of total billed charges",370.53,69,,,,,0,"fee schedule","69% of total billed charges",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",605.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",90.22,16.8,,72.18,,,0,"percent of total billed charges","16.8% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",90.22,16.8,,72.18,,,0,"percent of total billed charges","16.8% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.02,17.136,,73.62,,,0,"percent of total billed charges","17.136% of total billed charges",117.28,21.84,,93.82,,,0,"percent of total billed charges","21.84% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.45,37.7,,161.96,,,0,"percent of total billed charges","37.7% of total billed charges",202.45,37.7,,161.96,,,0,"percent of total billed charges","37.70% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",182.04,33.9,,145.63,,,0,"percent of total billed charges","33.9% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.86,78,,335.09,,,0,"percent of total billed charges","78% of total billed charges",175.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.56,82.6,,354.85,,,0,"percent of total billed charges","82.6% of total billed charges",90.22,16.8,,72.18,,,0,"percent of total billed charges","16.8% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.56,82.6,,354.85,,,0,"percent of total billed charges","82.6% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",90.22,16.8,,72.18,,,0,"percent of total billed charges","16.8% of total billed charges",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",82.16,605.96,
"Fetal Screen",30085461,CDM,300,RC,85461,CPT,OUTPATIENT,,,263,170.95,,231.44,88,,185.15,,,0,"percent of total billed charges","88% of total billed charges",9.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,263,100,,210.40,,,0,"percent of total billed charges","100% of total billed charges",16.38,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.23,100,,,,,0,"fee schedule",EAPG,9.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",165.69,63,,132.55,,,0,"percent of total billed charges","63% of total billed charges",40.24,15.3,,32.19,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,181.47,69,,,,,0,"fee schedule","69% of total billed charges",263,100,,210.40,,,0,"percent of total billed charges","100% of total billed charges",9.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",263,100,,210.40,,,0,"percent of total billed charges","100% of total billed charges",9.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",263,100,,210.40,,,0,"percent of total billed charges","100% of total billed charges",9.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.8,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,9.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.36,100,,,,,0,"fee schedule","100% of LI fee schedule",3.76,100,,,,,0,"fee schedule",EAPG,9.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,9.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.15,37.7,,79.32,,,0,"percent of total billed charges","37.7% of total billed charges",99.15,37.7,,79.32,,,0,"percent of total billed charges","37.70% of total billed charges",9.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.16,33.9,,71.33,,,0,"percent of total billed charges","33.9% of total billed charges",9.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",205.14,78,,164.11,,,0,"percent of total billed charges","78% of total billed charges",9.45,101,,,,,0,"fee schedule","101% of CMS fee schedule ",217.24,82.6,,173.79,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,9.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",217.24,82.6,,173.79,,,0,"percent of total billed charges","82.6% of total billed charges",9.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,263,100,,210.40,,,0,"percent of total billed charges","100% of total billed charges",3.76,263,
"XM AHG Gel Interp:Incompatible",30086922,CDM,300,RC,86922,CPT,OUTPATIENT,,,510,331.5,,448.8,88,,359.04,,,0,"percent of total billed charges","88% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",304.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",88.25,17.304,,70.60,,,0,"percent of total billed charges","17.304% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",321.3,63,,257.04,,,0,"percent of total billed charges","63% of total billed charges",78.03,15.3,,62.42,,,0,"percent of total billed charges","15.3% of total billed charges",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",351.9,69,,,,,0,"fee schedule","69% of total billed charges",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",605.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",87.39,17.136,,69.91,,,0,"percent of total billed charges","17.136% of total billed charges",111.38,21.84,,89.10,,,0,"percent of total billed charges","21.84% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",192.27,37.7,,153.82,,,0,"percent of total billed charges","37.7% of total billed charges",192.27,37.7,,153.82,,,0,"percent of total billed charges","37.70% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",172.89,33.9,,138.31,,,0,"percent of total billed charges","33.9% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397.8,78,,318.24,,,0,"percent of total billed charges","78% of total billed charges",175.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",421.26,82.6,,337.01,,,0,"percent of total billed charges","82.6% of total billed charges",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",421.26,82.6,,337.01,,,0,"percent of total billed charges","82.6% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",78.03,605.96,
"XM AHG Tube Interp:Incompatible",30086921,CDM,300,RC,86921,CPT,OUTPATIENT,,,510,331.5,,448.8,88,,359.04,,,0,"percent of total billed charges","88% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",304.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",88.25,17.304,,70.60,,,0,"percent of total billed charges","17.304% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",321.3,63,,257.04,,,0,"percent of total billed charges","63% of total billed charges",78.03,15.3,,62.42,,,0,"percent of total billed charges","15.3% of total billed charges",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",351.9,69,,,,,0,"fee schedule","69% of total billed charges",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",605.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",87.39,17.136,,69.91,,,0,"percent of total billed charges","17.136% of total billed charges",111.38,21.84,,89.10,,,0,"percent of total billed charges","21.84% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",192.27,37.7,,153.82,,,0,"percent of total billed charges","37.7% of total billed charges",192.27,37.7,,153.82,,,0,"percent of total billed charges","37.70% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",172.89,33.9,,138.31,,,0,"percent of total billed charges","33.9% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397.8,78,,318.24,,,0,"percent of total billed charges","78% of total billed charges",175.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",421.26,82.6,,337.01,,,0,"percent of total billed charges","82.6% of total billed charges",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",421.26,82.6,,337.01,,,0,"percent of total billed charges","82.6% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",78.03,605.96,
"XM AHG Gel Interp:Least Incompatible",30086922,CDM,300,RC,86922,CPT,OUTPATIENT,,,510,331.5,,448.8,88,,359.04,,,0,"percent of total billed charges","88% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",304.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",88.25,17.304,,70.60,,,0,"percent of total billed charges","17.304% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",321.3,63,,257.04,,,0,"percent of total billed charges","63% of total billed charges",78.03,15.3,,62.42,,,0,"percent of total billed charges","15.3% of total billed charges",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",351.9,69,,,,,0,"fee schedule","69% of total billed charges",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",605.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",87.39,17.136,,69.91,,,0,"percent of total billed charges","17.136% of total billed charges",111.38,21.84,,89.10,,,0,"percent of total billed charges","21.84% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",192.27,37.7,,153.82,,,0,"percent of total billed charges","37.7% of total billed charges",192.27,37.7,,153.82,,,0,"percent of total billed charges","37.70% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",172.89,33.9,,138.31,,,0,"percent of total billed charges","33.9% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397.8,78,,318.24,,,0,"percent of total billed charges","78% of total billed charges",175.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",421.26,82.6,,337.01,,,0,"percent of total billed charges","82.6% of total billed charges",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",421.26,82.6,,337.01,,,0,"percent of total billed charges","82.6% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",78.03,605.96,
"XM AHG Tube Interp:Least Incompatible",30086921,CDM,300,RC,86921,CPT,OUTPATIENT,,,510,331.5,,448.8,88,,359.04,,,0,"percent of total billed charges","88% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",304.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",88.25,17.304,,70.60,,,0,"percent of total billed charges","17.304% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",321.3,63,,257.04,,,0,"percent of total billed charges","63% of total billed charges",78.03,15.3,,62.42,,,0,"percent of total billed charges","15.3% of total billed charges",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",351.9,69,,,,,0,"fee schedule","69% of total billed charges",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",605.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",87.39,17.136,,69.91,,,0,"percent of total billed charges","17.136% of total billed charges",111.38,21.84,,89.10,,,0,"percent of total billed charges","21.84% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",192.27,37.7,,153.82,,,0,"percent of total billed charges","37.7% of total billed charges",192.27,37.7,,153.82,,,0,"percent of total billed charges","37.70% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",172.89,33.9,,138.31,,,0,"percent of total billed charges","33.9% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397.8,78,,318.24,,,0,"percent of total billed charges","78% of total billed charges",175.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",421.26,82.6,,337.01,,,0,"percent of total billed charges","82.6% of total billed charges",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",421.26,82.6,,337.01,,,0,"percent of total billed charges","82.6% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.68,16.8,,68.54,,,0,"percent of total billed charges","16.8% of total billed charges",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",78.03,605.96,
"Neonatal ABORh",30086900,CDM,300,RC,86900,CPT,OUTPATIENT,,,327,212.55,,287.76,88,,230.21,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206.01,63,,164.81,,,0,"percent of total billed charges","63% of total billed charges",50.03,15.3,,40.02,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,225.63,69,,,,,0,"fee schedule","69% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.7% of total billed charges",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.85,33.9,,88.68,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.06,78,,204.05,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",2.86,454.8,
"Neonatal ABORh",30086900,CDM,300,RC,86900,CPT,OUTPATIENT,,,327,212.55,,287.76,88,,230.21,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206.01,63,,164.81,,,0,"percent of total billed charges","63% of total billed charges",50.03,15.3,,40.02,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,225.63,69,,,,,0,"fee schedule","69% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.7% of total billed charges",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.85,33.9,,88.68,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.06,78,,204.05,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",2.86,454.8,
"REF Antibody Titer",30086886,CDM,300,RC,86886,CPT,OUTPATIENT,,,788,512.2,,693.44,88,,554.75,,,0,"percent of total billed charges","88% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,788,100,,630.40,,,0,"percent of total billed charges","100% of total billed charges",304.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",496.44,63,,397.15,,,0,"percent of total billed charges","63% of total billed charges",120.56,15.3,,96.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,543.72,69,,,,,0,"fee schedule","69% of total billed charges",788,100,,630.40,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",788,100,,630.40,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",788,100,,630.40,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",605.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.08,37.7,,237.66,,,0,"percent of total billed charges","37.7% of total billed charges",297.08,37.7,,237.66,,,0,"percent of total billed charges","37.70% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.13,33.9,,213.70,,,0,"percent of total billed charges","33.9% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",614.64,78,,491.71,,,0,"percent of total billed charges","78% of total billed charges",175.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",650.89,82.6,,520.71,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",650.89,82.6,,520.71,,,0,"percent of total billed charges","82.6% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,788,100,,630.40,,,0,"percent of total billed charges","100% of total billed charges",2.86,788,
"REF Kleihauer-Betke",30085460,CDM,300,RC,85460,CPT,OUTPATIENT,,,180,117,,158.4,88,,126.72,,,0,"percent of total billed charges","88% of total billed charges",7.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",13.52,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.23,100,,,,,0,"fee schedule",EAPG,7.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.4,63,,90.72,,,0,"percent of total billed charges","63% of total billed charges",27.54,15.3,,22.03,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,124.2,69,,,,,0,"fee schedule","69% of total billed charges",180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",7.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",7.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",7.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.56,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,7.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.73,100,,,,,0,"fee schedule","100% of LI fee schedule",3.76,100,,,,,0,"fee schedule",EAPG,7.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,7.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.86,37.7,,54.29,,,0,"percent of total billed charges","37.7% of total billed charges",67.86,37.7,,54.29,,,0,"percent of total billed charges","37.70% of total billed charges",7.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.02,33.9,,48.82,,,0,"percent of total billed charges","33.9% of total billed charges",7.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",140.4,78,,112.32,,,0,"percent of total billed charges","78% of total billed charges",7.8,101,,,,,0,"fee schedule","101% of CMS fee schedule ",148.68,82.6,,118.94,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,7.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",148.68,82.6,,118.94,,,0,"percent of total billed charges","82.6% of total billed charges",7.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",3.76,180,
"Rh Only",30086901,CDM,300,RC,86901,CPT,OUTPATIENT,,,327,212.55,,287.76,88,,230.21,,,0,"percent of total billed charges","88% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",71.58,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206.01,63,,164.81,,,0,"percent of total billed charges","63% of total billed charges",50.03,15.3,,40.02,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,225.63,69,,,,,0,"fee schedule","69% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.7% of total billed charges",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.70% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.85,33.9,,88.68,,,0,"percent of total billed charges","33.9% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.06,78,,204.05,,,0,"percent of total billed charges","78% of total billed charges",41.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",2.86,327,
RhIG,636J2790,CDM,636,RC,,,OUTPATIENT,,,250,162.5,,220,88,,176.00,,,0,"percent of total billed charges","88% of total billed charges",125,50,,100.00,,,0,"percent of total billed charges","50% of total billed charges",42,16.8,,33.60,,,0,"percent of total billed charges","16.8% of total billed charges",250,100,,200.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.26,17.304,,34.61,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.5,63,,126.00,,,0,"percent of total billed charges","63% of total billed charges",38.25,15.3,,30.60,,,0,"percent of total billed charges","15.3% of total billed charges",42,16.8,,33.60,,,0,"percent of total billed charges","16.8% of total billed charges",172.5,69,,,,,0,"fee schedule","69% of total billed charges",250,100,,200.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",250,100,,200.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",250,100,,200.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",154.63,61.85,,123.70,,,0,"percent of total billed charges","61.5% of total billed charges",42,16.8,,33.60,,,0,"percent of total billed charges","16.8% of total billed charges",125,50,,100.00,,,0,"percent of total billed charges","50% of total billed charges",80.5,32.2,,64.40,,,0,"percent of total billed charges","32.2% of total billed charges",42,16.8,,33.60,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.84,17.136,,34.27,,,0,"percent of total billed charges","17.136% of total billed charges",54.6,21.84,,43.68,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",94.25,37.7,,75.40,,,0,"percent of total billed charges","37.7% of total billed charges",94.25,37.7,,75.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.75,33.9,,67.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",195,78,,156.00,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",42,16.8,,33.60,,,0,"percent of total billed charges","16.8% of total billed charges",125,50,,100.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",42,16.8,,33.60,,,0,"percent of total billed charges","16.8% of total billed charges",250,100,,200.00,,,0,"percent of total billed charges","100% of total billed charges",38.25,250,
"Weak D",30086901,CDM,300,RC,86901,CPT,OUTPATIENT,,,327,212.55,,287.76,88,,230.21,,,0,"percent of total billed charges","88% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",71.58,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.98,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206.01,63,,164.81,,,0,"percent of total billed charges","63% of total billed charges",50.03,15.3,,40.02,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,225.63,69,,,,,0,"fee schedule","69% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2.86,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.94,100,,,,,0,"fee schedule",EAPG,5.02,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.7% of total billed charges",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.70% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.85,33.9,,88.68,,,0,"percent of total billed charges","33.9% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.06,78,,204.05,,,0,"percent of total billed charges","78% of total billed charges",41.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.86,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",2.86,327,
"Basic Metabolic Panel +ICA",30180047,CDM,301,RC,80047,CPT,OUTPATIENT,,,254,165.1,,223.52,88,,178.82,,,0,"percent of total billed charges","88% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",24.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",7.68,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.02,63,,128.02,,,0,"percent of total billed charges","63% of total billed charges",38.86,15.3,,31.09,,,0,"percent of total billed charges","15.3% of total billed charges",7.45,100,,,,,0,"fee schedule",EAPG,175.26,69,,,,,0,"fee schedule","69% of total billed charges",254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.73,100,,,,,0,"fee schedule","100% of LI fee schedule",5.52,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.6,100,,,,,0,"fee schedule",EAPG,9.69,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.76,37.7,,76.61,,,0,"percent of total billed charges","37.7% of total billed charges",95.76,37.7,,76.61,,,0,"percent of total billed charges","37.70% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",86.11,33.9,,68.89,,,0,"percent of total billed charges","33.9% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",198.12,78,,158.50,,,0,"percent of total billed charges","78% of total billed charges",13.86,101,,,,,0,"fee schedule","101% of CMS fee schedule ",209.8,82.6,,167.84,,,0,"percent of total billed charges","82.6% of total billed charges",7.45,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",209.8,82.6,,167.84,,,0,"percent of total billed charges","82.6% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",5.52,254,
"CARDIAC REHAB W/O MONITOR",94393797,CDM,943,RC,93797,CPT,OUTPATIENT,,,540,351,,475.2,88,,380.16,,,0,"percent of total billed charges","88% of total billed charges",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9.87,100,,,,,0,"fee schedule","100% of WA fee schedule",540,100,,432.00,,,0,"percent of total billed charges","100% of total billed charges",235.85,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.87,100,,,,,0,"fee schedule","100% of WA fee schedule",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",340.2,63,,272.16,,,0,"percent of total billed charges","63% of total billed charges",82.62,15.3,,66.10,,,0,"percent of total billed charges","15.3% of total billed charges",9.87,100,,,,,0,"fee schedule","100% of WA fee schedule",372.6,69,,,,,0,"fee schedule","69% of total billed charges",540,100,,432.00,,,0,"percent of total billed charges","100% of total billed charges",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",540,100,,432.00,,,0,"percent of total billed charges","100% of total billed charges",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",540,100,,432.00,,,0,"percent of total billed charges","100% of total billed charges",134.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",471.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9.87,100,,,,,0,"fee schedule","100% of WA fee schedule",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10.07,102,,,,,0,"fee schedule","102% of WA fee schedule",12.83,130,,,,,0,"fee schedule","130% of WA fee schedule",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",203.58,37.7,,162.86,,,0,"percent of total billed charges","37.7% of total billed charges",203.58,37.7,,162.86,,,0,"percent of total billed charges","37.70% of total billed charges",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",183.06,33.9,,146.45,,,0,"percent of total billed charges","33.9% of total billed charges",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",421.2,78,,336.96,,,0,"percent of total billed charges","78% of total billed charges",136.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",446.04,82.6,,356.83,,,0,"percent of total billed charges","82.6% of total billed charges",9.87,100,,,,,0,"fee schedule","100% of WA fee schedule",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",446.04,82.6,,356.83,,,0,"percent of total billed charges","82.6% of total billed charges",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9.87,100,,,,,0,"fee schedule","100% of WA fee schedule",540,100,,432.00,,,0,"percent of total billed charges","100% of total billed charges",9.87,540,
"CARDIAC REHAB W/ MONITOR",94393798,CDM,943,RC,93798,CPT,OUTPATIENT,,,625,406.25,,550,88,,440.00,,,0,"percent of total billed charges","88% of total billed charges",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15.18,100,,,,,0,"fee schedule","100% of WA fee schedule",625,100,,500.00,,,0,"percent of total billed charges","100% of total billed charges",235.85,175,,,,,0,"fee schedule","175% of CMS fee schedule",15.18,100,,,,,0,"fee schedule","100% of WA fee schedule",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",393.75,63,,315.00,,,0,"percent of total billed charges","63% of total billed charges",95.63,15.3,,76.50,,,0,"percent of total billed charges","15.3% of total billed charges",15.18,100,,,,,0,"fee schedule","100% of WA fee schedule",431.25,69,,,,,0,"fee schedule","69% of total billed charges",625,100,,500.00,,,0,"percent of total billed charges","100% of total billed charges",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",625,100,,500.00,,,0,"percent of total billed charges","100% of total billed charges",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",625,100,,500.00,,,0,"percent of total billed charges","100% of total billed charges",134.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",471.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15.18,100,,,,,0,"fee schedule","100% of WA fee schedule",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15.48,102,,,,,0,"fee schedule","102% of WA fee schedule",19.73,130,,,,,0,"fee schedule","130% of WA fee schedule",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",235.63,37.7,,188.50,,,0,"percent of total billed charges","37.7% of total billed charges",235.63,37.7,,188.50,,,0,"percent of total billed charges","37.70% of total billed charges",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",211.88,33.9,,169.50,,,0,"percent of total billed charges","33.9% of total billed charges",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",487.5,78,,390.00,,,0,"percent of total billed charges","78% of total billed charges",136.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",516.25,82.6,,413.00,,,0,"percent of total billed charges","82.6% of total billed charges",15.18,100,,,,,0,"fee schedule","100% of WA fee schedule",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",516.25,82.6,,413.00,,,0,"percent of total billed charges","82.6% of total billed charges",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15.18,100,,,,,0,"fee schedule","100% of WA fee schedule",625,100,,500.00,,,0,"percent of total billed charges","100% of total billed charges",15.18,625,
"94618 PULM STRESS TEST - 6 MIN WALK CHARGE",46094618,CDM,460,RC,94618,CPT,OUTPATIENT,,,350,227.5,,308,88,,246.40,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",48.3,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",220.5,63,,176.40,,,0,"percent of total billed charges","63% of total billed charges",53.55,15.3,,42.84,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,241.5,69,,,,,0,"fee schedule","69% of total billed charges",350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.73,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",131.95,37.7,,105.56,,,0,"percent of total billed charges","37.7% of total billed charges",131.95,37.7,,105.56,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.65,33.9,,94.92,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",273,78,,218.40,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.1,82.6,,231.28,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.1,82.6,,231.28,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",34.73,454.8,
"CARD REHAB GRADUATE EXERCISE",943,CDM,943,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.7% of total billed charges",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.37,33.9,,1.90,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"EVENT MONITOR RECORDING",73193270,CDM,731,RC,93270,CPT,OUTPATIENT,,,327,212.55,,287.76,88,,230.21,,,0,"percent of total billed charges","88% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",54.94,16.8,,43.95,,,0,"percent of total billed charges","16.8% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",67.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",56.58,17.304,,45.26,,,0,"percent of total billed charges","17.304% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206.01,63,,164.81,,,0,"percent of total billed charges","63% of total billed charges",50.03,15.3,,40.02,,,0,"percent of total billed charges","15.3% of total billed charges",54.94,16.8,,43.95,,,0,"percent of total billed charges","16.8% of total billed charges",225.63,69,,,,,0,"fee schedule","69% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",54.94,16.8,,43.95,,,0,"percent of total billed charges","16.8% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",54.94,16.8,,43.95,,,0,"percent of total billed charges","16.8% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",56.03,17.136,,44.82,,,0,"percent of total billed charges","17.136% of total billed charges",71.42,21.84,,57.14,,,0,"percent of total billed charges","21.84% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.7% of total billed charges",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.70% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.85,33.9,,88.68,,,0,"percent of total billed charges","33.9% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.06,78,,204.05,,,0,"percent of total billed charges","78% of total billed charges",38.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",54.94,16.8,,43.95,,,0,"percent of total billed charges","16.8% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",54.94,16.8,,43.95,,,0,"percent of total billed charges","16.8% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",38.46,327,
"CARDIOVASCULAR STRESS",48293017,CDM,482,RC,93017,CPT,OUTPATIENT,,,1022,664.3,,899.36,88,,719.49,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.99,100,,,,,0,"fee schedule",EAPG,1022,100,,817.60,,,0,"percent of total billed charges","100% of total billed charges",560.25,175,,,,,0,"fee schedule","175% of CMS fee schedule",155.52,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.86,63,,515.09,,,0,"percent of total billed charges","63% of total billed charges",156.37,15.3,,125.10,,,0,"percent of total billed charges","15.3% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,705.18,69,,,,,0,"fee schedule","69% of total billed charges",1022,100,,817.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022,100,,817.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022,100,,817.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.99,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.84,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.01,100,,,,,0,"fee schedule",EAPG,196.29,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",385.29,37.7,,308.23,,,0,"percent of total billed charges","37.7% of total billed charges",385.29,37.7,,308.23,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",346.46,33.9,,277.17,,,0,"percent of total billed charges","33.9% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",797.16,78,,637.73,,,0,"percent of total billed charges","78% of total billed charges",323.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.17,82.6,,675.34,,,0,"percent of total billed charges","82.6% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.17,82.6,,675.34,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.99,100,,,,,0,"fee schedule",EAPG,1022,100,,817.60,,,0,"percent of total billed charges","100% of total billed charges",111.84,1074.33,
EKG,EKG1,CDM,730,RC,93005,CPT,OUTPATIENT,,,367,238.55,,322.96,88,,258.37,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,367,100,,293.60,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",24.47,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",231.21,63,,184.97,,,0,"percent of total billed charges","63% of total billed charges",56.15,15.3,,44.92,,,0,"percent of total billed charges","15.3% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,253.23,69,,,,,0,"fee schedule","69% of total billed charges",367,100,,293.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367,100,,293.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367,100,,293.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17.6,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.23,100,,,,,0,"fee schedule",EAPG,30.89,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",138.36,37.7,,110.69,,,0,"percent of total billed charges","37.7% of total billed charges",138.36,37.7,,110.69,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.41,33.9,,99.53,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",286.26,78,,229.01,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",303.14,82.6,,242.51,,,0,"percent of total billed charges","82.6% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",303.14,82.6,,242.51,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,367,100,,293.60,,,0,"percent of total billed charges","100% of total billed charges",17.6,367,
ELECTROCARDIOGRAM,73093005,CDM,730,RC,93005,CPT,OUTPATIENT,,,509,330.85,,447.92,88,,358.34,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",24.47,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320.67,63,,256.54,,,0,"percent of total billed charges","63% of total billed charges",77.88,15.3,,62.30,,,0,"percent of total billed charges","15.3% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,351.21,69,,,,,0,"fee schedule","69% of total billed charges",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17.6,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.23,100,,,,,0,"fee schedule",EAPG,30.89,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191.89,37.7,,153.51,,,0,"percent of total billed charges","37.7% of total billed charges",191.89,37.7,,153.51,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",172.55,33.9,,138.04,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397.02,78,,317.62,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.43,82.6,,336.34,,,0,"percent of total billed charges","82.6% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.43,82.6,,336.34,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",17.6,509,
ELECTROCARDIOGRAM,73093005,CDM,730,RC,93005,CPT,OUTPATIENT,,,509,330.85,,447.92,88,,358.34,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",24.47,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320.67,63,,256.54,,,0,"percent of total billed charges","63% of total billed charges",77.88,15.3,,62.30,,,0,"percent of total billed charges","15.3% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,351.21,69,,,,,0,"fee schedule","69% of total billed charges",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17.6,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.23,100,,,,,0,"fee schedule",EAPG,30.89,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191.89,37.7,,153.51,,,0,"percent of total billed charges","37.7% of total billed charges",191.89,37.7,,153.51,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",172.55,33.9,,138.04,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397.02,78,,317.62,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.43,82.6,,336.34,,,0,"percent of total billed charges","82.6% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.43,82.6,,336.34,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",17.6,509,
"HEALTHY HEART CHECK",301,CDM,301,RC,,,OUTPATIENT,,,76,49.4,,66.88,88,,53.50,,,0,"percent of total billed charges","88% of total billed charges",38,50,,30.40,,,0,"percent of total billed charges","50% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.15,17.304,,10.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.88,63,,38.30,,,0,"percent of total billed charges","63% of total billed charges",11.63,15.3,,9.30,,,0,"percent of total billed charges","15.3% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",52.44,69,,,,,0,"fee schedule","69% of total billed charges",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.01,61.85,,37.61,,,0,"percent of total billed charges","61.5% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",38,50,,30.40,,,0,"percent of total billed charges","50% of total billed charges",24.47,32.2,,19.58,,,0,"percent of total billed charges","32.2% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.02,17.136,,10.42,,,0,"percent of total billed charges","17.136% of total billed charges",16.6,21.84,,13.28,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.65,37.7,,22.92,,,0,"percent of total billed charges","37.7% of total billed charges",28.65,37.7,,22.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.76,33.9,,20.61,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.28,78,,47.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.78,82.6,,50.22,,,0,"percent of total billed charges","82.6% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",38,50,,30.40,,,0,"percent of total billed charges","50% of total billed charges",62.78,82.6,,50.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",11.63,76,
"EVENT MONITOR RECORDING ONLY",73193270,CDM,731,RC,93270,CPT,OUTPATIENT,,,327,212.55,,287.76,88,,230.21,,,0,"percent of total billed charges","88% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",54.94,16.8,,43.95,,,0,"percent of total billed charges","16.8% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",67.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",56.58,17.304,,45.26,,,0,"percent of total billed charges","17.304% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206.01,63,,164.81,,,0,"percent of total billed charges","63% of total billed charges",50.03,15.3,,40.02,,,0,"percent of total billed charges","15.3% of total billed charges",54.94,16.8,,43.95,,,0,"percent of total billed charges","16.8% of total billed charges",225.63,69,,,,,0,"fee schedule","69% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",54.94,16.8,,43.95,,,0,"percent of total billed charges","16.8% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",54.94,16.8,,43.95,,,0,"percent of total billed charges","16.8% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",56.03,17.136,,44.82,,,0,"percent of total billed charges","17.136% of total billed charges",71.42,21.84,,57.14,,,0,"percent of total billed charges","21.84% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.7% of total billed charges",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.70% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.85,33.9,,88.68,,,0,"percent of total billed charges","33.9% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.06,78,,204.05,,,0,"percent of total billed charges","78% of total billed charges",38.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",54.94,16.8,,43.95,,,0,"percent of total billed charges","16.8% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",54.94,16.8,,43.95,,,0,"percent of total billed charges","16.8% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",38.46,327,
"HOLTER MONITOR RECORD/HOOKUP",73193225,CDM,731,RC,93225,CPT,OUTPATIENT,,,394,256.1,,346.72,88,,277.38,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.52,100,,,,,0,"fee schedule",EAPG,394,100,,315.20,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",63.37,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",248.22,63,,198.58,,,0,"percent of total billed charges","63% of total billed charges",60.28,15.3,,48.22,,,0,"percent of total billed charges","15.3% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,271.86,69,,,,,0,"fee schedule","69% of total billed charges",394,100,,315.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394,100,,315.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394,100,,315.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.52,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",45.57,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",62.75,100,,,,,0,"fee schedule",EAPG,79.98,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.54,37.7,,118.83,,,0,"percent of total billed charges","37.7% of total billed charges",148.54,37.7,,118.83,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",133.57,33.9,,106.86,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.32,78,,245.86,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",325.44,82.6,,260.35,,,0,"percent of total billed charges","82.6% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",325.44,82.6,,260.35,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.52,100,,,,,0,"fee schedule",EAPG,394,100,,315.20,,,0,"percent of total billed charges","100% of total billed charges",45.57,454.8,
"EKG RHYTHM STRIP",73093041,CDM,730,RC,93041,CPT,OUTPATIENT,,,234,152.1,,205.92,88,,164.74,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",24.47,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.42,63,,117.94,,,0,"percent of total billed charges","63% of total billed charges",35.8,15.3,,28.64,,,0,"percent of total billed charges","15.3% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,161.46,69,,,,,0,"fee schedule","69% of total billed charges",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17.6,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.23,100,,,,,0,"fee schedule",EAPG,30.89,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",88.22,37.7,,70.58,,,0,"percent of total billed charges","37.7% of total billed charges",88.22,37.7,,70.58,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",79.33,33.9,,63.46,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",182.52,78,,146.02,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",193.28,82.6,,154.62,,,0,"percent of total billed charges","82.6% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",193.28,82.6,,154.62,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",17.6,234,
"23929 Unlisted procedure, shoulder.",76123929,CDM,761,RC,23929,CPT,OUTPATIENT,,,450,292.5,,396,88,,316.80,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,450,100,,360.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.5,63,,226.80,,,0,"percent of total billed charges","63% of total billed charges",68.85,15.3,,55.08,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,310.5,69,,,,,0,"fee schedule","69% of total billed charges",450,100,,360.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",450,100,,360.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",450,100,,360.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.65,37.7,,135.72,,,0,"percent of total billed charges","37.7% of total billed charges",169.65,37.7,,135.72,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",152.55,33.9,,122.04,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",351,78,,280.80,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",371.7,82.6,,297.36,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",371.7,82.6,,297.36,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,450,100,,360.00,,,0,"percent of total billed charges","100% of total billed charges",68.85,837.64,
"64495 - INJ PARAVERT F JNT L/S 3 LEV.",76164495,CDM,761,RC,64495,CPT,OUTPATIENT,,,678,440.7,,596.64,88,,477.31,,,0,"percent of total billed charges","88% of total billed charges",339,50,,271.20,,,0,"percent of total billed charges","50% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,678,100,,542.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",793.79,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",427.14,63,,341.71,,,0,"percent of total billed charges","63% of total billed charges",103.73,15.3,,82.98,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,467.82,69,,,,,0,"fee schedule","69% of total billed charges",678,100,,542.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",678,100,,542.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",678,100,,542.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",419.34,61.85,,335.47,,,0,"percent of total billed charges","61.5% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,339,50,,271.20,,,0,"percent of total billed charges","50% of total billed charges",218.32,32.2,,174.66,,,0,"percent of total billed charges","32.2% of total billed charges",570.86,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",255.61,37.7,,204.49,,,0,"percent of total billed charges","37.7% of total billed charges",255.61,37.7,,204.49,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.84,33.9,,183.87,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",528.84,78,,423.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",560.03,82.6,,448.02,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,339,50,,271.20,,,0,"percent of total billed charges","50% of total billed charges",560.03,82.6,,448.02,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",770.67,100,,,,,0,"fee schedule",EAPG,678,100,,542.40,,,0,"percent of total billed charges","100% of total billed charges",103.73,1001.87,
"CENTRAL CATH NONTUN AGE 5+YRS",76136556,CDM,761,RC,36556,CPT,OUTPATIENT,,,5228,3398.2,,4600.64,88,,3680.51,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",1043.63,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3293.64,63,,2634.91,,,0,"percent of total billed charges","63% of total billed charges",799.88,15.3,,639.90,,,0,"percent of total billed charges","15.3% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,3607.32,69,,,,,0,"fee schedule","69% of total billed charges",5228,100,,4182.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5228,100,,4182.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5228,100,,4182.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",750.54,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033.49,100,,,,,0,"fee schedule",EAPG,1317.2,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1970.96,37.7,,1576.77,,,0,"percent of total billed charges","37.7% of total billed charges",1970.96,37.7,,1576.77,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1772.29,33.9,,1417.83,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4077.84,78,,3262.27,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4318.33,82.6,,3454.66,,,0,"percent of total billed charges","82.6% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4318.33,82.6,,3454.66,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,5228,100,,4182.40,,,0,"percent of total billed charges","100% of total billed charges",750.54,11625.57,
"PICC LINE INSERT > 5 YEARS OLD",76036569,CDM,760,RC,36569,CPT,OUTPATIENT,,,4109,2670.85,,3615.92,88,,2892.74,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,4109,100,,3287.20,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",1043.63,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2588.67,63,,2070.94,,,0,"percent of total billed charges","63% of total billed charges",821.8,15.3,,657.44,,,0,"percent of total billed charges","15.3% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,2835.21,69,,,,,0,"fee schedule","69% of total billed charges",4109,100,,3287.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4109,100,,3287.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4109,100,,3287.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",750.54,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033.49,100,,,,,0,"fee schedule",EAPG,1317.2,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1549.09,37.7,,1239.27,,,0,"percent of total billed charges","37.7% of total billed charges",1549.09,37.7,,1239.27,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1392.95,33.9,,1114.36,,,0,"percent of total billed charges","33.9% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3205.02,78,,2564.02,,,0,"percent of total billed charges","78% of total billed charges",1649.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3394.03,82.6,,2715.22,,,0,"percent of total billed charges","82.6% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3394.03,82.6,,2715.22,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,4109,100,,3287.20,,,0,"percent of total billed charges","100% of total billed charges",750.54,5712.48,
N/A,92136570,CDM,921,RC,36570,CPT,OUTPATIENT,,,2298,1493.7,,2022.24,88,,1617.79,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,2298,100,,1838.40,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",1043.63,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1447.74,63,,1158.19,,,0,"percent of total billed charges","63% of total billed charges",351.59,15.3,,281.27,,,0,"percent of total billed charges","15.3% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,1585.62,69,,,,,0,"fee schedule","69% of total billed charges",2298,100,,1838.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2298,100,,1838.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2298,100,,1838.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",750.54,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033.49,100,,,,,0,"fee schedule",EAPG,1317.2,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",866.35,37.7,,693.08,,,0,"percent of total billed charges","37.7% of total billed charges",866.35,37.7,,693.08,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",779.02,33.9,,623.22,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1792.44,78,,1433.95,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1898.15,82.6,,1518.52,,,0,"percent of total billed charges","82.6% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1898.15,82.6,,1518.52,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,2298,100,,1838.40,,,0,"percent of total billed charges","100% of total billed charges",351.59,11625.57,
"REMOVE TUNNELED CVC NO PORT/PU",76136589,CDM,761,RC,36589,CPT,OUTPATIENT,,,1470,955.5,,1293.6,88,,1034.88,,,0,"percent of total billed charges","88% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,1470,100,,1176.00,,,0,"percent of total billed charges","100% of total billed charges",1121.3,175,,,,,0,"fee schedule","175% of CMS fee schedule",678.35,100,,,,,0,"fee schedule",EAPG,640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",926.1,63,,740.88,,,0,"percent of total billed charges","63% of total billed charges",224.91,15.3,,179.93,,,0,"percent of total billed charges","15.3% of total billed charges",658.59,100,,,,,0,"fee schedule",EAPG,1014.3,69,,,,,0,"fee schedule","69% of total billed charges",1470,100,,1176.00,,,0,"percent of total billed charges","100% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1470,100,,1176.00,,,0,"percent of total billed charges","100% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1470,100,,1176.00,,,0,"percent of total billed charges","100% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",2200.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",575.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",487.85,100,,,,,0,"fee schedule",EAPG,640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671.77,100,,,,,0,"fee schedule",EAPG,856.17,100,,,,,0,"fee schedule",EAPG,640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.19,37.7,,443.35,,,0,"percent of total billed charges","37.7% of total billed charges",554.19,37.7,,443.35,,,0,"percent of total billed charges","37.70% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",498.33,33.9,,398.66,,,0,"percent of total billed charges","33.9% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1146.6,78,,917.28,,,0,"percent of total billed charges","78% of total billed charges",647.15,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1214.22,82.6,,971.38,,,0,"percent of total billed charges","82.6% of total billed charges",658.59,100,,,,,0,"fee schedule",EAPG,640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1214.22,82.6,,971.38,,,0,"percent of total billed charges","82.6% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,1470,100,,1176.00,,,0,"percent of total billed charges","100% of total billed charges",224.91,2200.34,
"DECLOT VASCULAR DEVICE",76036593,CDM,760,RC,36593,CPT,OUTPATIENT,,,1055,685.75,,928.4,88,,742.72,,,0,"percent of total billed charges","88% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,1055,100,,844.00,,,0,"percent of total billed charges","100% of total billed charges",604.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",281.17,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",664.65,63,,531.72,,,0,"percent of total billed charges","63% of total billed charges",211,15.3,,168.80,,,0,"percent of total billed charges","15.3% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,727.95,69,,,,,0,"fee schedule","69% of total billed charges",1055,100,,844.00,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055,100,,844.00,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055,100,,844.00,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",1262.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.21,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278.44,100,,,,,0,"fee schedule",EAPG,354.88,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397.74,37.7,,318.19,,,0,"percent of total billed charges","37.7% of total billed charges",397.74,37.7,,318.19,,,0,"percent of total billed charges","37.70% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",357.65,33.9,,286.12,,,0,"percent of total billed charges","33.9% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",822.9,78,,658.32,,,0,"percent of total billed charges","78% of total billed charges",348.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",871.43,82.6,,697.14,,,0,"percent of total billed charges","82.6% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",871.43,82.6,,697.14,,,0,"percent of total billed charges","82.6% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,1055,100,,844.00,,,0,"percent of total billed charges","100% of total billed charges",202.21,1262.42,
"LAB DRAW VIA CENTRAL LINE",30036592,CDM,300,RC,36592,CPT,OUTPATIENT,,,425,276.25,,374,88,,299.20,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,425,100,,340.00,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",54.44,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",65.03,15.3,,52.02,,,0,"percent of total billed charges","15.3% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,293.25,69,,,,,0,"fee schedule","69% of total billed charges",425,100,,340.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",425,100,,340.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",425,100,,340.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.15,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",53.92,100,,,,,0,"fee schedule",EAPG,68.72,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.23,37.7,,128.18,,,0,"percent of total billed charges","37.7% of total billed charges",160.23,37.7,,128.18,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",144.08,33.9,,115.26,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",331.5,78,,265.20,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",351.05,82.6,,280.84,,,0,"percent of total billed charges","82.6% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",351.05,82.6,,280.84,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,425,100,,340.00,,,0,"percent of total billed charges","100% of total billed charges",39.15,454.8,
"BONE MARROW ASPIRATION",76038220,CDM,760,RC,38220,CPT,OUTPATIENT,,,4467,2903.55,,3930.96,88,,3144.77,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1070.37,100,,,,,0,"fee schedule",EAPG,4467,100,,3573.60,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1102.48,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2814.21,63,,2251.37,,,0,"percent of total billed charges","63% of total billed charges",893.4,15.3,,714.72,,,0,"percent of total billed charges","15.3% of total billed charges",1070.37,100,,,,,0,"fee schedule",EAPG,3082.23,69,,,,,0,"fee schedule","69% of total billed charges",4467,100,,3573.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4467,100,,3573.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4467,100,,3573.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1070.37,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",792.87,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1091.78,100,,,,,0,"fee schedule",EAPG,1391.48,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1684.06,37.7,,1347.25,,,0,"percent of total billed charges","37.7% of total billed charges",1684.06,37.7,,1347.25,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1514.31,33.9,,1211.45,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3484.26,78,,2787.41,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3689.74,82.6,,2951.79,,,0,"percent of total billed charges","82.6% of total billed charges",1070.37,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3689.74,82.6,,2951.79,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1070.37,100,,,,,0,"fee schedule",EAPG,4467,100,,3573.60,,,0,"percent of total billed charges","100% of total billed charges",792.87,5715.97,
"BONE MARROW BIOPSY NDL OR TROC",76038221,CDM,760,RC,38221,CPT,OUTPATIENT,,,1188,772.2,,1045.44,88,,836.35,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1070.37,100,,,,,0,"fee schedule",EAPG,1188,100,,950.40,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1102.48,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",748.44,63,,598.75,,,0,"percent of total billed charges","63% of total billed charges",237.6,15.3,,190.08,,,0,"percent of total billed charges","15.3% of total billed charges",1070.37,100,,,,,0,"fee schedule",EAPG,819.72,69,,,,,0,"fee schedule","69% of total billed charges",1188,100,,950.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1188,100,,950.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1188,100,,950.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1070.37,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",792.87,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1091.78,100,,,,,0,"fee schedule",EAPG,1391.48,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",447.88,37.7,,358.30,,,0,"percent of total billed charges","37.7% of total billed charges",447.88,37.7,,358.30,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.73,33.9,,322.18,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",926.64,78,,741.31,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",981.29,82.6,,785.03,,,0,"percent of total billed charges","82.6% of total billed charges",1070.37,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",981.29,82.6,,785.03,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1070.37,100,,,,,0,"fee schedule",EAPG,1188,100,,950.40,,,0,"percent of total billed charges","100% of total billed charges",237.6,5715.97,
"38222 DIAGNOSTIC BONE MARROW; BIOPSY AND ASPIRATION",38222,CDM,761,RC,38222,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1070.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1102.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1070.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1070.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",792.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1091.78,100,,,,,0,"fee schedule",EAPG,1391.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1070.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1070.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",792.87,1391.48,
"51701 CATHETER INSERTION,SIMPLE CHARGE",76151701,CDM,761,RC,51701,CPT,OUTPATIENT,,,179,116.35,,157.52,88,,126.02,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,179,100,,143.20,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",66.85,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",112.77,63,,90.22,,,0,"percent of total billed charges","63% of total billed charges",27.39,15.3,,21.91,,,0,"percent of total billed charges","15.3% of total billed charges",64.9,100,,,,,0,"fee schedule",EAPG,123.51,69,,,,,0,"fee schedule","69% of total billed charges",179,100,,143.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",179,100,,143.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",179,100,,143.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",48.07,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.2,100,,,,,0,"fee schedule",EAPG,84.37,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",67.48,37.7,,53.98,,,0,"percent of total billed charges","37.7% of total billed charges",67.48,37.7,,53.98,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60.68,33.9,,48.54,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",139.62,78,,111.70,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.85,82.6,,118.28,,,0,"percent of total billed charges","82.6% of total billed charges",64.9,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.85,82.6,,118.28,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,179,100,,143.20,,,0,"percent of total billed charges","100% of total billed charges",27.39,454.8,
"51703 CATHETERIZATION COMPLEX CHARGE",76151703,CDM,761,RC,51703,CPT,OUTPATIENT,,,291,189.15,,256.08,88,,204.86,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,291,100,,232.80,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",66.85,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",183.33,63,,146.66,,,0,"percent of total billed charges","63% of total billed charges",44.52,15.3,,35.62,,,0,"percent of total billed charges","15.3% of total billed charges",64.9,100,,,,,0,"fee schedule",EAPG,200.79,69,,,,,0,"fee schedule","69% of total billed charges",291,100,,232.80,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",291,100,,232.80,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",291,100,,232.80,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",48.07,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.2,100,,,,,0,"fee schedule",EAPG,84.37,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.71,37.7,,87.77,,,0,"percent of total billed charges","37.7% of total billed charges",109.71,37.7,,87.77,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",98.65,33.9,,78.92,,,0,"percent of total billed charges","33.9% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",226.98,78,,181.58,,,0,"percent of total billed charges","78% of total billed charges",160.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",240.37,82.6,,192.30,,,0,"percent of total billed charges","82.6% of total billed charges",64.9,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",240.37,82.6,,192.30,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,291,100,,232.80,,,0,"percent of total billed charges","100% of total billed charges",44.52,566.91,
"FINGER STICK FOR GLUCOSE METER",30082962,CDM,300,RC,82962,CPT,OUTPATIENT,,,52,33.8,,45.76,88,,36.61,,,0,"percent of total billed charges","88% of total billed charges",3.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",5.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,3.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.76,63,,26.21,,,0,"percent of total billed charges","63% of total billed charges",7.96,15.3,,6.37,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,35.88,69,,,,,0,"fee schedule","69% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",3.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",3.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",3.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.54,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,3.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.28,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,3.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,3.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.6,37.7,,15.68,,,0,"percent of total billed charges","37.7% of total billed charges",19.6,37.7,,15.68,,,0,"percent of total billed charges","37.70% of total billed charges",3.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.63,33.9,,14.10,,,0,"percent of total billed charges","33.9% of total billed charges",3.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.56,78,,32.45,,,0,"percent of total billed charges","78% of total billed charges",3.31,101,,,,,0,"fee schedule","101% of CMS fee schedule ",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,3.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",3.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,52,
"IMMUNIZATION ADMIN 1 VACCINE",77190471,CDM,771,RC,90471,CPT,OUTPATIENT,,,415,269.75,,365.2,88,,292.16,,,0,"percent of total billed charges","88% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,415,100,,332.00,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.67,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",261.45,63,,209.16,,,0,"percent of total billed charges","63% of total billed charges",63.5,15.3,,50.80,,,0,"percent of total billed charges","15.3% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,286.35,69,,,,,0,"fee schedule","69% of total billed charges",415,100,,332.00,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",415,100,,332.00,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",415,100,,332.00,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.33,100,,,,,0,"fee schedule",EAPG,45.03,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",156.46,37.7,,125.17,,,0,"percent of total billed charges","37.7% of total billed charges",156.46,37.7,,125.17,,,0,"percent of total billed charges","37.70% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",140.69,33.9,,112.55,,,0,"percent of total billed charges","33.9% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",323.7,78,,258.96,,,0,"percent of total billed charges","78% of total billed charges",72.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.79,82.6,,274.23,,,0,"percent of total billed charges","82.6% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.79,82.6,,274.23,,,0,"percent of total billed charges","82.6% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,415,100,,332.00,,,0,"percent of total billed charges","100% of total billed charges",34.64,415,
"IMMUNIZATION ADMIN EA ADD'L",77190472,CDM,771,RC,90472,CPT,OUTPATIENT,,,494,321.1,,434.72,88,,347.78,,,0,"percent of total billed charges","88% of total billed charges",247,50,,197.60,,,0,"percent of total billed charges","50% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,494,100,,395.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.67,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",311.22,63,,248.98,,,0,"percent of total billed charges","63% of total billed charges",75.58,15.3,,60.46,,,0,"percent of total billed charges","15.3% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,340.86,69,,,,,0,"fee schedule","69% of total billed charges",494,100,,395.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",494,100,,395.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",494,100,,395.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",305.54,61.85,,244.43,,,0,"percent of total billed charges","61.5% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,247,50,,197.60,,,0,"percent of total billed charges","50% of total billed charges",159.07,32.2,,127.26,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.33,100,,,,,0,"fee schedule",EAPG,45.03,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",186.24,37.7,,148.99,,,0,"percent of total billed charges","37.7% of total billed charges",186.24,37.7,,148.99,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",167.47,33.9,,133.98,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",385.32,78,,308.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.04,82.6,,326.43,,,0,"percent of total billed charges","82.6% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,247,50,,197.60,,,0,"percent of total billed charges","50% of total billed charges",408.04,82.6,,326.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.64,100,,,,,0,"fee schedule",EAPG,494,100,,395.20,,,0,"percent of total billed charges","100% of total billed charges",34.64,494,
"IV INF THERA INITIAL 1ST HR",AMB820025,CDM,761,RC,96365,CPT,OUTPATIENT,,,939,610.35,,826.32,88,,661.06,,,0,"percent of total billed charges","88% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,939,100,,751.20,,,0,"percent of total billed charges","100% of total billed charges",382.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",281.17,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",143.67,15.3,,114.94,,,0,"percent of total billed charges","15.3% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,647.91,69,,,,,0,"fee schedule","69% of total billed charges",939,100,,751.20,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",939,100,,751.20,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",939,100,,751.20,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",826.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.21,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278.44,100,,,,,0,"fee schedule",EAPG,354.88,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",354,37.7,,283.20,,,0,"percent of total billed charges","37.7% of total billed charges",354,37.7,,283.20,,,0,"percent of total billed charges","37.70% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",318.32,33.9,,254.66,,,0,"percent of total billed charges","33.9% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",732.42,78,,585.94,,,0,"percent of total billed charges","78% of total billed charges",220.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",775.61,82.6,,620.49,,,0,"percent of total billed charges","82.6% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",775.61,82.6,,620.49,,,0,"percent of total billed charges","82.6% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,939,100,,751.20,,,0,"percent of total billed charges","100% of total billed charges",143.67,939,
"IV INFUSION SEQUENTIAL EA HR",AMB820061,CDM,761,RC,96367,CPT,OUTPATIENT,,,597,388.05,,525.36,88,,420.29,,,0,"percent of total billed charges","88% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,597,100,,477.60,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",281.17,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",91.34,15.3,,73.07,,,0,"percent of total billed charges","15.3% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,411.93,69,,,,,0,"fee schedule","69% of total billed charges",597,100,,477.60,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",597,100,,477.60,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",597,100,,477.60,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.21,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278.44,100,,,,,0,"fee schedule",EAPG,354.88,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",225.07,37.7,,180.06,,,0,"percent of total billed charges","37.7% of total billed charges",225.07,37.7,,180.06,,,0,"percent of total billed charges","37.70% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.38,33.9,,161.90,,,0,"percent of total billed charges","33.9% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465.66,78,,372.53,,,0,"percent of total billed charges","78% of total billed charges",72.56,100,,,,,0,"fee schedule","100% of CMS OPPS rate",493.12,82.6,,394.50,,,0,"percent of total billed charges","82.6% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",493.12,82.6,,394.50,,,0,"percent of total billed charges","82.6% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,597,100,,477.60,,,0,"percent of total billed charges","100% of total billed charges",65.81,597,
"CHEMO ADM SUBQ/IM NON HORMONAL",33196401,CDM,331,RC,96401,CPT,OUTPATIENT,,,652,423.8,,573.76,88,,459.01,,,0,"percent of total billed charges","88% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,652,100,,521.60,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.76,63,,328.61,,,0,"percent of total billed charges","63% of total billed charges",99.76,15.3,,79.81,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,449.88,69,,,,,0,"fee schedule","69% of total billed charges",652,100,,521.60,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652,100,,521.60,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652,100,,521.60,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.48,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",245.8,37.7,,196.64,,,0,"percent of total billed charges","37.7% of total billed charges",245.8,37.7,,196.64,,,0,"percent of total billed charges","37.70% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.03,33.9,,176.82,,,0,"percent of total billed charges","33.9% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",508.56,78,,406.85,,,0,"percent of total billed charges","78% of total billed charges",72.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",538.55,82.6,,430.84,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",538.55,82.6,,430.84,,,0,"percent of total billed charges","82.6% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,652,100,,521.60,,,0,"percent of total billed charges","100% of total billed charges",29.48,652,
"HORMONAL ANTI-NEOPLASTIC",33196402,CDM,331,RC,96402,CPT,OUTPATIENT,,,386,250.9,,339.68,88,,271.74,,,0,"percent of total billed charges","88% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",243.18,63,,194.54,,,0,"percent of total billed charges","63% of total billed charges",59.06,15.3,,47.25,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,266.34,69,,,,,0,"fee schedule","69% of total billed charges",386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.48,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",145.52,37.7,,116.42,,,0,"percent of total billed charges","37.7% of total billed charges",145.52,37.7,,116.42,,,0,"percent of total billed charges","37.70% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",130.85,33.9,,104.68,,,0,"percent of total billed charges","33.9% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",301.08,78,,240.86,,,0,"percent of total billed charges","78% of total billed charges",72.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",318.84,82.6,,255.07,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",318.84,82.6,,255.07,,,0,"percent of total billed charges","82.6% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",29.48,386,
"IVPUSH TECHNIQUE SGL/INIT DRUG",33596409,CDM,335,RC,96409,CPT,OUTPATIENT,,,939,610.35,,826.32,88,,661.06,,,0,"percent of total billed charges","88% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,939,100,,751.20,,,0,"percent of total billed charges","100% of total billed charges",604.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591.57,63,,473.26,,,0,"percent of total billed charges","63% of total billed charges",143.67,15.3,,114.94,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,647.91,69,,,,,0,"fee schedule","69% of total billed charges",939,100,,751.20,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",939,100,,751.20,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",939,100,,751.20,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",826.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.48,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",354,37.7,,283.20,,,0,"percent of total billed charges","37.7% of total billed charges",354,37.7,,283.20,,,0,"percent of total billed charges","37.70% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",318.32,33.9,,254.66,,,0,"percent of total billed charges","33.9% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",732.42,78,,585.94,,,0,"percent of total billed charges","78% of total billed charges",348.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",775.61,82.6,,620.49,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",775.61,82.6,,620.49,,,0,"percent of total billed charges","82.6% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,939,100,,751.20,,,0,"percent of total billed charges","100% of total billed charges",29.48,939,
"CHEMO ADM:INTRALESIONAL 1-7LES",33196405,CDM,331,RC,96405,CPT,OUTPATIENT,,,591,384.15,,520.08,88,,416.06,,,0,"percent of total billed charges","88% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",372.33,63,,297.86,,,0,"percent of total billed charges","63% of total billed charges",90.42,15.3,,72.34,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,407.79,69,,,,,0,"fee schedule","69% of total billed charges",591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.48,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",222.81,37.7,,178.25,,,0,"percent of total billed charges","37.7% of total billed charges",222.81,37.7,,178.25,,,0,"percent of total billed charges","37.70% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200.35,33.9,,160.28,,,0,"percent of total billed charges","33.9% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460.98,78,,368.78,,,0,"percent of total billed charges","78% of total billed charges",72.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",488.17,82.6,,390.54,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",488.17,82.6,,390.54,,,0,"percent of total billed charges","82.6% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",29.48,591,
"INTRALESIONAL > 7 LESIONS",33196406,CDM,331,RC,96406,CPT,OUTPATIENT,,,839,545.35,,738.32,88,,590.66,,,0,"percent of total billed charges","88% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,839,100,,671.20,,,0,"percent of total billed charges","100% of total billed charges",382.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",528.57,63,,422.86,,,0,"percent of total billed charges","63% of total billed charges",128.37,15.3,,102.70,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,578.91,69,,,,,0,"fee schedule","69% of total billed charges",839,100,,671.20,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",839,100,,671.20,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",839,100,,671.20,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",826.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.48,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",316.3,37.7,,253.04,,,0,"percent of total billed charges","37.7% of total billed charges",316.3,37.7,,253.04,,,0,"percent of total billed charges","37.70% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.42,33.9,,227.54,,,0,"percent of total billed charges","33.9% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",654.42,78,,523.54,,,0,"percent of total billed charges","78% of total billed charges",220.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",693.01,82.6,,554.41,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",693.01,82.6,,554.41,,,0,"percent of total billed charges","82.6% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,839,100,,671.20,,,0,"percent of total billed charges","100% of total billed charges",29.48,839,
"INT OR PROLONG CHEM >8HR WPUMP",33596416,CDM,335,RC,96416,CPT,OUTPATIENT,,,1542,1002.3,,1356.96,88,,1085.57,,,0,"percent of total billed charges","88% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,1542,100,,1233.60,,,0,"percent of total billed charges","100% of total billed charges",604.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",475.9,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",971.46,63,,777.17,,,0,"percent of total billed charges","63% of total billed charges",235.93,15.3,,188.74,,,0,"percent of total billed charges","15.3% of total billed charges",462.04,100,,,,,0,"fee schedule",EAPG,1063.98,69,,,,,0,"fee schedule","69% of total billed charges",1542,100,,1233.60,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1542,100,,1233.60,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1542,100,,1233.60,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",1262.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.25,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",471.28,100,,,,,0,"fee schedule",EAPG,600.65,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",581.33,37.7,,465.06,,,0,"percent of total billed charges","37.7% of total billed charges",581.33,37.7,,465.06,,,0,"percent of total billed charges","37.70% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",522.74,33.9,,418.19,,,0,"percent of total billed charges","33.9% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1202.76,78,,962.21,,,0,"percent of total billed charges","78% of total billed charges",348.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1273.69,82.6,,1018.95,,,0,"percent of total billed charges","82.6% of total billed charges",462.04,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1273.69,82.6,,1018.95,,,0,"percent of total billed charges","82.6% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,1542,100,,1233.60,,,0,"percent of total billed charges","100% of total billed charges",235.93,1542,
"EA ADD'L SEQ INF DIF DRUG/1HR",33596417,CDM,335,RC,96417,CPT,OUTPATIENT,,,368,239.2,,323.84,88,,259.07,,,0,"percent of total billed charges","88% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,368,100,,294.40,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",281.17,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",231.84,63,,185.47,,,0,"percent of total billed charges","63% of total billed charges",56.3,15.3,,45.04,,,0,"percent of total billed charges","15.3% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,253.92,69,,,,,0,"fee schedule","69% of total billed charges",368,100,,294.40,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",368,100,,294.40,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",368,100,,294.40,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.21,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278.44,100,,,,,0,"fee schedule",EAPG,354.88,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",138.74,37.7,,110.99,,,0,"percent of total billed charges","37.7% of total billed charges",138.74,37.7,,110.99,,,0,"percent of total billed charges","37.70% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.75,33.9,,99.80,,,0,"percent of total billed charges","33.9% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287.04,78,,229.63,,,0,"percent of total billed charges","78% of total billed charges",72.56,100,,,,,0,"fee schedule","100% of CMS OPPS rate",303.97,82.6,,243.18,,,0,"percent of total billed charges","82.6% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",303.97,82.6,,243.18,,,0,"percent of total billed charges","82.6% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,368,100,,294.40,,,0,"percent of total billed charges","100% of total billed charges",56.3,368,
"IVPUSH TECHNIQUE EA ADD'D DRUG",33596411,CDM,335,RC,96411,CPT,OUTPATIENT,,,376,244.4,,330.88,88,,264.70,,,0,"percent of total billed charges","88% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,376,100,,300.80,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",236.88,63,,189.50,,,0,"percent of total billed charges","63% of total billed charges",57.53,15.3,,46.02,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,259.44,69,,,,,0,"fee schedule","69% of total billed charges",376,100,,300.80,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",376,100,,300.80,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",376,100,,300.80,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.48,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",141.75,37.7,,113.40,,,0,"percent of total billed charges","37.7% of total billed charges",141.75,37.7,,113.40,,,0,"percent of total billed charges","37.70% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",127.46,33.9,,101.97,,,0,"percent of total billed charges","33.9% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",293.28,78,,234.62,,,0,"percent of total billed charges","78% of total billed charges",72.56,100,,,,,0,"fee schedule","100% of CMS OPPS rate",310.58,82.6,,248.46,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",310.58,82.6,,248.46,,,0,"percent of total billed charges","82.6% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,376,100,,300.80,,,0,"percent of total billed charges","100% of total billed charges",29.48,376,
"CHEMO ADM IV INF 1HR SGL INIT",33596413,CDM,335,RC,96413,CPT,OUTPATIENT,,,1542,1002.3,,1356.96,88,,1085.57,,,0,"percent of total billed charges","88% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,1542,100,,1233.60,,,0,"percent of total billed charges","100% of total billed charges",604.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",281.17,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",971.46,63,,777.17,,,0,"percent of total billed charges","63% of total billed charges",235.93,15.3,,188.74,,,0,"percent of total billed charges","15.3% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,1063.98,69,,,,,0,"fee schedule","69% of total billed charges",1542,100,,1233.60,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1542,100,,1233.60,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1542,100,,1233.60,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",1262.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.21,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278.44,100,,,,,0,"fee schedule",EAPG,354.88,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",581.33,37.7,,465.06,,,0,"percent of total billed charges","37.7% of total billed charges",581.33,37.7,,465.06,,,0,"percent of total billed charges","37.70% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",522.74,33.9,,418.19,,,0,"percent of total billed charges","33.9% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1202.76,78,,962.21,,,0,"percent of total billed charges","78% of total billed charges",348.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1273.69,82.6,,1018.95,,,0,"percent of total billed charges","82.6% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1273.69,82.6,,1018.95,,,0,"percent of total billed charges","82.6% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,1542,100,,1233.60,,,0,"percent of total billed charges","100% of total billed charges",202.21,1542,
"CHEMO ADM IV INF EA ADD'L HR",33596415,CDM,335,RC,96415,CPT,OUTPATIENT,,,288,187.2,,253.44,88,,202.75,,,0,"percent of total billed charges","88% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",475.9,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",181.44,63,,145.15,,,0,"percent of total billed charges","63% of total billed charges",44.06,15.3,,35.25,,,0,"percent of total billed charges","15.3% of total billed charges",462.04,100,,,,,0,"fee schedule",EAPG,198.72,69,,,,,0,"fee schedule","69% of total billed charges",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.25,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",471.28,100,,,,,0,"fee schedule",EAPG,600.65,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.58,37.7,,86.86,,,0,"percent of total billed charges","37.7% of total billed charges",108.58,37.7,,86.86,,,0,"percent of total billed charges","37.70% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",97.63,33.9,,78.10,,,0,"percent of total billed charges","33.9% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.64,78,,179.71,,,0,"percent of total billed charges","78% of total billed charges",72.56,100,,,,,0,"fee schedule","100% of CMS OPPS rate",237.89,82.6,,190.31,,,0,"percent of total billed charges","82.6% of total billed charges",462.04,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",237.89,82.6,,190.31,,,0,"percent of total billed charges","82.6% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",44.06,600.65,
"96450 CHEMO CNS (INTRATHECAL)",96450,CDM,280,RC,96450,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",462.04,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",475.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",462.04,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",462.04,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",342.25,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",471.28,100,,,,,0,"fee schedule",EAPG,600.65,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",462.04,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",462.04,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",342.25,600.65,
"IMPLNT VENOUS DEVICE IRRIGATIO",76096523,CDM,760,RC,96523,CPT,OUTPATIENT,,,425,276.25,,374,88,,299.20,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,425,100,,340.00,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",85,15.3,,68.00,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,293.25,69,,,,,0,"fee schedule","69% of total billed charges",425,100,,340.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",425,100,,340.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",425,100,,340.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.48,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.23,37.7,,128.18,,,0,"percent of total billed charges","37.7% of total billed charges",160.23,37.7,,128.18,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",144.08,33.9,,115.26,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",331.5,78,,265.20,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",351.05,82.6,,280.84,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",351.05,82.6,,280.84,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,425,100,,340.00,,,0,"percent of total billed charges","100% of total billed charges",29.48,425,
"99195 PHLEBOTOMY - THERAPEUTIC CHARGE",99195,CDM,940,RC,99195,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",52.86,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",54.44,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",52.86,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",52.86,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",53.92,100,,,,,0,"fee schedule",EAPG,68.72,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",52.86,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",52.86,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",39.15,68.72,
"OP VISIT LEVEL 5 NEW PT",51099205,CDM,510,RC,99205,CPT,OUTPATIENT,,,341,221.65,,300.08,88,,240.06,,,0,"percent of total billed charges","88% of total billed charges",170.5,50,,136.40,,,0,"percent of total billed charges","50% of total billed charges",57.29,16.8,,45.83,,,0,"percent of total billed charges","16.8% of total billed charges",341,100,,272.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.01,17.304,,47.21,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",214.83,63,,171.86,,,0,"percent of total billed charges","63% of total billed charges",52.17,15.3,,41.74,,,0,"percent of total billed charges","15.3% of total billed charges",57.29,16.8,,45.83,,,0,"percent of total billed charges","16.8% of total billed charges",235.29,69,,,,,0,"fee schedule","69% of total billed charges",341,100,,272.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",341,100,,272.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",341,100,,272.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",210.91,61.85,,168.73,,,0,"percent of total billed charges","61.5% of total billed charges",57.29,16.8,,45.83,,,0,"percent of total billed charges","16.8% of total billed charges",170.5,50,,136.40,,,0,"percent of total billed charges","50% of total billed charges",109.8,32.2,,87.84,,,0,"percent of total billed charges","32.2% of total billed charges",57.29,16.8,,45.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.43,17.136,,46.74,,,0,"percent of total billed charges","17.136% of total billed charges",74.47,21.84,,59.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",128.56,37.7,,102.85,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",265.98,78,,212.78,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.67,82.6,,225.34,,,0,"percent of total billed charges","82.6% of total billed charges",57.29,16.8,,45.83,,,0,"percent of total billed charges","16.8% of total billed charges",170.5,50,,136.40,,,0,"percent of total billed charges","50% of total billed charges",281.67,82.6,,225.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.29,16.8,,45.83,,,0,"percent of total billed charges","16.8% of total billed charges",341,100,,272.80,,,0,"percent of total billed charges","100% of total billed charges",52.17,341,
"OP VISIT LEVEL 2 NEW PT",51099202,CDM,510,RC,99202,CPT,OUTPATIENT,,,125,81.25,,110,88,,88.00,,,0,"percent of total billed charges","88% of total billed charges",62.5,50,,50.00,,,0,"percent of total billed charges","50% of total billed charges",21,16.8,,16.80,,,0,"percent of total billed charges","16.8% of total billed charges",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.63,17.304,,17.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.75,63,,63.00,,,0,"percent of total billed charges","63% of total billed charges",19.13,15.3,,15.30,,,0,"percent of total billed charges","15.3% of total billed charges",21,16.8,,16.80,,,0,"percent of total billed charges","16.8% of total billed charges",86.25,69,,,,,0,"fee schedule","69% of total billed charges",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.31,61.85,,61.85,,,0,"percent of total billed charges","61.5% of total billed charges",21,16.8,,16.80,,,0,"percent of total billed charges","16.8% of total billed charges",62.5,50,,50.00,,,0,"percent of total billed charges","50% of total billed charges",40.25,32.2,,32.20,,,0,"percent of total billed charges","32.2% of total billed charges",21,16.8,,16.80,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.42,17.136,,17.14,,,0,"percent of total billed charges","17.136% of total billed charges",27.3,21.84,,21.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47.13,37.7,,37.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",97.5,78,,78.00,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.25,82.6,,82.60,,,0,"percent of total billed charges","82.6% of total billed charges",21,16.8,,16.80,,,0,"percent of total billed charges","16.8% of total billed charges",62.5,50,,50.00,,,0,"percent of total billed charges","50% of total billed charges",103.25,82.6,,82.60,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,16.8,,16.80,,,0,"percent of total billed charges","16.8% of total billed charges",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",19.13,125,
"OP VISIT LEVEL 3 NEW PT",51099203,CDM,510,RC,99203,CPT,OUTPATIENT,,,175,113.75,,154,88,,123.20,,,0,"percent of total billed charges","88% of total billed charges",87.5,50,,70.00,,,0,"percent of total billed charges","50% of total billed charges",29.4,16.8,,23.52,,,0,"percent of total billed charges","16.8% of total billed charges",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.28,17.304,,24.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.25,63,,88.20,,,0,"percent of total billed charges","63% of total billed charges",26.78,15.3,,21.42,,,0,"percent of total billed charges","15.3% of total billed charges",29.4,16.8,,23.52,,,0,"percent of total billed charges","16.8% of total billed charges",120.75,69,,,,,0,"fee schedule","69% of total billed charges",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",108.24,61.85,,86.59,,,0,"percent of total billed charges","61.5% of total billed charges",29.4,16.8,,23.52,,,0,"percent of total billed charges","16.8% of total billed charges",87.5,50,,70.00,,,0,"percent of total billed charges","50% of total billed charges",56.35,32.2,,45.08,,,0,"percent of total billed charges","32.2% of total billed charges",29.4,16.8,,23.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.99,17.136,,23.99,,,0,"percent of total billed charges","17.136% of total billed charges",38.22,21.84,,30.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",65.98,37.7,,52.78,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",136.5,78,,109.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",144.55,82.6,,115.64,,,0,"percent of total billed charges","82.6% of total billed charges",29.4,16.8,,23.52,,,0,"percent of total billed charges","16.8% of total billed charges",87.5,50,,70.00,,,0,"percent of total billed charges","50% of total billed charges",144.55,82.6,,115.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.4,16.8,,23.52,,,0,"percent of total billed charges","16.8% of total billed charges",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",26.78,175,
"OP VISIT LEVEL 4 NEW PT",51099204,CDM,510,RC,99204,CPT,OUTPATIENT,,,272,176.8,,239.36,88,,191.49,,,0,"percent of total billed charges","88% of total billed charges",136,50,,108.80,,,0,"percent of total billed charges","50% of total billed charges",45.7,16.8,,36.56,,,0,"percent of total billed charges","16.8% of total billed charges",272,100,,217.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.07,17.304,,37.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",171.36,63,,137.09,,,0,"percent of total billed charges","63% of total billed charges",41.62,15.3,,33.30,,,0,"percent of total billed charges","15.3% of total billed charges",45.7,16.8,,36.56,,,0,"percent of total billed charges","16.8% of total billed charges",187.68,69,,,,,0,"fee schedule","69% of total billed charges",272,100,,217.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",272,100,,217.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",272,100,,217.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.23,61.85,,134.58,,,0,"percent of total billed charges","61.5% of total billed charges",45.7,16.8,,36.56,,,0,"percent of total billed charges","16.8% of total billed charges",136,50,,108.80,,,0,"percent of total billed charges","50% of total billed charges",87.58,32.2,,70.06,,,0,"percent of total billed charges","32.2% of total billed charges",45.7,16.8,,36.56,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.61,17.136,,37.29,,,0,"percent of total billed charges","17.136% of total billed charges",59.4,21.84,,47.52,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",102.54,37.7,,82.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",212.16,78,,169.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.67,82.6,,179.74,,,0,"percent of total billed charges","82.6% of total billed charges",45.7,16.8,,36.56,,,0,"percent of total billed charges","16.8% of total billed charges",136,50,,108.80,,,0,"percent of total billed charges","50% of total billed charges",224.67,82.6,,179.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.7,16.8,,36.56,,,0,"percent of total billed charges","16.8% of total billed charges",272,100,,217.60,,,0,"percent of total billed charges","100% of total billed charges",41.62,272,
"OP VISIT LEVEL 5 EST PT",51099215,CDM,510,RC,99215,CPT,OUTPATIENT,,,662,430.3,,582.56,88,,466.05,,,0,"percent of total billed charges","88% of total billed charges",331,50,,264.80,,,0,"percent of total billed charges","50% of total billed charges",111.22,16.8,,88.98,,,0,"percent of total billed charges","16.8% of total billed charges",662,100,,529.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.55,17.304,,91.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.06,63,,333.65,,,0,"percent of total billed charges","63% of total billed charges",101.29,15.3,,81.03,,,0,"percent of total billed charges","15.3% of total billed charges",111.22,16.8,,88.98,,,0,"percent of total billed charges","16.8% of total billed charges",456.78,69,,,,,0,"fee schedule","69% of total billed charges",662,100,,529.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662,100,,529.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662,100,,529.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",409.45,61.85,,327.56,,,0,"percent of total billed charges","61.5% of total billed charges",111.22,16.8,,88.98,,,0,"percent of total billed charges","16.8% of total billed charges",331,50,,264.80,,,0,"percent of total billed charges","50% of total billed charges",213.16,32.2,,170.53,,,0,"percent of total billed charges","32.2% of total billed charges",111.22,16.8,,88.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.44,17.136,,90.75,,,0,"percent of total billed charges","17.136% of total billed charges",144.58,21.84,,115.66,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",249.57,37.7,,199.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",516.36,78,,413.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",546.81,82.6,,437.45,,,0,"percent of total billed charges","82.6% of total billed charges",111.22,16.8,,88.98,,,0,"percent of total billed charges","16.8% of total billed charges",331,50,,264.80,,,0,"percent of total billed charges","50% of total billed charges",546.81,82.6,,437.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",111.22,16.8,,88.98,,,0,"percent of total billed charges","16.8% of total billed charges",662,100,,529.60,,,0,"percent of total billed charges","100% of total billed charges",101.29,662,
"OP VISIT LEVEL 1 EST PT",51099211,CDM,510,RC,99211,CPT,OUTPATIENT,,,508,330.2,,447.04,88,,357.63,,,0,"percent of total billed charges","88% of total billed charges",254,50,,203.20,,,0,"percent of total billed charges","50% of total billed charges",85.34,16.8,,68.27,,,0,"percent of total billed charges","16.8% of total billed charges",508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.9,17.304,,70.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",320.04,63,,256.03,,,0,"percent of total billed charges","63% of total billed charges",77.72,15.3,,62.18,,,0,"percent of total billed charges","15.3% of total billed charges",85.34,16.8,,68.27,,,0,"percent of total billed charges","16.8% of total billed charges",350.52,69,,,,,0,"fee schedule","69% of total billed charges",508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",314.2,61.85,,251.36,,,0,"percent of total billed charges","61.5% of total billed charges",85.34,16.8,,68.27,,,0,"percent of total billed charges","16.8% of total billed charges",254,50,,203.20,,,0,"percent of total billed charges","50% of total billed charges",163.58,32.2,,130.86,,,0,"percent of total billed charges","32.2% of total billed charges",85.34,16.8,,68.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.05,17.136,,69.64,,,0,"percent of total billed charges","17.136% of total billed charges",110.95,21.84,,88.76,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",191.52,37.7,,153.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",396.24,78,,316.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",419.61,82.6,,335.69,,,0,"percent of total billed charges","82.6% of total billed charges",85.34,16.8,,68.27,,,0,"percent of total billed charges","16.8% of total billed charges",254,50,,203.20,,,0,"percent of total billed charges","50% of total billed charges",419.61,82.6,,335.69,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.34,16.8,,68.27,,,0,"percent of total billed charges","16.8% of total billed charges",508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",77.72,508,
"OP VISIT LEVEL 2 EST PT",51099212,CDM,510,RC,99212,CPT,OUTPATIENT,,,508,330.2,,447.04,88,,357.63,,,0,"percent of total billed charges","88% of total billed charges",254,50,,203.20,,,0,"percent of total billed charges","50% of total billed charges",85.34,16.8,,68.27,,,0,"percent of total billed charges","16.8% of total billed charges",508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.9,17.304,,70.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",320.04,63,,256.03,,,0,"percent of total billed charges","63% of total billed charges",77.72,15.3,,62.18,,,0,"percent of total billed charges","15.3% of total billed charges",85.34,16.8,,68.27,,,0,"percent of total billed charges","16.8% of total billed charges",350.52,69,,,,,0,"fee schedule","69% of total billed charges",508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",314.2,61.85,,251.36,,,0,"percent of total billed charges","61.5% of total billed charges",85.34,16.8,,68.27,,,0,"percent of total billed charges","16.8% of total billed charges",254,50,,203.20,,,0,"percent of total billed charges","50% of total billed charges",163.58,32.2,,130.86,,,0,"percent of total billed charges","32.2% of total billed charges",85.34,16.8,,68.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.05,17.136,,69.64,,,0,"percent of total billed charges","17.136% of total billed charges",110.95,21.84,,88.76,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",191.52,37.7,,153.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",396.24,78,,316.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",419.61,82.6,,335.69,,,0,"percent of total billed charges","82.6% of total billed charges",85.34,16.8,,68.27,,,0,"percent of total billed charges","16.8% of total billed charges",254,50,,203.20,,,0,"percent of total billed charges","50% of total billed charges",419.61,82.6,,335.69,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.34,16.8,,68.27,,,0,"percent of total billed charges","16.8% of total billed charges",508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",77.72,508,
"OP VISIT LEVEL 3 EST PT",51099213,CDM,510,RC,99213,CPT,OUTPATIENT,,,453,294.45,,398.64,88,,318.91,,,0,"percent of total billed charges","88% of total billed charges",226.5,50,,181.20,,,0,"percent of total billed charges","50% of total billed charges",76.1,16.8,,60.88,,,0,"percent of total billed charges","16.8% of total billed charges",453,100,,362.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.39,17.304,,62.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",285.39,63,,228.31,,,0,"percent of total billed charges","63% of total billed charges",69.31,15.3,,55.45,,,0,"percent of total billed charges","15.3% of total billed charges",76.1,16.8,,60.88,,,0,"percent of total billed charges","16.8% of total billed charges",312.57,69,,,,,0,"fee schedule","69% of total billed charges",453,100,,362.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",453,100,,362.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",453,100,,362.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",280.18,61.85,,224.14,,,0,"percent of total billed charges","61.5% of total billed charges",76.1,16.8,,60.88,,,0,"percent of total billed charges","16.8% of total billed charges",226.5,50,,181.20,,,0,"percent of total billed charges","50% of total billed charges",145.87,32.2,,116.70,,,0,"percent of total billed charges","32.2% of total billed charges",76.1,16.8,,60.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.63,17.136,,62.10,,,0,"percent of total billed charges","17.136% of total billed charges",98.94,21.84,,79.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",170.78,37.7,,136.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.34,78,,282.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",374.18,82.6,,299.34,,,0,"percent of total billed charges","82.6% of total billed charges",76.1,16.8,,60.88,,,0,"percent of total billed charges","16.8% of total billed charges",226.5,50,,181.20,,,0,"percent of total billed charges","50% of total billed charges",374.18,82.6,,299.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.1,16.8,,60.88,,,0,"percent of total billed charges","16.8% of total billed charges",453,100,,362.40,,,0,"percent of total billed charges","100% of total billed charges",69.31,453,
"OP VISIT LEVEL 4 EST PT",51099214,CDM,510,RC,99214,CPT,OUTPATIENT,,,474,308.1,,417.12,88,,333.70,,,0,"percent of total billed charges","88% of total billed charges",237,50,,189.60,,,0,"percent of total billed charges","50% of total billed charges",79.63,16.8,,63.70,,,0,"percent of total billed charges","16.8% of total billed charges",474,100,,379.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.02,17.304,,65.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.62,63,,238.90,,,0,"percent of total billed charges","63% of total billed charges",72.52,15.3,,58.02,,,0,"percent of total billed charges","15.3% of total billed charges",79.63,16.8,,63.70,,,0,"percent of total billed charges","16.8% of total billed charges",327.06,69,,,,,0,"fee schedule","69% of total billed charges",474,100,,379.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",474,100,,379.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",474,100,,379.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",293.17,61.85,,234.54,,,0,"percent of total billed charges","61.5% of total billed charges",79.63,16.8,,63.70,,,0,"percent of total billed charges","16.8% of total billed charges",237,50,,189.60,,,0,"percent of total billed charges","50% of total billed charges",152.63,32.2,,122.10,,,0,"percent of total billed charges","32.2% of total billed charges",79.63,16.8,,63.70,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.22,17.136,,64.98,,,0,"percent of total billed charges","17.136% of total billed charges",103.52,21.84,,82.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",178.7,37.7,,142.96,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",369.72,78,,295.78,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",391.52,82.6,,313.22,,,0,"percent of total billed charges","82.6% of total billed charges",79.63,16.8,,63.70,,,0,"percent of total billed charges","16.8% of total billed charges",237,50,,189.60,,,0,"percent of total billed charges","50% of total billed charges",391.52,82.6,,313.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.63,16.8,,63.70,,,0,"percent of total billed charges","16.8% of total billed charges",474,100,,379.20,,,0,"percent of total billed charges","100% of total billed charges",72.52,474,
"OBSERVATION G0378",G0378,CDM,762,RC,,,OUTPATIENT,,,744,483.6,,654.72,88,,523.78,,,0,"percent of total billed charges","88% of total billed charges",372,50,,297.60,,,0,"percent of total billed charges","50% of total billed charges",124.99,16.8,,99.99,,,0,"percent of total billed charges","16.8% of total billed charges",744,100,,595.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.74,17.304,,102.99,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",468.72,63,,374.98,,,0,"percent of total billed charges","63% of total billed charges",148.8,15.3,,119.04,,,0,"percent of total billed charges","15.3% of total billed charges",124.99,16.8,,99.99,,,0,"percent of total billed charges","16.8% of total billed charges",513.36,69,,,,,0,"fee schedule","69% of total billed charges",744,100,,595.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",744,100,,595.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",744,100,,595.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",460.16,61.85,,368.13,,,0,"percent of total billed charges","61.5% of total billed charges",124.99,16.8,,99.99,,,0,"percent of total billed charges","16.8% of total billed charges",372,50,,297.60,,,0,"percent of total billed charges","50% of total billed charges",239.57,32.2,,191.66,,,0,"percent of total billed charges","32.2% of total billed charges",124.99,16.8,,99.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.49,17.136,,101.99,,,0,"percent of total billed charges","17.136% of total billed charges",162.49,21.84,,129.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",280.49,37.7,,224.39,,,0,"percent of total billed charges","37.7% of total billed charges",280.49,37.7,,224.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.22,33.9,,201.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.32,78,,464.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",614.54,82.6,,491.63,,,0,"percent of total billed charges","82.6% of total billed charges",124.99,16.8,,99.99,,,0,"percent of total billed charges","16.8% of total billed charges",372,50,,297.60,,,0,"percent of total billed charges","50% of total billed charges",614.54,82.6,,491.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.99,16.8,,99.99,,,0,"percent of total billed charges","16.8% of total billed charges",744,100,,595.20,,,0,"percent of total billed charges","100% of total billed charges",124.99,744,
"Observation Level 1 G0379",G0379,CDM,769,RC,,,OUTPATIENT,,,744,483.6,,654.72,88,,523.78,,,0,"percent of total billed charges","88% of total billed charges",372,50,,297.60,,,0,"percent of total billed charges","50% of total billed charges",124.99,16.8,,99.99,,,0,"percent of total billed charges","16.8% of total billed charges",744,100,,595.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.74,17.304,,102.99,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",468.72,63,,374.98,,,0,"percent of total billed charges","63% of total billed charges",148.8,15.3,,119.04,,,0,"percent of total billed charges","15.3% of total billed charges",124.99,16.8,,99.99,,,0,"percent of total billed charges","16.8% of total billed charges",513.36,69,,,,,0,"fee schedule","69% of total billed charges",744,100,,595.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",744,100,,595.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",744,100,,595.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",460.16,61.85,,368.13,,,0,"percent of total billed charges","61.5% of total billed charges",124.99,16.8,,99.99,,,0,"percent of total billed charges","16.8% of total billed charges",372,50,,297.60,,,0,"percent of total billed charges","50% of total billed charges",239.57,32.2,,191.66,,,0,"percent of total billed charges","32.2% of total billed charges",124.99,16.8,,99.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.49,17.136,,101.99,,,0,"percent of total billed charges","17.136% of total billed charges",162.49,21.84,,129.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",280.49,37.7,,224.39,,,0,"percent of total billed charges","37.7% of total billed charges",280.49,37.7,,224.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.22,33.9,,201.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.32,78,,464.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",614.54,82.6,,491.63,,,0,"percent of total billed charges","82.6% of total billed charges",124.99,16.8,,99.99,,,0,"percent of total billed charges","16.8% of total billed charges",372,50,,297.60,,,0,"percent of total billed charges","50% of total billed charges",614.54,82.6,,491.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.99,16.8,,99.99,,,0,"percent of total billed charges","16.8% of total billed charges",744,100,,595.20,,,0,"percent of total billed charges","100% of total billed charges",124.99,744,
"Arterial catheterization or cannulation for sampling, monito",76136620,CDM,761,RC,36620,CPT,OUTPATIENT,,,237,154.05,,208.56,88,,166.85,,,0,"percent of total billed charges","88% of total billed charges",118.5,50,,94.80,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,237,100,,189.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",149.31,63,,119.45,,,0,"percent of total billed charges","63% of total billed charges",36.26,15.3,,29.01,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,163.53,69,,,,,0,"fee schedule","69% of total billed charges",237,100,,189.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",237,100,,189.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",237,100,,189.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",146.58,61.85,,117.26,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,118.5,50,,94.80,,,0,"percent of total billed charges","50% of total billed charges",76.31,32.2,,61.05,,,0,"percent of total billed charges","32.2% of total billed charges",424.13,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",89.35,37.7,,71.48,,,0,"percent of total billed charges","37.7% of total billed charges",89.35,37.7,,71.48,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.34,33.9,,64.27,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",184.86,78,,147.89,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",195.76,82.6,,156.61,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,118.5,50,,94.80,,,0,"percent of total billed charges","50% of total billed charges",195.76,82.6,,156.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",572.57,100,,,,,0,"fee schedule",EAPG,237,100,,189.60,,,0,"percent of total billed charges","100% of total billed charges",36.26,744.35,
"IV INFUSION HYDRATION 31M-1HR",45096360,CDM,450,RC,96360,CPT,OUTPATIENT,,,560,364,,492.8,88,,394.24,,,0,"percent of total billed charges","88% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,560,100,,448.00,,,0,"percent of total billed charges","100% of total billed charges",382.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",281.17,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",85.68,15.3,,68.54,,,0,"percent of total billed charges","15.3% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,386.4,69,,,,,0,"fee schedule","69% of total billed charges",560,100,,448.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560,100,,448.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560,100,,448.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",826.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.21,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278.44,100,,,,,0,"fee schedule",EAPG,354.88,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",211.12,37.7,,168.90,,,0,"percent of total billed charges","37.7% of total billed charges",211.12,37.7,,168.90,,,0,"percent of total billed charges","37.70% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.84,33.9,,151.87,,,0,"percent of total billed charges","33.9% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",436.8,78,,349.44,,,0,"percent of total billed charges","78% of total billed charges",220.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.56,82.6,,370.05,,,0,"percent of total billed charges","82.6% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.56,82.6,,370.05,,,0,"percent of total billed charges","82.6% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,560,100,,448.00,,,0,"percent of total billed charges","100% of total billed charges",85.68,826.71,
"IV INFUSION HYDRATION ADDL HR",45096361,CDM,450,RC,96361,CPT,OUTPATIENT,,,140,91,,123.2,88,,98.56,,,0,"percent of total billed charges","88% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",84.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",475.9,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",21.42,15.3,,17.14,,,0,"percent of total billed charges","15.3% of total billed charges",462.04,100,,,,,0,"fee schedule",EAPG,96.6,69,,,,,0,"fee schedule","69% of total billed charges",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.25,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",471.28,100,,,,,0,"fee schedule",EAPG,600.65,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.78,37.7,,42.22,,,0,"percent of total billed charges","37.7% of total billed charges",52.78,37.7,,42.22,,,0,"percent of total billed charges","37.70% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.46,33.9,,37.97,,,0,"percent of total billed charges","33.9% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.2,78,,87.36,,,0,"percent of total billed charges","78% of total billed charges",48.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.64,82.6,,92.51,,,0,"percent of total billed charges","82.6% of total billed charges",462.04,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.64,82.6,,92.51,,,0,"percent of total billed charges","82.6% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",21.42,600.65,
"IV INFUSION THX/PX/DX FIRST HR",45096365,CDM,450,RC,96365,CPT,OUTPATIENT,,,745,484.25,,655.6,88,,524.48,,,0,"percent of total billed charges","88% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,745,100,,596.00,,,0,"percent of total billed charges","100% of total billed charges",382.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",281.17,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",113.99,15.3,,91.19,,,0,"percent of total billed charges","15.3% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,514.05,69,,,,,0,"fee schedule","69% of total billed charges",745,100,,596.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",745,100,,596.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",745,100,,596.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",826.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.21,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278.44,100,,,,,0,"fee schedule",EAPG,354.88,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,37.7,,224.70,,,0,"percent of total billed charges","37.7% of total billed charges",280.87,37.7,,224.70,,,0,"percent of total billed charges","37.70% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.56,33.9,,202.05,,,0,"percent of total billed charges","33.9% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",581.1,78,,464.88,,,0,"percent of total billed charges","78% of total billed charges",220.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",615.37,82.6,,492.30,,,0,"percent of total billed charges","82.6% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",615.37,82.6,,492.30,,,0,"percent of total billed charges","82.6% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,745,100,,596.00,,,0,"percent of total billed charges","100% of total billed charges",113.99,826.71,
"IV INFUSION THX/PX/DX ADDL HR",45096366,CDM,450,RC,96366,CPT,OUTPATIENT,,,140,91,,123.2,88,,98.56,,,0,"percent of total billed charges","88% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",84.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",475.9,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",21.42,15.3,,17.14,,,0,"percent of total billed charges","15.3% of total billed charges",462.04,100,,,,,0,"fee schedule",EAPG,96.6,69,,,,,0,"fee schedule","69% of total billed charges",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.25,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",471.28,100,,,,,0,"fee schedule",EAPG,600.65,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.78,37.7,,42.22,,,0,"percent of total billed charges","37.7% of total billed charges",52.78,37.7,,42.22,,,0,"percent of total billed charges","37.70% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.46,33.9,,37.97,,,0,"percent of total billed charges","33.9% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.2,78,,87.36,,,0,"percent of total billed charges","78% of total billed charges",48.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.64,82.6,,92.51,,,0,"percent of total billed charges","82.6% of total billed charges",462.04,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.64,82.6,,92.51,,,0,"percent of total billed charges","82.6% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",21.42,600.65,
"IV INFUSION ADDL SEQ 1HR",45096367,CDM,450,RC,96367,CPT,OUTPATIENT,,,474,308.1,,417.12,88,,333.70,,,0,"percent of total billed charges","88% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,474,100,,379.20,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",281.17,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",72.52,15.3,,58.02,,,0,"percent of total billed charges","15.3% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,327.06,69,,,,,0,"fee schedule","69% of total billed charges",474,100,,379.20,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",474,100,,379.20,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",474,100,,379.20,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.21,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278.44,100,,,,,0,"fee schedule",EAPG,354.88,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",178.7,37.7,,142.96,,,0,"percent of total billed charges","37.7% of total billed charges",178.7,37.7,,142.96,,,0,"percent of total billed charges","37.70% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.69,33.9,,128.55,,,0,"percent of total billed charges","33.9% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",369.72,78,,295.78,,,0,"percent of total billed charges","78% of total billed charges",72.56,100,,,,,0,"fee schedule","100% of CMS OPPS rate",391.52,82.6,,313.22,,,0,"percent of total billed charges","82.6% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",391.52,82.6,,313.22,,,0,"percent of total billed charges","82.6% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,474,100,,379.20,,,0,"percent of total billed charges","100% of total billed charges",65.81,474,
"CONCURRENT IV THER",45096368,CDM,450,RC,96368,CPT,OUTPATIENT,,,449,291.85,,395.12,88,,316.10,,,0,"percent of total billed charges","88% of total billed charges",224.5,50,,179.60,,,0,"percent of total billed charges","50% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,449,100,,359.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.17,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",68.7,15.3,,54.96,,,0,"percent of total billed charges","15.3% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,309.81,69,,,,,0,"fee schedule","69% of total billed charges",449,100,,359.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",449,100,,359.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",449,100,,359.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",277.71,61.85,,222.17,,,0,"percent of total billed charges","61.5% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,224.5,50,,179.60,,,0,"percent of total billed charges","50% of total billed charges",144.58,32.2,,115.66,,,0,"percent of total billed charges","32.2% of total billed charges",202.21,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",278.44,100,,,,,0,"fee schedule",EAPG,354.88,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",169.27,37.7,,135.42,,,0,"percent of total billed charges","37.7% of total billed charges",169.27,37.7,,135.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",152.21,33.9,,121.77,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",350.22,78,,280.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.87,82.6,,296.70,,,0,"percent of total billed charges","82.6% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,224.5,50,,179.60,,,0,"percent of total billed charges","50% of total billed charges",370.87,82.6,,296.70,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.98,100,,,,,0,"fee schedule",EAPG,449,100,,359.20,,,0,"percent of total billed charges","100% of total billed charges",68.7,449,
"INJ THER/DX IM/SQ",45096372,CDM,450,RC,96372,CPT,OUTPATIENT,,,320,208,,281.6,88,,225.28,,,0,"percent of total billed charges","88% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",48.96,15.3,,39.17,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,220.8,69,,,,,0,"fee schedule","69% of total billed charges",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.48,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",120.64,37.7,,96.51,,,0,"percent of total billed charges","37.7% of total billed charges",120.64,37.7,,96.51,,,0,"percent of total billed charges","37.70% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.48,33.9,,86.78,,,0,"percent of total billed charges","33.9% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",249.6,78,,199.68,,,0,"percent of total billed charges","78% of total billed charges",72.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",264.32,82.6,,211.46,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",264.32,82.6,,211.46,,,0,"percent of total billed charges","82.6% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",29.48,320,
"S-INJ NON CHEMO IA",45096373,CDM,450,RC,96373,CPT,OUTPATIENT,,,1420,923,,1249.6,88,,999.68,,,0,"percent of total billed charges","88% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,1420,100,,1136.00,,,0,"percent of total billed charges","100% of total billed charges",382.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",217.26,15.3,,173.81,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,979.8,69,,,,,0,"fee schedule","69% of total billed charges",1420,100,,1136.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1420,100,,1136.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1420,100,,1136.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",826.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.48,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",535.34,37.7,,428.27,,,0,"percent of total billed charges","37.7% of total billed charges",535.34,37.7,,428.27,,,0,"percent of total billed charges","37.70% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",481.38,33.9,,385.10,,,0,"percent of total billed charges","33.9% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1107.6,78,,886.08,,,0,"percent of total billed charges","78% of total billed charges",220.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1172.92,82.6,,938.34,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1172.92,82.6,,938.34,,,0,"percent of total billed charges","82.6% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,1420,100,,1136.00,,,0,"percent of total billed charges","100% of total billed charges",29.48,1420,
"THERAPEUTIC IV PUSH",45096374,CDM,450,RC,96374,CPT,OUTPATIENT,,,465,302.25,,409.2,88,,327.36,,,0,"percent of total billed charges","88% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,465,100,,372.00,,,0,"percent of total billed charges","100% of total billed charges",382.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",71.15,15.3,,56.92,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,320.85,69,,,,,0,"fee schedule","69% of total billed charges",465,100,,372.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465,100,,372.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465,100,,372.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",826.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.48,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",175.31,37.7,,140.25,,,0,"percent of total billed charges","37.7% of total billed charges",175.31,37.7,,140.25,,,0,"percent of total billed charges","37.70% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",157.64,33.9,,126.11,,,0,"percent of total billed charges","33.9% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",362.7,78,,290.16,,,0,"percent of total billed charges","78% of total billed charges",220.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",384.09,82.6,,307.27,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",384.09,82.6,,307.27,,,0,"percent of total billed charges","82.6% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,465,100,,372.00,,,0,"percent of total billed charges","100% of total billed charges",29.48,826.71,
"THERA EA AD IV PUSH",45096375,CDM,450,RC,96375,CPT,OUTPATIENT,,,306,198.9,,269.28,88,,215.42,,,0,"percent of total billed charges","88% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",84.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",46.82,15.3,,37.46,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,211.14,69,,,,,0,"fee schedule","69% of total billed charges",306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.48,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.36,37.7,,92.29,,,0,"percent of total billed charges","37.7% of total billed charges",115.36,37.7,,92.29,,,0,"percent of total billed charges","37.70% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",103.73,33.9,,82.98,,,0,"percent of total billed charges","33.9% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",238.68,78,,190.94,,,0,"percent of total billed charges","78% of total billed charges",48.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.76,82.6,,202.21,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.76,82.6,,202.21,,,0,"percent of total billed charges","82.6% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",29.48,306,
"THER AD IVP SAME MED",45096376,CDM,450,RC,96376,CPT,OUTPATIENT,,,314,204.1,,276.32,88,,221.06,,,0,"percent of total billed charges","88% of total billed charges",157,50,,125.60,,,0,"percent of total billed charges","50% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,314,100,,251.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",41,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",48.04,15.3,,38.43,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,216.66,69,,,,,0,"fee schedule","69% of total billed charges",314,100,,251.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",314,100,,251.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",314,100,,251.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.21,61.85,,155.37,,,0,"percent of total billed charges","61.5% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,157,50,,125.60,,,0,"percent of total billed charges","50% of total billed charges",101.11,32.2,,80.89,,,0,"percent of total billed charges","32.2% of total billed charges",29.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",118.38,37.7,,94.70,,,0,"percent of total billed charges","37.7% of total billed charges",118.38,37.7,,94.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.45,33.9,,85.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",244.92,78,,195.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",259.36,82.6,,207.49,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,157,50,,125.60,,,0,"percent of total billed charges","50% of total billed charges",259.36,82.6,,207.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.8,100,,,,,0,"fee schedule",EAPG,314,100,,251.20,,,0,"percent of total billed charges","100% of total billed charges",29.48,314,
"ER DEPT BASIC VISIT",45099281,CDM,450,RC,99281,CPT,OUTPATIENT,,,284,184.6,,249.92,88,,199.94,,,0,"percent of total billed charges","88% of total billed charges",90.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.71,16.8,,38.17,,,0,"percent of total billed charges","16.8% of total billed charges",284,100,,227.20,,,0,"percent of total billed charges","100% of total billed charges",158.46,175,,,,,0,"fee schedule","175% of CMS fee schedule",49.14,17.304,,39.31,,,0,"percent of total billed charges","17.304% of total billed charges",90.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",178.92,63,,143.14,,,0,"percent of total billed charges","63% of total billed charges",565,15.3,,452.00,,,0,"percent of total billed charges","15.3% of total billed charges",47.71,16.8,,38.17,,,0,"percent of total billed charges","16.8% of total billed charges",195.96,69,,,,,0,"fee schedule","69% of total billed charges",284,100,,227.20,,,0,"percent of total billed charges","100% of total billed charges",90.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284,100,,227.20,,,0,"percent of total billed charges","100% of total billed charges",90.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284,100,,227.20,,,0,"percent of total billed charges","100% of total billed charges",90.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",294.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.71,16.8,,38.17,,,0,"percent of total billed charges","16.8% of total billed charges",90.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.71,16.8,,38.17,,,0,"percent of total billed charges","16.8% of total billed charges",90.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",48.67,17.136,,38.94,,,0,"percent of total billed charges","17.136% of total billed charges",62.03,21.84,,49.62,,,0,"percent of total billed charges","21.84% of total billed charges",90.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.07,37.7,,85.66,,,0,"percent of total billed charges","37.7% of total billed charges",107.07,37.7,,85.66,,,0,"percent of total billed charges","37.70% of total billed charges",90.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",90.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.52,78,,177.22,,,0,"percent of total billed charges","78% of total billed charges",91.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.58,82.6,,187.66,,,0,"percent of total billed charges","82.6% of total billed charges",47.71,16.8,,38.17,,,0,"percent of total billed charges","16.8% of total billed charges",90.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.58,82.6,,187.66,,,0,"percent of total billed charges","82.6% of total billed charges",90.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.71,16.8,,38.17,,,0,"percent of total billed charges","16.8% of total billed charges",284,100,,227.20,,,0,"percent of total billed charges","100% of total billed charges",47.71,565,
"ER DEPT LIMITED VISIT",45099282,CDM,450,RC,99282,CPT,OUTPATIENT,,,484,314.6,25,425.92,88,,340.74,,,0,"percent of total billed charges","88% of total billed charges",166.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",81.31,16.8,,65.05,,,0,"percent of total billed charges","16.8% of total billed charges",484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",291.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",83.75,17.304,,67.00,,,0,"percent of total billed charges","17.304% of total billed charges",166.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",304.92,63,,243.94,,,0,"percent of total billed charges","63% of total billed charges",565,15.3,,452.00,,,0,"percent of total billed charges","15.3% of total billed charges",81.31,16.8,,65.05,,,0,"percent of total billed charges","16.8% of total billed charges",333.96,69,,,,,0,"fee schedule","69% of total billed charges",484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",166.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",166.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",166.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",534.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",81.31,16.8,,65.05,,,0,"percent of total billed charges","16.8% of total billed charges",166.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",139.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",81.31,16.8,,65.05,,,0,"percent of total billed charges","16.8% of total billed charges",166.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",82.94,17.136,,66.35,,,0,"percent of total billed charges","17.136% of total billed charges",105.71,21.84,,84.57,,,0,"percent of total billed charges","21.84% of total billed charges",166.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",182.47,37.7,,145.98,,,0,"percent of total billed charges","37.7% of total billed charges",182.47,37.7,,145.98,,,0,"percent of total billed charges","37.70% of total billed charges",166.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",166.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",377.52,78,,302.02,,,0,"percent of total billed charges","78% of total billed charges",168.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",399.78,82.6,,319.82,,,0,"percent of total billed charges","82.6% of total billed charges",81.31,16.8,,65.05,,,0,"percent of total billed charges","16.8% of total billed charges",166.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",399.78,82.6,,319.82,,,0,"percent of total billed charges","82.6% of total billed charges",166.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",81.31,16.8,,65.05,,,0,"percent of total billed charges","16.8% of total billed charges",484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",81.31,565,
"ER DEPT INTERMEDIATE VISIT",45099283,CDM,450,RC,99283,CPT,OUTPATIENT,,,852,553.8,25,749.76,88,,599.81,,,0,"percent of total billed charges","88% of total billed charges",291.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",143.14,16.8,,114.51,,,0,"percent of total billed charges","16.8% of total billed charges",852,100,,681.60,,,0,"percent of total billed charges","100% of total billed charges",509.26,175,,,,,0,"fee schedule","175% of CMS fee schedule",147.43,17.304,,117.94,,,0,"percent of total billed charges","17.304% of total billed charges",291.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",536.76,63,,429.41,,,0,"percent of total billed charges","63% of total billed charges",565,15.3,,452.00,,,0,"percent of total billed charges","15.3% of total billed charges",143.14,16.8,,114.51,,,0,"percent of total billed charges","16.8% of total billed charges",587.88,69,,,,,0,"fee schedule","69% of total billed charges",852,100,,681.60,,,0,"percent of total billed charges","100% of total billed charges",291.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",852,100,,681.60,,,0,"percent of total billed charges","100% of total billed charges",291.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",852,100,,681.60,,,0,"percent of total billed charges","100% of total billed charges",291.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",940.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",143.14,16.8,,114.51,,,0,"percent of total billed charges","16.8% of total billed charges",291.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",245.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",143.14,16.8,,114.51,,,0,"percent of total billed charges","16.8% of total billed charges",291.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",146,17.136,,116.80,,,0,"percent of total billed charges","17.136% of total billed charges",186.08,21.84,,148.86,,,0,"percent of total billed charges","21.84% of total billed charges",291.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",321.2,37.7,,256.96,,,0,"percent of total billed charges","37.7% of total billed charges",321.2,37.7,,256.96,,,0,"percent of total billed charges","37.70% of total billed charges",291.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",291.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",664.56,78,,531.65,,,0,"percent of total billed charges","78% of total billed charges",293.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",703.75,82.6,,563.00,,,0,"percent of total billed charges","82.6% of total billed charges",143.14,16.8,,114.51,,,0,"percent of total billed charges","16.8% of total billed charges",291.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",703.75,82.6,,563.00,,,0,"percent of total billed charges","82.6% of total billed charges",291.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",143.14,16.8,,114.51,,,0,"percent of total billed charges","16.8% of total billed charges",852,100,,681.60,,,0,"percent of total billed charges","100% of total billed charges",143.14,940.88,
"ER DEPT EXTENSIVE VISIT",45099284,CDM,450,RC,99284,CPT,OUTPATIENT,,,1469,954.85,25,1292.72,88,,1034.18,,,0,"percent of total billed charges","88% of total billed charges",451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",246.79,16.8,,197.43,,,0,"percent of total billed charges","16.8% of total billed charges",1469,100,,1175.20,,,0,"percent of total billed charges","100% of total billed charges",790.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",254.2,17.304,,203.36,,,0,"percent of total billed charges","17.304% of total billed charges",451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",925.47,63,,740.38,,,0,"percent of total billed charges","63% of total billed charges",565,15.3,,452.00,,,0,"percent of total billed charges","15.3% of total billed charges",246.79,16.8,,197.43,,,0,"percent of total billed charges","16.8% of total billed charges",1013.61,69,,,,,0,"fee schedule","69% of total billed charges",1469,100,,1175.20,,,0,"percent of total billed charges","100% of total billed charges",451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1469,100,,1175.20,,,0,"percent of total billed charges","100% of total billed charges",451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1469,100,,1175.20,,,0,"percent of total billed charges","100% of total billed charges",451.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",1477.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",246.79,16.8,,197.43,,,0,"percent of total billed charges","16.8% of total billed charges",451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",386.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",246.79,16.8,,197.43,,,0,"percent of total billed charges","16.8% of total billed charges",451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",251.73,17.136,,201.38,,,0,"percent of total billed charges","17.136% of total billed charges",320.83,21.84,,256.66,,,0,"percent of total billed charges","21.84% of total billed charges",451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",553.81,37.7,,443.05,,,0,"percent of total billed charges","37.7% of total billed charges",553.81,37.7,,443.05,,,0,"percent of total billed charges","37.70% of total billed charges",451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1145.82,78,,916.66,,,0,"percent of total billed charges","78% of total billed charges",456.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1213.39,82.6,,970.71,,,0,"percent of total billed charges","82.6% of total billed charges",246.79,16.8,,197.43,,,0,"percent of total billed charges","16.8% of total billed charges",451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1213.39,82.6,,970.71,,,0,"percent of total billed charges","82.6% of total billed charges",451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",246.79,16.8,,197.43,,,0,"percent of total billed charges","16.8% of total billed charges",1469,100,,1175.20,,,0,"percent of total billed charges","100% of total billed charges",246.79,1477.69,
"ER DEPT MAJOR VISIT",45099285,CDM,450,RC,99285,CPT,OUTPATIENT,,,3918,2546.7,25,3447.84,88,,2758.27,,,0,"percent of total billed charges","88% of total billed charges",655.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.22,16.8,,526.58,,,0,"percent of total billed charges","16.8% of total billed charges",3918,100,,3134.40,,,0,"percent of total billed charges","100% of total billed charges",1146.48,175,,,,,0,"fee schedule","175% of CMS fee schedule",677.97,17.304,,542.38,,,0,"percent of total billed charges","17.304% of total billed charges",655.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2468.34,63,,1974.67,,,0,"percent of total billed charges","63% of total billed charges",565,15.3,,452.00,,,0,"percent of total billed charges","15.3% of total billed charges",658.22,16.8,,526.58,,,0,"percent of total billed charges","16.8% of total billed charges",2703.42,69,,,,,0,"fee schedule","69% of total billed charges",3918,100,,3134.40,,,0,"percent of total billed charges","100% of total billed charges",655.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3918,100,,3134.40,,,0,"percent of total billed charges","100% of total billed charges",655.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3918,100,,3134.40,,,0,"percent of total billed charges","100% of total billed charges",655.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",2121.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.22,16.8,,526.58,,,0,"percent of total billed charges","16.8% of total billed charges",655.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.22,16.8,,526.58,,,0,"percent of total billed charges","16.8% of total billed charges",655.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671.39,17.136,,537.11,,,0,"percent of total billed charges","17.136% of total billed charges",855.69,21.84,,684.55,,,0,"percent of total billed charges","21.84% of total billed charges",655.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1477.09,37.7,,1181.67,,,0,"percent of total billed charges","37.7% of total billed charges",1477.09,37.7,,1181.67,,,0,"percent of total billed charges","37.70% of total billed charges",655.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",655.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3056.04,78,,2444.83,,,0,"percent of total billed charges","78% of total billed charges",661.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3236.27,82.6,,2589.02,,,0,"percent of total billed charges","82.6% of total billed charges",658.22,16.8,,526.58,,,0,"percent of total billed charges","16.8% of total billed charges",655.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3236.27,82.6,,2589.02,,,0,"percent of total billed charges","82.6% of total billed charges",655.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.22,16.8,,526.58,,,0,"percent of total billed charges","16.8% of total billed charges",3918,100,,3134.40,,,0,"percent of total billed charges","100% of total billed charges",554.54,3918,
"CRITICAL CARE 30-74 MIN",45099291,CDM,450,RC,99291,CPT,OUTPATIENT,,,4891,3179.15,25,4304.08,88,,3443.26,,,0,"percent of total billed charges","88% of total billed charges",905.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",821.69,16.8,,657.35,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",1583.9,175,,,,,0,"fee schedule","175% of CMS fee schedule",846.34,17.304,,677.07,,,0,"percent of total billed charges","17.304% of total billed charges",905.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3081.33,63,,2465.06,,,0,"percent of total billed charges","63% of total billed charges",565,15.3,,452.00,,,0,"percent of total billed charges","15.3% of total billed charges",821.69,16.8,,657.35,,,0,"percent of total billed charges","16.8% of total billed charges",3374.79,69,,,,,0,"fee schedule","69% of total billed charges",4891,100,,3912.80,,,0,"percent of total billed charges","100% of total billed charges",905.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4891,100,,3912.80,,,0,"percent of total billed charges","100% of total billed charges",905.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4891,100,,3912.80,,,0,"percent of total billed charges","100% of total billed charges",905.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",2814.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",821.69,16.8,,657.35,,,0,"percent of total billed charges","16.8% of total billed charges",905.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",821.69,16.8,,657.35,,,0,"percent of total billed charges","16.8% of total billed charges",905.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",838.12,17.136,,670.50,,,0,"percent of total billed charges","17.136% of total billed charges",1068.19,21.84,,854.55,,,0,"percent of total billed charges","21.84% of total billed charges",905.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1843.91,37.7,,1475.13,,,0,"percent of total billed charges","37.7% of total billed charges",1843.91,37.7,,1475.13,,,0,"percent of total billed charges","37.70% of total billed charges",905.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",905.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3814.98,78,,3051.98,,,0,"percent of total billed charges","78% of total billed charges",914.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4039.97,82.6,,3231.98,,,0,"percent of total billed charges","82.6% of total billed charges",821.69,16.8,,657.35,,,0,"percent of total billed charges","16.8% of total billed charges",905.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4039.97,82.6,,3231.98,,,0,"percent of total billed charges","82.6% of total billed charges",905.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",821.69,16.8,,657.35,,,0,"percent of total billed charges","16.8% of total billed charges",4891,100,,3912.80,,,0,"percent of total billed charges","100% of total billed charges",565,4891,
"CRITICAL CARE EA ADD 30MIN",45099292,CDM,450,RC,99292,CPT,OUTPATIENT,,,1822,1184.3,,1603.36,88,,1282.69,,,0,"percent of total billed charges","88% of total billed charges",911,50,,728.80,,,0,"percent of total billed charges","50% of total billed charges",306.1,16.8,,244.88,,,0,"percent of total billed charges","16.8% of total billed charges",1822,100,,1457.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",315.28,17.304,,252.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1147.86,63,,918.29,,,0,"percent of total billed charges","63% of total billed charges",565,15.3,,452.00,,,0,"percent of total billed charges","15.3% of total billed charges",306.1,16.8,,244.88,,,0,"percent of total billed charges","16.8% of total billed charges",1257.18,69,,,,,0,"fee schedule","69% of total billed charges",1822,100,,1457.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822,100,,1457.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822,100,,1457.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1126.91,61.85,,901.53,,,0,"percent of total billed charges","61.5% of total billed charges",306.1,16.8,,244.88,,,0,"percent of total billed charges","16.8% of total billed charges",911,50,,728.80,,,0,"percent of total billed charges","50% of total billed charges",586.68,32.2,,469.34,,,0,"percent of total billed charges","32.2% of total billed charges",306.1,16.8,,244.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",312.22,17.136,,249.78,,,0,"percent of total billed charges","17.136% of total billed charges",397.92,21.84,,318.34,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",686.89,37.7,,549.51,,,0,"percent of total billed charges","37.7% of total billed charges",686.89,37.7,,549.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1421.16,78,,1136.93,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1504.97,82.6,,1203.98,,,0,"percent of total billed charges","82.6% of total billed charges",306.1,16.8,,244.88,,,0,"percent of total billed charges","16.8% of total billed charges",911,50,,728.80,,,0,"percent of total billed charges","50% of total billed charges",1504.97,82.6,,1203.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",306.1,16.8,,244.88,,,0,"percent of total billed charges","16.8% of total billed charges",1822,100,,1457.60,,,0,"percent of total billed charges","100% of total billed charges",306.1,1822,
"MED NUT THERAPY GROUP 30MIN",94297804,CDM,942,RC,97804,CPT,OUTPATIENT,,,69,44.85,,60.72,88,,48.58,,,0,"percent of total billed charges","88% of total billed charges",15.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.87,100,,,,,0,"fee schedule","100% of WA fee schedule",69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",26.95,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.87,100,,,,,0,"fee schedule","100% of WA fee schedule",15.57,100,,,,,0,"fee schedule","100% of CMS fee sv",43.47,63,,34.78,,,0,"percent of total billed charges","63% of total billed charges",10.56,15.3,,8.45,,,0,"percent of total billed charges","15.3% of total billed charges",9.87,100,,,,,0,"fee schedule","100% of WA fee schedule",47.61,69,,,,,0,"fee schedule","69% of total billed charges",69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",15.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",15.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",15.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.05,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.87,100,,,,,0,"fee schedule","100% of WA fee schedule",15.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.32,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",15.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.07,102,,,,,0,"fee schedule","102% of WA fee schedule",12.83,130,,,,,0,"fee schedule","130% of WA fee schedule",15.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.01,37.7,,20.81,,,0,"percent of total billed charges","37.7% of total billed charges",26.01,37.7,,20.81,,,0,"percent of total billed charges","37.70% of total billed charges",15.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.39,33.9,,18.71,,,0,"percent of total billed charges","33.9% of total billed charges",15.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.82,78,,43.06,,,0,"percent of total billed charges","78% of total billed charges",15.73,101,,,,,0,"fee schedule","101% of CMS fee schedule ",56.99,82.6,,45.59,,,0,"percent of total billed charges","82.6% of total billed charges",9.87,100,,,,,0,"fee schedule","100% of WA fee schedule",15.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.99,82.6,,45.59,,,0,"percent of total billed charges","82.6% of total billed charges",15.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.87,100,,,,,0,"fee schedule","100% of WA fee schedule",69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",9.87,69,
"NUTRITION ANALYSIS INIT EA 15M",94297802,CDM,942,RC,97802,CPT,OUTPATIENT,,,148,96.2,,130.24,88,,104.19,,,0,"percent of total billed charges","88% of total billed charges",32.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.64,100,,,,,0,"fee schedule","100% of WA fee schedule",148,100,,118.40,,,0,"percent of total billed charges","100% of total billed charges",56.11,175,,,,,0,"fee schedule","175% of CMS fee schedule",21.64,100,,,,,0,"fee schedule","100% of WA fee schedule",32.22,100,,,,,0,"fee schedule","100% of CMS fee sv",93.24,63,,74.59,,,0,"percent of total billed charges","63% of total billed charges",22.64,15.3,,18.11,,,0,"percent of total billed charges","15.3% of total billed charges",21.64,100,,,,,0,"fee schedule","100% of WA fee schedule",102.12,69,,,,,0,"fee schedule","69% of total billed charges",148,100,,118.40,,,0,"percent of total billed charges","100% of total billed charges",32.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",148,100,,118.40,,,0,"percent of total billed charges","100% of total billed charges",32.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",148,100,,118.40,,,0,"percent of total billed charges","100% of total billed charges",32.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",126.84,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",21.64,100,,,,,0,"fee schedule","100% of WA fee schedule",32.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.72,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",32.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.07,102,,,,,0,"fee schedule","102% of WA fee schedule",28.13,130,,,,,0,"fee schedule","130% of WA fee schedule",32.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.8,37.7,,44.64,,,0,"percent of total billed charges","37.7% of total billed charges",55.8,37.7,,44.64,,,0,"percent of total billed charges","37.70% of total billed charges",32.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.17,33.9,,40.14,,,0,"percent of total billed charges","33.9% of total billed charges",32.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",115.44,78,,92.35,,,0,"percent of total billed charges","78% of total billed charges",32.54,101,,,,,0,"fee schedule","101% of CMS fee schedule ",122.25,82.6,,97.80,,,0,"percent of total billed charges","82.6% of total billed charges",21.64,100,,,,,0,"fee schedule","100% of WA fee schedule",32.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",122.25,82.6,,97.80,,,0,"percent of total billed charges","82.6% of total billed charges",32.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.64,100,,,,,0,"fee schedule","100% of WA fee schedule",148,100,,118.40,,,0,"percent of total billed charges","100% of total billed charges",21.64,148,
"MED NUT THRP-RE-ASSESS-15MIN",94297803,CDM,942,RC,97803,CPT,OUTPATIENT,,,129,83.85,,113.52,88,,90.82,,,0,"percent of total billed charges","88% of total billed charges",27.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",129,100,,103.20,,,0,"percent of total billed charges","100% of total billed charges",47.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",27.46,100,,,,,0,"fee schedule","100% of CMS fee sv",81.27,63,,65.02,,,0,"percent of total billed charges","63% of total billed charges",19.74,15.3,,15.79,,,0,"percent of total billed charges","15.3% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",89.01,69,,,,,0,"fee schedule","69% of total billed charges",129,100,,103.20,,,0,"percent of total billed charges","100% of total billed charges",27.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",129,100,,103.20,,,0,"percent of total billed charges","100% of total billed charges",27.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",129,100,,103.20,,,0,"percent of total billed charges","100% of total billed charges",27.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.06,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",27.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.04,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",27.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.17,102,,,,,0,"fee schedule","102% of WA fee schedule",24.43,130,,,,,0,"fee schedule","130% of WA fee schedule",27.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.63,37.7,,38.90,,,0,"percent of total billed charges","37.7% of total billed charges",48.63,37.7,,38.90,,,0,"percent of total billed charges","37.70% of total billed charges",27.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.73,33.9,,34.98,,,0,"percent of total billed charges","33.9% of total billed charges",27.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.62,78,,80.50,,,0,"percent of total billed charges","78% of total billed charges",27.73,101,,,,,0,"fee schedule","101% of CMS fee schedule ",106.55,82.6,,85.24,,,0,"percent of total billed charges","82.6% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",27.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.55,82.6,,85.24,,,0,"percent of total billed charges","82.6% of total billed charges",27.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",129,100,,103.20,,,0,"percent of total billed charges","100% of total billed charges",18.79,129,
"DIABETES MANAGE TRN IND/GROUP",94200001,CDM,942,RC,,,OUTPATIENT,,,57,37.05,,50.16,88,,40.13,,,0,"percent of total billed charges","88% of total billed charges",28.5,50,,22.80,,,0,"percent of total billed charges","50% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.86,17.304,,7.89,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.91,63,,28.73,,,0,"percent of total billed charges","63% of total billed charges",8.72,15.3,,6.98,,,0,"percent of total billed charges","15.3% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",39.33,69,,,,,0,"fee schedule","69% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.25,61.85,,28.20,,,0,"percent of total billed charges","61.5% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",28.5,50,,22.80,,,0,"percent of total billed charges","50% of total billed charges",18.35,32.2,,14.68,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.77,17.136,,7.82,,,0,"percent of total billed charges","17.136% of total billed charges",12.45,21.84,,9.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.49,37.7,,17.19,,,0,"percent of total billed charges","37.7% of total billed charges",21.49,37.7,,17.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.32,33.9,,15.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.46,78,,35.57,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.08,82.6,,37.66,,,0,"percent of total billed charges","82.6% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",28.5,50,,22.80,,,0,"percent of total billed charges","50% of total billed charges",47.08,82.6,,37.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",8.72,57,
"DIABETES MANAGE TRN PER INDIV",94200002,CDM,942,RC,,,OUTPATIENT,,,187,121.55,,164.56,88,,131.65,,,0,"percent of total billed charges","88% of total billed charges",93.5,50,,74.80,,,0,"percent of total billed charges","50% of total billed charges",31.42,16.8,,25.14,,,0,"percent of total billed charges","16.8% of total billed charges",187,100,,149.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.36,17.304,,25.89,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",117.81,63,,94.25,,,0,"percent of total billed charges","63% of total billed charges",28.61,15.3,,22.89,,,0,"percent of total billed charges","15.3% of total billed charges",31.42,16.8,,25.14,,,0,"percent of total billed charges","16.8% of total billed charges",129.03,69,,,,,0,"fee schedule","69% of total billed charges",187,100,,149.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",187,100,,149.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",187,100,,149.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.66,61.85,,92.53,,,0,"percent of total billed charges","61.5% of total billed charges",31.42,16.8,,25.14,,,0,"percent of total billed charges","16.8% of total billed charges",93.5,50,,74.80,,,0,"percent of total billed charges","50% of total billed charges",60.21,32.2,,48.17,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",32.04,17.136,,25.63,,,0,"percent of total billed charges","17.136% of total billed charges",40.84,21.84,,32.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.5,37.7,,56.40,,,0,"percent of total billed charges","37.7% of total billed charges",70.5,37.7,,56.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.39,33.9,,50.71,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",145.86,78,,116.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",154.46,82.6,,123.57,,,0,"percent of total billed charges","82.6% of total billed charges",31.42,16.8,,25.14,,,0,"percent of total billed charges","16.8% of total billed charges",93.5,50,,74.80,,,0,"percent of total billed charges","50% of total billed charges",154.46,82.6,,123.57,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.42,16.8,,25.14,,,0,"percent of total billed charges","16.8% of total billed charges",187,100,,149.60,,,0,"percent of total billed charges","100% of total billed charges",28.61,187,
"DIABETES SLF MANGMT INDV 30MIN",942G0108,CDM,942,RC,,,OUTPATIENT,,,252,163.8,,221.76,88,,177.41,,,0,"percent of total billed charges","88% of total billed charges",126,50,,100.80,,,0,"percent of total billed charges","50% of total billed charges",42.34,16.8,,33.87,,,0,"percent of total billed charges","16.8% of total billed charges",252,100,,201.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.61,17.304,,34.89,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.76,63,,127.01,,,0,"percent of total billed charges","63% of total billed charges",38.56,15.3,,30.85,,,0,"percent of total billed charges","15.3% of total billed charges",42.34,16.8,,33.87,,,0,"percent of total billed charges","16.8% of total billed charges",173.88,69,,,,,0,"fee schedule","69% of total billed charges",252,100,,201.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",252,100,,201.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",252,100,,201.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.86,61.85,,124.69,,,0,"percent of total billed charges","61.5% of total billed charges",42.34,16.8,,33.87,,,0,"percent of total billed charges","16.8% of total billed charges",126,50,,100.80,,,0,"percent of total billed charges","50% of total billed charges",81.14,32.2,,64.91,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.18,17.136,,34.54,,,0,"percent of total billed charges","17.136% of total billed charges",55.04,21.84,,44.03,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",95,37.7,,76.00,,,0,"percent of total billed charges","37.7% of total billed charges",95,37.7,,76.00,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.43,33.9,,68.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",196.56,78,,157.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.15,82.6,,166.52,,,0,"percent of total billed charges","82.6% of total billed charges",42.34,16.8,,33.87,,,0,"percent of total billed charges","16.8% of total billed charges",126,50,,100.80,,,0,"percent of total billed charges","50% of total billed charges",208.15,82.6,,166.52,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.34,16.8,,33.87,,,0,"percent of total billed charges","16.8% of total billed charges",252,100,,201.60,,,0,"percent of total billed charges","100% of total billed charges",38.56,252,
"DIABETES SLF MANGMT GRP 30MIN",942G0109,CDM,942,RC,,,OUTPATIENT,,,76,49.4,,66.88,88,,53.50,,,0,"percent of total billed charges","88% of total billed charges",38,50,,30.40,,,0,"percent of total billed charges","50% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.15,17.304,,10.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.88,63,,38.30,,,0,"percent of total billed charges","63% of total billed charges",11.63,15.3,,9.30,,,0,"percent of total billed charges","15.3% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",52.44,69,,,,,0,"fee schedule","69% of total billed charges",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.01,61.85,,37.61,,,0,"percent of total billed charges","61.5% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",38,50,,30.40,,,0,"percent of total billed charges","50% of total billed charges",24.47,32.2,,19.58,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.02,17.136,,10.42,,,0,"percent of total billed charges","17.136% of total billed charges",16.6,21.84,,13.28,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.65,37.7,,22.92,,,0,"percent of total billed charges","37.7% of total billed charges",28.65,37.7,,22.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.76,33.9,,20.61,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.28,78,,47.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.78,82.6,,50.22,,,0,"percent of total billed charges","82.6% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",38,50,,30.40,,,0,"percent of total billed charges","50% of total billed charges",62.78,82.6,,50.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",11.63,76,
"MED NUT 2ND RE-EVAL IND 15M",942G0270,CDM,942,RC,,,OUTPATIENT,,,151,98.15,,132.88,88,,106.30,,,0,"percent of total billed charges","88% of total billed charges",75.5,50,,60.40,,,0,"percent of total billed charges","50% of total billed charges",25.37,16.8,,20.30,,,0,"percent of total billed charges","16.8% of total billed charges",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.13,17.304,,20.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.13,63,,76.10,,,0,"percent of total billed charges","63% of total billed charges",23.1,15.3,,18.48,,,0,"percent of total billed charges","15.3% of total billed charges",25.37,16.8,,20.30,,,0,"percent of total billed charges","16.8% of total billed charges",104.19,69,,,,,0,"fee schedule","69% of total billed charges",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",93.39,61.85,,74.71,,,0,"percent of total billed charges","61.5% of total billed charges",25.37,16.8,,20.30,,,0,"percent of total billed charges","16.8% of total billed charges",75.5,50,,60.40,,,0,"percent of total billed charges","50% of total billed charges",48.62,32.2,,38.90,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25.88,17.136,,20.70,,,0,"percent of total billed charges","17.136% of total billed charges",32.98,21.84,,26.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.93,37.7,,45.54,,,0,"percent of total billed charges","37.7% of total billed charges",56.93,37.7,,45.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.19,33.9,,40.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",117.78,78,,94.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.73,82.6,,99.78,,,0,"percent of total billed charges","82.6% of total billed charges",25.37,16.8,,20.30,,,0,"percent of total billed charges","16.8% of total billed charges",75.5,50,,60.40,,,0,"percent of total billed charges","50% of total billed charges",124.73,82.6,,99.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.37,16.8,,20.30,,,0,"percent of total billed charges","16.8% of total billed charges",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",23.1,151,
"MED NUT 2ND RE-EVAL GRP 30M",942G0271,CDM,942,RC,,,OUTPATIENT,,,69,44.85,,60.72,88,,48.58,,,0,"percent of total billed charges","88% of total billed charges",34.5,50,,27.60,,,0,"percent of total billed charges","50% of total billed charges",11.59,16.8,,9.27,,,0,"percent of total billed charges","16.8% of total billed charges",69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.94,17.304,,9.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.47,63,,34.78,,,0,"percent of total billed charges","63% of total billed charges",10.56,15.3,,8.45,,,0,"percent of total billed charges","15.3% of total billed charges",11.59,16.8,,9.27,,,0,"percent of total billed charges","16.8% of total billed charges",47.61,69,,,,,0,"fee schedule","69% of total billed charges",69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.68,61.85,,34.14,,,0,"percent of total billed charges","61.5% of total billed charges",11.59,16.8,,9.27,,,0,"percent of total billed charges","16.8% of total billed charges",34.5,50,,27.60,,,0,"percent of total billed charges","50% of total billed charges",22.22,32.2,,17.78,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.82,17.136,,9.46,,,0,"percent of total billed charges","17.136% of total billed charges",15.07,21.84,,12.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.01,37.7,,20.81,,,0,"percent of total billed charges","37.7% of total billed charges",26.01,37.7,,20.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.39,33.9,,18.71,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.82,78,,43.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.99,82.6,,45.59,,,0,"percent of total billed charges","82.6% of total billed charges",11.59,16.8,,9.27,,,0,"percent of total billed charges","16.8% of total billed charges",34.5,50,,27.60,,,0,"percent of total billed charges","50% of total billed charges",56.99,82.6,,45.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.59,16.8,,9.27,,,0,"percent of total billed charges","16.8% of total billed charges",69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",10.56,69,
"CHILDBIRTH CLASSES",942S9436,CDM,942,RC,,,OUTPATIENT,,,96,62.4,,84.48,88,,67.58,,,0,"percent of total billed charges","88% of total billed charges",48,50,,38.40,,,0,"percent of total billed charges","50% of total billed charges",16.13,16.8,,12.90,,,0,"percent of total billed charges","16.8% of total billed charges",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.61,17.304,,13.29,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.48,63,,48.38,,,0,"percent of total billed charges","63% of total billed charges",14.69,15.3,,11.75,,,0,"percent of total billed charges","15.3% of total billed charges",16.13,16.8,,12.90,,,0,"percent of total billed charges","16.8% of total billed charges",66.24,69,,,,,0,"fee schedule","69% of total billed charges",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.38,61.85,,47.50,,,0,"percent of total billed charges","61.5% of total billed charges",16.13,16.8,,12.90,,,0,"percent of total billed charges","16.8% of total billed charges",48,50,,38.40,,,0,"percent of total billed charges","50% of total billed charges",30.91,32.2,,24.73,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.45,17.136,,13.16,,,0,"percent of total billed charges","17.136% of total billed charges",20.97,21.84,,16.78,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.19,37.7,,28.95,,,0,"percent of total billed charges","37.7% of total billed charges",36.19,37.7,,28.95,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.54,33.9,,26.03,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.88,78,,59.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",16.13,16.8,,12.90,,,0,"percent of total billed charges","16.8% of total billed charges",48,50,,38.40,,,0,"percent of total billed charges","50% of total billed charges",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.13,16.8,,12.90,,,0,"percent of total billed charges","16.8% of total billed charges",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",14.69,96,
HEMODIALYSIS,80190935,CDM,801,RC,90935,CPT,OUTPATIENT,,,5046,3279.9,,4440.48,88,,3552.38,,,0,"percent of total billed charges","88% of total billed charges",712.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",689.5,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",1247.3,175,,,,,0,"fee schedule","175% of CMS fee schedule",710.19,100,,,,,0,"fee schedule",EAPG,712.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3178.98,63,,2543.18,,,0,"percent of total billed charges","63% of total billed charges",772.04,15.3,,617.63,,,0,"percent of total billed charges","15.3% of total billed charges",689.5,100,,,,,0,"fee schedule",EAPG,3481.74,69,,,,,0,"fee schedule","69% of total billed charges",5046,100,,4036.80,,,0,"percent of total billed charges","100% of total billed charges",712.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5046,100,,4036.80,,,0,"percent of total billed charges","100% of total billed charges",712.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5046,100,,4036.80,,,0,"percent of total billed charges","100% of total billed charges",712.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",2658.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",689.5,100,,,,,0,"fee schedule",EAPG,712.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510.74,100,,,,,0,"fee schedule",EAPG,712.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",703.29,100,,,,,0,"fee schedule",EAPG,896.36,100,,,,,0,"fee schedule",EAPG,712.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1902.34,37.7,,1521.87,,,0,"percent of total billed charges","37.7% of total billed charges",1902.34,37.7,,1521.87,,,0,"percent of total billed charges","37.70% of total billed charges",712.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1710.59,33.9,,1368.47,,,0,"percent of total billed charges","33.9% of total billed charges",712.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3935.88,78,,3148.70,,,0,"percent of total billed charges","78% of total billed charges",719.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4168,82.6,,3334.40,,,0,"percent of total billed charges","82.6% of total billed charges",689.5,100,,,,,0,"fee schedule",EAPG,712.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4168,82.6,,3334.40,,,0,"percent of total billed charges","82.6% of total billed charges",712.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",689.5,100,,,,,0,"fee schedule",EAPG,5046,100,,4036.80,,,0,"percent of total billed charges","100% of total billed charges",510.74,5046,
"PERITONEAL DIALYSIS INPT",80290945,CDM,802,RC,90945,CPT,OUTPATIENT,,,1478,960.7,,1300.64,88,,1040.51,,,0,"percent of total billed charges","88% of total billed charges",451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",689.5,100,,,,,0,"fee schedule",EAPG,1478,100,,1182.40,,,0,"percent of total billed charges","100% of total billed charges",790.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",710.19,100,,,,,0,"fee schedule",EAPG,451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",931.14,63,,744.91,,,0,"percent of total billed charges","63% of total billed charges",226.13,15.3,,180.90,,,0,"percent of total billed charges","15.3% of total billed charges",689.5,100,,,,,0,"fee schedule",EAPG,1019.82,69,,,,,0,"fee schedule","69% of total billed charges",1478,100,,1182.40,,,0,"percent of total billed charges","100% of total billed charges",451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478,100,,1182.40,,,0,"percent of total billed charges","100% of total billed charges",451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478,100,,1182.40,,,0,"percent of total billed charges","100% of total billed charges",451.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",1477.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",689.5,100,,,,,0,"fee schedule",EAPG,451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",386.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510.74,100,,,,,0,"fee schedule",EAPG,451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",703.29,100,,,,,0,"fee schedule",EAPG,896.36,100,,,,,0,"fee schedule",EAPG,451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",557.21,37.7,,445.77,,,0,"percent of total billed charges","37.7% of total billed charges",557.21,37.7,,445.77,,,0,"percent of total billed charges","37.70% of total billed charges",451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",501.04,33.9,,400.83,,,0,"percent of total billed charges","33.9% of total billed charges",451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1152.84,78,,922.27,,,0,"percent of total billed charges","78% of total billed charges",456.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1220.83,82.6,,976.66,,,0,"percent of total billed charges","82.6% of total billed charges",689.5,100,,,,,0,"fee schedule",EAPG,451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1220.83,82.6,,976.66,,,0,"percent of total billed charges","82.6% of total billed charges",451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",689.5,100,,,,,0,"fee schedule",EAPG,1478,100,,1182.40,,,0,"percent of total billed charges","100% of total billed charges",226.13,1478,
"DIALYSIS NON-ROUTINE OP",820G0257,CDM,821,RC,,,OUTPATIENT,,,2843,1847.95,,2501.84,88,,2001.47,,,0,"percent of total billed charges","88% of total billed charges",1421.5,50,,1137.20,,,0,"percent of total billed charges","50% of total billed charges",477.62,16.8,,382.10,,,0,"percent of total billed charges","16.8% of total billed charges",2843,100,,2274.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",491.95,17.304,,393.56,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1791.09,63,,1432.87,,,0,"percent of total billed charges","63% of total billed charges",434.98,15.3,,347.98,,,0,"percent of total billed charges","15.3% of total billed charges",477.62,16.8,,382.10,,,0,"percent of total billed charges","16.8% of total billed charges",1961.67,69,,,,,0,"fee schedule","69% of total billed charges",2843,100,,2274.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2843,100,,2274.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2843,100,,2274.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1758.4,61.85,,1406.72,,,0,"percent of total billed charges","61.5% of total billed charges",477.62,16.8,,382.10,,,0,"percent of total billed charges","16.8% of total billed charges",1421.5,50,,1137.20,,,0,"percent of total billed charges","50% of total billed charges",915.45,32.2,,732.36,,,0,"percent of total billed charges","32.2% of total billed charges",477.62,16.8,,382.10,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",487.18,17.136,,389.74,,,0,"percent of total billed charges","17.136% of total billed charges",620.91,21.84,,496.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071.81,37.7,,857.45,,,0,"percent of total billed charges","37.7% of total billed charges",1071.81,37.7,,857.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",963.78,33.9,,771.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2217.54,78,,1774.03,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2348.32,82.6,,1878.66,,,0,"percent of total billed charges","82.6% of total billed charges",477.62,16.8,,382.10,,,0,"percent of total billed charges","16.8% of total billed charges",1421.5,50,,1137.20,,,0,"percent of total billed charges","50% of total billed charges",2348.32,82.6,,1878.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",477.62,16.8,,382.10,,,0,"percent of total billed charges","16.8% of total billed charges",2843,100,,2274.40,,,0,"percent of total billed charges","100% of total billed charges",434.98,2843,
"FINE NEEDLE ASPIR. W/O IMAGE",45010021,CDM,450,RC,10021,CPT,OUTPATIENT,,,560,364,,492.8,88,,394.24,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.92,100,,,,,0,"fee schedule",EAPG,560,100,,448.00,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",585.99,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352.8,63,,282.24,,,0,"percent of total billed charges","63% of total billed charges",85.68,15.3,,68.54,,,0,"percent of total billed charges","15.3% of total billed charges",568.92,100,,,,,0,"fee schedule",EAPG,386.4,69,,,,,0,"fee schedule","69% of total billed charges",560,100,,448.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560,100,,448.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560,100,,448.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.92,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",421.42,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",580.3,100,,,,,0,"fee schedule",EAPG,739.6,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",211.12,37.7,,168.90,,,0,"percent of total billed charges","37.7% of total billed charges",211.12,37.7,,168.90,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.84,33.9,,151.87,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",436.8,78,,349.44,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.56,82.6,,370.05,,,0,"percent of total billed charges","82.6% of total billed charges",568.92,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.56,82.6,,370.05,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.92,100,,,,,0,"fee schedule",EAPG,560,100,,448.00,,,0,"percent of total billed charges","100% of total billed charges",85.68,1404.97,
"I  D SUBCUT ABCESS SIMPLE",45010060,CDM,450,RC,10060,CPT,OUTPATIENT,,,731,475.15,,643.28,88,,514.62,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,731,100,,584.80,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460.53,63,,368.42,,,0,"percent of total billed charges","63% of total billed charges",111.84,15.3,,89.47,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,504.39,69,,,,,0,"fee schedule","69% of total billed charges",731,100,,584.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",731,100,,584.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",731,100,,584.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.13,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",275.59,37.7,,220.47,,,0,"percent of total billed charges","37.7% of total billed charges",275.59,37.7,,220.47,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",247.81,33.9,,198.25,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",570.18,78,,456.14,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",603.81,82.6,,483.05,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",603.81,82.6,,483.05,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,731,100,,584.80,,,0,"percent of total billed charges","100% of total billed charges",109.13,731,
"I  D ABCESS COMPLEX",45010061,CDM,450,RC,10061,CPT,OUTPATIENT,,,731,475.15,,643.28,88,,514.62,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,731,100,,584.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460.53,63,,368.42,,,0,"percent of total billed charges","63% of total billed charges",111.84,15.3,,89.47,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,504.39,69,,,,,0,"fee schedule","69% of total billed charges",731,100,,584.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",731,100,,584.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",731,100,,584.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.13,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",275.59,37.7,,220.47,,,0,"percent of total billed charges","37.7% of total billed charges",275.59,37.7,,220.47,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",247.81,33.9,,198.25,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",570.18,78,,456.14,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",603.81,82.6,,483.05,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",603.81,82.6,,483.05,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,731,100,,584.80,,,0,"percent of total billed charges","100% of total billed charges",109.13,1404.97,
"I  D PILONIDIAL SIMPLE",45010080,CDM,450,RC,10080,CPT,OUTPATIENT,,,731,475.15,,643.28,88,,514.62,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,731,100,,584.80,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460.53,63,,368.42,,,0,"percent of total billed charges","63% of total billed charges",111.84,15.3,,89.47,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,504.39,69,,,,,0,"fee schedule","69% of total billed charges",731,100,,584.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",731,100,,584.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",731,100,,584.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.13,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",275.59,37.7,,220.47,,,0,"percent of total billed charges","37.7% of total billed charges",275.59,37.7,,220.47,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",247.81,33.9,,198.25,,,0,"percent of total billed charges","33.9% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",570.18,78,,456.14,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",603.81,82.6,,483.05,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",603.81,82.6,,483.05,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,731,100,,584.80,,,0,"percent of total billed charges","100% of total billed charges",109.13,2526.76,
"I  D PILONIDAL CYST COMPLEX",45010081,CDM,450,RC,10081,CPT,OUTPATIENT,,,785,510.25,,690.8,88,,552.64,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",989.16,100,,,,,0,"fee schedule",EAPG,785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",1018.83,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",494.55,63,,395.64,,,0,"percent of total billed charges","63% of total billed charges",120.11,15.3,,96.09,,,0,"percent of total billed charges","15.3% of total billed charges",989.16,100,,,,,0,"fee schedule",EAPG,541.65,69,,,,,0,"fee schedule","69% of total billed charges",785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",989.16,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",732.71,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1008.94,100,,,,,0,"fee schedule",EAPG,1285.91,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",295.95,37.7,,236.76,,,0,"percent of total billed charges","37.7% of total billed charges",295.95,37.7,,236.76,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",266.12,33.9,,212.90,,,0,"percent of total billed charges","33.9% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",612.3,78,,489.84,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",648.41,82.6,,518.73,,,0,"percent of total billed charges","82.6% of total billed charges",989.16,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",648.41,82.6,,518.73,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",989.16,100,,,,,0,"fee schedule",EAPG,785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",120.11,2526.76,
"INC  REMOVAL FB SUBQ SIMPLE",45010120,CDM,450,RC,10120,CPT,OUTPATIENT,,,731,475.15,,643.28,88,,514.62,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,731,100,,584.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460.53,63,,368.42,,,0,"percent of total billed charges","63% of total billed charges",111.84,15.3,,89.47,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,504.39,69,,,,,0,"fee schedule","69% of total billed charges",731,100,,584.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",731,100,,584.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",731,100,,584.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.13,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",275.59,37.7,,220.47,,,0,"percent of total billed charges","37.7% of total billed charges",275.59,37.7,,220.47,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",247.81,33.9,,198.25,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",570.18,78,,456.14,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",603.81,82.6,,483.05,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",603.81,82.6,,483.05,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,731,100,,584.80,,,0,"percent of total billed charges","100% of total billed charges",109.13,1404.97,
"INC  REMOVAL FB SUBQ COMPLEX",45010121,CDM,450,RC,10121,CPT,OUTPATIENT,,,3890,2528.5,,3423.2,88,,2738.56,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,3890,100,,3112.00,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1066.24,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2450.7,63,,1960.56,,,0,"percent of total billed charges","63% of total billed charges",595.17,15.3,,476.14,,,0,"percent of total billed charges","15.3% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,2684.1,69,,,,,0,"fee schedule","69% of total billed charges",3890,100,,3112.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3890,100,,3112.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3890,100,,3112.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",766.8,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055.89,100,,,,,0,"fee schedule",EAPG,1345.74,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1466.53,37.7,,1173.22,,,0,"percent of total billed charges","37.7% of total billed charges",1466.53,37.7,,1173.22,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1318.71,33.9,,1054.97,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3034.2,78,,2427.36,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3213.14,82.6,,2570.51,,,0,"percent of total billed charges","82.6% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3213.14,82.6,,2570.51,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,3890,100,,3112.00,,,0,"percent of total billed charges","100% of total billed charges",595.17,5715.97,
"I  D HEMATOMA",45010140,CDM,450,RC,10140,CPT,OUTPATIENT,,,2885,1875.25,,2538.8,88,,2031.04,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",989.16,100,,,,,0,"fee schedule",EAPG,2885,100,,2308.00,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1018.83,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1817.55,63,,1454.04,,,0,"percent of total billed charges","63% of total billed charges",441.41,15.3,,353.13,,,0,"percent of total billed charges","15.3% of total billed charges",989.16,100,,,,,0,"fee schedule",EAPG,1990.65,69,,,,,0,"fee schedule","69% of total billed charges",2885,100,,2308.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2885,100,,2308.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2885,100,,2308.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",989.16,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",732.71,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1008.94,100,,,,,0,"fee schedule",EAPG,1285.91,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1087.65,37.7,,870.12,,,0,"percent of total billed charges","37.7% of total billed charges",1087.65,37.7,,870.12,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",978.02,33.9,,782.42,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2250.3,78,,1800.24,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2383.01,82.6,,1906.41,,,0,"percent of total billed charges","82.6% of total billed charges",989.16,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2383.01,82.6,,1906.41,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",989.16,100,,,,,0,"fee schedule",EAPG,2885,100,,2308.00,,,0,"percent of total billed charges","100% of total billed charges",441.41,5715.97,
"PUNCT ASP ABSCESS/CY",45010160,CDM,450,RC,10160,CPT,OUTPATIENT,,,289,187.85,,254.32,88,,203.46,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",182.07,63,,145.66,,,0,"percent of total billed charges","63% of total billed charges",44.22,15.3,,35.38,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,199.41,69,,,,,0,"fee schedule","69% of total billed charges",289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.13,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.95,37.7,,87.16,,,0,"percent of total billed charges","37.7% of total billed charges",108.95,37.7,,87.16,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",97.97,33.9,,78.38,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",225.42,78,,180.34,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",238.71,82.6,,190.97,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",238.71,82.6,,190.97,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",44.22,1404.97,
"DEB/ECZEMA OR INFECT SKIN <10%",45011000,CDM,450,RC,11000,CPT,OUTPATIENT,,,289,187.85,,254.32,88,,203.46,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",182.07,63,,145.66,,,0,"percent of total billed charges","63% of total billed charges",44.22,15.3,,35.38,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,199.41,69,,,,,0,"fee schedule","69% of total billed charges",289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.95,37.7,,87.16,,,0,"percent of total billed charges","37.7% of total billed charges",108.95,37.7,,87.16,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",97.97,33.9,,78.38,,,0,"percent of total billed charges","33.9% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",225.42,78,,180.34,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",238.71,82.6,,190.97,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",238.71,82.6,,190.97,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",44.22,2129.45,
"DEB/ECZEMA OR INFECT SKIN >10%",45011001,CDM,450,RC,11001,CPT,OUTPATIENT,,,509,330.85,,447.92,88,,358.34,,,0,"percent of total billed charges","88% of total billed charges",254.5,50,,203.60,,,0,"percent of total billed charges","50% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",320.67,63,,256.54,,,0,"percent of total billed charges","63% of total billed charges",77.88,15.3,,62.30,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,351.21,69,,,,,0,"fee schedule","69% of total billed charges",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",314.82,61.85,,251.86,,,0,"percent of total billed charges","61.5% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,254.5,50,,203.60,,,0,"percent of total billed charges","50% of total billed charges",163.9,32.2,,131.12,,,0,"percent of total billed charges","32.2% of total billed charges",250.91,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",191.89,37.7,,153.51,,,0,"percent of total billed charges","37.7% of total billed charges",191.89,37.7,,153.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",172.55,33.9,,138.04,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",397.02,78,,317.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",420.43,82.6,,336.34,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,254.5,50,,203.60,,,0,"percent of total billed charges","50% of total billed charges",420.43,82.6,,336.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.73,100,,,,,0,"fee schedule",EAPG,509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",77.88,509,
"DEBRID OPEN FX/DISLOC SKIN/SUB",45011010,CDM,450,RC,11010,CPT,OUTPATIENT,,,1090,708.5,,959.2,88,,767.36,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,1090,100,,872.00,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.7,63,,549.36,,,0,"percent of total billed charges","63% of total billed charges",166.77,15.3,,133.42,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,752.1,69,,,,,0,"fee schedule","69% of total billed charges",1090,100,,872.00,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1090,100,,872.00,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1090,100,,872.00,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.93,37.7,,328.74,,,0,"percent of total billed charges","37.7% of total billed charges",410.93,37.7,,328.74,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",369.51,33.9,,295.61,,,0,"percent of total billed charges","33.9% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",850.2,78,,680.16,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",900.34,82.6,,720.27,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",900.34,82.6,,720.27,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,1090,100,,872.00,,,0,"percent of total billed charges","100% of total billed charges",166.77,2526.76,
"DEBRIDE INC REMOV OF FM AT SIT",45011012,CDM,450,RC,11012,CPT,OUTPATIENT,,,3371,2191.15,,2966.48,88,,2373.18,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.83,100,,,,,0,"fee schedule",EAPG,3371,100,,2696.80,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",930.95,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2123.73,63,,1698.98,,,0,"percent of total billed charges","63% of total billed charges",515.76,15.3,,412.61,,,0,"percent of total billed charges","15.3% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,2325.99,69,,,,,0,"fee schedule","69% of total billed charges",3371,100,,2696.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3371,100,,2696.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3371,100,,2696.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.83,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",669.51,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",921.91,100,,,,,0,"fee schedule",EAPG,1174.99,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1270.87,37.7,,1016.70,,,0,"percent of total billed charges","37.7% of total billed charges",1270.87,37.7,,1016.70,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1142.77,33.9,,914.22,,,0,"percent of total billed charges","33.9% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2629.38,78,,2103.50,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2784.45,82.6,,2227.56,,,0,"percent of total billed charges","82.6% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2784.45,82.6,,2227.56,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.83,100,,,,,0,"fee schedule",EAPG,3371,100,,2696.80,,,0,"percent of total billed charges","100% of total billed charges",515.76,9628.23,
"DEBRID SKIN  SUBQ",45011042,CDM,450,RC,11042,CPT,OUTPATIENT,,,675,438.75,,594,88,,475.20,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,675,100,,540.00,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",425.25,63,,340.20,,,0,"percent of total billed charges","63% of total billed charges",103.28,15.3,,82.62,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,465.75,69,,,,,0,"fee schedule","69% of total billed charges",675,100,,540.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",675,100,,540.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",675,100,,540.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",254.48,37.7,,203.58,,,0,"percent of total billed charges","37.7% of total billed charges",254.48,37.7,,203.58,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",228.83,33.9,,183.06,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",526.5,78,,421.20,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",557.55,82.6,,446.04,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",557.55,82.6,,446.04,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,675,100,,540.00,,,0,"percent of total billed charges","100% of total billed charges",103.28,1404.97,
"DEBRIDEMENT,SKIN,TISSUE,MUSCLE",45011043,CDM,450,RC,11043,CPT,OUTPATIENT,,,675,438.75,,594,88,,475.20,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,675,100,,540.00,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",425.25,63,,340.20,,,0,"percent of total billed charges","63% of total billed charges",103.28,15.3,,82.62,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,465.75,69,,,,,0,"fee schedule","69% of total billed charges",675,100,,540.00,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",675,100,,540.00,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",675,100,,540.00,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",254.48,37.7,,203.58,,,0,"percent of total billed charges","37.7% of total billed charges",254.48,37.7,,203.58,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",228.83,33.9,,183.06,,,0,"percent of total billed charges","33.9% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",526.5,78,,421.20,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",557.55,82.6,,446.04,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",557.55,82.6,,446.04,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,675,100,,540.00,,,0,"percent of total billed charges","100% of total billed charges",103.28,2129.45,
"11044 DEBRIDE TISSUE/MUSCLE/BONE TechFee",45011044,CDM,450,RC,11044,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",903.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",930.95,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",903.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",903.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",669.51,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",921.91,100,,,,,0,"fee schedule",EAPG,1174.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",903.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",903.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",669.51,1174.99,
"Paring or cutting of benign hyperkeratotic lesion (eg, corn",45011055,CDM,450,RC,11055,CPT,OUTPATIENT,,,73,47.45,,64.24,88,,51.39,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",45.99,63,,36.79,,,0,"percent of total billed charges","63% of total billed charges",11.17,15.3,,8.94,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,50.37,69,,,,,0,"fee schedule","69% of total billed charges",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.13,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",27.52,37.7,,22.02,,,0,"percent of total billed charges","37.7% of total billed charges",27.52,37.7,,22.02,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.75,33.9,,19.80,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",56.94,78,,45.55,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",11.17,729.42,
"11102 TANGENTIAL BIOPSY SKIN SINGLE LESION",76111102,CDM,761,RC,11102,CPT,OUTPATIENT,,,390,253.5,,343.2,88,,274.56,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,390,100,,312.00,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",245.7,63,,196.56,,,0,"percent of total billed charges","63% of total billed charges",59.67,15.3,,47.74,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,269.1,69,,,,,0,"fee schedule","69% of total billed charges",390,100,,312.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390,100,,312.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390,100,,312.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.37,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.03,37.7,,117.62,,,0,"percent of total billed charges","37.7% of total billed charges",147.03,37.7,,117.62,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.21,33.9,,105.77,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",304.2,78,,243.36,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",322.14,82.6,,257.71,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",322.14,82.6,,257.71,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,390,100,,312.00,,,0,"percent of total billed charges","100% of total billed charges",59.67,729.41,
"11103 Tangntl bx skin ea sep/addl",76111103,CDM,761,RC,11103,CPT,OUTPATIENT,,,193,125.45,,169.84,88,,135.87,,,0,"percent of total billed charges","88% of total billed charges",96.5,50,,77.20,,,0,"percent of total billed charges","50% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",413.49,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",121.59,63,,97.27,,,0,"percent of total billed charges","63% of total billed charges",29.53,15.3,,23.62,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,133.17,69,,,,,0,"fee schedule","69% of total billed charges",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",119.37,61.85,,95.50,,,0,"percent of total billed charges","61.5% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,96.5,50,,77.20,,,0,"percent of total billed charges","50% of total billed charges",62.15,32.2,,49.72,,,0,"percent of total billed charges","32.2% of total billed charges",297.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",72.76,37.7,,58.21,,,0,"percent of total billed charges","37.7% of total billed charges",72.76,37.7,,58.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",65.43,33.9,,52.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",150.54,78,,120.43,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.42,82.6,,127.54,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,96.5,50,,77.20,,,0,"percent of total billed charges","50% of total billed charges",159.42,82.6,,127.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",401.45,100,,,,,0,"fee schedule",EAPG,193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",29.53,521.88,
"REMOVAL SKINTAGS UP TO 15",45011200,CDM,450,RC,11200,CPT,OUTPATIENT,,,289,187.85,,254.32,88,,203.46,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",182.07,63,,145.66,,,0,"percent of total billed charges","63% of total billed charges",44.22,15.3,,35.38,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,199.41,69,,,,,0,"fee schedule","69% of total billed charges",289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.13,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.95,37.7,,87.16,,,0,"percent of total billed charges","37.7% of total billed charges",108.95,37.7,,87.16,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",97.97,33.9,,78.38,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",225.42,78,,180.34,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",238.71,82.6,,190.97,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule","100% of WA fee schedule",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",238.71,82.6,,190.97,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",44.22,729.42,
"EXCISION BENIGN LESION < 0.5CM",45011420,CDM,450,RC,11420,CPT,OUTPATIENT,,,1755,1140.75,,1544.4,88,,1235.52,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,1755,100,,1404.00,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1066.24,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1105.65,63,,884.52,,,0,"percent of total billed charges","63% of total billed charges",268.52,15.3,,214.82,,,0,"percent of total billed charges","15.3% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,1210.95,69,,,,,0,"fee schedule","69% of total billed charges",1755,100,,1404.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1755,100,,1404.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1755,100,,1404.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",766.8,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055.89,100,,,,,0,"fee schedule",EAPG,1345.74,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",661.64,37.7,,529.31,,,0,"percent of total billed charges","37.7% of total billed charges",661.64,37.7,,529.31,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",594.95,33.9,,475.96,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1368.9,78,,1095.12,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1449.63,82.6,,1159.70,,,0,"percent of total billed charges","82.6% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1449.63,82.6,,1159.70,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,1755,100,,1404.00,,,0,"percent of total billed charges","100% of total billed charges",268.52,5715.97,
"EXCISION LESION BENIGN 1.1-2CM",45011422,CDM,450,RC,11422,CPT,OUTPATIENT,,,1433,931.45,,1261.04,88,,1008.83,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,1433,100,,1146.40,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1066.24,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",902.79,63,,722.23,,,0,"percent of total billed charges","63% of total billed charges",219.25,15.3,,175.40,,,0,"percent of total billed charges","15.3% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,988.77,69,,,,,0,"fee schedule","69% of total billed charges",1433,100,,1146.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1433,100,,1146.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1433,100,,1146.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",766.8,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055.89,100,,,,,0,"fee schedule",EAPG,1345.74,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",540.24,37.7,,432.19,,,0,"percent of total billed charges","37.7% of total billed charges",540.24,37.7,,432.19,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",485.79,33.9,,388.63,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1117.74,78,,894.19,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1183.66,82.6,,946.93,,,0,"percent of total billed charges","82.6% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1183.66,82.6,,946.93,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,1433,100,,1146.40,,,0,"percent of total billed charges","100% of total billed charges",219.25,5715.97,
"EX BENIGN LESION <0.5 ON FACE",45011440,CDM,450,RC,11440,CPT,OUTPATIENT,,,1454,945.1,,1279.52,88,,1023.62,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,1454,100,,1163.20,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",916.02,63,,732.82,,,0,"percent of total billed charges","63% of total billed charges",222.46,15.3,,177.97,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,1003.26,69,,,,,0,"fee schedule","69% of total billed charges",1454,100,,1163.20,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1454,100,,1163.20,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1454,100,,1163.20,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.37,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",548.16,37.7,,438.53,,,0,"percent of total billed charges","37.7% of total billed charges",548.16,37.7,,438.53,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",492.91,33.9,,394.33,,,0,"percent of total billed charges","33.9% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1134.12,78,,907.30,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1201,82.6,,960.80,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1201,82.6,,960.80,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,1454,100,,1163.20,,,0,"percent of total billed charges","100% of total billed charges",222.46,2526.76,
"EXCISION BENIGN LESION 2.1-3.0",45011443,CDM,450,RC,11443,CPT,OUTPATIENT,,,2620,1703,,2305.6,88,,1844.48,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,2620,100,,2096.00,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1066.24,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1650.6,63,,1320.48,,,0,"percent of total billed charges","63% of total billed charges",400.86,15.3,,320.69,,,0,"percent of total billed charges","15.3% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,1807.8,69,,,,,0,"fee schedule","69% of total billed charges",2620,100,,2096.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620,100,,2096.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620,100,,2096.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",766.8,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055.89,100,,,,,0,"fee schedule",EAPG,1345.74,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",987.74,37.7,,790.19,,,0,"percent of total billed charges","37.7% of total billed charges",987.74,37.7,,790.19,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",888.18,33.9,,710.54,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2043.6,78,,1634.88,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2164.12,82.6,,1731.30,,,0,"percent of total billed charges","82.6% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2164.12,82.6,,1731.30,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,2620,100,,2096.00,,,0,"percent of total billed charges","100% of total billed charges",400.86,5715.97,
"TRIM NONDYSTOPHIC NAIL",45011719,CDM,450,RC,11719,CPT,OUTPATIENT,,,91,59.15,,80.08,88,,64.06,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",60.86,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",57.33,63,,45.86,,,0,"percent of total billed charges","63% of total billed charges",13.92,15.3,,11.14,,,0,"percent of total billed charges","15.3% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,62.79,69,,,,,0,"fee schedule","69% of total billed charges",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",43.77,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60.27,100,,,,,0,"fee schedule",EAPG,76.81,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.31,37.7,,27.45,,,0,"percent of total billed charges","37.7% of total billed charges",34.31,37.7,,27.45,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",30.85,33.9,,24.68,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",70.98,78,,56.78,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75.17,82.6,,60.14,,,0,"percent of total billed charges","82.6% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75.17,82.6,,60.14,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",13.92,226.12,
"NAIL AVULSION",45011730,CDM,450,RC,11730,CPT,OUTPATIENT,,,709,460.85,,623.92,88,,499.14,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,709,100,,567.20,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",60.86,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",446.67,63,,357.34,,,0,"percent of total billed charges","63% of total billed charges",108.48,15.3,,86.78,,,0,"percent of total billed charges","15.3% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,489.21,69,,,,,0,"fee schedule","69% of total billed charges",709,100,,567.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",709,100,,567.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",709,100,,567.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",43.77,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60.27,100,,,,,0,"fee schedule",EAPG,76.81,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.29,37.7,,213.83,,,0,"percent of total billed charges","37.7% of total billed charges",267.29,37.7,,213.83,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",240.35,33.9,,192.28,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",553.02,78,,442.42,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",585.63,82.6,,468.50,,,0,"percent of total billed charges","82.6% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",585.63,82.6,,468.50,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,709,100,,567.20,,,0,"percent of total billed charges","100% of total billed charges",43.77,729.42,
"SUBUNGUAL HEMATOMA",45011740,CDM,450,RC,11740,CPT,OUTPATIENT,,,262,170.3,,230.56,88,,184.45,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",60.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",165.06,63,,132.05,,,0,"percent of total billed charges","63% of total billed charges",40.09,15.3,,32.07,,,0,"percent of total billed charges","15.3% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,180.78,69,,,,,0,"fee schedule","69% of total billed charges",262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",43.77,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60.27,100,,,,,0,"fee schedule",EAPG,76.81,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",98.77,37.7,,79.02,,,0,"percent of total billed charges","37.7% of total billed charges",98.77,37.7,,79.02,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",88.82,33.9,,71.06,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",204.36,78,,163.49,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.41,82.6,,173.13,,,0,"percent of total billed charges","82.6% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.41,82.6,,173.13,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",40.09,454.8,
"EXCISION NAIL TA",45011750,CDM,450,RC,11750,CPT,OUTPATIENT,,,2004,1302.6,,1763.52,88,,1410.82,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,2004,100,,1603.20,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1262.52,63,,1010.02,,,0,"percent of total billed charges","63% of total billed charges",306.61,15.3,,245.29,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,1382.76,69,,,,,0,"fee schedule","69% of total billed charges",2004,100,,1603.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2004,100,,1603.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2004,100,,1603.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.37,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",755.51,37.7,,604.41,,,0,"percent of total billed charges","37.7% of total billed charges",755.51,37.7,,604.41,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",679.36,33.9,,543.49,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1563.12,78,,1250.50,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1655.3,82.6,,1324.24,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1655.3,82.6,,1324.24,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,2004,100,,1603.20,,,0,"percent of total billed charges","100% of total billed charges",297.37,2004,
"REPAIR NAIL BED",45011760,CDM,450,RC,11760,CPT,OUTPATIENT,,,891,579.15,,784.08,88,,627.26,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",60.86,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.33,63,,449.06,,,0,"percent of total billed charges","63% of total billed charges",136.32,15.3,,109.06,,,0,"percent of total billed charges","15.3% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,614.79,69,,,,,0,"fee schedule","69% of total billed charges",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",43.77,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60.27,100,,,,,0,"fee schedule",EAPG,76.81,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.7% of total billed charges",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302.05,33.9,,241.64,,,0,"percent of total billed charges","33.9% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.98,78,,555.98,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",43.77,2129.45,
"INGROWN NAIL TA",45011765,CDM,450,RC,11765,CPT,OUTPATIENT,,,709,460.85,,623.92,88,,499.14,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,709,100,,567.20,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",60.86,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",446.67,63,,357.34,,,0,"percent of total billed charges","63% of total billed charges",108.48,15.3,,86.78,,,0,"percent of total billed charges","15.3% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,489.21,69,,,,,0,"fee schedule","69% of total billed charges",709,100,,567.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",709,100,,567.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",709,100,,567.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",43.77,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60.27,100,,,,,0,"fee schedule",EAPG,76.81,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.29,37.7,,213.83,,,0,"percent of total billed charges","37.7% of total billed charges",267.29,37.7,,213.83,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",240.35,33.9,,192.28,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",553.02,78,,442.42,,,0,"percent of total billed charges","78% of total billed charges",410.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",585.63,82.6,,468.50,,,0,"percent of total billed charges","82.6% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",585.63,82.6,,468.50,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,709,100,,567.20,,,0,"percent of total billed charges","100% of total billed charges",43.77,1404.98,
"11982 IUD REMOVAL TechFee",45011982,CDM,450,RC,11982,CPT,OUTPATIENT,,,1122,729.3,,987.36,88,,789.89,,,0,"percent of total billed charges","88% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,1122,100,,897.60,,,0,"percent of total billed charges","100% of total billed charges",711.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",706.86,63,,565.49,,,0,"percent of total billed charges","63% of total billed charges",171.67,15.3,,137.34,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,774.18,69,,,,,0,"fee schedule","69% of total billed charges",1122,100,,897.60,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1122,100,,897.60,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1122,100,,897.60,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",1097.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.13,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",422.99,37.7,,338.39,,,0,"percent of total billed charges","37.7% of total billed charges",422.99,37.7,,338.39,,,0,"percent of total billed charges","37.70% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",380.36,33.9,,304.29,,,0,"percent of total billed charges","33.9% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.16,78,,700.13,,,0,"percent of total billed charges","78% of total billed charges",410.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",926.77,82.6,,741.42,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",926.77,82.6,,741.42,,,0,"percent of total billed charges","82.6% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,1122,100,,897.60,,,0,"percent of total billed charges","100% of total billed charges",109.13,1122,
"LAC SPL < 2.5CM TR/EX",45012001,CDM,450,RC,12001,CPT,OUTPATIENT,,,891,579.15,,784.08,88,,627.26,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.33,63,,449.06,,,0,"percent of total billed charges","63% of total billed charges",136.32,15.3,,109.06,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,614.79,69,,,,,0,"fee schedule","69% of total billed charges",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.7% of total billed charges",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302.05,33.9,,241.64,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.98,78,,555.98,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",124.74,891,
"LACERATION SPL 7.5CM TR/EX",45012002,CDM,450,RC,12002,CPT,OUTPATIENT,,,891,579.15,,784.08,88,,627.26,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.33,63,,449.06,,,0,"percent of total billed charges","63% of total billed charges",136.32,15.3,,109.06,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,614.79,69,,,,,0,"fee schedule","69% of total billed charges",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.7% of total billed charges",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302.05,33.9,,241.64,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.98,78,,555.98,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",124.74,891,
"LACERATION SPL 12.5CM TR/EX",45012004,CDM,450,RC,12004,CPT,OUTPATIENT,,,891,579.15,,784.08,88,,627.26,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.33,63,,449.06,,,0,"percent of total billed charges","63% of total billed charges",136.32,15.3,,109.06,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,614.79,69,,,,,0,"fee schedule","69% of total billed charges",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.7% of total billed charges",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302.05,33.9,,241.64,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.98,78,,555.98,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",124.74,891,
"LACERATION SPL 20CM TR/EX",45012005,CDM,450,RC,12005,CPT,OUTPATIENT,,,891,579.15,,784.08,88,,627.26,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.33,63,,449.06,,,0,"percent of total billed charges","63% of total billed charges",136.32,15.3,,109.06,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,614.79,69,,,,,0,"fee schedule","69% of total billed charges",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.7% of total billed charges",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302.05,33.9,,241.64,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.98,78,,555.98,,,0,"percent of total billed charges","78% of total billed charges",410.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",124.74,1404.98,
"LACERATION SPL 30CM NONFACE",45012006,CDM,450,RC,12006,CPT,OUTPATIENT,,,891,579.15,,784.08,88,,627.26,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.33,63,,449.06,,,0,"percent of total billed charges","63% of total billed charges",136.32,15.3,,109.06,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,614.79,69,,,,,0,"fee schedule","69% of total billed charges",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.7% of total billed charges",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302.05,33.9,,241.64,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.98,78,,555.98,,,0,"percent of total billed charges","78% of total billed charges",410.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",124.74,1404.98,
"LACERATION SPL > 30CM TR/EX",45012007,CDM,450,RC,12007,CPT,OUTPATIENT,,,891,579.15,,784.08,88,,627.26,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.33,63,,449.06,,,0,"percent of total billed charges","63% of total billed charges",136.32,15.3,,109.06,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,614.79,69,,,,,0,"fee schedule","69% of total billed charges",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.7% of total billed charges",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302.05,33.9,,241.64,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.98,78,,555.98,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",124.74,891,
"LACERATION SPL < 2.5CM FACE",45012011,CDM,450,RC,12011,CPT,OUTPATIENT,,,891,579.15,,784.08,88,,627.26,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.33,63,,449.06,,,0,"percent of total billed charges","63% of total billed charges",136.32,15.3,,109.06,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,614.79,69,,,,,0,"fee schedule","69% of total billed charges",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.7% of total billed charges",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302.05,33.9,,241.64,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.98,78,,555.98,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",124.74,891,
"LACERATION SPL 5.0CM FACE",45012013,CDM,450,RC,12013,CPT,OUTPATIENT,,,891,579.15,,784.08,88,,627.26,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.33,63,,449.06,,,0,"percent of total billed charges","63% of total billed charges",136.32,15.3,,109.06,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,614.79,69,,,,,0,"fee schedule","69% of total billed charges",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.7% of total billed charges",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302.05,33.9,,241.64,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.98,78,,555.98,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",124.74,891,
"LACERATION SPL 7.5 CM FACE",45012014,CDM,450,RC,12014,CPT,OUTPATIENT,,,891,579.15,,784.08,88,,627.26,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.33,63,,449.06,,,0,"percent of total billed charges","63% of total billed charges",136.32,15.3,,109.06,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,614.79,69,,,,,0,"fee schedule","69% of total billed charges",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.7% of total billed charges",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302.05,33.9,,241.64,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.98,78,,555.98,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",124.74,891,
"LACERATION SPL 12.5CM FACE",45012015,CDM,450,RC,12015,CPT,OUTPATIENT,,,891,579.15,,784.08,88,,627.26,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.33,63,,449.06,,,0,"percent of total billed charges","63% of total billed charges",136.32,15.3,,109.06,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,614.79,69,,,,,0,"fee schedule","69% of total billed charges",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.7% of total billed charges",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302.05,33.9,,241.64,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.98,78,,555.98,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",124.74,891,
"LACERATION SPL 20CM FACE",45012016,CDM,450,RC,12016,CPT,OUTPATIENT,,,891,579.15,,784.08,88,,627.26,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.33,63,,449.06,,,0,"percent of total billed charges","63% of total billed charges",136.32,15.3,,109.06,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,614.79,69,,,,,0,"fee schedule","69% of total billed charges",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.7% of total billed charges",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302.05,33.9,,241.64,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.98,78,,555.98,,,0,"percent of total billed charges","78% of total billed charges",410.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",124.74,1404.98,
"LACERATION SPL 30CM FACE",45012017,CDM,450,RC,12017,CPT,OUTPATIENT,,,891,579.15,,784.08,88,,627.26,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.33,63,,449.06,,,0,"percent of total billed charges","63% of total billed charges",136.32,15.3,,109.06,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,614.79,69,,,,,0,"fee schedule","69% of total billed charges",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.7% of total billed charges",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302.05,33.9,,241.64,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.98,78,,555.98,,,0,"percent of total billed charges","78% of total billed charges",410.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",124.74,1404.98,
"LACERATION SPL > 30CM FACE",45012018,CDM,450,RC,12018,CPT,OUTPATIENT,,,891,579.15,,784.08,88,,627.26,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.33,63,,449.06,,,0,"percent of total billed charges","63% of total billed charges",136.32,15.3,,109.06,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,614.79,69,,,,,0,"fee schedule","69% of total billed charges",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.7% of total billed charges",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302.05,33.9,,241.64,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.98,78,,555.98,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",124.74,891,
"12020 TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE TechFee",45012020,CDM,450,RC,12020,CPT,OUTPATIENT,,,1923,1249.95,,1692.24,88,,1353.79,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,1923,100,,1538.40,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1211.49,63,,969.19,,,0,"percent of total billed charges","63% of total billed charges",294.22,15.3,,235.38,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,1326.87,69,,,,,0,"fee schedule","69% of total billed charges",1923,100,,1538.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1923,100,,1538.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1923,100,,1538.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",724.97,37.7,,579.98,,,0,"percent of total billed charges","37.7% of total billed charges",724.97,37.7,,579.98,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",651.9,33.9,,521.52,,,0,"percent of total billed charges","33.9% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1499.94,78,,1199.95,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1588.4,82.6,,1270.72,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1588.4,82.6,,1270.72,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,1923,100,,1538.40,,,0,"percent of total billed charges","100% of total billed charges",250.91,2129.45,
"LACERATION INT < 2.5CM TR/SCA",45012031,CDM,450,RC,12031,CPT,OUTPATIENT,,,891,579.15,,784.08,88,,627.26,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.33,63,,449.06,,,0,"percent of total billed charges","63% of total billed charges",136.32,15.3,,109.06,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,614.79,69,,,,,0,"fee schedule","69% of total billed charges",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.7% of total billed charges",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302.05,33.9,,241.64,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.98,78,,555.98,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",136.32,1404.97,
"LACERATION INT 7.5CM TR/SCA",45012032,CDM,450,RC,12032,CPT,OUTPATIENT,,,891,579.15,,784.08,88,,627.26,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.33,63,,449.06,,,0,"percent of total billed charges","63% of total billed charges",136.32,15.3,,109.06,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,614.79,69,,,,,0,"fee schedule","69% of total billed charges",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.7% of total billed charges",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302.05,33.9,,241.64,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.98,78,,555.98,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",136.32,1404.97,
"LACERATION INT 12.5CM TR/SC",45012034,CDM,450,RC,12034,CPT,OUTPATIENT,,,891,579.15,,784.08,88,,627.26,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.33,63,,449.06,,,0,"percent of total billed charges","63% of total billed charges",136.32,15.3,,109.06,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,614.79,69,,,,,0,"fee schedule","69% of total billed charges",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.7% of total billed charges",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302.05,33.9,,241.64,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.98,78,,555.98,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",136.32,1404.97,
"LACERATION INT 20CM TR/SCAL",45012035,CDM,450,RC,12035,CPT,OUTPATIENT,,,891,579.15,,784.08,88,,627.26,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.33,63,,449.06,,,0,"percent of total billed charges","63% of total billed charges",136.32,15.3,,109.06,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,614.79,69,,,,,0,"fee schedule","69% of total billed charges",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.7% of total billed charges",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302.05,33.9,,241.64,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.98,78,,555.98,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",136.32,1404.97,
"LACERATION INT 30CM TR/SCAL",45012036,CDM,450,RC,12036,CPT,OUTPATIENT,,,891,579.15,,784.08,88,,627.26,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.33,63,,449.06,,,0,"percent of total billed charges","63% of total billed charges",136.32,15.3,,109.06,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,614.79,69,,,,,0,"fee schedule","69% of total billed charges",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.7% of total billed charges",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302.05,33.9,,241.64,,,0,"percent of total billed charges","33.9% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.98,78,,555.98,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",136.32,2129.45,
"LACERATION INT > 30CM TR/SC",45012037,CDM,450,RC,12037,CPT,OUTPATIENT,,,4381,2847.65,,3855.28,88,,3084.22,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,4381,100,,3504.80,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2760.03,63,,2208.02,,,0,"percent of total billed charges","63% of total billed charges",670.29,15.3,,536.23,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,3022.89,69,,,,,0,"fee schedule","69% of total billed charges",4381,100,,3504.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4381,100,,3504.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4381,100,,3504.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1651.64,37.7,,1321.31,,,0,"percent of total billed charges","37.7% of total billed charges",1651.64,37.7,,1321.31,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1485.16,33.9,,1188.13,,,0,"percent of total billed charges","33.9% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3417.18,78,,2733.74,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3618.71,82.6,,2894.97,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3618.71,82.6,,2894.97,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,4381,100,,3504.80,,,0,"percent of total billed charges","100% of total billed charges",250.91,6968.7,
"LACERATION INT <2.5CM NK/HD/FT",45012041,CDM,450,RC,12041,CPT,OUTPATIENT,,,891,579.15,,784.08,88,,627.26,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.33,63,,449.06,,,0,"percent of total billed charges","63% of total billed charges",136.32,15.3,,109.06,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,614.79,69,,,,,0,"fee schedule","69% of total billed charges",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.7% of total billed charges",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302.05,33.9,,241.64,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.98,78,,555.98,,,0,"percent of total billed charges","78% of total billed charges",410.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",136.32,1404.98,
"LACERATION INT 7.5CM NK/HD/FT",45012042,CDM,450,RC,12042,CPT,OUTPATIENT,,,891,579.15,,784.08,88,,627.26,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.33,63,,449.06,,,0,"percent of total billed charges","63% of total billed charges",136.32,15.3,,109.06,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,614.79,69,,,,,0,"fee schedule","69% of total billed charges",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.7% of total billed charges",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302.05,33.9,,241.64,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.98,78,,555.98,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",136.32,1404.97,
"LACERATION INT 12.5CM NK/HD/FT",45012044,CDM,450,RC,12044,CPT,OUTPATIENT,,,891,579.15,,784.08,88,,627.26,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.33,63,,449.06,,,0,"percent of total billed charges","63% of total billed charges",136.32,15.3,,109.06,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,614.79,69,,,,,0,"fee schedule","69% of total billed charges",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.7% of total billed charges",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302.05,33.9,,241.64,,,0,"percent of total billed charges","33.9% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.98,78,,555.98,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",136.32,2129.45,
"LACERATION INT 20CM NK/HD/FT",45012045,CDM,450,RC,12045,CPT,OUTPATIENT,,,891,579.15,,784.08,88,,627.26,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.33,63,,449.06,,,0,"percent of total billed charges","63% of total billed charges",136.32,15.3,,109.06,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,614.79,69,,,,,0,"fee schedule","69% of total billed charges",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.7% of total billed charges",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302.05,33.9,,241.64,,,0,"percent of total billed charges","33.9% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.98,78,,555.98,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",136.32,2129.45,
"LACERATION INT 30CM NK/HD/FT",45012046,CDM,450,RC,12046,CPT,OUTPATIENT,,,891,579.15,,784.08,88,,627.26,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.33,63,,449.06,,,0,"percent of total billed charges","63% of total billed charges",136.32,15.3,,109.06,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,614.79,69,,,,,0,"fee schedule","69% of total billed charges",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.7% of total billed charges",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302.05,33.9,,241.64,,,0,"percent of total billed charges","33.9% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.98,78,,555.98,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",136.32,2129.45,
"LACERATION INT > 30CM NK/HD/FT",45012047,CDM,450,RC,12047,CPT,OUTPATIENT,,,4381,2847.65,,3855.28,88,,3084.22,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,4381,100,,3504.80,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2760.03,63,,2208.02,,,0,"percent of total billed charges","63% of total billed charges",670.29,15.3,,536.23,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,3022.89,69,,,,,0,"fee schedule","69% of total billed charges",4381,100,,3504.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4381,100,,3504.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4381,100,,3504.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1651.64,37.7,,1321.31,,,0,"percent of total billed charges","37.7% of total billed charges",1651.64,37.7,,1321.31,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1485.16,33.9,,1188.13,,,0,"percent of total billed charges","33.9% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3417.18,78,,2733.74,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3618.71,82.6,,2894.97,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3618.71,82.6,,2894.97,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,4381,100,,3504.80,,,0,"percent of total billed charges","100% of total billed charges",250.91,6968.7,
"LACERATION INT < 2.5CM FACE",45012051,CDM,450,RC,12051,CPT,OUTPATIENT,,,891,579.15,,784.08,88,,627.26,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.33,63,,449.06,,,0,"percent of total billed charges","63% of total billed charges",136.32,15.3,,109.06,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,614.79,69,,,,,0,"fee schedule","69% of total billed charges",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.7% of total billed charges",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302.05,33.9,,241.64,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.98,78,,555.98,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",136.32,1404.97,
"LACERATION INT 5.OCM FACE",45012052,CDM,450,RC,12052,CPT,OUTPATIENT,,,891,579.15,,784.08,88,,627.26,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.33,63,,449.06,,,0,"percent of total billed charges","63% of total billed charges",136.32,15.3,,109.06,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,614.79,69,,,,,0,"fee schedule","69% of total billed charges",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.7% of total billed charges",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302.05,33.9,,241.64,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.98,78,,555.98,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",136.32,1404.97,
"LACERATION INT 7.5CM FACE",45012053,CDM,450,RC,12053,CPT,OUTPATIENT,,,891,579.15,,784.08,88,,627.26,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.33,63,,449.06,,,0,"percent of total billed charges","63% of total billed charges",136.32,15.3,,109.06,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,614.79,69,,,,,0,"fee schedule","69% of total billed charges",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.7% of total billed charges",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302.05,33.9,,241.64,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.98,78,,555.98,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",136.32,1404.97,
"LACERATION INT 12.5CM FACE",45012054,CDM,450,RC,12054,CPT,OUTPATIENT,,,891,579.15,,784.08,88,,627.26,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.33,63,,449.06,,,0,"percent of total billed charges","63% of total billed charges",136.32,15.3,,109.06,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,614.79,69,,,,,0,"fee schedule","69% of total billed charges",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.7% of total billed charges",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302.05,33.9,,241.64,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.98,78,,555.98,,,0,"percent of total billed charges","78% of total billed charges",410.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",136.32,1404.98,
"LACERATION INT 20CM FACE",45012055,CDM,450,RC,12055,CPT,OUTPATIENT,,,891,579.15,,784.08,88,,627.26,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.33,63,,449.06,,,0,"percent of total billed charges","63% of total billed charges",136.32,15.3,,109.06,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,614.79,69,,,,,0,"fee schedule","69% of total billed charges",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.7% of total billed charges",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302.05,33.9,,241.64,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.98,78,,555.98,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",136.32,1404.97,
"LACERATION INT 30CM FACE",45012056,CDM,450,RC,12056,CPT,OUTPATIENT,,,891,579.15,,784.08,88,,627.26,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.33,63,,449.06,,,0,"percent of total billed charges","63% of total billed charges",136.32,15.3,,109.06,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,614.79,69,,,,,0,"fee schedule","69% of total billed charges",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.7% of total billed charges",335.91,37.7,,268.73,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302.05,33.9,,241.64,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.98,78,,555.98,,,0,"percent of total billed charges","78% of total billed charges",410.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.97,82.6,,588.78,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,891,100,,712.80,,,0,"percent of total billed charges","100% of total billed charges",136.32,1404.98,
"LACERATION COMPLEX 2.5CM TRUNK",45013100,CDM,450,RC,13100,CPT,OUTPATIENT,,,1358,882.7,,1195.04,88,,956.03,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",855.54,63,,684.43,,,0,"percent of total billed charges","63% of total billed charges",207.77,15.3,,166.22,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,937.02,69,,,,,0,"fee schedule","69% of total billed charges",1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.37,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",511.97,37.7,,409.58,,,0,"percent of total billed charges","37.7% of total billed charges",511.97,37.7,,409.58,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460.36,33.9,,368.29,,,0,"percent of total billed charges","33.9% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1059.24,78,,847.39,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1121.71,82.6,,897.37,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1121.71,82.6,,897.37,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",207.77,2129.45,
"LACERATION COMPLEX 7.5CM TRUNK",45013101,CDM,450,RC,13101,CPT,OUTPATIENT,,,1358,882.7,,1195.04,88,,956.03,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",855.54,63,,684.43,,,0,"percent of total billed charges","63% of total billed charges",207.77,15.3,,166.22,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,937.02,69,,,,,0,"fee schedule","69% of total billed charges",1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.37,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",511.97,37.7,,409.58,,,0,"percent of total billed charges","37.7% of total billed charges",511.97,37.7,,409.58,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460.36,33.9,,368.29,,,0,"percent of total billed charges","33.9% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1059.24,78,,847.39,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1121.71,82.6,,897.37,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1121.71,82.6,,897.37,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",207.77,2129.45,
"LACERATION COMPLEX 2.5CM S/A/L",45013120,CDM,450,RC,13120,CPT,OUTPATIENT,,,1358,882.7,,1195.04,88,,956.03,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",855.54,63,,684.43,,,0,"percent of total billed charges","63% of total billed charges",207.77,15.3,,166.22,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,937.02,69,,,,,0,"fee schedule","69% of total billed charges",1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.37,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",511.97,37.7,,409.58,,,0,"percent of total billed charges","37.7% of total billed charges",511.97,37.7,,409.58,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460.36,33.9,,368.29,,,0,"percent of total billed charges","33.9% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1059.24,78,,847.39,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1121.71,82.6,,897.37,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1121.71,82.6,,897.37,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",207.77,2129.45,
"LACERATION COMPLEX 7.5CM S/A/L",45013121,CDM,450,RC,13121,CPT,OUTPATIENT,,,1358,882.7,,1195.04,88,,956.03,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",855.54,63,,684.43,,,0,"percent of total billed charges","63% of total billed charges",207.77,15.3,,166.22,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,937.02,69,,,,,0,"fee schedule","69% of total billed charges",1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.37,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",511.97,37.7,,409.58,,,0,"percent of total billed charges","37.7% of total billed charges",511.97,37.7,,409.58,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460.36,33.9,,368.29,,,0,"percent of total billed charges","33.9% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1059.24,78,,847.39,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1121.71,82.6,,897.37,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1121.71,82.6,,897.37,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",207.77,2129.45,
"COMPLEX REPAIR ADD 5CM OR LESS",45013122,CDM,450,RC,13122,CPT,OUTPATIENT,,,1257,817.05,,1106.16,88,,884.93,,,0,"percent of total billed charges","88% of total billed charges",628.5,50,,502.80,,,0,"percent of total billed charges","50% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,1257,100,,1005.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",413.49,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",791.91,63,,633.53,,,0,"percent of total billed charges","63% of total billed charges",192.32,15.3,,153.86,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,867.33,69,,,,,0,"fee schedule","69% of total billed charges",1257,100,,1005.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1257,100,,1005.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1257,100,,1005.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",777.45,61.85,,621.96,,,0,"percent of total billed charges","61.5% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,628.5,50,,502.80,,,0,"percent of total billed charges","50% of total billed charges",404.75,32.2,,323.80,,,0,"percent of total billed charges","32.2% of total billed charges",297.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",473.89,37.7,,379.11,,,0,"percent of total billed charges","37.7% of total billed charges",473.89,37.7,,379.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",426.12,33.9,,340.90,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",980.46,78,,784.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1038.28,82.6,,830.62,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,628.5,50,,502.80,,,0,"percent of total billed charges","50% of total billed charges",1038.28,82.6,,830.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",401.45,100,,,,,0,"fee schedule",EAPG,1257,100,,1005.60,,,0,"percent of total billed charges","100% of total billed charges",192.32,1257,
"LACERATION COMPLEX 2.5CM FHF",45013131,CDM,450,RC,13131,CPT,OUTPATIENT,,,1358,882.7,,1195.04,88,,956.03,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",855.54,63,,684.43,,,0,"percent of total billed charges","63% of total billed charges",207.77,15.3,,166.22,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,937.02,69,,,,,0,"fee schedule","69% of total billed charges",1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.37,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",511.97,37.7,,409.58,,,0,"percent of total billed charges","37.7% of total billed charges",511.97,37.7,,409.58,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460.36,33.9,,368.29,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1059.24,78,,847.39,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1121.71,82.6,,897.37,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1121.71,82.6,,897.37,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",207.77,1404.97,
"LACERATION COMPLEX 7.5CM FHF",45013132,CDM,450,RC,13132,CPT,OUTPATIENT,,,1358,882.7,,1195.04,88,,956.03,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",855.54,63,,684.43,,,0,"percent of total billed charges","63% of total billed charges",207.77,15.3,,166.22,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,937.02,69,,,,,0,"fee schedule","69% of total billed charges",1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.37,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",511.97,37.7,,409.58,,,0,"percent of total billed charges","37.7% of total billed charges",511.97,37.7,,409.58,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460.36,33.9,,368.29,,,0,"percent of total billed charges","33.9% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1059.24,78,,847.39,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1121.71,82.6,,897.37,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1121.71,82.6,,897.37,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",207.77,2129.45,
"LAC COMPLEX EA ADDL 5CM OR LES",45013133,CDM,450,RC,13133,CPT,OUTPATIENT,,,1054,685.1,,927.52,88,,742.02,,,0,"percent of total billed charges","88% of total billed charges",527,50,,421.60,,,0,"percent of total billed charges","50% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,1054,100,,843.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",413.49,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",664.02,63,,531.22,,,0,"percent of total billed charges","63% of total billed charges",161.26,15.3,,129.01,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,727.26,69,,,,,0,"fee schedule","69% of total billed charges",1054,100,,843.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1054,100,,843.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1054,100,,843.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",651.9,61.85,,521.52,,,0,"percent of total billed charges","61.5% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,527,50,,421.60,,,0,"percent of total billed charges","50% of total billed charges",339.39,32.2,,271.51,,,0,"percent of total billed charges","32.2% of total billed charges",297.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",397.36,37.7,,317.89,,,0,"percent of total billed charges","37.7% of total billed charges",397.36,37.7,,317.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",357.31,33.9,,285.85,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",822.12,78,,657.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",870.6,82.6,,696.48,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,527,50,,421.60,,,0,"percent of total billed charges","50% of total billed charges",870.6,82.6,,696.48,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",401.45,100,,,,,0,"fee schedule",EAPG,1054,100,,843.20,,,0,"percent of total billed charges","100% of total billed charges",161.26,1054,
"SUTURE COMPLEX EYE,NOSE <1CM",45013150,CDM,450,RC,13150,CPT,OUTPATIENT,,,4381,2847.65,,3855.28,88,,3084.22,,,0,"percent of total billed charges","88% of total billed charges",2190.5,50,,1752.40,,,0,"percent of total billed charges","50% of total billed charges",736.01,16.8,,588.81,,,0,"percent of total billed charges","16.8% of total billed charges",4381,100,,3504.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",758.09,17.304,,606.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2760.03,63,,2208.02,,,0,"percent of total billed charges","63% of total billed charges",670.29,15.3,,536.23,,,0,"percent of total billed charges","15.3% of total billed charges",736.01,16.8,,588.81,,,0,"percent of total billed charges","16.8% of total billed charges",3022.89,69,,,,,0,"fee schedule","69% of total billed charges",4381,100,,3504.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4381,100,,3504.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4381,100,,3504.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2709.65,61.85,,2167.72,,,0,"percent of total billed charges","61.5% of total billed charges",736.01,16.8,,588.81,,,0,"percent of total billed charges","16.8% of total billed charges",2190.5,50,,1752.40,,,0,"percent of total billed charges","50% of total billed charges",1410.68,32.2,,1128.54,,,0,"percent of total billed charges","32.2% of total billed charges",736.01,16.8,,588.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",750.73,17.136,,600.58,,,0,"percent of total billed charges","17.136% of total billed charges",956.81,21.84,,765.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1651.64,37.7,,1321.31,,,0,"percent of total billed charges","37.7% of total billed charges",1651.64,37.7,,1321.31,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1485.16,33.9,,1188.13,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3417.18,78,,2733.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3618.71,82.6,,2894.97,,,0,"percent of total billed charges","82.6% of total billed charges",736.01,16.8,,588.81,,,0,"percent of total billed charges","16.8% of total billed charges",2190.5,50,,1752.40,,,0,"percent of total billed charges","50% of total billed charges",3618.71,82.6,,2894.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",736.01,16.8,,588.81,,,0,"percent of total billed charges","16.8% of total billed charges",4381,100,,3504.80,,,0,"percent of total billed charges","100% of total billed charges",670.29,4381,
"SUTURE COMPLEX EYE,NOSE 2.5CM",45013151,CDM,450,RC,13151,CPT,OUTPATIENT,,,1358,882.7,,1195.04,88,,956.03,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",855.54,63,,684.43,,,0,"percent of total billed charges","63% of total billed charges",207.77,15.3,,166.22,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,937.02,69,,,,,0,"fee schedule","69% of total billed charges",1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.37,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",511.97,37.7,,409.58,,,0,"percent of total billed charges","37.7% of total billed charges",511.97,37.7,,409.58,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460.36,33.9,,368.29,,,0,"percent of total billed charges","33.9% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1059.24,78,,847.39,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1121.71,82.6,,897.37,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1121.71,82.6,,897.37,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",207.77,2129.45,
"LACERATION COMPLEX 7.5CM FACE",45013152,CDM,450,RC,13152,CPT,OUTPATIENT,,,1358,882.7,,1195.04,88,,956.03,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",855.54,63,,684.43,,,0,"percent of total billed charges","63% of total billed charges",207.77,15.3,,166.22,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,937.02,69,,,,,0,"fee schedule","69% of total billed charges",1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.37,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",511.97,37.7,,409.58,,,0,"percent of total billed charges","37.7% of total billed charges",511.97,37.7,,409.58,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460.36,33.9,,368.29,,,0,"percent of total billed charges","33.9% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1059.24,78,,847.39,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1121.71,82.6,,897.37,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1121.71,82.6,,897.37,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",207.77,2129.45,
"LACERATION COMPLEX ADD'L 5CM",45013153,CDM,450,RC,13153,CPT,OUTPATIENT,,,663,430.95,,583.44,88,,466.75,,,0,"percent of total billed charges","88% of total billed charges",331.5,50,,265.20,,,0,"percent of total billed charges","50% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,663,100,,530.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1066.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",417.69,63,,334.15,,,0,"percent of total billed charges","63% of total billed charges",101.44,15.3,,81.15,,,0,"percent of total billed charges","15.3% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,457.47,69,,,,,0,"fee schedule","69% of total billed charges",663,100,,530.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",663,100,,530.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",663,100,,530.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",410.07,61.85,,328.06,,,0,"percent of total billed charges","61.5% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,331.5,50,,265.20,,,0,"percent of total billed charges","50% of total billed charges",213.49,32.2,,170.79,,,0,"percent of total billed charges","32.2% of total billed charges",766.8,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1055.89,100,,,,,0,"fee schedule",EAPG,1345.74,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",249.95,37.7,,199.96,,,0,"percent of total billed charges","37.7% of total billed charges",249.95,37.7,,199.96,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.76,33.9,,179.81,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",517.14,78,,413.71,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",547.64,82.6,,438.11,,,0,"percent of total billed charges","82.6% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,331.5,50,,265.20,,,0,"percent of total billed charges","50% of total billed charges",547.64,82.6,,438.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1035.18,100,,,,,0,"fee schedule",EAPG,663,100,,530.40,,,0,"percent of total billed charges","100% of total billed charges",101.44,1345.74,
"REMOVAL OF SUTURES UNDER ANES, OTHER SURGEON",45015851,CDM,450,RC,15851,CPT,OUTPATIENT,,,6408,4165.2,,5639.04,88,,4511.23,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1066.24,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4037.04,63,,3229.63,,,0,"percent of total billed charges","63% of total billed charges",980.42,15.3,,784.34,,,0,"percent of total billed charges","15.3% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,4421.52,69,,,,,0,"fee schedule","69% of total billed charges",6408,100,,5126.40,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6408,100,,5126.40,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6408,100,,5126.40,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",766.8,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055.89,100,,,,,0,"fee schedule",EAPG,1345.74,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2415.82,37.7,,1932.66,,,0,"percent of total billed charges","37.7% of total billed charges",2415.82,37.7,,1932.66,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2172.31,33.9,,1737.85,,,0,"percent of total billed charges","33.9% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4998.24,78,,3998.59,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5293.01,82.6,,4234.41,,,0,"percent of total billed charges","82.6% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5293.01,82.6,,4234.41,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,6408,100,,5126.40,,,0,"percent of total billed charges","100% of total billed charges",766.8,6968.7,
"15853 Removal of sutures and staples not requiring anesthesi",45015853,CDM,450,RC,15853,CPT,OUTPATIENT,,,43,27.95,,37.84,88,,30.27,,,0,"percent of total billed charges","88% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.44,17.304,,5.95,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.09,63,,21.67,,,0,"percent of total billed charges","63% of total billed charges",6.58,15.3,,5.26,,,0,"percent of total billed charges","15.3% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",29.67,69,,,,,0,"fee schedule","69% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.6,61.85,,21.28,,,0,"percent of total billed charges","61.5% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",11.72,100,,,,,0,"fee schedule","100% of LI fee schedule",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.37,17.136,,5.90,,,0,"percent of total billed charges","17.136% of total billed charges",9.39,21.84,,7.51,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.21,37.7,,12.97,,,0,"percent of total billed charges","37.7% of total billed charges",16.21,37.7,,12.97,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.58,33.9,,11.66,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.54,78,,26.83,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.52,82.6,,28.42,,,0,"percent of total billed charges","82.6% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",35.52,82.6,,28.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",6.58,43,
"BURN INITIAL",45016000,CDM,450,RC,16000,CPT,OUTPATIENT,,,422,274.3,,371.36,88,,297.09,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.86,63,,212.69,,,0,"percent of total billed charges","63% of total billed charges",64.57,15.3,,51.66,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,291.18,69,,,,,0,"fee schedule","69% of total billed charges",422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",159.09,37.7,,127.27,,,0,"percent of total billed charges","37.7% of total billed charges",159.09,37.7,,127.27,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",143.06,33.9,,114.45,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",329.16,78,,263.33,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.57,82.6,,278.86,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.57,82.6,,278.86,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",64.57,729.42,
"BURN DRESSING W/O ANES SMALL",45016020,CDM,450,RC,16020,CPT,OUTPATIENT,,,422,274.3,,371.36,88,,297.09,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.86,63,,212.69,,,0,"percent of total billed charges","63% of total billed charges",64.57,15.3,,51.66,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,291.18,69,,,,,0,"fee schedule","69% of total billed charges",422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",159.09,37.7,,127.27,,,0,"percent of total billed charges","37.7% of total billed charges",159.09,37.7,,127.27,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",143.06,33.9,,114.45,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",329.16,78,,263.33,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.57,82.6,,278.86,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.57,82.6,,278.86,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",64.57,729.42,
"BURN DRESSING MEDIUM",45016025,CDM,450,RC,16025,CPT,OUTPATIENT,,,509,330.85,,447.92,88,,358.34,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320.67,63,,256.54,,,0,"percent of total billed charges","63% of total billed charges",77.88,15.3,,62.30,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,351.21,69,,,,,0,"fee schedule","69% of total billed charges",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191.89,37.7,,153.51,,,0,"percent of total billed charges","37.7% of total billed charges",191.89,37.7,,153.51,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",172.55,33.9,,138.04,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397.02,78,,317.62,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.43,82.6,,336.34,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.43,82.6,,336.34,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",77.88,729.41,
"BURN DRESSING LARGE",45016030,CDM,450,RC,16030,CPT,OUTPATIENT,,,509,330.85,,447.92,88,,358.34,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320.67,63,,256.54,,,0,"percent of total billed charges","63% of total billed charges",77.88,15.3,,62.30,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,351.21,69,,,,,0,"fee schedule","69% of total billed charges",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191.89,37.7,,153.51,,,0,"percent of total billed charges","37.7% of total billed charges",191.89,37.7,,153.51,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",172.55,33.9,,138.04,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397.02,78,,317.62,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.43,82.6,,336.34,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.43,82.6,,336.34,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",77.88,1404.97,
"INCISION OF BURN SCAB INITIAL",45016035,CDM,450,RC,16035,CPT,OUTPATIENT,,,1120,728,,985.6,88,,788.48,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,1120,100,,896.00,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",705.6,63,,564.48,,,0,"percent of total billed charges","63% of total billed charges",171.36,15.3,,137.09,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,772.8,69,,,,,0,"fee schedule","69% of total billed charges",1120,100,,896.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1120,100,,896.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1120,100,,896.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",422.24,37.7,,337.79,,,0,"percent of total billed charges","37.7% of total billed charges",422.24,37.7,,337.79,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",379.68,33.9,,303.74,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.6,78,,698.88,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",925.12,82.6,,740.10,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",925.12,82.6,,740.10,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,1120,100,,896.00,,,0,"percent of total billed charges","100% of total billed charges",171.36,1404.97,
"ESCHAROTOMY ADD'L INCISION",45016036,CDM,450,RC,16036,CPT,OUTPATIENT,,,464,301.6,,408.32,88,,326.66,,,0,"percent of total billed charges","88% of total billed charges",464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",338.73,100,,,,,0,"fee schedule",EAPG,464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",464,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",292.32,63,,233.86,,,0,"percent of total billed charges","63% of total billed charges",70.99,15.3,,56.79,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,320.16,69,,,,,0,"fee schedule","69% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",464,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",338.73,100,,,,,0,"fee schedule",EAPG,464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",250.91,100,,,,,0,"fee schedule",EAPG,464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",174.93,37.7,,139.94,,,0,"percent of total billed charges","37.7% of total billed charges",174.93,37.7,,139.94,,,0,"percent of total billed charges","37.70% of total billed charges",464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",157.3,33.9,,125.84,,,0,"percent of total billed charges","33.9% of total billed charges",464,100,,,,,0,"fee schedule","100% of CMS fee schedule",361.92,78,,289.54,,,0,"percent of total billed charges","78% of total billed charges",464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",338.73,100,,,,,0,"fee schedule",EAPG,464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",70.99,464,
"OBLITORATE WART VIA CURRETT",45017110,CDM,450,RC,17110,CPT,OUTPATIENT,,,932,605.8,,820.16,88,,656.13,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,932,100,,745.60,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",587.16,63,,469.73,,,0,"percent of total billed charges","63% of total billed charges",142.6,15.3,,114.08,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,643.08,69,,,,,0,"fee schedule","69% of total billed charges",932,100,,745.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",932,100,,745.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",932,100,,745.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.13,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule",,351.36,37.7,,281.09,,,0,"percent of total billed charges","37.7% of total billed charges",351.36,37.7,,281.09,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule",,315.95,33.9,,252.76,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.96,78,,581.57,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",769.83,82.6,,615.86,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",769.83,82.6,,615.86,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,932,100,,745.60,,,0,"percent of total billed charges","100% of total billed charges",109.13,932,
"CHEM CAUTERIZATION OF GRAN TIS",45017250,CDM,450,RC,17250,CPT,OUTPATIENT,,,262,170.3,,230.56,88,,184.45,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",165.06,63,,132.05,,,0,"percent of total billed charges","63% of total billed charges",40.09,15.3,,32.07,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,180.78,69,,,,,0,"fee schedule","69% of total billed charges",262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.13,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule",,98.77,37.7,,79.02,,,0,"percent of total billed charges","37.7% of total billed charges",98.77,37.7,,79.02,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule",,88.82,33.9,,71.06,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",204.36,78,,163.49,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.41,82.6,,173.13,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.41,82.6,,173.13,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",40.09,729.42,
"Unlisted procedure, skin, mucous membrane and subcutaneous t",45017999,CDM,450,RC,17999,CPT,OUTPATIENT,,,578,375.7,,508.64,88,,406.91,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,578,100,,462.40,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",364.14,63,,291.31,,,0,"percent of total billed charges","63% of total billed charges",88.43,15.3,,70.74,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,398.82,69,,,,,0,"fee schedule","69% of total billed charges",578,100,,462.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",578,100,,462.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",578,100,,462.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.13,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",217.91,37.7,,174.33,,,0,"percent of total billed charges","37.7% of total billed charges",217.91,37.7,,174.33,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",195.94,33.9,,156.75,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",450.84,78,,360.67,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",477.43,82.6,,381.94,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",477.43,82.6,,381.94,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,578,100,,462.40,,,0,"percent of total billed charges","100% of total billed charges",88.43,729.42,
"NEEDLE ASPIRATIION CYST/BREAST",45019000,CDM,450,RC,19000,CPT,OUTPATIENT,,,1023,664.95,,900.24,88,,720.19,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.92,100,,,,,0,"fee schedule",EAPG,1023,100,,818.40,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",585.99,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",644.49,63,,515.59,,,0,"percent of total billed charges","63% of total billed charges",156.52,15.3,,125.22,,,0,"percent of total billed charges","15.3% of total billed charges",568.92,100,,,,,0,"fee schedule",EAPG,705.87,69,,,,,0,"fee schedule","69% of total billed charges",1023,100,,818.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1023,100,,818.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1023,100,,818.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.92,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",421.42,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",580.3,100,,,,,0,"fee schedule",EAPG,739.6,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",385.67,37.7,,308.54,,,0,"percent of total billed charges","37.7% of total billed charges",385.67,37.7,,308.54,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",346.8,33.9,,277.44,,,0,"percent of total billed charges","33.9% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",797.94,78,,638.35,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",845,82.6,,676.00,,,0,"percent of total billed charges","82.6% of total billed charges",568.92,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",845,82.6,,676.00,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.92,100,,,,,0,"fee schedule",EAPG,1023,100,,818.40,,,0,"percent of total billed charges","100% of total billed charges",156.52,2526.76,
"19020 MASTOTOMY WITH EXPLORATION OR DRAINAGE OF ABSCESS, DEE",45019020,CDM,450,RC,19020,CPT,OUTPATIENT,,,5841,3796.65,,5140.08,88,,4112.06,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1298.41,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3679.83,63,,2943.86,,,0,"percent of total billed charges","63% of total billed charges",893.67,15.3,,714.94,,,0,"percent of total billed charges","15.3% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,4030.29,69,,,,,0,"fee schedule","69% of total billed charges",5841,100,,4672.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5841,100,,4672.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5841,100,,4672.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",933.77,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1285.8,100,,,,,0,"fee schedule",EAPG,1638.77,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2202.06,37.7,,1761.65,,,0,"percent of total billed charges","37.7% of total billed charges",2202.06,37.7,,1761.65,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1980.1,33.9,,1584.08,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4555.98,78,,3644.78,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4824.67,82.6,,3859.74,,,0,"percent of total billed charges","82.6% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4824.67,82.6,,3859.74,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,5841,100,,4672.80,,,0,"percent of total billed charges","100% of total billed charges",893.67,5841,
"EXP PENETRATING WND EXTREMITY",45020103,CDM,450,RC,20103,CPT,OUTPATIENT,,,724,470.6,,637.12,88,,509.70,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,724,100,,579.20,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",456.12,63,,364.90,,,0,"percent of total billed charges","63% of total billed charges",110.77,15.3,,88.62,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,499.56,69,,,,,0,"fee schedule","69% of total billed charges",724,100,,579.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",724,100,,579.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",724,100,,579.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.95,37.7,,218.36,,,0,"percent of total billed charges","37.7% of total billed charges",272.95,37.7,,218.36,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",245.44,33.9,,196.35,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",564.72,78,,451.78,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",598.02,82.6,,478.42,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",598.02,82.6,,478.42,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,724,100,,579.20,,,0,"percent of total billed charges","100% of total billed charges",110.77,2893.89,
"REMOVAL FB IN MUSCLE SIMPLE",45020520,CDM,450,RC,20520,CPT,OUTPATIENT,,,1454,945.1,,1279.52,88,,1023.62,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1454,100,,1163.20,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",916.02,63,,732.82,,,0,"percent of total billed charges","63% of total billed charges",222.46,15.3,,177.97,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1003.26,69,,,,,0,"fee schedule","69% of total billed charges",1454,100,,1163.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1454,100,,1163.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1454,100,,1163.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1164.3,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",548.16,37.7,,438.53,,,0,"percent of total billed charges","37.7% of total billed charges",548.16,37.7,,438.53,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",492.91,33.9,,394.33,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1134.12,78,,907.30,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1201,82.6,,960.80,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1201,82.6,,960.80,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1454,100,,1163.20,,,0,"percent of total billed charges","100% of total billed charges",222.46,5715.97,
"INJECTION, CARPAL TUNNEL",45020526,CDM,450,RC,20526,CPT,OUTPATIENT,,,564,366.6,,496.32,88,,397.06,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",223.22,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.32,63,,284.26,,,0,"percent of total billed charges","63% of total billed charges",86.29,15.3,,69.03,,,0,"percent of total billed charges","15.3% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,389.16,69,,,,,0,"fee schedule","69% of total billed charges",564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.05,100,,,,,0,"fee schedule",EAPG,281.73,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",212.63,37.7,,170.10,,,0,"percent of total billed charges","37.7% of total billed charges",212.63,37.7,,170.10,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191.2,33.9,,152.96,,,0,"percent of total billed charges","33.9% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",439.92,78,,351.94,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465.86,82.6,,372.69,,,0,"percent of total billed charges","82.6% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465.86,82.6,,372.69,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",86.29,1061,
"TRIGGER PT INJECTION-TENDON",45020550,CDM,450,RC,20550,CPT,OUTPATIENT,,,775,503.75,,682,88,,545.60,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,775,100,,620.00,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",223.22,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",488.25,63,,390.60,,,0,"percent of total billed charges","63% of total billed charges",118.58,15.3,,94.86,,,0,"percent of total billed charges","15.3% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,534.75,69,,,,,0,"fee schedule","69% of total billed charges",775,100,,620.00,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",775,100,,620.00,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",775,100,,620.00,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.05,100,,,,,0,"fee schedule",EAPG,281.73,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",292.18,37.7,,233.74,,,0,"percent of total billed charges","37.7% of total billed charges",292.18,37.7,,233.74,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",262.73,33.9,,210.18,,,0,"percent of total billed charges","33.9% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",604.5,78,,483.60,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",640.15,82.6,,512.12,,,0,"percent of total billed charges","82.6% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",640.15,82.6,,512.12,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,775,100,,620.00,,,0,"percent of total billed charges","100% of total billed charges",118.58,1061,
"TRIGGER PT INJ 1-2 MUSCLE GRP",45020552,CDM,450,RC,20552,CPT,OUTPATIENT,,,703,456.95,,618.64,88,,494.91,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,703,100,,562.40,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",223.22,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",442.89,63,,354.31,,,0,"percent of total billed charges","63% of total billed charges",107.56,15.3,,86.05,,,0,"percent of total billed charges","15.3% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,485.07,69,,,,,0,"fee schedule","69% of total billed charges",703,100,,562.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",703,100,,562.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",703,100,,562.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.05,100,,,,,0,"fee schedule",EAPG,281.73,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.03,37.7,,212.02,,,0,"percent of total billed charges","37.7% of total billed charges",265.03,37.7,,212.02,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",238.32,33.9,,190.66,,,0,"percent of total billed charges","33.9% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",548.34,78,,438.67,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",580.68,82.6,,464.54,,,0,"percent of total billed charges","82.6% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",580.68,82.6,,464.54,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,703,100,,562.40,,,0,"percent of total billed charges","100% of total billed charges",107.56,1061,
"TRIGGER PT INJ 3-MORE MUSC GRP",45020553,CDM,450,RC,20553,CPT,OUTPATIENT,,,703,456.95,,618.64,88,,494.91,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,703,100,,562.40,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",223.22,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",442.89,63,,354.31,,,0,"percent of total billed charges","63% of total billed charges",107.56,15.3,,86.05,,,0,"percent of total billed charges","15.3% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,485.07,69,,,,,0,"fee schedule","69% of total billed charges",703,100,,562.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",703,100,,562.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",703,100,,562.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.05,100,,,,,0,"fee schedule",EAPG,281.73,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.03,37.7,,212.02,,,0,"percent of total billed charges","37.7% of total billed charges",265.03,37.7,,212.02,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",238.32,33.9,,190.66,,,0,"percent of total billed charges","33.9% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",548.34,78,,438.67,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",580.68,82.6,,464.54,,,0,"percent of total billed charges","82.6% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",580.68,82.6,,464.54,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,703,100,,562.40,,,0,"percent of total billed charges","100% of total billed charges",107.56,1061,
"ARTHROCENT ASP/INJ SM JT TA",45020600,CDM,450,RC,20600,CPT,OUTPATIENT,,,1182,768.3,,1040.16,88,,832.13,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,1182,100,,945.60,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",223.22,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",744.66,63,,595.73,,,0,"percent of total billed charges","63% of total billed charges",180.85,15.3,,144.68,,,0,"percent of total billed charges","15.3% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,815.58,69,,,,,0,"fee schedule","69% of total billed charges",1182,100,,945.60,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1182,100,,945.60,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1182,100,,945.60,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.05,100,,,,,0,"fee schedule",EAPG,281.73,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",445.61,37.7,,356.49,,,0,"percent of total billed charges","37.7% of total billed charges",445.61,37.7,,356.49,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.7,33.9,,320.56,,,0,"percent of total billed charges","33.9% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",921.96,78,,737.57,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",976.33,82.6,,781.06,,,0,"percent of total billed charges","82.6% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",976.33,82.6,,781.06,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,1182,100,,945.60,,,0,"percent of total billed charges","100% of total billed charges",160.53,1182,
"ARTHROCENT ASP/INJ MED JT",45020605,CDM,450,RC,20605,CPT,OUTPATIENT,,,1182,768.3,,1040.16,88,,832.13,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,1182,100,,945.60,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",223.22,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",744.66,63,,595.73,,,0,"percent of total billed charges","63% of total billed charges",180.85,15.3,,144.68,,,0,"percent of total billed charges","15.3% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,815.58,69,,,,,0,"fee schedule","69% of total billed charges",1182,100,,945.60,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1182,100,,945.60,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1182,100,,945.60,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.05,100,,,,,0,"fee schedule",EAPG,281.73,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",445.61,37.7,,356.49,,,0,"percent of total billed charges","37.7% of total billed charges",445.61,37.7,,356.49,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.7,33.9,,320.56,,,0,"percent of total billed charges","33.9% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",921.96,78,,737.57,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",976.33,82.6,,781.06,,,0,"percent of total billed charges","82.6% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",976.33,82.6,,781.06,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,1182,100,,945.60,,,0,"percent of total billed charges","100% of total billed charges",160.53,1182,
"ARTHROCENTESIS MAJOR JOINT",45020610,CDM,450,RC,20610,CPT,OUTPATIENT,,,775,503.75,,682,88,,545.60,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,775,100,,620.00,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",223.22,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",488.25,63,,390.60,,,0,"percent of total billed charges","63% of total billed charges",118.58,15.3,,94.86,,,0,"percent of total billed charges","15.3% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,534.75,69,,,,,0,"fee schedule","69% of total billed charges",775,100,,620.00,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",775,100,,620.00,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",775,100,,620.00,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.05,100,,,,,0,"fee schedule",EAPG,281.73,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",292.18,37.7,,233.74,,,0,"percent of total billed charges","37.7% of total billed charges",292.18,37.7,,233.74,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",262.73,33.9,,210.18,,,0,"percent of total billed charges","33.9% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",604.5,78,,483.60,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",640.15,82.6,,512.12,,,0,"percent of total billed charges","82.6% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",640.15,82.6,,512.12,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,775,100,,620.00,,,0,"percent of total billed charges","100% of total billed charges",118.58,1061,
"ASPIRATION OR INJ GANGLION CYS",45020612,CDM,450,RC,20612,CPT,OUTPATIENT,,,545,354.25,,479.6,88,,383.68,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,545,100,,436.00,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",223.22,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",343.35,63,,274.68,,,0,"percent of total billed charges","63% of total billed charges",83.39,15.3,,66.71,,,0,"percent of total billed charges","15.3% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,376.05,69,,,,,0,"fee schedule","69% of total billed charges",545,100,,436.00,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",545,100,,436.00,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",545,100,,436.00,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.05,100,,,,,0,"fee schedule",EAPG,281.73,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",205.47,37.7,,164.38,,,0,"percent of total billed charges","37.7% of total billed charges",205.47,37.7,,164.38,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",184.76,33.9,,147.81,,,0,"percent of total billed charges","33.9% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",425.1,78,,340.08,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",450.17,82.6,,360.14,,,0,"percent of total billed charges","82.6% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",450.17,82.6,,360.14,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,545,100,,436.00,,,0,"percent of total billed charges","100% of total billed charges",83.39,1061,
"REMOVAL OF IMPL WIRE, PIN, ROD",45020670,CDM,450,RC,20670,CPT,OUTPATIENT,,,3609,2345.85,,3175.92,88,,2540.74,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2168.78,100,,,,,0,"fee schedule",EAPG,3609,100,,2887.20,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",2233.84,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2273.67,63,,1818.94,,,0,"percent of total billed charges","63% of total billed charges",552.18,15.3,,441.74,,,0,"percent of total billed charges","15.3% of total billed charges",2168.78,100,,,,,0,"fee schedule",EAPG,2490.21,69,,,,,0,"fee schedule","69% of total billed charges",3609,100,,2887.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3609,100,,2887.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3609,100,,2887.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2168.78,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1606.5,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2212.16,100,,,,,0,"fee schedule",EAPG,2819.42,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1360.59,37.7,,1088.47,,,0,"percent of total billed charges","37.7% of total billed charges",1360.59,37.7,,1088.47,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1223.45,33.9,,978.76,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2815.02,78,,2252.02,,,0,"percent of total billed charges","78% of total billed charges",1670.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2981.03,82.6,,2384.82,,,0,"percent of total billed charges","82.6% of total billed charges",2168.78,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2981.03,82.6,,2384.82,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2168.78,100,,,,,0,"fee schedule",EAPG,3609,100,,2887.20,,,0,"percent of total billed charges","100% of total billed charges",552.18,5715.98,
"CL TX NASAL SEP FX W/WO STABIL",45021337,CDM,450,RC,21337,CPT,OUTPATIENT,,,3609,2345.85,,3175.92,88,,2540.74,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,3609,100,,2887.20,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2273.67,63,,1818.94,,,0,"percent of total billed charges","63% of total billed charges",552.18,15.3,,441.74,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,2490.21,69,,,,,0,"fee schedule","69% of total billed charges",3609,100,,2887.20,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3609,100,,2887.20,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3609,100,,2887.20,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1360.59,37.7,,1088.47,,,0,"percent of total billed charges","37.7% of total billed charges",1360.59,37.7,,1088.47,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1223.45,33.9,,978.76,,,0,"percent of total billed charges","33.9% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2815.02,78,,2252.02,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2981.03,82.6,,2384.82,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2981.03,82.6,,2384.82,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,3609,100,,2887.20,,,0,"percent of total billed charges","100% of total billed charges",296.48,11116.67,
"CL TX FX OF ORBIT W/O MANIP",45021400,CDM,450,RC,21400,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",412.25,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",296.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",296.48,520.32,
"CL TX MANDIBULAR FX W/O MANIP",45021450,CDM,450,RC,21450,CPT,OUTPATIENT,,,746,484.9,,656.48,88,,525.18,,,0,"percent of total billed charges","88% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",982.07,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",469.98,63,,375.98,,,0,"percent of total billed charges","63% of total billed charges",114.14,15.3,,91.31,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,514.74,69,,,,,0,"fee schedule","69% of total billed charges",746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",1837.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",480.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",281.24,37.7,,224.99,,,0,"percent of total billed charges","37.7% of total billed charges",281.24,37.7,,224.99,,,0,"percent of total billed charges","37.70% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.89,33.9,,202.31,,,0,"percent of total billed charges","33.9% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",581.88,78,,465.50,,,0,"percent of total billed charges","78% of total billed charges",566.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,82.6,,492.96,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,82.6,,492.96,,,0,"percent of total billed charges","82.6% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",114.14,1837.71,
"TX TMJ DISLOCATION UNCOMPLICAT",45021480,CDM,450,RC,21480,CPT,OUTPATIENT,,,628,408.2,,552.64,88,,442.11,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,628,100,,502.40,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",395.64,63,,316.51,,,0,"percent of total billed charges","63% of total billed charges",96.08,15.3,,76.86,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,433.32,69,,,,,0,"fee schedule","69% of total billed charges",628,100,,502.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",628,100,,502.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",628,100,,502.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.15,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",236.76,37.7,,189.41,,,0,"percent of total billed charges","37.7% of total billed charges",236.76,37.7,,189.41,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",212.89,33.9,,170.31,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",489.84,78,,391.87,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",518.73,82.6,,414.98,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",518.73,82.6,,414.98,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,628,100,,502.40,,,0,"percent of total billed charges","100% of total billed charges",74.15,837.64,
"FRACTURE RIBS EACH",45021800,CDM,450,RC,21800,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",395,50,,316.00,,,0,"percent of total billed charges","50% of total billed charges",132.72,16.8,,106.18,,,0,"percent of total billed charges","16.8% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.7,17.304,,109.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",132.72,16.8,,106.18,,,0,"percent of total billed charges","16.8% of total billed charges",545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",488.62,61.85,,390.90,,,0,"percent of total billed charges","61.5% of total billed charges",132.72,16.8,,106.18,,,0,"percent of total billed charges","16.8% of total billed charges",395,50,,316.00,,,0,"percent of total billed charges","50% of total billed charges",254.38,32.2,,203.50,,,0,"percent of total billed charges","32.2% of total billed charges",132.72,16.8,,106.18,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",135.37,17.136,,108.30,,,0,"percent of total billed charges","17.136% of total billed charges",172.54,21.84,,138.03,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",132.72,16.8,,106.18,,,0,"percent of total billed charges","16.8% of total billed charges",395,50,,316.00,,,0,"percent of total billed charges","50% of total billed charges",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",132.72,16.8,,106.18,,,0,"percent of total billed charges","16.8% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,790,
"CL TX STERNAL FX",45021820,CDM,450,RC,21820,CPT,OUTPATIENT,,,782,508.3,,688.16,88,,550.53,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",492.66,63,,394.13,,,0,"percent of total billed charges","63% of total billed charges",119.65,15.3,,95.72,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,539.58,69,,,,,0,"fee schedule","69% of total billed charges",782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.81,37.7,,235.85,,,0,"percent of total billed charges","37.7% of total billed charges",294.81,37.7,,235.85,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.1,33.9,,212.08,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",609.96,78,,487.97,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",645.93,82.6,,516.74,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",645.93,82.6,,516.74,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",119.65,837.64,
"CL TX VERT PROCESS",45022305,CDM,450,RC,,,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",395,50,,316.00,,,0,"percent of total billed charges","50% of total billed charges",132.72,16.8,,106.18,,,0,"percent of total billed charges","16.8% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.7,17.304,,109.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",132.72,16.8,,106.18,,,0,"percent of total billed charges","16.8% of total billed charges",545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",488.62,61.85,,390.90,,,0,"percent of total billed charges","61.5% of total billed charges",132.72,16.8,,106.18,,,0,"percent of total billed charges","16.8% of total billed charges",395,50,,316.00,,,0,"percent of total billed charges","50% of total billed charges",254.38,32.2,,203.50,,,0,"percent of total billed charges","32.2% of total billed charges",132.72,16.8,,106.18,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",135.37,17.136,,108.30,,,0,"percent of total billed charges","17.136% of total billed charges",172.54,21.84,,138.03,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",132.72,16.8,,106.18,,,0,"percent of total billed charges","16.8% of total billed charges",395,50,,316.00,,,0,"percent of total billed charges","50% of total billed charges",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",132.72,16.8,,106.18,,,0,"percent of total billed charges","16.8% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,790,
"FRACTURE CLAVICLE-W/O",45023500,CDM,450,RC,23500,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"REDUCTION CLAVICLE",45023505,CDM,450,RC,23505,CPT,OUTPATIENT,,,8684,5644.6,,7641.92,88,,6113.54,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5470.92,63,,4376.74,,,0,"percent of total billed charges","63% of total billed charges",1328.65,15.3,,1062.92,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,5991.96,69,,,,,0,"fee schedule","69% of total billed charges",8684,100,,6947.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8684,100,,6947.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8684,100,,6947.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3273.87,37.7,,2619.10,,,0,"percent of total billed charges","37.7% of total billed charges",3273.87,37.7,,2619.10,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2943.88,33.9,,2355.10,,,0,"percent of total billed charges","33.9% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6773.52,78,,5418.82,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7172.98,82.6,,5738.38,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7172.98,82.6,,5738.38,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,8684,100,,6947.20,,,0,"percent of total billed charges","100% of total billed charges",296.48,8684,
"CL TX STERNOCLAV DISLOC W/MAN",45023525,CDM,450,RC,23525,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"TX CL ACROMIOCLAV DIS W/O",45023540,CDM,450,RC,23540,CPT,OUTPATIENT,,,782,508.3,,688.16,88,,550.53,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",492.66,63,,394.13,,,0,"percent of total billed charges","63% of total billed charges",119.65,15.3,,95.72,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,539.58,69,,,,,0,"fee schedule","69% of total billed charges",782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.81,37.7,,235.85,,,0,"percent of total billed charges","37.7% of total billed charges",294.81,37.7,,235.85,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.1,33.9,,212.08,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",609.96,78,,487.97,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",645.93,82.6,,516.74,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",645.93,82.6,,516.74,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",119.65,837.64,
"CLOSED TX SCAPULAR FX W/O MANI",45023570,CDM,450,RC,23570,CPT,OUTPATIENT,,,460,299,,404.8,88,,323.84,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,460,100,,368.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.8,63,,231.84,,,0,"percent of total billed charges","63% of total billed charges",70.38,15.3,,56.30,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,317.4,69,,,,,0,"fee schedule","69% of total billed charges",460,100,,368.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460,100,,368.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460,100,,368.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.42,37.7,,138.74,,,0,"percent of total billed charges","37.7% of total billed charges",173.42,37.7,,138.74,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",155.94,33.9,,124.75,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",358.8,78,,287.04,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",379.96,82.6,,303.97,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",379.96,82.6,,303.97,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,460,100,,368.00,,,0,"percent of total billed charges","100% of total billed charges",70.38,837.64,
"TX CL HUMERAL FX W/O MAN NECK",45023600,CDM,450,RC,23600,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"CLSD TX RPOX HUMERAL FX W/MANI",45023605,CDM,450,RC,23605,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,5656.45,
"TX CL HUMERAL HEAD W/O MANIP",45023620,CDM,450,RC,23620,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"REDUCTION SHOULDER DISLOCATION",45023650,CDM,450,RC,23650,CPT,OUTPATIENT,,,1035,672.75,,910.8,88,,728.64,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1035,100,,828.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.05,63,,521.64,,,0,"percent of total billed charges","63% of total billed charges",158.36,15.3,,126.69,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,714.15,69,,,,,0,"fee schedule","69% of total billed charges",1035,100,,828.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035,100,,828.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035,100,,828.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.2,37.7,,312.16,,,0,"percent of total billed charges","37.7% of total billed charges",390.2,37.7,,312.16,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350.87,33.9,,280.70,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",807.3,78,,645.84,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",854.91,82.6,,683.93,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",854.91,82.6,,683.93,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1035,100,,828.00,,,0,"percent of total billed charges","100% of total billed charges",158.36,1035,
"REDUC SHLDR DISLOCAT;REQU ANES",45023655,CDM,450,RC,23655,CPT,OUTPATIENT,,,998,648.7,,878.24,88,,702.59,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,998,100,,798.40,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",916.1,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",628.74,63,,502.99,,,0,"percent of total billed charges","63% of total billed charges",152.69,15.3,,122.15,,,0,"percent of total billed charges","15.3% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,688.62,69,,,,,0,"fee schedule","69% of total billed charges",998,100,,798.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",998,100,,798.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",998,100,,798.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.83,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.21,100,,,,,0,"fee schedule",EAPG,1156.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",376.25,37.7,,301.00,,,0,"percent of total billed charges","37.7% of total billed charges",376.25,37.7,,301.00,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.32,33.9,,270.66,,,0,"percent of total billed charges","33.9% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",778.44,78,,622.75,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",824.35,82.6,,659.48,,,0,"percent of total billed charges","82.6% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",824.35,82.6,,659.48,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,998,100,,798.40,,,0,"percent of total billed charges","100% of total billed charges",152.69,5656.45,
"TX SHOULDER DISLC W/SURG/ANTMCL NECK FX W/MANJ TechFee",45023675,CDM,450,RC,23675,CPT,OUTPATIENT,,,5769,3749.85,,5076.72,88,,4061.38,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3634.47,63,,2907.58,,,0,"percent of total billed charges","63% of total billed charges",882.66,15.3,,706.13,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,3980.61,69,,,,,0,"fee schedule","69% of total billed charges",5769,100,,4615.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5769,100,,4615.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5769,100,,4615.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2174.91,37.7,,1739.93,,,0,"percent of total billed charges","37.7% of total billed charges",2174.91,37.7,,1739.93,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.69,33.9,,1564.55,,,0,"percent of total billed charges","33.9% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4499.82,78,,3599.86,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4765.19,82.6,,3812.15,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4765.19,82.6,,3812.15,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,5769,100,,4615.20,,,0,"percent of total billed charges","100% of total billed charges",296.48,5769,
"ID BURSA,ELBOW",45023931,CDM,450,RC,23931,CPT,OUTPATIENT,,,4131,2685.15,,3635.28,88,,2908.22,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,4131,100,,3304.80,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2602.53,63,,2082.02,,,0,"percent of total billed charges","63% of total billed charges",632.04,15.3,,505.63,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2850.39,69,,,,,0,"fee schedule","69% of total billed charges",4131,100,,3304.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4131,100,,3304.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4131,100,,3304.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1164.3,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1557.39,37.7,,1245.91,,,0,"percent of total billed charges","37.7% of total billed charges",1557.39,37.7,,1245.91,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1400.41,33.9,,1120.33,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.18,78,,2577.74,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3412.21,82.6,,2729.77,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3412.21,82.6,,2729.77,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,4131,100,,3304.80,,,0,"percent of total billed charges","100% of total billed charges",632.04,5715.97,
"Removal of foreign body, upper arm or elbow area; subcutaneo",45024200,CDM,450,RC,24200,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1571.81,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1618.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1571.81,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1571.81,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1164.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1571.81,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1571.81,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1164.3,2043.35,
"TX CL HUMERAL SHAFT W/O MANIP",45024500,CDM,450,RC,24500,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"CLOSED TX HUMORUS W/MANIPULAT",45024505,CDM,450,RC,24505,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,5656.45,
"TX FX DIST HUM W/O MANIP SUP/E",45024530,CDM,450,RC,24530,CPT,OUTPATIENT,,,465,302.25,,409.2,88,,327.36,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,465,100,,372.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",292.95,63,,234.36,,,0,"percent of total billed charges","63% of total billed charges",71.15,15.3,,56.92,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,320.85,69,,,,,0,"fee schedule","69% of total billed charges",465,100,,372.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465,100,,372.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465,100,,372.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",175.31,37.7,,140.25,,,0,"percent of total billed charges","37.7% of total billed charges",175.31,37.7,,140.25,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",157.64,33.9,,126.11,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",362.7,78,,290.16,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",384.09,82.6,,307.27,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",384.09,82.6,,307.27,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,465,100,,372.00,,,0,"percent of total billed charges","100% of total billed charges",71.15,837.64,
"TX FX DISTAL HUMERUS W/MAN",45024535,CDM,450,RC,24535,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,5656.45,
"TX FX HUMERAL EPI W/O MANIP",45024560,CDM,450,RC,24560,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"TX CL HUMERAL CONDYLAR FX MED",45024576,CDM,450,RC,24576,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"REDUCTION ELBOW DISLOCATION",45024600,CDM,450,RC,24600,CPT,OUTPATIENT,,,1271,826.15,,1118.48,88,,894.78,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1271,100,,1016.80,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",800.73,63,,640.58,,,0,"percent of total billed charges","63% of total billed charges",194.46,15.3,,155.57,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,876.99,69,,,,,0,"fee schedule","69% of total billed charges",1271,100,,1016.80,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1271,100,,1016.80,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1271,100,,1016.80,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",479.17,37.7,,383.34,,,0,"percent of total billed charges","37.7% of total billed charges",479.17,37.7,,383.34,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",430.87,33.9,,344.70,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",991.38,78,,793.10,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1049.85,82.6,,839.88,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1049.85,82.6,,839.88,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1271,100,,1016.80,,,0,"percent of total billed charges","100% of total billed charges",194.46,1271,
"CL TX FX/DISCLO ELBOW W MANIP",45024620,CDM,450,RC,24620,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,5656.45,
"TX RADIAL HEAD SUBLUXATION CHD",45024640,CDM,450,RC,24640,CPT,OUTPATIENT,,,1035,672.75,,910.8,88,,728.64,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1035,100,,828.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.05,63,,521.64,,,0,"percent of total billed charges","63% of total billed charges",158.36,15.3,,126.69,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,714.15,69,,,,,0,"fee schedule","69% of total billed charges",1035,100,,828.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035,100,,828.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035,100,,828.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.2,37.7,,312.16,,,0,"percent of total billed charges","37.7% of total billed charges",390.2,37.7,,312.16,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350.87,33.9,,280.70,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",807.3,78,,645.84,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",854.91,82.6,,683.93,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",854.91,82.6,,683.93,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1035,100,,828.00,,,0,"percent of total billed charges","100% of total billed charges",158.36,1035,
"TX RADIAL HEAD OR NECK FX W/O",45024650,CDM,450,RC,24650,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"TX RADIAL HD FX W/MANIP",45024655,CDM,450,RC,24655,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,5656.45,
"TX FX ULNAR, PROX W/O MANIP",45024670,CDM,450,RC,24670,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"Unlisted procedure, humerus or elbow",45024999,CDM,450,RC,24999,CPT,OUTPATIENT,,,700,455,,616,88,,492.80,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,700,100,,560.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441,63,,352.80,,,0,"percent of total billed charges","63% of total billed charges",107.1,15.3,,85.68,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,483,69,,,,,0,"fee schedule","69% of total billed charges",700,100,,560.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",700,100,,560.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",700,100,,560.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",263.9,37.7,,211.12,,,0,"percent of total billed charges","37.7% of total billed charges",263.9,37.7,,211.12,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",237.3,33.9,,189.84,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",546,78,,436.80,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",578.2,82.6,,462.56,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",578.2,82.6,,462.56,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,700,100,,560.00,,,0,"percent of total billed charges","100% of total billed charges",107.1,837.64,
"TX CL FX RADIAL SHFT W/O MANIP",45025500,CDM,450,RC,25500,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"TX CL FX RADIAL SHAFT W/MANIP",45025505,CDM,450,RC,25505,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,5656.45,
"TX FX ULNAR SHAFT W/O",45025530,CDM,450,RC,25530,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"TX CL RADIAL ULNAR W/O",45025560,CDM,450,RC,25560,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"TX FX RADIAL/ULNAR SHFT W/MANI",45025565,CDM,450,RC,25565,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,5656.45,
"TX FX DISTAL RADIAL COLLES W/O",45025600,CDM,450,RC,25600,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"TX FX NAVICULAR W/O",45025622,CDM,450,RC,25622,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"TX FX CARPAL W/O MANIP",45025630,CDM,450,RC,25630,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"TX CL ULNAR STYLOID",45025650,CDM,450,RC,25650,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"FINGER ABSCESS DRAIN SIMPLE",45026010,CDM,450,RC,26010,CPT,OUTPATIENT,,,459,298.35,,403.92,88,,323.14,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,459,100,,367.20,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.17,63,,231.34,,,0,"percent of total billed charges","63% of total billed charges",70.23,15.3,,56.18,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,316.71,69,,,,,0,"fee schedule","69% of total billed charges",459,100,,367.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",459,100,,367.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",459,100,,367.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.13,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.04,37.7,,138.43,,,0,"percent of total billed charges","37.7% of total billed charges",173.04,37.7,,138.43,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",155.6,33.9,,124.48,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",358.02,78,,286.42,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",379.13,82.6,,303.30,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",379.13,82.6,,303.30,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,459,100,,367.20,,,0,"percent of total billed charges","100% of total billed charges",70.23,729.41,
"ID FINGER ABSCESS COMPLEX",45026011,CDM,450,RC,26011,CPT,OUTPATIENT,,,2750,1787.5,,2420,88,,1936.00,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",989.16,100,,,,,0,"fee schedule",EAPG,2750,100,,2200.00,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1018.83,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.5,63,,1386.00,,,0,"percent of total billed charges","63% of total billed charges",420.75,15.3,,336.60,,,0,"percent of total billed charges","15.3% of total billed charges",989.16,100,,,,,0,"fee schedule",EAPG,1897.5,69,,,,,0,"fee schedule","69% of total billed charges",2750,100,,2200.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2750,100,,2200.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2750,100,,2200.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",989.16,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",732.71,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1008.94,100,,,,,0,"fee schedule",EAPG,1285.91,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1036.75,37.7,,829.40,,,0,"percent of total billed charges","37.7% of total billed charges",1036.75,37.7,,829.40,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",932.25,33.9,,745.80,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2145,78,,1716.00,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2271.5,82.6,,1817.20,,,0,"percent of total billed charges","82.6% of total billed charges",989.16,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2271.5,82.6,,1817.20,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",989.16,100,,,,,0,"fee schedule",EAPG,2750,100,,2200.00,,,0,"percent of total billed charges","100% of total billed charges",420.75,5715.97,
"REPAIR FLEXOR TENDON,FINGER",45026350,CDM,450,RC,26350,CPT,OUTPATIENT,,,3816,2480.4,,3358.08,88,,2686.46,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,3816,100,,3052.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2404.08,63,,1923.26,,,0,"percent of total billed charges","63% of total billed charges",583.85,15.3,,467.08,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,2633.04,69,,,,,0,"fee schedule","69% of total billed charges",3816,100,,3052.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3816,100,,3052.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3816,100,,3052.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",883.91,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1438.63,37.7,,1150.90,,,0,"percent of total billed charges","37.7% of total billed charges",1438.63,37.7,,1150.90,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1293.62,33.9,,1034.90,,,0,"percent of total billed charges","33.9% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2976.48,78,,2381.18,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3152.02,82.6,,2521.62,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3152.02,82.6,,2521.62,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,3816,100,,3052.80,,,0,"percent of total billed charges","100% of total billed charges",583.85,11498.59,
"REPAIR EXT TENDON, HAND EACH",45026410,CDM,450,RC,26410,CPT,OUTPATIENT,,,4165,2707.25,,3665.2,88,,2932.16,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,4165,100,,3332.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2623.95,63,,2099.16,,,0,"percent of total billed charges","63% of total billed charges",637.25,15.3,,509.80,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,2873.85,69,,,,,0,"fee schedule","69% of total billed charges",4165,100,,3332.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4165,100,,3332.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4165,100,,3332.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",883.91,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1570.21,37.7,,1256.17,,,0,"percent of total billed charges","37.7% of total billed charges",1570.21,37.7,,1256.17,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1411.94,33.9,,1129.55,,,0,"percent of total billed charges","33.9% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3248.7,78,,2598.96,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3440.29,82.6,,2752.23,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3440.29,82.6,,2752.23,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,4165,100,,3332.00,,,0,"percent of total billed charges","100% of total billed charges",637.25,5656.45,
"FINGER EXTENSON TENDON REPAIR",45026418,CDM,450,RC,26418,CPT,OUTPATIENT,,,4083,2653.95,,3593.04,88,,2874.43,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,4083,100,,3266.40,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2572.29,63,,2057.83,,,0,"percent of total billed charges","63% of total billed charges",624.7,15.3,,499.76,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,2817.27,69,,,,,0,"fee schedule","69% of total billed charges",4083,100,,3266.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4083,100,,3266.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4083,100,,3266.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",883.91,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1539.29,37.7,,1231.43,,,0,"percent of total billed charges","37.7% of total billed charges",1539.29,37.7,,1231.43,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1384.14,33.9,,1107.31,,,0,"percent of total billed charges","33.9% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3184.74,78,,2547.79,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3372.56,82.6,,2698.05,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3372.56,82.6,,2698.05,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,4083,100,,3266.40,,,0,"percent of total billed charges","100% of total billed charges",624.7,5656.45,
"Repair of collateral ligament, metacarpophalangeal or interp",45026540,CDM,450,RC,26540,CPT,OUTPATIENT,,,3568,2319.2,,3139.84,88,,2511.87,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,3568,100,,2854.40,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2247.84,63,,1798.27,,,0,"percent of total billed charges","63% of total billed charges",545.9,15.3,,436.72,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,2461.92,69,,,,,0,"fee schedule","69% of total billed charges",3568,100,,2854.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3568,100,,2854.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3568,100,,2854.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",883.91,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1345.14,37.7,,1076.11,,,0,"percent of total billed charges","37.7% of total billed charges",1345.14,37.7,,1076.11,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1209.55,33.9,,967.64,,,0,"percent of total billed charges","33.9% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2783.04,78,,2226.43,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2947.17,82.6,,2357.74,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2947.17,82.6,,2357.74,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,3568,100,,2854.40,,,0,"percent of total billed charges","100% of total billed charges",545.9,11498.59,
"FX METACARPAL EACH",45026600,CDM,450,RC,26600,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"TX FX METACARPAL W/MANIP EACH",45026605,CDM,450,RC,26605,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"TX CL DISLOC THUMB W/MANIP",45026641,CDM,450,RC,26641,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"26670 CLTX CARPO/METACARPL DISLC THMB MANJ EA W/O ANES TechF",45026670,CDM,450,RC,26670,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",412.25,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",296.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",296.48,520.32,
"TX METACARPAL DISLOC W/MANIP",45026700,CDM,450,RC,26700,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"TX FX PHALANX PROX/MEDIAL W/O",45026720,CDM,450,RC,26720,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"TX FX PHALANX PROX/MED W/MANIP",45026725,CDM,450,RC,26725,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"TX CLD FINGER FX ARTICU W/MANI",45026742,CDM,450,RC,26742,CPT,OUTPATIENT,,,492,319.8,,432.96,88,,346.37,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.96,63,,247.97,,,0,"percent of total billed charges","63% of total billed charges",75.28,15.3,,60.22,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,339.48,69,,,,,0,"fee schedule","69% of total billed charges",492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",185.48,37.7,,148.38,,,0,"percent of total billed charges","37.7% of total billed charges",185.48,37.7,,148.38,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",166.79,33.9,,133.43,,,0,"percent of total billed charges","33.9% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",383.76,78,,307.01,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",406.39,82.6,,325.11,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",406.39,82.6,,325.11,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",75.28,5656.45,
"TX CL FX FINGER",45026740,CDM,450,RC,26740,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"FX DISTAL PHALANX",45026750,CDM,450,RC,26750,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"TX FX PHALANX DISTAL W/MANIP",45026755,CDM,450,RC,26755,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"OPEN TREATMENT FINGER/THUMB",45026765,CDM,450,RC,26765,CPT,OUTPATIENT,,,3231,2100.15,,2843.28,88,,2274.62,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3231,100,,2584.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2035.53,63,,1628.42,,,0,"percent of total billed charges","63% of total billed charges",494.34,15.3,,395.47,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,2229.39,69,,,,,0,"fee schedule","69% of total billed charges",3231,100,,2584.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3231,100,,2584.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3231,100,,2584.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3545.24,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1218.09,37.7,,974.47,,,0,"percent of total billed charges","37.7% of total billed charges",1218.09,37.7,,974.47,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1095.31,33.9,,876.25,,,0,"percent of total billed charges","33.9% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2520.18,78,,2016.14,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2668.81,82.6,,2135.05,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2668.81,82.6,,2135.05,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3231,100,,2584.80,,,0,"percent of total billed charges","100% of total billed charges",494.34,11498.59,
"TX DISLOCATION FINGER",45026770,CDM,450,RC,26770,CPT,OUTPATIENT,,,793,515.45,,697.84,88,,558.27,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,793,100,,634.40,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.59,63,,399.67,,,0,"percent of total billed charges","63% of total billed charges",121.33,15.3,,97.06,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,547.17,69,,,,,0,"fee schedule","69% of total billed charges",793,100,,634.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",793,100,,634.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",793,100,,634.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.96,37.7,,239.17,,,0,"percent of total billed charges","37.7% of total billed charges",298.96,37.7,,239.17,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",268.83,33.9,,215.06,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",618.54,78,,494.83,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",655.02,82.6,,524.02,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",655.02,82.6,,524.02,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,793,100,,634.40,,,0,"percent of total billed charges","100% of total billed charges",121.33,837.64,
"26775 CLTX IPHAL JT DISLC W/MANJ REQ ANES TechFee",45026775,CDM,450,RC,26775,CPT,OUTPATIENT,,,755,490.75,,664.4,88,,531.52,,,0,"percent of total billed charges","88% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,755,100,,604.00,,,0,"percent of total billed charges","100% of total billed charges",479.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",916.1,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",475.65,63,,380.52,,,0,"percent of total billed charges","63% of total billed charges",115.52,15.3,,92.42,,,0,"percent of total billed charges","15.3% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,520.95,69,,,,,0,"fee schedule","69% of total billed charges",755,100,,604.00,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",755,100,,604.00,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",755,100,,604.00,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",979.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.83,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.21,100,,,,,0,"fee schedule",EAPG,1156.25,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.64,37.7,,227.71,,,0,"percent of total billed charges","37.7% of total billed charges",284.64,37.7,,227.71,,,0,"percent of total billed charges","37.70% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.95,33.9,,204.76,,,0,"percent of total billed charges","33.9% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",588.9,78,,471.12,,,0,"percent of total billed charges","78% of total billed charges",276.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",623.63,82.6,,498.90,,,0,"percent of total billed charges","82.6% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",623.63,82.6,,498.90,,,0,"percent of total billed charges","82.6% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,755,100,,604.00,,,0,"percent of total billed charges","100% of total billed charges",115.52,1156.25,
"AMPUTATION, FINGER OR THUMB",45026951,CDM,450,RC,26951,CPT,OUTPATIENT,,,3816,2480.4,,3358.08,88,,2686.46,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,3816,100,,3052.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2404.08,63,,1923.26,,,0,"percent of total billed charges","63% of total billed charges",583.85,15.3,,467.08,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,2633.04,69,,,,,0,"fee schedule","69% of total billed charges",3816,100,,3052.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3816,100,,3052.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3816,100,,3052.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",883.91,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1438.63,37.7,,1150.90,,,0,"percent of total billed charges","37.7% of total billed charges",1438.63,37.7,,1150.90,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1293.62,33.9,,1034.90,,,0,"percent of total billed charges","33.9% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2976.48,78,,2381.18,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3152.02,82.6,,2521.62,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3152.02,82.6,,2521.62,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,3816,100,,3052.80,,,0,"percent of total billed charges","100% of total billed charges",583.85,11498.59,
"AMP ANY DIGIT CLOSE W/LOC FLAP",45026952,CDM,450,RC,26952,CPT,OUTPATIENT,,,4165,2707.25,,3665.2,88,,2932.16,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,4165,100,,3332.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2038.17,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2623.95,63,,2099.16,,,0,"percent of total billed charges","63% of total billed charges",637.25,15.3,,509.80,,,0,"percent of total billed charges","15.3% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,2873.85,69,,,,,0,"fee schedule","69% of total billed charges",4165,100,,3332.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4165,100,,3332.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4165,100,,3332.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1465.78,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2018.38,100,,,,,0,"fee schedule",EAPG,2572.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1570.21,37.7,,1256.17,,,0,"percent of total billed charges","37.7% of total billed charges",1570.21,37.7,,1256.17,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1411.94,33.9,,1129.55,,,0,"percent of total billed charges","33.9% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3248.7,78,,2598.96,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3440.29,82.6,,2752.23,,,0,"percent of total billed charges","82.6% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3440.29,82.6,,2752.23,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,4165,100,,3332.00,,,0,"percent of total billed charges","100% of total billed charges",637.25,11498.59,
"FX COCCYX",45027200,CDM,450,RC,27200,CPT,OUTPATIENT,,,793,515.45,,697.84,88,,558.27,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,793,100,,634.40,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.59,63,,399.67,,,0,"percent of total billed charges","63% of total billed charges",121.33,15.3,,97.06,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,547.17,69,,,,,0,"fee schedule","69% of total billed charges",793,100,,634.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",793,100,,634.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",793,100,,634.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.96,37.7,,239.17,,,0,"percent of total billed charges","37.7% of total billed charges",298.96,37.7,,239.17,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",268.83,33.9,,215.06,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",618.54,78,,494.83,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",655.02,82.6,,524.02,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",655.02,82.6,,524.02,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,793,100,,634.40,,,0,"percent of total billed charges","100% of total billed charges",121.33,837.64,
"CL TX GR TROCHANTERIC FX W/O M",45027246,CDM,450,RC,27246,CPT,OUTPATIENT,,,1241,806.65,,1092.08,88,,873.66,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1241,100,,992.80,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",781.83,63,,625.46,,,0,"percent of total billed charges","63% of total billed charges",189.87,15.3,,151.90,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,856.29,69,,,,,0,"fee schedule","69% of total billed charges",1241,100,,992.80,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1241,100,,992.80,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1241,100,,992.80,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",467.86,37.7,,374.29,,,0,"percent of total billed charges","37.7% of total billed charges",467.86,37.7,,374.29,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.7,33.9,,336.56,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.98,78,,774.38,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1025.07,82.6,,820.06,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1025.07,82.6,,820.06,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1241,100,,992.80,,,0,"percent of total billed charges","100% of total billed charges",189.87,1241,
"CL TX HIP DISLOC TRAUM W/O ANE",45027250,CDM,450,RC,27250,CPT,OUTPATIENT,,,793,515.45,,697.84,88,,558.27,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,793,100,,634.40,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.59,63,,399.67,,,0,"percent of total billed charges","63% of total billed charges",121.33,15.3,,97.06,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,547.17,69,,,,,0,"fee schedule","69% of total billed charges",793,100,,634.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",793,100,,634.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",793,100,,634.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.96,37.7,,239.17,,,0,"percent of total billed charges","37.7% of total billed charges",298.96,37.7,,239.17,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",268.83,33.9,,215.06,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",618.54,78,,494.83,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",655.02,82.6,,524.02,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",655.02,82.6,,524.02,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,793,100,,634.40,,,0,"percent of total billed charges","100% of total billed charges",121.33,837.64,
"Closed treatment of hip dislocation, traumatic; requiring an",45027252,CDM,450,RC,27252,CPT,OUTPATIENT,,,5327,3462.55,,4687.76,88,,3750.21,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",916.1,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3356.01,63,,2684.81,,,0,"percent of total billed charges","63% of total billed charges",815.03,15.3,,652.02,,,0,"percent of total billed charges","15.3% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,3675.63,69,,,,,0,"fee schedule","69% of total billed charges",5327,100,,4261.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5327,100,,4261.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5327,100,,4261.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.83,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.21,100,,,,,0,"fee schedule",EAPG,1156.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2008.28,37.7,,1606.62,,,0,"percent of total billed charges","37.7% of total billed charges",2008.28,37.7,,1606.62,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1805.85,33.9,,1444.68,,,0,"percent of total billed charges","33.9% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4155.06,78,,3324.05,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4400.1,82.6,,3520.08,,,0,"percent of total billed charges","82.6% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4400.1,82.6,,3520.08,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,5327,100,,4261.60,,,0,"percent of total billed charges","100% of total billed charges",658.83,5656.45,
"CLOSED TX HIP DISL POST ARTHRO",45027265,CDM,450,RC,27265,CPT,OUTPATIENT,,,793,515.45,,697.84,88,,558.27,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,793,100,,634.40,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.59,63,,399.67,,,0,"percent of total billed charges","63% of total billed charges",121.33,15.3,,97.06,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,547.17,69,,,,,0,"fee schedule","69% of total billed charges",793,100,,634.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",793,100,,634.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",793,100,,634.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.96,37.7,,239.17,,,0,"percent of total billed charges","37.7% of total billed charges",298.96,37.7,,239.17,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",268.83,33.9,,215.06,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",618.54,78,,494.83,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",655.02,82.6,,524.02,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",655.02,82.6,,524.02,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,793,100,,634.40,,,0,"percent of total billed charges","100% of total billed charges",121.33,837.64,
"REM FB DEEP THIGHREG/NEW AREA",45027372,CDM,450,RC,27372,CPT,OUTPATIENT,,,2607,1694.55,,2294.16,88,,1835.33,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2607,100,,2085.60,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1642.41,63,,1313.93,,,0,"percent of total billed charges","63% of total billed charges",398.87,15.3,,319.10,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1798.83,69,,,,,0,"fee schedule","69% of total billed charges",2607,100,,2085.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2607,100,,2085.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2607,100,,2085.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1164.3,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",982.84,37.7,,786.27,,,0,"percent of total billed charges","37.7% of total billed charges",982.84,37.7,,786.27,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",883.77,33.9,,707.02,,,0,"percent of total billed charges","33.9% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2033.46,78,,1626.77,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2153.38,82.6,,1722.70,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2153.38,82.6,,1722.70,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2607,100,,2085.60,,,0,"percent of total billed charges","100% of total billed charges",398.87,9628.23,
"TX CL FX FEMORAL SHFT WO MANIP",45027500,CDM,450,RC,27500,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"CLD TX FEM SHAFT W/MAN",45027502,CDM,450,RC,27502,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,5656.45,
"TX CL FX FEM DISTAL W/WO MANIP",45027508,CDM,450,RC,27508,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"TX CL FX PATELLAR",45027520,CDM,450,RC,27520,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"TX FX PROX TIB W/O MANIP",45027530,CDM,450,RC,27530,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"KNEE DISLOCATION REDUCED",45027550,CDM,450,RC,27550,CPT,OUTPATIENT,,,1035,672.75,,910.8,88,,728.64,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1035,100,,828.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.05,63,,521.64,,,0,"percent of total billed charges","63% of total billed charges",158.36,15.3,,126.69,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,714.15,69,,,,,0,"fee schedule","69% of total billed charges",1035,100,,828.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035,100,,828.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035,100,,828.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.2,37.7,,312.16,,,0,"percent of total billed charges","37.7% of total billed charges",390.2,37.7,,312.16,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350.87,33.9,,280.70,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",807.3,78,,645.84,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",854.91,82.6,,683.93,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",854.91,82.6,,683.93,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1035,100,,828.00,,,0,"percent of total billed charges","100% of total billed charges",158.36,1035,
"REDUCTION DISLOCATED PATELLA",45027560,CDM,450,RC,27560,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"UNLISTED PROCEDURE FEMUR/KNEE",45027599,CDM,450,RC,27599,CPT,OUTPATIENT,,,940,611,,827.2,88,,661.76,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,940,100,,752.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",592.2,63,,473.76,,,0,"percent of total billed charges","63% of total billed charges",143.82,15.3,,115.06,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,648.6,69,,,,,0,"fee schedule","69% of total billed charges",940,100,,752.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",940,100,,752.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",940,100,,752.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",354.38,37.7,,283.50,,,0,"percent of total billed charges","37.7% of total billed charges",354.38,37.7,,283.50,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",318.66,33.9,,254.93,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",733.2,78,,586.56,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",776.44,82.6,,621.15,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",776.44,82.6,,621.15,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,940,100,,752.00,,,0,"percent of total billed charges","100% of total billed charges",143.82,940,
"TX CL FX TIB/FIB SHAFT W/O",45027750,CDM,450,RC,27750,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"TX CL FX TIB/FIB W/MANIP",45027752,CDM,450,RC,27752,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,5656.45,
"TX FX TIBIA DISTAL W/O",45027760,CDM,450,RC,27760,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"2 CLTX MEDIAL MALLS FX W/MANJ W/WO SKN/SKEL TRACJ TechFee",45027762,CDM,450,RC,27762,CPT,OUTPATIENT,,,5327,3462.55,,4687.76,88,,3750.21,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3356.01,63,,2684.81,,,0,"percent of total billed charges","63% of total billed charges",815.03,15.3,,652.02,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,3675.63,69,,,,,0,"fee schedule","69% of total billed charges",5327,100,,4261.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5327,100,,4261.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5327,100,,4261.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2008.28,37.7,,1606.62,,,0,"percent of total billed charges","37.7% of total billed charges",2008.28,37.7,,1606.62,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1805.85,33.9,,1444.68,,,0,"percent of total billed charges","33.9% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4155.06,78,,3324.05,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4400.1,82.6,,3520.08,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4400.1,82.6,,3520.08,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,5327,100,,4261.60,,,0,"percent of total billed charges","100% of total billed charges",296.48,5656.45,
"TX FX FIBULAR SHAFT W/O MANIP",45027780,CDM,450,RC,27780,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"TX CL FX FIBULA/ANKLE W/O",45027786,CDM,450,RC,27786,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"CL TX DISTAL FIBULAR FX W/MANI",45027788,CDM,450,RC,27788,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"TX FX BIMAL ANKLE W/O MANIP",45027808,CDM,450,RC,27808,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"TX CL FX BIMAL ANKLE W/MANIP",45027810,CDM,450,RC,27810,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,5656.45,
"CLOSED TX TRI MALLEOLAR FX W/O",45027816,CDM,450,RC,27816,CPT,OUTPATIENT,,,954,620.1,,839.52,88,,671.62,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,954,100,,763.20,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",601.02,63,,480.82,,,0,"percent of total billed charges","63% of total billed charges",145.96,15.3,,116.77,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,658.26,69,,,,,0,"fee schedule","69% of total billed charges",954,100,,763.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",954,100,,763.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",954,100,,763.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",359.66,37.7,,287.73,,,0,"percent of total billed charges","37.7% of total billed charges",359.66,37.7,,287.73,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",323.41,33.9,,258.73,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",744.12,78,,595.30,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",788,82.6,,630.40,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",788,82.6,,630.40,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,954,100,,763.20,,,0,"percent of total billed charges","100% of total billed charges",145.96,954,
"CLSD TX TRIMALLEOLAR ANK W/MAN",45027818,CDM,450,RC,27818,CPT,OUTPATIENT,,,4426,2876.9,,3894.88,88,,3115.90,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,4426,100,,3540.80,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2788.38,63,,2230.70,,,0,"percent of total billed charges","63% of total billed charges",677.18,15.3,,541.74,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,3053.94,69,,,,,0,"fee schedule","69% of total billed charges",4426,100,,3540.80,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4426,100,,3540.80,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4426,100,,3540.80,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1668.6,37.7,,1334.88,,,0,"percent of total billed charges","37.7% of total billed charges",1668.6,37.7,,1334.88,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1500.41,33.9,,1200.33,,,0,"percent of total billed charges","33.9% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3452.28,78,,2761.82,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3655.88,82.6,,2924.70,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3655.88,82.6,,2924.70,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,4426,100,,3540.80,,,0,"percent of total billed charges","100% of total billed charges",296.48,5656.45,
"FX DISTAL TIBIA W/O",45027824,CDM,450,RC,27824,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"ANKLE DISLOCATION REDUCTION",45027840,CDM,450,RC,27840,CPT,OUTPATIENT,,,1035,672.75,,910.8,88,,728.64,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1035,100,,828.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.05,63,,521.64,,,0,"percent of total billed charges","63% of total billed charges",158.36,15.3,,126.69,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,714.15,69,,,,,0,"fee schedule","69% of total billed charges",1035,100,,828.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035,100,,828.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035,100,,828.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.2,37.7,,312.16,,,0,"percent of total billed charges","37.7% of total billed charges",390.2,37.7,,312.16,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350.87,33.9,,280.70,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",807.3,78,,645.84,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",854.91,82.6,,683.93,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",854.91,82.6,,683.93,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1035,100,,828.00,,,0,"percent of total billed charges","100% of total billed charges",158.36,1035,
"REMOVAL FB FOOT SUBCUTANEOUS",45028190,CDM,450,RC,28190,CPT,OUTPATIENT,,,1454,945.1,,1279.52,88,,1023.62,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,1454,100,,1163.20,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",916.02,63,,732.82,,,0,"percent of total billed charges","63% of total billed charges",222.46,15.3,,177.97,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,1003.26,69,,,,,0,"fee schedule","69% of total billed charges",1454,100,,1163.20,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1454,100,,1163.20,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1454,100,,1163.20,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.37,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",548.16,37.7,,438.53,,,0,"percent of total billed charges","37.7% of total billed charges",548.16,37.7,,438.53,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",492.91,33.9,,394.33,,,0,"percent of total billed charges","33.9% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1134.12,78,,907.30,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1201,82.6,,960.80,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1201,82.6,,960.80,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,1454,100,,1163.20,,,0,"percent of total billed charges","100% of total billed charges",222.46,2526.76,
"REMOVAL FB FOOT DEEP",45028192,CDM,450,RC,28192,CPT,OUTPATIENT,,,3790,2463.5,,3335.2,88,,2668.16,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,3790,100,,3032.00,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2387.7,63,,1910.16,,,0,"percent of total billed charges","63% of total billed charges",579.87,15.3,,463.90,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2615.1,69,,,,,0,"fee schedule","69% of total billed charges",3790,100,,3032.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3790,100,,3032.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3790,100,,3032.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1164.3,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1428.83,37.7,,1143.06,,,0,"percent of total billed charges","37.7% of total billed charges",1428.83,37.7,,1143.06,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1284.81,33.9,,1027.85,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2956.2,78,,2364.96,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3130.54,82.6,,2504.43,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3130.54,82.6,,2504.43,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,3790,100,,3032.00,,,0,"percent of total billed charges","100% of total billed charges",579.87,5715.97,
"FX CALCANEUS W/O MANIP",45028400,CDM,450,RC,28400,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"TX CL FX TALUS W/O MANIP",45028430,CDM,450,RC,28430,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"TX FX TARSAL BONE W/O MANIP",45028450,CDM,450,RC,28450,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"FX METATARSAL EACH W/O",45028470,CDM,450,RC,28470,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"FX GREAT TOE W/O",45028490,CDM,450,RC,28490,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"CLSD TX FX GREAT TOE W/MANIP",45028495,CDM,450,RC,28495,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"FX OTHER TOE W/O",45028510,CDM,450,RC,28510,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"CLOSED FX TOE W/MANIPULATION",45028515,CDM,450,RC,28515,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"28630 CLTX METATARSOPHLNGL JT DISLC W/O ANES TechFee",45028630,CDM,450,RC,28630,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",412.25,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",296.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",296.48,520.32,
"REDUCTION DISLOCATED FING/TOE",45028660,CDM,450,RC,28660,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,837.64,
"TX TOE DIS W/ANS",28665,CDM,360,RC,28665,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",916.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",658.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",907.21,100,,,,,0,"fee schedule",EAPG,1156.25,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",658.83,3367,
"TX TOE DIS W/ANS",28665,CDM,360,RC,28665,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",916.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",658.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",907.21,100,,,,,0,"fee schedule",EAPG,1156.25,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",658.83,3367,
"TX TOE DIS W/ANS",28665,CDM,360,RC,28665,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",916.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",658.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",907.21,100,,,,,0,"fee schedule",EAPG,1156.25,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",658.83,3367,
"TX TOE DIS W/ANS",28665,CDM,360,RC,28665,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",916.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",658.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",907.21,100,,,,,0,"fee schedule",EAPG,1156.25,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",658.83,3367,
"TX TOE DIS W/ANS",28665,CDM,360,RC,28665,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",916.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",658.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",907.21,100,,,,,0,"fee schedule",EAPG,1156.25,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",658.83,3367,
"TX TOE DIS W/ANS",28665,CDM,360,RC,28665,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",916.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",658.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",907.21,100,,,,,0,"fee schedule",EAPG,1156.25,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",658.83,3367,
"TX TOE DIS W/ANS",28665,CDM,360,RC,28665,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",916.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",658.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",907.21,100,,,,,0,"fee schedule",EAPG,1156.25,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",658.83,3367,
"TX TOE DIS W/ ANS",28665,CDM,360,RC,28665,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",916.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",658.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",907.21,100,,,,,0,"fee schedule",EAPG,1156.25,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",658.83,3367,
"TX TOE DIS W/ANS",28665,CDM,360,RC,28665,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",916.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",658.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",907.21,100,,,,,0,"fee schedule",EAPG,1156.25,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",658.83,3367,
"TX TOE DIS W/ANS",28665,CDM,360,RC,28665,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",916.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",658.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",907.21,100,,,,,0,"fee schedule",EAPG,1156.25,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",889.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",658.83,3367,
"OPEN TX: DISLOCATION TOE JOINT",45028675,CDM,450,RC,28675,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4786.08,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4929.66,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4786.08,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4786.08,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3545.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4786.08,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4786.08,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3545.24,6221.9,
"APPLICATION CAST ELBOW FINGER SHORT ARM",45029075,CDM,450,RC,29075,CPT,OUTPATIENT,,,1033,671.45,,909.04,88,,727.23,,,0,"percent of total billed charges","88% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,1033,100,,826.40,,,0,"percent of total billed charges","100% of total billed charges",479.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",174.75,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",650.79,63,,520.63,,,0,"percent of total billed charges","63% of total billed charges",158.05,15.3,,126.44,,,0,"percent of total billed charges","15.3% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,712.77,69,,,,,0,"fee schedule","69% of total billed charges",1033,100,,826.40,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033,100,,826.40,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033,100,,826.40,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",979.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.68,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.06,100,,,,,0,"fee schedule",EAPG,220.57,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",389.44,37.7,,311.55,,,0,"percent of total billed charges","37.7% of total billed charges",389.44,37.7,,311.55,,,0,"percent of total billed charges","37.70% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350.19,33.9,,280.15,,,0,"percent of total billed charges","33.9% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",805.74,78,,644.59,,,0,"percent of total billed charges","78% of total billed charges",276.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",853.26,82.6,,682.61,,,0,"percent of total billed charges","82.6% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",853.26,82.6,,682.61,,,0,"percent of total billed charges","82.6% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,1033,100,,826.40,,,0,"percent of total billed charges","100% of total billed charges",125.68,1033,
"LONG SPLINT",45029105,CDM,450,RC,29105,CPT,OUTPATIENT,,,954,620.1,,839.52,88,,671.62,,,0,"percent of total billed charges","88% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,954,100,,763.20,,,0,"percent of total billed charges","100% of total billed charges",281.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.34,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",601.02,63,,480.82,,,0,"percent of total billed charges","63% of total billed charges",145.96,15.3,,116.77,,,0,"percent of total billed charges","15.3% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,658.26,69,,,,,0,"fee schedule","69% of total billed charges",954,100,,763.20,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",954,100,,763.20,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",954,100,,763.20,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",573.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",149.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.01,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.94,100,,,,,0,"fee schedule",EAPG,50.91,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",359.66,37.7,,287.73,,,0,"percent of total billed charges","37.7% of total billed charges",359.66,37.7,,287.73,,,0,"percent of total billed charges","37.70% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",323.41,33.9,,258.73,,,0,"percent of total billed charges","33.9% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",744.12,78,,595.30,,,0,"percent of total billed charges","78% of total billed charges",162.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",788,82.6,,630.40,,,0,"percent of total billed charges","82.6% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",788,82.6,,630.40,,,0,"percent of total billed charges","82.6% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,954,100,,763.20,,,0,"percent of total billed charges","100% of total billed charges",29.01,954,
"SHORT ARM SPLINT STATIC",45029125,CDM,450,RC,29125,CPT,OUTPATIENT,,,285,185.25,,250.8,88,,200.64,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.34,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",179.55,63,,143.64,,,0,"percent of total billed charges","63% of total billed charges",43.61,15.3,,34.89,,,0,"percent of total billed charges","15.3% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,196.65,69,,,,,0,"fee schedule","69% of total billed charges",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.01,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.94,100,,,,,0,"fee schedule",EAPG,50.91,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.45,37.7,,85.96,,,0,"percent of total billed charges","37.7% of total billed charges",107.45,37.7,,85.96,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",96.62,33.9,,77.30,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",222.3,78,,177.84,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",235.41,82.6,,188.33,,,0,"percent of total billed charges","82.6% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",235.41,82.6,,188.33,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",29.01,454.8,
"FINGER SPLINT APPLIC STATIC",45029130,CDM,450,RC,29130,CPT,OUTPATIENT,,,285,185.25,,250.8,88,,200.64,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.34,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",179.55,63,,143.64,,,0,"percent of total billed charges","63% of total billed charges",43.61,15.3,,34.89,,,0,"percent of total billed charges","15.3% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,196.65,69,,,,,0,"fee schedule","69% of total billed charges",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.01,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.94,100,,,,,0,"fee schedule",EAPG,50.91,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.45,37.7,,85.96,,,0,"percent of total billed charges","37.7% of total billed charges",107.45,37.7,,85.96,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",96.62,33.9,,77.30,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",222.3,78,,177.84,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",235.41,82.6,,188.33,,,0,"percent of total billed charges","82.6% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",235.41,82.6,,188.33,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",29.01,454.8,
"RIB BELT",45029200,CDM,450,RC,29200,CPT,OUTPATIENT,,,620,403,,545.6,88,,436.48,,,0,"percent of total billed charges","88% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,620,100,,496.00,,,0,"percent of total billed charges","100% of total billed charges",281.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.34,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.6,63,,312.48,,,0,"percent of total billed charges","63% of total billed charges",94.86,15.3,,75.89,,,0,"percent of total billed charges","15.3% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,427.8,69,,,,,0,"fee schedule","69% of total billed charges",620,100,,496.00,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",620,100,,496.00,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",620,100,,496.00,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",573.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",149.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.01,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.94,100,,,,,0,"fee schedule",EAPG,50.91,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",233.74,37.7,,186.99,,,0,"percent of total billed charges","37.7% of total billed charges",233.74,37.7,,186.99,,,0,"percent of total billed charges","37.70% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.18,33.9,,168.14,,,0,"percent of total billed charges","33.9% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",483.6,78,,386.88,,,0,"percent of total billed charges","78% of total billed charges",162.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.12,82.6,,409.70,,,0,"percent of total billed charges","82.6% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.12,82.6,,409.70,,,0,"percent of total billed charges","82.6% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,620,100,,496.00,,,0,"percent of total billed charges","100% of total billed charges",29.01,620,
"STRAPPING SHOULDER",45029240,CDM,450,RC,29240,CPT,OUTPATIENT,,,285,185.25,,250.8,88,,200.64,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.34,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",179.55,63,,143.64,,,0,"percent of total billed charges","63% of total billed charges",43.61,15.3,,34.89,,,0,"percent of total billed charges","15.3% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,196.65,69,,,,,0,"fee schedule","69% of total billed charges",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.01,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.94,100,,,,,0,"fee schedule",EAPG,50.91,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.45,37.7,,85.96,,,0,"percent of total billed charges","37.7% of total billed charges",107.45,37.7,,85.96,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",96.62,33.9,,77.30,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",222.3,78,,177.84,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",235.41,82.6,,188.33,,,0,"percent of total billed charges","82.6% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",235.41,82.6,,188.33,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",29.01,454.8,
"STRAPPING ELBOW OR WRIST",45029260,CDM,450,RC,29260,CPT,OUTPATIENT,,,285,185.25,,250.8,88,,200.64,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.34,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",179.55,63,,143.64,,,0,"percent of total billed charges","63% of total billed charges",43.61,15.3,,34.89,,,0,"percent of total billed charges","15.3% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,196.65,69,,,,,0,"fee schedule","69% of total billed charges",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.01,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.94,100,,,,,0,"fee schedule",EAPG,50.91,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.45,37.7,,85.96,,,0,"percent of total billed charges","37.7% of total billed charges",107.45,37.7,,85.96,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",96.62,33.9,,77.30,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",222.3,78,,177.84,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",235.41,82.6,,188.33,,,0,"percent of total billed charges","82.6% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",235.41,82.6,,188.33,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",29.01,285,
"STRAPPING HAND OR FINGER",45029280,CDM,450,RC,29280,CPT,OUTPATIENT,,,285,185.25,,250.8,88,,200.64,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.34,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",179.55,63,,143.64,,,0,"percent of total billed charges","63% of total billed charges",43.61,15.3,,34.89,,,0,"percent of total billed charges","15.3% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,196.65,69,,,,,0,"fee schedule","69% of total billed charges",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.01,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.94,100,,,,,0,"fee schedule",EAPG,50.91,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.45,37.7,,85.96,,,0,"percent of total billed charges","37.7% of total billed charges",107.45,37.7,,85.96,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",96.62,33.9,,77.30,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",222.3,78,,177.84,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",235.41,82.6,,188.33,,,0,"percent of total billed charges","82.6% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",235.41,82.6,,188.33,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",29.01,285,
"LONG LEG SPLINT",45029505,CDM,450,RC,29505,CPT,OUTPATIENT,,,954,620.1,,839.52,88,,671.62,,,0,"percent of total billed charges","88% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,954,100,,763.20,,,0,"percent of total billed charges","100% of total billed charges",281.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.34,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",601.02,63,,480.82,,,0,"percent of total billed charges","63% of total billed charges",145.96,15.3,,116.77,,,0,"percent of total billed charges","15.3% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,658.26,69,,,,,0,"fee schedule","69% of total billed charges",954,100,,763.20,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",954,100,,763.20,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",954,100,,763.20,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",573.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",149.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.01,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.94,100,,,,,0,"fee schedule",EAPG,50.91,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",359.66,37.7,,287.73,,,0,"percent of total billed charges","37.7% of total billed charges",359.66,37.7,,287.73,,,0,"percent of total billed charges","37.70% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",323.41,33.9,,258.73,,,0,"percent of total billed charges","33.9% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",744.12,78,,595.30,,,0,"percent of total billed charges","78% of total billed charges",162.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",788,82.6,,630.40,,,0,"percent of total billed charges","82.6% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",788,82.6,,630.40,,,0,"percent of total billed charges","82.6% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,954,100,,763.20,,,0,"percent of total billed charges","100% of total billed charges",29.01,954,
"SHORT LEG SPLINT",45029515,CDM,450,RC,29515,CPT,OUTPATIENT,,,954,620.1,,839.52,88,,671.62,,,0,"percent of total billed charges","88% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,954,100,,763.20,,,0,"percent of total billed charges","100% of total billed charges",281.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.34,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",601.02,63,,480.82,,,0,"percent of total billed charges","63% of total billed charges",145.96,15.3,,116.77,,,0,"percent of total billed charges","15.3% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,658.26,69,,,,,0,"fee schedule","69% of total billed charges",954,100,,763.20,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",954,100,,763.20,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",954,100,,763.20,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",573.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",149.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.01,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.94,100,,,,,0,"fee schedule",EAPG,50.91,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",359.66,37.7,,287.73,,,0,"percent of total billed charges","37.7% of total billed charges",359.66,37.7,,287.73,,,0,"percent of total billed charges","37.70% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",323.41,33.9,,258.73,,,0,"percent of total billed charges","33.9% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",744.12,78,,595.30,,,0,"percent of total billed charges","78% of total billed charges",162.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",788,82.6,,630.40,,,0,"percent of total billed charges","82.6% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",788,82.6,,630.40,,,0,"percent of total billed charges","82.6% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,954,100,,763.20,,,0,"percent of total billed charges","100% of total billed charges",29.01,954,
"STRAPPING - KNEE",45029530,CDM,450,RC,29530,CPT,OUTPATIENT,,,285,185.25,,250.8,88,,200.64,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.34,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",179.55,63,,143.64,,,0,"percent of total billed charges","63% of total billed charges",43.61,15.3,,34.89,,,0,"percent of total billed charges","15.3% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,196.65,69,,,,,0,"fee schedule","69% of total billed charges",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.01,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.94,100,,,,,0,"fee schedule",EAPG,50.91,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.45,37.7,,85.96,,,0,"percent of total billed charges","37.7% of total billed charges",107.45,37.7,,85.96,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",96.62,33.9,,77.30,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",222.3,78,,177.84,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",235.41,82.6,,188.33,,,0,"percent of total billed charges","82.6% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",235.41,82.6,,188.33,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",29.01,454.8,
"STRAPPING - ANKLE",45029540,CDM,450,RC,29540,CPT,OUTPATIENT,,,285,185.25,,250.8,88,,200.64,,,0,"percent of total billed charges","88% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",281.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.34,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",179.55,63,,143.64,,,0,"percent of total billed charges","63% of total billed charges",43.61,15.3,,34.89,,,0,"percent of total billed charges","15.3% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,196.65,69,,,,,0,"fee schedule","69% of total billed charges",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",573.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",149.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.01,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.94,100,,,,,0,"fee schedule",EAPG,50.91,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.45,37.7,,85.96,,,0,"percent of total billed charges","37.7% of total billed charges",107.45,37.7,,85.96,,,0,"percent of total billed charges","37.70% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",96.62,33.9,,77.30,,,0,"percent of total billed charges","33.9% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",222.3,78,,177.84,,,0,"percent of total billed charges","78% of total billed charges",162.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",235.41,82.6,,188.33,,,0,"percent of total billed charges","82.6% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",235.41,82.6,,188.33,,,0,"percent of total billed charges","82.6% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",29.01,573.54,
"STRAPPING TOES",45029550,CDM,450,RC,29550,CPT,OUTPATIENT,,,285,185.25,,250.8,88,,200.64,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.34,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",179.55,63,,143.64,,,0,"percent of total billed charges","63% of total billed charges",43.61,15.3,,34.89,,,0,"percent of total billed charges","15.3% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,196.65,69,,,,,0,"fee schedule","69% of total billed charges",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.01,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.94,100,,,,,0,"fee schedule",EAPG,50.91,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.45,37.7,,85.96,,,0,"percent of total billed charges","37.7% of total billed charges",107.45,37.7,,85.96,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",96.62,33.9,,77.30,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",222.3,78,,177.84,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",235.41,82.6,,188.33,,,0,"percent of total billed charges","82.6% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",235.41,82.6,,188.33,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",29.01,285,
"CAST REMOVAL LOMG ARM/LEG",45029705,CDM,450,RC,29705,CPT,OUTPATIENT,,,285,185.25,,250.8,88,,200.64,,,0,"percent of total billed charges","88% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",479.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",174.75,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",179.55,63,,143.64,,,0,"percent of total billed charges","63% of total billed charges",43.61,15.3,,34.89,,,0,"percent of total billed charges","15.3% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,196.65,69,,,,,0,"fee schedule","69% of total billed charges",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",979.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.68,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.06,100,,,,,0,"fee schedule",EAPG,220.57,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.45,37.7,,85.96,,,0,"percent of total billed charges","37.7% of total billed charges",107.45,37.7,,85.96,,,0,"percent of total billed charges","37.70% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",96.62,33.9,,77.30,,,0,"percent of total billed charges","33.9% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",222.3,78,,177.84,,,0,"percent of total billed charges","78% of total billed charges",276.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",235.41,82.6,,188.33,,,0,"percent of total billed charges","82.6% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",235.41,82.6,,188.33,,,0,"percent of total billed charges","82.6% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",43.61,979.75,
"REMOVAL INTRANASAL FB",45030300,CDM,450,RC,30300,CPT,OUTPATIENT,,,617,401.05,,542.96,88,,434.37,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,617,100,,493.60,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",388.71,63,,310.97,,,0,"percent of total billed charges","63% of total billed charges",94.4,15.3,,75.52,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,425.73,69,,,,,0,"fee schedule","69% of total billed charges",617,100,,493.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",617,100,,493.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",617,100,,493.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.15,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",232.61,37.7,,186.09,,,0,"percent of total billed charges","37.7% of total billed charges",232.61,37.7,,186.09,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",209.16,33.9,,167.33,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",481.26,78,,385.01,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509.64,82.6,,407.71,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509.64,82.6,,407.71,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,617,100,,493.60,,,0,"percent of total billed charges","100% of total billed charges",74.15,617,
"CAUTERIZE NASAL MUCOSA",45030801,CDM,450,RC,30801,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",827.71,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",852.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",827.71,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",827.71,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",613.12,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",827.71,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",827.71,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",613.12,1076.02,
"NASAL HEMORR ANTERIOR SIMPLE",45030901,CDM,450,RC,30901,CPT,OUTPATIENT,,,809,525.85,,711.92,88,,569.54,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509.67,63,,407.74,,,0,"percent of total billed charges","63% of total billed charges",123.78,15.3,,99.02,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,558.21,69,,,,,0,"fee schedule","69% of total billed charges",809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.15,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",304.99,37.7,,243.99,,,0,"percent of total billed charges","37.7% of total billed charges",304.99,37.7,,243.99,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",274.25,33.9,,219.40,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",631.02,78,,504.82,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",668.23,82.6,,534.58,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",668.23,82.6,,534.58,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",74.15,809,
"NASAL HEMORR ANTERIOR COMPLEX",45030903,CDM,450,RC,30903,CPT,OUTPATIENT,,,809,525.85,,711.92,88,,569.54,,,0,"percent of total billed charges","88% of total billed charges",130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509.67,63,,407.74,,,0,"percent of total billed charges","63% of total billed charges",123.78,15.3,,99.02,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,558.21,69,,,,,0,"fee schedule","69% of total billed charges",809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",130.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.15,100,,,,,0,"fee schedule",EAPG,130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",304.99,37.7,,243.99,,,0,"percent of total billed charges","37.7% of total billed charges",304.99,37.7,,243.99,,,0,"percent of total billed charges","37.70% of total billed charges",130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",274.25,33.9,,219.40,,,0,"percent of total billed charges","33.9% of total billed charges",130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",631.02,78,,504.82,,,0,"percent of total billed charges","78% of total billed charges",131.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",668.23,82.6,,534.58,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",668.23,82.6,,534.58,,,0,"percent of total billed charges","82.6% of total billed charges",130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",74.15,809,
"NASAL HEMORR POSTERIOR PACKING",45030905,CDM,450,RC,30905,CPT,OUTPATIENT,,,809,525.85,,711.92,88,,569.54,,,0,"percent of total billed charges","88% of total billed charges",130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509.67,63,,407.74,,,0,"percent of total billed charges","63% of total billed charges",123.78,15.3,,99.02,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,558.21,69,,,,,0,"fee schedule","69% of total billed charges",809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",130.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.15,100,,,,,0,"fee schedule",EAPG,130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",304.99,37.7,,243.99,,,0,"percent of total billed charges","37.7% of total billed charges",304.99,37.7,,243.99,,,0,"percent of total billed charges","37.70% of total billed charges",130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",274.25,33.9,,219.40,,,0,"percent of total billed charges","33.9% of total billed charges",130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",631.02,78,,504.82,,,0,"percent of total billed charges","78% of total billed charges",131.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",668.23,82.6,,534.58,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",668.23,82.6,,534.58,,,0,"percent of total billed charges","82.6% of total billed charges",130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",74.15,809,
"NASAL HEMORR POSTERIOR SUBS",45030906,CDM,450,RC,30906,CPT,OUTPATIENT,,,809,525.85,,711.92,88,,569.54,,,0,"percent of total billed charges","88% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",435.98,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509.67,63,,407.74,,,0,"percent of total billed charges","63% of total billed charges",123.78,15.3,,99.02,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,558.21,69,,,,,0,"fee schedule","69% of total billed charges",809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",859.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.15,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",304.99,37.7,,243.99,,,0,"percent of total billed charges","37.7% of total billed charges",304.99,37.7,,243.99,,,0,"percent of total billed charges","37.70% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",274.25,33.9,,219.40,,,0,"percent of total billed charges","33.9% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",631.02,78,,504.82,,,0,"percent of total billed charges","78% of total billed charges",251.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",668.23,82.6,,534.58,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",668.23,82.6,,534.58,,,0,"percent of total billed charges","82.6% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",74.15,859.63,
"NASAL ENDOSCOPY, DIAG",45031231,CDM,450,RC,31231,CPT,OUTPATIENT,,,330,214.5,,290.4,88,,232.32,,,0,"percent of total billed charges","88% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,330,100,,264.00,,,0,"percent of total billed charges","100% of total billed charges",353.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",207.9,63,,166.32,,,0,"percent of total billed charges","63% of total billed charges",50.49,15.3,,40.39,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,227.7,69,,,,,0,"fee schedule","69% of total billed charges",330,100,,264.00,,,0,"percent of total billed charges","100% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330,100,,264.00,,,0,"percent of total billed charges","100% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330,100,,264.00,,,0,"percent of total billed charges","100% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",667.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",174.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.15,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.41,37.7,,99.53,,,0,"percent of total billed charges","37.7% of total billed charges",124.41,37.7,,99.53,,,0,"percent of total billed charges","37.70% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.87,33.9,,89.50,,,0,"percent of total billed charges","33.9% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",257.4,78,,205.92,,,0,"percent of total billed charges","78% of total billed charges",204.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.58,82.6,,218.06,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.58,82.6,,218.06,,,0,"percent of total billed charges","82.6% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,330,100,,264.00,,,0,"percent of total billed charges","100% of total billed charges",50.49,667.83,
"ENDOTRACHEAL INTUBATION",45031500,CDM,450,RC,31500,CPT,OUTPATIENT,,,1677,1090.05,,1475.76,88,,1180.61,,,0,"percent of total billed charges","88% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818.62,100,,,,,0,"fee schedule",EAPG,1677,100,,1341.60,,,0,"percent of total billed charges","100% of total billed charges",435.98,175,,,,,0,"fee schedule","175% of CMS fee schedule",843.18,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056.51,63,,845.21,,,0,"percent of total billed charges","63% of total billed charges",256.58,15.3,,205.26,,,0,"percent of total billed charges","15.3% of total billed charges",818.62,100,,,,,0,"fee schedule",EAPG,1157.13,69,,,,,0,"fee schedule","69% of total billed charges",1677,100,,1341.60,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1677,100,,1341.60,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1677,100,,1341.60,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",859.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818.62,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",606.38,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",834.99,100,,,,,0,"fee schedule",EAPG,1064.21,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",632.23,37.7,,505.78,,,0,"percent of total billed charges","37.7% of total billed charges",632.23,37.7,,505.78,,,0,"percent of total billed charges","37.70% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.5,33.9,,454.80,,,0,"percent of total billed charges","33.9% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1308.06,78,,1046.45,,,0,"percent of total billed charges","78% of total billed charges",251.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1385.2,82.6,,1108.16,,,0,"percent of total billed charges","82.6% of total billed charges",818.62,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1385.2,82.6,,1108.16,,,0,"percent of total billed charges","82.6% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818.62,100,,,,,0,"fee schedule",EAPG,1677,100,,1341.60,,,0,"percent of total billed charges","100% of total billed charges",224.74,1677,
"CHANGE TRACH TUBE",45031502,CDM,450,RC,31502,CPT,OUTPATIENT,,,639,415.35,,562.32,88,,449.86,,,0,"percent of total billed charges","88% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,639,100,,511.20,,,0,"percent of total billed charges","100% of total billed charges",435.98,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.57,63,,322.06,,,0,"percent of total billed charges","63% of total billed charges",97.77,15.3,,78.22,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,440.91,69,,,,,0,"fee schedule","69% of total billed charges",639,100,,511.20,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",639,100,,511.20,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",639,100,,511.20,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",859.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.15,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",240.9,37.7,,192.72,,,0,"percent of total billed charges","37.7% of total billed charges",240.9,37.7,,192.72,,,0,"percent of total billed charges","37.70% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.62,33.9,,173.30,,,0,"percent of total billed charges","33.9% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",498.42,78,,398.74,,,0,"percent of total billed charges","78% of total billed charges",251.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",527.81,82.6,,422.25,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",527.81,82.6,,422.25,,,0,"percent of total billed charges","82.6% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,639,100,,511.20,,,0,"percent of total billed charges","100% of total billed charges",74.15,859.63,
"LARYNGOSCOPY INDIRECT",45031505,CDM,450,RC,31505,CPT,OUTPATIENT,,,467,303.55,,410.96,88,,328.77,,,0,"percent of total billed charges","88% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,467,100,,373.60,,,0,"percent of total billed charges","100% of total billed charges",353.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.21,63,,235.37,,,0,"percent of total billed charges","63% of total billed charges",71.45,15.3,,57.16,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,322.23,69,,,,,0,"fee schedule","69% of total billed charges",467,100,,373.60,,,0,"percent of total billed charges","100% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",467,100,,373.60,,,0,"percent of total billed charges","100% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",467,100,,373.60,,,0,"percent of total billed charges","100% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",667.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",174.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.15,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",176.06,37.7,,140.85,,,0,"percent of total billed charges","37.7% of total billed charges",176.06,37.7,,140.85,,,0,"percent of total billed charges","37.70% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.31,33.9,,126.65,,,0,"percent of total billed charges","33.9% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",364.26,78,,291.41,,,0,"percent of total billed charges","78% of total billed charges",204.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",385.74,82.6,,308.59,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",385.74,82.6,,308.59,,,0,"percent of total billed charges","82.6% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,467,100,,373.60,,,0,"percent of total billed charges","100% of total billed charges",71.45,667.83,
"31526 - Laryngoscopy direct, with or without trach",45031526,CDM,450,RC,31526,CPT,OUTPATIENT,,,6411,4167.15,,5641.68,88,,4513.34,,,0,"percent of total billed charges","88% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",684.89,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3029.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",705.44,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4038.93,63,,3231.14,,,0,"percent of total billed charges","63% of total billed charges",980.88,15.3,,784.70,,,0,"percent of total billed charges","15.3% of total billed charges",684.89,100,,,,,0,"fee schedule",EAPG,4423.59,69,,,,,0,"fee schedule","69% of total billed charges",6411,100,,5128.80,,,0,"percent of total billed charges","100% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6411,100,,5128.80,,,0,"percent of total billed charges","100% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6411,100,,5128.80,,,0,"percent of total billed charges","100% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",6079.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",684.89,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",507.33,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",698.59,100,,,,,0,"fee schedule",EAPG,890.36,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2416.95,37.7,,1933.56,,,0,"percent of total billed charges","37.7% of total billed charges",2416.95,37.7,,1933.56,,,0,"percent of total billed charges","37.70% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2173.33,33.9,,1738.66,,,0,"percent of total billed charges","33.9% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5000.58,78,,4000.46,,,0,"percent of total billed charges","78% of total billed charges",1748.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5295.49,82.6,,4236.39,,,0,"percent of total billed charges","82.6% of total billed charges",684.89,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5295.49,82.6,,4236.39,,,0,"percent of total billed charges","82.6% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",684.89,100,,,,,0,"fee schedule",EAPG,6411,100,,5128.80,,,0,"percent of total billed charges","100% of total billed charges",507.33,6411,
"Laryngoscopy, direct, operative, with foreign body removal;",45031530,CDM,450,RC,31530,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",684.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",705.44,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",684.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",684.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",507.33,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",698.59,100,,,,,0,"fee schedule",EAPG,890.36,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",684.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",684.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",507.33,890.36,
"LARYNGOSCOPY/DIRECT W/SCOPE",45031575,CDM,450,RC,31575,CPT,OUTPATIENT,,,467,303.55,,410.96,88,,328.77,,,0,"percent of total billed charges","88% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,467,100,,373.60,,,0,"percent of total billed charges","100% of total billed charges",353.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.21,63,,235.37,,,0,"percent of total billed charges","63% of total billed charges",71.45,15.3,,57.16,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,322.23,69,,,,,0,"fee schedule","69% of total billed charges",467,100,,373.60,,,0,"percent of total billed charges","100% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",467,100,,373.60,,,0,"percent of total billed charges","100% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",467,100,,373.60,,,0,"percent of total billed charges","100% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",667.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",174.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.15,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",176.06,37.7,,140.85,,,0,"percent of total billed charges","37.7% of total billed charges",176.06,37.7,,140.85,,,0,"percent of total billed charges","37.70% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.31,33.9,,126.65,,,0,"percent of total billed charges","33.9% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",364.26,78,,291.41,,,0,"percent of total billed charges","78% of total billed charges",204.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",385.74,82.6,,308.59,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",385.74,82.6,,308.59,,,0,"percent of total billed charges","82.6% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,467,100,,373.60,,,0,"percent of total billed charges","100% of total billed charges",71.45,667.83,
LARYNGOSCOPY,45031579,CDM,450,RC,31579,CPT,OUTPATIENT,,,9673,6287.45,,8512.24,88,,6809.79,,,0,"percent of total billed charges","88% of total billed charges",416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",684.89,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",728.82,175,,,,,0,"fee schedule","175% of CMS fee schedule",705.44,100,,,,,0,"fee schedule",EAPG,416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6093.99,63,,4875.19,,,0,"percent of total billed charges","63% of total billed charges",1479.97,15.3,,1183.98,,,0,"percent of total billed charges","15.3% of total billed charges",684.89,100,,,,,0,"fee schedule",EAPG,6674.37,69,,,,,0,"fee schedule","69% of total billed charges",9673,100,,7738.40,,,0,"percent of total billed charges","100% of total billed charges",416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9673,100,,7738.40,,,0,"percent of total billed charges","100% of total billed charges",416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9673,100,,7738.40,,,0,"percent of total billed charges","100% of total billed charges",416.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",1529.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",684.89,100,,,,,0,"fee schedule",EAPG,416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",399.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",507.33,100,,,,,0,"fee schedule",EAPG,416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",698.59,100,,,,,0,"fee schedule",EAPG,890.36,100,,,,,0,"fee schedule",EAPG,416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3646.72,37.7,,2917.38,,,0,"percent of total billed charges","37.7% of total billed charges",3646.72,37.7,,2917.38,,,0,"percent of total billed charges","37.70% of total billed charges",416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3279.15,33.9,,2623.32,,,0,"percent of total billed charges","33.9% of total billed charges",416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7544.94,78,,6035.95,,,0,"percent of total billed charges","78% of total billed charges",420.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7989.9,82.6,,6391.92,,,0,"percent of total billed charges","82.6% of total billed charges",684.89,100,,,,,0,"fee schedule",EAPG,416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7989.9,82.6,,6391.92,,,0,"percent of total billed charges","82.6% of total billed charges",416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",684.89,100,,,,,0,"fee schedule",EAPG,9673,100,,7738.40,,,0,"percent of total billed charges","100% of total billed charges",399.89,9673,
"Remove Foreign Body  Larynx Tech Fee",45031577,CDM,450,RC,31577,CPT,OUTPATIENT,,,1612,1047.8,,1418.56,88,,1134.85,,,0,"percent of total billed charges","88% of total billed charges",416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",684.89,100,,,,,0,"fee schedule",EAPG,1612,100,,1289.60,,,0,"percent of total billed charges","100% of total billed charges",728.82,175,,,,,0,"fee schedule","175% of CMS fee schedule",705.44,100,,,,,0,"fee schedule",EAPG,416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1015.56,63,,812.45,,,0,"percent of total billed charges","63% of total billed charges",246.64,15.3,,197.31,,,0,"percent of total billed charges","15.3% of total billed charges",684.89,100,,,,,0,"fee schedule",EAPG,1112.28,69,,,,,0,"fee schedule","69% of total billed charges",1612,100,,1289.60,,,0,"percent of total billed charges","100% of total billed charges",416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1612,100,,1289.60,,,0,"percent of total billed charges","100% of total billed charges",416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1612,100,,1289.60,,,0,"percent of total billed charges","100% of total billed charges",416.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",1529.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",684.89,100,,,,,0,"fee schedule",EAPG,416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",399.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",507.33,100,,,,,0,"fee schedule",EAPG,416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",698.59,100,,,,,0,"fee schedule",EAPG,890.36,100,,,,,0,"fee schedule",EAPG,416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",607.72,37.7,,486.18,,,0,"percent of total billed charges","37.7% of total billed charges",607.72,37.7,,486.18,,,0,"percent of total billed charges","37.70% of total billed charges",416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",546.47,33.9,,437.18,,,0,"percent of total billed charges","33.9% of total billed charges",416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1257.36,78,,1005.89,,,0,"percent of total billed charges","78% of total billed charges",420.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1331.51,82.6,,1065.21,,,0,"percent of total billed charges","82.6% of total billed charges",684.89,100,,,,,0,"fee schedule",EAPG,416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1331.51,82.6,,1065.21,,,0,"percent of total billed charges","82.6% of total billed charges",416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",684.89,100,,,,,0,"fee schedule",EAPG,1612,100,,1289.60,,,0,"percent of total billed charges","100% of total billed charges",246.64,1612,
"TRACHEOSTOMY EMERGENT",45031603,CDM,450,RC,31603,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1856.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1911.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1856.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1856.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1375.03,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1893.42,100,,,,,0,"fee schedule",EAPG,2413.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1856.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1856.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1375.03,2413.19,
"TRACH, CRICOTHYROID",45031605,CDM,450,RC,31605,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1856.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1911.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1856.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1856.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1375.03,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1893.42,100,,,,,0,"fee schedule",EAPG,2413.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1856.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1856.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1375.03,2413.19,
"TUBE THORACOSTOMY",45032551,CDM,450,RC,32551,CPT,OUTPATIENT,,,4657,3027.05,,4098.16,88,,3278.53,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,4657,100,,3725.60,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",884,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2933.91,63,,2347.13,,,0,"percent of total billed charges","63% of total billed charges",712.52,15.3,,570.02,,,0,"percent of total billed charges","15.3% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,3213.33,69,,,,,0,"fee schedule","69% of total billed charges",4657,100,,3725.60,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4657,100,,3725.60,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4657,100,,3725.60,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",635.74,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.42,100,,,,,0,"fee schedule",EAPG,1115.74,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1755.69,37.7,,1404.55,,,0,"percent of total billed charges","37.7% of total billed charges",1755.69,37.7,,1404.55,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1578.72,33.9,,1262.98,,,0,"percent of total billed charges","33.9% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3632.46,78,,2905.97,,,0,"percent of total billed charges","78% of total billed charges",1649.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3846.68,82.6,,3077.34,,,0,"percent of total billed charges","82.6% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3846.68,82.6,,3077.34,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,4657,100,,3725.60,,,0,"percent of total billed charges","100% of total billed charges",635.74,5712.48,
"32554 THORACENTESIS W/O IMAGING TechFee",45032554,CDM,450,RC,32554,CPT,OUTPATIENT,,,1991,1294.15,,1752.08,88,,1401.66,,,0,"percent of total billed charges","88% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,1991,100,,1592.80,,,0,"percent of total billed charges","100% of total billed charges",1121.3,175,,,,,0,"fee schedule","175% of CMS fee schedule",884,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1254.33,63,,1003.46,,,0,"percent of total billed charges","63% of total billed charges",304.62,15.3,,243.70,,,0,"percent of total billed charges","15.3% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,1373.79,69,,,,,0,"fee schedule","69% of total billed charges",1991,100,,1592.80,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1991,100,,1592.80,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1991,100,,1592.80,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",2200.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",575.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",635.74,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.42,100,,,,,0,"fee schedule",EAPG,1115.74,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",750.61,37.7,,600.49,,,0,"percent of total billed charges","37.7% of total billed charges",750.61,37.7,,600.49,,,0,"percent of total billed charges","37.70% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",674.95,33.9,,539.96,,,0,"percent of total billed charges","33.9% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1552.98,78,,1242.38,,,0,"percent of total billed charges","78% of total billed charges",647.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1644.57,82.6,,1315.66,,,0,"percent of total billed charges","82.6% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1644.57,82.6,,1315.66,,,0,"percent of total billed charges","82.6% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,1991,100,,1592.80,,,0,"percent of total billed charges","100% of total billed charges",304.62,2200.34,
"Pleural drainage, percutaneous, with insertion of indwelling",45032556,CDM,450,RC,32556,CPT,OUTPATIENT,,,6302,4096.3,,5545.76,88,,4436.61,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",884,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3970.26,63,,3176.21,,,0,"percent of total billed charges","63% of total billed charges",964.21,15.3,,771.37,,,0,"percent of total billed charges","15.3% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,4348.38,69,,,,,0,"fee schedule","69% of total billed charges",6302,100,,5041.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6302,100,,5041.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6302,100,,5041.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",635.74,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.42,100,,,,,0,"fee schedule",EAPG,1115.74,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2375.85,37.7,,1900.68,,,0,"percent of total billed charges","37.7% of total billed charges",2375.85,37.7,,1900.68,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2136.38,33.9,,1709.10,,,0,"percent of total billed charges","33.9% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4915.56,78,,3932.45,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5205.45,82.6,,4164.36,,,0,"percent of total billed charges","82.6% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5205.45,82.6,,4164.36,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,6302,100,,5041.60,,,0,"percent of total billed charges","100% of total billed charges",635.74,6601.69,
"32555 ASPIRATE PLEURA W/ IMAGING Tech Fee",45032555,CDM,450,RC,32555,CPT,OUTPATIENT,,,1991,1294.15,,1752.08,88,,1401.66,,,0,"percent of total billed charges","88% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,1991,100,,1592.80,,,0,"percent of total billed charges","100% of total billed charges",1121.3,175,,,,,0,"fee schedule","175% of CMS fee schedule",884,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1254.33,63,,1003.46,,,0,"percent of total billed charges","63% of total billed charges",304.62,15.3,,243.70,,,0,"percent of total billed charges","15.3% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,1373.79,69,,,,,0,"fee schedule","69% of total billed charges",1991,100,,1592.80,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1991,100,,1592.80,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1991,100,,1592.80,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",2200.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",575.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",635.74,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.42,100,,,,,0,"fee schedule",EAPG,1115.74,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",750.61,37.7,,600.49,,,0,"percent of total billed charges","37.7% of total billed charges",750.61,37.7,,600.49,,,0,"percent of total billed charges","37.70% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",674.95,33.9,,539.96,,,0,"percent of total billed charges","33.9% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1552.98,78,,1242.38,,,0,"percent of total billed charges","78% of total billed charges",647.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1644.57,82.6,,1315.66,,,0,"percent of total billed charges","82.6% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1644.57,82.6,,1315.66,,,0,"percent of total billed charges","82.6% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,1991,100,,1592.80,,,0,"percent of total billed charges","100% of total billed charges",304.62,2200.34,
"Pericardiocentesis, including imaging guidance, when perform",45033016,CDM,450,RC,33016,CPT,OUTPATIENT,,,2497,1623.05,,2197.36,88,,1757.89,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,2497,100,,1997.60,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",884,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1573.11,63,,1258.49,,,0,"percent of total billed charges","63% of total billed charges",382.04,15.3,,305.63,,,0,"percent of total billed charges","15.3% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,1722.93,69,,,,,0,"fee schedule","69% of total billed charges",2497,100,,1997.60,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2497,100,,1997.60,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2497,100,,1997.60,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",635.74,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.42,100,,,,,0,"fee schedule",EAPG,1115.74,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",941.37,37.7,,753.10,,,0,"percent of total billed charges","37.7% of total billed charges",941.37,37.7,,753.10,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",846.48,33.9,,677.18,,,0,"percent of total billed charges","33.9% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1947.66,78,,1558.13,,,0,"percent of total billed charges","78% of total billed charges",1649.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2062.52,82.6,,1650.02,,,0,"percent of total billed charges","82.6% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2062.52,82.6,,1650.02,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,2497,100,,1997.60,,,0,"percent of total billed charges","100% of total billed charges",382.04,5712.48,
"SCALP VENIPUNCTURE < 3",45036405,CDM,450,RC,36405,CPT,OUTPATIENT,,,90,58.5,,79.2,88,,63.36,,,0,"percent of total billed charges","88% of total billed charges",45,50,,36.00,,,0,"percent of total billed charges","50% of total billed charges",2.1,100,,,,,0,"fee schedule",EAPG,90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.16,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.77,15.3,,11.02,,,0,"percent of total billed charges","15.3% of total billed charges",2.1,100,,,,,0,"fee schedule",EAPG,62.1,69,,,,,0,"fee schedule","69% of total billed charges",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",55.67,61.85,,44.54,,,0,"percent of total billed charges","61.5% of total billed charges",2.1,100,,,,,0,"fee schedule",EAPG,45,50,,36.00,,,0,"percent of total billed charges","50% of total billed charges",28.98,32.2,,23.18,,,0,"percent of total billed charges","32.2% of total billed charges",1.55,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2.14,100,,,,,0,"fee schedule",EAPG,2.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",33.93,37.7,,27.14,,,0,"percent of total billed charges","37.7% of total billed charges",33.93,37.7,,27.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.51,33.9,,24.41,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.2,78,,56.16,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.34,82.6,,59.47,,,0,"percent of total billed charges","82.6% of total billed charges",2.1,100,,,,,0,"fee schedule",EAPG,45,50,,36.00,,,0,"percent of total billed charges","50% of total billed charges",74.34,82.6,,59.47,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.1,100,,,,,0,"fee schedule",EAPG,90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",1.55,90,
"VENIPUNCTURE COMPLEX > 3",45036410,CDM,450,RC,36410,CPT,OUTPATIENT,,,90,58.5,,79.2,88,,63.36,,,0,"percent of total billed charges","88% of total billed charges",45,50,,36.00,,,0,"percent of total billed charges","50% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54.44,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.77,15.3,,11.02,,,0,"percent of total billed charges","15.3% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,62.1,69,,,,,0,"fee schedule","69% of total billed charges",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",55.67,61.85,,44.54,,,0,"percent of total billed charges","61.5% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,45,50,,36.00,,,0,"percent of total billed charges","50% of total billed charges",28.98,32.2,,23.18,,,0,"percent of total billed charges","32.2% of total billed charges",39.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",53.92,100,,,,,0,"fee schedule",EAPG,68.72,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",33.93,37.7,,27.14,,,0,"percent of total billed charges","37.7% of total billed charges",33.93,37.7,,27.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.51,33.9,,24.41,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.2,78,,56.16,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.34,82.6,,59.47,,,0,"percent of total billed charges","82.6% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,45,50,,36.00,,,0,"percent of total billed charges","50% of total billed charges",74.34,82.6,,59.47,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.86,100,,,,,0,"fee schedule",EAPG,90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",13.77,90,
"VENOUS CUTDOWN > AGE 1",45036425,CDM,450,RC,36425,CPT,OUTPATIENT,,,80,52,,70.4,88,,56.32,,,0,"percent of total billed charges","88% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",711.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",54.44,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",50.4,63,,40.32,,,0,"percent of total billed charges","63% of total billed charges",12.24,15.3,,9.79,,,0,"percent of total billed charges","15.3% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,55.2,69,,,,,0,"fee schedule","69% of total billed charges",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",1097.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.15,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",53.92,100,,,,,0,"fee schedule",EAPG,68.72,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",30.16,37.7,,24.13,,,0,"percent of total billed charges","37.7% of total billed charges",30.16,37.7,,24.13,,,0,"percent of total billed charges","37.70% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",27.12,33.9,,21.70,,,0,"percent of total billed charges","33.9% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",62.4,78,,49.92,,,0,"percent of total billed charges","78% of total billed charges",410.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.08,82.6,,52.86,,,0,"percent of total billed charges","82.6% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.08,82.6,,52.86,,,0,"percent of total billed charges","82.6% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",12.24,1097.77,
"CENTRAL LINE PLCMT >5 YRS",45036556,CDM,450,RC,36556,CPT,OUTPATIENT,,,4689,3047.85,,4126.32,88,,3301.06,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,4689,100,,3751.20,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",1043.63,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2954.07,63,,2363.26,,,0,"percent of total billed charges","63% of total billed charges",717.42,15.3,,573.94,,,0,"percent of total billed charges","15.3% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,3235.41,69,,,,,0,"fee schedule","69% of total billed charges",4689,100,,3751.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4689,100,,3751.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4689,100,,3751.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",750.54,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033.49,100,,,,,0,"fee schedule",EAPG,1317.2,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1767.75,37.7,,1414.20,,,0,"percent of total billed charges","37.7% of total billed charges",1767.75,37.7,,1414.20,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.57,33.9,,1271.66,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3657.42,78,,2925.94,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3873.11,82.6,,3098.49,,,0,"percent of total billed charges","82.6% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3873.11,82.6,,3098.49,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,4689,100,,3751.20,,,0,"percent of total billed charges","100% of total billed charges",717.42,11625.57,
"CENTRAL LINE PLCMT <5 YRS",45036555,CDM,450,RC,36555,CPT,OUTPATIENT,,,5024,3265.6,,4421.12,88,,3536.90,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",1043.63,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3165.12,63,,2532.10,,,0,"percent of total billed charges","63% of total billed charges",768.67,15.3,,614.94,,,0,"percent of total billed charges","15.3% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,3466.56,69,,,,,0,"fee schedule","69% of total billed charges",5024,100,,4019.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5024,100,,4019.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5024,100,,4019.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",750.54,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033.49,100,,,,,0,"fee schedule",EAPG,1317.2,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1894.05,37.7,,1515.24,,,0,"percent of total billed charges","37.7% of total billed charges",1894.05,37.7,,1515.24,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1703.14,33.9,,1362.51,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3918.72,78,,3134.98,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4149.82,82.6,,3319.86,,,0,"percent of total billed charges","82.6% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4149.82,82.6,,3319.86,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,5024,100,,4019.20,,,0,"percent of total billed charges","100% of total billed charges",750.54,11625.57,
"PICC LINE PLCMT >5 YRS",45036569,CDM,450,RC,36569,CPT,OUTPATIENT,,,3685,2395.25,,3242.8,88,,2594.24,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,3685,100,,2948.00,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",1043.63,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2321.55,63,,1857.24,,,0,"percent of total billed charges","63% of total billed charges",563.81,15.3,,451.05,,,0,"percent of total billed charges","15.3% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,2542.65,69,,,,,0,"fee schedule","69% of total billed charges",3685,100,,2948.00,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3685,100,,2948.00,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3685,100,,2948.00,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",750.54,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033.49,100,,,,,0,"fee schedule",EAPG,1317.2,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1389.25,37.7,,1111.40,,,0,"percent of total billed charges","37.7% of total billed charges",1389.25,37.7,,1111.40,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1249.22,33.9,,999.38,,,0,"percent of total billed charges","33.9% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2874.3,78,,2299.44,,,0,"percent of total billed charges","78% of total billed charges",1649.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3043.81,82.6,,2435.05,,,0,"percent of total billed charges","82.6% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3043.81,82.6,,2435.05,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,3685,100,,2948.00,,,0,"percent of total billed charges","100% of total billed charges",563.81,5712.48,
"PICC LINE PLCMT <5 YRS",45036568,CDM,450,RC,36568,CPT,OUTPATIENT,,,5024,3265.6,,4421.12,88,,3536.90,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",1043.63,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3165.12,63,,2532.10,,,0,"percent of total billed charges","63% of total billed charges",768.67,15.3,,614.94,,,0,"percent of total billed charges","15.3% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,3466.56,69,,,,,0,"fee schedule","69% of total billed charges",5024,100,,4019.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5024,100,,4019.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5024,100,,4019.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",750.54,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033.49,100,,,,,0,"fee schedule",EAPG,1317.2,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1894.05,37.7,,1515.24,,,0,"percent of total billed charges","37.7% of total billed charges",1894.05,37.7,,1515.24,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1703.14,33.9,,1362.51,,,0,"percent of total billed charges","33.9% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3918.72,78,,3134.98,,,0,"percent of total billed charges","78% of total billed charges",1649.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4149.82,82.6,,3319.86,,,0,"percent of total billed charges","82.6% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4149.82,82.6,,3319.86,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,5024,100,,4019.20,,,0,"percent of total billed charges","100% of total billed charges",750.54,5712.48,
"36591 BLOOD COLLECTION FROM PORTACATHTECH FEE",45036591,CDM,450,RC,36591,CPT,OUTPATIENT,,,381,247.65,,335.28,88,,268.22,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",54.44,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",58.29,15.3,,46.63,,,0,"percent of total billed charges","15.3% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,262.89,69,,,,,0,"fee schedule","69% of total billed charges",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.15,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",53.92,100,,,,,0,"fee schedule",EAPG,68.72,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",143.64,37.7,,114.91,,,0,"percent of total billed charges","37.7% of total billed charges",143.64,37.7,,114.91,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",129.16,33.9,,103.33,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.18,78,,237.74,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",314.71,82.6,,251.77,,,0,"percent of total billed charges","82.6% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",314.71,82.6,,251.77,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",39.15,454.8,
"PLACEMENT/NDL INTRAOSSEOUS INF",45036680,CDM,450,RC,36680,CPT,OUTPATIENT,,,950,617.5,,836,88,,668.80,,,0,"percent of total billed charges","88% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,950,100,,760.00,,,0,"percent of total billed charges","100% of total billed charges",711.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",223.22,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",598.5,63,,478.80,,,0,"percent of total billed charges","63% of total billed charges",145.35,15.3,,116.28,,,0,"percent of total billed charges","15.3% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,655.5,69,,,,,0,"fee schedule","69% of total billed charges",950,100,,760.00,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",950,100,,760.00,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",950,100,,760.00,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",1097.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.05,100,,,,,0,"fee schedule",EAPG,281.73,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",358.15,37.7,,286.52,,,0,"percent of total billed charges","37.7% of total billed charges",358.15,37.7,,286.52,,,0,"percent of total billed charges","37.70% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",322.05,33.9,,257.64,,,0,"percent of total billed charges","33.9% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",741,78,,592.80,,,0,"percent of total billed charges","78% of total billed charges",410.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",784.7,82.6,,627.76,,,0,"percent of total billed charges","82.6% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",784.7,82.6,,627.76,,,0,"percent of total billed charges","82.6% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,950,100,,760.00,,,0,"percent of total billed charges","100% of total billed charges",145.35,1097.77,
"THROMBOLYTIC THERAPY STROKE",45037195,CDM,450,RC,37195,CPT,OUTPATIENT,,,210,136.5,,184.8,88,,147.84,,,0,"percent of total billed charges","88% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",604.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",281.17,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.3,63,,105.84,,,0,"percent of total billed charges","63% of total billed charges",32.13,15.3,,25.70,,,0,"percent of total billed charges","15.3% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,144.9,69,,,,,0,"fee schedule","69% of total billed charges",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",1262.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.21,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278.44,100,,,,,0,"fee schedule",EAPG,354.88,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",79.17,37.7,,63.34,,,0,"percent of total billed charges","37.7% of total billed charges",79.17,37.7,,63.34,,,0,"percent of total billed charges","37.70% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",71.19,33.9,,56.95,,,0,"percent of total billed charges","33.9% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",163.8,78,,131.04,,,0,"percent of total billed charges","78% of total billed charges",348.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.46,82.6,,138.77,,,0,"percent of total billed charges","82.6% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.46,82.6,,138.77,,,0,"percent of total billed charges","82.6% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",32.13,1262.42,
"BONE MARROW ASPIRATION",45038220,CDM,450,RC,38220,CPT,OUTPATIENT,,,4006,2603.9,,3525.28,88,,2820.22,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1070.37,100,,,,,0,"fee schedule",EAPG,4006,100,,3204.80,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1102.48,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2523.78,63,,2019.02,,,0,"percent of total billed charges","63% of total billed charges",612.92,15.3,,490.34,,,0,"percent of total billed charges","15.3% of total billed charges",1070.37,100,,,,,0,"fee schedule",EAPG,2764.14,69,,,,,0,"fee schedule","69% of total billed charges",4006,100,,3204.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4006,100,,3204.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4006,100,,3204.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1070.37,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",792.87,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1091.78,100,,,,,0,"fee schedule",EAPG,1391.48,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1510.26,37.7,,1208.21,,,0,"percent of total billed charges","37.7% of total billed charges",1510.26,37.7,,1208.21,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1358.03,33.9,,1086.42,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3124.68,78,,2499.74,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3308.96,82.6,,2647.17,,,0,"percent of total billed charges","82.6% of total billed charges",1070.37,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3308.96,82.6,,2647.17,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1070.37,100,,,,,0,"fee schedule",EAPG,4006,100,,3204.80,,,0,"percent of total billed charges","100% of total billed charges",612.92,5715.97,
"REPAIR LIP, VERMILLION",45040650,CDM,450,RC,40650,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",100.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",103.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",100.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",100.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",74.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",100.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",100.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",74.15,130.13,
"REP LIP UPTOHALF HT VERMBORDER",45040652,CDM,450,RC,40652,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",100.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",103.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",100.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",100.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",74.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",100.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",100.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",74.15,130.13,
"REPAIR LIP >1/2 VERMILION BORD",45040654,CDM,450,RC,40654,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",827.71,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",852.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",827.71,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",827.71,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",613.12,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",827.71,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",827.71,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",613.12,1076.02,
"ID ABSCESS MOUTH SIMPLE",45040800,CDM,450,RC,40800,CPT,OUTPATIENT,,,746,484.9,,656.48,88,,525.18,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",1784.31,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",469.98,63,,375.98,,,0,"percent of total billed charges","63% of total billed charges",114.14,15.3,,91.31,,,0,"percent of total billed charges","15.3% of total billed charges",1732.34,100,,,,,0,"fee schedule",EAPG,514.74,69,,,,,0,"fee schedule","69% of total billed charges",746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1283.21,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1766.99,100,,,,,0,"fee schedule",EAPG,2252.04,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",281.24,37.7,,224.99,,,0,"percent of total billed charges","37.7% of total billed charges",281.24,37.7,,224.99,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.89,33.9,,202.31,,,0,"percent of total billed charges","33.9% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",581.88,78,,465.50,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,82.6,,492.96,,,0,"percent of total billed charges","82.6% of total billed charges",1732.34,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,82.6,,492.96,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",114.14,2526.76,
"CLOSED LACERATION MOUTH < 2.5",45040830,CDM,450,RC,40830,CPT,OUTPATIENT,,,746,484.9,,656.48,88,,525.18,,,0,"percent of total billed charges","88% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",435.98,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",469.98,63,,375.98,,,0,"percent of total billed charges","63% of total billed charges",114.14,15.3,,91.31,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,514.74,69,,,,,0,"fee schedule","69% of total billed charges",746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",859.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.15,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",281.24,37.7,,224.99,,,0,"percent of total billed charges","37.7% of total billed charges",281.24,37.7,,224.99,,,0,"percent of total billed charges","37.70% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.89,33.9,,202.31,,,0,"percent of total billed charges","33.9% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",581.88,78,,465.50,,,0,"percent of total billed charges","78% of total billed charges",251.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,82.6,,492.96,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,82.6,,492.96,,,0,"percent of total billed charges","82.6% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",74.15,859.63,
"CLOSED LACERATION MOUTH > 2.5",45040831,CDM,450,RC,40831,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1732.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1784.31,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1732.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1732.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1283.21,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1766.99,100,,,,,0,"fee schedule",EAPG,2252.04,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1732.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1732.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1283.21,2252.04,
"SUTURE REPAIR TONGUE < 2.5 CM",45041250,CDM,450,RC,41250,CPT,OUTPATIENT,,,746,484.9,,656.48,88,,525.18,,,0,"percent of total billed charges","88% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",711.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",469.98,63,,375.98,,,0,"percent of total billed charges","63% of total billed charges",114.14,15.3,,91.31,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,514.74,69,,,,,0,"fee schedule","69% of total billed charges",746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",1097.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.15,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",281.24,37.7,,224.99,,,0,"percent of total billed charges","37.7% of total billed charges",281.24,37.7,,224.99,,,0,"percent of total billed charges","37.70% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.89,33.9,,202.31,,,0,"percent of total billed charges","33.9% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",581.88,78,,465.50,,,0,"percent of total billed charges","78% of total billed charges",410.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,82.6,,492.96,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,82.6,,492.96,,,0,"percent of total billed charges","82.6% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",74.15,1097.77,
"SUTURE REPAIR TONGUE > 2.6 CM",45041252,CDM,450,RC,41252,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",100.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",103.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",100.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",100.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",74.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",100.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",100.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",74.15,130.13,
"ID ABCESS DENTOALVEOLAR",45041800,CDM,450,RC,41800,CPT,OUTPATIENT,,,746,484.9,,656.48,88,,525.18,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",469.98,63,,375.98,,,0,"percent of total billed charges","63% of total billed charges",114.14,15.3,,91.31,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,514.74,69,,,,,0,"fee schedule","69% of total billed charges",746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.15,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",281.24,37.7,,224.99,,,0,"percent of total billed charges","37.7% of total billed charges",281.24,37.7,,224.99,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.89,33.9,,202.31,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",581.88,78,,465.50,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,82.6,,492.96,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,82.6,,492.96,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",74.15,746,
"REMOVAL FB DENTOALVEOLAR",45041805,CDM,450,RC,41805,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1732.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1784.31,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1732.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1732.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1283.21,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1766.99,100,,,,,0,"fee schedule",EAPG,2252.04,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1732.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1732.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1283.21,2252.04,
"ID PERITONSILLAR ABSCESS",45042700,CDM,450,RC,42700,CPT,OUTPATIENT,,,746,484.9,,656.48,88,,525.18,,,0,"percent of total billed charges","88% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",435.98,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",469.98,63,,375.98,,,0,"percent of total billed charges","63% of total billed charges",114.14,15.3,,91.31,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,514.74,69,,,,,0,"fee schedule","69% of total billed charges",746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",859.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.15,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",281.24,37.7,,224.99,,,0,"percent of total billed charges","37.7% of total billed charges",281.24,37.7,,224.99,,,0,"percent of total billed charges","37.70% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.89,33.9,,202.31,,,0,"percent of total billed charges","33.9% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",581.88,78,,465.50,,,0,"percent of total billed charges","78% of total billed charges",251.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,82.6,,492.96,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,82.6,,492.96,,,0,"percent of total billed charges","82.6% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",74.15,859.63,
"FB REMOVAL PHARYNX",45042809,CDM,450,RC,42809,CPT,OUTPATIENT,,,638,414.7,,561.44,88,,449.15,,,0,"percent of total billed charges","88% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,638,100,,510.40,,,0,"percent of total billed charges","100% of total billed charges",711.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.94,63,,321.55,,,0,"percent of total billed charges","63% of total billed charges",97.61,15.3,,78.09,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,440.22,69,,,,,0,"fee schedule","69% of total billed charges",638,100,,510.40,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638,100,,510.40,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638,100,,510.40,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",1097.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.15,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",240.53,37.7,,192.42,,,0,"percent of total billed charges","37.7% of total billed charges",240.53,37.7,,192.42,,,0,"percent of total billed charges","37.70% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.28,33.9,,173.02,,,0,"percent of total billed charges","33.9% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.64,78,,398.11,,,0,"percent of total billed charges","78% of total billed charges",410.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",526.99,82.6,,421.59,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",526.99,82.6,,421.59,,,0,"percent of total billed charges","82.6% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,638,100,,510.40,,,0,"percent of total billed charges","100% of total billed charges",74.15,1097.77,
"CONTROL OROPHARYNGEAL HEM SIMP",45042960,CDM,450,RC,42960,CPT,OUTPATIENT,,,746,484.9,,656.48,88,,525.18,,,0,"percent of total billed charges","88% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",982.07,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",469.98,63,,375.98,,,0,"percent of total billed charges","63% of total billed charges",114.14,15.3,,91.31,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,514.74,69,,,,,0,"fee schedule","69% of total billed charges",746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",1837.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",480.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",613.12,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",281.24,37.7,,224.99,,,0,"percent of total billed charges","37.7% of total billed charges",281.24,37.7,,224.99,,,0,"percent of total billed charges","37.70% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.89,33.9,,202.31,,,0,"percent of total billed charges","33.9% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",581.88,78,,465.50,,,0,"percent of total billed charges","78% of total billed charges",566.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,82.6,,492.96,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,82.6,,492.96,,,0,"percent of total billed charges","82.6% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",114.14,1837.71,
"GASTRIC INTUBATION TREATMENT",94043753,CDM,940,RC,43753,CPT,OUTPATIENT,,,517,336.05,,454.96,88,,363.97,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",86.86,16.8,,69.49,,,0,"percent of total billed charges","16.8% of total billed charges",517,100,,413.60,,,0,"percent of total billed charges","100% of total billed charges",560.25,175,,,,,0,"fee schedule","175% of CMS fee schedule",89.46,17.304,,71.57,,,0,"percent of total billed charges","17.304% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",325.71,63,,260.57,,,0,"percent of total billed charges","63% of total billed charges",79.1,15.3,,63.28,,,0,"percent of total billed charges","15.3% of total billed charges",86.86,16.8,,69.49,,,0,"percent of total billed charges","16.8% of total billed charges",356.73,69,,,,,0,"fee schedule","69% of total billed charges",517,100,,413.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",517,100,,413.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",517,100,,413.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",86.86,16.8,,69.49,,,0,"percent of total billed charges","16.8% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",86.86,16.8,,69.49,,,0,"percent of total billed charges","16.8% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",88.59,17.136,,70.87,,,0,"percent of total billed charges","17.136% of total billed charges",112.91,21.84,,90.33,,,0,"percent of total billed charges","21.84% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",194.91,37.7,,155.93,,,0,"percent of total billed charges","37.7% of total billed charges",194.91,37.7,,155.93,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",175.26,33.9,,140.21,,,0,"percent of total billed charges","33.9% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",403.26,78,,322.61,,,0,"percent of total billed charges","78% of total billed charges",323.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",427.04,82.6,,341.63,,,0,"percent of total billed charges","82.6% of total billed charges",86.86,16.8,,69.49,,,0,"percent of total billed charges","16.8% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",427.04,82.6,,341.63,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",86.86,16.8,,69.49,,,0,"percent of total billed charges","16.8% of total billed charges",517,100,,413.60,,,0,"percent of total billed charges","100% of total billed charges",79.1,1074.33,
"GASTROSTOMY TUBE CHANGE",45043762,CDM,450,RC,43762,CPT,OUTPATIENT,,,746,484.9,,656.48,88,,525.18,,,0,"percent of total billed charges","88% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",441.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",624,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",469.98,63,,375.98,,,0,"percent of total billed charges","63% of total billed charges",114.14,15.3,,91.31,,,0,"percent of total billed charges","15.3% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,514.74,69,,,,,0,"fee schedule","69% of total billed charges",746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1081.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",282.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",448.76,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",617.95,100,,,,,0,"fee schedule",EAPG,787.58,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",281.24,37.7,,224.99,,,0,"percent of total billed charges","37.7% of total billed charges",281.24,37.7,,224.99,,,0,"percent of total billed charges","37.70% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.89,33.9,,202.31,,,0,"percent of total billed charges","33.9% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",581.88,78,,465.50,,,0,"percent of total billed charges","78% of total billed charges",254.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,82.6,,492.96,,,0,"percent of total billed charges","82.6% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,82.6,,492.96,,,0,"percent of total billed charges","82.6% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,746,100,,596.80,,,0,"percent of total billed charges","100% of total billed charges",114.14,1081.19,
"ANORECTAL EXAM NO ANESTHESIA",45045999,CDM,450,RC,45999,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1327.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1367,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1327.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1327.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",983.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1327.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1327.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",983.1,1725.34,
"ID ABCESS PERIRECTAL",45046040,CDM,450,RC,46040,CPT,OUTPATIENT,,,4364,2836.6,,3840.32,88,,3072.26,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,4364,100,,3491.20,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",1367,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2749.32,63,,2199.46,,,0,"percent of total billed charges","63% of total billed charges",667.69,15.3,,534.15,,,0,"percent of total billed charges","15.3% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,3011.16,69,,,,,0,"fee schedule","69% of total billed charges",4364,100,,3491.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4364,100,,3491.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4364,100,,3491.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",983.1,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.23,37.7,,1316.18,,,0,"percent of total billed charges","37.7% of total billed charges",1645.23,37.7,,1316.18,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1479.4,33.9,,1183.52,,,0,"percent of total billed charges","33.9% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3403.92,78,,2723.14,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3604.66,82.6,,2883.73,,,0,"percent of total billed charges","82.6% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3604.66,82.6,,2883.73,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,4364,100,,3491.20,,,0,"percent of total billed charges","100% of total billed charges",667.69,4364,
"ID PERIANAL ABCESS SUPERFICI",45046050,CDM,450,RC,46050,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1631.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",1367,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",3224.22,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",842.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",983.1,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",941.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,3224.22,
"INCISION THROMBOSED HEMORRHOID",45046083,CDM,450,RC,46083,CPT,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",441.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",1367,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1081.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",282.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",983.1,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",254.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1725.34,
"EXCISION THROMB EXT HEMORRHOID",45046320,CDM,450,RC,46320,CPT,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",1367,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",983.1,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,4212.68,
ANOSCOPY,45046600,CDM,450,RC,46600,CPT,OUTPATIENT,,,638,414.7,,561.44,88,,449.15,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,638,100,,510.40,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",624,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.94,63,,321.55,,,0,"percent of total billed charges","63% of total billed charges",97.61,15.3,,78.09,,,0,"percent of total billed charges","15.3% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,440.22,69,,,,,0,"fee schedule","69% of total billed charges",638,100,,510.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638,100,,510.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638,100,,510.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",448.76,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",617.95,100,,,,,0,"fee schedule",EAPG,787.58,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",240.53,37.7,,192.42,,,0,"percent of total billed charges","37.7% of total billed charges",240.53,37.7,,192.42,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.28,33.9,,173.02,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.64,78,,398.11,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",526.99,82.6,,421.59,,,0,"percent of total billed charges","82.6% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",526.99,82.6,,421.59,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,638,100,,510.40,,,0,"percent of total billed charges","100% of total billed charges",97.61,787.58,
"ANOSCOPY REMOVAL FOREIGN BODY",45046608,CDM,450,RC,46608,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",874.68,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",900.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",874.68,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",874.68,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",647.91,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",874.68,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",874.68,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",647.91,1137.08,
"ABD PARACENTESIS WO IMAGING",45049082,CDM,450,RC,49082,CPT,OUTPATIENT,,,2372,1541.8,,2087.36,88,,1669.89,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,2372,100,,1897.60,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",685.84,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.36,63,,1195.49,,,0,"percent of total billed charges","63% of total billed charges",362.92,15.3,,290.34,,,0,"percent of total billed charges","15.3% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,1636.68,69,,,,,0,"fee schedule","69% of total billed charges",2372,100,,1897.60,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2372,100,,1897.60,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2372,100,,1897.60,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",493.23,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",679.18,100,,,,,0,"fee schedule",EAPG,865.63,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",894.24,37.7,,715.39,,,0,"percent of total billed charges","37.7% of total billed charges",894.24,37.7,,715.39,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",804.11,33.9,,643.29,,,0,"percent of total billed charges","33.9% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1850.16,78,,1480.13,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1959.27,82.6,,1567.42,,,0,"percent of total billed charges","82.6% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1959.27,82.6,,1567.42,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,2372,100,,1897.60,,,0,"percent of total billed charges","100% of total billed charges",362.92,3289.02,
"49083 PARACENTESIS ABDOMINAL W/ IMAGING Tech Fee",45049083,CDM,450,RC,49083,CPT,OUTPATIENT,,,2443,1587.95,,2149.84,88,,1719.87,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,2443,100,,1954.40,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",685.84,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1539.09,63,,1231.27,,,0,"percent of total billed charges","63% of total billed charges",373.78,15.3,,299.02,,,0,"percent of total billed charges","15.3% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,1685.67,69,,,,,0,"fee schedule","69% of total billed charges",2443,100,,1954.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2443,100,,1954.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2443,100,,1954.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",493.23,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",679.18,100,,,,,0,"fee schedule",EAPG,865.63,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",921.01,37.7,,736.81,,,0,"percent of total billed charges","37.7% of total billed charges",921.01,37.7,,736.81,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",828.18,33.9,,662.54,,,0,"percent of total billed charges","33.9% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1905.54,78,,1524.43,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2017.92,82.6,,1614.34,,,0,"percent of total billed charges","82.6% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2017.92,82.6,,1614.34,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,2443,100,,1954.40,,,0,"percent of total billed charges","100% of total billed charges",373.78,3289.02,
"BLADDER ASPIRATION",45051100,CDM,450,RC,51100,CPT,OUTPATIENT,,,1035,672.75,,910.8,88,,728.64,,,0,"percent of total billed charges","88% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.36,100,,,,,0,"fee schedule",EAPG,1035,100,,828.00,,,0,"percent of total billed charges","100% of total billed charges",441.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",352.63,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.05,63,,521.64,,,0,"percent of total billed charges","63% of total billed charges",158.36,15.3,,126.69,,,0,"percent of total billed charges","15.3% of total billed charges",342.36,100,,,,,0,"fee schedule",EAPG,714.15,69,,,,,0,"fee schedule","69% of total billed charges",1035,100,,828.00,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035,100,,828.00,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035,100,,828.00,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1081.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.36,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",282.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",253.6,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",349.21,100,,,,,0,"fee schedule",EAPG,445.07,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.2,37.7,,312.16,,,0,"percent of total billed charges","37.7% of total billed charges",390.2,37.7,,312.16,,,0,"percent of total billed charges","37.70% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350.87,33.9,,280.70,,,0,"percent of total billed charges","33.9% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",807.3,78,,645.84,,,0,"percent of total billed charges","78% of total billed charges",254.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",854.91,82.6,,683.93,,,0,"percent of total billed charges","82.6% of total billed charges",342.36,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",854.91,82.6,,683.93,,,0,"percent of total billed charges","82.6% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.36,100,,,,,0,"fee schedule",EAPG,1035,100,,828.00,,,0,"percent of total billed charges","100% of total billed charges",158.36,1081.19,
"BLADDER IRRIGATION",45051700,CDM,450,RC,51700,CPT,OUTPATIENT,,,1036,673.4,,911.68,88,,729.34,,,0,"percent of total billed charges","88% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,1036,100,,828.80,,,0,"percent of total billed charges","100% of total billed charges",441.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",66.85,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.68,63,,522.14,,,0,"percent of total billed charges","63% of total billed charges",158.51,15.3,,126.81,,,0,"percent of total billed charges","15.3% of total billed charges",64.9,100,,,,,0,"fee schedule",EAPG,714.84,69,,,,,0,"fee schedule","69% of total billed charges",1036,100,,828.80,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1036,100,,828.80,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1036,100,,828.80,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1081.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",282.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",48.07,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.2,100,,,,,0,"fee schedule",EAPG,84.37,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.57,37.7,,312.46,,,0,"percent of total billed charges","37.7% of total billed charges",390.57,37.7,,312.46,,,0,"percent of total billed charges","37.70% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",351.2,33.9,,280.96,,,0,"percent of total billed charges","33.9% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",808.08,78,,646.46,,,0,"percent of total billed charges","78% of total billed charges",254.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",855.74,82.6,,684.59,,,0,"percent of total billed charges","82.6% of total billed charges",64.9,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",855.74,82.6,,684.59,,,0,"percent of total billed charges","82.6% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,1036,100,,828.80,,,0,"percent of total billed charges","100% of total billed charges",48.07,1081.19,
"INSERT NON INDWELL CATH",45051701,CDM,450,RC,51701,CPT,OUTPATIENT,,,170,110.5,,149.6,88,,119.68,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",66.85,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.1,63,,85.68,,,0,"percent of total billed charges","63% of total billed charges",26.01,15.3,,20.81,,,0,"percent of total billed charges","15.3% of total billed charges",64.9,100,,,,,0,"fee schedule",EAPG,117.3,69,,,,,0,"fee schedule","69% of total billed charges",170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",48.07,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.2,100,,,,,0,"fee schedule",EAPG,84.37,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.09,37.7,,51.27,,,0,"percent of total billed charges","37.7% of total billed charges",64.09,37.7,,51.27,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",57.63,33.9,,46.10,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.6,78,,106.08,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",140.42,82.6,,112.34,,,0,"percent of total billed charges","82.6% of total billed charges",64.9,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",140.42,82.6,,112.34,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",26.01,454.8,
"INSERTION FOLEY CATHETER",45051702,CDM,450,RC,51702,CPT,OUTPATIENT,,,638,414.7,,561.44,88,,449.15,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,638,100,,510.40,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",66.85,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.94,63,,321.55,,,0,"percent of total billed charges","63% of total billed charges",97.61,15.3,,78.09,,,0,"percent of total billed charges","15.3% of total billed charges",64.9,100,,,,,0,"fee schedule",EAPG,440.22,69,,,,,0,"fee schedule","69% of total billed charges",638,100,,510.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638,100,,510.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638,100,,510.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",48.07,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.2,100,,,,,0,"fee schedule",EAPG,84.37,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",240.53,37.7,,192.42,,,0,"percent of total billed charges","37.7% of total billed charges",240.53,37.7,,192.42,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.28,33.9,,173.02,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.64,78,,398.11,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",526.99,82.6,,421.59,,,0,"percent of total billed charges","82.6% of total billed charges",64.9,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",526.99,82.6,,421.59,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,638,100,,510.40,,,0,"percent of total billed charges","100% of total billed charges",48.07,638,
"CATHERIZATION COMPLEX",45051703,CDM,450,RC,51703,CPT,OUTPATIENT,,,280,182,,246.4,88,,197.12,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",66.85,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",176.4,63,,141.12,,,0,"percent of total billed charges","63% of total billed charges",42.84,15.3,,34.27,,,0,"percent of total billed charges","15.3% of total billed charges",64.9,100,,,,,0,"fee schedule",EAPG,193.2,69,,,,,0,"fee schedule","69% of total billed charges",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",48.07,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.2,100,,,,,0,"fee schedule",EAPG,84.37,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.56,37.7,,84.45,,,0,"percent of total billed charges","37.7% of total billed charges",105.56,37.7,,84.45,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",94.92,33.9,,75.94,,,0,"percent of total billed charges","33.9% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.4,78,,174.72,,,0,"percent of total billed charges","78% of total billed charges",160.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",231.28,82.6,,185.02,,,0,"percent of total billed charges","82.6% of total billed charges",64.9,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",231.28,82.6,,185.02,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",42.84,566.91,
"POST VOID RESID BY US CPT",45051798,CDM,450,RC,51798,CPT,OUTPATIENT,,,255,165.75,,224.4,88,,179.52,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,255,100,,204.00,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",66.85,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.65,63,,128.52,,,0,"percent of total billed charges","63% of total billed charges",39.02,15.3,,31.22,,,0,"percent of total billed charges","15.3% of total billed charges",64.9,100,,,,,0,"fee schedule",EAPG,175.95,69,,,,,0,"fee schedule","69% of total billed charges",255,100,,204.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255,100,,204.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255,100,,204.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",48.07,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.2,100,,,,,0,"fee schedule",EAPG,84.37,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",96.14,37.7,,76.91,,,0,"percent of total billed charges","37.7% of total billed charges",96.14,37.7,,76.91,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",86.45,33.9,,69.16,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",198.9,78,,159.12,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.63,82.6,,168.50,,,0,"percent of total billed charges","82.6% of total billed charges",64.9,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.63,82.6,,168.50,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,255,100,,204.00,,,0,"percent of total billed charges","100% of total billed charges",39.02,255,
N/A,45052281,CDM,450,RC,52281,CPT,OUTPATIENT,,,5585,3630.25,,4914.8,88,,3931.84,,,0,"percent of total billed charges","88% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1405.94,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3635.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",1448.12,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3518.55,63,,2814.84,,,0,"percent of total billed charges","63% of total billed charges",854.51,15.3,,683.61,,,0,"percent of total billed charges","15.3% of total billed charges",1405.94,100,,,,,0,"fee schedule",EAPG,3853.65,69,,,,,0,"fee schedule","69% of total billed charges",5585,100,,4468.00,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5585,100,,4468.00,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5585,100,,4468.00,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",7284.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1405.94,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1904.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1041.44,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1434.06,100,,,,,0,"fee schedule",EAPG,1827.72,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2105.55,37.7,,1684.44,,,0,"percent of total billed charges","37.7% of total billed charges",2105.55,37.7,,1684.44,,,0,"percent of total billed charges","37.70% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1893.32,33.9,,1514.66,,,0,"percent of total billed charges","33.9% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4356.3,78,,3485.04,,,0,"percent of total billed charges","78% of total billed charges",2098.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4613.21,82.6,,3690.57,,,0,"percent of total billed charges","82.6% of total billed charges",1405.94,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4613.21,82.6,,3690.57,,,0,"percent of total billed charges","82.6% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1405.94,100,,,,,0,"fee schedule",EAPG,5585,100,,4468.00,,,0,"percent of total billed charges","100% of total billed charges",854.51,7284.07,
"MEATOTOMY CUT MEATUS EXCINFANT",45053020,CDM,450,RC,53020,CPT,OUTPATIENT,,,683,443.95,,601.04,88,,480.83,,,0,"percent of total billed charges","88% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2646.75,100,,,,,0,"fee schedule",EAPG,683,100,,546.40,,,0,"percent of total billed charges","100% of total billed charges",3635.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",2726.15,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",430.29,63,,344.23,,,0,"percent of total billed charges","63% of total billed charges",104.5,15.3,,83.60,,,0,"percent of total billed charges","15.3% of total billed charges",2646.75,100,,,,,0,"fee schedule",EAPG,471.27,69,,,,,0,"fee schedule","69% of total billed charges",683,100,,546.40,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",683,100,,546.40,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",683,100,,546.40,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",7284.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2646.75,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1904.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1960.55,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2699.68,100,,,,,0,"fee schedule",EAPG,3440.77,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",257.49,37.7,,205.99,,,0,"percent of total billed charges","37.7% of total billed charges",257.49,37.7,,205.99,,,0,"percent of total billed charges","37.70% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",231.54,33.9,,185.23,,,0,"percent of total billed charges","33.9% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",532.74,78,,426.19,,,0,"percent of total billed charges","78% of total billed charges",2098.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",564.16,82.6,,451.33,,,0,"percent of total billed charges","82.6% of total billed charges",2646.75,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",564.16,82.6,,451.33,,,0,"percent of total billed charges","82.6% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2646.75,100,,,,,0,"fee schedule",EAPG,683,100,,546.40,,,0,"percent of total billed charges","100% of total billed charges",104.5,7284.07,
"UNLIST PROCEDURE URINARY SYS",45053899,CDM,450,RC,53899,CPT,OUTPATIENT,,,1156,751.4,,1017.28,88,,813.82,,,0,"percent of total billed charges","88% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1359.89,100,,,,,0,"fee schedule",EAPG,1156,100,,924.80,,,0,"percent of total billed charges","100% of total billed charges",441.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",1400.69,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",728.28,63,,582.62,,,0,"percent of total billed charges","63% of total billed charges",176.87,15.3,,141.50,,,0,"percent of total billed charges","15.3% of total billed charges",1359.89,100,,,,,0,"fee schedule",EAPG,797.64,69,,,,,0,"fee schedule","69% of total billed charges",1156,100,,924.80,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1156,100,,924.80,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1156,100,,924.80,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1081.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1359.89,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",282.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1007.32,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1387.09,100,,,,,0,"fee schedule",EAPG,1767.86,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",435.81,37.7,,348.65,,,0,"percent of total billed charges","37.7% of total billed charges",435.81,37.7,,348.65,,,0,"percent of total billed charges","37.70% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",391.88,33.9,,313.50,,,0,"percent of total billed charges","33.9% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",901.68,78,,721.34,,,0,"percent of total billed charges","78% of total billed charges",254.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",954.86,82.6,,763.89,,,0,"percent of total billed charges","82.6% of total billed charges",1359.89,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",954.86,82.6,,763.89,,,0,"percent of total billed charges","82.6% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1359.89,100,,,,,0,"fee schedule",EAPG,1156,100,,924.80,,,0,"percent of total billed charges","100% of total billed charges",176.87,1767.86,
"SLITTING OF PREPUSE;EXCP NEWBO",45054001,CDM,450,RC,54001,CPT,OUTPATIENT,,,1303,846.95,,1146.64,88,,917.31,,,0,"percent of total billed charges","88% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1768.95,100,,,,,0,"fee schedule",EAPG,1303,100,,1042.40,,,0,"percent of total billed charges","100% of total billed charges",3635.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",1822.02,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",820.89,63,,656.71,,,0,"percent of total billed charges","63% of total billed charges",199.36,15.3,,159.49,,,0,"percent of total billed charges","15.3% of total billed charges",1768.95,100,,,,,0,"fee schedule",EAPG,899.07,69,,,,,0,"fee schedule","69% of total billed charges",1303,100,,1042.40,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1303,100,,1042.40,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1303,100,,1042.40,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",7284.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1768.95,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1904.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1310.34,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1804.33,100,,,,,0,"fee schedule",EAPG,2299.64,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",491.23,37.7,,392.98,,,0,"percent of total billed charges","37.7% of total billed charges",491.23,37.7,,392.98,,,0,"percent of total billed charges","37.70% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.72,33.9,,353.38,,,0,"percent of total billed charges","33.9% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1016.34,78,,813.07,,,0,"percent of total billed charges","78% of total billed charges",2098.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1076.28,82.6,,861.02,,,0,"percent of total billed charges","82.6% of total billed charges",1768.95,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1076.28,82.6,,861.02,,,0,"percent of total billed charges","82.6% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1768.95,100,,,,,0,"fee schedule",EAPG,1303,100,,1042.40,,,0,"percent of total billed charges","100% of total billed charges",199.36,7284.07,
"54220 PENILE IRRIGATION TechFee",45054220,CDM,450,RC,54220,CPT,OUTPATIENT,,,741,481.65,,652.08,88,,521.66,,,0,"percent of total billed charges","88% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,741,100,,592.80,,,0,"percent of total billed charges","100% of total billed charges",441.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",66.85,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",466.83,63,,373.46,,,0,"percent of total billed charges","63% of total billed charges",113.37,15.3,,90.70,,,0,"percent of total billed charges","15.3% of total billed charges",64.9,100,,,,,0,"fee schedule",EAPG,511.29,69,,,,,0,"fee schedule","69% of total billed charges",741,100,,592.80,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",741,100,,592.80,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",741,100,,592.80,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1081.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",282.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",48.07,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.2,100,,,,,0,"fee schedule",EAPG,84.37,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",279.36,37.7,,223.49,,,0,"percent of total billed charges","37.7% of total billed charges",279.36,37.7,,223.49,,,0,"percent of total billed charges","37.70% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",251.2,33.9,,200.96,,,0,"percent of total billed charges","33.9% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",577.98,78,,462.38,,,0,"percent of total billed charges","78% of total billed charges",254.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",612.07,82.6,,489.66,,,0,"percent of total billed charges","82.6% of total billed charges",64.9,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",612.07,82.6,,489.66,,,0,"percent of total billed charges","82.6% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,741,100,,592.80,,,0,"percent of total billed charges","100% of total billed charges",48.07,1081.19,
"FORESKIN MANIPULATION",45054450,CDM,450,RC,54450,CPT,OUTPATIENT,,,446,289.9,,392.48,88,,313.98,,,0,"percent of total billed charges","88% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.36,100,,,,,0,"fee schedule",EAPG,446,100,,356.80,,,0,"percent of total billed charges","100% of total billed charges",441.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",352.63,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.98,63,,224.78,,,0,"percent of total billed charges","63% of total billed charges",68.24,15.3,,54.59,,,0,"percent of total billed charges","15.3% of total billed charges",342.36,100,,,,,0,"fee schedule",EAPG,307.74,69,,,,,0,"fee schedule","69% of total billed charges",446,100,,356.80,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",446,100,,356.80,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",446,100,,356.80,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1081.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.36,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",282.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",253.6,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",349.21,100,,,,,0,"fee schedule",EAPG,445.07,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.14,37.7,,134.51,,,0,"percent of total billed charges","37.7% of total billed charges",168.14,37.7,,134.51,,,0,"percent of total billed charges","37.70% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.19,33.9,,120.95,,,0,"percent of total billed charges","33.9% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",347.88,78,,278.30,,,0,"percent of total billed charges","78% of total billed charges",254.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",368.4,82.6,,294.72,,,0,"percent of total billed charges","82.6% of total billed charges",342.36,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",368.4,82.6,,294.72,,,0,"percent of total billed charges","82.6% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.36,100,,,,,0,"fee schedule",EAPG,446,100,,356.80,,,0,"percent of total billed charges","100% of total billed charges",68.24,1081.19,
"REDUCTION OF TOSION OF TESTIS",45054600,CDM,450,RC,54600,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1855.02,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1910.67,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1855.02,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1855.02,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1374.09,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1892.12,100,,,,,0,"fee schedule",EAPG,2411.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1855.02,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1855.02,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1374.09,2411.53,
N/A,45055100,CDM,450,RC,55100,CPT,OUTPATIENT,,,4416,2870.4,,3886.08,88,,3108.86,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1855.02,100,,,,,0,"fee schedule",EAPG,4416,100,,3532.80,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1910.67,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2782.08,63,,2225.66,,,0,"percent of total billed charges","63% of total billed charges",675.65,15.3,,540.52,,,0,"percent of total billed charges","15.3% of total billed charges",1855.02,100,,,,,0,"fee schedule",EAPG,3047.04,69,,,,,0,"fee schedule","69% of total billed charges",4416,100,,3532.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4416,100,,3532.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4416,100,,3532.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1855.02,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1374.09,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1892.12,100,,,,,0,"fee schedule",EAPG,2411.53,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1664.83,37.7,,1331.86,,,0,"percent of total billed charges","37.7% of total billed charges",1664.83,37.7,,1331.86,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1497.02,33.9,,1197.62,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3444.48,78,,2755.58,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3647.62,82.6,,2918.10,,,0,"percent of total billed charges","82.6% of total billed charges",1855.02,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3647.62,82.6,,2918.10,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1855.02,100,,,,,0,"fee schedule",EAPG,4416,100,,3532.80,,,0,"percent of total billed charges","100% of total billed charges",675.65,5715.97,
"ID PERINEAL ABSCESS",45056405,CDM,450,RC,56405,CPT,OUTPATIENT,,,1097,713.05,,965.36,88,,772.29,,,0,"percent of total billed charges","88% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.73,100,,,,,0,"fee schedule",EAPG,1097,100,,877.60,,,0,"percent of total billed charges","100% of total billed charges",572.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",183.06,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",691.11,63,,552.89,,,0,"percent of total billed charges","63% of total billed charges",167.84,15.3,,134.27,,,0,"percent of total billed charges","15.3% of total billed charges",177.73,100,,,,,0,"fee schedule",EAPG,756.93,69,,,,,0,"fee schedule","69% of total billed charges",1097,100,,877.60,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1097,100,,877.60,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1097,100,,877.60,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",1143.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.73,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",131.65,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",181.28,100,,,,,0,"fee schedule",EAPG,231.05,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",413.57,37.7,,330.86,,,0,"percent of total billed charges","37.7% of total billed charges",413.57,37.7,,330.86,,,0,"percent of total billed charges","37.70% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",371.88,33.9,,297.50,,,0,"percent of total billed charges","33.9% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",855.66,78,,684.53,,,0,"percent of total billed charges","78% of total billed charges",330.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",906.12,82.6,,724.90,,,0,"percent of total billed charges","82.6% of total billed charges",177.73,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",906.12,82.6,,724.90,,,0,"percent of total billed charges","82.6% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.73,100,,,,,0,"fee schedule",EAPG,1097,100,,877.60,,,0,"percent of total billed charges","100% of total billed charges",131.65,1143.51,
"ID ABCESS BARTHOLIN GLAND",45056420,CDM,450,RC,56420,CPT,OUTPATIENT,,,947,615.55,,833.36,88,,666.69,,,0,"percent of total billed charges","88% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.73,100,,,,,0,"fee schedule",EAPG,947,100,,757.60,,,0,"percent of total billed charges","100% of total billed charges",355.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",183.06,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",596.61,63,,477.29,,,0,"percent of total billed charges","63% of total billed charges",144.89,15.3,,115.91,,,0,"percent of total billed charges","15.3% of total billed charges",177.73,100,,,,,0,"fee schedule",EAPG,653.43,69,,,,,0,"fee schedule","69% of total billed charges",947,100,,757.60,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",947,100,,757.60,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",947,100,,757.60,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",691.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.73,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",131.65,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",181.28,100,,,,,0,"fee schedule",EAPG,231.05,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",357.02,37.7,,285.62,,,0,"percent of total billed charges","37.7% of total billed charges",357.02,37.7,,285.62,,,0,"percent of total billed charges","37.70% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",321.03,33.9,,256.82,,,0,"percent of total billed charges","33.9% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",738.66,78,,590.93,,,0,"percent of total billed charges","78% of total billed charges",205.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",782.22,82.6,,625.78,,,0,"percent of total billed charges","82.6% of total billed charges",177.73,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",782.22,82.6,,625.78,,,0,"percent of total billed charges","82.6% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.73,100,,,,,0,"fee schedule",EAPG,947,100,,757.60,,,0,"percent of total billed charges","100% of total billed charges",131.65,947,
"ID VAG HEMATOMA:OB/POSTPARTUM",45057022,CDM,450,RC,57022,CPT,OUTPATIENT,,,1082,703.3,,952.16,88,,761.73,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1708.92,100,,,,,0,"fee schedule",EAPG,1082,100,,865.60,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1760.19,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",681.66,63,,545.33,,,0,"percent of total billed charges","63% of total billed charges",165.55,15.3,,132.44,,,0,"percent of total billed charges","15.3% of total billed charges",1708.92,100,,,,,0,"fee schedule",EAPG,746.58,69,,,,,0,"fee schedule","69% of total billed charges",1082,100,,865.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1082,100,,865.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1082,100,,865.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1708.92,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1265.87,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1743.1,100,,,,,0,"fee schedule",EAPG,2221.6,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",407.91,37.7,,326.33,,,0,"percent of total billed charges","37.7% of total billed charges",407.91,37.7,,326.33,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",366.8,33.9,,293.44,,,0,"percent of total billed charges","33.9% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",843.96,78,,675.17,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",893.73,82.6,,714.98,,,0,"percent of total billed charges","82.6% of total billed charges",1708.92,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",893.73,82.6,,714.98,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1708.92,100,,,,,0,"fee schedule",EAPG,1082,100,,865.60,,,0,"percent of total billed charges","100% of total billed charges",165.55,9628.23,
"VAGINAL DELIVERY ONLY",45059409,CDM,450,RC,59409,CPT,OUTPATIENT,,,4701,3055.65,,4136.88,88,,3309.50,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.83,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",2014.51,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2961.63,63,,2369.30,,,0,"percent of total billed charges","63% of total billed charges",719.25,15.3,,575.40,,,0,"percent of total billed charges","15.3% of total billed charges",1955.83,100,,,,,0,"fee schedule",EAPG,3243.69,69,,,,,0,"fee schedule","69% of total billed charges",4701,100,,3760.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4701,100,,3760.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4701,100,,3760.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.83,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1448.76,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1994.95,100,,,,,0,"fee schedule",EAPG,2542.58,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1772.28,37.7,,1417.82,,,0,"percent of total billed charges","37.7% of total billed charges",1772.28,37.7,,1417.82,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593.64,33.9,,1274.91,,,0,"percent of total billed charges","33.9% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3666.78,78,,2933.42,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3883.03,82.6,,3106.42,,,0,"percent of total billed charges","82.6% of total billed charges",1955.83,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3883.03,82.6,,3106.42,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.83,100,,,,,0,"fee schedule",EAPG,4701,100,,3760.80,,,0,"percent of total billed charges","100% of total billed charges",719.25,10656.86,
"59410 Vaginal Delivery TechFee",45059410,CDM,450,RC,59410,CPT,OUTPATIENT,,,4812,3127.8,,4234.56,88,,3387.65,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",1955.83,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2014.51,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3031.56,63,,2425.25,,,0,"percent of total billed charges","63% of total billed charges",736.24,15.3,,588.99,,,0,"percent of total billed charges","15.3% of total billed charges",1955.83,100,,,,,0,"fee schedule",EAPG,3320.28,69,,,,,0,"fee schedule","69% of total billed charges",4812,100,,3849.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4812,100,,3849.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4812,100,,3849.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1955.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1448.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1994.95,100,,,,,0,"fee schedule",EAPG,2542.58,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1814.12,37.7,,1451.30,,,0,"percent of total billed charges","37.7% of total billed charges",1814.12,37.7,,1451.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1631.27,33.9,,1305.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3753.36,78,,3002.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3974.71,82.6,,3179.77,,,0,"percent of total billed charges","82.6% of total billed charges",1955.83,100,,,,,0,"fee schedule","100% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",3974.71,82.6,,3179.77,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1955.83,100,,,,,0,"fee schedule",EAPG,4812,100,,3849.60,,,0,"percent of total billed charges","100% of total billed charges",736.24,4812,
"TREATMENT OF MISCARRIAGE",45059812,CDM,450,RC,59812,CPT,OUTPATIENT,,,2013,1308.45,,1771.44,88,,1417.15,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1591.42,100,,,,,0,"fee schedule",EAPG,2013,100,,1610.40,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",1639.16,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1268.19,63,,1014.55,,,0,"percent of total billed charges","63% of total billed charges",307.99,15.3,,246.39,,,0,"percent of total billed charges","15.3% of total billed charges",1591.42,100,,,,,0,"fee schedule",EAPG,1388.97,69,,,,,0,"fee schedule","69% of total billed charges",2013,100,,1610.40,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2013,100,,1610.40,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2013,100,,1610.40,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1591.42,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1178.83,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1623.25,100,,,,,0,"fee schedule",EAPG,2068.84,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",758.9,37.7,,607.12,,,0,"percent of total billed charges","37.7% of total billed charges",758.9,37.7,,607.12,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",682.41,33.9,,545.93,,,0,"percent of total billed charges","33.9% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1570.14,78,,1256.11,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1662.74,82.6,,1330.19,,,0,"percent of total billed charges","82.6% of total billed charges",1591.42,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1662.74,82.6,,1330.19,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1591.42,100,,,,,0,"fee schedule",EAPG,2013,100,,1610.40,,,0,"percent of total billed charges","100% of total billed charges",307.99,10656.86,
"LUMBAR PUNCTURE",45062270,CDM,450,RC,62270,CPT,OUTPATIENT,,,1808,1175.2,,1591.04,88,,1272.83,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1808,100,,1446.40,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1139.04,63,,911.23,,,0,"percent of total billed charges","63% of total billed charges",276.62,15.3,,221.30,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,1247.52,69,,,,,0,"fee schedule","69% of total billed charges",1808,100,,1446.40,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1808,100,,1446.40,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1808,100,,1446.40,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",570.86,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",681.62,37.7,,545.30,,,0,"percent of total billed charges","37.7% of total billed charges",681.62,37.7,,545.30,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",612.91,33.9,,490.33,,,0,"percent of total billed charges","33.9% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1410.24,78,,1128.19,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.41,82.6,,1194.73,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.41,82.6,,1194.73,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1808,100,,1446.40,,,0,"percent of total billed charges","100% of total billed charges",276.62,2578.03,
"POST EPIDURAL BLOOD PATCH",45062273,CDM,450,RC,62273,CPT,OUTPATIENT,,,1355,880.75,,1192.4,88,,953.92,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1355,100,,1084.00,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",853.65,63,,682.92,,,0,"percent of total billed charges","63% of total billed charges",207.32,15.3,,165.86,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,934.95,69,,,,,0,"fee schedule","69% of total billed charges",1355,100,,1084.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1355,100,,1084.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1355,100,,1084.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",570.86,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510.84,37.7,,408.67,,,0,"percent of total billed charges","37.7% of total billed charges",510.84,37.7,,408.67,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",459.35,33.9,,367.48,,,0,"percent of total billed charges","33.9% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056.9,78,,845.52,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1119.23,82.6,,895.38,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1119.23,82.6,,895.38,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1355,100,,1084.00,,,0,"percent of total billed charges","100% of total billed charges",207.32,2578.03,
"DIGITAL NERVE BLOCK",45064400,CDM,450,RC,64400,CPT,OUTPATIENT,,,1579,1026.35,,1389.52,88,,1111.62,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,1579,100,,1263.20,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",994.77,63,,795.82,,,0,"percent of total billed charges","63% of total billed charges",241.59,15.3,,193.27,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,1089.51,69,,,,,0,"fee schedule","69% of total billed charges",1579,100,,1263.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1579,100,,1263.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1579,100,,1263.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.52,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",595.28,37.7,,476.22,,,0,"percent of total billed charges","37.7% of total billed charges",595.28,37.7,,476.22,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",535.28,33.9,,428.22,,,0,"percent of total billed charges","33.9% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1231.62,78,,985.30,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1304.25,82.6,,1043.40,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1304.25,82.6,,1043.40,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,1579,100,,1263.20,,,0,"percent of total billed charges","100% of total billed charges",241.59,1579,
"NERVE BLOCK, GR OCCIPITAL",45064405,CDM,450,RC,64405,CPT,OUTPATIENT,,,591,384.15,,520.08,88,,416.06,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",372.33,63,,297.86,,,0,"percent of total billed charges","63% of total billed charges",90.42,15.3,,72.34,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,407.79,69,,,,,0,"fee schedule","69% of total billed charges",591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.52,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",222.81,37.7,,178.25,,,0,"percent of total billed charges","37.7% of total billed charges",222.81,37.7,,178.25,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200.35,33.9,,160.28,,,0,"percent of total billed charges","33.9% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460.98,78,,368.78,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",488.17,82.6,,390.54,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",488.17,82.6,,390.54,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",90.42,1061,
"NERVE BLOCK, BRACHIAL PLEXUS",45064415,CDM,450,RC,64415,CPT,OUTPATIENT,,,600,390,,528,88,,422.40,,,0,"percent of total billed charges","88% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,600,100,,480.00,,,0,"percent of total billed charges","100% of total billed charges",1626.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",1076.46,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",378,63,,302.40,,,0,"percent of total billed charges","63% of total billed charges",91.8,15.3,,73.44,,,0,"percent of total billed charges","15.3% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,414,69,,,,,0,"fee schedule","69% of total billed charges",600,100,,480.00,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",600,100,,480.00,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",600,100,,480.00,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3341.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",774.15,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1066.01,100,,,,,0,"fee schedule",EAPG,1358.64,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",226.2,37.7,,180.96,,,0,"percent of total billed charges","37.7% of total billed charges",226.2,37.7,,180.96,,,0,"percent of total billed charges","37.70% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",203.4,33.9,,162.72,,,0,"percent of total billed charges","33.9% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",468,78,,374.40,,,0,"percent of total billed charges","78% of total billed charges",938.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",495.6,82.6,,396.48,,,0,"percent of total billed charges","82.6% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",495.6,82.6,,396.48,,,0,"percent of total billed charges","82.6% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,600,100,,480.00,,,0,"percent of total billed charges","100% of total billed charges",91.8,3341.26,
"PERIPHERAL NERVE BLOCK",45064450,CDM,450,RC,64450,CPT,OUTPATIENT,,,600,390,,528,88,,422.40,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,600,100,,480.00,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",378,63,,302.40,,,0,"percent of total billed charges","63% of total billed charges",91.8,15.3,,73.44,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,414,69,,,,,0,"fee schedule","69% of total billed charges",600,100,,480.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",600,100,,480.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",600,100,,480.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.52,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",226.2,37.7,,180.96,,,0,"percent of total billed charges","37.7% of total billed charges",226.2,37.7,,180.96,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",203.4,33.9,,162.72,,,0,"percent of total billed charges","33.9% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",468,78,,374.40,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",495.6,82.6,,396.48,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",495.6,82.6,,396.48,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,600,100,,480.00,,,0,"percent of total billed charges","100% of total billed charges",91.8,2578.03,
"64505 - Inj -Sphenopalatine Ganglion",45064505,CDM,450,RC,64505,CPT,OUTPATIENT,,,1066,692.9,,938.08,88,,750.46,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,1066,100,,852.80,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671.58,63,,537.26,,,0,"percent of total billed charges","63% of total billed charges",163.1,15.3,,130.48,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,735.54,69,,,,,0,"fee schedule","69% of total billed charges",1066,100,,852.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1066,100,,852.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1066,100,,852.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.52,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.88,37.7,,321.50,,,0,"percent of total billed charges","37.7% of total billed charges",401.88,37.7,,321.50,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",361.37,33.9,,289.10,,,0,"percent of total billed charges","33.9% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",831.48,78,,665.18,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",880.52,82.6,,704.42,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",880.52,82.6,,704.42,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,1066,100,,852.80,,,0,"percent of total billed charges","100% of total billed charges",163.1,1066,
"REMOVAL FB CONJUNCTIVAL SIMPLE",45065205,CDM,450,RC,65205,CPT,OUTPATIENT,,,506,328.9,,445.28,88,,356.22,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.54,100,,,,,0,"fee schedule",EAPG,506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",67.51,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",318.78,63,,255.02,,,0,"percent of total billed charges","63% of total billed charges",77.42,15.3,,61.94,,,0,"percent of total billed charges","15.3% of total billed charges",65.54,100,,,,,0,"fee schedule",EAPG,349.14,69,,,,,0,"fee schedule","69% of total billed charges",506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.54,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",48.55,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.85,100,,,,,0,"fee schedule",EAPG,85.21,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.76,37.7,,152.61,,,0,"percent of total billed charges","37.7% of total billed charges",190.76,37.7,,152.61,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.53,33.9,,137.22,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394.68,78,,315.74,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",417.96,82.6,,334.37,,,0,"percent of total billed charges","82.6% of total billed charges",65.54,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",417.96,82.6,,334.37,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.54,100,,,,,0,"fee schedule",EAPG,506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",48.55,506,
"REM FB CONJUNCTIVAL EMBEDDED",45065210,CDM,450,RC,65210,CPT,OUTPATIENT,,,506,328.9,,445.28,88,,356.22,,,0,"percent of total billed charges","88% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.54,100,,,,,0,"fee schedule",EAPG,506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",711.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",67.51,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",318.78,63,,255.02,,,0,"percent of total billed charges","63% of total billed charges",77.42,15.3,,61.94,,,0,"percent of total billed charges","15.3% of total billed charges",65.54,100,,,,,0,"fee schedule",EAPG,349.14,69,,,,,0,"fee schedule","69% of total billed charges",506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",1097.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.54,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287,100,,,,,0,"fee schedule","100% of CMS OPPS rate",48.55,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.85,100,,,,,0,"fee schedule",EAPG,85.21,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.76,37.7,,152.61,,,0,"percent of total billed charges","37.7% of total billed charges",190.76,37.7,,152.61,,,0,"percent of total billed charges","37.70% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.53,33.9,,137.22,,,0,"percent of total billed charges","33.9% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394.68,78,,315.74,,,0,"percent of total billed charges","78% of total billed charges",410.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",417.96,82.6,,334.37,,,0,"percent of total billed charges","82.6% of total billed charges",65.54,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",417.96,82.6,,334.37,,,0,"percent of total billed charges","82.6% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.54,100,,,,,0,"fee schedule",EAPG,506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",48.55,1097.77,
"REM FB CORNEAL W/O SLIT LAMP",45065220,CDM,450,RC,65220,CPT,OUTPATIENT,,,506,328.9,,445.28,88,,356.22,,,0,"percent of total billed charges","88% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.54,100,,,,,0,"fee schedule",EAPG,506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",711.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",67.51,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",318.78,63,,255.02,,,0,"percent of total billed charges","63% of total billed charges",77.42,15.3,,61.94,,,0,"percent of total billed charges","15.3% of total billed charges",65.54,100,,,,,0,"fee schedule",EAPG,349.14,69,,,,,0,"fee schedule","69% of total billed charges",506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",1097.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.54,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287,100,,,,,0,"fee schedule","100% of CMS OPPS rate",48.55,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.85,100,,,,,0,"fee schedule",EAPG,85.21,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.76,37.7,,152.61,,,0,"percent of total billed charges","37.7% of total billed charges",190.76,37.7,,152.61,,,0,"percent of total billed charges","37.70% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.53,33.9,,137.22,,,0,"percent of total billed charges","33.9% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394.68,78,,315.74,,,0,"percent of total billed charges","78% of total billed charges",410.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",417.96,82.6,,334.37,,,0,"percent of total billed charges","82.6% of total billed charges",65.54,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",417.96,82.6,,334.37,,,0,"percent of total billed charges","82.6% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.54,100,,,,,0,"fee schedule",EAPG,506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",48.55,1097.77,
"REM FB CORNEAL W/LAMP",45065222,CDM,450,RC,65222,CPT,OUTPATIENT,,,506,328.9,,445.28,88,,356.22,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.54,100,,,,,0,"fee schedule",EAPG,506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",67.51,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",318.78,63,,255.02,,,0,"percent of total billed charges","63% of total billed charges",77.42,15.3,,61.94,,,0,"percent of total billed charges","15.3% of total billed charges",65.54,100,,,,,0,"fee schedule",EAPG,349.14,69,,,,,0,"fee schedule","69% of total billed charges",506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.54,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",48.55,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.85,100,,,,,0,"fee schedule",EAPG,85.21,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.76,37.7,,152.61,,,0,"percent of total billed charges","37.7% of total billed charges",190.76,37.7,,152.61,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.53,33.9,,137.22,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394.68,78,,315.74,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",417.96,82.6,,334.37,,,0,"percent of total billed charges","82.6% of total billed charges",65.54,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",417.96,82.6,,334.37,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.54,100,,,,,0,"fee schedule",EAPG,506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",48.55,506,
"REMOVAL FB,CORNEAL,CURETTAGE",45065435,CDM,450,RC,65435,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",478.12,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",492.47,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",478.12,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",478.12,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",354.16,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",487.69,100,,,,,0,"fee schedule",EAPG,621.56,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",478.12,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",478.12,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",354.16,621.56,
"ID STY/EYELID",45067700,CDM,450,RC,67700,CPT,OUTPATIENT,,,847,550.55,,745.36,88,,596.29,,,0,"percent of total billed charges","88% of total billed charges",297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.94,100,,,,,0,"fee schedule",EAPG,847,100,,677.60,,,0,"percent of total billed charges","100% of total billed charges",519.97,175,,,,,0,"fee schedule","175% of CMS fee schedule",292.46,100,,,,,0,"fee schedule",EAPG,297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",533.61,63,,426.89,,,0,"percent of total billed charges","63% of total billed charges",129.59,15.3,,103.67,,,0,"percent of total billed charges","15.3% of total billed charges",283.94,100,,,,,0,"fee schedule",EAPG,584.43,69,,,,,0,"fee schedule","69% of total billed charges",847,100,,677.60,,,0,"percent of total billed charges","100% of total billed charges",297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",847,100,,677.60,,,0,"percent of total billed charges","100% of total billed charges",297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",847,100,,677.60,,,0,"percent of total billed charges","100% of total billed charges",297.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.94,100,,,,,0,"fee schedule",EAPG,297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.32,100,,,,,0,"fee schedule",EAPG,297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.62,100,,,,,0,"fee schedule",EAPG,369.12,100,,,,,0,"fee schedule",EAPG,297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",319.32,37.7,,255.46,,,0,"percent of total billed charges","37.7% of total billed charges",319.32,37.7,,255.46,,,0,"percent of total billed charges","37.70% of total billed charges",297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287.13,33.9,,229.70,,,0,"percent of total billed charges","33.9% of total billed charges",297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.66,78,,528.53,,,0,"percent of total billed charges","78% of total billed charges",300.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",699.62,82.6,,559.70,,,0,"percent of total billed charges","82.6% of total billed charges",283.94,100,,,,,0,"fee schedule",EAPG,297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",699.62,82.6,,559.70,,,0,"percent of total billed charges","82.6% of total billed charges",297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.94,100,,,,,0,"fee schedule",EAPG,847,100,,677.60,,,0,"percent of total billed charges","100% of total billed charges",129.59,1061.45,
"Canthotomy (separate procedure)",45067715,CDM,450,RC,67715,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1208.03,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1244.27,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1208.03,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1208.03,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",894.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1232.19,100,,,,,0,"fee schedule",EAPG,1570.44,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1208.03,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1208.03,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",894.84,1570.44,
"REMOVAL OF EMBEDDED FB, EYELID",45067938,CDM,450,RC,67938,CPT,OUTPATIENT,,,950,617.5,,836,88,,668.80,,,0,"percent of total billed charges","88% of total billed charges",297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.94,100,,,,,0,"fee schedule",EAPG,950,100,,760.00,,,0,"percent of total billed charges","100% of total billed charges",519.97,175,,,,,0,"fee schedule","175% of CMS fee schedule",292.46,100,,,,,0,"fee schedule",EAPG,297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",598.5,63,,478.80,,,0,"percent of total billed charges","63% of total billed charges",145.35,15.3,,116.28,,,0,"percent of total billed charges","15.3% of total billed charges",283.94,100,,,,,0,"fee schedule",EAPG,655.5,69,,,,,0,"fee schedule","69% of total billed charges",950,100,,760.00,,,0,"percent of total billed charges","100% of total billed charges",297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",950,100,,760.00,,,0,"percent of total billed charges","100% of total billed charges",297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",950,100,,760.00,,,0,"percent of total billed charges","100% of total billed charges",297.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.94,100,,,,,0,"fee schedule",EAPG,297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.32,100,,,,,0,"fee schedule",EAPG,297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.62,100,,,,,0,"fee schedule",EAPG,369.12,100,,,,,0,"fee schedule",EAPG,297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",358.15,37.7,,286.52,,,0,"percent of total billed charges","37.7% of total billed charges",358.15,37.7,,286.52,,,0,"percent of total billed charges","37.70% of total billed charges",297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",322.05,33.9,,257.64,,,0,"percent of total billed charges","33.9% of total billed charges",297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",741,78,,592.80,,,0,"percent of total billed charges","78% of total billed charges",300.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",784.7,82.6,,627.76,,,0,"percent of total billed charges","82.6% of total billed charges",283.94,100,,,,,0,"fee schedule",EAPG,297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",784.7,82.6,,627.76,,,0,"percent of total billed charges","82.6% of total billed charges",297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.94,100,,,,,0,"fee schedule",EAPG,950,100,,760.00,,,0,"percent of total billed charges","100% of total billed charges",145.35,1061.45,
"DRAIN EXT EAR ABSCESS/HEMATOMA",45069000,CDM,450,RC,69000,CPT,OUTPATIENT,,,506,328.9,,445.28,88,,356.22,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",318.78,63,,255.02,,,0,"percent of total billed charges","63% of total billed charges",77.42,15.3,,61.94,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,349.14,69,,,,,0,"fee schedule","69% of total billed charges",506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.15,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.76,37.7,,152.61,,,0,"percent of total billed charges","37.7% of total billed charges",190.76,37.7,,152.61,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.53,33.9,,137.22,,,0,"percent of total billed charges","33.9% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394.68,78,,315.74,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",417.96,82.6,,334.37,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",417.96,82.6,,334.37,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",74.15,2526.76,
"DRAIN EXT AUDITORY CANAL ABCES",45069020,CDM,450,RC,69020,CPT,OUTPATIENT,,,936,608.4,,823.68,88,,658.94,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,936,100,,748.80,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",589.68,63,,471.74,,,0,"percent of total billed charges","63% of total billed charges",143.21,15.3,,114.57,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,645.84,69,,,,,0,"fee schedule","69% of total billed charges",936,100,,748.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",936,100,,748.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",936,100,,748.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.15,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352.87,37.7,,282.30,,,0,"percent of total billed charges","37.7% of total billed charges",352.87,37.7,,282.30,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",317.3,33.9,,253.84,,,0,"percent of total billed charges","33.9% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",730.08,78,,584.06,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",773.14,82.6,,618.51,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",773.14,82.6,,618.51,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,936,100,,748.80,,,0,"percent of total billed charges","100% of total billed charges",74.15,2526.76,
"REM FB EXT AUDITORY CANAL",45069200,CDM,450,RC,69200,CPT,OUTPATIENT,,,388,252.2,,341.44,88,,273.15,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.18,16.8,,52.14,,,0,"percent of total billed charges","16.8% of total billed charges",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",67.14,17.304,,53.71,,,0,"percent of total billed charges","17.304% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.44,63,,195.55,,,0,"percent of total billed charges","63% of total billed charges",59.36,15.3,,47.49,,,0,"percent of total billed charges","15.3% of total billed charges",65.18,16.8,,52.14,,,0,"percent of total billed charges","16.8% of total billed charges",267.72,69,,,,,0,"fee schedule","69% of total billed charges",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.18,16.8,,52.14,,,0,"percent of total billed charges","16.8% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.18,16.8,,52.14,,,0,"percent of total billed charges","16.8% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.49,17.136,,53.19,,,0,"percent of total billed charges","17.136% of total billed charges",84.74,21.84,,67.79,,,0,"percent of total billed charges","21.84% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",146.28,37.7,,117.02,,,0,"percent of total billed charges","37.7% of total billed charges",146.28,37.7,,117.02,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",131.53,33.9,,105.22,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302.64,78,,242.11,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320.49,82.6,,256.39,,,0,"percent of total billed charges","82.6% of total billed charges",65.18,16.8,,52.14,,,0,"percent of total billed charges","16.8% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320.49,82.6,,256.39,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.18,16.8,,52.14,,,0,"percent of total billed charges","16.8% of total billed charges",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",59.36,454.8,
"REMOVE IMPACTED EAR WAX",45069209,CDM,450,RC,69209,CPT,OUTPATIENT,,,83,53.95,,73.04,88,,58.43,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13.94,16.8,,11.15,,,0,"percent of total billed charges","16.8% of total billed charges",83,100,,66.40,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",14.36,17.304,,11.49,,,0,"percent of total billed charges","17.304% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.29,63,,41.83,,,0,"percent of total billed charges","63% of total billed charges",12.7,15.3,,10.16,,,0,"percent of total billed charges","15.3% of total billed charges",13.94,16.8,,11.15,,,0,"percent of total billed charges","16.8% of total billed charges",57.27,69,,,,,0,"fee schedule","69% of total billed charges",83,100,,66.40,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",83,100,,66.40,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",83,100,,66.40,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13.94,16.8,,11.15,,,0,"percent of total billed charges","16.8% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13.94,16.8,,11.15,,,0,"percent of total billed charges","16.8% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14.22,17.136,,11.38,,,0,"percent of total billed charges","17.136% of total billed charges",18.13,21.84,,14.50,,,0,"percent of total billed charges","21.84% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.29,37.7,,25.03,,,0,"percent of total billed charges","37.7% of total billed charges",31.29,37.7,,25.03,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",28.14,33.9,,22.51,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.74,78,,51.79,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",68.56,82.6,,54.85,,,0,"percent of total billed charges","82.6% of total billed charges",13.94,16.8,,11.15,,,0,"percent of total billed charges","16.8% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",68.56,82.6,,54.85,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13.94,16.8,,11.15,,,0,"percent of total billed charges","16.8% of total billed charges",83,100,,66.40,,,0,"percent of total billed charges","100% of total billed charges",12.7,226.12,
"Clear Outer Ear Canal Tech",45069205,CDM,450,RC,69205,CPT,OUTPATIENT,,,6023,3914.95,,5300.24,88,,4240.19,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3794.49,63,,3035.59,,,0,"percent of total billed charges","63% of total billed charges",921.52,15.3,,737.22,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,4155.87,69,,,,,0,"fee schedule","69% of total billed charges",6023,100,,4818.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6023,100,,4818.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6023,100,,4818.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",613.12,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2270.67,37.7,,1816.54,,,0,"percent of total billed charges","37.7% of total billed charges",2270.67,37.7,,1816.54,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2041.8,33.9,,1633.44,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4697.94,78,,3758.35,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4975,82.6,,3980.00,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4975,82.6,,3980.00,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,6023,100,,4818.40,,,0,"percent of total billed charges","100% of total billed charges",613.12,6023,
"CERUMEN REMOVAL",45069210,CDM,450,RC,69210,CPT,OUTPATIENT,,,296,192.4,,260.48,88,,208.38,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",49.73,16.8,,39.78,,,0,"percent of total billed charges","16.8% of total billed charges",296,100,,236.80,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",51.22,17.304,,40.98,,,0,"percent of total billed charges","17.304% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",186.48,63,,149.18,,,0,"percent of total billed charges","63% of total billed charges",45.29,15.3,,36.23,,,0,"percent of total billed charges","15.3% of total billed charges",49.73,16.8,,39.78,,,0,"percent of total billed charges","16.8% of total billed charges",204.24,69,,,,,0,"fee schedule","69% of total billed charges",296,100,,236.80,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296,100,,236.80,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296,100,,236.80,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",49.73,16.8,,39.78,,,0,"percent of total billed charges","16.8% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",49.73,16.8,,39.78,,,0,"percent of total billed charges","16.8% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",50.72,17.136,,40.58,,,0,"percent of total billed charges","17.136% of total billed charges",64.65,21.84,,51.72,,,0,"percent of total billed charges","21.84% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.59,37.7,,89.27,,,0,"percent of total billed charges","37.7% of total billed charges",111.59,37.7,,89.27,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.34,33.9,,80.27,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",230.88,78,,184.70,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.5,82.6,,195.60,,,0,"percent of total billed charges","82.6% of total billed charges",49.73,16.8,,39.78,,,0,"percent of total billed charges","16.8% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.5,82.6,,195.60,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",49.73,16.8,,39.78,,,0,"percent of total billed charges","16.8% of total billed charges",296,100,,236.80,,,0,"percent of total billed charges","100% of total billed charges",45.29,296,
"PPD SKIN TEST",45086580,CDM,450,RC,86580,CPT,OUTPATIENT,,,157,102.05,,138.16,88,,110.53,,,0,"percent of total billed charges","88% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9.39,100,,,,,0,"fee schedule",EAPG,157,100,,125.60,,,0,"percent of total billed charges","100% of total billed charges",53.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",98.91,63,,79.13,,,0,"percent of total billed charges","63% of total billed charges",24.02,15.3,,19.22,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,108.33,69,,,,,0,"fee schedule","69% of total billed charges",157,100,,125.60,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",157,100,,125.60,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",157,100,,125.60,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.22,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9.39,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6.96,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.19,37.7,,47.35,,,0,"percent of total billed charges","37.7% of total billed charges",59.19,37.7,,47.35,,,0,"percent of total billed charges","37.70% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",53.22,33.9,,42.58,,,0,"percent of total billed charges","33.9% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.46,78,,97.97,,,0,"percent of total billed charges","78% of total billed charges",30.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",129.68,82.6,,103.74,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",129.68,82.6,,103.74,,,0,"percent of total billed charges","82.6% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9.39,100,,,,,0,"fee schedule",EAPG,157,100,,125.60,,,0,"percent of total billed charges","100% of total billed charges",6.96,157,
"IMMUNIZATION ADMINISTRATION",45090471,CDM,450,RC,90471,CPT,OUTPATIENT,,,372,241.8,,327.36,88,,261.89,,,0,"percent of total billed charges","88% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,372,100,,297.60,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.67,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.36,63,,187.49,,,0,"percent of total billed charges","63% of total billed charges",56.92,15.3,,45.54,,,0,"percent of total billed charges","15.3% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,256.68,69,,,,,0,"fee schedule","69% of total billed charges",372,100,,297.60,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",372,100,,297.60,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",372,100,,297.60,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",25.65,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.33,100,,,,,0,"fee schedule",EAPG,45.03,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",140.24,37.7,,112.19,,,0,"percent of total billed charges","37.7% of total billed charges",140.24,37.7,,112.19,,,0,"percent of total billed charges","37.70% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",126.11,33.9,,100.89,,,0,"percent of total billed charges","33.9% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.16,78,,232.13,,,0,"percent of total billed charges","78% of total billed charges",72.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.27,82.6,,245.82,,,0,"percent of total billed charges","82.6% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.27,82.6,,245.82,,,0,"percent of total billed charges","82.6% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,372,100,,297.60,,,0,"percent of total billed charges","100% of total billed charges",25.65,372,
"VACCINE (ADDITIONAL)",45090472,CDM,450,RC,90472,CPT,OUTPATIENT,,,444,288.6,,390.72,88,,312.58,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.64,100,,,,,0,"fee schedule",EAPG,444,100,,355.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.67,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",279.72,63,,223.78,,,0,"percent of total billed charges","63% of total billed charges",67.93,15.3,,54.34,,,0,"percent of total billed charges","15.3% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,306.36,69,,,,,0,"fee schedule","69% of total billed charges",444,100,,355.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",444,100,,355.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",444,100,,355.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.64,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25.65,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",35.33,100,,,,,0,"fee schedule",EAPG,45.03,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",167.39,37.7,,133.91,,,0,"percent of total billed charges","37.7% of total billed charges",167.39,37.7,,133.91,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",150.52,33.9,,120.42,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",346.32,78,,277.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",366.74,82.6,,293.39,,,0,"percent of total billed charges","82.6% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",366.74,82.6,,293.39,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.64,100,,,,,0,"fee schedule",EAPG,444,100,,355.20,,,0,"percent of total billed charges","100% of total billed charges",25.65,444,
"ADMIN IMMUN VACCINE ORAL/NASAL",45090473,CDM,450,RC,90473,CPT,OUTPATIENT,,,161,104.65,,141.68,88,,113.34,,,0,"percent of total billed charges","88% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,161,100,,128.80,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.67,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.43,63,,81.14,,,0,"percent of total billed charges","63% of total billed charges",24.63,15.3,,19.70,,,0,"percent of total billed charges","15.3% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,111.09,69,,,,,0,"fee schedule","69% of total billed charges",161,100,,128.80,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",161,100,,128.80,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",161,100,,128.80,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",25.65,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.33,100,,,,,0,"fee schedule",EAPG,45.03,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60.7,37.7,,48.56,,,0,"percent of total billed charges","37.7% of total billed charges",60.7,37.7,,48.56,,,0,"percent of total billed charges","37.70% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",54.58,33.9,,43.66,,,0,"percent of total billed charges","33.9% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.58,78,,100.46,,,0,"percent of total billed charges","78% of total billed charges",72.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.99,82.6,,106.39,,,0,"percent of total billed charges","82.6% of total billed charges",34.64,100,,,,,0,"fee schedule","100% of WA fee schedule",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.99,82.6,,106.39,,,0,"percent of total billed charges","82.6% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,161,100,,128.80,,,0,"percent of total billed charges","100% of total billed charges",24.63,251.75,
CPR,45092950,CDM,450,RC,92950,CPT,OUTPATIENT,,,1155,750.75,,1016.4,88,,813.12,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818.62,100,,,,,0,"fee schedule",EAPG,1155,100,,924.00,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",843.18,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",727.65,63,,582.12,,,0,"percent of total billed charges","63% of total billed charges",176.72,15.3,,141.38,,,0,"percent of total billed charges","15.3% of total billed charges",818.62,100,,,,,0,"fee schedule",EAPG,796.95,69,,,,,0,"fee schedule","69% of total billed charges",1155,100,,924.00,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1155,100,,924.00,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1155,100,,924.00,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818.62,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",606.38,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",834.99,100,,,,,0,"fee schedule",EAPG,1064.21,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",435.44,37.7,,348.35,,,0,"percent of total billed charges","37.7% of total billed charges",435.44,37.7,,348.35,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",391.55,33.9,,313.24,,,0,"percent of total billed charges","33.9% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",900.9,78,,720.72,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",954.03,82.6,,763.22,,,0,"percent of total billed charges","82.6% of total billed charges",818.62,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",954.03,82.6,,763.22,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818.62,100,,,,,0,"fee schedule",EAPG,1155,100,,924.00,,,0,"percent of total billed charges","100% of total billed charges",176.72,1155,
"TRANSCUTANEOUS PACING",45092953,CDM,450,RC,92953,CPT,OUTPATIENT,,,2279,1481.35,,2005.52,88,,1604.42,,,0,"percent of total billed charges","88% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",582.08,100,,,,,0,"fee schedule",EAPG,2279,100,,1823.20,,,0,"percent of total billed charges","100% of total billed charges",1161.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",599.54,100,,,,,0,"fee schedule",EAPG,663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1435.77,63,,1148.62,,,0,"percent of total billed charges","63% of total billed charges",348.69,15.3,,278.95,,,0,"percent of total billed charges","15.3% of total billed charges",582.08,100,,,,,0,"fee schedule",EAPG,1572.51,69,,,,,0,"fee schedule","69% of total billed charges",2279,100,,1823.20,,,0,"percent of total billed charges","100% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2279,100,,1823.20,,,0,"percent of total billed charges","100% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2279,100,,1823.20,,,0,"percent of total billed charges","100% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",2282.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",582.08,100,,,,,0,"fee schedule",EAPG,663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",596.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",431.17,100,,,,,0,"fee schedule",EAPG,663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.72,100,,,,,0,"fee schedule",EAPG,756.7,100,,,,,0,"fee schedule",EAPG,663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.18,37.7,,687.34,,,0,"percent of total billed charges","37.7% of total billed charges",859.18,37.7,,687.34,,,0,"percent of total billed charges","37.70% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",772.58,33.9,,618.06,,,0,"percent of total billed charges","33.9% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1777.62,78,,1422.10,,,0,"percent of total billed charges","78% of total billed charges",670.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1882.45,82.6,,1505.96,,,0,"percent of total billed charges","82.6% of total billed charges",582.08,100,,,,,0,"fee schedule",EAPG,663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1882.45,82.6,,1505.96,,,0,"percent of total billed charges","82.6% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",582.08,100,,,,,0,"fee schedule",EAPG,2279,100,,1823.20,,,0,"percent of total billed charges","100% of total billed charges",348.69,2282.77,
"CARDIOVERSION ELECTIVE EXT",45092960,CDM,450,RC,92960,CPT,OUTPATIENT,,,2625,1706.25,,2310,88,,1848.00,,,0,"percent of total billed charges","88% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",582.08,100,,,,,0,"fee schedule",EAPG,2625,100,,2100.00,,,0,"percent of total billed charges","100% of total billed charges",1161.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",599.54,100,,,,,0,"fee schedule",EAPG,663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1653.75,63,,1323.00,,,0,"percent of total billed charges","63% of total billed charges",401.63,15.3,,321.30,,,0,"percent of total billed charges","15.3% of total billed charges",582.08,100,,,,,0,"fee schedule",EAPG,1811.25,69,,,,,0,"fee schedule","69% of total billed charges",2625,100,,2100.00,,,0,"percent of total billed charges","100% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2625,100,,2100.00,,,0,"percent of total billed charges","100% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2625,100,,2100.00,,,0,"percent of total billed charges","100% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",2282.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",582.08,100,,,,,0,"fee schedule",EAPG,663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",596.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",431.17,100,,,,,0,"fee schedule",EAPG,663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.72,100,,,,,0,"fee schedule",EAPG,756.7,100,,,,,0,"fee schedule",EAPG,663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",989.63,37.7,,791.70,,,0,"percent of total billed charges","37.7% of total billed charges",989.63,37.7,,791.70,,,0,"percent of total billed charges","37.70% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.88,33.9,,711.90,,,0,"percent of total billed charges","33.9% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.5,78,,1638.00,,,0,"percent of total billed charges","78% of total billed charges",670.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2168.25,82.6,,1734.60,,,0,"percent of total billed charges","82.6% of total billed charges",582.08,100,,,,,0,"fee schedule",EAPG,663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2168.25,82.6,,1734.60,,,0,"percent of total billed charges","82.6% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",582.08,100,,,,,0,"fee schedule",EAPG,2625,100,,2100.00,,,0,"percent of total billed charges","100% of total billed charges",401.63,2625,
EKG-ER,93005,CDM,730,RC,93005,CPT,OUTPATIENT,,,575,373.75,,506,88,,404.80,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,575,100,,460.00,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",24.47,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",362.25,63,,289.80,,,0,"percent of total billed charges","63% of total billed charges",87.98,15.3,,70.38,,,0,"percent of total billed charges","15.3% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,396.75,69,,,,,0,"fee schedule","69% of total billed charges",575,100,,460.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",575,100,,460.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",575,100,,460.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17.6,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.23,100,,,,,0,"fee schedule",EAPG,30.89,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.78,37.7,,173.42,,,0,"percent of total billed charges","37.7% of total billed charges",216.78,37.7,,173.42,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",194.93,33.9,,155.94,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",448.5,78,,358.80,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",474.95,82.6,,379.96,,,0,"percent of total billed charges","82.6% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",474.95,82.6,,379.96,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,575,100,,460.00,,,0,"percent of total billed charges","100% of total billed charges",17.6,575,
"RHYTHM STRIP",73093041,CDM,730,RC,93041,CPT,OUTPATIENT,,,264,171.6,,232.32,88,,185.86,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",24.47,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",166.32,63,,133.06,,,0,"percent of total billed charges","63% of total billed charges",40.39,15.3,,32.31,,,0,"percent of total billed charges","15.3% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,182.16,69,,,,,0,"fee schedule","69% of total billed charges",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17.6,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.23,100,,,,,0,"fee schedule",EAPG,30.89,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.53,37.7,,79.62,,,0,"percent of total billed charges","37.7% of total billed charges",99.53,37.7,,79.62,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",89.5,33.9,,71.60,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",205.92,78,,164.74,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.06,82.6,,174.45,,,0,"percent of total billed charges","82.6% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.06,82.6,,174.45,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",17.6,264,
"PULSE OX SINGLE",46094760,CDM,460,RC,94760,CPT,OUTPATIENT,,,174,113.1,,153.12,88,,122.50,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.23,16.8,,23.38,,,0,"percent of total billed charges","16.8% of total billed charges",174,100,,139.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.11,17.304,,24.09,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",109.62,63,,87.70,,,0,"percent of total billed charges","63% of total billed charges",26.62,15.3,,21.30,,,0,"percent of total billed charges","15.3% of total billed charges",29.23,16.8,,23.38,,,0,"percent of total billed charges","16.8% of total billed charges",120.06,69,,,,,0,"fee schedule","69% of total billed charges",174,100,,139.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",174,100,,139.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",174,100,,139.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.23,16.8,,23.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.23,16.8,,23.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.82,17.136,,23.86,,,0,"percent of total billed charges","17.136% of total billed charges",38,21.84,,30.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",65.6,37.7,,52.48,,,0,"percent of total billed charges","37.7% of total billed charges",65.6,37.7,,52.48,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.99,33.9,,47.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",135.72,78,,108.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",143.72,82.6,,114.98,,,0,"percent of total billed charges","82.6% of total billed charges",29.23,16.8,,23.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",143.72,82.6,,114.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.23,16.8,,23.38,,,0,"percent of total billed charges","16.8% of total billed charges",174,100,,139.20,,,0,"percent of total billed charges","100% of total billed charges",26.62,174,
"PULSE OX Multiple TechFee",45094761,CDM,450,RC,94761,CPT,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,17.304,,49.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.86,17.136,,49.49,,,0,"percent of total billed charges","17.136% of total billed charges",78.84,21.84,,63.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.7% of total billed charges",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",122.38,33.9,,97.90,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,361,
"DEBRIDEMENT WOUND, SCISSORS/SCAPEL 20SQTECH",45097597,CDM,450,RC,97597,CPT,OUTPATIENT,,,757,492.05,,666.16,88,,532.93,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,757,100,,605.60,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",476.91,63,,381.53,,,0,"percent of total billed charges","63% of total billed charges",115.82,15.3,,92.66,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,522.33,69,,,,,0,"fee schedule","69% of total billed charges",757,100,,605.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",757,100,,605.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",757,100,,605.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",285.39,37.7,,228.31,,,0,"percent of total billed charges","37.7% of total billed charges",285.39,37.7,,228.31,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.62,33.9,,205.30,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",590.46,78,,472.37,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",625.28,82.6,,500.22,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",625.28,82.6,,500.22,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,757,100,,605.60,,,0,"percent of total billed charges","100% of total billed charges",115.82,757,
"99152 MOD SED SAME PHYS/QHP 5/>YRS INITIAL 15 Tech Fee",45099152,CDM,450,RC,99152,CPT,OUTPATIENT,,,553,359.45,,486.64,88,,389.31,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.54,100,,,,,0,"fee schedule",EAPG,553,100,,442.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.18,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",348.39,63,,278.71,,,0,"percent of total billed charges","63% of total billed charges",84.61,15.3,,67.69,,,0,"percent of total billed charges","15.3% of total billed charges",21.54,100,,,,,0,"fee schedule",EAPG,381.57,69,,,,,0,"fee schedule","69% of total billed charges",553,100,,442.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",553,100,,442.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",553,100,,442.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.95,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",21.97,100,,,,,0,"fee schedule",EAPG,28,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",208.48,37.7,,166.78,,,0,"percent of total billed charges","37.7% of total billed charges",208.48,37.7,,166.78,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",187.47,33.9,,149.98,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",431.34,78,,345.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",456.78,82.6,,365.42,,,0,"percent of total billed charges","82.6% of total billed charges",21.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",456.78,82.6,,365.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.54,100,,,,,0,"fee schedule",EAPG,553,100,,442.40,,,0,"percent of total billed charges","100% of total billed charges",15.95,553,
"99151 MOD CS SAME INIT 15M <5 TechFee",45099151,CDM,450,RC,99151,CPT,OUTPATIENT,,,534,347.1,,469.92,88,,375.94,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.54,100,,,,,0,"fee schedule",EAPG,534,100,,427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.18,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",336.42,63,,269.14,,,0,"percent of total billed charges","63% of total billed charges",81.7,15.3,,65.36,,,0,"percent of total billed charges","15.3% of total billed charges",21.54,100,,,,,0,"fee schedule",EAPG,368.46,69,,,,,0,"fee schedule","69% of total billed charges",534,100,,427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",534,100,,427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",534,100,,427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.95,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",21.97,100,,,,,0,"fee schedule",EAPG,28,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",201.32,37.7,,161.06,,,0,"percent of total billed charges","37.7% of total billed charges",201.32,37.7,,161.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.03,33.9,,144.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",416.52,78,,333.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",441.08,82.6,,352.86,,,0,"percent of total billed charges","82.6% of total billed charges",21.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",441.08,82.6,,352.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.54,100,,,,,0,"fee schedule",EAPG,534,100,,427.20,,,0,"percent of total billed charges","100% of total billed charges",15.95,534,
"99155 MOD SED SAME PHYS/QHP 5/>YRS INITIAL 15 Tech Fee",45099155,CDM,450,RC,99155,CPT,OUTPATIENT,,,534,347.1,,469.92,88,,375.94,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.54,100,,,,,0,"fee schedule",EAPG,534,100,,427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.18,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",336.42,63,,269.14,,,0,"percent of total billed charges","63% of total billed charges",81.7,15.3,,65.36,,,0,"percent of total billed charges","15.3% of total billed charges",21.54,100,,,,,0,"fee schedule",EAPG,368.46,69,,,,,0,"fee schedule","69% of total billed charges",534,100,,427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",534,100,,427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",534,100,,427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.95,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",21.97,100,,,,,0,"fee schedule",EAPG,28,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",201.32,37.7,,161.06,,,0,"percent of total billed charges","37.7% of total billed charges",201.32,37.7,,161.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.03,33.9,,144.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",416.52,78,,333.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",441.08,82.6,,352.86,,,0,"percent of total billed charges","82.6% of total billed charges",21.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",441.08,82.6,,352.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.54,100,,,,,0,"fee schedule",EAPG,534,100,,427.20,,,0,"percent of total billed charges","100% of total billed charges",15.95,534,
"99157 MOD SED SAME PHYS/QHP 5/>YRS INITIAL 15 Tech Fee",45099157,CDM,450,RC,99157,CPT,OUTPATIENT,,,534,347.1,,469.92,88,,375.94,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.54,100,,,,,0,"fee schedule",EAPG,534,100,,427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.18,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",336.42,63,,269.14,,,0,"percent of total billed charges","63% of total billed charges",81.7,15.3,,65.36,,,0,"percent of total billed charges","15.3% of total billed charges",21.54,100,,,,,0,"fee schedule",EAPG,368.46,69,,,,,0,"fee schedule","69% of total billed charges",534,100,,427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",534,100,,427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",534,100,,427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.95,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",21.97,100,,,,,0,"fee schedule",EAPG,28,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",201.32,37.7,,161.06,,,0,"percent of total billed charges","37.7% of total billed charges",201.32,37.7,,161.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.03,33.9,,144.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",416.52,78,,333.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",441.08,82.6,,352.86,,,0,"percent of total billed charges","82.6% of total billed charges",21.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",441.08,82.6,,352.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.54,100,,,,,0,"fee schedule",EAPG,534,100,,427.20,,,0,"percent of total billed charges","100% of total billed charges",15.95,534,
"IPECAC EMESIS W/OBSERVATION",45099175,CDM,450,RC,99175,CPT,OUTPATIENT,,,655,425.75,,576.4,88,,461.12,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.04,16.8,,88.03,,,0,"percent of total billed charges","16.8% of total billed charges",655,100,,524.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.34,17.304,,90.67,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.65,63,,330.12,,,0,"percent of total billed charges","63% of total billed charges",100.22,15.3,,80.18,,,0,"percent of total billed charges","15.3% of total billed charges",110.04,16.8,,88.03,,,0,"percent of total billed charges","16.8% of total billed charges",451.95,69,,,,,0,"fee schedule","69% of total billed charges",655,100,,524.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",655,100,,524.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",655,100,,524.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",110.04,16.8,,88.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",110.04,16.8,,88.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.24,17.136,,89.79,,,0,"percent of total billed charges","17.136% of total billed charges",143.05,21.84,,114.44,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",246.94,37.7,,197.55,,,0,"percent of total billed charges","37.7% of total billed charges",246.94,37.7,,197.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",222.05,33.9,,177.64,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.9,78,,408.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",541.03,82.6,,432.82,,,0,"percent of total billed charges","82.6% of total billed charges",110.04,16.8,,88.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",541.03,82.6,,432.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.04,16.8,,88.03,,,0,"percent of total billed charges","16.8% of total billed charges",655,100,,524.00,,,0,"percent of total billed charges","100% of total billed charges",100.22,655,
"CLOSED TX DISTAL RAD W/MANI",45025605,CDM,450,RC,25605,CPT,OUTPATIENT,,,790,513.5,,695.2,88,,556.16,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.7,63,,398.16,,,0,"percent of total billed charges","63% of total billed charges",120.87,15.3,,96.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.1,69,,,,,0,"fee schedule","69% of total billed charges",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.7% of total billed charges",297.83,37.7,,238.26,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.81,33.9,,214.25,,,0,"percent of total billed charges","33.9% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.2,78,,492.96,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.54,82.6,,522.03,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,790,100,,632.00,,,0,"percent of total billed charges","100% of total billed charges",120.87,5656.45,
"ADHESIVE WND CLOSE-DERMABOND",450G0168,CDM,450,RC,,,OUTPATIENT,,,486,315.9,,427.68,88,,342.14,,,0,"percent of total billed charges","88% of total billed charges",243,50,,194.40,,,0,"percent of total billed charges","50% of total billed charges",81.65,16.8,,65.32,,,0,"percent of total billed charges","16.8% of total billed charges",486,100,,388.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.1,17.304,,67.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",306.18,63,,244.94,,,0,"percent of total billed charges","63% of total billed charges",74.36,15.3,,59.49,,,0,"percent of total billed charges","15.3% of total billed charges",81.65,16.8,,65.32,,,0,"percent of total billed charges","16.8% of total billed charges",335.34,69,,,,,0,"fee schedule","69% of total billed charges",486,100,,388.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",486,100,,388.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",486,100,,388.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",81.65,16.8,,65.32,,,0,"percent of total billed charges","16.8% of total billed charges",243,50,,194.40,,,0,"percent of total billed charges","50% of total billed charges",156.49,32.2,,125.19,,,0,"percent of total billed charges","32.2% of total billed charges",81.65,16.8,,65.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",83.28,17.136,,66.62,,,0,"percent of total billed charges","17.136% of total billed charges",106.14,21.84,,84.91,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.22,37.7,,146.58,,,0,"percent of total billed charges","37.7% of total billed charges",183.22,37.7,,146.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",164.75,33.9,,131.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.08,78,,303.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",401.44,82.6,,321.15,,,0,"percent of total billed charges","82.6% of total billed charges",81.65,16.8,,65.32,,,0,"percent of total billed charges","16.8% of total billed charges",243,50,,194.40,,,0,"percent of total billed charges","50% of total billed charges",401.44,82.6,,321.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.65,16.8,,65.32,,,0,"percent of total billed charges","16.8% of total billed charges",486,100,,388.80,,,0,"percent of total billed charges","100% of total billed charges",74.36,486,
"TRAUMA TEAM ACT W/CRIT CARE",681G0390,CDM,681,RC,,,OUTPATIENT,,,4313,2803.45,,3795.44,88,,3036.35,,,0,"percent of total billed charges","88% of total billed charges",2156.5,50,,1725.20,,,0,"percent of total billed charges","50% of total billed charges",724.58,16.8,,579.66,,,0,"percent of total billed charges","16.8% of total billed charges",4313,100,,3450.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",746.32,17.304,,597.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2717.19,63,,2173.75,,,0,"percent of total billed charges","63% of total billed charges",659.89,15.3,,527.91,,,0,"percent of total billed charges","15.3% of total billed charges",724.58,16.8,,579.66,,,0,"percent of total billed charges","16.8% of total billed charges",2975.97,69,,,,,0,"fee schedule","69% of total billed charges",4313,100,,3450.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4313,100,,3450.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4313,100,,3450.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",724.58,16.8,,579.66,,,0,"percent of total billed charges","16.8% of total billed charges",2156.5,50,,1725.20,,,0,"percent of total billed charges","50% of total billed charges",1388.79,32.2,,1111.03,,,0,"percent of total billed charges","32.2% of total billed charges",724.58,16.8,,579.66,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",739.08,17.136,,591.26,,,0,"percent of total billed charges","17.136% of total billed charges",941.96,21.84,,753.57,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1626,37.7,,1300.80,,,0,"percent of total billed charges","37.7% of total billed charges",1626,37.7,,1300.80,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1462.11,33.9,,1169.69,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3364.14,78,,2691.31,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3562.54,82.6,,2850.03,,,0,"percent of total billed charges","82.6% of total billed charges",724.58,16.8,,579.66,,,0,"percent of total billed charges","16.8% of total billed charges",2156.5,50,,1725.20,,,0,"percent of total billed charges","50% of total billed charges",3562.54,82.6,,2850.03,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",724.58,16.8,,579.66,,,0,"percent of total billed charges","16.8% of total billed charges",4313,100,,3450.40,,,0,"percent of total billed charges","100% of total billed charges",659.89,4313,
"G0425 ER TELEHEALTH CONS 30 MIN",G0425,CDM,450,RC,,,OUTPATIENT,,,520,338,,457.6,88,,366.08,,,0,"percent of total billed charges","88% of total billed charges",260,50,,208.00,,,0,"percent of total billed charges","50% of total billed charges",87.36,16.8,,69.89,,,0,"percent of total billed charges","16.8% of total billed charges",520,100,,416.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.98,17.304,,71.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",327.6,63,,262.08,,,0,"percent of total billed charges","63% of total billed charges",79.56,15.3,,63.65,,,0,"percent of total billed charges","15.3% of total billed charges",87.36,16.8,,69.89,,,0,"percent of total billed charges","16.8% of total billed charges",358.8,69,,,,,0,"fee schedule","69% of total billed charges",520,100,,416.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",520,100,,416.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",520,100,,416.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",87.36,16.8,,69.89,,,0,"percent of total billed charges","16.8% of total billed charges",260,50,,208.00,,,0,"percent of total billed charges","50% of total billed charges",167.44,32.2,,133.95,,,0,"percent of total billed charges","32.2% of total billed charges",87.36,16.8,,69.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.11,17.136,,71.29,,,0,"percent of total billed charges","17.136% of total billed charges",113.57,21.84,,90.86,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",196.04,37.7,,156.83,,,0,"percent of total billed charges","37.7% of total billed charges",196.04,37.7,,156.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.28,33.9,,141.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",405.6,78,,324.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",429.52,82.6,,343.62,,,0,"percent of total billed charges","82.6% of total billed charges",87.36,16.8,,69.89,,,0,"percent of total billed charges","16.8% of total billed charges",260,50,,208.00,,,0,"percent of total billed charges","50% of total billed charges",429.52,82.6,,343.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.36,16.8,,69.89,,,0,"percent of total billed charges","16.8% of total billed charges",520,100,,416.00,,,0,"percent of total billed charges","100% of total billed charges",79.56,520,
"G0426 ER TELEHEALTH CONS 50 MIN",G0425,CDM,450,RC,,,OUTPATIENT,,,709,460.85,,623.92,88,,499.14,,,0,"percent of total billed charges","88% of total billed charges",354.5,50,,283.60,,,0,"percent of total billed charges","50% of total billed charges",119.11,16.8,,95.29,,,0,"percent of total billed charges","16.8% of total billed charges",709,100,,567.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",122.69,17.304,,98.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",446.67,63,,357.34,,,0,"percent of total billed charges","63% of total billed charges",108.48,15.3,,86.78,,,0,"percent of total billed charges","15.3% of total billed charges",119.11,16.8,,95.29,,,0,"percent of total billed charges","16.8% of total billed charges",489.21,69,,,,,0,"fee schedule","69% of total billed charges",709,100,,567.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",709,100,,567.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",709,100,,567.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",119.11,16.8,,95.29,,,0,"percent of total billed charges","16.8% of total billed charges",354.5,50,,283.60,,,0,"percent of total billed charges","50% of total billed charges",228.3,32.2,,182.64,,,0,"percent of total billed charges","32.2% of total billed charges",119.11,16.8,,95.29,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",121.49,17.136,,97.19,,,0,"percent of total billed charges","17.136% of total billed charges",154.85,21.84,,123.88,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",267.29,37.7,,213.83,,,0,"percent of total billed charges","37.7% of total billed charges",267.29,37.7,,213.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",240.35,33.9,,192.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.02,78,,442.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",585.63,82.6,,468.50,,,0,"percent of total billed charges","82.6% of total billed charges",119.11,16.8,,95.29,,,0,"percent of total billed charges","16.8% of total billed charges",354.5,50,,283.60,,,0,"percent of total billed charges","50% of total billed charges",585.63,82.6,,468.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",119.11,16.8,,95.29,,,0,"percent of total billed charges","16.8% of total billed charges",709,100,,567.20,,,0,"percent of total billed charges","100% of total billed charges",108.48,709,
"G0427 ER TELEHEALTH CONS 70 MIN",G0427,CDM,450,RC,,,OUTPATIENT,,,1049,681.85,,923.12,88,,738.50,,,0,"percent of total billed charges","88% of total billed charges",524.5,50,,419.60,,,0,"percent of total billed charges","50% of total billed charges",176.23,16.8,,140.98,,,0,"percent of total billed charges","16.8% of total billed charges",1049,100,,839.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.52,17.304,,145.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",660.87,63,,528.70,,,0,"percent of total billed charges","63% of total billed charges",160.5,15.3,,128.40,,,0,"percent of total billed charges","15.3% of total billed charges",176.23,16.8,,140.98,,,0,"percent of total billed charges","16.8% of total billed charges",723.81,69,,,,,0,"fee schedule","69% of total billed charges",1049,100,,839.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1049,100,,839.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1049,100,,839.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.23,16.8,,140.98,,,0,"percent of total billed charges","16.8% of total billed charges",524.5,50,,419.60,,,0,"percent of total billed charges","50% of total billed charges",337.78,32.2,,270.22,,,0,"percent of total billed charges","32.2% of total billed charges",176.23,16.8,,140.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.76,17.136,,143.81,,,0,"percent of total billed charges","17.136% of total billed charges",229.1,21.84,,183.28,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",395.47,37.7,,316.38,,,0,"percent of total billed charges","37.7% of total billed charges",395.47,37.7,,316.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",355.61,33.9,,284.49,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",818.22,78,,654.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",866.47,82.6,,693.18,,,0,"percent of total billed charges","82.6% of total billed charges",176.23,16.8,,140.98,,,0,"percent of total billed charges","16.8% of total billed charges",524.5,50,,419.60,,,0,"percent of total billed charges","50% of total billed charges",866.47,82.6,,693.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.23,16.8,,140.98,,,0,"percent of total billed charges","16.8% of total billed charges",1049,100,,839.20,,,0,"percent of total billed charges","100% of total billed charges",160.5,1049,
"96136 Psych or neuropsych test administration and scoring; 2",96136,CDM,510,RC,96136,CPT,OUTPATIENT,,,539,350.35,,474.32,88,,379.46,,,0,"percent of total billed charges","88% of total billed charges",130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",521.69,100,,,,,0,"fee schedule",EAPG,539,100,,431.20,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",537.34,100,,,,,0,"fee schedule",EAPG,130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",339.57,63,,271.66,,,0,"percent of total billed charges","63% of total billed charges",82.47,15.3,,65.98,,,0,"percent of total billed charges","15.3% of total billed charges",521.69,100,,,,,0,"fee schedule",EAPG,371.91,69,,,,,0,"fee schedule","69% of total billed charges",539,100,,431.20,,,0,"percent of total billed charges","100% of total billed charges",130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",539,100,,431.20,,,0,"percent of total billed charges","100% of total billed charges",130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",539,100,,431.20,,,0,"percent of total billed charges","100% of total billed charges",130.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",521.69,100,,,,,0,"fee schedule",EAPG,130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",386.44,100,,,,,0,"fee schedule",EAPG,130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",532.13,100,,,,,0,"fee schedule",EAPG,678.2,100,,,,,0,"fee schedule",EAPG,130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",203.2,37.7,,162.56,,,0,"percent of total billed charges","37.70% of total billed charges",130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.42,78,,336.34,,,0,"percent of total billed charges","78% of total billed charges",131.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",445.21,82.6,,356.17,,,0,"percent of total billed charges","82.6% of total billed charges",521.69,100,,,,,0,"fee schedule",EAPG,130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",445.21,82.6,,356.17,,,0,"percent of total billed charges","82.6% of total billed charges",130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",521.69,100,,,,,0,"fee schedule",EAPG,539,100,,431.20,,,0,"percent of total billed charges","100% of total billed charges",82.47,678.2,
"96137 Psych or neuropsych test administration and scoring; 2",96137,CDM,918,RC,96137,CPT,OUTPATIENT,,,365,237.25,,321.2,88,,256.96,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",521.69,100,,,,,0,"fee schedule",EAPG,365,100,,292.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",537.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.95,63,,183.96,,,0,"percent of total billed charges","63% of total billed charges",55.85,15.3,,44.68,,,0,"percent of total billed charges","15.3% of total billed charges",521.69,100,,,,,0,"fee schedule",EAPG,251.85,69,,,,,0,"fee schedule","69% of total billed charges",365,100,,292.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",365,100,,292.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",365,100,,292.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",521.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",386.44,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",532.13,100,,,,,0,"fee schedule",EAPG,678.2,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",137.61,37.7,,110.09,,,0,"percent of total billed charges","37.7% of total billed charges",137.61,37.7,,110.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",123.74,33.9,,98.99,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",284.7,78,,227.76,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.49,82.6,,241.19,,,0,"percent of total billed charges","82.6% of total billed charges",521.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",301.49,82.6,,241.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",521.69,100,,,,,0,"fee schedule",EAPG,365,100,,292.00,,,0,"percent of total billed charges","100% of total billed charges",55.85,678.2,
"99203 Telehealth via audio andvideo, NPt Visit Lvl 3",TELE99203,CDM,510,RC,99203,CPT,OUTPATIENT,,,136,88.4,GT,119.68,88,,95.74,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.85,16.8,,18.28,,,0,"percent of total billed charges","16.8% of total billed charges",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.53,17.304,,18.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.68,63,,68.54,,,0,"percent of total billed charges","63% of total billed charges",20.81,15.3,,16.65,,,0,"percent of total billed charges","15.3% of total billed charges",22.85,16.8,,18.28,,,0,"percent of total billed charges","16.8% of total billed charges",93.84,69,,,,,0,"fee schedule","69% of total billed charges",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.85,16.8,,18.28,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.85,16.8,,18.28,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.3,17.136,,18.64,,,0,"percent of total billed charges","17.136% of total billed charges",29.7,21.84,,23.76,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",51.27,37.7,,41.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",106.08,78,,84.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.34,82.6,,89.87,,,0,"percent of total billed charges","82.6% of total billed charges",22.85,16.8,,18.28,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.34,82.6,,89.87,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.85,16.8,,18.28,,,0,"percent of total billed charges","16.8% of total billed charges",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",20.81,136,
"99204 Telehealth via audio andvideo, NPt Visit Lvl 4",TELE99204,CDM,510,RC,99204,CPT,OUTPATIENT,,,209,135.85,GT,183.92,88,,147.14,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.11,16.8,,28.09,,,0,"percent of total billed charges","16.8% of total billed charges",209,100,,167.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.17,17.304,,28.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",131.67,63,,105.34,,,0,"percent of total billed charges","63% of total billed charges",31.98,15.3,,25.58,,,0,"percent of total billed charges","15.3% of total billed charges",35.11,16.8,,28.09,,,0,"percent of total billed charges","16.8% of total billed charges",144.21,69,,,,,0,"fee schedule","69% of total billed charges",209,100,,167.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",209,100,,167.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",209,100,,167.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.11,16.8,,28.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.11,16.8,,28.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.81,17.136,,28.65,,,0,"percent of total billed charges","17.136% of total billed charges",45.65,21.84,,36.52,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",78.79,37.7,,63.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",163.02,78,,130.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",172.63,82.6,,138.10,,,0,"percent of total billed charges","82.6% of total billed charges",35.11,16.8,,28.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",172.63,82.6,,138.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.11,16.8,,28.09,,,0,"percent of total billed charges","16.8% of total billed charges",209,100,,167.20,,,0,"percent of total billed charges","100% of total billed charges",31.98,209,
"99205 Telehealth via audio andvideo, NPt Visit Lvl 5",TELE99205,CDM,510,RC,99205,CPT,OUTPATIENT,,,263,170.95,GT,231.44,88,,185.15,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.18,16.8,,35.34,,,0,"percent of total billed charges","16.8% of total billed charges",263,100,,210.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.51,17.304,,36.41,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.69,63,,132.55,,,0,"percent of total billed charges","63% of total billed charges",40.24,15.3,,32.19,,,0,"percent of total billed charges","15.3% of total billed charges",44.18,16.8,,35.34,,,0,"percent of total billed charges","16.8% of total billed charges",181.47,69,,,,,0,"fee schedule","69% of total billed charges",263,100,,210.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",263,100,,210.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",263,100,,210.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",44.18,16.8,,35.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",44.18,16.8,,35.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.07,17.136,,36.06,,,0,"percent of total billed charges","17.136% of total billed charges",57.44,21.84,,45.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",99.15,37.7,,79.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",205.14,78,,164.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",217.24,82.6,,173.79,,,0,"percent of total billed charges","82.6% of total billed charges",44.18,16.8,,35.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",217.24,82.6,,173.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.18,16.8,,35.34,,,0,"percent of total billed charges","16.8% of total billed charges",263,100,,210.40,,,0,"percent of total billed charges","100% of total billed charges",40.24,263,
".%fPSA Reflex LC",30184154,CDM,301,RC,84154,CPT,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",32.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.39,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.7% of total billed charges",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.55,33.9,,42.04,,,0,"percent of total billed charges","33.9% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",18.57,101,,,,,0,"fee schedule","101% of CMS fee schedule ",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",8.11,155,
".6-Acetylmorphine, MS, Ur RFX LC",30180356,CDM,301,RC,80356,CPT,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.7% of total billed charges",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.93,33.9,,12.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CULTURE ID NUCLEIC ACID PRB 1",30687149,CDM,306,RC,87149,CPT,OUTPATIENT,,,288,187.2,,253.44,88,,202.75,,,0,"percent of total billed charges","88% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",35.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",181.44,63,,145.15,,,0,"percent of total billed charges","63% of total billed charges",44.06,15.3,,35.25,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,198.72,69,,,,,0,"fee schedule","69% of total billed charges",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.69,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.05,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.58,37.7,,86.86,,,0,"percent of total billed charges","37.7% of total billed charges",108.58,37.7,,86.86,,,0,"percent of total billed charges","37.70% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.63,33.9,,78.10,,,0,"percent of total billed charges","33.9% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",224.64,78,,179.71,,,0,"percent of total billed charges","78% of total billed charges",20.25,101,,,,,0,"fee schedule","101% of CMS fee schedule ",237.89,82.6,,190.31,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",237.89,82.6,,190.31,,,0,"percent of total billed charges","82.6% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",4.81,288,
".ANA Comprehensive Plus Profile LC",30183516,CDM,301,RC,83516,CPT,OUTPATIENT,,,88,57.2,,77.44,88,,61.95,,,0,"percent of total billed charges","88% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",20.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",13.46,15.3,,10.77,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,60.72,69,,,,,0,"fee schedule","69% of total billed charges",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.53,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.18,37.7,,26.54,,,0,"percent of total billed charges","37.7% of total billed charges",33.18,37.7,,26.54,,,0,"percent of total billed charges","37.70% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.83,33.9,,23.86,,,0,"percent of total billed charges","33.9% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.64,78,,54.91,,,0,"percent of total billed charges","78% of total billed charges",11.64,101,,,,,0,"fee schedule","101% of CMS fee schedule ",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,88,
"AMPHETAMINES MS 1-2",30180324,CDM,301,RC,80324,CPT,OUTPATIENT,,,574,373.1,,505.12,88,,404.10,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",574,100,,459.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",361.62,63,,289.30,,,0,"percent of total billed charges","63% of total billed charges",87.82,15.3,,70.26,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",396.06,69,,,,,0,"fee schedule","69% of total billed charges",574,100,,459.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",574,100,,459.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",574,100,,459.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",216.4,37.7,,173.12,,,0,"percent of total billed charges","37.7% of total billed charges",216.4,37.7,,173.12,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.59,33.9,,155.67,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",447.72,78,,358.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",474.12,82.6,,379.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",474.12,82.6,,379.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",96.43,16.8,,77.14,,,0,"percent of total billed charges","16.8% of total billed charges",574,100,,459.20,,,0,"percent of total billed charges","100% of total billed charges",87.82,574,
".Amphetamines, MS, Ur RFX LC",30180325,CDM,301,RC,80324,CPT,OUTPATIENT,,,50,32.5,,44,88,,35.20,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",31.5,63,,25.20,,,0,"percent of total billed charges","63% of total billed charges",7.65,15.3,,6.12,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.5,69,,,,,0,"fee schedule","69% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.7% of total billed charges",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.95,33.9,,13.56,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,78,,31.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",7.65,50,
".Barbirturates,MS,WB/S/P Rfx LC",30180345,CDM,301,RC,80345,CPT,OUTPATIENT,,,313,203.45,,275.44,88,,220.35,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313,100,,250.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",197.19,63,,157.75,,,0,"percent of total billed charges","63% of total billed charges",47.89,15.3,,38.31,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",215.97,69,,,,,0,"fee schedule","69% of total billed charges",313,100,,250.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",313,100,,250.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",313,100,,250.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",118,37.7,,94.40,,,0,"percent of total billed charges","37.7% of total billed charges",118,37.7,,94.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.11,33.9,,84.89,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",244.14,78,,195.31,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.54,82.6,,206.83,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",258.54,82.6,,206.83,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.58,16.8,,42.06,,,0,"percent of total billed charges","16.8% of total billed charges",313,100,,250.40,,,0,"percent of total billed charges","100% of total billed charges",47.89,313,
".Barbiturates, MS, Ur RFX LC",30180345,CDM,301,RC,80345,CPT,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.7% of total billed charges",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.93,33.9,,12.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
".Benzodiazepines,MS,WB/S/P Rfx LC",30180347,CDM,301,RC,80347,CPT,OUTPATIENT,,,152,98.8,,133.76,88,,107.01,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",95.76,63,,76.61,,,0,"percent of total billed charges","63% of total billed charges",23.26,15.3,,18.61,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.88,69,,,,,0,"fee schedule","69% of total billed charges",152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",57.3,37.7,,45.84,,,0,"percent of total billed charges","37.7% of total billed charges",57.3,37.7,,45.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.53,33.9,,41.22,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",118.56,78,,94.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",125.55,82.6,,100.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",125.55,82.6,,100.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.54,16.8,,20.43,,,0,"percent of total billed charges","16.8% of total billed charges",152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",23.26,152,
".Benzodiazepines, MS, Ur RFX LC",30180347,CDM,301,RC,80347,CPT,OUTPATIENT,,,50,32.5,,44,88,,35.20,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",31.5,63,,25.20,,,0,"percent of total billed charges","63% of total billed charges",7.65,15.3,,6.12,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.5,69,,,,,0,"fee schedule","69% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.7% of total billed charges",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.95,33.9,,13.56,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,78,,31.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",7.65,50,
".Buprenorphine, MS, Ur RFX LC",30180348,CDM,301,RC,80348,CPT,OUTPATIENT,,,50,32.5,,44,88,,35.20,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",31.5,63,,25.20,,,0,"percent of total billed charges","63% of total billed charges",7.65,15.3,,6.12,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.5,69,,,,,0,"fee schedule","69% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.7% of total billed charges",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.95,33.9,,13.56,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,78,,31.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",7.65,50,
"CALR (calreticulin) LC",31081219,CDM,310,RC,81219,CPT,OUTPATIENT,,,615,399.75,,541.2,88,,432.96,,,0,"percent of total billed charges","88% of total billed charges",121.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,615,100,,492.00,,,0,"percent of total billed charges","100% of total billed charges",212.85,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.2,100,,,,,0,"fee schedule",EAPG,121.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",387.45,63,,309.96,,,0,"percent of total billed charges","63% of total billed charges",182.45,150,,,,,0,"fee schedule","150% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,424.35,69,,,,,0,"fee schedule","69% of total billed charges",615,100,,492.00,,,0,"percent of total billed charges","100% of total billed charges",121.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",615,100,,492.00,,,0,"percent of total billed charges","100% of total billed charges",121.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",615,100,,492.00,,,0,"percent of total billed charges","100% of total billed charges",121.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",465.23,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,121.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",121.63,100,,,,,0,"fee schedule","100% of LI fee schedule",28.91,100,,,,,0,"fee schedule",EAPG,121.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.81,100,,,,,0,"fee schedule",EAPG,50.73,100,,,,,0,"fee schedule",EAPG,121.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",231.86,37.7,,185.49,,,0,"percent of total billed charges","37.7% of total billed charges",231.86,37.7,,185.49,,,0,"percent of total billed charges","37.70% of total billed charges",121.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",208.49,33.9,,166.79,,,0,"percent of total billed charges","33.9% of total billed charges",121.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",479.7,78,,383.76,,,0,"percent of total billed charges","78% of total billed charges",122.84,101,,,,,0,"fee schedule","101% of CMS fee schedule ",507.99,82.6,,406.39,,,0,"percent of total billed charges","82.6% of total billed charges",39.02,100,,,,,0,"fee schedule","100% of WA fee schedule",121.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",507.99,82.6,,406.39,,,0,"percent of total billed charges","82.6% of total billed charges",121.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,615,100,,492.00,,,0,"percent of total billed charges","100% of total billed charges",28.91,615,
".Cannabinoids, MS, Ur RFX LC",30180349,CDM,301,RC,80349,CPT,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.7% of total billed charges",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.93,33.9,,12.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
N/A,31188142,CDM,311,RC,88142,CPT,OUTPATIENT,,,59,38.35,,51.92,88,,41.54,,,0,"percent of total billed charges","88% of total billed charges",20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",35.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.03,100,,,,,0,"fee schedule",EAPG,20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.17,63,,29.74,,,0,"percent of total billed charges","63% of total billed charges",30.39,150,,,,,0,"fee schedule","150% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,40.71,69,,,,,0,"fee schedule","69% of total billed charges",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.49,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.26,100,,,,,0,"fee schedule","100% of LI fee schedule",11.53,100,,,,,0,"fee schedule",EAPG,20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.87,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule",EAPG,20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.24,37.7,,17.79,,,0,"percent of total billed charges","37.7% of total billed charges",22.24,37.7,,17.79,,,0,"percent of total billed charges","37.70% of total billed charges",20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",20,33.9,,16.00,,,0,"percent of total billed charges","33.9% of total billed charges",20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.02,78,,36.82,,,0,"percent of total billed charges","78% of total billed charges",20.46,101,,,,,0,"fee schedule","101% of CMS fee schedule ",48.73,82.6,,38.98,,,0,"percent of total billed charges","82.6% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.73,82.6,,38.98,,,0,"percent of total billed charges","82.6% of total billed charges",20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",11.53,77.49,
"COCAINE MS",30180353,CDM,301,RC,80353,CPT,OUTPATIENT,,,405,263.25,,356.4,88,,285.12,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",405,100,,324.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",255.15,63,,204.12,,,0,"percent of total billed charges","63% of total billed charges",61.97,15.3,,49.58,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",279.45,69,,,,,0,"fee schedule","69% of total billed charges",405,100,,324.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",405,100,,324.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",405,100,,324.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",152.69,37.7,,122.15,,,0,"percent of total billed charges","37.7% of total billed charges",152.69,37.7,,122.15,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.3,33.9,,109.84,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",315.9,78,,252.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",334.53,82.6,,267.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",334.53,82.6,,267.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.04,16.8,,54.43,,,0,"percent of total billed charges","16.8% of total billed charges",405,100,,324.00,,,0,"percent of total billed charges","100% of total billed charges",61.97,405,
".Cocaine and Mtb, MS, Ur RFX LC",30180353,CDM,301,RC,80353,CPT,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.7% of total billed charges",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.93,33.9,,12.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
".ENA+DNA/DS+Antich+Centro+FA... LC",30183516,CDM,301,RC,83516,CPT,OUTPATIENT,,,88,57.2,,77.44,88,,61.95,,,0,"percent of total billed charges","88% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",20.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",13.46,15.3,,10.77,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,60.72,69,,,,,0,"fee schedule","69% of total billed charges",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.53,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.18,37.7,,26.54,,,0,"percent of total billed charges","37.7% of total billed charges",33.18,37.7,,26.54,,,0,"percent of total billed charges","37.70% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.83,33.9,,23.86,,,0,"percent of total billed charges","33.9% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.64,78,,54.91,,,0,"percent of total billed charges","78% of total billed charges",11.64,101,,,,,0,"fee schedule","101% of CMS fee schedule ",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,88,
"ANNA TYPE 1",30286256,CDM,302,RC,86256,CPT,OUTPATIENT,,,57,37.05,,50.16,88,,40.13,,,0,"percent of total billed charges","88% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",21.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.91,63,,28.73,,,0,"percent of total billed charges","63% of total billed charges",8.72,15.3,,6.98,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,39.33,69,,,,,0,"fee schedule","69% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.09,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.05,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.49,37.7,,17.19,,,0,"percent of total billed charges","37.7% of total billed charges",21.49,37.7,,17.19,,,0,"percent of total billed charges","37.70% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.32,33.9,,15.46,,,0,"percent of total billed charges","33.9% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.46,78,,35.57,,,0,"percent of total billed charges","78% of total billed charges",12.17,101,,,,,0,"fee schedule","101% of CMS fee schedule ",47.08,82.6,,37.66,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.08,82.6,,37.66,,,0,"percent of total billed charges","82.6% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",6.96,57,
".Enhanced Liver Fibrosis (ELF) LC",30081517,CDM,300,RC,81517,CPT,OUTPATIENT,,,1275,828.75,,1122,88,,897.60,,,0,"percent of total billed charges","88% of total billed charges",176.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",214.2,16.8,,171.36,,,0,"percent of total billed charges","16.8% of total billed charges",1275,100,,1020.00,,,0,"percent of total billed charges","100% of total billed charges",308.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",220.63,17.304,,176.50,,,0,"percent of total billed charges","17.304% of total billed charges",176.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",803.25,63,,642.60,,,0,"percent of total billed charges","63% of total billed charges",195.08,15.3,,156.06,,,0,"percent of total billed charges","15.3% of total billed charges",214.2,16.8,,171.36,,,0,"percent of total billed charges","16.8% of total billed charges",879.75,69,,,,,0,"fee schedule","69% of total billed charges",1275,100,,1020.00,,,0,"percent of total billed charges","100% of total billed charges",176.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",1275,100,,1020.00,,,0,"percent of total billed charges","100% of total billed charges",176.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",1275,100,,1020.00,,,0,"percent of total billed charges","100% of total billed charges",176.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",214.2,16.8,,171.36,,,0,"percent of total billed charges","16.8% of total billed charges",176.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",176.19,100,,,,,0,"fee schedule","100% of LI fee schedule",214.2,16.8,,171.36,,,0,"percent of total billed charges","16.8% of total billed charges",176.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",218.48,17.136,,174.78,,,0,"percent of total billed charges","17.136% of total billed charges",278.46,21.84,,222.77,,,0,"percent of total billed charges","21.84% of total billed charges",176.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",480.68,37.7,,384.54,,,0,"percent of total billed charges","37.7% of total billed charges",480.68,37.7,,384.54,,,0,"percent of total billed charges","37.70% of total billed charges",176.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",432.23,33.9,,345.78,,,0,"percent of total billed charges","33.9% of total billed charges",176.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",994.5,78,,795.60,,,0,"percent of total billed charges","78% of total billed charges",177.95,101,,,,,0,"fee schedule","101% of CMS fee schedule ",1053.15,82.6,,842.52,,,0,"percent of total billed charges","82.6% of total billed charges",214.2,16.8,,171.36,,,0,"percent of total billed charges","16.8% of total billed charges",176.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",1053.15,82.6,,842.52,,,0,"percent of total billed charges","82.6% of total billed charges",176.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",214.2,16.8,,171.36,,,0,"percent of total billed charges","16.8% of total billed charges",1275,100,,1020.00,,,0,"percent of total billed charges","100% of total billed charges",176.19,1275,
".Ethanol Biomarkers, MS, Ur RFX LC",30180321,CDM,301,RC,80321,CPT,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.7% of total billed charges",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.93,33.9,,12.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
".Fentanyl, MS, Ur, RFX LC",30180354,CDM,301,RC,80354,CPT,OUTPATIENT,,,50,32.5,,44,88,,35.20,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",31.5,63,,25.20,,,0,"percent of total billed charges","63% of total billed charges",7.65,15.3,,6.12,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.5,69,,,,,0,"fee schedule","69% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.7% of total billed charges",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.95,33.9,,13.56,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,78,,31.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",7.65,50,
".Fetal Hemoglobin LC",30183020,CDM,301,RC,83020,CPT,OUTPATIENT,,,198,128.7,,174.24,88,,139.39,,,0,"percent of total billed charges","88% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",22.52,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.74,63,,99.79,,,0,"percent of total billed charges","63% of total billed charges",30.29,15.3,,24.23,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,136.62,69,,,,,0,"fee schedule","69% of total billed charges",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.22,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.87,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.65,37.7,,59.72,,,0,"percent of total billed charges","37.7% of total billed charges",74.65,37.7,,59.72,,,0,"percent of total billed charges","37.70% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.12,33.9,,53.70,,,0,"percent of total billed charges","33.9% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",154.44,78,,123.55,,,0,"percent of total billed charges","78% of total billed charges",12.99,101,,,,,0,"fee schedule","101% of CMS fee schedule ",163.55,82.6,,130.84,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.55,82.6,,130.84,,,0,"percent of total billed charges","82.6% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,198,
".Gabapentin IA WB/SP RFX LC",30180171,CDM,301,RC,80171,CPT,OUTPATIENT,,,478,310.7,,420.64,88,,336.51,,,0,"percent of total billed charges","88% of total billed charges",21.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",37.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,21.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",301.14,63,,240.91,,,0,"percent of total billed charges","63% of total billed charges",73.13,15.3,,58.50,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,329.82,69,,,,,0,"fee schedule","69% of total billed charges",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",21.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",21.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",21.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.88,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,21.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.67,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,21.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,21.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",180.21,37.7,,144.17,,,0,"percent of total billed charges","37.7% of total billed charges",180.21,37.7,,144.17,,,0,"percent of total billed charges","37.70% of total billed charges",21.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.04,33.9,,129.63,,,0,"percent of total billed charges","33.9% of total billed charges",21.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",372.84,78,,298.27,,,0,"percent of total billed charges","78% of total billed charges",21.88,101,,,,,0,"fee schedule","101% of CMS fee schedule ",394.83,82.6,,315.86,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,21.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",394.83,82.6,,315.86,,,0,"percent of total billed charges","82.6% of total billed charges",21.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",7,478,
HIV-2,30286702,CDM,302,RC,86702,CPT,OUTPATIENT,,,238,154.7,,209.44,88,,167.55,,,0,"percent of total billed charges","88% of total billed charges",13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",23.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",149.94,63,,119.95,,,0,"percent of total billed charges","63% of total billed charges",36.41,15.3,,29.13,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,164.22,69,,,,,0,"fee schedule","69% of total billed charges",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.71,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.52,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.73,37.7,,71.78,,,0,"percent of total billed charges","37.7% of total billed charges",89.73,37.7,,71.78,,,0,"percent of total billed charges","37.70% of total billed charges",13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.68,33.9,,64.54,,,0,"percent of total billed charges","33.9% of total billed charges",13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",185.64,78,,148.51,,,0,"percent of total billed charges","78% of total billed charges",13.65,101,,,,,0,"fee schedule","101% of CMS fee schedule ",196.59,82.6,,157.27,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",196.59,82.6,,157.27,,,0,"percent of total billed charges","82.6% of total billed charges",13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",6.96,238,
".HPV Genotypes 16/18,45 LC",30687625,CDM,306,RC,87625,CPT,OUTPATIENT,,,139,90.35,,122.32,88,,97.86,,,0,"percent of total billed charges","88% of total billed charges",40.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",70.96,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,40.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.57,63,,70.06,,,0,"percent of total billed charges","63% of total billed charges",21.27,15.3,,17.02,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,95.91,69,,,,,0,"fee schedule","69% of total billed charges",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",40.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",40.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",40.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",155.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,40.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.54,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,40.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,40.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.4,37.7,,41.92,,,0,"percent of total billed charges","37.7% of total billed charges",52.4,37.7,,41.92,,,0,"percent of total billed charges","37.70% of total billed charges",40.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.12,33.9,,37.70,,,0,"percent of total billed charges","33.9% of total billed charges",40.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.42,78,,86.74,,,0,"percent of total billed charges","78% of total billed charges",40.95,101,,,,,0,"fee schedule","101% of CMS fee schedule ",114.81,82.6,,91.85,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,40.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",114.81,82.6,,91.85,,,0,"percent of total billed charges","82.6% of total billed charges",40.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",18.33,155.1,
".Hepatitis C Genotype LC 550486",30087902,CDM,300,RC,87902,CPT,OUTPATIENT,,,1476,959.4,,1298.88,88,,1039.10,,,0,"percent of total billed charges","88% of total billed charges",257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,1476,100,,1180.80,,,0,"percent of total billed charges","100% of total billed charges",450.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",110.23,100,,,,,0,"fee schedule",EAPG,257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",929.88,63,,743.90,,,0,"percent of total billed charges","63% of total billed charges",225.83,15.3,,180.66,,,0,"percent of total billed charges","15.3% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,1018.44,69,,,,,0,"fee schedule","69% of total billed charges",1476,100,,1180.80,,,0,"percent of total billed charges","100% of total billed charges",257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",1476,100,,1180.80,,,0,"percent of total billed charges","100% of total billed charges",257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",1476,100,,1180.80,,,0,"percent of total billed charges","100% of total billed charges",257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",984.74,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",257.45,100,,,,,0,"fee schedule","100% of LI fee schedule",79.27,100,,,,,0,"fee schedule",EAPG,257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.16,100,,,,,0,"fee schedule",EAPG,139.13,100,,,,,0,"fee schedule",EAPG,257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",556.45,37.7,,445.16,,,0,"percent of total billed charges","37.7% of total billed charges",556.45,37.7,,445.16,,,0,"percent of total billed charges","37.70% of total billed charges",257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",500.36,33.9,,400.29,,,0,"percent of total billed charges","33.9% of total billed charges",257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",1151.28,78,,921.02,,,0,"percent of total billed charges","78% of total billed charges",260.02,101,,,,,0,"fee schedule","101% of CMS fee schedule ",1219.18,82.6,,975.34,,,0,"percent of total billed charges","82.6% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",1219.18,82.6,,975.34,,,0,"percent of total billed charges","82.6% of total billed charges",257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,1476,100,,1180.80,,,0,"percent of total billed charges","100% of total billed charges",79.27,1476,
"Hexagonal Phase Phospholipid Reflex LC 241426",30585598,CDM,305,RC,85598,CPT,OUTPATIENT,,,222,144.3,,195.36,88,,156.29,,,0,"percent of total billed charges","88% of total billed charges",17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,222,100,,177.60,,,0,"percent of total billed charges","100% of total billed charges",31.46,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",139.86,63,,111.89,,,0,"percent of total billed charges","63% of total billed charges",33.97,15.3,,27.18,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,153.18,69,,,,,0,"fee schedule","69% of total billed charges",222,100,,177.60,,,0,"percent of total billed charges","100% of total billed charges",17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",222,100,,177.60,,,0,"percent of total billed charges","100% of total billed charges",17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",222,100,,177.60,,,0,"percent of total billed charges","100% of total billed charges",17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.77,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.98,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",83.69,37.7,,66.95,,,0,"percent of total billed charges","37.7% of total billed charges",83.69,37.7,,66.95,,,0,"percent of total billed charges","37.70% of total billed charges",17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",75.26,33.9,,60.21,,,0,"percent of total billed charges","33.9% of total billed charges",17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",173.16,78,,138.53,,,0,"percent of total billed charges","78% of total billed charges",18.15,101,,,,,0,"fee schedule","101% of CMS fee schedule ",183.37,82.6,,146.70,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule","100% of WA fee schedule",17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",183.37,82.6,,146.70,,,0,"percent of total billed charges","82.6% of total billed charges",17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,222,100,,177.60,,,0,"percent of total billed charges","100% of total billed charges",2.48,222,
"Hgb Fractionation by HPLC LC",30183021,CDM,301,RC,83021,CPT,OUTPATIENT,,,278,180.7,,244.64,88,,195.71,,,0,"percent of total billed charges","88% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",31.6,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.23,100,,,,,0,"fee schedule",EAPG,18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",175.14,63,,140.11,,,0,"percent of total billed charges","63% of total billed charges",42.53,15.3,,34.02,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,191.82,69,,,,,0,"fee schedule","69% of total billed charges",278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.07,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.05,100,,,,,0,"fee schedule","100% of LI fee schedule",3.76,100,,,,,0,"fee schedule",EAPG,18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",104.81,37.7,,83.85,,,0,"percent of total billed charges","37.7% of total billed charges",104.81,37.7,,83.85,,,0,"percent of total billed charges","37.70% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",94.24,33.9,,75.39,,,0,"percent of total billed charges","33.9% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",216.84,78,,173.47,,,0,"percent of total billed charges","78% of total billed charges",18.24,101,,,,,0,"fee schedule","101% of CMS fee schedule ",229.63,82.6,,183.70,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",229.63,82.6,,183.70,,,0,"percent of total billed charges","82.6% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",3.76,278,
"IFE PE and FLC Serum LC",30286334,CDM,302,RC,86334,CPT,OUTPATIENT,,,226,146.9,,198.88,88,,159.10,,,0,"percent of total billed charges","88% of total billed charges",22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",39.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.38,63,,113.90,,,0,"percent of total billed charges","63% of total billed charges",34.58,15.3,,27.66,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,155.94,69,,,,,0,"fee schedule","69% of total billed charges",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.45,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.34,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.2,37.7,,68.16,,,0,"percent of total billed charges","37.7% of total billed charges",85.2,37.7,,68.16,,,0,"percent of total billed charges","37.70% of total billed charges",22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.61,33.9,,61.29,,,0,"percent of total billed charges","33.9% of total billed charges",22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",176.28,78,,141.02,,,0,"percent of total billed charges","78% of total billed charges",22.56,101,,,,,0,"fee schedule","101% of CMS fee schedule ",186.68,82.6,,149.34,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",186.68,82.6,,149.34,,,0,"percent of total billed charges","82.6% of total billed charges",22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",6.96,226,
"BETA 2 TRANSFERRIN",30286334,CDM,302,RC,86334,CPT,OUTPATIENT,,,192,124.8,,168.96,88,,135.17,,,0,"percent of total billed charges","88% of total billed charges",22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",39.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",120.96,63,,96.77,,,0,"percent of total billed charges","63% of total billed charges",29.38,15.3,,23.50,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,132.48,69,,,,,0,"fee schedule","69% of total billed charges",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.45,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.34,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.38,37.7,,57.90,,,0,"percent of total billed charges","37.7% of total billed charges",72.38,37.7,,57.90,,,0,"percent of total billed charges","37.70% of total billed charges",22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.09,33.9,,52.07,,,0,"percent of total billed charges","33.9% of total billed charges",22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",149.76,78,,119.81,,,0,"percent of total billed charges","78% of total billed charges",22.56,101,,,,,0,"fee schedule","101% of CMS fee schedule ",158.59,82.6,,126.87,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",158.59,82.6,,126.87,,,0,"percent of total billed charges","82.6% of total billed charges",22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",6.96,192,
".JAK2 Exons 12-15 LC ZB3RV",31081279,CDM,310,RC,81279,CPT,OUTPATIENT,,,1433,931.45,,1261.04,88,,1008.83,,,0,"percent of total billed charges","88% of total billed charges",185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,1433,100,,1146.40,,,0,"percent of total billed charges","100% of total billed charges",324.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",110.23,100,,,,,0,"fee schedule",EAPG,185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",902.79,63,,722.23,,,0,"percent of total billed charges","63% of total billed charges",277.8,150,,,,,0,"fee schedule","150% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,988.77,69,,,,,0,"fee schedule","69% of total billed charges",1433,100,,1146.40,,,0,"percent of total billed charges","100% of total billed charges",185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",1433,100,,1146.40,,,0,"percent of total billed charges","100% of total billed charges",185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",1433,100,,1146.40,,,0,"percent of total billed charges","100% of total billed charges",185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",708.39,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",185.2,100,,,,,0,"fee schedule","100% of LI fee schedule",79.27,100,,,,,0,"fee schedule",EAPG,185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.16,100,,,,,0,"fee schedule",EAPG,139.13,100,,,,,0,"fee schedule",EAPG,185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",540.24,37.7,,432.19,,,0,"percent of total billed charges","37.7% of total billed charges",540.24,37.7,,432.19,,,0,"percent of total billed charges","37.70% of total billed charges",185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",485.79,33.9,,388.63,,,0,"percent of total billed charges","33.9% of total billed charges",185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",1117.74,78,,894.19,,,0,"percent of total billed charges","78% of total billed charges",187.05,101,,,,,0,"fee schedule","101% of CMS fee schedule ",1183.66,82.6,,946.93,,,0,"percent of total billed charges","82.6% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",1183.66,82.6,,946.93,,,0,"percent of total billed charges","82.6% of total billed charges",185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,1433,100,,1146.40,,,0,"percent of total billed charges","100% of total billed charges",79.27,1433,
"LYME WESTERN BLOT",30286617,CDM,302,RC,86617,CPT,OUTPATIENT,,,400,260,,352,88,,281.60,,,0,"percent of total billed charges","88% of total billed charges",15.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,400,100,,320.00,,,0,"percent of total billed charges","100% of total billed charges",27.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,15.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",252,63,,201.60,,,0,"percent of total billed charges","63% of total billed charges",61.2,15.3,,48.96,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,276,69,,,,,0,"fee schedule","69% of total billed charges",400,100,,320.00,,,0,"percent of total billed charges","100% of total billed charges",15.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",400,100,,320.00,,,0,"percent of total billed charges","100% of total billed charges",15.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",400,100,,320.00,,,0,"percent of total billed charges","100% of total billed charges",15.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.24,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,15.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.49,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,15.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,15.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.8,37.7,,120.64,,,0,"percent of total billed charges","37.7% of total billed charges",150.8,37.7,,120.64,,,0,"percent of total billed charges","37.70% of total billed charges",15.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",135.6,33.9,,108.48,,,0,"percent of total billed charges","33.9% of total billed charges",15.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",312,78,,249.60,,,0,"percent of total billed charges","78% of total billed charges",15.64,101,,,,,0,"fee schedule","101% of CMS fee schedule ",330.4,82.6,,264.32,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,15.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",330.4,82.6,,264.32,,,0,"percent of total billed charges","82.6% of total billed charges",15.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,400,100,,320.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,400,
"SENSITIVITY ADD'L-MIC",30687186,CDM,306,RC,87186,CPT,OUTPATIENT,,,391,254.15,,344.08,88,,275.26,,,0,"percent of total billed charges","88% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,391,100,,312.80,,,0,"percent of total billed charges","100% of total billed charges",15.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",246.33,63,,197.06,,,0,"percent of total billed charges","63% of total billed charges",59.82,15.3,,47.86,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,269.79,69,,,,,0,"fee schedule","69% of total billed charges",391,100,,312.80,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",391,100,,312.80,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",391,100,,312.80,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.08,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.65,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",147.41,37.7,,117.93,,,0,"percent of total billed charges","37.7% of total billed charges",147.41,37.7,,117.93,,,0,"percent of total billed charges","37.70% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",132.55,33.9,,106.04,,,0,"percent of total billed charges","33.9% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",304.98,78,,243.98,,,0,"percent of total billed charges","78% of total billed charges",8.73,101,,,,,0,"fee schedule","101% of CMS fee schedule ",322.97,82.6,,258.38,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",322.97,82.6,,258.38,,,0,"percent of total billed charges","82.6% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,391,100,,312.80,,,0,"percent of total billed charges","100% of total billed charges",4.81,391,
"SENSITIVITY ADD'L-MIC",30687186,CDM,306,RC,87186,CPT,OUTPATIENT,,,391,254.15,,344.08,88,,275.26,,,0,"percent of total billed charges","88% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,391,100,,312.80,,,0,"percent of total billed charges","100% of total billed charges",15.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",246.33,63,,197.06,,,0,"percent of total billed charges","63% of total billed charges",59.82,15.3,,47.86,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,269.79,69,,,,,0,"fee schedule","69% of total billed charges",391,100,,312.80,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",391,100,,312.80,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",391,100,,312.80,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.08,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.65,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",147.41,37.7,,117.93,,,0,"percent of total billed charges","37.7% of total billed charges",147.41,37.7,,117.93,,,0,"percent of total billed charges","37.70% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",132.55,33.9,,106.04,,,0,"percent of total billed charges","33.9% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",304.98,78,,243.98,,,0,"percent of total billed charges","78% of total billed charges",8.73,101,,,,,0,"fee schedule","101% of CMS fee schedule ",322.97,82.6,,258.38,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",322.97,82.6,,258.38,,,0,"percent of total billed charges","82.6% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,391,100,,312.80,,,0,"percent of total billed charges","100% of total billed charges",4.81,391,
".Methadone,MS,WB/S/P Rfx LC",30180358,CDM,301,RC,80358,CPT,OUTPATIENT,,,484,314.6,,425.92,88,,340.74,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",304.92,63,,243.94,,,0,"percent of total billed charges","63% of total billed charges",74.05,15.3,,59.24,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",333.96,69,,,,,0,"fee schedule","69% of total billed charges",484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",182.47,37.7,,145.98,,,0,"percent of total billed charges","37.7% of total billed charges",182.47,37.7,,145.98,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",164.08,33.9,,131.26,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",377.52,78,,302.02,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",399.78,82.6,,319.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",399.78,82.6,,319.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.31,16.8,,65.05,,,0,"percent of total billed charges","16.8% of total billed charges",484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",74.05,484,
".Methadone, MS, Ur RFX LC",30180358,CDM,301,RC,80358,CPT,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.7% of total billed charges",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.93,33.9,,12.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"AFB SENSITIVITY",30687188,CDM,306,RC,87188,CPT,OUTPATIENT,,,166,107.9,,146.08,88,,116.86,,,0,"percent of total billed charges","88% of total billed charges",6.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",11.62,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,6.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",104.58,63,,83.66,,,0,"percent of total billed charges","63% of total billed charges",25.4,15.3,,20.32,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,114.54,69,,,,,0,"fee schedule","69% of total billed charges",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",6.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",6.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",6.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.39,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,6.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.64,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,6.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,6.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.58,37.7,,50.06,,,0,"percent of total billed charges","37.7% of total billed charges",62.58,37.7,,50.06,,,0,"percent of total billed charges","37.70% of total billed charges",6.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.27,33.9,,45.02,,,0,"percent of total billed charges","33.9% of total billed charges",6.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.48,78,,103.58,,,0,"percent of total billed charges","78% of total billed charges",6.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",137.12,82.6,,109.70,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,6.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.12,82.6,,109.70,,,0,"percent of total billed charges","82.6% of total billed charges",6.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",4.81,166,
"SENSITIVITY ADD'L-MIC",30687186,CDM,306,RC,87186,CPT,OUTPATIENT,,,391,254.15,,344.08,88,,275.26,,,0,"percent of total billed charges","88% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,391,100,,312.80,,,0,"percent of total billed charges","100% of total billed charges",15.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",246.33,63,,197.06,,,0,"percent of total billed charges","63% of total billed charges",59.82,15.3,,47.86,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,269.79,69,,,,,0,"fee schedule","69% of total billed charges",391,100,,312.80,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",391,100,,312.80,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",391,100,,312.80,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.08,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.65,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",147.41,37.7,,117.93,,,0,"percent of total billed charges","37.7% of total billed charges",147.41,37.7,,117.93,,,0,"percent of total billed charges","37.70% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",132.55,33.9,,106.04,,,0,"percent of total billed charges","33.9% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",304.98,78,,243.98,,,0,"percent of total billed charges","78% of total billed charges",8.73,101,,,,,0,"fee schedule","101% of CMS fee schedule ",322.97,82.6,,258.38,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",322.97,82.6,,258.38,,,0,"percent of total billed charges","82.6% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,391,100,,312.80,,,0,"percent of total billed charges","100% of total billed charges",4.81,391,
".Opiates,MS,WB/S/P Rfx LC",30180361,CDM,301,RC,80361,CPT,OUTPATIENT,,,101,65.65,,88.88,88,,71.10,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",63.63,63,,50.90,,,0,"percent of total billed charges","63% of total billed charges",15.45,15.3,,12.36,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.69,69,,,,,0,"fee schedule","69% of total billed charges",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.08,37.7,,30.46,,,0,"percent of total billed charges","37.7% of total billed charges",38.08,37.7,,30.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.24,33.9,,27.39,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.78,78,,63.02,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",83.43,82.6,,66.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",83.43,82.6,,66.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.97,16.8,,13.58,,,0,"percent of total billed charges","16.8% of total billed charges",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",15.45,101,
".Opiate Class, MS, Ur RFX LC",30180361,CDM,301,RC,80361,CPT,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.7% of total billed charges",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.93,33.9,,12.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"ACID-FAST BACILLI ID",30687153,CDM,306,RC,87153,CPT,OUTPATIENT,,,502,326.3,,441.76,88,,353.41,,,0,"percent of total billed charges","88% of total billed charges",115.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.61,100,,,,,0,"fee schedule",EAPG,502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",201.88,175,,,,,0,"fee schedule","175% of CMS fee schedule",100.54,100,,,,,0,"fee schedule",EAPG,115.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",316.26,63,,253.01,,,0,"percent of total billed charges","63% of total billed charges",76.81,15.3,,61.45,,,0,"percent of total billed charges","15.3% of total billed charges",97.61,100,,,,,0,"fee schedule",EAPG,346.38,69,,,,,0,"fee schedule","69% of total billed charges",502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",115.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",115.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",115.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",441.25,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",97.61,100,,,,,0,"fee schedule",EAPG,115.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",115.36,100,,,,,0,"fee schedule","100% of LI fee schedule",72.3,100,,,,,0,"fee schedule",EAPG,115.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.56,100,,,,,0,"fee schedule",EAPG,126.89,100,,,,,0,"fee schedule",EAPG,115.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",189.25,37.7,,151.40,,,0,"percent of total billed charges","37.7% of total billed charges",189.25,37.7,,151.40,,,0,"percent of total billed charges","37.70% of total billed charges",115.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.18,33.9,,136.14,,,0,"percent of total billed charges","33.9% of total billed charges",115.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",391.56,78,,313.25,,,0,"percent of total billed charges","78% of total billed charges",116.51,101,,,,,0,"fee schedule","101% of CMS fee schedule ",414.65,82.6,,331.72,,,0,"percent of total billed charges","82.6% of total billed charges",97.61,100,,,,,0,"fee schedule","100% of WA fee schedule",115.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",414.65,82.6,,331.72,,,0,"percent of total billed charges","82.6% of total billed charges",115.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.61,100,,,,,0,"fee schedule",EAPG,502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",72.3,502,
"ACID-FAST BACILLI ID",30687153,CDM,306,RC,87153,CPT,OUTPATIENT,,,502,326.3,,441.76,88,,353.41,,,0,"percent of total billed charges","88% of total billed charges",115.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.61,100,,,,,0,"fee schedule",EAPG,502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",201.88,175,,,,,0,"fee schedule","175% of CMS fee schedule",100.54,100,,,,,0,"fee schedule",EAPG,115.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",316.26,63,,253.01,,,0,"percent of total billed charges","63% of total billed charges",76.81,15.3,,61.45,,,0,"percent of total billed charges","15.3% of total billed charges",97.61,100,,,,,0,"fee schedule",EAPG,346.38,69,,,,,0,"fee schedule","69% of total billed charges",502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",115.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",115.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",115.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",441.25,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",97.61,100,,,,,0,"fee schedule",EAPG,115.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",115.36,100,,,,,0,"fee schedule","100% of LI fee schedule",72.3,100,,,,,0,"fee schedule",EAPG,115.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.56,100,,,,,0,"fee schedule",EAPG,126.89,100,,,,,0,"fee schedule",EAPG,115.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",189.25,37.7,,151.40,,,0,"percent of total billed charges","37.7% of total billed charges",189.25,37.7,,151.40,,,0,"percent of total billed charges","37.70% of total billed charges",115.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.18,33.9,,136.14,,,0,"percent of total billed charges","33.9% of total billed charges",115.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",391.56,78,,313.25,,,0,"percent of total billed charges","78% of total billed charges",116.51,101,,,,,0,"fee schedule","101% of CMS fee schedule ",414.65,82.6,,331.72,,,0,"percent of total billed charges","82.6% of total billed charges",97.61,100,,,,,0,"fee schedule","100% of WA fee schedule",115.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",414.65,82.6,,331.72,,,0,"percent of total billed charges","82.6% of total billed charges",115.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.61,100,,,,,0,"fee schedule",EAPG,502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",72.3,502,
".Oxycodones,MS,WB/S/P Rfx LC",30180365,CDM,301,RC,80365,CPT,OUTPATIENT,,,478,310.7,,420.64,88,,336.51,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",301.14,63,,240.91,,,0,"percent of total billed charges","63% of total billed charges",73.13,15.3,,58.50,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",329.82,69,,,,,0,"fee schedule","69% of total billed charges",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",180.21,37.7,,144.17,,,0,"percent of total billed charges","37.7% of total billed charges",180.21,37.7,,144.17,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.04,33.9,,129.63,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.84,78,,298.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",394.83,82.6,,315.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",394.83,82.6,,315.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.3,16.8,,64.24,,,0,"percent of total billed charges","16.8% of total billed charges",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",73.13,478,
".Oxycodone Class, MS, Ur RFX LC",30180365,CDM,301,RC,80365,CPT,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.7% of total billed charges",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.93,33.9,,12.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"PTT-LA Incub Mix Reflex LC 241426",30585732,CDM,305,RC,85732,CPT,OUTPATIENT,,,143,92.95,,125.84,88,,100.67,,,0,"percent of total billed charges","88% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",11.32,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.09,63,,72.07,,,0,"percent of total billed charges","63% of total billed charges",21.88,15.3,,17.50,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,98.67,69,,,,,0,"fee schedule","69% of total billed charges",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.74,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.47,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.91,37.7,,43.13,,,0,"percent of total billed charges","37.7% of total billed charges",53.91,37.7,,43.13,,,0,"percent of total billed charges","37.70% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.48,33.9,,38.78,,,0,"percent of total billed charges","33.9% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",111.54,78,,89.23,,,0,"percent of total billed charges","78% of total billed charges",6.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",2.48,143,
"PTT-LA Mix Reflex LC 241426",30585732,CDM,305,RC,85732,CPT,OUTPATIENT,,,143,92.95,,125.84,88,,100.67,,,0,"percent of total billed charges","88% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",11.32,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.09,63,,72.07,,,0,"percent of total billed charges","63% of total billed charges",21.88,15.3,,17.50,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,98.67,69,,,,,0,"fee schedule","69% of total billed charges",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.74,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.47,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.91,37.7,,43.13,,,0,"percent of total billed charges","37.7% of total billed charges",53.91,37.7,,43.13,,,0,"percent of total billed charges","37.70% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.48,33.9,,38.78,,,0,"percent of total billed charges","33.9% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",111.54,78,,89.23,,,0,"percent of total billed charges","78% of total billed charges",6.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",2.48,143,
".Pap IG, Ct-Ng TV LC",31188175,CDM,311,RC,88175,CPT,OUTPATIENT,,,459,298.35,,403.92,88,,323.14,,,0,"percent of total billed charges","88% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,459,100,,367.20,,,0,"percent of total billed charges","100% of total billed charges",46.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.03,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",289.17,63,,231.34,,,0,"percent of total billed charges","63% of total billed charges",39.92,150,,,,,0,"fee schedule","150% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,316.71,69,,,,,0,"fee schedule","69% of total billed charges",459,100,,367.20,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",459,100,,367.20,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",459,100,,367.20,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.78,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.61,100,,,,,0,"fee schedule","100% of LI fee schedule",11.53,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.87,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",173.04,37.7,,138.43,,,0,"percent of total billed charges","37.7% of total billed charges",173.04,37.7,,138.43,,,0,"percent of total billed charges","37.70% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",155.6,33.9,,124.48,,,0,"percent of total billed charges","33.9% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",358.02,78,,286.42,,,0,"percent of total billed charges","78% of total billed charges",26.87,101,,,,,0,"fee schedule","101% of CMS fee schedule ",379.13,82.6,,303.30,,,0,"percent of total billed charges","82.6% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",379.13,82.6,,303.30,,,0,"percent of total billed charges","82.6% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,459,100,,367.20,,,0,"percent of total billed charges","100% of total billed charges",11.53,459,
".Phencyclidine,MS,WB/S/P Rfx LC",30183992,CDM,301,RC,83992,CPT,OUTPATIENT,,,77,50.05,,67.76,88,,54.21,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.88,100,,,,,0,"fee schedule",EAPG,77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.18,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",48.51,63,,38.81,,,0,"percent of total billed charges","63% of total billed charges",11.78,15.3,,9.42,,,0,"percent of total billed charges","15.3% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,53.13,69,,,,,0,"fee schedule","69% of total billed charges",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.88,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.32,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",10.08,100,,,,,0,"fee schedule",EAPG,12.85,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",29.03,37.7,,23.22,,,0,"percent of total billed charges","37.7% of total billed charges",29.03,37.7,,23.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.1,33.9,,20.88,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.06,78,,48.05,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.6,82.6,,50.88,,,0,"percent of total billed charges","82.6% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",63.6,82.6,,50.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.88,100,,,,,0,"fee schedule",EAPG,77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",7.32,77,
".Phencyclidine, MS, Ur RFX LC",30183992,CDM,301,RC,83992,CPT,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.88,100,,,,,0,"fee schedule",EAPG,47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.18,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.88,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.32,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",10.08,100,,,,,0,"fee schedule",EAPG,12.85,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.7% of total billed charges",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.93,33.9,,12.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.88,100,,,,,0,"fee schedule",EAPG,47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
".Propoxyphene,MS,WB/S/P Rfx LC",30180367,CDM,301,RC,80367,CPT,OUTPATIENT,,,29,18.85,,25.52,88,,20.42,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.27,63,,14.62,,,0,"percent of total billed charges","63% of total billed charges",4.44,15.3,,3.55,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.01,69,,,,,0,"fee schedule","69% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.93,37.7,,8.74,,,0,"percent of total billed charges","37.7% of total billed charges",10.93,37.7,,8.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.83,33.9,,7.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.62,78,,18.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",4.44,29,
".Propoxyphene, MS, Ur RFX LC",30180367,CDM,301,RC,80367,CPT,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.7% of total billed charges",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.93,33.9,,12.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"HIV DNA BY PCR",30687535,CDM,306,RC,87535,CPT,OUTPATIENT,,,418,271.7,,367.84,88,,294.27,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",263.34,63,,210.67,,,0,"percent of total billed charges","63% of total billed charges",63.95,15.3,,51.16,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,288.42,69,,,,,0,"fee schedule","69% of total billed charges",418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",157.59,37.7,,126.07,,,0,"percent of total billed charges","37.7% of total billed charges",157.59,37.7,,126.07,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",141.7,33.9,,113.36,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",326.04,78,,260.83,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",345.27,82.6,,276.22,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",345.27,82.6,,276.22,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",18.33,418,
"HIV DNA BY PCR",30687535,CDM,306,RC,87535,CPT,OUTPATIENT,,,418,271.7,,367.84,88,,294.27,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",263.34,63,,210.67,,,0,"percent of total billed charges","63% of total billed charges",63.95,15.3,,51.16,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,288.42,69,,,,,0,"fee schedule","69% of total billed charges",418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",157.59,37.7,,126.07,,,0,"percent of total billed charges","37.7% of total billed charges",157.59,37.7,,126.07,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",141.7,33.9,,113.36,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",326.04,78,,260.83,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",345.27,82.6,,276.22,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",345.27,82.6,,276.22,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",18.33,418,
".RPR LC",30286592,CDM,302,RC,86592,CPT,OUTPATIENT,,,110,71.5,,96.8,88,,77.44,,,0,"percent of total billed charges","88% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",7.47,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.3,63,,55.44,,,0,"percent of total billed charges","63% of total billed charges",16.83,15.3,,13.46,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,75.9,69,,,,,0,"fee schedule","69% of total billed charges",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.33,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.26,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.47,37.7,,33.18,,,0,"percent of total billed charges","37.7% of total billed charges",41.47,37.7,,33.18,,,0,"percent of total billed charges","37.70% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.29,33.9,,29.83,,,0,"percent of total billed charges","33.9% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.8,78,,68.64,,,0,"percent of total billed charges","78% of total billed charges",4.31,101,,,,,0,"fee schedule","101% of CMS fee schedule ",90.86,82.6,,72.69,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.86,82.6,,72.69,,,0,"percent of total billed charges","82.6% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",4.26,110,
VDRL/RPR(QUANT),30286593,CDM,302,RC,86593,CPT,OUTPATIENT,,,91,59.15,,80.08,88,,64.06,,,0,"percent of total billed charges","88% of total billed charges",4.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",7.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,4.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.33,63,,45.86,,,0,"percent of total billed charges","63% of total billed charges",13.92,15.3,,11.14,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,62.79,69,,,,,0,"fee schedule","69% of total billed charges",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",4.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",4.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",4.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.83,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,4.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.4,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,4.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,4.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.31,37.7,,27.45,,,0,"percent of total billed charges","37.7% of total billed charges",34.31,37.7,,27.45,,,0,"percent of total billed charges","37.70% of total billed charges",4.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.85,33.9,,24.68,,,0,"percent of total billed charges","33.9% of total billed charges",4.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.98,78,,56.78,,,0,"percent of total billed charges","78% of total billed charges",4.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",75.17,82.6,,60.14,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,4.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",75.17,82.6,,60.14,,,0,"percent of total billed charges","82.6% of total billed charges",4.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",4.4,91,
"SENSITIVITY ADD'L-MIC",30687186,CDM,306,RC,87186,CPT,OUTPATIENT,,,391,254.15,,344.08,88,,275.26,,,0,"percent of total billed charges","88% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,391,100,,312.80,,,0,"percent of total billed charges","100% of total billed charges",15.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",246.33,63,,197.06,,,0,"percent of total billed charges","63% of total billed charges",59.82,15.3,,47.86,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,269.79,69,,,,,0,"fee schedule","69% of total billed charges",391,100,,312.80,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",391,100,,312.80,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",391,100,,312.80,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.08,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.65,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",147.41,37.7,,117.93,,,0,"percent of total billed charges","37.7% of total billed charges",147.41,37.7,,117.93,,,0,"percent of total billed charges","37.70% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",132.55,33.9,,106.04,,,0,"percent of total billed charges","33.9% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",304.98,78,,243.98,,,0,"percent of total billed charges","78% of total billed charges",8.73,101,,,,,0,"fee schedule","101% of CMS fee schedule ",322.97,82.6,,258.38,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",322.97,82.6,,258.38,,,0,"percent of total billed charges","82.6% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,391,100,,312.80,,,0,"percent of total billed charges","100% of total billed charges",4.81,391,
"SYMPATHOMIMETICS, Amphetamines LC",30980326,CDM,309,RC,80326,CPT,OUTPATIENT,,,239,155.35,,210.32,88,,168.26,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",150.57,63,,120.46,,,0,"percent of total billed charges","63% of total billed charges",36.57,15.3,,29.26,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",164.91,69,,,,,0,"fee schedule","69% of total billed charges",239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",90.1,37.7,,72.08,,,0,"percent of total billed charges","37.7% of total billed charges",90.1,37.7,,72.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.02,33.9,,64.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",186.42,78,,149.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",197.41,82.6,,157.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",197.41,82.6,,157.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.15,16.8,,32.12,,,0,"percent of total billed charges","16.8% of total billed charges",239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",36.57,239,
".Serotonin Release Assay LC",30182542,CDM,301,RC,82542,CPT,OUTPATIENT,,,226,146.9,,198.88,88,,159.10,,,0,"percent of total billed charges","88% of total billed charges",24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",42.15,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.38,63,,113.90,,,0,"percent of total billed charges","63% of total billed charges",34.58,15.3,,27.66,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,155.94,69,,,,,0,"fee schedule","69% of total billed charges",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.14,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.09,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.2,37.7,,68.16,,,0,"percent of total billed charges","37.7% of total billed charges",85.2,37.7,,68.16,,,0,"percent of total billed charges","37.70% of total billed charges",24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.61,33.9,,61.29,,,0,"percent of total billed charges","33.9% of total billed charges",24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",176.28,78,,141.02,,,0,"percent of total billed charges","78% of total billed charges",24.33,101,,,,,0,"fee schedule","101% of CMS fee schedule ",186.68,82.6,,149.34,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",186.68,82.6,,149.34,,,0,"percent of total billed charges","82.6% of total billed charges",24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",8.11,226,
"SENSITIVITY ADD'L-MIC",30687186,CDM,306,RC,87186,CPT,OUTPATIENT,,,391,254.15,,344.08,88,,275.26,,,0,"percent of total billed charges","88% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,391,100,,312.80,,,0,"percent of total billed charges","100% of total billed charges",15.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",246.33,63,,197.06,,,0,"percent of total billed charges","63% of total billed charges",59.82,15.3,,47.86,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,269.79,69,,,,,0,"fee schedule","69% of total billed charges",391,100,,312.80,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",391,100,,312.80,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",391,100,,312.80,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.08,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.65,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",147.41,37.7,,117.93,,,0,"percent of total billed charges","37.7% of total billed charges",147.41,37.7,,117.93,,,0,"percent of total billed charges","37.70% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",132.55,33.9,,106.04,,,0,"percent of total billed charges","33.9% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",304.98,78,,243.98,,,0,"percent of total billed charges","78% of total billed charges",8.73,101,,,,,0,"fee schedule","101% of CMS fee schedule ",322.97,82.6,,258.38,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",322.97,82.6,,258.38,,,0,"percent of total billed charges","82.6% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,391,100,,312.80,,,0,"percent of total billed charges","100% of total billed charges",4.81,391,
".THC,MS,WB/S/P Rfx LC",30180349,CDM,301,RC,80349,CPT,OUTPATIENT,,,478,310.7,,420.64,88,,336.51,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",301.14,63,,240.91,,,0,"percent of total billed charges","63% of total billed charges",73.13,15.3,,58.50,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",329.82,69,,,,,0,"fee schedule","69% of total billed charges",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",180.21,37.7,,144.17,,,0,"percent of total billed charges","37.7% of total billed charges",180.21,37.7,,144.17,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.04,33.9,,129.63,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.84,78,,298.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",394.83,82.6,,315.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",394.83,82.6,,315.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.3,16.8,,64.24,,,0,"percent of total billed charges","16.8% of total billed charges",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",73.13,478,
"TT PT/PSO4 MIX",30585670,CDM,305,RC,85670,CPT,OUTPATIENT,,,31,20.15,,27.28,88,,21.82,,,0,"percent of total billed charges","88% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",10.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.53,63,,15.62,,,0,"percent of total billed charges","63% of total billed charges",4.74,15.3,,3.79,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,21.39,69,,,,,0,"fee schedule","69% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.07,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.77,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.69,37.7,,9.35,,,0,"percent of total billed charges","37.7% of total billed charges",11.69,37.7,,9.35,,,0,"percent of total billed charges","37.70% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.51,33.9,,8.41,,,0,"percent of total billed charges","33.9% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.18,78,,19.34,,,0,"percent of total billed charges","78% of total billed charges",5.82,101,,,,,0,"fee schedule","101% of CMS fee schedule ",25.61,82.6,,20.49,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.61,82.6,,20.49,,,0,"percent of total billed charges","82.6% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",2.48,31,
".Tapentadol, MS, Ur RFX LC",30180372,CDM,301,RC,80372,CPT,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.7% of total billed charges",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.93,33.9,,12.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
".Thrombin Neut 117203 LC",030585670R,CDM,305,RC,85670,CPT,OUTPATIENT,,,39,25.35,,34.32,88,,27.46,,,0,"percent of total billed charges","88% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",10.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.57,63,,19.66,,,0,"percent of total billed charges","63% of total billed charges",5.97,15.3,,4.78,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,26.91,69,,,,,0,"fee schedule","69% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.07,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.77,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.7% of total billed charges",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.70% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.22,33.9,,10.58,,,0,"percent of total billed charges","33.9% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.42,78,,24.34,,,0,"percent of total billed charges","78% of total billed charges",5.82,101,,,,,0,"fee schedule","101% of CMS fee schedule ",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",2.48,39,
THYROGLOBULIN,30184432,CDM,301,RC,84432,CPT,OUTPATIENT,,,286,185.9,,251.68,88,,201.34,,,0,"percent of total billed charges","88% of total billed charges",16.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,286,100,,228.80,,,0,"percent of total billed charges","100% of total billed charges",28.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,16.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",180.18,63,,144.14,,,0,"percent of total billed charges","63% of total billed charges",43.76,15.3,,35.01,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,197.34,69,,,,,0,"fee schedule","69% of total billed charges",286,100,,228.80,,,0,"percent of total billed charges","100% of total billed charges",16.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",286,100,,228.80,,,0,"percent of total billed charges","100% of total billed charges",16.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",286,100,,228.80,,,0,"percent of total billed charges","100% of total billed charges",16.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.42,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,16.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.05,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,16.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,16.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.82,37.7,,86.26,,,0,"percent of total billed charges","37.7% of total billed charges",107.82,37.7,,86.26,,,0,"percent of total billed charges","37.70% of total billed charges",16.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",96.95,33.9,,77.56,,,0,"percent of total billed charges","33.9% of total billed charges",16.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",223.08,78,,178.46,,,0,"percent of total billed charges","78% of total billed charges",16.22,101,,,,,0,"fee schedule","101% of CMS fee schedule ",236.24,82.6,,188.99,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,16.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",236.24,82.6,,188.99,,,0,"percent of total billed charges","82.6% of total billed charges",16.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,286,100,,228.80,,,0,"percent of total billed charges","100% of total billed charges",8.39,286,
".ThyraMIR LC",3100018,CDM,310,RC,0018U,CPT,OUTPATIENT,,,8487,5516.55,,7468.56,88,,5974.85,,,0,"percent of total billed charges","88% of total billed charges",3002.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5253.65,175,,,,,0,"fee schedule","175% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",3002.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",5346.81,63,,4277.45,,,0,"percent of total billed charges","63% of total billed charges",4503.14,150,,,,,0,"fee schedule","150% of total billed charges",,,,,,,0,other,"not separately reimbursment",5856.03,69,,,,,0,"fee schedule","69% of total billed charges",8487,100,,6789.60,,,0,"percent of total billed charges","100% of total billed charges",3002.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",8487,100,,6789.60,,,0,"percent of total billed charges","100% of total billed charges",3002.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",8487,100,,6789.60,,,0,"percent of total billed charges","100% of total billed charges",3002.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",11482.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",3002.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",3002.09,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",3002.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3002.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",3199.6,37.7,,2559.68,,,0,"percent of total billed charges","37.7% of total billed charges",3199.6,37.7,,2559.68,,,0,"percent of total billed charges","37.70% of total billed charges",3002.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",2877.09,33.9,,2301.67,,,0,"percent of total billed charges","33.9% of total billed charges",3002.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",6619.86,78,,5295.89,,,0,"percent of total billed charges","78% of total billed charges",3032.11,101,,,,,0,"fee schedule","101% of CMS fee schedule ",7010.26,82.6,,5608.21,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3002.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",7010.26,82.6,,5608.21,,,0,"percent of total billed charges","82.6% of total billed charges",3002.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",8487,100,,6789.60,,,0,"percent of total billed charges","100% of total billed charges",2877.09,11482.99,
".Tramadol Conf. LC",30080373,CDM,300,RC,80373,CPT,OUTPATIENT,,,478,310.7,,420.64,88,,336.51,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",301.14,63,,240.91,,,0,"percent of total billed charges","63% of total billed charges",73.13,15.3,,58.50,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",329.82,69,,,,,0,"fee schedule","69% of total billed charges",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",180.21,37.7,,144.17,,,0,"percent of total billed charges","37.7% of total billed charges",180.21,37.7,,144.17,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.04,33.9,,129.63,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.84,78,,298.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",394.83,82.6,,315.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",394.83,82.6,,315.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.3,16.8,,64.24,,,0,"percent of total billed charges","16.8% of total billed charges",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",73.13,478,
".Tramadol, MS, Ur RFX LC",30180373,CDM,301,RC,80373,CPT,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.7% of total billed charges",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.93,33.9,,12.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
".Trich vag by NAA LC",30687661,CDM,306,RC,87661,CPT,OUTPATIENT,,,200,130,,176,88,,140.80,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",126,63,,100.80,,,0,"percent of total billed charges","63% of total billed charges",30.6,15.3,,24.48,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,138,69,,,,,0,"fee schedule","69% of total billed charges",200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",75.4,37.7,,60.32,,,0,"percent of total billed charges","37.7% of total billed charges",75.4,37.7,,60.32,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.8,33.9,,54.24,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",156,78,,124.80,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",165.2,82.6,,132.16,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",165.2,82.6,,132.16,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",18.33,200,
"VIRAL CULTURE SHELL",30687254,CDM,306,RC,87254,CPT,OUTPATIENT,,,94,61.1,,82.72,88,,66.18,,,0,"percent of total billed charges","88% of total billed charges",19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",34.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,63,,47.38,,,0,"percent of total billed charges","63% of total billed charges",14.38,15.3,,11.50,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,64.86,69,,,,,0,"fee schedule","69% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.81,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.55,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.44,37.7,,28.35,,,0,"percent of total billed charges","37.7% of total billed charges",35.44,37.7,,28.35,,,0,"percent of total billed charges","37.70% of total billed charges",19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.87,33.9,,25.50,,,0,"percent of total billed charges","33.9% of total billed charges",19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.32,78,,58.66,,,0,"percent of total billed charges","78% of total billed charges",19.75,101,,,,,0,"fee schedule","101% of CMS fee schedule ",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,94,
".aPTT 1:1 Normal Plasma 117159 LC",030585730R,CDM,305,RC,85730,CPT,OUTPATIENT,,,41,26.65,,36.08,88,,28.86,,,0,"percent of total billed charges","88% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",10.51,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.83,63,,20.66,,,0,"percent of total billed charges","63% of total billed charges",6.27,15.3,,5.02,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,28.29,69,,,,,0,"fee schedule","69% of total billed charges",41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.98,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.01,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.46,37.7,,12.37,,,0,"percent of total billed charges","37.7% of total billed charges",15.46,37.7,,12.37,,,0,"percent of total billed charges","37.70% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.9,33.9,,11.12,,,0,"percent of total billed charges","33.9% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.98,78,,25.58,,,0,"percent of total billed charges","78% of total billed charges",6.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",33.87,82.6,,27.10,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.87,82.6,,27.10,,,0,"percent of total billed charges","82.6% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",2.48,41,
"dRVVT Mix Reflex LC 241426",30585613,CDM,305,RC,85613,CPT,OUTPATIENT,,,96,62.4,,84.48,88,,67.58,,,0,"percent of total billed charges","88% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",16.76,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.48,63,,48.38,,,0,"percent of total billed charges","63% of total billed charges",14.69,15.3,,11.75,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,66.24,69,,,,,0,"fee schedule","69% of total billed charges",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.64,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.19,37.7,,28.95,,,0,"percent of total billed charges","37.7% of total billed charges",36.19,37.7,,28.95,,,0,"percent of total billed charges","37.70% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.54,33.9,,26.03,,,0,"percent of total billed charges","33.9% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.88,78,,59.90,,,0,"percent of total billed charges","78% of total billed charges",9.67,101,,,,,0,"fee schedule","101% of CMS fee schedule ",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",2.48,96,
"dRVVT Confirm Reflex LC 241426",30585613,CDM,305,RC,85613,CPT,OUTPATIENT,,,151,98.15,,132.88,88,,106.30,,,0,"percent of total billed charges","88% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",16.76,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.13,63,,76.10,,,0,"percent of total billed charges","63% of total billed charges",23.1,15.3,,18.48,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,104.19,69,,,,,0,"fee schedule","69% of total billed charges",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.64,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.93,37.7,,45.54,,,0,"percent of total billed charges","37.7% of total billed charges",56.93,37.7,,45.54,,,0,"percent of total billed charges","37.70% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.19,33.9,,40.95,,,0,"percent of total billed charges","33.9% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",117.78,78,,94.22,,,0,"percent of total billed charges","78% of total billed charges",9.67,101,,,,,0,"fee schedule","101% of CMS fee schedule ",124.73,82.6,,99.78,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.73,82.6,,99.78,,,0,"percent of total billed charges","82.6% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",2.48,151,
".dRVVT Confirm 117924 LC",030585613R,CDM,305,RC,85613,CPT,OUTPATIENT,,,65,42.25,,57.2,88,,45.76,,,0,"percent of total billed charges","88% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",16.76,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.95,63,,32.76,,,0,"percent of total billed charges","63% of total billed charges",9.95,15.3,,7.96,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,44.85,69,,,,,0,"fee schedule","69% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.64,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.51,37.7,,19.61,,,0,"percent of total billed charges","37.7% of total billed charges",24.51,37.7,,19.61,,,0,"percent of total billed charges","37.70% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.04,33.9,,17.63,,,0,"percent of total billed charges","33.9% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.7,78,,40.56,,,0,"percent of total billed charges","78% of total billed charges",9.67,101,,,,,0,"fee schedule","101% of CMS fee schedule ",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",9.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",2.48,65,
"009191 Pap Smear 2 Slides LC",31188164,CDM,311,RC,88164,CPT,OUTPATIENT,,,96,62.4,,84.48,88,,67.58,,,0,"percent of total billed charges","88% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",31.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.03,100,,,,,0,"fee schedule",EAPG,17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.48,63,,48.38,,,0,"percent of total billed charges","63% of total billed charges",26.64,150,,,,,0,"fee schedule","150% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,66.24,69,,,,,0,"fee schedule","69% of total billed charges",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.94,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.76,100,,,,,0,"fee schedule","100% of LI fee schedule",11.53,100,,,,,0,"fee schedule",EAPG,17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.87,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule",EAPG,17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.19,37.7,,28.95,,,0,"percent of total billed charges","37.7% of total billed charges",36.19,37.7,,28.95,,,0,"percent of total billed charges","37.70% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.54,33.9,,26.03,,,0,"percent of total billed charges","33.9% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.88,78,,59.90,,,0,"percent of total billed charges","78% of total billed charges",17.93,101,,,,,0,"fee schedule","101% of CMS fee schedule ",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",11.53,96,
"IFE, Dara-Specific, Serum LC",30086334,CDM,302,RC,86334,CPT,OUTPATIENT,,,226,146.9,,198.88,88,,159.10,,,0,"percent of total billed charges","88% of total billed charges",22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",39.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.38,63,,113.90,,,0,"percent of total billed charges","63% of total billed charges",34.58,15.3,,27.66,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,155.94,69,,,,,0,"fee schedule","69% of total billed charges",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.45,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.34,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.2,37.7,,68.16,,,0,"percent of total billed charges","37.7% of total billed charges",85.2,37.7,,68.16,,,0,"percent of total billed charges","37.70% of total billed charges",22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.61,33.9,,61.29,,,0,"percent of total billed charges","33.9% of total billed charges",22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",176.28,78,,141.02,,,0,"percent of total billed charges","78% of total billed charges",22.56,101,,,,,0,"fee schedule","101% of CMS fee schedule ",186.68,82.6,,149.34,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",186.68,82.6,,149.34,,,0,"percent of total billed charges","82.6% of total billed charges",22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",6.96,226,
"17-OH Progesterone LCMS LC",30183498,CDM,301,RC,83498,CPT,OUTPATIENT,,,557,362.05,,490.16,88,,392.13,,,0,"percent of total billed charges","88% of total billed charges",27.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,557,100,,445.60,,,0,"percent of total billed charges","100% of total billed charges",47.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,27.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",350.91,63,,280.73,,,0,"percent of total billed charges","63% of total billed charges",85.22,15.3,,68.18,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,384.33,69,,,,,0,"fee schedule","69% of total billed charges",557,100,,445.60,,,0,"percent of total billed charges","100% of total billed charges",27.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",557,100,,445.60,,,0,"percent of total billed charges","100% of total billed charges",27.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",557,100,,445.60,,,0,"percent of total billed charges","100% of total billed charges",27.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",103.92,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,27.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.17,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,27.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,27.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",209.99,37.7,,167.99,,,0,"percent of total billed charges","37.7% of total billed charges",209.99,37.7,,167.99,,,0,"percent of total billed charges","37.70% of total billed charges",27.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",188.82,33.9,,151.06,,,0,"percent of total billed charges","33.9% of total billed charges",27.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",434.46,78,,347.57,,,0,"percent of total billed charges","78% of total billed charges",27.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",460.08,82.6,,368.06,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,27.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",460.08,82.6,,368.06,,,0,"percent of total billed charges","82.6% of total billed charges",27.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,557,100,,445.60,,,0,"percent of total billed charges","100% of total billed charges",8.39,557,
"180071 Vaginitis + HSV, NuSwab LC",30687801,CDM,306,RC,87801,CPT,OUTPATIENT,,,212,137.8,,186.56,88,,149.25,,,0,"percent of total billed charges","88% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",122.85,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",133.56,63,,106.85,,,0,"percent of total billed charges","63% of total billed charges",32.44,15.3,,25.95,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,146.28,69,,,,,0,"fee schedule","69% of total billed charges",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",268.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.2,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.92,37.7,,63.94,,,0,"percent of total billed charges","37.7% of total billed charges",79.92,37.7,,63.94,,,0,"percent of total billed charges","37.70% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.87,33.9,,57.50,,,0,"percent of total billed charges","33.9% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",165.36,78,,132.29,,,0,"percent of total billed charges","78% of total billed charges",70.9,101,,,,,0,"fee schedule","101% of CMS fee schedule ",175.11,82.6,,140.09,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",175.11,82.6,,140.09,,,0,"percent of total billed charges","82.6% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",18.33,268.51,
"183444 MTB-RIF, AFB sm/cul, Sputum LC",30687116,CDM,306,RC,87116,CPT,OUTPATIENT,,,529,343.85,,465.52,88,,372.42,,,0,"percent of total billed charges","88% of total billed charges",10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,529,100,,423.20,,,0,"percent of total billed charges","100% of total billed charges",18.9,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",333.27,63,,266.62,,,0,"percent of total billed charges","63% of total billed charges",80.94,15.3,,64.75,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,365.01,69,,,,,0,"fee schedule","69% of total billed charges",529,100,,423.20,,,0,"percent of total billed charges","100% of total billed charges",10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",529,100,,423.20,,,0,"percent of total billed charges","100% of total billed charges",10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",529,100,,423.20,,,0,"percent of total billed charges","100% of total billed charges",10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.31,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.8,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",199.43,37.7,,159.54,,,0,"percent of total billed charges","37.7% of total billed charges",199.43,37.7,,159.54,,,0,"percent of total billed charges","37.70% of total billed charges",10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",179.33,33.9,,143.46,,,0,"percent of total billed charges","33.9% of total billed charges",10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",412.62,78,,330.10,,,0,"percent of total billed charges","78% of total billed charges",10.9,101,,,,,0,"fee schedule","101% of CMS fee schedule ",436.95,82.6,,349.56,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",436.95,82.6,,349.56,,,0,"percent of total billed charges","82.6% of total billed charges",10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,529,100,,423.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,529,
"2019 Novel Coronavirus (CoVID-19), NAA LC",30687635,CDM,306,RC,87635,CPT,OUTPATIENT,,,284,184.6,,249.92,88,,199.94,,,0,"percent of total billed charges","88% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,284,100,,227.20,,,0,"percent of total billed charges","100% of total billed charges",89.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",178.92,63,,143.14,,,0,"percent of total billed charges","63% of total billed charges",43.45,15.3,,34.76,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,195.96,69,,,,,0,"fee schedule","69% of total billed charges",284,100,,227.20,,,0,"percent of total billed charges","100% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",284,100,,227.20,,,0,"percent of total billed charges","100% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",284,100,,227.20,,,0,"percent of total billed charges","100% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.31,382.5,,,,,0,"fee schedule","382.5% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.31,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.07,37.7,,85.66,,,0,"percent of total billed charges","37.7% of total billed charges",107.07,37.7,,85.66,,,0,"percent of total billed charges","37.70% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",96.28,33.9,,77.02,,,0,"percent of total billed charges","33.9% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",221.52,78,,177.22,,,0,"percent of total billed charges","78% of total billed charges",51.82,101,,,,,0,"fee schedule","101% of CMS fee schedule ",234.58,82.6,,187.66,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",234.58,82.6,,187.66,,,0,"percent of total billed charges","82.6% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,284,100,,227.20,,,0,"percent of total billed charges","100% of total billed charges",18.33,284,
"2019 Novel Coronavirus (CoVID19), NAA INC",30687635,CDM,306,RC,87635,CPT,OUTPATIENT,,,242,157.3,,212.96,88,,170.37,,,0,"percent of total billed charges","88% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,242,100,,193.60,,,0,"percent of total billed charges","100% of total billed charges",89.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",152.46,63,,121.97,,,0,"percent of total billed charges","63% of total billed charges",37.03,15.3,,29.62,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,166.98,69,,,,,0,"fee schedule","69% of total billed charges",242,100,,193.60,,,0,"percent of total billed charges","100% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",242,100,,193.60,,,0,"percent of total billed charges","100% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",242,100,,193.60,,,0,"percent of total billed charges","100% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.31,382.5,,,,,0,"fee schedule","382.5% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.31,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.23,37.7,,72.98,,,0,"percent of total billed charges","37.7% of total billed charges",91.23,37.7,,72.98,,,0,"percent of total billed charges","37.70% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.04,33.9,,65.63,,,0,"percent of total billed charges","33.9% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",188.76,78,,151.01,,,0,"percent of total billed charges","78% of total billed charges",51.82,101,,,,,0,"fee schedule","101% of CMS fee schedule ",199.89,82.6,,159.91,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",199.89,82.6,,159.91,,,0,"percent of total billed charges","82.6% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,242,100,,193.60,,,0,"percent of total billed charges","100% of total billed charges",18.33,242,
"25-Hydroxyvitamin D LCMS D2+D3 LC",30182306,CDM,301,RC,82306,CPT,OUTPATIENT,,,234,152.1,,205.92,88,,164.74,,,0,"percent of total billed charges","88% of total billed charges",29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",51.8,175,,,,,0,"fee schedule","175% of CMS fee schedule",29.67,100,,,,,0,"fee schedule",EAPG,29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",147.42,63,,117.94,,,0,"percent of total billed charges","63% of total billed charges",35.8,15.3,,28.64,,,0,"percent of total billed charges","15.3% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,161.46,69,,,,,0,"fee schedule","69% of total billed charges",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.22,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.6,100,,,,,0,"fee schedule","100% of LI fee schedule",21.33,100,,,,,0,"fee schedule",EAPG,29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.38,100,,,,,0,"fee schedule",EAPG,37.44,100,,,,,0,"fee schedule",EAPG,29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.22,37.7,,70.58,,,0,"percent of total billed charges","37.7% of total billed charges",88.22,37.7,,70.58,,,0,"percent of total billed charges","37.70% of total billed charges",29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.33,33.9,,63.46,,,0,"percent of total billed charges","33.9% of total billed charges",29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",182.52,78,,146.02,,,0,"percent of total billed charges","78% of total billed charges",29.89,101,,,,,0,"fee schedule","101% of CMS fee schedule ",193.28,82.6,,154.62,,,0,"percent of total billed charges","82.6% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",193.28,82.6,,154.62,,,0,"percent of total billed charges","82.6% of total billed charges",29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",21.33,234,
"480875  KRAS Gene Mutation Analysis, IVD LC",31081275,CDM,310,RC,81275,CPT,OUTPATIENT,,,955,620.75,,840.4,88,,672.32,,,0,"percent of total billed charges","88% of total billed charges",193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",338.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",110.23,100,,,,,0,"fee schedule",EAPG,193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",601.65,63,,481.32,,,0,"percent of total billed charges","63% of total billed charges",289.88,150,,,,,0,"fee schedule","150% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,658.95,69,,,,,0,"fee schedule","69% of total billed charges",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",739.18,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",193.25,100,,,,,0,"fee schedule","100% of LI fee schedule",79.27,100,,,,,0,"fee schedule",EAPG,193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.16,100,,,,,0,"fee schedule",EAPG,139.13,100,,,,,0,"fee schedule",EAPG,193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",360.04,37.7,,288.03,,,0,"percent of total billed charges","37.7% of total billed charges",360.04,37.7,,288.03,,,0,"percent of total billed charges","37.70% of total billed charges",193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",323.75,33.9,,259.00,,,0,"percent of total billed charges","33.9% of total billed charges",193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",744.9,78,,595.92,,,0,"percent of total billed charges","78% of total billed charges",195.18,101,,,,,0,"fee schedule","101% of CMS fee schedule ",788.83,82.6,,631.06,,,0,"percent of total billed charges","82.6% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",788.83,82.6,,631.06,,,0,"percent of total billed charges","82.6% of total billed charges",193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",79.27,955,
"KRAS Extended Analysis LC",31081275,CDM,310,RC,81275,CPT,OUTPATIENT,,,1543,1002.95,,1357.84,88,,1086.27,,,0,"percent of total billed charges","88% of total billed charges",193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,1543,100,,1234.40,,,0,"percent of total billed charges","100% of total billed charges",338.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",110.23,100,,,,,0,"fee schedule",EAPG,193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",972.09,63,,777.67,,,0,"percent of total billed charges","63% of total billed charges",289.88,150,,,,,0,"fee schedule","150% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,1064.67,69,,,,,0,"fee schedule","69% of total billed charges",1543,100,,1234.40,,,0,"percent of total billed charges","100% of total billed charges",193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1543,100,,1234.40,,,0,"percent of total billed charges","100% of total billed charges",193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1543,100,,1234.40,,,0,"percent of total billed charges","100% of total billed charges",193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",739.18,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",193.25,100,,,,,0,"fee schedule","100% of LI fee schedule",79.27,100,,,,,0,"fee schedule",EAPG,193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.16,100,,,,,0,"fee schedule",EAPG,139.13,100,,,,,0,"fee schedule",EAPG,193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",581.71,37.7,,465.37,,,0,"percent of total billed charges","37.7% of total billed charges",581.71,37.7,,465.37,,,0,"percent of total billed charges","37.70% of total billed charges",193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",523.08,33.9,,418.46,,,0,"percent of total billed charges","33.9% of total billed charges",193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1203.54,78,,962.83,,,0,"percent of total billed charges","78% of total billed charges",195.18,101,,,,,0,"fee schedule","101% of CMS fee schedule ",1274.52,82.6,,1019.62,,,0,"percent of total billed charges","82.6% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1274.52,82.6,,1019.62,,,0,"percent of total billed charges","82.6% of total billed charges",193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,1543,100,,1234.40,,,0,"percent of total billed charges","100% of total billed charges",79.27,1543,
"481120 NRAS Gene Mutation Analysis, Extended LC",30181311,CDM,310,RC,81311,CPT,OUTPATIENT,,,1061,689.65,,933.68,88,,746.94,,,0,"percent of total billed charges","88% of total billed charges",295.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,1061,100,,848.80,,,0,"percent of total billed charges","100% of total billed charges",517.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",110.23,100,,,,,0,"fee schedule",EAPG,295.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",668.43,63,,534.74,,,0,"percent of total billed charges","63% of total billed charges",443.69,150,,,,,0,"fee schedule","150% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,732.09,69,,,,,0,"fee schedule","69% of total billed charges",1061,100,,848.80,,,0,"percent of total billed charges","100% of total billed charges",295.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,848.80,,,0,"percent of total billed charges","100% of total billed charges",295.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,848.80,,,0,"percent of total billed charges","100% of total billed charges",295.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",1131.39,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,295.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",295.79,100,,,,,0,"fee schedule","100% of LI fee schedule",79.27,100,,,,,0,"fee schedule",EAPG,295.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.16,100,,,,,0,"fee schedule",EAPG,139.13,100,,,,,0,"fee schedule",EAPG,295.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",400,37.7,,320.00,,,0,"percent of total billed charges","37.7% of total billed charges",400,37.7,,320.00,,,0,"percent of total billed charges","37.70% of total billed charges",295.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",359.68,33.9,,287.74,,,0,"percent of total billed charges","33.9% of total billed charges",295.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",827.58,78,,662.06,,,0,"percent of total billed charges","78% of total billed charges",298.74,101,,,,,0,"fee schedule","101% of CMS fee schedule ",876.39,82.6,,701.11,,,0,"percent of total billed charges","82.6% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,295.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",876.39,82.6,,701.11,,,0,"percent of total billed charges","82.6% of total billed charges",295.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,1061,100,,848.80,,,0,"percent of total billed charges","100% of total billed charges",79.27,1131.39,
"489555 Jak2, Quant w/rfx CALR 12-15 LC",31081270,CDM,310,RC,81270,CPT,OUTPATIENT,,,637,414.05,,560.56,88,,448.45,,,0,"percent of total billed charges","88% of total billed charges",91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,637,100,,509.60,,,0,"percent of total billed charges","100% of total billed charges",160.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.2,100,,,,,0,"fee schedule",EAPG,91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",401.31,63,,321.05,,,0,"percent of total billed charges","63% of total billed charges",137.49,150,,,,,0,"fee schedule","150% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,439.53,69,,,,,0,"fee schedule","69% of total billed charges",637,100,,509.60,,,0,"percent of total billed charges","100% of total billed charges",91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",637,100,,509.60,,,0,"percent of total billed charges","100% of total billed charges",91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",637,100,,509.60,,,0,"percent of total billed charges","100% of total billed charges",91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",350.59,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.66,100,,,,,0,"fee schedule","100% of LI fee schedule",28.91,100,,,,,0,"fee schedule",EAPG,91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.81,100,,,,,0,"fee schedule",EAPG,50.73,100,,,,,0,"fee schedule",EAPG,91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",240.15,37.7,,192.12,,,0,"percent of total billed charges","37.7% of total billed charges",240.15,37.7,,192.12,,,0,"percent of total billed charges","37.70% of total billed charges",91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",215.94,33.9,,172.75,,,0,"percent of total billed charges","33.9% of total billed charges",91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",496.86,78,,397.49,,,0,"percent of total billed charges","78% of total billed charges",92.57,101,,,,,0,"fee schedule","101% of CMS fee schedule ",526.16,82.6,,420.93,,,0,"percent of total billed charges","82.6% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",526.16,82.6,,420.93,,,0,"percent of total billed charges","82.6% of total billed charges",91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,637,100,,509.60,,,0,"percent of total billed charges","100% of total billed charges",28.91,637,
"5' Nucleotidase LC",30183915,CDM,301,RC,83915,CPT,OUTPATIENT,,,242,157.3,,212.96,88,,170.37,,,0,"percent of total billed charges","88% of total billed charges",11.15,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,242,100,,193.60,,,0,"percent of total billed charges","100% of total billed charges",19.51,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,11.15,100,,,,,0,"fee schedule","100% of CMS fee schedule",152.46,63,,121.97,,,0,"percent of total billed charges","63% of total billed charges",37.03,15.3,,29.62,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,166.98,69,,,,,0,"fee schedule","69% of total billed charges",242,100,,193.60,,,0,"percent of total billed charges","100% of total billed charges",11.15,100,,,,,0,"fee schedule","100% of CMS fee schedule",242,100,,193.60,,,0,"percent of total billed charges","100% of total billed charges",11.15,100,,,,,0,"fee schedule","100% of CMS fee schedule",242,100,,193.60,,,0,"percent of total billed charges","100% of total billed charges",11.15,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.64,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,11.15,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.15,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,11.15,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,11.15,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.23,37.7,,72.98,,,0,"percent of total billed charges","37.7% of total billed charges",91.23,37.7,,72.98,,,0,"percent of total billed charges","37.70% of total billed charges",11.15,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.04,33.9,,65.63,,,0,"percent of total billed charges","33.9% of total billed charges",11.15,100,,,,,0,"fee schedule","100% of CMS fee schedule",188.76,78,,151.01,,,0,"percent of total billed charges","78% of total billed charges",11.26,101,,,,,0,"fee schedule","101% of CMS fee schedule ",199.89,82.6,,159.91,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,11.15,100,,,,,0,"fee schedule","100% of CMS fee schedule",199.89,82.6,,159.91,,,0,"percent of total billed charges","82.6% of total billed charges",11.15,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,242,100,,193.60,,,0,"percent of total billed charges","100% of total billed charges",8.11,242,
"CREATININE URINE RANDOM",30182570,CDM,301,RC,82570,CPT,OUTPATIENT,,,75,48.75,,66,88,,52.80,,,0,"percent of total billed charges","88% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",9.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.25,63,,37.80,,,0,"percent of total billed charges","63% of total billed charges",11.48,15.3,,9.18,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,51.75,69,,,,,0,"fee schedule","69% of total billed charges",75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.81,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.28,37.7,,22.62,,,0,"percent of total billed charges","37.7% of total billed charges",28.28,37.7,,22.62,,,0,"percent of total billed charges","37.70% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.43,33.9,,20.34,,,0,"percent of total billed charges","33.9% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.5,78,,46.80,,,0,"percent of total billed charges","78% of total billed charges",5.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",61.95,82.6,,49.56,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.95,82.6,,49.56,,,0,"percent of total billed charges","82.6% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",3.25,75,
"5-HIAA,Quant 24 Hr Urine LC 004069",30183497,CDM,301,RC,83497,CPT,OUTPATIENT,,,139,90.35,,122.32,88,,97.86,,,0,"percent of total billed charges","88% of total billed charges",12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",22.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.57,63,,70.06,,,0,"percent of total billed charges","63% of total billed charges",21.27,15.3,,17.02,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,95.91,69,,,,,0,"fee schedule","69% of total billed charges",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.9,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.4,37.7,,41.92,,,0,"percent of total billed charges","37.7% of total billed charges",52.4,37.7,,41.92,,,0,"percent of total billed charges","37.70% of total billed charges",12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.12,33.9,,37.70,,,0,"percent of total billed charges","33.9% of total billed charges",12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.42,78,,86.74,,,0,"percent of total billed charges","78% of total billed charges",13.02,101,,,,,0,"fee schedule","101% of CMS fee schedule ",114.81,82.6,,91.85,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",114.81,82.6,,91.85,,,0,"percent of total billed charges","82.6% of total billed charges",12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",8.39,139,
"80055 Obstetric panel",30180055,CDM,301,RC,80055,CPT,OUTPATIENT,,,151,98.15,,132.88,88,,106.30,,,0,"percent of total billed charges","88% of total billed charges",47.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",83.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",7.68,100,,,,,0,"fee schedule",EAPG,47.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.13,63,,76.10,,,0,"percent of total billed charges","63% of total billed charges",23.1,15.3,,18.48,,,0,"percent of total billed charges","15.3% of total billed charges",7.45,100,,,,,0,"fee schedule",EAPG,104.19,69,,,,,0,"fee schedule","69% of total billed charges",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",47.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",47.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",47.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",182.87,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,47.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.81,100,,,,,0,"fee schedule","100% of LI fee schedule",5.52,100,,,,,0,"fee schedule",EAPG,47.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.6,100,,,,,0,"fee schedule",EAPG,9.69,100,,,,,0,"fee schedule",EAPG,47.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.93,37.7,,45.54,,,0,"percent of total billed charges","37.7% of total billed charges",56.93,37.7,,45.54,,,0,"percent of total billed charges","37.70% of total billed charges",47.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.19,33.9,,40.95,,,0,"percent of total billed charges","33.9% of total billed charges",47.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",117.78,78,,94.22,,,0,"percent of total billed charges","78% of total billed charges",48.28,101,,,,,0,"fee schedule","101% of CMS fee schedule ",124.73,82.6,,99.78,,,0,"percent of total billed charges","82.6% of total billed charges",7.45,100,,,,,0,"fee schedule",EAPG,47.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.73,82.6,,99.78,,,0,"percent of total billed charges","82.6% of total billed charges",47.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",5.52,182.87,
"High-Risk HPV Types and Pooled Results AVR",30687626,CDM,306,RC,87626,CPT,OUTPATIENT,,,174,113.1,,153.12,88,,122.50,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.23,16.8,,23.38,,,0,"percent of total billed charges","16.8% of total billed charges",174,100,,139.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.11,17.304,,24.09,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",109.62,63,,87.70,,,0,"percent of total billed charges","63% of total billed charges",26.62,15.3,,21.30,,,0,"percent of total billed charges","15.3% of total billed charges",29.23,16.8,,23.38,,,0,"percent of total billed charges","16.8% of total billed charges",120.06,69,,,,,0,"fee schedule","69% of total billed charges",174,100,,139.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",174,100,,139.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",174,100,,139.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.23,16.8,,23.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.23,16.8,,23.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.82,17.136,,23.86,,,0,"percent of total billed charges","17.136% of total billed charges",38,21.84,,30.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",65.6,37.7,,52.48,,,0,"percent of total billed charges","37.7% of total billed charges",65.6,37.7,,52.48,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.99,33.9,,47.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",135.72,78,,108.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",143.72,82.6,,114.98,,,0,"percent of total billed charges","82.6% of total billed charges",29.23,16.8,,23.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",143.72,82.6,,114.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.23,16.8,,23.38,,,0,"percent of total billed charges","16.8% of total billed charges",174,100,,139.20,,,0,"percent of total billed charges","100% of total billed charges",26.62,174,
"Drug Screen 17 w/Conf, Ur LC",30180307,CDM,301,RC,80307,CPT,OUTPATIENT,,,1145,744.25,,1007.6,88,,806.08,,,0,"percent of total billed charges","88% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",192.36,16.8,,153.89,,,0,"percent of total billed charges","16.8% of total billed charges",1145,100,,916.00,,,0,"percent of total billed charges","100% of total billed charges",108.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",198.13,17.304,,158.50,,,0,"percent of total billed charges","17.304% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",721.35,63,,577.08,,,0,"percent of total billed charges","63% of total billed charges",175.19,15.3,,140.15,,,0,"percent of total billed charges","15.3% of total billed charges",192.36,16.8,,153.89,,,0,"percent of total billed charges","16.8% of total billed charges",790.05,69,,,,,0,"fee schedule","69% of total billed charges",1145,100,,916.00,,,0,"percent of total billed charges","100% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1145,100,,916.00,,,0,"percent of total billed charges","100% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1145,100,,916.00,,,0,"percent of total billed charges","100% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",237.68,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",192.36,16.8,,153.89,,,0,"percent of total billed charges","16.8% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.14,100,,,,,0,"fee schedule","100% of LI fee schedule",192.36,16.8,,153.89,,,0,"percent of total billed charges","16.8% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",196.21,17.136,,156.97,,,0,"percent of total billed charges","17.136% of total billed charges",250.07,21.84,,200.06,,,0,"percent of total billed charges","21.84% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",431.67,37.7,,345.34,,,0,"percent of total billed charges","37.7% of total billed charges",431.67,37.7,,345.34,,,0,"percent of total billed charges","37.70% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",388.16,33.9,,310.53,,,0,"percent of total billed charges","33.9% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",893.1,78,,714.48,,,0,"percent of total billed charges","78% of total billed charges",62.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",945.77,82.6,,756.62,,,0,"percent of total billed charges","82.6% of total billed charges",192.36,16.8,,153.89,,,0,"percent of total billed charges","16.8% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",945.77,82.6,,756.62,,,0,"percent of total billed charges","82.6% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",192.36,16.8,,153.89,,,0,"percent of total billed charges","16.8% of total billed charges",1145,100,,916.00,,,0,"percent of total billed charges","100% of total billed charges",62.14,1145,
"ACTH, Plasma LC",30182024,CDM,301,RC,82024,CPT,OUTPATIENT,,,1004,652.6,,883.52,88,,706.82,,,0,"percent of total billed charges","88% of total billed charges",38.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,1004,100,,803.20,,,0,"percent of total billed charges","100% of total billed charges",67.58,175,,,,,0,"fee schedule","175% of CMS fee schedule",30.04,100,,,,,0,"fee schedule",EAPG,38.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",632.52,63,,506.02,,,0,"percent of total billed charges","63% of total billed charges",153.61,15.3,,122.89,,,0,"percent of total billed charges","15.3% of total billed charges",29.16,100,,,,,0,"fee schedule",EAPG,692.76,69,,,,,0,"fee schedule","69% of total billed charges",1004,100,,803.20,,,0,"percent of total billed charges","100% of total billed charges",38.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",1004,100,,803.20,,,0,"percent of total billed charges","100% of total billed charges",38.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",1004,100,,803.20,,,0,"percent of total billed charges","100% of total billed charges",38.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",147.72,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,38.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.61,100,,,,,0,"fee schedule","100% of LI fee schedule",21.6,100,,,,,0,"fee schedule",EAPG,38.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.74,100,,,,,0,"fee schedule",EAPG,37.91,100,,,,,0,"fee schedule",EAPG,38.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",378.51,37.7,,302.81,,,0,"percent of total billed charges","37.7% of total billed charges",378.51,37.7,,302.81,,,0,"percent of total billed charges","37.70% of total billed charges",38.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",340.36,33.9,,272.29,,,0,"percent of total billed charges","33.9% of total billed charges",38.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",783.12,78,,626.50,,,0,"percent of total billed charges","78% of total billed charges",39,101,,,,,0,"fee schedule","101% of CMS fee schedule ",829.3,82.6,,663.44,,,0,"percent of total billed charges","82.6% of total billed charges",29.16,100,,,,,0,"fee schedule",EAPG,38.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",829.3,82.6,,663.44,,,0,"percent of total billed charges","82.6% of total billed charges",38.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,1004,100,,803.20,,,0,"percent of total billed charges","100% of total billed charges",21.6,1004,
"AChR Binding Abs LC",30183519,CDM,301,RC,83519,CPT,OUTPATIENT,,,209,135.85,,183.92,88,,147.14,,,0,"percent of total billed charges","88% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,209,100,,167.20,,,0,"percent of total billed charges","100% of total billed charges",32.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",31.98,15.3,,25.58,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,144.21,69,,,,,0,"fee schedule","69% of total billed charges",209,100,,167.20,,,0,"percent of total billed charges","100% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",209,100,,167.20,,,0,"percent of total billed charges","100% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",209,100,,167.20,,,0,"percent of total billed charges","100% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.37,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.39,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.79,37.7,,63.03,,,0,"percent of total billed charges","37.7% of total billed charges",78.79,37.7,,63.03,,,0,"percent of total billed charges","37.70% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.85,33.9,,56.68,,,0,"percent of total billed charges","33.9% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.02,78,,130.42,,,0,"percent of total billed charges","78% of total billed charges",18.58,101,,,,,0,"fee schedule","101% of CMS fee schedule ",172.63,82.6,,138.10,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",172.63,82.6,,138.10,,,0,"percent of total billed charges","82.6% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,209,100,,167.20,,,0,"percent of total billed charges","100% of total billed charges",8.11,209,
"AChR Blocking Abs LC",30183519,CDM,301,RC,83519,CPT,OUTPATIENT,,,205,133.25,,180.4,88,,144.32,,,0,"percent of total billed charges","88% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,205,100,,164.00,,,0,"percent of total billed charges","100% of total billed charges",32.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",31.37,15.3,,25.10,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,141.45,69,,,,,0,"fee schedule","69% of total billed charges",205,100,,164.00,,,0,"percent of total billed charges","100% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",205,100,,164.00,,,0,"percent of total billed charges","100% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",205,100,,164.00,,,0,"percent of total billed charges","100% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.37,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.39,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.29,37.7,,61.83,,,0,"percent of total billed charges","37.7% of total billed charges",77.29,37.7,,61.83,,,0,"percent of total billed charges","37.70% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.5,33.9,,55.60,,,0,"percent of total billed charges","33.9% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",159.9,78,,127.92,,,0,"percent of total billed charges","78% of total billed charges",18.58,101,,,,,0,"fee schedule","101% of CMS fee schedule ",169.33,82.6,,135.46,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",169.33,82.6,,135.46,,,0,"percent of total billed charges","82.6% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,205,100,,164.00,,,0,"percent of total billed charges","100% of total billed charges",8.11,205,
"AChR Modulating Antibodies LC",30183519,CDM,301,RC,83519,CPT,OUTPATIENT,,,205,133.25,,180.4,88,,144.32,,,0,"percent of total billed charges","88% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,205,100,,164.00,,,0,"percent of total billed charges","100% of total billed charges",32.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",31.37,15.3,,25.10,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,141.45,69,,,,,0,"fee schedule","69% of total billed charges",205,100,,164.00,,,0,"percent of total billed charges","100% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",205,100,,164.00,,,0,"percent of total billed charges","100% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",205,100,,164.00,,,0,"percent of total billed charges","100% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.37,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.39,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.29,37.7,,61.83,,,0,"percent of total billed charges","37.7% of total billed charges",77.29,37.7,,61.83,,,0,"percent of total billed charges","37.70% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.5,33.9,,55.60,,,0,"percent of total billed charges","33.9% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",159.9,78,,127.92,,,0,"percent of total billed charges","78% of total billed charges",18.58,101,,,,,0,"fee schedule","101% of CMS fee schedule ",169.33,82.6,,135.46,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",169.33,82.6,,135.46,,,0,"percent of total billed charges","82.6% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,205,100,,164.00,,,0,"percent of total billed charges","100% of total billed charges",8.11,205,
"Vasopressin (antidiuretic hormone, ADH) LC",30184588,CDM,301,RC,84588,CPT,OUTPATIENT,,,177,115.05,,155.76,88,,124.61,,,0,"percent of total billed charges","88% of total billed charges",33.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",59.39,175,,,,,0,"fee schedule","175% of CMS fee schedule",30.04,100,,,,,0,"fee schedule",EAPG,33.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",111.51,63,,89.21,,,0,"percent of total billed charges","63% of total billed charges",27.08,15.3,,21.66,,,0,"percent of total billed charges","15.3% of total billed charges",29.16,100,,,,,0,"fee schedule",EAPG,122.13,69,,,,,0,"fee schedule","69% of total billed charges",177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",33.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",33.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",33.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.82,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,33.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.94,100,,,,,0,"fee schedule","100% of LI fee schedule",21.6,100,,,,,0,"fee schedule",EAPG,33.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.74,100,,,,,0,"fee schedule",EAPG,37.91,100,,,,,0,"fee schedule",EAPG,33.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.73,37.7,,53.38,,,0,"percent of total billed charges","37.7% of total billed charges",66.73,37.7,,53.38,,,0,"percent of total billed charges","37.70% of total billed charges",33.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",60,33.9,,48.00,,,0,"percent of total billed charges","33.9% of total billed charges",33.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",138.06,78,,110.45,,,0,"percent of total billed charges","78% of total billed charges",34.27,101,,,,,0,"fee schedule","101% of CMS fee schedule ",146.2,82.6,,116.96,,,0,"percent of total billed charges","82.6% of total billed charges",29.16,100,,,,,0,"fee schedule",EAPG,33.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",146.2,82.6,,116.96,,,0,"percent of total billed charges","82.6% of total billed charges",33.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",21.6,177,
"CULTURE ID NUCLEIC ACID PRB 1",30687149,CDM,306,RC,87149,CPT,OUTPATIENT,,,288,187.2,,253.44,88,,202.75,,,0,"percent of total billed charges","88% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",35.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",181.44,63,,145.15,,,0,"percent of total billed charges","63% of total billed charges",44.06,15.3,,35.25,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,198.72,69,,,,,0,"fee schedule","69% of total billed charges",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.69,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.05,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.58,37.7,,86.86,,,0,"percent of total billed charges","37.7% of total billed charges",108.58,37.7,,86.86,,,0,"percent of total billed charges","37.70% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.63,33.9,,78.10,,,0,"percent of total billed charges","33.9% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",224.64,78,,179.71,,,0,"percent of total billed charges","78% of total billed charges",20.25,101,,,,,0,"fee schedule","101% of CMS fee schedule ",237.89,82.6,,190.31,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",237.89,82.6,,190.31,,,0,"percent of total billed charges","82.6% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",4.81,288,
"AFP Tetra (PR4)",30286336,CDM,302,RC,86336,CPT,OUTPATIENT,,,113,73.45,,99.44,88,,79.55,,,0,"percent of total billed charges","88% of total billed charges",15.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,113,100,,90.40,,,0,"percent of total billed charges","100% of total billed charges",27.28,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,15.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.19,63,,56.95,,,0,"percent of total billed charges","63% of total billed charges",17.29,15.3,,13.83,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,77.97,69,,,,,0,"fee schedule","69% of total billed charges",113,100,,90.40,,,0,"percent of total billed charges","100% of total billed charges",15.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",113,100,,90.40,,,0,"percent of total billed charges","100% of total billed charges",15.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",113,100,,90.40,,,0,"percent of total billed charges","100% of total billed charges",15.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.63,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,15.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.59,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,15.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,15.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.6,37.7,,34.08,,,0,"percent of total billed charges","37.7% of total billed charges",42.6,37.7,,34.08,,,0,"percent of total billed charges","37.70% of total billed charges",15.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.31,33.9,,30.65,,,0,"percent of total billed charges","33.9% of total billed charges",15.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.14,78,,70.51,,,0,"percent of total billed charges","78% of total billed charges",15.74,101,,,,,0,"fee schedule","101% of CMS fee schedule ",93.34,82.6,,74.67,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,15.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",93.34,82.6,,74.67,,,0,"percent of total billed charges","82.6% of total billed charges",15.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,113,100,,90.40,,,0,"percent of total billed charges","100% of total billed charges",6.96,113,
"AFP, Tumor Marker LC",30182105,CDM,301,RC,82105,CPT,OUTPATIENT,,,455,295.75,,400.4,88,,320.32,,,0,"percent of total billed charges","88% of total billed charges",16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,455,100,,364.00,,,0,"percent of total billed charges","100% of total billed charges",29.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",286.65,63,,229.32,,,0,"percent of total billed charges","63% of total billed charges",69.62,15.3,,55.70,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,313.95,69,,,,,0,"fee schedule","69% of total billed charges",455,100,,364.00,,,0,"percent of total billed charges","100% of total billed charges",16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",455,100,,364.00,,,0,"percent of total billed charges","100% of total billed charges",16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",455,100,,364.00,,,0,"percent of total billed charges","100% of total billed charges",16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.14,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.77,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",171.54,37.7,,137.23,,,0,"percent of total billed charges","37.7% of total billed charges",171.54,37.7,,137.23,,,0,"percent of total billed charges","37.70% of total billed charges",16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",154.25,33.9,,123.40,,,0,"percent of total billed charges","33.9% of total billed charges",16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",354.9,78,,283.92,,,0,"percent of total billed charges","78% of total billed charges",16.93,101,,,,,0,"fee schedule","101% of CMS fee schedule ",375.83,82.6,,300.66,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",375.83,82.6,,300.66,,,0,"percent of total billed charges","82.6% of total billed charges",16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,455,100,,364.00,,,0,"percent of total billed charges","100% of total billed charges",8.11,455,
"AFP, Open Spina Bifida LC",30182105,CDM,301,RC,82105,CPT,OUTPATIENT,,,433,281.45,,381.04,88,,304.83,,,0,"percent of total billed charges","88% of total billed charges",16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",29.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",272.79,63,,218.23,,,0,"percent of total billed charges","63% of total billed charges",66.25,15.3,,53.00,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,298.77,69,,,,,0,"fee schedule","69% of total billed charges",433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.14,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.77,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.24,37.7,,130.59,,,0,"percent of total billed charges","37.7% of total billed charges",163.24,37.7,,130.59,,,0,"percent of total billed charges","37.70% of total billed charges",16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",146.79,33.9,,117.43,,,0,"percent of total billed charges","33.9% of total billed charges",16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",337.74,78,,270.19,,,0,"percent of total billed charges","78% of total billed charges",16.93,101,,,,,0,"fee schedule","101% of CMS fee schedule ",357.66,82.6,,286.13,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",357.66,82.6,,286.13,,,0,"percent of total billed charges","82.6% of total billed charges",16.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,433,
"AFP/AChE/HbF, Amniotic Fluid LC",30082106,CDM,300,RC,82106,CPT,OUTPATIENT,,,147,95.55,,129.36,88,,103.49,,,0,"percent of total billed charges","88% of total billed charges",17,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",29.75,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,17,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.61,63,,74.09,,,0,"percent of total billed charges","63% of total billed charges",22.49,15.3,,17.99,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,101.43,69,,,,,0,"fee schedule","69% of total billed charges",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",17,100,,,,,0,"fee schedule","100% of CMS fee schedule",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",17,100,,,,,0,"fee schedule","100% of CMS fee schedule",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",17,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.02,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,17,100,,,,,0,"fee schedule","100% of CMS fee schedule",17,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,17,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,17,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.42,37.7,,44.34,,,0,"percent of total billed charges","37.7% of total billed charges",55.42,37.7,,44.34,,,0,"percent of total billed charges","37.70% of total billed charges",17,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.83,33.9,,39.86,,,0,"percent of total billed charges","33.9% of total billed charges",17,100,,,,,0,"fee schedule","100% of CMS fee schedule",114.66,78,,91.73,,,0,"percent of total billed charges","78% of total billed charges",17.17,101,,,,,0,"fee schedule","101% of CMS fee schedule ",121.42,82.6,,97.14,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,17,100,,,,,0,"fee schedule","100% of CMS fee schedule",121.42,82.6,,97.14,,,0,"percent of total billed charges","82.6% of total billed charges",17,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",8.11,147,
"Transferase; alanine amino (ALT) (SGPT) LC",30184460,CDM,301,RC,84460,CPT,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",9.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.27,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.3,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.7% of total billed charges",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.92,33.9,,27.94,,,0,"percent of total billed charges","33.9% of total billed charges",5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",5.35,101,,,,,0,"fee schedule","101% of CMS fee schedule ",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,103,
"ANNA TYPE 1",30286256,CDM,302,RC,86256,CPT,OUTPATIENT,,,57,37.05,,50.16,88,,40.13,,,0,"percent of total billed charges","88% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",21.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.91,63,,28.73,,,0,"percent of total billed charges","63% of total billed charges",8.72,15.3,,6.98,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,39.33,69,,,,,0,"fee schedule","69% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.09,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.05,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.49,37.7,,17.19,,,0,"percent of total billed charges","37.7% of total billed charges",21.49,37.7,,17.19,,,0,"percent of total billed charges","37.70% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.32,33.9,,15.46,,,0,"percent of total billed charges","33.9% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.46,78,,35.57,,,0,"percent of total billed charges","78% of total billed charges",12.17,101,,,,,0,"fee schedule","101% of CMS fee schedule ",47.08,82.6,,37.66,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.08,82.6,,37.66,,,0,"percent of total billed charges","82.6% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",6.96,57,
"ANA w/Rflx+C3+C4+RA QN+CCP(... LC",30286160,CDM,302,RC,86160,CPT,OUTPATIENT,,,91,59.15,,80.08,88,,64.06,,,0,"percent of total billed charges","88% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",21,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.33,63,,45.86,,,0,"percent of total billed charges","63% of total billed charges",13.92,15.3,,11.14,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,62.79,69,,,,,0,"fee schedule","69% of total billed charges",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.9,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12,100,,,,,0,"fee schedule","100% of CMS fee schedule",12,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.31,37.7,,27.45,,,0,"percent of total billed charges","37.7% of total billed charges",34.31,37.7,,27.45,,,0,"percent of total billed charges","37.70% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.85,33.9,,24.68,,,0,"percent of total billed charges","33.9% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.98,78,,56.78,,,0,"percent of total billed charges","78% of total billed charges",12.12,101,,,,,0,"fee schedule","101% of CMS fee schedule ",75.17,82.6,,60.14,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12,100,,,,,0,"fee schedule","100% of CMS fee schedule",75.17,82.6,,60.14,,,0,"percent of total billed charges","82.6% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",6.96,91,
"ANA W/Rfx to all if Positive",30286038,CDM,302,RC,86038,CPT,OUTPATIENT,,,60,39,,52.8,88,,42.24,,,0,"percent of total billed charges","88% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",21.15,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.8,63,,30.24,,,0,"percent of total billed charges","63% of total billed charges",9.18,15.3,,7.34,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,41.4,69,,,,,0,"fee schedule","69% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.24,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.09,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.62,37.7,,18.10,,,0,"percent of total billed charges","37.7% of total billed charges",22.62,37.7,,18.10,,,0,"percent of total billed charges","37.70% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.34,33.9,,16.27,,,0,"percent of total billed charges","33.9% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.8,78,,37.44,,,0,"percent of total billed charges","78% of total billed charges",12.21,101,,,,,0,"fee schedule","101% of CMS fee schedule ",49.56,82.6,,39.65,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.56,82.6,,39.65,,,0,"percent of total billed charges","82.6% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,60,
"ANA w/Reflex LC",30286038,CDM,302,RC,86038,CPT,OUTPATIENT,,,70,45.5,,61.6,88,,49.28,,,0,"percent of total billed charges","88% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",21.15,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.1,63,,35.28,,,0,"percent of total billed charges","63% of total billed charges",10.71,15.3,,8.57,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,48.3,69,,,,,0,"fee schedule","69% of total billed charges",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.24,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.09,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.39,37.7,,21.11,,,0,"percent of total billed charges","37.7% of total billed charges",26.39,37.7,,21.11,,,0,"percent of total billed charges","37.70% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.73,33.9,,18.98,,,0,"percent of total billed charges","33.9% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.6,78,,43.68,,,0,"percent of total billed charges","78% of total billed charges",12.21,101,,,,,0,"fee schedule","101% of CMS fee schedule ",57.82,82.6,,46.26,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.82,82.6,,46.26,,,0,"percent of total billed charges","82.6% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,70,
"ANCA Profile LC",30286037,CDM,302,RC,86037,CPT,OUTPATIENT,,,38,24.7,,33.44,88,,26.75,,,0,"percent of total billed charges","88% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",21.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.94,63,,19.15,,,0,"percent of total billed charges","63% of total billed charges",5.81,15.3,,4.65,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,26.22,69,,,,,0,"fee schedule","69% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",9.39,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.05,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.33,37.7,,11.46,,,0,"percent of total billed charges","37.7% of total billed charges",14.33,37.7,,11.46,,,0,"percent of total billed charges","37.70% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.88,33.9,,10.30,,,0,"percent of total billed charges","33.9% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.64,78,,23.71,,,0,"percent of total billed charges","78% of total billed charges",12.17,101,,,,,0,"fee schedule","101% of CMS fee schedule ",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",5.81,38,
"ANCA+Sca(IgA/G) LC",30286671,CDM,302,RC,86671,CPT,OUTPATIENT,,,102,66.3,,89.76,88,,71.81,,,0,"percent of total billed charges","88% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",21.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.26,63,,51.41,,,0,"percent of total billed charges","63% of total billed charges",15.61,15.3,,12.49,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,70.38,69,,,,,0,"fee schedule","69% of total billed charges",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.85,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.25,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.45,37.7,,30.76,,,0,"percent of total billed charges","37.7% of total billed charges",38.45,37.7,,30.76,,,0,"percent of total billed charges","37.70% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.58,33.9,,27.66,,,0,"percent of total billed charges","33.9% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.56,78,,63.65,,,0,"percent of total billed charges","78% of total billed charges",12.37,101,,,,,0,"fee schedule","101% of CMS fee schedule ",84.25,82.6,,67.40,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",84.25,82.6,,67.40,,,0,"percent of total billed charges","82.6% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",6.96,102,
"ANCA by IFA (RDL) LC",30286036,CDM,302,RC,86036,CPT,OUTPATIENT,,,38,24.7,,33.44,88,,26.75,,,0,"percent of total billed charges","88% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",21.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.94,63,,19.15,,,0,"percent of total billed charges","63% of total billed charges",5.81,15.3,,4.65,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,26.22,69,,,,,0,"fee schedule","69% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",9.39,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.05,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.33,37.7,,11.46,,,0,"percent of total billed charges","37.7% of total billed charges",14.33,37.7,,11.46,,,0,"percent of total billed charges","37.70% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.88,33.9,,10.30,,,0,"percent of total billed charges","33.9% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.64,78,,23.71,,,0,"percent of total billed charges","78% of total billed charges",12.17,101,,,,,0,"fee schedule","101% of CMS fee schedule ",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",5.81,38,
"Abdominal Fluid Cytology LC",31188112,CDM,311,RC,88112,CPT,OUTPATIENT,,,215,139.75,,189.2,88,,151.36,,,0,"percent of total billed charges","88% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",96.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",26.78,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",135.45,63,,108.36,,,0,"percent of total billed charges","63% of total billed charges",32.9,15.3,,26.32,,,0,"percent of total billed charges","15.3% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,148.35,69,,,,,0,"fee schedule","69% of total billed charges",215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.15,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.26,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.52,100,,,,,0,"fee schedule",EAPG,33.8,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",81.06,37.7,,64.85,,,0,"percent of total billed charges","37.7% of total billed charges",81.06,37.7,,64.85,,,0,"percent of total billed charges","37.70% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",72.89,33.9,,58.31,,,0,"percent of total billed charges","33.9% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",167.7,78,,134.16,,,0,"percent of total billed charges","78% of total billed charges",55.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.59,82.6,,142.07,,,0,"percent of total billed charges","82.6% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.59,82.6,,142.07,,,0,"percent of total billed charges","82.6% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",19.26,215,
Acetaminophen,30180143,CDM,301,RC,80307,CPT,OUTPATIENT,,,294,191.1,,258.72,88,,206.98,,,0,"percent of total billed charges","88% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.39,16.8,,39.51,,,0,"percent of total billed charges","16.8% of total billed charges",294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",108.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",50.87,17.304,,40.70,,,0,"percent of total billed charges","17.304% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",185.22,63,,148.18,,,0,"percent of total billed charges","63% of total billed charges",44.98,15.3,,35.98,,,0,"percent of total billed charges","15.3% of total billed charges",49.39,16.8,,39.51,,,0,"percent of total billed charges","16.8% of total billed charges",202.86,69,,,,,0,"fee schedule","69% of total billed charges",294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",237.68,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",49.39,16.8,,39.51,,,0,"percent of total billed charges","16.8% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.14,100,,,,,0,"fee schedule","100% of LI fee schedule",49.39,16.8,,39.51,,,0,"percent of total billed charges","16.8% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.38,17.136,,40.30,,,0,"percent of total billed charges","17.136% of total billed charges",64.21,21.84,,51.37,,,0,"percent of total billed charges","21.84% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",110.84,37.7,,88.67,,,0,"percent of total billed charges","37.7% of total billed charges",110.84,37.7,,88.67,,,0,"percent of total billed charges","37.70% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.67,33.9,,79.74,,,0,"percent of total billed charges","33.9% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",229.32,78,,183.46,,,0,"percent of total billed charges","78% of total billed charges",62.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",242.84,82.6,,194.27,,,0,"percent of total billed charges","82.6% of total billed charges",49.39,16.8,,39.51,,,0,"percent of total billed charges","16.8% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",242.84,82.6,,194.27,,,0,"percent of total billed charges","82.6% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.39,16.8,,39.51,,,0,"percent of total billed charges","16.8% of total billed charges",294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",44.98,294,
"Acetone Serum",30182009,CDM,301,RC,82009,CPT,OUTPATIENT,,,88,57.2,,77.44,88,,61.95,,,0,"percent of total billed charges","88% of total billed charges",4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",7.9,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.44,63,,44.35,,,0,"percent of total billed charges","63% of total billed charges",13.46,15.3,,10.77,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,60.72,69,,,,,0,"fee schedule","69% of total billed charges",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.28,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.51,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.18,37.7,,26.54,,,0,"percent of total billed charges","37.7% of total billed charges",33.18,37.7,,26.54,,,0,"percent of total billed charges","37.70% of total billed charges",4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.83,33.9,,23.86,,,0,"percent of total billed charges","33.9% of total billed charges",4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.64,78,,54.91,,,0,"percent of total billed charges","78% of total billed charges",4.56,101,,,,,0,"fee schedule","101% of CMS fee schedule ",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,88,
"ACID FAST CULTURE",30687116,CDM,306,RC,87116,CPT,OUTPATIENT,,,77,50.05,,67.76,88,,54.21,,,0,"percent of total billed charges","88% of total billed charges",10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",18.9,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.51,63,,38.81,,,0,"percent of total billed charges","63% of total billed charges",11.78,15.3,,9.42,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,53.13,69,,,,,0,"fee schedule","69% of total billed charges",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.31,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.8,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.03,37.7,,23.22,,,0,"percent of total billed charges","37.7% of total billed charges",29.03,37.7,,23.22,,,0,"percent of total billed charges","37.70% of total billed charges",10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.1,33.9,,20.88,,,0,"percent of total billed charges","33.9% of total billed charges",10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.06,78,,48.05,,,0,"percent of total billed charges","78% of total billed charges",10.9,101,,,,,0,"fee schedule","101% of CMS fee schedule ",63.6,82.6,,50.88,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.6,82.6,,50.88,,,0,"percent of total billed charges","82.6% of total billed charges",10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",4.81,77,
"Activated PTT",30585730,CDM,305,RC,85730,CPT,OUTPATIENT,,,117,76.05,,102.96,88,,82.37,,,0,"percent of total billed charges","88% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",10.51,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.71,63,,58.97,,,0,"percent of total billed charges","63% of total billed charges",17.9,15.3,,14.32,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,80.73,69,,,,,0,"fee schedule","69% of total billed charges",117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.98,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.01,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.11,37.7,,35.29,,,0,"percent of total billed charges","37.7% of total billed charges",44.11,37.7,,35.29,,,0,"percent of total billed charges","37.70% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.66,33.9,,31.73,,,0,"percent of total billed charges","33.9% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.26,78,,73.01,,,0,"percent of total billed charges","78% of total billed charges",6.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",96.64,82.6,,77.31,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",96.64,82.6,,77.31,,,0,"percent of total billed charges","82.6% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",2.48,117,
"Actin (Smooth Muscle) Antibody LC",30183516,CDM,301,RC,83516,CPT,OUTPATIENT,,,145,94.25,,127.6,88,,102.08,,,0,"percent of total billed charges","88% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",20.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",22.19,15.3,,17.75,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,100.05,69,,,,,0,"fee schedule","69% of total billed charges",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.53,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.67,37.7,,43.74,,,0,"percent of total billed charges","37.7% of total billed charges",54.67,37.7,,43.74,,,0,"percent of total billed charges","37.70% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.16,33.9,,39.33,,,0,"percent of total billed charges","33.9% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.1,78,,90.48,,,0,"percent of total billed charges","78% of total billed charges",11.64,101,,,,,0,"fee schedule","101% of CMS fee schedule ",119.77,82.6,,95.82,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",119.77,82.6,,95.82,,,0,"percent of total billed charges","82.6% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",8.11,145,
"Acute Viral Hepatitis LC",30180074,CDM,301,RC,80074,CPT,OUTPATIENT,,,177,115.05,,155.76,88,,124.61,,,0,"percent of total billed charges","88% of total billed charges",47.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",83.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",7.68,100,,,,,0,"fee schedule",EAPG,47.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",111.51,63,,89.21,,,0,"percent of total billed charges","63% of total billed charges",27.08,15.3,,21.66,,,0,"percent of total billed charges","15.3% of total billed charges",7.45,100,,,,,0,"fee schedule",EAPG,122.13,69,,,,,0,"fee schedule","69% of total billed charges",177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",47.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",47.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",47.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",182.18,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,47.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.63,100,,,,,0,"fee schedule","100% of LI fee schedule",5.52,100,,,,,0,"fee schedule",EAPG,47.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.6,100,,,,,0,"fee schedule",EAPG,9.69,100,,,,,0,"fee schedule",EAPG,47.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.73,37.7,,53.38,,,0,"percent of total billed charges","37.7% of total billed charges",66.73,37.7,,53.38,,,0,"percent of total billed charges","37.70% of total billed charges",47.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",60,33.9,,48.00,,,0,"percent of total billed charges","33.9% of total billed charges",47.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",138.06,78,,110.45,,,0,"percent of total billed charges","78% of total billed charges",48.1,101,,,,,0,"fee schedule","101% of CMS fee schedule ",146.2,82.6,,116.96,,,0,"percent of total billed charges","82.6% of total billed charges",7.45,100,,,,,0,"fee schedule",EAPG,47.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",146.2,82.6,,116.96,,,0,"percent of total billed charges","82.6% of total billed charges",47.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",5.52,182.18,
"Aerobe ID + Suscept LC",30687077,CDM,306,RC,87077,CPT,OUTPATIENT,,,329,213.85,,289.52,88,,231.62,,,0,"percent of total billed charges","88% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",14.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",207.27,63,,165.82,,,0,"percent of total billed charges","63% of total billed charges",50.34,15.3,,40.27,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,227.01,69,,,,,0,"fee schedule","69% of total billed charges",329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.9,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.08,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.03,37.7,,99.22,,,0,"percent of total billed charges","37.7% of total billed charges",124.03,37.7,,99.22,,,0,"percent of total billed charges","37.70% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",111.53,33.9,,89.22,,,0,"percent of total billed charges","33.9% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",256.62,78,,205.30,,,0,"percent of total billed charges","78% of total billed charges",8.16,101,,,,,0,"fee schedule","101% of CMS fee schedule ",271.75,82.6,,217.40,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",271.75,82.6,,217.40,,,0,"percent of total billed charges","82.6% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,329,
"Aerobic Vaginitis Panel AVR",30687640,CDM,306,RC,87640,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"SGPT OR ALT",30184460,CDM,301,RC,84460,CPT,OUTPATIENT,,,123,79.95,,108.24,88,,86.59,,,0,"percent of total billed charges","88% of total billed charges",5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",9.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.49,63,,61.99,,,0,"percent of total billed charges","63% of total billed charges",18.82,15.3,,15.06,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,84.87,69,,,,,0,"fee schedule","69% of total billed charges",123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.27,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.3,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.37,37.7,,37.10,,,0,"percent of total billed charges","37.7% of total billed charges",46.37,37.7,,37.10,,,0,"percent of total billed charges","37.70% of total billed charges",5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.7,33.9,,33.36,,,0,"percent of total billed charges","33.9% of total billed charges",5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.94,78,,76.75,,,0,"percent of total billed charges","78% of total billed charges",5.35,101,,,,,0,"fee schedule","101% of CMS fee schedule ",101.6,82.6,,81.28,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.6,82.6,,81.28,,,0,"percent of total billed charges","82.6% of total billed charges",5.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,123,
"ALBUMIN SERUM",30182040,CDM,301,RC,82040,CPT,OUTPATIENT,,,136,88.4,,119.68,88,,95.74,,,0,"percent of total billed charges","88% of total billed charges",4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",8.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.68,63,,68.54,,,0,"percent of total billed charges","63% of total billed charges",20.81,15.3,,16.65,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,93.84,69,,,,,0,"fee schedule","69% of total billed charges",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.93,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.95,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.27,37.7,,41.02,,,0,"percent of total billed charges","37.7% of total billed charges",51.27,37.7,,41.02,,,0,"percent of total billed charges","37.70% of total billed charges",4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.1,33.9,,36.88,,,0,"percent of total billed charges","33.9% of total billed charges",4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.08,78,,84.86,,,0,"percent of total billed charges","78% of total billed charges",4.99,101,,,,,0,"fee schedule","101% of CMS fee schedule ",112.34,82.6,,89.87,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",112.34,82.6,,89.87,,,0,"percent of total billed charges","82.6% of total billed charges",4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",3.25,136,
"Albumin Body Fluid",30182042,CDM,301,RC,82042,CPT,OUTPATIENT,,,146,94.9,,128.48,88,,102.78,,,0,"percent of total billed charges","88% of total billed charges",7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",13.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.98,63,,73.58,,,0,"percent of total billed charges","63% of total billed charges",22.34,15.3,,17.87,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,100.74,69,,,,,0,"fee schedule","69% of total billed charges",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.75,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.78,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.04,37.7,,44.03,,,0,"percent of total billed charges","37.7% of total billed charges",55.04,37.7,,44.03,,,0,"percent of total billed charges","37.70% of total billed charges",7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.49,33.9,,39.59,,,0,"percent of total billed charges","33.9% of total billed charges",7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.88,78,,91.10,,,0,"percent of total billed charges","78% of total billed charges",7.85,101,,,,,0,"fee schedule","101% of CMS fee schedule ",120.6,82.6,,96.48,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",120.6,82.6,,96.48,,,0,"percent of total billed charges","82.6% of total billed charges",7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",3.25,146,
"Albumin Level 24 Hr Urine",30182042,CDM,301,RC,82042,CPT,OUTPATIENT,,,146,94.9,,128.48,88,,102.78,,,0,"percent of total billed charges","88% of total billed charges",7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",13.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.98,63,,73.58,,,0,"percent of total billed charges","63% of total billed charges",22.34,15.3,,17.87,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,100.74,69,,,,,0,"fee schedule","69% of total billed charges",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.75,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.78,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.04,37.7,,44.03,,,0,"percent of total billed charges","37.7% of total billed charges",55.04,37.7,,44.03,,,0,"percent of total billed charges","37.70% of total billed charges",7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.49,33.9,,39.59,,,0,"percent of total billed charges","33.9% of total billed charges",7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.88,78,,91.10,,,0,"percent of total billed charges","78% of total billed charges",7.85,101,,,,,0,"fee schedule","101% of CMS fee schedule ",120.6,82.6,,96.48,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",120.6,82.6,,96.48,,,0,"percent of total billed charges","82.6% of total billed charges",7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",3.25,146,
"Albumin CSF",30182042,CDM,301,RC,82042,CPT,OUTPATIENT,,,146,94.9,,128.48,88,,102.78,,,0,"percent of total billed charges","88% of total billed charges",7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",13.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.98,63,,73.58,,,0,"percent of total billed charges","63% of total billed charges",22.34,15.3,,17.87,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,100.74,69,,,,,0,"fee schedule","69% of total billed charges",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.75,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.78,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.04,37.7,,44.03,,,0,"percent of total billed charges","37.7% of total billed charges",55.04,37.7,,44.03,,,0,"percent of total billed charges","37.70% of total billed charges",7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.49,33.9,,39.59,,,0,"percent of total billed charges","33.9% of total billed charges",7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.88,78,,91.10,,,0,"percent of total billed charges","78% of total billed charges",7.85,101,,,,,0,"fee schedule","101% of CMS fee schedule ",120.6,82.6,,96.48,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",120.6,82.6,,96.48,,,0,"percent of total billed charges","82.6% of total billed charges",7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",3.25,146,
"Albumin Level Urine",30082040,CDM,300,RC,82040,CPT,OUTPATIENT,,,136,88.4,,119.68,88,,95.74,,,0,"percent of total billed charges","88% of total billed charges",4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",8.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.68,63,,68.54,,,0,"percent of total billed charges","63% of total billed charges",20.81,15.3,,16.65,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,93.84,69,,,,,0,"fee schedule","69% of total billed charges",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.93,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.95,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.27,37.7,,41.02,,,0,"percent of total billed charges","37.7% of total billed charges",51.27,37.7,,41.02,,,0,"percent of total billed charges","37.70% of total billed charges",4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.1,33.9,,36.88,,,0,"percent of total billed charges","33.9% of total billed charges",4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.08,78,,84.86,,,0,"percent of total billed charges","78% of total billed charges",4.99,101,,,,,0,"fee schedule","101% of CMS fee schedule ",112.34,82.6,,89.87,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",112.34,82.6,,89.87,,,0,"percent of total billed charges","82.6% of total billed charges",4.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",3.25,136,
"Albumin, Body Fluid LC",30182042,CDM,301,RC,82042,CPT,OUTPATIENT,,,42,27.3,,36.96,88,,29.57,,,0,"percent of total billed charges","88% of total billed charges",7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",13.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.46,63,,21.17,,,0,"percent of total billed charges","63% of total billed charges",6.43,15.3,,5.14,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,28.98,69,,,,,0,"fee schedule","69% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.75,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.78,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.7% of total billed charges",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.70% of total billed charges",7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.24,33.9,,11.39,,,0,"percent of total billed charges","33.9% of total billed charges",7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.76,78,,26.21,,,0,"percent of total billed charges","78% of total billed charges",7.85,101,,,,,0,"fee schedule","101% of CMS fee schedule ",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",7.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,42,
"Alcohol Serum Level",30182077,CDM,301,RC,82077,CPT,OUTPATIENT,,,346,224.9,,304.48,88,,243.58,,,0,"percent of total billed charges","88% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.13,16.8,,46.50,,,0,"percent of total billed charges","16.8% of total billed charges",346,100,,276.80,,,0,"percent of total billed charges","100% of total billed charges",30.22,175,,,,,0,"fee schedule","175% of CMS fee schedule",59.87,17.304,,47.90,,,0,"percent of total billed charges","17.304% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",217.98,63,,174.38,,,0,"percent of total billed charges","63% of total billed charges",52.94,15.3,,42.35,,,0,"percent of total billed charges","15.3% of total billed charges",58.13,16.8,,46.50,,,0,"percent of total billed charges","16.8% of total billed charges",238.74,69,,,,,0,"fee schedule","69% of total billed charges",346,100,,276.80,,,0,"percent of total billed charges","100% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",346,100,,276.80,,,0,"percent of total billed charges","100% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",346,100,,276.80,,,0,"percent of total billed charges","100% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.05,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",58.13,16.8,,46.50,,,0,"percent of total billed charges","16.8% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.27,100,,,,,0,"fee schedule","100% of LI fee schedule",58.13,16.8,,46.50,,,0,"percent of total billed charges","16.8% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.29,17.136,,47.43,,,0,"percent of total billed charges","17.136% of total billed charges",75.57,21.84,,60.46,,,0,"percent of total billed charges","21.84% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",130.44,37.7,,104.35,,,0,"percent of total billed charges","37.7% of total billed charges",130.44,37.7,,104.35,,,0,"percent of total billed charges","37.70% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",117.29,33.9,,93.83,,,0,"percent of total billed charges","33.9% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",269.88,78,,215.90,,,0,"percent of total billed charges","78% of total billed charges",17.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",285.8,82.6,,228.64,,,0,"percent of total billed charges","82.6% of total billed charges",58.13,16.8,,46.50,,,0,"percent of total billed charges","16.8% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",285.8,82.6,,228.64,,,0,"percent of total billed charges","82.6% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.13,16.8,,46.50,,,0,"percent of total billed charges","16.8% of total billed charges",346,100,,276.80,,,0,"percent of total billed charges","100% of total billed charges",17.27,346,
"Alcohol Blood",30182077,CDM,301,RC,82077,CPT,OUTPATIENT,,,346,224.9,,304.48,88,,243.58,,,0,"percent of total billed charges","88% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.13,16.8,,46.50,,,0,"percent of total billed charges","16.8% of total billed charges",346,100,,276.80,,,0,"percent of total billed charges","100% of total billed charges",30.22,175,,,,,0,"fee schedule","175% of CMS fee schedule",59.87,17.304,,47.90,,,0,"percent of total billed charges","17.304% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",217.98,63,,174.38,,,0,"percent of total billed charges","63% of total billed charges",52.94,15.3,,42.35,,,0,"percent of total billed charges","15.3% of total billed charges",58.13,16.8,,46.50,,,0,"percent of total billed charges","16.8% of total billed charges",238.74,69,,,,,0,"fee schedule","69% of total billed charges",346,100,,276.80,,,0,"percent of total billed charges","100% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",346,100,,276.80,,,0,"percent of total billed charges","100% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",346,100,,276.80,,,0,"percent of total billed charges","100% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.05,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",58.13,16.8,,46.50,,,0,"percent of total billed charges","16.8% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.27,100,,,,,0,"fee schedule","100% of LI fee schedule",58.13,16.8,,46.50,,,0,"percent of total billed charges","16.8% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.29,17.136,,47.43,,,0,"percent of total billed charges","17.136% of total billed charges",75.57,21.84,,60.46,,,0,"percent of total billed charges","21.84% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",130.44,37.7,,104.35,,,0,"percent of total billed charges","37.7% of total billed charges",130.44,37.7,,104.35,,,0,"percent of total billed charges","37.70% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",117.29,33.9,,93.83,,,0,"percent of total billed charges","33.9% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",269.88,78,,215.90,,,0,"percent of total billed charges","78% of total billed charges",17.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",285.8,82.6,,228.64,,,0,"percent of total billed charges","82.6% of total billed charges",58.13,16.8,,46.50,,,0,"percent of total billed charges","16.8% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",285.8,82.6,,228.64,,,0,"percent of total billed charges","82.6% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.13,16.8,,46.50,,,0,"percent of total billed charges","16.8% of total billed charges",346,100,,276.80,,,0,"percent of total billed charges","100% of total billed charges",17.27,346,
"Aldolase LC",82085,CDM,300,RC,82085,CPT,OUTPATIENT,,,200,130,,176,88,,140.80,,,0,"percent of total billed charges","88% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",16.99,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",126,63,,100.80,,,0,"percent of total billed charges","63% of total billed charges",30.6,15.3,,24.48,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,138,69,,,,,0,"fee schedule","69% of total billed charges",200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.14,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.71,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",75.4,37.7,,60.32,,,0,"percent of total billed charges","37.7% of total billed charges",75.4,37.7,,60.32,,,0,"percent of total billed charges","37.70% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.8,33.9,,54.24,,,0,"percent of total billed charges","33.9% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",156,78,,124.80,,,0,"percent of total billed charges","78% of total billed charges",9.8,101,,,,,0,"fee schedule","101% of CMS fee schedule ",165.2,82.6,,132.16,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",165.2,82.6,,132.16,,,0,"percent of total billed charges","82.6% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",3.25,200,
"Aldosterone U LC",30182088,CDM,301,RC,82088,CPT,OUTPATIENT,,,97,63.05,,85.36,88,,68.29,,,0,"percent of total billed charges","88% of total billed charges",40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",71.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",30.04,100,,,,,0,"fee schedule",EAPG,40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.11,63,,48.89,,,0,"percent of total billed charges","63% of total billed charges",14.84,15.3,,11.87,,,0,"percent of total billed charges","15.3% of total billed charges",29.16,100,,,,,0,"fee schedule",EAPG,66.93,69,,,,,0,"fee schedule","69% of total billed charges",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",155.86,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.75,100,,,,,0,"fee schedule","100% of LI fee schedule",21.6,100,,,,,0,"fee schedule",EAPG,40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.74,100,,,,,0,"fee schedule",EAPG,37.91,100,,,,,0,"fee schedule",EAPG,40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.57,37.7,,29.26,,,0,"percent of total billed charges","37.7% of total billed charges",36.57,37.7,,29.26,,,0,"percent of total billed charges","37.70% of total billed charges",40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.88,33.9,,26.30,,,0,"percent of total billed charges","33.9% of total billed charges",40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",75.66,78,,60.53,,,0,"percent of total billed charges","78% of total billed charges",41.15,101,,,,,0,"fee schedule","101% of CMS fee schedule ",80.12,82.6,,64.10,,,0,"percent of total billed charges","82.6% of total billed charges",29.16,100,,,,,0,"fee schedule",EAPG,40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.12,82.6,,64.10,,,0,"percent of total billed charges","82.6% of total billed charges",40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",14.84,155.86,
"Aldosterone LCMS LC",30182088,CDM,301,RC,82088,CPT,OUTPATIENT,,,241,156.65,,212.08,88,,169.66,,,0,"percent of total billed charges","88% of total billed charges",40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",71.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",30.04,100,,,,,0,"fee schedule",EAPG,40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.83,63,,121.46,,,0,"percent of total billed charges","63% of total billed charges",36.87,15.3,,29.50,,,0,"percent of total billed charges","15.3% of total billed charges",29.16,100,,,,,0,"fee schedule",EAPG,166.29,69,,,,,0,"fee schedule","69% of total billed charges",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",155.86,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.75,100,,,,,0,"fee schedule","100% of LI fee schedule",21.6,100,,,,,0,"fee schedule",EAPG,40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.74,100,,,,,0,"fee schedule",EAPG,37.91,100,,,,,0,"fee schedule",EAPG,40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.86,37.7,,72.69,,,0,"percent of total billed charges","37.7% of total billed charges",90.86,37.7,,72.69,,,0,"percent of total billed charges","37.70% of total billed charges",40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.7,33.9,,65.36,,,0,"percent of total billed charges","33.9% of total billed charges",40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",187.98,78,,150.38,,,0,"percent of total billed charges","78% of total billed charges",41.15,101,,,,,0,"fee schedule","101% of CMS fee schedule ",199.07,82.6,,159.26,,,0,"percent of total billed charges","82.6% of total billed charges",29.16,100,,,,,0,"fee schedule",EAPG,40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",199.07,82.6,,159.26,,,0,"percent of total billed charges","82.6% of total billed charges",40.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",21.6,241,
"Aldosterone/Renin Ratio LC",30184244,CDM,301,RC,84244,CPT,OUTPATIENT,,,386,250.9,,339.68,88,,271.74,,,0,"percent of total billed charges","88% of total billed charges",21.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",38.48,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,21.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",243.18,63,,194.54,,,0,"percent of total billed charges","63% of total billed charges",59.06,15.3,,47.25,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,266.34,69,,,,,0,"fee schedule","69% of total billed charges",386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",21.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",21.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",21.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",84.11,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,21.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.99,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,21.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,21.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",145.52,37.7,,116.42,,,0,"percent of total billed charges","37.7% of total billed charges",145.52,37.7,,116.42,,,0,"percent of total billed charges","37.70% of total billed charges",21.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",130.85,33.9,,104.68,,,0,"percent of total billed charges","33.9% of total billed charges",21.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",301.08,78,,240.86,,,0,"percent of total billed charges","78% of total billed charges",22.2,101,,,,,0,"fee schedule","101% of CMS fee schedule ",318.84,82.6,,255.07,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,21.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",318.84,82.6,,255.07,,,0,"percent of total billed charges","82.6% of total billed charges",21.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",8.39,386,
"Alk Phos Isoenzyme LC",30184075,CDM,301,RC,84075,CPT,OUTPATIENT,,,194,126.1,,170.72,88,,136.58,,,0,"percent of total billed charges","88% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",9.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",122.22,63,,97.78,,,0,"percent of total billed charges","63% of total billed charges",29.68,15.3,,23.74,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,133.86,69,,,,,0,"fee schedule","69% of total billed charges",194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.81,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.14,37.7,,58.51,,,0,"percent of total billed charges","37.7% of total billed charges",73.14,37.7,,58.51,,,0,"percent of total billed charges","37.70% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.77,33.9,,52.62,,,0,"percent of total billed charges","33.9% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.32,78,,121.06,,,0,"percent of total billed charges","78% of total billed charges",5.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",160.24,82.6,,128.19,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.24,82.6,,128.19,,,0,"percent of total billed charges","82.6% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",3.25,194,
"ALKALINE PHOSPHATASE BONE SPEC",30184080,CDM,301,RC,84080,CPT,OUTPATIENT,,,317,206.05,,278.96,88,,223.17,,,0,"percent of total billed charges","88% of total billed charges",14.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,317,100,,253.60,,,0,"percent of total billed charges","100% of total billed charges",25.86,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,14.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",199.71,63,,159.77,,,0,"percent of total billed charges","63% of total billed charges",48.5,15.3,,38.80,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,218.73,69,,,,,0,"fee schedule","69% of total billed charges",317,100,,253.60,,,0,"percent of total billed charges","100% of total billed charges",14.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",317,100,,253.60,,,0,"percent of total billed charges","100% of total billed charges",14.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",317,100,,253.60,,,0,"percent of total billed charges","100% of total billed charges",14.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.53,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,14.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.78,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,14.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,14.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",119.51,37.7,,95.61,,,0,"percent of total billed charges","37.7% of total billed charges",119.51,37.7,,95.61,,,0,"percent of total billed charges","37.70% of total billed charges",14.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.46,33.9,,85.97,,,0,"percent of total billed charges","33.9% of total billed charges",14.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",247.26,78,,197.81,,,0,"percent of total billed charges","78% of total billed charges",14.92,101,,,,,0,"fee schedule","101% of CMS fee schedule ",261.84,82.6,,209.47,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,14.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",261.84,82.6,,209.47,,,0,"percent of total billed charges","82.6% of total billed charges",14.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,317,100,,253.60,,,0,"percent of total billed charges","100% of total billed charges",8.11,317,
"Alkaline Phosphatase",30184075,CDM,301,RC,84075,CPT,OUTPATIENT,,,173,112.45,,152.24,88,,121.79,,,0,"percent of total billed charges","88% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",9.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.99,63,,87.19,,,0,"percent of total billed charges","63% of total billed charges",26.47,15.3,,21.18,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,119.37,69,,,,,0,"fee schedule","69% of total billed charges",173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.81,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.22,37.7,,52.18,,,0,"percent of total billed charges","37.7% of total billed charges",65.22,37.7,,52.18,,,0,"percent of total billed charges","37.70% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.65,33.9,,46.92,,,0,"percent of total billed charges","33.9% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.94,78,,107.95,,,0,"percent of total billed charges","78% of total billed charges",5.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",142.9,82.6,,114.32,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.9,82.6,,114.32,,,0,"percent of total billed charges","82.6% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,173,
"Allergens (11) Foods LC",30286003,CDM,302,RC,86003,CPT,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",9.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.96,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.22,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.7% of total billed charges",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.75,33.9,,3.80,,,0,"percent of total billed charges","33.9% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",5.27,101,,,,,0,"fee schedule","101% of CMS fee schedule ",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,19.96,
"Allergens (17) LC 605801",30286003,CDM,302,RC,86003,CPT,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",9.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.96,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.22,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.7% of total billed charges",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.75,33.9,,3.80,,,0,"percent of total billed charges","33.9% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",5.27,101,,,,,0,"fee schedule","101% of CMS fee schedule ",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,19.96,
"Allergens (15) Foods LC",30286003,CDM,302,RC,86003,CPT,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",9.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.96,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.22,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.7% of total billed charges",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.75,33.9,,3.80,,,0,"percent of total billed charges","33.9% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",5.27,101,,,,,0,"fee schedule","101% of CMS fee schedule ",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,19.96,
"Allergens (35) Foods LC",30286003,CDM,302,RC,86003,CPT,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",9.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.96,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.22,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.7% of total billed charges",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.75,33.9,,3.80,,,0,"percent of total billed charges","33.9% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",5.27,101,,,,,0,"fee schedule","101% of CMS fee schedule ",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,19.96,
"Allergens (3) LC 605853",30286003,CDM,302,RC,86003,CPT,OUTPATIENT,,,84,54.6,,73.92,88,,59.14,,,0,"percent of total billed charges","88% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,84,100,,67.20,,,0,"percent of total billed charges","100% of total billed charges",9.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.92,63,,42.34,,,0,"percent of total billed charges","63% of total billed charges",12.85,15.3,,10.28,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,57.96,69,,,,,0,"fee schedule","69% of total billed charges",84,100,,67.20,,,0,"percent of total billed charges","100% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",84,100,,67.20,,,0,"percent of total billed charges","100% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",84,100,,67.20,,,0,"percent of total billed charges","100% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.96,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.22,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.67,37.7,,25.34,,,0,"percent of total billed charges","37.7% of total billed charges",31.67,37.7,,25.34,,,0,"percent of total billed charges","37.70% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.48,33.9,,22.78,,,0,"percent of total billed charges","33.9% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.52,78,,52.42,,,0,"percent of total billed charges","78% of total billed charges",5.27,101,,,,,0,"fee schedule","101% of CMS fee schedule ",69.38,82.6,,55.50,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.38,82.6,,55.50,,,0,"percent of total billed charges","82.6% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,84,100,,67.20,,,0,"percent of total billed charges","100% of total billed charges",5.22,84,
"Allergens (5) LC 672748",30286003,CDM,302,RC,86003,CPT,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",9.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.96,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.22,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.7% of total billed charges",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.75,33.9,,3.80,,,0,"percent of total billed charges","33.9% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",5.27,101,,,,,0,"fee schedule","101% of CMS fee schedule ",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",5.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,19.96,
"Alpha-1-Antitrypsin LC",30182103,CDM,301,RC,82103,CPT,OUTPATIENT,,,238,154.7,,209.44,88,,167.55,,,0,"percent of total billed charges","88% of total billed charges",13.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",23.52,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,13.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",149.94,63,,119.95,,,0,"percent of total billed charges","63% of total billed charges",36.41,15.3,,29.13,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,164.22,69,,,,,0,"fee schedule","69% of total billed charges",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",13.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",13.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",13.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.4,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,13.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.44,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,13.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,13.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.73,37.7,,71.78,,,0,"percent of total billed charges","37.7% of total billed charges",89.73,37.7,,71.78,,,0,"percent of total billed charges","37.70% of total billed charges",13.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.68,33.9,,64.54,,,0,"percent of total billed charges","33.9% of total billed charges",13.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",185.64,78,,148.51,,,0,"percent of total billed charges","78% of total billed charges",13.57,101,,,,,0,"fee schedule","101% of CMS fee schedule ",196.59,82.6,,157.27,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,13.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",196.59,82.6,,157.27,,,0,"percent of total billed charges","82.6% of total billed charges",13.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,238,
"Alpha Thalassemia LC",30081257,CDM,300,RC,81257,CPT,OUTPATIENT,,,589,382.85,,518.32,88,,414.66,,,0,"percent of total billed charges","88% of total billed charges",102.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,589,100,,471.20,,,0,"percent of total billed charges","100% of total billed charges",178.95,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.2,100,,,,,0,"fee schedule",EAPG,102.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",371.07,63,,296.86,,,0,"percent of total billed charges","63% of total billed charges",90.12,15.3,,72.10,,,0,"percent of total billed charges","15.3% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,406.41,69,,,,,0,"fee schedule","69% of total billed charges",589,100,,471.20,,,0,"percent of total billed charges","100% of total billed charges",102.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",589,100,,471.20,,,0,"percent of total billed charges","100% of total billed charges",102.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",589,100,,471.20,,,0,"percent of total billed charges","100% of total billed charges",102.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",391.14,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,102.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",102.26,100,,,,,0,"fee schedule","100% of LI fee schedule",28.91,100,,,,,0,"fee schedule",EAPG,102.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.81,100,,,,,0,"fee schedule",EAPG,50.73,100,,,,,0,"fee schedule",EAPG,102.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",222.05,37.7,,177.64,,,0,"percent of total billed charges","37.7% of total billed charges",222.05,37.7,,177.64,,,0,"percent of total billed charges","37.70% of total billed charges",102.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",199.67,33.9,,159.74,,,0,"percent of total billed charges","33.9% of total billed charges",102.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",459.42,78,,367.54,,,0,"percent of total billed charges","78% of total billed charges",103.28,101,,,,,0,"fee schedule","101% of CMS fee schedule ",486.51,82.6,,389.21,,,0,"percent of total billed charges","82.6% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,102.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",486.51,82.6,,389.21,,,0,"percent of total billed charges","82.6% of total billed charges",102.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,589,100,,471.20,,,0,"percent of total billed charges","100% of total billed charges",28.91,589,
"Aluminum, P/S LC",30182108,CDM,301,RC,82108,CPT,OUTPATIENT,,,553,359.45,,486.64,88,,389.31,,,0,"percent of total billed charges","88% of total billed charges",25.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,553,100,,442.40,,,0,"percent of total billed charges","100% of total billed charges",44.59,175,,,,,0,"fee schedule","175% of CMS fee schedule",10.18,100,,,,,0,"fee schedule",EAPG,25.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",348.39,63,,278.71,,,0,"percent of total billed charges","63% of total billed charges",84.61,15.3,,67.69,,,0,"percent of total billed charges","15.3% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,381.57,69,,,,,0,"fee schedule","69% of total billed charges",553,100,,442.40,,,0,"percent of total billed charges","100% of total billed charges",25.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",553,100,,442.40,,,0,"percent of total billed charges","100% of total billed charges",25.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",553,100,,442.40,,,0,"percent of total billed charges","100% of total billed charges",25.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.46,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,25.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.48,100,,,,,0,"fee schedule","100% of LI fee schedule",7.32,100,,,,,0,"fee schedule",EAPG,25.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.08,100,,,,,0,"fee schedule",EAPG,12.85,100,,,,,0,"fee schedule",EAPG,25.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",208.48,37.7,,166.78,,,0,"percent of total billed charges","37.7% of total billed charges",208.48,37.7,,166.78,,,0,"percent of total billed charges","37.70% of total billed charges",25.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",187.47,33.9,,149.98,,,0,"percent of total billed charges","33.9% of total billed charges",25.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",431.34,78,,345.07,,,0,"percent of total billed charges","78% of total billed charges",25.73,101,,,,,0,"fee schedule","101% of CMS fee schedule ",456.78,82.6,,365.42,,,0,"percent of total billed charges","82.6% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,25.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",456.78,82.6,,365.42,,,0,"percent of total billed charges","82.6% of total billed charges",25.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,553,100,,442.40,,,0,"percent of total billed charges","100% of total billed charges",7.32,553,
"Amebiasis Antibodies LC",30286753,CDM,302,RC,86753,CPT,OUTPATIENT,,,90,58.5,,79.2,88,,63.36,,,0,"percent of total billed charges","88% of total billed charges",12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",21.68,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.7,63,,45.36,,,0,"percent of total billed charges","63% of total billed charges",13.77,15.3,,11.02,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,62.1,69,,,,,0,"fee schedule","69% of total billed charges",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.39,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.39,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.93,37.7,,27.14,,,0,"percent of total billed charges","37.7% of total billed charges",33.93,37.7,,27.14,,,0,"percent of total billed charges","37.70% of total billed charges",12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.51,33.9,,24.41,,,0,"percent of total billed charges","33.9% of total billed charges",12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.2,78,,56.16,,,0,"percent of total billed charges","78% of total billed charges",12.51,101,,,,,0,"fee schedule","101% of CMS fee schedule ",74.34,82.6,,59.47,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.34,82.6,,59.47,,,0,"percent of total billed charges","82.6% of total billed charges",12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,90,
Ammonia,30182140,CDM,301,RC,82140,CPT,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",25.49,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.73,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.57,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.7% of total billed charges",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.85,33.9,,72.68,,,0,"percent of total billed charges","33.9% of total billed charges",14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",14.71,101,,,,,0,"fee schedule","101% of CMS fee schedule ",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,268,
"Ammonia, Plasma",30182140,CDM,301,RC,82140,CPT,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",25.49,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.73,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.57,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.7% of total billed charges",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.85,33.9,,72.68,,,0,"percent of total billed charges","33.9% of total billed charges",14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",14.71,101,,,,,0,"fee schedule","101% of CMS fee schedule ",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,268,
Amylase,30182150,CDM,301,RC,82150,CPT,OUTPATIENT,,,32,20.8,,28.16,88,,22.53,,,0,"percent of total billed charges","88% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",11.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.16,63,,16.13,,,0,"percent of total billed charges","63% of total billed charges",4.9,15.3,,3.92,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,22.08,69,,,,,0,"fee schedule","69% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.78,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.48,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.7% of total billed charges",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.70% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.85,33.9,,8.68,,,0,"percent of total billed charges","33.9% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.96,78,,19.97,,,0,"percent of total billed charges","78% of total billed charges",6.54,101,,,,,0,"fee schedule","101% of CMS fee schedule ",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,32,
"Amylase Urine",30182150,CDM,301,RC,82150,CPT,OUTPATIENT,,,32,20.8,,28.16,88,,22.53,,,0,"percent of total billed charges","88% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",11.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.16,63,,16.13,,,0,"percent of total billed charges","63% of total billed charges",4.9,15.3,,3.92,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,22.08,69,,,,,0,"fee schedule","69% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.78,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.48,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.7% of total billed charges",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.70% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.85,33.9,,8.68,,,0,"percent of total billed charges","33.9% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.96,78,,19.97,,,0,"percent of total billed charges","78% of total billed charges",6.54,101,,,,,0,"fee schedule","101% of CMS fee schedule ",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,32,
"Amylase 24 Hr Urine",30182150,CDM,301,RC,82150,CPT,OUTPATIENT,,,32,20.8,,28.16,88,,22.53,,,0,"percent of total billed charges","88% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",11.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.16,63,,16.13,,,0,"percent of total billed charges","63% of total billed charges",4.9,15.3,,3.92,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,22.08,69,,,,,0,"fee schedule","69% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.78,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.48,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.7% of total billed charges",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.70% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.85,33.9,,8.68,,,0,"percent of total billed charges","33.9% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.96,78,,19.97,,,0,"percent of total billed charges","78% of total billed charges",6.54,101,,,,,0,"fee schedule","101% of CMS fee schedule ",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,32,
"Amylase Body Fluid",30182150,CDM,301,RC,82150,CPT,OUTPATIENT,,,32,20.8,,28.16,88,,22.53,,,0,"percent of total billed charges","88% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",11.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.16,63,,16.13,,,0,"percent of total billed charges","63% of total billed charges",4.9,15.3,,3.92,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,22.08,69,,,,,0,"fee schedule","69% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.78,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.48,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.7% of total billed charges",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.70% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.85,33.9,,8.68,,,0,"percent of total billed charges","33.9% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.96,78,,19.97,,,0,"percent of total billed charges","78% of total billed charges",6.54,101,,,,,0,"fee schedule","101% of CMS fee schedule ",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,32,
"Amylase Body Fluid LC",30182150,CDM,301,RC,82150,CPT,OUTPATIENT,,,21,13.65,,18.48,88,,14.78,,,0,"percent of total billed charges","88% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",11.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.23,63,,10.58,,,0,"percent of total billed charges","63% of total billed charges",3.21,15.3,,2.57,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,14.49,69,,,,,0,"fee schedule","69% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.78,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.48,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.92,37.7,,6.34,,,0,"percent of total billed charges","37.7% of total billed charges",7.92,37.7,,6.34,,,0,"percent of total billed charges","37.70% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.12,33.9,,5.70,,,0,"percent of total billed charges","33.9% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.38,78,,13.10,,,0,"percent of total billed charges","78% of total billed charges",6.54,101,,,,,0,"fee schedule","101% of CMS fee schedule ",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",6.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",3.21,24.78,
"Anaerobe Identification Only LC",30687076,CDM,306,RC,87076,CPT,OUTPATIENT,,,439,285.35,,386.32,88,,309.06,,,0,"percent of total billed charges","88% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",14.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",276.57,63,,221.26,,,0,"percent of total billed charges","63% of total billed charges",67.17,15.3,,53.74,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,302.91,69,,,,,0,"fee schedule","69% of total billed charges",439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.9,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.08,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",165.5,37.7,,132.40,,,0,"percent of total billed charges","37.7% of total billed charges",165.5,37.7,,132.40,,,0,"percent of total billed charges","37.70% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",148.82,33.9,,119.06,,,0,"percent of total billed charges","33.9% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",342.42,78,,273.94,,,0,"percent of total billed charges","78% of total billed charges",8.16,101,,,,,0,"fee schedule","101% of CMS fee schedule ",362.61,82.6,,290.09,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",362.61,82.6,,290.09,,,0,"percent of total billed charges","82.6% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,439,
"Anal Pap AVR",31188160,CDM,311,RC,88160,CPT,OUTPATIENT,,,306,198.9,,269.28,88,,215.42,,,0,"percent of total billed charges","88% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",53.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",26.78,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",192.78,63,,154.22,,,0,"percent of total billed charges","63% of total billed charges",46.82,15.3,,37.46,,,0,"percent of total billed charges","15.3% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,211.14,69,,,,,0,"fee schedule","69% of total billed charges",306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.22,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.26,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.52,100,,,,,0,"fee schedule",EAPG,33.8,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.36,37.7,,92.29,,,0,"percent of total billed charges","37.7% of total billed charges",115.36,37.7,,92.29,,,0,"percent of total billed charges","37.70% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",103.73,33.9,,82.98,,,0,"percent of total billed charges","33.9% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",238.68,78,,190.94,,,0,"percent of total billed charges","78% of total billed charges",30.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.76,82.6,,202.21,,,0,"percent of total billed charges","82.6% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.76,82.6,,202.21,,,0,"percent of total billed charges","82.6% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",19.26,306,
"Androstenedione LCMS LC",30182157,CDM,301,RC,82157,CPT,OUTPATIENT,,,572,371.8,,503.36,88,,402.69,,,0,"percent of total billed charges","88% of total billed charges",29.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,572,100,,457.60,,,0,"percent of total billed charges","100% of total billed charges",51.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,29.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",360.36,63,,288.29,,,0,"percent of total billed charges","63% of total billed charges",87.52,15.3,,70.02,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,394.68,69,,,,,0,"fee schedule","69% of total billed charges",572,100,,457.60,,,0,"percent of total billed charges","100% of total billed charges",29.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",572,100,,457.60,,,0,"percent of total billed charges","100% of total billed charges",29.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",572,100,,457.60,,,0,"percent of total billed charges","100% of total billed charges",29.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",111.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,29.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.28,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,29.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,29.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",215.64,37.7,,172.51,,,0,"percent of total billed charges","37.7% of total billed charges",215.64,37.7,,172.51,,,0,"percent of total billed charges","37.70% of total billed charges",29.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",193.91,33.9,,155.13,,,0,"percent of total billed charges","33.9% of total billed charges",29.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",446.16,78,,356.93,,,0,"percent of total billed charges","78% of total billed charges",29.57,101,,,,,0,"fee schedule","101% of CMS fee schedule ",472.47,82.6,,377.98,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,29.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",472.47,82.6,,377.98,,,0,"percent of total billed charges","82.6% of total billed charges",29.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,572,100,,457.60,,,0,"percent of total billed charges","100% of total billed charges",8.39,572,
"Angiotensin-Converting Enzyme LC",30182164,CDM,301,RC,82164,CPT,OUTPATIENT,,,299,194.35,,263.12,88,,210.50,,,0,"percent of total billed charges","88% of total billed charges",14.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,299,100,,239.20,,,0,"percent of total billed charges","100% of total billed charges",25.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,14.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",188.37,63,,150.70,,,0,"percent of total billed charges","63% of total billed charges",45.75,15.3,,36.60,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,206.31,69,,,,,0,"fee schedule","69% of total billed charges",299,100,,239.20,,,0,"percent of total billed charges","100% of total billed charges",14.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",299,100,,239.20,,,0,"percent of total billed charges","100% of total billed charges",14.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",299,100,,239.20,,,0,"percent of total billed charges","100% of total billed charges",14.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.84,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,14.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.6,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,14.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,14.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",112.72,37.7,,90.18,,,0,"percent of total billed charges","37.7% of total billed charges",112.72,37.7,,90.18,,,0,"percent of total billed charges","37.70% of total billed charges",14.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.36,33.9,,81.09,,,0,"percent of total billed charges","33.9% of total billed charges",14.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",233.22,78,,186.58,,,0,"percent of total billed charges","78% of total billed charges",14.74,101,,,,,0,"fee schedule","101% of CMS fee schedule ",246.97,82.6,,197.58,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,14.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",246.97,82.6,,197.58,,,0,"percent of total billed charges","82.6% of total billed charges",14.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,299,100,,239.20,,,0,"percent of total billed charges","100% of total billed charges",8.11,299,
"Antithrombin Antigen LC",30585301,CDM,305,RC,85301,CPT,OUTPATIENT,,,127,82.55,,111.76,88,,89.41,,,0,"percent of total billed charges","88% of total billed charges",10.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",18.91,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,10.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.01,63,,64.01,,,0,"percent of total billed charges","63% of total billed charges",19.43,15.3,,15.54,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,87.63,69,,,,,0,"fee schedule","69% of total billed charges",127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",10.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",10.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",10.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,10.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.81,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,10.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,10.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.88,37.7,,38.30,,,0,"percent of total billed charges","37.7% of total billed charges",47.88,37.7,,38.30,,,0,"percent of total billed charges","37.70% of total billed charges",10.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.05,33.9,,34.44,,,0,"percent of total billed charges","33.9% of total billed charges",10.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.06,78,,79.25,,,0,"percent of total billed charges","78% of total billed charges",10.91,101,,,,,0,"fee schedule","101% of CMS fee schedule ",104.9,82.6,,83.92,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,10.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",104.9,82.6,,83.92,,,0,"percent of total billed charges","82.6% of total billed charges",10.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",2.48,127,
"IA2 AUTOANTIBODIES",30286341,CDM,302,RC,86341,CPT,OUTPATIENT,,,163,105.95,,143.44,88,,114.75,,,0,"percent of total billed charges","88% of total billed charges",23.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",41.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,23.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",102.69,63,,82.15,,,0,"percent of total billed charges","63% of total billed charges",24.94,15.3,,19.95,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,112.47,69,,,,,0,"fee schedule","69% of total billed charges",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",23.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",23.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",23.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.15,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,23.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.57,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,23.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,23.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.45,37.7,,49.16,,,0,"percent of total billed charges","37.7% of total billed charges",61.45,37.7,,49.16,,,0,"percent of total billed charges","37.70% of total billed charges",23.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.26,33.9,,44.21,,,0,"percent of total billed charges","33.9% of total billed charges",23.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",127.14,78,,101.71,,,0,"percent of total billed charges","78% of total billed charges",23.8,101,,,,,0,"fee schedule","101% of CMS fee schedule ",134.64,82.6,,107.71,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,23.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.64,82.6,,107.71,,,0,"percent of total billed charges","82.6% of total billed charges",23.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",6.96,163,
"Anti-Jo-1 LC",30286235,CDM,302,RC,86235,CPT,OUTPATIENT,,,100,65,91,88,88,,70.40,,,0,"percent of total billed charges","88% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",31.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",63,63,,50.40,,,0,"percent of total billed charges","63% of total billed charges",15.3,15.3,,12.24,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,69,69,,,,,0,"fee schedule","69% of total billed charges",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.58,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.93,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.7% of total billed charges",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.70% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.9,33.9,,27.12,,,0,"percent of total billed charges","33.9% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,78,,62.40,,,0,"percent of total billed charges","78% of total billed charges",18.1,101,,,,,0,"fee schedule","101% of CMS fee schedule ",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,100,
"Anti-Centromere B Antibodies LC",30286235,CDM,302,RC,86235,CPT,OUTPATIENT,,,73,47.45,91,64.24,88,,51.39,,,0,"percent of total billed charges","88% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",31.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.99,63,,36.79,,,0,"percent of total billed charges","63% of total billed charges",11.17,15.3,,8.94,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,50.37,69,,,,,0,"fee schedule","69% of total billed charges",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.58,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.93,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.52,37.7,,22.02,,,0,"percent of total billed charges","37.7% of total billed charges",27.52,37.7,,22.02,,,0,"percent of total billed charges","37.70% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,33.9,,19.80,,,0,"percent of total billed charges","33.9% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.94,78,,45.55,,,0,"percent of total billed charges","78% of total billed charges",18.1,101,,,,,0,"fee schedule","101% of CMS fee schedule ",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",6.96,73,
"Antinuclear Antibodies Direct LC",30286038,CDM,302,RC,86038,CPT,OUTPATIENT,,,70,45.5,,61.6,88,,49.28,,,0,"percent of total billed charges","88% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",21.15,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.1,63,,35.28,,,0,"percent of total billed charges","63% of total billed charges",10.71,15.3,,8.57,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,48.3,69,,,,,0,"fee schedule","69% of total billed charges",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.24,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.09,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.39,37.7,,21.11,,,0,"percent of total billed charges","37.7% of total billed charges",26.39,37.7,,21.11,,,0,"percent of total billed charges","37.70% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.73,33.9,,18.98,,,0,"percent of total billed charges","33.9% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.6,78,,43.68,,,0,"percent of total billed charges","78% of total billed charges",12.21,101,,,,,0,"fee schedule","101% of CMS fee schedule ",57.82,82.6,,46.26,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.82,82.6,,46.26,,,0,"percent of total billed charges","82.6% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,70,
"Antiextractable Nuclear Ag LC",30286235,CDM,302,RC,86235,CPT,OUTPATIENT,,,196,127.4,91,172.48,88,,137.98,,,0,"percent of total billed charges","88% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",31.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",123.48,63,,98.78,,,0,"percent of total billed charges","63% of total billed charges",29.99,15.3,,23.99,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,135.24,69,,,,,0,"fee schedule","69% of total billed charges",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.58,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.93,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.89,37.7,,59.11,,,0,"percent of total billed charges","37.7% of total billed charges",73.89,37.7,,59.11,,,0,"percent of total billed charges","37.70% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.44,33.9,,53.15,,,0,"percent of total billed charges","33.9% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",152.88,78,,122.30,,,0,"percent of total billed charges","78% of total billed charges",18.1,101,,,,,0,"fee schedule","101% of CMS fee schedule ",161.9,82.6,,129.52,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",161.9,82.6,,129.52,,,0,"percent of total billed charges","82.6% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",6.96,196,
"Antistreptolysin O Ab LC",30286060,CDM,302,RC,86060,CPT,OUTPATIENT,,,149,96.85,,131.12,88,,104.90,,,0,"percent of total billed charges","88% of total billed charges",7.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,149,100,,119.20,,,0,"percent of total billed charges","100% of total billed charges",12.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,7.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",93.87,63,,75.10,,,0,"percent of total billed charges","63% of total billed charges",22.8,15.3,,18.24,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,102.81,69,,,,,0,"fee schedule","69% of total billed charges",149,100,,119.20,,,0,"percent of total billed charges","100% of total billed charges",7.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",149,100,,119.20,,,0,"percent of total billed charges","100% of total billed charges",7.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",149,100,,119.20,,,0,"percent of total billed charges","100% of total billed charges",7.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.92,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,7.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.3,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,7.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,7.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.17,37.7,,44.94,,,0,"percent of total billed charges","37.7% of total billed charges",56.17,37.7,,44.94,,,0,"percent of total billed charges","37.70% of total billed charges",7.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.51,33.9,,40.41,,,0,"percent of total billed charges","33.9% of total billed charges",7.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",116.22,78,,92.98,,,0,"percent of total billed charges","78% of total billed charges",7.37,101,,,,,0,"fee schedule","101% of CMS fee schedule ",123.07,82.6,,98.46,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,7.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",123.07,82.6,,98.46,,,0,"percent of total billed charges","82.6% of total billed charges",7.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,149,100,,119.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,149,
"ANTITHROMBIN III;ACTIVITY",30585300,CDM,305,RC,85300,CPT,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",11.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",20.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,11.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",11.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",11.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",11.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.32,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,11.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.85,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,11.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,11.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.7% of total billed charges",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",11.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.83,33.9,,55.86,,,0,"percent of total billed charges","33.9% of total billed charges",11.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",11.96,101,,,,,0,"fee schedule","101% of CMS fee schedule ",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,11.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",11.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",2.48,206,
"Antiscleroderma-70 Antibodies LC",30286235,CDM,302,RC,86235,CPT,OUTPATIENT,,,100,65,91,88,88,,70.40,,,0,"percent of total billed charges","88% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",31.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",63,63,,50.40,,,0,"percent of total billed charges","63% of total billed charges",15.3,15.3,,12.24,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,69,69,,,,,0,"fee schedule","69% of total billed charges",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.58,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.93,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.7% of total billed charges",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.70% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.9,33.9,,27.12,,,0,"percent of total billed charges","33.9% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,78,,62.40,,,0,"percent of total billed charges","78% of total billed charges",18.1,101,,,,,0,"fee schedule","101% of CMS fee schedule ",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,100,
"Antiglomerular BM Ab LC",30183516,CDM,301,RC,83516,CPT,OUTPATIENT,,,173,112.45,,152.24,88,,121.79,,,0,"percent of total billed charges","88% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",20.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",26.47,15.3,,21.18,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,119.37,69,,,,,0,"fee schedule","69% of total billed charges",173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.53,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.22,37.7,,52.18,,,0,"percent of total billed charges","37.7% of total billed charges",65.22,37.7,,52.18,,,0,"percent of total billed charges","37.70% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.65,33.9,,46.92,,,0,"percent of total billed charges","33.9% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.94,78,,107.95,,,0,"percent of total billed charges","78% of total billed charges",11.64,101,,,,,0,"fee schedule","101% of CMS fee schedule ",142.9,82.6,,114.32,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.9,82.6,,114.32,,,0,"percent of total billed charges","82.6% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,173,
"Anti-dsDNA Antibodies LC",30286225,CDM,302,RC,86225,CPT,OUTPATIENT,,,76,49.4,,66.88,88,,53.50,,,0,"percent of total billed charges","88% of total billed charges",13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",24.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.88,63,,38.30,,,0,"percent of total billed charges","63% of total billed charges",11.63,15.3,,9.30,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,52.44,69,,,,,0,"fee schedule","69% of total billed charges",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.55,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.74,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.65,37.7,,22.92,,,0,"percent of total billed charges","37.7% of total billed charges",28.65,37.7,,22.92,,,0,"percent of total billed charges","37.70% of total billed charges",13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.76,33.9,,20.61,,,0,"percent of total billed charges","33.9% of total billed charges",13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.28,78,,47.42,,,0,"percent of total billed charges","78% of total billed charges",13.87,101,,,,,0,"fee schedule","101% of CMS fee schedule ",62.78,82.6,,50.22,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.78,82.6,,50.22,,,0,"percent of total billed charges","82.6% of total billed charges",13.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",6.96,76,
"Antimyeloperoxidase (MPO) Abs",30183520,CDM,301,RC,83520,CPT,OUTPATIENT,,,55,35.75,,48.4,88,,38.72,,,0,"percent of total billed charges","88% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,55,100,,44.00,,,0,"percent of total billed charges","100% of total billed charges",30.22,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",8.42,15.3,,6.74,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,37.95,69,,,,,0,"fee schedule","69% of total billed charges",55,100,,44.00,,,0,"percent of total billed charges","100% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",55,100,,44.00,,,0,"percent of total billed charges","100% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",55,100,,44.00,,,0,"percent of total billed charges","100% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.05,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.27,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.74,37.7,,16.59,,,0,"percent of total billed charges","37.7% of total billed charges",20.74,37.7,,16.59,,,0,"percent of total billed charges","37.70% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.65,33.9,,14.92,,,0,"percent of total billed charges","33.9% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.9,78,,34.32,,,0,"percent of total billed charges","78% of total billed charges",17.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",45.43,82.6,,36.34,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.43,82.6,,36.34,,,0,"percent of total billed charges","82.6% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,55,100,,44.00,,,0,"percent of total billed charges","100% of total billed charges",8.11,66.05,
"Anticardiolipin Ab, IgG/M, Qn LC",30286147,CDM,302,RC,86147,CPT,OUTPATIENT,,,142,92.3,,124.96,88,,99.97,,,0,"percent of total billed charges","88% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",44.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.46,63,,71.57,,,0,"percent of total billed charges","63% of total billed charges",21.73,15.3,,17.38,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,97.98,69,,,,,0,"fee schedule","69% of total billed charges",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.45,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.53,37.7,,42.82,,,0,"percent of total billed charges","37.7% of total billed charges",53.53,37.7,,42.82,,,0,"percent of total billed charges","37.70% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.14,33.9,,38.51,,,0,"percent of total billed charges","33.9% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",110.76,78,,88.61,,,0,"percent of total billed charges","78% of total billed charges",25.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",117.29,82.6,,93.83,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",117.29,82.6,,93.83,,,0,"percent of total billed charges","82.6% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",6.96,142,
"Antinuclear Antibodies, IFA LC",30286038,CDM,302,RC,86038,CPT,OUTPATIENT,,,70,45.5,,61.6,88,,49.28,,,0,"percent of total billed charges","88% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",21.15,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.1,63,,35.28,,,0,"percent of total billed charges","63% of total billed charges",10.71,15.3,,8.57,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,48.3,69,,,,,0,"fee schedule","69% of total billed charges",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.24,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.09,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.39,37.7,,21.11,,,0,"percent of total billed charges","37.7% of total billed charges",26.39,37.7,,21.11,,,0,"percent of total billed charges","37.70% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.73,33.9,,18.98,,,0,"percent of total billed charges","33.9% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.6,78,,43.68,,,0,"percent of total billed charges","78% of total billed charges",12.21,101,,,,,0,"fee schedule","101% of CMS fee schedule ",57.82,82.6,,46.26,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.82,82.6,,46.26,,,0,"percent of total billed charges","82.6% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,70,
"Antifungal Suscep, Fluconazole LC",306000000,CDM,306,RC,87186,CPT,OUTPATIENT,,,508,330.2,,447.04,88,,357.63,,,0,"percent of total billed charges","88% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",15.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",320.04,63,,256.03,,,0,"percent of total billed charges","63% of total billed charges",77.72,15.3,,62.18,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,350.52,69,,,,,0,"fee schedule","69% of total billed charges",508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.08,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.65,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",191.52,37.7,,153.22,,,0,"percent of total billed charges","37.7% of total billed charges",191.52,37.7,,153.22,,,0,"percent of total billed charges","37.70% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",172.21,33.9,,137.77,,,0,"percent of total billed charges","33.9% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",396.24,78,,316.99,,,0,"percent of total billed charges","78% of total billed charges",8.73,101,,,,,0,"fee schedule","101% of CMS fee schedule ",419.61,82.6,,335.69,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",419.61,82.6,,335.69,,,0,"percent of total billed charges","82.6% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",4.81,508,
"Anti-Chromatin Ab, IgG (RDL) LC",30286235,CDM,302,RC,86235,CPT,OUTPATIENT,,,139,90.35,91,122.32,88,,97.86,,,0,"percent of total billed charges","88% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",31.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.57,63,,70.06,,,0,"percent of total billed charges","63% of total billed charges",21.27,15.3,,17.02,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,95.91,69,,,,,0,"fee schedule","69% of total billed charges",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.58,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.93,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.4,37.7,,41.92,,,0,"percent of total billed charges","37.7% of total billed charges",52.4,37.7,,41.92,,,0,"percent of total billed charges","37.70% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.12,33.9,,37.70,,,0,"percent of total billed charges","33.9% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.42,78,,86.74,,,0,"percent of total billed charges","78% of total billed charges",18.1,101,,,,,0,"fee schedule","101% of CMS fee schedule ",114.81,82.6,,91.85,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",114.81,82.6,,91.85,,,0,"percent of total billed charges","82.6% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,139,
"Antiphospholipid Syndrome LC",30585598,CDM,305,RC,85598,CPT,OUTPATIENT,,,222,144.3,,195.36,88,,156.29,,,0,"percent of total billed charges","88% of total billed charges",17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,222,100,,177.60,,,0,"percent of total billed charges","100% of total billed charges",31.46,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",139.86,63,,111.89,,,0,"percent of total billed charges","63% of total billed charges",33.97,15.3,,27.18,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,153.18,69,,,,,0,"fee schedule","69% of total billed charges",222,100,,177.60,,,0,"percent of total billed charges","100% of total billed charges",17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",222,100,,177.60,,,0,"percent of total billed charges","100% of total billed charges",17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",222,100,,177.60,,,0,"percent of total billed charges","100% of total billed charges",17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.77,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.98,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",83.69,37.7,,66.95,,,0,"percent of total billed charges","37.7% of total billed charges",83.69,37.7,,66.95,,,0,"percent of total billed charges","37.70% of total billed charges",17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",75.26,33.9,,60.21,,,0,"percent of total billed charges","33.9% of total billed charges",17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",173.16,78,,138.53,,,0,"percent of total billed charges","78% of total billed charges",18.15,101,,,,,0,"fee schedule","101% of CMS fee schedule ",183.37,82.6,,146.70,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule","100% of WA fee schedule",17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",183.37,82.6,,146.70,,,0,"percent of total billed charges","82.6% of total billed charges",17.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,222,100,,177.60,,,0,"percent of total billed charges","100% of total billed charges",2.48,222,
"Apolipoprotein B LC",30182172,CDM,301,RC,82172,CPT,OUTPATIENT,,,280,182,,246.4,88,,197.12,,,0,"percent of total billed charges","88% of total billed charges",21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",36.9,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",176.4,63,,141.12,,,0,"percent of total billed charges","63% of total billed charges",42.84,15.3,,34.27,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,193.2,69,,,,,0,"fee schedule","69% of total billed charges",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.66,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.09,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",105.56,37.7,,84.45,,,0,"percent of total billed charges","37.7% of total billed charges",105.56,37.7,,84.45,,,0,"percent of total billed charges","37.70% of total billed charges",21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",94.92,33.9,,75.94,,,0,"percent of total billed charges","33.9% of total billed charges",21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",218.4,78,,174.72,,,0,"percent of total billed charges","78% of total billed charges",21.3,101,,,,,0,"fee schedule","101% of CMS fee schedule ",231.28,82.6,,185.02,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",231.28,82.6,,185.02,,,0,"percent of total billed charges","82.6% of total billed charges",21.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",8.11,280,
"SGOT OR AST",30184450,CDM,301,RC,84450,CPT,OUTPATIENT,,,119,77.35,,104.72,88,,83.78,,,0,"percent of total billed charges","88% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",9.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.97,63,,59.98,,,0,"percent of total billed charges","63% of total billed charges",18.21,15.3,,14.57,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,82.11,69,,,,,0,"fee schedule","69% of total billed charges",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.81,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.7% of total billed charges",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.70% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.34,33.9,,32.27,,,0,"percent of total billed charges","33.9% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.82,78,,74.26,,,0,"percent of total billed charges","78% of total billed charges",5.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",3.25,119,
"Aspergillus Ag, BAL/Serum LC",30687305,CDM,306,RC,87305,CPT,OUTPATIENT,,,528,343.2,,464.64,88,,371.71,,,0,"percent of total billed charges","88% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,528,100,,422.40,,,0,"percent of total billed charges","100% of total billed charges",20.96,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",332.64,63,,266.11,,,0,"percent of total billed charges","63% of total billed charges",80.78,15.3,,64.62,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,364.32,69,,,,,0,"fee schedule","69% of total billed charges",528,100,,422.40,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",528,100,,422.40,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",528,100,,422.40,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.82,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.98,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",199.06,37.7,,159.25,,,0,"percent of total billed charges","37.7% of total billed charges",199.06,37.7,,159.25,,,0,"percent of total billed charges","37.70% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",178.99,33.9,,143.19,,,0,"percent of total billed charges","33.9% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",411.84,78,,329.47,,,0,"percent of total billed charges","78% of total billed charges",12.09,101,,,,,0,"fee schedule","101% of CMS fee schedule ",436.13,82.6,,348.90,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",436.13,82.6,,348.90,,,0,"percent of total billed charges","82.6% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,528,100,,422.40,,,0,"percent of total billed charges","100% of total billed charges",4.81,528,
"B-Type Natriuretic Peptide",30183880,CDM,301,RC,83880,CPT,OUTPATIENT,,,170,110.5,,149.6,88,,119.68,,,0,"percent of total billed charges","88% of total billed charges",39.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",68.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",29.67,100,,,,,0,"fee schedule",EAPG,39.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.1,63,,85.68,,,0,"percent of total billed charges","63% of total billed charges",26.01,15.3,,20.81,,,0,"percent of total billed charges","15.3% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,117.3,69,,,,,0,"fee schedule","69% of total billed charges",170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",39.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",39.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",39.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.16,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,39.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.26,100,,,,,0,"fee schedule","100% of LI fee schedule",21.33,100,,,,,0,"fee schedule",EAPG,39.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.38,100,,,,,0,"fee schedule",EAPG,37.44,100,,,,,0,"fee schedule",EAPG,39.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.09,37.7,,51.27,,,0,"percent of total billed charges","37.7% of total billed charges",64.09,37.7,,51.27,,,0,"percent of total billed charges","37.70% of total billed charges",39.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.63,33.9,,46.10,,,0,"percent of total billed charges","33.9% of total billed charges",39.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",132.6,78,,106.08,,,0,"percent of total billed charges","78% of total billed charges",39.65,101,,,,,0,"fee schedule","101% of CMS fee schedule ",140.42,82.6,,112.34,,,0,"percent of total billed charges","82.6% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,39.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",140.42,82.6,,112.34,,,0,"percent of total billed charges","82.6% of total billed charges",39.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",21.33,170,
"B.pertussisB.parapertussis PCR LC",30687798,CDM,306,RC,87798,CPT,OUTPATIENT,,,188,122.2,,165.44,88,,132.35,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,188,100,,150.40,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",118.44,63,,94.75,,,0,"percent of total billed charges","63% of total billed charges",28.76,15.3,,23.01,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,129.72,69,,,,,0,"fee schedule","69% of total billed charges",188,100,,150.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",188,100,,150.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",188,100,,150.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.88,37.7,,56.70,,,0,"percent of total billed charges","37.7% of total billed charges",70.88,37.7,,56.70,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.73,33.9,,50.98,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",146.64,78,,117.31,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",155.29,82.6,,124.23,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",155.29,82.6,,124.23,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,188,100,,150.40,,,0,"percent of total billed charges","100% of total billed charges",18.33,188,
"BCR-ABL1, CML/ALL, PCR Qn LC 480481",30081206,CDM,301,RC,81206,CPT,OUTPATIENT,,,883,573.95,,777.04,88,,621.63,,,0,"percent of total billed charges","88% of total billed charges",163.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,883,100,,706.40,,,0,"percent of total billed charges","100% of total billed charges",286.93,175,,,,,0,"fee schedule","175% of CMS fee schedule",110.23,100,,,,,0,"fee schedule",EAPG,163.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",556.29,63,,445.03,,,0,"percent of total billed charges","63% of total billed charges",135.1,15.3,,108.08,,,0,"percent of total billed charges","15.3% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,609.27,69,,,,,0,"fee schedule","69% of total billed charges",883,100,,706.40,,,0,"percent of total billed charges","100% of total billed charges",163.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",883,100,,706.40,,,0,"percent of total billed charges","100% of total billed charges",163.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",883,100,,706.40,,,0,"percent of total billed charges","100% of total billed charges",163.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",627.14,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,163.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.96,100,,,,,0,"fee schedule","100% of LI fee schedule",79.27,100,,,,,0,"fee schedule",EAPG,163.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.16,100,,,,,0,"fee schedule",EAPG,139.13,100,,,,,0,"fee schedule",EAPG,163.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",332.89,37.7,,266.31,,,0,"percent of total billed charges","37.7% of total billed charges",332.89,37.7,,266.31,,,0,"percent of total billed charges","37.70% of total billed charges",163.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",299.34,33.9,,239.47,,,0,"percent of total billed charges","33.9% of total billed charges",163.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",688.74,78,,550.99,,,0,"percent of total billed charges","78% of total billed charges",165.59,101,,,,,0,"fee schedule","101% of CMS fee schedule ",729.36,82.6,,583.49,,,0,"percent of total billed charges","82.6% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,163.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.36,82.6,,583.49,,,0,"percent of total billed charges","82.6% of total billed charges",163.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,883,100,,706.40,,,0,"percent of total billed charges","100% of total billed charges",79.27,883,
"BK Quant PCR (Urine) LC",30687799,CDM,306,RC,87799,CPT,OUTPATIENT,,,1325,861.25,,1166,88,,932.80,,,0,"percent of total billed charges","88% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,1325,100,,1060.00,,,0,"percent of total billed charges","100% of total billed charges",74.97,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",202.73,15.3,,162.18,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,914.25,69,,,,,0,"fee schedule","69% of total billed charges",1325,100,,1060.00,,,0,"percent of total billed charges","100% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",1325,100,,1060.00,,,0,"percent of total billed charges","100% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",1325,100,,1060.00,,,0,"percent of total billed charges","100% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.86,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.84,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",499.53,37.7,,399.62,,,0,"percent of total billed charges","37.7% of total billed charges",499.53,37.7,,399.62,,,0,"percent of total billed charges","37.70% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",449.18,33.9,,359.34,,,0,"percent of total billed charges","33.9% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",1033.5,78,,826.80,,,0,"percent of total billed charges","78% of total billed charges",43.26,101,,,,,0,"fee schedule","101% of CMS fee schedule ",1094.45,82.6,,875.56,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",1094.45,82.6,,875.56,,,0,"percent of total billed charges","82.6% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,1325,100,,1060.00,,,0,"percent of total billed charges","100% of total billed charges",18.33,1325,
"BK Quant PCR (Plasma/Serum) LC 138962",30687799,CDM,306,RC,87799,CPT,OUTPATIENT,,,642,417.3,,564.96,88,,451.97,,,0,"percent of total billed charges","88% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,642,100,,513.60,,,0,"percent of total billed charges","100% of total billed charges",74.97,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",98.23,15.3,,78.58,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,442.98,69,,,,,0,"fee schedule","69% of total billed charges",642,100,,513.60,,,0,"percent of total billed charges","100% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",642,100,,513.60,,,0,"percent of total billed charges","100% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",642,100,,513.60,,,0,"percent of total billed charges","100% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.86,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.84,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",242.03,37.7,,193.62,,,0,"percent of total billed charges","37.7% of total billed charges",242.03,37.7,,193.62,,,0,"percent of total billed charges","37.70% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",217.64,33.9,,174.11,,,0,"percent of total billed charges","33.9% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",500.76,78,,400.61,,,0,"percent of total billed charges","78% of total billed charges",43.26,101,,,,,0,"fee schedule","101% of CMS fee schedule ",530.29,82.6,,424.23,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",530.29,82.6,,424.23,,,0,"percent of total billed charges","82.6% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,642,100,,513.60,,,0,"percent of total billed charges","100% of total billed charges",18.33,642,
"BV + CG + Trich, NAA w/Yeast Cul LC",30687102,CDM,306,RC,87102,CPT,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",8.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",14.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",8.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",8.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",8.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.16,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.41,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.7% of total billed charges",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",8.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.05,33.9,,2.44,,,0,"percent of total billed charges","33.9% of total billed charges",8.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",8.49,101,,,,,0,"fee schedule","101% of CMS fee schedule ",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",8.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,32.16,
"Bacterial Vaginosis NAA LC",30687798,CDM,306,RC,87798,CPT,OUTPATIENT,,,175,113.75,,154,88,,123.20,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",110.25,63,,88.20,,,0,"percent of total billed charges","63% of total billed charges",26.78,15.3,,21.42,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,120.75,69,,,,,0,"fee schedule","69% of total billed charges",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.98,37.7,,52.78,,,0,"percent of total billed charges","37.7% of total billed charges",65.98,37.7,,52.78,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.33,33.9,,47.46,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.5,78,,109.20,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",144.55,82.6,,115.64,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.55,82.6,,115.64,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",18.33,175,
"Bacterial Vaginosis Panel AVR",30687511,CDM,306,RC,87511,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"Basic Metabolic Panel",30180048,CDM,301,RC,80048,CPT,OUTPATIENT,,,218,141.7,,191.84,88,,153.47,,,0,"percent of total billed charges","88% of total billed charges",8.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",14.8,175,,,,,0,"fee schedule","175% of CMS fee schedule",7.68,100,,,,,0,"fee schedule",EAPG,8.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.34,63,,109.87,,,0,"percent of total billed charges","63% of total billed charges",33.35,15.3,,26.68,,,0,"percent of total billed charges","15.3% of total billed charges",7.45,100,,,,,0,"fee schedule",EAPG,150.42,69,,,,,0,"fee schedule","69% of total billed charges",218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",8.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",8.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",8.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.35,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,8.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.46,100,,,,,0,"fee schedule","100% of LI fee schedule",5.52,100,,,,,0,"fee schedule",EAPG,8.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.6,100,,,,,0,"fee schedule",EAPG,9.69,100,,,,,0,"fee schedule",EAPG,8.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.19,37.7,,65.75,,,0,"percent of total billed charges","37.7% of total billed charges",82.19,37.7,,65.75,,,0,"percent of total billed charges","37.70% of total billed charges",8.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.9,33.9,,59.12,,,0,"percent of total billed charges","33.9% of total billed charges",8.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.04,78,,136.03,,,0,"percent of total billed charges","78% of total billed charges",8.54,101,,,,,0,"fee schedule","101% of CMS fee schedule ",180.07,82.6,,144.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.45,100,,,,,0,"fee schedule",EAPG,8.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",180.07,82.6,,144.06,,,0,"percent of total billed charges","82.6% of total billed charges",8.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",5.52,218,
"Benzodiazepine Conf (LCMSMS) LC 910569",30180347,CDM,301,RC,80347,CPT,OUTPATIENT,,,152,98.8,,133.76,88,,107.01,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",95.76,63,,76.61,,,0,"percent of total billed charges","63% of total billed charges",23.26,15.3,,18.61,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.88,69,,,,,0,"fee schedule","69% of total billed charges",152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",57.3,37.7,,45.84,,,0,"percent of total billed charges","37.7% of total billed charges",57.3,37.7,,45.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.53,33.9,,41.22,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",118.56,78,,94.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",125.55,82.6,,100.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",125.55,82.6,,100.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.54,16.8,,20.43,,,0,"percent of total billed charges","16.8% of total billed charges",152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",23.26,152,
"Beta hCG Quantitative",30184702,CDM,301,RC,84702,CPT,OUTPATIENT,,,454,295.1,,399.52,88,,319.62,,,0,"percent of total billed charges","88% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",26.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",286.02,63,,228.82,,,0,"percent of total billed charges","63% of total billed charges",69.46,15.3,,55.57,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,313.26,69,,,,,0,"fee schedule","69% of total billed charges",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.56,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.05,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",171.16,37.7,,136.93,,,0,"percent of total billed charges","37.7% of total billed charges",171.16,37.7,,136.93,,,0,"percent of total billed charges","37.70% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",153.91,33.9,,123.13,,,0,"percent of total billed charges","33.9% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",354.12,78,,283.30,,,0,"percent of total billed charges","78% of total billed charges",15.2,101,,,,,0,"fee schedule","101% of CMS fee schedule ",375,82.6,,300.00,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",375,82.6,,300.00,,,0,"percent of total billed charges","82.6% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",8.39,454,
"BETA 2 MICROGLOBULIN",30182232,CDM,301,RC,82232,CPT,OUTPATIENT,,,235,152.75,,206.8,88,,165.44,,,0,"percent of total billed charges","88% of total billed charges",16.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,235,100,,188.00,,,0,"percent of total billed charges","100% of total billed charges",28.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,16.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",148.05,63,,118.44,,,0,"percent of total billed charges","63% of total billed charges",35.96,15.3,,28.77,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,162.15,69,,,,,0,"fee schedule","69% of total billed charges",235,100,,188.00,,,0,"percent of total billed charges","100% of total billed charges",16.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",235,100,,188.00,,,0,"percent of total billed charges","100% of total billed charges",16.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",235,100,,188.00,,,0,"percent of total billed charges","100% of total billed charges",16.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.88,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,16.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.18,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,16.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,16.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.6,37.7,,70.88,,,0,"percent of total billed charges","37.7% of total billed charges",88.6,37.7,,70.88,,,0,"percent of total billed charges","37.70% of total billed charges",16.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.67,33.9,,63.74,,,0,"percent of total billed charges","33.9% of total billed charges",16.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",183.3,78,,146.64,,,0,"percent of total billed charges","78% of total billed charges",16.34,101,,,,,0,"fee schedule","101% of CMS fee schedule ",194.11,82.6,,155.29,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,16.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",194.11,82.6,,155.29,,,0,"percent of total billed charges","82.6% of total billed charges",16.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,235,100,,188.00,,,0,"percent of total billed charges","100% of total billed charges",8.39,235,
"Bile Acids, Fractionated LCMS LC",30182542,CDM,301,RC,82542,CPT,OUTPATIENT,,,226,146.9,,198.88,88,,159.10,,,0,"percent of total billed charges","88% of total billed charges",24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",42.15,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.38,63,,113.90,,,0,"percent of total billed charges","63% of total billed charges",34.58,15.3,,27.66,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,155.94,69,,,,,0,"fee schedule","69% of total billed charges",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.14,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.09,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.2,37.7,,68.16,,,0,"percent of total billed charges","37.7% of total billed charges",85.2,37.7,,68.16,,,0,"percent of total billed charges","37.70% of total billed charges",24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.61,33.9,,61.29,,,0,"percent of total billed charges","33.9% of total billed charges",24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",176.28,78,,141.02,,,0,"percent of total billed charges","78% of total billed charges",24.33,101,,,,,0,"fee schedule","101% of CMS fee schedule ",186.68,82.6,,149.34,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",186.68,82.6,,149.34,,,0,"percent of total billed charges","82.6% of total billed charges",24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",8.11,226,
"Bile Acids LC",30082239,CDM,300,RC,82239,CPT,OUTPATIENT,,,96,62.4,,84.48,88,,67.58,,,0,"percent of total billed charges","88% of total billed charges",17.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",29.96,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,17.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.48,63,,48.38,,,0,"percent of total billed charges","63% of total billed charges",14.69,15.3,,11.75,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,66.24,69,,,,,0,"fee schedule","69% of total billed charges",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",17.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",17.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",17.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.48,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,17.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.12,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,17.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,17.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.19,37.7,,28.95,,,0,"percent of total billed charges","37.7% of total billed charges",36.19,37.7,,28.95,,,0,"percent of total billed charges","37.70% of total billed charges",17.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.54,33.9,,26.03,,,0,"percent of total billed charges","33.9% of total billed charges",17.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.88,78,,59.90,,,0,"percent of total billed charges","78% of total billed charges",17.29,101,,,,,0,"fee schedule","101% of CMS fee schedule ",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,17.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",17.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",8.11,96,
"Bilirubin Total",30182247,CDM,301,RC,82247,CPT,OUTPATIENT,,,72,46.8,,63.36,88,,50.69,,,0,"percent of total billed charges","88% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",8.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.36,63,,36.29,,,0,"percent of total billed charges","63% of total billed charges",11.02,15.3,,8.82,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,49.68,69,,,,,0,"fee schedule","69% of total billed charges",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.2,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.01,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.14,37.7,,21.71,,,0,"percent of total billed charges","37.7% of total billed charges",27.14,37.7,,21.71,,,0,"percent of total billed charges","37.70% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.41,33.9,,19.53,,,0,"percent of total billed charges","33.9% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.16,78,,44.93,,,0,"percent of total billed charges","78% of total billed charges",5.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",59.47,82.6,,47.58,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.47,82.6,,47.58,,,0,"percent of total billed charges","82.6% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,72,
"Bilirubin Neonatal",30082247,CDM,300,RC,82247,CPT,OUTPATIENT,,,72,46.8,,63.36,88,,50.69,,,0,"percent of total billed charges","88% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",8.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.36,63,,36.29,,,0,"percent of total billed charges","63% of total billed charges",11.02,15.3,,8.82,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,49.68,69,,,,,0,"fee schedule","69% of total billed charges",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.2,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.01,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.14,37.7,,21.71,,,0,"percent of total billed charges","37.7% of total billed charges",27.14,37.7,,21.71,,,0,"percent of total billed charges","37.70% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.41,33.9,,19.53,,,0,"percent of total billed charges","33.9% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.16,78,,44.93,,,0,"percent of total billed charges","78% of total billed charges",5.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",59.47,82.6,,47.58,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.47,82.6,,47.58,,,0,"percent of total billed charges","82.6% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,72,
"BILIRUBIN TOTAL, BODY FLUID",30182247,CDM,301,RC,82247,CPT,OUTPATIENT,,,72,46.8,,63.36,88,,50.69,,,0,"percent of total billed charges","88% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",8.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.36,63,,36.29,,,0,"percent of total billed charges","63% of total billed charges",11.02,15.3,,8.82,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,49.68,69,,,,,0,"fee schedule","69% of total billed charges",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.2,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.01,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.14,37.7,,21.71,,,0,"percent of total billed charges","37.7% of total billed charges",27.14,37.7,,21.71,,,0,"percent of total billed charges","37.70% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.41,33.9,,19.53,,,0,"percent of total billed charges","33.9% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.16,78,,44.93,,,0,"percent of total billed charges","78% of total billed charges",5.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",59.47,82.6,,47.58,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.47,82.6,,47.58,,,0,"percent of total billed charges","82.6% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,72,
"Bilirubin Direct",30182248,CDM,301,RC,82248,CPT,OUTPATIENT,,,73,47.45,,64.24,88,,51.39,,,0,"percent of total billed charges","88% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",8.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.99,63,,36.79,,,0,"percent of total billed charges","63% of total billed charges",11.17,15.3,,8.94,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,50.37,69,,,,,0,"fee schedule","69% of total billed charges",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.2,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.01,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.52,37.7,,22.02,,,0,"percent of total billed charges","37.7% of total billed charges",27.52,37.7,,22.02,,,0,"percent of total billed charges","37.70% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,33.9,,19.80,,,0,"percent of total billed charges","33.9% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.94,78,,45.55,,,0,"percent of total billed charges","78% of total billed charges",5.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,73,
"Bilirubin; total",30182247,CDM,301,RC,82247,CPT,OUTPATIENT,,,72,46.8,,63.36,88,,50.69,,,0,"percent of total billed charges","88% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",8.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.36,63,,36.29,,,0,"percent of total billed charges","63% of total billed charges",11.02,15.3,,8.82,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,49.68,69,,,,,0,"fee schedule","69% of total billed charges",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.2,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.01,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.14,37.7,,21.71,,,0,"percent of total billed charges","37.7% of total billed charges",27.14,37.7,,21.71,,,0,"percent of total billed charges","37.70% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.41,33.9,,19.53,,,0,"percent of total billed charges","33.9% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.16,78,,44.93,,,0,"percent of total billed charges","78% of total billed charges",5.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",59.47,82.6,,47.58,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.47,82.6,,47.58,,,0,"percent of total billed charges","82.6% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,72,
"Bilirubin Fractionated, Neonatal RLC",30182247,CDM,301,RC,82247,CPT,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",8.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.2,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.01,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.7% of total billed charges",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",0.34,33.9,,0.27,,,0,"percent of total billed charges","33.9% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",5.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,19.2,
"General Health Panel",30180050,CDM,301,RC,80050,CPT,OUTPATIENT,,,655,425.75,,576.4,88,,461.12,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.45,100,,,,,0,"fee schedule",EAPG,655,100,,524.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.68,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",412.65,63,,330.12,,,0,"percent of total billed charges","63% of total billed charges",100.22,15.3,,80.18,,,0,"percent of total billed charges","15.3% of total billed charges",7.45,100,,,,,0,"fee schedule",EAPG,451.95,69,,,,,0,"fee schedule","69% of total billed charges",655,100,,524.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",655,100,,524.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",655,100,,524.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.45,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",7.6,100,,,,,0,"fee schedule",EAPG,9.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",246.94,37.7,,197.55,,,0,"percent of total billed charges","37.7% of total billed charges",246.94,37.7,,197.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",222.05,33.9,,177.64,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.9,78,,408.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",541.03,82.6,,432.82,,,0,"percent of total billed charges","82.6% of total billed charges",7.45,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",541.03,82.6,,432.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.45,100,,,,,0,"fee schedule",EAPG,655,100,,524.00,,,0,"percent of total billed charges","100% of total billed charges",5.52,655,
"Bill PATHOLOGY CONSULT LIMITED",31080500,CDM,310,RC,80500,CPT,OUTPATIENT,,,108,70.2,,95.04,88,,76.03,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.17,100,,,,,0,"fee schedule",EAPG,108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.17,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",68.04,63,,54.43,,,0,"percent of total billed charges","63% of total billed charges",16.52,15.3,,13.22,,,0,"percent of total billed charges","15.3% of total billed charges",33.17,100,,,,,0,"fee schedule",EAPG,74.52,69,,,,,0,"fee schedule","69% of total billed charges",108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.15,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33.17,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",52.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.57,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",33.84,100,,,,,0,"fee schedule",EAPG,43.13,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",40.72,37.7,,32.58,,,0,"percent of total billed charges","37.7% of total billed charges",40.72,37.7,,32.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.61,33.9,,29.29,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.24,78,,67.39,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.21,82.6,,71.37,,,0,"percent of total billed charges","82.6% of total billed charges",33.17,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",89.21,82.6,,71.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.17,100,,,,,0,"fee schedule",EAPG,108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",16.52,202.15,
"Bill BRAF GENE ANALYSIS",31081210,CDM,310,RC,81210,CPT,OUTPATIENT,,,602,391.3,,529.76,88,,423.81,,,0,"percent of total billed charges","88% of total billed charges",175.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",306.95,175,,,,,0,"fee schedule","175% of CMS fee schedule",110.23,100,,,,,0,"fee schedule",EAPG,175.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",379.26,63,,303.41,,,0,"percent of total billed charges","63% of total billed charges",263.1,150,,,,,0,"fee schedule","150% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,415.38,69,,,,,0,"fee schedule","69% of total billed charges",602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",175.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",175.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",175.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",670.9,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,175.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",175.4,100,,,,,0,"fee schedule","100% of LI fee schedule",79.27,100,,,,,0,"fee schedule",EAPG,175.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.16,100,,,,,0,"fee schedule",EAPG,139.13,100,,,,,0,"fee schedule",EAPG,175.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.95,37.7,,181.56,,,0,"percent of total billed charges","37.7% of total billed charges",226.95,37.7,,181.56,,,0,"percent of total billed charges","37.70% of total billed charges",175.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",204.08,33.9,,163.26,,,0,"percent of total billed charges","33.9% of total billed charges",175.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",469.56,78,,375.65,,,0,"percent of total billed charges","78% of total billed charges",177.15,101,,,,,0,"fee schedule","101% of CMS fee schedule ",497.25,82.6,,397.80,,,0,"percent of total billed charges","82.6% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,175.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",497.25,82.6,,397.80,,,0,"percent of total billed charges","82.6% of total billed charges",175.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",79.27,670.9,
"Bill EGFR MUTATION ANALYSIS",30181235,CDM,301,RC,81235,CPT,OUTPATIENT,,,1610,1046.5,,1416.8,88,,1133.44,,,0,"percent of total billed charges","88% of total billed charges",324.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",364.01,100,,,,,0,"fee schedule",EAPG,1610,100,,1288.00,,,0,"percent of total billed charges","100% of total billed charges",568.01,175,,,,,0,"fee schedule","175% of CMS fee schedule",374.93,100,,,,,0,"fee schedule",EAPG,324.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",1014.3,63,,811.44,,,0,"percent of total billed charges","63% of total billed charges",246.33,15.3,,197.06,,,0,"percent of total billed charges","15.3% of total billed charges",364.01,100,,,,,0,"fee schedule",EAPG,1110.9,69,,,,,0,"fee schedule","69% of total billed charges",1610,100,,1288.00,,,0,"percent of total billed charges","100% of total billed charges",324.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",1610,100,,1288.00,,,0,"percent of total billed charges","100% of total billed charges",324.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",1610,100,,1288.00,,,0,"percent of total billed charges","100% of total billed charges",324.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",1241.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",364.01,100,,,,,0,"fee schedule",EAPG,324.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",324.58,100,,,,,0,"fee schedule","100% of LI fee schedule",269.63,100,,,,,0,"fee schedule",EAPG,324.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",371.29,100,,,,,0,"fee schedule",EAPG,473.21,100,,,,,0,"fee schedule",EAPG,324.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",606.97,37.7,,485.58,,,0,"percent of total billed charges","37.7% of total billed charges",606.97,37.7,,485.58,,,0,"percent of total billed charges","37.70% of total billed charges",324.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",545.79,33.9,,436.63,,,0,"percent of total billed charges","33.9% of total billed charges",324.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",1255.8,78,,1004.64,,,0,"percent of total billed charges","78% of total billed charges",327.82,101,,,,,0,"fee schedule","101% of CMS fee schedule ",1329.86,82.6,,1063.89,,,0,"percent of total billed charges","82.6% of total billed charges",364.01,100,,,,,0,"fee schedule",EAPG,324.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",1329.86,82.6,,1063.89,,,0,"percent of total billed charges","82.6% of total billed charges",324.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",364.01,100,,,,,0,"fee schedule",EAPG,1610,100,,1288.00,,,0,"percent of total billed charges","100% of total billed charges",246.33,1610,
"Bill IGH GENE REARRANGEMENT ANAL",31081261,CDM,310,RC,81261,CPT,OUTPATIENT,,,1011,657.15,,889.68,88,,711.74,,,0,"percent of total billed charges","88% of total billed charges",197.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,1011,100,,808.80,,,0,"percent of total billed charges","100% of total billed charges",346.48,175,,,,,0,"fee schedule","175% of CMS fee schedule",110.23,100,,,,,0,"fee schedule",EAPG,197.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",636.93,63,,509.54,,,0,"percent of total billed charges","63% of total billed charges",296.99,150,,,,,0,"fee schedule","150% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,697.59,69,,,,,0,"fee schedule","69% of total billed charges",1011,100,,808.80,,,0,"percent of total billed charges","100% of total billed charges",197.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",1011,100,,808.80,,,0,"percent of total billed charges","100% of total billed charges",197.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",1011,100,,808.80,,,0,"percent of total billed charges","100% of total billed charges",197.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",757.31,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,197.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",197.99,100,,,,,0,"fee schedule","100% of LI fee schedule",79.27,100,,,,,0,"fee schedule",EAPG,197.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.16,100,,,,,0,"fee schedule",EAPG,139.13,100,,,,,0,"fee schedule",EAPG,197.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",381.15,37.7,,304.92,,,0,"percent of total billed charges","37.7% of total billed charges",381.15,37.7,,304.92,,,0,"percent of total billed charges","37.70% of total billed charges",197.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",342.73,33.9,,274.18,,,0,"percent of total billed charges","33.9% of total billed charges",197.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",788.58,78,,630.86,,,0,"percent of total billed charges","78% of total billed charges",199.96,101,,,,,0,"fee schedule","101% of CMS fee schedule ",835.09,82.6,,668.07,,,0,"percent of total billed charges","82.6% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,197.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",835.09,82.6,,668.07,,,0,"percent of total billed charges","82.6% of total billed charges",197.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,1011,100,,808.80,,,0,"percent of total billed charges","100% of total billed charges",79.27,1011,
"Bill Kras Gene Analysis",31081275,CDM,310,RC,81275,CPT,OUTPATIENT,,,763,495.95,,671.44,88,,537.15,,,0,"percent of total billed charges","88% of total billed charges",193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,763,100,,610.40,,,0,"percent of total billed charges","100% of total billed charges",338.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",110.23,100,,,,,0,"fee schedule",EAPG,193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",480.69,63,,384.55,,,0,"percent of total billed charges","63% of total billed charges",289.88,150,,,,,0,"fee schedule","150% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,526.47,69,,,,,0,"fee schedule","69% of total billed charges",763,100,,610.40,,,0,"percent of total billed charges","100% of total billed charges",193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",763,100,,610.40,,,0,"percent of total billed charges","100% of total billed charges",193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",763,100,,610.40,,,0,"percent of total billed charges","100% of total billed charges",193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",739.18,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",193.25,100,,,,,0,"fee schedule","100% of LI fee schedule",79.27,100,,,,,0,"fee schedule",EAPG,193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.16,100,,,,,0,"fee schedule",EAPG,139.13,100,,,,,0,"fee schedule",EAPG,193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",287.65,37.7,,230.12,,,0,"percent of total billed charges","37.7% of total billed charges",287.65,37.7,,230.12,,,0,"percent of total billed charges","37.70% of total billed charges",193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",258.66,33.9,,206.93,,,0,"percent of total billed charges","33.9% of total billed charges",193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",595.14,78,,476.11,,,0,"percent of total billed charges","78% of total billed charges",195.18,101,,,,,0,"fee schedule","101% of CMS fee schedule ",630.24,82.6,,504.19,,,0,"percent of total billed charges","82.6% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",630.24,82.6,,504.19,,,0,"percent of total billed charges","82.6% of total billed charges",193.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,763,100,,610.40,,,0,"percent of total billed charges","100% of total billed charges",79.27,763,
"Bill MICROSATELLITE INSTABILITY",31081301,CDM,310,RC,81301,CPT,OUTPATIENT,,,1514,984.1,,1332.32,88,,1065.86,,,0,"percent of total billed charges","88% of total billed charges",348.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,1514,100,,1211.20,,,0,"percent of total billed charges","100% of total billed charges",609.98,175,,,,,0,"fee schedule","175% of CMS fee schedule",110.23,100,,,,,0,"fee schedule",EAPG,348.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",953.82,63,,763.06,,,0,"percent of total billed charges","63% of total billed charges",522.84,150,,,,,0,"fee schedule","150% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,1044.66,69,,,,,0,"fee schedule","69% of total billed charges",1514,100,,1211.20,,,0,"percent of total billed charges","100% of total billed charges",348.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",1514,100,,1211.20,,,0,"percent of total billed charges","100% of total billed charges",348.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",1514,100,,1211.20,,,0,"percent of total billed charges","100% of total billed charges",348.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",1333.24,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,348.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",348.56,100,,,,,0,"fee schedule","100% of LI fee schedule",79.27,100,,,,,0,"fee schedule",EAPG,348.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.16,100,,,,,0,"fee schedule",EAPG,139.13,100,,,,,0,"fee schedule",EAPG,348.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",570.78,37.7,,456.62,,,0,"percent of total billed charges","37.7% of total billed charges",570.78,37.7,,456.62,,,0,"percent of total billed charges","37.70% of total billed charges",348.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",513.25,33.9,,410.60,,,0,"percent of total billed charges","33.9% of total billed charges",348.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",1180.92,78,,944.74,,,0,"percent of total billed charges","78% of total billed charges",352.04,101,,,,,0,"fee schedule","101% of CMS fee schedule ",1250.56,82.6,,1000.45,,,0,"percent of total billed charges","82.6% of total billed charges",107.02,100,,,,,0,"fee schedule","100% of WA fee schedule",348.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",1250.56,82.6,,1000.45,,,0,"percent of total billed charges","82.6% of total billed charges",348.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,1514,100,,1211.20,,,0,"percent of total billed charges","100% of total billed charges",79.27,1514,
"Bill T CELL (TCRGAMMA)",31081342,CDM,310,RC,81342,CPT,OUTPATIENT,,,922,599.3,,811.36,88,,649.09,,,0,"percent of total billed charges","88% of total billed charges",201.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,922,100,,737.60,,,0,"percent of total billed charges","100% of total billed charges",352.62,175,,,,,0,"fee schedule","175% of CMS fee schedule",110.23,100,,,,,0,"fee schedule",EAPG,201.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",580.86,63,,464.69,,,0,"percent of total billed charges","63% of total billed charges",302.25,150,,,,,0,"fee schedule","150% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,636.18,69,,,,,0,"fee schedule","69% of total billed charges",922,100,,737.60,,,0,"percent of total billed charges","100% of total billed charges",201.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",922,100,,737.60,,,0,"percent of total billed charges","100% of total billed charges",201.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",922,100,,737.60,,,0,"percent of total billed charges","100% of total billed charges",201.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",770.73,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,201.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",201.5,100,,,,,0,"fee schedule","100% of LI fee schedule",79.27,100,,,,,0,"fee schedule",EAPG,201.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.16,100,,,,,0,"fee schedule",EAPG,139.13,100,,,,,0,"fee schedule",EAPG,201.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",347.59,37.7,,278.07,,,0,"percent of total billed charges","37.7% of total billed charges",347.59,37.7,,278.07,,,0,"percent of total billed charges","37.70% of total billed charges",201.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",312.56,33.9,,250.05,,,0,"percent of total billed charges","33.9% of total billed charges",201.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",719.16,78,,575.33,,,0,"percent of total billed charges","78% of total billed charges",203.51,101,,,,,0,"fee schedule","101% of CMS fee schedule ",761.57,82.6,,609.26,,,0,"percent of total billed charges","82.6% of total billed charges",107.02,100,,,,,0,"fee schedule","100% of WA fee schedule",201.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",761.57,82.6,,609.26,,,0,"percent of total billed charges","82.6% of total billed charges",201.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,922,100,,737.60,,,0,"percent of total billed charges","100% of total billed charges",79.27,922,
"Bill PROGESTERONE RECEPTOR",30184234,CDM,301,RC,84234,CPT,OUTPATIENT,,,384,249.6,,337.92,88,,270.34,,,0,"percent of total billed charges","88% of total billed charges",64.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,384,100,,307.20,,,0,"percent of total billed charges","100% of total billed charges",113.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",30.04,100,,,,,0,"fee schedule",EAPG,64.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",241.92,63,,193.54,,,0,"percent of total billed charges","63% of total billed charges",58.75,15.3,,47.00,,,0,"percent of total billed charges","15.3% of total billed charges",29.16,100,,,,,0,"fee schedule",EAPG,264.96,69,,,,,0,"fee schedule","69% of total billed charges",384,100,,307.20,,,0,"percent of total billed charges","100% of total billed charges",64.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",384,100,,307.20,,,0,"percent of total billed charges","100% of total billed charges",64.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",384,100,,307.20,,,0,"percent of total billed charges","100% of total billed charges",64.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",248.16,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,64.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.88,100,,,,,0,"fee schedule","100% of LI fee schedule",21.6,100,,,,,0,"fee schedule",EAPG,64.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.74,100,,,,,0,"fee schedule",EAPG,37.91,100,,,,,0,"fee schedule",EAPG,64.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.77,37.7,,115.82,,,0,"percent of total billed charges","37.7% of total billed charges",144.77,37.7,,115.82,,,0,"percent of total billed charges","37.70% of total billed charges",64.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",130.18,33.9,,104.14,,,0,"percent of total billed charges","33.9% of total billed charges",64.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",299.52,78,,239.62,,,0,"percent of total billed charges","78% of total billed charges",65.52,101,,,,,0,"fee schedule","101% of CMS fee schedule ",317.18,82.6,,253.74,,,0,"percent of total billed charges","82.6% of total billed charges",29.16,100,,,,,0,"fee schedule",EAPG,64.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",317.18,82.6,,253.74,,,0,"percent of total billed charges","82.6% of total billed charges",64.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,384,100,,307.20,,,0,"percent of total billed charges","100% of total billed charges",21.6,384,
"Bill PERIPH BLOOD SMEAR INTER",30085060,CDM,300,RC,85060,CPT,OUTPATIENT,,,97,63.05,,85.36,88,,68.29,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.08,100,,,,,0,"fee schedule",EAPG,97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.23,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",61.11,63,,48.89,,,0,"percent of total billed charges","63% of total billed charges",14.84,15.3,,11.87,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,66.93,69,,,,,0,"fee schedule","69% of total billed charges",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.08,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",36.57,37.7,,29.26,,,0,"percent of total billed charges","37.7% of total billed charges",36.57,37.7,,29.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.88,33.9,,26.30,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.66,78,,60.53,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.12,82.6,,64.10,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule","100% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",80.12,82.6,,64.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.08,100,,,,,0,"fee schedule",EAPG,97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",3.76,97,
"Bill Bone Marrow Smear Intrerp",31085097,CDM,310,RC,85097,CPT,OUTPATIENT,,,1529,993.85,,1345.52,88,,1076.42,,,0,"percent of total billed charges","88% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.87,16.8,,205.50,,,0,"percent of total billed charges","16.8% of total billed charges",1529,100,,1223.20,,,0,"percent of total billed charges","100% of total billed charges",1534.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",264.58,17.304,,211.66,,,0,"percent of total billed charges","17.304% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",963.27,63,,770.62,,,0,"percent of total billed charges","63% of total billed charges",233.94,15.3,,187.15,,,0,"percent of total billed charges","15.3% of total billed charges",256.87,16.8,,205.50,,,0,"percent of total billed charges","16.8% of total billed charges",1055.01,69,,,,,0,"fee schedule","69% of total billed charges",1529,100,,1223.20,,,0,"percent of total billed charges","100% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1529,100,,1223.20,,,0,"percent of total billed charges","100% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1529,100,,1223.20,,,0,"percent of total billed charges","100% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",2665.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.87,16.8,,205.50,,,0,"percent of total billed charges","16.8% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",696.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.87,16.8,,205.50,,,0,"percent of total billed charges","16.8% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",262.01,17.136,,209.61,,,0,"percent of total billed charges","17.136% of total billed charges",333.93,21.84,,267.14,,,0,"percent of total billed charges","21.84% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",576.43,37.7,,461.14,,,0,"percent of total billed charges","37.7% of total billed charges",576.43,37.7,,461.14,,,0,"percent of total billed charges","37.70% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",518.33,33.9,,414.66,,,0,"percent of total billed charges","33.9% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1192.62,78,,954.10,,,0,"percent of total billed charges","78% of total billed charges",885.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1262.95,82.6,,1010.36,,,0,"percent of total billed charges","82.6% of total billed charges",256.87,16.8,,205.50,,,0,"percent of total billed charges","16.8% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1262.95,82.6,,1010.36,,,0,"percent of total billed charges","82.6% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.87,16.8,,205.50,,,0,"percent of total billed charges","16.8% of total billed charges",1529,100,,1223.20,,,0,"percent of total billed charges","100% of total billed charges",233.94,2665.63,
"Bill CYTO NON GYN SMEAR INTERP",31088104,CDM,310,RC,88104,CPT,OUTPATIENT,,,149,96.85,,131.12,88,,104.90,,,0,"percent of total billed charges","88% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,149,100,,119.20,,,0,"percent of total billed charges","100% of total billed charges",71.58,175,,,,,0,"fee schedule","175% of CMS fee schedule",26.78,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",93.87,63,,75.10,,,0,"percent of total billed charges","63% of total billed charges",22.8,15.3,,18.24,,,0,"percent of total billed charges","15.3% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,102.81,69,,,,,0,"fee schedule","69% of total billed charges",149,100,,119.20,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",149,100,,119.20,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",149,100,,119.20,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.26,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.52,100,,,,,0,"fee schedule",EAPG,33.8,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",56.17,37.7,,44.94,,,0,"percent of total billed charges","37.7% of total billed charges",56.17,37.7,,44.94,,,0,"percent of total billed charges","37.70% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",50.51,33.9,,40.41,,,0,"percent of total billed charges","33.9% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",116.22,78,,92.98,,,0,"percent of total billed charges","78% of total billed charges",41.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.07,82.6,,98.46,,,0,"percent of total billed charges","82.6% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.07,82.6,,98.46,,,0,"percent of total billed charges","82.6% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,149,100,,119.20,,,0,"percent of total billed charges","100% of total billed charges",19.26,149,
"Bill Cyto Path Cell Enhance Tech",31088112,CDM,310,RC,88112,CPT,OUTPATIENT,,,502,326.3,,441.76,88,,353.41,,,0,"percent of total billed charges","88% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",96.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",26.78,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",316.26,63,,253.01,,,0,"percent of total billed charges","63% of total billed charges",76.81,15.3,,61.45,,,0,"percent of total billed charges","15.3% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,346.38,69,,,,,0,"fee schedule","69% of total billed charges",502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.15,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.26,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.52,100,,,,,0,"fee schedule",EAPG,33.8,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.25,37.7,,151.40,,,0,"percent of total billed charges","37.7% of total billed charges",189.25,37.7,,151.40,,,0,"percent of total billed charges","37.70% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",170.18,33.9,,136.14,,,0,"percent of total billed charges","33.9% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",391.56,78,,313.25,,,0,"percent of total billed charges","78% of total billed charges",55.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",414.65,82.6,,331.72,,,0,"percent of total billed charges","82.6% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",414.65,82.6,,331.72,,,0,"percent of total billed charges","82.6% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",19.26,502,
"Bill CYTO OTHER SOURCE SCREEN",31188160,CDM,311,RC,88160,CPT,OUTPATIENT,,,176,114.4,,154.88,88,,123.90,,,0,"percent of total billed charges","88% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",53.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",26.78,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.88,63,,88.70,,,0,"percent of total billed charges","63% of total billed charges",26.93,15.3,,21.54,,,0,"percent of total billed charges","15.3% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,121.44,69,,,,,0,"fee schedule","69% of total billed charges",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.22,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.26,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.52,100,,,,,0,"fee schedule",EAPG,33.8,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.35,37.7,,53.08,,,0,"percent of total billed charges","37.7% of total billed charges",66.35,37.7,,53.08,,,0,"percent of total billed charges","37.70% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.66,33.9,,47.73,,,0,"percent of total billed charges","33.9% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",137.28,78,,109.82,,,0,"percent of total billed charges","78% of total billed charges",30.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",145.38,82.6,,116.30,,,0,"percent of total billed charges","82.6% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",145.38,82.6,,116.30,,,0,"percent of total billed charges","82.6% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",19.26,176,
"Bill CYTO EXT STUDY >5",31188162,CDM,311,RC,88162,CPT,OUTPATIENT,,,198,128.7,,174.24,88,,139.39,,,0,"percent of total billed charges","88% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",96.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",26.78,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,63,,99.79,,,0,"percent of total billed charges","63% of total billed charges",30.29,15.3,,24.23,,,0,"percent of total billed charges","15.3% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,136.62,69,,,,,0,"fee schedule","69% of total billed charges",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.15,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.26,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.52,100,,,,,0,"fee schedule",EAPG,33.8,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.65,37.7,,59.72,,,0,"percent of total billed charges","37.7% of total billed charges",74.65,37.7,,59.72,,,0,"percent of total billed charges","37.70% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",67.12,33.9,,53.70,,,0,"percent of total billed charges","33.9% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.44,78,,123.55,,,0,"percent of total billed charges","78% of total billed charges",55.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",163.55,82.6,,130.84,,,0,"percent of total billed charges","82.6% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",163.55,82.6,,130.84,,,0,"percent of total billed charges","82.6% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",19.26,202.15,
"Bill PAP SMEAR DIAGNOSTIC-BETHESDA",31188164,CDM,311,RC,88164,CPT,OUTPATIENT,,,81,52.65,,71.28,88,,57.02,,,0,"percent of total billed charges","88% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",31.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.03,100,,,,,0,"fee schedule",EAPG,17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.03,63,,40.82,,,0,"percent of total billed charges","63% of total billed charges",26.64,150,,,,,0,"fee schedule","150% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,55.89,69,,,,,0,"fee schedule","69% of total billed charges",81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.94,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.76,100,,,,,0,"fee schedule","100% of LI fee schedule",11.53,100,,,,,0,"fee schedule",EAPG,17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.87,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule",EAPG,17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.54,37.7,,24.43,,,0,"percent of total billed charges","37.7% of total billed charges",30.54,37.7,,24.43,,,0,"percent of total billed charges","37.70% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.46,33.9,,21.97,,,0,"percent of total billed charges","33.9% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.18,78,,50.54,,,0,"percent of total billed charges","78% of total billed charges",17.93,101,,,,,0,"fee schedule","101% of CMS fee schedule ",66.91,82.6,,53.53,,,0,"percent of total billed charges","82.6% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.91,82.6,,53.53,,,0,"percent of total billed charges","82.6% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",11.53,81,
"Bill FNA EVALUATION",31088172,CDM,310,RC,88172,CPT,OUTPATIENT,,,526,341.9,,462.88,88,,370.30,,,0,"percent of total billed charges","88% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.75,100,,,,,0,"fee schedule",EAPG,526,100,,420.80,,,0,"percent of total billed charges","100% of total billed charges",304.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",36.82,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",331.38,63,,265.10,,,0,"percent of total billed charges","63% of total billed charges",80.48,15.3,,64.38,,,0,"percent of total billed charges","15.3% of total billed charges",35.75,100,,,,,0,"fee schedule",EAPG,362.94,69,,,,,0,"fee schedule","69% of total billed charges",526,100,,420.80,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",526,100,,420.80,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",526,100,,420.80,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",605.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.75,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.48,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.46,100,,,,,0,"fee schedule",EAPG,46.47,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",198.3,37.7,,158.64,,,0,"percent of total billed charges","37.7% of total billed charges",198.3,37.7,,158.64,,,0,"percent of total billed charges","37.70% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",178.31,33.9,,142.65,,,0,"percent of total billed charges","33.9% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.28,78,,328.22,,,0,"percent of total billed charges","78% of total billed charges",175.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",434.48,82.6,,347.58,,,0,"percent of total billed charges","82.6% of total billed charges",35.75,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",434.48,82.6,,347.58,,,0,"percent of total billed charges","82.6% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.75,100,,,,,0,"fee schedule",EAPG,526,100,,420.80,,,0,"percent of total billed charges","100% of total billed charges",26.48,605.96,
"Bill FNA EVAL INTERP  RPT",31088173,CDM,310,RC,88173,CPT,OUTPATIENT,,,526,341.9,,462.88,88,,370.30,,,0,"percent of total billed charges","88% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33.17,100,,,,,0,"fee schedule",EAPG,526,100,,420.80,,,0,"percent of total billed charges","100% of total billed charges",96.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",34.17,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",331.38,63,,265.10,,,0,"percent of total billed charges","63% of total billed charges",80.48,15.3,,64.38,,,0,"percent of total billed charges","15.3% of total billed charges",33.17,100,,,,,0,"fee schedule",EAPG,362.94,69,,,,,0,"fee schedule","69% of total billed charges",526,100,,420.80,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",526,100,,420.80,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",526,100,,420.80,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.15,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33.17,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.57,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33.84,100,,,,,0,"fee schedule",EAPG,43.13,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",198.3,37.7,,158.64,,,0,"percent of total billed charges","37.7% of total billed charges",198.3,37.7,,158.64,,,0,"percent of total billed charges","37.70% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",178.31,33.9,,142.65,,,0,"percent of total billed charges","33.9% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.28,78,,328.22,,,0,"percent of total billed charges","78% of total billed charges",55.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",434.48,82.6,,347.58,,,0,"percent of total billed charges","82.6% of total billed charges",33.17,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",434.48,82.6,,347.58,,,0,"percent of total billed charges","82.6% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33.17,100,,,,,0,"fee schedule",EAPG,526,100,,420.80,,,0,"percent of total billed charges","100% of total billed charges",24.57,526,
"Bill FLOW CYTOMETRY TECH INITIAL",31088184,CDM,310,RC,88184,CPT,OUTPATIENT,,,671,436.15,,590.48,88,,472.38,,,0,"percent of total billed charges","88% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.75,100,,,,,0,"fee schedule",EAPG,671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",641.59,175,,,,,0,"fee schedule","175% of CMS fee schedule",36.82,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",422.73,63,,338.18,,,0,"percent of total billed charges","63% of total billed charges",102.66,15.3,,82.13,,,0,"percent of total billed charges","15.3% of total billed charges",35.75,100,,,,,0,"fee schedule",EAPG,462.99,69,,,,,0,"fee schedule","69% of total billed charges",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",1183.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.75,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.48,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.46,100,,,,,0,"fee schedule",EAPG,46.47,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.97,37.7,,202.38,,,0,"percent of total billed charges","37.7% of total billed charges",252.97,37.7,,202.38,,,0,"percent of total billed charges","37.70% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",227.47,33.9,,181.98,,,0,"percent of total billed charges","33.9% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",523.38,78,,418.70,,,0,"percent of total billed charges","78% of total billed charges",370.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.25,82.6,,443.40,,,0,"percent of total billed charges","82.6% of total billed charges",35.75,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.25,82.6,,443.40,,,0,"percent of total billed charges","82.6% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.75,100,,,,,0,"fee schedule",EAPG,671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",26.48,1183.25,
"Bill FLOW CYTOMETRY TECH EA ADD",31088185,CDM,310,RC,88185,CPT,OUTPATIENT,,,94,61.1,,82.72,88,,66.18,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,,,,0,"fee schedule",EAPG,94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.78,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",59.22,63,,47.38,,,0,"percent of total billed charges","63% of total billed charges",14.38,15.3,,11.50,,,0,"percent of total billed charges","15.3% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,64.86,69,,,,,0,"fee schedule","69% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.26,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",26.52,100,,,,,0,"fee schedule",EAPG,33.8,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",35.44,37.7,,28.35,,,0,"percent of total billed charges","37.7% of total billed charges",35.44,37.7,,28.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.87,33.9,,25.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",73.32,78,,58.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,,,,0,"fee schedule",EAPG,94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",14.38,94,
"Bill FLOW CYTOMETRY INTERP 2-8",31088187,CDM,310,RC,88187,CPT,OUTPATIENT,,,190,123.5,,167.2,88,,133.76,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,,,,0,"fee schedule",EAPG,190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.78,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",119.7,63,,95.76,,,0,"percent of total billed charges","63% of total billed charges",29.07,15.3,,23.26,,,0,"percent of total billed charges","15.3% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,131.1,69,,,,,0,"fee schedule","69% of total billed charges",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.26,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",26.52,100,,,,,0,"fee schedule",EAPG,33.8,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",71.63,37.7,,57.30,,,0,"percent of total billed charges","37.7% of total billed charges",71.63,37.7,,57.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.41,33.9,,51.53,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",148.2,78,,118.56,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.94,82.6,,125.55,,,0,"percent of total billed charges","82.6% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",156.94,82.6,,125.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,,,,0,"fee schedule",EAPG,190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",19.26,190,
"Bill FLOW CYTOMETRY INTERP 9-15",31088188,CDM,310,RC,88188,CPT,OUTPATIENT,,,933,606.45,,821.04,88,,656.83,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,,,,0,"fee schedule",EAPG,933,100,,746.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.78,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",587.79,63,,470.23,,,0,"percent of total billed charges","63% of total billed charges",142.75,15.3,,114.20,,,0,"percent of total billed charges","15.3% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,643.77,69,,,,,0,"fee schedule","69% of total billed charges",933,100,,746.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",933,100,,746.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",933,100,,746.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.26,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",26.52,100,,,,,0,"fee schedule",EAPG,33.8,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",351.74,37.7,,281.39,,,0,"percent of total billed charges","37.7% of total billed charges",351.74,37.7,,281.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",316.29,33.9,,253.03,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",727.74,78,,582.19,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",770.66,82.6,,616.53,,,0,"percent of total billed charges","82.6% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",770.66,82.6,,616.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,,,,0,"fee schedule",EAPG,933,100,,746.40,,,0,"percent of total billed charges","100% of total billed charges",19.26,933,
"Bill FLOW CYTOMETRY INTERP 16 >",31088189,CDM,310,RC,88189,CPT,OUTPATIENT,,,888,577.2,,781.44,88,,625.15,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,,,,0,"fee schedule",EAPG,888,100,,710.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.78,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",559.44,63,,447.55,,,0,"percent of total billed charges","63% of total billed charges",135.86,15.3,,108.69,,,0,"percent of total billed charges","15.3% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,612.72,69,,,,,0,"fee schedule","69% of total billed charges",888,100,,710.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",888,100,,710.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",888,100,,710.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.26,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",26.52,100,,,,,0,"fee schedule",EAPG,33.8,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",334.78,37.7,,267.82,,,0,"percent of total billed charges","37.7% of total billed charges",334.78,37.7,,267.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.03,33.9,,240.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",692.64,78,,554.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",733.49,82.6,,586.79,,,0,"percent of total billed charges","82.6% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",733.49,82.6,,586.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,,,,0,"fee schedule",EAPG,888,100,,710.40,,,0,"percent of total billed charges","100% of total billed charges",19.26,888,
"Bill TISS CX NON NEOPLASTIC DISORDER",31188230,CDM,311,RC,88230,CPT,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",116.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.75,100,,,,,0,"fee schedule",EAPG,803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",203.85,175,,,,,0,"fee schedule","175% of CMS fee schedule",36.82,100,,,,,0,"fee schedule",EAPG,116.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",174.74,150,,,,,0,"fee schedule","150% of total billed charges",35.75,100,,,,,0,"fee schedule",EAPG,554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",116.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",116.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",116.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",445.57,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",35.75,100,,,,,0,"fee schedule",EAPG,116.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",116.49,100,,,,,0,"fee schedule","100% of LI fee schedule",26.48,100,,,,,0,"fee schedule",EAPG,116.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.46,100,,,,,0,"fee schedule",EAPG,46.47,100,,,,,0,"fee schedule",EAPG,116.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",116.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",116.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",117.65,101,,,,,0,"fee schedule","101% of CMS fee schedule ",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",35.75,100,,,,,0,"fee schedule",EAPG,116.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",116.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.75,100,,,,,0,"fee schedule",EAPG,803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",26.48,803,
"Bill CRYO SKIN OR SOLID TISS BIOPSY",31188233,CDM,311,RC,88233,CPT,OUTPATIENT,,,1361,884.65,,1197.68,88,,958.14,,,0,"percent of total billed charges","88% of total billed charges",140.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.75,100,,,,,0,"fee schedule",EAPG,1361,100,,1088.80,,,0,"percent of total billed charges","100% of total billed charges",246.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",36.82,100,,,,,0,"fee schedule",EAPG,140.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",857.43,63,,685.94,,,0,"percent of total billed charges","63% of total billed charges",211.1,150,,,,,0,"fee schedule","150% of total billed charges",35.75,100,,,,,0,"fee schedule",EAPG,939.09,69,,,,,0,"fee schedule","69% of total billed charges",1361,100,,1088.80,,,0,"percent of total billed charges","100% of total billed charges",140.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",1361,100,,1088.80,,,0,"percent of total billed charges","100% of total billed charges",140.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",1361,100,,1088.80,,,0,"percent of total billed charges","100% of total billed charges",140.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",538.29,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",35.75,100,,,,,0,"fee schedule",EAPG,140.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",140.72,100,,,,,0,"fee schedule","100% of LI fee schedule",26.48,100,,,,,0,"fee schedule",EAPG,140.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.46,100,,,,,0,"fee schedule",EAPG,46.47,100,,,,,0,"fee schedule",EAPG,140.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",513.1,37.7,,410.48,,,0,"percent of total billed charges","37.7% of total billed charges",513.1,37.7,,410.48,,,0,"percent of total billed charges","37.70% of total billed charges",140.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",461.38,33.9,,369.10,,,0,"percent of total billed charges","33.9% of total billed charges",140.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061.58,78,,849.26,,,0,"percent of total billed charges","78% of total billed charges",142.13,101,,,,,0,"fee schedule","101% of CMS fee schedule ",1124.19,82.6,,899.35,,,0,"percent of total billed charges","82.6% of total billed charges",35.75,100,,,,,0,"fee schedule",EAPG,140.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",1124.19,82.6,,899.35,,,0,"percent of total billed charges","82.6% of total billed charges",140.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.75,100,,,,,0,"fee schedule",EAPG,1361,100,,1088.80,,,0,"percent of total billed charges","100% of total billed charges",26.48,1361,
"Bill TISS CX NEOPLASTIC DISORDERS",31188237,CDM,311,RC,88237,CPT,OUTPATIENT,,,646,419.9,,568.48,88,,454.78,,,0,"percent of total billed charges","88% of total billed charges",143.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.75,100,,,,,0,"fee schedule",EAPG,646,100,,516.80,,,0,"percent of total billed charges","100% of total billed charges",251.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",36.82,100,,,,,0,"fee schedule",EAPG,143.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",406.98,63,,325.58,,,0,"percent of total billed charges","63% of total billed charges",215.63,150,,,,,0,"fee schedule","150% of total billed charges",35.75,100,,,,,0,"fee schedule",EAPG,445.74,69,,,,,0,"fee schedule","69% of total billed charges",646,100,,516.80,,,0,"percent of total billed charges","100% of total billed charges",143.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",646,100,,516.80,,,0,"percent of total billed charges","100% of total billed charges",143.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",646,100,,516.80,,,0,"percent of total billed charges","100% of total billed charges",143.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",549.84,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",35.75,100,,,,,0,"fee schedule",EAPG,143.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",143.75,100,,,,,0,"fee schedule","100% of LI fee schedule",26.48,100,,,,,0,"fee schedule",EAPG,143.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.46,100,,,,,0,"fee schedule",EAPG,46.47,100,,,,,0,"fee schedule",EAPG,143.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",243.54,37.7,,194.83,,,0,"percent of total billed charges","37.7% of total billed charges",243.54,37.7,,194.83,,,0,"percent of total billed charges","37.70% of total billed charges",143.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",218.99,33.9,,175.19,,,0,"percent of total billed charges","33.9% of total billed charges",143.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",503.88,78,,403.10,,,0,"percent of total billed charges","78% of total billed charges",145.18,101,,,,,0,"fee schedule","101% of CMS fee schedule ",533.6,82.6,,426.88,,,0,"percent of total billed charges","82.6% of total billed charges",35.75,100,,,,,0,"fee schedule",EAPG,143.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",533.6,82.6,,426.88,,,0,"percent of total billed charges","82.6% of total billed charges",143.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.75,100,,,,,0,"fee schedule",EAPG,646,100,,516.80,,,0,"percent of total billed charges","100% of total billed charges",26.48,646,
"Bill CHROM ANALYSIS 5 CELLS",31188261,CDM,311,RC,88261,CPT,OUTPATIENT,,,905,588.25,,796.4,88,,637.12,,,0,"percent of total billed charges","88% of total billed charges",264.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,905,100,,724.00,,,0,"percent of total billed charges","100% of total billed charges",462.59,175,,,,,0,"fee schedule","175% of CMS fee schedule",110.23,100,,,,,0,"fee schedule",EAPG,264.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",570.15,63,,456.12,,,0,"percent of total billed charges","63% of total billed charges",396.51,150,,,,,0,"fee schedule","150% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,624.45,69,,,,,0,"fee schedule","69% of total billed charges",905,100,,724.00,,,0,"percent of total billed charges","100% of total billed charges",264.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",905,100,,724.00,,,0,"percent of total billed charges","100% of total billed charges",264.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",905,100,,724.00,,,0,"percent of total billed charges","100% of total billed charges",264.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",1011.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,264.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",264.33,100,,,,,0,"fee schedule","100% of LI fee schedule",79.27,100,,,,,0,"fee schedule",EAPG,264.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.16,100,,,,,0,"fee schedule",EAPG,139.13,100,,,,,0,"fee schedule",EAPG,264.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",341.19,37.7,,272.95,,,0,"percent of total billed charges","37.7% of total billed charges",341.19,37.7,,272.95,,,0,"percent of total billed charges","37.70% of total billed charges",264.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",306.8,33.9,,245.44,,,0,"percent of total billed charges","33.9% of total billed charges",264.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",705.9,78,,564.72,,,0,"percent of total billed charges","78% of total billed charges",266.98,101,,,,,0,"fee schedule","101% of CMS fee schedule ",747.53,82.6,,598.02,,,0,"percent of total billed charges","82.6% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,264.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",747.53,82.6,,598.02,,,0,"percent of total billed charges","82.6% of total billed charges",264.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,905,100,,724.00,,,0,"percent of total billed charges","100% of total billed charges",79.27,1011.1,
"Bill CHROM ANALYSIS 15-20 CELLS",31188262,CDM,311,RC,88262,CPT,OUTPATIENT,,,934,607.1,,821.92,88,,657.54,,,0,"percent of total billed charges","88% of total billed charges",125.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,934,100,,747.20,,,0,"percent of total billed charges","100% of total billed charges",219.6,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.2,100,,,,,0,"fee schedule",EAPG,125.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",588.42,63,,470.74,,,0,"percent of total billed charges","63% of total billed charges",188.24,150,,,,,0,"fee schedule","150% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,644.46,69,,,,,0,"fee schedule","69% of total billed charges",934,100,,747.20,,,0,"percent of total billed charges","100% of total billed charges",125.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",934,100,,747.20,,,0,"percent of total billed charges","100% of total billed charges",125.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",934,100,,747.20,,,0,"percent of total billed charges","100% of total billed charges",125.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",479.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,125.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",125.49,100,,,,,0,"fee schedule","100% of LI fee schedule",28.91,100,,,,,0,"fee schedule",EAPG,125.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.81,100,,,,,0,"fee schedule",EAPG,50.73,100,,,,,0,"fee schedule",EAPG,125.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",352.12,37.7,,281.70,,,0,"percent of total billed charges","37.7% of total billed charges",352.12,37.7,,281.70,,,0,"percent of total billed charges","37.70% of total billed charges",125.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",316.63,33.9,,253.30,,,0,"percent of total billed charges","33.9% of total billed charges",125.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",728.52,78,,582.82,,,0,"percent of total billed charges","78% of total billed charges",126.74,101,,,,,0,"fee schedule","101% of CMS fee schedule ",771.48,82.6,,617.18,,,0,"percent of total billed charges","82.6% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,125.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",771.48,82.6,,617.18,,,0,"percent of total billed charges","82.6% of total billed charges",125.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,934,100,,747.20,,,0,"percent of total billed charges","100% of total billed charges",28.91,934,
"Bill CHROM ANALYSIS 20-25 CELLS",31188264,CDM,311,RC,88264,CPT,OUTPATIENT,,,825,536.25,,726,88,,580.80,,,0,"percent of total billed charges","88% of total billed charges",144.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,825,100,,660.00,,,0,"percent of total billed charges","100% of total billed charges",253.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",110.23,100,,,,,0,"fee schedule",EAPG,144.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",519.75,63,,415.80,,,0,"percent of total billed charges","63% of total billed charges",216.92,150,,,,,0,"fee schedule","150% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,569.25,69,,,,,0,"fee schedule","69% of total billed charges",825,100,,660.00,,,0,"percent of total billed charges","100% of total billed charges",144.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",825,100,,660.00,,,0,"percent of total billed charges","100% of total billed charges",144.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",825,100,,660.00,,,0,"percent of total billed charges","100% of total billed charges",144.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",553.13,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,144.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.61,100,,,,,0,"fee schedule","100% of LI fee schedule",79.27,100,,,,,0,"fee schedule",EAPG,144.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.16,100,,,,,0,"fee schedule",EAPG,139.13,100,,,,,0,"fee schedule",EAPG,144.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",311.03,37.7,,248.82,,,0,"percent of total billed charges","37.7% of total billed charges",311.03,37.7,,248.82,,,0,"percent of total billed charges","37.70% of total billed charges",144.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",279.68,33.9,,223.74,,,0,"percent of total billed charges","33.9% of total billed charges",144.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",643.5,78,,514.80,,,0,"percent of total billed charges","78% of total billed charges",146.05,101,,,,,0,"fee schedule","101% of CMS fee schedule ",681.45,82.6,,545.16,,,0,"percent of total billed charges","82.6% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,144.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",681.45,82.6,,545.16,,,0,"percent of total billed charges","82.6% of total billed charges",144.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,825,100,,660.00,,,0,"percent of total billed charges","100% of total billed charges",79.27,825,
"Bill MOLECULAR CYTO DNA PROBE",31188271,CDM,311,RC,88271,CPT,OUTPATIENT,,,254,165.1,,223.52,88,,178.82,,,0,"percent of total billed charges","88% of total billed charges",21.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",37.48,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.2,100,,,,,0,"fee schedule",EAPG,21.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.02,63,,128.02,,,0,"percent of total billed charges","63% of total billed charges",32.13,150,,,,,0,"fee schedule","150% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,175.26,69,,,,,0,"fee schedule","69% of total billed charges",254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",21.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",21.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",21.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.93,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,21.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.42,100,,,,,0,"fee schedule","100% of LI fee schedule",28.91,100,,,,,0,"fee schedule",EAPG,21.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.81,100,,,,,0,"fee schedule",EAPG,50.73,100,,,,,0,"fee schedule",EAPG,21.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.76,37.7,,76.61,,,0,"percent of total billed charges","37.7% of total billed charges",95.76,37.7,,76.61,,,0,"percent of total billed charges","37.70% of total billed charges",21.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",86.11,33.9,,68.89,,,0,"percent of total billed charges","33.9% of total billed charges",21.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",198.12,78,,158.50,,,0,"percent of total billed charges","78% of total billed charges",21.63,101,,,,,0,"fee schedule","101% of CMS fee schedule ",209.8,82.6,,167.84,,,0,"percent of total billed charges","82.6% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,21.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",209.8,82.6,,167.84,,,0,"percent of total billed charges","82.6% of total billed charges",21.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",21.42,254,
"Bill MOLEC INTERPHASE INSITU",31088275,CDM,310,RC,88275,CPT,OUTPATIENT,,,278,180.7,,244.64,88,,195.71,,,0,"percent of total billed charges","88% of total billed charges",51.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",89.58,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.2,100,,,,,0,"fee schedule",EAPG,51.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",175.14,63,,140.11,,,0,"percent of total billed charges","63% of total billed charges",76.79,150,,,,,0,"fee schedule","150% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,191.82,69,,,,,0,"fee schedule","69% of total billed charges",278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",51.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",51.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",51.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",195.8,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,51.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.19,100,,,,,0,"fee schedule","100% of LI fee schedule",28.91,100,,,,,0,"fee schedule",EAPG,51.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.81,100,,,,,0,"fee schedule",EAPG,50.73,100,,,,,0,"fee schedule",EAPG,51.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",104.81,37.7,,83.85,,,0,"percent of total billed charges","37.7% of total billed charges",104.81,37.7,,83.85,,,0,"percent of total billed charges","37.70% of total billed charges",51.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",94.24,33.9,,75.39,,,0,"percent of total billed charges","33.9% of total billed charges",51.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",216.84,78,,173.47,,,0,"percent of total billed charges","78% of total billed charges",51.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",229.63,82.6,,183.70,,,0,"percent of total billed charges","82.6% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,51.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",229.63,82.6,,183.70,,,0,"percent of total billed charges","82.6% of total billed charges",51.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",28.91,278,
"Bill Chrom Anal ADDL Karyotype",31188280,CDM,311,RC,88280,CPT,OUTPATIENT,,,188,122.2,,165.44,88,,132.35,,,0,"percent of total billed charges","88% of total billed charges",33.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,188,100,,150.40,,,0,"percent of total billed charges","100% of total billed charges",58.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.2,100,,,,,0,"fee schedule",EAPG,33.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",118.44,63,,94.75,,,0,"percent of total billed charges","63% of total billed charges",50.21,150,,,,,0,"fee schedule","150% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,129.72,69,,,,,0,"fee schedule","69% of total billed charges",188,100,,150.40,,,0,"percent of total billed charges","100% of total billed charges",33.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",188,100,,150.40,,,0,"percent of total billed charges","100% of total billed charges",33.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",188,100,,150.40,,,0,"percent of total billed charges","100% of total billed charges",33.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",128.02,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,33.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.47,100,,,,,0,"fee schedule","100% of LI fee schedule",28.91,100,,,,,0,"fee schedule",EAPG,33.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.81,100,,,,,0,"fee schedule",EAPG,50.73,100,,,,,0,"fee schedule",EAPG,33.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.88,37.7,,56.70,,,0,"percent of total billed charges","37.7% of total billed charges",70.88,37.7,,56.70,,,0,"percent of total billed charges","37.70% of total billed charges",33.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.73,33.9,,50.98,,,0,"percent of total billed charges","33.9% of total billed charges",33.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",146.64,78,,117.31,,,0,"percent of total billed charges","78% of total billed charges",33.8,101,,,,,0,"fee schedule","101% of CMS fee schedule ",155.29,82.6,,124.23,,,0,"percent of total billed charges","82.6% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,33.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",155.29,82.6,,124.23,,,0,"percent of total billed charges","82.6% of total billed charges",33.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,188,100,,150.40,,,0,"percent of total billed charges","100% of total billed charges",28.91,188,
"Bill CHROM COUNT ADDL CELL",31188285,CDM,311,RC,88285,CPT,OUTPATIENT,,,91,59.15,,80.08,88,,64.06,,,0,"percent of total billed charges","88% of total billed charges",26.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",47.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.2,100,,,,,0,"fee schedule",EAPG,26.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.33,63,,45.86,,,0,"percent of total billed charges","63% of total billed charges",40.37,150,,,,,0,"fee schedule","150% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,62.79,69,,,,,0,"fee schedule","69% of total billed charges",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",26.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",26.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",26.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",102.93,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,26.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.91,100,,,,,0,"fee schedule","100% of LI fee schedule",28.91,100,,,,,0,"fee schedule",EAPG,26.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.81,100,,,,,0,"fee schedule",EAPG,50.73,100,,,,,0,"fee schedule",EAPG,26.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.31,37.7,,27.45,,,0,"percent of total billed charges","37.7% of total billed charges",34.31,37.7,,27.45,,,0,"percent of total billed charges","37.70% of total billed charges",26.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.85,33.9,,24.68,,,0,"percent of total billed charges","33.9% of total billed charges",26.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.98,78,,56.78,,,0,"percent of total billed charges","78% of total billed charges",27.17,101,,,,,0,"fee schedule","101% of CMS fee schedule ",75.17,82.6,,60.14,,,0,"percent of total billed charges","82.6% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,26.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",75.17,82.6,,60.14,,,0,"percent of total billed charges","82.6% of total billed charges",26.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",26.91,102.93,
"Bill CHROM COUNT ADDL HIGH STUDY",31088289,CDM,310,RC,88289,CPT,OUTPATIENT,,,172,111.8,,151.36,88,,121.09,,,0,"percent of total billed charges","88% of total billed charges",34.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",60.25,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.2,100,,,,,0,"fee schedule",EAPG,34.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.36,63,,86.69,,,0,"percent of total billed charges","63% of total billed charges",51.65,150,,,,,0,"fee schedule","150% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,118.68,69,,,,,0,"fee schedule","69% of total billed charges",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",34.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",34.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",34.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",131.69,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,34.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.43,100,,,,,0,"fee schedule","100% of LI fee schedule",28.91,100,,,,,0,"fee schedule",EAPG,34.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.81,100,,,,,0,"fee schedule",EAPG,50.73,100,,,,,0,"fee schedule",EAPG,34.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.84,37.7,,51.87,,,0,"percent of total billed charges","37.7% of total billed charges",64.84,37.7,,51.87,,,0,"percent of total billed charges","37.70% of total billed charges",34.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.31,33.9,,46.65,,,0,"percent of total billed charges","33.9% of total billed charges",34.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.16,78,,107.33,,,0,"percent of total billed charges","78% of total billed charges",34.77,101,,,,,0,"fee schedule","101% of CMS fee schedule ",142.07,82.6,,113.66,,,0,"percent of total billed charges","82.6% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,34.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.07,82.6,,113.66,,,0,"percent of total billed charges","82.6% of total billed charges",34.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",28.91,172,
"Bill PATHOLOGY LEVEL I",31288300,CDM,312,RC,88300,CPT,OUTPATIENT,,,119,77.35,,104.72,88,,83.78,,,0,"percent of total billed charges","88% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.92,100,,,,,0,"fee schedule",EAPG,119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",53.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",20.52,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.97,63,,59.98,,,0,"percent of total billed charges","63% of total billed charges",18.21,15.3,,14.57,,,0,"percent of total billed charges","15.3% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,82.11,69,,,,,0,"fee schedule","69% of total billed charges",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.22,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.92,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14.76,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",20.32,100,,,,,0,"fee schedule",EAPG,25.9,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.7% of total billed charges",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.70% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.34,33.9,,32.27,,,0,"percent of total billed charges","33.9% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.82,78,,74.26,,,0,"percent of total billed charges","78% of total billed charges",30.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.92,100,,,,,0,"fee schedule",EAPG,119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",14.76,119,
"Bill PATHOLOGY LEVEL II",31288302,CDM,312,RC,88302,CPT,OUTPATIENT,,,208,135.2,,183.04,88,,146.43,,,0,"percent of total billed charges","88% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.92,100,,,,,0,"fee schedule",EAPG,208,100,,166.40,,,0,"percent of total billed charges","100% of total billed charges",53.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",20.52,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",131.04,63,,104.83,,,0,"percent of total billed charges","63% of total billed charges",31.82,15.3,,25.46,,,0,"percent of total billed charges","15.3% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,143.52,69,,,,,0,"fee schedule","69% of total billed charges",208,100,,166.40,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",208,100,,166.40,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",208,100,,166.40,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.22,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.92,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14.76,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",20.32,100,,,,,0,"fee schedule",EAPG,25.9,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",78.42,37.7,,62.74,,,0,"percent of total billed charges","37.7% of total billed charges",78.42,37.7,,62.74,,,0,"percent of total billed charges","37.70% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",70.51,33.9,,56.41,,,0,"percent of total billed charges","33.9% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",162.24,78,,129.79,,,0,"percent of total billed charges","78% of total billed charges",30.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.81,82.6,,137.45,,,0,"percent of total billed charges","82.6% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.81,82.6,,137.45,,,0,"percent of total billed charges","82.6% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.92,100,,,,,0,"fee schedule",EAPG,208,100,,166.40,,,0,"percent of total billed charges","100% of total billed charges",14.76,208,
"Bill PATHOLOGY LEVEL III",31288304,CDM,312,RC,88304,CPT,OUTPATIENT,,,131,85.15,,115.28,88,,92.22,,,0,"percent of total billed charges","88% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.92,100,,,,,0,"fee schedule",EAPG,131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",96.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",20.52,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",82.53,63,,66.02,,,0,"percent of total billed charges","63% of total billed charges",20.04,15.3,,16.03,,,0,"percent of total billed charges","15.3% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,90.39,69,,,,,0,"fee schedule","69% of total billed charges",131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.15,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.92,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14.76,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",20.32,100,,,,,0,"fee schedule",EAPG,25.9,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",49.39,37.7,,39.51,,,0,"percent of total billed charges","37.7% of total billed charges",49.39,37.7,,39.51,,,0,"percent of total billed charges","37.70% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",44.41,33.9,,35.53,,,0,"percent of total billed charges","33.9% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.18,78,,81.74,,,0,"percent of total billed charges","78% of total billed charges",55.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.21,82.6,,86.57,,,0,"percent of total billed charges","82.6% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.21,82.6,,86.57,,,0,"percent of total billed charges","82.6% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.92,100,,,,,0,"fee schedule",EAPG,131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",14.76,202.15,
"Bill PATHOLOGY LEVEL IV",31288305,CDM,312,RC,88305,CPT,OUTPATIENT,,,143,92.95,,125.84,88,,100.67,,,0,"percent of total billed charges","88% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.92,100,,,,,0,"fee schedule",EAPG,143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",96.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",20.52,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",90.09,63,,72.07,,,0,"percent of total billed charges","63% of total billed charges",21.88,15.3,,17.50,,,0,"percent of total billed charges","15.3% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,98.67,69,,,,,0,"fee schedule","69% of total billed charges",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.15,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.92,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14.76,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",20.32,100,,,,,0,"fee schedule",EAPG,25.9,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",53.91,37.7,,43.13,,,0,"percent of total billed charges","37.7% of total billed charges",53.91,37.7,,43.13,,,0,"percent of total billed charges","37.70% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",48.48,33.9,,38.78,,,0,"percent of total billed charges","33.9% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.54,78,,89.23,,,0,"percent of total billed charges","78% of total billed charges",55.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.92,100,,,,,0,"fee schedule",EAPG,143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",14.76,202.15,
"Bill PATHOLOGY LEVEL V",31288307,CDM,312,RC,88307,CPT,OUTPATIENT,,,862,560.3,,758.56,88,,606.85,,,0,"percent of total billed charges","88% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,862,100,,689.60,,,0,"percent of total billed charges","100% of total billed charges",641.59,175,,,,,0,"fee schedule","175% of CMS fee schedule",37.5,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",543.06,63,,434.45,,,0,"percent of total billed charges","63% of total billed charges",131.89,15.3,,105.51,,,0,"percent of total billed charges","15.3% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,594.78,69,,,,,0,"fee schedule","69% of total billed charges",862,100,,689.60,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",862,100,,689.60,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",862,100,,689.60,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",1183.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.97,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37.13,100,,,,,0,"fee schedule",EAPG,47.33,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",324.97,37.7,,259.98,,,0,"percent of total billed charges","37.7% of total billed charges",324.97,37.7,,259.98,,,0,"percent of total billed charges","37.70% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",292.22,33.9,,233.78,,,0,"percent of total billed charges","33.9% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672.36,78,,537.89,,,0,"percent of total billed charges","78% of total billed charges",370.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",712.01,82.6,,569.61,,,0,"percent of total billed charges","82.6% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",712.01,82.6,,569.61,,,0,"percent of total billed charges","82.6% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,862,100,,689.60,,,0,"percent of total billed charges","100% of total billed charges",26.97,1183.25,
"Bill PATHOLOGY LEVEL VI",31288309,CDM,312,RC,88309,CPT,OUTPATIENT,,,1073,697.45,,944.24,88,,755.39,,,0,"percent of total billed charges","88% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,1073,100,,858.40,,,0,"percent of total billed charges","100% of total billed charges",1534.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",37.5,100,,,,,0,"fee schedule",EAPG,877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",675.99,63,,540.79,,,0,"percent of total billed charges","63% of total billed charges",164.17,15.3,,131.34,,,0,"percent of total billed charges","15.3% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,740.37,69,,,,,0,"fee schedule","69% of total billed charges",1073,100,,858.40,,,0,"percent of total billed charges","100% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1073,100,,858.40,,,0,"percent of total billed charges","100% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1073,100,,858.40,,,0,"percent of total billed charges","100% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",2665.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",696.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.97,100,,,,,0,"fee schedule",EAPG,877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37.13,100,,,,,0,"fee schedule",EAPG,47.33,100,,,,,0,"fee schedule",EAPG,877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",404.52,37.7,,323.62,,,0,"percent of total billed charges","37.7% of total billed charges",404.52,37.7,,323.62,,,0,"percent of total billed charges","37.70% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",363.75,33.9,,291.00,,,0,"percent of total billed charges","33.9% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",836.94,78,,669.55,,,0,"percent of total billed charges","78% of total billed charges",885.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.3,82.6,,709.04,,,0,"percent of total billed charges","82.6% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.3,82.6,,709.04,,,0,"percent of total billed charges","82.6% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,1073,100,,858.40,,,0,"percent of total billed charges","100% of total billed charges",26.97,2665.63,
"Bill DECALCIFICATION PROCEDURE",31288311,CDM,312,RC,88311,CPT,OUTPATIENT,,,48,31.2,,42.24,88,,33.79,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",30.24,63,,24.19,,,0,"percent of total billed charges","63% of total billed charges",7.34,15.3,,5.87,,,0,"percent of total billed charges","15.3% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,33.12,69,,,,,0,"fee schedule","69% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",20.32,100,,,,,0,"fee schedule",EAPG,25.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",18.1,37.7,,14.48,,,0,"percent of total billed charges","37.7% of total billed charges",18.1,37.7,,14.48,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.27,33.9,,13.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.44,78,,29.95,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.65,82.6,,31.72,,,0,"percent of total billed charges","82.6% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",39.65,82.6,,31.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",7.34,48,
"Labcorp Bill SPECIAL STAINS GROUP I",31288312,CDM,312,RC,88312,CPT,OUTPATIENT,,,198,128.7,,174.24,88,,139.39,,,0,"percent of total billed charges","88% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.92,100,,,,,0,"fee schedule",EAPG,198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",96.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",20.52,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,63,,99.79,,,0,"percent of total billed charges","63% of total billed charges",30.29,15.3,,24.23,,,0,"percent of total billed charges","15.3% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,136.62,69,,,,,0,"fee schedule","69% of total billed charges",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.15,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.92,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14.76,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",20.32,100,,,,,0,"fee schedule",EAPG,25.9,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.65,37.7,,59.72,,,0,"percent of total billed charges","37.7% of total billed charges",74.65,37.7,,59.72,,,0,"percent of total billed charges","37.70% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",67.12,33.9,,53.70,,,0,"percent of total billed charges","33.9% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.44,78,,123.55,,,0,"percent of total billed charges","78% of total billed charges",55.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",163.55,82.6,,130.84,,,0,"percent of total billed charges","82.6% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",163.55,82.6,,130.84,,,0,"percent of total billed charges","82.6% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.92,100,,,,,0,"fee schedule",EAPG,198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",14.76,202.15,
"Bill SPECIAL STAINS GROUP II",31288313,CDM,312,RC,88313,CPT,OUTPATIENT,,,289,187.85,,254.32,88,,203.46,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.92,100,,,,,0,"fee schedule",EAPG,289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",20.52,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",182.07,63,,145.66,,,0,"percent of total billed charges","63% of total billed charges",44.22,15.3,,35.38,,,0,"percent of total billed charges","15.3% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,199.41,69,,,,,0,"fee schedule","69% of total billed charges",289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.92,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14.76,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",20.32,100,,,,,0,"fee schedule",EAPG,25.9,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.95,37.7,,87.16,,,0,"percent of total billed charges","37.7% of total billed charges",108.95,37.7,,87.16,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",97.97,33.9,,78.38,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",225.42,78,,180.34,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",238.71,82.6,,190.97,,,0,"percent of total billed charges","82.6% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",238.71,82.6,,190.97,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.92,100,,,,,0,"fee schedule",EAPG,289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",14.76,289,
"Bill HISTO STAIN FROZEN SECT",31288314,CDM,312,RC,88314,CPT,OUTPATIENT,,,79,51.35,,69.52,88,,55.62,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",49.77,63,,39.82,,,0,"percent of total billed charges","63% of total billed charges",12.09,15.3,,9.67,,,0,"percent of total billed charges","15.3% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,54.51,69,,,,,0,"fee schedule","69% of total billed charges",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",20.32,100,,,,,0,"fee schedule",EAPG,25.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",29.78,37.7,,23.82,,,0,"percent of total billed charges","37.7% of total billed charges",29.78,37.7,,23.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.78,33.9,,21.42,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.62,78,,49.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",65.25,82.6,,52.20,,,0,"percent of total billed charges","82.6% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",65.25,82.6,,52.20,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",12.09,79,
"Bill CYTOCHEMICAL STAIN",31188319,CDM,311,RC,88319,CPT,OUTPATIENT,,,1072,696.8,,943.36,88,,754.69,,,0,"percent of total billed charges","88% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,1072,100,,857.60,,,0,"percent of total billed charges","100% of total billed charges",1534.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",37.5,100,,,,,0,"fee schedule",EAPG,877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",675.36,63,,540.29,,,0,"percent of total billed charges","63% of total billed charges",164.02,15.3,,131.22,,,0,"percent of total billed charges","15.3% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,739.68,69,,,,,0,"fee schedule","69% of total billed charges",1072,100,,857.60,,,0,"percent of total billed charges","100% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1072,100,,857.60,,,0,"percent of total billed charges","100% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1072,100,,857.60,,,0,"percent of total billed charges","100% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",2665.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",696.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.97,100,,,,,0,"fee schedule",EAPG,877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37.13,100,,,,,0,"fee schedule",EAPG,47.33,100,,,,,0,"fee schedule",EAPG,877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",404.14,37.7,,323.31,,,0,"percent of total billed charges","37.7% of total billed charges",404.14,37.7,,323.31,,,0,"percent of total billed charges","37.70% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",363.41,33.9,,290.73,,,0,"percent of total billed charges","33.9% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",836.16,78,,668.93,,,0,"percent of total billed charges","78% of total billed charges",885.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",885.47,82.6,,708.38,,,0,"percent of total billed charges","82.6% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",885.47,82.6,,708.38,,,0,"percent of total billed charges","82.6% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,1072,100,,857.60,,,0,"percent of total billed charges","100% of total billed charges",26.97,2665.63,
"Bill CONSULT RPT ON OS SLIDES",31288321,CDM,312,RC,88321,CPT,OUTPATIENT,,,781,507.65,,687.28,88,,549.82,,,0,"percent of total billed charges","88% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33.17,100,,,,,0,"fee schedule",EAPG,781,100,,624.80,,,0,"percent of total billed charges","100% of total billed charges",71.58,175,,,,,0,"fee schedule","175% of CMS fee schedule",34.17,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",492.03,63,,393.62,,,0,"percent of total billed charges","63% of total billed charges",119.49,15.3,,95.59,,,0,"percent of total billed charges","15.3% of total billed charges",33.17,100,,,,,0,"fee schedule",EAPG,538.89,69,,,,,0,"fee schedule","69% of total billed charges",781,100,,624.80,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",781,100,,624.80,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",781,100,,624.80,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33.17,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.57,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33.84,100,,,,,0,"fee schedule",EAPG,43.13,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.44,37.7,,235.55,,,0,"percent of total billed charges","37.7% of total billed charges",294.44,37.7,,235.55,,,0,"percent of total billed charges","37.70% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",264.76,33.9,,211.81,,,0,"percent of total billed charges","33.9% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",609.18,78,,487.34,,,0,"percent of total billed charges","78% of total billed charges",41.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",645.11,82.6,,516.09,,,0,"percent of total billed charges","82.6% of total billed charges",33.17,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",645.11,82.6,,516.09,,,0,"percent of total billed charges","82.6% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33.17,100,,,,,0,"fee schedule",EAPG,781,100,,624.80,,,0,"percent of total billed charges","100% of total billed charges",24.57,781,
"Bill CONSULT 2ND PREP SLIDE",31288323,CDM,312,RC,88323,CPT,OUTPATIENT,,,671,436.15,,590.48,88,,472.38,,,0,"percent of total billed charges","88% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33.17,100,,,,,0,"fee schedule",EAPG,671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",96.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",34.17,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",422.73,63,,338.18,,,0,"percent of total billed charges","63% of total billed charges",102.66,15.3,,82.13,,,0,"percent of total billed charges","15.3% of total billed charges",33.17,100,,,,,0,"fee schedule",EAPG,462.99,69,,,,,0,"fee schedule","69% of total billed charges",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.15,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33.17,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.57,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33.84,100,,,,,0,"fee schedule",EAPG,43.13,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.97,37.7,,202.38,,,0,"percent of total billed charges","37.7% of total billed charges",252.97,37.7,,202.38,,,0,"percent of total billed charges","37.70% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",227.47,33.9,,181.98,,,0,"percent of total billed charges","33.9% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",523.38,78,,418.70,,,0,"percent of total billed charges","78% of total billed charges",55.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.25,82.6,,443.40,,,0,"percent of total billed charges","82.6% of total billed charges",33.17,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.25,82.6,,443.40,,,0,"percent of total billed charges","82.6% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33.17,100,,,,,0,"fee schedule",EAPG,671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",24.57,671,
"Bill PATH CONSULT IN SURGERY",31288329,CDM,312,RC,88329,CPT,OUTPATIENT,,,219,142.35,,192.72,88,,154.18,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33.17,100,,,,,0,"fee schedule",EAPG,219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",34.17,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",137.97,63,,110.38,,,0,"percent of total billed charges","63% of total billed charges",33.51,15.3,,26.81,,,0,"percent of total billed charges","15.3% of total billed charges",33.17,100,,,,,0,"fee schedule",EAPG,151.11,69,,,,,0,"fee schedule","69% of total billed charges",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33.17,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.57,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33.84,100,,,,,0,"fee schedule",EAPG,43.13,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",82.56,37.7,,66.05,,,0,"percent of total billed charges","37.7% of total billed charges",82.56,37.7,,66.05,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.24,33.9,,59.39,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",170.82,78,,136.66,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180.89,82.6,,144.71,,,0,"percent of total billed charges","82.6% of total billed charges",33.17,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180.89,82.6,,144.71,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33.17,100,,,,,0,"fee schedule",EAPG,219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",24.57,219,
"Bill FROZEN SECTION SINGLE SPECIMEN",31288331,CDM,312,RC,88331,CPT,OUTPATIENT,,,671,436.15,,590.48,88,,472.38,,,0,"percent of total billed charges","88% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33.17,100,,,,,0,"fee schedule",EAPG,671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",304.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",34.17,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",422.73,63,,338.18,,,0,"percent of total billed charges","63% of total billed charges",102.66,15.3,,82.13,,,0,"percent of total billed charges","15.3% of total billed charges",33.17,100,,,,,0,"fee schedule",EAPG,462.99,69,,,,,0,"fee schedule","69% of total billed charges",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",605.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33.17,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.57,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33.84,100,,,,,0,"fee schedule",EAPG,43.13,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.97,37.7,,202.38,,,0,"percent of total billed charges","37.7% of total billed charges",252.97,37.7,,202.38,,,0,"percent of total billed charges","37.70% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",227.47,33.9,,181.98,,,0,"percent of total billed charges","33.9% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",523.38,78,,418.70,,,0,"percent of total billed charges","78% of total billed charges",175.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.25,82.6,,443.40,,,0,"percent of total billed charges","82.6% of total billed charges",33.17,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.25,82.6,,443.40,,,0,"percent of total billed charges","82.6% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33.17,100,,,,,0,"fee schedule",EAPG,671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",24.57,671,
"Bill FROZEN SECTION ADDL TISSUE BLK",31288332,CDM,312,RC,88332,CPT,OUTPATIENT,,,43,27.95,,37.84,88,,30.27,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.17,100,,,,,0,"fee schedule",EAPG,43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.17,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",27.09,63,,21.67,,,0,"percent of total billed charges","63% of total billed charges",6.58,15.3,,5.26,,,0,"percent of total billed charges","15.3% of total billed charges",33.17,100,,,,,0,"fee schedule",EAPG,29.67,69,,,,,0,"fee schedule","69% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",33.17,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.57,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",33.84,100,,,,,0,"fee schedule",EAPG,43.13,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",16.21,37.7,,12.97,,,0,"percent of total billed charges","37.7% of total billed charges",16.21,37.7,,12.97,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.58,33.9,,11.66,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.54,78,,26.83,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.52,82.6,,28.42,,,0,"percent of total billed charges","82.6% of total billed charges",33.17,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",35.52,82.6,,28.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.17,100,,,,,0,"fee schedule",EAPG,43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",6.58,43.13,
"Bill ICC ADD AB PER SLIDE",31288341,CDM,312,RC,88341,CPT,OUTPATIENT,,,242,157.3,,212.96,88,,170.37,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,242,100,,193.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",152.46,63,,121.97,,,0,"percent of total billed charges","63% of total billed charges",37.03,15.3,,29.62,,,0,"percent of total billed charges","15.3% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,166.98,69,,,,,0,"fee schedule","69% of total billed charges",242,100,,193.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",242,100,,193.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",242,100,,193.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",20.32,100,,,,,0,"fee schedule",EAPG,25.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",91.23,37.7,,72.98,,,0,"percent of total billed charges","37.7% of total billed charges",91.23,37.7,,72.98,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.04,33.9,,65.63,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",188.76,78,,151.01,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",199.89,82.6,,159.91,,,0,"percent of total billed charges","82.6% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",199.89,82.6,,159.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,242,100,,193.60,,,0,"percent of total billed charges","100% of total billed charges",14.76,242,
"Bill ICC 1ST AB SLID NMCR",31288342,CDM,312,RC,88342,CPT,OUTPATIENT,,,256,166.4,,225.28,88,,180.22,,,0,"percent of total billed charges","88% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",304.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",37.5,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",161.28,63,,129.02,,,0,"percent of total billed charges","63% of total billed charges",39.17,15.3,,31.34,,,0,"percent of total billed charges","15.3% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,176.64,69,,,,,0,"fee schedule","69% of total billed charges",256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",605.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.97,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37.13,100,,,,,0,"fee schedule",EAPG,47.33,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",96.51,37.7,,77.21,,,0,"percent of total billed charges","37.7% of total billed charges",96.51,37.7,,77.21,,,0,"percent of total billed charges","37.70% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",86.78,33.9,,69.42,,,0,"percent of total billed charges","33.9% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.68,78,,159.74,,,0,"percent of total billed charges","78% of total billed charges",175.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",211.46,82.6,,169.17,,,0,"percent of total billed charges","82.6% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",211.46,82.6,,169.17,,,0,"percent of total billed charges","82.6% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",26.97,605.96,
"Immunohistochemistry or Immunocytochemistry Mltpx Ab Stain",31288344,CDM,312,RC,88344,CPT,OUTPATIENT,,,541,351.65,,476.08,88,,380.86,,,0,"percent of total billed charges","88% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,541,100,,432.80,,,0,"percent of total billed charges","100% of total billed charges",641.59,175,,,,,0,"fee schedule","175% of CMS fee schedule",37.5,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",340.83,63,,272.66,,,0,"percent of total billed charges","63% of total billed charges",82.77,15.3,,66.22,,,0,"percent of total billed charges","15.3% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,373.29,69,,,,,0,"fee schedule","69% of total billed charges",541,100,,432.80,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",541,100,,432.80,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",541,100,,432.80,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",1183.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.97,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37.13,100,,,,,0,"fee schedule",EAPG,47.33,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",203.96,37.7,,163.17,,,0,"percent of total billed charges","37.7% of total billed charges",203.96,37.7,,163.17,,,0,"percent of total billed charges","37.70% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",183.4,33.9,,146.72,,,0,"percent of total billed charges","33.9% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",421.98,78,,337.58,,,0,"percent of total billed charges","78% of total billed charges",370.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",446.87,82.6,,357.50,,,0,"percent of total billed charges","82.6% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",446.87,82.6,,357.50,,,0,"percent of total billed charges","82.6% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,541,100,,432.80,,,0,"percent of total billed charges","100% of total billed charges",26.97,1183.25,
"Bill IMMUNOFLUORESCENT AB DIRECT",31288346,CDM,312,RC,88346,CPT,OUTPATIENT,,,671,436.15,,590.48,88,,472.38,,,0,"percent of total billed charges","88% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",304.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",37.5,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",422.73,63,,338.18,,,0,"percent of total billed charges","63% of total billed charges",102.66,15.3,,82.13,,,0,"percent of total billed charges","15.3% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,462.99,69,,,,,0,"fee schedule","69% of total billed charges",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",1183.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.97,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37.13,100,,,,,0,"fee schedule",EAPG,47.33,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.97,37.7,,202.38,,,0,"percent of total billed charges","37.7% of total billed charges",252.97,37.7,,202.38,,,0,"percent of total billed charges","37.70% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",227.47,33.9,,181.98,,,0,"percent of total billed charges","33.9% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",523.38,78,,418.70,,,0,"percent of total billed charges","78% of total billed charges",175.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.25,82.6,,443.40,,,0,"percent of total billed charges","82.6% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.25,82.6,,443.40,,,0,"percent of total billed charges","82.6% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",26.97,1183.25,
"Bill ELECTRON MICROSCOPY DIAGNOSTIC",31288348,CDM,312,RC,88348,CPT,OUTPATIENT,,,1647,1070.55,,1449.36,88,,1159.49,,,0,"percent of total billed charges","88% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,1647,100,,1317.60,,,0,"percent of total billed charges","100% of total billed charges",1534.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",37.5,100,,,,,0,"fee schedule",EAPG,877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1037.61,63,,830.09,,,0,"percent of total billed charges","63% of total billed charges",251.99,15.3,,201.59,,,0,"percent of total billed charges","15.3% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,1136.43,69,,,,,0,"fee schedule","69% of total billed charges",1647,100,,1317.60,,,0,"percent of total billed charges","100% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1647,100,,1317.60,,,0,"percent of total billed charges","100% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1647,100,,1317.60,,,0,"percent of total billed charges","100% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",2665.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",696.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.97,100,,,,,0,"fee schedule",EAPG,877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37.13,100,,,,,0,"fee schedule",EAPG,47.33,100,,,,,0,"fee schedule",EAPG,877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",620.92,37.7,,496.74,,,0,"percent of total billed charges","37.7% of total billed charges",620.92,37.7,,496.74,,,0,"percent of total billed charges","37.70% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",558.33,33.9,,446.66,,,0,"percent of total billed charges","33.9% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1284.66,78,,1027.73,,,0,"percent of total billed charges","78% of total billed charges",885.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1360.42,82.6,,1088.34,,,0,"percent of total billed charges","82.6% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1360.42,82.6,,1088.34,,,0,"percent of total billed charges","82.6% of total billed charges",877.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,1647,100,,1317.60,,,0,"percent of total billed charges","100% of total billed charges",26.97,2665.63,
"Bill IMF SPEC ADDL AB ST",31288350,CDM,312,RC,88350,CPT,OUTPATIENT,,,671,436.15,,590.48,88,,472.38,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",422.73,63,,338.18,,,0,"percent of total billed charges","63% of total billed charges",102.66,15.3,,82.13,,,0,"percent of total billed charges","15.3% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,462.99,69,,,,,0,"fee schedule","69% of total billed charges",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",20.32,100,,,,,0,"fee schedule",EAPG,25.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",252.97,37.7,,202.38,,,0,"percent of total billed charges","37.7% of total billed charges",252.97,37.7,,202.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.47,33.9,,181.98,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",523.38,78,,418.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",554.25,82.6,,443.40,,,0,"percent of total billed charges","82.6% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",554.25,82.6,,443.40,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",14.76,671,
"Bill TUMOR IHC QT MAN",31288360,CDM,312,RC,88360,CPT,OUTPATIENT,,,671,436.15,,590.48,88,,472.38,,,0,"percent of total billed charges","88% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",304.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",37.5,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",422.73,63,,338.18,,,0,"percent of total billed charges","63% of total billed charges",102.66,15.3,,82.13,,,0,"percent of total billed charges","15.3% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,462.99,69,,,,,0,"fee schedule","69% of total billed charges",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",605.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.97,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37.13,100,,,,,0,"fee schedule",EAPG,47.33,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.97,37.7,,202.38,,,0,"percent of total billed charges","37.7% of total billed charges",252.97,37.7,,202.38,,,0,"percent of total billed charges","37.70% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",227.47,33.9,,181.98,,,0,"percent of total billed charges","33.9% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",523.38,78,,418.70,,,0,"percent of total billed charges","78% of total billed charges",175.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.25,82.6,,443.40,,,0,"percent of total billed charges","82.6% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.25,82.6,,443.40,,,0,"percent of total billed charges","82.6% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",26.97,671,
"Bill TUMOR IHC QT AUTO",31288361,CDM,312,RC,88361,CPT,OUTPATIENT,,,671,436.15,,590.48,88,,472.38,,,0,"percent of total billed charges","88% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",641.59,175,,,,,0,"fee schedule","175% of CMS fee schedule",37.5,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",422.73,63,,338.18,,,0,"percent of total billed charges","63% of total billed charges",102.66,15.3,,82.13,,,0,"percent of total billed charges","15.3% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,462.99,69,,,,,0,"fee schedule","69% of total billed charges",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",1183.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.97,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37.13,100,,,,,0,"fee schedule",EAPG,47.33,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.97,37.7,,202.38,,,0,"percent of total billed charges","37.7% of total billed charges",252.97,37.7,,202.38,,,0,"percent of total billed charges","37.70% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",227.47,33.9,,181.98,,,0,"percent of total billed charges","33.9% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",523.38,78,,418.70,,,0,"percent of total billed charges","78% of total billed charges",370.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.25,82.6,,443.40,,,0,"percent of total billed charges","82.6% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.25,82.6,,443.40,,,0,"percent of total billed charges","82.6% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",26.97,1183.25,
"Bill TIS HYBRID AD SNG PRB",31288364,CDM,312,RC,88364,CPT,OUTPATIENT,,,470,305.5,,413.6,88,,330.88,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",296.1,63,,236.88,,,0,"percent of total billed charges","63% of total billed charges",71.91,15.3,,57.53,,,0,"percent of total billed charges","15.3% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,324.3,69,,,,,0,"fee schedule","69% of total billed charges",470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",20.32,100,,,,,0,"fee schedule",EAPG,25.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",177.19,37.7,,141.75,,,0,"percent of total billed charges","37.7% of total billed charges",177.19,37.7,,141.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.33,33.9,,127.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",366.6,78,,293.28,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",388.22,82.6,,310.58,,,0,"percent of total billed charges","82.6% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",388.22,82.6,,310.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",14.76,470,
"Bill TIS HYBRID SPEC INIT",31288365,CDM,312,RC,88365,CPT,OUTPATIENT,,,470,305.5,,413.6,88,,330.88,,,0,"percent of total billed charges","88% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",304.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",37.5,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.1,63,,236.88,,,0,"percent of total billed charges","63% of total billed charges",71.91,15.3,,57.53,,,0,"percent of total billed charges","15.3% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,324.3,69,,,,,0,"fee schedule","69% of total billed charges",470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",605.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.97,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37.13,100,,,,,0,"fee schedule",EAPG,47.33,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.19,37.7,,141.75,,,0,"percent of total billed charges","37.7% of total billed charges",177.19,37.7,,141.75,,,0,"percent of total billed charges","37.70% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",159.33,33.9,,127.46,,,0,"percent of total billed charges","33.9% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",366.6,78,,293.28,,,0,"percent of total billed charges","78% of total billed charges",175.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",388.22,82.6,,310.58,,,0,"percent of total billed charges","82.6% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",388.22,82.6,,310.58,,,0,"percent of total billed charges","82.6% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",26.97,605.96,
"Bill TIS HYBRID MUL PRB",31288366,CDM,312,RC,88366,CPT,OUTPATIENT,,,470,305.5,,413.6,88,,330.88,,,0,"percent of total billed charges","88% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",304.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",37.5,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.1,63,,236.88,,,0,"percent of total billed charges","63% of total billed charges",71.91,15.3,,57.53,,,0,"percent of total billed charges","15.3% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,324.3,69,,,,,0,"fee schedule","69% of total billed charges",470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",1183.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.97,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37.13,100,,,,,0,"fee schedule",EAPG,47.33,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.19,37.7,,141.75,,,0,"percent of total billed charges","37.7% of total billed charges",177.19,37.7,,141.75,,,0,"percent of total billed charges","37.70% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",159.33,33.9,,127.46,,,0,"percent of total billed charges","33.9% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",366.6,78,,293.28,,,0,"percent of total billed charges","78% of total billed charges",175.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",388.22,82.6,,310.58,,,0,"percent of total billed charges","82.6% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",388.22,82.6,,310.58,,,0,"percent of total billed charges","82.6% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",26.97,1183.25,
"Bill INSITU HYBR EA PROBE COMP ASST",31288367,CDM,312,RC,88367,CPT,OUTPATIENT,,,343,222.95,,301.84,88,,241.47,,,0,"percent of total billed charges","88% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",641.59,175,,,,,0,"fee schedule","175% of CMS fee schedule",37.5,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.09,63,,172.87,,,0,"percent of total billed charges","63% of total billed charges",52.48,15.3,,41.98,,,0,"percent of total billed charges","15.3% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,236.67,69,,,,,0,"fee schedule","69% of total billed charges",343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",1183.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.97,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37.13,100,,,,,0,"fee schedule",EAPG,47.33,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",129.31,37.7,,103.45,,,0,"percent of total billed charges","37.7% of total billed charges",129.31,37.7,,103.45,,,0,"percent of total billed charges","37.70% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",116.28,33.9,,93.02,,,0,"percent of total billed charges","33.9% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.54,78,,214.03,,,0,"percent of total billed charges","78% of total billed charges",370.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.32,82.6,,226.66,,,0,"percent of total billed charges","82.6% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.32,82.6,,226.66,,,0,"percent of total billed charges","82.6% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",26.97,1183.25,
"Bill Ins Hybr Man Sp IniI",31288368,CDM,312,RC,88368,CPT,OUTPATIENT,,,588,382.2,,517.44,88,,413.95,,,0,"percent of total billed charges","88% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,588,100,,470.40,,,0,"percent of total billed charges","100% of total billed charges",641.59,175,,,,,0,"fee schedule","175% of CMS fee schedule",37.5,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",370.44,63,,296.35,,,0,"percent of total billed charges","63% of total billed charges",89.96,15.3,,71.97,,,0,"percent of total billed charges","15.3% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,405.72,69,,,,,0,"fee schedule","69% of total billed charges",588,100,,470.40,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",588,100,,470.40,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",588,100,,470.40,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",1183.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.97,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37.13,100,,,,,0,"fee schedule",EAPG,47.33,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.68,37.7,,177.34,,,0,"percent of total billed charges","37.7% of total billed charges",221.68,37.7,,177.34,,,0,"percent of total billed charges","37.70% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.33,33.9,,159.46,,,0,"percent of total billed charges","33.9% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",458.64,78,,366.91,,,0,"percent of total billed charges","78% of total billed charges",370.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",485.69,82.6,,388.55,,,0,"percent of total billed charges","82.6% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",485.69,82.6,,388.55,,,0,"percent of total billed charges","82.6% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,588,100,,470.40,,,0,"percent of total billed charges","100% of total billed charges",26.97,1183.25,
"Bill INS HYBRD MAN SNG PR",31288369,CDM,312,RC,88369,CPT,OUTPATIENT,,,588,382.2,,517.44,88,,413.95,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,588,100,,470.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",370.44,63,,296.35,,,0,"percent of total billed charges","63% of total billed charges",89.96,15.3,,71.97,,,0,"percent of total billed charges","15.3% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,405.72,69,,,,,0,"fee schedule","69% of total billed charges",588,100,,470.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",588,100,,470.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",588,100,,470.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",20.32,100,,,,,0,"fee schedule",EAPG,25.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",221.68,37.7,,177.34,,,0,"percent of total billed charges","37.7% of total billed charges",221.68,37.7,,177.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",199.33,33.9,,159.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.64,78,,366.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",485.69,82.6,,388.55,,,0,"percent of total billed charges","82.6% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",485.69,82.6,,388.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,588,100,,470.40,,,0,"percent of total billed charges","100% of total billed charges",14.76,588,
"Bill INS HYBR AUT SNG PR",31288373,CDM,312,RC,88373,CPT,OUTPATIENT,,,514,334.1,,452.32,88,,361.86,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,514,100,,411.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",323.82,63,,259.06,,,0,"percent of total billed charges","63% of total billed charges",78.64,15.3,,62.91,,,0,"percent of total billed charges","15.3% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,354.66,69,,,,,0,"fee schedule","69% of total billed charges",514,100,,411.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",514,100,,411.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",514,100,,411.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",20.32,100,,,,,0,"fee schedule",EAPG,25.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",193.78,37.7,,155.02,,,0,"percent of total billed charges","37.7% of total billed charges",193.78,37.7,,155.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",174.25,33.9,,139.40,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",400.92,78,,320.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",424.56,82.6,,339.65,,,0,"percent of total billed charges","82.6% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",424.56,82.6,,339.65,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,514,100,,411.20,,,0,"percent of total billed charges","100% of total billed charges",14.76,514,
"Bill INS HYBR AUT MUL PR",31288374,CDM,312,RC,88374,CPT,OUTPATIENT,,,581,377.65,,511.28,88,,409.02,,,0,"percent of total billed charges","88% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,581,100,,464.80,,,0,"percent of total billed charges","100% of total billed charges",304.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",37.5,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",366.03,63,,292.82,,,0,"percent of total billed charges","63% of total billed charges",88.89,15.3,,71.11,,,0,"percent of total billed charges","15.3% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,400.89,69,,,,,0,"fee schedule","69% of total billed charges",581,100,,464.80,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",581,100,,464.80,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",581,100,,464.80,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",605.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.97,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37.13,100,,,,,0,"fee schedule",EAPG,47.33,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",219.04,37.7,,175.23,,,0,"percent of total billed charges","37.7% of total billed charges",219.04,37.7,,175.23,,,0,"percent of total billed charges","37.70% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",196.96,33.9,,157.57,,,0,"percent of total billed charges","33.9% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",453.18,78,,362.54,,,0,"percent of total billed charges","78% of total billed charges",175.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",479.91,82.6,,383.93,,,0,"percent of total billed charges","82.6% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",479.91,82.6,,383.93,,,0,"percent of total billed charges","82.6% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,581,100,,464.80,,,0,"percent of total billed charges","100% of total billed charges",26.97,605.96,
"Bill INS HYBR MAN MUL PR",31288377,CDM,312,RC,88377,CPT,OUTPATIENT,,,588,382.2,,517.44,88,,413.95,,,0,"percent of total billed charges","88% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,588,100,,470.40,,,0,"percent of total billed charges","100% of total billed charges",304.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",37.5,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",370.44,63,,296.35,,,0,"percent of total billed charges","63% of total billed charges",89.96,15.3,,71.97,,,0,"percent of total billed charges","15.3% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,405.72,69,,,,,0,"fee schedule","69% of total billed charges",588,100,,470.40,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",588,100,,470.40,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",588,100,,470.40,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",605.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.97,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37.13,100,,,,,0,"fee schedule",EAPG,47.33,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.68,37.7,,177.34,,,0,"percent of total billed charges","37.7% of total billed charges",221.68,37.7,,177.34,,,0,"percent of total billed charges","37.70% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.33,33.9,,159.46,,,0,"percent of total billed charges","33.9% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",458.64,78,,366.91,,,0,"percent of total billed charges","78% of total billed charges",175.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",485.69,82.6,,388.55,,,0,"percent of total billed charges","82.6% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",485.69,82.6,,388.55,,,0,"percent of total billed charges","82.6% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,588,100,,470.40,,,0,"percent of total billed charges","100% of total billed charges",26.97,605.96,
"Bill MICRODISSECTION",31088381,CDM,310,RC,88381,CPT,OUTPATIENT,,,385,250.25,,338.8,88,,271.04,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",242.55,63,,194.04,,,0,"percent of total billed charges","63% of total billed charges",58.91,15.3,,47.13,,,0,"percent of total billed charges","15.3% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,265.65,69,,,,,0,"fee schedule","69% of total billed charges",385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",20.32,100,,,,,0,"fee schedule",EAPG,25.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",145.15,37.7,,116.12,,,0,"percent of total billed charges","37.7% of total billed charges",145.15,37.7,,116.12,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",130.52,33.9,,104.42,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",300.3,78,,240.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",318.01,82.6,,254.41,,,0,"percent of total billed charges","82.6% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",318.01,82.6,,254.41,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",14.76,385,
"Bill UNLISTED MISC PATH LAB",31088399,CDM,310,RC,88399,CPT,OUTPATIENT,,,198,128.7,,174.24,88,,139.39,,,0,"percent of total billed charges","88% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",96.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",26.78,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,63,,99.79,,,0,"percent of total billed charges","63% of total billed charges",30.29,15.3,,24.23,,,0,"percent of total billed charges","15.3% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,136.62,69,,,,,0,"fee schedule","69% of total billed charges",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.15,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.26,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.52,100,,,,,0,"fee schedule",EAPG,33.8,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.65,37.7,,59.72,,,0,"percent of total billed charges","37.7% of total billed charges",74.65,37.7,,59.72,,,0,"percent of total billed charges","37.70% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",67.12,33.9,,53.70,,,0,"percent of total billed charges","33.9% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.44,78,,123.55,,,0,"percent of total billed charges","78% of total billed charges",55.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",163.55,82.6,,130.84,,,0,"percent of total billed charges","82.6% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",163.55,82.6,,130.84,,,0,"percent of total billed charges","82.6% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",19.26,202.15,
"Bill SPECIMEN HANDLING",30099001,CDM,300,RC,99001,CPT,OUTPATIENT,,,113,73.45,,99.44,88,,79.55,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.1,100,,,,,0,"fee schedule",EAPG,113,100,,90.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.16,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",71.19,63,,56.95,,,0,"percent of total billed charges","63% of total billed charges",17.29,15.3,,13.83,,,0,"percent of total billed charges","15.3% of total billed charges",2.1,100,,,,,0,"fee schedule",EAPG,77.97,69,,,,,0,"fee schedule","69% of total billed charges",113,100,,90.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",113,100,,90.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",113,100,,90.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.55,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2.14,100,,,,,0,"fee schedule",EAPG,2.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",42.6,37.7,,34.08,,,0,"percent of total billed charges","37.7% of total billed charges",42.6,37.7,,34.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.31,33.9,,30.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.14,78,,70.51,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",93.34,82.6,,74.67,,,0,"percent of total billed charges","82.6% of total billed charges",2.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",93.34,82.6,,74.67,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.1,100,,,,,0,"fee schedule",EAPG,113,100,,90.40,,,0,"percent of total billed charges","100% of total billed charges",1.55,113,
"Bill Urinalysis w/Microscopic",30781001,CDM,307,RC,81001,CPT,OUTPATIENT,,,59,38.35,,51.92,88,,41.54,,,0,"percent of total billed charges","88% of total billed charges",3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",5.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2.55,100,,,,,0,"fee schedule",EAPG,3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.17,63,,29.74,,,0,"percent of total billed charges","63% of total billed charges",9.03,15.3,,7.22,,,0,"percent of total billed charges","15.3% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,40.71,69,,,,,0,"fee schedule","69% of total billed charges",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.12,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.17,100,,,,,0,"fee schedule","100% of LI fee schedule",1.83,100,,,,,0,"fee schedule",EAPG,3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.52,100,,,,,0,"fee schedule",EAPG,3.22,100,,,,,0,"fee schedule",EAPG,3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.24,37.7,,17.79,,,0,"percent of total billed charges","37.7% of total billed charges",22.24,37.7,,17.79,,,0,"percent of total billed charges","37.70% of total billed charges",3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",20,33.9,,16.00,,,0,"percent of total billed charges","33.9% of total billed charges",3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.02,78,,36.82,,,0,"percent of total billed charges","78% of total billed charges",3.2,101,,,,,0,"fee schedule","101% of CMS fee schedule ",48.73,82.6,,38.98,,,0,"percent of total billed charges","82.6% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.73,82.6,,38.98,,,0,"percent of total billed charges","82.6% of total billed charges",3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",1.83,59,
"Bill Only UA Micro Not Ind",30781003,CDM,307,RC,81003,CPT,OUTPATIENT,,,42,27.3,,36.96,88,,29.57,,,0,"percent of total billed charges","88% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",3.93,175,,,,,0,"fee schedule","175% of CMS fee schedule",2.55,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.46,63,,21.17,,,0,"percent of total billed charges","63% of total billed charges",6.43,15.3,,5.14,,,0,"percent of total billed charges","15.3% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,28.98,69,,,,,0,"fee schedule","69% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.6,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.25,100,,,,,0,"fee schedule","100% of LI fee schedule",1.83,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.52,100,,,,,0,"fee schedule",EAPG,3.22,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.7% of total billed charges",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.70% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.24,33.9,,11.39,,,0,"percent of total billed charges","33.9% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.76,78,,26.21,,,0,"percent of total billed charges","78% of total billed charges",2.27,101,,,,,0,"fee schedule","101% of CMS fee schedule ",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",1.83,42,
"Bill GLU POCT",BGP,CDM,301,RC,82948,CPT,OUTPATIENT,,,66,42.9,,58.08,88,,46.46,,,0,"percent of total billed charges","88% of total billed charges",5.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",8.82,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.58,63,,33.26,,,0,"percent of total billed charges","63% of total billed charges",10.1,15.3,,8.08,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,45.54,69,,,,,0,"fee schedule","69% of total billed charges",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",5.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",5.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",5.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.27,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.04,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.88,37.7,,19.90,,,0,"percent of total billed charges","37.7% of total billed charges",24.88,37.7,,19.90,,,0,"percent of total billed charges","37.70% of total billed charges",5.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.37,33.9,,17.90,,,0,"percent of total billed charges","33.9% of total billed charges",5.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.48,78,,41.18,,,0,"percent of total billed charges","78% of total billed charges",5.09,101,,,,,0,"fee schedule","101% of CMS fee schedule ",54.52,82.6,,43.62,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.52,82.6,,43.62,,,0,"percent of total billed charges","82.6% of total billed charges",5.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",3.25,66,
"Buprenorphine LC",30180348,CDM,301,RC,80348,CPT,OUTPATIENT,,,303,196.95,,266.64,88,,213.31,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",303,100,,242.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",190.89,63,,152.71,,,0,"percent of total billed charges","63% of total billed charges",46.36,15.3,,37.09,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.07,69,,,,,0,"fee schedule","69% of total billed charges",303,100,,242.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",303,100,,242.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",303,100,,242.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",114.23,37.7,,91.38,,,0,"percent of total billed charges","37.7% of total billed charges",114.23,37.7,,91.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",102.72,33.9,,82.18,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",236.34,78,,189.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",250.28,82.6,,200.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",250.28,82.6,,200.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.9,16.8,,40.72,,,0,"percent of total billed charges","16.8% of total billed charges",303,100,,242.40,,,0,"percent of total billed charges","100% of total billed charges",46.36,303,
"Bill Basic Metabolic Panel +ICA",30180047,CDM,301,RC,80047,CPT,OUTPATIENT,,,216,140.4,,190.08,88,,152.06,,,0,"percent of total billed charges","88% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,216,100,,172.80,,,0,"percent of total billed charges","100% of total billed charges",24.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",7.68,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.08,63,,108.86,,,0,"percent of total billed charges","63% of total billed charges",33.05,15.3,,26.44,,,0,"percent of total billed charges","15.3% of total billed charges",7.45,100,,,,,0,"fee schedule",EAPG,149.04,69,,,,,0,"fee schedule","69% of total billed charges",216,100,,172.80,,,0,"percent of total billed charges","100% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",216,100,,172.80,,,0,"percent of total billed charges","100% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",216,100,,172.80,,,0,"percent of total billed charges","100% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.73,100,,,,,0,"fee schedule","100% of LI fee schedule",5.52,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.6,100,,,,,0,"fee schedule",EAPG,9.69,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.43,37.7,,65.14,,,0,"percent of total billed charges","37.7% of total billed charges",81.43,37.7,,65.14,,,0,"percent of total billed charges","37.70% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.22,33.9,,58.58,,,0,"percent of total billed charges","33.9% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",168.48,78,,134.78,,,0,"percent of total billed charges","78% of total billed charges",13.86,101,,,,,0,"fee schedule","101% of CMS fee schedule ",178.42,82.6,,142.74,,,0,"percent of total billed charges","82.6% of total billed charges",7.45,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",178.42,82.6,,142.74,,,0,"percent of total billed charges","82.6% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,216,100,,172.80,,,0,"percent of total billed charges","100% of total billed charges",5.52,216,
"HLA Class I Antibody, Class II Ab Scrn",30286828,CDM,302,RC,86828,CPT,OUTPATIENT,,,271,176.15,,238.48,88,,190.78,,,0,"percent of total billed charges","88% of total billed charges",64.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.6,100,,,,,0,"fee schedule",EAPG,271,100,,216.80,,,0,"percent of total billed charges","100% of total billed charges",112.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",24.31,100,,,,,0,"fee schedule",EAPG,64.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.73,63,,136.58,,,0,"percent of total billed charges","63% of total billed charges",41.46,15.3,,33.17,,,0,"percent of total billed charges","15.3% of total billed charges",23.6,100,,,,,0,"fee schedule",EAPG,186.99,69,,,,,0,"fee schedule","69% of total billed charges",271,100,,216.80,,,0,"percent of total billed charges","100% of total billed charges",64.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",271,100,,216.80,,,0,"percent of total billed charges","100% of total billed charges",64.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",271,100,,216.80,,,0,"percent of total billed charges","100% of total billed charges",64.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",245.52,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",23.6,100,,,,,0,"fee schedule",EAPG,64.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.19,100,,,,,0,"fee schedule","100% of LI fee schedule",17.48,100,,,,,0,"fee schedule",EAPG,64.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.07,100,,,,,0,"fee schedule",EAPG,30.68,100,,,,,0,"fee schedule",EAPG,64.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",102.17,37.7,,81.74,,,0,"percent of total billed charges","37.7% of total billed charges",102.17,37.7,,81.74,,,0,"percent of total billed charges","37.70% of total billed charges",64.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.87,33.9,,73.50,,,0,"percent of total billed charges","33.9% of total billed charges",64.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",211.38,78,,169.10,,,0,"percent of total billed charges","78% of total billed charges",64.83,101,,,,,0,"fee schedule","101% of CMS fee schedule ",223.85,82.6,,179.08,,,0,"percent of total billed charges","82.6% of total billed charges",23.6,100,,,,,0,"fee schedule",EAPG,64.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",223.85,82.6,,179.08,,,0,"percent of total billed charges","82.6% of total billed charges",64.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.6,100,,,,,0,"fee schedule",EAPG,271,100,,216.80,,,0,"percent of total billed charges","100% of total billed charges",17.48,271,
"Bill Only Organism ID - Mold LC",30687107,CDM,306,RC,87107,CPT,OUTPATIENT,,,96,62.4,,84.48,88,,67.58,,,0,"percent of total billed charges","88% of total billed charges",10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",18.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.48,63,,48.38,,,0,"percent of total billed charges","63% of total billed charges",14.69,15.3,,11.75,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,66.24,69,,,,,0,"fee schedule","69% of total billed charges",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.47,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.32,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.19,37.7,,28.95,,,0,"percent of total billed charges","37.7% of total billed charges",36.19,37.7,,28.95,,,0,"percent of total billed charges","37.70% of total billed charges",10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.54,33.9,,26.03,,,0,"percent of total billed charges","33.9% of total billed charges",10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.88,78,,59.90,,,0,"percent of total billed charges","78% of total billed charges",10.42,101,,,,,0,"fee schedule","101% of CMS fee schedule ",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",4.81,96,
"Beta 2 Glycoprotein I antibody, each",30286146,CDM,302,RC,86146,CPT,OUTPATIENT,,,231,150.15,,203.28,88,,162.62,,,0,"percent of total billed charges","88% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,231,100,,184.80,,,0,"percent of total billed charges","100% of total billed charges",44.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",145.53,63,,116.42,,,0,"percent of total billed charges","63% of total billed charges",35.34,15.3,,28.27,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,159.39,69,,,,,0,"fee schedule","69% of total billed charges",231,100,,184.80,,,0,"percent of total billed charges","100% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",231,100,,184.80,,,0,"percent of total billed charges","100% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",231,100,,184.80,,,0,"percent of total billed charges","100% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.45,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.09,37.7,,69.67,,,0,"percent of total billed charges","37.7% of total billed charges",87.09,37.7,,69.67,,,0,"percent of total billed charges","37.70% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.31,33.9,,62.65,,,0,"percent of total billed charges","33.9% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",180.18,78,,144.14,,,0,"percent of total billed charges","78% of total billed charges",25.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",190.81,82.6,,152.65,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",190.81,82.6,,152.65,,,0,"percent of total billed charges","82.6% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,231,100,,184.80,,,0,"percent of total billed charges","100% of total billed charges",6.96,231,
"Avero Bill SPECIAL STAINS GROUP I",31288312,CDM,312,RC,88312,CPT,OUTPATIENT,,,356,231.4,,313.28,88,,250.62,,,0,"percent of total billed charges","88% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.92,100,,,,,0,"fee schedule",EAPG,356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",96.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",20.52,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.28,63,,179.42,,,0,"percent of total billed charges","63% of total billed charges",54.47,15.3,,43.58,,,0,"percent of total billed charges","15.3% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,245.64,69,,,,,0,"fee schedule","69% of total billed charges",356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.15,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.92,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14.76,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",20.32,100,,,,,0,"fee schedule",EAPG,25.9,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",134.21,37.7,,107.37,,,0,"percent of total billed charges","37.7% of total billed charges",134.21,37.7,,107.37,,,0,"percent of total billed charges","37.70% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",120.68,33.9,,96.54,,,0,"percent of total billed charges","33.9% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.68,78,,222.14,,,0,"percent of total billed charges","78% of total billed charges",55.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.06,82.6,,235.25,,,0,"percent of total billed charges","82.6% of total billed charges",19.92,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.06,82.6,,235.25,,,0,"percent of total billed charges","82.6% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.92,100,,,,,0,"fee schedule",EAPG,356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",14.76,356,
"87801 Vaginosis/Vaginitis Ext Panel AVR",30687801,CDM,306,RC,87801,CPT,OUTPATIENT,,,282,183.3,,248.16,88,,198.53,,,0,"percent of total billed charges","88% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,282,100,,225.60,,,0,"percent of total billed charges","100% of total billed charges",122.85,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",177.66,63,,142.13,,,0,"percent of total billed charges","63% of total billed charges",43.15,15.3,,34.52,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,194.58,69,,,,,0,"fee schedule","69% of total billed charges",282,100,,225.60,,,0,"percent of total billed charges","100% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",282,100,,225.60,,,0,"percent of total billed charges","100% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",282,100,,225.60,,,0,"percent of total billed charges","100% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",268.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.2,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.31,37.7,,85.05,,,0,"percent of total billed charges","37.7% of total billed charges",106.31,37.7,,85.05,,,0,"percent of total billed charges","37.70% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.6,33.9,,76.48,,,0,"percent of total billed charges","33.9% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",219.96,78,,175.97,,,0,"percent of total billed charges","78% of total billed charges",70.9,101,,,,,0,"fee schedule","101% of CMS fee schedule ",232.93,82.6,,186.34,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",232.93,82.6,,186.34,,,0,"percent of total billed charges","82.6% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,282,100,,225.60,,,0,"percent of total billed charges","100% of total billed charges",18.33,282,
"87801 Chlamydia and Gonorrhea (GeneXpert",30687801,CDM,306,RC,87801,CPT,OUTPATIENT,,,302,196.3,,265.76,88,,212.61,,,0,"percent of total billed charges","88% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",122.85,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",190.26,63,,152.21,,,0,"percent of total billed charges","63% of total billed charges",46.21,15.3,,36.97,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,208.38,69,,,,,0,"fee schedule","69% of total billed charges",302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",268.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.2,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.85,37.7,,91.08,,,0,"percent of total billed charges","37.7% of total billed charges",113.85,37.7,,91.08,,,0,"percent of total billed charges","37.70% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",102.38,33.9,,81.90,,,0,"percent of total billed charges","33.9% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",235.56,78,,188.45,,,0,"percent of total billed charges","78% of total billed charges",70.9,101,,,,,0,"fee schedule","101% of CMS fee schedule ",249.45,82.6,,199.56,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",249.45,82.6,,199.56,,,0,"percent of total billed charges","82.6% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",18.33,302,
"87801 Chlamydia/Gonorrhea Panel AVR",30687801,CDM,306,RC,87801,CPT,OUTPATIENT,,,185,120.25,,162.8,88,,130.24,,,0,"percent of total billed charges","88% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",122.85,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",116.55,63,,93.24,,,0,"percent of total billed charges","63% of total billed charges",28.31,15.3,,22.65,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,127.65,69,,,,,0,"fee schedule","69% of total billed charges",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",268.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.2,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.75,37.7,,55.80,,,0,"percent of total billed charges","37.7% of total billed charges",69.75,37.7,,55.80,,,0,"percent of total billed charges","37.70% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.72,33.9,,50.18,,,0,"percent of total billed charges","33.9% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.3,78,,115.44,,,0,"percent of total billed charges","78% of total billed charges",70.9,101,,,,,0,"fee schedule","101% of CMS fee schedule ",152.81,82.6,,122.25,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",152.81,82.6,,122.25,,,0,"percent of total billed charges","82.6% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",18.33,268.51,
"Blood Urea Nitrogen",30184520,CDM,301,RC,84520,CPT,OUTPATIENT,,,74,48.1,,65.12,88,,52.10,,,0,"percent of total billed charges","88% of total billed charges",3.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",6.91,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,3.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.62,63,,37.30,,,0,"percent of total billed charges","63% of total billed charges",11.32,15.3,,9.06,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,51.06,69,,,,,0,"fee schedule","69% of total billed charges",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",3.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",3.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",3.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,3.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.95,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,3.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,3.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.9,37.7,,22.32,,,0,"percent of total billed charges","37.7% of total billed charges",27.9,37.7,,22.32,,,0,"percent of total billed charges","37.70% of total billed charges",3.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.09,33.9,,20.07,,,0,"percent of total billed charges","33.9% of total billed charges",3.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.72,78,,46.18,,,0,"percent of total billed charges","78% of total billed charges",3.98,101,,,,,0,"fee schedule","101% of CMS fee schedule ",61.12,82.6,,48.90,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,3.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.12,82.6,,48.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",3.25,74,
"Blood Gas Venous",30082803,CDM,300,RC,82803,CPT,OUTPATIENT,,,433,281.45,,381.04,88,,304.83,,,0,"percent of total billed charges","88% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",45.62,175,,,,,0,"fee schedule","175% of CMS fee schedule",29.67,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",272.79,63,,218.23,,,0,"percent of total billed charges","63% of total billed charges",66.25,15.3,,53.00,,,0,"percent of total billed charges","15.3% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,298.77,69,,,,,0,"fee schedule","69% of total billed charges",433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.71,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.07,100,,,,,0,"fee schedule","100% of LI fee schedule",21.33,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.38,100,,,,,0,"fee schedule",EAPG,37.44,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.24,37.7,,130.59,,,0,"percent of total billed charges","37.7% of total billed charges",163.24,37.7,,130.59,,,0,"percent of total billed charges","37.70% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",146.79,33.9,,117.43,,,0,"percent of total billed charges","33.9% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",337.74,78,,270.19,,,0,"percent of total billed charges","78% of total billed charges",26.33,101,,,,,0,"fee schedule","101% of CMS fee schedule ",357.66,82.6,,286.13,,,0,"percent of total billed charges","82.6% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",357.66,82.6,,286.13,,,0,"percent of total billed charges","82.6% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",21.33,433,
"Blood Gas Arterial",30082803,CDM,300,RC,82803,CPT,OUTPATIENT,,,438,284.7,,385.44,88,,308.35,,,0,"percent of total billed charges","88% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,438,100,,350.40,,,0,"percent of total billed charges","100% of total billed charges",45.62,175,,,,,0,"fee schedule","175% of CMS fee schedule",29.67,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",275.94,63,,220.75,,,0,"percent of total billed charges","63% of total billed charges",67.01,15.3,,53.61,,,0,"percent of total billed charges","15.3% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,302.22,69,,,,,0,"fee schedule","69% of total billed charges",438,100,,350.40,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",438,100,,350.40,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",438,100,,350.40,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.71,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.07,100,,,,,0,"fee schedule","100% of LI fee schedule",21.33,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.38,100,,,,,0,"fee schedule",EAPG,37.44,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",165.13,37.7,,132.10,,,0,"percent of total billed charges","37.7% of total billed charges",165.13,37.7,,132.10,,,0,"percent of total billed charges","37.70% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",148.48,33.9,,118.78,,,0,"percent of total billed charges","33.9% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",341.64,78,,273.31,,,0,"percent of total billed charges","78% of total billed charges",26.33,101,,,,,0,"fee schedule","101% of CMS fee schedule ",361.79,82.6,,289.43,,,0,"percent of total billed charges","82.6% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",361.79,82.6,,289.43,,,0,"percent of total billed charges","82.6% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,438,100,,350.40,,,0,"percent of total billed charges","100% of total billed charges",21.33,438,
"CAPILLARY BLOOD GAS",30182803,CDM,301,RC,82803,CPT,OUTPATIENT,,,433,281.45,,381.04,88,,304.83,,,0,"percent of total billed charges","88% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",45.62,175,,,,,0,"fee schedule","175% of CMS fee schedule",29.67,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",272.79,63,,218.23,,,0,"percent of total billed charges","63% of total billed charges",66.25,15.3,,53.00,,,0,"percent of total billed charges","15.3% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,298.77,69,,,,,0,"fee schedule","69% of total billed charges",433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.71,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.07,100,,,,,0,"fee schedule","100% of LI fee schedule",21.33,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.38,100,,,,,0,"fee schedule",EAPG,37.44,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.24,37.7,,130.59,,,0,"percent of total billed charges","37.7% of total billed charges",163.24,37.7,,130.59,,,0,"percent of total billed charges","37.70% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",146.79,33.9,,117.43,,,0,"percent of total billed charges","33.9% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",337.74,78,,270.19,,,0,"percent of total billed charges","78% of total billed charges",26.33,101,,,,,0,"fee schedule","101% of CMS fee schedule ",357.66,82.6,,286.13,,,0,"percent of total billed charges","82.6% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",357.66,82.6,,286.13,,,0,"percent of total billed charges","82.6% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",21.33,433,
"Blood Gas Arterial",30082803,CDM,300,RC,82803,CPT,OUTPATIENT,,,170,110.5,,149.6,88,,119.68,,,0,"percent of total billed charges","88% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",45.62,175,,,,,0,"fee schedule","175% of CMS fee schedule",29.67,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.1,63,,85.68,,,0,"percent of total billed charges","63% of total billed charges",26.01,15.3,,20.81,,,0,"percent of total billed charges","15.3% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,117.3,69,,,,,0,"fee schedule","69% of total billed charges",170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.71,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.07,100,,,,,0,"fee schedule","100% of LI fee schedule",21.33,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.38,100,,,,,0,"fee schedule",EAPG,37.44,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.09,37.7,,51.27,,,0,"percent of total billed charges","37.7% of total billed charges",64.09,37.7,,51.27,,,0,"percent of total billed charges","37.70% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.63,33.9,,46.10,,,0,"percent of total billed charges","33.9% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",132.6,78,,106.08,,,0,"percent of total billed charges","78% of total billed charges",26.33,101,,,,,0,"fee schedule","101% of CMS fee schedule ",140.42,82.6,,112.34,,,0,"percent of total billed charges","82.6% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",140.42,82.6,,112.34,,,0,"percent of total billed charges","82.6% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",21.33,170,
"Blood Gas Capillary RT",30082803,CDM,300,RC,82803,CPT,OUTPATIENT,,,433,281.45,,381.04,88,,304.83,,,0,"percent of total billed charges","88% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",45.62,175,,,,,0,"fee schedule","175% of CMS fee schedule",29.67,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",272.79,63,,218.23,,,0,"percent of total billed charges","63% of total billed charges",66.25,15.3,,53.00,,,0,"percent of total billed charges","15.3% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,298.77,69,,,,,0,"fee schedule","69% of total billed charges",433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.71,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.07,100,,,,,0,"fee schedule","100% of LI fee schedule",21.33,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.38,100,,,,,0,"fee schedule",EAPG,37.44,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.24,37.7,,130.59,,,0,"percent of total billed charges","37.7% of total billed charges",163.24,37.7,,130.59,,,0,"percent of total billed charges","37.70% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",146.79,33.9,,117.43,,,0,"percent of total billed charges","33.9% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",337.74,78,,270.19,,,0,"percent of total billed charges","78% of total billed charges",26.33,101,,,,,0,"fee schedule","101% of CMS fee schedule ",357.66,82.6,,286.13,,,0,"percent of total billed charges","82.6% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",357.66,82.6,,286.13,,,0,"percent of total billed charges","82.6% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",21.33,433,
"Blood Gas Venous RT",30082803,CDM,300,RC,82803,CPT,OUTPATIENT,,,433,281.45,,381.04,88,,304.83,,,0,"percent of total billed charges","88% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",45.62,175,,,,,0,"fee schedule","175% of CMS fee schedule",29.67,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",272.79,63,,218.23,,,0,"percent of total billed charges","63% of total billed charges",66.25,15.3,,53.00,,,0,"percent of total billed charges","15.3% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,298.77,69,,,,,0,"fee schedule","69% of total billed charges",433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.71,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.07,100,,,,,0,"fee schedule","100% of LI fee schedule",21.33,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.38,100,,,,,0,"fee schedule",EAPG,37.44,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.24,37.7,,130.59,,,0,"percent of total billed charges","37.7% of total billed charges",163.24,37.7,,130.59,,,0,"percent of total billed charges","37.70% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",146.79,33.9,,117.43,,,0,"percent of total billed charges","33.9% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",337.74,78,,270.19,,,0,"percent of total billed charges","78% of total billed charges",26.33,101,,,,,0,"fee schedule","101% of CMS fee schedule ",357.66,82.6,,286.13,,,0,"percent of total billed charges","82.6% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",357.66,82.6,,286.13,,,0,"percent of total billed charges","82.6% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",21.33,433,
"Blood Smear Review",30585007,CDM,305,RC,85007,CPT,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",3.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",6.65,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.23,100,,,,,0,"fee schedule",EAPG,3.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",3.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",3.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",3.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.53,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,3.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.8,100,,,,,0,"fee schedule","100% of LI fee schedule",3.76,100,,,,,0,"fee schedule",EAPG,3.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,3.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.7% of total billed charges",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",3.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.39,33.9,,2.71,,,0,"percent of total billed charges","33.9% of total billed charges",3.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",3.83,101,,,,,0,"fee schedule","101% of CMS fee schedule ",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,3.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",3.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,14.53,
"Body Fluid Differential",30089051,CDM,300,RC,89051,CPT,OUTPATIENT,,,133,86.45,,117.04,88,,93.63,,,0,"percent of total billed charges","88% of total billed charges",5.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.65,100,,,,,0,"fee schedule",EAPG,133,100,,106.40,,,0,"percent of total billed charges","100% of total billed charges",9.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.91,100,,,,,0,"fee schedule",EAPG,5.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",83.79,63,,67.03,,,0,"percent of total billed charges","63% of total billed charges",20.35,15.3,,16.28,,,0,"percent of total billed charges","15.3% of total billed charges",8.65,100,,,,,0,"fee schedule",EAPG,91.77,69,,,,,0,"fee schedule","69% of total billed charges",133,100,,106.40,,,0,"percent of total billed charges","100% of total billed charges",5.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",133,100,,106.40,,,0,"percent of total billed charges","100% of total billed charges",5.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",133,100,,106.40,,,0,"percent of total billed charges","100% of total billed charges",5.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.42,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.65,100,,,,,0,"fee schedule",EAPG,5.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.6,100,,,,,0,"fee schedule","100% of LI fee schedule",6.4,100,,,,,0,"fee schedule",EAPG,5.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.82,100,,,,,0,"fee schedule",EAPG,11.24,100,,,,,0,"fee schedule",EAPG,5.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.14,37.7,,40.11,,,0,"percent of total billed charges","37.7% of total billed charges",50.14,37.7,,40.11,,,0,"percent of total billed charges","37.70% of total billed charges",5.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.09,33.9,,36.07,,,0,"percent of total billed charges","33.9% of total billed charges",5.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",103.74,78,,82.99,,,0,"percent of total billed charges","78% of total billed charges",5.65,101,,,,,0,"fee schedule","101% of CMS fee schedule ",109.86,82.6,,87.89,,,0,"percent of total billed charges","82.6% of total billed charges",8.65,100,,,,,0,"fee schedule",EAPG,5.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.86,82.6,,87.89,,,0,"percent of total billed charges","82.6% of total billed charges",5.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.65,100,,,,,0,"fee schedule",EAPG,133,100,,106.40,,,0,"percent of total billed charges","100% of total billed charges",5.6,133,
"Body Fluid Cell Count w/Diff If Indicated",30989050,CDM,300,RC,89050,CPT,OUTPATIENT,,,106,68.9,,93.28,88,,74.62,,,0,"percent of total billed charges","88% of total billed charges",4.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.65,100,,,,,0,"fee schedule",EAPG,106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",8.26,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.91,100,,,,,0,"fee schedule",EAPG,4.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.78,63,,53.42,,,0,"percent of total billed charges","63% of total billed charges",16.22,15.3,,12.98,,,0,"percent of total billed charges","15.3% of total billed charges",8.65,100,,,,,0,"fee schedule",EAPG,73.14,69,,,,,0,"fee schedule","69% of total billed charges",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",4.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",4.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",4.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.05,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.65,100,,,,,0,"fee schedule",EAPG,4.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.72,100,,,,,0,"fee schedule","100% of LI fee schedule",6.4,100,,,,,0,"fee schedule",EAPG,4.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.82,100,,,,,0,"fee schedule",EAPG,11.24,100,,,,,0,"fee schedule",EAPG,4.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.96,37.7,,31.97,,,0,"percent of total billed charges","37.7% of total billed charges",39.96,37.7,,31.97,,,0,"percent of total billed charges","37.70% of total billed charges",4.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.93,33.9,,28.74,,,0,"percent of total billed charges","33.9% of total billed charges",4.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.68,78,,66.14,,,0,"percent of total billed charges","78% of total billed charges",4.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",87.56,82.6,,70.05,,,0,"percent of total billed charges","82.6% of total billed charges",8.65,100,,,,,0,"fee schedule",EAPG,4.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.56,82.6,,70.05,,,0,"percent of total billed charges","82.6% of total billed charges",4.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.65,100,,,,,0,"fee schedule",EAPG,106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",4.72,106,
"Pathology Billing Gyn Cytology Thin Prep",31188161,CDM,311,RC,88161,CPT,OUTPATIENT,,,127,82.55,,111.76,88,,89.41,,,0,"percent of total billed charges","88% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",53.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",26.78,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.01,63,,64.01,,,0,"percent of total billed charges","63% of total billed charges",19.43,15.3,,15.54,,,0,"percent of total billed charges","15.3% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,87.63,69,,,,,0,"fee schedule","69% of total billed charges",127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.22,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.26,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.52,100,,,,,0,"fee schedule",EAPG,33.8,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.88,37.7,,38.30,,,0,"percent of total billed charges","37.7% of total billed charges",47.88,37.7,,38.30,,,0,"percent of total billed charges","37.70% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",43.05,33.9,,34.44,,,0,"percent of total billed charges","33.9% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.06,78,,79.25,,,0,"percent of total billed charges","78% of total billed charges",30.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",104.9,82.6,,83.92,,,0,"percent of total billed charges","82.6% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",104.9,82.6,,83.92,,,0,"percent of total billed charges","82.6% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",19.26,127,
"Bronchial Washings Cytology LC",31188112,CDM,311,RC,88112,CPT,OUTPATIENT,,,215,139.75,,189.2,88,,151.36,,,0,"percent of total billed charges","88% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",96.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",26.78,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",135.45,63,,108.36,,,0,"percent of total billed charges","63% of total billed charges",32.9,15.3,,26.32,,,0,"percent of total billed charges","15.3% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,148.35,69,,,,,0,"fee schedule","69% of total billed charges",215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.15,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.26,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.52,100,,,,,0,"fee schedule",EAPG,33.8,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",81.06,37.7,,64.85,,,0,"percent of total billed charges","37.7% of total billed charges",81.06,37.7,,64.85,,,0,"percent of total billed charges","37.70% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",72.89,33.9,,58.31,,,0,"percent of total billed charges","33.9% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",167.7,78,,134.16,,,0,"percent of total billed charges","78% of total billed charges",55.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.59,82.6,,142.07,,,0,"percent of total billed charges","82.6% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.59,82.6,,142.07,,,0,"percent of total billed charges","82.6% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",19.26,215,
N/A,31188104,CDM,311,RC,88104,CPT,OUTPATIENT,,,381,247.65,,335.28,88,,268.22,,,0,"percent of total billed charges","88% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",71.58,175,,,,,0,"fee schedule","175% of CMS fee schedule",26.78,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",240.03,63,,192.02,,,0,"percent of total billed charges","63% of total billed charges",58.29,15.3,,46.63,,,0,"percent of total billed charges","15.3% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,262.89,69,,,,,0,"fee schedule","69% of total billed charges",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.26,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.52,100,,,,,0,"fee schedule",EAPG,33.8,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",143.64,37.7,,114.91,,,0,"percent of total billed charges","37.7% of total billed charges",143.64,37.7,,114.91,,,0,"percent of total billed charges","37.70% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",129.16,33.9,,103.33,,,0,"percent of total billed charges","33.9% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.18,78,,237.74,,,0,"percent of total billed charges","78% of total billed charges",41.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",314.71,82.6,,251.77,,,0,"percent of total billed charges","82.6% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",314.71,82.6,,251.77,,,0,"percent of total billed charges","82.6% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",19.26,381,
"Brucella Antibody IgG/IgM LC",30286622,CDM,302,RC,86622,CPT,OUTPATIENT,,,132,85.8,,116.16,88,,92.93,,,0,"percent of total billed charges","88% of total billed charges",8.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",15.62,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,8.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",83.16,63,,66.53,,,0,"percent of total billed charges","63% of total billed charges",20.2,15.3,,16.16,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,91.08,69,,,,,0,"fee schedule","69% of total billed charges",132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",8.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",8.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",8.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.15,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,8.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.93,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,8.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,8.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.76,37.7,,39.81,,,0,"percent of total billed charges","37.7% of total billed charges",49.76,37.7,,39.81,,,0,"percent of total billed charges","37.70% of total billed charges",8.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.75,33.9,,35.80,,,0,"percent of total billed charges","33.9% of total billed charges",8.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",102.96,78,,82.37,,,0,"percent of total billed charges","78% of total billed charges",9.01,101,,,,,0,"fee schedule","101% of CMS fee schedule ",109.03,82.6,,87.22,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,8.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.03,82.6,,87.22,,,0,"percent of total billed charges","82.6% of total billed charges",8.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",6.96,132,
"C albicans + C glabrata, NAA LC",30687801,CDM,306,RC,87801,CPT,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",122.85,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",268.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.2,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.7% of total billed charges",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.46,33.9,,69.97,,,0,"percent of total billed charges","33.9% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",70.9,101,,,,,0,"fee schedule","101% of CMS fee schedule ",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",18.33,268.51,
"C Difficile Toxins, Molecular",30687324,CDM,306,RC,87324,CPT,OUTPATIENT,,,280,182,,246.4,88,,197.12,,,0,"percent of total billed charges","88% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",20.96,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",176.4,63,,141.12,,,0,"percent of total billed charges","63% of total billed charges",42.84,15.3,,34.27,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,193.2,69,,,,,0,"fee schedule","69% of total billed charges",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.82,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.98,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",105.56,37.7,,84.45,,,0,"percent of total billed charges","37.7% of total billed charges",105.56,37.7,,84.45,,,0,"percent of total billed charges","37.70% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",94.92,33.9,,75.94,,,0,"percent of total billed charges","33.9% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",218.4,78,,174.72,,,0,"percent of total billed charges","78% of total billed charges",12.09,101,,,,,0,"fee schedule","101% of CMS fee schedule ",231.28,82.6,,185.02,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",231.28,82.6,,185.02,,,0,"percent of total billed charges","82.6% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",4.81,280,
"C difficile Toxins A+B, EIA LC",30687324,CDM,306,RC,87324,CPT,OUTPATIENT,,,347,225.55,,305.36,88,,244.29,,,0,"percent of total billed charges","88% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",20.96,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",218.61,63,,174.89,,,0,"percent of total billed charges","63% of total billed charges",53.09,15.3,,42.47,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,239.43,69,,,,,0,"fee schedule","69% of total billed charges",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.82,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.98,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",130.82,37.7,,104.66,,,0,"percent of total billed charges","37.7% of total billed charges",130.82,37.7,,104.66,,,0,"percent of total billed charges","37.70% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",117.63,33.9,,94.10,,,0,"percent of total billed charges","33.9% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",270.66,78,,216.53,,,0,"percent of total billed charges","78% of total billed charges",12.09,101,,,,,0,"fee schedule","101% of CMS fee schedule ",286.62,82.6,,229.30,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",286.62,82.6,,229.30,,,0,"percent of total billed charges","82.6% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",4.81,347,
"C difficile Toxin Gene NAA LC",30687493,CDM,306,RC,87493,CPT,OUTPATIENT,,,150,97.5,,132,88,,105.60,,,0,"percent of total billed charges","88% of total billed charges",37.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",65.22,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,37.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",94.5,63,,75.60,,,0,"percent of total billed charges","63% of total billed charges",22.95,15.3,,18.36,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,103.5,69,,,,,0,"fee schedule","69% of total billed charges",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",37.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",37.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",37.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.55,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,37.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.27,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,37.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,37.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.7% of total billed charges",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.70% of total billed charges",37.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.85,33.9,,40.68,,,0,"percent of total billed charges","33.9% of total billed charges",37.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",117,78,,93.60,,,0,"percent of total billed charges","78% of total billed charges",37.64,101,,,,,0,"fee schedule","101% of CMS fee schedule ",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,37.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",37.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",18.33,150,
"C-Diff Toxin B PCR (GeneXpert)",30687493,CDM,306,RC,87493,CPT,OUTPATIENT,,,101,65.65,,88.88,88,,71.10,,,0,"percent of total billed charges","88% of total billed charges",37.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",65.22,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,37.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.63,63,,50.90,,,0,"percent of total billed charges","63% of total billed charges",15.45,15.3,,12.36,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,69.69,69,,,,,0,"fee schedule","69% of total billed charges",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",37.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",37.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",37.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.55,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,37.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.27,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,37.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,37.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.08,37.7,,30.46,,,0,"percent of total billed charges","37.7% of total billed charges",38.08,37.7,,30.46,,,0,"percent of total billed charges","37.70% of total billed charges",37.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.24,33.9,,27.39,,,0,"percent of total billed charges","33.9% of total billed charges",37.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.78,78,,63.02,,,0,"percent of total billed charges","78% of total billed charges",37.64,101,,,,,0,"fee schedule","101% of CMS fee schedule ",83.43,82.6,,66.74,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,37.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",83.43,82.6,,66.74,,,0,"percent of total billed charges","82.6% of total billed charges",37.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",15.45,142.55,
"C-Peptide LC",30184681,CDM,301,RC,84681,CPT,OUTPATIENT,,,426,276.9,,374.88,88,,299.90,,,0,"percent of total billed charges","88% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",36.41,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",268.38,63,,214.70,,,0,"percent of total billed charges","63% of total billed charges",65.18,15.3,,52.14,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,293.94,69,,,,,0,"fee schedule","69% of total billed charges",426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.59,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.81,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.6,37.7,,128.48,,,0,"percent of total billed charges","37.7% of total billed charges",160.6,37.7,,128.48,,,0,"percent of total billed charges","37.70% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.41,33.9,,115.53,,,0,"percent of total billed charges","33.9% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",332.28,78,,265.82,,,0,"percent of total billed charges","78% of total billed charges",21.01,101,,,,,0,"fee schedule","101% of CMS fee schedule ",351.88,82.6,,281.50,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",351.88,82.6,,281.50,,,0,"percent of total billed charges","82.6% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",8.11,426,
"C-Reactive Protein",30286140,CDM,302,RC,86140,CPT,OUTPATIENT,,,34,22.1,,29.92,88,,23.94,,,0,"percent of total billed charges","88% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",9.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.42,63,,17.14,,,0,"percent of total billed charges","63% of total billed charges",5.2,15.3,,4.16,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,23.46,69,,,,,0,"fee schedule","69% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.81,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.82,37.7,,10.26,,,0,"percent of total billed charges","37.7% of total billed charges",12.82,37.7,,10.26,,,0,"percent of total billed charges","37.70% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.53,33.9,,9.22,,,0,"percent of total billed charges","33.9% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.52,78,,21.22,,,0,"percent of total billed charges","78% of total billed charges",5.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",5.18,34,
"C-Reactive Protein High Sensitivity",30086141,CDM,300,RC,86141,CPT,OUTPATIENT,,,234,152.1,,205.92,88,,164.74,,,0,"percent of total billed charges","88% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",22.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",147.42,63,,117.94,,,0,"percent of total billed charges","63% of total billed charges",35.8,15.3,,28.64,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,161.46,69,,,,,0,"fee schedule","69% of total billed charges",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.53,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.95,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.22,37.7,,70.58,,,0,"percent of total billed charges","37.7% of total billed charges",88.22,37.7,,70.58,,,0,"percent of total billed charges","37.70% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.33,33.9,,63.46,,,0,"percent of total billed charges","33.9% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",182.52,78,,146.02,,,0,"percent of total billed charges","78% of total billed charges",13.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",193.28,82.6,,154.62,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",193.28,82.6,,154.62,,,0,"percent of total billed charges","82.6% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,234,
"C-Reactive Protein, Cardiac LC",30286141,CDM,302,RC,86141,CPT,OUTPATIENT,,,262,170.3,,230.56,88,,184.45,,,0,"percent of total billed charges","88% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",22.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",165.06,63,,132.05,,,0,"percent of total billed charges","63% of total billed charges",40.09,15.3,,32.07,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,180.78,69,,,,,0,"fee schedule","69% of total billed charges",262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.53,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.95,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.77,37.7,,79.02,,,0,"percent of total billed charges","37.7% of total billed charges",98.77,37.7,,79.02,,,0,"percent of total billed charges","37.70% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.82,33.9,,71.06,,,0,"percent of total billed charges","33.9% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",204.36,78,,163.49,,,0,"percent of total billed charges","78% of total billed charges",13.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",216.41,82.6,,173.13,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",216.41,82.6,,173.13,,,0,"percent of total billed charges","82.6% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",6.96,262,
"C-reactive protein LC",30286140,CDM,302,RC,86140,CPT,OUTPATIENT,,,40,26,,35.2,88,,28.16,,,0,"percent of total billed charges","88% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",9.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.2,63,,20.16,,,0,"percent of total billed charges","63% of total billed charges",6.12,15.3,,4.90,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,27.6,69,,,,,0,"fee schedule","69% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.81,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.08,37.7,,12.06,,,0,"percent of total billed charges","37.7% of total billed charges",15.08,37.7,,12.06,,,0,"percent of total billed charges","37.70% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.56,33.9,,10.85,,,0,"percent of total billed charges","33.9% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.2,78,,24.96,,,0,"percent of total billed charges","78% of total billed charges",5.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",5.18,40,
"C1 Esterase Inhibitor LC",30286160,CDM,302,RC,86160,CPT,OUTPATIENT,,,111,72.15,,97.68,88,,78.14,,,0,"percent of total billed charges","88% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",21,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.93,63,,55.94,,,0,"percent of total billed charges","63% of total billed charges",16.98,15.3,,13.58,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,76.59,69,,,,,0,"fee schedule","69% of total billed charges",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.9,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12,100,,,,,0,"fee schedule","100% of CMS fee schedule",12,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.85,37.7,,33.48,,,0,"percent of total billed charges","37.7% of total billed charges",41.85,37.7,,33.48,,,0,"percent of total billed charges","37.70% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.63,33.9,,30.10,,,0,"percent of total billed charges","33.9% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",86.58,78,,69.26,,,0,"percent of total billed charges","78% of total billed charges",12.12,101,,,,,0,"fee schedule","101% of CMS fee schedule ",91.69,82.6,,73.35,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.69,82.6,,73.35,,,0,"percent of total billed charges","82.6% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",6.96,111,
"C1 Esterase Inhibitor, Func LC",30286161,CDM,302,RC,86161,CPT,OUTPATIENT,,,169,109.85,,148.72,88,,118.98,,,0,"percent of total billed charges","88% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",21,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.47,63,,85.18,,,0,"percent of total billed charges","63% of total billed charges",25.86,15.3,,20.69,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,116.61,69,,,,,0,"fee schedule","69% of total billed charges",169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.9,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12,100,,,,,0,"fee schedule","100% of CMS fee schedule",12,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.71,37.7,,50.97,,,0,"percent of total billed charges","37.7% of total billed charges",63.71,37.7,,50.97,,,0,"percent of total billed charges","37.70% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.29,33.9,,45.83,,,0,"percent of total billed charges","33.9% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",131.82,78,,105.46,,,0,"percent of total billed charges","78% of total billed charges",12.12,101,,,,,0,"fee schedule","101% of CMS fee schedule ",139.59,82.6,,111.67,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12,100,,,,,0,"fee schedule","100% of CMS fee schedule",139.59,82.6,,111.67,,,0,"percent of total billed charges","82.6% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,169,
"C3d Immune Complexes LC",30286332,CDM,302,RC,86332,CPT,OUTPATIENT,,,140,91,,123.2,88,,98.56,,,0,"percent of total billed charges","88% of total billed charges",24.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",42.64,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,24.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.2,63,,70.56,,,0,"percent of total billed charges","63% of total billed charges",21.42,15.3,,17.14,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,96.6,69,,,,,0,"fee schedule","69% of total billed charges",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",24.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",24.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",24.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",93.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,24.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.37,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,24.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,24.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.78,37.7,,42.22,,,0,"percent of total billed charges","37.7% of total billed charges",52.78,37.7,,42.22,,,0,"percent of total billed charges","37.70% of total billed charges",24.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.46,33.9,,37.97,,,0,"percent of total billed charges","33.9% of total billed charges",24.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.2,78,,87.36,,,0,"percent of total billed charges","78% of total billed charges",24.61,101,,,,,0,"fee schedule","101% of CMS fee schedule ",115.64,82.6,,92.51,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,24.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",115.64,82.6,,92.51,,,0,"percent of total billed charges","82.6% of total billed charges",24.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,140,
"C4+C3 LC",30286160,CDM,302,RC,86160,CPT,OUTPATIENT,,,91,59.15,,80.08,88,,64.06,,,0,"percent of total billed charges","88% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",21,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.33,63,,45.86,,,0,"percent of total billed charges","63% of total billed charges",13.92,15.3,,11.14,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,62.79,69,,,,,0,"fee schedule","69% of total billed charges",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.9,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12,100,,,,,0,"fee schedule","100% of CMS fee schedule",12,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.31,37.7,,27.45,,,0,"percent of total billed charges","37.7% of total billed charges",34.31,37.7,,27.45,,,0,"percent of total billed charges","37.70% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.85,33.9,,24.68,,,0,"percent of total billed charges","33.9% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.98,78,,56.78,,,0,"percent of total billed charges","78% of total billed charges",12.12,101,,,,,0,"fee schedule","101% of CMS fee schedule ",75.17,82.6,,60.14,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12,100,,,,,0,"fee schedule","100% of CMS fee schedule",75.17,82.6,,60.14,,,0,"percent of total billed charges","82.6% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",6.96,91,
"CA 19-9 LC",30286301,CDM,302,RC,86301,CPT,OUTPATIENT,,,426,276.9,,374.88,88,,299.90,,,0,"percent of total billed charges","88% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",36.41,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",268.38,63,,214.70,,,0,"percent of total billed charges","63% of total billed charges",65.18,15.3,,52.14,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,293.94,69,,,,,0,"fee schedule","69% of total billed charges",426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.59,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.81,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.6,37.7,,128.48,,,0,"percent of total billed charges","37.7% of total billed charges",160.6,37.7,,128.48,,,0,"percent of total billed charges","37.70% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.41,33.9,,115.53,,,0,"percent of total billed charges","33.9% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",332.28,78,,265.82,,,0,"percent of total billed charges","78% of total billed charges",21.01,101,,,,,0,"fee schedule","101% of CMS fee schedule ",351.88,82.6,,281.50,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",351.88,82.6,,281.50,,,0,"percent of total billed charges","82.6% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",6.96,426,
"CA 27.29 LC",30286300,CDM,302,RC,86300,CPT,OUTPATIENT,,,426,276.9,,374.88,88,,299.90,,,0,"percent of total billed charges","88% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",36.41,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",268.38,63,,214.70,,,0,"percent of total billed charges","63% of total billed charges",65.18,15.3,,52.14,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,293.94,69,,,,,0,"fee schedule","69% of total billed charges",426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.59,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.81,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.6,37.7,,128.48,,,0,"percent of total billed charges","37.7% of total billed charges",160.6,37.7,,128.48,,,0,"percent of total billed charges","37.70% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.41,33.9,,115.53,,,0,"percent of total billed charges","33.9% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",332.28,78,,265.82,,,0,"percent of total billed charges","78% of total billed charges",21.01,101,,,,,0,"fee schedule","101% of CMS fee schedule ",351.88,82.6,,281.50,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",351.88,82.6,,281.50,,,0,"percent of total billed charges","82.6% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",6.96,426,
"CBC w/ Manual Differential",30585027,CDM,305,RC,85027,CPT,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",11.32,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.23,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.74,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.47,100,,,,,0,"fee schedule","100% of LI fee schedule",3.76,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.7% of total billed charges",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.55,33.9,,42.04,,,0,"percent of total billed charges","33.9% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",6.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",3.76,155,
"CBC w/ Differential",30585025,CDM,305,RC,85025,CPT,OUTPATIENT,,,168,109.2,,147.84,88,,118.27,,,0,"percent of total billed charges","88% of total billed charges",7.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,168,100,,134.40,,,0,"percent of total billed charges","100% of total billed charges",13.59,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.23,100,,,,,0,"fee schedule",EAPG,7.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",105.84,63,,84.67,,,0,"percent of total billed charges","63% of total billed charges",25.7,15.3,,20.56,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,115.92,69,,,,,0,"fee schedule","69% of total billed charges",168,100,,134.40,,,0,"percent of total billed charges","100% of total billed charges",7.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",168,100,,134.40,,,0,"percent of total billed charges","100% of total billed charges",7.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",168,100,,134.40,,,0,"percent of total billed charges","100% of total billed charges",7.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.72,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,7.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.77,100,,,,,0,"fee schedule","100% of LI fee schedule",3.76,100,,,,,0,"fee schedule",EAPG,7.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,7.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.34,37.7,,50.67,,,0,"percent of total billed charges","37.7% of total billed charges",63.34,37.7,,50.67,,,0,"percent of total billed charges","37.70% of total billed charges",7.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.95,33.9,,45.56,,,0,"percent of total billed charges","33.9% of total billed charges",7.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",131.04,78,,104.83,,,0,"percent of total billed charges","78% of total billed charges",7.84,101,,,,,0,"fee schedule","101% of CMS fee schedule ",138.77,82.6,,111.02,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,7.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",138.77,82.6,,111.02,,,0,"percent of total billed charges","82.6% of total billed charges",7.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,168,100,,134.40,,,0,"percent of total billed charges","100% of total billed charges",3.76,168,
"Hemogram Automated",30585027,CDM,305,RC,85027,CPT,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",11.32,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.23,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.74,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.47,100,,,,,0,"fee schedule","100% of LI fee schedule",3.76,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.7% of total billed charges",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.55,33.9,,42.04,,,0,"percent of total billed charges","33.9% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",6.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",3.76,155,
"CCP Antibodies IgG/IgA LC",30286200,CDM,302,RC,86200,CPT,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",22.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.53,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.95,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.7% of total billed charges",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.92,33.9,,27.94,,,0,"percent of total billed charges","33.9% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",13.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",6.96,103,
"CEA LC",30182378,CDM,301,RC,82378,CPT,OUTPATIENT,,,409,265.85,,359.92,88,,287.94,,,0,"percent of total billed charges","88% of total billed charges",18.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",33.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,18.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",257.67,63,,206.14,,,0,"percent of total billed charges","63% of total billed charges",62.58,15.3,,50.06,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,282.21,69,,,,,0,"fee schedule","69% of total billed charges",409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",18.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",18.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",18.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.52,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,18.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.96,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,18.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,18.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",154.19,37.7,,123.35,,,0,"percent of total billed charges","37.7% of total billed charges",154.19,37.7,,123.35,,,0,"percent of total billed charges","37.70% of total billed charges",18.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",138.65,33.9,,110.92,,,0,"percent of total billed charges","33.9% of total billed charges",18.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",319.02,78,,255.22,,,0,"percent of total billed charges","78% of total billed charges",19.14,101,,,,,0,"fee schedule","101% of CMS fee schedule ",337.83,82.6,,270.26,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,18.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",337.83,82.6,,270.26,,,0,"percent of total billed charges","82.6% of total billed charges",18.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",8.11,409,
"CEA, Fluid LC",30182378,CDM,301,RC,82378,CPT,OUTPATIENT,,,156,101.4,,137.28,88,,109.82,,,0,"percent of total billed charges","88% of total billed charges",18.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",33.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,18.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.28,63,,78.62,,,0,"percent of total billed charges","63% of total billed charges",23.87,15.3,,19.10,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,107.64,69,,,,,0,"fee schedule","69% of total billed charges",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",18.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",18.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",18.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.52,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,18.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.96,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,18.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,18.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.81,37.7,,47.05,,,0,"percent of total billed charges","37.7% of total billed charges",58.81,37.7,,47.05,,,0,"percent of total billed charges","37.70% of total billed charges",18.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.88,33.9,,42.30,,,0,"percent of total billed charges","33.9% of total billed charges",18.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",121.68,78,,97.34,,,0,"percent of total billed charges","78% of total billed charges",19.14,101,,,,,0,"fee schedule","101% of CMS fee schedule ",128.86,82.6,,103.09,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,18.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",128.86,82.6,,103.09,,,0,"percent of total billed charges","82.6% of total billed charges",18.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",8.11,156,
"iSTAT CG4 Blood Gases POCT",30182803,CDM,301,RC,82803,CPT,OUTPATIENT,,,70,45.5,,61.6,88,,49.28,,,0,"percent of total billed charges","88% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",45.62,175,,,,,0,"fee schedule","175% of CMS fee schedule",29.67,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.1,63,,35.28,,,0,"percent of total billed charges","63% of total billed charges",10.71,15.3,,8.57,,,0,"percent of total billed charges","15.3% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,48.3,69,,,,,0,"fee schedule","69% of total billed charges",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.71,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.07,100,,,,,0,"fee schedule","100% of LI fee schedule",21.33,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.38,100,,,,,0,"fee schedule",EAPG,37.44,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.39,37.7,,21.11,,,0,"percent of total billed charges","37.7% of total billed charges",26.39,37.7,,21.11,,,0,"percent of total billed charges","37.70% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.73,33.9,,18.98,,,0,"percent of total billed charges","33.9% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.6,78,,43.68,,,0,"percent of total billed charges","78% of total billed charges",26.33,101,,,,,0,"fee schedule","101% of CMS fee schedule ",57.82,82.6,,46.26,,,0,"percent of total billed charges","82.6% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.82,82.6,,46.26,,,0,"percent of total billed charges","82.6% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",10.71,99.71,
"CPK ISOENZYMES",30182552,CDM,301,RC,82552,CPT,OUTPATIENT,,,247,160.55,,217.36,88,,173.89,,,0,"percent of total billed charges","88% of total billed charges",13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,247,100,,197.60,,,0,"percent of total billed charges","100% of total billed charges",23.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",155.61,63,,124.49,,,0,"percent of total billed charges","63% of total billed charges",37.79,15.3,,30.23,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,170.43,69,,,,,0,"fee schedule","69% of total billed charges",247,100,,197.60,,,0,"percent of total billed charges","100% of total billed charges",13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",247,100,,197.60,,,0,"percent of total billed charges","100% of total billed charges",13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",247,100,,197.60,,,0,"percent of total billed charges","100% of total billed charges",13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.39,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",93.12,37.7,,74.50,,,0,"percent of total billed charges","37.7% of total billed charges",93.12,37.7,,74.50,,,0,"percent of total billed charges","37.70% of total billed charges",13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",83.73,33.9,,66.98,,,0,"percent of total billed charges","33.9% of total billed charges",13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",192.66,78,,154.13,,,0,"percent of total billed charges","78% of total billed charges",13.52,101,,,,,0,"fee schedule","101% of CMS fee schedule ",204.02,82.6,,163.22,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",204.02,82.6,,163.22,,,0,"percent of total billed charges","82.6% of total billed charges",13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,247,100,,197.60,,,0,"percent of total billed charges","100% of total billed charges",8.11,247,
"CLL FISH Panel LC",0310MISC,CDM,310,RC,88365,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.41,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",37.5,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.41,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.41,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.97,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",37.13,100,,,,,0,"fee schedule",EAPG,47.33,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.41,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.41,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",26.97,47.33,
"CLO Test",30687081,CDM,306,RC,87081,CPT,OUTPATIENT,,,28,18.2,,24.64,88,,19.71,,,0,"percent of total billed charges","88% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",11.6,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.64,63,,14.11,,,0,"percent of total billed charges","63% of total billed charges",4.28,15.3,,3.42,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,19.32,69,,,,,0,"fee schedule","69% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.35,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.63,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.56,37.7,,8.45,,,0,"percent of total billed charges","37.7% of total billed charges",10.56,37.7,,8.45,,,0,"percent of total billed charges","37.70% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.49,33.9,,7.59,,,0,"percent of total billed charges","33.9% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.84,78,,17.47,,,0,"percent of total billed charges","78% of total billed charges",6.69,101,,,,,0,"fee schedule","101% of CMS fee schedule ",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",4.28,28,
"CMV PCR LC",30687496,CDM,306,RC,87496,CPT,OUTPATIENT,,,624,405.6,,549.12,88,,439.30,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,624,100,,499.20,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",393.12,63,,314.50,,,0,"percent of total billed charges","63% of total billed charges",95.47,15.3,,76.38,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,430.56,69,,,,,0,"fee schedule","69% of total billed charges",624,100,,499.20,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",624,100,,499.20,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",624,100,,499.20,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",235.25,37.7,,188.20,,,0,"percent of total billed charges","37.7% of total billed charges",235.25,37.7,,188.20,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",211.54,33.9,,169.23,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",486.72,78,,389.38,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",515.42,82.6,,412.34,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",515.42,82.6,,412.34,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,624,100,,499.20,,,0,"percent of total billed charges","100% of total billed charges",18.33,624,
"CMV Abs IgG/IgM LC",30086644,CDM,300,RC,86644,CPT,OUTPATIENT,,,54,35.1,,47.52,88,,38.02,,,0,"percent of total billed charges","88% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",25.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.02,63,,27.22,,,0,"percent of total billed charges","63% of total billed charges",8.26,15.3,,6.61,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,37.26,69,,,,,0,"fee schedule","69% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.04,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.39,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.36,37.7,,16.29,,,0,"percent of total billed charges","37.7% of total billed charges",20.36,37.7,,16.29,,,0,"percent of total billed charges","37.70% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.31,33.9,,14.65,,,0,"percent of total billed charges","33.9% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.12,78,,33.70,,,0,"percent of total billed charges","78% of total billed charges",14.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",44.6,82.6,,35.68,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.6,82.6,,35.68,,,0,"percent of total billed charges","82.6% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,55.04,
"CMV Quant DNA PCR (Plasma) LC",30687497,CDM,306,RC,87497,CPT,OUTPATIENT,,,1999,1299.35,,1759.12,88,,1407.30,,,0,"percent of total billed charges","88% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,1999,100,,1599.20,,,0,"percent of total billed charges","100% of total billed charges",74.97,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",1259.37,63,,1007.50,,,0,"percent of total billed charges","63% of total billed charges",305.85,15.3,,244.68,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,1379.31,69,,,,,0,"fee schedule","69% of total billed charges",1999,100,,1599.20,,,0,"percent of total billed charges","100% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",1999,100,,1599.20,,,0,"percent of total billed charges","100% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",1999,100,,1599.20,,,0,"percent of total billed charges","100% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.86,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.84,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",753.62,37.7,,602.90,,,0,"percent of total billed charges","37.7% of total billed charges",753.62,37.7,,602.90,,,0,"percent of total billed charges","37.70% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",677.66,33.9,,542.13,,,0,"percent of total billed charges","33.9% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",1559.22,78,,1247.38,,,0,"percent of total billed charges","78% of total billed charges",43.26,101,,,,,0,"fee schedule","101% of CMS fee schedule ",1651.17,82.6,,1320.94,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",1651.17,82.6,,1320.94,,,0,"percent of total billed charges","82.6% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,1999,100,,1599.20,,,0,"percent of total billed charges","100% of total billed charges",18.33,1999,
"Venipuncture Routine",30036415,CDM,300,RC,36415,CPT,OUTPATIENT,,,102,66.3,,,,,,,,0,other,"not separately reimbursment",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.1,100,,,,,0,"fee schedule",EAPG,102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",15.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",2.16,100,,,,,0,"fee schedule",EAPG,8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",15.61,15.3,,12.49,,,0,"percent of total billed charges","15.3% of total billed charges",2.1,100,,,,,0,"fee schedule",EAPG,70.38,69,,,,,0,"fee schedule","69% of total billed charges",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.47,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",2.1,100,,,,,0,"fee schedule",EAPG,8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.83,100,,,,,0,"fee schedule","100% of LI fee schedule",1.55,100,,,,,0,"fee schedule",EAPG,8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.14,100,,,,,0,"fee schedule",EAPG,2.73,100,,,,,0,"fee schedule",EAPG,8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.45,37.7,,30.76,,,0,"percent of total billed charges","37.7% of total billed charges",38.45,37.7,,30.76,,,0,"percent of total billed charges","37.70% of total billed charges",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.58,33.9,,27.66,,,0,"percent of total billed charges","33.9% of total billed charges",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.56,78,,63.65,,,0,"percent of total billed charges","78% of total billed charges",8.91,101,,,,,0,"fee schedule","101% of CMS fee schedule ",84.25,82.6,,67.40,,,0,"percent of total billed charges","82.6% of total billed charges",2.1,100,,,,,0,"fee schedule",EAPG,8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",84.25,82.6,,67.40,,,0,"percent of total billed charges","82.6% of total billed charges",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.1,100,,,,,0,"fee schedule",EAPG,102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",1.55,102,
"CORDSTAT 13 LC",30080307,CDM,300,RC,80307,CPT,OUTPATIENT,,,346,224.9,,304.48,88,,243.58,,,0,"percent of total billed charges","88% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.13,16.8,,46.50,,,0,"percent of total billed charges","16.8% of total billed charges",346,100,,276.80,,,0,"percent of total billed charges","100% of total billed charges",108.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",59.87,17.304,,47.90,,,0,"percent of total billed charges","17.304% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",217.98,63,,174.38,,,0,"percent of total billed charges","63% of total billed charges",52.94,15.3,,42.35,,,0,"percent of total billed charges","15.3% of total billed charges",58.13,16.8,,46.50,,,0,"percent of total billed charges","16.8% of total billed charges",238.74,69,,,,,0,"fee schedule","69% of total billed charges",346,100,,276.80,,,0,"percent of total billed charges","100% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",346,100,,276.80,,,0,"percent of total billed charges","100% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",346,100,,276.80,,,0,"percent of total billed charges","100% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",237.68,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",58.13,16.8,,46.50,,,0,"percent of total billed charges","16.8% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.14,100,,,,,0,"fee schedule","100% of LI fee schedule",58.13,16.8,,46.50,,,0,"percent of total billed charges","16.8% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.29,17.136,,47.43,,,0,"percent of total billed charges","17.136% of total billed charges",75.57,21.84,,60.46,,,0,"percent of total billed charges","21.84% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",130.44,37.7,,104.35,,,0,"percent of total billed charges","37.7% of total billed charges",130.44,37.7,,104.35,,,0,"percent of total billed charges","37.70% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",117.29,33.9,,93.83,,,0,"percent of total billed charges","33.9% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",269.88,78,,215.90,,,0,"percent of total billed charges","78% of total billed charges",62.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",285.8,82.6,,228.64,,,0,"percent of total billed charges","82.6% of total billed charges",58.13,16.8,,46.50,,,0,"percent of total billed charges","16.8% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",285.8,82.6,,228.64,,,0,"percent of total billed charges","82.6% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.13,16.8,,46.50,,,0,"percent of total billed charges","16.8% of total billed charges",346,100,,276.80,,,0,"percent of total billed charges","100% of total billed charges",52.94,346,
"CORDSTAT 9 LC",30080307,CDM,300,RC,80307,CPT,OUTPATIENT,,,425,276.25,,374,88,,299.20,,,0,"percent of total billed charges","88% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.4,16.8,,57.12,,,0,"percent of total billed charges","16.8% of total billed charges",425,100,,340.00,,,0,"percent of total billed charges","100% of total billed charges",108.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",73.54,17.304,,58.83,,,0,"percent of total billed charges","17.304% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",267.75,63,,214.20,,,0,"percent of total billed charges","63% of total billed charges",65.03,15.3,,52.02,,,0,"percent of total billed charges","15.3% of total billed charges",71.4,16.8,,57.12,,,0,"percent of total billed charges","16.8% of total billed charges",293.25,69,,,,,0,"fee schedule","69% of total billed charges",425,100,,340.00,,,0,"percent of total billed charges","100% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",425,100,,340.00,,,0,"percent of total billed charges","100% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",425,100,,340.00,,,0,"percent of total billed charges","100% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",237.68,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",71.4,16.8,,57.12,,,0,"percent of total billed charges","16.8% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.14,100,,,,,0,"fee schedule","100% of LI fee schedule",71.4,16.8,,57.12,,,0,"percent of total billed charges","16.8% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.83,17.136,,58.26,,,0,"percent of total billed charges","17.136% of total billed charges",92.82,21.84,,74.26,,,0,"percent of total billed charges","21.84% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.23,37.7,,128.18,,,0,"percent of total billed charges","37.7% of total billed charges",160.23,37.7,,128.18,,,0,"percent of total billed charges","37.70% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.08,33.9,,115.26,,,0,"percent of total billed charges","33.9% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",331.5,78,,265.20,,,0,"percent of total billed charges","78% of total billed charges",62.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",351.05,82.6,,280.84,,,0,"percent of total billed charges","82.6% of total billed charges",71.4,16.8,,57.12,,,0,"percent of total billed charges","16.8% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",351.05,82.6,,280.84,,,0,"percent of total billed charges","82.6% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.4,16.8,,57.12,,,0,"percent of total billed charges","16.8% of total billed charges",425,100,,340.00,,,0,"percent of total billed charges","100% of total billed charges",62.14,425,
"SARS-CoV-2 (COVID-19)/Flu/RSV (GeneXpert Plus)",3003241U,CDM,306,RC,87637,CPT,OUTPATIENT,,,386,250.9,,339.68,88,,271.74,,,0,"percent of total billed charges","88% of total billed charges",142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",249.6,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",243.18,63,,194.54,,,0,"percent of total billed charges","63% of total billed charges",59.06,15.3,,47.25,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,266.34,69,,,,,0,"fee schedule","69% of total billed charges",386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.63,382.5,,,,,0,"fee schedule","382.5% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.63,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",145.52,37.7,,116.42,,,0,"percent of total billed charges","37.7% of total billed charges",145.52,37.7,,116.42,,,0,"percent of total billed charges","37.70% of total billed charges",142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",130.85,33.9,,104.68,,,0,"percent of total billed charges","33.9% of total billed charges",142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",301.08,78,,240.86,,,0,"percent of total billed charges","78% of total billed charges",144.05,101,,,,,0,"fee schedule","101% of CMS fee schedule ",318.84,82.6,,255.07,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",318.84,82.6,,255.07,,,0,"percent of total billed charges","82.6% of total billed charges",142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",18.33,386,
"CSF Cell Count W/Diff if Indicated",30989050,CDM,300,RC,89050,CPT,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",4.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.65,100,,,,,0,"fee schedule",EAPG,206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",8.26,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.91,100,,,,,0,"fee schedule",EAPG,4.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",8.65,100,,,,,0,"fee schedule",EAPG,142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",4.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",4.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",4.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.05,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.65,100,,,,,0,"fee schedule",EAPG,4.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.72,100,,,,,0,"fee schedule","100% of LI fee schedule",6.4,100,,,,,0,"fee schedule",EAPG,4.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.82,100,,,,,0,"fee schedule",EAPG,11.24,100,,,,,0,"fee schedule",EAPG,4.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.7% of total billed charges",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",4.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.83,33.9,,55.86,,,0,"percent of total billed charges","33.9% of total billed charges",4.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",4.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",8.65,100,,,,,0,"fee schedule",EAPG,4.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",4.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.65,100,,,,,0,"fee schedule",EAPG,206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",4.72,206,
"CSF Differential",30989051,CDM,309,RC,89051,CPT,OUTPATIENT,,,106,68.9,,93.28,88,,74.62,,,0,"percent of total billed charges","88% of total billed charges",5.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.65,100,,,,,0,"fee schedule",EAPG,106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",9.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.91,100,,,,,0,"fee schedule",EAPG,5.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.78,63,,53.42,,,0,"percent of total billed charges","63% of total billed charges",16.22,15.3,,12.98,,,0,"percent of total billed charges","15.3% of total billed charges",8.65,100,,,,,0,"fee schedule",EAPG,73.14,69,,,,,0,"fee schedule","69% of total billed charges",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",5.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",5.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",5.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.42,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.65,100,,,,,0,"fee schedule",EAPG,5.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.6,100,,,,,0,"fee schedule","100% of LI fee schedule",6.4,100,,,,,0,"fee schedule",EAPG,5.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.82,100,,,,,0,"fee schedule",EAPG,11.24,100,,,,,0,"fee schedule",EAPG,5.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.96,37.7,,31.97,,,0,"percent of total billed charges","37.7% of total billed charges",39.96,37.7,,31.97,,,0,"percent of total billed charges","37.70% of total billed charges",5.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.93,33.9,,28.74,,,0,"percent of total billed charges","33.9% of total billed charges",5.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.68,78,,66.14,,,0,"percent of total billed charges","78% of total billed charges",5.65,101,,,,,0,"fee schedule","101% of CMS fee schedule ",87.56,82.6,,70.05,,,0,"percent of total billed charges","82.6% of total billed charges",8.65,100,,,,,0,"fee schedule",EAPG,5.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.56,82.6,,70.05,,,0,"percent of total billed charges","82.6% of total billed charges",5.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.65,100,,,,,0,"fee schedule",EAPG,106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",5.6,106,
"CT/NG PCR (GeneXpert)",30687491,CDM,306,RC,87491|8759,CPT,OUTPATIENT,,,190,123.5,,167.2,88,,133.76,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.92,16.8,,25.54,,,0,"percent of total billed charges","16.8% of total billed charges",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.88,17.304,,26.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",119.7,63,,95.76,,,0,"percent of total billed charges","63% of total billed charges",29.07,15.3,,23.26,,,0,"percent of total billed charges","15.3% of total billed charges",31.92,16.8,,25.54,,,0,"percent of total billed charges","16.8% of total billed charges",131.1,69,,,,,0,"fee schedule","69% of total billed charges",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",31.92,16.8,,25.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",31.92,16.8,,25.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.56,17.136,,26.05,,,0,"percent of total billed charges","17.136% of total billed charges",41.5,21.84,,33.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.63,37.7,,57.30,,,0,"percent of total billed charges","37.7% of total billed charges",71.63,37.7,,57.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.41,33.9,,51.53,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",148.2,78,,118.56,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.94,82.6,,125.55,,,0,"percent of total billed charges","82.6% of total billed charges",31.92,16.8,,25.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.94,82.6,,125.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.92,16.8,,25.54,,,0,"percent of total billed charges","16.8% of total billed charges",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",29.07,190,
"CADMIUM BLOOD",30182300,CDM,301,RC,82300,CPT,OUTPATIENT,,,109,70.85,,95.92,88,,76.74,,,0,"percent of total billed charges","88% of total billed charges",23.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",41.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",10.18,100,,,,,0,"fee schedule",EAPG,23.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.67,63,,54.94,,,0,"percent of total billed charges","63% of total billed charges",16.68,15.3,,13.34,,,0,"percent of total billed charges","15.3% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,75.21,69,,,,,0,"fee schedule","69% of total billed charges",109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",23.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",23.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",23.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.42,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,23.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.64,100,,,,,0,"fee schedule","100% of LI fee schedule",7.32,100,,,,,0,"fee schedule",EAPG,23.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.08,100,,,,,0,"fee schedule",EAPG,12.85,100,,,,,0,"fee schedule",EAPG,23.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.09,37.7,,32.87,,,0,"percent of total billed charges","37.7% of total billed charges",41.09,37.7,,32.87,,,0,"percent of total billed charges","37.70% of total billed charges",23.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.95,33.9,,29.56,,,0,"percent of total billed charges","33.9% of total billed charges",23.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.02,78,,68.02,,,0,"percent of total billed charges","78% of total billed charges",23.87,101,,,,,0,"fee schedule","101% of CMS fee schedule ",90.03,82.6,,72.02,,,0,"percent of total billed charges","82.6% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,23.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.03,82.6,,72.02,,,0,"percent of total billed charges","82.6% of total billed charges",23.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",7.32,109,
"CALCIUM 24HR URINE",30182340,CDM,301,RC,82340,CPT,OUTPATIENT,,,39,25.35,,34.32,88,,27.46,,,0,"percent of total billed charges","88% of total billed charges",6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",10.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.57,63,,19.66,,,0,"percent of total billed charges","63% of total billed charges",5.97,15.3,,4.78,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,26.91,69,,,,,0,"fee schedule","69% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.06,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.03,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.7% of total billed charges",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.70% of total billed charges",6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.22,33.9,,10.58,,,0,"percent of total billed charges","33.9% of total billed charges",6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.42,78,,24.34,,,0,"percent of total billed charges","78% of total billed charges",6.09,101,,,,,0,"fee schedule","101% of CMS fee schedule ",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",3.25,39,
"Calcium Total",30182310,CDM,301,RC,82310,CPT,OUTPATIENT,,,94,61.1,,82.72,88,,66.18,,,0,"percent of total billed charges","88% of total billed charges",5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",9.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,63,,47.38,,,0,"percent of total billed charges","63% of total billed charges",14.38,15.3,,11.50,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,64.86,69,,,,,0,"fee schedule","69% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.73,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.16,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.44,37.7,,28.35,,,0,"percent of total billed charges","37.7% of total billed charges",35.44,37.7,,28.35,,,0,"percent of total billed charges","37.70% of total billed charges",5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.87,33.9,,25.50,,,0,"percent of total billed charges","33.9% of total billed charges",5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.32,78,,58.66,,,0,"percent of total billed charges","78% of total billed charges",5.21,101,,,,,0,"fee schedule","101% of CMS fee schedule ",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",3.25,94,
"Calcium Ionized",30082330,CDM,301,RC,82330,CPT,OUTPATIENT,,,165,107.25,,145.2,88,,116.16,,,0,"percent of total billed charges","88% of total billed charges",13.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",23.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,13.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",103.95,63,,83.16,,,0,"percent of total billed charges","63% of total billed charges",25.25,15.3,,20.20,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,113.85,69,,,,,0,"fee schedule","69% of total billed charges",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",13.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",13.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",13.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.32,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,13.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.68,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,13.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,13.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.21,37.7,,49.77,,,0,"percent of total billed charges","37.7% of total billed charges",62.21,37.7,,49.77,,,0,"percent of total billed charges","37.70% of total billed charges",13.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.94,33.9,,44.75,,,0,"percent of total billed charges","33.9% of total billed charges",13.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",128.7,78,,102.96,,,0,"percent of total billed charges","78% of total billed charges",13.81,101,,,,,0,"fee schedule","101% of CMS fee schedule ",136.29,82.6,,109.03,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,13.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.29,82.6,,109.03,,,0,"percent of total billed charges","82.6% of total billed charges",13.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",8.11,165,
"CALCIUM RANDOM URINE",30182340,CDM,301,RC,82340,CPT,OUTPATIENT,,,39,25.35,,34.32,88,,27.46,,,0,"percent of total billed charges","88% of total billed charges",6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",10.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.57,63,,19.66,,,0,"percent of total billed charges","63% of total billed charges",5.97,15.3,,4.78,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,26.91,69,,,,,0,"fee schedule","69% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.06,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.03,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.7% of total billed charges",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.70% of total billed charges",6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.22,33.9,,10.58,,,0,"percent of total billed charges","33.9% of total billed charges",6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.42,78,,24.34,,,0,"percent of total billed charges","78% of total billed charges",6.09,101,,,,,0,"fee schedule","101% of CMS fee schedule ",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",3.25,39,
"Calcitonin LC",30182308,CDM,301,RC,82308,CPT,OUTPATIENT,,,581,377.65,,511.28,88,,409.02,,,0,"percent of total billed charges","88% of total billed charges",26.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,581,100,,464.80,,,0,"percent of total billed charges","100% of total billed charges",46.88,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,26.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",366.03,63,,292.82,,,0,"percent of total billed charges","63% of total billed charges",88.89,15.3,,71.11,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,400.89,69,,,,,0,"fee schedule","69% of total billed charges",581,100,,464.80,,,0,"percent of total billed charges","100% of total billed charges",26.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",581,100,,464.80,,,0,"percent of total billed charges","100% of total billed charges",26.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",581,100,,464.80,,,0,"percent of total billed charges","100% of total billed charges",26.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",102.47,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,26.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.79,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,26.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,26.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",219.04,37.7,,175.23,,,0,"percent of total billed charges","37.7% of total billed charges",219.04,37.7,,175.23,,,0,"percent of total billed charges","37.70% of total billed charges",26.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",196.96,33.9,,157.57,,,0,"percent of total billed charges","33.9% of total billed charges",26.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",453.18,78,,362.54,,,0,"percent of total billed charges","78% of total billed charges",27.05,101,,,,,0,"fee schedule","101% of CMS fee schedule ",479.91,82.6,,383.93,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,26.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",479.91,82.6,,383.93,,,0,"percent of total billed charges","82.6% of total billed charges",26.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,581,100,,464.80,,,0,"percent of total billed charges","100% of total billed charges",8.39,581,
"Calcium, Ionized LC",30182330,CDM,301,RC,82330,CPT,OUTPATIENT,,,358,232.7,,315.04,88,,252.03,,,0,"percent of total billed charges","88% of total billed charges",13.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,358,100,,286.40,,,0,"percent of total billed charges","100% of total billed charges",23.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,13.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",225.54,63,,180.43,,,0,"percent of total billed charges","63% of total billed charges",54.77,15.3,,43.82,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,247.02,69,,,,,0,"fee schedule","69% of total billed charges",358,100,,286.40,,,0,"percent of total billed charges","100% of total billed charges",13.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",358,100,,286.40,,,0,"percent of total billed charges","100% of total billed charges",13.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",358,100,,286.40,,,0,"percent of total billed charges","100% of total billed charges",13.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.32,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,13.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.68,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,13.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,13.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.97,37.7,,107.98,,,0,"percent of total billed charges","37.7% of total billed charges",134.97,37.7,,107.98,,,0,"percent of total billed charges","37.70% of total billed charges",13.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",121.36,33.9,,97.09,,,0,"percent of total billed charges","33.9% of total billed charges",13.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",279.24,78,,223.39,,,0,"percent of total billed charges","78% of total billed charges",13.81,101,,,,,0,"fee schedule","101% of CMS fee schedule ",295.71,82.6,,236.57,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,13.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",295.71,82.6,,236.57,,,0,"percent of total billed charges","82.6% of total billed charges",13.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,358,100,,286.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,358,
"VITAMIN D,1,25-DIHYDROXY",30182652,CDM,301,RC,82652,CPT,OUTPATIENT,,,535,347.75,,470.8,88,,376.64,,,0,"percent of total billed charges","88% of total billed charges",38.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",67.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",29.67,100,,,,,0,"fee schedule",EAPG,38.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",337.05,63,,269.64,,,0,"percent of total billed charges","63% of total billed charges",81.86,15.3,,65.49,,,0,"percent of total billed charges","15.3% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,369.15,69,,,,,0,"fee schedule","69% of total billed charges",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",38.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",38.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",38.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",147.26,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,38.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.5,100,,,,,0,"fee schedule","100% of LI fee schedule",21.33,100,,,,,0,"fee schedule",EAPG,38.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.38,100,,,,,0,"fee schedule",EAPG,37.44,100,,,,,0,"fee schedule",EAPG,38.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",201.7,37.7,,161.36,,,0,"percent of total billed charges","37.7% of total billed charges",201.7,37.7,,161.36,,,0,"percent of total billed charges","37.70% of total billed charges",38.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",181.37,33.9,,145.10,,,0,"percent of total billed charges","33.9% of total billed charges",38.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",417.3,78,,333.84,,,0,"percent of total billed charges","78% of total billed charges",38.88,101,,,,,0,"fee schedule","101% of CMS fee schedule ",441.91,82.6,,353.53,,,0,"percent of total billed charges","82.6% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,38.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",441.91,82.6,,353.53,,,0,"percent of total billed charges","82.6% of total billed charges",38.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",21.33,535,
"Calculi, Urinary LC 120790",30182360,CDM,301,RC,82360,CPT,OUTPATIENT,,,152,98.8,,133.76,88,,107.01,,,0,"percent of total billed charges","88% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",22.52,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.76,63,,76.61,,,0,"percent of total billed charges","63% of total billed charges",23.26,15.3,,18.61,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,104.88,69,,,,,0,"fee schedule","69% of total billed charges",152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.22,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.87,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.3,37.7,,45.84,,,0,"percent of total billed charges","37.7% of total billed charges",57.3,37.7,,45.84,,,0,"percent of total billed charges","37.70% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.53,33.9,,41.22,,,0,"percent of total billed charges","33.9% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",118.56,78,,94.85,,,0,"percent of total billed charges","78% of total billed charges",12.99,101,,,,,0,"fee schedule","101% of CMS fee schedule ",125.55,82.6,,100.44,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",125.55,82.6,,100.44,,,0,"percent of total billed charges","82.6% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",8.11,152,
"Calcium 24Hr Urine LC",30182340,CDM,301,RC,82340,CPT,OUTPATIENT,,,93,60.45,,81.84,88,,65.47,,,0,"percent of total billed charges","88% of total billed charges",6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",10.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.59,63,,46.87,,,0,"percent of total billed charges","63% of total billed charges",14.23,15.3,,11.38,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,64.17,69,,,,,0,"fee schedule","69% of total billed charges",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.06,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.03,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.06,37.7,,28.05,,,0,"percent of total billed charges","37.7% of total billed charges",35.06,37.7,,28.05,,,0,"percent of total billed charges","37.70% of total billed charges",6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.53,33.9,,25.22,,,0,"percent of total billed charges","33.9% of total billed charges",6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.54,78,,58.03,,,0,"percent of total billed charges","78% of total billed charges",6.09,101,,,,,0,"fee schedule","101% of CMS fee schedule ",76.82,82.6,,61.46,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.82,82.6,,61.46,,,0,"percent of total billed charges","82.6% of total billed charges",6.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,93,
"Calprotectin, Fecal LC",30183993,CDM,301,RC,83993,CPT,OUTPATIENT,,,1026,666.9,,902.88,88,,722.30,,,0,"percent of total billed charges","88% of total billed charges",19.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,1026,100,,820.80,,,0,"percent of total billed charges","100% of total billed charges",34.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,19.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",646.38,63,,517.10,,,0,"percent of total billed charges","63% of total billed charges",156.98,15.3,,125.58,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,707.94,69,,,,,0,"fee schedule","69% of total billed charges",1026,100,,820.80,,,0,"percent of total billed charges","100% of total billed charges",19.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",1026,100,,820.80,,,0,"percent of total billed charges","100% of total billed charges",19.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",1026,100,,820.80,,,0,"percent of total billed charges","100% of total billed charges",19.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",75.08,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,19.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.63,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,19.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,19.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",386.8,37.7,,309.44,,,0,"percent of total billed charges","37.7% of total billed charges",386.8,37.7,,309.44,,,0,"percent of total billed charges","37.70% of total billed charges",19.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",347.81,33.9,,278.25,,,0,"percent of total billed charges","33.9% of total billed charges",19.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",800.28,78,,640.22,,,0,"percent of total billed charges","78% of total billed charges",19.82,101,,,,,0,"fee schedule","101% of CMS fee schedule ",847.48,82.6,,677.98,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,19.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",847.48,82.6,,677.98,,,0,"percent of total billed charges","82.6% of total billed charges",19.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,1026,100,,820.80,,,0,"percent of total billed charges","100% of total billed charges",8.11,1026,
"Cancer Antigen (CA) 15-3 LC",30286300,CDM,302,RC,86300,CPT,OUTPATIENT,,,451,293.15,,396.88,88,,317.50,,,0,"percent of total billed charges","88% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,451,100,,360.80,,,0,"percent of total billed charges","100% of total billed charges",36.41,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",284.13,63,,227.30,,,0,"percent of total billed charges","63% of total billed charges",69,15.3,,55.20,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,311.19,69,,,,,0,"fee schedule","69% of total billed charges",451,100,,360.80,,,0,"percent of total billed charges","100% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",451,100,,360.80,,,0,"percent of total billed charges","100% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",451,100,,360.80,,,0,"percent of total billed charges","100% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.59,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.81,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.03,37.7,,136.02,,,0,"percent of total billed charges","37.7% of total billed charges",170.03,37.7,,136.02,,,0,"percent of total billed charges","37.70% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",152.89,33.9,,122.31,,,0,"percent of total billed charges","33.9% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",351.78,78,,281.42,,,0,"percent of total billed charges","78% of total billed charges",21.01,101,,,,,0,"fee schedule","101% of CMS fee schedule ",372.53,82.6,,298.02,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",372.53,82.6,,298.02,,,0,"percent of total billed charges","82.6% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,451,100,,360.80,,,0,"percent of total billed charges","100% of total billed charges",6.96,451,
"Cancer Antigen (CA) 125 LC",30286304,CDM,302,RC,86304,CPT,OUTPATIENT,,,620,403,,545.6,88,,436.48,,,0,"percent of total billed charges","88% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,620,100,,496.00,,,0,"percent of total billed charges","100% of total billed charges",36.41,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",390.6,63,,312.48,,,0,"percent of total billed charges","63% of total billed charges",94.86,15.3,,75.89,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,427.8,69,,,,,0,"fee schedule","69% of total billed charges",620,100,,496.00,,,0,"percent of total billed charges","100% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",620,100,,496.00,,,0,"percent of total billed charges","100% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",620,100,,496.00,,,0,"percent of total billed charges","100% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.59,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.81,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",233.74,37.7,,186.99,,,0,"percent of total billed charges","37.7% of total billed charges",233.74,37.7,,186.99,,,0,"percent of total billed charges","37.70% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",210.18,33.9,,168.14,,,0,"percent of total billed charges","33.9% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",483.6,78,,386.88,,,0,"percent of total billed charges","78% of total billed charges",21.01,101,,,,,0,"fee schedule","101% of CMS fee schedule ",512.12,82.6,,409.70,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",512.12,82.6,,409.70,,,0,"percent of total billed charges","82.6% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,620,100,,496.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,620,
"Candidiasis Panel AVR",30687481,CDM,306,RC,87481,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"CARBAMAZEPINE (TEGRETOL)",30180156,CDM,301,RC,80156,CPT,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",25.49,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.73,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.57,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.7% of total billed charges",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.85,33.9,,72.68,,,0,"percent of total billed charges","33.9% of total billed charges",14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",14.71,101,,,,,0,"fee schedule","101% of CMS fee schedule ",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",14.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",7,268,
"CARBON DIOXIDE",30182374,CDM,301,RC,82374,CPT,OUTPATIENT,,,75,48.75,,66,88,,52.80,,,0,"percent of total billed charges","88% of total billed charges",4.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",8.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.25,63,,37.80,,,0,"percent of total billed charges","63% of total billed charges",11.48,15.3,,9.18,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,51.75,69,,,,,0,"fee schedule","69% of total billed charges",75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",4.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",4.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",4.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.66,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.88,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.28,37.7,,22.62,,,0,"percent of total billed charges","37.7% of total billed charges",28.28,37.7,,22.62,,,0,"percent of total billed charges","37.70% of total billed charges",4.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.43,33.9,,20.34,,,0,"percent of total billed charges","33.9% of total billed charges",4.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.5,78,,46.80,,,0,"percent of total billed charges","78% of total billed charges",4.92,101,,,,,0,"fee schedule","101% of CMS fee schedule ",61.95,82.6,,49.56,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.95,82.6,,49.56,,,0,"percent of total billed charges","82.6% of total billed charges",4.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",3.25,75,
"Carboxyhemoglobin Venous",30082375,CDM,300,RC,82375,CPT,OUTPATIENT,,,150,97.5,,132,88,,105.60,,,0,"percent of total billed charges","88% of total billed charges",12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",21.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",94.5,63,,75.60,,,0,"percent of total billed charges","63% of total billed charges",22.95,15.3,,18.36,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,103.5,69,,,,,0,"fee schedule","69% of total billed charges",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.12,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.32,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.7% of total billed charges",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.70% of total billed charges",12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.85,33.9,,40.68,,,0,"percent of total billed charges","33.9% of total billed charges",12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",117,78,,93.60,,,0,"percent of total billed charges","78% of total billed charges",12.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",8.11,150,
CARBOXYHEMOGLOBIN,30182375,CDM,301,RC,82375,CPT,OUTPATIENT,,,150,97.5,,132,88,,105.60,,,0,"percent of total billed charges","88% of total billed charges",12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",21.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",94.5,63,,75.60,,,0,"percent of total billed charges","63% of total billed charges",22.95,15.3,,18.36,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,103.5,69,,,,,0,"fee schedule","69% of total billed charges",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.12,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.32,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.7% of total billed charges",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.70% of total billed charges",12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.85,33.9,,40.68,,,0,"percent of total billed charges","33.9% of total billed charges",12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",117,78,,93.60,,,0,"percent of total billed charges","78% of total billed charges",12.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",8.11,150,
"Carboxy-THC (GCMS) LC",30180349,CDM,301,RC,80349,CPT,OUTPATIENT,,,329,213.85,,289.52,88,,231.62,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",207.27,63,,165.82,,,0,"percent of total billed charges","63% of total billed charges",50.34,15.3,,40.27,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.01,69,,,,,0,"fee schedule","69% of total billed charges",329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",124.03,37.7,,99.22,,,0,"percent of total billed charges","37.7% of total billed charges",124.03,37.7,,99.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",111.53,33.9,,89.22,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",256.62,78,,205.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",271.75,82.6,,217.40,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",271.75,82.6,,217.40,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",55.27,16.8,,44.22,,,0,"percent of total billed charges","16.8% of total billed charges",329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",50.34,329,
"Carbon Monoxide Level (Arterial)",30182375,CDM,300,RC,82375,CPT,OUTPATIENT,,,150,97.5,,132,88,,105.60,,,0,"percent of total billed charges","88% of total billed charges",12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",21.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",94.5,63,,75.60,,,0,"percent of total billed charges","63% of total billed charges",22.95,15.3,,18.36,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,103.5,69,,,,,0,"fee schedule","69% of total billed charges",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.12,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.32,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.7% of total billed charges",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.70% of total billed charges",12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.85,33.9,,40.68,,,0,"percent of total billed charges","33.9% of total billed charges",12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",117,78,,93.60,,,0,"percent of total billed charges","78% of total billed charges",12.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",12.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",8.11,150,
"CATECHOLAMINES FRAC BLOOD",30182384,CDM,301,RC,82384,CPT,OUTPATIENT,,,317,206.05,,278.96,88,,223.17,,,0,"percent of total billed charges","88% of total billed charges",25.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,317,100,,253.60,,,0,"percent of total billed charges","100% of total billed charges",44.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,25.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",199.71,63,,159.77,,,0,"percent of total billed charges","63% of total billed charges",48.5,15.3,,38.80,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,218.73,69,,,,,0,"fee schedule","69% of total billed charges",317,100,,253.60,,,0,"percent of total billed charges","100% of total billed charges",25.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",317,100,,253.60,,,0,"percent of total billed charges","100% of total billed charges",25.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",317,100,,253.60,,,0,"percent of total billed charges","100% of total billed charges",25.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",96.58,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,25.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,25.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,25.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",119.51,37.7,,95.61,,,0,"percent of total billed charges","37.7% of total billed charges",119.51,37.7,,95.61,,,0,"percent of total billed charges","37.70% of total billed charges",25.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.46,33.9,,85.97,,,0,"percent of total billed charges","33.9% of total billed charges",25.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",247.26,78,,197.81,,,0,"percent of total billed charges","78% of total billed charges",25.5,101,,,,,0,"fee schedule","101% of CMS fee schedule ",261.84,82.6,,209.47,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,25.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",261.84,82.6,,209.47,,,0,"percent of total billed charges","82.6% of total billed charges",25.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,317,100,,253.60,,,0,"percent of total billed charges","100% of total billed charges",8.39,317,
"Celiac Disease HLA DQ Assoc. LC",31081377,CDM,310,RC,81377,CPT,OUTPATIENT,,,553,359.45,,486.64,88,,389.31,,,0,"percent of total billed charges","88% of total billed charges",94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,553,100,,442.40,,,0,"percent of total billed charges","100% of total billed charges",165.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.2,100,,,,,0,"fee schedule",EAPG,94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",348.39,63,,278.71,,,0,"percent of total billed charges","63% of total billed charges",142.11,150,,,,,0,"fee schedule","150% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,381.57,69,,,,,0,"fee schedule","69% of total billed charges",553,100,,442.40,,,0,"percent of total billed charges","100% of total billed charges",94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",553,100,,442.40,,,0,"percent of total billed charges","100% of total billed charges",94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",553,100,,442.40,,,0,"percent of total billed charges","100% of total billed charges",94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",362.38,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",94.74,100,,,,,0,"fee schedule","100% of LI fee schedule",28.91,100,,,,,0,"fee schedule",EAPG,94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.81,100,,,,,0,"fee schedule",EAPG,50.73,100,,,,,0,"fee schedule",EAPG,94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",208.48,37.7,,166.78,,,0,"percent of total billed charges","37.7% of total billed charges",208.48,37.7,,166.78,,,0,"percent of total billed charges","37.70% of total billed charges",94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",187.47,33.9,,149.98,,,0,"percent of total billed charges","33.9% of total billed charges",94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",431.34,78,,345.07,,,0,"percent of total billed charges","78% of total billed charges",95.68,101,,,,,0,"fee schedule","101% of CMS fee schedule ",456.78,82.6,,365.42,,,0,"percent of total billed charges","82.6% of total billed charges",39.02,100,,,,,0,"fee schedule","100% of WA fee schedule",94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",456.78,82.6,,365.42,,,0,"percent of total billed charges","82.6% of total billed charges",94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,553,100,,442.40,,,0,"percent of total billed charges","100% of total billed charges",28.91,553,
"Celiac HLA DQ Association LC",31081377,CDM,310,RC,81377,CPT,OUTPATIENT,,,537,349.05,,472.56,88,,378.05,,,0,"percent of total billed charges","88% of total billed charges",94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",165.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.2,100,,,,,0,"fee schedule",EAPG,94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",338.31,63,,270.65,,,0,"percent of total billed charges","63% of total billed charges",142.11,150,,,,,0,"fee schedule","150% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,370.53,69,,,,,0,"fee schedule","69% of total billed charges",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",362.38,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",94.74,100,,,,,0,"fee schedule","100% of LI fee schedule",28.91,100,,,,,0,"fee schedule",EAPG,94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.81,100,,,,,0,"fee schedule",EAPG,50.73,100,,,,,0,"fee schedule",EAPG,94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.45,37.7,,161.96,,,0,"percent of total billed charges","37.7% of total billed charges",202.45,37.7,,161.96,,,0,"percent of total billed charges","37.70% of total billed charges",94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",182.04,33.9,,145.63,,,0,"percent of total billed charges","33.9% of total billed charges",94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",418.86,78,,335.09,,,0,"percent of total billed charges","78% of total billed charges",95.68,101,,,,,0,"fee schedule","101% of CMS fee schedule ",443.56,82.6,,354.85,,,0,"percent of total billed charges","82.6% of total billed charges",39.02,100,,,,,0,"fee schedule","100% of WA fee schedule",94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",443.56,82.6,,354.85,,,0,"percent of total billed charges","82.6% of total billed charges",94.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",28.91,537,
"Ceruloplasmin LC",30182390,CDM,301,RC,82390,CPT,OUTPATIENT,,,245,159.25,,215.6,88,,172.48,,,0,"percent of total billed charges","88% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,245,100,,196.00,,,0,"percent of total billed charges","100% of total billed charges",18.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",154.35,63,,123.48,,,0,"percent of total billed charges","63% of total billed charges",37.49,15.3,,29.99,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,169.05,69,,,,,0,"fee schedule","69% of total billed charges",245,100,,196.00,,,0,"percent of total billed charges","100% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",245,100,,196.00,,,0,"percent of total billed charges","100% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",245,100,,196.00,,,0,"percent of total billed charges","100% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.08,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.74,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.37,37.7,,73.90,,,0,"percent of total billed charges","37.7% of total billed charges",92.37,37.7,,73.90,,,0,"percent of total billed charges","37.70% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",83.06,33.9,,66.45,,,0,"percent of total billed charges","33.9% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",191.1,78,,152.88,,,0,"percent of total billed charges","78% of total billed charges",10.84,101,,,,,0,"fee schedule","101% of CMS fee schedule ",202.37,82.6,,161.90,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.37,82.6,,161.90,,,0,"percent of total billed charges","82.6% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,245,100,,196.00,,,0,"percent of total billed charges","100% of total billed charges",3.25,245,
"Cervicitis/Vaginitis Panel AVR",30687491,CDM,306,RC,87491,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"Chlamydia trachomatis Culture LC",30687140,CDM,306,RC,87140,CPT,OUTPATIENT,,,128,83.2,,112.64,88,,90.11,,,0,"percent of total billed charges","88% of total billed charges",5.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",9.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,5.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.64,63,,64.51,,,0,"percent of total billed charges","63% of total billed charges",19.58,15.3,,15.66,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,88.32,69,,,,,0,"fee schedule","69% of total billed charges",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",5.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",5.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",5.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.3,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,5.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.57,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,5.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,5.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.26,37.7,,38.61,,,0,"percent of total billed charges","37.7% of total billed charges",48.26,37.7,,38.61,,,0,"percent of total billed charges","37.70% of total billed charges",5.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.39,33.9,,34.71,,,0,"percent of total billed charges","33.9% of total billed charges",5.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.84,78,,79.87,,,0,"percent of total billed charges","78% of total billed charges",5.62,101,,,,,0,"fee schedule","101% of CMS fee schedule ",105.73,82.6,,84.58,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,5.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",105.73,82.6,,84.58,,,0,"percent of total billed charges","82.6% of total billed charges",5.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",4.81,128,
"Chlamydia/GC Amplification LC",30687491,CDM,306,RC,87491,CPT,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.7% of total billed charges",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.83,33.9,,55.86,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",18.33,206,
"Chlamydia, Conjunctiva, NAA LC",30687491,CDM,306,RC,87491,CPT,OUTPATIENT,,,172,111.8,,151.36,88,,121.09,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.36,63,,86.69,,,0,"percent of total billed charges","63% of total billed charges",26.32,15.3,,21.06,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,118.68,69,,,,,0,"fee schedule","69% of total billed charges",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.84,37.7,,51.87,,,0,"percent of total billed charges","37.7% of total billed charges",64.84,37.7,,51.87,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.31,33.9,,46.65,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.16,78,,107.33,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",142.07,82.6,,113.66,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.07,82.6,,113.66,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",18.33,172,
"Chlamydia and Gonorrhea (GeneXpert)",30687491,CDM,306,RC,87491,CPT,OUTPATIENT,,,190,123.5,,167.2,88,,133.76,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",119.7,63,,95.76,,,0,"percent of total billed charges","63% of total billed charges",29.07,15.3,,23.26,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,131.1,69,,,,,0,"fee schedule","69% of total billed charges",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.63,37.7,,57.30,,,0,"percent of total billed charges","37.7% of total billed charges",71.63,37.7,,57.30,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.41,33.9,,51.53,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",148.2,78,,118.56,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",156.94,82.6,,125.55,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",156.94,82.6,,125.55,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",18.33,190,
"Chlamydia trachomatis AVR",30687491,CDM,306,RC,87491,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"Chlamydia/Gonorrhea Panel AVR",30687491,CDM,306,RC,87491,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"CHLORIDE BLOOD",30182435,CDM,301,RC,82435,CPT,OUTPATIENT,,,90,58.5,,79.2,88,,63.36,,,0,"percent of total billed charges","88% of total billed charges",4.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",8.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.7,63,,45.36,,,0,"percent of total billed charges","63% of total billed charges",13.77,15.3,,11.02,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,62.1,69,,,,,0,"fee schedule","69% of total billed charges",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",4.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",4.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",4.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.59,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.59,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.93,37.7,,27.14,,,0,"percent of total billed charges","37.7% of total billed charges",33.93,37.7,,27.14,,,0,"percent of total billed charges","37.70% of total billed charges",4.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.51,33.9,,24.41,,,0,"percent of total billed charges","33.9% of total billed charges",4.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.2,78,,56.16,,,0,"percent of total billed charges","78% of total billed charges",4.64,101,,,,,0,"fee schedule","101% of CMS fee schedule ",74.34,82.6,,59.47,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.34,82.6,,59.47,,,0,"percent of total billed charges","82.6% of total billed charges",4.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",3.25,90,
"Chloride Level Body Fluid",30182438,CDM,301,RC,82438,CPT,OUTPATIENT,,,45,29.25,,39.6,88,,31.68,,,0,"percent of total billed charges","88% of total billed charges",5,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",8.75,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.35,63,,22.68,,,0,"percent of total billed charges","63% of total billed charges",6.89,15.3,,5.51,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,31.05,69,,,,,0,"fee schedule","69% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",5,100,,,,,0,"fee schedule","100% of CMS fee schedule",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",5,100,,,,,0,"fee schedule","100% of CMS fee schedule",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",5,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.12,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.97,37.7,,13.58,,,0,"percent of total billed charges","37.7% of total billed charges",16.97,37.7,,13.58,,,0,"percent of total billed charges","37.70% of total billed charges",5,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.26,33.9,,12.21,,,0,"percent of total billed charges","33.9% of total billed charges",5,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.1,78,,28.08,,,0,"percent of total billed charges","78% of total billed charges",5.05,101,,,,,0,"fee schedule","101% of CMS fee schedule ",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",5,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",3.25,45,
"CHLORIDE RANDOM URINE",30182436,CDM,301,RC,82436,CPT,OUTPATIENT,,,87,56.55,,76.56,88,,61.25,,,0,"percent of total billed charges","88% of total billed charges",5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",10.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.81,63,,43.85,,,0,"percent of total billed charges","63% of total billed charges",13.31,15.3,,10.65,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,60.03,69,,,,,0,"fee schedule","69% of total billed charges",87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.75,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.8,37.7,,26.24,,,0,"percent of total billed charges","37.7% of total billed charges",32.8,37.7,,26.24,,,0,"percent of total billed charges","37.70% of total billed charges",5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.49,33.9,,23.59,,,0,"percent of total billed charges","33.9% of total billed charges",5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.86,78,,54.29,,,0,"percent of total billed charges","78% of total billed charges",5.8,101,,,,,0,"fee schedule","101% of CMS fee schedule ",71.86,82.6,,57.49,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.86,82.6,,57.49,,,0,"percent of total billed charges","82.6% of total billed charges",5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,87,
"CHLORIDE 24HR URINE",30182436,CDM,301,RC,82436,CPT,OUTPATIENT,,,87,56.55,,76.56,88,,61.25,,,0,"percent of total billed charges","88% of total billed charges",5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",10.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.81,63,,43.85,,,0,"percent of total billed charges","63% of total billed charges",13.31,15.3,,10.65,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,60.03,69,,,,,0,"fee schedule","69% of total billed charges",87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.75,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.8,37.7,,26.24,,,0,"percent of total billed charges","37.7% of total billed charges",32.8,37.7,,26.24,,,0,"percent of total billed charges","37.70% of total billed charges",5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.49,33.9,,23.59,,,0,"percent of total billed charges","33.9% of total billed charges",5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.86,78,,54.29,,,0,"percent of total billed charges","78% of total billed charges",5.8,101,,,,,0,"fee schedule","101% of CMS fee schedule ",71.86,82.6,,57.49,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.86,82.6,,57.49,,,0,"percent of total billed charges","82.6% of total billed charges",5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,87,
"Chloride, Urine LC",30182436,CDM,301,RC,82436,CPT,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",10.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.75,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.7% of total billed charges",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.09,33.9,,4.07,,,0,"percent of total billed charges","33.9% of total billed charges",5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",5.8,101,,,,,0,"fee schedule","101% of CMS fee schedule ",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",5.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,21.99,
"Cholesterol Serum Total",30182465,CDM,301,RC,82465,CPT,OUTPATIENT,,,100,65,,88,88,,70.40,,,0,"percent of total billed charges","88% of total billed charges",4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",7.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",63,63,,50.40,,,0,"percent of total billed charges","63% of total billed charges",15.3,15.3,,12.24,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,69,69,,,,,0,"fee schedule","69% of total billed charges",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.63,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.34,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.7% of total billed charges",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.70% of total billed charges",4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.9,33.9,,27.12,,,0,"percent of total billed charges","33.9% of total billed charges",4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,78,,62.40,,,0,"percent of total billed charges","78% of total billed charges",4.39,101,,,,,0,"fee schedule","101% of CMS fee schedule ",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",3.25,100,
"HDL CHOLESTEROL",30183718,CDM,301,RC,83718,CPT,OUTPATIENT,,,158,102.7,,139.04,88,,111.23,,,0,"percent of total billed charges","88% of total billed charges",8.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",14.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,8.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.54,63,,79.63,,,0,"percent of total billed charges","63% of total billed charges",24.17,15.3,,19.34,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,109.02,69,,,,,0,"fee schedule","69% of total billed charges",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",8.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",8.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",8.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.32,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,8.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.19,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,8.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,8.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.57,37.7,,47.66,,,0,"percent of total billed charges","37.7% of total billed charges",59.57,37.7,,47.66,,,0,"percent of total billed charges","37.70% of total billed charges",8.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.56,33.9,,42.85,,,0,"percent of total billed charges","33.9% of total billed charges",8.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",123.24,78,,98.59,,,0,"percent of total billed charges","78% of total billed charges",8.27,101,,,,,0,"fee schedule","101% of CMS fee schedule ",130.51,82.6,,104.41,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,8.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",130.51,82.6,,104.41,,,0,"percent of total billed charges","82.6% of total billed charges",8.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,158,
"Cholesterol Body Fluid",30182465,CDM,301,RC,82465,CPT,OUTPATIENT,,,100,65,,88,88,,70.40,,,0,"percent of total billed charges","88% of total billed charges",4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",7.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",63,63,,50.40,,,0,"percent of total billed charges","63% of total billed charges",15.3,15.3,,12.24,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,69,69,,,,,0,"fee schedule","69% of total billed charges",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.63,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.34,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.7% of total billed charges",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.70% of total billed charges",4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.9,33.9,,27.12,,,0,"percent of total billed charges","33.9% of total billed charges",4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,78,,62.40,,,0,"percent of total billed charges","78% of total billed charges",4.39,101,,,,,0,"fee schedule","101% of CMS fee schedule ",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",4.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",3.25,100,
"Cholesterol LDL",30183721,CDM,301,RC,83721,CPT,OUTPATIENT,,,184,119.6,,161.92,88,,129.54,,,0,"percent of total billed charges","88% of total billed charges",10.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",18.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,10.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",115.92,63,,92.74,,,0,"percent of total billed charges","63% of total billed charges",28.15,15.3,,22.52,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,126.96,69,,,,,0,"fee schedule","69% of total billed charges",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",10.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",10.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",10.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.16,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,10.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.5,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,10.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,10.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.37,37.7,,55.50,,,0,"percent of total billed charges","37.7% of total billed charges",69.37,37.7,,55.50,,,0,"percent of total billed charges","37.70% of total billed charges",10.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.38,33.9,,49.90,,,0,"percent of total billed charges","33.9% of total billed charges",10.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",143.52,78,,114.82,,,0,"percent of total billed charges","78% of total billed charges",10.6,101,,,,,0,"fee schedule","101% of CMS fee schedule ",151.98,82.6,,121.58,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,10.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.98,82.6,,121.58,,,0,"percent of total billed charges","82.6% of total billed charges",10.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",3.25,184,
"Cholinesterase LC",30182480,CDM,301,RC,82480,CPT,OUTPATIENT,,,227,147.55,,199.76,88,,159.81,,,0,"percent of total billed charges","88% of total billed charges",7.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",13.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,7.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",143.01,63,,114.41,,,0,"percent of total billed charges","63% of total billed charges",34.73,15.3,,27.78,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,156.63,69,,,,,0,"fee schedule","69% of total billed charges",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",7.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",7.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",7.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,7.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.87,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,7.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,7.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.58,37.7,,68.46,,,0,"percent of total billed charges","37.7% of total billed charges",85.58,37.7,,68.46,,,0,"percent of total billed charges","37.70% of total billed charges",7.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.95,33.9,,61.56,,,0,"percent of total billed charges","33.9% of total billed charges",7.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",177.06,78,,141.65,,,0,"percent of total billed charges","78% of total billed charges",7.94,101,,,,,0,"fee schedule","101% of CMS fee schedule ",187.5,82.6,,150.00,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,7.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",187.5,82.6,,150.00,,,0,"percent of total billed charges","82.6% of total billed charges",7.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,227,
"Cholinesterase, Plasma and RBC LC",30182482,CDM,301,RC,82482,CPT,OUTPATIENT,,,168,109.2,,147.84,88,,118.27,,,0,"percent of total billed charges","88% of total billed charges",9.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,168,100,,134.40,,,0,"percent of total billed charges","100% of total billed charges",17.16,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,9.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",105.84,63,,84.67,,,0,"percent of total billed charges","63% of total billed charges",25.7,15.3,,20.56,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,115.92,69,,,,,0,"fee schedule","69% of total billed charges",168,100,,134.40,,,0,"percent of total billed charges","100% of total billed charges",9.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",168,100,,134.40,,,0,"percent of total billed charges","100% of total billed charges",9.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",168,100,,134.40,,,0,"percent of total billed charges","100% of total billed charges",9.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.52,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,9.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.81,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,9.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,9.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.34,37.7,,50.67,,,0,"percent of total billed charges","37.7% of total billed charges",63.34,37.7,,50.67,,,0,"percent of total billed charges","37.70% of total billed charges",9.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.95,33.9,,45.56,,,0,"percent of total billed charges","33.9% of total billed charges",9.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",131.04,78,,104.83,,,0,"percent of total billed charges","78% of total billed charges",9.9,101,,,,,0,"fee schedule","101% of CMS fee schedule ",138.77,82.6,,111.02,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,9.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",138.77,82.6,,111.02,,,0,"percent of total billed charges","82.6% of total billed charges",9.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,168,100,,134.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,168,
"Chromogranin A LC 140848",30286316,CDM,302,RC,86316,CPT,OUTPATIENT,,,210,136.5,,184.8,88,,147.84,,,0,"percent of total billed charges","88% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",36.41,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",132.3,63,,105.84,,,0,"percent of total billed charges","63% of total billed charges",32.13,15.3,,25.70,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,144.9,69,,,,,0,"fee schedule","69% of total billed charges",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.59,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.81,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.17,37.7,,63.34,,,0,"percent of total billed charges","37.7% of total billed charges",79.17,37.7,,63.34,,,0,"percent of total billed charges","37.70% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.19,33.9,,56.95,,,0,"percent of total billed charges","33.9% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.8,78,,131.04,,,0,"percent of total billed charges","78% of total billed charges",21.01,101,,,,,0,"fee schedule","101% of CMS fee schedule ",173.46,82.6,,138.77,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",173.46,82.6,,138.77,,,0,"percent of total billed charges","82.6% of total billed charges",20.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,210,
"Chromosome, Leukemia/Lymphoma LC",30288237,CDM,302,RC,88237,CPT,OUTPATIENT,,,545,354.25,,479.6,88,,383.68,,,0,"percent of total billed charges","88% of total billed charges",143.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.75,100,,,,,0,"fee schedule",EAPG,545,100,,436.00,,,0,"percent of total billed charges","100% of total billed charges",251.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",36.82,100,,,,,0,"fee schedule",EAPG,143.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",343.35,63,,274.68,,,0,"percent of total billed charges","63% of total billed charges",83.39,15.3,,66.71,,,0,"percent of total billed charges","15.3% of total billed charges",35.75,100,,,,,0,"fee schedule",EAPG,376.05,69,,,,,0,"fee schedule","69% of total billed charges",545,100,,436.00,,,0,"percent of total billed charges","100% of total billed charges",143.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",545,100,,436.00,,,0,"percent of total billed charges","100% of total billed charges",143.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",545,100,,436.00,,,0,"percent of total billed charges","100% of total billed charges",143.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",549.84,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",35.75,100,,,,,0,"fee schedule",EAPG,143.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",143.75,100,,,,,0,"fee schedule","100% of LI fee schedule",26.48,100,,,,,0,"fee schedule",EAPG,143.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.46,100,,,,,0,"fee schedule",EAPG,46.47,100,,,,,0,"fee schedule",EAPG,143.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",205.47,37.7,,164.38,,,0,"percent of total billed charges","37.7% of total billed charges",205.47,37.7,,164.38,,,0,"percent of total billed charges","37.70% of total billed charges",143.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",184.76,33.9,,147.81,,,0,"percent of total billed charges","33.9% of total billed charges",143.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",425.1,78,,340.08,,,0,"percent of total billed charges","78% of total billed charges",145.18,101,,,,,0,"fee schedule","101% of CMS fee schedule ",450.17,82.6,,360.14,,,0,"percent of total billed charges","82.6% of total billed charges",35.75,100,,,,,0,"fee schedule",EAPG,143.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",450.17,82.6,,360.14,,,0,"percent of total billed charges","82.6% of total billed charges",143.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.75,100,,,,,0,"fee schedule",EAPG,545,100,,436.00,,,0,"percent of total billed charges","100% of total billed charges",26.48,549.84,
"Chromium and Cobalt WB MoM LC",30182495,CDM,301,RC,82495,CPT,OUTPATIENT,,,76,49.4,,66.88,88,,53.50,,,0,"percent of total billed charges","88% of total billed charges",20.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",35.49,175,,,,,0,"fee schedule","175% of CMS fee schedule",10.18,100,,,,,0,"fee schedule",EAPG,20.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.88,63,,38.30,,,0,"percent of total billed charges","63% of total billed charges",11.63,15.3,,9.30,,,0,"percent of total billed charges","15.3% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,52.44,69,,,,,0,"fee schedule","69% of total billed charges",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",20.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",20.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",20.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.57,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,20.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.28,100,,,,,0,"fee schedule","100% of LI fee schedule",7.32,100,,,,,0,"fee schedule",EAPG,20.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.08,100,,,,,0,"fee schedule",EAPG,12.85,100,,,,,0,"fee schedule",EAPG,20.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.65,37.7,,22.92,,,0,"percent of total billed charges","37.7% of total billed charges",28.65,37.7,,22.92,,,0,"percent of total billed charges","37.70% of total billed charges",20.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.76,33.9,,20.61,,,0,"percent of total billed charges","33.9% of total billed charges",20.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.28,78,,47.42,,,0,"percent of total billed charges","78% of total billed charges",20.48,101,,,,,0,"fee schedule","101% of CMS fee schedule ",62.78,82.6,,50.22,,,0,"percent of total billed charges","82.6% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,20.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.78,82.6,,50.22,,,0,"percent of total billed charges","82.6% of total billed charges",20.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",7.32,77.57,
"ELECTROPHORECTIC TECH",30182664,CDM,301,RC,82664,CPT,OUTPATIENT,,,238,154.7,,209.44,88,,167.55,,,0,"percent of total billed charges","88% of total billed charges",61.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",107.62,175,,,,,0,"fee schedule","175% of CMS fee schedule",29.67,100,,,,,0,"fee schedule",EAPG,61.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",149.94,63,,119.95,,,0,"percent of total billed charges","63% of total billed charges",36.41,15.3,,29.13,,,0,"percent of total billed charges","15.3% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,164.22,69,,,,,0,"fee schedule","69% of total billed charges",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",61.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",61.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",61.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",235.23,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,61.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.5,100,,,,,0,"fee schedule","100% of LI fee schedule",21.33,100,,,,,0,"fee schedule",EAPG,61.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.38,100,,,,,0,"fee schedule",EAPG,37.44,100,,,,,0,"fee schedule",EAPG,61.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.73,37.7,,71.78,,,0,"percent of total billed charges","37.7% of total billed charges",89.73,37.7,,71.78,,,0,"percent of total billed charges","37.70% of total billed charges",61.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.68,33.9,,64.54,,,0,"percent of total billed charges","33.9% of total billed charges",61.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",185.64,78,,148.51,,,0,"percent of total billed charges","78% of total billed charges",62.11,101,,,,,0,"fee schedule","101% of CMS fee schedule ",196.59,82.6,,157.27,,,0,"percent of total billed charges","82.6% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,61.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",196.59,82.6,,157.27,,,0,"percent of total billed charges","82.6% of total billed charges",61.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",21.33,238,
"Citric Acid (Citrate) U LC",30182507,CDM,301,RC,82507,CPT,OUTPATIENT,,,156,101.4,,137.28,88,,109.82,,,0,"percent of total billed charges","88% of total billed charges",27.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",48.65,175,,,,,0,"fee schedule","175% of CMS fee schedule",29.67,100,,,,,0,"fee schedule",EAPG,27.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.28,63,,78.62,,,0,"percent of total billed charges","63% of total billed charges",23.87,15.3,,19.10,,,0,"percent of total billed charges","15.3% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,107.64,69,,,,,0,"fee schedule","69% of total billed charges",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",27.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",27.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",27.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.33,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,27.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.8,100,,,,,0,"fee schedule","100% of LI fee schedule",21.33,100,,,,,0,"fee schedule",EAPG,27.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.38,100,,,,,0,"fee schedule",EAPG,37.44,100,,,,,0,"fee schedule",EAPG,27.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.81,37.7,,47.05,,,0,"percent of total billed charges","37.7% of total billed charges",58.81,37.7,,47.05,,,0,"percent of total billed charges","37.70% of total billed charges",27.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.88,33.9,,42.30,,,0,"percent of total billed charges","33.9% of total billed charges",27.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",121.68,78,,97.34,,,0,"percent of total billed charges","78% of total billed charges",28.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",128.86,82.6,,103.09,,,0,"percent of total billed charges","82.6% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,27.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",128.86,82.6,,103.09,,,0,"percent of total billed charges","82.6% of total billed charges",27.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",21.33,156,
"Clostridium Difficile Toxins",30087324,CDM,300,RC,87324,CPT,OUTPATIENT,,,62,40.3,,54.56,88,,43.65,,,0,"percent of total billed charges","88% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",20.96,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.06,63,,31.25,,,0,"percent of total billed charges","63% of total billed charges",9.49,15.3,,7.59,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,42.78,69,,,,,0,"fee schedule","69% of total billed charges",62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.82,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.98,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.37,37.7,,18.70,,,0,"percent of total billed charges","37.7% of total billed charges",23.37,37.7,,18.70,,,0,"percent of total billed charges","37.70% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.02,33.9,,16.82,,,0,"percent of total billed charges","33.9% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.36,78,,38.69,,,0,"percent of total billed charges","78% of total billed charges",12.09,101,,,,,0,"fee schedule","101% of CMS fee schedule ",51.21,82.6,,40.97,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.21,82.6,,40.97,,,0,"percent of total billed charges","82.6% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",4.81,62,
"Clostridium difficile Quik Chek Complete",30687324,CDM,306,RC,87324,CPT,OUTPATIENT,,,208,135.2,,183.04,88,,146.43,,,0,"percent of total billed charges","88% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,208,100,,166.40,,,0,"percent of total billed charges","100% of total billed charges",20.96,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",131.04,63,,104.83,,,0,"percent of total billed charges","63% of total billed charges",31.82,15.3,,25.46,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,143.52,69,,,,,0,"fee schedule","69% of total billed charges",208,100,,166.40,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",208,100,,166.40,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",208,100,,166.40,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.82,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.98,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.42,37.7,,62.74,,,0,"percent of total billed charges","37.7% of total billed charges",78.42,37.7,,62.74,,,0,"percent of total billed charges","37.70% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.51,33.9,,56.41,,,0,"percent of total billed charges","33.9% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.24,78,,129.79,,,0,"percent of total billed charges","78% of total billed charges",12.09,101,,,,,0,"fee schedule","101% of CMS fee schedule ",171.81,82.6,,137.45,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",171.81,82.6,,137.45,,,0,"percent of total billed charges","82.6% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,208,100,,166.40,,,0,"percent of total billed charges","100% of total billed charges",4.81,208,
"Clozapine (Clozaril), Serum LC",30180159,CDM,301,RC,80159,CPT,OUTPATIENT,,,128,83.2,,112.64,88,,90.11,,,0,"percent of total billed charges","88% of total billed charges",20.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",35.26,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,20.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.64,63,,64.51,,,0,"percent of total billed charges","63% of total billed charges",19.58,15.3,,15.66,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,88.32,69,,,,,0,"fee schedule","69% of total billed charges",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",20.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",20.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",20.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.07,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,20.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.14,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,20.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,20.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.26,37.7,,38.61,,,0,"percent of total billed charges","37.7% of total billed charges",48.26,37.7,,38.61,,,0,"percent of total billed charges","37.70% of total billed charges",20.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.39,33.9,,34.71,,,0,"percent of total billed charges","33.9% of total billed charges",20.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.84,78,,79.87,,,0,"percent of total billed charges","78% of total billed charges",20.35,101,,,,,0,"fee schedule","101% of CMS fee schedule ",105.73,82.6,,84.58,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,20.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",105.73,82.6,,84.58,,,0,"percent of total billed charges","82.6% of total billed charges",20.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",7,128,
"Cocaine Metab Confirm LC",30180353,CDM,301,RC,80353,CPT,OUTPATIENT,,,329,213.85,,289.52,88,,231.62,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",207.27,63,,165.82,,,0,"percent of total billed charges","63% of total billed charges",50.34,15.3,,40.27,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.01,69,,,,,0,"fee schedule","69% of total billed charges",329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",124.03,37.7,,99.22,,,0,"percent of total billed charges","37.7% of total billed charges",124.03,37.7,,99.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",111.53,33.9,,89.22,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",256.62,78,,205.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",271.75,82.6,,217.40,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",271.75,82.6,,217.40,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",55.27,16.8,,44.22,,,0,"percent of total billed charges","16.8% of total billed charges",329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",50.34,329,
"Coccidioides CF Antibody LC",30286635,CDM,302,RC,86635,CPT,OUTPATIENT,,,249,161.85,,219.12,88,,175.30,,,0,"percent of total billed charges","88% of total billed charges",11.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,249,100,,199.20,,,0,"percent of total billed charges","100% of total billed charges",20.07,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,11.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",156.87,63,,125.50,,,0,"percent of total billed charges","63% of total billed charges",38.1,15.3,,30.48,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,171.81,69,,,,,0,"fee schedule","69% of total billed charges",249,100,,199.20,,,0,"percent of total billed charges","100% of total billed charges",11.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",249,100,,199.20,,,0,"percent of total billed charges","100% of total billed charges",11.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",249,100,,199.20,,,0,"percent of total billed charges","100% of total billed charges",11.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.87,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,11.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.47,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,11.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,11.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",93.87,37.7,,75.10,,,0,"percent of total billed charges","37.7% of total billed charges",93.87,37.7,,75.10,,,0,"percent of total billed charges","37.70% of total billed charges",11.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",84.41,33.9,,67.53,,,0,"percent of total billed charges","33.9% of total billed charges",11.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",194.22,78,,155.38,,,0,"percent of total billed charges","78% of total billed charges",11.58,101,,,,,0,"fee schedule","101% of CMS fee schedule ",205.67,82.6,,164.54,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,11.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",205.67,82.6,,164.54,,,0,"percent of total billed charges","82.6% of total billed charges",11.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,249,100,,199.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,249,
"Occult Blood, Fecal, IA LC",30182274,CDM,301,RC,82274,CPT,OUTPATIENT,,,107,69.55,,94.16,88,,75.33,,,0,"percent of total billed charges","88% of total billed charges",15.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",27.86,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,15.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.41,63,,53.93,,,0,"percent of total billed charges","63% of total billed charges",16.37,15.3,,13.10,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,73.83,69,,,,,0,"fee schedule","69% of total billed charges",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",15.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",15.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",15.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.89,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,15.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.92,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,15.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,15.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.34,37.7,,32.27,,,0,"percent of total billed charges","37.7% of total billed charges",40.34,37.7,,32.27,,,0,"percent of total billed charges","37.70% of total billed charges",15.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.27,33.9,,29.02,,,0,"percent of total billed charges","33.9% of total billed charges",15.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",83.46,78,,66.77,,,0,"percent of total billed charges","78% of total billed charges",16.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",88.38,82.6,,70.70,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,15.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.38,82.6,,70.70,,,0,"percent of total billed charges","82.6% of total billed charges",15.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",8.11,107,
"Comprehensive Metabolic Panel",30180053,CDM,301,RC,80053,CPT,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",10.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",18.48,175,,,,,0,"fee schedule","175% of CMS fee schedule",7.68,100,,,,,0,"fee schedule",EAPG,10.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",7.45,100,,,,,0,"fee schedule",EAPG,249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",10.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",10.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",10.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.39,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,10.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.56,100,,,,,0,"fee schedule","100% of LI fee schedule",5.52,100,,,,,0,"fee schedule",EAPG,10.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.6,100,,,,,0,"fee schedule",EAPG,9.69,100,,,,,0,"fee schedule",EAPG,10.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.7% of total billed charges",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",10.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",122.38,33.9,,97.90,,,0,"percent of total billed charges","33.9% of total billed charges",10.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",10.66,101,,,,,0,"fee schedule","101% of CMS fee schedule ",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",7.45,100,,,,,0,"fee schedule",EAPG,10.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",10.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",5.52,361,
"Complement C4 LC",30286160,CDM,302,RC,86160,CPT,OUTPATIENT,,,91,59.15,,80.08,88,,64.06,,,0,"percent of total billed charges","88% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",21,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.33,63,,45.86,,,0,"percent of total billed charges","63% of total billed charges",13.92,15.3,,11.14,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,62.79,69,,,,,0,"fee schedule","69% of total billed charges",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.9,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12,100,,,,,0,"fee schedule","100% of CMS fee schedule",12,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.31,37.7,,27.45,,,0,"percent of total billed charges","37.7% of total billed charges",34.31,37.7,,27.45,,,0,"percent of total billed charges","37.70% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.85,33.9,,24.68,,,0,"percent of total billed charges","33.9% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.98,78,,56.78,,,0,"percent of total billed charges","78% of total billed charges",12.12,101,,,,,0,"fee schedule","101% of CMS fee schedule ",75.17,82.6,,60.14,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12,100,,,,,0,"fee schedule","100% of CMS fee schedule",75.17,82.6,,60.14,,,0,"percent of total billed charges","82.6% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",6.96,91,
"COMPLEMENT TOTAL (CH 50)",30286162,CDM,302,RC,86162,CPT,OUTPATIENT,,,354,230.1,,311.52,88,,249.22,,,0,"percent of total billed charges","88% of total billed charges",20.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,354,100,,283.20,,,0,"percent of total billed charges","100% of total billed charges",35.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,20.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",223.02,63,,178.42,,,0,"percent of total billed charges","63% of total billed charges",54.16,15.3,,43.33,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,244.26,69,,,,,0,"fee schedule","69% of total billed charges",354,100,,283.20,,,0,"percent of total billed charges","100% of total billed charges",20.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",354,100,,283.20,,,0,"percent of total billed charges","100% of total billed charges",20.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",354,100,,283.20,,,0,"percent of total billed charges","100% of total billed charges",20.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.72,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,20.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.32,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,20.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,20.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",133.46,37.7,,106.77,,,0,"percent of total billed charges","37.7% of total billed charges",133.46,37.7,,106.77,,,0,"percent of total billed charges","37.70% of total billed charges",20.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",120.01,33.9,,96.01,,,0,"percent of total billed charges","33.9% of total billed charges",20.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",276.12,78,,220.90,,,0,"percent of total billed charges","78% of total billed charges",20.52,101,,,,,0,"fee schedule","101% of CMS fee schedule ",292.4,82.6,,233.92,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,20.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",292.4,82.6,,233.92,,,0,"percent of total billed charges","82.6% of total billed charges",20.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,354,100,,283.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,354,
"Complement C3 LC",30286160,CDM,302,RC,86160,CPT,OUTPATIENT,,,91,59.15,,80.08,88,,64.06,,,0,"percent of total billed charges","88% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",21,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.33,63,,45.86,,,0,"percent of total billed charges","63% of total billed charges",13.92,15.3,,11.14,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,62.79,69,,,,,0,"fee schedule","69% of total billed charges",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.9,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12,100,,,,,0,"fee schedule","100% of CMS fee schedule",12,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.31,37.7,,27.45,,,0,"percent of total billed charges","37.7% of total billed charges",34.31,37.7,,27.45,,,0,"percent of total billed charges","37.70% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.85,33.9,,24.68,,,0,"percent of total billed charges","33.9% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.98,78,,56.78,,,0,"percent of total billed charges","78% of total billed charges",12.12,101,,,,,0,"fee schedule","101% of CMS fee schedule ",75.17,82.6,,60.14,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12,100,,,,,0,"fee schedule","100% of CMS fee schedule",75.17,82.6,,60.14,,,0,"percent of total billed charges","82.6% of total billed charges",12,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",6.96,91,
"Comp panel Leukemia/Lymphoma LC",31188184,CDM,311,RC,88184,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.82,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",36.46,100,,,,,0,"fee schedule",EAPG,46.47,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",26.48,46.47,
"Comp Bld Drug Scr w/Med Rpt LC",30180307,CDM,301,RC,80307,CPT,OUTPATIENT,,,1145,744.25,,1007.6,88,,806.08,,,0,"percent of total billed charges","88% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",192.36,16.8,,153.89,,,0,"percent of total billed charges","16.8% of total billed charges",1145,100,,916.00,,,0,"percent of total billed charges","100% of total billed charges",108.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",198.13,17.304,,158.50,,,0,"percent of total billed charges","17.304% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",721.35,63,,577.08,,,0,"percent of total billed charges","63% of total billed charges",175.19,15.3,,140.15,,,0,"percent of total billed charges","15.3% of total billed charges",192.36,16.8,,153.89,,,0,"percent of total billed charges","16.8% of total billed charges",790.05,69,,,,,0,"fee schedule","69% of total billed charges",1145,100,,916.00,,,0,"percent of total billed charges","100% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1145,100,,916.00,,,0,"percent of total billed charges","100% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1145,100,,916.00,,,0,"percent of total billed charges","100% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",237.68,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",192.36,16.8,,153.89,,,0,"percent of total billed charges","16.8% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.14,100,,,,,0,"fee schedule","100% of LI fee schedule",192.36,16.8,,153.89,,,0,"percent of total billed charges","16.8% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",196.21,17.136,,156.97,,,0,"percent of total billed charges","17.136% of total billed charges",250.07,21.84,,200.06,,,0,"percent of total billed charges","21.84% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",431.67,37.7,,345.34,,,0,"percent of total billed charges","37.7% of total billed charges",431.67,37.7,,345.34,,,0,"percent of total billed charges","37.70% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",388.16,33.9,,310.53,,,0,"percent of total billed charges","33.9% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",893.1,78,,714.48,,,0,"percent of total billed charges","78% of total billed charges",62.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",945.77,82.6,,756.62,,,0,"percent of total billed charges","82.6% of total billed charges",192.36,16.8,,153.89,,,0,"percent of total billed charges","16.8% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",945.77,82.6,,756.62,,,0,"percent of total billed charges","82.6% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",192.36,16.8,,153.89,,,0,"percent of total billed charges","16.8% of total billed charges",1145,100,,916.00,,,0,"percent of total billed charges","100% of total billed charges",62.14,1145,
"Comprehensive UTI Panel AVR",30687640,CDM,306,RC,87640,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"Copper LC",30182525,CDM,301,RC,82525,CPT,OUTPATIENT,,,328,213.2,,288.64,88,,230.91,,,0,"percent of total billed charges","88% of total billed charges",12.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",21.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",10.18,100,,,,,0,"fee schedule",EAPG,12.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",206.64,63,,165.31,,,0,"percent of total billed charges","63% of total billed charges",50.18,15.3,,40.14,,,0,"percent of total billed charges","15.3% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,226.32,69,,,,,0,"fee schedule","69% of total billed charges",328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",12.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",12.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",12.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.46,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,12.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.41,100,,,,,0,"fee schedule","100% of LI fee schedule",7.32,100,,,,,0,"fee schedule",EAPG,12.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.08,100,,,,,0,"fee schedule",EAPG,12.85,100,,,,,0,"fee schedule",EAPG,12.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",123.66,37.7,,98.93,,,0,"percent of total billed charges","37.7% of total billed charges",123.66,37.7,,98.93,,,0,"percent of total billed charges","37.70% of total billed charges",12.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",111.19,33.9,,88.95,,,0,"percent of total billed charges","33.9% of total billed charges",12.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",255.84,78,,204.67,,,0,"percent of total billed charges","78% of total billed charges",12.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",270.93,82.6,,216.74,,,0,"percent of total billed charges","82.6% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,12.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",270.93,82.6,,216.74,,,0,"percent of total billed charges","82.6% of total billed charges",12.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",7.32,328,
"Cord Blood Gas (Arterial)",30082803,CDM,300,RC,82803,CPT,OUTPATIENT,,,433,281.45,,381.04,88,,304.83,,,0,"percent of total billed charges","88% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",45.62,175,,,,,0,"fee schedule","175% of CMS fee schedule",29.67,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",272.79,63,,218.23,,,0,"percent of total billed charges","63% of total billed charges",66.25,15.3,,53.00,,,0,"percent of total billed charges","15.3% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,298.77,69,,,,,0,"fee schedule","69% of total billed charges",433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.71,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.07,100,,,,,0,"fee schedule","100% of LI fee schedule",21.33,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.38,100,,,,,0,"fee schedule",EAPG,37.44,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.24,37.7,,130.59,,,0,"percent of total billed charges","37.7% of total billed charges",163.24,37.7,,130.59,,,0,"percent of total billed charges","37.70% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",146.79,33.9,,117.43,,,0,"percent of total billed charges","33.9% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",337.74,78,,270.19,,,0,"percent of total billed charges","78% of total billed charges",26.33,101,,,,,0,"fee schedule","101% of CMS fee schedule ",357.66,82.6,,286.13,,,0,"percent of total billed charges","82.6% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",357.66,82.6,,286.13,,,0,"percent of total billed charges","82.6% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",21.33,433,
"Cord Blood Gas (Venous)",30082803,CDM,300,RC,82803,CPT,OUTPATIENT,,,433,281.45,,381.04,88,,304.83,,,0,"percent of total billed charges","88% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",45.62,175,,,,,0,"fee schedule","175% of CMS fee schedule",29.67,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",272.79,63,,218.23,,,0,"percent of total billed charges","63% of total billed charges",66.25,15.3,,53.00,,,0,"percent of total billed charges","15.3% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,298.77,69,,,,,0,"fee schedule","69% of total billed charges",433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.71,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.07,100,,,,,0,"fee schedule","100% of LI fee schedule",21.33,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.38,100,,,,,0,"fee schedule",EAPG,37.44,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.24,37.7,,130.59,,,0,"percent of total billed charges","37.7% of total billed charges",163.24,37.7,,130.59,,,0,"percent of total billed charges","37.70% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",146.79,33.9,,117.43,,,0,"percent of total billed charges","33.9% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",337.74,78,,270.19,,,0,"percent of total billed charges","78% of total billed charges",26.33,101,,,,,0,"fee schedule","101% of CMS fee schedule ",357.66,82.6,,286.13,,,0,"percent of total billed charges","82.6% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",357.66,82.6,,286.13,,,0,"percent of total billed charges","82.6% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",21.33,433,
"Coronavirus SARS Ag (Sofia)",30687426,CDM,306,RC,87426,CPT,OUTPATIENT,,,197,128.05,,173.36,88,,138.69,,,0,"percent of total billed charges","88% of total billed charges",35.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,197,100,,157.60,,,0,"percent of total billed charges","100% of total billed charges",61.82,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,35.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.11,63,,99.29,,,0,"percent of total billed charges","63% of total billed charges",30.14,15.3,,24.11,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,135.93,69,,,,,0,"fee schedule","69% of total billed charges",197,100,,157.60,,,0,"percent of total billed charges","100% of total billed charges",35.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",197,100,,157.60,,,0,"percent of total billed charges","100% of total billed charges",35.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",197,100,,157.60,,,0,"percent of total billed charges","100% of total billed charges",35.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.33,382.5,,,,,0,"fee schedule","382.5% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,35.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.33,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,35.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,35.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.27,37.7,,59.42,,,0,"percent of total billed charges","37.7% of total billed charges",74.27,37.7,,59.42,,,0,"percent of total billed charges","37.70% of total billed charges",35.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.78,33.9,,53.42,,,0,"percent of total billed charges","33.9% of total billed charges",35.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",153.66,78,,122.93,,,0,"percent of total billed charges","78% of total billed charges",35.68,101,,,,,0,"fee schedule","101% of CMS fee schedule ",162.72,82.6,,130.18,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,35.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.72,82.6,,130.18,,,0,"percent of total billed charges","82.6% of total billed charges",35.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,197,100,,157.60,,,0,"percent of total billed charges","100% of total billed charges",4.81,197,
"Cortisol Baseline",30082533,CDM,300,RC,82533,CPT,OUTPATIENT,,,388,252.2,,341.44,88,,273.15,,,0,"percent of total billed charges","88% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",28.52,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",244.44,63,,195.55,,,0,"percent of total billed charges","63% of total billed charges",59.36,15.3,,47.49,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,267.72,69,,,,,0,"fee schedule","69% of total billed charges",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.3,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",146.28,37.7,,117.02,,,0,"percent of total billed charges","37.7% of total billed charges",146.28,37.7,,117.02,,,0,"percent of total billed charges","37.70% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",131.53,33.9,,105.22,,,0,"percent of total billed charges","33.9% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",302.64,78,,242.11,,,0,"percent of total billed charges","78% of total billed charges",16.46,101,,,,,0,"fee schedule","101% of CMS fee schedule ",320.49,82.6,,256.39,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",320.49,82.6,,256.39,,,0,"percent of total billed charges","82.6% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",8.39,388,
"Cortisol Stimulated",30080400,CDM,300,RC,80400,CPT,OUTPATIENT,,,339,220.35,,298.32,88,,238.66,,,0,"percent of total billed charges","88% of total billed charges",32.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",57.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",30.04,100,,,,,0,"fee schedule",EAPG,32.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",213.57,63,,170.86,,,0,"percent of total billed charges","63% of total billed charges",51.87,15.3,,41.50,,,0,"percent of total billed charges","15.3% of total billed charges",29.16,100,,,,,0,"fee schedule",EAPG,233.91,69,,,,,0,"fee schedule","69% of total billed charges",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",32.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",32.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",32.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.77,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,32.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.61,100,,,,,0,"fee schedule","100% of LI fee schedule",21.6,100,,,,,0,"fee schedule",EAPG,32.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.74,100,,,,,0,"fee schedule",EAPG,37.91,100,,,,,0,"fee schedule",EAPG,32.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",127.8,37.7,,102.24,,,0,"percent of total billed charges","37.7% of total billed charges",127.8,37.7,,102.24,,,0,"percent of total billed charges","37.70% of total billed charges",32.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",114.92,33.9,,91.94,,,0,"percent of total billed charges","33.9% of total billed charges",32.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",264.42,78,,211.54,,,0,"percent of total billed charges","78% of total billed charges",32.94,101,,,,,0,"fee schedule","101% of CMS fee schedule ",280.01,82.6,,224.01,,,0,"percent of total billed charges","82.6% of total billed charges",29.16,100,,,,,0,"fee schedule",EAPG,32.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",280.01,82.6,,224.01,,,0,"percent of total billed charges","82.6% of total billed charges",32.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",21.6,339,
"Cortisol AM",30182533,CDM,301,RC,82533,CPT,OUTPATIENT,,,172,111.8,,151.36,88,,121.09,,,0,"percent of total billed charges","88% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",28.52,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.36,63,,86.69,,,0,"percent of total billed charges","63% of total billed charges",26.32,15.3,,21.06,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,118.68,69,,,,,0,"fee schedule","69% of total billed charges",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.3,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.84,37.7,,51.87,,,0,"percent of total billed charges","37.7% of total billed charges",64.84,37.7,,51.87,,,0,"percent of total billed charges","37.70% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.31,33.9,,46.65,,,0,"percent of total billed charges","33.9% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.16,78,,107.33,,,0,"percent of total billed charges","78% of total billed charges",16.46,101,,,,,0,"fee schedule","101% of CMS fee schedule ",142.07,82.6,,113.66,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.07,82.6,,113.66,,,0,"percent of total billed charges","82.6% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",8.39,172,
"CORTISOL 24HR URINE",30182530,CDM,301,RC,82530,CPT,OUTPATIENT,,,479,311.35,,421.52,88,,337.22,,,0,"percent of total billed charges","88% of total billed charges",16.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,479,100,,383.20,,,0,"percent of total billed charges","100% of total billed charges",29.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,16.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",301.77,63,,241.42,,,0,"percent of total billed charges","63% of total billed charges",73.29,15.3,,58.63,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,330.51,69,,,,,0,"fee schedule","69% of total billed charges",479,100,,383.20,,,0,"percent of total billed charges","100% of total billed charges",16.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",479,100,,383.20,,,0,"percent of total billed charges","100% of total billed charges",16.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",479,100,,383.20,,,0,"percent of total billed charges","100% of total billed charges",16.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.91,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,16.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.71,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,16.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,16.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",180.58,37.7,,144.46,,,0,"percent of total billed charges","37.7% of total billed charges",180.58,37.7,,144.46,,,0,"percent of total billed charges","37.70% of total billed charges",16.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.38,33.9,,129.90,,,0,"percent of total billed charges","33.9% of total billed charges",16.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",373.62,78,,298.90,,,0,"percent of total billed charges","78% of total billed charges",16.87,101,,,,,0,"fee schedule","101% of CMS fee schedule ",395.65,82.6,,316.52,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,16.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",395.65,82.6,,316.52,,,0,"percent of total billed charges","82.6% of total billed charges",16.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,479,100,,383.20,,,0,"percent of total billed charges","100% of total billed charges",8.11,479,
"Cortisol LC",30182533,CDM,301,RC,82533,CPT,OUTPATIENT,,,164,106.6,,144.32,88,,115.46,,,0,"percent of total billed charges","88% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",28.52,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",103.32,63,,82.66,,,0,"percent of total billed charges","63% of total billed charges",25.09,15.3,,20.07,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,113.16,69,,,,,0,"fee schedule","69% of total billed charges",164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.3,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.83,37.7,,49.46,,,0,"percent of total billed charges","37.7% of total billed charges",61.83,37.7,,49.46,,,0,"percent of total billed charges","37.70% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.6,33.9,,44.48,,,0,"percent of total billed charges","33.9% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",127.92,78,,102.34,,,0,"percent of total billed charges","78% of total billed charges",16.46,101,,,,,0,"fee schedule","101% of CMS fee schedule ",135.46,82.6,,108.37,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",135.46,82.6,,108.37,,,0,"percent of total billed charges","82.6% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",8.39,164,
"Cortisol - AM LC",30182533,CDM,301,RC,82533,CPT,OUTPATIENT,,,436,283.4,,383.68,88,,306.94,,,0,"percent of total billed charges","88% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,436,100,,348.80,,,0,"percent of total billed charges","100% of total billed charges",28.52,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",274.68,63,,219.74,,,0,"percent of total billed charges","63% of total billed charges",66.71,15.3,,53.37,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,300.84,69,,,,,0,"fee schedule","69% of total billed charges",436,100,,348.80,,,0,"percent of total billed charges","100% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",436,100,,348.80,,,0,"percent of total billed charges","100% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",436,100,,348.80,,,0,"percent of total billed charges","100% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.3,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",164.37,37.7,,131.50,,,0,"percent of total billed charges","37.7% of total billed charges",164.37,37.7,,131.50,,,0,"percent of total billed charges","37.70% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",147.8,33.9,,118.24,,,0,"percent of total billed charges","33.9% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",340.08,78,,272.06,,,0,"percent of total billed charges","78% of total billed charges",16.46,101,,,,,0,"fee schedule","101% of CMS fee schedule ",360.14,82.6,,288.11,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",360.14,82.6,,288.11,,,0,"percent of total billed charges","82.6% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,436,100,,348.80,,,0,"percent of total billed charges","100% of total billed charges",8.39,436,
"Cortisol (3 Specimens) LC",30182533,CDM,301,RC,82533,CPT,OUTPATIENT,,,164,106.6,,144.32,88,,115.46,,,0,"percent of total billed charges","88% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",28.52,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",103.32,63,,82.66,,,0,"percent of total billed charges","63% of total billed charges",25.09,15.3,,20.07,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,113.16,69,,,,,0,"fee schedule","69% of total billed charges",164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.3,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.83,37.7,,49.46,,,0,"percent of total billed charges","37.7% of total billed charges",61.83,37.7,,49.46,,,0,"percent of total billed charges","37.70% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.6,33.9,,44.48,,,0,"percent of total billed charges","33.9% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",127.92,78,,102.34,,,0,"percent of total billed charges","78% of total billed charges",16.46,101,,,,,0,"fee schedule","101% of CMS fee schedule ",135.46,82.6,,108.37,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",135.46,82.6,,108.37,,,0,"percent of total billed charges","82.6% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",8.39,164,
"CORTISOL 24HR URINE",30182530,CDM,301,RC,82530,CPT,OUTPATIENT,,,479,311.35,,421.52,88,,337.22,,,0,"percent of total billed charges","88% of total billed charges",16.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,479,100,,383.20,,,0,"percent of total billed charges","100% of total billed charges",29.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,16.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",301.77,63,,241.42,,,0,"percent of total billed charges","63% of total billed charges",73.29,15.3,,58.63,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,330.51,69,,,,,0,"fee schedule","69% of total billed charges",479,100,,383.20,,,0,"percent of total billed charges","100% of total billed charges",16.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",479,100,,383.20,,,0,"percent of total billed charges","100% of total billed charges",16.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",479,100,,383.20,,,0,"percent of total billed charges","100% of total billed charges",16.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.91,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,16.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.71,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,16.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,16.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",180.58,37.7,,144.46,,,0,"percent of total billed charges","37.7% of total billed charges",180.58,37.7,,144.46,,,0,"percent of total billed charges","37.70% of total billed charges",16.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.38,33.9,,129.90,,,0,"percent of total billed charges","33.9% of total billed charges",16.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",373.62,78,,298.90,,,0,"percent of total billed charges","78% of total billed charges",16.87,101,,,,,0,"fee schedule","101% of CMS fee schedule ",395.65,82.6,,316.52,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,16.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",395.65,82.6,,316.52,,,0,"percent of total billed charges","82.6% of total billed charges",16.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,479,100,,383.20,,,0,"percent of total billed charges","100% of total billed charges",8.11,479,
"Cortisol PM",30082533,CDM,300,RC,82533,CPT,OUTPATIENT,,,388,252.2,,341.44,88,,273.15,,,0,"percent of total billed charges","88% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",28.52,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",244.44,63,,195.55,,,0,"percent of total billed charges","63% of total billed charges",59.36,15.3,,47.49,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,267.72,69,,,,,0,"fee schedule","69% of total billed charges",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.3,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",146.28,37.7,,117.02,,,0,"percent of total billed charges","37.7% of total billed charges",146.28,37.7,,117.02,,,0,"percent of total billed charges","37.70% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",131.53,33.9,,105.22,,,0,"percent of total billed charges","33.9% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",302.64,78,,242.11,,,0,"percent of total billed charges","78% of total billed charges",16.46,101,,,,,0,"fee schedule","101% of CMS fee schedule ",320.49,82.6,,256.39,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",320.49,82.6,,256.39,,,0,"percent of total billed charges","82.6% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",8.39,388,
"Cortisol Dexamethasone Reflex LC",30182533,CDM,301,RC,82533,CPT,OUTPATIENT,,,231,150.15,,203.28,88,,162.62,,,0,"percent of total billed charges","88% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,231,100,,184.80,,,0,"percent of total billed charges","100% of total billed charges",28.52,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",145.53,63,,116.42,,,0,"percent of total billed charges","63% of total billed charges",35.34,15.3,,28.27,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,159.39,69,,,,,0,"fee schedule","69% of total billed charges",231,100,,184.80,,,0,"percent of total billed charges","100% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",231,100,,184.80,,,0,"percent of total billed charges","100% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",231,100,,184.80,,,0,"percent of total billed charges","100% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.3,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.09,37.7,,69.67,,,0,"percent of total billed charges","37.7% of total billed charges",87.09,37.7,,69.67,,,0,"percent of total billed charges","37.70% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.31,33.9,,62.65,,,0,"percent of total billed charges","33.9% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",180.18,78,,144.14,,,0,"percent of total billed charges","78% of total billed charges",16.46,101,,,,,0,"fee schedule","101% of CMS fee schedule ",190.81,82.6,,152.65,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",190.81,82.6,,152.65,,,0,"percent of total billed charges","82.6% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,231,100,,184.80,,,0,"percent of total billed charges","100% of total billed charges",8.39,231,
"CREATININE CLEARANCE",30182575,CDM,301,RC,82575,CPT,OUTPATIENT,,,173,112.45,,152.24,88,,121.79,,,0,"percent of total billed charges","88% of total billed charges",9.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",16.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,9.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.99,63,,87.19,,,0,"percent of total billed charges","63% of total billed charges",26.47,15.3,,21.18,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,119.37,69,,,,,0,"fee schedule","69% of total billed charges",173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",9.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",9.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",9.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.18,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,9.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.46,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,9.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,9.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.22,37.7,,52.18,,,0,"percent of total billed charges","37.7% of total billed charges",65.22,37.7,,52.18,,,0,"percent of total billed charges","37.70% of total billed charges",9.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.65,33.9,,46.92,,,0,"percent of total billed charges","33.9% of total billed charges",9.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.94,78,,107.95,,,0,"percent of total billed charges","78% of total billed charges",9.55,101,,,,,0,"fee schedule","101% of CMS fee schedule ",142.9,82.6,,114.32,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,9.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.9,82.6,,114.32,,,0,"percent of total billed charges","82.6% of total billed charges",9.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,173,
"Creatine Kinase (CPK)",30182550,CDM,301,RC,82550,CPT,OUTPATIENT,,,136,88.4,,119.68,88,,95.74,,,0,"percent of total billed charges","88% of total billed charges",6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",11.39,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.68,63,,68.54,,,0,"percent of total billed charges","63% of total billed charges",20.81,15.3,,16.65,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,93.84,69,,,,,0,"fee schedule","69% of total billed charges",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.9,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.51,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.27,37.7,,41.02,,,0,"percent of total billed charges","37.7% of total billed charges",51.27,37.7,,41.02,,,0,"percent of total billed charges","37.70% of total billed charges",6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.1,33.9,,36.88,,,0,"percent of total billed charges","33.9% of total billed charges",6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.08,78,,84.86,,,0,"percent of total billed charges","78% of total billed charges",6.57,101,,,,,0,"fee schedule","101% of CMS fee schedule ",112.34,82.6,,89.87,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",112.34,82.6,,89.87,,,0,"percent of total billed charges","82.6% of total billed charges",6.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",3.25,136,
"Creatinine 24 Hr Urine",30182570,CDM,301,RC,82570,CPT,OUTPATIENT,,,78,50.7,,68.64,88,,54.91,,,0,"percent of total billed charges","88% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",9.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.14,63,,39.31,,,0,"percent of total billed charges","63% of total billed charges",11.93,15.3,,9.54,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,53.82,69,,,,,0,"fee schedule","69% of total billed charges",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.81,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.41,37.7,,23.53,,,0,"percent of total billed charges","37.7% of total billed charges",29.41,37.7,,23.53,,,0,"percent of total billed charges","37.70% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.44,33.9,,21.15,,,0,"percent of total billed charges","33.9% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.84,78,,48.67,,,0,"percent of total billed charges","78% of total billed charges",5.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,78,
"Creatinine Urine",30182570,CDM,301,RC,82570,CPT,OUTPATIENT,,,78,50.7,,68.64,88,,54.91,,,0,"percent of total billed charges","88% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",9.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.14,63,,39.31,,,0,"percent of total billed charges","63% of total billed charges",11.93,15.3,,9.54,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,53.82,69,,,,,0,"fee schedule","69% of total billed charges",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.81,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.41,37.7,,23.53,,,0,"percent of total billed charges","37.7% of total billed charges",29.41,37.7,,23.53,,,0,"percent of total billed charges","37.70% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.44,33.9,,21.15,,,0,"percent of total billed charges","33.9% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.84,78,,48.67,,,0,"percent of total billed charges","78% of total billed charges",5.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,78,
"Creatinine Serum",30182565,CDM,301,RC,82565,CPT,OUTPATIENT,,,82,53.3,,72.16,88,,57.73,,,0,"percent of total billed charges","88% of total billed charges",5.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",8.96,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.66,63,,41.33,,,0,"percent of total billed charges","63% of total billed charges",12.55,15.3,,10.04,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,56.58,69,,,,,0,"fee schedule","69% of total billed charges",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",5.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",5.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",5.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.58,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.12,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.91,37.7,,24.73,,,0,"percent of total billed charges","37.7% of total billed charges",30.91,37.7,,24.73,,,0,"percent of total billed charges","37.70% of total billed charges",5.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.8,33.9,,22.24,,,0,"percent of total billed charges","33.9% of total billed charges",5.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.96,78,,51.17,,,0,"percent of total billed charges","78% of total billed charges",5.17,101,,,,,0,"fee schedule","101% of CMS fee schedule ",67.73,82.6,,54.18,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.73,82.6,,54.18,,,0,"percent of total billed charges","82.6% of total billed charges",5.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,82,
"Creatinine Body Fluid",30182570,CDM,301,RC,82570,CPT,OUTPATIENT,,,78,50.7,,68.64,88,,54.91,,,0,"percent of total billed charges","88% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",9.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.14,63,,39.31,,,0,"percent of total billed charges","63% of total billed charges",11.93,15.3,,9.54,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,53.82,69,,,,,0,"fee schedule","69% of total billed charges",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.81,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.41,37.7,,23.53,,,0,"percent of total billed charges","37.7% of total billed charges",29.41,37.7,,23.53,,,0,"percent of total billed charges","37.70% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.44,33.9,,21.15,,,0,"percent of total billed charges","33.9% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.84,78,,48.67,,,0,"percent of total billed charges","78% of total billed charges",5.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,78,
"CreatU+5 HIAA LC",30182570,CDM,301,RC,82570,CPT,OUTPATIENT,,,88,57.2,,77.44,88,,61.95,,,0,"percent of total billed charges","88% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",9.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.44,63,,44.35,,,0,"percent of total billed charges","63% of total billed charges",13.46,15.3,,10.77,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,60.72,69,,,,,0,"fee schedule","69% of total billed charges",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.81,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.18,37.7,,26.54,,,0,"percent of total billed charges","37.7% of total billed charges",33.18,37.7,,26.54,,,0,"percent of total billed charges","37.70% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.83,33.9,,23.86,,,0,"percent of total billed charges","33.9% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.64,78,,54.91,,,0,"percent of total billed charges","78% of total billed charges",5.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,88,
"Creatine Kinase (CK), MB/Total LC",30182553,CDM,301,RC,82553,CPT,OUTPATIENT,,,207,134.55,,182.16,88,,145.73,,,0,"percent of total billed charges","88% of total billed charges",11.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",20.21,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,11.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",130.41,63,,104.33,,,0,"percent of total billed charges","63% of total billed charges",31.67,15.3,,25.34,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,142.83,69,,,,,0,"fee schedule","69% of total billed charges",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",11.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",11.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",11.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.17,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,11.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.55,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,11.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,11.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.04,37.7,,62.43,,,0,"percent of total billed charges","37.7% of total billed charges",78.04,37.7,,62.43,,,0,"percent of total billed charges","37.70% of total billed charges",11.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.17,33.9,,56.14,,,0,"percent of total billed charges","33.9% of total billed charges",11.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",161.46,78,,129.17,,,0,"percent of total billed charges","78% of total billed charges",11.66,101,,,,,0,"fee schedule","101% of CMS fee schedule ",170.98,82.6,,136.78,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,11.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.98,82.6,,136.78,,,0,"percent of total billed charges","82.6% of total billed charges",11.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",8.11,207,
"CREATININE CLEARANCE",30182575,CDM,301,RC,82575,CPT,OUTPATIENT,,,173,112.45,,152.24,88,,121.79,,,0,"percent of total billed charges","88% of total billed charges",9.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",16.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,9.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.99,63,,87.19,,,0,"percent of total billed charges","63% of total billed charges",26.47,15.3,,21.18,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,119.37,69,,,,,0,"fee schedule","69% of total billed charges",173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",9.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",9.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",9.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.18,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,9.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.46,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,9.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,9.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.22,37.7,,52.18,,,0,"percent of total billed charges","37.7% of total billed charges",65.22,37.7,,52.18,,,0,"percent of total billed charges","37.70% of total billed charges",9.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.65,33.9,,46.92,,,0,"percent of total billed charges","33.9% of total billed charges",9.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.94,78,,107.95,,,0,"percent of total billed charges","78% of total billed charges",9.55,101,,,,,0,"fee schedule","101% of CMS fee schedule ",142.9,82.6,,114.32,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,9.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.9,82.6,,114.32,,,0,"percent of total billed charges","82.6% of total billed charges",9.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,173,
"Cryoglobulin, Ql, Rflx LC",30182595,CDM,301,RC,82595,CPT,OUTPATIENT,,,85,55.25,,74.8,88,,59.84,,,0,"percent of total billed charges","88% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",11.32,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.55,63,,42.84,,,0,"percent of total billed charges","63% of total billed charges",13.01,15.3,,10.41,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,58.65,69,,,,,0,"fee schedule","69% of total billed charges",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.74,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.47,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.05,37.7,,25.64,,,0,"percent of total billed charges","37.7% of total billed charges",32.05,37.7,,25.64,,,0,"percent of total billed charges","37.70% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.82,33.9,,23.06,,,0,"percent of total billed charges","33.9% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.3,78,,53.04,,,0,"percent of total billed charges","78% of total billed charges",6.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",70.21,82.6,,56.17,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.21,82.6,,56.17,,,0,"percent of total billed charges","82.6% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",3.25,85,
"CRYPTOSPORIUM ANTIGEN",30687328,CDM,306,RC,87328,CPT,OUTPATIENT,,,81,52.65,,71.28,88,,57.02,,,0,"percent of total billed charges","88% of total billed charges",13.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",24.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,13.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.03,63,,40.82,,,0,"percent of total billed charges","63% of total billed charges",12.39,15.3,,9.91,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,55.89,69,,,,,0,"fee schedule","69% of total billed charges",81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",13.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",13.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",13.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.86,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,13.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.82,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,13.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,13.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.54,37.7,,24.43,,,0,"percent of total billed charges","37.7% of total billed charges",30.54,37.7,,24.43,,,0,"percent of total billed charges","37.70% of total billed charges",13.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.46,33.9,,21.97,,,0,"percent of total billed charges","33.9% of total billed charges",13.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.18,78,,50.54,,,0,"percent of total billed charges","78% of total billed charges",13.95,101,,,,,0,"fee schedule","101% of CMS fee schedule ",66.91,82.6,,53.53,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,13.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.91,82.6,,53.53,,,0,"percent of total billed charges","82.6% of total billed charges",13.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",4.81,81,
"Cryptococcus Antigen CSF",30287327,CDM,302,RC,87327,CPT,OUTPATIENT,,,122,79.3,,107.36,88,,85.89,,,0,"percent of total billed charges","88% of total billed charges",13.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,122,100,,97.60,,,0,"percent of total billed charges","100% of total billed charges",23.48,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,13.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.86,63,,61.49,,,0,"percent of total billed charges","63% of total billed charges",18.67,15.3,,14.94,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,84.18,69,,,,,0,"fee schedule","69% of total billed charges",122,100,,97.60,,,0,"percent of total billed charges","100% of total billed charges",13.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",122,100,,97.60,,,0,"percent of total billed charges","100% of total billed charges",13.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",122,100,,97.60,,,0,"percent of total billed charges","100% of total billed charges",13.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.33,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,13.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.42,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,13.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,13.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.99,37.7,,36.79,,,0,"percent of total billed charges","37.7% of total billed charges",45.99,37.7,,36.79,,,0,"percent of total billed charges","37.70% of total billed charges",13.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.36,33.9,,33.09,,,0,"percent of total billed charges","33.9% of total billed charges",13.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.16,78,,76.13,,,0,"percent of total billed charges","78% of total billed charges",13.55,101,,,,,0,"fee schedule","101% of CMS fee schedule ",100.77,82.6,,80.62,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,13.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.77,82.6,,80.62,,,0,"percent of total billed charges","82.6% of total billed charges",13.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,122,100,,97.60,,,0,"percent of total billed charges","100% of total billed charges",4.81,122,
"Cryptococcus Antigen, Serum LC",30687899,CDM,306,RC,87899,CPT,OUTPATIENT,,,116,75.4,,102.08,88,,81.66,,,0,"percent of total billed charges","88% of total billed charges",16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",28.12,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.08,63,,58.46,,,0,"percent of total billed charges","63% of total billed charges",17.75,15.3,,14.20,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,80.04,69,,,,,0,"fee schedule","69% of total billed charges",116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.46,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.07,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.73,37.7,,34.98,,,0,"percent of total billed charges","37.7% of total billed charges",43.73,37.7,,34.98,,,0,"percent of total billed charges","37.70% of total billed charges",16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.32,33.9,,31.46,,,0,"percent of total billed charges","33.9% of total billed charges",16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.48,78,,72.38,,,0,"percent of total billed charges","78% of total billed charges",16.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",95.82,82.6,,76.66,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.82,82.6,,76.66,,,0,"percent of total billed charges","82.6% of total billed charges",16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",4.81,116,
"Crystal Examination Body Fluid",30089060,CDM,300,RC,89060,CPT,OUTPATIENT,,,73,47.45,,64.24,88,,51.39,,,0,"percent of total billed charges","88% of total billed charges",7.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.65,100,,,,,0,"fee schedule",EAPG,73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",12.82,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.91,100,,,,,0,"fee schedule",EAPG,7.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.99,63,,36.79,,,0,"percent of total billed charges","63% of total billed charges",11.17,15.3,,8.94,,,0,"percent of total billed charges","15.3% of total billed charges",8.65,100,,,,,0,"fee schedule",EAPG,50.37,69,,,,,0,"fee schedule","69% of total billed charges",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",7.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",7.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",7.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.03,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.65,100,,,,,0,"fee schedule",EAPG,7.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.33,100,,,,,0,"fee schedule","100% of LI fee schedule",6.4,100,,,,,0,"fee schedule",EAPG,7.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.82,100,,,,,0,"fee schedule",EAPG,11.24,100,,,,,0,"fee schedule",EAPG,7.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.52,37.7,,22.02,,,0,"percent of total billed charges","37.7% of total billed charges",27.52,37.7,,22.02,,,0,"percent of total billed charges","37.70% of total billed charges",7.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,33.9,,19.80,,,0,"percent of total billed charges","33.9% of total billed charges",7.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.94,78,,45.55,,,0,"percent of total billed charges","78% of total billed charges",7.4,101,,,,,0,"fee schedule","101% of CMS fee schedule ",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",8.65,100,,,,,0,"fee schedule",EAPG,7.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",7.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.65,100,,,,,0,"fee schedule",EAPG,73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",6.4,73,
"Pathology Billing Non-Gyn Cytology",30687591,CDM,306,RC,87591,CPT,OUTPATIENT,,,226,146.9,,198.88,88,,159.10,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.38,63,,113.90,,,0,"percent of total billed charges","63% of total billed charges",34.58,15.3,,27.66,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,155.94,69,,,,,0,"fee schedule","69% of total billed charges",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.2,37.7,,68.16,,,0,"percent of total billed charges","37.7% of total billed charges",85.2,37.7,,68.16,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.61,33.9,,61.29,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",176.28,78,,141.02,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",186.68,82.6,,149.34,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",186.68,82.6,,149.34,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",18.33,226,
"Ct, Ng, Trich vag by NAA LC",30687491,CDM,306,RC,87494,CPT,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.7% of total billed charges",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.83,33.9,,55.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"Ct/GC NAA, Rectal LC",30687491,CDM,306,RC,87494,CPT,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.7% of total billed charges",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.83,33.9,,55.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"Ct/GC NAA, Pharyngeal LC",30687591,CDM,306,RC,87494,CPT,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.7% of total billed charges",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.83,33.9,,55.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"GC by Nucleic Acid Amplification",30687591,CDM,306,RC,87591,CPT,OUTPATIENT,,,226,146.9,,198.88,88,,159.10,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.38,63,,113.90,,,0,"percent of total billed charges","63% of total billed charges",34.58,15.3,,27.66,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,155.94,69,,,,,0,"fee schedule","69% of total billed charges",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.2,37.7,,68.16,,,0,"percent of total billed charges","37.7% of total billed charges",85.2,37.7,,68.16,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.61,33.9,,61.29,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",176.28,78,,141.02,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",186.68,82.6,,149.34,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",186.68,82.6,,149.34,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",18.33,226,
"Cyclosporine, Blood LC",30180158,CDM,301,RC,80158,CPT,OUTPATIENT,,,911,592.15,,801.68,88,,641.34,,,0,"percent of total billed charges","88% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,911,100,,728.80,,,0,"percent of total billed charges","100% of total billed charges",31.58,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",573.93,63,,459.14,,,0,"percent of total billed charges","63% of total billed charges",139.38,15.3,,111.50,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,628.59,69,,,,,0,"fee schedule","69% of total billed charges",911,100,,728.80,,,0,"percent of total billed charges","100% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",911,100,,728.80,,,0,"percent of total billed charges","100% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",911,100,,728.80,,,0,"percent of total billed charges","100% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.04,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.05,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",343.45,37.7,,274.76,,,0,"percent of total billed charges","37.7% of total billed charges",343.45,37.7,,274.76,,,0,"percent of total billed charges","37.70% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",308.83,33.9,,247.06,,,0,"percent of total billed charges","33.9% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",710.58,78,,568.46,,,0,"percent of total billed charges","78% of total billed charges",18.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",752.49,82.6,,601.99,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",752.49,82.6,,601.99,,,0,"percent of total billed charges","82.6% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,911,100,,728.80,,,0,"percent of total billed charges","100% of total billed charges",7,911,
"Cystic Fibrosis Profile LC",30181220,CDM,301,RC,81220,CPT,OUTPATIENT,,,390,253.5,,343.2,88,,274.56,,,0,"percent of total billed charges","88% of total billed charges",556.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",364.01,100,,,,,0,"fee schedule",EAPG,390,100,,312.00,,,0,"percent of total billed charges","100% of total billed charges",974.05,175,,,,,0,"fee schedule","175% of CMS fee schedule",374.93,100,,,,,0,"fee schedule",EAPG,556.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",245.7,63,,196.56,,,0,"percent of total billed charges","63% of total billed charges",59.67,15.3,,47.74,,,0,"percent of total billed charges","15.3% of total billed charges",364.01,100,,,,,0,"fee schedule",EAPG,269.1,69,,,,,0,"fee schedule","69% of total billed charges",390,100,,312.00,,,0,"percent of total billed charges","100% of total billed charges",556.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",390,100,,312.00,,,0,"percent of total billed charges","100% of total billed charges",556.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",390,100,,312.00,,,0,"percent of total billed charges","100% of total billed charges",556.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",2128.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",364.01,100,,,,,0,"fee schedule",EAPG,556.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",556.6,100,,,,,0,"fee schedule","100% of LI fee schedule",269.63,100,,,,,0,"fee schedule",EAPG,556.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",371.29,100,,,,,0,"fee schedule",EAPG,473.21,100,,,,,0,"fee schedule",EAPG,556.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",147.03,37.7,,117.62,,,0,"percent of total billed charges","37.7% of total billed charges",147.03,37.7,,117.62,,,0,"percent of total billed charges","37.70% of total billed charges",556.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",132.21,33.9,,105.77,,,0,"percent of total billed charges","33.9% of total billed charges",556.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",304.2,78,,243.36,,,0,"percent of total billed charges","78% of total billed charges",562.16,101,,,,,0,"fee schedule","101% of CMS fee schedule ",322.14,82.6,,257.71,,,0,"percent of total billed charges","82.6% of total billed charges",364.01,100,,,,,0,"fee schedule",EAPG,556.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",322.14,82.6,,257.71,,,0,"percent of total billed charges","82.6% of total billed charges",556.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",364.01,100,,,,,0,"fee schedule",EAPG,390,100,,312.00,,,0,"percent of total billed charges","100% of total billed charges",59.67,2128.99,
"CYSTATIN C",30182610,CDM,301,RC,82610,CPT,OUTPATIENT,,,125,81.25,,110,88,,88.00,,,0,"percent of total billed charges","88% of total billed charges",18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",32.41,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.75,63,,63.00,,,0,"percent of total billed charges","63% of total billed charges",19.13,15.3,,15.30,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,86.25,69,,,,,0,"fee schedule","69% of total billed charges",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.83,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.52,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.13,37.7,,37.70,,,0,"percent of total billed charges","37.7% of total billed charges",47.13,37.7,,37.70,,,0,"percent of total billed charges","37.70% of total billed charges",18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.38,33.9,,33.90,,,0,"percent of total billed charges","33.9% of total billed charges",18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.5,78,,78.00,,,0,"percent of total billed charges","78% of total billed charges",18.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",103.25,82.6,,82.60,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",103.25,82.6,,82.60,,,0,"percent of total billed charges","82.6% of total billed charges",18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",8.11,125,
"Cytomegalovirus (CMV) Ab, IgM LC",30286645,CDM,302,RC,86645,CPT,OUTPATIENT,,,384,249.6,,337.92,88,,270.34,,,0,"percent of total billed charges","88% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,384,100,,307.20,,,0,"percent of total billed charges","100% of total billed charges",29.48,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",241.92,63,,193.54,,,0,"percent of total billed charges","63% of total billed charges",58.75,15.3,,47.00,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,264.96,69,,,,,0,"fee schedule","69% of total billed charges",384,100,,307.20,,,0,"percent of total billed charges","100% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",384,100,,307.20,,,0,"percent of total billed charges","100% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",384,100,,307.20,,,0,"percent of total billed charges","100% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.45,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.85,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.77,37.7,,115.82,,,0,"percent of total billed charges","37.7% of total billed charges",144.77,37.7,,115.82,,,0,"percent of total billed charges","37.70% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",130.18,33.9,,104.14,,,0,"percent of total billed charges","33.9% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",299.52,78,,239.62,,,0,"percent of total billed charges","78% of total billed charges",17.01,101,,,,,0,"fee schedule","101% of CMS fee schedule ",317.18,82.6,,253.74,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",317.18,82.6,,253.74,,,0,"percent of total billed charges","82.6% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,384,100,,307.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,384,
D-Dimer,30585379,CDM,305,RC,85379,CPT,OUTPATIENT,,,153,99.45,,134.64,88,,107.71,,,0,"percent of total billed charges","88% of total billed charges",10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",17.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",96.39,63,,77.11,,,0,"percent of total billed charges","63% of total billed charges",23.41,15.3,,18.73,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,105.57,69,,,,,0,"fee schedule","69% of total billed charges",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.93,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.18,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.68,37.7,,46.14,,,0,"percent of total billed charges","37.7% of total billed charges",57.68,37.7,,46.14,,,0,"percent of total billed charges","37.70% of total billed charges",10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.87,33.9,,41.50,,,0,"percent of total billed charges","33.9% of total billed charges",10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",119.34,78,,95.47,,,0,"percent of total billed charges","78% of total billed charges",10.28,101,,,,,0,"fee schedule","101% of CMS fee schedule ",126.38,82.6,,101.10,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",126.38,82.6,,101.10,,,0,"percent of total billed charges","82.6% of total billed charges",10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",2.48,153,
"DHEA-Sulfate LC",30082627,CDM,300,RC,82627,CPT,OUTPATIENT,,,455,295.75,,400.4,88,,320.32,,,0,"percent of total billed charges","88% of total billed charges",22.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,455,100,,364.00,,,0,"percent of total billed charges","100% of total billed charges",38.9,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,22.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",286.65,63,,229.32,,,0,"percent of total billed charges","63% of total billed charges",69.62,15.3,,55.70,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,313.95,69,,,,,0,"fee schedule","69% of total billed charges",455,100,,364.00,,,0,"percent of total billed charges","100% of total billed charges",22.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",455,100,,364.00,,,0,"percent of total billed charges","100% of total billed charges",22.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",455,100,,364.00,,,0,"percent of total billed charges","100% of total billed charges",22.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.02,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,22.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.23,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,22.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,22.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",171.54,37.7,,137.23,,,0,"percent of total billed charges","37.7% of total billed charges",171.54,37.7,,137.23,,,0,"percent of total billed charges","37.70% of total billed charges",22.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",154.25,33.9,,123.40,,,0,"percent of total billed charges","33.9% of total billed charges",22.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",354.9,78,,283.92,,,0,"percent of total billed charges","78% of total billed charges",22.45,101,,,,,0,"fee schedule","101% of CMS fee schedule ",375.83,82.6,,300.66,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,22.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",375.83,82.6,,300.66,,,0,"percent of total billed charges","82.6% of total billed charges",22.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,455,100,,364.00,,,0,"percent of total billed charges","100% of total billed charges",8.39,455,
"DHEA LC",30182626,CDM,301,RC,82626,CPT,OUTPATIENT,,,173,112.45,,152.24,88,,121.79,,,0,"percent of total billed charges","88% of total billed charges",25.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",44.22,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,25.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.99,63,,87.19,,,0,"percent of total billed charges","63% of total billed charges",26.47,15.3,,21.18,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,119.37,69,,,,,0,"fee schedule","69% of total billed charges",173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",25.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",25.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",25.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",96.65,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,25.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.27,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,25.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,25.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.22,37.7,,52.18,,,0,"percent of total billed charges","37.7% of total billed charges",65.22,37.7,,52.18,,,0,"percent of total billed charges","37.70% of total billed charges",25.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.65,33.9,,46.92,,,0,"percent of total billed charges","33.9% of total billed charges",25.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.94,78,,107.95,,,0,"percent of total billed charges","78% of total billed charges",25.52,101,,,,,0,"fee schedule","101% of CMS fee schedule ",142.9,82.6,,114.32,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,25.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.9,82.6,,114.32,,,0,"percent of total billed charges","82.6% of total billed charges",25.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,173,
"DUI Legal Blood Draw",DUI,CDM,300,RC,36415,CPT,OUTPATIENT,,,96,62.4,,,,,,,,0,other,"not separately reimbursment",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.1,100,,,,,0,"fee schedule",EAPG,96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",15.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",2.16,100,,,,,0,"fee schedule",EAPG,8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",14.69,15.3,,11.75,,,0,"percent of total billed charges","15.3% of total billed charges",2.1,100,,,,,0,"fee schedule",EAPG,66.24,69,,,,,0,"fee schedule","69% of total billed charges",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.47,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",2.1,100,,,,,0,"fee schedule",EAPG,8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.83,100,,,,,0,"fee schedule","100% of LI fee schedule",1.55,100,,,,,0,"fee schedule",EAPG,8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.14,100,,,,,0,"fee schedule",EAPG,2.73,100,,,,,0,"fee schedule",EAPG,8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.19,37.7,,28.95,,,0,"percent of total billed charges","37.7% of total billed charges",36.19,37.7,,28.95,,,0,"percent of total billed charges","37.70% of total billed charges",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.54,33.9,,26.03,,,0,"percent of total billed charges","33.9% of total billed charges",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.88,78,,59.90,,,0,"percent of total billed charges","78% of total billed charges",8.91,101,,,,,0,"fee schedule","101% of CMS fee schedule ",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",2.1,100,,,,,0,"fee schedule",EAPG,8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.1,100,,,,,0,"fee schedule",EAPG,96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",1.55,96,
"Dexamethasone, Serum LC",30180299,CDM,301,RC,80299,CPT,OUTPATIENT,,,98,63.7,,86.24,88,,68.99,,,0,"percent of total billed charges","88% of total billed charges",18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",32.62,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.74,63,,49.39,,,0,"percent of total billed charges","63% of total billed charges",14.99,15.3,,11.99,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,67.62,69,,,,,0,"fee schedule","69% of total billed charges",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.29,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.64,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.95,37.7,,29.56,,,0,"percent of total billed charges","37.7% of total billed charges",36.95,37.7,,29.56,,,0,"percent of total billed charges","37.70% of total billed charges",18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.22,33.9,,26.58,,,0,"percent of total billed charges","33.9% of total billed charges",18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.44,78,,61.15,,,0,"percent of total billed charges","78% of total billed charges",18.82,101,,,,,0,"fee schedule","101% of CMS fee schedule ",80.95,82.6,,64.76,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.95,82.6,,64.76,,,0,"percent of total billed charges","82.6% of total billed charges",18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",7,98,
"Digitoxin LC",30180299,CDM,301,RC,80299,CPT,OUTPATIENT,,,274,178.1,,241.12,88,,192.90,,,0,"percent of total billed charges","88% of total billed charges",18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,274,100,,219.20,,,0,"percent of total billed charges","100% of total billed charges",32.62,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",172.62,63,,138.10,,,0,"percent of total billed charges","63% of total billed charges",41.92,15.3,,33.54,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,189.06,69,,,,,0,"fee schedule","69% of total billed charges",274,100,,219.20,,,0,"percent of total billed charges","100% of total billed charges",18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",274,100,,219.20,,,0,"percent of total billed charges","100% of total billed charges",18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",274,100,,219.20,,,0,"percent of total billed charges","100% of total billed charges",18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.29,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.64,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",103.3,37.7,,82.64,,,0,"percent of total billed charges","37.7% of total billed charges",103.3,37.7,,82.64,,,0,"percent of total billed charges","37.70% of total billed charges",18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.89,33.9,,74.31,,,0,"percent of total billed charges","33.9% of total billed charges",18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",213.72,78,,170.98,,,0,"percent of total billed charges","78% of total billed charges",18.82,101,,,,,0,"fee schedule","101% of CMS fee schedule ",226.32,82.6,,181.06,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.32,82.6,,181.06,,,0,"percent of total billed charges","82.6% of total billed charges",18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,274,100,,219.20,,,0,"percent of total billed charges","100% of total billed charges",7,274,
"Digoxin Total",30180162,CDM,301,RC,80162,CPT,OUTPATIENT,,,246,159.9,,216.48,88,,173.18,,,0,"percent of total billed charges","88% of total billed charges",13.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",23.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,13.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",154.98,63,,123.98,,,0,"percent of total billed charges","63% of total billed charges",37.64,15.3,,30.11,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,169.74,69,,,,,0,"fee schedule","69% of total billed charges",246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",13.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",13.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",13.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.79,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,13.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.28,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,13.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,13.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.74,37.7,,74.19,,,0,"percent of total billed charges","37.7% of total billed charges",92.74,37.7,,74.19,,,0,"percent of total billed charges","37.70% of total billed charges",13.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",83.39,33.9,,66.71,,,0,"percent of total billed charges","33.9% of total billed charges",13.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",191.88,78,,153.50,,,0,"percent of total billed charges","78% of total billed charges",13.41,101,,,,,0,"fee schedule","101% of CMS fee schedule ",203.2,82.6,,162.56,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,13.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",203.2,82.6,,162.56,,,0,"percent of total billed charges","82.6% of total billed charges",13.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",7,246,
"Drug Screen 10 w/Conf LC",30080307,CDM,300,RC,80307,CPT,OUTPATIENT,,,346,224.9,,304.48,88,,243.58,,,0,"percent of total billed charges","88% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.13,16.8,,46.50,,,0,"percent of total billed charges","16.8% of total billed charges",346,100,,276.80,,,0,"percent of total billed charges","100% of total billed charges",108.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",59.87,17.304,,47.90,,,0,"percent of total billed charges","17.304% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",217.98,63,,174.38,,,0,"percent of total billed charges","63% of total billed charges",52.94,15.3,,42.35,,,0,"percent of total billed charges","15.3% of total billed charges",58.13,16.8,,46.50,,,0,"percent of total billed charges","16.8% of total billed charges",238.74,69,,,,,0,"fee schedule","69% of total billed charges",346,100,,276.80,,,0,"percent of total billed charges","100% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",346,100,,276.80,,,0,"percent of total billed charges","100% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",346,100,,276.80,,,0,"percent of total billed charges","100% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",237.68,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",58.13,16.8,,46.50,,,0,"percent of total billed charges","16.8% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.14,100,,,,,0,"fee schedule","100% of LI fee schedule",58.13,16.8,,46.50,,,0,"percent of total billed charges","16.8% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.29,17.136,,47.43,,,0,"percent of total billed charges","17.136% of total billed charges",75.57,21.84,,60.46,,,0,"percent of total billed charges","21.84% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",130.44,37.7,,104.35,,,0,"percent of total billed charges","37.7% of total billed charges",130.44,37.7,,104.35,,,0,"percent of total billed charges","37.70% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",117.29,33.9,,93.83,,,0,"percent of total billed charges","33.9% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",269.88,78,,215.90,,,0,"percent of total billed charges","78% of total billed charges",62.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",285.8,82.6,,228.64,,,0,"percent of total billed charges","82.6% of total billed charges",58.13,16.8,,46.50,,,0,"percent of total billed charges","16.8% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",285.8,82.6,,228.64,,,0,"percent of total billed charges","82.6% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.13,16.8,,46.50,,,0,"percent of total billed charges","16.8% of total billed charges",346,100,,276.80,,,0,"percent of total billed charges","100% of total billed charges",52.94,346,
"E coli Shiga Toxin EIA LC",30687427,CDM,306,RC,87427,CPT,OUTPATIENT,,,79,51.35,,69.52,88,,55.62,,,0,"percent of total billed charges","88% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",20.96,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.77,63,,39.82,,,0,"percent of total billed charges","63% of total billed charges",12.09,15.3,,9.67,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,54.51,69,,,,,0,"fee schedule","69% of total billed charges",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.82,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.98,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.78,37.7,,23.82,,,0,"percent of total billed charges","37.7% of total billed charges",29.78,37.7,,23.82,,,0,"percent of total billed charges","37.70% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.78,33.9,,21.42,,,0,"percent of total billed charges","33.9% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.62,78,,49.30,,,0,"percent of total billed charges","78% of total billed charges",12.09,101,,,,,0,"fee schedule","101% of CMS fee schedule ",65.25,82.6,,52.20,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.25,82.6,,52.20,,,0,"percent of total billed charges","82.6% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,79,
"EBV Ab VCA, IgG LC",30286665,CDM,302,RC,86665,CPT,OUTPATIENT,,,349,226.85,,307.12,88,,245.70,,,0,"percent of total billed charges","88% of total billed charges",18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,349,100,,279.20,,,0,"percent of total billed charges","100% of total billed charges",31.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",219.87,63,,175.90,,,0,"percent of total billed charges","63% of total billed charges",53.4,15.3,,42.72,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,240.81,69,,,,,0,"fee schedule","69% of total billed charges",349,100,,279.20,,,0,"percent of total billed charges","100% of total billed charges",18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",349,100,,279.20,,,0,"percent of total billed charges","100% of total billed charges",18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",349,100,,279.20,,,0,"percent of total billed charges","100% of total billed charges",18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.38,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.14,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",131.57,37.7,,105.26,,,0,"percent of total billed charges","37.7% of total billed charges",131.57,37.7,,105.26,,,0,"percent of total billed charges","37.70% of total billed charges",18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",118.31,33.9,,94.65,,,0,"percent of total billed charges","33.9% of total billed charges",18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",272.22,78,,217.78,,,0,"percent of total billed charges","78% of total billed charges",18.32,101,,,,,0,"fee schedule","101% of CMS fee schedule ",288.27,82.6,,230.62,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",288.27,82.6,,230.62,,,0,"percent of total billed charges","82.6% of total billed charges",18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,349,100,,279.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,349,
"EBV Ab VCA, IgM LC",30286665,CDM,302,RC,86665,CPT,OUTPATIENT,,,190,123.5,,167.2,88,,133.76,,,0,"percent of total billed charges","88% of total billed charges",18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",31.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",119.7,63,,95.76,,,0,"percent of total billed charges","63% of total billed charges",29.07,15.3,,23.26,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,131.1,69,,,,,0,"fee schedule","69% of total billed charges",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.38,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.14,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.63,37.7,,57.30,,,0,"percent of total billed charges","37.7% of total billed charges",71.63,37.7,,57.30,,,0,"percent of total billed charges","37.70% of total billed charges",18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.41,33.9,,51.53,,,0,"percent of total billed charges","33.9% of total billed charges",18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",148.2,78,,118.56,,,0,"percent of total billed charges","78% of total billed charges",18.32,101,,,,,0,"fee schedule","101% of CMS fee schedule ",156.94,82.6,,125.55,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",156.94,82.6,,125.55,,,0,"percent of total billed charges","82.6% of total billed charges",18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,190,
"EBNA AB",30286664,CDM,302,RC,86664,CPT,OUTPATIENT,,,58,37.7,,51.04,88,,40.83,,,0,"percent of total billed charges","88% of total billed charges",15.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",26.75,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,15.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.54,63,,29.23,,,0,"percent of total billed charges","63% of total billed charges",8.87,15.3,,7.10,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,40.02,69,,,,,0,"fee schedule","69% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",15.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",15.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",15.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.48,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,15.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.29,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,15.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,15.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.87,37.7,,17.50,,,0,"percent of total billed charges","37.7% of total billed charges",21.87,37.7,,17.50,,,0,"percent of total billed charges","37.70% of total billed charges",15.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.66,33.9,,15.73,,,0,"percent of total billed charges","33.9% of total billed charges",15.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.24,78,,36.19,,,0,"percent of total billed charges","78% of total billed charges",15.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,15.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",15.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",6.96,58.48,
"EBV Antibody Profile LC",30286664,CDM,302,RC,86664,CPT,OUTPATIENT,,,210,136.5,,184.8,88,,147.84,,,0,"percent of total billed charges","88% of total billed charges",15.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",26.75,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,15.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",132.3,63,,105.84,,,0,"percent of total billed charges","63% of total billed charges",32.13,15.3,,25.70,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,144.9,69,,,,,0,"fee schedule","69% of total billed charges",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",15.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",15.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",15.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.48,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,15.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.29,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,15.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,15.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.17,37.7,,63.34,,,0,"percent of total billed charges","37.7% of total billed charges",79.17,37.7,,63.34,,,0,"percent of total billed charges","37.70% of total billed charges",15.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.19,33.9,,56.95,,,0,"percent of total billed charges","33.9% of total billed charges",15.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.8,78,,131.04,,,0,"percent of total billed charges","78% of total billed charges",15.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",173.46,82.6,,138.77,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,15.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",173.46,82.6,,138.77,,,0,"percent of total billed charges","82.6% of total billed charges",15.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,210,
"EPSTEIN-BARR VIRAL CAP IGG",30286665,CDM,302,RC,86665,CPT,OUTPATIENT,,,162,105.3,,142.56,88,,114.05,,,0,"percent of total billed charges","88% of total billed charges",18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,162,100,,129.60,,,0,"percent of total billed charges","100% of total billed charges",31.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",102.06,63,,81.65,,,0,"percent of total billed charges","63% of total billed charges",24.79,15.3,,19.83,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,111.78,69,,,,,0,"fee schedule","69% of total billed charges",162,100,,129.60,,,0,"percent of total billed charges","100% of total billed charges",18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",162,100,,129.60,,,0,"percent of total billed charges","100% of total billed charges",18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",162,100,,129.60,,,0,"percent of total billed charges","100% of total billed charges",18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.38,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.14,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.07,37.7,,48.86,,,0,"percent of total billed charges","37.7% of total billed charges",61.07,37.7,,48.86,,,0,"percent of total billed charges","37.70% of total billed charges",18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.92,33.9,,43.94,,,0,"percent of total billed charges","33.9% of total billed charges",18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",126.36,78,,101.09,,,0,"percent of total billed charges","78% of total billed charges",18.32,101,,,,,0,"fee schedule","101% of CMS fee schedule ",133.81,82.6,,107.05,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",133.81,82.6,,107.05,,,0,"percent of total billed charges","82.6% of total billed charges",18.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,162,100,,129.60,,,0,"percent of total billed charges","100% of total billed charges",6.96,162,
"Electrolyte Panel",30180051,CDM,301,RC,80051,CPT,OUTPATIENT,,,94,61.1,,82.72,88,,66.18,,,0,"percent of total billed charges","88% of total billed charges",7.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",12.26,175,,,,,0,"fee schedule","175% of CMS fee schedule",7.68,100,,,,,0,"fee schedule",EAPG,7.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,63,,47.38,,,0,"percent of total billed charges","63% of total billed charges",14.38,15.3,,11.50,,,0,"percent of total billed charges","15.3% of total billed charges",7.45,100,,,,,0,"fee schedule",EAPG,64.86,69,,,,,0,"fee schedule","69% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",7.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",7.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",7.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.81,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,7.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.01,100,,,,,0,"fee schedule","100% of LI fee schedule",5.52,100,,,,,0,"fee schedule",EAPG,7.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.6,100,,,,,0,"fee schedule",EAPG,9.69,100,,,,,0,"fee schedule",EAPG,7.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.44,37.7,,28.35,,,0,"percent of total billed charges","37.7% of total billed charges",35.44,37.7,,28.35,,,0,"percent of total billed charges","37.70% of total billed charges",7.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.87,33.9,,25.50,,,0,"percent of total billed charges","33.9% of total billed charges",7.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.32,78,,58.66,,,0,"percent of total billed charges","78% of total billed charges",7.08,101,,,,,0,"fee schedule","101% of CMS fee schedule ",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",7.45,100,,,,,0,"fee schedule",EAPG,7.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",7.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",5.52,94,
"MITOCHONDRIAL ANTIBODY",30286255,CDM,302,RC,86255,CPT,OUTPATIENT,,,280,182,,246.4,88,,197.12,,,0,"percent of total billed charges","88% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",21.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",176.4,63,,141.12,,,0,"percent of total billed charges","63% of total billed charges",42.84,15.3,,34.27,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,193.2,69,,,,,0,"fee schedule","69% of total billed charges",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.09,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.05,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",105.56,37.7,,84.45,,,0,"percent of total billed charges","37.7% of total billed charges",105.56,37.7,,84.45,,,0,"percent of total billed charges","37.70% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",94.92,33.9,,75.94,,,0,"percent of total billed charges","33.9% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",218.4,78,,174.72,,,0,"percent of total billed charges","78% of total billed charges",12.17,101,,,,,0,"fee schedule","101% of CMS fee schedule ",231.28,82.6,,185.02,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",231.28,82.6,,185.02,,,0,"percent of total billed charges","82.6% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,280,
"Eosinophil Smear - Nasal",30089190,CDM,300,RC,89190,CPT,OUTPATIENT,,,68,44.2,,59.84,88,,47.87,,,0,"percent of total billed charges","88% of total billed charges",5.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.65,100,,,,,0,"fee schedule",EAPG,68,100,,54.40,,,0,"percent of total billed charges","100% of total billed charges",10.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.91,100,,,,,0,"fee schedule",EAPG,5.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.84,63,,34.27,,,0,"percent of total billed charges","63% of total billed charges",10.4,15.3,,8.32,,,0,"percent of total billed charges","15.3% of total billed charges",8.65,100,,,,,0,"fee schedule",EAPG,46.92,69,,,,,0,"fee schedule","69% of total billed charges",68,100,,54.40,,,0,"percent of total billed charges","100% of total billed charges",5.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",68,100,,54.40,,,0,"percent of total billed charges","100% of total billed charges",5.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",68,100,,54.40,,,0,"percent of total billed charges","100% of total billed charges",5.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.14,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.65,100,,,,,0,"fee schedule",EAPG,5.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.79,100,,,,,0,"fee schedule","100% of LI fee schedule",6.4,100,,,,,0,"fee schedule",EAPG,5.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.82,100,,,,,0,"fee schedule",EAPG,11.24,100,,,,,0,"fee schedule",EAPG,5.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.64,37.7,,20.51,,,0,"percent of total billed charges","37.7% of total billed charges",25.64,37.7,,20.51,,,0,"percent of total billed charges","37.70% of total billed charges",5.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.05,33.9,,18.44,,,0,"percent of total billed charges","33.9% of total billed charges",5.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.04,78,,42.43,,,0,"percent of total billed charges","78% of total billed charges",5.84,101,,,,,0,"fee schedule","101% of CMS fee schedule ",56.17,82.6,,44.94,,,0,"percent of total billed charges","82.6% of total billed charges",8.65,100,,,,,0,"fee schedule",EAPG,5.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.17,82.6,,44.94,,,0,"percent of total billed charges","82.6% of total billed charges",5.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.65,100,,,,,0,"fee schedule",EAPG,68,100,,54.40,,,0,"percent of total billed charges","100% of total billed charges",5.79,68,
"EOSINOPHIL COUNT",30585048,CDM,305,RC,85048,CPT,OUTPATIENT,,,50,32.5,,44,88,,35.20,,,0,"percent of total billed charges","88% of total billed charges",2.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",4.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.23,100,,,,,0,"fee schedule",EAPG,2.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.5,63,,25.20,,,0,"percent of total billed charges","63% of total billed charges",7.65,15.3,,6.12,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,34.5,69,,,,,0,"fee schedule","69% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",2.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",2.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",2.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.71,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,2.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.54,100,,,,,0,"fee schedule","100% of LI fee schedule",3.76,100,,,,,0,"fee schedule",EAPG,2.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,2.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.7% of total billed charges",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.70% of total billed charges",2.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.95,33.9,,13.56,,,0,"percent of total billed charges","33.9% of total billed charges",2.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",39,78,,31.20,,,0,"percent of total billed charges","78% of total billed charges",2.56,101,,,,,0,"fee schedule","101% of CMS fee schedule ",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,2.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",2.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",2.54,50,
"Epstein-Barr Virus PCR LC",30687798,CDM,306,RC,87798,CPT,OUTPATIENT,,,520,338,,457.6,88,,366.08,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,520,100,,416.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",327.6,63,,262.08,,,0,"percent of total billed charges","63% of total billed charges",79.56,15.3,,63.65,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,358.8,69,,,,,0,"fee schedule","69% of total billed charges",520,100,,416.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",520,100,,416.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",520,100,,416.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",196.04,37.7,,156.83,,,0,"percent of total billed charges","37.7% of total billed charges",196.04,37.7,,156.83,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",176.28,33.9,,141.02,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",405.6,78,,324.48,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",429.52,82.6,,343.62,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",429.52,82.6,,343.62,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,520,100,,416.00,,,0,"percent of total billed charges","100% of total billed charges",18.33,520,
"Erythrocyte Sedimentation Rate (ESR)",30585652,CDM,305,RC,85652,CPT,OUTPATIENT,,,90,58.5,,79.2,88,,63.36,,,0,"percent of total billed charges","88% of total billed charges",2.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",4.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.23,100,,,,,0,"fee schedule",EAPG,2.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.7,63,,45.36,,,0,"percent of total billed charges","63% of total billed charges",13.77,15.3,,11.02,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,62.1,69,,,,,0,"fee schedule","69% of total billed charges",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",2.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",2.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",2.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.32,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,2.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.7,100,,,,,0,"fee schedule","100% of LI fee schedule",3.76,100,,,,,0,"fee schedule",EAPG,2.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,2.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.93,37.7,,27.14,,,0,"percent of total billed charges","37.7% of total billed charges",33.93,37.7,,27.14,,,0,"percent of total billed charges","37.70% of total billed charges",2.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.51,33.9,,24.41,,,0,"percent of total billed charges","33.9% of total billed charges",2.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.2,78,,56.16,,,0,"percent of total billed charges","78% of total billed charges",2.72,101,,,,,0,"fee schedule","101% of CMS fee schedule ",74.34,82.6,,59.47,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,2.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.34,82.6,,59.47,,,0,"percent of total billed charges","82.6% of total billed charges",2.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",2.7,90,
"Erythropoietin (EPO) LC",30182668,CDM,301,RC,82668,CPT,OUTPATIENT,,,385,250.25,,338.8,88,,271.04,,,0,"percent of total billed charges","88% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",32.88,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,18.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",242.55,63,,194.04,,,0,"percent of total billed charges","63% of total billed charges",58.91,15.3,,47.13,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,265.65,69,,,,,0,"fee schedule","69% of total billed charges",385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.87,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,18.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,18.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,18.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",145.15,37.7,,116.12,,,0,"percent of total billed charges","37.7% of total billed charges",145.15,37.7,,116.12,,,0,"percent of total billed charges","37.70% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",130.52,33.9,,104.42,,,0,"percent of total billed charges","33.9% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",300.3,78,,240.24,,,0,"percent of total billed charges","78% of total billed charges",18.97,101,,,,,0,"fee schedule","101% of CMS fee schedule ",318.01,82.6,,254.41,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,18.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",318.01,82.6,,254.41,,,0,"percent of total billed charges","82.6% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",8.11,385,
ESTRIOL,30182677,CDM,301,RC,82677,CPT,OUTPATIENT,,,182,118.3,,160.16,88,,128.13,,,0,"percent of total billed charges","88% of total billed charges",24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",42.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",27.85,15.3,,22.28,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,125.58,69,,,,,0,"fee schedule","69% of total billed charges",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.48,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.18,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.61,37.7,,54.89,,,0,"percent of total billed charges","37.7% of total billed charges",68.61,37.7,,54.89,,,0,"percent of total billed charges","37.70% of total billed charges",24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.7,33.9,,49.36,,,0,"percent of total billed charges","33.9% of total billed charges",24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",141.96,78,,113.57,,,0,"percent of total billed charges","78% of total billed charges",24.42,101,,,,,0,"fee schedule","101% of CMS fee schedule ",150.33,82.6,,120.26,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.33,82.6,,120.26,,,0,"percent of total billed charges","82.6% of total billed charges",24.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",8.39,182,
"Estradiol, Sensitive LC",30182670,CDM,301,RC,82670,CPT,OUTPATIENT,,,602,391.3,,529.76,88,,423.81,,,0,"percent of total billed charges","88% of total billed charges",27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",48.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",379.26,63,,303.41,,,0,"percent of total billed charges","63% of total billed charges",92.11,15.3,,73.69,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,415.38,69,,,,,0,"fee schedule","69% of total billed charges",602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.87,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.94,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.95,37.7,,181.56,,,0,"percent of total billed charges","37.7% of total billed charges",226.95,37.7,,181.56,,,0,"percent of total billed charges","37.70% of total billed charges",27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",204.08,33.9,,163.26,,,0,"percent of total billed charges","33.9% of total billed charges",27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",469.56,78,,375.65,,,0,"percent of total billed charges","78% of total billed charges",28.21,101,,,,,0,"fee schedule","101% of CMS fee schedule ",497.25,82.6,,397.80,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",497.25,82.6,,397.80,,,0,"percent of total billed charges","82.6% of total billed charges",27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",8.39,602,
"Estradiol LC",30182670,CDM,301,RC,82670,CPT,OUTPATIENT,,,602,391.3,,529.76,88,,423.81,,,0,"percent of total billed charges","88% of total billed charges",27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",48.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",379.26,63,,303.41,,,0,"percent of total billed charges","63% of total billed charges",92.11,15.3,,73.69,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,415.38,69,,,,,0,"fee schedule","69% of total billed charges",602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.87,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.94,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.95,37.7,,181.56,,,0,"percent of total billed charges","37.7% of total billed charges",226.95,37.7,,181.56,,,0,"percent of total billed charges","37.70% of total billed charges",27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",204.08,33.9,,163.26,,,0,"percent of total billed charges","33.9% of total billed charges",27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",469.56,78,,375.65,,,0,"percent of total billed charges","78% of total billed charges",28.21,101,,,,,0,"fee schedule","101% of CMS fee schedule ",497.25,82.6,,397.80,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",497.25,82.6,,397.80,,,0,"percent of total billed charges","82.6% of total billed charges",27.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",8.39,602,
"Estrone LC",30182679,CDM,301,RC,82679,CPT,OUTPATIENT,,,143,92.95,,125.84,88,,100.67,,,0,"percent of total billed charges","88% of total billed charges",24.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",43.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,24.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.09,63,,72.07,,,0,"percent of total billed charges","63% of total billed charges",21.88,15.3,,17.50,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,98.67,69,,,,,0,"fee schedule","69% of total billed charges",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",24.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",24.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",24.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.43,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,24.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.95,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,24.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,24.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.91,37.7,,43.13,,,0,"percent of total billed charges","37.7% of total billed charges",53.91,37.7,,43.13,,,0,"percent of total billed charges","37.70% of total billed charges",24.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.48,33.9,,38.78,,,0,"percent of total billed charges","33.9% of total billed charges",24.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",111.54,78,,89.23,,,0,"percent of total billed charges","78% of total billed charges",25.19,101,,,,,0,"fee schedule","101% of CMS fee schedule ",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,24.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",24.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",8.39,143,
"Estrogens Fractionated LC",30082671,CDM,300,RC,82671,CPT,OUTPATIENT,,,286,185.9,,251.68,88,,201.34,,,0,"percent of total billed charges","88% of total billed charges",32.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,286,100,,228.80,,,0,"percent of total billed charges","100% of total billed charges",56.52,175,,,,,0,"fee schedule","175% of CMS fee schedule",30.04,100,,,,,0,"fee schedule",EAPG,32.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",180.18,63,,144.14,,,0,"percent of total billed charges","63% of total billed charges",43.76,15.3,,35.01,,,0,"percent of total billed charges","15.3% of total billed charges",29.16,100,,,,,0,"fee schedule",EAPG,197.34,69,,,,,0,"fee schedule","69% of total billed charges",286,100,,228.80,,,0,"percent of total billed charges","100% of total billed charges",32.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",286,100,,228.80,,,0,"percent of total billed charges","100% of total billed charges",32.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",286,100,,228.80,,,0,"percent of total billed charges","100% of total billed charges",32.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",123.54,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,32.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.29,100,,,,,0,"fee schedule","100% of LI fee schedule",21.6,100,,,,,0,"fee schedule",EAPG,32.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.74,100,,,,,0,"fee schedule",EAPG,37.91,100,,,,,0,"fee schedule",EAPG,32.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.82,37.7,,86.26,,,0,"percent of total billed charges","37.7% of total billed charges",107.82,37.7,,86.26,,,0,"percent of total billed charges","37.70% of total billed charges",32.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",96.95,33.9,,77.56,,,0,"percent of total billed charges","33.9% of total billed charges",32.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",223.08,78,,178.46,,,0,"percent of total billed charges","78% of total billed charges",32.62,101,,,,,0,"fee schedule","101% of CMS fee schedule ",236.24,82.6,,188.99,,,0,"percent of total billed charges","82.6% of total billed charges",29.16,100,,,,,0,"fee schedule",EAPG,32.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",236.24,82.6,,188.99,,,0,"percent of total billed charges","82.6% of total billed charges",32.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,286,100,,228.80,,,0,"percent of total billed charges","100% of total billed charges",21.6,286,
"Ethosuximide (Zarontin) LC",30180168,CDM,301,RC,80168,CPT,OUTPATIENT,,,355,230.75,,312.4,88,,249.92,,,0,"percent of total billed charges","88% of total billed charges",16.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,355,100,,284.00,,,0,"percent of total billed charges","100% of total billed charges",28.59,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,16.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",223.65,63,,178.92,,,0,"percent of total billed charges","63% of total billed charges",54.32,15.3,,43.46,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,244.95,69,,,,,0,"fee schedule","69% of total billed charges",355,100,,284.00,,,0,"percent of total billed charges","100% of total billed charges",16.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",355,100,,284.00,,,0,"percent of total billed charges","100% of total billed charges",16.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",355,100,,284.00,,,0,"percent of total billed charges","100% of total billed charges",16.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.5,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,16.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.34,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,16.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,16.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",133.84,37.7,,107.07,,,0,"percent of total billed charges","37.7% of total billed charges",133.84,37.7,,107.07,,,0,"percent of total billed charges","37.70% of total billed charges",16.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",120.35,33.9,,96.28,,,0,"percent of total billed charges","33.9% of total billed charges",16.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",276.9,78,,221.52,,,0,"percent of total billed charges","78% of total billed charges",16.5,101,,,,,0,"fee schedule","101% of CMS fee schedule ",293.23,82.6,,234.58,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,16.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",293.23,82.6,,234.58,,,0,"percent of total billed charges","82.6% of total billed charges",16.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,355,100,,284.00,,,0,"percent of total billed charges","100% of total billed charges",7,355,
EVEROLIMUS,30180169,CDM,301,RC,80169,CPT,OUTPATIENT,,,259,168.35,,227.92,88,,182.34,,,0,"percent of total billed charges","88% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",24.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.17,63,,130.54,,,0,"percent of total billed charges","63% of total billed charges",39.63,15.3,,31.70,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,178.71,69,,,,,0,"fee schedule","69% of total billed charges",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.73,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.64,37.7,,78.11,,,0,"percent of total billed charges","37.7% of total billed charges",97.64,37.7,,78.11,,,0,"percent of total billed charges","37.70% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.8,33.9,,70.24,,,0,"percent of total billed charges","33.9% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.02,78,,161.62,,,0,"percent of total billed charges","78% of total billed charges",13.86,101,,,,,0,"fee schedule","101% of CMS fee schedule ",213.93,82.6,,171.14,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",213.93,82.6,,171.14,,,0,"percent of total billed charges","82.6% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",7,259,
"Ext Amphetamine Conf LC 910990",30180324,CDM,301,RC,80324,CPT,OUTPATIENT,,,710,461.5,,624.8,88,,499.84,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",710,100,,568.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",447.3,63,,357.84,,,0,"percent of total billed charges","63% of total billed charges",108.63,15.3,,86.90,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",489.9,69,,,,,0,"fee schedule","69% of total billed charges",710,100,,568.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",710,100,,568.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",710,100,,568.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",267.67,37.7,,214.14,,,0,"percent of total billed charges","37.7% of total billed charges",267.67,37.7,,214.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",240.69,33.9,,192.55,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.8,78,,443.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",586.46,82.6,,469.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",586.46,82.6,,469.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",119.28,16.8,,95.42,,,0,"percent of total billed charges","16.8% of total billed charges",710,100,,568.00,,,0,"percent of total billed charges","100% of total billed charges",108.63,710,
"METHYLMALONIC ACID",30182542,CDM,301,RC,82542,CPT,OUTPATIENT,,,192,124.8,,168.96,88,,135.17,,,0,"percent of total billed charges","88% of total billed charges",24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",42.15,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",120.96,63,,96.77,,,0,"percent of total billed charges","63% of total billed charges",29.38,15.3,,23.50,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,132.48,69,,,,,0,"fee schedule","69% of total billed charges",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.14,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.09,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.38,37.7,,57.90,,,0,"percent of total billed charges","37.7% of total billed charges",72.38,37.7,,57.90,,,0,"percent of total billed charges","37.70% of total billed charges",24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.09,33.9,,52.07,,,0,"percent of total billed charges","33.9% of total billed charges",24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",149.76,78,,119.81,,,0,"percent of total billed charges","78% of total billed charges",24.33,101,,,,,0,"fee schedule","101% of CMS fee schedule ",158.59,82.6,,126.87,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",158.59,82.6,,126.87,,,0,"percent of total billed charges","82.6% of total billed charges",24.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",8.11,192,
"FIB-4 w/rflx to Enhanced Liver Fibrosis (ELF) 402175 LC",30184450,CDM,301,RC,84450,CPT,OUTPATIENT,,,119,77.35,,104.72,88,,83.78,,,0,"percent of total billed charges","88% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",9.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.97,63,,59.98,,,0,"percent of total billed charges","63% of total billed charges",18.21,15.3,,14.57,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,82.11,69,,,,,0,"fee schedule","69% of total billed charges",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.81,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.7% of total billed charges",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.70% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.34,33.9,,32.27,,,0,"percent of total billed charges","33.9% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.82,78,,74.26,,,0,"percent of total billed charges","78% of total billed charges",5.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",3.25,119,
"FSH LC",30183001,CDM,301,RC,83001,CPT,OUTPATIENT,,,381,247.65,,335.28,88,,268.22,,,0,"percent of total billed charges","88% of total billed charges",18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",32.51,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",240.03,63,,192.02,,,0,"percent of total billed charges","63% of total billed charges",58.29,15.3,,46.63,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,262.89,69,,,,,0,"fee schedule","69% of total billed charges",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.06,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.57,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",143.64,37.7,,114.91,,,0,"percent of total billed charges","37.7% of total billed charges",143.64,37.7,,114.91,,,0,"percent of total billed charges","37.70% of total billed charges",18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.16,33.9,,103.33,,,0,"percent of total billed charges","33.9% of total billed charges",18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",297.18,78,,237.74,,,0,"percent of total billed charges","78% of total billed charges",18.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",314.71,82.6,,251.77,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",314.71,82.6,,251.77,,,0,"percent of total billed charges","82.6% of total billed charges",18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",8.39,381,
"FSH and LH LC",30183001,CDM,301,RC,83001,CPT,OUTPATIENT,,,381,247.65,,335.28,88,,268.22,,,0,"percent of total billed charges","88% of total billed charges",18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",32.51,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",240.03,63,,192.02,,,0,"percent of total billed charges","63% of total billed charges",58.29,15.3,,46.63,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,262.89,69,,,,,0,"fee schedule","69% of total billed charges",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.06,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.57,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",143.64,37.7,,114.91,,,0,"percent of total billed charges","37.7% of total billed charges",143.64,37.7,,114.91,,,0,"percent of total billed charges","37.70% of total billed charges",18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.16,33.9,,103.33,,,0,"percent of total billed charges","33.9% of total billed charges",18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",297.18,78,,237.74,,,0,"percent of total billed charges","78% of total billed charges",18.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",314.71,82.6,,251.77,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",314.71,82.6,,251.77,,,0,"percent of total billed charges","82.6% of total billed charges",18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",8.39,381,
"Factor V Activity LC",30585220,CDM,305,RC,85220,CPT,OUTPATIENT,,,64,41.6,,56.32,88,,45.06,,,0,"percent of total billed charges","88% of total billed charges",17.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",30.88,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,17.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.32,63,,32.26,,,0,"percent of total billed charges","63% of total billed charges",9.79,15.3,,7.83,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,44.16,69,,,,,0,"fee schedule","69% of total billed charges",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",17.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",17.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",17.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,17.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.64,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,17.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,17.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.13,37.7,,19.30,,,0,"percent of total billed charges","37.7% of total billed charges",24.13,37.7,,19.30,,,0,"percent of total billed charges","37.70% of total billed charges",17.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.7,33.9,,17.36,,,0,"percent of total billed charges","33.9% of total billed charges",17.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.92,78,,39.94,,,0,"percent of total billed charges","78% of total billed charges",17.82,101,,,,,0,"fee schedule","101% of CMS fee schedule ",52.86,82.6,,42.29,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,17.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.86,82.6,,42.29,,,0,"percent of total billed charges","82.6% of total billed charges",17.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",2.48,67.51,
"Factor VIII Activity LC",30585240,CDM,305,RC,85240,CPT,OUTPATIENT,,,275,178.75,,242,88,,193.60,,,0,"percent of total billed charges","88% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,275,100,,220.00,,,0,"percent of total billed charges","100% of total billed charges",31.32,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",173.25,63,,138.60,,,0,"percent of total billed charges","63% of total billed charges",42.08,15.3,,33.66,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,189.75,69,,,,,0,"fee schedule","69% of total billed charges",275,100,,220.00,,,0,"percent of total billed charges","100% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",275,100,,220.00,,,0,"percent of total billed charges","100% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",275,100,,220.00,,,0,"percent of total billed charges","100% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.46,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.89,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",103.68,37.7,,82.94,,,0,"percent of total billed charges","37.7% of total billed charges",103.68,37.7,,82.94,,,0,"percent of total billed charges","37.70% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",93.23,33.9,,74.58,,,0,"percent of total billed charges","33.9% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",214.5,78,,171.60,,,0,"percent of total billed charges","78% of total billed charges",18.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",227.15,82.6,,181.72,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",227.15,82.6,,181.72,,,0,"percent of total billed charges","82.6% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,275,100,,220.00,,,0,"percent of total billed charges","100% of total billed charges",2.48,275,
"Factor IX Activity LC",30585250,CDM,305,RC,85250,CPT,OUTPATIENT,,,286,185.9,,251.68,88,,201.34,,,0,"percent of total billed charges","88% of total billed charges",19.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.29,100,,,,,0,"fee schedule",EAPG,286,100,,228.80,,,0,"percent of total billed charges","100% of total billed charges",33.32,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.78,100,,,,,0,"fee schedule",EAPG,19.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",180.18,63,,144.14,,,0,"percent of total billed charges","63% of total billed charges",43.76,15.3,,35.01,,,0,"percent of total billed charges","15.3% of total billed charges",16.29,100,,,,,0,"fee schedule",EAPG,197.34,69,,,,,0,"fee schedule","69% of total billed charges",286,100,,228.80,,,0,"percent of total billed charges","100% of total billed charges",19.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",286,100,,228.80,,,0,"percent of total billed charges","100% of total billed charges",19.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",286,100,,228.80,,,0,"percent of total billed charges","100% of total billed charges",19.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.82,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",16.29,100,,,,,0,"fee schedule",EAPG,19.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.04,100,,,,,0,"fee schedule","100% of LI fee schedule",12.07,100,,,,,0,"fee schedule",EAPG,19.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.62,100,,,,,0,"fee schedule",EAPG,21.18,100,,,,,0,"fee schedule",EAPG,19.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.82,37.7,,86.26,,,0,"percent of total billed charges","37.7% of total billed charges",107.82,37.7,,86.26,,,0,"percent of total billed charges","37.70% of total billed charges",19.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",96.95,33.9,,77.56,,,0,"percent of total billed charges","33.9% of total billed charges",19.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",223.08,78,,178.46,,,0,"percent of total billed charges","78% of total billed charges",19.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",236.24,82.6,,188.99,,,0,"percent of total billed charges","82.6% of total billed charges",16.29,100,,,,,0,"fee schedule",EAPG,19.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",236.24,82.6,,188.99,,,0,"percent of total billed charges","82.6% of total billed charges",19.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.29,100,,,,,0,"fee schedule",EAPG,286,100,,228.80,,,0,"percent of total billed charges","100% of total billed charges",12.07,286,
"Factor X Activity LC",30585260,CDM,305,RC,85260,CPT,OUTPATIENT,,,131,85.15,,115.28,88,,92.22,,,0,"percent of total billed charges","88% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",31.32,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.53,63,,66.02,,,0,"percent of total billed charges","63% of total billed charges",20.04,15.3,,16.03,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,90.39,69,,,,,0,"fee schedule","69% of total billed charges",131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.46,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.89,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.39,37.7,,39.51,,,0,"percent of total billed charges","37.7% of total billed charges",49.39,37.7,,39.51,,,0,"percent of total billed charges","37.70% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.41,33.9,,35.53,,,0,"percent of total billed charges","33.9% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",102.18,78,,81.74,,,0,"percent of total billed charges","78% of total billed charges",18.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",108.21,82.6,,86.57,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.21,82.6,,86.57,,,0,"percent of total billed charges","82.6% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",2.48,131,
"Factor XI Activity LC",30585270,CDM,305,RC,85270,CPT,OUTPATIENT,,,386,250.9,,339.68,88,,271.74,,,0,"percent of total billed charges","88% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",31.32,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",243.18,63,,194.54,,,0,"percent of total billed charges","63% of total billed charges",59.06,15.3,,47.25,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,266.34,69,,,,,0,"fee schedule","69% of total billed charges",386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.46,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.89,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",145.52,37.7,,116.42,,,0,"percent of total billed charges","37.7% of total billed charges",145.52,37.7,,116.42,,,0,"percent of total billed charges","37.70% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",130.85,33.9,,104.68,,,0,"percent of total billed charges","33.9% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",301.08,78,,240.86,,,0,"percent of total billed charges","78% of total billed charges",18.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",318.84,82.6,,255.07,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",318.84,82.6,,255.07,,,0,"percent of total billed charges","82.6% of total billed charges",17.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",2.48,386,
"Factor VIII Bethesda Titer LC",30585335,CDM,305,RC,85335,CPT,OUTPATIENT,,,311,202.15,,273.68,88,,218.94,,,0,"percent of total billed charges","88% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,311,100,,248.80,,,0,"percent of total billed charges","100% of total billed charges",22.52,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",195.93,63,,156.74,,,0,"percent of total billed charges","63% of total billed charges",47.58,15.3,,38.06,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,214.59,69,,,,,0,"fee schedule","69% of total billed charges",311,100,,248.80,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",311,100,,248.80,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",311,100,,248.80,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.22,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.87,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",117.25,37.7,,93.80,,,0,"percent of total billed charges","37.7% of total billed charges",117.25,37.7,,93.80,,,0,"percent of total billed charges","37.70% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",105.43,33.9,,84.34,,,0,"percent of total billed charges","33.9% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",242.58,78,,194.06,,,0,"percent of total billed charges","78% of total billed charges",12.99,101,,,,,0,"fee schedule","101% of CMS fee schedule ",256.89,82.6,,205.51,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",256.89,82.6,,205.51,,,0,"percent of total billed charges","82.6% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,311,100,,248.80,,,0,"percent of total billed charges","100% of total billed charges",2.48,311,
"Factor II Activity LC",30585210,CDM,305,RC,85210,CPT,OUTPATIENT,,,106,68.9,,93.28,88,,74.62,,,0,"percent of total billed charges","88% of total billed charges",12.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",22.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,12.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.78,63,,53.42,,,0,"percent of total billed charges","63% of total billed charges",16.22,15.3,,12.98,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,73.14,69,,,,,0,"fee schedule","69% of total billed charges",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",12.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",12.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",12.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.64,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,12.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.98,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,12.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,12.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.96,37.7,,31.97,,,0,"percent of total billed charges","37.7% of total billed charges",39.96,37.7,,31.97,,,0,"percent of total billed charges","37.70% of total billed charges",12.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.93,33.9,,28.74,,,0,"percent of total billed charges","33.9% of total billed charges",12.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.68,78,,66.14,,,0,"percent of total billed charges","78% of total billed charges",13.1,101,,,,,0,"fee schedule","101% of CMS fee schedule ",87.56,82.6,,70.05,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,12.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.56,82.6,,70.05,,,0,"percent of total billed charges","82.6% of total billed charges",12.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",2.48,106,
"F5 GENE LEIDEN VARIANT ZB0O4",30181241,CDM,301,RC,81241,CPT,OUTPATIENT,,,289,187.85,,254.32,88,,203.46,,,0,"percent of total billed charges","88% of total billed charges",73.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",128.39,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.2,100,,,,,0,"fee schedule",EAPG,73.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",182.07,63,,145.66,,,0,"percent of total billed charges","63% of total billed charges",44.22,15.3,,35.38,,,0,"percent of total billed charges","15.3% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,199.41,69,,,,,0,"fee schedule","69% of total billed charges",289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",73.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",73.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",73.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",280.64,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,73.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.37,100,,,,,0,"fee schedule","100% of LI fee schedule",28.91,100,,,,,0,"fee schedule",EAPG,73.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.81,100,,,,,0,"fee schedule",EAPG,50.73,100,,,,,0,"fee schedule",EAPG,73.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.95,37.7,,87.16,,,0,"percent of total billed charges","37.7% of total billed charges",108.95,37.7,,87.16,,,0,"percent of total billed charges","37.70% of total billed charges",73.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.97,33.9,,78.38,,,0,"percent of total billed charges","33.9% of total billed charges",73.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",225.42,78,,180.34,,,0,"percent of total billed charges","78% of total billed charges",74.1,101,,,,,0,"fee schedule","101% of CMS fee schedule ",238.71,82.6,,190.97,,,0,"percent of total billed charges","82.6% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,73.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",238.71,82.6,,190.97,,,0,"percent of total billed charges","82.6% of total billed charges",73.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",28.91,289,
"Factor II, DNA Analysis LC 511162 ZB0N4",31081240,CDM,310,RC,81240,CPT,OUTPATIENT,,,274,178.1,,241.12,88,,192.90,,,0,"percent of total billed charges","88% of total billed charges",65.69,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,274,100,,219.20,,,0,"percent of total billed charges","100% of total billed charges",114.95,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.2,100,,,,,0,"fee schedule",EAPG,65.69,100,,,,,0,"fee schedule","100% of CMS fee schedule",172.62,63,,138.10,,,0,"percent of total billed charges","63% of total billed charges",98.54,150,,,,,0,"fee schedule","150% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,189.06,69,,,,,0,"fee schedule","69% of total billed charges",274,100,,219.20,,,0,"percent of total billed charges","100% of total billed charges",65.69,100,,,,,0,"fee schedule","100% of CMS fee schedule",274,100,,219.20,,,0,"percent of total billed charges","100% of total billed charges",65.69,100,,,,,0,"fee schedule","100% of CMS fee schedule",274,100,,219.20,,,0,"percent of total billed charges","100% of total billed charges",65.69,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.26,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,65.69,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.69,100,,,,,0,"fee schedule","100% of LI fee schedule",28.91,100,,,,,0,"fee schedule",EAPG,65.69,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.81,100,,,,,0,"fee schedule",EAPG,50.73,100,,,,,0,"fee schedule",EAPG,65.69,100,,,,,0,"fee schedule","100% of CMS fee schedule",103.3,37.7,,82.64,,,0,"percent of total billed charges","37.7% of total billed charges",103.3,37.7,,82.64,,,0,"percent of total billed charges","37.70% of total billed charges",65.69,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.89,33.9,,74.31,,,0,"percent of total billed charges","33.9% of total billed charges",65.69,100,,,,,0,"fee schedule","100% of CMS fee schedule",213.72,78,,170.98,,,0,"percent of total billed charges","78% of total billed charges",66.34,101,,,,,0,"fee schedule","101% of CMS fee schedule ",226.32,82.6,,181.06,,,0,"percent of total billed charges","82.6% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,65.69,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.32,82.6,,181.06,,,0,"percent of total billed charges","82.6% of total billed charges",65.69,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,274,100,,219.20,,,0,"percent of total billed charges","100% of total billed charges",28.91,274,
"Fecal WBC",30687205,CDM,306,RC,87205,CPT,OUTPATIENT,,,73,47.45,,64.24,88,,51.39,,,0,"percent of total billed charges","88% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",7.47,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.99,63,,36.79,,,0,"percent of total billed charges","63% of total billed charges",11.17,15.3,,8.94,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,50.37,69,,,,,0,"fee schedule","69% of total billed charges",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.33,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.26,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.52,37.7,,22.02,,,0,"percent of total billed charges","37.7% of total billed charges",27.52,37.7,,22.02,,,0,"percent of total billed charges","37.70% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,33.9,,19.80,,,0,"percent of total billed charges","33.9% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.94,78,,45.55,,,0,"percent of total billed charges","78% of total billed charges",4.31,101,,,,,0,"fee schedule","101% of CMS fee schedule ",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",4.26,73,
"Fecal Fat, Quantitative LC",30182710,CDM,301,RC,82710,CPT,OUTPATIENT,,,365,237.25,,321.2,88,,256.96,,,0,"percent of total billed charges","88% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,365,100,,292.00,,,0,"percent of total billed charges","100% of total billed charges",29.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",229.95,63,,183.96,,,0,"percent of total billed charges","63% of total billed charges",55.85,15.3,,44.68,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,251.85,69,,,,,0,"fee schedule","69% of total billed charges",365,100,,292.00,,,0,"percent of total billed charges","100% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",365,100,,292.00,,,0,"percent of total billed charges","100% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",365,100,,292.00,,,0,"percent of total billed charges","100% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.26,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.8,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.61,37.7,,110.09,,,0,"percent of total billed charges","37.7% of total billed charges",137.61,37.7,,110.09,,,0,"percent of total billed charges","37.70% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",123.74,33.9,,98.99,,,0,"percent of total billed charges","33.9% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",284.7,78,,227.76,,,0,"percent of total billed charges","78% of total billed charges",16.96,101,,,,,0,"fee schedule","101% of CMS fee schedule ",301.49,82.6,,241.19,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",301.49,82.6,,241.19,,,0,"percent of total billed charges","82.6% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,365,100,,292.00,,,0,"percent of total billed charges","100% of total billed charges",8.11,365,
"Fecal Fat, Qualitative LC",30182705,CDM,301,RC,82705,CPT,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",5.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",8.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.5,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.09,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.7% of total billed charges",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",5.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.2,33.9,,9.76,,,0,"percent of total billed charges","33.9% of total billed charges",5.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",5.15,101,,,,,0,"fee schedule","101% of CMS fee schedule ",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",5.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",3.25,36,
"Fentanyl Screen, UR Rfx LC",30180307,CDM,301,RC,80307,CPT,OUTPATIENT,,,346,224.9,,304.48,88,,243.58,,,0,"percent of total billed charges","88% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.13,16.8,,46.50,,,0,"percent of total billed charges","16.8% of total billed charges",346,100,,276.80,,,0,"percent of total billed charges","100% of total billed charges",108.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",59.87,17.304,,47.90,,,0,"percent of total billed charges","17.304% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",217.98,63,,174.38,,,0,"percent of total billed charges","63% of total billed charges",52.94,15.3,,42.35,,,0,"percent of total billed charges","15.3% of total billed charges",58.13,16.8,,46.50,,,0,"percent of total billed charges","16.8% of total billed charges",238.74,69,,,,,0,"fee schedule","69% of total billed charges",346,100,,276.80,,,0,"percent of total billed charges","100% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",346,100,,276.80,,,0,"percent of total billed charges","100% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",346,100,,276.80,,,0,"percent of total billed charges","100% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",237.68,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",58.13,16.8,,46.50,,,0,"percent of total billed charges","16.8% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.14,100,,,,,0,"fee schedule","100% of LI fee schedule",58.13,16.8,,46.50,,,0,"percent of total billed charges","16.8% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.29,17.136,,47.43,,,0,"percent of total billed charges","17.136% of total billed charges",75.57,21.84,,60.46,,,0,"percent of total billed charges","21.84% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",130.44,37.7,,104.35,,,0,"percent of total billed charges","37.7% of total billed charges",130.44,37.7,,104.35,,,0,"percent of total billed charges","37.70% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",117.29,33.9,,93.83,,,0,"percent of total billed charges","33.9% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",269.88,78,,215.90,,,0,"percent of total billed charges","78% of total billed charges",62.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",285.8,82.6,,228.64,,,0,"percent of total billed charges","82.6% of total billed charges",58.13,16.8,,46.50,,,0,"percent of total billed charges","16.8% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",285.8,82.6,,228.64,,,0,"percent of total billed charges","82.6% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.13,16.8,,46.50,,,0,"percent of total billed charges","16.8% of total billed charges",346,100,,276.80,,,0,"percent of total billed charges","100% of total billed charges",52.94,346,
Ferritin,30182728,CDM,301,RC,82728,CPT,OUTPATIENT,,,306,198.9,,269.28,88,,215.42,,,0,"percent of total billed charges","88% of total billed charges",13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",23.85,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",192.78,63,,154.22,,,0,"percent of total billed charges","63% of total billed charges",46.82,15.3,,37.46,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,211.14,69,,,,,0,"fee schedule","69% of total billed charges",306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.13,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.63,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",115.36,37.7,,92.29,,,0,"percent of total billed charges","37.7% of total billed charges",115.36,37.7,,92.29,,,0,"percent of total billed charges","37.70% of total billed charges",13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",103.73,33.9,,82.98,,,0,"percent of total billed charges","33.9% of total billed charges",13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",238.68,78,,190.94,,,0,"percent of total billed charges","78% of total billed charges",13.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",252.76,82.6,,202.21,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",252.76,82.6,,202.21,,,0,"percent of total billed charges","82.6% of total billed charges",13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",8.11,306,
"Ferritin LC",30182728,CDM,301,RC,82728,CPT,OUTPATIENT,,,23,14.95,,20.24,88,,16.19,,,0,"percent of total billed charges","88% of total billed charges",13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",23.85,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.49,63,,11.59,,,0,"percent of total billed charges","63% of total billed charges",3.52,15.3,,2.82,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,15.87,69,,,,,0,"fee schedule","69% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.13,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.63,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.7% of total billed charges",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.70% of total billed charges",13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.8,33.9,,6.24,,,0,"percent of total billed charges","33.9% of total billed charges",13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.94,78,,14.35,,,0,"percent of total billed charges","78% of total billed charges",13.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",13.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",3.52,52.13,
"FETAL FIBRONECTIN",30182731,CDM,301,RC,82731,CPT,OUTPATIENT,,,812,527.8,,714.56,88,,571.65,,,0,"percent of total billed charges","88% of total billed charges",64.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.85,100,,,,,0,"fee schedule",EAPG,812,100,,649.60,,,0,"percent of total billed charges","100% of total billed charges",112.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",101.81,100,,,,,0,"fee schedule",EAPG,64.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",511.56,63,,409.25,,,0,"percent of total billed charges","63% of total billed charges",124.24,15.3,,99.39,,,0,"percent of total billed charges","15.3% of total billed charges",98.85,100,,,,,0,"fee schedule",EAPG,560.28,69,,,,,0,"fee schedule","69% of total billed charges",812,100,,649.60,,,0,"percent of total billed charges","100% of total billed charges",64.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",812,100,,649.60,,,0,"percent of total billed charges","100% of total billed charges",64.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",812,100,,649.60,,,0,"percent of total billed charges","100% of total billed charges",64.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",246.36,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",98.85,100,,,,,0,"fee schedule",EAPG,64.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.41,100,,,,,0,"fee schedule","100% of LI fee schedule",73.22,100,,,,,0,"fee schedule",EAPG,64.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.82,100,,,,,0,"fee schedule",EAPG,128.5,100,,,,,0,"fee schedule",EAPG,64.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",306.12,37.7,,244.90,,,0,"percent of total billed charges","37.7% of total billed charges",306.12,37.7,,244.90,,,0,"percent of total billed charges","37.70% of total billed charges",64.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",275.27,33.9,,220.22,,,0,"percent of total billed charges","33.9% of total billed charges",64.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",633.36,78,,506.69,,,0,"percent of total billed charges","78% of total billed charges",65.05,101,,,,,0,"fee schedule","101% of CMS fee schedule ",670.71,82.6,,536.57,,,0,"percent of total billed charges","82.6% of total billed charges",98.85,100,,,,,0,"fee schedule",EAPG,64.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",670.71,82.6,,536.57,,,0,"percent of total billed charges","82.6% of total billed charges",64.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.85,100,,,,,0,"fee schedule",EAPG,812,100,,649.60,,,0,"percent of total billed charges","100% of total billed charges",64.41,812,
"Fibrinogen Activity",30585384,CDM,305,RC,85384,CPT,OUTPATIENT,,,157,102.05,,138.16,88,,110.53,,,0,"percent of total billed charges","88% of total billed charges",9.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,157,100,,125.60,,,0,"percent of total billed charges","100% of total billed charges",17.01,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,9.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.91,63,,79.13,,,0,"percent of total billed charges","63% of total billed charges",24.02,15.3,,19.22,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,108.33,69,,,,,0,"fee schedule","69% of total billed charges",157,100,,125.60,,,0,"percent of total billed charges","100% of total billed charges",9.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",157,100,,125.60,,,0,"percent of total billed charges","100% of total billed charges",9.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",157,100,,125.60,,,0,"percent of total billed charges","100% of total billed charges",9.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.17,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,9.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.72,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,9.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,9.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.19,37.7,,47.35,,,0,"percent of total billed charges","37.7% of total billed charges",59.19,37.7,,47.35,,,0,"percent of total billed charges","37.70% of total billed charges",9.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.22,33.9,,42.58,,,0,"percent of total billed charges","33.9% of total billed charges",9.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",122.46,78,,97.97,,,0,"percent of total billed charges","78% of total billed charges",9.81,101,,,,,0,"fee schedule","101% of CMS fee schedule ",129.68,82.6,,103.74,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,9.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.68,82.6,,103.74,,,0,"percent of total billed charges","82.6% of total billed charges",9.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,157,100,,125.60,,,0,"percent of total billed charges","100% of total billed charges",2.48,157,
"Fine-Needle Aspiration LC",31188173,CDM,311,RC,88173,CPT,OUTPATIENT,,,299,194.35,,263.12,88,,210.50,,,0,"percent of total billed charges","88% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33.17,100,,,,,0,"fee schedule",EAPG,299,100,,239.20,,,0,"percent of total billed charges","100% of total billed charges",96.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",34.17,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",188.37,63,,150.70,,,0,"percent of total billed charges","63% of total billed charges",45.75,15.3,,36.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.17,100,,,,,0,"fee schedule",EAPG,206.31,69,,,,,0,"fee schedule","69% of total billed charges",299,100,,239.20,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",299,100,,239.20,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",299,100,,239.20,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.15,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33.17,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.57,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33.84,100,,,,,0,"fee schedule",EAPG,43.13,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",112.72,37.7,,90.18,,,0,"percent of total billed charges","37.7% of total billed charges",112.72,37.7,,90.18,,,0,"percent of total billed charges","37.70% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.36,33.9,,81.09,,,0,"percent of total billed charges","33.9% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",233.22,78,,186.58,,,0,"percent of total billed charges","78% of total billed charges",55.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",246.97,82.6,,197.58,,,0,"percent of total billed charges","82.6% of total billed charges",33.17,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",246.97,82.6,,197.58,,,0,"percent of total billed charges","82.6% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33.17,100,,,,,0,"fee schedule",EAPG,299,100,,239.20,,,0,"percent of total billed charges","100% of total billed charges",24.57,299,
"Fine Needle Aspiration Cytology With Immediate Assessment LC",31188172,CDM,311,RC,88172,CPT,OUTPATIENT,,,1216,790.4,,1070.08,88,,856.06,,,0,"percent of total billed charges","88% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.75,100,,,,,0,"fee schedule",EAPG,1216,100,,972.80,,,0,"percent of total billed charges","100% of total billed charges",304.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",36.82,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",766.08,63,,612.86,,,0,"percent of total billed charges","63% of total billed charges",186.05,15.3,,148.84,,,0,"percent of total billed charges","15.3% of total billed charges",35.75,100,,,,,0,"fee schedule",EAPG,839.04,69,,,,,0,"fee schedule","69% of total billed charges",1216,100,,972.80,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1216,100,,972.80,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1216,100,,972.80,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",605.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.75,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.48,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.46,100,,,,,0,"fee schedule",EAPG,46.47,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",458.43,37.7,,366.74,,,0,"percent of total billed charges","37.7% of total billed charges",458.43,37.7,,366.74,,,0,"percent of total billed charges","37.70% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.22,33.9,,329.78,,,0,"percent of total billed charges","33.9% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",948.48,78,,758.78,,,0,"percent of total billed charges","78% of total billed charges",175.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1004.42,82.6,,803.54,,,0,"percent of total billed charges","82.6% of total billed charges",35.75,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1004.42,82.6,,803.54,,,0,"percent of total billed charges","82.6% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.75,100,,,,,0,"fee schedule",EAPG,1216,100,,972.80,,,0,"percent of total billed charges","100% of total billed charges",26.48,1216,
"Flow Cytometry AVR",31088184,CDM,310,RC,88184,CPT,OUTPATIENT,,,246,159.9,,216.48,88,,173.18,,,0,"percent of total billed charges","88% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.75,100,,,,,0,"fee schedule",EAPG,246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",641.59,175,,,,,0,"fee schedule","175% of CMS fee schedule",36.82,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.98,63,,123.98,,,0,"percent of total billed charges","63% of total billed charges",37.64,15.3,,30.11,,,0,"percent of total billed charges","15.3% of total billed charges",35.75,100,,,,,0,"fee schedule",EAPG,169.74,69,,,,,0,"fee schedule","69% of total billed charges",246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",1183.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.75,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.48,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.46,100,,,,,0,"fee schedule",EAPG,46.47,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.74,37.7,,74.19,,,0,"percent of total billed charges","37.7% of total billed charges",92.74,37.7,,74.19,,,0,"percent of total billed charges","37.70% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",83.39,33.9,,66.71,,,0,"percent of total billed charges","33.9% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191.88,78,,153.50,,,0,"percent of total billed charges","78% of total billed charges",370.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",203.2,82.6,,162.56,,,0,"percent of total billed charges","82.6% of total billed charges",35.75,100,,,,,0,"fee schedule",EAPG,366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",203.2,82.6,,162.56,,,0,"percent of total billed charges","82.6% of total billed charges",366.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.75,100,,,,,0,"fee schedule",EAPG,246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",26.48,1183.25,
"Influenza A/B",30687804,CDM,306,RC,87804,CPT,OUTPATIENT,,,106,68.9,,93.28,88,,74.62,,,0,"percent of total billed charges","88% of total billed charges",16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",28.96,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.78,63,,53.42,,,0,"percent of total billed charges","63% of total billed charges",16.22,15.3,,12.98,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,73.14,69,,,,,0,"fee schedule","69% of total billed charges",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.3,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.55,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.96,37.7,,31.97,,,0,"percent of total billed charges","37.7% of total billed charges",39.96,37.7,,31.97,,,0,"percent of total billed charges","37.70% of total billed charges",16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.93,33.9,,28.74,,,0,"percent of total billed charges","33.9% of total billed charges",16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.68,78,,66.14,,,0,"percent of total billed charges","78% of total billed charges",16.71,101,,,,,0,"fee schedule","101% of CMS fee schedule ",87.56,82.6,,70.05,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.56,82.6,,70.05,,,0,"percent of total billed charges","82.6% of total billed charges",16.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",4.81,106,
"Flu A/B PCR (GeneXpert)",30687502,CDM,306,RC,87502,CPT,OUTPATIENT,,,259,168.35,,227.92,88,,182.34,,,0,"percent of total billed charges","88% of total billed charges",95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.61,100,,,,,0,"fee schedule",EAPG,259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",167.65,175,,,,,0,"fee schedule","175% of CMS fee schedule",100.54,100,,,,,0,"fee schedule",EAPG,95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.17,63,,130.54,,,0,"percent of total billed charges","63% of total billed charges",39.63,15.3,,31.70,,,0,"percent of total billed charges","15.3% of total billed charges",97.61,100,,,,,0,"fee schedule",EAPG,178.71,69,,,,,0,"fee schedule","69% of total billed charges",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",366.43,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",97.61,100,,,,,0,"fee schedule",EAPG,95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.8,100,,,,,0,"fee schedule","100% of LI fee schedule",72.3,100,,,,,0,"fee schedule",EAPG,95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.56,100,,,,,0,"fee schedule",EAPG,126.89,100,,,,,0,"fee schedule",EAPG,95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.64,37.7,,78.11,,,0,"percent of total billed charges","37.7% of total billed charges",97.64,37.7,,78.11,,,0,"percent of total billed charges","37.70% of total billed charges",95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.8,33.9,,70.24,,,0,"percent of total billed charges","33.9% of total billed charges",95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.02,78,,161.62,,,0,"percent of total billed charges","78% of total billed charges",96.75,101,,,,,0,"fee schedule","101% of CMS fee schedule ",213.93,82.6,,171.14,,,0,"percent of total billed charges","82.6% of total billed charges",97.61,100,,,,,0,"fee schedule",EAPG,95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",213.93,82.6,,171.14,,,0,"percent of total billed charges","82.6% of total billed charges",95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.61,100,,,,,0,"fee schedule",EAPG,259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",39.63,366.43,
"Flu (GeneXpert Xpress) POCT",30687502,CDM,306,RC,87502,CPT,OUTPATIENT,,,259,168.35,,227.92,88,,182.34,,,0,"percent of total billed charges","88% of total billed charges",95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.61,100,,,,,0,"fee schedule",EAPG,259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",167.65,175,,,,,0,"fee schedule","175% of CMS fee schedule",100.54,100,,,,,0,"fee schedule",EAPG,95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.17,63,,130.54,,,0,"percent of total billed charges","63% of total billed charges",39.63,15.3,,31.70,,,0,"percent of total billed charges","15.3% of total billed charges",97.61,100,,,,,0,"fee schedule",EAPG,178.71,69,,,,,0,"fee schedule","69% of total billed charges",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",366.43,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",97.61,100,,,,,0,"fee schedule",EAPG,95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.8,100,,,,,0,"fee schedule","100% of LI fee schedule",72.3,100,,,,,0,"fee schedule",EAPG,95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.56,100,,,,,0,"fee schedule",EAPG,126.89,100,,,,,0,"fee schedule",EAPG,95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.64,37.7,,78.11,,,0,"percent of total billed charges","37.7% of total billed charges",97.64,37.7,,78.11,,,0,"percent of total billed charges","37.70% of total billed charges",95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.8,33.9,,70.24,,,0,"percent of total billed charges","33.9% of total billed charges",95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.02,78,,161.62,,,0,"percent of total billed charges","78% of total billed charges",96.75,101,,,,,0,"fee schedule","101% of CMS fee schedule ",213.93,82.6,,171.14,,,0,"percent of total billed charges","82.6% of total billed charges",97.61,100,,,,,0,"fee schedule",EAPG,95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",213.93,82.6,,171.14,,,0,"percent of total billed charges","82.6% of total billed charges",95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.61,100,,,,,0,"fee schedule",EAPG,259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",39.63,366.43,
"Flu/RSV (GeneXpert Xpress) POCT",30687502,CDM,306,RC,87502|8763,CPT,OUTPATIENT,,,259,168.35,,227.92,88,,182.34,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.51,16.8,,34.81,,,0,"percent of total billed charges","16.8% of total billed charges",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.82,17.304,,35.86,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",163.17,63,,130.54,,,0,"percent of total billed charges","63% of total billed charges",39.63,15.3,,31.70,,,0,"percent of total billed charges","15.3% of total billed charges",43.51,16.8,,34.81,,,0,"percent of total billed charges","16.8% of total billed charges",178.71,69,,,,,0,"fee schedule","69% of total billed charges",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.51,16.8,,34.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.51,16.8,,34.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.38,17.136,,35.50,,,0,"percent of total billed charges","17.136% of total billed charges",56.57,21.84,,45.26,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.64,37.7,,78.11,,,0,"percent of total billed charges","37.7% of total billed charges",97.64,37.7,,78.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.8,33.9,,70.24,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.02,78,,161.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.93,82.6,,171.14,,,0,"percent of total billed charges","82.6% of total billed charges",43.51,16.8,,34.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.93,82.6,,171.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.51,16.8,,34.81,,,0,"percent of total billed charges","16.8% of total billed charges",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",39.63,259,
"Folate Serum",30182746,CDM,301,RC,82746,CPT,OUTPATIENT,,,269,174.85,,236.72,88,,189.38,,,0,"percent of total billed charges","88% of total billed charges",14.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",25.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,14.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",169.47,63,,135.58,,,0,"percent of total billed charges","63% of total billed charges",41.16,15.3,,32.93,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,185.61,69,,,,,0,"fee schedule","69% of total billed charges",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",14.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",14.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",14.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.22,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,14.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.7,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,14.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,14.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.41,37.7,,81.13,,,0,"percent of total billed charges","37.7% of total billed charges",101.41,37.7,,81.13,,,0,"percent of total billed charges","37.70% of total billed charges",14.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.19,33.9,,72.95,,,0,"percent of total billed charges","33.9% of total billed charges",14.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",209.82,78,,167.86,,,0,"percent of total billed charges","78% of total billed charges",14.84,101,,,,,0,"fee schedule","101% of CMS fee schedule ",222.19,82.6,,177.75,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,14.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",222.19,82.6,,177.75,,,0,"percent of total billed charges","82.6% of total billed charges",14.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",8.11,269,
"Folate (Folic Acid) LC",30182746,CDM,301,RC,82746,CPT,OUTPATIENT,,,29,18.85,,25.52,88,,20.42,,,0,"percent of total billed charges","88% of total billed charges",14.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",25.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,14.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.27,63,,14.62,,,0,"percent of total billed charges","63% of total billed charges",4.44,15.3,,3.55,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,20.01,69,,,,,0,"fee schedule","69% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",14.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",14.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",14.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.22,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,14.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.7,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,14.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,14.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.93,37.7,,8.74,,,0,"percent of total billed charges","37.7% of total billed charges",10.93,37.7,,8.74,,,0,"percent of total billed charges","37.70% of total billed charges",14.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.83,33.9,,7.86,,,0,"percent of total billed charges","33.9% of total billed charges",14.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.62,78,,18.10,,,0,"percent of total billed charges","78% of total billed charges",14.84,101,,,,,0,"fee schedule","101% of CMS fee schedule ",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,14.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",14.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",4.44,56.22,
FSH,30183001,CDM,301,RC,83001,CPT,OUTPATIENT,,,340,221,,299.2,88,,239.36,,,0,"percent of total billed charges","88% of total billed charges",18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",32.51,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",214.2,63,,171.36,,,0,"percent of total billed charges","63% of total billed charges",52.02,15.3,,41.62,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,234.6,69,,,,,0,"fee schedule","69% of total billed charges",340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.06,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.57,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",128.18,37.7,,102.54,,,0,"percent of total billed charges","37.7% of total billed charges",128.18,37.7,,102.54,,,0,"percent of total billed charges","37.70% of total billed charges",18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",115.26,33.9,,92.21,,,0,"percent of total billed charges","33.9% of total billed charges",18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",265.2,78,,212.16,,,0,"percent of total billed charges","78% of total billed charges",18.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",280.84,82.6,,224.67,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",280.84,82.6,,224.67,,,0,"percent of total billed charges","82.6% of total billed charges",18.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",8.39,340,
"Free T4",30184439,CDM,301,RC,84439,CPT,OUTPATIENT,,,136,88.4,,119.68,88,,95.74,,,0,"percent of total billed charges","88% of total billed charges",9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",15.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.68,63,,68.54,,,0,"percent of total billed charges","63% of total billed charges",20.81,15.3,,16.65,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,93.84,69,,,,,0,"fee schedule","69% of total billed charges",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.5,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.02,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.27,37.7,,41.02,,,0,"percent of total billed charges","37.7% of total billed charges",51.27,37.7,,41.02,,,0,"percent of total billed charges","37.70% of total billed charges",9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.1,33.9,,36.88,,,0,"percent of total billed charges","33.9% of total billed charges",9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.08,78,,84.86,,,0,"percent of total billed charges","78% of total billed charges",9.11,101,,,,,0,"fee schedule","101% of CMS fee schedule ",112.34,82.6,,89.87,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",112.34,82.6,,89.87,,,0,"percent of total billed charges","82.6% of total billed charges",9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",8.39,136,
"Free K+L Lt Chains,Qn LC",30183883,CDM,301,RC,83521,CPT,OUTPATIENT,,,167,108.55,,146.96,88,,117.57,,,0,"percent of total billed charges","88% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,167,100,,133.60,,,0,"percent of total billed charges","100% of total billed charges",30.22,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",105.21,63,,84.17,,,0,"percent of total billed charges","63% of total billed charges",25.55,15.3,,20.44,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,115.23,69,,,,,0,"fee schedule","69% of total billed charges",167,100,,133.60,,,0,"percent of total billed charges","100% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",167,100,,133.60,,,0,"percent of total billed charges","100% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",167,100,,133.60,,,0,"percent of total billed charges","100% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",10.95,100,,,,,0,"fee schedule",EAPG,17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.27,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.96,37.7,,50.37,,,0,"percent of total billed charges","37.7% of total billed charges",62.96,37.7,,50.37,,,0,"percent of total billed charges","37.70% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.61,33.9,,45.29,,,0,"percent of total billed charges","33.9% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",130.26,78,,104.21,,,0,"percent of total billed charges","78% of total billed charges",17.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",137.94,82.6,,110.35,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.94,82.6,,110.35,,,0,"percent of total billed charges","82.6% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,167,100,,133.60,,,0,"percent of total billed charges","100% of total billed charges",8.11,167,
"Fructose, Semen Analysis LC #001875",30082757,CDM,300,RC,82757,CPT,OUTPATIENT,,,122,79.3,,107.36,88,,85.89,,,0,"percent of total billed charges","88% of total billed charges",17.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,122,100,,97.60,,,0,"percent of total billed charges","100% of total billed charges",30.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,17.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.86,63,,61.49,,,0,"percent of total billed charges","63% of total billed charges",18.67,15.3,,14.94,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,84.18,69,,,,,0,"fee schedule","69% of total billed charges",122,100,,97.60,,,0,"percent of total billed charges","100% of total billed charges",17.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",122,100,,97.60,,,0,"percent of total billed charges","100% of total billed charges",17.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",122,100,,97.60,,,0,"percent of total billed charges","100% of total billed charges",17.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.32,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,17.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.34,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,17.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,17.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.99,37.7,,36.79,,,0,"percent of total billed charges","37.7% of total billed charges",45.99,37.7,,36.79,,,0,"percent of total billed charges","37.70% of total billed charges",17.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.36,33.9,,33.09,,,0,"percent of total billed charges","33.9% of total billed charges",17.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.16,78,,76.13,,,0,"percent of total billed charges","78% of total billed charges",17.51,101,,,,,0,"fee schedule","101% of CMS fee schedule ",100.77,82.6,,80.62,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,17.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.77,82.6,,80.62,,,0,"percent of total billed charges","82.6% of total billed charges",17.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,122,100,,97.60,,,0,"percent of total billed charges","100% of total billed charges",8.11,122,
"Fructosamine LC",30182985,CDM,301,RC,82985,CPT,OUTPATIENT,,,93,60.45,,81.84,88,,65.47,,,0,"percent of total billed charges","88% of total billed charges",16.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",29.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,16.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.59,63,,46.87,,,0,"percent of total billed charges","63% of total billed charges",14.23,15.3,,11.38,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,64.17,69,,,,,0,"fee schedule","69% of total billed charges",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",16.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",16.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",16.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,16.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.76,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,16.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,16.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.06,37.7,,28.05,,,0,"percent of total billed charges","37.7% of total billed charges",35.06,37.7,,28.05,,,0,"percent of total billed charges","37.70% of total billed charges",16.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.53,33.9,,25.22,,,0,"percent of total billed charges","33.9% of total billed charges",16.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.54,78,,58.03,,,0,"percent of total billed charges","78% of total billed charges",16.92,101,,,,,0,"fee schedule","101% of CMS fee schedule ",76.82,82.6,,61.46,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,16.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.82,82.6,,61.46,,,0,"percent of total billed charges","82.6% of total billed charges",16.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,93,
"Fungus (Mycology) Culture LC",30687101,CDM,306,RC,87101,CPT,OUTPATIENT,,,229,148.85,,201.52,88,,161.22,,,0,"percent of total billed charges","88% of total billed charges",7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,229,100,,183.20,,,0,"percent of total billed charges","100% of total billed charges",13.49,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.27,63,,115.42,,,0,"percent of total billed charges","63% of total billed charges",35.04,15.3,,28.03,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,158.01,69,,,,,0,"fee schedule","69% of total billed charges",229,100,,183.20,,,0,"percent of total billed charges","100% of total billed charges",7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",229,100,,183.20,,,0,"percent of total billed charges","100% of total billed charges",7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",229,100,,183.20,,,0,"percent of total billed charges","100% of total billed charges",7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.49,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.71,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",86.33,37.7,,69.06,,,0,"percent of total billed charges","37.7% of total billed charges",86.33,37.7,,69.06,,,0,"percent of total billed charges","37.70% of total billed charges",7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.63,33.9,,62.10,,,0,"percent of total billed charges","33.9% of total billed charges",7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",178.62,78,,142.90,,,0,"percent of total billed charges","78% of total billed charges",7.78,101,,,,,0,"fee schedule","101% of CMS fee schedule ",189.15,82.6,,151.32,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",189.15,82.6,,151.32,,,0,"percent of total billed charges","82.6% of total billed charges",7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,229,100,,183.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,229,
"GLUCOSE-6-PHOS DEHYD",30082955,CDM,300,RC,82955,CPT,OUTPATIENT,,,57,37.05,,50.16,88,,40.13,,,0,"percent of total billed charges","88% of total billed charges",9.69,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",16.97,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,9.69,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.91,63,,28.73,,,0,"percent of total billed charges","63% of total billed charges",8.72,15.3,,6.98,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,39.33,69,,,,,0,"fee schedule","69% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",9.69,100,,,,,0,"fee schedule","100% of CMS fee schedule",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",9.69,100,,,,,0,"fee schedule","100% of CMS fee schedule",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",9.69,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,9.69,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.69,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,9.69,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,9.69,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.49,37.7,,17.19,,,0,"percent of total billed charges","37.7% of total billed charges",21.49,37.7,,17.19,,,0,"percent of total billed charges","37.70% of total billed charges",9.69,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.32,33.9,,15.46,,,0,"percent of total billed charges","33.9% of total billed charges",9.69,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.46,78,,35.57,,,0,"percent of total billed charges","78% of total billed charges",9.79,101,,,,,0,"fee schedule","101% of CMS fee schedule ",47.08,82.6,,37.66,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,9.69,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.08,82.6,,37.66,,,0,"percent of total billed charges","82.6% of total billed charges",9.69,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,57,
"GAD-65 Autoantibody LC",30286341,CDM,302,RC,86341,CPT,OUTPATIENT,,,329,213.85,,289.52,88,,231.62,,,0,"percent of total billed charges","88% of total billed charges",23.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",41.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,23.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",207.27,63,,165.82,,,0,"percent of total billed charges","63% of total billed charges",50.34,15.3,,40.27,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,227.01,69,,,,,0,"fee schedule","69% of total billed charges",329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",23.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",23.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",23.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.15,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,23.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.57,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,23.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,23.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.03,37.7,,99.22,,,0,"percent of total billed charges","37.7% of total billed charges",124.03,37.7,,99.22,,,0,"percent of total billed charges","37.70% of total billed charges",23.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",111.53,33.9,,89.22,,,0,"percent of total billed charges","33.9% of total billed charges",23.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",256.62,78,,205.30,,,0,"percent of total billed charges","78% of total billed charges",23.8,101,,,,,0,"fee schedule","101% of CMS fee schedule ",271.75,82.6,,217.40,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,23.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",271.75,82.6,,217.40,,,0,"percent of total billed charges","82.6% of total billed charges",23.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,329,
NEURONTIN,30180171,CDM,301,RC,80171,CPT,OUTPATIENT,,,109,70.85,,95.92,88,,76.74,,,0,"percent of total billed charges","88% of total billed charges",21.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",37.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,21.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.67,63,,54.94,,,0,"percent of total billed charges","63% of total billed charges",16.68,15.3,,13.34,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,75.21,69,,,,,0,"fee schedule","69% of total billed charges",109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",21.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",21.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",21.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.88,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,21.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.67,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,21.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,21.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.09,37.7,,32.87,,,0,"percent of total billed charges","37.7% of total billed charges",41.09,37.7,,32.87,,,0,"percent of total billed charges","37.70% of total billed charges",21.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.95,33.9,,29.56,,,0,"percent of total billed charges","33.9% of total billed charges",21.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.02,78,,68.02,,,0,"percent of total billed charges","78% of total billed charges",21.88,101,,,,,0,"fee schedule","101% of CMS fee schedule ",90.03,82.6,,72.02,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,21.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.03,82.6,,72.02,,,0,"percent of total billed charges","82.6% of total billed charges",21.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",7,109,
GGT,30182977,CDM,301,RC,82977,CPT,OUTPATIENT,,,132,85.8,,116.16,88,,92.93,,,0,"percent of total billed charges","88% of total billed charges",7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",12.6,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",83.16,63,,66.53,,,0,"percent of total billed charges","63% of total billed charges",20.2,15.3,,16.16,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,91.08,69,,,,,0,"fee schedule","69% of total billed charges",132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.54,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.2,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.76,37.7,,39.81,,,0,"percent of total billed charges","37.7% of total billed charges",49.76,37.7,,39.81,,,0,"percent of total billed charges","37.70% of total billed charges",7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.75,33.9,,35.80,,,0,"percent of total billed charges","33.9% of total billed charges",7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",102.96,78,,82.37,,,0,"percent of total billed charges","78% of total billed charges",7.27,101,,,,,0,"fee schedule","101% of CMS fee schedule ",109.03,82.6,,87.22,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.03,82.6,,87.22,,,0,"percent of total billed charges","82.6% of total billed charges",7.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,132,
"Gastric Occult Blood",30182271,CDM,301,RC,82271,CPT,OUTPATIENT,,,60,39,,52.8,88,,42.24,,,0,"percent of total billed charges","88% of total billed charges",5.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",9.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.8,63,,30.24,,,0,"percent of total billed charges","63% of total billed charges",9.18,15.3,,7.34,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,41.4,69,,,,,0,"fee schedule","69% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",5.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",5.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",5.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.32,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.62,37.7,,18.10,,,0,"percent of total billed charges","37.7% of total billed charges",22.62,37.7,,18.10,,,0,"percent of total billed charges","37.70% of total billed charges",5.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.34,33.9,,16.27,,,0,"percent of total billed charges","33.9% of total billed charges",5.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.8,78,,37.44,,,0,"percent of total billed charges","78% of total billed charges",5.37,101,,,,,0,"fee schedule","101% of CMS fee schedule ",49.56,82.6,,39.65,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.56,82.6,,39.65,,,0,"percent of total billed charges","82.6% of total billed charges",5.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",3.25,60,
"Gastrin LC",30182941,CDM,301,RC,82941,CPT,OUTPATIENT,,,383,248.95,,337.04,88,,269.63,,,0,"percent of total billed charges","88% of total billed charges",17.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,383,100,,306.40,,,0,"percent of total billed charges","100% of total billed charges",30.85,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,17.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",241.29,63,,193.03,,,0,"percent of total billed charges","63% of total billed charges",58.6,15.3,,46.88,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,264.27,69,,,,,0,"fee schedule","69% of total billed charges",383,100,,306.40,,,0,"percent of total billed charges","100% of total billed charges",17.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",383,100,,306.40,,,0,"percent of total billed charges","100% of total billed charges",17.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",383,100,,306.40,,,0,"percent of total billed charges","100% of total billed charges",17.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.43,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,17.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.63,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,17.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,17.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.39,37.7,,115.51,,,0,"percent of total billed charges","37.7% of total billed charges",144.39,37.7,,115.51,,,0,"percent of total billed charges","37.70% of total billed charges",17.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.84,33.9,,103.87,,,0,"percent of total billed charges","33.9% of total billed charges",17.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",298.74,78,,238.99,,,0,"percent of total billed charges","78% of total billed charges",17.8,101,,,,,0,"fee schedule","101% of CMS fee schedule ",316.36,82.6,,253.09,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,17.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",316.36,82.6,,253.09,,,0,"percent of total billed charges","82.6% of total billed charges",17.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,383,100,,306.40,,,0,"percent of total billed charges","100% of total billed charges",8.39,383,
"Genital Ulcer Panel AVR",30687529,CDM,306,RC,87529,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"GENTAMICIN LEVEL",30180170,CDM,301,RC,80170,CPT,OUTPATIENT,,,381,247.65,,335.28,88,,268.22,,,0,"percent of total billed charges","88% of total billed charges",16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",28.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",240.03,63,,192.02,,,0,"percent of total billed charges","63% of total billed charges",58.29,15.3,,46.63,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,262.89,69,,,,,0,"fee schedule","69% of total billed charges",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.65,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.38,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",143.64,37.7,,114.91,,,0,"percent of total billed charges","37.7% of total billed charges",143.64,37.7,,114.91,,,0,"percent of total billed charges","37.70% of total billed charges",16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.16,33.9,,103.33,,,0,"percent of total billed charges","33.9% of total billed charges",16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",297.18,78,,237.74,,,0,"percent of total billed charges","78% of total billed charges",16.54,101,,,,,0,"fee schedule","101% of CMS fee schedule ",314.71,82.6,,251.77,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",314.71,82.6,,251.77,,,0,"percent of total billed charges","82.6% of total billed charges",16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",7,381,
"GENTAMICIN LEVEL PEAK",30180170,CDM,301,RC,80170,CPT,OUTPATIENT,,,381,247.65,,335.28,88,,268.22,,,0,"percent of total billed charges","88% of total billed charges",16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",28.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",240.03,63,,192.02,,,0,"percent of total billed charges","63% of total billed charges",58.29,15.3,,46.63,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,262.89,69,,,,,0,"fee schedule","69% of total billed charges",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.65,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.38,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",143.64,37.7,,114.91,,,0,"percent of total billed charges","37.7% of total billed charges",143.64,37.7,,114.91,,,0,"percent of total billed charges","37.70% of total billed charges",16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.16,33.9,,103.33,,,0,"percent of total billed charges","33.9% of total billed charges",16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",297.18,78,,237.74,,,0,"percent of total billed charges","78% of total billed charges",16.54,101,,,,,0,"fee schedule","101% of CMS fee schedule ",314.71,82.6,,251.77,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",314.71,82.6,,251.77,,,0,"percent of total billed charges","82.6% of total billed charges",16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",7,381,
"GENTAMICIN RANDOM",30180170,CDM,301,RC,80170,CPT,OUTPATIENT,,,381,247.65,,335.28,88,,268.22,,,0,"percent of total billed charges","88% of total billed charges",16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",28.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",240.03,63,,192.02,,,0,"percent of total billed charges","63% of total billed charges",58.29,15.3,,46.63,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,262.89,69,,,,,0,"fee schedule","69% of total billed charges",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.65,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.38,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",143.64,37.7,,114.91,,,0,"percent of total billed charges","37.7% of total billed charges",143.64,37.7,,114.91,,,0,"percent of total billed charges","37.70% of total billed charges",16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.16,33.9,,103.33,,,0,"percent of total billed charges","33.9% of total billed charges",16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",297.18,78,,237.74,,,0,"percent of total billed charges","78% of total billed charges",16.54,101,,,,,0,"fee schedule","101% of CMS fee schedule ",314.71,82.6,,251.77,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",314.71,82.6,,251.77,,,0,"percent of total billed charges","82.6% of total billed charges",16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",7,381,
"GENTAMICIN LEVEL TROUGH",30180170,CDM,301,RC,80170,CPT,OUTPATIENT,,,381,247.65,,335.28,88,,268.22,,,0,"percent of total billed charges","88% of total billed charges",16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",28.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",240.03,63,,192.02,,,0,"percent of total billed charges","63% of total billed charges",58.29,15.3,,46.63,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,262.89,69,,,,,0,"fee schedule","69% of total billed charges",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.65,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.38,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",143.64,37.7,,114.91,,,0,"percent of total billed charges","37.7% of total billed charges",143.64,37.7,,114.91,,,0,"percent of total billed charges","37.70% of total billed charges",16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.16,33.9,,103.33,,,0,"percent of total billed charges","33.9% of total billed charges",16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",297.18,78,,237.74,,,0,"percent of total billed charges","78% of total billed charges",16.54,101,,,,,0,"fee schedule","101% of CMS fee schedule ",314.71,82.6,,251.77,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",314.71,82.6,,251.77,,,0,"percent of total billed charges","82.6% of total billed charges",16.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",7,381,
"Giardia Antigen",30687329,CDM,306,RC,87329,CPT,OUTPATIENT,,,187,121.55,,164.56,88,,131.65,,,0,"percent of total billed charges","88% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,187,100,,149.60,,,0,"percent of total billed charges","100% of total billed charges",20.96,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",117.81,63,,94.25,,,0,"percent of total billed charges","63% of total billed charges",28.61,15.3,,22.89,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,129.03,69,,,,,0,"fee schedule","69% of total billed charges",187,100,,149.60,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",187,100,,149.60,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",187,100,,149.60,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.82,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.98,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.5,37.7,,56.40,,,0,"percent of total billed charges","37.7% of total billed charges",70.5,37.7,,56.40,,,0,"percent of total billed charges","37.70% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.39,33.9,,50.71,,,0,"percent of total billed charges","33.9% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",145.86,78,,116.69,,,0,"percent of total billed charges","78% of total billed charges",12.09,101,,,,,0,"fee schedule","101% of CMS fee schedule ",154.46,82.6,,123.57,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",154.46,82.6,,123.57,,,0,"percent of total billed charges","82.6% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,187,100,,149.60,,,0,"percent of total billed charges","100% of total billed charges",4.81,187,
"Giardia lamblia Ag, EIA LC",30687329,CDM,306,RC,87329,CPT,OUTPATIENT,,,220,143,,193.6,88,,154.88,,,0,"percent of total billed charges","88% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,220,100,,176.00,,,0,"percent of total billed charges","100% of total billed charges",20.96,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",138.6,63,,110.88,,,0,"percent of total billed charges","63% of total billed charges",33.66,15.3,,26.93,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,151.8,69,,,,,0,"fee schedule","69% of total billed charges",220,100,,176.00,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",220,100,,176.00,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",220,100,,176.00,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.82,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.98,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.94,37.7,,66.35,,,0,"percent of total billed charges","37.7% of total billed charges",82.94,37.7,,66.35,,,0,"percent of total billed charges","37.70% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.58,33.9,,59.66,,,0,"percent of total billed charges","33.9% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",171.6,78,,137.28,,,0,"percent of total billed charges","78% of total billed charges",12.09,101,,,,,0,"fee schedule","101% of CMS fee schedule ",181.72,82.6,,145.38,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",181.72,82.6,,145.38,,,0,"percent of total billed charges","82.6% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,220,100,,176.00,,,0,"percent of total billed charges","100% of total billed charges",4.81,220,
"Giardia/Cryptosporidium EIA LC",30687329,CDM,306,RC,87329,CPT,OUTPATIENT,,,104,67.6,,91.52,88,,73.22,,,0,"percent of total billed charges","88% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",20.96,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.52,63,,52.42,,,0,"percent of total billed charges","63% of total billed charges",15.91,15.3,,12.73,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,71.76,69,,,,,0,"fee schedule","69% of total billed charges",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.82,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.98,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.21,37.7,,31.37,,,0,"percent of total billed charges","37.7% of total billed charges",39.21,37.7,,31.37,,,0,"percent of total billed charges","37.70% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.26,33.9,,28.21,,,0,"percent of total billed charges","33.9% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.12,78,,64.90,,,0,"percent of total billed charges","78% of total billed charges",12.09,101,,,,,0,"fee schedule","101% of CMS fee schedule ",85.9,82.6,,68.72,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.9,82.6,,68.72,,,0,"percent of total billed charges","82.6% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,104,
"Gliadin IgG/IgA Ab Prof, EIA LC",30183516,CDM,301,RC,83516,CPT,OUTPATIENT,,,98,63.7,,86.24,88,,68.99,,,0,"percent of total billed charges","88% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",20.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",14.99,15.3,,11.99,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,67.62,69,,,,,0,"fee schedule","69% of total billed charges",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.53,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.95,37.7,,29.56,,,0,"percent of total billed charges","37.7% of total billed charges",36.95,37.7,,29.56,,,0,"percent of total billed charges","37.70% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.22,33.9,,26.58,,,0,"percent of total billed charges","33.9% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.44,78,,61.15,,,0,"percent of total billed charges","78% of total billed charges",11.64,101,,,,,0,"fee schedule","101% of CMS fee schedule ",80.95,82.6,,64.76,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.95,82.6,,64.76,,,0,"percent of total billed charges","82.6% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,98,
"GLUCOSE BLOOD",30182947,CDM,301,RC,82947,CPT,OUTPATIENT,,,50,32.5,,44,88,,35.20,,,0,"percent of total billed charges","88% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",6.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.5,63,,25.20,,,0,"percent of total billed charges","63% of total billed charges",7.65,15.3,,6.12,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,34.5,69,,,,,0,"fee schedule","69% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.03,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.93,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.7% of total billed charges",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.70% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.95,33.9,,13.56,,,0,"percent of total billed charges","33.9% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",39,78,,31.20,,,0,"percent of total billed charges","78% of total billed charges",3.96,101,,,,,0,"fee schedule","101% of CMS fee schedule ",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",3.25,50,
"Glucose Body Fluid",30182945,CDM,301,RC,82945,CPT,OUTPATIENT,,,79,51.35,,69.52,88,,55.62,,,0,"percent of total billed charges","88% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",6.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.77,63,,39.82,,,0,"percent of total billed charges","63% of total billed charges",12.09,15.3,,9.67,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,54.51,69,,,,,0,"fee schedule","69% of total billed charges",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.03,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.93,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.78,37.7,,23.82,,,0,"percent of total billed charges","37.7% of total billed charges",29.78,37.7,,23.82,,,0,"percent of total billed charges","37.70% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.78,33.9,,21.42,,,0,"percent of total billed charges","33.9% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.62,78,,49.30,,,0,"percent of total billed charges","78% of total billed charges",3.96,101,,,,,0,"fee schedule","101% of CMS fee schedule ",65.25,82.6,,52.20,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.25,82.6,,52.20,,,0,"percent of total billed charges","82.6% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",3.25,79,
"Glucose CSF",30182945,CDM,301,RC,82945,CPT,OUTPATIENT,,,79,51.35,,69.52,88,,55.62,,,0,"percent of total billed charges","88% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",6.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.77,63,,39.82,,,0,"percent of total billed charges","63% of total billed charges",12.09,15.3,,9.67,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,54.51,69,,,,,0,"fee schedule","69% of total billed charges",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.03,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.93,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.78,37.7,,23.82,,,0,"percent of total billed charges","37.7% of total billed charges",29.78,37.7,,23.82,,,0,"percent of total billed charges","37.70% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.78,33.9,,21.42,,,0,"percent of total billed charges","33.9% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.62,78,,49.30,,,0,"percent of total billed charges","78% of total billed charges",3.96,101,,,,,0,"fee schedule","101% of CMS fee schedule ",65.25,82.6,,52.20,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.25,82.6,,52.20,,,0,"percent of total billed charges","82.6% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",3.25,79,
"Glucose Urine",30082945,CDM,300,RC,82945,CPT,OUTPATIENT,,,79,51.35,,69.52,88,,55.62,,,0,"percent of total billed charges","88% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",6.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.77,63,,39.82,,,0,"percent of total billed charges","63% of total billed charges",12.09,15.3,,9.67,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,54.51,69,,,,,0,"fee schedule","69% of total billed charges",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.03,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.93,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.78,37.7,,23.82,,,0,"percent of total billed charges","37.7% of total billed charges",29.78,37.7,,23.82,,,0,"percent of total billed charges","37.70% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.78,33.9,,21.42,,,0,"percent of total billed charges","33.9% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.62,78,,49.30,,,0,"percent of total billed charges","78% of total billed charges",3.96,101,,,,,0,"fee schedule","101% of CMS fee schedule ",65.25,82.6,,52.20,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.25,82.6,,52.20,,,0,"percent of total billed charges","82.6% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",3.25,79,
"Glucose 1 Hour",30082950,CDM,300,RC,82950,CPT,OUTPATIENT,,,99,64.35,,87.12,88,,69.70,,,0,"percent of total billed charges","88% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",8.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.37,63,,49.90,,,0,"percent of total billed charges","63% of total billed charges",15.15,15.3,,12.12,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,68.31,69,,,,,0,"fee schedule","69% of total billed charges",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.16,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.75,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.32,37.7,,29.86,,,0,"percent of total billed charges","37.7% of total billed charges",37.32,37.7,,29.86,,,0,"percent of total billed charges","37.70% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.56,33.9,,26.85,,,0,"percent of total billed charges","33.9% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.22,78,,61.78,,,0,"percent of total billed charges","78% of total billed charges",4.79,101,,,,,0,"fee schedule","101% of CMS fee schedule ",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",3.25,99,
"Glucose, tolerance test",30082950,CDM,301,RC,82952,CPT,OUTPATIENT,,,99,64.35,,87.12,88,,69.70,,,0,"percent of total billed charges","88% of total billed charges",3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",6.86,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.37,63,,49.90,,,0,"percent of total billed charges","63% of total billed charges",15.15,15.3,,12.12,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,68.31,69,,,,,0,"fee schedule","69% of total billed charges",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.92,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.32,37.7,,29.86,,,0,"percent of total billed charges","37.7% of total billed charges",37.32,37.7,,29.86,,,0,"percent of total billed charges","37.70% of total billed charges",3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.56,33.9,,26.85,,,0,"percent of total billed charges","33.9% of total billed charges",3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.22,78,,61.78,,,0,"percent of total billed charges","78% of total billed charges",3.95,101,,,,,0,"fee schedule","101% of CMS fee schedule ",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",3.25,99,
"Glucose 3 Hour",30182952,CDM,301,RC,82952,CPT,OUTPATIENT,,,38,24.7,,33.44,88,,26.75,,,0,"percent of total billed charges","88% of total billed charges",3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",6.86,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.94,63,,19.15,,,0,"percent of total billed charges","63% of total billed charges",5.81,15.3,,4.65,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,26.22,69,,,,,0,"fee schedule","69% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.92,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.33,37.7,,11.46,,,0,"percent of total billed charges","37.7% of total billed charges",14.33,37.7,,11.46,,,0,"percent of total billed charges","37.70% of total billed charges",3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.88,33.9,,10.30,,,0,"percent of total billed charges","33.9% of total billed charges",3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.64,78,,23.71,,,0,"percent of total billed charges","78% of total billed charges",3.95,101,,,,,0,"fee schedule","101% of CMS fee schedule ",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,38,
"Glucose 1 Hour Post Prandial",30082950,CDM,300,RC,82950,CPT,OUTPATIENT,,,238,154.7,,209.44,88,,167.55,,,0,"percent of total billed charges","88% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",8.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",149.94,63,,119.95,,,0,"percent of total billed charges","63% of total billed charges",36.41,15.3,,29.13,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,164.22,69,,,,,0,"fee schedule","69% of total billed charges",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.16,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.75,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.73,37.7,,71.78,,,0,"percent of total billed charges","37.7% of total billed charges",89.73,37.7,,71.78,,,0,"percent of total billed charges","37.70% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.68,33.9,,64.54,,,0,"percent of total billed charges","33.9% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",185.64,78,,148.51,,,0,"percent of total billed charges","78% of total billed charges",4.79,101,,,,,0,"fee schedule","101% of CMS fee schedule ",196.59,82.6,,157.27,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",196.59,82.6,,157.27,,,0,"percent of total billed charges","82.6% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,238,
"GLUCOSE 2 HR PP",30182950,CDM,301,RC,82950,CPT,OUTPATIENT,,,238,154.7,,209.44,88,,167.55,,,0,"percent of total billed charges","88% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",8.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",149.94,63,,119.95,,,0,"percent of total billed charges","63% of total billed charges",36.41,15.3,,29.13,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,164.22,69,,,,,0,"fee schedule","69% of total billed charges",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.16,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.75,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.73,37.7,,71.78,,,0,"percent of total billed charges","37.7% of total billed charges",89.73,37.7,,71.78,,,0,"percent of total billed charges","37.70% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.68,33.9,,64.54,,,0,"percent of total billed charges","33.9% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",185.64,78,,148.51,,,0,"percent of total billed charges","78% of total billed charges",4.79,101,,,,,0,"fee schedule","101% of CMS fee schedule ",196.59,82.6,,157.27,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",196.59,82.6,,157.27,,,0,"percent of total billed charges","82.6% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,238,
"Glucose Level 24 hour Urine",30082947,CDM,300,RC,82947,CPT,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",6.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.03,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.93,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.7% of total billed charges",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.41,33.9,,3.53,,,0,"percent of total billed charges","33.9% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",3.96,101,,,,,0,"fee schedule","101% of CMS fee schedule ",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,15.03,
"Glucose Tolerance Test - 3 Hours",30082951,CDM,300,RC,82951,CPT,OUTPATIENT,,,253,164.45,,222.64,88,,178.11,,,0,"percent of total billed charges","88% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",22.52,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",159.39,63,,127.51,,,0,"percent of total billed charges","63% of total billed charges",38.71,15.3,,30.97,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,174.57,69,,,,,0,"fee schedule","69% of total billed charges",253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.22,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.87,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.38,37.7,,76.30,,,0,"percent of total billed charges","37.7% of total billed charges",95.38,37.7,,76.30,,,0,"percent of total billed charges","37.70% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.77,33.9,,68.62,,,0,"percent of total billed charges","33.9% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",197.34,78,,157.87,,,0,"percent of total billed charges","78% of total billed charges",12.99,101,,,,,0,"fee schedule","101% of CMS fee schedule ",208.98,82.6,,167.18,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",208.98,82.6,,167.18,,,0,"percent of total billed charges","82.6% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,253,
"Glucose Tolerance Test - 4 Hours",30082951,CDM,300,RC,82951,CPT,OUTPATIENT,,,253,164.45,,222.64,88,,178.11,,,0,"percent of total billed charges","88% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",22.52,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",159.39,63,,127.51,,,0,"percent of total billed charges","63% of total billed charges",38.71,15.3,,30.97,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,174.57,69,,,,,0,"fee schedule","69% of total billed charges",253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.22,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.87,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.38,37.7,,76.30,,,0,"percent of total billed charges","37.7% of total billed charges",95.38,37.7,,76.30,,,0,"percent of total billed charges","37.70% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.77,33.9,,68.62,,,0,"percent of total billed charges","33.9% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",197.34,78,,157.87,,,0,"percent of total billed charges","78% of total billed charges",12.99,101,,,,,0,"fee schedule","101% of CMS fee schedule ",208.98,82.6,,167.18,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",208.98,82.6,,167.18,,,0,"percent of total billed charges","82.6% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,253,
"Glucose Tolerance Test - 5 Hours",30082951,CDM,300,RC,82951,CPT,OUTPATIENT,,,253,164.45,,222.64,88,,178.11,,,0,"percent of total billed charges","88% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",22.52,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",159.39,63,,127.51,,,0,"percent of total billed charges","63% of total billed charges",38.71,15.3,,30.97,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,174.57,69,,,,,0,"fee schedule","69% of total billed charges",253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.22,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.87,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.38,37.7,,76.30,,,0,"percent of total billed charges","37.7% of total billed charges",95.38,37.7,,76.30,,,0,"percent of total billed charges","37.70% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.77,33.9,,68.62,,,0,"percent of total billed charges","33.9% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",197.34,78,,157.87,,,0,"percent of total billed charges","78% of total billed charges",12.99,101,,,,,0,"fee schedule","101% of CMS fee schedule ",208.98,82.6,,167.18,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",208.98,82.6,,167.18,,,0,"percent of total billed charges","82.6% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,253,
"Glucose Tolerance Test - 6 Hours",30082951,CDM,300,RC,82951,CPT,OUTPATIENT,,,253,164.45,,222.64,88,,178.11,,,0,"percent of total billed charges","88% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",22.52,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",159.39,63,,127.51,,,0,"percent of total billed charges","63% of total billed charges",38.71,15.3,,30.97,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,174.57,69,,,,,0,"fee schedule","69% of total billed charges",253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.22,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.87,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.38,37.7,,76.30,,,0,"percent of total billed charges","37.7% of total billed charges",95.38,37.7,,76.30,,,0,"percent of total billed charges","37.70% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.77,33.9,,68.62,,,0,"percent of total billed charges","33.9% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",197.34,78,,157.87,,,0,"percent of total billed charges","78% of total billed charges",12.99,101,,,,,0,"fee schedule","101% of CMS fee schedule ",208.98,82.6,,167.18,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",208.98,82.6,,167.18,,,0,"percent of total billed charges","82.6% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,253,
"Glucose 1 Hour Post Prandial OB",30082950,CDM,300,RC,82950,CPT,OUTPATIENT,,,238,154.7,,209.44,88,,167.55,,,0,"percent of total billed charges","88% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",8.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",149.94,63,,119.95,,,0,"percent of total billed charges","63% of total billed charges",36.41,15.3,,29.13,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,164.22,69,,,,,0,"fee schedule","69% of total billed charges",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.16,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.75,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.73,37.7,,71.78,,,0,"percent of total billed charges","37.7% of total billed charges",89.73,37.7,,71.78,,,0,"percent of total billed charges","37.70% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.68,33.9,,64.54,,,0,"percent of total billed charges","33.9% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",185.64,78,,148.51,,,0,"percent of total billed charges","78% of total billed charges",4.79,101,,,,,0,"fee schedule","101% of CMS fee schedule ",196.59,82.6,,157.27,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",196.59,82.6,,157.27,,,0,"percent of total billed charges","82.6% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,238,
"GC by Nucleic Acid Amplification",30182950,CDM,301,RC,82950,CPT,OUTPATIENT,,,99,64.35,,87.12,88,,69.70,,,0,"percent of total billed charges","88% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",8.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.37,63,,49.90,,,0,"percent of total billed charges","63% of total billed charges",15.15,15.3,,12.12,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,68.31,69,,,,,0,"fee schedule","69% of total billed charges",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.16,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.75,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.32,37.7,,29.86,,,0,"percent of total billed charges","37.7% of total billed charges",37.32,37.7,,29.86,,,0,"percent of total billed charges","37.70% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.56,33.9,,26.85,,,0,"percent of total billed charges","33.9% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.22,78,,61.78,,,0,"percent of total billed charges","78% of total billed charges",4.79,101,,,,,0,"fee schedule","101% of CMS fee schedule ",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",3.25,99,
"Glucose, Body Fluid LC",30182945,CDM,301,RC,82945,CPT,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",6.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.03,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.93,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.7% of total billed charges",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.07,33.9,,3.26,,,0,"percent of total billed charges","33.9% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",3.96,101,,,,,0,"fee schedule","101% of CMS fee schedule ",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",3.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,15.03,
"GTT 3 Hr OB Add'l Specimen",30082952,CDM,300,RC,82952,CPT,OUTPATIENT,,,238,154.7,,209.44,88,,167.55,,,0,"percent of total billed charges","88% of total billed charges",3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",6.86,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",149.94,63,,119.95,,,0,"percent of total billed charges","63% of total billed charges",36.41,15.3,,29.13,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,164.22,69,,,,,0,"fee schedule","69% of total billed charges",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.92,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.73,37.7,,71.78,,,0,"percent of total billed charges","37.7% of total billed charges",89.73,37.7,,71.78,,,0,"percent of total billed charges","37.70% of total billed charges",3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.68,33.9,,64.54,,,0,"percent of total billed charges","33.9% of total billed charges",3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",185.64,78,,148.51,,,0,"percent of total billed charges","78% of total billed charges",3.95,101,,,,,0,"fee schedule","101% of CMS fee schedule ",196.59,82.6,,157.27,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",196.59,82.6,,157.27,,,0,"percent of total billed charges","82.6% of total billed charges",3.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,238,
"Glucose Tolerance Test (3 hr OB)",30082950,CDM,301,RC,82951,CPT,OUTPATIENT,,,99,64.35,,87.12,88,,69.70,,,0,"percent of total billed charges","88% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",22.52,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.37,63,,49.90,,,0,"percent of total billed charges","63% of total billed charges",15.15,15.3,,12.12,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,68.31,69,,,,,0,"fee schedule","69% of total billed charges",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.22,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.87,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.32,37.7,,29.86,,,0,"percent of total billed charges","37.7% of total billed charges",37.32,37.7,,29.86,,,0,"percent of total billed charges","37.70% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.56,33.9,,26.85,,,0,"percent of total billed charges","33.9% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.22,78,,61.78,,,0,"percent of total billed charges","78% of total billed charges",12.99,101,,,,,0,"fee schedule","101% of CMS fee schedule ",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",8.11,99,
"Glucose Tolerance Test 3 Hr OB",30082951,CDM,300,RC,82951,CPT,OUTPATIENT,,,253,164.45,,222.64,88,,178.11,,,0,"percent of total billed charges","88% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",22.52,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",159.39,63,,127.51,,,0,"percent of total billed charges","63% of total billed charges",38.71,15.3,,30.97,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,174.57,69,,,,,0,"fee schedule","69% of total billed charges",253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.22,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.87,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.38,37.7,,76.30,,,0,"percent of total billed charges","37.7% of total billed charges",95.38,37.7,,76.30,,,0,"percent of total billed charges","37.70% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.77,33.9,,68.62,,,0,"percent of total billed charges","33.9% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",197.34,78,,157.87,,,0,"percent of total billed charges","78% of total billed charges",12.99,101,,,,,0,"fee schedule","101% of CMS fee schedule ",208.98,82.6,,167.18,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",208.98,82.6,,167.18,,,0,"percent of total billed charges","82.6% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,253,
"GLUCOSE TOL 2HR",30182951,CDM,301,RC,82951,CPT,OUTPATIENT,,,253,164.45,,222.64,88,,178.11,,,0,"percent of total billed charges","88% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",22.52,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",159.39,63,,127.51,,,0,"percent of total billed charges","63% of total billed charges",38.71,15.3,,30.97,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,174.57,69,,,,,0,"fee schedule","69% of total billed charges",253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.22,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.87,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.38,37.7,,76.30,,,0,"percent of total billed charges","37.7% of total billed charges",95.38,37.7,,76.30,,,0,"percent of total billed charges","37.70% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.77,33.9,,68.62,,,0,"percent of total billed charges","33.9% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",197.34,78,,157.87,,,0,"percent of total billed charges","78% of total billed charges",12.99,101,,,,,0,"fee schedule","101% of CMS fee schedule ",208.98,82.6,,167.18,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",208.98,82.6,,167.18,,,0,"percent of total billed charges","82.6% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,253,
"Glucose Tolerance Test 30m",30082951,CDM,300,RC,82951,CPT,OUTPATIENT,,,253,164.45,,222.64,88,,178.11,,,0,"percent of total billed charges","88% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",22.52,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",159.39,63,,127.51,,,0,"percent of total billed charges","63% of total billed charges",38.71,15.3,,30.97,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,174.57,69,,,,,0,"fee schedule","69% of total billed charges",253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.22,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.87,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.38,37.7,,76.30,,,0,"percent of total billed charges","37.7% of total billed charges",95.38,37.7,,76.30,,,0,"percent of total billed charges","37.70% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.77,33.9,,68.62,,,0,"percent of total billed charges","33.9% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",197.34,78,,157.87,,,0,"percent of total billed charges","78% of total billed charges",12.99,101,,,,,0,"fee schedule","101% of CMS fee schedule ",208.98,82.6,,167.18,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",208.98,82.6,,167.18,,,0,"percent of total billed charges","82.6% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,253,
"Group B Strep PCR (GeneXpert)",30687653,CDM,306,RC,87653,CPT,OUTPATIENT,,,96,62.4,,84.48,88,,67.58,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.48,63,,48.38,,,0,"percent of total billed charges","63% of total billed charges",14.69,15.3,,11.75,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,66.24,69,,,,,0,"fee schedule","69% of total billed charges",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.19,37.7,,28.95,,,0,"percent of total billed charges","37.7% of total billed charges",36.19,37.7,,28.95,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.54,33.9,,26.03,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.88,78,,59.90,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",14.69,134.21,
"Group B Streptococcus AVR",30687653,CDM,306,RC,87653,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"Growth Hormone LC",30183003,CDM,301,RC,83003,CPT,OUTPATIENT,,,362,235.3,,318.56,88,,254.85,,,0,"percent of total billed charges","88% of total billed charges",16.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,362,100,,289.60,,,0,"percent of total billed charges","100% of total billed charges",29.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,16.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",228.06,63,,182.45,,,0,"percent of total billed charges","63% of total billed charges",55.39,15.3,,44.31,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,249.78,69,,,,,0,"fee schedule","69% of total billed charges",362,100,,289.60,,,0,"percent of total billed charges","100% of total billed charges",16.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",362,100,,289.60,,,0,"percent of total billed charges","100% of total billed charges",16.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",362,100,,289.60,,,0,"percent of total billed charges","100% of total billed charges",16.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.76,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,16.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.67,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,16.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,16.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.47,37.7,,109.18,,,0,"percent of total billed charges","37.7% of total billed charges",136.47,37.7,,109.18,,,0,"percent of total billed charges","37.70% of total billed charges",16.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",122.72,33.9,,98.18,,,0,"percent of total billed charges","33.9% of total billed charges",16.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",282.36,78,,225.89,,,0,"percent of total billed charges","78% of total billed charges",16.83,101,,,,,0,"fee schedule","101% of CMS fee schedule ",299.01,82.6,,239.21,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,16.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",299.01,82.6,,239.21,,,0,"percent of total billed charges","82.6% of total billed charges",16.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,362,100,,289.60,,,0,"percent of total billed charges","100% of total billed charges",8.39,362,
"H. pylori, IgG Abs LC",30286677,CDM,302,RC,86677,CPT,OUTPATIENT,,,94,61.1,,82.72,88,,66.18,,,0,"percent of total billed charges","88% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",29.48,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,63,,47.38,,,0,"percent of total billed charges","63% of total billed charges",14.38,15.3,,11.50,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,64.86,69,,,,,0,"fee schedule","69% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.45,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.85,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.44,37.7,,28.35,,,0,"percent of total billed charges","37.7% of total billed charges",35.44,37.7,,28.35,,,0,"percent of total billed charges","37.70% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.87,33.9,,25.50,,,0,"percent of total billed charges","33.9% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.32,78,,58.66,,,0,"percent of total billed charges","78% of total billed charges",17.01,101,,,,,0,"fee schedule","101% of CMS fee schedule ",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,94,
"H. pylori Stool Ag, EIA LC",30687338,CDM,306,RC,87338,CPT,OUTPATIENT,,,527,342.55,,463.76,88,,371.01,,,0,"percent of total billed charges","88% of total billed charges",14.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,527,100,,421.60,,,0,"percent of total billed charges","100% of total billed charges",25.16,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,14.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",332.01,63,,265.61,,,0,"percent of total billed charges","63% of total billed charges",80.63,15.3,,64.50,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,363.63,69,,,,,0,"fee schedule","69% of total billed charges",527,100,,421.60,,,0,"percent of total billed charges","100% of total billed charges",14.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",527,100,,421.60,,,0,"percent of total billed charges","100% of total billed charges",14.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",527,100,,421.60,,,0,"percent of total billed charges","100% of total billed charges",14.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",55,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,14.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.38,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,14.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,14.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",198.68,37.7,,158.94,,,0,"percent of total billed charges","37.7% of total billed charges",198.68,37.7,,158.94,,,0,"percent of total billed charges","37.70% of total billed charges",14.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",178.65,33.9,,142.92,,,0,"percent of total billed charges","33.9% of total billed charges",14.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",411.06,78,,328.85,,,0,"percent of total billed charges","78% of total billed charges",14.52,101,,,,,0,"fee schedule","101% of CMS fee schedule ",435.3,82.6,,348.24,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,14.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",435.3,82.6,,348.24,,,0,"percent of total billed charges","82.6% of total billed charges",14.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,527,100,,421.60,,,0,"percent of total billed charges","100% of total billed charges",4.81,527,
"H. pylori Breath Test LC",30083013,CDM,300,RC,83013,CPT,OUTPATIENT,,,452,293.8,,397.76,88,,318.21,,,0,"percent of total billed charges","88% of total billed charges",67.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.85,100,,,,,0,"fee schedule",EAPG,452,100,,361.60,,,0,"percent of total billed charges","100% of total billed charges",117.88,175,,,,,0,"fee schedule","175% of CMS fee schedule",101.81,100,,,,,0,"fee schedule",EAPG,67.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",284.76,63,,227.81,,,0,"percent of total billed charges","63% of total billed charges",69.16,15.3,,55.33,,,0,"percent of total billed charges","15.3% of total billed charges",98.85,100,,,,,0,"fee schedule",EAPG,311.88,69,,,,,0,"fee schedule","69% of total billed charges",452,100,,361.60,,,0,"percent of total billed charges","100% of total billed charges",67.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",452,100,,361.60,,,0,"percent of total billed charges","100% of total billed charges",67.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",452,100,,361.60,,,0,"percent of total billed charges","100% of total billed charges",67.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",257.65,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",98.85,100,,,,,0,"fee schedule",EAPG,67.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.36,100,,,,,0,"fee schedule","100% of LI fee schedule",73.22,100,,,,,0,"fee schedule",EAPG,67.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.82,100,,,,,0,"fee schedule",EAPG,128.5,100,,,,,0,"fee schedule",EAPG,67.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.4,37.7,,136.32,,,0,"percent of total billed charges","37.7% of total billed charges",170.4,37.7,,136.32,,,0,"percent of total billed charges","37.70% of total billed charges",67.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",153.23,33.9,,122.58,,,0,"percent of total billed charges","33.9% of total billed charges",67.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",352.56,78,,282.05,,,0,"percent of total billed charges","78% of total billed charges",68.03,101,,,,,0,"fee schedule","101% of CMS fee schedule ",373.35,82.6,,298.68,,,0,"percent of total billed charges","82.6% of total billed charges",98.85,100,,,,,0,"fee schedule",EAPG,67.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",373.35,82.6,,298.68,,,0,"percent of total billed charges","82.6% of total billed charges",67.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.85,100,,,,,0,"fee schedule",EAPG,452,100,,361.60,,,0,"percent of total billed charges","100% of total billed charges",67.36,452,
"H.pylori IgG/IgA Ab LC",30286677,CDM,302,RC,86677,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.39,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.67,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.39,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.39,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.39,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.39,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",6.96,12.21,
"HBV DNA RealTime Abbott LC",30687517,CDM,306,RC,87517,CPT,OUTPATIENT,,,1753,1139.45,,1542.64,88,,1234.11,,,0,"percent of total billed charges","88% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,1753,100,,1402.40,,,0,"percent of total billed charges","100% of total billed charges",74.97,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",1104.39,63,,883.51,,,0,"percent of total billed charges","63% of total billed charges",268.21,15.3,,214.57,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,1209.57,69,,,,,0,"fee schedule","69% of total billed charges",1753,100,,1402.40,,,0,"percent of total billed charges","100% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",1753,100,,1402.40,,,0,"percent of total billed charges","100% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",1753,100,,1402.40,,,0,"percent of total billed charges","100% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.86,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.84,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",660.88,37.7,,528.70,,,0,"percent of total billed charges","37.7% of total billed charges",660.88,37.7,,528.70,,,0,"percent of total billed charges","37.70% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",594.27,33.9,,475.42,,,0,"percent of total billed charges","33.9% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",1367.34,78,,1093.87,,,0,"percent of total billed charges","78% of total billed charges",43.26,101,,,,,0,"fee schedule","101% of CMS fee schedule ",1447.98,82.6,,1158.38,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",1447.98,82.6,,1158.38,,,0,"percent of total billed charges","82.6% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,1753,100,,1402.40,,,0,"percent of total billed charges","100% of total billed charges",18.33,1753,
"HBV DNA RealTime Abbott LC",30687517,CDM,306,RC,87517,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25.49,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.33,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",18.33,32.18,
"HBsAg Screen LC",30687340,CDM,306,RC,87340,CPT,OUTPATIENT,,,177,115.05,,155.76,88,,124.61,,,0,"percent of total billed charges","88% of total billed charges",10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",18.07,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",111.51,63,,89.21,,,0,"percent of total billed charges","63% of total billed charges",27.08,15.3,,21.66,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,122.13,69,,,,,0,"fee schedule","69% of total billed charges",177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.33,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.73,37.7,,53.38,,,0,"percent of total billed charges","37.7% of total billed charges",66.73,37.7,,53.38,,,0,"percent of total billed charges","37.70% of total billed charges",10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",60,33.9,,48.00,,,0,"percent of total billed charges","33.9% of total billed charges",10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",138.06,78,,110.45,,,0,"percent of total billed charges","78% of total billed charges",10.43,101,,,,,0,"fee schedule","101% of CMS fee schedule ",146.2,82.6,,116.96,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",146.2,82.6,,116.96,,,0,"percent of total billed charges","82.6% of total billed charges",10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",4.81,177,
"HCV Antibody LC",30286803,CDM,302,RC,86803,CPT,OUTPATIENT,,,194,126.1,,170.72,88,,136.58,,,0,"percent of total billed charges","88% of total billed charges",14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",24.97,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",122.22,63,,97.78,,,0,"percent of total billed charges","63% of total billed charges",29.68,15.3,,23.74,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,133.86,69,,,,,0,"fee schedule","69% of total billed charges",194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.58,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.27,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.14,37.7,,58.51,,,0,"percent of total billed charges","37.7% of total billed charges",73.14,37.7,,58.51,,,0,"percent of total billed charges","37.70% of total billed charges",14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.77,33.9,,52.62,,,0,"percent of total billed charges","33.9% of total billed charges",14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.32,78,,121.06,,,0,"percent of total billed charges","78% of total billed charges",14.41,101,,,,,0,"fee schedule","101% of CMS fee schedule ",160.24,82.6,,128.19,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.24,82.6,,128.19,,,0,"percent of total billed charges","82.6% of total billed charges",14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,194,
"HCV FibroSure LC",30182247,CDM,301,RC,82247,CPT,OUTPATIENT,,,79,51.35,,69.52,88,,55.62,,,0,"percent of total billed charges","88% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",8.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.77,63,,39.82,,,0,"percent of total billed charges","63% of total billed charges",12.09,15.3,,9.67,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,54.51,69,,,,,0,"fee schedule","69% of total billed charges",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.2,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.01,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.78,37.7,,23.82,,,0,"percent of total billed charges","37.7% of total billed charges",29.78,37.7,,23.82,,,0,"percent of total billed charges","37.70% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.78,33.9,,21.42,,,0,"percent of total billed charges","33.9% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.62,78,,49.30,,,0,"percent of total billed charges","78% of total billed charges",5.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",65.25,82.6,,52.20,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.25,82.6,,52.20,,,0,"percent of total billed charges","82.6% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",3.25,79,
"HCV Genotyping Non Reflex LC",30087902,CDM,300,RC,87902,CPT,OUTPATIENT,,,1476,959.4,,1298.88,88,,1039.10,,,0,"percent of total billed charges","88% of total billed charges",257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,1476,100,,1180.80,,,0,"percent of total billed charges","100% of total billed charges",450.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",110.23,100,,,,,0,"fee schedule",EAPG,257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",929.88,63,,743.90,,,0,"percent of total billed charges","63% of total billed charges",225.83,15.3,,180.66,,,0,"percent of total billed charges","15.3% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,1018.44,69,,,,,0,"fee schedule","69% of total billed charges",1476,100,,1180.80,,,0,"percent of total billed charges","100% of total billed charges",257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",1476,100,,1180.80,,,0,"percent of total billed charges","100% of total billed charges",257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",1476,100,,1180.80,,,0,"percent of total billed charges","100% of total billed charges",257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",984.74,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",257.45,100,,,,,0,"fee schedule","100% of LI fee schedule",79.27,100,,,,,0,"fee schedule",EAPG,257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.16,100,,,,,0,"fee schedule",EAPG,139.13,100,,,,,0,"fee schedule",EAPG,257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",556.45,37.7,,445.16,,,0,"percent of total billed charges","37.7% of total billed charges",556.45,37.7,,445.16,,,0,"percent of total billed charges","37.70% of total billed charges",257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",500.36,33.9,,400.29,,,0,"percent of total billed charges","33.9% of total billed charges",257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",1151.28,78,,921.02,,,0,"percent of total billed charges","78% of total billed charges",260.02,101,,,,,0,"fee schedule","101% of CMS fee schedule ",1219.18,82.6,,975.34,,,0,"percent of total billed charges","82.6% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",1219.18,82.6,,975.34,,,0,"percent of total billed charges","82.6% of total billed charges",257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,1476,100,,1180.80,,,0,"percent of total billed charges","100% of total billed charges",79.27,1476,
"HCV RT-PCR, Quant (Non-Graph) LC",30687522,CDM,306,RC,87522,CPT,OUTPATIENT,,,923,599.95,,812.24,88,,649.79,,,0,"percent of total billed charges","88% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,923,100,,738.40,,,0,"percent of total billed charges","100% of total billed charges",74.97,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",581.49,63,,465.19,,,0,"percent of total billed charges","63% of total billed charges",141.22,15.3,,112.98,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,636.87,69,,,,,0,"fee schedule","69% of total billed charges",923,100,,738.40,,,0,"percent of total billed charges","100% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",923,100,,738.40,,,0,"percent of total billed charges","100% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",923,100,,738.40,,,0,"percent of total billed charges","100% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.86,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.84,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",347.97,37.7,,278.38,,,0,"percent of total billed charges","37.7% of total billed charges",347.97,37.7,,278.38,,,0,"percent of total billed charges","37.70% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",312.9,33.9,,250.32,,,0,"percent of total billed charges","33.9% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",719.94,78,,575.95,,,0,"percent of total billed charges","78% of total billed charges",43.26,101,,,,,0,"fee schedule","101% of CMS fee schedule ",762.4,82.6,,609.92,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",762.4,82.6,,609.92,,,0,"percent of total billed charges","82.6% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,923,100,,738.40,,,0,"percent of total billed charges","100% of total billed charges",18.33,923,
"HCV RNA by PCR, Qn Rfx Geno LC",30687522,CDM,306,RC,87522,CPT,OUTPATIENT,,,563,365.95,,495.44,88,,396.35,,,0,"percent of total billed charges","88% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,563,100,,450.40,,,0,"percent of total billed charges","100% of total billed charges",74.97,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",354.69,63,,283.75,,,0,"percent of total billed charges","63% of total billed charges",86.14,15.3,,68.91,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,388.47,69,,,,,0,"fee schedule","69% of total billed charges",563,100,,450.40,,,0,"percent of total billed charges","100% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",563,100,,450.40,,,0,"percent of total billed charges","100% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",563,100,,450.40,,,0,"percent of total billed charges","100% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.86,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.84,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",212.25,37.7,,169.80,,,0,"percent of total billed charges","37.7% of total billed charges",212.25,37.7,,169.80,,,0,"percent of total billed charges","37.70% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",190.86,33.9,,152.69,,,0,"percent of total billed charges","33.9% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",439.14,78,,351.31,,,0,"percent of total billed charges","78% of total billed charges",43.26,101,,,,,0,"fee schedule","101% of CMS fee schedule ",465.04,82.6,,372.03,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",465.04,82.6,,372.03,,,0,"percent of total billed charges","82.6% of total billed charges",42.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,563,100,,450.40,,,0,"percent of total billed charges","100% of total billed charges",18.33,563,
"HCV Genotyping LC 144052",30687902,CDM,306,RC,87902,CPT,OUTPATIENT,,,1433,931.45,,1261.04,88,,1008.83,,,0,"percent of total billed charges","88% of total billed charges",257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,1433,100,,1146.40,,,0,"percent of total billed charges","100% of total billed charges",450.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",110.23,100,,,,,0,"fee schedule",EAPG,257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",902.79,63,,722.23,,,0,"percent of total billed charges","63% of total billed charges",219.25,15.3,,175.40,,,0,"percent of total billed charges","15.3% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,988.77,69,,,,,0,"fee schedule","69% of total billed charges",1433,100,,1146.40,,,0,"percent of total billed charges","100% of total billed charges",257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",1433,100,,1146.40,,,0,"percent of total billed charges","100% of total billed charges",257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",1433,100,,1146.40,,,0,"percent of total billed charges","100% of total billed charges",257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",984.74,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",257.45,100,,,,,0,"fee schedule","100% of LI fee schedule",79.27,100,,,,,0,"fee schedule",EAPG,257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.16,100,,,,,0,"fee schedule",EAPG,139.13,100,,,,,0,"fee schedule",EAPG,257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",540.24,37.7,,432.19,,,0,"percent of total billed charges","37.7% of total billed charges",540.24,37.7,,432.19,,,0,"percent of total billed charges","37.70% of total billed charges",257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",485.79,33.9,,388.63,,,0,"percent of total billed charges","33.9% of total billed charges",257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",1117.74,78,,894.19,,,0,"percent of total billed charges","78% of total billed charges",260.02,101,,,,,0,"fee schedule","101% of CMS fee schedule ",1183.66,82.6,,946.93,,,0,"percent of total billed charges","82.6% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",1183.66,82.6,,946.93,,,0,"percent of total billed charges","82.6% of total billed charges",257.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,1433,100,,1146.40,,,0,"percent of total billed charges","100% of total billed charges",79.27,1433,
"HER-2/CEP17 FISH LC",31088377,CDM,310,RC,88377,CPT,OUTPATIENT,,,2373,1542.45,,2088.24,88,,1670.59,,,0,"percent of total billed charges","88% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,2373,100,,1898.40,,,0,"percent of total billed charges","100% of total billed charges",304.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",37.5,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.99,63,,1195.99,,,0,"percent of total billed charges","63% of total billed charges",363.07,15.3,,290.46,,,0,"percent of total billed charges","15.3% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,1637.37,69,,,,,0,"fee schedule","69% of total billed charges",2373,100,,1898.40,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2373,100,,1898.40,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2373,100,,1898.40,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",605.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.97,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37.13,100,,,,,0,"fee schedule",EAPG,47.33,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",894.62,37.7,,715.70,,,0,"percent of total billed charges","37.7% of total billed charges",894.62,37.7,,715.70,,,0,"percent of total billed charges","37.70% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",804.45,33.9,,643.56,,,0,"percent of total billed charges","33.9% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1850.94,78,,1480.75,,,0,"percent of total billed charges","78% of total billed charges",175.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1960.1,82.6,,1568.08,,,0,"percent of total billed charges","82.6% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1960.1,82.6,,1568.08,,,0,"percent of total billed charges","82.6% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,2373,100,,1898.40,,,0,"percent of total billed charges","100% of total billed charges",26.97,2373,
"HIV ANTIBODY 1 AND 2",30286703,CDM,302,RC,86703,CPT,OUTPATIENT,,,160,104,,140.8,88,,112.64,,,0,"percent of total billed charges","88% of total billed charges",13.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",23.99,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,13.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.8,63,,80.64,,,0,"percent of total billed charges","63% of total billed charges",24.48,15.3,,19.58,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,110.4,69,,,,,0,"fee schedule","69% of total billed charges",160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",13.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",13.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",13.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.44,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,13.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.71,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,13.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,13.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.32,37.7,,48.26,,,0,"percent of total billed charges","37.7% of total billed charges",60.32,37.7,,48.26,,,0,"percent of total billed charges","37.70% of total billed charges",13.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.24,33.9,,43.39,,,0,"percent of total billed charges","33.9% of total billed charges",13.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.8,78,,99.84,,,0,"percent of total billed charges","78% of total billed charges",13.84,101,,,,,0,"fee schedule","101% of CMS fee schedule ",132.16,82.6,,105.73,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,13.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",132.16,82.6,,105.73,,,0,"percent of total billed charges","82.6% of total billed charges",13.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,160,
"HIV 1/2 Antibody Screen",30086701,CDM,300,RC,86701,CPT,OUTPATIENT,,,72,46.8,,63.36,88,,50.69,,,0,"percent of total billed charges","88% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",15.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.36,63,,36.29,,,0,"percent of total billed charges","63% of total billed charges",11.02,15.3,,8.82,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,49.68,69,,,,,0,"fee schedule","69% of total billed charges",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.89,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.14,37.7,,21.71,,,0,"percent of total billed charges","37.7% of total billed charges",27.14,37.7,,21.71,,,0,"percent of total billed charges","37.70% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.41,33.9,,19.53,,,0,"percent of total billed charges","33.9% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.16,78,,44.93,,,0,"percent of total billed charges","78% of total billed charges",8.97,101,,,,,0,"fee schedule","101% of CMS fee schedule ",59.47,82.6,,47.58,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.47,82.6,,47.58,,,0,"percent of total billed charges","82.6% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",6.96,72,
"HIV 1/2 Antibody w/ Interp",30286701,CDM,302,RC,86701,CPT,OUTPATIENT,,,184,119.6,,161.92,88,,129.54,,,0,"percent of total billed charges","88% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",15.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",115.92,63,,92.74,,,0,"percent of total billed charges","63% of total billed charges",28.15,15.3,,22.52,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,126.96,69,,,,,0,"fee schedule","69% of total billed charges",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.89,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.37,37.7,,55.50,,,0,"percent of total billed charges","37.7% of total billed charges",69.37,37.7,,55.50,,,0,"percent of total billed charges","37.70% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.38,33.9,,49.90,,,0,"percent of total billed charges","33.9% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",143.52,78,,114.82,,,0,"percent of total billed charges","78% of total billed charges",8.97,101,,,,,0,"fee schedule","101% of CMS fee schedule ",151.98,82.6,,121.58,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.98,82.6,,121.58,,,0,"percent of total billed charges","82.6% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,184,
"HIV-1/2 Ag/Ab",30286703,CDM,302,RC,86703,CPT,OUTPATIENT,,,160,104,,140.8,88,,112.64,,,0,"percent of total billed charges","88% of total billed charges",13.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",23.99,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,13.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.8,63,,80.64,,,0,"percent of total billed charges","63% of total billed charges",24.48,15.3,,19.58,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,110.4,69,,,,,0,"fee schedule","69% of total billed charges",160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",13.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",13.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",13.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.44,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,13.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.71,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,13.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,13.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.32,37.7,,48.26,,,0,"percent of total billed charges","37.7% of total billed charges",60.32,37.7,,48.26,,,0,"percent of total billed charges","37.70% of total billed charges",13.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.24,33.9,,43.39,,,0,"percent of total billed charges","33.9% of total billed charges",13.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.8,78,,99.84,,,0,"percent of total billed charges","78% of total billed charges",13.84,101,,,,,0,"fee schedule","101% of CMS fee schedule ",132.16,82.6,,105.73,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,13.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",132.16,82.6,,105.73,,,0,"percent of total billed charges","82.6% of total billed charges",13.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,160,
"HIV1; Panel 083955 LC",30286701,CDM,302,RC,86701,CPT,OUTPATIENT,,,178,115.7,,156.64,88,,125.31,,,0,"percent of total billed charges","88% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,178,100,,142.40,,,0,"percent of total billed charges","100% of total billed charges",15.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",112.14,63,,89.71,,,0,"percent of total billed charges","63% of total billed charges",27.23,15.3,,21.78,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,122.82,69,,,,,0,"fee schedule","69% of total billed charges",178,100,,142.40,,,0,"percent of total billed charges","100% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",178,100,,142.40,,,0,"percent of total billed charges","100% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",178,100,,142.40,,,0,"percent of total billed charges","100% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.89,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.11,37.7,,53.69,,,0,"percent of total billed charges","37.7% of total billed charges",67.11,37.7,,53.69,,,0,"percent of total billed charges","37.70% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.34,33.9,,48.27,,,0,"percent of total billed charges","33.9% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",138.84,78,,111.07,,,0,"percent of total billed charges","78% of total billed charges",8.97,101,,,,,0,"fee schedule","101% of CMS fee schedule ",147.03,82.6,,117.62,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",147.03,82.6,,117.62,,,0,"percent of total billed charges","82.6% of total billed charges",8.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,178,100,,142.40,,,0,"percent of total billed charges","100% of total billed charges",6.96,178,
"HIV-1/HIV-2 Qualitative RNA LC",30687535,CDM,306,RC,87535,CPT,OUTPATIENT,,,492,319.8,,432.96,88,,346.37,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",309.96,63,,247.97,,,0,"percent of total billed charges","63% of total billed charges",75.28,15.3,,60.22,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,339.48,69,,,,,0,"fee schedule","69% of total billed charges",492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",185.48,37.7,,148.38,,,0,"percent of total billed charges","37.7% of total billed charges",185.48,37.7,,148.38,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",166.79,33.9,,133.43,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",383.76,78,,307.01,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",406.39,82.6,,325.11,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",406.39,82.6,,325.11,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",18.33,492,
"HLA B 27 Disease Association LC ZB3HG",31081374,CDM,310,RC,81374,CPT,OUTPATIENT,,,526,341.9,,462.88,88,,370.30,,,0,"percent of total billed charges","88% of total billed charges",74.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,526,100,,420.80,,,0,"percent of total billed charges","100% of total billed charges",130.07,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.2,100,,,,,0,"fee schedule",EAPG,74.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",331.38,63,,265.10,,,0,"percent of total billed charges","63% of total billed charges",111.5,150,,,,,0,"fee schedule","150% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,362.94,69,,,,,0,"fee schedule","69% of total billed charges",526,100,,420.80,,,0,"percent of total billed charges","100% of total billed charges",74.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",526,100,,420.80,,,0,"percent of total billed charges","100% of total billed charges",74.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",526,100,,420.80,,,0,"percent of total billed charges","100% of total billed charges",74.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",284.31,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,74.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.33,100,,,,,0,"fee schedule","100% of LI fee schedule",28.91,100,,,,,0,"fee schedule",EAPG,74.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.81,100,,,,,0,"fee schedule",EAPG,50.73,100,,,,,0,"fee schedule",EAPG,74.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",198.3,37.7,,158.64,,,0,"percent of total billed charges","37.7% of total billed charges",198.3,37.7,,158.64,,,0,"percent of total billed charges","37.70% of total billed charges",74.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",178.31,33.9,,142.65,,,0,"percent of total billed charges","33.9% of total billed charges",74.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",410.28,78,,328.22,,,0,"percent of total billed charges","78% of total billed charges",75.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",434.48,82.6,,347.58,,,0,"percent of total billed charges","82.6% of total billed charges",39.02,100,,,,,0,"fee schedule","100% of WA fee schedule",74.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",434.48,82.6,,347.58,,,0,"percent of total billed charges","82.6% of total billed charges",74.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,526,100,,420.80,,,0,"percent of total billed charges","100% of total billed charges",28.91,526,
"HP5 LC",30286704,CDM,302,RC,86704,CPT,OUTPATIENT,,,99,64.35,,87.12,88,,69.70,,,0,"percent of total billed charges","88% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",21.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.37,63,,49.90,,,0,"percent of total billed charges","63% of total billed charges",15.15,15.3,,12.12,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,68.31,69,,,,,0,"fee schedule","69% of total billed charges",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.09,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.05,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.32,37.7,,29.86,,,0,"percent of total billed charges","37.7% of total billed charges",37.32,37.7,,29.86,,,0,"percent of total billed charges","37.70% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.56,33.9,,26.85,,,0,"percent of total billed charges","33.9% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.22,78,,61.78,,,0,"percent of total billed charges","78% of total billed charges",12.17,101,,,,,0,"fee schedule","101% of CMS fee schedule ",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,99,
"HPV Aptima LC",30687624,CDM,306,RC,87624,CPT,OUTPATIENT,,,175,113.75,,154,88,,123.20,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",110.25,63,,88.20,,,0,"percent of total billed charges","63% of total billed charges",26.78,15.3,,21.42,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,120.75,69,,,,,0,"fee schedule","69% of total billed charges",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.98,37.7,,52.78,,,0,"percent of total billed charges","37.7% of total billed charges",65.98,37.7,,52.78,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.33,33.9,,47.46,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.5,78,,109.20,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",144.55,82.6,,115.64,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.55,82.6,,115.64,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",18.33,175,
"HPV Aptima LC",30687624,CDM,306,RC,87624,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25.49,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.33,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",18.33,32.18,
"HPV, cobas high-risk/16/18 LC",30687624,CDM,306,RC,87624,CPT,OUTPATIENT,,,175,113.75,,154,88,,123.20,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",110.25,63,,88.20,,,0,"percent of total billed charges","63% of total billed charges",26.78,15.3,,21.42,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,120.75,69,,,,,0,"fee schedule","69% of total billed charges",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.98,37.7,,52.78,,,0,"percent of total billed charges","37.7% of total billed charges",65.98,37.7,,52.78,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.33,33.9,,47.46,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.5,78,,109.20,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",144.55,82.6,,115.64,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.55,82.6,,115.64,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",18.33,175,
"HSV 1/2 PCR LC",30687529,CDM,306,RC,87529,CPT,OUTPATIENT,,,232,150.8,,204.16,88,,163.33,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,232,100,,185.60,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",146.16,63,,116.93,,,0,"percent of total billed charges","63% of total billed charges",35.5,15.3,,28.40,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,160.08,69,,,,,0,"fee schedule","69% of total billed charges",232,100,,185.60,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",232,100,,185.60,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",232,100,,185.60,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.46,37.7,,69.97,,,0,"percent of total billed charges","37.7% of total billed charges",87.46,37.7,,69.97,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.65,33.9,,62.92,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",180.96,78,,144.77,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",191.63,82.6,,153.30,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",191.63,82.6,,153.30,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,232,100,,185.60,,,0,"percent of total billed charges","100% of total billed charges",18.33,232,
"HSV 1 and 2-Spec AB, IgG w/Rflx LC 164922",30286696,CDM,302,RC,86696,CPT,OUTPATIENT,,,108,70.2,,95.04,88,,76.03,,,0,"percent of total billed charges","88% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",33.86,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.04,63,,54.43,,,0,"percent of total billed charges","63% of total billed charges",16.52,15.3,,13.22,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,74.52,69,,,,,0,"fee schedule","69% of total billed charges",108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.01,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.35,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.72,37.7,,32.58,,,0,"percent of total billed charges","37.7% of total billed charges",40.72,37.7,,32.58,,,0,"percent of total billed charges","37.70% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.61,33.9,,29.29,,,0,"percent of total billed charges","33.9% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",84.24,78,,67.39,,,0,"percent of total billed charges","78% of total billed charges",19.54,101,,,,,0,"fee schedule","101% of CMS fee schedule ",89.21,82.6,,71.37,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.21,82.6,,71.37,,,0,"percent of total billed charges","82.6% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",6.96,108,
"HSV, IgM I/II Combination LC",30286694,CDM,302,RC,86694,CPT,OUTPATIENT,,,123,79.95,,108.24,88,,86.59,,,0,"percent of total billed charges","88% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",25.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.49,63,,61.99,,,0,"percent of total billed charges","63% of total billed charges",18.82,15.3,,15.06,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,84.87,69,,,,,0,"fee schedule","69% of total billed charges",123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.04,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.39,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.37,37.7,,37.10,,,0,"percent of total billed charges","37.7% of total billed charges",46.37,37.7,,37.10,,,0,"percent of total billed charges","37.70% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.7,33.9,,33.36,,,0,"percent of total billed charges","33.9% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.94,78,,76.75,,,0,"percent of total billed charges","78% of total billed charges",14.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",101.6,82.6,,81.28,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.6,82.6,,81.28,,,0,"percent of total billed charges","82.6% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",6.96,123,
"HSV-2 Type Spec Ab, IgG w/Rflx LC 163033",30286696,CDM,302,RC,86696,CPT,OUTPATIENT,,,108,70.2,,95.04,88,,76.03,,,0,"percent of total billed charges","88% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",33.86,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.04,63,,54.43,,,0,"percent of total billed charges","63% of total billed charges",16.52,15.3,,13.22,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,74.52,69,,,,,0,"fee schedule","69% of total billed charges",108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.01,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.35,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.72,37.7,,32.58,,,0,"percent of total billed charges","37.7% of total billed charges",40.72,37.7,,32.58,,,0,"percent of total billed charges","37.70% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.61,33.9,,29.29,,,0,"percent of total billed charges","33.9% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",84.24,78,,67.39,,,0,"percent of total billed charges","78% of total billed charges",19.54,101,,,,,0,"fee schedule","101% of CMS fee schedule ",89.21,82.6,,71.37,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.21,82.6,,71.37,,,0,"percent of total billed charges","82.6% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",6.96,108,
"HSV1 and HSV2 AVR",30687529,CDM,306,RC,87529,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"HSVIgM+HSV1/HSV2(IgG) LC 240823",30286694,CDM,302,RC,86694,CPT,OUTPATIENT,,,129,83.85,,113.52,88,,90.82,,,0,"percent of total billed charges","88% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,129,100,,103.20,,,0,"percent of total billed charges","100% of total billed charges",25.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.27,63,,65.02,,,0,"percent of total billed charges","63% of total billed charges",19.74,15.3,,15.79,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,89.01,69,,,,,0,"fee schedule","69% of total billed charges",129,100,,103.20,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",129,100,,103.20,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",129,100,,103.20,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.04,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.39,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.63,37.7,,38.90,,,0,"percent of total billed charges","37.7% of total billed charges",48.63,37.7,,38.90,,,0,"percent of total billed charges","37.70% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.73,33.9,,34.98,,,0,"percent of total billed charges","33.9% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.62,78,,80.50,,,0,"percent of total billed charges","78% of total billed charges",14.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",106.55,82.6,,85.24,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.55,82.6,,85.24,,,0,"percent of total billed charges","82.6% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,129,100,,103.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,129,
"HTLV-I/II Antibodies, Qual. LC",30286790,CDM,302,RC,86790,CPT,OUTPATIENT,,,64,41.6,,56.32,88,,45.06,,,0,"percent of total billed charges","88% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",22.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.32,63,,32.26,,,0,"percent of total billed charges","63% of total billed charges",9.79,15.3,,7.83,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,44.16,69,,,,,0,"fee schedule","69% of total billed charges",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.26,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.88,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.13,37.7,,19.30,,,0,"percent of total billed charges","37.7% of total billed charges",24.13,37.7,,19.30,,,0,"percent of total billed charges","37.70% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.7,33.9,,17.36,,,0,"percent of total billed charges","33.9% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.92,78,,39.94,,,0,"percent of total billed charges","78% of total billed charges",13,101,,,,,0,"fee schedule","101% of CMS fee schedule ",52.86,82.6,,42.29,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.86,82.6,,42.29,,,0,"percent of total billed charges","82.6% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,64,
"Haptoglobin LC",30183010,CDM,301,RC,83010,CPT,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",22.01,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.11,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.58,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.7% of total billed charges",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.46,33.9,,69.97,,,0,"percent of total billed charges","33.9% of total billed charges",12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",12.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",12.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,258,
"Heavy Metals Profile I, Blood LC",30183825,CDM,301,RC,83825,CPT,OUTPATIENT,,,353,229.45,,310.64,88,,248.51,,,0,"percent of total billed charges","88% of total billed charges",16.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,353,100,,282.40,,,0,"percent of total billed charges","100% of total billed charges",28.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",10.18,100,,,,,0,"fee schedule",EAPG,16.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",222.39,63,,177.91,,,0,"percent of total billed charges","63% of total billed charges",54.01,15.3,,43.21,,,0,"percent of total billed charges","15.3% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,243.57,69,,,,,0,"fee schedule","69% of total billed charges",353,100,,282.40,,,0,"percent of total billed charges","100% of total billed charges",16.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",353,100,,282.40,,,0,"percent of total billed charges","100% of total billed charges",16.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",353,100,,282.40,,,0,"percent of total billed charges","100% of total billed charges",16.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.19,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,16.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.26,100,,,,,0,"fee schedule","100% of LI fee schedule",7.32,100,,,,,0,"fee schedule",EAPG,16.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.08,100,,,,,0,"fee schedule",EAPG,12.85,100,,,,,0,"fee schedule",EAPG,16.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",133.08,37.7,,106.46,,,0,"percent of total billed charges","37.7% of total billed charges",133.08,37.7,,106.46,,,0,"percent of total billed charges","37.70% of total billed charges",16.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",119.67,33.9,,95.74,,,0,"percent of total billed charges","33.9% of total billed charges",16.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",275.34,78,,220.27,,,0,"percent of total billed charges","78% of total billed charges",16.42,101,,,,,0,"fee schedule","101% of CMS fee schedule ",291.58,82.6,,233.26,,,0,"percent of total billed charges","82.6% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,16.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",291.58,82.6,,233.26,,,0,"percent of total billed charges","82.6% of total billed charges",16.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,353,100,,282.40,,,0,"percent of total billed charges","100% of total billed charges",7.32,353,
"Helicobacter Pylori Antibody IgG",30086677,CDM,300,RC,86677,CPT,OUTPATIENT,,,45,29.25,,39.6,88,,31.68,,,0,"percent of total billed charges","88% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",29.48,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.35,63,,22.68,,,0,"percent of total billed charges","63% of total billed charges",6.89,15.3,,5.51,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,31.05,69,,,,,0,"fee schedule","69% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.45,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.85,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.97,37.7,,13.58,,,0,"percent of total billed charges","37.7% of total billed charges",16.97,37.7,,13.58,,,0,"percent of total billed charges","37.70% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.26,33.9,,12.21,,,0,"percent of total billed charges","33.9% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.1,78,,28.08,,,0,"percent of total billed charges","78% of total billed charges",17.01,101,,,,,0,"fee schedule","101% of CMS fee schedule ",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",6.89,64.45,
"Helicobacter pylori, IgA LC",30286677,CDM,302,RC,86677,CPT,OUTPATIENT,,,94,61.1,,82.72,88,,66.18,,,0,"percent of total billed charges","88% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",29.48,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,63,,47.38,,,0,"percent of total billed charges","63% of total billed charges",14.38,15.3,,11.50,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,64.86,69,,,,,0,"fee schedule","69% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.45,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.85,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.44,37.7,,28.35,,,0,"percent of total billed charges","37.7% of total billed charges",35.44,37.7,,28.35,,,0,"percent of total billed charges","37.70% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.87,33.9,,25.50,,,0,"percent of total billed charges","33.9% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.32,78,,58.66,,,0,"percent of total billed charges","78% of total billed charges",17.01,101,,,,,0,"fee schedule","101% of CMS fee schedule ",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,94,
"Helicobacter pylori, IgM Ab LC",30286677,CDM,302,RC,86677,CPT,OUTPATIENT,,,94,61.1,,82.72,88,,66.18,,,0,"percent of total billed charges","88% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",29.48,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,63,,47.38,,,0,"percent of total billed charges","63% of total billed charges",14.38,15.3,,11.50,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,64.86,69,,,,,0,"fee schedule","69% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.45,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.85,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.44,37.7,,28.35,,,0,"percent of total billed charges","37.7% of total billed charges",35.44,37.7,,28.35,,,0,"percent of total billed charges","37.70% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.87,33.9,,25.50,,,0,"percent of total billed charges","33.9% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.32,78,,58.66,,,0,"percent of total billed charges","78% of total billed charges",17.01,101,,,,,0,"fee schedule","101% of CMS fee schedule ",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,94,
"ABSOLUTE CD4 COUNT",30286361,CDM,302,RC,86361,CPT,OUTPATIENT,,,131,85.15,,115.28,88,,92.22,,,0,"percent of total billed charges","88% of total billed charges",26.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.28,100,,,,,0,"fee schedule",EAPG,131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",46.86,175,,,,,0,"fee schedule","175% of CMS fee schedule",28.1,100,,,,,0,"fee schedule",EAPG,26.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.53,63,,66.02,,,0,"percent of total billed charges","63% of total billed charges",20.04,15.3,,16.03,,,0,"percent of total billed charges","15.3% of total billed charges",27.28,100,,,,,0,"fee schedule",EAPG,90.39,69,,,,,0,"fee schedule","69% of total billed charges",131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",26.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",26.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",26.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",102.43,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",27.28,100,,,,,0,"fee schedule",EAPG,26.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.78,100,,,,,0,"fee schedule","100% of LI fee schedule",20.21,100,,,,,0,"fee schedule",EAPG,26.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.83,100,,,,,0,"fee schedule",EAPG,35.47,100,,,,,0,"fee schedule",EAPG,26.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.39,37.7,,39.51,,,0,"percent of total billed charges","37.7% of total billed charges",49.39,37.7,,39.51,,,0,"percent of total billed charges","37.70% of total billed charges",26.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.41,33.9,,35.53,,,0,"percent of total billed charges","33.9% of total billed charges",26.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",102.18,78,,81.74,,,0,"percent of total billed charges","78% of total billed charges",27.04,101,,,,,0,"fee schedule","101% of CMS fee schedule ",108.21,82.6,,86.57,,,0,"percent of total billed charges","82.6% of total billed charges",27.28,100,,,,,0,"fee schedule",EAPG,26.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.21,82.6,,86.57,,,0,"percent of total billed charges","82.6% of total billed charges",26.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.28,100,,,,,0,"fee schedule",EAPG,131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",20.04,131,
HEMATOCRIT,30585014,CDM,305,RC,85014,CPT,OUTPATIENT,,,50,32.5,,44,88,,35.20,,,0,"percent of total billed charges","88% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",4.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.23,100,,,,,0,"fee schedule",EAPG,2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.5,63,,25.20,,,0,"percent of total billed charges","63% of total billed charges",7.65,15.3,,6.12,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,34.5,69,,,,,0,"fee schedule","69% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.06,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.37,100,,,,,0,"fee schedule","100% of LI fee schedule",3.76,100,,,,,0,"fee schedule",EAPG,2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.7% of total billed charges",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.70% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.95,33.9,,13.56,,,0,"percent of total billed charges","33.9% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",39,78,,31.20,,,0,"percent of total billed charges","78% of total billed charges",2.39,101,,,,,0,"fee schedule","101% of CMS fee schedule ",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",2.37,50,
"Hematopath Consultation, Smear LC",30585060,CDM,305,RC,85060,CPT,OUTPATIENT,,,113,73.45,,99.44,88,,79.55,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.08,100,,,,,0,"fee schedule",EAPG,113,100,,90.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.23,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",71.19,63,,56.95,,,0,"percent of total billed charges","63% of total billed charges",17.29,15.3,,13.83,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,77.97,69,,,,,0,"fee schedule","69% of total billed charges",113,100,,90.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",113,100,,90.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",113,100,,90.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.08,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",42.6,37.7,,34.08,,,0,"percent of total billed charges","37.7% of total billed charges",42.6,37.7,,34.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.31,33.9,,30.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.14,78,,70.51,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",93.34,82.6,,74.67,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule","100% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",93.34,82.6,,74.67,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.08,100,,,,,0,"fee schedule",EAPG,113,100,,90.40,,,0,"percent of total billed charges","100% of total billed charges",3.76,113,
HEMOGLOBIN,30585018,CDM,305,RC,85018,CPT,OUTPATIENT,,,62,40.3,,54.56,88,,43.65,,,0,"percent of total billed charges","88% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",4.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.23,100,,,,,0,"fee schedule",EAPG,2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.06,63,,31.25,,,0,"percent of total billed charges","63% of total billed charges",9.49,15.3,,7.59,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,42.78,69,,,,,0,"fee schedule","69% of total billed charges",62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.06,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.37,100,,,,,0,"fee schedule","100% of LI fee schedule",3.76,100,,,,,0,"fee schedule",EAPG,2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.37,37.7,,18.70,,,0,"percent of total billed charges","37.7% of total billed charges",23.37,37.7,,18.70,,,0,"percent of total billed charges","37.70% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.02,33.9,,16.82,,,0,"percent of total billed charges","33.9% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.36,78,,38.69,,,0,"percent of total billed charges","78% of total billed charges",2.39,101,,,,,0,"fee schedule","101% of CMS fee schedule ",51.21,82.6,,40.97,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.21,82.6,,40.97,,,0,"percent of total billed charges","82.6% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",2.37,62,
"Hemoglobin A1c",30183036,CDM,301,RC,83036,CPT,OUTPATIENT,,,218,141.7,,191.84,88,,153.47,,,0,"percent of total billed charges","88% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",16.99,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.34,63,,109.87,,,0,"percent of total billed charges","63% of total billed charges",33.35,15.3,,26.68,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,150.42,69,,,,,0,"fee schedule","69% of total billed charges",218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.14,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.71,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.19,37.7,,65.75,,,0,"percent of total billed charges","37.7% of total billed charges",82.19,37.7,,65.75,,,0,"percent of total billed charges","37.70% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.9,33.9,,59.12,,,0,"percent of total billed charges","33.9% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.04,78,,136.03,,,0,"percent of total billed charges","78% of total billed charges",9.8,101,,,,,0,"fee schedule","101% of CMS fee schedule ",180.07,82.6,,144.06,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",180.07,82.6,,144.06,,,0,"percent of total billed charges","82.6% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,218,
Hematocrit,30585014,CDM,305,RC,85014,CPT,OUTPATIENT,,,50,32.5,,44,88,,35.20,,,0,"percent of total billed charges","88% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",4.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.23,100,,,,,0,"fee schedule",EAPG,2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.5,63,,25.20,,,0,"percent of total billed charges","63% of total billed charges",7.65,15.3,,6.12,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,34.5,69,,,,,0,"fee schedule","69% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.06,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.37,100,,,,,0,"fee schedule","100% of LI fee schedule",3.76,100,,,,,0,"fee schedule",EAPG,2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.7% of total billed charges",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.70% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.95,33.9,,13.56,,,0,"percent of total billed charges","33.9% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",39,78,,31.20,,,0,"percent of total billed charges","78% of total billed charges",2.39,101,,,,,0,"fee schedule","101% of CMS fee schedule ",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",2.37,50,
"Hemoglobin A1c POCT",30183036,CDM,301,RC,83036,CPT,OUTPATIENT,,,218,141.7,,191.84,88,,153.47,,,0,"percent of total billed charges","88% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",16.99,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.34,63,,109.87,,,0,"percent of total billed charges","63% of total billed charges",33.35,15.3,,26.68,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,150.42,69,,,,,0,"fee schedule","69% of total billed charges",218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.14,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.71,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.19,37.7,,65.75,,,0,"percent of total billed charges","37.7% of total billed charges",82.19,37.7,,65.75,,,0,"percent of total billed charges","37.70% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.9,33.9,,59.12,,,0,"percent of total billed charges","33.9% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.04,78,,136.03,,,0,"percent of total billed charges","78% of total billed charges",9.8,101,,,,,0,"fee schedule","101% of CMS fee schedule ",180.07,82.6,,144.06,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",180.07,82.6,,144.06,,,0,"percent of total billed charges","82.6% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,218,
"Hemoglobin A1c LC",30183036,CDM,301,RC,83036,CPT,OUTPATIENT,,,256,166.4,,225.28,88,,180.22,,,0,"percent of total billed charges","88% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",16.99,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",161.28,63,,129.02,,,0,"percent of total billed charges","63% of total billed charges",39.17,15.3,,31.34,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,176.64,69,,,,,0,"fee schedule","69% of total billed charges",256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.14,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.71,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",96.51,37.7,,77.21,,,0,"percent of total billed charges","37.7% of total billed charges",96.51,37.7,,77.21,,,0,"percent of total billed charges","37.70% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",86.78,33.9,,69.42,,,0,"percent of total billed charges","33.9% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",199.68,78,,159.74,,,0,"percent of total billed charges","78% of total billed charges",9.8,101,,,,,0,"fee schedule","101% of CMS fee schedule ",211.46,82.6,,169.17,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",211.46,82.6,,169.17,,,0,"percent of total billed charges","82.6% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",3.25,256,
"Hemosiderin U LC",30183070,CDM,301,RC,83070,CPT,OUTPATIENT,,,96,62.4,,84.48,88,,67.58,,,0,"percent of total billed charges","88% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",8.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.48,63,,48.38,,,0,"percent of total billed charges","63% of total billed charges",14.69,15.3,,11.75,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,66.24,69,,,,,0,"fee schedule","69% of total billed charges",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.16,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.75,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.19,37.7,,28.95,,,0,"percent of total billed charges","37.7% of total billed charges",36.19,37.7,,28.95,,,0,"percent of total billed charges","37.70% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.54,33.9,,26.03,,,0,"percent of total billed charges","33.9% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.88,78,,59.90,,,0,"percent of total billed charges","78% of total billed charges",4.79,101,,,,,0,"fee schedule","101% of CMS fee schedule ",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",3.25,96,
"Hep Be Ag LC",30687350,CDM,306,RC,87350,CPT,OUTPATIENT,,,77,50.05,,67.76,88,,54.21,,,0,"percent of total billed charges","88% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",20.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.51,63,,38.81,,,0,"percent of total billed charges","63% of total billed charges",11.78,15.3,,9.42,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,53.13,69,,,,,0,"fee schedule","69% of total billed charges",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.53,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.03,37.7,,23.22,,,0,"percent of total billed charges","37.7% of total billed charges",29.03,37.7,,23.22,,,0,"percent of total billed charges","37.70% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.1,33.9,,20.88,,,0,"percent of total billed charges","33.9% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.06,78,,48.05,,,0,"percent of total billed charges","78% of total billed charges",11.64,101,,,,,0,"fee schedule","101% of CMS fee schedule ",63.6,82.6,,50.88,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.6,82.6,,50.88,,,0,"percent of total billed charges","82.6% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",4.81,77,
"Hep B Core Ab, Tot LC",30286704,CDM,302,RC,86704,CPT,OUTPATIENT,,,99,64.35,,87.12,88,,69.70,,,0,"percent of total billed charges","88% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",21.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.37,63,,49.90,,,0,"percent of total billed charges","63% of total billed charges",15.15,15.3,,12.12,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,68.31,69,,,,,0,"fee schedule","69% of total billed charges",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.09,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.05,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.32,37.7,,29.86,,,0,"percent of total billed charges","37.7% of total billed charges",37.32,37.7,,29.86,,,0,"percent of total billed charges","37.70% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.56,33.9,,26.85,,,0,"percent of total billed charges","33.9% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.22,78,,61.78,,,0,"percent of total billed charges","78% of total billed charges",12.17,101,,,,,0,"fee schedule","101% of CMS fee schedule ",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,99,
"Hep A Ab, Total LC",30286708,CDM,302,RC,86708,CPT,OUTPATIENT,,,99,64.35,,87.12,88,,69.70,,,0,"percent of total billed charges","88% of total billed charges",12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",21.68,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.37,63,,49.90,,,0,"percent of total billed charges","63% of total billed charges",15.15,15.3,,12.12,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,68.31,69,,,,,0,"fee schedule","69% of total billed charges",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.39,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.39,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.32,37.7,,29.86,,,0,"percent of total billed charges","37.7% of total billed charges",37.32,37.7,,29.86,,,0,"percent of total billed charges","37.70% of total billed charges",12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.56,33.9,,26.85,,,0,"percent of total billed charges","33.9% of total billed charges",12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.22,78,,61.78,,,0,"percent of total billed charges","78% of total billed charges",12.51,101,,,,,0,"fee schedule","101% of CMS fee schedule ",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",12.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,99,
"Hep A Ab, IgM LC",30286709,CDM,302,RC,86709,CPT,OUTPATIENT,,,163,105.95,,143.44,88,,114.75,,,0,"percent of total billed charges","88% of total billed charges",11.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",19.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,11.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",102.69,63,,82.15,,,0,"percent of total billed charges","63% of total billed charges",24.94,15.3,,19.95,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,112.47,69,,,,,0,"fee schedule","69% of total billed charges",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",11.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",11.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",11.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.06,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,11.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.26,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,11.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,11.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.45,37.7,,49.16,,,0,"percent of total billed charges","37.7% of total billed charges",61.45,37.7,,49.16,,,0,"percent of total billed charges","37.70% of total billed charges",11.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.26,33.9,,44.21,,,0,"percent of total billed charges","33.9% of total billed charges",11.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",127.14,78,,101.71,,,0,"percent of total billed charges","78% of total billed charges",11.37,101,,,,,0,"fee schedule","101% of CMS fee schedule ",134.64,82.6,,107.71,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,11.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.64,82.6,,107.71,,,0,"percent of total billed charges","82.6% of total billed charges",11.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",6.96,163,
"HEPATITIS B CORE AB IGM",30286705,CDM,302,RC,86705,CPT,OUTPATIENT,,,151,98.15,,132.88,88,,106.30,,,0,"percent of total billed charges","88% of total billed charges",11.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",20.59,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,11.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.13,63,,76.10,,,0,"percent of total billed charges","63% of total billed charges",23.1,15.3,,18.48,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,104.19,69,,,,,0,"fee schedule","69% of total billed charges",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",11.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",11.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",11.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.02,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,11.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,11.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,11.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.93,37.7,,45.54,,,0,"percent of total billed charges","37.7% of total billed charges",56.93,37.7,,45.54,,,0,"percent of total billed charges","37.70% of total billed charges",11.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.19,33.9,,40.95,,,0,"percent of total billed charges","33.9% of total billed charges",11.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",117.78,78,,94.22,,,0,"percent of total billed charges","78% of total billed charges",11.88,101,,,,,0,"fee schedule","101% of CMS fee schedule ",124.73,82.6,,99.78,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,11.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.73,82.6,,99.78,,,0,"percent of total billed charges","82.6% of total billed charges",11.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",6.96,151,
"Hepatic Function Panel",30180076,CDM,301,RC,80076,CPT,OUTPATIENT,,,119,77.35,,104.72,88,,83.78,,,0,"percent of total billed charges","88% of total billed charges",8.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",14.29,175,,,,,0,"fee schedule","175% of CMS fee schedule",7.68,100,,,,,0,"fee schedule",EAPG,8.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.97,63,,59.98,,,0,"percent of total billed charges","63% of total billed charges",18.21,15.3,,14.57,,,0,"percent of total billed charges","15.3% of total billed charges",7.45,100,,,,,0,"fee schedule",EAPG,82.11,69,,,,,0,"fee schedule","69% of total billed charges",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",8.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",8.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",8.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.25,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,8.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.17,100,,,,,0,"fee schedule","100% of LI fee schedule",5.52,100,,,,,0,"fee schedule",EAPG,8.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.6,100,,,,,0,"fee schedule",EAPG,9.69,100,,,,,0,"fee schedule",EAPG,8.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.7% of total billed charges",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.70% of total billed charges",8.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.34,33.9,,32.27,,,0,"percent of total billed charges","33.9% of total billed charges",8.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.82,78,,74.26,,,0,"percent of total billed charges","78% of total billed charges",8.25,101,,,,,0,"fee schedule","101% of CMS fee schedule ",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",7.45,100,,,,,0,"fee schedule",EAPG,8.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",8.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",5.52,119,
"Hepatitis B Surface Antigen",30087340,CDM,300,RC,87467,CPT,OUTPATIENT,,,150,97.5,,132,88,,105.60,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.49,100,,,,,0,"fee schedule",EAPG,150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.68,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",94.5,63,,75.60,,,0,"percent of total billed charges","63% of total billed charges",22.95,15.3,,18.36,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,103.5,69,,,,,0,"fee schedule","69% of total billed charges",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.49,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.81,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.7% of total billed charges",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.85,33.9,,40.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",117,78,,93.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.49,100,,,,,0,"fee schedule",EAPG,150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",4.81,150,
"Hepatitis C Antibody",30286803,CDM,302,RC,86803,CPT,OUTPATIENT,,,166,107.9,,146.08,88,,116.86,,,0,"percent of total billed charges","88% of total billed charges",14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",24.97,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",104.58,63,,83.66,,,0,"percent of total billed charges","63% of total billed charges",25.4,15.3,,20.32,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,114.54,69,,,,,0,"fee schedule","69% of total billed charges",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.58,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.27,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.58,37.7,,50.06,,,0,"percent of total billed charges","37.7% of total billed charges",62.58,37.7,,50.06,,,0,"percent of total billed charges","37.70% of total billed charges",14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.27,33.9,,45.02,,,0,"percent of total billed charges","33.9% of total billed charges",14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.48,78,,103.58,,,0,"percent of total billed charges","78% of total billed charges",14.41,101,,,,,0,"fee schedule","101% of CMS fee schedule ",137.12,82.6,,109.70,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.12,82.6,,109.70,,,0,"percent of total billed charges","82.6% of total billed charges",14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",6.96,166,
"ANTI-XA HEPARIN",30585520,CDM,305,RC,85520,CPT,OUTPATIENT,,,213,138.45,,187.44,88,,149.95,,,0,"percent of total billed charges","88% of total billed charges",13.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",22.9,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,13.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.19,63,,107.35,,,0,"percent of total billed charges","63% of total billed charges",32.59,15.3,,26.07,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,146.97,69,,,,,0,"fee schedule","69% of total billed charges",213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",13.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",13.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",13.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.06,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,13.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.09,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,13.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,13.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.3,37.7,,64.24,,,0,"percent of total billed charges","37.7% of total billed charges",80.3,37.7,,64.24,,,0,"percent of total billed charges","37.70% of total billed charges",13.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.21,33.9,,57.77,,,0,"percent of total billed charges","33.9% of total billed charges",13.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",166.14,78,,132.91,,,0,"percent of total billed charges","78% of total billed charges",13.22,101,,,,,0,"fee schedule","101% of CMS fee schedule ",175.94,82.6,,140.75,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,13.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",175.94,82.6,,140.75,,,0,"percent of total billed charges","82.6% of total billed charges",13.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",2.48,213,
"Hepatitis D Virus (HDV) Total LC",30286692,CDM,302,RC,86692,CPT,OUTPATIENT,,,340,221,,299.2,88,,239.36,,,0,"percent of total billed charges","88% of total billed charges",17.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",30.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,17.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",214.2,63,,171.36,,,0,"percent of total billed charges","63% of total billed charges",52.02,15.3,,41.62,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,234.6,69,,,,,0,"fee schedule","69% of total billed charges",340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",17.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",17.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",17.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.63,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,17.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.16,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,17.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,17.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",128.18,37.7,,102.54,,,0,"percent of total billed charges","37.7% of total billed charges",128.18,37.7,,102.54,,,0,"percent of total billed charges","37.70% of total billed charges",17.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",115.26,33.9,,92.21,,,0,"percent of total billed charges","33.9% of total billed charges",17.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",265.2,78,,212.16,,,0,"percent of total billed charges","78% of total billed charges",17.33,101,,,,,0,"fee schedule","101% of CMS fee schedule ",280.84,82.6,,224.67,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,17.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",280.84,82.6,,224.67,,,0,"percent of total billed charges","82.6% of total billed charges",17.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,340,
"Hepatitis B Surf Ab Quant LC",30086317,CDM,300,RC,86317,CPT,OUTPATIENT,,,66,42.9,,58.08,88,,46.46,,,0,"percent of total billed charges","88% of total billed charges",14.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",26.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,14.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.58,63,,33.26,,,0,"percent of total billed charges","63% of total billed charges",10.1,15.3,,8.08,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,45.54,69,,,,,0,"fee schedule","69% of total billed charges",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",14.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",14.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",14.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.33,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.99,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,14.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,14.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.88,37.7,,19.90,,,0,"percent of total billed charges","37.7% of total billed charges",24.88,37.7,,19.90,,,0,"percent of total billed charges","37.70% of total billed charges",14.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.37,33.9,,17.90,,,0,"percent of total billed charges","33.9% of total billed charges",14.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.48,78,,41.18,,,0,"percent of total billed charges","78% of total billed charges",15.13,101,,,,,0,"fee schedule","101% of CMS fee schedule ",54.52,82.6,,43.62,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,14.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.52,82.6,,43.62,,,0,"percent of total billed charges","82.6% of total billed charges",14.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",6.96,66,
"Heparin Induced Platelet W/Rfx LC",30286022,CDM,302,RC,86022,CPT,OUTPATIENT,,,349,226.85,,307.12,88,,245.70,,,0,"percent of total billed charges","88% of total billed charges",18.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,349,100,,279.20,,,0,"percent of total billed charges","100% of total billed charges",32.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,18.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",219.87,63,,175.90,,,0,"percent of total billed charges","63% of total billed charges",53.4,15.3,,42.72,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,240.81,69,,,,,0,"fee schedule","69% of total billed charges",349,100,,279.20,,,0,"percent of total billed charges","100% of total billed charges",18.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",349,100,,279.20,,,0,"percent of total billed charges","100% of total billed charges",18.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",349,100,,279.20,,,0,"percent of total billed charges","100% of total billed charges",18.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.26,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,18.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.37,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,18.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,18.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",131.57,37.7,,105.26,,,0,"percent of total billed charges","37.7% of total billed charges",131.57,37.7,,105.26,,,0,"percent of total billed charges","37.70% of total billed charges",18.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",118.31,33.9,,94.65,,,0,"percent of total billed charges","33.9% of total billed charges",18.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",272.22,78,,217.78,,,0,"percent of total billed charges","78% of total billed charges",18.55,101,,,,,0,"fee schedule","101% of CMS fee schedule ",288.27,82.6,,230.62,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,18.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",288.27,82.6,,230.62,,,0,"percent of total billed charges","82.6% of total billed charges",18.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,349,100,,279.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,349,
"Hepatitis Panel (4) LC",30180074,CDM,301,RC,80074,CPT,OUTPATIENT,,,1183,768.95,,1041.04,88,,832.83,,,0,"percent of total billed charges","88% of total billed charges",47.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,1183,100,,946.40,,,0,"percent of total billed charges","100% of total billed charges",83.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",7.68,100,,,,,0,"fee schedule",EAPG,47.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",745.29,63,,596.23,,,0,"percent of total billed charges","63% of total billed charges",181,15.3,,144.80,,,0,"percent of total billed charges","15.3% of total billed charges",7.45,100,,,,,0,"fee schedule",EAPG,816.27,69,,,,,0,"fee schedule","69% of total billed charges",1183,100,,946.40,,,0,"percent of total billed charges","100% of total billed charges",47.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",1183,100,,946.40,,,0,"percent of total billed charges","100% of total billed charges",47.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",1183,100,,946.40,,,0,"percent of total billed charges","100% of total billed charges",47.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",182.18,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,47.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.63,100,,,,,0,"fee schedule","100% of LI fee schedule",5.52,100,,,,,0,"fee schedule",EAPG,47.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.6,100,,,,,0,"fee schedule",EAPG,9.69,100,,,,,0,"fee schedule",EAPG,47.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",445.99,37.7,,356.79,,,0,"percent of total billed charges","37.7% of total billed charges",445.99,37.7,,356.79,,,0,"percent of total billed charges","37.70% of total billed charges",47.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",401.04,33.9,,320.83,,,0,"percent of total billed charges","33.9% of total billed charges",47.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",922.74,78,,738.19,,,0,"percent of total billed charges","78% of total billed charges",48.1,101,,,,,0,"fee schedule","101% of CMS fee schedule ",977.16,82.6,,781.73,,,0,"percent of total billed charges","82.6% of total billed charges",7.45,100,,,,,0,"fee schedule",EAPG,47.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",977.16,82.6,,781.73,,,0,"percent of total billed charges","82.6% of total billed charges",47.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,1183,100,,946.40,,,0,"percent of total billed charges","100% of total billed charges",5.52,1183,
"Hepatitis B Surface Antigen w/ Interp",30087340,CDM,300,RC,87340,CPT,OUTPATIENT,,,158,102.7,,139.04,88,,111.23,,,0,"percent of total billed charges","88% of total billed charges",10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",18.07,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.54,63,,79.63,,,0,"percent of total billed charges","63% of total billed charges",24.17,15.3,,19.34,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,109.02,69,,,,,0,"fee schedule","69% of total billed charges",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.33,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.57,37.7,,47.66,,,0,"percent of total billed charges","37.7% of total billed charges",59.57,37.7,,47.66,,,0,"percent of total billed charges","37.70% of total billed charges",10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.56,33.9,,42.85,,,0,"percent of total billed charges","33.9% of total billed charges",10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",123.24,78,,98.59,,,0,"percent of total billed charges","78% of total billed charges",10.43,101,,,,,0,"fee schedule","101% of CMS fee schedule ",130.51,82.6,,104.41,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",130.51,82.6,,104.41,,,0,"percent of total billed charges","82.6% of total billed charges",10.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",4.81,158,
"Hepatitis C Antibody w/ Interp",30286803,CDM,302,RC,86803,CPT,OUTPATIENT,,,166,107.9,,146.08,88,,116.86,,,0,"percent of total billed charges","88% of total billed charges",14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",24.97,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",104.58,63,,83.66,,,0,"percent of total billed charges","63% of total billed charges",25.4,15.3,,20.32,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,114.54,69,,,,,0,"fee schedule","69% of total billed charges",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.58,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.27,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.58,37.7,,50.06,,,0,"percent of total billed charges","37.7% of total billed charges",62.58,37.7,,50.06,,,0,"percent of total billed charges","37.70% of total billed charges",14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.27,33.9,,45.02,,,0,"percent of total billed charges","33.9% of total billed charges",14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.48,78,,103.58,,,0,"percent of total billed charges","78% of total billed charges",14.41,101,,,,,0,"fee schedule","101% of CMS fee schedule ",137.12,82.6,,109.70,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.12,82.6,,109.70,,,0,"percent of total billed charges","82.6% of total billed charges",14.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",6.96,166,
"Hered.Hemochromatosis, DNA LC ZB0N2",30181256,CDM,301,RC,81256,CPT,OUTPATIENT,,,320,208,,281.6,88,,225.28,,,0,"percent of total billed charges","88% of total billed charges",65.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",114.38,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.2,100,,,,,0,"fee schedule",EAPG,65.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",201.6,63,,161.28,,,0,"percent of total billed charges","63% of total billed charges",48.96,15.3,,39.17,,,0,"percent of total billed charges","15.3% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,220.8,69,,,,,0,"fee schedule","69% of total billed charges",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",65.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",65.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",65.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",250,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,65.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.36,100,,,,,0,"fee schedule","100% of LI fee schedule",28.91,100,,,,,0,"fee schedule",EAPG,65.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.81,100,,,,,0,"fee schedule",EAPG,50.73,100,,,,,0,"fee schedule",EAPG,65.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",120.64,37.7,,96.51,,,0,"percent of total billed charges","37.7% of total billed charges",120.64,37.7,,96.51,,,0,"percent of total billed charges","37.70% of total billed charges",65.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.48,33.9,,86.78,,,0,"percent of total billed charges","33.9% of total billed charges",65.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",249.6,78,,199.68,,,0,"percent of total billed charges","78% of total billed charges",66.01,101,,,,,0,"fee schedule","101% of CMS fee schedule ",264.32,82.6,,211.46,,,0,"percent of total billed charges","82.6% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,65.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",264.32,82.6,,211.46,,,0,"percent of total billed charges","82.6% of total billed charges",65.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",28.91,320,
"Herpes Simplex Virus (HSV) Types 1 and 2, NAA LC",30687529,CDM,306,RC,87529,CPT,OUTPATIENT,,,128,83.2,,112.64,88,,90.11,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.64,63,,64.51,,,0,"percent of total billed charges","63% of total billed charges",19.58,15.3,,15.66,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,88.32,69,,,,,0,"fee schedule","69% of total billed charges",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.26,37.7,,38.61,,,0,"percent of total billed charges","37.7% of total billed charges",48.26,37.7,,38.61,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.39,33.9,,34.71,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.84,78,,79.87,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",105.73,82.6,,84.58,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",105.73,82.6,,84.58,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",18.33,134.21,
"Hgb Solubility LC",30585660,CDM,305,RC,85660,CPT,OUTPATIENT,,,119,77.35,,104.72,88,,83.78,,,0,"percent of total billed charges","88% of total billed charges",5.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",9.64,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.23,100,,,,,0,"fee schedule",EAPG,5.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.97,63,,59.98,,,0,"percent of total billed charges","63% of total billed charges",18.21,15.3,,14.57,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,82.11,69,,,,,0,"fee schedule","69% of total billed charges",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",5.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",5.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",5.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.07,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,5.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.51,100,,,,,0,"fee schedule","100% of LI fee schedule",3.76,100,,,,,0,"fee schedule",EAPG,5.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,5.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.7% of total billed charges",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.70% of total billed charges",5.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.34,33.9,,32.27,,,0,"percent of total billed charges","33.9% of total billed charges",5.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.82,78,,74.26,,,0,"percent of total billed charges","78% of total billed charges",5.56,101,,,,,0,"fee schedule","101% of CMS fee schedule ",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,5.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",5.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",3.76,119,
"HEMOGLOBIN F QUANT",30183021,CDM,301,RC,83021,CPT,OUTPATIENT,,,237,154.05,,208.56,88,,166.85,,,0,"percent of total billed charges","88% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,237,100,,189.60,,,0,"percent of total billed charges","100% of total billed charges",31.6,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.23,100,,,,,0,"fee schedule",EAPG,18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",149.31,63,,119.45,,,0,"percent of total billed charges","63% of total billed charges",36.26,15.3,,29.01,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,163.53,69,,,,,0,"fee schedule","69% of total billed charges",237,100,,189.60,,,0,"percent of total billed charges","100% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",237,100,,189.60,,,0,"percent of total billed charges","100% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",237,100,,189.60,,,0,"percent of total billed charges","100% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.07,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.05,100,,,,,0,"fee schedule","100% of LI fee schedule",3.76,100,,,,,0,"fee schedule",EAPG,18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.35,37.7,,71.48,,,0,"percent of total billed charges","37.7% of total billed charges",89.35,37.7,,71.48,,,0,"percent of total billed charges","37.70% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.34,33.9,,64.27,,,0,"percent of total billed charges","33.9% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",184.86,78,,147.89,,,0,"percent of total billed charges","78% of total billed charges",18.24,101,,,,,0,"fee schedule","101% of CMS fee schedule ",195.76,82.6,,156.61,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",195.76,82.6,,156.61,,,0,"percent of total billed charges","82.6% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,237,100,,189.60,,,0,"percent of total billed charges","100% of total billed charges",3.76,237,
"Hgb Fractionation Cascade LC",30183020,CDM,301,RC,83020,CPT,OUTPATIENT,,,198,128.7,,174.24,88,,139.39,,,0,"percent of total billed charges","88% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",22.52,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.74,63,,99.79,,,0,"percent of total billed charges","63% of total billed charges",30.29,15.3,,24.23,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,136.62,69,,,,,0,"fee schedule","69% of total billed charges",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.22,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.87,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.65,37.7,,59.72,,,0,"percent of total billed charges","37.7% of total billed charges",74.65,37.7,,59.72,,,0,"percent of total billed charges","37.70% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.12,33.9,,53.70,,,0,"percent of total billed charges","33.9% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",154.44,78,,123.55,,,0,"percent of total billed charges","78% of total billed charges",12.99,101,,,,,0,"fee schedule","101% of CMS fee schedule ",163.55,82.6,,130.84,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.55,82.6,,130.84,,,0,"percent of total billed charges","82.6% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,198,
"Hgb Frac by HPLC+Solubility LC",30183021,CDM,301,RC,83021,CPT,OUTPATIENT,,,278,180.7,,244.64,88,,195.71,,,0,"percent of total billed charges","88% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",31.6,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.23,100,,,,,0,"fee schedule",EAPG,18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",175.14,63,,140.11,,,0,"percent of total billed charges","63% of total billed charges",42.53,15.3,,34.02,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,191.82,69,,,,,0,"fee schedule","69% of total billed charges",278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.07,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.05,100,,,,,0,"fee schedule","100% of LI fee schedule",3.76,100,,,,,0,"fee schedule",EAPG,18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",104.81,37.7,,83.85,,,0,"percent of total billed charges","37.7% of total billed charges",104.81,37.7,,83.85,,,0,"percent of total billed charges","37.70% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",94.24,33.9,,75.39,,,0,"percent of total billed charges","33.9% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",216.84,78,,173.47,,,0,"percent of total billed charges","78% of total billed charges",18.24,101,,,,,0,"fee schedule","101% of CMS fee schedule ",229.63,82.6,,183.70,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",229.63,82.6,,183.70,,,0,"percent of total billed charges","82.6% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",3.76,278,
"High Sensitivity Troponin I",30184484,CDM,301,RC,84484,CPT,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",21.82,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.69,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.47,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",12.59,101,,,,,0,"fee schedule","101% of CMS fee schedule ",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",8.11,469,
"High-Risk HPV Panel with Genotyping AVR",30687624,CDM,306,RC,87624,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"Histoplasma Gal'mannan Ag Ser LC",30687385,CDM,306,RC,87385,CPT,OUTPATIENT,,,165,107.25,,145.2,88,,116.16,,,0,"percent of total billed charges","88% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",23.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",103.95,63,,83.16,,,0,"percent of total billed charges","63% of total billed charges",25.25,15.3,,20.20,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,113.85,69,,,,,0,"fee schedule","69% of total billed charges",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.68,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.25,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.21,37.7,,49.77,,,0,"percent of total billed charges","37.7% of total billed charges",62.21,37.7,,49.77,,,0,"percent of total billed charges","37.70% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.94,33.9,,44.75,,,0,"percent of total billed charges","33.9% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",128.7,78,,102.96,,,0,"percent of total billed charges","78% of total billed charges",13.38,101,,,,,0,"fee schedule","101% of CMS fee schedule ",136.29,82.6,,109.03,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.29,82.6,,109.03,,,0,"percent of total billed charges","82.6% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",4.81,165,
"Homocyst(e)ine, Plasma LC",30183090,CDM,301,RC,83090,CPT,OUTPATIENT,,,347,225.55,,305.36,88,,244.29,,,0,"percent of total billed charges","88% of total billed charges",17.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",31.36,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,17.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",218.61,63,,174.89,,,0,"percent of total billed charges","63% of total billed charges",53.09,15.3,,42.47,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,239.43,69,,,,,0,"fee schedule","69% of total billed charges",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",17.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",17.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",17.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.54,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,17.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.92,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,17.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,17.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",130.82,37.7,,104.66,,,0,"percent of total billed charges","37.7% of total billed charges",130.82,37.7,,104.66,,,0,"percent of total billed charges","37.70% of total billed charges",17.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",117.63,33.9,,94.10,,,0,"percent of total billed charges","33.9% of total billed charges",17.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",270.66,78,,216.53,,,0,"percent of total billed charges","78% of total billed charges",18.09,101,,,,,0,"fee schedule","101% of CMS fee schedule ",286.62,82.6,,229.30,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,17.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",286.62,82.6,,229.30,,,0,"percent of total billed charges","82.6% of total billed charges",17.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",8.39,347,
"Human Granulocytic Ehrlich-HGE LC",30286666,CDM,302,RC,86666,CPT,OUTPATIENT,,,74,48.1,,65.12,88,,52.10,,,0,"percent of total billed charges","88% of total billed charges",10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",17.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.62,63,,37.30,,,0,"percent of total billed charges","63% of total billed charges",11.32,15.3,,9.06,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,51.06,69,,,,,0,"fee schedule","69% of total billed charges",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.93,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.18,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.9,37.7,,22.32,,,0,"percent of total billed charges","37.7% of total billed charges",27.9,37.7,,22.32,,,0,"percent of total billed charges","37.70% of total billed charges",10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.09,33.9,,20.07,,,0,"percent of total billed charges","33.9% of total billed charges",10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.72,78,,46.18,,,0,"percent of total billed charges","78% of total billed charges",10.28,101,,,,,0,"fee schedule","101% of CMS fee schedule ",61.12,82.6,,48.90,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.12,82.6,,48.90,,,0,"percent of total billed charges","82.6% of total billed charges",10.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,74,
"Hypersensitivity Pneumonitis#6 LC",30286671,CDM,302,RC,86671,CPT,OUTPATIENT,,,107,69.55,,94.16,88,,75.33,,,0,"percent of total billed charges","88% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",21.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.41,63,,53.93,,,0,"percent of total billed charges","63% of total billed charges",16.37,15.3,,13.10,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,73.83,69,,,,,0,"fee schedule","69% of total billed charges",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.85,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.25,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.34,37.7,,32.27,,,0,"percent of total billed charges","37.7% of total billed charges",40.34,37.7,,32.27,,,0,"percent of total billed charges","37.70% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.27,33.9,,29.02,,,0,"percent of total billed charges","33.9% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",83.46,78,,66.77,,,0,"percent of total billed charges","78% of total billed charges",12.37,101,,,,,0,"fee schedule","101% of CMS fee schedule ",88.38,82.6,,70.70,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.38,82.6,,70.70,,,0,"percent of total billed charges","82.6% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",6.96,107,
"Hypersensitivity Pneumonitis  LC",30286671,CDM,302,RC,86671,CPT,OUTPATIENT,,,117,76.05,,102.96,88,,82.37,,,0,"percent of total billed charges","88% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",21.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.71,63,,58.97,,,0,"percent of total billed charges","63% of total billed charges",17.9,15.3,,14.32,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,80.73,69,,,,,0,"fee schedule","69% of total billed charges",117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.85,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.25,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.11,37.7,,35.29,,,0,"percent of total billed charges","37.7% of total billed charges",44.11,37.7,,35.29,,,0,"percent of total billed charges","37.70% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.66,33.9,,31.73,,,0,"percent of total billed charges","33.9% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.26,78,,73.01,,,0,"percent of total billed charges","78% of total billed charges",12.37,101,,,,,0,"fee schedule","101% of CMS fee schedule ",96.64,82.6,,77.31,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",96.64,82.6,,77.31,,,0,"percent of total billed charges","82.6% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",6.96,117,
"IFE U+Prot U LC",30184156,CDM,301,RC,84156,CPT,OUTPATIENT,,,517,336.05,,454.96,88,,363.97,,,0,"percent of total billed charges","88% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,517,100,,413.60,,,0,"percent of total billed charges","100% of total billed charges",6.42,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",325.71,63,,260.57,,,0,"percent of total billed charges","63% of total billed charges",79.1,15.3,,63.28,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,356.73,69,,,,,0,"fee schedule","69% of total billed charges",517,100,,413.60,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",517,100,,413.60,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",517,100,,413.60,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.03,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.67,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",194.91,37.7,,155.93,,,0,"percent of total billed charges","37.7% of total billed charges",194.91,37.7,,155.93,,,0,"percent of total billed charges","37.70% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",175.26,33.9,,140.21,,,0,"percent of total billed charges","33.9% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",403.26,78,,322.61,,,0,"percent of total billed charges","78% of total billed charges",3.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",427.04,82.6,,341.63,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",427.04,82.6,,341.63,,,0,"percent of total billed charges","82.6% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,517,100,,413.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,517,
"IFE and PE LC",30286334,CDM,302,RC,86334,CPT,OUTPATIENT,,,226,146.9,,198.88,88,,159.10,,,0,"percent of total billed charges","88% of total billed charges",22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",39.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.38,63,,113.90,,,0,"percent of total billed charges","63% of total billed charges",34.58,15.3,,27.66,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,155.94,69,,,,,0,"fee schedule","69% of total billed charges",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.45,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.34,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.2,37.7,,68.16,,,0,"percent of total billed charges","37.7% of total billed charges",85.2,37.7,,68.16,,,0,"percent of total billed charges","37.70% of total billed charges",22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.61,33.9,,61.29,,,0,"percent of total billed charges","33.9% of total billed charges",22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",176.28,78,,141.02,,,0,"percent of total billed charges","78% of total billed charges",22.56,101,,,,,0,"fee schedule","101% of CMS fee schedule ",186.68,82.6,,149.34,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",186.68,82.6,,149.34,,,0,"percent of total billed charges","82.6% of total billed charges",22.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",6.96,226,
"IGF-1 LC",30184305,CDM,301,RC,84305,CPT,OUTPATIENT,,,485,315.25,,426.8,88,,341.44,,,0,"percent of total billed charges","88% of total billed charges",21.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,485,100,,388.00,,,0,"percent of total billed charges","100% of total billed charges",37.2,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,21.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",305.55,63,,244.44,,,0,"percent of total billed charges","63% of total billed charges",74.21,15.3,,59.37,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,334.65,69,,,,,0,"fee schedule","69% of total billed charges",485,100,,388.00,,,0,"percent of total billed charges","100% of total billed charges",21.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",485,100,,388.00,,,0,"percent of total billed charges","100% of total billed charges",21.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",485,100,,388.00,,,0,"percent of total billed charges","100% of total billed charges",21.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.31,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,21.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.26,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,21.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,21.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",182.85,37.7,,146.28,,,0,"percent of total billed charges","37.7% of total billed charges",182.85,37.7,,146.28,,,0,"percent of total billed charges","37.70% of total billed charges",21.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",164.42,33.9,,131.54,,,0,"percent of total billed charges","33.9% of total billed charges",21.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",378.3,78,,302.64,,,0,"percent of total billed charges","78% of total billed charges",21.47,101,,,,,0,"fee schedule","101% of CMS fee schedule ",400.61,82.6,,320.49,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,21.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",400.61,82.6,,320.49,,,0,"percent of total billed charges","82.6% of total billed charges",21.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,485,100,,388.00,,,0,"percent of total billed charges","100% of total billed charges",8.39,485,
"Cortisol 24 Hour Urine",30183520,CDM,301,RC,83520,CPT,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",30.22,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.05,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.27,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.7% of total billed charges",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.92,33.9,,27.94,,,0,"percent of total billed charges","33.9% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",17.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,103,
"Pathology Billing Gyn Cyto Image Guided Thin Prep",31188175,CDM,311,RC,88175,CPT,OUTPATIENT,,,390,253.5,,343.2,88,,274.56,,,0,"percent of total billed charges","88% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,390,100,,312.00,,,0,"percent of total billed charges","100% of total billed charges",46.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.03,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",245.7,63,,196.56,,,0,"percent of total billed charges","63% of total billed charges",39.92,150,,,,,0,"fee schedule","150% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,269.1,69,,,,,0,"fee schedule","69% of total billed charges",390,100,,312.00,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",390,100,,312.00,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",390,100,,312.00,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.78,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.61,100,,,,,0,"fee schedule","100% of LI fee schedule",11.53,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.87,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",147.03,37.7,,117.62,,,0,"percent of total billed charges","37.7% of total billed charges",147.03,37.7,,117.62,,,0,"percent of total billed charges","37.70% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",132.21,33.9,,105.77,,,0,"percent of total billed charges","33.9% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",304.2,78,,243.36,,,0,"percent of total billed charges","78% of total billed charges",26.87,101,,,,,0,"fee schedule","101% of CMS fee schedule ",322.14,82.6,,257.71,,,0,"percent of total billed charges","82.6% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",322.14,82.6,,257.71,,,0,"percent of total billed charges","82.6% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,390,100,,312.00,,,0,"percent of total billed charges","100% of total billed charges",11.53,390,
"Pathology Billing Gyn Cyto Image Guided Thin Prep",31188175,CDM,311,RC,88175,CPT,OUTPATIENT,,,97,63.05,,85.36,88,,68.29,,,0,"percent of total billed charges","88% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",46.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.03,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.11,63,,48.89,,,0,"percent of total billed charges","63% of total billed charges",39.92,150,,,,,0,"fee schedule","150% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,66.93,69,,,,,0,"fee schedule","69% of total billed charges",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.78,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.61,100,,,,,0,"fee schedule","100% of LI fee schedule",11.53,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.87,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.57,37.7,,29.26,,,0,"percent of total billed charges","37.7% of total billed charges",36.57,37.7,,29.26,,,0,"percent of total billed charges","37.70% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.88,33.9,,26.30,,,0,"percent of total billed charges","33.9% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",75.66,78,,60.53,,,0,"percent of total billed charges","78% of total billed charges",26.87,101,,,,,0,"fee schedule","101% of CMS fee schedule ",80.12,82.6,,64.10,,,0,"percent of total billed charges","82.6% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.12,82.6,,64.10,,,0,"percent of total billed charges","82.6% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",11.53,101.78,
".IGP,CtNgTv,Apt HPV,rfx16/18,45 LC",31188175,CDM,311,RC,88175,CPT,OUTPATIENT,,,116,75.4,,102.08,88,,81.66,,,0,"percent of total billed charges","88% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",46.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.03,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.08,63,,58.46,,,0,"percent of total billed charges","63% of total billed charges",39.92,150,,,,,0,"fee schedule","150% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,80.04,69,,,,,0,"fee schedule","69% of total billed charges",116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.78,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.61,100,,,,,0,"fee schedule","100% of LI fee schedule",11.53,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.87,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.73,37.7,,34.98,,,0,"percent of total billed charges","37.7% of total billed charges",43.73,37.7,,34.98,,,0,"percent of total billed charges","37.70% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.32,33.9,,31.46,,,0,"percent of total billed charges","33.9% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.48,78,,72.38,,,0,"percent of total billed charges","78% of total billed charges",26.87,101,,,,,0,"fee schedule","101% of CMS fee schedule ",95.82,82.6,,76.66,,,0,"percent of total billed charges","82.6% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.82,82.6,,76.66,,,0,"percent of total billed charges","82.6% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",11.53,116,
"Pathology Billing Gyn Cyto Image Guided Thin Prep",31188175,CDM,311,RC,88175,CPT,OUTPATIENT,,,390,253.5,,343.2,88,,274.56,,,0,"percent of total billed charges","88% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,390,100,,312.00,,,0,"percent of total billed charges","100% of total billed charges",46.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.03,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",245.7,63,,196.56,,,0,"percent of total billed charges","63% of total billed charges",39.92,150,,,,,0,"fee schedule","150% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,269.1,69,,,,,0,"fee schedule","69% of total billed charges",390,100,,312.00,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",390,100,,312.00,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",390,100,,312.00,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.78,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.61,100,,,,,0,"fee schedule","100% of LI fee schedule",11.53,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.87,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",147.03,37.7,,117.62,,,0,"percent of total billed charges","37.7% of total billed charges",147.03,37.7,,117.62,,,0,"percent of total billed charges","37.70% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",132.21,33.9,,105.77,,,0,"percent of total billed charges","33.9% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",304.2,78,,243.36,,,0,"percent of total billed charges","78% of total billed charges",26.87,101,,,,,0,"fee schedule","101% of CMS fee schedule ",322.14,82.6,,257.71,,,0,"percent of total billed charges","82.6% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",322.14,82.6,,257.71,,,0,"percent of total billed charges","82.6% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,390,100,,312.00,,,0,"percent of total billed charges","100% of total billed charges",11.53,390,
"Pathology Billing Gyn Cyto Image Guided Thin Prep",31188175,CDM,311,RC,88175,CPT,OUTPATIENT,,,100,65,,88,88,,70.40,,,0,"percent of total billed charges","88% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",46.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.03,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",63,63,,50.40,,,0,"percent of total billed charges","63% of total billed charges",39.92,150,,,,,0,"fee schedule","150% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,69,69,,,,,0,"fee schedule","69% of total billed charges",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.78,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.61,100,,,,,0,"fee schedule","100% of LI fee schedule",11.53,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.87,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.7% of total billed charges",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.70% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.9,33.9,,27.12,,,0,"percent of total billed charges","33.9% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,78,,62.40,,,0,"percent of total billed charges","78% of total billed charges",26.87,101,,,,,0,"fee schedule","101% of CMS fee schedule ",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",11.53,101.78,
"Pathology Billing Gyn Cyto Image Guided Thin Prep",31188175,CDM,311,RC,88175,CPT,OUTPATIENT,,,100,65,,88,88,,70.40,,,0,"percent of total billed charges","88% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",46.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.03,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",63,63,,50.40,,,0,"percent of total billed charges","63% of total billed charges",39.92,150,,,,,0,"fee schedule","150% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,69,69,,,,,0,"fee schedule","69% of total billed charges",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.78,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.61,100,,,,,0,"fee schedule","100% of LI fee schedule",11.53,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.87,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.7% of total billed charges",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.70% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.9,33.9,,27.12,,,0,"percent of total billed charges","33.9% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,78,,62.40,,,0,"percent of total billed charges","78% of total billed charges",26.87,101,,,,,0,"fee schedule","101% of CMS fee schedule ",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",11.53,101.78,
"Pathology Billing Gyn Cyto Image Guided Thin Prep",31188175,CDM,311,RC,88175,CPT,OUTPATIENT,,,100,65,,88,88,,70.40,,,0,"percent of total billed charges","88% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",46.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.03,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",63,63,,50.40,,,0,"percent of total billed charges","63% of total billed charges",39.92,150,,,,,0,"fee schedule","150% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,69,69,,,,,0,"fee schedule","69% of total billed charges",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.78,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.61,100,,,,,0,"fee schedule","100% of LI fee schedule",11.53,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.87,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.7% of total billed charges",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.70% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.9,33.9,,27.12,,,0,"percent of total billed charges","33.9% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,78,,62.40,,,0,"percent of total billed charges","78% of total billed charges",26.87,101,,,,,0,"fee schedule","101% of CMS fee schedule ",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",11.53,101.78,
"IGP, CtNg, rfx Aptima HPV ASCU (Charted) LC",31188175,CDM,311,RC,88175,CPT,OUTPATIENT,,,294,191.1,,258.72,88,,206.98,,,0,"percent of total billed charges","88% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",46.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.03,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",185.22,63,,148.18,,,0,"percent of total billed charges","63% of total billed charges",39.92,150,,,,,0,"fee schedule","150% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,202.86,69,,,,,0,"fee schedule","69% of total billed charges",294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.78,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.61,100,,,,,0,"fee schedule","100% of LI fee schedule",11.53,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.87,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",110.84,37.7,,88.67,,,0,"percent of total billed charges","37.7% of total billed charges",110.84,37.7,,88.67,,,0,"percent of total billed charges","37.70% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.67,33.9,,79.74,,,0,"percent of total billed charges","33.9% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",229.32,78,,183.46,,,0,"percent of total billed charges","78% of total billed charges",26.87,101,,,,,0,"fee schedule","101% of CMS fee schedule ",242.84,82.6,,194.27,,,0,"percent of total billed charges","82.6% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",242.84,82.6,,194.27,,,0,"percent of total billed charges","82.6% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",11.53,294,
INR,30085610,CDM,300,RC,85610,CPT,OUTPATIENT,,,73,47.45,,64.24,88,,51.39,,,0,"percent of total billed charges","88% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",7.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.99,63,,36.79,,,0,"percent of total billed charges","63% of total billed charges",11.17,15.3,,8.94,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,50.37,69,,,,,0,"fee schedule","69% of total billed charges",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.4,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.29,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.52,37.7,,22.02,,,0,"percent of total billed charges","37.7% of total billed charges",27.52,37.7,,22.02,,,0,"percent of total billed charges","37.70% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,33.9,,19.80,,,0,"percent of total billed charges","33.9% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.94,78,,45.55,,,0,"percent of total billed charges","78% of total billed charges",4.33,101,,,,,0,"fee schedule","101% of CMS fee schedule ",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",2.48,73,
"INR POC Lab",30085610,CDM,300,RC,85610,CPT,OUTPATIENT,,,73,47.45,,64.24,88,,51.39,,,0,"percent of total billed charges","88% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",7.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.99,63,,36.79,,,0,"percent of total billed charges","63% of total billed charges",11.17,15.3,,8.94,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,50.37,69,,,,,0,"fee schedule","69% of total billed charges",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.4,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.29,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.52,37.7,,22.02,,,0,"percent of total billed charges","37.7% of total billed charges",27.52,37.7,,22.02,,,0,"percent of total billed charges","37.70% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,33.9,,19.80,,,0,"percent of total billed charges","33.9% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.94,78,,45.55,,,0,"percent of total billed charges","78% of total billed charges",4.33,101,,,,,0,"fee schedule","101% of CMS fee schedule ",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",2.48,73,
"IgE+Allergens(23) LC 602224",30182785,CDM,301,RC,82785,CPT,OUTPATIENT,,,455,295.75,,400.4,88,,320.32,,,0,"percent of total billed charges","88% of total billed charges",16.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,455,100,,364.00,,,0,"percent of total billed charges","100% of total billed charges",28.8,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,16.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",286.65,63,,229.32,,,0,"percent of total billed charges","63% of total billed charges",69.62,15.3,,55.70,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,313.95,69,,,,,0,"fee schedule","69% of total billed charges",455,100,,364.00,,,0,"percent of total billed charges","100% of total billed charges",16.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",455,100,,364.00,,,0,"percent of total billed charges","100% of total billed charges",16.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",455,100,,364.00,,,0,"percent of total billed charges","100% of total billed charges",16.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.95,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,16.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.46,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,16.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,16.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",171.54,37.7,,137.23,,,0,"percent of total billed charges","37.7% of total billed charges",171.54,37.7,,137.23,,,0,"percent of total billed charges","37.70% of total billed charges",16.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",154.25,33.9,,123.40,,,0,"percent of total billed charges","33.9% of total billed charges",16.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",354.9,78,,283.92,,,0,"percent of total billed charges","78% of total billed charges",16.62,101,,,,,0,"fee schedule","101% of CMS fee schedule ",375.83,82.6,,300.66,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,16.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",375.83,82.6,,300.66,,,0,"percent of total billed charges","82.6% of total billed charges",16.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,455,100,,364.00,,,0,"percent of total billed charges","100% of total billed charges",8.11,455,
"IgG, Subclasses(1-4) LC",30182787,CDM,301,RC,82787,CPT,OUTPATIENT,,,48,31.2,,42.24,88,,33.79,,,0,"percent of total billed charges","88% of total billed charges",8.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",14.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,8.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.24,63,,24.19,,,0,"percent of total billed charges","63% of total billed charges",7.34,15.3,,5.87,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,33.12,69,,,,,0,"fee schedule","69% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",8.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",8.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",8.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.67,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,8.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.02,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,8.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,8.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.1,37.7,,14.48,,,0,"percent of total billed charges","37.7% of total billed charges",18.1,37.7,,14.48,,,0,"percent of total billed charges","37.70% of total billed charges",8.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.27,33.9,,13.02,,,0,"percent of total billed charges","33.9% of total billed charges",8.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.44,78,,29.95,,,0,"percent of total billed charges","78% of total billed charges",8.1,101,,,,,0,"fee schedule","101% of CMS fee schedule ",39.65,82.6,,31.72,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,8.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.65,82.6,,31.72,,,0,"percent of total billed charges","82.6% of total billed charges",8.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,48,
"Immunofixation U LC",30286335,CDM,302,RC,86335,CPT,OUTPATIENT,,,226,146.9,,198.88,88,,159.10,,,0,"percent of total billed charges","88% of total billed charges",29.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.28,100,,,,,0,"fee schedule",EAPG,226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",51.36,175,,,,,0,"fee schedule","175% of CMS fee schedule",28.1,100,,,,,0,"fee schedule",EAPG,29.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.38,63,,113.90,,,0,"percent of total billed charges","63% of total billed charges",34.58,15.3,,27.66,,,0,"percent of total billed charges","15.3% of total billed charges",27.28,100,,,,,0,"fee schedule",EAPG,155.94,69,,,,,0,"fee schedule","69% of total billed charges",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",29.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",29.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",29.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",112.26,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",27.28,100,,,,,0,"fee schedule",EAPG,29.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.35,100,,,,,0,"fee schedule","100% of LI fee schedule",20.21,100,,,,,0,"fee schedule",EAPG,29.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.83,100,,,,,0,"fee schedule",EAPG,35.47,100,,,,,0,"fee schedule",EAPG,29.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.2,37.7,,68.16,,,0,"percent of total billed charges","37.7% of total billed charges",85.2,37.7,,68.16,,,0,"percent of total billed charges","37.70% of total billed charges",29.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.61,33.9,,61.29,,,0,"percent of total billed charges","33.9% of total billed charges",29.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",176.28,78,,141.02,,,0,"percent of total billed charges","78% of total billed charges",29.64,101,,,,,0,"fee schedule","101% of CMS fee schedule ",186.68,82.6,,149.34,,,0,"percent of total billed charges","82.6% of total billed charges",27.28,100,,,,,0,"fee schedule",EAPG,29.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",186.68,82.6,,149.34,,,0,"percent of total billed charges","82.6% of total billed charges",29.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.28,100,,,,,0,"fee schedule",EAPG,226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",20.21,226,
"Immunoglobulins A/G/M, Qn, Ser LC",30182784,CDM,301,RC,82784,CPT,OUTPATIENT,,,191,124.15,,168.08,88,,134.46,,,0,"percent of total billed charges","88% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",16.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",120.33,63,,96.26,,,0,"percent of total billed charges","63% of total billed charges",29.22,15.3,,23.38,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,131.79,69,,,,,0,"fee schedule","69% of total billed charges",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.57,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.3,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.01,37.7,,57.61,,,0,"percent of total billed charges","37.7% of total billed charges",72.01,37.7,,57.61,,,0,"percent of total billed charges","37.70% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.75,33.9,,51.80,,,0,"percent of total billed charges","33.9% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",148.98,78,,119.18,,,0,"percent of total billed charges","78% of total billed charges",9.39,101,,,,,0,"fee schedule","101% of CMS fee schedule ",157.77,82.6,,126.22,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",157.77,82.6,,126.22,,,0,"percent of total billed charges","82.6% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",3.25,191,
"Immunoglobulin G, Qn LC 001776",30182784,CDM,301,RC,82784,CPT,OUTPATIENT,,,191,124.15,,168.08,88,,134.46,,,0,"percent of total billed charges","88% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",16.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",120.33,63,,96.26,,,0,"percent of total billed charges","63% of total billed charges",29.22,15.3,,23.38,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,131.79,69,,,,,0,"fee schedule","69% of total billed charges",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.57,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.3,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.01,37.7,,57.61,,,0,"percent of total billed charges","37.7% of total billed charges",72.01,37.7,,57.61,,,0,"percent of total billed charges","37.70% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.75,33.9,,51.80,,,0,"percent of total billed charges","33.9% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",148.98,78,,119.18,,,0,"percent of total billed charges","78% of total billed charges",9.39,101,,,,,0,"fee schedule","101% of CMS fee schedule ",157.77,82.6,,126.22,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",157.77,82.6,,126.22,,,0,"percent of total billed charges","82.6% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",3.25,191,
"Immunoglobulin A, Qn LC",30182784,CDM,301,RC,82784,CPT,OUTPATIENT,,,191,124.15,,168.08,88,,134.46,,,0,"percent of total billed charges","88% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",16.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",120.33,63,,96.26,,,0,"percent of total billed charges","63% of total billed charges",29.22,15.3,,23.38,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,131.79,69,,,,,0,"fee schedule","69% of total billed charges",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.57,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.3,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.01,37.7,,57.61,,,0,"percent of total billed charges","37.7% of total billed charges",72.01,37.7,,57.61,,,0,"percent of total billed charges","37.70% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.75,33.9,,51.80,,,0,"percent of total billed charges","33.9% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",148.98,78,,119.18,,,0,"percent of total billed charges","78% of total billed charges",9.39,101,,,,,0,"fee schedule","101% of CMS fee schedule ",157.77,82.6,,126.22,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",157.77,82.6,,126.22,,,0,"percent of total billed charges","82.6% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",3.25,191,
"Immunoglobulin M, Qn LC",30182784,CDM,301,RC,82784,CPT,OUTPATIENT,,,191,124.15,,168.08,88,,134.46,,,0,"percent of total billed charges","88% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",16.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",120.33,63,,96.26,,,0,"percent of total billed charges","63% of total billed charges",29.22,15.3,,23.38,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,131.79,69,,,,,0,"fee schedule","69% of total billed charges",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.57,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.3,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.01,37.7,,57.61,,,0,"percent of total billed charges","37.7% of total billed charges",72.01,37.7,,57.61,,,0,"percent of total billed charges","37.70% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.75,33.9,,51.80,,,0,"percent of total billed charges","33.9% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",148.98,78,,119.18,,,0,"percent of total billed charges","78% of total billed charges",9.39,101,,,,,0,"fee schedule","101% of CMS fee schedule ",157.77,82.6,,126.22,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",157.77,82.6,,126.22,,,0,"percent of total billed charges","82.6% of total billed charges",9.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",3.25,191,
"Immunoglobulin E, Total LC",30182785,CDM,301,RC,82785,CPT,OUTPATIENT,,,455,295.75,,400.4,88,,320.32,,,0,"percent of total billed charges","88% of total billed charges",16.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,455,100,,364.00,,,0,"percent of total billed charges","100% of total billed charges",28.8,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,16.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",286.65,63,,229.32,,,0,"percent of total billed charges","63% of total billed charges",69.62,15.3,,55.70,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,313.95,69,,,,,0,"fee schedule","69% of total billed charges",455,100,,364.00,,,0,"percent of total billed charges","100% of total billed charges",16.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",455,100,,364.00,,,0,"percent of total billed charges","100% of total billed charges",16.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",455,100,,364.00,,,0,"percent of total billed charges","100% of total billed charges",16.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.95,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,16.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.46,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,16.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,16.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",171.54,37.7,,137.23,,,0,"percent of total billed charges","37.7% of total billed charges",171.54,37.7,,137.23,,,0,"percent of total billed charges","37.70% of total billed charges",16.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",154.25,33.9,,123.40,,,0,"percent of total billed charges","33.9% of total billed charges",16.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",354.9,78,,283.92,,,0,"percent of total billed charges","78% of total billed charges",16.62,101,,,,,0,"fee schedule","101% of CMS fee schedule ",375.83,82.6,,300.66,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,16.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",375.83,82.6,,300.66,,,0,"percent of total billed charges","82.6% of total billed charges",16.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,455,100,,364.00,,,0,"percent of total billed charges","100% of total billed charges",8.11,455,
"Immunohistochemical Stain(s) LC",31088342,CDM,310,RC,88342,CPT,OUTPATIENT,,,228,148.2,,200.64,88,,160.51,,,0,"percent of total billed charges","88% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",304.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",37.5,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",143.64,63,,114.91,,,0,"percent of total billed charges","63% of total billed charges",34.88,15.3,,27.90,,,0,"percent of total billed charges","15.3% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,157.32,69,,,,,0,"fee schedule","69% of total billed charges",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",605.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.97,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37.13,100,,,,,0,"fee schedule",EAPG,47.33,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.96,37.7,,68.77,,,0,"percent of total billed charges","37.7% of total billed charges",85.96,37.7,,68.77,,,0,"percent of total billed charges","37.70% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.29,33.9,,61.83,,,0,"percent of total billed charges","33.9% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.84,78,,142.27,,,0,"percent of total billed charges","78% of total billed charges",175.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",188.33,82.6,,150.66,,,0,"percent of total billed charges","82.6% of total billed charges",36.41,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",188.33,82.6,,150.66,,,0,"percent of total billed charges","82.6% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.41,100,,,,,0,"fee schedule",EAPG,228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",26.97,605.96,
"Influenza A Abs, CF LC",30286710,CDM,302,RC,86710,CPT,OUTPATIENT,,,93,60.45,,81.84,88,,65.47,,,0,"percent of total billed charges","88% of total billed charges",13.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",23.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,13.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.59,63,,46.87,,,0,"percent of total billed charges","63% of total billed charges",14.23,15.3,,11.38,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,64.17,69,,,,,0,"fee schedule","69% of total billed charges",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",13.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",13.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",13.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.82,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,13.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.55,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,13.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,13.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.06,37.7,,28.05,,,0,"percent of total billed charges","37.7% of total billed charges",35.06,37.7,,28.05,,,0,"percent of total billed charges","37.70% of total billed charges",13.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.53,33.9,,25.22,,,0,"percent of total billed charges","33.9% of total billed charges",13.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.54,78,,58.03,,,0,"percent of total billed charges","78% of total billed charges",13.68,101,,,,,0,"fee schedule","101% of CMS fee schedule ",76.82,82.6,,61.46,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,13.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.82,82.6,,61.46,,,0,"percent of total billed charges","82.6% of total billed charges",13.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",6.96,93,
"Insulin Antibodies LC",30286337,CDM,302,RC,86337,CPT,OUTPATIENT,,,191,124.15,,168.08,88,,134.46,,,0,"percent of total billed charges","88% of total billed charges",21.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",37.46,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,21.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",120.33,63,,96.26,,,0,"percent of total billed charges","63% of total billed charges",29.22,15.3,,23.38,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,131.79,69,,,,,0,"fee schedule","69% of total billed charges",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",21.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",21.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",21.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.89,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,21.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.41,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,21.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,21.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.01,37.7,,57.61,,,0,"percent of total billed charges","37.7% of total billed charges",72.01,37.7,,57.61,,,0,"percent of total billed charges","37.70% of total billed charges",21.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.75,33.9,,51.80,,,0,"percent of total billed charges","33.9% of total billed charges",21.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",148.98,78,,119.18,,,0,"percent of total billed charges","78% of total billed charges",21.62,101,,,,,0,"fee schedule","101% of CMS fee schedule ",157.77,82.6,,126.22,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,21.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",157.77,82.6,,126.22,,,0,"percent of total billed charges","82.6% of total billed charges",21.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",6.96,191,
"Insulin LC",30183525,CDM,301,RC,83525,CPT,OUTPATIENT,,,166,107.9,,146.08,88,,116.86,,,0,"percent of total billed charges","88% of total billed charges",11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",20,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",104.58,63,,83.66,,,0,"percent of total billed charges","63% of total billed charges",25.4,15.3,,20.32,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,114.54,69,,,,,0,"fee schedule","69% of total billed charges",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.71,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.43,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.58,37.7,,50.06,,,0,"percent of total billed charges","37.7% of total billed charges",62.58,37.7,,50.06,,,0,"percent of total billed charges","37.70% of total billed charges",11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.27,33.9,,45.02,,,0,"percent of total billed charges","33.9% of total billed charges",11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.48,78,,103.58,,,0,"percent of total billed charges","78% of total billed charges",11.54,101,,,,,0,"fee schedule","101% of CMS fee schedule ",137.12,82.6,,109.70,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.12,82.6,,109.70,,,0,"percent of total billed charges","82.6% of total billed charges",11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",8.39,166,
INSULIN,30183525,CDM,301,RC,83525,CPT,OUTPATIENT,,,141,91.65,,124.08,88,,99.26,,,0,"percent of total billed charges","88% of total billed charges",11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,141,100,,112.80,,,0,"percent of total billed charges","100% of total billed charges",20,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.83,63,,71.06,,,0,"percent of total billed charges","63% of total billed charges",21.57,15.3,,17.26,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,97.29,69,,,,,0,"fee schedule","69% of total billed charges",141,100,,112.80,,,0,"percent of total billed charges","100% of total billed charges",11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",141,100,,112.80,,,0,"percent of total billed charges","100% of total billed charges",11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",141,100,,112.80,,,0,"percent of total billed charges","100% of total billed charges",11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.71,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.43,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.16,37.7,,42.53,,,0,"percent of total billed charges","37.7% of total billed charges",53.16,37.7,,42.53,,,0,"percent of total billed charges","37.70% of total billed charges",11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.8,33.9,,38.24,,,0,"percent of total billed charges","33.9% of total billed charges",11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.98,78,,87.98,,,0,"percent of total billed charges","78% of total billed charges",11.54,101,,,,,0,"fee schedule","101% of CMS fee schedule ",116.47,82.6,,93.18,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",116.47,82.6,,93.18,,,0,"percent of total billed charges","82.6% of total billed charges",11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,141,100,,112.80,,,0,"percent of total billed charges","100% of total billed charges",8.39,141,
INSULIN,30183525,CDM,301,RC,83525,CPT,OUTPATIENT,,,141,91.65,,124.08,88,,99.26,,,0,"percent of total billed charges","88% of total billed charges",11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,141,100,,112.80,,,0,"percent of total billed charges","100% of total billed charges",20,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.83,63,,71.06,,,0,"percent of total billed charges","63% of total billed charges",21.57,15.3,,17.26,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,97.29,69,,,,,0,"fee schedule","69% of total billed charges",141,100,,112.80,,,0,"percent of total billed charges","100% of total billed charges",11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",141,100,,112.80,,,0,"percent of total billed charges","100% of total billed charges",11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",141,100,,112.80,,,0,"percent of total billed charges","100% of total billed charges",11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.71,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.43,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.16,37.7,,42.53,,,0,"percent of total billed charges","37.7% of total billed charges",53.16,37.7,,42.53,,,0,"percent of total billed charges","37.70% of total billed charges",11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.8,33.9,,38.24,,,0,"percent of total billed charges","33.9% of total billed charges",11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.98,78,,87.98,,,0,"percent of total billed charges","78% of total billed charges",11.54,101,,,,,0,"fee schedule","101% of CMS fee schedule ",116.47,82.6,,93.18,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",116.47,82.6,,93.18,,,0,"percent of total billed charges","82.6% of total billed charges",11.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,141,100,,112.80,,,0,"percent of total billed charges","100% of total billed charges",8.39,141,
"PHOSPHATIDYLSERINE IGG",30184163,CDM,301,RC,84163,CPT,OUTPATIENT,,,138,89.7,,121.44,88,,97.15,,,0,"percent of total billed charges","88% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",26.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",86.94,63,,69.55,,,0,"percent of total billed charges","63% of total billed charges",21.11,15.3,,16.89,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,95.22,69,,,,,0,"fee schedule","69% of total billed charges",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.56,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.05,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.03,37.7,,41.62,,,0,"percent of total billed charges","37.7% of total billed charges",52.03,37.7,,41.62,,,0,"percent of total billed charges","37.70% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.78,33.9,,37.42,,,0,"percent of total billed charges","33.9% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.64,78,,86.11,,,0,"percent of total billed charges","78% of total billed charges",15.2,101,,,,,0,"fee schedule","101% of CMS fee schedule ",113.99,82.6,,91.19,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.99,82.6,,91.19,,,0,"percent of total billed charges","82.6% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,138,
"DIMERIC INHIBINA (DIA)",30286336,CDM,302,RC,86336,CPT,OUTPATIENT,,,108,70.2,,95.04,88,,76.03,,,0,"percent of total billed charges","88% of total billed charges",15.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",27.28,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,15.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.04,63,,54.43,,,0,"percent of total billed charges","63% of total billed charges",16.52,15.3,,13.22,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,74.52,69,,,,,0,"fee schedule","69% of total billed charges",108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",15.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",15.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",15.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.63,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,15.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.59,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,15.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,15.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.72,37.7,,32.58,,,0,"percent of total billed charges","37.7% of total billed charges",40.72,37.7,,32.58,,,0,"percent of total billed charges","37.70% of total billed charges",15.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.61,33.9,,29.29,,,0,"percent of total billed charges","33.9% of total billed charges",15.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",84.24,78,,67.39,,,0,"percent of total billed charges","78% of total billed charges",15.74,101,,,,,0,"fee schedule","101% of CMS fee schedule ",89.21,82.6,,71.37,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,15.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.21,82.6,,71.37,,,0,"percent of total billed charges","82.6% of total billed charges",15.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",6.96,108,
"Intrinsic Factor Abs LC",30286340,CDM,302,RC,86340,CPT,OUTPATIENT,,,343,222.95,,301.84,88,,241.47,,,0,"percent of total billed charges","88% of total billed charges",15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",26.39,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",216.09,63,,172.87,,,0,"percent of total billed charges","63% of total billed charges",52.48,15.3,,41.98,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,236.67,69,,,,,0,"fee schedule","69% of total billed charges",343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.68,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.08,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.31,37.7,,103.45,,,0,"percent of total billed charges","37.7% of total billed charges",129.31,37.7,,103.45,,,0,"percent of total billed charges","37.70% of total billed charges",15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",116.28,33.9,,93.02,,,0,"percent of total billed charges","33.9% of total billed charges",15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",267.54,78,,214.03,,,0,"percent of total billed charges","78% of total billed charges",15.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",283.32,82.6,,226.66,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",283.32,82.6,,226.66,,,0,"percent of total billed charges","82.6% of total billed charges",15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",6.96,343,
Iron,30083540,CDM,300,RC,83540,CPT,OUTPATIENT,,,136,88.4,,119.68,88,,95.74,,,0,"percent of total billed charges","88% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",11.32,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.68,63,,68.54,,,0,"percent of total billed charges","63% of total billed charges",20.81,15.3,,16.65,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,93.84,69,,,,,0,"fee schedule","69% of total billed charges",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.74,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.47,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.27,37.7,,41.02,,,0,"percent of total billed charges","37.7% of total billed charges",51.27,37.7,,41.02,,,0,"percent of total billed charges","37.70% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.1,33.9,,36.88,,,0,"percent of total billed charges","33.9% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.08,78,,84.86,,,0,"percent of total billed charges","78% of total billed charges",6.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",112.34,82.6,,89.87,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",112.34,82.6,,89.87,,,0,"percent of total billed charges","82.6% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",3.25,136,
"Iron Panel",30183540,CDM,301,RC,83540,CPT,OUTPATIENT,,,136,88.4,,119.68,88,,95.74,,,0,"percent of total billed charges","88% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",11.32,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.68,63,,68.54,,,0,"percent of total billed charges","63% of total billed charges",20.81,15.3,,16.65,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,93.84,69,,,,,0,"fee schedule","69% of total billed charges",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.74,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.47,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.27,37.7,,41.02,,,0,"percent of total billed charges","37.7% of total billed charges",51.27,37.7,,41.02,,,0,"percent of total billed charges","37.70% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.1,33.9,,36.88,,,0,"percent of total billed charges","33.9% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.08,78,,84.86,,,0,"percent of total billed charges","78% of total billed charges",6.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",112.34,82.6,,89.87,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",112.34,82.6,,89.87,,,0,"percent of total billed charges","82.6% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",3.25,136,
"Iron and TIBC LC",30183540,CDM,301,RC,83540,CPT,OUTPATIENT,,,344,223.6,,302.72,88,,242.18,,,0,"percent of total billed charges","88% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",11.32,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",216.72,63,,173.38,,,0,"percent of total billed charges","63% of total billed charges",52.63,15.3,,42.10,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,237.36,69,,,,,0,"fee schedule","69% of total billed charges",344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.74,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.47,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.69,37.7,,103.75,,,0,"percent of total billed charges","37.7% of total billed charges",129.69,37.7,,103.75,,,0,"percent of total billed charges","37.70% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",116.62,33.9,,93.30,,,0,"percent of total billed charges","33.9% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",268.32,78,,214.66,,,0,"percent of total billed charges","78% of total billed charges",6.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",284.14,82.6,,227.31,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",284.14,82.6,,227.31,,,0,"percent of total billed charges","82.6% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",3.25,344,
"Iron LC",30183540,CDM,301,RC,83540,CPT,OUTPATIENT,,,22,14.3,,19.36,88,,15.49,,,0,"percent of total billed charges","88% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",11.32,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.86,63,,11.09,,,0,"percent of total billed charges","63% of total billed charges",3.37,15.3,,2.70,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,15.18,69,,,,,0,"fee schedule","69% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.74,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.47,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.29,37.7,,6.63,,,0,"percent of total billed charges","37.7% of total billed charges",8.29,37.7,,6.63,,,0,"percent of total billed charges","37.70% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.46,33.9,,5.97,,,0,"percent of total billed charges","33.9% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.16,78,,13.73,,,0,"percent of total billed charges","78% of total billed charges",6.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,24.74,
"JAK2 V617 Mutation LC",31081270,CDM,310,RC,81270,CPT,OUTPATIENT,,,541,351.65,,476.08,88,,380.86,,,0,"percent of total billed charges","88% of total billed charges",91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,541,100,,432.80,,,0,"percent of total billed charges","100% of total billed charges",160.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.2,100,,,,,0,"fee schedule",EAPG,91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",340.83,63,,272.66,,,0,"percent of total billed charges","63% of total billed charges",137.49,150,,,,,0,"fee schedule","150% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,373.29,69,,,,,0,"fee schedule","69% of total billed charges",541,100,,432.80,,,0,"percent of total billed charges","100% of total billed charges",91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",541,100,,432.80,,,0,"percent of total billed charges","100% of total billed charges",91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",541,100,,432.80,,,0,"percent of total billed charges","100% of total billed charges",91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",350.59,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.66,100,,,,,0,"fee schedule","100% of LI fee schedule",28.91,100,,,,,0,"fee schedule",EAPG,91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.81,100,,,,,0,"fee schedule",EAPG,50.73,100,,,,,0,"fee schedule",EAPG,91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",203.96,37.7,,163.17,,,0,"percent of total billed charges","37.7% of total billed charges",203.96,37.7,,163.17,,,0,"percent of total billed charges","37.70% of total billed charges",91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",183.4,33.9,,146.72,,,0,"percent of total billed charges","33.9% of total billed charges",91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",421.98,78,,337.58,,,0,"percent of total billed charges","78% of total billed charges",92.57,101,,,,,0,"fee schedule","101% of CMS fee schedule ",446.87,82.6,,357.50,,,0,"percent of total billed charges","82.6% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",446.87,82.6,,357.50,,,0,"percent of total billed charges","82.6% of total billed charges",91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,541,100,,432.80,,,0,"percent of total billed charges","100% of total billed charges",28.91,541,
N/A,31081270,CDM,310,RC,81270,CPT,OUTPATIENT,,,637,414.05,,560.56,88,,448.45,,,0,"percent of total billed charges","88% of total billed charges",91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,637,100,,509.60,,,0,"percent of total billed charges","100% of total billed charges",160.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.2,100,,,,,0,"fee schedule",EAPG,91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",401.31,63,,321.05,,,0,"percent of total billed charges","63% of total billed charges",137.49,150,,,,,0,"fee schedule","150% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,439.53,69,,,,,0,"fee schedule","69% of total billed charges",637,100,,509.60,,,0,"percent of total billed charges","100% of total billed charges",91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",637,100,,509.60,,,0,"percent of total billed charges","100% of total billed charges",91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",637,100,,509.60,,,0,"percent of total billed charges","100% of total billed charges",91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",350.59,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.66,100,,,,,0,"fee schedule","100% of LI fee schedule",28.91,100,,,,,0,"fee schedule",EAPG,91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.81,100,,,,,0,"fee schedule",EAPG,50.73,100,,,,,0,"fee schedule",EAPG,91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",240.15,37.7,,192.12,,,0,"percent of total billed charges","37.7% of total billed charges",240.15,37.7,,192.12,,,0,"percent of total billed charges","37.70% of total billed charges",91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",215.94,33.9,,172.75,,,0,"percent of total billed charges","33.9% of total billed charges",91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",496.86,78,,397.49,,,0,"percent of total billed charges","78% of total billed charges",92.57,101,,,,,0,"fee schedule","101% of CMS fee schedule ",526.16,82.6,,420.93,,,0,"percent of total billed charges","82.6% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",526.16,82.6,,420.93,,,0,"percent of total billed charges","82.6% of total billed charges",91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,637,100,,509.60,,,0,"percent of total billed charges","100% of total billed charges",28.91,637,
"JAK2 V617F, reflex to E12-15 LC",31081270,CDM,310,RC,81270,CPT,OUTPATIENT,,,637,414.05,,560.56,88,,448.45,,,0,"percent of total billed charges","88% of total billed charges",91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,637,100,,509.60,,,0,"percent of total billed charges","100% of total billed charges",160.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.2,100,,,,,0,"fee schedule",EAPG,91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",401.31,63,,321.05,,,0,"percent of total billed charges","63% of total billed charges",137.49,150,,,,,0,"fee schedule","150% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,439.53,69,,,,,0,"fee schedule","69% of total billed charges",637,100,,509.60,,,0,"percent of total billed charges","100% of total billed charges",91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",637,100,,509.60,,,0,"percent of total billed charges","100% of total billed charges",91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",637,100,,509.60,,,0,"percent of total billed charges","100% of total billed charges",91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",350.59,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.66,100,,,,,0,"fee schedule","100% of LI fee schedule",28.91,100,,,,,0,"fee schedule",EAPG,91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.81,100,,,,,0,"fee schedule",EAPG,50.73,100,,,,,0,"fee schedule",EAPG,91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",240.15,37.7,,192.12,,,0,"percent of total billed charges","37.7% of total billed charges",240.15,37.7,,192.12,,,0,"percent of total billed charges","37.70% of total billed charges",91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",215.94,33.9,,172.75,,,0,"percent of total billed charges","33.9% of total billed charges",91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",496.86,78,,397.49,,,0,"percent of total billed charges","78% of total billed charges",92.57,101,,,,,0,"fee schedule","101% of CMS fee schedule ",526.16,82.6,,420.93,,,0,"percent of total billed charges","82.6% of total billed charges",39.02,100,,,,,0,"fee schedule",EAPG,91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",526.16,82.6,,420.93,,,0,"percent of total billed charges","82.6% of total billed charges",91.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.02,100,,,,,0,"fee schedule",EAPG,637,100,,509.60,,,0,"percent of total billed charges","100% of total billed charges",28.91,637,
"Kidney Stone Analysis LC",30182365,CDM,301,RC,82365,CPT,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",22.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.9,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.7% of total billed charges",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.93,33.9,,12.74,,,0,"percent of total billed charges","33.9% of total billed charges",12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",13.02,101,,,,,0,"fee schedule","101% of CMS fee schedule ",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",12.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,49.34,
"L. pneumophila Serogp 1 Ur Ag LC",30687449,CDM,306,RC,87449,CPT,OUTPATIENT,,,209,135.85,,183.92,88,,147.14,,,0,"percent of total billed charges","88% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,209,100,,167.20,,,0,"percent of total billed charges","100% of total billed charges",20.96,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",131.67,63,,105.34,,,0,"percent of total billed charges","63% of total billed charges",31.98,15.3,,25.58,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,144.21,69,,,,,0,"fee schedule","69% of total billed charges",209,100,,167.20,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",209,100,,167.20,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",209,100,,167.20,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.82,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.98,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.79,37.7,,63.03,,,0,"percent of total billed charges","37.7% of total billed charges",78.79,37.7,,63.03,,,0,"percent of total billed charges","37.70% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.85,33.9,,56.68,,,0,"percent of total billed charges","33.9% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.02,78,,130.42,,,0,"percent of total billed charges","78% of total billed charges",12.09,101,,,,,0,"fee schedule","101% of CMS fee schedule ",172.63,82.6,,138.10,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",172.63,82.6,,138.10,,,0,"percent of total billed charges","82.6% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,209,100,,167.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,209,
"LA Ven - Sepsis 2Hr",30083605,CDM,301,RC,83605,CPT,OUTPATIENT,,,198,128.7,,174.24,88,,139.39,,,0,"percent of total billed charges","88% of total billed charges",11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",20.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.74,63,,99.79,,,0,"percent of total billed charges","63% of total billed charges",30.29,15.3,,24.23,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,136.62,69,,,,,0,"fee schedule","69% of total billed charges",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.25,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.57,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.65,37.7,,59.72,,,0,"percent of total billed charges","37.7% of total billed charges",74.65,37.7,,59.72,,,0,"percent of total billed charges","37.70% of total billed charges",11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.12,33.9,,53.70,,,0,"percent of total billed charges","33.9% of total billed charges",11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",154.44,78,,123.55,,,0,"percent of total billed charges","78% of total billed charges",11.68,101,,,,,0,"fee schedule","101% of CMS fee schedule ",163.55,82.6,,130.84,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.55,82.6,,130.84,,,0,"percent of total billed charges","82.6% of total billed charges",11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,198,
"Lactate dehydrogenase (LD), Body Fluid LC",30183615,CDM,301,RC,83615,CPT,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",10.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.04,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.7% of total billed charges",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.78,33.9,,5.42,,,0,"percent of total billed charges","33.9% of total billed charges",6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",6.1,101,,,,,0,"fee schedule","101% of CMS fee schedule ",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,23.1,
"LDL Cholesterol (Direct) LC",30183721,CDM,301,RC,83721,CPT,OUTPATIENT,,,207,134.55,,182.16,88,,145.73,,,0,"percent of total billed charges","88% of total billed charges",10.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",18.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,10.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",130.41,63,,104.33,,,0,"percent of total billed charges","63% of total billed charges",31.67,15.3,,25.34,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,142.83,69,,,,,0,"fee schedule","69% of total billed charges",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",10.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",10.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",10.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.16,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,10.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.5,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,10.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,10.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.04,37.7,,62.43,,,0,"percent of total billed charges","37.7% of total billed charges",78.04,37.7,,62.43,,,0,"percent of total billed charges","37.70% of total billed charges",10.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.17,33.9,,56.14,,,0,"percent of total billed charges","33.9% of total billed charges",10.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",161.46,78,,129.17,,,0,"percent of total billed charges","78% of total billed charges",10.6,101,,,,,0,"fee schedule","101% of CMS fee schedule ",170.98,82.6,,136.78,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,10.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.98,82.6,,136.78,,,0,"percent of total billed charges","82.6% of total billed charges",10.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,207,
"Lacosamide LC",30180235,CDM,301,RC,80235,CPT,OUTPATIENT,,,594,386.1,,522.72,88,,418.18,,,0,"percent of total billed charges","88% of total billed charges",27.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,594,100,,475.20,,,0,"percent of total billed charges","100% of total billed charges",47.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,27.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",374.22,63,,299.38,,,0,"percent of total billed charges","63% of total billed charges",90.88,15.3,,72.70,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,409.86,69,,,,,0,"fee schedule","69% of total billed charges",594,100,,475.20,,,0,"percent of total billed charges","100% of total billed charges",27.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",594,100,,475.20,,,0,"percent of total billed charges","100% of total billed charges",27.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",594,100,,475.20,,,0,"percent of total billed charges","100% of total billed charges",27.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",103.69,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,27.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.11,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,27.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,27.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",223.94,37.7,,179.15,,,0,"percent of total billed charges","37.7% of total billed charges",223.94,37.7,,179.15,,,0,"percent of total billed charges","37.70% of total billed charges",27.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",201.37,33.9,,161.10,,,0,"percent of total billed charges","33.9% of total billed charges",27.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",463.32,78,,370.66,,,0,"percent of total billed charges","78% of total billed charges",27.38,101,,,,,0,"fee schedule","101% of CMS fee schedule ",490.64,82.6,,392.51,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,27.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",490.64,82.6,,392.51,,,0,"percent of total billed charges","82.6% of total billed charges",27.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,594,100,,475.20,,,0,"percent of total billed charges","100% of total billed charges",7,594,
LDH,30183615,CDM,301,RC,83615,CPT,OUTPATIENT,,,111,72.15,,97.68,88,,78.14,,,0,"percent of total billed charges","88% of total billed charges",6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",10.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.93,63,,55.94,,,0,"percent of total billed charges","63% of total billed charges",16.98,15.3,,13.58,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,76.59,69,,,,,0,"fee schedule","69% of total billed charges",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.04,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.85,37.7,,33.48,,,0,"percent of total billed charges","37.7% of total billed charges",41.85,37.7,,33.48,,,0,"percent of total billed charges","37.70% of total billed charges",6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.63,33.9,,30.10,,,0,"percent of total billed charges","33.9% of total billed charges",6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",86.58,78,,69.26,,,0,"percent of total billed charges","78% of total billed charges",6.1,101,,,,,0,"fee schedule","101% of CMS fee schedule ",91.69,82.6,,73.35,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.69,82.6,,73.35,,,0,"percent of total billed charges","82.6% of total billed charges",6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",3.25,111,
"Lactic Acid",30183605,CDM,301,RC,83605,CPT,OUTPATIENT,,,198,128.7,,174.24,88,,139.39,,,0,"percent of total billed charges","88% of total billed charges",11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",20.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.74,63,,99.79,,,0,"percent of total billed charges","63% of total billed charges",30.29,15.3,,24.23,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,136.62,69,,,,,0,"fee schedule","69% of total billed charges",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.25,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.57,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.65,37.7,,59.72,,,0,"percent of total billed charges","37.7% of total billed charges",74.65,37.7,,59.72,,,0,"percent of total billed charges","37.70% of total billed charges",11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.12,33.9,,53.70,,,0,"percent of total billed charges","33.9% of total billed charges",11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",154.44,78,,123.55,,,0,"percent of total billed charges","78% of total billed charges",11.68,101,,,,,0,"fee schedule","101% of CMS fee schedule ",163.55,82.6,,130.84,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.55,82.6,,130.84,,,0,"percent of total billed charges","82.6% of total billed charges",11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,198,
"LDH Body Fluid",30183615,CDM,301,RC,83615,CPT,OUTPATIENT,,,111,72.15,,97.68,88,,78.14,,,0,"percent of total billed charges","88% of total billed charges",6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",10.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.93,63,,55.94,,,0,"percent of total billed charges","63% of total billed charges",16.98,15.3,,13.58,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,76.59,69,,,,,0,"fee schedule","69% of total billed charges",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.04,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.85,37.7,,33.48,,,0,"percent of total billed charges","37.7% of total billed charges",41.85,37.7,,33.48,,,0,"percent of total billed charges","37.70% of total billed charges",6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.63,33.9,,30.10,,,0,"percent of total billed charges","33.9% of total billed charges",6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",86.58,78,,69.26,,,0,"percent of total billed charges","78% of total billed charges",6.1,101,,,,,0,"fee schedule","101% of CMS fee schedule ",91.69,82.6,,73.35,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.69,82.6,,73.35,,,0,"percent of total billed charges","82.6% of total billed charges",6.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",3.25,111,
"Lactic Acid (Venous) - Sepsis",30083605,CDM,301,RC,83605,CPT,OUTPATIENT,,,198,128.7,,174.24,88,,139.39,,,0,"percent of total billed charges","88% of total billed charges",11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",20.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.74,63,,99.79,,,0,"percent of total billed charges","63% of total billed charges",30.29,15.3,,24.23,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,136.62,69,,,,,0,"fee schedule","69% of total billed charges",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.25,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.57,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.65,37.7,,59.72,,,0,"percent of total billed charges","37.7% of total billed charges",74.65,37.7,,59.72,,,0,"percent of total billed charges","37.70% of total billed charges",11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.12,33.9,,53.70,,,0,"percent of total billed charges","33.9% of total billed charges",11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",154.44,78,,123.55,,,0,"percent of total billed charges","78% of total billed charges",11.68,101,,,,,0,"fee schedule","101% of CMS fee schedule ",163.55,82.6,,130.84,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.55,82.6,,130.84,,,0,"percent of total billed charges","82.6% of total billed charges",11.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,198,
"Lactose Tolerance Test LC",30182951,CDM,301,RC,82951,CPT,OUTPATIENT,,,73,47.45,,64.24,88,,51.39,,,0,"percent of total billed charges","88% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",22.52,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.99,63,,36.79,,,0,"percent of total billed charges","63% of total billed charges",11.17,15.3,,8.94,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,50.37,69,,,,,0,"fee schedule","69% of total billed charges",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.22,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.87,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.52,37.7,,22.02,,,0,"percent of total billed charges","37.7% of total billed charges",27.52,37.7,,22.02,,,0,"percent of total billed charges","37.70% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,33.9,,19.80,,,0,"percent of total billed charges","33.9% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.94,78,,45.55,,,0,"percent of total billed charges","78% of total billed charges",12.99,101,,,,,0,"fee schedule","101% of CMS fee schedule ",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",12.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,73,
"Lamotrigine (Lamictal) LC",30180175,CDM,301,RC,80175,CPT,OUTPATIENT,,,207,134.55,,182.16,88,,145.73,,,0,"percent of total billed charges","88% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",23.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",130.41,63,,104.33,,,0,"percent of total billed charges","63% of total billed charges",31.67,15.3,,25.34,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,142.83,69,,,,,0,"fee schedule","69% of total billed charges",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.68,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.25,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.04,37.7,,62.43,,,0,"percent of total billed charges","37.7% of total billed charges",78.04,37.7,,62.43,,,0,"percent of total billed charges","37.70% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.17,33.9,,56.14,,,0,"percent of total billed charges","33.9% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",161.46,78,,129.17,,,0,"percent of total billed charges","78% of total billed charges",13.38,101,,,,,0,"fee schedule","101% of CMS fee schedule ",170.98,82.6,,136.78,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.98,82.6,,136.78,,,0,"percent of total billed charges","82.6% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",7,207,
"Lead, Blood (Adult) LC 007625",30183655,CDM,301,RC,83655,CPT,OUTPATIENT,,,147,95.55,,129.36,88,,103.49,,,0,"percent of total billed charges","88% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",21.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",10.18,100,,,,,0,"fee schedule",EAPG,12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.61,63,,74.09,,,0,"percent of total billed charges","63% of total billed charges",22.49,15.3,,17.99,,,0,"percent of total billed charges","15.3% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,101.43,69,,,,,0,"fee schedule","69% of total billed charges",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.32,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.11,100,,,,,0,"fee schedule","100% of LI fee schedule",7.32,100,,,,,0,"fee schedule",EAPG,12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.08,100,,,,,0,"fee schedule",EAPG,12.85,100,,,,,0,"fee schedule",EAPG,12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.42,37.7,,44.34,,,0,"percent of total billed charges","37.7% of total billed charges",55.42,37.7,,44.34,,,0,"percent of total billed charges","37.70% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.83,33.9,,39.86,,,0,"percent of total billed charges","33.9% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",114.66,78,,91.73,,,0,"percent of total billed charges","78% of total billed charges",12.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",121.42,82.6,,97.14,,,0,"percent of total billed charges","82.6% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",121.42,82.6,,97.14,,,0,"percent of total billed charges","82.6% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",7.32,147,
"zLead Standard Profile, Blood LC 038158",30183655,CDM,301,RC,83655,CPT,OUTPATIENT,,,147,95.55,,129.36,88,,103.49,,,0,"percent of total billed charges","88% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",21.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",10.18,100,,,,,0,"fee schedule",EAPG,12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.61,63,,74.09,,,0,"percent of total billed charges","63% of total billed charges",22.49,15.3,,17.99,,,0,"percent of total billed charges","15.3% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,101.43,69,,,,,0,"fee schedule","69% of total billed charges",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.32,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.11,100,,,,,0,"fee schedule","100% of LI fee schedule",7.32,100,,,,,0,"fee schedule",EAPG,12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.08,100,,,,,0,"fee schedule",EAPG,12.85,100,,,,,0,"fee schedule",EAPG,12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.42,37.7,,44.34,,,0,"percent of total billed charges","37.7% of total billed charges",55.42,37.7,,44.34,,,0,"percent of total billed charges","37.70% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.83,33.9,,39.86,,,0,"percent of total billed charges","33.9% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",114.66,78,,91.73,,,0,"percent of total billed charges","78% of total billed charges",12.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",121.42,82.6,,97.14,,,0,"percent of total billed charges","82.6% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",121.42,82.6,,97.14,,,0,"percent of total billed charges","82.6% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",7.32,147,
"Lead, Blood (Pediatric) LC 717009",30183655,CDM,301,RC,83655,CPT,OUTPATIENT,,,147,95.55,,129.36,88,,103.49,,,0,"percent of total billed charges","88% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",21.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",10.18,100,,,,,0,"fee schedule",EAPG,12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.61,63,,74.09,,,0,"percent of total billed charges","63% of total billed charges",22.49,15.3,,17.99,,,0,"percent of total billed charges","15.3% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,101.43,69,,,,,0,"fee schedule","69% of total billed charges",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.32,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.11,100,,,,,0,"fee schedule","100% of LI fee schedule",7.32,100,,,,,0,"fee schedule",EAPG,12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.08,100,,,,,0,"fee schedule",EAPG,12.85,100,,,,,0,"fee schedule",EAPG,12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.42,37.7,,44.34,,,0,"percent of total billed charges","37.7% of total billed charges",55.42,37.7,,44.34,,,0,"percent of total billed charges","37.70% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.83,33.9,,39.86,,,0,"percent of total billed charges","33.9% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",114.66,78,,91.73,,,0,"percent of total billed charges","78% of total billed charges",12.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",121.42,82.6,,97.14,,,0,"percent of total billed charges","82.6% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",121.42,82.6,,97.14,,,0,"percent of total billed charges","82.6% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",7.32,147,
"Lead Stan Profile LC 038170",30183655,CDM,301,RC,83655,CPT,OUTPATIENT,,,147,95.55,,129.36,88,,103.49,,,0,"percent of total billed charges","88% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",21.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",10.18,100,,,,,0,"fee schedule",EAPG,12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.61,63,,74.09,,,0,"percent of total billed charges","63% of total billed charges",22.49,15.3,,17.99,,,0,"percent of total billed charges","15.3% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,101.43,69,,,,,0,"fee schedule","69% of total billed charges",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.32,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.11,100,,,,,0,"fee schedule","100% of LI fee schedule",7.32,100,,,,,0,"fee schedule",EAPG,12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.08,100,,,,,0,"fee schedule",EAPG,12.85,100,,,,,0,"fee schedule",EAPG,12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.42,37.7,,44.34,,,0,"percent of total billed charges","37.7% of total billed charges",55.42,37.7,,44.34,,,0,"percent of total billed charges","37.70% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.83,33.9,,39.86,,,0,"percent of total billed charges","33.9% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",114.66,78,,91.73,,,0,"percent of total billed charges","78% of total billed charges",12.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",121.42,82.6,,97.14,,,0,"percent of total billed charges","82.6% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",121.42,82.6,,97.14,,,0,"percent of total billed charges","82.6% of total billed charges",12.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",7.32,147,
"CULTURE WOUND AEROBIC",30687070,CDM,306,RC,87070,CPT,OUTPATIENT,,,122,79.3,,107.36,88,,85.89,,,0,"percent of total billed charges","88% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,122,100,,97.60,,,0,"percent of total billed charges","100% of total billed charges",15.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.86,63,,61.49,,,0,"percent of total billed charges","63% of total billed charges",18.67,15.3,,14.94,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,84.18,69,,,,,0,"fee schedule","69% of total billed charges",122,100,,97.60,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",122,100,,97.60,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",122,100,,97.60,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.97,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.61,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.99,37.7,,36.79,,,0,"percent of total billed charges","37.7% of total billed charges",45.99,37.7,,36.79,,,0,"percent of total billed charges","37.70% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.36,33.9,,33.09,,,0,"percent of total billed charges","33.9% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.16,78,,76.13,,,0,"percent of total billed charges","78% of total billed charges",8.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",100.77,82.6,,80.62,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.77,82.6,,80.62,,,0,"percent of total billed charges","82.6% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,122,100,,97.60,,,0,"percent of total billed charges","100% of total billed charges",4.81,122,
"Leptospira IgM LC",30286720,CDM,302,RC,86720,CPT,OUTPATIENT,,,165,107.25,,145.2,88,,116.16,,,0,"percent of total billed charges","88% of total billed charges",16.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",28.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,16.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",103.95,63,,83.16,,,0,"percent of total billed charges","63% of total billed charges",25.25,15.3,,20.20,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,113.85,69,,,,,0,"fee schedule","69% of total billed charges",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",16.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",16.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",16.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.96,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,16.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.2,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,16.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,16.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.21,37.7,,49.77,,,0,"percent of total billed charges","37.7% of total billed charges",62.21,37.7,,49.77,,,0,"percent of total billed charges","37.70% of total billed charges",16.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.94,33.9,,44.75,,,0,"percent of total billed charges","33.9% of total billed charges",16.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",128.7,78,,102.96,,,0,"percent of total billed charges","78% of total billed charges",16.36,101,,,,,0,"fee schedule","101% of CMS fee schedule ",136.29,82.6,,109.03,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,16.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.29,82.6,,109.03,,,0,"percent of total billed charges","82.6% of total billed charges",16.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,165,
"Leukorrhea Panel AVR",30687491,CDM,306,RC,87491,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"Leukorrhea Panel AVR - Extended",30687563,CDM,306,RC,87563,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"Levetiracetam (Keppra), S LC",30180177,CDM,301,RC,80177,CPT,OUTPATIENT,,,222,144.3,,195.36,88,,156.29,,,0,"percent of total billed charges","88% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,222,100,,177.60,,,0,"percent of total billed charges","100% of total billed charges",23.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",139.86,63,,111.89,,,0,"percent of total billed charges","63% of total billed charges",33.97,15.3,,27.18,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,153.18,69,,,,,0,"fee schedule","69% of total billed charges",222,100,,177.60,,,0,"percent of total billed charges","100% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",222,100,,177.60,,,0,"percent of total billed charges","100% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",222,100,,177.60,,,0,"percent of total billed charges","100% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.68,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.25,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",83.69,37.7,,66.95,,,0,"percent of total billed charges","37.7% of total billed charges",83.69,37.7,,66.95,,,0,"percent of total billed charges","37.70% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",75.26,33.9,,60.21,,,0,"percent of total billed charges","33.9% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",173.16,78,,138.53,,,0,"percent of total billed charges","78% of total billed charges",13.38,101,,,,,0,"fee schedule","101% of CMS fee schedule ",183.37,82.6,,146.70,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",183.37,82.6,,146.70,,,0,"percent of total billed charges","82.6% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,222,100,,177.60,,,0,"percent of total billed charges","100% of total billed charges",7,222,
Lipase,30183690,CDM,301,RC,83690,CPT,OUTPATIENT,,,142,92.3,,124.96,88,,99.97,,,0,"percent of total billed charges","88% of total billed charges",6.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",12.05,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,6.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.46,63,,71.57,,,0,"percent of total billed charges","63% of total billed charges",21.73,15.3,,17.38,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,97.98,69,,,,,0,"fee schedule","69% of total billed charges",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",6.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",6.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",6.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.35,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,6.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.89,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,6.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,6.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.53,37.7,,42.82,,,0,"percent of total billed charges","37.7% of total billed charges",53.53,37.7,,42.82,,,0,"percent of total billed charges","37.70% of total billed charges",6.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.14,33.9,,38.51,,,0,"percent of total billed charges","33.9% of total billed charges",6.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",110.76,78,,88.61,,,0,"percent of total billed charges","78% of total billed charges",6.95,101,,,,,0,"fee schedule","101% of CMS fee schedule ",117.29,82.6,,93.83,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,6.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",117.29,82.6,,93.83,,,0,"percent of total billed charges","82.6% of total billed charges",6.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,142,
"Lipid Panel",30180061,CDM,301,RC,80061,CPT,OUTPATIENT,,,307,199.55,,270.16,88,,216.13,,,0,"percent of total billed charges","88% of total billed charges",13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,307,100,,245.60,,,0,"percent of total billed charges","100% of total billed charges",23.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",7.68,100,,,,,0,"fee schedule",EAPG,13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",193.41,63,,154.73,,,0,"percent of total billed charges","63% of total billed charges",46.97,15.3,,37.58,,,0,"percent of total billed charges","15.3% of total billed charges",7.45,100,,,,,0,"fee schedule",EAPG,211.83,69,,,,,0,"fee schedule","69% of total billed charges",307,100,,245.60,,,0,"percent of total billed charges","100% of total billed charges",13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",307,100,,245.60,,,0,"percent of total billed charges","100% of total billed charges",13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",307,100,,245.60,,,0,"percent of total billed charges","100% of total billed charges",13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.39,100,,,,,0,"fee schedule","100% of LI fee schedule",5.52,100,,,,,0,"fee schedule",EAPG,13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.6,100,,,,,0,"fee schedule",EAPG,9.69,100,,,,,0,"fee schedule",EAPG,13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",115.74,37.7,,92.59,,,0,"percent of total billed charges","37.7% of total billed charges",115.74,37.7,,92.59,,,0,"percent of total billed charges","37.70% of total billed charges",13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",104.07,33.9,,83.26,,,0,"percent of total billed charges","33.9% of total billed charges",13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",239.46,78,,191.57,,,0,"percent of total billed charges","78% of total billed charges",13.52,101,,,,,0,"fee schedule","101% of CMS fee schedule ",253.58,82.6,,202.86,,,0,"percent of total billed charges","82.6% of total billed charges",7.45,100,,,,,0,"fee schedule",EAPG,13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",253.58,82.6,,202.86,,,0,"percent of total billed charges","82.6% of total billed charges",13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,307,100,,245.60,,,0,"percent of total billed charges","100% of total billed charges",5.52,307,
"Lipoprotein Phenotyping LC",30180061,CDM,301,RC,80061,CPT,OUTPATIENT,,,343,222.95,,301.84,88,,241.47,,,0,"percent of total billed charges","88% of total billed charges",13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",23.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",7.68,100,,,,,0,"fee schedule",EAPG,13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",216.09,63,,172.87,,,0,"percent of total billed charges","63% of total billed charges",52.48,15.3,,41.98,,,0,"percent of total billed charges","15.3% of total billed charges",7.45,100,,,,,0,"fee schedule",EAPG,236.67,69,,,,,0,"fee schedule","69% of total billed charges",343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.39,100,,,,,0,"fee schedule","100% of LI fee schedule",5.52,100,,,,,0,"fee schedule",EAPG,13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.6,100,,,,,0,"fee schedule",EAPG,9.69,100,,,,,0,"fee schedule",EAPG,13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.31,37.7,,103.45,,,0,"percent of total billed charges","37.7% of total billed charges",129.31,37.7,,103.45,,,0,"percent of total billed charges","37.70% of total billed charges",13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",116.28,33.9,,93.02,,,0,"percent of total billed charges","33.9% of total billed charges",13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",267.54,78,,214.03,,,0,"percent of total billed charges","78% of total billed charges",13.52,101,,,,,0,"fee schedule","101% of CMS fee schedule ",283.32,82.6,,226.66,,,0,"percent of total billed charges","82.6% of total billed charges",7.45,100,,,,,0,"fee schedule",EAPG,13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",283.32,82.6,,226.66,,,0,"percent of total billed charges","82.6% of total billed charges",13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",5.52,343,
"Lipoprotein (a) LC",30183695,CDM,301,RC,83695,CPT,OUTPATIENT,,,308,200.2,,271.04,88,,216.83,,,0,"percent of total billed charges","88% of total billed charges",14.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,308,100,,246.40,,,0,"percent of total billed charges","100% of total billed charges",25.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,14.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",194.04,63,,155.23,,,0,"percent of total billed charges","63% of total billed charges",47.12,15.3,,37.70,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,212.52,69,,,,,0,"fee schedule","69% of total billed charges",308,100,,246.40,,,0,"percent of total billed charges","100% of total billed charges",14.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",308,100,,246.40,,,0,"percent of total billed charges","100% of total billed charges",14.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",308,100,,246.40,,,0,"percent of total billed charges","100% of total billed charges",14.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.77,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,14.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.32,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,14.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,14.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",116.12,37.7,,92.90,,,0,"percent of total billed charges","37.7% of total billed charges",116.12,37.7,,92.90,,,0,"percent of total billed charges","37.70% of total billed charges",14.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",104.41,33.9,,83.53,,,0,"percent of total billed charges","33.9% of total billed charges",14.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",240.24,78,,192.19,,,0,"percent of total billed charges","78% of total billed charges",14.46,101,,,,,0,"fee schedule","101% of CMS fee schedule ",254.41,82.6,,203.53,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,14.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",254.41,82.6,,203.53,,,0,"percent of total billed charges","82.6% of total billed charges",14.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,308,100,,246.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,308,
"Lithium Level",30080178,CDM,300,RC,80178,CPT,OUTPATIENT,,,153,99.45,,134.64,88,,107.71,,,0,"percent of total billed charges","88% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",11.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",96.39,63,,77.11,,,0,"percent of total billed charges","63% of total billed charges",23.41,15.3,,18.73,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,105.57,69,,,,,0,"fee schedule","69% of total billed charges",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.28,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.61,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.68,37.7,,46.14,,,0,"percent of total billed charges","37.7% of total billed charges",57.68,37.7,,46.14,,,0,"percent of total billed charges","37.70% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.87,33.9,,41.50,,,0,"percent of total billed charges","33.9% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",119.34,78,,95.47,,,0,"percent of total billed charges","78% of total billed charges",6.67,101,,,,,0,"fee schedule","101% of CMS fee schedule ",126.38,82.6,,101.10,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",126.38,82.6,,101.10,,,0,"percent of total billed charges","82.6% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",6.61,153,
"Lithium Lvl",30080178,CDM,300,RC,80178,CPT,OUTPATIENT,,,153,99.45,,134.64,88,,107.71,,,0,"percent of total billed charges","88% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",11.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",96.39,63,,77.11,,,0,"percent of total billed charges","63% of total billed charges",23.41,15.3,,18.73,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,105.57,69,,,,,0,"fee schedule","69% of total billed charges",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.28,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.61,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.68,37.7,,46.14,,,0,"percent of total billed charges","37.7% of total billed charges",57.68,37.7,,46.14,,,0,"percent of total billed charges","37.70% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.87,33.9,,41.50,,,0,"percent of total billed charges","33.9% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",119.34,78,,95.47,,,0,"percent of total billed charges","78% of total billed charges",6.67,101,,,,,0,"fee schedule","101% of CMS fee schedule ",126.38,82.6,,101.10,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",126.38,82.6,,101.10,,,0,"percent of total billed charges","82.6% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",6.61,153,
"Liver Kidney Microsomal Ab LC",30286376,CDM,302,RC,86376,CPT,OUTPATIENT,,,254,165.1,,223.52,88,,178.82,,,0,"percent of total billed charges","88% of total billed charges",14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",25.46,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.02,63,,128.02,,,0,"percent of total billed charges","63% of total billed charges",38.86,15.3,,31.09,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,175.26,69,,,,,0,"fee schedule","69% of total billed charges",254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.65,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.55,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.76,37.7,,76.61,,,0,"percent of total billed charges","37.7% of total billed charges",95.76,37.7,,76.61,,,0,"percent of total billed charges","37.70% of total billed charges",14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",86.11,33.9,,68.89,,,0,"percent of total billed charges","33.9% of total billed charges",14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",198.12,78,,158.50,,,0,"percent of total billed charges","78% of total billed charges",14.69,101,,,,,0,"fee schedule","101% of CMS fee schedule ",209.8,82.6,,167.84,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",209.8,82.6,,167.84,,,0,"percent of total billed charges","82.6% of total billed charges",14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,254,
"Lupus Anticoagulant Panel LC",30585705,CDM,305,RC,85705,CPT,OUTPATIENT,,,681,442.65,,599.28,88,,479.42,,,0,"percent of total billed charges","88% of total billed charges",9.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,681,100,,544.80,,,0,"percent of total billed charges","100% of total billed charges",16.85,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,9.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",429.03,63,,343.22,,,0,"percent of total billed charges","63% of total billed charges",104.19,15.3,,83.35,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,469.89,69,,,,,0,"fee schedule","69% of total billed charges",681,100,,544.80,,,0,"percent of total billed charges","100% of total billed charges",9.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",681,100,,544.80,,,0,"percent of total billed charges","100% of total billed charges",9.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",681,100,,544.80,,,0,"percent of total billed charges","100% of total billed charges",9.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.83,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,9.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.63,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,9.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,9.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",256.74,37.7,,205.39,,,0,"percent of total billed charges","37.7% of total billed charges",256.74,37.7,,205.39,,,0,"percent of total billed charges","37.70% of total billed charges",9.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",230.86,33.9,,184.69,,,0,"percent of total billed charges","33.9% of total billed charges",9.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",531.18,78,,424.94,,,0,"percent of total billed charges","78% of total billed charges",9.72,101,,,,,0,"fee schedule","101% of CMS fee schedule ",562.51,82.6,,450.01,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,9.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",562.51,82.6,,450.01,,,0,"percent of total billed charges","82.6% of total billed charges",9.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,681,100,,544.80,,,0,"percent of total billed charges","100% of total billed charges",2.48,681,
"Luteinizing Hormone (LH)",30183002,CDM,301,RC,83002,CPT,OUTPATIENT,,,339,220.35,,298.32,88,,238.66,,,0,"percent of total billed charges","88% of total billed charges",18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",32.41,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",213.57,63,,170.86,,,0,"percent of total billed charges","63% of total billed charges",51.87,15.3,,41.50,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,233.91,69,,,,,0,"fee schedule","69% of total billed charges",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.83,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.52,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",127.8,37.7,,102.24,,,0,"percent of total billed charges","37.7% of total billed charges",127.8,37.7,,102.24,,,0,"percent of total billed charges","37.70% of total billed charges",18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",114.92,33.9,,91.94,,,0,"percent of total billed charges","33.9% of total billed charges",18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",264.42,78,,211.54,,,0,"percent of total billed charges","78% of total billed charges",18.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",280.01,82.6,,224.01,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",280.01,82.6,,224.01,,,0,"percent of total billed charges","82.6% of total billed charges",18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",8.39,339,
"Luteinizing Hormone(LH) LC",30183002,CDM,301,RC,83002,CPT,OUTPATIENT,,,380,247,,334.4,88,,267.52,,,0,"percent of total billed charges","88% of total billed charges",18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,380,100,,304.00,,,0,"percent of total billed charges","100% of total billed charges",32.41,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",239.4,63,,191.52,,,0,"percent of total billed charges","63% of total billed charges",58.14,15.3,,46.51,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,262.2,69,,,,,0,"fee schedule","69% of total billed charges",380,100,,304.00,,,0,"percent of total billed charges","100% of total billed charges",18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",380,100,,304.00,,,0,"percent of total billed charges","100% of total billed charges",18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",380,100,,304.00,,,0,"percent of total billed charges","100% of total billed charges",18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.83,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.52,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",143.26,37.7,,114.61,,,0,"percent of total billed charges","37.7% of total billed charges",143.26,37.7,,114.61,,,0,"percent of total billed charges","37.70% of total billed charges",18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",128.82,33.9,,103.06,,,0,"percent of total billed charges","33.9% of total billed charges",18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",296.4,78,,237.12,,,0,"percent of total billed charges","78% of total billed charges",18.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",313.88,82.6,,251.10,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",313.88,82.6,,251.10,,,0,"percent of total billed charges","82.6% of total billed charges",18.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,380,100,,304.00,,,0,"percent of total billed charges","100% of total billed charges",8.39,380,
"Lyme, Total Ab Test/Reflex LC",30286618,CDM,302,RC,86618,CPT,OUTPATIENT,,,388,252.2,,341.44,88,,273.15,,,0,"percent of total billed charges","88% of total billed charges",17.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",29.8,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,17.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",244.44,63,,195.55,,,0,"percent of total billed charges","63% of total billed charges",59.36,15.3,,47.49,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,267.72,69,,,,,0,"fee schedule","69% of total billed charges",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",17.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",17.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",17.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.13,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,17.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.03,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,17.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,17.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",146.28,37.7,,117.02,,,0,"percent of total billed charges","37.7% of total billed charges",146.28,37.7,,117.02,,,0,"percent of total billed charges","37.70% of total billed charges",17.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",131.53,33.9,,105.22,,,0,"percent of total billed charges","33.9% of total billed charges",17.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",302.64,78,,242.11,,,0,"percent of total billed charges","78% of total billed charges",17.2,101,,,,,0,"fee schedule","101% of CMS fee schedule ",320.49,82.6,,256.39,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,17.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",320.49,82.6,,256.39,,,0,"percent of total billed charges","82.6% of total billed charges",17.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",6.96,388,
"Lyme (B. burgdorferi) PCR LC",30687476,CDM,306,RC,87476,CPT,OUTPATIENT,,,626,406.9,,550.88,88,,440.70,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,626,100,,500.80,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",394.38,63,,315.50,,,0,"percent of total billed charges","63% of total billed charges",95.78,15.3,,76.62,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,431.94,69,,,,,0,"fee schedule","69% of total billed charges",626,100,,500.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",626,100,,500.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",626,100,,500.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",236,37.7,,188.80,,,0,"percent of total billed charges","37.7% of total billed charges",236,37.7,,188.80,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",212.21,33.9,,169.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",488.28,78,,390.62,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",517.08,82.6,,413.66,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",517.08,82.6,,413.66,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,626,100,,500.80,,,0,"percent of total billed charges","100% of total billed charges",18.33,626,
"Lyme Disease Total Antibody w/Reflex to Immunoassay LC",30286618,CDM,302,RC,86618,CPT,OUTPATIENT,,,388,252.2,,341.44,88,,273.15,,,0,"percent of total billed charges","88% of total billed charges",17.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",29.8,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,17.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",244.44,63,,195.55,,,0,"percent of total billed charges","63% of total billed charges",59.36,15.3,,47.49,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,267.72,69,,,,,0,"fee schedule","69% of total billed charges",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",17.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",17.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",17.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.13,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,17.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.03,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,17.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,17.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",146.28,37.7,,117.02,,,0,"percent of total billed charges","37.7% of total billed charges",146.28,37.7,,117.02,,,0,"percent of total billed charges","37.70% of total billed charges",17.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",131.53,33.9,,105.22,,,0,"percent of total billed charges","33.9% of total billed charges",17.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",302.64,78,,242.11,,,0,"percent of total billed charges","78% of total billed charges",17.2,101,,,,,0,"fee schedule","101% of CMS fee schedule ",320.49,82.6,,256.39,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,17.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",320.49,82.6,,256.39,,,0,"percent of total billed charges","82.6% of total billed charges",17.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",6.96,388,
"MRSA Screen PCR (GeneXpert)",30687641,CDM,306,RC,87641,CPT,OUTPATIENT,,,96,62.4,,84.48,88,,67.58,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.48,63,,48.38,,,0,"percent of total billed charges","63% of total billed charges",14.69,15.3,,11.75,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,66.24,69,,,,,0,"fee schedule","69% of total billed charges",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.19,37.7,,28.95,,,0,"percent of total billed charges","37.7% of total billed charges",36.19,37.7,,28.95,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.54,33.9,,26.03,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.88,78,,59.90,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",14.69,134.21,
Magnesium,30183735,CDM,301,RC,83735,CPT,OUTPATIENT,,,150,97.5,,132,88,,105.60,,,0,"percent of total billed charges","88% of total billed charges",6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",11.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",94.5,63,,75.60,,,0,"percent of total billed charges","63% of total billed charges",22.95,15.3,,18.36,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,103.5,69,,,,,0,"fee schedule","69% of total billed charges",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.62,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.7,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.7% of total billed charges",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.70% of total billed charges",6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.85,33.9,,40.68,,,0,"percent of total billed charges","33.9% of total billed charges",6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",117,78,,93.60,,,0,"percent of total billed charges","78% of total billed charges",6.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",3.25,150,
"Magnesium Urine",30083735,CDM,300,RC,83735,CPT,OUTPATIENT,,,50,32.5,,44,88,,35.20,,,0,"percent of total billed charges","88% of total billed charges",6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",11.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.5,63,,25.20,,,0,"percent of total billed charges","63% of total billed charges",7.65,15.3,,6.12,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,34.5,69,,,,,0,"fee schedule","69% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.62,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.7,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.7% of total billed charges",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.70% of total billed charges",6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.95,33.9,,13.56,,,0,"percent of total billed charges","33.9% of total billed charges",6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",39,78,,31.20,,,0,"percent of total billed charges","78% of total billed charges",6.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",3.25,50,
"Magnesium 24 Hour Urine",30183735,CDM,301,RC,83735,CPT,OUTPATIENT,,,50,32.5,,44,88,,35.20,,,0,"percent of total billed charges","88% of total billed charges",6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",11.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.5,63,,25.20,,,0,"percent of total billed charges","63% of total billed charges",7.65,15.3,,6.12,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,34.5,69,,,,,0,"fee schedule","69% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.62,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.7,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.7% of total billed charges",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.70% of total billed charges",6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.95,33.9,,13.56,,,0,"percent of total billed charges","33.9% of total billed charges",6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",39,78,,31.20,,,0,"percent of total billed charges","78% of total billed charges",6.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",6.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",3.25,50,
"Manganese, P LC",30183785,CDM,301,RC,83785,CPT,OUTPATIENT,,,218,141.7,,191.84,88,,153.47,,,0,"percent of total billed charges","88% of total billed charges",26.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",46.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",10.18,100,,,,,0,"fee schedule",EAPG,26.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.34,63,,109.87,,,0,"percent of total billed charges","63% of total billed charges",33.35,15.3,,26.68,,,0,"percent of total billed charges","15.3% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,150.42,69,,,,,0,"fee schedule","69% of total billed charges",218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",26.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",26.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",26.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.93,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,26.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.65,100,,,,,0,"fee schedule","100% of LI fee schedule",7.32,100,,,,,0,"fee schedule",EAPG,26.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.08,100,,,,,0,"fee schedule",EAPG,12.85,100,,,,,0,"fee schedule",EAPG,26.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.19,37.7,,65.75,,,0,"percent of total billed charges","37.7% of total billed charges",82.19,37.7,,65.75,,,0,"percent of total billed charges","37.70% of total billed charges",26.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.9,33.9,,59.12,,,0,"percent of total billed charges","33.9% of total billed charges",26.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.04,78,,136.03,,,0,"percent of total billed charges","78% of total billed charges",26.91,101,,,,,0,"fee schedule","101% of CMS fee schedule ",180.07,82.6,,144.06,,,0,"percent of total billed charges","82.6% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,26.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",180.07,82.6,,144.06,,,0,"percent of total billed charges","82.6% of total billed charges",26.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",7.32,218,
"CULTURE VIRUS",30687252,CDM,306,RC,87252,CPT,OUTPATIENT,,,123,79.95,,108.24,88,,86.59,,,0,"percent of total billed charges","88% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",45.62,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.49,63,,61.99,,,0,"percent of total billed charges","63% of total billed charges",18.82,15.3,,15.06,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,84.87,69,,,,,0,"fee schedule","69% of total billed charges",123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.71,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.07,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.37,37.7,,37.10,,,0,"percent of total billed charges","37.7% of total billed charges",46.37,37.7,,37.10,,,0,"percent of total billed charges","37.70% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.7,33.9,,33.36,,,0,"percent of total billed charges","33.9% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.94,78,,76.75,,,0,"percent of total billed charges","78% of total billed charges",26.33,101,,,,,0,"fee schedule","101% of CMS fee schedule ",101.6,82.6,,81.28,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.6,82.6,,81.28,,,0,"percent of total billed charges","82.6% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",4.81,123,
RUBEOLA,30286765,CDM,302,RC,86765,CPT,OUTPATIENT,,,64,41.6,,56.32,88,,45.06,,,0,"percent of total billed charges","88% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",22.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.32,63,,32.26,,,0,"percent of total billed charges","63% of total billed charges",9.79,15.3,,7.83,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,44.16,69,,,,,0,"fee schedule","69% of total billed charges",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.26,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.88,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.13,37.7,,19.30,,,0,"percent of total billed charges","37.7% of total billed charges",24.13,37.7,,19.30,,,0,"percent of total billed charges","37.70% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.7,33.9,,17.36,,,0,"percent of total billed charges","33.9% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.92,78,,39.94,,,0,"percent of total billed charges","78% of total billed charges",13,101,,,,,0,"fee schedule","101% of CMS fee schedule ",52.86,82.6,,42.29,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.86,82.6,,42.29,,,0,"percent of total billed charges","82.6% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,64,
"Meconium 5 Panel LC",30080307,CDM,300,RC,80307,CPT,OUTPATIENT,,,330,214.5,,290.4,88,,232.32,,,0,"percent of total billed charges","88% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.44,16.8,,44.35,,,0,"percent of total billed charges","16.8% of total billed charges",330,100,,264.00,,,0,"percent of total billed charges","100% of total billed charges",108.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",57.1,17.304,,45.68,,,0,"percent of total billed charges","17.304% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",207.9,63,,166.32,,,0,"percent of total billed charges","63% of total billed charges",50.49,15.3,,40.39,,,0,"percent of total billed charges","15.3% of total billed charges",55.44,16.8,,44.35,,,0,"percent of total billed charges","16.8% of total billed charges",227.7,69,,,,,0,"fee schedule","69% of total billed charges",330,100,,264.00,,,0,"percent of total billed charges","100% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",330,100,,264.00,,,0,"percent of total billed charges","100% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",330,100,,264.00,,,0,"percent of total billed charges","100% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",237.68,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",55.44,16.8,,44.35,,,0,"percent of total billed charges","16.8% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.14,100,,,,,0,"fee schedule","100% of LI fee schedule",55.44,16.8,,44.35,,,0,"percent of total billed charges","16.8% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.55,17.136,,45.24,,,0,"percent of total billed charges","17.136% of total billed charges",72.07,21.84,,57.66,,,0,"percent of total billed charges","21.84% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.41,37.7,,99.53,,,0,"percent of total billed charges","37.7% of total billed charges",124.41,37.7,,99.53,,,0,"percent of total billed charges","37.70% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",111.87,33.9,,89.50,,,0,"percent of total billed charges","33.9% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",257.4,78,,205.92,,,0,"percent of total billed charges","78% of total billed charges",62.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",272.58,82.6,,218.06,,,0,"percent of total billed charges","82.6% of total billed charges",55.44,16.8,,44.35,,,0,"percent of total billed charges","16.8% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",272.58,82.6,,218.06,,,0,"percent of total billed charges","82.6% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.44,16.8,,44.35,,,0,"percent of total billed charges","16.8% of total billed charges",330,100,,264.00,,,0,"percent of total billed charges","100% of total billed charges",50.49,330,
"Mercury, Blood LC",30183825,CDM,301,RC,83825,CPT,OUTPATIENT,,,353,229.45,,310.64,88,,248.51,,,0,"percent of total billed charges","88% of total billed charges",16.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,353,100,,282.40,,,0,"percent of total billed charges","100% of total billed charges",28.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",10.18,100,,,,,0,"fee schedule",EAPG,16.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",222.39,63,,177.91,,,0,"percent of total billed charges","63% of total billed charges",54.01,15.3,,43.21,,,0,"percent of total billed charges","15.3% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,243.57,69,,,,,0,"fee schedule","69% of total billed charges",353,100,,282.40,,,0,"percent of total billed charges","100% of total billed charges",16.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",353,100,,282.40,,,0,"percent of total billed charges","100% of total billed charges",16.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",353,100,,282.40,,,0,"percent of total billed charges","100% of total billed charges",16.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.19,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,16.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.26,100,,,,,0,"fee schedule","100% of LI fee schedule",7.32,100,,,,,0,"fee schedule",EAPG,16.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.08,100,,,,,0,"fee schedule",EAPG,12.85,100,,,,,0,"fee schedule",EAPG,16.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",133.08,37.7,,106.46,,,0,"percent of total billed charges","37.7% of total billed charges",133.08,37.7,,106.46,,,0,"percent of total billed charges","37.70% of total billed charges",16.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",119.67,33.9,,95.74,,,0,"percent of total billed charges","33.9% of total billed charges",16.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",275.34,78,,220.27,,,0,"percent of total billed charges","78% of total billed charges",16.42,101,,,,,0,"fee schedule","101% of CMS fee schedule ",291.58,82.6,,233.26,,,0,"percent of total billed charges","82.6% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,16.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",291.58,82.6,,233.26,,,0,"percent of total billed charges","82.6% of total billed charges",16.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,353,100,,282.40,,,0,"percent of total billed charges","100% of total billed charges",7.32,353,
"Metanephrines, Frac, Qn, U24 LC",30183835,CDM,301,RC,83835,CPT,OUTPATIENT,,,140,91,,123.2,88,,98.56,,,0,"percent of total billed charges","88% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",29.64,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.2,63,,70.56,,,0,"percent of total billed charges","63% of total billed charges",21.42,15.3,,17.14,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,96.6,69,,,,,0,"fee schedule","69% of total billed charges",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.79,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.94,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.78,37.7,,42.22,,,0,"percent of total billed charges","37.7% of total billed charges",52.78,37.7,,42.22,,,0,"percent of total billed charges","37.70% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.46,33.9,,37.97,,,0,"percent of total billed charges","33.9% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.2,78,,87.36,,,0,"percent of total billed charges","78% of total billed charges",17.1,101,,,,,0,"fee schedule","101% of CMS fee schedule ",115.64,82.6,,92.51,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",115.64,82.6,,92.51,,,0,"percent of total billed charges","82.6% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",8.39,140,
"Metanephrines, Pheochromocyt LC",30183835,CDM,301,RC,83835,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",29.64,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.79,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.94,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",17.1,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",8.39,95,
"Metanephrines, Frac., Pl. Free LC",30183835,CDM,301,RC,83835,CPT,OUTPATIENT,,,431,280.15,,379.28,88,,303.42,,,0,"percent of total billed charges","88% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,431,100,,344.80,,,0,"percent of total billed charges","100% of total billed charges",29.64,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",271.53,63,,217.22,,,0,"percent of total billed charges","63% of total billed charges",65.94,15.3,,52.75,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,297.39,69,,,,,0,"fee schedule","69% of total billed charges",431,100,,344.80,,,0,"percent of total billed charges","100% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",431,100,,344.80,,,0,"percent of total billed charges","100% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",431,100,,344.80,,,0,"percent of total billed charges","100% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.79,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.94,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.49,37.7,,129.99,,,0,"percent of total billed charges","37.7% of total billed charges",162.49,37.7,,129.99,,,0,"percent of total billed charges","37.70% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",146.11,33.9,,116.89,,,0,"percent of total billed charges","33.9% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",336.18,78,,268.94,,,0,"percent of total billed charges","78% of total billed charges",17.1,101,,,,,0,"fee schedule","101% of CMS fee schedule ",356.01,82.6,,284.81,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",356.01,82.6,,284.81,,,0,"percent of total billed charges","82.6% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,431,100,,344.80,,,0,"percent of total billed charges","100% of total billed charges",8.39,431,
"Methemoglobin Quantitative",30083050,CDM,300,RC,83050,CPT,OUTPATIENT,,,141,91.65,,124.08,88,,99.26,,,0,"percent of total billed charges","88% of total billed charges",8.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,141,100,,112.80,,,0,"percent of total billed charges","100% of total billed charges",14.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,8.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.83,63,,71.06,,,0,"percent of total billed charges","63% of total billed charges",21.57,15.3,,17.26,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,97.29,69,,,,,0,"fee schedule","69% of total billed charges",141,100,,112.80,,,0,"percent of total billed charges","100% of total billed charges",8.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",141,100,,112.80,,,0,"percent of total billed charges","100% of total billed charges",8.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",141,100,,112.80,,,0,"percent of total billed charges","100% of total billed charges",8.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.36,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,8.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.19,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,8.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,8.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.16,37.7,,42.53,,,0,"percent of total billed charges","37.7% of total billed charges",53.16,37.7,,42.53,,,0,"percent of total billed charges","37.70% of total billed charges",8.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.8,33.9,,38.24,,,0,"percent of total billed charges","33.9% of total billed charges",8.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.98,78,,87.98,,,0,"percent of total billed charges","78% of total billed charges",8.28,101,,,,,0,"fee schedule","101% of CMS fee schedule ",116.47,82.6,,93.18,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,8.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",116.47,82.6,,93.18,,,0,"percent of total billed charges","82.6% of total billed charges",8.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,141,100,,112.80,,,0,"percent of total billed charges","100% of total billed charges",3.25,141,
"Methylmalonic Acid LC",30183921,CDM,301,RC,83921,CPT,OUTPATIENT,,,366,237.9,,322.08,88,,257.66,,,0,"percent of total billed charges","88% of total billed charges",21.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,366,100,,292.80,,,0,"percent of total billed charges","100% of total billed charges",37.11,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,21.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",230.58,63,,184.46,,,0,"percent of total billed charges","63% of total billed charges",56,15.3,,44.80,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,252.54,69,,,,,0,"fee schedule","69% of total billed charges",366,100,,292.80,,,0,"percent of total billed charges","100% of total billed charges",21.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",366,100,,292.80,,,0,"percent of total billed charges","100% of total billed charges",21.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",366,100,,292.80,,,0,"percent of total billed charges","100% of total billed charges",21.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.12,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,21.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.21,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,21.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,21.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.98,37.7,,110.38,,,0,"percent of total billed charges","37.7% of total billed charges",137.98,37.7,,110.38,,,0,"percent of total billed charges","37.70% of total billed charges",21.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.07,33.9,,99.26,,,0,"percent of total billed charges","33.9% of total billed charges",21.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",285.48,78,,228.38,,,0,"percent of total billed charges","78% of total billed charges",21.42,101,,,,,0,"fee schedule","101% of CMS fee schedule ",302.32,82.6,,241.86,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,21.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",302.32,82.6,,241.86,,,0,"percent of total billed charges","82.6% of total billed charges",21.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,366,100,,292.80,,,0,"percent of total billed charges","100% of total billed charges",8.11,366,
"Microalbumin 24hr Urine",30182043,CDM,301,RC,82043,CPT,OUTPATIENT,,,39,25.35,,34.32,88,,27.46,,,0,"percent of total billed charges","88% of total billed charges",5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",10.11,175,,,,,0,"fee schedule","175% of CMS fee schedule",2.55,100,,,,,0,"fee schedule",EAPG,5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.57,63,,19.66,,,0,"percent of total billed charges","63% of total billed charges",5.97,15.3,,4.78,,,0,"percent of total billed charges","15.3% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,26.91,69,,,,,0,"fee schedule","69% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.78,100,,,,,0,"fee schedule","100% of LI fee schedule",1.83,100,,,,,0,"fee schedule",EAPG,5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.52,100,,,,,0,"fee schedule",EAPG,3.22,100,,,,,0,"fee schedule",EAPG,5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.7% of total billed charges",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.70% of total billed charges",5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.22,33.9,,10.58,,,0,"percent of total billed charges","33.9% of total billed charges",5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.42,78,,24.34,,,0,"percent of total billed charges","78% of total billed charges",5.83,101,,,,,0,"fee schedule","101% of CMS fee schedule ",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",1.83,39,
"Microalbumin/Creatinine Ratio Urine",30182043,CDM,301,RC,82043,CPT,OUTPATIENT,,,110,71.5,,96.8,88,,77.44,,,0,"percent of total billed charges","88% of total billed charges",5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",10.11,175,,,,,0,"fee schedule","175% of CMS fee schedule",2.55,100,,,,,0,"fee schedule",EAPG,5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.3,63,,55.44,,,0,"percent of total billed charges","63% of total billed charges",16.83,15.3,,13.46,,,0,"percent of total billed charges","15.3% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,75.9,69,,,,,0,"fee schedule","69% of total billed charges",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.78,100,,,,,0,"fee schedule","100% of LI fee schedule",1.83,100,,,,,0,"fee schedule",EAPG,5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.52,100,,,,,0,"fee schedule",EAPG,3.22,100,,,,,0,"fee schedule",EAPG,5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.47,37.7,,33.18,,,0,"percent of total billed charges","37.7% of total billed charges",41.47,37.7,,33.18,,,0,"percent of total billed charges","37.70% of total billed charges",5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.29,33.9,,29.83,,,0,"percent of total billed charges","33.9% of total billed charges",5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.8,78,,68.64,,,0,"percent of total billed charges","78% of total billed charges",5.83,101,,,,,0,"fee schedule","101% of CMS fee schedule ",90.86,82.6,,72.69,,,0,"percent of total billed charges","82.6% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.86,82.6,,72.69,,,0,"percent of total billed charges","82.6% of total billed charges",5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",1.83,110,
N/A,31188161,CDM,311,RC,88161,CPT,OUTPATIENT,,,307,199.55,,270.16,88,,216.13,,,0,"percent of total billed charges","88% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,307,100,,245.60,,,0,"percent of total billed charges","100% of total billed charges",53.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",26.78,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",193.41,63,,154.73,,,0,"percent of total billed charges","63% of total billed charges",46.97,15.3,,37.58,,,0,"percent of total billed charges","15.3% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,211.83,69,,,,,0,"fee schedule","69% of total billed charges",307,100,,245.60,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307,100,,245.60,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307,100,,245.60,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.22,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.26,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.52,100,,,,,0,"fee schedule",EAPG,33.8,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.74,37.7,,92.59,,,0,"percent of total billed charges","37.7% of total billed charges",115.74,37.7,,92.59,,,0,"percent of total billed charges","37.70% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",104.07,33.9,,83.26,,,0,"percent of total billed charges","33.9% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",239.46,78,,191.57,,,0,"percent of total billed charges","78% of total billed charges",30.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",253.58,82.6,,202.86,,,0,"percent of total billed charges","82.6% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",253.58,82.6,,202.86,,,0,"percent of total billed charges","82.6% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,307,100,,245.60,,,0,"percent of total billed charges","100% of total billed charges",19.26,307,
"Pathology Billing Cytopathology NG Thin Prep, with interpretation, except cervical or vaginal",31188112,CDM,311,RC,88112,CPT,OUTPATIENT,,,359,233.35,,315.92,88,,252.74,,,0,"percent of total billed charges","88% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,359,100,,287.20,,,0,"percent of total billed charges","100% of total billed charges",96.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",26.78,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",226.17,63,,180.94,,,0,"percent of total billed charges","63% of total billed charges",54.93,15.3,,43.94,,,0,"percent of total billed charges","15.3% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,247.71,69,,,,,0,"fee schedule","69% of total billed charges",359,100,,287.20,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",359,100,,287.20,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",359,100,,287.20,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.15,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.26,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.52,100,,,,,0,"fee schedule",EAPG,33.8,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",135.34,37.7,,108.27,,,0,"percent of total billed charges","37.7% of total billed charges",135.34,37.7,,108.27,,,0,"percent of total billed charges","37.70% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",121.7,33.9,,97.36,,,0,"percent of total billed charges","33.9% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.02,78,,224.02,,,0,"percent of total billed charges","78% of total billed charges",55.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.53,82.6,,237.22,,,0,"percent of total billed charges","82.6% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.53,82.6,,237.22,,,0,"percent of total billed charges","82.6% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,359,100,,287.20,,,0,"percent of total billed charges","100% of total billed charges",19.26,359,
"C albicans + C glabrata, NAA LC",30186381,CDM,302,RC,86381,CPT,OUTPATIENT,,,104,67.6,,91.52,88,,73.22,,,0,"percent of total billed charges","88% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",44.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.52,63,,52.42,,,0,"percent of total billed charges","63% of total billed charges",15.91,15.3,,12.73,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,71.76,69,,,,,0,"fee schedule","69% of total billed charges",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",9.39,100,,,,,0,"fee schedule",EAPG,25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.45,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.21,37.7,,31.37,,,0,"percent of total billed charges","37.7% of total billed charges",39.21,37.7,,31.37,,,0,"percent of total billed charges","37.70% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.26,33.9,,28.21,,,0,"percent of total billed charges","33.9% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.12,78,,64.90,,,0,"percent of total billed charges","78% of total billed charges",25.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",85.9,82.6,,68.72,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.9,82.6,,68.72,,,0,"percent of total billed charges","82.6% of total billed charges",25.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,104,
"Mononucleosis Screen",30086308,CDM,300,RC,86308,CPT,OUTPATIENT,,,96,62.4,,84.48,88,,67.58,,,0,"percent of total billed charges","88% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",9.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.48,63,,48.38,,,0,"percent of total billed charges","63% of total billed charges",14.69,15.3,,11.75,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,66.24,69,,,,,0,"fee schedule","69% of total billed charges",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.81,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.19,37.7,,28.95,,,0,"percent of total billed charges","37.7% of total billed charges",36.19,37.7,,28.95,,,0,"percent of total billed charges","37.70% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.54,33.9,,26.03,,,0,"percent of total billed charges","33.9% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.88,78,,59.90,,,0,"percent of total billed charges","78% of total billed charges",5.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",5.18,96,
"MUMPS ABS, IGG",30286735,CDM,302,RC,86735,CPT,OUTPATIENT,,,227,147.55,,199.76,88,,159.81,,,0,"percent of total billed charges","88% of total billed charges",13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",22.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",143.01,63,,114.41,,,0,"percent of total billed charges","63% of total billed charges",34.73,15.3,,27.78,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,156.63,69,,,,,0,"fee schedule","69% of total billed charges",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.91,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.05,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.58,37.7,,68.46,,,0,"percent of total billed charges","37.7% of total billed charges",85.58,37.7,,68.46,,,0,"percent of total billed charges","37.70% of total billed charges",13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.95,33.9,,61.56,,,0,"percent of total billed charges","33.9% of total billed charges",13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",177.06,78,,141.65,,,0,"percent of total billed charges","78% of total billed charges",13.18,101,,,,,0,"fee schedule","101% of CMS fee schedule ",187.5,82.6,,150.00,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",187.5,82.6,,150.00,,,0,"percent of total billed charges","82.6% of total billed charges",13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",6.96,227,
"MUMPS IGG",30286735,CDM,302,RC,86735,CPT,OUTPATIENT,,,80,52,,70.4,88,,56.32,,,0,"percent of total billed charges","88% of total billed charges",13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",22.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.4,63,,40.32,,,0,"percent of total billed charges","63% of total billed charges",12.24,15.3,,9.79,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,55.2,69,,,,,0,"fee schedule","69% of total billed charges",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.91,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.05,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.16,37.7,,24.13,,,0,"percent of total billed charges","37.7% of total billed charges",30.16,37.7,,24.13,,,0,"percent of total billed charges","37.70% of total billed charges",13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.12,33.9,,21.70,,,0,"percent of total billed charges","33.9% of total billed charges",13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.4,78,,49.92,,,0,"percent of total billed charges","78% of total billed charges",13.18,101,,,,,0,"fee schedule","101% of CMS fee schedule ",66.08,82.6,,52.86,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.08,82.6,,52.86,,,0,"percent of total billed charges","82.6% of total billed charges",13.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,80,
"VIRAL CULTURE SHELL",30687254,CDM,306,RC,87254,CPT,OUTPATIENT,,,94,61.1,,82.72,88,,66.18,,,0,"percent of total billed charges","88% of total billed charges",19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",34.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,63,,47.38,,,0,"percent of total billed charges","63% of total billed charges",14.38,15.3,,11.50,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,64.86,69,,,,,0,"fee schedule","69% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.81,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.55,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.44,37.7,,28.35,,,0,"percent of total billed charges","37.7% of total billed charges",35.44,37.7,,28.35,,,0,"percent of total billed charges","37.70% of total billed charges",19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.87,33.9,,25.50,,,0,"percent of total billed charges","33.9% of total billed charges",19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.32,78,,58.66,,,0,"percent of total billed charges","78% of total billed charges",19.75,101,,,,,0,"fee schedule","101% of CMS fee schedule ",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",19.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,94,
"Mutation Sequence Analysis,1st LC ZB594",31081403,CDM,310,RC,81403,CPT,OUTPATIENT,,,955,620.75,,840.4,88,,672.32,,,0,"percent of total billed charges","88% of total billed charges",185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",324.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",110.23,100,,,,,0,"fee schedule",EAPG,185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",601.65,63,,481.32,,,0,"percent of total billed charges","63% of total billed charges",277.8,150,,,,,0,"fee schedule","150% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,658.95,69,,,,,0,"fee schedule","69% of total billed charges",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",708.39,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",185.2,100,,,,,0,"fee schedule","100% of LI fee schedule",79.27,100,,,,,0,"fee schedule",EAPG,185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.16,100,,,,,0,"fee schedule",EAPG,139.13,100,,,,,0,"fee schedule",EAPG,185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",360.04,37.7,,288.03,,,0,"percent of total billed charges","37.7% of total billed charges",360.04,37.7,,288.03,,,0,"percent of total billed charges","37.70% of total billed charges",185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",323.75,33.9,,259.00,,,0,"percent of total billed charges","33.9% of total billed charges",185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",744.9,78,,595.92,,,0,"percent of total billed charges","78% of total billed charges",187.05,101,,,,,0,"fee schedule","101% of CMS fee schedule ",788.83,82.6,,631.06,,,0,"percent of total billed charges","82.6% of total billed charges",107.02,100,,,,,0,"fee schedule",EAPG,185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",788.83,82.6,,631.06,,,0,"percent of total billed charges","82.6% of total billed charges",185.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.02,100,,,,,0,"fee schedule",EAPG,955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",79.27,955,
"MYCOPLASMA PNEUMONIAE IGG",30286738,CDM,302,RC,86738,CPT,OUTPATIENT,,,196,127.4,,172.48,88,,137.98,,,0,"percent of total billed charges","88% of total billed charges",13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",23.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",123.48,63,,98.78,,,0,"percent of total billed charges","63% of total billed charges",29.99,15.3,,23.99,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,135.24,69,,,,,0,"fee schedule","69% of total billed charges",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.64,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.24,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.89,37.7,,59.11,,,0,"percent of total billed charges","37.7% of total billed charges",73.89,37.7,,59.11,,,0,"percent of total billed charges","37.70% of total billed charges",13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.44,33.9,,53.15,,,0,"percent of total billed charges","33.9% of total billed charges",13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",152.88,78,,122.30,,,0,"percent of total billed charges","78% of total billed charges",13.37,101,,,,,0,"fee schedule","101% of CMS fee schedule ",161.9,82.6,,129.52,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",161.9,82.6,,129.52,,,0,"percent of total billed charges","82.6% of total billed charges",13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",6.96,196,
"MYCOPHENOLIC ACID",30180180,CDM,301,RC,80180,CPT,OUTPATIENT,,,85,55.25,,74.8,88,,59.84,,,0,"percent of total billed charges","88% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",31.58,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.55,63,,42.84,,,0,"percent of total billed charges","63% of total billed charges",13.01,15.3,,10.41,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,58.65,69,,,,,0,"fee schedule","69% of total billed charges",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.04,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.05,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.05,37.7,,25.64,,,0,"percent of total billed charges","37.7% of total billed charges",32.05,37.7,,25.64,,,0,"percent of total billed charges","37.70% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.82,33.9,,23.06,,,0,"percent of total billed charges","33.9% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.3,78,,53.04,,,0,"percent of total billed charges","78% of total billed charges",18.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",70.21,82.6,,56.17,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.21,82.6,,56.17,,,0,"percent of total billed charges","82.6% of total billed charges",18.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",7,85,
"Mycoplasma Panel AVR",30687798,CDM,306,RC,87798,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"Mycoplasma genitalium AVR",30687563,CDM,306,RC,87563,CPT,OUTPATIENT,,,109,70.85,,95.92,88,,76.74,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.67,63,,54.94,,,0,"percent of total billed charges","63% of total billed charges",16.68,15.3,,13.34,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,75.21,69,,,,,0,"fee schedule","69% of total billed charges",109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.09,37.7,,32.87,,,0,"percent of total billed charges","37.7% of total billed charges",41.09,37.7,,32.87,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.95,33.9,,29.56,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.02,78,,68.02,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",90.03,82.6,,72.02,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.03,82.6,,72.02,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",16.68,134.21,
"IntelliGEN(R) Myeloid LC",30081415,CDM,300,RC,81450,CPT,OUTPATIENT,,,13645,8869.25,,12007.6,88,,9606.08,,,0,"percent of total billed charges","88% of total billed charges",759.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",2292.36,16.8,,1833.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",1329.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",2361.13,17.304,,1888.90,,,0,"percent of total billed charges","17.304% of total billed charges",759.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",8596.35,63,,6877.08,,,0,"percent of total billed charges","63% of total billed charges",2087.69,15.3,,1670.15,,,0,"percent of total billed charges","15.3% of total billed charges",2292.36,16.8,,1833.89,,,0,"percent of total billed charges","16.8% of total billed charges",9415.05,69,,,,,0,"fee schedule","69% of total billed charges",13645,100,,10916.00,,,0,"percent of total billed charges","100% of total billed charges",759.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",13645,100,,10916.00,,,0,"percent of total billed charges","100% of total billed charges",759.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",13645,100,,10916.00,,,0,"percent of total billed charges","100% of total billed charges",759.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",2905.2,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",2292.36,16.8,,1833.89,,,0,"percent of total billed charges","16.8% of total billed charges",759.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",759.53,100,,,,,0,"fee schedule","100% of LI fee schedule",2292.36,16.8,,1833.89,,,0,"percent of total billed charges","16.8% of total billed charges",759.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",2338.21,17.136,,1870.57,,,0,"percent of total billed charges","17.136% of total billed charges",2980.07,21.84,,2384.06,,,0,"percent of total billed charges","21.84% of total billed charges",759.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",5144.17,37.7,,4115.34,,,0,"percent of total billed charges","37.7% of total billed charges",5144.17,37.7,,4115.34,,,0,"percent of total billed charges","37.70% of total billed charges",759.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",4625.66,33.9,,3700.53,,,0,"percent of total billed charges","33.9% of total billed charges",759.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",10643.1,78,,8514.48,,,0,"percent of total billed charges","78% of total billed charges",767.12,101,,,,,0,"fee schedule","101% of CMS fee schedule ",11270.77,82.6,,9016.62,,,0,"percent of total billed charges","82.6% of total billed charges",2292.36,16.8,,1833.89,,,0,"percent of total billed charges","16.8% of total billed charges",759.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",11270.77,82.6,,9016.62,,,0,"percent of total billed charges","82.6% of total billed charges",759.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",2292.36,16.8,,1833.89,,,0,"percent of total billed charges","16.8% of total billed charges",13645,100,,10916.00,,,0,"percent of total billed charges","100% of total billed charges",759.53,13645,
"Myoglobin U LC",30183874,CDM,301,RC,83874,CPT,OUTPATIENT,,,264,171.6,,232.32,88,,185.86,,,0,"percent of total billed charges","88% of total billed charges",12.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",22.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,12.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",166.32,63,,133.06,,,0,"percent of total billed charges","63% of total billed charges",40.39,15.3,,32.31,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,182.16,69,,,,,0,"fee schedule","69% of total billed charges",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",12.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",12.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",12.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.41,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,12.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.92,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,12.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,12.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.53,37.7,,79.62,,,0,"percent of total billed charges","37.7% of total billed charges",99.53,37.7,,79.62,,,0,"percent of total billed charges","37.70% of total billed charges",12.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.5,33.9,,71.60,,,0,"percent of total billed charges","33.9% of total billed charges",12.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",205.92,78,,164.74,,,0,"percent of total billed charges","78% of total billed charges",13.04,101,,,,,0,"fee schedule","101% of CMS fee schedule ",218.06,82.6,,174.45,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,12.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",218.06,82.6,,174.45,,,0,"percent of total billed charges","82.6% of total billed charges",12.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",8.11,264,
"Myoglobin LC",30183874,CDM,301,RC,83874,CPT,OUTPATIENT,,,294,191.1,,258.72,88,,206.98,,,0,"percent of total billed charges","88% of total billed charges",12.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",22.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,12.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",185.22,63,,148.18,,,0,"percent of total billed charges","63% of total billed charges",44.98,15.3,,35.98,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,202.86,69,,,,,0,"fee schedule","69% of total billed charges",294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",12.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",12.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",12.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.41,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,12.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.92,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,12.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,12.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",110.84,37.7,,88.67,,,0,"percent of total billed charges","37.7% of total billed charges",110.84,37.7,,88.67,,,0,"percent of total billed charges","37.70% of total billed charges",12.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.67,33.9,,79.74,,,0,"percent of total billed charges","33.9% of total billed charges",12.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",229.32,78,,183.46,,,0,"percent of total billed charges","78% of total billed charges",13.04,101,,,,,0,"fee schedule","101% of CMS fee schedule ",242.84,82.6,,194.27,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,12.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",242.84,82.6,,194.27,,,0,"percent of total billed charges","82.6% of total billed charges",12.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",8.11,294,
"NASH FibroSure LC",30184450,CDM,301,RC,84450,CPT,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",9.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.81,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.7% of total billed charges",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.43,33.9,,36.34,,,0,"percent of total billed charges","33.9% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",5.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",3.25,134,
"NMR LipoProf+Graph LC",30180061,CDM,301,RC,80061,CPT,OUTPATIENT,,,343,222.95,,301.84,88,,241.47,,,0,"percent of total billed charges","88% of total billed charges",13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",23.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",7.68,100,,,,,0,"fee schedule",EAPG,13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",216.09,63,,172.87,,,0,"percent of total billed charges","63% of total billed charges",52.48,15.3,,41.98,,,0,"percent of total billed charges","15.3% of total billed charges",7.45,100,,,,,0,"fee schedule",EAPG,236.67,69,,,,,0,"fee schedule","69% of total billed charges",343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.39,100,,,,,0,"fee schedule","100% of LI fee schedule",5.52,100,,,,,0,"fee schedule",EAPG,13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.6,100,,,,,0,"fee schedule",EAPG,9.69,100,,,,,0,"fee schedule",EAPG,13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.31,37.7,,103.45,,,0,"percent of total billed charges","37.7% of total billed charges",129.31,37.7,,103.45,,,0,"percent of total billed charges","37.70% of total billed charges",13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",116.28,33.9,,93.02,,,0,"percent of total billed charges","33.9% of total billed charges",13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",267.54,78,,214.03,,,0,"percent of total billed charges","78% of total billed charges",13.52,101,,,,,0,"fee schedule","101% of CMS fee schedule ",283.32,82.6,,226.66,,,0,"percent of total billed charges","82.6% of total billed charges",7.45,100,,,,,0,"fee schedule",EAPG,13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",283.32,82.6,,226.66,,,0,"percent of total billed charges","82.6% of total billed charges",13.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",5.52,343,
"Neisseria gonorrhoeae, NAA LC",30687591,CDM,306,RC,87591,CPT,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.7% of total billed charges",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.83,33.9,,55.86,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",18.33,206,
"Neisseria gonorrhoeae AVR",30687591,CDM,306,RC,87591,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"Newborn Screen (PKU)",30084030,CDM,300,RC,84030,CPT,OUTPATIENT,,,376,244.4,,330.88,88,,264.70,,,0,"percent of total billed charges","88% of total billed charges",5.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,376,100,,300.80,,,0,"percent of total billed charges","100% of total billed charges",9.62,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",236.88,63,,189.50,,,0,"percent of total billed charges","63% of total billed charges",57.53,15.3,,46.02,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,259.44,69,,,,,0,"fee schedule","69% of total billed charges",376,100,,300.80,,,0,"percent of total billed charges","100% of total billed charges",5.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",376,100,,300.80,,,0,"percent of total billed charges","100% of total billed charges",5.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",376,100,,300.80,,,0,"percent of total billed charges","100% of total billed charges",5.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.03,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.5,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",141.75,37.7,,113.40,,,0,"percent of total billed charges","37.7% of total billed charges",141.75,37.7,,113.40,,,0,"percent of total billed charges","37.70% of total billed charges",5.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",127.46,33.9,,101.97,,,0,"percent of total billed charges","33.9% of total billed charges",5.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",293.28,78,,234.62,,,0,"percent of total billed charges","78% of total billed charges",5.55,101,,,,,0,"fee schedule","101% of CMS fee schedule ",310.58,82.6,,248.46,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",310.58,82.6,,248.46,,,0,"percent of total billed charges","82.6% of total billed charges",5.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,376,100,,300.80,,,0,"percent of total billed charges","100% of total billed charges",3.25,376,
"Nicotine and Metabolite, Ur Qn LC",30180323,CDM,301,RC,80323,CPT,OUTPATIENT,,,267,173.55,,234.96,88,,187.97,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",168.21,63,,134.57,,,0,"percent of total billed charges","63% of total billed charges",40.85,15.3,,32.68,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",184.23,69,,,,,0,"fee schedule","69% of total billed charges",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",100.66,37.7,,80.53,,,0,"percent of total billed charges","37.7% of total billed charges",100.66,37.7,,80.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.51,33.9,,72.41,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.26,78,,166.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",220.54,82.6,,176.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",220.54,82.6,,176.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.86,16.8,,35.89,,,0,"percent of total billed charges","16.8% of total billed charges",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",40.85,267,
"Non-gyn Pap AVR",31188104,CDM,311,RC,88104,CPT,OUTPATIENT,,,282,183.3,,248.16,88,,198.53,,,0,"percent of total billed charges","88% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,282,100,,225.60,,,0,"percent of total billed charges","100% of total billed charges",71.58,175,,,,,0,"fee schedule","175% of CMS fee schedule",26.78,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.66,63,,142.13,,,0,"percent of total billed charges","63% of total billed charges",43.15,15.3,,34.52,,,0,"percent of total billed charges","15.3% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,194.58,69,,,,,0,"fee schedule","69% of total billed charges",282,100,,225.60,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",282,100,,225.60,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",282,100,,225.60,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.26,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.52,100,,,,,0,"fee schedule",EAPG,33.8,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",106.31,37.7,,85.05,,,0,"percent of total billed charges","37.7% of total billed charges",106.31,37.7,,85.05,,,0,"percent of total billed charges","37.70% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",95.6,33.9,,76.48,,,0,"percent of total billed charges","33.9% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",219.96,78,,175.97,,,0,"percent of total billed charges","78% of total billed charges",41.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",232.93,82.6,,186.34,,,0,"percent of total billed charges","82.6% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",232.93,82.6,,186.34,,,0,"percent of total billed charges","82.6% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,282,100,,225.60,,,0,"percent of total billed charges","100% of total billed charges",19.26,282,
"Norovirus, RT-PCR LC",30687798,CDM,306,RC,87798,CPT,OUTPATIENT,,,340,221,,299.2,88,,239.36,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",214.2,63,,171.36,,,0,"percent of total billed charges","63% of total billed charges",52.02,15.3,,41.62,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,234.6,69,,,,,0,"fee schedule","69% of total billed charges",340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",128.18,37.7,,102.54,,,0,"percent of total billed charges","37.7% of total billed charges",128.18,37.7,,102.54,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",115.26,33.9,,92.21,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",265.2,78,,212.16,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",280.84,82.6,,224.67,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",280.84,82.6,,224.67,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",18.33,340,
"C albicans + C glabrata, NAA LC",30687801,CDM,306,RC,87801,CPT,OUTPATIENT,,,180,117,,158.4,88,,126.72,,,0,"percent of total billed charges","88% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",122.85,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.4,63,,90.72,,,0,"percent of total billed charges","63% of total billed charges",27.54,15.3,,22.03,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,124.2,69,,,,,0,"fee schedule","69% of total billed charges",180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",268.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.2,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.86,37.7,,54.29,,,0,"percent of total billed charges","37.7% of total billed charges",67.86,37.7,,54.29,,,0,"percent of total billed charges","37.70% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.02,33.9,,48.82,,,0,"percent of total billed charges","33.9% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",140.4,78,,112.32,,,0,"percent of total billed charges","78% of total billed charges",70.9,101,,,,,0,"fee schedule","101% of CMS fee schedule ",148.68,82.6,,118.94,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",148.68,82.6,,118.94,,,0,"percent of total billed charges","82.6% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",18.33,268.51,
"C albicans + C glabrata, NAA LC",30687801,CDM,306,RC,87801,CPT,OUTPATIENT,,,180,117,,158.4,88,,126.72,,,0,"percent of total billed charges","88% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",122.85,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.4,63,,90.72,,,0,"percent of total billed charges","63% of total billed charges",27.54,15.3,,22.03,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,124.2,69,,,,,0,"fee schedule","69% of total billed charges",180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",268.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.2,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.86,37.7,,54.29,,,0,"percent of total billed charges","37.7% of total billed charges",67.86,37.7,,54.29,,,0,"percent of total billed charges","37.70% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.02,33.9,,48.82,,,0,"percent of total billed charges","33.9% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",140.4,78,,112.32,,,0,"percent of total billed charges","78% of total billed charges",70.9,101,,,,,0,"fee schedule","101% of CMS fee schedule ",148.68,82.6,,118.94,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",148.68,82.6,,118.94,,,0,"percent of total billed charges","82.6% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",18.33,268.51,
"Occult Blood Stool Screen",30182272,CDM,301,RC,82270,CPT,OUTPATIENT,,,67,43.55,,58.96,88,,47.17,,,0,"percent of total billed charges","88% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",7.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.21,63,,33.77,,,0,"percent of total billed charges","63% of total billed charges",10.25,15.3,,8.20,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,46.23,69,,,,,0,"fee schedule","69% of total billed charges",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.75,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.38,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.26,37.7,,20.21,,,0,"percent of total billed charges","37.7% of total billed charges",25.26,37.7,,20.21,,,0,"percent of total billed charges","37.70% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.71,33.9,,18.17,,,0,"percent of total billed charges","33.9% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.26,78,,41.81,,,0,"percent of total billed charges","78% of total billed charges",4.42,101,,,,,0,"fee schedule","101% of CMS fee schedule ",55.34,82.6,,44.27,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.34,82.6,,44.27,,,0,"percent of total billed charges","82.6% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,67,
"Occult Blood Stool I",30082270,CDM,300,RC,82270,CPT,OUTPATIENT,,,52,33.8,,45.76,88,,36.61,,,0,"percent of total billed charges","88% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",7.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.76,63,,26.21,,,0,"percent of total billed charges","63% of total billed charges",7.96,15.3,,6.37,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,35.88,69,,,,,0,"fee schedule","69% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.75,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.38,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.6,37.7,,15.68,,,0,"percent of total billed charges","37.7% of total billed charges",19.6,37.7,,15.68,,,0,"percent of total billed charges","37.70% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.63,33.9,,14.10,,,0,"percent of total billed charges","33.9% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.56,78,,32.45,,,0,"percent of total billed charges","78% of total billed charges",4.42,101,,,,,0,"fee schedule","101% of CMS fee schedule ",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,52,
"Occult Blood Stool II",30082270,CDM,300,RC,82270,CPT,OUTPATIENT,,,52,33.8,,45.76,88,,36.61,,,0,"percent of total billed charges","88% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",7.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.76,63,,26.21,,,0,"percent of total billed charges","63% of total billed charges",7.96,15.3,,6.37,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,35.88,69,,,,,0,"fee schedule","69% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.75,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.38,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.6,37.7,,15.68,,,0,"percent of total billed charges","37.7% of total billed charges",19.6,37.7,,15.68,,,0,"percent of total billed charges","37.70% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.63,33.9,,14.10,,,0,"percent of total billed charges","33.9% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.56,78,,32.45,,,0,"percent of total billed charges","78% of total billed charges",4.42,101,,,,,0,"fee schedule","101% of CMS fee schedule ",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,52,
"Occult Blood Stool III",30082270,CDM,300,RC,82270,CPT,OUTPATIENT,,,52,33.8,,45.76,88,,36.61,,,0,"percent of total billed charges","88% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",7.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.76,63,,26.21,,,0,"percent of total billed charges","63% of total billed charges",7.96,15.3,,6.37,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,35.88,69,,,,,0,"fee schedule","69% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.75,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.38,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.6,37.7,,15.68,,,0,"percent of total billed charges","37.7% of total billed charges",19.6,37.7,,15.68,,,0,"percent of total billed charges","37.70% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.63,33.9,,14.10,,,0,"percent of total billed charges","33.9% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.56,78,,32.45,,,0,"percent of total billed charges","78% of total billed charges",4.42,101,,,,,0,"fee schedule","101% of CMS fee schedule ",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,52,
"Occult Blood Screen 1-3",30082270,CDM,301,RC,82270,CPT,OUTPATIENT,,,52,33.8,,45.76,88,,36.61,,,0,"percent of total billed charges","88% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",7.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.76,63,,26.21,,,0,"percent of total billed charges","63% of total billed charges",7.96,15.3,,6.37,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,35.88,69,,,,,0,"fee schedule","69% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.75,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.38,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.6,37.7,,15.68,,,0,"percent of total billed charges","37.7% of total billed charges",19.6,37.7,,15.68,,,0,"percent of total billed charges","37.70% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.63,33.9,,14.10,,,0,"percent of total billed charges","33.9% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.56,78,,32.45,,,0,"percent of total billed charges","78% of total billed charges",4.42,101,,,,,0,"fee schedule","101% of CMS fee schedule ",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,52,
"Organism ID, Bacteria LC",30687077,CDM,306,RC,87077,CPT,OUTPATIENT,,,264,171.6,,232.32,88,,185.86,,,0,"percent of total billed charges","88% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",14.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",166.32,63,,133.06,,,0,"percent of total billed charges","63% of total billed charges",40.39,15.3,,32.31,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,182.16,69,,,,,0,"fee schedule","69% of total billed charges",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.9,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.08,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.53,37.7,,79.62,,,0,"percent of total billed charges","37.7% of total billed charges",99.53,37.7,,79.62,,,0,"percent of total billed charges","37.70% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.5,33.9,,71.60,,,0,"percent of total billed charges","33.9% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",205.92,78,,164.74,,,0,"percent of total billed charges","78% of total billed charges",8.16,101,,,,,0,"fee schedule","101% of CMS fee schedule ",218.06,82.6,,174.45,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",218.06,82.6,,174.45,,,0,"percent of total billed charges","82.6% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,264,
"Organism Identification, Yeast LC",30687106,CDM,306,RC,87106,CPT,OUTPATIENT,,,307,199.55,,270.16,88,,216.13,,,0,"percent of total billed charges","88% of total billed charges",10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,307,100,,245.60,,,0,"percent of total billed charges","100% of total billed charges",18.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",193.41,63,,154.73,,,0,"percent of total billed charges","63% of total billed charges",46.97,15.3,,37.58,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,211.83,69,,,,,0,"fee schedule","69% of total billed charges",307,100,,245.60,,,0,"percent of total billed charges","100% of total billed charges",10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",307,100,,245.60,,,0,"percent of total billed charges","100% of total billed charges",10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",307,100,,245.60,,,0,"percent of total billed charges","100% of total billed charges",10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.47,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.32,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",115.74,37.7,,92.59,,,0,"percent of total billed charges","37.7% of total billed charges",115.74,37.7,,92.59,,,0,"percent of total billed charges","37.70% of total billed charges",10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",104.07,33.9,,83.26,,,0,"percent of total billed charges","33.9% of total billed charges",10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",239.46,78,,191.57,,,0,"percent of total billed charges","78% of total billed charges",10.42,101,,,,,0,"fee schedule","101% of CMS fee schedule ",253.58,82.6,,202.86,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",253.58,82.6,,202.86,,,0,"percent of total billed charges","82.6% of total billed charges",10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,307,100,,245.60,,,0,"percent of total billed charges","100% of total billed charges",4.81,307,
"Osmolality Blood",30183930,CDM,301,RC,83930,CPT,OUTPATIENT,,,78,50.7,,68.64,88,,54.91,,,0,"percent of total billed charges","88% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",11.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.14,63,,39.31,,,0,"percent of total billed charges","63% of total billed charges",11.93,15.3,,9.54,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,53.82,69,,,,,0,"fee schedule","69% of total billed charges",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.28,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.61,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.41,37.7,,23.53,,,0,"percent of total billed charges","37.7% of total billed charges",29.41,37.7,,23.53,,,0,"percent of total billed charges","37.70% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.44,33.9,,21.15,,,0,"percent of total billed charges","33.9% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.84,78,,48.67,,,0,"percent of total billed charges","78% of total billed charges",6.67,101,,,,,0,"fee schedule","101% of CMS fee schedule ",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,78,
"Osmolality Urine",30083935,CDM,300,RC,83935,CPT,OUTPATIENT,,,652,423.8,,573.76,88,,459.01,,,0,"percent of total billed charges","88% of total billed charges",6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,652,100,,521.60,,,0,"percent of total billed charges","100% of total billed charges",11.93,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",410.76,63,,328.61,,,0,"percent of total billed charges","63% of total billed charges",99.76,15.3,,79.81,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,449.88,69,,,,,0,"fee schedule","69% of total billed charges",652,100,,521.60,,,0,"percent of total billed charges","100% of total billed charges",6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",652,100,,521.60,,,0,"percent of total billed charges","100% of total billed charges",6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",652,100,,521.60,,,0,"percent of total billed charges","100% of total billed charges",6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.08,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.82,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",245.8,37.7,,196.64,,,0,"percent of total billed charges","37.7% of total billed charges",245.8,37.7,,196.64,,,0,"percent of total billed charges","37.70% of total billed charges",6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",221.03,33.9,,176.82,,,0,"percent of total billed charges","33.9% of total billed charges",6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",508.56,78,,406.85,,,0,"percent of total billed charges","78% of total billed charges",6.88,101,,,,,0,"fee schedule","101% of CMS fee schedule ",538.55,82.6,,430.84,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",538.55,82.6,,430.84,,,0,"percent of total billed charges","82.6% of total billed charges",6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,652,100,,521.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,652,
"Osmolality, Urine LC",30183935,CDM,301,RC,83935,CPT,OUTPATIENT,,,190,123.5,,167.2,88,,133.76,,,0,"percent of total billed charges","88% of total billed charges",6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",11.93,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",119.7,63,,95.76,,,0,"percent of total billed charges","63% of total billed charges",29.07,15.3,,23.26,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,131.1,69,,,,,0,"fee schedule","69% of total billed charges",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.08,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.82,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.63,37.7,,57.30,,,0,"percent of total billed charges","37.7% of total billed charges",71.63,37.7,,57.30,,,0,"percent of total billed charges","37.70% of total billed charges",6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.41,33.9,,51.53,,,0,"percent of total billed charges","33.9% of total billed charges",6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",148.2,78,,118.56,,,0,"percent of total billed charges","78% of total billed charges",6.88,101,,,,,0,"fee schedule","101% of CMS fee schedule ",156.94,82.6,,125.55,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",156.94,82.6,,125.55,,,0,"percent of total billed charges","82.6% of total billed charges",6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",3.25,190,
"Osmolality, Blood LC",30183930,CDM,301,RC,83930,CPT,OUTPATIENT,,,190,123.5,,167.2,88,,133.76,,,0,"percent of total billed charges","88% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",11.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",119.7,63,,95.76,,,0,"percent of total billed charges","63% of total billed charges",29.07,15.3,,23.26,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,131.1,69,,,,,0,"fee schedule","69% of total billed charges",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.28,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.61,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.63,37.7,,57.30,,,0,"percent of total billed charges","37.7% of total billed charges",71.63,37.7,,57.30,,,0,"percent of total billed charges","37.70% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.41,33.9,,51.53,,,0,"percent of total billed charges","33.9% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",148.2,78,,118.56,,,0,"percent of total billed charges","78% of total billed charges",6.67,101,,,,,0,"fee schedule","101% of CMS fee schedule ",156.94,82.6,,125.55,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",156.94,82.6,,125.55,,,0,"percent of total billed charges","82.6% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",3.25,190,
"Ova + Parasite Exam LC",30687177,CDM,306,RC,87177,CPT,OUTPATIENT,,,218,141.7,,191.84,88,,153.47,,,0,"percent of total billed charges","88% of total billed charges",8.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",15.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.34,63,,109.87,,,0,"percent of total billed charges","63% of total billed charges",33.35,15.3,,26.68,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,150.42,69,,,,,0,"fee schedule","69% of total billed charges",218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",8.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",8.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",8.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.04,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.9,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.19,37.7,,65.75,,,0,"percent of total billed charges","37.7% of total billed charges",82.19,37.7,,65.75,,,0,"percent of total billed charges","37.70% of total billed charges",8.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.9,33.9,,59.12,,,0,"percent of total billed charges","33.9% of total billed charges",8.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.04,78,,136.03,,,0,"percent of total billed charges","78% of total billed charges",8.98,101,,,,,0,"fee schedule","101% of CMS fee schedule ",180.07,82.6,,144.06,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",180.07,82.6,,144.06,,,0,"percent of total billed charges","82.6% of total billed charges",8.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",4.81,218,
"Oxalate, Quant, U24 LC",30183945,CDM,301,RC,83945,CPT,OUTPATIENT,,,279,181.35,,245.52,88,,196.42,,,0,"percent of total billed charges","88% of total billed charges",14.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",25.28,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,14.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",175.77,63,,140.62,,,0,"percent of total billed charges","63% of total billed charges",42.69,15.3,,34.15,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,192.51,69,,,,,0,"fee schedule","69% of total billed charges",279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",14.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",14.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",14.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.27,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,14.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.45,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,14.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,14.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",105.18,37.7,,84.14,,,0,"percent of total billed charges","37.7% of total billed charges",105.18,37.7,,84.14,,,0,"percent of total billed charges","37.70% of total billed charges",14.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",94.58,33.9,,75.66,,,0,"percent of total billed charges","33.9% of total billed charges",14.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",217.62,78,,174.10,,,0,"percent of total billed charges","78% of total billed charges",14.59,101,,,,,0,"fee schedule","101% of CMS fee schedule ",230.45,82.6,,184.36,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,14.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",230.45,82.6,,184.36,,,0,"percent of total billed charges","82.6% of total billed charges",14.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",8.11,279,
"Oxcarbazepine (Trileptal),S LC",30180183,CDM,301,RC,80183,CPT,OUTPATIENT,,,123,79.95,,108.24,88,,86.59,,,0,"percent of total billed charges","88% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",23.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.49,63,,61.99,,,0,"percent of total billed charges","63% of total billed charges",18.82,15.3,,15.06,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,84.87,69,,,,,0,"fee schedule","69% of total billed charges",123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.68,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.25,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.37,37.7,,37.10,,,0,"percent of total billed charges","37.7% of total billed charges",46.37,37.7,,37.10,,,0,"percent of total billed charges","37.70% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.7,33.9,,33.36,,,0,"percent of total billed charges","33.9% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.94,78,,76.75,,,0,"percent of total billed charges","78% of total billed charges",13.38,101,,,,,0,"fee schedule","101% of CMS fee schedule ",101.6,82.6,,81.28,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.6,82.6,,81.28,,,0,"percent of total billed charges","82.6% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",7,123,
"PAP IGP Aptima HPV LC",31188175,CDM,311,RC,88175,CPT,OUTPATIENT,,,116,75.4,,102.08,88,,81.66,,,0,"percent of total billed charges","88% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",46.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.03,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.08,63,,58.46,,,0,"percent of total billed charges","63% of total billed charges",39.92,150,,,,,0,"fee schedule","150% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,80.04,69,,,,,0,"fee schedule","69% of total billed charges",116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.78,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.61,100,,,,,0,"fee schedule","100% of LI fee schedule",11.53,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.87,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.73,37.7,,34.98,,,0,"percent of total billed charges","37.7% of total billed charges",43.73,37.7,,34.98,,,0,"percent of total billed charges","37.70% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.32,33.9,,31.46,,,0,"percent of total billed charges","33.9% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.48,78,,72.38,,,0,"percent of total billed charges","78% of total billed charges",26.87,101,,,,,0,"fee schedule","101% of CMS fee schedule ",95.82,82.6,,76.66,,,0,"percent of total billed charges","82.6% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.82,82.6,,76.66,,,0,"percent of total billed charges","82.6% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",11.53,116,
"PAP IGP, Aptima HPV, rfx 16/18,45 LC",31188175,CDM,311,RC,88175,CPT,OUTPATIENT,,,116,75.4,,102.08,88,,81.66,,,0,"percent of total billed charges","88% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",46.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.03,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.08,63,,58.46,,,0,"percent of total billed charges","63% of total billed charges",39.92,150,,,,,0,"fee schedule","150% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,80.04,69,,,,,0,"fee schedule","69% of total billed charges",116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.78,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.61,100,,,,,0,"fee schedule","100% of LI fee schedule",11.53,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.87,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.73,37.7,,34.98,,,0,"percent of total billed charges","37.7% of total billed charges",43.73,37.7,,34.98,,,0,"percent of total billed charges","37.70% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.32,33.9,,31.46,,,0,"percent of total billed charges","33.9% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.48,78,,72.38,,,0,"percent of total billed charges","78% of total billed charges",26.87,101,,,,,0,"fee schedule","101% of CMS fee schedule ",95.82,82.6,,76.66,,,0,"percent of total billed charges","82.6% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.82,82.6,,76.66,,,0,"percent of total billed charges","82.6% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",11.53,116,
"Pathology Billing Gyn Cyto Image Guided Thin Prep",31188175,CDM,311,RC,88175,CPT,OUTPATIENT,,,100,65,,88,88,,70.40,,,0,"percent of total billed charges","88% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",46.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.03,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",63,63,,50.40,,,0,"percent of total billed charges","63% of total billed charges",39.92,150,,,,,0,"fee schedule","150% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,69,69,,,,,0,"fee schedule","69% of total billed charges",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.78,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.61,100,,,,,0,"fee schedule","100% of LI fee schedule",11.53,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.87,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.7% of total billed charges",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.70% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.9,33.9,,27.12,,,0,"percent of total billed charges","33.9% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,78,,62.40,,,0,"percent of total billed charges","78% of total billed charges",26.87,101,,,,,0,"fee schedule","101% of CMS fee schedule ",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",11.53,101.78,
"PAP IGP, CtNg, rfx Aptima HPV ASCU LC",31188175,CDM,311,RC,88175,CPT,OUTPATIENT,,,294,191.1,,258.72,88,,206.98,,,0,"percent of total billed charges","88% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",46.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.03,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",185.22,63,,148.18,,,0,"percent of total billed charges","63% of total billed charges",39.92,150,,,,,0,"fee schedule","150% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,202.86,69,,,,,0,"fee schedule","69% of total billed charges",294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.78,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.61,100,,,,,0,"fee schedule","100% of LI fee schedule",11.53,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.87,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",110.84,37.7,,88.67,,,0,"percent of total billed charges","37.7% of total billed charges",110.84,37.7,,88.67,,,0,"percent of total billed charges","37.70% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.67,33.9,,79.74,,,0,"percent of total billed charges","33.9% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",229.32,78,,183.46,,,0,"percent of total billed charges","78% of total billed charges",26.87,101,,,,,0,"fee schedule","101% of CMS fee schedule ",242.84,82.6,,194.27,,,0,"percent of total billed charges","82.6% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",242.84,82.6,,194.27,,,0,"percent of total billed charges","82.6% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",11.53,294,
"Pathology Billing Gyn Cyto Image Guided Thin Prep",31188175,CDM,311,RC,88175,CPT,OUTPATIENT,,,100,65,,88,88,,70.40,,,0,"percent of total billed charges","88% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",46.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.03,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",63,63,,50.40,,,0,"percent of total billed charges","63% of total billed charges",39.92,150,,,,,0,"fee schedule","150% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,69,69,,,,,0,"fee schedule","69% of total billed charges",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.78,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.61,100,,,,,0,"fee schedule","100% of LI fee schedule",11.53,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.87,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.7% of total billed charges",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.70% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.9,33.9,,27.12,,,0,"percent of total billed charges","33.9% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,78,,62.40,,,0,"percent of total billed charges","78% of total billed charges",26.87,101,,,,,0,"fee schedule","101% of CMS fee schedule ",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",11.53,101.78,
"199305 PAP IGP, Apt HPV,rfx 16/18,45 LC",31188175,CDM,311,RC,88175,CPT,OUTPATIENT,,,116,75.4,,102.08,88,,81.66,,,0,"percent of total billed charges","88% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",46.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.03,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.08,63,,58.46,,,0,"percent of total billed charges","63% of total billed charges",39.92,150,,,,,0,"fee schedule","150% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,80.04,69,,,,,0,"fee schedule","69% of total billed charges",116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.78,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.61,100,,,,,0,"fee schedule","100% of LI fee schedule",11.53,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.87,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.73,37.7,,34.98,,,0,"percent of total billed charges","37.7% of total billed charges",43.73,37.7,,34.98,,,0,"percent of total billed charges","37.70% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.32,33.9,,31.46,,,0,"percent of total billed charges","33.9% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.48,78,,72.38,,,0,"percent of total billed charges","78% of total billed charges",26.87,101,,,,,0,"fee schedule","101% of CMS fee schedule ",95.82,82.6,,76.66,,,0,"percent of total billed charges","82.6% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.82,82.6,,76.66,,,0,"percent of total billed charges","82.6% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",11.53,116,
"PID/Infertility Panel AVR",30687491,CDM,306,RC,87491,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"POC Osmolality Serum",30083930,CDM,300,RC,83930,CPT,OUTPATIENT,,,78,50.7,,68.64,88,,54.91,,,0,"percent of total billed charges","88% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",11.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.14,63,,39.31,,,0,"percent of total billed charges","63% of total billed charges",11.93,15.3,,9.54,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,53.82,69,,,,,0,"fee schedule","69% of total billed charges",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.28,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.61,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.41,37.7,,23.53,,,0,"percent of total billed charges","37.7% of total billed charges",29.41,37.7,,23.53,,,0,"percent of total billed charges","37.70% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.44,33.9,,21.15,,,0,"percent of total billed charges","33.9% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.84,78,,48.67,,,0,"percent of total billed charges","78% of total billed charges",6.67,101,,,,,0,"fee schedule","101% of CMS fee schedule ",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,78,
"POC Urine Osmolality",30083935,CDM,300,RC,83935,CPT,OUTPATIENT,,,652,423.8,,573.76,88,,459.01,,,0,"percent of total billed charges","88% of total billed charges",6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,652,100,,521.60,,,0,"percent of total billed charges","100% of total billed charges",11.93,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",410.76,63,,328.61,,,0,"percent of total billed charges","63% of total billed charges",99.76,15.3,,79.81,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,449.88,69,,,,,0,"fee schedule","69% of total billed charges",652,100,,521.60,,,0,"percent of total billed charges","100% of total billed charges",6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",652,100,,521.60,,,0,"percent of total billed charges","100% of total billed charges",6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",652,100,,521.60,,,0,"percent of total billed charges","100% of total billed charges",6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.08,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.82,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",245.8,37.7,,196.64,,,0,"percent of total billed charges","37.7% of total billed charges",245.8,37.7,,196.64,,,0,"percent of total billed charges","37.70% of total billed charges",6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",221.03,33.9,,176.82,,,0,"percent of total billed charges","33.9% of total billed charges",6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",508.56,78,,406.85,,,0,"percent of total billed charges","78% of total billed charges",6.88,101,,,,,0,"fee schedule","101% of CMS fee schedule ",538.55,82.6,,430.84,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",538.55,82.6,,430.84,,,0,"percent of total billed charges","82.6% of total billed charges",6.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,652,100,,521.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,652,
"iSTAT Basic metabolic panel (Calcium, ionized) Chem8+",30180047,CDM,301,RC,80047,CPT,OUTPATIENT,,,43,27.95,,37.84,88,,30.27,,,0,"percent of total billed charges","88% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",24.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",7.68,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.09,63,,21.67,,,0,"percent of total billed charges","63% of total billed charges",6.58,15.3,,5.26,,,0,"percent of total billed charges","15.3% of total billed charges",7.45,100,,,,,0,"fee schedule",EAPG,29.67,69,,,,,0,"fee schedule","69% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.73,100,,,,,0,"fee schedule","100% of LI fee schedule",5.52,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.6,100,,,,,0,"fee schedule",EAPG,9.69,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.21,37.7,,12.97,,,0,"percent of total billed charges","37.7% of total billed charges",16.21,37.7,,12.97,,,0,"percent of total billed charges","37.70% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.58,33.9,,11.66,,,0,"percent of total billed charges","33.9% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.54,78,,26.83,,,0,"percent of total billed charges","78% of total billed charges",13.86,101,,,,,0,"fee schedule","101% of CMS fee schedule ",35.52,82.6,,28.42,,,0,"percent of total billed charges","82.6% of total billed charges",7.45,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.52,82.6,,28.42,,,0,"percent of total billed charges","82.6% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",5.52,52.51,
"COVID-19 Rapid Antigen POCT",30287811,CDM,302,RC,87811,CPT,OUTPATIENT,,,114,74.1,,100.32,88,,80.26,,,0,"percent of total billed charges","88% of total billed charges",41.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,114,100,,91.20,,,0,"percent of total billed charges","100% of total billed charges",72.41,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,41.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.82,63,,57.46,,,0,"percent of total billed charges","63% of total billed charges",17.44,15.3,,13.95,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,78.66,69,,,,,0,"fee schedule","69% of total billed charges",114,100,,91.20,,,0,"percent of total billed charges","100% of total billed charges",41.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",114,100,,91.20,,,0,"percent of total billed charges","100% of total billed charges",41.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",114,100,,91.20,,,0,"percent of total billed charges","100% of total billed charges",41.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.38,382.5,,,,,0,"fee schedule","382.5% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,41.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.38,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,41.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,41.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.98,37.7,,34.38,,,0,"percent of total billed charges","37.7% of total billed charges",42.98,37.7,,34.38,,,0,"percent of total billed charges","37.70% of total billed charges",41.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.65,33.9,,30.92,,,0,"percent of total billed charges","33.9% of total billed charges",41.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.92,78,,71.14,,,0,"percent of total billed charges","78% of total billed charges",41.79,101,,,,,0,"fee schedule","101% of CMS fee schedule ",94.16,82.6,,75.33,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,41.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",94.16,82.6,,75.33,,,0,"percent of total billed charges","82.6% of total billed charges",41.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,114,100,,91.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,114,
"POCT INR - TOP Coagucheck",30085610,CDM,300,RC,85610,CPT,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",7.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.4,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.29,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.7% of total billed charges",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.07,33.9,,3.26,,,0,"percent of total billed charges","33.9% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",4.33,101,,,,,0,"fee schedule","101% of CMS fee schedule ",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,16.4,
"POCT SARS-CoV-2 (COVID-19)/Flu/RSV (Genexpert)",0003000241U,CDM,306,RC,87637,CPT,OUTPATIENT,,,386,250.9,,339.68,88,,271.74,,,0,"percent of total billed charges","88% of total billed charges",142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",249.6,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",243.18,63,,194.54,,,0,"percent of total billed charges","63% of total billed charges",59.06,15.3,,47.25,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,266.34,69,,,,,0,"fee schedule","69% of total billed charges",386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.63,382.5,,,,,0,"fee schedule","382.5% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.63,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",145.52,37.7,,116.42,,,0,"percent of total billed charges","37.7% of total billed charges",145.52,37.7,,116.42,,,0,"percent of total billed charges","37.70% of total billed charges",142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",130.85,33.9,,104.68,,,0,"percent of total billed charges","33.9% of total billed charges",142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",301.08,78,,240.86,,,0,"percent of total billed charges","78% of total billed charges",144.05,101,,,,,0,"fee schedule","101% of CMS fee schedule ",318.84,82.6,,255.07,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",318.84,82.6,,255.07,,,0,"percent of total billed charges","82.6% of total billed charges",142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",18.33,386,
"POCT iSTAT INR",30085610,CDM,300,RC,85610,CPT,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",7.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.4,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.29,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.7% of total billed charges",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.07,33.9,,3.26,,,0,"percent of total billed charges","33.9% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",4.33,101,,,,,0,"fee schedule","101% of CMS fee schedule ",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,16.4,
"Prostate specific antigen (PSA) total; Diagnostic",30184153,CDM,301,RC,84153,CPT,OUTPATIENT,,,509,330.85,,447.92,88,,358.34,,,0,"percent of total billed charges","88% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",32.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",320.67,63,,256.54,,,0,"percent of total billed charges","63% of total billed charges",77.88,15.3,,62.30,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,351.21,69,,,,,0,"fee schedule","69% of total billed charges",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.39,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",191.89,37.7,,153.51,,,0,"percent of total billed charges","37.7% of total billed charges",191.89,37.7,,153.51,,,0,"percent of total billed charges","37.70% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",172.55,33.9,,138.04,,,0,"percent of total billed charges","33.9% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",397.02,78,,317.62,,,0,"percent of total billed charges","78% of total billed charges",18.57,101,,,,,0,"fee schedule","101% of CMS fee schedule ",420.43,82.6,,336.34,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",420.43,82.6,,336.34,,,0,"percent of total billed charges","82.6% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",8.11,509,
"PSA Screening",30184153,CDM,301,RC,,,OUTPATIENT,,,430,279.5,,378.4,88,,302.72,,,0,"percent of total billed charges","88% of total billed charges",215,50,,172.00,,,0,"percent of total billed charges","50% of total billed charges",72.24,16.8,,57.79,,,0,"percent of total billed charges","16.8% of total billed charges",430,100,,344.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.41,17.304,,59.53,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",270.9,63,,216.72,,,0,"percent of total billed charges","63% of total billed charges",65.79,15.3,,52.63,,,0,"percent of total billed charges","15.3% of total billed charges",72.24,16.8,,57.79,,,0,"percent of total billed charges","16.8% of total billed charges",296.7,69,,,,,0,"fee schedule","69% of total billed charges",430,100,,344.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",430,100,,344.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",430,100,,344.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",72.24,16.8,,57.79,,,0,"percent of total billed charges","16.8% of total billed charges",215,50,,172.00,,,0,"percent of total billed charges","50% of total billed charges",138.46,32.2,,110.77,,,0,"percent of total billed charges","32.2% of total billed charges",72.24,16.8,,57.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",73.68,17.136,,58.94,,,0,"percent of total billed charges","17.136% of total billed charges",93.91,21.84,,75.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.11,37.7,,129.69,,,0,"percent of total billed charges","37.7% of total billed charges",162.11,37.7,,129.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",145.77,33.9,,116.62,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",335.4,78,,268.32,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",355.18,82.6,,284.14,,,0,"percent of total billed charges","82.6% of total billed charges",72.24,16.8,,57.79,,,0,"percent of total billed charges","16.8% of total billed charges",215,50,,172.00,,,0,"percent of total billed charges","50% of total billed charges",355.18,82.6,,284.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",72.24,16.8,,57.79,,,0,"percent of total billed charges","16.8% of total billed charges",430,100,,344.00,,,0,"percent of total billed charges","100% of total billed charges",65.79,430,
"PSA Total+% Free LC",30184153,CDM,301,RC,84153,CPT,OUTPATIENT,,,475,308.75,,418,88,,334.40,,,0,"percent of total billed charges","88% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",32.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",299.25,63,,239.40,,,0,"percent of total billed charges","63% of total billed charges",72.68,15.3,,58.14,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,327.75,69,,,,,0,"fee schedule","69% of total billed charges",475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.39,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",179.08,37.7,,143.26,,,0,"percent of total billed charges","37.7% of total billed charges",179.08,37.7,,143.26,,,0,"percent of total billed charges","37.70% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",161.03,33.9,,128.82,,,0,"percent of total billed charges","33.9% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",370.5,78,,296.40,,,0,"percent of total billed charges","78% of total billed charges",18.57,101,,,,,0,"fee schedule","101% of CMS fee schedule ",392.35,82.6,,313.88,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",392.35,82.6,,313.88,,,0,"percent of total billed charges","82.6% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",8.11,475,
"PSA Total (Reflex To Free) LC",30184153,CDM,301,RC,84153,CPT,OUTPATIENT,,,475,308.75,,418,88,,334.40,,,0,"percent of total billed charges","88% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",32.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",299.25,63,,239.40,,,0,"percent of total billed charges","63% of total billed charges",72.68,15.3,,58.14,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,327.75,69,,,,,0,"fee schedule","69% of total billed charges",475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.39,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",179.08,37.7,,143.26,,,0,"percent of total billed charges","37.7% of total billed charges",179.08,37.7,,143.26,,,0,"percent of total billed charges","37.70% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",161.03,33.9,,128.82,,,0,"percent of total billed charges","33.9% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",370.5,78,,296.40,,,0,"percent of total billed charges","78% of total billed charges",18.57,101,,,,,0,"fee schedule","101% of CMS fee schedule ",392.35,82.6,,313.88,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",392.35,82.6,,313.88,,,0,"percent of total billed charges","82.6% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",8.11,475,
"Ca+PTH Intact LC",30182310,CDM,301,RC,82310,CPT,OUTPATIENT,,,110,71.5,,96.8,88,,77.44,,,0,"percent of total billed charges","88% of total billed charges",5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",9.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.3,63,,55.44,,,0,"percent of total billed charges","63% of total billed charges",16.83,15.3,,13.46,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,75.9,69,,,,,0,"fee schedule","69% of total billed charges",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.73,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.16,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.47,37.7,,33.18,,,0,"percent of total billed charges","37.7% of total billed charges",41.47,37.7,,33.18,,,0,"percent of total billed charges","37.70% of total billed charges",5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.29,33.9,,29.83,,,0,"percent of total billed charges","33.9% of total billed charges",5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.8,78,,68.64,,,0,"percent of total billed charges","78% of total billed charges",5.21,101,,,,,0,"fee schedule","101% of CMS fee schedule ",90.86,82.6,,72.69,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.86,82.6,,72.69,,,0,"percent of total billed charges","82.6% of total billed charges",5.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",3.25,110,
"PTH, Intact LC",30183970,CDM,301,RC,83970,CPT,OUTPATIENT,,,241,156.65,,212.08,88,,169.66,,,0,"percent of total billed charges","88% of total billed charges",41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",72.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",30.04,100,,,,,0,"fee schedule",EAPG,41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.83,63,,121.46,,,0,"percent of total billed charges","63% of total billed charges",36.87,15.3,,29.50,,,0,"percent of total billed charges","15.3% of total billed charges",29.16,100,,,,,0,"fee schedule",EAPG,166.29,69,,,,,0,"fee schedule","69% of total billed charges",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",157.89,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.28,100,,,,,0,"fee schedule","100% of LI fee schedule",21.6,100,,,,,0,"fee schedule",EAPG,41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.74,100,,,,,0,"fee schedule",EAPG,37.91,100,,,,,0,"fee schedule",EAPG,41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.86,37.7,,72.69,,,0,"percent of total billed charges","37.7% of total billed charges",90.86,37.7,,72.69,,,0,"percent of total billed charges","37.70% of total billed charges",41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.7,33.9,,65.36,,,0,"percent of total billed charges","33.9% of total billed charges",41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",187.98,78,,150.38,,,0,"percent of total billed charges","78% of total billed charges",41.69,101,,,,,0,"fee schedule","101% of CMS fee schedule ",199.07,82.6,,159.26,,,0,"percent of total billed charges","82.6% of total billed charges",29.16,100,,,,,0,"fee schedule",EAPG,41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",199.07,82.6,,159.26,,,0,"percent of total billed charges","82.6% of total billed charges",41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",21.6,241,
"PTHrP (PTH-Related Peptide)",30182397,CDM,301,RC,82397,CPT,OUTPATIENT,,,283,183.95,,249.04,88,,199.23,,,0,"percent of total billed charges","88% of total billed charges",14.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,283,100,,226.40,,,0,"percent of total billed charges","100% of total billed charges",24.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,14.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",178.29,63,,142.63,,,0,"percent of total billed charges","63% of total billed charges",43.3,15.3,,34.64,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,195.27,69,,,,,0,"fee schedule","69% of total billed charges",283,100,,226.40,,,0,"percent of total billed charges","100% of total billed charges",14.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",283,100,,226.40,,,0,"percent of total billed charges","100% of total billed charges",14.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",283,100,,226.40,,,0,"percent of total billed charges","100% of total billed charges",14.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",54,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,14.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.12,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,14.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,14.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.69,37.7,,85.35,,,0,"percent of total billed charges","37.7% of total billed charges",106.69,37.7,,85.35,,,0,"percent of total billed charges","37.70% of total billed charges",14.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.94,33.9,,76.75,,,0,"percent of total billed charges","33.9% of total billed charges",14.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",220.74,78,,176.59,,,0,"percent of total billed charges","78% of total billed charges",14.26,101,,,,,0,"fee schedule","101% of CMS fee schedule ",233.76,82.6,,187.01,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,14.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",233.76,82.6,,187.01,,,0,"percent of total billed charges","82.6% of total billed charges",14.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,283,100,,226.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,283,
"Pancreatic Elastase Fecal LC",30182653,CDM,301,RC,82653,CPT,OUTPATIENT,,,780,507,,686.4,88,,549.12,,,0,"percent of total billed charges","88% of total billed charges",22.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,780,100,,624.00,,,0,"percent of total billed charges","100% of total billed charges",40.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,22.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",491.4,63,,393.12,,,0,"percent of total billed charges","63% of total billed charges",119.34,15.3,,95.47,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,538.2,69,,,,,0,"fee schedule","69% of total billed charges",780,100,,624.00,,,0,"percent of total billed charges","100% of total billed charges",22.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",780,100,,624.00,,,0,"percent of total billed charges","100% of total billed charges",22.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",780,100,,624.00,,,0,"percent of total billed charges","100% of total billed charges",22.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",10.95,100,,,,,0,"fee schedule",EAPG,22.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.97,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,22.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,22.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",294.06,37.7,,235.25,,,0,"percent of total billed charges","37.7% of total billed charges",294.06,37.7,,235.25,,,0,"percent of total billed charges","37.70% of total billed charges",22.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",264.42,33.9,,211.54,,,0,"percent of total billed charges","33.9% of total billed charges",22.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",608.4,78,,486.72,,,0,"percent of total billed charges","78% of total billed charges",23.19,101,,,,,0,"fee schedule","101% of CMS fee schedule ",644.28,82.6,,515.42,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,22.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",644.28,82.6,,515.42,,,0,"percent of total billed charges","82.6% of total billed charges",22.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,780,100,,624.00,,,0,"percent of total billed charges","100% of total billed charges",8.11,780,
"Panel 083904 (HIV-2) LC",30286702,CDM,302,RC,86702,CPT,OUTPATIENT,,,279,181.35,,245.52,88,,196.42,,,0,"percent of total billed charges","88% of total billed charges",13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",23.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",175.77,63,,140.62,,,0,"percent of total billed charges","63% of total billed charges",42.69,15.3,,34.15,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,192.51,69,,,,,0,"fee schedule","69% of total billed charges",279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.71,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.52,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",105.18,37.7,,84.14,,,0,"percent of total billed charges","37.7% of total billed charges",105.18,37.7,,84.14,,,0,"percent of total billed charges","37.70% of total billed charges",13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",94.58,33.9,,75.66,,,0,"percent of total billed charges","33.9% of total billed charges",13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",217.62,78,,174.10,,,0,"percent of total billed charges","78% of total billed charges",13.65,101,,,,,0,"fee schedule","101% of CMS fee schedule ",230.45,82.6,,184.36,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",230.45,82.6,,184.36,,,0,"percent of total billed charges","82.6% of total billed charges",13.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,279,
"HIV-1 AG W/HIV-1  and HIV-2 AB",30687389,CDM,306,RC,87389,CPT,OUTPATIENT,,,61,39.65,,53.68,88,,42.94,,,0,"percent of total billed charges","88% of total billed charges",24.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",42.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,24.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.43,63,,30.74,,,0,"percent of total billed charges","63% of total billed charges",9.33,15.3,,7.46,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,42.09,69,,,,,0,"fee schedule","69% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",24.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",24.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",24.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,24.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.08,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,24.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,24.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",23,37.7,,18.40,,,0,"percent of total billed charges","37.7% of total billed charges",23,37.7,,18.40,,,0,"percent of total billed charges","37.70% of total billed charges",24.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.68,33.9,,16.54,,,0,"percent of total billed charges","33.9% of total billed charges",24.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.58,78,,38.06,,,0,"percent of total billed charges","78% of total billed charges",24.32,101,,,,,0,"fee schedule","101% of CMS fee schedule ",50.39,82.6,,40.31,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,24.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.39,82.6,,40.31,,,0,"percent of total billed charges","82.6% of total billed charges",24.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",4.81,92.1,
"Pap IG (Image Guided) LC",31188175,CDM,311,RC,88175,CPT,OUTPATIENT,,,97,63.05,,85.36,88,,68.29,,,0,"percent of total billed charges","88% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",46.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.03,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.11,63,,48.89,,,0,"percent of total billed charges","63% of total billed charges",39.92,150,,,,,0,"fee schedule","150% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,66.93,69,,,,,0,"fee schedule","69% of total billed charges",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.78,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.61,100,,,,,0,"fee schedule","100% of LI fee schedule",11.53,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.87,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.57,37.7,,29.26,,,0,"percent of total billed charges","37.7% of total billed charges",36.57,37.7,,29.26,,,0,"percent of total billed charges","37.70% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.88,33.9,,26.30,,,0,"percent of total billed charges","33.9% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",75.66,78,,60.53,,,0,"percent of total billed charges","78% of total billed charges",26.87,101,,,,,0,"fee schedule","101% of CMS fee schedule ",80.12,82.6,,64.10,,,0,"percent of total billed charges","82.6% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.12,82.6,,64.10,,,0,"percent of total billed charges","82.6% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",11.53,101.78,
"Pap IG, rfx HPV all pth LC",31188175,CDM,311,RC,88175,CPT,OUTPATIENT,,,97,63.05,,85.36,88,,68.29,,,0,"percent of total billed charges","88% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",46.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.03,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.11,63,,48.89,,,0,"percent of total billed charges","63% of total billed charges",39.92,150,,,,,0,"fee schedule","150% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,66.93,69,,,,,0,"fee schedule","69% of total billed charges",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.78,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.61,100,,,,,0,"fee schedule","100% of LI fee schedule",11.53,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.87,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.57,37.7,,29.26,,,0,"percent of total billed charges","37.7% of total billed charges",36.57,37.7,,29.26,,,0,"percent of total billed charges","37.70% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.88,33.9,,26.30,,,0,"percent of total billed charges","33.9% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",75.66,78,,60.53,,,0,"percent of total billed charges","78% of total billed charges",26.87,101,,,,,0,"fee schedule","101% of CMS fee schedule ",80.12,82.6,,64.10,,,0,"percent of total billed charges","82.6% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.12,82.6,,64.10,,,0,"percent of total billed charges","82.6% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",11.53,101.78,
"Pathology Billing Gyn Cyto Image Guided Thin Prep",31188175,CDM,311,RC,88175,CPT,OUTPATIENT,,,100,65,,88,88,,70.40,,,0,"percent of total billed charges","88% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",46.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.03,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",63,63,,50.40,,,0,"percent of total billed charges","63% of total billed charges",39.92,150,,,,,0,"fee schedule","150% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,69,69,,,,,0,"fee schedule","69% of total billed charges",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.78,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.61,100,,,,,0,"fee schedule","100% of LI fee schedule",11.53,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.87,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.7% of total billed charges",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.70% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.9,33.9,,27.12,,,0,"percent of total billed charges","33.9% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,78,,62.40,,,0,"percent of total billed charges","78% of total billed charges",26.87,101,,,,,0,"fee schedule","101% of CMS fee schedule ",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",11.53,101.78,
"Pap IG, Ct-Ng TV LC",31188175,CDM,311,RC,88175,CPT,OUTPATIENT,,,460,299,,404.8,88,,323.84,,,0,"percent of total billed charges","88% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,460,100,,368.00,,,0,"percent of total billed charges","100% of total billed charges",46.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.03,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",289.8,63,,231.84,,,0,"percent of total billed charges","63% of total billed charges",39.92,150,,,,,0,"fee schedule","150% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,317.4,69,,,,,0,"fee schedule","69% of total billed charges",460,100,,368.00,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",460,100,,368.00,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",460,100,,368.00,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.78,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.61,100,,,,,0,"fee schedule","100% of LI fee schedule",11.53,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.87,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",173.42,37.7,,138.74,,,0,"percent of total billed charges","37.7% of total billed charges",173.42,37.7,,138.74,,,0,"percent of total billed charges","37.70% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",155.94,33.9,,124.75,,,0,"percent of total billed charges","33.9% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",358.8,78,,287.04,,,0,"percent of total billed charges","78% of total billed charges",26.87,101,,,,,0,"fee schedule","101% of CMS fee schedule ",379.96,82.6,,303.97,,,0,"percent of total billed charges","82.6% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",379.96,82.6,,303.97,,,0,"percent of total billed charges","82.6% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,460,100,,368.00,,,0,"percent of total billed charges","100% of total billed charges",11.53,460,
"Pathology Billing Gyn Cytology Thin Prep",31188142,CDM,311,RC,88142,CPT,OUTPATIENT,,,144,93.6,,126.72,88,,101.38,,,0,"percent of total billed charges","88% of total billed charges",20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",35.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.03,100,,,,,0,"fee schedule",EAPG,20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.72,63,,72.58,,,0,"percent of total billed charges","63% of total billed charges",30.39,150,,,,,0,"fee schedule","150% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,99.36,69,,,,,0,"fee schedule","69% of total billed charges",144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.49,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.26,100,,,,,0,"fee schedule","100% of LI fee schedule",11.53,100,,,,,0,"fee schedule",EAPG,20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.87,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule",EAPG,20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.29,37.7,,43.43,,,0,"percent of total billed charges","37.7% of total billed charges",54.29,37.7,,43.43,,,0,"percent of total billed charges","37.70% of total billed charges",20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.82,33.9,,39.06,,,0,"percent of total billed charges","33.9% of total billed charges",20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",112.32,78,,89.86,,,0,"percent of total billed charges","78% of total billed charges",20.46,101,,,,,0,"fee schedule","101% of CMS fee schedule ",118.94,82.6,,95.15,,,0,"percent of total billed charges","82.6% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",118.94,82.6,,95.15,,,0,"percent of total billed charges","82.6% of total billed charges",20.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",11.53,144,
"Pathology Billing Gyn Cytology without Pathologist Interpretation",31188164,CDM,311,RC,88164,CPT,OUTPATIENT,,,35,22.75,,30.8,88,,24.64,,,0,"percent of total billed charges","88% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",31.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.03,100,,,,,0,"fee schedule",EAPG,17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.05,63,,17.64,,,0,"percent of total billed charges","63% of total billed charges",26.64,150,,,,,0,"fee schedule","150% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,24.15,69,,,,,0,"fee schedule","69% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.94,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.76,100,,,,,0,"fee schedule","100% of LI fee schedule",11.53,100,,,,,0,"fee schedule",EAPG,17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.87,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule",EAPG,17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.2,37.7,,10.56,,,0,"percent of total billed charges","37.7% of total billed charges",13.2,37.7,,10.56,,,0,"percent of total billed charges","37.70% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.87,33.9,,9.50,,,0,"percent of total billed charges","33.9% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.3,78,,21.84,,,0,"percent of total billed charges","78% of total billed charges",17.93,101,,,,,0,"fee schedule","101% of CMS fee schedule ",28.91,82.6,,23.13,,,0,"percent of total billed charges","82.6% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.91,82.6,,23.13,,,0,"percent of total billed charges","82.6% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",11.53,57.94,
"Pathology Billing Gyn Cytology without Pathologist Interpretation",31188164,CDM,311,RC,88164,CPT,OUTPATIENT,,,70,45.5,,61.6,88,,49.28,,,0,"percent of total billed charges","88% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",31.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.03,100,,,,,0,"fee schedule",EAPG,17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.1,63,,35.28,,,0,"percent of total billed charges","63% of total billed charges",26.64,150,,,,,0,"fee schedule","150% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,48.3,69,,,,,0,"fee schedule","69% of total billed charges",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.94,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.76,100,,,,,0,"fee schedule","100% of LI fee schedule",11.53,100,,,,,0,"fee schedule",EAPG,17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.87,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule",EAPG,17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.39,37.7,,21.11,,,0,"percent of total billed charges","37.7% of total billed charges",26.39,37.7,,21.11,,,0,"percent of total billed charges","37.70% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.73,33.9,,18.98,,,0,"percent of total billed charges","33.9% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.6,78,,43.68,,,0,"percent of total billed charges","78% of total billed charges",17.93,101,,,,,0,"fee schedule","101% of CMS fee schedule ",57.82,82.6,,46.26,,,0,"percent of total billed charges","82.6% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.82,82.6,,46.26,,,0,"percent of total billed charges","82.6% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",11.53,70,
"009100 Pap Smear LC",31188164,CDM,311,RC,88164,CPT,OUTPATIENT,,,48,31.2,,42.24,88,,33.79,,,0,"percent of total billed charges","88% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",31.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.03,100,,,,,0,"fee schedule",EAPG,17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.24,63,,24.19,,,0,"percent of total billed charges","63% of total billed charges",26.64,150,,,,,0,"fee schedule","150% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,33.12,69,,,,,0,"fee schedule","69% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.94,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.76,100,,,,,0,"fee schedule","100% of LI fee schedule",11.53,100,,,,,0,"fee schedule",EAPG,17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.87,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule",EAPG,17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.1,37.7,,14.48,,,0,"percent of total billed charges","37.7% of total billed charges",18.1,37.7,,14.48,,,0,"percent of total billed charges","37.70% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.27,33.9,,13.02,,,0,"percent of total billed charges","33.9% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.44,78,,29.95,,,0,"percent of total billed charges","78% of total billed charges",17.93,101,,,,,0,"fee schedule","101% of CMS fee schedule ",39.65,82.6,,31.72,,,0,"percent of total billed charges","82.6% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.65,82.6,,31.72,,,0,"percent of total billed charges","82.6% of total billed charges",17.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",11.53,57.94,
"Parathyroid Hormone Intact",30083970,CDM,300,RC,83970,CPT,OUTPATIENT,,,205,133.25,,180.4,88,,144.32,,,0,"percent of total billed charges","88% of total billed charges",41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,205,100,,164.00,,,0,"percent of total billed charges","100% of total billed charges",72.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",30.04,100,,,,,0,"fee schedule",EAPG,41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.15,63,,103.32,,,0,"percent of total billed charges","63% of total billed charges",31.37,15.3,,25.10,,,0,"percent of total billed charges","15.3% of total billed charges",29.16,100,,,,,0,"fee schedule",EAPG,141.45,69,,,,,0,"fee schedule","69% of total billed charges",205,100,,164.00,,,0,"percent of total billed charges","100% of total billed charges",41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",205,100,,164.00,,,0,"percent of total billed charges","100% of total billed charges",41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",205,100,,164.00,,,0,"percent of total billed charges","100% of total billed charges",41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",157.89,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.28,100,,,,,0,"fee schedule","100% of LI fee schedule",21.6,100,,,,,0,"fee schedule",EAPG,41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.74,100,,,,,0,"fee schedule",EAPG,37.91,100,,,,,0,"fee schedule",EAPG,41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.29,37.7,,61.83,,,0,"percent of total billed charges","37.7% of total billed charges",77.29,37.7,,61.83,,,0,"percent of total billed charges","37.70% of total billed charges",41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.5,33.9,,55.60,,,0,"percent of total billed charges","33.9% of total billed charges",41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",159.9,78,,127.92,,,0,"percent of total billed charges","78% of total billed charges",41.69,101,,,,,0,"fee schedule","101% of CMS fee schedule ",169.33,82.6,,135.46,,,0,"percent of total billed charges","82.6% of total billed charges",29.16,100,,,,,0,"fee schedule",EAPG,41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",169.33,82.6,,135.46,,,0,"percent of total billed charges","82.6% of total billed charges",41.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,205,100,,164.00,,,0,"percent of total billed charges","100% of total billed charges",21.6,205,
"Partial Thromboplastin Time",30085730,CDM,305,RC,85730,CPT,OUTPATIENT,,,117,76.05,,102.96,88,,82.37,,,0,"percent of total billed charges","88% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",10.51,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.71,63,,58.97,,,0,"percent of total billed charges","63% of total billed charges",17.9,15.3,,14.32,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,80.73,69,,,,,0,"fee schedule","69% of total billed charges",117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.98,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.01,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.11,37.7,,35.29,,,0,"percent of total billed charges","37.7% of total billed charges",44.11,37.7,,35.29,,,0,"percent of total billed charges","37.70% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.66,33.9,,31.73,,,0,"percent of total billed charges","33.9% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.26,78,,73.01,,,0,"percent of total billed charges","78% of total billed charges",6.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",96.64,82.6,,77.31,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",96.64,82.6,,77.31,,,0,"percent of total billed charges","82.6% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",2.48,117,
"Parvo B19 IgG LC",30286747,CDM,302,RC,86747,CPT,OUTPATIENT,,,67,43.55,,58.96,88,,47.17,,,0,"percent of total billed charges","88% of total billed charges",15.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",26.3,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,15.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.21,63,,33.77,,,0,"percent of total billed charges","63% of total billed charges",10.25,15.3,,8.20,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,46.23,69,,,,,0,"fee schedule","69% of total billed charges",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",15.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",15.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",15.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.48,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,15.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.03,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,15.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,15.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.26,37.7,,20.21,,,0,"percent of total billed charges","37.7% of total billed charges",25.26,37.7,,20.21,,,0,"percent of total billed charges","37.70% of total billed charges",15.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.71,33.9,,18.17,,,0,"percent of total billed charges","33.9% of total billed charges",15.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.26,78,,41.81,,,0,"percent of total billed charges","78% of total billed charges",15.18,101,,,,,0,"fee schedule","101% of CMS fee schedule ",55.34,82.6,,44.27,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,15.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.34,82.6,,44.27,,,0,"percent of total billed charges","82.6% of total billed charges",15.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",6.96,67,
"Pathology Report LC",9958018,CDM,312,RC,88300,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",20.32,100,,,,,0,"fee schedule",EAPG,25.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",14.76,25.9,
"Phenobarbital Level",30180184,CDM,301,RC,80184,CPT,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",15.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",26.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,15.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",15.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",15.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",15.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.52,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,15.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.3,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,15.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,15.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.7% of total billed charges",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",15.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.55,33.9,,42.04,,,0,"percent of total billed charges","33.9% of total billed charges",15.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",15.45,101,,,,,0,"fee schedule","101% of CMS fee schedule ",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,15.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",15.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",7,155,
PHENOBARBITAL,30180184,CDM,301,RC,80184,CPT,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",15.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",26.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,15.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",15.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",15.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",15.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.52,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,15.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.3,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,15.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,15.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.7% of total billed charges",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",15.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.55,33.9,,42.04,,,0,"percent of total billed charges","33.9% of total billed charges",15.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",15.45,101,,,,,0,"fee schedule","101% of CMS fee schedule ",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,15.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",15.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",7,155,
Phenytoin,30180185,CDM,301,RC,80185,CPT,OUTPATIENT,,,243,157.95,,213.84,88,,171.07,,,0,"percent of total billed charges","88% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,243,100,,194.40,,,0,"percent of total billed charges","100% of total billed charges",23.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",153.09,63,,122.47,,,0,"percent of total billed charges","63% of total billed charges",37.18,15.3,,29.74,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,167.67,69,,,,,0,"fee schedule","69% of total billed charges",243,100,,194.40,,,0,"percent of total billed charges","100% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",243,100,,194.40,,,0,"percent of total billed charges","100% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",243,100,,194.40,,,0,"percent of total billed charges","100% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.68,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.25,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.61,37.7,,73.29,,,0,"percent of total billed charges","37.7% of total billed charges",91.61,37.7,,73.29,,,0,"percent of total billed charges","37.70% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.38,33.9,,65.90,,,0,"percent of total billed charges","33.9% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",189.54,78,,151.63,,,0,"percent of total billed charges","78% of total billed charges",13.38,101,,,,,0,"fee schedule","101% of CMS fee schedule ",200.72,82.6,,160.58,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",200.72,82.6,,160.58,,,0,"percent of total billed charges","82.6% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,243,100,,194.40,,,0,"percent of total billed charges","100% of total billed charges",7,243,
"PHENYTOIN FREE",30180186,CDM,301,RC,80186,CPT,OUTPATIENT,,,160,104,,140.8,88,,112.64,,,0,"percent of total billed charges","88% of total billed charges",13.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",24.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,13.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.8,63,,80.64,,,0,"percent of total billed charges","63% of total billed charges",24.48,15.3,,19.58,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,110.4,69,,,,,0,"fee schedule","69% of total billed charges",160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",13.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",13.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",13.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.63,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,13.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.76,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,13.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,13.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.32,37.7,,48.26,,,0,"percent of total billed charges","37.7% of total billed charges",60.32,37.7,,48.26,,,0,"percent of total billed charges","37.70% of total billed charges",13.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.24,33.9,,43.39,,,0,"percent of total billed charges","33.9% of total billed charges",13.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.8,78,,99.84,,,0,"percent of total billed charges","78% of total billed charges",13.89,101,,,,,0,"fee schedule","101% of CMS fee schedule ",132.16,82.6,,105.73,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,13.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",132.16,82.6,,105.73,,,0,"percent of total billed charges","82.6% of total billed charges",13.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",7,160,
"Phenytoin, Free, Serum LC",30180186,CDM,301,RC,80186,CPT,OUTPATIENT,,,160,104,,140.8,88,,112.64,,,0,"percent of total billed charges","88% of total billed charges",13.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",24.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,13.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.8,63,,80.64,,,0,"percent of total billed charges","63% of total billed charges",24.48,15.3,,19.58,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,110.4,69,,,,,0,"fee schedule","69% of total billed charges",160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",13.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",13.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",13.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.63,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,13.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.76,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,13.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,13.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.32,37.7,,48.26,,,0,"percent of total billed charges","37.7% of total billed charges",60.32,37.7,,48.26,,,0,"percent of total billed charges","37.70% of total billed charges",13.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.24,33.9,,43.39,,,0,"percent of total billed charges","33.9% of total billed charges",13.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.8,78,,99.84,,,0,"percent of total billed charges","78% of total billed charges",13.89,101,,,,,0,"fee schedule","101% of CMS fee schedule ",132.16,82.6,,105.73,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,13.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",132.16,82.6,,105.73,,,0,"percent of total billed charges","82.6% of total billed charges",13.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",7,160,
Phosphorus,30184100,CDM,301,RC,84100,CPT,OUTPATIENT,,,111,72.15,,97.68,88,,78.14,,,0,"percent of total billed charges","88% of total billed charges",4.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",8.29,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.93,63,,55.94,,,0,"percent of total billed charges","63% of total billed charges",16.98,15.3,,13.58,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,76.59,69,,,,,0,"fee schedule","69% of total billed charges",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",4.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",4.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",4.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.13,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.74,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.85,37.7,,33.48,,,0,"percent of total billed charges","37.7% of total billed charges",41.85,37.7,,33.48,,,0,"percent of total billed charges","37.70% of total billed charges",4.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.63,33.9,,30.10,,,0,"percent of total billed charges","33.9% of total billed charges",4.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",86.58,78,,69.26,,,0,"percent of total billed charges","78% of total billed charges",4.78,101,,,,,0,"fee schedule","101% of CMS fee schedule ",91.69,82.6,,73.35,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.69,82.6,,73.35,,,0,"percent of total billed charges","82.6% of total billed charges",4.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",3.25,111,
"PHOSPHORUS, RANDOM URINE",30184105,CDM,301,RC,84105,CPT,OUTPATIENT,,,52,33.8,,45.76,88,,36.61,,,0,"percent of total billed charges","88% of total billed charges",5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",10.11,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.76,63,,26.21,,,0,"percent of total billed charges","63% of total billed charges",7.96,15.3,,6.37,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,35.88,69,,,,,0,"fee schedule","69% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.78,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.6,37.7,,15.68,,,0,"percent of total billed charges","37.7% of total billed charges",19.6,37.7,,15.68,,,0,"percent of total billed charges","37.70% of total billed charges",5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.63,33.9,,14.10,,,0,"percent of total billed charges","33.9% of total billed charges",5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.56,78,,32.45,,,0,"percent of total billed charges","78% of total billed charges",5.83,101,,,,,0,"fee schedule","101% of CMS fee schedule ",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,52,
"PHOSPHORUS 24HR URINE",30184105,CDM,301,RC,84105,CPT,OUTPATIENT,,,52,33.8,,45.76,88,,36.61,,,0,"percent of total billed charges","88% of total billed charges",5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",10.11,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.76,63,,26.21,,,0,"percent of total billed charges","63% of total billed charges",7.96,15.3,,6.37,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,35.88,69,,,,,0,"fee schedule","69% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.78,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.6,37.7,,15.68,,,0,"percent of total billed charges","37.7% of total billed charges",19.6,37.7,,15.68,,,0,"percent of total billed charges","37.70% of total billed charges",5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.63,33.9,,14.10,,,0,"percent of total billed charges","33.9% of total billed charges",5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.56,78,,32.45,,,0,"percent of total billed charges","78% of total billed charges",5.83,101,,,,,0,"fee schedule","101% of CMS fee schedule ",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",5.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,52,
"PINWORM PREP",30687172,CDM,306,RC,87172,CPT,OUTPATIENT,,,110,71.5,,96.8,88,,77.44,,,0,"percent of total billed charges","88% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",7.47,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.3,63,,55.44,,,0,"percent of total billed charges","63% of total billed charges",16.83,15.3,,13.46,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,75.9,69,,,,,0,"fee schedule","69% of total billed charges",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.33,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.26,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.47,37.7,,33.18,,,0,"percent of total billed charges","37.7% of total billed charges",41.47,37.7,,33.18,,,0,"percent of total billed charges","37.70% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.29,33.9,,29.83,,,0,"percent of total billed charges","33.9% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.8,78,,68.64,,,0,"percent of total billed charges","78% of total billed charges",4.31,101,,,,,0,"fee schedule","101% of CMS fee schedule ",90.86,82.6,,72.69,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.86,82.6,,72.69,,,0,"percent of total billed charges","82.6% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",4.26,110,
"AUTOMATED PLATELET COUNT",30585049,CDM,305,RC,85049,CPT,OUTPATIENT,,,28,18.2,,24.64,88,,19.71,,,0,"percent of total billed charges","88% of total billed charges",4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",7.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.23,100,,,,,0,"fee schedule",EAPG,4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.64,63,,14.11,,,0,"percent of total billed charges","63% of total billed charges",4.28,15.3,,3.42,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,19.32,69,,,,,0,"fee schedule","69% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.13,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule","100% of LI fee schedule",3.76,100,,,,,0,"fee schedule",EAPG,4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.56,37.7,,8.45,,,0,"percent of total billed charges","37.7% of total billed charges",10.56,37.7,,8.45,,,0,"percent of total billed charges","37.70% of total billed charges",4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.49,33.9,,7.59,,,0,"percent of total billed charges","33.9% of total billed charges",4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.84,78,,17.47,,,0,"percent of total billed charges","78% of total billed charges",4.52,101,,,,,0,"fee schedule","101% of CMS fee schedule ",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",3.76,28,
"PLATELET AGGREGATION",30585576,CDM,305,RC,85576,CPT,OUTPATIENT,,,184,119.6,,161.92,88,,129.54,,,0,"percent of total billed charges","88% of total billed charges",24.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.29,100,,,,,0,"fee schedule",EAPG,184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",43.59,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.78,100,,,,,0,"fee schedule",EAPG,24.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",115.92,63,,92.74,,,0,"percent of total billed charges","63% of total billed charges",28.15,15.3,,22.52,,,0,"percent of total billed charges","15.3% of total billed charges",16.29,100,,,,,0,"fee schedule",EAPG,126.96,69,,,,,0,"fee schedule","69% of total billed charges",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",24.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",24.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",24.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.28,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",16.29,100,,,,,0,"fee schedule",EAPG,24.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.91,100,,,,,0,"fee schedule","100% of LI fee schedule",12.07,100,,,,,0,"fee schedule",EAPG,24.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.62,100,,,,,0,"fee schedule",EAPG,21.18,100,,,,,0,"fee schedule",EAPG,24.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.37,37.7,,55.50,,,0,"percent of total billed charges","37.7% of total billed charges",69.37,37.7,,55.50,,,0,"percent of total billed charges","37.70% of total billed charges",24.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.38,33.9,,49.90,,,0,"percent of total billed charges","33.9% of total billed charges",24.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",143.52,78,,114.82,,,0,"percent of total billed charges","78% of total billed charges",25.15,101,,,,,0,"fee schedule","101% of CMS fee schedule ",151.98,82.6,,121.58,,,0,"percent of total billed charges","82.6% of total billed charges",16.29,100,,,,,0,"fee schedule",EAPG,24.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.98,82.6,,121.58,,,0,"percent of total billed charges","82.6% of total billed charges",24.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.29,100,,,,,0,"fee schedule",EAPG,184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",12.07,184,
"Platelet Count Manual",30085049,CDM,300,RC,85049,CPT,OUTPATIENT,,,28,18.2,,24.64,88,,19.71,,,0,"percent of total billed charges","88% of total billed charges",4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",7.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.23,100,,,,,0,"fee schedule",EAPG,4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.64,63,,14.11,,,0,"percent of total billed charges","63% of total billed charges",4.28,15.3,,3.42,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,19.32,69,,,,,0,"fee schedule","69% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.13,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule","100% of LI fee schedule",3.76,100,,,,,0,"fee schedule",EAPG,4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.56,37.7,,8.45,,,0,"percent of total billed charges","37.7% of total billed charges",10.56,37.7,,8.45,,,0,"percent of total billed charges","37.70% of total billed charges",4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.49,33.9,,7.59,,,0,"percent of total billed charges","33.9% of total billed charges",4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.84,78,,17.47,,,0,"percent of total billed charges","78% of total billed charges",4.52,101,,,,,0,"fee schedule","101% of CMS fee schedule ",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",4.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",3.76,28,
"Platelet Antibody Profile LC",30286022,CDM,302,RC,86022,CPT,OUTPATIENT,,,111,72.15,,97.68,88,,78.14,,,0,"percent of total billed charges","88% of total billed charges",18.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",32.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,18.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.93,63,,55.94,,,0,"percent of total billed charges","63% of total billed charges",16.98,15.3,,13.58,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,76.59,69,,,,,0,"fee schedule","69% of total billed charges",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",18.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",18.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",18.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.26,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,18.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.37,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,18.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,18.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.85,37.7,,33.48,,,0,"percent of total billed charges","37.7% of total billed charges",41.85,37.7,,33.48,,,0,"percent of total billed charges","37.70% of total billed charges",18.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.63,33.9,,30.10,,,0,"percent of total billed charges","33.9% of total billed charges",18.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",86.58,78,,69.26,,,0,"percent of total billed charges","78% of total billed charges",18.55,101,,,,,0,"fee schedule","101% of CMS fee schedule ",91.69,82.6,,73.35,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,18.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.69,82.6,,73.35,,,0,"percent of total billed charges","82.6% of total billed charges",18.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",6.96,111,
"Pleural Fluid Cytology LC",31188112,CDM,311,RC,88112,CPT,OUTPATIENT,,,215,139.75,,189.2,88,,151.36,,,0,"percent of total billed charges","88% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",96.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",26.78,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",135.45,63,,108.36,,,0,"percent of total billed charges","63% of total billed charges",32.9,15.3,,26.32,,,0,"percent of total billed charges","15.3% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,148.35,69,,,,,0,"fee schedule","69% of total billed charges",215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.15,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.26,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.52,100,,,,,0,"fee schedule",EAPG,33.8,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",81.06,37.7,,64.85,,,0,"percent of total billed charges","37.7% of total billed charges",81.06,37.7,,64.85,,,0,"percent of total billed charges","37.70% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",72.89,33.9,,58.31,,,0,"percent of total billed charges","33.9% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",167.7,78,,134.16,,,0,"percent of total billed charges","78% of total billed charges",55.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.59,82.6,,142.07,,,0,"percent of total billed charges","82.6% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.59,82.6,,142.07,,,0,"percent of total billed charges","82.6% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",19.26,215,
"Pneumocystis PCR LC 816658",30687798,CDM,306,RC,87798,CPT,OUTPATIENT,,,733,476.45,,645.04,88,,516.03,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,733,100,,586.40,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",461.79,63,,369.43,,,0,"percent of total billed charges","63% of total billed charges",112.15,15.3,,89.72,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,505.77,69,,,,,0,"fee schedule","69% of total billed charges",733,100,,586.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",733,100,,586.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",733,100,,586.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",276.34,37.7,,221.07,,,0,"percent of total billed charges","37.7% of total billed charges",276.34,37.7,,221.07,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",248.49,33.9,,198.79,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",571.74,78,,457.39,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",605.46,82.6,,484.37,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",605.46,82.6,,484.37,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,733,100,,586.40,,,0,"percent of total billed charges","100% of total billed charges",18.33,733,
"Porphyrins Qn Urine LC",30184120,CDM,301,RC,84120,CPT,OUTPATIENT,,,108,70.2,,95.04,88,,76.03,,,0,"percent of total billed charges","88% of total billed charges",14.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",25.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,14.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.04,63,,54.43,,,0,"percent of total billed charges","63% of total billed charges",16.52,15.3,,13.22,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,74.52,69,,,,,0,"fee schedule","69% of total billed charges",108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",14.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",14.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",14.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.26,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,14.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.71,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,14.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,14.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.72,37.7,,32.58,,,0,"percent of total billed charges","37.7% of total billed charges",40.72,37.7,,32.58,,,0,"percent of total billed charges","37.70% of total billed charges",14.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.61,33.9,,29.29,,,0,"percent of total billed charges","33.9% of total billed charges",14.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",84.24,78,,67.39,,,0,"percent of total billed charges","78% of total billed charges",14.85,101,,,,,0,"fee schedule","101% of CMS fee schedule ",89.21,82.6,,71.37,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,14.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.21,82.6,,71.37,,,0,"percent of total billed charges","82.6% of total billed charges",14.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,108,
Potassium,30184132,CDM,301,RC,84132,CPT,OUTPATIENT,,,102,66.3,,89.76,88,,71.81,,,0,"percent of total billed charges","88% of total billed charges",4.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",8.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.26,63,,51.41,,,0,"percent of total billed charges","63% of total billed charges",15.61,15.3,,12.49,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,70.38,69,,,,,0,"fee schedule","69% of total billed charges",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",4.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",4.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",4.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.2,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.76,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.45,37.7,,30.76,,,0,"percent of total billed charges","37.7% of total billed charges",38.45,37.7,,30.76,,,0,"percent of total billed charges","37.70% of total billed charges",4.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.58,33.9,,27.66,,,0,"percent of total billed charges","33.9% of total billed charges",4.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.56,78,,63.65,,,0,"percent of total billed charges","78% of total billed charges",4.8,101,,,,,0,"fee schedule","101% of CMS fee schedule ",84.25,82.6,,67.40,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",84.25,82.6,,67.40,,,0,"percent of total billed charges","82.6% of total billed charges",4.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,102,
"POTASSIUM 24HR URINE",30184133,CDM,301,RC,84133,CPT,OUTPATIENT,,,78,50.7,,68.64,88,,54.91,,,0,"percent of total billed charges","88% of total billed charges",4.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",8.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.14,63,,39.31,,,0,"percent of total billed charges","63% of total billed charges",11.93,15.3,,9.54,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,53.82,69,,,,,0,"fee schedule","69% of total billed charges",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",4.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",4.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",4.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.09,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.73,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.41,37.7,,23.53,,,0,"percent of total billed charges","37.7% of total billed charges",29.41,37.7,,23.53,,,0,"percent of total billed charges","37.70% of total billed charges",4.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.44,33.9,,21.15,,,0,"percent of total billed charges","33.9% of total billed charges",4.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.84,78,,48.67,,,0,"percent of total billed charges","78% of total billed charges",4.77,101,,,,,0,"fee schedule","101% of CMS fee schedule ",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",4.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,78,
"Potassium Body Fluid",30184132,CDM,301,RC,84132,CPT,OUTPATIENT,,,102,66.3,,89.76,88,,71.81,,,0,"percent of total billed charges","88% of total billed charges",4.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",8.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.26,63,,51.41,,,0,"percent of total billed charges","63% of total billed charges",15.61,15.3,,12.49,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,70.38,69,,,,,0,"fee schedule","69% of total billed charges",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",4.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",4.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",4.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.2,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.76,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.45,37.7,,30.76,,,0,"percent of total billed charges","37.7% of total billed charges",38.45,37.7,,30.76,,,0,"percent of total billed charges","37.70% of total billed charges",4.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.58,33.9,,27.66,,,0,"percent of total billed charges","33.9% of total billed charges",4.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.56,78,,63.65,,,0,"percent of total billed charges","78% of total billed charges",4.8,101,,,,,0,"fee schedule","101% of CMS fee schedule ",84.25,82.6,,67.40,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",84.25,82.6,,67.40,,,0,"percent of total billed charges","82.6% of total billed charges",4.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,102,
"POTASSIUM RANDOM URINE",30184133,CDM,301,RC,84133,CPT,OUTPATIENT,,,78,50.7,,68.64,88,,54.91,,,0,"percent of total billed charges","88% of total billed charges",4.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",8.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.14,63,,39.31,,,0,"percent of total billed charges","63% of total billed charges",11.93,15.3,,9.54,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,53.82,69,,,,,0,"fee schedule","69% of total billed charges",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",4.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",4.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",4.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.09,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.73,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.41,37.7,,23.53,,,0,"percent of total billed charges","37.7% of total billed charges",29.41,37.7,,23.53,,,0,"percent of total billed charges","37.70% of total billed charges",4.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.44,33.9,,21.15,,,0,"percent of total billed charges","33.9% of total billed charges",4.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.84,78,,48.67,,,0,"percent of total billed charges","78% of total billed charges",4.77,101,,,,,0,"fee schedule","101% of CMS fee schedule ",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",4.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,78,
PREALBUMIN,30184134,CDM,301,RC,84134,CPT,OUTPATIENT,,,90,58.5,,79.2,88,,63.36,,,0,"percent of total billed charges","88% of total billed charges",14.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",25.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,14.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.7,63,,45.36,,,0,"percent of total billed charges","63% of total billed charges",13.77,15.3,,11.02,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,62.1,69,,,,,0,"fee schedule","69% of total billed charges",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",14.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",14.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",14.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.8,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,14.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.59,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,14.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,14.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.93,37.7,,27.14,,,0,"percent of total billed charges","37.7% of total billed charges",33.93,37.7,,27.14,,,0,"percent of total billed charges","37.70% of total billed charges",14.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.51,33.9,,24.41,,,0,"percent of total billed charges","33.9% of total billed charges",14.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.2,78,,56.16,,,0,"percent of total billed charges","78% of total billed charges",14.73,101,,,,,0,"fee schedule","101% of CMS fee schedule ",74.34,82.6,,59.47,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,14.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.34,82.6,,59.47,,,0,"percent of total billed charges","82.6% of total billed charges",14.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",8.11,90,
"Prealbumin LC",30184134,CDM,301,RC,84134,CPT,OUTPATIENT,,,100,65,,88,88,,70.40,,,0,"percent of total billed charges","88% of total billed charges",14.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",25.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,14.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",63,63,,50.40,,,0,"percent of total billed charges","63% of total billed charges",15.3,15.3,,12.24,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,69,69,,,,,0,"fee schedule","69% of total billed charges",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",14.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",14.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",14.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.8,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,14.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.59,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,14.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,14.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.7% of total billed charges",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.70% of total billed charges",14.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.9,33.9,,27.12,,,0,"percent of total billed charges","33.9% of total billed charges",14.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,78,,62.40,,,0,"percent of total billed charges","78% of total billed charges",14.73,101,,,,,0,"fee schedule","101% of CMS fee schedule ",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,14.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",14.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",8.11,100,
"Pregnenolone, MS LC",30184140,CDM,301,RC,84140,CPT,OUTPATIENT,,,229,148.85,,201.52,88,,161.22,,,0,"percent of total billed charges","88% of total billed charges",20.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,229,100,,183.20,,,0,"percent of total billed charges","100% of total billed charges",36.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,20.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.27,63,,115.42,,,0,"percent of total billed charges","63% of total billed charges",35.04,15.3,,28.03,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,158.01,69,,,,,0,"fee schedule","69% of total billed charges",229,100,,183.20,,,0,"percent of total billed charges","100% of total billed charges",20.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",229,100,,183.20,,,0,"percent of total billed charges","100% of total billed charges",20.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",229,100,,183.20,,,0,"percent of total billed charges","100% of total billed charges",20.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.06,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,20.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.67,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,20.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,20.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",86.33,37.7,,69.06,,,0,"percent of total billed charges","37.7% of total billed charges",86.33,37.7,,69.06,,,0,"percent of total billed charges","37.70% of total billed charges",20.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.63,33.9,,62.10,,,0,"percent of total billed charges","33.9% of total billed charges",20.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",178.62,78,,142.90,,,0,"percent of total billed charges","78% of total billed charges",20.87,101,,,,,0,"fee schedule","101% of CMS fee schedule ",189.15,82.6,,151.32,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,20.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",189.15,82.6,,151.32,,,0,"percent of total billed charges","82.6% of total billed charges",20.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,229,100,,183.20,,,0,"percent of total billed charges","100% of total billed charges",8.39,229,
"144053 Pregnancy, Initial Screen LC",30286592,CDM,302,RC,86592,CPT,OUTPATIENT,,,110,71.5,,96.8,88,,77.44,,,0,"percent of total billed charges","88% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",7.47,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.3,63,,55.44,,,0,"percent of total billed charges","63% of total billed charges",16.83,15.3,,13.46,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,75.9,69,,,,,0,"fee schedule","69% of total billed charges",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.33,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.26,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.47,37.7,,33.18,,,0,"percent of total billed charges","37.7% of total billed charges",41.47,37.7,,33.18,,,0,"percent of total billed charges","37.70% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.29,33.9,,29.83,,,0,"percent of total billed charges","33.9% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.8,78,,68.64,,,0,"percent of total billed charges","78% of total billed charges",4.31,101,,,,,0,"fee schedule","101% of CMS fee schedule ",90.86,82.6,,72.69,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.86,82.6,,72.69,,,0,"percent of total billed charges","82.6% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",4.26,110,
"Procalcitonin (PCT)",30184145,CDM,301,RC,84145,CPT,OUTPATIENT,,,954,620.1,,839.52,88,,671.62,,,0,"percent of total billed charges","88% of total billed charges",27.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,954,100,,763.20,,,0,"percent of total billed charges","100% of total billed charges",47.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,27.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",601.02,63,,480.82,,,0,"percent of total billed charges","63% of total billed charges",145.96,15.3,,116.77,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,658.26,69,,,,,0,"fee schedule","69% of total billed charges",954,100,,763.20,,,0,"percent of total billed charges","100% of total billed charges",27.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",954,100,,763.20,,,0,"percent of total billed charges","100% of total billed charges",27.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",954,100,,763.20,,,0,"percent of total billed charges","100% of total billed charges",27.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",104.11,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,27.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.22,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,27.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,27.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",359.66,37.7,,287.73,,,0,"percent of total billed charges","37.7% of total billed charges",359.66,37.7,,287.73,,,0,"percent of total billed charges","37.70% of total billed charges",27.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",323.41,33.9,,258.73,,,0,"percent of total billed charges","33.9% of total billed charges",27.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",744.12,78,,595.30,,,0,"percent of total billed charges","78% of total billed charges",27.49,101,,,,,0,"fee schedule","101% of CMS fee schedule ",788,82.6,,630.40,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,27.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",788,82.6,,630.40,,,0,"percent of total billed charges","82.6% of total billed charges",27.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,954,100,,763.20,,,0,"percent of total billed charges","100% of total billed charges",8.39,954,
"Progesterone LC",30184144,CDM,301,RC,84144,CPT,OUTPATIENT,,,561,364.65,,493.68,88,,394.94,,,0,"percent of total billed charges","88% of total billed charges",20.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,561,100,,448.80,,,0,"percent of total billed charges","100% of total billed charges",36.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,20.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",353.43,63,,282.74,,,0,"percent of total billed charges","63% of total billed charges",85.83,15.3,,68.66,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,387.09,69,,,,,0,"fee schedule","69% of total billed charges",561,100,,448.80,,,0,"percent of total billed charges","100% of total billed charges",20.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",561,100,,448.80,,,0,"percent of total billed charges","100% of total billed charges",20.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",561,100,,448.80,,,0,"percent of total billed charges","100% of total billed charges",20.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.78,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,20.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.86,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,20.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,20.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",211.5,37.7,,169.20,,,0,"percent of total billed charges","37.7% of total billed charges",211.5,37.7,,169.20,,,0,"percent of total billed charges","37.70% of total billed charges",20.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",190.18,33.9,,152.14,,,0,"percent of total billed charges","33.9% of total billed charges",20.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",437.58,78,,350.06,,,0,"percent of total billed charges","78% of total billed charges",21.06,101,,,,,0,"fee schedule","101% of CMS fee schedule ",463.39,82.6,,370.71,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,20.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",463.39,82.6,,370.71,,,0,"percent of total billed charges","82.6% of total billed charges",20.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,561,100,,448.80,,,0,"percent of total billed charges","100% of total billed charges",8.39,561,
"Prolactin LC",30184146,CDM,301,RC,84146,CPT,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",19.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",33.91,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,19.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",19.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",19.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",19.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.12,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,19.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.38,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,19.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,19.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",19.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",19.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",19.57,101,,,,,0,"fee schedule","101% of CMS fee schedule ",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,19.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",19.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",8.39,402,
"PSA Total",30184153,CDM,301,RC,84153,CPT,OUTPATIENT,,,424,275.6,,373.12,88,,298.50,,,0,"percent of total billed charges","88% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,424,100,,339.20,,,0,"percent of total billed charges","100% of total billed charges",32.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",267.12,63,,213.70,,,0,"percent of total billed charges","63% of total billed charges",64.87,15.3,,51.90,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,292.56,69,,,,,0,"fee schedule","69% of total billed charges",424,100,,339.20,,,0,"percent of total billed charges","100% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",424,100,,339.20,,,0,"percent of total billed charges","100% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",424,100,,339.20,,,0,"percent of total billed charges","100% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.39,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",159.85,37.7,,127.88,,,0,"percent of total billed charges","37.7% of total billed charges",159.85,37.7,,127.88,,,0,"percent of total billed charges","37.70% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",143.74,33.9,,114.99,,,0,"percent of total billed charges","33.9% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",330.72,78,,264.58,,,0,"percent of total billed charges","78% of total billed charges",18.57,101,,,,,0,"fee schedule","101% of CMS fee schedule ",350.22,82.6,,280.18,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",350.22,82.6,,280.18,,,0,"percent of total billed charges","82.6% of total billed charges",18.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,424,100,,339.20,,,0,"percent of total billed charges","100% of total billed charges",8.11,424,
"Prostatic Acid Phos LC",30184066,CDM,301,RC,84066,CPT,OUTPATIENT,,,210,136.5,,184.8,88,,147.84,,,0,"percent of total billed charges","88% of total billed charges",9.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",16.9,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,9.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",132.3,63,,105.84,,,0,"percent of total billed charges","63% of total billed charges",32.13,15.3,,25.70,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,144.9,69,,,,,0,"fee schedule","69% of total billed charges",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",9.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",9.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",9.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.94,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,9.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.66,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,9.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,9.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.17,37.7,,63.34,,,0,"percent of total billed charges","37.7% of total billed charges",79.17,37.7,,63.34,,,0,"percent of total billed charges","37.70% of total billed charges",9.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.19,33.9,,56.95,,,0,"percent of total billed charges","33.9% of total billed charges",9.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.8,78,,131.04,,,0,"percent of total billed charges","78% of total billed charges",9.75,101,,,,,0,"fee schedule","101% of CMS fee schedule ",173.46,82.6,,138.77,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,9.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",173.46,82.6,,138.77,,,0,"percent of total billed charges","82.6% of total billed charges",9.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",3.25,210,
"Prothrombin Time and INR",30085610,CDM,300,RC,85610,CPT,OUTPATIENT,,,73,47.45,,64.24,88,,51.39,,,0,"percent of total billed charges","88% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",7.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.99,63,,36.79,,,0,"percent of total billed charges","63% of total billed charges",11.17,15.3,,8.94,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,50.37,69,,,,,0,"fee schedule","69% of total billed charges",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.4,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.29,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.52,37.7,,22.02,,,0,"percent of total billed charges","37.7% of total billed charges",27.52,37.7,,22.02,,,0,"percent of total billed charges","37.70% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,33.9,,19.80,,,0,"percent of total billed charges","33.9% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.94,78,,45.55,,,0,"percent of total billed charges","78% of total billed charges",4.33,101,,,,,0,"fee schedule","101% of CMS fee schedule ",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",2.48,73,
"Protein 24 Hr Urine",30184156,CDM,301,RC,84156,CPT,OUTPATIENT,,,439,285.35,,386.32,88,,309.06,,,0,"percent of total billed charges","88% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",6.42,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",276.57,63,,221.26,,,0,"percent of total billed charges","63% of total billed charges",67.17,15.3,,53.74,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,302.91,69,,,,,0,"fee schedule","69% of total billed charges",439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.03,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.67,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",165.5,37.7,,132.40,,,0,"percent of total billed charges","37.7% of total billed charges",165.5,37.7,,132.40,,,0,"percent of total billed charges","37.70% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",148.82,33.9,,119.06,,,0,"percent of total billed charges","33.9% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",342.42,78,,273.94,,,0,"percent of total billed charges","78% of total billed charges",3.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",362.61,82.6,,290.09,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",362.61,82.6,,290.09,,,0,"percent of total billed charges","82.6% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",3.25,439,
"Protein Total",30184155,CDM,301,RC,84155,CPT,OUTPATIENT,,,87,56.55,,76.56,88,,61.25,,,0,"percent of total billed charges","88% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",6.42,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.81,63,,43.85,,,0,"percent of total billed charges","63% of total billed charges",13.31,15.3,,10.65,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,60.03,69,,,,,0,"fee schedule","69% of total billed charges",87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.03,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.67,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.8,37.7,,26.24,,,0,"percent of total billed charges","37.7% of total billed charges",32.8,37.7,,26.24,,,0,"percent of total billed charges","37.70% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.49,33.9,,23.59,,,0,"percent of total billed charges","33.9% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.86,78,,54.29,,,0,"percent of total billed charges","78% of total billed charges",3.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",71.86,82.6,,57.49,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.86,82.6,,57.49,,,0,"percent of total billed charges","82.6% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,87,
"Protein Body Fluid",30184157,CDM,301,RC,84157,CPT,OUTPATIENT,,,67,43.55,,58.96,88,,47.17,,,0,"percent of total billed charges","88% of total billed charges",4,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",7,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.21,63,,33.77,,,0,"percent of total billed charges","63% of total billed charges",10.25,15.3,,8.20,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,46.23,69,,,,,0,"fee schedule","69% of total billed charges",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",4,100,,,,,0,"fee schedule","100% of CMS fee schedule",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",4,100,,,,,0,"fee schedule","100% of CMS fee schedule",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",4,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.3,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4,100,,,,,0,"fee schedule","100% of CMS fee schedule",4,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.26,37.7,,20.21,,,0,"percent of total billed charges","37.7% of total billed charges",25.26,37.7,,20.21,,,0,"percent of total billed charges","37.70% of total billed charges",4,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.71,33.9,,18.17,,,0,"percent of total billed charges","33.9% of total billed charges",4,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.26,78,,41.81,,,0,"percent of total billed charges","78% of total billed charges",4.04,101,,,,,0,"fee schedule","101% of CMS fee schedule ",55.34,82.6,,44.27,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.34,82.6,,44.27,,,0,"percent of total billed charges","82.6% of total billed charges",4,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,67,
"Protein CSF",30084157,CDM,300,RC,84157,CPT,OUTPATIENT,,,364,236.6,,320.32,88,,256.26,,,0,"percent of total billed charges","88% of total billed charges",4,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,364,100,,291.20,,,0,"percent of total billed charges","100% of total billed charges",7,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4,100,,,,,0,"fee schedule","100% of CMS fee schedule",229.32,63,,183.46,,,0,"percent of total billed charges","63% of total billed charges",55.69,15.3,,44.55,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,251.16,69,,,,,0,"fee schedule","69% of total billed charges",364,100,,291.20,,,0,"percent of total billed charges","100% of total billed charges",4,100,,,,,0,"fee schedule","100% of CMS fee schedule",364,100,,291.20,,,0,"percent of total billed charges","100% of total billed charges",4,100,,,,,0,"fee schedule","100% of CMS fee schedule",364,100,,291.20,,,0,"percent of total billed charges","100% of total billed charges",4,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.3,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4,100,,,,,0,"fee schedule","100% of CMS fee schedule",4,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.23,37.7,,109.78,,,0,"percent of total billed charges","37.7% of total billed charges",137.23,37.7,,109.78,,,0,"percent of total billed charges","37.70% of total billed charges",4,100,,,,,0,"fee schedule","100% of CMS fee schedule",123.4,33.9,,98.72,,,0,"percent of total billed charges","33.9% of total billed charges",4,100,,,,,0,"fee schedule","100% of CMS fee schedule",283.92,78,,227.14,,,0,"percent of total billed charges","78% of total billed charges",4.04,101,,,,,0,"fee schedule","101% of CMS fee schedule ",300.66,82.6,,240.53,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4,100,,,,,0,"fee schedule","100% of CMS fee schedule",300.66,82.6,,240.53,,,0,"percent of total billed charges","82.6% of total billed charges",4,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,364,100,,291.20,,,0,"percent of total billed charges","100% of total billed charges",3.25,364,
"Protein/Creatinine Ratio Urine",30184156,CDM,301,RC,84156,CPT,OUTPATIENT,,,439,285.35,,386.32,88,,309.06,,,0,"percent of total billed charges","88% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",6.42,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",276.57,63,,221.26,,,0,"percent of total billed charges","63% of total billed charges",67.17,15.3,,53.74,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,302.91,69,,,,,0,"fee schedule","69% of total billed charges",439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.03,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.67,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",165.5,37.7,,132.40,,,0,"percent of total billed charges","37.7% of total billed charges",165.5,37.7,,132.40,,,0,"percent of total billed charges","37.70% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",148.82,33.9,,119.06,,,0,"percent of total billed charges","33.9% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",342.42,78,,273.94,,,0,"percent of total billed charges","78% of total billed charges",3.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",362.61,82.6,,290.09,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",362.61,82.6,,290.09,,,0,"percent of total billed charges","82.6% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",3.25,439,
"Protein Urine",30184156,CDM,301,RC,84156,CPT,OUTPATIENT,,,439,285.35,,386.32,88,,309.06,,,0,"percent of total billed charges","88% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",6.42,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",276.57,63,,221.26,,,0,"percent of total billed charges","63% of total billed charges",67.17,15.3,,53.74,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,302.91,69,,,,,0,"fee schedule","69% of total billed charges",439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.03,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.67,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",165.5,37.7,,132.40,,,0,"percent of total billed charges","37.7% of total billed charges",165.5,37.7,,132.40,,,0,"percent of total billed charges","37.70% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",148.82,33.9,,119.06,,,0,"percent of total billed charges","33.9% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",342.42,78,,273.94,,,0,"percent of total billed charges","78% of total billed charges",3.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",362.61,82.6,,290.09,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",362.61,82.6,,290.09,,,0,"percent of total billed charges","82.6% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",3.25,439,
"Protein Electro, U24 LC",30184156,CDM,301,RC,84156,CPT,OUTPATIENT,,,78,50.7,,68.64,88,,54.91,,,0,"percent of total billed charges","88% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",6.42,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.14,63,,39.31,,,0,"percent of total billed charges","63% of total billed charges",11.93,15.3,,9.54,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,53.82,69,,,,,0,"fee schedule","69% of total billed charges",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.03,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.67,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.41,37.7,,23.53,,,0,"percent of total billed charges","37.7% of total billed charges",29.41,37.7,,23.53,,,0,"percent of total billed charges","37.70% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.44,33.9,,21.15,,,0,"percent of total billed charges","33.9% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.84,78,,48.67,,,0,"percent of total billed charges","78% of total billed charges",3.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,78,
"Prot Electro+Interp, U24 LC",30184156,CDM,301,RC,84156,CPT,OUTPATIENT,,,78,50.7,,68.64,88,,54.91,,,0,"percent of total billed charges","88% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",6.42,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.14,63,,39.31,,,0,"percent of total billed charges","63% of total billed charges",11.93,15.3,,9.54,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,53.82,69,,,,,0,"fee schedule","69% of total billed charges",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.03,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.67,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.41,37.7,,23.53,,,0,"percent of total billed charges","37.7% of total billed charges",29.41,37.7,,23.53,,,0,"percent of total billed charges","37.70% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.44,33.9,,21.15,,,0,"percent of total billed charges","33.9% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.84,78,,48.67,,,0,"percent of total billed charges","78% of total billed charges",3.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,78,
"PROTEIN TOTAL SERUM",30184155,CDM,301,RC,84155,CPT,OUTPATIENT,,,82,53.3,,72.16,88,,57.73,,,0,"percent of total billed charges","88% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",6.42,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.66,63,,41.33,,,0,"percent of total billed charges","63% of total billed charges",12.55,15.3,,10.04,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,56.58,69,,,,,0,"fee schedule","69% of total billed charges",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.03,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.67,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.91,37.7,,24.73,,,0,"percent of total billed charges","37.7% of total billed charges",30.91,37.7,,24.73,,,0,"percent of total billed charges","37.70% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.8,33.9,,22.24,,,0,"percent of total billed charges","33.9% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.96,78,,51.17,,,0,"percent of total billed charges","78% of total billed charges",3.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",67.73,82.6,,54.18,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.73,82.6,,54.18,,,0,"percent of total billed charges","82.6% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,82,
"Protoporphyrin, FEP/ZPP LC",30184202,CDM,301,RC,84202,CPT,OUTPATIENT,,,176,114.4,,154.88,88,,123.90,,,0,"percent of total billed charges","88% of total billed charges",14.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",25.11,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,14.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",110.88,63,,88.70,,,0,"percent of total billed charges","63% of total billed charges",26.93,15.3,,21.54,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,121.44,69,,,,,0,"fee schedule","69% of total billed charges",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",14.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",14.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",14.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.88,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,14.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.35,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,14.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,14.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.35,37.7,,53.08,,,0,"percent of total billed charges","37.7% of total billed charges",66.35,37.7,,53.08,,,0,"percent of total billed charges","37.70% of total billed charges",14.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.66,33.9,,47.73,,,0,"percent of total billed charges","33.9% of total billed charges",14.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.28,78,,109.82,,,0,"percent of total billed charges","78% of total billed charges",14.49,101,,,,,0,"fee schedule","101% of CMS fee schedule ",145.38,82.6,,116.30,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,14.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",145.38,82.6,,116.30,,,0,"percent of total billed charges","82.6% of total billed charges",14.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",8.11,176,
"PROTEIN C ANTIGEN",30585302,CDM,305,RC,85302,CPT,OUTPATIENT,,,221,143.65,,194.48,88,,155.58,,,0,"percent of total billed charges","88% of total billed charges",12.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,221,100,,176.80,,,0,"percent of total billed charges","100% of total billed charges",21.01,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,12.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",139.23,63,,111.38,,,0,"percent of total billed charges","63% of total billed charges",33.81,15.3,,27.05,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,152.49,69,,,,,0,"fee schedule","69% of total billed charges",221,100,,176.80,,,0,"percent of total billed charges","100% of total billed charges",12.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",221,100,,176.80,,,0,"percent of total billed charges","100% of total billed charges",12.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",221,100,,176.80,,,0,"percent of total billed charges","100% of total billed charges",12.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.93,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,12.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.01,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,12.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,12.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",83.32,37.7,,66.66,,,0,"percent of total billed charges","37.7% of total billed charges",83.32,37.7,,66.66,,,0,"percent of total billed charges","37.70% of total billed charges",12.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.92,33.9,,59.94,,,0,"percent of total billed charges","33.9% of total billed charges",12.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",172.38,78,,137.90,,,0,"percent of total billed charges","78% of total billed charges",12.13,101,,,,,0,"fee schedule","101% of CMS fee schedule ",182.55,82.6,,146.04,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,12.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",182.55,82.6,,146.04,,,0,"percent of total billed charges","82.6% of total billed charges",12.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,221,100,,176.80,,,0,"percent of total billed charges","100% of total billed charges",2.48,221,
"PROTEIN C ACTIVITY",30585303,CDM,305,RC,85303,CPT,OUTPATIENT,,,287,186.55,,252.56,88,,202.05,,,0,"percent of total billed charges","88% of total billed charges",13.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",24.22,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,13.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",180.81,63,,144.65,,,0,"percent of total billed charges","63% of total billed charges",43.91,15.3,,35.13,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,198.03,69,,,,,0,"fee schedule","69% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",13.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",13.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",13.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.93,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,13.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.84,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,13.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,13.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.7% of total billed charges",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.70% of total billed charges",13.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.29,33.9,,77.83,,,0,"percent of total billed charges","33.9% of total billed charges",13.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",223.86,78,,179.09,,,0,"percent of total billed charges","78% of total billed charges",13.97,101,,,,,0,"fee schedule","101% of CMS fee schedule ",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,13.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",13.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",2.48,287,
"PROTEIN S ACTIVITY",30585306,CDM,305,RC,85306,CPT,OUTPATIENT,,,283,183.95,,249.04,88,,199.23,,,0,"percent of total billed charges","88% of total billed charges",15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,283,100,,226.40,,,0,"percent of total billed charges","100% of total billed charges",26.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",178.29,63,,142.63,,,0,"percent of total billed charges","63% of total billed charges",43.3,15.3,,34.64,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,195.27,69,,,,,0,"fee schedule","69% of total billed charges",283,100,,226.40,,,0,"percent of total billed charges","100% of total billed charges",15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",283,100,,226.40,,,0,"percent of total billed charges","100% of total billed charges",15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",283,100,,226.40,,,0,"percent of total billed charges","100% of total billed charges",15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.59,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.32,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.69,37.7,,85.35,,,0,"percent of total billed charges","37.7% of total billed charges",106.69,37.7,,85.35,,,0,"percent of total billed charges","37.70% of total billed charges",15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.94,33.9,,76.75,,,0,"percent of total billed charges","33.9% of total billed charges",15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",220.74,78,,176.59,,,0,"percent of total billed charges","78% of total billed charges",15.47,101,,,,,0,"fee schedule","101% of CMS fee schedule ",233.76,82.6,,187.01,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",233.76,82.6,,187.01,,,0,"percent of total billed charges","82.6% of total billed charges",15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,283,100,,226.40,,,0,"percent of total billed charges","100% of total billed charges",2.48,283,
"Prot+CreatU (Random) LC",30182570,CDM,301,RC,82570,CPT,OUTPATIENT,,,88,57.2,,77.44,88,,61.95,,,0,"percent of total billed charges","88% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",9.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.44,63,,44.35,,,0,"percent of total billed charges","63% of total billed charges",13.46,15.3,,10.77,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,60.72,69,,,,,0,"fee schedule","69% of total billed charges",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.81,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.18,37.7,,26.54,,,0,"percent of total billed charges","37.7% of total billed charges",33.18,37.7,,26.54,,,0,"percent of total billed charges","37.70% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.83,33.9,,23.86,,,0,"percent of total billed charges","33.9% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.64,78,,54.91,,,0,"percent of total billed charges","78% of total billed charges",5.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,88,
"PROTEIN S ACTIVITY",30585306,CDM,305,RC,85306,CPT,OUTPATIENT,,,283,183.95,,249.04,88,,199.23,,,0,"percent of total billed charges","88% of total billed charges",15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,283,100,,226.40,,,0,"percent of total billed charges","100% of total billed charges",26.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",178.29,63,,142.63,,,0,"percent of total billed charges","63% of total billed charges",43.3,15.3,,34.64,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,195.27,69,,,,,0,"fee schedule","69% of total billed charges",283,100,,226.40,,,0,"percent of total billed charges","100% of total billed charges",15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",283,100,,226.40,,,0,"percent of total billed charges","100% of total billed charges",15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",283,100,,226.40,,,0,"percent of total billed charges","100% of total billed charges",15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.59,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.32,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.69,37.7,,85.35,,,0,"percent of total billed charges","37.7% of total billed charges",106.69,37.7,,85.35,,,0,"percent of total billed charges","37.70% of total billed charges",15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.94,33.9,,76.75,,,0,"percent of total billed charges","33.9% of total billed charges",15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",220.74,78,,176.59,,,0,"percent of total billed charges","78% of total billed charges",15.47,101,,,,,0,"fee schedule","101% of CMS fee schedule ",233.76,82.6,,187.01,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",233.76,82.6,,187.01,,,0,"percent of total billed charges","82.6% of total billed charges",15.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,283,100,,226.40,,,0,"percent of total billed charges","100% of total billed charges",2.48,283,
"Protein Elec + Interp LC",30184165,CDM,301,RC,84165,CPT,OUTPATIENT,,,563,365.95,,495.44,88,,396.35,,,0,"percent of total billed charges","88% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,563,100,,450.40,,,0,"percent of total billed charges","100% of total billed charges",18.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",354.69,63,,283.75,,,0,"percent of total billed charges","63% of total billed charges",86.14,15.3,,68.91,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,388.47,69,,,,,0,"fee schedule","69% of total billed charges",563,100,,450.40,,,0,"percent of total billed charges","100% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",563,100,,450.40,,,0,"percent of total billed charges","100% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",563,100,,450.40,,,0,"percent of total billed charges","100% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.08,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.74,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",212.25,37.7,,169.80,,,0,"percent of total billed charges","37.7% of total billed charges",212.25,37.7,,169.80,,,0,"percent of total billed charges","37.70% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",190.86,33.9,,152.69,,,0,"percent of total billed charges","33.9% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",439.14,78,,351.31,,,0,"percent of total billed charges","78% of total billed charges",10.84,101,,,,,0,"fee schedule","101% of CMS fee schedule ",465.04,82.6,,372.03,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",465.04,82.6,,372.03,,,0,"percent of total billed charges","82.6% of total billed charges",10.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,563,100,,450.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,563,
"Protein Electro, Random Ur LC",30184156,CDM,301,RC,84156,CPT,OUTPATIENT,,,517,336.05,,454.96,88,,363.97,,,0,"percent of total billed charges","88% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,517,100,,413.60,,,0,"percent of total billed charges","100% of total billed charges",6.42,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",325.71,63,,260.57,,,0,"percent of total billed charges","63% of total billed charges",79.1,15.3,,63.28,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,356.73,69,,,,,0,"fee schedule","69% of total billed charges",517,100,,413.60,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",517,100,,413.60,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",517,100,,413.60,,,0,"percent of total billed charges","100% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.03,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.67,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",194.91,37.7,,155.93,,,0,"percent of total billed charges","37.7% of total billed charges",194.91,37.7,,155.93,,,0,"percent of total billed charges","37.70% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",175.26,33.9,,140.21,,,0,"percent of total billed charges","33.9% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",403.26,78,,322.61,,,0,"percent of total billed charges","78% of total billed charges",3.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",427.04,82.6,,341.63,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",427.04,82.6,,341.63,,,0,"percent of total billed charges","82.6% of total billed charges",3.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,517,100,,413.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,517,
"Protein, Body Fluid LC",30184157,CDM,301,RC,84157,CPT,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",4,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",7,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",4,100,,,,,0,"fee schedule","100% of CMS fee schedule",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",4,100,,,,,0,"fee schedule","100% of CMS fee schedule",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",4,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.3,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4,100,,,,,0,"fee schedule","100% of CMS fee schedule",4,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.7% of total billed charges",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",4,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.41,33.9,,3.53,,,0,"percent of total billed charges","33.9% of total billed charges",4,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",4.04,101,,,,,0,"fee schedule","101% of CMS fee schedule ",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",4,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,15.3,
"Protein S Deficiency Profile LC",30585305,CDM,305,RC,85305,CPT,OUTPATIENT,,,404,262.6,,355.52,88,,284.42,,,0,"percent of total billed charges","88% of total billed charges",11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,404,100,,323.20,,,0,"percent of total billed charges","100% of total billed charges",20.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",254.52,63,,203.62,,,0,"percent of total billed charges","63% of total billed charges",61.81,15.3,,49.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,278.76,69,,,,,0,"fee schedule","69% of total billed charges",404,100,,323.20,,,0,"percent of total billed charges","100% of total billed charges",11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",404,100,,323.20,,,0,"percent of total billed charges","100% of total billed charges",11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",404,100,,323.20,,,0,"percent of total billed charges","100% of total billed charges",11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.4,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.61,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",152.31,37.7,,121.85,,,0,"percent of total billed charges","37.7% of total billed charges",152.31,37.7,,121.85,,,0,"percent of total billed charges","37.70% of total billed charges",11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.96,33.9,,109.57,,,0,"percent of total billed charges","33.9% of total billed charges",11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",315.12,78,,252.10,,,0,"percent of total billed charges","78% of total billed charges",11.72,101,,,,,0,"fee schedule","101% of CMS fee schedule ",333.7,82.6,,266.96,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",333.7,82.6,,266.96,,,0,"percent of total billed charges","82.6% of total billed charges",11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,404,100,,323.20,,,0,"percent of total billed charges","100% of total billed charges",2.48,404,
"QuantiFERON (Client Incubated) LC 182893",30286480,CDM,302,RC,86480,CPT,OUTPATIENT,,,363,235.95,,319.44,88,,255.55,,,0,"percent of total billed charges","88% of total billed charges",61.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.28,100,,,,,0,"fee schedule",EAPG,363,100,,290.40,,,0,"percent of total billed charges","100% of total billed charges",108.46,175,,,,,0,"fee schedule","175% of CMS fee schedule",28.1,100,,,,,0,"fee schedule",EAPG,61.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",228.69,63,,182.95,,,0,"percent of total billed charges","63% of total billed charges",55.54,15.3,,44.43,,,0,"percent of total billed charges","15.3% of total billed charges",27.28,100,,,,,0,"fee schedule",EAPG,250.47,69,,,,,0,"fee schedule","69% of total billed charges",363,100,,290.40,,,0,"percent of total billed charges","100% of total billed charges",61.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",363,100,,290.40,,,0,"percent of total billed charges","100% of total billed charges",61.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",363,100,,290.40,,,0,"percent of total billed charges","100% of total billed charges",61.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",237.07,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",27.28,100,,,,,0,"fee schedule",EAPG,61.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.98,100,,,,,0,"fee schedule","100% of LI fee schedule",20.21,100,,,,,0,"fee schedule",EAPG,61.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.83,100,,,,,0,"fee schedule",EAPG,35.47,100,,,,,0,"fee schedule",EAPG,61.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.85,37.7,,109.48,,,0,"percent of total billed charges","37.7% of total billed charges",136.85,37.7,,109.48,,,0,"percent of total billed charges","37.70% of total billed charges",61.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",123.06,33.9,,98.45,,,0,"percent of total billed charges","33.9% of total billed charges",61.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",283.14,78,,226.51,,,0,"percent of total billed charges","78% of total billed charges",62.59,101,,,,,0,"fee schedule","101% of CMS fee schedule ",299.84,82.6,,239.87,,,0,"percent of total billed charges","82.6% of total billed charges",27.28,100,,,,,0,"fee schedule",EAPG,61.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",299.84,82.6,,239.87,,,0,"percent of total billed charges","82.6% of total billed charges",61.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.28,100,,,,,0,"fee schedule",EAPG,363,100,,290.40,,,0,"percent of total billed charges","100% of total billed charges",20.21,363,
"HIV DNA BY PCR",30687535,CDM,306,RC,87535,CPT,OUTPATIENT,,,418,271.7,,367.84,88,,294.27,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",263.34,63,,210.67,,,0,"percent of total billed charges","63% of total billed charges",63.95,15.3,,51.16,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,288.42,69,,,,,0,"fee schedule","69% of total billed charges",418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",157.59,37.7,,126.07,,,0,"percent of total billed charges","37.7% of total billed charges",157.59,37.7,,126.07,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",141.7,33.9,,113.36,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",326.04,78,,260.83,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",345.27,82.6,,276.22,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",345.27,82.6,,276.22,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",18.33,418,
"HIV-1 RNA BY PCR QUANT",30687536,CDM,306,RC,87536,CPT,OUTPATIENT,,,435,282.75,,382.8,88,,306.24,,,0,"percent of total billed charges","88% of total billed charges",85.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,435,100,,348.00,,,0,"percent of total billed charges","100% of total billed charges",148.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,85.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",274.05,63,,219.24,,,0,"percent of total billed charges","63% of total billed charges",66.56,15.3,,53.25,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,300.15,69,,,,,0,"fee schedule","69% of total billed charges",435,100,,348.00,,,0,"percent of total billed charges","100% of total billed charges",85.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",435,100,,348.00,,,0,"percent of total billed charges","100% of total billed charges",85.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",435,100,,348.00,,,0,"percent of total billed charges","100% of total billed charges",85.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",325.5,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,85.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.1,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,85.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,85.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",164,37.7,,131.20,,,0,"percent of total billed charges","37.7% of total billed charges",164,37.7,,131.20,,,0,"percent of total billed charges","37.70% of total billed charges",85.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",147.47,33.9,,117.98,,,0,"percent of total billed charges","33.9% of total billed charges",85.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",339.3,78,,271.44,,,0,"percent of total billed charges","78% of total billed charges",85.95,101,,,,,0,"fee schedule","101% of CMS fee schedule ",359.31,82.6,,287.45,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,85.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",359.31,82.6,,287.45,,,0,"percent of total billed charges","82.6% of total billed charges",85.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,435,100,,348.00,,,0,"percent of total billed charges","100% of total billed charges",18.33,435,
"RNP Antibodies LC",30286235,CDM,302,RC,86235,CPT,OUTPATIENT,,,100,65,91,88,88,,70.40,,,0,"percent of total billed charges","88% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",31.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",63,63,,50.40,,,0,"percent of total billed charges","63% of total billed charges",15.3,15.3,,12.24,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,69,69,,,,,0,"fee schedule","69% of total billed charges",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.58,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.93,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.7% of total billed charges",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.70% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.9,33.9,,27.12,,,0,"percent of total billed charges","33.9% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,78,,62.40,,,0,"percent of total billed charges","78% of total billed charges",18.1,101,,,,,0,"fee schedule","101% of CMS fee schedule ",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,100,
"RPR LC",30286592,CDM,302,RC,86592,CPT,OUTPATIENT,,,110,71.5,,96.8,88,,77.44,,,0,"percent of total billed charges","88% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",7.47,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.3,63,,55.44,,,0,"percent of total billed charges","63% of total billed charges",16.83,15.3,,13.46,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,75.9,69,,,,,0,"fee schedule","69% of total billed charges",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.33,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.26,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.47,37.7,,33.18,,,0,"percent of total billed charges","37.7% of total billed charges",41.47,37.7,,33.18,,,0,"percent of total billed charges","37.70% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.29,33.9,,29.83,,,0,"percent of total billed charges","33.9% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.8,78,,68.64,,,0,"percent of total billed charges","78% of total billed charges",4.31,101,,,,,0,"fee schedule","101% of CMS fee schedule ",90.86,82.6,,72.69,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.86,82.6,,72.69,,,0,"percent of total billed charges","82.6% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",4.26,110,
RSV,30687807,CDM,306,RC,87807,CPT,OUTPATIENT,,,244,158.6,,214.72,88,,171.78,,,0,"percent of total billed charges","88% of total billed charges",13.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,244,100,,195.20,,,0,"percent of total billed charges","100% of total billed charges",22.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,13.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",153.72,63,,122.98,,,0,"percent of total billed charges","63% of total billed charges",37.33,15.3,,29.86,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,168.36,69,,,,,0,"fee schedule","69% of total billed charges",244,100,,195.20,,,0,"percent of total billed charges","100% of total billed charges",13.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",244,100,,195.20,,,0,"percent of total billed charges","100% of total billed charges",13.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",244,100,,195.20,,,0,"percent of total billed charges","100% of total billed charges",13.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,13.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.1,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,13.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,13.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.99,37.7,,73.59,,,0,"percent of total billed charges","37.7% of total billed charges",91.99,37.7,,73.59,,,0,"percent of total billed charges","37.70% of total billed charges",13.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.72,33.9,,66.18,,,0,"percent of total billed charges","33.9% of total billed charges",13.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",190.32,78,,152.26,,,0,"percent of total billed charges","78% of total billed charges",13.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",201.54,82.6,,161.23,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,13.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",201.54,82.6,,161.23,,,0,"percent of total billed charges","82.6% of total billed charges",13.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,244,100,,195.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,244,
"Flu A/B PCR (GeneXpert) + RSV",30687502,CDM,306,RC,87502|8763,CPT,OUTPATIENT,,,259,168.35,,227.92,88,,182.34,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.51,16.8,,34.81,,,0,"percent of total billed charges","16.8% of total billed charges",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.82,17.304,,35.86,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",163.17,63,,130.54,,,0,"percent of total billed charges","63% of total billed charges",39.63,15.3,,31.70,,,0,"percent of total billed charges","15.3% of total billed charges",43.51,16.8,,34.81,,,0,"percent of total billed charges","16.8% of total billed charges",178.71,69,,,,,0,"fee schedule","69% of total billed charges",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.51,16.8,,34.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.51,16.8,,34.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.38,17.136,,35.50,,,0,"percent of total billed charges","17.136% of total billed charges",56.57,21.84,,45.26,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.64,37.7,,78.11,,,0,"percent of total billed charges","37.7% of total billed charges",97.64,37.7,,78.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.8,33.9,,70.24,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.02,78,,161.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.93,82.6,,171.14,,,0,"percent of total billed charges","82.6% of total billed charges",43.51,16.8,,34.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.93,82.6,,171.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.51,16.8,,34.81,,,0,"percent of total billed charges","16.8% of total billed charges",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",39.63,259,
"Rapid Plasma Reagin Qualitative",30086592,CDM,300,RC,86592,CPT,OUTPATIENT,,,338,219.7,,297.44,88,,237.95,,,0,"percent of total billed charges","88% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",7.47,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",212.94,63,,170.35,,,0,"percent of total billed charges","63% of total billed charges",51.71,15.3,,41.37,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,233.22,69,,,,,0,"fee schedule","69% of total billed charges",338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.33,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.26,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",127.43,37.7,,101.94,,,0,"percent of total billed charges","37.7% of total billed charges",127.43,37.7,,101.94,,,0,"percent of total billed charges","37.70% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",114.58,33.9,,91.66,,,0,"percent of total billed charges","33.9% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",263.64,78,,210.91,,,0,"percent of total billed charges","78% of total billed charges",4.31,101,,,,,0,"fee schedule","101% of CMS fee schedule ",279.19,82.6,,223.35,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",279.19,82.6,,223.35,,,0,"percent of total billed charges","82.6% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",4.26,338,
"Rapid Plasma Reagin Titer",30286593,CDM,302,RC,86593,CPT,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",4.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",7.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,4.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",4.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",4.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",4.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.83,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,4.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.4,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,4.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,4.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.7% of total billed charges",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",4.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.75,33.9,,3.80,,,0,"percent of total billed charges","33.9% of total billed charges",4.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",4.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,4.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",4.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,16.83,
"RBC COUNT ONLY",30585041,CDM,305,RC,85041,CPT,OUTPATIENT,,,58,37.7,,51.04,88,,40.83,,,0,"percent of total billed charges","88% of total billed charges",3.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",5.28,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.23,100,,,,,0,"fee schedule",EAPG,3.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.54,63,,29.23,,,0,"percent of total billed charges","63% of total billed charges",8.87,15.3,,7.10,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,40.02,69,,,,,0,"fee schedule","69% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",3.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",3.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",3.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.55,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,3.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.02,100,,,,,0,"fee schedule","100% of LI fee schedule",3.76,100,,,,,0,"fee schedule",EAPG,3.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,3.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.87,37.7,,17.50,,,0,"percent of total billed charges","37.7% of total billed charges",21.87,37.7,,17.50,,,0,"percent of total billed charges","37.70% of total billed charges",3.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.66,33.9,,15.73,,,0,"percent of total billed charges","33.9% of total billed charges",3.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.24,78,,36.19,,,0,"percent of total billed charges","78% of total billed charges",3.05,101,,,,,0,"fee schedule","101% of CMS fee schedule ",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,3.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",3.02,58,
"Renal Function Panel",30180069,CDM,301,RC,80069,CPT,OUTPATIENT,,,153,99.45,,134.64,88,,107.71,,,0,"percent of total billed charges","88% of total billed charges",8.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",15.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",7.68,100,,,,,0,"fee schedule",EAPG,8.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",96.39,63,,77.11,,,0,"percent of total billed charges","63% of total billed charges",23.41,15.3,,18.73,,,0,"percent of total billed charges","15.3% of total billed charges",7.45,100,,,,,0,"fee schedule",EAPG,105.57,69,,,,,0,"fee schedule","69% of total billed charges",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",8.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",8.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",8.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.2,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,8.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.68,100,,,,,0,"fee schedule","100% of LI fee schedule",5.52,100,,,,,0,"fee schedule",EAPG,8.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.6,100,,,,,0,"fee schedule",EAPG,9.69,100,,,,,0,"fee schedule",EAPG,8.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.68,37.7,,46.14,,,0,"percent of total billed charges","37.7% of total billed charges",57.68,37.7,,46.14,,,0,"percent of total billed charges","37.70% of total billed charges",8.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.87,33.9,,41.50,,,0,"percent of total billed charges","33.9% of total billed charges",8.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",119.34,78,,95.47,,,0,"percent of total billed charges","78% of total billed charges",8.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",126.38,82.6,,101.10,,,0,"percent of total billed charges","82.6% of total billed charges",7.45,100,,,,,0,"fee schedule",EAPG,8.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",126.38,82.6,,101.10,,,0,"percent of total billed charges","82.6% of total billed charges",8.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.45,100,,,,,0,"fee schedule",EAPG,153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",5.52,153,
"Renin Activity, P LC",30184244,CDM,301,RC,84244,CPT,OUTPATIENT,,,386,250.9,,339.68,88,,271.74,,,0,"percent of total billed charges","88% of total billed charges",21.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",38.48,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,21.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",243.18,63,,194.54,,,0,"percent of total billed charges","63% of total billed charges",59.06,15.3,,47.25,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,266.34,69,,,,,0,"fee schedule","69% of total billed charges",386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",21.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",21.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",21.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",84.11,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,21.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.99,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,21.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,21.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",145.52,37.7,,116.42,,,0,"percent of total billed charges","37.7% of total billed charges",145.52,37.7,,116.42,,,0,"percent of total billed charges","37.70% of total billed charges",21.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",130.85,33.9,,104.68,,,0,"percent of total billed charges","33.9% of total billed charges",21.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",301.08,78,,240.86,,,0,"percent of total billed charges","78% of total billed charges",22.2,101,,,,,0,"fee schedule","101% of CMS fee schedule ",318.84,82.6,,255.07,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,21.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",318.84,82.6,,255.07,,,0,"percent of total billed charges","82.6% of total billed charges",21.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",8.39,386,
N/A,30182397,CDM,301,RC,82397,CPT,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",14.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",24.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,14.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",14.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",14.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",14.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",54,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,14.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.12,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,14.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,14.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",14.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",14.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",14.26,101,,,,,0,"fee schedule","101% of CMS fee schedule ",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,14.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",14.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",8.11,402,
"MYCOPLASMA BY PCR",30687581,CDM,306,RC,87581,CPT,OUTPATIENT,,,399,259.35,,351.12,88,,280.90,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,399,100,,319.20,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.37,63,,201.10,,,0,"percent of total billed charges","63% of total billed charges",61.05,15.3,,48.84,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,275.31,69,,,,,0,"fee schedule","69% of total billed charges",399,100,,319.20,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",399,100,,319.20,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",399,100,,319.20,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.42,37.7,,120.34,,,0,"percent of total billed charges","37.7% of total billed charges",150.42,37.7,,120.34,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",135.26,33.9,,108.21,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",311.22,78,,248.98,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",329.57,82.6,,263.66,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",329.57,82.6,,263.66,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,399,100,,319.20,,,0,"percent of total billed charges","100% of total billed charges",18.33,399,
"Respiratory Syncytial Virus (Sofia)",30687807,CDM,306,RC,87807,CPT,OUTPATIENT,,,244,158.6,,214.72,88,,171.78,,,0,"percent of total billed charges","88% of total billed charges",13.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,244,100,,195.20,,,0,"percent of total billed charges","100% of total billed charges",22.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,13.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",153.72,63,,122.98,,,0,"percent of total billed charges","63% of total billed charges",37.33,15.3,,29.86,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,168.36,69,,,,,0,"fee schedule","69% of total billed charges",244,100,,195.20,,,0,"percent of total billed charges","100% of total billed charges",13.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",244,100,,195.20,,,0,"percent of total billed charges","100% of total billed charges",13.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",244,100,,195.20,,,0,"percent of total billed charges","100% of total billed charges",13.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,13.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.1,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,13.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,13.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.99,37.7,,73.59,,,0,"percent of total billed charges","37.7% of total billed charges",91.99,37.7,,73.59,,,0,"percent of total billed charges","37.70% of total billed charges",13.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.72,33.9,,66.18,,,0,"percent of total billed charges","33.9% of total billed charges",13.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",190.32,78,,152.26,,,0,"percent of total billed charges","78% of total billed charges",13.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",201.54,82.6,,161.23,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,13.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",201.54,82.6,,161.23,,,0,"percent of total billed charges","82.6% of total billed charges",13.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,244,100,,195.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,244,
"Retic Count w/ IRF",30085046,CDM,300,RC,85046,CPT,OUTPATIENT,,,78,50.7,,68.64,88,,54.91,,,0,"percent of total billed charges","88% of total billed charges",5.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",9.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.23,100,,,,,0,"fee schedule",EAPG,5.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.14,63,,39.31,,,0,"percent of total billed charges","63% of total billed charges",11.93,15.3,,9.54,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,53.82,69,,,,,0,"fee schedule","69% of total billed charges",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",5.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",5.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",5.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.3,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,5.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.57,100,,,,,0,"fee schedule","100% of LI fee schedule",3.76,100,,,,,0,"fee schedule",EAPG,5.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,5.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.41,37.7,,23.53,,,0,"percent of total billed charges","37.7% of total billed charges",29.41,37.7,,23.53,,,0,"percent of total billed charges","37.70% of total billed charges",5.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.44,33.9,,21.15,,,0,"percent of total billed charges","33.9% of total billed charges",5.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.84,78,,48.67,,,0,"percent of total billed charges","78% of total billed charges",5.62,101,,,,,0,"fee schedule","101% of CMS fee schedule ",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,5.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",5.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",3.76,78,
"Retic Count Automated",30085045,CDM,300,RC,85045,CPT,OUTPATIENT,,,78,50.7,,68.64,88,,54.91,,,0,"percent of total billed charges","88% of total billed charges",3.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",6.98,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.23,100,,,,,0,"fee schedule",EAPG,3.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.14,63,,39.31,,,0,"percent of total billed charges","63% of total billed charges",11.93,15.3,,9.54,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,53.82,69,,,,,0,"fee schedule","69% of total billed charges",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",3.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",3.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",3.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.26,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,3.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.99,100,,,,,0,"fee schedule","100% of LI fee schedule",3.76,100,,,,,0,"fee schedule",EAPG,3.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,3.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.41,37.7,,23.53,,,0,"percent of total billed charges","37.7% of total billed charges",29.41,37.7,,23.53,,,0,"percent of total billed charges","37.70% of total billed charges",3.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.44,33.9,,21.15,,,0,"percent of total billed charges","33.9% of total billed charges",3.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.84,78,,48.67,,,0,"percent of total billed charges","78% of total billed charges",4.02,101,,,,,0,"fee schedule","101% of CMS fee schedule ",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,3.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",3.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",3.76,78,
"T-3 REVERSE",30184482,CDM,301,RC,84482,CPT,OUTPATIENT,,,111,72.15,,97.68,88,,78.14,,,0,"percent of total billed charges","88% of total billed charges",15.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",27.58,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,15.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.93,63,,55.94,,,0,"percent of total billed charges","63% of total billed charges",16.98,15.3,,13.58,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,76.59,69,,,,,0,"fee schedule","69% of total billed charges",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",15.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",15.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",15.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.28,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,15.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.76,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,15.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,15.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.85,37.7,,33.48,,,0,"percent of total billed charges","37.7% of total billed charges",41.85,37.7,,33.48,,,0,"percent of total billed charges","37.70% of total billed charges",15.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.63,33.9,,30.10,,,0,"percent of total billed charges","33.9% of total billed charges",15.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",86.58,78,,69.26,,,0,"percent of total billed charges","78% of total billed charges",15.91,101,,,,,0,"fee schedule","101% of CMS fee schedule ",91.69,82.6,,73.35,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,15.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.69,82.6,,73.35,,,0,"percent of total billed charges","82.6% of total billed charges",15.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",8.39,111,
"Rheumatoid Factor Qualitative",30084157,CDM,300,RC,84157,CPT,OUTPATIENT,,,364,236.6,,320.32,88,,256.26,,,0,"percent of total billed charges","88% of total billed charges",4,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,364,100,,291.20,,,0,"percent of total billed charges","100% of total billed charges",7,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4,100,,,,,0,"fee schedule","100% of CMS fee schedule",229.32,63,,183.46,,,0,"percent of total billed charges","63% of total billed charges",55.69,15.3,,44.55,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,251.16,69,,,,,0,"fee schedule","69% of total billed charges",364,100,,291.20,,,0,"percent of total billed charges","100% of total billed charges",4,100,,,,,0,"fee schedule","100% of CMS fee schedule",364,100,,291.20,,,0,"percent of total billed charges","100% of total billed charges",4,100,,,,,0,"fee schedule","100% of CMS fee schedule",364,100,,291.20,,,0,"percent of total billed charges","100% of total billed charges",4,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.3,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4,100,,,,,0,"fee schedule","100% of CMS fee schedule",4,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.23,37.7,,109.78,,,0,"percent of total billed charges","37.7% of total billed charges",137.23,37.7,,109.78,,,0,"percent of total billed charges","37.70% of total billed charges",4,100,,,,,0,"fee schedule","100% of CMS fee schedule",123.4,33.9,,98.72,,,0,"percent of total billed charges","33.9% of total billed charges",4,100,,,,,0,"fee schedule","100% of CMS fee schedule",283.92,78,,227.14,,,0,"percent of total billed charges","78% of total billed charges",4.04,101,,,,,0,"fee schedule","101% of CMS fee schedule ",300.66,82.6,,240.53,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4,100,,,,,0,"fee schedule","100% of CMS fee schedule",300.66,82.6,,240.53,,,0,"percent of total billed charges","82.6% of total billed charges",4,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,364,100,,291.20,,,0,"percent of total billed charges","100% of total billed charges",3.25,364,
"Rheumatoid Arthritis Profile LC",30286200,CDM,302,RC,86200,CPT,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",22.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.53,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.95,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.7% of total billed charges",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.92,33.9,,27.94,,,0,"percent of total billed charges","33.9% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",13.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",12.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",6.96,103,
"Rheumatoid Arthritis Factor LC",30286431,CDM,302,RC,86431,CPT,OUTPATIENT,,,38,24.7,,33.44,88,,26.75,,,0,"percent of total billed charges","88% of total billed charges",5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",9.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.94,63,,19.15,,,0,"percent of total billed charges","63% of total billed charges",5.81,15.3,,4.65,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,26.22,69,,,,,0,"fee schedule","69% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.68,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.67,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.33,37.7,,11.46,,,0,"percent of total billed charges","37.7% of total billed charges",14.33,37.7,,11.46,,,0,"percent of total billed charges","37.70% of total billed charges",5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.88,33.9,,10.30,,,0,"percent of total billed charges","33.9% of total billed charges",5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.64,78,,23.71,,,0,"percent of total billed charges","78% of total billed charges",5.72,101,,,,,0,"fee schedule","101% of CMS fee schedule ",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",5.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",5.67,38,
"Rotavirus Ag, EIA LC",30687425,CDM,306,RC,87425,CPT,OUTPATIENT,,,177,115.05,,155.76,88,,124.61,,,0,"percent of total billed charges","88% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",20.96,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",111.51,63,,89.21,,,0,"percent of total billed charges","63% of total billed charges",27.08,15.3,,21.66,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,122.13,69,,,,,0,"fee schedule","69% of total billed charges",177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.82,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.98,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.73,37.7,,53.38,,,0,"percent of total billed charges","37.7% of total billed charges",66.73,37.7,,53.38,,,0,"percent of total billed charges","37.70% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",60,33.9,,48.00,,,0,"percent of total billed charges","33.9% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",138.06,78,,110.45,,,0,"percent of total billed charges","78% of total billed charges",12.09,101,,,,,0,"fee schedule","101% of CMS fee schedule ",146.2,82.6,,116.96,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",146.2,82.6,,116.96,,,0,"percent of total billed charges","82.6% of total billed charges",11.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",4.81,177,
"Rubella IgG Antibody",30086762,CDM,300,RC,86762,CPT,OUTPATIENT,,,274,178.1,,241.12,88,,192.90,,,0,"percent of total billed charges","88% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,274,100,,219.20,,,0,"percent of total billed charges","100% of total billed charges",25.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",172.62,63,,138.10,,,0,"percent of total billed charges","63% of total billed charges",41.92,15.3,,33.54,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,189.06,69,,,,,0,"fee schedule","69% of total billed charges",274,100,,219.20,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",274,100,,219.20,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",274,100,,219.20,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.04,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.39,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",103.3,37.7,,82.64,,,0,"percent of total billed charges","37.7% of total billed charges",103.3,37.7,,82.64,,,0,"percent of total billed charges","37.70% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.89,33.9,,74.31,,,0,"percent of total billed charges","33.9% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",213.72,78,,170.98,,,0,"percent of total billed charges","78% of total billed charges",14.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",226.32,82.6,,181.06,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.32,82.6,,181.06,,,0,"percent of total billed charges","82.6% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,274,100,,219.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,274,
"Rubella Antibodies, IgG LC",30086762,CDM,300,RC,86762,CPT,OUTPATIENT,,,322,209.3,,283.36,88,,226.69,,,0,"percent of total billed charges","88% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,322,100,,257.60,,,0,"percent of total billed charges","100% of total billed charges",25.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.86,63,,162.29,,,0,"percent of total billed charges","63% of total billed charges",49.27,15.3,,39.42,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,222.18,69,,,,,0,"fee schedule","69% of total billed charges",322,100,,257.60,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",322,100,,257.60,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",322,100,,257.60,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.04,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.39,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",121.39,37.7,,97.11,,,0,"percent of total billed charges","37.7% of total billed charges",121.39,37.7,,97.11,,,0,"percent of total billed charges","37.70% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.16,33.9,,87.33,,,0,"percent of total billed charges","33.9% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.16,78,,200.93,,,0,"percent of total billed charges","78% of total billed charges",14.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",265.97,82.6,,212.78,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",265.97,82.6,,212.78,,,0,"percent of total billed charges","82.6% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,322,100,,257.60,,,0,"percent of total billed charges","100% of total billed charges",6.96,322,
"Rubeola Antibodies, IgG LC",30286765,CDM,302,RC,86765,CPT,OUTPATIENT,,,160,104,,140.8,88,,112.64,,,0,"percent of total billed charges","88% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",22.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.8,63,,80.64,,,0,"percent of total billed charges","63% of total billed charges",24.48,15.3,,19.58,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,110.4,69,,,,,0,"fee schedule","69% of total billed charges",160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.26,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.88,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.32,37.7,,48.26,,,0,"percent of total billed charges","37.7% of total billed charges",60.32,37.7,,48.26,,,0,"percent of total billed charges","37.70% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.24,33.9,,43.39,,,0,"percent of total billed charges","33.9% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.8,78,,99.84,,,0,"percent of total billed charges","78% of total billed charges",13,101,,,,,0,"fee schedule","101% of CMS fee schedule ",132.16,82.6,,105.73,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",132.16,82.6,,105.73,,,0,"percent of total billed charges","82.6% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,160,
"Rubella IgG Antibody w/ Interp",30286762,CDM,302,RC,86762,CPT,OUTPATIENT,,,109,70.85,,95.92,88,,76.74,,,0,"percent of total billed charges","88% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",25.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.67,63,,54.94,,,0,"percent of total billed charges","63% of total billed charges",16.68,15.3,,13.34,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,75.21,69,,,,,0,"fee schedule","69% of total billed charges",109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.04,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.39,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.09,37.7,,32.87,,,0,"percent of total billed charges","37.7% of total billed charges",41.09,37.7,,32.87,,,0,"percent of total billed charges","37.70% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.95,33.9,,29.56,,,0,"percent of total billed charges","33.9% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.02,78,,68.02,,,0,"percent of total billed charges","78% of total billed charges",14.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",90.03,82.6,,72.02,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.03,82.6,,72.02,,,0,"percent of total billed charges","82.6% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,109,
"Rupture of Fetal Membranes Test",30084112,CDM,300,RC,84112,CPT,OUTPATIENT,,,332,215.8,,292.16,88,,233.73,,,0,"percent of total billed charges","88% of total billed charges",98.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.85,100,,,,,0,"fee schedule",EAPG,332,100,,265.60,,,0,"percent of total billed charges","100% of total billed charges",171.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",101.81,100,,,,,0,"fee schedule",EAPG,98.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",50.8,15.3,,40.64,,,0,"percent of total billed charges","15.3% of total billed charges",98.85,100,,,,,0,"fee schedule",EAPG,229.08,69,,,,,0,"fee schedule","69% of total billed charges",332,100,,265.60,,,0,"percent of total billed charges","100% of total billed charges",98.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",332,100,,265.60,,,0,"percent of total billed charges","100% of total billed charges",98.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",332,100,,265.60,,,0,"percent of total billed charges","100% of total billed charges",98.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",375.27,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",98.85,100,,,,,0,"fee schedule",EAPG,98.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.11,100,,,,,0,"fee schedule","100% of LI fee schedule",73.22,100,,,,,0,"fee schedule",EAPG,98.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.82,100,,,,,0,"fee schedule",EAPG,128.5,100,,,,,0,"fee schedule",EAPG,98.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",125.16,37.7,,100.13,,,0,"percent of total billed charges","37.7% of total billed charges",125.16,37.7,,100.13,,,0,"percent of total billed charges","37.70% of total billed charges",98.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",112.55,33.9,,90.04,,,0,"percent of total billed charges","33.9% of total billed charges",98.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",258.96,78,,207.17,,,0,"percent of total billed charges","78% of total billed charges",99.09,101,,,,,0,"fee schedule","101% of CMS fee schedule ",274.23,82.6,,219.38,,,0,"percent of total billed charges","82.6% of total billed charges",98.85,100,,,,,0,"fee schedule","100% of WA fee schedule",98.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",274.23,82.6,,219.38,,,0,"percent of total billed charges","82.6% of total billed charges",98.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.85,100,,,,,0,"fee schedule",EAPG,332,100,,265.60,,,0,"percent of total billed charges","100% of total billed charges",50.8,375.27,
"SARS-CoV-2 (COVID-19) PCR (GeneXpert)",30687635,CDM,306,RC,87635,CPT,OUTPATIENT,,,259,168.35,,227.92,88,,182.34,,,0,"percent of total billed charges","88% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",89.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.17,63,,130.54,,,0,"percent of total billed charges","63% of total billed charges",39.63,15.3,,31.70,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,178.71,69,,,,,0,"fee schedule","69% of total billed charges",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.31,382.5,,,,,0,"fee schedule","382.5% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.31,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.64,37.7,,78.11,,,0,"percent of total billed charges","37.7% of total billed charges",97.64,37.7,,78.11,,,0,"percent of total billed charges","37.70% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.8,33.9,,70.24,,,0,"percent of total billed charges","33.9% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.02,78,,161.62,,,0,"percent of total billed charges","78% of total billed charges",51.82,101,,,,,0,"fee schedule","101% of CMS fee schedule ",213.93,82.6,,171.14,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",213.93,82.6,,171.14,,,0,"percent of total billed charges","82.6% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",18.33,259,
"SARS-CoV-2 (COVID-19) IgG Ab LC",30286769,CDM,302,RC,86769,CPT,OUTPATIENT,,,137,89.05,,120.56,88,,96.45,,,0,"percent of total billed charges","88% of total billed charges",42.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,137,100,,109.60,,,0,"percent of total billed charges","100% of total billed charges",73.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,42.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",86.31,63,,69.05,,,0,"percent of total billed charges","63% of total billed charges",20.96,15.3,,16.77,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,94.53,69,,,,,0,"fee schedule","69% of total billed charges",137,100,,109.60,,,0,"percent of total billed charges","100% of total billed charges",42.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",137,100,,109.60,,,0,"percent of total billed charges","100% of total billed charges",42.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",137,100,,109.60,,,0,"percent of total billed charges","100% of total billed charges",42.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.13,382.5,,,,,0,"fee schedule","382.5% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,42.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.13,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,42.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,42.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.65,37.7,,41.32,,,0,"percent of total billed charges","37.7% of total billed charges",51.65,37.7,,41.32,,,0,"percent of total billed charges","37.70% of total billed charges",42.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.44,33.9,,37.15,,,0,"percent of total billed charges","33.9% of total billed charges",42.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.86,78,,85.49,,,0,"percent of total billed charges","78% of total billed charges",42.55,101,,,,,0,"fee schedule","101% of CMS fee schedule ",113.16,82.6,,90.53,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,42.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.16,82.6,,90.53,,,0,"percent of total billed charges","82.6% of total billed charges",42.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,137,100,,109.60,,,0,"percent of total billed charges","100% of total billed charges",6.96,137,
"SARS/Flu A andB Ag (Sofia 2)",30687428,CDM,306,RC,87812,CPT,OUTPATIENT,,,386,250.9,,339.68,88,,271.74,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.85,16.8,,51.88,,,0,"percent of total billed charges","16.8% of total billed charges",386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",66.79,17.304,,53.43,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",243.18,63,,194.54,,,0,"percent of total billed charges","63% of total billed charges",59.06,15.3,,47.25,,,0,"percent of total billed charges","15.3% of total billed charges",64.85,16.8,,51.88,,,0,"percent of total billed charges","16.8% of total billed charges",266.34,69,,,,,0,"fee schedule","69% of total billed charges",386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",64.85,16.8,,51.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",64.85,16.8,,51.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",66.14,17.136,,52.91,,,0,"percent of total billed charges","17.136% of total billed charges",84.3,21.84,,67.44,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",145.52,37.7,,116.42,,,0,"percent of total billed charges","37.7% of total billed charges",145.52,37.7,,116.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",130.85,33.9,,104.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.08,78,,240.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",318.84,82.6,,255.07,,,0,"percent of total billed charges","82.6% of total billed charges",64.85,16.8,,51.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",318.84,82.6,,255.07,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.85,16.8,,51.88,,,0,"percent of total billed charges","16.8% of total billed charges",386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",59.06,386,
"SARS-CoV-2 COVID-19/Flu/RSV (GeneXpert)",003000241U,CDM,306,RC,87637,CPT,OUTPATIENT,,,386,250.9,,339.68,88,,271.74,,,0,"percent of total billed charges","88% of total billed charges",142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",249.6,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",243.18,63,,194.54,,,0,"percent of total billed charges","63% of total billed charges",59.06,15.3,,47.25,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,266.34,69,,,,,0,"fee schedule","69% of total billed charges",386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.63,382.5,,,,,0,"fee schedule","382.5% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.63,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",145.52,37.7,,116.42,,,0,"percent of total billed charges","37.7% of total billed charges",145.52,37.7,,116.42,,,0,"percent of total billed charges","37.70% of total billed charges",142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",130.85,33.9,,104.68,,,0,"percent of total billed charges","33.9% of total billed charges",142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",301.08,78,,240.86,,,0,"percent of total billed charges","78% of total billed charges",144.05,101,,,,,0,"fee schedule","101% of CMS fee schedule ",318.84,82.6,,255.07,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",318.84,82.6,,255.07,,,0,"percent of total billed charges","82.6% of total billed charges",142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",18.33,386,
"SARS-CoV-2 (COVID-19) PCR (GeneXpert) POCT",30687635,CDM,306,RC,87635,CPT,OUTPATIENT,,,139,90.35,,122.32,88,,97.86,,,0,"percent of total billed charges","88% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",89.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.57,63,,70.06,,,0,"percent of total billed charges","63% of total billed charges",21.27,15.3,,17.02,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,95.91,69,,,,,0,"fee schedule","69% of total billed charges",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.31,382.5,,,,,0,"fee schedule","382.5% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.31,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.4,37.7,,41.92,,,0,"percent of total billed charges","37.7% of total billed charges",52.4,37.7,,41.92,,,0,"percent of total billed charges","37.70% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.12,33.9,,37.70,,,0,"percent of total billed charges","33.9% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.42,78,,86.74,,,0,"percent of total billed charges","78% of total billed charges",51.82,101,,,,,0,"fee schedule","101% of CMS fee schedule ",114.81,82.6,,91.85,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",114.81,82.6,,91.85,,,0,"percent of total billed charges","82.6% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",18.33,139,
"Saccharomyces cerevisiae Panel LC",30286671,CDM,302,RC,86671,CPT,OUTPATIENT,,,102,66.3,,89.76,88,,71.81,,,0,"percent of total billed charges","88% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",21.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.26,63,,51.41,,,0,"percent of total billed charges","63% of total billed charges",15.61,15.3,,12.49,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,70.38,69,,,,,0,"fee schedule","69% of total billed charges",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.85,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.25,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.45,37.7,,30.76,,,0,"percent of total billed charges","37.7% of total billed charges",38.45,37.7,,30.76,,,0,"percent of total billed charges","37.70% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.58,33.9,,27.66,,,0,"percent of total billed charges","33.9% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.56,78,,63.65,,,0,"percent of total billed charges","78% of total billed charges",12.37,101,,,,,0,"fee schedule","101% of CMS fee schedule ",84.25,82.6,,67.40,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",84.25,82.6,,67.40,,,0,"percent of total billed charges","82.6% of total billed charges",12.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",6.96,102,
Salicylate,30180307,CDM,301,RC,80179,CPT,OUTPATIENT,,,294,191.1,,258.72,88,,206.98,,,0,"percent of total billed charges","88% of total billed charges",18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",32.62,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",185.22,63,,148.18,,,0,"percent of total billed charges","63% of total billed charges",44.98,15.3,,35.98,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,202.86,69,,,,,0,"fee schedule","69% of total billed charges",294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.29,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.64,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",110.84,37.7,,88.67,,,0,"percent of total billed charges","37.7% of total billed charges",110.84,37.7,,88.67,,,0,"percent of total billed charges","37.70% of total billed charges",18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.67,33.9,,79.74,,,0,"percent of total billed charges","33.9% of total billed charges",18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",229.32,78,,183.46,,,0,"percent of total billed charges","78% of total billed charges",18.82,101,,,,,0,"fee schedule","101% of CMS fee schedule ",242.84,82.6,,194.27,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",242.84,82.6,,194.27,,,0,"percent of total billed charges","82.6% of total billed charges",18.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",7,294,
"Salivary Cortisol,MS LC",30182533,CDM,301,RC,82533,CPT,OUTPATIENT,,,231,150.15,,203.28,88,,162.62,,,0,"percent of total billed charges","88% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,231,100,,184.80,,,0,"percent of total billed charges","100% of total billed charges",28.52,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",145.53,63,,116.42,,,0,"percent of total billed charges","63% of total billed charges",35.34,15.3,,28.27,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,159.39,69,,,,,0,"fee schedule","69% of total billed charges",231,100,,184.80,,,0,"percent of total billed charges","100% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",231,100,,184.80,,,0,"percent of total billed charges","100% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",231,100,,184.80,,,0,"percent of total billed charges","100% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.3,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.09,37.7,,69.67,,,0,"percent of total billed charges","37.7% of total billed charges",87.09,37.7,,69.67,,,0,"percent of total billed charges","37.70% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.31,33.9,,62.65,,,0,"percent of total billed charges","33.9% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",180.18,78,,144.14,,,0,"percent of total billed charges","78% of total billed charges",16.46,101,,,,,0,"fee schedule","101% of CMS fee schedule ",190.81,82.6,,152.65,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",190.81,82.6,,152.65,,,0,"percent of total billed charges","82.6% of total billed charges",16.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,231,100,,184.80,,,0,"percent of total billed charges","100% of total billed charges",8.39,231,
N/A,311G0145,CDM,311,RC,,,OUTPATIENT,,,98,63.7,,86.24,88,,68.99,,,0,"percent of total billed charges","88% of total billed charges",49,50,,39.20,,,0,"percent of total billed charges","50% of total billed charges",16.46,16.8,,13.17,,,0,"percent of total billed charges","16.8% of total billed charges",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.96,17.304,,13.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.74,63,,49.39,,,0,"percent of total billed charges","63% of total billed charges",14.99,15.3,,11.99,,,0,"percent of total billed charges","15.3% of total billed charges",16.46,16.8,,13.17,,,0,"percent of total billed charges","16.8% of total billed charges",67.62,69,,,,,0,"fee schedule","69% of total billed charges",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.46,16.8,,13.17,,,0,"percent of total billed charges","16.8% of total billed charges",49,50,,39.20,,,0,"percent of total billed charges","50% of total billed charges",31.56,32.2,,25.25,,,0,"percent of total billed charges","32.2% of total billed charges",16.46,16.8,,13.17,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.79,17.136,,13.43,,,0,"percent of total billed charges","17.136% of total billed charges",21.4,21.84,,17.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.95,37.7,,29.56,,,0,"percent of total billed charges","37.7% of total billed charges",36.95,37.7,,29.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.22,33.9,,26.58,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.44,78,,61.15,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.95,82.6,,64.76,,,0,"percent of total billed charges","82.6% of total billed charges",16.46,16.8,,13.17,,,0,"percent of total billed charges","16.8% of total billed charges",49,50,,39.20,,,0,"percent of total billed charges","50% of total billed charges",80.95,82.6,,64.76,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.46,16.8,,13.17,,,0,"percent of total billed charges","16.8% of total billed charges",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",14.99,98,
"Semen Examination Post Vasectomy",30089321,CDM,300,RC,89321,CPT,OUTPATIENT,,,170,110.5,,149.6,88,,119.68,,,0,"percent of total billed charges","88% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.65,100,,,,,0,"fee schedule",EAPG,170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",21.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.91,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.1,63,,85.68,,,0,"percent of total billed charges","63% of total billed charges",26.01,15.3,,20.81,,,0,"percent of total billed charges","15.3% of total billed charges",8.65,100,,,,,0,"fee schedule",EAPG,117.3,69,,,,,0,"fee schedule","69% of total billed charges",170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.09,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.65,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.05,100,,,,,0,"fee schedule","100% of LI fee schedule",6.4,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.82,100,,,,,0,"fee schedule",EAPG,11.24,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.09,37.7,,51.27,,,0,"percent of total billed charges","37.7% of total billed charges",64.09,37.7,,51.27,,,0,"percent of total billed charges","37.70% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.63,33.9,,46.10,,,0,"percent of total billed charges","33.9% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",132.6,78,,106.08,,,0,"percent of total billed charges","78% of total billed charges",12.17,101,,,,,0,"fee schedule","101% of CMS fee schedule ",140.42,82.6,,112.34,,,0,"percent of total billed charges","82.6% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of WA fee schedule",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",140.42,82.6,,112.34,,,0,"percent of total billed charges","82.6% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.65,100,,,,,0,"fee schedule",EAPG,170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",6.4,170,
"Serum Pregnancy Test Qualitative",30084703,CDM,300,RC,84703,CPT,OUTPATIENT,,,137,89.05,,120.56,88,,96.45,,,0,"percent of total billed charges","88% of total billed charges",7.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,137,100,,109.60,,,0,"percent of total billed charges","100% of total billed charges",13.16,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,7.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",86.31,63,,69.05,,,0,"percent of total billed charges","63% of total billed charges",20.96,15.3,,16.77,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,94.53,69,,,,,0,"fee schedule","69% of total billed charges",137,100,,109.60,,,0,"percent of total billed charges","100% of total billed charges",7.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",137,100,,109.60,,,0,"percent of total billed charges","100% of total billed charges",7.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",137,100,,109.60,,,0,"percent of total billed charges","100% of total billed charges",7.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.76,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,7.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.52,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,7.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,7.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.65,37.7,,41.32,,,0,"percent of total billed charges","37.7% of total billed charges",51.65,37.7,,41.32,,,0,"percent of total billed charges","37.70% of total billed charges",7.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.44,33.9,,37.15,,,0,"percent of total billed charges","33.9% of total billed charges",7.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.86,78,,85.49,,,0,"percent of total billed charges","78% of total billed charges",7.59,101,,,,,0,"fee schedule","101% of CMS fee schedule ",113.16,82.6,,90.53,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,7.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.16,82.6,,90.53,,,0,"percent of total billed charges","82.6% of total billed charges",7.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,137,100,,109.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,137,
"Sex Horm Binding Glob LC",30184270,CDM,301,RC,84270,CPT,OUTPATIENT,,,128,83.2,,112.64,88,,90.11,,,0,"percent of total billed charges","88% of total billed charges",21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",38.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.64,63,,64.51,,,0,"percent of total billed charges","63% of total billed charges",19.58,15.3,,15.66,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,88.32,69,,,,,0,"fee schedule","69% of total billed charges",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",83.11,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.73,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.26,37.7,,38.61,,,0,"percent of total billed charges","37.7% of total billed charges",48.26,37.7,,38.61,,,0,"percent of total billed charges","37.70% of total billed charges",21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.39,33.9,,34.71,,,0,"percent of total billed charges","33.9% of total billed charges",21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.84,78,,79.87,,,0,"percent of total billed charges","78% of total billed charges",21.94,101,,,,,0,"fee schedule","101% of CMS fee schedule ",105.73,82.6,,84.58,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",105.73,82.6,,84.58,,,0,"percent of total billed charges","82.6% of total billed charges",21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,128,
"SHIGA TOXIN 1",30687899,CDM,306,RC,87899,CPT,OUTPATIENT,,,64,41.6,,56.32,88,,45.06,,,0,"percent of total billed charges","88% of total billed charges",16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",28.12,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.32,63,,32.26,,,0,"percent of total billed charges","63% of total billed charges",9.79,15.3,,7.83,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,44.16,69,,,,,0,"fee schedule","69% of total billed charges",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.46,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.07,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.13,37.7,,19.30,,,0,"percent of total billed charges","37.7% of total billed charges",24.13,37.7,,19.30,,,0,"percent of total billed charges","37.70% of total billed charges",16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.7,33.9,,17.36,,,0,"percent of total billed charges","33.9% of total billed charges",16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.92,78,,39.94,,,0,"percent of total billed charges","78% of total billed charges",16.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",52.86,82.6,,42.29,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.86,82.6,,42.29,,,0,"percent of total billed charges","82.6% of total billed charges",16.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,64,
"Sirolimus (Rapamune), Blood LC",30180195,CDM,301,RC,80195,CPT,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",24.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.73,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.7% of total billed charges",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.46,33.9,,69.97,,,0,"percent of total billed charges","33.9% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",13.86,101,,,,,0,"fee schedule","101% of CMS fee schedule ",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",7,258,
"Sjogren's Anti-SS-A LC",30286235,CDM,302,RC,86235,CPT,OUTPATIENT,,,100,65,91,88,88,,70.40,,,0,"percent of total billed charges","88% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",31.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",63,63,,50.40,,,0,"percent of total billed charges","63% of total billed charges",15.3,15.3,,12.24,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,69,69,,,,,0,"fee schedule","69% of total billed charges",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.58,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.93,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.7% of total billed charges",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.70% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.9,33.9,,27.12,,,0,"percent of total billed charges","33.9% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,78,,62.40,,,0,"percent of total billed charges","78% of total billed charges",18.1,101,,,,,0,"fee schedule","101% of CMS fee schedule ",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,100,
"Sjogren's Anti-SS-B LC",30286235,CDM,302,RC,86235,CPT,OUTPATIENT,,,100,65,91,88,88,,70.40,,,0,"percent of total billed charges","88% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",31.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",63,63,,50.40,,,0,"percent of total billed charges","63% of total billed charges",15.3,15.3,,12.24,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,69,69,,,,,0,"fee schedule","69% of total billed charges",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.58,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.93,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.7% of total billed charges",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.70% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.9,33.9,,27.12,,,0,"percent of total billed charges","33.9% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,78,,62.40,,,0,"percent of total billed charges","78% of total billed charges",18.1,101,,,,,0,"fee schedule","101% of CMS fee schedule ",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,100,
"Sjogren's Ab, Anti-SS-A/-SS-B LC",30286235,CDM,302,RC,86235,CPT,OUTPATIENT,,,100,65,91,88,88,,70.40,,,0,"percent of total billed charges","88% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",31.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",63,63,,50.40,,,0,"percent of total billed charges","63% of total billed charges",15.3,15.3,,12.24,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,69,69,,,,,0,"fee schedule","69% of total billed charges",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.58,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.93,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.7% of total billed charges",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.70% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.9,33.9,,27.12,,,0,"percent of total billed charges","33.9% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,78,,62.40,,,0,"percent of total billed charges","78% of total billed charges",18.1,101,,,,,0,"fee schedule","101% of CMS fee schedule ",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",17.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,100,
"Sodium Level",30184295,CDM,301,RC,84295,CPT,OUTPATIENT,,,98,63.7,,86.24,88,,68.99,,,0,"percent of total billed charges","88% of total billed charges",4.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",8.41,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.74,63,,49.39,,,0,"percent of total billed charges","63% of total billed charges",14.99,15.3,,11.99,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,67.62,69,,,,,0,"fee schedule","69% of total billed charges",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",4.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",4.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",4.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.39,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.8,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.95,37.7,,29.56,,,0,"percent of total billed charges","37.7% of total billed charges",36.95,37.7,,29.56,,,0,"percent of total billed charges","37.70% of total billed charges",4.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.22,33.9,,26.58,,,0,"percent of total billed charges","33.9% of total billed charges",4.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.44,78,,61.15,,,0,"percent of total billed charges","78% of total billed charges",4.85,101,,,,,0,"fee schedule","101% of CMS fee schedule ",80.95,82.6,,64.76,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.95,82.6,,64.76,,,0,"percent of total billed charges","82.6% of total billed charges",4.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,98,
"Sodium 24 Hr Urine",30184300,CDM,301,RC,84300,CPT,OUTPATIENT,,,109,70.85,,95.92,88,,76.74,,,0,"percent of total billed charges","88% of total billed charges",5.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",8.85,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.67,63,,54.94,,,0,"percent of total billed charges","63% of total billed charges",16.68,15.3,,13.34,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,75.21,69,,,,,0,"fee schedule","69% of total billed charges",109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",5.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",5.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",5.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.35,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.05,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.09,37.7,,32.87,,,0,"percent of total billed charges","37.7% of total billed charges",41.09,37.7,,32.87,,,0,"percent of total billed charges","37.70% of total billed charges",5.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.95,33.9,,29.56,,,0,"percent of total billed charges","33.9% of total billed charges",5.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.02,78,,68.02,,,0,"percent of total billed charges","78% of total billed charges",5.11,101,,,,,0,"fee schedule","101% of CMS fee schedule ",90.03,82.6,,72.02,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.03,82.6,,72.02,,,0,"percent of total billed charges","82.6% of total billed charges",5.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",3.25,109,
"SODIUM BODY FLUID",30184302,CDM,301,RC,84302,CPT,OUTPATIENT,,,88,57.2,,77.44,88,,61.95,,,0,"percent of total billed charges","88% of total billed charges",4.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",8.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.44,63,,44.35,,,0,"percent of total billed charges","63% of total billed charges",13.46,15.3,,10.77,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,60.72,69,,,,,0,"fee schedule","69% of total billed charges",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",4.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",4.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",4.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.58,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.86,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.18,37.7,,26.54,,,0,"percent of total billed charges","37.7% of total billed charges",33.18,37.7,,26.54,,,0,"percent of total billed charges","37.70% of total billed charges",4.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.83,33.9,,23.86,,,0,"percent of total billed charges","33.9% of total billed charges",4.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.64,78,,54.91,,,0,"percent of total billed charges","78% of total billed charges",4.9,101,,,,,0,"fee schedule","101% of CMS fee schedule ",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",4.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,88,
"Sodium Urine",30184300,CDM,301,RC,84300,CPT,OUTPATIENT,,,109,70.85,,95.92,88,,76.74,,,0,"percent of total billed charges","88% of total billed charges",5.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",8.85,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.67,63,,54.94,,,0,"percent of total billed charges","63% of total billed charges",16.68,15.3,,13.34,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,75.21,69,,,,,0,"fee schedule","69% of total billed charges",109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",5.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",5.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",5.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.35,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.05,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.09,37.7,,32.87,,,0,"percent of total billed charges","37.7% of total billed charges",41.09,37.7,,32.87,,,0,"percent of total billed charges","37.70% of total billed charges",5.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.95,33.9,,29.56,,,0,"percent of total billed charges","33.9% of total billed charges",5.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.02,78,,68.02,,,0,"percent of total billed charges","78% of total billed charges",5.11,101,,,,,0,"fee schedule","101% of CMS fee schedule ",90.03,82.6,,72.02,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.03,82.6,,72.02,,,0,"percent of total billed charges","82.6% of total billed charges",5.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",3.25,109,
"Soluble Liver Antigen (SLA) AutoAntibody LC",30283516,CDM,302,RC,83516,CPT,OUTPATIENT,,,112,72.8,,98.56,88,,78.85,,,0,"percent of total billed charges","88% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",20.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",17.14,15.3,,13.71,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,77.28,69,,,,,0,"fee schedule","69% of total billed charges",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.53,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.22,37.7,,33.78,,,0,"percent of total billed charges","37.7% of total billed charges",42.22,37.7,,33.78,,,0,"percent of total billed charges","37.70% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.97,33.9,,30.38,,,0,"percent of total billed charges","33.9% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.36,78,,69.89,,,0,"percent of total billed charges","78% of total billed charges",11.64,101,,,,,0,"fee schedule","101% of CMS fee schedule ",92.51,82.6,,74.01,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.51,82.6,,74.01,,,0,"percent of total billed charges","82.6% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",8.11,112,
"Specific Gravity Urine",30781002,CDM,307,RC,81002,CPT,OUTPATIENT,,,143,92.95,,125.84,88,,100.67,,,0,"percent of total billed charges","88% of total billed charges",3.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",6.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",2.55,100,,,,,0,"fee schedule",EAPG,3.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.09,63,,72.07,,,0,"percent of total billed charges","63% of total billed charges",21.88,15.3,,17.50,,,0,"percent of total billed charges","15.3% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,98.67,69,,,,,0,"fee schedule","69% of total billed charges",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",3.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",3.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",3.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.31,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,3.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.48,100,,,,,0,"fee schedule","100% of LI fee schedule",1.83,100,,,,,0,"fee schedule",EAPG,3.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.52,100,,,,,0,"fee schedule",EAPG,3.22,100,,,,,0,"fee schedule",EAPG,3.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.91,37.7,,43.13,,,0,"percent of total billed charges","37.7% of total billed charges",53.91,37.7,,43.13,,,0,"percent of total billed charges","37.70% of total billed charges",3.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.48,33.9,,38.78,,,0,"percent of total billed charges","33.9% of total billed charges",3.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",111.54,78,,89.23,,,0,"percent of total billed charges","78% of total billed charges",3.51,101,,,,,0,"fee schedule","101% of CMS fee schedule ",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,3.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",3.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",1.83,143,
"016502 Spotted Fever Abs, IgG, IgM",30286757,CDM,302,RC,86757,CPT,OUTPATIENT,,,404,262.6,,355.52,88,,284.42,,,0,"percent of total billed charges","88% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,404,100,,323.20,,,0,"percent of total billed charges","100% of total billed charges",33.86,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",254.52,63,,203.62,,,0,"percent of total billed charges","63% of total billed charges",61.81,15.3,,49.45,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,278.76,69,,,,,0,"fee schedule","69% of total billed charges",404,100,,323.20,,,0,"percent of total billed charges","100% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",404,100,,323.20,,,0,"percent of total billed charges","100% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",404,100,,323.20,,,0,"percent of total billed charges","100% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.01,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.35,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",152.31,37.7,,121.85,,,0,"percent of total billed charges","37.7% of total billed charges",152.31,37.7,,121.85,,,0,"percent of total billed charges","37.70% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.96,33.9,,109.57,,,0,"percent of total billed charges","33.9% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",315.12,78,,252.10,,,0,"percent of total billed charges","78% of total billed charges",19.54,101,,,,,0,"fee schedule","101% of CMS fee schedule ",333.7,82.6,,266.96,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",333.7,82.6,,266.96,,,0,"percent of total billed charges","82.6% of total billed charges",19.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,404,100,,323.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,404,
"Sputum Cytology LC",31188108,CDM,311,RC,88108,CPT,OUTPATIENT,,,196,127.4,,172.48,88,,137.98,,,0,"percent of total billed charges","88% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",71.58,175,,,,,0,"fee schedule","175% of CMS fee schedule",26.78,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.48,63,,98.78,,,0,"percent of total billed charges","63% of total billed charges",29.99,15.3,,23.99,,,0,"percent of total billed charges","15.3% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,135.24,69,,,,,0,"fee schedule","69% of total billed charges",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.26,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.52,100,,,,,0,"fee schedule",EAPG,33.8,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.89,37.7,,59.11,,,0,"percent of total billed charges","37.7% of total billed charges",73.89,37.7,,59.11,,,0,"percent of total billed charges","37.70% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.44,33.9,,53.15,,,0,"percent of total billed charges","33.9% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",152.88,78,,122.30,,,0,"percent of total billed charges","78% of total billed charges",41.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",161.9,82.6,,129.52,,,0,"percent of total billed charges","82.6% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",161.9,82.6,,129.52,,,0,"percent of total billed charges","82.6% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",19.26,196,
"Standard Panel AVR",30687511,CDM,306,RC,87511,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"Stool Culture, Yersinia Only LC",30687046,CDM,306,RC,87046,CPT,OUTPATIENT,,,61,39.65,,53.68,88,,42.94,,,0,"percent of total billed charges","88% of total billed charges",9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",16.52,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.43,63,,30.74,,,0,"percent of total billed charges","63% of total billed charges",9.33,15.3,,7.46,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,42.09,69,,,,,0,"fee schedule","69% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.44,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",23,37.7,,18.40,,,0,"percent of total billed charges","37.7% of total billed charges",23,37.7,,18.40,,,0,"percent of total billed charges","37.70% of total billed charges",9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.68,33.9,,16.54,,,0,"percent of total billed charges","33.9% of total billed charges",9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.58,78,,38.06,,,0,"percent of total billed charges","78% of total billed charges",9.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",50.39,82.6,,40.31,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.39,82.6,,40.31,,,0,"percent of total billed charges","82.6% of total billed charges",9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",4.81,61,
"Strep A, Rapid",30687880,CDM,306,RC,87880,CPT,OUTPATIENT,,,60,39,,52.8,88,,42.24,,,0,"percent of total billed charges","88% of total billed charges",16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",28.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.8,63,,30.24,,,0,"percent of total billed charges","63% of total billed charges",9.18,15.3,,7.34,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,41.4,69,,,,,0,"fee schedule","69% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.22,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.53,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.62,37.7,,18.10,,,0,"percent of total billed charges","37.7% of total billed charges",22.62,37.7,,18.10,,,0,"percent of total billed charges","37.70% of total billed charges",16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.34,33.9,,16.27,,,0,"percent of total billed charges","33.9% of total billed charges",16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.8,78,,37.44,,,0,"percent of total billed charges","78% of total billed charges",16.69,101,,,,,0,"fee schedule","101% of CMS fee schedule ",49.56,82.6,,39.65,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.56,82.6,,39.65,,,0,"percent of total billed charges","82.6% of total billed charges",16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",4.81,63.22,
"Strep B Rapid",30087880,CDM,300,RC,87880,CPT,OUTPATIENT,,,60,39,,52.8,88,,42.24,,,0,"percent of total billed charges","88% of total billed charges",16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",28.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.8,63,,30.24,,,0,"percent of total billed charges","63% of total billed charges",9.18,15.3,,7.34,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,41.4,69,,,,,0,"fee schedule","69% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.22,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.53,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.62,37.7,,18.10,,,0,"percent of total billed charges","37.7% of total billed charges",22.62,37.7,,18.10,,,0,"percent of total billed charges","37.70% of total billed charges",16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.34,33.9,,16.27,,,0,"percent of total billed charges","33.9% of total billed charges",16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.8,78,,37.44,,,0,"percent of total billed charges","78% of total billed charges",16.69,101,,,,,0,"fee schedule","101% of CMS fee schedule ",49.56,82.6,,39.65,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.56,82.6,,39.65,,,0,"percent of total billed charges","82.6% of total billed charges",16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",4.81,63.22,
"Strep A (Sofia)",30687430,CDM,306,RC,87430,CPT,OUTPATIENT,,,33,21.45,,29.04,88,,23.23,,,0,"percent of total billed charges","88% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",29.41,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.79,63,,16.63,,,0,"percent of total billed charges","63% of total billed charges",5.05,15.3,,4.04,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,22.77,69,,,,,0,"fee schedule","69% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.29,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.8,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.44,37.7,,9.95,,,0,"percent of total billed charges","37.7% of total billed charges",12.44,37.7,,9.95,,,0,"percent of total billed charges","37.70% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.19,33.9,,8.95,,,0,"percent of total billed charges","33.9% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.74,78,,20.59,,,0,"percent of total billed charges","78% of total billed charges",16.97,101,,,,,0,"fee schedule","101% of CMS fee schedule ",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",4.81,64.29,
"Strep A (GeneXpert Xpress) POCT",30687651,CDM,306,RC,87651,CPT,OUTPATIENT,,,33,21.45,,29.04,88,,23.23,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.79,63,,16.63,,,0,"percent of total billed charges","63% of total billed charges",5.05,15.3,,4.04,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,22.77,69,,,,,0,"fee schedule","69% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.44,37.7,,9.95,,,0,"percent of total billed charges","37.7% of total billed charges",12.44,37.7,,9.95,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.19,33.9,,8.95,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.74,78,,20.59,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",5.05,134.21,
"SurePath Pap AVR",31188175,CDM,311,RC,88175,CPT,OUTPATIENT,,,107,69.55,,94.16,88,,75.33,,,0,"percent of total billed charges","88% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",46.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.03,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.41,63,,53.93,,,0,"percent of total billed charges","63% of total billed charges",39.92,150,,,,,0,"fee schedule","150% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,73.83,69,,,,,0,"fee schedule","69% of total billed charges",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.78,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.61,100,,,,,0,"fee schedule","100% of LI fee schedule",11.53,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.87,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.34,37.7,,32.27,,,0,"percent of total billed charges","37.7% of total billed charges",40.34,37.7,,32.27,,,0,"percent of total billed charges","37.70% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.27,33.9,,29.02,,,0,"percent of total billed charges","33.9% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",83.46,78,,66.77,,,0,"percent of total billed charges","78% of total billed charges",26.87,101,,,,,0,"fee schedule","101% of CMS fee schedule ",88.38,82.6,,70.70,,,0,"percent of total billed charges","82.6% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.38,82.6,,70.70,,,0,"percent of total billed charges","82.6% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",11.53,107,
"Surgical AVR",31288300,CDM,312,RC,88300,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",20.32,100,,,,,0,"fee schedule",EAPG,25.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",14.76,25.9,
"T pallidum Screening Cascade LC",30186780,CDM,301,RC,86780,CPT,OUTPATIENT,,,91,59.15,,80.08,88,,64.06,,,0,"percent of total billed charges","88% of total billed charges",13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",23.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.33,63,,45.86,,,0,"percent of total billed charges","63% of total billed charges",13.92,15.3,,11.14,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,62.79,69,,,,,0,"fee schedule","69% of total billed charges",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.64,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.24,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.31,37.7,,27.45,,,0,"percent of total billed charges","37.7% of total billed charges",34.31,37.7,,27.45,,,0,"percent of total billed charges","37.70% of total billed charges",13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.85,33.9,,24.68,,,0,"percent of total billed charges","33.9% of total billed charges",13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.98,78,,56.78,,,0,"percent of total billed charges","78% of total billed charges",13.37,101,,,,,0,"fee schedule","101% of CMS fee schedule ",75.17,82.6,,60.14,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",75.17,82.6,,60.14,,,0,"percent of total billed charges","82.6% of total billed charges",13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",6.96,91,
"T pallidum Immunoblot LC",30186780,CDM,301,RC,86780,CPT,OUTPATIENT,,,104,67.6,,91.52,88,,73.22,,,0,"percent of total billed charges","88% of total billed charges",13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",23.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.52,63,,52.42,,,0,"percent of total billed charges","63% of total billed charges",15.91,15.3,,12.73,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,71.76,69,,,,,0,"fee schedule","69% of total billed charges",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.64,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.24,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.21,37.7,,31.37,,,0,"percent of total billed charges","37.7% of total billed charges",39.21,37.7,,31.37,,,0,"percent of total billed charges","37.70% of total billed charges",13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.26,33.9,,28.21,,,0,"percent of total billed charges","33.9% of total billed charges",13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.12,78,,64.90,,,0,"percent of total billed charges","78% of total billed charges",13.37,101,,,,,0,"fee schedule","101% of CMS fee schedule ",85.9,82.6,,68.72,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.9,82.6,,68.72,,,0,"percent of total billed charges","82.6% of total billed charges",13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,104,
"T-Lymphocyte Helper/Suppressor LC",30286360,CDM,302,RC,86360,CPT,OUTPATIENT,,,626,406.9,,550.88,88,,440.70,,,0,"percent of total billed charges","88% of total billed charges",46.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.28,100,,,,,0,"fee schedule",EAPG,626,100,,500.80,,,0,"percent of total billed charges","100% of total billed charges",82.21,175,,,,,0,"fee schedule","175% of CMS fee schedule",28.1,100,,,,,0,"fee schedule",EAPG,46.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",394.38,63,,315.50,,,0,"percent of total billed charges","63% of total billed charges",95.78,15.3,,76.62,,,0,"percent of total billed charges","15.3% of total billed charges",27.28,100,,,,,0,"fee schedule",EAPG,431.94,69,,,,,0,"fee schedule","69% of total billed charges",626,100,,500.80,,,0,"percent of total billed charges","100% of total billed charges",46.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",626,100,,500.80,,,0,"percent of total billed charges","100% of total billed charges",46.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",626,100,,500.80,,,0,"percent of total billed charges","100% of total billed charges",46.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",179.69,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",27.28,100,,,,,0,"fee schedule",EAPG,46.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.98,100,,,,,0,"fee schedule","100% of LI fee schedule",20.21,100,,,,,0,"fee schedule",EAPG,46.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.83,100,,,,,0,"fee schedule",EAPG,35.47,100,,,,,0,"fee schedule",EAPG,46.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",236,37.7,,188.80,,,0,"percent of total billed charges","37.7% of total billed charges",236,37.7,,188.80,,,0,"percent of total billed charges","37.70% of total billed charges",46.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",212.21,33.9,,169.77,,,0,"percent of total billed charges","33.9% of total billed charges",46.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",488.28,78,,390.62,,,0,"percent of total billed charges","78% of total billed charges",47.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",517.08,82.6,,413.66,,,0,"percent of total billed charges","82.6% of total billed charges",27.28,100,,,,,0,"fee schedule",EAPG,46.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",517.08,82.6,,413.66,,,0,"percent of total billed charges","82.6% of total billed charges",46.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.28,100,,,,,0,"fee schedule",EAPG,626,100,,500.80,,,0,"percent of total billed charges","100% of total billed charges",20.21,626,
"T3 Free",30084481,CDM,300,RC,84481,CPT,OUTPATIENT,,,388,252.2,,341.44,88,,273.15,,,0,"percent of total billed charges","88% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",29.64,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",244.44,63,,195.55,,,0,"percent of total billed charges","63% of total billed charges",59.36,15.3,,47.49,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,267.72,69,,,,,0,"fee schedule","69% of total billed charges",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.79,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.94,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",146.28,37.7,,117.02,,,0,"percent of total billed charges","37.7% of total billed charges",146.28,37.7,,117.02,,,0,"percent of total billed charges","37.70% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",131.53,33.9,,105.22,,,0,"percent of total billed charges","33.9% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",302.64,78,,242.11,,,0,"percent of total billed charges","78% of total billed charges",17.1,101,,,,,0,"fee schedule","101% of CMS fee schedule ",320.49,82.6,,256.39,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",320.49,82.6,,256.39,,,0,"percent of total billed charges","82.6% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",8.39,388,
"T3 Uptake LC",30184479,CDM,301,RC,84479,CPT,OUTPATIENT,,,66,42.9,,58.08,88,,46.46,,,0,"percent of total billed charges","88% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",11.32,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.58,63,,33.26,,,0,"percent of total billed charges","63% of total billed charges",10.1,15.3,,8.08,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,45.54,69,,,,,0,"fee schedule","69% of total billed charges",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.74,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.47,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.88,37.7,,19.90,,,0,"percent of total billed charges","37.7% of total billed charges",24.88,37.7,,19.90,,,0,"percent of total billed charges","37.70% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.37,33.9,,17.90,,,0,"percent of total billed charges","33.9% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.48,78,,41.18,,,0,"percent of total billed charges","78% of total billed charges",6.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",54.52,82.6,,43.62,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.52,82.6,,43.62,,,0,"percent of total billed charges","82.6% of total billed charges",6.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",6.47,66,
N/A,30184481,CDM,301,RC,84481,CPT,OUTPATIENT,,,677,440.05,,595.76,88,,476.61,,,0,"percent of total billed charges","88% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,677,100,,541.60,,,0,"percent of total billed charges","100% of total billed charges",29.64,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",426.51,63,,341.21,,,0,"percent of total billed charges","63% of total billed charges",103.58,15.3,,82.86,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,467.13,69,,,,,0,"fee schedule","69% of total billed charges",677,100,,541.60,,,0,"percent of total billed charges","100% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",677,100,,541.60,,,0,"percent of total billed charges","100% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",677,100,,541.60,,,0,"percent of total billed charges","100% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.79,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.94,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",255.23,37.7,,204.18,,,0,"percent of total billed charges","37.7% of total billed charges",255.23,37.7,,204.18,,,0,"percent of total billed charges","37.70% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",229.5,33.9,,183.60,,,0,"percent of total billed charges","33.9% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",528.06,78,,422.45,,,0,"percent of total billed charges","78% of total billed charges",17.1,101,,,,,0,"fee schedule","101% of CMS fee schedule ",559.2,82.6,,447.36,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",559.2,82.6,,447.36,,,0,"percent of total billed charges","82.6% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,677,100,,541.60,,,0,"percent of total billed charges","100% of total billed charges",8.39,677,
"T4 Total",30084436,CDM,300,RC,84436,CPT,OUTPATIENT,,,153,99.45,,134.64,88,,107.71,,,0,"percent of total billed charges","88% of total billed charges",6.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",12.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,6.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",96.39,63,,77.11,,,0,"percent of total billed charges","63% of total billed charges",23.41,15.3,,18.73,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,105.57,69,,,,,0,"fee schedule","69% of total billed charges",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",6.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",6.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",6.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.27,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,6.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.87,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,6.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,6.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.68,37.7,,46.14,,,0,"percent of total billed charges","37.7% of total billed charges",57.68,37.7,,46.14,,,0,"percent of total billed charges","37.70% of total billed charges",6.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.87,33.9,,41.50,,,0,"percent of total billed charges","33.9% of total billed charges",6.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",119.34,78,,95.47,,,0,"percent of total billed charges","78% of total billed charges",6.93,101,,,,,0,"fee schedule","101% of CMS fee schedule ",126.38,82.6,,101.10,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,6.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",126.38,82.6,,101.10,,,0,"percent of total billed charges","82.6% of total billed charges",6.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",6.87,153,
"TSH w/ Rflx to FT4",30184443,CDM,301,RC,84443,CPT,OUTPATIENT,,,169,109.85,,148.72,88,,118.98,,,0,"percent of total billed charges","88% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",29.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.47,63,,85.18,,,0,"percent of total billed charges","63% of total billed charges",25.86,15.3,,20.69,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,116.61,69,,,,,0,"fee schedule","69% of total billed charges",169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.26,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.8,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.71,37.7,,50.97,,,0,"percent of total billed charges","37.7% of total billed charges",63.71,37.7,,50.97,,,0,"percent of total billed charges","37.70% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.29,33.9,,45.83,,,0,"percent of total billed charges","33.9% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",131.82,78,,105.46,,,0,"percent of total billed charges","78% of total billed charges",16.96,101,,,,,0,"fee schedule","101% of CMS fee schedule ",139.59,82.6,,111.67,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",139.59,82.6,,111.67,,,0,"percent of total billed charges","82.6% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",8.39,169,
"TSH LC",30184443,CDM,301,RC,84443,CPT,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",29.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.26,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.8,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.7% of total billed charges",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.78,33.9,,5.42,,,0,"percent of total billed charges","33.9% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",16.96,101,,,,,0,"fee schedule","101% of CMS fee schedule ",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,64.26,
"TSH+Free T4 LC",30184443,CDM,301,RC,84443,CPT,OUTPATIENT,,,73,47.45,,64.24,88,,51.39,,,0,"percent of total billed charges","88% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",29.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.99,63,,36.79,,,0,"percent of total billed charges","63% of total billed charges",11.17,15.3,,8.94,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,50.37,69,,,,,0,"fee schedule","69% of total billed charges",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.26,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.8,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.52,37.7,,22.02,,,0,"percent of total billed charges","37.7% of total billed charges",27.52,37.7,,22.02,,,0,"percent of total billed charges","37.70% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,33.9,,19.80,,,0,"percent of total billed charges","33.9% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.94,78,,45.55,,,0,"percent of total billed charges","78% of total billed charges",16.96,101,,,,,0,"fee schedule","101% of CMS fee schedule ",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",8.39,73,
"Tacrolimus by Immunoassay LC 711034",30180197,CDM,301,RC,80197,CPT,OUTPATIENT,,,164,106.6,,144.32,88,,115.46,,,0,"percent of total billed charges","88% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",24.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",103.32,63,,82.66,,,0,"percent of total billed charges","63% of total billed charges",25.09,15.3,,20.07,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,113.16,69,,,,,0,"fee schedule","69% of total billed charges",164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.73,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.83,37.7,,49.46,,,0,"percent of total billed charges","37.7% of total billed charges",61.83,37.7,,49.46,,,0,"percent of total billed charges","37.70% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.6,33.9,,44.48,,,0,"percent of total billed charges","33.9% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",127.92,78,,102.34,,,0,"percent of total billed charges","78% of total billed charges",13.86,101,,,,,0,"fee schedule","101% of CMS fee schedule ",135.46,82.6,,108.37,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",135.46,82.6,,108.37,,,0,"percent of total billed charges","82.6% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",7,164,
"Tacrolimus (FK506), Blood LC 700248",30180197,CDM,301,RC,80197,CPT,OUTPATIENT,,,426,276.9,,374.88,88,,299.90,,,0,"percent of total billed charges","88% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",24.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",268.38,63,,214.70,,,0,"percent of total billed charges","63% of total billed charges",65.18,15.3,,52.14,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,293.94,69,,,,,0,"fee schedule","69% of total billed charges",426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.73,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.6,37.7,,128.48,,,0,"percent of total billed charges","37.7% of total billed charges",160.6,37.7,,128.48,,,0,"percent of total billed charges","37.70% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.41,33.9,,115.53,,,0,"percent of total billed charges","33.9% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",332.28,78,,265.82,,,0,"percent of total billed charges","78% of total billed charges",13.86,101,,,,,0,"fee schedule","101% of CMS fee schedule ",351.88,82.6,,281.50,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",351.88,82.6,,281.50,,,0,"percent of total billed charges","82.6% of total billed charges",13.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",7,426,
"Testosterone Total",30084403,CDM,300,RC,84403,CPT,OUTPATIENT,,,428,278.2,,376.64,88,,301.31,,,0,"percent of total billed charges","88% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,428,100,,342.40,,,0,"percent of total billed charges","100% of total billed charges",45.16,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",269.64,63,,215.71,,,0,"percent of total billed charges","63% of total billed charges",65.48,15.3,,52.38,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,295.32,69,,,,,0,"fee schedule","69% of total billed charges",428,100,,342.40,,,0,"percent of total billed charges","100% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",428,100,,342.40,,,0,"percent of total billed charges","100% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",428,100,,342.40,,,0,"percent of total billed charges","100% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.72,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.81,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",161.36,37.7,,129.09,,,0,"percent of total billed charges","37.7% of total billed charges",161.36,37.7,,129.09,,,0,"percent of total billed charges","37.70% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",145.09,33.9,,116.07,,,0,"percent of total billed charges","33.9% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",333.84,78,,267.07,,,0,"percent of total billed charges","78% of total billed charges",26.06,101,,,,,0,"fee schedule","101% of CMS fee schedule ",353.53,82.6,,282.82,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",353.53,82.6,,282.82,,,0,"percent of total billed charges","82.6% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,428,100,,342.40,,,0,"percent of total billed charges","100% of total billed charges",8.39,428,
"Testosterone LC",30184403,CDM,301,RC,84403,CPT,OUTPATIENT,,,481,312.65,,423.28,88,,338.62,,,0,"percent of total billed charges","88% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,481,100,,384.80,,,0,"percent of total billed charges","100% of total billed charges",45.16,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",303.03,63,,242.42,,,0,"percent of total billed charges","63% of total billed charges",73.59,15.3,,58.87,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,331.89,69,,,,,0,"fee schedule","69% of total billed charges",481,100,,384.80,,,0,"percent of total billed charges","100% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",481,100,,384.80,,,0,"percent of total billed charges","100% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",481,100,,384.80,,,0,"percent of total billed charges","100% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.72,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.81,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",181.34,37.7,,145.07,,,0,"percent of total billed charges","37.7% of total billed charges",181.34,37.7,,145.07,,,0,"percent of total billed charges","37.70% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.06,33.9,,130.45,,,0,"percent of total billed charges","33.9% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",375.18,78,,300.14,,,0,"percent of total billed charges","78% of total billed charges",26.06,101,,,,,0,"fee schedule","101% of CMS fee schedule ",397.31,82.6,,317.85,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",397.31,82.6,,317.85,,,0,"percent of total billed charges","82.6% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,481,100,,384.80,,,0,"percent of total billed charges","100% of total billed charges",8.39,481,
"Testosterone, Total, LC/MS LC",30184403,CDM,301,RC,84403,CPT,OUTPATIENT,,,481,312.65,,423.28,88,,338.62,,,0,"percent of total billed charges","88% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,481,100,,384.80,,,0,"percent of total billed charges","100% of total billed charges",45.16,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",303.03,63,,242.42,,,0,"percent of total billed charges","63% of total billed charges",73.59,15.3,,58.87,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,331.89,69,,,,,0,"fee schedule","69% of total billed charges",481,100,,384.80,,,0,"percent of total billed charges","100% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",481,100,,384.80,,,0,"percent of total billed charges","100% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",481,100,,384.80,,,0,"percent of total billed charges","100% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.72,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.81,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",181.34,37.7,,145.07,,,0,"percent of total billed charges","37.7% of total billed charges",181.34,37.7,,145.07,,,0,"percent of total billed charges","37.70% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.06,33.9,,130.45,,,0,"percent of total billed charges","33.9% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",375.18,78,,300.14,,,0,"percent of total billed charges","78% of total billed charges",26.06,101,,,,,0,"fee schedule","101% of CMS fee schedule ",397.31,82.6,,317.85,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",397.31,82.6,,317.85,,,0,"percent of total billed charges","82.6% of total billed charges",25.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,481,100,,384.80,,,0,"percent of total billed charges","100% of total billed charges",8.39,481,
"Testosterone,Free and Total LC 140103",30184402,CDM,301,RC,84402,CPT,OUTPATIENT,,,549,356.85,,483.12,88,,386.50,,,0,"percent of total billed charges","88% of total billed charges",25.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",44.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,25.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",345.87,63,,276.70,,,0,"percent of total billed charges","63% of total billed charges",84,15.3,,67.20,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,378.81,69,,,,,0,"fee schedule","69% of total billed charges",549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",25.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",25.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",25.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.42,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,25.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.47,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,25.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,25.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",206.97,37.7,,165.58,,,0,"percent of total billed charges","37.7% of total billed charges",206.97,37.7,,165.58,,,0,"percent of total billed charges","37.70% of total billed charges",25.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",186.11,33.9,,148.89,,,0,"percent of total billed charges","33.9% of total billed charges",25.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",428.22,78,,342.58,,,0,"percent of total billed charges","78% of total billed charges",25.72,101,,,,,0,"fee schedule","101% of CMS fee schedule ",453.47,82.6,,362.78,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,25.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",453.47,82.6,,362.78,,,0,"percent of total billed charges","82.6% of total billed charges",25.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",8.39,549,
"SEX HORMONE BIND GLOBULIN",30184270,CDM,301,RC,84270,CPT,OUTPATIENT,,,108,70.2,,95.04,88,,76.03,,,0,"percent of total billed charges","88% of total billed charges",21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",38.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.04,63,,54.43,,,0,"percent of total billed charges","63% of total billed charges",16.52,15.3,,13.22,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,74.52,69,,,,,0,"fee schedule","69% of total billed charges",108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",83.11,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.73,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.72,37.7,,32.58,,,0,"percent of total billed charges","37.7% of total billed charges",40.72,37.7,,32.58,,,0,"percent of total billed charges","37.70% of total billed charges",21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.61,33.9,,29.29,,,0,"percent of total billed charges","33.9% of total billed charges",21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",84.24,78,,67.39,,,0,"percent of total billed charges","78% of total billed charges",21.94,101,,,,,0,"fee schedule","101% of CMS fee schedule ",89.21,82.6,,71.37,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.21,82.6,,71.37,,,0,"percent of total billed charges","82.6% of total billed charges",21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,108,
"SEX HORMONE BIND GLOBULIN",30184270,CDM,301,RC,84270,CPT,OUTPATIENT,,,108,70.2,,95.04,88,,76.03,,,0,"percent of total billed charges","88% of total billed charges",21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",38.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.04,63,,54.43,,,0,"percent of total billed charges","63% of total billed charges",16.52,15.3,,13.22,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,74.52,69,,,,,0,"fee schedule","69% of total billed charges",108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",83.11,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.73,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.72,37.7,,32.58,,,0,"percent of total billed charges","37.7% of total billed charges",40.72,37.7,,32.58,,,0,"percent of total billed charges","37.70% of total billed charges",21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.61,33.9,,29.29,,,0,"percent of total billed charges","33.9% of total billed charges",21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",84.24,78,,67.39,,,0,"percent of total billed charges","78% of total billed charges",21.94,101,,,,,0,"fee schedule","101% of CMS fee schedule ",89.21,82.6,,71.37,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.21,82.6,,71.37,,,0,"percent of total billed charges","82.6% of total billed charges",21.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,108,
"Testosterone, Free+Total, LC/MS LC 070195",30084402,CDM,300,RC,84402,CPT,OUTPATIENT,,,481,312.65,,423.28,88,,338.62,,,0,"percent of total billed charges","88% of total billed charges",25.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,481,100,,384.80,,,0,"percent of total billed charges","100% of total billed charges",44.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,25.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",303.03,63,,242.42,,,0,"percent of total billed charges","63% of total billed charges",73.59,15.3,,58.87,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,331.89,69,,,,,0,"fee schedule","69% of total billed charges",481,100,,384.80,,,0,"percent of total billed charges","100% of total billed charges",25.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",481,100,,384.80,,,0,"percent of total billed charges","100% of total billed charges",25.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",481,100,,384.80,,,0,"percent of total billed charges","100% of total billed charges",25.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.42,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,25.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.47,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,25.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,25.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",181.34,37.7,,145.07,,,0,"percent of total billed charges","37.7% of total billed charges",181.34,37.7,,145.07,,,0,"percent of total billed charges","37.70% of total billed charges",25.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.06,33.9,,130.45,,,0,"percent of total billed charges","33.9% of total billed charges",25.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",375.18,78,,300.14,,,0,"percent of total billed charges","78% of total billed charges",25.72,101,,,,,0,"fee schedule","101% of CMS fee schedule ",397.31,82.6,,317.85,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,25.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",397.31,82.6,,317.85,,,0,"percent of total billed charges","82.6% of total billed charges",25.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,481,100,,384.80,,,0,"percent of total billed charges","100% of total billed charges",8.39,481,
"Tetanus Antitoxoid IgG Ab LC",30086317,CDM,300,RC,86317,CPT,OUTPATIENT,,,321,208.65,,282.48,88,,225.98,,,0,"percent of total billed charges","88% of total billed charges",14.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,321,100,,256.80,,,0,"percent of total billed charges","100% of total billed charges",26.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,14.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.23,63,,161.78,,,0,"percent of total billed charges","63% of total billed charges",49.11,15.3,,39.29,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,221.49,69,,,,,0,"fee schedule","69% of total billed charges",321,100,,256.80,,,0,"percent of total billed charges","100% of total billed charges",14.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",321,100,,256.80,,,0,"percent of total billed charges","100% of total billed charges",14.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",321,100,,256.80,,,0,"percent of total billed charges","100% of total billed charges",14.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.33,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.99,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,14.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,14.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",121.02,37.7,,96.82,,,0,"percent of total billed charges","37.7% of total billed charges",121.02,37.7,,96.82,,,0,"percent of total billed charges","37.70% of total billed charges",14.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.82,33.9,,87.06,,,0,"percent of total billed charges","33.9% of total billed charges",14.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",250.38,78,,200.30,,,0,"percent of total billed charges","78% of total billed charges",15.13,101,,,,,0,"fee schedule","101% of CMS fee schedule ",265.15,82.6,,212.12,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,14.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",265.15,82.6,,212.12,,,0,"percent of total billed charges","82.6% of total billed charges",14.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,321,100,,256.80,,,0,"percent of total billed charges","100% of total billed charges",6.96,321,
"TgAb+Thyrog IMA reflex if Neg LC",30286800,CDM,302,RC,86800,CPT,OUTPATIENT,,,385,250.25,,338.8,88,,271.04,,,0,"percent of total billed charges","88% of total billed charges",15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",27.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",242.55,63,,194.04,,,0,"percent of total billed charges","63% of total billed charges",58.91,15.3,,47.13,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,265.65,69,,,,,0,"fee schedule","69% of total billed charges",385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.85,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.91,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",145.15,37.7,,116.12,,,0,"percent of total billed charges","37.7% of total billed charges",145.15,37.7,,116.12,,,0,"percent of total billed charges","37.70% of total billed charges",15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",130.52,33.9,,104.42,,,0,"percent of total billed charges","33.9% of total billed charges",15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",300.3,78,,240.24,,,0,"percent of total billed charges","78% of total billed charges",16.06,101,,,,,0,"fee schedule","101% of CMS fee schedule ",318.01,82.6,,254.41,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",318.01,82.6,,254.41,,,0,"percent of total billed charges","82.6% of total billed charges",15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,385,
"TgAb+Thyroglobulin,IMA or LCMS LC",30286800,CDM,302,RC,86800,CPT,OUTPATIENT,,,69,44.85,,60.72,88,,48.58,,,0,"percent of total billed charges","88% of total billed charges",15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",27.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.47,63,,34.78,,,0,"percent of total billed charges","63% of total billed charges",10.56,15.3,,8.45,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,47.61,69,,,,,0,"fee schedule","69% of total billed charges",69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.85,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.91,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.01,37.7,,20.81,,,0,"percent of total billed charges","37.7% of total billed charges",26.01,37.7,,20.81,,,0,"percent of total billed charges","37.70% of total billed charges",15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.39,33.9,,18.71,,,0,"percent of total billed charges","33.9% of total billed charges",15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.82,78,,43.06,,,0,"percent of total billed charges","78% of total billed charges",16.06,101,,,,,0,"fee schedule","101% of CMS fee schedule ",56.99,82.6,,45.59,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.99,82.6,,45.59,,,0,"percent of total billed charges","82.6% of total billed charges",15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,69,
"Theophylline LC",30180198,CDM,301,RC,80198,CPT,OUTPATIENT,,,289,187.85,,254.32,88,,203.46,,,0,"percent of total billed charges","88% of total billed charges",14.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",24.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,14.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",182.07,63,,145.66,,,0,"percent of total billed charges","63% of total billed charges",44.22,15.3,,35.38,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,199.41,69,,,,,0,"fee schedule","69% of total billed charges",289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",14.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",14.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",14.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.08,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,14.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.14,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,14.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,14.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.95,37.7,,87.16,,,0,"percent of total billed charges","37.7% of total billed charges",108.95,37.7,,87.16,,,0,"percent of total billed charges","37.70% of total billed charges",14.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.97,33.9,,78.38,,,0,"percent of total billed charges","33.9% of total billed charges",14.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",225.42,78,,180.34,,,0,"percent of total billed charges","78% of total billed charges",14.28,101,,,,,0,"fee schedule","101% of CMS fee schedule ",238.71,82.6,,190.97,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,14.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",238.71,82.6,,190.97,,,0,"percent of total billed charges","82.6% of total billed charges",14.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",7,289,
"Therapeutic Phlebotomy",94099195,CDM,940,RC,99195,CPT,OUTPATIENT,,,298,193.7,,262.24,88,,209.79,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,298,100,,238.40,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",54.44,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",187.74,63,,150.19,,,0,"percent of total billed charges","63% of total billed charges",45.59,15.3,,36.47,,,0,"percent of total billed charges","15.3% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,205.62,69,,,,,0,"fee schedule","69% of total billed charges",298,100,,238.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298,100,,238.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298,100,,238.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.15,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",53.92,100,,,,,0,"fee schedule",EAPG,68.72,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",112.35,37.7,,89.88,,,0,"percent of total billed charges","37.7% of total billed charges",112.35,37.7,,89.88,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.02,33.9,,80.82,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",232.44,78,,185.95,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",246.15,82.6,,196.92,,,0,"percent of total billed charges","82.6% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",246.15,82.6,,196.92,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,298,100,,238.40,,,0,"percent of total billed charges","100% of total billed charges",39.15,454.8,
"ThinPrep Pap AVR",31188175,CDM,311,RC,88175,CPT,OUTPATIENT,,,107,69.55,,94.16,88,,75.33,,,0,"percent of total billed charges","88% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",46.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.03,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.41,63,,53.93,,,0,"percent of total billed charges","63% of total billed charges",39.92,150,,,,,0,"fee schedule","150% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,73.83,69,,,,,0,"fee schedule","69% of total billed charges",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.78,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.61,100,,,,,0,"fee schedule","100% of LI fee schedule",11.53,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.87,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.34,37.7,,32.27,,,0,"percent of total billed charges","37.7% of total billed charges",40.34,37.7,,32.27,,,0,"percent of total billed charges","37.70% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.27,33.9,,29.02,,,0,"percent of total billed charges","33.9% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",83.46,78,,66.77,,,0,"percent of total billed charges","78% of total billed charges",26.87,101,,,,,0,"fee schedule","101% of CMS fee schedule ",88.38,82.6,,70.70,,,0,"percent of total billed charges","82.6% of total billed charges",15.56,100,,,,,0,"fee schedule",EAPG,26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.38,82.6,,70.70,,,0,"percent of total billed charges","82.6% of total billed charges",26.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.56,100,,,,,0,"fee schedule",EAPG,107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",11.53,107,
"Thiocyanate LC",30184430,CDM,301,RC,84430,CPT,OUTPATIENT,,,140,91,,123.2,88,,98.56,,,0,"percent of total billed charges","88% of total billed charges",11.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",20.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",10.18,100,,,,,0,"fee schedule",EAPG,11.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.2,63,,70.56,,,0,"percent of total billed charges","63% of total billed charges",21.42,15.3,,17.14,,,0,"percent of total billed charges","15.3% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,96.6,69,,,,,0,"fee schedule","69% of total billed charges",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",11.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",11.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",11.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.48,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,11.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.63,100,,,,,0,"fee schedule","100% of LI fee schedule",7.32,100,,,,,0,"fee schedule",EAPG,11.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.08,100,,,,,0,"fee schedule",EAPG,12.85,100,,,,,0,"fee schedule",EAPG,11.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.78,37.7,,42.22,,,0,"percent of total billed charges","37.7% of total billed charges",52.78,37.7,,42.22,,,0,"percent of total billed charges","37.70% of total billed charges",11.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.46,33.9,,37.97,,,0,"percent of total billed charges","33.9% of total billed charges",11.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.2,78,,87.36,,,0,"percent of total billed charges","78% of total billed charges",11.74,101,,,,,0,"fee schedule","101% of CMS fee schedule ",115.64,82.6,,92.51,,,0,"percent of total billed charges","82.6% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,11.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",115.64,82.6,,92.51,,,0,"percent of total billed charges","82.6% of total billed charges",11.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",7.32,140,
"Thiopurine Methyltransferase LC",30184433,CDM,301,RC,84433,CPT,OUTPATIENT,,,955,620.75,,840.4,88,,672.32,,,0,"percent of total billed charges","88% of total billed charges",22.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",38.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,22.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",601.65,63,,481.32,,,0,"percent of total billed charges","63% of total billed charges",146.12,15.3,,116.90,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,658.95,69,,,,,0,"fee schedule","69% of total billed charges",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",22.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",22.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",22.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",10.95,100,,,,,0,"fee schedule",EAPG,22.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.17,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,22.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,22.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",360.04,37.7,,288.03,,,0,"percent of total billed charges","37.7% of total billed charges",360.04,37.7,,288.03,,,0,"percent of total billed charges","37.70% of total billed charges",22.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",323.75,33.9,,259.00,,,0,"percent of total billed charges","33.9% of total billed charges",22.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",744.9,78,,595.92,,,0,"percent of total billed charges","78% of total billed charges",22.39,101,,,,,0,"fee schedule","101% of CMS fee schedule ",788.83,82.6,,631.06,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,22.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",788.83,82.6,,631.06,,,0,"percent of total billed charges","82.6% of total billed charges",22.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",8.11,955,
N/A,3100245,CDM,310,RC,0245U,CPT,OUTPATIENT,,,3878,2520.7,,3412.64,88,,2730.11,,,0,"percent of total billed charges","88% of total billed charges",1266.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",364.01,100,,,,,0,"fee schedule",EAPG,3878,100,,3102.40,,,0,"percent of total billed charges","100% of total billed charges",2215.62,175,,,,,0,"fee schedule","175% of CMS fee schedule",374.93,100,,,,,0,"fee schedule",EAPG,1266.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",2443.14,63,,1954.51,,,0,"percent of total billed charges","63% of total billed charges",1899.11,150,,,,,0,"fee schedule","150% of total billed charges",364.01,100,,,,,0,"fee schedule",EAPG,2675.82,69,,,,,0,"fee schedule","69% of total billed charges",3878,100,,3102.40,,,0,"percent of total billed charges","100% of total billed charges",1266.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",3878,100,,3102.40,,,0,"percent of total billed charges","100% of total billed charges",1266.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",3878,100,,3102.40,,,0,"percent of total billed charges","100% of total billed charges",1266.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",364.01,100,,,,,0,"fee schedule",EAPG,1266.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",1266.07,100,,,,,0,"fee schedule","100% of LI fee schedule",269.63,100,,,,,0,"fee schedule",EAPG,1266.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",371.29,100,,,,,0,"fee schedule",EAPG,473.21,100,,,,,0,"fee schedule",EAPG,1266.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",1462.01,37.7,,1169.61,,,0,"percent of total billed charges","37.7% of total billed charges",1462.01,37.7,,1169.61,,,0,"percent of total billed charges","37.70% of total billed charges",1266.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",1314.64,33.9,,1051.71,,,0,"percent of total billed charges","33.9% of total billed charges",1266.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",3024.84,78,,2419.87,,,0,"percent of total billed charges","78% of total billed charges",1278.73,101,,,,,0,"fee schedule","101% of CMS fee schedule ",3203.23,82.6,,2562.58,,,0,"percent of total billed charges","82.6% of total billed charges",364.01,100,,,,,0,"fee schedule","100% of WA fee schedule",1266.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",3203.23,82.6,,2562.58,,,0,"percent of total billed charges","82.6% of total billed charges",1266.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",364.01,100,,,,,0,"fee schedule",EAPG,3878,100,,3102.40,,,0,"percent of total billed charges","100% of total billed charges",269.63,3878,
"Thyroid Stimulating Hormone",30184443,CDM,301,RC,84443,CPT,OUTPATIENT,,,169,109.85,,148.72,88,,118.98,,,0,"percent of total billed charges","88% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",29.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.47,63,,85.18,,,0,"percent of total billed charges","63% of total billed charges",25.86,15.3,,20.69,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,116.61,69,,,,,0,"fee schedule","69% of total billed charges",169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.26,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.8,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.71,37.7,,50.97,,,0,"percent of total billed charges","37.7% of total billed charges",63.71,37.7,,50.97,,,0,"percent of total billed charges","37.70% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.29,33.9,,45.83,,,0,"percent of total billed charges","33.9% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",131.82,78,,105.46,,,0,"percent of total billed charges","78% of total billed charges",16.96,101,,,,,0,"fee schedule","101% of CMS fee schedule ",139.59,82.6,,111.67,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",139.59,82.6,,111.67,,,0,"percent of total billed charges","82.6% of total billed charges",16.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",8.39,169,
"Thyroglobulin by LCMS LC",30184432,CDM,301,RC,84432,CPT,OUTPATIENT,,,338,219.7,,297.44,88,,237.95,,,0,"percent of total billed charges","88% of total billed charges",16.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",28.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,16.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",212.94,63,,170.35,,,0,"percent of total billed charges","63% of total billed charges",51.71,15.3,,41.37,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,233.22,69,,,,,0,"fee schedule","69% of total billed charges",338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",16.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",16.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",16.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.42,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,16.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.05,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,16.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,16.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",127.43,37.7,,101.94,,,0,"percent of total billed charges","37.7% of total billed charges",127.43,37.7,,101.94,,,0,"percent of total billed charges","37.70% of total billed charges",16.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",114.58,33.9,,91.66,,,0,"percent of total billed charges","33.9% of total billed charges",16.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",263.64,78,,210.91,,,0,"percent of total billed charges","78% of total billed charges",16.22,101,,,,,0,"fee schedule","101% of CMS fee schedule ",279.19,82.6,,223.35,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,16.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",279.19,82.6,,223.35,,,0,"percent of total billed charges","82.6% of total billed charges",16.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",8.39,338,
"Thyroxine (T4) LC",30184436,CDM,301,RC,84436,CPT,OUTPATIENT,,,172,111.8,,151.36,88,,121.09,,,0,"percent of total billed charges","88% of total billed charges",6.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",12.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,6.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.36,63,,86.69,,,0,"percent of total billed charges","63% of total billed charges",26.32,15.3,,21.06,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,118.68,69,,,,,0,"fee schedule","69% of total billed charges",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",6.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",6.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",6.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.27,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,6.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.87,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,6.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,6.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.84,37.7,,51.87,,,0,"percent of total billed charges","37.7% of total billed charges",64.84,37.7,,51.87,,,0,"percent of total billed charges","37.70% of total billed charges",6.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.31,33.9,,46.65,,,0,"percent of total billed charges","33.9% of total billed charges",6.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.16,78,,107.33,,,0,"percent of total billed charges","78% of total billed charges",6.93,101,,,,,0,"fee schedule","101% of CMS fee schedule ",142.07,82.6,,113.66,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,6.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.07,82.6,,113.66,,,0,"percent of total billed charges","82.6% of total billed charges",6.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",6.87,172,
"Thyroxine (T4) Free, Direct, S LC",30184439,CDM,301,RC,84439,CPT,OUTPATIENT,,,152,98.8,,133.76,88,,107.01,,,0,"percent of total billed charges","88% of total billed charges",9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",15.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.76,63,,76.61,,,0,"percent of total billed charges","63% of total billed charges",23.26,15.3,,18.61,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,104.88,69,,,,,0,"fee schedule","69% of total billed charges",152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.5,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.02,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.3,37.7,,45.84,,,0,"percent of total billed charges","37.7% of total billed charges",57.3,37.7,,45.84,,,0,"percent of total billed charges","37.70% of total billed charges",9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.53,33.9,,41.22,,,0,"percent of total billed charges","33.9% of total billed charges",9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",118.56,78,,94.85,,,0,"percent of total billed charges","78% of total billed charges",9.11,101,,,,,0,"fee schedule","101% of CMS fee schedule ",125.55,82.6,,100.44,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",125.55,82.6,,100.44,,,0,"percent of total billed charges","82.6% of total billed charges",9.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",8.39,152,
"Thyroid Peroxidase (TPO) Ab LC",30286376,CDM,302,RC,86376,CPT,OUTPATIENT,,,379,246.35,,333.52,88,,266.82,,,0,"percent of total billed charges","88% of total billed charges",14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,379,100,,303.20,,,0,"percent of total billed charges","100% of total billed charges",25.46,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",238.77,63,,191.02,,,0,"percent of total billed charges","63% of total billed charges",57.99,15.3,,46.39,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,261.51,69,,,,,0,"fee schedule","69% of total billed charges",379,100,,303.20,,,0,"percent of total billed charges","100% of total billed charges",14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",379,100,,303.20,,,0,"percent of total billed charges","100% of total billed charges",14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",379,100,,303.20,,,0,"percent of total billed charges","100% of total billed charges",14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.65,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.55,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.88,37.7,,114.30,,,0,"percent of total billed charges","37.7% of total billed charges",142.88,37.7,,114.30,,,0,"percent of total billed charges","37.70% of total billed charges",14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",128.48,33.9,,102.78,,,0,"percent of total billed charges","33.9% of total billed charges",14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",295.62,78,,236.50,,,0,"percent of total billed charges","78% of total billed charges",14.69,101,,,,,0,"fee schedule","101% of CMS fee schedule ",313.05,82.6,,250.44,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",313.05,82.6,,250.44,,,0,"percent of total billed charges","82.6% of total billed charges",14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,379,100,,303.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,379,
"THYROGLOBULIN ANTIB",30286800,CDM,302,RC,86800,CPT,OUTPATIENT,,,328,213.2,,288.64,88,,230.91,,,0,"percent of total billed charges","88% of total billed charges",15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",27.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",206.64,63,,165.31,,,0,"percent of total billed charges","63% of total billed charges",50.18,15.3,,40.14,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,226.32,69,,,,,0,"fee schedule","69% of total billed charges",328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.85,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.91,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",123.66,37.7,,98.93,,,0,"percent of total billed charges","37.7% of total billed charges",123.66,37.7,,98.93,,,0,"percent of total billed charges","37.70% of total billed charges",15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",111.19,33.9,,88.95,,,0,"percent of total billed charges","33.9% of total billed charges",15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",255.84,78,,204.67,,,0,"percent of total billed charges","78% of total billed charges",16.06,101,,,,,0,"fee schedule","101% of CMS fee schedule ",270.93,82.6,,216.74,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",270.93,82.6,,216.74,,,0,"percent of total billed charges","82.6% of total billed charges",15.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",6.96,328,
"Thyroid Stim Immunoglobulin LC",30184445,CDM,301,RC,84445,CPT,OUTPATIENT,,,678,440.7,,596.64,88,,477.31,,,0,"percent of total billed charges","88% of total billed charges",50.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,678,100,,542.40,,,0,"percent of total billed charges","100% of total billed charges",89,175,,,,,0,"fee schedule","175% of CMS fee schedule",30.04,100,,,,,0,"fee schedule",EAPG,50.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",427.14,63,,341.71,,,0,"percent of total billed charges","63% of total billed charges",103.73,15.3,,82.98,,,0,"percent of total billed charges","15.3% of total billed charges",29.16,100,,,,,0,"fee schedule",EAPG,467.82,69,,,,,0,"fee schedule","69% of total billed charges",678,100,,542.40,,,0,"percent of total billed charges","100% of total billed charges",50.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",678,100,,542.40,,,0,"percent of total billed charges","100% of total billed charges",50.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",678,100,,542.40,,,0,"percent of total billed charges","100% of total billed charges",50.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",194.53,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,50.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.86,100,,,,,0,"fee schedule","100% of LI fee schedule",21.6,100,,,,,0,"fee schedule",EAPG,50.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.74,100,,,,,0,"fee schedule",EAPG,37.91,100,,,,,0,"fee schedule",EAPG,50.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",255.61,37.7,,204.49,,,0,"percent of total billed charges","37.7% of total billed charges",255.61,37.7,,204.49,,,0,"percent of total billed charges","37.70% of total billed charges",50.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",229.84,33.9,,183.87,,,0,"percent of total billed charges","33.9% of total billed charges",50.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",528.84,78,,423.07,,,0,"percent of total billed charges","78% of total billed charges",51.36,101,,,,,0,"fee schedule","101% of CMS fee schedule ",560.03,82.6,,448.02,,,0,"percent of total billed charges","82.6% of total billed charges",29.16,100,,,,,0,"fee schedule",EAPG,50.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",560.03,82.6,,448.02,,,0,"percent of total billed charges","82.6% of total billed charges",50.86,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,678,100,,542.40,,,0,"percent of total billed charges","100% of total billed charges",21.6,678,
"Thyroid Antibodies LC",30286376,CDM,302,RC,86376,CPT,OUTPATIENT,,,316,205.4,,278.08,88,,222.46,,,0,"percent of total billed charges","88% of total billed charges",14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",25.46,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",199.08,63,,159.26,,,0,"percent of total billed charges","63% of total billed charges",48.35,15.3,,38.68,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,218.04,69,,,,,0,"fee schedule","69% of total billed charges",316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.65,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.55,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",119.13,37.7,,95.30,,,0,"percent of total billed charges","37.7% of total billed charges",119.13,37.7,,95.30,,,0,"percent of total billed charges","37.70% of total billed charges",14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.12,33.9,,85.70,,,0,"percent of total billed charges","33.9% of total billed charges",14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",246.48,78,,197.18,,,0,"percent of total billed charges","78% of total billed charges",14.69,101,,,,,0,"fee schedule","101% of CMS fee schedule ",261.02,82.6,,208.82,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",261.02,82.6,,208.82,,,0,"percent of total billed charges","82.6% of total billed charges",14.55,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",6.96,316,
"Topiramate (Topamax) LC",30180201,CDM,301,RC,80201,CPT,OUTPATIENT,,,218,141.7,,191.84,88,,153.47,,,0,"percent of total billed charges","88% of total billed charges",11.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",20.86,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,11.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.34,63,,109.87,,,0,"percent of total billed charges","63% of total billed charges",33.35,15.3,,26.68,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,150.42,69,,,,,0,"fee schedule","69% of total billed charges",218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",11.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",11.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",11.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.59,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,11.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.92,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,11.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,11.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.19,37.7,,65.75,,,0,"percent of total billed charges","37.7% of total billed charges",82.19,37.7,,65.75,,,0,"percent of total billed charges","37.70% of total billed charges",11.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.9,33.9,,59.12,,,0,"percent of total billed charges","33.9% of total billed charges",11.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.04,78,,136.03,,,0,"percent of total billed charges","78% of total billed charges",12.03,101,,,,,0,"fee schedule","101% of CMS fee schedule ",180.07,82.6,,144.06,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,11.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",180.07,82.6,,144.06,,,0,"percent of total billed charges","82.6% of total billed charges",11.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",7,218,
"Total Iron Binding Capacity",30083550,CDM,300,RC,83550,CPT,OUTPATIENT,,,182,118.3,,160.16,88,,128.13,,,0,"percent of total billed charges","88% of total billed charges",8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",15.29,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",114.66,63,,91.73,,,0,"percent of total billed charges","63% of total billed charges",27.85,15.3,,22.28,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,125.58,69,,,,,0,"fee schedule","69% of total billed charges",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.43,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.74,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.61,37.7,,54.89,,,0,"percent of total billed charges","37.7% of total billed charges",68.61,37.7,,54.89,,,0,"percent of total billed charges","37.70% of total billed charges",8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.7,33.9,,49.36,,,0,"percent of total billed charges","33.9% of total billed charges",8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",141.96,78,,113.57,,,0,"percent of total billed charges","78% of total billed charges",8.82,101,,,,,0,"fee schedule","101% of CMS fee schedule ",150.33,82.6,,120.26,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.33,82.6,,120.26,,,0,"percent of total billed charges","82.6% of total billed charges",8.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,182,
"Toxoplasma gondii Ab, IgG, Qn LC",30286777,CDM,302,RC,86777,CPT,OUTPATIENT,,,328,213.2,,288.64,88,,230.91,,,0,"percent of total billed charges","88% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",25.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",206.64,63,,165.31,,,0,"percent of total billed charges","63% of total billed charges",50.18,15.3,,40.14,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,226.32,69,,,,,0,"fee schedule","69% of total billed charges",328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.04,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.39,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",123.66,37.7,,98.93,,,0,"percent of total billed charges","37.7% of total billed charges",123.66,37.7,,98.93,,,0,"percent of total billed charges","37.70% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",111.19,33.9,,88.95,,,0,"percent of total billed charges","33.9% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",255.84,78,,204.67,,,0,"percent of total billed charges","78% of total billed charges",14.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",270.93,82.6,,216.74,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",270.93,82.6,,216.74,,,0,"percent of total billed charges","82.6% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",6.96,328,
"Toxoplasma Abs IgG/IgM LC",30286777,CDM,302,RC,86777,CPT,OUTPATIENT,,,328,213.2,,288.64,88,,230.91,,,0,"percent of total billed charges","88% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",25.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",206.64,63,,165.31,,,0,"percent of total billed charges","63% of total billed charges",50.18,15.3,,40.14,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,226.32,69,,,,,0,"fee schedule","69% of total billed charges",328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.04,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.39,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",123.66,37.7,,98.93,,,0,"percent of total billed charges","37.7% of total billed charges",123.66,37.7,,98.93,,,0,"percent of total billed charges","37.70% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",111.19,33.9,,88.95,,,0,"percent of total billed charges","33.9% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",255.84,78,,204.67,,,0,"percent of total billed charges","78% of total billed charges",14.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",270.93,82.6,,216.74,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",270.93,82.6,,216.74,,,0,"percent of total billed charges","82.6% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",6.96,328,
"Transferrin LC",30184466,CDM,301,RC,84466,CPT,OUTPATIENT,,,270,175.5,,237.6,88,,190.08,,,0,"percent of total billed charges","88% of total billed charges",12.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",22.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,12.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.1,63,,136.08,,,0,"percent of total billed charges","63% of total billed charges",41.31,15.3,,33.05,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,186.3,69,,,,,0,"fee schedule","69% of total billed charges",270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",12.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",12.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",12.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.8,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,12.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.76,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,12.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,12.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.79,37.7,,81.43,,,0,"percent of total billed charges","37.7% of total billed charges",101.79,37.7,,81.43,,,0,"percent of total billed charges","37.70% of total billed charges",12.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.53,33.9,,73.22,,,0,"percent of total billed charges","33.9% of total billed charges",12.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",210.6,78,,168.48,,,0,"percent of total billed charges","78% of total billed charges",12.88,101,,,,,0,"fee schedule","101% of CMS fee schedule ",223.02,82.6,,178.42,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,12.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",223.02,82.6,,178.42,,,0,"percent of total billed charges","82.6% of total billed charges",12.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",8.11,270,
"Treponema pallidum Abs LC 082370",30186780,CDM,301,RC,86780,CPT,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.64,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.24,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.7% of total billed charges",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.55,33.9,,42.04,,,0,"percent of total billed charges","33.9% of total billed charges",13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",13.37,101,,,,,0,"fee schedule","101% of CMS fee schedule ",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",13.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,155,
"Treponema pallidum (Syphilis) AVR",30687798,CDM,306,RC,87798,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"TRICHOMONAS VAGIN DIR PROBE",30687661,CDM,306,RC,87661,CPT,OUTPATIENT,,,170,110.5,,149.6,88,,119.68,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.1,63,,85.68,,,0,"percent of total billed charges","63% of total billed charges",26.01,15.3,,20.81,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,117.3,69,,,,,0,"fee schedule","69% of total billed charges",170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.09,37.7,,51.27,,,0,"percent of total billed charges","37.7% of total billed charges",64.09,37.7,,51.27,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.63,33.9,,46.10,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",132.6,78,,106.08,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",140.42,82.6,,112.34,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",140.42,82.6,,112.34,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",18.33,170,
"Tricyclic Antidepressant Conf LC 739070",30180369,CDM,301,RC,80369,CPT,OUTPATIENT,,,220,143,,193.6,88,,154.88,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",220,100,,176.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",138.6,63,,110.88,,,0,"percent of total billed charges","63% of total billed charges",33.66,15.3,,26.93,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.8,69,,,,,0,"fee schedule","69% of total billed charges",220,100,,176.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",220,100,,176.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",220,100,,176.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",82.94,37.7,,66.35,,,0,"percent of total billed charges","37.7% of total billed charges",82.94,37.7,,66.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.58,33.9,,59.66,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",171.6,78,,137.28,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.72,82.6,,145.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",181.72,82.6,,145.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.96,16.8,,29.57,,,0,"percent of total billed charges","16.8% of total billed charges",220,100,,176.00,,,0,"percent of total billed charges","100% of total billed charges",33.66,220,
"Trichomonas Vaginalis AVR",30687661,CDM,306,RC,87661,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
Triglycerides,30184478,CDM,301,RC,84478,CPT,OUTPATIENT,,,64,41.6,,56.32,88,,45.06,,,0,"percent of total billed charges","88% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",10.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.32,63,,32.26,,,0,"percent of total billed charges","63% of total billed charges",9.79,15.3,,7.83,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,44.16,69,,,,,0,"fee schedule","69% of total billed charges",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.95,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.74,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.13,37.7,,19.30,,,0,"percent of total billed charges","37.7% of total billed charges",24.13,37.7,,19.30,,,0,"percent of total billed charges","37.70% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.7,33.9,,17.36,,,0,"percent of total billed charges","33.9% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.92,78,,39.94,,,0,"percent of total billed charges","78% of total billed charges",5.79,101,,,,,0,"fee schedule","101% of CMS fee schedule ",52.86,82.6,,42.29,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.86,82.6,,42.29,,,0,"percent of total billed charges","82.6% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",3.25,64,
"Triglyceride Body Fluid",30184478,CDM,301,RC,84478,CPT,OUTPATIENT,,,64,41.6,,56.32,88,,45.06,,,0,"percent of total billed charges","88% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",10.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.32,63,,32.26,,,0,"percent of total billed charges","63% of total billed charges",9.79,15.3,,7.83,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,44.16,69,,,,,0,"fee schedule","69% of total billed charges",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.95,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.74,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.13,37.7,,19.30,,,0,"percent of total billed charges","37.7% of total billed charges",24.13,37.7,,19.30,,,0,"percent of total billed charges","37.70% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.7,33.9,,17.36,,,0,"percent of total billed charges","33.9% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.92,78,,39.94,,,0,"percent of total billed charges","78% of total billed charges",5.79,101,,,,,0,"fee schedule","101% of CMS fee schedule ",52.86,82.6,,42.29,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.86,82.6,,42.29,,,0,"percent of total billed charges","82.6% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",3.25,64,
"Triiodothyronine T3 Free LC",30184481,CDM,301,RC,84481,CPT,OUTPATIENT,,,457,297.05,,402.16,88,,321.73,,,0,"percent of total billed charges","88% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,457,100,,365.60,,,0,"percent of total billed charges","100% of total billed charges",29.64,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",287.91,63,,230.33,,,0,"percent of total billed charges","63% of total billed charges",69.92,15.3,,55.94,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,315.33,69,,,,,0,"fee schedule","69% of total billed charges",457,100,,365.60,,,0,"percent of total billed charges","100% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",457,100,,365.60,,,0,"percent of total billed charges","100% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",457,100,,365.60,,,0,"percent of total billed charges","100% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.79,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.94,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",172.29,37.7,,137.83,,,0,"percent of total billed charges","37.7% of total billed charges",172.29,37.7,,137.83,,,0,"percent of total billed charges","37.70% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",154.92,33.9,,123.94,,,0,"percent of total billed charges","33.9% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",356.46,78,,285.17,,,0,"percent of total billed charges","78% of total billed charges",17.1,101,,,,,0,"fee schedule","101% of CMS fee schedule ",377.48,82.6,,301.98,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",377.48,82.6,,301.98,,,0,"percent of total billed charges","82.6% of total billed charges",16.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,457,100,,365.60,,,0,"percent of total billed charges","100% of total billed charges",8.39,457,
"Triiodothyronine (T3) LC",30184480,CDM,301,RC,84480,CPT,OUTPATIENT,,,235,152.75,,206.8,88,,165.44,,,0,"percent of total billed charges","88% of total billed charges",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,235,100,,188.00,,,0,"percent of total billed charges","100% of total billed charges",24.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",148.05,63,,118.44,,,0,"percent of total billed charges","63% of total billed charges",35.96,15.3,,28.77,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,162.15,69,,,,,0,"fee schedule","69% of total billed charges",235,100,,188.00,,,0,"percent of total billed charges","100% of total billed charges",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",235,100,,188.00,,,0,"percent of total billed charges","100% of total billed charges",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",235,100,,188.00,,,0,"percent of total billed charges","100% of total billed charges",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.23,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.18,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.6,37.7,,70.88,,,0,"percent of total billed charges","37.7% of total billed charges",88.6,37.7,,70.88,,,0,"percent of total billed charges","37.70% of total billed charges",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.67,33.9,,63.74,,,0,"percent of total billed charges","33.9% of total billed charges",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",183.3,78,,146.64,,,0,"percent of total billed charges","78% of total billed charges",14.32,101,,,,,0,"fee schedule","101% of CMS fee schedule ",194.11,82.6,,155.29,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",194.11,82.6,,155.29,,,0,"percent of total billed charges","82.6% of total billed charges",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,235,100,,188.00,,,0,"percent of total billed charges","100% of total billed charges",8.39,235,
Troponin-I,30184484,CDM,301,RC,84484,CPT,OUTPATIENT,,,227,147.55,,199.76,88,,159.81,,,0,"percent of total billed charges","88% of total billed charges",12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",21.82,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",143.01,63,,114.41,,,0,"percent of total billed charges","63% of total billed charges",34.73,15.3,,27.78,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,156.63,69,,,,,0,"fee schedule","69% of total billed charges",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.69,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.47,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.58,37.7,,68.46,,,0,"percent of total billed charges","37.7% of total billed charges",85.58,37.7,,68.46,,,0,"percent of total billed charges","37.70% of total billed charges",12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.95,33.9,,61.56,,,0,"percent of total billed charges","33.9% of total billed charges",12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",177.06,78,,141.65,,,0,"percent of total billed charges","78% of total billed charges",12.59,101,,,,,0,"fee schedule","101% of CMS fee schedule ",187.5,82.6,,150.00,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",187.5,82.6,,150.00,,,0,"percent of total billed charges","82.6% of total billed charges",12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",8.11,227,
"Troponin- I Biosite",30184484,CDM,301,RC,84484,CPT,OUTPATIENT,,,291,189.15,,256.08,88,,204.86,,,0,"percent of total billed charges","88% of total billed charges",12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,291,100,,232.80,,,0,"percent of total billed charges","100% of total billed charges",21.82,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",183.33,63,,146.66,,,0,"percent of total billed charges","63% of total billed charges",44.52,15.3,,35.62,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,200.79,69,,,,,0,"fee schedule","69% of total billed charges",291,100,,232.80,,,0,"percent of total billed charges","100% of total billed charges",12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",291,100,,232.80,,,0,"percent of total billed charges","100% of total billed charges",12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",291,100,,232.80,,,0,"percent of total billed charges","100% of total billed charges",12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.69,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.47,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.71,37.7,,87.77,,,0,"percent of total billed charges","37.7% of total billed charges",109.71,37.7,,87.77,,,0,"percent of total billed charges","37.70% of total billed charges",12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.65,33.9,,78.92,,,0,"percent of total billed charges","33.9% of total billed charges",12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.98,78,,181.58,,,0,"percent of total billed charges","78% of total billed charges",12.59,101,,,,,0,"fee schedule","101% of CMS fee schedule ",240.37,82.6,,192.30,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",240.37,82.6,,192.30,,,0,"percent of total billed charges","82.6% of total billed charges",12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,291,100,,232.80,,,0,"percent of total billed charges","100% of total billed charges",8.11,291,
"Tryptase LC",30183520,CDM,301,RC,83520,CPT,OUTPATIENT,,,112,72.8,,98.56,88,,78.85,,,0,"percent of total billed charges","88% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",30.22,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",17.14,15.3,,13.71,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,77.28,69,,,,,0,"fee schedule","69% of total billed charges",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.05,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.27,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.22,37.7,,33.78,,,0,"percent of total billed charges","37.7% of total billed charges",42.22,37.7,,33.78,,,0,"percent of total billed charges","37.70% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.97,33.9,,30.38,,,0,"percent of total billed charges","33.9% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.36,78,,69.89,,,0,"percent of total billed charges","78% of total billed charges",17.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",92.51,82.6,,74.01,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.51,82.6,,74.01,,,0,"percent of total billed charges","82.6% of total billed charges",17.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",8.11,112,
"U Dipstick Cotinine (Nicotine) POCT",30080305,CDM,300,RC,80305,CPT,OUTPATIENT,,,70,45.5,,61.6,88,,49.28,,,0,"percent of total billed charges","88% of total billed charges",12.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.76,16.8,,9.41,,,0,"percent of total billed charges","16.8% of total billed charges",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",22.05,175,,,,,0,"fee schedule","175% of CMS fee schedule",12.11,17.304,,9.69,,,0,"percent of total billed charges","17.304% of total billed charges",12.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.1,63,,35.28,,,0,"percent of total billed charges","63% of total billed charges",10.71,15.3,,8.57,,,0,"percent of total billed charges","15.3% of total billed charges",11.76,16.8,,9.41,,,0,"percent of total billed charges","16.8% of total billed charges",48.3,69,,,,,0,"fee schedule","69% of total billed charges",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",12.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",12.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",12.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.19,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.76,16.8,,9.41,,,0,"percent of total billed charges","16.8% of total billed charges",12.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.6,100,,,,,0,"fee schedule","100% of LI fee schedule",11.76,16.8,,9.41,,,0,"percent of total billed charges","16.8% of total billed charges",12.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",12,17.136,,9.60,,,0,"percent of total billed charges","17.136% of total billed charges",15.29,21.84,,12.23,,,0,"percent of total billed charges","21.84% of total billed charges",12.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.39,37.7,,21.11,,,0,"percent of total billed charges","37.7% of total billed charges",26.39,37.7,,21.11,,,0,"percent of total billed charges","37.70% of total billed charges",12.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.73,33.9,,18.98,,,0,"percent of total billed charges","33.9% of total billed charges",12.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.6,78,,43.68,,,0,"percent of total billed charges","78% of total billed charges",12.72,101,,,,,0,"fee schedule","101% of CMS fee schedule ",57.82,82.6,,46.26,,,0,"percent of total billed charges","82.6% of total billed charges",11.76,16.8,,9.41,,,0,"percent of total billed charges","16.8% of total billed charges",12.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.82,82.6,,46.26,,,0,"percent of total billed charges","82.6% of total billed charges",12.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.76,16.8,,9.41,,,0,"percent of total billed charges","16.8% of total billed charges",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",10.71,70,
"UA Complete w/ Culture if Indicated",30781003,CDM,307,RC,81003,CPT,OUTPATIENT,,,42,27.3,,36.96,88,,29.57,,,0,"percent of total billed charges","88% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",3.93,175,,,,,0,"fee schedule","175% of CMS fee schedule",2.55,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.46,63,,21.17,,,0,"percent of total billed charges","63% of total billed charges",6.43,15.3,,5.14,,,0,"percent of total billed charges","15.3% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,28.98,69,,,,,0,"fee schedule","69% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.6,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.25,100,,,,,0,"fee schedule","100% of LI fee schedule",1.83,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.52,100,,,,,0,"fee schedule",EAPG,3.22,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.7% of total billed charges",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.70% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.24,33.9,,11.39,,,0,"percent of total billed charges","33.9% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.76,78,,26.21,,,0,"percent of total billed charges","78% of total billed charges",2.27,101,,,,,0,"fee schedule","101% of CMS fee schedule ",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",1.83,42,
"UA Microscopic",30781015,CDM,307,RC,81015,CPT,OUTPATIENT,,,33,21.45,,29.04,88,,23.23,,,0,"percent of total billed charges","88% of total billed charges",3.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",5.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",2.55,100,,,,,0,"fee schedule",EAPG,3.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.79,63,,16.63,,,0,"percent of total billed charges","63% of total billed charges",5.05,15.3,,4.04,,,0,"percent of total billed charges","15.3% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,22.77,69,,,,,0,"fee schedule","69% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",3.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",3.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",3.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.66,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,3.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.05,100,,,,,0,"fee schedule","100% of LI fee schedule",1.83,100,,,,,0,"fee schedule",EAPG,3.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.52,100,,,,,0,"fee schedule",EAPG,3.22,100,,,,,0,"fee schedule",EAPG,3.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.44,37.7,,9.95,,,0,"percent of total billed charges","37.7% of total billed charges",12.44,37.7,,9.95,,,0,"percent of total billed charges","37.70% of total billed charges",3.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.19,33.9,,8.95,,,0,"percent of total billed charges","33.9% of total billed charges",3.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.74,78,,20.59,,,0,"percent of total billed charges","78% of total billed charges",3.08,101,,,,,0,"fee schedule","101% of CMS fee schedule ",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,3.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",3.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",1.83,33,
"URINALYSIS AUTO W/MICRO",30781001,CDM,307,RC,81001,CPT,OUTPATIENT,,,59,38.35,,51.92,88,,41.54,,,0,"percent of total billed charges","88% of total billed charges",3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",5.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2.55,100,,,,,0,"fee schedule",EAPG,3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.17,63,,29.74,,,0,"percent of total billed charges","63% of total billed charges",9.03,15.3,,7.22,,,0,"percent of total billed charges","15.3% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,40.71,69,,,,,0,"fee schedule","69% of total billed charges",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.12,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.17,100,,,,,0,"fee schedule","100% of LI fee schedule",1.83,100,,,,,0,"fee schedule",EAPG,3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.52,100,,,,,0,"fee schedule",EAPG,3.22,100,,,,,0,"fee schedule",EAPG,3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.24,37.7,,17.79,,,0,"percent of total billed charges","37.7% of total billed charges",22.24,37.7,,17.79,,,0,"percent of total billed charges","37.70% of total billed charges",3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",20,33.9,,16.00,,,0,"percent of total billed charges","33.9% of total billed charges",3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.02,78,,36.82,,,0,"percent of total billed charges","78% of total billed charges",3.2,101,,,,,0,"fee schedule","101% of CMS fee schedule ",48.73,82.6,,38.98,,,0,"percent of total billed charges","82.6% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.73,82.6,,38.98,,,0,"percent of total billed charges","82.6% of total billed charges",3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",1.83,59,
"UA w/ Microscopic if Indicated",30781003,CDM,307,RC,81003,CPT,OUTPATIENT,,,42,27.3,,36.96,88,,29.57,,,0,"percent of total billed charges","88% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",3.93,175,,,,,0,"fee schedule","175% of CMS fee schedule",2.55,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.46,63,,21.17,,,0,"percent of total billed charges","63% of total billed charges",6.43,15.3,,5.14,,,0,"percent of total billed charges","15.3% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,28.98,69,,,,,0,"fee schedule","69% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.6,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.25,100,,,,,0,"fee schedule","100% of LI fee schedule",1.83,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.52,100,,,,,0,"fee schedule",EAPG,3.22,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.7% of total billed charges",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.70% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.24,33.9,,11.39,,,0,"percent of total billed charges","33.9% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.76,78,,26.21,,,0,"percent of total billed charges","78% of total billed charges",2.27,101,,,,,0,"fee schedule","101% of CMS fee schedule ",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",1.83,42,
"UA  w/ Microscopic",30781003,CDM,307,RC,81003,CPT,OUTPATIENT,,,42,27.3,,36.96,88,,29.57,,,0,"percent of total billed charges","88% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",3.93,175,,,,,0,"fee schedule","175% of CMS fee schedule",2.55,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.46,63,,21.17,,,0,"percent of total billed charges","63% of total billed charges",6.43,15.3,,5.14,,,0,"percent of total billed charges","15.3% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,28.98,69,,,,,0,"fee schedule","69% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.6,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.25,100,,,,,0,"fee schedule","100% of LI fee schedule",1.83,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.52,100,,,,,0,"fee schedule",EAPG,3.22,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.7% of total billed charges",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.70% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.24,33.9,,11.39,,,0,"percent of total billed charges","33.9% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.76,78,,26.21,,,0,"percent of total billed charges","78% of total billed charges",2.27,101,,,,,0,"fee schedule","101% of CMS fee schedule ",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",1.83,42,
"UA w/ Micro if Indicated  Culture if Indicated",30781003,CDM,307,RC,81003,CPT,OUTPATIENT,,,42,27.3,,36.96,88,,29.57,,,0,"percent of total billed charges","88% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",3.93,175,,,,,0,"fee schedule","175% of CMS fee schedule",2.55,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.46,63,,21.17,,,0,"percent of total billed charges","63% of total billed charges",6.43,15.3,,5.14,,,0,"percent of total billed charges","15.3% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,28.98,69,,,,,0,"fee schedule","69% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.6,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.25,100,,,,,0,"fee schedule","100% of LI fee schedule",1.83,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.52,100,,,,,0,"fee schedule",EAPG,3.22,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.7% of total billed charges",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.70% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.24,33.9,,11.39,,,0,"percent of total billed charges","33.9% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.76,78,,26.21,,,0,"percent of total billed charges","78% of total billed charges",2.27,101,,,,,0,"fee schedule","101% of CMS fee schedule ",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",1.83,42,
"Urinalysis, Routine RLC",30781003,CDM,307,RC,81003,CPT,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",3.93,175,,,,,0,"fee schedule","175% of CMS fee schedule",2.55,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.6,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.25,100,,,,,0,"fee schedule","100% of LI fee schedule",1.83,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.52,100,,,,,0,"fee schedule",EAPG,3.22,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.7% of total billed charges",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",0.68,33.9,,0.54,,,0,"percent of total billed charges","33.9% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",2.27,101,,,,,0,"fee schedule","101% of CMS fee schedule ",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,8.6,
"UREA NITROGEN 24HR URINE",30184540,CDM,301,RC,84540,CPT,OUTPATIENT,,,67,43.55,,58.96,88,,47.17,,,0,"percent of total billed charges","88% of total billed charges",5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",9.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.21,63,,33.77,,,0,"percent of total billed charges","63% of total billed charges",10.25,15.3,,8.20,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,46.23,69,,,,,0,"fee schedule","69% of total billed charges",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.26,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.56,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.26,37.7,,20.21,,,0,"percent of total billed charges","37.7% of total billed charges",25.26,37.7,,20.21,,,0,"percent of total billed charges","37.70% of total billed charges",5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.71,33.9,,18.17,,,0,"percent of total billed charges","33.9% of total billed charges",5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.26,78,,41.81,,,0,"percent of total billed charges","78% of total billed charges",5.61,101,,,,,0,"fee schedule","101% of CMS fee schedule ",55.34,82.6,,44.27,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.34,82.6,,44.27,,,0,"percent of total billed charges","82.6% of total billed charges",5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,67,
"UREA NITROGEN URINE",30184540,CDM,301,RC,84540,CPT,OUTPATIENT,,,67,43.55,,58.96,88,,47.17,,,0,"percent of total billed charges","88% of total billed charges",5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",9.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.21,63,,33.77,,,0,"percent of total billed charges","63% of total billed charges",10.25,15.3,,8.20,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,46.23,69,,,,,0,"fee schedule","69% of total billed charges",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.26,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.56,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.26,37.7,,20.21,,,0,"percent of total billed charges","37.7% of total billed charges",25.26,37.7,,20.21,,,0,"percent of total billed charges","37.70% of total billed charges",5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.71,33.9,,18.17,,,0,"percent of total billed charges","33.9% of total billed charges",5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.26,78,,41.81,,,0,"percent of total billed charges","78% of total billed charges",5.61,101,,,,,0,"fee schedule","101% of CMS fee schedule ",55.34,82.6,,44.27,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.34,82.6,,44.27,,,0,"percent of total billed charges","82.6% of total billed charges",5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,67,
"Urea Nitrogen, U LC",30184540,CDM,301,RC,84540,CPT,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",9.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.26,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.56,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.7% of total billed charges",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.39,33.9,,2.71,,,0,"percent of total billed charges","33.9% of total billed charges",5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",5.61,101,,,,,0,"fee schedule","101% of CMS fee schedule ",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",5.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,21.26,
"Ureaplasma urealyticum AVR",30687798,CDM,306,RC,87798,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"Uric Acid",30184550,CDM,301,RC,84550,CPT,OUTPATIENT,,,83,53.95,,73.04,88,,58.43,,,0,"percent of total billed charges","88% of total billed charges",4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,83,100,,66.40,,,0,"percent of total billed charges","100% of total billed charges",7.9,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.29,63,,41.83,,,0,"percent of total billed charges","63% of total billed charges",12.7,15.3,,10.16,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,57.27,69,,,,,0,"fee schedule","69% of total billed charges",83,100,,66.40,,,0,"percent of total billed charges","100% of total billed charges",4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",83,100,,66.40,,,0,"percent of total billed charges","100% of total billed charges",4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",83,100,,66.40,,,0,"percent of total billed charges","100% of total billed charges",4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.28,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.51,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.29,37.7,,25.03,,,0,"percent of total billed charges","37.7% of total billed charges",31.29,37.7,,25.03,,,0,"percent of total billed charges","37.70% of total billed charges",4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.14,33.9,,22.51,,,0,"percent of total billed charges","33.9% of total billed charges",4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.74,78,,51.79,,,0,"percent of total billed charges","78% of total billed charges",4.56,101,,,,,0,"fee schedule","101% of CMS fee schedule ",68.56,82.6,,54.85,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.56,82.6,,54.85,,,0,"percent of total billed charges","82.6% of total billed charges",4.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,83,100,,66.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,83,
"URIC ACID, URINE",30184560,CDM,301,RC,84560,CPT,OUTPATIENT,,,380,247,,334.4,88,,267.52,,,0,"percent of total billed charges","88% of total billed charges",5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,380,100,,304.00,,,0,"percent of total billed charges","100% of total billed charges",8.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",239.4,63,,191.52,,,0,"percent of total billed charges","63% of total billed charges",58.14,15.3,,46.51,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,262.2,69,,,,,0,"fee schedule","69% of total billed charges",380,100,,304.00,,,0,"percent of total billed charges","100% of total billed charges",5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",380,100,,304.00,,,0,"percent of total billed charges","100% of total billed charges",5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",380,100,,304.00,,,0,"percent of total billed charges","100% of total billed charges",5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.43,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",143.26,37.7,,114.61,,,0,"percent of total billed charges","37.7% of total billed charges",143.26,37.7,,114.61,,,0,"percent of total billed charges","37.70% of total billed charges",5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",128.82,33.9,,103.06,,,0,"percent of total billed charges","33.9% of total billed charges",5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",296.4,78,,237.12,,,0,"percent of total billed charges","78% of total billed charges",5.13,101,,,,,0,"fee schedule","101% of CMS fee schedule ",313.88,82.6,,251.10,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",313.88,82.6,,251.10,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,380,100,,304.00,,,0,"percent of total billed charges","100% of total billed charges",3.25,380,
"URIC ACID 24HR URINE",30184560,CDM,301,RC,84560,CPT,OUTPATIENT,,,380,247,,334.4,88,,267.52,,,0,"percent of total billed charges","88% of total billed charges",5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,380,100,,304.00,,,0,"percent of total billed charges","100% of total billed charges",8.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",239.4,63,,191.52,,,0,"percent of total billed charges","63% of total billed charges",58.14,15.3,,46.51,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,262.2,69,,,,,0,"fee schedule","69% of total billed charges",380,100,,304.00,,,0,"percent of total billed charges","100% of total billed charges",5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",380,100,,304.00,,,0,"percent of total billed charges","100% of total billed charges",5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",380,100,,304.00,,,0,"percent of total billed charges","100% of total billed charges",5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.43,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",143.26,37.7,,114.61,,,0,"percent of total billed charges","37.7% of total billed charges",143.26,37.7,,114.61,,,0,"percent of total billed charges","37.70% of total billed charges",5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",128.82,33.9,,103.06,,,0,"percent of total billed charges","33.9% of total billed charges",5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",296.4,78,,237.12,,,0,"percent of total billed charges","78% of total billed charges",5.13,101,,,,,0,"fee schedule","101% of CMS fee schedule ",313.88,82.6,,251.10,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",313.88,82.6,,251.10,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,380,100,,304.00,,,0,"percent of total billed charges","100% of total billed charges",3.25,380,
"Uric A+ANA w/Rflx+RA Qn+CRP... LC",30286038,CDM,302,RC,86038,CPT,OUTPATIENT,,,70,45.5,,61.6,88,,49.28,,,0,"percent of total billed charges","88% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",21.15,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.1,63,,35.28,,,0,"percent of total billed charges","63% of total billed charges",10.71,15.3,,8.57,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,48.3,69,,,,,0,"fee schedule","69% of total billed charges",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.24,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.09,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.39,37.7,,21.11,,,0,"percent of total billed charges","37.7% of total billed charges",26.39,37.7,,21.11,,,0,"percent of total billed charges","37.70% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.73,33.9,,18.98,,,0,"percent of total billed charges","33.9% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.6,78,,43.68,,,0,"percent of total billed charges","78% of total billed charges",12.21,101,,,,,0,"fee schedule","101% of CMS fee schedule ",57.82,82.6,,46.26,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.82,82.6,,46.26,,,0,"percent of total billed charges","82.6% of total billed charges",12.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,70,
"Uric Acid, Body Fluid LC",30184560,CDM,301,RC,84560,CPT,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",8.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.43,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.7% of total billed charges",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.42,33.9,,4.34,,,0,"percent of total billed charges","33.9% of total billed charges",5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",5.13,101,,,,,0,"fee schedule","101% of CMS fee schedule ",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,19.43,
"Urinalysis Dipstick",30781003,CDM,307,RC,81003,CPT,OUTPATIENT,,,42,27.3,,36.96,88,,29.57,,,0,"percent of total billed charges","88% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",3.93,175,,,,,0,"fee schedule","175% of CMS fee schedule",2.55,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.46,63,,21.17,,,0,"percent of total billed charges","63% of total billed charges",6.43,15.3,,5.14,,,0,"percent of total billed charges","15.3% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,28.98,69,,,,,0,"fee schedule","69% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.6,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.25,100,,,,,0,"fee schedule","100% of LI fee schedule",1.83,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.52,100,,,,,0,"fee schedule",EAPG,3.22,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.7% of total billed charges",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.70% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.24,33.9,,11.39,,,0,"percent of total billed charges","33.9% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.76,78,,26.21,,,0,"percent of total billed charges","78% of total billed charges",2.27,101,,,,,0,"fee schedule","101% of CMS fee schedule ",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",1.83,42,
"Urine Drug Screen",30180306,CDM,301,RC,80306,CPT,OUTPATIENT,,,140,91,,123.2,88,,98.56,,,0,"percent of total billed charges","88% of total billed charges",17.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.52,16.8,,18.82,,,0,"percent of total billed charges","16.8% of total billed charges",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",29.99,175,,,,,0,"fee schedule","175% of CMS fee schedule",24.23,17.304,,19.38,,,0,"percent of total billed charges","17.304% of total billed charges",17.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.2,63,,70.56,,,0,"percent of total billed charges","63% of total billed charges",21.42,15.3,,17.14,,,0,"percent of total billed charges","15.3% of total billed charges",23.52,16.8,,18.82,,,0,"percent of total billed charges","16.8% of total billed charges",96.6,69,,,,,0,"fee schedule","69% of total billed charges",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",17.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",17.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",17.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.56,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",23.52,16.8,,18.82,,,0,"percent of total billed charges","16.8% of total billed charges",17.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.14,100,,,,,0,"fee schedule","100% of LI fee schedule",23.52,16.8,,18.82,,,0,"percent of total billed charges","16.8% of total billed charges",17.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.99,17.136,,19.19,,,0,"percent of total billed charges","17.136% of total billed charges",30.58,21.84,,24.46,,,0,"percent of total billed charges","21.84% of total billed charges",17.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.78,37.7,,42.22,,,0,"percent of total billed charges","37.7% of total billed charges",52.78,37.7,,42.22,,,0,"percent of total billed charges","37.70% of total billed charges",17.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.46,33.9,,37.97,,,0,"percent of total billed charges","33.9% of total billed charges",17.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.2,78,,87.36,,,0,"percent of total billed charges","78% of total billed charges",17.31,101,,,,,0,"fee schedule","101% of CMS fee schedule ",115.64,82.6,,92.51,,,0,"percent of total billed charges","82.6% of total billed charges",23.52,16.8,,18.82,,,0,"percent of total billed charges","16.8% of total billed charges",17.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",115.64,82.6,,92.51,,,0,"percent of total billed charges","82.6% of total billed charges",17.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.52,16.8,,18.82,,,0,"percent of total billed charges","16.8% of total billed charges",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",17.14,140,
"Urine Pregnancy Test Qualitative",30081025,CDM,300,RC,81025,CPT,OUTPATIENT,,,132,85.8,,116.16,88,,92.93,,,0,"percent of total billed charges","88% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",15.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",2.55,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",83.16,63,,66.53,,,0,"percent of total billed charges","63% of total billed charges",20.2,15.3,,16.16,,,0,"percent of total billed charges","15.3% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,91.08,69,,,,,0,"fee schedule","69% of total billed charges",132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.93,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.61,100,,,,,0,"fee schedule","100% of LI fee schedule",1.83,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.52,100,,,,,0,"fee schedule",EAPG,3.22,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.76,37.7,,39.81,,,0,"percent of total billed charges","37.7% of total billed charges",49.76,37.7,,39.81,,,0,"percent of total billed charges","37.70% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.75,33.9,,35.80,,,0,"percent of total billed charges","33.9% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",102.96,78,,82.37,,,0,"percent of total billed charges","78% of total billed charges",8.69,101,,,,,0,"fee schedule","101% of CMS fee schedule ",109.03,82.6,,87.22,,,0,"percent of total billed charges","82.6% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.03,82.6,,87.22,,,0,"percent of total billed charges","82.6% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",1.83,132,
"EOSINOPHILS URINE",30089190,CDM,300,RC,89190,CPT,OUTPATIENT,,,68,44.2,,59.84,88,,47.87,,,0,"percent of total billed charges","88% of total billed charges",5.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.65,100,,,,,0,"fee schedule",EAPG,68,100,,54.40,,,0,"percent of total billed charges","100% of total billed charges",10.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.91,100,,,,,0,"fee schedule",EAPG,5.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.84,63,,34.27,,,0,"percent of total billed charges","63% of total billed charges",10.4,15.3,,8.32,,,0,"percent of total billed charges","15.3% of total billed charges",8.65,100,,,,,0,"fee schedule",EAPG,46.92,69,,,,,0,"fee schedule","69% of total billed charges",68,100,,54.40,,,0,"percent of total billed charges","100% of total billed charges",5.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",68,100,,54.40,,,0,"percent of total billed charges","100% of total billed charges",5.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",68,100,,54.40,,,0,"percent of total billed charges","100% of total billed charges",5.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.14,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.65,100,,,,,0,"fee schedule",EAPG,5.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.79,100,,,,,0,"fee schedule","100% of LI fee schedule",6.4,100,,,,,0,"fee schedule",EAPG,5.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.82,100,,,,,0,"fee schedule",EAPG,11.24,100,,,,,0,"fee schedule",EAPG,5.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.64,37.7,,20.51,,,0,"percent of total billed charges","37.7% of total billed charges",25.64,37.7,,20.51,,,0,"percent of total billed charges","37.70% of total billed charges",5.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.05,33.9,,18.44,,,0,"percent of total billed charges","33.9% of total billed charges",5.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.04,78,,42.43,,,0,"percent of total billed charges","78% of total billed charges",5.84,101,,,,,0,"fee schedule","101% of CMS fee schedule ",56.17,82.6,,44.94,,,0,"percent of total billed charges","82.6% of total billed charges",8.65,100,,,,,0,"fee schedule",EAPG,5.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.17,82.6,,44.94,,,0,"percent of total billed charges","82.6% of total billed charges",5.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.65,100,,,,,0,"fee schedule",EAPG,68,100,,54.40,,,0,"percent of total billed charges","100% of total billed charges",5.79,68,
"Urine Cytology LC",31188112,CDM,311,RC,88112,CPT,OUTPATIENT,,,215,139.75,,189.2,88,,151.36,,,0,"percent of total billed charges","88% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",96.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",26.78,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",135.45,63,,108.36,,,0,"percent of total billed charges","63% of total billed charges",32.9,15.3,,26.32,,,0,"percent of total billed charges","15.3% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,148.35,69,,,,,0,"fee schedule","69% of total billed charges",215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.15,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19.26,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.52,100,,,,,0,"fee schedule",EAPG,33.8,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",81.06,37.7,,64.85,,,0,"percent of total billed charges","37.7% of total billed charges",81.06,37.7,,64.85,,,0,"percent of total billed charges","37.70% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",72.89,33.9,,58.31,,,0,"percent of total billed charges","33.9% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",167.7,78,,134.16,,,0,"percent of total billed charges","78% of total billed charges",55.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.59,82.6,,142.07,,,0,"percent of total billed charges","82.6% of total billed charges",26,100,,,,,0,"fee schedule",EAPG,55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.59,82.6,,142.07,,,0,"percent of total billed charges","82.6% of total billed charges",55.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26,100,,,,,0,"fee schedule",EAPG,215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",19.26,215,
"Urine Fentanyl Screen",30180307,CDM,301,RC,80307,CPT,OUTPATIENT,,,294,191.1,,258.72,88,,206.98,,,0,"percent of total billed charges","88% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.39,16.8,,39.51,,,0,"percent of total billed charges","16.8% of total billed charges",294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",108.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",50.87,17.304,,40.70,,,0,"percent of total billed charges","17.304% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",185.22,63,,148.18,,,0,"percent of total billed charges","63% of total billed charges",44.98,15.3,,35.98,,,0,"percent of total billed charges","15.3% of total billed charges",49.39,16.8,,39.51,,,0,"percent of total billed charges","16.8% of total billed charges",202.86,69,,,,,0,"fee schedule","69% of total billed charges",294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",237.68,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",49.39,16.8,,39.51,,,0,"percent of total billed charges","16.8% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.14,100,,,,,0,"fee schedule","100% of LI fee schedule",49.39,16.8,,39.51,,,0,"percent of total billed charges","16.8% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.38,17.136,,40.30,,,0,"percent of total billed charges","17.136% of total billed charges",64.21,21.84,,51.37,,,0,"percent of total billed charges","21.84% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",110.84,37.7,,88.67,,,0,"percent of total billed charges","37.7% of total billed charges",110.84,37.7,,88.67,,,0,"percent of total billed charges","37.70% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.67,33.9,,79.74,,,0,"percent of total billed charges","33.9% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",229.32,78,,183.46,,,0,"percent of total billed charges","78% of total billed charges",62.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",242.84,82.6,,194.27,,,0,"percent of total billed charges","82.6% of total billed charges",49.39,16.8,,39.51,,,0,"percent of total billed charges","16.8% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",242.84,82.6,,194.27,,,0,"percent of total billed charges","82.6% of total billed charges",62.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.39,16.8,,39.51,,,0,"percent of total billed charges","16.8% of total billed charges",294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",44.98,294,
"VDRL, CSF LC",30286592,CDM,302,RC,86592,CPT,OUTPATIENT,,,378,245.7,,332.64,88,,266.11,,,0,"percent of total billed charges","88% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,378,100,,302.40,,,0,"percent of total billed charges","100% of total billed charges",7.47,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",238.14,63,,190.51,,,0,"percent of total billed charges","63% of total billed charges",57.83,15.3,,46.26,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,260.82,69,,,,,0,"fee schedule","69% of total billed charges",378,100,,302.40,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",378,100,,302.40,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",378,100,,302.40,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.33,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.26,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.51,37.7,,114.01,,,0,"percent of total billed charges","37.7% of total billed charges",142.51,37.7,,114.01,,,0,"percent of total billed charges","37.70% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",128.14,33.9,,102.51,,,0,"percent of total billed charges","33.9% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",294.84,78,,235.87,,,0,"percent of total billed charges","78% of total billed charges",4.31,101,,,,,0,"fee schedule","101% of CMS fee schedule ",312.23,82.6,,249.78,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",312.23,82.6,,249.78,,,0,"percent of total billed charges","82.6% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,378,100,,302.40,,,0,"percent of total billed charges","100% of total billed charges",4.26,378,
"VIP, P LC",30184586,CDM,301,RC,84586,CPT,OUTPATIENT,,,432,280.8,,380.16,88,,304.13,,,0,"percent of total billed charges","88% of total billed charges",35.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,432,100,,345.60,,,0,"percent of total billed charges","100% of total billed charges",61.82,175,,,,,0,"fee schedule","175% of CMS fee schedule",30.04,100,,,,,0,"fee schedule",EAPG,35.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",272.16,63,,217.73,,,0,"percent of total billed charges","63% of total billed charges",66.1,15.3,,52.88,,,0,"percent of total billed charges","15.3% of total billed charges",29.16,100,,,,,0,"fee schedule",EAPG,298.08,69,,,,,0,"fee schedule","69% of total billed charges",432,100,,345.60,,,0,"percent of total billed charges","100% of total billed charges",35.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",432,100,,345.60,,,0,"percent of total billed charges","100% of total billed charges",35.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",432,100,,345.60,,,0,"percent of total billed charges","100% of total billed charges",35.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",135.13,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,35.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.33,100,,,,,0,"fee schedule","100% of LI fee schedule",21.6,100,,,,,0,"fee schedule",EAPG,35.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.74,100,,,,,0,"fee schedule",EAPG,37.91,100,,,,,0,"fee schedule",EAPG,35.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.86,37.7,,130.29,,,0,"percent of total billed charges","37.7% of total billed charges",162.86,37.7,,130.29,,,0,"percent of total billed charges","37.70% of total billed charges",35.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",146.45,33.9,,117.16,,,0,"percent of total billed charges","33.9% of total billed charges",35.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",336.96,78,,269.57,,,0,"percent of total billed charges","78% of total billed charges",35.68,101,,,,,0,"fee schedule","101% of CMS fee schedule ",356.83,82.6,,285.46,,,0,"percent of total billed charges","82.6% of total billed charges",29.16,100,,,,,0,"fee schedule",EAPG,35.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",356.83,82.6,,285.46,,,0,"percent of total billed charges","82.6% of total billed charges",35.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.16,100,,,,,0,"fee schedule",EAPG,432,100,,345.60,,,0,"percent of total billed charges","100% of total billed charges",21.6,432,
"Vaginitis/Vaginosis, DNA Probe LC 180026",30687480,CDM,306,RC,87480,CPT,OUTPATIENT,,,99,64.35,,87.12,88,,69.70,,,0,"percent of total billed charges","88% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",35.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",15.15,15.3,,12.12,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,68.31,69,,,,,0,"fee schedule","69% of total billed charges",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.69,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.05,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.32,37.7,,29.86,,,0,"percent of total billed charges","37.7% of total billed charges",37.32,37.7,,29.86,,,0,"percent of total billed charges","37.70% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.56,33.9,,26.85,,,0,"percent of total billed charges","33.9% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.22,78,,61.78,,,0,"percent of total billed charges","78% of total billed charges",20.25,101,,,,,0,"fee schedule","101% of CMS fee schedule ",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",20.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,99,
"Vaginitis Plus w/Candida, NuSwab LC",30687801,CDM,306,RC,87801,CPT,OUTPATIENT,,,304,197.6,,267.52,88,,214.02,,,0,"percent of total billed charges","88% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",122.85,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",191.52,63,,153.22,,,0,"percent of total billed charges","63% of total billed charges",46.51,15.3,,37.21,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,209.76,69,,,,,0,"fee schedule","69% of total billed charges",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",268.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.2,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",114.61,37.7,,91.69,,,0,"percent of total billed charges","37.7% of total billed charges",114.61,37.7,,91.69,,,0,"percent of total billed charges","37.70% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",103.06,33.9,,82.45,,,0,"percent of total billed charges","33.9% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",237.12,78,,189.70,,,0,"percent of total billed charges","78% of total billed charges",70.9,101,,,,,0,"fee schedule","101% of CMS fee schedule ",251.1,82.6,,200.88,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.1,82.6,,200.88,,,0,"percent of total billed charges","82.6% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",18.33,304,
"Vaginitis Plus (VG+), NuSwab",30687801,CDM,306,RC,87801,CPT,OUTPATIENT,,,183,118.95,,161.04,88,,128.83,,,0,"percent of total billed charges","88% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,183,100,,146.40,,,0,"percent of total billed charges","100% of total billed charges",122.85,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",115.29,63,,92.23,,,0,"percent of total billed charges","63% of total billed charges",28,15.3,,22.40,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,126.27,69,,,,,0,"fee schedule","69% of total billed charges",183,100,,146.40,,,0,"percent of total billed charges","100% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",183,100,,146.40,,,0,"percent of total billed charges","100% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",183,100,,146.40,,,0,"percent of total billed charges","100% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",268.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.2,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.99,37.7,,55.19,,,0,"percent of total billed charges","37.7% of total billed charges",68.99,37.7,,55.19,,,0,"percent of total billed charges","37.70% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.04,33.9,,49.63,,,0,"percent of total billed charges","33.9% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.74,78,,114.19,,,0,"percent of total billed charges","78% of total billed charges",70.9,101,,,,,0,"fee schedule","101% of CMS fee schedule ",151.16,82.6,,120.93,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.16,82.6,,120.93,,,0,"percent of total billed charges","82.6% of total billed charges",70.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,183,100,,146.40,,,0,"percent of total billed charges","100% of total billed charges",18.33,268.51,
"Vaginosis/Vaginitis Panel AVR",30687511,CDM,306,RC,87511,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"Vaginosis/Vaginitis Extended Panel AVR",30687491,CDM,306,RC,87491,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.7% of total billed charges",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,33.9,,25.77,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,134.21,
"Valproic Acid Total",30180164,CDM,301,RC,80164,CPT,OUTPATIENT,,,190,123.5,,167.2,88,,133.76,,,0,"percent of total billed charges","88% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",23.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",119.7,63,,95.76,,,0,"percent of total billed charges","63% of total billed charges",29.07,15.3,,23.26,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,131.1,69,,,,,0,"fee schedule","69% of total billed charges",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.79,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.54,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.63,37.7,,57.30,,,0,"percent of total billed charges","37.7% of total billed charges",71.63,37.7,,57.30,,,0,"percent of total billed charges","37.70% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.41,33.9,,51.53,,,0,"percent of total billed charges","33.9% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",148.2,78,,118.56,,,0,"percent of total billed charges","78% of total billed charges",13.67,101,,,,,0,"fee schedule","101% of CMS fee schedule ",156.94,82.6,,125.55,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",156.94,82.6,,125.55,,,0,"percent of total billed charges","82.6% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",7,190,
Vancomycin,30180202,CDM,301,RC,80202,CPT,OUTPATIENT,,,202,131.3,,177.76,88,,142.21,,,0,"percent of total billed charges","88% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",23.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",127.26,63,,101.81,,,0,"percent of total billed charges","63% of total billed charges",30.91,15.3,,24.73,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,139.38,69,,,,,0,"fee schedule","69% of total billed charges",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.79,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.54,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.15,37.7,,60.92,,,0,"percent of total billed charges","37.7% of total billed charges",76.15,37.7,,60.92,,,0,"percent of total billed charges","37.70% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.48,33.9,,54.78,,,0,"percent of total billed charges","33.9% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",157.56,78,,126.05,,,0,"percent of total billed charges","78% of total billed charges",13.67,101,,,,,0,"fee schedule","101% of CMS fee schedule ",166.85,82.6,,133.48,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",166.85,82.6,,133.48,,,0,"percent of total billed charges","82.6% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",7,202,
"Vancomycin Peak",30180202,CDM,301,RC,80202,CPT,OUTPATIENT,,,202,131.3,,177.76,88,,142.21,,,0,"percent of total billed charges","88% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",23.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",127.26,63,,101.81,,,0,"percent of total billed charges","63% of total billed charges",30.91,15.3,,24.73,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,139.38,69,,,,,0,"fee schedule","69% of total billed charges",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.79,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.54,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.15,37.7,,60.92,,,0,"percent of total billed charges","37.7% of total billed charges",76.15,37.7,,60.92,,,0,"percent of total billed charges","37.70% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.48,33.9,,54.78,,,0,"percent of total billed charges","33.9% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",157.56,78,,126.05,,,0,"percent of total billed charges","78% of total billed charges",13.67,101,,,,,0,"fee schedule","101% of CMS fee schedule ",166.85,82.6,,133.48,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",166.85,82.6,,133.48,,,0,"percent of total billed charges","82.6% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",7,202,
"Vancomycin Trough",30180202,CDM,301,RC,80202,CPT,OUTPATIENT,,,259,168.35,,227.92,88,,182.34,,,0,"percent of total billed charges","88% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",23.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.17,63,,130.54,,,0,"percent of total billed charges","63% of total billed charges",39.63,15.3,,31.70,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,178.71,69,,,,,0,"fee schedule","69% of total billed charges",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.79,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.54,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.64,37.7,,78.11,,,0,"percent of total billed charges","37.7% of total billed charges",97.64,37.7,,78.11,,,0,"percent of total billed charges","37.70% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.8,33.9,,70.24,,,0,"percent of total billed charges","33.9% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.02,78,,161.62,,,0,"percent of total billed charges","78% of total billed charges",13.67,101,,,,,0,"fee schedule","101% of CMS fee schedule ",213.93,82.6,,171.14,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",213.93,82.6,,171.14,,,0,"percent of total billed charges","82.6% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",7,259,
"Vancomycin Lvl Trough AUC",30180202,CDM,301,RC,80202,CPT,OUTPATIENT,,,259,168.35,,227.92,88,,182.34,,,0,"percent of total billed charges","88% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",23.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.17,63,,130.54,,,0,"percent of total billed charges","63% of total billed charges",39.63,15.3,,31.70,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,178.71,69,,,,,0,"fee schedule","69% of total billed charges",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.79,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.54,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.64,37.7,,78.11,,,0,"percent of total billed charges","37.7% of total billed charges",97.64,37.7,,78.11,,,0,"percent of total billed charges","37.70% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.8,33.9,,70.24,,,0,"percent of total billed charges","33.9% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.02,78,,161.62,,,0,"percent of total billed charges","78% of total billed charges",13.67,101,,,,,0,"fee schedule","101% of CMS fee schedule ",213.93,82.6,,171.14,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",213.93,82.6,,171.14,,,0,"percent of total billed charges","82.6% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",7,259,
"Vancomycin Lvl Peak AUC",30180202,CDM,301,RC,80202,CPT,OUTPATIENT,,,202,131.3,,177.76,88,,142.21,,,0,"percent of total billed charges","88% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",23.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",127.26,63,,101.81,,,0,"percent of total billed charges","63% of total billed charges",30.91,15.3,,24.73,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,139.38,69,,,,,0,"fee schedule","69% of total billed charges",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.79,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.54,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.15,37.7,,60.92,,,0,"percent of total billed charges","37.7% of total billed charges",76.15,37.7,,60.92,,,0,"percent of total billed charges","37.70% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.48,33.9,,54.78,,,0,"percent of total billed charges","33.9% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",157.56,78,,126.05,,,0,"percent of total billed charges","78% of total billed charges",13.67,101,,,,,0,"fee schedule","101% of CMS fee schedule ",166.85,82.6,,133.48,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",166.85,82.6,,133.48,,,0,"percent of total billed charges","82.6% of total billed charges",13.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",7,202,
"Vanillylmandelic Acid, U24 LC",30184585,CDM,301,RC,84585,CPT,OUTPATIENT,,,337,219.05,,296.56,88,,237.25,,,0,"percent of total billed charges","88% of total billed charges",15.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,337,100,,269.60,,,0,"percent of total billed charges","100% of total billed charges",27.12,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,15.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",212.31,63,,169.85,,,0,"percent of total billed charges","63% of total billed charges",51.56,15.3,,41.25,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,232.53,69,,,,,0,"fee schedule","69% of total billed charges",337,100,,269.60,,,0,"percent of total billed charges","100% of total billed charges",15.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",337,100,,269.60,,,0,"percent of total billed charges","100% of total billed charges",15.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",337,100,,269.60,,,0,"percent of total billed charges","100% of total billed charges",15.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.28,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,15.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.5,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,15.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,15.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",127.05,37.7,,101.64,,,0,"percent of total billed charges","37.7% of total billed charges",127.05,37.7,,101.64,,,0,"percent of total billed charges","37.70% of total billed charges",15.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",114.24,33.9,,91.39,,,0,"percent of total billed charges","33.9% of total billed charges",15.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",262.86,78,,210.29,,,0,"percent of total billed charges","78% of total billed charges",15.65,101,,,,,0,"fee schedule","101% of CMS fee schedule ",278.36,82.6,,222.69,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,15.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",278.36,82.6,,222.69,,,0,"percent of total billed charges","82.6% of total billed charges",15.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,337,100,,269.60,,,0,"percent of total billed charges","100% of total billed charges",8.39,337,
"Varicella Zoster Abs, IgG/IgM LC",30286787,CDM,302,RC,86787,CPT,OUTPATIENT,,,293,190.45,,257.84,88,,206.27,,,0,"percent of total billed charges","88% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,293,100,,234.40,,,0,"percent of total billed charges","100% of total billed charges",22.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",184.59,63,,147.67,,,0,"percent of total billed charges","63% of total billed charges",44.83,15.3,,35.86,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,202.17,69,,,,,0,"fee schedule","69% of total billed charges",293,100,,234.40,,,0,"percent of total billed charges","100% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",293,100,,234.40,,,0,"percent of total billed charges","100% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",293,100,,234.40,,,0,"percent of total billed charges","100% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.26,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.88,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",110.46,37.7,,88.37,,,0,"percent of total billed charges","37.7% of total billed charges",110.46,37.7,,88.37,,,0,"percent of total billed charges","37.70% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.33,33.9,,79.46,,,0,"percent of total billed charges","33.9% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",228.54,78,,182.83,,,0,"percent of total billed charges","78% of total billed charges",13,101,,,,,0,"fee schedule","101% of CMS fee schedule ",242.02,82.6,,193.62,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",242.02,82.6,,193.62,,,0,"percent of total billed charges","82.6% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,293,100,,234.40,,,0,"percent of total billed charges","100% of total billed charges",6.96,293,
"Varicella-Zoster V Ab, IgG LC",30286787,CDM,302,RC,86787,CPT,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",22.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.26,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.88,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.7% of total billed charges",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",104.75,33.9,,83.80,,,0,"percent of total billed charges","33.9% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",13,101,,,,,0,"fee schedule","101% of CMS fee schedule ",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,309,
"Varicella-Zoster Ab, IgM LC",30286787,CDM,302,RC,86787,CPT,OUTPATIENT,,,279,181.35,,245.52,88,,196.42,,,0,"percent of total billed charges","88% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",22.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",175.77,63,,140.62,,,0,"percent of total billed charges","63% of total billed charges",42.69,15.3,,34.15,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,192.51,69,,,,,0,"fee schedule","69% of total billed charges",279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.26,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.88,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",105.18,37.7,,84.14,,,0,"percent of total billed charges","37.7% of total billed charges",105.18,37.7,,84.14,,,0,"percent of total billed charges","37.70% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",94.58,33.9,,75.66,,,0,"percent of total billed charges","33.9% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",217.62,78,,174.10,,,0,"percent of total billed charges","78% of total billed charges",13,101,,,,,0,"fee schedule","101% of CMS fee schedule ",230.45,82.6,,184.36,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",230.45,82.6,,184.36,,,0,"percent of total billed charges","82.6% of total billed charges",12.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,279,
"Vectra LC",30081490,CDM,300,RC,81490,CPT,OUTPATIENT,,,1050,682.5,,924,88,,739.20,,,0,"percent of total billed charges","88% of total billed charges",840.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",1050,100,,840.00,,,0,"percent of total billed charges","100% of total billed charges",1471.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",840.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",661.5,63,,529.20,,,0,"percent of total billed charges","63% of total billed charges",160.65,15.3,,128.52,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",724.5,69,,,,,0,"fee schedule","69% of total billed charges",1050,100,,840.00,,,0,"percent of total billed charges","100% of total billed charges",840.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",1050,100,,840.00,,,0,"percent of total billed charges","100% of total billed charges",840.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",1050,100,,840.00,,,0,"percent of total billed charges","100% of total billed charges",840.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",3215.48,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",840.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",840.65,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",840.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",840.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",395.85,37.7,,316.68,,,0,"percent of total billed charges","37.7% of total billed charges",395.85,37.7,,316.68,,,0,"percent of total billed charges","37.70% of total billed charges",840.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",355.95,33.9,,284.76,,,0,"percent of total billed charges","33.9% of total billed charges",840.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",819,78,,655.20,,,0,"percent of total billed charges","78% of total billed charges",849.05,101,,,,,0,"fee schedule","101% of CMS fee schedule ",867.3,82.6,,693.84,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",840.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",867.3,82.6,,693.84,,,0,"percent of total billed charges","82.6% of total billed charges",840.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",176.4,16.8,,141.12,,,0,"percent of total billed charges","16.8% of total billed charges",1050,100,,840.00,,,0,"percent of total billed charges","100% of total billed charges",160.65,3215.48,
"Venipuncture Routine",30036415,CDM,300,RC,36415,CPT,OUTPATIENT,,,102,66.3,,,,,,,,0,other,"not separately reimbursment",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.1,100,,,,,0,"fee schedule",EAPG,102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",15.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",2.16,100,,,,,0,"fee schedule",EAPG,8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",15.61,15.3,,12.49,,,0,"percent of total billed charges","15.3% of total billed charges",2.1,100,,,,,0,"fee schedule",EAPG,70.38,69,,,,,0,"fee schedule","69% of total billed charges",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.47,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",2.1,100,,,,,0,"fee schedule",EAPG,8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.83,100,,,,,0,"fee schedule","100% of LI fee schedule",1.55,100,,,,,0,"fee schedule",EAPG,8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.14,100,,,,,0,"fee schedule",EAPG,2.73,100,,,,,0,"fee schedule",EAPG,8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.45,37.7,,30.76,,,0,"percent of total billed charges","37.7% of total billed charges",38.45,37.7,,30.76,,,0,"percent of total billed charges","37.70% of total billed charges",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.58,33.9,,27.66,,,0,"percent of total billed charges","33.9% of total billed charges",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.56,78,,63.65,,,0,"percent of total billed charges","78% of total billed charges",8.91,101,,,,,0,"fee schedule","101% of CMS fee schedule ",84.25,82.6,,67.40,,,0,"percent of total billed charges","82.6% of total billed charges",2.1,100,,,,,0,"fee schedule",EAPG,8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",84.25,82.6,,67.40,,,0,"percent of total billed charges","82.6% of total billed charges",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.1,100,,,,,0,"fee schedule",EAPG,102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",1.55,102,
"CULTURE VIRUS",30687252,CDM,306,RC,87252,CPT,OUTPATIENT,,,123,79.95,,108.24,88,,86.59,,,0,"percent of total billed charges","88% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",45.62,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.49,63,,61.99,,,0,"percent of total billed charges","63% of total billed charges",18.82,15.3,,15.06,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,84.87,69,,,,,0,"fee schedule","69% of total billed charges",123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.71,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.07,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.37,37.7,,37.10,,,0,"percent of total billed charges","37.7% of total billed charges",46.37,37.7,,37.10,,,0,"percent of total billed charges","37.70% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.7,33.9,,33.36,,,0,"percent of total billed charges","33.9% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.94,78,,76.75,,,0,"percent of total billed charges","78% of total billed charges",26.33,101,,,,,0,"fee schedule","101% of CMS fee schedule ",101.6,82.6,,81.28,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.6,82.6,,81.28,,,0,"percent of total billed charges","82.6% of total billed charges",26.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",4.81,123,
"Hepatitis B core antibody (HBcAb) total; Screen LC",30286704,CDM,302,RC,86704,CPT,OUTPATIENT,,,191,124.15,,168.08,88,,134.46,,,0,"percent of total billed charges","88% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",21.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",120.33,63,,96.26,,,0,"percent of total billed charges","63% of total billed charges",29.22,15.3,,23.38,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,131.79,69,,,,,0,"fee schedule","69% of total billed charges",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.09,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.05,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.01,37.7,,57.61,,,0,"percent of total billed charges","37.7% of total billed charges",72.01,37.7,,57.61,,,0,"percent of total billed charges","37.70% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.75,33.9,,51.80,,,0,"percent of total billed charges","33.9% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",148.98,78,,119.18,,,0,"percent of total billed charges","78% of total billed charges",12.17,101,,,,,0,"fee schedule","101% of CMS fee schedule ",157.77,82.6,,126.22,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",157.77,82.6,,126.22,,,0,"percent of total billed charges","82.6% of total billed charges",12.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",6.96,191,
"RSV AG DFA",30687280,CDM,306,RC,87280,CPT,OUTPATIENT,,,59,38.35,,51.92,88,,41.54,,,0,"percent of total billed charges","88% of total billed charges",13.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",23.48,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,13.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.17,63,,29.74,,,0,"percent of total billed charges","63% of total billed charges",9.03,15.3,,7.22,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,40.71,69,,,,,0,"fee schedule","69% of total billed charges",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",13.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",13.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",13.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.33,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,13.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.42,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,13.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,13.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.24,37.7,,17.79,,,0,"percent of total billed charges","37.7% of total billed charges",22.24,37.7,,17.79,,,0,"percent of total billed charges","37.70% of total billed charges",13.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",20,33.9,,16.00,,,0,"percent of total billed charges","33.9% of total billed charges",13.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.02,78,,36.82,,,0,"percent of total billed charges","78% of total billed charges",13.55,101,,,,,0,"fee schedule","101% of CMS fee schedule ",48.73,82.6,,38.98,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,13.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.73,82.6,,38.98,,,0,"percent of total billed charges","82.6% of total billed charges",13.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,59,
"Vitamin B12",30182607,CDM,301,RC,82607,CPT,OUTPATIENT,,,289,187.85,,254.32,88,,203.46,,,0,"percent of total billed charges","88% of total billed charges",15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",26.39,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",182.07,63,,145.66,,,0,"percent of total billed charges","63% of total billed charges",44.22,15.3,,35.38,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,199.41,69,,,,,0,"fee schedule","69% of total billed charges",289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.68,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.08,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.95,37.7,,87.16,,,0,"percent of total billed charges","37.7% of total billed charges",108.95,37.7,,87.16,,,0,"percent of total billed charges","37.70% of total billed charges",15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.97,33.9,,78.38,,,0,"percent of total billed charges","33.9% of total billed charges",15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",225.42,78,,180.34,,,0,"percent of total billed charges","78% of total billed charges",15.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",238.71,82.6,,190.97,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",238.71,82.6,,190.97,,,0,"percent of total billed charges","82.6% of total billed charges",15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",8.39,289,
"Vitamin D 25 Hydroxy",30182306,CDM,301,RC,82306,CPT,OUTPATIENT,,,199,129.35,,175.12,88,,140.10,,,0,"percent of total billed charges","88% of total billed charges",29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,199,100,,159.20,,,0,"percent of total billed charges","100% of total billed charges",51.8,175,,,,,0,"fee schedule","175% of CMS fee schedule",29.67,100,,,,,0,"fee schedule",EAPG,29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",125.37,63,,100.30,,,0,"percent of total billed charges","63% of total billed charges",30.45,15.3,,24.36,,,0,"percent of total billed charges","15.3% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,137.31,69,,,,,0,"fee schedule","69% of total billed charges",199,100,,159.20,,,0,"percent of total billed charges","100% of total billed charges",29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",199,100,,159.20,,,0,"percent of total billed charges","100% of total billed charges",29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",199,100,,159.20,,,0,"percent of total billed charges","100% of total billed charges",29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.22,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.6,100,,,,,0,"fee schedule","100% of LI fee schedule",21.33,100,,,,,0,"fee schedule",EAPG,29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.38,100,,,,,0,"fee schedule",EAPG,37.44,100,,,,,0,"fee schedule",EAPG,29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",75.02,37.7,,60.02,,,0,"percent of total billed charges","37.7% of total billed charges",75.02,37.7,,60.02,,,0,"percent of total billed charges","37.70% of total billed charges",29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.46,33.9,,53.97,,,0,"percent of total billed charges","33.9% of total billed charges",29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",155.22,78,,124.18,,,0,"percent of total billed charges","78% of total billed charges",29.89,101,,,,,0,"fee schedule","101% of CMS fee schedule ",164.37,82.6,,131.50,,,0,"percent of total billed charges","82.6% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",164.37,82.6,,131.50,,,0,"percent of total billed charges","82.6% of total billed charges",29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,199,100,,159.20,,,0,"percent of total billed charges","100% of total billed charges",21.33,199,
"Vitamin B6, P LC",30184207,CDM,301,RC,84207,CPT,OUTPATIENT,,,444,288.6,,390.72,88,,312.58,,,0,"percent of total billed charges","88% of total billed charges",28.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,444,100,,355.20,,,0,"percent of total billed charges","100% of total billed charges",49.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",29.67,100,,,,,0,"fee schedule",EAPG,28.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",279.72,63,,223.78,,,0,"percent of total billed charges","63% of total billed charges",67.93,15.3,,54.34,,,0,"percent of total billed charges","15.3% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,306.36,69,,,,,0,"fee schedule","69% of total billed charges",444,100,,355.20,,,0,"percent of total billed charges","100% of total billed charges",28.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",444,100,,355.20,,,0,"percent of total billed charges","100% of total billed charges",28.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",444,100,,355.20,,,0,"percent of total billed charges","100% of total billed charges",28.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.48,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,28.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.1,100,,,,,0,"fee schedule","100% of LI fee schedule",21.33,100,,,,,0,"fee schedule",EAPG,28.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.38,100,,,,,0,"fee schedule",EAPG,37.44,100,,,,,0,"fee schedule",EAPG,28.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",167.39,37.7,,133.91,,,0,"percent of total billed charges","37.7% of total billed charges",167.39,37.7,,133.91,,,0,"percent of total billed charges","37.70% of total billed charges",28.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.52,33.9,,120.42,,,0,"percent of total billed charges","33.9% of total billed charges",28.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",346.32,78,,277.06,,,0,"percent of total billed charges","78% of total billed charges",28.38,101,,,,,0,"fee schedule","101% of CMS fee schedule ",366.74,82.6,,293.39,,,0,"percent of total billed charges","82.6% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,28.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",366.74,82.6,,293.39,,,0,"percent of total billed charges","82.6% of total billed charges",28.1,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,444,100,,355.20,,,0,"percent of total billed charges","100% of total billed charges",21.33,444,
"Vitamin A LC",30184590,CDM,301,RC,84590,CPT,OUTPATIENT,,,262,170.3,,230.56,88,,184.45,,,0,"percent of total billed charges","88% of total billed charges",11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",20.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",165.06,63,,132.05,,,0,"percent of total billed charges","63% of total billed charges",40.09,15.3,,32.07,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,180.78,69,,,,,0,"fee schedule","69% of total billed charges",262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.4,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.61,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.77,37.7,,79.02,,,0,"percent of total billed charges","37.7% of total billed charges",98.77,37.7,,79.02,,,0,"percent of total billed charges","37.70% of total billed charges",11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.82,33.9,,71.06,,,0,"percent of total billed charges","33.9% of total billed charges",11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",204.36,78,,163.49,,,0,"percent of total billed charges","78% of total billed charges",11.72,101,,,,,0,"fee schedule","101% of CMS fee schedule ",216.41,82.6,,173.13,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",216.41,82.6,,173.13,,,0,"percent of total billed charges","82.6% of total billed charges",11.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",8.11,262,
"Vitamin E LC",30184446,CDM,301,RC,84446,CPT,OUTPATIENT,,,269,174.85,,236.72,88,,189.38,,,0,"percent of total billed charges","88% of total billed charges",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",24.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",169.47,63,,135.58,,,0,"percent of total billed charges","63% of total billed charges",41.16,15.3,,32.93,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,185.61,69,,,,,0,"fee schedule","69% of total billed charges",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.23,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.18,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.41,37.7,,81.13,,,0,"percent of total billed charges","37.7% of total billed charges",101.41,37.7,,81.13,,,0,"percent of total billed charges","37.70% of total billed charges",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.19,33.9,,72.95,,,0,"percent of total billed charges","33.9% of total billed charges",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",209.82,78,,167.86,,,0,"percent of total billed charges","78% of total billed charges",14.32,101,,,,,0,"fee schedule","101% of CMS fee schedule ",222.19,82.6,,177.75,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",222.19,82.6,,177.75,,,0,"percent of total billed charges","82.6% of total billed charges",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",8.11,269,
"Vitamin D, 25-Hydroxy LC",30182306,CDM,301,RC,82306,CPT,OUTPATIENT,,,804,522.6,,707.52,88,,566.02,,,0,"percent of total billed charges","88% of total billed charges",29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,804,100,,643.20,,,0,"percent of total billed charges","100% of total billed charges",51.8,175,,,,,0,"fee schedule","175% of CMS fee schedule",29.67,100,,,,,0,"fee schedule",EAPG,29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",506.52,63,,405.22,,,0,"percent of total billed charges","63% of total billed charges",123.01,15.3,,98.41,,,0,"percent of total billed charges","15.3% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,554.76,69,,,,,0,"fee schedule","69% of total billed charges",804,100,,643.20,,,0,"percent of total billed charges","100% of total billed charges",29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",804,100,,643.20,,,0,"percent of total billed charges","100% of total billed charges",29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",804,100,,643.20,,,0,"percent of total billed charges","100% of total billed charges",29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.22,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.6,100,,,,,0,"fee schedule","100% of LI fee schedule",21.33,100,,,,,0,"fee schedule",EAPG,29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.38,100,,,,,0,"fee schedule",EAPG,37.44,100,,,,,0,"fee schedule",EAPG,29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",303.11,37.7,,242.49,,,0,"percent of total billed charges","37.7% of total billed charges",303.11,37.7,,242.49,,,0,"percent of total billed charges","37.70% of total billed charges",29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",272.56,33.9,,218.05,,,0,"percent of total billed charges","33.9% of total billed charges",29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",627.12,78,,501.70,,,0,"percent of total billed charges","78% of total billed charges",29.89,101,,,,,0,"fee schedule","101% of CMS fee schedule ",664.1,82.6,,531.28,,,0,"percent of total billed charges","82.6% of total billed charges",28.8,100,,,,,0,"fee schedule",EAPG,29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",664.1,82.6,,531.28,,,0,"percent of total billed charges","82.6% of total billed charges",29.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.8,100,,,,,0,"fee schedule",EAPG,804,100,,643.20,,,0,"percent of total billed charges","100% of total billed charges",21.33,804,
"Vitamin B1 (Thiamine), Blood LC",30084425,CDM,300,RC,84425,CPT,OUTPATIENT,,,441,286.65,,388.08,88,,310.46,,,0,"percent of total billed charges","88% of total billed charges",21.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",37.15,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,21.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",277.83,63,,222.26,,,0,"percent of total billed charges","63% of total billed charges",67.47,15.3,,53.98,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,304.29,69,,,,,0,"fee schedule","69% of total billed charges",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",21.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",21.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",21.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.2,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,21.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.23,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,21.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,21.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",166.26,37.7,,133.01,,,0,"percent of total billed charges","37.7% of total billed charges",166.26,37.7,,133.01,,,0,"percent of total billed charges","37.70% of total billed charges",21.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",149.5,33.9,,119.60,,,0,"percent of total billed charges","33.9% of total billed charges",21.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",343.98,78,,275.18,,,0,"percent of total billed charges","78% of total billed charges",21.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",364.27,82.6,,291.42,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,21.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",364.27,82.6,,291.42,,,0,"percent of total billed charges","82.6% of total billed charges",21.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",8.11,441,
"VITAMIN K",30184597,CDM,301,RC,84597,CPT,OUTPATIENT,,,269,174.85,,236.72,88,,189.38,,,0,"percent of total billed charges","88% of total billed charges",13.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",24.01,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,13.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",169.47,63,,135.58,,,0,"percent of total billed charges","63% of total billed charges",41.16,15.3,,32.93,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,185.61,69,,,,,0,"fee schedule","69% of total billed charges",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",13.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",13.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",13.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.47,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,13.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.72,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,13.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,13.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.41,37.7,,81.13,,,0,"percent of total billed charges","37.7% of total billed charges",101.41,37.7,,81.13,,,0,"percent of total billed charges","37.70% of total billed charges",13.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.19,33.9,,72.95,,,0,"percent of total billed charges","33.9% of total billed charges",13.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",209.82,78,,167.86,,,0,"percent of total billed charges","78% of total billed charges",13.85,101,,,,,0,"fee schedule","101% of CMS fee schedule ",222.19,82.6,,177.75,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,13.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",222.19,82.6,,177.75,,,0,"percent of total billed charges","82.6% of total billed charges",13.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",8.11,269,
"Vitamin B2, Whole Blood",30184252,CDM,301,RC,84252,CPT,OUTPATIENT,,,145,94.25,,127.6,88,,102.08,,,0,"percent of total billed charges","88% of total billed charges",20.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",35.41,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.35,63,,73.08,,,0,"percent of total billed charges","63% of total billed charges",22.19,15.3,,17.75,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,100.05,69,,,,,0,"fee schedule","69% of total billed charges",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",20.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",20.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",20.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.41,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.23,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.67,37.7,,43.74,,,0,"percent of total billed charges","37.7% of total billed charges",54.67,37.7,,43.74,,,0,"percent of total billed charges","37.70% of total billed charges",20.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.16,33.9,,39.33,,,0,"percent of total billed charges","33.9% of total billed charges",20.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.1,78,,90.48,,,0,"percent of total billed charges","78% of total billed charges",20.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",119.77,82.6,,95.82,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,20.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",119.77,82.6,,95.82,,,0,"percent of total billed charges","82.6% of total billed charges",20.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",8.11,145,
"Vitamin B12 LC",30182607,CDM,301,RC,82607,CPT,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",26.39,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.68,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.08,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.7% of total billed charges",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.44,33.9,,5.15,,,0,"percent of total billed charges","33.9% of total billed charges",15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",15.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",15.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,57.68,
"Vitamin B3 (Niacin+Metabolite) LC",30184591,CDM,301,RC,84591,CPT,OUTPATIENT,,,348,226.2,,306.24,88,,244.99,,,0,"percent of total billed charges","88% of total billed charges",17.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,348,100,,278.40,,,0,"percent of total billed charges","100% of total billed charges",29.85,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,17.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",219.24,63,,175.39,,,0,"percent of total billed charges","63% of total billed charges",53.24,15.3,,42.59,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,240.12,69,,,,,0,"fee schedule","69% of total billed charges",348,100,,278.40,,,0,"percent of total billed charges","100% of total billed charges",17.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",348,100,,278.40,,,0,"percent of total billed charges","100% of total billed charges",17.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",348,100,,278.40,,,0,"percent of total billed charges","100% of total billed charges",17.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.25,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,17.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.05,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,17.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,17.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",131.2,37.7,,104.96,,,0,"percent of total billed charges","37.7% of total billed charges",131.2,37.7,,104.96,,,0,"percent of total billed charges","37.70% of total billed charges",17.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",117.97,33.9,,94.38,,,0,"percent of total billed charges","33.9% of total billed charges",17.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",271.44,78,,217.15,,,0,"percent of total billed charges","78% of total billed charges",17.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",287.45,82.6,,229.96,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,17.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",287.45,82.6,,229.96,,,0,"percent of total billed charges","82.6% of total billed charges",17.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,348,100,,278.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,348,
"vWF Multimers LC",30585247,CDM,305,RC,85247,CPT,OUTPATIENT,,,755,490.75,,664.4,88,,531.52,,,0,"percent of total billed charges","88% of total billed charges",22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.29,100,,,,,0,"fee schedule",EAPG,755,100,,604.00,,,0,"percent of total billed charges","100% of total billed charges",40.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.78,100,,,,,0,"fee schedule",EAPG,22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",475.65,63,,380.52,,,0,"percent of total billed charges","63% of total billed charges",115.52,15.3,,92.42,,,0,"percent of total billed charges","15.3% of total billed charges",16.29,100,,,,,0,"fee schedule",EAPG,520.95,69,,,,,0,"fee schedule","69% of total billed charges",755,100,,604.00,,,0,"percent of total billed charges","100% of total billed charges",22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",755,100,,604.00,,,0,"percent of total billed charges","100% of total billed charges",22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",755,100,,604.00,,,0,"percent of total billed charges","100% of total billed charges",22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.74,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",16.29,100,,,,,0,"fee schedule",EAPG,22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.94,100,,,,,0,"fee schedule","100% of LI fee schedule",12.07,100,,,,,0,"fee schedule",EAPG,22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.62,100,,,,,0,"fee schedule",EAPG,21.18,100,,,,,0,"fee schedule",EAPG,22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",284.64,37.7,,227.71,,,0,"percent of total billed charges","37.7% of total billed charges",284.64,37.7,,227.71,,,0,"percent of total billed charges","37.70% of total billed charges",22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",255.95,33.9,,204.76,,,0,"percent of total billed charges","33.9% of total billed charges",22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",588.9,78,,471.12,,,0,"percent of total billed charges","78% of total billed charges",23.16,101,,,,,0,"fee schedule","101% of CMS fee schedule ",623.63,82.6,,498.90,,,0,"percent of total billed charges","82.6% of total billed charges",16.29,100,,,,,0,"fee schedule",EAPG,22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",623.63,82.6,,498.90,,,0,"percent of total billed charges","82.6% of total billed charges",22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.29,100,,,,,0,"fee schedule",EAPG,755,100,,604.00,,,0,"percent of total billed charges","100% of total billed charges",12.07,755,
"Voriconazole, Serum/Plasma LC",30180285,CDM,301,RC,80285,CPT,OUTPATIENT,,,410,266.5,,360.8,88,,288.64,,,0,"percent of total billed charges","88% of total billed charges",27.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,410,100,,328.00,,,0,"percent of total billed charges","100% of total billed charges",47.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,27.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",258.3,63,,206.64,,,0,"percent of total billed charges","63% of total billed charges",62.73,15.3,,50.18,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,282.9,69,,,,,0,"fee schedule","69% of total billed charges",410,100,,328.00,,,0,"percent of total billed charges","100% of total billed charges",27.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",410,100,,328.00,,,0,"percent of total billed charges","100% of total billed charges",27.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",410,100,,328.00,,,0,"percent of total billed charges","100% of total billed charges",27.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",103.69,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,27.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.11,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,27.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,27.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",154.57,37.7,,123.66,,,0,"percent of total billed charges","37.7% of total billed charges",154.57,37.7,,123.66,,,0,"percent of total billed charges","37.70% of total billed charges",27.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",138.99,33.9,,111.19,,,0,"percent of total billed charges","33.9% of total billed charges",27.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",319.8,78,,255.84,,,0,"percent of total billed charges","78% of total billed charges",27.38,101,,,,,0,"fee schedule","101% of CMS fee schedule ",338.66,82.6,,270.93,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,27.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",338.66,82.6,,270.93,,,0,"percent of total billed charges","82.6% of total billed charges",27.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,410,100,,328.00,,,0,"percent of total billed charges","100% of total billed charges",7,410,
"Body Fluid Cell Count with Differential If Indicated",30989050,CDM,309,RC,,,OUTPATIENT,,,106,68.9,,93.28,88,,74.62,,,0,"percent of total billed charges","88% of total billed charges",53,50,,42.40,,,0,"percent of total billed charges","50% of total billed charges",17.81,16.8,,14.25,,,0,"percent of total billed charges","16.8% of total billed charges",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.34,17.304,,14.67,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",66.78,63,,53.42,,,0,"percent of total billed charges","63% of total billed charges",16.22,15.3,,12.98,,,0,"percent of total billed charges","15.3% of total billed charges",17.81,16.8,,14.25,,,0,"percent of total billed charges","16.8% of total billed charges",73.14,69,,,,,0,"fee schedule","69% of total billed charges",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.81,16.8,,14.25,,,0,"percent of total billed charges","16.8% of total billed charges",53,50,,42.40,,,0,"percent of total billed charges","50% of total billed charges",34.13,32.2,,27.30,,,0,"percent of total billed charges","32.2% of total billed charges",17.81,16.8,,14.25,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.16,17.136,,14.53,,,0,"percent of total billed charges","17.136% of total billed charges",23.15,21.84,,18.52,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.96,37.7,,31.97,,,0,"percent of total billed charges","37.7% of total billed charges",39.96,37.7,,31.97,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.93,33.9,,28.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.68,78,,66.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.56,82.6,,70.05,,,0,"percent of total billed charges","82.6% of total billed charges",17.81,16.8,,14.25,,,0,"percent of total billed charges","16.8% of total billed charges",53,50,,42.40,,,0,"percent of total billed charges","50% of total billed charges",87.56,82.6,,70.05,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.81,16.8,,14.25,,,0,"percent of total billed charges","16.8% of total billed charges",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",16.22,106,
"West Nile Virus Antibody, CSF LC",30286788,CDM,302,RC,86788,CPT,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",29.48,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.45,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.85,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.7% of total billed charges",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.55,33.9,,42.04,,,0,"percent of total billed charges","33.9% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",17.01,101,,,,,0,"fee schedule","101% of CMS fee schedule ",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",16.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,155,
"West Nile Virus Ab LC",30286789,CDM,302,RC,86789,CPT,OUTPATIENT,,,163,105.95,,143.44,88,,114.75,,,0,"percent of total billed charges","88% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",25.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",102.69,63,,82.15,,,0,"percent of total billed charges","63% of total billed charges",24.94,15.3,,19.95,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,112.47,69,,,,,0,"fee schedule","69% of total billed charges",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.04,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.39,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.45,37.7,,49.16,,,0,"percent of total billed charges","37.7% of total billed charges",61.45,37.7,,49.16,,,0,"percent of total billed charges","37.70% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.26,33.9,,44.21,,,0,"percent of total billed charges","33.9% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",127.14,78,,101.71,,,0,"percent of total billed charges","78% of total billed charges",14.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",134.64,82.6,,107.71,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.64,82.6,,107.71,,,0,"percent of total billed charges","82.6% of total billed charges",14.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",6.96,163,
"West Nile Virus RT PCR LC",30687798,CDM,306,RC,87798,CPT,OUTPATIENT,,,430,279.5,,378.4,88,,302.72,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,430,100,,344.00,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",270.9,63,,216.72,,,0,"percent of total billed charges","63% of total billed charges",65.79,15.3,,52.63,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,296.7,69,,,,,0,"fee schedule","69% of total billed charges",430,100,,344.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",430,100,,344.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",430,100,,344.00,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.11,37.7,,129.69,,,0,"percent of total billed charges","37.7% of total billed charges",162.11,37.7,,129.69,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",145.77,33.9,,116.62,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",335.4,78,,268.32,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",355.18,82.6,,284.14,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",355.18,82.6,,284.14,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,430,100,,344.00,,,0,"percent of total billed charges","100% of total billed charges",18.33,430,
"WET PREP",30687210,CDM,306,RC,87210,CPT,OUTPATIENT,,,63,40.95,,55.44,88,,44.35,,,0,"percent of total billed charges","88% of total billed charges",5.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",10.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,5.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.69,63,,31.75,,,0,"percent of total billed charges","63% of total billed charges",9.64,15.3,,7.71,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,43.47,69,,,,,0,"fee schedule","69% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",5.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",5.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",5.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.26,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,5.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.82,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,5.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,5.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.75,37.7,,19.00,,,0,"percent of total billed charges","37.7% of total billed charges",23.75,37.7,,19.00,,,0,"percent of total billed charges","37.70% of total billed charges",5.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.36,33.9,,17.09,,,0,"percent of total billed charges","33.9% of total billed charges",5.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.14,78,,39.31,,,0,"percent of total billed charges","78% of total billed charges",5.87,101,,,,,0,"fee schedule","101% of CMS fee schedule ",52.04,82.6,,41.63,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,5.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.04,82.6,,41.63,,,0,"percent of total billed charges","82.6% of total billed charges",5.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",4.81,63,
"White Blood Cell Count (WBC)",30085048,CDM,300,RC,85048,CPT,OUTPATIENT,,,50,32.5,,44,88,,35.20,,,0,"percent of total billed charges","88% of total billed charges",2.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",4.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.23,100,,,,,0,"fee schedule",EAPG,2.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.5,63,,25.20,,,0,"percent of total billed charges","63% of total billed charges",7.65,15.3,,6.12,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,34.5,69,,,,,0,"fee schedule","69% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",2.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",2.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",2.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.71,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,2.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.54,100,,,,,0,"fee schedule","100% of LI fee schedule",3.76,100,,,,,0,"fee schedule",EAPG,2.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,2.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.7% of total billed charges",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.70% of total billed charges",2.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.95,33.9,,13.56,,,0,"percent of total billed charges","33.9% of total billed charges",2.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",39,78,,31.20,,,0,"percent of total billed charges","78% of total billed charges",2.56,101,,,,,0,"fee schedule","101% of CMS fee schedule ",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,2.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",2.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",2.54,50,
"White Blood Cells (WBC), Stool LC",30989055,CDM,309,RC,89055,CPT,OUTPATIENT,,,52,33.8,,45.76,88,,36.61,,,0,"percent of total billed charges","88% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.65,100,,,,,0,"fee schedule",EAPG,52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",7.47,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.91,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.76,63,,26.21,,,0,"percent of total billed charges","63% of total billed charges",7.96,15.3,,6.37,,,0,"percent of total billed charges","15.3% of total billed charges",8.65,100,,,,,0,"fee schedule",EAPG,35.88,69,,,,,0,"fee schedule","69% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.33,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.65,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.26,100,,,,,0,"fee schedule","100% of LI fee schedule",6.4,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.82,100,,,,,0,"fee schedule",EAPG,11.24,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.6,37.7,,15.68,,,0,"percent of total billed charges","37.7% of total billed charges",19.6,37.7,,15.68,,,0,"percent of total billed charges","37.70% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.63,33.9,,14.10,,,0,"percent of total billed charges","33.9% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.56,78,,32.45,,,0,"percent of total billed charges","78% of total billed charges",4.31,101,,,,,0,"fee schedule","101% of CMS fee schedule ",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",8.65,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.65,100,,,,,0,"fee schedule",EAPG,52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",4.26,52,
"Yeast Only, Culture LC",30687101,CDM,306,RC,87101,CPT,OUTPATIENT,,,79,51.35,,69.52,88,,55.62,,,0,"percent of total billed charges","88% of total billed charges",7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",13.49,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.77,63,,39.82,,,0,"percent of total billed charges","63% of total billed charges",12.09,15.3,,9.67,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,54.51,69,,,,,0,"fee schedule","69% of total billed charges",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.49,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.71,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.78,37.7,,23.82,,,0,"percent of total billed charges","37.7% of total billed charges",29.78,37.7,,23.82,,,0,"percent of total billed charges","37.70% of total billed charges",7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.78,33.9,,21.42,,,0,"percent of total billed charges","33.9% of total billed charges",7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.62,78,,49.30,,,0,"percent of total billed charges","78% of total billed charges",7.78,101,,,,,0,"fee schedule","101% of CMS fee schedule ",65.25,82.6,,52.20,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.25,82.6,,52.20,,,0,"percent of total billed charges","82.6% of total billed charges",7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,79,
"Zinc, Plasma or Serum LC",30184630,CDM,301,RC,84630,CPT,OUTPATIENT,,,298,193.7,,262.24,88,,209.79,,,0,"percent of total billed charges","88% of total billed charges",11.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,298,100,,238.40,,,0,"percent of total billed charges","100% of total billed charges",19.93,175,,,,,0,"fee schedule","175% of CMS fee schedule",10.18,100,,,,,0,"fee schedule",EAPG,11.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",187.74,63,,150.19,,,0,"percent of total billed charges","63% of total billed charges",45.59,15.3,,36.47,,,0,"percent of total billed charges","15.3% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,205.62,69,,,,,0,"fee schedule","69% of total billed charges",298,100,,238.40,,,0,"percent of total billed charges","100% of total billed charges",11.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",298,100,,238.40,,,0,"percent of total billed charges","100% of total billed charges",11.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",298,100,,238.40,,,0,"percent of total billed charges","100% of total billed charges",11.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.56,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,11.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.39,100,,,,,0,"fee schedule","100% of LI fee schedule",7.32,100,,,,,0,"fee schedule",EAPG,11.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.08,100,,,,,0,"fee schedule",EAPG,12.85,100,,,,,0,"fee schedule",EAPG,11.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",112.35,37.7,,89.88,,,0,"percent of total billed charges","37.7% of total billed charges",112.35,37.7,,89.88,,,0,"percent of total billed charges","37.70% of total billed charges",11.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.02,33.9,,80.82,,,0,"percent of total billed charges","33.9% of total billed charges",11.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",232.44,78,,185.95,,,0,"percent of total billed charges","78% of total billed charges",11.5,101,,,,,0,"fee schedule","101% of CMS fee schedule ",246.15,82.6,,196.92,,,0,"percent of total billed charges","82.6% of total billed charges",9.88,100,,,,,0,"fee schedule",EAPG,11.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",246.15,82.6,,196.92,,,0,"percent of total billed charges","82.6% of total billed charges",11.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.88,100,,,,,0,"fee schedule",EAPG,298,100,,238.40,,,0,"percent of total billed charges","100% of total billed charges",7.32,298,
"Zonisamide(Zonegran) LC",30180203,CDM,301,RC,80203,CPT,OUTPATIENT,,,210,136.5,,184.8,88,,147.84,,,0,"percent of total billed charges","88% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",23.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.73,100,,,,,0,"fee schedule",EAPG,13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",132.3,63,,105.84,,,0,"percent of total billed charges","63% of total billed charges",32.13,15.3,,25.70,,,0,"percent of total billed charges","15.3% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,144.9,69,,,,,0,"fee schedule","69% of total billed charges",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.68,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.25,100,,,,,0,"fee schedule","100% of LI fee schedule",7,100,,,,,0,"fee schedule",EAPG,13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.64,100,,,,,0,"fee schedule",EAPG,12.28,100,,,,,0,"fee schedule",EAPG,13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.17,37.7,,63.34,,,0,"percent of total billed charges","37.7% of total billed charges",79.17,37.7,,63.34,,,0,"percent of total billed charges","37.70% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.19,33.9,,56.95,,,0,"percent of total billed charges","33.9% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.8,78,,131.04,,,0,"percent of total billed charges","78% of total billed charges",13.38,101,,,,,0,"fee schedule","101% of CMS fee schedule ",173.46,82.6,,138.77,,,0,"percent of total billed charges","82.6% of total billed charges",9.45,100,,,,,0,"fee schedule",EAPG,13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",173.46,82.6,,138.77,,,0,"percent of total billed charges","82.6% of total billed charges",13.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.45,100,,,,,0,"fee schedule",EAPG,210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",7,210,
"zaPTTMx+dRVVT+Hexago+PT+PT M... LC 236823",30085730,CDM,300,RC,85730,CPT,OUTPATIENT,,,106,68.9,,93.28,88,,74.62,,,0,"percent of total billed charges","88% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",10.51,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.78,63,,53.42,,,0,"percent of total billed charges","63% of total billed charges",16.22,15.3,,12.98,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,73.14,69,,,,,0,"fee schedule","69% of total billed charges",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.98,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.01,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.96,37.7,,31.97,,,0,"percent of total billed charges","37.7% of total billed charges",39.96,37.7,,31.97,,,0,"percent of total billed charges","37.70% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.93,33.9,,28.74,,,0,"percent of total billed charges","33.9% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.68,78,,66.14,,,0,"percent of total billed charges","78% of total billed charges",6.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",87.56,82.6,,70.05,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.56,82.6,,70.05,,,0,"percent of total billed charges","82.6% of total billed charges",6.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",2.48,106,
"dRVVT+PT+PT Mix+PTT LA+TTMx LC 241426",30585670,CDM,305,RC,85670,CPT,OUTPATIENT,,,133,86.45,,117.04,88,,93.63,,,0,"percent of total billed charges","88% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,133,100,,106.40,,,0,"percent of total billed charges","100% of total billed charges",10.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",83.79,63,,67.03,,,0,"percent of total billed charges","63% of total billed charges",20.35,15.3,,16.28,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,91.77,69,,,,,0,"fee schedule","69% of total billed charges",133,100,,106.40,,,0,"percent of total billed charges","100% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",133,100,,106.40,,,0,"percent of total billed charges","100% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",133,100,,106.40,,,0,"percent of total billed charges","100% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.07,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.77,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.14,37.7,,40.11,,,0,"percent of total billed charges","37.7% of total billed charges",50.14,37.7,,40.11,,,0,"percent of total billed charges","37.70% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.09,33.9,,36.07,,,0,"percent of total billed charges","33.9% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",103.74,78,,82.99,,,0,"percent of total billed charges","78% of total billed charges",5.82,101,,,,,0,"fee schedule","101% of CMS fee schedule ",109.86,82.6,,87.89,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.86,82.6,,87.89,,,0,"percent of total billed charges","82.6% of total billed charges",5.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,133,100,,106.40,,,0,"percent of total billed charges","100% of total billed charges",2.48,133,
"iSTAT Total B-hCG Gonadotropin, chorionic (hCG); quantitativ",30184702,CDM,301,RC,84702,CPT,OUTPATIENT,,,454,295.1,,399.52,88,,319.62,,,0,"percent of total billed charges","88% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",26.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.67,100,,,,,0,"fee schedule",EAPG,15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",286.02,63,,228.82,,,0,"percent of total billed charges","63% of total billed charges",69.46,15.3,,55.57,,,0,"percent of total billed charges","15.3% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,313.26,69,,,,,0,"fee schedule","69% of total billed charges",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.56,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.05,100,,,,,0,"fee schedule","100% of LI fee schedule",8.39,100,,,,,0,"fee schedule",EAPG,15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.56,100,,,,,0,"fee schedule",EAPG,14.73,100,,,,,0,"fee schedule",EAPG,15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",171.16,37.7,,136.93,,,0,"percent of total billed charges","37.7% of total billed charges",171.16,37.7,,136.93,,,0,"percent of total billed charges","37.70% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",153.91,33.9,,123.13,,,0,"percent of total billed charges","33.9% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",354.12,78,,283.30,,,0,"percent of total billed charges","78% of total billed charges",15.2,101,,,,,0,"fee schedule","101% of CMS fee schedule ",375,82.6,,300.00,,,0,"percent of total billed charges","82.6% of total billed charges",11.33,100,,,,,0,"fee schedule",EAPG,15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",375,82.6,,300.00,,,0,"percent of total billed charges","82.6% of total billed charges",15.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.33,100,,,,,0,"fee schedule",EAPG,454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",8.39,454,
"iSTAT Cardiac Troponin I Quantitative POCT",30184484,CDM,301,RC,84484,CPT,OUTPATIENT,,,291,189.15,,256.08,88,,204.86,,,0,"percent of total billed charges","88% of total billed charges",12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,291,100,,232.80,,,0,"percent of total billed charges","100% of total billed charges",21.82,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",183.33,63,,146.66,,,0,"percent of total billed charges","63% of total billed charges",44.52,15.3,,35.62,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,200.79,69,,,,,0,"fee schedule","69% of total billed charges",291,100,,232.80,,,0,"percent of total billed charges","100% of total billed charges",12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",291,100,,232.80,,,0,"percent of total billed charges","100% of total billed charges",12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",291,100,,232.80,,,0,"percent of total billed charges","100% of total billed charges",12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.69,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.47,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.71,37.7,,87.77,,,0,"percent of total billed charges","37.7% of total billed charges",109.71,37.7,,87.77,,,0,"percent of total billed charges","37.70% of total billed charges",12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.65,33.9,,78.92,,,0,"percent of total billed charges","33.9% of total billed charges",12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.98,78,,181.58,,,0,"percent of total billed charges","78% of total billed charges",12.59,101,,,,,0,"fee schedule","101% of CMS fee schedule ",240.37,82.6,,192.30,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",240.37,82.6,,192.30,,,0,"percent of total billed charges","82.6% of total billed charges",12.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,291,100,,232.80,,,0,"percent of total billed charges","100% of total billed charges",8.11,291,
"iSTAT Creatinine; blood POCT",30182565,CDM,301,RC,82565,CPT,OUTPATIENT,,,143,92.95,,125.84,88,,100.67,,,0,"percent of total billed charges","88% of total billed charges",5.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",8.96,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,5.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.09,63,,72.07,,,0,"percent of total billed charges","63% of total billed charges",21.88,15.3,,17.50,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,98.67,69,,,,,0,"fee schedule","69% of total billed charges",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",5.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",5.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",5.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.58,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,5.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.12,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,5.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,5.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.91,37.7,,43.13,,,0,"percent of total billed charges","37.7% of total billed charges",53.91,37.7,,43.13,,,0,"percent of total billed charges","37.70% of total billed charges",5.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.48,33.9,,38.78,,,0,"percent of total billed charges","33.9% of total billed charges",5.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",111.54,78,,89.23,,,0,"percent of total billed charges","78% of total billed charges",5.17,101,,,,,0,"fee schedule","101% of CMS fee schedule ",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,5.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",5.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,143,
"pH Arterial",30082800,CDM,300,RC,82800,CPT,OUTPATIENT,,,177,115.05,,155.76,88,,124.61,,,0,"percent of total billed charges","88% of total billed charges",11,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",19.25,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,11,100,,,,,0,"fee schedule","100% of CMS fee schedule",111.51,63,,89.21,,,0,"percent of total billed charges","63% of total billed charges",27.08,15.3,,21.66,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,122.13,69,,,,,0,"fee schedule","69% of total billed charges",177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",11,100,,,,,0,"fee schedule","100% of CMS fee schedule",177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",11,100,,,,,0,"fee schedule","100% of CMS fee schedule",177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",11,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.07,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,11,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.73,37.7,,53.38,,,0,"percent of total billed charges","37.7% of total billed charges",66.73,37.7,,53.38,,,0,"percent of total billed charges","37.70% of total billed charges",11,100,,,,,0,"fee schedule","100% of CMS fee schedule",60,33.9,,48.00,,,0,"percent of total billed charges","33.9% of total billed charges",11,100,,,,,0,"fee schedule","100% of CMS fee schedule",138.06,78,,110.45,,,0,"percent of total billed charges","78% of total billed charges",11.11,101,,,,,0,"fee schedule","101% of CMS fee schedule ",146.2,82.6,,116.96,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,11,100,,,,,0,"fee schedule","100% of CMS fee schedule",146.2,82.6,,116.96,,,0,"percent of total billed charges","82.6% of total billed charges",11,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",8.11,177,
"PH BODY FLUID",30183986,CDM,301,RC,83986,CPT,OUTPATIENT,,,35,22.75,,30.8,88,,24.64,,,0,"percent of total billed charges","88% of total billed charges",3.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",6.26,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,3.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.05,63,,17.64,,,0,"percent of total billed charges","63% of total billed charges",5.36,15.3,,4.29,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,24.15,69,,,,,0,"fee schedule","69% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",3.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",3.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",3.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.69,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,3.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.58,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,3.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,3.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.2,37.7,,10.56,,,0,"percent of total billed charges","37.7% of total billed charges",13.2,37.7,,10.56,,,0,"percent of total billed charges","37.70% of total billed charges",3.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.87,33.9,,9.50,,,0,"percent of total billed charges","33.9% of total billed charges",3.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.3,78,,21.84,,,0,"percent of total billed charges","78% of total billed charges",3.61,101,,,,,0,"fee schedule","101% of CMS fee schedule ",28.91,82.6,,23.13,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,3.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.91,82.6,,23.13,,,0,"percent of total billed charges","82.6% of total billed charges",3.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",3.25,35,
"PH VENOUS SAMPLE",30182800,CDM,301,RC,82800,CPT,OUTPATIENT,,,177,115.05,,155.76,88,,124.61,,,0,"percent of total billed charges","88% of total billed charges",11,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",19.25,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,11,100,,,,,0,"fee schedule","100% of CMS fee schedule",111.51,63,,89.21,,,0,"percent of total billed charges","63% of total billed charges",27.08,15.3,,21.66,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,122.13,69,,,,,0,"fee schedule","69% of total billed charges",177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",11,100,,,,,0,"fee schedule","100% of CMS fee schedule",177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",11,100,,,,,0,"fee schedule","100% of CMS fee schedule",177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",11,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.07,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,11,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.73,37.7,,53.38,,,0,"percent of total billed charges","37.7% of total billed charges",66.73,37.7,,53.38,,,0,"percent of total billed charges","37.70% of total billed charges",11,100,,,,,0,"fee schedule","100% of CMS fee schedule",60,33.9,,48.00,,,0,"percent of total billed charges","33.9% of total billed charges",11,100,,,,,0,"fee schedule","100% of CMS fee schedule",138.06,78,,110.45,,,0,"percent of total billed charges","78% of total billed charges",11.11,101,,,,,0,"fee schedule","101% of CMS fee schedule ",146.2,82.6,,116.96,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,11,100,,,,,0,"fee schedule","100% of CMS fee schedule",146.2,82.6,,116.96,,,0,"percent of total billed charges","82.6% of total billed charges",11,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",8.11,177,
"pH Urine",30781003,CDM,307,RC,81003,CPT,OUTPATIENT,,,34,22.1,,29.92,88,,23.94,,,0,"percent of total billed charges","88% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",3.93,175,,,,,0,"fee schedule","175% of CMS fee schedule",2.55,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.42,63,,17.14,,,0,"percent of total billed charges","63% of total billed charges",5.2,15.3,,4.16,,,0,"percent of total billed charges","15.3% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,23.46,69,,,,,0,"fee schedule","69% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.6,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.25,100,,,,,0,"fee schedule","100% of LI fee schedule",1.83,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.52,100,,,,,0,"fee schedule",EAPG,3.22,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.82,37.7,,10.26,,,0,"percent of total billed charges","37.7% of total billed charges",12.82,37.7,,10.26,,,0,"percent of total billed charges","37.70% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.53,33.9,,9.22,,,0,"percent of total billed charges","33.9% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.52,78,,21.22,,,0,"percent of total billed charges","78% of total billed charges",2.27,101,,,,,0,"fee schedule","101% of CMS fee schedule ",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",1.83,34,
"pH Venous",30082800,CDM,300,RC,82800,CPT,OUTPATIENT,,,177,115.05,,155.76,88,,124.61,,,0,"percent of total billed charges","88% of total billed charges",11,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",19.25,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,11,100,,,,,0,"fee schedule","100% of CMS fee schedule",111.51,63,,89.21,,,0,"percent of total billed charges","63% of total billed charges",27.08,15.3,,21.66,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,122.13,69,,,,,0,"fee schedule","69% of total billed charges",177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",11,100,,,,,0,"fee schedule","100% of CMS fee schedule",177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",11,100,,,,,0,"fee schedule","100% of CMS fee schedule",177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",11,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.07,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,11,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.73,37.7,,53.38,,,0,"percent of total billed charges","37.7% of total billed charges",66.73,37.7,,53.38,,,0,"percent of total billed charges","37.70% of total billed charges",11,100,,,,,0,"fee schedule","100% of CMS fee schedule",60,33.9,,48.00,,,0,"percent of total billed charges","33.9% of total billed charges",11,100,,,,,0,"fee schedule","100% of CMS fee schedule",138.06,78,,110.45,,,0,"percent of total billed charges","78% of total billed charges",11.11,101,,,,,0,"fee schedule","101% of CMS fee schedule ",146.2,82.6,,116.96,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,11,100,,,,,0,"fee schedule","100% of CMS fee schedule",146.2,82.6,,116.96,,,0,"percent of total billed charges","82.6% of total billed charges",11,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",8.11,177,
"t-Transglutaminase (tTG) IgA LC",30186364,CDM,301,RC,86364,CPT,OUTPATIENT,,,187,121.55,,164.56,88,,131.65,,,0,"percent of total billed charges","88% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,187,100,,149.60,,,0,"percent of total billed charges","100% of total billed charges",20.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",117.81,63,,94.25,,,0,"percent of total billed charges","63% of total billed charges",28.61,15.3,,22.89,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,129.03,69,,,,,0,"fee schedule","69% of total billed charges",187,100,,149.60,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",187,100,,149.60,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",187,100,,149.60,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",9.39,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.53,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.5,37.7,,56.40,,,0,"percent of total billed charges","37.7% of total billed charges",70.5,37.7,,56.40,,,0,"percent of total billed charges","37.70% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.39,33.9,,50.71,,,0,"percent of total billed charges","33.9% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",145.86,78,,116.69,,,0,"percent of total billed charges","78% of total billed charges",11.64,101,,,,,0,"fee schedule","101% of CMS fee schedule ",154.46,82.6,,123.57,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",154.46,82.6,,123.57,,,0,"percent of total billed charges","82.6% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,187,100,,149.60,,,0,"percent of total billed charges","100% of total billed charges",6.96,187,
"t-Transglutaminase (tTG) IgG LC",30186364,CDM,301,RC,86364,CPT,OUTPATIENT,,,234,152.1,,205.92,88,,164.74,,,0,"percent of total billed charges","88% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",20.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",147.42,63,,117.94,,,0,"percent of total billed charges","63% of total billed charges",35.8,15.3,,28.64,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,161.46,69,,,,,0,"fee schedule","69% of total billed charges",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",9.39,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.53,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.22,37.7,,70.58,,,0,"percent of total billed charges","37.7% of total billed charges",88.22,37.7,,70.58,,,0,"percent of total billed charges","37.70% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.33,33.9,,63.46,,,0,"percent of total billed charges","33.9% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",182.52,78,,146.02,,,0,"percent of total billed charges","78% of total billed charges",11.64,101,,,,,0,"fee schedule","101% of CMS fee schedule ",193.28,82.6,,154.62,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",193.28,82.6,,154.62,,,0,"percent of total billed charges","82.6% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,234,
"tTG IgA/G LC",30186364,CDM,301,RC,86364,CPT,OUTPATIENT,,,199,129.35,,175.12,88,,140.10,,,0,"percent of total billed charges","88% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,199,100,,159.20,,,0,"percent of total billed charges","100% of total billed charges",20.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",125.37,63,,100.30,,,0,"percent of total billed charges","63% of total billed charges",30.45,15.3,,24.36,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,137.31,69,,,,,0,"fee schedule","69% of total billed charges",199,100,,159.20,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",199,100,,159.20,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",199,100,,159.20,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",9.39,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.53,100,,,,,0,"fee schedule","100% of LI fee schedule",6.96,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",75.02,37.7,,60.02,,,0,"percent of total billed charges","37.7% of total billed charges",75.02,37.7,,60.02,,,0,"percent of total billed charges","37.70% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.46,33.9,,53.97,,,0,"percent of total billed charges","33.9% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",155.22,78,,124.18,,,0,"percent of total billed charges","78% of total billed charges",11.64,101,,,,,0,"fee schedule","101% of CMS fee schedule ",164.37,82.6,,131.50,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",164.37,82.6,,131.50,,,0,"percent of total billed charges","82.6% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.39,100,,,,,0,"fee schedule",EAPG,199,100,,159.20,,,0,"percent of total billed charges","100% of total billed charges",6.96,199,
"von Willebrand Profile LC",30585245,CDM,305,RC,85245,CPT,OUTPATIENT,,,534,347.1,,469.92,88,,375.94,,,0,"percent of total billed charges","88% of total billed charges",22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.29,100,,,,,0,"fee schedule",EAPG,534,100,,427.20,,,0,"percent of total billed charges","100% of total billed charges",40.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",16.78,100,,,,,0,"fee schedule",EAPG,22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",336.42,63,,269.14,,,0,"percent of total billed charges","63% of total billed charges",81.7,15.3,,65.36,,,0,"percent of total billed charges","15.3% of total billed charges",16.29,100,,,,,0,"fee schedule",EAPG,368.46,69,,,,,0,"fee schedule","69% of total billed charges",534,100,,427.20,,,0,"percent of total billed charges","100% of total billed charges",22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",534,100,,427.20,,,0,"percent of total billed charges","100% of total billed charges",22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",534,100,,427.20,,,0,"percent of total billed charges","100% of total billed charges",22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.74,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",16.29,100,,,,,0,"fee schedule",EAPG,22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.94,100,,,,,0,"fee schedule","100% of LI fee schedule",12.07,100,,,,,0,"fee schedule",EAPG,22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.62,100,,,,,0,"fee schedule",EAPG,21.18,100,,,,,0,"fee schedule",EAPG,22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",201.32,37.7,,161.06,,,0,"percent of total billed charges","37.7% of total billed charges",201.32,37.7,,161.06,,,0,"percent of total billed charges","37.70% of total billed charges",22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",181.03,33.9,,144.82,,,0,"percent of total billed charges","33.9% of total billed charges",22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",416.52,78,,333.22,,,0,"percent of total billed charges","78% of total billed charges",23.16,101,,,,,0,"fee schedule","101% of CMS fee schedule ",441.08,82.6,,352.86,,,0,"percent of total billed charges","82.6% of total billed charges",16.29,100,,,,,0,"fee schedule",EAPG,22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",441.08,82.6,,352.86,,,0,"percent of total billed charges","82.6% of total billed charges",22.94,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.29,100,,,,,0,"fee schedule",EAPG,534,100,,427.20,,,0,"percent of total billed charges","100% of total billed charges",12.07,534,
"IV INFUSION HYDRATION 31M-1HR",76196360,CDM,761,RC,96360,CPT,OUTPATIENT,,,706,458.9,,621.28,88,,497.02,,,0,"percent of total billed charges","88% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,706,100,,564.80,,,0,"percent of total billed charges","100% of total billed charges",382.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",281.17,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",108.02,15.3,,86.42,,,0,"percent of total billed charges","15.3% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,487.14,69,,,,,0,"fee schedule","69% of total billed charges",706,100,,564.80,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",706,100,,564.80,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",706,100,,564.80,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",826.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.21,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278.44,100,,,,,0,"fee schedule",EAPG,354.88,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",266.16,37.7,,212.93,,,0,"percent of total billed charges","37.7% of total billed charges",266.16,37.7,,212.93,,,0,"percent of total billed charges","37.70% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",239.33,33.9,,191.46,,,0,"percent of total billed charges","33.9% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",550.68,78,,440.54,,,0,"percent of total billed charges","78% of total billed charges",220.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",583.16,82.6,,466.53,,,0,"percent of total billed charges","82.6% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",583.16,82.6,,466.53,,,0,"percent of total billed charges","82.6% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,706,100,,564.80,,,0,"percent of total billed charges","100% of total billed charges",108.02,826.71,
"IV INFUSION HYDRATION ADDL HR",76196361,CDM,761,RC,96361,CPT,OUTPATIENT,,,176,114.4,,154.88,88,,123.90,,,0,"percent of total billed charges","88% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",84.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",475.9,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",26.93,15.3,,21.54,,,0,"percent of total billed charges","15.3% of total billed charges",462.04,100,,,,,0,"fee schedule",EAPG,121.44,69,,,,,0,"fee schedule","69% of total billed charges",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.25,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",471.28,100,,,,,0,"fee schedule",EAPG,600.65,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.35,37.7,,53.08,,,0,"percent of total billed charges","37.7% of total billed charges",66.35,37.7,,53.08,,,0,"percent of total billed charges","37.70% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.66,33.9,,47.73,,,0,"percent of total billed charges","33.9% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",137.28,78,,109.82,,,0,"percent of total billed charges","78% of total billed charges",48.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",145.38,82.6,,116.30,,,0,"percent of total billed charges","82.6% of total billed charges",462.04,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",145.38,82.6,,116.30,,,0,"percent of total billed charges","82.6% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",26.93,600.65,
"IV INFUSION THX/PX/DX FIRST HR",76196365,CDM,761,RC,96365,CPT,OUTPATIENT,,,939,610.35,,826.32,88,,661.06,,,0,"percent of total billed charges","88% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,939,100,,751.20,,,0,"percent of total billed charges","100% of total billed charges",382.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",281.17,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",143.67,15.3,,114.94,,,0,"percent of total billed charges","15.3% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,647.91,69,,,,,0,"fee schedule","69% of total billed charges",939,100,,751.20,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",939,100,,751.20,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",939,100,,751.20,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",826.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.21,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278.44,100,,,,,0,"fee schedule",EAPG,354.88,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",354,37.7,,283.20,,,0,"percent of total billed charges","37.7% of total billed charges",354,37.7,,283.20,,,0,"percent of total billed charges","37.70% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",318.32,33.9,,254.66,,,0,"percent of total billed charges","33.9% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",732.42,78,,585.94,,,0,"percent of total billed charges","78% of total billed charges",220.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",775.61,82.6,,620.49,,,0,"percent of total billed charges","82.6% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",775.61,82.6,,620.49,,,0,"percent of total billed charges","82.6% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,939,100,,751.20,,,0,"percent of total billed charges","100% of total billed charges",143.67,939,
"IV INFUSION THX/PX/DX ADDL HR",76196366,CDM,761,RC,96366,CPT,OUTPATIENT,,,176,114.4,,154.88,88,,123.90,,,0,"percent of total billed charges","88% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",84.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",475.9,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",26.93,15.3,,21.54,,,0,"percent of total billed charges","15.3% of total billed charges",462.04,100,,,,,0,"fee schedule",EAPG,121.44,69,,,,,0,"fee schedule","69% of total billed charges",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.25,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",471.28,100,,,,,0,"fee schedule",EAPG,600.65,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.35,37.7,,53.08,,,0,"percent of total billed charges","37.7% of total billed charges",66.35,37.7,,53.08,,,0,"percent of total billed charges","37.70% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.66,33.9,,47.73,,,0,"percent of total billed charges","33.9% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",137.28,78,,109.82,,,0,"percent of total billed charges","78% of total billed charges",48.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",145.38,82.6,,116.30,,,0,"percent of total billed charges","82.6% of total billed charges",462.04,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",145.38,82.6,,116.30,,,0,"percent of total billed charges","82.6% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",26.93,600.65,
"IV INFUSION ADDL SEQ 1HR",76196367,CDM,761,RC,96367,CPT,OUTPATIENT,,,597,388.05,,525.36,88,,420.29,,,0,"percent of total billed charges","88% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,597,100,,477.60,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",281.17,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",91.34,15.3,,73.07,,,0,"percent of total billed charges","15.3% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,411.93,69,,,,,0,"fee schedule","69% of total billed charges",597,100,,477.60,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",597,100,,477.60,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",597,100,,477.60,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.21,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278.44,100,,,,,0,"fee schedule",EAPG,354.88,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",225.07,37.7,,180.06,,,0,"percent of total billed charges","37.7% of total billed charges",225.07,37.7,,180.06,,,0,"percent of total billed charges","37.70% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.38,33.9,,161.90,,,0,"percent of total billed charges","33.9% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465.66,78,,372.53,,,0,"percent of total billed charges","78% of total billed charges",72.56,100,,,,,0,"fee schedule","100% of CMS OPPS rate",493.12,82.6,,394.50,,,0,"percent of total billed charges","82.6% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",493.12,82.6,,394.50,,,0,"percent of total billed charges","82.6% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,597,100,,477.60,,,0,"percent of total billed charges","100% of total billed charges",65.81,597,
"CONCURRENT IV THER",76196368,CDM,761,RC,96368,CPT,OUTPATIENT,,,565,367.25,,497.2,88,,397.76,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.98,100,,,,,0,"fee schedule",EAPG,565,100,,452.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.17,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",86.45,15.3,,69.16,,,0,"percent of total billed charges","15.3% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,389.85,69,,,,,0,"fee schedule","69% of total billed charges",565,100,,452.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",565,100,,452.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",565,100,,452.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",272.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.21,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",278.44,100,,,,,0,"fee schedule",EAPG,354.88,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",213.01,37.7,,170.41,,,0,"percent of total billed charges","37.7% of total billed charges",213.01,37.7,,170.41,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.54,33.9,,153.23,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",440.7,78,,352.56,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",466.69,82.6,,373.35,,,0,"percent of total billed charges","82.6% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",466.69,82.6,,373.35,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.98,100,,,,,0,"fee schedule",EAPG,565,100,,452.00,,,0,"percent of total billed charges","100% of total billed charges",86.45,565,
"IV HYDRATION INITIAL 1ST HOUR",AMB820058,CDM,761,RC,96360,CPT,OUTPATIENT,,,706,458.9,,621.28,88,,497.02,,,0,"percent of total billed charges","88% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,706,100,,564.80,,,0,"percent of total billed charges","100% of total billed charges",382.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",281.17,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",108.02,15.3,,86.42,,,0,"percent of total billed charges","15.3% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,487.14,69,,,,,0,"fee schedule","69% of total billed charges",706,100,,564.80,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",706,100,,564.80,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",706,100,,564.80,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",826.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.21,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278.44,100,,,,,0,"fee schedule",EAPG,354.88,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",266.16,37.7,,212.93,,,0,"percent of total billed charges","37.7% of total billed charges",266.16,37.7,,212.93,,,0,"percent of total billed charges","37.70% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",239.33,33.9,,191.46,,,0,"percent of total billed charges","33.9% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",550.68,78,,440.54,,,0,"percent of total billed charges","78% of total billed charges",220.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",583.16,82.6,,466.53,,,0,"percent of total billed charges","82.6% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",583.16,82.6,,466.53,,,0,"percent of total billed charges","82.6% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,706,100,,564.80,,,0,"percent of total billed charges","100% of total billed charges",108.02,826.71,
"IV HYDRATION EA ADDL HR",AMB20059,CDM,761,RC,96361,CPT,OUTPATIENT,,,176,114.4,,154.88,88,,123.90,,,0,"percent of total billed charges","88% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",84.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",475.9,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",26.93,15.3,,21.54,,,0,"percent of total billed charges","15.3% of total billed charges",462.04,100,,,,,0,"fee schedule",EAPG,121.44,69,,,,,0,"fee schedule","69% of total billed charges",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.25,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",471.28,100,,,,,0,"fee schedule",EAPG,600.65,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.35,37.7,,53.08,,,0,"percent of total billed charges","37.7% of total billed charges",66.35,37.7,,53.08,,,0,"percent of total billed charges","37.70% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.66,33.9,,47.73,,,0,"percent of total billed charges","33.9% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",137.28,78,,109.82,,,0,"percent of total billed charges","78% of total billed charges",48.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",145.38,82.6,,116.30,,,0,"percent of total billed charges","82.6% of total billed charges",462.04,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",145.38,82.6,,116.30,,,0,"percent of total billed charges","82.6% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",26.93,600.65,
"IV INF THERAPEUTIC EA ADD'L HR",AMB820045,CDM,761,RC,96366,CPT,OUTPATIENT,,,176,114.4,,154.88,88,,123.90,,,0,"percent of total billed charges","88% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",84.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",475.9,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",26.93,15.3,,21.54,,,0,"percent of total billed charges","15.3% of total billed charges",462.04,100,,,,,0,"fee schedule",EAPG,121.44,69,,,,,0,"fee schedule","69% of total billed charges",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.25,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",471.28,100,,,,,0,"fee schedule",EAPG,600.65,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.35,37.7,,53.08,,,0,"percent of total billed charges","37.7% of total billed charges",66.35,37.7,,53.08,,,0,"percent of total billed charges","37.70% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.66,33.9,,47.73,,,0,"percent of total billed charges","33.9% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",137.28,78,,109.82,,,0,"percent of total billed charges","78% of total billed charges",48.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",145.38,82.6,,116.30,,,0,"percent of total billed charges","82.6% of total billed charges",462.04,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",145.38,82.6,,116.30,,,0,"percent of total billed charges","82.6% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",26.93,600.65,
"96365 IV INFUSION 2ND VISIT SAMEDAY",AMB820052,CDM,761,RC,96365,CPT,OUTPATIENT,,,939,610.35,59,826.32,88,,661.06,,,0,"percent of total billed charges","88% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,939,100,,751.20,,,0,"percent of total billed charges","100% of total billed charges",382.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",281.17,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",143.67,15.3,,114.94,,,0,"percent of total billed charges","15.3% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,647.91,69,,,,,0,"fee schedule","69% of total billed charges",939,100,,751.20,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",939,100,,751.20,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",939,100,,751.20,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",826.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.21,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278.44,100,,,,,0,"fee schedule",EAPG,354.88,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",354,37.7,,283.20,,,0,"percent of total billed charges","37.7% of total billed charges",354,37.7,,283.20,,,0,"percent of total billed charges","37.70% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",318.32,33.9,,254.66,,,0,"percent of total billed charges","33.9% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",732.42,78,,585.94,,,0,"percent of total billed charges","78% of total billed charges",220.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",775.61,82.6,,620.49,,,0,"percent of total billed charges","82.6% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",775.61,82.6,,620.49,,,0,"percent of total billed charges","82.6% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,939,100,,751.20,,,0,"percent of total billed charges","100% of total billed charges",143.67,939,
"96366 IV INFUSION 2ND VISIT SAMEDAY EA ADDT'L HOUR",AMB820057,CDM,761,RC,96366,CPT,OUTPATIENT,,,176,114.4,59,154.88,88,,123.90,,,0,"percent of total billed charges","88% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",84.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",475.9,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",26.93,15.3,,21.54,,,0,"percent of total billed charges","15.3% of total billed charges",462.04,100,,,,,0,"fee schedule",EAPG,121.44,69,,,,,0,"fee schedule","69% of total billed charges",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.25,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",471.28,100,,,,,0,"fee schedule",EAPG,600.65,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.35,37.7,,53.08,,,0,"percent of total billed charges","37.7% of total billed charges",66.35,37.7,,53.08,,,0,"percent of total billed charges","37.70% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.66,33.9,,47.73,,,0,"percent of total billed charges","33.9% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",137.28,78,,109.82,,,0,"percent of total billed charges","78% of total billed charges",48.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",145.38,82.6,,116.30,,,0,"percent of total billed charges","82.6% of total billed charges",462.04,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",145.38,82.6,,116.30,,,0,"percent of total billed charges","82.6% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",26.93,600.65,
"INJ THER/DX IM/SQ",76196372,CDM,761,RC,96372,CPT,OUTPATIENT,,,404,262.6,,355.52,88,,284.42,,,0,"percent of total billed charges","88% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,404,100,,323.20,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",61.81,15.3,,49.45,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,278.76,69,,,,,0,"fee schedule","69% of total billed charges",404,100,,323.20,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",404,100,,323.20,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",404,100,,323.20,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.48,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",152.31,37.7,,121.85,,,0,"percent of total billed charges","37.7% of total billed charges",152.31,37.7,,121.85,,,0,"percent of total billed charges","37.70% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",136.96,33.9,,109.57,,,0,"percent of total billed charges","33.9% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",315.12,78,,252.10,,,0,"percent of total billed charges","78% of total billed charges",72.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",333.7,82.6,,266.96,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",333.7,82.6,,266.96,,,0,"percent of total billed charges","82.6% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,404,100,,323.20,,,0,"percent of total billed charges","100% of total billed charges",29.48,404,
"S-INJ NON CHEMO IA",26096373,CDM,260,RC,96373,CPT,OUTPATIENT,,,1790,1163.5,,1575.2,88,,1260.16,,,0,"percent of total billed charges","88% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,1790,100,,1432.00,,,0,"percent of total billed charges","100% of total billed charges",382.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",273.87,15.3,,219.10,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,1235.1,69,,,,,0,"fee schedule","69% of total billed charges",1790,100,,1432.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1790,100,,1432.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1790,100,,1432.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",826.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.48,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",674.83,37.7,,539.86,,,0,"percent of total billed charges","37.7% of total billed charges",674.83,37.7,,539.86,,,0,"percent of total billed charges","37.70% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",606.81,33.9,,485.45,,,0,"percent of total billed charges","33.9% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1396.2,78,,1116.96,,,0,"percent of total billed charges","78% of total billed charges",220.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.54,82.6,,1182.83,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.54,82.6,,1182.83,,,0,"percent of total billed charges","82.6% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,1790,100,,1432.00,,,0,"percent of total billed charges","100% of total billed charges",29.48,1790,
"THERAPEUTIC IV PUSH",76196374,CDM,761,RC,96374,CPT,OUTPATIENT,,,586,380.9,,515.68,88,,412.54,,,0,"percent of total billed charges","88% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",382.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",89.66,15.3,,71.73,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,404.34,69,,,,,0,"fee schedule","69% of total billed charges",586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",826.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.48,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",220.92,37.7,,176.74,,,0,"percent of total billed charges","37.7% of total billed charges",220.92,37.7,,176.74,,,0,"percent of total billed charges","37.70% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",198.65,33.9,,158.92,,,0,"percent of total billed charges","33.9% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",457.08,78,,365.66,,,0,"percent of total billed charges","78% of total billed charges",220.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",484.04,82.6,,387.23,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",484.04,82.6,,387.23,,,0,"percent of total billed charges","82.6% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",29.48,826.71,
"THERA EA AD IV PUSH",76196375,CDM,761,RC,96375,CPT,OUTPATIENT,,,385,250.25,,338.8,88,,271.04,,,0,"percent of total billed charges","88% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",84.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",58.91,15.3,,47.13,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,265.65,69,,,,,0,"fee schedule","69% of total billed charges",385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.48,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",145.15,37.7,,116.12,,,0,"percent of total billed charges","37.7% of total billed charges",145.15,37.7,,116.12,,,0,"percent of total billed charges","37.70% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",130.52,33.9,,104.42,,,0,"percent of total billed charges","33.9% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",300.3,78,,240.24,,,0,"percent of total billed charges","78% of total billed charges",48.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",318.01,82.6,,254.41,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",318.01,82.6,,254.41,,,0,"percent of total billed charges","82.6% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",29.48,385,
"THER AD IVP SAME MED",76196376,CDM,761,RC,96376,CPT,OUTPATIENT,,,396,257.4,,348.48,88,,278.78,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.8,100,,,,,0,"fee schedule",EAPG,396,100,,316.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",41,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",60.59,15.3,,48.47,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,273.24,69,,,,,0,"fee schedule","69% of total billed charges",396,100,,316.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",396,100,,316.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",396,100,,316.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39.8,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",149.29,37.7,,119.43,,,0,"percent of total billed charges","37.7% of total billed charges",149.29,37.7,,119.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.24,33.9,,107.39,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",308.88,78,,247.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",327.1,82.6,,261.68,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",327.1,82.6,,261.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.8,100,,,,,0,"fee schedule",EAPG,396,100,,316.80,,,0,"percent of total billed charges","100% of total billed charges",29.48,396,
"IV PUSH SAME DRUG ADDON AFT 31",AMB20079,CDM,260,RC,96376,CPT,OUTPATIENT,,,396,257.4,,348.48,88,,278.78,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.8,100,,,,,0,"fee schedule",EAPG,396,100,,316.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",41,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",60.59,15.3,,48.47,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,273.24,69,,,,,0,"fee schedule","69% of total billed charges",396,100,,316.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",396,100,,316.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",396,100,,316.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39.8,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",149.29,37.7,,119.43,,,0,"percent of total billed charges","37.7% of total billed charges",149.29,37.7,,119.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.24,33.9,,107.39,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",308.88,78,,247.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",327.1,82.6,,261.68,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",327.1,82.6,,261.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.8,100,,,,,0,"fee schedule",EAPG,396,100,,316.80,,,0,"percent of total billed charges","100% of total billed charges",29.48,396,
"96374 IV INJECTION 2ND VISIT SAMEDAY",AMB820053,CDM,761,RC,96374,CPT,OUTPATIENT,,,586,380.9,59,515.68,88,,412.54,,,0,"percent of total billed charges","88% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",382.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",89.66,15.3,,71.73,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,404.34,69,,,,,0,"fee schedule","69% of total billed charges",586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",826.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.48,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",220.92,37.7,,176.74,,,0,"percent of total billed charges","37.7% of total billed charges",220.92,37.7,,176.74,,,0,"percent of total billed charges","37.70% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",198.65,33.9,,158.92,,,0,"percent of total billed charges","33.9% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",457.08,78,,365.66,,,0,"percent of total billed charges","78% of total billed charges",220.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",484.04,82.6,,387.23,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",484.04,82.6,,387.23,,,0,"percent of total billed charges","82.6% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",29.48,826.71,
"M0222- Bebtelovimab, injection and post administration monit",M0222,CDM,771,RC,,,OUTPATIENT,,,1407,914.55,,1238.16,88,,990.53,,,0,"percent of total billed charges","88% of total billed charges",703.5,50,,562.80,,,0,"percent of total billed charges","50% of total billed charges",236.38,16.8,,189.10,,,0,"percent of total billed charges","16.8% of total billed charges",1407,100,,1125.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",243.47,17.304,,194.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",886.41,63,,709.13,,,0,"percent of total billed charges","63% of total billed charges",215.27,15.3,,172.22,,,0,"percent of total billed charges","15.3% of total billed charges",236.38,16.8,,189.10,,,0,"percent of total billed charges","16.8% of total billed charges",970.83,69,,,,,0,"fee schedule","69% of total billed charges",1407,100,,1125.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1407,100,,1125.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1407,100,,1125.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",236.38,16.8,,189.10,,,0,"percent of total billed charges","16.8% of total billed charges",703.5,50,,562.80,,,0,"percent of total billed charges","50% of total billed charges",453.05,32.2,,362.44,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.1,17.136,,192.88,,,0,"percent of total billed charges","17.136% of total billed charges",307.29,21.84,,245.83,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",530.44,37.7,,424.35,,,0,"percent of total billed charges","37.7% of total billed charges",530.44,37.7,,424.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",476.97,33.9,,381.58,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1097.46,78,,877.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1162.18,82.6,,929.74,,,0,"percent of total billed charges","82.6% of total billed charges",236.38,16.8,,189.10,,,0,"percent of total billed charges","16.8% of total billed charges",703.5,50,,562.80,,,0,"percent of total billed charges","50% of total billed charges",1162.18,82.6,,929.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",236.38,16.8,,189.10,,,0,"percent of total billed charges","16.8% of total billed charges",1407,100,,1125.60,,,0,"percent of total billed charges","100% of total billed charges",215.27,1407,
"Intravenous infusion, casirivimab and imdevimab includes inf",M0243,CDM,771,RC,,,OUTPATIENT,,,1841,1196.65,,1620.08,88,,1296.06,,,0,"percent of total billed charges","88% of total billed charges",920.5,50,,736.40,,,0,"percent of total billed charges","50% of total billed charges",309.29,16.8,,247.43,,,0,"percent of total billed charges","16.8% of total billed charges",1841,100,,1472.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",318.57,17.304,,254.86,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1159.83,63,,927.86,,,0,"percent of total billed charges","63% of total billed charges",281.67,15.3,,225.34,,,0,"percent of total billed charges","15.3% of total billed charges",309.29,16.8,,247.43,,,0,"percent of total billed charges","16.8% of total billed charges",1270.29,69,,,,,0,"fee schedule","69% of total billed charges",1841,100,,1472.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1841,100,,1472.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1841,100,,1472.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",309.29,16.8,,247.43,,,0,"percent of total billed charges","16.8% of total billed charges",920.5,50,,736.40,,,0,"percent of total billed charges","50% of total billed charges",592.8,32.2,,474.24,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",315.47,17.136,,252.38,,,0,"percent of total billed charges","17.136% of total billed charges",402.07,21.84,,321.66,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",694.06,37.7,,555.25,,,0,"percent of total billed charges","37.7% of total billed charges",694.06,37.7,,555.25,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",624.1,33.9,,499.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1435.98,78,,1148.78,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1520.67,82.6,,1216.54,,,0,"percent of total billed charges","82.6% of total billed charges",309.29,16.8,,247.43,,,0,"percent of total billed charges","16.8% of total billed charges",920.5,50,,736.40,,,0,"percent of total billed charges","50% of total billed charges",1520.67,82.6,,1216.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",309.29,16.8,,247.43,,,0,"percent of total billed charges","16.8% of total billed charges",1841,100,,1472.80,,,0,"percent of total billed charges","100% of total billed charges",281.67,1841,
"Bamlan and Estesev Infusion",M0245,CDM,771,RC,,,OUTPATIENT,,,1841,1196.65,,1620.08,88,,1296.06,,,0,"percent of total billed charges","88% of total billed charges",920.5,50,,736.40,,,0,"percent of total billed charges","50% of total billed charges",309.29,16.8,,247.43,,,0,"percent of total billed charges","16.8% of total billed charges",1841,100,,1472.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",318.57,17.304,,254.86,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1159.83,63,,927.86,,,0,"percent of total billed charges","63% of total billed charges",281.67,15.3,,225.34,,,0,"percent of total billed charges","15.3% of total billed charges",309.29,16.8,,247.43,,,0,"percent of total billed charges","16.8% of total billed charges",1270.29,69,,,,,0,"fee schedule","69% of total billed charges",1841,100,,1472.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1841,100,,1472.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1841,100,,1472.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",309.29,16.8,,247.43,,,0,"percent of total billed charges","16.8% of total billed charges",920.5,50,,736.40,,,0,"percent of total billed charges","50% of total billed charges",592.8,32.2,,474.24,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",315.47,17.136,,252.38,,,0,"percent of total billed charges","17.136% of total billed charges",402.07,21.84,,321.66,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",694.06,37.7,,555.25,,,0,"percent of total billed charges","37.7% of total billed charges",694.06,37.7,,555.25,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",624.1,33.9,,499.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1435.98,78,,1148.78,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1520.67,82.6,,1216.54,,,0,"percent of total billed charges","82.6% of total billed charges",309.29,16.8,,247.43,,,0,"percent of total billed charges","16.8% of total billed charges",920.5,50,,736.40,,,0,"percent of total billed charges","50% of total billed charges",1520.67,82.6,,1216.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",309.29,16.8,,247.43,,,0,"percent of total billed charges","16.8% of total billed charges",1841,100,,1472.80,,,0,"percent of total billed charges","100% of total billed charges",281.67,1841,
"Intravenous infusion, tocilizumab, for hospitalized adults a",M0249,CDM,771,RC,,,OUTPATIENT,,,1841,1196.65,,1620.08,88,,1296.06,,,0,"percent of total billed charges","88% of total billed charges",920.5,50,,736.40,,,0,"percent of total billed charges","50% of total billed charges",309.29,16.8,,247.43,,,0,"percent of total billed charges","16.8% of total billed charges",1841,100,,1472.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",318.57,17.304,,254.86,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1159.83,63,,927.86,,,0,"percent of total billed charges","63% of total billed charges",281.67,15.3,,225.34,,,0,"percent of total billed charges","15.3% of total billed charges",309.29,16.8,,247.43,,,0,"percent of total billed charges","16.8% of total billed charges",1270.29,69,,,,,0,"fee schedule","69% of total billed charges",1841,100,,1472.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1841,100,,1472.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1841,100,,1472.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",309.29,16.8,,247.43,,,0,"percent of total billed charges","16.8% of total billed charges",920.5,50,,736.40,,,0,"percent of total billed charges","50% of total billed charges",592.8,32.2,,474.24,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",315.47,17.136,,252.38,,,0,"percent of total billed charges","17.136% of total billed charges",402.07,21.84,,321.66,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",694.06,37.7,,555.25,,,0,"percent of total billed charges","37.7% of total billed charges",694.06,37.7,,555.25,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",624.1,33.9,,499.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1435.98,78,,1148.78,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1520.67,82.6,,1216.54,,,0,"percent of total billed charges","82.6% of total billed charges",309.29,16.8,,247.43,,,0,"percent of total billed charges","16.8% of total billed charges",920.5,50,,736.40,,,0,"percent of total billed charges","50% of total billed charges",1520.67,82.6,,1216.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",309.29,16.8,,247.43,,,0,"percent of total billed charges","16.8% of total billed charges",1841,100,,1472.80,,,0,"percent of total billed charges","100% of total billed charges",281.67,1841,
"M0247 Intravenous infusion, sotrovimab, includes infusion an",M0247,CDM,771,RC,,,OUTPATIENT,,,1841,1196.65,,1620.08,88,,1296.06,,,0,"percent of total billed charges","88% of total billed charges",920.5,50,,736.40,,,0,"percent of total billed charges","50% of total billed charges",309.29,16.8,,247.43,,,0,"percent of total billed charges","16.8% of total billed charges",1841,100,,1472.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",318.57,17.304,,254.86,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1159.83,63,,927.86,,,0,"percent of total billed charges","63% of total billed charges",281.67,15.3,,225.34,,,0,"percent of total billed charges","15.3% of total billed charges",309.29,16.8,,247.43,,,0,"percent of total billed charges","16.8% of total billed charges",1270.29,69,,,,,0,"fee schedule","69% of total billed charges",1841,100,,1472.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1841,100,,1472.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1841,100,,1472.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",309.29,16.8,,247.43,,,0,"percent of total billed charges","16.8% of total billed charges",920.5,50,,736.40,,,0,"percent of total billed charges","50% of total billed charges",592.8,32.2,,474.24,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",315.47,17.136,,252.38,,,0,"percent of total billed charges","17.136% of total billed charges",402.07,21.84,,321.66,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",694.06,37.7,,555.25,,,0,"percent of total billed charges","37.7% of total billed charges",694.06,37.7,,555.25,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",624.1,33.9,,499.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1435.98,78,,1148.78,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1520.67,82.6,,1216.54,,,0,"percent of total billed charges","82.6% of total billed charges",309.29,16.8,,247.43,,,0,"percent of total billed charges","16.8% of total billed charges",920.5,50,,736.40,,,0,"percent of total billed charges","50% of total billed charges",1520.67,82.6,,1216.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",309.29,16.8,,247.43,,,0,"percent of total billed charges","16.8% of total billed charges",1841,100,,1472.80,,,0,"percent of total billed charges","100% of total billed charges",281.67,1841,
"Intravenous infusion, tocilizumab, for hospitalized adults a",M0250,CDM,771,RC,,,OUTPATIENT,,,1841,1196.65,,1620.08,88,,1296.06,,,0,"percent of total billed charges","88% of total billed charges",920.5,50,,736.40,,,0,"percent of total billed charges","50% of total billed charges",309.29,16.8,,247.43,,,0,"percent of total billed charges","16.8% of total billed charges",1841,100,,1472.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",318.57,17.304,,254.86,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1159.83,63,,927.86,,,0,"percent of total billed charges","63% of total billed charges",281.67,15.3,,225.34,,,0,"percent of total billed charges","15.3% of total billed charges",309.29,16.8,,247.43,,,0,"percent of total billed charges","16.8% of total billed charges",1270.29,69,,,,,0,"fee schedule","69% of total billed charges",1841,100,,1472.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1841,100,,1472.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1841,100,,1472.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",309.29,16.8,,247.43,,,0,"percent of total billed charges","16.8% of total billed charges",920.5,50,,736.40,,,0,"percent of total billed charges","50% of total billed charges",592.8,32.2,,474.24,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",315.47,17.136,,252.38,,,0,"percent of total billed charges","17.136% of total billed charges",402.07,21.84,,321.66,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",694.06,37.7,,555.25,,,0,"percent of total billed charges","37.7% of total billed charges",694.06,37.7,,555.25,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",624.1,33.9,,499.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1435.98,78,,1148.78,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1520.67,82.6,,1216.54,,,0,"percent of total billed charges","82.6% of total billed charges",309.29,16.8,,247.43,,,0,"percent of total billed charges","16.8% of total billed charges",920.5,50,,736.40,,,0,"percent of total billed charges","50% of total billed charges",1520.67,82.6,,1216.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",309.29,16.8,,247.43,,,0,"percent of total billed charges","16.8% of total billed charges",1841,100,,1472.80,,,0,"percent of total billed charges","100% of total billed charges",281.67,1841,
"Bullous pemphigoid 180 Antibody LC",30183516,CDM,301,RC,83516,CPT,OUTPATIENT,,,132,85.8,,116.16,88,,92.93,,,0,"percent of total billed charges","88% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",20.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.27,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",20.2,15.3,,16.16,,,0,"percent of total billed charges","15.3% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,91.08,69,,,,,0,"fee schedule","69% of total billed charges",132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.53,100,,,,,0,"fee schedule","100% of LI fee schedule",8.11,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.17,100,,,,,0,"fee schedule",EAPG,14.23,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.76,37.7,,39.81,,,0,"percent of total billed charges","37.7% of total billed charges",49.76,37.7,,39.81,,,0,"percent of total billed charges","37.70% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.75,33.9,,35.80,,,0,"percent of total billed charges","33.9% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",102.96,78,,82.37,,,0,"percent of total billed charges","78% of total billed charges",11.64,101,,,,,0,"fee schedule","101% of CMS fee schedule ",109.03,82.6,,87.22,,,0,"percent of total billed charges","82.6% of total billed charges",10.95,100,,,,,0,"fee schedule",EAPG,11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.03,82.6,,87.22,,,0,"percent of total billed charges","82.6% of total billed charges",11.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.95,100,,,,,0,"fee schedule",EAPG,132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",8.11,132,
"Fetal non-stress test",76159025,CDM,761,RC,59025,CPT,OUTPATIENT,,,357,232.05,,314.16,88,,251.33,,,0,"percent of total billed charges","88% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",165.98,100,,,,,0,"fee schedule",EAPG,357,100,,285.60,,,0,"percent of total billed charges","100% of total billed charges",355.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",170.96,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.91,63,,179.93,,,0,"percent of total billed charges","63% of total billed charges",54.62,15.3,,43.70,,,0,"percent of total billed charges","15.3% of total billed charges",165.98,100,,,,,0,"fee schedule",EAPG,246.33,69,,,,,0,"fee schedule","69% of total billed charges",357,100,,285.60,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",357,100,,285.60,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",357,100,,285.60,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",691.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",165.98,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.94,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.3,100,,,,,0,"fee schedule",EAPG,215.77,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",134.59,37.7,,107.67,,,0,"percent of total billed charges","37.7% of total billed charges",134.59,37.7,,107.67,,,0,"percent of total billed charges","37.70% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",121.02,33.9,,96.82,,,0,"percent of total billed charges","33.9% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278.46,78,,222.77,,,0,"percent of total billed charges","78% of total billed charges",205.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.88,82.6,,235.90,,,0,"percent of total billed charges","82.6% of total billed charges",165.98,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.88,82.6,,235.90,,,0,"percent of total billed charges","82.6% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",165.98,100,,,,,0,"fee schedule",EAPG,357,100,,285.60,,,0,"percent of total billed charges","100% of total billed charges",54.62,691.92,
N/A,30687206,CDM,306,RC,87206,CPT,OUTPATIENT,,,115,74.75,,101.2,88,,80.96,,,0,"percent of total billed charges","88% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",9.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.45,63,,57.96,,,0,"percent of total billed charges","63% of total billed charges",17.6,15.3,,14.08,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,79.35,69,,,,,0,"fee schedule","69% of total billed charges",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.61,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.39,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.36,37.7,,34.69,,,0,"percent of total billed charges","37.7% of total billed charges",43.36,37.7,,34.69,,,0,"percent of total billed charges","37.70% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.99,33.9,,31.19,,,0,"percent of total billed charges","33.9% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.7,78,,71.76,,,0,"percent of total billed charges","78% of total billed charges",5.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",94.99,82.6,,75.99,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",94.99,82.6,,75.99,,,0,"percent of total billed charges","82.6% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",4.81,115,
"ACID FAST CULTURE",30687116,CDM,306,RC,87116,CPT,OUTPATIENT,,,529,343.85,,465.52,88,,372.42,,,0,"percent of total billed charges","88% of total billed charges",10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,529,100,,423.20,,,0,"percent of total billed charges","100% of total billed charges",18.9,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",333.27,63,,266.62,,,0,"percent of total billed charges","63% of total billed charges",80.94,15.3,,64.75,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,365.01,69,,,,,0,"fee schedule","69% of total billed charges",529,100,,423.20,,,0,"percent of total billed charges","100% of total billed charges",10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",529,100,,423.20,,,0,"percent of total billed charges","100% of total billed charges",10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",529,100,,423.20,,,0,"percent of total billed charges","100% of total billed charges",10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.31,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.8,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",199.43,37.7,,159.54,,,0,"percent of total billed charges","37.7% of total billed charges",199.43,37.7,,159.54,,,0,"percent of total billed charges","37.70% of total billed charges",10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",179.33,33.9,,143.46,,,0,"percent of total billed charges","33.9% of total billed charges",10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",412.62,78,,330.10,,,0,"percent of total billed charges","78% of total billed charges",10.9,101,,,,,0,"fee schedule","101% of CMS fee schedule ",436.95,82.6,,349.56,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",436.95,82.6,,349.56,,,0,"percent of total billed charges","82.6% of total billed charges",10.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,529,100,,423.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,529,
N/A,30687206,CDM,306,RC,87206,CPT,OUTPATIENT,,,115,74.75,,101.2,88,,80.96,,,0,"percent of total billed charges","88% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",9.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.45,63,,57.96,,,0,"percent of total billed charges","63% of total billed charges",17.6,15.3,,14.08,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,79.35,69,,,,,0,"fee schedule","69% of total billed charges",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.61,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.39,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.36,37.7,,34.69,,,0,"percent of total billed charges","37.7% of total billed charges",43.36,37.7,,34.69,,,0,"percent of total billed charges","37.70% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.99,33.9,,31.19,,,0,"percent of total billed charges","33.9% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.7,78,,71.76,,,0,"percent of total billed charges","78% of total billed charges",5.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",94.99,82.6,,75.99,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",94.99,82.6,,75.99,,,0,"percent of total billed charges","82.6% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",4.81,115,
"CULTURE ANAEROBIC",30687075,CDM,306,RC,87075,CPT,OUTPATIENT,,,241,156.65,,212.08,88,,169.66,,,0,"percent of total billed charges","88% of total billed charges",9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",16.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.83,63,,121.46,,,0,"percent of total billed charges","63% of total billed charges",36.87,15.3,,29.50,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,166.29,69,,,,,0,"fee schedule","69% of total billed charges",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.22,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.47,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.86,37.7,,72.69,,,0,"percent of total billed charges","37.7% of total billed charges",90.86,37.7,,72.69,,,0,"percent of total billed charges","37.70% of total billed charges",9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.7,33.9,,65.36,,,0,"percent of total billed charges","33.9% of total billed charges",9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",187.98,78,,150.38,,,0,"percent of total billed charges","78% of total billed charges",9.56,101,,,,,0,"fee schedule","101% of CMS fee schedule ",199.07,82.6,,159.26,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",199.07,82.6,,159.26,,,0,"percent of total billed charges","82.6% of total billed charges",9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",4.81,241,
N/A,30687076,CDM,306,RC,87076,CPT,OUTPATIENT,,,93,60.45,,81.84,88,,65.47,,,0,"percent of total billed charges","88% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",14.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.59,63,,46.87,,,0,"percent of total billed charges","63% of total billed charges",14.23,15.3,,11.38,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,64.17,69,,,,,0,"fee schedule","69% of total billed charges",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.9,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.08,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.06,37.7,,28.05,,,0,"percent of total billed charges","37.7% of total billed charges",35.06,37.7,,28.05,,,0,"percent of total billed charges","37.70% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.53,33.9,,25.22,,,0,"percent of total billed charges","33.9% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.54,78,,58.03,,,0,"percent of total billed charges","78% of total billed charges",8.16,101,,,,,0,"fee schedule","101% of CMS fee schedule ",76.82,82.6,,61.46,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.82,82.6,,61.46,,,0,"percent of total billed charges","82.6% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",4.81,93,
N/A,30687076,CDM,306,RC,87076,CPT,OUTPATIENT,,,93,60.45,,81.84,88,,65.47,,,0,"percent of total billed charges","88% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",14.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.59,63,,46.87,,,0,"percent of total billed charges","63% of total billed charges",14.23,15.3,,11.38,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,64.17,69,,,,,0,"fee schedule","69% of total billed charges",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.9,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.08,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.06,37.7,,28.05,,,0,"percent of total billed charges","37.7% of total billed charges",35.06,37.7,,28.05,,,0,"percent of total billed charges","37.70% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.53,33.9,,25.22,,,0,"percent of total billed charges","33.9% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.54,78,,58.03,,,0,"percent of total billed charges","78% of total billed charges",8.16,101,,,,,0,"fee schedule","101% of CMS fee schedule ",76.82,82.6,,61.46,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.82,82.6,,61.46,,,0,"percent of total billed charges","82.6% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",4.81,93,
N/A,30687168,CDM,306,RC,87168,CPT,OUTPATIENT,,,45,29.25,,39.6,88,,31.68,,,0,"percent of total billed charges","88% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",7.47,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.35,63,,22.68,,,0,"percent of total billed charges","63% of total billed charges",6.89,15.3,,5.51,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,31.05,69,,,,,0,"fee schedule","69% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.33,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.26,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.97,37.7,,13.58,,,0,"percent of total billed charges","37.7% of total billed charges",16.97,37.7,,13.58,,,0,"percent of total billed charges","37.70% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.26,33.9,,12.21,,,0,"percent of total billed charges","33.9% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.1,78,,28.08,,,0,"percent of total billed charges","78% of total billed charges",4.31,101,,,,,0,"fee schedule","101% of CMS fee schedule ",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",4.26,45,
"Blood Culture",30687040,CDM,306,RC,87040,CPT,OUTPATIENT,,,263,170.95,,231.44,88,,185.15,,,0,"percent of total billed charges","88% of total billed charges",10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,263,100,,210.40,,,0,"percent of total billed charges","100% of total billed charges",18.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",165.69,63,,132.55,,,0,"percent of total billed charges","63% of total billed charges",40.24,15.3,,32.19,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,181.47,69,,,,,0,"fee schedule","69% of total billed charges",263,100,,210.40,,,0,"percent of total billed charges","100% of total billed charges",10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",263,100,,210.40,,,0,"percent of total billed charges","100% of total billed charges",10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",263,100,,210.40,,,0,"percent of total billed charges","100% of total billed charges",10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.47,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.32,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.15,37.7,,79.32,,,0,"percent of total billed charges","37.7% of total billed charges",99.15,37.7,,79.32,,,0,"percent of total billed charges","37.70% of total billed charges",10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.16,33.9,,71.33,,,0,"percent of total billed charges","33.9% of total billed charges",10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",205.14,78,,164.11,,,0,"percent of total billed charges","78% of total billed charges",10.42,101,,,,,0,"fee schedule","101% of CMS fee schedule ",217.24,82.6,,173.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",217.24,82.6,,173.79,,,0,"percent of total billed charges","82.6% of total billed charges",10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,263,100,,210.40,,,0,"percent of total billed charges","100% of total billed charges",4.81,263,
"CULTURE BODY FLUID",30687070,CDM,306,RC,87070,CPT,OUTPATIENT,,,535,347.75,,470.8,88,,376.64,,,0,"percent of total billed charges","88% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",15.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",337.05,63,,269.64,,,0,"percent of total billed charges","63% of total billed charges",81.86,15.3,,65.49,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,369.15,69,,,,,0,"fee schedule","69% of total billed charges",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.97,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.61,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",201.7,37.7,,161.36,,,0,"percent of total billed charges","37.7% of total billed charges",201.7,37.7,,161.36,,,0,"percent of total billed charges","37.70% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",181.37,33.9,,145.10,,,0,"percent of total billed charges","33.9% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",417.3,78,,333.84,,,0,"percent of total billed charges","78% of total billed charges",8.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",441.91,82.6,,353.53,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",441.91,82.6,,353.53,,,0,"percent of total billed charges","82.6% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",4.81,535,
"CULTURE BONE MARROW",30687070,CDM,306,RC,87070,CPT,OUTPATIENT,,,535,347.75,,470.8,88,,376.64,,,0,"percent of total billed charges","88% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",15.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",337.05,63,,269.64,,,0,"percent of total billed charges","63% of total billed charges",81.86,15.3,,65.49,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,369.15,69,,,,,0,"fee schedule","69% of total billed charges",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.97,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.61,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",201.7,37.7,,161.36,,,0,"percent of total billed charges","37.7% of total billed charges",201.7,37.7,,161.36,,,0,"percent of total billed charges","37.70% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",181.37,33.9,,145.10,,,0,"percent of total billed charges","33.9% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",417.3,78,,333.84,,,0,"percent of total billed charges","78% of total billed charges",8.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",441.91,82.6,,353.53,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",441.91,82.6,,353.53,,,0,"percent of total billed charges","82.6% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",4.81,535,
N/A,30687206,CDM,306,RC,87206,CPT,OUTPATIENT,,,115,74.75,,101.2,88,,80.96,,,0,"percent of total billed charges","88% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",9.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.45,63,,57.96,,,0,"percent of total billed charges","63% of total billed charges",17.6,15.3,,14.08,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,79.35,69,,,,,0,"fee schedule","69% of total billed charges",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.61,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.39,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.36,37.7,,34.69,,,0,"percent of total billed charges","37.7% of total billed charges",43.36,37.7,,34.69,,,0,"percent of total billed charges","37.70% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.99,33.9,,31.19,,,0,"percent of total billed charges","33.9% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.7,78,,71.76,,,0,"percent of total billed charges","78% of total billed charges",5.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",94.99,82.6,,75.99,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",94.99,82.6,,75.99,,,0,"percent of total billed charges","82.6% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",4.81,115,
"CULTURE CATH TIP",30687071,CDM,306,RC,87070,CPT,OUTPATIENT,,,525,341.25,,462,88,,369.60,,,0,"percent of total billed charges","88% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,525,100,,420.00,,,0,"percent of total billed charges","100% of total billed charges",15.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",330.75,63,,264.60,,,0,"percent of total billed charges","63% of total billed charges",80.33,15.3,,64.26,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,362.25,69,,,,,0,"fee schedule","69% of total billed charges",525,100,,420.00,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",525,100,,420.00,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",525,100,,420.00,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.97,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.61,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",197.93,37.7,,158.34,,,0,"percent of total billed charges","37.7% of total billed charges",197.93,37.7,,158.34,,,0,"percent of total billed charges","37.70% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",177.98,33.9,,142.38,,,0,"percent of total billed charges","33.9% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",409.5,78,,327.60,,,0,"percent of total billed charges","78% of total billed charges",8.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",433.65,82.6,,346.92,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",433.65,82.6,,346.92,,,0,"percent of total billed charges","82.6% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,525,100,,420.00,,,0,"percent of total billed charges","100% of total billed charges",4.81,525,
RMC-Etest,30687181,CDM,306,RC,87181,CPT,OUTPATIENT,,,45,29.25,,39.6,88,,31.68,,,0,"percent of total billed charges","88% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",8.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.35,63,,22.68,,,0,"percent of total billed charges","63% of total billed charges",6.89,15.3,,5.51,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,31.05,69,,,,,0,"fee schedule","69% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.16,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.75,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.97,37.7,,13.58,,,0,"percent of total billed charges","37.7% of total billed charges",16.97,37.7,,13.58,,,0,"percent of total billed charges","37.70% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.26,33.9,,12.21,,,0,"percent of total billed charges","33.9% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.1,78,,28.08,,,0,"percent of total billed charges","78% of total billed charges",4.79,101,,,,,0,"fee schedule","101% of CMS fee schedule ",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",4.75,45,
RMC-Etest,30687181,CDM,306,RC,87181,CPT,OUTPATIENT,,,42,27.3,,36.96,88,,29.57,,,0,"percent of total billed charges","88% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",8.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.46,63,,21.17,,,0,"percent of total billed charges","63% of total billed charges",6.43,15.3,,5.14,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,28.98,69,,,,,0,"fee schedule","69% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.16,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.75,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.7% of total billed charges",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.70% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.24,33.9,,11.39,,,0,"percent of total billed charges","33.9% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.76,78,,26.21,,,0,"percent of total billed charges","78% of total billed charges",4.79,101,,,,,0,"fee schedule","101% of CMS fee schedule ",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",4.75,42,
"CULTURE CSF",30687070,CDM,306,RC,87070,CPT,OUTPATIENT,,,426,276.9,,374.88,88,,299.90,,,0,"percent of total billed charges","88% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",15.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",268.38,63,,214.70,,,0,"percent of total billed charges","63% of total billed charges",65.18,15.3,,52.14,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,293.94,69,,,,,0,"fee schedule","69% of total billed charges",426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.97,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.61,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.6,37.7,,128.48,,,0,"percent of total billed charges","37.7% of total billed charges",160.6,37.7,,128.48,,,0,"percent of total billed charges","37.70% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.41,33.9,,115.53,,,0,"percent of total billed charges","33.9% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",332.28,78,,265.82,,,0,"percent of total billed charges","78% of total billed charges",8.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",351.88,82.6,,281.50,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",351.88,82.6,,281.50,,,0,"percent of total billed charges","82.6% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",4.81,426,
"TISSUE GRIND",30687176,CDM,306,RC,87176,CPT,OUTPATIENT,,,88,57.2,,77.44,88,,61.95,,,0,"percent of total billed charges","88% of total billed charges",5.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",10.29,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,5.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.44,63,,44.35,,,0,"percent of total billed charges","63% of total billed charges",13.46,15.3,,10.77,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,60.72,69,,,,,0,"fee schedule","69% of total billed charges",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",5.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",5.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",5.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.49,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,5.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.88,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,5.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,5.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.18,37.7,,26.54,,,0,"percent of total billed charges","37.7% of total billed charges",33.18,37.7,,26.54,,,0,"percent of total billed charges","37.70% of total billed charges",5.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.83,33.9,,23.86,,,0,"percent of total billed charges","33.9% of total billed charges",5.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.64,78,,54.91,,,0,"percent of total billed charges","78% of total billed charges",5.93,101,,,,,0,"fee schedule","101% of CMS fee schedule ",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,5.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",5.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",4.81,88,
"CONCENTRATION FOR INF AGENT",30687015,CDM,306,RC,87015,CPT,OUTPATIENT,,,142,92.3,,124.96,88,,99.97,,,0,"percent of total billed charges","88% of total billed charges",6.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",11.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,6.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.46,63,,71.57,,,0,"percent of total billed charges","63% of total billed charges",21.73,15.3,,17.38,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,97.98,69,,,,,0,"fee schedule","69% of total billed charges",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",6.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",6.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",6.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.55,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,6.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.68,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,6.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,6.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.53,37.7,,42.82,,,0,"percent of total billed charges","37.7% of total billed charges",53.53,37.7,,42.82,,,0,"percent of total billed charges","37.70% of total billed charges",6.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.14,33.9,,38.51,,,0,"percent of total billed charges","33.9% of total billed charges",6.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",110.76,78,,88.61,,,0,"percent of total billed charges","78% of total billed charges",6.74,101,,,,,0,"fee schedule","101% of CMS fee schedule ",117.29,82.6,,93.83,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,6.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",117.29,82.6,,93.83,,,0,"percent of total billed charges","82.6% of total billed charges",6.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",4.81,142,
"PRESUMP URINE ID",30687088,CDM,306,RC,87088,CPT,OUTPATIENT,,,219,142.35,,192.72,88,,154.18,,,0,"percent of total billed charges","88% of total billed charges",8.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",14.15,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.97,63,,110.38,,,0,"percent of total billed charges","63% of total billed charges",33.51,15.3,,26.81,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,151.11,69,,,,,0,"fee schedule","69% of total billed charges",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",8.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",8.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",8.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.94,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.09,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.56,37.7,,66.05,,,0,"percent of total billed charges","37.7% of total billed charges",82.56,37.7,,66.05,,,0,"percent of total billed charges","37.70% of total billed charges",8.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.24,33.9,,59.39,,,0,"percent of total billed charges","33.9% of total billed charges",8.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.82,78,,136.66,,,0,"percent of total billed charges","78% of total billed charges",8.17,101,,,,,0,"fee schedule","101% of CMS fee schedule ",180.89,82.6,,144.71,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",180.89,82.6,,144.71,,,0,"percent of total billed charges","82.6% of total billed charges",8.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,219,
"STREP LATEX AGGLUTINATION",30687147,CDM,306,RC,87147,CPT,OUTPATIENT,,,50,32.5,,44,88,,35.20,,,0,"percent of total billed charges","88% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",9.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.5,63,,25.20,,,0,"percent of total billed charges","63% of total billed charges",7.65,15.3,,6.12,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,34.5,69,,,,,0,"fee schedule","69% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.81,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.7% of total billed charges",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.70% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.95,33.9,,13.56,,,0,"percent of total billed charges","33.9% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",39,78,,31.20,,,0,"percent of total billed charges","78% of total billed charges",5.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",4.81,50,
"ANAEROBIC ID",30687076,CDM,306,RC,87076,CPT,OUTPATIENT,,,93,60.45,,81.84,88,,65.47,,,0,"percent of total billed charges","88% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",14.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.59,63,,46.87,,,0,"percent of total billed charges","63% of total billed charges",14.23,15.3,,11.38,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,64.17,69,,,,,0,"fee schedule","69% of total billed charges",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.9,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.08,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.06,37.7,,28.05,,,0,"percent of total billed charges","37.7% of total billed charges",35.06,37.7,,28.05,,,0,"percent of total billed charges","37.70% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.53,33.9,,25.22,,,0,"percent of total billed charges","33.9% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.54,78,,58.03,,,0,"percent of total billed charges","78% of total billed charges",8.16,101,,,,,0,"fee schedule","101% of CMS fee schedule ",76.82,82.6,,61.46,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.82,82.6,,61.46,,,0,"percent of total billed charges","82.6% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",4.81,93,
"CULTURE ANAEROBIC",30687075,CDM,306,RC,87075,CPT,OUTPATIENT,,,241,156.65,,212.08,88,,169.66,,,0,"percent of total billed charges","88% of total billed charges",9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",16.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.83,63,,121.46,,,0,"percent of total billed charges","63% of total billed charges",36.87,15.3,,29.50,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,166.29,69,,,,,0,"fee schedule","69% of total billed charges",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.22,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.47,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.86,37.7,,72.69,,,0,"percent of total billed charges","37.7% of total billed charges",90.86,37.7,,72.69,,,0,"percent of total billed charges","37.70% of total billed charges",9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.7,33.9,,65.36,,,0,"percent of total billed charges","33.9% of total billed charges",9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",187.98,78,,150.38,,,0,"percent of total billed charges","78% of total billed charges",9.56,101,,,,,0,"fee schedule","101% of CMS fee schedule ",199.07,82.6,,159.26,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",199.07,82.6,,159.26,,,0,"percent of total billed charges","82.6% of total billed charges",9.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",4.81,241,
"LATEX AGGLUTINATION",30687147,CDM,306,RC,87147,CPT,OUTPATIENT,,,50,32.5,,44,88,,35.20,,,0,"percent of total billed charges","88% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",9.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.5,63,,25.20,,,0,"percent of total billed charges","63% of total billed charges",7.65,15.3,,6.12,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,34.5,69,,,,,0,"fee schedule","69% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.81,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.7% of total billed charges",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.70% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.95,33.9,,13.56,,,0,"percent of total billed charges","33.9% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",39,78,,31.20,,,0,"percent of total billed charges","78% of total billed charges",5.23,101,,,,,0,"fee schedule","101% of CMS fee schedule ",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",5.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",4.81,50,
"FUNGUS IDENTIFICATION",30687107,CDM,306,RC,87185,CPT,OUTPATIENT,,,228,148.2,,200.64,88,,160.51,,,0,"percent of total billed charges","88% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",8.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",143.64,63,,114.91,,,0,"percent of total billed charges","63% of total billed charges",34.88,15.3,,27.90,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,157.32,69,,,,,0,"fee schedule","69% of total billed charges",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.16,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.75,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.96,37.7,,68.77,,,0,"percent of total billed charges","37.7% of total billed charges",85.96,37.7,,68.77,,,0,"percent of total billed charges","37.70% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.29,33.9,,61.83,,,0,"percent of total billed charges","33.9% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",177.84,78,,142.27,,,0,"percent of total billed charges","78% of total billed charges",4.79,101,,,,,0,"fee schedule","101% of CMS fee schedule ",188.33,82.6,,150.66,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",188.33,82.6,,150.66,,,0,"percent of total billed charges","82.6% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",4.75,228,
"BETA LACTAMASE",30687185,CDM,306,RC,87185,CPT,OUTPATIENT,,,83,53.95,,73.04,88,,58.43,,,0,"percent of total billed charges","88% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,83,100,,66.40,,,0,"percent of total billed charges","100% of total billed charges",8.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.29,63,,41.83,,,0,"percent of total billed charges","63% of total billed charges",12.7,15.3,,10.16,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,57.27,69,,,,,0,"fee schedule","69% of total billed charges",83,100,,66.40,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",83,100,,66.40,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",83,100,,66.40,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.16,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.75,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.29,37.7,,25.03,,,0,"percent of total billed charges","37.7% of total billed charges",31.29,37.7,,25.03,,,0,"percent of total billed charges","37.70% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.14,33.9,,22.51,,,0,"percent of total billed charges","33.9% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.74,78,,51.79,,,0,"percent of total billed charges","78% of total billed charges",4.79,101,,,,,0,"fee schedule","101% of CMS fee schedule ",68.56,82.6,,54.85,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.56,82.6,,54.85,,,0,"percent of total billed charges","82.6% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,83,100,,66.40,,,0,"percent of total billed charges","100% of total billed charges",4.75,83,
N/A,30687101,CDM,306,RC,87101,CPT,OUTPATIENT,,,385,250.25,,338.8,88,,271.04,,,0,"percent of total billed charges","88% of total billed charges",7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",13.49,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",242.55,63,,194.04,,,0,"percent of total billed charges","63% of total billed charges",58.91,15.3,,47.13,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,265.65,69,,,,,0,"fee schedule","69% of total billed charges",385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.49,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.71,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",145.15,37.7,,116.12,,,0,"percent of total billed charges","37.7% of total billed charges",145.15,37.7,,116.12,,,0,"percent of total billed charges","37.70% of total billed charges",7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",130.52,33.9,,104.42,,,0,"percent of total billed charges","33.9% of total billed charges",7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",300.3,78,,240.24,,,0,"percent of total billed charges","78% of total billed charges",7.78,101,,,,,0,"fee schedule","101% of CMS fee schedule ",318.01,82.6,,254.41,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",318.01,82.6,,254.41,,,0,"percent of total billed charges","82.6% of total billed charges",7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",4.81,385,
N/A,,,306,RC,87181,CPT,OUTPATIENT,,,42,27.3,,36.96,88,,29.57,,,0,"percent of total billed charges","88% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",8.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.46,63,,21.17,,,0,"percent of total billed charges","63% of total billed charges",6.43,15.3,,5.14,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,28.98,69,,,,,0,"fee schedule","69% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.16,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.75,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.7% of total billed charges",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.70% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.24,33.9,,11.39,,,0,"percent of total billed charges","33.9% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.76,78,,26.21,,,0,"percent of total billed charges","78% of total billed charges",4.79,101,,,,,0,"fee schedule","101% of CMS fee schedule ",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",4.75,42,
"CULTURE EAR",30687070,CDM,306,RC,87070,CPT,OUTPATIENT,,,427,277.55,,375.76,88,,300.61,,,0,"percent of total billed charges","88% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",15.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",269.01,63,,215.21,,,0,"percent of total billed charges","63% of total billed charges",65.33,15.3,,52.26,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,294.63,69,,,,,0,"fee schedule","69% of total billed charges",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.97,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.61,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.98,37.7,,128.78,,,0,"percent of total billed charges","37.7% of total billed charges",160.98,37.7,,128.78,,,0,"percent of total billed charges","37.70% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.75,33.9,,115.80,,,0,"percent of total billed charges","33.9% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",333.06,78,,266.45,,,0,"percent of total billed charges","78% of total billed charges",8.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",352.7,82.6,,282.16,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",352.7,82.6,,282.16,,,0,"percent of total billed charges","82.6% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",4.81,427,
"CULTURE EYE",30687070,CDM,306,RC,87070,CPT,OUTPATIENT,,,427,277.55,,375.76,88,,300.61,,,0,"percent of total billed charges","88% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",15.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",269.01,63,,215.21,,,0,"percent of total billed charges","63% of total billed charges",65.33,15.3,,52.26,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,294.63,69,,,,,0,"fee schedule","69% of total billed charges",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.97,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.61,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.98,37.7,,128.78,,,0,"percent of total billed charges","37.7% of total billed charges",160.98,37.7,,128.78,,,0,"percent of total billed charges","37.70% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.75,33.9,,115.80,,,0,"percent of total billed charges","33.9% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",333.06,78,,266.45,,,0,"percent of total billed charges","78% of total billed charges",8.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",352.7,82.6,,282.16,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",352.7,82.6,,282.16,,,0,"percent of total billed charges","82.6% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",4.81,427,
N/A,30687077,CDM,306,RC,87077,CPT,OUTPATIENT,,,277,180.05,,243.76,88,,195.01,,,0,"percent of total billed charges","88% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,277,100,,221.60,,,0,"percent of total billed charges","100% of total billed charges",14.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",174.51,63,,139.61,,,0,"percent of total billed charges","63% of total billed charges",42.38,15.3,,33.90,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,191.13,69,,,,,0,"fee schedule","69% of total billed charges",277,100,,221.60,,,0,"percent of total billed charges","100% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",277,100,,221.60,,,0,"percent of total billed charges","100% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",277,100,,221.60,,,0,"percent of total billed charges","100% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.9,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.08,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",104.43,37.7,,83.54,,,0,"percent of total billed charges","37.7% of total billed charges",104.43,37.7,,83.54,,,0,"percent of total billed charges","37.70% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",93.9,33.9,,75.12,,,0,"percent of total billed charges","33.9% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",216.06,78,,172.85,,,0,"percent of total billed charges","78% of total billed charges",8.16,101,,,,,0,"fee schedule","101% of CMS fee schedule ",228.8,82.6,,183.04,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",228.8,82.6,,183.04,,,0,"percent of total billed charges","82.6% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,277,100,,221.60,,,0,"percent of total billed charges","100% of total billed charges",4.81,277,
"CULTURE FUNGUS (BLOOD)",30687103,CDM,306,RC,87103,CPT,OUTPATIENT,,,367,238.55,,322.96,88,,258.37,,,0,"percent of total billed charges","88% of total billed charges",20.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,367,100,,293.60,,,0,"percent of total billed charges","100% of total billed charges",35.8,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,20.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",231.21,63,,184.97,,,0,"percent of total billed charges","63% of total billed charges",56.15,15.3,,44.92,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,253.23,69,,,,,0,"fee schedule","69% of total billed charges",367,100,,293.60,,,0,"percent of total billed charges","100% of total billed charges",20.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",367,100,,293.60,,,0,"percent of total billed charges","100% of total billed charges",20.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",367,100,,293.60,,,0,"percent of total billed charges","100% of total billed charges",20.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.25,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,20.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.46,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,20.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,20.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",138.36,37.7,,110.69,,,0,"percent of total billed charges","37.7% of total billed charges",138.36,37.7,,110.69,,,0,"percent of total billed charges","37.70% of total billed charges",20.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.41,33.9,,99.53,,,0,"percent of total billed charges","33.9% of total billed charges",20.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",286.26,78,,229.01,,,0,"percent of total billed charges","78% of total billed charges",20.66,101,,,,,0,"fee schedule","101% of CMS fee schedule ",303.14,82.6,,242.51,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,20.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",303.14,82.6,,242.51,,,0,"percent of total billed charges","82.6% of total billed charges",20.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,367,100,,293.60,,,0,"percent of total billed charges","100% of total billed charges",4.81,367,
N/A,30687102,CDM,306,RC,87102,CPT,OUTPATIENT,,,347,225.55,,305.36,88,,244.29,,,0,"percent of total billed charges","88% of total billed charges",8.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",14.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",218.61,63,,174.89,,,0,"percent of total billed charges","63% of total billed charges",53.09,15.3,,42.47,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,239.43,69,,,,,0,"fee schedule","69% of total billed charges",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",8.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",8.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",8.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.16,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.41,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",130.82,37.7,,104.66,,,0,"percent of total billed charges","37.7% of total billed charges",130.82,37.7,,104.66,,,0,"percent of total billed charges","37.70% of total billed charges",8.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",117.63,33.9,,94.10,,,0,"percent of total billed charges","33.9% of total billed charges",8.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",270.66,78,,216.53,,,0,"percent of total billed charges","78% of total billed charges",8.49,101,,,,,0,"fee schedule","101% of CMS fee schedule ",286.62,82.6,,229.30,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",286.62,82.6,,229.30,,,0,"percent of total billed charges","82.6% of total billed charges",8.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",4.81,347,
"CULTURE GC",30687081,CDM,306,RC,87081,CPT,OUTPATIENT,,,274,178.1,,241.12,88,,192.90,,,0,"percent of total billed charges","88% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,274,100,,219.20,,,0,"percent of total billed charges","100% of total billed charges",11.6,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",172.62,63,,138.10,,,0,"percent of total billed charges","63% of total billed charges",41.92,15.3,,33.54,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,189.06,69,,,,,0,"fee schedule","69% of total billed charges",274,100,,219.20,,,0,"percent of total billed charges","100% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",274,100,,219.20,,,0,"percent of total billed charges","100% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",274,100,,219.20,,,0,"percent of total billed charges","100% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.35,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.63,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",103.3,37.7,,82.64,,,0,"percent of total billed charges","37.7% of total billed charges",103.3,37.7,,82.64,,,0,"percent of total billed charges","37.70% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.89,33.9,,74.31,,,0,"percent of total billed charges","33.9% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",213.72,78,,170.98,,,0,"percent of total billed charges","78% of total billed charges",6.69,101,,,,,0,"fee schedule","101% of CMS fee schedule ",226.32,82.6,,181.06,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.32,82.6,,181.06,,,0,"percent of total billed charges","82.6% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,274,100,,219.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,274,
"CULTURE GENITAL",30687070,CDM,306,RC,87070,CPT,OUTPATIENT,,,426,276.9,,374.88,88,,299.90,,,0,"percent of total billed charges","88% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",15.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",268.38,63,,214.70,,,0,"percent of total billed charges","63% of total billed charges",65.18,15.3,,52.14,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,293.94,69,,,,,0,"fee schedule","69% of total billed charges",426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.97,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.61,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.6,37.7,,128.48,,,0,"percent of total billed charges","37.7% of total billed charges",160.6,37.7,,128.48,,,0,"percent of total billed charges","37.70% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.41,33.9,,115.53,,,0,"percent of total billed charges","33.9% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",332.28,78,,265.82,,,0,"percent of total billed charges","78% of total billed charges",8.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",351.88,82.6,,281.50,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",351.88,82.6,,281.50,,,0,"percent of total billed charges","82.6% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",4.81,426,
N/A,30687077,CDM,306,RC,87077,CPT,OUTPATIENT,,,277,180.05,,243.76,88,,195.01,,,0,"percent of total billed charges","88% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,277,100,,221.60,,,0,"percent of total billed charges","100% of total billed charges",14.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",174.51,63,,139.61,,,0,"percent of total billed charges","63% of total billed charges",42.38,15.3,,33.90,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,191.13,69,,,,,0,"fee schedule","69% of total billed charges",277,100,,221.60,,,0,"percent of total billed charges","100% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",277,100,,221.60,,,0,"percent of total billed charges","100% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",277,100,,221.60,,,0,"percent of total billed charges","100% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.9,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.08,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",104.43,37.7,,83.54,,,0,"percent of total billed charges","37.7% of total billed charges",104.43,37.7,,83.54,,,0,"percent of total billed charges","37.70% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",93.9,33.9,,75.12,,,0,"percent of total billed charges","33.9% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",216.06,78,,172.85,,,0,"percent of total billed charges","78% of total billed charges",8.16,101,,,,,0,"fee schedule","101% of CMS fee schedule ",228.8,82.6,,183.04,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",228.8,82.6,,183.04,,,0,"percent of total billed charges","82.6% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,277,100,,221.60,,,0,"percent of total billed charges","100% of total billed charges",4.81,277,
N/A,30687077,CDM,306,RC,87077,CPT,OUTPATIENT,,,277,180.05,,243.76,88,,195.01,,,0,"percent of total billed charges","88% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,277,100,,221.60,,,0,"percent of total billed charges","100% of total billed charges",14.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",174.51,63,,139.61,,,0,"percent of total billed charges","63% of total billed charges",42.38,15.3,,33.90,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,191.13,69,,,,,0,"fee schedule","69% of total billed charges",277,100,,221.60,,,0,"percent of total billed charges","100% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",277,100,,221.60,,,0,"percent of total billed charges","100% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",277,100,,221.60,,,0,"percent of total billed charges","100% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.9,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.08,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",104.43,37.7,,83.54,,,0,"percent of total billed charges","37.7% of total billed charges",104.43,37.7,,83.54,,,0,"percent of total billed charges","37.70% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",93.9,33.9,,75.12,,,0,"percent of total billed charges","33.9% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",216.06,78,,172.85,,,0,"percent of total billed charges","78% of total billed charges",8.16,101,,,,,0,"fee schedule","101% of CMS fee schedule ",228.8,82.6,,183.04,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",228.8,82.6,,183.04,,,0,"percent of total billed charges","82.6% of total billed charges",8.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,277,100,,221.60,,,0,"percent of total billed charges","100% of total billed charges",4.81,277,
"GRAM STAIN ORDER",30687205,CDM,306,RC,87205,CPT,OUTPATIENT,,,85,55.25,,74.8,88,,59.84,,,0,"percent of total billed charges","88% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",7.47,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.55,63,,42.84,,,0,"percent of total billed charges","63% of total billed charges",13.01,15.3,,10.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,58.65,69,,,,,0,"fee schedule","69% of total billed charges",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.33,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.26,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.05,37.7,,25.64,,,0,"percent of total billed charges","37.7% of total billed charges",32.05,37.7,,25.64,,,0,"percent of total billed charges","37.70% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.82,33.9,,23.06,,,0,"percent of total billed charges","33.9% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.3,78,,53.04,,,0,"percent of total billed charges","78% of total billed charges",4.31,101,,,,,0,"fee schedule","101% of CMS fee schedule ",70.21,82.6,,56.17,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.21,82.6,,56.17,,,0,"percent of total billed charges","82.6% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",4.26,85,
"GRAM STAIN",30687205,CDM,306,RC,87205,CPT,OUTPATIENT,,,85,55.25,,74.8,88,,59.84,,,0,"percent of total billed charges","88% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",7.47,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.55,63,,42.84,,,0,"percent of total billed charges","63% of total billed charges",13.01,15.3,,10.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,58.65,69,,,,,0,"fee schedule","69% of total billed charges",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.33,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.26,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.05,37.7,,25.64,,,0,"percent of total billed charges","37.7% of total billed charges",32.05,37.7,,25.64,,,0,"percent of total billed charges","37.70% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.82,33.9,,23.06,,,0,"percent of total billed charges","33.9% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.3,78,,53.04,,,0,"percent of total billed charges","78% of total billed charges",4.31,101,,,,,0,"fee schedule","101% of CMS fee schedule ",70.21,82.6,,56.17,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.21,82.6,,56.17,,,0,"percent of total billed charges","82.6% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",4.26,85,
"Gram Stain",30687205,CDM,306,RC,87205,CPT,OUTPATIENT,,,85,55.25,,74.8,88,,59.84,,,0,"percent of total billed charges","88% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",7.47,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.55,63,,42.84,,,0,"percent of total billed charges","63% of total billed charges",13.01,15.3,,10.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,58.65,69,,,,,0,"fee schedule","69% of total billed charges",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.33,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.26,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.05,37.7,,25.64,,,0,"percent of total billed charges","37.7% of total billed charges",32.05,37.7,,25.64,,,0,"percent of total billed charges","37.70% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.82,33.9,,23.06,,,0,"percent of total billed charges","33.9% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.3,78,,53.04,,,0,"percent of total billed charges","78% of total billed charges",4.31,101,,,,,0,"fee schedule","101% of CMS fee schedule ",70.21,82.6,,56.17,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.21,82.6,,56.17,,,0,"percent of total billed charges","82.6% of total billed charges",4.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",4.26,85,
N/A,30687081,CDM,306,RC,87081,CPT,OUTPATIENT,,,293,190.45,,257.84,88,,206.27,,,0,"percent of total billed charges","88% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,293,100,,234.40,,,0,"percent of total billed charges","100% of total billed charges",11.6,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",184.59,63,,147.67,,,0,"percent of total billed charges","63% of total billed charges",44.83,15.3,,35.86,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,202.17,69,,,,,0,"fee schedule","69% of total billed charges",293,100,,234.40,,,0,"percent of total billed charges","100% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",293,100,,234.40,,,0,"percent of total billed charges","100% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",293,100,,234.40,,,0,"percent of total billed charges","100% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.35,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.63,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",110.46,37.7,,88.37,,,0,"percent of total billed charges","37.7% of total billed charges",110.46,37.7,,88.37,,,0,"percent of total billed charges","37.70% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.33,33.9,,79.46,,,0,"percent of total billed charges","33.9% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",228.54,78,,182.83,,,0,"percent of total billed charges","78% of total billed charges",6.69,101,,,,,0,"fee schedule","101% of CMS fee schedule ",242.02,82.6,,193.62,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",242.02,82.6,,193.62,,,0,"percent of total billed charges","82.6% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,293,100,,234.40,,,0,"percent of total billed charges","100% of total billed charges",4.81,293,
"KOH Prep",30687206,CDM,306,RC,87206,CPT,OUTPATIENT,,,115,74.75,,101.2,88,,80.96,,,0,"percent of total billed charges","88% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",9.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.45,63,,57.96,,,0,"percent of total billed charges","63% of total billed charges",17.6,15.3,,14.08,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,79.35,69,,,,,0,"fee schedule","69% of total billed charges",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.61,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.39,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.36,37.7,,34.69,,,0,"percent of total billed charges","37.7% of total billed charges",43.36,37.7,,34.69,,,0,"percent of total billed charges","37.70% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.99,33.9,,31.19,,,0,"percent of total billed charges","33.9% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.7,78,,71.76,,,0,"percent of total billed charges","78% of total billed charges",5.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",94.99,82.6,,75.99,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",94.99,82.6,,75.99,,,0,"percent of total billed charges","82.6% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",4.81,115,
N/A,30687206,CDM,306,RC,87206,CPT,OUTPATIENT,,,115,74.75,,101.2,88,,80.96,,,0,"percent of total billed charges","88% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",9.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.45,63,,57.96,,,0,"percent of total billed charges","63% of total billed charges",17.6,15.3,,14.08,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,79.35,69,,,,,0,"fee schedule","69% of total billed charges",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.61,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.39,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.36,37.7,,34.69,,,0,"percent of total billed charges","37.7% of total billed charges",43.36,37.7,,34.69,,,0,"percent of total billed charges","37.70% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.99,33.9,,31.19,,,0,"percent of total billed charges","33.9% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.7,78,,71.76,,,0,"percent of total billed charges","78% of total billed charges",5.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",94.99,82.6,,75.99,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",94.99,82.6,,75.99,,,0,"percent of total billed charges","82.6% of total billed charges",5.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",4.81,115,
N/A,30687081,CDM,306,RC,87081,CPT,OUTPATIENT,,,302,196.3,,265.76,88,,212.61,,,0,"percent of total billed charges","88% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",11.6,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",190.26,63,,152.21,,,0,"percent of total billed charges","63% of total billed charges",46.21,15.3,,36.97,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,208.38,69,,,,,0,"fee schedule","69% of total billed charges",302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.35,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.63,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.85,37.7,,91.08,,,0,"percent of total billed charges","37.7% of total billed charges",113.85,37.7,,91.08,,,0,"percent of total billed charges","37.70% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",102.38,33.9,,81.90,,,0,"percent of total billed charges","33.9% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",235.56,78,,188.45,,,0,"percent of total billed charges","78% of total billed charges",6.69,101,,,,,0,"fee schedule","101% of CMS fee schedule ",249.45,82.6,,199.56,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",249.45,82.6,,199.56,,,0,"percent of total billed charges","82.6% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",4.81,302,
N/A,30687081,CDM,306,RC,87081,CPT,OUTPATIENT,,,302,196.3,,265.76,88,,212.61,,,0,"percent of total billed charges","88% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",11.6,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",190.26,63,,152.21,,,0,"percent of total billed charges","63% of total billed charges",46.21,15.3,,36.97,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,208.38,69,,,,,0,"fee schedule","69% of total billed charges",302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.35,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.63,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.85,37.7,,91.08,,,0,"percent of total billed charges","37.7% of total billed charges",113.85,37.7,,91.08,,,0,"percent of total billed charges","37.70% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",102.38,33.9,,81.90,,,0,"percent of total billed charges","33.9% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",235.56,78,,188.45,,,0,"percent of total billed charges","78% of total billed charges",6.69,101,,,,,0,"fee schedule","101% of CMS fee schedule ",249.45,82.6,,199.56,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",249.45,82.6,,199.56,,,0,"percent of total billed charges","82.6% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",4.81,302,
N/A,30687081,CDM,306,RC,87081,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.49,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.68,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.49,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.49,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.81,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.49,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.49,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",4.81,8.44,
RMC-GNDCEtest,30687181,CDM,306,RC,87181,CPT,OUTPATIENT,,,42,27.3,,36.96,88,,29.57,,,0,"percent of total billed charges","88% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",8.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.46,63,,21.17,,,0,"percent of total billed charges","63% of total billed charges",6.43,15.3,,5.14,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,28.98,69,,,,,0,"fee schedule","69% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.16,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.75,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.7% of total billed charges",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.70% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.24,33.9,,11.39,,,0,"percent of total billed charges","33.9% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.76,78,,26.21,,,0,"percent of total billed charges","78% of total billed charges",4.79,101,,,,,0,"fee schedule","101% of CMS fee schedule ",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",4.75,42,
"Minimum Inhibitory Concentration",30687186,CDM,306,RC,87186,CPT,OUTPATIENT,,,194,126.1,,170.72,88,,136.58,,,0,"percent of total billed charges","88% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",15.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",122.22,63,,97.78,,,0,"percent of total billed charges","63% of total billed charges",29.68,15.3,,23.74,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,133.86,69,,,,,0,"fee schedule","69% of total billed charges",194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.08,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.65,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.14,37.7,,58.51,,,0,"percent of total billed charges","37.7% of total billed charges",73.14,37.7,,58.51,,,0,"percent of total billed charges","37.70% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.77,33.9,,52.62,,,0,"percent of total billed charges","33.9% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.32,78,,121.06,,,0,"percent of total billed charges","78% of total billed charges",8.73,101,,,,,0,"fee schedule","101% of CMS fee schedule ",160.24,82.6,,128.19,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.24,82.6,,128.19,,,0,"percent of total billed charges","82.6% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,194,
N/A,30687070,CDM,306,RC,87070,CPT,OUTPATIENT,,,475,308.75,,418,88,,334.40,,,0,"percent of total billed charges","88% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",15.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",299.25,63,,239.40,,,0,"percent of total billed charges","63% of total billed charges",72.68,15.3,,58.14,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,327.75,69,,,,,0,"fee schedule","69% of total billed charges",475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.97,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.61,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",179.08,37.7,,143.26,,,0,"percent of total billed charges","37.7% of total billed charges",179.08,37.7,,143.26,,,0,"percent of total billed charges","37.70% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",161.03,33.9,,128.82,,,0,"percent of total billed charges","33.9% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",370.5,78,,296.40,,,0,"percent of total billed charges","78% of total billed charges",8.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",392.35,82.6,,313.88,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",392.35,82.6,,313.88,,,0,"percent of total billed charges","82.6% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",4.81,475,
"OVA AND PARASITES",30687177,CDM,306,RC,87177,CPT,OUTPATIENT,,,236,153.4,,207.68,88,,166.14,,,0,"percent of total billed charges","88% of total billed charges",8.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,236,100,,188.80,,,0,"percent of total billed charges","100% of total billed charges",15.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",148.68,63,,118.94,,,0,"percent of total billed charges","63% of total billed charges",36.11,15.3,,28.89,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,162.84,69,,,,,0,"fee schedule","69% of total billed charges",236,100,,188.80,,,0,"percent of total billed charges","100% of total billed charges",8.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",236,100,,188.80,,,0,"percent of total billed charges","100% of total billed charges",8.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",236,100,,188.80,,,0,"percent of total billed charges","100% of total billed charges",8.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.04,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.9,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.97,37.7,,71.18,,,0,"percent of total billed charges","37.7% of total billed charges",88.97,37.7,,71.18,,,0,"percent of total billed charges","37.70% of total billed charges",8.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",80,33.9,,64.00,,,0,"percent of total billed charges","33.9% of total billed charges",8.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",184.08,78,,147.26,,,0,"percent of total billed charges","78% of total billed charges",8.98,101,,,,,0,"fee schedule","101% of CMS fee schedule ",194.94,82.6,,155.95,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",194.94,82.6,,155.95,,,0,"percent of total billed charges","82.6% of total billed charges",8.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,236,100,,188.80,,,0,"percent of total billed charges","100% of total billed charges",4.81,236,
N/A,30687169,CDM,306,RC,87169,CPT,OUTPATIENT,,,41,26.65,,36.08,88,,28.86,,,0,"percent of total billed charges","88% of total billed charges",4.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",7.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,4.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.83,63,,20.66,,,0,"percent of total billed charges","63% of total billed charges",6.27,15.3,,5.02,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,28.29,69,,,,,0,"fee schedule","69% of total billed charges",41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",4.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",4.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",4.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.48,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,4.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.3,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,4.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,4.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.46,37.7,,12.37,,,0,"percent of total billed charges","37.7% of total billed charges",15.46,37.7,,12.37,,,0,"percent of total billed charges","37.70% of total billed charges",4.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.9,33.9,,11.12,,,0,"percent of total billed charges","33.9% of total billed charges",4.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.98,78,,25.58,,,0,"percent of total billed charges","78% of total billed charges",4.35,101,,,,,0,"fee schedule","101% of CMS fee schedule ",33.87,82.6,,27.10,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,4.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.87,82.6,,27.10,,,0,"percent of total billed charges","82.6% of total billed charges",4.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",4.3,41,
RMC-Etest,30687181,CDM,306,RC,87181,CPT,OUTPATIENT,,,42,27.3,,36.96,88,,29.57,,,0,"percent of total billed charges","88% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",8.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.46,63,,21.17,,,0,"percent of total billed charges","63% of total billed charges",6.43,15.3,,5.14,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,28.98,69,,,,,0,"fee schedule","69% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.16,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.75,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.7% of total billed charges",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.70% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.24,33.9,,11.39,,,0,"percent of total billed charges","33.9% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.76,78,,26.21,,,0,"percent of total billed charges","78% of total billed charges",4.79,101,,,,,0,"fee schedule","101% of CMS fee schedule ",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",4.75,42,
N/A,30687184,CDM,306,RC,87184,CPT,OUTPATIENT,,,156,101.4,,137.28,88,,109.82,,,0,"percent of total billed charges","88% of total billed charges",7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",13.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.28,63,,78.62,,,0,"percent of total billed charges","63% of total billed charges",23.87,15.3,,19.10,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,107.64,69,,,,,0,"fee schedule","69% of total billed charges",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.61,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.48,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.81,37.7,,47.05,,,0,"percent of total billed charges","37.7% of total billed charges",58.81,37.7,,47.05,,,0,"percent of total billed charges","37.70% of total billed charges",7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.88,33.9,,42.30,,,0,"percent of total billed charges","33.9% of total billed charges",7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",121.68,78,,97.34,,,0,"percent of total billed charges","78% of total billed charges",7.55,101,,,,,0,"fee schedule","101% of CMS fee schedule ",128.86,82.6,,103.09,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",128.86,82.6,,103.09,,,0,"percent of total billed charges","82.6% of total billed charges",7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",4.81,156,
N/A,30687184,CDM,306,RC,87184,CPT,OUTPATIENT,,,156,101.4,,137.28,88,,109.82,,,0,"percent of total billed charges","88% of total billed charges",7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",13.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.28,63,,78.62,,,0,"percent of total billed charges","63% of total billed charges",23.87,15.3,,19.10,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,107.64,69,,,,,0,"fee schedule","69% of total billed charges",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.61,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.48,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.81,37.7,,47.05,,,0,"percent of total billed charges","37.7% of total billed charges",58.81,37.7,,47.05,,,0,"percent of total billed charges","37.70% of total billed charges",7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.88,33.9,,42.30,,,0,"percent of total billed charges","33.9% of total billed charges",7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",121.68,78,,97.34,,,0,"percent of total billed charges","78% of total billed charges",7.55,101,,,,,0,"fee schedule","101% of CMS fee schedule ",128.86,82.6,,103.09,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",128.86,82.6,,103.09,,,0,"percent of total billed charges","82.6% of total billed charges",7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",4.81,156,
N/A,30687184,CDM,306,RC,87184,CPT,OUTPATIENT,,,156,101.4,,137.28,88,,109.82,,,0,"percent of total billed charges","88% of total billed charges",7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",13.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.28,63,,78.62,,,0,"percent of total billed charges","63% of total billed charges",23.87,15.3,,19.10,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,107.64,69,,,,,0,"fee schedule","69% of total billed charges",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.61,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.48,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.81,37.7,,47.05,,,0,"percent of total billed charges","37.7% of total billed charges",58.81,37.7,,47.05,,,0,"percent of total billed charges","37.70% of total billed charges",7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.88,33.9,,42.30,,,0,"percent of total billed charges","33.9% of total billed charges",7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",121.68,78,,97.34,,,0,"percent of total billed charges","78% of total billed charges",7.55,101,,,,,0,"fee schedule","101% of CMS fee schedule ",128.86,82.6,,103.09,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",128.86,82.6,,103.09,,,0,"percent of total billed charges","82.6% of total billed charges",7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",4.81,156,
N/A,30687186,CDM,306,RC,87186,CPT,OUTPATIENT,,,484,314.6,,425.92,88,,340.74,,,0,"percent of total billed charges","88% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",15.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",304.92,63,,243.94,,,0,"percent of total billed charges","63% of total billed charges",74.05,15.3,,59.24,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,333.96,69,,,,,0,"fee schedule","69% of total billed charges",484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.08,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.65,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",182.47,37.7,,145.98,,,0,"percent of total billed charges","37.7% of total billed charges",182.47,37.7,,145.98,,,0,"percent of total billed charges","37.70% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",164.08,33.9,,131.26,,,0,"percent of total billed charges","33.9% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",377.52,78,,302.02,,,0,"percent of total billed charges","78% of total billed charges",8.73,101,,,,,0,"fee schedule","101% of CMS fee schedule ",399.78,82.6,,319.82,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",399.78,82.6,,319.82,,,0,"percent of total billed charges","82.6% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,484,
N/A,30687186,CDM,306,RC,87186,CPT,OUTPATIENT,,,484,314.6,,425.92,88,,340.74,,,0,"percent of total billed charges","88% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",15.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",304.92,63,,243.94,,,0,"percent of total billed charges","63% of total billed charges",74.05,15.3,,59.24,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,333.96,69,,,,,0,"fee schedule","69% of total billed charges",484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.08,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.65,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",182.47,37.7,,145.98,,,0,"percent of total billed charges","37.7% of total billed charges",182.47,37.7,,145.98,,,0,"percent of total billed charges","37.70% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",164.08,33.9,,131.26,,,0,"percent of total billed charges","33.9% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",377.52,78,,302.02,,,0,"percent of total billed charges","78% of total billed charges",8.73,101,,,,,0,"fee schedule","101% of CMS fee schedule ",399.78,82.6,,319.82,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",399.78,82.6,,319.82,,,0,"percent of total billed charges","82.6% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,484,
N/A,30687186,CDM,306,RC,87186,CPT,OUTPATIENT,,,484,314.6,,425.92,88,,340.74,,,0,"percent of total billed charges","88% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",15.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",304.92,63,,243.94,,,0,"percent of total billed charges","63% of total billed charges",74.05,15.3,,59.24,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,333.96,69,,,,,0,"fee schedule","69% of total billed charges",484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.08,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.65,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",182.47,37.7,,145.98,,,0,"percent of total billed charges","37.7% of total billed charges",182.47,37.7,,145.98,,,0,"percent of total billed charges","37.70% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",164.08,33.9,,131.26,,,0,"percent of total billed charges","33.9% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",377.52,78,,302.02,,,0,"percent of total billed charges","78% of total billed charges",8.73,101,,,,,0,"fee schedule","101% of CMS fee schedule ",399.78,82.6,,319.82,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",399.78,82.6,,319.82,,,0,"percent of total billed charges","82.6% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,484,
N/A,30687186,CDM,306,RC,87186,CPT,OUTPATIENT,,,484,314.6,,425.92,88,,340.74,,,0,"percent of total billed charges","88% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",15.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",304.92,63,,243.94,,,0,"percent of total billed charges","63% of total billed charges",74.05,15.3,,59.24,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,333.96,69,,,,,0,"fee schedule","69% of total billed charges",484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.08,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.65,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",182.47,37.7,,145.98,,,0,"percent of total billed charges","37.7% of total billed charges",182.47,37.7,,145.98,,,0,"percent of total billed charges","37.70% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",164.08,33.9,,131.26,,,0,"percent of total billed charges","33.9% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",377.52,78,,302.02,,,0,"percent of total billed charges","78% of total billed charges",8.73,101,,,,,0,"fee schedule","101% of CMS fee schedule ",399.78,82.6,,319.82,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",399.78,82.6,,319.82,,,0,"percent of total billed charges","82.6% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,484,
N/A,,,306,RC,87181,CPT,OUTPATIENT,,,42,27.3,,36.96,88,,29.57,,,0,"percent of total billed charges","88% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",8.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.46,63,,21.17,,,0,"percent of total billed charges","63% of total billed charges",6.43,15.3,,5.14,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,28.98,69,,,,,0,"fee schedule","69% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.16,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.75,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.7% of total billed charges",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.70% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.24,33.9,,11.39,,,0,"percent of total billed charges","33.9% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.76,78,,26.21,,,0,"percent of total billed charges","78% of total billed charges",4.79,101,,,,,0,"fee schedule","101% of CMS fee schedule ",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",4.75,42,
"CULTURE RESPIRATORY",30687070,CDM,306,RC,87070,CPT,OUTPATIENT,,,433,281.45,,381.04,88,,304.83,,,0,"percent of total billed charges","88% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",15.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",272.79,63,,218.23,,,0,"percent of total billed charges","63% of total billed charges",66.25,15.3,,53.00,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,298.77,69,,,,,0,"fee schedule","69% of total billed charges",433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.97,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.61,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.24,37.7,,130.59,,,0,"percent of total billed charges","37.7% of total billed charges",163.24,37.7,,130.59,,,0,"percent of total billed charges","37.70% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",146.79,33.9,,117.43,,,0,"percent of total billed charges","33.9% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",337.74,78,,270.19,,,0,"percent of total billed charges","78% of total billed charges",8.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",357.66,82.6,,286.13,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",357.66,82.6,,286.13,,,0,"percent of total billed charges","82.6% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",4.81,433,
"SUN-NEG GN84",30687186,CDM,306,RC,87186,CPT,OUTPATIENT,,,194,126.1,,170.72,88,,136.58,,,0,"percent of total billed charges","88% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",15.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",122.22,63,,97.78,,,0,"percent of total billed charges","63% of total billed charges",29.68,15.3,,23.74,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,133.86,69,,,,,0,"fee schedule","69% of total billed charges",194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.08,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.65,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.14,37.7,,58.51,,,0,"percent of total billed charges","37.7% of total billed charges",73.14,37.7,,58.51,,,0,"percent of total billed charges","37.70% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.77,33.9,,52.62,,,0,"percent of total billed charges","33.9% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.32,78,,121.06,,,0,"percent of total billed charges","78% of total billed charges",8.73,101,,,,,0,"fee schedule","101% of CMS fee schedule ",160.24,82.6,,128.19,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.24,82.6,,128.19,,,0,"percent of total billed charges","82.6% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,194,
"SUN-POS GP67",30687186,CDM,306,RC,87186,CPT,OUTPATIENT,,,194,126.1,,170.72,88,,136.58,,,0,"percent of total billed charges","88% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",15.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",122.22,63,,97.78,,,0,"percent of total billed charges","63% of total billed charges",29.68,15.3,,23.74,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,133.86,69,,,,,0,"fee schedule","69% of total billed charges",194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.08,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.65,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.14,37.7,,58.51,,,0,"percent of total billed charges","37.7% of total billed charges",73.14,37.7,,58.51,,,0,"percent of total billed charges","37.70% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.77,33.9,,52.62,,,0,"percent of total billed charges","33.9% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.32,78,,121.06,,,0,"percent of total billed charges","78% of total billed charges",8.73,101,,,,,0,"fee schedule","101% of CMS fee schedule ",160.24,82.6,,128.19,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.24,82.6,,128.19,,,0,"percent of total billed charges","82.6% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,194,
"SUN-GP 74 SPN Sens",30687186,CDM,306,RC,87186,CPT,OUTPATIENT,,,194,126.1,,170.72,88,,136.58,,,0,"percent of total billed charges","88% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",15.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",122.22,63,,97.78,,,0,"percent of total billed charges","63% of total billed charges",29.68,15.3,,23.74,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,133.86,69,,,,,0,"fee schedule","69% of total billed charges",194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.08,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.65,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.14,37.7,,58.51,,,0,"percent of total billed charges","37.7% of total billed charges",73.14,37.7,,58.51,,,0,"percent of total billed charges","37.70% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.77,33.9,,52.62,,,0,"percent of total billed charges","33.9% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.32,78,,121.06,,,0,"percent of total billed charges","78% of total billed charges",8.73,101,,,,,0,"fee schedule","101% of CMS fee schedule ",160.24,82.6,,128.19,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.24,82.6,,128.19,,,0,"percent of total billed charges","82.6% of total billed charges",8.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,194,
N/A,30687070,CDM,306,RC,87070,CPT,OUTPATIENT,,,433,281.45,,381.04,88,,304.83,,,0,"percent of total billed charges","88% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",15.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",272.79,63,,218.23,,,0,"percent of total billed charges","63% of total billed charges",66.25,15.3,,53.00,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,298.77,69,,,,,0,"fee schedule","69% of total billed charges",433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.97,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.61,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.24,37.7,,130.59,,,0,"percent of total billed charges","37.7% of total billed charges",163.24,37.7,,130.59,,,0,"percent of total billed charges","37.70% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",146.79,33.9,,117.43,,,0,"percent of total billed charges","33.9% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",337.74,78,,270.19,,,0,"percent of total billed charges","78% of total billed charges",8.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",357.66,82.6,,286.13,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",357.66,82.6,,286.13,,,0,"percent of total billed charges","82.6% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,433,100,,346.40,,,0,"percent of total billed charges","100% of total billed charges",4.81,433,
N/A,30687081,CDM,306,RC,87081,CPT,OUTPATIENT,,,302,196.3,,265.76,88,,212.61,,,0,"percent of total billed charges","88% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",11.6,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",190.26,63,,152.21,,,0,"percent of total billed charges","63% of total billed charges",46.21,15.3,,36.97,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,208.38,69,,,,,0,"fee schedule","69% of total billed charges",302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.35,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.63,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.85,37.7,,91.08,,,0,"percent of total billed charges","37.7% of total billed charges",113.85,37.7,,91.08,,,0,"percent of total billed charges","37.70% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",102.38,33.9,,81.90,,,0,"percent of total billed charges","33.9% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",235.56,78,,188.45,,,0,"percent of total billed charges","78% of total billed charges",6.69,101,,,,,0,"fee schedule","101% of CMS fee schedule ",249.45,82.6,,199.56,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",249.45,82.6,,199.56,,,0,"percent of total billed charges","82.6% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",4.81,302,
N/A,30687081,CDM,306,RC,87081,CPT,OUTPATIENT,,,302,196.3,,265.76,88,,212.61,,,0,"percent of total billed charges","88% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",11.6,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",190.26,63,,152.21,,,0,"percent of total billed charges","63% of total billed charges",46.21,15.3,,36.97,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,208.38,69,,,,,0,"fee schedule","69% of total billed charges",302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.35,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.63,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.85,37.7,,91.08,,,0,"percent of total billed charges","37.7% of total billed charges",113.85,37.7,,91.08,,,0,"percent of total billed charges","37.70% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",102.38,33.9,,81.90,,,0,"percent of total billed charges","33.9% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",235.56,78,,188.45,,,0,"percent of total billed charges","78% of total billed charges",6.69,101,,,,,0,"fee schedule","101% of CMS fee schedule ",249.45,82.6,,199.56,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",249.45,82.6,,199.56,,,0,"percent of total billed charges","82.6% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",4.81,302,
N/A,30687081,CDM,306,RC,87081,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.49,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.68,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.49,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.49,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.81,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.49,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.49,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",4.81,8.44,
"Stool Culture",30687045,CDM,306,RC,87045,CPT,OUTPATIENT,,,232,150.8,,204.16,88,,163.33,,,0,"percent of total billed charges","88% of total billed charges",9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,232,100,,185.60,,,0,"percent of total billed charges","100% of total billed charges",16.52,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",146.16,63,,116.93,,,0,"percent of total billed charges","63% of total billed charges",35.5,15.3,,28.40,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,160.08,69,,,,,0,"fee schedule","69% of total billed charges",232,100,,185.60,,,0,"percent of total billed charges","100% of total billed charges",9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",232,100,,185.60,,,0,"percent of total billed charges","100% of total billed charges",9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",232,100,,185.60,,,0,"percent of total billed charges","100% of total billed charges",9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.44,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.46,37.7,,69.97,,,0,"percent of total billed charges","37.7% of total billed charges",87.46,37.7,,69.97,,,0,"percent of total billed charges","37.70% of total billed charges",9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.65,33.9,,62.92,,,0,"percent of total billed charges","33.9% of total billed charges",9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",180.96,78,,144.77,,,0,"percent of total billed charges","78% of total billed charges",9.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",191.63,82.6,,153.30,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",191.63,82.6,,153.30,,,0,"percent of total billed charges","82.6% of total billed charges",9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,232,100,,185.60,,,0,"percent of total billed charges","100% of total billed charges",4.81,232,
"CULTURE YERSENIA",30687046,CDM,306,RC,87046,CPT,OUTPATIENT,,,57,37.05,,50.16,88,,40.13,,,0,"percent of total billed charges","88% of total billed charges",9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",16.52,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.91,63,,28.73,,,0,"percent of total billed charges","63% of total billed charges",8.72,15.3,,6.98,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,39.33,69,,,,,0,"fee schedule","69% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.1,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.44,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.49,37.7,,17.19,,,0,"percent of total billed charges","37.7% of total billed charges",21.49,37.7,,17.19,,,0,"percent of total billed charges","37.70% of total billed charges",9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.32,33.9,,15.46,,,0,"percent of total billed charges","33.9% of total billed charges",9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.46,78,,35.57,,,0,"percent of total billed charges","78% of total billed charges",9.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",47.08,82.6,,37.66,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.08,82.6,,37.66,,,0,"percent of total billed charges","82.6% of total billed charges",9.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",4.81,57,
"Strep Culture",30687081,CDM,306,RC,87081,CPT,OUTPATIENT,,,296,192.4,,260.48,88,,208.38,,,0,"percent of total billed charges","88% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,296,100,,236.80,,,0,"percent of total billed charges","100% of total billed charges",11.6,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",186.48,63,,149.18,,,0,"percent of total billed charges","63% of total billed charges",45.29,15.3,,36.23,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,204.24,69,,,,,0,"fee schedule","69% of total billed charges",296,100,,236.80,,,0,"percent of total billed charges","100% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",296,100,,236.80,,,0,"percent of total billed charges","100% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",296,100,,236.80,,,0,"percent of total billed charges","100% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.35,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.63,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",111.59,37.7,,89.27,,,0,"percent of total billed charges","37.7% of total billed charges",111.59,37.7,,89.27,,,0,"percent of total billed charges","37.70% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.34,33.9,,80.27,,,0,"percent of total billed charges","33.9% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",230.88,78,,184.70,,,0,"percent of total billed charges","78% of total billed charges",6.69,101,,,,,0,"fee schedule","101% of CMS fee schedule ",244.5,82.6,,195.60,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",244.5,82.6,,195.60,,,0,"percent of total billed charges","82.6% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,296,100,,236.80,,,0,"percent of total billed charges","100% of total billed charges",4.81,296,
N/A,30687070,CDM,306,RC,87070,CPT,OUTPATIENT,,,535,347.75,,470.8,88,,376.64,,,0,"percent of total billed charges","88% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",15.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",337.05,63,,269.64,,,0,"percent of total billed charges","63% of total billed charges",81.86,15.3,,65.49,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,369.15,69,,,,,0,"fee schedule","69% of total billed charges",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.97,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.61,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",201.7,37.7,,161.36,,,0,"percent of total billed charges","37.7% of total billed charges",201.7,37.7,,161.36,,,0,"percent of total billed charges","37.70% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",181.37,33.9,,145.10,,,0,"percent of total billed charges","33.9% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",417.3,78,,333.84,,,0,"percent of total billed charges","78% of total billed charges",8.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",441.91,82.6,,353.53,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",441.91,82.6,,353.53,,,0,"percent of total billed charges","82.6% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",4.81,535,
"CULTURE THROAT",30687070,CDM,306,RC,87070,CPT,OUTPATIENT,,,167,108.55,,146.96,88,,117.57,,,0,"percent of total billed charges","88% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,167,100,,133.60,,,0,"percent of total billed charges","100% of total billed charges",15.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",105.21,63,,84.17,,,0,"percent of total billed charges","63% of total billed charges",25.55,15.3,,20.44,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,115.23,69,,,,,0,"fee schedule","69% of total billed charges",167,100,,133.60,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",167,100,,133.60,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",167,100,,133.60,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.97,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.61,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.96,37.7,,50.37,,,0,"percent of total billed charges","37.7% of total billed charges",62.96,37.7,,50.37,,,0,"percent of total billed charges","37.70% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.61,33.9,,45.29,,,0,"percent of total billed charges","33.9% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",130.26,78,,104.21,,,0,"percent of total billed charges","78% of total billed charges",8.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",137.94,82.6,,110.35,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.94,82.6,,110.35,,,0,"percent of total billed charges","82.6% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,167,100,,133.60,,,0,"percent of total billed charges","100% of total billed charges",4.81,167,
"CULTURE TISSUE",30687070,CDM,306,RC,87070,CPT,OUTPATIENT,,,475,308.75,,418,88,,334.40,,,0,"percent of total billed charges","88% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",15.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",299.25,63,,239.40,,,0,"percent of total billed charges","63% of total billed charges",72.68,15.3,,58.14,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,327.75,69,,,,,0,"fee schedule","69% of total billed charges",475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.97,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.61,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",179.08,37.7,,143.26,,,0,"percent of total billed charges","37.7% of total billed charges",179.08,37.7,,143.26,,,0,"percent of total billed charges","37.70% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",161.03,33.9,,128.82,,,0,"percent of total billed charges","33.9% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",370.5,78,,296.40,,,0,"percent of total billed charges","78% of total billed charges",8.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",392.35,82.6,,313.88,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",392.35,82.6,,313.88,,,0,"percent of total billed charges","82.6% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",4.81,475,
"Culture Urine",30687086,CDM,306,RC,87086,CPT,OUTPATIENT,,,176,114.4,,154.88,88,,123.90,,,0,"percent of total billed charges","88% of total billed charges",8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",14.12,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",110.88,63,,88.70,,,0,"percent of total billed charges","63% of total billed charges",26.93,15.3,,21.54,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,121.44,69,,,,,0,"fee schedule","69% of total billed charges",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.86,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.07,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.35,37.7,,53.08,,,0,"percent of total billed charges","37.7% of total billed charges",66.35,37.7,,53.08,,,0,"percent of total billed charges","37.70% of total billed charges",8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.66,33.9,,47.73,,,0,"percent of total billed charges","33.9% of total billed charges",8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.28,78,,109.82,,,0,"percent of total billed charges","78% of total billed charges",8.15,101,,,,,0,"fee schedule","101% of CMS fee schedule ",145.38,82.6,,116.30,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",145.38,82.6,,116.30,,,0,"percent of total billed charges","82.6% of total billed charges",8.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",4.81,176,
N/A,30687081,CDM,306,RC,87081,CPT,OUTPATIENT,,,302,196.3,,265.76,88,,212.61,,,0,"percent of total billed charges","88% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",11.6,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",190.26,63,,152.21,,,0,"percent of total billed charges","63% of total billed charges",46.21,15.3,,36.97,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,208.38,69,,,,,0,"fee schedule","69% of total billed charges",302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.35,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.63,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.85,37.7,,91.08,,,0,"percent of total billed charges","37.7% of total billed charges",113.85,37.7,,91.08,,,0,"percent of total billed charges","37.70% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",102.38,33.9,,81.90,,,0,"percent of total billed charges","33.9% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",235.56,78,,188.45,,,0,"percent of total billed charges","78% of total billed charges",6.69,101,,,,,0,"fee schedule","101% of CMS fee schedule ",249.45,82.6,,199.56,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",249.45,82.6,,199.56,,,0,"percent of total billed charges","82.6% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",4.81,302,
RMC-Etest,30687181,CDM,306,RC,87181,CPT,OUTPATIENT,,,42,27.3,,36.96,88,,29.57,,,0,"percent of total billed charges","88% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",8.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.46,63,,21.17,,,0,"percent of total billed charges","63% of total billed charges",6.43,15.3,,5.14,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,28.98,69,,,,,0,"fee schedule","69% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.16,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.75,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.7% of total billed charges",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.70% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.24,33.9,,11.39,,,0,"percent of total billed charges","33.9% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.76,78,,26.21,,,0,"percent of total billed charges","78% of total billed charges",4.79,101,,,,,0,"fee schedule","101% of CMS fee schedule ",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",4.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",4.75,42,
"Wound Culture",30687070,CDM,306,RC,87070,CPT,OUTPATIENT,,,525,341.25,,462,88,,369.60,,,0,"percent of total billed charges","88% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,525,100,,420.00,,,0,"percent of total billed charges","100% of total billed charges",15.08,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",330.75,63,,264.60,,,0,"percent of total billed charges","63% of total billed charges",80.33,15.3,,64.26,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,362.25,69,,,,,0,"fee schedule","69% of total billed charges",525,100,,420.00,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",525,100,,420.00,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",525,100,,420.00,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.97,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.61,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",197.93,37.7,,158.34,,,0,"percent of total billed charges","37.7% of total billed charges",197.93,37.7,,158.34,,,0,"percent of total billed charges","37.70% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",177.98,33.9,,142.38,,,0,"percent of total billed charges","33.9% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",409.5,78,,327.60,,,0,"percent of total billed charges","78% of total billed charges",8.7,101,,,,,0,"fee schedule","101% of CMS fee schedule ",433.65,82.6,,346.92,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",433.65,82.6,,346.92,,,0,"percent of total billed charges","82.6% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,525,100,,420.00,,,0,"percent of total billed charges","100% of total billed charges",4.81,525,
N/A,30687106,CDM,306,RC,87106,CPT,OUTPATIENT,,,228,148.2,,200.64,88,,160.51,,,0,"percent of total billed charges","88% of total billed charges",10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",18.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",143.64,63,,114.91,,,0,"percent of total billed charges","63% of total billed charges",34.88,15.3,,27.90,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,157.32,69,,,,,0,"fee schedule","69% of total billed charges",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.47,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.32,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.96,37.7,,68.77,,,0,"percent of total billed charges","37.7% of total billed charges",85.96,37.7,,68.77,,,0,"percent of total billed charges","37.70% of total billed charges",10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.29,33.9,,61.83,,,0,"percent of total billed charges","33.9% of total billed charges",10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",177.84,78,,142.27,,,0,"percent of total billed charges","78% of total billed charges",10.42,101,,,,,0,"fee schedule","101% of CMS fee schedule ",188.33,82.6,,150.66,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",188.33,82.6,,150.66,,,0,"percent of total billed charges","82.6% of total billed charges",10.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",4.81,228,
"CULTURE YEAST",30687081,CDM,306,RC,87081,CPT,OUTPATIENT,,,475,308.75,,418,88,,334.40,,,0,"percent of total billed charges","88% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",11.6,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",299.25,63,,239.40,,,0,"percent of total billed charges","63% of total billed charges",72.68,15.3,,58.14,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,327.75,69,,,,,0,"fee schedule","69% of total billed charges",475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.35,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.63,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",179.08,37.7,,143.26,,,0,"percent of total billed charges","37.7% of total billed charges",179.08,37.7,,143.26,,,0,"percent of total billed charges","37.70% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",161.03,33.9,,128.82,,,0,"percent of total billed charges","33.9% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",370.5,78,,296.40,,,0,"percent of total billed charges","78% of total billed charges",6.69,101,,,,,0,"fee schedule","101% of CMS fee schedule ",392.35,82.6,,313.88,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",392.35,82.6,,313.88,,,0,"percent of total billed charges","82.6% of total billed charges",6.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",4.81,475,
N/A,97129,CDM,430,RC,97129,CPT,OUTPATIENT,,,261,169.65,GO,229.68,88,,183.74,,,0,"percent of total billed charges","88% of total billed charges",22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,261,100,,208.80,,,0,"percent of total billed charges","100% of total billed charges",38.59,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.83,100,,,,,0,"fee schedule",EAPG,22.22,100,,,,,0,"fee schedule","100% of CMS fee sv",164.43,63,,131.54,,,0,"percent of total billed charges","63% of total billed charges",39.93,15.3,,31.94,,,0,"percent of total billed charges","15.3% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,180.09,69,,,,,0,"fee schedule","69% of total billed charges",261,100,,208.80,,,0,"percent of total billed charges","100% of total billed charges",22.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",261,100,,208.80,,,0,"percent of total billed charges","100% of total billed charges",22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",261,100,,208.80,,,0,"percent of total billed charges","100% of total billed charges",22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.01,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.95,100,,,,,0,"fee schedule","100% of LI fee schedule",25.77,100,,,,,0,"fee schedule",EAPG,22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.48,100,,,,,0,"fee schedule",EAPG,45.23,100,,,,,0,"fee schedule",EAPG,22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.4,37.7,,78.72,,,0,"percent of total billed charges","37.7% of total billed charges",98.4,37.7,,78.72,,,0,"percent of total billed charges","37.70% of total billed charges",22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.48,33.9,,70.78,,,0,"percent of total billed charges","33.9% of total billed charges",22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",203.58,78,,162.86,,,0,"percent of total billed charges","78% of total billed charges",22.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",215.59,82.6,,172.47,,,0,"percent of total billed charges","82.6% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",215.59,82.6,,172.47,,,0,"percent of total billed charges","82.6% of total billed charges",22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,261,100,,208.80,,,0,"percent of total billed charges","100% of total billed charges",21.95,261,
"EEG AWAKE/ASLEEP AT BEDSIDE",74095819,CDM,740,RC,95819,CPT,OUTPATIENT,,,1148,746.2,,1010.24,88,,808.19,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287.75,100,,,,,0,"fee schedule",EAPG,1148,100,,918.40,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",296.39,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",723.24,63,,578.59,,,0,"percent of total billed charges","63% of total billed charges",175.64,15.3,,140.51,,,0,"percent of total billed charges","15.3% of total billed charges",287.75,100,,,,,0,"fee schedule",EAPG,792.12,69,,,,,0,"fee schedule","69% of total billed charges",1148,100,,918.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1148,100,,918.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1148,100,,918.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287.75,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",213.15,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",293.51,100,,,,,0,"fee schedule",EAPG,374.08,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",432.8,37.7,,346.24,,,0,"percent of total billed charges","37.7% of total billed charges",432.8,37.7,,346.24,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",389.17,33.9,,311.34,,,0,"percent of total billed charges","33.9% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",895.44,78,,716.35,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",948.25,82.6,,758.60,,,0,"percent of total billed charges","82.6% of total billed charges",287.75,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",948.25,82.6,,758.60,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287.75,100,,,,,0,"fee schedule",EAPG,1148,100,,918.40,,,0,"percent of total billed charges","100% of total billed charges",175.64,1148,
"EEG SLEEP ONLY",74095822,CDM,740,RC,95822,CPT,OUTPATIENT,,,1541,1001.65,,1356.08,88,,1084.86,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287.75,100,,,,,0,"fee schedule",EAPG,1541,100,,1232.80,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",296.39,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",235.77,15.3,,188.62,,,0,"percent of total billed charges","15.3% of total billed charges",287.75,100,,,,,0,"fee schedule",EAPG,1063.29,69,,,,,0,"fee schedule","69% of total billed charges",1541,100,,1232.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1541,100,,1232.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1541,100,,1232.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287.75,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",213.15,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",293.51,100,,,,,0,"fee schedule",EAPG,374.08,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",580.96,37.7,,464.77,,,0,"percent of total billed charges","37.7% of total billed charges",580.96,37.7,,464.77,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",522.4,33.9,,417.92,,,0,"percent of total billed charges","33.9% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1201.98,78,,961.58,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1272.87,82.6,,1018.30,,,0,"percent of total billed charges","82.6% of total billed charges",287.75,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1272.87,82.6,,1018.30,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287.75,100,,,,,0,"fee schedule",EAPG,1541,100,,1232.80,,,0,"percent of total billed charges","100% of total billed charges",213.15,1541,
"EEG DEATH EVALUATION",74095824,CDM,740,RC,95824,CPT,OUTPATIENT,,,976,634.4,,858.88,88,,687.10,,,0,"percent of total billed charges","88% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287.75,100,,,,,0,"fee schedule",EAPG,976,100,,780.80,,,0,"percent of total billed charges","100% of total billed charges",956.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",296.39,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",614.88,63,,491.90,,,0,"percent of total billed charges","63% of total billed charges",149.33,15.3,,119.46,,,0,"percent of total billed charges","15.3% of total billed charges",287.75,100,,,,,0,"fee schedule",EAPG,673.44,69,,,,,0,"fee schedule","69% of total billed charges",976,100,,780.80,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",976,100,,780.80,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",976,100,,780.80,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1981.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287.75,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",518.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",213.15,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",293.51,100,,,,,0,"fee schedule",EAPG,374.08,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.95,37.7,,294.36,,,0,"percent of total billed charges","37.7% of total billed charges",367.95,37.7,,294.36,,,0,"percent of total billed charges","37.70% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.86,33.9,,264.69,,,0,"percent of total billed charges","33.9% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",761.28,78,,609.02,,,0,"percent of total billed charges","78% of total billed charges",552.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",806.18,82.6,,644.94,,,0,"percent of total billed charges","82.6% of total billed charges",287.75,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",806.18,82.6,,644.94,,,0,"percent of total billed charges","82.6% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287.75,100,,,,,0,"fee schedule",EAPG,976,100,,780.80,,,0,"percent of total billed charges","100% of total billed charges",149.33,1981.61,
"Pfizer-Biontech Covid-19 Vaccine Admin-3rd Dose",0003A,CDM,771,RC,,,OUTPATIENT,,,93,60.45,,81.84,88,,65.47,,,0,"percent of total billed charges","88% of total billed charges",46.5,50,,37.20,,,0,"percent of total billed charges","50% of total billed charges",15.62,16.8,,12.50,,,0,"percent of total billed charges","16.8% of total billed charges",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.09,17.304,,12.87,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.59,63,,46.87,,,0,"percent of total billed charges","63% of total billed charges",14.23,15.3,,11.38,,,0,"percent of total billed charges","15.3% of total billed charges",15.62,16.8,,12.50,,,0,"percent of total billed charges","16.8% of total billed charges",64.17,69,,,,,0,"fee schedule","69% of total billed charges",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.52,61.85,,46.02,,,0,"percent of total billed charges","61.5% of total billed charges",15.62,16.8,,12.50,,,0,"percent of total billed charges","16.8% of total billed charges",46.5,50,,37.20,,,0,"percent of total billed charges","50% of total billed charges",29.95,32.2,,23.96,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.94,17.136,,12.75,,,0,"percent of total billed charges","17.136% of total billed charges",20.31,21.84,,16.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.06,37.7,,28.05,,,0,"percent of total billed charges","37.7% of total billed charges",35.06,37.7,,28.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.53,33.9,,25.22,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",72.54,78,,58.03,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.82,82.6,,61.46,,,0,"percent of total billed charges","82.6% of total billed charges",15.62,16.8,,12.50,,,0,"percent of total billed charges","16.8% of total billed charges",46.5,50,,37.20,,,0,"percent of total billed charges","50% of total billed charges",76.82,82.6,,61.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.62,16.8,,12.50,,,0,"percent of total billed charges","16.8% of total billed charges",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",14.23,93,
"CHANGE OF BLADDER TUBE, SIMPLE CHARGE",76151705,CDM,761,RC,51705,CPT,OUTPATIENT,,,863,560.95,,759.44,88,,607.55,,,0,"percent of total billed charges","88% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,863,100,,690.40,,,0,"percent of total billed charges","100% of total billed charges",441.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",66.85,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",543.69,63,,434.95,,,0,"percent of total billed charges","63% of total billed charges",132.04,15.3,,105.63,,,0,"percent of total billed charges","15.3% of total billed charges",64.9,100,,,,,0,"fee schedule",EAPG,595.47,69,,,,,0,"fee schedule","69% of total billed charges",863,100,,690.40,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",863,100,,690.40,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",863,100,,690.40,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1081.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",282.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",48.07,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.2,100,,,,,0,"fee schedule",EAPG,84.37,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",325.35,37.7,,260.28,,,0,"percent of total billed charges","37.7% of total billed charges",325.35,37.7,,260.28,,,0,"percent of total billed charges","37.70% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",292.56,33.9,,234.05,,,0,"percent of total billed charges","33.9% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.14,78,,538.51,,,0,"percent of total billed charges","78% of total billed charges",254.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",712.84,82.6,,570.27,,,0,"percent of total billed charges","82.6% of total billed charges",64.9,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",712.84,82.6,,570.27,,,0,"percent of total billed charges","82.6% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,863,100,,690.40,,,0,"percent of total billed charges","100% of total billed charges",48.07,1081.19,
"OCT STRESS TEST",92059020,CDM,920,RC,59020,CPT,OUTPATIENT,,,702,456.3,,617.76,88,,494.21,,,0,"percent of total billed charges","88% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",165.98,100,,,,,0,"fee schedule",EAPG,702,100,,561.60,,,0,"percent of total billed charges","100% of total billed charges",355.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",170.96,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",442.26,63,,353.81,,,0,"percent of total billed charges","63% of total billed charges",107.41,15.3,,85.93,,,0,"percent of total billed charges","15.3% of total billed charges",165.98,100,,,,,0,"fee schedule",EAPG,484.38,69,,,,,0,"fee schedule","69% of total billed charges",702,100,,561.60,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",702,100,,561.60,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",702,100,,561.60,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",691.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",165.98,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.94,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.3,100,,,,,0,"fee schedule",EAPG,215.77,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",264.65,37.7,,211.72,,,0,"percent of total billed charges","37.7% of total billed charges",264.65,37.7,,211.72,,,0,"percent of total billed charges","37.70% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",237.98,33.9,,190.38,,,0,"percent of total billed charges","33.9% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",547.56,78,,438.05,,,0,"percent of total billed charges","78% of total billed charges",205.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579.85,82.6,,463.88,,,0,"percent of total billed charges","82.6% of total billed charges",165.98,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579.85,82.6,,463.88,,,0,"percent of total billed charges","82.6% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",165.98,100,,,,,0,"fee schedule",EAPG,702,100,,561.60,,,0,"percent of total billed charges","100% of total billed charges",107.41,702,
"FETAL MONITOR  NON OB",72059051,CDM,720,RC,59051,CPT,OUTPATIENT,,,248,161.2,,218.24,88,,174.59,,,0,"percent of total billed charges","88% of total billed charges",124,50,,99.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.24,63,,124.99,,,0,"percent of total billed charges","63% of total billed charges",37.94,15.3,,30.35,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",171.12,69,,,,,0,"fee schedule","69% of total billed charges",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",153.39,61.85,,122.71,,,0,"percent of total billed charges","61.5% of total billed charges",,,,,,,0,other,"not separately reimbursment",124,50,,99.20,,,0,"percent of total billed charges","50% of total billed charges",79.86,32.2,,63.89,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",93.5,37.7,,74.80,,,0,"percent of total billed charges","37.7% of total billed charges",93.5,37.7,,74.80,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.07,33.9,,67.26,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",193.44,78,,154.75,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.85,82.6,,163.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",124,50,,99.20,,,0,"percent of total billed charges","50% of total billed charges",204.85,82.6,,163.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.66,16.8,,33.33,,,0,"percent of total billed charges","16.8% of total billed charges",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",37.94,248,
"EXT VERSION ANTE MANIP",72059412,CDM,720,RC,59412,CPT,OUTPATIENT,,,7920,5148,,6969.6,88,,5575.68,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",586.37,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",603.96,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4989.6,63,,3991.68,,,0,"percent of total billed charges","63% of total billed charges",1211.76,15.3,,969.41,,,0,"percent of total billed charges","15.3% of total billed charges",586.37,100,,,,,0,"fee schedule",EAPG,5464.8,69,,,,,0,"fee schedule","69% of total billed charges",7920,100,,6336.00,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7920,100,,6336.00,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7920,100,,6336.00,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",586.37,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",434.35,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",598.1,100,,,,,0,"fee schedule",EAPG,762.28,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2985.84,37.7,,2388.67,,,0,"percent of total billed charges","37.7% of total billed charges",2985.84,37.7,,2388.67,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2684.88,33.9,,2147.90,,,0,"percent of total billed charges","33.9% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6177.6,78,,4942.08,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6541.92,82.6,,5233.54,,,0,"percent of total billed charges","82.6% of total billed charges",586.37,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6541.92,82.6,,5233.54,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",586.37,100,,,,,0,"fee schedule",EAPG,7920,100,,6336.00,,,0,"percent of total billed charges","100% of total billed charges",434.35,10656.86,
"SPINAL PUNCTURE LUMBAR DX CHARGE",76162270,CDM,761,RC,62270,CPT,OUTPATIENT,,,1600,1040,,1408,88,,1126.40,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1600,100,,1280.00,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1008,63,,806.40,,,0,"percent of total billed charges","63% of total billed charges",244.8,15.3,,195.84,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,1104,69,,,,,0,"fee schedule","69% of total billed charges",1600,100,,1280.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1600,100,,1280.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1600,100,,1280.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",570.86,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",603.2,37.7,,482.56,,,0,"percent of total billed charges","37.7% of total billed charges",603.2,37.7,,482.56,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",542.4,33.9,,433.92,,,0,"percent of total billed charges","33.9% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1248,78,,998.40,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1321.6,82.6,,1057.28,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1321.6,82.6,,1057.28,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1600,100,,1280.00,,,0,"percent of total billed charges","100% of total billed charges",244.8,2578.03,
"ADMIN OF VACCINE",77190471,CDM,771,RC,90471,CPT,OUTPATIENT,,,329,213.85,,289.52,88,,231.62,,,0,"percent of total billed charges","88% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.67,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",207.27,63,,165.82,,,0,"percent of total billed charges","63% of total billed charges",50.34,15.3,,40.27,,,0,"percent of total billed charges","15.3% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,227.01,69,,,,,0,"fee schedule","69% of total billed charges",329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.33,100,,,,,0,"fee schedule",EAPG,45.03,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.03,37.7,,99.22,,,0,"percent of total billed charges","37.7% of total billed charges",124.03,37.7,,99.22,,,0,"percent of total billed charges","37.70% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.53,33.9,,89.22,,,0,"percent of total billed charges","33.9% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.62,78,,205.30,,,0,"percent of total billed charges","78% of total billed charges",72.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",271.75,82.6,,217.40,,,0,"percent of total billed charges","82.6% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",271.75,82.6,,217.40,,,0,"percent of total billed charges","82.6% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",34.64,329,
"INJ VACCINE ADDL",77190472,CDM,771,RC,,,OUTPATIENT,,,392,254.8,,344.96,88,,275.97,,,0,"percent of total billed charges","88% of total billed charges",196,50,,156.80,,,0,"percent of total billed charges","50% of total billed charges",65.86,16.8,,52.69,,,0,"percent of total billed charges","16.8% of total billed charges",392,100,,313.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.83,17.304,,54.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",246.96,63,,197.57,,,0,"percent of total billed charges","63% of total billed charges",59.98,15.3,,47.98,,,0,"percent of total billed charges","15.3% of total billed charges",65.86,16.8,,52.69,,,0,"percent of total billed charges","16.8% of total billed charges",270.48,69,,,,,0,"fee schedule","69% of total billed charges",392,100,,313.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",392,100,,313.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",392,100,,313.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",242.45,61.85,,193.96,,,0,"percent of total billed charges","61.5% of total billed charges",65.86,16.8,,52.69,,,0,"percent of total billed charges","16.8% of total billed charges",196,50,,156.80,,,0,"percent of total billed charges","50% of total billed charges",126.22,32.2,,100.98,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",67.17,17.136,,53.74,,,0,"percent of total billed charges","17.136% of total billed charges",85.61,21.84,,68.49,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",147.78,37.7,,118.22,,,0,"percent of total billed charges","37.7% of total billed charges",147.78,37.7,,118.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",132.89,33.9,,106.31,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",305.76,78,,244.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",323.79,82.6,,259.03,,,0,"percent of total billed charges","82.6% of total billed charges",65.86,16.8,,52.69,,,0,"percent of total billed charges","16.8% of total billed charges",196,50,,156.80,,,0,"percent of total billed charges","50% of total billed charges",323.79,82.6,,259.03,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",65.86,16.8,,52.69,,,0,"percent of total billed charges","16.8% of total billed charges",392,100,,313.60,,,0,"percent of total billed charges","100% of total billed charges",59.98,392,
"ADMIN IMMUN VACCINE ORAL/NASAL",77190473,CDM,771,RC,90473,CPT,OUTPATIENT,,,122,79.3,,107.36,88,,85.89,,,0,"percent of total billed charges","88% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,122,100,,97.60,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.67,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",76.86,63,,61.49,,,0,"percent of total billed charges","63% of total billed charges",18.67,15.3,,14.94,,,0,"percent of total billed charges","15.3% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,84.18,69,,,,,0,"fee schedule","69% of total billed charges",122,100,,97.60,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122,100,,97.60,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122,100,,97.60,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.33,100,,,,,0,"fee schedule",EAPG,45.03,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",45.99,37.7,,36.79,,,0,"percent of total billed charges","37.7% of total billed charges",45.99,37.7,,36.79,,,0,"percent of total billed charges","37.70% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",41.36,33.9,,33.09,,,0,"percent of total billed charges","33.9% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",95.16,78,,76.13,,,0,"percent of total billed charges","78% of total billed charges",72.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.77,82.6,,80.62,,,0,"percent of total billed charges","82.6% of total billed charges",34.64,100,,,,,0,"fee schedule","100% of WA fee schedule",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.77,82.6,,80.62,,,0,"percent of total billed charges","82.6% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,122,100,,97.60,,,0,"percent of total billed charges","100% of total billed charges",18.67,251.75,
"IV INJECTION INITIAL PUSH",AMB820035,CDM,260,RC,96374,CPT,OUTPATIENT,,,465,302.25,,409.2,88,,327.36,,,0,"percent of total billed charges","88% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,465,100,,372.00,,,0,"percent of total billed charges","100% of total billed charges",382.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",71.15,15.3,,56.92,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,320.85,69,,,,,0,"fee schedule","69% of total billed charges",465,100,,372.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465,100,,372.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465,100,,372.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",826.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.48,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",175.31,37.7,,140.25,,,0,"percent of total billed charges","37.7% of total billed charges",175.31,37.7,,140.25,,,0,"percent of total billed charges","37.70% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",157.64,33.9,,126.11,,,0,"percent of total billed charges","33.9% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",362.7,78,,290.16,,,0,"percent of total billed charges","78% of total billed charges",220.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",384.09,82.6,,307.27,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",384.09,82.6,,307.27,,,0,"percent of total billed charges","82.6% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,465,100,,372.00,,,0,"percent of total billed charges","100% of total billed charges",29.48,826.71,
"IV INJECTION NEW DRUG",AMB820060,CDM,260,RC,96375,CPT,OUTPATIENT,,,306,198.9,,269.28,88,,215.42,,,0,"percent of total billed charges","88% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",84.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",46.82,15.3,,37.46,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,211.14,69,,,,,0,"fee schedule","69% of total billed charges",306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.48,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.36,37.7,,92.29,,,0,"percent of total billed charges","37.7% of total billed charges",115.36,37.7,,92.29,,,0,"percent of total billed charges","37.70% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",103.73,33.9,,82.98,,,0,"percent of total billed charges","33.9% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",238.68,78,,190.94,,,0,"percent of total billed charges","78% of total billed charges",48.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.76,82.6,,202.21,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.76,82.6,,202.21,,,0,"percent of total billed charges","82.6% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",29.48,306,
"IM/SUBQ INJECTION",AMB820018,CDM,761,RC,96372,CPT,OUTPATIENT,,,320,208,,281.6,88,,225.28,,,0,"percent of total billed charges","88% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",48.96,15.3,,39.17,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,220.8,69,,,,,0,"fee schedule","69% of total billed charges",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.48,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",120.64,37.7,,96.51,,,0,"percent of total billed charges","37.7% of total billed charges",120.64,37.7,,96.51,,,0,"percent of total billed charges","37.70% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.48,33.9,,86.78,,,0,"percent of total billed charges","33.9% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",249.6,78,,199.68,,,0,"percent of total billed charges","78% of total billed charges",72.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",264.32,82.6,,211.46,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",264.32,82.6,,211.46,,,0,"percent of total billed charges","82.6% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",29.48,320,
"IV PUSH EA ADDL NEW DRUG",84096375,CDM,940,RC,96375,CPT,OUTPATIENT,,,306,198.9,,269.28,88,,215.42,,,0,"percent of total billed charges","88% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",84.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",46.82,15.3,,37.46,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,211.14,69,,,,,0,"fee schedule","69% of total billed charges",306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.48,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.36,37.7,,92.29,,,0,"percent of total billed charges","37.7% of total billed charges",115.36,37.7,,92.29,,,0,"percent of total billed charges","37.70% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",103.73,33.9,,82.98,,,0,"percent of total billed charges","33.9% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",238.68,78,,190.94,,,0,"percent of total billed charges","78% of total billed charges",48.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.76,82.6,,202.21,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.76,82.6,,202.21,,,0,"percent of total billed charges","82.6% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",29.48,306,
"OB VISIT LEVEL 1 (NEW PT)",76199201,CDM,761,RC,99202,CPT,OUTPATIENT,,,300,195,,264,88,,211.20,,,0,"percent of total billed charges","88% of total billed charges",150,50,,120.00,,,0,"percent of total billed charges","50% of total billed charges",50.4,16.8,,40.32,,,0,"percent of total billed charges","16.8% of total billed charges",300,100,,240.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,17.304,,41.53,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",189,63,,151.20,,,0,"percent of total billed charges","63% of total billed charges",45.9,15.3,,36.72,,,0,"percent of total billed charges","15.3% of total billed charges",50.4,16.8,,40.32,,,0,"percent of total billed charges","16.8% of total billed charges",207,69,,,,,0,"fee schedule","69% of total billed charges",300,100,,240.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",300,100,,240.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",300,100,,240.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.55,61.85,,148.44,,,0,"percent of total billed charges","61.5% of total billed charges",50.4,16.8,,40.32,,,0,"percent of total billed charges","16.8% of total billed charges",150,50,,120.00,,,0,"percent of total billed charges","50% of total billed charges",96.6,32.2,,77.28,,,0,"percent of total billed charges","32.2% of total billed charges",50.4,16.8,,40.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.41,17.136,,41.13,,,0,"percent of total billed charges","17.136% of total billed charges",65.52,21.84,,52.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.1,37.7,,90.48,,,0,"percent of total billed charges","37.7% of total billed charges",113.1,37.7,,90.48,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",234,78,,187.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",247.8,82.6,,198.24,,,0,"percent of total billed charges","82.6% of total billed charges",50.4,16.8,,40.32,,,0,"percent of total billed charges","16.8% of total billed charges",150,50,,120.00,,,0,"percent of total billed charges","50% of total billed charges",247.8,82.6,,198.24,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.4,16.8,,40.32,,,0,"percent of total billed charges","16.8% of total billed charges",300,100,,240.00,,,0,"percent of total billed charges","100% of total billed charges",45.9,300,
"OB VISIT LEVEL 2 NEW PT",76199202,CDM,761,RC,99202,CPT,OUTPATIENT,,,474,308.1,,417.12,88,,333.70,,,0,"percent of total billed charges","88% of total billed charges",237,50,,189.60,,,0,"percent of total billed charges","50% of total billed charges",79.63,16.8,,63.70,,,0,"percent of total billed charges","16.8% of total billed charges",474,100,,379.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.02,17.304,,65.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.62,63,,238.90,,,0,"percent of total billed charges","63% of total billed charges",72.52,15.3,,58.02,,,0,"percent of total billed charges","15.3% of total billed charges",79.63,16.8,,63.70,,,0,"percent of total billed charges","16.8% of total billed charges",327.06,69,,,,,0,"fee schedule","69% of total billed charges",474,100,,379.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",474,100,,379.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",474,100,,379.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",293.17,61.85,,234.54,,,0,"percent of total billed charges","61.5% of total billed charges",79.63,16.8,,63.70,,,0,"percent of total billed charges","16.8% of total billed charges",237,50,,189.60,,,0,"percent of total billed charges","50% of total billed charges",152.63,32.2,,122.10,,,0,"percent of total billed charges","32.2% of total billed charges",79.63,16.8,,63.70,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.22,17.136,,64.98,,,0,"percent of total billed charges","17.136% of total billed charges",103.52,21.84,,82.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.7,37.7,,142.96,,,0,"percent of total billed charges","37.7% of total billed charges",178.7,37.7,,142.96,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",369.72,78,,295.78,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",391.52,82.6,,313.22,,,0,"percent of total billed charges","82.6% of total billed charges",79.63,16.8,,63.70,,,0,"percent of total billed charges","16.8% of total billed charges",237,50,,189.60,,,0,"percent of total billed charges","50% of total billed charges",391.52,82.6,,313.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.63,16.8,,63.70,,,0,"percent of total billed charges","16.8% of total billed charges",474,100,,379.20,,,0,"percent of total billed charges","100% of total billed charges",72.52,474,
"OB VISIT LEVEL 3 NEW PT",76199203,CDM,761,RC,99203,CPT,OUTPATIENT,,,890,578.5,,783.2,88,,626.56,,,0,"percent of total billed charges","88% of total billed charges",445,50,,356.00,,,0,"percent of total billed charges","50% of total billed charges",149.52,16.8,,119.62,,,0,"percent of total billed charges","16.8% of total billed charges",890,100,,712.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",154.01,17.304,,123.21,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",560.7,63,,448.56,,,0,"percent of total billed charges","63% of total billed charges",136.17,15.3,,108.94,,,0,"percent of total billed charges","15.3% of total billed charges",149.52,16.8,,119.62,,,0,"percent of total billed charges","16.8% of total billed charges",614.1,69,,,,,0,"fee schedule","69% of total billed charges",890,100,,712.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",890,100,,712.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",890,100,,712.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.47,61.85,,440.38,,,0,"percent of total billed charges","61.5% of total billed charges",149.52,16.8,,119.62,,,0,"percent of total billed charges","16.8% of total billed charges",445,50,,356.00,,,0,"percent of total billed charges","50% of total billed charges",286.58,32.2,,229.26,,,0,"percent of total billed charges","32.2% of total billed charges",149.52,16.8,,119.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",152.51,17.136,,122.01,,,0,"percent of total billed charges","17.136% of total billed charges",194.38,21.84,,155.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",335.53,37.7,,268.42,,,0,"percent of total billed charges","37.7% of total billed charges",335.53,37.7,,268.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",694.2,78,,555.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",735.14,82.6,,588.11,,,0,"percent of total billed charges","82.6% of total billed charges",149.52,16.8,,119.62,,,0,"percent of total billed charges","16.8% of total billed charges",445,50,,356.00,,,0,"percent of total billed charges","50% of total billed charges",735.14,82.6,,588.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",149.52,16.8,,119.62,,,0,"percent of total billed charges","16.8% of total billed charges",890,100,,712.00,,,0,"percent of total billed charges","100% of total billed charges",136.17,890,
"OB VISIT LEVEL 3 NEW PT",76199204,CDM,761,RC,99204,CPT,OUTPATIENT,,,1775,1153.75,,1562,88,,1249.60,,,0,"percent of total billed charges","88% of total billed charges",887.5,50,,710.00,,,0,"percent of total billed charges","50% of total billed charges",298.2,16.8,,238.56,,,0,"percent of total billed charges","16.8% of total billed charges",1775,100,,1420.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",307.15,17.304,,245.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1118.25,63,,894.60,,,0,"percent of total billed charges","63% of total billed charges",271.58,15.3,,217.26,,,0,"percent of total billed charges","15.3% of total billed charges",298.2,16.8,,238.56,,,0,"percent of total billed charges","16.8% of total billed charges",1224.75,69,,,,,0,"fee schedule","69% of total billed charges",1775,100,,1420.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1775,100,,1420.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1775,100,,1420.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1097.84,61.85,,878.27,,,0,"percent of total billed charges","61.5% of total billed charges",298.2,16.8,,238.56,,,0,"percent of total billed charges","16.8% of total billed charges",887.5,50,,710.00,,,0,"percent of total billed charges","50% of total billed charges",571.55,32.2,,457.24,,,0,"percent of total billed charges","32.2% of total billed charges",298.2,16.8,,238.56,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",304.16,17.136,,243.33,,,0,"percent of total billed charges","17.136% of total billed charges",387.66,21.84,,310.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",669.18,37.7,,535.34,,,0,"percent of total billed charges","37.7% of total billed charges",669.18,37.7,,535.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1384.5,78,,1107.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1466.15,82.6,,1172.92,,,0,"percent of total billed charges","82.6% of total billed charges",298.2,16.8,,238.56,,,0,"percent of total billed charges","16.8% of total billed charges",887.5,50,,710.00,,,0,"percent of total billed charges","50% of total billed charges",1466.15,82.6,,1172.92,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.2,16.8,,238.56,,,0,"percent of total billed charges","16.8% of total billed charges",1775,100,,1420.00,,,0,"percent of total billed charges","100% of total billed charges",271.58,1775,
"OB VISIT LEVEL 1 (ESTABLISHED PT)",76199211,CDM,761,RC,99211,CPT,OUTPATIENT,,,403,261.95,,354.64,88,,283.71,,,0,"percent of total billed charges","88% of total billed charges",201.5,50,,161.20,,,0,"percent of total billed charges","50% of total billed charges",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.74,17.304,,55.79,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.89,63,,203.11,,,0,"percent of total billed charges","63% of total billed charges",61.66,15.3,,49.33,,,0,"percent of total billed charges","15.3% of total billed charges",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",278.07,69,,,,,0,"fee schedule","69% of total billed charges",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",249.26,61.85,,199.41,,,0,"percent of total billed charges","61.5% of total billed charges",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",201.5,50,,161.20,,,0,"percent of total billed charges","50% of total billed charges",129.77,32.2,,103.82,,,0,"percent of total billed charges","32.2% of total billed charges",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.06,17.136,,55.25,,,0,"percent of total billed charges","17.136% of total billed charges",88.02,21.84,,70.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.7% of total billed charges",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",314.34,78,,251.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",201.5,50,,161.20,,,0,"percent of total billed charges","50% of total billed charges",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",61.66,403,
"OB VISIT LEVEL 2 (ESTABLISHED PT)",76199212,CDM,761,RC,99212,CPT,OUTPATIENT,,,403,261.95,,354.64,88,,283.71,,,0,"percent of total billed charges","88% of total billed charges",201.5,50,,161.20,,,0,"percent of total billed charges","50% of total billed charges",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.74,17.304,,55.79,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.89,63,,203.11,,,0,"percent of total billed charges","63% of total billed charges",61.66,15.3,,49.33,,,0,"percent of total billed charges","15.3% of total billed charges",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",278.07,69,,,,,0,"fee schedule","69% of total billed charges",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",249.26,61.85,,199.41,,,0,"percent of total billed charges","61.5% of total billed charges",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",201.5,50,,161.20,,,0,"percent of total billed charges","50% of total billed charges",129.77,32.2,,103.82,,,0,"percent of total billed charges","32.2% of total billed charges",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.06,17.136,,55.25,,,0,"percent of total billed charges","17.136% of total billed charges",88.02,21.84,,70.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.7% of total billed charges",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",314.34,78,,251.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",201.5,50,,161.20,,,0,"percent of total billed charges","50% of total billed charges",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",61.66,403,
"OB VISIT LEVEL 3 (ESTABLISHED PT)",76199213,CDM,761,RC,99213,CPT,OUTPATIENT,,,359,233.35,,315.92,88,,252.74,,,0,"percent of total billed charges","88% of total billed charges",179.5,50,,143.60,,,0,"percent of total billed charges","50% of total billed charges",60.31,16.8,,48.25,,,0,"percent of total billed charges","16.8% of total billed charges",359,100,,287.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.12,17.304,,49.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",226.17,63,,180.94,,,0,"percent of total billed charges","63% of total billed charges",54.93,15.3,,43.94,,,0,"percent of total billed charges","15.3% of total billed charges",60.31,16.8,,48.25,,,0,"percent of total billed charges","16.8% of total billed charges",247.71,69,,,,,0,"fee schedule","69% of total billed charges",359,100,,287.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",359,100,,287.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",359,100,,287.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",222.04,61.85,,177.63,,,0,"percent of total billed charges","61.5% of total billed charges",60.31,16.8,,48.25,,,0,"percent of total billed charges","16.8% of total billed charges",179.5,50,,143.60,,,0,"percent of total billed charges","50% of total billed charges",115.6,32.2,,92.48,,,0,"percent of total billed charges","32.2% of total billed charges",60.31,16.8,,48.25,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.52,17.136,,49.22,,,0,"percent of total billed charges","17.136% of total billed charges",78.41,21.84,,62.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",135.34,37.7,,108.27,,,0,"percent of total billed charges","37.7% of total billed charges",135.34,37.7,,108.27,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",280.02,78,,224.02,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",296.53,82.6,,237.22,,,0,"percent of total billed charges","82.6% of total billed charges",60.31,16.8,,48.25,,,0,"percent of total billed charges","16.8% of total billed charges",179.5,50,,143.60,,,0,"percent of total billed charges","50% of total billed charges",296.53,82.6,,237.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.31,16.8,,48.25,,,0,"percent of total billed charges","16.8% of total billed charges",359,100,,287.20,,,0,"percent of total billed charges","100% of total billed charges",54.93,359,
"OB VISIT LEVEL 4 (ESTABLISHED PT)",76199214,CDM,761,RC,99214,CPT,OUTPATIENT,,,377,245.05,,331.76,88,,265.41,,,0,"percent of total billed charges","88% of total billed charges",188.5,50,,150.80,,,0,"percent of total billed charges","50% of total billed charges",63.34,16.8,,50.67,,,0,"percent of total billed charges","16.8% of total billed charges",377,100,,301.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",65.24,17.304,,52.19,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",237.51,63,,190.01,,,0,"percent of total billed charges","63% of total billed charges",57.68,15.3,,46.14,,,0,"percent of total billed charges","15.3% of total billed charges",63.34,16.8,,50.67,,,0,"percent of total billed charges","16.8% of total billed charges",260.13,69,,,,,0,"fee schedule","69% of total billed charges",377,100,,301.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",377,100,,301.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",377,100,,301.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",233.17,61.85,,186.54,,,0,"percent of total billed charges","61.5% of total billed charges",63.34,16.8,,50.67,,,0,"percent of total billed charges","16.8% of total billed charges",188.5,50,,150.80,,,0,"percent of total billed charges","50% of total billed charges",121.39,32.2,,97.11,,,0,"percent of total billed charges","32.2% of total billed charges",63.34,16.8,,50.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.6,17.136,,51.68,,,0,"percent of total billed charges","17.136% of total billed charges",82.34,21.84,,65.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.13,37.7,,113.70,,,0,"percent of total billed charges","37.7% of total billed charges",142.13,37.7,,113.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",294.06,78,,235.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",311.4,82.6,,249.12,,,0,"percent of total billed charges","82.6% of total billed charges",63.34,16.8,,50.67,,,0,"percent of total billed charges","16.8% of total billed charges",188.5,50,,150.80,,,0,"percent of total billed charges","50% of total billed charges",311.4,82.6,,249.12,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.34,16.8,,50.67,,,0,"percent of total billed charges","16.8% of total billed charges",377,100,,301.60,,,0,"percent of total billed charges","100% of total billed charges",57.68,377,
"OB VISIT LEVEL 5 (ESTABLISHED PT)",76199215,CDM,761,RC,99215,CPT,OUTPATIENT,,,767,498.55,,674.96,88,,539.97,,,0,"percent of total billed charges","88% of total billed charges",383.5,50,,306.80,,,0,"percent of total billed charges","50% of total billed charges",128.86,16.8,,103.09,,,0,"percent of total billed charges","16.8% of total billed charges",767,100,,613.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",132.72,17.304,,106.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",483.21,63,,386.57,,,0,"percent of total billed charges","63% of total billed charges",117.35,15.3,,93.88,,,0,"percent of total billed charges","15.3% of total billed charges",128.86,16.8,,103.09,,,0,"percent of total billed charges","16.8% of total billed charges",529.23,69,,,,,0,"fee schedule","69% of total billed charges",767,100,,613.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",767,100,,613.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",767,100,,613.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",474.39,61.85,,379.51,,,0,"percent of total billed charges","61.5% of total billed charges",128.86,16.8,,103.09,,,0,"percent of total billed charges","16.8% of total billed charges",383.5,50,,306.80,,,0,"percent of total billed charges","50% of total billed charges",246.97,32.2,,197.58,,,0,"percent of total billed charges","32.2% of total billed charges",128.86,16.8,,103.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",131.43,17.136,,105.14,,,0,"percent of total billed charges","17.136% of total billed charges",167.51,21.84,,134.01,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",289.16,37.7,,231.33,,,0,"percent of total billed charges","37.7% of total billed charges",289.16,37.7,,231.33,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",598.26,78,,478.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",633.54,82.6,,506.83,,,0,"percent of total billed charges","82.6% of total billed charges",128.86,16.8,,103.09,,,0,"percent of total billed charges","16.8% of total billed charges",383.5,50,,306.80,,,0,"percent of total billed charges","50% of total billed charges",633.54,82.6,,506.83,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.86,16.8,,103.09,,,0,"percent of total billed charges","16.8% of total billed charges",767,100,,613.60,,,0,"percent of total billed charges","100% of total billed charges",117.35,767,
"EPIDURAL FOR OB DELIVERY CHARGE",37000000,CDM,370,RC,,,OUTPATIENT,,,1833,1191.45,,1613.04,88,,1290.43,,,0,"percent of total billed charges","88% of total billed charges",916.5,50,,733.20,,,0,"percent of total billed charges","50% of total billed charges",307.94,16.8,,246.35,,,0,"percent of total billed charges","16.8% of total billed charges",1833,100,,1466.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.18,17.304,,253.74,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1154.79,63,,923.83,,,0,"percent of total billed charges","63% of total billed charges",280.45,15.3,,224.36,,,0,"percent of total billed charges","15.3% of total billed charges",307.94,16.8,,246.35,,,0,"percent of total billed charges","16.8% of total billed charges",1264.77,69,,,,,0,"fee schedule","69% of total billed charges",1833,100,,1466.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1833,100,,1466.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1833,100,,1466.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1133.71,61.85,,906.97,,,0,"percent of total billed charges","61.5% of total billed charges",307.94,16.8,,246.35,,,0,"percent of total billed charges","16.8% of total billed charges",916.5,50,,733.20,,,0,"percent of total billed charges","50% of total billed charges",590.23,32.2,,472.18,,,0,"percent of total billed charges","32.2% of total billed charges",307.94,16.8,,246.35,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",314.1,17.136,,251.28,,,0,"percent of total billed charges","17.136% of total billed charges",400.33,21.84,,320.26,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",691.04,37.7,,552.83,,,0,"percent of total billed charges","37.7% of total billed charges",691.04,37.7,,552.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",621.39,33.9,,497.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1429.74,78,,1143.79,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.06,82.6,,1211.25,,,0,"percent of total billed charges","82.6% of total billed charges",307.94,16.8,,246.35,,,0,"percent of total billed charges","16.8% of total billed charges",916.5,50,,733.20,,,0,"percent of total billed charges","50% of total billed charges",1514.06,82.6,,1211.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",307.94,16.8,,246.35,,,0,"percent of total billed charges","16.8% of total billed charges",1833,100,,1466.40,,,0,"percent of total billed charges","100% of total billed charges",280.45,1833,
"FIRST HOUR DIRECT OBSERVATION CHARGE",G0379,CDM,769,RC,,,OUTPATIENT,,,744,483.6,,654.72,88,,523.78,,,0,"percent of total billed charges","88% of total billed charges",372,50,,297.60,,,0,"percent of total billed charges","50% of total billed charges",124.99,16.8,,99.99,,,0,"percent of total billed charges","16.8% of total billed charges",744,100,,595.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.74,17.304,,102.99,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",468.72,63,,374.98,,,0,"percent of total billed charges","63% of total billed charges",148.8,15.3,,119.04,,,0,"percent of total billed charges","15.3% of total billed charges",124.99,16.8,,99.99,,,0,"percent of total billed charges","16.8% of total billed charges",513.36,69,,,,,0,"fee schedule","69% of total billed charges",744,100,,595.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",744,100,,595.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",744,100,,595.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",460.16,61.85,,368.13,,,0,"percent of total billed charges","61.5% of total billed charges",124.99,16.8,,99.99,,,0,"percent of total billed charges","16.8% of total billed charges",372,50,,297.60,,,0,"percent of total billed charges","50% of total billed charges",239.57,32.2,,191.66,,,0,"percent of total billed charges","32.2% of total billed charges",124.99,16.8,,99.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.49,17.136,,101.99,,,0,"percent of total billed charges","17.136% of total billed charges",162.49,21.84,,129.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",280.49,37.7,,224.39,,,0,"percent of total billed charges","37.7% of total billed charges",280.49,37.7,,224.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.22,33.9,,201.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.32,78,,464.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",614.54,82.6,,491.63,,,0,"percent of total billed charges","82.6% of total billed charges",124.99,16.8,,99.99,,,0,"percent of total billed charges","16.8% of total billed charges",372,50,,297.60,,,0,"percent of total billed charges","50% of total billed charges",614.54,82.6,,491.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.99,16.8,,99.99,,,0,"percent of total billed charges","16.8% of total billed charges",744,100,,595.20,,,0,"percent of total billed charges","100% of total billed charges",124.99,744,
"ADMIN FLU VACCINE",771G0008,CDM,771,RC,,,OUTPATIENT,,,140,91,,123.2,88,,98.56,,,0,"percent of total billed charges","88% of total billed charges",70,50,,56.00,,,0,"percent of total billed charges","50% of total billed charges",23.52,16.8,,18.82,,,0,"percent of total billed charges","16.8% of total billed charges",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.23,17.304,,19.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.2,63,,70.56,,,0,"percent of total billed charges","63% of total billed charges",21.42,15.3,,17.14,,,0,"percent of total billed charges","15.3% of total billed charges",23.52,16.8,,18.82,,,0,"percent of total billed charges","16.8% of total billed charges",96.6,69,,,,,0,"fee schedule","69% of total billed charges",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.59,61.85,,69.27,,,0,"percent of total billed charges","61.5% of total billed charges",23.52,16.8,,18.82,,,0,"percent of total billed charges","16.8% of total billed charges",70,50,,56.00,,,0,"percent of total billed charges","50% of total billed charges",45.08,32.2,,36.06,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.99,17.136,,19.19,,,0,"percent of total billed charges","17.136% of total billed charges",30.58,21.84,,24.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.78,37.7,,42.22,,,0,"percent of total billed charges","37.7% of total billed charges",52.78,37.7,,42.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.46,33.9,,37.97,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",109.2,78,,87.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.64,82.6,,92.51,,,0,"percent of total billed charges","82.6% of total billed charges",23.52,16.8,,18.82,,,0,"percent of total billed charges","16.8% of total billed charges",70,50,,56.00,,,0,"percent of total billed charges","50% of total billed charges",115.64,82.6,,92.51,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.52,16.8,,18.82,,,0,"percent of total billed charges","16.8% of total billed charges",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",21.42,140,
"ADMIN PNEUMO VACCINE",771G0009,CDM,771,RC,,,OUTPATIENT,,,355,230.75,,312.4,88,,249.92,,,0,"percent of total billed charges","88% of total billed charges",177.5,50,,142.00,,,0,"percent of total billed charges","50% of total billed charges",59.64,16.8,,47.71,,,0,"percent of total billed charges","16.8% of total billed charges",355,100,,284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.43,17.304,,49.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.65,63,,178.92,,,0,"percent of total billed charges","63% of total billed charges",54.32,15.3,,43.46,,,0,"percent of total billed charges","15.3% of total billed charges",59.64,16.8,,47.71,,,0,"percent of total billed charges","16.8% of total billed charges",244.95,69,,,,,0,"fee schedule","69% of total billed charges",355,100,,284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",355,100,,284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",355,100,,284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",219.57,61.85,,175.66,,,0,"percent of total billed charges","61.5% of total billed charges",59.64,16.8,,47.71,,,0,"percent of total billed charges","16.8% of total billed charges",177.5,50,,142.00,,,0,"percent of total billed charges","50% of total billed charges",114.31,32.2,,91.45,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",60.83,17.136,,48.66,,,0,"percent of total billed charges","17.136% of total billed charges",77.53,21.84,,62.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",133.84,37.7,,107.07,,,0,"percent of total billed charges","37.7% of total billed charges",133.84,37.7,,107.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",120.35,33.9,,96.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.9,78,,221.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",293.23,82.6,,234.58,,,0,"percent of total billed charges","82.6% of total billed charges",59.64,16.8,,47.71,,,0,"percent of total billed charges","16.8% of total billed charges",177.5,50,,142.00,,,0,"percent of total billed charges","50% of total billed charges",293.23,82.6,,234.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.64,16.8,,47.71,,,0,"percent of total billed charges","16.8% of total billed charges",355,100,,284.00,,,0,"percent of total billed charges","100% of total billed charges",54.32,355,
"HEP B VACCINE ADMIN",771G0010,CDM,771,RC,,,OUTPATIENT,,,229,148.85,,201.52,88,,161.22,,,0,"percent of total billed charges","88% of total billed charges",114.5,50,,91.60,,,0,"percent of total billed charges","50% of total billed charges",38.47,16.8,,30.78,,,0,"percent of total billed charges","16.8% of total billed charges",229,100,,183.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.63,17.304,,31.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",144.27,63,,115.42,,,0,"percent of total billed charges","63% of total billed charges",35.04,15.3,,28.03,,,0,"percent of total billed charges","15.3% of total billed charges",38.47,16.8,,30.78,,,0,"percent of total billed charges","16.8% of total billed charges",158.01,69,,,,,0,"fee schedule","69% of total billed charges",229,100,,183.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",229,100,,183.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",229,100,,183.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",141.64,61.85,,113.31,,,0,"percent of total billed charges","61.5% of total billed charges",38.47,16.8,,30.78,,,0,"percent of total billed charges","16.8% of total billed charges",114.5,50,,91.60,,,0,"percent of total billed charges","50% of total billed charges",73.74,32.2,,58.99,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39.24,17.136,,31.39,,,0,"percent of total billed charges","17.136% of total billed charges",50.01,21.84,,40.01,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.33,37.7,,69.06,,,0,"percent of total billed charges","37.7% of total billed charges",86.33,37.7,,69.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.63,33.9,,62.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.62,78,,142.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",189.15,82.6,,151.32,,,0,"percent of total billed charges","82.6% of total billed charges",38.47,16.8,,30.78,,,0,"percent of total billed charges","16.8% of total billed charges",114.5,50,,91.60,,,0,"percent of total billed charges","50% of total billed charges",189.15,82.6,,151.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.47,16.8,,30.78,,,0,"percent of total billed charges","16.8% of total billed charges",229,100,,183.20,,,0,"percent of total billed charges","100% of total billed charges",35.04,229,
"G0463 Hospital Outpatient Visit Charge",761G0463,CDM,761,RC,,,OUTPATIENT,,,308,200.2,,271.04,88,,216.83,,,0,"percent of total billed charges","88% of total billed charges",154,50,,123.20,,,0,"percent of total billed charges","50% of total billed charges",51.74,16.8,,41.39,,,0,"percent of total billed charges","16.8% of total billed charges",308,100,,246.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.3,17.304,,42.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.04,63,,155.23,,,0,"percent of total billed charges","63% of total billed charges",47.12,15.3,,37.70,,,0,"percent of total billed charges","15.3% of total billed charges",51.74,16.8,,41.39,,,0,"percent of total billed charges","16.8% of total billed charges",212.52,69,,,,,0,"fee schedule","69% of total billed charges",308,100,,246.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",308,100,,246.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",308,100,,246.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",190.5,61.85,,152.40,,,0,"percent of total billed charges","61.5% of total billed charges",51.74,16.8,,41.39,,,0,"percent of total billed charges","16.8% of total billed charges",154,50,,123.20,,,0,"percent of total billed charges","50% of total billed charges",99.18,32.2,,79.34,,,0,"percent of total billed charges","32.2% of total billed charges",51.74,16.8,,41.39,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.78,17.136,,42.22,,,0,"percent of total billed charges","17.136% of total billed charges",67.27,21.84,,53.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",116.12,37.7,,92.90,,,0,"percent of total billed charges","37.7% of total billed charges",116.12,37.7,,92.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.41,33.9,,83.53,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",240.24,78,,192.19,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",254.41,82.6,,203.53,,,0,"percent of total billed charges","82.6% of total billed charges",51.74,16.8,,41.39,,,0,"percent of total billed charges","16.8% of total billed charges",154,50,,123.20,,,0,"percent of total billed charges","50% of total billed charges",254.41,82.6,,203.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.74,16.8,,41.39,,,0,"percent of total billed charges","16.8% of total billed charges",308,100,,246.40,,,0,"percent of total billed charges","100% of total billed charges",47.12,308,
"LABOR LEVEL I PER HOUR",72000001,CDM,720,RC,,,OUTPATIENT,,,4471,2906.15,,3934.48,88,,3147.58,,,0,"percent of total billed charges","88% of total billed charges",2235.5,50,,1788.40,,,0,"percent of total billed charges","50% of total billed charges",751.13,16.8,,600.90,,,0,"percent of total billed charges","16.8% of total billed charges",4471,100,,3576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.66,17.304,,618.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2816.73,63,,2253.38,,,0,"percent of total billed charges","63% of total billed charges",684.06,15.3,,547.25,,,0,"percent of total billed charges","15.3% of total billed charges",751.13,16.8,,600.90,,,0,"percent of total billed charges","16.8% of total billed charges",3084.99,69,,,,,0,"fee schedule","69% of total billed charges",4471,100,,3576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4471,100,,3576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4471,100,,3576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2765.31,61.85,,2212.25,,,0,"percent of total billed charges","61.5% of total billed charges",751.13,16.8,,600.90,,,0,"percent of total billed charges","16.8% of total billed charges",2235.5,50,,1788.40,,,0,"percent of total billed charges","50% of total billed charges",1439.66,32.2,,1151.73,,,0,"percent of total billed charges","32.2% of total billed charges",751.13,16.8,,600.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",766.15,17.136,,612.92,,,0,"percent of total billed charges","17.136% of total billed charges",976.47,21.84,,781.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1685.57,37.7,,1348.46,,,0,"percent of total billed charges","37.7% of total billed charges",1685.57,37.7,,1348.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1515.67,33.9,,1212.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3487.38,78,,2789.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3693.05,82.6,,2954.44,,,0,"percent of total billed charges","82.6% of total billed charges",751.13,16.8,,600.90,,,0,"percent of total billed charges","16.8% of total billed charges",2235.5,50,,1788.40,,,0,"percent of total billed charges","50% of total billed charges",3693.05,82.6,,2954.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",751.13,16.8,,600.90,,,0,"percent of total billed charges","16.8% of total billed charges",4471,100,,3576.80,,,0,"percent of total billed charges","100% of total billed charges",684.06,4471,
"LABOR LEVEL II PER HOUR",72000002,CDM,720,RC,,,OUTPATIENT,,,4569,2969.85,,4020.72,88,,3216.58,,,0,"percent of total billed charges","88% of total billed charges",2284.5,50,,1827.60,,,0,"percent of total billed charges","50% of total billed charges",767.59,16.8,,614.07,,,0,"percent of total billed charges","16.8% of total billed charges",4569,100,,3655.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",790.62,17.304,,632.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2878.47,63,,2302.78,,,0,"percent of total billed charges","63% of total billed charges",699.06,15.3,,559.25,,,0,"percent of total billed charges","15.3% of total billed charges",767.59,16.8,,614.07,,,0,"percent of total billed charges","16.8% of total billed charges",3152.61,69,,,,,0,"fee schedule","69% of total billed charges",4569,100,,3655.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4569,100,,3655.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4569,100,,3655.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2825.93,61.85,,2260.74,,,0,"percent of total billed charges","61.5% of total billed charges",767.59,16.8,,614.07,,,0,"percent of total billed charges","16.8% of total billed charges",2284.5,50,,1827.60,,,0,"percent of total billed charges","50% of total billed charges",1471.22,32.2,,1176.98,,,0,"percent of total billed charges","32.2% of total billed charges",767.59,16.8,,614.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",782.94,17.136,,626.35,,,0,"percent of total billed charges","17.136% of total billed charges",997.87,21.84,,798.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1722.51,37.7,,1378.01,,,0,"percent of total billed charges","37.7% of total billed charges",1722.51,37.7,,1378.01,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1548.89,33.9,,1239.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3563.82,78,,2851.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3773.99,82.6,,3019.19,,,0,"percent of total billed charges","82.6% of total billed charges",767.59,16.8,,614.07,,,0,"percent of total billed charges","16.8% of total billed charges",2284.5,50,,1827.60,,,0,"percent of total billed charges","50% of total billed charges",3773.99,82.6,,3019.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",767.59,16.8,,614.07,,,0,"percent of total billed charges","16.8% of total billed charges",4569,100,,3655.20,,,0,"percent of total billed charges","100% of total billed charges",699.06,4569,
"LABOR LEVEL III PER HOUR",72000003,CDM,720,RC,,,OUTPATIENT,,,4691,3049.15,,4128.08,88,,3302.46,,,0,"percent of total billed charges","88% of total billed charges",2345.5,50,,1876.40,,,0,"percent of total billed charges","50% of total billed charges",788.09,16.8,,630.47,,,0,"percent of total billed charges","16.8% of total billed charges",4691,100,,3752.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",811.73,17.304,,649.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2955.33,63,,2364.26,,,0,"percent of total billed charges","63% of total billed charges",717.72,15.3,,574.18,,,0,"percent of total billed charges","15.3% of total billed charges",788.09,16.8,,630.47,,,0,"percent of total billed charges","16.8% of total billed charges",3236.79,69,,,,,0,"fee schedule","69% of total billed charges",4691,100,,3752.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4691,100,,3752.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4691,100,,3752.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2901.38,61.85,,2321.10,,,0,"percent of total billed charges","61.5% of total billed charges",788.09,16.8,,630.47,,,0,"percent of total billed charges","16.8% of total billed charges",2345.5,50,,1876.40,,,0,"percent of total billed charges","50% of total billed charges",1510.5,32.2,,1208.40,,,0,"percent of total billed charges","32.2% of total billed charges",788.09,16.8,,630.47,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",803.85,17.136,,643.08,,,0,"percent of total billed charges","17.136% of total billed charges",1024.51,21.84,,819.61,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1768.51,37.7,,1414.81,,,0,"percent of total billed charges","37.7% of total billed charges",1768.51,37.7,,1414.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1590.25,33.9,,1272.20,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3658.98,78,,2927.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3874.77,82.6,,3099.82,,,0,"percent of total billed charges","82.6% of total billed charges",788.09,16.8,,630.47,,,0,"percent of total billed charges","16.8% of total billed charges",2345.5,50,,1876.40,,,0,"percent of total billed charges","50% of total billed charges",3874.77,82.6,,3099.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",788.09,16.8,,630.47,,,0,"percent of total billed charges","16.8% of total billed charges",4691,100,,3752.80,,,0,"percent of total billed charges","100% of total billed charges",717.72,4691,
"LEVEL I DELIVERY",72000011,CDM,720,RC,,,OUTPATIENT,,,7919,5147.35,,6968.72,88,,5574.98,,,0,"percent of total billed charges","88% of total billed charges",3959.5,50,,3167.60,,,0,"percent of total billed charges","50% of total billed charges",1330.39,16.8,,1064.31,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1370.3,17.304,,1096.24,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4988.97,63,,3991.18,,,0,"percent of total billed charges","63% of total billed charges",1211.61,15.3,,969.29,,,0,"percent of total billed charges","15.3% of total billed charges",1330.39,16.8,,1064.31,,,0,"percent of total billed charges","16.8% of total billed charges",5464.11,69,,,,,0,"fee schedule","69% of total billed charges",7919,100,,6335.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7919,100,,6335.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7919,100,,6335.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4897.9,61.85,,3918.32,,,0,"percent of total billed charges","61.5% of total billed charges",1330.39,16.8,,1064.31,,,0,"percent of total billed charges","16.8% of total billed charges",3959.5,50,,3167.60,,,0,"percent of total billed charges","50% of total billed charges",2549.92,32.2,,2039.94,,,0,"percent of total billed charges","32.2% of total billed charges",1330.39,16.8,,1064.31,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357,17.136,,1085.60,,,0,"percent of total billed charges","17.136% of total billed charges",1729.51,21.84,,1383.61,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2985.46,37.7,,2388.37,,,0,"percent of total billed charges","37.7% of total billed charges",2985.46,37.7,,2388.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2684.54,33.9,,2147.63,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6176.82,78,,4941.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6541.09,82.6,,5232.87,,,0,"percent of total billed charges","82.6% of total billed charges",1330.39,16.8,,1064.31,,,0,"percent of total billed charges","16.8% of total billed charges",3959.5,50,,3167.60,,,0,"percent of total billed charges","50% of total billed charges",6541.09,82.6,,5232.87,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1330.39,16.8,,1064.31,,,0,"percent of total billed charges","16.8% of total billed charges",7919,100,,6335.20,,,0,"percent of total billed charges","100% of total billed charges",1211.61,7919,
"LEVEL II DELIVERY",72000012,CDM,720,RC,,,OUTPATIENT,,,7919,5147.35,,6968.72,88,,5574.98,,,0,"percent of total billed charges","88% of total billed charges",3959.5,50,,3167.60,,,0,"percent of total billed charges","50% of total billed charges",1330.39,16.8,,1064.31,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1370.3,17.304,,1096.24,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4988.97,63,,3991.18,,,0,"percent of total billed charges","63% of total billed charges",1211.61,15.3,,969.29,,,0,"percent of total billed charges","15.3% of total billed charges",1330.39,16.8,,1064.31,,,0,"percent of total billed charges","16.8% of total billed charges",5464.11,69,,,,,0,"fee schedule","69% of total billed charges",7919,100,,6335.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7919,100,,6335.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7919,100,,6335.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4897.9,61.85,,3918.32,,,0,"percent of total billed charges","61.5% of total billed charges",1330.39,16.8,,1064.31,,,0,"percent of total billed charges","16.8% of total billed charges",3959.5,50,,3167.60,,,0,"percent of total billed charges","50% of total billed charges",2549.92,32.2,,2039.94,,,0,"percent of total billed charges","32.2% of total billed charges",1330.39,16.8,,1064.31,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357,17.136,,1085.60,,,0,"percent of total billed charges","17.136% of total billed charges",1729.51,21.84,,1383.61,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2985.46,37.7,,2388.37,,,0,"percent of total billed charges","37.7% of total billed charges",2985.46,37.7,,2388.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2684.54,33.9,,2147.63,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6176.82,78,,4941.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6541.09,82.6,,5232.87,,,0,"percent of total billed charges","82.6% of total billed charges",1330.39,16.8,,1064.31,,,0,"percent of total billed charges","16.8% of total billed charges",3959.5,50,,3167.60,,,0,"percent of total billed charges","50% of total billed charges",6541.09,82.6,,5232.87,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1330.39,16.8,,1064.31,,,0,"percent of total billed charges","16.8% of total billed charges",7919,100,,6335.20,,,0,"percent of total billed charges","100% of total billed charges",1211.61,7919,
"ELEC STIM MAN/15MIN/-GO",43097032X,CDM,430,RC,97032,CPT,OUTPATIENT,,,202,131.3,GO,177.76,88,,142.21,,,0,"percent of total billed charges","88% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",25.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee sv",127.26,63,,101.81,,,0,"percent of total billed charges","63% of total billed charges",30.91,15.3,,24.73,,,0,"percent of total billed charges","15.3% of total billed charges",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",139.38,69,,,,,0,"fee schedule","69% of total billed charges",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",14.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.3,100,,,,,0,"fee schedule","100% of LI fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.52,102,,,,,0,"fee schedule","102% of WA fee schedule",10.86,130,,,,,0,"fee schedule","130% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.15,37.7,,60.92,,,0,"percent of total billed charges","37.7% of total billed charges",76.15,37.7,,60.92,,,0,"percent of total billed charges","37.70% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.48,33.9,,54.78,,,0,"percent of total billed charges","33.9% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",157.56,78,,126.05,,,0,"percent of total billed charges","78% of total billed charges",14.68,101,,,,,0,"fee schedule","101% of CMS fee schedule ",166.85,82.6,,133.48,,,0,"percent of total billed charges","82.6% of total billed charges",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",166.85,82.6,,133.48,,,0,"percent of total billed charges","82.6% of total billed charges",14.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",8.35,202,
"OT Attended E-Stim Assistant Units",43097032X,CDM,430,RC,97032,CPT,OUTPATIENT,,,202,131.3,GO,177.76,88,,142.21,,,0,"percent of total billed charges","88% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",25.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee sv",127.26,63,,101.81,,,0,"percent of total billed charges","63% of total billed charges",30.91,15.3,,24.73,,,0,"percent of total billed charges","15.3% of total billed charges",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",139.38,69,,,,,0,"fee schedule","69% of total billed charges",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",14.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.3,100,,,,,0,"fee schedule","100% of LI fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.52,102,,,,,0,"fee schedule","102% of WA fee schedule",10.86,130,,,,,0,"fee schedule","130% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.15,37.7,,60.92,,,0,"percent of total billed charges","37.7% of total billed charges",76.15,37.7,,60.92,,,0,"percent of total billed charges","37.70% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.48,33.9,,54.78,,,0,"percent of total billed charges","33.9% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",157.56,78,,126.05,,,0,"percent of total billed charges","78% of total billed charges",14.68,101,,,,,0,"fee schedule","101% of CMS fee schedule ",166.85,82.6,,133.48,,,0,"percent of total billed charges","82.6% of total billed charges",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",166.85,82.6,,133.48,,,0,"percent of total billed charges","82.6% of total billed charges",14.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",8.35,202,
"CONTRAST BATH/15MIN/-GO",43097034X,CDM,430,RC,97034,CPT,OUTPATIENT,,,112,72.8,GO,98.56,88,,78.85,,,0,"percent of total billed charges","88% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",24.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee sv",70.56,63,,56.45,,,0,"percent of total billed charges","63% of total billed charges",17.14,15.3,,13.71,,,0,"percent of total billed charges","15.3% of total billed charges",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",77.28,69,,,,,0,"fee schedule","69% of total billed charges",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",14.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.41,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.98,100,,,,,0,"fee schedule","100% of LI fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.71,102,,,,,0,"fee schedule","102% of WA fee schedule",11.1,130,,,,,0,"fee schedule","130% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.22,37.7,,33.78,,,0,"percent of total billed charges","37.7% of total billed charges",42.22,37.7,,33.78,,,0,"percent of total billed charges","37.70% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.97,33.9,,30.38,,,0,"percent of total billed charges","33.9% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.36,78,,69.89,,,0,"percent of total billed charges","78% of total billed charges",14.37,101,,,,,0,"fee schedule","101% of CMS fee schedule ",92.51,82.6,,74.01,,,0,"percent of total billed charges","82.6% of total billed charges",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.51,82.6,,74.01,,,0,"percent of total billed charges","82.6% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",8.54,112,
"OT Contrast Bath Assistant Units",43097034X,CDM,430,RC,97034,CPT,OUTPATIENT,,,112,72.8,GO,98.56,88,,78.85,,,0,"percent of total billed charges","88% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",24.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee sv",70.56,63,,56.45,,,0,"percent of total billed charges","63% of total billed charges",17.14,15.3,,13.71,,,0,"percent of total billed charges","15.3% of total billed charges",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",77.28,69,,,,,0,"fee schedule","69% of total billed charges",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",14.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.41,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.98,100,,,,,0,"fee schedule","100% of LI fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.71,102,,,,,0,"fee schedule","102% of WA fee schedule",11.1,130,,,,,0,"fee schedule","130% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.22,37.7,,33.78,,,0,"percent of total billed charges","37.7% of total billed charges",42.22,37.7,,33.78,,,0,"percent of total billed charges","37.70% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.97,33.9,,30.38,,,0,"percent of total billed charges","33.9% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.36,78,,69.89,,,0,"percent of total billed charges","78% of total billed charges",14.37,101,,,,,0,"fee schedule","101% of CMS fee schedule ",92.51,82.6,,74.01,,,0,"percent of total billed charges","82.6% of total billed charges",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.51,82.6,,74.01,,,0,"percent of total billed charges","82.6% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",8.54,112,
"OT Community, Work Reintegration Assistant Units",43097537X,CDM,430,RC,97537,CPT,OUTPATIENT,,,280,182,GO,246.4,88,,197.12,,,0,"percent of total billed charges","88% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",56.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee sv",176.4,63,,141.12,,,0,"percent of total billed charges","63% of total billed charges",42.84,15.3,,34.27,,,0,"percent of total billed charges","15.3% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",193.2,69,,,,,0,"fee schedule","69% of total billed charges",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",32.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.24,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.75,100,,,,,0,"fee schedule","100% of LI fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.17,102,,,,,0,"fee schedule","102% of WA fee schedule",24.43,130,,,,,0,"fee schedule","130% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",105.56,37.7,,84.45,,,0,"percent of total billed charges","37.7% of total billed charges",105.56,37.7,,84.45,,,0,"percent of total billed charges","37.70% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",94.92,33.9,,75.94,,,0,"percent of total billed charges","33.9% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",218.4,78,,174.72,,,0,"percent of total billed charges","78% of total billed charges",32.6,101,,,,,0,"fee schedule","101% of CMS fee schedule ",231.28,82.6,,185.02,,,0,"percent of total billed charges","82.6% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",231.28,82.6,,185.02,,,0,"percent of total billed charges","82.6% of total billed charges",32.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",18.79,280,
"OT Cog Ther Intervent, First 15 Min Asst",43097129,CDM,430,RC,97129,CPT,OUTPATIENT,,,109,70.85,CO|GO,95.92,88,,76.74,,,0,"percent of total billed charges","88% of total billed charges",22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",38.59,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.83,100,,,,,0,"fee schedule",EAPG,22.22,100,,,,,0,"fee schedule","100% of CMS fee sv",68.67,63,,54.94,,,0,"percent of total billed charges","63% of total billed charges",16.68,15.3,,13.34,,,0,"percent of total billed charges","15.3% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,75.21,69,,,,,0,"fee schedule","69% of total billed charges",109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",22.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.01,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.95,100,,,,,0,"fee schedule","100% of LI fee schedule",25.77,100,,,,,0,"fee schedule",EAPG,22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.48,100,,,,,0,"fee schedule",EAPG,45.23,100,,,,,0,"fee schedule",EAPG,22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.09,37.7,,32.87,,,0,"percent of total billed charges","37.7% of total billed charges",41.09,37.7,,32.87,,,0,"percent of total billed charges","37.70% of total billed charges",22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.95,33.9,,29.56,,,0,"percent of total billed charges","33.9% of total billed charges",22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.02,78,,68.02,,,0,"percent of total billed charges","78% of total billed charges",22.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",90.03,82.6,,72.02,,,0,"percent of total billed charges","82.6% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.03,82.6,,72.02,,,0,"percent of total billed charges","82.6% of total billed charges",22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",16.68,109,
"OT Cog Ther Intervent, Addl 15 Min Asst",43097130,CDM,430,RC,97130,CPT,OUTPATIENT,,,105,68.25,CO|GO,92.4,88,,73.92,,,0,"percent of total billed charges","88% of total billed charges",21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,105,100,,84.00,,,0,"percent of total billed charges","100% of total billed charges",36.8,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.83,100,,,,,0,"fee schedule",EAPG,21.2,100,,,,,0,"fee schedule","100% of CMS fee sv",66.15,63,,52.92,,,0,"percent of total billed charges","63% of total billed charges",16.07,15.3,,12.86,,,0,"percent of total billed charges","15.3% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,72.45,69,,,,,0,"fee schedule","69% of total billed charges",105,100,,84.00,,,0,"percent of total billed charges","100% of total billed charges",21.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",105,100,,84.00,,,0,"percent of total billed charges","100% of total billed charges",21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",105,100,,84.00,,,0,"percent of total billed charges","100% of total billed charges",21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",84.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.95,100,,,,,0,"fee schedule","100% of LI fee schedule",25.77,100,,,,,0,"fee schedule",EAPG,21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.48,100,,,,,0,"fee schedule",EAPG,45.23,100,,,,,0,"fee schedule",EAPG,21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.59,37.7,,31.67,,,0,"percent of total billed charges","37.7% of total billed charges",39.59,37.7,,31.67,,,0,"percent of total billed charges","37.70% of total billed charges",21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.6,33.9,,28.48,,,0,"percent of total billed charges","33.9% of total billed charges",21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.9,78,,65.52,,,0,"percent of total billed charges","78% of total billed charges",21.41,101,,,,,0,"fee schedule","101% of CMS fee schedule ",86.73,82.6,,69.38,,,0,"percent of total billed charges","82.6% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",86.73,82.6,,69.38,,,0,"percent of total billed charges","82.6% of total billed charges",21.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,105,100,,84.00,,,0,"percent of total billed charges","100% of total billed charges",16.07,105,
"OT EVAL- LOW COMP",43497165X,CDM,434,RC,97165,CPT,OUTPATIENT,,,403,261.95,GO,354.64,88,,283.71,,,0,"percent of total billed charges","88% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",179.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee sv",253.89,63,,203.11,,,0,"percent of total billed charges","63% of total billed charges",61.66,15.3,,49.33,,,0,"percent of total billed charges","15.3% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",278.07,69,,,,,0,"fee schedule","69% of total billed charges",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",102.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",378.29,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.53,100,,,,,0,"fee schedule","100% of LI fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.4,102,,,,,0,"fee schedule","102% of WA fee schedule",76.99,130,,,,,0,"fee schedule","130% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.7% of total billed charges",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.70% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.62,33.9,,109.30,,,0,"percent of total billed charges","33.9% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",314.34,78,,251.47,,,0,"percent of total billed charges","78% of total billed charges",104.26,101,,,,,0,"fee schedule","101% of CMS fee schedule ",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",103.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",59.22,403,
"OT EVAL- MOD COMP",43497166X,CDM,434,RC,97166,CPT,OUTPATIENT,,,403,261.95,GO,354.64,88,,283.71,,,0,"percent of total billed charges","88% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",179.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee sv",253.89,63,,203.11,,,0,"percent of total billed charges","63% of total billed charges",61.66,15.3,,49.33,,,0,"percent of total billed charges","15.3% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",278.07,69,,,,,0,"fee schedule","69% of total billed charges",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",102.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",378.29,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.53,100,,,,,0,"fee schedule","100% of LI fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.4,102,,,,,0,"fee schedule","102% of WA fee schedule",76.99,130,,,,,0,"fee schedule","130% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.7% of total billed charges",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.70% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.62,33.9,,109.30,,,0,"percent of total billed charges","33.9% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",314.34,78,,251.47,,,0,"percent of total billed charges","78% of total billed charges",104.26,101,,,,,0,"fee schedule","101% of CMS fee schedule ",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",103.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",59.22,403,
"OT EVAL- HGH COMP",43497167X,CDM,434,RC,97167,CPT,OUTPATIENT,,,403,261.95,GO,354.64,88,,283.71,,,0,"percent of total billed charges","88% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",179.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee sv",253.89,63,,203.11,,,0,"percent of total billed charges","63% of total billed charges",61.66,15.3,,49.33,,,0,"percent of total billed charges","15.3% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",278.07,69,,,,,0,"fee schedule","69% of total billed charges",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",102.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",378.29,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.53,100,,,,,0,"fee schedule","100% of LI fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.4,102,,,,,0,"fee schedule","102% of WA fee schedule",76.99,130,,,,,0,"fee schedule","130% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.7% of total billed charges",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.70% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.62,33.9,,109.30,,,0,"percent of total billed charges","33.9% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",314.34,78,,251.47,,,0,"percent of total billed charges","78% of total billed charges",104.26,101,,,,,0,"fee schedule","101% of CMS fee schedule ",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",103.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",59.22,403,
"OCCUP THERAPY GROUP/-GO",43397150,CDM,433,RC,97150,CPT,OUTPATIENT,,,147,95.55,GO,129.36,88,,103.49,,,0,"percent of total billed charges","88% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",31.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee sv",92.61,63,,74.09,,,0,"percent of total billed charges","63% of total billed charges",22.49,15.3,,17.99,,,0,"percent of total billed charges","15.3% of total billed charges",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",101.43,69,,,,,0,"fee schedule","69% of total billed charges",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",18.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.46,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",18,100,,,,,0,"fee schedule","100% of LI fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.65,102,,,,,0,"fee schedule","102% of WA fee schedule",13.57,130,,,,,0,"fee schedule","130% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.42,37.7,,44.34,,,0,"percent of total billed charges","37.7% of total billed charges",55.42,37.7,,44.34,,,0,"percent of total billed charges","37.70% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.83,33.9,,39.86,,,0,"percent of total billed charges","33.9% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",114.66,78,,91.73,,,0,"percent of total billed charges","78% of total billed charges",18.47,101,,,,,0,"fee schedule","101% of CMS fee schedule ",121.42,82.6,,97.14,,,0,"percent of total billed charges","82.6% of total billed charges",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",121.42,82.6,,97.14,,,0,"percent of total billed charges","82.6% of total billed charges",18.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",10.44,147,
"OT Group Therapy Assistant Units",43097150X,CDM,430,RC,97150,CPT,OUTPATIENT,,,147,95.55,GO|CO,129.36,88,,103.49,,,0,"percent of total billed charges","88% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",31.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee sv",92.61,63,,74.09,,,0,"percent of total billed charges","63% of total billed charges",22.49,15.3,,17.99,,,0,"percent of total billed charges","15.3% of total billed charges",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",101.43,69,,,,,0,"fee schedule","69% of total billed charges",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",18.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.46,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",18,100,,,,,0,"fee schedule","100% of LI fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.65,102,,,,,0,"fee schedule","102% of WA fee schedule",13.57,130,,,,,0,"fee schedule","130% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.42,37.7,,44.34,,,0,"percent of total billed charges","37.7% of total billed charges",55.42,37.7,,44.34,,,0,"percent of total billed charges","37.70% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.83,33.9,,39.86,,,0,"percent of total billed charges","33.9% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",114.66,78,,91.73,,,0,"percent of total billed charges","78% of total billed charges",18.47,101,,,,,0,"fee schedule","101% of CMS fee schedule ",121.42,82.6,,97.14,,,0,"percent of total billed charges","82.6% of total billed charges",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",121.42,82.6,,97.14,,,0,"percent of total billed charges","82.6% of total billed charges",18.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",10.44,147,
IONTOPHORESIS/15MIN/-GO,43097033X,CDM,430,RC,97033,CPT,OUTPATIENT,,,201,130.65,GO,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",34.2,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee sv",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",19.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of LI fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.01,102,,,,,0,"fee schedule","102% of WA fee schedule",15.3,130,,,,,0,"fee schedule","130% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.7% of total billed charges",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.14,33.9,,54.51,,,0,"percent of total billed charges","33.9% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",19.91,101,,,,,0,"fee schedule","101% of CMS fee schedule ",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",19.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",11.77,201,
"MANUAL THERAPY/15MIN/-GO",43097140X,CDM,430,RC,97140,CPT,OUTPATIENT,,,269,174.85,GO,236.72,88,,189.38,,,0,"percent of total billed charges","88% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",47.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee sv",169.47,63,,135.58,,,0,"percent of total billed charges","63% of total billed charges",41.16,15.3,,32.93,,,0,"percent of total billed charges","15.3% of total billed charges",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",185.61,69,,,,,0,"fee schedule","69% of total billed charges",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",27.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.72,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.05,100,,,,,0,"fee schedule","100% of LI fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.26,102,,,,,0,"fee schedule","102% of WA fee schedule",20.72,130,,,,,0,"fee schedule","130% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.41,37.7,,81.13,,,0,"percent of total billed charges","37.7% of total billed charges",101.41,37.7,,81.13,,,0,"percent of total billed charges","37.70% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.19,33.9,,72.95,,,0,"percent of total billed charges","33.9% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",209.82,78,,167.86,,,0,"percent of total billed charges","78% of total billed charges",27.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",222.19,82.6,,177.75,,,0,"percent of total billed charges","82.6% of total billed charges",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",222.19,82.6,,177.75,,,0,"percent of total billed charges","82.6% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",15.94,269,
"MASSAGE EA 15MIN/-GO",43097124X,CDM,430,RC,97124,CPT,OUTPATIENT,,,119,77.35,GO,104.72,88,,83.78,,,0,"percent of total billed charges","88% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",54.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee sv",74.97,63,,59.98,,,0,"percent of total billed charges","63% of total billed charges",18.21,15.3,,14.57,,,0,"percent of total billed charges","15.3% of total billed charges",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",82.11,69,,,,,0,"fee schedule","69% of total billed charges",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",30.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.46,100,,,,,0,"fee schedule","100% of LI fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.2,102,,,,,0,"fee schedule","102% of WA fee schedule",23.19,130,,,,,0,"fee schedule","130% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.7% of total billed charges",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.70% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.34,33.9,,32.27,,,0,"percent of total billed charges","33.9% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.82,78,,74.26,,,0,"percent of total billed charges","78% of total billed charges",31.34,101,,,,,0,"fee schedule","101% of CMS fee schedule ",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",31.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",17.84,119,
"OT Massage Assistant Units",43097124X,CDM,430,RC,97124,CPT,OUTPATIENT,,,119,77.35,GO,104.72,88,,83.78,,,0,"percent of total billed charges","88% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",54.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee sv",74.97,63,,59.98,,,0,"percent of total billed charges","63% of total billed charges",18.21,15.3,,14.57,,,0,"percent of total billed charges","15.3% of total billed charges",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",82.11,69,,,,,0,"fee schedule","69% of total billed charges",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",30.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.46,100,,,,,0,"fee schedule","100% of LI fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.2,102,,,,,0,"fee schedule","102% of WA fee schedule",23.19,130,,,,,0,"fee schedule","130% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.7% of total billed charges",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.70% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.34,33.9,,32.27,,,0,"percent of total billed charges","33.9% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.82,78,,74.26,,,0,"percent of total billed charges","78% of total billed charges",31.34,101,,,,,0,"fee schedule","101% of CMS fee schedule ",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",31.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",17.84,119,
"OT Manual Therapy Assistant Units",43097140X,CDM,430,RC,97140,CPT,OUTPATIENT,,,269,174.85,GO,236.72,88,,189.38,,,0,"percent of total billed charges","88% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",47.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee sv",169.47,63,,135.58,,,0,"percent of total billed charges","63% of total billed charges",41.16,15.3,,32.93,,,0,"percent of total billed charges","15.3% of total billed charges",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",185.61,69,,,,,0,"fee schedule","69% of total billed charges",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",27.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.72,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.05,100,,,,,0,"fee schedule","100% of LI fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.26,102,,,,,0,"fee schedule","102% of WA fee schedule",20.72,130,,,,,0,"fee schedule","130% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.41,37.7,,81.13,,,0,"percent of total billed charges","37.7% of total billed charges",101.41,37.7,,81.13,,,0,"percent of total billed charges","37.70% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.19,33.9,,72.95,,,0,"percent of total billed charges","33.9% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",209.82,78,,167.86,,,0,"percent of total billed charges","78% of total billed charges",27.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",222.19,82.6,,177.75,,,0,"percent of total billed charges","82.6% of total billed charges",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",222.19,82.6,,177.75,,,0,"percent of total billed charges","82.6% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",15.94,269,
"NEUROMUSC RE-ED/15MIN/-GO",43097112X,CDM,430,RC,97112,CPT,OUTPATIENT,,,228,148.2,GO,200.64,88,,160.51,,,0,"percent of total billed charges","88% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",59.8,175,,,,,0,"fee schedule","175% of CMS fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee sv",143.64,63,,114.91,,,0,"percent of total billed charges","63% of total billed charges",34.88,15.3,,27.90,,,0,"percent of total billed charges","15.3% of total billed charges",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",157.32,69,,,,,0,"fee schedule","69% of total billed charges",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",34.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",135.02,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.76,100,,,,,0,"fee schedule","100% of LI fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.33,102,,,,,0,"fee schedule","102% of WA fee schedule",25.91,130,,,,,0,"fee schedule","130% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.96,37.7,,68.77,,,0,"percent of total billed charges","37.7% of total billed charges",85.96,37.7,,68.77,,,0,"percent of total billed charges","37.70% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.29,33.9,,61.83,,,0,"percent of total billed charges","33.9% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",177.84,78,,142.27,,,0,"percent of total billed charges","78% of total billed charges",34.67,101,,,,,0,"fee schedule","101% of CMS fee schedule ",188.33,82.6,,150.66,,,0,"percent of total billed charges","82.6% of total billed charges",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",188.33,82.6,,150.66,,,0,"percent of total billed charges","82.6% of total billed charges",34.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",19.93,228,
"DEBRIDEMENT NON-SELCT/SESS/-GO",43097602X,CDM,430,RC,97602,CPT,OUTPATIENT,,,737,479.05,GO,648.56,88,,518.85,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",464.31,63,,371.45,,,0,"percent of total billed charges","63% of total billed charges",112.76,15.3,,90.21,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,508.53,69,,,,,0,"fee schedule","69% of total billed charges",737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.85,37.7,,222.28,,,0,"percent of total billed charges","37.7% of total billed charges",277.85,37.7,,222.28,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",249.84,33.9,,199.87,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",574.86,78,,459.89,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",608.76,82.6,,487.01,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",608.76,82.6,,487.01,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",112.76,737,
"OT Neuromuscular Reeducation Assistant Units",43097112X,CDM,430,RC,97112,CPT,OUTPATIENT,,,228,148.2,GO,200.64,88,,160.51,,,0,"percent of total billed charges","88% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",59.8,175,,,,,0,"fee schedule","175% of CMS fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee sv",143.64,63,,114.91,,,0,"percent of total billed charges","63% of total billed charges",34.88,15.3,,27.90,,,0,"percent of total billed charges","15.3% of total billed charges",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",157.32,69,,,,,0,"fee schedule","69% of total billed charges",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",34.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",135.02,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.76,100,,,,,0,"fee schedule","100% of LI fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.33,102,,,,,0,"fee schedule","102% of WA fee schedule",25.91,130,,,,,0,"fee schedule","130% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.96,37.7,,68.77,,,0,"percent of total billed charges","37.7% of total billed charges",85.96,37.7,,68.77,,,0,"percent of total billed charges","37.70% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.29,33.9,,61.83,,,0,"percent of total billed charges","33.9% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",177.84,78,,142.27,,,0,"percent of total billed charges","78% of total billed charges",34.67,101,,,,,0,"fee schedule","101% of CMS fee schedule ",188.33,82.6,,150.66,,,0,"percent of total billed charges","82.6% of total billed charges",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",188.33,82.6,,150.66,,,0,"percent of total billed charges","82.6% of total billed charges",34.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",19.93,228,
"ORTHOTIC MGMT EA 15M OT",43097760X,CDM,430,RC,97760,CPT,OUTPATIENT,,,175,113.75,GO,154,88,,123.20,,,0,"percent of total billed charges","88% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",85.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee sv",110.25,63,,88.20,,,0,"percent of total billed charges","63% of total billed charges",26.78,15.3,,21.42,,,0,"percent of total billed charges","15.3% of total billed charges",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",120.75,69,,,,,0,"fee schedule","69% of total billed charges",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",48.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",193.2,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.94,100,,,,,0,"fee schedule","100% of LI fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.62,102,,,,,0,"fee schedule","102% of WA fee schedule",37.75,130,,,,,0,"fee schedule","130% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.98,37.7,,52.78,,,0,"percent of total billed charges","37.7% of total billed charges",65.98,37.7,,52.78,,,0,"percent of total billed charges","37.70% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.33,33.9,,47.46,,,0,"percent of total billed charges","33.9% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.5,78,,109.20,,,0,"percent of total billed charges","78% of total billed charges",49.36,101,,,,,0,"fee schedule","101% of CMS fee schedule ",144.55,82.6,,115.64,,,0,"percent of total billed charges","82.6% of total billed charges",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.55,82.6,,115.64,,,0,"percent of total billed charges","82.6% of total billed charges",48.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",26.78,193.2,
"ORTH/PROS CHECKOUT EST 15M GO",43097763X,CDM,430,RC,97763,CPT,OUTPATIENT,,,184,119.6,GO,161.92,88,,129.54,,,0,"percent of total billed charges","88% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",93.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.83,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee sv",115.92,63,,92.74,,,0,"percent of total billed charges","63% of total billed charges",28.15,15.3,,22.52,,,0,"percent of total billed charges","15.3% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,126.96,69,,,,,0,"fee schedule","69% of total billed charges",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",53.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",212.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.67,100,,,,,0,"fee schedule","100% of LI fee schedule",25.77,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.48,100,,,,,0,"fee schedule",EAPG,45.23,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.37,37.7,,55.50,,,0,"percent of total billed charges","37.7% of total billed charges",69.37,37.7,,55.50,,,0,"percent of total billed charges","37.70% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.38,33.9,,49.90,,,0,"percent of total billed charges","33.9% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",143.52,78,,114.82,,,0,"percent of total billed charges","78% of total billed charges",54.28,101,,,,,0,"fee schedule","101% of CMS fee schedule ",151.98,82.6,,121.58,,,0,"percent of total billed charges","82.6% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.98,82.6,,121.58,,,0,"percent of total billed charges","82.6% of total billed charges",53.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",25.77,212.21,
"ORTHOTIC MGMT EA 15M OT",43097760X,CDM,430,RC,97760,CPT,OUTPATIENT,,,175,113.75,GO,154,88,,123.20,,,0,"percent of total billed charges","88% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",85.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee sv",110.25,63,,88.20,,,0,"percent of total billed charges","63% of total billed charges",26.78,15.3,,21.42,,,0,"percent of total billed charges","15.3% of total billed charges",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",120.75,69,,,,,0,"fee schedule","69% of total billed charges",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",48.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",193.2,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.94,100,,,,,0,"fee schedule","100% of LI fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.62,102,,,,,0,"fee schedule","102% of WA fee schedule",37.75,130,,,,,0,"fee schedule","130% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.98,37.7,,52.78,,,0,"percent of total billed charges","37.7% of total billed charges",65.98,37.7,,52.78,,,0,"percent of total billed charges","37.70% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.33,33.9,,47.46,,,0,"percent of total billed charges","33.9% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.5,78,,109.20,,,0,"percent of total billed charges","78% of total billed charges",49.36,101,,,,,0,"fee schedule","101% of CMS fee schedule ",144.55,82.6,,115.64,,,0,"percent of total billed charges","82.6% of total billed charges",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.55,82.6,,115.64,,,0,"percent of total billed charges","82.6% of total billed charges",48.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",26.78,193.2,
"OT Orthotic Management, Train Assistant Units",43097760X,CDM,430,RC,97760,CPT,OUTPATIENT,,,175,113.75,GO,154,88,,123.20,,,0,"percent of total billed charges","88% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",85.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee sv",110.25,63,,88.20,,,0,"percent of total billed charges","63% of total billed charges",26.78,15.3,,21.42,,,0,"percent of total billed charges","15.3% of total billed charges",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",120.75,69,,,,,0,"fee schedule","69% of total billed charges",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",48.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",193.2,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.94,100,,,,,0,"fee schedule","100% of LI fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.62,102,,,,,0,"fee schedule","102% of WA fee schedule",37.75,130,,,,,0,"fee schedule","130% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.98,37.7,,52.78,,,0,"percent of total billed charges","37.7% of total billed charges",65.98,37.7,,52.78,,,0,"percent of total billed charges","37.70% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.33,33.9,,47.46,,,0,"percent of total billed charges","33.9% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.5,78,,109.20,,,0,"percent of total billed charges","78% of total billed charges",49.36,101,,,,,0,"fee schedule","101% of CMS fee schedule ",144.55,82.6,,115.64,,,0,"percent of total billed charges","82.6% of total billed charges",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.55,82.6,,115.64,,,0,"percent of total billed charges","82.6% of total billed charges",48.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",26.78,193.2,
"OT Orthotic/Prosthetic Manage,Train Assistant Units",43097763X,CDM,430,RC,97763,CPT,OUTPATIENT,,,184,119.6,GO,161.92,88,,129.54,,,0,"percent of total billed charges","88% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",93.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.83,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee sv",115.92,63,,92.74,,,0,"percent of total billed charges","63% of total billed charges",28.15,15.3,,22.52,,,0,"percent of total billed charges","15.3% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,126.96,69,,,,,0,"fee schedule","69% of total billed charges",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",53.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",212.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.67,100,,,,,0,"fee schedule","100% of LI fee schedule",25.77,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.48,100,,,,,0,"fee schedule",EAPG,45.23,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.37,37.7,,55.50,,,0,"percent of total billed charges","37.7% of total billed charges",69.37,37.7,,55.50,,,0,"percent of total billed charges","37.70% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.38,33.9,,49.90,,,0,"percent of total billed charges","33.9% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",143.52,78,,114.82,,,0,"percent of total billed charges","78% of total billed charges",54.28,101,,,,,0,"fee schedule","101% of CMS fee schedule ",151.98,82.6,,121.58,,,0,"percent of total billed charges","82.6% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.98,82.6,,121.58,,,0,"percent of total billed charges","82.6% of total billed charges",53.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",25.77,212.21,
"PARAFFIN BATH/-GO",43097018X,CDM,430,RC,97018,CPT,OUTPATIENT,,,143,92.95,GO,125.84,88,,100.67,,,0,"percent of total billed charges","88% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",9.75,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee sv",90.09,63,,72.07,,,0,"percent of total billed charges","63% of total billed charges",21.88,15.3,,17.50,,,0,"percent of total billed charges","15.3% of total billed charges",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",98.67,69,,,,,0,"fee schedule","69% of total billed charges",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",5.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.53,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.62,100,,,,,0,"fee schedule","100% of LI fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.49,102,,,,,0,"fee schedule","102% of WA fee schedule",4.45,130,,,,,0,"fee schedule","130% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.91,37.7,,43.13,,,0,"percent of total billed charges","37.7% of total billed charges",53.91,37.7,,43.13,,,0,"percent of total billed charges","37.70% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.48,33.9,,38.78,,,0,"percent of total billed charges","33.9% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",111.54,78,,89.23,,,0,"percent of total billed charges","78% of total billed charges",5.8,101,,,,,0,"fee schedule","101% of CMS fee schedule ",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",3.42,143,
"FUNCT CAP TEST/15MIN/-GO",43097750X,CDM,430,RC,97750,CPT,OUTPATIENT,,,233,151.45,GO,205.04,88,,164.03,,,0,"percent of total billed charges","88% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",233,100,,186.40,,,0,"percent of total billed charges","100% of total billed charges",60.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee sv",146.79,63,,117.43,,,0,"percent of total billed charges","63% of total billed charges",35.65,15.3,,28.52,,,0,"percent of total billed charges","15.3% of total billed charges",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",160.77,69,,,,,0,"fee schedule","69% of total billed charges",233,100,,186.40,,,0,"percent of total billed charges","100% of total billed charges",34.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",233,100,,186.40,,,0,"percent of total billed charges","100% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",233,100,,186.40,,,0,"percent of total billed charges","100% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",132.38,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.12,100,,,,,0,"fee schedule","100% of LI fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.52,102,,,,,0,"fee schedule","102% of WA fee schedule",26.16,130,,,,,0,"fee schedule","130% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.84,37.7,,70.27,,,0,"percent of total billed charges","37.7% of total billed charges",87.84,37.7,,70.27,,,0,"percent of total billed charges","37.70% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.99,33.9,,63.19,,,0,"percent of total billed charges","33.9% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",181.74,78,,145.39,,,0,"percent of total billed charges","78% of total billed charges",35.08,101,,,,,0,"fee schedule","101% of CMS fee schedule ",192.46,82.6,,153.97,,,0,"percent of total billed charges","82.6% of total billed charges",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",192.46,82.6,,153.97,,,0,"percent of total billed charges","82.6% of total billed charges",34.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",233,100,,186.40,,,0,"percent of total billed charges","100% of total billed charges",20.12,233,
"SELECT DEBRIDE/20 CM OR < GO",43097597X,CDM,430,RC,97597,CPT,OUTPATIENT,,,737,479.05,GO,648.56,88,,518.85,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",464.31,63,,371.45,,,0,"percent of total billed charges","63% of total billed charges",112.76,15.3,,90.21,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,508.53,69,,,,,0,"fee schedule","69% of total billed charges",737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.85,37.7,,222.28,,,0,"percent of total billed charges","37.7% of total billed charges",277.85,37.7,,222.28,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",249.84,33.9,,199.87,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",574.86,78,,459.89,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",608.76,82.6,,487.01,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",608.76,82.6,,487.01,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",112.76,737,
"OT RE-EVAL/-GO",43497168X,CDM,434,RC,97168,CPT,OUTPATIENT,,,264,171.6,GO,232.32,88,,185.86,,,0,"percent of total billed charges","88% of total billed charges",71.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",41,100,,,,,0,"fee schedule","100% of WA fee schedule",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",124.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule","100% of WA fee schedule",71.4,100,,,,,0,"fee schedule","100% of CMS fee sv",166.32,63,,133.06,,,0,"percent of total billed charges","63% of total billed charges",40.39,15.3,,32.31,,,0,"percent of total billed charges","15.3% of total billed charges",41,100,,,,,0,"fee schedule","100% of WA fee schedule",182.16,69,,,,,0,"fee schedule","69% of total billed charges",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",70.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",71.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",71.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",255.24,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",41,100,,,,,0,"fee schedule","100% of WA fee schedule",71.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.16,100,,,,,0,"fee schedule","100% of LI fee schedule",41,100,,,,,0,"fee schedule","100% of WA fee schedule",71.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.82,102,,,,,0,"fee schedule","102% of WA fee schedule",53.3,130,,,,,0,"fee schedule","130% of WA fee schedule",71.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.53,37.7,,79.62,,,0,"percent of total billed charges","37.7% of total billed charges",99.53,37.7,,79.62,,,0,"percent of total billed charges","37.70% of total billed charges",71.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.5,33.9,,71.60,,,0,"percent of total billed charges","33.9% of total billed charges",71.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",205.92,78,,164.74,,,0,"percent of total billed charges","78% of total billed charges",72.11,101,,,,,0,"fee schedule","101% of CMS fee schedule ",218.06,82.6,,174.45,,,0,"percent of total billed charges","82.6% of total billed charges",41,100,,,,,0,"fee schedule","100% of WA fee schedule",71.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",218.06,82.6,,174.45,,,0,"percent of total billed charges","82.6% of total billed charges",71.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",41,100,,,,,0,"fee schedule","100% of WA fee schedule",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",40.39,264,
"SENSORY INTEGRATION/GO",43097533X,CDM,430,RC,97533,CPT,OUTPATIENT,,,267,173.55,GO,234.96,88,,187.97,,,0,"percent of total billed charges","88% of total billed charges",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.15,100,,,,,0,"fee schedule","100% of WA fee schedule",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",111.93,175,,,,,0,"fee schedule","175% of CMS fee schedule",38.15,100,,,,,0,"fee schedule","100% of WA fee schedule",64.13,100,,,,,0,"fee schedule","100% of CMS fee sv",168.21,63,,134.57,,,0,"percent of total billed charges","63% of total billed charges",40.85,15.3,,32.68,,,0,"percent of total billed charges","15.3% of total billed charges",38.15,100,,,,,0,"fee schedule","100% of WA fee schedule",184.23,69,,,,,0,"fee schedule","69% of total billed charges",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",63.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",233.86,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",38.15,100,,,,,0,"fee schedule","100% of WA fee schedule",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.8,100,,,,,0,"fee schedule","100% of LI fee schedule",38.15,100,,,,,0,"fee schedule","100% of WA fee schedule",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.91,102,,,,,0,"fee schedule","102% of WA fee schedule",49.6,130,,,,,0,"fee schedule","130% of WA fee schedule",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.66,37.7,,80.53,,,0,"percent of total billed charges","37.7% of total billed charges",100.66,37.7,,80.53,,,0,"percent of total billed charges","37.70% of total billed charges",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.51,33.9,,72.41,,,0,"percent of total billed charges","33.9% of total billed charges",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",208.26,78,,166.61,,,0,"percent of total billed charges","78% of total billed charges",64.77,101,,,,,0,"fee schedule","101% of CMS fee schedule ",220.54,82.6,,176.43,,,0,"percent of total billed charges","82.6% of total billed charges",38.15,100,,,,,0,"fee schedule","100% of WA fee schedule",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",220.54,82.6,,176.43,,,0,"percent of total billed charges","82.6% of total billed charges",64.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.15,100,,,,,0,"fee schedule","100% of WA fee schedule",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",38.15,267,
"ACT DAILY LIV/15MIN/-GO",43097535X,CDM,430,RC,97535,CPT,OUTPATIENT,,,150,97.5,GO,132,88,,105.60,,,0,"percent of total billed charges","88% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",58.07,175,,,,,0,"fee schedule","175% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee sv",94.5,63,,75.60,,,0,"percent of total billed charges","63% of total billed charges",22.95,15.3,,18.36,,,0,"percent of total billed charges","15.3% of total billed charges",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",103.5,69,,,,,0,"fee schedule","69% of total billed charges",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",33.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.71,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.77,100,,,,,0,"fee schedule","100% of LI fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.75,102,,,,,0,"fee schedule","102% of WA fee schedule",25.17,130,,,,,0,"fee schedule","130% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.7% of total billed charges",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.70% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.85,33.9,,40.68,,,0,"percent of total billed charges","33.9% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",117,78,,93.60,,,0,"percent of total billed charges","78% of total billed charges",33.68,101,,,,,0,"fee schedule","101% of CMS fee schedule ",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",33.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",19.36,150,
"SELECT DEBRIDE > 20 CM GO",43097598X,CDM,430,RC,97598,CPT,OUTPATIENT,,,955,620.75,GO,840.4,88,,672.32,,,0,"percent of total billed charges","88% of total billed charges",477.5,50,,382.00,,,0,"percent of total billed charges","50% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",930.95,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",601.65,63,,481.32,,,0,"percent of total billed charges","63% of total billed charges",146.12,15.3,,116.90,,,0,"percent of total billed charges","15.3% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,658.95,69,,,,,0,"fee schedule","69% of total billed charges",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.67,61.85,,472.54,,,0,"percent of total billed charges","61.5% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,477.5,50,,382.00,,,0,"percent of total billed charges","50% of total billed charges",307.51,32.2,,246.01,,,0,"percent of total billed charges","32.2% of total billed charges",669.51,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",921.91,100,,,,,0,"fee schedule",EAPG,1174.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",360.04,37.7,,288.03,,,0,"percent of total billed charges","37.7% of total billed charges",360.04,37.7,,288.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",323.75,33.9,,259.00,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",744.9,78,,595.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",788.83,82.6,,631.06,,,0,"percent of total billed charges","82.6% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,477.5,50,,382.00,,,0,"percent of total billed charges","50% of total billed charges",788.83,82.6,,631.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",903.83,100,,,,,0,"fee schedule",EAPG,955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",146.12,1174.99,
"SELECT DEBRIDE/20 CM OR < GO",43097597X,CDM,430,RC,97597,CPT,OUTPATIENT,,,737,479.05,GO,648.56,88,,518.85,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",464.31,63,,371.45,,,0,"percent of total billed charges","63% of total billed charges",112.76,15.3,,90.21,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,508.53,69,,,,,0,"fee schedule","69% of total billed charges",737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.85,37.7,,222.28,,,0,"percent of total billed charges","37.7% of total billed charges",277.85,37.7,,222.28,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",249.84,33.9,,199.87,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",574.86,78,,459.89,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",608.76,82.6,,487.01,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",608.76,82.6,,487.01,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",112.76,737,
"OT Sensory Integrative Tech Assistant Units",43097533X,CDM,430,RC,97533,CPT,OUTPATIENT,,,267,173.55,GO,234.96,88,,187.97,,,0,"percent of total billed charges","88% of total billed charges",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.15,100,,,,,0,"fee schedule","100% of WA fee schedule",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",111.93,175,,,,,0,"fee schedule","175% of CMS fee schedule",38.15,100,,,,,0,"fee schedule","100% of WA fee schedule",64.13,100,,,,,0,"fee schedule","100% of CMS fee sv",168.21,63,,134.57,,,0,"percent of total billed charges","63% of total billed charges",40.85,15.3,,32.68,,,0,"percent of total billed charges","15.3% of total billed charges",38.15,100,,,,,0,"fee schedule","100% of WA fee schedule",184.23,69,,,,,0,"fee schedule","69% of total billed charges",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",63.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",233.86,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",38.15,100,,,,,0,"fee schedule","100% of WA fee schedule",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.8,100,,,,,0,"fee schedule","100% of LI fee schedule",38.15,100,,,,,0,"fee schedule","100% of WA fee schedule",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.91,102,,,,,0,"fee schedule","102% of WA fee schedule",49.6,130,,,,,0,"fee schedule","130% of WA fee schedule",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.66,37.7,,80.53,,,0,"percent of total billed charges","37.7% of total billed charges",100.66,37.7,,80.53,,,0,"percent of total billed charges","37.70% of total billed charges",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.51,33.9,,72.41,,,0,"percent of total billed charges","33.9% of total billed charges",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",208.26,78,,166.61,,,0,"percent of total billed charges","78% of total billed charges",64.77,101,,,,,0,"fee schedule","101% of CMS fee schedule ",220.54,82.6,,176.43,,,0,"percent of total billed charges","82.6% of total billed charges",38.15,100,,,,,0,"fee schedule","100% of WA fee schedule",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",220.54,82.6,,176.43,,,0,"percent of total billed charges","82.6% of total billed charges",64.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.15,100,,,,,0,"fee schedule","100% of WA fee schedule",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",38.15,267,
"OT Self Care, Home Mgmt Assistant Units",43097535X,CDM,430,RC,97535,CPT,OUTPATIENT,,,150,97.5,GO,132,88,,105.60,,,0,"percent of total billed charges","88% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",58.07,175,,,,,0,"fee schedule","175% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee sv",94.5,63,,75.60,,,0,"percent of total billed charges","63% of total billed charges",22.95,15.3,,18.36,,,0,"percent of total billed charges","15.3% of total billed charges",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",103.5,69,,,,,0,"fee schedule","69% of total billed charges",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",33.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.71,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.77,100,,,,,0,"fee schedule","100% of LI fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.75,102,,,,,0,"fee schedule","102% of WA fee schedule",25.17,130,,,,,0,"fee schedule","130% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.7% of total billed charges",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.70% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.85,33.9,,40.68,,,0,"percent of total billed charges","33.9% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",117,78,,93.60,,,0,"percent of total billed charges","78% of total billed charges",33.68,101,,,,,0,"fee schedule","101% of CMS fee schedule ",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",33.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",19.36,150,
"THERA EXERCISE/15MIN/-GO",43097110X,CDM,430,RC,97110,CPT,OUTPATIENT,,,181,117.65,GO,159.28,88,,127.42,,,0,"percent of total billed charges","88% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",52.01,175,,,,,0,"fee schedule","175% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee sv",114.03,63,,91.22,,,0,"percent of total billed charges","63% of total billed charges",27.69,15.3,,22.15,,,0,"percent of total billed charges","15.3% of total billed charges",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",124.89,69,,,,,0,"fee schedule","69% of total billed charges",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",29.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",116.17,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.4,100,,,,,0,"fee schedule","100% of LI fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.81,102,,,,,0,"fee schedule","102% of WA fee schedule",22.7,130,,,,,0,"fee schedule","130% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.24,37.7,,54.59,,,0,"percent of total billed charges","37.7% of total billed charges",68.24,37.7,,54.59,,,0,"percent of total billed charges","37.70% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.36,33.9,,49.09,,,0,"percent of total billed charges","33.9% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",141.18,78,,112.94,,,0,"percent of total billed charges","78% of total billed charges",30.19,101,,,,,0,"fee schedule","101% of CMS fee schedule ",149.51,82.6,,119.61,,,0,"percent of total billed charges","82.6% of total billed charges",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",149.51,82.6,,119.61,,,0,"percent of total billed charges","82.6% of total billed charges",29.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",17.46,181,
"THERAPEUTIC ACT/15MIN/-GO",43097530X,CDM,430,RC,97530,CPT,OUTPATIENT,,,206,133.9,GO,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",65.36,175,,,,,0,"fee schedule","175% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee sv",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",37.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.36,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.83,100,,,,,0,"fee schedule","100% of LI fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.65,102,,,,,0,"fee schedule","102% of WA fee schedule",28.87,130,,,,,0,"fee schedule","130% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.7% of total billed charges",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.83,33.9,,55.86,,,0,"percent of total billed charges","33.9% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",37.89,101,,,,,0,"fee schedule","101% of CMS fee schedule ",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",37.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",22.21,206,
"THERAP ACT 1:1/15MIN/-GP",42097530X,CDM,430,RC,97530,CPT,OUTPATIENT,,,206,133.9,GO,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",65.36,175,,,,,0,"fee schedule","175% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee sv",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",37.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.36,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.83,100,,,,,0,"fee schedule","100% of LI fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.65,102,,,,,0,"fee schedule","102% of WA fee schedule",28.87,130,,,,,0,"fee schedule","130% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.7% of total billed charges",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.83,33.9,,55.86,,,0,"percent of total billed charges","33.9% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",37.89,101,,,,,0,"fee schedule","101% of CMS fee schedule ",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",37.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",22.21,206,
"THERA EXERCISE/15MIN/-GO",43097110X,CDM,430,RC,97110,CPT,OUTPATIENT,,,181,117.65,GO,159.28,88,,127.42,,,0,"percent of total billed charges","88% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",52.01,175,,,,,0,"fee schedule","175% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee sv",114.03,63,,91.22,,,0,"percent of total billed charges","63% of total billed charges",27.69,15.3,,22.15,,,0,"percent of total billed charges","15.3% of total billed charges",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",124.89,69,,,,,0,"fee schedule","69% of total billed charges",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",29.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",116.17,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.4,100,,,,,0,"fee schedule","100% of LI fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.81,102,,,,,0,"fee schedule","102% of WA fee schedule",22.7,130,,,,,0,"fee schedule","130% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.24,37.7,,54.59,,,0,"percent of total billed charges","37.7% of total billed charges",68.24,37.7,,54.59,,,0,"percent of total billed charges","37.70% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.36,33.9,,49.09,,,0,"percent of total billed charges","33.9% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",141.18,78,,112.94,,,0,"percent of total billed charges","78% of total billed charges",30.19,101,,,,,0,"fee schedule","101% of CMS fee schedule ",149.51,82.6,,119.61,,,0,"percent of total billed charges","82.6% of total billed charges",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",149.51,82.6,,119.61,,,0,"percent of total billed charges","82.6% of total billed charges",29.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",17.46,181,
"THERAPEUTIC ACT/15MIN/-GO",43097530X,CDM,430,RC,97530,CPT,OUTPATIENT,,,206,133.9,GO,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",65.36,175,,,,,0,"fee schedule","175% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee sv",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",37.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.36,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.83,100,,,,,0,"fee schedule","100% of LI fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.65,102,,,,,0,"fee schedule","102% of WA fee schedule",28.87,130,,,,,0,"fee schedule","130% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.7% of total billed charges",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.83,33.9,,55.86,,,0,"percent of total billed charges","33.9% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",37.89,101,,,,,0,"fee schedule","101% of CMS fee schedule ",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",37.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",22.21,206,
"Therapeutic procedure, 1 or more areas, each 15 minutes; the",43097110,CDM,430,RC,97110,CPT,OUTPATIENT,,,196,127.4,CO|GO,172.48,88,,137.98,,,0,"percent of total billed charges","88% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",52.01,175,,,,,0,"fee schedule","175% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee sv",123.48,63,,98.78,,,0,"percent of total billed charges","63% of total billed charges",29.99,15.3,,23.99,,,0,"percent of total billed charges","15.3% of total billed charges",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",135.24,69,,,,,0,"fee schedule","69% of total billed charges",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",29.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",116.17,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.4,100,,,,,0,"fee schedule","100% of LI fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.81,102,,,,,0,"fee schedule","102% of WA fee schedule",22.7,130,,,,,0,"fee schedule","130% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.89,37.7,,59.11,,,0,"percent of total billed charges","37.7% of total billed charges",73.89,37.7,,59.11,,,0,"percent of total billed charges","37.70% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.44,33.9,,53.15,,,0,"percent of total billed charges","33.9% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",152.88,78,,122.30,,,0,"percent of total billed charges","78% of total billed charges",30.19,101,,,,,0,"fee schedule","101% of CMS fee schedule ",161.9,82.6,,129.52,,,0,"percent of total billed charges","82.6% of total billed charges",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",161.9,82.6,,129.52,,,0,"percent of total billed charges","82.6% of total billed charges",29.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",17.46,196,
"Therapeutic activities, direct (one-on-one) patient contact",43097530,CDM,430,RC,97530,CPT,OUTPATIENT,,,206,133.9,GO|CO,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",65.36,175,,,,,0,"fee schedule","175% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee sv",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",37.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.36,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.83,100,,,,,0,"fee schedule","100% of LI fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.65,102,,,,,0,"fee schedule","102% of WA fee schedule",28.87,130,,,,,0,"fee schedule","130% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.7% of total billed charges",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.83,33.9,,55.86,,,0,"percent of total billed charges","33.9% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",37.89,101,,,,,0,"fee schedule","101% of CMS fee schedule ",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",37.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",22.21,206,
ULTRASOUND/15MIN/-GO,43097035X,CDM,430,RC,97035,CPT,OUTPATIENT,,,227,147.55,GO,199.76,88,,159.81,,,0,"percent of total billed charges","88% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",24.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee sv",143.01,63,,114.41,,,0,"percent of total billed charges","63% of total billed charges",34.73,15.3,,27.78,,,0,"percent of total billed charges","15.3% of total billed charges",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",156.63,69,,,,,0,"fee schedule","69% of total billed charges",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",14.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.07,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.98,100,,,,,0,"fee schedule","100% of LI fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.71,102,,,,,0,"fee schedule","102% of WA fee schedule",11.1,130,,,,,0,"fee schedule","130% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.58,37.7,,68.46,,,0,"percent of total billed charges","37.7% of total billed charges",85.58,37.7,,68.46,,,0,"percent of total billed charges","37.70% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.95,33.9,,61.56,,,0,"percent of total billed charges","33.9% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",177.06,78,,141.65,,,0,"percent of total billed charges","78% of total billed charges",14.37,101,,,,,0,"fee schedule","101% of CMS fee schedule ",187.5,82.6,,150.00,,,0,"percent of total billed charges","82.6% of total billed charges",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",187.5,82.6,,150.00,,,0,"percent of total billed charges","82.6% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",8.54,227,
"Electrical stimulation (unattended), to one or more areas fo",430G0283,CDM,430,RC,,,OUTPATIENT,,,165,107.25,CO|GO,145.2,88,,116.16,,,0,"percent of total billed charges","88% of total billed charges",82.5,50,,66.00,,,0,"percent of total billed charges","50% of total billed charges",27.72,16.8,,22.18,,,0,"percent of total billed charges","16.8% of total billed charges",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.55,17.304,,22.84,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.95,63,,83.16,,,0,"percent of total billed charges","63% of total billed charges",25.25,15.3,,20.20,,,0,"percent of total billed charges","15.3% of total billed charges",27.72,16.8,,22.18,,,0,"percent of total billed charges","16.8% of total billed charges",113.85,69,,,,,0,"fee schedule","69% of total billed charges",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",102.05,61.85,,81.64,,,0,"percent of total billed charges","61.5% of total billed charges",27.72,16.8,,22.18,,,0,"percent of total billed charges","16.8% of total billed charges",82.5,50,,66.00,,,0,"percent of total billed charges","50% of total billed charges",53.13,32.2,,42.50,,,0,"percent of total billed charges","32.2% of total billed charges",27.72,16.8,,22.18,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.27,17.136,,22.62,,,0,"percent of total billed charges","17.136% of total billed charges",36.04,21.84,,28.83,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.21,37.7,,49.77,,,0,"percent of total billed charges","37.7% of total billed charges",62.21,37.7,,49.77,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",55.94,33.9,,44.75,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.7,78,,102.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.29,82.6,,109.03,,,0,"percent of total billed charges","82.6% of total billed charges",27.72,16.8,,22.18,,,0,"percent of total billed charges","16.8% of total billed charges",82.5,50,,66.00,,,0,"percent of total billed charges","50% of total billed charges",136.29,82.6,,109.03,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.72,16.8,,22.18,,,0,"percent of total billed charges","16.8% of total billed charges",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",25.25,165,
"Application of a modality to 1 or more areas; ultrasound, ea",43097035,CDM,430,RC,97035,CPT,OUTPATIENT,,,239,155.35,CO|GO,210.32,88,,168.26,,,0,"percent of total billed charges","88% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",24.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee sv",150.57,63,,120.46,,,0,"percent of total billed charges","63% of total billed charges",36.57,15.3,,29.26,,,0,"percent of total billed charges","15.3% of total billed charges",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",164.91,69,,,,,0,"fee schedule","69% of total billed charges",239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",14.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.07,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.98,100,,,,,0,"fee schedule","100% of LI fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.71,102,,,,,0,"fee schedule","102% of WA fee schedule",11.1,130,,,,,0,"fee schedule","130% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.1,37.7,,72.08,,,0,"percent of total billed charges","37.7% of total billed charges",90.1,37.7,,72.08,,,0,"percent of total billed charges","37.70% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.02,33.9,,64.82,,,0,"percent of total billed charges","33.9% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",186.42,78,,149.14,,,0,"percent of total billed charges","78% of total billed charges",14.37,101,,,,,0,"fee schedule","101% of CMS fee schedule ",197.41,82.6,,157.93,,,0,"percent of total billed charges","82.6% of total billed charges",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",197.41,82.6,,157.93,,,0,"percent of total billed charges","82.6% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",8.54,239,
"VASOPNEUMATIC DEVICES/-GO",43097016X,CDM,430,RC,97016,CPT,OUTPATIENT,,,142,92.3,GO,124.96,88,,99.97,,,0,"percent of total billed charges","88% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",20.42,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",11.84,100,,,,,0,"fee schedule","100% of CMS fee sv",89.46,63,,71.57,,,0,"percent of total billed charges","63% of total billed charges",21.73,15.3,,17.38,,,0,"percent of total billed charges","15.3% of total billed charges",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",97.98,69,,,,,0,"fee schedule","69% of total billed charges",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",11.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.67,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.63,100,,,,,0,"fee schedule","100% of LI fee schedule",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.97,102,,,,,0,"fee schedule","102% of WA fee schedule",8.88,130,,,,,0,"fee schedule","130% of WA fee schedule",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.53,37.7,,42.82,,,0,"percent of total billed charges","37.7% of total billed charges",53.53,37.7,,42.82,,,0,"percent of total billed charges","37.70% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.14,33.9,,38.51,,,0,"percent of total billed charges","33.9% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",110.76,78,,88.61,,,0,"percent of total billed charges","78% of total billed charges",11.96,101,,,,,0,"fee schedule","101% of CMS fee schedule ",117.29,82.6,,93.83,,,0,"percent of total billed charges","82.6% of total billed charges",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",117.29,82.6,,93.83,,,0,"percent of total billed charges","82.6% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",6.83,142,
WHIRLPOOL/-GO,43097022X,CDM,430,RC,97022,CPT,OUTPATIENT,,,186,120.9,GO,163.68,88,,130.94,,,0,"percent of total billed charges","88% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",30.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee sv",117.18,63,,93.74,,,0,"percent of total billed charges","63% of total billed charges",28.46,15.3,,22.77,,,0,"percent of total billed charges","15.3% of total billed charges",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",128.34,69,,,,,0,"fee schedule","69% of total billed charges",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",17.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.69,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.04,100,,,,,0,"fee schedule","100% of LI fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.46,102,,,,,0,"fee schedule","102% of WA fee schedule",13.33,130,,,,,0,"fee schedule","130% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.12,37.7,,56.10,,,0,"percent of total billed charges","37.7% of total billed charges",70.12,37.7,,56.10,,,0,"percent of total billed charges","37.70% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.05,33.9,,50.44,,,0,"percent of total billed charges","33.9% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",145.08,78,,116.06,,,0,"percent of total billed charges","78% of total billed charges",17.56,101,,,,,0,"fee schedule","101% of CMS fee schedule ",153.64,82.6,,122.91,,,0,"percent of total billed charges","82.6% of total billed charges",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",153.64,82.6,,122.91,,,0,"percent of total billed charges","82.6% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",10.25,186,
WHIRLPOOL/-GO,43097022X,CDM,430,RC,97022,CPT,OUTPATIENT,,,186,120.9,GO,163.68,88,,130.94,,,0,"percent of total billed charges","88% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",30.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee sv",117.18,63,,93.74,,,0,"percent of total billed charges","63% of total billed charges",28.46,15.3,,22.77,,,0,"percent of total billed charges","15.3% of total billed charges",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",128.34,69,,,,,0,"fee schedule","69% of total billed charges",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",17.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.69,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.04,100,,,,,0,"fee schedule","100% of LI fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.46,102,,,,,0,"fee schedule","102% of WA fee schedule",13.33,130,,,,,0,"fee schedule","130% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.12,37.7,,56.10,,,0,"percent of total billed charges","37.7% of total billed charges",70.12,37.7,,56.10,,,0,"percent of total billed charges","37.70% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.05,33.9,,50.44,,,0,"percent of total billed charges","33.9% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",145.08,78,,116.06,,,0,"percent of total billed charges","78% of total billed charges",17.56,101,,,,,0,"fee schedule","101% of CMS fee schedule ",153.64,82.6,,122.91,,,0,"percent of total billed charges","82.6% of total billed charges",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",153.64,82.6,,122.91,,,0,"percent of total billed charges","82.6% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",10.25,186,
"Application of a modality to 1 or more areas; whirlpool",43097022,CDM,430,RC,97022,CPT,OUTPATIENT,,,191,124.15,CO|GO,168.08,88,,134.46,,,0,"percent of total billed charges","88% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",30.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee sv",120.33,63,,96.26,,,0,"percent of total billed charges","63% of total billed charges",29.22,15.3,,23.38,,,0,"percent of total billed charges","15.3% of total billed charges",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",131.79,69,,,,,0,"fee schedule","69% of total billed charges",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",17.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.69,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.04,100,,,,,0,"fee schedule","100% of LI fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.46,102,,,,,0,"fee schedule","102% of WA fee schedule",13.33,130,,,,,0,"fee schedule","130% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.01,37.7,,57.61,,,0,"percent of total billed charges","37.7% of total billed charges",72.01,37.7,,57.61,,,0,"percent of total billed charges","37.70% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.75,33.9,,51.80,,,0,"percent of total billed charges","33.9% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",148.98,78,,119.18,,,0,"percent of total billed charges","78% of total billed charges",17.56,101,,,,,0,"fee schedule","101% of CMS fee schedule ",157.77,82.6,,126.22,,,0,"percent of total billed charges","82.6% of total billed charges",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",157.77,82.6,,126.22,,,0,"percent of total billed charges","82.6% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",10.25,191,
"Electrical stimulation (unattended), to one or more areas fo",430G0283,CDM,430,RC,,,OUTPATIENT,,,165,107.25,CO|GO,145.2,88,,116.16,,,0,"percent of total billed charges","88% of total billed charges",82.5,50,,66.00,,,0,"percent of total billed charges","50% of total billed charges",27.72,16.8,,22.18,,,0,"percent of total billed charges","16.8% of total billed charges",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.55,17.304,,22.84,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.95,63,,83.16,,,0,"percent of total billed charges","63% of total billed charges",25.25,15.3,,20.20,,,0,"percent of total billed charges","15.3% of total billed charges",27.72,16.8,,22.18,,,0,"percent of total billed charges","16.8% of total billed charges",113.85,69,,,,,0,"fee schedule","69% of total billed charges",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",102.05,61.85,,81.64,,,0,"percent of total billed charges","61.5% of total billed charges",27.72,16.8,,22.18,,,0,"percent of total billed charges","16.8% of total billed charges",82.5,50,,66.00,,,0,"percent of total billed charges","50% of total billed charges",53.13,32.2,,42.50,,,0,"percent of total billed charges","32.2% of total billed charges",27.72,16.8,,22.18,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.27,17.136,,22.62,,,0,"percent of total billed charges","17.136% of total billed charges",36.04,21.84,,28.83,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.21,37.7,,49.77,,,0,"percent of total billed charges","37.7% of total billed charges",62.21,37.7,,49.77,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",55.94,33.9,,44.75,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.7,78,,102.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.29,82.6,,109.03,,,0,"percent of total billed charges","82.6% of total billed charges",27.72,16.8,,22.18,,,0,"percent of total billed charges","16.8% of total billed charges",82.5,50,,66.00,,,0,"percent of total billed charges","50% of total billed charges",136.29,82.6,,109.03,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.72,16.8,,22.18,,,0,"percent of total billed charges","16.8% of total billed charges",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",25.25,165,
"Electrical stimulation (unattended), to one or more areas fo",430G0283,CDM,430,RC,,,OUTPATIENT,,,165,107.25,CO|GO,145.2,88,,116.16,,,0,"percent of total billed charges","88% of total billed charges",82.5,50,,66.00,,,0,"percent of total billed charges","50% of total billed charges",27.72,16.8,,22.18,,,0,"percent of total billed charges","16.8% of total billed charges",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.55,17.304,,22.84,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.95,63,,83.16,,,0,"percent of total billed charges","63% of total billed charges",25.25,15.3,,20.20,,,0,"percent of total billed charges","15.3% of total billed charges",27.72,16.8,,22.18,,,0,"percent of total billed charges","16.8% of total billed charges",113.85,69,,,,,0,"fee schedule","69% of total billed charges",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",102.05,61.85,,81.64,,,0,"percent of total billed charges","61.5% of total billed charges",27.72,16.8,,22.18,,,0,"percent of total billed charges","16.8% of total billed charges",82.5,50,,66.00,,,0,"percent of total billed charges","50% of total billed charges",53.13,32.2,,42.50,,,0,"percent of total billed charges","32.2% of total billed charges",27.72,16.8,,22.18,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.27,17.136,,22.62,,,0,"percent of total billed charges","17.136% of total billed charges",36.04,21.84,,28.83,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.21,37.7,,49.77,,,0,"percent of total billed charges","37.7% of total billed charges",62.21,37.7,,49.77,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",55.94,33.9,,44.75,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.7,78,,102.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.29,82.6,,109.03,,,0,"percent of total billed charges","82.6% of total billed charges",27.72,16.8,,22.18,,,0,"percent of total billed charges","16.8% of total billed charges",82.5,50,,66.00,,,0,"percent of total billed charges","50% of total billed charges",136.29,82.6,,109.03,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.72,16.8,,22.18,,,0,"percent of total billed charges","16.8% of total billed charges",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",25.25,165,
"PARAFFIN BATH/-GO",43097018,CDM,430,RC,97018,CPT,OUTPATIENT,,,143,92.95,GO,125.84,88,,100.67,,,0,"percent of total billed charges","88% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",9.75,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee sv",90.09,63,,72.07,,,0,"percent of total billed charges","63% of total billed charges",21.88,15.3,,17.50,,,0,"percent of total billed charges","15.3% of total billed charges",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",98.67,69,,,,,0,"fee schedule","69% of total billed charges",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",5.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.53,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.62,100,,,,,0,"fee schedule","100% of LI fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.49,102,,,,,0,"fee schedule","102% of WA fee schedule",4.45,130,,,,,0,"fee schedule","130% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.91,37.7,,43.13,,,0,"percent of total billed charges","37.7% of total billed charges",53.91,37.7,,43.13,,,0,"percent of total billed charges","37.70% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.48,33.9,,38.78,,,0,"percent of total billed charges","33.9% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",111.54,78,,89.23,,,0,"percent of total billed charges","78% of total billed charges",5.8,101,,,,,0,"fee schedule","101% of CMS fee schedule ",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",3.42,143,
"VASOPNEUMATIC DEVICES/-GO",43097016,CDM,430,RC,97016,CPT,OUTPATIENT,,,142,92.3,GO,124.96,88,,99.97,,,0,"percent of total billed charges","88% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",20.42,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",11.84,100,,,,,0,"fee schedule","100% of CMS fee sv",89.46,63,,71.57,,,0,"percent of total billed charges","63% of total billed charges",21.73,15.3,,17.38,,,0,"percent of total billed charges","15.3% of total billed charges",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",97.98,69,,,,,0,"fee schedule","69% of total billed charges",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",11.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.67,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.63,100,,,,,0,"fee schedule","100% of LI fee schedule",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.97,102,,,,,0,"fee schedule","102% of WA fee schedule",8.88,130,,,,,0,"fee schedule","130% of WA fee schedule",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.53,37.7,,42.82,,,0,"percent of total billed charges","37.7% of total billed charges",53.53,37.7,,42.82,,,0,"percent of total billed charges","37.70% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.14,33.9,,38.51,,,0,"percent of total billed charges","33.9% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",110.76,78,,88.61,,,0,"percent of total billed charges","78% of total billed charges",11.96,101,,,,,0,"fee schedule","101% of CMS fee schedule ",117.29,82.6,,93.83,,,0,"percent of total billed charges","82.6% of total billed charges",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",117.29,82.6,,93.83,,,0,"percent of total billed charges","82.6% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",6.83,142,
"Application of a modality to 1 or more areas; hot or cold pa",43097010,CDM,430,RC,97010,CPT,OUTPATIENT,,,37,24.05,,32.56,88,,26.05,,,0,"percent of total billed charges","88% of total billed charges",6.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.1,100,,,,,0,"fee schedule",EAPG,37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",10.96,175,,,,,0,"fee schedule","175% of CMS fee schedule",29.97,100,,,,,0,"fee schedule",EAPG,6.43,100,,,,,0,"fee schedule","100% of CMS fee sv",23.31,63,,18.65,,,0,"percent of total billed charges","63% of total billed charges",5.66,15.3,,4.53,,,0,"percent of total billed charges","15.3% of total billed charges",29.1,100,,,,,0,"fee schedule",EAPG,25.53,69,,,,,0,"fee schedule","69% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",6.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",6.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",6.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.87,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",29.1,100,,,,,0,"fee schedule",EAPG,6.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.29,100,,,,,0,"fee schedule","100% of LI fee schedule",21.55,100,,,,,0,"fee schedule",EAPG,6.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.68,100,,,,,0,"fee schedule",EAPG,37.83,100,,,,,0,"fee schedule",EAPG,6.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.95,37.7,,11.16,,,0,"percent of total billed charges","37.7% of total billed charges",13.95,37.7,,11.16,,,0,"percent of total billed charges","37.70% of total billed charges",6.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.54,33.9,,10.03,,,0,"percent of total billed charges","33.9% of total billed charges",6.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.86,78,,23.09,,,0,"percent of total billed charges","78% of total billed charges",6.49,101,,,,,0,"fee schedule","101% of CMS fee schedule ",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",29.1,100,,,,,0,"fee schedule",EAPG,6.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",6.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.1,100,,,,,0,"fee schedule",EAPG,37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",5.66,37.83,
WHIRLPOOL/-GO,43097022,CDM,430,RC,97022,CPT,OUTPATIENT,,,186,120.9,CO|GO,163.68,88,,130.94,,,0,"percent of total billed charges","88% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",30.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee sv",117.18,63,,93.74,,,0,"percent of total billed charges","63% of total billed charges",28.46,15.3,,22.77,,,0,"percent of total billed charges","15.3% of total billed charges",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",128.34,69,,,,,0,"fee schedule","69% of total billed charges",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",17.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.69,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.04,100,,,,,0,"fee schedule","100% of LI fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.46,102,,,,,0,"fee schedule","102% of WA fee schedule",13.33,130,,,,,0,"fee schedule","130% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.12,37.7,,56.10,,,0,"percent of total billed charges","37.7% of total billed charges",70.12,37.7,,56.10,,,0,"percent of total billed charges","37.70% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.05,33.9,,50.44,,,0,"percent of total billed charges","33.9% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",145.08,78,,116.06,,,0,"percent of total billed charges","78% of total billed charges",17.56,101,,,,,0,"fee schedule","101% of CMS fee schedule ",153.64,82.6,,122.91,,,0,"percent of total billed charges","82.6% of total billed charges",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",153.64,82.6,,122.91,,,0,"percent of total billed charges","82.6% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",10.25,186,
ULTRASOUND/15MIN/-GO,43097035,CDM,430,RC,97035,CPT,OUTPATIENT,,,227,147.55,CO|GO,199.76,88,,159.81,,,0,"percent of total billed charges","88% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",24.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee sv",143.01,63,,114.41,,,0,"percent of total billed charges","63% of total billed charges",34.73,15.3,,27.78,,,0,"percent of total billed charges","15.3% of total billed charges",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",156.63,69,,,,,0,"fee schedule","69% of total billed charges",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",14.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.07,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.98,100,,,,,0,"fee schedule","100% of LI fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.71,102,,,,,0,"fee schedule","102% of WA fee schedule",11.1,130,,,,,0,"fee schedule","130% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.58,37.7,,68.46,,,0,"percent of total billed charges","37.7% of total billed charges",85.58,37.7,,68.46,,,0,"percent of total billed charges","37.70% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.95,33.9,,61.56,,,0,"percent of total billed charges","33.9% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",177.06,78,,141.65,,,0,"percent of total billed charges","78% of total billed charges",14.37,101,,,,,0,"fee schedule","101% of CMS fee schedule ",187.5,82.6,,150.00,,,0,"percent of total billed charges","82.6% of total billed charges",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",187.5,82.6,,150.00,,,0,"percent of total billed charges","82.6% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",8.54,227,
"ELEC STIM MAN/15MIN/-GO",43097032,CDM,430,RC,97032,CPT,OUTPATIENT,,,202,131.3,GO,177.76,88,,142.21,,,0,"percent of total billed charges","88% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",25.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee sv",127.26,63,,101.81,,,0,"percent of total billed charges","63% of total billed charges",30.91,15.3,,24.73,,,0,"percent of total billed charges","15.3% of total billed charges",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",139.38,69,,,,,0,"fee schedule","69% of total billed charges",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",14.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.3,100,,,,,0,"fee schedule","100% of LI fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.52,102,,,,,0,"fee schedule","102% of WA fee schedule",10.86,130,,,,,0,"fee schedule","130% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.15,37.7,,60.92,,,0,"percent of total billed charges","37.7% of total billed charges",76.15,37.7,,60.92,,,0,"percent of total billed charges","37.70% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.48,33.9,,54.78,,,0,"percent of total billed charges","33.9% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",157.56,78,,126.05,,,0,"percent of total billed charges","78% of total billed charges",14.68,101,,,,,0,"fee schedule","101% of CMS fee schedule ",166.85,82.6,,133.48,,,0,"percent of total billed charges","82.6% of total billed charges",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",166.85,82.6,,133.48,,,0,"percent of total billed charges","82.6% of total billed charges",14.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",8.35,202,
IONTOPHORESIS/15MIN/-GO,43097033,CDM,430,RC,97033,CPT,OUTPATIENT,,,201,130.65,GO,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",34.2,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee sv",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",19.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of LI fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.01,102,,,,,0,"fee schedule","102% of WA fee schedule",15.3,130,,,,,0,"fee schedule","130% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.7% of total billed charges",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.14,33.9,,54.51,,,0,"percent of total billed charges","33.9% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",19.91,101,,,,,0,"fee schedule","101% of CMS fee schedule ",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",19.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",11.77,201,
"CONTRAST BATH/15MIN/-GO",43097034,CDM,430,RC,97034,CPT,OUTPATIENT,,,112,72.8,GO,98.56,88,,78.85,,,0,"percent of total billed charges","88% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",24.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee sv",70.56,63,,56.45,,,0,"percent of total billed charges","63% of total billed charges",17.14,15.3,,13.71,,,0,"percent of total billed charges","15.3% of total billed charges",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",77.28,69,,,,,0,"fee schedule","69% of total billed charges",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",14.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.41,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.98,100,,,,,0,"fee schedule","100% of LI fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.71,102,,,,,0,"fee schedule","102% of WA fee schedule",11.1,130,,,,,0,"fee schedule","130% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.22,37.7,,33.78,,,0,"percent of total billed charges","37.7% of total billed charges",42.22,37.7,,33.78,,,0,"percent of total billed charges","37.70% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.97,33.9,,30.38,,,0,"percent of total billed charges","33.9% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.36,78,,69.89,,,0,"percent of total billed charges","78% of total billed charges",14.37,101,,,,,0,"fee schedule","101% of CMS fee schedule ",92.51,82.6,,74.01,,,0,"percent of total billed charges","82.6% of total billed charges",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.51,82.6,,74.01,,,0,"percent of total billed charges","82.6% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",8.54,112,
"NEUROMUSC RE-ED/15MIN/-GO",43097112,CDM,430,RC,97112,CPT,OUTPATIENT,,,228,148.2,GO,200.64,88,,160.51,,,0,"percent of total billed charges","88% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",59.8,175,,,,,0,"fee schedule","175% of CMS fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee sv",143.64,63,,114.91,,,0,"percent of total billed charges","63% of total billed charges",34.88,15.3,,27.90,,,0,"percent of total billed charges","15.3% of total billed charges",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",157.32,69,,,,,0,"fee schedule","69% of total billed charges",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",34.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",135.02,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.76,100,,,,,0,"fee schedule","100% of LI fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.33,102,,,,,0,"fee schedule","102% of WA fee schedule",25.91,130,,,,,0,"fee schedule","130% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.96,37.7,,68.77,,,0,"percent of total billed charges","37.7% of total billed charges",85.96,37.7,,68.77,,,0,"percent of total billed charges","37.70% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.29,33.9,,61.83,,,0,"percent of total billed charges","33.9% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",177.84,78,,142.27,,,0,"percent of total billed charges","78% of total billed charges",34.67,101,,,,,0,"fee schedule","101% of CMS fee schedule ",188.33,82.6,,150.66,,,0,"percent of total billed charges","82.6% of total billed charges",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",188.33,82.6,,150.66,,,0,"percent of total billed charges","82.6% of total billed charges",34.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",19.93,228,
"THERA EXERCISE/15MIN/-GO",43097110,CDM,430,RC,97110,CPT,OUTPATIENT,,,181,117.65,CO|GO,159.28,88,,127.42,,,0,"percent of total billed charges","88% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",52.01,175,,,,,0,"fee schedule","175% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee sv",114.03,63,,91.22,,,0,"percent of total billed charges","63% of total billed charges",27.69,15.3,,22.15,,,0,"percent of total billed charges","15.3% of total billed charges",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",124.89,69,,,,,0,"fee schedule","69% of total billed charges",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",29.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",116.17,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.4,100,,,,,0,"fee schedule","100% of LI fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.81,102,,,,,0,"fee schedule","102% of WA fee schedule",22.7,130,,,,,0,"fee schedule","130% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.24,37.7,,54.59,,,0,"percent of total billed charges","37.7% of total billed charges",68.24,37.7,,54.59,,,0,"percent of total billed charges","37.70% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.36,33.9,,49.09,,,0,"percent of total billed charges","33.9% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",141.18,78,,112.94,,,0,"percent of total billed charges","78% of total billed charges",30.19,101,,,,,0,"fee schedule","101% of CMS fee schedule ",149.51,82.6,,119.61,,,0,"percent of total billed charges","82.6% of total billed charges",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",149.51,82.6,,119.61,,,0,"percent of total billed charges","82.6% of total billed charges",29.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",17.46,181,
"MASSAGE EA 15MIN/-GO",43097124,CDM,430,RC,97124,CPT,OUTPATIENT,,,119,77.35,GO,104.72,88,,83.78,,,0,"percent of total billed charges","88% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",54.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee sv",74.97,63,,59.98,,,0,"percent of total billed charges","63% of total billed charges",18.21,15.3,,14.57,,,0,"percent of total billed charges","15.3% of total billed charges",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",82.11,69,,,,,0,"fee schedule","69% of total billed charges",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",30.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.46,100,,,,,0,"fee schedule","100% of LI fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.2,102,,,,,0,"fee schedule","102% of WA fee schedule",23.19,130,,,,,0,"fee schedule","130% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.7% of total billed charges",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.70% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.34,33.9,,32.27,,,0,"percent of total billed charges","33.9% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.82,78,,74.26,,,0,"percent of total billed charges","78% of total billed charges",31.34,101,,,,,0,"fee schedule","101% of CMS fee schedule ",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",31.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",17.84,119,
"OT Cognitive Skills Development Initial 15 min",43097129,CDM,430,RC,97129,CPT,OUTPATIENT,,,261,169.65,CO|GO,229.68,88,,183.74,,,0,"percent of total billed charges","88% of total billed charges",22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,261,100,,208.80,,,0,"percent of total billed charges","100% of total billed charges",38.59,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.83,100,,,,,0,"fee schedule",EAPG,22.22,100,,,,,0,"fee schedule","100% of CMS fee sv",164.43,63,,131.54,,,0,"percent of total billed charges","63% of total billed charges",39.93,15.3,,31.94,,,0,"percent of total billed charges","15.3% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,180.09,69,,,,,0,"fee schedule","69% of total billed charges",261,100,,208.80,,,0,"percent of total billed charges","100% of total billed charges",22.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",261,100,,208.80,,,0,"percent of total billed charges","100% of total billed charges",22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",261,100,,208.80,,,0,"percent of total billed charges","100% of total billed charges",22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.01,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.95,100,,,,,0,"fee schedule","100% of LI fee schedule",25.77,100,,,,,0,"fee schedule",EAPG,22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.48,100,,,,,0,"fee schedule",EAPG,45.23,100,,,,,0,"fee schedule",EAPG,22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.4,37.7,,78.72,,,0,"percent of total billed charges","37.7% of total billed charges",98.4,37.7,,78.72,,,0,"percent of total billed charges","37.70% of total billed charges",22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.48,33.9,,70.78,,,0,"percent of total billed charges","33.9% of total billed charges",22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",203.58,78,,162.86,,,0,"percent of total billed charges","78% of total billed charges",22.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",215.59,82.6,,172.47,,,0,"percent of total billed charges","82.6% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",215.59,82.6,,172.47,,,0,"percent of total billed charges","82.6% of total billed charges",22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,261,100,,208.80,,,0,"percent of total billed charges","100% of total billed charges",21.95,261,
"OT Cognitive Skills Development Each add 15",43097130,CDM,430,RC,97130,CPT,OUTPATIENT,,,151,98.15,CO|GO,132.88,88,,106.30,,,0,"percent of total billed charges","88% of total billed charges",21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",36.8,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.83,100,,,,,0,"fee schedule",EAPG,21.2,100,,,,,0,"fee schedule","100% of CMS fee sv",95.13,63,,76.10,,,0,"percent of total billed charges","63% of total billed charges",23.1,15.3,,18.48,,,0,"percent of total billed charges","15.3% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,104.19,69,,,,,0,"fee schedule","69% of total billed charges",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",21.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",84.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.95,100,,,,,0,"fee schedule","100% of LI fee schedule",25.77,100,,,,,0,"fee schedule",EAPG,21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.48,100,,,,,0,"fee schedule",EAPG,45.23,100,,,,,0,"fee schedule",EAPG,21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.93,37.7,,45.54,,,0,"percent of total billed charges","37.7% of total billed charges",56.93,37.7,,45.54,,,0,"percent of total billed charges","37.70% of total billed charges",21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.19,33.9,,40.95,,,0,"percent of total billed charges","33.9% of total billed charges",21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",117.78,78,,94.22,,,0,"percent of total billed charges","78% of total billed charges",21.41,101,,,,,0,"fee schedule","101% of CMS fee schedule ",124.73,82.6,,99.78,,,0,"percent of total billed charges","82.6% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.73,82.6,,99.78,,,0,"percent of total billed charges","82.6% of total billed charges",21.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",20.95,151,
"MANUAL THERAPY/15MIN/-GO",43097140,CDM,430,RC,97140,CPT,OUTPATIENT,,,269,174.85,GO,236.72,88,,189.38,,,0,"percent of total billed charges","88% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",47.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee sv",169.47,63,,135.58,,,0,"percent of total billed charges","63% of total billed charges",41.16,15.3,,32.93,,,0,"percent of total billed charges","15.3% of total billed charges",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",185.61,69,,,,,0,"fee schedule","69% of total billed charges",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",27.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.72,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.05,100,,,,,0,"fee schedule","100% of LI fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.26,102,,,,,0,"fee schedule","102% of WA fee schedule",20.72,130,,,,,0,"fee schedule","130% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.41,37.7,,81.13,,,0,"percent of total billed charges","37.7% of total billed charges",101.41,37.7,,81.13,,,0,"percent of total billed charges","37.70% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.19,33.9,,72.95,,,0,"percent of total billed charges","33.9% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",209.82,78,,167.86,,,0,"percent of total billed charges","78% of total billed charges",27.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",222.19,82.6,,177.75,,,0,"percent of total billed charges","82.6% of total billed charges",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",222.19,82.6,,177.75,,,0,"percent of total billed charges","82.6% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",15.94,269,
"OT EVAL- HGH COMP",43497167,CDM,434,RC,97167,CPT,OUTPATIENT,,,403,261.95,GO,354.64,88,,283.71,,,0,"percent of total billed charges","88% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",179.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee sv",253.89,63,,203.11,,,0,"percent of total billed charges","63% of total billed charges",61.66,15.3,,49.33,,,0,"percent of total billed charges","15.3% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",278.07,69,,,,,0,"fee schedule","69% of total billed charges",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",102.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",378.29,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.53,100,,,,,0,"fee schedule","100% of LI fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.4,102,,,,,0,"fee schedule","102% of WA fee schedule",76.99,130,,,,,0,"fee schedule","130% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.7% of total billed charges",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.70% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.62,33.9,,109.30,,,0,"percent of total billed charges","33.9% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",314.34,78,,251.47,,,0,"percent of total billed charges","78% of total billed charges",104.26,101,,,,,0,"fee schedule","101% of CMS fee schedule ",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",103.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",59.22,403,
"OT EVAL- LOW COMP",43497165,CDM,434,RC,97165,CPT,OUTPATIENT,,,403,261.95,GO,354.64,88,,283.71,,,0,"percent of total billed charges","88% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",179.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee sv",253.89,63,,203.11,,,0,"percent of total billed charges","63% of total billed charges",61.66,15.3,,49.33,,,0,"percent of total billed charges","15.3% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",278.07,69,,,,,0,"fee schedule","69% of total billed charges",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",102.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",378.29,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.53,100,,,,,0,"fee schedule","100% of LI fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.4,102,,,,,0,"fee schedule","102% of WA fee schedule",76.99,130,,,,,0,"fee schedule","130% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.7% of total billed charges",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.70% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.62,33.9,,109.30,,,0,"percent of total billed charges","33.9% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",314.34,78,,251.47,,,0,"percent of total billed charges","78% of total billed charges",104.26,101,,,,,0,"fee schedule","101% of CMS fee schedule ",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",103.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",59.22,403,
"OT EVAL- MOD COMP",43497166,CDM,434,RC,97166,CPT,OUTPATIENT,,,403,261.95,GO,354.64,88,,283.71,,,0,"percent of total billed charges","88% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",179.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee sv",253.89,63,,203.11,,,0,"percent of total billed charges","63% of total billed charges",61.66,15.3,,49.33,,,0,"percent of total billed charges","15.3% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",278.07,69,,,,,0,"fee schedule","69% of total billed charges",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",102.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",378.29,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.53,100,,,,,0,"fee schedule","100% of LI fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.4,102,,,,,0,"fee schedule","102% of WA fee schedule",76.99,130,,,,,0,"fee schedule","130% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.7% of total billed charges",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.70% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.62,33.9,,109.30,,,0,"percent of total billed charges","33.9% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",314.34,78,,251.47,,,0,"percent of total billed charges","78% of total billed charges",104.26,101,,,,,0,"fee schedule","101% of CMS fee schedule ",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",103.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",59.22,403,
"OT RE-EVAL/-GO",43497168,CDM,434,RC,97168,CPT,OUTPATIENT,,,264,171.6,GO,232.32,88,,185.86,,,0,"percent of total billed charges","88% of total billed charges",71.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",41,100,,,,,0,"fee schedule","100% of WA fee schedule",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",124.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule","100% of WA fee schedule",71.4,100,,,,,0,"fee schedule","100% of CMS fee sv",166.32,63,,133.06,,,0,"percent of total billed charges","63% of total billed charges",40.39,15.3,,32.31,,,0,"percent of total billed charges","15.3% of total billed charges",41,100,,,,,0,"fee schedule","100% of WA fee schedule",182.16,69,,,,,0,"fee schedule","69% of total billed charges",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",70.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",71.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",71.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",255.24,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",41,100,,,,,0,"fee schedule","100% of WA fee schedule",71.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.16,100,,,,,0,"fee schedule","100% of LI fee schedule",41,100,,,,,0,"fee schedule","100% of WA fee schedule",71.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.82,102,,,,,0,"fee schedule","102% of WA fee schedule",53.3,130,,,,,0,"fee schedule","130% of WA fee schedule",71.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.53,37.7,,79.62,,,0,"percent of total billed charges","37.7% of total billed charges",99.53,37.7,,79.62,,,0,"percent of total billed charges","37.70% of total billed charges",71.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.5,33.9,,71.60,,,0,"percent of total billed charges","33.9% of total billed charges",71.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",205.92,78,,164.74,,,0,"percent of total billed charges","78% of total billed charges",72.11,101,,,,,0,"fee schedule","101% of CMS fee schedule ",218.06,82.6,,174.45,,,0,"percent of total billed charges","82.6% of total billed charges",41,100,,,,,0,"fee schedule","100% of WA fee schedule",71.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",218.06,82.6,,174.45,,,0,"percent of total billed charges","82.6% of total billed charges",71.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",41,100,,,,,0,"fee schedule","100% of WA fee schedule",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",40.39,264,
"ACT DAILY LIV/15MIN/-GO",43097535,CDM,430,RC,97535,CPT,OUTPATIENT,,,150,97.5,GO,132,88,,105.60,,,0,"percent of total billed charges","88% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",58.07,175,,,,,0,"fee schedule","175% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee sv",94.5,63,,75.60,,,0,"percent of total billed charges","63% of total billed charges",22.95,15.3,,18.36,,,0,"percent of total billed charges","15.3% of total billed charges",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",103.5,69,,,,,0,"fee schedule","69% of total billed charges",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",33.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.71,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.77,100,,,,,0,"fee schedule","100% of LI fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.75,102,,,,,0,"fee schedule","102% of WA fee schedule",25.17,130,,,,,0,"fee schedule","130% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.7% of total billed charges",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.70% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.85,33.9,,40.68,,,0,"percent of total billed charges","33.9% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",117,78,,93.60,,,0,"percent of total billed charges","78% of total billed charges",33.68,101,,,,,0,"fee schedule","101% of CMS fee schedule ",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",33.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",19.36,150,
"THERAPEUTIC ACT/15MIN/-GO",43097530,CDM,430,RC,97530,CPT,OUTPATIENT,,,206,133.9,GO|CO,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",65.36,175,,,,,0,"fee schedule","175% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee sv",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",37.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.36,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.83,100,,,,,0,"fee schedule","100% of LI fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.65,102,,,,,0,"fee schedule","102% of WA fee schedule",28.87,130,,,,,0,"fee schedule","130% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.7% of total billed charges",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.83,33.9,,55.86,,,0,"percent of total billed charges","33.9% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",37.89,101,,,,,0,"fee schedule","101% of CMS fee schedule ",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",37.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",22.21,206,
"SENSORY INTEGRATION/GO",43097533,CDM,430,RC,97533,CPT,OUTPATIENT,,,267,173.55,GO,234.96,88,,187.97,,,0,"percent of total billed charges","88% of total billed charges",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.15,100,,,,,0,"fee schedule","100% of WA fee schedule",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",111.93,175,,,,,0,"fee schedule","175% of CMS fee schedule",38.15,100,,,,,0,"fee schedule","100% of WA fee schedule",64.13,100,,,,,0,"fee schedule","100% of CMS fee sv",168.21,63,,134.57,,,0,"percent of total billed charges","63% of total billed charges",40.85,15.3,,32.68,,,0,"percent of total billed charges","15.3% of total billed charges",38.15,100,,,,,0,"fee schedule","100% of WA fee schedule",184.23,69,,,,,0,"fee schedule","69% of total billed charges",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",63.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",233.86,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",38.15,100,,,,,0,"fee schedule","100% of WA fee schedule",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.8,100,,,,,0,"fee schedule","100% of LI fee schedule",38.15,100,,,,,0,"fee schedule","100% of WA fee schedule",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.91,102,,,,,0,"fee schedule","102% of WA fee schedule",49.6,130,,,,,0,"fee schedule","130% of WA fee schedule",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.66,37.7,,80.53,,,0,"percent of total billed charges","37.7% of total billed charges",100.66,37.7,,80.53,,,0,"percent of total billed charges","37.70% of total billed charges",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.51,33.9,,72.41,,,0,"percent of total billed charges","33.9% of total billed charges",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",208.26,78,,166.61,,,0,"percent of total billed charges","78% of total billed charges",64.77,101,,,,,0,"fee schedule","101% of CMS fee schedule ",220.54,82.6,,176.43,,,0,"percent of total billed charges","82.6% of total billed charges",38.15,100,,,,,0,"fee schedule","100% of WA fee schedule",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",220.54,82.6,,176.43,,,0,"percent of total billed charges","82.6% of total billed charges",64.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.15,100,,,,,0,"fee schedule","100% of WA fee schedule",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",38.15,267,
"COMM/WORK REINT/15MIN/-GO",43097537,CDM,430,RC,97537,CPT,OUTPATIENT,,,280,182,GO,246.4,88,,197.12,,,0,"percent of total billed charges","88% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",56.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee sv",176.4,63,,141.12,,,0,"percent of total billed charges","63% of total billed charges",42.84,15.3,,34.27,,,0,"percent of total billed charges","15.3% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",193.2,69,,,,,0,"fee schedule","69% of total billed charges",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",32.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.24,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.75,100,,,,,0,"fee schedule","100% of LI fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.17,102,,,,,0,"fee schedule","102% of WA fee schedule",24.43,130,,,,,0,"fee schedule","130% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",105.56,37.7,,84.45,,,0,"percent of total billed charges","37.7% of total billed charges",105.56,37.7,,84.45,,,0,"percent of total billed charges","37.70% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",94.92,33.9,,75.94,,,0,"percent of total billed charges","33.9% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",218.4,78,,174.72,,,0,"percent of total billed charges","78% of total billed charges",32.6,101,,,,,0,"fee schedule","101% of CMS fee schedule ",231.28,82.6,,185.02,,,0,"percent of total billed charges","82.6% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",231.28,82.6,,185.02,,,0,"percent of total billed charges","82.6% of total billed charges",32.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",18.79,280,
"SELECT DEBRIDE/20 CM OR < GO",43097597,CDM,430,RC,97597,CPT,OUTPATIENT,,,737,479.05,GO,648.56,88,,518.85,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",464.31,63,,371.45,,,0,"percent of total billed charges","63% of total billed charges",112.76,15.3,,90.21,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,508.53,69,,,,,0,"fee schedule","69% of total billed charges",737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.85,37.7,,222.28,,,0,"percent of total billed charges","37.7% of total billed charges",277.85,37.7,,222.28,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",249.84,33.9,,199.87,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",574.86,78,,459.89,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",608.76,82.6,,487.01,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",608.76,82.6,,487.01,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",112.76,737,
"SELECT DEBRIDE > 20 CM GO",43097598,CDM,430,RC,97598,CPT,OUTPATIENT,,,955,620.75,GO,840.4,88,,672.32,,,0,"percent of total billed charges","88% of total billed charges",477.5,50,,382.00,,,0,"percent of total billed charges","50% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",930.95,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",601.65,63,,481.32,,,0,"percent of total billed charges","63% of total billed charges",146.12,15.3,,116.90,,,0,"percent of total billed charges","15.3% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,658.95,69,,,,,0,"fee schedule","69% of total billed charges",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.67,61.85,,472.54,,,0,"percent of total billed charges","61.5% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,477.5,50,,382.00,,,0,"percent of total billed charges","50% of total billed charges",307.51,32.2,,246.01,,,0,"percent of total billed charges","32.2% of total billed charges",669.51,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",921.91,100,,,,,0,"fee schedule",EAPG,1174.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",360.04,37.7,,288.03,,,0,"percent of total billed charges","37.7% of total billed charges",360.04,37.7,,288.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",323.75,33.9,,259.00,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",744.9,78,,595.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",788.83,82.6,,631.06,,,0,"percent of total billed charges","82.6% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,477.5,50,,382.00,,,0,"percent of total billed charges","50% of total billed charges",788.83,82.6,,631.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",903.83,100,,,,,0,"fee schedule",EAPG,955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",146.12,1174.99,
"DEBRIDEMENT NON-SELCT/SESS/-GO",43097602,CDM,430,RC,97602,CPT,OUTPATIENT,,,737,479.05,GO,648.56,88,,518.85,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",464.31,63,,371.45,,,0,"percent of total billed charges","63% of total billed charges",112.76,15.3,,90.21,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,508.53,69,,,,,0,"fee schedule","69% of total billed charges",737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.85,37.7,,222.28,,,0,"percent of total billed charges","37.7% of total billed charges",277.85,37.7,,222.28,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",249.84,33.9,,199.87,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",574.86,78,,459.89,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",608.76,82.6,,487.01,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",608.76,82.6,,487.01,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",112.76,737,
"DEBRIDEMENT NON-SELCT/SESS/-GO",43097602,CDM,430,RC,97602,CPT,OUTPATIENT,,,737,479.05,GO,648.56,88,,518.85,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",464.31,63,,371.45,,,0,"percent of total billed charges","63% of total billed charges",112.76,15.3,,90.21,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,508.53,69,,,,,0,"fee schedule","69% of total billed charges",737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.85,37.7,,222.28,,,0,"percent of total billed charges","37.7% of total billed charges",277.85,37.7,,222.28,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",249.84,33.9,,199.87,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",574.86,78,,459.89,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",608.76,82.6,,487.01,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",608.76,82.6,,487.01,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",112.76,737,
"FUNCT CAP TEST/15MIN/-GO",43097750,CDM,430,RC,97750,CPT,OUTPATIENT,,,233,151.45,GO,205.04,88,,164.03,,,0,"percent of total billed charges","88% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",233,100,,186.40,,,0,"percent of total billed charges","100% of total billed charges",60.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee sv",146.79,63,,117.43,,,0,"percent of total billed charges","63% of total billed charges",35.65,15.3,,28.52,,,0,"percent of total billed charges","15.3% of total billed charges",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",160.77,69,,,,,0,"fee schedule","69% of total billed charges",233,100,,186.40,,,0,"percent of total billed charges","100% of total billed charges",34.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",233,100,,186.40,,,0,"percent of total billed charges","100% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",233,100,,186.40,,,0,"percent of total billed charges","100% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",132.38,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.12,100,,,,,0,"fee schedule","100% of LI fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.52,102,,,,,0,"fee schedule","102% of WA fee schedule",26.16,130,,,,,0,"fee schedule","130% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.84,37.7,,70.27,,,0,"percent of total billed charges","37.7% of total billed charges",87.84,37.7,,70.27,,,0,"percent of total billed charges","37.70% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.99,33.9,,63.19,,,0,"percent of total billed charges","33.9% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",181.74,78,,145.39,,,0,"percent of total billed charges","78% of total billed charges",35.08,101,,,,,0,"fee schedule","101% of CMS fee schedule ",192.46,82.6,,153.97,,,0,"percent of total billed charges","82.6% of total billed charges",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",192.46,82.6,,153.97,,,0,"percent of total billed charges","82.6% of total billed charges",34.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",233,100,,186.40,,,0,"percent of total billed charges","100% of total billed charges",20.12,233,
"ORTHOTIC MGMT EA 15M OT",43097760,CDM,430,RC,97760,CPT,OUTPATIENT,,,175,113.75,GO,154,88,,123.20,,,0,"percent of total billed charges","88% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",85.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee sv",110.25,63,,88.20,,,0,"percent of total billed charges","63% of total billed charges",26.78,15.3,,21.42,,,0,"percent of total billed charges","15.3% of total billed charges",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",120.75,69,,,,,0,"fee schedule","69% of total billed charges",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",48.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",193.2,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.94,100,,,,,0,"fee schedule","100% of LI fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.62,102,,,,,0,"fee schedule","102% of WA fee schedule",37.75,130,,,,,0,"fee schedule","130% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.98,37.7,,52.78,,,0,"percent of total billed charges","37.7% of total billed charges",65.98,37.7,,52.78,,,0,"percent of total billed charges","37.70% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.33,33.9,,47.46,,,0,"percent of total billed charges","33.9% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.5,78,,109.20,,,0,"percent of total billed charges","78% of total billed charges",49.36,101,,,,,0,"fee schedule","101% of CMS fee schedule ",144.55,82.6,,115.64,,,0,"percent of total billed charges","82.6% of total billed charges",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.55,82.6,,115.64,,,0,"percent of total billed charges","82.6% of total billed charges",48.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",26.78,193.2,
"ORTH/PROS CHECKOUT EST 15M GO",43097763,CDM,430,RC,97763,CPT,OUTPATIENT,,,184,119.6,GO,161.92,88,,129.54,,,0,"percent of total billed charges","88% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",93.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.83,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee sv",115.92,63,,92.74,,,0,"percent of total billed charges","63% of total billed charges",28.15,15.3,,22.52,,,0,"percent of total billed charges","15.3% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,126.96,69,,,,,0,"fee schedule","69% of total billed charges",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",53.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",212.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.67,100,,,,,0,"fee schedule","100% of LI fee schedule",25.77,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.48,100,,,,,0,"fee schedule",EAPG,45.23,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.37,37.7,,55.50,,,0,"percent of total billed charges","37.7% of total billed charges",69.37,37.7,,55.50,,,0,"percent of total billed charges","37.70% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.38,33.9,,49.90,,,0,"percent of total billed charges","33.9% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",143.52,78,,114.82,,,0,"percent of total billed charges","78% of total billed charges",54.28,101,,,,,0,"fee schedule","101% of CMS fee schedule ",151.98,82.6,,121.58,,,0,"percent of total billed charges","82.6% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.98,82.6,,121.58,,,0,"percent of total billed charges","82.6% of total billed charges",53.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",25.77,212.21,
"Qualified nonphysician healthcare professional online assess",43098971,CDM,430,RC,98971,CPT,OUTPATIENT,,,98,63.7,GO,86.24,88,,68.99,,,0,"percent of total billed charges","88% of total billed charges",20.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",35.86,175,,,,,0,"fee schedule","175% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",20.82,100,,,,,0,"fee schedule","100% of CMS fee sv",61.74,63,,49.39,,,0,"percent of total billed charges","63% of total billed charges",14.99,15.3,,11.99,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.62,69,,,,,0,"fee schedule","69% of total billed charges",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",20.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",20.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",20.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.3,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",20.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.54,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",20.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.95,37.7,,29.56,,,0,"percent of total billed charges","37.7% of total billed charges",36.95,37.7,,29.56,,,0,"percent of total billed charges","37.70% of total billed charges",20.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.22,33.9,,26.58,,,0,"percent of total billed charges","33.9% of total billed charges",20.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.44,78,,61.15,,,0,"percent of total billed charges","78% of total billed charges",21.03,101,,,,,0,"fee schedule","101% of CMS fee schedule ",80.95,82.6,,64.76,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.95,82.6,,64.76,,,0,"percent of total billed charges","82.6% of total billed charges",20.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.46,16.8,,13.17,,,0,"percent of total billed charges","16.8% of total billed charges",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",14.99,98,
"ACT DAILY LIV/15MIN/-GO",43097535X,CDM,430,RC,97535,CPT,OUTPATIENT,,,150,97.5,GO,132,88,,105.60,,,0,"percent of total billed charges","88% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",58.07,175,,,,,0,"fee schedule","175% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee sv",94.5,63,,75.60,,,0,"percent of total billed charges","63% of total billed charges",22.95,15.3,,18.36,,,0,"percent of total billed charges","15.3% of total billed charges",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",103.5,69,,,,,0,"fee schedule","69% of total billed charges",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",33.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.71,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.77,100,,,,,0,"fee schedule","100% of LI fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.75,102,,,,,0,"fee schedule","102% of WA fee schedule",25.17,130,,,,,0,"fee schedule","130% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.7% of total billed charges",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.70% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.85,33.9,,40.68,,,0,"percent of total billed charges","33.9% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",117,78,,93.60,,,0,"percent of total billed charges","78% of total billed charges",33.68,101,,,,,0,"fee schedule","101% of CMS fee schedule ",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",33.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",19.36,150,
"ELEC STIM MAN/15MIN/-GO",43097032X,CDM,430,RC,97032,CPT,OUTPATIENT,,,202,131.3,GO,177.76,88,,142.21,,,0,"percent of total billed charges","88% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",25.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee sv",127.26,63,,101.81,,,0,"percent of total billed charges","63% of total billed charges",30.91,15.3,,24.73,,,0,"percent of total billed charges","15.3% of total billed charges",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",139.38,69,,,,,0,"fee schedule","69% of total billed charges",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",14.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.3,100,,,,,0,"fee schedule","100% of LI fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.52,102,,,,,0,"fee schedule","102% of WA fee schedule",10.86,130,,,,,0,"fee schedule","130% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.15,37.7,,60.92,,,0,"percent of total billed charges","37.7% of total billed charges",76.15,37.7,,60.92,,,0,"percent of total billed charges","37.70% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.48,33.9,,54.78,,,0,"percent of total billed charges","33.9% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",157.56,78,,126.05,,,0,"percent of total billed charges","78% of total billed charges",14.68,101,,,,,0,"fee schedule","101% of CMS fee schedule ",166.85,82.6,,133.48,,,0,"percent of total billed charges","82.6% of total billed charges",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",166.85,82.6,,133.48,,,0,"percent of total billed charges","82.6% of total billed charges",14.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",8.35,202,
"ORTH/PROS CHECKOUT EST 15M GO",43097763X,CDM,430,RC,97763,CPT,OUTPATIENT,,,184,119.6,GO,161.92,88,,129.54,,,0,"percent of total billed charges","88% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",93.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.83,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee sv",115.92,63,,92.74,,,0,"percent of total billed charges","63% of total billed charges",28.15,15.3,,22.52,,,0,"percent of total billed charges","15.3% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,126.96,69,,,,,0,"fee schedule","69% of total billed charges",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",53.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",212.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.67,100,,,,,0,"fee schedule","100% of LI fee schedule",25.77,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.48,100,,,,,0,"fee schedule",EAPG,45.23,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.37,37.7,,55.50,,,0,"percent of total billed charges","37.7% of total billed charges",69.37,37.7,,55.50,,,0,"percent of total billed charges","37.70% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.38,33.9,,49.90,,,0,"percent of total billed charges","33.9% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",143.52,78,,114.82,,,0,"percent of total billed charges","78% of total billed charges",54.28,101,,,,,0,"fee schedule","101% of CMS fee schedule ",151.98,82.6,,121.58,,,0,"percent of total billed charges","82.6% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.98,82.6,,121.58,,,0,"percent of total billed charges","82.6% of total billed charges",53.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",25.77,212.21,
"COMM/WORK REINT/15MIN/-GO",43097537X,CDM,430,RC,97537,CPT,OUTPATIENT,,,280,182,GO,246.4,88,,197.12,,,0,"percent of total billed charges","88% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",56.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee sv",176.4,63,,141.12,,,0,"percent of total billed charges","63% of total billed charges",42.84,15.3,,34.27,,,0,"percent of total billed charges","15.3% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",193.2,69,,,,,0,"fee schedule","69% of total billed charges",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",32.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.24,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.75,100,,,,,0,"fee schedule","100% of LI fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.17,102,,,,,0,"fee schedule","102% of WA fee schedule",24.43,130,,,,,0,"fee schedule","130% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",105.56,37.7,,84.45,,,0,"percent of total billed charges","37.7% of total billed charges",105.56,37.7,,84.45,,,0,"percent of total billed charges","37.70% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",94.92,33.9,,75.94,,,0,"percent of total billed charges","33.9% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",218.4,78,,174.72,,,0,"percent of total billed charges","78% of total billed charges",32.6,101,,,,,0,"fee schedule","101% of CMS fee schedule ",231.28,82.6,,185.02,,,0,"percent of total billed charges","82.6% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",231.28,82.6,,185.02,,,0,"percent of total billed charges","82.6% of total billed charges",32.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",18.79,280,
"E STIM UNATTEND NON-WOUND GO",430G0283,CDM,430,RC,,,OUTPATIENT,,,138,89.7,CO|GO,121.44,88,,97.15,,,0,"percent of total billed charges","88% of total billed charges",69,50,,55.20,,,0,"percent of total billed charges","50% of total billed charges",23.18,16.8,,18.54,,,0,"percent of total billed charges","16.8% of total billed charges",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.88,17.304,,19.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.94,63,,69.55,,,0,"percent of total billed charges","63% of total billed charges",21.11,15.3,,16.89,,,0,"percent of total billed charges","15.3% of total billed charges",23.18,16.8,,18.54,,,0,"percent of total billed charges","16.8% of total billed charges",95.22,69,,,,,0,"fee schedule","69% of total billed charges",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.35,61.85,,68.28,,,0,"percent of total billed charges","61.5% of total billed charges",23.18,16.8,,18.54,,,0,"percent of total billed charges","16.8% of total billed charges",69,50,,55.20,,,0,"percent of total billed charges","50% of total billed charges",44.44,32.2,,35.55,,,0,"percent of total billed charges","32.2% of total billed charges",23.18,16.8,,18.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.65,17.136,,18.92,,,0,"percent of total billed charges","17.136% of total billed charges",30.14,21.84,,24.11,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.03,37.7,,41.62,,,0,"percent of total billed charges","37.7% of total billed charges",52.03,37.7,,41.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.78,33.9,,37.42,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",107.64,78,,86.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.99,82.6,,91.19,,,0,"percent of total billed charges","82.6% of total billed charges",23.18,16.8,,18.54,,,0,"percent of total billed charges","16.8% of total billed charges",69,50,,55.20,,,0,"percent of total billed charges","50% of total billed charges",113.99,82.6,,91.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.18,16.8,,18.54,,,0,"percent of total billed charges","16.8% of total billed charges",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",21.11,138,
"G0283 OT ELEC STIM MEDICARE CHARGE",GOG0283,CDM,430,RC,,,OUTPATIENT,,,138,89.7,GO|GO,121.44,88,,97.15,,,0,"percent of total billed charges","88% of total billed charges",69,50,,55.20,,,0,"percent of total billed charges","50% of total billed charges",23.18,16.8,,18.54,,,0,"percent of total billed charges","16.8% of total billed charges",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.88,17.304,,19.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.94,63,,69.55,,,0,"percent of total billed charges","63% of total billed charges",21.11,15.3,,16.89,,,0,"percent of total billed charges","15.3% of total billed charges",23.18,16.8,,18.54,,,0,"percent of total billed charges","16.8% of total billed charges",95.22,69,,,,,0,"fee schedule","69% of total billed charges",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.35,61.85,,68.28,,,0,"percent of total billed charges","61.5% of total billed charges",23.18,16.8,,18.54,,,0,"percent of total billed charges","16.8% of total billed charges",69,50,,55.20,,,0,"percent of total billed charges","50% of total billed charges",44.44,32.2,,35.55,,,0,"percent of total billed charges","32.2% of total billed charges",23.18,16.8,,18.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.65,17.136,,18.92,,,0,"percent of total billed charges","17.136% of total billed charges",30.14,21.84,,24.11,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.03,37.7,,41.62,,,0,"percent of total billed charges","37.7% of total billed charges",52.03,37.7,,41.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.78,33.9,,37.42,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",107.64,78,,86.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.99,82.6,,91.19,,,0,"percent of total billed charges","82.6% of total billed charges",23.18,16.8,,18.54,,,0,"percent of total billed charges","16.8% of total billed charges",69,50,,55.20,,,0,"percent of total billed charges","50% of total billed charges",113.99,82.6,,91.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.18,16.8,,18.54,,,0,"percent of total billed charges","16.8% of total billed charges",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",21.11,138,
"OCCUP THERAPY GROUP/-GO",43397150,CDM,433,RC,97150,CPT,OUTPATIENT,,,147,95.55,GO,129.36,88,,103.49,,,0,"percent of total billed charges","88% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",31.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee sv",92.61,63,,74.09,,,0,"percent of total billed charges","63% of total billed charges",22.49,15.3,,17.99,,,0,"percent of total billed charges","15.3% of total billed charges",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",101.43,69,,,,,0,"fee schedule","69% of total billed charges",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",18.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.46,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",18,100,,,,,0,"fee schedule","100% of LI fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.65,102,,,,,0,"fee schedule","102% of WA fee schedule",13.57,130,,,,,0,"fee schedule","130% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.42,37.7,,44.34,,,0,"percent of total billed charges","37.7% of total billed charges",55.42,37.7,,44.34,,,0,"percent of total billed charges","37.70% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.83,33.9,,39.86,,,0,"percent of total billed charges","33.9% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",114.66,78,,91.73,,,0,"percent of total billed charges","78% of total billed charges",18.47,101,,,,,0,"fee schedule","101% of CMS fee schedule ",121.42,82.6,,97.14,,,0,"percent of total billed charges","82.6% of total billed charges",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",121.42,82.6,,97.14,,,0,"percent of total billed charges","82.6% of total billed charges",18.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",10.44,147,
IONTOPHORESIS/15MIN/-GO,43097033X,CDM,430,RC,97033,CPT,OUTPATIENT,,,201,130.65,GO,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",34.2,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee sv",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",19.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of LI fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.01,102,,,,,0,"fee schedule","102% of WA fee schedule",15.3,130,,,,,0,"fee schedule","130% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.7% of total billed charges",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.14,33.9,,54.51,,,0,"percent of total billed charges","33.9% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",19.91,101,,,,,0,"fee schedule","101% of CMS fee schedule ",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",19.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",11.77,201,
"97140 MANUAL THERAPY-MANIPULATION 15 CHARGE",43097140,CDM,430,RC,97140,CPT,OUTPATIENT,,,269,174.85,GO,236.72,88,,189.38,,,0,"percent of total billed charges","88% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",47.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee sv",169.47,63,,135.58,,,0,"percent of total billed charges","63% of total billed charges",41.16,15.3,,32.93,,,0,"percent of total billed charges","15.3% of total billed charges",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",185.61,69,,,,,0,"fee schedule","69% of total billed charges",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",27.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.72,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.05,100,,,,,0,"fee schedule","100% of LI fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.26,102,,,,,0,"fee schedule","102% of WA fee schedule",20.72,130,,,,,0,"fee schedule","130% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.41,37.7,,81.13,,,0,"percent of total billed charges","37.7% of total billed charges",101.41,37.7,,81.13,,,0,"percent of total billed charges","37.70% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.19,33.9,,72.95,,,0,"percent of total billed charges","33.9% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",209.82,78,,167.86,,,0,"percent of total billed charges","78% of total billed charges",27.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",222.19,82.6,,177.75,,,0,"percent of total billed charges","82.6% of total billed charges",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",222.19,82.6,,177.75,,,0,"percent of total billed charges","82.6% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",15.94,269,
"MASSAGE EA 15MIN/-GO",43097124X,CDM,430,RC,97124,CPT,OUTPATIENT,,,119,77.35,GO,104.72,88,,83.78,,,0,"percent of total billed charges","88% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",54.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee sv",74.97,63,,59.98,,,0,"percent of total billed charges","63% of total billed charges",18.21,15.3,,14.57,,,0,"percent of total billed charges","15.3% of total billed charges",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",82.11,69,,,,,0,"fee schedule","69% of total billed charges",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",30.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.46,100,,,,,0,"fee schedule","100% of LI fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.2,102,,,,,0,"fee schedule","102% of WA fee schedule",23.19,130,,,,,0,"fee schedule","130% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.7% of total billed charges",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.70% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.34,33.9,,32.27,,,0,"percent of total billed charges","33.9% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.82,78,,74.26,,,0,"percent of total billed charges","78% of total billed charges",31.34,101,,,,,0,"fee schedule","101% of CMS fee schedule ",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",31.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",17.84,119,
"NEUROMUSC RE-ED/15MIN/-GO",43097112X,CDM,430,RC,97112,CPT,OUTPATIENT,,,228,148.2,GO,200.64,88,,160.51,,,0,"percent of total billed charges","88% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",59.8,175,,,,,0,"fee schedule","175% of CMS fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee sv",143.64,63,,114.91,,,0,"percent of total billed charges","63% of total billed charges",34.88,15.3,,27.90,,,0,"percent of total billed charges","15.3% of total billed charges",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",157.32,69,,,,,0,"fee schedule","69% of total billed charges",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",34.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",135.02,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.76,100,,,,,0,"fee schedule","100% of LI fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.33,102,,,,,0,"fee schedule","102% of WA fee schedule",25.91,130,,,,,0,"fee schedule","130% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.96,37.7,,68.77,,,0,"percent of total billed charges","37.7% of total billed charges",85.96,37.7,,68.77,,,0,"percent of total billed charges","37.70% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.29,33.9,,61.83,,,0,"percent of total billed charges","33.9% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",177.84,78,,142.27,,,0,"percent of total billed charges","78% of total billed charges",34.67,101,,,,,0,"fee schedule","101% of CMS fee schedule ",188.33,82.6,,150.66,,,0,"percent of total billed charges","82.6% of total billed charges",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",188.33,82.6,,150.66,,,0,"percent of total billed charges","82.6% of total billed charges",34.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",19.93,228,
"CONTRAST BATH/15MIN/-GO",43097034X,CDM,430,RC,97034,CPT,OUTPATIENT,,,112,72.8,GO,98.56,88,,78.85,,,0,"percent of total billed charges","88% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",24.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee sv",70.56,63,,56.45,,,0,"percent of total billed charges","63% of total billed charges",17.14,15.3,,13.71,,,0,"percent of total billed charges","15.3% of total billed charges",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",77.28,69,,,,,0,"fee schedule","69% of total billed charges",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",14.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.41,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.98,100,,,,,0,"fee schedule","100% of LI fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.71,102,,,,,0,"fee schedule","102% of WA fee schedule",11.1,130,,,,,0,"fee schedule","130% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.22,37.7,,33.78,,,0,"percent of total billed charges","37.7% of total billed charges",42.22,37.7,,33.78,,,0,"percent of total billed charges","37.70% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.97,33.9,,30.38,,,0,"percent of total billed charges","33.9% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.36,78,,69.89,,,0,"percent of total billed charges","78% of total billed charges",14.37,101,,,,,0,"fee schedule","101% of CMS fee schedule ",92.51,82.6,,74.01,,,0,"percent of total billed charges","82.6% of total billed charges",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.51,82.6,,74.01,,,0,"percent of total billed charges","82.6% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",8.54,112,
"OT EVAL- HGH COMP",43497167X,CDM,434,RC,97167,CPT,OUTPATIENT,,,403,261.95,GO,354.64,88,,283.71,,,0,"percent of total billed charges","88% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",179.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee sv",253.89,63,,203.11,,,0,"percent of total billed charges","63% of total billed charges",61.66,15.3,,49.33,,,0,"percent of total billed charges","15.3% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",278.07,69,,,,,0,"fee schedule","69% of total billed charges",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",102.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",378.29,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.53,100,,,,,0,"fee schedule","100% of LI fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.4,102,,,,,0,"fee schedule","102% of WA fee schedule",76.99,130,,,,,0,"fee schedule","130% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.7% of total billed charges",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.70% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.62,33.9,,109.30,,,0,"percent of total billed charges","33.9% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",314.34,78,,251.47,,,0,"percent of total billed charges","78% of total billed charges",104.26,101,,,,,0,"fee schedule","101% of CMS fee schedule ",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",103.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",59.22,403,
"OT EVAL- LOW COMP",43497165X,CDM,434,RC,97165,CPT,OUTPATIENT,,,403,261.95,GO,354.64,88,,283.71,,,0,"percent of total billed charges","88% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",179.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee sv",253.89,63,,203.11,,,0,"percent of total billed charges","63% of total billed charges",61.66,15.3,,49.33,,,0,"percent of total billed charges","15.3% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",278.07,69,,,,,0,"fee schedule","69% of total billed charges",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",102.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",378.29,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.53,100,,,,,0,"fee schedule","100% of LI fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.4,102,,,,,0,"fee schedule","102% of WA fee schedule",76.99,130,,,,,0,"fee schedule","130% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.7% of total billed charges",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.70% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.62,33.9,,109.30,,,0,"percent of total billed charges","33.9% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",314.34,78,,251.47,,,0,"percent of total billed charges","78% of total billed charges",104.26,101,,,,,0,"fee schedule","101% of CMS fee schedule ",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",103.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",59.22,403,
"MANUAL THERAPY/15MIN/-GO",43097140X,CDM,430,RC,97140,CPT,OUTPATIENT,,,269,174.85,GO,236.72,88,,189.38,,,0,"percent of total billed charges","88% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",47.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee sv",169.47,63,,135.58,,,0,"percent of total billed charges","63% of total billed charges",41.16,15.3,,32.93,,,0,"percent of total billed charges","15.3% of total billed charges",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",185.61,69,,,,,0,"fee schedule","69% of total billed charges",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",27.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.72,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.05,100,,,,,0,"fee schedule","100% of LI fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.26,102,,,,,0,"fee schedule","102% of WA fee schedule",20.72,130,,,,,0,"fee schedule","130% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.41,37.7,,81.13,,,0,"percent of total billed charges","37.7% of total billed charges",101.41,37.7,,81.13,,,0,"percent of total billed charges","37.70% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.19,33.9,,72.95,,,0,"percent of total billed charges","33.9% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",209.82,78,,167.86,,,0,"percent of total billed charges","78% of total billed charges",27.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",222.19,82.6,,177.75,,,0,"percent of total billed charges","82.6% of total billed charges",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",222.19,82.6,,177.75,,,0,"percent of total billed charges","82.6% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",15.94,269,
"OT EVAL- MOD COMP",43497166X,CDM,434,RC,97166,CPT,OUTPATIENT,,,403,261.95,GO,354.64,88,,283.71,,,0,"percent of total billed charges","88% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",179.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee sv",253.89,63,,203.11,,,0,"percent of total billed charges","63% of total billed charges",61.66,15.3,,49.33,,,0,"percent of total billed charges","15.3% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",278.07,69,,,,,0,"fee schedule","69% of total billed charges",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",102.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",378.29,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.53,100,,,,,0,"fee schedule","100% of LI fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.4,102,,,,,0,"fee schedule","102% of WA fee schedule",76.99,130,,,,,0,"fee schedule","130% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.7% of total billed charges",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.70% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.62,33.9,,109.30,,,0,"percent of total billed charges","33.9% of total billed charges",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",314.34,78,,251.47,,,0,"percent of total billed charges","78% of total billed charges",104.26,101,,,,,0,"fee schedule","101% of CMS fee schedule ",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",103.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",103.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",59.22,403,
"FUNCT CAP TEST/15MIN/-GO",43097750X,CDM,430,RC,97750,CPT,OUTPATIENT,,,233,151.45,GO,205.04,88,,164.03,,,0,"percent of total billed charges","88% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",233,100,,186.40,,,0,"percent of total billed charges","100% of total billed charges",60.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee sv",146.79,63,,117.43,,,0,"percent of total billed charges","63% of total billed charges",35.65,15.3,,28.52,,,0,"percent of total billed charges","15.3% of total billed charges",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",160.77,69,,,,,0,"fee schedule","69% of total billed charges",233,100,,186.40,,,0,"percent of total billed charges","100% of total billed charges",34.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",233,100,,186.40,,,0,"percent of total billed charges","100% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",233,100,,186.40,,,0,"percent of total billed charges","100% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",132.38,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.12,100,,,,,0,"fee schedule","100% of LI fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.52,102,,,,,0,"fee schedule","102% of WA fee schedule",26.16,130,,,,,0,"fee schedule","130% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.84,37.7,,70.27,,,0,"percent of total billed charges","37.7% of total billed charges",87.84,37.7,,70.27,,,0,"percent of total billed charges","37.70% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.99,33.9,,63.19,,,0,"percent of total billed charges","33.9% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",181.74,78,,145.39,,,0,"percent of total billed charges","78% of total billed charges",35.08,101,,,,,0,"fee schedule","101% of CMS fee schedule ",192.46,82.6,,153.97,,,0,"percent of total billed charges","82.6% of total billed charges",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",192.46,82.6,,153.97,,,0,"percent of total billed charges","82.6% of total billed charges",34.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",233,100,,186.40,,,0,"percent of total billed charges","100% of total billed charges",20.12,233,
"OT RE-EVAL/-GO",43497168X,CDM,434,RC,97168,CPT,OUTPATIENT,,,264,171.6,GO,232.32,88,,185.86,,,0,"percent of total billed charges","88% of total billed charges",71.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",41,100,,,,,0,"fee schedule","100% of WA fee schedule",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",124.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule","100% of WA fee schedule",71.4,100,,,,,0,"fee schedule","100% of CMS fee sv",166.32,63,,133.06,,,0,"percent of total billed charges","63% of total billed charges",40.39,15.3,,32.31,,,0,"percent of total billed charges","15.3% of total billed charges",41,100,,,,,0,"fee schedule","100% of WA fee schedule",182.16,69,,,,,0,"fee schedule","69% of total billed charges",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",70.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",71.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",71.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",255.24,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",41,100,,,,,0,"fee schedule","100% of WA fee schedule",71.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.16,100,,,,,0,"fee schedule","100% of LI fee schedule",41,100,,,,,0,"fee schedule","100% of WA fee schedule",71.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.82,102,,,,,0,"fee schedule","102% of WA fee schedule",53.3,130,,,,,0,"fee schedule","130% of WA fee schedule",71.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.53,37.7,,79.62,,,0,"percent of total billed charges","37.7% of total billed charges",99.53,37.7,,79.62,,,0,"percent of total billed charges","37.70% of total billed charges",71.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.5,33.9,,71.60,,,0,"percent of total billed charges","33.9% of total billed charges",71.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",205.92,78,,164.74,,,0,"percent of total billed charges","78% of total billed charges",72.11,101,,,,,0,"fee schedule","101% of CMS fee schedule ",218.06,82.6,,174.45,,,0,"percent of total billed charges","82.6% of total billed charges",41,100,,,,,0,"fee schedule","100% of WA fee schedule",71.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",218.06,82.6,,174.45,,,0,"percent of total billed charges","82.6% of total billed charges",71.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",41,100,,,,,0,"fee schedule","100% of WA fee schedule",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",40.39,264,
"SELECT DEBRIDE/20 CM OR < GO",43097597X,CDM,430,RC,97597,CPT,OUTPATIENT,,,737,479.05,GO,648.56,88,,518.85,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",464.31,63,,371.45,,,0,"percent of total billed charges","63% of total billed charges",112.76,15.3,,90.21,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,508.53,69,,,,,0,"fee schedule","69% of total billed charges",737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.85,37.7,,222.28,,,0,"percent of total billed charges","37.7% of total billed charges",277.85,37.7,,222.28,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",249.84,33.9,,199.87,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",574.86,78,,459.89,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",608.76,82.6,,487.01,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",608.76,82.6,,487.01,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",112.76,737,
"SELECT DEBRIDE > 20 CM GO",43097598X,CDM,430,RC,97598,CPT,OUTPATIENT,,,955,620.75,GO,840.4,88,,672.32,,,0,"percent of total billed charges","88% of total billed charges",477.5,50,,382.00,,,0,"percent of total billed charges","50% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",930.95,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",601.65,63,,481.32,,,0,"percent of total billed charges","63% of total billed charges",146.12,15.3,,116.90,,,0,"percent of total billed charges","15.3% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,658.95,69,,,,,0,"fee schedule","69% of total billed charges",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.67,61.85,,472.54,,,0,"percent of total billed charges","61.5% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,477.5,50,,382.00,,,0,"percent of total billed charges","50% of total billed charges",307.51,32.2,,246.01,,,0,"percent of total billed charges","32.2% of total billed charges",669.51,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",921.91,100,,,,,0,"fee schedule",EAPG,1174.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",360.04,37.7,,288.03,,,0,"percent of total billed charges","37.7% of total billed charges",360.04,37.7,,288.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",323.75,33.9,,259.00,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",744.9,78,,595.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",788.83,82.6,,631.06,,,0,"percent of total billed charges","82.6% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,477.5,50,,382.00,,,0,"percent of total billed charges","50% of total billed charges",788.83,82.6,,631.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",903.83,100,,,,,0,"fee schedule",EAPG,955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",146.12,1174.99,
"VASOPNEUMATIC DEVICES/-GO",43097016X,CDM,430,RC,97016,CPT,OUTPATIENT,,,142,92.3,GO,124.96,88,,99.97,,,0,"percent of total billed charges","88% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",20.42,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",11.84,100,,,,,0,"fee schedule","100% of CMS fee sv",89.46,63,,71.57,,,0,"percent of total billed charges","63% of total billed charges",21.73,15.3,,17.38,,,0,"percent of total billed charges","15.3% of total billed charges",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",97.98,69,,,,,0,"fee schedule","69% of total billed charges",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",11.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.67,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.63,100,,,,,0,"fee schedule","100% of LI fee schedule",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.97,102,,,,,0,"fee schedule","102% of WA fee schedule",8.88,130,,,,,0,"fee schedule","130% of WA fee schedule",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.53,37.7,,42.82,,,0,"percent of total billed charges","37.7% of total billed charges",53.53,37.7,,42.82,,,0,"percent of total billed charges","37.70% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.14,33.9,,38.51,,,0,"percent of total billed charges","33.9% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",110.76,78,,88.61,,,0,"percent of total billed charges","78% of total billed charges",11.96,101,,,,,0,"fee schedule","101% of CMS fee schedule ",117.29,82.6,,93.83,,,0,"percent of total billed charges","82.6% of total billed charges",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",117.29,82.6,,93.83,,,0,"percent of total billed charges","82.6% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",6.83,142,
WHIRLPOOL/-GO,43097022X,CDM,430,RC,97022,CPT,OUTPATIENT,,,186,120.9,GO,163.68,88,,130.94,,,0,"percent of total billed charges","88% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",30.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee sv",117.18,63,,93.74,,,0,"percent of total billed charges","63% of total billed charges",28.46,15.3,,22.77,,,0,"percent of total billed charges","15.3% of total billed charges",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",128.34,69,,,,,0,"fee schedule","69% of total billed charges",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",17.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.69,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.04,100,,,,,0,"fee schedule","100% of LI fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.46,102,,,,,0,"fee schedule","102% of WA fee schedule",13.33,130,,,,,0,"fee schedule","130% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.12,37.7,,56.10,,,0,"percent of total billed charges","37.7% of total billed charges",70.12,37.7,,56.10,,,0,"percent of total billed charges","37.70% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.05,33.9,,50.44,,,0,"percent of total billed charges","33.9% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",145.08,78,,116.06,,,0,"percent of total billed charges","78% of total billed charges",17.56,101,,,,,0,"fee schedule","101% of CMS fee schedule ",153.64,82.6,,122.91,,,0,"percent of total billed charges","82.6% of total billed charges",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",153.64,82.6,,122.91,,,0,"percent of total billed charges","82.6% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",10.25,186,
"ORTHOTIC MGMT EA 15M OT",43097760X,CDM,430,RC,97760,CPT,OUTPATIENT,,,175,113.75,GO,154,88,,123.20,,,0,"percent of total billed charges","88% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",85.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee sv",110.25,63,,88.20,,,0,"percent of total billed charges","63% of total billed charges",26.78,15.3,,21.42,,,0,"percent of total billed charges","15.3% of total billed charges",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",120.75,69,,,,,0,"fee schedule","69% of total billed charges",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",48.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",193.2,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.94,100,,,,,0,"fee schedule","100% of LI fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.62,102,,,,,0,"fee schedule","102% of WA fee schedule",37.75,130,,,,,0,"fee schedule","130% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.98,37.7,,52.78,,,0,"percent of total billed charges","37.7% of total billed charges",65.98,37.7,,52.78,,,0,"percent of total billed charges","37.70% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.33,33.9,,47.46,,,0,"percent of total billed charges","33.9% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.5,78,,109.20,,,0,"percent of total billed charges","78% of total billed charges",49.36,101,,,,,0,"fee schedule","101% of CMS fee schedule ",144.55,82.6,,115.64,,,0,"percent of total billed charges","82.6% of total billed charges",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.55,82.6,,115.64,,,0,"percent of total billed charges","82.6% of total billed charges",48.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",26.78,193.2,
"PARAFFIN BATH/-GO",43097018X,CDM,430,RC,97018,CPT,OUTPATIENT,,,143,92.95,GO,125.84,88,,100.67,,,0,"percent of total billed charges","88% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",9.75,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee sv",90.09,63,,72.07,,,0,"percent of total billed charges","63% of total billed charges",21.88,15.3,,17.50,,,0,"percent of total billed charges","15.3% of total billed charges",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",98.67,69,,,,,0,"fee schedule","69% of total billed charges",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",5.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.53,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.62,100,,,,,0,"fee schedule","100% of LI fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.49,102,,,,,0,"fee schedule","102% of WA fee schedule",4.45,130,,,,,0,"fee schedule","130% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.91,37.7,,43.13,,,0,"percent of total billed charges","37.7% of total billed charges",53.91,37.7,,43.13,,,0,"percent of total billed charges","37.70% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.48,33.9,,38.78,,,0,"percent of total billed charges","33.9% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",111.54,78,,89.23,,,0,"percent of total billed charges","78% of total billed charges",5.8,101,,,,,0,"fee schedule","101% of CMS fee schedule ",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",3.42,143,
"SENSORY INTEGRATION/GO",43097533X,CDM,430,RC,97533,CPT,OUTPATIENT,,,267,173.55,GO,234.96,88,,187.97,,,0,"percent of total billed charges","88% of total billed charges",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.15,100,,,,,0,"fee schedule","100% of WA fee schedule",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",111.93,175,,,,,0,"fee schedule","175% of CMS fee schedule",38.15,100,,,,,0,"fee schedule","100% of WA fee schedule",64.13,100,,,,,0,"fee schedule","100% of CMS fee sv",168.21,63,,134.57,,,0,"percent of total billed charges","63% of total billed charges",40.85,15.3,,32.68,,,0,"percent of total billed charges","15.3% of total billed charges",38.15,100,,,,,0,"fee schedule","100% of WA fee schedule",184.23,69,,,,,0,"fee schedule","69% of total billed charges",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",63.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",233.86,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",38.15,100,,,,,0,"fee schedule","100% of WA fee schedule",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.8,100,,,,,0,"fee schedule","100% of LI fee schedule",38.15,100,,,,,0,"fee schedule","100% of WA fee schedule",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.91,102,,,,,0,"fee schedule","102% of WA fee schedule",49.6,130,,,,,0,"fee schedule","130% of WA fee schedule",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.66,37.7,,80.53,,,0,"percent of total billed charges","37.7% of total billed charges",100.66,37.7,,80.53,,,0,"percent of total billed charges","37.70% of total billed charges",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.51,33.9,,72.41,,,0,"percent of total billed charges","33.9% of total billed charges",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",208.26,78,,166.61,,,0,"percent of total billed charges","78% of total billed charges",64.77,101,,,,,0,"fee schedule","101% of CMS fee schedule ",220.54,82.6,,176.43,,,0,"percent of total billed charges","82.6% of total billed charges",38.15,100,,,,,0,"fee schedule","100% of WA fee schedule",64.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",220.54,82.6,,176.43,,,0,"percent of total billed charges","82.6% of total billed charges",64.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.15,100,,,,,0,"fee schedule","100% of WA fee schedule",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",38.15,267,
"THERA EXERCISE/15MIN/-GO",42097110X,CDM,430,RC,97110,CPT,OUTPATIENT,,,181,117.65,GO,159.28,88,,127.42,,,0,"percent of total billed charges","88% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",52.01,175,,,,,0,"fee schedule","175% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee sv",114.03,63,,91.22,,,0,"percent of total billed charges","63% of total billed charges",27.69,15.3,,22.15,,,0,"percent of total billed charges","15.3% of total billed charges",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",124.89,69,,,,,0,"fee schedule","69% of total billed charges",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",29.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",116.17,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.4,100,,,,,0,"fee schedule","100% of LI fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.81,102,,,,,0,"fee schedule","102% of WA fee schedule",22.7,130,,,,,0,"fee schedule","130% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.24,37.7,,54.59,,,0,"percent of total billed charges","37.7% of total billed charges",68.24,37.7,,54.59,,,0,"percent of total billed charges","37.70% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.36,33.9,,49.09,,,0,"percent of total billed charges","33.9% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",141.18,78,,112.94,,,0,"percent of total billed charges","78% of total billed charges",30.19,101,,,,,0,"fee schedule","101% of CMS fee schedule ",149.51,82.6,,119.61,,,0,"percent of total billed charges","82.6% of total billed charges",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",149.51,82.6,,119.61,,,0,"percent of total billed charges","82.6% of total billed charges",29.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",17.46,181,
"THERAP ACT 1:1/15MIN/-GP",42097530X,CDM,430,RC,97530,CPT,OUTPATIENT,,,206,133.9,GO,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",65.36,175,,,,,0,"fee schedule","175% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee sv",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",37.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.36,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.83,100,,,,,0,"fee schedule","100% of LI fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.65,102,,,,,0,"fee schedule","102% of WA fee schedule",28.87,130,,,,,0,"fee schedule","130% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.7% of total billed charges",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.83,33.9,,55.86,,,0,"percent of total billed charges","33.9% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",37.89,101,,,,,0,"fee schedule","101% of CMS fee schedule ",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",37.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",22.21,206,
ULTRASOUND/15MIN/-GO,43097035X,CDM,430,RC,97035,CPT,OUTPATIENT,,,227,147.55,GO,199.76,88,,159.81,,,0,"percent of total billed charges","88% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",24.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee sv",143.01,63,,114.41,,,0,"percent of total billed charges","63% of total billed charges",34.73,15.3,,27.78,,,0,"percent of total billed charges","15.3% of total billed charges",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",156.63,69,,,,,0,"fee schedule","69% of total billed charges",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",14.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.07,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.98,100,,,,,0,"fee schedule","100% of LI fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.71,102,,,,,0,"fee schedule","102% of WA fee schedule",11.1,130,,,,,0,"fee schedule","130% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.58,37.7,,68.46,,,0,"percent of total billed charges","37.7% of total billed charges",85.58,37.7,,68.46,,,0,"percent of total billed charges","37.70% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.95,33.9,,61.56,,,0,"percent of total billed charges","33.9% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",177.06,78,,141.65,,,0,"percent of total billed charges","78% of total billed charges",14.37,101,,,,,0,"fee schedule","101% of CMS fee schedule ",187.5,82.6,,150.00,,,0,"percent of total billed charges","82.6% of total billed charges",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",187.5,82.6,,150.00,,,0,"percent of total billed charges","82.6% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",8.54,227,
"99211 OP CLINIC LEVEL 1 (BRIEF)",AMB820051,CDM,761,RC,99211,CPT,OUTPATIENT,,,403,261.95,,354.64,88,,283.71,,,0,"percent of total billed charges","88% of total billed charges",201.5,50,,161.20,,,0,"percent of total billed charges","50% of total billed charges",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.74,17.304,,55.79,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.89,63,,203.11,,,0,"percent of total billed charges","63% of total billed charges",61.66,15.3,,49.33,,,0,"percent of total billed charges","15.3% of total billed charges",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",278.07,69,,,,,0,"fee schedule","69% of total billed charges",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",249.26,61.85,,199.41,,,0,"percent of total billed charges","61.5% of total billed charges",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",201.5,50,,161.20,,,0,"percent of total billed charges","50% of total billed charges",129.77,32.2,,103.82,,,0,"percent of total billed charges","32.2% of total billed charges",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.06,17.136,,55.25,,,0,"percent of total billed charges","17.136% of total billed charges",88.02,21.84,,70.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.7% of total billed charges",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",314.34,78,,251.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",201.5,50,,161.20,,,0,"percent of total billed charges","50% of total billed charges",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",61.66,403,
"99212 OP CLINIC LEVEL 2 (1+HR)",AMB820004,CDM,761,RC,99212,CPT,OUTPATIENT,,,403,261.95,,354.64,88,,283.71,,,0,"percent of total billed charges","88% of total billed charges",201.5,50,,161.20,,,0,"percent of total billed charges","50% of total billed charges",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.74,17.304,,55.79,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.89,63,,203.11,,,0,"percent of total billed charges","63% of total billed charges",61.66,15.3,,49.33,,,0,"percent of total billed charges","15.3% of total billed charges",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",278.07,69,,,,,0,"fee schedule","69% of total billed charges",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",249.26,61.85,,199.41,,,0,"percent of total billed charges","61.5% of total billed charges",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",201.5,50,,161.20,,,0,"percent of total billed charges","50% of total billed charges",129.77,32.2,,103.82,,,0,"percent of total billed charges","32.2% of total billed charges",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.06,17.136,,55.25,,,0,"percent of total billed charges","17.136% of total billed charges",88.02,21.84,,70.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.7% of total billed charges",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",314.34,78,,251.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",201.5,50,,161.20,,,0,"percent of total billed charges","50% of total billed charges",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",61.66,403,
"99213 OP CLINIC LEVEL 3 (2+HR)",AMB820046,CDM,761,RC,99213,CPT,OUTPATIENT,,,359,233.35,,315.92,88,,252.74,,,0,"percent of total billed charges","88% of total billed charges",179.5,50,,143.60,,,0,"percent of total billed charges","50% of total billed charges",60.31,16.8,,48.25,,,0,"percent of total billed charges","16.8% of total billed charges",359,100,,287.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.12,17.304,,49.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",226.17,63,,180.94,,,0,"percent of total billed charges","63% of total billed charges",54.93,15.3,,43.94,,,0,"percent of total billed charges","15.3% of total billed charges",60.31,16.8,,48.25,,,0,"percent of total billed charges","16.8% of total billed charges",247.71,69,,,,,0,"fee schedule","69% of total billed charges",359,100,,287.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",359,100,,287.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",359,100,,287.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",222.04,61.85,,177.63,,,0,"percent of total billed charges","61.5% of total billed charges",60.31,16.8,,48.25,,,0,"percent of total billed charges","16.8% of total billed charges",179.5,50,,143.60,,,0,"percent of total billed charges","50% of total billed charges",115.6,32.2,,92.48,,,0,"percent of total billed charges","32.2% of total billed charges",60.31,16.8,,48.25,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.52,17.136,,49.22,,,0,"percent of total billed charges","17.136% of total billed charges",78.41,21.84,,62.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",135.34,37.7,,108.27,,,0,"percent of total billed charges","37.7% of total billed charges",135.34,37.7,,108.27,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",280.02,78,,224.02,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",296.53,82.6,,237.22,,,0,"percent of total billed charges","82.6% of total billed charges",60.31,16.8,,48.25,,,0,"percent of total billed charges","16.8% of total billed charges",179.5,50,,143.60,,,0,"percent of total billed charges","50% of total billed charges",296.53,82.6,,237.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.31,16.8,,48.25,,,0,"percent of total billed charges","16.8% of total billed charges",359,100,,287.20,,,0,"percent of total billed charges","100% of total billed charges",54.93,359,
"99214 OP CLINIC LEVEL 4 (3+ HR)",AMB820047,CDM,761,RC,99214,CPT,OUTPATIENT,,,377,245.05,,331.76,88,,265.41,,,0,"percent of total billed charges","88% of total billed charges",188.5,50,,150.80,,,0,"percent of total billed charges","50% of total billed charges",63.34,16.8,,50.67,,,0,"percent of total billed charges","16.8% of total billed charges",377,100,,301.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",65.24,17.304,,52.19,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",237.51,63,,190.01,,,0,"percent of total billed charges","63% of total billed charges",57.68,15.3,,46.14,,,0,"percent of total billed charges","15.3% of total billed charges",63.34,16.8,,50.67,,,0,"percent of total billed charges","16.8% of total billed charges",260.13,69,,,,,0,"fee schedule","69% of total billed charges",377,100,,301.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",377,100,,301.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",377,100,,301.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",233.17,61.85,,186.54,,,0,"percent of total billed charges","61.5% of total billed charges",63.34,16.8,,50.67,,,0,"percent of total billed charges","16.8% of total billed charges",188.5,50,,150.80,,,0,"percent of total billed charges","50% of total billed charges",121.39,32.2,,97.11,,,0,"percent of total billed charges","32.2% of total billed charges",63.34,16.8,,50.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.6,17.136,,51.68,,,0,"percent of total billed charges","17.136% of total billed charges",82.34,21.84,,65.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.13,37.7,,113.70,,,0,"percent of total billed charges","37.7% of total billed charges",142.13,37.7,,113.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",294.06,78,,235.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",311.4,82.6,,249.12,,,0,"percent of total billed charges","82.6% of total billed charges",63.34,16.8,,50.67,,,0,"percent of total billed charges","16.8% of total billed charges",188.5,50,,150.80,,,0,"percent of total billed charges","50% of total billed charges",311.4,82.6,,249.12,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.34,16.8,,50.67,,,0,"percent of total billed charges","16.8% of total billed charges",377,100,,301.60,,,0,"percent of total billed charges","100% of total billed charges",57.68,377,
"Insertion of peripherally inserted central venous catheter",88800001,CDM,761,RC,36569,CPT,OUTPATIENT,,,2949,1916.85,,2595.12,88,,2076.10,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,2949,100,,2359.20,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",1043.63,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1857.87,63,,1486.30,,,0,"percent of total billed charges","63% of total billed charges",451.2,15.3,,360.96,,,0,"percent of total billed charges","15.3% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,2034.81,69,,,,,0,"fee schedule","69% of total billed charges",2949,100,,2359.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2949,100,,2359.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2949,100,,2359.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",750.54,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033.49,100,,,,,0,"fee schedule",EAPG,1317.2,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1111.77,37.7,,889.42,,,0,"percent of total billed charges","37.7% of total billed charges",1111.77,37.7,,889.42,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",999.71,33.9,,799.77,,,0,"percent of total billed charges","33.9% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2300.22,78,,1840.18,,,0,"percent of total billed charges","78% of total billed charges",1649.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2435.87,82.6,,1948.70,,,0,"percent of total billed charges","82.6% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2435.87,82.6,,1948.70,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,2949,100,,2359.20,,,0,"percent of total billed charges","100% of total billed charges",451.2,5712.48,
"36573 INS PICC INCL IMAG >5YR CHARGE",76136573,CDM,761,RC,36573,CPT,OUTPATIENT,,,3106,2018.9,,2733.28,88,,2186.62,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,3106,100,,2484.80,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",1043.63,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1956.78,63,,1565.42,,,0,"percent of total billed charges","63% of total billed charges",475.22,15.3,,380.18,,,0,"percent of total billed charges","15.3% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,2143.14,69,,,,,0,"fee schedule","69% of total billed charges",3106,100,,2484.80,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3106,100,,2484.80,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3106,100,,2484.80,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",750.54,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033.49,100,,,,,0,"fee schedule",EAPG,1317.2,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1170.96,37.7,,936.77,,,0,"percent of total billed charges","37.7% of total billed charges",1170.96,37.7,,936.77,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1052.93,33.9,,842.34,,,0,"percent of total billed charges","33.9% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2422.68,78,,1938.14,,,0,"percent of total billed charges","78% of total billed charges",1649.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2565.56,82.6,,2052.45,,,0,"percent of total billed charges","82.6% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2565.56,82.6,,2052.45,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,3106,100,,2484.80,,,0,"percent of total billed charges","100% of total billed charges",475.22,5712.48,
"COVID-19 Rapid Antigen POC (RE)",30287811,CDM,302,RC,87811,CPT,OUTPATIENT,,,135,87.75,,118.8,88,,95.04,,,0,"percent of total billed charges","88% of total billed charges",41.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,135,100,,108.00,,,0,"percent of total billed charges","100% of total billed charges",72.41,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,41.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.05,63,,68.04,,,0,"percent of total billed charges","63% of total billed charges",20.66,15.3,,16.53,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,93.15,69,,,,,0,"fee schedule","69% of total billed charges",135,100,,108.00,,,0,"percent of total billed charges","100% of total billed charges",41.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",135,100,,108.00,,,0,"percent of total billed charges","100% of total billed charges",41.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",135,100,,108.00,,,0,"percent of total billed charges","100% of total billed charges",41.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.38,382.5,,,,,0,"fee schedule","382.5% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,41.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.38,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,41.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,41.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.9,37.7,,40.72,,,0,"percent of total billed charges","37.7% of total billed charges",50.9,37.7,,40.72,,,0,"percent of total billed charges","37.70% of total billed charges",41.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.77,33.9,,36.62,,,0,"percent of total billed charges","33.9% of total billed charges",41.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",105.3,78,,84.24,,,0,"percent of total billed charges","78% of total billed charges",41.79,101,,,,,0,"fee schedule","101% of CMS fee schedule ",111.51,82.6,,89.21,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,41.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",111.51,82.6,,89.21,,,0,"percent of total billed charges","82.6% of total billed charges",41.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,135,100,,108.00,,,0,"percent of total billed charges","100% of total billed charges",4.81,135,
"Flu (GeneXpert Xpress) POCT",30687502,CDM,306,RC,87502,CPT,OUTPATIENT,,,259,168.35,,227.92,88,,182.34,,,0,"percent of total billed charges","88% of total billed charges",95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.61,100,,,,,0,"fee schedule",EAPG,259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",167.65,175,,,,,0,"fee schedule","175% of CMS fee schedule",100.54,100,,,,,0,"fee schedule",EAPG,95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.17,63,,130.54,,,0,"percent of total billed charges","63% of total billed charges",39.63,15.3,,31.70,,,0,"percent of total billed charges","15.3% of total billed charges",97.61,100,,,,,0,"fee schedule",EAPG,178.71,69,,,,,0,"fee schedule","69% of total billed charges",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",366.43,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",97.61,100,,,,,0,"fee schedule",EAPG,95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.8,100,,,,,0,"fee schedule","100% of LI fee schedule",72.3,100,,,,,0,"fee schedule",EAPG,95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.56,100,,,,,0,"fee schedule",EAPG,126.89,100,,,,,0,"fee schedule",EAPG,95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.64,37.7,,78.11,,,0,"percent of total billed charges","37.7% of total billed charges",97.64,37.7,,78.11,,,0,"percent of total billed charges","37.70% of total billed charges",95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.8,33.9,,70.24,,,0,"percent of total billed charges","33.9% of total billed charges",95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",202.02,78,,161.62,,,0,"percent of total billed charges","78% of total billed charges",96.75,101,,,,,0,"fee schedule","101% of CMS fee schedule ",213.93,82.6,,171.14,,,0,"percent of total billed charges","82.6% of total billed charges",97.61,100,,,,,0,"fee schedule",EAPG,95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",213.93,82.6,,171.14,,,0,"percent of total billed charges","82.6% of total billed charges",95.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.61,100,,,,,0,"fee schedule",EAPG,259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",39.63,366.43,
"Flu/RSV (GeneXpert Xpress) POCT",30687502,CDM,306,RC,87502|8763,CPT,OUTPATIENT,,,259,168.35,,227.92,88,,182.34,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.51,16.8,,34.81,,,0,"percent of total billed charges","16.8% of total billed charges",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.82,17.304,,35.86,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",163.17,63,,130.54,,,0,"percent of total billed charges","63% of total billed charges",39.63,15.3,,31.70,,,0,"percent of total billed charges","15.3% of total billed charges",43.51,16.8,,34.81,,,0,"percent of total billed charges","16.8% of total billed charges",178.71,69,,,,,0,"fee schedule","69% of total billed charges",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.51,16.8,,34.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.51,16.8,,34.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.38,17.136,,35.50,,,0,"percent of total billed charges","17.136% of total billed charges",56.57,21.84,,45.26,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.64,37.7,,78.11,,,0,"percent of total billed charges","37.7% of total billed charges",97.64,37.7,,78.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.8,33.9,,70.24,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.02,78,,161.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.93,82.6,,171.14,,,0,"percent of total billed charges","82.6% of total billed charges",43.51,16.8,,34.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.93,82.6,,171.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.51,16.8,,34.81,,,0,"percent of total billed charges","16.8% of total billed charges",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",39.63,259,
"Hemoglobin A1C POCT",30183036,CDM,301,RC,83036,CPT,OUTPATIENT,,,218,141.7,,191.84,88,,153.47,,,0,"percent of total billed charges","88% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",16.99,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.34,63,,109.87,,,0,"percent of total billed charges","63% of total billed charges",33.35,15.3,,26.68,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,150.42,69,,,,,0,"fee schedule","69% of total billed charges",218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.14,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.71,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.19,37.7,,65.75,,,0,"percent of total billed charges","37.7% of total billed charges",82.19,37.7,,65.75,,,0,"percent of total billed charges","37.70% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.9,33.9,,59.12,,,0,"percent of total billed charges","33.9% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.04,78,,136.03,,,0,"percent of total billed charges","78% of total billed charges",9.8,101,,,,,0,"fee schedule","101% of CMS fee schedule ",180.07,82.6,,144.06,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",180.07,82.6,,144.06,,,0,"percent of total billed charges","82.6% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",3.25,218,
"POCT SARS-CoV-2 (COVID-19)/Flu/RSV (Genexpert)",0003000241U,CDM,306,RC,87637,CPT,OUTPATIENT,,,386,250.9,,339.68,88,,271.74,,,0,"percent of total billed charges","88% of total billed charges",142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",249.6,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",243.18,63,,194.54,,,0,"percent of total billed charges","63% of total billed charges",59.06,15.3,,47.25,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,266.34,69,,,,,0,"fee schedule","69% of total billed charges",386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.63,382.5,,,,,0,"fee schedule","382.5% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.63,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",145.52,37.7,,116.42,,,0,"percent of total billed charges","37.7% of total billed charges",145.52,37.7,,116.42,,,0,"percent of total billed charges","37.70% of total billed charges",142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",130.85,33.9,,104.68,,,0,"percent of total billed charges","33.9% of total billed charges",142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",301.08,78,,240.86,,,0,"percent of total billed charges","78% of total billed charges",144.05,101,,,,,0,"fee schedule","101% of CMS fee schedule ",318.84,82.6,,255.07,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",318.84,82.6,,255.07,,,0,"percent of total billed charges","82.6% of total billed charges",142.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,386,100,,308.80,,,0,"percent of total billed charges","100% of total billed charges",18.33,386,
"SARS-CoV-2 (COVID-19) PCR (GeneXpert) POC",30687635,CDM,306,RC,87635,CPT,OUTPATIENT,,,139,90.35,,122.32,88,,97.86,,,0,"percent of total billed charges","88% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",89.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.57,63,,70.06,,,0,"percent of total billed charges","63% of total billed charges",21.27,15.3,,17.02,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,95.91,69,,,,,0,"fee schedule","69% of total billed charges",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.31,382.5,,,,,0,"fee schedule","382.5% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.31,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.4,37.7,,41.92,,,0,"percent of total billed charges","37.7% of total billed charges",52.4,37.7,,41.92,,,0,"percent of total billed charges","37.70% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.12,33.9,,37.70,,,0,"percent of total billed charges","33.9% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.42,78,,86.74,,,0,"percent of total billed charges","78% of total billed charges",51.82,101,,,,,0,"fee schedule","101% of CMS fee schedule ",114.81,82.6,,91.85,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",114.81,82.6,,91.85,,,0,"percent of total billed charges","82.6% of total billed charges",51.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",18.33,139,
"Strep A (GeneXpert Xpress) POCT",30687651,CDM,306,RC,87651,CPT,OUTPATIENT,,,33,21.45,,29.04,88,,23.23,,,0,"percent of total billed charges","88% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",61.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.49,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.79,63,,16.63,,,0,"percent of total billed charges","63% of total billed charges",5.05,15.3,,4.04,,,0,"percent of total billed charges","15.3% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,22.77,69,,,,,0,"fee schedule","69% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.09,100,,,,,0,"fee schedule","100% of LI fee schedule",18.33,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.25,100,,,,,0,"fee schedule",EAPG,32.18,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.44,37.7,,9.95,,,0,"percent of total billed charges","37.7% of total billed charges",12.44,37.7,,9.95,,,0,"percent of total billed charges","37.70% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.19,33.9,,8.95,,,0,"percent of total billed charges","33.9% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.74,78,,20.59,,,0,"percent of total billed charges","78% of total billed charges",35.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",24.75,100,,,,,0,"fee schedule",EAPG,35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",35.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.75,100,,,,,0,"fee schedule",EAPG,33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",5.05,134.21,
"U Dipstick Cotinine (Nicotine) POCT",30080305,CDM,300,RC,80305,CPT,OUTPATIENT,,,70,45.5,,61.6,88,,49.28,,,0,"percent of total billed charges","88% of total billed charges",12.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.76,16.8,,9.41,,,0,"percent of total billed charges","16.8% of total billed charges",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",22.05,175,,,,,0,"fee schedule","175% of CMS fee schedule",12.11,17.304,,9.69,,,0,"percent of total billed charges","17.304% of total billed charges",12.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.1,63,,35.28,,,0,"percent of total billed charges","63% of total billed charges",10.71,15.3,,8.57,,,0,"percent of total billed charges","15.3% of total billed charges",11.76,16.8,,9.41,,,0,"percent of total billed charges","16.8% of total billed charges",48.3,69,,,,,0,"fee schedule","69% of total billed charges",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",12.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",12.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",12.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.19,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.76,16.8,,9.41,,,0,"percent of total billed charges","16.8% of total billed charges",12.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.6,100,,,,,0,"fee schedule","100% of LI fee schedule",11.76,16.8,,9.41,,,0,"percent of total billed charges","16.8% of total billed charges",12.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",12,17.136,,9.60,,,0,"percent of total billed charges","17.136% of total billed charges",15.29,21.84,,12.23,,,0,"percent of total billed charges","21.84% of total billed charges",12.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.39,37.7,,21.11,,,0,"percent of total billed charges","37.7% of total billed charges",26.39,37.7,,21.11,,,0,"percent of total billed charges","37.70% of total billed charges",12.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.73,33.9,,18.98,,,0,"percent of total billed charges","33.9% of total billed charges",12.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.6,78,,43.68,,,0,"percent of total billed charges","78% of total billed charges",12.72,101,,,,,0,"fee schedule","101% of CMS fee schedule ",57.82,82.6,,46.26,,,0,"percent of total billed charges","82.6% of total billed charges",11.76,16.8,,9.41,,,0,"percent of total billed charges","16.8% of total billed charges",12.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.82,82.6,,46.26,,,0,"percent of total billed charges","82.6% of total billed charges",12.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.76,16.8,,9.41,,,0,"percent of total billed charges","16.8% of total billed charges",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",10.71,70,
"AQUATIC EXER/15MIN/-GP",42097113X,CDM,420,RC,97113,CPT,OUTPATIENT,,,250,162.5,GP,220,88,,176.00,,,0,"percent of total billed charges","88% of total billed charges",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.83,100,,,,,0,"fee schedule","100% of WA fee schedule",250,100,,200.00,,,0,"percent of total billed charges","100% of total billed charges",65.28,175,,,,,0,"fee schedule","175% of CMS fee schedule",21.83,100,,,,,0,"fee schedule","100% of WA fee schedule",37.47,100,,,,,0,"fee schedule","100% of CMS fee sv",157.5,63,,126.00,,,0,"percent of total billed charges","63% of total billed charges",38.25,15.3,,30.60,,,0,"percent of total billed charges","15.3% of total billed charges",21.83,100,,,,,0,"fee schedule","100% of WA fee schedule",172.5,69,,,,,0,"fee schedule","69% of total billed charges",250,100,,200.00,,,0,"percent of total billed charges","100% of total billed charges",37.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",250,100,,200.00,,,0,"percent of total billed charges","100% of total billed charges",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",250,100,,200.00,,,0,"percent of total billed charges","100% of total billed charges",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",147.22,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",21.83,100,,,,,0,"fee schedule","100% of WA fee schedule",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.81,100,,,,,0,"fee schedule","100% of LI fee schedule",21.83,100,,,,,0,"fee schedule","100% of WA fee schedule",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.27,102,,,,,0,"fee schedule","102% of WA fee schedule",28.38,130,,,,,0,"fee schedule","130% of WA fee schedule",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",94.25,37.7,,75.40,,,0,"percent of total billed charges","37.7% of total billed charges",94.25,37.7,,75.40,,,0,"percent of total billed charges","37.70% of total billed charges",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",84.75,33.9,,67.80,,,0,"percent of total billed charges","33.9% of total billed charges",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",195,78,,156.00,,,0,"percent of total billed charges","78% of total billed charges",37.84,101,,,,,0,"fee schedule","101% of CMS fee schedule ",206.5,82.6,,165.20,,,0,"percent of total billed charges","82.6% of total billed charges",21.83,100,,,,,0,"fee schedule","100% of WA fee schedule",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",206.5,82.6,,165.20,,,0,"percent of total billed charges","82.6% of total billed charges",37.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.83,100,,,,,0,"fee schedule","100% of WA fee schedule",250,100,,200.00,,,0,"percent of total billed charges","100% of total billed charges",21.83,250,
"ASSIST TECH ASSESS EA 15MIN GP",42097755X,CDM,420,RC,97755,CPT,OUTPATIENT,,,209,135.85,GP,183.92,88,,147.14,,,0,"percent of total billed charges","88% of total billed charges",38.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.59,100,,,,,0,"fee schedule","100% of WA fee schedule",209,100,,167.20,,,0,"percent of total billed charges","100% of total billed charges",67.62,175,,,,,0,"fee schedule","175% of CMS fee schedule",22.59,100,,,,,0,"fee schedule","100% of WA fee schedule",38.97,100,,,,,0,"fee schedule","100% of CMS fee sv",131.67,63,,105.34,,,0,"percent of total billed charges","63% of total billed charges",31.98,15.3,,25.58,,,0,"percent of total billed charges","15.3% of total billed charges",22.59,100,,,,,0,"fee schedule","100% of WA fee schedule",144.21,69,,,,,0,"fee schedule","69% of total billed charges",209,100,,167.20,,,0,"percent of total billed charges","100% of total billed charges",38.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",209,100,,167.20,,,0,"percent of total billed charges","100% of total billed charges",38.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",209,100,,167.20,,,0,"percent of total billed charges","100% of total billed charges",38.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",148.33,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",22.59,100,,,,,0,"fee schedule","100% of WA fee schedule",38.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.34,100,,,,,0,"fee schedule","100% of LI fee schedule",22.59,100,,,,,0,"fee schedule","100% of WA fee schedule",38.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.04,102,,,,,0,"fee schedule","102% of WA fee schedule",29.37,130,,,,,0,"fee schedule","130% of WA fee schedule",38.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.79,37.7,,63.03,,,0,"percent of total billed charges","37.7% of total billed charges",78.79,37.7,,63.03,,,0,"percent of total billed charges","37.70% of total billed charges",38.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.85,33.9,,56.68,,,0,"percent of total billed charges","33.9% of total billed charges",38.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.02,78,,130.42,,,0,"percent of total billed charges","78% of total billed charges",39.36,101,,,,,0,"fee schedule","101% of CMS fee schedule ",172.63,82.6,,138.10,,,0,"percent of total billed charges","82.6% of total billed charges",22.59,100,,,,,0,"fee schedule","100% of WA fee schedule",38.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",172.63,82.6,,138.10,,,0,"percent of total billed charges","82.6% of total billed charges",38.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.59,100,,,,,0,"fee schedule","100% of WA fee schedule",209,100,,167.20,,,0,"percent of total billed charges","100% of total billed charges",22.59,209,
"ELEC STIM MAN/15MIN/-GP",42097032X,CDM,420,RC,97032,CPT,OUTPATIENT,,,202,131.3,GP,177.76,88,,142.21,,,0,"percent of total billed charges","88% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",25.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee sv",127.26,63,,101.81,,,0,"percent of total billed charges","63% of total billed charges",30.91,15.3,,24.73,,,0,"percent of total billed charges","15.3% of total billed charges",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",139.38,69,,,,,0,"fee schedule","69% of total billed charges",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",14.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.3,100,,,,,0,"fee schedule","100% of LI fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.52,102,,,,,0,"fee schedule","102% of WA fee schedule",10.86,130,,,,,0,"fee schedule","130% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.15,37.7,,60.92,,,0,"percent of total billed charges","37.7% of total billed charges",76.15,37.7,,60.92,,,0,"percent of total billed charges","37.70% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.48,33.9,,54.78,,,0,"percent of total billed charges","33.9% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",157.56,78,,126.05,,,0,"percent of total billed charges","78% of total billed charges",14.68,101,,,,,0,"fee schedule","101% of CMS fee schedule ",166.85,82.6,,133.48,,,0,"percent of total billed charges","82.6% of total billed charges",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",166.85,82.6,,133.48,,,0,"percent of total billed charges","82.6% of total billed charges",14.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",8.35,202,
"PT Attended E-Stim Assistant Units",42097032,CDM,420,RC,97032,CPT,OUTPATIENT,,,211,137.15,GP|CQ,185.68,88,,148.54,,,0,"percent of total billed charges","88% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",25.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee sv",132.93,63,,106.34,,,0,"percent of total billed charges","63% of total billed charges",32.28,15.3,,25.82,,,0,"percent of total billed charges","15.3% of total billed charges",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",145.59,69,,,,,0,"fee schedule","69% of total billed charges",211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",14.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.3,100,,,,,0,"fee schedule","100% of LI fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.52,102,,,,,0,"fee schedule","102% of WA fee schedule",10.86,130,,,,,0,"fee schedule","130% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.55,37.7,,63.64,,,0,"percent of total billed charges","37.7% of total billed charges",79.55,37.7,,63.64,,,0,"percent of total billed charges","37.70% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.53,33.9,,57.22,,,0,"percent of total billed charges","33.9% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",164.58,78,,131.66,,,0,"percent of total billed charges","78% of total billed charges",14.68,101,,,,,0,"fee schedule","101% of CMS fee schedule ",174.29,82.6,,139.43,,,0,"percent of total billed charges","82.6% of total billed charges",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",174.29,82.6,,139.43,,,0,"percent of total billed charges","82.6% of total billed charges",14.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",8.35,211,
"PT Aquatic Assistant Units",42097113,CDM,420,RC,97113,CPT,OUTPATIENT,,,262,170.3,GP,230.56,88,,184.45,,,0,"percent of total billed charges","88% of total billed charges",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.83,100,,,,,0,"fee schedule","100% of WA fee schedule",262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",65.28,175,,,,,0,"fee schedule","175% of CMS fee schedule",21.83,100,,,,,0,"fee schedule","100% of WA fee schedule",37.47,100,,,,,0,"fee schedule","100% of CMS fee sv",165.06,63,,132.05,,,0,"percent of total billed charges","63% of total billed charges",40.09,15.3,,32.07,,,0,"percent of total billed charges","15.3% of total billed charges",21.83,100,,,,,0,"fee schedule","100% of WA fee schedule",180.78,69,,,,,0,"fee schedule","69% of total billed charges",262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",37.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",147.22,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",21.83,100,,,,,0,"fee schedule","100% of WA fee schedule",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.81,100,,,,,0,"fee schedule","100% of LI fee schedule",21.83,100,,,,,0,"fee schedule","100% of WA fee schedule",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.27,102,,,,,0,"fee schedule","102% of WA fee schedule",28.38,130,,,,,0,"fee schedule","130% of WA fee schedule",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.77,37.7,,79.02,,,0,"percent of total billed charges","37.7% of total billed charges",98.77,37.7,,79.02,,,0,"percent of total billed charges","37.70% of total billed charges",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.82,33.9,,71.06,,,0,"percent of total billed charges","33.9% of total billed charges",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",204.36,78,,163.49,,,0,"percent of total billed charges","78% of total billed charges",37.84,101,,,,,0,"fee schedule","101% of CMS fee schedule ",216.41,82.6,,173.13,,,0,"percent of total billed charges","82.6% of total billed charges",21.83,100,,,,,0,"fee schedule","100% of WA fee schedule",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",216.41,82.6,,173.13,,,0,"percent of total billed charges","82.6% of total billed charges",37.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.83,100,,,,,0,"fee schedule","100% of WA fee schedule",262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",21.83,262,
"CONTRAST BATH15MIN/-GP",42097034X,CDM,420,RC,97034,CPT,OUTPATIENT,,,112,72.8,GP,98.56,88,,78.85,,,0,"percent of total billed charges","88% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",24.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee sv",70.56,63,,56.45,,,0,"percent of total billed charges","63% of total billed charges",17.14,15.3,,13.71,,,0,"percent of total billed charges","15.3% of total billed charges",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",77.28,69,,,,,0,"fee schedule","69% of total billed charges",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",14.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.41,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.98,100,,,,,0,"fee schedule","100% of LI fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.71,102,,,,,0,"fee schedule","102% of WA fee schedule",11.1,130,,,,,0,"fee schedule","130% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.22,37.7,,33.78,,,0,"percent of total billed charges","37.7% of total billed charges",42.22,37.7,,33.78,,,0,"percent of total billed charges","37.70% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.97,33.9,,30.38,,,0,"percent of total billed charges","33.9% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.36,78,,69.89,,,0,"percent of total billed charges","78% of total billed charges",14.37,101,,,,,0,"fee schedule","101% of CMS fee schedule ",92.51,82.6,,74.01,,,0,"percent of total billed charges","82.6% of total billed charges",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.51,82.6,,74.01,,,0,"percent of total billed charges","82.6% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",8.54,112,
"COMM/WORK REINT/15MIN/-GP",42097537X,CDM,420,RC,97537,CPT,OUTPATIENT,,,280,182,GP,246.4,88,,197.12,,,0,"percent of total billed charges","88% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",56.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee sv",176.4,63,,141.12,,,0,"percent of total billed charges","63% of total billed charges",42.84,15.3,,34.27,,,0,"percent of total billed charges","15.3% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",193.2,69,,,,,0,"fee schedule","69% of total billed charges",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",32.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.24,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.75,100,,,,,0,"fee schedule","100% of LI fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.17,102,,,,,0,"fee schedule","102% of WA fee schedule",24.43,130,,,,,0,"fee schedule","130% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",105.56,37.7,,84.45,,,0,"percent of total billed charges","37.7% of total billed charges",105.56,37.7,,84.45,,,0,"percent of total billed charges","37.70% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",94.92,33.9,,75.94,,,0,"percent of total billed charges","33.9% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",218.4,78,,174.72,,,0,"percent of total billed charges","78% of total billed charges",32.6,101,,,,,0,"fee schedule","101% of CMS fee schedule ",231.28,82.6,,185.02,,,0,"percent of total billed charges","82.6% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",231.28,82.6,,185.02,,,0,"percent of total billed charges","82.6% of total billed charges",32.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",280,100,,224.00,,,0,"percent of total billed charges","100% of total billed charges",18.79,280,
N/A,,,420,RC,,,OUTPATIENT,,,249,161.85,,219.12,88,,175.30,,,0,"percent of total billed charges","88% of total billed charges",124.5,50,,99.60,,,0,"percent of total billed charges","50% of total billed charges",41.83,16.8,,33.46,,,0,"percent of total billed charges","16.8% of total billed charges",249,100,,199.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.09,17.304,,34.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.87,63,,125.50,,,0,"percent of total billed charges","63% of total billed charges",38.1,15.3,,30.48,,,0,"percent of total billed charges","15.3% of total billed charges",41.83,16.8,,33.46,,,0,"percent of total billed charges","16.8% of total billed charges",171.81,69,,,,,0,"fee schedule","69% of total billed charges",249,100,,199.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",249,100,,199.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",249,100,,199.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.83,16.8,,33.46,,,0,"percent of total billed charges","16.8% of total billed charges",124.5,50,,99.60,,,0,"percent of total billed charges","50% of total billed charges",80.18,32.2,,64.14,,,0,"percent of total billed charges","32.2% of total billed charges",41.83,16.8,,33.46,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.67,17.136,,34.14,,,0,"percent of total billed charges","17.136% of total billed charges",54.38,21.84,,43.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",93.87,37.7,,75.10,,,0,"percent of total billed charges","37.7% of total billed charges",93.87,37.7,,75.10,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.41,33.9,,67.53,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.22,78,,155.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",205.67,82.6,,164.54,,,0,"percent of total billed charges","82.6% of total billed charges",41.83,16.8,,33.46,,,0,"percent of total billed charges","16.8% of total billed charges",124.5,50,,99.60,,,0,"percent of total billed charges","50% of total billed charges",205.67,82.6,,164.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.83,16.8,,33.46,,,0,"percent of total billed charges","16.8% of total billed charges",249,100,,199.20,,,0,"percent of total billed charges","100% of total billed charges",38.1,249,
"PT Community,Work Reintegration Assistant Units",42097537,CDM,420,RC,97537,CPT,OUTPATIENT,,,250,162.5,CQ|GP,220,88,,176.00,,,0,"percent of total billed charges","88% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",250,100,,200.00,,,0,"percent of total billed charges","100% of total billed charges",56.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee sv",157.5,63,,126.00,,,0,"percent of total billed charges","63% of total billed charges",38.25,15.3,,30.60,,,0,"percent of total billed charges","15.3% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",172.5,69,,,,,0,"fee schedule","69% of total billed charges",250,100,,200.00,,,0,"percent of total billed charges","100% of total billed charges",32.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",250,100,,200.00,,,0,"percent of total billed charges","100% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",250,100,,200.00,,,0,"percent of total billed charges","100% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.24,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.75,100,,,,,0,"fee schedule","100% of LI fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.17,102,,,,,0,"fee schedule","102% of WA fee schedule",24.43,130,,,,,0,"fee schedule","130% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",94.25,37.7,,75.40,,,0,"percent of total billed charges","37.7% of total billed charges",94.25,37.7,,75.40,,,0,"percent of total billed charges","37.70% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",84.75,33.9,,67.80,,,0,"percent of total billed charges","33.9% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",195,78,,156.00,,,0,"percent of total billed charges","78% of total billed charges",32.6,101,,,,,0,"fee schedule","101% of CMS fee schedule ",206.5,82.6,,165.20,,,0,"percent of total billed charges","82.6% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",206.5,82.6,,165.20,,,0,"percent of total billed charges","82.6% of total billed charges",32.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",250,100,,200.00,,,0,"percent of total billed charges","100% of total billed charges",18.79,250,
"THER PROC GROUP 2/MORE IND-GP",42097150X,CDM,420,RC,97150,CPT,OUTPATIENT,,,147,95.55,GP,129.36,88,,103.49,,,0,"percent of total billed charges","88% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",31.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee sv",92.61,63,,74.09,,,0,"percent of total billed charges","63% of total billed charges",22.49,15.3,,17.99,,,0,"percent of total billed charges","15.3% of total billed charges",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",101.43,69,,,,,0,"fee schedule","69% of total billed charges",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",18.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.46,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",18,100,,,,,0,"fee schedule","100% of LI fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.65,102,,,,,0,"fee schedule","102% of WA fee schedule",13.57,130,,,,,0,"fee schedule","130% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.42,37.7,,44.34,,,0,"percent of total billed charges","37.7% of total billed charges",55.42,37.7,,44.34,,,0,"percent of total billed charges","37.70% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.83,33.9,,39.86,,,0,"percent of total billed charges","33.9% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",114.66,78,,91.73,,,0,"percent of total billed charges","78% of total billed charges",18.47,101,,,,,0,"fee schedule","101% of CMS fee schedule ",121.42,82.6,,97.14,,,0,"percent of total billed charges","82.6% of total billed charges",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",121.42,82.6,,97.14,,,0,"percent of total billed charges","82.6% of total billed charges",18.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",10.44,147,
"MANUAL THERAPY/15MIN/-GP",42097140X,CDM,420,RC,97140,CPT,OUTPATIENT,,,269,174.85,GP,236.72,88,,189.38,,,0,"percent of total billed charges","88% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",47.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee sv",169.47,63,,135.58,,,0,"percent of total billed charges","63% of total billed charges",41.16,15.3,,32.93,,,0,"percent of total billed charges","15.3% of total billed charges",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",185.61,69,,,,,0,"fee schedule","69% of total billed charges",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",27.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.72,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.05,100,,,,,0,"fee schedule","100% of LI fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.26,102,,,,,0,"fee schedule","102% of WA fee schedule",20.72,130,,,,,0,"fee schedule","130% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.41,37.7,,81.13,,,0,"percent of total billed charges","37.7% of total billed charges",101.41,37.7,,81.13,,,0,"percent of total billed charges","37.70% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.19,33.9,,72.95,,,0,"percent of total billed charges","33.9% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",209.82,78,,167.86,,,0,"percent of total billed charges","78% of total billed charges",27.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",222.19,82.6,,177.75,,,0,"percent of total billed charges","82.6% of total billed charges",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",222.19,82.6,,177.75,,,0,"percent of total billed charges","82.6% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",15.94,269,
"PT EVAL- LOW COMP",42497161X,CDM,424,RC,97161,CPT,OUTPATIENT,,,403,261.95,GP,354.64,88,,283.71,,,0,"percent of total billed charges","88% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",177.68,175,,,,,0,"fee schedule","175% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee sv",253.89,63,,203.11,,,0,"percent of total billed charges","63% of total billed charges",61.66,15.3,,49.33,,,0,"percent of total billed charges","15.3% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",278.07,69,,,,,0,"fee schedule","69% of total billed charges",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",101.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",390.49,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.52,100,,,,,0,"fee schedule","100% of LI fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.4,102,,,,,0,"fee schedule","102% of WA fee schedule",76.99,130,,,,,0,"fee schedule","130% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.7% of total billed charges",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.70% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.62,33.9,,109.30,,,0,"percent of total billed charges","33.9% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",314.34,78,,251.47,,,0,"percent of total billed charges","78% of total billed charges",103.21,101,,,,,0,"fee schedule","101% of CMS fee schedule ",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",102.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",59.22,403,
"PT EVAL- MOD COMP",42497162X,CDM,424,RC,97162,CPT,OUTPATIENT,,,403,261.95,GP,354.64,88,,283.71,,,0,"percent of total billed charges","88% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",177.68,175,,,,,0,"fee schedule","175% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee sv",253.89,63,,203.11,,,0,"percent of total billed charges","63% of total billed charges",61.66,15.3,,49.33,,,0,"percent of total billed charges","15.3% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",278.07,69,,,,,0,"fee schedule","69% of total billed charges",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",101.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",390.49,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.52,100,,,,,0,"fee schedule","100% of LI fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.4,102,,,,,0,"fee schedule","102% of WA fee schedule",76.99,130,,,,,0,"fee schedule","130% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.7% of total billed charges",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.70% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.62,33.9,,109.30,,,0,"percent of total billed charges","33.9% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",314.34,78,,251.47,,,0,"percent of total billed charges","78% of total billed charges",103.21,101,,,,,0,"fee schedule","101% of CMS fee schedule ",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",102.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",59.22,403,
"PT EVAL- HGH COMP",42497163X,CDM,424,RC,97163,CPT,OUTPATIENT,,,403,261.95,GP,354.64,88,,283.71,,,0,"percent of total billed charges","88% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",177.68,175,,,,,0,"fee schedule","175% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee sv",253.89,63,,203.11,,,0,"percent of total billed charges","63% of total billed charges",61.66,15.3,,49.33,,,0,"percent of total billed charges","15.3% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",278.07,69,,,,,0,"fee schedule","69% of total billed charges",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",101.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",390.49,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.52,100,,,,,0,"fee schedule","100% of LI fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.4,102,,,,,0,"fee schedule","102% of WA fee schedule",76.99,130,,,,,0,"fee schedule","130% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.7% of total billed charges",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.70% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.62,33.9,,109.30,,,0,"percent of total billed charges","33.9% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",314.34,78,,251.47,,,0,"percent of total billed charges","78% of total billed charges",103.21,101,,,,,0,"fee schedule","101% of CMS fee schedule ",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",102.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",59.22,403,
"GAIT TRAINING/15MIN/-GP",42197116X,CDM,421,RC,97116,CPT,OUTPATIENT,,,182,118.3,GP,160.16,88,,128.13,,,0,"percent of total billed charges","88% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",52.01,175,,,,,0,"fee schedule","175% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee sv",114.66,63,,91.73,,,0,"percent of total billed charges","63% of total billed charges",27.85,15.3,,22.28,,,0,"percent of total billed charges","15.3% of total billed charges",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",125.58,69,,,,,0,"fee schedule","69% of total billed charges",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",29.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",116.17,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.4,100,,,,,0,"fee schedule","100% of LI fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.81,102,,,,,0,"fee schedule","102% of WA fee schedule",22.7,130,,,,,0,"fee schedule","130% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.61,37.7,,54.89,,,0,"percent of total billed charges","37.7% of total billed charges",68.61,37.7,,54.89,,,0,"percent of total billed charges","37.70% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.7,33.9,,49.36,,,0,"percent of total billed charges","33.9% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",141.96,78,,113.57,,,0,"percent of total billed charges","78% of total billed charges",30.19,101,,,,,0,"fee schedule","101% of CMS fee schedule ",150.33,82.6,,120.26,,,0,"percent of total billed charges","82.6% of total billed charges",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.33,82.6,,120.26,,,0,"percent of total billed charges","82.6% of total billed charges",29.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",17.46,182,
"THER PROC GROUP 2/MORE IND-GP",42097150X,CDM,420,RC,97150,CPT,OUTPATIENT,,,147,95.55,GP,129.36,88,,103.49,,,0,"percent of total billed charges","88% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",31.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee sv",92.61,63,,74.09,,,0,"percent of total billed charges","63% of total billed charges",22.49,15.3,,17.99,,,0,"percent of total billed charges","15.3% of total billed charges",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",101.43,69,,,,,0,"fee schedule","69% of total billed charges",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",18.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.46,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",18,100,,,,,0,"fee schedule","100% of LI fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.65,102,,,,,0,"fee schedule","102% of WA fee schedule",13.57,130,,,,,0,"fee schedule","130% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.42,37.7,,44.34,,,0,"percent of total billed charges","37.7% of total billed charges",55.42,37.7,,44.34,,,0,"percent of total billed charges","37.70% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.83,33.9,,39.86,,,0,"percent of total billed charges","33.9% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",114.66,78,,91.73,,,0,"percent of total billed charges","78% of total billed charges",18.47,101,,,,,0,"fee schedule","101% of CMS fee schedule ",121.42,82.6,,97.14,,,0,"percent of total billed charges","82.6% of total billed charges",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",121.42,82.6,,97.14,,,0,"percent of total billed charges","82.6% of total billed charges",18.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",10.44,147,
"PT Group Therapy Assistant Units",42097150,CDM,423,RC,97150,CPT,OUTPATIENT,,,153,99.45,CQ|GP,134.64,88,,107.71,,,0,"percent of total billed charges","88% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",31.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee sv",96.39,63,,77.11,,,0,"percent of total billed charges","63% of total billed charges",23.41,15.3,,18.73,,,0,"percent of total billed charges","15.3% of total billed charges",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",105.57,69,,,,,0,"fee schedule","69% of total billed charges",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",18.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.46,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",18,100,,,,,0,"fee schedule","100% of LI fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.65,102,,,,,0,"fee schedule","102% of WA fee schedule",13.57,130,,,,,0,"fee schedule","130% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.68,37.7,,46.14,,,0,"percent of total billed charges","37.7% of total billed charges",57.68,37.7,,46.14,,,0,"percent of total billed charges","37.70% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.87,33.9,,41.50,,,0,"percent of total billed charges","33.9% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",119.34,78,,95.47,,,0,"percent of total billed charges","78% of total billed charges",18.47,101,,,,,0,"fee schedule","101% of CMS fee schedule ",126.38,82.6,,101.10,,,0,"percent of total billed charges","82.6% of total billed charges",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",126.38,82.6,,101.10,,,0,"percent of total billed charges","82.6% of total billed charges",18.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",10.44,153,
"PT Gait Training Assistant Units",42197116,CDM,421,RC,97116,CPT,OUTPATIENT,,,196,127.4,GP|CQ,172.48,88,,137.98,,,0,"percent of total billed charges","88% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",52.01,175,,,,,0,"fee schedule","175% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee sv",123.48,63,,98.78,,,0,"percent of total billed charges","63% of total billed charges",29.99,15.3,,23.99,,,0,"percent of total billed charges","15.3% of total billed charges",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",135.24,69,,,,,0,"fee schedule","69% of total billed charges",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",29.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",116.17,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.4,100,,,,,0,"fee schedule","100% of LI fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.81,102,,,,,0,"fee schedule","102% of WA fee schedule",22.7,130,,,,,0,"fee schedule","130% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.89,37.7,,59.11,,,0,"percent of total billed charges","37.7% of total billed charges",73.89,37.7,,59.11,,,0,"percent of total billed charges","37.70% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.44,33.9,,53.15,,,0,"percent of total billed charges","33.9% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",152.88,78,,122.30,,,0,"percent of total billed charges","78% of total billed charges",30.19,101,,,,,0,"fee schedule","101% of CMS fee schedule ",161.9,82.6,,129.52,,,0,"percent of total billed charges","82.6% of total billed charges",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",161.9,82.6,,129.52,,,0,"percent of total billed charges","82.6% of total billed charges",29.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",17.46,196,
THERAPEUTIC,42097110X,CDM,420,RC,97110,CPT,OUTPATIENT,,,181,117.65,GO,159.28,88,,127.42,,,0,"percent of total billed charges","88% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",52.01,175,,,,,0,"fee schedule","175% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee sv",114.03,63,,91.22,,,0,"percent of total billed charges","63% of total billed charges",27.69,15.3,,22.15,,,0,"percent of total billed charges","15.3% of total billed charges",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",124.89,69,,,,,0,"fee schedule","69% of total billed charges",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",29.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",116.17,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.4,100,,,,,0,"fee schedule","100% of LI fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.81,102,,,,,0,"fee schedule","102% of WA fee schedule",22.7,130,,,,,0,"fee schedule","130% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.24,37.7,,54.59,,,0,"percent of total billed charges","37.7% of total billed charges",68.24,37.7,,54.59,,,0,"percent of total billed charges","37.70% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.36,33.9,,49.09,,,0,"percent of total billed charges","33.9% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",141.18,78,,112.94,,,0,"percent of total billed charges","78% of total billed charges",30.19,101,,,,,0,"fee schedule","101% of CMS fee schedule ",149.51,82.6,,119.61,,,0,"percent of total billed charges","82.6% of total billed charges",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",149.51,82.6,,119.61,,,0,"percent of total billed charges","82.6% of total billed charges",29.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",17.46,181,
IONTOPHORESIS/15MIN,42097033X,CDM,420,RC,97033,CPT,OUTPATIENT,,,201,130.65,GP,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",34.2,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee sv",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",19.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of LI fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.01,102,,,,,0,"fee schedule","102% of WA fee schedule",15.3,130,,,,,0,"fee schedule","130% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.7% of total billed charges",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.14,33.9,,54.51,,,0,"percent of total billed charges","33.9% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",19.91,101,,,,,0,"fee schedule","101% of CMS fee schedule ",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",19.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",11.77,201,
INFRARED,42097026X,CDM,420,RC,97026,CPT,OUTPATIENT,,,37,24.05,GP,32.56,88,,26.05,,,0,"percent of total billed charges","88% of total billed charges",6.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.99,100,,,,,0,"fee schedule","100% of WA fee schedule",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",11.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.99,100,,,,,0,"fee schedule","100% of WA fee schedule",6.77,100,,,,,0,"fee schedule","100% of CMS fee sv",,,,,,,0,other,"not separately reimbursment",5.66,15.3,,4.53,,,0,"percent of total billed charges","15.3% of total billed charges",3.99,100,,,,,0,"fee schedule","100% of WA fee schedule",25.53,69,,,,,0,"fee schedule","69% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",6.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",6.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.99,100,,,,,0,"fee schedule","100% of WA fee schedule",6.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.63,100,,,,,0,"fee schedule","100% of LI fee schedule",3.99,100,,,,,0,"fee schedule","100% of WA fee schedule",6.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.07,102,,,,,0,"fee schedule","102% of WA fee schedule",5.19,130,,,,,0,"fee schedule","130% of WA fee schedule",6.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.95,37.7,,11.16,,,0,"percent of total billed charges","37.7% of total billed charges",13.95,37.7,,11.16,,,0,"percent of total billed charges","37.70% of total billed charges",6.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.54,33.9,,10.03,,,0,"percent of total billed charges","33.9% of total billed charges",6.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.86,78,,23.09,,,0,"percent of total billed charges","78% of total billed charges",6.84,101,,,,,0,"fee schedule","101% of CMS fee schedule ",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",3.99,100,,,,,0,"fee schedule","100% of WA fee schedule",6.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",6.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.99,100,,,,,0,"fee schedule","100% of WA fee schedule",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",3.99,37,
"PT Iontophoresis Assistant Units",42097033,CDM,420,RC,97033,CPT,OUTPATIENT,,,210,136.5,CQ|GP,184.8,88,,147.84,,,0,"percent of total billed charges","88% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",34.2,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee sv",132.3,63,,105.84,,,0,"percent of total billed charges","63% of total billed charges",32.13,15.3,,25.70,,,0,"percent of total billed charges","15.3% of total billed charges",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",144.9,69,,,,,0,"fee schedule","69% of total billed charges",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",19.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of LI fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.01,102,,,,,0,"fee schedule","102% of WA fee schedule",15.3,130,,,,,0,"fee schedule","130% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.17,37.7,,63.34,,,0,"percent of total billed charges","37.7% of total billed charges",79.17,37.7,,63.34,,,0,"percent of total billed charges","37.70% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.19,33.9,,56.95,,,0,"percent of total billed charges","33.9% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.8,78,,131.04,,,0,"percent of total billed charges","78% of total billed charges",19.91,101,,,,,0,"fee schedule","101% of CMS fee schedule ",173.46,82.6,,138.77,,,0,"percent of total billed charges","82.6% of total billed charges",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",173.46,82.6,,138.77,,,0,"percent of total billed charges","82.6% of total billed charges",19.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",11.77,210,
"MANUAL THERAPY/15MIN/-GP",42097140X,CDM,420,RC,97140,CPT,OUTPATIENT,,,269,174.85,GP,236.72,88,,189.38,,,0,"percent of total billed charges","88% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",47.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee sv",169.47,63,,135.58,,,0,"percent of total billed charges","63% of total billed charges",41.16,15.3,,32.93,,,0,"percent of total billed charges","15.3% of total billed charges",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",185.61,69,,,,,0,"fee schedule","69% of total billed charges",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",27.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.72,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.05,100,,,,,0,"fee schedule","100% of LI fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.26,102,,,,,0,"fee schedule","102% of WA fee schedule",20.72,130,,,,,0,"fee schedule","130% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.41,37.7,,81.13,,,0,"percent of total billed charges","37.7% of total billed charges",101.41,37.7,,81.13,,,0,"percent of total billed charges","37.70% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.19,33.9,,72.95,,,0,"percent of total billed charges","33.9% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",209.82,78,,167.86,,,0,"percent of total billed charges","78% of total billed charges",27.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",222.19,82.6,,177.75,,,0,"percent of total billed charges","82.6% of total billed charges",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",222.19,82.6,,177.75,,,0,"percent of total billed charges","82.6% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",15.94,269,
MASSAGE/15MIN/-GP,42097124X,CDM,420,RC,97124,CPT,OUTPATIENT,,,119,77.35,GP,104.72,88,,83.78,,,0,"percent of total billed charges","88% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",54.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee sv",74.97,63,,59.98,,,0,"percent of total billed charges","63% of total billed charges",18.21,15.3,,14.57,,,0,"percent of total billed charges","15.3% of total billed charges",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",82.11,69,,,,,0,"fee schedule","69% of total billed charges",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",30.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.46,100,,,,,0,"fee schedule","100% of LI fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.2,102,,,,,0,"fee schedule","102% of WA fee schedule",23.19,130,,,,,0,"fee schedule","130% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.7% of total billed charges",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.70% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.34,33.9,,32.27,,,0,"percent of total billed charges","33.9% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.82,78,,74.26,,,0,"percent of total billed charges","78% of total billed charges",31.34,101,,,,,0,"fee schedule","101% of CMS fee schedule ",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",31.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",17.84,119,
"TRACTION MECHANICAL/-GP",42097012X,CDM,420,RC,97012,CPT,OUTPATIENT,,,129,83.85,GP,113.52,88,,90.82,,,0,"percent of total billed charges","88% of total billed charges",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",129,100,,103.20,,,0,"percent of total billed charges","100% of total billed charges",24.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.18,100,,,,,0,"fee schedule","100% of CMS fee sv",81.27,63,,65.02,,,0,"percent of total billed charges","63% of total billed charges",19.74,15.3,,15.79,,,0,"percent of total billed charges","15.3% of total billed charges",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",89.01,69,,,,,0,"fee schedule","69% of total billed charges",129,100,,103.20,,,0,"percent of total billed charges","100% of total billed charges",14.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",129,100,,103.20,,,0,"percent of total billed charges","100% of total billed charges",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",129,100,,103.20,,,0,"percent of total billed charges","100% of total billed charges",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.97,100,,,,,0,"fee schedule","100% of LI fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.52,102,,,,,0,"fee schedule","102% of WA fee schedule",10.86,130,,,,,0,"fee schedule","130% of WA fee schedule",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.63,37.7,,38.90,,,0,"percent of total billed charges","37.7% of total billed charges",48.63,37.7,,38.90,,,0,"percent of total billed charges","37.70% of total billed charges",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.73,33.9,,34.98,,,0,"percent of total billed charges","33.9% of total billed charges",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.62,78,,80.50,,,0,"percent of total billed charges","78% of total billed charges",14.32,101,,,,,0,"fee schedule","101% of CMS fee schedule ",106.55,82.6,,85.24,,,0,"percent of total billed charges","82.6% of total billed charges",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.55,82.6,,85.24,,,0,"percent of total billed charges","82.6% of total billed charges",14.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",129,100,,103.20,,,0,"percent of total billed charges","100% of total billed charges",8.35,129,
"PT Manual Therapy Assistant Units",42097140,CDM,420,RC,97140,CPT,OUTPATIENT,,,282,183.3,GP|CQ,248.16,88,,198.53,,,0,"percent of total billed charges","88% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",282,100,,225.60,,,0,"percent of total billed charges","100% of total billed charges",47.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee sv",177.66,63,,142.13,,,0,"percent of total billed charges","63% of total billed charges",43.15,15.3,,34.52,,,0,"percent of total billed charges","15.3% of total billed charges",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",194.58,69,,,,,0,"fee schedule","69% of total billed charges",282,100,,225.60,,,0,"percent of total billed charges","100% of total billed charges",27.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",282,100,,225.60,,,0,"percent of total billed charges","100% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",282,100,,225.60,,,0,"percent of total billed charges","100% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.72,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.05,100,,,,,0,"fee schedule","100% of LI fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.26,102,,,,,0,"fee schedule","102% of WA fee schedule",20.72,130,,,,,0,"fee schedule","130% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.31,37.7,,85.05,,,0,"percent of total billed charges","37.7% of total billed charges",106.31,37.7,,85.05,,,0,"percent of total billed charges","37.70% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.6,33.9,,76.48,,,0,"percent of total billed charges","33.9% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",219.96,78,,175.97,,,0,"percent of total billed charges","78% of total billed charges",27.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",232.93,82.6,,186.34,,,0,"percent of total billed charges","82.6% of total billed charges",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",232.93,82.6,,186.34,,,0,"percent of total billed charges","82.6% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",282,100,,225.60,,,0,"percent of total billed charges","100% of total billed charges",15.94,282,
"NEURO RE-ED/15MIN/-GP",42197112X,CDM,420,RC,97112,CPT,OUTPATIENT,,,228,148.2,GP,200.64,88,,160.51,,,0,"percent of total billed charges","88% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",59.8,175,,,,,0,"fee schedule","175% of CMS fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee sv",143.64,63,,114.91,,,0,"percent of total billed charges","63% of total billed charges",34.88,15.3,,27.90,,,0,"percent of total billed charges","15.3% of total billed charges",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",157.32,69,,,,,0,"fee schedule","69% of total billed charges",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",34.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",135.02,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.76,100,,,,,0,"fee schedule","100% of LI fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.33,102,,,,,0,"fee schedule","102% of WA fee schedule",25.91,130,,,,,0,"fee schedule","130% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.96,37.7,,68.77,,,0,"percent of total billed charges","37.7% of total billed charges",85.96,37.7,,68.77,,,0,"percent of total billed charges","37.70% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.29,33.9,,61.83,,,0,"percent of total billed charges","33.9% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",177.84,78,,142.27,,,0,"percent of total billed charges","78% of total billed charges",34.67,101,,,,,0,"fee schedule","101% of CMS fee schedule ",188.33,82.6,,150.66,,,0,"percent of total billed charges","82.6% of total billed charges",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",188.33,82.6,,150.66,,,0,"percent of total billed charges","82.6% of total billed charges",34.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",19.93,228,
"NEG PRESS WOUND TX >50 CM GP",42097606X,CDM,420,RC,97606,CPT,OUTPATIENT,,,591,384.15,GP,520.08,88,,416.06,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",372.33,63,,297.86,,,0,"percent of total billed charges","63% of total billed charges",90.42,15.3,,72.34,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,407.79,69,,,,,0,"fee schedule","69% of total billed charges",591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",222.81,37.7,,178.25,,,0,"percent of total billed charges","37.7% of total billed charges",222.81,37.7,,178.25,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200.35,33.9,,160.28,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460.98,78,,368.78,,,0,"percent of total billed charges","78% of total billed charges",410.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",488.17,82.6,,390.54,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",488.17,82.6,,390.54,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",90.42,1404.98,
"NEG PRESS WOUND TX <50 CM GP",42097605X,CDM,420,RC,97605,CPT,OUTPATIENT,,,591,384.15,GP,520.08,88,,416.06,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",372.33,63,,297.86,,,0,"percent of total billed charges","63% of total billed charges",90.42,15.3,,72.34,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,407.79,69,,,,,0,"fee schedule","69% of total billed charges",591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",222.81,37.7,,178.25,,,0,"percent of total billed charges","37.7% of total billed charges",222.81,37.7,,178.25,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200.35,33.9,,160.28,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460.98,78,,368.78,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",488.17,82.6,,390.54,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",488.17,82.6,,390.54,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",90.42,729.42,
"DEBRIDEMENT NON-SELCT/SESS/-GP",42097602X,CDM,420,RC,97602,CPT,OUTPATIENT,,,737,479.05,GP,648.56,88,,518.85,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",464.31,63,,371.45,,,0,"percent of total billed charges","63% of total billed charges",112.76,15.3,,90.21,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,508.53,69,,,,,0,"fee schedule","69% of total billed charges",737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.85,37.7,,222.28,,,0,"percent of total billed charges","37.7% of total billed charges",277.85,37.7,,222.28,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",249.84,33.9,,199.87,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",574.86,78,,459.89,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",608.76,82.6,,487.01,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",608.76,82.6,,487.01,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",112.76,737,
"PT Neuromuscular Reeducation Assistant Units",42097112,CDM,420,RC,97112,CPT,OUTPATIENT,,,240,156,CQ|GP,211.2,88,,168.96,,,0,"percent of total billed charges","88% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",59.8,175,,,,,0,"fee schedule","175% of CMS fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee sv",151.2,63,,120.96,,,0,"percent of total billed charges","63% of total billed charges",36.72,15.3,,29.38,,,0,"percent of total billed charges","15.3% of total billed charges",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",165.6,69,,,,,0,"fee schedule","69% of total billed charges",240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",34.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",135.02,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.76,100,,,,,0,"fee schedule","100% of LI fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.33,102,,,,,0,"fee schedule","102% of WA fee schedule",25.91,130,,,,,0,"fee schedule","130% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.48,37.7,,72.38,,,0,"percent of total billed charges","37.7% of total billed charges",90.48,37.7,,72.38,,,0,"percent of total billed charges","37.70% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.36,33.9,,65.09,,,0,"percent of total billed charges","33.9% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",187.2,78,,149.76,,,0,"percent of total billed charges","78% of total billed charges",34.67,101,,,,,0,"fee schedule","101% of CMS fee schedule ",198.24,82.6,,158.59,,,0,"percent of total billed charges","82.6% of total billed charges",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",198.24,82.6,,158.59,,,0,"percent of total billed charges","82.6% of total billed charges",34.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",19.93,240,
"ORTH/PROS CHECKOUT EST 15M GP",42097763X,CDM,420,RC,97763,CPT,OUTPATIENT,,,184,119.6,GP,161.92,88,,129.54,,,0,"percent of total billed charges","88% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",93.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.83,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee sv",115.92,63,,92.74,,,0,"percent of total billed charges","63% of total billed charges",28.15,15.3,,22.52,,,0,"percent of total billed charges","15.3% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,126.96,69,,,,,0,"fee schedule","69% of total billed charges",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",53.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",212.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.67,100,,,,,0,"fee schedule","100% of LI fee schedule",25.77,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.48,100,,,,,0,"fee schedule",EAPG,45.23,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.37,37.7,,55.50,,,0,"percent of total billed charges","37.7% of total billed charges",69.37,37.7,,55.50,,,0,"percent of total billed charges","37.70% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.38,33.9,,49.90,,,0,"percent of total billed charges","33.9% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",143.52,78,,114.82,,,0,"percent of total billed charges","78% of total billed charges",54.28,101,,,,,0,"fee schedule","101% of CMS fee schedule ",151.98,82.6,,121.58,,,0,"percent of total billed charges","82.6% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.98,82.6,,121.58,,,0,"percent of total billed charges","82.6% of total billed charges",53.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",25.77,212.21,
"ORTHOTIC MGMT EA 15M PT",42097760X,CDM,420,RC,97760,CPT,OUTPATIENT,,,175,113.75,GP,154,88,,123.20,,,0,"percent of total billed charges","88% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",85.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee sv",110.25,63,,88.20,,,0,"percent of total billed charges","63% of total billed charges",26.78,15.3,,21.42,,,0,"percent of total billed charges","15.3% of total billed charges",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",120.75,69,,,,,0,"fee schedule","69% of total billed charges",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",48.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",193.2,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.94,100,,,,,0,"fee schedule","100% of LI fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.62,102,,,,,0,"fee schedule","102% of WA fee schedule",37.75,130,,,,,0,"fee schedule","130% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.98,37.7,,52.78,,,0,"percent of total billed charges","37.7% of total billed charges",65.98,37.7,,52.78,,,0,"percent of total billed charges","37.70% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.33,33.9,,47.46,,,0,"percent of total billed charges","33.9% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.5,78,,109.20,,,0,"percent of total billed charges","78% of total billed charges",49.36,101,,,,,0,"fee schedule","101% of CMS fee schedule ",144.55,82.6,,115.64,,,0,"percent of total billed charges","82.6% of total billed charges",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.55,82.6,,115.64,,,0,"percent of total billed charges","82.6% of total billed charges",48.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",26.78,193.2,
"PT Orthotic Management, Train Assistant Units",42097760,CDM,420,RC,97760,CPT,OUTPATIENT,,,282,183.3,CQ|GP,248.16,88,,198.53,,,0,"percent of total billed charges","88% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",282,100,,225.60,,,0,"percent of total billed charges","100% of total billed charges",85.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee sv",177.66,63,,142.13,,,0,"percent of total billed charges","63% of total billed charges",43.15,15.3,,34.52,,,0,"percent of total billed charges","15.3% of total billed charges",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",194.58,69,,,,,0,"fee schedule","69% of total billed charges",282,100,,225.60,,,0,"percent of total billed charges","100% of total billed charges",48.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",282,100,,225.60,,,0,"percent of total billed charges","100% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",282,100,,225.60,,,0,"percent of total billed charges","100% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",193.2,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.94,100,,,,,0,"fee schedule","100% of LI fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.62,102,,,,,0,"fee schedule","102% of WA fee schedule",37.75,130,,,,,0,"fee schedule","130% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.31,37.7,,85.05,,,0,"percent of total billed charges","37.7% of total billed charges",106.31,37.7,,85.05,,,0,"percent of total billed charges","37.70% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.6,33.9,,76.48,,,0,"percent of total billed charges","33.9% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",219.96,78,,175.97,,,0,"percent of total billed charges","78% of total billed charges",49.36,101,,,,,0,"fee schedule","101% of CMS fee schedule ",232.93,82.6,,186.34,,,0,"percent of total billed charges","82.6% of total billed charges",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",232.93,82.6,,186.34,,,0,"percent of total billed charges","82.6% of total billed charges",48.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",282,100,,225.60,,,0,"percent of total billed charges","100% of total billed charges",29.04,282,
"PT Orthotic/Prost Mgmt,Train Assist Unit",42097763,CDM,420,RC,97763,CPT,OUTPATIENT,,,194,126.1,GP|CQ,170.72,88,,136.58,,,0,"percent of total billed charges","88% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",93.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.83,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee sv",122.22,63,,97.78,,,0,"percent of total billed charges","63% of total billed charges",29.68,15.3,,23.74,,,0,"percent of total billed charges","15.3% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,133.86,69,,,,,0,"fee schedule","69% of total billed charges",194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",53.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",212.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.67,100,,,,,0,"fee schedule","100% of LI fee schedule",25.77,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.48,100,,,,,0,"fee schedule",EAPG,45.23,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.14,37.7,,58.51,,,0,"percent of total billed charges","37.7% of total billed charges",73.14,37.7,,58.51,,,0,"percent of total billed charges","37.70% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.77,33.9,,52.62,,,0,"percent of total billed charges","33.9% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.32,78,,121.06,,,0,"percent of total billed charges","78% of total billed charges",54.28,101,,,,,0,"fee schedule","101% of CMS fee schedule ",160.24,82.6,,128.19,,,0,"percent of total billed charges","82.6% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.24,82.6,,128.19,,,0,"percent of total billed charges","82.6% of total billed charges",53.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,194,100,,155.20,,,0,"percent of total billed charges","100% of total billed charges",25.77,212.21,
"PARAFFIN BATH",42097018X,CDM,420,RC,97018,CPT,OUTPATIENT,,,143,92.95,GP,125.84,88,,100.67,,,0,"percent of total billed charges","88% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",9.75,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee sv",90.09,63,,72.07,,,0,"percent of total billed charges","63% of total billed charges",21.88,15.3,,17.50,,,0,"percent of total billed charges","15.3% of total billed charges",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",98.67,69,,,,,0,"fee schedule","69% of total billed charges",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",5.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.53,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.62,100,,,,,0,"fee schedule","100% of LI fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.49,102,,,,,0,"fee schedule","102% of WA fee schedule",4.45,130,,,,,0,"fee schedule","130% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.91,37.7,,43.13,,,0,"percent of total billed charges","37.7% of total billed charges",53.91,37.7,,43.13,,,0,"percent of total billed charges","37.70% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.48,33.9,,38.78,,,0,"percent of total billed charges","33.9% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",111.54,78,,89.23,,,0,"percent of total billed charges","78% of total billed charges",5.8,101,,,,,0,"fee schedule","101% of CMS fee schedule ",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",3.42,143,
"FUNCT CAP TEST 15 MIN/-GP",42097750X,CDM,420,RC,97750,CPT,OUTPATIENT,,,233,151.45,GP,205.04,88,,164.03,,,0,"percent of total billed charges","88% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",233,100,,186.40,,,0,"percent of total billed charges","100% of total billed charges",60.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee sv",146.79,63,,117.43,,,0,"percent of total billed charges","63% of total billed charges",35.65,15.3,,28.52,,,0,"percent of total billed charges","15.3% of total billed charges",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",160.77,69,,,,,0,"fee schedule","69% of total billed charges",233,100,,186.40,,,0,"percent of total billed charges","100% of total billed charges",34.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",233,100,,186.40,,,0,"percent of total billed charges","100% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",233,100,,186.40,,,0,"percent of total billed charges","100% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",132.38,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.12,100,,,,,0,"fee schedule","100% of LI fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.52,102,,,,,0,"fee schedule","102% of WA fee schedule",26.16,130,,,,,0,"fee schedule","130% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.84,37.7,,70.27,,,0,"percent of total billed charges","37.7% of total billed charges",87.84,37.7,,70.27,,,0,"percent of total billed charges","37.70% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.99,33.9,,63.19,,,0,"percent of total billed charges","33.9% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",181.74,78,,145.39,,,0,"percent of total billed charges","78% of total billed charges",35.08,101,,,,,0,"fee schedule","101% of CMS fee schedule ",192.46,82.6,,153.97,,,0,"percent of total billed charges","82.6% of total billed charges",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",192.46,82.6,,153.97,,,0,"percent of total billed charges","82.6% of total billed charges",34.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",233,100,,186.40,,,0,"percent of total billed charges","100% of total billed charges",20.12,233,
"PROS TRAIN UP/LO EXT15M PT",42097761X,CDM,420,RC,97761,CPT,OUTPATIENT,,,171,111.15,GP,150.48,88,,120.38,,,0,"percent of total billed charges","88% of total billed charges",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.86,100,,,,,0,"fee schedule","100% of WA fee schedule",171,100,,136.80,,,0,"percent of total billed charges","100% of total billed charges",74.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",24.86,100,,,,,0,"fee schedule","100% of WA fee schedule",42.64,100,,,,,0,"fee schedule","100% of CMS fee sv",107.73,63,,86.18,,,0,"percent of total billed charges","63% of total billed charges",26.16,15.3,,20.93,,,0,"percent of total billed charges","15.3% of total billed charges",24.86,100,,,,,0,"fee schedule","100% of WA fee schedule",117.99,69,,,,,0,"fee schedule","69% of total billed charges",171,100,,136.80,,,0,"percent of total billed charges","100% of total billed charges",42.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",171,100,,136.80,,,0,"percent of total billed charges","100% of total billed charges",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",171,100,,136.80,,,0,"percent of total billed charges","100% of total billed charges",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.44,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.86,100,,,,,0,"fee schedule","100% of WA fee schedule",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.86,100,,,,,0,"fee schedule","100% of LI fee schedule",24.86,100,,,,,0,"fee schedule","100% of WA fee schedule",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.36,102,,,,,0,"fee schedule","102% of WA fee schedule",32.32,130,,,,,0,"fee schedule","130% of WA fee schedule",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.47,37.7,,51.58,,,0,"percent of total billed charges","37.7% of total billed charges",64.47,37.7,,51.58,,,0,"percent of total billed charges","37.70% of total billed charges",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.97,33.9,,46.38,,,0,"percent of total billed charges","33.9% of total billed charges",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",133.38,78,,106.70,,,0,"percent of total billed charges","78% of total billed charges",43.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",141.25,82.6,,113.00,,,0,"percent of total billed charges","82.6% of total billed charges",24.86,100,,,,,0,"fee schedule","100% of WA fee schedule",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",141.25,82.6,,113.00,,,0,"percent of total billed charges","82.6% of total billed charges",42.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.86,100,,,,,0,"fee schedule","100% of WA fee schedule",171,100,,136.80,,,0,"percent of total billed charges","100% of total billed charges",24.86,171,
"Application of a modality to 1 or more areas; paraffin bath",43097018,CDM,430,RC,97018,CPT,OUTPATIENT,,,150,97.5,GO,132,88,,105.60,,,0,"percent of total billed charges","88% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",9.75,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee sv",94.5,63,,75.60,,,0,"percent of total billed charges","63% of total billed charges",22.95,15.3,,18.36,,,0,"percent of total billed charges","15.3% of total billed charges",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",103.5,69,,,,,0,"fee schedule","69% of total billed charges",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",5.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.53,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.62,100,,,,,0,"fee schedule","100% of LI fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.49,102,,,,,0,"fee schedule","102% of WA fee schedule",4.45,130,,,,,0,"fee schedule","130% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.7% of total billed charges",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.70% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.85,33.9,,40.68,,,0,"percent of total billed charges","33.9% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",117,78,,93.60,,,0,"percent of total billed charges","78% of total billed charges",5.8,101,,,,,0,"fee schedule","101% of CMS fee schedule ",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",3.42,150,
"PT Prosthetic Mgmt,Train Assistant Units",42097761,CDM,420,RC,97761,CPT,OUTPATIENT,,,179,116.35,CQ|GP,157.52,88,,126.02,,,0,"percent of total billed charges","88% of total billed charges",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.86,100,,,,,0,"fee schedule","100% of WA fee schedule",179,100,,143.20,,,0,"percent of total billed charges","100% of total billed charges",74.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",24.86,100,,,,,0,"fee schedule","100% of WA fee schedule",42.64,100,,,,,0,"fee schedule","100% of CMS fee sv",112.77,63,,90.22,,,0,"percent of total billed charges","63% of total billed charges",27.39,15.3,,21.91,,,0,"percent of total billed charges","15.3% of total billed charges",24.86,100,,,,,0,"fee schedule","100% of WA fee schedule",123.51,69,,,,,0,"fee schedule","69% of total billed charges",179,100,,143.20,,,0,"percent of total billed charges","100% of total billed charges",42.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",179,100,,143.20,,,0,"percent of total billed charges","100% of total billed charges",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",179,100,,143.20,,,0,"percent of total billed charges","100% of total billed charges",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.44,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.86,100,,,,,0,"fee schedule","100% of WA fee schedule",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.86,100,,,,,0,"fee schedule","100% of LI fee schedule",24.86,100,,,,,0,"fee schedule","100% of WA fee schedule",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.36,102,,,,,0,"fee schedule","102% of WA fee schedule",32.32,130,,,,,0,"fee schedule","130% of WA fee schedule",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.48,37.7,,53.98,,,0,"percent of total billed charges","37.7% of total billed charges",67.48,37.7,,53.98,,,0,"percent of total billed charges","37.70% of total billed charges",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.68,33.9,,48.54,,,0,"percent of total billed charges","33.9% of total billed charges",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",139.62,78,,111.70,,,0,"percent of total billed charges","78% of total billed charges",43.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",147.85,82.6,,118.28,,,0,"percent of total billed charges","82.6% of total billed charges",24.86,100,,,,,0,"fee schedule","100% of WA fee schedule",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",147.85,82.6,,118.28,,,0,"percent of total billed charges","82.6% of total billed charges",42.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.86,100,,,,,0,"fee schedule","100% of WA fee schedule",179,100,,143.20,,,0,"percent of total billed charges","100% of total billed charges",24.86,179,
"PT RE-EVALUATION/-GP",42497164X,CDM,424,RC,97164,CPT,OUTPATIENT,,,240,156,GP,211.2,88,,168.96,,,0,"percent of total billed charges","88% of total billed charges",71.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.19,100,,,,,0,"fee schedule","100% of WA fee schedule",240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",123.48,175,,,,,0,"fee schedule","175% of CMS fee schedule",41.19,100,,,,,0,"fee schedule","100% of WA fee schedule",71.06,100,,,,,0,"fee schedule","100% of CMS fee sv",151.2,63,,120.96,,,0,"percent of total billed charges","63% of total billed charges",36.72,15.3,,29.38,,,0,"percent of total billed charges","15.3% of total billed charges",41.19,100,,,,,0,"fee schedule","100% of WA fee schedule",165.6,69,,,,,0,"fee schedule","69% of total billed charges",240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",70.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",71.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",71.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",267.41,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",41.19,100,,,,,0,"fee schedule","100% of WA fee schedule",71.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.82,100,,,,,0,"fee schedule","100% of LI fee schedule",41.19,100,,,,,0,"fee schedule","100% of WA fee schedule",71.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.01,102,,,,,0,"fee schedule","102% of WA fee schedule",53.55,130,,,,,0,"fee schedule","130% of WA fee schedule",71.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.48,37.7,,72.38,,,0,"percent of total billed charges","37.7% of total billed charges",90.48,37.7,,72.38,,,0,"percent of total billed charges","37.70% of total billed charges",71.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.36,33.9,,65.09,,,0,"percent of total billed charges","33.9% of total billed charges",71.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",187.2,78,,149.76,,,0,"percent of total billed charges","78% of total billed charges",71.77,101,,,,,0,"fee schedule","101% of CMS fee schedule ",198.24,82.6,,158.59,,,0,"percent of total billed charges","82.6% of total billed charges",41.19,100,,,,,0,"fee schedule","100% of WA fee schedule",71.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",198.24,82.6,,158.59,,,0,"percent of total billed charges","82.6% of total billed charges",71.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.19,100,,,,,0,"fee schedule","100% of WA fee schedule",240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",36.72,267.41,
ADL/15MIN/-GP,42097535X,CDM,420,RC,97535,CPT,OUTPATIENT,,,150,97.5,GP,132,88,,105.60,,,0,"percent of total billed charges","88% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",58.07,175,,,,,0,"fee schedule","175% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee sv",94.5,63,,75.60,,,0,"percent of total billed charges","63% of total billed charges",22.95,15.3,,18.36,,,0,"percent of total billed charges","15.3% of total billed charges",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",103.5,69,,,,,0,"fee schedule","69% of total billed charges",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",33.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.71,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.77,100,,,,,0,"fee schedule","100% of LI fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.75,102,,,,,0,"fee schedule","102% of WA fee schedule",25.17,130,,,,,0,"fee schedule","130% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.7% of total billed charges",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.70% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.85,33.9,,40.68,,,0,"percent of total billed charges","33.9% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",117,78,,93.60,,,0,"percent of total billed charges","78% of total billed charges",33.68,101,,,,,0,"fee schedule","101% of CMS fee schedule ",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",33.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",19.36,150,
"SELECT DEBRIDE/20 CM OR < GP",42097597X,CDM,420,RC,97597,CPT,OUTPATIENT,,,737,479.05,GP,648.56,88,,518.85,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",464.31,63,,371.45,,,0,"percent of total billed charges","63% of total billed charges",112.76,15.3,,90.21,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,508.53,69,,,,,0,"fee schedule","69% of total billed charges",737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.85,37.7,,222.28,,,0,"percent of total billed charges","37.7% of total billed charges",277.85,37.7,,222.28,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",249.84,33.9,,199.87,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",574.86,78,,459.89,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",608.76,82.6,,487.01,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",608.76,82.6,,487.01,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",112.76,737,
"SELECT DEBRIDE > 20 CM GP",42097598X,CDM,420,RC,97598,CPT,OUTPATIENT,,,955,620.75,GP,840.4,88,,672.32,,,0,"percent of total billed charges","88% of total billed charges",477.5,50,,382.00,,,0,"percent of total billed charges","50% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",930.95,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",601.65,63,,481.32,,,0,"percent of total billed charges","63% of total billed charges",146.12,15.3,,116.90,,,0,"percent of total billed charges","15.3% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,658.95,69,,,,,0,"fee schedule","69% of total billed charges",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.67,61.85,,472.54,,,0,"percent of total billed charges","61.5% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,477.5,50,,382.00,,,0,"percent of total billed charges","50% of total billed charges",307.51,32.2,,246.01,,,0,"percent of total billed charges","32.2% of total billed charges",669.51,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",921.91,100,,,,,0,"fee schedule",EAPG,1174.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",360.04,37.7,,288.03,,,0,"percent of total billed charges","37.7% of total billed charges",360.04,37.7,,288.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",323.75,33.9,,259.00,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",744.9,78,,595.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",788.83,82.6,,631.06,,,0,"percent of total billed charges","82.6% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,477.5,50,,382.00,,,0,"percent of total billed charges","50% of total billed charges",788.83,82.6,,631.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",903.83,100,,,,,0,"fee schedule",EAPG,955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",146.12,1174.99,
"THERAPEUTIC EX/15MIN/-GP",42097110X,CDM,420,RC,97110,CPT,OUTPATIENT,,,181,117.65,GO,159.28,88,,127.42,,,0,"percent of total billed charges","88% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",52.01,175,,,,,0,"fee schedule","175% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee sv",114.03,63,,91.22,,,0,"percent of total billed charges","63% of total billed charges",27.69,15.3,,22.15,,,0,"percent of total billed charges","15.3% of total billed charges",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",124.89,69,,,,,0,"fee schedule","69% of total billed charges",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",29.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",116.17,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.4,100,,,,,0,"fee schedule","100% of LI fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.81,102,,,,,0,"fee schedule","102% of WA fee schedule",22.7,130,,,,,0,"fee schedule","130% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.24,37.7,,54.59,,,0,"percent of total billed charges","37.7% of total billed charges",68.24,37.7,,54.59,,,0,"percent of total billed charges","37.70% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.36,33.9,,49.09,,,0,"percent of total billed charges","33.9% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",141.18,78,,112.94,,,0,"percent of total billed charges","78% of total billed charges",30.19,101,,,,,0,"fee schedule","101% of CMS fee schedule ",149.51,82.6,,119.61,,,0,"percent of total billed charges","82.6% of total billed charges",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",149.51,82.6,,119.61,,,0,"percent of total billed charges","82.6% of total billed charges",29.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",17.46,181,
"THERAP ACT 1:1/15MIN/-GP",42097530X,CDM,420,RC,97530,CPT,OUTPATIENT,,,182,118.3,GO,160.16,88,,128.13,,,0,"percent of total billed charges","88% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",65.36,175,,,,,0,"fee schedule","175% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee sv",114.66,63,,91.73,,,0,"percent of total billed charges","63% of total billed charges",27.85,15.3,,22.28,,,0,"percent of total billed charges","15.3% of total billed charges",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",125.58,69,,,,,0,"fee schedule","69% of total billed charges",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",37.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.36,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.83,100,,,,,0,"fee schedule","100% of LI fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.65,102,,,,,0,"fee schedule","102% of WA fee schedule",28.87,130,,,,,0,"fee schedule","130% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.61,37.7,,54.89,,,0,"percent of total billed charges","37.7% of total billed charges",68.61,37.7,,54.89,,,0,"percent of total billed charges","37.70% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.7,33.9,,49.36,,,0,"percent of total billed charges","33.9% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",141.96,78,,113.57,,,0,"percent of total billed charges","78% of total billed charges",37.89,101,,,,,0,"fee schedule","101% of CMS fee schedule ",150.33,82.6,,120.26,,,0,"percent of total billed charges","82.6% of total billed charges",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.33,82.6,,120.26,,,0,"percent of total billed charges","82.6% of total billed charges",37.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",22.21,182,
"PT Therapeutic Exercise Assistant Units",42097110,CDM,420,RC,97110,CPT,OUTPATIENT,,,196,127.4,GP|CQ,172.48,88,,137.98,,,0,"percent of total billed charges","88% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",52.01,175,,,,,0,"fee schedule","175% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee sv",123.48,63,,98.78,,,0,"percent of total billed charges","63% of total billed charges",29.99,15.3,,23.99,,,0,"percent of total billed charges","15.3% of total billed charges",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",135.24,69,,,,,0,"fee schedule","69% of total billed charges",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",29.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",116.17,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.4,100,,,,,0,"fee schedule","100% of LI fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.81,102,,,,,0,"fee schedule","102% of WA fee schedule",22.7,130,,,,,0,"fee schedule","130% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.89,37.7,,59.11,,,0,"percent of total billed charges","37.7% of total billed charges",73.89,37.7,,59.11,,,0,"percent of total billed charges","37.70% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.44,33.9,,53.15,,,0,"percent of total billed charges","33.9% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",152.88,78,,122.30,,,0,"percent of total billed charges","78% of total billed charges",30.19,101,,,,,0,"fee schedule","101% of CMS fee schedule ",161.9,82.6,,129.52,,,0,"percent of total billed charges","82.6% of total billed charges",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",161.9,82.6,,129.52,,,0,"percent of total billed charges","82.6% of total billed charges",29.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",17.46,196,
N/A,42097530,CDM,420,RC,97530,CPT,OUTPATIENT,,,206,133.9,CQ|GP,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",65.36,175,,,,,0,"fee schedule","175% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee sv",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",37.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.36,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.83,100,,,,,0,"fee schedule","100% of LI fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.65,102,,,,,0,"fee schedule","102% of WA fee schedule",28.87,130,,,,,0,"fee schedule","130% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.7% of total billed charges",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.83,33.9,,55.86,,,0,"percent of total billed charges","33.9% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",37.89,101,,,,,0,"fee schedule","101% of CMS fee schedule ",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",37.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",22.21,206,
ULTRASOUND/15MIN/-GP,42097035X,CDM,420,RC,97035,CPT,OUTPATIENT,,,227,147.55,GP,199.76,88,,159.81,,,0,"percent of total billed charges","88% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",24.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee sv",143.01,63,,114.41,,,0,"percent of total billed charges","63% of total billed charges",34.73,15.3,,27.78,,,0,"percent of total billed charges","15.3% of total billed charges",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",156.63,69,,,,,0,"fee schedule","69% of total billed charges",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",14.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.07,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.98,100,,,,,0,"fee schedule","100% of LI fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.71,102,,,,,0,"fee schedule","102% of WA fee schedule",11.1,130,,,,,0,"fee schedule","130% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.58,37.7,,68.46,,,0,"percent of total billed charges","37.7% of total billed charges",85.58,37.7,,68.46,,,0,"percent of total billed charges","37.70% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.95,33.9,,61.56,,,0,"percent of total billed charges","33.9% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",177.06,78,,141.65,,,0,"percent of total billed charges","78% of total billed charges",14.37,101,,,,,0,"fee schedule","101% of CMS fee schedule ",187.5,82.6,,150.00,,,0,"percent of total billed charges","82.6% of total billed charges",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",187.5,82.6,,150.00,,,0,"percent of total billed charges","82.6% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",8.54,227,
"ELECTRIC STIMULATION THERAPY",42097014X,CDM,420,RC,97014,CPT,OUTPATIENT,,,77,50.05,GP,67.76,88,,54.21,,,0,"percent of total billed charges","88% of total billed charges",38.5,50,,30.80,,,0,"percent of total billed charges","50% of total billed charges",7.21,100,,,,,0,"fee schedule","100% of WA fee schedule",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.21,100,,,,,0,"fee schedule","100% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",48.51,63,,38.81,,,0,"percent of total billed charges","63% of total billed charges",11.78,15.3,,9.42,,,0,"percent of total billed charges","15.3% of total billed charges",7.21,100,,,,,0,"fee schedule","100% of WA fee schedule",53.13,69,,,,,0,"fee schedule","69% of total billed charges",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.62,61.85,,38.10,,,0,"percent of total billed charges","61.5% of total billed charges",7.21,100,,,,,0,"fee schedule","100% of WA fee schedule",38.5,50,,30.80,,,0,"percent of total billed charges","50% of total billed charges",24.79,32.2,,19.83,,,0,"percent of total billed charges","32.2% of total billed charges",7.21,100,,,,,0,"fee schedule","100% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",7.35,102,,,,,0,"fee schedule","102% of WA fee schedule",9.37,130,,,,,0,"fee schedule","130% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",29.03,37.7,,23.22,,,0,"percent of total billed charges","37.7% of total billed charges",29.03,37.7,,23.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.1,33.9,,20.88,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.06,78,,48.05,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.6,82.6,,50.88,,,0,"percent of total billed charges","82.6% of total billed charges",7.21,100,,,,,0,"fee schedule","100% of WA fee schedule",38.5,50,,30.80,,,0,"percent of total billed charges","50% of total billed charges",63.6,82.6,,50.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.21,100,,,,,0,"fee schedule","100% of WA fee schedule",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",7.21,77,
"ELEC STIM MAN/15MIN/-GP",42097032X,CDM,420,RC,97032,CPT,OUTPATIENT,,,202,131.3,GP,177.76,88,,142.21,,,0,"percent of total billed charges","88% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",25.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee sv",127.26,63,,101.81,,,0,"percent of total billed charges","63% of total billed charges",30.91,15.3,,24.73,,,0,"percent of total billed charges","15.3% of total billed charges",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",139.38,69,,,,,0,"fee schedule","69% of total billed charges",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",14.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.3,100,,,,,0,"fee schedule","100% of LI fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.52,102,,,,,0,"fee schedule","102% of WA fee schedule",10.86,130,,,,,0,"fee schedule","130% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.15,37.7,,60.92,,,0,"percent of total billed charges","37.7% of total billed charges",76.15,37.7,,60.92,,,0,"percent of total billed charges","37.70% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.48,33.9,,54.78,,,0,"percent of total billed charges","33.9% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",157.56,78,,126.05,,,0,"percent of total billed charges","78% of total billed charges",14.68,101,,,,,0,"fee schedule","101% of CMS fee schedule ",166.85,82.6,,133.48,,,0,"percent of total billed charges","82.6% of total billed charges",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",166.85,82.6,,133.48,,,0,"percent of total billed charges","82.6% of total billed charges",14.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",8.35,202,
ULTRAVIOLET,42097028X,CDM,420,RC,97028,CPT,OUTPATIENT,,,46,29.9,GP,40.48,88,,32.38,,,0,"percent of total billed charges","88% of total billed charges",8.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.93,100,,,,,0,"fee schedule","100% of WA fee schedule",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",14.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.93,100,,,,,0,"fee schedule","100% of WA fee schedule",8.48,100,,,,,0,"fee schedule","100% of CMS fee sv",28.98,63,,23.18,,,0,"percent of total billed charges","63% of total billed charges",7.04,15.3,,5.63,,,0,"percent of total billed charges","15.3% of total billed charges",4.93,100,,,,,0,"fee schedule","100% of WA fee schedule",31.74,69,,,,,0,"fee schedule","69% of total billed charges",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",8.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",8.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",8.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.94,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.93,100,,,,,0,"fee schedule","100% of WA fee schedule",8.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.31,100,,,,,0,"fee schedule","100% of LI fee schedule",4.93,100,,,,,0,"fee schedule","100% of WA fee schedule",8.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.03,102,,,,,0,"fee schedule","102% of WA fee schedule",6.41,130,,,,,0,"fee schedule","130% of WA fee schedule",8.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.34,37.7,,13.87,,,0,"percent of total billed charges","37.7% of total billed charges",17.34,37.7,,13.87,,,0,"percent of total billed charges","37.70% of total billed charges",8.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.59,33.9,,12.47,,,0,"percent of total billed charges","33.9% of total billed charges",8.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.88,78,,28.70,,,0,"percent of total billed charges","78% of total billed charges",8.56,101,,,,,0,"fee schedule","101% of CMS fee schedule ",38,82.6,,30.40,,,0,"percent of total billed charges","82.6% of total billed charges",4.93,100,,,,,0,"fee schedule","100% of WA fee schedule",8.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",38,82.6,,30.40,,,0,"percent of total billed charges","82.6% of total billed charges",8.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.93,100,,,,,0,"fee schedule","100% of WA fee schedule",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",4.93,46,
N/A,421G0283,CDM,420,RC,,,OUTPATIENT,,,138,89.7,GP|CQ,121.44,88,,97.15,,,0,"percent of total billed charges","88% of total billed charges",69,50,,55.20,,,0,"percent of total billed charges","50% of total billed charges",23.18,16.8,,18.54,,,0,"percent of total billed charges","16.8% of total billed charges",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.88,17.304,,19.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.94,63,,69.55,,,0,"percent of total billed charges","63% of total billed charges",21.11,15.3,,16.89,,,0,"percent of total billed charges","15.3% of total billed charges",23.18,16.8,,18.54,,,0,"percent of total billed charges","16.8% of total billed charges",95.22,69,,,,,0,"fee schedule","69% of total billed charges",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.35,61.85,,68.28,,,0,"percent of total billed charges","61.5% of total billed charges",23.18,16.8,,18.54,,,0,"percent of total billed charges","16.8% of total billed charges",69,50,,55.20,,,0,"percent of total billed charges","50% of total billed charges",44.44,32.2,,35.55,,,0,"percent of total billed charges","32.2% of total billed charges",23.18,16.8,,18.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.65,17.136,,18.92,,,0,"percent of total billed charges","17.136% of total billed charges",30.14,21.84,,24.11,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.03,37.7,,41.62,,,0,"percent of total billed charges","37.7% of total billed charges",52.03,37.7,,41.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.78,33.9,,37.42,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",107.64,78,,86.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.99,82.6,,91.19,,,0,"percent of total billed charges","82.6% of total billed charges",23.18,16.8,,18.54,,,0,"percent of total billed charges","16.8% of total billed charges",69,50,,55.20,,,0,"percent of total billed charges","50% of total billed charges",113.99,82.6,,91.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.18,16.8,,18.54,,,0,"percent of total billed charges","16.8% of total billed charges",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",21.11,138,
N/A,42097035,CDM,420,RC,97035,CPT,OUTPATIENT,,,239,155.35,CQ|GP,210.32,88,,168.26,,,0,"percent of total billed charges","88% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",24.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee sv",150.57,63,,120.46,,,0,"percent of total billed charges","63% of total billed charges",36.57,15.3,,29.26,,,0,"percent of total billed charges","15.3% of total billed charges",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",164.91,69,,,,,0,"fee schedule","69% of total billed charges",239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",14.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.07,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.98,100,,,,,0,"fee schedule","100% of LI fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.71,102,,,,,0,"fee schedule","102% of WA fee schedule",11.1,130,,,,,0,"fee schedule","130% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.1,37.7,,72.08,,,0,"percent of total billed charges","37.7% of total billed charges",90.1,37.7,,72.08,,,0,"percent of total billed charges","37.70% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.02,33.9,,64.82,,,0,"percent of total billed charges","33.9% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",186.42,78,,149.14,,,0,"percent of total billed charges","78% of total billed charges",14.37,101,,,,,0,"fee schedule","101% of CMS fee schedule ",197.41,82.6,,157.93,,,0,"percent of total billed charges","82.6% of total billed charges",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",197.41,82.6,,157.93,,,0,"percent of total billed charges","82.6% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",8.54,239,
"VASOPNEUMATIC DEVICES/-GP",42097016X,CDM,420,RC,97016,CPT,OUTPATIENT,,,142,92.3,GP,124.96,88,,99.97,,,0,"percent of total billed charges","88% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",20.42,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",11.84,100,,,,,0,"fee schedule","100% of CMS fee sv",89.46,63,,71.57,,,0,"percent of total billed charges","63% of total billed charges",21.73,15.3,,17.38,,,0,"percent of total billed charges","15.3% of total billed charges",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",97.98,69,,,,,0,"fee schedule","69% of total billed charges",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",11.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.67,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.63,100,,,,,0,"fee schedule","100% of LI fee schedule",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.97,102,,,,,0,"fee schedule","102% of WA fee schedule",8.88,130,,,,,0,"fee schedule","130% of WA fee schedule",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.53,37.7,,42.82,,,0,"percent of total billed charges","37.7% of total billed charges",53.53,37.7,,42.82,,,0,"percent of total billed charges","37.70% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.14,33.9,,38.51,,,0,"percent of total billed charges","33.9% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",110.76,78,,88.61,,,0,"percent of total billed charges","78% of total billed charges",11.96,101,,,,,0,"fee schedule","101% of CMS fee schedule ",117.29,82.6,,93.83,,,0,"percent of total billed charges","82.6% of total billed charges",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",117.29,82.6,,93.83,,,0,"percent of total billed charges","82.6% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",6.83,142,
"WHEELCHAIR MNGT/15MIN/-GP",42097542X,CDM,420,RC,97542,CPT,OUTPATIENT,,,156,101.4,GP,137.28,88,,109.82,,,0,"percent of total billed charges","88% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",56.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee sv",98.28,63,,78.62,,,0,"percent of total billed charges","63% of total billed charges",23.87,15.3,,19.10,,,0,"percent of total billed charges","15.3% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",107.64,69,,,,,0,"fee schedule","69% of total billed charges",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",32.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",125.57,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.75,100,,,,,0,"fee schedule","100% of LI fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.17,102,,,,,0,"fee schedule","102% of WA fee schedule",24.43,130,,,,,0,"fee schedule","130% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.81,37.7,,47.05,,,0,"percent of total billed charges","37.7% of total billed charges",58.81,37.7,,47.05,,,0,"percent of total billed charges","37.70% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.88,33.9,,42.30,,,0,"percent of total billed charges","33.9% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",121.68,78,,97.34,,,0,"percent of total billed charges","78% of total billed charges",32.6,101,,,,,0,"fee schedule","101% of CMS fee schedule ",128.86,82.6,,103.09,,,0,"percent of total billed charges","82.6% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",128.86,82.6,,103.09,,,0,"percent of total billed charges","82.6% of total billed charges",32.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",18.79,156,
WHIRLPOOL/-GP,42097022X,CDM,420,RC,97022,CPT,OUTPATIENT,,,186,120.9,GP,163.68,88,,130.94,,,0,"percent of total billed charges","88% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",30.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee sv",117.18,63,,93.74,,,0,"percent of total billed charges","63% of total billed charges",28.46,15.3,,22.77,,,0,"percent of total billed charges","15.3% of total billed charges",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",128.34,69,,,,,0,"fee schedule","69% of total billed charges",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",17.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.69,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.04,100,,,,,0,"fee schedule","100% of LI fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.46,102,,,,,0,"fee schedule","102% of WA fee schedule",13.33,130,,,,,0,"fee schedule","130% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.12,37.7,,56.10,,,0,"percent of total billed charges","37.7% of total billed charges",70.12,37.7,,56.10,,,0,"percent of total billed charges","37.70% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.05,33.9,,50.44,,,0,"percent of total billed charges","33.9% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",145.08,78,,116.06,,,0,"percent of total billed charges","78% of total billed charges",17.56,101,,,,,0,"fee schedule","101% of CMS fee schedule ",153.64,82.6,,122.91,,,0,"percent of total billed charges","82.6% of total billed charges",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",153.64,82.6,,122.91,,,0,"percent of total billed charges","82.6% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",10.25,186,
"PT Wheelchair Management Assistant Units",42097542,CDM,420,RC,97542,CPT,OUTPATIENT,,,172,111.8,CQ|GO,151.36,88,,121.09,,,0,"percent of total billed charges","88% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",56.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee sv",108.36,63,,86.69,,,0,"percent of total billed charges","63% of total billed charges",26.32,15.3,,21.06,,,0,"percent of total billed charges","15.3% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",118.68,69,,,,,0,"fee schedule","69% of total billed charges",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",32.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",125.57,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.75,100,,,,,0,"fee schedule","100% of LI fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.17,102,,,,,0,"fee schedule","102% of WA fee schedule",24.43,130,,,,,0,"fee schedule","130% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.84,37.7,,51.87,,,0,"percent of total billed charges","37.7% of total billed charges",64.84,37.7,,51.87,,,0,"percent of total billed charges","37.70% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.31,33.9,,46.65,,,0,"percent of total billed charges","33.9% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.16,78,,107.33,,,0,"percent of total billed charges","78% of total billed charges",32.6,101,,,,,0,"fee schedule","101% of CMS fee schedule ",142.07,82.6,,113.66,,,0,"percent of total billed charges","82.6% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",142.07,82.6,,113.66,,,0,"percent of total billed charges","82.6% of total billed charges",32.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",18.79,172,
"INJ TENDON SHEATH OR LIGAMENT",84020550,CDM,360,RC,20550,CPT,OUTPATIENT,,,281,182.65,,247.28,88,,197.82,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,281,100,,224.80,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",223.22,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.03,63,,141.62,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,193.89,69,,,,,0,"fee schedule","69% of total billed charges",281,100,,224.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",281,100,,224.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",281,100,,224.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.05,100,,,,,0,"fee schedule",EAPG,281.73,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.94,37.7,,84.75,,,0,"percent of total billed charges","37.7% of total billed charges",105.94,37.7,,84.75,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",95.26,33.9,,76.21,,,0,"percent of total billed charges","33.9% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",219.18,78,,175.34,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",232.11,82.6,,185.69,,,0,"percent of total billed charges","82.6% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",232.11,82.6,,185.69,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,281,100,,224.80,,,0,"percent of total billed charges","100% of total billed charges",95.26,3367,
"INJ SINGLE/MULTI TRIGGER PTS",84020552,CDM,360,RC,20552,CPT,OUTPATIENT,,,263,170.95,,231.44,88,,185.15,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,263,100,,210.40,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",223.22,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",165.69,63,,132.55,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,181.47,69,,,,,0,"fee schedule","69% of total billed charges",263,100,,210.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",263,100,,210.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",263,100,,210.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.05,100,,,,,0,"fee schedule",EAPG,281.73,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.15,37.7,,79.32,,,0,"percent of total billed charges","37.7% of total billed charges",99.15,37.7,,79.32,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",89.16,33.9,,71.33,,,0,"percent of total billed charges","33.9% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",205.14,78,,164.11,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",217.24,82.6,,173.79,,,0,"percent of total billed charges","82.6% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",217.24,82.6,,173.79,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,263,100,,210.40,,,0,"percent of total billed charges","100% of total billed charges",89.16,3367,
"ARTHROCENTESIS INTERMED JT/BUR",84020605,CDM,761,RC,20605,CPT,OUTPATIENT,,,1048,681.2,,922.24,88,,737.79,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,1048,100,,838.40,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",223.22,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.24,63,,528.19,,,0,"percent of total billed charges","63% of total billed charges",160.34,15.3,,128.27,,,0,"percent of total billed charges","15.3% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,723.12,69,,,,,0,"fee schedule","69% of total billed charges",1048,100,,838.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1048,100,,838.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1048,100,,838.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.05,100,,,,,0,"fee schedule",EAPG,281.73,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",395.1,37.7,,316.08,,,0,"percent of total billed charges","37.7% of total billed charges",395.1,37.7,,316.08,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.27,33.9,,284.22,,,0,"percent of total billed charges","33.9% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",817.44,78,,653.95,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",865.65,82.6,,692.52,,,0,"percent of total billed charges","82.6% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",865.65,82.6,,692.52,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,1048,100,,838.40,,,0,"percent of total billed charges","100% of total billed charges",160.34,1061,
"ARTHROCENTESIS MAJOR JT/BURSA",84020610,CDM,761,RC,20610,CPT,OUTPATIENT,,,315,204.75,,277.2,88,,221.76,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,315,100,,252.00,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",223.22,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",198.45,63,,158.76,,,0,"percent of total billed charges","63% of total billed charges",48.2,15.3,,38.56,,,0,"percent of total billed charges","15.3% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,217.35,69,,,,,0,"fee schedule","69% of total billed charges",315,100,,252.00,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",315,100,,252.00,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",315,100,,252.00,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.05,100,,,,,0,"fee schedule",EAPG,281.73,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.76,37.7,,95.01,,,0,"percent of total billed charges","37.7% of total billed charges",118.76,37.7,,95.01,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",106.79,33.9,,85.43,,,0,"percent of total billed charges","33.9% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",245.7,78,,196.56,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.19,82.6,,208.15,,,0,"percent of total billed charges","82.6% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.19,82.6,,208.15,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,315,100,,252.00,,,0,"percent of total billed charges","100% of total billed charges",48.2,1061,
"INJ FOR SPINE DISK XRAY LUMBAR",84062290,CDM,761,RC,62290,CPT,OUTPATIENT,,,872,566.8,,767.36,88,,613.89,,,0,"percent of total billed charges","88% of total billed charges",436,50,,348.80,,,0,"percent of total billed charges","50% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,872,100,,697.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.05,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",549.36,63,,439.49,,,0,"percent of total billed charges","63% of total billed charges",133.42,15.3,,106.74,,,0,"percent of total billed charges","15.3% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,601.68,69,,,,,0,"fee schedule","69% of total billed charges",872,100,,697.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",872,100,,697.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",872,100,,697.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.33,61.85,,431.46,,,0,"percent of total billed charges","61.5% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,436,50,,348.80,,,0,"percent of total billed charges","50% of total billed charges",280.78,32.2,,224.62,,,0,"percent of total billed charges","32.2% of total billed charges",202.12,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",278.32,100,,,,,0,"fee schedule",EAPG,354.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",328.74,37.7,,262.99,,,0,"percent of total billed charges","37.7% of total billed charges",328.74,37.7,,262.99,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.61,33.9,,236.49,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",680.16,78,,544.13,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",720.27,82.6,,576.22,,,0,"percent of total billed charges","82.6% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,436,50,,348.80,,,0,"percent of total billed charges","50% of total billed charges",720.27,82.6,,576.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.87,100,,,,,0,"fee schedule",EAPG,872,100,,697.60,,,0,"percent of total billed charges","100% of total billed charges",133.42,872,
"INJ SP DISK XRAY CERV/THORAC",84062291,CDM,761,RC,62291,CPT,OUTPATIENT,,,869,564.85,,764.72,88,,611.78,,,0,"percent of total billed charges","88% of total billed charges",434.5,50,,347.60,,,0,"percent of total billed charges","50% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,869,100,,695.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.05,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",547.47,63,,437.98,,,0,"percent of total billed charges","63% of total billed charges",132.96,15.3,,106.37,,,0,"percent of total billed charges","15.3% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,599.61,69,,,,,0,"fee schedule","69% of total billed charges",869,100,,695.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",869,100,,695.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",869,100,,695.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",537.48,61.85,,429.98,,,0,"percent of total billed charges","61.5% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,434.5,50,,347.60,,,0,"percent of total billed charges","50% of total billed charges",279.82,32.2,,223.86,,,0,"percent of total billed charges","32.2% of total billed charges",202.12,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",278.32,100,,,,,0,"fee schedule",EAPG,354.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",327.61,37.7,,262.09,,,0,"percent of total billed charges","37.7% of total billed charges",327.61,37.7,,262.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",294.59,33.9,,235.67,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",677.82,78,,542.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",717.79,82.6,,574.23,,,0,"percent of total billed charges","82.6% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,434.5,50,,347.60,,,0,"percent of total billed charges","50% of total billed charges",717.79,82.6,,574.23,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.87,100,,,,,0,"fee schedule",EAPG,869,100,,695.20,,,0,"percent of total billed charges","100% of total billed charges",132.96,869,
"NJX INTERLAMINAR LMBR/SAC",84062323,CDM,761,RC,62323,CPT,OUTPATIENT,,,511,332.15,,449.68,88,,359.74,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,511,100,,408.80,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",321.93,63,,257.54,,,0,"percent of total billed charges","63% of total billed charges",78.18,15.3,,62.54,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,352.59,69,,,,,0,"fee schedule","69% of total billed charges",511,100,,408.80,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",511,100,,408.80,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",511,100,,408.80,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",570.86,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",192.65,37.7,,154.12,,,0,"percent of total billed charges","37.7% of total billed charges",192.65,37.7,,154.12,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.23,33.9,,138.58,,,0,"percent of total billed charges","33.9% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",398.58,78,,318.86,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",422.09,82.6,,337.67,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",422.09,82.6,,337.67,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,511,100,,408.80,,,0,"percent of total billed charges","100% of total billed charges",78.18,2578.03,
"N BLOCK INJ FEM SINGLE",84064447,CDM,360,RC,64447,CPT,OUTPATIENT,,,342,222.3,,300.96,88,,240.77,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,342,100,,273.60,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",1076.46,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",215.46,63,,172.37,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,235.98,69,,,,,0,"fee schedule","69% of total billed charges",342,100,,273.60,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342,100,,273.60,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342,100,,273.60,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",774.15,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1066.01,100,,,,,0,"fee schedule",EAPG,1358.64,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",128.93,37.7,,103.14,,,0,"percent of total billed charges","37.7% of total billed charges",128.93,37.7,,103.14,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.94,33.9,,92.75,,,0,"percent of total billed charges","33.9% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",266.76,78,,213.41,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",282.49,82.6,,225.99,,,0,"percent of total billed charges","82.6% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",282.49,82.6,,225.99,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,342,100,,273.60,,,0,"percent of total billed charges","100% of total billed charges",115.94,3367,
"TRANSFORAMINAL INJC/T SPINE 1L",84064479,CDM,761,RC,64479,CPT,OUTPATIENT,,,2565,1667.25,,2257.2,88,,1805.76,,,0,"percent of total billed charges","88% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,2565,100,,2052.00,,,0,"percent of total billed charges","100% of total billed charges",1626.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1615.95,63,,1292.76,,,0,"percent of total billed charges","63% of total billed charges",392.45,15.3,,313.96,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,1769.85,69,,,,,0,"fee schedule","69% of total billed charges",2565,100,,2052.00,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2565,100,,2052.00,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2565,100,,2052.00,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3341.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",570.86,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.01,37.7,,773.61,,,0,"percent of total billed charges","37.7% of total billed charges",967.01,37.7,,773.61,,,0,"percent of total billed charges","37.70% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",869.54,33.9,,695.63,,,0,"percent of total billed charges","33.9% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2000.7,78,,1600.56,,,0,"percent of total billed charges","78% of total billed charges",938.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2118.69,82.6,,1694.95,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2118.69,82.6,,1694.95,,,0,"percent of total billed charges","82.6% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,2565,100,,2052.00,,,0,"percent of total billed charges","100% of total billed charges",392.45,3341.26,
"TRANSFORAMINAL INJL/S SPINE 1L",84064483,CDM,761,RC,64483,CPT,OUTPATIENT,,,2432,1580.8,,2140.16,88,,1712.13,,,0,"percent of total billed charges","88% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,2432,100,,1945.60,,,0,"percent of total billed charges","100% of total billed charges",1626.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1532.16,63,,1225.73,,,0,"percent of total billed charges","63% of total billed charges",372.1,15.3,,297.68,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,1678.08,69,,,,,0,"fee schedule","69% of total billed charges",2432,100,,1945.60,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2432,100,,1945.60,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2432,100,,1945.60,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3341.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",570.86,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",916.86,37.7,,733.49,,,0,"percent of total billed charges","37.7% of total billed charges",916.86,37.7,,733.49,,,0,"percent of total billed charges","37.70% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",824.45,33.9,,659.56,,,0,"percent of total billed charges","33.9% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1896.96,78,,1517.57,,,0,"percent of total billed charges","78% of total billed charges",938.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2008.83,82.6,,1607.06,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2008.83,82.6,,1607.06,,,0,"percent of total billed charges","82.6% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,2432,100,,1945.60,,,0,"percent of total billed charges","100% of total billed charges",372.1,3341.26,
"TRANSFORAMINAL INJL/S SPINE 2L",84064484,CDM,761,RC,64484,CPT,OUTPATIENT,,,1421,923.65,,1250.48,88,,1000.38,,,0,"percent of total billed charges","88% of total billed charges",710.5,50,,568.40,,,0,"percent of total billed charges","50% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,1421,100,,1136.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",793.79,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",895.23,63,,716.18,,,0,"percent of total billed charges","63% of total billed charges",217.41,15.3,,173.93,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,980.49,69,,,,,0,"fee schedule","69% of total billed charges",1421,100,,1136.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1421,100,,1136.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1421,100,,1136.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",878.89,61.85,,703.11,,,0,"percent of total billed charges","61.5% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,710.5,50,,568.40,,,0,"percent of total billed charges","50% of total billed charges",457.56,32.2,,366.05,,,0,"percent of total billed charges","32.2% of total billed charges",570.86,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",535.72,37.7,,428.58,,,0,"percent of total billed charges","37.7% of total billed charges",535.72,37.7,,428.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",481.72,33.9,,385.38,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1108.38,78,,886.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1173.75,82.6,,939.00,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,710.5,50,,568.40,,,0,"percent of total billed charges","50% of total billed charges",1173.75,82.6,,939.00,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",770.67,100,,,,,0,"fee schedule",EAPG,1421,100,,1136.80,,,0,"percent of total billed charges","100% of total billed charges",217.41,1421,
"TRANSFORAMINAL INJC/T SPINE 2L",84064480,CDM,360,RC,64480,CPT,OUTPATIENT,,,1597,1038.05,,1405.36,88,,1124.29,,,0,"percent of total billed charges","88% of total billed charges",798.5,50,,638.80,,,0,"percent of total billed charges","50% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,1597,100,,1277.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",793.79,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1006.11,63,,804.89,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,1101.93,69,,,,,0,"fee schedule","69% of total billed charges",1597,100,,1277.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1597,100,,1277.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1597,100,,1277.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",987.74,61.85,,790.19,,,0,"percent of total billed charges","61.5% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,798.5,50,,638.80,,,0,"percent of total billed charges","50% of total billed charges",514.23,32.2,,411.38,,,0,"percent of total billed charges","32.2% of total billed charges",570.86,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",602.07,37.7,,481.66,,,0,"percent of total billed charges","37.7% of total billed charges",602.07,37.7,,481.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",541.38,33.9,,433.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1245.66,78,,996.53,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1319.12,82.6,,1055.30,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,798.5,50,,638.80,,,0,"percent of total billed charges","50% of total billed charges",1319.12,82.6,,1055.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",770.67,100,,,,,0,"fee schedule",EAPG,1597,100,,1277.60,,,0,"percent of total billed charges","100% of total billed charges",514.23,3367,
"FACET INJ C/T SPINE ONE LEVEL",84064490,CDM,761,RC,64490,CPT,OUTPATIENT,,,763,495.95,,671.44,88,,537.15,,,0,"percent of total billed charges","88% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,763,100,,610.40,,,0,"percent of total billed charges","100% of total billed charges",1626.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",480.69,63,,384.55,,,0,"percent of total billed charges","63% of total billed charges",116.74,15.3,,93.39,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,526.47,69,,,,,0,"fee schedule","69% of total billed charges",763,100,,610.40,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",763,100,,610.40,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",763,100,,610.40,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3341.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",570.86,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287.65,37.7,,230.12,,,0,"percent of total billed charges","37.7% of total billed charges",287.65,37.7,,230.12,,,0,"percent of total billed charges","37.70% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",258.66,33.9,,206.93,,,0,"percent of total billed charges","33.9% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",595.14,78,,476.11,,,0,"percent of total billed charges","78% of total billed charges",938.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",630.24,82.6,,504.19,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",630.24,82.6,,504.19,,,0,"percent of total billed charges","82.6% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,763,100,,610.40,,,0,"percent of total billed charges","100% of total billed charges",116.74,3341.26,
"FACET INJ C/T SPINE SEC LEVEL",84064491,CDM,360,RC,64491,CPT,OUTPATIENT,,,428,278.2,,376.64,88,,301.31,,,0,"percent of total billed charges","88% of total billed charges",214,50,,171.20,,,0,"percent of total billed charges","50% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,428,100,,342.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",793.79,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",269.64,63,,215.71,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,295.32,69,,,,,0,"fee schedule","69% of total billed charges",428,100,,342.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",428,100,,342.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",428,100,,342.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",264.72,61.85,,211.78,,,0,"percent of total billed charges","61.5% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,214,50,,171.20,,,0,"percent of total billed charges","50% of total billed charges",137.82,32.2,,110.26,,,0,"percent of total billed charges","32.2% of total billed charges",570.86,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",161.36,37.7,,129.09,,,0,"percent of total billed charges","37.7% of total billed charges",161.36,37.7,,129.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",145.09,33.9,,116.07,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",333.84,78,,267.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.53,82.6,,282.82,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,214,50,,171.20,,,0,"percent of total billed charges","50% of total billed charges",353.53,82.6,,282.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",770.67,100,,,,,0,"fee schedule",EAPG,428,100,,342.40,,,0,"percent of total billed charges","100% of total billed charges",137.82,3367,
"FACET INJ L/S SPINE ONE LEVEL",84064493,CDM,761,RC,64493,CPT,OUTPATIENT,,,647,420.55,,569.36,88,,455.49,,,0,"percent of total billed charges","88% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,647,100,,517.60,,,0,"percent of total billed charges","100% of total billed charges",1626.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",407.61,63,,326.09,,,0,"percent of total billed charges","63% of total billed charges",98.99,15.3,,79.19,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,446.43,69,,,,,0,"fee schedule","69% of total billed charges",647,100,,517.60,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647,100,,517.60,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647,100,,517.60,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3341.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",570.86,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",243.92,37.7,,195.14,,,0,"percent of total billed charges","37.7% of total billed charges",243.92,37.7,,195.14,,,0,"percent of total billed charges","37.70% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",219.33,33.9,,175.46,,,0,"percent of total billed charges","33.9% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",504.66,78,,403.73,,,0,"percent of total billed charges","78% of total billed charges",938.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",534.42,82.6,,427.54,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",534.42,82.6,,427.54,,,0,"percent of total billed charges","82.6% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,647,100,,517.60,,,0,"percent of total billed charges","100% of total billed charges",98.99,3341.26,
"XRAY FOR LOWER SPINE DISK",84072295,CDM,329,RC,72295,CPT,OUTPATIENT,,,317,206.05,,278.96,88,,223.17,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",528.24,100,,,,,0,"fee schedule",EAPG,317,100,,253.60,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",544.08,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.71,63,,159.77,,,0,"percent of total billed charges","63% of total billed charges",48.5,15.3,,38.80,,,0,"percent of total billed charges","15.3% of total billed charges",528.24,100,,,,,0,"fee schedule",EAPG,218.73,69,,,,,0,"fee schedule","69% of total billed charges",317,100,,253.60,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",317,100,,253.60,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",317,100,,253.60,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",528.24,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",391.29,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",538.8,100,,,,,0,"fee schedule",EAPG,686.71,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",119.51,37.7,,95.61,,,0,"percent of total billed charges","37.7% of total billed charges",119.51,37.7,,95.61,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.46,33.9,,85.97,,,0,"percent of total billed charges","33.9% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",247.26,78,,197.81,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",261.84,82.6,,209.47,,,0,"percent of total billed charges","82.6% of total billed charges",528.24,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",261.84,82.6,,209.47,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",528.24,100,,,,,0,"fee schedule",EAPG,317,100,,253.60,,,0,"percent of total billed charges","100% of total billed charges",48.5,7127.26,
"GUIDENEEDLE PLACEMENT",40276942,CDM,402,RC,76942,CPT,OUTPATIENT,,,1214,789.1,TC,1068.32,88,,854.66,,,0,"percent of total billed charges","88% of total billed charges",607,50,,485.60,,,0,"percent of total billed charges","50% of total billed charges",101.95,100,,,,,0,"fee schedule",EAPG,1214,100,,971.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.01,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",764.82,63,,611.86,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",101.95,100,,,,,0,"fee schedule",EAPG,837.66,69,,,,,0,"fee schedule","69% of total billed charges",1214,100,,971.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1214,100,,971.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1214,100,,971.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",750.86,61.85,,600.69,,,0,"percent of total billed charges","61.5% of total billed charges",101.95,100,,,,,0,"fee schedule",EAPG,607,50,,485.60,,,0,"percent of total billed charges","50% of total billed charges",390.91,32.2,,312.73,,,0,"percent of total billed charges","32.2% of total billed charges",75.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",103.99,100,,,,,0,"fee schedule",EAPG,132.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",457.68,37.7,,366.14,,,0,"percent of total billed charges","37.7% of total billed charges",457.68,37.7,,366.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",411.55,33.9,,329.24,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",946.92,78,,757.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1002.76,82.6,,802.21,,,0,"percent of total billed charges","82.6% of total billed charges",101.95,100,,,,,0,"fee schedule",EAPG,607,50,,485.60,,,0,"percent of total billed charges","50% of total billed charges",1002.76,82.6,,802.21,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.95,100,,,,,0,"fee schedule",EAPG,1214,100,,971.20,,,0,"percent of total billed charges","100% of total billed charges",75.52,1214,
"FLUORO NEEDLE PLACEMENT",84077002,CDM,320,RC,77002,CPT,OUTPATIENT,,,1612,1047.8,TC,1418.56,88,,1134.85,,,0,"percent of total billed charges","88% of total billed charges",806,50,,644.80,,,0,"percent of total billed charges","50% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,1612,100,,1289.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1015.56,63,,812.45,,,0,"percent of total billed charges","63% of total billed charges",246.64,15.3,,197.31,,,0,"percent of total billed charges","15.3% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,1112.28,69,,,,,0,"fee schedule","69% of total billed charges",1612,100,,1289.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1612,100,,1289.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1612,100,,1289.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",997.02,61.85,,797.62,,,0,"percent of total billed charges","61.5% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,806,50,,644.80,,,0,"percent of total billed charges","50% of total billed charges",519.06,32.2,,415.25,,,0,"percent of total billed charges","32.2% of total billed charges",119.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",165.21,100,,,,,0,"fee schedule",EAPG,210.57,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",607.72,37.7,,486.18,,,0,"percent of total billed charges","37.7% of total billed charges",607.72,37.7,,486.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",546.47,33.9,,437.18,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1257.36,78,,1005.89,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1331.51,82.6,,1065.21,,,0,"percent of total billed charges","82.6% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,806,50,,644.80,,,0,"percent of total billed charges","50% of total billed charges",1331.51,82.6,,1065.21,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",161.97,100,,,,,0,"fee schedule",EAPG,1612,100,,1289.60,,,0,"percent of total billed charges","100% of total billed charges",119.98,1612,
"FLUORO GUIDANCE",84077003,CDM,320,RC,77003,CPT,OUTPATIENT,,,2860,1859,,2516.8,88,,2013.44,,,0,"percent of total billed charges","88% of total billed charges",1430,50,,1144.00,,,0,"percent of total billed charges","50% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,2860,100,,2288.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1801.8,63,,1441.44,,,0,"percent of total billed charges","63% of total billed charges",437.58,15.3,,350.06,,,0,"percent of total billed charges","15.3% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,1973.4,69,,,,,0,"fee schedule","69% of total billed charges",2860,100,,2288.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2860,100,,2288.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2860,100,,2288.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1768.91,61.85,,1415.13,,,0,"percent of total billed charges","61.5% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,1430,50,,1144.00,,,0,"percent of total billed charges","50% of total billed charges",920.92,32.2,,736.74,,,0,"percent of total billed charges","32.2% of total billed charges",119.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",165.21,100,,,,,0,"fee schedule",EAPG,210.57,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1078.22,37.7,,862.58,,,0,"percent of total billed charges","37.7% of total billed charges",1078.22,37.7,,862.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",969.54,33.9,,775.63,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2230.8,78,,1784.64,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2362.36,82.6,,1889.89,,,0,"percent of total billed charges","82.6% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,1430,50,,1144.00,,,0,"percent of total billed charges","50% of total billed charges",2362.36,82.6,,1889.89,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",161.97,100,,,,,0,"fee schedule",EAPG,2860,100,,2288.00,,,0,"percent of total billed charges","100% of total billed charges",119.98,2860,
"CONSCIOUS SEDATION 1ST 15 MIN",37099152,CDM,370,RC,99152,CPT,OUTPATIENT,,,492,319.8,,432.96,88,,346.37,,,0,"percent of total billed charges","88% of total billed charges",246,50,,196.80,,,0,"percent of total billed charges","50% of total billed charges",21.54,100,,,,,0,"fee schedule",EAPG,492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.18,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",309.96,63,,247.97,,,0,"percent of total billed charges","63% of total billed charges",75.28,15.3,,60.22,,,0,"percent of total billed charges","15.3% of total billed charges",21.54,100,,,,,0,"fee schedule",EAPG,339.48,69,,,,,0,"fee schedule","69% of total billed charges",492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",304.3,61.85,,243.44,,,0,"percent of total billed charges","61.5% of total billed charges",21.54,100,,,,,0,"fee schedule",EAPG,246,50,,196.80,,,0,"percent of total billed charges","50% of total billed charges",158.42,32.2,,126.74,,,0,"percent of total billed charges","32.2% of total billed charges",15.95,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",21.97,100,,,,,0,"fee schedule",EAPG,28,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",185.48,37.7,,148.38,,,0,"percent of total billed charges","37.7% of total billed charges",185.48,37.7,,148.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.79,33.9,,133.43,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",383.76,78,,307.01,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",406.39,82.6,,325.11,,,0,"percent of total billed charges","82.6% of total billed charges",21.54,100,,,,,0,"fee schedule",EAPG,246,50,,196.80,,,0,"percent of total billed charges","50% of total billed charges",406.39,82.6,,325.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.54,100,,,,,0,"fee schedule",EAPG,492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",15.95,492,
"CONSCIOUS SEDATION EA ADD15MIN",84099153,CDM,370,RC,99153,CPT,OUTPATIENT,,,492,319.8,,432.96,88,,346.37,,,0,"percent of total billed charges","88% of total billed charges",246,50,,196.80,,,0,"percent of total billed charges","50% of total billed charges",21.54,100,,,,,0,"fee schedule",EAPG,492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.18,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",309.96,63,,247.97,,,0,"percent of total billed charges","63% of total billed charges",75.28,15.3,,60.22,,,0,"percent of total billed charges","15.3% of total billed charges",21.54,100,,,,,0,"fee schedule",EAPG,339.48,69,,,,,0,"fee schedule","69% of total billed charges",492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",304.3,61.85,,243.44,,,0,"percent of total billed charges","61.5% of total billed charges",21.54,100,,,,,0,"fee schedule",EAPG,246,50,,196.80,,,0,"percent of total billed charges","50% of total billed charges",158.42,32.2,,126.74,,,0,"percent of total billed charges","32.2% of total billed charges",15.95,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",21.97,100,,,,,0,"fee schedule",EAPG,28,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",185.48,37.7,,148.38,,,0,"percent of total billed charges","37.7% of total billed charges",185.48,37.7,,148.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.79,33.9,,133.43,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",383.76,78,,307.01,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",406.39,82.6,,325.11,,,0,"percent of total billed charges","82.6% of total billed charges",21.54,100,,,,,0,"fee schedule",EAPG,246,50,,196.80,,,0,"percent of total billed charges","50% of total billed charges",406.39,82.6,,325.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.54,100,,,,,0,"fee schedule",EAPG,492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",15.95,492,
"20610 ARTHROCENTESIS INJECTION JOINT OR BURSA",76120610,CDM,761,RC,20610,CPT,OUTPATIENT,,,703,456.95,,618.64,88,,494.91,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,703,100,,562.40,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",223.22,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",442.89,63,,354.31,,,0,"percent of total billed charges","63% of total billed charges",107.56,15.3,,86.05,,,0,"percent of total billed charges","15.3% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,485.07,69,,,,,0,"fee schedule","69% of total billed charges",703,100,,562.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",703,100,,562.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",703,100,,562.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.05,100,,,,,0,"fee schedule",EAPG,281.73,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.03,37.7,,212.02,,,0,"percent of total billed charges","37.7% of total billed charges",265.03,37.7,,212.02,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",238.32,33.9,,190.66,,,0,"percent of total billed charges","33.9% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",548.34,78,,438.67,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",580.68,82.6,,464.54,,,0,"percent of total billed charges","82.6% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",580.68,82.6,,464.54,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,703,100,,562.40,,,0,"percent of total billed charges","100% of total billed charges",107.56,1061,
"FACET INJ L/S SPINE SEC LEVEL",84064494,CDM,761,RC,64494,CPT,OUTPATIENT,,,365,237.25,,321.2,88,,256.96,,,0,"percent of total billed charges","88% of total billed charges",182.5,50,,146.00,,,0,"percent of total billed charges","50% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,365,100,,292.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",793.79,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.95,63,,183.96,,,0,"percent of total billed charges","63% of total billed charges",55.85,15.3,,44.68,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,251.85,69,,,,,0,"fee schedule","69% of total billed charges",365,100,,292.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",365,100,,292.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",365,100,,292.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",225.75,61.85,,180.60,,,0,"percent of total billed charges","61.5% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,182.5,50,,146.00,,,0,"percent of total billed charges","50% of total billed charges",117.53,32.2,,94.02,,,0,"percent of total billed charges","32.2% of total billed charges",570.86,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",137.61,37.7,,110.09,,,0,"percent of total billed charges","37.7% of total billed charges",137.61,37.7,,110.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",123.74,33.9,,98.99,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",284.7,78,,227.76,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.49,82.6,,241.19,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,182.5,50,,146.00,,,0,"percent of total billed charges","50% of total billed charges",301.49,82.6,,241.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",770.67,100,,,,,0,"fee schedule",EAPG,365,100,,292.00,,,0,"percent of total billed charges","100% of total billed charges",55.85,1001.87,
"Arterial catheterization or cannulation for sampling, monito",76136620,CDM,761,RC,36620,CPT,OUTPATIENT,,,237,154.05,,208.56,88,,166.85,,,0,"percent of total billed charges","88% of total billed charges",118.5,50,,94.80,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,237,100,,189.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",149.31,63,,119.45,,,0,"percent of total billed charges","63% of total billed charges",36.26,15.3,,29.01,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,163.53,69,,,,,0,"fee schedule","69% of total billed charges",237,100,,189.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",237,100,,189.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",237,100,,189.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",146.58,61.85,,117.26,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,118.5,50,,94.80,,,0,"percent of total billed charges","50% of total billed charges",76.31,32.2,,61.05,,,0,"percent of total billed charges","32.2% of total billed charges",424.13,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",89.35,37.7,,71.48,,,0,"percent of total billed charges","37.7% of total billed charges",89.35,37.7,,71.48,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.34,33.9,,64.27,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",184.86,78,,147.89,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",195.76,82.6,,156.61,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,118.5,50,,94.80,,,0,"percent of total billed charges","50% of total billed charges",195.76,82.6,,156.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",572.57,100,,,,,0,"fee schedule",EAPG,237,100,,189.60,,,0,"percent of total billed charges","100% of total billed charges",36.26,744.35,
"49083-Abdominal Paracentesis w/ Imaging Guide",45049083,CDM,450,RC,49083,CPT,OUTPATIENT,,,2162,1405.3,,1902.56,88,,1522.05,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,2162,100,,1729.60,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",685.84,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1362.06,63,,1089.65,,,0,"percent of total billed charges","63% of total billed charges",330.79,15.3,,264.63,,,0,"percent of total billed charges","15.3% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,1491.78,69,,,,,0,"fee schedule","69% of total billed charges",2162,100,,1729.60,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2162,100,,1729.60,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2162,100,,1729.60,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",493.23,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",679.18,100,,,,,0,"fee schedule",EAPG,865.63,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",815.07,37.7,,652.06,,,0,"percent of total billed charges","37.7% of total billed charges",815.07,37.7,,652.06,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",732.92,33.9,,586.34,,,0,"percent of total billed charges","33.9% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1686.36,78,,1349.09,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1785.81,82.6,,1428.65,,,0,"percent of total billed charges","82.6% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1785.81,82.6,,1428.65,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,2162,100,,1729.60,,,0,"percent of total billed charges","100% of total billed charges",330.79,3289.02,
"90471: IM/SUBQ First dose",90471,CDM,450,RC,90471,CPT,OUTPATIENT,,,329,213.85,,289.52,88,,231.62,,,0,"percent of total billed charges","88% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.67,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",207.27,63,,165.82,,,0,"percent of total billed charges","63% of total billed charges",50.34,15.3,,40.27,,,0,"percent of total billed charges","15.3% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,227.01,69,,,,,0,"fee schedule","69% of total billed charges",329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",25.65,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.33,100,,,,,0,"fee schedule",EAPG,45.03,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.03,37.7,,99.22,,,0,"percent of total billed charges","37.7% of total billed charges",124.03,37.7,,99.22,,,0,"percent of total billed charges","37.70% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.53,33.9,,89.22,,,0,"percent of total billed charges","33.9% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.62,78,,205.30,,,0,"percent of total billed charges","78% of total billed charges",72.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",271.75,82.6,,217.40,,,0,"percent of total billed charges","82.6% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",271.75,82.6,,217.40,,,0,"percent of total billed charges","82.6% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",25.65,329,
"94002 VENTILATION ASSIST  MGMT INPATIENT 1ST DAY",41094002,CDM,410,RC,94002,CPT,OUTPATIENT,,,2978,1935.7,,2620.64,88,,2096.51,,,0,"percent of total billed charges","88% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579.9,100,,,,,0,"fee schedule",EAPG,2978,100,,2382.40,,,0,"percent of total billed charges","100% of total billed charges",1118.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",597.3,100,,,,,0,"fee schedule",EAPG,639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1876.14,63,,1500.91,,,0,"percent of total billed charges","63% of total billed charges",455.63,15.3,,364.50,,,0,"percent of total billed charges","15.3% of total billed charges",579.9,100,,,,,0,"fee schedule",EAPG,2054.82,69,,,,,0,"fee schedule","69% of total billed charges",2978,100,,2382.40,,,0,"percent of total billed charges","100% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2978,100,,2382.40,,,0,"percent of total billed charges","100% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2978,100,,2382.40,,,0,"percent of total billed charges","100% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",1971.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579.9,100,,,,,0,"fee schedule",EAPG,639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",515.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",429.56,100,,,,,0,"fee schedule",EAPG,639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591.5,100,,,,,0,"fee schedule",EAPG,753.87,100,,,,,0,"fee schedule",EAPG,639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1122.71,37.7,,898.17,,,0,"percent of total billed charges","37.7% of total billed charges",1122.71,37.7,,898.17,,,0,"percent of total billed charges","37.70% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1009.54,33.9,,807.63,,,0,"percent of total billed charges","33.9% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2322.84,78,,1858.27,,,0,"percent of total billed charges","78% of total billed charges",645.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2459.83,82.6,,1967.86,,,0,"percent of total billed charges","82.6% of total billed charges",579.9,100,,,,,0,"fee schedule",EAPG,639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2459.83,82.6,,1967.86,,,0,"percent of total billed charges","82.6% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579.9,100,,,,,0,"fee schedule",EAPG,2978,100,,2382.40,,,0,"percent of total billed charges","100% of total billed charges",429.56,2978,
"VENTILATOR MGMT EA SUB DAY",41094003,CDM,410,RC,94003,CPT,OUTPATIENT,,,2459,1598.35,,2163.92,88,,1731.14,,,0,"percent of total billed charges","88% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579.9,100,,,,,0,"fee schedule",EAPG,2459,100,,1967.20,,,0,"percent of total billed charges","100% of total billed charges",1118.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",597.3,100,,,,,0,"fee schedule",EAPG,639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1549.17,63,,1239.34,,,0,"percent of total billed charges","63% of total billed charges",376.23,15.3,,300.98,,,0,"percent of total billed charges","15.3% of total billed charges",579.9,100,,,,,0,"fee schedule",EAPG,1696.71,69,,,,,0,"fee schedule","69% of total billed charges",2459,100,,1967.20,,,0,"percent of total billed charges","100% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2459,100,,1967.20,,,0,"percent of total billed charges","100% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2459,100,,1967.20,,,0,"percent of total billed charges","100% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",1971.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579.9,100,,,,,0,"fee schedule",EAPG,639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",515.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",429.56,100,,,,,0,"fee schedule",EAPG,639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591.5,100,,,,,0,"fee schedule",EAPG,753.87,100,,,,,0,"fee schedule",EAPG,639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",927.04,37.7,,741.63,,,0,"percent of total billed charges","37.7% of total billed charges",927.04,37.7,,741.63,,,0,"percent of total billed charges","37.70% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",833.6,33.9,,666.88,,,0,"percent of total billed charges","33.9% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1918.02,78,,1534.42,,,0,"percent of total billed charges","78% of total billed charges",645.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2031.13,82.6,,1624.90,,,0,"percent of total billed charges","82.6% of total billed charges",579.9,100,,,,,0,"fee schedule","100% of WA fee schedule",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2031.13,82.6,,1624.90,,,0,"percent of total billed charges","82.6% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579.9,100,,,,,0,"fee schedule",EAPG,2459,100,,1967.20,,,0,"percent of total billed charges","100% of total billed charges",376.23,2459,
"94640 AIRWAY INHALATION TREATMENT",41094640,CDM,410,RC,94640,CPT,OUTPATIENT,,,707,459.55,76,622.16,88,,497.73,,,0,"percent of total billed charges","88% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",380.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",445.41,63,,356.33,,,0,"percent of total billed charges","63% of total billed charges",108.17,15.3,,86.54,,,0,"percent of total billed charges","15.3% of total billed charges",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",487.83,69,,,,,0,"fee schedule","69% of total billed charges",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",763.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.61,102,,,,,0,"fee schedule","102% of WA fee schedule",7.15,130,,,,,0,"fee schedule","130% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",266.54,37.7,,213.23,,,0,"percent of total billed charges","37.7% of total billed charges",266.54,37.7,,213.23,,,0,"percent of total billed charges","37.70% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",239.67,33.9,,191.74,,,0,"percent of total billed charges","33.9% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",551.46,78,,441.17,,,0,"percent of total billed charges","78% of total billed charges",219.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",583.98,82.6,,467.18,,,0,"percent of total billed charges","82.6% of total billed charges",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",583.98,82.6,,467.18,,,0,"percent of total billed charges","82.6% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",5.5,763.26,
"CONT INHAL TX FIRST HOUR",41094644,CDM,410,RC,94644,CPT,OUTPATIENT,,,785,510.25,,690.8,88,,552.64,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",48.3,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",494.55,63,,395.64,,,0,"percent of total billed charges","63% of total billed charges",120.11,15.3,,96.09,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,541.65,69,,,,,0,"fee schedule","69% of total billed charges",785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.73,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",295.95,37.7,,236.76,,,0,"percent of total billed charges","37.7% of total billed charges",295.95,37.7,,236.76,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",266.12,33.9,,212.90,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",612.3,78,,489.84,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",648.41,82.6,,518.73,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",648.41,82.6,,518.73,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",34.73,785,
"CONT INHAL TX EA ADD HOUR",41094645,CDM,410,RC,94645,CPT,OUTPATIENT,,,743,482.95,,653.84,88,,523.07,,,0,"percent of total billed charges","88% of total billed charges",371.5,50,,297.20,,,0,"percent of total billed charges","50% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,743,100,,594.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",468.09,63,,374.47,,,0,"percent of total billed charges","63% of total billed charges",113.68,15.3,,90.94,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,512.67,69,,,,,0,"fee schedule","69% of total billed charges",743,100,,594.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",743,100,,594.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",743,100,,594.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",459.55,61.85,,367.64,,,0,"percent of total billed charges","61.5% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,371.5,50,,297.20,,,0,"percent of total billed charges","50% of total billed charges",239.25,32.2,,191.40,,,0,"percent of total billed charges","32.2% of total billed charges",34.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",280.11,37.7,,224.09,,,0,"percent of total billed charges","37.7% of total billed charges",280.11,37.7,,224.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",251.88,33.9,,201.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.54,78,,463.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",613.72,82.6,,490.98,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,371.5,50,,297.20,,,0,"percent of total billed charges","50% of total billed charges",613.72,82.6,,490.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.89,100,,,,,0,"fee schedule",EAPG,743,100,,594.40,,,0,"percent of total billed charges","100% of total billed charges",34.73,743,
"AEROSOL TRX PENTAMIDINE",41094642,CDM,410,RC,94642,CPT,OUTPATIENT,,,806,523.9,,709.28,88,,567.42,,,0,"percent of total billed charges","88% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.79,100,,,,,0,"fee schedule","100% of WA fee schedule",806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",380.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",34.79,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",507.78,63,,406.22,,,0,"percent of total billed charges","63% of total billed charges",123.32,15.3,,98.66,,,0,"percent of total billed charges","15.3% of total billed charges",34.79,100,,,,,0,"fee schedule","100% of WA fee schedule",556.14,69,,,,,0,"fee schedule","69% of total billed charges",806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",763.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.79,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.79,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.49,102,,,,,0,"fee schedule","102% of WA fee schedule",45.23,130,,,,,0,"fee schedule","130% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",303.86,37.7,,243.09,,,0,"percent of total billed charges","37.7% of total billed charges",303.86,37.7,,243.09,,,0,"percent of total billed charges","37.70% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",273.23,33.9,,218.58,,,0,"percent of total billed charges","33.9% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",628.68,78,,502.94,,,0,"percent of total billed charges","78% of total billed charges",219.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.76,82.6,,532.61,,,0,"percent of total billed charges","82.6% of total billed charges",34.79,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.76,82.6,,532.61,,,0,"percent of total billed charges","82.6% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.79,100,,,,,0,"fee schedule","100% of WA fee schedule",806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",34.79,806,
"BIPAP/CPAP INIT  MGMT",41094660,CDM,410,RC,94660,CPT,OUTPATIENT,,,919,597.35,,808.72,88,,646.98,,,0,"percent of total billed charges","88% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.78,100,,,,,0,"fee schedule",EAPG,919,100,,735.20,,,0,"percent of total billed charges","100% of total billed charges",380.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",115.13,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",578.97,63,,463.18,,,0,"percent of total billed charges","63% of total billed charges",140.61,15.3,,112.49,,,0,"percent of total billed charges","15.3% of total billed charges",111.78,100,,,,,0,"fee schedule",EAPG,634.11,69,,,,,0,"fee schedule","69% of total billed charges",919,100,,735.20,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",919,100,,735.20,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",919,100,,735.20,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",763.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.78,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",82.8,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",114.01,100,,,,,0,"fee schedule",EAPG,145.31,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",346.46,37.7,,277.17,,,0,"percent of total billed charges","37.7% of total billed charges",346.46,37.7,,277.17,,,0,"percent of total billed charges","37.70% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",311.54,33.9,,249.23,,,0,"percent of total billed charges","33.9% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",716.82,78,,573.46,,,0,"percent of total billed charges","78% of total billed charges",219.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.09,82.6,,607.27,,,0,"percent of total billed charges","82.6% of total billed charges",111.78,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.09,82.6,,607.27,,,0,"percent of total billed charges","82.6% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.78,100,,,,,0,"fee schedule",EAPG,919,100,,735.20,,,0,"percent of total billed charges","100% of total billed charges",82.8,919,
"FLUTTER VALVE INITIAL",41094667,CDM,410,RC,94667,CPT,OUTPATIENT,,,707,459.55,,622.16,88,,497.73,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14.24,100,,,,,0,"fee schedule","100% of WA fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",14.24,100,,,,,0,"fee schedule","100% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",445.41,63,,356.33,,,0,"percent of total billed charges","63% of total billed charges",108.17,15.3,,86.54,,,0,"percent of total billed charges","15.3% of total billed charges",14.24,100,,,,,0,"fee schedule","100% of WA fee schedule",487.83,69,,,,,0,"fee schedule","69% of total billed charges",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14.24,100,,,,,0,"fee schedule","100% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14.24,100,,,,,0,"fee schedule","100% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14.52,102,,,,,0,"fee schedule","102% of WA fee schedule",18.51,130,,,,,0,"fee schedule","130% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",266.54,37.7,,213.23,,,0,"percent of total billed charges","37.7% of total billed charges",266.54,37.7,,213.23,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",239.67,33.9,,191.74,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",551.46,78,,441.17,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",583.98,82.6,,467.18,,,0,"percent of total billed charges","82.6% of total billed charges",14.24,100,,,,,0,"fee schedule","100% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",583.98,82.6,,467.18,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14.24,100,,,,,0,"fee schedule","100% of WA fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",14.24,707,
"FLUTTER VALVE SUB",41094668,CDM,410,RC,94668,CPT,OUTPATIENT,,,423,274.95,,372.24,88,,297.79,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",423,100,,338.40,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",266.49,63,,213.19,,,0,"percent of total billed charges","63% of total billed charges",64.72,15.3,,51.78,,,0,"percent of total billed charges","15.3% of total billed charges",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",291.87,69,,,,,0,"fee schedule","69% of total billed charges",423,100,,338.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",423,100,,338.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",423,100,,338.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22.65,102,,,,,0,"fee schedule","102% of WA fee schedule",28.87,130,,,,,0,"fee schedule","130% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",159.47,37.7,,127.58,,,0,"percent of total billed charges","37.7% of total billed charges",159.47,37.7,,127.58,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",143.4,33.9,,114.72,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",329.94,78,,263.95,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",349.4,82.6,,279.52,,,0,"percent of total billed charges","82.6% of total billed charges",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",349.4,82.6,,279.52,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",423,100,,338.40,,,0,"percent of total billed charges","100% of total billed charges",22.21,454.8,
"DEMO/EVAL GEN/NEBUL/MDI/IPPB",41094664,CDM,410,RC,94664,CPT,OUTPATIENT,,,707,459.55,,622.16,88,,497.73,,,0,"percent of total billed charges","88% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",380.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",48.3,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",445.41,63,,356.33,,,0,"percent of total billed charges","63% of total billed charges",108.17,15.3,,86.54,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,487.83,69,,,,,0,"fee schedule","69% of total billed charges",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",763.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.73,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",266.54,37.7,,213.23,,,0,"percent of total billed charges","37.7% of total billed charges",266.54,37.7,,213.23,,,0,"percent of total billed charges","37.70% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",239.67,33.9,,191.74,,,0,"percent of total billed charges","33.9% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",551.46,78,,441.17,,,0,"percent of total billed charges","78% of total billed charges",219.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",583.98,82.6,,467.18,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",583.98,82.6,,467.18,,,0,"percent of total billed charges","82.6% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",34.73,763.26,
"ASTHMA EDUCATIION (30 MIN)",41098960,CDM,410,RC,98960,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",59.14,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",60.91,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",59.14,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",59.14,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.8,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",60.32,100,,,,,0,"fee schedule",EAPG,76.88,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",59.14,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",59.14,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",43.8,76.88,
"ASTHMA EDUCATION (15 MIN)",41098961,CDM,410,RC,98961,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",42.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.64,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",42.2,100,,,,,0,"fee schedule",EAPG,53.79,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",30.64,53.79,
"PULM FUNC TST PLESTHYSMOGRAPH",46094726,CDM,460,RC,94726,CPT,OUTPATIENT,,,333,216.45,,293.04,88,,234.43,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.19,100,,,,,0,"fee schedule",EAPG,333,100,,266.40,,,0,"percent of total billed charges","100% of total billed charges",560.25,175,,,,,0,"fee schedule","175% of CMS fee schedule",94.95,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",209.79,63,,167.83,,,0,"percent of total billed charges","63% of total billed charges",50.95,15.3,,40.76,,,0,"percent of total billed charges","15.3% of total billed charges",92.19,100,,,,,0,"fee schedule",EAPG,229.77,69,,,,,0,"fee schedule","69% of total billed charges",333,100,,266.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",333,100,,266.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",333,100,,266.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.19,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",68.29,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",94.03,100,,,,,0,"fee schedule",EAPG,119.84,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.54,37.7,,100.43,,,0,"percent of total billed charges","37.7% of total billed charges",125.54,37.7,,100.43,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",112.89,33.9,,90.31,,,0,"percent of total billed charges","33.9% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",259.74,78,,207.79,,,0,"percent of total billed charges","78% of total billed charges",323.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",275.06,82.6,,220.05,,,0,"percent of total billed charges","82.6% of total billed charges",92.19,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",275.06,82.6,,220.05,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.19,100,,,,,0,"fee schedule",EAPG,333,100,,266.40,,,0,"percent of total billed charges","100% of total billed charges",50.95,1074.33,
CPR,48192950,CDM,481,RC,92950,CPT,OUTPATIENT,,,1022,664.3,,899.36,88,,719.49,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818.62,100,,,,,0,"fee schedule",EAPG,1022,100,,817.60,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",843.18,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.86,63,,515.09,,,0,"percent of total billed charges","63% of total billed charges",156.37,15.3,,125.10,,,0,"percent of total billed charges","15.3% of total billed charges",818.62,100,,,,,0,"fee schedule",EAPG,705.18,69,,,,,0,"fee schedule","69% of total billed charges",1022,100,,817.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022,100,,817.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022,100,,817.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818.62,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",606.38,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",834.99,100,,,,,0,"fee schedule",EAPG,1064.21,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",385.29,37.7,,308.23,,,0,"percent of total billed charges","37.7% of total billed charges",385.29,37.7,,308.23,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",346.46,33.9,,277.17,,,0,"percent of total billed charges","33.9% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",797.16,78,,637.73,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.17,82.6,,675.34,,,0,"percent of total billed charges","82.6% of total billed charges",818.62,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.17,82.6,,675.34,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818.62,100,,,,,0,"fee schedule",EAPG,1022,100,,817.60,,,0,"percent of total billed charges","100% of total billed charges",156.37,1074.33,
"CO/MEMBRANE DIFFUSE CAPACITY",46094729,CDM,460,RC,94729,CPT,OUTPATIENT,,,303,196.95,,266.64,88,,213.31,,,0,"percent of total billed charges","88% of total billed charges",151.5,50,,121.20,,,0,"percent of total billed charges","50% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,303,100,,242.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",190.89,63,,152.71,,,0,"percent of total billed charges","63% of total billed charges",46.36,15.3,,37.09,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,209.07,69,,,,,0,"fee schedule","69% of total billed charges",303,100,,242.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",303,100,,242.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",303,100,,242.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",187.41,61.85,,149.93,,,0,"percent of total billed charges","61.5% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,151.5,50,,121.20,,,0,"percent of total billed charges","50% of total billed charges",97.57,32.2,,78.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",114.23,37.7,,91.38,,,0,"percent of total billed charges","37.7% of total billed charges",114.23,37.7,,91.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",102.72,33.9,,82.18,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",236.34,78,,189.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",250.28,82.6,,200.22,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,151.5,50,,121.20,,,0,"percent of total billed charges","50% of total billed charges",250.28,82.6,,200.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.89,100,,,,,0,"fee schedule",EAPG,303,100,,242.40,,,0,"percent of total billed charges","100% of total billed charges",34.73,303,
"END TIDAL CO2 INITIAL DAY",46094770,CDM,460,RC,94799,CPT,OUTPATIENT,,,967,628.55,,850.96,88,,680.77,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,967,100,,773.60,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",48.3,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",609.21,63,,487.37,,,0,"percent of total billed charges","63% of total billed charges",147.95,15.3,,118.36,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,667.23,69,,,,,0,"fee schedule","69% of total billed charges",967,100,,773.60,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967,100,,773.60,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967,100,,773.60,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.73,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",364.56,37.7,,291.65,,,0,"percent of total billed charges","37.7% of total billed charges",364.56,37.7,,291.65,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327.81,33.9,,262.25,,,0,"percent of total billed charges","33.9% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",754.26,78,,603.41,,,0,"percent of total billed charges","78% of total billed charges",160.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",798.74,82.6,,638.99,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",798.74,82.6,,638.99,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,967,100,,773.60,,,0,"percent of total billed charges","100% of total billed charges",34.73,967,
"RESP TX LUNG STRENGTH 15MIN",410G0237,CDM,410,RC,,,OUTPATIENT,,,156,101.4,,137.28,88,,109.82,,,0,"percent of total billed charges","88% of total billed charges",78,50,,62.40,,,0,"percent of total billed charges","50% of total billed charges",26.21,16.8,,20.97,,,0,"percent of total billed charges","16.8% of total billed charges",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.99,17.304,,21.59,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.28,63,,78.62,,,0,"percent of total billed charges","63% of total billed charges",23.87,15.3,,19.10,,,0,"percent of total billed charges","15.3% of total billed charges",26.21,16.8,,20.97,,,0,"percent of total billed charges","16.8% of total billed charges",107.64,69,,,,,0,"fee schedule","69% of total billed charges",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",96.49,61.85,,77.19,,,0,"percent of total billed charges","61.5% of total billed charges",26.21,16.8,,20.97,,,0,"percent of total billed charges","16.8% of total billed charges",78,50,,62.40,,,0,"percent of total billed charges","50% of total billed charges",50.23,32.2,,40.18,,,0,"percent of total billed charges","32.2% of total billed charges",26.21,16.8,,20.97,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.73,17.136,,21.38,,,0,"percent of total billed charges","17.136% of total billed charges",34.07,21.84,,27.26,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.81,37.7,,47.05,,,0,"percent of total billed charges","37.7% of total billed charges",58.81,37.7,,47.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.88,33.9,,42.30,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",121.68,78,,97.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.86,82.6,,103.09,,,0,"percent of total billed charges","82.6% of total billed charges",26.21,16.8,,20.97,,,0,"percent of total billed charges","16.8% of total billed charges",78,50,,62.40,,,0,"percent of total billed charges","50% of total billed charges",128.86,82.6,,103.09,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.21,16.8,,20.97,,,0,"percent of total billed charges","16.8% of total billed charges",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",23.87,156,
"GAS ANALYSIS REST INDIR",46094690,CDM,460,RC,94690,CPT,OUTPATIENT,,,213,138.45,,187.44,88,,149.95,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",48.3,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",134.19,63,,107.35,,,0,"percent of total billed charges","63% of total billed charges",32.59,15.3,,26.07,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,146.97,69,,,,,0,"fee schedule","69% of total billed charges",213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.73,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.3,37.7,,64.24,,,0,"percent of total billed charges","37.7% of total billed charges",80.3,37.7,,64.24,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",72.21,33.9,,57.77,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",166.14,78,,132.91,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",175.94,82.6,,140.75,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",175.94,82.6,,140.75,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",32.59,226.12,
"RESP TX  RESP FUNCTION 15MIN",410G0238,CDM,410,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.7% of total billed charges",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.55,33.9,,42.04,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"Manual Therapy Minutes",43097140,CDM,430,RC,97140,CPT,OUTPATIENT,,,269,174.85,GO,236.72,88,,189.38,,,0,"percent of total billed charges","88% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",47.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee sv",169.47,63,,135.58,,,0,"percent of total billed charges","63% of total billed charges",41.16,15.3,,32.93,,,0,"percent of total billed charges","15.3% of total billed charges",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",185.61,69,,,,,0,"fee schedule","69% of total billed charges",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",27.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.72,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.05,100,,,,,0,"fee schedule","100% of LI fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.26,102,,,,,0,"fee schedule","102% of WA fee schedule",20.72,130,,,,,0,"fee schedule","130% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",101.41,37.7,,81.13,,,0,"percent of total billed charges","37.7% of total billed charges",101.41,37.7,,81.13,,,0,"percent of total billed charges","37.70% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.19,33.9,,72.95,,,0,"percent of total billed charges","33.9% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",209.82,78,,167.86,,,0,"percent of total billed charges","78% of total billed charges",27.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",222.19,82.6,,177.75,,,0,"percent of total billed charges","82.6% of total billed charges",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",222.19,82.6,,177.75,,,0,"percent of total billed charges","82.6% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",15.94,269,
"PT Infrared Therapy Minutes",42097033,CDM,420,RC,97033,CPT,OUTPATIENT,,,210,136.5,CQ|GP,184.8,88,,147.84,,,0,"percent of total billed charges","88% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",34.2,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee sv",132.3,63,,105.84,,,0,"percent of total billed charges","63% of total billed charges",32.13,15.3,,25.70,,,0,"percent of total billed charges","15.3% of total billed charges",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",144.9,69,,,,,0,"fee schedule","69% of total billed charges",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",19.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of LI fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.01,102,,,,,0,"fee schedule","102% of WA fee schedule",15.3,130,,,,,0,"fee schedule","130% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.17,37.7,,63.34,,,0,"percent of total billed charges","37.7% of total billed charges",79.17,37.7,,63.34,,,0,"percent of total billed charges","37.70% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.19,33.9,,56.95,,,0,"percent of total billed charges","33.9% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.8,78,,131.04,,,0,"percent of total billed charges","78% of total billed charges",19.91,101,,,,,0,"fee schedule","101% of CMS fee schedule ",173.46,82.6,,138.77,,,0,"percent of total billed charges","82.6% of total billed charges",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",173.46,82.6,,138.77,,,0,"percent of total billed charges","82.6% of total billed charges",19.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",11.77,210,
"Peak Flow",41094375,CDM,460,RC,94375,CPT,OUTPATIENT,,,716,465.4,,630.08,88,,504.06,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.19,100,,,,,0,"fee schedule",EAPG,716,100,,572.80,,,0,"percent of total billed charges","100% of total billed charges",560.25,175,,,,,0,"fee schedule","175% of CMS fee schedule",94.95,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",451.08,63,,360.86,,,0,"percent of total billed charges","63% of total billed charges",109.55,15.3,,87.64,,,0,"percent of total billed charges","15.3% of total billed charges",92.19,100,,,,,0,"fee schedule",EAPG,494.04,69,,,,,0,"fee schedule","69% of total billed charges",716,100,,572.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",716,100,,572.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",716,100,,572.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.19,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",68.29,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",94.03,100,,,,,0,"fee schedule",EAPG,119.84,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",269.93,37.7,,215.94,,,0,"percent of total billed charges","37.7% of total billed charges",269.93,37.7,,215.94,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",242.72,33.9,,194.18,,,0,"percent of total billed charges","33.9% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",558.48,78,,446.78,,,0,"percent of total billed charges","78% of total billed charges",323.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591.42,82.6,,473.14,,,0,"percent of total billed charges","82.6% of total billed charges",92.19,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591.42,82.6,,473.14,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.19,100,,,,,0,"fee schedule",EAPG,716,100,,572.80,,,0,"percent of total billed charges","100% of total billed charges",68.29,1074.33,
"SPIROM PP B-D P/F STUDY",46094060,CDM,460,RC,94060,CPT,OUTPATIENT,,,1226,796.9,,1078.88,88,,863.10,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.19,100,,,,,0,"fee schedule",EAPG,1226,100,,980.80,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",94.95,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",772.38,63,,617.90,,,0,"percent of total billed charges","63% of total billed charges",187.58,15.3,,150.06,,,0,"percent of total billed charges","15.3% of total billed charges",92.19,100,,,,,0,"fee schedule",EAPG,845.94,69,,,,,0,"fee schedule","69% of total billed charges",1226,100,,980.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1226,100,,980.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1226,100,,980.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.19,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",68.29,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",94.03,100,,,,,0,"fee schedule",EAPG,119.84,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.2,37.7,,369.76,,,0,"percent of total billed charges","37.7% of total billed charges",462.2,37.7,,369.76,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",415.61,33.9,,332.49,,,0,"percent of total billed charges","33.9% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",956.28,78,,765.02,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1012.68,82.6,,810.14,,,0,"percent of total billed charges","82.6% of total billed charges",92.19,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1012.68,82.6,,810.14,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.19,100,,,,,0,"fee schedule",EAPG,1226,100,,980.80,,,0,"percent of total billed charges","100% of total billed charges",68.29,1226,
"SPIROM SIMPL INCL FLO",46094010,CDM,460,RC,94010,CPT,OUTPATIENT,,,840,546,,739.2,88,,591.36,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,840,100,,672.00,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",48.3,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",529.2,63,,423.36,,,0,"percent of total billed charges","63% of total billed charges",128.52,15.3,,102.82,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,579.6,69,,,,,0,"fee schedule","69% of total billed charges",840,100,,672.00,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",840,100,,672.00,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",840,100,,672.00,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.73,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",316.68,37.7,,253.34,,,0,"percent of total billed charges","37.7% of total billed charges",316.68,37.7,,253.34,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.76,33.9,,227.81,,,0,"percent of total billed charges","33.9% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",655.2,78,,524.16,,,0,"percent of total billed charges","78% of total billed charges",160.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",693.84,82.6,,555.07,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",693.84,82.6,,555.07,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,840,100,,672.00,,,0,"percent of total billed charges","100% of total billed charges",34.73,840,
"SPUTUM COLLECTION",30089220,CDM,300,RC,89220,CPT,OUTPATIENT,,,750,487.5,,660,88,,528.00,,,0,"percent of total billed charges","88% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.75,100,,,,,0,"fee schedule",EAPG,750,100,,600.00,,,0,"percent of total billed charges","100% of total billed charges",304.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",36.82,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",472.5,63,,378.00,,,0,"percent of total billed charges","63% of total billed charges",114.75,15.3,,91.80,,,0,"percent of total billed charges","15.3% of total billed charges",35.75,100,,,,,0,"fee schedule",EAPG,517.5,69,,,,,0,"fee schedule","69% of total billed charges",750,100,,600.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",750,100,,600.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",750,100,,600.00,,,0,"percent of total billed charges","100% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",605.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.75,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.48,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.46,100,,,,,0,"fee schedule",EAPG,46.47,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",282.75,37.7,,226.20,,,0,"percent of total billed charges","37.7% of total billed charges",282.75,37.7,,226.20,,,0,"percent of total billed charges","37.70% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",254.25,33.9,,203.40,,,0,"percent of total billed charges","33.9% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",585,78,,468.00,,,0,"percent of total billed charges","78% of total billed charges",175.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",619.5,82.6,,495.60,,,0,"percent of total billed charges","82.6% of total billed charges",35.75,100,,,,,0,"fee schedule",EAPG,174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",619.5,82.6,,495.60,,,0,"percent of total billed charges","82.6% of total billed charges",174.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.75,100,,,,,0,"fee schedule",EAPG,750,100,,600.00,,,0,"percent of total billed charges","100% of total billed charges",26.48,750,
"Therapeutic Phlebotomy ONCOLOGY.",94099195,CDM,940,RC,99195,CPT,OUTPATIENT,,,351,228.15,,308.88,88,,247.10,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,351,100,,280.80,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",54.44,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.13,63,,176.90,,,0,"percent of total billed charges","63% of total billed charges",53.7,15.3,,42.96,,,0,"percent of total billed charges","15.3% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,242.19,69,,,,,0,"fee schedule","69% of total billed charges",351,100,,280.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",351,100,,280.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",351,100,,280.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.15,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",53.92,100,,,,,0,"fee schedule",EAPG,68.72,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.33,37.7,,105.86,,,0,"percent of total billed charges","37.7% of total billed charges",132.33,37.7,,105.86,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.99,33.9,,95.19,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",273.78,78,,219.02,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.93,82.6,,231.94,,,0,"percent of total billed charges","82.6% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.93,82.6,,231.94,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,351,100,,280.80,,,0,"percent of total billed charges","100% of total billed charges",39.15,454.8,
"TOTAL VITAL CAPACITY",46094150,CDM,460,RC,94150,CPT,OUTPATIENT,,,659,428.35,,579.92,88,,463.94,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,659,100,,527.20,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",48.3,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",415.17,63,,332.14,,,0,"percent of total billed charges","63% of total billed charges",100.83,15.3,,80.66,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,454.71,69,,,,,0,"fee schedule","69% of total billed charges",659,100,,527.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",659,100,,527.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",659,100,,527.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.73,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",248.44,37.7,,198.75,,,0,"percent of total billed charges","37.7% of total billed charges",248.44,37.7,,198.75,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",223.4,33.9,,178.72,,,0,"percent of total billed charges","33.9% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",514.02,78,,411.22,,,0,"percent of total billed charges","78% of total billed charges",160.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",544.33,82.6,,435.46,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",544.33,82.6,,435.46,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,659,100,,527.20,,,0,"percent of total billed charges","100% of total billed charges",34.73,659,
"ROOM/BED: ICU",ICU,CDM,200,RC,,,INPATIENT,,,3301,2145.65,,2904.88,88,,2323.90,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3301,100,,2640.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2079.63,63,,1663.70,,,0,"percent of total billed charges","63% of total billed charges",3427,,,,,,0,"per diem","pays based on per day rate",,,,,,,0,other,"not separately reimbursment",2277.69,69,,,,,0,"fee schedule","69% of total billed charges",3301,100,,2640.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3301,100,,2640.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3301,100,,2640.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2041.67,61.85,,1633.34,,,0,"percent of total billed charges","61.5% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1062.92,32.2,,850.34,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1244.48,37.7,,995.58,,,0,"percent of total billed charges","37.7% of total billed charges",1244.48,37.7,,995.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1624.09,33.9,,1299.27,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2574.78,78,,2059.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2888.38,82.6,,2310.70,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2888.38,82.6,,2310.70,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3301,100,,2640.80,,,0,"percent of total billed charges","100% of total billed charges",1062.92,3427,
OBSERVATION,OBSERVATION,CDM,762,RC,,,OUTPATIENT,,,176,114.4,,154.88,88,,123.90,,,0,"percent of total billed charges","88% of total billed charges",88,50,,70.40,,,0,"percent of total billed charges","50% of total billed charges",29.57,16.8,,23.66,,,0,"percent of total billed charges","16.8% of total billed charges",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.46,17.304,,24.37,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.88,63,,88.70,,,0,"percent of total billed charges","63% of total billed charges",35.2,15.3,,28.16,,,0,"percent of total billed charges","15.3% of total billed charges",29.57,16.8,,23.66,,,0,"percent of total billed charges","16.8% of total billed charges",121.44,69,,,,,0,"fee schedule","69% of total billed charges",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",108.86,61.85,,87.09,,,0,"percent of total billed charges","61.5% of total billed charges",29.57,16.8,,23.66,,,0,"percent of total billed charges","16.8% of total billed charges",88,50,,70.40,,,0,"percent of total billed charges","50% of total billed charges",56.67,32.2,,45.34,,,0,"percent of total billed charges","32.2% of total billed charges",29.57,16.8,,23.66,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.16,17.136,,24.13,,,0,"percent of total billed charges","17.136% of total billed charges",38.44,21.84,,30.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",66.35,37.7,,53.08,,,0,"percent of total billed charges","37.7% of total billed charges",66.35,37.7,,53.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.66,33.9,,47.73,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.28,78,,109.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",145.38,82.6,,116.30,,,0,"percent of total billed charges","82.6% of total billed charges",29.57,16.8,,23.66,,,0,"percent of total billed charges","16.8% of total billed charges",88,50,,70.40,,,0,"percent of total billed charges","50% of total billed charges",145.38,82.6,,116.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.57,16.8,,23.66,,,0,"percent of total billed charges","16.8% of total billed charges",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",29.57,176,
"ROOM/BED: Med/Surg",MED/SURG,CDM,121,RC,,,INPATIENT,,,1706,1108.9,,1501.28,88,,1201.02,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1706,100,,1364.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1074.78,63,,859.82,,,0,"percent of total billed charges","63% of total billed charges",3184,,,,,,0,"per diem","pays based on per day rate",,,,,,,0,other,"not separately reimbursment",1177.14,69,,,,,0,"fee schedule","69% of total billed charges",1706,100,,1364.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1706,100,,1364.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1706,100,,1364.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1055.16,61.85,,844.13,,,0,"percent of total billed charges","61.5% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",549.33,32.2,,439.46,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",643.16,37.7,,514.53,,,0,"percent of total billed charges","37.7% of total billed charges",643.16,37.7,,514.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",839.35,33.9,,671.48,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1330.68,78,,1064.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1492.75,82.6,,1194.20,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1492.75,82.6,,1194.20,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1706,100,,1364.80,,,0,"percent of total billed charges","100% of total billed charges",549.33,3184,
"SEMI PRIVATE",SEMIPRIVATE,CDM,121,RC,,,INPATIENT,,,1473,957.45,,1296.24,88,,1036.99,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1473,100,,1178.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",927.99,63,,742.39,,,0,"percent of total billed charges","63% of total billed charges",3184,,,,,,0,"per diem","pays based on per day rate",,,,,,,0,other,"not separately reimbursment",1016.37,69,,,,,0,"fee schedule","69% of total billed charges",1473,100,,1178.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1473,100,,1178.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1473,100,,1178.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",911.05,61.85,,728.84,,,0,"percent of total billed charges","61.5% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",474.31,32.2,,379.45,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",555.32,37.7,,444.26,,,0,"percent of total billed charges","37.7% of total billed charges",555.32,37.7,,444.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",724.72,33.9,,579.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1148.94,78,,919.15,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1288.88,82.6,,1031.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1288.88,82.6,,1031.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1473,100,,1178.40,,,0,"percent of total billed charges","100% of total billed charges",474.31,3184,
"ROOM/BED: Nursery Level 2",NSY2,CDM,172,RC,,,INPATIENT,,,1367,888.55,,1202.96,88,,962.37,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1367,100,,1093.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",861.21,63,,688.97,,,0,"percent of total billed charges","63% of total billed charges",1665,,,,,,0,"per diem","pays based on per day rate",,,,,,,0,other,"not separately reimbursment",943.23,69,,,,,0,"fee schedule","69% of total billed charges",1367,100,,1093.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1367,100,,1093.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1367,100,,1093.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",845.49,61.85,,676.39,,,0,"percent of total billed charges","61.5% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",440.17,32.2,,352.14,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",515.36,37.7,,412.29,,,0,"percent of total billed charges","37.7% of total billed charges",515.36,37.7,,412.29,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",672.56,33.9,,538.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1066.26,78,,853.01,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1196.13,82.6,,956.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1196.13,82.6,,956.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1367,100,,1093.60,,,0,"percent of total billed charges","100% of total billed charges",440.17,1665,
PRIVATE,PRIVATE,CDM,111,RC,,,INPATIENT,,,1473,957.45,,1296.24,88,,1036.99,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1473,100,,1178.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",927.99,63,,742.39,,,0,"percent of total billed charges","63% of total billed charges",3184,,,,,,0,"per diem","pays based on per day rate",,,,,,,0,other,"not separately reimbursment",1016.37,69,,,,,0,"fee schedule","69% of total billed charges",1473,100,,1178.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1473,100,,1178.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1473,100,,1178.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",911.05,61.85,,728.84,,,0,"percent of total billed charges","61.5% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",474.31,32.2,,379.45,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",555.32,37.7,,444.26,,,0,"percent of total billed charges","37.7% of total billed charges",555.32,37.7,,444.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",724.72,33.9,,579.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1148.94,78,,919.15,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1288.88,82.6,,1031.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1288.88,82.6,,1031.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1473,100,,1178.40,,,0,"percent of total billed charges","100% of total billed charges",474.31,3184,
"ROOM/BED: MW Semi Private",MWPSO,CDM,121,RC,,,INPATIENT,,,2380,1547,,2094.4,88,,1675.52,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2380,100,,1904.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1499.4,63,,1199.52,,,0,"percent of total billed charges","63% of total billed charges",3184,,,,,,0,"per diem","pays based on per day rate",,,,,,,0,other,"not separately reimbursment",1642.2,69,,,,,0,"fee schedule","69% of total billed charges",2380,100,,1904.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2380,100,,1904.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2380,100,,1904.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1472.03,61.85,,1177.62,,,0,"percent of total billed charges","61.5% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",766.36,32.2,,613.09,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",897.26,37.7,,717.81,,,0,"percent of total billed charges","37.7% of total billed charges",897.26,37.7,,717.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1170.96,33.9,,936.77,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1856.4,78,,1485.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2082.5,82.6,,1666.00,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2082.5,82.6,,1666.00,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2380,100,,1904.00,,,0,"percent of total billed charges","100% of total billed charges",766.36,3184,
"ROOM/BED: Intermediate ICU",INTERICU,CDM,206,RC,,,INPATIENT,,,2713,1763.45,,2387.44,88,,1909.95,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2713,100,,2170.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1709.19,63,,1367.35,,,0,"percent of total billed charges","63% of total billed charges",3168,,,,,,0,"per diem","pays based on per day rate",,,,,,,0,other,"not separately reimbursment",1871.97,69,,,,,0,"fee schedule","69% of total billed charges",2713,100,,2170.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2713,100,,2170.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2713,100,,2170.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1677.99,61.85,,1342.39,,,0,"percent of total billed charges","61.5% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",873.59,32.2,,698.87,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1022.8,37.7,,818.24,,,0,"percent of total billed charges","37.7% of total billed charges",1022.8,37.7,,818.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1334.8,33.9,,1067.84,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2116.14,78,,1692.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2373.88,82.6,,1899.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2373.88,82.6,,1899.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2713,100,,2170.40,,,0,"percent of total billed charges","100% of total billed charges",873.59,3168,
"ROOM/BED: Obstetrics",OB,CDM,122,RC,,,INPATIENT,,,1403,911.95,,1234.64,88,,987.71,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1403,100,,1122.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",883.89,63,,707.11,,,0,"percent of total billed charges","63% of total billed charges",3184,,,,,,0,"per diem","pays based on per day rate",,,,,,,0,other,"not separately reimbursment",968.07,69,,,,,0,"fee schedule","69% of total billed charges",1403,100,,1122.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1403,100,,1122.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1403,100,,1122.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",867.76,61.85,,694.21,,,0,"percent of total billed charges","61.5% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",451.77,32.2,,361.42,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",528.93,37.7,,423.14,,,0,"percent of total billed charges","37.7% of total billed charges",528.93,37.7,,423.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",690.28,33.9,,552.22,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1094.34,78,,875.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1227.63,82.6,,982.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1227.63,82.6,,982.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1403,100,,1122.40,,,0,"percent of total billed charges","100% of total billed charges",451.77,3184,
"ROOM/BED: Nursery Level 1",NSY1,CDM,171,RC,,,INPATIENT,,,1249,811.85,,1099.12,88,,879.30,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1249,100,,999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",786.87,63,,629.50,,,0,"percent of total billed charges","63% of total billed charges",1089,,,,,,0,"per diem","pays based on per day rate",,,,,,,0,other,"not separately reimbursment",861.81,69,,,,,0,"fee schedule","69% of total billed charges",1249,100,,999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1249,100,,999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1249,100,,999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",772.51,61.85,,618.01,,,0,"percent of total billed charges","61.5% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",402.18,32.2,,321.74,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.87,37.7,,376.70,,,0,"percent of total billed charges","37.7% of total billed charges",470.87,37.7,,376.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",614.51,33.9,,491.61,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",974.22,78,,779.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1092.88,82.6,,874.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1092.88,82.6,,874.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1249,100,,999.20,,,0,"percent of total billed charges","100% of total billed charges",402.18,1249,
"ROOM/BED: Psych Semi Private",PSYSP,CDM,124,RC,,,INPATIENT,,,2380,1547,,2094.4,88,,1675.52,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.63,,,,,,0,"per diem","pays based on per day rate",2380,100,,1904.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.63,,,,,,0,"per diem","pays based on per day rate",,,,,,,0,other,"not separately reimbursment",1499.4,63,,1199.52,,,0,"percent of total billed charges","63% of total billed charges",1753,,,,,,0,"per diem","pays based on per day rate",1349.63,,,,,,0,"per diem","pays based on per day rate",1642.2,69,,,,,0,"fee schedule","69% of total billed charges",2380,100,,1904.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2380,100,,1904.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2380,100,,1904.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1472.03,61.85,,1177.62,,,0,"percent of total billed charges","61.5% of total billed charges",1349.63,,,,,,0,"per diem","pays based on per day rate",,,,,,,0,other,"not separately reimbursment",1191.09,,,,,,0,"per diem","pays based on per visit rate",1349.63,,,,,,0,"per diem","pays based on per day rate",,,,,,,0,other,"not separately reimbursment",1349.63,,,,,,0,"per diem","pays based on per day rate",1754.52,,,,,,0,"per diem","pays based on per day rate",,,,,,,0,other,"not separately reimbursment",897.26,37.7,,717.81,,,0,"percent of total billed charges","37.7% of total billed charges",897.26,37.7,,717.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1170.96,33.9,,936.77,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1856.4,78,,1485.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2082.5,82.6,,1666.00,,,0,"percent of total billed charges","82.6% of total billed charges",1349.63,,,,,,0,"per diem","pays based on per day rate",,,,,,,0,other,"not separately reimbursment",2082.5,82.6,,1666.00,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.63,,,,,,0,"per diem","pays based on per day rate",2380,100,,1904.00,,,0,"percent of total billed charges","100% of total billed charges",897.26,2380,
"Application of a modality to 1 or more areas; hot or cold pa",42097010,CDM,420,RC,97010,CPT,OUTPATIENT,,,37,24.05,,32.56,88,,26.05,,,0,"percent of total billed charges","88% of total billed charges",6.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.1,100,,,,,0,"fee schedule",EAPG,37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",10.96,175,,,,,0,"fee schedule","175% of CMS fee schedule",29.97,100,,,,,0,"fee schedule",EAPG,6.43,100,,,,,0,"fee schedule","100% of CMS fee sv",23.31,63,,18.65,,,0,"percent of total billed charges","63% of total billed charges",5.66,15.3,,4.53,,,0,"percent of total billed charges","15.3% of total billed charges",29.1,100,,,,,0,"fee schedule",EAPG,25.53,69,,,,,0,"fee schedule","69% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",6.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",6.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",6.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.87,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",29.1,100,,,,,0,"fee schedule",EAPG,6.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.29,100,,,,,0,"fee schedule","100% of LI fee schedule",21.55,100,,,,,0,"fee schedule",EAPG,6.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.68,100,,,,,0,"fee schedule",EAPG,37.83,100,,,,,0,"fee schedule",EAPG,6.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.95,37.7,,11.16,,,0,"percent of total billed charges","37.7% of total billed charges",13.95,37.7,,11.16,,,0,"percent of total billed charges","37.70% of total billed charges",6.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.54,33.9,,10.03,,,0,"percent of total billed charges","33.9% of total billed charges",6.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.86,78,,23.09,,,0,"percent of total billed charges","78% of total billed charges",6.49,101,,,,,0,"fee schedule","101% of CMS fee schedule ",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",29.1,100,,,,,0,"fee schedule",EAPG,6.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",6.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.1,100,,,,,0,"fee schedule",EAPG,37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",5.66,37.83,
"TRACTION MECHANICAL/-GP",42097012,CDM,420,RC,97012,CPT,OUTPATIENT,,,136,88.4,GP,119.68,88,,95.74,,,0,"percent of total billed charges","88% of total billed charges",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",24.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.18,100,,,,,0,"fee schedule","100% of CMS fee sv",85.68,63,,68.54,,,0,"percent of total billed charges","63% of total billed charges",20.81,15.3,,16.65,,,0,"percent of total billed charges","15.3% of total billed charges",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",93.84,69,,,,,0,"fee schedule","69% of total billed charges",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",14.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.97,100,,,,,0,"fee schedule","100% of LI fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.52,102,,,,,0,"fee schedule","102% of WA fee schedule",10.86,130,,,,,0,"fee schedule","130% of WA fee schedule",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.27,37.7,,41.02,,,0,"percent of total billed charges","37.7% of total billed charges",51.27,37.7,,41.02,,,0,"percent of total billed charges","37.70% of total billed charges",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.1,33.9,,36.88,,,0,"percent of total billed charges","33.9% of total billed charges",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.08,78,,84.86,,,0,"percent of total billed charges","78% of total billed charges",14.32,101,,,,,0,"fee schedule","101% of CMS fee schedule ",112.34,82.6,,89.87,,,0,"percent of total billed charges","82.6% of total billed charges",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",112.34,82.6,,89.87,,,0,"percent of total billed charges","82.6% of total billed charges",14.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",8.35,136,
"ELECTRIC STIMULATION THERAPY",42097014,CDM,420,RC,97014,CPT,OUTPATIENT,,,81,52.65,GP,71.28,88,,57.02,,,0,"percent of total billed charges","88% of total billed charges",40.5,50,,32.40,,,0,"percent of total billed charges","50% of total billed charges",7.21,100,,,,,0,"fee schedule","100% of WA fee schedule",81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.21,100,,,,,0,"fee schedule","100% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",51.03,63,,40.82,,,0,"percent of total billed charges","63% of total billed charges",12.39,15.3,,9.91,,,0,"percent of total billed charges","15.3% of total billed charges",7.21,100,,,,,0,"fee schedule","100% of WA fee schedule",55.89,69,,,,,0,"fee schedule","69% of total billed charges",81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.1,61.85,,40.08,,,0,"percent of total billed charges","61.5% of total billed charges",7.21,100,,,,,0,"fee schedule","100% of WA fee schedule",40.5,50,,32.40,,,0,"percent of total billed charges","50% of total billed charges",26.08,32.2,,20.86,,,0,"percent of total billed charges","32.2% of total billed charges",7.21,100,,,,,0,"fee schedule","100% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",7.35,102,,,,,0,"fee schedule","102% of WA fee schedule",9.37,130,,,,,0,"fee schedule","130% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",30.54,37.7,,24.43,,,0,"percent of total billed charges","37.7% of total billed charges",30.54,37.7,,24.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.46,33.9,,21.97,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.18,78,,50.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",66.91,82.6,,53.53,,,0,"percent of total billed charges","82.6% of total billed charges",7.21,100,,,,,0,"fee schedule","100% of WA fee schedule",40.5,50,,32.40,,,0,"percent of total billed charges","50% of total billed charges",66.91,82.6,,53.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.21,100,,,,,0,"fee schedule","100% of WA fee schedule",81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",7.21,81,
"PARAFFIN BATH",42097018,CDM,420,RC,97018,CPT,OUTPATIENT,,,151,98.15,GP,132.88,88,,106.30,,,0,"percent of total billed charges","88% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",9.75,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee sv",95.13,63,,76.10,,,0,"percent of total billed charges","63% of total billed charges",23.1,15.3,,18.48,,,0,"percent of total billed charges","15.3% of total billed charges",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",104.19,69,,,,,0,"fee schedule","69% of total billed charges",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",5.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.53,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.62,100,,,,,0,"fee schedule","100% of LI fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.49,102,,,,,0,"fee schedule","102% of WA fee schedule",4.45,130,,,,,0,"fee schedule","130% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.93,37.7,,45.54,,,0,"percent of total billed charges","37.7% of total billed charges",56.93,37.7,,45.54,,,0,"percent of total billed charges","37.70% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.19,33.9,,40.95,,,0,"percent of total billed charges","33.9% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",117.78,78,,94.22,,,0,"percent of total billed charges","78% of total billed charges",5.8,101,,,,,0,"fee schedule","101% of CMS fee schedule ",124.73,82.6,,99.78,,,0,"percent of total billed charges","82.6% of total billed charges",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.73,82.6,,99.78,,,0,"percent of total billed charges","82.6% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",3.42,151,
"VASOPNEUMATIC DEVICES/-GP",42097016,CDM,420,RC,97016,CPT,OUTPATIENT,,,150,97.5,GP,132,88,,105.60,,,0,"percent of total billed charges","88% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",20.42,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",11.84,100,,,,,0,"fee schedule","100% of CMS fee sv",94.5,63,,75.60,,,0,"percent of total billed charges","63% of total billed charges",22.95,15.3,,18.36,,,0,"percent of total billed charges","15.3% of total billed charges",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",103.5,69,,,,,0,"fee schedule","69% of total billed charges",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",11.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.67,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.63,100,,,,,0,"fee schedule","100% of LI fee schedule",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.97,102,,,,,0,"fee schedule","102% of WA fee schedule",8.88,130,,,,,0,"fee schedule","130% of WA fee schedule",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.7% of total billed charges",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.70% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.85,33.9,,40.68,,,0,"percent of total billed charges","33.9% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",117,78,,93.60,,,0,"percent of total billed charges","78% of total billed charges",11.96,101,,,,,0,"fee schedule","101% of CMS fee schedule ",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",6.83,150,
DIATHERMY,42097024,CDM,420,RC,97024,CPT,OUTPATIENT,,,40,26,GP,35.2,88,,28.16,,,0,"percent of total billed charges","88% of total billed charges",7.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.37,100,,,,,0,"fee schedule","100% of WA fee schedule",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",12.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.37,100,,,,,0,"fee schedule","100% of WA fee schedule",7.47,100,,,,,0,"fee schedule","100% of CMS fee sv",25.2,63,,20.16,,,0,"percent of total billed charges","63% of total billed charges",6.12,15.3,,4.90,,,0,"percent of total billed charges","15.3% of total billed charges",4.37,100,,,,,0,"fee schedule","100% of WA fee schedule",27.6,69,,,,,0,"fee schedule","69% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",7.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",7.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",7.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.92,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.37,100,,,,,0,"fee schedule","100% of WA fee schedule",7.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.3,100,,,,,0,"fee schedule","100% of LI fee schedule",4.37,100,,,,,0,"fee schedule","100% of WA fee schedule",7.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.46,102,,,,,0,"fee schedule","102% of WA fee schedule",5.68,130,,,,,0,"fee schedule","130% of WA fee schedule",7.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.08,37.7,,12.06,,,0,"percent of total billed charges","37.7% of total billed charges",15.08,37.7,,12.06,,,0,"percent of total billed charges","37.70% of total billed charges",7.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.56,33.9,,10.85,,,0,"percent of total billed charges","33.9% of total billed charges",7.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.2,78,,24.96,,,0,"percent of total billed charges","78% of total billed charges",7.54,101,,,,,0,"fee schedule","101% of CMS fee schedule ",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",4.37,100,,,,,0,"fee schedule","100% of WA fee schedule",7.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",7.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.37,100,,,,,0,"fee schedule","100% of WA fee schedule",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",4.37,40,
ULTRAVIOLET,42097028,CDM,420,RC,97028,CPT,OUTPATIENT,,,49,31.85,GP,43.12,88,,34.50,,,0,"percent of total billed charges","88% of total billed charges",8.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.93,100,,,,,0,"fee schedule","100% of WA fee schedule",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",14.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.93,100,,,,,0,"fee schedule","100% of WA fee schedule",8.48,100,,,,,0,"fee schedule","100% of CMS fee sv",30.87,63,,24.70,,,0,"percent of total billed charges","63% of total billed charges",7.5,15.3,,6.00,,,0,"percent of total billed charges","15.3% of total billed charges",4.93,100,,,,,0,"fee schedule","100% of WA fee schedule",33.81,69,,,,,0,"fee schedule","69% of total billed charges",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",8.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",8.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",8.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.94,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.93,100,,,,,0,"fee schedule","100% of WA fee schedule",8.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.31,100,,,,,0,"fee schedule","100% of LI fee schedule",4.93,100,,,,,0,"fee schedule","100% of WA fee schedule",8.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.03,102,,,,,0,"fee schedule","102% of WA fee schedule",6.41,130,,,,,0,"fee schedule","130% of WA fee schedule",8.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.47,37.7,,14.78,,,0,"percent of total billed charges","37.7% of total billed charges",18.47,37.7,,14.78,,,0,"percent of total billed charges","37.70% of total billed charges",8.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.61,33.9,,13.29,,,0,"percent of total billed charges","33.9% of total billed charges",8.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.22,78,,30.58,,,0,"percent of total billed charges","78% of total billed charges",8.56,101,,,,,0,"fee schedule","101% of CMS fee schedule ",40.47,82.6,,32.38,,,0,"percent of total billed charges","82.6% of total billed charges",4.93,100,,,,,0,"fee schedule","100% of WA fee schedule",8.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.47,82.6,,32.38,,,0,"percent of total billed charges","82.6% of total billed charges",8.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.93,100,,,,,0,"fee schedule","100% of WA fee schedule",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",4.93,49,
WHIRLPOOL/-GP,42097022,CDM,420,RC,97022,CPT,OUTPATIENT,,,199,129.35,GP,175.12,88,,140.10,,,0,"percent of total billed charges","88% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",199,100,,159.20,,,0,"percent of total billed charges","100% of total billed charges",30.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee sv",125.37,63,,100.30,,,0,"percent of total billed charges","63% of total billed charges",30.45,15.3,,24.36,,,0,"percent of total billed charges","15.3% of total billed charges",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",137.31,69,,,,,0,"fee schedule","69% of total billed charges",199,100,,159.20,,,0,"percent of total billed charges","100% of total billed charges",17.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",199,100,,159.20,,,0,"percent of total billed charges","100% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",199,100,,159.20,,,0,"percent of total billed charges","100% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.69,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.04,100,,,,,0,"fee schedule","100% of LI fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.46,102,,,,,0,"fee schedule","102% of WA fee schedule",13.33,130,,,,,0,"fee schedule","130% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",75.02,37.7,,60.02,,,0,"percent of total billed charges","37.7% of total billed charges",75.02,37.7,,60.02,,,0,"percent of total billed charges","37.70% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.46,33.9,,53.97,,,0,"percent of total billed charges","33.9% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",155.22,78,,124.18,,,0,"percent of total billed charges","78% of total billed charges",17.56,101,,,,,0,"fee schedule","101% of CMS fee schedule ",164.37,82.6,,131.50,,,0,"percent of total billed charges","82.6% of total billed charges",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",164.37,82.6,,131.50,,,0,"percent of total billed charges","82.6% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",199,100,,159.20,,,0,"percent of total billed charges","100% of total billed charges",10.25,199,
INFRARED,42097026,CDM,420,RC,97026,CPT,OUTPATIENT,,,39,25.35,GP,34.32,88,,27.46,,,0,"percent of total billed charges","88% of total billed charges",6.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.99,100,,,,,0,"fee schedule","100% of WA fee schedule",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",11.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.99,100,,,,,0,"fee schedule","100% of WA fee schedule",6.77,100,,,,,0,"fee schedule","100% of CMS fee sv",,,,,,,0,other,"not separately reimbursment",5.97,15.3,,4.78,,,0,"percent of total billed charges","15.3% of total billed charges",3.99,100,,,,,0,"fee schedule","100% of WA fee schedule",26.91,69,,,,,0,"fee schedule","69% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",6.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",6.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.99,100,,,,,0,"fee schedule","100% of WA fee schedule",6.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.63,100,,,,,0,"fee schedule","100% of LI fee schedule",3.99,100,,,,,0,"fee schedule","100% of WA fee schedule",6.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.07,102,,,,,0,"fee schedule","102% of WA fee schedule",5.19,130,,,,,0,"fee schedule","130% of WA fee schedule",6.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.7% of total billed charges",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.70% of total billed charges",6.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.22,33.9,,10.58,,,0,"percent of total billed charges","33.9% of total billed charges",6.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.42,78,,24.34,,,0,"percent of total billed charges","78% of total billed charges",6.84,101,,,,,0,"fee schedule","101% of CMS fee schedule ",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",3.99,100,,,,,0,"fee schedule","100% of WA fee schedule",6.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",6.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.99,100,,,,,0,"fee schedule","100% of WA fee schedule",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",3.99,39,
"HUBBARD TANK EACH 15 MINUTES",42097036,CDM,420,RC,97036,CPT,OUTPATIENT,,,210,136.5,GP,184.8,88,,147.84,,,0,"percent of total billed charges","88% of total billed charges",35.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.88,100,,,,,0,"fee schedule","100% of WA fee schedule",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",62.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",20.88,100,,,,,0,"fee schedule","100% of WA fee schedule",35.96,100,,,,,0,"fee schedule","100% of CMS fee sv",132.3,63,,105.84,,,0,"percent of total billed charges","63% of total billed charges",32.13,15.3,,25.70,,,0,"percent of total billed charges","15.3% of total billed charges",20.88,100,,,,,0,"fee schedule","100% of WA fee schedule",144.9,69,,,,,0,"fee schedule","69% of total billed charges",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",35.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",35.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",35.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",135.79,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",20.88,100,,,,,0,"fee schedule","100% of WA fee schedule",35.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.22,100,,,,,0,"fee schedule","100% of LI fee schedule",20.88,100,,,,,0,"fee schedule","100% of WA fee schedule",35.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.3,102,,,,,0,"fee schedule","102% of WA fee schedule",27.14,130,,,,,0,"fee schedule","130% of WA fee schedule",35.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.17,37.7,,63.34,,,0,"percent of total billed charges","37.7% of total billed charges",79.17,37.7,,63.34,,,0,"percent of total billed charges","37.70% of total billed charges",35.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.19,33.9,,56.95,,,0,"percent of total billed charges","33.9% of total billed charges",35.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.8,78,,131.04,,,0,"percent of total billed charges","78% of total billed charges",36.32,101,,,,,0,"fee schedule","101% of CMS fee schedule ",173.46,82.6,,138.77,,,0,"percent of total billed charges","82.6% of total billed charges",20.88,100,,,,,0,"fee schedule","100% of WA fee schedule",35.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",173.46,82.6,,138.77,,,0,"percent of total billed charges","82.6% of total billed charges",35.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.88,100,,,,,0,"fee schedule","100% of WA fee schedule",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",20.88,210,
"ELEC STIM MAN/15MIN/-GP",42097032,CDM,420,RC,97032,CPT,OUTPATIENT,,,213,138.45,GP|CQ,187.44,88,,149.95,,,0,"percent of total billed charges","88% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",25.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee sv",134.19,63,,107.35,,,0,"percent of total billed charges","63% of total billed charges",32.59,15.3,,26.07,,,0,"percent of total billed charges","15.3% of total billed charges",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",146.97,69,,,,,0,"fee schedule","69% of total billed charges",213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",14.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.3,100,,,,,0,"fee schedule","100% of LI fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.52,102,,,,,0,"fee schedule","102% of WA fee schedule",10.86,130,,,,,0,"fee schedule","130% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.3,37.7,,64.24,,,0,"percent of total billed charges","37.7% of total billed charges",80.3,37.7,,64.24,,,0,"percent of total billed charges","37.70% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.21,33.9,,57.77,,,0,"percent of total billed charges","33.9% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",166.14,78,,132.91,,,0,"percent of total billed charges","78% of total billed charges",14.68,101,,,,,0,"fee schedule","101% of CMS fee schedule ",175.94,82.6,,140.75,,,0,"percent of total billed charges","82.6% of total billed charges",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",175.94,82.6,,140.75,,,0,"percent of total billed charges","82.6% of total billed charges",14.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",8.35,213,
IONTOPHORESIS/15MIN,42097033,CDM,420,RC,97033,CPT,OUTPATIENT,,,212,137.8,CQ|GP,186.56,88,,149.25,,,0,"percent of total billed charges","88% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",34.2,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee sv",133.56,63,,106.85,,,0,"percent of total billed charges","63% of total billed charges",32.44,15.3,,25.95,,,0,"percent of total billed charges","15.3% of total billed charges",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",146.28,69,,,,,0,"fee schedule","69% of total billed charges",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",19.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of LI fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.01,102,,,,,0,"fee schedule","102% of WA fee schedule",15.3,130,,,,,0,"fee schedule","130% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.92,37.7,,63.94,,,0,"percent of total billed charges","37.7% of total billed charges",79.92,37.7,,63.94,,,0,"percent of total billed charges","37.70% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.87,33.9,,57.50,,,0,"percent of total billed charges","33.9% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",165.36,78,,132.29,,,0,"percent of total billed charges","78% of total billed charges",19.91,101,,,,,0,"fee schedule","101% of CMS fee schedule ",175.11,82.6,,140.09,,,0,"percent of total billed charges","82.6% of total billed charges",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",175.11,82.6,,140.09,,,0,"percent of total billed charges","82.6% of total billed charges",19.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",11.77,212,
"CONTRAST BATH15MIN/-GP",42097034,CDM,420,RC,97034,CPT,OUTPATIENT,,,118,76.7,GP,103.84,88,,83.07,,,0,"percent of total billed charges","88% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",118,100,,94.40,,,0,"percent of total billed charges","100% of total billed charges",24.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee sv",74.34,63,,59.47,,,0,"percent of total billed charges","63% of total billed charges",18.05,15.3,,14.44,,,0,"percent of total billed charges","15.3% of total billed charges",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",81.42,69,,,,,0,"fee schedule","69% of total billed charges",118,100,,94.40,,,0,"percent of total billed charges","100% of total billed charges",14.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",118,100,,94.40,,,0,"percent of total billed charges","100% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",118,100,,94.40,,,0,"percent of total billed charges","100% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.41,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.98,100,,,,,0,"fee schedule","100% of LI fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.71,102,,,,,0,"fee schedule","102% of WA fee schedule",11.1,130,,,,,0,"fee schedule","130% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.49,37.7,,35.59,,,0,"percent of total billed charges","37.7% of total billed charges",44.49,37.7,,35.59,,,0,"percent of total billed charges","37.70% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",40,33.9,,32.00,,,0,"percent of total billed charges","33.9% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.04,78,,73.63,,,0,"percent of total billed charges","78% of total billed charges",14.37,101,,,,,0,"fee schedule","101% of CMS fee schedule ",97.47,82.6,,77.98,,,0,"percent of total billed charges","82.6% of total billed charges",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.47,82.6,,77.98,,,0,"percent of total billed charges","82.6% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",118,100,,94.40,,,0,"percent of total billed charges","100% of total billed charges",8.54,118,
ULTRASOUND/15MIN/-GP,42097035,CDM,420,RC,97035,CPT,OUTPATIENT,,,241,156.65,CQ|GP,212.08,88,,169.66,,,0,"percent of total billed charges","88% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",24.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee sv",151.83,63,,121.46,,,0,"percent of total billed charges","63% of total billed charges",36.87,15.3,,29.50,,,0,"percent of total billed charges","15.3% of total billed charges",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",166.29,69,,,,,0,"fee schedule","69% of total billed charges",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",14.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.07,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.98,100,,,,,0,"fee schedule","100% of LI fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.71,102,,,,,0,"fee schedule","102% of WA fee schedule",11.1,130,,,,,0,"fee schedule","130% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.86,37.7,,72.69,,,0,"percent of total billed charges","37.7% of total billed charges",90.86,37.7,,72.69,,,0,"percent of total billed charges","37.70% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.7,33.9,,65.36,,,0,"percent of total billed charges","33.9% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",187.98,78,,150.38,,,0,"percent of total billed charges","78% of total billed charges",14.37,101,,,,,0,"fee schedule","101% of CMS fee schedule ",199.07,82.6,,159.26,,,0,"percent of total billed charges","82.6% of total billed charges",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",199.07,82.6,,159.26,,,0,"percent of total billed charges","82.6% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",8.54,241,
"THERAPEUTIC EX/15MIN/-GP",42097110,CDM,420,RC,97110,CPT,OUTPATIENT,,,192,124.8,GP|CQ,168.96,88,,135.17,,,0,"percent of total billed charges","88% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",52.01,175,,,,,0,"fee schedule","175% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee sv",120.96,63,,96.77,,,0,"percent of total billed charges","63% of total billed charges",29.38,15.3,,23.50,,,0,"percent of total billed charges","15.3% of total billed charges",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",132.48,69,,,,,0,"fee schedule","69% of total billed charges",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",29.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",116.17,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.4,100,,,,,0,"fee schedule","100% of LI fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.81,102,,,,,0,"fee schedule","102% of WA fee schedule",22.7,130,,,,,0,"fee schedule","130% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.38,37.7,,57.90,,,0,"percent of total billed charges","37.7% of total billed charges",72.38,37.7,,57.90,,,0,"percent of total billed charges","37.70% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.09,33.9,,52.07,,,0,"percent of total billed charges","33.9% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",149.76,78,,119.81,,,0,"percent of total billed charges","78% of total billed charges",30.19,101,,,,,0,"fee schedule","101% of CMS fee schedule ",158.59,82.6,,126.87,,,0,"percent of total billed charges","82.6% of total billed charges",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",158.59,82.6,,126.87,,,0,"percent of total billed charges","82.6% of total billed charges",29.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",17.46,192,
"NEURO RE-ED/15MIN/-GP",42197112,CDM,421,RC,97112,CPT,OUTPATIENT,,,242,157.3,GP,212.96,88,,170.37,,,0,"percent of total billed charges","88% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",242,100,,193.60,,,0,"percent of total billed charges","100% of total billed charges",59.8,175,,,,,0,"fee schedule","175% of CMS fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee sv",152.46,63,,121.97,,,0,"percent of total billed charges","63% of total billed charges",37.03,15.3,,29.62,,,0,"percent of total billed charges","15.3% of total billed charges",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",166.98,69,,,,,0,"fee schedule","69% of total billed charges",242,100,,193.60,,,0,"percent of total billed charges","100% of total billed charges",34.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",242,100,,193.60,,,0,"percent of total billed charges","100% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",242,100,,193.60,,,0,"percent of total billed charges","100% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",135.02,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.76,100,,,,,0,"fee schedule","100% of LI fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.33,102,,,,,0,"fee schedule","102% of WA fee schedule",25.91,130,,,,,0,"fee schedule","130% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.23,37.7,,72.98,,,0,"percent of total billed charges","37.7% of total billed charges",91.23,37.7,,72.98,,,0,"percent of total billed charges","37.70% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.04,33.9,,65.63,,,0,"percent of total billed charges","33.9% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",188.76,78,,151.01,,,0,"percent of total billed charges","78% of total billed charges",34.67,101,,,,,0,"fee schedule","101% of CMS fee schedule ",199.89,82.6,,159.91,,,0,"percent of total billed charges","82.6% of total billed charges",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",199.89,82.6,,159.91,,,0,"percent of total billed charges","82.6% of total billed charges",34.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",242,100,,193.60,,,0,"percent of total billed charges","100% of total billed charges",19.93,242,
"GAIT TRAINING/15MIN/-GP",42197116,CDM,421,RC,97116,CPT,OUTPATIENT,,,193,125.45,GP|CQ,169.84,88,,135.87,,,0,"percent of total billed charges","88% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",52.01,175,,,,,0,"fee schedule","175% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee sv",121.59,63,,97.27,,,0,"percent of total billed charges","63% of total billed charges",29.53,15.3,,23.62,,,0,"percent of total billed charges","15.3% of total billed charges",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",133.17,69,,,,,0,"fee schedule","69% of total billed charges",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",29.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",116.17,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.4,100,,,,,0,"fee schedule","100% of LI fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.81,102,,,,,0,"fee schedule","102% of WA fee schedule",22.7,130,,,,,0,"fee schedule","130% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.76,37.7,,58.21,,,0,"percent of total billed charges","37.7% of total billed charges",72.76,37.7,,58.21,,,0,"percent of total billed charges","37.70% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.43,33.9,,52.34,,,0,"percent of total billed charges","33.9% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.54,78,,120.43,,,0,"percent of total billed charges","78% of total billed charges",30.19,101,,,,,0,"fee schedule","101% of CMS fee schedule ",159.42,82.6,,127.54,,,0,"percent of total billed charges","82.6% of total billed charges",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",159.42,82.6,,127.54,,,0,"percent of total billed charges","82.6% of total billed charges",29.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",17.46,193,
MASSAGE/15MIN/-GP,42097124,CDM,420,RC,97124,CPT,OUTPATIENT,,,128,83.2,GP,112.64,88,,90.11,,,0,"percent of total billed charges","88% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",54.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee sv",80.64,63,,64.51,,,0,"percent of total billed charges","63% of total billed charges",19.58,15.3,,15.66,,,0,"percent of total billed charges","15.3% of total billed charges",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",88.32,69,,,,,0,"fee schedule","69% of total billed charges",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",30.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.46,100,,,,,0,"fee schedule","100% of LI fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.2,102,,,,,0,"fee schedule","102% of WA fee schedule",23.19,130,,,,,0,"fee schedule","130% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.26,37.7,,38.61,,,0,"percent of total billed charges","37.7% of total billed charges",48.26,37.7,,38.61,,,0,"percent of total billed charges","37.70% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.39,33.9,,34.71,,,0,"percent of total billed charges","33.9% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.84,78,,79.87,,,0,"percent of total billed charges","78% of total billed charges",31.34,101,,,,,0,"fee schedule","101% of CMS fee schedule ",105.73,82.6,,84.58,,,0,"percent of total billed charges","82.6% of total billed charges",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",105.73,82.6,,84.58,,,0,"percent of total billed charges","82.6% of total billed charges",31.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",17.84,128,
"Cognitive Skills Development intial 15 minutes",42097129,CDM,420,RC,97129,CPT,OUTPATIENT,,,277,180.05,GP,243.76,88,,195.01,,,0,"percent of total billed charges","88% of total billed charges",22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,277,100,,221.60,,,0,"percent of total billed charges","100% of total billed charges",38.59,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.83,100,,,,,0,"fee schedule",EAPG,22.22,100,,,,,0,"fee schedule","100% of CMS fee sv",174.51,63,,139.61,,,0,"percent of total billed charges","63% of total billed charges",42.38,15.3,,33.90,,,0,"percent of total billed charges","15.3% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,191.13,69,,,,,0,"fee schedule","69% of total billed charges",277,100,,221.60,,,0,"percent of total billed charges","100% of total billed charges",22.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",277,100,,221.60,,,0,"percent of total billed charges","100% of total billed charges",22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",277,100,,221.60,,,0,"percent of total billed charges","100% of total billed charges",22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.01,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.95,100,,,,,0,"fee schedule","100% of LI fee schedule",25.77,100,,,,,0,"fee schedule",EAPG,22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.48,100,,,,,0,"fee schedule",EAPG,45.23,100,,,,,0,"fee schedule",EAPG,22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",104.43,37.7,,83.54,,,0,"percent of total billed charges","37.7% of total billed charges",104.43,37.7,,83.54,,,0,"percent of total billed charges","37.70% of total billed charges",22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",93.9,33.9,,75.12,,,0,"percent of total billed charges","33.9% of total billed charges",22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",216.06,78,,172.85,,,0,"percent of total billed charges","78% of total billed charges",22.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",228.8,82.6,,183.04,,,0,"percent of total billed charges","82.6% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",228.8,82.6,,183.04,,,0,"percent of total billed charges","82.6% of total billed charges",22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,277,100,,221.60,,,0,"percent of total billed charges","100% of total billed charges",21.95,277,
"Cognitive Skill Development Each add 15 Min",42097130,CDM,420,RC,97130,CPT,OUTPATIENT,,,162,105.3,GP,142.56,88,,114.05,,,0,"percent of total billed charges","88% of total billed charges",21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,162,100,,129.60,,,0,"percent of total billed charges","100% of total billed charges",36.8,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.83,100,,,,,0,"fee schedule",EAPG,21.2,100,,,,,0,"fee schedule","100% of CMS fee sv",102.06,63,,81.65,,,0,"percent of total billed charges","63% of total billed charges",24.79,15.3,,19.83,,,0,"percent of total billed charges","15.3% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,111.78,69,,,,,0,"fee schedule","69% of total billed charges",162,100,,129.60,,,0,"percent of total billed charges","100% of total billed charges",21.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",162,100,,129.60,,,0,"percent of total billed charges","100% of total billed charges",21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",162,100,,129.60,,,0,"percent of total billed charges","100% of total billed charges",21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",84.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.95,100,,,,,0,"fee schedule","100% of LI fee schedule",25.77,100,,,,,0,"fee schedule",EAPG,21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.48,100,,,,,0,"fee schedule",EAPG,45.23,100,,,,,0,"fee schedule",EAPG,21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.07,37.7,,48.86,,,0,"percent of total billed charges","37.7% of total billed charges",61.07,37.7,,48.86,,,0,"percent of total billed charges","37.70% of total billed charges",21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.92,33.9,,43.94,,,0,"percent of total billed charges","33.9% of total billed charges",21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",126.36,78,,101.09,,,0,"percent of total billed charges","78% of total billed charges",21.41,101,,,,,0,"fee schedule","101% of CMS fee schedule ",133.81,82.6,,107.05,,,0,"percent of total billed charges","82.6% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",133.81,82.6,,107.05,,,0,"percent of total billed charges","82.6% of total billed charges",21.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,162,100,,129.60,,,0,"percent of total billed charges","100% of total billed charges",20.95,162,
"MANUAL THERAPY/15MIN/-GP",42097140,CDM,420,RC,97140,CPT,OUTPATIENT,,,284,184.6,GP|CQ,249.92,88,,199.94,,,0,"percent of total billed charges","88% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",284,100,,227.20,,,0,"percent of total billed charges","100% of total billed charges",47.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee sv",178.92,63,,143.14,,,0,"percent of total billed charges","63% of total billed charges",43.45,15.3,,34.76,,,0,"percent of total billed charges","15.3% of total billed charges",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",195.96,69,,,,,0,"fee schedule","69% of total billed charges",284,100,,227.20,,,0,"percent of total billed charges","100% of total billed charges",27.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",284,100,,227.20,,,0,"percent of total billed charges","100% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",284,100,,227.20,,,0,"percent of total billed charges","100% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.72,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.05,100,,,,,0,"fee schedule","100% of LI fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.26,102,,,,,0,"fee schedule","102% of WA fee schedule",20.72,130,,,,,0,"fee schedule","130% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.07,37.7,,85.66,,,0,"percent of total billed charges","37.7% of total billed charges",107.07,37.7,,85.66,,,0,"percent of total billed charges","37.70% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",96.28,33.9,,77.02,,,0,"percent of total billed charges","33.9% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",221.52,78,,177.22,,,0,"percent of total billed charges","78% of total billed charges",27.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",234.58,82.6,,187.66,,,0,"percent of total billed charges","82.6% of total billed charges",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",234.58,82.6,,187.66,,,0,"percent of total billed charges","82.6% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",284,100,,227.20,,,0,"percent of total billed charges","100% of total billed charges",15.94,284,
"THER PROC GROUP 2/MORE IND-GP",42097150,CDM,420,RC,97150,CPT,OUTPATIENT,,,156,101.4,CQ|GP,137.28,88,,109.82,,,0,"percent of total billed charges","88% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",31.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee sv",98.28,63,,78.62,,,0,"percent of total billed charges","63% of total billed charges",23.87,15.3,,19.10,,,0,"percent of total billed charges","15.3% of total billed charges",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",107.64,69,,,,,0,"fee schedule","69% of total billed charges",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",18.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.46,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",18,100,,,,,0,"fee schedule","100% of LI fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.65,102,,,,,0,"fee schedule","102% of WA fee schedule",13.57,130,,,,,0,"fee schedule","130% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.81,37.7,,47.05,,,0,"percent of total billed charges","37.7% of total billed charges",58.81,37.7,,47.05,,,0,"percent of total billed charges","37.70% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.88,33.9,,42.30,,,0,"percent of total billed charges","33.9% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",121.68,78,,97.34,,,0,"percent of total billed charges","78% of total billed charges",18.47,101,,,,,0,"fee schedule","101% of CMS fee schedule ",128.86,82.6,,103.09,,,0,"percent of total billed charges","82.6% of total billed charges",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",128.86,82.6,,103.09,,,0,"percent of total billed charges","82.6% of total billed charges",18.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",10.44,156,
"PT EVAL- LOW COMP",42497161,CDM,424,RC,97161,CPT,OUTPATIENT,,,427,277.55,GP,375.76,88,,300.61,,,0,"percent of total billed charges","88% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",177.68,175,,,,,0,"fee schedule","175% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee sv",269.01,63,,215.21,,,0,"percent of total billed charges","63% of total billed charges",65.33,15.3,,52.26,,,0,"percent of total billed charges","15.3% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",294.63,69,,,,,0,"fee schedule","69% of total billed charges",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",101.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",390.49,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.52,100,,,,,0,"fee schedule","100% of LI fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.4,102,,,,,0,"fee schedule","102% of WA fee schedule",76.99,130,,,,,0,"fee schedule","130% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.98,37.7,,128.78,,,0,"percent of total billed charges","37.7% of total billed charges",160.98,37.7,,128.78,,,0,"percent of total billed charges","37.70% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.75,33.9,,115.80,,,0,"percent of total billed charges","33.9% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",333.06,78,,266.45,,,0,"percent of total billed charges","78% of total billed charges",103.21,101,,,,,0,"fee schedule","101% of CMS fee schedule ",352.7,82.6,,282.16,,,0,"percent of total billed charges","82.6% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",352.7,82.6,,282.16,,,0,"percent of total billed charges","82.6% of total billed charges",102.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",59.22,427,
"PT EVAL- MOD COMP",42497162,CDM,424,RC,97162,CPT,OUTPATIENT,,,427,277.55,GP,375.76,88,,300.61,,,0,"percent of total billed charges","88% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",177.68,175,,,,,0,"fee schedule","175% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee sv",269.01,63,,215.21,,,0,"percent of total billed charges","63% of total billed charges",65.33,15.3,,52.26,,,0,"percent of total billed charges","15.3% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",294.63,69,,,,,0,"fee schedule","69% of total billed charges",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",101.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",390.49,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.52,100,,,,,0,"fee schedule","100% of LI fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.4,102,,,,,0,"fee schedule","102% of WA fee schedule",76.99,130,,,,,0,"fee schedule","130% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.98,37.7,,128.78,,,0,"percent of total billed charges","37.7% of total billed charges",160.98,37.7,,128.78,,,0,"percent of total billed charges","37.70% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.75,33.9,,115.80,,,0,"percent of total billed charges","33.9% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",333.06,78,,266.45,,,0,"percent of total billed charges","78% of total billed charges",103.21,101,,,,,0,"fee schedule","101% of CMS fee schedule ",352.7,82.6,,282.16,,,0,"percent of total billed charges","82.6% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",352.7,82.6,,282.16,,,0,"percent of total billed charges","82.6% of total billed charges",102.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",59.22,427,
"PT EVAL- HGH COMP",42497163,CDM,424,RC,97163,CPT,OUTPATIENT,,,427,277.55,GP,375.76,88,,300.61,,,0,"percent of total billed charges","88% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",177.68,175,,,,,0,"fee schedule","175% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee sv",269.01,63,,215.21,,,0,"percent of total billed charges","63% of total billed charges",65.33,15.3,,52.26,,,0,"percent of total billed charges","15.3% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",294.63,69,,,,,0,"fee schedule","69% of total billed charges",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",101.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",390.49,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.52,100,,,,,0,"fee schedule","100% of LI fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.4,102,,,,,0,"fee schedule","102% of WA fee schedule",76.99,130,,,,,0,"fee schedule","130% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.98,37.7,,128.78,,,0,"percent of total billed charges","37.7% of total billed charges",160.98,37.7,,128.78,,,0,"percent of total billed charges","37.70% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.75,33.9,,115.80,,,0,"percent of total billed charges","33.9% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",333.06,78,,266.45,,,0,"percent of total billed charges","78% of total billed charges",103.21,101,,,,,0,"fee schedule","101% of CMS fee schedule ",352.7,82.6,,282.16,,,0,"percent of total billed charges","82.6% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",352.7,82.6,,282.16,,,0,"percent of total billed charges","82.6% of total billed charges",102.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",59.22,427,
"PT RE-EVALUATION/-GP",42497164,CDM,424,RC,97164,CPT,OUTPATIENT,,,254,165.1,GP,223.52,88,,178.82,,,0,"percent of total billed charges","88% of total billed charges",71.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.19,100,,,,,0,"fee schedule","100% of WA fee schedule",254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",123.48,175,,,,,0,"fee schedule","175% of CMS fee schedule",41.19,100,,,,,0,"fee schedule","100% of WA fee schedule",71.06,100,,,,,0,"fee schedule","100% of CMS fee sv",160.02,63,,128.02,,,0,"percent of total billed charges","63% of total billed charges",38.86,15.3,,31.09,,,0,"percent of total billed charges","15.3% of total billed charges",41.19,100,,,,,0,"fee schedule","100% of WA fee schedule",175.26,69,,,,,0,"fee schedule","69% of total billed charges",254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",70.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",71.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",71.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",267.41,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",41.19,100,,,,,0,"fee schedule","100% of WA fee schedule",71.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.82,100,,,,,0,"fee schedule","100% of LI fee schedule",41.19,100,,,,,0,"fee schedule","100% of WA fee schedule",71.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.01,102,,,,,0,"fee schedule","102% of WA fee schedule",53.55,130,,,,,0,"fee schedule","130% of WA fee schedule",71.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.76,37.7,,76.61,,,0,"percent of total billed charges","37.7% of total billed charges",95.76,37.7,,76.61,,,0,"percent of total billed charges","37.70% of total billed charges",71.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",86.11,33.9,,68.89,,,0,"percent of total billed charges","33.9% of total billed charges",71.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",198.12,78,,158.50,,,0,"percent of total billed charges","78% of total billed charges",71.77,101,,,,,0,"fee schedule","101% of CMS fee schedule ",209.8,82.6,,167.84,,,0,"percent of total billed charges","82.6% of total billed charges",41.19,100,,,,,0,"fee schedule","100% of WA fee schedule",71.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",209.8,82.6,,167.84,,,0,"percent of total billed charges","82.6% of total billed charges",71.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.19,100,,,,,0,"fee schedule","100% of WA fee schedule",254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",38.86,267.41,
"THERAP ACT 1:1/15MIN/-GP",42097530,CDM,420,RC,97530,CPT,OUTPATIENT,,,193,125.45,CQ|GP,169.84,88,,135.87,,,0,"percent of total billed charges","88% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",65.36,175,,,,,0,"fee schedule","175% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee sv",121.59,63,,97.27,,,0,"percent of total billed charges","63% of total billed charges",29.53,15.3,,23.62,,,0,"percent of total billed charges","15.3% of total billed charges",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",133.17,69,,,,,0,"fee schedule","69% of total billed charges",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",37.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.36,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.83,100,,,,,0,"fee schedule","100% of LI fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.65,102,,,,,0,"fee schedule","102% of WA fee schedule",28.87,130,,,,,0,"fee schedule","130% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.76,37.7,,58.21,,,0,"percent of total billed charges","37.7% of total billed charges",72.76,37.7,,58.21,,,0,"percent of total billed charges","37.70% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.43,33.9,,52.34,,,0,"percent of total billed charges","33.9% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.54,78,,120.43,,,0,"percent of total billed charges","78% of total billed charges",37.89,101,,,,,0,"fee schedule","101% of CMS fee schedule ",159.42,82.6,,127.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",159.42,82.6,,127.54,,,0,"percent of total billed charges","82.6% of total billed charges",37.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",22.21,193,
ADL/15MIN/-GP,42097535,CDM,420,RC,97535,CPT,OUTPATIENT,,,161,104.65,GP,141.68,88,,113.34,,,0,"percent of total billed charges","88% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",161,100,,128.80,,,0,"percent of total billed charges","100% of total billed charges",58.07,175,,,,,0,"fee schedule","175% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee sv",101.43,63,,81.14,,,0,"percent of total billed charges","63% of total billed charges",24.63,15.3,,19.70,,,0,"percent of total billed charges","15.3% of total billed charges",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",111.09,69,,,,,0,"fee schedule","69% of total billed charges",161,100,,128.80,,,0,"percent of total billed charges","100% of total billed charges",33.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",161,100,,128.80,,,0,"percent of total billed charges","100% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",161,100,,128.80,,,0,"percent of total billed charges","100% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.71,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.77,100,,,,,0,"fee schedule","100% of LI fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.75,102,,,,,0,"fee schedule","102% of WA fee schedule",25.17,130,,,,,0,"fee schedule","130% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.7,37.7,,48.56,,,0,"percent of total billed charges","37.7% of total billed charges",60.7,37.7,,48.56,,,0,"percent of total billed charges","37.70% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.58,33.9,,43.66,,,0,"percent of total billed charges","33.9% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",125.58,78,,100.46,,,0,"percent of total billed charges","78% of total billed charges",33.68,101,,,,,0,"fee schedule","101% of CMS fee schedule ",132.99,82.6,,106.39,,,0,"percent of total billed charges","82.6% of total billed charges",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",132.99,82.6,,106.39,,,0,"percent of total billed charges","82.6% of total billed charges",33.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",161,100,,128.80,,,0,"percent of total billed charges","100% of total billed charges",19.36,161,
"COMM/WORK REINT/15MIN/-GP",42097537,CDM,420,RC,97537,CPT,OUTPATIENT,,,297,193.05,CQ|GP,261.36,88,,209.09,,,0,"percent of total billed charges","88% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",297,100,,237.60,,,0,"percent of total billed charges","100% of total billed charges",56.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee sv",187.11,63,,149.69,,,0,"percent of total billed charges","63% of total billed charges",45.44,15.3,,36.35,,,0,"percent of total billed charges","15.3% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",204.93,69,,,,,0,"fee schedule","69% of total billed charges",297,100,,237.60,,,0,"percent of total billed charges","100% of total billed charges",32.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",297,100,,237.60,,,0,"percent of total billed charges","100% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",297,100,,237.60,,,0,"percent of total billed charges","100% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.24,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.75,100,,,,,0,"fee schedule","100% of LI fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.17,102,,,,,0,"fee schedule","102% of WA fee schedule",24.43,130,,,,,0,"fee schedule","130% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",111.97,37.7,,89.58,,,0,"percent of total billed charges","37.7% of total billed charges",111.97,37.7,,89.58,,,0,"percent of total billed charges","37.70% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.68,33.9,,80.54,,,0,"percent of total billed charges","33.9% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",231.66,78,,185.33,,,0,"percent of total billed charges","78% of total billed charges",32.6,101,,,,,0,"fee schedule","101% of CMS fee schedule ",245.32,82.6,,196.26,,,0,"percent of total billed charges","82.6% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",245.32,82.6,,196.26,,,0,"percent of total billed charges","82.6% of total billed charges",32.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",297,100,,237.60,,,0,"percent of total billed charges","100% of total billed charges",18.79,297,
"WHEELCHAIR MNGT/15MIN/-GP",42097542,CDM,420,RC,97542,CPT,OUTPATIENT,,,166,107.9,CQ|GO,146.08,88,,116.86,,,0,"percent of total billed charges","88% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",56.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee sv",104.58,63,,83.66,,,0,"percent of total billed charges","63% of total billed charges",25.4,15.3,,20.32,,,0,"percent of total billed charges","15.3% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",114.54,69,,,,,0,"fee schedule","69% of total billed charges",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",32.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",125.57,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.75,100,,,,,0,"fee schedule","100% of LI fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.17,102,,,,,0,"fee schedule","102% of WA fee schedule",24.43,130,,,,,0,"fee schedule","130% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.58,37.7,,50.06,,,0,"percent of total billed charges","37.7% of total billed charges",62.58,37.7,,50.06,,,0,"percent of total billed charges","37.70% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.27,33.9,,45.02,,,0,"percent of total billed charges","33.9% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.48,78,,103.58,,,0,"percent of total billed charges","78% of total billed charges",32.6,101,,,,,0,"fee schedule","101% of CMS fee schedule ",137.12,82.6,,109.70,,,0,"percent of total billed charges","82.6% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.12,82.6,,109.70,,,0,"percent of total billed charges","82.6% of total billed charges",32.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",18.79,166,
"SELECT DEBRIDE/20 CM OR < GP",42097597,CDM,420,RC,97597,CPT,OUTPATIENT,,,782,508.3,GP,688.16,88,,550.53,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",492.66,63,,394.13,,,0,"percent of total billed charges","63% of total billed charges",119.65,15.3,,95.72,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,539.58,69,,,,,0,"fee schedule","69% of total billed charges",782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.81,37.7,,235.85,,,0,"percent of total billed charges","37.7% of total billed charges",294.81,37.7,,235.85,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.1,33.9,,212.08,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",609.96,78,,487.97,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",645.93,82.6,,516.74,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",645.93,82.6,,516.74,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",119.65,782,
"SELECT DEBRIDE > 20 CM GP",42097598,CDM,420,RC,97598,CPT,OUTPATIENT,,,1012,657.8,GP,890.56,88,,712.45,,,0,"percent of total billed charges","88% of total billed charges",506,50,,404.80,,,0,"percent of total billed charges","50% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,1012,100,,809.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",930.95,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",637.56,63,,510.05,,,0,"percent of total billed charges","63% of total billed charges",154.84,15.3,,123.87,,,0,"percent of total billed charges","15.3% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,698.28,69,,,,,0,"fee schedule","69% of total billed charges",1012,100,,809.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1012,100,,809.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1012,100,,809.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",625.92,61.85,,500.74,,,0,"percent of total billed charges","61.5% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,506,50,,404.80,,,0,"percent of total billed charges","50% of total billed charges",325.86,32.2,,260.69,,,0,"percent of total billed charges","32.2% of total billed charges",669.51,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",921.91,100,,,,,0,"fee schedule",EAPG,1174.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",381.52,37.7,,305.22,,,0,"percent of total billed charges","37.7% of total billed charges",381.52,37.7,,305.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",343.07,33.9,,274.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",789.36,78,,631.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.91,82.6,,668.73,,,0,"percent of total billed charges","82.6% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,506,50,,404.80,,,0,"percent of total billed charges","50% of total billed charges",835.91,82.6,,668.73,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",903.83,100,,,,,0,"fee schedule",EAPG,1012,100,,809.60,,,0,"percent of total billed charges","100% of total billed charges",154.84,1174.99,
"DEBRIDEMENT NON-SELCT/SESS/-GP",42097602,CDM,420,RC,97602,CPT,OUTPATIENT,,,782,508.3,GP,688.16,88,,550.53,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",492.66,63,,394.13,,,0,"percent of total billed charges","63% of total billed charges",119.65,15.3,,95.72,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,539.58,69,,,,,0,"fee schedule","69% of total billed charges",782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.81,37.7,,235.85,,,0,"percent of total billed charges","37.7% of total billed charges",294.81,37.7,,235.85,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.1,33.9,,212.08,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",609.96,78,,487.97,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",645.93,82.6,,516.74,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",645.93,82.6,,516.74,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",119.65,782,
"NEG PRESS WOUND TX >50 CM GP",42097606,CDM,420,RC,97606,CPT,OUTPATIENT,,,626,406.9,GP,550.88,88,,440.70,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,626,100,,500.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394.38,63,,315.50,,,0,"percent of total billed charges","63% of total billed charges",95.78,15.3,,76.62,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,431.94,69,,,,,0,"fee schedule","69% of total billed charges",626,100,,500.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",626,100,,500.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",626,100,,500.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",236,37.7,,188.80,,,0,"percent of total billed charges","37.7% of total billed charges",236,37.7,,188.80,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",212.21,33.9,,169.77,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",488.28,78,,390.62,,,0,"percent of total billed charges","78% of total billed charges",410.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",517.08,82.6,,413.66,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",517.08,82.6,,413.66,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,626,100,,500.80,,,0,"percent of total billed charges","100% of total billed charges",95.78,1404.98,
"NEG PRESS WOUND TX <50 CM GP",42097605,CDM,420,RC,97605,CPT,OUTPATIENT,,,626,406.9,GP,550.88,88,,440.70,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,626,100,,500.80,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394.38,63,,315.50,,,0,"percent of total billed charges","63% of total billed charges",95.78,15.3,,76.62,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,431.94,69,,,,,0,"fee schedule","69% of total billed charges",626,100,,500.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",626,100,,500.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",626,100,,500.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",236,37.7,,188.80,,,0,"percent of total billed charges","37.7% of total billed charges",236,37.7,,188.80,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",212.21,33.9,,169.77,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",488.28,78,,390.62,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",517.08,82.6,,413.66,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",517.08,82.6,,413.66,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,626,100,,500.80,,,0,"percent of total billed charges","100% of total billed charges",95.78,729.42,
"ASSIST TECH ASSESS EA 15MIN GP",42097755,CDM,420,RC,97755,CPT,OUTPATIENT,,,221,143.65,GP,194.48,88,,155.58,,,0,"percent of total billed charges","88% of total billed charges",38.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.59,100,,,,,0,"fee schedule","100% of WA fee schedule",221,100,,176.80,,,0,"percent of total billed charges","100% of total billed charges",67.62,175,,,,,0,"fee schedule","175% of CMS fee schedule",22.59,100,,,,,0,"fee schedule","100% of WA fee schedule",38.97,100,,,,,0,"fee schedule","100% of CMS fee sv",139.23,63,,111.38,,,0,"percent of total billed charges","63% of total billed charges",33.81,15.3,,27.05,,,0,"percent of total billed charges","15.3% of total billed charges",22.59,100,,,,,0,"fee schedule","100% of WA fee schedule",152.49,69,,,,,0,"fee schedule","69% of total billed charges",221,100,,176.80,,,0,"percent of total billed charges","100% of total billed charges",38.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",221,100,,176.80,,,0,"percent of total billed charges","100% of total billed charges",38.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",221,100,,176.80,,,0,"percent of total billed charges","100% of total billed charges",38.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",148.33,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",22.59,100,,,,,0,"fee schedule","100% of WA fee schedule",38.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.34,100,,,,,0,"fee schedule","100% of LI fee schedule",22.59,100,,,,,0,"fee schedule","100% of WA fee schedule",38.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.04,102,,,,,0,"fee schedule","102% of WA fee schedule",29.37,130,,,,,0,"fee schedule","130% of WA fee schedule",38.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",83.32,37.7,,66.66,,,0,"percent of total billed charges","37.7% of total billed charges",83.32,37.7,,66.66,,,0,"percent of total billed charges","37.70% of total billed charges",38.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.92,33.9,,59.94,,,0,"percent of total billed charges","33.9% of total billed charges",38.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",172.38,78,,137.90,,,0,"percent of total billed charges","78% of total billed charges",39.36,101,,,,,0,"fee schedule","101% of CMS fee schedule ",182.55,82.6,,146.04,,,0,"percent of total billed charges","82.6% of total billed charges",22.59,100,,,,,0,"fee schedule","100% of WA fee schedule",38.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",182.55,82.6,,146.04,,,0,"percent of total billed charges","82.6% of total billed charges",38.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.59,100,,,,,0,"fee schedule","100% of WA fee schedule",221,100,,176.80,,,0,"percent of total billed charges","100% of total billed charges",22.59,221,
"FUNCT CAP TEST 15 MIN/-GP",42097750,CDM,420,RC,97750,CPT,OUTPATIENT,,,246,159.9,GP,216.48,88,,173.18,,,0,"percent of total billed charges","88% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",60.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee sv",154.98,63,,123.98,,,0,"percent of total billed charges","63% of total billed charges",37.64,15.3,,30.11,,,0,"percent of total billed charges","15.3% of total billed charges",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",169.74,69,,,,,0,"fee schedule","69% of total billed charges",246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",34.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",132.38,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.12,100,,,,,0,"fee schedule","100% of LI fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.52,102,,,,,0,"fee schedule","102% of WA fee schedule",26.16,130,,,,,0,"fee schedule","130% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.74,37.7,,74.19,,,0,"percent of total billed charges","37.7% of total billed charges",92.74,37.7,,74.19,,,0,"percent of total billed charges","37.70% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",83.39,33.9,,66.71,,,0,"percent of total billed charges","33.9% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",191.88,78,,153.50,,,0,"percent of total billed charges","78% of total billed charges",35.08,101,,,,,0,"fee schedule","101% of CMS fee schedule ",203.2,82.6,,162.56,,,0,"percent of total billed charges","82.6% of total billed charges",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",203.2,82.6,,162.56,,,0,"percent of total billed charges","82.6% of total billed charges",34.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",20.12,246,
"ORTHOTIC MGMT EA 15M PT",42097760,CDM,420,RC,97760,CPT,OUTPATIENT,,,185,120.25,CQ|GP,162.8,88,,130.24,,,0,"percent of total billed charges","88% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",85.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee sv",116.55,63,,93.24,,,0,"percent of total billed charges","63% of total billed charges",28.31,15.3,,22.65,,,0,"percent of total billed charges","15.3% of total billed charges",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",127.65,69,,,,,0,"fee schedule","69% of total billed charges",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",48.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",193.2,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.94,100,,,,,0,"fee schedule","100% of LI fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.62,102,,,,,0,"fee schedule","102% of WA fee schedule",37.75,130,,,,,0,"fee schedule","130% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.75,37.7,,55.80,,,0,"percent of total billed charges","37.7% of total billed charges",69.75,37.7,,55.80,,,0,"percent of total billed charges","37.70% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.72,33.9,,50.18,,,0,"percent of total billed charges","33.9% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.3,78,,115.44,,,0,"percent of total billed charges","78% of total billed charges",49.36,101,,,,,0,"fee schedule","101% of CMS fee schedule ",152.81,82.6,,122.25,,,0,"percent of total billed charges","82.6% of total billed charges",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",152.81,82.6,,122.25,,,0,"percent of total billed charges","82.6% of total billed charges",48.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",28.31,193.2,
"ORTH/PROS CHECKOUT EST 15M GP",42097763,CDM,420,RC,97763,CPT,OUTPATIENT,,,196,127.4,GP|CQ,172.48,88,,137.98,,,0,"percent of total billed charges","88% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",93.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.83,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee sv",123.48,63,,98.78,,,0,"percent of total billed charges","63% of total billed charges",29.99,15.3,,23.99,,,0,"percent of total billed charges","15.3% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,135.24,69,,,,,0,"fee schedule","69% of total billed charges",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",53.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",212.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.67,100,,,,,0,"fee schedule","100% of LI fee schedule",25.77,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.48,100,,,,,0,"fee schedule",EAPG,45.23,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.89,37.7,,59.11,,,0,"percent of total billed charges","37.7% of total billed charges",73.89,37.7,,59.11,,,0,"percent of total billed charges","37.70% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.44,33.9,,53.15,,,0,"percent of total billed charges","33.9% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",152.88,78,,122.30,,,0,"percent of total billed charges","78% of total billed charges",54.28,101,,,,,0,"fee schedule","101% of CMS fee schedule ",161.9,82.6,,129.52,,,0,"percent of total billed charges","82.6% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",161.9,82.6,,129.52,,,0,"percent of total billed charges","82.6% of total billed charges",53.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",25.77,212.21,
"PROS TRAIN UP/LO EXT15M PT",42097761,CDM,420,RC,97761,CPT,OUTPATIENT,,,181,117.65,CQ|GP,159.28,88,,127.42,,,0,"percent of total billed charges","88% of total billed charges",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.86,100,,,,,0,"fee schedule","100% of WA fee schedule",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",74.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",24.86,100,,,,,0,"fee schedule","100% of WA fee schedule",42.64,100,,,,,0,"fee schedule","100% of CMS fee sv",114.03,63,,91.22,,,0,"percent of total billed charges","63% of total billed charges",27.69,15.3,,22.15,,,0,"percent of total billed charges","15.3% of total billed charges",24.86,100,,,,,0,"fee schedule","100% of WA fee schedule",124.89,69,,,,,0,"fee schedule","69% of total billed charges",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",42.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.44,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.86,100,,,,,0,"fee schedule","100% of WA fee schedule",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.86,100,,,,,0,"fee schedule","100% of LI fee schedule",24.86,100,,,,,0,"fee schedule","100% of WA fee schedule",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.36,102,,,,,0,"fee schedule","102% of WA fee schedule",32.32,130,,,,,0,"fee schedule","130% of WA fee schedule",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.24,37.7,,54.59,,,0,"percent of total billed charges","37.7% of total billed charges",68.24,37.7,,54.59,,,0,"percent of total billed charges","37.70% of total billed charges",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.36,33.9,,49.09,,,0,"percent of total billed charges","33.9% of total billed charges",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",141.18,78,,112.94,,,0,"percent of total billed charges","78% of total billed charges",43.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",149.51,82.6,,119.61,,,0,"percent of total billed charges","82.6% of total billed charges",24.86,100,,,,,0,"fee schedule","100% of WA fee schedule",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",149.51,82.6,,119.61,,,0,"percent of total billed charges","82.6% of total billed charges",42.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.86,100,,,,,0,"fee schedule","100% of WA fee schedule",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",24.86,181,
ADL/15MIN/-GP,42097535X,CDM,420,RC,97535,CPT,OUTPATIENT,,,161,104.65,GP,141.68,88,,113.34,,,0,"percent of total billed charges","88% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",161,100,,128.80,,,0,"percent of total billed charges","100% of total billed charges",58.07,175,,,,,0,"fee schedule","175% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee sv",101.43,63,,81.14,,,0,"percent of total billed charges","63% of total billed charges",24.63,15.3,,19.70,,,0,"percent of total billed charges","15.3% of total billed charges",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",111.09,69,,,,,0,"fee schedule","69% of total billed charges",161,100,,128.80,,,0,"percent of total billed charges","100% of total billed charges",33.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",161,100,,128.80,,,0,"percent of total billed charges","100% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",161,100,,128.80,,,0,"percent of total billed charges","100% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.71,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.77,100,,,,,0,"fee schedule","100% of LI fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.75,102,,,,,0,"fee schedule","102% of WA fee schedule",25.17,130,,,,,0,"fee schedule","130% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.7,37.7,,48.56,,,0,"percent of total billed charges","37.7% of total billed charges",60.7,37.7,,48.56,,,0,"percent of total billed charges","37.70% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.58,33.9,,43.66,,,0,"percent of total billed charges","33.9% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",125.58,78,,100.46,,,0,"percent of total billed charges","78% of total billed charges",33.68,101,,,,,0,"fee schedule","101% of CMS fee schedule ",132.99,82.6,,106.39,,,0,"percent of total billed charges","82.6% of total billed charges",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",132.99,82.6,,106.39,,,0,"percent of total billed charges","82.6% of total billed charges",33.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",161,100,,128.80,,,0,"percent of total billed charges","100% of total billed charges",19.36,161,
"AQUATIC EXER/15MIN/-GP",42097113X,CDM,420,RC,97113,CPT,OUTPATIENT,,,266,172.9,GP,234.08,88,,187.26,,,0,"percent of total billed charges","88% of total billed charges",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.83,100,,,,,0,"fee schedule","100% of WA fee schedule",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",65.28,175,,,,,0,"fee schedule","175% of CMS fee schedule",21.83,100,,,,,0,"fee schedule","100% of WA fee schedule",37.47,100,,,,,0,"fee schedule","100% of CMS fee sv",167.58,63,,134.06,,,0,"percent of total billed charges","63% of total billed charges",40.7,15.3,,32.56,,,0,"percent of total billed charges","15.3% of total billed charges",21.83,100,,,,,0,"fee schedule","100% of WA fee schedule",183.54,69,,,,,0,"fee schedule","69% of total billed charges",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",37.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",147.22,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",21.83,100,,,,,0,"fee schedule","100% of WA fee schedule",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.81,100,,,,,0,"fee schedule","100% of LI fee schedule",21.83,100,,,,,0,"fee schedule","100% of WA fee schedule",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.27,102,,,,,0,"fee schedule","102% of WA fee schedule",28.38,130,,,,,0,"fee schedule","130% of WA fee schedule",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.28,37.7,,80.22,,,0,"percent of total billed charges","37.7% of total billed charges",100.28,37.7,,80.22,,,0,"percent of total billed charges","37.70% of total billed charges",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.17,33.9,,72.14,,,0,"percent of total billed charges","33.9% of total billed charges",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",207.48,78,,165.98,,,0,"percent of total billed charges","78% of total billed charges",37.84,101,,,,,0,"fee schedule","101% of CMS fee schedule ",219.72,82.6,,175.78,,,0,"percent of total billed charges","82.6% of total billed charges",21.83,100,,,,,0,"fee schedule","100% of WA fee schedule",37.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",219.72,82.6,,175.78,,,0,"percent of total billed charges","82.6% of total billed charges",37.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.83,100,,,,,0,"fee schedule","100% of WA fee schedule",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",21.83,266,
"ELEC STIM MAN/15MIN/-GP",42097032X,CDM,420,RC,97032,CPT,OUTPATIENT,,,213,138.45,GP,187.44,88,,149.95,,,0,"percent of total billed charges","88% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",25.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee sv",134.19,63,,107.35,,,0,"percent of total billed charges","63% of total billed charges",32.59,15.3,,26.07,,,0,"percent of total billed charges","15.3% of total billed charges",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",146.97,69,,,,,0,"fee schedule","69% of total billed charges",213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",14.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.3,100,,,,,0,"fee schedule","100% of LI fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.52,102,,,,,0,"fee schedule","102% of WA fee schedule",10.86,130,,,,,0,"fee schedule","130% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",80.3,37.7,,64.24,,,0,"percent of total billed charges","37.7% of total billed charges",80.3,37.7,,64.24,,,0,"percent of total billed charges","37.70% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.21,33.9,,57.77,,,0,"percent of total billed charges","33.9% of total billed charges",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",166.14,78,,132.91,,,0,"percent of total billed charges","78% of total billed charges",14.68,101,,,,,0,"fee schedule","101% of CMS fee schedule ",175.94,82.6,,140.75,,,0,"percent of total billed charges","82.6% of total billed charges",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",175.94,82.6,,140.75,,,0,"percent of total billed charges","82.6% of total billed charges",14.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",8.35,213,
"ORTH/PROS CHECKOUT EST 15M GP",42097763X,CDM,420,RC,97763,CPT,OUTPATIENT,,,196,127.4,GP,172.48,88,,137.98,,,0,"percent of total billed charges","88% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",93.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.83,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee sv",123.48,63,,98.78,,,0,"percent of total billed charges","63% of total billed charges",29.99,15.3,,23.99,,,0,"percent of total billed charges","15.3% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,135.24,69,,,,,0,"fee schedule","69% of total billed charges",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",53.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",212.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.67,100,,,,,0,"fee schedule","100% of LI fee schedule",25.77,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.48,100,,,,,0,"fee schedule",EAPG,45.23,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.89,37.7,,59.11,,,0,"percent of total billed charges","37.7% of total billed charges",73.89,37.7,,59.11,,,0,"percent of total billed charges","37.70% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.44,33.9,,53.15,,,0,"percent of total billed charges","33.9% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",152.88,78,,122.30,,,0,"percent of total billed charges","78% of total billed charges",54.28,101,,,,,0,"fee schedule","101% of CMS fee schedule ",161.9,82.6,,129.52,,,0,"percent of total billed charges","82.6% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",161.9,82.6,,129.52,,,0,"percent of total billed charges","82.6% of total billed charges",53.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",25.77,212.21,
"Custom splint",27030862,CDM,270,RC,,,OUTPATIENT,,,207,134.55,,182.16,88,,145.73,,,0,"percent of total billed charges","88% of total billed charges",103.5,50,,82.80,,,0,"percent of total billed charges","50% of total billed charges",34.78,16.8,,27.82,,,0,"percent of total billed charges","16.8% of total billed charges",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.82,17.304,,28.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",130.41,63,,104.33,,,0,"percent of total billed charges","63% of total billed charges",31.67,15.3,,25.34,,,0,"percent of total billed charges","15.3% of total billed charges",34.78,16.8,,27.82,,,0,"percent of total billed charges","16.8% of total billed charges",142.83,69,,,,,0,"fee schedule","69% of total billed charges",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,61.85,,102.42,,,0,"percent of total billed charges","61.5% of total billed charges",34.78,16.8,,27.82,,,0,"percent of total billed charges","16.8% of total billed charges",103.5,50,,82.80,,,0,"percent of total billed charges","50% of total billed charges",66.65,32.2,,53.32,,,0,"percent of total billed charges","32.2% of total billed charges",34.78,16.8,,27.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.47,17.136,,28.38,,,0,"percent of total billed charges","17.136% of total billed charges",45.21,21.84,,36.17,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",78.04,37.7,,62.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",161.46,78,,129.17,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.98,82.6,,136.78,,,0,"percent of total billed charges","82.6% of total billed charges",34.78,16.8,,27.82,,,0,"percent of total billed charges","16.8% of total billed charges",103.5,50,,82.80,,,0,"percent of total billed charges","50% of total billed charges",170.98,82.6,,136.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,16.8,,27.82,,,0,"percent of total billed charges","16.8% of total billed charges",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",31.67,207,
Dexamethasone,63609920,CDM,636,RC,,,OUTPATIENT,,,49,31.85,,43.12,88,,34.50,,,0,"percent of total billed charges","88% of total billed charges",24.5,50,,19.60,,,0,"percent of total billed charges","50% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.48,17.304,,6.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.87,63,,24.70,,,0,"percent of total billed charges","63% of total billed charges",7.5,15.3,,6.00,,,0,"percent of total billed charges","15.3% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",33.81,69,,,,,0,"fee schedule","69% of total billed charges",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.31,61.85,,24.25,,,0,"percent of total billed charges","61.5% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",24.5,50,,19.60,,,0,"percent of total billed charges","50% of total billed charges",15.78,32.2,,12.62,,,0,"percent of total billed charges","32.2% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.4,17.136,,6.72,,,0,"percent of total billed charges","17.136% of total billed charges",10.7,21.84,,8.56,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.47,37.7,,14.78,,,0,"percent of total billed charges","37.7% of total billed charges",18.47,37.7,,14.78,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.61,33.9,,13.29,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.22,78,,30.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",24.5,50,,19.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",7.5,49,
"E STIM UNATTEND NON-WOUND GP",421G0283,CDM,420,RC,,,OUTPATIENT,,,146,94.9,GP|CQ,128.48,88,,102.78,,,0,"percent of total billed charges","88% of total billed charges",73,50,,58.40,,,0,"percent of total billed charges","50% of total billed charges",24.53,16.8,,19.62,,,0,"percent of total billed charges","16.8% of total billed charges",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.26,17.304,,20.21,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.98,63,,73.58,,,0,"percent of total billed charges","63% of total billed charges",22.34,15.3,,17.87,,,0,"percent of total billed charges","15.3% of total billed charges",24.53,16.8,,19.62,,,0,"percent of total billed charges","16.8% of total billed charges",100.74,69,,,,,0,"fee schedule","69% of total billed charges",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.3,61.85,,72.24,,,0,"percent of total billed charges","61.5% of total billed charges",24.53,16.8,,19.62,,,0,"percent of total billed charges","16.8% of total billed charges",73,50,,58.40,,,0,"percent of total billed charges","50% of total billed charges",47.01,32.2,,37.61,,,0,"percent of total billed charges","32.2% of total billed charges",24.53,16.8,,19.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.02,17.136,,20.02,,,0,"percent of total billed charges","17.136% of total billed charges",31.89,21.84,,25.51,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",55.04,37.7,,44.03,,,0,"percent of total billed charges","37.7% of total billed charges",55.04,37.7,,44.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.49,33.9,,39.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.88,78,,91.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",120.6,82.6,,96.48,,,0,"percent of total billed charges","82.6% of total billed charges",24.53,16.8,,19.62,,,0,"percent of total billed charges","16.8% of total billed charges",73,50,,58.40,,,0,"percent of total billed charges","50% of total billed charges",120.6,82.6,,96.48,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.53,16.8,,19.62,,,0,"percent of total billed charges","16.8% of total billed charges",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",22.34,146,
Electrodes,27095355,CDM,270,RC,,,OUTPATIENT,,,54,35.1,,47.52,88,,38.02,,,0,"percent of total billed charges","88% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.34,17.304,,7.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.02,63,,27.22,,,0,"percent of total billed charges","63% of total billed charges",8.26,15.3,,6.61,,,0,"percent of total billed charges","15.3% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",37.26,69,,,,,0,"fee schedule","69% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.4,61.85,,26.72,,,0,"percent of total billed charges","61.5% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",17.39,32.2,,13.91,,,0,"percent of total billed charges","32.2% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.25,17.136,,7.40,,,0,"percent of total billed charges","17.136% of total billed charges",11.79,21.84,,9.43,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.36,37.7,,16.29,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",42.12,78,,33.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.6,82.6,,35.68,,,0,"percent of total billed charges","82.6% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",44.6,82.6,,35.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",8.26,54,
"FUNCT CAP TEST 15 MIN/-GP",42097750X,CDM,420,RC,97750,CPT,OUTPATIENT,,,246,159.9,GP,216.48,88,,173.18,,,0,"percent of total billed charges","88% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",60.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee sv",154.98,63,,123.98,,,0,"percent of total billed charges","63% of total billed charges",37.64,15.3,,30.11,,,0,"percent of total billed charges","15.3% of total billed charges",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",169.74,69,,,,,0,"fee schedule","69% of total billed charges",246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",34.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",132.38,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.12,100,,,,,0,"fee schedule","100% of LI fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.52,102,,,,,0,"fee schedule","102% of WA fee schedule",26.16,130,,,,,0,"fee schedule","130% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.74,37.7,,74.19,,,0,"percent of total billed charges","37.7% of total billed charges",92.74,37.7,,74.19,,,0,"percent of total billed charges","37.70% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",83.39,33.9,,66.71,,,0,"percent of total billed charges","33.9% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",191.88,78,,153.50,,,0,"percent of total billed charges","78% of total billed charges",35.08,101,,,,,0,"fee schedule","101% of CMS fee schedule ",203.2,82.6,,162.56,,,0,"percent of total billed charges","82.6% of total billed charges",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",203.2,82.6,,162.56,,,0,"percent of total billed charges","82.6% of total billed charges",34.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",20.12,246,
"GAIT TRAINING/15MIN/-GP",42197116X,CDM,421,RC,97116,CPT,OUTPATIENT,,,193,125.45,GP,169.84,88,,135.87,,,0,"percent of total billed charges","88% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",52.01,175,,,,,0,"fee schedule","175% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee sv",121.59,63,,97.27,,,0,"percent of total billed charges","63% of total billed charges",29.53,15.3,,23.62,,,0,"percent of total billed charges","15.3% of total billed charges",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",133.17,69,,,,,0,"fee schedule","69% of total billed charges",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",29.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",116.17,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.4,100,,,,,0,"fee schedule","100% of LI fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.81,102,,,,,0,"fee schedule","102% of WA fee schedule",22.7,130,,,,,0,"fee schedule","130% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.76,37.7,,58.21,,,0,"percent of total billed charges","37.7% of total billed charges",72.76,37.7,,58.21,,,0,"percent of total billed charges","37.70% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.43,33.9,,52.34,,,0,"percent of total billed charges","33.9% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.54,78,,120.43,,,0,"percent of total billed charges","78% of total billed charges",30.19,101,,,,,0,"fee schedule","101% of CMS fee schedule ",159.42,82.6,,127.54,,,0,"percent of total billed charges","82.6% of total billed charges",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",159.42,82.6,,127.54,,,0,"percent of total billed charges","82.6% of total billed charges",29.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",17.46,193,
"THER PROC GROUP 2/MORE IND-GP",42097150X,CDM,420,RC,97150,CPT,OUTPATIENT,,,156,101.4,GP,137.28,88,,109.82,,,0,"percent of total billed charges","88% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",31.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee sv",98.28,63,,78.62,,,0,"percent of total billed charges","63% of total billed charges",23.87,15.3,,19.10,,,0,"percent of total billed charges","15.3% of total billed charges",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",107.64,69,,,,,0,"fee schedule","69% of total billed charges",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",18.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.46,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",18,100,,,,,0,"fee schedule","100% of LI fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.65,102,,,,,0,"fee schedule","102% of WA fee schedule",13.57,130,,,,,0,"fee schedule","130% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",58.81,37.7,,47.05,,,0,"percent of total billed charges","37.7% of total billed charges",58.81,37.7,,47.05,,,0,"percent of total billed charges","37.70% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.88,33.9,,42.30,,,0,"percent of total billed charges","33.9% of total billed charges",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",121.68,78,,97.34,,,0,"percent of total billed charges","78% of total billed charges",18.47,101,,,,,0,"fee schedule","101% of CMS fee schedule ",128.86,82.6,,103.09,,,0,"percent of total billed charges","82.6% of total billed charges",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",18.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",128.86,82.6,,103.09,,,0,"percent of total billed charges","82.6% of total billed charges",18.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.44,100,,,,,0,"fee schedule","100% of WA fee schedule",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",10.44,156,
INFRARED,42097026X,CDM,420,RC,97026,CPT,OUTPATIENT,,,39,25.35,GP,34.32,88,,27.46,,,0,"percent of total billed charges","88% of total billed charges",6.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.99,100,,,,,0,"fee schedule","100% of WA fee schedule",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",11.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.99,100,,,,,0,"fee schedule","100% of WA fee schedule",6.77,100,,,,,0,"fee schedule","100% of CMS fee sv",,,,,,,0,other,"not separately reimbursment",5.97,15.3,,4.78,,,0,"percent of total billed charges","15.3% of total billed charges",3.99,100,,,,,0,"fee schedule","100% of WA fee schedule",26.91,69,,,,,0,"fee schedule","69% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",6.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",6.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",6.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.99,100,,,,,0,"fee schedule","100% of WA fee schedule",6.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.63,100,,,,,0,"fee schedule","100% of LI fee schedule",3.99,100,,,,,0,"fee schedule","100% of WA fee schedule",6.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.07,102,,,,,0,"fee schedule","102% of WA fee schedule",5.19,130,,,,,0,"fee schedule","130% of WA fee schedule",6.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.7% of total billed charges",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.70% of total billed charges",6.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.22,33.9,,10.58,,,0,"percent of total billed charges","33.9% of total billed charges",6.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.42,78,,24.34,,,0,"percent of total billed charges","78% of total billed charges",6.84,101,,,,,0,"fee schedule","101% of CMS fee schedule ",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",3.99,100,,,,,0,"fee schedule","100% of WA fee schedule",6.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",6.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.99,100,,,,,0,"fee schedule","100% of WA fee schedule",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",3.99,39,
IONTOPHORESIS/15MIN,42097033X,CDM,420,RC,97033,CPT,OUTPATIENT,,,212,137.8,GP,186.56,88,,149.25,,,0,"percent of total billed charges","88% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",34.2,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee sv",133.56,63,,106.85,,,0,"percent of total billed charges","63% of total billed charges",32.44,15.3,,25.95,,,0,"percent of total billed charges","15.3% of total billed charges",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",146.28,69,,,,,0,"fee schedule","69% of total billed charges",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",19.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of LI fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.01,102,,,,,0,"fee schedule","102% of WA fee schedule",15.3,130,,,,,0,"fee schedule","130% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.92,37.7,,63.94,,,0,"percent of total billed charges","37.7% of total billed charges",79.92,37.7,,63.94,,,0,"percent of total billed charges","37.70% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",71.87,33.9,,57.50,,,0,"percent of total billed charges","33.9% of total billed charges",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",165.36,78,,132.29,,,0,"percent of total billed charges","78% of total billed charges",19.91,101,,,,,0,"fee schedule","101% of CMS fee schedule ",175.11,82.6,,140.09,,,0,"percent of total billed charges","82.6% of total billed charges",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",19.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",175.11,82.6,,140.09,,,0,"percent of total billed charges","82.6% of total billed charges",19.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.77,100,,,,,0,"fee schedule","100% of WA fee schedule",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",11.77,212,
"MANUAL THERAPY/15MIN/-GP",42097140X,CDM,420,RC,97140,CPT,OUTPATIENT,,,284,184.6,GP,249.92,88,,199.94,,,0,"percent of total billed charges","88% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",284,100,,227.20,,,0,"percent of total billed charges","100% of total billed charges",47.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee sv",178.92,63,,143.14,,,0,"percent of total billed charges","63% of total billed charges",43.45,15.3,,34.76,,,0,"percent of total billed charges","15.3% of total billed charges",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",195.96,69,,,,,0,"fee schedule","69% of total billed charges",284,100,,227.20,,,0,"percent of total billed charges","100% of total billed charges",27.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",284,100,,227.20,,,0,"percent of total billed charges","100% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",284,100,,227.20,,,0,"percent of total billed charges","100% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.72,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.05,100,,,,,0,"fee schedule","100% of LI fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.26,102,,,,,0,"fee schedule","102% of WA fee schedule",20.72,130,,,,,0,"fee schedule","130% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.07,37.7,,85.66,,,0,"percent of total billed charges","37.7% of total billed charges",107.07,37.7,,85.66,,,0,"percent of total billed charges","37.70% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",96.28,33.9,,77.02,,,0,"percent of total billed charges","33.9% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",221.52,78,,177.22,,,0,"percent of total billed charges","78% of total billed charges",27.76,101,,,,,0,"fee schedule","101% of CMS fee schedule ",234.58,82.6,,187.66,,,0,"percent of total billed charges","82.6% of total billed charges",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",234.58,82.6,,187.66,,,0,"percent of total billed charges","82.6% of total billed charges",27.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.94,100,,,,,0,"fee schedule","100% of WA fee schedule",284,100,,227.20,,,0,"percent of total billed charges","100% of total billed charges",15.94,284,
MASSAGE/15MIN/-GP,42097124X,CDM,420,RC,97124,CPT,OUTPATIENT,,,128,83.2,GP,112.64,88,,90.11,,,0,"percent of total billed charges","88% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",54.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee sv",80.64,63,,64.51,,,0,"percent of total billed charges","63% of total billed charges",19.58,15.3,,15.66,,,0,"percent of total billed charges","15.3% of total billed charges",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",88.32,69,,,,,0,"fee schedule","69% of total billed charges",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",30.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.46,100,,,,,0,"fee schedule","100% of LI fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.2,102,,,,,0,"fee schedule","102% of WA fee schedule",23.19,130,,,,,0,"fee schedule","130% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.26,37.7,,38.61,,,0,"percent of total billed charges","37.7% of total billed charges",48.26,37.7,,38.61,,,0,"percent of total billed charges","37.70% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",43.39,33.9,,34.71,,,0,"percent of total billed charges","33.9% of total billed charges",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",99.84,78,,79.87,,,0,"percent of total billed charges","78% of total billed charges",31.34,101,,,,,0,"fee schedule","101% of CMS fee schedule ",105.73,82.6,,84.58,,,0,"percent of total billed charges","82.6% of total billed charges",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",31.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",105.73,82.6,,84.58,,,0,"percent of total billed charges","82.6% of total billed charges",31.04,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.84,100,,,,,0,"fee schedule","100% of WA fee schedule",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",17.84,128,
"TRACTION MECHANICAL/-GP",42097012X,CDM,420,RC,97012,CPT,OUTPATIENT,,,136,88.4,GP,119.68,88,,95.74,,,0,"percent of total billed charges","88% of total billed charges",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",24.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.18,100,,,,,0,"fee schedule","100% of CMS fee sv",85.68,63,,68.54,,,0,"percent of total billed charges","63% of total billed charges",20.81,15.3,,16.65,,,0,"percent of total billed charges","15.3% of total billed charges",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",93.84,69,,,,,0,"fee schedule","69% of total billed charges",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",14.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.34,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.97,100,,,,,0,"fee schedule","100% of LI fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.52,102,,,,,0,"fee schedule","102% of WA fee schedule",10.86,130,,,,,0,"fee schedule","130% of WA fee schedule",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.27,37.7,,41.02,,,0,"percent of total billed charges","37.7% of total billed charges",51.27,37.7,,41.02,,,0,"percent of total billed charges","37.70% of total billed charges",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.1,33.9,,36.88,,,0,"percent of total billed charges","33.9% of total billed charges",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.08,78,,84.86,,,0,"percent of total billed charges","78% of total billed charges",14.32,101,,,,,0,"fee schedule","101% of CMS fee schedule ",112.34,82.6,,89.87,,,0,"percent of total billed charges","82.6% of total billed charges",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",14.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",112.34,82.6,,89.87,,,0,"percent of total billed charges","82.6% of total billed charges",14.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.35,100,,,,,0,"fee schedule","100% of WA fee schedule",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",8.35,136,
"NEURO RE-ED/15MIN/-GP",42197112X,CDM,420,RC,97112,CPT,OUTPATIENT,,,242,157.3,GP,212.96,88,,170.37,,,0,"percent of total billed charges","88% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",242,100,,193.60,,,0,"percent of total billed charges","100% of total billed charges",59.8,175,,,,,0,"fee schedule","175% of CMS fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee sv",152.46,63,,121.97,,,0,"percent of total billed charges","63% of total billed charges",37.03,15.3,,29.62,,,0,"percent of total billed charges","15.3% of total billed charges",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",166.98,69,,,,,0,"fee schedule","69% of total billed charges",242,100,,193.60,,,0,"percent of total billed charges","100% of total billed charges",34.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",242,100,,193.60,,,0,"percent of total billed charges","100% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",242,100,,193.60,,,0,"percent of total billed charges","100% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",135.02,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.76,100,,,,,0,"fee schedule","100% of LI fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.33,102,,,,,0,"fee schedule","102% of WA fee schedule",25.91,130,,,,,0,"fee schedule","130% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.23,37.7,,72.98,,,0,"percent of total billed charges","37.7% of total billed charges",91.23,37.7,,72.98,,,0,"percent of total billed charges","37.70% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.04,33.9,,65.63,,,0,"percent of total billed charges","33.9% of total billed charges",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",188.76,78,,151.01,,,0,"percent of total billed charges","78% of total billed charges",34.67,101,,,,,0,"fee schedule","101% of CMS fee schedule ",199.89,82.6,,159.91,,,0,"percent of total billed charges","82.6% of total billed charges",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",34.33,100,,,,,0,"fee schedule","100% of CMS fee schedule",199.89,82.6,,159.91,,,0,"percent of total billed charges","82.6% of total billed charges",34.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.93,100,,,,,0,"fee schedule","100% of WA fee schedule",242,100,,193.60,,,0,"percent of total billed charges","100% of total billed charges",19.93,242,
"DEBRIDEMENT NON-SELCT/SESS/-GP",42097602X,CDM,420,RC,97602,CPT,OUTPATIENT,,,782,508.3,GP,688.16,88,,550.53,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",492.66,63,,394.13,,,0,"percent of total billed charges","63% of total billed charges",119.65,15.3,,95.72,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,539.58,69,,,,,0,"fee schedule","69% of total billed charges",782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.81,37.7,,235.85,,,0,"percent of total billed charges","37.7% of total billed charges",294.81,37.7,,235.85,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.1,33.9,,212.08,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",609.96,78,,487.97,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",645.93,82.6,,516.74,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",645.93,82.6,,516.74,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",119.65,782,
"ORTHOTIC MGMT EA 15M PT",42097760X,CDM,420,RC,97760,CPT,OUTPATIENT,,,185,120.25,GP,162.8,88,,130.24,,,0,"percent of total billed charges","88% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",85.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee sv",116.55,63,,93.24,,,0,"percent of total billed charges","63% of total billed charges",28.31,15.3,,22.65,,,0,"percent of total billed charges","15.3% of total billed charges",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",127.65,69,,,,,0,"fee schedule","69% of total billed charges",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",48.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",193.2,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.94,100,,,,,0,"fee schedule","100% of LI fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.62,102,,,,,0,"fee schedule","102% of WA fee schedule",37.75,130,,,,,0,"fee schedule","130% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.75,37.7,,55.80,,,0,"percent of total billed charges","37.7% of total billed charges",69.75,37.7,,55.80,,,0,"percent of total billed charges","37.70% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.72,33.9,,50.18,,,0,"percent of total billed charges","33.9% of total billed charges",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.3,78,,115.44,,,0,"percent of total billed charges","78% of total billed charges",49.36,101,,,,,0,"fee schedule","101% of CMS fee schedule ",152.81,82.6,,122.25,,,0,"percent of total billed charges","82.6% of total billed charges",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",48.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",152.81,82.6,,122.25,,,0,"percent of total billed charges","82.6% of total billed charges",48.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.04,100,,,,,0,"fee schedule","100% of WA fee schedule",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",28.31,193.2,
"ASSIST TECH ASSESS EA 15MIN GP",42097755X,CDM,420,RC,97755,CPT,OUTPATIENT,,,221,143.65,GP,194.48,88,,155.58,,,0,"percent of total billed charges","88% of total billed charges",38.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.59,100,,,,,0,"fee schedule","100% of WA fee schedule",221,100,,176.80,,,0,"percent of total billed charges","100% of total billed charges",67.62,175,,,,,0,"fee schedule","175% of CMS fee schedule",22.59,100,,,,,0,"fee schedule","100% of WA fee schedule",38.97,100,,,,,0,"fee schedule","100% of CMS fee sv",139.23,63,,111.38,,,0,"percent of total billed charges","63% of total billed charges",33.81,15.3,,27.05,,,0,"percent of total billed charges","15.3% of total billed charges",22.59,100,,,,,0,"fee schedule","100% of WA fee schedule",152.49,69,,,,,0,"fee schedule","69% of total billed charges",221,100,,176.80,,,0,"percent of total billed charges","100% of total billed charges",38.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",221,100,,176.80,,,0,"percent of total billed charges","100% of total billed charges",38.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",221,100,,176.80,,,0,"percent of total billed charges","100% of total billed charges",38.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",148.33,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",22.59,100,,,,,0,"fee schedule","100% of WA fee schedule",38.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.34,100,,,,,0,"fee schedule","100% of LI fee schedule",22.59,100,,,,,0,"fee schedule","100% of WA fee schedule",38.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.04,102,,,,,0,"fee schedule","102% of WA fee schedule",29.37,130,,,,,0,"fee schedule","130% of WA fee schedule",38.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",83.32,37.7,,66.66,,,0,"percent of total billed charges","37.7% of total billed charges",83.32,37.7,,66.66,,,0,"percent of total billed charges","37.70% of total billed charges",38.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.92,33.9,,59.94,,,0,"percent of total billed charges","33.9% of total billed charges",38.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",172.38,78,,137.90,,,0,"percent of total billed charges","78% of total billed charges",39.36,101,,,,,0,"fee schedule","101% of CMS fee schedule ",182.55,82.6,,146.04,,,0,"percent of total billed charges","82.6% of total billed charges",22.59,100,,,,,0,"fee schedule","100% of WA fee schedule",38.97,100,,,,,0,"fee schedule","100% of CMS fee schedule",182.55,82.6,,146.04,,,0,"percent of total billed charges","82.6% of total billed charges",38.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.59,100,,,,,0,"fee schedule","100% of WA fee schedule",221,100,,176.80,,,0,"percent of total billed charges","100% of total billed charges",22.59,221,
"CONTRAST BATH15MIN/-GP",42097034X,CDM,420,RC,97034,CPT,OUTPATIENT,,,118,76.7,GP,103.84,88,,83.07,,,0,"percent of total billed charges","88% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",118,100,,94.40,,,0,"percent of total billed charges","100% of total billed charges",24.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee sv",74.34,63,,59.47,,,0,"percent of total billed charges","63% of total billed charges",18.05,15.3,,14.44,,,0,"percent of total billed charges","15.3% of total billed charges",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",81.42,69,,,,,0,"fee schedule","69% of total billed charges",118,100,,94.40,,,0,"percent of total billed charges","100% of total billed charges",14.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",118,100,,94.40,,,0,"percent of total billed charges","100% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",118,100,,94.40,,,0,"percent of total billed charges","100% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.41,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.98,100,,,,,0,"fee schedule","100% of LI fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.71,102,,,,,0,"fee schedule","102% of WA fee schedule",11.1,130,,,,,0,"fee schedule","130% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.49,37.7,,35.59,,,0,"percent of total billed charges","37.7% of total billed charges",44.49,37.7,,35.59,,,0,"percent of total billed charges","37.70% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",40,33.9,,32.00,,,0,"percent of total billed charges","33.9% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.04,78,,73.63,,,0,"percent of total billed charges","78% of total billed charges",14.37,101,,,,,0,"fee schedule","101% of CMS fee schedule ",97.47,82.6,,77.98,,,0,"percent of total billed charges","82.6% of total billed charges",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",97.47,82.6,,77.98,,,0,"percent of total billed charges","82.6% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",118,100,,94.40,,,0,"percent of total billed charges","100% of total billed charges",8.54,118,
"COMM/WORK REINT/15MIN/-GP",42097537X,CDM,420,RC,97537,CPT,OUTPATIENT,,,297,193.05,GP,261.36,88,,209.09,,,0,"percent of total billed charges","88% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",297,100,,237.60,,,0,"percent of total billed charges","100% of total billed charges",56.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee sv",187.11,63,,149.69,,,0,"percent of total billed charges","63% of total billed charges",45.44,15.3,,36.35,,,0,"percent of total billed charges","15.3% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",204.93,69,,,,,0,"fee schedule","69% of total billed charges",297,100,,237.60,,,0,"percent of total billed charges","100% of total billed charges",32.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",297,100,,237.60,,,0,"percent of total billed charges","100% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",297,100,,237.60,,,0,"percent of total billed charges","100% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.24,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.75,100,,,,,0,"fee schedule","100% of LI fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.17,102,,,,,0,"fee schedule","102% of WA fee schedule",24.43,130,,,,,0,"fee schedule","130% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",111.97,37.7,,89.58,,,0,"percent of total billed charges","37.7% of total billed charges",111.97,37.7,,89.58,,,0,"percent of total billed charges","37.70% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.68,33.9,,80.54,,,0,"percent of total billed charges","33.9% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",231.66,78,,185.33,,,0,"percent of total billed charges","78% of total billed charges",32.6,101,,,,,0,"fee schedule","101% of CMS fee schedule ",245.32,82.6,,196.26,,,0,"percent of total billed charges","82.6% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",245.32,82.6,,196.26,,,0,"percent of total billed charges","82.6% of total billed charges",32.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",297,100,,237.60,,,0,"percent of total billed charges","100% of total billed charges",18.79,297,
"PT EVAL- HGH COMP",42497163X,CDM,424,RC,97163,CPT,OUTPATIENT,,,427,277.55,GP,375.76,88,,300.61,,,0,"percent of total billed charges","88% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",177.68,175,,,,,0,"fee schedule","175% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee sv",269.01,63,,215.21,,,0,"percent of total billed charges","63% of total billed charges",65.33,15.3,,52.26,,,0,"percent of total billed charges","15.3% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",294.63,69,,,,,0,"fee schedule","69% of total billed charges",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",101.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",390.49,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.52,100,,,,,0,"fee schedule","100% of LI fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.4,102,,,,,0,"fee schedule","102% of WA fee schedule",76.99,130,,,,,0,"fee schedule","130% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.98,37.7,,128.78,,,0,"percent of total billed charges","37.7% of total billed charges",160.98,37.7,,128.78,,,0,"percent of total billed charges","37.70% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.75,33.9,,115.80,,,0,"percent of total billed charges","33.9% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",333.06,78,,266.45,,,0,"percent of total billed charges","78% of total billed charges",103.21,101,,,,,0,"fee schedule","101% of CMS fee schedule ",352.7,82.6,,282.16,,,0,"percent of total billed charges","82.6% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",352.7,82.6,,282.16,,,0,"percent of total billed charges","82.6% of total billed charges",102.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",59.22,427,
"PT EVAL- LOW COMP",42497161X,CDM,424,RC,97161,CPT,OUTPATIENT,,,427,277.55,GP,375.76,88,,300.61,,,0,"percent of total billed charges","88% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",177.68,175,,,,,0,"fee schedule","175% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee sv",269.01,63,,215.21,,,0,"percent of total billed charges","63% of total billed charges",65.33,15.3,,52.26,,,0,"percent of total billed charges","15.3% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",294.63,69,,,,,0,"fee schedule","69% of total billed charges",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",101.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",390.49,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.52,100,,,,,0,"fee schedule","100% of LI fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.4,102,,,,,0,"fee schedule","102% of WA fee schedule",76.99,130,,,,,0,"fee schedule","130% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.98,37.7,,128.78,,,0,"percent of total billed charges","37.7% of total billed charges",160.98,37.7,,128.78,,,0,"percent of total billed charges","37.70% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.75,33.9,,115.80,,,0,"percent of total billed charges","33.9% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",333.06,78,,266.45,,,0,"percent of total billed charges","78% of total billed charges",103.21,101,,,,,0,"fee schedule","101% of CMS fee schedule ",352.7,82.6,,282.16,,,0,"percent of total billed charges","82.6% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",352.7,82.6,,282.16,,,0,"percent of total billed charges","82.6% of total billed charges",102.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",59.22,427,
"PT EVAL- MOD COMP",42497162X,CDM,424,RC,97162,CPT,OUTPATIENT,,,427,277.55,GP,375.76,88,,300.61,,,0,"percent of total billed charges","88% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",177.68,175,,,,,0,"fee schedule","175% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee sv",269.01,63,,215.21,,,0,"percent of total billed charges","63% of total billed charges",65.33,15.3,,52.26,,,0,"percent of total billed charges","15.3% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",294.63,69,,,,,0,"fee schedule","69% of total billed charges",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",101.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",390.49,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.52,100,,,,,0,"fee schedule","100% of LI fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.4,102,,,,,0,"fee schedule","102% of WA fee schedule",76.99,130,,,,,0,"fee schedule","130% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.98,37.7,,128.78,,,0,"percent of total billed charges","37.7% of total billed charges",160.98,37.7,,128.78,,,0,"percent of total billed charges","37.70% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",144.75,33.9,,115.80,,,0,"percent of total billed charges","33.9% of total billed charges",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",333.06,78,,266.45,,,0,"percent of total billed charges","78% of total billed charges",103.21,101,,,,,0,"fee schedule","101% of CMS fee schedule ",352.7,82.6,,282.16,,,0,"percent of total billed charges","82.6% of total billed charges",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",102.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",352.7,82.6,,282.16,,,0,"percent of total billed charges","82.6% of total billed charges",102.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.22,100,,,,,0,"fee schedule","100% of WA fee schedule",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",59.22,427,
"PT RE-EVALUATION/-GP",42497164X,CDM,424,RC,97164,CPT,OUTPATIENT,,,254,165.1,GP,223.52,88,,178.82,,,0,"percent of total billed charges","88% of total billed charges",71.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.19,100,,,,,0,"fee schedule","100% of WA fee schedule",254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",123.48,175,,,,,0,"fee schedule","175% of CMS fee schedule",41.19,100,,,,,0,"fee schedule","100% of WA fee schedule",71.06,100,,,,,0,"fee schedule","100% of CMS fee sv",160.02,63,,128.02,,,0,"percent of total billed charges","63% of total billed charges",38.86,15.3,,31.09,,,0,"percent of total billed charges","15.3% of total billed charges",41.19,100,,,,,0,"fee schedule","100% of WA fee schedule",175.26,69,,,,,0,"fee schedule","69% of total billed charges",254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",70.56,100,,,,,0,"fee schedule","100% of CMS fee schedule",254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",71.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",71.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",267.41,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",41.19,100,,,,,0,"fee schedule","100% of WA fee schedule",71.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.82,100,,,,,0,"fee schedule","100% of LI fee schedule",41.19,100,,,,,0,"fee schedule","100% of WA fee schedule",71.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.01,102,,,,,0,"fee schedule","102% of WA fee schedule",53.55,130,,,,,0,"fee schedule","130% of WA fee schedule",71.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.76,37.7,,76.61,,,0,"percent of total billed charges","37.7% of total billed charges",95.76,37.7,,76.61,,,0,"percent of total billed charges","37.70% of total billed charges",71.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",86.11,33.9,,68.89,,,0,"percent of total billed charges","33.9% of total billed charges",71.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",198.12,78,,158.50,,,0,"percent of total billed charges","78% of total billed charges",71.77,101,,,,,0,"fee schedule","101% of CMS fee schedule ",209.8,82.6,,167.84,,,0,"percent of total billed charges","82.6% of total billed charges",41.19,100,,,,,0,"fee schedule","100% of WA fee schedule",71.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",209.8,82.6,,167.84,,,0,"percent of total billed charges","82.6% of total billed charges",71.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.19,100,,,,,0,"fee schedule","100% of WA fee schedule",254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",38.86,267.41,
ADL/15MIN/-GP,42097535,CDM,420,RC,97535,CPT,OUTPATIENT,,,161,104.65,GP,141.68,88,,113.34,,,0,"percent of total billed charges","88% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",161,100,,128.80,,,0,"percent of total billed charges","100% of total billed charges",58.07,175,,,,,0,"fee schedule","175% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee sv",101.43,63,,81.14,,,0,"percent of total billed charges","63% of total billed charges",24.63,15.3,,19.70,,,0,"percent of total billed charges","15.3% of total billed charges",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",111.09,69,,,,,0,"fee schedule","69% of total billed charges",161,100,,128.80,,,0,"percent of total billed charges","100% of total billed charges",33.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",161,100,,128.80,,,0,"percent of total billed charges","100% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",161,100,,128.80,,,0,"percent of total billed charges","100% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.71,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.77,100,,,,,0,"fee schedule","100% of LI fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.75,102,,,,,0,"fee schedule","102% of WA fee schedule",25.17,130,,,,,0,"fee schedule","130% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.7,37.7,,48.56,,,0,"percent of total billed charges","37.7% of total billed charges",60.7,37.7,,48.56,,,0,"percent of total billed charges","37.70% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",54.58,33.9,,43.66,,,0,"percent of total billed charges","33.9% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",125.58,78,,100.46,,,0,"percent of total billed charges","78% of total billed charges",33.68,101,,,,,0,"fee schedule","101% of CMS fee schedule ",132.99,82.6,,106.39,,,0,"percent of total billed charges","82.6% of total billed charges",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",132.99,82.6,,106.39,,,0,"percent of total billed charges","82.6% of total billed charges",33.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",161,100,,128.80,,,0,"percent of total billed charges","100% of total billed charges",19.36,161,
"NEG PRESS WOUND TX <50 CM GP",42097605X,CDM,420,RC,97605,CPT,OUTPATIENT,,,626,406.9,GP,550.88,88,,440.70,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,626,100,,500.80,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394.38,63,,315.50,,,0,"percent of total billed charges","63% of total billed charges",95.78,15.3,,76.62,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,431.94,69,,,,,0,"fee schedule","69% of total billed charges",626,100,,500.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",626,100,,500.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",626,100,,500.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",236,37.7,,188.80,,,0,"percent of total billed charges","37.7% of total billed charges",236,37.7,,188.80,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",212.21,33.9,,169.77,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",488.28,78,,390.62,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",517.08,82.6,,413.66,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",517.08,82.6,,413.66,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,626,100,,500.80,,,0,"percent of total billed charges","100% of total billed charges",95.78,729.42,
"NEG PRESS WOUND TX >50 CM GP",42097606X,CDM,420,RC,97606,CPT,OUTPATIENT,,,626,406.9,GP,550.88,88,,440.70,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,626,100,,500.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394.38,63,,315.50,,,0,"percent of total billed charges","63% of total billed charges",95.78,15.3,,76.62,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,431.94,69,,,,,0,"fee schedule","69% of total billed charges",626,100,,500.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",626,100,,500.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",626,100,,500.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",236,37.7,,188.80,,,0,"percent of total billed charges","37.7% of total billed charges",236,37.7,,188.80,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",212.21,33.9,,169.77,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",488.28,78,,390.62,,,0,"percent of total billed charges","78% of total billed charges",410.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",517.08,82.6,,413.66,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",517.08,82.6,,413.66,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,626,100,,500.80,,,0,"percent of total billed charges","100% of total billed charges",95.78,1404.98,
"PARAFFIN BATH",42097018X,CDM,420,RC,97018,CPT,OUTPATIENT,,,151,98.15,GP,132.88,88,,106.30,,,0,"percent of total billed charges","88% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",9.75,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee sv",95.13,63,,76.10,,,0,"percent of total billed charges","63% of total billed charges",23.1,15.3,,18.48,,,0,"percent of total billed charges","15.3% of total billed charges",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",104.19,69,,,,,0,"fee schedule","69% of total billed charges",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",5.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.53,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.62,100,,,,,0,"fee schedule","100% of LI fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.49,102,,,,,0,"fee schedule","102% of WA fee schedule",4.45,130,,,,,0,"fee schedule","130% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.93,37.7,,45.54,,,0,"percent of total billed charges","37.7% of total billed charges",56.93,37.7,,45.54,,,0,"percent of total billed charges","37.70% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",51.19,33.9,,40.95,,,0,"percent of total billed charges","33.9% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",117.78,78,,94.22,,,0,"percent of total billed charges","78% of total billed charges",5.8,101,,,,,0,"fee schedule","101% of CMS fee schedule ",124.73,82.6,,99.78,,,0,"percent of total billed charges","82.6% of total billed charges",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.73,82.6,,99.78,,,0,"percent of total billed charges","82.6% of total billed charges",5.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.42,100,,,,,0,"fee schedule","100% of WA fee schedule",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",3.42,151,
"PROS TRAIN UP/LO EXT15M PT",42097761X,CDM,420,RC,97761,CPT,OUTPATIENT,,,181,117.65,GP,159.28,88,,127.42,,,0,"percent of total billed charges","88% of total billed charges",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.86,100,,,,,0,"fee schedule","100% of WA fee schedule",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",74.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",24.86,100,,,,,0,"fee schedule","100% of WA fee schedule",42.64,100,,,,,0,"fee schedule","100% of CMS fee sv",114.03,63,,91.22,,,0,"percent of total billed charges","63% of total billed charges",27.69,15.3,,22.15,,,0,"percent of total billed charges","15.3% of total billed charges",24.86,100,,,,,0,"fee schedule","100% of WA fee schedule",124.89,69,,,,,0,"fee schedule","69% of total billed charges",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",42.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",163.44,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.86,100,,,,,0,"fee schedule","100% of WA fee schedule",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.86,100,,,,,0,"fee schedule","100% of LI fee schedule",24.86,100,,,,,0,"fee schedule","100% of WA fee schedule",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.36,102,,,,,0,"fee schedule","102% of WA fee schedule",32.32,130,,,,,0,"fee schedule","130% of WA fee schedule",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.24,37.7,,54.59,,,0,"percent of total billed charges","37.7% of total billed charges",68.24,37.7,,54.59,,,0,"percent of total billed charges","37.70% of total billed charges",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.36,33.9,,49.09,,,0,"percent of total billed charges","33.9% of total billed charges",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",141.18,78,,112.94,,,0,"percent of total billed charges","78% of total billed charges",43.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",149.51,82.6,,119.61,,,0,"percent of total billed charges","82.6% of total billed charges",24.86,100,,,,,0,"fee schedule","100% of WA fee schedule",42.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",149.51,82.6,,119.61,,,0,"percent of total billed charges","82.6% of total billed charges",42.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.86,100,,,,,0,"fee schedule","100% of WA fee schedule",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",24.86,181,
"SVC PT IN HOME OR HEALTH SET",42000001,CDM,420,RC,,,OUTPATIENT,,,234,152.1,GP,205.92,88,,164.74,,,0,"percent of total billed charges","88% of total billed charges",117,50,,93.60,,,0,"percent of total billed charges","50% of total billed charges",39.31,16.8,,31.45,,,0,"percent of total billed charges","16.8% of total billed charges",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.49,17.304,,32.39,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",147.42,63,,117.94,,,0,"percent of total billed charges","63% of total billed charges",35.8,15.3,,28.64,,,0,"percent of total billed charges","15.3% of total billed charges",39.31,16.8,,31.45,,,0,"percent of total billed charges","16.8% of total billed charges",161.46,69,,,,,0,"fee schedule","69% of total billed charges",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",144.73,61.85,,115.78,,,0,"percent of total billed charges","61.5% of total billed charges",39.31,16.8,,31.45,,,0,"percent of total billed charges","16.8% of total billed charges",117,50,,93.60,,,0,"percent of total billed charges","50% of total billed charges",75.35,32.2,,60.28,,,0,"percent of total billed charges","32.2% of total billed charges",39.31,16.8,,31.45,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.1,17.136,,32.08,,,0,"percent of total billed charges","17.136% of total billed charges",51.11,21.84,,40.89,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.22,37.7,,70.58,,,0,"percent of total billed charges","37.7% of total billed charges",88.22,37.7,,70.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.33,33.9,,63.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",182.52,78,,146.02,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",193.28,82.6,,154.62,,,0,"percent of total billed charges","82.6% of total billed charges",39.31,16.8,,31.45,,,0,"percent of total billed charges","16.8% of total billed charges",117,50,,93.60,,,0,"percent of total billed charges","50% of total billed charges",193.28,82.6,,154.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.31,16.8,,31.45,,,0,"percent of total billed charges","16.8% of total billed charges",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",35.8,234,
"SELECT DEBRIDE/20 CM OR < GP",42097597X,CDM,420,RC,97597,CPT,OUTPATIENT,,,782,508.3,GP,688.16,88,,550.53,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",492.66,63,,394.13,,,0,"percent of total billed charges","63% of total billed charges",119.65,15.3,,95.72,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,539.58,69,,,,,0,"fee schedule","69% of total billed charges",782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.81,37.7,,235.85,,,0,"percent of total billed charges","37.7% of total billed charges",294.81,37.7,,235.85,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.1,33.9,,212.08,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",609.96,78,,487.97,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",645.93,82.6,,516.74,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",645.93,82.6,,516.74,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",119.65,782,
"SELECT DEBRIDE > 20 CM GP",42097598X,CDM,420,RC,97598,CPT,OUTPATIENT,,,1012,657.8,GP,890.56,88,,712.45,,,0,"percent of total billed charges","88% of total billed charges",506,50,,404.80,,,0,"percent of total billed charges","50% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,1012,100,,809.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",930.95,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",637.56,63,,510.05,,,0,"percent of total billed charges","63% of total billed charges",154.84,15.3,,123.87,,,0,"percent of total billed charges","15.3% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,698.28,69,,,,,0,"fee schedule","69% of total billed charges",1012,100,,809.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1012,100,,809.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1012,100,,809.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",625.92,61.85,,500.74,,,0,"percent of total billed charges","61.5% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,506,50,,404.80,,,0,"percent of total billed charges","50% of total billed charges",325.86,32.2,,260.69,,,0,"percent of total billed charges","32.2% of total billed charges",669.51,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",921.91,100,,,,,0,"fee schedule",EAPG,1174.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",381.52,37.7,,305.22,,,0,"percent of total billed charges","37.7% of total billed charges",381.52,37.7,,305.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",343.07,33.9,,274.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",789.36,78,,631.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.91,82.6,,668.73,,,0,"percent of total billed charges","82.6% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,506,50,,404.80,,,0,"percent of total billed charges","50% of total billed charges",835.91,82.6,,668.73,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",903.83,100,,,,,0,"fee schedule",EAPG,1012,100,,809.60,,,0,"percent of total billed charges","100% of total billed charges",154.84,1174.99,
"THERAP ACT 1:1/15MIN/-GP",42097530X,CDM,420,RC,97530,CPT,OUTPATIENT,,,193,125.45,GO,169.84,88,,135.87,,,0,"percent of total billed charges","88% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",65.36,175,,,,,0,"fee schedule","175% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee sv",121.59,63,,97.27,,,0,"percent of total billed charges","63% of total billed charges",29.53,15.3,,23.62,,,0,"percent of total billed charges","15.3% of total billed charges",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",133.17,69,,,,,0,"fee schedule","69% of total billed charges",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",37.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",151.36,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.83,100,,,,,0,"fee schedule","100% of LI fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.65,102,,,,,0,"fee schedule","102% of WA fee schedule",28.87,130,,,,,0,"fee schedule","130% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.76,37.7,,58.21,,,0,"percent of total billed charges","37.7% of total billed charges",72.76,37.7,,58.21,,,0,"percent of total billed charges","37.70% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.43,33.9,,52.34,,,0,"percent of total billed charges","33.9% of total billed charges",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.54,78,,120.43,,,0,"percent of total billed charges","78% of total billed charges",37.89,101,,,,,0,"fee schedule","101% of CMS fee schedule ",159.42,82.6,,127.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",37.51,100,,,,,0,"fee schedule","100% of CMS fee schedule",159.42,82.6,,127.54,,,0,"percent of total billed charges","82.6% of total billed charges",37.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",22.21,193,
"THERAPEUTIC EX/15MIN/-GP",42097110X,CDM,420,RC,97110,CPT,OUTPATIENT,,,192,124.8,GO,168.96,88,,135.17,,,0,"percent of total billed charges","88% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",52.01,175,,,,,0,"fee schedule","175% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee sv",120.96,63,,96.77,,,0,"percent of total billed charges","63% of total billed charges",29.38,15.3,,23.50,,,0,"percent of total billed charges","15.3% of total billed charges",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",132.48,69,,,,,0,"fee schedule","69% of total billed charges",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",29.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",116.17,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.4,100,,,,,0,"fee schedule","100% of LI fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.81,102,,,,,0,"fee schedule","102% of WA fee schedule",22.7,130,,,,,0,"fee schedule","130% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.38,37.7,,57.90,,,0,"percent of total billed charges","37.7% of total billed charges",72.38,37.7,,57.90,,,0,"percent of total billed charges","37.70% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.09,33.9,,52.07,,,0,"percent of total billed charges","33.9% of total billed charges",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",149.76,78,,119.81,,,0,"percent of total billed charges","78% of total billed charges",30.19,101,,,,,0,"fee schedule","101% of CMS fee schedule ",158.59,82.6,,126.87,,,0,"percent of total billed charges","82.6% of total billed charges",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",29.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",158.59,82.6,,126.87,,,0,"percent of total billed charges","82.6% of total billed charges",29.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.46,100,,,,,0,"fee schedule","100% of WA fee schedule",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",17.46,192,
ULTRASOUND/15MIN/-GP,42097035X,CDM,420,RC,97035,CPT,OUTPATIENT,,,241,156.65,GP,212.08,88,,169.66,,,0,"percent of total billed charges","88% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",24.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee sv",151.83,63,,121.46,,,0,"percent of total billed charges","63% of total billed charges",36.87,15.3,,29.50,,,0,"percent of total billed charges","15.3% of total billed charges",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",166.29,69,,,,,0,"fee schedule","69% of total billed charges",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",14.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.07,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.98,100,,,,,0,"fee schedule","100% of LI fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.71,102,,,,,0,"fee schedule","102% of WA fee schedule",11.1,130,,,,,0,"fee schedule","130% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",90.86,37.7,,72.69,,,0,"percent of total billed charges","37.7% of total billed charges",90.86,37.7,,72.69,,,0,"percent of total billed charges","37.70% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.7,33.9,,65.36,,,0,"percent of total billed charges","33.9% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",187.98,78,,150.38,,,0,"percent of total billed charges","78% of total billed charges",14.37,101,,,,,0,"fee schedule","101% of CMS fee schedule ",199.07,82.6,,159.26,,,0,"percent of total billed charges","82.6% of total billed charges",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",199.07,82.6,,159.26,,,0,"percent of total billed charges","82.6% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",8.54,241,
ULTRAVIOLET,42097028X,CDM,420,RC,97028,CPT,OUTPATIENT,,,49,31.85,GP,43.12,88,,34.50,,,0,"percent of total billed charges","88% of total billed charges",8.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.93,100,,,,,0,"fee schedule","100% of WA fee schedule",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",14.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.93,100,,,,,0,"fee schedule","100% of WA fee schedule",8.48,100,,,,,0,"fee schedule","100% of CMS fee sv",30.87,63,,24.70,,,0,"percent of total billed charges","63% of total billed charges",7.5,15.3,,6.00,,,0,"percent of total billed charges","15.3% of total billed charges",4.93,100,,,,,0,"fee schedule","100% of WA fee schedule",33.81,69,,,,,0,"fee schedule","69% of total billed charges",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",8.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",8.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",8.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.94,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.93,100,,,,,0,"fee schedule","100% of WA fee schedule",8.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.31,100,,,,,0,"fee schedule","100% of LI fee schedule",4.93,100,,,,,0,"fee schedule","100% of WA fee schedule",8.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.03,102,,,,,0,"fee schedule","102% of WA fee schedule",6.41,130,,,,,0,"fee schedule","130% of WA fee schedule",8.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.47,37.7,,14.78,,,0,"percent of total billed charges","37.7% of total billed charges",18.47,37.7,,14.78,,,0,"percent of total billed charges","37.70% of total billed charges",8.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.61,33.9,,13.29,,,0,"percent of total billed charges","33.9% of total billed charges",8.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.22,78,,30.58,,,0,"percent of total billed charges","78% of total billed charges",8.56,101,,,,,0,"fee schedule","101% of CMS fee schedule ",40.47,82.6,,32.38,,,0,"percent of total billed charges","82.6% of total billed charges",4.93,100,,,,,0,"fee schedule","100% of WA fee schedule",8.48,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.47,82.6,,32.38,,,0,"percent of total billed charges","82.6% of total billed charges",8.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.93,100,,,,,0,"fee schedule","100% of WA fee schedule",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",4.93,49,
"ELECTRIC STIMULATION THERAPY",42097014X,CDM,420,RC,97014,CPT,OUTPATIENT,,,81,52.65,GP,71.28,88,,57.02,,,0,"percent of total billed charges","88% of total billed charges",40.5,50,,32.40,,,0,"percent of total billed charges","50% of total billed charges",7.21,100,,,,,0,"fee schedule","100% of WA fee schedule",81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.21,100,,,,,0,"fee schedule","100% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",51.03,63,,40.82,,,0,"percent of total billed charges","63% of total billed charges",12.39,15.3,,9.91,,,0,"percent of total billed charges","15.3% of total billed charges",7.21,100,,,,,0,"fee schedule","100% of WA fee schedule",55.89,69,,,,,0,"fee schedule","69% of total billed charges",81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.1,61.85,,40.08,,,0,"percent of total billed charges","61.5% of total billed charges",7.21,100,,,,,0,"fee schedule","100% of WA fee schedule",40.5,50,,32.40,,,0,"percent of total billed charges","50% of total billed charges",26.08,32.2,,20.86,,,0,"percent of total billed charges","32.2% of total billed charges",7.21,100,,,,,0,"fee schedule","100% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",7.35,102,,,,,0,"fee schedule","102% of WA fee schedule",9.37,130,,,,,0,"fee schedule","130% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",30.54,37.7,,24.43,,,0,"percent of total billed charges","37.7% of total billed charges",30.54,37.7,,24.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.46,33.9,,21.97,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.18,78,,50.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",66.91,82.6,,53.53,,,0,"percent of total billed charges","82.6% of total billed charges",7.21,100,,,,,0,"fee schedule","100% of WA fee schedule",40.5,50,,32.40,,,0,"percent of total billed charges","50% of total billed charges",66.91,82.6,,53.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.21,100,,,,,0,"fee schedule","100% of WA fee schedule",81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",7.21,81,
"VASOPNEUMATIC DEVICES/-GP",42097016X,CDM,420,RC,97016,CPT,OUTPATIENT,,,150,97.5,GP,132,88,,105.60,,,0,"percent of total billed charges","88% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",20.42,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",11.84,100,,,,,0,"fee schedule","100% of CMS fee sv",94.5,63,,75.60,,,0,"percent of total billed charges","63% of total billed charges",22.95,15.3,,18.36,,,0,"percent of total billed charges","15.3% of total billed charges",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",103.5,69,,,,,0,"fee schedule","69% of total billed charges",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",11.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.67,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.63,100,,,,,0,"fee schedule","100% of LI fee schedule",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.97,102,,,,,0,"fee schedule","102% of WA fee schedule",8.88,130,,,,,0,"fee schedule","130% of WA fee schedule",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.7% of total billed charges",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.70% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.85,33.9,,40.68,,,0,"percent of total billed charges","33.9% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",117,78,,93.60,,,0,"percent of total billed charges","78% of total billed charges",11.96,101,,,,,0,"fee schedule","101% of CMS fee schedule ",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",11.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.83,100,,,,,0,"fee schedule","100% of WA fee schedule",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",6.83,150,
"WHEELCHAIR MNGT/15MIN/-GP",42097542X,CDM,420,RC,97542,CPT,OUTPATIENT,,,166,107.9,GP,146.08,88,,116.86,,,0,"percent of total billed charges","88% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",56.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee sv",104.58,63,,83.66,,,0,"percent of total billed charges","63% of total billed charges",25.4,15.3,,20.32,,,0,"percent of total billed charges","15.3% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",114.54,69,,,,,0,"fee schedule","69% of total billed charges",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",32.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",125.57,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.75,100,,,,,0,"fee schedule","100% of LI fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.17,102,,,,,0,"fee schedule","102% of WA fee schedule",24.43,130,,,,,0,"fee schedule","130% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.58,37.7,,50.06,,,0,"percent of total billed charges","37.7% of total billed charges",62.58,37.7,,50.06,,,0,"percent of total billed charges","37.70% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.27,33.9,,45.02,,,0,"percent of total billed charges","33.9% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.48,78,,103.58,,,0,"percent of total billed charges","78% of total billed charges",32.6,101,,,,,0,"fee schedule","101% of CMS fee schedule ",137.12,82.6,,109.70,,,0,"percent of total billed charges","82.6% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.12,82.6,,109.70,,,0,"percent of total billed charges","82.6% of total billed charges",32.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",18.79,166,
WHIRLPOOL/-GP,42097022X,CDM,420,RC,97022,CPT,OUTPATIENT,,,199,129.35,GP,175.12,88,,140.10,,,0,"percent of total billed charges","88% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",199,100,,159.20,,,0,"percent of total billed charges","100% of total billed charges",30.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee sv",125.37,63,,100.30,,,0,"percent of total billed charges","63% of total billed charges",30.45,15.3,,24.36,,,0,"percent of total billed charges","15.3% of total billed charges",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",137.31,69,,,,,0,"fee schedule","69% of total billed charges",199,100,,159.20,,,0,"percent of total billed charges","100% of total billed charges",17.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",199,100,,159.20,,,0,"percent of total billed charges","100% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",199,100,,159.20,,,0,"percent of total billed charges","100% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.69,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.04,100,,,,,0,"fee schedule","100% of LI fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.46,102,,,,,0,"fee schedule","102% of WA fee schedule",13.33,130,,,,,0,"fee schedule","130% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",75.02,37.7,,60.02,,,0,"percent of total billed charges","37.7% of total billed charges",75.02,37.7,,60.02,,,0,"percent of total billed charges","37.70% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",67.46,33.9,,53.97,,,0,"percent of total billed charges","33.9% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",155.22,78,,124.18,,,0,"percent of total billed charges","78% of total billed charges",17.56,101,,,,,0,"fee schedule","101% of CMS fee schedule ",164.37,82.6,,131.50,,,0,"percent of total billed charges","82.6% of total billed charges",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",164.37,82.6,,131.50,,,0,"percent of total billed charges","82.6% of total billed charges",17.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.25,100,,,,,0,"fee schedule","100% of WA fee schedule",199,100,,159.20,,,0,"percent of total billed charges","100% of total billed charges",10.25,199,
"ANES FOR DX ARTERIO/VENOGRAPHY",84001916,CDM,360,RC,1916,CPT,OUTPATIENT,,,914,594.1,,804.32,88,,643.46,,,0,"percent of total billed charges","88% of total billed charges",457,50,,365.60,,,0,"percent of total billed charges","50% of total billed charges",21.54,100,,,,,0,"fee schedule",EAPG,914,100,,731.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.18,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",575.82,63,,460.66,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",21.54,100,,,,,0,"fee schedule",EAPG,630.66,69,,,,,0,"fee schedule","69% of total billed charges",914,100,,731.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",914,100,,731.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",914,100,,731.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",565.31,61.85,,452.25,,,0,"percent of total billed charges","61.5% of total billed charges",21.54,100,,,,,0,"fee schedule",EAPG,457,50,,365.60,,,0,"percent of total billed charges","50% of total billed charges",294.31,32.2,,235.45,,,0,"percent of total billed charges","32.2% of total billed charges",15.95,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",21.97,100,,,,,0,"fee schedule",EAPG,28,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",344.58,37.7,,275.66,,,0,"percent of total billed charges","37.7% of total billed charges",344.58,37.7,,275.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",309.85,33.9,,247.88,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",712.92,78,,570.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",754.96,82.6,,603.97,,,0,"percent of total billed charges","82.6% of total billed charges",21.54,100,,,,,0,"fee schedule",EAPG,457,50,,365.60,,,0,"percent of total billed charges","50% of total billed charges",754.96,82.6,,603.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.54,100,,,,,0,"fee schedule",EAPG,914,100,,731.20,,,0,"percent of total billed charges","100% of total billed charges",15.95,3367,
"TRLUML PERIP ATHRC RENAL ART",8400234T,CDM,361,RC,0234T,CPT,OUTPATIENT,,,60876,39569.4,,53570.88,88,,42856.70,,,0,"percent of total billed charges","88% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16110.1,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",19636.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",16593.41,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38351.88,63,,30681.50,,,0,"percent of total billed charges","63% of total billed charges",9314.03,15.3,,7451.22,,,0,"percent of total billed charges","15.3% of total billed charges",16110.1,100,,,,,0,"fee schedule",EAPG,42004.44,69,,,,,0,"fee schedule","69% of total billed charges",60876,100,,48700.80,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60876,100,,48700.80,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60876,100,,48700.80,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",40799.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16110.1,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10666.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11933.41,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16432.31,100,,,,,0,"fee schedule",EAPG,20943.14,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22950.25,37.7,,18360.20,,,0,"percent of total billed charges","37.7% of total billed charges",22950.25,37.7,,18360.20,,,0,"percent of total billed charges","37.70% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",20636.96,33.9,,16509.57,,,0,"percent of total billed charges","33.9% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47483.28,78,,37986.62,,,0,"percent of total billed charges","78% of total billed charges",11332.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",50283.58,82.6,,40226.86,,,0,"percent of total billed charges","82.6% of total billed charges",16110.1,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",50283.58,82.6,,40226.86,,,0,"percent of total billed charges","82.6% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16110.1,100,,,,,0,"fee schedule",EAPG,60876,100,,48700.80,,,0,"percent of total billed charges","100% of total billed charges",4695,60876,
"TRLUML PERP ATHRC VISC - IP",8400235T,CDM,361,RC,0235T,CPT,OUTPATIENT,,,60876,39569.4,,53570.88,88,,42856.70,,,0,"percent of total billed charges","88% of total billed charges",60876,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5310.28,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",60876,175,,,,,0,"fee schedule","175% of CMS fee schedule",5469.59,100,,,,,0,"fee schedule",EAPG,60876,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",38351.88,63,,30681.50,,,0,"percent of total billed charges","63% of total billed charges",9314.03,15.3,,7451.22,,,0,"percent of total billed charges","15.3% of total billed charges",5310.28,100,,,,,0,"fee schedule",EAPG,42004.44,69,,,,,0,"fee schedule","69% of total billed charges",60876,100,,48700.80,,,0,"percent of total billed charges","100% of total billed charges",60876,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",60876,100,,48700.80,,,0,"percent of total billed charges","100% of total billed charges",60876,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",60876,100,,48700.80,,,0,"percent of total billed charges","100% of total billed charges",60876,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",60876,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5310.28,100,,,,,0,"fee schedule",EAPG,60876,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",60876,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3933.54,100,,,,,0,"fee schedule",EAPG,60876,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5416.49,100,,,,,0,"fee schedule",EAPG,6903.37,100,,,,,0,"fee schedule",EAPG,60876,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",22950.25,37.7,,18360.20,,,0,"percent of total billed charges","37.7% of total billed charges",22950.25,37.7,,18360.20,,,0,"percent of total billed charges","37.70% of total billed charges",60876,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",20636.96,33.9,,16509.57,,,0,"percent of total billed charges","33.9% of total billed charges",60876,100,,,,,0,"fee schedule","100% of CMS fee schedule",47483.28,78,,37986.62,,,0,"percent of total billed charges","78% of total billed charges",60876,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",50283.58,82.6,,40226.86,,,0,"percent of total billed charges","82.6% of total billed charges",5310.28,100,,,,,0,"fee schedule",EAPG,60876,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",50283.58,82.6,,40226.86,,,0,"percent of total billed charges","82.6% of total billed charges",60876,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5310.28,100,,,,,0,"fee schedule",EAPG,60876,100,,48700.80,,,0,"percent of total billed charges","100% of total billed charges",3933.54,60876,
"TRLUML PERIP ATHRC ILIAC ART",8400238T,CDM,361,RC,0238T,CPT,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",31299.05,175,,,,,0,"fee schedule","175% of CMS fee schedule",10180.16,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",65260.52,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17061.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7321.22,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10081.33,100,,,,,0,"fee schedule",EAPG,12848.75,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.7% of total billed charges",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",0.68,33.9,,0.54,,,0,"percent of total billed charges","33.9% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",18064.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,65260.52,
"FLUID DRAIN SOFT TIS PERC GUID",84010030,CDM,361,RC,10030,CPT,OUTPATIENT,,,6718,4366.7,,5911.84,88,,4729.47,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",989.16,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",1018.83,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4232.34,63,,3385.87,,,0,"percent of total billed charges","63% of total billed charges",1027.85,15.3,,822.28,,,0,"percent of total billed charges","15.3% of total billed charges",989.16,100,,,,,0,"fee schedule",EAPG,4635.42,69,,,,,0,"fee schedule","69% of total billed charges",6718,100,,5374.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6718,100,,5374.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6718,100,,5374.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",989.16,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",732.71,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1008.94,100,,,,,0,"fee schedule",EAPG,1285.91,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2532.69,37.7,,2026.15,,,0,"percent of total billed charges","37.7% of total billed charges",2532.69,37.7,,2026.15,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2277.4,33.9,,1821.92,,,0,"percent of total billed charges","33.9% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5240.04,78,,4192.03,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5549.07,82.6,,4439.26,,,0,"percent of total billed charges","82.6% of total billed charges",989.16,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5549.07,82.6,,4439.26,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",989.16,100,,,,,0,"fee schedule",EAPG,6718,100,,5374.40,,,0,"percent of total billed charges","100% of total billed charges",660.59,6718,
"10060 Drainage of skin abscess",76110060,CDM,761,RC,10060,CPT,OUTPATIENT,,,375,243.75,,330,88,,264.00,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,375,100,,300.00,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",236.25,63,,189.00,,,0,"percent of total billed charges","63% of total billed charges",57.38,15.3,,45.90,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,258.75,69,,,,,0,"fee schedule","69% of total billed charges",375,100,,300.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",375,100,,300.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",375,100,,300.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.13,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",141.38,37.7,,113.10,,,0,"percent of total billed charges","37.7% of total billed charges",141.38,37.7,,113.10,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",127.13,33.9,,101.70,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",292.5,78,,234.00,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.75,82.6,,247.80,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.75,82.6,,247.80,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,375,100,,300.00,,,0,"percent of total billed charges","100% of total billed charges",57.38,729.41,
"11104 Punch Biopsy of skin, single",76111104,CDM,761,RC,11104,CPT,OUTPATIENT,,,524,340.6,,461.12,88,,368.90,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,524,100,,419.20,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.12,63,,264.10,,,0,"percent of total billed charges","63% of total billed charges",80.17,15.3,,64.14,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,361.56,69,,,,,0,"fee schedule","69% of total billed charges",524,100,,419.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",524,100,,419.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",524,100,,419.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.37,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",197.55,37.7,,158.04,,,0,"percent of total billed charges","37.7% of total billed charges",197.55,37.7,,158.04,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.64,33.9,,142.11,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.72,78,,326.98,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",432.82,82.6,,346.26,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",432.82,82.6,,346.26,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,524,100,,419.20,,,0,"percent of total billed charges","100% of total billed charges",80.17,1404.97,
"11105 Punch Biopsy of Skin, Each Additional Lesion Procedure",76111105,CDM,761,RC,11105,CPT,OUTPATIENT,,,123,79.95,,108.24,88,,86.59,,,0,"percent of total billed charges","88% of total billed charges",61.5,50,,49.20,,,0,"percent of total billed charges","50% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",413.49,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",77.49,63,,61.99,,,0,"percent of total billed charges","63% of total billed charges",18.82,15.3,,15.06,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,84.87,69,,,,,0,"fee schedule","69% of total billed charges",123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.08,61.85,,60.86,,,0,"percent of total billed charges","61.5% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,61.5,50,,49.20,,,0,"percent of total billed charges","50% of total billed charges",39.61,32.2,,31.69,,,0,"percent of total billed charges","32.2% of total billed charges",297.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",46.37,37.7,,37.10,,,0,"percent of total billed charges","37.7% of total billed charges",46.37,37.7,,37.10,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.7,33.9,,33.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.94,78,,76.75,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.6,82.6,,81.28,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,61.5,50,,49.20,,,0,"percent of total billed charges","50% of total billed charges",101.6,82.6,,81.28,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",401.45,100,,,,,0,"fee schedule",EAPG,123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",18.82,521.88,
"11426 EXCISION, BENIGN LESION INCLUDING MARGINS, EXCEPT SKIN",76111426,CDM,761,RC,11426,CPT,OUTPATIENT,,,10387,6751.55,,9140.56,88,,7312.45,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1640.79,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6543.81,63,,5235.05,,,0,"percent of total billed charges","63% of total billed charges",1589.21,15.3,,1271.37,,,0,"percent of total billed charges","15.3% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,7167.03,69,,,,,0,"fee schedule","69% of total billed charges",10387,100,,8309.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10387,100,,8309.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10387,100,,8309.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1180,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1624.86,100,,,,,0,"fee schedule",EAPG,2070.9,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3915.9,37.7,,3132.72,,,0,"percent of total billed charges","37.7% of total billed charges",3915.9,37.7,,3132.72,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3521.19,33.9,,2816.95,,,0,"percent of total billed charges","33.9% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8101.86,78,,6481.49,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8579.66,82.6,,6863.73,,,0,"percent of total billed charges","82.6% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8579.66,82.6,,6863.73,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,10387,100,,8309.60,,,0,"percent of total billed charges","100% of total billed charges",1180,10387,
"Simple repair of superficial wounds of scalp, neck, axillae",76112001,CDM,761,RC,12001,CPT,OUTPATIENT,,,671,436.15,,590.48,88,,472.38,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",422.73,63,,338.18,,,0,"percent of total billed charges","63% of total billed charges",102.66,15.3,,82.13,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,462.99,69,,,,,0,"fee schedule","69% of total billed charges",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.97,37.7,,202.38,,,0,"percent of total billed charges","37.7% of total billed charges",252.97,37.7,,202.38,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",227.47,33.9,,181.98,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",523.38,78,,418.70,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.25,82.6,,443.40,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.25,82.6,,443.40,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",102.66,729.42,
"12013 Simple Repair of Superficial Wound of Face",76112013,CDM,761,RC,12013,CPT,OUTPATIENT,,,894,581.1,,786.72,88,,629.38,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,894,100,,715.20,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",563.22,63,,450.58,,,0,"percent of total billed charges","63% of total billed charges",136.78,15.3,,109.42,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,616.86,69,,,,,0,"fee schedule","69% of total billed charges",894,100,,715.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",894,100,,715.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",894,100,,715.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",337.04,37.7,,269.63,,,0,"percent of total billed charges","37.7% of total billed charges",337.04,37.7,,269.63,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",303.07,33.9,,242.46,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",697.32,78,,557.86,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",738.44,82.6,,590.75,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",738.44,82.6,,590.75,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,894,100,,715.20,,,0,"percent of total billed charges","100% of total billed charges",124.74,894,
"EXCISION OF CHEST WALL TUMOR",84021601,CDM,360,RC,21601,CPT,OUTPATIENT,,,4953,3219.45,,4358.64,88,,3486.91,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2020.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",2081.34,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3120.39,63,,2496.31,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,3417.57,69,,,,,0,"fee schedule","69% of total billed charges",4953,100,,3962.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4953,100,,3962.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4953,100,,3962.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2020.72,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1496.83,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2061.13,100,,,,,0,"fee schedule",EAPG,2626.94,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1867.28,37.7,,1493.82,,,0,"percent of total billed charges","37.7% of total billed charges",1867.28,37.7,,1493.82,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1679.07,33.9,,1343.26,,,0,"percent of total billed charges","33.9% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3863.34,78,,3090.67,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4091.18,82.6,,3272.94,,,0,"percent of total billed charges","82.6% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4091.18,82.6,,3272.94,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2020.72,100,,,,,0,"fee schedule",EAPG,4953,100,,3962.40,,,0,"percent of total billed charges","100% of total billed charges",1496.83,9628.23,
"19285 Placement of breast localization device(s) (eg, clip,",76119285,CDM,761,RC,19285,CPT,OUTPATIENT,,,1316,855.4,,1158.08,88,,926.46,,,0,"percent of total billed charges","88% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,1316,100,,1052.80,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",1298.41,100,,,,,0,"fee schedule",EAPG,717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",829.08,63,,663.26,,,0,"percent of total billed charges","63% of total billed charges",201.35,15.3,,161.08,,,0,"percent of total billed charges","15.3% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,908.04,69,,,,,0,"fee schedule","69% of total billed charges",1316,100,,1052.80,,,0,"percent of total billed charges","100% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1316,100,,1052.80,,,0,"percent of total billed charges","100% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1316,100,,1052.80,,,0,"percent of total billed charges","100% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",933.77,100,,,,,0,"fee schedule",EAPG,717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1285.8,100,,,,,0,"fee schedule",EAPG,1638.77,100,,,,,0,"fee schedule",EAPG,717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",496.13,37.7,,396.90,,,0,"percent of total billed charges","37.7% of total billed charges",496.13,37.7,,396.90,,,0,"percent of total billed charges","37.70% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",446.12,33.9,,356.90,,,0,"percent of total billed charges","33.9% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1026.48,78,,821.18,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1087.02,82.6,,869.62,,,0,"percent of total billed charges","82.6% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1087.02,82.6,,869.62,,,0,"percent of total billed charges","82.6% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,1316,100,,1052.80,,,0,"percent of total billed charges","100% of total billed charges",201.35,2526.77,
"BONE BX DEEP SURG",84020225,CDM,361,RC,20225,CPT,OUTPATIENT,,,5375,3493.75,,4730,88,,3784.00,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3386.25,63,,2709.00,,,0,"percent of total billed charges","63% of total billed charges",822.38,15.3,,657.90,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,3708.75,69,,,,,0,"fee schedule","69% of total billed charges",5375,100,,4300.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5375,100,,4300.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5375,100,,4300.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1164.3,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2026.38,37.7,,1621.10,,,0,"percent of total billed charges","37.7% of total billed charges",2026.38,37.7,,1621.10,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1822.13,33.9,,1457.70,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.5,78,,3354.00,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4439.75,82.6,,3551.80,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4439.75,82.6,,3551.80,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,5375,100,,4300.00,,,0,"percent of total billed charges","100% of total billed charges",822.38,5715.97,
"INJ OF SINUS TRACT THERAPEUTIC",84020500,CDM,360,RC,20500,CPT,OUTPATIENT,,,587,381.55,,516.56,88,,413.25,,,0,"percent of total billed charges","88% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,587,100,,469.60,,,0,"percent of total billed charges","100% of total billed charges",2722.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",369.81,63,,295.85,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,405.03,69,,,,,0,"fee schedule","69% of total billed charges",587,100,,469.60,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",587,100,,469.60,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",587,100,,469.60,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",5495.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1436.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",613.12,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.3,37.7,,177.04,,,0,"percent of total billed charges","37.7% of total billed charges",221.3,37.7,,177.04,,,0,"percent of total billed charges","37.70% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",198.99,33.9,,159.19,,,0,"percent of total billed charges","33.9% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",457.86,78,,366.29,,,0,"percent of total billed charges","78% of total billed charges",1571.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",484.86,82.6,,387.89,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",484.86,82.6,,387.89,,,0,"percent of total billed charges","82.6% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,587,100,,469.60,,,0,"percent of total billed charges","100% of total billed charges",198.99,5495.75,
"INJ SINUS TRACT DIAGNOSTIC SUR",84020501,CDM,361,RC,20501,CPT,OUTPATIENT,,,1785,1160.25,,1570.8,88,,1256.64,,,0,"percent of total billed charges","88% of total billed charges",892.5,50,,714.00,,,0,"percent of total billed charges","50% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,1785,100,,1428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.05,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1124.55,63,,899.64,,,0,"percent of total billed charges","63% of total billed charges",273.11,15.3,,218.49,,,0,"percent of total billed charges","15.3% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,1231.65,69,,,,,0,"fee schedule","69% of total billed charges",1785,100,,1428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1785,100,,1428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1785,100,,1428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1104.02,61.85,,883.22,,,0,"percent of total billed charges","61.5% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,892.5,50,,714.00,,,0,"percent of total billed charges","50% of total billed charges",574.77,32.2,,459.82,,,0,"percent of total billed charges","32.2% of total billed charges",202.12,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",278.32,100,,,,,0,"fee schedule",EAPG,354.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",672.95,37.7,,538.36,,,0,"percent of total billed charges","37.7% of total billed charges",672.95,37.7,,538.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",605.12,33.9,,484.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1392.3,78,,1113.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1474.41,82.6,,1179.53,,,0,"percent of total billed charges","82.6% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,892.5,50,,714.00,,,0,"percent of total billed charges","50% of total billed charges",1474.41,82.6,,1179.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.87,100,,,,,0,"fee schedule",EAPG,1785,100,,1428.00,,,0,"percent of total billed charges","100% of total billed charges",202.12,1785,
"REM FOREIGN BODY MUSCLE/TENDON",84020520,CDM,360,RC,20520,CPT,OUTPATIENT,,,1011,657.15,,889.68,88,,711.74,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1011,100,,808.80,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",636.93,63,,509.54,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,697.59,69,,,,,0,"fee schedule","69% of total billed charges",1011,100,,808.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1011,100,,808.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1011,100,,808.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1164.3,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",381.15,37.7,,304.92,,,0,"percent of total billed charges","37.7% of total billed charges",381.15,37.7,,304.92,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.73,33.9,,274.18,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",788.58,78,,630.86,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",835.09,82.6,,668.07,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",835.09,82.6,,668.07,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1011,100,,808.80,,,0,"percent of total billed charges","100% of total billed charges",342.73,5715.97,
"20526 Injection, therapeutic carpal tunnel",84020526,CDM,761,RC,20526,CPT,OUTPATIENT,,,564,366.6,,496.32,88,,397.06,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",223.22,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.32,63,,284.26,,,0,"percent of total billed charges","63% of total billed charges",86.29,15.3,,69.03,,,0,"percent of total billed charges","15.3% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,389.16,69,,,,,0,"fee schedule","69% of total billed charges",564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.05,100,,,,,0,"fee schedule",EAPG,281.73,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",212.63,37.7,,170.10,,,0,"percent of total billed charges","37.7% of total billed charges",212.63,37.7,,170.10,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191.2,33.9,,152.96,,,0,"percent of total billed charges","33.9% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",439.92,78,,351.94,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465.86,82.6,,372.69,,,0,"percent of total billed charges","82.6% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465.86,82.6,,372.69,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",86.29,1061,
"ASPIR/INJ TREATMENT BONE CYST",84020615,CDM,360,RC,20615,CPT,OUTPATIENT,,,1111,722.15,,977.68,88,,782.14,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.75,100,,,,,0,"fee schedule",EAPG,1111,100,,888.80,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",457.07,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",699.93,63,,559.94,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",443.75,100,,,,,0,"fee schedule",EAPG,766.59,69,,,,,0,"fee schedule","69% of total billed charges",1111,100,,888.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1111,100,,888.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1111,100,,888.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.75,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",328.7,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",452.63,100,,,,,0,"fee schedule",EAPG,576.88,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.85,37.7,,335.08,,,0,"percent of total billed charges","37.7% of total billed charges",418.85,37.7,,335.08,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",376.63,33.9,,301.30,,,0,"percent of total billed charges","33.9% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",866.58,78,,693.26,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",917.69,82.6,,734.15,,,0,"percent of total billed charges","82.6% of total billed charges",443.75,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",917.69,82.6,,734.15,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.75,100,,,,,0,"fee schedule",EAPG,1111,100,,888.80,,,0,"percent of total billed charges","100% of total billed charges",328.7,3367,
"Arthrocentesis aspir  and/or Inj major join/bursa w/US",84020611,CDM,761,RC,20611,CPT,OUTPATIENT,,,284,184.6,,249.92,88,,199.94,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.75,100,,,,,0,"fee schedule",EAPG,284,100,,227.20,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",457.07,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",178.92,63,,143.14,,,0,"percent of total billed charges","63% of total billed charges",43.45,15.3,,34.76,,,0,"percent of total billed charges","15.3% of total billed charges",443.75,100,,,,,0,"fee schedule",EAPG,195.96,69,,,,,0,"fee schedule","69% of total billed charges",284,100,,227.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284,100,,227.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284,100,,227.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.75,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",328.7,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",452.63,100,,,,,0,"fee schedule",EAPG,576.88,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.07,37.7,,85.66,,,0,"percent of total billed charges","37.7% of total billed charges",107.07,37.7,,85.66,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",96.28,33.9,,77.02,,,0,"percent of total billed charges","33.9% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.52,78,,177.22,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.58,82.6,,187.66,,,0,"percent of total billed charges","82.6% of total billed charges",443.75,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.58,82.6,,187.66,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.75,100,,,,,0,"fee schedule",EAPG,284,100,,227.20,,,0,"percent of total billed charges","100% of total billed charges",43.45,1061,
"Closed treatment of carpometacarpal dislocation, other than",76126670,CDM,761,RC,26670,CPT,OUTPATIENT,,,782,508.3,,688.16,88,,550.53,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",492.66,63,,394.13,,,0,"percent of total billed charges","63% of total billed charges",119.65,15.3,,95.72,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,539.58,69,,,,,0,"fee schedule","69% of total billed charges",782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.81,37.7,,235.85,,,0,"percent of total billed charges","37.7% of total billed charges",294.81,37.7,,235.85,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.1,33.9,,212.08,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",609.96,78,,487.97,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",645.93,82.6,,516.74,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",645.93,82.6,,516.74,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",119.65,837.64,
"Interphalangeal Joint w/man w/o Anesthesia",76126770,CDM,761,RC,26770,CPT,OUTPATIENT,,,818,531.7,,719.84,88,,575.87,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,818,100,,654.40,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",515.34,63,,412.27,,,0,"percent of total billed charges","63% of total billed charges",125.15,15.3,,100.12,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,564.42,69,,,,,0,"fee schedule","69% of total billed charges",818,100,,654.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818,100,,654.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818,100,,654.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.48,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",308.39,37.7,,246.71,,,0,"percent of total billed charges","37.7% of total billed charges",308.39,37.7,,246.71,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.3,33.9,,221.84,,,0,"percent of total billed charges","33.9% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.04,78,,510.43,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",675.67,82.6,,540.54,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",675.67,82.6,,540.54,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,818,100,,654.40,,,0,"percent of total billed charges","100% of total billed charges",125.15,837.64,
"INJ FOR SACROILIAC JOINT",84027096,CDM,761,RC,27096,CPT,OUTPATIENT,,,912,592.8,,802.56,88,,642.05,,,0,"percent of total billed charges","88% of total billed charges",456,50,,364.80,,,0,"percent of total billed charges","50% of total billed charges",443.75,100,,,,,0,"fee schedule",EAPG,912,100,,729.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",457.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",574.56,63,,459.65,,,0,"percent of total billed charges","63% of total billed charges",139.54,15.3,,111.63,,,0,"percent of total billed charges","15.3% of total billed charges",443.75,100,,,,,0,"fee schedule",EAPG,629.28,69,,,,,0,"fee schedule","69% of total billed charges",912,100,,729.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",912,100,,729.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",912,100,,729.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",564.07,61.85,,451.26,,,0,"percent of total billed charges","61.5% of total billed charges",443.75,100,,,,,0,"fee schedule",EAPG,456,50,,364.80,,,0,"percent of total billed charges","50% of total billed charges",293.66,32.2,,234.93,,,0,"percent of total billed charges","32.2% of total billed charges",328.7,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",452.63,100,,,,,0,"fee schedule",EAPG,576.88,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",343.82,37.7,,275.06,,,0,"percent of total billed charges","37.7% of total billed charges",343.82,37.7,,275.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",309.17,33.9,,247.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",711.36,78,,569.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",753.31,82.6,,602.65,,,0,"percent of total billed charges","82.6% of total billed charges",443.75,100,,,,,0,"fee schedule","100% of WA fee schedule",456,50,,364.80,,,0,"percent of total billed charges","50% of total billed charges",753.31,82.6,,602.65,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",443.75,100,,,,,0,"fee schedule",EAPG,912,100,,729.60,,,0,"percent of total billed charges","100% of total billed charges",139.54,912,
"REMOVAL FB,FOOT,DEEP",84028192,CDM,360,RC,28192,CPT,OUTPATIENT,,,2124,1380.6,,1869.12,88,,1495.30,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2124,100,,1699.20,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1338.12,63,,1070.50,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1465.56,69,,,,,0,"fee schedule","69% of total billed charges",2124,100,,1699.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2124,100,,1699.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2124,100,,1699.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1164.3,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",800.75,37.7,,640.60,,,0,"percent of total billed charges","37.7% of total billed charges",800.75,37.7,,640.60,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",720.04,33.9,,576.03,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1656.72,78,,1325.38,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1754.42,82.6,,1403.54,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1754.42,82.6,,1403.54,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2124,100,,1699.20,,,0,"percent of total billed charges","100% of total billed charges",720.04,5715.97,
"Laryngoscopy, indirect; with removal of foreign body",45031511,CDM,450,RC,31511,CPT,OUTPATIENT,,,247,160.55,,217.36,88,,173.89,,,0,"percent of total billed charges","88% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,247,100,,197.60,,,0,"percent of total billed charges","100% of total billed charges",353.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",155.61,63,,124.49,,,0,"percent of total billed charges","63% of total billed charges",37.79,15.3,,30.23,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,170.43,69,,,,,0,"fee schedule","69% of total billed charges",247,100,,197.60,,,0,"percent of total billed charges","100% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",247,100,,197.60,,,0,"percent of total billed charges","100% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",247,100,,197.60,,,0,"percent of total billed charges","100% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",667.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",174.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.15,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",93.12,37.7,,74.50,,,0,"percent of total billed charges","37.7% of total billed charges",93.12,37.7,,74.50,,,0,"percent of total billed charges","37.70% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",83.73,33.9,,66.98,,,0,"percent of total billed charges","33.9% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",192.66,78,,154.13,,,0,"percent of total billed charges","78% of total billed charges",204.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",204.02,82.6,,163.22,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",204.02,82.6,,163.22,,,0,"percent of total billed charges","82.6% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,247,100,,197.60,,,0,"percent of total billed charges","100% of total billed charges",37.79,667.83,
"THORACENTESIS W/O IMAGING",76132554,CDM,761,RC,32554,CPT,OUTPATIENT,,,1762,1145.3,,1550.56,88,,1240.45,,,0,"percent of total billed charges","88% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,1762,100,,1409.60,,,0,"percent of total billed charges","100% of total billed charges",1121.3,175,,,,,0,"fee schedule","175% of CMS fee schedule",884,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1110.06,63,,888.05,,,0,"percent of total billed charges","63% of total billed charges",269.59,15.3,,215.67,,,0,"percent of total billed charges","15.3% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,1215.78,69,,,,,0,"fee schedule","69% of total billed charges",1762,100,,1409.60,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1762,100,,1409.60,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1762,100,,1409.60,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",2200.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",575.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",635.74,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.42,100,,,,,0,"fee schedule",EAPG,1115.74,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",664.27,37.7,,531.42,,,0,"percent of total billed charges","37.7% of total billed charges",664.27,37.7,,531.42,,,0,"percent of total billed charges","37.70% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",597.32,33.9,,477.86,,,0,"percent of total billed charges","33.9% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1374.36,78,,1099.49,,,0,"percent of total billed charges","78% of total billed charges",647.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1455.41,82.6,,1164.33,,,0,"percent of total billed charges","82.6% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1455.41,82.6,,1164.33,,,0,"percent of total billed charges","82.6% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,1762,100,,1409.60,,,0,"percent of total billed charges","100% of total billed charges",269.59,2200.34,
"THORACENTESIS;IMAGING GUIDED",84032555,CDM,761,RC,32555,CPT,OUTPATIENT,,,4488,2917.2,,3949.44,88,,3159.55,,,0,"percent of total billed charges","88% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,4488,100,,3590.40,,,0,"percent of total billed charges","100% of total billed charges",1121.3,175,,,,,0,"fee schedule","175% of CMS fee schedule",884,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2827.44,63,,2261.95,,,0,"percent of total billed charges","63% of total billed charges",686.66,15.3,,549.33,,,0,"percent of total billed charges","15.3% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,3096.72,69,,,,,0,"fee schedule","69% of total billed charges",4488,100,,3590.40,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4488,100,,3590.40,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4488,100,,3590.40,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",2200.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",575.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",635.74,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.42,100,,,,,0,"fee schedule",EAPG,1115.74,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1691.98,37.7,,1353.58,,,0,"percent of total billed charges","37.7% of total billed charges",1691.98,37.7,,1353.58,,,0,"percent of total billed charges","37.70% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1521.43,33.9,,1217.14,,,0,"percent of total billed charges","33.9% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3500.64,78,,2800.51,,,0,"percent of total billed charges","78% of total billed charges",647.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3707.09,82.6,,2965.67,,,0,"percent of total billed charges","82.6% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3707.09,82.6,,2965.67,,,0,"percent of total billed charges","82.6% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,4488,100,,3590.40,,,0,"percent of total billed charges","100% of total billed charges",575.25,4488,
"INSERT CATH PLEURA W IMAGE",84032550,CDM,329,RC,32550,CPT,OUTPATIENT,,,7921,5148.65,,6970.48,88,,5576.38,,,0,"percent of total billed charges","88% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6175.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",884,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4990.23,63,,3992.18,,,0,"percent of total billed charges","63% of total billed charges",1211.91,15.3,,969.53,,,0,"percent of total billed charges","15.3% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,5465.49,69,,,,,0,"fee schedule","69% of total billed charges",7921,100,,6336.80,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7921,100,,6336.80,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7921,100,,6336.80,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",635.74,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.42,100,,,,,0,"fee schedule",EAPG,1115.74,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2986.22,37.7,,2388.98,,,0,"percent of total billed charges","37.7% of total billed charges",2986.22,37.7,,2388.98,,,0,"percent of total billed charges","37.70% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2685.22,33.9,,2148.18,,,0,"percent of total billed charges","33.9% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6178.38,78,,4942.70,,,0,"percent of total billed charges","78% of total billed charges",3564.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6542.75,82.6,,5234.20,,,0,"percent of total billed charges","82.6% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6542.75,82.6,,5234.20,,,0,"percent of total billed charges","82.6% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,7921,100,,6336.80,,,0,"percent of total billed charges","100% of total billed charges",635.74,12932.7,
"CHEST TUBE PLACEMENT",84032551,CDM,360,RC,32551,CPT,OUTPATIENT,,,1242,807.3,,1092.96,88,,874.37,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,1242,100,,993.60,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",884,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",782.46,63,,625.97,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,856.98,69,,,,,0,"fee schedule","69% of total billed charges",1242,100,,993.60,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1242,100,,993.60,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1242,100,,993.60,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",635.74,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.42,100,,,,,0,"fee schedule",EAPG,1115.74,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",468.23,37.7,,374.58,,,0,"percent of total billed charges","37.7% of total billed charges",468.23,37.7,,374.58,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",421.04,33.9,,336.83,,,0,"percent of total billed charges","33.9% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",968.76,78,,775.01,,,0,"percent of total billed charges","78% of total billed charges",1649.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1025.89,82.6,,820.71,,,0,"percent of total billed charges","82.6% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1025.89,82.6,,820.71,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,1242,100,,993.60,,,0,"percent of total billed charges","100% of total billed charges",421.04,5712.48,
"32557 Pleural drainage, percutaneous procedure with insert i",76132557,CDM,761,RC,32557,CPT,OUTPATIENT,,,3106,2018.9,,2733.28,88,,2186.62,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,3106,100,,2484.80,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",884,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1956.78,63,,1565.42,,,0,"percent of total billed charges","63% of total billed charges",475.22,15.3,,380.18,,,0,"percent of total billed charges","15.3% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,2143.14,69,,,,,0,"fee schedule","69% of total billed charges",3106,100,,2484.80,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3106,100,,2484.80,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3106,100,,2484.80,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",635.74,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.42,100,,,,,0,"fee schedule",EAPG,1115.74,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1170.96,37.7,,936.77,,,0,"percent of total billed charges","37.7% of total billed charges",1170.96,37.7,,936.77,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1052.93,33.9,,842.34,,,0,"percent of total billed charges","33.9% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2422.68,78,,1938.14,,,0,"percent of total billed charges","78% of total billed charges",1649.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2565.56,82.6,,2052.45,,,0,"percent of total billed charges","82.6% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2565.56,82.6,,2052.45,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,3106,100,,2484.80,,,0,"percent of total billed charges","100% of total billed charges",475.22,5712.48,
"32556 PLEURAL DRAINAGE W/O IMAGING",76132556,CDM,761,RC,32556,CPT,OUTPATIENT,,,6302,4096.3,,5545.76,88,,4436.61,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",884,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3970.26,63,,3176.21,,,0,"percent of total billed charges","63% of total billed charges",964.21,15.3,,771.37,,,0,"percent of total billed charges","15.3% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,4348.38,69,,,,,0,"fee schedule","69% of total billed charges",6302,100,,5041.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6302,100,,5041.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6302,100,,5041.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",635.74,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.42,100,,,,,0,"fee schedule",EAPG,1115.74,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2375.85,37.7,,1900.68,,,0,"percent of total billed charges","37.7% of total billed charges",2375.85,37.7,,1900.68,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2136.38,33.9,,1709.10,,,0,"percent of total billed charges","33.9% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4915.56,78,,3932.45,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5205.45,82.6,,4164.36,,,0,"percent of total billed charges","82.6% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5205.45,82.6,,4164.36,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,6302,100,,5041.60,,,0,"percent of total billed charges","100% of total billed charges",635.74,6601.69,
"PERICARDIOCENTESIS; INITIAL|Pericardiocentesis, including imaging guidance, when perform",84033010|84033016,CDM,361,RC,33016,CPT,OUTPATIENT,,,2144,1393.6,,1886.72,88,,1509.38,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,2144,100,,1715.20,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",884,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1350.72,63,,1080.58,,,0,"percent of total billed charges","63% of total billed charges",328.03,15.3,,262.42,,,0,"percent of total billed charges","15.3% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,1479.36,69,,,,,0,"fee schedule","69% of total billed charges",2144,100,,1715.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2144,100,,1715.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2144,100,,1715.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",635.74,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.42,100,,,,,0,"fee schedule",EAPG,1115.74,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",808.29,37.7,,646.63,,,0,"percent of total billed charges","37.7% of total billed charges",808.29,37.7,,646.63,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.82,33.9,,581.46,,,0,"percent of total billed charges","33.9% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1672.32,78,,1337.86,,,0,"percent of total billed charges","78% of total billed charges",1649.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1770.94,82.6,,1416.75,,,0,"percent of total billed charges","82.6% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1770.94,82.6,,1416.75,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,2144,100,,1715.20,,,0,"percent of total billed charges","100% of total billed charges",328.03,5712.48,
"33017 Peri Drain w/indwelling Cath Insert, Percuta",84033017,CDM,481,RC,33017,CPT,OUTPATIENT,,,1141,741.65,,1004.08,88,,803.26,,,0,"percent of total billed charges","88% of total billed charges",1141,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",858.26,100,,,,,0,"fee schedule",EAPG,1141,100,,912.80,,,0,"percent of total billed charges","100% of total billed charges",1141,175,,,,,0,"fee schedule","175% of CMS fee schedule",884,100,,,,,0,"fee schedule",EAPG,1141,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",718.83,63,,575.06,,,0,"percent of total billed charges","63% of total billed charges",174.57,15.3,,139.66,,,0,"percent of total billed charges","15.3% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,787.29,69,,,,,0,"fee schedule","69% of total billed charges",1141,100,,912.80,,,0,"percent of total billed charges","100% of total billed charges",1141,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1141,100,,912.80,,,0,"percent of total billed charges","100% of total billed charges",1141,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1141,100,,912.80,,,0,"percent of total billed charges","100% of total billed charges",1141,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1141,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",858.26,100,,,,,0,"fee schedule",EAPG,1141,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1141,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",635.74,100,,,,,0,"fee schedule",EAPG,1141,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",875.42,100,,,,,0,"fee schedule",EAPG,1115.74,100,,,,,0,"fee schedule",EAPG,1141,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",430.16,37.7,,344.13,,,0,"percent of total billed charges","37.7% of total billed charges",430.16,37.7,,344.13,,,0,"percent of total billed charges","37.70% of total billed charges",1141,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",386.8,33.9,,309.44,,,0,"percent of total billed charges","33.9% of total billed charges",1141,100,,,,,0,"fee schedule","100% of CMS fee schedule",889.98,78,,711.98,,,0,"percent of total billed charges","78% of total billed charges",1141,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",942.47,82.6,,753.98,,,0,"percent of total billed charges","82.6% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,1141,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",942.47,82.6,,753.98,,,0,"percent of total billed charges","82.6% of total billed charges",1141,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",858.26,100,,,,,0,"fee schedule",EAPG,1141,100,,912.80,,,0,"percent of total billed charges","100% of total billed charges",174.57,1141,
"PACER SING PERM IN/REPL VE SUR",84033207,CDM,361,RC,33207,CPT,OUTPATIENT,,,3238,2104.7,,2849.44,88,,2279.55,,,0,"percent of total billed charges","88% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,3238,100,,2590.40,,,0,"percent of total billed charges","100% of total billed charges",19060,175,,,,,0,"fee schedule","175% of CMS fee schedule",7701.7,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2039.94,63,,1631.95,,,0,"percent of total billed charges","63% of total billed charges",495.41,15.3,,396.33,,,0,"percent of total billed charges","15.3% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,2234.22,69,,,,,0,"fee schedule","69% of total billed charges",3238,100,,2590.40,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3238,100,,2590.40,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3238,100,,2590.40,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",42250.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11045.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5538.8,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7626.93,100,,,,,0,"fee schedule",EAPG,9720.59,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1220.73,37.7,,976.58,,,0,"percent of total billed charges","37.7% of total billed charges",1220.73,37.7,,976.58,,,0,"percent of total billed charges","37.70% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1097.68,33.9,,878.14,,,0,"percent of total billed charges","33.9% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2525.64,78,,2020.51,,,0,"percent of total billed charges","78% of total billed charges",11000.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2674.59,82.6,,2139.67,,,0,"percent of total billed charges","82.6% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2674.59,82.6,,2139.67,,,0,"percent of total billed charges","82.6% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,3238,100,,2590.40,,,0,"percent of total billed charges","100% of total billed charges",495.41,42250.94,
"INSERT NEW/REPL PERMAN PACEMAK Dual",84033208,CDM,481,RC,33208,CPT,OUTPATIENT,,,2922,1899.3,,2571.36,88,,2057.09,,,0,"percent of total billed charges","88% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,2922,100,,2337.60,,,0,"percent of total billed charges","100% of total billed charges",19060,175,,,,,0,"fee schedule","175% of CMS fee schedule",7701.7,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1840.86,63,,1472.69,,,0,"percent of total billed charges","63% of total billed charges",447.07,15.3,,357.66,,,0,"percent of total billed charges","15.3% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,2016.18,69,,,,,0,"fee schedule","69% of total billed charges",2922,100,,2337.60,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2922,100,,2337.60,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2922,100,,2337.60,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",42250.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11045.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5538.8,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7626.93,100,,,,,0,"fee schedule",EAPG,9720.59,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.59,37.7,,881.27,,,0,"percent of total billed charges","37.7% of total billed charges",1101.59,37.7,,881.27,,,0,"percent of total billed charges","37.70% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",990.56,33.9,,792.45,,,0,"percent of total billed charges","33.9% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2279.16,78,,1823.33,,,0,"percent of total billed charges","78% of total billed charges",11000.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2413.57,82.6,,1930.86,,,0,"percent of total billed charges","82.6% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2413.57,82.6,,1930.86,,,0,"percent of total billed charges","82.6% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,2922,100,,2337.60,,,0,"percent of total billed charges","100% of total billed charges",447.07,42250.94,
"INSERT TEMP PACEMAKER SUR SING",84033210,CDM,361,RC,33210,CPT,OUTPATIENT,,,976,634.4,,858.88,88,,687.10,,,0,"percent of total billed charges","88% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,976,100,,780.80,,,0,"percent of total billed charges","100% of total billed charges",15164.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",1576.9,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",614.88,63,,491.90,,,0,"percent of total billed charges","63% of total billed charges",149.33,15.3,,119.46,,,0,"percent of total billed charges","15.3% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,673.44,69,,,,,0,"fee schedule","69% of total billed charges",976,100,,780.80,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",976,100,,780.80,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",976,100,,780.80,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",33120.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8658.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1134.05,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561.59,100,,,,,0,"fee schedule",EAPG,1990.26,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.95,37.7,,294.36,,,0,"percent of total billed charges","37.7% of total billed charges",367.95,37.7,,294.36,,,0,"percent of total billed charges","37.70% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.86,33.9,,264.69,,,0,"percent of total billed charges","33.9% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",761.28,78,,609.02,,,0,"percent of total billed charges","78% of total billed charges",8751.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",806.18,82.6,,644.94,,,0,"percent of total billed charges","82.6% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",806.18,82.6,,644.94,,,0,"percent of total billed charges","82.6% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,976,100,,780.80,,,0,"percent of total billed charges","100% of total billed charges",149.33,33120.11,
"PACER DUAL TEMP INS/REPL SURG",84033211,CDM,361,RC,33211,CPT,OUTPATIENT,,,18151,11798.15,,15972.88,88,,12778.30,,,0,"percent of total billed charges","88% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",15164.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",1576.9,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11435.13,63,,9148.10,,,0,"percent of total billed charges","63% of total billed charges",2777.1,15.3,,2221.68,,,0,"percent of total billed charges","15.3% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,12524.19,69,,,,,0,"fee schedule","69% of total billed charges",18151,100,,14520.80,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18151,100,,14520.80,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18151,100,,14520.80,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",33120.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8658.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1134.05,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561.59,100,,,,,0,"fee schedule",EAPG,1990.26,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6842.93,37.7,,5474.34,,,0,"percent of total billed charges","37.7% of total billed charges",6842.93,37.7,,5474.34,,,0,"percent of total billed charges","37.70% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6153.19,33.9,,4922.55,,,0,"percent of total billed charges","33.9% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14157.78,78,,11326.22,,,0,"percent of total billed charges","78% of total billed charges",8751.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14992.73,82.6,,11994.18,,,0,"percent of total billed charges","82.6% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14992.73,82.6,,11994.18,,,0,"percent of total billed charges","82.6% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,18151,100,,14520.80,,,0,"percent of total billed charges","100% of total billed charges",1134.05,33120.11,
"REPOSITION LEADS",84033215,CDM,361,RC,33215,CPT,OUTPATIENT,,,6639,4315.35,,5842.32,88,,4673.86,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",1576.9,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4182.57,63,,3346.06,,,0,"percent of total billed charges","63% of total billed charges",1015.77,15.3,,812.62,,,0,"percent of total billed charges","15.3% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,4580.91,69,,,,,0,"fee schedule","69% of total billed charges",6639,100,,5311.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6639,100,,5311.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6639,100,,5311.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1134.05,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561.59,100,,,,,0,"fee schedule",EAPG,1990.26,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2502.9,37.7,,2002.32,,,0,"percent of total billed charges","37.7% of total billed charges",2502.9,37.7,,2002.32,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2250.62,33.9,,1800.50,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5178.42,78,,4142.74,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5483.81,82.6,,4387.05,,,0,"percent of total billed charges","82.6% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5483.81,82.6,,4387.05,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,6639,100,,5311.20,,,0,"percent of total billed charges","100% of total billed charges",1015.77,11625.57,
"INSERT 2 ELEC PERM PACE/AICD",84033217,CDM,361,RC,33217,CPT,OUTPATIENT,,,18151,11798.15,,15972.88,88,,12778.30,,,0,"percent of total billed charges","88% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",15164.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",1576.9,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11435.13,63,,9148.10,,,0,"percent of total billed charges","63% of total billed charges",2777.1,15.3,,2221.68,,,0,"percent of total billed charges","15.3% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,12524.19,69,,,,,0,"fee schedule","69% of total billed charges",18151,100,,14520.80,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18151,100,,14520.80,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18151,100,,14520.80,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",33120.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8658.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1134.05,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561.59,100,,,,,0,"fee schedule",EAPG,1990.26,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6842.93,37.7,,5474.34,,,0,"percent of total billed charges","37.7% of total billed charges",6842.93,37.7,,5474.34,,,0,"percent of total billed charges","37.70% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6153.19,33.9,,4922.55,,,0,"percent of total billed charges","33.9% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14157.78,78,,11326.22,,,0,"percent of total billed charges","78% of total billed charges",8751.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14992.73,82.6,,11994.18,,,0,"percent of total billed charges","82.6% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14992.73,82.6,,11994.18,,,0,"percent of total billed charges","82.6% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,18151,100,,14520.80,,,0,"percent of total billed charges","100% of total billed charges",1134.05,33120.11,
"REPAIR SINGLE LEAD",84033218,CDM,361,RC,33218,CPT,OUTPATIENT,,,15344,9973.6,,13502.72,88,,10802.18,,,0,"percent of total billed charges","88% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7009.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",1576.9,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9666.72,63,,7733.38,,,0,"percent of total billed charges","63% of total billed charges",2347.63,15.3,,1878.10,,,0,"percent of total billed charges","15.3% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,10587.36,69,,,,,0,"fee schedule","69% of total billed charges",15344,100,,12275.20,,,0,"percent of total billed charges","100% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15344,100,,12275.20,,,0,"percent of total billed charges","100% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15344,100,,12275.20,,,0,"percent of total billed charges","100% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",13976.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3654.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1134.05,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561.59,100,,,,,0,"fee schedule",EAPG,1990.26,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5784.69,37.7,,4627.75,,,0,"percent of total billed charges","37.7% of total billed charges",5784.69,37.7,,4627.75,,,0,"percent of total billed charges","37.70% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5201.62,33.9,,4161.30,,,0,"percent of total billed charges","33.9% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11968.32,78,,9574.66,,,0,"percent of total billed charges","78% of total billed charges",4045.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",12674.14,82.6,,10139.31,,,0,"percent of total billed charges","82.6% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",12674.14,82.6,,10139.31,,,0,"percent of total billed charges","82.6% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,15344,100,,12275.20,,,0,"percent of total billed charges","100% of total billed charges",1134.05,15344,
"PACER ELECT DUAL REPAIR SURG",84033220,CDM,361,RC,33220,CPT,OUTPATIENT,,,17701,11505.65,,15576.88,88,,12461.50,,,0,"percent of total billed charges","88% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7009.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",1576.9,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11151.63,63,,8921.30,,,0,"percent of total billed charges","63% of total billed charges",2708.25,15.3,,2166.60,,,0,"percent of total billed charges","15.3% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,12213.69,69,,,,,0,"fee schedule","69% of total billed charges",17701,100,,14160.80,,,0,"percent of total billed charges","100% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17701,100,,14160.80,,,0,"percent of total billed charges","100% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17701,100,,14160.80,,,0,"percent of total billed charges","100% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",13976.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3654.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1134.05,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561.59,100,,,,,0,"fee schedule",EAPG,1990.26,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6673.28,37.7,,5338.62,,,0,"percent of total billed charges","37.7% of total billed charges",6673.28,37.7,,5338.62,,,0,"percent of total billed charges","37.70% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6000.64,33.9,,4800.51,,,0,"percent of total billed charges","33.9% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13806.78,78,,11045.42,,,0,"percent of total billed charges","78% of total billed charges",4045.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14621.03,82.6,,11696.82,,,0,"percent of total billed charges","82.6% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14621.03,82.6,,11696.82,,,0,"percent of total billed charges","82.6% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,17701,100,,14160.80,,,0,"percent of total billed charges","100% of total billed charges",1134.05,17701,
"RELOCATE POCKET PPG SURG",84033222,CDM,361,RC,33222,CPT,OUTPATIENT,,,6535,4247.75,,5750.8,88,,4600.64,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1576.9,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4117.05,63,,3293.64,,,0,"percent of total billed charges","63% of total billed charges",999.86,15.3,,799.89,,,0,"percent of total billed charges","15.3% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,4509.15,69,,,,,0,"fee schedule","69% of total billed charges",6535,100,,5228.00,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6535,100,,5228.00,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6535,100,,5228.00,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1134.05,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561.59,100,,,,,0,"fee schedule",EAPG,1990.26,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2463.7,37.7,,1970.96,,,0,"percent of total billed charges","37.7% of total billed charges",2463.7,37.7,,1970.96,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2215.37,33.9,,1772.30,,,0,"percent of total billed charges","33.9% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5097.3,78,,4077.84,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5397.91,82.6,,4318.33,,,0,"percent of total billed charges","82.6% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5397.91,82.6,,4318.33,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,6535,100,,5228.00,,,0,"percent of total billed charges","100% of total billed charges",999.86,6968.7,
"INSERT PACING LEAD  CONNECT",84033224,CDM,361,RC,33224,CPT,OUTPATIENT,,,42808,27825.2,,37671.04,88,,30136.83,,,0,"percent of total billed charges","88% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",19060,175,,,,,0,"fee schedule","175% of CMS fee schedule",7701.7,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26969.04,63,,21575.23,,,0,"percent of total billed charges","63% of total billed charges",6549.62,15.3,,5239.70,,,0,"percent of total billed charges","15.3% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,29537.52,69,,,,,0,"fee schedule","69% of total billed charges",42808,100,,34246.40,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42808,100,,34246.40,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42808,100,,34246.40,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",42250.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11045.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5538.8,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7626.93,100,,,,,0,"fee schedule",EAPG,9720.59,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16138.62,37.7,,12910.90,,,0,"percent of total billed charges","37.7% of total billed charges",16138.62,37.7,,12910.90,,,0,"percent of total billed charges","37.70% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14511.91,33.9,,11609.53,,,0,"percent of total billed charges","33.9% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33390.24,78,,26712.19,,,0,"percent of total billed charges","78% of total billed charges",11000.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35359.41,82.6,,28287.53,,,0,"percent of total billed charges","82.6% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35359.41,82.6,,28287.53,,,0,"percent of total billed charges","82.6% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,42808,100,,34246.40,,,0,"percent of total billed charges","100% of total billed charges",4695,42808,
"NEW CORONARY SINUS LEAD",84033225,CDM,360,RC,33225,CPT,OUTPATIENT,,,41774,27153.1,,36761.12,88,,29408.90,,,0,"percent of total billed charges","88% of total billed charges",20887,50,,16709.60,,,0,"percent of total billed charges","50% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7701.7,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",26317.62,63,,21054.10,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,28824.06,69,,,,,0,"fee schedule","69% of total billed charges",41774,100,,33419.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",41774,100,,33419.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",41774,100,,33419.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25837.22,61.85,,20669.78,,,0,"percent of total billed charges","61.5% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,20887,50,,16709.60,,,0,"percent of total billed charges","50% of total billed charges",13451.23,32.2,,10760.98,,,0,"percent of total billed charges","32.2% of total billed charges",5538.8,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",7626.93,100,,,,,0,"fee schedule",EAPG,9720.59,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",15748.8,37.7,,12599.04,,,0,"percent of total billed charges","37.7% of total billed charges",15748.8,37.7,,12599.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",14161.39,33.9,,11329.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",32583.72,78,,26066.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",34505.32,82.6,,27604.26,,,0,"percent of total billed charges","82.6% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,20887,50,,16709.60,,,0,"percent of total billed charges","50% of total billed charges",34505.32,82.6,,27604.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7477.38,100,,,,,0,"fee schedule",EAPG,41774,100,,33419.20,,,0,"percent of total billed charges","100% of total billed charges",3367,41774,
"REPO LV LEAD",84033226,CDM,361,RC,33226,CPT,OUTPATIENT,,,7468,4854.2,,6571.84,88,,5257.47,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6298.95,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",6487.92,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4704.84,63,,3763.87,,,0,"percent of total billed charges","63% of total billed charges",1142.6,15.3,,914.08,,,0,"percent of total billed charges","15.3% of total billed charges",6298.95,100,,,,,0,"fee schedule",EAPG,5152.92,69,,,,,0,"fee schedule","69% of total billed charges",7468,100,,5974.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7468,100,,5974.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7468,100,,5974.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6298.95,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4665.89,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6424.93,100,,,,,0,"fee schedule",EAPG,8188.64,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2815.44,37.7,,2252.35,,,0,"percent of total billed charges","37.7% of total billed charges",2815.44,37.7,,2252.35,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2531.65,33.9,,2025.32,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5825.04,78,,4660.03,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6168.57,82.6,,4934.86,,,0,"percent of total billed charges","82.6% of total billed charges",6298.95,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6168.57,82.6,,4934.86,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6298.95,100,,,,,0,"fee schedule",EAPG,7468,100,,5974.40,,,0,"percent of total billed charges","100% of total billed charges",1142.6,11625.57,
"GEN REPLACE SING SURG",84033227,CDM,361,RC,33227,CPT,OUTPATIENT,,,51061,33189.65,,44933.68,88,,35946.94,,,0,"percent of total billed charges","88% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",15164.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",7701.7,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32168.43,63,,25734.74,,,0,"percent of total billed charges","63% of total billed charges",7812.33,15.3,,6249.86,,,0,"percent of total billed charges","15.3% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,35232.09,69,,,,,0,"fee schedule","69% of total billed charges",51061,100,,40848.80,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51061,100,,40848.80,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51061,100,,40848.80,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",33120.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8658.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5538.8,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7626.93,100,,,,,0,"fee schedule",EAPG,9720.59,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19250,37.7,,15400.00,,,0,"percent of total billed charges","37.7% of total billed charges",19250,37.7,,15400.00,,,0,"percent of total billed charges","37.70% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17309.68,33.9,,13847.74,,,0,"percent of total billed charges","33.9% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39827.58,78,,31862.06,,,0,"percent of total billed charges","78% of total billed charges",8751.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42176.39,82.6,,33741.11,,,0,"percent of total billed charges","82.6% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42176.39,82.6,,33741.11,,,0,"percent of total billed charges","82.6% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,51061,100,,40848.80,,,0,"percent of total billed charges","100% of total billed charges",4695,51061,
"REPLACE OF GENERATOR PACEMAKER",84033228,CDM,360,RC,33228,CPT,OUTPATIENT,,,2271,1476.15,,1998.48,88,,1598.78,,,0,"percent of total billed charges","88% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,2271,100,,1816.80,,,0,"percent of total billed charges","100% of total billed charges",19060,175,,,,,0,"fee schedule","175% of CMS fee schedule",7701.7,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1430.73,63,,1144.58,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,1566.99,69,,,,,0,"fee schedule","69% of total billed charges",2271,100,,1816.80,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2271,100,,1816.80,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2271,100,,1816.80,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",42250.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11045.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5538.8,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7626.93,100,,,,,0,"fee schedule",EAPG,9720.59,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",856.17,37.7,,684.94,,,0,"percent of total billed charges","37.7% of total billed charges",856.17,37.7,,684.94,,,0,"percent of total billed charges","37.70% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",769.87,33.9,,615.90,,,0,"percent of total billed charges","33.9% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1771.38,78,,1417.10,,,0,"percent of total billed charges","78% of total billed charges",11000.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1875.85,82.6,,1500.68,,,0,"percent of total billed charges","82.6% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1875.85,82.6,,1500.68,,,0,"percent of total billed charges","82.6% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,2271,100,,1816.80,,,0,"percent of total billed charges","100% of total billed charges",769.87,42250.94,
"REM/REP PM GEN MULTI LEADS",84033229,CDM,361,RC,33229,CPT,OUTPATIENT,,,55988,36392.2,,49269.44,88,,39415.55,,,0,"percent of total billed charges","88% of total billed charges",19874.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",34779.85,175,,,,,0,"fee schedule","175% of CMS fee schedule",7701.7,100,,,,,0,"fee schedule",EAPG,19874.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35272.44,63,,28217.95,,,0,"percent of total billed charges","63% of total billed charges",8566.16,15.3,,6852.93,,,0,"percent of total billed charges","15.3% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,38631.72,69,,,,,0,"fee schedule","69% of total billed charges",55988,100,,44790.40,,,0,"percent of total billed charges","100% of total billed charges",19874.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",55988,100,,44790.40,,,0,"percent of total billed charges","100% of total billed charges",19874.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",55988,100,,44790.40,,,0,"percent of total billed charges","100% of total billed charges",19874.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",75608.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,19874.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19767,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5538.8,100,,,,,0,"fee schedule",EAPG,19874.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7626.93,100,,,,,0,"fee schedule",EAPG,9720.59,100,,,,,0,"fee schedule",EAPG,19874.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",21107.48,37.7,,16885.98,,,0,"percent of total billed charges","37.7% of total billed charges",21107.48,37.7,,16885.98,,,0,"percent of total billed charges","37.70% of total billed charges",19874.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18979.93,33.9,,15183.94,,,0,"percent of total billed charges","33.9% of total billed charges",19874.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",43670.64,78,,34936.51,,,0,"percent of total billed charges","78% of total billed charges",20072.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46246.09,82.6,,36996.87,,,0,"percent of total billed charges","82.6% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,19874.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46246.09,82.6,,36996.87,,,0,"percent of total billed charges","82.6% of total billed charges",19874.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,55988,100,,44790.40,,,0,"percent of total billed charges","100% of total billed charges",4695,75608.83,
"INSERT PULSE GEN W MULTI LEADS",84033231,CDM,361,RC,33231,CPT,OUTPATIENT,,,185060,120289,,162852.8,88,,130282.24,,,0,"percent of total billed charges","88% of total billed charges",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22419.38,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",58722.76,175,,,,,0,"fee schedule","175% of CMS fee schedule",23091.96,100,,,,,0,"fee schedule",EAPG,33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",116587.8,63,,93270.24,,,0,"percent of total billed charges","63% of total billed charges",28314.18,15.3,,22651.34,,,0,"percent of total billed charges","15.3% of total billed charges",22419.38,100,,,,,0,"fee schedule",EAPG,127691.4,69,,,,,0,"fee schedule","69% of total billed charges",185060,100,,148048.00,,,0,"percent of total billed charges","100% of total billed charges",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",185060,100,,148048.00,,,0,"percent of total billed charges","100% of total billed charges",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",185060,100,,148048.00,,,0,"percent of total billed charges","100% of total billed charges",33555.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",133409.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22419.38,100,,,,,0,"fee schedule",EAPG,33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34878.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16606.94,100,,,,,0,"fee schedule",EAPG,33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22867.76,100,,,,,0,"fee schedule",EAPG,29145.19,100,,,,,0,"fee schedule",EAPG,33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",69767.62,37.7,,55814.10,,,0,"percent of total billed charges","37.7% of total billed charges",69767.62,37.7,,55814.10,,,0,"percent of total billed charges","37.70% of total billed charges",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",62735.34,33.9,,50188.27,,,0,"percent of total billed charges","33.9% of total billed charges",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",144346.8,78,,115477.44,,,0,"percent of total billed charges","78% of total billed charges",33891.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",152859.56,82.6,,122287.65,,,0,"percent of total billed charges","82.6% of total billed charges",22419.38,100,,,,,0,"fee schedule",EAPG,33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",152859.56,82.6,,122287.65,,,0,"percent of total billed charges","82.6% of total billed charges",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22419.38,100,,,,,0,"fee schedule",EAPG,185060,100,,148048.00,,,0,"percent of total billed charges","100% of total billed charges",4695,185060,
"REMOVAL OF PERMANENT PACEMAKER",84033241,CDM,361,RC,33241,CPT,OUTPATIENT,,,9144,5943.6,,8046.72,88,,6437.38,,,0,"percent of total billed charges","88% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6298.95,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7009.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",6487.92,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5760.72,63,,4608.58,,,0,"percent of total billed charges","63% of total billed charges",1399.03,15.3,,1119.22,,,0,"percent of total billed charges","15.3% of total billed charges",6298.95,100,,,,,0,"fee schedule",EAPG,6309.36,69,,,,,0,"fee schedule","69% of total billed charges",9144,100,,7315.20,,,0,"percent of total billed charges","100% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9144,100,,7315.20,,,0,"percent of total billed charges","100% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9144,100,,7315.20,,,0,"percent of total billed charges","100% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",13976.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6298.95,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3654.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4665.89,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6424.93,100,,,,,0,"fee schedule",EAPG,8188.64,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3447.29,37.7,,2757.83,,,0,"percent of total billed charges","37.7% of total billed charges",3447.29,37.7,,2757.83,,,0,"percent of total billed charges","37.70% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3099.82,33.9,,2479.86,,,0,"percent of total billed charges","33.9% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7132.32,78,,5705.86,,,0,"percent of total billed charges","78% of total billed charges",4045.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7552.94,82.6,,6042.35,,,0,"percent of total billed charges","82.6% of total billed charges",6298.95,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7552.94,82.6,,6042.35,,,0,"percent of total billed charges","82.6% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6298.95,100,,,,,0,"fee schedule",EAPG,9144,100,,7315.20,,,0,"percent of total billed charges","100% of total billed charges",1399.03,13976.61,
"REMOVE ICD ELECT0TRANS EXTRACT",84033244,CDM,361,RC,33244,CPT,OUTPATIENT,,,10068,6544.2,,8859.84,88,,7087.87,,,0,"percent of total billed charges","88% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7009.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",1576.9,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6342.84,63,,5074.27,,,0,"percent of total billed charges","63% of total billed charges",1540.4,15.3,,1232.32,,,0,"percent of total billed charges","15.3% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,6946.92,69,,,,,0,"fee schedule","69% of total billed charges",10068,100,,8054.40,,,0,"percent of total billed charges","100% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10068,100,,8054.40,,,0,"percent of total billed charges","100% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10068,100,,8054.40,,,0,"percent of total billed charges","100% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",13976.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3654.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1134.05,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561.59,100,,,,,0,"fee schedule",EAPG,1990.26,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3795.64,37.7,,3036.51,,,0,"percent of total billed charges","37.7% of total billed charges",3795.64,37.7,,3036.51,,,0,"percent of total billed charges","37.70% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3413.05,33.9,,2730.44,,,0,"percent of total billed charges","33.9% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7853.04,78,,6282.43,,,0,"percent of total billed charges","78% of total billed charges",4045.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8316.17,82.6,,6652.94,,,0,"percent of total billed charges","82.6% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8316.17,82.6,,6652.94,,,0,"percent of total billed charges","82.6% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,10068,100,,8054.40,,,0,"percent of total billed charges","100% of total billed charges",1134.05,13976.61,
"REM/REP CVD GEN SINGLE LEAD",84033262,CDM,361,RC,33262,CPT,OUTPATIENT,,,185060,120289,,162852.8,88,,130282.24,,,0,"percent of total billed charges","88% of total billed charges",25119.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22419.38,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",42073.46,175,,,,,0,"fee schedule","175% of CMS fee schedule",23091.96,100,,,,,0,"fee schedule",EAPG,25119.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",116587.8,63,,93270.24,,,0,"percent of total billed charges","63% of total billed charges",28314.18,15.3,,22651.34,,,0,"percent of total billed charges","15.3% of total billed charges",22419.38,100,,,,,0,"fee schedule",EAPG,127691.4,69,,,,,0,"fee schedule","69% of total billed charges",185060,100,,148048.00,,,0,"percent of total billed charges","100% of total billed charges",25119.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",185060,100,,148048.00,,,0,"percent of total billed charges","100% of total billed charges",25119.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",185060,100,,148048.00,,,0,"percent of total billed charges","100% of total billed charges",25119.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",93601.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22419.38,100,,,,,0,"fee schedule",EAPG,25119.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24470.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16606.94,100,,,,,0,"fee schedule",EAPG,25119.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22867.76,100,,,,,0,"fee schedule",EAPG,29145.19,100,,,,,0,"fee schedule",EAPG,25119.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",69767.62,37.7,,55814.10,,,0,"percent of total billed charges","37.7% of total billed charges",69767.62,37.7,,55814.10,,,0,"percent of total billed charges","37.70% of total billed charges",25119.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",62735.34,33.9,,50188.27,,,0,"percent of total billed charges","33.9% of total billed charges",25119.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",144346.8,78,,115477.44,,,0,"percent of total billed charges","78% of total billed charges",25149.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",152859.56,82.6,,122287.65,,,0,"percent of total billed charges","82.6% of total billed charges",22419.38,100,,,,,0,"fee schedule",EAPG,25119.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",152859.56,82.6,,122287.65,,,0,"percent of total billed charges","82.6% of total billed charges",25119.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22419.38,100,,,,,0,"fee schedule",EAPG,185060,100,,148048.00,,,0,"percent of total billed charges","100% of total billed charges",4695,185060,
"REM/REP PM GEN DUAL LEADS",84033263,CDM,361,RC,33263,CPT,OUTPATIENT,,,49785,32360.25,,43810.8,88,,35048.64,,,0,"percent of total billed charges","88% of total billed charges",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22419.38,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",42073.46,175,,,,,0,"fee schedule","175% of CMS fee schedule",23091.96,100,,,,,0,"fee schedule",EAPG,24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31364.55,63,,25091.64,,,0,"percent of total billed charges","63% of total billed charges",7617.11,15.3,,6093.69,,,0,"percent of total billed charges","15.3% of total billed charges",22419.38,100,,,,,0,"fee schedule",EAPG,34351.65,69,,,,,0,"fee schedule","69% of total billed charges",49785,100,,39828.00,,,0,"percent of total billed charges","100% of total billed charges",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",49785,100,,39828.00,,,0,"percent of total billed charges","100% of total billed charges",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",49785,100,,39828.00,,,0,"percent of total billed charges","100% of total billed charges",24041.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",93601.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22419.38,100,,,,,0,"fee schedule",EAPG,24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24470.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16606.94,100,,,,,0,"fee schedule",EAPG,24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22867.76,100,,,,,0,"fee schedule",EAPG,29145.19,100,,,,,0,"fee schedule",EAPG,24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18768.95,37.7,,15015.16,,,0,"percent of total billed charges","37.7% of total billed charges",18768.95,37.7,,15015.16,,,0,"percent of total billed charges","37.70% of total billed charges",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16877.12,33.9,,13501.70,,,0,"percent of total billed charges","33.9% of total billed charges",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38832.3,78,,31065.84,,,0,"percent of total billed charges","78% of total billed charges",24282.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",41122.41,82.6,,32897.93,,,0,"percent of total billed charges","82.6% of total billed charges",22419.38,100,,,,,0,"fee schedule",EAPG,24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",41122.41,82.6,,32897.93,,,0,"percent of total billed charges","82.6% of total billed charges",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22419.38,100,,,,,0,"fee schedule",EAPG,49785,100,,39828.00,,,0,"percent of total billed charges","100% of total billed charges",4695,93601.39,
"REM IMPL/DEFIB/PUL/GEN RPLSAME",84033264,CDM,360,RC,33264,CPT,OUTPATIENT,,,2098,1363.7,,1846.24,88,,1476.99,,,0,"percent of total billed charges","88% of total billed charges",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22419.38,100,,,,,0,"fee schedule",EAPG,2098,100,,1678.40,,,0,"percent of total billed charges","100% of total billed charges",58722.76,175,,,,,0,"fee schedule","175% of CMS fee schedule",23091.96,100,,,,,0,"fee schedule",EAPG,33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1321.74,63,,1057.39,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",22419.38,100,,,,,0,"fee schedule",EAPG,1447.62,69,,,,,0,"fee schedule","69% of total billed charges",2098,100,,1678.40,,,0,"percent of total billed charges","100% of total billed charges",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2098,100,,1678.40,,,0,"percent of total billed charges","100% of total billed charges",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2098,100,,1678.40,,,0,"percent of total billed charges","100% of total billed charges",33555.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",133409.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22419.38,100,,,,,0,"fee schedule",EAPG,33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34878.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16606.94,100,,,,,0,"fee schedule",EAPG,33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22867.76,100,,,,,0,"fee schedule",EAPG,29145.19,100,,,,,0,"fee schedule",EAPG,33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790.95,37.7,,632.76,,,0,"percent of total billed charges","37.7% of total billed charges",790.95,37.7,,632.76,,,0,"percent of total billed charges","37.70% of total billed charges",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",711.22,33.9,,568.98,,,0,"percent of total billed charges","33.9% of total billed charges",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1636.44,78,,1309.15,,,0,"percent of total billed charges","78% of total billed charges",33891.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.95,82.6,,1386.36,,,0,"percent of total billed charges","82.6% of total billed charges",22419.38,100,,,,,0,"fee schedule",EAPG,33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.95,82.6,,1386.36,,,0,"percent of total billed charges","82.6% of total billed charges",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22419.38,100,,,,,0,"fee schedule",EAPG,2098,100,,1678.40,,,0,"percent of total billed charges","100% of total billed charges",711.22,133409.05,
"IMPLANT PAT-ACTIVE HT RECORDER",84033285,CDM,481,RC,33285,CPT,OUTPATIENT,,,28075,18248.75,,24706,88,,19764.80,,,0,"percent of total billed charges","88% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",15164.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",7701.7,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17687.25,63,,14149.80,,,0,"percent of total billed charges","63% of total billed charges",4295.48,15.3,,3436.38,,,0,"percent of total billed charges","15.3% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,19371.75,69,,,,,0,"fee schedule","69% of total billed charges",28075,100,,22460.00,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",28075,100,,22460.00,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",28075,100,,22460.00,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",33120.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8658.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5538.8,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7626.93,100,,,,,0,"fee schedule",EAPG,9720.59,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10584.28,37.7,,8467.42,,,0,"percent of total billed charges","37.7% of total billed charges",10584.28,37.7,,8467.42,,,0,"percent of total billed charges","37.70% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9517.43,33.9,,7613.94,,,0,"percent of total billed charges","33.9% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",21898.5,78,,17518.80,,,0,"percent of total billed charges","78% of total billed charges",8751.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23189.95,82.6,,18551.96,,,0,"percent of total billed charges","82.6% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23189.95,82.6,,18551.96,,,0,"percent of total billed charges","82.6% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,28075,100,,22460.00,,,0,"percent of total billed charges","100% of total billed charges",4295.48,33120.11,
"REMOVE PT ACT CARD EVENT MON",84033286,CDM,361,RC,33286,CPT,OUTPATIENT,,,1063,690.95,,935.44,88,,748.35,,,0,"percent of total billed charges","88% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,1063,100,,850.40,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",1576.9,100,,,,,0,"fee schedule",EAPG,717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",669.69,63,,535.75,,,0,"percent of total billed charges","63% of total billed charges",162.64,15.3,,130.11,,,0,"percent of total billed charges","15.3% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,733.47,69,,,,,0,"fee schedule","69% of total billed charges",1063,100,,850.40,,,0,"percent of total billed charges","100% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1063,100,,850.40,,,0,"percent of total billed charges","100% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1063,100,,850.40,,,0,"percent of total billed charges","100% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1134.05,100,,,,,0,"fee schedule",EAPG,717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561.59,100,,,,,0,"fee schedule",EAPG,1990.26,100,,,,,0,"fee schedule",EAPG,717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.75,37.7,,320.60,,,0,"percent of total billed charges","37.7% of total billed charges",400.75,37.7,,320.60,,,0,"percent of total billed charges","37.70% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",360.36,33.9,,288.29,,,0,"percent of total billed charges","33.9% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",829.14,78,,663.31,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",878.04,82.6,,702.43,,,0,"percent of total billed charges","82.6% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",878.04,82.6,,702.43,,,0,"percent of total billed charges","82.6% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,1063,100,,850.40,,,0,"percent of total billed charges","100% of total billed charges",162.64,2526.77,
"INSERT I-AORT PERCUT DEVICE",84033967,CDM,360,RC,33967,CPT,OUTPATIENT,,,1343,872.95,,1181.84,88,,945.47,,,0,"percent of total billed charges","88% of total billed charges",1343,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7477.38,100,,,,,0,"fee schedule",EAPG,1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",1343,175,,,,,0,"fee schedule","175% of CMS fee schedule",7701.7,100,,,,,0,"fee schedule",EAPG,1343,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",846.09,63,,676.87,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,926.67,69,,,,,0,"fee schedule","69% of total billed charges",1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",1343,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",1343,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",1343,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1343,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7477.38,100,,,,,0,"fee schedule",EAPG,1343,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1343,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5538.8,100,,,,,0,"fee schedule",EAPG,1343,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7626.93,100,,,,,0,"fee schedule",EAPG,9720.59,100,,,,,0,"fee schedule",EAPG,1343,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",506.31,37.7,,405.05,,,0,"percent of total billed charges","37.7% of total billed charges",506.31,37.7,,405.05,,,0,"percent of total billed charges","37.70% of total billed charges",1343,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",455.28,33.9,,364.22,,,0,"percent of total billed charges","33.9% of total billed charges",1343,100,,,,,0,"fee schedule","100% of CMS fee schedule",1047.54,78,,838.03,,,0,"percent of total billed charges","78% of total billed charges",1343,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1109.32,82.6,,887.46,,,0,"percent of total billed charges","82.6% of total billed charges",7477.38,100,,,,,0,"fee schedule","100% of WA fee schedule",1343,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1109.32,82.6,,887.46,,,0,"percent of total billed charges","82.6% of total billed charges",1343,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7477.38,100,,,,,0,"fee schedule",EAPG,1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",455.28,9720.59,
"INSERT VAD ARTERY ACCESS",84033990,CDM,361,RC,33990,CPT,OUTPATIENT,,,3148,2046.2,,2770.24,88,,2216.19,,,0,"percent of total billed charges","88% of total billed charges",3148,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",528.86,16.8,,423.09,,,0,"percent of total billed charges","16.8% of total billed charges",3148,100,,2518.40,,,0,"percent of total billed charges","100% of total billed charges",3148,175,,,,,0,"fee schedule","175% of CMS fee schedule",544.73,17.304,,435.78,,,0,"percent of total billed charges","17.304% of total billed charges",3148,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1983.24,63,,1586.59,,,0,"percent of total billed charges","63% of total billed charges",481.64,15.3,,385.31,,,0,"percent of total billed charges","15.3% of total billed charges",528.86,16.8,,423.09,,,0,"percent of total billed charges","16.8% of total billed charges",2172.12,69,,,,,0,"fee schedule","69% of total billed charges",3148,100,,2518.40,,,0,"percent of total billed charges","100% of total billed charges",3148,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3148,100,,2518.40,,,0,"percent of total billed charges","100% of total billed charges",3148,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3148,100,,2518.40,,,0,"percent of total billed charges","100% of total billed charges",3148,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3148,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",528.86,16.8,,423.09,,,0,"percent of total billed charges","16.8% of total billed charges",3148,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3148,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",528.86,16.8,,423.09,,,0,"percent of total billed charges","16.8% of total billed charges",3148,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",539.44,17.136,,431.55,,,0,"percent of total billed charges","17.136% of total billed charges",687.52,21.84,,550.02,,,0,"percent of total billed charges","21.84% of total billed charges",3148,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1186.8,37.7,,949.44,,,0,"percent of total billed charges","37.7% of total billed charges",1186.8,37.7,,949.44,,,0,"percent of total billed charges","37.70% of total billed charges",3148,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1067.17,33.9,,853.74,,,0,"percent of total billed charges","33.9% of total billed charges",3148,100,,,,,0,"fee schedule","100% of CMS fee schedule",2455.44,78,,1964.35,,,0,"percent of total billed charges","78% of total billed charges",3148,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2600.25,82.6,,2080.20,,,0,"percent of total billed charges","82.6% of total billed charges",528.86,16.8,,423.09,,,0,"percent of total billed charges","16.8% of total billed charges",3148,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2600.25,82.6,,2080.20,,,0,"percent of total billed charges","82.6% of total billed charges",3148,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",528.86,16.8,,423.09,,,0,"percent of total billed charges","16.8% of total billed charges",3148,100,,2518.40,,,0,"percent of total billed charges","100% of total billed charges",481.64,3148,
"REMOVE VAD DIFFERENT SESSION",84033992,CDM,361,RC,33992,CPT,OUTPATIENT,,,1823,1184.95,,1604.24,88,,1283.39,,,0,"percent of total billed charges","88% of total billed charges",1823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6298.95,100,,,,,0,"fee schedule",EAPG,1823,100,,1458.40,,,0,"percent of total billed charges","100% of total billed charges",1823,175,,,,,0,"fee schedule","175% of CMS fee schedule",6487.92,100,,,,,0,"fee schedule",EAPG,1823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1148.49,63,,918.79,,,0,"percent of total billed charges","63% of total billed charges",278.92,15.3,,223.14,,,0,"percent of total billed charges","15.3% of total billed charges",6298.95,100,,,,,0,"fee schedule",EAPG,1257.87,69,,,,,0,"fee schedule","69% of total billed charges",1823,100,,1458.40,,,0,"percent of total billed charges","100% of total billed charges",1823,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1823,100,,1458.40,,,0,"percent of total billed charges","100% of total billed charges",1823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1823,100,,1458.40,,,0,"percent of total billed charges","100% of total billed charges",1823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6298.95,100,,,,,0,"fee schedule",EAPG,1823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4665.89,100,,,,,0,"fee schedule",EAPG,1823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6424.93,100,,,,,0,"fee schedule",EAPG,8188.64,100,,,,,0,"fee schedule",EAPG,1823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",687.27,37.7,,549.82,,,0,"percent of total billed charges","37.7% of total billed charges",687.27,37.7,,549.82,,,0,"percent of total billed charges","37.70% of total billed charges",1823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",618,33.9,,494.40,,,0,"percent of total billed charges","33.9% of total billed charges",1823,100,,,,,0,"fee schedule","100% of CMS fee schedule",1421.94,78,,1137.55,,,0,"percent of total billed charges","78% of total billed charges",1823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1505.8,82.6,,1204.64,,,0,"percent of total billed charges","82.6% of total billed charges",6298.95,100,,,,,0,"fee schedule",EAPG,1823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1505.8,82.6,,1204.64,,,0,"percent of total billed charges","82.6% of total billed charges",1823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6298.95,100,,,,,0,"fee schedule",EAPG,1823,100,,1458.40,,,0,"percent of total billed charges","100% of total billed charges",278.92,8188.64,
"REPOSITION VAD DIFF SESSION",84033993,CDM,360,RC,33993,CPT,OUTPATIENT,,,1823,1184.95,,1604.24,88,,1283.39,,,0,"percent of total billed charges","88% of total billed charges",1823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6298.95,100,,,,,0,"fee schedule",EAPG,1823,100,,1458.40,,,0,"percent of total billed charges","100% of total billed charges",1823,175,,,,,0,"fee schedule","175% of CMS fee schedule",6487.92,100,,,,,0,"fee schedule",EAPG,1823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1148.49,63,,918.79,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",6298.95,100,,,,,0,"fee schedule",EAPG,1257.87,69,,,,,0,"fee schedule","69% of total billed charges",1823,100,,1458.40,,,0,"percent of total billed charges","100% of total billed charges",1823,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1823,100,,1458.40,,,0,"percent of total billed charges","100% of total billed charges",1823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1823,100,,1458.40,,,0,"percent of total billed charges","100% of total billed charges",1823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6298.95,100,,,,,0,"fee schedule",EAPG,1823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4665.89,100,,,,,0,"fee schedule",EAPG,1823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6424.93,100,,,,,0,"fee schedule",EAPG,8188.64,100,,,,,0,"fee schedule",EAPG,1823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",687.27,37.7,,549.82,,,0,"percent of total billed charges","37.7% of total billed charges",687.27,37.7,,549.82,,,0,"percent of total billed charges","37.70% of total billed charges",1823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",618,33.9,,494.40,,,0,"percent of total billed charges","33.9% of total billed charges",1823,100,,,,,0,"fee schedule","100% of CMS fee schedule",1421.94,78,,1137.55,,,0,"percent of total billed charges","78% of total billed charges",1823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1505.8,82.6,,1204.64,,,0,"percent of total billed charges","82.6% of total billed charges",6298.95,100,,,,,0,"fee schedule",EAPG,1823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1505.8,82.6,,1204.64,,,0,"percent of total billed charges","82.6% of total billed charges",1823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6298.95,100,,,,,0,"fee schedule",EAPG,1823,100,,1458.40,,,0,"percent of total billed charges","100% of total billed charges",618,8188.64,
"INJ TREAT PSEUDOANEURYSM",84036002,CDM,361,RC,36002,CPT,OUTPATIENT,,,664,431.6,,584.32,88,,467.46,,,0,"percent of total billed charges","88% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.06,100,,,,,0,"fee schedule",EAPG,664,100,,531.20,,,0,"percent of total billed charges","100% of total billed charges",1121.3,175,,,,,0,"fee schedule","175% of CMS fee schedule",781.83,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.32,63,,334.66,,,0,"percent of total billed charges","63% of total billed charges",101.59,15.3,,81.27,,,0,"percent of total billed charges","15.3% of total billed charges",759.06,100,,,,,0,"fee schedule",EAPG,458.16,69,,,,,0,"fee schedule","69% of total billed charges",664,100,,531.20,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",664,100,,531.20,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",664,100,,531.20,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",2200.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.06,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",575.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",562.26,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",774.24,100,,,,,0,"fee schedule",EAPG,986.78,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.33,37.7,,200.26,,,0,"percent of total billed charges","37.7% of total billed charges",250.33,37.7,,200.26,,,0,"percent of total billed charges","37.70% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",225.1,33.9,,180.08,,,0,"percent of total billed charges","33.9% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",517.92,78,,414.34,,,0,"percent of total billed charges","78% of total billed charges",647.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",548.46,82.6,,438.77,,,0,"percent of total billed charges","82.6% of total billed charges",759.06,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",548.46,82.6,,438.77,,,0,"percent of total billed charges","82.6% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.06,100,,,,,0,"fee schedule",EAPG,664,100,,531.20,,,0,"percent of total billed charges","100% of total billed charges",101.59,2200.34,
"INJ PROC CONTRAST VENOGRAPHY",84036005,CDM,361,RC,36005,CPT,OUTPATIENT,,,761,494.65,,669.68,88,,535.74,,,0,"percent of total billed charges","88% of total billed charges",380.5,50,,304.40,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,761,100,,608.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",479.43,63,,383.54,,,0,"percent of total billed charges","63% of total billed charges",116.43,15.3,,93.14,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,525.09,69,,,,,0,"fee schedule","69% of total billed charges",761,100,,608.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",761,100,,608.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",761,100,,608.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.68,61.85,,376.54,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,380.5,50,,304.40,,,0,"percent of total billed charges","50% of total billed charges",245.04,32.2,,196.03,,,0,"percent of total billed charges","32.2% of total billed charges",424.13,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",286.9,37.7,,229.52,,,0,"percent of total billed charges","37.7% of total billed charges",286.9,37.7,,229.52,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",257.98,33.9,,206.38,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",593.58,78,,474.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",628.59,82.6,,502.87,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,380.5,50,,304.40,,,0,"percent of total billed charges","50% of total billed charges",628.59,82.6,,502.87,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",572.57,100,,,,,0,"fee schedule",EAPG,761,100,,608.80,,,0,"percent of total billed charges","100% of total billed charges",116.43,761,
"INTRO CATH SUP/INF VENA CAVA",84036010,CDM,361,RC,36010,CPT,OUTPATIENT,,,2541,1651.65,,2236.08,88,,1788.86,,,0,"percent of total billed charges","88% of total billed charges",1270.5,50,,1016.40,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,2541,100,,2032.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1600.83,63,,1280.66,,,0,"percent of total billed charges","63% of total billed charges",388.77,15.3,,311.02,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,1753.29,69,,,,,0,"fee schedule","69% of total billed charges",2541,100,,2032.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2541,100,,2032.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2541,100,,2032.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1571.61,61.85,,1257.29,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,1270.5,50,,1016.40,,,0,"percent of total billed charges","50% of total billed charges",818.2,32.2,,654.56,,,0,"percent of total billed charges","32.2% of total billed charges",424.13,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",957.96,37.7,,766.37,,,0,"percent of total billed charges","37.7% of total billed charges",957.96,37.7,,766.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",861.4,33.9,,689.12,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1981.98,78,,1585.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2098.87,82.6,,1679.10,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,1270.5,50,,1016.40,,,0,"percent of total billed charges","50% of total billed charges",2098.87,82.6,,1679.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",572.57,100,,,,,0,"fee schedule",EAPG,2541,100,,2032.80,,,0,"percent of total billed charges","100% of total billed charges",388.77,2541,
"PLACE CATHETER IN VEIN",84036011,CDM,360,RC,36011,CPT,OUTPATIENT,,,798,518.7,,702.24,88,,561.79,,,0,"percent of total billed charges","88% of total billed charges",399,50,,319.20,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,798,100,,638.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",502.74,63,,402.19,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,550.62,69,,,,,0,"fee schedule","69% of total billed charges",798,100,,638.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",798,100,,638.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",798,100,,638.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",493.56,61.85,,394.85,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,399,50,,319.20,,,0,"percent of total billed charges","50% of total billed charges",256.96,32.2,,205.57,,,0,"percent of total billed charges","32.2% of total billed charges",424.13,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",300.85,37.7,,240.68,,,0,"percent of total billed charges","37.7% of total billed charges",300.85,37.7,,240.68,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",270.52,33.9,,216.42,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",622.44,78,,497.95,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",659.15,82.6,,527.32,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,399,50,,319.20,,,0,"percent of total billed charges","50% of total billed charges",659.15,82.6,,527.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",572.57,100,,,,,0,"fee schedule",EAPG,798,100,,638.40,,,0,"percent of total billed charges","100% of total billed charges",256.96,3367,
"CATH PLC VENOUSE 2ND ORD/SEL",84036012,CDM,360,RC,36012,CPT,OUTPATIENT,,,1090,708.5,,959.2,88,,767.36,,,0,"percent of total billed charges","88% of total billed charges",545,50,,436.00,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,1090,100,,872.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",686.7,63,,549.36,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,752.1,69,,,,,0,"fee schedule","69% of total billed charges",1090,100,,872.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1090,100,,872.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1090,100,,872.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.17,61.85,,539.34,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,545,50,,436.00,,,0,"percent of total billed charges","50% of total billed charges",350.98,32.2,,280.78,,,0,"percent of total billed charges","32.2% of total billed charges",424.13,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",410.93,37.7,,328.74,,,0,"percent of total billed charges","37.7% of total billed charges",410.93,37.7,,328.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",369.51,33.9,,295.61,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",850.2,78,,680.16,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",900.34,82.6,,720.27,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,545,50,,436.00,,,0,"percent of total billed charges","50% of total billed charges",900.34,82.6,,720.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",572.57,100,,,,,0,"fee schedule",EAPG,1090,100,,872.00,,,0,"percent of total billed charges","100% of total billed charges",350.98,3367,
"INTRO CATH MAIN PULMON ARTERY",84036013,CDM,361,RC,36013,CPT,OUTPATIENT,,,2353,1529.45,,2070.64,88,,1656.51,,,0,"percent of total billed charges","88% of total billed charges",1176.5,50,,941.20,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,2353,100,,1882.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1482.39,63,,1185.91,,,0,"percent of total billed charges","63% of total billed charges",360.01,15.3,,288.01,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,1623.57,69,,,,,0,"fee schedule","69% of total billed charges",2353,100,,1882.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2353,100,,1882.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2353,100,,1882.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1455.33,61.85,,1164.26,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,1176.5,50,,941.20,,,0,"percent of total billed charges","50% of total billed charges",757.67,32.2,,606.14,,,0,"percent of total billed charges","32.2% of total billed charges",424.13,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",887.08,37.7,,709.66,,,0,"percent of total billed charges","37.7% of total billed charges",887.08,37.7,,709.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",797.67,33.9,,638.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1835.34,78,,1468.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1943.58,82.6,,1554.86,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,1176.5,50,,941.20,,,0,"percent of total billed charges","50% of total billed charges",1943.58,82.6,,1554.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",572.57,100,,,,,0,"fee schedule",EAPG,2353,100,,1882.40,,,0,"percent of total billed charges","100% of total billed charges",360.01,2353,
"SELECT CATH PLMT LT/RT PULM",84036014,CDM,361,RC,36014,CPT,OUTPATIENT,,,2353,1529.45,,2070.64,88,,1656.51,,,0,"percent of total billed charges","88% of total billed charges",1176.5,50,,941.20,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,2353,100,,1882.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1482.39,63,,1185.91,,,0,"percent of total billed charges","63% of total billed charges",360.01,15.3,,288.01,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,1623.57,69,,,,,0,"fee schedule","69% of total billed charges",2353,100,,1882.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2353,100,,1882.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2353,100,,1882.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1455.33,61.85,,1164.26,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,1176.5,50,,941.20,,,0,"percent of total billed charges","50% of total billed charges",757.67,32.2,,606.14,,,0,"percent of total billed charges","32.2% of total billed charges",424.13,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",887.08,37.7,,709.66,,,0,"percent of total billed charges","37.7% of total billed charges",887.08,37.7,,709.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",797.67,33.9,,638.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1835.34,78,,1468.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1943.58,82.6,,1554.86,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,1176.5,50,,941.20,,,0,"percent of total billed charges","50% of total billed charges",1943.58,82.6,,1554.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",572.57,100,,,,,0,"fee schedule",EAPG,2353,100,,1882.40,,,0,"percent of total billed charges","100% of total billed charges",360.01,2353,
"SELCT CATH PLMT SEG/SUBSEG",84036015,CDM,361,RC,36015,CPT,OUTPATIENT,,,2975,1933.75,,2618,88,,2094.40,,,0,"percent of total billed charges","88% of total billed charges",1487.5,50,,1190.00,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,2975,100,,2380.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1874.25,63,,1499.40,,,0,"percent of total billed charges","63% of total billed charges",455.18,15.3,,364.14,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,2052.75,69,,,,,0,"fee schedule","69% of total billed charges",2975,100,,2380.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2975,100,,2380.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2975,100,,2380.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1840.04,61.85,,1472.03,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,1487.5,50,,1190.00,,,0,"percent of total billed charges","50% of total billed charges",957.95,32.2,,766.36,,,0,"percent of total billed charges","32.2% of total billed charges",424.13,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1121.58,37.7,,897.26,,,0,"percent of total billed charges","37.7% of total billed charges",1121.58,37.7,,897.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1008.53,33.9,,806.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2320.5,78,,1856.40,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2457.35,82.6,,1965.88,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,1487.5,50,,1190.00,,,0,"percent of total billed charges","50% of total billed charges",2457.35,82.6,,1965.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",572.57,100,,,,,0,"fee schedule",EAPG,2975,100,,2380.00,,,0,"percent of total billed charges","100% of total billed charges",424.13,2975,
"INTRO NDL/CATH BRACH ART",84036140,CDM,361,RC,36140,CPT,OUTPATIENT,,,1544,1003.6,,1358.72,88,,1086.98,,,0,"percent of total billed charges","88% of total billed charges",772,50,,617.60,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,1544,100,,1235.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",972.72,63,,778.18,,,0,"percent of total billed charges","63% of total billed charges",236.23,15.3,,188.98,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,1065.36,69,,,,,0,"fee schedule","69% of total billed charges",1544,100,,1235.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1544,100,,1235.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1544,100,,1235.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",954.96,61.85,,763.97,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,772,50,,617.60,,,0,"percent of total billed charges","50% of total billed charges",497.17,32.2,,397.74,,,0,"percent of total billed charges","32.2% of total billed charges",424.13,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",582.09,37.7,,465.67,,,0,"percent of total billed charges","37.7% of total billed charges",582.09,37.7,,465.67,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",523.42,33.9,,418.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1204.32,78,,963.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1275.34,82.6,,1020.27,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,772,50,,617.60,,,0,"percent of total billed charges","50% of total billed charges",1275.34,82.6,,1020.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",572.57,100,,,,,0,"fee schedule",EAPG,1544,100,,1235.20,,,0,"percent of total billed charges","100% of total billed charges",236.23,1544,
"PLACE CATHETER IN AORTA",84036200,CDM,360,RC,36200,CPT,OUTPATIENT,,,722,469.3,,635.36,88,,508.29,,,0,"percent of total billed charges","88% of total billed charges",361,50,,288.80,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,722,100,,577.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",454.86,63,,363.89,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,498.18,69,,,,,0,"fee schedule","69% of total billed charges",722,100,,577.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",722,100,,577.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",722,100,,577.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",446.56,61.85,,357.25,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,361,50,,288.80,,,0,"percent of total billed charges","50% of total billed charges",232.48,32.2,,185.98,,,0,"percent of total billed charges","32.2% of total billed charges",424.13,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",272.19,37.7,,217.75,,,0,"percent of total billed charges","37.7% of total billed charges",272.19,37.7,,217.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",244.76,33.9,,195.81,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",563.16,78,,450.53,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",596.37,82.6,,477.10,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,361,50,,288.80,,,0,"percent of total billed charges","50% of total billed charges",596.37,82.6,,477.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",572.57,100,,,,,0,"fee schedule",EAPG,722,100,,577.60,,,0,"percent of total billed charges","100% of total billed charges",232.48,3367,
"SEL CATH PLMT BRACHIO 1ST ORD",84036215,CDM,361,RC,36215,CPT,OUTPATIENT,,,4857,3157.05,,4274.16,88,,3419.33,,,0,"percent of total billed charges","88% of total billed charges",2428.5,50,,1942.80,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3059.91,63,,2447.93,,,0,"percent of total billed charges","63% of total billed charges",743.12,15.3,,594.50,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,3351.33,69,,,,,0,"fee schedule","69% of total billed charges",4857,100,,3885.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4857,100,,3885.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4857,100,,3885.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3004.05,61.85,,2403.24,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,2428.5,50,,1942.80,,,0,"percent of total billed charges","50% of total billed charges",1563.95,32.2,,1251.16,,,0,"percent of total billed charges","32.2% of total billed charges",424.13,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1831.09,37.7,,1464.87,,,0,"percent of total billed charges","37.7% of total billed charges",1831.09,37.7,,1464.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1646.52,33.9,,1317.22,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3788.46,78,,3030.77,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4011.88,82.6,,3209.50,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,2428.5,50,,1942.80,,,0,"percent of total billed charges","50% of total billed charges",4011.88,82.6,,3209.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",572.57,100,,,,,0,"fee schedule",EAPG,4857,100,,3885.60,,,0,"percent of total billed charges","100% of total billed charges",424.13,4857,
"SEL CATH PLMT BRACHIO 2ND",84036216,CDM,361,RC,36216,CPT,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",424.13,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",572.57,100,,,,,0,"fee schedule",EAPG,1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"SEL CATH PLMT BRACHIO 3RD ORD",84036217,CDM,361,RC,36217,CPT,OUTPATIENT,,,6104,3967.6,,5371.52,88,,4297.22,,,0,"percent of total billed charges","88% of total billed charges",3052,50,,2441.60,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3845.52,63,,3076.42,,,0,"percent of total billed charges","63% of total billed charges",933.91,15.3,,747.13,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,4211.76,69,,,,,0,"fee schedule","69% of total billed charges",6104,100,,4883.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6104,100,,4883.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6104,100,,4883.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3775.32,61.85,,3020.26,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,3052,50,,2441.60,,,0,"percent of total billed charges","50% of total billed charges",1965.49,32.2,,1572.39,,,0,"percent of total billed charges","32.2% of total billed charges",424.13,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2301.21,37.7,,1840.97,,,0,"percent of total billed charges","37.7% of total billed charges",2301.21,37.7,,1840.97,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2069.26,33.9,,1655.41,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4761.12,78,,3808.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5041.9,82.6,,4033.52,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,3052,50,,2441.60,,,0,"percent of total billed charges","50% of total billed charges",5041.9,82.6,,4033.52,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",572.57,100,,,,,0,"fee schedule",EAPG,6104,100,,4883.20,,,0,"percent of total billed charges","100% of total billed charges",424.13,6104,
"SEL CATH PLMT BRACHIO 2ND ORD",84036218,CDM,361,RC,36218,CPT,OUTPATIENT,,,4987,3241.55,,4388.56,88,,3510.85,,,0,"percent of total billed charges","88% of total billed charges",2493.5,50,,1994.80,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3141.81,63,,2513.45,,,0,"percent of total billed charges","63% of total billed charges",763.01,15.3,,610.41,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,3441.03,69,,,,,0,"fee schedule","69% of total billed charges",4987,100,,3989.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4987,100,,3989.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4987,100,,3989.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3084.46,61.85,,2467.57,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,2493.5,50,,1994.80,,,0,"percent of total billed charges","50% of total billed charges",1605.81,32.2,,1284.65,,,0,"percent of total billed charges","32.2% of total billed charges",424.13,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1880.1,37.7,,1504.08,,,0,"percent of total billed charges","37.7% of total billed charges",1880.1,37.7,,1504.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1690.59,33.9,,1352.47,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3889.86,78,,3111.89,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4119.26,82.6,,3295.41,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,2493.5,50,,1994.80,,,0,"percent of total billed charges","50% of total billed charges",4119.26,82.6,,3295.41,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",572.57,100,,,,,0,"fee schedule",EAPG,4987,100,,3989.60,,,0,"percent of total billed charges","100% of total billed charges",424.13,4987,
"PLACE CATH INOM ART W CCA",84036222,CDM,361,RC,36222,CPT,OUTPATIENT,,,10164,6606.6,,8944.32,88,,7155.46,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5689.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",3820.51,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6403.32,63,,5122.66,,,0,"percent of total billed charges","63% of total billed charges",1555.09,15.3,,1244.07,,,0,"percent of total billed charges","15.3% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,7013.16,69,,,,,0,"fee schedule","69% of total billed charges",10164,100,,8131.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10164,100,,8131.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10164,100,,8131.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2747.58,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3783.42,100,,,,,0,"fee schedule",EAPG,4822.01,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3831.83,37.7,,3065.46,,,0,"percent of total billed charges","37.7% of total billed charges",3831.83,37.7,,3065.46,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3445.6,33.9,,2756.48,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7927.92,78,,6342.34,,,0,"percent of total billed charges","78% of total billed charges",3283.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8395.46,82.6,,6716.37,,,0,"percent of total billed charges","82.6% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8395.46,82.6,,6716.37,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,10164,100,,8131.20,,,0,"percent of total billed charges","100% of total billed charges",1555.09,11625.58,
"PLACE CATH INOM ART W CCA BI",84036223,CDM,361,RC,36223,CPT,OUTPATIENT,,,17511,11382.15,,15409.68,88,,12327.74,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3820.51,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11031.93,63,,8825.54,,,0,"percent of total billed charges","63% of total billed charges",2679.18,15.3,,2143.34,,,0,"percent of total billed charges","15.3% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,12082.59,69,,,,,0,"fee schedule","69% of total billed charges",17511,100,,14008.80,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17511,100,,14008.80,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17511,100,,14008.80,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2747.58,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3783.42,100,,,,,0,"fee schedule",EAPG,4822.01,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6601.65,37.7,,5281.32,,,0,"percent of total billed charges","37.7% of total billed charges",6601.65,37.7,,5281.32,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5936.23,33.9,,4748.98,,,0,"percent of total billed charges","33.9% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13658.58,78,,10926.86,,,0,"percent of total billed charges","78% of total billed charges",5661.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14464.09,82.6,,11571.27,,,0,"percent of total billed charges","82.6% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14464.09,82.6,,11571.27,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,17511,100,,14008.80,,,0,"percent of total billed charges","100% of total billed charges",2679.18,19379.78,
"PLACE CATH CAROTID ART",84036224,CDM,361,RC,36224,CPT,OUTPATIENT,,,17808,11575.2,,15671.04,88,,12536.83,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3820.51,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11219.04,63,,8975.23,,,0,"percent of total billed charges","63% of total billed charges",2724.62,15.3,,2179.70,,,0,"percent of total billed charges","15.3% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,12287.52,69,,,,,0,"fee schedule","69% of total billed charges",17808,100,,14246.40,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17808,100,,14246.40,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17808,100,,14246.40,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2747.58,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3783.42,100,,,,,0,"fee schedule",EAPG,4822.01,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6713.62,37.7,,5370.90,,,0,"percent of total billed charges","37.7% of total billed charges",6713.62,37.7,,5370.90,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6036.91,33.9,,4829.53,,,0,"percent of total billed charges","33.9% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13890.24,78,,11112.19,,,0,"percent of total billed charges","78% of total billed charges",5661.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14709.41,82.6,,11767.53,,,0,"percent of total billed charges","82.6% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14709.41,82.6,,11767.53,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,17808,100,,14246.40,,,0,"percent of total billed charges","100% of total billed charges",2724.62,19379.78,
"PLACE CATH SUBCLAVIAN ART BI",84036225,CDM,361,RC,36225,CPT,OUTPATIENT,,,17516,11385.4,,15414.08,88,,12331.26,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5689.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",3820.51,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11035.08,63,,8828.06,,,0,"percent of total billed charges","63% of total billed charges",2679.95,15.3,,2143.96,,,0,"percent of total billed charges","15.3% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,12086.04,69,,,,,0,"fee schedule","69% of total billed charges",17516,100,,14012.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17516,100,,14012.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17516,100,,14012.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2747.58,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3783.42,100,,,,,0,"fee schedule",EAPG,4822.01,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6603.53,37.7,,5282.82,,,0,"percent of total billed charges","37.7% of total billed charges",6603.53,37.7,,5282.82,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5937.92,33.9,,4750.34,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13662.48,78,,10929.98,,,0,"percent of total billed charges","78% of total billed charges",3283.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14468.22,82.6,,11574.58,,,0,"percent of total billed charges","82.6% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14468.22,82.6,,11574.58,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,17516,100,,14012.80,,,0,"percent of total billed charges","100% of total billed charges",2679.95,17516,
"PLACE CATH VERTEBRAL ART",84036226,CDM,361,RC,36226,CPT,OUTPATIENT,,,17808,11575.2,,15671.04,88,,12536.83,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3820.51,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11219.04,63,,8975.23,,,0,"percent of total billed charges","63% of total billed charges",2724.62,15.3,,2179.70,,,0,"percent of total billed charges","15.3% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,12287.52,69,,,,,0,"fee schedule","69% of total billed charges",17808,100,,14246.40,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17808,100,,14246.40,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17808,100,,14246.40,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2747.58,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3783.42,100,,,,,0,"fee schedule",EAPG,4822.01,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6713.62,37.7,,5370.90,,,0,"percent of total billed charges","37.7% of total billed charges",6713.62,37.7,,5370.90,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6036.91,33.9,,4829.53,,,0,"percent of total billed charges","33.9% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13890.24,78,,11112.19,,,0,"percent of total billed charges","78% of total billed charges",5661.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14709.41,82.6,,11767.53,,,0,"percent of total billed charges","82.6% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14709.41,82.6,,11767.53,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,17808,100,,14246.40,,,0,"percent of total billed charges","100% of total billed charges",2724.62,19379.78,
"SEL CATH PLMT FEM 1ST ORD SURG",84036245,CDM,481,RC,36245,CPT,OUTPATIENT,,,3952,2568.8,,3477.76,88,,2782.21,,,0,"percent of total billed charges","88% of total billed charges",1976,50,,1580.80,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,3952,100,,3161.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2489.76,63,,1991.81,,,0,"percent of total billed charges","63% of total billed charges",604.66,15.3,,483.73,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,2726.88,69,,,,,0,"fee schedule","69% of total billed charges",3952,100,,3161.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3952,100,,3161.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3952,100,,3161.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2444.31,61.85,,1955.45,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,1976,50,,1580.80,,,0,"percent of total billed charges","50% of total billed charges",1272.54,32.2,,1018.03,,,0,"percent of total billed charges","32.2% of total billed charges",424.13,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1489.9,37.7,,1191.92,,,0,"percent of total billed charges","37.7% of total billed charges",1489.9,37.7,,1191.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339.73,33.9,,1071.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3082.56,78,,2466.05,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3264.35,82.6,,2611.48,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,1976,50,,1580.80,,,0,"percent of total billed charges","50% of total billed charges",3264.35,82.6,,2611.48,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",572.57,100,,,,,0,"fee schedule",EAPG,3952,100,,3161.60,,,0,"percent of total billed charges","100% of total billed charges",424.13,3952,
"SELECTIVE CATH SECOND ORDER",84036246,CDM,360,RC,36246,CPT,OUTPATIENT,,,5008,3255.2,,4407.04,88,,3525.63,,,0,"percent of total billed charges","88% of total billed charges",2504,50,,2003.20,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3155.04,63,,2524.03,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,3455.52,69,,,,,0,"fee schedule","69% of total billed charges",5008,100,,4006.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5008,100,,4006.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5008,100,,4006.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3097.45,61.85,,2477.96,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,2504,50,,2003.20,,,0,"percent of total billed charges","50% of total billed charges",1612.58,32.2,,1290.06,,,0,"percent of total billed charges","32.2% of total billed charges",424.13,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1888.02,37.7,,1510.42,,,0,"percent of total billed charges","37.7% of total billed charges",1888.02,37.7,,1510.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1697.71,33.9,,1358.17,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3906.24,78,,3124.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4136.61,82.6,,3309.29,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,2504,50,,2003.20,,,0,"percent of total billed charges","50% of total billed charges",4136.61,82.6,,3309.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",572.57,100,,,,,0,"fee schedule",EAPG,5008,100,,4006.40,,,0,"percent of total billed charges","100% of total billed charges",424.13,5008,
"SEL CATH PLACE ART SYS 3RD ORD",84036247,CDM,360,RC,36247,CPT,OUTPATIENT,,,1634,1062.1,,1437.92,88,,1150.34,,,0,"percent of total billed charges","88% of total billed charges",817,50,,653.60,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,1634,100,,1307.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1029.42,63,,823.54,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,1127.46,69,,,,,0,"fee schedule","69% of total billed charges",1634,100,,1307.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1634,100,,1307.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1634,100,,1307.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1010.63,61.85,,808.50,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,817,50,,653.60,,,0,"percent of total billed charges","50% of total billed charges",526.15,32.2,,420.92,,,0,"percent of total billed charges","32.2% of total billed charges",424.13,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",616.02,37.7,,492.82,,,0,"percent of total billed charges","37.7% of total billed charges",616.02,37.7,,492.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.93,33.9,,443.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1274.52,78,,1019.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.68,82.6,,1079.74,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,817,50,,653.60,,,0,"percent of total billed charges","50% of total billed charges",1349.68,82.6,,1079.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",572.57,100,,,,,0,"fee schedule",EAPG,1634,100,,1307.20,,,0,"percent of total billed charges","100% of total billed charges",424.13,3367,
"CATH EA ADD 2/3RD ABD/PELVIC",84036248,CDM,361,RC,36248,CPT,OUTPATIENT,,,837,544.05,,736.56,88,,589.25,,,0,"percent of total billed charges","88% of total billed charges",418.5,50,,334.80,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,837,100,,669.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",527.31,63,,421.85,,,0,"percent of total billed charges","63% of total billed charges",128.06,15.3,,102.45,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,577.53,69,,,,,0,"fee schedule","69% of total billed charges",837,100,,669.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",837,100,,669.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",837,100,,669.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",517.68,61.85,,414.14,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,418.5,50,,334.80,,,0,"percent of total billed charges","50% of total billed charges",269.51,32.2,,215.61,,,0,"percent of total billed charges","32.2% of total billed charges",424.13,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",315.55,37.7,,252.44,,,0,"percent of total billed charges","37.7% of total billed charges",315.55,37.7,,252.44,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",283.74,33.9,,226.99,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",652.86,78,,522.29,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",691.36,82.6,,553.09,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,418.5,50,,334.80,,,0,"percent of total billed charges","50% of total billed charges",691.36,82.6,,553.09,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",572.57,100,,,,,0,"fee schedule",EAPG,837,100,,669.60,,,0,"percent of total billed charges","100% of total billed charges",128.06,837,
"INS CATH REN ART 1ST UNILAT",84036251,CDM,481,RC,36251,CPT,OUTPATIENT,,,14318,9306.7,,12599.84,88,,10079.87,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5689.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",3820.51,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9020.34,63,,7216.27,,,0,"percent of total billed charges","63% of total billed charges",2190.65,15.3,,1752.52,,,0,"percent of total billed charges","15.3% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,9879.42,69,,,,,0,"fee schedule","69% of total billed charges",14318,100,,11454.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14318,100,,11454.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14318,100,,11454.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2747.58,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3783.42,100,,,,,0,"fee schedule",EAPG,4822.01,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5397.89,37.7,,4318.31,,,0,"percent of total billed charges","37.7% of total billed charges",5397.89,37.7,,4318.31,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4853.8,33.9,,3883.04,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11168.04,78,,8934.43,,,0,"percent of total billed charges","78% of total billed charges",3283.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11826.67,82.6,,9461.34,,,0,"percent of total billed charges","82.6% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11826.67,82.6,,9461.34,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,14318,100,,11454.40,,,0,"percent of total billed charges","100% of total billed charges",2190.65,14318,
"INS CATH REN ART 1ST BILAT",84036252,CDM,361,RC,36252,CPT,OUTPATIENT,,,14318,9306.7,,12599.84,88,,10079.87,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5689.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",3820.51,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9020.34,63,,7216.27,,,0,"percent of total billed charges","63% of total billed charges",2190.65,15.3,,1752.52,,,0,"percent of total billed charges","15.3% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,9879.42,69,,,,,0,"fee schedule","69% of total billed charges",14318,100,,11454.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14318,100,,11454.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14318,100,,11454.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2747.58,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3783.42,100,,,,,0,"fee schedule",EAPG,4822.01,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5397.89,37.7,,4318.31,,,0,"percent of total billed charges","37.7% of total billed charges",5397.89,37.7,,4318.31,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4853.8,33.9,,3883.04,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11168.04,78,,8934.43,,,0,"percent of total billed charges","78% of total billed charges",3283.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11826.67,82.6,,9461.34,,,0,"percent of total billed charges","82.6% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11826.67,82.6,,9461.34,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,14318,100,,11454.40,,,0,"percent of total billed charges","100% of total billed charges",2190.65,14318,
"INS CATH REN ART 2ND + UNILAT",84036253,CDM,361,RC,36253,CPT,OUTPATIENT,,,16106,10468.9,,14173.28,88,,11338.62,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3820.51,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10146.78,63,,8117.42,,,0,"percent of total billed charges","63% of total billed charges",2464.22,15.3,,1971.38,,,0,"percent of total billed charges","15.3% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,11113.14,69,,,,,0,"fee schedule","69% of total billed charges",16106,100,,12884.80,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16106,100,,12884.80,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16106,100,,12884.80,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2747.58,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3783.42,100,,,,,0,"fee schedule",EAPG,4822.01,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6071.96,37.7,,4857.57,,,0,"percent of total billed charges","37.7% of total billed charges",6071.96,37.7,,4857.57,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5459.93,33.9,,4367.94,,,0,"percent of total billed charges","33.9% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",12562.68,78,,10050.14,,,0,"percent of total billed charges","78% of total billed charges",5661.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13303.56,82.6,,10642.85,,,0,"percent of total billed charges","82.6% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13303.56,82.6,,10642.85,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,16106,100,,12884.80,,,0,"percent of total billed charges","100% of total billed charges",2464.22,19379.78,
"INS CATH REN ART 2ND + BILAT",84036254,CDM,361,RC,36254,CPT,OUTPATIENT,,,16106,10468.9,,14173.28,88,,11338.62,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5689.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",3820.51,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10146.78,63,,8117.42,,,0,"percent of total billed charges","63% of total billed charges",2464.22,15.3,,1971.38,,,0,"percent of total billed charges","15.3% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,11113.14,69,,,,,0,"fee schedule","69% of total billed charges",16106,100,,12884.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16106,100,,12884.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16106,100,,12884.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2747.58,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3783.42,100,,,,,0,"fee schedule",EAPG,4822.01,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6071.96,37.7,,4857.57,,,0,"percent of total billed charges","37.7% of total billed charges",6071.96,37.7,,4857.57,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5459.93,33.9,,4367.94,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",12562.68,78,,10050.14,,,0,"percent of total billed charges","78% of total billed charges",3283.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13303.56,82.6,,10642.85,,,0,"percent of total billed charges","82.6% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13303.56,82.6,,10642.85,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,16106,100,,12884.80,,,0,"percent of total billed charges","100% of total billed charges",2464.22,16106,
"36410 - Venipuncture, Age 3 Years or Older",76136410,CDM,761,RC,36410,CPT,OUTPATIENT,,,269,174.85,,236.72,88,,189.38,,,0,"percent of total billed charges","88% of total billed charges",134.5,50,,107.60,,,0,"percent of total billed charges","50% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54.44,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.16,15.3,,32.93,,,0,"percent of total billed charges","15.3% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,185.61,69,,,,,0,"fee schedule","69% of total billed charges",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.38,61.85,,133.10,,,0,"percent of total billed charges","61.5% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,134.5,50,,107.60,,,0,"percent of total billed charges","50% of total billed charges",86.62,32.2,,69.30,,,0,"percent of total billed charges","32.2% of total billed charges",39.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",53.92,100,,,,,0,"fee schedule",EAPG,68.72,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",101.41,37.7,,81.13,,,0,"percent of total billed charges","37.7% of total billed charges",101.41,37.7,,81.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.19,33.9,,72.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.82,78,,167.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",222.19,82.6,,177.75,,,0,"percent of total billed charges","82.6% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,134.5,50,,107.60,,,0,"percent of total billed charges","50% of total billed charges",222.19,82.6,,177.75,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.86,100,,,,,0,"fee schedule",EAPG,269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",39.15,269,
"CATH PORTAL VEIN PERC",84036481,CDM,361,RC,36481,CPT,OUTPATIENT,,,494,321.1,,434.72,88,,347.78,,,0,"percent of total billed charges","88% of total billed charges",247,50,,197.60,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,494,100,,395.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",311.22,63,,248.98,,,0,"percent of total billed charges","63% of total billed charges",75.58,15.3,,60.46,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,340.86,69,,,,,0,"fee schedule","69% of total billed charges",494,100,,395.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",494,100,,395.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",494,100,,395.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",305.54,61.85,,244.43,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,247,50,,197.60,,,0,"percent of total billed charges","50% of total billed charges",159.07,32.2,,127.26,,,0,"percent of total billed charges","32.2% of total billed charges",424.13,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",186.24,37.7,,148.99,,,0,"percent of total billed charges","37.7% of total billed charges",186.24,37.7,,148.99,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",167.47,33.9,,133.98,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",385.32,78,,308.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.04,82.6,,326.43,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,247,50,,197.60,,,0,"percent of total billed charges","50% of total billed charges",408.04,82.6,,326.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",572.57,100,,,,,0,"fee schedule",EAPG,494,100,,395.20,,,0,"percent of total billed charges","100% of total billed charges",75.58,744.35,
"VEN CATH FOR SEL ORGAN SAMPLE",84036500,CDM,361,RC,36500,CPT,OUTPATIENT,,,2158,1402.7,,1899.04,88,,1519.23,,,0,"percent of total billed charges","88% of total billed charges",1079,50,,863.20,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,2158,100,,1726.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1359.54,63,,1087.63,,,0,"percent of total billed charges","63% of total billed charges",330.17,15.3,,264.14,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,1489.02,69,,,,,0,"fee schedule","69% of total billed charges",2158,100,,1726.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2158,100,,1726.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2158,100,,1726.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1334.72,61.85,,1067.78,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,1079,50,,863.20,,,0,"percent of total billed charges","50% of total billed charges",694.88,32.2,,555.90,,,0,"percent of total billed charges","32.2% of total billed charges",424.13,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",813.57,37.7,,650.86,,,0,"percent of total billed charges","37.7% of total billed charges",813.57,37.7,,650.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",731.56,33.9,,585.25,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1683.24,78,,1346.59,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1782.51,82.6,,1426.01,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,1079,50,,863.20,,,0,"percent of total billed charges","50% of total billed charges",1782.51,82.6,,1426.01,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",572.57,100,,,,,0,"fee schedule",EAPG,2158,100,,1726.40,,,0,"percent of total billed charges","100% of total billed charges",330.17,2158,
"INSRT NON-TNNL CVC >=5YR SURG",84036556,CDM,761,RC,36556,CPT,OUTPATIENT,,,4149,2696.85,,3651.12,88,,2920.90,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,4149,100,,3319.20,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",1043.63,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2613.87,63,,2091.10,,,0,"percent of total billed charges","63% of total billed charges",634.8,15.3,,507.84,,,0,"percent of total billed charges","15.3% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,2862.81,69,,,,,0,"fee schedule","69% of total billed charges",4149,100,,3319.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4149,100,,3319.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4149,100,,3319.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",750.54,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033.49,100,,,,,0,"fee schedule",EAPG,1317.2,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1564.17,37.7,,1251.34,,,0,"percent of total billed charges","37.7% of total billed charges",1564.17,37.7,,1251.34,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1406.51,33.9,,1125.21,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3236.22,78,,2588.98,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3427.07,82.6,,2741.66,,,0,"percent of total billed charges","82.6% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3427.07,82.6,,2741.66,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,4149,100,,3319.20,,,0,"percent of total billed charges","100% of total billed charges",634.8,11625.57,
"INSRT TUNNELED CVC >=5YR SURG",84036558,CDM,481,RC,36558,CPT,OUTPATIENT,,,3939,2560.35,,3466.32,88,,2773.06,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1979.08,100,,,,,0,"fee schedule",EAPG,3939,100,,3151.20,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",2038.45,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2481.57,63,,1985.26,,,0,"percent of total billed charges","63% of total billed charges",602.67,15.3,,482.14,,,0,"percent of total billed charges","15.3% of total billed charges",1979.08,100,,,,,0,"fee schedule",EAPG,2717.91,69,,,,,0,"fee schedule","69% of total billed charges",3939,100,,3151.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3939,100,,3151.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3939,100,,3151.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1979.08,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1465.98,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2018.66,100,,,,,0,"fee schedule",EAPG,2572.8,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1485,37.7,,1188.00,,,0,"percent of total billed charges","37.7% of total billed charges",1485,37.7,,1188.00,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1335.32,33.9,,1068.26,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3072.42,78,,2457.94,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3253.61,82.6,,2602.89,,,0,"percent of total billed charges","82.6% of total billed charges",1979.08,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3253.61,82.6,,2602.89,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1979.08,100,,,,,0,"fee schedule",EAPG,3939,100,,3151.20,,,0,"percent of total billed charges","100% of total billed charges",602.67,11625.57,
"PICC LINE REPLACEMENT",48136568,CDM,481,RC,36568,CPT,OUTPATIENT,,,4447,2890.55,,3913.36,88,,3130.69,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,4447,100,,3557.60,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",1043.63,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2801.61,63,,2241.29,,,0,"percent of total billed charges","63% of total billed charges",680.39,15.3,,544.31,,,0,"percent of total billed charges","15.3% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,3068.43,69,,,,,0,"fee schedule","69% of total billed charges",4447,100,,3557.60,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4447,100,,3557.60,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4447,100,,3557.60,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",750.54,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033.49,100,,,,,0,"fee schedule",EAPG,1317.2,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1676.52,37.7,,1341.22,,,0,"percent of total billed charges","37.7% of total billed charges",1676.52,37.7,,1341.22,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1507.53,33.9,,1206.02,,,0,"percent of total billed charges","33.9% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3468.66,78,,2774.93,,,0,"percent of total billed charges","78% of total billed charges",1649.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3673.22,82.6,,2938.58,,,0,"percent of total billed charges","82.6% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3673.22,82.6,,2938.58,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,4447,100,,3557.60,,,0,"percent of total billed charges","100% of total billed charges",680.39,5712.48,
N/A,84036569,CDM,761,RC,36569,CPT,OUTPATIENT,,,3261,2119.65,,2869.68,88,,2295.74,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,3261,100,,2608.80,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",1043.63,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054.43,63,,1643.54,,,0,"percent of total billed charges","63% of total billed charges",498.93,15.3,,399.14,,,0,"percent of total billed charges","15.3% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,2250.09,69,,,,,0,"fee schedule","69% of total billed charges",3261,100,,2608.80,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3261,100,,2608.80,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3261,100,,2608.80,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",750.54,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033.49,100,,,,,0,"fee schedule",EAPG,1317.2,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1229.4,37.7,,983.52,,,0,"percent of total billed charges","37.7% of total billed charges",1229.4,37.7,,983.52,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1105.48,33.9,,884.38,,,0,"percent of total billed charges","33.9% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2543.58,78,,2034.86,,,0,"percent of total billed charges","78% of total billed charges",1649.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2693.59,82.6,,2154.87,,,0,"percent of total billed charges","82.6% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2693.59,82.6,,2154.87,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,3261,100,,2608.80,,,0,"percent of total billed charges","100% of total billed charges",498.93,5712.48,
"INSERTION POWER PORT",84036578,CDM,360,RC,36578,CPT,OUTPATIENT,,,1310,851.5,,1152.8,88,,922.24,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,1310,100,,1048.00,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",678.35,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",825.3,63,,660.24,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",658.59,100,,,,,0,"fee schedule",EAPG,903.9,69,,,,,0,"fee schedule","69% of total billed charges",1310,100,,1048.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1310,100,,1048.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1310,100,,1048.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",487.85,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671.77,100,,,,,0,"fee schedule",EAPG,856.17,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",493.87,37.7,,395.10,,,0,"percent of total billed charges","37.7% of total billed charges",493.87,37.7,,395.10,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",444.09,33.9,,355.27,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1021.8,78,,817.44,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1082.06,82.6,,865.65,,,0,"percent of total billed charges","82.6% of total billed charges",658.59,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1082.06,82.6,,865.65,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,1310,100,,1048.00,,,0,"percent of total billed charges","100% of total billed charges",444.09,11625.57,
"REPAIR CVC ONLY SURG",84036575,CDM,361,RC,36575,CPT,OUTPATIENT,,,3907,2539.55,,3438.16,88,,2750.53,,,0,"percent of total billed charges","88% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,3907,100,,3125.60,,,0,"percent of total billed charges","100% of total billed charges",1121.3,175,,,,,0,"fee schedule","175% of CMS fee schedule",678.35,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2461.41,63,,1969.13,,,0,"percent of total billed charges","63% of total billed charges",597.77,15.3,,478.22,,,0,"percent of total billed charges","15.3% of total billed charges",658.59,100,,,,,0,"fee schedule",EAPG,2695.83,69,,,,,0,"fee schedule","69% of total billed charges",3907,100,,3125.60,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3907,100,,3125.60,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3907,100,,3125.60,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",2200.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",575.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",487.85,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671.77,100,,,,,0,"fee schedule",EAPG,856.17,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1472.94,37.7,,1178.35,,,0,"percent of total billed charges","37.7% of total billed charges",1472.94,37.7,,1178.35,,,0,"percent of total billed charges","37.70% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1324.47,33.9,,1059.58,,,0,"percent of total billed charges","33.9% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3047.46,78,,2437.97,,,0,"percent of total billed charges","78% of total billed charges",647.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3227.18,82.6,,2581.74,,,0,"percent of total billed charges","82.6% of total billed charges",658.59,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3227.18,82.6,,2581.74,,,0,"percent of total billed charges","82.6% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,3907,100,,3125.60,,,0,"percent of total billed charges","100% of total billed charges",487.85,3907,
"REPAIR CVC W/PORT/PUMP  SURG",84036576,CDM,361,RC,36576,CPT,OUTPATIENT,,,3928,2553.2,,3456.64,88,,2765.31,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,3928,100,,3142.40,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",678.35,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2474.64,63,,1979.71,,,0,"percent of total billed charges","63% of total billed charges",600.98,15.3,,480.78,,,0,"percent of total billed charges","15.3% of total billed charges",658.59,100,,,,,0,"fee schedule",EAPG,2710.32,69,,,,,0,"fee schedule","69% of total billed charges",3928,100,,3142.40,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3928,100,,3142.40,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3928,100,,3142.40,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",487.85,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671.77,100,,,,,0,"fee schedule",EAPG,856.17,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1480.86,37.7,,1184.69,,,0,"percent of total billed charges","37.7% of total billed charges",1480.86,37.7,,1184.69,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1331.59,33.9,,1065.27,,,0,"percent of total billed charges","33.9% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3063.84,78,,2451.07,,,0,"percent of total billed charges","78% of total billed charges",1649.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3244.53,82.6,,2595.62,,,0,"percent of total billed charges","82.6% of total billed charges",658.59,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3244.53,82.6,,2595.62,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,3928,100,,3142.40,,,0,"percent of total billed charges","100% of total billed charges",487.85,5712.48,
"36571 Insertion of peripherally inserted central venous acce",76136571,CDM,761,RC,36571,CPT,OUTPATIENT,,,9291,6039.15,,8176.08,88,,6540.86,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",1043.63,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5853.33,63,,4682.66,,,0,"percent of total billed charges","63% of total billed charges",1421.52,15.3,,1137.22,,,0,"percent of total billed charges","15.3% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,6410.79,69,,,,,0,"fee schedule","69% of total billed charges",9291,100,,7432.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9291,100,,7432.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9291,100,,7432.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",750.54,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033.49,100,,,,,0,"fee schedule",EAPG,1317.2,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3502.71,37.7,,2802.17,,,0,"percent of total billed charges","37.7% of total billed charges",3502.71,37.7,,2802.17,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3149.65,33.9,,2519.72,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7246.98,78,,5797.58,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7674.37,82.6,,6139.50,,,0,"percent of total billed charges","82.6% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7674.37,82.6,,6139.50,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,9291,100,,7432.80,,,0,"percent of total billed charges","100% of total billed charges",750.54,11625.57,
"REPLACE TUNNELED CVC W/O PORT",84036581,CDM,761,RC,36581,CPT,OUTPATIENT,,,1230,799.5,,1082.4,88,,865.92,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1979.08,100,,,,,0,"fee schedule",EAPG,1230,100,,984.00,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",2038.45,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",774.9,63,,619.92,,,0,"percent of total billed charges","63% of total billed charges",188.19,15.3,,150.55,,,0,"percent of total billed charges","15.3% of total billed charges",1979.08,100,,,,,0,"fee schedule",EAPG,848.7,69,,,,,0,"fee schedule","69% of total billed charges",1230,100,,984.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1230,100,,984.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1230,100,,984.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1979.08,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1465.98,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2018.66,100,,,,,0,"fee schedule",EAPG,2572.8,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",463.71,37.7,,370.97,,,0,"percent of total billed charges","37.7% of total billed charges",463.71,37.7,,370.97,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",416.97,33.9,,333.58,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",959.4,78,,767.52,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1015.98,82.6,,812.78,,,0,"percent of total billed charges","82.6% of total billed charges",1979.08,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1015.98,82.6,,812.78,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1979.08,100,,,,,0,"fee schedule",EAPG,1230,100,,984.00,,,0,"percent of total billed charges","100% of total billed charges",188.19,11625.57,
"REPLACE TUNNELED CVC W/PORT",84036582,CDM,360,RC,36582,CPT,OUTPATIENT,,,1913,1243.45,,1683.44,88,,1346.75,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1979.08,100,,,,,0,"fee schedule",EAPG,1913,100,,1530.40,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",2038.45,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1205.19,63,,964.15,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",1979.08,100,,,,,0,"fee schedule",EAPG,1319.97,69,,,,,0,"fee schedule","69% of total billed charges",1913,100,,1530.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1913,100,,1530.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1913,100,,1530.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1979.08,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1465.98,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2018.66,100,,,,,0,"fee schedule",EAPG,2572.8,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",721.2,37.7,,576.96,,,0,"percent of total billed charges","37.7% of total billed charges",721.2,37.7,,576.96,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",648.51,33.9,,518.81,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1492.14,78,,1193.71,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1580.14,82.6,,1264.11,,,0,"percent of total billed charges","82.6% of total billed charges",1979.08,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1580.14,82.6,,1264.11,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1979.08,100,,,,,0,"fee schedule",EAPG,1913,100,,1530.40,,,0,"percent of total billed charges","100% of total billed charges",648.51,11625.57,
"REMOVE TUNNELD CVC SURG",84036589,CDM,761,RC,36589,CPT,OUTPATIENT,,,883,573.95,,777.04,88,,621.63,,,0,"percent of total billed charges","88% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,883,100,,706.40,,,0,"percent of total billed charges","100% of total billed charges",1121.3,175,,,,,0,"fee schedule","175% of CMS fee schedule",678.35,100,,,,,0,"fee schedule",EAPG,640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.29,63,,445.03,,,0,"percent of total billed charges","63% of total billed charges",135.1,15.3,,108.08,,,0,"percent of total billed charges","15.3% of total billed charges",658.59,100,,,,,0,"fee schedule",EAPG,609.27,69,,,,,0,"fee schedule","69% of total billed charges",883,100,,706.40,,,0,"percent of total billed charges","100% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",883,100,,706.40,,,0,"percent of total billed charges","100% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",883,100,,706.40,,,0,"percent of total billed charges","100% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",2200.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",575.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",487.85,100,,,,,0,"fee schedule",EAPG,640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671.77,100,,,,,0,"fee schedule",EAPG,856.17,100,,,,,0,"fee schedule",EAPG,640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",332.89,37.7,,266.31,,,0,"percent of total billed charges","37.7% of total billed charges",332.89,37.7,,266.31,,,0,"percent of total billed charges","37.70% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",299.34,33.9,,239.47,,,0,"percent of total billed charges","33.9% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",688.74,78,,550.99,,,0,"percent of total billed charges","78% of total billed charges",647.15,100,,,,,0,"fee schedule","100% of CMS OPPS rate",729.36,82.6,,583.49,,,0,"percent of total billed charges","82.6% of total billed charges",658.59,100,,,,,0,"fee schedule",EAPG,640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",729.36,82.6,,583.49,,,0,"percent of total billed charges","82.6% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,883,100,,706.40,,,0,"percent of total billed charges","100% of total billed charges",135.1,2200.34,
"36589 REMOVAL VENOUS DEVICE",76136589,CDM,761,RC,36589,CPT,OUTPATIENT,,,1166,757.9,,1026.08,88,,820.86,,,0,"percent of total billed charges","88% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,1166,100,,932.80,,,0,"percent of total billed charges","100% of total billed charges",1121.3,175,,,,,0,"fee schedule","175% of CMS fee schedule",678.35,100,,,,,0,"fee schedule",EAPG,640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",734.58,63,,587.66,,,0,"percent of total billed charges","63% of total billed charges",178.4,15.3,,142.72,,,0,"percent of total billed charges","15.3% of total billed charges",658.59,100,,,,,0,"fee schedule",EAPG,804.54,69,,,,,0,"fee schedule","69% of total billed charges",1166,100,,932.80,,,0,"percent of total billed charges","100% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1166,100,,932.80,,,0,"percent of total billed charges","100% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1166,100,,932.80,,,0,"percent of total billed charges","100% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",2200.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",575.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",487.85,100,,,,,0,"fee schedule",EAPG,640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671.77,100,,,,,0,"fee schedule",EAPG,856.17,100,,,,,0,"fee schedule",EAPG,640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",439.58,37.7,,351.66,,,0,"percent of total billed charges","37.7% of total billed charges",439.58,37.7,,351.66,,,0,"percent of total billed charges","37.70% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",395.27,33.9,,316.22,,,0,"percent of total billed charges","33.9% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",909.48,78,,727.58,,,0,"percent of total billed charges","78% of total billed charges",647.15,100,,,,,0,"fee schedule","100% of CMS OPPS rate",963.12,82.6,,770.50,,,0,"percent of total billed charges","82.6% of total billed charges",658.59,100,,,,,0,"fee schedule",EAPG,640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",963.12,82.6,,770.50,,,0,"percent of total billed charges","82.6% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,1166,100,,932.80,,,0,"percent of total billed charges","100% of total billed charges",178.4,2200.34,
"REMOVAL TUNNELED CVC W/PORT",84036590,CDM,320,RC,36590,CPT,OUTPATIENT,,,1391,904.15,,1224.08,88,,979.26,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,1391,100,,1112.80,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",678.35,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",876.33,63,,701.06,,,0,"percent of total billed charges","63% of total billed charges",212.82,15.3,,170.26,,,0,"percent of total billed charges","15.3% of total billed charges",658.59,100,,,,,0,"fee schedule",EAPG,959.79,69,,,,,0,"fee schedule","69% of total billed charges",1391,100,,1112.80,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1391,100,,1112.80,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1391,100,,1112.80,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",487.85,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671.77,100,,,,,0,"fee schedule",EAPG,856.17,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",524.41,37.7,,419.53,,,0,"percent of total billed charges","37.7% of total billed charges",524.41,37.7,,419.53,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",471.55,33.9,,377.24,,,0,"percent of total billed charges","33.9% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1084.98,78,,867.98,,,0,"percent of total billed charges","78% of total billed charges",1649.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1148.97,82.6,,919.18,,,0,"percent of total billed charges","82.6% of total billed charges",658.59,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1148.97,82.6,,919.18,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,1391,100,,1112.80,,,0,"percent of total billed charges","100% of total billed charges",212.82,5712.48,
"PICC W/O SUBQ PORT > 5 YRS OLD",84036591,CDM,360,RC,36591,CPT,OUTPATIENT,,,338,219.7,,297.44,88,,237.95,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",54.44,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,233.22,69,,,,,0,"fee schedule","69% of total billed charges",338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.15,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",53.92,100,,,,,0,"fee schedule",EAPG,68.72,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",127.43,37.7,,101.94,,,0,"percent of total billed charges","37.7% of total billed charges",127.43,37.7,,101.94,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",114.58,33.9,,91.66,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",263.64,78,,210.91,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",279.19,82.6,,223.35,,,0,"percent of total billed charges","82.6% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",279.19,82.6,,223.35,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",39.15,3367,
"CENTRAL LINE DECLOT W/THROM AG",84036593,CDM,360,RC,36593,CPT,OUTPATIENT,,,837,544.05,,736.56,88,,589.25,,,0,"percent of total billed charges","88% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,837,100,,669.60,,,0,"percent of total billed charges","100% of total billed charges",604.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",281.17,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",527.31,63,,421.85,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,577.53,69,,,,,0,"fee schedule","69% of total billed charges",837,100,,669.60,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",837,100,,669.60,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",837,100,,669.60,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",1262.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.21,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278.44,100,,,,,0,"fee schedule",EAPG,354.88,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",315.55,37.7,,252.44,,,0,"percent of total billed charges","37.7% of total billed charges",315.55,37.7,,252.44,,,0,"percent of total billed charges","37.70% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.74,33.9,,226.99,,,0,"percent of total billed charges","33.9% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.86,78,,522.29,,,0,"percent of total billed charges","78% of total billed charges",348.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",691.36,82.6,,553.09,,,0,"percent of total billed charges","82.6% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",691.36,82.6,,553.09,,,0,"percent of total billed charges","82.6% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,837,100,,669.60,,,0,"percent of total billed charges","100% of total billed charges",202.21,3367,
"SURG SHEATH SEP ACCESS SURG",84036595,CDM,361,RC,36595,CPT,OUTPATIENT,,,7988,5192.2,,7029.44,88,,5623.55,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",678.35,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5032.44,63,,4025.95,,,0,"percent of total billed charges","63% of total billed charges",1222.16,15.3,,977.73,,,0,"percent of total billed charges","15.3% of total billed charges",658.59,100,,,,,0,"fee schedule",EAPG,5511.72,69,,,,,0,"fee schedule","69% of total billed charges",7988,100,,6390.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7988,100,,6390.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7988,100,,6390.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",487.85,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671.77,100,,,,,0,"fee schedule",EAPG,856.17,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3011.48,37.7,,2409.18,,,0,"percent of total billed charges","37.7% of total billed charges",3011.48,37.7,,2409.18,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2707.93,33.9,,2166.34,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6230.64,78,,4984.51,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6598.09,82.6,,5278.47,,,0,"percent of total billed charges","82.6% of total billed charges",658.59,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6598.09,82.6,,5278.47,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,7988,100,,6390.40,,,0,"percent of total billed charges","100% of total billed charges",487.85,11625.57,
"MECH REMOVE TUNNELED CV CATH",84036596,CDM,360,RC,36596,CPT,OUTPATIENT,,,232,150.8,,204.16,88,,163.33,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,232,100,,185.60,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",678.35,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",146.16,63,,116.93,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",658.59,100,,,,,0,"fee schedule",EAPG,160.08,69,,,,,0,"fee schedule","69% of total billed charges",232,100,,185.60,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",232,100,,185.60,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",232,100,,185.60,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",487.85,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671.77,100,,,,,0,"fee schedule",EAPG,856.17,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",87.46,37.7,,69.97,,,0,"percent of total billed charges","37.7% of total billed charges",87.46,37.7,,69.97,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",78.65,33.9,,62.92,,,0,"percent of total billed charges","33.9% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180.96,78,,144.77,,,0,"percent of total billed charges","78% of total billed charges",1649.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191.63,82.6,,153.30,,,0,"percent of total billed charges","82.6% of total billed charges",658.59,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191.63,82.6,,153.30,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,232,100,,185.60,,,0,"percent of total billed charges","100% of total billed charges",78.65,5712.48,
"REPOSITION OF CVC W/FLUORO SUR",84036597,CDM,361,RC,36597,CPT,OUTPATIENT,,,419,272.35,,368.72,88,,294.98,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,419,100,,335.20,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",678.35,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",263.97,63,,211.18,,,0,"percent of total billed charges","63% of total billed charges",64.11,15.3,,51.29,,,0,"percent of total billed charges","15.3% of total billed charges",658.59,100,,,,,0,"fee schedule",EAPG,289.11,69,,,,,0,"fee schedule","69% of total billed charges",419,100,,335.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",419,100,,335.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",419,100,,335.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",487.85,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671.77,100,,,,,0,"fee schedule",EAPG,856.17,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",157.96,37.7,,126.37,,,0,"percent of total billed charges","37.7% of total billed charges",157.96,37.7,,126.37,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",142.04,33.9,,113.63,,,0,"percent of total billed charges","33.9% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",326.82,78,,261.46,,,0,"percent of total billed charges","78% of total billed charges",1649.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",346.09,82.6,,276.87,,,0,"percent of total billed charges","82.6% of total billed charges",658.59,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",346.09,82.6,,276.87,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,419,100,,335.20,,,0,"percent of total billed charges","100% of total billed charges",64.11,5712.48,
"VENOGRAM EXISTING LINE",84036598,CDM,761,RC,36598,CPT,OUTPATIENT,,,1636,1063.4,,1439.68,88,,1151.74,,,0,"percent of total billed charges","88% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.87,100,,,,,0,"fee schedule",EAPG,1636,100,,1308.80,,,0,"percent of total billed charges","100% of total billed charges",382.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",281.05,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1030.68,63,,824.54,,,0,"percent of total billed charges","63% of total billed charges",250.31,15.3,,200.25,,,0,"percent of total billed charges","15.3% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,1128.84,69,,,,,0,"fee schedule","69% of total billed charges",1636,100,,1308.80,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1636,100,,1308.80,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1636,100,,1308.80,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",826.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.87,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.12,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278.32,100,,,,,0,"fee schedule",EAPG,354.73,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.77,37.7,,493.42,,,0,"percent of total billed charges","37.7% of total billed charges",616.77,37.7,,493.42,,,0,"percent of total billed charges","37.70% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.6,33.9,,443.68,,,0,"percent of total billed charges","33.9% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1276.08,78,,1020.86,,,0,"percent of total billed charges","78% of total billed charges",220.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1351.34,82.6,,1081.07,,,0,"percent of total billed charges","82.6% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1351.34,82.6,,1081.07,,,0,"percent of total billed charges","82.6% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.87,100,,,,,0,"fee schedule",EAPG,1636,100,,1308.80,,,0,"percent of total billed charges","100% of total billed charges",202.12,1636,
"36593 DECLOT BY THMROMBOLYTIC AGENTS",AMB820078,CDM,761,RC,36593,CPT,OUTPATIENT,,,837,544.05,,736.56,88,,589.25,,,0,"percent of total billed charges","88% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,837,100,,669.60,,,0,"percent of total billed charges","100% of total billed charges",604.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",281.17,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",527.31,63,,421.85,,,0,"percent of total billed charges","63% of total billed charges",128.06,15.3,,102.45,,,0,"percent of total billed charges","15.3% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,577.53,69,,,,,0,"fee schedule","69% of total billed charges",837,100,,669.60,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",837,100,,669.60,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",837,100,,669.60,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",1262.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.21,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278.44,100,,,,,0,"fee schedule",EAPG,354.88,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",315.55,37.7,,252.44,,,0,"percent of total billed charges","37.7% of total billed charges",315.55,37.7,,252.44,,,0,"percent of total billed charges","37.70% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.74,33.9,,226.99,,,0,"percent of total billed charges","33.9% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.86,78,,522.29,,,0,"percent of total billed charges","78% of total billed charges",348.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",691.36,82.6,,553.09,,,0,"percent of total billed charges","82.6% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",691.36,82.6,,553.09,,,0,"percent of total billed charges","82.6% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,837,100,,669.60,,,0,"percent of total billed charges","100% of total billed charges",128.06,1262.42,
"36592 LAB DRAW VIA CENTRAL LINE",AMB820028,CDM,761,RC,36592,CPT,OUTPATIENT,,,338,219.7,,297.44,88,,237.95,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",54.44,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",51.71,15.3,,41.37,,,0,"percent of total billed charges","15.3% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,233.22,69,,,,,0,"fee schedule","69% of total billed charges",338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.15,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",53.92,100,,,,,0,"fee schedule",EAPG,68.72,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",127.43,37.7,,101.94,,,0,"percent of total billed charges","37.7% of total billed charges",127.43,37.7,,101.94,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",114.58,33.9,,91.66,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",263.64,78,,210.91,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",279.19,82.6,,223.35,,,0,"percent of total billed charges","82.6% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",279.19,82.6,,223.35,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",39.15,454.8,
"ARTERIAL CATH LINE INSERT SURG",84036620,CDM,481,RC,36620,CPT,OUTPATIENT,,,224,145.6,,197.12,88,,157.70,,,0,"percent of total billed charges","88% of total billed charges",112,50,,89.60,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,224,100,,179.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",141.12,63,,112.90,,,0,"percent of total billed charges","63% of total billed charges",34.27,15.3,,27.42,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,154.56,69,,,,,0,"fee schedule","69% of total billed charges",224,100,,179.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",224,100,,179.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",224,100,,179.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.54,61.85,,110.83,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,112,50,,89.60,,,0,"percent of total billed charges","50% of total billed charges",72.13,32.2,,57.70,,,0,"percent of total billed charges","32.2% of total billed charges",424.13,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",84.45,37.7,,67.56,,,0,"percent of total billed charges","37.7% of total billed charges",84.45,37.7,,67.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.94,33.9,,60.75,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",174.72,78,,139.78,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.02,82.6,,148.02,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,112,50,,89.60,,,0,"percent of total billed charges","50% of total billed charges",185.02,82.6,,148.02,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",572.57,100,,,,,0,"fee schedule",EAPG,224,100,,179.20,,,0,"percent of total billed charges","100% of total billed charges",34.27,744.35,
"FISTULA ACCESS AND IMAGING",84036901,CDM,360,RC,36901,CPT,OUTPATIENT,,,6652,4323.8,,5853.76,88,,4683.01,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",1694.66,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4190.76,63,,3352.61,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,4589.88,69,,,,,0,"fee schedule","69% of total billed charges",6652,100,,5321.60,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6652,100,,5321.60,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6652,100,,5321.60,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1218.74,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1678.2,100,,,,,0,"fee schedule",EAPG,2138.89,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2507.8,37.7,,2006.24,,,0,"percent of total billed charges","37.7% of total billed charges",2507.8,37.7,,2006.24,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2255.03,33.9,,1804.02,,,0,"percent of total billed charges","33.9% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5188.56,78,,4150.85,,,0,"percent of total billed charges","78% of total billed charges",1649.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5494.55,82.6,,4395.64,,,0,"percent of total billed charges","82.6% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5494.55,82.6,,4395.64,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,6652,100,,5321.60,,,0,"percent of total billed charges","100% of total billed charges",1218.74,6652,
"FISTUAL IMAGING W/PTA",84036902,CDM,360,RC,36902,CPT,OUTPATIENT,,,26088,16957.2,,22957.44,88,,18365.95,,,0,"percent of total billed charges","88% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",10202.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",3318.68,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16435.44,63,,13148.35,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,18000.72,69,,,,,0,"fee schedule","69% of total billed charges",26088,100,,20870.40,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26088,100,,20870.40,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26088,100,,20870.40,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",20137.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5264.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2386.68,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.46,100,,,,,0,"fee schedule",EAPG,4188.63,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9835.18,37.7,,7868.14,,,0,"percent of total billed charges","37.7% of total billed charges",9835.18,37.7,,7868.14,,,0,"percent of total billed charges","37.70% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8843.83,33.9,,7075.06,,,0,"percent of total billed charges","33.9% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",20348.64,78,,16278.91,,,0,"percent of total billed charges","78% of total billed charges",5888.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",21548.69,82.6,,17238.95,,,0,"percent of total billed charges","82.6% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",21548.69,82.6,,17238.95,,,0,"percent of total billed charges","82.6% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,26088,100,,20870.40,,,0,"percent of total billed charges","100% of total billed charges",2386.68,26088,
"FISTULA IMAGING W/ STENT",84036903,CDM,360,RC,36903,CPT,OUTPATIENT,,,5210,3386.5,,4584.8,88,,3667.84,,,0,"percent of total billed charges","88% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",19636.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",10180.16,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3282.3,63,,2625.84,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,3594.9,69,,,,,0,"fee schedule","69% of total billed charges",5210,100,,4168.00,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5210,100,,4168.00,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5210,100,,4168.00,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",40799.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10666.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7321.22,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10081.33,100,,,,,0,"fee schedule",EAPG,12848.75,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1964.17,37.7,,1571.34,,,0,"percent of total billed charges","37.7% of total billed charges",1964.17,37.7,,1571.34,,,0,"percent of total billed charges","37.70% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1766.19,33.9,,1412.95,,,0,"percent of total billed charges","33.9% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4063.8,78,,3251.04,,,0,"percent of total billed charges","78% of total billed charges",11332.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4303.46,82.6,,3442.77,,,0,"percent of total billed charges","82.6% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4303.46,82.6,,3442.77,,,0,"percent of total billed charges","82.6% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,5210,100,,4168.00,,,0,"percent of total billed charges","100% of total billed charges",1766.19,40799.76,
"FISTULA IMAGING W/THROMBECTOMY",84036904,CDM,360,RC,36904,CPT,OUTPATIENT,,,17022,11064.3,,14979.36,88,,11983.49,,,0,"percent of total billed charges","88% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",10202.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",3318.68,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10723.86,63,,8579.09,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,11745.18,69,,,,,0,"fee schedule","69% of total billed charges",17022,100,,13617.60,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17022,100,,13617.60,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17022,100,,13617.60,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",20137.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5264.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2386.68,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.46,100,,,,,0,"fee schedule",EAPG,4188.63,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6417.29,37.7,,5133.83,,,0,"percent of total billed charges","37.7% of total billed charges",6417.29,37.7,,5133.83,,,0,"percent of total billed charges","37.70% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5770.46,33.9,,4616.37,,,0,"percent of total billed charges","33.9% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13277.16,78,,10621.73,,,0,"percent of total billed charges","78% of total billed charges",5888.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14060.17,82.6,,11248.14,,,0,"percent of total billed charges","82.6% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14060.17,82.6,,11248.14,,,0,"percent of total billed charges","82.6% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,17022,100,,13617.60,,,0,"percent of total billed charges","100% of total billed charges",2386.68,20137.31,
"FISTUAL IMAGING W/THROMBECTOMY/PTA",84036905,CDM,320,RC,36905,CPT,OUTPATIENT,,,34637,22514.05,,30480.56,88,,24384.45,,,0,"percent of total billed charges","88% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5310.28,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",19636.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",5469.59,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",21821.31,63,,17457.05,,,0,"percent of total billed charges","63% of total billed charges",5299.46,15.3,,4239.57,,,0,"percent of total billed charges","15.3% of total billed charges",5310.28,100,,,,,0,"fee schedule",EAPG,23899.53,69,,,,,0,"fee schedule","69% of total billed charges",34637,100,,27709.60,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34637,100,,27709.60,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34637,100,,27709.60,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",40799.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5310.28,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10666.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3933.54,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5416.49,100,,,,,0,"fee schedule",EAPG,6903.37,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13058.15,37.7,,10446.52,,,0,"percent of total billed charges","37.7% of total billed charges",13058.15,37.7,,10446.52,,,0,"percent of total billed charges","37.70% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11741.94,33.9,,9393.55,,,0,"percent of total billed charges","33.9% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",27016.86,78,,21613.49,,,0,"percent of total billed charges","78% of total billed charges",11332.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",28610.16,82.6,,22888.13,,,0,"percent of total billed charges","82.6% of total billed charges",5310.28,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",28610.16,82.6,,22888.13,,,0,"percent of total billed charges","82.6% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5310.28,100,,,,,0,"fee schedule",EAPG,34637,100,,27709.60,,,0,"percent of total billed charges","100% of total billed charges",3933.54,40799.76,
"FISTULA IMAGING W/THROMBECTOMY/STENT",84036906,CDM,360,RC,36906,CPT,OUTPATIENT,,,13761,8944.65,,12109.68,88,,9687.74,,,0,"percent of total billed charges","88% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",31299.05,175,,,,,0,"fee schedule","175% of CMS fee schedule",10180.16,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8669.43,63,,6935.54,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,9495.09,69,,,,,0,"fee schedule","69% of total billed charges",13761,100,,11008.80,,,0,"percent of total billed charges","100% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13761,100,,11008.80,,,0,"percent of total billed charges","100% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13761,100,,11008.80,,,0,"percent of total billed charges","100% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",65260.52,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17061.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7321.22,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10081.33,100,,,,,0,"fee schedule",EAPG,12848.75,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5187.9,37.7,,4150.32,,,0,"percent of total billed charges","37.7% of total billed charges",5187.9,37.7,,4150.32,,,0,"percent of total billed charges","37.70% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4664.98,33.9,,3731.98,,,0,"percent of total billed charges","33.9% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10733.58,78,,8586.86,,,0,"percent of total billed charges","78% of total billed charges",18064.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11366.59,82.6,,9093.27,,,0,"percent of total billed charges","82.6% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11366.59,82.6,,9093.27,,,0,"percent of total billed charges","82.6% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,13761,100,,11008.80,,,0,"percent of total billed charges","100% of total billed charges",3367,65260.52,
"REVISE TIPS",84037183,CDM,361,RC,37183,CPT,OUTPATIENT,,,38409,24965.85,,33799.92,88,,27039.94,,,0,"percent of total billed charges","88% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5310.28,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",10202.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",5469.59,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24197.67,63,,19358.14,,,0,"percent of total billed charges","63% of total billed charges",5876.58,15.3,,4701.26,,,0,"percent of total billed charges","15.3% of total billed charges",5310.28,100,,,,,0,"fee schedule",EAPG,26502.21,69,,,,,0,"fee schedule","69% of total billed charges",38409,100,,30727.20,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38409,100,,30727.20,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38409,100,,30727.20,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",20137.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5310.28,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5264.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3933.54,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5416.49,100,,,,,0,"fee schedule",EAPG,6903.37,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14480.19,37.7,,11584.15,,,0,"percent of total billed charges","37.7% of total billed charges",14480.19,37.7,,11584.15,,,0,"percent of total billed charges","37.70% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13020.65,33.9,,10416.52,,,0,"percent of total billed charges","33.9% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29959.02,78,,23967.22,,,0,"percent of total billed charges","78% of total billed charges",5888.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31725.83,82.6,,25380.66,,,0,"percent of total billed charges","82.6% of total billed charges",5310.28,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31725.83,82.6,,25380.66,,,0,"percent of total billed charges","82.6% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5310.28,100,,,,,0,"fee schedule",EAPG,38409,100,,30727.20,,,0,"percent of total billed charges","100% of total billed charges",3933.54,38409,
"PRIMARY ART MECH THROMBO SURG",84037184,CDM,361,RC,37184,CPT,OUTPATIENT,,,17962,11675.3,,15806.56,88,,12645.25,,,0,"percent of total billed charges","88% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5310.28,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",31299.05,175,,,,,0,"fee schedule","175% of CMS fee schedule",5469.59,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11316.06,63,,9052.85,,,0,"percent of total billed charges","63% of total billed charges",2748.19,15.3,,2198.55,,,0,"percent of total billed charges","15.3% of total billed charges",5310.28,100,,,,,0,"fee schedule",EAPG,12393.78,69,,,,,0,"fee schedule","69% of total billed charges",17962,100,,14369.60,,,0,"percent of total billed charges","100% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17962,100,,14369.60,,,0,"percent of total billed charges","100% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17962,100,,14369.60,,,0,"percent of total billed charges","100% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",40799.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5310.28,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10666.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3933.54,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5416.49,100,,,,,0,"fee schedule",EAPG,6903.37,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6771.67,37.7,,5417.34,,,0,"percent of total billed charges","37.7% of total billed charges",6771.67,37.7,,5417.34,,,0,"percent of total billed charges","37.70% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6089.12,33.9,,4871.30,,,0,"percent of total billed charges","33.9% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14010.36,78,,11208.29,,,0,"percent of total billed charges","78% of total billed charges",18064.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14836.61,82.6,,11869.29,,,0,"percent of total billed charges","82.6% of total billed charges",5310.28,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14836.61,82.6,,11869.29,,,0,"percent of total billed charges","82.6% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5310.28,100,,,,,0,"fee schedule",EAPG,17962,100,,14369.60,,,0,"percent of total billed charges","100% of total billed charges",2748.19,40799.76,
"PRIMARY ART MECH THROMBO AD ON",84037185,CDM,361,RC,37185,CPT,OUTPATIENT,,,13755,8940.75,,12104.4,88,,9683.52,,,0,"percent of total billed charges","88% of total billed charges",6877.5,50,,5502.00,,,0,"percent of total billed charges","50% of total billed charges",5310.28,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5469.59,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",8665.65,63,,6932.52,,,0,"percent of total billed charges","63% of total billed charges",2104.52,15.3,,1683.62,,,0,"percent of total billed charges","15.3% of total billed charges",5310.28,100,,,,,0,"fee schedule",EAPG,9490.95,69,,,,,0,"fee schedule","69% of total billed charges",13755,100,,11004.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13755,100,,11004.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13755,100,,11004.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8507.47,61.85,,6805.98,,,0,"percent of total billed charges","61.5% of total billed charges",5310.28,100,,,,,0,"fee schedule",EAPG,6877.5,50,,5502.00,,,0,"percent of total billed charges","50% of total billed charges",4429.11,32.2,,3543.29,,,0,"percent of total billed charges","32.2% of total billed charges",3933.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",5416.49,100,,,,,0,"fee schedule",EAPG,6903.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",5185.64,37.7,,4148.51,,,0,"percent of total billed charges","37.7% of total billed charges",5185.64,37.7,,4148.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4662.95,33.9,,3730.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",10728.9,78,,8583.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11361.63,82.6,,9089.30,,,0,"percent of total billed charges","82.6% of total billed charges",5310.28,100,,,,,0,"fee schedule",EAPG,6877.5,50,,5502.00,,,0,"percent of total billed charges","50% of total billed charges",11361.63,82.6,,9089.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5310.28,100,,,,,0,"fee schedule",EAPG,13755,100,,11004.00,,,0,"percent of total billed charges","100% of total billed charges",2104.52,13755,
"SEC PER TRANSLUM THROM SURG",84037186,CDM,361,RC,37186,CPT,OUTPATIENT,,,17434,11332.1,,15341.92,88,,12273.54,,,0,"percent of total billed charges","88% of total billed charges",8717,50,,6973.60,,,0,"percent of total billed charges","50% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10180.16,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",10983.42,63,,8786.74,,,0,"percent of total billed charges","63% of total billed charges",2667.4,15.3,,2133.92,,,0,"percent of total billed charges","15.3% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,12029.46,69,,,,,0,"fee schedule","69% of total billed charges",17434,100,,13947.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17434,100,,13947.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17434,100,,13947.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10782.93,61.85,,8626.34,,,0,"percent of total billed charges","61.5% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,8717,50,,6973.60,,,0,"percent of total billed charges","50% of total billed charges",5613.75,32.2,,4491.00,,,0,"percent of total billed charges","32.2% of total billed charges",7321.22,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",10081.33,100,,,,,0,"fee schedule",EAPG,12848.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",6572.62,37.7,,5258.10,,,0,"percent of total billed charges","37.7% of total billed charges",6572.62,37.7,,5258.10,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",5910.13,33.9,,4728.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",13598.52,78,,10878.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14400.48,82.6,,11520.38,,,0,"percent of total billed charges","82.6% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,8717,50,,6973.60,,,0,"percent of total billed charges","50% of total billed charges",14400.48,82.6,,11520.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9883.65,100,,,,,0,"fee schedule",EAPG,17434,100,,13947.20,,,0,"percent of total billed charges","100% of total billed charges",2667.4,17434,
"PERC MECH THROM W/LYSIS INIT",84037187,CDM,361,RC,37187,CPT,OUTPATIENT,,,15503,10076.95,,13642.64,88,,10914.11,,,0,"percent of total billed charges","88% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",19636.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",3318.68,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9766.89,63,,7813.51,,,0,"percent of total billed charges","63% of total billed charges",2371.96,15.3,,1897.57,,,0,"percent of total billed charges","15.3% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,10697.07,69,,,,,0,"fee schedule","69% of total billed charges",15503,100,,12402.40,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15503,100,,12402.40,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15503,100,,12402.40,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",40799.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10666.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2386.68,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.46,100,,,,,0,"fee schedule",EAPG,4188.63,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5844.63,37.7,,4675.70,,,0,"percent of total billed charges","37.7% of total billed charges",5844.63,37.7,,4675.70,,,0,"percent of total billed charges","37.70% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5255.52,33.9,,4204.42,,,0,"percent of total billed charges","33.9% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",12092.34,78,,9673.87,,,0,"percent of total billed charges","78% of total billed charges",11332.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",12805.48,82.6,,10244.38,,,0,"percent of total billed charges","82.6% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",12805.48,82.6,,10244.38,,,0,"percent of total billed charges","82.6% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,15503,100,,12402.40,,,0,"percent of total billed charges","100% of total billed charges",2371.96,40799.76,
"VENOUS MECH THROMBO ADD ON",84037188,CDM,361,RC,37188,CPT,OUTPATIENT,,,13755,8940.75,,12104.4,88,,9683.52,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",3318.68,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8665.65,63,,6932.52,,,0,"percent of total billed charges","63% of total billed charges",2104.52,15.3,,1683.62,,,0,"percent of total billed charges","15.3% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,9490.95,69,,,,,0,"fee schedule","69% of total billed charges",13755,100,,11004.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13755,100,,11004.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13755,100,,11004.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2386.68,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.46,100,,,,,0,"fee schedule",EAPG,4188.63,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5185.64,37.7,,4148.51,,,0,"percent of total billed charges","37.7% of total billed charges",5185.64,37.7,,4148.51,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4662.95,33.9,,3730.36,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10728.9,78,,8583.12,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11361.63,82.6,,9089.30,,,0,"percent of total billed charges","82.6% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11361.63,82.6,,9089.30,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,13755,100,,11004.00,,,0,"percent of total billed charges","100% of total billed charges",2104.52,13755,
"INS ENDOVAS VENA CAVA FILTER",84037191,CDM,361,RC,37191,CPT,OUTPATIENT,,,13592,8834.8,,11960.96,88,,9568.77,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3318.68,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8562.96,63,,6850.37,,,0,"percent of total billed charges","63% of total billed charges",2079.58,15.3,,1663.66,,,0,"percent of total billed charges","15.3% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,9378.48,69,,,,,0,"fee schedule","69% of total billed charges",13592,100,,10873.60,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13592,100,,10873.60,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13592,100,,10873.60,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2386.68,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.46,100,,,,,0,"fee schedule",EAPG,4188.63,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5124.18,37.7,,4099.34,,,0,"percent of total billed charges","37.7% of total billed charges",5124.18,37.7,,4099.34,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4607.69,33.9,,3686.15,,,0,"percent of total billed charges","33.9% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10601.76,78,,8481.41,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11226.99,82.6,,8981.59,,,0,"percent of total billed charges","82.6% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11226.99,82.6,,8981.59,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,13592,100,,10873.60,,,0,"percent of total billed charges","100% of total billed charges",2079.58,19379.77,
"RETRIEVE/REMOVE IVC FILTER",84037193,CDM,361,RC,37193,CPT,OUTPATIENT,,,8121,5278.65,,7146.48,88,,5717.18,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",3318.68,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5116.23,63,,4092.98,,,0,"percent of total billed charges","63% of total billed charges",1242.51,15.3,,994.01,,,0,"percent of total billed charges","15.3% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,5603.49,69,,,,,0,"fee schedule","69% of total billed charges",8121,100,,6496.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8121,100,,6496.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8121,100,,6496.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2386.68,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.46,100,,,,,0,"fee schedule",EAPG,4188.63,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3061.62,37.7,,2449.30,,,0,"percent of total billed charges","37.7% of total billed charges",3061.62,37.7,,2449.30,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2753.02,33.9,,2202.42,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6334.38,78,,5067.50,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6707.95,82.6,,5366.36,,,0,"percent of total billed charges","82.6% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6707.95,82.6,,5366.36,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,8121,100,,6496.80,,,0,"percent of total billed charges","100% of total billed charges",1242.51,11625.57,
"REMOVE INTRAVASCULAR FB",84037197,CDM,361,RC,37197,CPT,OUTPATIENT,,,10116,6575.4,,8902.08,88,,7121.66,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",3318.68,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6373.08,63,,5098.46,,,0,"percent of total billed charges","63% of total billed charges",1547.75,15.3,,1238.20,,,0,"percent of total billed charges","15.3% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,6980.04,69,,,,,0,"fee schedule","69% of total billed charges",10116,100,,8092.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10116,100,,8092.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10116,100,,8092.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2386.68,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.46,100,,,,,0,"fee schedule",EAPG,4188.63,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3813.73,37.7,,3050.98,,,0,"percent of total billed charges","37.7% of total billed charges",3813.73,37.7,,3050.98,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3429.32,33.9,,2743.46,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7890.48,78,,6312.38,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8355.82,82.6,,6684.66,,,0,"percent of total billed charges","82.6% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8355.82,82.6,,6684.66,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,10116,100,,8092.80,,,0,"percent of total billed charges","100% of total billed charges",1547.75,11625.57,
"REPOSITION OF VENA CAVA FILTER",84037492,CDM,481,RC,37192,CPT,OUTPATIENT,,,7829,5088.85,,6889.52,88,,5511.62,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",3318.68,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4932.27,63,,3945.82,,,0,"percent of total billed charges","63% of total billed charges",1197.84,15.3,,958.27,,,0,"percent of total billed charges","15.3% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,5402.01,69,,,,,0,"fee schedule","69% of total billed charges",7829,100,,6263.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7829,100,,6263.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7829,100,,6263.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2386.68,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.46,100,,,,,0,"fee schedule",EAPG,4188.63,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2951.53,37.7,,2361.22,,,0,"percent of total billed charges","37.7% of total billed charges",2951.53,37.7,,2361.22,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2654.03,33.9,,2123.22,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6106.62,78,,4885.30,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6466.75,82.6,,5173.40,,,0,"percent of total billed charges","82.6% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6466.75,82.6,,5173.40,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,7829,100,,6263.20,,,0,"percent of total billed charges","100% of total billed charges",1197.84,11625.57,
"TRANSCATHETER BIOPSY",84037200,CDM,360,RC,37200,CPT,OUTPATIENT,,,1394,906.1,,1226.72,88,,981.38,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,1394,100,,1115.20,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3318.68,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",878.22,63,,702.58,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,961.86,69,,,,,0,"fee schedule","69% of total billed charges",1394,100,,1115.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1394,100,,1115.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1394,100,,1115.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2386.68,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.46,100,,,,,0,"fee schedule",EAPG,4188.63,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",525.54,37.7,,420.43,,,0,"percent of total billed charges","37.7% of total billed charges",525.54,37.7,,420.43,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",472.57,33.9,,378.06,,,0,"percent of total billed charges","33.9% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1087.32,78,,869.86,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1151.44,82.6,,921.15,,,0,"percent of total billed charges","82.6% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1151.44,82.6,,921.15,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,1394,100,,1115.20,,,0,"percent of total billed charges","100% of total billed charges",472.57,19379.77,
"THROMBOLYTIC ART THERAPY",84037211,CDM,360,RC,37211,CPT,OUTPATIENT,,,1955,1270.75,,1720.4,88,,1376.32,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,1955,100,,1564.00,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3318.68,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1231.65,63,,985.32,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,1348.95,69,,,,,0,"fee schedule","69% of total billed charges",1955,100,,1564.00,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955,100,,1564.00,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955,100,,1564.00,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2386.68,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.46,100,,,,,0,"fee schedule",EAPG,4188.63,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737.04,37.7,,589.63,,,0,"percent of total billed charges","37.7% of total billed charges",737.04,37.7,,589.63,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",662.75,33.9,,530.20,,,0,"percent of total billed charges","33.9% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1524.9,78,,1219.92,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1614.83,82.6,,1291.86,,,0,"percent of total billed charges","82.6% of total billed charges",3222.02,100,,,,,0,"fee schedule","100% of WA fee schedule",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1614.83,82.6,,1291.86,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,1955,100,,1564.00,,,0,"percent of total billed charges","100% of total billed charges",662.75,19379.77,
"THROMBOLYTIC VENOUS THERAPY",84037212,CDM,361,RC,37212,CPT,OUTPATIENT,,,3489,2267.85,,3070.32,88,,2456.26,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,3489,100,,2791.20,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",3318.68,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2198.07,63,,1758.46,,,0,"percent of total billed charges","63% of total billed charges",533.82,15.3,,427.06,,,0,"percent of total billed charges","15.3% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,2407.41,69,,,,,0,"fee schedule","69% of total billed charges",3489,100,,2791.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3489,100,,2791.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3489,100,,2791.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2386.68,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.46,100,,,,,0,"fee schedule",EAPG,4188.63,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1315.35,37.7,,1052.28,,,0,"percent of total billed charges","37.7% of total billed charges",1315.35,37.7,,1052.28,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1182.77,33.9,,946.22,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2721.42,78,,2177.14,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2881.91,82.6,,2305.53,,,0,"percent of total billed charges","82.6% of total billed charges",3222.02,100,,,,,0,"fee schedule","100% of WA fee schedule",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2881.91,82.6,,2305.53,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,3489,100,,2791.20,,,0,"percent of total billed charges","100% of total billed charges",533.82,11625.57,
"THROMB ART/VEN THERAPY SUBSEQ",84037213,CDM,361,RC,37213,CPT,OUTPATIENT,,,7785,5060.25,,6850.8,88,,5480.64,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",3318.68,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4904.55,63,,3923.64,,,0,"percent of total billed charges","63% of total billed charges",1191.11,15.3,,952.89,,,0,"percent of total billed charges","15.3% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,5371.65,69,,,,,0,"fee schedule","69% of total billed charges",7785,100,,6228.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7785,100,,6228.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7785,100,,6228.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2386.68,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.46,100,,,,,0,"fee schedule",EAPG,4188.63,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2934.95,37.7,,2347.96,,,0,"percent of total billed charges","37.7% of total billed charges",2934.95,37.7,,2347.96,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2639.12,33.9,,2111.30,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6072.3,78,,4857.84,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6430.41,82.6,,5144.33,,,0,"percent of total billed charges","82.6% of total billed charges",3222.02,100,,,,,0,"fee schedule","100% of WA fee schedule",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6430.41,82.6,,5144.33,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,7785,100,,6228.00,,,0,"percent of total billed charges","100% of total billed charges",1191.11,11625.57,
"CESSATION ART/VEN THROMB THER",84037214,CDM,361,RC,37214,CPT,OUTPATIENT,,,7785,5060.25,,6850.8,88,,5480.64,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",3318.68,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4904.55,63,,3923.64,,,0,"percent of total billed charges","63% of total billed charges",1191.11,15.3,,952.89,,,0,"percent of total billed charges","15.3% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,5371.65,69,,,,,0,"fee schedule","69% of total billed charges",7785,100,,6228.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7785,100,,6228.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7785,100,,6228.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2386.68,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.46,100,,,,,0,"fee schedule",EAPG,4188.63,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2934.95,37.7,,2347.96,,,0,"percent of total billed charges","37.7% of total billed charges",2934.95,37.7,,2347.96,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2639.12,33.9,,2111.30,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6072.3,78,,4857.84,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6430.41,82.6,,5144.33,,,0,"percent of total billed charges","82.6% of total billed charges",3222.02,100,,,,,0,"fee schedule","100% of WA fee schedule",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6430.41,82.6,,5144.33,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,7785,100,,6228.00,,,0,"percent of total billed charges","100% of total billed charges",1191.11,11625.57,
"TXCATH STENT DIS EMBO PROT SUR",84037215,CDM,361,RC,37215,CPT,OUTPATIENT,,,9970,6480.5,,8773.6,88,,7018.88,,,0,"percent of total billed charges","88% of total billed charges",9970,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10125.25,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9970,175,,,,,0,"fee schedule","175% of CMS fee schedule",10429,100,,,,,0,"fee schedule",EAPG,9970,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6281.1,63,,5024.88,,,0,"percent of total billed charges","63% of total billed charges",1525.41,15.3,,1220.33,,,0,"percent of total billed charges","15.3% of total billed charges",10125.25,100,,,,,0,"fee schedule",EAPG,6879.3,69,,,,,0,"fee schedule","69% of total billed charges",9970,100,,7976.00,,,0,"percent of total billed charges","100% of total billed charges",9970,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9970,100,,7976.00,,,0,"percent of total billed charges","100% of total billed charges",9970,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9970,100,,7976.00,,,0,"percent of total billed charges","100% of total billed charges",9970,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9970,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10125.25,100,,,,,0,"fee schedule",EAPG,9970,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9970,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7500.18,100,,,,,0,"fee schedule",EAPG,9970,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10327.75,100,,,,,0,"fee schedule",EAPG,13162.82,100,,,,,0,"fee schedule",EAPG,9970,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3758.69,37.7,,3006.95,,,0,"percent of total billed charges","37.7% of total billed charges",3758.69,37.7,,3006.95,,,0,"percent of total billed charges","37.70% of total billed charges",9970,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3379.83,33.9,,2703.86,,,0,"percent of total billed charges","33.9% of total billed charges",9970,100,,,,,0,"fee schedule","100% of CMS fee schedule",7776.6,78,,6221.28,,,0,"percent of total billed charges","78% of total billed charges",9970,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8235.22,82.6,,6588.18,,,0,"percent of total billed charges","82.6% of total billed charges",10125.25,100,,,,,0,"fee schedule","100% of WA fee schedule",9970,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8235.22,82.6,,6588.18,,,0,"percent of total billed charges","82.6% of total billed charges",9970,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10125.25,100,,,,,0,"fee schedule",EAPG,9970,100,,7976.00,,,0,"percent of total billed charges","100% of total billed charges",1525.41,13162.82,
"STENT TRUNK/UPP EXT INIT ART",84037236,CDM,361,RC,37236,CPT,OUTPATIENT,,,35980,23387,,31662.4,88,,25329.92,,,0,"percent of total billed charges","88% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",19636.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",10180.16,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22667.4,63,,18133.92,,,0,"percent of total billed charges","63% of total billed charges",5504.94,15.3,,4403.95,,,0,"percent of total billed charges","15.3% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,24826.2,69,,,,,0,"fee schedule","69% of total billed charges",35980,100,,28784.00,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35980,100,,28784.00,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35980,100,,28784.00,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",40799.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10666.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7321.22,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10081.33,100,,,,,0,"fee schedule",EAPG,12848.75,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13564.46,37.7,,10851.57,,,0,"percent of total billed charges","37.7% of total billed charges",13564.46,37.7,,10851.57,,,0,"percent of total billed charges","37.70% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",12197.22,33.9,,9757.78,,,0,"percent of total billed charges","33.9% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",28064.4,78,,22451.52,,,0,"percent of total billed charges","78% of total billed charges",11332.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29719.48,82.6,,23775.58,,,0,"percent of total billed charges","82.6% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29719.48,82.6,,23775.58,,,0,"percent of total billed charges","82.6% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,35980,100,,28784.00,,,0,"percent of total billed charges","100% of total billed charges",4695,40799.76,
"STENT TRUNK/UPP EXT EA ADD ART",84037237,CDM,361,RC,37237,CPT,OUTPATIENT,,,38419,24972.35,,33808.72,88,,27046.98,,,0,"percent of total billed charges","88% of total billed charges",19209.5,50,,15367.60,,,0,"percent of total billed charges","50% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10180.16,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",24203.97,63,,19363.18,,,0,"percent of total billed charges","63% of total billed charges",5878.11,15.3,,4702.49,,,0,"percent of total billed charges","15.3% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,26509.11,69,,,,,0,"fee schedule","69% of total billed charges",38419,100,,30735.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38419,100,,30735.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38419,100,,30735.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23762.15,61.85,,19009.72,,,0,"percent of total billed charges","61.5% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,19209.5,50,,15367.60,,,0,"percent of total billed charges","50% of total billed charges",12370.92,32.2,,9896.74,,,0,"percent of total billed charges","32.2% of total billed charges",7321.22,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",10081.33,100,,,,,0,"fee schedule",EAPG,12848.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",14483.96,37.7,,11587.17,,,0,"percent of total billed charges","37.7% of total billed charges",14483.96,37.7,,11587.17,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",13024.04,33.9,,10419.23,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",29966.82,78,,23973.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",31734.09,82.6,,25387.27,,,0,"percent of total billed charges","82.6% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,19209.5,50,,15367.60,,,0,"percent of total billed charges","50% of total billed charges",31734.09,82.6,,25387.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9883.65,100,,,,,0,"fee schedule",EAPG,38419,100,,30735.20,,,0,"percent of total billed charges","100% of total billed charges",4695,38419,
"STENT PLACE INIT VEIN",84037238,CDM,361,RC,37238,CPT,OUTPATIENT,,,35980,23387,,31662.4,88,,25329.92,,,0,"percent of total billed charges","88% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",19636.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",10180.16,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22667.4,63,,18133.92,,,0,"percent of total billed charges","63% of total billed charges",5504.94,15.3,,4403.95,,,0,"percent of total billed charges","15.3% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,24826.2,69,,,,,0,"fee schedule","69% of total billed charges",35980,100,,28784.00,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35980,100,,28784.00,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35980,100,,28784.00,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",40799.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10666.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7321.22,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10081.33,100,,,,,0,"fee schedule",EAPG,12848.75,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13564.46,37.7,,10851.57,,,0,"percent of total billed charges","37.7% of total billed charges",13564.46,37.7,,10851.57,,,0,"percent of total billed charges","37.70% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",12197.22,33.9,,9757.78,,,0,"percent of total billed charges","33.9% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",28064.4,78,,22451.52,,,0,"percent of total billed charges","78% of total billed charges",11332.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29719.48,82.6,,23775.58,,,0,"percent of total billed charges","82.6% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29719.48,82.6,,23775.58,,,0,"percent of total billed charges","82.6% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,35980,100,,28784.00,,,0,"percent of total billed charges","100% of total billed charges",4695,40799.76,
"STENT TRUNK/UP EXT EA ADD VEIN",84037239,CDM,361,RC,37239,CPT,OUTPATIENT,,,17396,11307.4,,15308.48,88,,12246.78,,,0,"percent of total billed charges","88% of total billed charges",8698,50,,6958.40,,,0,"percent of total billed charges","50% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10180.16,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",10959.48,63,,8767.58,,,0,"percent of total billed charges","63% of total billed charges",2661.59,15.3,,2129.27,,,0,"percent of total billed charges","15.3% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,12003.24,69,,,,,0,"fee schedule","69% of total billed charges",17396,100,,13916.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17396,100,,13916.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17396,100,,13916.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10759.43,61.85,,8607.54,,,0,"percent of total billed charges","61.5% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,8698,50,,6958.40,,,0,"percent of total billed charges","50% of total billed charges",5601.51,32.2,,4481.21,,,0,"percent of total billed charges","32.2% of total billed charges",7321.22,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",10081.33,100,,,,,0,"fee schedule",EAPG,12848.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",6558.29,37.7,,5246.63,,,0,"percent of total billed charges","37.7% of total billed charges",6558.29,37.7,,5246.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",5897.24,33.9,,4717.79,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",13568.88,78,,10855.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14369.1,82.6,,11495.28,,,0,"percent of total billed charges","82.6% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,8698,50,,6958.40,,,0,"percent of total billed charges","50% of total billed charges",14369.1,82.6,,11495.28,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9883.65,100,,,,,0,"fee schedule",EAPG,17396,100,,13916.80,,,0,"percent of total billed charges","100% of total billed charges",2661.59,17396,
"VAC EMBOL OCCLU IMAGE VENOUS",84037241,CDM,360,RC,37241,CPT,OUTPATIENT,,,13013,8458.45,,11451.44,88,,9161.15,,,0,"percent of total billed charges","88% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",19636.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",10180.16,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8198.19,63,,6558.55,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,8978.97,69,,,,,0,"fee schedule","69% of total billed charges",13013,100,,10410.40,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13013,100,,10410.40,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13013,100,,10410.40,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",40799.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10666.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7321.22,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10081.33,100,,,,,0,"fee schedule",EAPG,12848.75,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4905.9,37.7,,3924.72,,,0,"percent of total billed charges","37.7% of total billed charges",4905.9,37.7,,3924.72,,,0,"percent of total billed charges","37.70% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4411.41,33.9,,3529.13,,,0,"percent of total billed charges","33.9% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10150.14,78,,8120.11,,,0,"percent of total billed charges","78% of total billed charges",11332.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10748.74,82.6,,8598.99,,,0,"percent of total billed charges","82.6% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10748.74,82.6,,8598.99,,,0,"percent of total billed charges","82.6% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,13013,100,,10410.40,,,0,"percent of total billed charges","100% of total billed charges",3367,40799.76,
"VAC EMBOL OCCLU IMAGE ARTERIAL",84037242,CDM,360,RC,37242,CPT,OUTPATIENT,,,20277,13180.05,,17843.76,88,,14275.01,,,0,"percent of total billed charges","88% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",31299.05,175,,,,,0,"fee schedule","175% of CMS fee schedule",10180.16,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",12774.51,63,,10219.61,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,13991.13,69,,,,,0,"fee schedule","69% of total billed charges",20277,100,,16221.60,,,0,"percent of total billed charges","100% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",20277,100,,16221.60,,,0,"percent of total billed charges","100% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",20277,100,,16221.60,,,0,"percent of total billed charges","100% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",40799.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10666.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7321.22,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10081.33,100,,,,,0,"fee schedule",EAPG,12848.75,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7644.43,37.7,,6115.54,,,0,"percent of total billed charges","37.7% of total billed charges",7644.43,37.7,,6115.54,,,0,"percent of total billed charges","37.70% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6873.9,33.9,,5499.12,,,0,"percent of total billed charges","33.9% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15816.06,78,,12652.85,,,0,"percent of total billed charges","78% of total billed charges",18064.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16748.8,82.6,,13399.04,,,0,"percent of total billed charges","82.6% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16748.8,82.6,,13399.04,,,0,"percent of total billed charges","82.6% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,20277,100,,16221.60,,,0,"percent of total billed charges","100% of total billed charges",3367,40799.76,
"EMBOLIZE/OCCLUSION FOR TUMORS",84037243,CDM,360,RC,37243,CPT,OUTPATIENT,,,35197,22878.05,,30973.36,88,,24778.69,,,0,"percent of total billed charges","88% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",19636.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",10180.16,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22174.11,63,,17739.29,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,24285.93,69,,,,,0,"fee schedule","69% of total billed charges",35197,100,,28157.60,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35197,100,,28157.60,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35197,100,,28157.60,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",40799.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10666.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7321.22,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10081.33,100,,,,,0,"fee schedule",EAPG,12848.75,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13269.27,37.7,,10615.42,,,0,"percent of total billed charges","37.7% of total billed charges",13269.27,37.7,,10615.42,,,0,"percent of total billed charges","37.70% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11931.78,33.9,,9545.42,,,0,"percent of total billed charges","33.9% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",27453.66,78,,21962.93,,,0,"percent of total billed charges","78% of total billed charges",11332.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29072.72,82.6,,23258.18,,,0,"percent of total billed charges","82.6% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29072.72,82.6,,23258.18,,,0,"percent of total billed charges","82.6% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,35197,100,,28157.60,,,0,"percent of total billed charges","100% of total billed charges",3367,40799.76,
"TRLUML BALO ANTIOP 1ST ART",84037246,CDM,360,RC,37246,CPT,OUTPATIENT,,,1789,1162.85,,1574.32,88,,1259.46,,,0,"percent of total billed charges","88% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,1789,100,,1431.20,,,0,"percent of total billed charges","100% of total billed charges",10202.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",3318.68,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1127.07,63,,901.66,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,1234.41,69,,,,,0,"fee schedule","69% of total billed charges",1789,100,,1431.20,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1789,100,,1431.20,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1789,100,,1431.20,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",20137.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5264.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2386.68,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.46,100,,,,,0,"fee schedule",EAPG,4188.63,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",674.45,37.7,,539.56,,,0,"percent of total billed charges","37.7% of total billed charges",674.45,37.7,,539.56,,,0,"percent of total billed charges","37.70% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",606.47,33.9,,485.18,,,0,"percent of total billed charges","33.9% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1395.42,78,,1116.34,,,0,"percent of total billed charges","78% of total billed charges",5888.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1477.71,82.6,,1182.17,,,0,"percent of total billed charges","82.6% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1477.71,82.6,,1182.17,,,0,"percent of total billed charges","82.6% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,1789,100,,1431.20,,,0,"percent of total billed charges","100% of total billed charges",606.47,20137.31,
"IR-TLUM BAL ANG 1STV",84037248,CDM,360,RC,37248,CPT,OUTPATIENT,,,30169,19609.85,,26548.72,88,,21238.98,,,0,"percent of total billed charges","88% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",10202.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",3318.68,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19006.47,63,,15205.18,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,20816.61,69,,,,,0,"fee schedule","69% of total billed charges",30169,100,,24135.20,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",30169,100,,24135.20,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",30169,100,,24135.20,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",20137.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5264.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2386.68,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.46,100,,,,,0,"fee schedule",EAPG,4188.63,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11373.71,37.7,,9098.97,,,0,"percent of total billed charges","37.7% of total billed charges",11373.71,37.7,,9098.97,,,0,"percent of total billed charges","37.70% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10227.29,33.9,,8181.83,,,0,"percent of total billed charges","33.9% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23531.82,78,,18825.46,,,0,"percent of total billed charges","78% of total billed charges",5888.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24919.59,82.6,,19935.67,,,0,"percent of total billed charges","82.6% of total billed charges",3222.02,100,,,,,0,"fee schedule","100% of WA fee schedule",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24919.59,82.6,,19935.67,,,0,"percent of total billed charges","82.6% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,30169,100,,24135.20,,,0,"percent of total billed charges","100% of total billed charges",2386.68,30169,
"IVUS PERIPHIAL ADDL SURG",84037251,CDM,361,RC,37251,CPT,OUTPATIENT,,,7990,5193.5,,7031.2,88,,5624.96,,,0,"percent of total billed charges","88% of total billed charges",3995,50,,3196.00,,,0,"percent of total billed charges","50% of total billed charges",1342.32,16.8,,1073.86,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1382.59,17.304,,1106.07,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5033.7,63,,4026.96,,,0,"percent of total billed charges","63% of total billed charges",1222.47,15.3,,977.98,,,0,"percent of total billed charges","15.3% of total billed charges",1342.32,16.8,,1073.86,,,0,"percent of total billed charges","16.8% of total billed charges",5513.1,69,,,,,0,"fee schedule","69% of total billed charges",7990,100,,6392.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7990,100,,6392.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7990,100,,6392.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4941.82,61.85,,3953.46,,,0,"percent of total billed charges","61.5% of total billed charges",1342.32,16.8,,1073.86,,,0,"percent of total billed charges","16.8% of total billed charges",3995,50,,3196.00,,,0,"percent of total billed charges","50% of total billed charges",2572.78,32.2,,2058.22,,,0,"percent of total billed charges","32.2% of total billed charges",1342.32,16.8,,1073.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1369.17,17.136,,1095.34,,,0,"percent of total billed charges","17.136% of total billed charges",1745.02,21.84,,1396.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3012.23,37.7,,2409.78,,,0,"percent of total billed charges","37.7% of total billed charges",3012.23,37.7,,2409.78,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2708.61,33.9,,2166.89,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6232.2,78,,4985.76,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6599.74,82.6,,5279.79,,,0,"percent of total billed charges","82.6% of total billed charges",1342.32,16.8,,1073.86,,,0,"percent of total billed charges","16.8% of total billed charges",3995,50,,3196.00,,,0,"percent of total billed charges","50% of total billed charges",6599.74,82.6,,5279.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1342.32,16.8,,1073.86,,,0,"percent of total billed charges","16.8% of total billed charges",7990,100,,6392.00,,,0,"percent of total billed charges","100% of total billed charges",1222.47,7990,
"IVUS SUPERVISION SI",84037252,CDM,320,RC,37252,CPT,OUTPATIENT,,,868,564.2,,763.84,88,,611.07,,,0,"percent of total billed charges","88% of total billed charges",434,50,,347.20,,,0,"percent of total billed charges","50% of total billed charges",145.82,16.8,,116.66,,,0,"percent of total billed charges","16.8% of total billed charges",868,100,,694.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",150.2,17.304,,120.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",546.84,63,,437.47,,,0,"percent of total billed charges","63% of total billed charges",132.8,15.3,,106.24,,,0,"percent of total billed charges","15.3% of total billed charges",145.82,16.8,,116.66,,,0,"percent of total billed charges","16.8% of total billed charges",598.92,69,,,,,0,"fee schedule","69% of total billed charges",868,100,,694.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",868,100,,694.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",868,100,,694.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536.86,61.85,,429.49,,,0,"percent of total billed charges","61.5% of total billed charges",145.82,16.8,,116.66,,,0,"percent of total billed charges","16.8% of total billed charges",434,50,,347.20,,,0,"percent of total billed charges","50% of total billed charges",279.5,32.2,,223.60,,,0,"percent of total billed charges","32.2% of total billed charges",145.82,16.8,,116.66,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",148.74,17.136,,118.99,,,0,"percent of total billed charges","17.136% of total billed charges",189.57,21.84,,151.66,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",327.24,37.7,,261.79,,,0,"percent of total billed charges","37.7% of total billed charges",327.24,37.7,,261.79,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",294.25,33.9,,235.40,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",677.04,78,,541.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",716.97,82.6,,573.58,,,0,"percent of total billed charges","82.6% of total billed charges",145.82,16.8,,116.66,,,0,"percent of total billed charges","16.8% of total billed charges",434,50,,347.20,,,0,"percent of total billed charges","50% of total billed charges",716.97,82.6,,573.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",145.82,16.8,,116.66,,,0,"percent of total billed charges","16.8% of total billed charges",868,100,,694.40,,,0,"percent of total billed charges","100% of total billed charges",132.8,868,
"UNLISTED PROC VASC SURGERY",84037799,CDM,761,RC,37799,CPT,OUTPATIENT,,,2662,1730.3,,2342.56,88,,1874.05,,,0,"percent of total billed charges","88% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.89,100,,,,,0,"fee schedule",EAPG,2662,100,,2129.60,,,0,"percent of total billed charges","100% of total billed charges",1121.3,175,,,,,0,"fee schedule","175% of CMS fee schedule",2014.57,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1677.06,63,,1341.65,,,0,"percent of total billed charges","63% of total billed charges",407.29,15.3,,325.83,,,0,"percent of total billed charges","15.3% of total billed charges",1955.89,100,,,,,0,"fee schedule",EAPG,1836.78,69,,,,,0,"fee schedule","69% of total billed charges",2662,100,,2129.60,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2662,100,,2129.60,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2662,100,,2129.60,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",2200.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.89,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",575.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1448.81,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1995.01,100,,,,,0,"fee schedule",EAPG,2542.66,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1003.57,37.7,,802.86,,,0,"percent of total billed charges","37.7% of total billed charges",1003.57,37.7,,802.86,,,0,"percent of total billed charges","37.70% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",902.42,33.9,,721.94,,,0,"percent of total billed charges","33.9% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2076.36,78,,1661.09,,,0,"percent of total billed charges","78% of total billed charges",647.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2198.81,82.6,,1759.05,,,0,"percent of total billed charges","82.6% of total billed charges",1955.89,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2198.81,82.6,,1759.05,,,0,"percent of total billed charges","82.6% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.89,100,,,,,0,"fee schedule",EAPG,2662,100,,2129.60,,,0,"percent of total billed charges","100% of total billed charges",407.29,2662,
"BONE MARROW BX SURG",84038221,CDM,361,RC,38221,CPT,OUTPATIENT,,,2528,1643.2,,2224.64,88,,1779.71,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1070.37,100,,,,,0,"fee schedule",EAPG,2528,100,,2022.40,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1102.48,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1592.64,63,,1274.11,,,0,"percent of total billed charges","63% of total billed charges",386.78,15.3,,309.42,,,0,"percent of total billed charges","15.3% of total billed charges",1070.37,100,,,,,0,"fee schedule",EAPG,1744.32,69,,,,,0,"fee schedule","69% of total billed charges",2528,100,,2022.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2528,100,,2022.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2528,100,,2022.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1070.37,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",792.87,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1091.78,100,,,,,0,"fee schedule",EAPG,1391.48,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",953.06,37.7,,762.45,,,0,"percent of total billed charges","37.7% of total billed charges",953.06,37.7,,762.45,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",856.99,33.9,,685.59,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1971.84,78,,1577.47,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2088.13,82.6,,1670.50,,,0,"percent of total billed charges","82.6% of total billed charges",1070.37,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2088.13,82.6,,1670.50,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1070.37,100,,,,,0,"fee schedule",EAPG,2528,100,,2022.40,,,0,"percent of total billed charges","100% of total billed charges",386.78,5715.97,
"Drug-induced sleep endoscopy, with dynamic evaluation of vel",36042975,CDM,360,RC,42975,CPT,OUTPATIENT,,,535,347.75,,470.8,88,,376.64,,,0,"percent of total billed charges","88% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",3029.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",337.05,63,,269.64,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,369.15,69,,,,,0,"fee schedule","69% of total billed charges",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",330.9,61.85,,264.72,,,0,"percent of total billed charges","61.5% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",95.41,100,,,,,0,"fee schedule","100% of LI fee schedule",74.15,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",201.7,37.7,,161.36,,,0,"percent of total billed charges","37.7% of total billed charges",201.7,37.7,,161.36,,,0,"percent of total billed charges","37.70% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",181.37,33.9,,145.10,,,0,"percent of total billed charges","33.9% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",417.3,78,,333.84,,,0,"percent of total billed charges","78% of total billed charges",1748.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.91,82.6,,353.53,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule","100% of WA fee schedule",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.91,82.6,,353.53,,,0,"percent of total billed charges","82.6% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",74.15,3367,
"PLACE NASO/ORO-GASTRIC TUBE",84043752,CDM,361,RC,43752,CPT,OUTPATIENT,,,272,176.8,,239.36,88,,191.49,,,0,"percent of total billed charges","88% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,272,100,,217.60,,,0,"percent of total billed charges","100% of total billed charges",711.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",624,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.36,63,,137.09,,,0,"percent of total billed charges","63% of total billed charges",41.62,15.3,,33.30,,,0,"percent of total billed charges","15.3% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,187.68,69,,,,,0,"fee schedule","69% of total billed charges",272,100,,217.60,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272,100,,217.60,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272,100,,217.60,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",1097.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287,100,,,,,0,"fee schedule","100% of CMS OPPS rate",448.76,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",617.95,100,,,,,0,"fee schedule",EAPG,787.58,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.54,37.7,,82.03,,,0,"percent of total billed charges","37.7% of total billed charges",102.54,37.7,,82.03,,,0,"percent of total billed charges","37.70% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.21,33.9,,73.77,,,0,"percent of total billed charges","33.9% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",212.16,78,,169.73,,,0,"percent of total billed charges","78% of total billed charges",410.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.67,82.6,,179.74,,,0,"percent of total billed charges","82.6% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.67,82.6,,179.74,,,0,"percent of total billed charges","82.6% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,272,100,,217.60,,,0,"percent of total billed charges","100% of total billed charges",41.62,1097.77,
"REPO NASO/ORO GASTRC FEED TUBE",84043761,CDM,361,RC,43761,CPT,OUTPATIENT,,,2766,1797.9,,2434.08,88,,1947.26,,,0,"percent of total billed charges","88% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,2766,100,,2212.80,,,0,"percent of total billed charges","100% of total billed charges",441.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",624,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1742.58,63,,1394.06,,,0,"percent of total billed charges","63% of total billed charges",423.2,15.3,,338.56,,,0,"percent of total billed charges","15.3% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,1908.54,69,,,,,0,"fee schedule","69% of total billed charges",2766,100,,2212.80,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2766,100,,2212.80,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2766,100,,2212.80,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1081.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",282.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",448.76,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",617.95,100,,,,,0,"fee schedule",EAPG,787.58,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1042.78,37.7,,834.22,,,0,"percent of total billed charges","37.7% of total billed charges",1042.78,37.7,,834.22,,,0,"percent of total billed charges","37.70% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",937.67,33.9,,750.14,,,0,"percent of total billed charges","33.9% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2157.48,78,,1725.98,,,0,"percent of total billed charges","78% of total billed charges",254.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2284.72,82.6,,1827.78,,,0,"percent of total billed charges","82.6% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2284.72,82.6,,1827.78,,,0,"percent of total billed charges","82.6% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,2766,100,,2212.80,,,0,"percent of total billed charges","100% of total billed charges",252.08,2766,
"IR CHOLE DRAIN CHECK (BOTH)",84047531,CDM,360,RC,47531,CPT,OUTPATIENT,,,667,433.55,,586.96,88,,469.57,,,0,"percent of total billed charges","88% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,667,100,,533.60,,,0,"percent of total billed charges","100% of total billed charges",6175.28,175,,,,,0,"fee schedule","175% of CMS fee schedule",1694.66,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.21,63,,336.17,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,460.23,69,,,,,0,"fee schedule","69% of total billed charges",667,100,,533.60,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",667,100,,533.60,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",667,100,,533.60,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1218.74,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1678.2,100,,,,,0,"fee schedule",EAPG,2138.89,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",251.46,37.7,,201.17,,,0,"percent of total billed charges","37.7% of total billed charges",251.46,37.7,,201.17,,,0,"percent of total billed charges","37.70% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",226.11,33.9,,180.89,,,0,"percent of total billed charges","33.9% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",520.26,78,,416.21,,,0,"percent of total billed charges","78% of total billed charges",3564.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",550.94,82.6,,440.75,,,0,"percent of total billed charges","82.6% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",550.94,82.6,,440.75,,,0,"percent of total billed charges","82.6% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,667,100,,533.60,,,0,"percent of total billed charges","100% of total billed charges",226.11,12932.7,
"IR PERC CHOLANGIOGRAM GALLBLAD",84047532,CDM,360,RC,47532,CPT,OUTPATIENT,,,1484,964.6,,1305.92,88,,1044.74,,,0,"percent of total billed charges","88% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,1484,100,,1187.20,,,0,"percent of total billed charges","100% of total billed charges",6175.28,175,,,,,0,"fee schedule","175% of CMS fee schedule",1694.66,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",934.92,63,,747.94,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,1023.96,69,,,,,0,"fee schedule","69% of total billed charges",1484,100,,1187.20,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1484,100,,1187.20,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1484,100,,1187.20,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1218.74,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1678.2,100,,,,,0,"fee schedule",EAPG,2138.89,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",559.47,37.7,,447.58,,,0,"percent of total billed charges","37.7% of total billed charges",559.47,37.7,,447.58,,,0,"percent of total billed charges","37.70% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",503.08,33.9,,402.46,,,0,"percent of total billed charges","33.9% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1157.52,78,,926.02,,,0,"percent of total billed charges","78% of total billed charges",3564.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1225.78,82.6,,980.62,,,0,"percent of total billed charges","82.6% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1225.78,82.6,,980.62,,,0,"percent of total billed charges","82.6% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,1484,100,,1187.20,,,0,"percent of total billed charges","100% of total billed charges",503.08,12932.7,
"IR PTC EXT (BILLARY SYSTEM)",84047533,CDM,360,RC,47533,CPT,OUTPATIENT,,,2086,1355.9,,1835.68,88,,1468.54,,,0,"percent of total billed charges","88% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2269.56,100,,,,,0,"fee schedule",EAPG,2086,100,,1668.80,,,0,"percent of total billed charges","100% of total billed charges",6175.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",2337.65,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1314.18,63,,1051.34,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",2269.56,100,,,,,0,"fee schedule",EAPG,1439.34,69,,,,,0,"fee schedule","69% of total billed charges",2086,100,,1668.80,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2086,100,,1668.80,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2086,100,,1668.80,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2269.56,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1681.16,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2314.95,100,,,,,0,"fee schedule",EAPG,2950.43,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.42,37.7,,629.14,,,0,"percent of total billed charges","37.7% of total billed charges",786.42,37.7,,629.14,,,0,"percent of total billed charges","37.70% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",707.15,33.9,,565.72,,,0,"percent of total billed charges","33.9% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1627.08,78,,1301.66,,,0,"percent of total billed charges","78% of total billed charges",3564.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1723.04,82.6,,1378.43,,,0,"percent of total billed charges","82.6% of total billed charges",2269.56,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1723.04,82.6,,1378.43,,,0,"percent of total billed charges","82.6% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2269.56,100,,,,,0,"fee schedule",EAPG,2086,100,,1668.80,,,0,"percent of total billed charges","100% of total billed charges",707.15,12932.7,
"IR PTC IN/EXT (BILLARY SYSTEM)",84047534,CDM,360,RC,47534,CPT,OUTPATIENT,,,2673,1737.45,,2352.24,88,,1881.79,,,0,"percent of total billed charges","88% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2269.56,100,,,,,0,"fee schedule",EAPG,2673,100,,2138.40,,,0,"percent of total billed charges","100% of total billed charges",6175.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",2337.65,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1683.99,63,,1347.19,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",2269.56,100,,,,,0,"fee schedule",EAPG,1844.37,69,,,,,0,"fee schedule","69% of total billed charges",2673,100,,2138.40,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2673,100,,2138.40,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2673,100,,2138.40,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2269.56,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1681.16,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2314.95,100,,,,,0,"fee schedule",EAPG,2950.43,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1007.72,37.7,,806.18,,,0,"percent of total billed charges","37.7% of total billed charges",1007.72,37.7,,806.18,,,0,"percent of total billed charges","37.70% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",906.15,33.9,,724.92,,,0,"percent of total billed charges","33.9% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2084.94,78,,1667.95,,,0,"percent of total billed charges","78% of total billed charges",3564.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2207.9,82.6,,1766.32,,,0,"percent of total billed charges","82.6% of total billed charges",2269.56,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2207.9,82.6,,1766.32,,,0,"percent of total billed charges","82.6% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2269.56,100,,,,,0,"fee schedule",EAPG,2673,100,,2138.40,,,0,"percent of total billed charges","100% of total billed charges",906.15,12932.7,
"IR PTC CONV EXT TO INT BILLSYS",84047535,CDM,360,RC,47535,CPT,OUTPATIENT,,,1536,998.4,,1351.68,88,,1081.34,,,0,"percent of total billed charges","88% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2269.56,100,,,,,0,"fee schedule",EAPG,1536,100,,1228.80,,,0,"percent of total billed charges","100% of total billed charges",6175.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",2337.65,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.68,63,,774.14,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",2269.56,100,,,,,0,"fee schedule",EAPG,1059.84,69,,,,,0,"fee schedule","69% of total billed charges",1536,100,,1228.80,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1536,100,,1228.80,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1536,100,,1228.80,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2269.56,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1681.16,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2314.95,100,,,,,0,"fee schedule",EAPG,2950.43,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579.07,37.7,,463.26,,,0,"percent of total billed charges","37.7% of total billed charges",579.07,37.7,,463.26,,,0,"percent of total billed charges","37.70% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",520.7,33.9,,416.56,,,0,"percent of total billed charges","33.9% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1198.08,78,,958.46,,,0,"percent of total billed charges","78% of total billed charges",3564.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1268.74,82.6,,1014.99,,,0,"percent of total billed charges","82.6% of total billed charges",2269.56,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1268.74,82.6,,1014.99,,,0,"percent of total billed charges","82.6% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2269.56,100,,,,,0,"fee schedule",EAPG,1536,100,,1228.80,,,0,"percent of total billed charges","100% of total billed charges",520.7,12932.7,
"IR CHOLE DRAIN EXCHANGE (BOTH)",84047536,CDM,360,RC,47536,CPT,OUTPATIENT,,,987,641.55,,868.56,88,,694.85,,,0,"percent of total billed charges","88% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2269.56,100,,,,,0,"fee schedule",EAPG,987,100,,789.60,,,0,"percent of total billed charges","100% of total billed charges",6175.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",2337.65,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",621.81,63,,497.45,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",2269.56,100,,,,,0,"fee schedule",EAPG,681.03,69,,,,,0,"fee schedule","69% of total billed charges",987,100,,789.60,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",987,100,,789.60,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",987,100,,789.60,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2269.56,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1681.16,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2314.95,100,,,,,0,"fee schedule",EAPG,2950.43,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",372.1,37.7,,297.68,,,0,"percent of total billed charges","37.7% of total billed charges",372.1,37.7,,297.68,,,0,"percent of total billed charges","37.70% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",334.59,33.9,,267.67,,,0,"percent of total billed charges","33.9% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",769.86,78,,615.89,,,0,"percent of total billed charges","78% of total billed charges",3564.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",815.26,82.6,,652.21,,,0,"percent of total billed charges","82.6% of total billed charges",2269.56,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",815.26,82.6,,652.21,,,0,"percent of total billed charges","82.6% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2269.56,100,,,,,0,"fee schedule",EAPG,987,100,,789.60,,,0,"percent of total billed charges","100% of total billed charges",334.59,12932.7,
"IR CHOLE DRAIN REMOVAL (BOTH)",84047537,CDM,360,RC,47537,CPT,OUTPATIENT,,,660,429,,580.8,88,,464.64,,,0,"percent of total billed charges","88% of total billed charges",924.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,660,100,,528.00,,,0,"percent of total billed charges","100% of total billed charges",1618.01,175,,,,,0,"fee schedule","175% of CMS fee schedule",624,100,,,,,0,"fee schedule",EAPG,924.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",415.8,63,,332.64,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,455.4,69,,,,,0,"fee schedule","69% of total billed charges",660,100,,528.00,,,0,"percent of total billed charges","100% of total billed charges",924.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660,100,,528.00,,,0,"percent of total billed charges","100% of total billed charges",924.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660,100,,528.00,,,0,"percent of total billed charges","100% of total billed charges",924.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,924.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",448.76,100,,,,,0,"fee schedule",EAPG,924.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",617.95,100,,,,,0,"fee schedule",EAPG,787.58,100,,,,,0,"fee schedule",EAPG,924.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",248.82,37.7,,199.06,,,0,"percent of total billed charges","37.7% of total billed charges",248.82,37.7,,199.06,,,0,"percent of total billed charges","37.70% of total billed charges",924.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",223.74,33.9,,178.99,,,0,"percent of total billed charges","33.9% of total billed charges",924.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",514.8,78,,411.84,,,0,"percent of total billed charges","78% of total billed charges",933.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",545.16,82.6,,436.13,,,0,"percent of total billed charges","82.6% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,924.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",545.16,82.6,,436.13,,,0,"percent of total billed charges","82.6% of total billed charges",924.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,660,100,,528.00,,,0,"percent of total billed charges","100% of total billed charges",223.74,3367,
"EX CHOLE PTA/STENT W/O (DRAIN)",84047538,CDM,360,RC,47538,CPT,OUTPATIENT,,,2195,1426.75,,1931.6,88,,1545.28,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2269.56,100,,,,,0,"fee schedule",EAPG,2195,100,,1756.00,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",2337.65,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1382.85,63,,1106.28,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",2269.56,100,,,,,0,"fee schedule",EAPG,1514.55,69,,,,,0,"fee schedule","69% of total billed charges",2195,100,,1756.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2195,100,,1756.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2195,100,,1756.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2269.56,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1681.16,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2314.95,100,,,,,0,"fee schedule",EAPG,2950.43,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.52,37.7,,662.02,,,0,"percent of total billed charges","37.7% of total billed charges",827.52,37.7,,662.02,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",744.11,33.9,,595.29,,,0,"percent of total billed charges","33.9% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1712.1,78,,1369.68,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1813.07,82.6,,1450.46,,,0,"percent of total billed charges","82.6% of total billed charges",2269.56,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1813.07,82.6,,1450.46,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2269.56,100,,,,,0,"fee schedule",EAPG,2195,100,,1756.00,,,0,"percent of total billed charges","100% of total billed charges",744.11,20558.19,
"NEW CHOLE PTA/STENT W/O DRAIN",84047539,CDM,360,RC,47539,CPT,OUTPATIENT,,,2962,1925.3,,2606.56,88,,2085.25,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2269.56,100,,,,,0,"fee schedule",EAPG,2962,100,,2369.60,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",2337.65,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1866.06,63,,1492.85,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",2269.56,100,,,,,0,"fee schedule",EAPG,2043.78,69,,,,,0,"fee schedule","69% of total billed charges",2962,100,,2369.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2962,100,,2369.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2962,100,,2369.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2269.56,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1681.16,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2314.95,100,,,,,0,"fee schedule",EAPG,2950.43,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1116.67,37.7,,893.34,,,0,"percent of total billed charges","37.7% of total billed charges",1116.67,37.7,,893.34,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1004.12,33.9,,803.30,,,0,"percent of total billed charges","33.9% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2310.36,78,,1848.29,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2446.61,82.6,,1957.29,,,0,"percent of total billed charges","82.6% of total billed charges",2269.56,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2446.61,82.6,,1957.29,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2269.56,100,,,,,0,"fee schedule",EAPG,2962,100,,2369.60,,,0,"percent of total billed charges","100% of total billed charges",1004.12,20558.19,
"NEW CHOLE PTA/STENT W/DRAIN",84047540,CDM,360,RC,47540,CPT,OUTPATIENT,,,3535,2297.75,,3110.8,88,,2488.64,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5749.65,100,,,,,0,"fee schedule",EAPG,3535,100,,2828.00,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",5922.14,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2227.05,63,,1781.64,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",5749.65,100,,,,,0,"fee schedule",EAPG,2439.15,69,,,,,0,"fee schedule","69% of total billed charges",3535,100,,2828.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3535,100,,2828.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3535,100,,2828.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5749.65,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4259,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5864.64,100,,,,,0,"fee schedule",EAPG,7474.55,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1332.7,37.7,,1066.16,,,0,"percent of total billed charges","37.7% of total billed charges",1332.7,37.7,,1066.16,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1198.37,33.9,,958.70,,,0,"percent of total billed charges","33.9% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2757.3,78,,2205.84,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2919.91,82.6,,2335.93,,,0,"percent of total billed charges","82.6% of total billed charges",5749.65,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2919.91,82.6,,2335.93,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5749.65,100,,,,,0,"fee schedule",EAPG,3535,100,,2828.00,,,0,"percent of total billed charges","100% of total billed charges",1198.37,20558.19,
"PERC DIL BILIARY W/O STENT SUR",84047555,CDM,361,RC,47555,CPT,OUTPATIENT,,,9219,5992.35,,8112.72,88,,6490.18,,,0,"percent of total billed charges","88% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3870.92,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6175.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",3987.05,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5807.97,63,,4646.38,,,0,"percent of total billed charges","63% of total billed charges",1410.51,15.3,,1128.41,,,0,"percent of total billed charges","15.3% of total billed charges",3870.92,100,,,,,0,"fee schedule",EAPG,6361.11,69,,,,,0,"fee schedule","69% of total billed charges",9219,100,,7375.20,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9219,100,,7375.20,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9219,100,,7375.20,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3870.92,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2867.35,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3948.34,100,,,,,0,"fee schedule",EAPG,5032.19,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3475.56,37.7,,2780.45,,,0,"percent of total billed charges","37.7% of total billed charges",3475.56,37.7,,2780.45,,,0,"percent of total billed charges","37.70% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3125.24,33.9,,2500.19,,,0,"percent of total billed charges","33.9% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7190.82,78,,5752.66,,,0,"percent of total billed charges","78% of total billed charges",3564.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7614.89,82.6,,6091.91,,,0,"percent of total billed charges","82.6% of total billed charges",3870.92,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7614.89,82.6,,6091.91,,,0,"percent of total billed charges","82.6% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3870.92,100,,,,,0,"fee schedule",EAPG,9219,100,,7375.20,,,0,"percent of total billed charges","100% of total billed charges",1410.51,12932.7,
"BILIARY STENT PLACE SURG",84047556,CDM,361,RC,47556,CPT,OUTPATIENT,,,16423,10674.95,,14452.24,88,,11561.79,,,0,"percent of total billed charges","88% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3870.92,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",18373.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",3987.05,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10346.49,63,,8277.19,,,0,"percent of total billed charges","63% of total billed charges",2512.72,15.3,,2010.18,,,0,"percent of total billed charges","15.3% of total billed charges",3870.92,100,,,,,0,"fee schedule",EAPG,11331.87,69,,,,,0,"fee schedule","69% of total billed charges",16423,100,,13138.40,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16423,100,,13138.40,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16423,100,,13138.40,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3870.92,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2867.35,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3948.34,100,,,,,0,"fee schedule",EAPG,5032.19,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6191.47,37.7,,4953.18,,,0,"percent of total billed charges","37.7% of total billed charges",6191.47,37.7,,4953.18,,,0,"percent of total billed charges","37.70% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5567.4,33.9,,4453.92,,,0,"percent of total billed charges","33.9% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",12809.94,78,,10247.95,,,0,"percent of total billed charges","78% of total billed charges",10604.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13565.4,82.6,,10852.32,,,0,"percent of total billed charges","82.6% of total billed charges",3870.92,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13565.4,82.6,,10852.32,,,0,"percent of total billed charges","82.6% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3870.92,100,,,,,0,"fee schedule",EAPG,16423,100,,13138.40,,,0,"percent of total billed charges","100% of total billed charges",2512.72,20558.19,
"CHOLEDONCHAL STENT SURG",84047801,CDM,361,RC,47801,CPT,OUTPATIENT,,,739,480.35,,650.32,88,,520.26,,,0,"percent of total billed charges","88% of total billed charges",739,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5749.65,100,,,,,0,"fee schedule",EAPG,739,100,,591.20,,,0,"percent of total billed charges","100% of total billed charges",739,175,,,,,0,"fee schedule","175% of CMS fee schedule",5922.14,100,,,,,0,"fee schedule",EAPG,739,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",465.57,63,,372.46,,,0,"percent of total billed charges","63% of total billed charges",113.07,15.3,,90.46,,,0,"percent of total billed charges","15.3% of total billed charges",5749.65,100,,,,,0,"fee schedule",EAPG,509.91,69,,,,,0,"fee schedule","69% of total billed charges",739,100,,591.20,,,0,"percent of total billed charges","100% of total billed charges",739,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",739,100,,591.20,,,0,"percent of total billed charges","100% of total billed charges",739,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",739,100,,591.20,,,0,"percent of total billed charges","100% of total billed charges",739,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",739,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5749.65,100,,,,,0,"fee schedule",EAPG,739,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",739,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4259,100,,,,,0,"fee schedule",EAPG,739,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5864.64,100,,,,,0,"fee schedule",EAPG,7474.55,100,,,,,0,"fee schedule",EAPG,739,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",278.6,37.7,,222.88,,,0,"percent of total billed charges","37.7% of total billed charges",278.6,37.7,,222.88,,,0,"percent of total billed charges","37.70% of total billed charges",739,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",250.52,33.9,,200.42,,,0,"percent of total billed charges","33.9% of total billed charges",739,100,,,,,0,"fee schedule","100% of CMS fee schedule",576.42,78,,461.14,,,0,"percent of total billed charges","78% of total billed charges",739,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",610.41,82.6,,488.33,,,0,"percent of total billed charges","82.6% of total billed charges",5749.65,100,,,,,0,"fee schedule",EAPG,739,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",610.41,82.6,,488.33,,,0,"percent of total billed charges","82.6% of total billed charges",739,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5749.65,100,,,,,0,"fee schedule",EAPG,739,100,,591.20,,,0,"percent of total billed charges","100% of total billed charges",113.07,7474.55,
"PARACENTESIS: IMAGING GUIDED",36049083,CDM,360,RC,49083,CPT,OUTPATIENT,,,2099,1364.35,,1847.12,88,,1477.70,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,2099,100,,1679.20,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",685.84,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1322.37,63,,1057.90,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,1448.31,69,,,,,0,"fee schedule","69% of total billed charges",2099,100,,1679.20,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2099,100,,1679.20,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2099,100,,1679.20,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",493.23,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",679.18,100,,,,,0,"fee schedule",EAPG,865.63,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",791.32,37.7,,633.06,,,0,"percent of total billed charges","37.7% of total billed charges",791.32,37.7,,633.06,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",711.56,33.9,,569.25,,,0,"percent of total billed charges","33.9% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1637.22,78,,1309.78,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1733.77,82.6,,1387.02,,,0,"percent of total billed charges","82.6% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1733.77,82.6,,1387.02,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,2099,100,,1679.20,,,0,"percent of total billed charges","100% of total billed charges",493.23,3367,
"Abdominal paracentesis (diagnostic or therapeutic); with ima",84049083,CDM,761,RC,49083,CPT,OUTPATIENT,,,2099,1364.35,,1847.12,88,,1477.70,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,2099,100,,1679.20,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",685.84,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1322.37,63,,1057.90,,,0,"percent of total billed charges","63% of total billed charges",321.15,15.3,,256.92,,,0,"percent of total billed charges","15.3% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,1448.31,69,,,,,0,"fee schedule","69% of total billed charges",2099,100,,1679.20,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2099,100,,1679.20,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2099,100,,1679.20,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",493.23,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",679.18,100,,,,,0,"fee schedule",EAPG,865.63,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",791.32,37.7,,633.06,,,0,"percent of total billed charges","37.7% of total billed charges",791.32,37.7,,633.06,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",711.56,33.9,,569.25,,,0,"percent of total billed charges","33.9% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1637.22,78,,1309.78,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1733.77,82.6,,1387.02,,,0,"percent of total billed charges","82.6% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1733.77,82.6,,1387.02,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,2099,100,,1679.20,,,0,"percent of total billed charges","100% of total billed charges",321.15,3289.02,
"49185 SCLEROTHERAPY OF A FLUID COLLECTION (EG, LYMPHOCELE, C",76149185,CDM,761,RC,49185,CPT,OUTPATIENT,,,9591,6234.15,,8440.08,88,,6752.06,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",685.84,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6042.33,63,,4833.86,,,0,"percent of total billed charges","63% of total billed charges",1467.42,15.3,,1173.94,,,0,"percent of total billed charges","15.3% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,6617.79,69,,,,,0,"fee schedule","69% of total billed charges",9591,100,,7672.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9591,100,,7672.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9591,100,,7672.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",493.23,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",679.18,100,,,,,0,"fee schedule",EAPG,865.63,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3615.81,37.7,,2892.65,,,0,"percent of total billed charges","37.7% of total billed charges",3615.81,37.7,,2892.65,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3251.35,33.9,,2601.08,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7480.98,78,,5984.78,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7922.17,82.6,,6337.74,,,0,"percent of total billed charges","82.6% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7922.17,82.6,,6337.74,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,9591,100,,7672.80,,,0,"percent of total billed charges","100% of total billed charges",493.23,9591,
"DRAIN/CATHETER W/IMAGING",84049406,CDM,320,RC,49406,CPT,OUTPATIENT,,,5044,3278.6,,4438.72,88,,3550.98,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",685.84,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3177.72,63,,2542.18,,,0,"percent of total billed charges","63% of total billed charges",771.73,15.3,,617.38,,,0,"percent of total billed charges","15.3% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,3480.36,69,,,,,0,"fee schedule","69% of total billed charges",5044,100,,4035.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5044,100,,4035.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5044,100,,4035.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",493.23,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",679.18,100,,,,,0,"fee schedule",EAPG,865.63,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1901.59,37.7,,1521.27,,,0,"percent of total billed charges","37.7% of total billed charges",1901.59,37.7,,1521.27,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1709.92,33.9,,1367.94,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3934.32,78,,3147.46,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4166.34,82.6,,3333.07,,,0,"percent of total billed charges","82.6% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4166.34,82.6,,3333.07,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,5044,100,,4035.20,,,0,"percent of total billed charges","100% of total billed charges",493.23,5715.97,
"INSERTION PD CATHETER",84049421,CDM,360,RC,49421,CPT,OUTPATIENT,,,7345,4774.25,,6463.6,88,,5170.88,,,0,"percent of total billed charges","88% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3355.36,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6175.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",3456.02,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4627.35,63,,3701.88,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,5068.05,69,,,,,0,"fee schedule","69% of total billed charges",7345,100,,5876.00,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7345,100,,5876.00,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7345,100,,5876.00,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3355.36,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2485.45,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3422.47,100,,,,,0,"fee schedule",EAPG,4361.97,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2769.07,37.7,,2215.26,,,0,"percent of total billed charges","37.7% of total billed charges",2769.07,37.7,,2215.26,,,0,"percent of total billed charges","37.70% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2489.96,33.9,,1991.97,,,0,"percent of total billed charges","33.9% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5729.1,78,,4583.28,,,0,"percent of total billed charges","78% of total billed charges",3564.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6066.97,82.6,,4853.58,,,0,"percent of total billed charges","82.6% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6066.97,82.6,,4853.58,,,0,"percent of total billed charges","82.6% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3355.36,100,,,,,0,"fee schedule",EAPG,7345,100,,5876.00,,,0,"percent of total billed charges","100% of total billed charges",2485.45,12932.7,
"REMOVAL OF PD CATH",84049422,CDM,360,RC,49422,CPT,OUTPATIENT,,,1888,1227.2,,1661.44,88,,1329.15,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,1888,100,,1510.40,,,0,"percent of total billed charges","100% of total billed charges",5689.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",685.84,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1189.44,63,,951.55,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,1302.72,69,,,,,0,"fee schedule","69% of total billed charges",1888,100,,1510.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1888,100,,1510.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1888,100,,1510.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",493.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",679.18,100,,,,,0,"fee schedule",EAPG,865.63,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",711.78,37.7,,569.42,,,0,"percent of total billed charges","37.7% of total billed charges",711.78,37.7,,569.42,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",640.03,33.9,,512.02,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1472.64,78,,1178.11,,,0,"percent of total billed charges","78% of total billed charges",3283.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1559.49,82.6,,1247.59,,,0,"percent of total billed charges","82.6% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1559.49,82.6,,1247.59,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,1888,100,,1510.40,,,0,"percent of total billed charges","100% of total billed charges",493.23,11625.58,
"PLACE GASTROSTOMY TUBE PERC",84049440,CDM,360,RC,49440,CPT,OUTPATIENT,,,1132,735.8,,996.16,88,,796.93,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,1132,100,,905.60,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",624,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",713.16,63,,570.53,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,781.08,69,,,,,0,"fee schedule","69% of total billed charges",1132,100,,905.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1132,100,,905.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1132,100,,905.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",448.76,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",617.95,100,,,,,0,"fee schedule",EAPG,787.58,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.76,37.7,,341.41,,,0,"percent of total billed charges","37.7% of total billed charges",426.76,37.7,,341.41,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",383.75,33.9,,307.00,,,0,"percent of total billed charges","33.9% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",882.96,78,,706.37,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",935.03,82.6,,748.02,,,0,"percent of total billed charges","82.6% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",935.03,82.6,,748.02,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,1132,100,,905.60,,,0,"percent of total billed charges","100% of total billed charges",383.75,6601.69,
"GASTRO TUBE CHGN SURG",84049450,CDM,361,RC,49450,CPT,OUTPATIENT,,,945,614.25,,831.6,88,,665.28,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,945,100,,756.00,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",624,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",595.35,63,,476.28,,,0,"percent of total billed charges","63% of total billed charges",144.59,15.3,,115.67,,,0,"percent of total billed charges","15.3% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,652.05,69,,,,,0,"fee schedule","69% of total billed charges",945,100,,756.00,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",945,100,,756.00,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",945,100,,756.00,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",448.76,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",617.95,100,,,,,0,"fee schedule",EAPG,787.58,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",356.27,37.7,,285.02,,,0,"percent of total billed charges","37.7% of total billed charges",356.27,37.7,,285.02,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320.36,33.9,,256.29,,,0,"percent of total billed charges","33.9% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737.1,78,,589.68,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",780.57,82.6,,624.46,,,0,"percent of total billed charges","82.6% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",780.57,82.6,,624.46,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,945,100,,756.00,,,0,"percent of total billed charges","100% of total billed charges",144.59,3289.02,
"49451 REPLACE DUOD/JEJ TUBE PERC",84049451,CDM,761,RC,49451,CPT,OUTPATIENT,,,3480,2262,,3062.4,88,,2449.92,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,3480,100,,2784.00,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",624,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2192.4,63,,1753.92,,,0,"percent of total billed charges","63% of total billed charges",532.44,15.3,,425.95,,,0,"percent of total billed charges","15.3% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,2401.2,69,,,,,0,"fee schedule","69% of total billed charges",3480,100,,2784.00,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3480,100,,2784.00,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3480,100,,2784.00,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",448.76,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",617.95,100,,,,,0,"fee schedule",EAPG,787.58,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1311.96,37.7,,1049.57,,,0,"percent of total billed charges","37.7% of total billed charges",1311.96,37.7,,1049.57,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1179.72,33.9,,943.78,,,0,"percent of total billed charges","33.9% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2714.4,78,,2171.52,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2874.48,82.6,,2299.58,,,0,"percent of total billed charges","82.6% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2874.48,82.6,,2299.58,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,3480,100,,2784.00,,,0,"percent of total billed charges","100% of total billed charges",448.76,3480,
"CON INJECT OF EXIST STOMY TUBE",84049465,CDM,360,RC,49465,CPT,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.7% of total billed charges",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",69.83,33.9,,55.86,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",69.83,3367,
"IR NEPH TUBE REMOVAL",84050389,CDM,360,RC,50389,CPT,OUTPATIENT,,,359,233.35,,315.92,88,,252.74,,,0,"percent of total billed charges","88% of total billed charges",696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.36,100,,,,,0,"fee schedule",EAPG,359,100,,287.20,,,0,"percent of total billed charges","100% of total billed charges",1219.3,175,,,,,0,"fee schedule","175% of CMS fee schedule",352.63,100,,,,,0,"fee schedule",EAPG,696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",226.17,63,,180.94,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",342.36,100,,,,,0,"fee schedule",EAPG,247.71,69,,,,,0,"fee schedule","69% of total billed charges",359,100,,287.20,,,0,"percent of total billed charges","100% of total billed charges",696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",359,100,,287.20,,,0,"percent of total billed charges","100% of total billed charges",696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",359,100,,287.20,,,0,"percent of total billed charges","100% of total billed charges",696.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",2335.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.36,100,,,,,0,"fee schedule",EAPG,696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",610.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",253.6,100,,,,,0,"fee schedule",EAPG,696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",349.21,100,,,,,0,"fee schedule",EAPG,445.07,100,,,,,0,"fee schedule",EAPG,696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",135.34,37.7,,108.27,,,0,"percent of total billed charges","37.7% of total billed charges",135.34,37.7,,108.27,,,0,"percent of total billed charges","37.70% of total billed charges",696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",121.7,33.9,,97.36,,,0,"percent of total billed charges","33.9% of total billed charges",696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.02,78,,224.02,,,0,"percent of total billed charges","78% of total billed charges",703.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.53,82.6,,237.22,,,0,"percent of total billed charges","82.6% of total billed charges",342.36,100,,,,,0,"fee schedule",EAPG,696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.53,82.6,,237.22,,,0,"percent of total billed charges","82.6% of total billed charges",696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.36,100,,,,,0,"fee schedule",EAPG,359,100,,287.20,,,0,"percent of total billed charges","100% of total billed charges",121.7,3367,
"IR NEPH TUBE CHECK",84050431,CDM,360,RC,50431,CPT,OUTPATIENT,,,454,295.1,,399.52,88,,319.62,,,0,"percent of total billed charges","88% of total billed charges",696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.36,100,,,,,0,"fee schedule",EAPG,454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",1219.3,175,,,,,0,"fee schedule","175% of CMS fee schedule",352.63,100,,,,,0,"fee schedule",EAPG,696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",286.02,63,,228.82,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",342.36,100,,,,,0,"fee schedule",EAPG,313.26,69,,,,,0,"fee schedule","69% of total billed charges",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",696.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",2335.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.36,100,,,,,0,"fee schedule",EAPG,696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",610.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",253.6,100,,,,,0,"fee schedule",EAPG,696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",349.21,100,,,,,0,"fee schedule",EAPG,445.07,100,,,,,0,"fee schedule",EAPG,696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.16,37.7,,136.93,,,0,"percent of total billed charges","37.7% of total billed charges",171.16,37.7,,136.93,,,0,"percent of total billed charges","37.70% of total billed charges",696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",153.91,33.9,,123.13,,,0,"percent of total billed charges","33.9% of total billed charges",696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",354.12,78,,283.30,,,0,"percent of total billed charges","78% of total billed charges",703.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",375,82.6,,300.00,,,0,"percent of total billed charges","82.6% of total billed charges",342.36,100,,,,,0,"fee schedule",EAPG,696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",375,82.6,,300.00,,,0,"percent of total billed charges","82.6% of total billed charges",696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.36,100,,,,,0,"fee schedule",EAPG,454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",153.91,3367,
"IR NEPH TUBE PLACEMENT",84050432,CDM,361,RC,50432,CPT,OUTPATIENT,,,1481,962.65,,1303.28,88,,1042.62,,,0,"percent of total billed charges","88% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1359.89,100,,,,,0,"fee schedule",EAPG,1481,100,,1184.80,,,0,"percent of total billed charges","100% of total billed charges",3635.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",1400.69,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",933.03,63,,746.42,,,0,"percent of total billed charges","63% of total billed charges",226.59,15.3,,181.27,,,0,"percent of total billed charges","15.3% of total billed charges",1359.89,100,,,,,0,"fee schedule",EAPG,1021.89,69,,,,,0,"fee schedule","69% of total billed charges",1481,100,,1184.80,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1481,100,,1184.80,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1481,100,,1184.80,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",7284.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1359.89,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1904.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1007.32,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1387.09,100,,,,,0,"fee schedule",EAPG,1767.86,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",558.34,37.7,,446.67,,,0,"percent of total billed charges","37.7% of total billed charges",558.34,37.7,,446.67,,,0,"percent of total billed charges","37.70% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",502.06,33.9,,401.65,,,0,"percent of total billed charges","33.9% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1155.18,78,,924.14,,,0,"percent of total billed charges","78% of total billed charges",2098.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1223.31,82.6,,978.65,,,0,"percent of total billed charges","82.6% of total billed charges",1359.89,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1223.31,82.6,,978.65,,,0,"percent of total billed charges","82.6% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1359.89,100,,,,,0,"fee schedule",EAPG,1481,100,,1184.80,,,0,"percent of total billed charges","100% of total billed charges",226.59,7284.07,
"IR NEPHROURETERAL PLACEMENT",84050433,CDM,360,RC,50433,CPT,OUTPATIENT,,,1822,1184.3,,1603.36,88,,1282.69,,,0,"percent of total billed charges","88% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2650.83,100,,,,,0,"fee schedule",EAPG,1822,100,,1457.60,,,0,"percent of total billed charges","100% of total billed charges",6222.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",2730.36,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1147.86,63,,918.29,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",2650.83,100,,,,,0,"fee schedule",EAPG,1257.18,69,,,,,0,"fee schedule","69% of total billed charges",1822,100,,1457.60,,,0,"percent of total billed charges","100% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1822,100,,1457.60,,,0,"percent of total billed charges","100% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1822,100,,1457.60,,,0,"percent of total billed charges","100% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",12497.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2650.83,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3267.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1963.58,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2703.85,100,,,,,0,"fee schedule",EAPG,3446.08,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.89,37.7,,549.51,,,0,"percent of total billed charges","37.7% of total billed charges",686.89,37.7,,549.51,,,0,"percent of total billed charges","37.70% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",617.66,33.9,,494.13,,,0,"percent of total billed charges","33.9% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1421.16,78,,1136.93,,,0,"percent of total billed charges","78% of total billed charges",3591.3,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1504.97,82.6,,1203.98,,,0,"percent of total billed charges","82.6% of total billed charges",2650.83,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1504.97,82.6,,1203.98,,,0,"percent of total billed charges","82.6% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2650.83,100,,,,,0,"fee schedule",EAPG,1822,100,,1457.60,,,0,"percent of total billed charges","100% of total billed charges",617.66,12497.73,
"IR NEPHROURETERAL CONVERSION",84050434,CDM,360,RC,50434,CPT,OUTPATIENT,,,1400,910,,1232,88,,985.60,,,0,"percent of total billed charges","88% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1359.89,100,,,,,0,"fee schedule",EAPG,1400,100,,1120.00,,,0,"percent of total billed charges","100% of total billed charges",3635.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",1400.69,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",882,63,,705.60,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",1359.89,100,,,,,0,"fee schedule",EAPG,966,69,,,,,0,"fee schedule","69% of total billed charges",1400,100,,1120.00,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1400,100,,1120.00,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1400,100,,1120.00,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",7284.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1359.89,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1904.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1007.32,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1387.09,100,,,,,0,"fee schedule",EAPG,1767.86,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",527.8,37.7,,422.24,,,0,"percent of total billed charges","37.7% of total billed charges",527.8,37.7,,422.24,,,0,"percent of total billed charges","37.70% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",474.6,33.9,,379.68,,,0,"percent of total billed charges","33.9% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1092,78,,873.60,,,0,"percent of total billed charges","78% of total billed charges",2098.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1156.4,82.6,,925.12,,,0,"percent of total billed charges","82.6% of total billed charges",1359.89,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1156.4,82.6,,925.12,,,0,"percent of total billed charges","82.6% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1359.89,100,,,,,0,"fee schedule",EAPG,1400,100,,1120.00,,,0,"percent of total billed charges","100% of total billed charges",474.6,7284.07,
"IR NEPH TUBE EXCHANGE",84050435,CDM,360,RC,50435,CPT,OUTPATIENT,,,688,447.2,,605.44,88,,484.35,,,0,"percent of total billed charges","88% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1359.89,100,,,,,0,"fee schedule",EAPG,688,100,,550.40,,,0,"percent of total billed charges","100% of total billed charges",3635.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",1400.69,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",433.44,63,,346.75,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",1359.89,100,,,,,0,"fee schedule",EAPG,474.72,69,,,,,0,"fee schedule","69% of total billed charges",688,100,,550.40,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",688,100,,550.40,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",688,100,,550.40,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",7284.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1359.89,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1904.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1007.32,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1387.09,100,,,,,0,"fee schedule",EAPG,1767.86,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",259.38,37.7,,207.50,,,0,"percent of total billed charges","37.7% of total billed charges",259.38,37.7,,207.50,,,0,"percent of total billed charges","37.70% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",233.23,33.9,,186.58,,,0,"percent of total billed charges","33.9% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",536.64,78,,429.31,,,0,"percent of total billed charges","78% of total billed charges",2098.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.29,82.6,,454.63,,,0,"percent of total billed charges","82.6% of total billed charges",1359.89,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.29,82.6,,454.63,,,0,"percent of total billed charges","82.6% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1359.89,100,,,,,0,"fee schedule",EAPG,688,100,,550.40,,,0,"percent of total billed charges","100% of total billed charges",233.23,7284.07,
"CHG URETERO CATH SURG",84050688,CDM,361,RC,50688,CPT,OUTPATIENT,,,5332,3465.8,,4692.16,88,,3753.73,,,0,"percent of total billed charges","88% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1359.89,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3635.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",1400.69,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3359.16,63,,2687.33,,,0,"percent of total billed charges","63% of total billed charges",815.8,15.3,,652.64,,,0,"percent of total billed charges","15.3% of total billed charges",1359.89,100,,,,,0,"fee schedule",EAPG,3679.08,69,,,,,0,"fee schedule","69% of total billed charges",5332,100,,4265.60,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5332,100,,4265.60,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5332,100,,4265.60,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",7284.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1359.89,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1904.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1007.32,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1387.09,100,,,,,0,"fee schedule",EAPG,1767.86,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2010.16,37.7,,1608.13,,,0,"percent of total billed charges","37.7% of total billed charges",2010.16,37.7,,1608.13,,,0,"percent of total billed charges","37.70% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1807.55,33.9,,1446.04,,,0,"percent of total billed charges","33.9% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4158.96,78,,3327.17,,,0,"percent of total billed charges","78% of total billed charges",2098.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4404.23,82.6,,3523.38,,,0,"percent of total billed charges","82.6% of total billed charges",1359.89,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4404.23,82.6,,3523.38,,,0,"percent of total billed charges","82.6% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1359.89,100,,,,,0,"fee schedule",EAPG,5332,100,,4265.60,,,0,"percent of total billed charges","100% of total billed charges",815.8,7284.07,
"IR EXIST ACCESS URETERAL STENT",84050693,CDM,360,RC,50693,CPT,OUTPATIENT,,,1464,951.6,,1288.32,88,,1030.66,,,0,"percent of total billed charges","88% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2650.83,100,,,,,0,"fee schedule",EAPG,1464,100,,1171.20,,,0,"percent of total billed charges","100% of total billed charges",6222.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",2730.36,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",922.32,63,,737.86,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",2650.83,100,,,,,0,"fee schedule",EAPG,1010.16,69,,,,,0,"fee schedule","69% of total billed charges",1464,100,,1171.20,,,0,"percent of total billed charges","100% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1464,100,,1171.20,,,0,"percent of total billed charges","100% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1464,100,,1171.20,,,0,"percent of total billed charges","100% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",12497.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2650.83,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3267.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1963.58,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2703.85,100,,,,,0,"fee schedule",EAPG,3446.08,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",551.93,37.7,,441.54,,,0,"percent of total billed charges","37.7% of total billed charges",551.93,37.7,,441.54,,,0,"percent of total billed charges","37.70% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",496.3,33.9,,397.04,,,0,"percent of total billed charges","33.9% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1141.92,78,,913.54,,,0,"percent of total billed charges","78% of total billed charges",3591.3,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1209.26,82.6,,967.41,,,0,"percent of total billed charges","82.6% of total billed charges",2650.83,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1209.26,82.6,,967.41,,,0,"percent of total billed charges","82.6% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2650.83,100,,,,,0,"fee schedule",EAPG,1464,100,,1171.20,,,0,"percent of total billed charges","100% of total billed charges",496.3,12497.73,
"NEW ACCESS URET STENT W/ODRAIN",84050694,CDM,360,RC,50694,CPT,OUTPATIENT,,,1955,1270.75,,1720.4,88,,1376.32,,,0,"percent of total billed charges","88% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2650.83,100,,,,,0,"fee schedule",EAPG,1955,100,,1564.00,,,0,"percent of total billed charges","100% of total billed charges",6222.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",2730.36,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1231.65,63,,985.32,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",2650.83,100,,,,,0,"fee schedule",EAPG,1348.95,69,,,,,0,"fee schedule","69% of total billed charges",1955,100,,1564.00,,,0,"percent of total billed charges","100% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955,100,,1564.00,,,0,"percent of total billed charges","100% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955,100,,1564.00,,,0,"percent of total billed charges","100% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",12497.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2650.83,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3267.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1963.58,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2703.85,100,,,,,0,"fee schedule",EAPG,3446.08,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737.04,37.7,,589.63,,,0,"percent of total billed charges","37.7% of total billed charges",737.04,37.7,,589.63,,,0,"percent of total billed charges","37.70% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",662.75,33.9,,530.20,,,0,"percent of total billed charges","33.9% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1524.9,78,,1219.92,,,0,"percent of total billed charges","78% of total billed charges",3591.3,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1614.83,82.6,,1291.86,,,0,"percent of total billed charges","82.6% of total billed charges",2650.83,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1614.83,82.6,,1291.86,,,0,"percent of total billed charges","82.6% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2650.83,100,,,,,0,"fee schedule",EAPG,1955,100,,1564.00,,,0,"percent of total billed charges","100% of total billed charges",662.75,12497.73,
"NEW ACCESS URET STENT W/DRAIN",84050695,CDM,360,RC,50695,CPT,OUTPATIENT,,,2393,1555.45,,2105.84,88,,1684.67,,,0,"percent of total billed charges","88% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2650.83,100,,,,,0,"fee schedule",EAPG,2393,100,,1914.40,,,0,"percent of total billed charges","100% of total billed charges",6222.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",2730.36,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1507.59,63,,1206.07,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",2650.83,100,,,,,0,"fee schedule",EAPG,1651.17,69,,,,,0,"fee schedule","69% of total billed charges",2393,100,,1914.40,,,0,"percent of total billed charges","100% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2393,100,,1914.40,,,0,"percent of total billed charges","100% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2393,100,,1914.40,,,0,"percent of total billed charges","100% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",12497.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2650.83,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3267.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1963.58,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2703.85,100,,,,,0,"fee schedule",EAPG,3446.08,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",902.16,37.7,,721.73,,,0,"percent of total billed charges","37.7% of total billed charges",902.16,37.7,,721.73,,,0,"percent of total billed charges","37.70% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",811.23,33.9,,648.98,,,0,"percent of total billed charges","33.9% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1866.54,78,,1493.23,,,0,"percent of total billed charges","78% of total billed charges",3591.3,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1976.62,82.6,,1581.30,,,0,"percent of total billed charges","82.6% of total billed charges",2650.83,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1976.62,82.6,,1581.30,,,0,"percent of total billed charges","82.6% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2650.83,100,,,,,0,"fee schedule",EAPG,2393,100,,1914.40,,,0,"percent of total billed charges","100% of total billed charges",811.23,12497.73,
"ASPIRATION OF BLADDER",84051102,CDM,360,RC,51102,CPT,OUTPATIENT,,,817,531.05,,718.96,88,,575.17,,,0,"percent of total billed charges","88% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1405.94,100,,,,,0,"fee schedule",EAPG,817,100,,653.60,,,0,"percent of total billed charges","100% of total billed charges",3635.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",1448.12,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",514.71,63,,411.77,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",1405.94,100,,,,,0,"fee schedule",EAPG,563.73,69,,,,,0,"fee schedule","69% of total billed charges",817,100,,653.60,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",817,100,,653.60,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",817,100,,653.60,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",7284.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1405.94,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1904.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1041.44,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1434.06,100,,,,,0,"fee schedule",EAPG,1827.72,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",308.01,37.7,,246.41,,,0,"percent of total billed charges","37.7% of total billed charges",308.01,37.7,,246.41,,,0,"percent of total billed charges","37.70% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",276.96,33.9,,221.57,,,0,"percent of total billed charges","33.9% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",637.26,78,,509.81,,,0,"percent of total billed charges","78% of total billed charges",2098.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",674.84,82.6,,539.87,,,0,"percent of total billed charges","82.6% of total billed charges",1405.94,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",674.84,82.6,,539.87,,,0,"percent of total billed charges","82.6% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1405.94,100,,,,,0,"fee schedule",EAPG,817,100,,653.60,,,0,"percent of total billed charges","100% of total billed charges",276.96,7284.07,
"INS CATH FOLEY SIMPLE",84051702,CDM,361,RC,51702,CPT,OUTPATIENT,,,564,366.6,,496.32,88,,397.06,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",66.85,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.32,63,,284.26,,,0,"percent of total billed charges","63% of total billed charges",86.29,15.3,,69.03,,,0,"percent of total billed charges","15.3% of total billed charges",64.9,100,,,,,0,"fee schedule",EAPG,389.16,69,,,,,0,"fee schedule","69% of total billed charges",564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",48.07,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.2,100,,,,,0,"fee schedule",EAPG,84.37,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",212.63,37.7,,170.10,,,0,"percent of total billed charges","37.7% of total billed charges",212.63,37.7,,170.10,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191.2,33.9,,152.96,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",439.92,78,,351.94,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465.86,82.6,,372.69,,,0,"percent of total billed charges","82.6% of total billed charges",64.9,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465.86,82.6,,372.69,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",48.07,564,
"51702 CATHETER INSERTION FOLEY",AMB820027,CDM,761,RC,51702,CPT,OUTPATIENT,,,564,366.6,,496.32,88,,397.06,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",66.85,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.32,63,,284.26,,,0,"percent of total billed charges","63% of total billed charges",86.29,15.3,,69.03,,,0,"percent of total billed charges","15.3% of total billed charges",64.9,100,,,,,0,"fee schedule",EAPG,389.16,69,,,,,0,"fee schedule","69% of total billed charges",564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",48.07,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.2,100,,,,,0,"fee schedule",EAPG,84.37,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",212.63,37.7,,170.10,,,0,"percent of total billed charges","37.7% of total billed charges",212.63,37.7,,170.10,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191.2,33.9,,152.96,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",439.92,78,,351.94,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465.86,82.6,,372.69,,,0,"percent of total billed charges","82.6% of total billed charges",64.9,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465.86,82.6,,372.69,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",48.07,564,
"excision procedures on the cervix uter",76157500,CDM,761,RC,57500,CPT,OUTPATIENT,,,2404,1562.6,,2115.52,88,,1692.42,,,0,"percent of total billed charges","88% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.4,100,,,,,0,"fee schedule",EAPG,2404,100,,1923.20,,,0,"percent of total billed charges","100% of total billed charges",1434.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",424.77,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1514.52,63,,1211.62,,,0,"percent of total billed charges","63% of total billed charges",367.81,15.3,,294.25,,,0,"percent of total billed charges","15.3% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,1658.76,69,,,,,0,"fee schedule","69% of total billed charges",2404,100,,1923.20,,,0,"percent of total billed charges","100% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2404,100,,1923.20,,,0,"percent of total billed charges","100% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2404,100,,1923.20,,,0,"percent of total billed charges","100% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",2573.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.4,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",305.48,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.64,100,,,,,0,"fee schedule",EAPG,536.12,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",906.31,37.7,,725.05,,,0,"percent of total billed charges","37.7% of total billed charges",906.31,37.7,,725.05,,,0,"percent of total billed charges","37.70% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",814.96,33.9,,651.97,,,0,"percent of total billed charges","33.9% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1875.12,78,,1500.10,,,0,"percent of total billed charges","78% of total billed charges",828.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1985.7,82.6,,1588.56,,,0,"percent of total billed charges","82.6% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1985.7,82.6,,1588.56,,,0,"percent of total billed charges","82.6% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.4,100,,,,,0,"fee schedule",EAPG,2404,100,,1923.20,,,0,"percent of total billed charges","100% of total billed charges",305.48,2573.24,
"EPISIOTOMY OR VAGINAL REPAIR, BY OTHER THAN ATTENDING.",72059300,CDM,720,RC,59300,CPT,OUTPATIENT,,,9947,6465.55,,8753.36,88,,7002.69,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1708.92,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",1760.19,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6266.61,63,,5013.29,,,0,"percent of total billed charges","63% of total billed charges",1521.89,15.3,,1217.51,,,0,"percent of total billed charges","15.3% of total billed charges",1708.92,100,,,,,0,"fee schedule",EAPG,6863.43,69,,,,,0,"fee schedule","69% of total billed charges",9947,100,,7957.60,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9947,100,,7957.60,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9947,100,,7957.60,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1708.92,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1265.87,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1743.1,100,,,,,0,"fee schedule",EAPG,2221.6,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3750.02,37.7,,3000.02,,,0,"percent of total billed charges","37.7% of total billed charges",3750.02,37.7,,3000.02,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3372.03,33.9,,2697.62,,,0,"percent of total billed charges","33.9% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7758.66,78,,6206.93,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8216.22,82.6,,6572.98,,,0,"percent of total billed charges","82.6% of total billed charges",1708.92,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8216.22,82.6,,6572.98,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1708.92,100,,,,,0,"fee schedule",EAPG,9947,100,,7957.60,,,0,"percent of total billed charges","100% of total billed charges",1265.87,10656.86,
"VAGINAL DELIVERY ONLY, AFTER PREVIOUS CESARE",72059614,CDM,720,RC,59614,CPT,OUTPATIENT,,,9947,6465.55,,8753.36,88,,7002.69,,,0,"percent of total billed charges","88% of total billed charges",4973.5,50,,3978.80,,,0,"percent of total billed charges","50% of total billed charges",1955.83,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2014.51,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",6266.61,63,,5013.29,,,0,"percent of total billed charges","63% of total billed charges",1521.89,15.3,,1217.51,,,0,"percent of total billed charges","15.3% of total billed charges",1955.83,100,,,,,0,"fee schedule",EAPG,6863.43,69,,,,,0,"fee schedule","69% of total billed charges",9947,100,,7957.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9947,100,,7957.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9947,100,,7957.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6152.22,61.85,,4921.78,,,0,"percent of total billed charges","61.5% of total billed charges",1955.83,100,,,,,0,"fee schedule",EAPG,4973.5,50,,3978.80,,,0,"percent of total billed charges","50% of total billed charges",3202.93,32.2,,2562.34,,,0,"percent of total billed charges","32.2% of total billed charges",1448.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1994.95,100,,,,,0,"fee schedule",EAPG,2542.58,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3750.02,37.7,,3000.02,,,0,"percent of total billed charges","37.7% of total billed charges",3750.02,37.7,,3000.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3372.03,33.9,,2697.62,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7758.66,78,,6206.93,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8216.22,82.6,,6572.98,,,0,"percent of total billed charges","82.6% of total billed charges",1955.83,100,,,,,0,"fee schedule","100% of WA fee schedule",4973.5,50,,3978.80,,,0,"percent of total billed charges","50% of total billed charges",8216.22,82.6,,6572.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1955.83,100,,,,,0,"fee schedule",EAPG,9947,100,,7957.60,,,0,"percent of total billed charges","100% of total billed charges",1448.76,9947,
"62273 INJECT EPIDURAL PATCH CHARGE",76162273,CDM,761,RC,62273,CPT,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",570.86,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,2578.03,
"SPINAL PUNCTURE LUMBAR DX",84062270,CDM,361,RC,62270,CPT,OUTPATIENT,,,1600,1040,,1408,88,,1126.40,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1600,100,,1280.00,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1008,63,,806.40,,,0,"percent of total billed charges","63% of total billed charges",244.8,15.3,,195.84,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,1104,69,,,,,0,"fee schedule","69% of total billed charges",1600,100,,1280.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1600,100,,1280.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1600,100,,1280.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",570.86,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",603.2,37.7,,482.56,,,0,"percent of total billed charges","37.7% of total billed charges",603.2,37.7,,482.56,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",542.4,33.9,,433.92,,,0,"percent of total billed charges","33.9% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1248,78,,998.40,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1321.6,82.6,,1057.28,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1321.6,82.6,,1057.28,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1600,100,,1280.00,,,0,"percent of total billed charges","100% of total billed charges",244.8,2578.03,
"MYELOGRAM LUMBAR SPINE",84062284,CDM,361,RC,62284,CPT,OUTPATIENT,,,1067,693.55,,938.96,88,,751.17,,,0,"percent of total billed charges","88% of total billed charges",533.5,50,,426.80,,,0,"percent of total billed charges","50% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,1067,100,,853.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.05,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",672.21,63,,537.77,,,0,"percent of total billed charges","63% of total billed charges",163.25,15.3,,130.60,,,0,"percent of total billed charges","15.3% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,736.23,69,,,,,0,"fee schedule","69% of total billed charges",1067,100,,853.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1067,100,,853.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1067,100,,853.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",659.94,61.85,,527.95,,,0,"percent of total billed charges","61.5% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,533.5,50,,426.80,,,0,"percent of total billed charges","50% of total billed charges",343.57,32.2,,274.86,,,0,"percent of total billed charges","32.2% of total billed charges",202.12,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",278.32,100,,,,,0,"fee schedule",EAPG,354.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",402.26,37.7,,321.81,,,0,"percent of total billed charges","37.7% of total billed charges",402.26,37.7,,321.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",361.71,33.9,,289.37,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",832.26,78,,665.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",881.34,82.6,,705.07,,,0,"percent of total billed charges","82.6% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,533.5,50,,426.80,,,0,"percent of total billed charges","50% of total billed charges",881.34,82.6,,705.07,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.87,100,,,,,0,"fee schedule",EAPG,1067,100,,853.60,,,0,"percent of total billed charges","100% of total billed charges",163.25,1067,
"MYELOGRAPHY VIA LUMBAR INJ",84062303,CDM,360,RC,62303,CPT,OUTPATIENT,,,4162,2705.3,,3662.56,88,,2930.05,,,0,"percent of total billed charges","88% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",528.24,100,,,,,0,"fee schedule",EAPG,4162,100,,3329.60,,,0,"percent of total billed charges","100% of total billed charges",1429.16,175,,,,,0,"fee schedule","175% of CMS fee schedule",544.08,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2622.06,63,,2097.65,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",528.24,100,,,,,0,"fee schedule",EAPG,2871.78,69,,,,,0,"fee schedule","69% of total billed charges",4162,100,,3329.60,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4162,100,,3329.60,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4162,100,,3329.60,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",2905.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",528.24,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",391.29,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",538.8,100,,,,,0,"fee schedule",EAPG,686.71,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1569.07,37.7,,1255.26,,,0,"percent of total billed charges","37.7% of total billed charges",1569.07,37.7,,1255.26,,,0,"percent of total billed charges","37.70% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1410.92,33.9,,1128.74,,,0,"percent of total billed charges","33.9% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3246.36,78,,2597.09,,,0,"percent of total billed charges","78% of total billed charges",824.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3437.81,82.6,,2750.25,,,0,"percent of total billed charges","82.6% of total billed charges",528.24,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3437.81,82.6,,2750.25,,,0,"percent of total billed charges","82.6% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",528.24,100,,,,,0,"fee schedule",EAPG,4162,100,,3329.60,,,0,"percent of total billed charges","100% of total billed charges",391.29,4162,
"INTERLAMINAR INJ C/T SPINE",84062310,CDM,360,RC,62310,CPT,OUTPATIENT,,,1865,1212.25,,1641.2,88,,1312.96,,,0,"percent of total billed charges","88% of total billed charges",932.5,50,,746.00,,,0,"percent of total billed charges","50% of total billed charges",313.32,16.8,,250.66,,,0,"percent of total billed charges","16.8% of total billed charges",1865,100,,1492.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",322.72,17.304,,258.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1174.95,63,,939.96,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",313.32,16.8,,250.66,,,0,"percent of total billed charges","16.8% of total billed charges",1286.85,69,,,,,0,"fee schedule","69% of total billed charges",1865,100,,1492.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1865,100,,1492.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1865,100,,1492.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1153.5,61.85,,922.80,,,0,"percent of total billed charges","61.5% of total billed charges",313.32,16.8,,250.66,,,0,"percent of total billed charges","16.8% of total billed charges",932.5,50,,746.00,,,0,"percent of total billed charges","50% of total billed charges",600.53,32.2,,480.42,,,0,"percent of total billed charges","32.2% of total billed charges",313.32,16.8,,250.66,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",319.59,17.136,,255.67,,,0,"percent of total billed charges","17.136% of total billed charges",407.32,21.84,,325.86,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",703.11,37.7,,562.49,,,0,"percent of total billed charges","37.7% of total billed charges",703.11,37.7,,562.49,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",632.24,33.9,,505.79,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1454.7,78,,1163.76,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540.49,82.6,,1232.39,,,0,"percent of total billed charges","82.6% of total billed charges",313.32,16.8,,250.66,,,0,"percent of total billed charges","16.8% of total billed charges",932.5,50,,746.00,,,0,"percent of total billed charges","50% of total billed charges",1540.49,82.6,,1232.39,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.32,16.8,,250.66,,,0,"percent of total billed charges","16.8% of total billed charges",1865,100,,1492.00,,,0,"percent of total billed charges","100% of total billed charges",313.32,3367,
"INTERLAMINAR INJ L/S SPINE",84062311,CDM,360,RC,62311,CPT,OUTPATIENT,,,1865,1212.25,,1641.2,88,,1312.96,,,0,"percent of total billed charges","88% of total billed charges",932.5,50,,746.00,,,0,"percent of total billed charges","50% of total billed charges",313.32,16.8,,250.66,,,0,"percent of total billed charges","16.8% of total billed charges",1865,100,,1492.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",322.72,17.304,,258.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1174.95,63,,939.96,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",313.32,16.8,,250.66,,,0,"percent of total billed charges","16.8% of total billed charges",1286.85,69,,,,,0,"fee schedule","69% of total billed charges",1865,100,,1492.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1865,100,,1492.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1865,100,,1492.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1153.5,61.85,,922.80,,,0,"percent of total billed charges","61.5% of total billed charges",313.32,16.8,,250.66,,,0,"percent of total billed charges","16.8% of total billed charges",932.5,50,,746.00,,,0,"percent of total billed charges","50% of total billed charges",600.53,32.2,,480.42,,,0,"percent of total billed charges","32.2% of total billed charges",313.32,16.8,,250.66,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",319.59,17.136,,255.67,,,0,"percent of total billed charges","17.136% of total billed charges",407.32,21.84,,325.86,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",703.11,37.7,,562.49,,,0,"percent of total billed charges","37.7% of total billed charges",703.11,37.7,,562.49,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",632.24,33.9,,505.79,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1454.7,78,,1163.76,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540.49,82.6,,1232.39,,,0,"percent of total billed charges","82.6% of total billed charges",313.32,16.8,,250.66,,,0,"percent of total billed charges","16.8% of total billed charges",932.5,50,,746.00,,,0,"percent of total billed charges","50% of total billed charges",1540.49,82.6,,1232.39,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.32,16.8,,250.66,,,0,"percent of total billed charges","16.8% of total billed charges",1865,100,,1492.00,,,0,"percent of total billed charges","100% of total billed charges",313.32,3367,
"BLOOD PATCH",84063707,CDM,360,RC,63707,CPT,OUTPATIENT,,,238,154.7,,209.44,88,,167.55,,,0,"percent of total billed charges","88% of total billed charges",238,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4192.88,100,,,,,0,"fee schedule",EAPG,238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",238,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,238,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",149.94,63,,119.95,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,164.22,69,,,,,0,"fee schedule","69% of total billed charges",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",238,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",238,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",238,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",238,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4192.88,100,,,,,0,"fee schedule",EAPG,238,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",238,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3105.84,100,,,,,0,"fee schedule",EAPG,238,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,238,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",89.73,37.7,,71.78,,,0,"percent of total billed charges","37.7% of total billed charges",89.73,37.7,,71.78,,,0,"percent of total billed charges","37.70% of total billed charges",238,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",80.68,33.9,,64.54,,,0,"percent of total billed charges","33.9% of total billed charges",238,100,,,,,0,"fee schedule","100% of CMS fee schedule",185.64,78,,148.51,,,0,"percent of total billed charges","78% of total billed charges",238,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",196.59,82.6,,157.27,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,238,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",196.59,82.6,,157.27,,,0,"percent of total billed charges","82.6% of total billed charges",238,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4192.88,100,,,,,0,"fee schedule",EAPG,238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",80.68,5450.75,
"64405 Injection anesthetic agent or steroid greater occipita",84064405,CDM,761,RC,64405,CPT,OUTPATIENT,,,591,384.15,,520.08,88,,416.06,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",372.33,63,,297.86,,,0,"percent of total billed charges","63% of total billed charges",90.42,15.3,,72.34,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,407.79,69,,,,,0,"fee schedule","69% of total billed charges",591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.52,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",222.81,37.7,,178.25,,,0,"percent of total billed charges","37.7% of total billed charges",222.81,37.7,,178.25,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200.35,33.9,,160.28,,,0,"percent of total billed charges","33.9% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460.98,78,,368.78,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",488.17,82.6,,390.54,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",488.17,82.6,,390.54,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",90.42,1061,
"INJ ANE AGENT PERIPHEAL NERVE",84064450,CDM,360,RC,64450,CPT,OUTPATIENT,,,492,319.8,,432.96,88,,346.37,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.96,63,,247.97,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,339.48,69,,,,,0,"fee schedule","69% of total billed charges",492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.52,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",185.48,37.7,,148.38,,,0,"percent of total billed charges","37.7% of total billed charges",185.48,37.7,,148.38,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",166.79,33.9,,133.43,,,0,"percent of total billed charges","33.9% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",383.76,78,,307.01,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",406.39,82.6,,325.11,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",406.39,82.6,,325.11,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",166.79,3367,
"64454 Injection(s), anesthetic agent(s) and/or steroid; geni",76164454,CDM,761,RC,64454,CPT,OUTPATIENT,,,979,636.35,,861.52,88,,689.22,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,979,100,,783.20,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.77,63,,493.42,,,0,"percent of total billed charges","63% of total billed charges",149.79,15.3,,119.83,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,675.51,69,,,,,0,"fee schedule","69% of total billed charges",979,100,,783.20,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",979,100,,783.20,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",979,100,,783.20,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.52,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",369.08,37.7,,295.26,,,0,"percent of total billed charges","37.7% of total billed charges",369.08,37.7,,295.26,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",331.88,33.9,,265.50,,,0,"percent of total billed charges","33.9% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",763.62,78,,610.90,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",808.65,82.6,,646.92,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule","100% of WA fee schedule",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",808.65,82.6,,646.92,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,979,100,,783.20,,,0,"percent of total billed charges","100% of total billed charges",149.79,2578.03,
"64468 Thoracic Fascial Plane Block, bilateral inj",76164468,CDM,761,RC,64468,CPT,OUTPATIENT,,,500,325,,440,88,,352.00,,,0,"percent of total billed charges","88% of total billed charges",250,50,,200.00,,,0,"percent of total billed charges","50% of total billed charges",84,16.8,,67.20,,,0,"percent of total billed charges","16.8% of total billed charges",500,100,,400.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.52,17.304,,69.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",315,63,,252.00,,,0,"percent of total billed charges","63% of total billed charges",76.5,15.3,,61.20,,,0,"percent of total billed charges","15.3% of total billed charges",84,16.8,,67.20,,,0,"percent of total billed charges","16.8% of total billed charges",345,69,,,,,0,"fee schedule","69% of total billed charges",500,100,,400.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",500,100,,400.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",500,100,,400.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309.25,61.85,,247.40,,,0,"percent of total billed charges","61.5% of total billed charges",84,16.8,,67.20,,,0,"percent of total billed charges","16.8% of total billed charges",250,50,,200.00,,,0,"percent of total billed charges","50% of total billed charges",161,32.2,,128.80,,,0,"percent of total billed charges","32.2% of total billed charges",84,16.8,,67.20,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.68,17.136,,68.54,,,0,"percent of total billed charges","17.136% of total billed charges",109.2,21.84,,87.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",188.5,37.7,,150.80,,,0,"percent of total billed charges","37.7% of total billed charges",188.5,37.7,,150.80,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",169.5,33.9,,135.60,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",390,78,,312.00,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",413,82.6,,330.40,,,0,"percent of total billed charges","82.6% of total billed charges",84,16.8,,67.20,,,0,"percent of total billed charges","16.8% of total billed charges",250,50,,200.00,,,0,"percent of total billed charges","50% of total billed charges",413,82.6,,330.40,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",84,16.8,,67.20,,,0,"percent of total billed charges","16.8% of total billed charges",500,100,,400.00,,,0,"percent of total billed charges","100% of total billed charges",76.5,500,
"Open implantation of hypoglossal nerve neurostimulator array",36064582,CDM,360,RC,64582,CPT,OUTPATIENT,,,95682,62193.3,,84200.16,88,,67360.13,,,0,"percent of total billed charges","88% of total billed charges",31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18609.86,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",55426.2,175,,,,,0,"fee schedule","175% of CMS fee schedule",19168.16,100,,,,,0,"fee schedule",EAPG,31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60279.66,63,,48223.73,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",18609.86,100,,,,,0,"fee schedule",EAPG,66020.58,69,,,,,0,"fee schedule","69% of total billed charges",95682,100,,76545.60,,,0,"percent of total billed charges","100% of total billed charges",31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",95682,100,,76545.60,,,0,"percent of total billed charges","100% of total billed charges",31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",95682,100,,76545.60,,,0,"percent of total billed charges","100% of total billed charges",31672.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",59179.32,61.85,,47343.46,,,0,"percent of total billed charges","61.5% of total billed charges",18609.86,100,,,,,0,"fee schedule",EAPG,31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",823.36,100,,,,,0,"fee schedule","100% of LI fee schedule",13785.08,100,,,,,0,"fee schedule",EAPG,31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18982.06,100,,,,,0,"fee schedule",EAPG,24192.82,100,,,,,0,"fee schedule",EAPG,31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36072.11,37.7,,28857.69,,,0,"percent of total billed charges","37.7% of total billed charges",36072.11,37.7,,28857.69,,,0,"percent of total billed charges","37.70% of total billed charges",31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32436.2,33.9,,25948.96,,,0,"percent of total billed charges","33.9% of total billed charges",31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74631.96,78,,59705.57,,,0,"percent of total billed charges","78% of total billed charges",31988.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",79033.33,82.6,,63226.66,,,0,"percent of total billed charges","82.6% of total billed charges",18609.86,100,,,,,0,"fee schedule","100% of WA fee schedule",31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",79033.33,82.6,,63226.66,,,0,"percent of total billed charges","82.6% of total billed charges",31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18609.86,100,,,,,0,"fee schedule",EAPG,95682,100,,76545.60,,,0,"percent of total billed charges","100% of total billed charges",823.36,95682,
"Revision or replacement of hypoglossal nerve neurostimulato",36064583,CDM,360,RC,64583,CPT,OUTPATIENT,,,35488,23067.2,,31229.44,88,,24983.55,,,0,"percent of total billed charges","88% of total billed charges",13893.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5344.89,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",24314.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",5505.24,100,,,,,0,"fee schedule",EAPG,13893.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22357.44,63,,17885.95,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",5344.89,100,,,,,0,"fee schedule",EAPG,24486.72,69,,,,,0,"fee schedule","69% of total billed charges",35488,100,,28390.40,,,0,"percent of total billed charges","100% of total billed charges",13893.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35488,100,,28390.40,,,0,"percent of total billed charges","100% of total billed charges",13893.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35488,100,,28390.40,,,0,"percent of total billed charges","100% of total billed charges",13893.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",21949.33,61.85,,17559.46,,,0,"percent of total billed charges","61.5% of total billed charges",5344.89,100,,,,,0,"fee schedule",EAPG,13893.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",849.75,100,,,,,0,"fee schedule","100% of LI fee schedule",3959.18,100,,,,,0,"fee schedule",EAPG,13893.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5451.79,100,,,,,0,"fee schedule",EAPG,6948.36,100,,,,,0,"fee schedule",EAPG,13893.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13378.98,37.7,,10703.18,,,0,"percent of total billed charges","37.7% of total billed charges",13378.98,37.7,,10703.18,,,0,"percent of total billed charges","37.70% of total billed charges",13893.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",12030.43,33.9,,9624.34,,,0,"percent of total billed charges","33.9% of total billed charges",13893.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",27680.64,78,,22144.51,,,0,"percent of total billed charges","78% of total billed charges",14032.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29313.09,82.6,,23450.47,,,0,"percent of total billed charges","82.6% of total billed charges",5344.89,100,,,,,0,"fee schedule","100% of WA fee schedule",13893.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29313.09,82.6,,23450.47,,,0,"percent of total billed charges","82.6% of total billed charges",13893.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5344.89,100,,,,,0,"fee schedule",EAPG,35488,100,,28390.40,,,0,"percent of total billed charges","100% of total billed charges",849.75,35488,
"Removal of hypoglossal nerve neurostimulator array, pulse ge",36064584,CDM,360,RC,64584,CPT,OUTPATIENT,,,18536,12048.4,,16311.68,88,,13049.34,,,0,"percent of total billed charges","88% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.79,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",11890.25,175,,,,,0,"fee schedule","175% of CMS fee schedule",3483.24,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11677.68,63,,9342.14,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",3381.79,100,,,,,0,"fee schedule",EAPG,12789.84,69,,,,,0,"fee schedule","69% of total billed charges",18536,100,,14828.80,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18536,100,,14828.80,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18536,100,,14828.80,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",11464.52,61.85,,9171.62,,,0,"percent of total billed charges","61.5% of total billed charges",3381.79,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",717.63,100,,,,,0,"fee schedule","100% of LI fee schedule",2505.03,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3449.42,100,,,,,0,"fee schedule",EAPG,4396.32,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6988.07,37.7,,5590.46,,,0,"percent of total billed charges","37.7% of total billed charges",6988.07,37.7,,5590.46,,,0,"percent of total billed charges","37.70% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6283.7,33.9,,5026.96,,,0,"percent of total billed charges","33.9% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14458.08,78,,11566.46,,,0,"percent of total billed charges","78% of total billed charges",6862.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15310.74,82.6,,12248.59,,,0,"percent of total billed charges","82.6% of total billed charges",3381.79,100,,,,,0,"fee schedule","100% of WA fee schedule",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15310.74,82.6,,12248.59,,,0,"percent of total billed charges","82.6% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.79,100,,,,,0,"fee schedule",EAPG,18536,100,,14828.80,,,0,"percent of total billed charges","100% of total billed charges",717.63,18536,
ACT,84085347,CDM,305,RC,85347,CPT,OUTPATIENT,,,91,59.15,,80.08,88,,64.06,,,0,"percent of total billed charges","88% of total billed charges",4.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",7.49,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,4.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",57.33,63,,45.86,,,0,"percent of total billed charges","63% of total billed charges",13.92,15.3,,11.14,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,62.79,69,,,,,0,"fee schedule","69% of total billed charges",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",4.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",4.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",4.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.37,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,4.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.28,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,4.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,4.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.31,37.7,,27.45,,,0,"percent of total billed charges","37.7% of total billed charges",34.31,37.7,,27.45,,,0,"percent of total billed charges","37.70% of total billed charges",4.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",30.85,33.9,,24.68,,,0,"percent of total billed charges","33.9% of total billed charges",4.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.98,78,,56.78,,,0,"percent of total billed charges","78% of total billed charges",4.32,101,,,,,0,"fee schedule","101% of CMS fee schedule ",75.17,82.6,,60.14,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,4.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",75.17,82.6,,60.14,,,0,"percent of total billed charges","82.6% of total billed charges",4.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",2.48,91,
"PERC CARD ANGIOPLASTY 1 ART",84092920,CDM,481,RC,92920,CPT,OUTPATIENT,,,42789,27812.85,,37654.32,88,,30123.46,,,0,"percent of total billed charges","88% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7748.35,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",10202.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",7980.8,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26957.07,63,,21565.66,,,0,"percent of total billed charges","63% of total billed charges",6546.72,15.3,,5237.38,,,0,"percent of total billed charges","15.3% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,29524.41,69,,,,,0,"fee schedule","69% of total billed charges",42789,100,,34231.20,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42789,100,,34231.20,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42789,100,,34231.20,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",20137.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7748.35,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5264.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5739.52,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7903.32,100,,,,,0,"fee schedule",EAPG,10072.86,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16131.45,37.7,,12905.16,,,0,"percent of total billed charges","37.7% of total billed charges",16131.45,37.7,,12905.16,,,0,"percent of total billed charges","37.70% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14505.47,33.9,,11604.38,,,0,"percent of total billed charges","33.9% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33375.42,78,,26700.34,,,0,"percent of total billed charges","78% of total billed charges",5888.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35343.71,82.6,,28274.97,,,0,"percent of total billed charges","82.6% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35343.71,82.6,,28274.97,,,0,"percent of total billed charges","82.6% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7748.35,100,,,,,0,"fee schedule",EAPG,42789,100,,34231.20,,,0,"percent of total billed charges","100% of total billed charges",4695,42789,
"PERC CARD ANGIO/ATHRECT 1 ART",84092924,CDM,481,RC,92924,CPT,OUTPATIENT,,,73722,47919.3,,64875.36,88,,51900.29,,,0,"percent of total billed charges","88% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7748.35,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",19636.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",7980.8,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46444.86,63,,37155.89,,,0,"percent of total billed charges","63% of total billed charges",11279.47,15.3,,9023.58,,,0,"percent of total billed charges","15.3% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,50868.18,69,,,,,0,"fee schedule","69% of total billed charges",73722,100,,58977.60,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73722,100,,58977.60,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73722,100,,58977.60,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",40799.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7748.35,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10666.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5739.52,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7903.32,100,,,,,0,"fee schedule",EAPG,10072.86,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",27793.19,37.7,,22234.55,,,0,"percent of total billed charges","37.7% of total billed charges",27793.19,37.7,,22234.55,,,0,"percent of total billed charges","37.70% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24991.76,33.9,,19993.41,,,0,"percent of total billed charges","33.9% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",57503.16,78,,46002.53,,,0,"percent of total billed charges","78% of total billed charges",11332.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60894.37,82.6,,48715.50,,,0,"percent of total billed charges","82.6% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60894.37,82.6,,48715.50,,,0,"percent of total billed charges","82.6% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7748.35,100,,,,,0,"fee schedule",EAPG,73722,100,,58977.60,,,0,"percent of total billed charges","100% of total billed charges",4695,73722,
"PERC CARD STENT/ANGIO 1 VSL",84092928,CDM,481,RC,92928,CPT,OUTPATIENT,,,75243,48907.95,,66213.84,88,,52971.07,,,0,"percent of total billed charges","88% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7748.35,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",19636.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",7980.8,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47403.09,63,,37922.47,,,0,"percent of total billed charges","63% of total billed charges",11512.18,15.3,,9209.74,,,0,"percent of total billed charges","15.3% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,51917.67,69,,,,,0,"fee schedule","69% of total billed charges",75243,100,,60194.40,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75243,100,,60194.40,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75243,100,,60194.40,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",40799.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7748.35,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10666.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5739.52,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7903.32,100,,,,,0,"fee schedule",EAPG,10072.86,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",28366.61,37.7,,22693.29,,,0,"percent of total billed charges","37.7% of total billed charges",28366.61,37.7,,22693.29,,,0,"percent of total billed charges","37.70% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",25507.38,33.9,,20405.90,,,0,"percent of total billed charges","33.9% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",58689.54,78,,46951.63,,,0,"percent of total billed charges","78% of total billed charges",11332.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",62150.72,82.6,,49720.58,,,0,"percent of total billed charges","82.6% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",62150.72,82.6,,49720.58,,,0,"percent of total billed charges","82.6% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7748.35,100,,,,,0,"fee schedule",EAPG,75243,100,,60194.40,,,0,"percent of total billed charges","100% of total billed charges",4695,75243,
"PERC CARD STENT/ATH/ANG 1 VSL",84092933,CDM,481,RC,92933,CPT,OUTPATIENT,,,96324,62610.6,,84765.12,88,,67812.10,,,0,"percent of total billed charges","88% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7748.35,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",31299.05,175,,,,,0,"fee schedule","175% of CMS fee schedule",7980.8,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60684.12,63,,48547.30,,,0,"percent of total billed charges","63% of total billed charges",14737.57,15.3,,11790.06,,,0,"percent of total billed charges","15.3% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,66463.56,69,,,,,0,"fee schedule","69% of total billed charges",96324,100,,77059.20,,,0,"percent of total billed charges","100% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",96324,100,,77059.20,,,0,"percent of total billed charges","100% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",96324,100,,77059.20,,,0,"percent of total billed charges","100% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",65260.52,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7748.35,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17061.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5739.52,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7903.32,100,,,,,0,"fee schedule",EAPG,10072.86,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36314.15,37.7,,29051.32,,,0,"percent of total billed charges","37.7% of total billed charges",36314.15,37.7,,29051.32,,,0,"percent of total billed charges","37.70% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32653.84,33.9,,26123.07,,,0,"percent of total billed charges","33.9% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75132.72,78,,60106.18,,,0,"percent of total billed charges","78% of total billed charges",18064.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",79563.62,82.6,,63650.90,,,0,"percent of total billed charges","82.6% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",79563.62,82.6,,63650.90,,,0,"percent of total billed charges","82.6% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7748.35,100,,,,,0,"fee schedule",EAPG,96324,100,,77059.20,,,0,"percent of total billed charges","100% of total billed charges",4695,96324,
"PERC REVASC BYPASS GRFT 1 VSL",84092937,CDM,481,RC,92937,CPT,OUTPATIENT,,,75243,48907.95,,66213.84,88,,52971.07,,,0,"percent of total billed charges","88% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7748.35,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",19636.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",7980.8,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47403.09,63,,37922.47,,,0,"percent of total billed charges","63% of total billed charges",11512.18,15.3,,9209.74,,,0,"percent of total billed charges","15.3% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,51917.67,69,,,,,0,"fee schedule","69% of total billed charges",75243,100,,60194.40,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75243,100,,60194.40,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75243,100,,60194.40,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",40799.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7748.35,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10666.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5739.52,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7903.32,100,,,,,0,"fee schedule",EAPG,10072.86,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",28366.61,37.7,,22693.29,,,0,"percent of total billed charges","37.7% of total billed charges",28366.61,37.7,,22693.29,,,0,"percent of total billed charges","37.70% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",25507.38,33.9,,20405.90,,,0,"percent of total billed charges","33.9% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",58689.54,78,,46951.63,,,0,"percent of total billed charges","78% of total billed charges",11332.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",62150.72,82.6,,49720.58,,,0,"percent of total billed charges","82.6% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",62150.72,82.6,,49720.58,,,0,"percent of total billed charges","82.6% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7748.35,100,,,,,0,"fee schedule",EAPG,75243,100,,60194.40,,,0,"percent of total billed charges","100% of total billed charges",4695,75243,
"PERC CARD REVASC MI 1 VSL",84092941,CDM,481,RC,92941,CPT,OUTPATIENT,,,73722,47919.3,,64875.36,88,,51900.29,,,0,"percent of total billed charges","88% of total billed charges",73722,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7748.35,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",73722,175,,,,,0,"fee schedule","175% of CMS fee schedule",7980.8,100,,,,,0,"fee schedule",EAPG,73722,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",46444.86,63,,37155.89,,,0,"percent of total billed charges","63% of total billed charges",11279.47,15.3,,9023.58,,,0,"percent of total billed charges","15.3% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,50868.18,69,,,,,0,"fee schedule","69% of total billed charges",73722,100,,58977.60,,,0,"percent of total billed charges","100% of total billed charges",73722,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",73722,100,,58977.60,,,0,"percent of total billed charges","100% of total billed charges",73722,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",73722,100,,58977.60,,,0,"percent of total billed charges","100% of total billed charges",73722,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",73722,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7748.35,100,,,,,0,"fee schedule",EAPG,73722,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",73722,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5739.52,100,,,,,0,"fee schedule",EAPG,73722,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7903.32,100,,,,,0,"fee schedule",EAPG,10072.86,100,,,,,0,"fee schedule",EAPG,73722,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",27793.19,37.7,,22234.55,,,0,"percent of total billed charges","37.7% of total billed charges",27793.19,37.7,,22234.55,,,0,"percent of total billed charges","37.70% of total billed charges",73722,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",24991.76,33.9,,19993.41,,,0,"percent of total billed charges","33.9% of total billed charges",73722,100,,,,,0,"fee schedule","100% of CMS fee schedule",57503.16,78,,46002.53,,,0,"percent of total billed charges","78% of total billed charges",73722,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",60894.37,82.6,,48715.50,,,0,"percent of total billed charges","82.6% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,73722,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",60894.37,82.6,,48715.50,,,0,"percent of total billed charges","82.6% of total billed charges",73722,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7748.35,100,,,,,0,"fee schedule",EAPG,73722,100,,58977.60,,,0,"percent of total billed charges","100% of total billed charges",4695,73722,
"PERC CARD REVASC CHRONIC 1 VSL",84092943,CDM,481,RC,92943,CPT,OUTPATIENT,,,73722,47919.3,,64875.36,88,,51900.29,,,0,"percent of total billed charges","88% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7748.35,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",19636.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",7980.8,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46444.86,63,,37155.89,,,0,"percent of total billed charges","63% of total billed charges",11279.47,15.3,,9023.58,,,0,"percent of total billed charges","15.3% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,50868.18,69,,,,,0,"fee schedule","69% of total billed charges",73722,100,,58977.60,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73722,100,,58977.60,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73722,100,,58977.60,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",40799.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7748.35,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10666.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5739.52,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7903.32,100,,,,,0,"fee schedule",EAPG,10072.86,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",27793.19,37.7,,22234.55,,,0,"percent of total billed charges","37.7% of total billed charges",27793.19,37.7,,22234.55,,,0,"percent of total billed charges","37.70% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24991.76,33.9,,19993.41,,,0,"percent of total billed charges","33.9% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",57503.16,78,,46002.53,,,0,"percent of total billed charges","78% of total billed charges",11332.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60894.37,82.6,,48715.50,,,0,"percent of total billed charges","82.6% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60894.37,82.6,,48715.50,,,0,"percent of total billed charges","82.6% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7748.35,100,,,,,0,"fee schedule",EAPG,73722,100,,58977.60,,,0,"percent of total billed charges","100% of total billed charges",4695,73722,
"CPR CATH LAB",84092950,CDM,481,RC,92950,CPT,OUTPATIENT,,,1022,664.3,,899.36,88,,719.49,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818.62,100,,,,,0,"fee schedule",EAPG,1022,100,,817.60,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",843.18,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.86,63,,515.09,,,0,"percent of total billed charges","63% of total billed charges",156.37,15.3,,125.10,,,0,"percent of total billed charges","15.3% of total billed charges",818.62,100,,,,,0,"fee schedule",EAPG,705.18,69,,,,,0,"fee schedule","69% of total billed charges",1022,100,,817.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022,100,,817.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022,100,,817.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818.62,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",606.38,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",834.99,100,,,,,0,"fee schedule",EAPG,1064.21,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",385.29,37.7,,308.23,,,0,"percent of total billed charges","37.7% of total billed charges",385.29,37.7,,308.23,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",346.46,33.9,,277.17,,,0,"percent of total billed charges","33.9% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",797.16,78,,637.73,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.17,82.6,,675.34,,,0,"percent of total billed charges","82.6% of total billed charges",818.62,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.17,82.6,,675.34,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818.62,100,,,,,0,"fee schedule",EAPG,1022,100,,817.60,,,0,"percent of total billed charges","100% of total billed charges",156.37,1074.33,
CARDIOVERSION,84092960,CDM,480,RC,92960,CPT,OUTPATIENT,,,2324,1510.6,,2045.12,88,,1636.10,,,0,"percent of total billed charges","88% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",582.08,100,,,,,0,"fee schedule",EAPG,2324,100,,1859.20,,,0,"percent of total billed charges","100% of total billed charges",1161.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",599.54,100,,,,,0,"fee schedule",EAPG,663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1464.12,63,,1171.30,,,0,"percent of total billed charges","63% of total billed charges",355.57,15.3,,284.46,,,0,"percent of total billed charges","15.3% of total billed charges",582.08,100,,,,,0,"fee schedule",EAPG,1603.56,69,,,,,0,"fee schedule","69% of total billed charges",2324,100,,1859.20,,,0,"percent of total billed charges","100% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2324,100,,1859.20,,,0,"percent of total billed charges","100% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2324,100,,1859.20,,,0,"percent of total billed charges","100% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",2282.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",582.08,100,,,,,0,"fee schedule",EAPG,663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",596.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",431.17,100,,,,,0,"fee schedule",EAPG,663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.72,100,,,,,0,"fee schedule",EAPG,756.7,100,,,,,0,"fee schedule",EAPG,663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",876.15,37.7,,700.92,,,0,"percent of total billed charges","37.7% of total billed charges",876.15,37.7,,700.92,,,0,"percent of total billed charges","37.70% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",787.84,33.9,,630.27,,,0,"percent of total billed charges","33.9% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1812.72,78,,1450.18,,,0,"percent of total billed charges","78% of total billed charges",670.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1919.62,82.6,,1535.70,,,0,"percent of total billed charges","82.6% of total billed charges",582.08,100,,,,,0,"fee schedule",EAPG,663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1919.62,82.6,,1535.70,,,0,"percent of total billed charges","82.6% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",582.08,100,,,,,0,"fee schedule",EAPG,2324,100,,1859.20,,,0,"percent of total billed charges","100% of total billed charges",355.57,2324,
"CARDIOVERSION ELECTIVE INT",84092961,CDM,481,RC,92961,CPT,OUTPATIENT,,,2130,1384.5,,1874.4,88,,1499.52,,,0,"percent of total billed charges","88% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",582.08,100,,,,,0,"fee schedule",EAPG,2130,100,,1704.00,,,0,"percent of total billed charges","100% of total billed charges",1161.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",599.54,100,,,,,0,"fee schedule",EAPG,663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1341.9,63,,1073.52,,,0,"percent of total billed charges","63% of total billed charges",325.89,15.3,,260.71,,,0,"percent of total billed charges","15.3% of total billed charges",582.08,100,,,,,0,"fee schedule",EAPG,1469.7,69,,,,,0,"fee schedule","69% of total billed charges",2130,100,,1704.00,,,0,"percent of total billed charges","100% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2130,100,,1704.00,,,0,"percent of total billed charges","100% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2130,100,,1704.00,,,0,"percent of total billed charges","100% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",2282.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",582.08,100,,,,,0,"fee schedule",EAPG,663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",596.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",431.17,100,,,,,0,"fee schedule",EAPG,663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.72,100,,,,,0,"fee schedule",EAPG,756.7,100,,,,,0,"fee schedule",EAPG,663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",803.01,37.7,,642.41,,,0,"percent of total billed charges","37.7% of total billed charges",803.01,37.7,,642.41,,,0,"percent of total billed charges","37.70% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",722.07,33.9,,577.66,,,0,"percent of total billed charges","33.9% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1661.4,78,,1329.12,,,0,"percent of total billed charges","78% of total billed charges",670.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1759.38,82.6,,1407.50,,,0,"percent of total billed charges","82.6% of total billed charges",582.08,100,,,,,0,"fee schedule",EAPG,663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1759.38,82.6,,1407.50,,,0,"percent of total billed charges","82.6% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",582.08,100,,,,,0,"fee schedule",EAPG,2130,100,,1704.00,,,0,"percent of total billed charges","100% of total billed charges",325.89,2282.77,
"CIRC ASSIST - IP ONLY",84092970,CDM,481,RC,92970,CPT,OUTPATIENT,,,26692,17349.8,,23488.96,88,,18791.17,,,0,"percent of total billed charges","88% of total billed charges",26692,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3222.02,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",26692,175,,,,,0,"fee schedule","175% of CMS fee schedule",3318.68,100,,,,,0,"fee schedule",EAPG,26692,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",16815.96,63,,13452.77,,,0,"percent of total billed charges","63% of total billed charges",4083.88,15.3,,3267.10,,,0,"percent of total billed charges","15.3% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,18417.48,69,,,,,0,"fee schedule","69% of total billed charges",26692,100,,21353.60,,,0,"percent of total billed charges","100% of total billed charges",26692,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",26692,100,,21353.60,,,0,"percent of total billed charges","100% of total billed charges",26692,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",26692,100,,21353.60,,,0,"percent of total billed charges","100% of total billed charges",26692,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",26692,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3222.02,100,,,,,0,"fee schedule",EAPG,26692,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",26692,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2386.68,100,,,,,0,"fee schedule",EAPG,26692,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3286.46,100,,,,,0,"fee schedule",EAPG,4188.63,100,,,,,0,"fee schedule",EAPG,26692,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10062.88,37.7,,8050.30,,,0,"percent of total billed charges","37.7% of total billed charges",10062.88,37.7,,8050.30,,,0,"percent of total billed charges","37.70% of total billed charges",26692,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9048.59,33.9,,7238.87,,,0,"percent of total billed charges","33.9% of total billed charges",26692,100,,,,,0,"fee schedule","100% of CMS fee schedule",20819.76,78,,16655.81,,,0,"percent of total billed charges","78% of total billed charges",26692,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",22047.59,82.6,,17638.07,,,0,"percent of total billed charges","82.6% of total billed charges",3222.02,100,,,,,0,"fee schedule","100% of WA fee schedule",26692,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",22047.59,82.6,,17638.07,,,0,"percent of total billed charges","82.6% of total billed charges",26692,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3222.02,100,,,,,0,"fee schedule",EAPG,26692,100,,21353.60,,,0,"percent of total billed charges","100% of total billed charges",2386.68,26692,
"PERCUT CORONARY THROMBECTOMY",84092973,CDM,481,RC,92973,CPT,OUTPATIENT,,,13759,8943.35,,12107.92,88,,9686.34,,,0,"percent of total billed charges","88% of total billed charges",6879.5,50,,5503.60,,,0,"percent of total billed charges","50% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7980.8,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",8668.17,63,,6934.54,,,0,"percent of total billed charges","63% of total billed charges",2105.13,15.3,,1684.10,,,0,"percent of total billed charges","15.3% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,9493.71,69,,,,,0,"fee schedule","69% of total billed charges",13759,100,,11007.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13759,100,,11007.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13759,100,,11007.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8509.94,61.85,,6807.95,,,0,"percent of total billed charges","61.5% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,6879.5,50,,5503.60,,,0,"percent of total billed charges","50% of total billed charges",4430.4,32.2,,3544.32,,,0,"percent of total billed charges","32.2% of total billed charges",5739.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",7903.32,100,,,,,0,"fee schedule",EAPG,10072.86,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",5187.14,37.7,,4149.71,,,0,"percent of total billed charges","37.7% of total billed charges",5187.14,37.7,,4149.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4664.3,33.9,,3731.44,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",10732.02,78,,8585.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11364.93,82.6,,9091.94,,,0,"percent of total billed charges","82.6% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,6879.5,50,,5503.60,,,0,"percent of total billed charges","50% of total billed charges",11364.93,82.6,,9091.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7748.35,100,,,,,0,"fee schedule",EAPG,13759,100,,11007.20,,,0,"percent of total billed charges","100% of total billed charges",2105.13,13759,
"CORONARY IVUS INTIAL VESSEL",84092978,CDM,481,RC,92978,CPT,OUTPATIENT,,,8149,5296.85,,7171.12,88,,5736.90,,,0,"percent of total billed charges","88% of total billed charges",4074.5,50,,3259.60,,,0,"percent of total billed charges","50% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",5133.87,63,,4107.10,,,0,"percent of total billed charges","63% of total billed charges",1246.8,15.3,,997.44,,,0,"percent of total billed charges","15.3% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,5622.81,69,,,,,0,"fee schedule","69% of total billed charges",8149,100,,6519.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8149,100,,6519.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8149,100,,6519.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5040.16,61.85,,4032.13,,,0,"percent of total billed charges","61.5% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,4074.5,50,,3259.60,,,0,"percent of total billed charges","50% of total billed charges",2623.98,32.2,,2099.18,,,0,"percent of total billed charges","32.2% of total billed charges",119.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",165.21,100,,,,,0,"fee schedule",EAPG,210.57,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3072.17,37.7,,2457.74,,,0,"percent of total billed charges","37.7% of total billed charges",3072.17,37.7,,2457.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2762.51,33.9,,2210.01,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6356.22,78,,5084.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6731.07,82.6,,5384.86,,,0,"percent of total billed charges","82.6% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,4074.5,50,,3259.60,,,0,"percent of total billed charges","50% of total billed charges",6731.07,82.6,,5384.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",161.97,100,,,,,0,"fee schedule",EAPG,8149,100,,6519.20,,,0,"percent of total billed charges","100% of total billed charges",119.98,8149,
"CORONARY IVUS SUB VESSEL",84092979,CDM,481,RC,92979,CPT,OUTPATIENT,,,8149,5296.85,,7171.12,88,,5736.90,,,0,"percent of total billed charges","88% of total billed charges",4074.5,50,,3259.60,,,0,"percent of total billed charges","50% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",5133.87,63,,4107.10,,,0,"percent of total billed charges","63% of total billed charges",1246.8,15.3,,997.44,,,0,"percent of total billed charges","15.3% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,5622.81,69,,,,,0,"fee schedule","69% of total billed charges",8149,100,,6519.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8149,100,,6519.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8149,100,,6519.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5040.16,61.85,,4032.13,,,0,"percent of total billed charges","61.5% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,4074.5,50,,3259.60,,,0,"percent of total billed charges","50% of total billed charges",2623.98,32.2,,2099.18,,,0,"percent of total billed charges","32.2% of total billed charges",119.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",165.21,100,,,,,0,"fee schedule",EAPG,210.57,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3072.17,37.7,,2457.74,,,0,"percent of total billed charges","37.7% of total billed charges",3072.17,37.7,,2457.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2762.51,33.9,,2210.01,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6356.22,78,,5084.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6731.07,82.6,,5384.86,,,0,"percent of total billed charges","82.6% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,4074.5,50,,3259.60,,,0,"percent of total billed charges","50% of total billed charges",6731.07,82.6,,5384.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",161.97,100,,,,,0,"fee schedule",EAPG,8149,100,,6519.20,,,0,"percent of total billed charges","100% of total billed charges",119.98,8149,
ELECTROCARDIOGRAM,84093005,CDM,730,RC,93005,CPT,OUTPATIENT,,,509,330.85,,447.92,88,,358.34,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",24.47,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320.67,63,,256.54,,,0,"percent of total billed charges","63% of total billed charges",77.88,15.3,,62.30,,,0,"percent of total billed charges","15.3% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,351.21,69,,,,,0,"fee schedule","69% of total billed charges",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17.6,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.23,100,,,,,0,"fee schedule",EAPG,30.89,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191.89,37.7,,153.51,,,0,"percent of total billed charges","37.7% of total billed charges",191.89,37.7,,153.51,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",172.55,33.9,,138.04,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397.02,78,,317.62,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.43,82.6,,336.34,,,0,"percent of total billed charges","82.6% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.43,82.6,,336.34,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",17.6,509,
"CARDIAC STRESS TEST",84093017,CDM,482,RC,93017,CPT,OUTPATIENT,,,1022,664.3,,899.36,88,,719.49,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.99,100,,,,,0,"fee schedule",EAPG,1022,100,,817.60,,,0,"percent of total billed charges","100% of total billed charges",560.25,175,,,,,0,"fee schedule","175% of CMS fee schedule",155.52,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.86,63,,515.09,,,0,"percent of total billed charges","63% of total billed charges",156.37,15.3,,125.10,,,0,"percent of total billed charges","15.3% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,705.18,69,,,,,0,"fee schedule","69% of total billed charges",1022,100,,817.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022,100,,817.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022,100,,817.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.99,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.84,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.01,100,,,,,0,"fee schedule",EAPG,196.29,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",385.29,37.7,,308.23,,,0,"percent of total billed charges","37.7% of total billed charges",385.29,37.7,,308.23,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",346.46,33.9,,277.17,,,0,"percent of total billed charges","33.9% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",797.16,78,,637.73,,,0,"percent of total billed charges","78% of total billed charges",323.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.17,82.6,,675.34,,,0,"percent of total billed charges","82.6% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.17,82.6,,675.34,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.99,100,,,,,0,"fee schedule",EAPG,1022,100,,817.60,,,0,"percent of total billed charges","100% of total billed charges",111.84,1074.33,
"TRANSESOPHOGEAL ECHO",84093312,CDM,480,RC,93312,CPT,OUTPATIENT,,,2549,1656.85,,2243.12,88,,1794.50,,,0,"percent of total billed charges","88% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,2549,100,,2039.20,,,0,"percent of total billed charges","100% of total billed charges",984.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",430.64,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1605.87,63,,1284.70,,,0,"percent of total billed charges","63% of total billed charges",390,15.3,,312.00,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,1758.81,69,,,,,0,"fee schedule","69% of total billed charges",2549,100,,2039.20,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2549,100,,2039.20,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2549,100,,2039.20,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1961.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.7,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",960.97,37.7,,768.78,,,0,"percent of total billed charges","37.7% of total billed charges",960.97,37.7,,768.78,,,0,"percent of total billed charges","37.70% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",864.11,33.9,,691.29,,,0,"percent of total billed charges","33.9% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1988.22,78,,1590.58,,,0,"percent of total billed charges","78% of total billed charges",568.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2105.47,82.6,,1684.38,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2105.47,82.6,,1684.38,,,0,"percent of total billed charges","82.6% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,2549,100,,2039.20,,,0,"percent of total billed charges","100% of total billed charges",309.7,2549,
"RIGHT HEART CATH",84093451,CDM,481,RC,93451,CPT,OUTPATIENT,,,39491,25669.15,,34752.08,88,,27801.66,,,0,"percent of total billed charges","88% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5816.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",2184.59,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24879.33,63,,19903.46,,,0,"percent of total billed charges","63% of total billed charges",6042.12,15.3,,4833.70,,,0,"percent of total billed charges","15.3% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,27248.79,69,,,,,0,"fee schedule","69% of total billed charges",39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",11777.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3079.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.08,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2163.38,100,,,,,0,"fee schedule",EAPG,2757.26,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14888.11,37.7,,11910.49,,,0,"percent of total billed charges","37.7% of total billed charges",14888.11,37.7,,11910.49,,,0,"percent of total billed charges","37.70% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13387.45,33.9,,10709.96,,,0,"percent of total billed charges","33.9% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",30802.98,78,,24642.38,,,0,"percent of total billed charges","78% of total billed charges",5138.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32619.57,82.6,,26095.66,,,0,"percent of total billed charges","82.6% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32619.57,82.6,,26095.66,,,0,"percent of total billed charges","82.6% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",1571.08,39491,
"LEFT HRT CATH W/VENTRICLGRPHY",84093452,CDM,481,RC,93452,CPT,OUTPATIENT,,,39491,25669.15,,34752.08,88,,27801.66,,,0,"percent of total billed charges","88% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5816.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",2184.59,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24879.33,63,,19903.46,,,0,"percent of total billed charges","63% of total billed charges",6042.12,15.3,,4833.70,,,0,"percent of total billed charges","15.3% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,27248.79,69,,,,,0,"fee schedule","69% of total billed charges",39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",11777.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3079.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.08,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2163.38,100,,,,,0,"fee schedule",EAPG,2757.26,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14888.11,37.7,,11910.49,,,0,"percent of total billed charges","37.7% of total billed charges",14888.11,37.7,,11910.49,,,0,"percent of total billed charges","37.70% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13387.45,33.9,,10709.96,,,0,"percent of total billed charges","33.9% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",30802.98,78,,24642.38,,,0,"percent of total billed charges","78% of total billed charges",5138.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32619.57,82.6,,26095.66,,,0,"percent of total billed charges","82.6% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32619.57,82.6,,26095.66,,,0,"percent of total billed charges","82.6% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",1571.08,39491,
"RL HRT CATH W/VENTRICLGRPHY",84093453,CDM,481,RC,93453,CPT,OUTPATIENT,,,42531,27645.15,,37427.28,88,,29941.82,,,0,"percent of total billed charges","88% of total billed charges",5497.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5816.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",2184.59,100,,,,,0,"fee schedule",EAPG,5497.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26794.53,63,,21435.62,,,0,"percent of total billed charges","63% of total billed charges",6507.24,15.3,,5205.79,,,0,"percent of total billed charges","15.3% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,29346.39,69,,,,,0,"fee schedule","69% of total billed charges",42531,100,,34024.80,,,0,"percent of total billed charges","100% of total billed charges",5497.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42531,100,,34024.80,,,0,"percent of total billed charges","100% of total billed charges",5497.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42531,100,,34024.80,,,0,"percent of total billed charges","100% of total billed charges",5497.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",11777.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,5497.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3079.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.08,100,,,,,0,"fee schedule",EAPG,5497.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2163.38,100,,,,,0,"fee schedule",EAPG,2757.26,100,,,,,0,"fee schedule",EAPG,5497.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16034.19,37.7,,12827.35,,,0,"percent of total billed charges","37.7% of total billed charges",16034.19,37.7,,12827.35,,,0,"percent of total billed charges","37.70% of total billed charges",5497.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14418.01,33.9,,11534.41,,,0,"percent of total billed charges","33.9% of total billed charges",5497.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33174.18,78,,26539.34,,,0,"percent of total billed charges","78% of total billed charges",5502.06,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35130.61,82.6,,28104.49,,,0,"percent of total billed charges","82.6% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,5497.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35130.61,82.6,,28104.49,,,0,"percent of total billed charges","82.6% of total billed charges",5497.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,42531,100,,34024.80,,,0,"percent of total billed charges","100% of total billed charges",1571.08,42531,
"CORONARY ARTERY ANGIO SI",84093454,CDM,481,RC,93454,CPT,OUTPATIENT,,,39491,25669.15,,34752.08,88,,27801.66,,,0,"percent of total billed charges","88% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5816.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",2184.59,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24879.33,63,,19903.46,,,0,"percent of total billed charges","63% of total billed charges",6042.12,15.3,,4833.70,,,0,"percent of total billed charges","15.3% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,27248.79,69,,,,,0,"fee schedule","69% of total billed charges",39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",11777.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3079.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.08,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2163.38,100,,,,,0,"fee schedule",EAPG,2757.26,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14888.11,37.7,,11910.49,,,0,"percent of total billed charges","37.7% of total billed charges",14888.11,37.7,,11910.49,,,0,"percent of total billed charges","37.70% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13387.45,33.9,,10709.96,,,0,"percent of total billed charges","33.9% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",30802.98,78,,24642.38,,,0,"percent of total billed charges","78% of total billed charges",5138.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32619.57,82.6,,26095.66,,,0,"percent of total billed charges","82.6% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32619.57,82.6,,26095.66,,,0,"percent of total billed charges","82.6% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",1571.08,39491,
"CORONARY ART/GRFT ANGIO SI",84093455,CDM,481,RC,93455,CPT,OUTPATIENT,,,39491,25669.15,,34752.08,88,,27801.66,,,0,"percent of total billed charges","88% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5816.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",2184.59,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24879.33,63,,19903.46,,,0,"percent of total billed charges","63% of total billed charges",6042.12,15.3,,4833.70,,,0,"percent of total billed charges","15.3% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,27248.79,69,,,,,0,"fee schedule","69% of total billed charges",39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",11777.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3079.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.08,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2163.38,100,,,,,0,"fee schedule",EAPG,2757.26,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14888.11,37.7,,11910.49,,,0,"percent of total billed charges","37.7% of total billed charges",14888.11,37.7,,11910.49,,,0,"percent of total billed charges","37.70% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13387.45,33.9,,10709.96,,,0,"percent of total billed charges","33.9% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",30802.98,78,,24642.38,,,0,"percent of total billed charges","78% of total billed charges",5138.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32619.57,82.6,,26095.66,,,0,"percent of total billed charges","82.6% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32619.57,82.6,,26095.66,,,0,"percent of total billed charges","82.6% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",1571.08,39491,
"R HRT CORONARY ARTERY ANGIO",84093456,CDM,481,RC,93456,CPT,OUTPATIENT,,,39491,25669.15,,34752.08,88,,27801.66,,,0,"percent of total billed charges","88% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5816.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",2184.59,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24879.33,63,,19903.46,,,0,"percent of total billed charges","63% of total billed charges",6042.12,15.3,,4833.70,,,0,"percent of total billed charges","15.3% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,27248.79,69,,,,,0,"fee schedule","69% of total billed charges",39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",11777.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3079.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.08,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2163.38,100,,,,,0,"fee schedule",EAPG,2757.26,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14888.11,37.7,,11910.49,,,0,"percent of total billed charges","37.7% of total billed charges",14888.11,37.7,,11910.49,,,0,"percent of total billed charges","37.70% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13387.45,33.9,,10709.96,,,0,"percent of total billed charges","33.9% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",30802.98,78,,24642.38,,,0,"percent of total billed charges","78% of total billed charges",5138.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32619.57,82.6,,26095.66,,,0,"percent of total billed charges","82.6% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32619.57,82.6,,26095.66,,,0,"percent of total billed charges","82.6% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",1571.08,39491,
"R HRT AR/GRFT ANGIO",84093457,CDM,481,RC,93457,CPT,OUTPATIENT,,,39491,25669.15,,34752.08,88,,27801.66,,,0,"percent of total billed charges","88% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5816.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",2184.59,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24879.33,63,,19903.46,,,0,"percent of total billed charges","63% of total billed charges",6042.12,15.3,,4833.70,,,0,"percent of total billed charges","15.3% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,27248.79,69,,,,,0,"fee schedule","69% of total billed charges",39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",11777.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3079.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.08,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2163.38,100,,,,,0,"fee schedule",EAPG,2757.26,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14888.11,37.7,,11910.49,,,0,"percent of total billed charges","37.7% of total billed charges",14888.11,37.7,,11910.49,,,0,"percent of total billed charges","37.70% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13387.45,33.9,,10709.96,,,0,"percent of total billed charges","33.9% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",30802.98,78,,24642.38,,,0,"percent of total billed charges","78% of total billed charges",5138.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32619.57,82.6,,26095.66,,,0,"percent of total billed charges","82.6% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32619.57,82.6,,26095.66,,,0,"percent of total billed charges","82.6% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",1571.08,39491,
"L HRT ARTERY/VENTRICLE ANGIO",84093458,CDM,481,RC,93458,CPT,OUTPATIENT,,,39491,25669.15,,34752.08,88,,27801.66,,,0,"percent of total billed charges","88% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5816.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",2184.59,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24879.33,63,,19903.46,,,0,"percent of total billed charges","63% of total billed charges",6042.12,15.3,,4833.70,,,0,"percent of total billed charges","15.3% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,27248.79,69,,,,,0,"fee schedule","69% of total billed charges",39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",11777.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3079.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.08,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2163.38,100,,,,,0,"fee schedule",EAPG,2757.26,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14888.11,37.7,,11910.49,,,0,"percent of total billed charges","37.7% of total billed charges",14888.11,37.7,,11910.49,,,0,"percent of total billed charges","37.70% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13387.45,33.9,,10709.96,,,0,"percent of total billed charges","33.9% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",30802.98,78,,24642.38,,,0,"percent of total billed charges","78% of total billed charges",5138.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32619.57,82.6,,26095.66,,,0,"percent of total billed charges","82.6% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32619.57,82.6,,26095.66,,,0,"percent of total billed charges","82.6% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",1571.08,39491,
"L HRT ART/GRFT ANGIO",84093459,CDM,481,RC,93459,CPT,OUTPATIENT,,,39491,25669.15,,34752.08,88,,27801.66,,,0,"percent of total billed charges","88% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5816.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",2184.59,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24879.33,63,,19903.46,,,0,"percent of total billed charges","63% of total billed charges",6042.12,15.3,,4833.70,,,0,"percent of total billed charges","15.3% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,27248.79,69,,,,,0,"fee schedule","69% of total billed charges",39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",11777.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3079.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.08,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2163.38,100,,,,,0,"fee schedule",EAPG,2757.26,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14888.11,37.7,,11910.49,,,0,"percent of total billed charges","37.7% of total billed charges",14888.11,37.7,,11910.49,,,0,"percent of total billed charges","37.70% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13387.45,33.9,,10709.96,,,0,"percent of total billed charges","33.9% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",30802.98,78,,24642.38,,,0,"percent of total billed charges","78% of total billed charges",5138.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32619.57,82.6,,26095.66,,,0,"percent of total billed charges","82.6% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32619.57,82.6,,26095.66,,,0,"percent of total billed charges","82.6% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",1571.08,39491,
"RL HRT ART/VENTRICLE ANGIO",84093460,CDM,481,RC,93460,CPT,OUTPATIENT,,,39491,25669.15,,34752.08,88,,27801.66,,,0,"percent of total billed charges","88% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5816.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",2184.59,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24879.33,63,,19903.46,,,0,"percent of total billed charges","63% of total billed charges",6042.12,15.3,,4833.70,,,0,"percent of total billed charges","15.3% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,27248.79,69,,,,,0,"fee schedule","69% of total billed charges",39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",11777.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3079.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.08,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2163.38,100,,,,,0,"fee schedule",EAPG,2757.26,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14888.11,37.7,,11910.49,,,0,"percent of total billed charges","37.7% of total billed charges",14888.11,37.7,,11910.49,,,0,"percent of total billed charges","37.70% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13387.45,33.9,,10709.96,,,0,"percent of total billed charges","33.9% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",30802.98,78,,24642.38,,,0,"percent of total billed charges","78% of total billed charges",5138.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32619.57,82.6,,26095.66,,,0,"percent of total billed charges","82.6% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32619.57,82.6,,26095.66,,,0,"percent of total billed charges","82.6% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",1571.08,39491,
"RL HRT ART/VENT GRFT ANGIO",84093461,CDM,481,RC,93461,CPT,OUTPATIENT,,,39491,25669.15,,34752.08,88,,27801.66,,,0,"percent of total billed charges","88% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5816.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",2184.59,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24879.33,63,,19903.46,,,0,"percent of total billed charges","63% of total billed charges",6042.12,15.3,,4833.70,,,0,"percent of total billed charges","15.3% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,27248.79,69,,,,,0,"fee schedule","69% of total billed charges",39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",11777.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3079.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.08,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2163.38,100,,,,,0,"fee schedule",EAPG,2757.26,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14888.11,37.7,,11910.49,,,0,"percent of total billed charges","37.7% of total billed charges",14888.11,37.7,,11910.49,,,0,"percent of total billed charges","37.70% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13387.45,33.9,,10709.96,,,0,"percent of total billed charges","33.9% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",30802.98,78,,24642.38,,,0,"percent of total billed charges","78% of total billed charges",5138.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32619.57,82.6,,26095.66,,,0,"percent of total billed charges","82.6% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32619.57,82.6,,26095.66,,,0,"percent of total billed charges","82.6% of total billed charges",5134.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,39491,100,,31592.80,,,0,"percent of total billed charges","100% of total billed charges",1571.08,39491,
"L HRT CATH TRSNSPTL PUNCTURE",84093462,CDM,481,RC,93462,CPT,OUTPATIENT,,,10917,7096.05,,9606.96,88,,7685.57,,,0,"percent of total billed charges","88% of total billed charges",5458.5,50,,4366.80,,,0,"percent of total billed charges","50% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2184.59,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",6877.71,63,,5502.17,,,0,"percent of total billed charges","63% of total billed charges",1670.3,15.3,,1336.24,,,0,"percent of total billed charges","15.3% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,7532.73,69,,,,,0,"fee schedule","69% of total billed charges",10917,100,,8733.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10917,100,,8733.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10917,100,,8733.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6752.16,61.85,,5401.73,,,0,"percent of total billed charges","61.5% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,5458.5,50,,4366.80,,,0,"percent of total billed charges","50% of total billed charges",3515.27,32.2,,2812.22,,,0,"percent of total billed charges","32.2% of total billed charges",1571.08,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2163.38,100,,,,,0,"fee schedule",EAPG,2757.26,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",4115.71,37.7,,3292.57,,,0,"percent of total billed charges","37.7% of total billed charges",4115.71,37.7,,3292.57,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3700.86,33.9,,2960.69,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",8515.26,78,,6812.21,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9017.44,82.6,,7213.95,,,0,"percent of total billed charges","82.6% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,5458.5,50,,4366.80,,,0,"percent of total billed charges","50% of total billed charges",9017.44,82.6,,7213.95,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2120.96,100,,,,,0,"fee schedule",EAPG,10917,100,,8733.60,,,0,"percent of total billed charges","100% of total billed charges",1571.08,10917,
"DRUG ADMIN  HEMODYNMIC MEAS",84093463,CDM,481,RC,93463,CPT,OUTPATIENT,,,501,325.65,,440.88,88,,352.70,,,0,"percent of total billed charges","88% of total billed charges",250.5,50,,200.40,,,0,"percent of total billed charges","50% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,501,100,,400.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",41,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",315.63,63,,252.50,,,0,"percent of total billed charges","63% of total billed charges",76.65,15.3,,61.32,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,345.69,69,,,,,0,"fee schedule","69% of total billed charges",501,100,,400.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",501,100,,400.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",501,100,,400.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309.87,61.85,,247.90,,,0,"percent of total billed charges","61.5% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,250.5,50,,200.40,,,0,"percent of total billed charges","50% of total billed charges",161.32,32.2,,129.06,,,0,"percent of total billed charges","32.2% of total billed charges",29.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",188.88,37.7,,151.10,,,0,"percent of total billed charges","37.7% of total billed charges",188.88,37.7,,151.10,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",169.84,33.9,,135.87,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",390.78,78,,312.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",413.83,82.6,,331.06,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule","100% of WA fee schedule",250.5,50,,200.40,,,0,"percent of total billed charges","50% of total billed charges",413.83,82.6,,331.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.8,100,,,,,0,"fee schedule",EAPG,501,100,,400.80,,,0,"percent of total billed charges","100% of total billed charges",29.48,501,
"EXERCISE W/HEMODYNAMIC MEAS",84093464,CDM,481,RC,93464,CPT,OUTPATIENT,,,473,307.45,,416.24,88,,332.99,,,0,"percent of total billed charges","88% of total billed charges",236.5,50,,189.20,,,0,"percent of total billed charges","50% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,473,100,,378.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",297.99,63,,238.39,,,0,"percent of total billed charges","63% of total billed charges",72.37,15.3,,57.90,,,0,"percent of total billed charges","15.3% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,326.37,69,,,,,0,"fee schedule","69% of total billed charges",473,100,,378.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",473,100,,378.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",473,100,,378.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.55,61.85,,234.04,,,0,"percent of total billed charges","61.5% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,236.5,50,,189.20,,,0,"percent of total billed charges","50% of total billed charges",152.31,32.2,,121.85,,,0,"percent of total billed charges","32.2% of total billed charges",111.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",154.01,100,,,,,0,"fee schedule",EAPG,196.29,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",178.32,37.7,,142.66,,,0,"percent of total billed charges","37.7% of total billed charges",178.32,37.7,,142.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.35,33.9,,128.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",368.94,78,,295.15,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",390.7,82.6,,312.56,,,0,"percent of total billed charges","82.6% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,236.5,50,,189.20,,,0,"percent of total billed charges","50% of total billed charges",390.7,82.6,,312.56,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",150.99,100,,,,,0,"fee schedule",EAPG,473,100,,378.40,,,0,"percent of total billed charges","100% of total billed charges",72.37,473,
"SWAN GANZ INSERT",84093503,CDM,481,RC,93503,CPT,OUTPATIENT,,,6013,3908.45,,5291.44,88,,4233.15,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",1043.63,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3788.19,63,,3030.55,,,0,"percent of total billed charges","63% of total billed charges",919.99,15.3,,735.99,,,0,"percent of total billed charges","15.3% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,4148.97,69,,,,,0,"fee schedule","69% of total billed charges",6013,100,,4810.40,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6013,100,,4810.40,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6013,100,,4810.40,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",750.54,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033.49,100,,,,,0,"fee schedule",EAPG,1317.2,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2266.9,37.7,,1813.52,,,0,"percent of total billed charges","37.7% of total billed charges",2266.9,37.7,,1813.52,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2038.41,33.9,,1630.73,,,0,"percent of total billed charges","33.9% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4690.14,78,,3752.11,,,0,"percent of total billed charges","78% of total billed charges",1649.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4966.74,82.6,,3973.39,,,0,"percent of total billed charges","82.6% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4966.74,82.6,,3973.39,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,6013,100,,4810.40,,,0,"percent of total billed charges","100% of total billed charges",750.54,6013,
"ENDOMYOCARDIAL BIOPSY",84093505,CDM,481,RC,93505,CPT,OUTPATIENT,,,6011,3907.15,,5289.68,88,,4231.74,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",2184.59,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3786.93,63,,3029.54,,,0,"percent of total billed charges","63% of total billed charges",919.68,15.3,,735.74,,,0,"percent of total billed charges","15.3% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,4147.59,69,,,,,0,"fee schedule","69% of total billed charges",6011,100,,4808.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6011,100,,4808.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6011,100,,4808.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.08,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2163.38,100,,,,,0,"fee schedule",EAPG,2757.26,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2266.15,37.7,,1812.92,,,0,"percent of total billed charges","37.7% of total billed charges",2266.15,37.7,,1812.92,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2037.73,33.9,,1630.18,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4688.58,78,,3750.86,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4965.09,82.6,,3972.07,,,0,"percent of total billed charges","82.6% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4965.09,82.6,,3972.07,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,6011,100,,4808.80,,,0,"percent of total billed charges","100% of total billed charges",919.68,11625.57,
"INJECT CONGENITAL CARD CATH",84093563,CDM,481,RC,93563,CPT,OUTPATIENT,,,219,142.35,,192.72,88,,154.18,,,0,"percent of total billed charges","88% of total billed charges",109.5,50,,87.60,,,0,"percent of total billed charges","50% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.05,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",137.97,63,,110.38,,,0,"percent of total billed charges","63% of total billed charges",33.51,15.3,,26.81,,,0,"percent of total billed charges","15.3% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,151.11,69,,,,,0,"fee schedule","69% of total billed charges",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",135.45,61.85,,108.36,,,0,"percent of total billed charges","61.5% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,109.5,50,,87.60,,,0,"percent of total billed charges","50% of total billed charges",70.52,32.2,,56.42,,,0,"percent of total billed charges","32.2% of total billed charges",202.12,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",278.32,100,,,,,0,"fee schedule",EAPG,354.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",82.56,37.7,,66.05,,,0,"percent of total billed charges","37.7% of total billed charges",82.56,37.7,,66.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.24,33.9,,59.39,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.82,78,,136.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",180.89,82.6,,144.71,,,0,"percent of total billed charges","82.6% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,109.5,50,,87.60,,,0,"percent of total billed charges","50% of total billed charges",180.89,82.6,,144.71,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.87,100,,,,,0,"fee schedule",EAPG,219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",33.51,354.73,
"INJECT L VENTR/ATRIAL ANGIO",84093565,CDM,481,RC,93565,CPT,OUTPATIENT,,,219,142.35,,192.72,88,,154.18,,,0,"percent of total billed charges","88% of total billed charges",109.5,50,,87.60,,,0,"percent of total billed charges","50% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.05,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",137.97,63,,110.38,,,0,"percent of total billed charges","63% of total billed charges",33.51,15.3,,26.81,,,0,"percent of total billed charges","15.3% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,151.11,69,,,,,0,"fee schedule","69% of total billed charges",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",135.45,61.85,,108.36,,,0,"percent of total billed charges","61.5% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,109.5,50,,87.60,,,0,"percent of total billed charges","50% of total billed charges",70.52,32.2,,56.42,,,0,"percent of total billed charges","32.2% of total billed charges",202.12,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",278.32,100,,,,,0,"fee schedule",EAPG,354.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",82.56,37.7,,66.05,,,0,"percent of total billed charges","37.7% of total billed charges",82.56,37.7,,66.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.24,33.9,,59.39,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.82,78,,136.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",180.89,82.6,,144.71,,,0,"percent of total billed charges","82.6% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,109.5,50,,87.60,,,0,"percent of total billed charges","50% of total billed charges",180.89,82.6,,144.71,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.87,100,,,,,0,"fee schedule",EAPG,219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",33.51,354.73,
"INJECT SUPRVLV AORTOGRAPHY",84093567,CDM,481,RC,93567,CPT,OUTPATIENT,,,219,142.35,,192.72,88,,154.18,,,0,"percent of total billed charges","88% of total billed charges",109.5,50,,87.60,,,0,"percent of total billed charges","50% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.05,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",137.97,63,,110.38,,,0,"percent of total billed charges","63% of total billed charges",33.51,15.3,,26.81,,,0,"percent of total billed charges","15.3% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,151.11,69,,,,,0,"fee schedule","69% of total billed charges",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",135.45,61.85,,108.36,,,0,"percent of total billed charges","61.5% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,109.5,50,,87.60,,,0,"percent of total billed charges","50% of total billed charges",70.52,32.2,,56.42,,,0,"percent of total billed charges","32.2% of total billed charges",202.12,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",278.32,100,,,,,0,"fee schedule",EAPG,354.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",82.56,37.7,,66.05,,,0,"percent of total billed charges","37.7% of total billed charges",82.56,37.7,,66.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.24,33.9,,59.39,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.82,78,,136.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",180.89,82.6,,144.71,,,0,"percent of total billed charges","82.6% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,109.5,50,,87.60,,,0,"percent of total billed charges","50% of total billed charges",180.89,82.6,,144.71,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.87,100,,,,,0,"fee schedule",EAPG,219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",33.51,354.73,
"INJECT PULM ART HRT CATH",84093568,CDM,481,RC,93568,CPT,OUTPATIENT,,,219,142.35,,192.72,88,,154.18,,,0,"percent of total billed charges","88% of total billed charges",109.5,50,,87.60,,,0,"percent of total billed charges","50% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.05,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",137.97,63,,110.38,,,0,"percent of total billed charges","63% of total billed charges",33.51,15.3,,26.81,,,0,"percent of total billed charges","15.3% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,151.11,69,,,,,0,"fee schedule","69% of total billed charges",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",135.45,61.85,,108.36,,,0,"percent of total billed charges","61.5% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,109.5,50,,87.60,,,0,"percent of total billed charges","50% of total billed charges",70.52,32.2,,56.42,,,0,"percent of total billed charges","32.2% of total billed charges",202.12,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",278.32,100,,,,,0,"fee schedule",EAPG,354.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",82.56,37.7,,66.05,,,0,"percent of total billed charges","37.7% of total billed charges",82.56,37.7,,66.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.24,33.9,,59.39,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.82,78,,136.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",180.89,82.6,,144.71,,,0,"percent of total billed charges","82.6% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,109.5,50,,87.60,,,0,"percent of total billed charges","50% of total billed charges",180.89,82.6,,144.71,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.87,100,,,,,0,"fee schedule",EAPG,219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",33.51,354.73,
"INTRAVASC DOPPLER FLOW MEASURE",84093571,CDM,481,RC,93571,CPT,OUTPATIENT,,,11402,7411.3,,10033.76,88,,8027.01,,,0,"percent of total billed charges","88% of total billed charges",5701,50,,4560.80,,,0,"percent of total billed charges","50% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1694.66,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",7183.26,63,,5746.61,,,0,"percent of total billed charges","63% of total billed charges",1744.51,15.3,,1395.61,,,0,"percent of total billed charges","15.3% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,7867.38,69,,,,,0,"fee schedule","69% of total billed charges",11402,100,,9121.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11402,100,,9121.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11402,100,,9121.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7052.14,61.85,,5641.71,,,0,"percent of total billed charges","61.5% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,5701,50,,4560.80,,,0,"percent of total billed charges","50% of total billed charges",3671.44,32.2,,2937.15,,,0,"percent of total billed charges","32.2% of total billed charges",1218.74,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1678.2,100,,,,,0,"fee schedule",EAPG,2138.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",4298.55,37.7,,3438.84,,,0,"percent of total billed charges","37.7% of total billed charges",4298.55,37.7,,3438.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3865.28,33.9,,3092.22,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",8893.56,78,,7114.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9418.05,82.6,,7534.44,,,0,"percent of total billed charges","82.6% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,5701,50,,4560.80,,,0,"percent of total billed charges","50% of total billed charges",9418.05,82.6,,7534.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1645.3,100,,,,,0,"fee schedule",EAPG,11402,100,,9121.60,,,0,"percent of total billed charges","100% of total billed charges",1218.74,11402,
"INTRAVASCULAR DOPP EA ADD VESS",84093572,CDM,481,RC,93572,CPT,OUTPATIENT,,,3638,2364.7,,3201.44,88,,2561.15,,,0,"percent of total billed charges","88% of total billed charges",1819,50,,1455.20,,,0,"percent of total billed charges","50% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,3638,100,,2910.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1694.66,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2291.94,63,,1833.55,,,0,"percent of total billed charges","63% of total billed charges",556.61,15.3,,445.29,,,0,"percent of total billed charges","15.3% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,2510.22,69,,,,,0,"fee schedule","69% of total billed charges",3638,100,,2910.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3638,100,,2910.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3638,100,,2910.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2250.1,61.85,,1800.08,,,0,"percent of total billed charges","61.5% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,1819,50,,1455.20,,,0,"percent of total billed charges","50% of total billed charges",1171.44,32.2,,937.15,,,0,"percent of total billed charges","32.2% of total billed charges",1218.74,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1678.2,100,,,,,0,"fee schedule",EAPG,2138.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1371.53,37.7,,1097.22,,,0,"percent of total billed charges","37.7% of total billed charges",1371.53,37.7,,1097.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1233.28,33.9,,986.62,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2837.64,78,,2270.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3004.99,82.6,,2403.99,,,0,"percent of total billed charges","82.6% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,1819,50,,1455.20,,,0,"percent of total billed charges","50% of total billed charges",3004.99,82.6,,2403.99,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1645.3,100,,,,,0,"fee schedule",EAPG,3638,100,,2910.40,,,0,"percent of total billed charges","100% of total billed charges",556.61,3638,
"TRANSCATH CLOSURE OF ASD",84093580,CDM,481,RC,93580,CPT,OUTPATIENT,,,99434,64632.1,,87501.92,88,,70001.54,,,0,"percent of total billed charges","88% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9106.04,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",31299.05,175,,,,,0,"fee schedule","175% of CMS fee schedule",9379.23,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",62643.42,63,,50114.74,,,0,"percent of total billed charges","63% of total billed charges",15213.4,15.3,,12170.72,,,0,"percent of total billed charges","15.3% of total billed charges",9106.04,100,,,,,0,"fee schedule",EAPG,68609.46,69,,,,,0,"fee schedule","69% of total billed charges",99434,100,,79547.20,,,0,"percent of total billed charges","100% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99434,100,,79547.20,,,0,"percent of total billed charges","100% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99434,100,,79547.20,,,0,"percent of total billed charges","100% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",65260.52,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9106.04,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17061.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6745.22,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9288.16,100,,,,,0,"fee schedule",EAPG,11837.86,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37486.62,37.7,,29989.30,,,0,"percent of total billed charges","37.7% of total billed charges",37486.62,37.7,,29989.30,,,0,"percent of total billed charges","37.70% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33708.13,33.9,,26966.50,,,0,"percent of total billed charges","33.9% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77558.52,78,,62046.82,,,0,"percent of total billed charges","78% of total billed charges",18064.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",82132.48,82.6,,65705.98,,,0,"percent of total billed charges","82.6% of total billed charges",9106.04,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",82132.48,82.6,,65705.98,,,0,"percent of total billed charges","82.6% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9106.04,100,,,,,0,"fee schedule",EAPG,99434,100,,79547.20,,,0,"percent of total billed charges","100% of total billed charges",4695,99434,
"HIS BUNDLE RECORDING",84093600,CDM,480,RC,93600,CPT,OUTPATIENT,,,19407,12614.55,,17078.16,88,,13662.53,,,0,"percent of total billed charges","88% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",13330.21,175,,,,,0,"fee schedule","175% of CMS fee schedule",5750.89,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",12226.41,63,,9781.13,,,0,"percent of total billed charges","63% of total billed charges",2969.27,15.3,,2375.42,,,0,"percent of total billed charges","15.3% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,13390.83,69,,,,,0,"fee schedule","69% of total billed charges",19407,100,,15525.60,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19407,100,,15525.60,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19407,100,,15525.60,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",24694.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6455.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4135.84,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5695.05,100,,,,,0,"fee schedule",EAPG,7258.4,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7316.44,37.7,,5853.15,,,0,"percent of total billed charges","37.7% of total billed charges",7316.44,37.7,,5853.15,,,0,"percent of total billed charges","37.70% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6578.97,33.9,,5263.18,,,0,"percent of total billed charges","33.9% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15137.46,78,,12109.97,,,0,"percent of total billed charges","78% of total billed charges",7693.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16030.18,82.6,,12824.14,,,0,"percent of total billed charges","82.6% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16030.18,82.6,,12824.14,,,0,"percent of total billed charges","82.6% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,19407,100,,15525.60,,,0,"percent of total billed charges","100% of total billed charges",2969.27,24694.01,
"EPS 3-D MAPING",84093613,CDM,481,RC,93613,CPT,OUTPATIENT,,,1637,1064.05,,1440.56,88,,1152.45,,,0,"percent of total billed charges","88% of total billed charges",818.5,50,,654.80,,,0,"percent of total billed charges","50% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,1637,100,,1309.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5750.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1031.31,63,,825.05,,,0,"percent of total billed charges","63% of total billed charges",250.46,15.3,,200.37,,,0,"percent of total billed charges","15.3% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,1129.53,69,,,,,0,"fee schedule","69% of total billed charges",1637,100,,1309.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1637,100,,1309.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1637,100,,1309.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1012.48,61.85,,809.98,,,0,"percent of total billed charges","61.5% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,818.5,50,,654.80,,,0,"percent of total billed charges","50% of total billed charges",527.11,32.2,,421.69,,,0,"percent of total billed charges","32.2% of total billed charges",4135.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",5695.05,100,,,,,0,"fee schedule",EAPG,7258.4,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",617.15,37.7,,493.72,,,0,"percent of total billed charges","37.7% of total billed charges",617.15,37.7,,493.72,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",554.94,33.9,,443.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1276.86,78,,1021.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1352.16,82.6,,1081.73,,,0,"percent of total billed charges","82.6% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,818.5,50,,654.80,,,0,"percent of total billed charges","50% of total billed charges",1352.16,82.6,,1081.73,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5583.39,100,,,,,0,"fee schedule",EAPG,1637,100,,1309.60,,,0,"percent of total billed charges","100% of total billed charges",250.46,7258.4,
"EPS COMP W/O INDUCTION",84093619,CDM,480,RC,93619,CPT,OUTPATIENT,,,24583,15978.95,,21633.04,88,,17306.43,,,0,"percent of total billed charges","88% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",13330.21,175,,,,,0,"fee schedule","175% of CMS fee schedule",5750.89,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15487.29,63,,12389.83,,,0,"percent of total billed charges","63% of total billed charges",3761.2,15.3,,3008.96,,,0,"percent of total billed charges","15.3% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,16962.27,69,,,,,0,"fee schedule","69% of total billed charges",24583,100,,19666.40,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24583,100,,19666.40,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24583,100,,19666.40,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",24694.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6455.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4135.84,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5695.05,100,,,,,0,"fee schedule",EAPG,7258.4,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9267.79,37.7,,7414.23,,,0,"percent of total billed charges","37.7% of total billed charges",9267.79,37.7,,7414.23,,,0,"percent of total billed charges","37.70% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8333.64,33.9,,6666.91,,,0,"percent of total billed charges","33.9% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19174.74,78,,15339.79,,,0,"percent of total billed charges","78% of total billed charges",7693.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",20305.56,82.6,,16244.45,,,0,"percent of total billed charges","82.6% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",20305.56,82.6,,16244.45,,,0,"percent of total billed charges","82.6% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,24583,100,,19666.40,,,0,"percent of total billed charges","100% of total billed charges",3761.2,24694.01,
"COMPREHENSIVE EPS (3 WIRE)",84093620,CDM,480,RC,93620,CPT,OUTPATIENT,,,27317,17756.05,,24038.96,88,,19231.17,,,0,"percent of total billed charges","88% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",13330.21,175,,,,,0,"fee schedule","175% of CMS fee schedule",5750.89,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17209.71,63,,13767.77,,,0,"percent of total billed charges","63% of total billed charges",4179.5,15.3,,3343.60,,,0,"percent of total billed charges","15.3% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,18848.73,69,,,,,0,"fee schedule","69% of total billed charges",27317,100,,21853.60,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",27317,100,,21853.60,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",27317,100,,21853.60,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",24694.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6455.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4135.84,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5695.05,100,,,,,0,"fee schedule",EAPG,7258.4,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10298.51,37.7,,8238.81,,,0,"percent of total billed charges","37.7% of total billed charges",10298.51,37.7,,8238.81,,,0,"percent of total billed charges","37.70% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9260.46,33.9,,7408.37,,,0,"percent of total billed charges","33.9% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",21307.26,78,,17045.81,,,0,"percent of total billed charges","78% of total billed charges",7693.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22563.84,82.6,,18051.07,,,0,"percent of total billed charges","82.6% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22563.84,82.6,,18051.07,,,0,"percent of total billed charges","82.6% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,27317,100,,21853.60,,,0,"percent of total billed charges","100% of total billed charges",4135.84,27317,
"EPS COMP W LA/CS RECORD",84093621,CDM,481,RC,93621,CPT,OUTPATIENT,,,491,319.15,,432.08,88,,345.66,,,0,"percent of total billed charges","88% of total billed charges",245.5,50,,196.40,,,0,"percent of total billed charges","50% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,491,100,,392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5750.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",309.33,63,,247.46,,,0,"percent of total billed charges","63% of total billed charges",75.12,15.3,,60.10,,,0,"percent of total billed charges","15.3% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,338.79,69,,,,,0,"fee schedule","69% of total billed charges",491,100,,392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",491,100,,392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",491,100,,392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",303.68,61.85,,242.94,,,0,"percent of total billed charges","61.5% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,245.5,50,,196.40,,,0,"percent of total billed charges","50% of total billed charges",158.1,32.2,,126.48,,,0,"percent of total billed charges","32.2% of total billed charges",4135.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",5695.05,100,,,,,0,"fee schedule",EAPG,7258.4,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",185.11,37.7,,148.09,,,0,"percent of total billed charges","37.7% of total billed charges",185.11,37.7,,148.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.45,33.9,,133.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.98,78,,306.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",405.57,82.6,,324.46,,,0,"percent of total billed charges","82.6% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,245.5,50,,196.40,,,0,"percent of total billed charges","50% of total billed charges",405.57,82.6,,324.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5583.39,100,,,,,0,"fee schedule",EAPG,491,100,,392.80,,,0,"percent of total billed charges","100% of total billed charges",75.12,7258.4,
"LEFT VENTRICULAR RECORDING 02",84093622,CDM,481,RC,93622,CPT,OUTPATIENT,,,720,468,,633.6,88,,506.88,,,0,"percent of total billed charges","88% of total billed charges",360,50,,288.00,,,0,"percent of total billed charges","50% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,720,100,,576.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5750.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",453.6,63,,362.88,,,0,"percent of total billed charges","63% of total billed charges",110.16,15.3,,88.13,,,0,"percent of total billed charges","15.3% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,496.8,69,,,,,0,"fee schedule","69% of total billed charges",720,100,,576.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",720,100,,576.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",720,100,,576.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",445.32,61.85,,356.26,,,0,"percent of total billed charges","61.5% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,360,50,,288.00,,,0,"percent of total billed charges","50% of total billed charges",231.84,32.2,,185.47,,,0,"percent of total billed charges","32.2% of total billed charges",4135.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",5695.05,100,,,,,0,"fee schedule",EAPG,7258.4,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",271.44,37.7,,217.15,,,0,"percent of total billed charges","37.7% of total billed charges",271.44,37.7,,217.15,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",244.08,33.9,,195.26,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",561.6,78,,449.28,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",594.72,82.6,,475.78,,,0,"percent of total billed charges","82.6% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,360,50,,288.00,,,0,"percent of total billed charges","50% of total billed charges",594.72,82.6,,475.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5583.39,100,,,,,0,"fee schedule",EAPG,720,100,,576.00,,,0,"percent of total billed charges","100% of total billed charges",110.16,7258.4,
"EPA DRUG INFUSION",84093623,CDM,481,RC,93623,CPT,OUTPATIENT,,,667,433.55,,586.96,88,,469.57,,,0,"percent of total billed charges","88% of total billed charges",333.5,50,,266.80,,,0,"percent of total billed charges","50% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,667,100,,533.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5750.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",420.21,63,,336.17,,,0,"percent of total billed charges","63% of total billed charges",102.05,15.3,,81.64,,,0,"percent of total billed charges","15.3% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,460.23,69,,,,,0,"fee schedule","69% of total billed charges",667,100,,533.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",667,100,,533.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",667,100,,533.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.54,61.85,,330.03,,,0,"percent of total billed charges","61.5% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,333.5,50,,266.80,,,0,"percent of total billed charges","50% of total billed charges",214.77,32.2,,171.82,,,0,"percent of total billed charges","32.2% of total billed charges",4135.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",5695.05,100,,,,,0,"fee schedule",EAPG,7258.4,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",251.46,37.7,,201.17,,,0,"percent of total billed charges","37.7% of total billed charges",251.46,37.7,,201.17,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",226.11,33.9,,180.89,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",520.26,78,,416.21,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.94,82.6,,440.75,,,0,"percent of total billed charges","82.6% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,333.5,50,,266.80,,,0,"percent of total billed charges","50% of total billed charges",550.94,82.6,,440.75,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5583.39,100,,,,,0,"fee schedule",EAPG,667,100,,533.60,,,0,"percent of total billed charges","100% of total billed charges",102.05,7258.4,
"HEART PACING, MAPPING",84093631,CDM,480,RC,93631,CPT,OUTPATIENT,,,1695,1101.75,,1491.6,88,,1193.28,,,0,"percent of total billed charges","88% of total billed charges",847.5,50,,678.00,,,0,"percent of total billed charges","50% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,1695,100,,1356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5750.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1067.85,63,,854.28,,,0,"percent of total billed charges","63% of total billed charges",259.34,15.3,,207.47,,,0,"percent of total billed charges","15.3% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,1169.55,69,,,,,0,"fee schedule","69% of total billed charges",1695,100,,1356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1695,100,,1356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1695,100,,1356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1048.36,61.85,,838.69,,,0,"percent of total billed charges","61.5% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,847.5,50,,678.00,,,0,"percent of total billed charges","50% of total billed charges",545.79,32.2,,436.63,,,0,"percent of total billed charges","32.2% of total billed charges",4135.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",5695.05,100,,,,,0,"fee schedule",EAPG,7258.4,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",639.02,37.7,,511.22,,,0,"percent of total billed charges","37.7% of total billed charges",639.02,37.7,,511.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",574.61,33.9,,459.69,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1322.1,78,,1057.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1400.07,82.6,,1120.06,,,0,"percent of total billed charges","82.6% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,847.5,50,,678.00,,,0,"percent of total billed charges","50% of total billed charges",1400.07,82.6,,1120.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5583.39,100,,,,,0,"fee schedule",EAPG,1695,100,,1356.00,,,0,"percent of total billed charges","100% of total billed charges",259.34,7258.4,
"EP EVAL W/TESTING SGL/DUAL CH",84093641,CDM,480,RC,93641,CPT,OUTPATIENT,,,2209,1435.85,,1943.92,88,,1555.14,,,0,"percent of total billed charges","88% of total billed charges",1104.5,50,,883.60,,,0,"percent of total billed charges","50% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,2209,100,,1767.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5750.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1391.67,63,,1113.34,,,0,"percent of total billed charges","63% of total billed charges",337.98,15.3,,270.38,,,0,"percent of total billed charges","15.3% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,1524.21,69,,,,,0,"fee schedule","69% of total billed charges",2209,100,,1767.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2209,100,,1767.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2209,100,,1767.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1366.27,61.85,,1093.02,,,0,"percent of total billed charges","61.5% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,1104.5,50,,883.60,,,0,"percent of total billed charges","50% of total billed charges",711.3,32.2,,569.04,,,0,"percent of total billed charges","32.2% of total billed charges",4135.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",5695.05,100,,,,,0,"fee schedule",EAPG,7258.4,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",832.79,37.7,,666.23,,,0,"percent of total billed charges","37.7% of total billed charges",832.79,37.7,,666.23,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",748.85,33.9,,599.08,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1723.02,78,,1378.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1824.63,82.6,,1459.70,,,0,"percent of total billed charges","82.6% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,1104.5,50,,883.60,,,0,"percent of total billed charges","50% of total billed charges",1824.63,82.6,,1459.70,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5583.39,100,,,,,0,"fee schedule",EAPG,2209,100,,1767.20,,,0,"percent of total billed charges","100% of total billed charges",337.98,7258.4,
"INTRA CARDI ABLAT AV NODE",84093650,CDM,481,RC,93650,CPT,OUTPATIENT,,,21849,14201.85,,19227.12,88,,15381.70,,,0,"percent of total billed charges","88% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14724.59,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",13330.21,175,,,,,0,"fee schedule","175% of CMS fee schedule",15166.32,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13764.87,63,,11011.90,,,0,"percent of total billed charges","63% of total billed charges",3342.9,15.3,,2674.32,,,0,"percent of total billed charges","15.3% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,15075.81,69,,,,,0,"fee schedule","69% of total billed charges",21849,100,,17479.20,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",21849,100,,17479.20,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",21849,100,,17479.20,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",24694.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14724.59,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6455.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10907.1,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15019.08,100,,,,,0,"fee schedule",EAPG,19141.96,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8237.07,37.7,,6589.66,,,0,"percent of total billed charges","37.7% of total billed charges",8237.07,37.7,,6589.66,,,0,"percent of total billed charges","37.70% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7406.81,33.9,,5925.45,,,0,"percent of total billed charges","33.9% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17042.22,78,,13633.78,,,0,"percent of total billed charges","78% of total billed charges",7693.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18047.27,82.6,,14437.82,,,0,"percent of total billed charges","82.6% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18047.27,82.6,,14437.82,,,0,"percent of total billed charges","82.6% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14724.59,100,,,,,0,"fee schedule",EAPG,21849,100,,17479.20,,,0,"percent of total billed charges","100% of total billed charges",3342.9,24694.01,
"EP/ABLATE SUPRAVENT ARRYTH",84093653,CDM,481,RC,93653,CPT,OUTPATIENT,,,54966,35727.9,,48370.08,88,,38696.06,,,0,"percent of total billed charges","88% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14724.59,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",42392.95,175,,,,,0,"fee schedule","175% of CMS fee schedule",15166.32,100,,,,,0,"fee schedule",EAPG,24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34628.58,63,,27702.86,,,0,"percent of total billed charges","63% of total billed charges",8409.8,15.3,,6727.84,,,0,"percent of total billed charges","15.3% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,37926.54,69,,,,,0,"fee schedule","69% of total billed charges",54966,100,,43972.80,,,0,"percent of total billed charges","100% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",54966,100,,43972.80,,,0,"percent of total billed charges","100% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",54966,100,,43972.80,,,0,"percent of total billed charges","100% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",87199.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14724.59,100,,,,,0,"fee schedule",EAPG,24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22797.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10907.1,100,,,,,0,"fee schedule",EAPG,24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15019.08,100,,,,,0,"fee schedule",EAPG,19141.96,100,,,,,0,"fee schedule",EAPG,24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",20722.18,37.7,,16577.74,,,0,"percent of total billed charges","37.7% of total billed charges",20722.18,37.7,,16577.74,,,0,"percent of total billed charges","37.70% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18633.47,33.9,,14906.78,,,0,"percent of total billed charges","33.9% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42873.48,78,,34298.78,,,0,"percent of total billed charges","78% of total billed charges",24466.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",45401.92,82.6,,36321.54,,,0,"percent of total billed charges","82.6% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",45401.92,82.6,,36321.54,,,0,"percent of total billed charges","82.6% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14724.59,100,,,,,0,"fee schedule",EAPG,54966,100,,43972.80,,,0,"percent of total billed charges","100% of total billed charges",4695,87199.85,
"EP/ABLATE VENTRIC TACHY",84093654,CDM,481,RC,93654,CPT,OUTPATIENT,,,51729,33623.85,,45521.52,88,,36417.22,,,0,"percent of total billed charges","88% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14724.59,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",42392.95,175,,,,,0,"fee schedule","175% of CMS fee schedule",15166.32,100,,,,,0,"fee schedule",EAPG,24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32589.27,63,,26071.42,,,0,"percent of total billed charges","63% of total billed charges",7914.54,15.3,,6331.63,,,0,"percent of total billed charges","15.3% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,35693.01,69,,,,,0,"fee schedule","69% of total billed charges",51729,100,,41383.20,,,0,"percent of total billed charges","100% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51729,100,,41383.20,,,0,"percent of total billed charges","100% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51729,100,,41383.20,,,0,"percent of total billed charges","100% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",87199.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14724.59,100,,,,,0,"fee schedule",EAPG,24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22797.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10907.1,100,,,,,0,"fee schedule",EAPG,24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15019.08,100,,,,,0,"fee schedule",EAPG,19141.96,100,,,,,0,"fee schedule",EAPG,24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19501.83,37.7,,15601.46,,,0,"percent of total billed charges","37.7% of total billed charges",19501.83,37.7,,15601.46,,,0,"percent of total billed charges","37.70% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17536.13,33.9,,14028.90,,,0,"percent of total billed charges","33.9% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40348.62,78,,32278.90,,,0,"percent of total billed charges","78% of total billed charges",24466.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42728.15,82.6,,34182.52,,,0,"percent of total billed charges","82.6% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42728.15,82.6,,34182.52,,,0,"percent of total billed charges","82.6% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14724.59,100,,,,,0,"fee schedule",EAPG,51729,100,,41383.20,,,0,"percent of total billed charges","100% of total billed charges",4695,87199.85,
"ABLATE ARRYTHMIA ADD ON",84093655,CDM,481,RC,93655,CPT,OUTPATIENT,,,1756,1141.4,,1545.28,88,,1236.22,,,0,"percent of total billed charges","88% of total billed charges",878,50,,702.40,,,0,"percent of total billed charges","50% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,1756,100,,1404.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15166.32,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1106.28,63,,885.02,,,0,"percent of total billed charges","63% of total billed charges",268.67,15.3,,214.94,,,0,"percent of total billed charges","15.3% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,1211.64,69,,,,,0,"fee schedule","69% of total billed charges",1756,100,,1404.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1756,100,,1404.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1756,100,,1404.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1086.09,61.85,,868.87,,,0,"percent of total billed charges","61.5% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,878,50,,702.40,,,0,"percent of total billed charges","50% of total billed charges",565.43,32.2,,452.34,,,0,"percent of total billed charges","32.2% of total billed charges",10907.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",15019.08,100,,,,,0,"fee schedule",EAPG,19141.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",662.01,37.7,,529.61,,,0,"percent of total billed charges","37.7% of total billed charges",662.01,37.7,,529.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",595.28,33.9,,476.22,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1369.68,78,,1095.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1450.46,82.6,,1160.37,,,0,"percent of total billed charges","82.6% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,878,50,,702.40,,,0,"percent of total billed charges","50% of total billed charges",1450.46,82.6,,1160.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",14724.59,100,,,,,0,"fee schedule",EAPG,1756,100,,1404.80,,,0,"percent of total billed charges","100% of total billed charges",268.67,19141.96,
"TX ATRIAL FIB PULM VEIN ISOL",84093656,CDM,481,RC,93656,CPT,OUTPATIENT,,,51729,33623.85,,45521.52,88,,36417.22,,,0,"percent of total billed charges","88% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14724.59,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",42392.95,175,,,,,0,"fee schedule","175% of CMS fee schedule",15166.32,100,,,,,0,"fee schedule",EAPG,24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32589.27,63,,26071.42,,,0,"percent of total billed charges","63% of total billed charges",7914.54,15.3,,6331.63,,,0,"percent of total billed charges","15.3% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,35693.01,69,,,,,0,"fee schedule","69% of total billed charges",51729,100,,41383.20,,,0,"percent of total billed charges","100% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51729,100,,41383.20,,,0,"percent of total billed charges","100% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51729,100,,41383.20,,,0,"percent of total billed charges","100% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",87199.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14724.59,100,,,,,0,"fee schedule",EAPG,24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22797.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10907.1,100,,,,,0,"fee schedule",EAPG,24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15019.08,100,,,,,0,"fee schedule",EAPG,19141.96,100,,,,,0,"fee schedule",EAPG,24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19501.83,37.7,,15601.46,,,0,"percent of total billed charges","37.7% of total billed charges",19501.83,37.7,,15601.46,,,0,"percent of total billed charges","37.70% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17536.13,33.9,,14028.90,,,0,"percent of total billed charges","33.9% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40348.62,78,,32278.90,,,0,"percent of total billed charges","78% of total billed charges",24466.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42728.15,82.6,,34182.52,,,0,"percent of total billed charges","82.6% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42728.15,82.6,,34182.52,,,0,"percent of total billed charges","82.6% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14724.59,100,,,,,0,"fee schedule",EAPG,51729,100,,41383.20,,,0,"percent of total billed charges","100% of total billed charges",4695,87199.85,
"TX L/R ATRIAL FIB ADDL",84093657,CDM,481,RC,93657,CPT,OUTPATIENT,,,1756,1141.4,,1545.28,88,,1236.22,,,0,"percent of total billed charges","88% of total billed charges",878,50,,702.40,,,0,"percent of total billed charges","50% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,1756,100,,1404.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15166.32,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1106.28,63,,885.02,,,0,"percent of total billed charges","63% of total billed charges",268.67,15.3,,214.94,,,0,"percent of total billed charges","15.3% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,1211.64,69,,,,,0,"fee schedule","69% of total billed charges",1756,100,,1404.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1756,100,,1404.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1756,100,,1404.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1086.09,61.85,,868.87,,,0,"percent of total billed charges","61.5% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,878,50,,702.40,,,0,"percent of total billed charges","50% of total billed charges",565.43,32.2,,452.34,,,0,"percent of total billed charges","32.2% of total billed charges",10907.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",15019.08,100,,,,,0,"fee schedule",EAPG,19141.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",662.01,37.7,,529.61,,,0,"percent of total billed charges","37.7% of total billed charges",662.01,37.7,,529.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",595.28,33.9,,476.22,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1369.68,78,,1095.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1450.46,82.6,,1160.37,,,0,"percent of total billed charges","82.6% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,878,50,,702.40,,,0,"percent of total billed charges","50% of total billed charges",1450.46,82.6,,1160.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",14724.59,100,,,,,0,"fee schedule",EAPG,1756,100,,1404.80,,,0,"percent of total billed charges","100% of total billed charges",268.67,19141.96,
"TILT TABLE TEST",84093660,CDM,481,RC,93660,CPT,OUTPATIENT,,,1961,1274.65,,1725.68,88,,1380.54,,,0,"percent of total billed charges","88% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.99,100,,,,,0,"fee schedule",EAPG,1961,100,,1568.80,,,0,"percent of total billed charges","100% of total billed charges",956.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",155.52,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1235.43,63,,988.34,,,0,"percent of total billed charges","63% of total billed charges",300.03,15.3,,240.02,,,0,"percent of total billed charges","15.3% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,1353.09,69,,,,,0,"fee schedule","69% of total billed charges",1961,100,,1568.80,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1961,100,,1568.80,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1961,100,,1568.80,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1981.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.99,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",518.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.84,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.01,100,,,,,0,"fee schedule",EAPG,196.29,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",739.3,37.7,,591.44,,,0,"percent of total billed charges","37.7% of total billed charges",739.3,37.7,,591.44,,,0,"percent of total billed charges","37.70% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",664.78,33.9,,531.82,,,0,"percent of total billed charges","33.9% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1529.58,78,,1223.66,,,0,"percent of total billed charges","78% of total billed charges",552.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1619.79,82.6,,1295.83,,,0,"percent of total billed charges","82.6% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1619.79,82.6,,1295.83,,,0,"percent of total billed charges","82.6% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.99,100,,,,,0,"fee schedule",EAPG,1961,100,,1568.80,,,0,"percent of total billed charges","100% of total billed charges",111.84,1981.61,
"INTRACARDIAC ECHO DURING PRCDR",84093662,CDM,480,RC,93662,CPT,OUTPATIENT,,,2051,1333.15,,1804.88,88,,1443.90,,,0,"percent of total billed charges","88% of total billed charges",1025.5,50,,820.40,,,0,"percent of total billed charges","50% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,2051,100,,1640.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",430.64,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1292.13,63,,1033.70,,,0,"percent of total billed charges","63% of total billed charges",313.8,15.3,,251.04,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,1415.19,69,,,,,0,"fee schedule","69% of total billed charges",2051,100,,1640.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2051,100,,1640.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2051,100,,1640.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1268.54,61.85,,1014.83,,,0,"percent of total billed charges","61.5% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,1025.5,50,,820.40,,,0,"percent of total billed charges","50% of total billed charges",660.42,32.2,,528.34,,,0,"percent of total billed charges","32.2% of total billed charges",309.7,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",773.23,37.7,,618.58,,,0,"percent of total billed charges","37.7% of total billed charges",773.23,37.7,,618.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.29,33.9,,556.23,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1599.78,78,,1279.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1694.13,82.6,,1355.30,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,1025.5,50,,820.40,,,0,"percent of total billed charges","50% of total billed charges",1694.13,82.6,,1355.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.1,100,,,,,0,"fee schedule",EAPG,2051,100,,1640.80,,,0,"percent of total billed charges","100% of total billed charges",309.7,2051,
"PERCUSURGE PROCEDURE",84093799,CDM,480,RC,93799,CPT,OUTPATIENT,,,994,646.1,,874.72,88,,699.78,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,994,100,,795.20,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",24.47,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",626.22,63,,500.98,,,0,"percent of total billed charges","63% of total billed charges",152.08,15.3,,121.66,,,0,"percent of total billed charges","15.3% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,685.86,69,,,,,0,"fee schedule","69% of total billed charges",994,100,,795.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",994,100,,795.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",994,100,,795.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17.6,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.23,100,,,,,0,"fee schedule",EAPG,30.89,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",374.74,37.7,,299.79,,,0,"percent of total billed charges","37.7% of total billed charges",374.74,37.7,,299.79,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",336.97,33.9,,269.58,,,0,"percent of total billed charges","33.9% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",775.32,78,,620.26,,,0,"percent of total billed charges","78% of total billed charges",160.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",821.04,82.6,,656.83,,,0,"percent of total billed charges","82.6% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",821.04,82.6,,656.83,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,994,100,,795.20,,,0,"percent of total billed charges","100% of total billed charges",17.6,994,
"IV INFUSION HYDRATION 31M-1HR",84096360,CDM,761,RC,96360,CPT,OUTPATIENT,,,560,364,,492.8,88,,394.24,,,0,"percent of total billed charges","88% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,560,100,,448.00,,,0,"percent of total billed charges","100% of total billed charges",382.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",281.17,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",85.68,15.3,,68.54,,,0,"percent of total billed charges","15.3% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,386.4,69,,,,,0,"fee schedule","69% of total billed charges",560,100,,448.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560,100,,448.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560,100,,448.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",826.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.21,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278.44,100,,,,,0,"fee schedule",EAPG,354.88,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",211.12,37.7,,168.90,,,0,"percent of total billed charges","37.7% of total billed charges",211.12,37.7,,168.90,,,0,"percent of total billed charges","37.70% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.84,33.9,,151.87,,,0,"percent of total billed charges","33.9% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",436.8,78,,349.44,,,0,"percent of total billed charges","78% of total billed charges",220.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.56,82.6,,370.05,,,0,"percent of total billed charges","82.6% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.56,82.6,,370.05,,,0,"percent of total billed charges","82.6% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,560,100,,448.00,,,0,"percent of total billed charges","100% of total billed charges",85.68,826.71,
"IV INFUSION HYDRATION ADDL HR",84096361,CDM,761,RC,96361,CPT,OUTPATIENT,,,140,91,,123.2,88,,98.56,,,0,"percent of total billed charges","88% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",84.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",475.9,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",21.42,15.3,,17.14,,,0,"percent of total billed charges","15.3% of total billed charges",462.04,100,,,,,0,"fee schedule",EAPG,96.6,69,,,,,0,"fee schedule","69% of total billed charges",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.25,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",471.28,100,,,,,0,"fee schedule",EAPG,600.65,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.78,37.7,,42.22,,,0,"percent of total billed charges","37.7% of total billed charges",52.78,37.7,,42.22,,,0,"percent of total billed charges","37.70% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.46,33.9,,37.97,,,0,"percent of total billed charges","33.9% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.2,78,,87.36,,,0,"percent of total billed charges","78% of total billed charges",48.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.64,82.6,,92.51,,,0,"percent of total billed charges","82.6% of total billed charges",462.04,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.64,82.6,,92.51,,,0,"percent of total billed charges","82.6% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",21.42,600.65,
"IV INFUSION THX/PX/DX FIRST HR",84096365,CDM,761,RC,96365,CPT,OUTPATIENT,,,745,484.25,,655.6,88,,524.48,,,0,"percent of total billed charges","88% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,745,100,,596.00,,,0,"percent of total billed charges","100% of total billed charges",382.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",281.17,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",113.99,15.3,,91.19,,,0,"percent of total billed charges","15.3% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,514.05,69,,,,,0,"fee schedule","69% of total billed charges",745,100,,596.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",745,100,,596.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",745,100,,596.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",826.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.21,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278.44,100,,,,,0,"fee schedule",EAPG,354.88,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,37.7,,224.70,,,0,"percent of total billed charges","37.7% of total billed charges",280.87,37.7,,224.70,,,0,"percent of total billed charges","37.70% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.56,33.9,,202.05,,,0,"percent of total billed charges","33.9% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",581.1,78,,464.88,,,0,"percent of total billed charges","78% of total billed charges",220.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",615.37,82.6,,492.30,,,0,"percent of total billed charges","82.6% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",615.37,82.6,,492.30,,,0,"percent of total billed charges","82.6% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,745,100,,596.00,,,0,"percent of total billed charges","100% of total billed charges",113.99,826.71,
"IV INFUSION THX/PX/DX ADDL HR",84096366,CDM,761,RC,96366,CPT,OUTPATIENT,,,140,91,,123.2,88,,98.56,,,0,"percent of total billed charges","88% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",84.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",475.9,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",21.42,15.3,,17.14,,,0,"percent of total billed charges","15.3% of total billed charges",462.04,100,,,,,0,"fee schedule",EAPG,96.6,69,,,,,0,"fee schedule","69% of total billed charges",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.25,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",471.28,100,,,,,0,"fee schedule",EAPG,600.65,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.78,37.7,,42.22,,,0,"percent of total billed charges","37.7% of total billed charges",52.78,37.7,,42.22,,,0,"percent of total billed charges","37.70% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.46,33.9,,37.97,,,0,"percent of total billed charges","33.9% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.2,78,,87.36,,,0,"percent of total billed charges","78% of total billed charges",48.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.64,82.6,,92.51,,,0,"percent of total billed charges","82.6% of total billed charges",462.04,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.64,82.6,,92.51,,,0,"percent of total billed charges","82.6% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",21.42,600.65,
"IV INFUSION ADDL SEQ 1HR",84096367,CDM,761,RC,96367,CPT,OUTPATIENT,,,474,308.1,,417.12,88,,333.70,,,0,"percent of total billed charges","88% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,474,100,,379.20,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",281.17,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",72.52,15.3,,58.02,,,0,"percent of total billed charges","15.3% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,327.06,69,,,,,0,"fee schedule","69% of total billed charges",474,100,,379.20,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",474,100,,379.20,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",474,100,,379.20,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.21,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278.44,100,,,,,0,"fee schedule",EAPG,354.88,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",178.7,37.7,,142.96,,,0,"percent of total billed charges","37.7% of total billed charges",178.7,37.7,,142.96,,,0,"percent of total billed charges","37.70% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.69,33.9,,128.55,,,0,"percent of total billed charges","33.9% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",369.72,78,,295.78,,,0,"percent of total billed charges","78% of total billed charges",72.56,100,,,,,0,"fee schedule","100% of CMS OPPS rate",391.52,82.6,,313.22,,,0,"percent of total billed charges","82.6% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",391.52,82.6,,313.22,,,0,"percent of total billed charges","82.6% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,474,100,,379.20,,,0,"percent of total billed charges","100% of total billed charges",65.81,474,
"INJ THER/DX IM/SQ",84096372,CDM,761,RC,96372,CPT,OUTPATIENT,,,320,208,,281.6,88,,225.28,,,0,"percent of total billed charges","88% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",48.96,15.3,,39.17,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,220.8,69,,,,,0,"fee schedule","69% of total billed charges",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.48,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",120.64,37.7,,96.51,,,0,"percent of total billed charges","37.7% of total billed charges",120.64,37.7,,96.51,,,0,"percent of total billed charges","37.70% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.48,33.9,,86.78,,,0,"percent of total billed charges","33.9% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",249.6,78,,199.68,,,0,"percent of total billed charges","78% of total billed charges",72.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",264.32,82.6,,211.46,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",264.32,82.6,,211.46,,,0,"percent of total billed charges","82.6% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",29.48,320,
"INTRA-ARTERIAL INJECTION,THER",84096373,CDM,940,RC,96373,CPT,OUTPATIENT,,,1420,923,,1249.6,88,,999.68,,,0,"percent of total billed charges","88% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,1420,100,,1136.00,,,0,"percent of total billed charges","100% of total billed charges",382.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",217.26,15.3,,173.81,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,979.8,69,,,,,0,"fee schedule","69% of total billed charges",1420,100,,1136.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1420,100,,1136.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1420,100,,1136.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",826.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.48,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",535.34,37.7,,428.27,,,0,"percent of total billed charges","37.7% of total billed charges",535.34,37.7,,428.27,,,0,"percent of total billed charges","37.70% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",481.38,33.9,,385.10,,,0,"percent of total billed charges","33.9% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1107.6,78,,886.08,,,0,"percent of total billed charges","78% of total billed charges",220.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1172.92,82.6,,938.34,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1172.92,82.6,,938.34,,,0,"percent of total billed charges","82.6% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,1420,100,,1136.00,,,0,"percent of total billed charges","100% of total billed charges",29.48,1420,
"IV PUSH ONE/FIRST DRUG",84096374,CDM,761,RC,96374,CPT,OUTPATIENT,,,465,302.25,,409.2,88,,327.36,,,0,"percent of total billed charges","88% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,465,100,,372.00,,,0,"percent of total billed charges","100% of total billed charges",382.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",71.15,15.3,,56.92,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,320.85,69,,,,,0,"fee schedule","69% of total billed charges",465,100,,372.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465,100,,372.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465,100,,372.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",826.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.48,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",175.31,37.7,,140.25,,,0,"percent of total billed charges","37.7% of total billed charges",175.31,37.7,,140.25,,,0,"percent of total billed charges","37.70% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",157.64,33.9,,126.11,,,0,"percent of total billed charges","33.9% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",362.7,78,,290.16,,,0,"percent of total billed charges","78% of total billed charges",220.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",384.09,82.6,,307.27,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",384.09,82.6,,307.27,,,0,"percent of total billed charges","82.6% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,465,100,,372.00,,,0,"percent of total billed charges","100% of total billed charges",29.48,826.71,
"IV PUSH SAME DRUG/SUB 31M",84096376,CDM,940,RC,96376,CPT,OUTPATIENT,,,314,204.1,,276.32,88,,221.06,,,0,"percent of total billed charges","88% of total billed charges",157,50,,125.60,,,0,"percent of total billed charges","50% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,314,100,,251.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",41,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",48.04,15.3,,38.43,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,216.66,69,,,,,0,"fee schedule","69% of total billed charges",314,100,,251.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",314,100,,251.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",314,100,,251.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.21,61.85,,155.37,,,0,"percent of total billed charges","61.5% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,157,50,,125.60,,,0,"percent of total billed charges","50% of total billed charges",101.11,32.2,,80.89,,,0,"percent of total billed charges","32.2% of total billed charges",29.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",118.38,37.7,,94.70,,,0,"percent of total billed charges","37.7% of total billed charges",118.38,37.7,,94.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.45,33.9,,85.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",244.92,78,,195.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",259.36,82.6,,207.49,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,157,50,,125.60,,,0,"percent of total billed charges","50% of total billed charges",259.36,82.6,,207.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.8,100,,,,,0,"fee schedule",EAPG,314,100,,251.20,,,0,"percent of total billed charges","100% of total billed charges",29.48,314,
DEBRIDEMENT,84097597,CDM,360,RC,97597,CPT,OUTPATIENT,,,93,60.45,,81.84,88,,65.47,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",58.59,63,,46.87,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,64.17,69,,,,,0,"fee schedule","69% of total billed charges",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.06,37.7,,28.05,,,0,"percent of total billed charges","37.7% of total billed charges",35.06,37.7,,28.05,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.53,33.9,,25.22,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",72.54,78,,58.03,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",76.82,82.6,,61.46,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",76.82,82.6,,61.46,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",31.53,3367,
"MODSED OTH GT5 1ST15",84099156,CDM,370,RC,99156,CPT,OUTPATIENT,,,492,319.8,,432.96,88,,346.37,,,0,"percent of total billed charges","88% of total billed charges",246,50,,196.80,,,0,"percent of total billed charges","50% of total billed charges",21.54,100,,,,,0,"fee schedule",EAPG,492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.18,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",309.96,63,,247.97,,,0,"percent of total billed charges","63% of total billed charges",75.28,15.3,,60.22,,,0,"percent of total billed charges","15.3% of total billed charges",21.54,100,,,,,0,"fee schedule",EAPG,339.48,69,,,,,0,"fee schedule","69% of total billed charges",492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",304.3,61.85,,243.44,,,0,"percent of total billed charges","61.5% of total billed charges",21.54,100,,,,,0,"fee schedule",EAPG,246,50,,196.80,,,0,"percent of total billed charges","50% of total billed charges",158.42,32.2,,126.74,,,0,"percent of total billed charges","32.2% of total billed charges",15.95,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",21.97,100,,,,,0,"fee schedule",EAPG,28,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",185.48,37.7,,148.38,,,0,"percent of total billed charges","37.7% of total billed charges",185.48,37.7,,148.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.79,33.9,,133.43,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",383.76,78,,307.01,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",406.39,82.6,,325.11,,,0,"percent of total billed charges","82.6% of total billed charges",21.54,100,,,,,0,"fee schedule",EAPG,246,50,,196.80,,,0,"percent of total billed charges","50% of total billed charges",406.39,82.6,,325.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.54,100,,,,,0,"fee schedule",EAPG,492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",15.95,492,
"KIT 6FR PIGTAIL PERICARDIOCENT",840C1729,CDM,270,RC,,,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",47.5,50,,38.00,,,0,"percent of total billed charges","50% of total billed charges",15.96,16.8,,12.77,,,0,"percent of total billed charges","16.8% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.44,17.304,,13.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",15.96,16.8,,12.77,,,0,"percent of total billed charges","16.8% of total billed charges",65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.76,61.85,,47.01,,,0,"percent of total billed charges","61.5% of total billed charges",15.96,16.8,,12.77,,,0,"percent of total billed charges","16.8% of total billed charges",47.5,50,,38.00,,,0,"percent of total billed charges","50% of total billed charges",30.59,32.2,,24.47,,,0,"percent of total billed charges","32.2% of total billed charges",15.96,16.8,,12.77,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.28,17.136,,13.02,,,0,"percent of total billed charges","17.136% of total billed charges",20.75,21.84,,16.60,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",15.96,16.8,,12.77,,,0,"percent of total billed charges","16.8% of total billed charges",47.5,50,,38.00,,,0,"percent of total billed charges","50% of total billed charges",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.96,16.8,,12.77,,,0,"percent of total billed charges","16.8% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,95,
"KIT 6FR STRAIGHT PERICARDIOCEN",840C1769,CDM,270,RC,,,OUTPATIENT,,,143,92.95,,125.84,88,,100.67,,,0,"percent of total billed charges","88% of total billed charges",71.5,50,,57.20,,,0,"percent of total billed charges","50% of total billed charges",24.02,16.8,,19.22,,,0,"percent of total billed charges","16.8% of total billed charges",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.74,17.304,,19.79,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.09,63,,72.07,,,0,"percent of total billed charges","63% of total billed charges",21.88,15.3,,17.50,,,0,"percent of total billed charges","15.3% of total billed charges",24.02,16.8,,19.22,,,0,"percent of total billed charges","16.8% of total billed charges",98.67,69,,,,,0,"fee schedule","69% of total billed charges",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.45,61.85,,70.76,,,0,"percent of total billed charges","61.5% of total billed charges",24.02,16.8,,19.22,,,0,"percent of total billed charges","16.8% of total billed charges",71.5,50,,57.20,,,0,"percent of total billed charges","50% of total billed charges",46.05,32.2,,36.84,,,0,"percent of total billed charges","32.2% of total billed charges",24.02,16.8,,19.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.5,17.136,,19.60,,,0,"percent of total billed charges","17.136% of total billed charges",31.23,21.84,,24.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",53.91,37.7,,43.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",111.54,78,,89.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",24.02,16.8,,19.22,,,0,"percent of total billed charges","16.8% of total billed charges",71.5,50,,57.20,,,0,"percent of total billed charges","50% of total billed charges",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.02,16.8,,19.22,,,0,"percent of total billed charges","16.8% of total billed charges",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",21.88,143,
"PERC DE COR STENT BRANCH",840C9601,CDM,481,RC,,,OUTPATIENT,,,38285,24885.25,,33690.8,88,,26952.64,,,0,"percent of total billed charges","88% of total billed charges",19142.5,50,,15314.00,,,0,"percent of total billed charges","50% of total billed charges",6431.88,16.8,,5145.50,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6624.84,17.304,,5299.87,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",24119.55,63,,19295.64,,,0,"percent of total billed charges","63% of total billed charges",5857.61,15.3,,4686.09,,,0,"percent of total billed charges","15.3% of total billed charges",6431.88,16.8,,5145.50,,,0,"percent of total billed charges","16.8% of total billed charges",26416.65,69,,,,,0,"fee schedule","69% of total billed charges",38285,100,,30628.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38285,100,,30628.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38285,100,,30628.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23679.27,61.85,,18943.42,,,0,"percent of total billed charges","61.5% of total billed charges",6431.88,16.8,,5145.50,,,0,"percent of total billed charges","16.8% of total billed charges",19142.5,50,,15314.00,,,0,"percent of total billed charges","50% of total billed charges",12327.77,32.2,,9862.22,,,0,"percent of total billed charges","32.2% of total billed charges",6431.88,16.8,,5145.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6560.52,17.136,,5248.42,,,0,"percent of total billed charges","17.136% of total billed charges",8361.44,21.84,,6689.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",14433.45,37.7,,11546.76,,,0,"percent of total billed charges","37.7% of total billed charges",14433.45,37.7,,11546.76,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",12978.62,33.9,,10382.90,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",29862.3,78,,23889.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",31623.41,82.6,,25298.73,,,0,"percent of total billed charges","82.6% of total billed charges",6431.88,16.8,,5145.50,,,0,"percent of total billed charges","16.8% of total billed charges",19142.5,50,,15314.00,,,0,"percent of total billed charges","50% of total billed charges",31623.41,82.6,,25298.73,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6431.88,16.8,,5145.50,,,0,"percent of total billed charges","16.8% of total billed charges",38285,100,,30628.00,,,0,"percent of total billed charges","100% of total billed charges",4695,38285,
"PERC DE COR STENT/ATHER SING",840C9602,CDM,481,RC,,,OUTPATIENT,,,30628,19908.2,,26952.64,88,,21562.11,,,0,"percent of total billed charges","88% of total billed charges",15314,50,,12251.20,,,0,"percent of total billed charges","50% of total billed charges",5145.5,16.8,,4116.40,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5299.87,17.304,,4239.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",19295.64,63,,15436.51,,,0,"percent of total billed charges","63% of total billed charges",4686.08,15.3,,3748.86,,,0,"percent of total billed charges","15.3% of total billed charges",5145.5,16.8,,4116.40,,,0,"percent of total billed charges","16.8% of total billed charges",21133.32,69,,,,,0,"fee schedule","69% of total billed charges",30628,100,,24502.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30628,100,,24502.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30628,100,,24502.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18943.42,61.85,,15154.74,,,0,"percent of total billed charges","61.5% of total billed charges",5145.5,16.8,,4116.40,,,0,"percent of total billed charges","16.8% of total billed charges",15314,50,,12251.20,,,0,"percent of total billed charges","50% of total billed charges",9862.22,32.2,,7889.78,,,0,"percent of total billed charges","32.2% of total billed charges",5145.5,16.8,,4116.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5248.41,17.136,,4198.73,,,0,"percent of total billed charges","17.136% of total billed charges",6689.16,21.84,,5351.33,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",11546.76,37.7,,9237.41,,,0,"percent of total billed charges","37.7% of total billed charges",11546.76,37.7,,9237.41,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",10382.89,33.9,,8306.31,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",23889.84,78,,19111.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",25298.73,82.6,,20238.98,,,0,"percent of total billed charges","82.6% of total billed charges",5145.5,16.8,,4116.40,,,0,"percent of total billed charges","16.8% of total billed charges",15314,50,,12251.20,,,0,"percent of total billed charges","50% of total billed charges",25298.73,82.6,,20238.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5145.5,16.8,,4116.40,,,0,"percent of total billed charges","16.8% of total billed charges",30628,100,,24502.40,,,0,"percent of total billed charges","100% of total billed charges",4686.08,30628,
"PERC DE COR STENT/ATHER BRANCH",840C9603,CDM,481,RC,,,OUTPATIENT,,,34452,22393.8,,30317.76,88,,24254.21,,,0,"percent of total billed charges","88% of total billed charges",17226,50,,13780.80,,,0,"percent of total billed charges","50% of total billed charges",5787.94,16.8,,4630.35,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5961.57,17.304,,4769.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",21704.76,63,,17363.81,,,0,"percent of total billed charges","63% of total billed charges",5271.16,15.3,,4216.93,,,0,"percent of total billed charges","15.3% of total billed charges",5787.94,16.8,,4630.35,,,0,"percent of total billed charges","16.8% of total billed charges",23771.88,69,,,,,0,"fee schedule","69% of total billed charges",34452,100,,27561.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34452,100,,27561.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34452,100,,27561.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21308.56,61.85,,17046.85,,,0,"percent of total billed charges","61.5% of total billed charges",5787.94,16.8,,4630.35,,,0,"percent of total billed charges","16.8% of total billed charges",17226,50,,13780.80,,,0,"percent of total billed charges","50% of total billed charges",11093.54,32.2,,8874.83,,,0,"percent of total billed charges","32.2% of total billed charges",5787.94,16.8,,4630.35,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5903.69,17.136,,4722.95,,,0,"percent of total billed charges","17.136% of total billed charges",7524.32,21.84,,6019.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",12988.4,37.7,,10390.72,,,0,"percent of total billed charges","37.7% of total billed charges",12988.4,37.7,,10390.72,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",11679.23,33.9,,9343.38,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",26872.56,78,,21498.05,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28457.35,82.6,,22765.88,,,0,"percent of total billed charges","82.6% of total billed charges",5787.94,16.8,,4630.35,,,0,"percent of total billed charges","16.8% of total billed charges",17226,50,,13780.80,,,0,"percent of total billed charges","50% of total billed charges",28457.35,82.6,,22765.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5787.94,16.8,,4630.35,,,0,"percent of total billed charges","16.8% of total billed charges",34452,100,,27561.60,,,0,"percent of total billed charges","100% of total billed charges",4695,34452,
"PERC DE COR STENT/CABG SING",840C9604,CDM,481,RC,,,OUTPATIENT,,,30628,19908.2,,26952.64,88,,21562.11,,,0,"percent of total billed charges","88% of total billed charges",15314,50,,12251.20,,,0,"percent of total billed charges","50% of total billed charges",5145.5,16.8,,4116.40,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5299.87,17.304,,4239.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",19295.64,63,,15436.51,,,0,"percent of total billed charges","63% of total billed charges",4686.08,15.3,,3748.86,,,0,"percent of total billed charges","15.3% of total billed charges",5145.5,16.8,,4116.40,,,0,"percent of total billed charges","16.8% of total billed charges",21133.32,69,,,,,0,"fee schedule","69% of total billed charges",30628,100,,24502.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30628,100,,24502.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30628,100,,24502.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18943.42,61.85,,15154.74,,,0,"percent of total billed charges","61.5% of total billed charges",5145.5,16.8,,4116.40,,,0,"percent of total billed charges","16.8% of total billed charges",15314,50,,12251.20,,,0,"percent of total billed charges","50% of total billed charges",9862.22,32.2,,7889.78,,,0,"percent of total billed charges","32.2% of total billed charges",5145.5,16.8,,4116.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5248.41,17.136,,4198.73,,,0,"percent of total billed charges","17.136% of total billed charges",6689.16,21.84,,5351.33,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",11546.76,37.7,,9237.41,,,0,"percent of total billed charges","37.7% of total billed charges",11546.76,37.7,,9237.41,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",10382.89,33.9,,8306.31,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",23889.84,78,,19111.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",25298.73,82.6,,20238.98,,,0,"percent of total billed charges","82.6% of total billed charges",5145.5,16.8,,4116.40,,,0,"percent of total billed charges","16.8% of total billed charges",15314,50,,12251.20,,,0,"percent of total billed charges","50% of total billed charges",25298.73,82.6,,20238.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5145.5,16.8,,4116.40,,,0,"percent of total billed charges","16.8% of total billed charges",30628,100,,24502.40,,,0,"percent of total billed charges","100% of total billed charges",4686.08,30628,
"PERC DE COR STENT/CABG BRANCH",840C9605,CDM,481,RC,,,OUTPATIENT,,,34452,22393.8,,30317.76,88,,24254.21,,,0,"percent of total billed charges","88% of total billed charges",17226,50,,13780.80,,,0,"percent of total billed charges","50% of total billed charges",5787.94,16.8,,4630.35,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5961.57,17.304,,4769.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",21704.76,63,,17363.81,,,0,"percent of total billed charges","63% of total billed charges",5271.16,15.3,,4216.93,,,0,"percent of total billed charges","15.3% of total billed charges",5787.94,16.8,,4630.35,,,0,"percent of total billed charges","16.8% of total billed charges",23771.88,69,,,,,0,"fee schedule","69% of total billed charges",34452,100,,27561.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34452,100,,27561.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34452,100,,27561.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21308.56,61.85,,17046.85,,,0,"percent of total billed charges","61.5% of total billed charges",5787.94,16.8,,4630.35,,,0,"percent of total billed charges","16.8% of total billed charges",17226,50,,13780.80,,,0,"percent of total billed charges","50% of total billed charges",11093.54,32.2,,8874.83,,,0,"percent of total billed charges","32.2% of total billed charges",5787.94,16.8,,4630.35,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5903.69,17.136,,4722.95,,,0,"percent of total billed charges","17.136% of total billed charges",7524.32,21.84,,6019.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",12988.4,37.7,,10390.72,,,0,"percent of total billed charges","37.7% of total billed charges",12988.4,37.7,,10390.72,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",11679.23,33.9,,9343.38,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",26872.56,78,,21498.05,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28457.35,82.6,,22765.88,,,0,"percent of total billed charges","82.6% of total billed charges",5787.94,16.8,,4630.35,,,0,"percent of total billed charges","16.8% of total billed charges",17226,50,,13780.80,,,0,"percent of total billed charges","50% of total billed charges",28457.35,82.6,,22765.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5787.94,16.8,,4630.35,,,0,"percent of total billed charges","16.8% of total billed charges",34452,100,,27561.60,,,0,"percent of total billed charges","100% of total billed charges",4695,34452,
"PERC DE COR REVASC W AMI SING",840C9606,CDM,481,RC,,,OUTPATIENT,,,35405,23013.25,,31156.4,88,,24925.12,,,0,"percent of total billed charges","88% of total billed charges",17702.5,50,,14162.00,,,0,"percent of total billed charges","50% of total billed charges",5948.04,16.8,,4758.43,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6126.48,17.304,,4901.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22305.15,63,,17844.12,,,0,"percent of total billed charges","63% of total billed charges",5416.97,15.3,,4333.58,,,0,"percent of total billed charges","15.3% of total billed charges",5948.04,16.8,,4758.43,,,0,"percent of total billed charges","16.8% of total billed charges",24429.45,69,,,,,0,"fee schedule","69% of total billed charges",35405,100,,28324.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35405,100,,28324.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35405,100,,28324.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21897.99,61.85,,17518.39,,,0,"percent of total billed charges","61.5% of total billed charges",5948.04,16.8,,4758.43,,,0,"percent of total billed charges","16.8% of total billed charges",17702.5,50,,14162.00,,,0,"percent of total billed charges","50% of total billed charges",11400.41,32.2,,9120.33,,,0,"percent of total billed charges","32.2% of total billed charges",5948.04,16.8,,4758.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6067,17.136,,4853.60,,,0,"percent of total billed charges","17.136% of total billed charges",7732.45,21.84,,6185.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",13347.69,37.7,,10678.15,,,0,"percent of total billed charges","37.7% of total billed charges",13347.69,37.7,,10678.15,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",12002.3,33.9,,9601.84,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",27615.9,78,,22092.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29244.53,82.6,,23395.62,,,0,"percent of total billed charges","82.6% of total billed charges",5948.04,16.8,,4758.43,,,0,"percent of total billed charges","16.8% of total billed charges",17702.5,50,,14162.00,,,0,"percent of total billed charges","50% of total billed charges",29244.53,82.6,,23395.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5948.04,16.8,,4758.43,,,0,"percent of total billed charges","16.8% of total billed charges",35405,100,,28324.00,,,0,"percent of total billed charges","100% of total billed charges",4695,35405,
"PERC DE COR REVASC CHRON SING",840C9607,CDM,481,RC,,,OUTPATIENT,,,30628,19908.2,,26952.64,88,,21562.11,,,0,"percent of total billed charges","88% of total billed charges",15314,50,,12251.20,,,0,"percent of total billed charges","50% of total billed charges",5145.5,16.8,,4116.40,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5299.87,17.304,,4239.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",19295.64,63,,15436.51,,,0,"percent of total billed charges","63% of total billed charges",4686.08,15.3,,3748.86,,,0,"percent of total billed charges","15.3% of total billed charges",5145.5,16.8,,4116.40,,,0,"percent of total billed charges","16.8% of total billed charges",21133.32,69,,,,,0,"fee schedule","69% of total billed charges",30628,100,,24502.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30628,100,,24502.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30628,100,,24502.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18943.42,61.85,,15154.74,,,0,"percent of total billed charges","61.5% of total billed charges",5145.5,16.8,,4116.40,,,0,"percent of total billed charges","16.8% of total billed charges",15314,50,,12251.20,,,0,"percent of total billed charges","50% of total billed charges",9862.22,32.2,,7889.78,,,0,"percent of total billed charges","32.2% of total billed charges",5145.5,16.8,,4116.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5248.41,17.136,,4198.73,,,0,"percent of total billed charges","17.136% of total billed charges",6689.16,21.84,,5351.33,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",11546.76,37.7,,9237.41,,,0,"percent of total billed charges","37.7% of total billed charges",11546.76,37.7,,9237.41,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",10382.89,33.9,,8306.31,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",23889.84,78,,19111.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",25298.73,82.6,,20238.98,,,0,"percent of total billed charges","82.6% of total billed charges",5145.5,16.8,,4116.40,,,0,"percent of total billed charges","16.8% of total billed charges",15314,50,,12251.20,,,0,"percent of total billed charges","50% of total billed charges",25298.73,82.6,,20238.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5145.5,16.8,,4116.40,,,0,"percent of total billed charges","16.8% of total billed charges",30628,100,,24502.40,,,0,"percent of total billed charges","100% of total billed charges",4686.08,30628,
"PERC DE COR REVASC CHRON ADD",840C9608,CDM,481,RC,,,OUTPATIENT,,,34443,22387.95,,30309.84,88,,24247.87,,,0,"percent of total billed charges","88% of total billed charges",17221.5,50,,13777.20,,,0,"percent of total billed charges","50% of total billed charges",5786.42,16.8,,4629.14,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5960.02,17.304,,4768.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",21699.09,63,,17359.27,,,0,"percent of total billed charges","63% of total billed charges",5269.78,15.3,,4215.82,,,0,"percent of total billed charges","15.3% of total billed charges",5786.42,16.8,,4629.14,,,0,"percent of total billed charges","16.8% of total billed charges",23765.67,69,,,,,0,"fee schedule","69% of total billed charges",34443,100,,27554.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34443,100,,27554.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34443,100,,27554.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21303,61.85,,17042.40,,,0,"percent of total billed charges","61.5% of total billed charges",5786.42,16.8,,4629.14,,,0,"percent of total billed charges","16.8% of total billed charges",17221.5,50,,13777.20,,,0,"percent of total billed charges","50% of total billed charges",11090.65,32.2,,8872.52,,,0,"percent of total billed charges","32.2% of total billed charges",5786.42,16.8,,4629.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5902.15,17.136,,4721.72,,,0,"percent of total billed charges","17.136% of total billed charges",7522.35,21.84,,6017.88,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",12985.01,37.7,,10388.01,,,0,"percent of total billed charges","37.7% of total billed charges",12985.01,37.7,,10388.01,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",11676.18,33.9,,9340.94,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",26865.54,78,,21492.43,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28449.92,82.6,,22759.94,,,0,"percent of total billed charges","82.6% of total billed charges",5786.42,16.8,,4629.14,,,0,"percent of total billed charges","16.8% of total billed charges",17221.5,50,,13777.20,,,0,"percent of total billed charges","50% of total billed charges",28449.92,82.6,,22759.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5786.42,16.8,,4629.14,,,0,"percent of total billed charges","16.8% of total billed charges",34443,100,,27554.40,,,0,"percent of total billed charges","100% of total billed charges",4695,34443,
"C9756 Intraop Near-Infrared Fluorescence Lymphatic Mapping",360C9756,CDM,360,RC,,,OUTPATIENT,,,1132,735.8,,996.16,88,,796.93,,,0,"percent of total billed charges","88% of total billed charges",566,50,,452.80,,,0,"percent of total billed charges","50% of total billed charges",190.18,16.8,,152.14,,,0,"percent of total billed charges","16.8% of total billed charges",1132,100,,905.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",195.88,17.304,,156.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",713.16,63,,570.53,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",190.18,16.8,,152.14,,,0,"percent of total billed charges","16.8% of total billed charges",781.08,69,,,,,0,"fee schedule","69% of total billed charges",1132,100,,905.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1132,100,,905.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1132,100,,905.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",700.14,61.85,,560.11,,,0,"percent of total billed charges","61.5% of total billed charges",190.18,16.8,,152.14,,,0,"percent of total billed charges","16.8% of total billed charges",566,50,,452.80,,,0,"percent of total billed charges","50% of total billed charges",364.5,32.2,,291.60,,,0,"percent of total billed charges","32.2% of total billed charges",190.18,16.8,,152.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",193.98,17.136,,155.18,,,0,"percent of total billed charges","17.136% of total billed charges",247.23,21.84,,197.78,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",426.76,37.7,,341.41,,,0,"percent of total billed charges","37.7% of total billed charges",426.76,37.7,,341.41,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",383.75,33.9,,307.00,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",882.96,78,,706.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",935.03,82.6,,748.02,,,0,"percent of total billed charges","82.6% of total billed charges",190.18,16.8,,152.14,,,0,"percent of total billed charges","16.8% of total billed charges",566,50,,452.80,,,0,"percent of total billed charges","50% of total billed charges",935.03,82.6,,748.02,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",190.18,16.8,,152.14,,,0,"percent of total billed charges","16.8% of total billed charges",1132,100,,905.60,,,0,"percent of total billed charges","100% of total billed charges",190.18,3367,
"PLACE OCCLUSIVE DEVICE",840G0269,CDM,361,RC,,,OUTPATIENT,,,8329,5413.85,,7329.52,88,,5863.62,,,0,"percent of total billed charges","88% of total billed charges",4164.5,50,,3331.60,,,0,"percent of total billed charges","50% of total billed charges",1399.27,16.8,,1119.42,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1441.25,17.304,,1153.00,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5247.27,63,,4197.82,,,0,"percent of total billed charges","63% of total billed charges",1274.34,15.3,,1019.47,,,0,"percent of total billed charges","15.3% of total billed charges",1399.27,16.8,,1119.42,,,0,"percent of total billed charges","16.8% of total billed charges",5747.01,69,,,,,0,"fee schedule","69% of total billed charges",8329,100,,6663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8329,100,,6663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8329,100,,6663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5151.49,61.85,,4121.19,,,0,"percent of total billed charges","61.5% of total billed charges",1399.27,16.8,,1119.42,,,0,"percent of total billed charges","16.8% of total billed charges",4164.5,50,,3331.60,,,0,"percent of total billed charges","50% of total billed charges",2681.94,32.2,,2145.55,,,0,"percent of total billed charges","32.2% of total billed charges",1399.27,16.8,,1119.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1427.26,17.136,,1141.81,,,0,"percent of total billed charges","17.136% of total billed charges",1819.05,21.84,,1455.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3140.03,37.7,,2512.02,,,0,"percent of total billed charges","37.7% of total billed charges",3140.03,37.7,,2512.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2823.53,33.9,,2258.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6496.62,78,,5197.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6879.75,82.6,,5503.80,,,0,"percent of total billed charges","82.6% of total billed charges",1399.27,16.8,,1119.42,,,0,"percent of total billed charges","16.8% of total billed charges",4164.5,50,,3331.60,,,0,"percent of total billed charges","50% of total billed charges",6879.75,82.6,,5503.80,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1399.27,16.8,,1119.42,,,0,"percent of total billed charges","16.8% of total billed charges",8329,100,,6663.20,,,0,"percent of total billed charges","100% of total billed charges",1274.34,8329,
"ILIAC ANGIO W/CARDIAC CATH",840G0278,CDM,481,RC,,,OUTPATIENT,,,6433,4181.45,,5661.04,88,,4528.83,,,0,"percent of total billed charges","88% of total billed charges",3216.5,50,,2573.20,,,0,"percent of total billed charges","50% of total billed charges",1080.74,16.8,,864.59,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1113.17,17.304,,890.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4052.79,63,,3242.23,,,0,"percent of total billed charges","63% of total billed charges",984.25,15.3,,787.40,,,0,"percent of total billed charges","15.3% of total billed charges",1080.74,16.8,,864.59,,,0,"percent of total billed charges","16.8% of total billed charges",4438.77,69,,,,,0,"fee schedule","69% of total billed charges",6433,100,,5146.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6433,100,,5146.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6433,100,,5146.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3978.81,61.85,,3183.05,,,0,"percent of total billed charges","61.5% of total billed charges",1080.74,16.8,,864.59,,,0,"percent of total billed charges","16.8% of total billed charges",3216.5,50,,2573.20,,,0,"percent of total billed charges","50% of total billed charges",2071.43,32.2,,1657.14,,,0,"percent of total billed charges","32.2% of total billed charges",1080.74,16.8,,864.59,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1102.36,17.136,,881.89,,,0,"percent of total billed charges","17.136% of total billed charges",1404.97,21.84,,1123.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2425.24,37.7,,1940.19,,,0,"percent of total billed charges","37.7% of total billed charges",2425.24,37.7,,1940.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2180.79,33.9,,1744.63,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5017.74,78,,4014.19,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5313.66,82.6,,4250.93,,,0,"percent of total billed charges","82.6% of total billed charges",1080.74,16.8,,864.59,,,0,"percent of total billed charges","16.8% of total billed charges",3216.5,50,,2573.20,,,0,"percent of total billed charges","50% of total billed charges",5313.66,82.6,,4250.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1080.74,16.8,,864.59,,,0,"percent of total billed charges","16.8% of total billed charges",6433,100,,5146.40,,,0,"percent of total billed charges","100% of total billed charges",984.25,6433,
"Intubation, endotracheal, emergency procedure",41031500,CDM,410,RC,31500,CPT,OUTPATIENT,,,1677,1090.05,,1475.76,88,,1180.61,,,0,"percent of total billed charges","88% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818.62,100,,,,,0,"fee schedule",EAPG,1677,100,,1341.60,,,0,"percent of total billed charges","100% of total billed charges",435.98,175,,,,,0,"fee schedule","175% of CMS fee schedule",843.18,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056.51,63,,845.21,,,0,"percent of total billed charges","63% of total billed charges",256.58,15.3,,205.26,,,0,"percent of total billed charges","15.3% of total billed charges",818.62,100,,,,,0,"fee schedule",EAPG,1157.13,69,,,,,0,"fee schedule","69% of total billed charges",1677,100,,1341.60,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1677,100,,1341.60,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1677,100,,1341.60,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",859.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818.62,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",606.38,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",834.99,100,,,,,0,"fee schedule",EAPG,1064.21,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",632.23,37.7,,505.78,,,0,"percent of total billed charges","37.7% of total billed charges",632.23,37.7,,505.78,,,0,"percent of total billed charges","37.70% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.5,33.9,,454.80,,,0,"percent of total billed charges","33.9% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1308.06,78,,1046.45,,,0,"percent of total billed charges","78% of total billed charges",251.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1385.2,82.6,,1108.16,,,0,"percent of total billed charges","82.6% of total billed charges",818.62,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1385.2,82.6,,1108.16,,,0,"percent of total billed charges","82.6% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818.62,100,,,,,0,"fee schedule",EAPG,1677,100,,1341.60,,,0,"percent of total billed charges","100% of total billed charges",224.74,1677,
"Venipuncture Routine",30036415,CDM,300,RC,36415,CPT,OUTPATIENT,,,119,77.35,,,,,,,,0,other,"not separately reimbursment",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.1,100,,,,,0,"fee schedule",EAPG,119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",15.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",2.16,100,,,,,0,"fee schedule",EAPG,8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",18.21,15.3,,14.57,,,0,"percent of total billed charges","15.3% of total billed charges",2.1,100,,,,,0,"fee schedule",EAPG,82.11,69,,,,,0,"fee schedule","69% of total billed charges",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.47,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",2.1,100,,,,,0,"fee schedule",EAPG,8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.83,100,,,,,0,"fee schedule","100% of LI fee schedule",1.55,100,,,,,0,"fee schedule",EAPG,8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.14,100,,,,,0,"fee schedule",EAPG,2.73,100,,,,,0,"fee schedule",EAPG,8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.7% of total billed charges",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.70% of total billed charges",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.34,33.9,,32.27,,,0,"percent of total billed charges","33.9% of total billed charges",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.82,78,,74.26,,,0,"percent of total billed charges","78% of total billed charges",8.91,101,,,,,0,"fee schedule","101% of CMS fee schedule ",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",2.1,100,,,,,0,"fee schedule",EAPG,8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.1,100,,,,,0,"fee schedule",EAPG,119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",1.55,119,
"DIABETES SLF MANGMT INDV 30MIN",942G0108,CDM,942,RC,,,OUTPATIENT,,,252,163.8,,221.76,88,,177.41,,,0,"percent of total billed charges","88% of total billed charges",126,50,,100.80,,,0,"percent of total billed charges","50% of total billed charges",42.34,16.8,,33.87,,,0,"percent of total billed charges","16.8% of total billed charges",252,100,,201.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.61,17.304,,34.89,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.76,63,,127.01,,,0,"percent of total billed charges","63% of total billed charges",38.56,15.3,,30.85,,,0,"percent of total billed charges","15.3% of total billed charges",42.34,16.8,,33.87,,,0,"percent of total billed charges","16.8% of total billed charges",173.88,69,,,,,0,"fee schedule","69% of total billed charges",252,100,,201.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",252,100,,201.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",252,100,,201.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.86,61.85,,124.69,,,0,"percent of total billed charges","61.5% of total billed charges",42.34,16.8,,33.87,,,0,"percent of total billed charges","16.8% of total billed charges",126,50,,100.80,,,0,"percent of total billed charges","50% of total billed charges",81.14,32.2,,64.91,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.18,17.136,,34.54,,,0,"percent of total billed charges","17.136% of total billed charges",55.04,21.84,,44.03,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",95,37.7,,76.00,,,0,"percent of total billed charges","37.7% of total billed charges",95,37.7,,76.00,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.43,33.9,,68.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",196.56,78,,157.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.15,82.6,,166.52,,,0,"percent of total billed charges","82.6% of total billed charges",42.34,16.8,,33.87,,,0,"percent of total billed charges","16.8% of total billed charges",126,50,,100.80,,,0,"percent of total billed charges","50% of total billed charges",208.15,82.6,,166.52,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.34,16.8,,33.87,,,0,"percent of total billed charges","16.8% of total billed charges",252,100,,201.60,,,0,"percent of total billed charges","100% of total billed charges",38.56,252,
"DIABETES SLF MANGMT GRP 30MIN",942G0109,CDM,942,RC,,,OUTPATIENT,,,76,49.4,,66.88,88,,53.50,,,0,"percent of total billed charges","88% of total billed charges",38,50,,30.40,,,0,"percent of total billed charges","50% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.15,17.304,,10.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.88,63,,38.30,,,0,"percent of total billed charges","63% of total billed charges",11.63,15.3,,9.30,,,0,"percent of total billed charges","15.3% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",52.44,69,,,,,0,"fee schedule","69% of total billed charges",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.01,61.85,,37.61,,,0,"percent of total billed charges","61.5% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",38,50,,30.40,,,0,"percent of total billed charges","50% of total billed charges",24.47,32.2,,19.58,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.02,17.136,,10.42,,,0,"percent of total billed charges","17.136% of total billed charges",16.6,21.84,,13.28,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.65,37.7,,22.92,,,0,"percent of total billed charges","37.7% of total billed charges",28.65,37.7,,22.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.76,33.9,,20.61,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.28,78,,47.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.78,82.6,,50.22,,,0,"percent of total billed charges","82.6% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",38,50,,30.40,,,0,"percent of total billed charges","50% of total billed charges",62.78,82.6,,50.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",11.63,76,
"Telehealth facility fee",780Q3014,CDM,780,RC,,,OUTPATIENT,,,112,72.8,,98.56,88,,78.85,,,0,"percent of total billed charges","88% of total billed charges",56,50,,44.80,,,0,"percent of total billed charges","50% of total billed charges",18.82,16.8,,15.06,,,0,"percent of total billed charges","16.8% of total billed charges",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.38,17.304,,15.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.56,63,,56.45,,,0,"percent of total billed charges","63% of total billed charges",17.14,15.3,,13.71,,,0,"percent of total billed charges","15.3% of total billed charges",18.82,16.8,,15.06,,,0,"percent of total billed charges","16.8% of total billed charges",77.28,69,,,,,0,"fee schedule","69% of total billed charges",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.27,61.85,,55.42,,,0,"percent of total billed charges","61.5% of total billed charges",18.82,16.8,,15.06,,,0,"percent of total billed charges","16.8% of total billed charges",56,50,,44.80,,,0,"percent of total billed charges","50% of total billed charges",36.06,32.2,,28.85,,,0,"percent of total billed charges","32.2% of total billed charges",18.82,16.8,,15.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.19,17.136,,15.35,,,0,"percent of total billed charges","17.136% of total billed charges",24.46,21.84,,19.57,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.22,37.7,,33.78,,,0,"percent of total billed charges","37.7% of total billed charges",42.22,37.7,,33.78,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.97,33.9,,30.38,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.36,78,,69.89,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.51,82.6,,74.01,,,0,"percent of total billed charges","82.6% of total billed charges",18.82,16.8,,15.06,,,0,"percent of total billed charges","16.8% of total billed charges",56,50,,44.80,,,0,"percent of total billed charges","50% of total billed charges",92.51,82.6,,74.01,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.82,16.8,,15.06,,,0,"percent of total billed charges","16.8% of total billed charges",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",17.14,112,
"BIPAP/CPAP INIT  MGMT",41094660,CDM,410,RC,94660,CPT,OUTPATIENT,,,874,568.1,,769.12,88,,615.30,,,0,"percent of total billed charges","88% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.78,100,,,,,0,"fee schedule",EAPG,874,100,,699.20,,,0,"percent of total billed charges","100% of total billed charges",380.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",115.13,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",550.62,63,,440.50,,,0,"percent of total billed charges","63% of total billed charges",133.72,15.3,,106.98,,,0,"percent of total billed charges","15.3% of total billed charges",111.78,100,,,,,0,"fee schedule",EAPG,603.06,69,,,,,0,"fee schedule","69% of total billed charges",874,100,,699.20,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874,100,,699.20,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874,100,,699.20,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",763.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.78,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",82.8,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",114.01,100,,,,,0,"fee schedule",EAPG,145.31,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",329.5,37.7,,263.60,,,0,"percent of total billed charges","37.7% of total billed charges",329.5,37.7,,263.60,,,0,"percent of total billed charges","37.70% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.29,33.9,,237.03,,,0,"percent of total billed charges","33.9% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",681.72,78,,545.38,,,0,"percent of total billed charges","78% of total billed charges",219.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",721.92,82.6,,577.54,,,0,"percent of total billed charges","82.6% of total billed charges",111.78,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",721.92,82.6,,577.54,,,0,"percent of total billed charges","82.6% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.78,100,,,,,0,"fee schedule",EAPG,874,100,,699.20,,,0,"percent of total billed charges","100% of total billed charges",82.8,874,
"CO/MEMBRANE DIFFUSE CAPACITY",46094729,CDM,460,RC,94729,CPT,OUTPATIENT,,,317,206.05,,278.96,88,,223.17,,,0,"percent of total billed charges","88% of total billed charges",158.5,50,,126.80,,,0,"percent of total billed charges","50% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,317,100,,253.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",199.71,63,,159.77,,,0,"percent of total billed charges","63% of total billed charges",48.5,15.3,,38.80,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,218.73,69,,,,,0,"fee schedule","69% of total billed charges",317,100,,253.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",317,100,,253.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",317,100,,253.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",196.06,61.85,,156.85,,,0,"percent of total billed charges","61.5% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,158.5,50,,126.80,,,0,"percent of total billed charges","50% of total billed charges",102.07,32.2,,81.66,,,0,"percent of total billed charges","32.2% of total billed charges",34.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",119.51,37.7,,95.61,,,0,"percent of total billed charges","37.7% of total billed charges",119.51,37.7,,95.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",107.46,33.9,,85.97,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",247.26,78,,197.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.84,82.6,,209.47,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,158.5,50,,126.80,,,0,"percent of total billed charges","50% of total billed charges",261.84,82.6,,209.47,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.89,100,,,,,0,"fee schedule",EAPG,317,100,,253.60,,,0,"percent of total billed charges","100% of total billed charges",34.73,317,
"HELIOX INITIAL (hourly charge)",41094640,CDM,410,RC,94640,CPT,OUTPATIENT,,,672,436.8,76,591.36,88,,473.09,,,0,"percent of total billed charges","88% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",380.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",423.36,63,,338.69,,,0,"percent of total billed charges","63% of total billed charges",102.82,15.3,,82.26,,,0,"percent of total billed charges","15.3% of total billed charges",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",463.68,69,,,,,0,"fee schedule","69% of total billed charges",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",763.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.61,102,,,,,0,"fee schedule","102% of WA fee schedule",7.15,130,,,,,0,"fee schedule","130% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",253.34,37.7,,202.67,,,0,"percent of total billed charges","37.7% of total billed charges",253.34,37.7,,202.67,,,0,"percent of total billed charges","37.70% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",227.81,33.9,,182.25,,,0,"percent of total billed charges","33.9% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",524.16,78,,419.33,,,0,"percent of total billed charges","78% of total billed charges",219.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",555.07,82.6,,444.06,,,0,"percent of total billed charges","82.6% of total billed charges",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",555.07,82.6,,444.06,,,0,"percent of total billed charges","82.6% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",5.5,763.26,
"Home Oxygen Evaluation",SMW94618,CDM,460,RC,94618,CPT,OUTPATIENT,,,350,227.5,,308,88,,246.40,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",48.3,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",220.5,63,,176.40,,,0,"percent of total billed charges","63% of total billed charges",53.55,15.3,,42.84,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,241.5,69,,,,,0,"fee schedule","69% of total billed charges",350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.73,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",131.95,37.7,,105.56,,,0,"percent of total billed charges","37.7% of total billed charges",131.95,37.7,,105.56,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.65,33.9,,94.92,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",273,78,,218.40,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.1,82.6,,231.28,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.1,82.6,,231.28,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",34.73,454.8,
"INHALER MDI TX SUBSQ",41094640,CDM,410,RC,94640,CPT,OUTPATIENT,,,672,436.8,76,591.36,88,,473.09,,,0,"percent of total billed charges","88% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",380.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",423.36,63,,338.69,,,0,"percent of total billed charges","63% of total billed charges",102.82,15.3,,82.26,,,0,"percent of total billed charges","15.3% of total billed charges",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",463.68,69,,,,,0,"fee schedule","69% of total billed charges",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",763.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.61,102,,,,,0,"fee schedule","102% of WA fee schedule",7.15,130,,,,,0,"fee schedule","130% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",253.34,37.7,,202.67,,,0,"percent of total billed charges","37.7% of total billed charges",253.34,37.7,,202.67,,,0,"percent of total billed charges","37.70% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",227.81,33.9,,182.25,,,0,"percent of total billed charges","33.9% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",524.16,78,,419.33,,,0,"percent of total billed charges","78% of total billed charges",219.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",555.07,82.6,,444.06,,,0,"percent of total billed charges","82.6% of total billed charges",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",555.07,82.6,,444.06,,,0,"percent of total billed charges","82.6% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",5.5,763.26,
"BIPAP/CPAP INIT  MGMT",41094660,CDM,410,RC,94660,CPT,OUTPATIENT,,,874,568.1,,769.12,88,,615.30,,,0,"percent of total billed charges","88% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.78,100,,,,,0,"fee schedule",EAPG,874,100,,699.20,,,0,"percent of total billed charges","100% of total billed charges",380.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",115.13,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",550.62,63,,440.50,,,0,"percent of total billed charges","63% of total billed charges",133.72,15.3,,106.98,,,0,"percent of total billed charges","15.3% of total billed charges",111.78,100,,,,,0,"fee schedule",EAPG,603.06,69,,,,,0,"fee schedule","69% of total billed charges",874,100,,699.20,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874,100,,699.20,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874,100,,699.20,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",763.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.78,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",82.8,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",114.01,100,,,,,0,"fee schedule",EAPG,145.31,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",329.5,37.7,,263.60,,,0,"percent of total billed charges","37.7% of total billed charges",329.5,37.7,,263.60,,,0,"percent of total billed charges","37.70% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.29,33.9,,237.03,,,0,"percent of total billed charges","33.9% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",681.72,78,,545.38,,,0,"percent of total billed charges","78% of total billed charges",219.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",721.92,82.6,,577.54,,,0,"percent of total billed charges","82.6% of total billed charges",111.78,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",721.92,82.6,,577.54,,,0,"percent of total billed charges","82.6% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.78,100,,,,,0,"fee schedule",EAPG,874,100,,699.20,,,0,"percent of total billed charges","100% of total billed charges",82.8,874,
"BIPAP/CPAP INIT  MGMT",41094660,CDM,410,RC,94660,CPT,OUTPATIENT,,,874,568.1,,769.12,88,,615.30,,,0,"percent of total billed charges","88% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.78,100,,,,,0,"fee schedule",EAPG,874,100,,699.20,,,0,"percent of total billed charges","100% of total billed charges",380.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",115.13,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",550.62,63,,440.50,,,0,"percent of total billed charges","63% of total billed charges",133.72,15.3,,106.98,,,0,"percent of total billed charges","15.3% of total billed charges",111.78,100,,,,,0,"fee schedule",EAPG,603.06,69,,,,,0,"fee schedule","69% of total billed charges",874,100,,699.20,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874,100,,699.20,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874,100,,699.20,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",763.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.78,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",82.8,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",114.01,100,,,,,0,"fee schedule",EAPG,145.31,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",329.5,37.7,,263.60,,,0,"percent of total billed charges","37.7% of total billed charges",329.5,37.7,,263.60,,,0,"percent of total billed charges","37.70% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.29,33.9,,237.03,,,0,"percent of total billed charges","33.9% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",681.72,78,,545.38,,,0,"percent of total billed charges","78% of total billed charges",219.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",721.92,82.6,,577.54,,,0,"percent of total billed charges","82.6% of total billed charges",111.78,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",721.92,82.6,,577.54,,,0,"percent of total billed charges","82.6% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.78,100,,,,,0,"fee schedule",EAPG,874,100,,699.20,,,0,"percent of total billed charges","100% of total billed charges",82.8,874,
"CPT W PERCUS/VIBRATION SUB",41094668,CDM,410,RC,94668,CPT,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22.65,102,,,,,0,"fee schedule","102% of WA fee schedule",28.87,130,,,,,0,"fee schedule","130% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",22.21,454.8,
"CPT W PERCUS/VIBRATION INITIAL",41094667,CDM,410,RC,94667,CPT,OUTPATIENT,,,672,436.8,,591.36,88,,473.09,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14.24,100,,,,,0,"fee schedule","100% of WA fee schedule",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",14.24,100,,,,,0,"fee schedule","100% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",423.36,63,,338.69,,,0,"percent of total billed charges","63% of total billed charges",102.82,15.3,,82.26,,,0,"percent of total billed charges","15.3% of total billed charges",14.24,100,,,,,0,"fee schedule","100% of WA fee schedule",463.68,69,,,,,0,"fee schedule","69% of total billed charges",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14.24,100,,,,,0,"fee schedule","100% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14.24,100,,,,,0,"fee schedule","100% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14.52,102,,,,,0,"fee schedule","102% of WA fee schedule",18.51,130,,,,,0,"fee schedule","130% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",253.34,37.7,,202.67,,,0,"percent of total billed charges","37.7% of total billed charges",253.34,37.7,,202.67,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",227.81,33.9,,182.25,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",524.16,78,,419.33,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",555.07,82.6,,444.06,,,0,"percent of total billed charges","82.6% of total billed charges",14.24,100,,,,,0,"fee schedule","100% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",555.07,82.6,,444.06,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14.24,100,,,,,0,"fee schedule","100% of WA fee schedule",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",14.24,672,
"MULTIPLE SLEEP LATENCY",92095805,CDM,920,RC,95805,CPT,OUTPATIENT,,,4058,2637.7,TC,3571.04,88,,2856.83,,,0,"percent of total billed charges","88% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.53,100,,,,,0,"fee schedule",EAPG,4058,100,,3246.40,,,0,"percent of total billed charges","100% of total billed charges",956.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",707.12,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2556.54,63,,2045.23,,,0,"percent of total billed charges","63% of total billed charges",620.87,15.3,,496.70,,,0,"percent of total billed charges","15.3% of total billed charges",686.53,100,,,,,0,"fee schedule",EAPG,2800.02,69,,,,,0,"fee schedule","69% of total billed charges",4058,100,,3246.40,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4058,100,,3246.40,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4058,100,,3246.40,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1981.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.53,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",518.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",508.54,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",700.26,100,,,,,0,"fee schedule",EAPG,892.49,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1529.87,37.7,,1223.90,,,0,"percent of total billed charges","37.7% of total billed charges",1529.87,37.7,,1223.90,,,0,"percent of total billed charges","37.70% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1375.66,33.9,,1100.53,,,0,"percent of total billed charges","33.9% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3165.24,78,,2532.19,,,0,"percent of total billed charges","78% of total billed charges",552.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3351.91,82.6,,2681.53,,,0,"percent of total billed charges","82.6% of total billed charges",686.53,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3351.91,82.6,,2681.53,,,0,"percent of total billed charges","82.6% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.53,100,,,,,0,"fee schedule",EAPG,4058,100,,3246.40,,,0,"percent of total billed charges","100% of total billed charges",508.54,4058,
"NASOTRACHEAL ASPIRATION",94031720,CDM,940,RC,31720,CPT,OUTPATIENT,,,672,436.8,,591.36,88,,473.09,,,0,"percent of total billed charges","88% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",380.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",48.3,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",423.36,63,,338.69,,,0,"percent of total billed charges","63% of total billed charges",102.82,15.3,,82.26,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,463.68,69,,,,,0,"fee schedule","69% of total billed charges",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",763.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.73,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",253.34,37.7,,202.67,,,0,"percent of total billed charges","37.7% of total billed charges",253.34,37.7,,202.67,,,0,"percent of total billed charges","37.70% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",227.81,33.9,,182.25,,,0,"percent of total billed charges","33.9% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",524.16,78,,419.33,,,0,"percent of total billed charges","78% of total billed charges",219.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",555.07,82.6,,444.06,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",555.07,82.6,,444.06,,,0,"percent of total billed charges","82.6% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",34.73,763.26,
"PULSE OXIMETRY CONT OVERNIGHT",46094762,CDM,460,RC,94762,CPT,OUTPATIENT,,,492,319.8,,432.96,88,,346.37,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",48.3,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.96,63,,247.97,,,0,"percent of total billed charges","63% of total billed charges",75.28,15.3,,60.22,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,339.48,69,,,,,0,"fee schedule","69% of total billed charges",492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.73,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",185.48,37.7,,148.38,,,0,"percent of total billed charges","37.7% of total billed charges",185.48,37.7,,148.38,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",166.79,33.9,,133.43,,,0,"percent of total billed charges","33.9% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",383.76,78,,307.01,,,0,"percent of total billed charges","78% of total billed charges",160.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",406.39,82.6,,325.11,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",406.39,82.6,,325.11,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",34.73,566.91,
"PULMONARY STRESS TEST COMPLX",46094621,CDM,460,RC,94621,CPT,OUTPATIENT,,,961,624.65,,845.68,88,,676.54,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.19,100,,,,,0,"fee schedule",EAPG,961,100,,768.80,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",94.95,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.43,63,,484.34,,,0,"percent of total billed charges","63% of total billed charges",147.03,15.3,,117.62,,,0,"percent of total billed charges","15.3% of total billed charges",92.19,100,,,,,0,"fee schedule",EAPG,663.09,69,,,,,0,"fee schedule","69% of total billed charges",961,100,,768.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",961,100,,768.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",961,100,,768.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.19,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",68.29,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",94.03,100,,,,,0,"fee schedule",EAPG,119.84,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",362.3,37.7,,289.84,,,0,"percent of total billed charges","37.7% of total billed charges",362.3,37.7,,289.84,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",325.78,33.9,,260.62,,,0,"percent of total billed charges","33.9% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",749.58,78,,599.66,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",793.79,82.6,,635.03,,,0,"percent of total billed charges","82.6% of total billed charges",92.19,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",793.79,82.6,,635.03,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.19,100,,,,,0,"fee schedule",EAPG,961,100,,768.80,,,0,"percent of total billed charges","100% of total billed charges",68.29,1074.33,
"PULM FUNC TST PLESTHYSMOGRAPH",46094726,CDM,460,RC,94726,CPT,OUTPATIENT,,,350,227.5,,308,88,,246.40,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.19,100,,,,,0,"fee schedule",EAPG,350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",560.25,175,,,,,0,"fee schedule","175% of CMS fee schedule",94.95,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",220.5,63,,176.40,,,0,"percent of total billed charges","63% of total billed charges",53.55,15.3,,42.84,,,0,"percent of total billed charges","15.3% of total billed charges",92.19,100,,,,,0,"fee schedule",EAPG,241.5,69,,,,,0,"fee schedule","69% of total billed charges",350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.19,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",68.29,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",94.03,100,,,,,0,"fee schedule",EAPG,119.84,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",131.95,37.7,,105.56,,,0,"percent of total billed charges","37.7% of total billed charges",131.95,37.7,,105.56,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.65,33.9,,94.92,,,0,"percent of total billed charges","33.9% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",273,78,,218.40,,,0,"percent of total billed charges","78% of total billed charges",323.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.1,82.6,,231.28,,,0,"percent of total billed charges","82.6% of total billed charges",92.19,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.1,82.6,,231.28,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.19,100,,,,,0,"fee schedule",EAPG,350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",53.55,1074.33,
"PULM FUNCTION TEST BY GAS",46094727,CDM,460,RC,94727,CPT,OUTPATIENT,,,350,227.5,,308,88,,246.40,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",48.3,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",220.5,63,,176.40,,,0,"percent of total billed charges","63% of total billed charges",53.55,15.3,,42.84,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,241.5,69,,,,,0,"fee schedule","69% of total billed charges",350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.73,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",131.95,37.7,,105.56,,,0,"percent of total billed charges","37.7% of total billed charges",131.95,37.7,,105.56,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.65,33.9,,94.92,,,0,"percent of total billed charges","33.9% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",273,78,,218.40,,,0,"percent of total billed charges","78% of total billed charges",160.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.1,82.6,,231.28,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.1,82.6,,231.28,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",34.73,566.92,
"INTUBATION ASSIST",41031500,CDM,410,RC,31500,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",818.62,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",843.18,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",818.62,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",818.62,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",606.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",834.99,100,,,,,0,"fee schedule",EAPG,1064.21,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",818.62,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",818.62,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",606.38,1064.21,
"TRACH TUBE CHANGE PRE FISTUAL",76131502,CDM,761,RC,31502,CPT,OUTPATIENT,,,508,330.2,,447.04,88,,357.63,,,0,"percent of total billed charges","88% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",435.98,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320.04,63,,256.03,,,0,"percent of total billed charges","63% of total billed charges",77.72,15.3,,62.18,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,350.52,69,,,,,0,"fee schedule","69% of total billed charges",508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",859.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.15,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191.52,37.7,,153.22,,,0,"percent of total billed charges","37.7% of total billed charges",191.52,37.7,,153.22,,,0,"percent of total billed charges","37.70% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",172.21,33.9,,137.77,,,0,"percent of total billed charges","33.9% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",396.24,78,,316.99,,,0,"percent of total billed charges","78% of total billed charges",251.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",419.61,82.6,,335.69,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",419.61,82.6,,335.69,,,0,"percent of total billed charges","82.6% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",74.15,859.63,
"INTUBATION EMERGENCY",92000001,CDM,410,RC,31500,CPT,OUTPATIENT,,,586,380.9,,515.68,88,,412.54,,,0,"percent of total billed charges","88% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818.62,100,,,,,0,"fee schedule",EAPG,586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",435.98,175,,,,,0,"fee schedule","175% of CMS fee schedule",843.18,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",369.18,63,,295.34,,,0,"percent of total billed charges","63% of total billed charges",89.66,15.3,,71.73,,,0,"percent of total billed charges","15.3% of total billed charges",818.62,100,,,,,0,"fee schedule",EAPG,404.34,69,,,,,0,"fee schedule","69% of total billed charges",586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",859.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818.62,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",606.38,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",834.99,100,,,,,0,"fee schedule",EAPG,1064.21,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",220.92,37.7,,176.74,,,0,"percent of total billed charges","37.7% of total billed charges",220.92,37.7,,176.74,,,0,"percent of total billed charges","37.70% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",198.65,33.9,,158.92,,,0,"percent of total billed charges","33.9% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",457.08,78,,365.66,,,0,"percent of total billed charges","78% of total billed charges",251.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",484.04,82.6,,387.23,,,0,"percent of total billed charges","82.6% of total billed charges",818.62,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",484.04,82.6,,387.23,,,0,"percent of total billed charges","82.6% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818.62,100,,,,,0,"fee schedule",EAPG,586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",89.66,1064.21,
"Six Minute Walk",TMP600159,CDM,460,RC,94618,CPT,OUTPATIENT,,,350,227.5,,308,88,,246.40,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",48.3,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",220.5,63,,176.40,,,0,"percent of total billed charges","63% of total billed charges",53.55,15.3,,42.84,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,241.5,69,,,,,0,"fee schedule","69% of total billed charges",350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.73,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",131.95,37.7,,105.56,,,0,"percent of total billed charges","37.7% of total billed charges",131.95,37.7,,105.56,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.65,33.9,,94.92,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",273,78,,218.40,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.1,82.6,,231.28,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.1,82.6,,231.28,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",34.73,454.8,
"SLEEP STUDY UNATTENDED",92095806,CDM,920,RC,95806,CPT,OUTPATIENT,,,701,455.65,,616.88,88,,493.50,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",127.33,100,,,,,0,"fee schedule",EAPG,701,100,,560.80,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",131.15,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.63,63,,353.30,,,0,"percent of total billed charges","63% of total billed charges",107.25,15.3,,85.80,,,0,"percent of total billed charges","15.3% of total billed charges",127.33,100,,,,,0,"fee schedule",EAPG,483.69,69,,,,,0,"fee schedule","69% of total billed charges",701,100,,560.80,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",701,100,,560.80,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",701,100,,560.80,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",127.33,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",94.32,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",129.88,100,,,,,0,"fee schedule",EAPG,165.54,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",264.28,37.7,,211.42,,,0,"percent of total billed charges","37.7% of total billed charges",264.28,37.7,,211.42,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",237.64,33.9,,190.11,,,0,"percent of total billed charges","33.9% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",546.78,78,,437.42,,,0,"percent of total billed charges","78% of total billed charges",160.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579.03,82.6,,463.22,,,0,"percent of total billed charges","82.6% of total billed charges",127.33,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579.03,82.6,,463.22,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",127.33,100,,,,,0,"fee schedule",EAPG,701,100,,560.80,,,0,"percent of total billed charges","100% of total billed charges",94.32,701,
"Spirometry Pre and Post Exercise",46094618,CDM,460,RC,94618,CPT,OUTPATIENT,,,350,227.5,,308,88,,246.40,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",48.3,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",220.5,63,,176.40,,,0,"percent of total billed charges","63% of total billed charges",53.55,15.3,,42.84,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,241.5,69,,,,,0,"fee schedule","69% of total billed charges",350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.73,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",131.95,37.7,,105.56,,,0,"percent of total billed charges","37.7% of total billed charges",131.95,37.7,,105.56,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.65,33.9,,94.92,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",273,78,,218.40,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.1,82.6,,231.28,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.1,82.6,,231.28,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",34.73,454.8,
"SPUTUM INDUCTION INIT",41094640,CDM,410,RC,94640,CPT,OUTPATIENT,,,672,436.8,76,591.36,88,,473.09,,,0,"percent of total billed charges","88% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",380.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",423.36,63,,338.69,,,0,"percent of total billed charges","63% of total billed charges",102.82,15.3,,82.26,,,0,"percent of total billed charges","15.3% of total billed charges",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",463.68,69,,,,,0,"fee schedule","69% of total billed charges",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",763.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.61,102,,,,,0,"fee schedule","102% of WA fee schedule",7.15,130,,,,,0,"fee schedule","130% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",253.34,37.7,,202.67,,,0,"percent of total billed charges","37.7% of total billed charges",253.34,37.7,,202.67,,,0,"percent of total billed charges","37.70% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",227.81,33.9,,182.25,,,0,"percent of total billed charges","33.9% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",524.16,78,,419.33,,,0,"percent of total billed charges","78% of total billed charges",219.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",555.07,82.6,,444.06,,,0,"percent of total billed charges","82.6% of total billed charges",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",555.07,82.6,,444.06,,,0,"percent of total billed charges","82.6% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",5.5,763.26,
"AEROSOL NEBULIZER TX SUBSEQUEN",41094640,CDM,410,RC,94640,CPT,OUTPATIENT,,,672,436.8,76,591.36,88,,473.09,,,0,"percent of total billed charges","88% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",380.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",423.36,63,,338.69,,,0,"percent of total billed charges","63% of total billed charges",102.82,15.3,,82.26,,,0,"percent of total billed charges","15.3% of total billed charges",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",463.68,69,,,,,0,"fee schedule","69% of total billed charges",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",763.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.61,102,,,,,0,"fee schedule","102% of WA fee schedule",7.15,130,,,,,0,"fee schedule","130% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",253.34,37.7,,202.67,,,0,"percent of total billed charges","37.7% of total billed charges",253.34,37.7,,202.67,,,0,"percent of total billed charges","37.70% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",227.81,33.9,,182.25,,,0,"percent of total billed charges","33.9% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",524.16,78,,419.33,,,0,"percent of total billed charges","78% of total billed charges",219.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",555.07,82.6,,444.06,,,0,"percent of total billed charges","82.6% of total billed charges",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",555.07,82.6,,444.06,,,0,"percent of total billed charges","82.6% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",5.5,763.26,
"INITIAL INHALER (MDI) TX",41294640,CDM,412,RC,94640,CPT,OUTPATIENT,,,672,436.8,,591.36,88,,473.09,,,0,"percent of total billed charges","88% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",380.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",423.36,63,,338.69,,,0,"percent of total billed charges","63% of total billed charges",102.82,15.3,,82.26,,,0,"percent of total billed charges","15.3% of total billed charges",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",463.68,69,,,,,0,"fee schedule","69% of total billed charges",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",763.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.61,102,,,,,0,"fee schedule","102% of WA fee schedule",7.15,130,,,,,0,"fee schedule","130% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",253.34,37.7,,202.67,,,0,"percent of total billed charges","37.7% of total billed charges",253.34,37.7,,202.67,,,0,"percent of total billed charges","37.70% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",227.81,33.9,,182.25,,,0,"percent of total billed charges","33.9% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",524.16,78,,419.33,,,0,"percent of total billed charges","78% of total billed charges",219.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",555.07,82.6,,444.06,,,0,"percent of total billed charges","82.6% of total billed charges",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",555.07,82.6,,444.06,,,0,"percent of total billed charges","82.6% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",5.5,763.26,
"SMOKE/TOBAC COUNSEL 3-10M",94299406,CDM,942,RC,99406,CPT,OUTPATIENT,,,106,68.9,,93.28,88,,74.62,,,0,"percent of total billed charges","88% of total billed charges",29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",21.69,100,,,,,0,"fee schedule",EAPG,106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",51.21,175,,,,,0,"fee schedule","175% of CMS fee schedule",22.34,100,,,,,0,"fee schedule",EAPG,29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.78,63,,53.42,,,0,"percent of total billed charges","63% of total billed charges",16.22,15.3,,12.98,,,0,"percent of total billed charges","15.3% of total billed charges",21.69,100,,,,,0,"fee schedule",EAPG,73.14,69,,,,,0,"fee schedule","69% of total billed charges",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",29.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",21.69,100,,,,,0,"fee schedule",EAPG,29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",27.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22.13,100,,,,,0,"fee schedule",EAPG,28.2,100,,,,,0,"fee schedule",EAPG,29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.96,37.7,,31.97,,,0,"percent of total billed charges","37.7% of total billed charges",39.96,37.7,,31.97,,,0,"percent of total billed charges","37.70% of total billed charges",29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",82.68,78,,66.14,,,0,"percent of total billed charges","78% of total billed charges",29.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",87.56,82.6,,70.05,,,0,"percent of total billed charges","82.6% of total billed charges",21.69,100,,,,,0,"fee schedule","100% of WA fee schedule",29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",87.56,82.6,,70.05,,,0,"percent of total billed charges","82.6% of total billed charges",29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",21.69,100,,,,,0,"fee schedule",EAPG,106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",16.22,106.54,
"VENTILATOR MGMT EA SUB DAY",41094003,CDM,410,RC,94003,CPT,OUTPATIENT,,,2340,1521,,2059.2,88,,1647.36,,,0,"percent of total billed charges","88% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579.9,100,,,,,0,"fee schedule",EAPG,2340,100,,1872.00,,,0,"percent of total billed charges","100% of total billed charges",1118.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",597.3,100,,,,,0,"fee schedule",EAPG,639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1474.2,63,,1179.36,,,0,"percent of total billed charges","63% of total billed charges",358.02,15.3,,286.42,,,0,"percent of total billed charges","15.3% of total billed charges",579.9,100,,,,,0,"fee schedule",EAPG,1614.6,69,,,,,0,"fee schedule","69% of total billed charges",2340,100,,1872.00,,,0,"percent of total billed charges","100% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2340,100,,1872.00,,,0,"percent of total billed charges","100% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2340,100,,1872.00,,,0,"percent of total billed charges","100% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",1971.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579.9,100,,,,,0,"fee schedule",EAPG,639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",515.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",429.56,100,,,,,0,"fee schedule",EAPG,639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591.5,100,,,,,0,"fee schedule",EAPG,753.87,100,,,,,0,"fee schedule",EAPG,639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",882.18,37.7,,705.74,,,0,"percent of total billed charges","37.7% of total billed charges",882.18,37.7,,705.74,,,0,"percent of total billed charges","37.70% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",793.26,33.9,,634.61,,,0,"percent of total billed charges","33.9% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1825.2,78,,1460.16,,,0,"percent of total billed charges","78% of total billed charges",645.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1932.84,82.6,,1546.27,,,0,"percent of total billed charges","82.6% of total billed charges",579.9,100,,,,,0,"fee schedule","100% of WA fee schedule",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1932.84,82.6,,1546.27,,,0,"percent of total billed charges","82.6% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579.9,100,,,,,0,"fee schedule",EAPG,2340,100,,1872.00,,,0,"percent of total billed charges","100% of total billed charges",358.02,2340,
"OXYGEN DAILY",27200001,CDM,272,RC,,,OUTPATIENT,,,985,640.25,,866.8,88,,693.44,,,0,"percent of total billed charges","88% of total billed charges",492.5,50,,394.00,,,0,"percent of total billed charges","50% of total billed charges",165.48,16.8,,132.38,,,0,"percent of total billed charges","16.8% of total billed charges",985,100,,788.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.44,17.304,,136.35,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",620.55,63,,496.44,,,0,"percent of total billed charges","63% of total billed charges",150.71,15.3,,120.57,,,0,"percent of total billed charges","15.3% of total billed charges",165.48,16.8,,132.38,,,0,"percent of total billed charges","16.8% of total billed charges",679.65,69,,,,,0,"fee schedule","69% of total billed charges",985,100,,788.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",985,100,,788.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",985,100,,788.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",609.22,61.85,,487.38,,,0,"percent of total billed charges","61.5% of total billed charges",165.48,16.8,,132.38,,,0,"percent of total billed charges","16.8% of total billed charges",492.5,50,,394.00,,,0,"percent of total billed charges","50% of total billed charges",317.17,32.2,,253.74,,,0,"percent of total billed charges","32.2% of total billed charges",165.48,16.8,,132.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.79,17.136,,135.03,,,0,"percent of total billed charges","17.136% of total billed charges",215.12,21.84,,172.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",371.35,37.7,,297.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",768.3,78,,614.64,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",813.61,82.6,,650.89,,,0,"percent of total billed charges","82.6% of total billed charges",165.48,16.8,,132.38,,,0,"percent of total billed charges","16.8% of total billed charges",492.5,50,,394.00,,,0,"percent of total billed charges","50% of total billed charges",813.61,82.6,,650.89,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.48,16.8,,132.38,,,0,"percent of total billed charges","16.8% of total billed charges",985,100,,788.00,,,0,"percent of total billed charges","100% of total billed charges",150.71,985,
"UROGRAPHY ANTEGRADE",84074425,CDM,320,RC,74425,CPT,OUTPATIENT,,,3117,2026.05,,2742.96,88,,2194.37,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,3117,100,,2493.60,,,0,"percent of total billed charges","100% of total billed charges",686.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1963.71,63,,1570.97,,,0,"percent of total billed charges","63% of total billed charges",476.9,15.3,,381.52,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,2150.73,69,,,,,0,"fee schedule","69% of total billed charges",3117,100,,2493.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3117,100,,2493.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3117,100,,2493.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1175.11,37.7,,940.09,,,0,"percent of total billed charges","37.7% of total billed charges",1175.11,37.7,,940.09,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056.66,33.9,,845.33,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2431.26,78,,1945.01,,,0,"percent of total billed charges","78% of total billed charges",396.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2574.64,82.6,,2059.71,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2574.64,82.6,,2059.71,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,3117,100,,2493.60,,,0,"percent of total billed charges","100% of total billed charges",80.56,3117,
"CYSTOGRAM MIN 3V",84074430,CDM,360,RC,74430,CPT,OUTPATIENT,,,1138,739.7,,1001.44,88,,801.15,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1138,100,,910.40,,,0,"percent of total billed charges","100% of total billed charges",686.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",716.94,63,,573.55,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,785.22,69,,,,,0,"fee schedule","69% of total billed charges",1138,100,,910.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1138,100,,910.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1138,100,,910.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",429.03,37.7,,343.22,,,0,"percent of total billed charges","37.7% of total billed charges",429.03,37.7,,343.22,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",385.78,33.9,,308.62,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",887.64,78,,710.11,,,0,"percent of total billed charges","78% of total billed charges",396.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",939.99,82.6,,751.99,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",939.99,82.6,,751.99,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1138,100,,910.40,,,0,"percent of total billed charges","100% of total billed charges",80.56,3367,
"CT ANGIO ABDOMINAL ARTERIES",84075635,CDM,360,RC,75635,CPT,OUTPATIENT,,,8438,5484.7,,7425.44,88,,5940.35,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.95,175,,,,,0,"fee schedule","175% of CMS fee schedule",359.04,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5315.94,63,,4252.75,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",348.58,100,,,,,0,"fee schedule",EAPG,5822.22,69,,,,,0,"fee schedule","69% of total billed charges",8438,100,,6750.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8438,100,,6750.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8438,100,,6750.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",258.21,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.55,100,,,,,0,"fee schedule",EAPG,453.15,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3181.13,37.7,,2544.90,,,0,"percent of total billed charges","37.7% of total billed charges",3181.13,37.7,,2544.90,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2860.48,33.9,,2288.38,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6581.64,78,,5265.31,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6969.79,82.6,,5575.83,,,0,"percent of total billed charges","82.6% of total billed charges",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6969.79,82.6,,5575.83,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,8438,100,,6750.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,8438,
"ANGIO EXTREMITY UNILATERAL",84075710,CDM,323,RC,75710,CPT,OUTPATIENT,,,10983,7138.95,,9665.04,88,,7732.03,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5689.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",1694.66,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6919.29,63,,5535.43,,,0,"percent of total billed charges","63% of total billed charges",1680.4,15.3,,1344.32,,,0,"percent of total billed charges","15.3% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,7578.27,69,,,,,0,"fee schedule","69% of total billed charges",10983,100,,8786.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10983,100,,8786.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10983,100,,8786.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1218.74,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1678.2,100,,,,,0,"fee schedule",EAPG,2138.89,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4140.59,37.7,,3312.47,,,0,"percent of total billed charges","37.7% of total billed charges",4140.59,37.7,,3312.47,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3723.24,33.9,,2978.59,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8566.74,78,,6853.39,,,0,"percent of total billed charges","78% of total billed charges",3283.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9071.96,82.6,,7257.57,,,0,"percent of total billed charges","82.6% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9071.96,82.6,,7257.57,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,10983,100,,8786.40,,,0,"percent of total billed charges","100% of total billed charges",1218.74,11625.58,
"VENOGRAPHY EXTREMITY UNILAT",84075820,CDM,320,RC,75820,CPT,OUTPATIENT,,,3549,2306.85,,3123.12,88,,2498.50,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.06,100,,,,,0,"fee schedule",EAPG,3549,100,,2839.20,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",781.83,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2235.87,63,,1788.70,,,0,"percent of total billed charges","63% of total billed charges",543,15.3,,434.40,,,0,"percent of total billed charges","15.3% of total billed charges",759.06,100,,,,,0,"fee schedule",EAPG,2448.81,69,,,,,0,"fee schedule","69% of total billed charges",3549,100,,2839.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3549,100,,2839.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3549,100,,2839.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.06,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",562.26,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",774.24,100,,,,,0,"fee schedule",EAPG,986.78,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1337.97,37.7,,1070.38,,,0,"percent of total billed charges","37.7% of total billed charges",1337.97,37.7,,1070.38,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1203.11,33.9,,962.49,,,0,"percent of total billed charges","33.9% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2768.22,78,,2214.58,,,0,"percent of total billed charges","78% of total billed charges",1649.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2931.47,82.6,,2345.18,,,0,"percent of total billed charges","82.6% of total billed charges",759.06,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2931.47,82.6,,2345.18,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.06,100,,,,,0,"fee schedule",EAPG,3549,100,,2839.20,,,0,"percent of total billed charges","100% of total billed charges",543,5712.48,
"ANGIO THRU EXIST CATH FOR F/U",84075898,CDM,323,RC,75898,CPT,OUTPATIENT,,,3261,2119.65,,2869.68,88,,2295.74,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.06,100,,,,,0,"fee schedule",EAPG,3261,100,,2608.80,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",781.83,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054.43,63,,1643.54,,,0,"percent of total billed charges","63% of total billed charges",498.93,15.3,,399.14,,,0,"percent of total billed charges","15.3% of total billed charges",759.06,100,,,,,0,"fee schedule",EAPG,2250.09,69,,,,,0,"fee schedule","69% of total billed charges",3261,100,,2608.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3261,100,,2608.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3261,100,,2608.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.06,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",562.26,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",774.24,100,,,,,0,"fee schedule",EAPG,986.78,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1229.4,37.7,,983.52,,,0,"percent of total billed charges","37.7% of total billed charges",1229.4,37.7,,983.52,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1105.48,33.9,,884.38,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2543.58,78,,2034.86,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2693.59,82.6,,2154.87,,,0,"percent of total billed charges","82.6% of total billed charges",759.06,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2693.59,82.6,,2154.87,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.06,100,,,,,0,"fee schedule",EAPG,3261,100,,2608.80,,,0,"percent of total billed charges","100% of total billed charges",498.93,11625.57,
"ENDOVASC REPR AORTIC ANEUR and or Iliac Artery",84034705,CDM,320,RC,34705,CPT,OUTPATIENT,,,959,623.35,,843.92,88,,675.14,,,0,"percent of total billed charges","88% of total billed charges",959,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",16110.1,100,,,,,0,"fee schedule",EAPG,959,100,,767.20,,,0,"percent of total billed charges","100% of total billed charges",959,175,,,,,0,"fee schedule","175% of CMS fee schedule",16593.41,100,,,,,0,"fee schedule",EAPG,959,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",604.17,63,,483.34,,,0,"percent of total billed charges","63% of total billed charges",146.73,15.3,,117.38,,,0,"percent of total billed charges","15.3% of total billed charges",16110.1,100,,,,,0,"fee schedule",EAPG,661.71,69,,,,,0,"fee schedule","69% of total billed charges",959,100,,767.20,,,0,"percent of total billed charges","100% of total billed charges",959,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",959,100,,767.20,,,0,"percent of total billed charges","100% of total billed charges",959,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",959,100,,767.20,,,0,"percent of total billed charges","100% of total billed charges",959,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",959,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",16110.1,100,,,,,0,"fee schedule",EAPG,959,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",959,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11933.41,100,,,,,0,"fee schedule",EAPG,959,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",16432.31,100,,,,,0,"fee schedule",EAPG,20943.14,100,,,,,0,"fee schedule",EAPG,959,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",361.54,37.7,,289.23,,,0,"percent of total billed charges","37.7% of total billed charges",361.54,37.7,,289.23,,,0,"percent of total billed charges","37.70% of total billed charges",959,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",325.1,33.9,,260.08,,,0,"percent of total billed charges","33.9% of total billed charges",959,100,,,,,0,"fee schedule","100% of CMS fee schedule",748.02,78,,598.42,,,0,"percent of total billed charges","78% of total billed charges",959,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",792.13,82.6,,633.70,,,0,"percent of total billed charges","82.6% of total billed charges",16110.1,100,,,,,0,"fee schedule","100% of WA fee schedule",959,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",792.13,82.6,,633.70,,,0,"percent of total billed charges","82.6% of total billed charges",959,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",16110.1,100,,,,,0,"fee schedule",EAPG,959,100,,767.20,,,0,"percent of total billed charges","100% of total billed charges",146.73,20943.14,
"Endovascular repair of iliac artery by deployment of an ilio",84034707,CDM,320,RC,34707,CPT,OUTPATIENT,,,290,188.5,,255.2,88,,204.16,,,0,"percent of total billed charges","88% of total billed charges",290,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",16110.1,100,,,,,0,"fee schedule",EAPG,290,100,,232.00,,,0,"percent of total billed charges","100% of total billed charges",290,175,,,,,0,"fee schedule","175% of CMS fee schedule",16593.41,100,,,,,0,"fee schedule",EAPG,290,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",182.7,63,,146.16,,,0,"percent of total billed charges","63% of total billed charges",44.37,15.3,,35.50,,,0,"percent of total billed charges","15.3% of total billed charges",16110.1,100,,,,,0,"fee schedule",EAPG,200.1,69,,,,,0,"fee schedule","69% of total billed charges",290,100,,232.00,,,0,"percent of total billed charges","100% of total billed charges",290,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",290,100,,232.00,,,0,"percent of total billed charges","100% of total billed charges",290,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",290,100,,232.00,,,0,"percent of total billed charges","100% of total billed charges",290,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",290,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",16110.1,100,,,,,0,"fee schedule",EAPG,290,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",290,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11933.41,100,,,,,0,"fee schedule",EAPG,290,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",16432.31,100,,,,,0,"fee schedule",EAPG,20943.14,100,,,,,0,"fee schedule",EAPG,290,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",109.33,37.7,,87.46,,,0,"percent of total billed charges","37.7% of total billed charges",109.33,37.7,,87.46,,,0,"percent of total billed charges","37.70% of total billed charges",290,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",98.31,33.9,,78.65,,,0,"percent of total billed charges","33.9% of total billed charges",290,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.2,78,,180.96,,,0,"percent of total billed charges","78% of total billed charges",290,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",239.54,82.6,,191.63,,,0,"percent of total billed charges","82.6% of total billed charges",16110.1,100,,,,,0,"fee schedule","100% of WA fee schedule",290,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",239.54,82.6,,191.63,,,0,"percent of total billed charges","82.6% of total billed charges",290,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",16110.1,100,,,,,0,"fee schedule",EAPG,290,100,,232.00,,,0,"percent of total billed charges","100% of total billed charges",44.37,20943.14,
"CHNG PERC HEP CATH SI",84075984,CDM,320,RC,75984,CPT,OUTPATIENT,,,1695,1101.75,,1491.6,88,,1193.28,,,0,"percent of total billed charges","88% of total billed charges",847.5,50,,678.00,,,0,"percent of total billed charges","50% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,1695,100,,1356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1067.85,63,,854.28,,,0,"percent of total billed charges","63% of total billed charges",259.34,15.3,,207.47,,,0,"percent of total billed charges","15.3% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,1169.55,69,,,,,0,"fee schedule","69% of total billed charges",1695,100,,1356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1695,100,,1356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1695,100,,1356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1048.36,61.85,,838.69,,,0,"percent of total billed charges","61.5% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,847.5,50,,678.00,,,0,"percent of total billed charges","50% of total billed charges",545.79,32.2,,436.63,,,0,"percent of total billed charges","32.2% of total billed charges",119.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",165.21,100,,,,,0,"fee schedule",EAPG,210.57,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",639.02,37.7,,511.22,,,0,"percent of total billed charges","37.7% of total billed charges",639.02,37.7,,511.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",574.61,33.9,,459.69,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1322.1,78,,1057.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1400.07,82.6,,1120.06,,,0,"percent of total billed charges","82.6% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,847.5,50,,678.00,,,0,"percent of total billed charges","50% of total billed charges",1400.07,82.6,,1120.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",161.97,100,,,,,0,"fee schedule",EAPG,1695,100,,1356.00,,,0,"percent of total billed charges","100% of total billed charges",119.98,1695,
"RADIO GUIDANCE PERCU DRAINAGE",84075989,CDM,320,RC,75989,CPT,OUTPATIENT,,,1888,1227.2,,1661.44,88,,1329.15,,,0,"percent of total billed charges","88% of total billed charges",944,50,,755.20,,,0,"percent of total billed charges","50% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,1888,100,,1510.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1189.44,63,,951.55,,,0,"percent of total billed charges","63% of total billed charges",288.86,15.3,,231.09,,,0,"percent of total billed charges","15.3% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,1302.72,69,,,,,0,"fee schedule","69% of total billed charges",1888,100,,1510.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1888,100,,1510.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1888,100,,1510.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1167.73,61.85,,934.18,,,0,"percent of total billed charges","61.5% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,944,50,,755.20,,,0,"percent of total billed charges","50% of total billed charges",607.94,32.2,,486.35,,,0,"percent of total billed charges","32.2% of total billed charges",119.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",165.21,100,,,,,0,"fee schedule",EAPG,210.57,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",711.78,37.7,,569.42,,,0,"percent of total billed charges","37.7% of total billed charges",711.78,37.7,,569.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",640.03,33.9,,512.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1472.64,78,,1178.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1559.49,82.6,,1247.59,,,0,"percent of total billed charges","82.6% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,944,50,,755.20,,,0,"percent of total billed charges","50% of total billed charges",1559.49,82.6,,1247.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",161.97,100,,,,,0,"fee schedule",EAPG,1888,100,,1510.40,,,0,"percent of total billed charges","100% of total billed charges",119.98,1888,
"FLUORO W/O FILM",84076000,CDM,320,RC,76000,CPT,OUTPATIENT,,,1765,1147.25,,1553.2,88,,1242.56,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1765,100,,1412.00,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1111.95,63,,889.56,,,0,"percent of total billed charges","63% of total billed charges",270.05,15.3,,216.04,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,1217.85,69,,,,,0,"fee schedule","69% of total billed charges",1765,100,,1412.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1765,100,,1412.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1765,100,,1412.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.41,37.7,,532.33,,,0,"percent of total billed charges","37.7% of total billed charges",665.41,37.7,,532.33,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",598.34,33.9,,478.67,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1376.7,78,,1101.36,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1457.89,82.6,,1166.31,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1457.89,82.6,,1166.31,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1765,100,,1412.00,,,0,"percent of total billed charges","100% of total billed charges",80.56,1765,
"RADIOL EXAM ABCESS/FISTU/SINUS",84076080,CDM,320,RC,76080,CPT,OUTPATIENT,,,1960,1274,,1724.8,88,,1379.84,,,0,"percent of total billed charges","88% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1960,100,,1568.00,,,0,"percent of total billed charges","100% of total billed charges",984.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1234.8,63,,987.84,,,0,"percent of total billed charges","63% of total billed charges",299.88,15.3,,239.90,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,1352.4,69,,,,,0,"fee schedule","69% of total billed charges",1960,100,,1568.00,,,0,"percent of total billed charges","100% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1960,100,,1568.00,,,0,"percent of total billed charges","100% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1960,100,,1568.00,,,0,"percent of total billed charges","100% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",1961.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",738.92,37.7,,591.14,,,0,"percent of total billed charges","37.7% of total billed charges",738.92,37.7,,591.14,,,0,"percent of total billed charges","37.70% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",664.44,33.9,,531.55,,,0,"percent of total billed charges","33.9% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1528.8,78,,1223.04,,,0,"percent of total billed charges","78% of total billed charges",568.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1618.96,82.6,,1295.17,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1618.96,82.6,,1295.17,,,0,"percent of total billed charges","82.6% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1960,100,,1568.00,,,0,"percent of total billed charges","100% of total billed charges",80.56,1961.75,
"ULS VASCULAR ACCCESS",84076937,CDM,402,RC,76937,CPT,OUTPATIENT,,,1386,900.9,TC,1219.68,88,,975.74,,,0,"percent of total billed charges","88% of total billed charges",693,50,,554.40,,,0,"percent of total billed charges","50% of total billed charges",101.95,100,,,,,0,"fee schedule",EAPG,1386,100,,1108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.01,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",873.18,63,,698.54,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",101.95,100,,,,,0,"fee schedule",EAPG,956.34,69,,,,,0,"fee schedule","69% of total billed charges",1386,100,,1108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1386,100,,1108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1386,100,,1108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",857.24,61.85,,685.79,,,0,"percent of total billed charges","61.5% of total billed charges",101.95,100,,,,,0,"fee schedule",EAPG,693,50,,554.40,,,0,"percent of total billed charges","50% of total billed charges",446.29,32.2,,357.03,,,0,"percent of total billed charges","32.2% of total billed charges",75.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",103.99,100,,,,,0,"fee schedule",EAPG,132.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",522.52,37.7,,418.02,,,0,"percent of total billed charges","37.7% of total billed charges",522.52,37.7,,418.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",469.85,33.9,,375.88,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1081.08,78,,864.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1144.84,82.6,,915.87,,,0,"percent of total billed charges","82.6% of total billed charges",101.95,100,,,,,0,"fee schedule",EAPG,693,50,,554.40,,,0,"percent of total billed charges","50% of total billed charges",1144.84,82.6,,915.87,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.95,100,,,,,0,"fee schedule",EAPG,1386,100,,1108.80,,,0,"percent of total billed charges","100% of total billed charges",75.52,1386,
"FLOURO CENTRAL VENUOUS ACCESS",84077001,CDM,320,RC,77001,CPT,OUTPATIENT,,,1418,921.7,,1247.84,88,,998.27,,,0,"percent of total billed charges","88% of total billed charges",709,50,,567.20,,,0,"percent of total billed charges","50% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,1418,100,,1134.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",893.34,63,,714.67,,,0,"percent of total billed charges","63% of total billed charges",216.95,15.3,,173.56,,,0,"percent of total billed charges","15.3% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,978.42,69,,,,,0,"fee schedule","69% of total billed charges",1418,100,,1134.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1418,100,,1134.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1418,100,,1134.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",877.03,61.85,,701.62,,,0,"percent of total billed charges","61.5% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,709,50,,567.20,,,0,"percent of total billed charges","50% of total billed charges",456.6,32.2,,365.28,,,0,"percent of total billed charges","32.2% of total billed charges",119.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",165.21,100,,,,,0,"fee schedule",EAPG,210.57,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",534.59,37.7,,427.67,,,0,"percent of total billed charges","37.7% of total billed charges",534.59,37.7,,427.67,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",480.7,33.9,,384.56,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.04,78,,884.83,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1171.27,82.6,,937.02,,,0,"percent of total billed charges","82.6% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,709,50,,567.20,,,0,"percent of total billed charges","50% of total billed charges",1171.27,82.6,,937.02,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",161.97,100,,,,,0,"fee schedule",EAPG,1418,100,,1134.40,,,0,"percent of total billed charges","100% of total billed charges",119.98,1418,
"THYROID UPTAKE MEASUREMENT",84078012,CDM,360,RC,78012,CPT,OUTPATIENT,,,1378,895.7,,1212.64,88,,970.11,,,0,"percent of total billed charges","88% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,1378,100,,1102.40,,,0,"percent of total billed charges","100% of total billed charges",736.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",356.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.14,63,,694.51,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,950.82,69,,,,,0,"fee schedule","69% of total billed charges",1378,100,,1102.40,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1378,100,,1102.40,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1378,100,,1102.40,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1532.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352.65,100,,,,,0,"fee schedule",EAPG,449.45,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",519.51,37.7,,415.61,,,0,"percent of total billed charges","37.7% of total billed charges",519.51,37.7,,415.61,,,0,"percent of total billed charges","37.70% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",467.14,33.9,,373.71,,,0,"percent of total billed charges","33.9% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1074.84,78,,859.87,,,0,"percent of total billed charges","78% of total billed charges",424.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1138.23,82.6,,910.58,,,0,"percent of total billed charges","82.6% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1138.23,82.6,,910.58,,,0,"percent of total billed charges","82.6% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,1378,100,,1102.40,,,0,"percent of total billed charges","100% of total billed charges",256.1,3367,
"ULS VASCULAR ACCCESS",40276937,CDM,402,RC,76937,CPT,OUTPATIENT,,,1386,900.9,TC,1219.68,88,,975.74,,,0,"percent of total billed charges","88% of total billed charges",693,50,,554.40,,,0,"percent of total billed charges","50% of total billed charges",101.95,100,,,,,0,"fee schedule",EAPG,1386,100,,1108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.01,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",873.18,63,,698.54,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",101.95,100,,,,,0,"fee schedule",EAPG,956.34,69,,,,,0,"fee schedule","69% of total billed charges",1386,100,,1108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1386,100,,1108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1386,100,,1108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",857.24,61.85,,685.79,,,0,"percent of total billed charges","61.5% of total billed charges",101.95,100,,,,,0,"fee schedule",EAPG,693,50,,554.40,,,0,"percent of total billed charges","50% of total billed charges",446.29,32.2,,357.03,,,0,"percent of total billed charges","32.2% of total billed charges",75.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",103.99,100,,,,,0,"fee schedule",EAPG,132.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",522.52,37.7,,418.02,,,0,"percent of total billed charges","37.7% of total billed charges",522.52,37.7,,418.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",469.85,33.9,,375.88,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1081.08,78,,864.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1144.84,82.6,,915.87,,,0,"percent of total billed charges","82.6% of total billed charges",101.95,100,,,,,0,"fee schedule",EAPG,693,50,,554.40,,,0,"percent of total billed charges","50% of total billed charges",1144.84,82.6,,915.87,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.95,100,,,,,0,"fee schedule",EAPG,1386,100,,1108.80,,,0,"percent of total billed charges","100% of total billed charges",75.52,1386,
"NM IN-111 PENTETREOTIDE T",343A9572,CDM,343,RC,,,OUTPATIENT,,,5594,3636.1,TC,4922.72,88,,3938.18,,,0,"percent of total billed charges","88% of total billed charges",2797,50,,2237.60,,,0,"percent of total billed charges","50% of total billed charges",939.79,16.8,,751.83,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",967.99,17.304,,774.39,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3524.22,63,,2819.38,,,0,"percent of total billed charges","63% of total billed charges",855.88,15.3,,684.70,,,0,"percent of total billed charges","15.3% of total billed charges",939.79,16.8,,751.83,,,0,"percent of total billed charges","16.8% of total billed charges",3859.86,69,,,,,0,"fee schedule","69% of total billed charges",5594,100,,4475.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5594,100,,4475.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5594,100,,4475.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3459.89,61.85,,2767.91,,,0,"percent of total billed charges","61.5% of total billed charges",939.79,16.8,,751.83,,,0,"percent of total billed charges","16.8% of total billed charges",2797,50,,2237.60,,,0,"percent of total billed charges","50% of total billed charges",1801.27,32.2,,1441.02,,,0,"percent of total billed charges","32.2% of total billed charges",939.79,16.8,,751.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",958.59,17.136,,766.87,,,0,"percent of total billed charges","17.136% of total billed charges",1221.73,21.84,,977.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2108.94,37.7,,1687.15,,,0,"percent of total billed charges","37.7% of total billed charges",2108.94,37.7,,1687.15,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1896.37,33.9,,1517.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4363.32,78,,3490.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.79,16.8,,751.83,,,0,"percent of total billed charges","16.8% of total billed charges",2797,50,,2237.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.79,16.8,,751.83,,,0,"percent of total billed charges","16.8% of total billed charges",5594,100,,4475.20,,,0,"percent of total billed charges","100% of total billed charges",855.88,5594,
"NM PERTECHNETATE  PER MCI",343A9512,CDM,343,RC,,,OUTPATIENT,,,275,178.75,TC,242,88,,193.60,,,0,"percent of total billed charges","88% of total billed charges",137.5,50,,110.00,,,0,"percent of total billed charges","50% of total billed charges",46.2,16.8,,36.96,,,0,"percent of total billed charges","16.8% of total billed charges",275,100,,220.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.59,17.304,,38.07,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.25,63,,138.60,,,0,"percent of total billed charges","63% of total billed charges",42.08,15.3,,33.66,,,0,"percent of total billed charges","15.3% of total billed charges",46.2,16.8,,36.96,,,0,"percent of total billed charges","16.8% of total billed charges",189.75,69,,,,,0,"fee schedule","69% of total billed charges",275,100,,220.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",275,100,,220.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",275,100,,220.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.09,61.85,,136.07,,,0,"percent of total billed charges","61.5% of total billed charges",46.2,16.8,,36.96,,,0,"percent of total billed charges","16.8% of total billed charges",137.5,50,,110.00,,,0,"percent of total billed charges","50% of total billed charges",88.55,32.2,,70.84,,,0,"percent of total billed charges","32.2% of total billed charges",46.2,16.8,,36.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.12,17.136,,37.70,,,0,"percent of total billed charges","17.136% of total billed charges",60.06,21.84,,48.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.68,37.7,,82.94,,,0,"percent of total billed charges","37.7% of total billed charges",103.68,37.7,,82.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",93.23,33.9,,74.58,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",214.5,78,,171.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.2,16.8,,36.96,,,0,"percent of total billed charges","16.8% of total billed charges",137.5,50,,110.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.2,16.8,,36.96,,,0,"percent of total billed charges","16.8% of total billed charges",275,100,,220.00,,,0,"percent of total billed charges","100% of total billed charges",42.08,275,
"I-123 PER 100 UCI",343A9516,CDM,343,RC,,,OUTPATIENT,,,594,386.1,,522.72,88,,418.18,,,0,"percent of total billed charges","88% of total billed charges",297,50,,237.60,,,0,"percent of total billed charges","50% of total billed charges",99.79,16.8,,79.83,,,0,"percent of total billed charges","16.8% of total billed charges",594,100,,475.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",102.79,17.304,,82.23,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",374.22,63,,299.38,,,0,"percent of total billed charges","63% of total billed charges",90.88,15.3,,72.70,,,0,"percent of total billed charges","15.3% of total billed charges",99.79,16.8,,79.83,,,0,"percent of total billed charges","16.8% of total billed charges",409.86,69,,,,,0,"fee schedule","69% of total billed charges",594,100,,475.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",594,100,,475.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",594,100,,475.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",367.39,61.85,,293.91,,,0,"percent of total billed charges","61.5% of total billed charges",99.79,16.8,,79.83,,,0,"percent of total billed charges","16.8% of total billed charges",297,50,,237.60,,,0,"percent of total billed charges","50% of total billed charges",191.27,32.2,,153.02,,,0,"percent of total billed charges","32.2% of total billed charges",99.79,16.8,,79.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.79,17.136,,81.43,,,0,"percent of total billed charges","17.136% of total billed charges",129.73,21.84,,103.78,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.94,37.7,,179.15,,,0,"percent of total billed charges","37.7% of total billed charges",223.94,37.7,,179.15,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",201.37,33.9,,161.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.32,78,,370.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",99.79,16.8,,79.83,,,0,"percent of total billed charges","16.8% of total billed charges",297,50,,237.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",99.79,16.8,,79.83,,,0,"percent of total billed charges","16.8% of total billed charges",594,100,,475.20,,,0,"percent of total billed charges","100% of total billed charges",90.88,594,
"I-131 DIAGNOSTIC PER 5 MC",344A9528,CDM,344,RC,,,OUTPATIENT,,,219,142.35,TC,192.72,88,,154.18,,,0,"percent of total billed charges","88% of total billed charges",109.5,50,,87.60,,,0,"percent of total billed charges","50% of total billed charges",36.79,16.8,,29.43,,,0,"percent of total billed charges","16.8% of total billed charges",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.9,17.304,,30.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.97,63,,110.38,,,0,"percent of total billed charges","63% of total billed charges",33.51,15.3,,26.81,,,0,"percent of total billed charges","15.3% of total billed charges",36.79,16.8,,29.43,,,0,"percent of total billed charges","16.8% of total billed charges",151.11,69,,,,,0,"fee schedule","69% of total billed charges",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",135.45,61.85,,108.36,,,0,"percent of total billed charges","61.5% of total billed charges",36.79,16.8,,29.43,,,0,"percent of total billed charges","16.8% of total billed charges",109.5,50,,87.60,,,0,"percent of total billed charges","50% of total billed charges",70.52,32.2,,56.42,,,0,"percent of total billed charges","32.2% of total billed charges",36.79,16.8,,29.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.53,17.136,,30.02,,,0,"percent of total billed charges","17.136% of total billed charges",47.83,21.84,,38.26,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.56,37.7,,66.05,,,0,"percent of total billed charges","37.7% of total billed charges",82.56,37.7,,66.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.24,33.9,,59.39,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.82,78,,136.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.79,16.8,,29.43,,,0,"percent of total billed charges","16.8% of total billed charges",109.5,50,,87.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.79,16.8,,29.43,,,0,"percent of total billed charges","16.8% of total billed charges",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",33.51,219,
"I131 PER 0.5 MCI",343A9508,CDM,343,RC,,,OUTPATIENT,,,15385,10000.25,TC,13538.8,88,,10831.04,,,0,"percent of total billed charges","88% of total billed charges",7692.5,50,,6154.00,,,0,"percent of total billed charges","50% of total billed charges",2584.68,16.8,,2067.74,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2662.22,17.304,,2129.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9692.55,63,,7754.04,,,0,"percent of total billed charges","63% of total billed charges",2353.91,15.3,,1883.13,,,0,"percent of total billed charges","15.3% of total billed charges",2584.68,16.8,,2067.74,,,0,"percent of total billed charges","16.8% of total billed charges",10615.65,69,,,,,0,"fee schedule","69% of total billed charges",15385,100,,12308.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15385,100,,12308.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15385,100,,12308.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9515.62,61.85,,7612.50,,,0,"percent of total billed charges","61.5% of total billed charges",2584.68,16.8,,2067.74,,,0,"percent of total billed charges","16.8% of total billed charges",7692.5,50,,6154.00,,,0,"percent of total billed charges","50% of total billed charges",4953.97,32.2,,3963.18,,,0,"percent of total billed charges","32.2% of total billed charges",2584.68,16.8,,2067.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2636.37,17.136,,2109.10,,,0,"percent of total billed charges","17.136% of total billed charges",3360.08,21.84,,2688.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",5800.15,37.7,,4640.12,,,0,"percent of total billed charges","37.7% of total billed charges",5800.15,37.7,,4640.12,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",5215.52,33.9,,4172.42,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",12000.3,78,,9600.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2584.68,16.8,,2067.74,,,0,"percent of total billed charges","16.8% of total billed charges",7692.5,50,,6154.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2584.68,16.8,,2067.74,,,0,"percent of total billed charges","16.8% of total billed charges",15385,100,,12308.00,,,0,"percent of total billed charges","100% of total billed charges",2353.91,15385,
"I131 SOD ID TX / MCI",344A9517,CDM,344,RC,,,OUTPATIENT,,,171,111.15,TC,150.48,88,,120.38,,,0,"percent of total billed charges","88% of total billed charges",85.5,50,,68.40,,,0,"percent of total billed charges","50% of total billed charges",28.73,16.8,,22.98,,,0,"percent of total billed charges","16.8% of total billed charges",171,100,,136.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.59,17.304,,23.67,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",107.73,63,,86.18,,,0,"percent of total billed charges","63% of total billed charges",26.16,15.3,,20.93,,,0,"percent of total billed charges","15.3% of total billed charges",28.73,16.8,,22.98,,,0,"percent of total billed charges","16.8% of total billed charges",117.99,69,,,,,0,"fee schedule","69% of total billed charges",171,100,,136.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",171,100,,136.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",171,100,,136.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.76,61.85,,84.61,,,0,"percent of total billed charges","61.5% of total billed charges",28.73,16.8,,22.98,,,0,"percent of total billed charges","16.8% of total billed charges",85.5,50,,68.40,,,0,"percent of total billed charges","50% of total billed charges",55.06,32.2,,44.05,,,0,"percent of total billed charges","32.2% of total billed charges",28.73,16.8,,22.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.3,17.136,,23.44,,,0,"percent of total billed charges","17.136% of total billed charges",37.35,21.84,,29.88,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.47,37.7,,51.58,,,0,"percent of total billed charges","37.7% of total billed charges",64.47,37.7,,51.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,33.9,,46.38,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",133.38,78,,106.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.73,16.8,,22.98,,,0,"percent of total billed charges","16.8% of total billed charges",85.5,50,,68.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.73,16.8,,22.98,,,0,"percent of total billed charges","16.8% of total billed charges",171,100,,136.80,,,0,"percent of total billed charges","100% of total billed charges",26.16,171,
"IN111 CAPRO PEND/DO",343A9507,CDM,343,RC,,,OUTPATIENT,,,22429,14578.85,TC,19737.52,88,,15790.02,,,0,"percent of total billed charges","88% of total billed charges",11214.5,50,,8971.60,,,0,"percent of total billed charges","50% of total billed charges",3768.07,16.8,,3014.46,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3881.11,17.304,,3104.89,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14130.27,63,,11304.22,,,0,"percent of total billed charges","63% of total billed charges",3431.64,15.3,,2745.31,,,0,"percent of total billed charges","15.3% of total billed charges",3768.07,16.8,,3014.46,,,0,"percent of total billed charges","16.8% of total billed charges",15476.01,69,,,,,0,"fee schedule","69% of total billed charges",22429,100,,17943.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22429,100,,17943.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22429,100,,17943.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13872.34,61.85,,11097.87,,,0,"percent of total billed charges","61.5% of total billed charges",3768.07,16.8,,3014.46,,,0,"percent of total billed charges","16.8% of total billed charges",11214.5,50,,8971.60,,,0,"percent of total billed charges","50% of total billed charges",7222.14,32.2,,5777.71,,,0,"percent of total billed charges","32.2% of total billed charges",3768.07,16.8,,3014.46,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3843.43,17.136,,3074.74,,,0,"percent of total billed charges","17.136% of total billed charges",4898.49,21.84,,3918.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",8455.73,37.7,,6764.58,,,0,"percent of total billed charges","37.7% of total billed charges",8455.73,37.7,,6764.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",7603.43,33.9,,6082.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",17494.62,78,,13995.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3768.07,16.8,,3014.46,,,0,"percent of total billed charges","16.8% of total billed charges",11214.5,50,,8971.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3768.07,16.8,,3014.46,,,0,"percent of total billed charges","16.8% of total billed charges",22429,100,,17943.20,,,0,"percent of total billed charges","100% of total billed charges",3431.64,22429,
"IN111 PENTETAT/.5MCI",343A9548,CDM,343,RC,,,OUTPATIENT,,,2406,1563.9,TC,2117.28,88,,1693.82,,,0,"percent of total billed charges","88% of total billed charges",1203,50,,962.40,,,0,"percent of total billed charges","50% of total billed charges",404.21,16.8,,323.37,,,0,"percent of total billed charges","16.8% of total billed charges",2406,100,,1924.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",416.33,17.304,,333.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1515.78,63,,1212.62,,,0,"percent of total billed charges","63% of total billed charges",368.12,15.3,,294.50,,,0,"percent of total billed charges","15.3% of total billed charges",404.21,16.8,,323.37,,,0,"percent of total billed charges","16.8% of total billed charges",1660.14,69,,,,,0,"fee schedule","69% of total billed charges",2406,100,,1924.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2406,100,,1924.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2406,100,,1924.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1488.11,61.85,,1190.49,,,0,"percent of total billed charges","61.5% of total billed charges",404.21,16.8,,323.37,,,0,"percent of total billed charges","16.8% of total billed charges",1203,50,,962.40,,,0,"percent of total billed charges","50% of total billed charges",774.73,32.2,,619.78,,,0,"percent of total billed charges","32.2% of total billed charges",404.21,16.8,,323.37,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.29,17.136,,329.83,,,0,"percent of total billed charges","17.136% of total billed charges",525.47,21.84,,420.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",907.06,37.7,,725.65,,,0,"percent of total billed charges","37.7% of total billed charges",907.06,37.7,,725.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",815.63,33.9,,652.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1876.68,78,,1501.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",404.21,16.8,,323.37,,,0,"percent of total billed charges","16.8% of total billed charges",1203,50,,962.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",404.21,16.8,,323.37,,,0,"percent of total billed charges","16.8% of total billed charges",2406,100,,1924.80,,,0,"percent of total billed charges","100% of total billed charges",368.12,2406,
"GA67 GALLIUM/MCI",343A9556,CDM,343,RC,,,OUTPATIENT,,,145,94.25,TC,127.6,88,,102.08,,,0,"percent of total billed charges","88% of total billed charges",72.5,50,,58.00,,,0,"percent of total billed charges","50% of total billed charges",24.36,16.8,,19.49,,,0,"percent of total billed charges","16.8% of total billed charges",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.09,17.304,,20.07,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.35,63,,73.08,,,0,"percent of total billed charges","63% of total billed charges",22.19,15.3,,17.75,,,0,"percent of total billed charges","15.3% of total billed charges",24.36,16.8,,19.49,,,0,"percent of total billed charges","16.8% of total billed charges",100.05,69,,,,,0,"fee schedule","69% of total billed charges",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.68,61.85,,71.74,,,0,"percent of total billed charges","61.5% of total billed charges",24.36,16.8,,19.49,,,0,"percent of total billed charges","16.8% of total billed charges",72.5,50,,58.00,,,0,"percent of total billed charges","50% of total billed charges",46.69,32.2,,37.35,,,0,"percent of total billed charges","32.2% of total billed charges",24.36,16.8,,19.49,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.85,17.136,,19.88,,,0,"percent of total billed charges","17.136% of total billed charges",31.67,21.84,,25.34,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",54.67,37.7,,43.74,,,0,"percent of total billed charges","37.7% of total billed charges",54.67,37.7,,43.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.16,33.9,,39.33,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.1,78,,90.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.36,16.8,,19.49,,,0,"percent of total billed charges","16.8% of total billed charges",72.5,50,,58.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.36,16.8,,19.49,,,0,"percent of total billed charges","16.8% of total billed charges",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",22.19,145,
"GALLIUM GA-67 10 MCI",343A9556,CDM,343,RC,,,OUTPATIENT,,,1507,979.55,TC,1326.16,88,,1060.93,,,0,"percent of total billed charges","88% of total billed charges",753.5,50,,602.80,,,0,"percent of total billed charges","50% of total billed charges",253.18,16.8,,202.54,,,0,"percent of total billed charges","16.8% of total billed charges",1507,100,,1205.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",260.77,17.304,,208.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",949.41,63,,759.53,,,0,"percent of total billed charges","63% of total billed charges",230.57,15.3,,184.46,,,0,"percent of total billed charges","15.3% of total billed charges",253.18,16.8,,202.54,,,0,"percent of total billed charges","16.8% of total billed charges",1039.83,69,,,,,0,"fee schedule","69% of total billed charges",1507,100,,1205.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1507,100,,1205.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1507,100,,1205.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",932.08,61.85,,745.66,,,0,"percent of total billed charges","61.5% of total billed charges",253.18,16.8,,202.54,,,0,"percent of total billed charges","16.8% of total billed charges",753.5,50,,602.80,,,0,"percent of total billed charges","50% of total billed charges",485.25,32.2,,388.20,,,0,"percent of total billed charges","32.2% of total billed charges",253.18,16.8,,202.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.24,17.136,,206.59,,,0,"percent of total billed charges","17.136% of total billed charges",329.13,21.84,,263.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",568.14,37.7,,454.51,,,0,"percent of total billed charges","37.7% of total billed charges",568.14,37.7,,454.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.87,33.9,,408.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1175.46,78,,940.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",253.18,16.8,,202.54,,,0,"percent of total billed charges","16.8% of total billed charges",753.5,50,,602.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",253.18,16.8,,202.54,,,0,"percent of total billed charges","16.8% of total billed charges",1507,100,,1205.60,,,0,"percent of total billed charges","100% of total billed charges",230.57,1507,
"GALLIUM GA-67 6 MCI",343A9556,CDM,343,RC,,,OUTPATIENT,,,753,489.45,TC,662.64,88,,530.11,,,0,"percent of total billed charges","88% of total billed charges",376.5,50,,301.20,,,0,"percent of total billed charges","50% of total billed charges",126.5,16.8,,101.20,,,0,"percent of total billed charges","16.8% of total billed charges",753,100,,602.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",130.3,17.304,,104.24,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",474.39,63,,379.51,,,0,"percent of total billed charges","63% of total billed charges",115.21,15.3,,92.17,,,0,"percent of total billed charges","15.3% of total billed charges",126.5,16.8,,101.20,,,0,"percent of total billed charges","16.8% of total billed charges",519.57,69,,,,,0,"fee schedule","69% of total billed charges",753,100,,602.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",753,100,,602.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",753,100,,602.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",465.73,61.85,,372.58,,,0,"percent of total billed charges","61.5% of total billed charges",126.5,16.8,,101.20,,,0,"percent of total billed charges","16.8% of total billed charges",376.5,50,,301.20,,,0,"percent of total billed charges","50% of total billed charges",242.47,32.2,,193.98,,,0,"percent of total billed charges","32.2% of total billed charges",126.5,16.8,,101.20,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.03,17.136,,103.22,,,0,"percent of total billed charges","17.136% of total billed charges",164.46,21.84,,131.57,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",283.88,37.7,,227.10,,,0,"percent of total billed charges","37.7% of total billed charges",283.88,37.7,,227.10,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.27,33.9,,204.22,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",587.34,78,,469.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.5,16.8,,101.20,,,0,"percent of total billed charges","16.8% of total billed charges",376.5,50,,301.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.5,16.8,,101.20,,,0,"percent of total billed charges","16.8% of total billed charges",753,100,,602.40,,,0,"percent of total billed charges","100% of total billed charges",115.21,753,
"US OB TO 14 WEEKS ADDL",40276802,CDM,402,RC,76802,CPT,OUTPATIENT,,,362,235.3,TC,318.56,88,,254.85,,,0,"percent of total billed charges","88% of total billed charges",181,50,,144.80,,,0,"percent of total billed charges","50% of total billed charges",91.6,100,,,,,0,"fee schedule",EAPG,362,100,,289.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",94.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",228.06,63,,182.45,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",91.6,100,,,,,0,"fee schedule",EAPG,249.78,69,,,,,0,"fee schedule","69% of total billed charges",362,100,,289.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",362,100,,289.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",362,100,,289.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.9,61.85,,179.12,,,0,"percent of total billed charges","61.5% of total billed charges",91.6,100,,,,,0,"fee schedule",EAPG,181,50,,144.80,,,0,"percent of total billed charges","50% of total billed charges",116.56,32.2,,93.25,,,0,"percent of total billed charges","32.2% of total billed charges",67.85,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",93.43,100,,,,,0,"fee schedule",EAPG,119.08,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",136.47,37.7,,109.18,,,0,"percent of total billed charges","37.7% of total billed charges",136.47,37.7,,109.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",122.72,33.9,,98.18,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",282.36,78,,225.89,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",299.01,82.6,,239.21,,,0,"percent of total billed charges","82.6% of total billed charges",91.6,100,,,,,0,"fee schedule",EAPG,181,50,,144.80,,,0,"percent of total billed charges","50% of total billed charges",299.01,82.6,,239.21,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.6,100,,,,,0,"fee schedule",EAPG,362,100,,289.60,,,0,"percent of total billed charges","100% of total billed charges",67.85,362,
"SODIUM PHOSPH P-32 PER MC",344A9563,CDM,344,RC,,,OUTPATIENT,,,949,616.85,TC,835.12,88,,668.10,,,0,"percent of total billed charges","88% of total billed charges",474.5,50,,379.60,,,0,"percent of total billed charges","50% of total billed charges",159.43,16.8,,127.54,,,0,"percent of total billed charges","16.8% of total billed charges",949,100,,759.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",164.21,17.304,,131.37,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",597.87,63,,478.30,,,0,"percent of total billed charges","63% of total billed charges",145.2,15.3,,116.16,,,0,"percent of total billed charges","15.3% of total billed charges",159.43,16.8,,127.54,,,0,"percent of total billed charges","16.8% of total billed charges",654.81,69,,,,,0,"fee schedule","69% of total billed charges",949,100,,759.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",949,100,,759.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",949,100,,759.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",586.96,61.85,,469.57,,,0,"percent of total billed charges","61.5% of total billed charges",159.43,16.8,,127.54,,,0,"percent of total billed charges","16.8% of total billed charges",474.5,50,,379.60,,,0,"percent of total billed charges","50% of total billed charges",305.58,32.2,,244.46,,,0,"percent of total billed charges","32.2% of total billed charges",159.43,16.8,,127.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.62,17.136,,130.10,,,0,"percent of total billed charges","17.136% of total billed charges",207.26,21.84,,165.81,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",357.77,37.7,,286.22,,,0,"percent of total billed charges","37.7% of total billed charges",357.77,37.7,,286.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",321.71,33.9,,257.37,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",740.22,78,,592.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",159.43,16.8,,127.54,,,0,"percent of total billed charges","16.8% of total billed charges",474.5,50,,379.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",159.43,16.8,,127.54,,,0,"percent of total billed charges","16.8% of total billed charges",949,100,,759.20,,,0,"percent of total billed charges","100% of total billed charges",145.2,949,
"SATUM PEND / DOSE",343A4642,CDM,343,RC,,,OUTPATIENT,,,7704,5007.6,TC,6779.52,88,,5423.62,,,0,"percent of total billed charges","88% of total billed charges",3852,50,,3081.60,,,0,"percent of total billed charges","50% of total billed charges",1294.27,16.8,,1035.42,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1333.1,17.304,,1066.48,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4853.52,63,,3882.82,,,0,"percent of total billed charges","63% of total billed charges",1178.71,15.3,,942.97,,,0,"percent of total billed charges","15.3% of total billed charges",1294.27,16.8,,1035.42,,,0,"percent of total billed charges","16.8% of total billed charges",5315.76,69,,,,,0,"fee schedule","69% of total billed charges",7704,100,,6163.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7704,100,,6163.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7704,100,,6163.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4764.92,61.85,,3811.94,,,0,"percent of total billed charges","61.5% of total billed charges",1294.27,16.8,,1035.42,,,0,"percent of total billed charges","16.8% of total billed charges",3852,50,,3081.60,,,0,"percent of total billed charges","50% of total billed charges",2480.69,32.2,,1984.55,,,0,"percent of total billed charges","32.2% of total billed charges",1294.27,16.8,,1035.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1320.16,17.136,,1056.13,,,0,"percent of total billed charges","17.136% of total billed charges",1682.55,21.84,,1346.04,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2904.41,37.7,,2323.53,,,0,"percent of total billed charges","37.7% of total billed charges",2904.41,37.7,,2323.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2611.66,33.9,,2089.33,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6009.12,78,,4807.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1294.27,16.8,,1035.42,,,0,"percent of total billed charges","16.8% of total billed charges",3852,50,,3081.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1294.27,16.8,,1035.42,,,0,"percent of total billed charges","16.8% of total billed charges",7704,100,,6163.20,,,0,"percent of total billed charges","100% of total billed charges",1178.71,7704,
"THALLIUM PER MILICURIE",343A9505,CDM,343,RC,,,OUTPATIENT,,,1254,815.1,TC,1103.52,88,,882.82,,,0,"percent of total billed charges","88% of total billed charges",627,50,,501.60,,,0,"percent of total billed charges","50% of total billed charges",210.67,16.8,,168.54,,,0,"percent of total billed charges","16.8% of total billed charges",1254,100,,1003.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",216.99,17.304,,173.59,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",790.02,63,,632.02,,,0,"percent of total billed charges","63% of total billed charges",191.86,15.3,,153.49,,,0,"percent of total billed charges","15.3% of total billed charges",210.67,16.8,,168.54,,,0,"percent of total billed charges","16.8% of total billed charges",865.26,69,,,,,0,"fee schedule","69% of total billed charges",1254,100,,1003.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1254,100,,1003.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1254,100,,1003.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",775.6,61.85,,620.48,,,0,"percent of total billed charges","61.5% of total billed charges",210.67,16.8,,168.54,,,0,"percent of total billed charges","16.8% of total billed charges",627,50,,501.60,,,0,"percent of total billed charges","50% of total billed charges",403.79,32.2,,323.03,,,0,"percent of total billed charges","32.2% of total billed charges",210.67,16.8,,168.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",214.89,17.136,,171.91,,,0,"percent of total billed charges","17.136% of total billed charges",273.87,21.84,,219.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",472.76,37.7,,378.21,,,0,"percent of total billed charges","37.7% of total billed charges",472.76,37.7,,378.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",425.11,33.9,,340.09,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",978.12,78,,782.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",210.67,16.8,,168.54,,,0,"percent of total billed charges","16.8% of total billed charges",627,50,,501.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",210.67,16.8,,168.54,,,0,"percent of total billed charges","16.8% of total billed charges",1254,100,,1003.20,,,0,"percent of total billed charges","100% of total billed charges",191.86,1254,
"TC 99 OXIDRONATE TO 30 MC",343A9561,CDM,343,RC,,,OUTPATIENT,,,119,77.35,TC,104.72,88,,83.78,,,0,"percent of total billed charges","88% of total billed charges",59.5,50,,47.60,,,0,"percent of total billed charges","50% of total billed charges",19.99,16.8,,15.99,,,0,"percent of total billed charges","16.8% of total billed charges",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.59,17.304,,16.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.97,63,,59.98,,,0,"percent of total billed charges","63% of total billed charges",18.21,15.3,,14.57,,,0,"percent of total billed charges","15.3% of total billed charges",19.99,16.8,,15.99,,,0,"percent of total billed charges","16.8% of total billed charges",82.11,69,,,,,0,"fee schedule","69% of total billed charges",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",73.6,61.85,,58.88,,,0,"percent of total billed charges","61.5% of total billed charges",19.99,16.8,,15.99,,,0,"percent of total billed charges","16.8% of total billed charges",59.5,50,,47.60,,,0,"percent of total billed charges","50% of total billed charges",38.32,32.2,,30.66,,,0,"percent of total billed charges","32.2% of total billed charges",19.99,16.8,,15.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.39,17.136,,16.31,,,0,"percent of total billed charges","17.136% of total billed charges",25.99,21.84,,20.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.7% of total billed charges",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.34,33.9,,32.27,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.82,78,,74.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.99,16.8,,15.99,,,0,"percent of total billed charges","16.8% of total billed charges",59.5,50,,47.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.99,16.8,,15.99,,,0,"percent of total billed charges","16.8% of total billed charges",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",18.21,119,
"TC 99M APCITIDE < = 20 MC",343A9504,CDM,343,RC,,,OUTPATIENT,,,2359,1533.35,TC,2075.92,88,,1660.74,,,0,"percent of total billed charges","88% of total billed charges",1179.5,50,,943.60,,,0,"percent of total billed charges","50% of total billed charges",396.31,16.8,,317.05,,,0,"percent of total billed charges","16.8% of total billed charges",2359,100,,1887.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.2,17.304,,326.56,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1486.17,63,,1188.94,,,0,"percent of total billed charges","63% of total billed charges",360.93,15.3,,288.74,,,0,"percent of total billed charges","15.3% of total billed charges",396.31,16.8,,317.05,,,0,"percent of total billed charges","16.8% of total billed charges",1627.71,69,,,,,0,"fee schedule","69% of total billed charges",2359,100,,1887.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2359,100,,1887.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2359,100,,1887.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1459.04,61.85,,1167.23,,,0,"percent of total billed charges","61.5% of total billed charges",396.31,16.8,,317.05,,,0,"percent of total billed charges","16.8% of total billed charges",1179.5,50,,943.60,,,0,"percent of total billed charges","50% of total billed charges",759.6,32.2,,607.68,,,0,"percent of total billed charges","32.2% of total billed charges",396.31,16.8,,317.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.24,17.136,,323.39,,,0,"percent of total billed charges","17.136% of total billed charges",515.21,21.84,,412.17,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",889.34,37.7,,711.47,,,0,"percent of total billed charges","37.7% of total billed charges",889.34,37.7,,711.47,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",799.7,33.9,,639.76,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1840.02,78,,1472.02,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",396.31,16.8,,317.05,,,0,"percent of total billed charges","16.8% of total billed charges",1179.5,50,,943.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",396.31,16.8,,317.05,,,0,"percent of total billed charges","16.8% of total billed charges",2359,100,,1887.20,,,0,"percent of total billed charges","100% of total billed charges",360.93,2359,
"TC 99M DISOFENIN < = 15MC",343A9510,CDM,343,RC,,,OUTPATIENT,,,629,408.85,TC,553.52,88,,442.82,,,0,"percent of total billed charges","88% of total billed charges",314.5,50,,251.60,,,0,"percent of total billed charges","50% of total billed charges",105.67,16.8,,84.54,,,0,"percent of total billed charges","16.8% of total billed charges",629,100,,503.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",108.84,17.304,,87.07,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",396.27,63,,317.02,,,0,"percent of total billed charges","63% of total billed charges",96.24,15.3,,76.99,,,0,"percent of total billed charges","15.3% of total billed charges",105.67,16.8,,84.54,,,0,"percent of total billed charges","16.8% of total billed charges",434.01,69,,,,,0,"fee schedule","69% of total billed charges",629,100,,503.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",629,100,,503.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",629,100,,503.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.04,61.85,,311.23,,,0,"percent of total billed charges","61.5% of total billed charges",105.67,16.8,,84.54,,,0,"percent of total billed charges","16.8% of total billed charges",314.5,50,,251.60,,,0,"percent of total billed charges","50% of total billed charges",202.54,32.2,,162.03,,,0,"percent of total billed charges","32.2% of total billed charges",105.67,16.8,,84.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",107.79,17.136,,86.23,,,0,"percent of total billed charges","17.136% of total billed charges",137.37,21.84,,109.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",237.13,37.7,,189.70,,,0,"percent of total billed charges","37.7% of total billed charges",237.13,37.7,,189.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.23,33.9,,170.58,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",490.62,78,,392.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",105.67,16.8,,84.54,,,0,"percent of total billed charges","16.8% of total billed charges",314.5,50,,251.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",105.67,16.8,,84.54,,,0,"percent of total billed charges","16.8% of total billed charges",629,100,,503.20,,,0,"percent of total billed charges","100% of total billed charges",96.24,629,
"TC 99M EXAMETAZIME TO 25",343A9521,CDM,343,RC,,,OUTPATIENT,,,2527,1642.55,TC,2223.76,88,,1779.01,,,0,"percent of total billed charges","88% of total billed charges",1263.5,50,,1010.80,,,0,"percent of total billed charges","50% of total billed charges",424.54,16.8,,339.63,,,0,"percent of total billed charges","16.8% of total billed charges",2527,100,,2021.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",437.27,17.304,,349.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1592.01,63,,1273.61,,,0,"percent of total billed charges","63% of total billed charges",386.63,15.3,,309.30,,,0,"percent of total billed charges","15.3% of total billed charges",424.54,16.8,,339.63,,,0,"percent of total billed charges","16.8% of total billed charges",1743.63,69,,,,,0,"fee schedule","69% of total billed charges",2527,100,,2021.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2527,100,,2021.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2527,100,,2021.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1562.95,61.85,,1250.36,,,0,"percent of total billed charges","61.5% of total billed charges",424.54,16.8,,339.63,,,0,"percent of total billed charges","16.8% of total billed charges",1263.5,50,,1010.80,,,0,"percent of total billed charges","50% of total billed charges",813.69,32.2,,650.95,,,0,"percent of total billed charges","32.2% of total billed charges",424.54,16.8,,339.63,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",433.03,17.136,,346.42,,,0,"percent of total billed charges","17.136% of total billed charges",551.9,21.84,,441.52,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.68,37.7,,762.14,,,0,"percent of total billed charges","37.7% of total billed charges",952.68,37.7,,762.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",856.65,33.9,,685.32,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1971.06,78,,1576.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",424.54,16.8,,339.63,,,0,"percent of total billed charges","16.8% of total billed charges",1263.5,50,,1010.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",424.54,16.8,,339.63,,,0,"percent of total billed charges","16.8% of total billed charges",2527,100,,2021.60,,,0,"percent of total billed charges","100% of total billed charges",386.63,2527,
"TC 99M MEBROFENIN < = 15",343A9537,CDM,343,RC,,,OUTPATIENT,,,394,256.1,TC,346.72,88,,277.38,,,0,"percent of total billed charges","88% of total billed charges",197,50,,157.60,,,0,"percent of total billed charges","50% of total billed charges",66.19,16.8,,52.95,,,0,"percent of total billed charges","16.8% of total billed charges",394,100,,315.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.18,17.304,,54.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.22,63,,198.58,,,0,"percent of total billed charges","63% of total billed charges",60.28,15.3,,48.22,,,0,"percent of total billed charges","15.3% of total billed charges",66.19,16.8,,52.95,,,0,"percent of total billed charges","16.8% of total billed charges",271.86,69,,,,,0,"fee schedule","69% of total billed charges",394,100,,315.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",394,100,,315.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",394,100,,315.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",243.69,61.85,,194.95,,,0,"percent of total billed charges","61.5% of total billed charges",66.19,16.8,,52.95,,,0,"percent of total billed charges","16.8% of total billed charges",197,50,,157.60,,,0,"percent of total billed charges","50% of total billed charges",126.87,32.2,,101.50,,,0,"percent of total billed charges","32.2% of total billed charges",66.19,16.8,,52.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.52,17.136,,54.02,,,0,"percent of total billed charges","17.136% of total billed charges",86.05,21.84,,68.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",148.54,37.7,,118.83,,,0,"percent of total billed charges","37.7% of total billed charges",148.54,37.7,,118.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",133.57,33.9,,106.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",307.32,78,,245.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",66.19,16.8,,52.95,,,0,"percent of total billed charges","16.8% of total billed charges",197,50,,157.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",66.19,16.8,,52.95,,,0,"percent of total billed charges","16.8% of total billed charges",394,100,,315.20,,,0,"percent of total billed charges","100% of total billed charges",60.28,394,
"TC 99M PENTETATE TO 25MCI",343A9539,CDM,343,RC,,,OUTPATIENT,,,356,231.4,TC,313.28,88,,250.62,,,0,"percent of total billed charges","88% of total billed charges",178,50,,142.40,,,0,"percent of total billed charges","50% of total billed charges",59.81,16.8,,47.85,,,0,"percent of total billed charges","16.8% of total billed charges",356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.6,17.304,,49.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.28,63,,179.42,,,0,"percent of total billed charges","63% of total billed charges",54.47,15.3,,43.58,,,0,"percent of total billed charges","15.3% of total billed charges",59.81,16.8,,47.85,,,0,"percent of total billed charges","16.8% of total billed charges",245.64,69,,,,,0,"fee schedule","69% of total billed charges",356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",220.19,61.85,,176.15,,,0,"percent of total billed charges","61.5% of total billed charges",59.81,16.8,,47.85,,,0,"percent of total billed charges","16.8% of total billed charges",178,50,,142.40,,,0,"percent of total billed charges","50% of total billed charges",114.63,32.2,,91.70,,,0,"percent of total billed charges","32.2% of total billed charges",59.81,16.8,,47.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61,17.136,,48.80,,,0,"percent of total billed charges","17.136% of total billed charges",77.75,21.84,,62.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.21,37.7,,107.37,,,0,"percent of total billed charges","37.7% of total billed charges",134.21,37.7,,107.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",120.68,33.9,,96.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",277.68,78,,222.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",59.81,16.8,,47.85,,,0,"percent of total billed charges","16.8% of total billed charges",178,50,,142.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",59.81,16.8,,47.85,,,0,"percent of total billed charges","16.8% of total billed charges",356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",54.47,356,
"TC99 MAA DX TO 10MCI",343A9540,CDM,343,RC,,,OUTPATIENT,,,457,297.05,TC,402.16,88,,321.73,,,0,"percent of total billed charges","88% of total billed charges",228.5,50,,182.80,,,0,"percent of total billed charges","50% of total billed charges",76.78,16.8,,61.42,,,0,"percent of total billed charges","16.8% of total billed charges",457,100,,365.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.08,17.304,,63.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",287.91,63,,230.33,,,0,"percent of total billed charges","63% of total billed charges",69.92,15.3,,55.94,,,0,"percent of total billed charges","15.3% of total billed charges",76.78,16.8,,61.42,,,0,"percent of total billed charges","16.8% of total billed charges",315.33,69,,,,,0,"fee schedule","69% of total billed charges",457,100,,365.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",457,100,,365.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",457,100,,365.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",282.65,61.85,,226.12,,,0,"percent of total billed charges","61.5% of total billed charges",76.78,16.8,,61.42,,,0,"percent of total billed charges","16.8% of total billed charges",228.5,50,,182.80,,,0,"percent of total billed charges","50% of total billed charges",147.15,32.2,,117.72,,,0,"percent of total billed charges","32.2% of total billed charges",76.78,16.8,,61.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.31,17.136,,62.65,,,0,"percent of total billed charges","17.136% of total billed charges",99.81,21.84,,79.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",172.29,37.7,,137.83,,,0,"percent of total billed charges","37.7% of total billed charges",172.29,37.7,,137.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",154.92,33.9,,123.94,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",356.46,78,,285.17,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",76.78,16.8,,61.42,,,0,"percent of total billed charges","16.8% of total billed charges",228.5,50,,182.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",76.78,16.8,,61.42,,,0,"percent of total billed charges","16.8% of total billed charges",457,100,,365.60,,,0,"percent of total billed charges","100% of total billed charges",69.92,457,
"TC99 MERTIATIDE DX TO 15M",343A9562,CDM,343,RC,,,OUTPATIENT,,,1052,683.8,TC,925.76,88,,740.61,,,0,"percent of total billed charges","88% of total billed charges",526,50,,420.80,,,0,"percent of total billed charges","50% of total billed charges",176.74,16.8,,141.39,,,0,"percent of total billed charges","16.8% of total billed charges",1052,100,,841.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",182.04,17.304,,145.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.76,63,,530.21,,,0,"percent of total billed charges","63% of total billed charges",160.96,15.3,,128.77,,,0,"percent of total billed charges","15.3% of total billed charges",176.74,16.8,,141.39,,,0,"percent of total billed charges","16.8% of total billed charges",725.88,69,,,,,0,"fee schedule","69% of total billed charges",1052,100,,841.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1052,100,,841.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1052,100,,841.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",650.66,61.85,,520.53,,,0,"percent of total billed charges","61.5% of total billed charges",176.74,16.8,,141.39,,,0,"percent of total billed charges","16.8% of total billed charges",526,50,,420.80,,,0,"percent of total billed charges","50% of total billed charges",338.74,32.2,,270.99,,,0,"percent of total billed charges","32.2% of total billed charges",176.74,16.8,,141.39,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",180.27,17.136,,144.22,,,0,"percent of total billed charges","17.136% of total billed charges",229.76,21.84,,183.81,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",396.6,37.7,,317.28,,,0,"percent of total billed charges","37.7% of total billed charges",396.6,37.7,,317.28,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",356.63,33.9,,285.30,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",820.56,78,,656.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.74,16.8,,141.39,,,0,"percent of total billed charges","16.8% of total billed charges",526,50,,420.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.74,16.8,,141.39,,,0,"percent of total billed charges","16.8% of total billed charges",1052,100,,841.60,,,0,"percent of total billed charges","100% of total billed charges",160.96,1052,
"TC99 PYROPHOS DX TO 25MCI",343A9538,CDM,343,RC,,,OUTPATIENT,,,354,230.1,TC,311.52,88,,249.22,,,0,"percent of total billed charges","88% of total billed charges",177,50,,141.60,,,0,"percent of total billed charges","50% of total billed charges",59.47,16.8,,47.58,,,0,"percent of total billed charges","16.8% of total billed charges",354,100,,283.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.26,17.304,,49.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.02,63,,178.42,,,0,"percent of total billed charges","63% of total billed charges",54.16,15.3,,43.33,,,0,"percent of total billed charges","15.3% of total billed charges",59.47,16.8,,47.58,,,0,"percent of total billed charges","16.8% of total billed charges",244.26,69,,,,,0,"fee schedule","69% of total billed charges",354,100,,283.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",354,100,,283.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",354,100,,283.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",218.95,61.85,,175.16,,,0,"percent of total billed charges","61.5% of total billed charges",59.47,16.8,,47.58,,,0,"percent of total billed charges","16.8% of total billed charges",177,50,,141.60,,,0,"percent of total billed charges","50% of total billed charges",113.99,32.2,,91.19,,,0,"percent of total billed charges","32.2% of total billed charges",59.47,16.8,,47.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.66,17.136,,48.53,,,0,"percent of total billed charges","17.136% of total billed charges",77.31,21.84,,61.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",133.46,37.7,,106.77,,,0,"percent of total billed charges","37.7% of total billed charges",133.46,37.7,,106.77,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",120.01,33.9,,96.01,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.12,78,,220.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",59.47,16.8,,47.58,,,0,"percent of total billed charges","16.8% of total billed charges",177,50,,141.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",59.47,16.8,,47.58,,,0,"percent of total billed charges","16.8% of total billed charges",354,100,,283.20,,,0,"percent of total billed charges","100% of total billed charges",54.16,354,
"TC99 SUL COL DX TO 20MCI",343A9541,CDM,343,RC,,,OUTPATIENT,,,410,266.5,TC,360.8,88,,288.64,,,0,"percent of total billed charges","88% of total billed charges",205,50,,164.00,,,0,"percent of total billed charges","50% of total billed charges",68.88,16.8,,55.10,,,0,"percent of total billed charges","16.8% of total billed charges",410,100,,328.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.95,17.304,,56.76,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.3,63,,206.64,,,0,"percent of total billed charges","63% of total billed charges",62.73,15.3,,50.18,,,0,"percent of total billed charges","15.3% of total billed charges",68.88,16.8,,55.10,,,0,"percent of total billed charges","16.8% of total billed charges",282.9,69,,,,,0,"fee schedule","69% of total billed charges",410,100,,328.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",410,100,,328.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",410,100,,328.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.59,61.85,,202.87,,,0,"percent of total billed charges","61.5% of total billed charges",68.88,16.8,,55.10,,,0,"percent of total billed charges","16.8% of total billed charges",205,50,,164.00,,,0,"percent of total billed charges","50% of total billed charges",132.02,32.2,,105.62,,,0,"percent of total billed charges","32.2% of total billed charges",68.88,16.8,,55.10,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.26,17.136,,56.21,,,0,"percent of total billed charges","17.136% of total billed charges",89.54,21.84,,71.63,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",154.57,37.7,,123.66,,,0,"percent of total billed charges","37.7% of total billed charges",154.57,37.7,,123.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.99,33.9,,111.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",319.8,78,,255.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",68.88,16.8,,55.10,,,0,"percent of total billed charges","16.8% of total billed charges",205,50,,164.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",68.88,16.8,,55.10,,,0,"percent of total billed charges","16.8% of total billed charges",410,100,,328.00,,,0,"percent of total billed charges","100% of total billed charges",62.73,410,
"TC99 TILMAN DX .5MCI",343A9520,CDM,343,RC,,,OUTPATIENT,,,1904,1237.6,TC,1675.52,88,,1340.42,,,0,"percent of total billed charges","88% of total billed charges",952,50,,761.60,,,0,"percent of total billed charges","50% of total billed charges",319.87,16.8,,255.90,,,0,"percent of total billed charges","16.8% of total billed charges",1904,100,,1523.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",329.47,17.304,,263.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1199.52,63,,959.62,,,0,"percent of total billed charges","63% of total billed charges",291.31,15.3,,233.05,,,0,"percent of total billed charges","15.3% of total billed charges",319.87,16.8,,255.90,,,0,"percent of total billed charges","16.8% of total billed charges",1313.76,69,,,,,0,"fee schedule","69% of total billed charges",1904,100,,1523.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1904,100,,1523.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1904,100,,1523.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1177.62,61.85,,942.10,,,0,"percent of total billed charges","61.5% of total billed charges",319.87,16.8,,255.90,,,0,"percent of total billed charges","16.8% of total billed charges",952,50,,761.60,,,0,"percent of total billed charges","50% of total billed charges",613.09,32.2,,490.47,,,0,"percent of total billed charges","32.2% of total billed charges",319.87,16.8,,255.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.27,17.136,,261.02,,,0,"percent of total billed charges","17.136% of total billed charges",415.83,21.84,,332.66,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",717.81,37.7,,574.25,,,0,"percent of total billed charges","37.7% of total billed charges",717.81,37.7,,574.25,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",645.46,33.9,,516.37,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1485.12,78,,1188.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",319.87,16.8,,255.90,,,0,"percent of total billed charges","16.8% of total billed charges",952,50,,761.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",319.87,16.8,,255.90,,,0,"percent of total billed charges","16.8% of total billed charges",1904,100,,1523.20,,,0,"percent of total billed charges","100% of total billed charges",291.31,1904,
"TC99M GLUCEPTA/25MCI",343A9550,CDM,343,RC,,,OUTPATIENT,,,3276,2129.4,TC,2882.88,88,,2306.30,,,0,"percent of total billed charges","88% of total billed charges",1638,50,,1310.40,,,0,"percent of total billed charges","50% of total billed charges",550.37,16.8,,440.30,,,0,"percent of total billed charges","16.8% of total billed charges",3276,100,,2620.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",566.88,17.304,,453.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2063.88,63,,1651.10,,,0,"percent of total billed charges","63% of total billed charges",501.23,15.3,,400.98,,,0,"percent of total billed charges","15.3% of total billed charges",550.37,16.8,,440.30,,,0,"percent of total billed charges","16.8% of total billed charges",2260.44,69,,,,,0,"fee schedule","69% of total billed charges",3276,100,,2620.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3276,100,,2620.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3276,100,,2620.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2026.21,61.85,,1620.97,,,0,"percent of total billed charges","61.5% of total billed charges",550.37,16.8,,440.30,,,0,"percent of total billed charges","16.8% of total billed charges",1638,50,,1310.40,,,0,"percent of total billed charges","50% of total billed charges",1054.87,32.2,,843.90,,,0,"percent of total billed charges","32.2% of total billed charges",550.37,16.8,,440.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",561.38,17.136,,449.10,,,0,"percent of total billed charges","17.136% of total billed charges",715.48,21.84,,572.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1235.05,37.7,,988.04,,,0,"percent of total billed charges","37.7% of total billed charges",1235.05,37.7,,988.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1110.56,33.9,,888.45,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2555.28,78,,2044.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",550.37,16.8,,440.30,,,0,"percent of total billed charges","16.8% of total billed charges",1638,50,,1310.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",550.37,16.8,,440.30,,,0,"percent of total billed charges","16.8% of total billed charges",3276,100,,2620.80,,,0,"percent of total billed charges","100% of total billed charges",501.23,3276,
"TC99M LABLED RBC TO 30 MC",343A9560,CDM,343,RC,,,OUTPATIENT,,,558,362.7,TC,491.04,88,,392.83,,,0,"percent of total billed charges","88% of total billed charges",279,50,,223.20,,,0,"percent of total billed charges","50% of total billed charges",93.74,16.8,,74.99,,,0,"percent of total billed charges","16.8% of total billed charges",558,100,,446.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",96.56,17.304,,77.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",351.54,63,,281.23,,,0,"percent of total billed charges","63% of total billed charges",85.37,15.3,,68.30,,,0,"percent of total billed charges","15.3% of total billed charges",93.74,16.8,,74.99,,,0,"percent of total billed charges","16.8% of total billed charges",385.02,69,,,,,0,"fee schedule","69% of total billed charges",558,100,,446.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",558,100,,446.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",558,100,,446.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",345.12,61.85,,276.10,,,0,"percent of total billed charges","61.5% of total billed charges",93.74,16.8,,74.99,,,0,"percent of total billed charges","16.8% of total billed charges",279,50,,223.20,,,0,"percent of total billed charges","50% of total billed charges",179.68,32.2,,143.74,,,0,"percent of total billed charges","32.2% of total billed charges",93.74,16.8,,74.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.62,17.136,,76.50,,,0,"percent of total billed charges","17.136% of total billed charges",121.87,21.84,,97.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",210.37,37.7,,168.30,,,0,"percent of total billed charges","37.7% of total billed charges",210.37,37.7,,168.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",189.16,33.9,,151.33,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",435.24,78,,348.19,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",93.74,16.8,,74.99,,,0,"percent of total billed charges","16.8% of total billed charges",279,50,,223.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",93.74,16.8,,74.99,,,0,"percent of total billed charges","16.8% of total billed charges",558,100,,446.40,,,0,"percent of total billed charges","100% of total billed charges",85.37,558,
"TC99M MEDRO TO 30MCI",343A9503,CDM,343,RC,,,OUTPATIENT,,,454,295.1,TC,399.52,88,,319.62,,,0,"percent of total billed charges","88% of total billed charges",227,50,,181.60,,,0,"percent of total billed charges","50% of total billed charges",76.27,16.8,,61.02,,,0,"percent of total billed charges","16.8% of total billed charges",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.56,17.304,,62.85,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",286.02,63,,228.82,,,0,"percent of total billed charges","63% of total billed charges",69.46,15.3,,55.57,,,0,"percent of total billed charges","15.3% of total billed charges",76.27,16.8,,61.02,,,0,"percent of total billed charges","16.8% of total billed charges",313.26,69,,,,,0,"fee schedule","69% of total billed charges",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",280.8,61.85,,224.64,,,0,"percent of total billed charges","61.5% of total billed charges",76.27,16.8,,61.02,,,0,"percent of total billed charges","16.8% of total billed charges",227,50,,181.60,,,0,"percent of total billed charges","50% of total billed charges",146.19,32.2,,116.95,,,0,"percent of total billed charges","32.2% of total billed charges",76.27,16.8,,61.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.8,17.136,,62.24,,,0,"percent of total billed charges","17.136% of total billed charges",99.15,21.84,,79.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",171.16,37.7,,136.93,,,0,"percent of total billed charges","37.7% of total billed charges",171.16,37.7,,136.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",153.91,33.9,,123.13,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",354.12,78,,283.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",76.27,16.8,,61.02,,,0,"percent of total billed charges","16.8% of total billed charges",227,50,,181.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",76.27,16.8,,61.02,,,0,"percent of total billed charges","16.8% of total billed charges",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",69.46,454,
"TC-99M SESTAMIBI DX PER S",343A9500,CDM,343,RC,,,OUTPATIENT,,,1120,728,TC,985.6,88,,788.48,,,0,"percent of total billed charges","88% of total billed charges",560,50,,448.00,,,0,"percent of total billed charges","50% of total billed charges",188.16,16.8,,150.53,,,0,"percent of total billed charges","16.8% of total billed charges",1120,100,,896.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",193.8,17.304,,155.04,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",705.6,63,,564.48,,,0,"percent of total billed charges","63% of total billed charges",171.36,15.3,,137.09,,,0,"percent of total billed charges","15.3% of total billed charges",188.16,16.8,,150.53,,,0,"percent of total billed charges","16.8% of total billed charges",772.8,69,,,,,0,"fee schedule","69% of total billed charges",1120,100,,896.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1120,100,,896.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1120,100,,896.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",692.72,61.85,,554.18,,,0,"percent of total billed charges","61.5% of total billed charges",188.16,16.8,,150.53,,,0,"percent of total billed charges","16.8% of total billed charges",560,50,,448.00,,,0,"percent of total billed charges","50% of total billed charges",360.64,32.2,,288.51,,,0,"percent of total billed charges","32.2% of total billed charges",188.16,16.8,,150.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.92,17.136,,153.54,,,0,"percent of total billed charges","17.136% of total billed charges",244.61,21.84,,195.69,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.24,37.7,,337.79,,,0,"percent of total billed charges","37.7% of total billed charges",422.24,37.7,,337.79,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.68,33.9,,303.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",873.6,78,,698.88,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",188.16,16.8,,150.53,,,0,"percent of total billed charges","16.8% of total billed charges",560,50,,448.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",188.16,16.8,,150.53,,,0,"percent of total billed charges","16.8% of total billed charges",1120,100,,896.00,,,0,"percent of total billed charges","100% of total billed charges",171.36,1120,
"TC99M SUCCIMER/10MCI",343A9551,CDM,343,RC,,,OUTPATIENT,,,1179,766.35,TC,1037.52,88,,830.02,,,0,"percent of total billed charges","88% of total billed charges",589.5,50,,471.60,,,0,"percent of total billed charges","50% of total billed charges",198.07,16.8,,158.46,,,0,"percent of total billed charges","16.8% of total billed charges",1179,100,,943.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.01,17.304,,163.21,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",742.77,63,,594.22,,,0,"percent of total billed charges","63% of total billed charges",180.39,15.3,,144.31,,,0,"percent of total billed charges","15.3% of total billed charges",198.07,16.8,,158.46,,,0,"percent of total billed charges","16.8% of total billed charges",813.51,69,,,,,0,"fee schedule","69% of total billed charges",1179,100,,943.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1179,100,,943.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1179,100,,943.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",729.21,61.85,,583.37,,,0,"percent of total billed charges","61.5% of total billed charges",198.07,16.8,,158.46,,,0,"percent of total billed charges","16.8% of total billed charges",589.5,50,,471.60,,,0,"percent of total billed charges","50% of total billed charges",379.64,32.2,,303.71,,,0,"percent of total billed charges","32.2% of total billed charges",198.07,16.8,,158.46,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.03,17.136,,161.62,,,0,"percent of total billed charges","17.136% of total billed charges",257.49,21.84,,205.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",444.48,37.7,,355.58,,,0,"percent of total billed charges","37.7% of total billed charges",444.48,37.7,,355.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",399.68,33.9,,319.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",919.62,78,,735.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",198.07,16.8,,158.46,,,0,"percent of total billed charges","16.8% of total billed charges",589.5,50,,471.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",198.07,16.8,,158.46,,,0,"percent of total billed charges","16.8% of total billed charges",1179,100,,943.20,,,0,"percent of total billed charges","100% of total billed charges",180.39,1179,
"F18 FDG / 45 MCI",343A9552,CDM,343,RC,,,OUTPATIENT,,,1548,1006.2,,1362.24,88,,1089.79,,,0,"percent of total billed charges","88% of total billed charges",774,50,,619.20,,,0,"percent of total billed charges","50% of total billed charges",260.06,16.8,,208.05,,,0,"percent of total billed charges","16.8% of total billed charges",1548,100,,1238.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",267.87,17.304,,214.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",975.24,63,,780.19,,,0,"percent of total billed charges","63% of total billed charges",236.84,15.3,,189.47,,,0,"percent of total billed charges","15.3% of total billed charges",260.06,16.8,,208.05,,,0,"percent of total billed charges","16.8% of total billed charges",1068.12,69,,,,,0,"fee schedule","69% of total billed charges",1548,100,,1238.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1548,100,,1238.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1548,100,,1238.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",957.44,61.85,,765.95,,,0,"percent of total billed charges","61.5% of total billed charges",260.06,16.8,,208.05,,,0,"percent of total billed charges","16.8% of total billed charges",774,50,,619.20,,,0,"percent of total billed charges","50% of total billed charges",498.46,32.2,,398.77,,,0,"percent of total billed charges","32.2% of total billed charges",260.06,16.8,,208.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",265.27,17.136,,212.22,,,0,"percent of total billed charges","17.136% of total billed charges",338.08,21.84,,270.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",583.6,37.7,,466.88,,,0,"percent of total billed charges","37.7% of total billed charges",583.6,37.7,,466.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",524.77,33.9,,419.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1207.44,78,,965.95,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",260.06,16.8,,208.05,,,0,"percent of total billed charges","16.8% of total billed charges",774,50,,619.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",260.06,16.8,,208.05,,,0,"percent of total billed charges","16.8% of total billed charges",1548,100,,1238.40,,,0,"percent of total billed charges","100% of total billed charges",236.84,1548,
"CT 3D RECONSTRUCT COMPLEX",35076377,CDM,350,RC,76376,CPT,OUTPATIENT,,,417,271.05,TC,366.96,88,,293.57,,,0,"percent of total billed charges","88% of total billed charges",208.5,50,,166.80,,,0,"percent of total billed charges","50% of total billed charges",70.06,16.8,,56.05,,,0,"percent of total billed charges","16.8% of total billed charges",417,100,,333.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",72.16,17.304,,57.73,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",262.71,63,,210.17,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",70.06,16.8,,56.05,,,0,"percent of total billed charges","16.8% of total billed charges",287.73,69,,,,,0,"fee schedule","69% of total billed charges",417,100,,333.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417,100,,333.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417,100,,333.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",257.91,61.85,,206.33,,,0,"percent of total billed charges","61.5% of total billed charges",70.06,16.8,,56.05,,,0,"percent of total billed charges","16.8% of total billed charges",208.5,50,,166.80,,,0,"percent of total billed charges","50% of total billed charges",134.27,32.2,,107.42,,,0,"percent of total billed charges","32.2% of total billed charges",70.06,16.8,,56.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.46,17.136,,57.17,,,0,"percent of total billed charges","17.136% of total billed charges",91.07,21.84,,72.86,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.21,37.7,,125.77,,,0,"percent of total billed charges","37.7% of total billed charges",157.21,37.7,,125.77,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",141.36,33.9,,113.09,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",325.26,78,,260.21,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",344.44,82.6,,275.55,,,0,"percent of total billed charges","82.6% of total billed charges",70.06,16.8,,56.05,,,0,"percent of total billed charges","16.8% of total billed charges",208.5,50,,166.80,,,0,"percent of total billed charges","50% of total billed charges",344.44,82.6,,275.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.06,16.8,,56.05,,,0,"percent of total billed charges","16.8% of total billed charges",417,100,,333.60,,,0,"percent of total billed charges","100% of total billed charges",70.06,417,
"MRI 3D RECONSTRUCT SIMPLE",61076376,CDM,611,RC,76376,CPT,OUTPATIENT,,,209,135.85,TC,183.92,88,,147.14,,,0,"percent of total billed charges","88% of total billed charges",104.5,50,,83.60,,,0,"percent of total billed charges","50% of total billed charges",35.11,16.8,,28.09,,,0,"percent of total billed charges","16.8% of total billed charges",209,100,,167.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.17,17.304,,28.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",131.67,63,,105.34,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",35.11,16.8,,28.09,,,0,"percent of total billed charges","16.8% of total billed charges",144.21,69,,,,,0,"fee schedule","69% of total billed charges",209,100,,167.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",209,100,,167.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",209,100,,167.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.27,61.85,,103.42,,,0,"percent of total billed charges","61.5% of total billed charges",35.11,16.8,,28.09,,,0,"percent of total billed charges","16.8% of total billed charges",104.5,50,,83.60,,,0,"percent of total billed charges","50% of total billed charges",67.3,32.2,,53.84,,,0,"percent of total billed charges","32.2% of total billed charges",35.11,16.8,,28.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.81,17.136,,28.65,,,0,"percent of total billed charges","17.136% of total billed charges",45.65,21.84,,36.52,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,37.7,,63.03,,,0,"percent of total billed charges","37.7% of total billed charges",78.79,37.7,,63.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.85,33.9,,56.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",163.02,78,,130.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",172.63,82.6,,138.10,,,0,"percent of total billed charges","82.6% of total billed charges",35.11,16.8,,28.09,,,0,"percent of total billed charges","16.8% of total billed charges",104.5,50,,83.60,,,0,"percent of total billed charges","50% of total billed charges",172.63,82.6,,138.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.11,16.8,,28.09,,,0,"percent of total billed charges","16.8% of total billed charges",209,100,,167.20,,,0,"percent of total billed charges","100% of total billed charges",35.11,620,
"Ultrasound, pregnant uterus",9727617,CDM,402,RC,76817,CPT,OUTPATIENT,,,579,376.35,,509.52,88,,407.62,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.6,100,,,,,0,"fee schedule",EAPG,579,100,,463.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",94.35,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",364.77,63,,291.82,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",91.6,100,,,,,0,"fee schedule",EAPG,399.51,69,,,,,0,"fee schedule","69% of total billed charges",579,100,,463.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579,100,,463.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579,100,,463.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.6,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",67.85,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",93.43,100,,,,,0,"fee schedule",EAPG,119.08,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.28,37.7,,174.62,,,0,"percent of total billed charges","37.7% of total billed charges",218.28,37.7,,174.62,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",196.28,33.9,,157.02,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",451.62,78,,361.30,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",478.25,82.6,,382.60,,,0,"percent of total billed charges","82.6% of total billed charges",91.6,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",478.25,82.6,,382.60,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.6,100,,,,,0,"fee schedule",EAPG,579,100,,463.20,,,0,"percent of total billed charges","100% of total billed charges",67.85,579,
"AST PELVIC TRANSVAGINAL",40276830,CDM,402,RC,76830,CPT,OUTPATIENT,,,825,536.25,TC,726,88,,580.80,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,825,100,,660.00,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",519.75,63,,415.80,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,569.25,69,,,,,0,"fee schedule","69% of total billed charges",825,100,,660.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",825,100,,660.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",825,100,,660.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",311.03,37.7,,248.82,,,0,"percent of total billed charges","37.7% of total billed charges",311.03,37.7,,248.82,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",279.68,33.9,,223.74,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.5,78,,514.80,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",681.45,82.6,,545.16,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",681.45,82.6,,545.16,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,825,100,,660.00,,,0,"percent of total billed charges","100% of total billed charges",73.81,825,
"AST Stress Echo Contrast Admin",48393352,CDM,483,RC,93352,CPT,OUTPATIENT,,,136,88.4,,119.68,88,,95.74,,,0,"percent of total billed charges","88% of total billed charges",68,50,,54.40,,,0,"percent of total billed charges","50% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",430.64,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",85.68,63,,68.54,,,0,"percent of total billed charges","63% of total billed charges",20.81,15.3,,16.65,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,93.84,69,,,,,0,"fee schedule","69% of total billed charges",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.12,61.85,,67.30,,,0,"percent of total billed charges","61.5% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,68,50,,54.40,,,0,"percent of total billed charges","50% of total billed charges",43.79,32.2,,35.03,,,0,"percent of total billed charges","32.2% of total billed charges",309.7,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",51.27,37.7,,41.02,,,0,"percent of total billed charges","37.7% of total billed charges",51.27,37.7,,41.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.1,33.9,,36.88,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.08,78,,84.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.34,82.6,,89.87,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,68,50,,54.40,,,0,"percent of total billed charges","50% of total billed charges",112.34,82.6,,89.87,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.1,100,,,,,0,"fee schedule",EAPG,136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",20.81,543.53,
"AST Treadmill Stress Test",48293017,CDM,482,RC,93017,CPT,OUTPATIENT,,,1021,663.65,,898.48,88,,718.78,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.99,100,,,,,0,"fee schedule",EAPG,1021,100,,816.80,,,0,"percent of total billed charges","100% of total billed charges",560.25,175,,,,,0,"fee schedule","175% of CMS fee schedule",155.52,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.23,63,,514.58,,,0,"percent of total billed charges","63% of total billed charges",156.21,15.3,,124.97,,,0,"percent of total billed charges","15.3% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,704.49,69,,,,,0,"fee schedule","69% of total billed charges",1021,100,,816.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1021,100,,816.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1021,100,,816.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.99,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.84,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.01,100,,,,,0,"fee schedule",EAPG,196.29,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",384.92,37.7,,307.94,,,0,"percent of total billed charges","37.7% of total billed charges",384.92,37.7,,307.94,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",346.12,33.9,,276.90,,,0,"percent of total billed charges","33.9% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",796.38,78,,637.10,,,0,"percent of total billed charges","78% of total billed charges",323.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",843.35,82.6,,674.68,,,0,"percent of total billed charges","82.6% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",843.35,82.6,,674.68,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.99,100,,,,,0,"fee schedule",EAPG,1021,100,,816.80,,,0,"percent of total billed charges","100% of total billed charges",111.84,1074.33,
"US Elastography Each Addl Lesion",40276983,CDM,402,RC,76983,CPT,OUTPATIENT,,,138,89.7,,121.44,88,,97.15,,,0,"percent of total billed charges","88% of total billed charges",69,50,,55.20,,,0,"percent of total billed charges","50% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",102.64,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",86.94,63,,69.55,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,95.22,69,,,,,0,"fee schedule","69% of total billed charges",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.35,61.85,,68.28,,,0,"percent of total billed charges","61.5% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,69,50,,55.20,,,0,"percent of total billed charges","50% of total billed charges",44.44,32.2,,35.55,,,0,"percent of total billed charges","32.2% of total billed charges",73.81,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",52.03,37.7,,41.62,,,0,"percent of total billed charges","37.7% of total billed charges",52.03,37.7,,41.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.78,33.9,,37.42,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",107.64,78,,86.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.99,82.6,,91.19,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,69,50,,55.20,,,0,"percent of total billed charges","50% of total billed charges",113.99,82.6,,91.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",99.65,100,,,,,0,"fee schedule",EAPG,138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",44.44,235,
"BD Bone Density DEXA App Skeleton",32077081,CDM,320,RC,77081,CPT,OUTPATIENT,,,254,165.1,TC,223.52,88,,178.82,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",71.5,100,,,,,0,"fee schedule",EAPG,254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",73.65,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.02,63,,128.02,,,0,"percent of total billed charges","63% of total billed charges",38.86,15.3,,31.09,,,0,"percent of total billed charges","15.3% of total billed charges",71.5,100,,,,,0,"fee schedule",EAPG,175.26,69,,,,,0,"fee schedule","69% of total billed charges",254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",71.5,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.97,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",72.94,100,,,,,0,"fee schedule",EAPG,92.96,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",95.76,37.7,,76.61,,,0,"percent of total billed charges","37.7% of total billed charges",95.76,37.7,,76.61,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",86.11,33.9,,68.89,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",198.12,78,,158.50,,,0,"percent of total billed charges","78% of total billed charges",93.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",209.8,82.6,,167.84,,,0,"percent of total billed charges","82.6% of total billed charges",71.5,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",209.8,82.6,,167.84,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",71.5,100,,,,,0,"fee schedule",EAPG,254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",38.86,328.65,
"BD Bone Density DEXA Axial Skeleton",32077080,CDM,320,RC,77080,CPT,OUTPATIENT,,,588,382.2,TC,517.44,88,,413.95,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",71.5,100,,,,,0,"fee schedule",EAPG,588,100,,470.40,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",73.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",370.44,63,,296.35,,,0,"percent of total billed charges","63% of total billed charges",89.96,15.3,,71.97,,,0,"percent of total billed charges","15.3% of total billed charges",71.5,100,,,,,0,"fee schedule",EAPG,405.72,69,,,,,0,"fee schedule","69% of total billed charges",588,100,,470.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",588,100,,470.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",588,100,,470.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",71.5,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.97,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",72.94,100,,,,,0,"fee schedule",EAPG,92.96,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.68,37.7,,177.34,,,0,"percent of total billed charges","37.7% of total billed charges",221.68,37.7,,177.34,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.33,33.9,,159.46,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",458.64,78,,366.91,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",485.69,82.6,,388.55,,,0,"percent of total billed charges","82.6% of total billed charges",71.5,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",485.69,82.6,,388.55,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",71.5,100,,,,,0,"fee schedule",EAPG,588,100,,470.40,,,0,"percent of total billed charges","100% of total billed charges",52.97,588,
"BD Bone Density DEXA Body Composition",32076499,CDM,320,RC,76499,CPT,OUTPATIENT,,,1067,693.55,TC,938.96,88,,751.17,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1067,100,,853.60,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672.21,63,,537.77,,,0,"percent of total billed charges","63% of total billed charges",163.25,15.3,,130.60,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,736.23,69,,,,,0,"fee schedule","69% of total billed charges",1067,100,,853.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1067,100,,853.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1067,100,,853.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.26,37.7,,321.81,,,0,"percent of total billed charges","37.7% of total billed charges",402.26,37.7,,321.81,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",361.71,33.9,,289.37,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",832.26,78,,665.81,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",881.34,82.6,,705.07,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",881.34,82.6,,705.07,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1067,100,,853.60,,,0,"percent of total billed charges","100% of total billed charges",38.21,1067,
"BD Bone Density DEXA Axial w/Frac Assess",32077080,CDM,320,RC,77080,CPT,OUTPATIENT,,,793,515.45,TC,697.84,88,,558.27,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",71.5,100,,,,,0,"fee schedule",EAPG,793,100,,634.40,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",73.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.59,63,,399.67,,,0,"percent of total billed charges","63% of total billed charges",121.33,15.3,,97.06,,,0,"percent of total billed charges","15.3% of total billed charges",71.5,100,,,,,0,"fee schedule",EAPG,547.17,69,,,,,0,"fee schedule","69% of total billed charges",793,100,,634.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",793,100,,634.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",793,100,,634.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",71.5,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.97,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",72.94,100,,,,,0,"fee schedule",EAPG,92.96,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.96,37.7,,239.17,,,0,"percent of total billed charges","37.7% of total billed charges",298.96,37.7,,239.17,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",268.83,33.9,,215.06,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",618.54,78,,494.83,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",655.02,82.6,,524.02,,,0,"percent of total billed charges","82.6% of total billed charges",71.5,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",655.02,82.6,,524.02,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",71.5,100,,,,,0,"fee schedule",EAPG,793,100,,634.40,,,0,"percent of total billed charges","100% of total billed charges",52.97,793,
"CT Abdomen w/ + w/o Contrast",35274170,CDM,352,RC,74170,CPT,OUTPATIENT,,,5754,3740.1,TC,5063.52,88,,4050.82,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3625.02,63,,2900.02,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,3970.26,69,,,,,0,"fee schedule","69% of total billed charges",5754,100,,4603.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5754,100,,4603.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5754,100,,4603.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2169.26,37.7,,1735.41,,,0,"percent of total billed charges","37.7% of total billed charges",2169.26,37.7,,1735.41,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1950.61,33.9,,1560.49,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4488.12,78,,3590.50,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4752.8,82.6,,3802.24,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4752.8,82.6,,3802.24,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,5754,100,,4603.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,5754,
"CT Abdomen w/ Contrast",35274160,CDM,352,RC,74160,CPT,OUTPATIENT,,,4846,3149.9,TC,4264.48,88,,3411.58,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3052.98,63,,2442.38,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,3343.74,69,,,,,0,"fee schedule","69% of total billed charges",4846,100,,3876.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4846,100,,3876.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4846,100,,3876.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1826.94,37.7,,1461.55,,,0,"percent of total billed charges","37.7% of total billed charges",1826.94,37.7,,1461.55,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1642.79,33.9,,1314.23,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3779.88,78,,3023.90,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4002.8,82.6,,3202.24,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4002.8,82.6,,3202.24,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4846,100,,3876.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,4846,
"CT Abdomen w/o Contrast",35274150,CDM,352,RC,74150,CPT,OUTPATIENT,,,3375,2193.75,TC,2970,88,,2376.00,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,3375,100,,2700.00,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",108.24,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2126.25,63,,1701.00,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",105.09,100,,,,,0,"fee schedule",EAPG,2328.75,69,,,,,0,"fee schedule","69% of total billed charges",3375,100,,2700.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3375,100,,2700.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3375,100,,2700.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.84,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.19,100,,,,,0,"fee schedule",EAPG,136.62,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1272.38,37.7,,1017.90,,,0,"percent of total billed charges","37.7% of total billed charges",1272.38,37.7,,1017.90,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1144.13,33.9,,915.30,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2632.5,78,,2106.00,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2787.75,82.6,,2230.20,,,0,"percent of total billed charges","82.6% of total billed charges",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2787.75,82.6,,2230.20,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,3375,100,,2700.00,,,0,"percent of total billed charges","100% of total billed charges",77.84,3375,
"CT Angio Abdomen Aorta + Iliofemoral",35275635,CDM,352,RC,75635,CPT,OUTPATIENT,,,8438,5484.7,TC,7425.44,88,,5940.35,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.95,175,,,,,0,"fee schedule","175% of CMS fee schedule",359.04,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5315.94,63,,4252.75,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",348.58,100,,,,,0,"fee schedule",EAPG,5822.22,69,,,,,0,"fee schedule","69% of total billed charges",8438,100,,6750.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8438,100,,6750.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8438,100,,6750.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",258.21,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.55,100,,,,,0,"fee schedule",EAPG,453.15,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3181.13,37.7,,2544.90,,,0,"percent of total billed charges","37.7% of total billed charges",3181.13,37.7,,2544.90,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2860.48,33.9,,2288.38,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6581.64,78,,5265.31,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6969.79,82.6,,5575.83,,,0,"percent of total billed charges","82.6% of total billed charges",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6969.79,82.6,,5575.83,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,8438,100,,6750.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,8438,
"CT Angio Abdomen",35274175,CDM,352,RC,74175,CPT,OUTPATIENT,,,7205,4683.25,TC,6340.4,88,,5072.32,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",359.04,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4539.15,63,,3631.32,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",348.58,100,,,,,0,"fee schedule",EAPG,4971.45,69,,,,,0,"fee schedule","69% of total billed charges",7205,100,,5764.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7205,100,,5764.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7205,100,,5764.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",258.21,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.55,100,,,,,0,"fee schedule",EAPG,453.15,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2716.29,37.7,,2173.03,,,0,"percent of total billed charges","37.7% of total billed charges",2716.29,37.7,,2173.03,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2442.5,33.9,,1954.00,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5619.9,78,,4495.92,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5951.33,82.6,,4761.06,,,0,"percent of total billed charges","82.6% of total billed charges",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5951.33,82.6,,4761.06,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,7205,100,,5764.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,7205,
"CT Angio Chest",35271275,CDM,352,RC,71275,CPT,OUTPATIENT,,,8718,5666.7,TC,7671.84,88,,6137.47,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",359.04,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5492.34,63,,4393.87,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",348.58,100,,,,,0,"fee schedule",EAPG,6015.42,69,,,,,0,"fee schedule","69% of total billed charges",8718,100,,6974.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8718,100,,6974.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8718,100,,6974.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",258.21,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.55,100,,,,,0,"fee schedule",EAPG,453.15,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.69,37.7,,2629.35,,,0,"percent of total billed charges","37.7% of total billed charges",3286.69,37.7,,2629.35,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2955.4,33.9,,2364.32,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6800.04,78,,5440.03,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7201.07,82.6,,5760.86,,,0,"percent of total billed charges","82.6% of total billed charges",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7201.07,82.6,,5760.86,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,8718,100,,6974.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,8718,
"CT Angio Brain/Head",35170496,CDM,351,RC,70496,CPT,OUTPATIENT,,,5204,3382.6,TC,4579.52,88,,3663.62,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",359.04,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3278.52,63,,2622.82,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",348.58,100,,,,,0,"fee schedule",EAPG,3590.76,69,,,,,0,"fee schedule","69% of total billed charges",5204,100,,4163.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5204,100,,4163.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5204,100,,4163.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",258.21,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.55,100,,,,,0,"fee schedule",EAPG,453.15,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1961.91,37.7,,1569.53,,,0,"percent of total billed charges","37.7% of total billed charges",1961.91,37.7,,1569.53,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.16,33.9,,1411.33,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4059.12,78,,3247.30,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4298.5,82.6,,3438.80,,,0,"percent of total billed charges","82.6% of total billed charges",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4298.5,82.6,,3438.80,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,5204,100,,4163.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,5204,
"CT Angio Lower Extremity Left",32375710,CDM,352,RC,73706,CPT,OUTPATIENT,,,9885,6425.25,TC|LT,8698.8,88,,6959.04,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",359.04,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6227.55,63,,4982.04,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",348.58,100,,,,,0,"fee schedule",EAPG,6820.65,69,,,,,0,"fee schedule","69% of total billed charges",9885,100,,7908.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9885,100,,7908.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9885,100,,7908.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",258.21,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.55,100,,,,,0,"fee schedule",EAPG,453.15,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3726.65,37.7,,2981.32,,,0,"percent of total billed charges","37.7% of total billed charges",3726.65,37.7,,2981.32,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3351.02,33.9,,2680.82,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7710.3,78,,6168.24,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8165.01,82.6,,6532.01,,,0,"percent of total billed charges","82.6% of total billed charges",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8165.01,82.6,,6532.01,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,9885,100,,7908.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,9885,
"CT Angio Lower Extremity Right",35273706,CDM,352,RC,73706,CPT,OUTPATIENT,,,6939,4510.35,TC|RT,6106.32,88,,4885.06,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",359.04,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4371.57,63,,3497.26,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",348.58,100,,,,,0,"fee schedule",EAPG,4787.91,69,,,,,0,"fee schedule","69% of total billed charges",6939,100,,5551.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6939,100,,5551.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6939,100,,5551.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",258.21,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.55,100,,,,,0,"fee schedule",EAPG,453.15,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2616,37.7,,2092.80,,,0,"percent of total billed charges","37.7% of total billed charges",2616,37.7,,2092.80,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2352.32,33.9,,1881.86,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5412.42,78,,4329.94,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5731.61,82.6,,4585.29,,,0,"percent of total billed charges","82.6% of total billed charges",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5731.61,82.6,,4585.29,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,6939,100,,5551.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,6939,
"CT Angio Neck",35170498,CDM,351,RC,70498,CPT,OUTPATIENT,,,5530,3594.5,TC,4866.4,88,,3893.12,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",359.04,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3483.9,63,,2787.12,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",348.58,100,,,,,0,"fee schedule",EAPG,3815.7,69,,,,,0,"fee schedule","69% of total billed charges",5530,100,,4424.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5530,100,,4424.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5530,100,,4424.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",258.21,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.55,100,,,,,0,"fee schedule",EAPG,453.15,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2084.81,37.7,,1667.85,,,0,"percent of total billed charges","37.7% of total billed charges",2084.81,37.7,,1667.85,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1874.67,33.9,,1499.74,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4313.4,78,,3450.72,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4567.78,82.6,,3654.22,,,0,"percent of total billed charges","82.6% of total billed charges",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4567.78,82.6,,3654.22,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,5530,100,,4424.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,5530,
"CT Angio Pelvis",35272191,CDM,352,RC,72191,CPT,OUTPATIENT,,,5694,3701.1,TC,5010.72,88,,4008.58,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",359.04,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3587.22,63,,2869.78,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",348.58,100,,,,,0,"fee schedule",EAPG,3928.86,69,,,,,0,"fee schedule","69% of total billed charges",5694,100,,4555.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5694,100,,4555.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5694,100,,4555.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",258.21,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.55,100,,,,,0,"fee schedule",EAPG,453.15,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2146.64,37.7,,1717.31,,,0,"percent of total billed charges","37.7% of total billed charges",2146.64,37.7,,1717.31,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1930.27,33.9,,1544.22,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4441.32,78,,3553.06,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4703.24,82.6,,3762.59,,,0,"percent of total billed charges","82.6% of total billed charges",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4703.24,82.6,,3762.59,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,5694,100,,4555.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,5694,
"CT Angio Upper Extremity Left",32375710,CDM,323,RC,73206,CPT,OUTPATIENT,,,9885,6425.25,TC|LT,8698.8,88,,6959.04,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",359.04,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6227.55,63,,4982.04,,,0,"percent of total billed charges","63% of total billed charges",1512.41,15.3,,1209.93,,,0,"percent of total billed charges","15.3% of total billed charges",348.58,100,,,,,0,"fee schedule",EAPG,6820.65,69,,,,,0,"fee schedule","69% of total billed charges",9885,100,,7908.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9885,100,,7908.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9885,100,,7908.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",258.21,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.55,100,,,,,0,"fee schedule",EAPG,453.15,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3726.65,37.7,,2981.32,,,0,"percent of total billed charges","37.7% of total billed charges",3726.65,37.7,,2981.32,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3351.02,33.9,,2680.82,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7710.3,78,,6168.24,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8165.01,82.6,,6532.01,,,0,"percent of total billed charges","82.6% of total billed charges",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8165.01,82.6,,6532.01,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,9885,100,,7908.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,9885,
"CT Angio Upper Extremity Right",35273206,CDM,352,RC,73206,CPT,OUTPATIENT,,,7281,4732.65,TC|RT,6407.28,88,,5125.82,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",359.04,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4587.03,63,,3669.62,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",348.58,100,,,,,0,"fee schedule",EAPG,5023.89,69,,,,,0,"fee schedule","69% of total billed charges",7281,100,,5824.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7281,100,,5824.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7281,100,,5824.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",258.21,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.55,100,,,,,0,"fee schedule",EAPG,453.15,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2744.94,37.7,,2195.95,,,0,"percent of total billed charges","37.7% of total billed charges",2744.94,37.7,,2195.95,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2468.26,33.9,,1974.61,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5679.18,78,,4543.34,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6014.11,82.6,,4811.29,,,0,"percent of total billed charges","82.6% of total billed charges",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6014.11,82.6,,4811.29,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,7281,100,,5824.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,7281,
"CT Abdomen and Pelvis w/ + w/o Contrast",35274178,CDM,352,RC,74178,CPT,OUTPATIENT,,,9200,5980,TC,8096,88,,6476.80,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5796,63,,4636.80,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,6348,69,,,,,0,"fee schedule","69% of total billed charges",9200,100,,7360.00,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9200,100,,7360.00,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9200,100,,7360.00,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3468.4,37.7,,2774.72,,,0,"percent of total billed charges","37.7% of total billed charges",3468.4,37.7,,2774.72,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3118.8,33.9,,2495.04,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7176,78,,5740.80,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7599.2,82.6,,6079.36,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7599.2,82.6,,6079.36,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,9200,100,,7360.00,,,0,"percent of total billed charges","100% of total billed charges",210.9,9200,
"CT Abdomen and Pelvis w/ Contrast",35274177,CDM,352,RC,74177,CPT,OUTPATIENT,,,8590,5583.5,TC,7559.2,88,,6047.36,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5411.7,63,,4329.36,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,5927.1,69,,,,,0,"fee schedule","69% of total billed charges",8590,100,,6872.00,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8590,100,,6872.00,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8590,100,,6872.00,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3238.43,37.7,,2590.74,,,0,"percent of total billed charges","37.7% of total billed charges",3238.43,37.7,,2590.74,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2912.01,33.9,,2329.61,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6700.2,78,,5360.16,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7095.34,82.6,,5676.27,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7095.34,82.6,,5676.27,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,8590,100,,6872.00,,,0,"percent of total billed charges","100% of total billed charges",210.9,8590,
"CT Abdomen and Pelvis w/o Contrast",35274176,CDM,352,RC,74176,CPT,OUTPATIENT,,,5953,3869.45,TC,5238.64,88,,4190.91,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3750.39,63,,3000.31,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,4107.57,69,,,,,0,"fee schedule","69% of total billed charges",5953,100,,4762.40,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5953,100,,4762.40,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5953,100,,4762.40,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2244.28,37.7,,1795.42,,,0,"percent of total billed charges","37.7% of total billed charges",2244.28,37.7,,1795.42,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2018.07,33.9,,1614.46,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4643.34,78,,3714.67,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4917.18,82.6,,3933.74,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4917.18,82.6,,3933.74,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,5953,100,,4762.40,,,0,"percent of total billed charges","100% of total billed charges",210.9,5953,
"CT Angio Abdomen and Pelvis",35274174,CDM,352,RC,74174,CPT,OUTPATIENT,,,7612,4947.8,TC,6698.56,88,,5358.85,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",359.04,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4795.56,63,,3836.45,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",348.58,100,,,,,0,"fee schedule",EAPG,5252.28,69,,,,,0,"fee schedule","69% of total billed charges",7612,100,,6089.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7612,100,,6089.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7612,100,,6089.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",258.21,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.55,100,,,,,0,"fee schedule",EAPG,453.15,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2869.72,37.7,,2295.78,,,0,"percent of total billed charges","37.7% of total billed charges",2869.72,37.7,,2295.78,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2580.47,33.9,,2064.38,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5937.36,78,,4749.89,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6287.51,82.6,,5030.01,,,0,"percent of total billed charges","82.6% of total billed charges",348.58,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6287.51,82.6,,5030.01,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,7612,100,,6089.60,,,0,"percent of total billed charges","100% of total billed charges",258.21,7612,
"CT Angio Coronary Artery w/ Ca Score",35275574,CDM,352,RC,75574,CPT,OUTPATIENT,,,2132,1385.8,TC,1876.16,88,,1500.93,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,2132,100,,1705.60,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",359.04,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1343.16,63,,1074.53,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",348.58,100,,,,,0,"fee schedule",EAPG,1471.08,69,,,,,0,"fee schedule","69% of total billed charges",2132,100,,1705.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2132,100,,1705.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2132,100,,1705.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",258.21,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.55,100,,,,,0,"fee schedule",EAPG,453.15,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",803.76,37.7,,643.01,,,0,"percent of total billed charges","37.7% of total billed charges",803.76,37.7,,643.01,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",722.75,33.9,,578.20,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1662.96,78,,1330.37,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1761.03,82.6,,1408.82,,,0,"percent of total billed charges","82.6% of total billed charges",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1761.03,82.6,,1408.82,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,2132,100,,1705.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,2132,
"CT Angio Coronary Artery w/o Ca Score",35275574,CDM,352,RC,75574,CPT,OUTPATIENT,,,2132,1385.8,TC,1876.16,88,,1500.93,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,2132,100,,1705.60,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",359.04,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1343.16,63,,1074.53,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",348.58,100,,,,,0,"fee schedule",EAPG,1471.08,69,,,,,0,"fee schedule","69% of total billed charges",2132,100,,1705.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2132,100,,1705.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2132,100,,1705.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",258.21,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.55,100,,,,,0,"fee schedule",EAPG,453.15,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",803.76,37.7,,643.01,,,0,"percent of total billed charges","37.7% of total billed charges",803.76,37.7,,643.01,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",722.75,33.9,,578.20,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1662.96,78,,1330.37,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1761.03,82.6,,1408.82,,,0,"percent of total billed charges","82.6% of total billed charges",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1761.03,82.6,,1408.82,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,2132,100,,1705.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,2132,
"CT Angio Lower Extremity Bilateral",35273706,CDM,352,RC,73706,CPT,OUTPATIENT,,,6939,4510.35,TC|RT,6106.32,88,,4885.06,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",359.04,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4371.57,63,,3497.26,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",348.58,100,,,,,0,"fee schedule",EAPG,4787.91,69,,,,,0,"fee schedule","69% of total billed charges",6939,100,,5551.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6939,100,,5551.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6939,100,,5551.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",258.21,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.55,100,,,,,0,"fee schedule",EAPG,453.15,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2616,37.7,,2092.80,,,0,"percent of total billed charges","37.7% of total billed charges",2616,37.7,,2092.80,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2352.32,33.9,,1881.86,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5412.42,78,,4329.94,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5731.61,82.6,,4585.29,,,0,"percent of total billed charges","82.6% of total billed charges",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5731.61,82.6,,4585.29,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,6939,100,,5551.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,6939,
"CT Angio Upper Extremity Bilateral",32375716,CDM,323,RC,73206,CPT,OUTPATIENT,,,6939,4510.35,TC|50,6106.32,88,,4885.06,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",359.04,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4371.57,63,,3497.26,,,0,"percent of total billed charges","63% of total billed charges",1061.67,15.3,,849.34,,,0,"percent of total billed charges","15.3% of total billed charges",348.58,100,,,,,0,"fee schedule",EAPG,4787.91,69,,,,,0,"fee schedule","69% of total billed charges",6939,100,,5551.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6939,100,,5551.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6939,100,,5551.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",258.21,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.55,100,,,,,0,"fee schedule",EAPG,453.15,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2616,37.7,,2092.80,,,0,"percent of total billed charges","37.7% of total billed charges",2616,37.7,,2092.80,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2352.32,33.9,,1881.86,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5412.42,78,,4329.94,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5731.61,82.6,,4585.29,,,0,"percent of total billed charges","82.6% of total billed charges",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5731.61,82.6,,4585.29,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,6939,100,,5551.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,6939,
"CT Angio Chest/Adbdomen/Pelvis w/ Runoff",35271275,CDM,352,RC,71275,CPT,OUTPATIENT,,,8718,5666.7,TC,7671.84,88,,6137.47,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",359.04,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5492.34,63,,4393.87,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",348.58,100,,,,,0,"fee schedule",EAPG,6015.42,69,,,,,0,"fee schedule","69% of total billed charges",8718,100,,6974.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8718,100,,6974.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8718,100,,6974.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",258.21,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.55,100,,,,,0,"fee schedule",EAPG,453.15,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.69,37.7,,2629.35,,,0,"percent of total billed charges","37.7% of total billed charges",3286.69,37.7,,2629.35,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2955.4,33.9,,2364.32,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6800.04,78,,5440.03,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7201.07,82.6,,5760.86,,,0,"percent of total billed charges","82.6% of total billed charges",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7201.07,82.6,,5760.86,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,8718,100,,6974.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,8718,
"CT Angio Head",35170496,CDM,351,RC,70496,CPT,OUTPATIENT,,,5204,3382.6,TC,4579.52,88,,3663.62,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",359.04,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3278.52,63,,2622.82,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",348.58,100,,,,,0,"fee schedule",EAPG,3590.76,69,,,,,0,"fee schedule","69% of total billed charges",5204,100,,4163.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5204,100,,4163.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5204,100,,4163.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",258.21,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.55,100,,,,,0,"fee schedule",EAPG,453.15,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1961.91,37.7,,1569.53,,,0,"percent of total billed charges","37.7% of total billed charges",1961.91,37.7,,1569.53,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.16,33.9,,1411.33,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4059.12,78,,3247.30,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4298.5,82.6,,3438.80,,,0,"percent of total billed charges","82.6% of total billed charges",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4298.5,82.6,,3438.80,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,5204,100,,4163.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,5204,
"CT Angio Chest",35271275,CDM,352,RC,71275,CPT,OUTPATIENT,,,4062,2640.3,TC,3574.56,88,,2859.65,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,4062,100,,3249.60,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",359.04,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2559.06,63,,2047.25,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",348.58,100,,,,,0,"fee schedule",EAPG,2802.78,69,,,,,0,"fee schedule","69% of total billed charges",4062,100,,3249.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4062,100,,3249.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4062,100,,3249.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",258.21,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.55,100,,,,,0,"fee schedule",EAPG,453.15,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1531.37,37.7,,1225.10,,,0,"percent of total billed charges","37.7% of total billed charges",1531.37,37.7,,1225.10,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1377.02,33.9,,1101.62,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3168.36,78,,2534.69,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3355.21,82.6,,2684.17,,,0,"percent of total billed charges","82.6% of total billed charges",348.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3355.21,82.6,,2684.17,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.58,100,,,,,0,"fee schedule",EAPG,4062,100,,3249.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,4062,
"CT Biopsy Liver",35047000,CDM,350,RC,47000,CPT,OUTPATIENT,,,3675,2388.75,,3234,88,,2587.20,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,3675,100,,2940.00,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",685.84,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2315.25,63,,1852.20,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",665.87,100,,,,,0,"fee schedule",EAPG,2535.75,69,,,,,0,"fee schedule","69% of total billed charges",3675,100,,2940.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3675,100,,2940.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3675,100,,2940.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",493.23,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",679.18,100,,,,,0,"fee schedule",EAPG,865.63,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1385.48,37.7,,1108.38,,,0,"percent of total billed charges","37.7% of total billed charges",1385.48,37.7,,1108.38,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1245.83,33.9,,996.66,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2866.5,78,,2293.20,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3035.55,82.6,,2428.44,,,0,"percent of total billed charges","82.6% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3035.55,82.6,,2428.44,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,3675,100,,2940.00,,,0,"percent of total billed charges","100% of total billed charges",358,5715.97,
"CT Biopsy Lung/Mediastinum",35032408,CDM,350,RC,32408,CPT,OUTPATIENT,,,3675,2388.75,,3234,88,,2587.20,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,3675,100,,2940.00,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",884,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2315.25,63,,1852.20,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",858.26,100,,,,,0,"fee schedule",EAPG,2535.75,69,,,,,0,"fee schedule","69% of total billed charges",3675,100,,2940.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3675,100,,2940.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3675,100,,2940.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",635.74,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.42,100,,,,,0,"fee schedule",EAPG,1115.74,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1385.48,37.7,,1108.38,,,0,"percent of total billed charges","37.7% of total billed charges",1385.48,37.7,,1108.38,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1245.83,33.9,,996.66,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2866.5,78,,2293.20,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3035.55,82.6,,2428.44,,,0,"percent of total billed charges","82.6% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3035.55,82.6,,2428.44,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,3675,100,,2940.00,,,0,"percent of total billed charges","100% of total billed charges",358,5715.97,
"CT Biopsy Pancreas",35048102,CDM,350,RC,48102,CPT,OUTPATIENT,,,3675,2388.75,,3234,88,,2587.20,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,3675,100,,2940.00,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",685.84,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2315.25,63,,1852.20,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",665.87,100,,,,,0,"fee schedule",EAPG,2535.75,69,,,,,0,"fee schedule","69% of total billed charges",3675,100,,2940.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3675,100,,2940.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3675,100,,2940.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",493.23,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",679.18,100,,,,,0,"fee schedule",EAPG,865.63,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1385.48,37.7,,1108.38,,,0,"percent of total billed charges","37.7% of total billed charges",1385.48,37.7,,1108.38,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1245.83,33.9,,996.66,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2866.5,78,,2293.20,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3035.55,82.6,,2428.44,,,0,"percent of total billed charges","82.6% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3035.55,82.6,,2428.44,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,3675,100,,2940.00,,,0,"percent of total billed charges","100% of total billed charges",358,5715.97,
"CT Biopsy Renal",35050200,CDM,350,RC,50200,CPT,OUTPATIENT,,,3675,2388.75,,3234,88,,2587.20,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1359.89,100,,,,,0,"fee schedule",EAPG,3675,100,,2940.00,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1400.69,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2315.25,63,,1852.20,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",1359.89,100,,,,,0,"fee schedule",EAPG,2535.75,69,,,,,0,"fee schedule","69% of total billed charges",3675,100,,2940.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3675,100,,2940.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3675,100,,2940.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1359.89,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1007.32,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1387.09,100,,,,,0,"fee schedule",EAPG,1767.86,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1385.48,37.7,,1108.38,,,0,"percent of total billed charges","37.7% of total billed charges",1385.48,37.7,,1108.38,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1245.83,33.9,,996.66,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2866.5,78,,2293.20,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3035.55,82.6,,2428.44,,,0,"percent of total billed charges","82.6% of total billed charges",1359.89,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3035.55,82.6,,2428.44,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1359.89,100,,,,,0,"fee schedule",EAPG,3675,100,,2940.00,,,0,"percent of total billed charges","100% of total billed charges",358,5715.97,
"CT Brain/Head w/ + w/o Contrast",35170470,CDM,351,RC,70470,CPT,OUTPATIENT,,,4369,2839.85,TC,3844.72,88,,3075.78,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4369,100,,3495.20,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2752.47,63,,2201.98,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,3014.61,69,,,,,0,"fee schedule","69% of total billed charges",4369,100,,3495.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4369,100,,3495.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4369,100,,3495.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1647.11,37.7,,1317.69,,,0,"percent of total billed charges","37.7% of total billed charges",1647.11,37.7,,1317.69,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1481.09,33.9,,1184.87,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3407.82,78,,2726.26,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3608.79,82.6,,2887.03,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3608.79,82.6,,2887.03,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4369,100,,3495.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,4369,
"CT Brain/Head w/ Contrast",35170460,CDM,351,RC,70460,CPT,OUTPATIENT,,,3819,2482.35,TC,3360.72,88,,2688.58,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,3819,100,,3055.20,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2405.97,63,,1924.78,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,2635.11,69,,,,,0,"fee schedule","69% of total billed charges",3819,100,,3055.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3819,100,,3055.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3819,100,,3055.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1439.76,37.7,,1151.81,,,0,"percent of total billed charges","37.7% of total billed charges",1439.76,37.7,,1151.81,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1294.64,33.9,,1035.71,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2978.82,78,,2383.06,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3154.49,82.6,,2523.59,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3154.49,82.6,,2523.59,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,3819,100,,3055.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,3819,
"CT Brain/Head w/o Contrast",35170450,CDM,351,RC,70450,CPT,OUTPATIENT,,,2818,1831.7,TC,2479.84,88,,1983.87,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,2818,100,,2254.40,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1775.34,63,,1420.27,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,1944.42,69,,,,,0,"fee schedule","69% of total billed charges",2818,100,,2254.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2818,100,,2254.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2818,100,,2254.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1062.39,37.7,,849.91,,,0,"percent of total billed charges","37.7% of total billed charges",1062.39,37.7,,849.91,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",955.3,33.9,,764.24,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2198.04,78,,1758.43,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2327.67,82.6,,1862.14,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2327.67,82.6,,1862.14,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,2818,100,,2254.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,2818,
"CT Celiac Plexus INJ",35074150,CDM,350,RC,64530,CPT,OUTPATIENT,,,3209,2085.85,TC,2823.92,88,,2259.14,,,0,"percent of total billed charges","88% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,3209,100,,2567.20,,,0,"percent of total billed charges","100% of total billed charges",1626.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",1076.46,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2021.67,63,,1617.34,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",1045.11,100,,,,,0,"fee schedule",EAPG,2214.21,69,,,,,0,"fee schedule","69% of total billed charges",3209,100,,2567.20,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3209,100,,2567.20,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3209,100,,2567.20,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3341.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",774.15,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1066.01,100,,,,,0,"fee schedule",EAPG,1358.64,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1209.79,37.7,,967.83,,,0,"percent of total billed charges","37.7% of total billed charges",1209.79,37.7,,967.83,,,0,"percent of total billed charges","37.70% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1087.85,33.9,,870.28,,,0,"percent of total billed charges","33.9% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2503.02,78,,2002.42,,,0,"percent of total billed charges","78% of total billed charges",938.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2650.63,82.6,,2120.50,,,0,"percent of total billed charges","82.6% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2650.63,82.6,,2120.50,,,0,"percent of total billed charges","82.6% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,3209,100,,2567.20,,,0,"percent of total billed charges","100% of total billed charges",358,3341.26,
"CT Chest w/ + w/o Contrast",35071270,CDM,350,RC,71270,CPT,OUTPATIENT,,,6287,4086.55,TC,5532.56,88,,4426.05,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3960.81,63,,3168.65,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,4338.03,69,,,,,0,"fee schedule","69% of total billed charges",6287,100,,5029.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6287,100,,5029.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6287,100,,5029.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2370.2,37.7,,1896.16,,,0,"percent of total billed charges","37.7% of total billed charges",2370.2,37.7,,1896.16,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2131.29,33.9,,1705.03,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4903.86,78,,3923.09,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5193.06,82.6,,4154.45,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5193.06,82.6,,4154.45,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,6287,100,,5029.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,6287,
"CT Chest w/ Contrast",35071260,CDM,350,RC,71260,CPT,OUTPATIENT,,,4964,3226.6,TC,4368.32,88,,3494.66,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3127.32,63,,2501.86,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,3425.16,69,,,,,0,"fee schedule","69% of total billed charges",4964,100,,3971.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4964,100,,3971.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4964,100,,3971.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1871.43,37.7,,1497.14,,,0,"percent of total billed charges","37.7% of total billed charges",1871.43,37.7,,1497.14,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1682.8,33.9,,1346.24,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3871.92,78,,3097.54,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.26,82.6,,3280.21,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.26,82.6,,3280.21,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4964,100,,3971.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,4964,
"CT Chest w/o Contrast",35071250,CDM,350,RC,71250,CPT,OUTPATIENT,,,3547,2305.55,TC,3121.36,88,,2497.09,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,3547,100,,2837.60,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",108.24,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2234.61,63,,1787.69,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",105.09,100,,,,,0,"fee schedule",EAPG,2447.43,69,,,,,0,"fee schedule","69% of total billed charges",3547,100,,2837.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3547,100,,2837.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3547,100,,2837.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.84,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.19,100,,,,,0,"fee schedule",EAPG,136.62,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1337.22,37.7,,1069.78,,,0,"percent of total billed charges","37.7% of total billed charges",1337.22,37.7,,1069.78,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1202.43,33.9,,961.94,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2766.66,78,,2213.33,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2929.82,82.6,,2343.86,,,0,"percent of total billed charges","82.6% of total billed charges",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2929.82,82.6,,2343.86,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,3547,100,,2837.60,,,0,"percent of total billed charges","100% of total billed charges",77.84,3547,
"CT Chest/Adbomen/Pelvis w/ + w/o Contras",35071270,CDM,350,RC,71270,CPT,OUTPATIENT,,,6287,4086.55,TC,5532.56,88,,4426.05,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3960.81,63,,3168.65,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,4338.03,69,,,,,0,"fee schedule","69% of total billed charges",6287,100,,5029.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6287,100,,5029.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6287,100,,5029.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2370.2,37.7,,1896.16,,,0,"percent of total billed charges","37.7% of total billed charges",2370.2,37.7,,1896.16,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2131.29,33.9,,1705.03,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4903.86,78,,3923.09,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5193.06,82.6,,4154.45,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5193.06,82.6,,4154.45,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,6287,100,,5029.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,6287,
"CT Chest/Adbomen/Pelvis w/ Contrast",35071260,CDM,350,RC,71260,CPT,OUTPATIENT,,,4964,3226.6,TC,4368.32,88,,3494.66,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3127.32,63,,2501.86,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,3425.16,69,,,,,0,"fee schedule","69% of total billed charges",4964,100,,3971.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4964,100,,3971.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4964,100,,3971.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1871.43,37.7,,1497.14,,,0,"percent of total billed charges","37.7% of total billed charges",1871.43,37.7,,1497.14,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1682.8,33.9,,1346.24,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3871.92,78,,3097.54,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.26,82.6,,3280.21,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.26,82.6,,3280.21,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4964,100,,3971.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,4964,
"CT Chest/Adbomen/Pelvis w/o Contrast",35071250,CDM,350,RC,71250,CPT,OUTPATIENT,,,3547,2305.55,TC,3121.36,88,,2497.09,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,3547,100,,2837.60,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",108.24,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2234.61,63,,1787.69,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",105.09,100,,,,,0,"fee schedule",EAPG,2447.43,69,,,,,0,"fee schedule","69% of total billed charges",3547,100,,2837.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3547,100,,2837.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3547,100,,2837.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.84,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.19,100,,,,,0,"fee schedule",EAPG,136.62,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1337.22,37.7,,1069.78,,,0,"percent of total billed charges","37.7% of total billed charges",1337.22,37.7,,1069.78,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1202.43,33.9,,961.94,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2766.66,78,,2213.33,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2929.82,82.6,,2343.86,,,0,"percent of total billed charges","82.6% of total billed charges",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2929.82,82.6,,2343.86,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,3547,100,,2837.60,,,0,"percent of total billed charges","100% of total billed charges",77.84,3547,
"CT Chest/Abdomen w/ + w/o Contrast",35071270,CDM,350,RC,71270,CPT,OUTPATIENT,,,6287,4086.55,TC,5532.56,88,,4426.05,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3960.81,63,,3168.65,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,4338.03,69,,,,,0,"fee schedule","69% of total billed charges",6287,100,,5029.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6287,100,,5029.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6287,100,,5029.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2370.2,37.7,,1896.16,,,0,"percent of total billed charges","37.7% of total billed charges",2370.2,37.7,,1896.16,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2131.29,33.9,,1705.03,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4903.86,78,,3923.09,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5193.06,82.6,,4154.45,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5193.06,82.6,,4154.45,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,6287,100,,5029.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,6287,
"CT Chest/Abdomen w/ Contrast",35071260,CDM,350,RC,71260,CPT,OUTPATIENT,,,4964,3226.6,TC,4368.32,88,,3494.66,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3127.32,63,,2501.86,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,3425.16,69,,,,,0,"fee schedule","69% of total billed charges",4964,100,,3971.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4964,100,,3971.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4964,100,,3971.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1871.43,37.7,,1497.14,,,0,"percent of total billed charges","37.7% of total billed charges",1871.43,37.7,,1497.14,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1682.8,33.9,,1346.24,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3871.92,78,,3097.54,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.26,82.6,,3280.21,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.26,82.6,,3280.21,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4964,100,,3971.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,4964,
"CT Chest/Abdomen w/o Contrast",35071250,CDM,350,RC,71250,CPT,OUTPATIENT,,,3547,2305.55,TC,3121.36,88,,2497.09,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,3547,100,,2837.60,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",108.24,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2234.61,63,,1787.69,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",105.09,100,,,,,0,"fee schedule",EAPG,2447.43,69,,,,,0,"fee schedule","69% of total billed charges",3547,100,,2837.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3547,100,,2837.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3547,100,,2837.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.84,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.19,100,,,,,0,"fee schedule",EAPG,136.62,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1337.22,37.7,,1069.78,,,0,"percent of total billed charges","37.7% of total billed charges",1337.22,37.7,,1069.78,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1202.43,33.9,,961.94,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2766.66,78,,2213.33,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2929.82,82.6,,2343.86,,,0,"percent of total billed charges","82.6% of total billed charges",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2929.82,82.6,,2343.86,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,3547,100,,2837.60,,,0,"percent of total billed charges","100% of total billed charges",77.84,3547,
"CT Drain Soft Tissue Fluid w/Cath Perc",35010030,CDM,350,RC,10030,CPT,OUTPATIENT,,,6046,3929.9,,5320.48,88,,4256.38,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",989.16,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",1018.83,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3808.98,63,,3047.18,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",989.16,100,,,,,0,"fee schedule",EAPG,4171.74,69,,,,,0,"fee schedule","69% of total billed charges",6046,100,,4836.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6046,100,,4836.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6046,100,,4836.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",989.16,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",732.71,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1008.94,100,,,,,0,"fee schedule",EAPG,1285.91,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2279.34,37.7,,1823.47,,,0,"percent of total billed charges","37.7% of total billed charges",2279.34,37.7,,1823.47,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2049.59,33.9,,1639.67,,,0,"percent of total billed charges","33.9% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4715.88,78,,3772.70,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4994,82.6,,3995.20,,,0,"percent of total billed charges","82.6% of total billed charges",989.16,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4994,82.6,,3995.20,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",989.16,100,,,,,0,"fee schedule",EAPG,6046,100,,4836.80,,,0,"percent of total billed charges","100% of total billed charges",358,6046,
"CT Drain Visceral Fluid w/Cath Perc",35075989,CDM,350,RC,75989,CPT,OUTPATIENT,,,1700,1105,TC,1496,88,,1196.80,,,0,"percent of total billed charges","88% of total billed charges",850,50,,680.00,,,0,"percent of total billed charges","50% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,1700,100,,1360.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1071,63,,856.80,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",161.97,100,,,,,0,"fee schedule",EAPG,1173,69,,,,,0,"fee schedule","69% of total billed charges",1700,100,,1360.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1700,100,,1360.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1700,100,,1360.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1051.45,61.85,,841.16,,,0,"percent of total billed charges","61.5% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,850,50,,680.00,,,0,"percent of total billed charges","50% of total billed charges",547.4,32.2,,437.92,,,0,"percent of total billed charges","32.2% of total billed charges",119.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",165.21,100,,,,,0,"fee schedule",EAPG,210.57,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",640.9,37.7,,512.72,,,0,"percent of total billed charges","37.7% of total billed charges",640.9,37.7,,512.72,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",576.3,33.9,,461.04,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1326,78,,1060.80,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1404.2,82.6,,1123.36,,,0,"percent of total billed charges","82.6% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,850,50,,680.00,,,0,"percent of total billed charges","50% of total billed charges",1404.2,82.6,,1123.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",161.97,100,,,,,0,"fee schedule",EAPG,1700,100,,1360.00,,,0,"percent of total billed charges","100% of total billed charges",119.98,1700,
"CT Guided Needle Placement",35077012,CDM,350,RC,77012,CPT,OUTPATIENT,,,3675,2388.75,TC,3234,88,,2587.20,,,0,"percent of total billed charges","88% of total billed charges",1837.5,50,,1470.00,,,0,"percent of total billed charges","50% of total billed charges",83.84,100,,,,,0,"fee schedule",EAPG,3675,100,,2940.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.36,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2315.25,63,,1852.20,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",83.84,100,,,,,0,"fee schedule",EAPG,2535.75,69,,,,,0,"fee schedule","69% of total billed charges",3675,100,,2940.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3675,100,,2940.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3675,100,,2940.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2272.99,61.85,,1818.39,,,0,"percent of total billed charges","61.5% of total billed charges",83.84,100,,,,,0,"fee schedule",EAPG,1837.5,50,,1470.00,,,0,"percent of total billed charges","50% of total billed charges",1183.35,32.2,,946.68,,,0,"percent of total billed charges","32.2% of total billed charges",62.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",85.52,100,,,,,0,"fee schedule",EAPG,109,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1385.48,37.7,,1108.38,,,0,"percent of total billed charges","37.7% of total billed charges",1385.48,37.7,,1108.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1245.83,33.9,,996.66,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2866.5,78,,2293.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3035.55,82.6,,2428.44,,,0,"percent of total billed charges","82.6% of total billed charges",83.84,100,,,,,0,"fee schedule",EAPG,1837.5,50,,1470.00,,,0,"percent of total billed charges","50% of total billed charges",3035.55,82.6,,2428.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",83.84,100,,,,,0,"fee schedule",EAPG,3675,100,,2940.00,,,0,"percent of total billed charges","100% of total billed charges",62.1,3675,
"CT Guided Cryoablation",35050593,CDM,350,RC,50593,CPT,OUTPATIENT,,,2883,1873.95,TC,2537.04,88,,2029.63,,,0,"percent of total billed charges","88% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6248.26,100,,,,,0,"fee schedule",EAPG,2883,100,,2306.40,,,0,"percent of total billed charges","100% of total billed charges",18373.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",6435.7,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1816.29,63,,1453.03,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",6248.26,100,,,,,0,"fee schedule",EAPG,1989.27,69,,,,,0,"fee schedule","69% of total billed charges",2883,100,,2306.40,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2883,100,,2306.40,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2883,100,,2306.40,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",36187.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6248.26,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9460.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4628.34,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6373.22,100,,,,,0,"fee schedule",EAPG,8122.73,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1086.89,37.7,,869.51,,,0,"percent of total billed charges","37.7% of total billed charges",1086.89,37.7,,869.51,,,0,"percent of total billed charges","37.70% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",977.34,33.9,,781.87,,,0,"percent of total billed charges","33.9% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2248.74,78,,1798.99,,,0,"percent of total billed charges","78% of total billed charges",10604.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2381.36,82.6,,1905.09,,,0,"percent of total billed charges","82.6% of total billed charges",6248.26,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2381.36,82.6,,1905.09,,,0,"percent of total billed charges","82.6% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6248.26,100,,,,,0,"fee schedule",EAPG,2883,100,,2306.40,,,0,"percent of total billed charges","100% of total billed charges",358,36187.64,
"CT Guided Microablation",35047382,CDM,350,RC,47382,CPT,OUTPATIENT,,,2883,1873.95,TC,2537.04,88,,2029.63,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5749.65,100,,,,,0,"fee schedule",EAPG,2883,100,,2306.40,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",5922.14,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1816.29,63,,1453.03,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",5749.65,100,,,,,0,"fee schedule",EAPG,1989.27,69,,,,,0,"fee schedule","69% of total billed charges",2883,100,,2306.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2883,100,,2306.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2883,100,,2306.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5749.65,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4259,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5864.64,100,,,,,0,"fee schedule",EAPG,7474.55,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1086.89,37.7,,869.51,,,0,"percent of total billed charges","37.7% of total billed charges",1086.89,37.7,,869.51,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",977.34,33.9,,781.87,,,0,"percent of total billed charges","33.9% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2248.74,78,,1798.99,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2381.36,82.6,,1905.09,,,0,"percent of total billed charges","82.6% of total billed charges",5749.65,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2381.36,82.6,,1905.09,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5749.65,100,,,,,0,"fee schedule",EAPG,2883,100,,2306.40,,,0,"percent of total billed charges","100% of total billed charges",358,20558.19,
"CT Guided Bone Marrow Biopsy",68638222,CDM,761,RC,38222,CPT,OUTPATIENT,,,1825,1186.25,,1606,88,,1284.80,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1070.37,100,,,,,0,"fee schedule",EAPG,1825,100,,1460.00,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1102.48,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1149.75,63,,919.80,,,0,"percent of total billed charges","63% of total billed charges",279.23,15.3,,223.38,,,0,"percent of total billed charges","15.3% of total billed charges",1070.37,100,,,,,0,"fee schedule",EAPG,1259.25,69,,,,,0,"fee schedule","69% of total billed charges",1825,100,,1460.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1825,100,,1460.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1825,100,,1460.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1070.37,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",792.87,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1091.78,100,,,,,0,"fee schedule",EAPG,1391.48,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",688.03,37.7,,550.42,,,0,"percent of total billed charges","37.7% of total billed charges",688.03,37.7,,550.42,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",618.68,33.9,,494.94,,,0,"percent of total billed charges","33.9% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1423.5,78,,1138.80,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1507.45,82.6,,1205.96,,,0,"percent of total billed charges","82.6% of total billed charges",1070.37,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1507.45,82.6,,1205.96,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1070.37,100,,,,,0,"fee schedule",EAPG,1825,100,,1460.00,,,0,"percent of total billed charges","100% of total billed charges",279.23,9628.23,
"CT Heart + Eval w/ Contrast",35275572,CDM,352,RC,75572,CPT,OUTPATIENT,,,902,586.3,TC,793.76,88,,635.01,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,902,100,,721.60,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.26,63,,454.61,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,622.38,69,,,,,0,"fee schedule","69% of total billed charges",902,100,,721.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",902,100,,721.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",902,100,,721.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",340.05,37.7,,272.04,,,0,"percent of total billed charges","37.7% of total billed charges",340.05,37.7,,272.04,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",305.78,33.9,,244.62,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",703.56,78,,562.85,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",745.05,82.6,,596.04,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",745.05,82.6,,596.04,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,902,100,,721.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,902,
"CT Heart Congenital + Eval w/ Contrast",35275573,CDM,352,RC,75573,CPT,OUTPATIENT,,,1781,1157.65,TC,1567.28,88,,1253.82,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,1781,100,,1424.80,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1122.03,63,,897.62,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,1228.89,69,,,,,0,"fee schedule","69% of total billed charges",1781,100,,1424.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1781,100,,1424.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1781,100,,1424.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671.44,37.7,,537.15,,,0,"percent of total billed charges","37.7% of total billed charges",671.44,37.7,,537.15,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",603.76,33.9,,483.01,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1389.18,78,,1111.34,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1471.11,82.6,,1176.89,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1471.11,82.6,,1176.89,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,1781,100,,1424.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,1781,
"CT Heart Calcium Scoring",35275571,CDM,352,RC,75571,CPT,OUTPATIENT,,,2131,1385.15,TC,1875.28,88,,1500.22,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,2131,100,,1704.80,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",108.24,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1342.53,63,,1074.02,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",105.09,100,,,,,0,"fee schedule",EAPG,1470.39,69,,,,,0,"fee schedule","69% of total billed charges",2131,100,,1704.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2131,100,,1704.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2131,100,,1704.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.84,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.19,100,,,,,0,"fee schedule",EAPG,136.62,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",803.39,37.7,,642.71,,,0,"percent of total billed charges","37.7% of total billed charges",803.39,37.7,,642.71,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",722.41,33.9,,577.93,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1662.18,78,,1329.74,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1760.21,82.6,,1408.17,,,0,"percent of total billed charges","82.6% of total billed charges",105.09,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1760.21,82.6,,1408.17,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,2131,100,,1704.80,,,0,"percent of total billed charges","100% of total billed charges",77.84,2131,
"CT Head/Neck w/ + w/o Contrast",35170470,CDM,351,RC,70470,CPT,OUTPATIENT,,,4369,2839.85,TC,3844.72,88,,3075.78,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4369,100,,3495.20,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2752.47,63,,2201.98,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,3014.61,69,,,,,0,"fee schedule","69% of total billed charges",4369,100,,3495.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4369,100,,3495.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4369,100,,3495.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1647.11,37.7,,1317.69,,,0,"percent of total billed charges","37.7% of total billed charges",1647.11,37.7,,1317.69,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1481.09,33.9,,1184.87,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3407.82,78,,2726.26,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3608.79,82.6,,2887.03,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3608.79,82.6,,2887.03,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4369,100,,3495.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,4369,
"CT Head/Neck w/ Contrast",35170460,CDM,351,RC,70460,CPT,OUTPATIENT,,,3819,2482.35,TC,3360.72,88,,2688.58,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,3819,100,,3055.20,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2405.97,63,,1924.78,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,2635.11,69,,,,,0,"fee schedule","69% of total billed charges",3819,100,,3055.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3819,100,,3055.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3819,100,,3055.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1439.76,37.7,,1151.81,,,0,"percent of total billed charges","37.7% of total billed charges",1439.76,37.7,,1151.81,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1294.64,33.9,,1035.71,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2978.82,78,,2383.06,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3154.49,82.6,,2523.59,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3154.49,82.6,,2523.59,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,3819,100,,3055.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,3819,
"CT Head/Neck w/o Contrast",35170450,CDM,351,RC,70450,CPT,OUTPATIENT,,,2818,1831.7,TC,2479.84,88,,1983.87,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,2818,100,,2254.40,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1775.34,63,,1420.27,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,1944.42,69,,,,,0,"fee schedule","69% of total billed charges",2818,100,,2254.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2818,100,,2254.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2818,100,,2254.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1062.39,37.7,,849.91,,,0,"percent of total billed charges","37.7% of total billed charges",1062.39,37.7,,849.91,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",955.3,33.9,,764.24,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2198.04,78,,1758.43,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2327.67,82.6,,1862.14,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2327.67,82.6,,1862.14,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,2818,100,,2254.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,2818,
"CT Head/Orbits w/ + w/o Contrast",35170470,CDM,351,RC,70470,CPT,OUTPATIENT,,,4369,2839.85,TC,3844.72,88,,3075.78,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4369,100,,3495.20,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2752.47,63,,2201.98,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,3014.61,69,,,,,0,"fee schedule","69% of total billed charges",4369,100,,3495.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4369,100,,3495.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4369,100,,3495.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1647.11,37.7,,1317.69,,,0,"percent of total billed charges","37.7% of total billed charges",1647.11,37.7,,1317.69,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1481.09,33.9,,1184.87,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3407.82,78,,2726.26,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3608.79,82.6,,2887.03,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3608.79,82.6,,2887.03,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4369,100,,3495.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,4369,
"CT Head/Orbits w/ Contrast",35170460,CDM,351,RC,70460,CPT,OUTPATIENT,,,3819,2482.35,TC,3360.72,88,,2688.58,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,3819,100,,3055.20,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2405.97,63,,1924.78,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,2635.11,69,,,,,0,"fee schedule","69% of total billed charges",3819,100,,3055.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3819,100,,3055.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3819,100,,3055.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1439.76,37.7,,1151.81,,,0,"percent of total billed charges","37.7% of total billed charges",1439.76,37.7,,1151.81,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1294.64,33.9,,1035.71,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2978.82,78,,2383.06,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3154.49,82.6,,2523.59,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3154.49,82.6,,2523.59,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,3819,100,,3055.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,3819,
"CT Head/Orbits w/o Contrast",35170450,CDM,351,RC,70450,CPT,OUTPATIENT,,,2818,1831.7,TC,2479.84,88,,1983.87,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,2818,100,,2254.40,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1775.34,63,,1420.27,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,1944.42,69,,,,,0,"fee schedule","69% of total billed charges",2818,100,,2254.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2818,100,,2254.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2818,100,,2254.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1062.39,37.7,,849.91,,,0,"percent of total billed charges","37.7% of total billed charges",1062.39,37.7,,849.91,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",955.3,33.9,,764.24,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2198.04,78,,1758.43,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2327.67,82.6,,1862.14,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2327.67,82.6,,1862.14,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,2818,100,,2254.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,2818,
"CT Lower Extremity w/ Contrast Bilat",35273701,CDM,352,RC,73701,CPT,OUTPATIENT,,,6431,4180.15,TC|50,5659.28,88,,4527.42,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4051.53,63,,3241.22,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,4437.39,69,,,,,0,"fee schedule","69% of total billed charges",6431,100,,5144.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6431,100,,5144.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6431,100,,5144.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2424.49,37.7,,1939.59,,,0,"percent of total billed charges","37.7% of total billed charges",2424.49,37.7,,1939.59,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2180.11,33.9,,1744.09,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5016.18,78,,4012.94,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5312.01,82.6,,4249.61,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5312.01,82.6,,4249.61,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,6431,100,,5144.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,6431,
"CT Lower Extremity w/ Contrast Left",35273701,CDM,352,RC,73701,CPT,OUTPATIENT,,,6052,3933.8,TC|50,5325.76,88,,4260.61,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3812.76,63,,3050.21,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,4175.88,69,,,,,0,"fee schedule","69% of total billed charges",6052,100,,4841.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6052,100,,4841.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6052,100,,4841.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2281.6,37.7,,1825.28,,,0,"percent of total billed charges","37.7% of total billed charges",2281.6,37.7,,1825.28,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2051.63,33.9,,1641.30,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4720.56,78,,3776.45,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4998.95,82.6,,3999.16,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4998.95,82.6,,3999.16,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,6052,100,,4841.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,6052,
"CT Lower Extremity w/ Contrast Right",35273701,CDM,352,RC,73701,CPT,OUTPATIENT,,,6052,3933.8,TC|50,5325.76,88,,4260.61,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3812.76,63,,3050.21,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,4175.88,69,,,,,0,"fee schedule","69% of total billed charges",6052,100,,4841.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6052,100,,4841.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6052,100,,4841.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2281.6,37.7,,1825.28,,,0,"percent of total billed charges","37.7% of total billed charges",2281.6,37.7,,1825.28,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2051.63,33.9,,1641.30,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4720.56,78,,3776.45,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4998.95,82.6,,3999.16,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4998.95,82.6,,3999.16,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,6052,100,,4841.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,6052,
"CT Lower Extremity w/+w/o Contrast Bilat",35273702,CDM,352,RC,73702,CPT,OUTPATIENT,,,5163,3355.95,TC|50,4543.44,88,,3634.75,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3252.69,63,,2602.15,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,3562.47,69,,,,,0,"fee schedule","69% of total billed charges",5163,100,,4130.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5163,100,,4130.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5163,100,,4130.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1946.45,37.7,,1557.16,,,0,"percent of total billed charges","37.7% of total billed charges",1946.45,37.7,,1557.16,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1750.26,33.9,,1400.21,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4027.14,78,,3221.71,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4264.64,82.6,,3411.71,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4264.64,82.6,,3411.71,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,5163,100,,4130.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,5163,
"CT Lower Extremity w/+w/o Contrast Left",35273702,CDM,352,RC,73702,CPT,OUTPATIENT,,,5163,3355.95,TC|50,4543.44,88,,3634.75,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3252.69,63,,2602.15,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,3562.47,69,,,,,0,"fee schedule","69% of total billed charges",5163,100,,4130.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5163,100,,4130.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5163,100,,4130.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1946.45,37.7,,1557.16,,,0,"percent of total billed charges","37.7% of total billed charges",1946.45,37.7,,1557.16,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1750.26,33.9,,1400.21,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4027.14,78,,3221.71,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4264.64,82.6,,3411.71,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4264.64,82.6,,3411.71,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,5163,100,,4130.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,5163,
"CT Lower Extremity w/+w/o Contrast Right",35273702,CDM,352,RC,73702,CPT,OUTPATIENT,,,5163,3355.95,TC|50,4543.44,88,,3634.75,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3252.69,63,,2602.15,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,3562.47,69,,,,,0,"fee schedule","69% of total billed charges",5163,100,,4130.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5163,100,,4130.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5163,100,,4130.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1946.45,37.7,,1557.16,,,0,"percent of total billed charges","37.7% of total billed charges",1946.45,37.7,,1557.16,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1750.26,33.9,,1400.21,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4027.14,78,,3221.71,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4264.64,82.6,,3411.71,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4264.64,82.6,,3411.71,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,5163,100,,4130.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,5163,
"CT Lower Extremity w/o Contrast Bilat",35273700,CDM,352,RC,73700,CPT,OUTPATIENT,,,5106,3318.9,TC|50,4493.28,88,,3594.62,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",108.24,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3216.78,63,,2573.42,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",105.09,100,,,,,0,"fee schedule",EAPG,3523.14,69,,,,,0,"fee schedule","69% of total billed charges",5106,100,,4084.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5106,100,,4084.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5106,100,,4084.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.84,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.19,100,,,,,0,"fee schedule",EAPG,136.62,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1924.96,37.7,,1539.97,,,0,"percent of total billed charges","37.7% of total billed charges",1924.96,37.7,,1539.97,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1730.93,33.9,,1384.74,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3982.68,78,,3186.14,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4217.56,82.6,,3374.05,,,0,"percent of total billed charges","82.6% of total billed charges",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4217.56,82.6,,3374.05,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,5106,100,,4084.80,,,0,"percent of total billed charges","100% of total billed charges",77.84,5106,
"CT Lower Extremity w/o Contrast Left",35273700,CDM,352,RC,73700,CPT,OUTPATIENT,,,3597,2338.05,TC|50,3165.36,88,,2532.29,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,3597,100,,2877.60,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",108.24,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2266.11,63,,1812.89,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",105.09,100,,,,,0,"fee schedule",EAPG,2481.93,69,,,,,0,"fee schedule","69% of total billed charges",3597,100,,2877.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3597,100,,2877.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3597,100,,2877.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.84,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.19,100,,,,,0,"fee schedule",EAPG,136.62,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1356.07,37.7,,1084.86,,,0,"percent of total billed charges","37.7% of total billed charges",1356.07,37.7,,1084.86,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1219.38,33.9,,975.50,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2805.66,78,,2244.53,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2971.12,82.6,,2376.90,,,0,"percent of total billed charges","82.6% of total billed charges",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2971.12,82.6,,2376.90,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,3597,100,,2877.60,,,0,"percent of total billed charges","100% of total billed charges",77.84,3597,
"CT Lower Extremity w/o Contrast Right",35273700,CDM,352,RC,73700,CPT,OUTPATIENT,,,3597,2338.05,TC|50,3165.36,88,,2532.29,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,3597,100,,2877.60,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",108.24,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2266.11,63,,1812.89,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",105.09,100,,,,,0,"fee schedule",EAPG,2481.93,69,,,,,0,"fee schedule","69% of total billed charges",3597,100,,2877.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3597,100,,2877.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3597,100,,2877.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.84,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.19,100,,,,,0,"fee schedule",EAPG,136.62,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1356.07,37.7,,1084.86,,,0,"percent of total billed charges","37.7% of total billed charges",1356.07,37.7,,1084.86,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1219.38,33.9,,975.50,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2805.66,78,,2244.53,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2971.12,82.6,,2376.90,,,0,"percent of total billed charges","82.6% of total billed charges",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2971.12,82.6,,2376.90,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,3597,100,,2877.60,,,0,"percent of total billed charges","100% of total billed charges",77.84,3597,
"CT Limited or Localized F/U Study",35076380,CDM,350,RC,76380,CPT,OUTPATIENT,,,2141,1391.65,TC,1884.08,88,,1507.26,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,2141,100,,1712.80,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",108.24,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1348.83,63,,1079.06,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",105.09,100,,,,,0,"fee schedule",EAPG,1477.29,69,,,,,0,"fee schedule","69% of total billed charges",2141,100,,1712.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2141,100,,1712.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2141,100,,1712.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.84,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.19,100,,,,,0,"fee schedule",EAPG,136.62,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",807.16,37.7,,645.73,,,0,"percent of total billed charges","37.7% of total billed charges",807.16,37.7,,645.73,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",725.8,33.9,,580.64,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1669.98,78,,1335.98,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1768.47,82.6,,1414.78,,,0,"percent of total billed charges","82.6% of total billed charges",105.09,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1768.47,82.6,,1414.78,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,2141,100,,1712.80,,,0,"percent of total billed charges","100% of total billed charges",77.84,2141,
"CT Low Dose Lung Screening",35071271,CDM,350,RC,71271,CPT,OUTPATIENT,,,1102,716.3,TC,969.76,88,,775.81,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,1102,100,,881.60,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",108.24,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.26,63,,555.41,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",105.09,100,,,,,0,"fee schedule",EAPG,760.38,69,,,,,0,"fee schedule","69% of total billed charges",1102,100,,881.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1102,100,,881.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1102,100,,881.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.84,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.19,100,,,,,0,"fee schedule",EAPG,136.62,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",415.45,37.7,,332.36,,,0,"percent of total billed charges","37.7% of total billed charges",415.45,37.7,,332.36,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",373.58,33.9,,298.86,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.56,78,,687.65,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",910.25,82.6,,728.20,,,0,"percent of total billed charges","82.6% of total billed charges",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",910.25,82.6,,728.20,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,1102,100,,881.60,,,0,"percent of total billed charges","100% of total billed charges",77.84,1102,
"CT Maxillofacial w/ + w/o Contrast",35170488,CDM,351,RC,70488,CPT,OUTPATIENT,,,2898,1883.7,TC,2550.24,88,,2040.19,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,2898,100,,2318.40,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1825.74,63,,1460.59,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,1999.62,69,,,,,0,"fee schedule","69% of total billed charges",2898,100,,2318.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2898,100,,2318.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2898,100,,2318.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1092.55,37.7,,874.04,,,0,"percent of total billed charges","37.7% of total billed charges",1092.55,37.7,,874.04,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",982.42,33.9,,785.94,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2260.44,78,,1808.35,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2393.75,82.6,,1915.00,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2393.75,82.6,,1915.00,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,2898,100,,2318.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,2898,
"CT Maxillofacial w/ Contrast",35170487,CDM,351,RC,70487,CPT,OUTPATIENT,,,2731,1775.15,TC,2403.28,88,,1922.62,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,2731,100,,2184.80,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1720.53,63,,1376.42,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,1884.39,69,,,,,0,"fee schedule","69% of total billed charges",2731,100,,2184.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2731,100,,2184.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2731,100,,2184.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1029.59,37.7,,823.67,,,0,"percent of total billed charges","37.7% of total billed charges",1029.59,37.7,,823.67,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",925.81,33.9,,740.65,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2130.18,78,,1704.14,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2255.81,82.6,,1804.65,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2255.81,82.6,,1804.65,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,2731,100,,2184.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,2731,
"CT Maxillofacial w/o Contrast",35170486,CDM,351,RC,70486,CPT,OUTPATIENT,,,1137,739.05,TC,1000.56,88,,800.45,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,1137,100,,909.60,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",108.24,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",716.31,63,,573.05,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",105.09,100,,,,,0,"fee schedule",EAPG,784.53,69,,,,,0,"fee schedule","69% of total billed charges",1137,100,,909.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1137,100,,909.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1137,100,,909.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.84,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.19,100,,,,,0,"fee schedule",EAPG,136.62,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",428.65,37.7,,342.92,,,0,"percent of total billed charges","37.7% of total billed charges",428.65,37.7,,342.92,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",385.44,33.9,,308.35,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.86,78,,709.49,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",939.16,82.6,,751.33,,,0,"percent of total billed charges","82.6% of total billed charges",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",939.16,82.6,,751.33,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,1137,100,,909.60,,,0,"percent of total billed charges","100% of total billed charges",77.84,1137,
"CT Neck Soft Tissue w/ + w/o Contrast",35170492,CDM,351,RC,70492,CPT,OUTPATIENT,,,4490,2918.5,TC,3951.2,88,,3160.96,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4490,100,,3592.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2828.7,63,,2262.96,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,3098.1,69,,,,,0,"fee schedule","69% of total billed charges",4490,100,,3592.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4490,100,,3592.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4490,100,,3592.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1692.73,37.7,,1354.18,,,0,"percent of total billed charges","37.7% of total billed charges",1692.73,37.7,,1354.18,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1522.11,33.9,,1217.69,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3502.2,78,,2801.76,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3708.74,82.6,,2966.99,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3708.74,82.6,,2966.99,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4490,100,,3592.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,4490,
"CT Neck Soft Tissue w/ Contrast",35170491,CDM,351,RC,70491,CPT,OUTPATIENT,,,4214,2739.1,TC,3708.32,88,,2966.66,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4214,100,,3371.20,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2654.82,63,,2123.86,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,2907.66,69,,,,,0,"fee schedule","69% of total billed charges",4214,100,,3371.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4214,100,,3371.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4214,100,,3371.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1588.68,37.7,,1270.94,,,0,"percent of total billed charges","37.7% of total billed charges",1588.68,37.7,,1270.94,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1428.55,33.9,,1142.84,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.92,78,,2629.54,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3480.76,82.6,,2784.61,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3480.76,82.6,,2784.61,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4214,100,,3371.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,4214,
"CT Neck Soft Tissue w/o Contrast",35170490,CDM,351,RC,70490,CPT,OUTPATIENT,,,3245,2109.25,TC,2855.6,88,,2284.48,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,3245,100,,2596.00,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",108.24,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2044.35,63,,1635.48,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",105.09,100,,,,,0,"fee schedule",EAPG,2239.05,69,,,,,0,"fee schedule","69% of total billed charges",3245,100,,2596.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3245,100,,2596.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3245,100,,2596.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.84,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.19,100,,,,,0,"fee schedule",EAPG,136.62,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1223.37,37.7,,978.70,,,0,"percent of total billed charges","37.7% of total billed charges",1223.37,37.7,,978.70,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1100.06,33.9,,880.05,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2531.1,78,,2024.88,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2680.37,82.6,,2144.30,,,0,"percent of total billed charges","82.6% of total billed charges",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2680.37,82.6,,2144.30,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,3245,100,,2596.00,,,0,"percent of total billed charges","100% of total billed charges",77.84,3245,
"CT Neck/Chest w/ + w/o Contrast",35070492,CDM,350,RC,70492,CPT,OUTPATIENT,,,4490,2918.5,TC,3951.2,88,,3160.96,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4490,100,,3592.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2828.7,63,,2262.96,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,3098.1,69,,,,,0,"fee schedule","69% of total billed charges",4490,100,,3592.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4490,100,,3592.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4490,100,,3592.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1692.73,37.7,,1354.18,,,0,"percent of total billed charges","37.7% of total billed charges",1692.73,37.7,,1354.18,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1522.11,33.9,,1217.69,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3502.2,78,,2801.76,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3708.74,82.6,,2966.99,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3708.74,82.6,,2966.99,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4490,100,,3592.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,4490,
"CT Neck/Chest w/ Contrast",35170491,CDM,351,RC,70491,CPT,OUTPATIENT,,,4214,2739.1,TC,3708.32,88,,2966.66,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4214,100,,3371.20,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2654.82,63,,2123.86,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,2907.66,69,,,,,0,"fee schedule","69% of total billed charges",4214,100,,3371.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4214,100,,3371.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4214,100,,3371.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1588.68,37.7,,1270.94,,,0,"percent of total billed charges","37.7% of total billed charges",1588.68,37.7,,1270.94,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1428.55,33.9,,1142.84,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.92,78,,2629.54,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3480.76,82.6,,2784.61,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3480.76,82.6,,2784.61,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4214,100,,3371.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,4214,
"CT Neck/Chest w/o Contrast",35170490,CDM,351,RC,70490,CPT,OUTPATIENT,,,3245,2109.25,TC,2855.6,88,,2284.48,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,3245,100,,2596.00,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",108.24,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2044.35,63,,1635.48,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",105.09,100,,,,,0,"fee schedule",EAPG,2239.05,69,,,,,0,"fee schedule","69% of total billed charges",3245,100,,2596.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3245,100,,2596.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3245,100,,2596.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.84,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.19,100,,,,,0,"fee schedule",EAPG,136.62,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1223.37,37.7,,978.70,,,0,"percent of total billed charges","37.7% of total billed charges",1223.37,37.7,,978.70,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1100.06,33.9,,880.05,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2531.1,78,,2024.88,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2680.37,82.6,,2144.30,,,0,"percent of total billed charges","82.6% of total billed charges",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2680.37,82.6,,2144.30,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,3245,100,,2596.00,,,0,"percent of total billed charges","100% of total billed charges",77.84,3245,
"CT Neck/Chest/Abdomen/Pelvis w/ + w/o Co",35170492,CDM,351,RC,70492,CPT,OUTPATIENT,,,4490,2918.5,TC,3951.2,88,,3160.96,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4490,100,,3592.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2828.7,63,,2262.96,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,3098.1,69,,,,,0,"fee schedule","69% of total billed charges",4490,100,,3592.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4490,100,,3592.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4490,100,,3592.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1692.73,37.7,,1354.18,,,0,"percent of total billed charges","37.7% of total billed charges",1692.73,37.7,,1354.18,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1522.11,33.9,,1217.69,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3502.2,78,,2801.76,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3708.74,82.6,,2966.99,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3708.74,82.6,,2966.99,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4490,100,,3592.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,4490,
"CT Neck/Chest/Abdomen/Pelvis w/ Contrast",35170491,CDM,351,RC,70491,CPT,OUTPATIENT,,,4214,2739.1,TC,3708.32,88,,2966.66,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4214,100,,3371.20,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2654.82,63,,2123.86,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,2907.66,69,,,,,0,"fee schedule","69% of total billed charges",4214,100,,3371.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4214,100,,3371.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4214,100,,3371.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1588.68,37.7,,1270.94,,,0,"percent of total billed charges","37.7% of total billed charges",1588.68,37.7,,1270.94,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1428.55,33.9,,1142.84,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.92,78,,2629.54,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3480.76,82.6,,2784.61,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3480.76,82.6,,2784.61,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4214,100,,3371.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,4214,
"CT Neck/Chest/Abdomen/Pelvis w/o Contras",35170490,CDM,351,RC,70490,CPT,OUTPATIENT,,,3245,2109.25,TC,2855.6,88,,2284.48,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,3245,100,,2596.00,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",108.24,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2044.35,63,,1635.48,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",105.09,100,,,,,0,"fee schedule",EAPG,2239.05,69,,,,,0,"fee schedule","69% of total billed charges",3245,100,,2596.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3245,100,,2596.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3245,100,,2596.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.84,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.19,100,,,,,0,"fee schedule",EAPG,136.62,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1223.37,37.7,,978.70,,,0,"percent of total billed charges","37.7% of total billed charges",1223.37,37.7,,978.70,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1100.06,33.9,,880.05,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2531.1,78,,2024.88,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2680.37,82.6,,2144.30,,,0,"percent of total billed charges","82.6% of total billed charges",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2680.37,82.6,,2144.30,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,3245,100,,2596.00,,,0,"percent of total billed charges","100% of total billed charges",77.84,3245,
"CT Orbits Sella w/ + w/o Contrast",35170482,CDM,351,RC,70482,CPT,OUTPATIENT,,,4353,2829.45,TC,3830.64,88,,3064.51,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4353,100,,3482.40,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2742.39,63,,2193.91,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,3003.57,69,,,,,0,"fee schedule","69% of total billed charges",4353,100,,3482.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353,100,,3482.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353,100,,3482.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1641.08,37.7,,1312.86,,,0,"percent of total billed charges","37.7% of total billed charges",1641.08,37.7,,1312.86,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1475.67,33.9,,1180.54,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3395.34,78,,2716.27,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3595.58,82.6,,2876.46,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3595.58,82.6,,2876.46,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4353,100,,3482.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,4353,
"CT Orbits Sella w/ Contrast",35170481,CDM,351,RC,70481,CPT,OUTPATIENT,,,3275,2128.75,TC,2882,88,,2305.60,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,3275,100,,2620.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2063.25,63,,1650.60,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,2259.75,69,,,,,0,"fee schedule","69% of total billed charges",3275,100,,2620.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3275,100,,2620.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3275,100,,2620.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1234.68,37.7,,987.74,,,0,"percent of total billed charges","37.7% of total billed charges",1234.68,37.7,,987.74,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1110.23,33.9,,888.18,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2554.5,78,,2043.60,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2705.15,82.6,,2164.12,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2705.15,82.6,,2164.12,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,3275,100,,2620.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,3275,
"CT Orbits Sella w/o Contrast",35170480,CDM,351,RC,70480,CPT,OUTPATIENT,,,4021,2613.65,TC,3538.48,88,,2830.78,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,4021,100,,3216.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",108.24,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2533.23,63,,2026.58,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",105.09,100,,,,,0,"fee schedule",EAPG,2774.49,69,,,,,0,"fee schedule","69% of total billed charges",4021,100,,3216.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4021,100,,3216.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4021,100,,3216.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.84,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.19,100,,,,,0,"fee schedule",EAPG,136.62,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1515.92,37.7,,1212.74,,,0,"percent of total billed charges","37.7% of total billed charges",1515.92,37.7,,1212.74,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1363.12,33.9,,1090.50,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3136.38,78,,2509.10,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3321.35,82.6,,2657.08,,,0,"percent of total billed charges","82.6% of total billed charges",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3321.35,82.6,,2657.08,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,4021,100,,3216.80,,,0,"percent of total billed charges","100% of total billed charges",77.84,4021,
"CT Orbit Sella etc. or IAC w/ + w/o Cont",35170482,CDM,351,RC,70482,CPT,OUTPATIENT,,,4353,2829.45,TC,3830.64,88,,3064.51,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4353,100,,3482.40,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2742.39,63,,2193.91,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,3003.57,69,,,,,0,"fee schedule","69% of total billed charges",4353,100,,3482.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353,100,,3482.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353,100,,3482.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1641.08,37.7,,1312.86,,,0,"percent of total billed charges","37.7% of total billed charges",1641.08,37.7,,1312.86,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1475.67,33.9,,1180.54,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3395.34,78,,2716.27,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3595.58,82.6,,2876.46,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3595.58,82.6,,2876.46,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4353,100,,3482.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,4353,
"CT Orbit Sella etc. or IAC w/ Cont",35170481,CDM,351,RC,70481,CPT,OUTPATIENT,,,3275,2128.75,TC,2882,88,,2305.60,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,3275,100,,2620.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2063.25,63,,1650.60,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,2259.75,69,,,,,0,"fee schedule","69% of total billed charges",3275,100,,2620.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3275,100,,2620.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3275,100,,2620.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1234.68,37.7,,987.74,,,0,"percent of total billed charges","37.7% of total billed charges",1234.68,37.7,,987.74,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1110.23,33.9,,888.18,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2554.5,78,,2043.60,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2705.15,82.6,,2164.12,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2705.15,82.6,,2164.12,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,3275,100,,2620.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,3275,
"CT Pelvis w/ + w/o Contrast",35272194,CDM,352,RC,72194,CPT,OUTPATIENT,,,4291,2789.15,TC,3776.08,88,,3020.86,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4291,100,,3432.80,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2703.33,63,,2162.66,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,2960.79,69,,,,,0,"fee schedule","69% of total billed charges",4291,100,,3432.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4291,100,,3432.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4291,100,,3432.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1617.71,37.7,,1294.17,,,0,"percent of total billed charges","37.7% of total billed charges",1617.71,37.7,,1294.17,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1454.65,33.9,,1163.72,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3346.98,78,,2677.58,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3544.37,82.6,,2835.50,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3544.37,82.6,,2835.50,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4291,100,,3432.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,4291,
"CT Pelvis w/ Contrast",35272193,CDM,352,RC,72193,CPT,OUTPATIENT,,,4765,3097.25,TC,4193.2,88,,3354.56,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3001.95,63,,2401.56,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,3287.85,69,,,,,0,"fee schedule","69% of total billed charges",4765,100,,3812.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4765,100,,3812.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4765,100,,3812.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1796.41,37.7,,1437.13,,,0,"percent of total billed charges","37.7% of total billed charges",1796.41,37.7,,1437.13,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1615.34,33.9,,1292.27,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3716.7,78,,2973.36,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3935.89,82.6,,3148.71,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3935.89,82.6,,3148.71,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4765,100,,3812.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,4765,
"CT Pelvis w/o Contrast",35272192,CDM,352,RC,72192,CPT,OUTPATIENT,,,3393,2205.45,TC,2985.84,88,,2388.67,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,3393,100,,2714.40,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",108.24,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2137.59,63,,1710.07,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",105.09,100,,,,,0,"fee schedule",EAPG,2341.17,69,,,,,0,"fee schedule","69% of total billed charges",3393,100,,2714.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3393,100,,2714.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3393,100,,2714.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.84,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.19,100,,,,,0,"fee schedule",EAPG,136.62,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1279.16,37.7,,1023.33,,,0,"percent of total billed charges","37.7% of total billed charges",1279.16,37.7,,1023.33,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1150.23,33.9,,920.18,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2646.54,78,,2117.23,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2802.62,82.6,,2242.10,,,0,"percent of total billed charges","82.6% of total billed charges",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2802.62,82.6,,2242.10,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,3393,100,,2714.40,,,0,"percent of total billed charges","100% of total billed charges",77.84,3393,
"CT Sinus w/o Contrast",35170486,CDM,351,RC,70486,CPT,OUTPATIENT,,,1137,739.05,TC,1000.56,88,,800.45,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,1137,100,,909.60,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",108.24,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",716.31,63,,573.05,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",105.09,100,,,,,0,"fee schedule",EAPG,784.53,69,,,,,0,"fee schedule","69% of total billed charges",1137,100,,909.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1137,100,,909.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1137,100,,909.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.84,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.19,100,,,,,0,"fee schedule",EAPG,136.62,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",428.65,37.7,,342.92,,,0,"percent of total billed charges","37.7% of total billed charges",428.65,37.7,,342.92,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",385.44,33.9,,308.35,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.86,78,,709.49,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",939.16,82.6,,751.33,,,0,"percent of total billed charges","82.6% of total billed charges",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",939.16,82.6,,751.33,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,1137,100,,909.60,,,0,"percent of total billed charges","100% of total billed charges",77.84,1137,
"CT Spine Cervical w/ + w/o Contrast",35272127,CDM,352,RC,72127,CPT,OUTPATIENT,,,4116,2675.4,TC,3622.08,88,,2897.66,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4116,100,,3292.80,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2593.08,63,,2074.46,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,2840.04,69,,,,,0,"fee schedule","69% of total billed charges",4116,100,,3292.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4116,100,,3292.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4116,100,,3292.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1551.73,37.7,,1241.38,,,0,"percent of total billed charges","37.7% of total billed charges",1551.73,37.7,,1241.38,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1395.32,33.9,,1116.26,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3210.48,78,,2568.38,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3399.82,82.6,,2719.86,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3399.82,82.6,,2719.86,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4116,100,,3292.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,4116,
"CT Spine Cervical w/ Contrast",35272126,CDM,352,RC,72126,CPT,OUTPATIENT,,,4060,2639,TC,3572.8,88,,2858.24,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4060,100,,3248.00,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2557.8,63,,2046.24,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,2801.4,69,,,,,0,"fee schedule","69% of total billed charges",4060,100,,3248.00,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4060,100,,3248.00,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4060,100,,3248.00,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.62,37.7,,1224.50,,,0,"percent of total billed charges","37.7% of total billed charges",1530.62,37.7,,1224.50,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1376.34,33.9,,1101.07,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3166.8,78,,2533.44,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3353.56,82.6,,2682.85,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3353.56,82.6,,2682.85,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4060,100,,3248.00,,,0,"percent of total billed charges","100% of total billed charges",210.9,4060,
"CT Spine Cervical w/o Contrast",35272125,CDM,352,RC,72125,CPT,OUTPATIENT,,,3178,2065.7,TC,2796.64,88,,2237.31,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,3178,100,,2542.40,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",108.24,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2002.14,63,,1601.71,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",105.09,100,,,,,0,"fee schedule",EAPG,2192.82,69,,,,,0,"fee schedule","69% of total billed charges",3178,100,,2542.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3178,100,,2542.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3178,100,,2542.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.84,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.19,100,,,,,0,"fee schedule",EAPG,136.62,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1198.11,37.7,,958.49,,,0,"percent of total billed charges","37.7% of total billed charges",1198.11,37.7,,958.49,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1077.34,33.9,,861.87,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2478.84,78,,1983.07,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2625.03,82.6,,2100.02,,,0,"percent of total billed charges","82.6% of total billed charges",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2625.03,82.6,,2100.02,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,3178,100,,2542.40,,,0,"percent of total billed charges","100% of total billed charges",77.84,3178,
"CT Spine Lumbar w/ + w/o Contrast",35272133,CDM,352,RC,72133,CPT,OUTPATIENT,,,4276,2779.4,TC,3762.88,88,,3010.30,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4276,100,,3420.80,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2693.88,63,,2155.10,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,2950.44,69,,,,,0,"fee schedule","69% of total billed charges",4276,100,,3420.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276,100,,3420.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276,100,,3420.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1612.05,37.7,,1289.64,,,0,"percent of total billed charges","37.7% of total billed charges",1612.05,37.7,,1289.64,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1449.56,33.9,,1159.65,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3335.28,78,,2668.22,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3531.98,82.6,,2825.58,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3531.98,82.6,,2825.58,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4276,100,,3420.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,4276,
"CT Spine Lumbar w/ Contrast",35272132,CDM,352,RC,72132,CPT,OUTPATIENT,,,5140,3341,TC,4523.2,88,,3618.56,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3238.2,63,,2590.56,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,3546.6,69,,,,,0,"fee schedule","69% of total billed charges",5140,100,,4112.00,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5140,100,,4112.00,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5140,100,,4112.00,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1937.78,37.7,,1550.22,,,0,"percent of total billed charges","37.7% of total billed charges",1937.78,37.7,,1550.22,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1742.46,33.9,,1393.97,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4009.2,78,,3207.36,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.64,82.6,,3396.51,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.64,82.6,,3396.51,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,5140,100,,4112.00,,,0,"percent of total billed charges","100% of total billed charges",210.9,5140,
"CT Spine Lumbar w/o Contrast",35272131,CDM,352,RC,72131,CPT,OUTPATIENT,,,3599,2339.35,TC,3167.12,88,,2533.70,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,3599,100,,2879.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",108.24,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2267.37,63,,1813.90,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",105.09,100,,,,,0,"fee schedule",EAPG,2483.31,69,,,,,0,"fee schedule","69% of total billed charges",3599,100,,2879.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3599,100,,2879.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3599,100,,2879.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.84,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.19,100,,,,,0,"fee schedule",EAPG,136.62,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1356.82,37.7,,1085.46,,,0,"percent of total billed charges","37.7% of total billed charges",1356.82,37.7,,1085.46,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1220.06,33.9,,976.05,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2807.22,78,,2245.78,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2972.77,82.6,,2378.22,,,0,"percent of total billed charges","82.6% of total billed charges",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2972.77,82.6,,2378.22,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,3599,100,,2879.20,,,0,"percent of total billed charges","100% of total billed charges",77.84,3599,
"CT Spine Thoracic w/ + w/o Contrast",35272130,CDM,352,RC,72130,CPT,OUTPATIENT,,,4277,2780.05,TC,3763.76,88,,3011.01,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4277,100,,3421.60,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2694.51,63,,2155.61,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,2951.13,69,,,,,0,"fee schedule","69% of total billed charges",4277,100,,3421.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4277,100,,3421.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4277,100,,3421.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1612.43,37.7,,1289.94,,,0,"percent of total billed charges","37.7% of total billed charges",1612.43,37.7,,1289.94,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1449.9,33.9,,1159.92,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3336.06,78,,2668.85,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3532.8,82.6,,2826.24,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3532.8,82.6,,2826.24,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4277,100,,3421.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,4277,
"CT Spine Thoracic w/ Contrast",35272129,CDM,352,RC,72129,CPT,OUTPATIENT,,,4264,2771.6,TC,3752.32,88,,3001.86,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4264,100,,3411.20,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2686.32,63,,2149.06,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,2942.16,69,,,,,0,"fee schedule","69% of total billed charges",4264,100,,3411.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4264,100,,3411.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4264,100,,3411.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1607.53,37.7,,1286.02,,,0,"percent of total billed charges","37.7% of total billed charges",1607.53,37.7,,1286.02,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1445.5,33.9,,1156.40,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3325.92,78,,2660.74,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3522.06,82.6,,2817.65,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3522.06,82.6,,2817.65,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4264,100,,3411.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,4264,
"CT Spine Thoracic w/o Contrast",35272128,CDM,352,RC,72128,CPT,OUTPATIENT,,,4715,3064.75,TC,4149.2,88,,3319.36,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",108.24,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2970.45,63,,2376.36,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",105.09,100,,,,,0,"fee schedule",EAPG,3253.35,69,,,,,0,"fee schedule","69% of total billed charges",4715,100,,3772.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4715,100,,3772.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4715,100,,3772.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.84,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.19,100,,,,,0,"fee schedule",EAPG,136.62,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1777.56,37.7,,1422.05,,,0,"percent of total billed charges","37.7% of total billed charges",1777.56,37.7,,1422.05,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1598.39,33.9,,1278.71,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3677.7,78,,2942.16,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3894.59,82.6,,3115.67,,,0,"percent of total billed charges","82.6% of total billed charges",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3894.59,82.6,,3115.67,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,4715,100,,3772.00,,,0,"percent of total billed charges","100% of total billed charges",77.84,4715,
"CT Sinus w/o Contrast Ltd",35170486,CDM,351,RC,70486,CPT,OUTPATIENT,,,1137,739.05,TC,1000.56,88,,800.45,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,1137,100,,909.60,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",108.24,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",716.31,63,,573.05,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",105.09,100,,,,,0,"fee schedule",EAPG,784.53,69,,,,,0,"fee schedule","69% of total billed charges",1137,100,,909.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1137,100,,909.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1137,100,,909.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.84,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.19,100,,,,,0,"fee schedule",EAPG,136.62,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",428.65,37.7,,342.92,,,0,"percent of total billed charges","37.7% of total billed charges",428.65,37.7,,342.92,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",385.44,33.9,,308.35,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.86,78,,709.49,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",939.16,82.6,,751.33,,,0,"percent of total billed charges","82.6% of total billed charges",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",939.16,82.6,,751.33,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,1137,100,,909.60,,,0,"percent of total billed charges","100% of total billed charges",77.84,1137,
"CT Thorax w/ + w/o Contrast",35271270,CDM,352,RC,71270,CPT,OUTPATIENT,,,6287,4086.55,TC,5532.56,88,,4426.05,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3960.81,63,,3168.65,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,4338.03,69,,,,,0,"fee schedule","69% of total billed charges",6287,100,,5029.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6287,100,,5029.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6287,100,,5029.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2370.2,37.7,,1896.16,,,0,"percent of total billed charges","37.7% of total billed charges",2370.2,37.7,,1896.16,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2131.29,33.9,,1705.03,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4903.86,78,,3923.09,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5193.06,82.6,,4154.45,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5193.06,82.6,,4154.45,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,6287,100,,5029.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,6287,
"CT Thorax w/ Contrast",35271260,CDM,352,RC,71260,CPT,OUTPATIENT,,,4964,3226.6,TC,4368.32,88,,3494.66,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3127.32,63,,2501.86,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,3425.16,69,,,,,0,"fee schedule","69% of total billed charges",4964,100,,3971.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4964,100,,3971.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4964,100,,3971.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1871.43,37.7,,1497.14,,,0,"percent of total billed charges","37.7% of total billed charges",1871.43,37.7,,1497.14,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1682.8,33.9,,1346.24,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3871.92,78,,3097.54,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.26,82.6,,3280.21,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.26,82.6,,3280.21,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4964,100,,3971.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,4964,
"CT Thorax w/o Contrast",35271250,CDM,352,RC,71250,CPT,OUTPATIENT,,,3547,2305.55,TC,3121.36,88,,2497.09,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,3547,100,,2837.60,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",108.24,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2234.61,63,,1787.69,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",105.09,100,,,,,0,"fee schedule",EAPG,2447.43,69,,,,,0,"fee schedule","69% of total billed charges",3547,100,,2837.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3547,100,,2837.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3547,100,,2837.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.84,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.19,100,,,,,0,"fee schedule",EAPG,136.62,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1337.22,37.7,,1069.78,,,0,"percent of total billed charges","37.7% of total billed charges",1337.22,37.7,,1069.78,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1202.43,33.9,,961.94,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2766.66,78,,2213.33,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2929.82,82.6,,2343.86,,,0,"percent of total billed charges","82.6% of total billed charges",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2929.82,82.6,,2343.86,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,3547,100,,2837.60,,,0,"percent of total billed charges","100% of total billed charges",77.84,3547,
"CT Upper Extremity w/ Contrast Left",35273201,CDM,352,RC,73201,CPT,OUTPATIENT,,,4974,3233.1,TC|LT,4377.12,88,,3501.70,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3133.62,63,,2506.90,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,3432.06,69,,,,,0,"fee schedule","69% of total billed charges",4974,100,,3979.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4974,100,,3979.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4974,100,,3979.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1875.2,37.7,,1500.16,,,0,"percent of total billed charges","37.7% of total billed charges",1875.2,37.7,,1500.16,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1686.19,33.9,,1348.95,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3879.72,78,,3103.78,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4108.52,82.6,,3286.82,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4108.52,82.6,,3286.82,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4974,100,,3979.20,,,0,"percent of total billed charges","100% of total billed charges",210.9,4974,
"CT Upper Extremity w/ Contrast Right",35273201,CDM,352,RC,73201,CPT,OUTPATIENT,,,4974,3233.1,TC|LT,4377.12,88,,3501.70,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3133.62,63,,2506.90,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,3432.06,69,,,,,0,"fee schedule","69% of total billed charges",4974,100,,3979.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4974,100,,3979.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4974,100,,3979.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1875.2,37.7,,1500.16,,,0,"percent of total billed charges","37.7% of total billed charges",1875.2,37.7,,1500.16,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1686.19,33.9,,1348.95,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3879.72,78,,3103.78,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4108.52,82.6,,3286.82,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4108.52,82.6,,3286.82,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4974,100,,3979.20,,,0,"percent of total billed charges","100% of total billed charges",210.9,4974,
"CT Upper Extremity w/+w/o Contrast Left",35273202,CDM,352,RC,73202,CPT,OUTPATIENT,,,5598,3638.7,TC|LT,4926.24,88,,3940.99,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3526.74,63,,2821.39,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,3862.62,69,,,,,0,"fee schedule","69% of total billed charges",5598,100,,4478.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5598,100,,4478.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5598,100,,4478.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2110.45,37.7,,1688.36,,,0,"percent of total billed charges","37.7% of total billed charges",2110.45,37.7,,1688.36,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1897.72,33.9,,1518.18,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4366.44,78,,3493.15,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4623.95,82.6,,3699.16,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4623.95,82.6,,3699.16,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,5598,100,,4478.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,5598,
"CT Upper Extremity w/+w/o Contrast Right",35273202,CDM,352,RC,73202,CPT,OUTPATIENT,,,5598,3638.7,TC|LT,4926.24,88,,3940.99,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",293.26,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3526.74,63,,2821.39,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",284.72,100,,,,,0,"fee schedule",EAPG,3862.62,69,,,,,0,"fee schedule","69% of total billed charges",5598,100,,4478.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5598,100,,4478.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5598,100,,4478.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.9,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.41,100,,,,,0,"fee schedule",EAPG,370.14,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2110.45,37.7,,1688.36,,,0,"percent of total billed charges","37.7% of total billed charges",2110.45,37.7,,1688.36,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1897.72,33.9,,1518.18,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4366.44,78,,3493.15,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4623.95,82.6,,3699.16,,,0,"percent of total billed charges","82.6% of total billed charges",284.72,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4623.95,82.6,,3699.16,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.72,100,,,,,0,"fee schedule",EAPG,5598,100,,4478.40,,,0,"percent of total billed charges","100% of total billed charges",187.4,5598,
"CT Upper Extremity w/o Contrast Left",35273200,CDM,352,RC,73200,CPT,OUTPATIENT,,,4185,2720.25,TC|LT,3682.8,88,,2946.24,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,4185,100,,3348.00,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",108.24,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2636.55,63,,2109.24,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",105.09,100,,,,,0,"fee schedule",EAPG,2887.65,69,,,,,0,"fee schedule","69% of total billed charges",4185,100,,3348.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4185,100,,3348.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4185,100,,3348.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.84,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.19,100,,,,,0,"fee schedule",EAPG,136.62,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1577.75,37.7,,1262.20,,,0,"percent of total billed charges","37.7% of total billed charges",1577.75,37.7,,1262.20,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1418.72,33.9,,1134.98,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3264.3,78,,2611.44,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3456.81,82.6,,2765.45,,,0,"percent of total billed charges","82.6% of total billed charges",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3456.81,82.6,,2765.45,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,4185,100,,3348.00,,,0,"percent of total billed charges","100% of total billed charges",77.84,4185,
"CT Upper Extremity w/o Contrast Right",35273200,CDM,352,RC,73200,CPT,OUTPATIENT,,,4185,2720.25,TC|LT,3682.8,88,,2946.24,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,4185,100,,3348.00,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",108.24,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2636.55,63,,2109.24,,,0,"percent of total billed charges","63% of total billed charges",358,100,,,,,0,"case rate","pays based on per visit rate",105.09,100,,,,,0,"fee schedule",EAPG,2887.65,69,,,,,0,"fee schedule","69% of total billed charges",4185,100,,3348.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4185,100,,3348.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4185,100,,3348.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.84,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.19,100,,,,,0,"fee schedule",EAPG,136.62,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1577.75,37.7,,1262.20,,,0,"percent of total billed charges","37.7% of total billed charges",1577.75,37.7,,1262.20,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1418.72,33.9,,1134.98,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3264.3,78,,2611.44,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3456.81,82.6,,2765.45,,,0,"percent of total billed charges","82.6% of total billed charges",105.09,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3456.81,82.6,,2765.45,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.09,100,,,,,0,"fee schedule",EAPG,4185,100,,3348.00,,,0,"percent of total billed charges","100% of total billed charges",77.84,4185,
ELECTROCARDIOGRAM,73093005,CDM,730,RC,93005,CPT,OUTPATIENT,,,509,330.85,,447.92,88,,358.34,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",24.47,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320.67,63,,256.54,,,0,"percent of total billed charges","63% of total billed charges",77.88,15.3,,62.30,,,0,"percent of total billed charges","15.3% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,351.21,69,,,,,0,"fee schedule","69% of total billed charges",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17.6,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.23,100,,,,,0,"fee schedule",EAPG,30.89,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191.89,37.7,,153.51,,,0,"percent of total billed charges","37.7% of total billed charges",191.89,37.7,,153.51,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",172.55,33.9,,138.04,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397.02,78,,317.62,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.43,82.6,,336.34,,,0,"percent of total billed charges","82.6% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.43,82.6,,336.34,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",17.6,509,
"IR Angio LE Right",32375710,CDM,323,RC,75710,CPT,OUTPATIENT,,,10983,7138.95,TC|LT,9665.04,88,,7732.03,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5689.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",1694.66,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6919.29,63,,5535.43,,,0,"percent of total billed charges","63% of total billed charges",1680.4,15.3,,1344.32,,,0,"percent of total billed charges","15.3% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,7578.27,69,,,,,0,"fee schedule","69% of total billed charges",10983,100,,8786.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10983,100,,8786.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10983,100,,8786.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1218.74,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1678.2,100,,,,,0,"fee schedule",EAPG,2138.89,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4140.59,37.7,,3312.47,,,0,"percent of total billed charges","37.7% of total billed charges",4140.59,37.7,,3312.47,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3723.24,33.9,,2978.59,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8566.74,78,,6853.39,,,0,"percent of total billed charges","78% of total billed charges",3283.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9071.96,82.6,,7257.57,,,0,"percent of total billed charges","82.6% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9071.96,82.6,,7257.57,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,10983,100,,8786.40,,,0,"percent of total billed charges","100% of total billed charges",1218.74,11625.58,
"IR Angio Internal Mammary",32375756,CDM,323,RC,75756,CPT,OUTPATIENT,,,11195,7276.75,TC,9851.6,88,,7881.28,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5689.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",1694.66,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7052.85,63,,5642.28,,,0,"percent of total billed charges","63% of total billed charges",1712.84,15.3,,1370.27,,,0,"percent of total billed charges","15.3% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,7724.55,69,,,,,0,"fee schedule","69% of total billed charges",11195,100,,8956.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11195,100,,8956.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11195,100,,8956.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1218.74,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1678.2,100,,,,,0,"fee schedule",EAPG,2138.89,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4220.52,37.7,,3376.42,,,0,"percent of total billed charges","37.7% of total billed charges",4220.52,37.7,,3376.42,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3795.11,33.9,,3036.09,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8732.1,78,,6985.68,,,0,"percent of total billed charges","78% of total billed charges",3283.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9247.07,82.6,,7397.66,,,0,"percent of total billed charges","82.6% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9247.07,82.6,,7397.66,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,11195,100,,8956.00,,,0,"percent of total billed charges","100% of total billed charges",1218.74,11625.58,
"IR Angio LE Bilateral",32075716,CDM,320,RC,75716,CPT,OUTPATIENT,,,10164,6606.6,TC|50,8944.32,88,,7155.46,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5689.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",1694.66,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6403.32,63,,5122.66,,,0,"percent of total billed charges","63% of total billed charges",1555.09,15.3,,1244.07,,,0,"percent of total billed charges","15.3% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,7013.16,69,,,,,0,"fee schedule","69% of total billed charges",10164,100,,8131.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10164,100,,8131.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10164,100,,8131.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1218.74,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1678.2,100,,,,,0,"fee schedule",EAPG,2138.89,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3831.83,37.7,,3065.46,,,0,"percent of total billed charges","37.7% of total billed charges",3831.83,37.7,,3065.46,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3445.6,33.9,,2756.48,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7927.92,78,,6342.34,,,0,"percent of total billed charges","78% of total billed charges",3283.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8395.46,82.6,,6716.37,,,0,"percent of total billed charges","82.6% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8395.46,82.6,,6716.37,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,10164,100,,8131.20,,,0,"percent of total billed charges","100% of total billed charges",1218.74,11625.58,
"IR Angio LE Left",32375710,CDM,323,RC,75710,CPT,OUTPATIENT,,,10983,7138.95,TC|LT,9665.04,88,,7732.03,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5689.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",1694.66,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6919.29,63,,5535.43,,,0,"percent of total billed charges","63% of total billed charges",1680.4,15.3,,1344.32,,,0,"percent of total billed charges","15.3% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,7578.27,69,,,,,0,"fee schedule","69% of total billed charges",10983,100,,8786.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10983,100,,8786.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10983,100,,8786.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1218.74,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1678.2,100,,,,,0,"fee schedule",EAPG,2138.89,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4140.59,37.7,,3312.47,,,0,"percent of total billed charges","37.7% of total billed charges",4140.59,37.7,,3312.47,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3723.24,33.9,,2978.59,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8566.74,78,,6853.39,,,0,"percent of total billed charges","78% of total billed charges",3283.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9071.96,82.6,,7257.57,,,0,"percent of total billed charges","82.6% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9071.96,82.6,,7257.57,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,10983,100,,8786.40,,,0,"percent of total billed charges","100% of total billed charges",1218.74,11625.58,
"IR Angio Pelvis",32075736,CDM,320,RC,75736,CPT,OUTPATIENT,,,10162,6605.3,TC,8942.56,88,,7154.05,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3820.51,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6402.06,63,,5121.65,,,0,"percent of total billed charges","63% of total billed charges",1554.79,15.3,,1243.83,,,0,"percent of total billed charges","15.3% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,7011.78,69,,,,,0,"fee schedule","69% of total billed charges",10162,100,,8129.60,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10162,100,,8129.60,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10162,100,,8129.60,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2747.58,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3783.42,100,,,,,0,"fee schedule",EAPG,4822.01,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3831.07,37.7,,3064.86,,,0,"percent of total billed charges","37.7% of total billed charges",3831.07,37.7,,3064.86,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3444.92,33.9,,2755.94,,,0,"percent of total billed charges","33.9% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7926.36,78,,6341.09,,,0,"percent of total billed charges","78% of total billed charges",5661.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8393.81,82.6,,6715.05,,,0,"percent of total billed charges","82.6% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8393.81,82.6,,6715.05,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,10162,100,,8129.60,,,0,"percent of total billed charges","100% of total billed charges",1554.79,19379.78,
"IR Angio Pulmonary Bilateral",32375743,CDM,323,RC,75743,CPT,OUTPATIENT,,,10162,6605.3,TC,8942.56,88,,7154.05,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5689.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",1694.66,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6402.06,63,,5121.65,,,0,"percent of total billed charges","63% of total billed charges",1554.79,15.3,,1243.83,,,0,"percent of total billed charges","15.3% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,7011.78,69,,,,,0,"fee schedule","69% of total billed charges",10162,100,,8129.60,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10162,100,,8129.60,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10162,100,,8129.60,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1218.74,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1678.2,100,,,,,0,"fee schedule",EAPG,2138.89,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3831.07,37.7,,3064.86,,,0,"percent of total billed charges","37.7% of total billed charges",3831.07,37.7,,3064.86,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3444.92,33.9,,2755.94,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7926.36,78,,6341.09,,,0,"percent of total billed charges","78% of total billed charges",3283.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8393.81,82.6,,6715.05,,,0,"percent of total billed charges","82.6% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8393.81,82.6,,6715.05,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,10162,100,,8129.60,,,0,"percent of total billed charges","100% of total billed charges",1218.74,11625.58,
"IR Angio Pulmonary Right",32375741,CDM,323,RC,75741,CPT,OUTPATIENT,,,10162,6605.3,TC|RT,8942.56,88,,7154.05,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5689.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",1694.66,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6402.06,63,,5121.65,,,0,"percent of total billed charges","63% of total billed charges",1554.79,15.3,,1243.83,,,0,"percent of total billed charges","15.3% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,7011.78,69,,,,,0,"fee schedule","69% of total billed charges",10162,100,,8129.60,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10162,100,,8129.60,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10162,100,,8129.60,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1218.74,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1678.2,100,,,,,0,"fee schedule",EAPG,2138.89,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3831.07,37.7,,3064.86,,,0,"percent of total billed charges","37.7% of total billed charges",3831.07,37.7,,3064.86,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3444.92,33.9,,2755.94,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7926.36,78,,6341.09,,,0,"percent of total billed charges","78% of total billed charges",3283.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8393.81,82.6,,6715.05,,,0,"percent of total billed charges","82.6% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8393.81,82.6,,6715.05,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,10162,100,,8129.60,,,0,"percent of total billed charges","100% of total billed charges",1218.74,11625.58,
"IR Angio UE Bilateral",32075716,CDM,320,RC,75716,CPT,OUTPATIENT,,,10164,6606.6,TC|50,8944.32,88,,7155.46,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5689.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",1694.66,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6403.32,63,,5122.66,,,0,"percent of total billed charges","63% of total billed charges",1555.09,15.3,,1244.07,,,0,"percent of total billed charges","15.3% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,7013.16,69,,,,,0,"fee schedule","69% of total billed charges",10164,100,,8131.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10164,100,,8131.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10164,100,,8131.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1218.74,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1678.2,100,,,,,0,"fee schedule",EAPG,2138.89,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3831.83,37.7,,3065.46,,,0,"percent of total billed charges","37.7% of total billed charges",3831.83,37.7,,3065.46,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3445.6,33.9,,2756.48,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7927.92,78,,6342.34,,,0,"percent of total billed charges","78% of total billed charges",3283.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8395.46,82.6,,6716.37,,,0,"percent of total billed charges","82.6% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8395.46,82.6,,6716.37,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,10164,100,,8131.20,,,0,"percent of total billed charges","100% of total billed charges",1218.74,11625.58,
"IR Angio UE Left",32375710,CDM,323,RC,75710,CPT,OUTPATIENT,,,10983,7138.95,TC|LT,9665.04,88,,7732.03,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5689.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",1694.66,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6919.29,63,,5535.43,,,0,"percent of total billed charges","63% of total billed charges",1680.4,15.3,,1344.32,,,0,"percent of total billed charges","15.3% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,7578.27,69,,,,,0,"fee schedule","69% of total billed charges",10983,100,,8786.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10983,100,,8786.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10983,100,,8786.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1218.74,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1678.2,100,,,,,0,"fee schedule",EAPG,2138.89,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4140.59,37.7,,3312.47,,,0,"percent of total billed charges","37.7% of total billed charges",4140.59,37.7,,3312.47,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3723.24,33.9,,2978.59,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8566.74,78,,6853.39,,,0,"percent of total billed charges","78% of total billed charges",3283.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9071.96,82.6,,7257.57,,,0,"percent of total billed charges","82.6% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9071.96,82.6,,7257.57,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,10983,100,,8786.40,,,0,"percent of total billed charges","100% of total billed charges",1218.74,11625.58,
"IR Angio UE Right",32375710,CDM,323,RC,75710,CPT,OUTPATIENT,,,10983,7138.95,TC|LT,9665.04,88,,7732.03,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5689.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",1694.66,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6919.29,63,,5535.43,,,0,"percent of total billed charges","63% of total billed charges",1680.4,15.3,,1344.32,,,0,"percent of total billed charges","15.3% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,7578.27,69,,,,,0,"fee schedule","69% of total billed charges",10983,100,,8786.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10983,100,,8786.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10983,100,,8786.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1218.74,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1678.2,100,,,,,0,"fee schedule",EAPG,2138.89,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4140.59,37.7,,3312.47,,,0,"percent of total billed charges","37.7% of total billed charges",4140.59,37.7,,3312.47,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3723.24,33.9,,2978.59,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8566.74,78,,6853.39,,,0,"percent of total billed charges","78% of total billed charges",3283.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9071.96,82.6,,7257.57,,,0,"percent of total billed charges","82.6% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9071.96,82.6,,7257.57,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,10983,100,,8786.40,,,0,"percent of total billed charges","100% of total billed charges",1218.74,11625.58,
"IR Angio Visceral Sel or Suprasel",32375726,CDM,323,RC,75726,CPT,OUTPATIENT,,,17808,11575.2,TC,15671.04,88,,12536.83,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3820.51,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11219.04,63,,8975.23,,,0,"percent of total billed charges","63% of total billed charges",2724.62,15.3,,2179.70,,,0,"percent of total billed charges","15.3% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,12287.52,69,,,,,0,"fee schedule","69% of total billed charges",17808,100,,14246.40,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17808,100,,14246.40,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17808,100,,14246.40,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2747.58,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3783.42,100,,,,,0,"fee schedule",EAPG,4822.01,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6713.62,37.7,,5370.90,,,0,"percent of total billed charges","37.7% of total billed charges",6713.62,37.7,,5370.90,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6036.91,33.9,,4829.53,,,0,"percent of total billed charges","33.9% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13890.24,78,,11112.19,,,0,"percent of total billed charges","78% of total billed charges",5661.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14709.41,82.6,,11767.53,,,0,"percent of total billed charges","82.6% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14709.41,82.6,,11767.53,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,17808,100,,14246.40,,,0,"percent of total billed charges","100% of total billed charges",2724.62,19379.78,
"IR Aortogram Thoracic w/ Serialography",32375605,CDM,323,RC,75605,CPT,OUTPATIENT,,,10164,6606.6,TC,8944.32,88,,7155.46,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3820.51,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6403.32,63,,5122.66,,,0,"percent of total billed charges","63% of total billed charges",1555.09,15.3,,1244.07,,,0,"percent of total billed charges","15.3% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,7013.16,69,,,,,0,"fee schedule","69% of total billed charges",10164,100,,8131.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10164,100,,8131.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10164,100,,8131.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2747.58,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3783.42,100,,,,,0,"fee schedule",EAPG,4822.01,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3831.83,37.7,,3065.46,,,0,"percent of total billed charges","37.7% of total billed charges",3831.83,37.7,,3065.46,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3445.6,33.9,,2756.48,,,0,"percent of total billed charges","33.9% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7927.92,78,,6342.34,,,0,"percent of total billed charges","78% of total billed charges",5661.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8395.46,82.6,,6716.37,,,0,"percent of total billed charges","82.6% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8395.46,82.6,,6716.37,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,10164,100,,8131.20,,,0,"percent of total billed charges","100% of total billed charges",1555.09,19379.78,
"IR Biliary Endoscopy",32074328,CDM,320,RC,74328,CPT,OUTPATIENT,,,1815,1179.75,TC,1597.2,88,,1277.76,,,0,"percent of total billed charges","88% of total billed charges",907.5,50,,726.00,,,0,"percent of total billed charges","50% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,1815,100,,1452.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1143.45,63,,914.76,,,0,"percent of total billed charges","63% of total billed charges",277.7,15.3,,222.16,,,0,"percent of total billed charges","15.3% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,1252.35,69,,,,,0,"fee schedule","69% of total billed charges",1815,100,,1452.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1815,100,,1452.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1815,100,,1452.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1122.58,61.85,,898.06,,,0,"percent of total billed charges","61.5% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,907.5,50,,726.00,,,0,"percent of total billed charges","50% of total billed charges",584.43,32.2,,467.54,,,0,"percent of total billed charges","32.2% of total billed charges",119.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",165.21,100,,,,,0,"fee schedule",EAPG,210.57,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",684.26,37.7,,547.41,,,0,"percent of total billed charges","37.7% of total billed charges",684.26,37.7,,547.41,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",615.29,33.9,,492.23,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1415.7,78,,1132.56,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1499.19,82.6,,1199.35,,,0,"percent of total billed charges","82.6% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,907.5,50,,726.00,,,0,"percent of total billed charges","50% of total billed charges",1499.19,82.6,,1199.35,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",161.97,100,,,,,0,"fee schedule",EAPG,1815,100,,1452.00,,,0,"percent of total billed charges","100% of total billed charges",119.98,1815,
"IR Biliary Stent Placement New w/ Drain",32074363,CDM,320,RC,74363,CPT,OUTPATIENT,,,2582,1678.3,TC,2272.16,88,,1817.73,,,0,"percent of total billed charges","88% of total billed charges",1291,50,,1032.80,,,0,"percent of total billed charges","50% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,2582,100,,2065.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1626.66,63,,1301.33,,,0,"percent of total billed charges","63% of total billed charges",395.05,15.3,,316.04,,,0,"percent of total billed charges","15.3% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,1781.58,69,,,,,0,"fee schedule","69% of total billed charges",2582,100,,2065.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2582,100,,2065.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2582,100,,2065.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1596.97,61.85,,1277.58,,,0,"percent of total billed charges","61.5% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,1291,50,,1032.80,,,0,"percent of total billed charges","50% of total billed charges",831.4,32.2,,665.12,,,0,"percent of total billed charges","32.2% of total billed charges",119.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",165.21,100,,,,,0,"fee schedule",EAPG,210.57,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",973.41,37.7,,778.73,,,0,"percent of total billed charges","37.7% of total billed charges",973.41,37.7,,778.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",875.3,33.9,,700.24,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2013.96,78,,1611.17,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2132.73,82.6,,1706.18,,,0,"percent of total billed charges","82.6% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,1291,50,,1032.80,,,0,"percent of total billed charges","50% of total billed charges",2132.73,82.6,,1706.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",161.97,100,,,,,0,"fee schedule",EAPG,2582,100,,2065.60,,,0,"percent of total billed charges","100% of total billed charges",119.98,2582,
"IR CVC Removal",32936589,CDM,329,RC,36589,CPT,OUTPATIENT,,,2366,1537.9,TC,2082.08,88,,1665.66,,,0,"percent of total billed charges","88% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,2366,100,,1892.80,,,0,"percent of total billed charges","100% of total billed charges",1121.3,175,,,,,0,"fee schedule","175% of CMS fee schedule",678.35,100,,,,,0,"fee schedule",EAPG,640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1490.58,63,,1192.46,,,0,"percent of total billed charges","63% of total billed charges",362,15.3,,289.60,,,0,"percent of total billed charges","15.3% of total billed charges",658.59,100,,,,,0,"fee schedule",EAPG,1632.54,69,,,,,0,"fee schedule","69% of total billed charges",2366,100,,1892.80,,,0,"percent of total billed charges","100% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2366,100,,1892.80,,,0,"percent of total billed charges","100% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2366,100,,1892.80,,,0,"percent of total billed charges","100% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",2200.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",575.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",487.85,100,,,,,0,"fee schedule",EAPG,640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671.77,100,,,,,0,"fee schedule",EAPG,856.17,100,,,,,0,"fee schedule",EAPG,640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891.98,37.7,,713.58,,,0,"percent of total billed charges","37.7% of total billed charges",891.98,37.7,,713.58,,,0,"percent of total billed charges","37.70% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",802.07,33.9,,641.66,,,0,"percent of total billed charges","33.9% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1845.48,78,,1476.38,,,0,"percent of total billed charges","78% of total billed charges",647.15,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1954.32,82.6,,1563.46,,,0,"percent of total billed charges","82.6% of total billed charges",658.59,100,,,,,0,"fee schedule",EAPG,640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1954.32,82.6,,1563.46,,,0,"percent of total billed charges","82.6% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,2366,100,,1892.80,,,0,"percent of total billed charges","100% of total billed charges",362,2366,
"IR Gastric Tube",32943752,CDM,329,RC,43752,CPT,OUTPATIENT,,,1803,1171.95,TC,1586.64,88,,1269.31,,,0,"percent of total billed charges","88% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,1803,100,,1442.40,,,0,"percent of total billed charges","100% of total billed charges",711.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",624,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1135.89,63,,908.71,,,0,"percent of total billed charges","63% of total billed charges",275.86,15.3,,220.69,,,0,"percent of total billed charges","15.3% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,1244.07,69,,,,,0,"fee schedule","69% of total billed charges",1803,100,,1442.40,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1803,100,,1442.40,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1803,100,,1442.40,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",1097.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287,100,,,,,0,"fee schedule","100% of CMS OPPS rate",448.76,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",617.95,100,,,,,0,"fee schedule",EAPG,787.58,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",679.73,37.7,,543.78,,,0,"percent of total billed charges","37.7% of total billed charges",679.73,37.7,,543.78,,,0,"percent of total billed charges","37.70% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",611.22,33.9,,488.98,,,0,"percent of total billed charges","33.9% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1406.34,78,,1125.07,,,0,"percent of total billed charges","78% of total billed charges",410.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1489.28,82.6,,1191.42,,,0,"percent of total billed charges","82.6% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1489.28,82.6,,1191.42,,,0,"percent of total billed charges","82.6% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,1803,100,,1442.40,,,0,"percent of total billed charges","100% of total billed charges",275.86,1803,
"IR Gastrostomy Tube Change",32075984,CDM,320,RC,75984,CPT,OUTPATIENT,,,1695,1101.75,TC,1491.6,88,,1193.28,,,0,"percent of total billed charges","88% of total billed charges",847.5,50,,678.00,,,0,"percent of total billed charges","50% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,1695,100,,1356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1067.85,63,,854.28,,,0,"percent of total billed charges","63% of total billed charges",259.34,15.3,,207.47,,,0,"percent of total billed charges","15.3% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,1169.55,69,,,,,0,"fee schedule","69% of total billed charges",1695,100,,1356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1695,100,,1356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1695,100,,1356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1048.36,61.85,,838.69,,,0,"percent of total billed charges","61.5% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,847.5,50,,678.00,,,0,"percent of total billed charges","50% of total billed charges",545.79,32.2,,436.63,,,0,"percent of total billed charges","32.2% of total billed charges",119.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",165.21,100,,,,,0,"fee schedule",EAPG,210.57,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",639.02,37.7,,511.22,,,0,"percent of total billed charges","37.7% of total billed charges",639.02,37.7,,511.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",574.61,33.9,,459.69,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1322.1,78,,1057.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1400.07,82.6,,1120.06,,,0,"percent of total billed charges","82.6% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,847.5,50,,678.00,,,0,"percent of total billed charges","50% of total billed charges",1400.07,82.6,,1120.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",161.97,100,,,,,0,"fee schedule",EAPG,1695,100,,1356.00,,,0,"percent of total billed charges","100% of total billed charges",119.98,1695,
"IR Hepatic Venogram",32075889,CDM,320,RC,75889,CPT,OUTPATIENT,,,10162,6605.3,TC,8942.56,88,,7154.05,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5689.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",1694.66,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6402.06,63,,5121.65,,,0,"percent of total billed charges","63% of total billed charges",1554.79,15.3,,1243.83,,,0,"percent of total billed charges","15.3% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,7011.78,69,,,,,0,"fee schedule","69% of total billed charges",10162,100,,8129.60,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10162,100,,8129.60,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10162,100,,8129.60,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1218.74,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1678.2,100,,,,,0,"fee schedule",EAPG,2138.89,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3831.07,37.7,,3064.86,,,0,"percent of total billed charges","37.7% of total billed charges",3831.07,37.7,,3064.86,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3444.92,33.9,,2755.94,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7926.36,78,,6341.09,,,0,"percent of total billed charges","78% of total billed charges",3283.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8393.81,82.6,,6715.05,,,0,"percent of total billed charges","82.6% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8393.81,82.6,,6715.05,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,10162,100,,8129.60,,,0,"percent of total billed charges","100% of total billed charges",1218.74,11625.58,
"IR Insertion Gastrostomy Tube Perc",32074350,CDM,320,RC,74350,CPT,OUTPATIENT,,,860,559,TC,756.8,88,,605.44,,,0,"percent of total billed charges","88% of total billed charges",430,50,,344.00,,,0,"percent of total billed charges","50% of total billed charges",144.48,16.8,,115.58,,,0,"percent of total billed charges","16.8% of total billed charges",860,100,,688.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",148.81,17.304,,119.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",541.8,63,,433.44,,,0,"percent of total billed charges","63% of total billed charges",131.58,15.3,,105.26,,,0,"percent of total billed charges","15.3% of total billed charges",144.48,16.8,,115.58,,,0,"percent of total billed charges","16.8% of total billed charges",593.4,69,,,,,0,"fee schedule","69% of total billed charges",860,100,,688.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",860,100,,688.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",860,100,,688.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",531.91,61.85,,425.53,,,0,"percent of total billed charges","61.5% of total billed charges",144.48,16.8,,115.58,,,0,"percent of total billed charges","16.8% of total billed charges",430,50,,344.00,,,0,"percent of total billed charges","50% of total billed charges",276.92,32.2,,221.54,,,0,"percent of total billed charges","32.2% of total billed charges",144.48,16.8,,115.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",147.37,17.136,,117.90,,,0,"percent of total billed charges","17.136% of total billed charges",187.82,21.84,,150.26,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",324.22,37.7,,259.38,,,0,"percent of total billed charges","37.7% of total billed charges",324.22,37.7,,259.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",291.54,33.9,,233.23,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",670.8,78,,536.64,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",710.36,82.6,,568.29,,,0,"percent of total billed charges","82.6% of total billed charges",144.48,16.8,,115.58,,,0,"percent of total billed charges","16.8% of total billed charges",430,50,,344.00,,,0,"percent of total billed charges","50% of total billed charges",710.36,82.6,,568.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",144.48,16.8,,115.58,,,0,"percent of total billed charges","16.8% of total billed charges",860,100,,688.00,,,0,"percent of total billed charges","100% of total billed charges",131.58,860,
"IR Insertion Long GI Tube w/ Fluoro",32074340,CDM,320,RC,74340,CPT,OUTPATIENT,,,860,559,TC,756.8,88,,605.44,,,0,"percent of total billed charges","88% of total billed charges",430,50,,344.00,,,0,"percent of total billed charges","50% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,860,100,,688.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",541.8,63,,433.44,,,0,"percent of total billed charges","63% of total billed charges",131.58,15.3,,105.26,,,0,"percent of total billed charges","15.3% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,593.4,69,,,,,0,"fee schedule","69% of total billed charges",860,100,,688.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",860,100,,688.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",860,100,,688.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",531.91,61.85,,425.53,,,0,"percent of total billed charges","61.5% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,430,50,,344.00,,,0,"percent of total billed charges","50% of total billed charges",276.92,32.2,,221.54,,,0,"percent of total billed charges","32.2% of total billed charges",119.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",165.21,100,,,,,0,"fee schedule",EAPG,210.57,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",324.22,37.7,,259.38,,,0,"percent of total billed charges","37.7% of total billed charges",324.22,37.7,,259.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",291.54,33.9,,233.23,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",670.8,78,,536.64,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",710.36,82.6,,568.29,,,0,"percent of total billed charges","82.6% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,430,50,,344.00,,,0,"percent of total billed charges","50% of total billed charges",710.36,82.6,,568.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",161.97,100,,,,,0,"fee schedule",EAPG,860,100,,688.00,,,0,"percent of total billed charges","100% of total billed charges",119.98,860,
"IR Loopogram",32074425,CDM,320,RC,74425,CPT,OUTPATIENT,,,3117,2026.05,TC,2742.96,88,,2194.37,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,3117,100,,2493.60,,,0,"percent of total billed charges","100% of total billed charges",686.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1963.71,63,,1570.97,,,0,"percent of total billed charges","63% of total billed charges",476.9,15.3,,381.52,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,2150.73,69,,,,,0,"fee schedule","69% of total billed charges",3117,100,,2493.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3117,100,,2493.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3117,100,,2493.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1175.11,37.7,,940.09,,,0,"percent of total billed charges","37.7% of total billed charges",1175.11,37.7,,940.09,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056.66,33.9,,845.33,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2431.26,78,,1945.01,,,0,"percent of total billed charges","78% of total billed charges",396.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2574.64,82.6,,2059.71,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2574.64,82.6,,2059.71,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,3117,100,,2493.60,,,0,"percent of total billed charges","100% of total billed charges",80.56,3117,
"IR Pleural Drainage Perc",32932557,CDM,329,RC,32557,CPT,OUTPATIENT,,,7921,5148.65,TC,6970.48,88,,5576.38,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",884,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4990.23,63,,3992.18,,,0,"percent of total billed charges","63% of total billed charges",1211.91,15.3,,969.53,,,0,"percent of total billed charges","15.3% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,5465.49,69,,,,,0,"fee schedule","69% of total billed charges",7921,100,,6336.80,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7921,100,,6336.80,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7921,100,,6336.80,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",635.74,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.42,100,,,,,0,"fee schedule",EAPG,1115.74,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2986.22,37.7,,2388.98,,,0,"percent of total billed charges","37.7% of total billed charges",2986.22,37.7,,2388.98,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2685.22,33.9,,2148.18,,,0,"percent of total billed charges","33.9% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6178.38,78,,4942.70,,,0,"percent of total billed charges","78% of total billed charges",1649.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6542.75,82.6,,5234.20,,,0,"percent of total billed charges","82.6% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6542.75,82.6,,5234.20,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,7921,100,,6336.80,,,0,"percent of total billed charges","100% of total billed charges",635.74,7921,
"IR Pyelostogram",32074420,CDM,320,RC,74420,CPT,OUTPATIENT,,,2238,1454.7,TC,1969.44,88,,1575.55,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,2238,100,,1790.40,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1409.94,63,,1127.95,,,0,"percent of total billed charges","63% of total billed charges",342.41,15.3,,273.93,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,1544.22,69,,,,,0,"fee schedule","69% of total billed charges",2238,100,,1790.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2238,100,,1790.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2238,100,,1790.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",843.73,37.7,,674.98,,,0,"percent of total billed charges","37.7% of total billed charges",843.73,37.7,,674.98,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",758.68,33.9,,606.94,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1745.64,78,,1396.51,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1848.59,82.6,,1478.87,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1848.59,82.6,,1478.87,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,2238,100,,1790.40,,,0,"percent of total billed charges","100% of total billed charges",80.56,2238,
"IR Select Cath Placement External Carotid",32336227,CDM,323,RC,36227,CPT,OUTPATIENT,,,28638,18614.7,TC,25201.44,88,,20161.15,,,0,"percent of total billed charges","88% of total billed charges",14319,50,,11455.20,,,0,"percent of total billed charges","50% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3820.51,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",18041.94,63,,14433.55,,,0,"percent of total billed charges","63% of total billed charges",4381.61,15.3,,3505.29,,,0,"percent of total billed charges","15.3% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,19760.22,69,,,,,0,"fee schedule","69% of total billed charges",28638,100,,22910.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28638,100,,22910.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28638,100,,22910.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17712.6,61.85,,14170.08,,,0,"percent of total billed charges","61.5% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,14319,50,,11455.20,,,0,"percent of total billed charges","50% of total billed charges",9221.44,32.2,,7377.15,,,0,"percent of total billed charges","32.2% of total billed charges",2747.58,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3783.42,100,,,,,0,"fee schedule",EAPG,4822.01,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",10796.53,37.7,,8637.22,,,0,"percent of total billed charges","37.7% of total billed charges",10796.53,37.7,,8637.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",9708.28,33.9,,7766.62,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",22337.64,78,,17870.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23654.99,82.6,,18923.99,,,0,"percent of total billed charges","82.6% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,14319,50,,11455.20,,,0,"percent of total billed charges","50% of total billed charges",23654.99,82.6,,18923.99,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3709.23,100,,,,,0,"fee schedule",EAPG,28638,100,,22910.40,,,0,"percent of total billed charges","100% of total billed charges",2747.58,28638,
"IR Sialography",32070390,CDM,320,RC,70390,CPT,OUTPATIENT,,,1552,1008.8,TC,1365.76,88,,1092.61,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1552,100,,1241.60,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",977.76,63,,782.21,,,0,"percent of total billed charges","63% of total billed charges",237.46,15.3,,189.97,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,1070.88,69,,,,,0,"fee schedule","69% of total billed charges",1552,100,,1241.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1552,100,,1241.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1552,100,,1241.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",585.1,37.7,,468.08,,,0,"percent of total billed charges","37.7% of total billed charges",585.1,37.7,,468.08,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",526.13,33.9,,420.90,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1210.56,78,,968.45,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1281.95,82.6,,1025.56,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1281.95,82.6,,1025.56,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1552,100,,1241.60,,,0,"percent of total billed charges","100% of total billed charges",80.56,1552,
"IR Venous Sampling",32075893,CDM,320,RC,75893,CPT,OUTPATIENT,,,10162,6605.3,TC,8942.56,88,,7154.05,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3820.51,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6402.06,63,,5121.65,,,0,"percent of total billed charges","63% of total billed charges",1554.79,15.3,,1243.83,,,0,"percent of total billed charges","15.3% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,7011.78,69,,,,,0,"fee schedule","69% of total billed charges",10162,100,,8129.60,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10162,100,,8129.60,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10162,100,,8129.60,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2747.58,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3783.42,100,,,,,0,"fee schedule",EAPG,4822.01,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3831.07,37.7,,3064.86,,,0,"percent of total billed charges","37.7% of total billed charges",3831.07,37.7,,3064.86,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3444.92,33.9,,2755.94,,,0,"percent of total billed charges","33.9% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7926.36,78,,6341.09,,,0,"percent of total billed charges","78% of total billed charges",5661.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8393.81,82.6,,6715.05,,,0,"percent of total billed charges","82.6% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8393.81,82.6,,6715.05,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,10162,100,,8129.60,,,0,"percent of total billed charges","100% of total billed charges",1554.79,19379.78,
"IR Venogram Extremity Bilateral",32075822,CDM,320,RC,75822,CPT,OUTPATIENT,,,2914,1894.1,TC,2564.32,88,,2051.46,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.06,100,,,,,0,"fee schedule",EAPG,2914,100,,2331.20,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",781.83,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1835.82,63,,1468.66,,,0,"percent of total billed charges","63% of total billed charges",445.84,15.3,,356.67,,,0,"percent of total billed charges","15.3% of total billed charges",759.06,100,,,,,0,"fee schedule",EAPG,2010.66,69,,,,,0,"fee schedule","69% of total billed charges",2914,100,,2331.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2914,100,,2331.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2914,100,,2331.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.06,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",562.26,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",774.24,100,,,,,0,"fee schedule",EAPG,986.78,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1098.58,37.7,,878.86,,,0,"percent of total billed charges","37.7% of total billed charges",1098.58,37.7,,878.86,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",987.85,33.9,,790.28,,,0,"percent of total billed charges","33.9% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2272.92,78,,1818.34,,,0,"percent of total billed charges","78% of total billed charges",1649.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2406.96,82.6,,1925.57,,,0,"percent of total billed charges","82.6% of total billed charges",759.06,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2406.96,82.6,,1925.57,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.06,100,,,,,0,"fee schedule",EAPG,2914,100,,2331.20,,,0,"percent of total billed charges","100% of total billed charges",445.84,5712.48,
"IR Venogram Extremity Left",32075820,CDM,320,RC,75820,CPT,OUTPATIENT,,,3549,2306.85,TC|LT,3123.12,88,,2498.50,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.06,100,,,,,0,"fee schedule",EAPG,3549,100,,2839.20,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",781.83,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2235.87,63,,1788.70,,,0,"percent of total billed charges","63% of total billed charges",543,15.3,,434.40,,,0,"percent of total billed charges","15.3% of total billed charges",759.06,100,,,,,0,"fee schedule",EAPG,2448.81,69,,,,,0,"fee schedule","69% of total billed charges",3549,100,,2839.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3549,100,,2839.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3549,100,,2839.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.06,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",562.26,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",774.24,100,,,,,0,"fee schedule",EAPG,986.78,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1337.97,37.7,,1070.38,,,0,"percent of total billed charges","37.7% of total billed charges",1337.97,37.7,,1070.38,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1203.11,33.9,,962.49,,,0,"percent of total billed charges","33.9% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2768.22,78,,2214.58,,,0,"percent of total billed charges","78% of total billed charges",1649.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2931.47,82.6,,2345.18,,,0,"percent of total billed charges","82.6% of total billed charges",759.06,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2931.47,82.6,,2345.18,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.06,100,,,,,0,"fee schedule",EAPG,3549,100,,2839.20,,,0,"percent of total billed charges","100% of total billed charges",543,5712.48,
"IR Venogram Extremity Right",32075820,CDM,320,RC,75820,CPT,OUTPATIENT,,,3549,2306.85,TC|LT,3123.12,88,,2498.50,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.06,100,,,,,0,"fee schedule",EAPG,3549,100,,2839.20,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",781.83,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2235.87,63,,1788.70,,,0,"percent of total billed charges","63% of total billed charges",543,15.3,,434.40,,,0,"percent of total billed charges","15.3% of total billed charges",759.06,100,,,,,0,"fee schedule",EAPG,2448.81,69,,,,,0,"fee schedule","69% of total billed charges",3549,100,,2839.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3549,100,,2839.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3549,100,,2839.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.06,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",562.26,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",774.24,100,,,,,0,"fee schedule",EAPG,986.78,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1337.97,37.7,,1070.38,,,0,"percent of total billed charges","37.7% of total billed charges",1337.97,37.7,,1070.38,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1203.11,33.9,,962.49,,,0,"percent of total billed charges","33.9% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2768.22,78,,2214.58,,,0,"percent of total billed charges","78% of total billed charges",1649.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2931.47,82.6,,2345.18,,,0,"percent of total billed charges","82.6% of total billed charges",759.06,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2931.47,82.6,,2345.18,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.06,100,,,,,0,"fee schedule",EAPG,3549,100,,2839.20,,,0,"percent of total billed charges","100% of total billed charges",543,5712.48,
"IR Venogram Sinus or Jugular",32075860,CDM,320,RC,75860,CPT,OUTPATIENT,,,11195,7276.75,TC,9851.6,88,,7881.28,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5689.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",1694.66,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7052.85,63,,5642.28,,,0,"percent of total billed charges","63% of total billed charges",1712.84,15.3,,1370.27,,,0,"percent of total billed charges","15.3% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,7724.55,69,,,,,0,"fee schedule","69% of total billed charges",11195,100,,8956.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11195,100,,8956.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11195,100,,8956.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1218.74,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1678.2,100,,,,,0,"fee schedule",EAPG,2138.89,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4220.52,37.7,,3376.42,,,0,"percent of total billed charges","37.7% of total billed charges",4220.52,37.7,,3376.42,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3795.11,33.9,,3036.09,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8732.1,78,,6985.68,,,0,"percent of total billed charges","78% of total billed charges",3283.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9247.07,82.6,,7397.66,,,0,"percent of total billed charges","82.6% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9247.07,82.6,,7397.66,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,11195,100,,8956.00,,,0,"percent of total billed charges","100% of total billed charges",1218.74,11625.58,
"MG Breast Tissue Specimen Surgical Left",32076098,CDM,320,RC,76098,CPT,OUTPATIENT,,,2255,1465.75,TC|LT,1984.4,88,,1587.52,,,0,"percent of total billed charges","88% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,2255,100,,1804.00,,,0,"percent of total billed charges","100% of total billed charges",984.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1420.65,63,,1136.52,,,0,"percent of total billed charges","63% of total billed charges",345.02,15.3,,276.02,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,1555.95,69,,,,,0,"fee schedule","69% of total billed charges",2255,100,,1804.00,,,0,"percent of total billed charges","100% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2255,100,,1804.00,,,0,"percent of total billed charges","100% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2255,100,,1804.00,,,0,"percent of total billed charges","100% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",1961.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",850.14,37.7,,680.11,,,0,"percent of total billed charges","37.7% of total billed charges",850.14,37.7,,680.11,,,0,"percent of total billed charges","37.70% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",764.45,33.9,,611.56,,,0,"percent of total billed charges","33.9% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1758.9,78,,1407.12,,,0,"percent of total billed charges","78% of total billed charges",568.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1862.63,82.6,,1490.10,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1862.63,82.6,,1490.10,,,0,"percent of total billed charges","82.6% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,2255,100,,1804.00,,,0,"percent of total billed charges","100% of total billed charges",80.56,2255,
"MG Breast Tissue Specimen Surgical Right",32076098,CDM,320,RC,76098,CPT,OUTPATIENT,,,2255,1465.75,TC|LT,1984.4,88,,1587.52,,,0,"percent of total billed charges","88% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,2255,100,,1804.00,,,0,"percent of total billed charges","100% of total billed charges",984.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1420.65,63,,1136.52,,,0,"percent of total billed charges","63% of total billed charges",345.02,15.3,,276.02,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,1555.95,69,,,,,0,"fee schedule","69% of total billed charges",2255,100,,1804.00,,,0,"percent of total billed charges","100% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2255,100,,1804.00,,,0,"percent of total billed charges","100% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2255,100,,1804.00,,,0,"percent of total billed charges","100% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",1961.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",850.14,37.7,,680.11,,,0,"percent of total billed charges","37.7% of total billed charges",850.14,37.7,,680.11,,,0,"percent of total billed charges","37.70% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",764.45,33.9,,611.56,,,0,"percent of total billed charges","33.9% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1758.9,78,,1407.12,,,0,"percent of total billed charges","78% of total billed charges",568.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1862.63,82.6,,1490.10,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1862.63,82.6,,1490.10,,,0,"percent of total billed charges","82.6% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,2255,100,,1804.00,,,0,"percent of total billed charges","100% of total billed charges",80.56,2255,
"MG Breast Tomo 3D Digital Diag Bilateral",40177062,CDM,401,RC,77062,CPT,OUTPATIENT,,,163,105.95,TC,143.44,88,,114.75,,,0,"percent of total billed charges","88% of total billed charges",81.5,50,,65.20,,,0,"percent of total billed charges","50% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",102.69,63,,82.15,,,0,"percent of total billed charges","63% of total billed charges",24.94,15.3,,19.95,,,0,"percent of total billed charges","15.3% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,112.47,69,,,,,0,"fee schedule","69% of total billed charges",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",100.82,61.85,,80.66,,,0,"percent of total billed charges","61.5% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,81.5,50,,65.20,,,0,"percent of total billed charges","50% of total billed charges",52.49,32.2,,41.99,,,0,"percent of total billed charges","32.2% of total billed charges",33.79,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",46.53,100,,,,,0,"fee schedule",EAPG,59.31,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",61.45,37.7,,49.16,,,0,"percent of total billed charges","37.7% of total billed charges",61.45,37.7,,49.16,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",55.26,33.9,,44.21,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.14,78,,101.71,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.64,82.6,,107.71,,,0,"percent of total billed charges","82.6% of total billed charges",45.62,100,,,,,0,"fee schedule","100% of WA fee schedule",81.5,50,,65.20,,,0,"percent of total billed charges","50% of total billed charges",134.64,82.6,,107.71,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.62,100,,,,,0,"fee schedule",EAPG,163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",24.94,163,
"MG Breast Biopsy w/ Stereo Guide Left",40119081,CDM,401,RC,19081,CPT,OUTPATIENT,,,3289,2137.85,TC|LT,2894.32,88,,2315.46,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,3289,100,,2631.20,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1298.41,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2072.07,63,,1657.66,,,0,"percent of total billed charges","63% of total billed charges",503.22,15.3,,402.58,,,0,"percent of total billed charges","15.3% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,2269.41,69,,,,,0,"fee schedule","69% of total billed charges",3289,100,,2631.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3289,100,,2631.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3289,100,,2631.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",933.77,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1285.8,100,,,,,0,"fee schedule",EAPG,1638.77,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.95,37.7,,991.96,,,0,"percent of total billed charges","37.7% of total billed charges",1239.95,37.7,,991.96,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1114.97,33.9,,891.98,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2565.42,78,,2052.34,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2716.71,82.6,,2173.37,,,0,"percent of total billed charges","82.6% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2716.71,82.6,,2173.37,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,3289,100,,2631.20,,,0,"percent of total billed charges","100% of total billed charges",503.22,5715.97,
"MG Breast Biopsy w/ Stereo Guide Right",40119081,CDM,401,RC,19081,CPT,OUTPATIENT,,,3289,2137.85,TC|LT,2894.32,88,,2315.46,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,3289,100,,2631.20,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1298.41,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2072.07,63,,1657.66,,,0,"percent of total billed charges","63% of total billed charges",503.22,15.3,,402.58,,,0,"percent of total billed charges","15.3% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,2269.41,69,,,,,0,"fee schedule","69% of total billed charges",3289,100,,2631.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3289,100,,2631.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3289,100,,2631.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",933.77,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1285.8,100,,,,,0,"fee schedule",EAPG,1638.77,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.95,37.7,,991.96,,,0,"percent of total billed charges","37.7% of total billed charges",1239.95,37.7,,991.96,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1114.97,33.9,,891.98,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2565.42,78,,2052.34,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2716.71,82.6,,2173.37,,,0,"percent of total billed charges","82.6% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2716.71,82.6,,2173.37,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,3289,100,,2631.20,,,0,"percent of total billed charges","100% of total billed charges",503.22,5715.97,
"MG Breast Tomo 3D Digital Screening",40377063,CDM,403,RC,77063,CPT,OUTPATIENT,,,163,105.95,TC,143.44,88,,114.75,,,0,"percent of total billed charges","88% of total billed charges",24.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",43.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",46.99,100,,,,,0,"fee schedule",EAPG,24.92,100,,,,,0,"fee schedule","100% of CMS fee sv",102.69,63,,82.15,,,0,"percent of total billed charges","63% of total billed charges",24.94,15.3,,19.95,,,0,"percent of total billed charges","15.3% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,112.47,69,,,,,0,"fee schedule","69% of total billed charges",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",24.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",24.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",24.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",98.76,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,24.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.3,100,,,,,0,"fee schedule","100% of LI fee schedule",33.79,100,,,,,0,"fee schedule",EAPG,24.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.53,100,,,,,0,"fee schedule",EAPG,59.31,100,,,,,0,"fee schedule",EAPG,24.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.45,37.7,,49.16,,,0,"percent of total billed charges","37.7% of total billed charges",61.45,37.7,,49.16,,,0,"percent of total billed charges","37.70% of total billed charges",24.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",55.26,33.9,,44.21,,,0,"percent of total billed charges","33.9% of total billed charges",24.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",127.14,78,,101.71,,,0,"percent of total billed charges","78% of total billed charges",25.17,101,,,,,0,"fee schedule","101% of CMS fee schedule ",134.64,82.6,,107.71,,,0,"percent of total billed charges","82.6% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,24.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",134.64,82.6,,107.71,,,0,"percent of total billed charges","82.6% of total billed charges",24.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",24.3,163,
"MG Device Plcmnt w/ Mammo Guide Left",40119281,CDM,401,RC,19281,CPT,OUTPATIENT,,,3418,2221.7,TC|LT,3007.84,88,,2406.27,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,3418,100,,2734.40,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1298.41,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2153.34,63,,1722.67,,,0,"percent of total billed charges","63% of total billed charges",522.95,15.3,,418.36,,,0,"percent of total billed charges","15.3% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,2358.42,69,,,,,0,"fee schedule","69% of total billed charges",3418,100,,2734.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3418,100,,2734.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3418,100,,2734.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",933.77,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1285.8,100,,,,,0,"fee schedule",EAPG,1638.77,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1288.59,37.7,,1030.87,,,0,"percent of total billed charges","37.7% of total billed charges",1288.59,37.7,,1030.87,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1158.7,33.9,,926.96,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2666.04,78,,2132.83,,,0,"percent of total billed charges","78% of total billed charges",1670.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2823.27,82.6,,2258.62,,,0,"percent of total billed charges","82.6% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2823.27,82.6,,2258.62,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,3418,100,,2734.40,,,0,"percent of total billed charges","100% of total billed charges",522.95,3418,
"MG Device Plcmnt w/ Mammo Guide Right",40119281,CDM,401,RC,19281,CPT,OUTPATIENT,,,3418,2221.7,TC|LT,3007.84,88,,2406.27,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,3418,100,,2734.40,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1298.41,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2153.34,63,,1722.67,,,0,"percent of total billed charges","63% of total billed charges",522.95,15.3,,418.36,,,0,"percent of total billed charges","15.3% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,2358.42,69,,,,,0,"fee schedule","69% of total billed charges",3418,100,,2734.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3418,100,,2734.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3418,100,,2734.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",933.77,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1285.8,100,,,,,0,"fee schedule",EAPG,1638.77,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1288.59,37.7,,1030.87,,,0,"percent of total billed charges","37.7% of total billed charges",1288.59,37.7,,1030.87,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1158.7,33.9,,926.96,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2666.04,78,,2132.83,,,0,"percent of total billed charges","78% of total billed charges",1670.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2823.27,82.6,,2258.62,,,0,"percent of total billed charges","82.6% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2823.27,82.6,,2258.62,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,3418,100,,2734.40,,,0,"percent of total billed charges","100% of total billed charges",522.95,3418,
"MG Ductogram or Galactogram Single Left",32077053,CDM,320,RC,77053,CPT,OUTPATIENT,,,1446,939.9,TC|LT,1272.48,88,,1017.98,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1446,100,,1156.80,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",910.98,63,,728.78,,,0,"percent of total billed charges","63% of total billed charges",221.24,15.3,,176.99,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,997.74,69,,,,,0,"fee schedule","69% of total billed charges",1446,100,,1156.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1446,100,,1156.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1446,100,,1156.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",545.14,37.7,,436.11,,,0,"percent of total billed charges","37.7% of total billed charges",545.14,37.7,,436.11,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",490.19,33.9,,392.15,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1127.88,78,,902.30,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1194.4,82.6,,955.52,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1194.4,82.6,,955.52,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1446,100,,1156.80,,,0,"percent of total billed charges","100% of total billed charges",80.56,1446,
"MG Ductogram or Galactogram Single Right",32077053,CDM,320,RC,77053,CPT,OUTPATIENT,,,1446,939.9,TC|LT,1272.48,88,,1017.98,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1446,100,,1156.80,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",910.98,63,,728.78,,,0,"percent of total billed charges","63% of total billed charges",221.24,15.3,,176.99,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,997.74,69,,,,,0,"fee schedule","69% of total billed charges",1446,100,,1156.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1446,100,,1156.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1446,100,,1156.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",545.14,37.7,,436.11,,,0,"percent of total billed charges","37.7% of total billed charges",545.14,37.7,,436.11,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",490.19,33.9,,392.15,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1127.88,78,,902.30,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1194.4,82.6,,955.52,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1194.4,82.6,,955.52,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1446,100,,1156.80,,,0,"percent of total billed charges","100% of total billed charges",80.56,1446,
"MG Mammo Digital Diagnostic Bilat.",40177066,CDM,401,RC,77066,CPT,OUTPATIENT,,,629,408.85,TC|50,553.52,88,,442.82,,,0,"percent of total billed charges","88% of total billed charges",116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,629,100,,503.20,,,0,"percent of total billed charges","100% of total billed charges",202.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",46.99,100,,,,,0,"fee schedule",EAPG,116.16,100,,,,,0,"fee schedule","100% of CMS fee sv",396.27,63,,317.02,,,0,"percent of total billed charges","63% of total billed charges",96.24,15.3,,76.99,,,0,"percent of total billed charges","15.3% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,434.01,69,,,,,0,"fee schedule","69% of total billed charges",629,100,,503.20,,,0,"percent of total billed charges","100% of total billed charges",115.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",629,100,,503.20,,,0,"percent of total billed charges","100% of total billed charges",116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",629,100,,503.20,,,0,"percent of total billed charges","100% of total billed charges",116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",452.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.23,100,,,,,0,"fee schedule","100% of LI fee schedule",33.79,100,,,,,0,"fee schedule",EAPG,116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.53,100,,,,,0,"fee schedule",EAPG,59.31,100,,,,,0,"fee schedule",EAPG,116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",237.13,37.7,,189.70,,,0,"percent of total billed charges","37.7% of total billed charges",237.13,37.7,,189.70,,,0,"percent of total billed charges","37.70% of total billed charges",116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",213.23,33.9,,170.58,,,0,"percent of total billed charges","33.9% of total billed charges",116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",490.62,78,,392.50,,,0,"percent of total billed charges","78% of total billed charges",117.32,101,,,,,0,"fee schedule","101% of CMS fee schedule ",519.55,82.6,,415.64,,,0,"percent of total billed charges","82.6% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",519.55,82.6,,415.64,,,0,"percent of total billed charges","82.6% of total billed charges",116.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,629,100,,503.20,,,0,"percent of total billed charges","100% of total billed charges",33.79,629,
"MG Mammo Digital Diagnostic Left.",40177065,CDM,401,RC,77065,CPT,OUTPATIENT,,,502,326.3,TC|LT,441.76,88,,353.41,,,0,"percent of total billed charges","88% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",158.29,175,,,,,0,"fee schedule","175% of CMS fee schedule",46.99,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee sv",316.26,63,,253.01,,,0,"percent of total billed charges","63% of total billed charges",76.81,15.3,,61.45,,,0,"percent of total billed charges","15.3% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,346.38,69,,,,,0,"fee schedule","69% of total billed charges",502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",90.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",354.2,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.34,100,,,,,0,"fee schedule","100% of LI fee schedule",33.79,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.53,100,,,,,0,"fee schedule",EAPG,59.31,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",189.25,37.7,,151.40,,,0,"percent of total billed charges","37.7% of total billed charges",189.25,37.7,,151.40,,,0,"percent of total billed charges","37.70% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.18,33.9,,136.14,,,0,"percent of total billed charges","33.9% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",391.56,78,,313.25,,,0,"percent of total billed charges","78% of total billed charges",91.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",414.65,82.6,,331.72,,,0,"percent of total billed charges","82.6% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",414.65,82.6,,331.72,,,0,"percent of total billed charges","82.6% of total billed charges",90.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",33.79,502,
"MG Mammo Digital Diagnostic Right.",40177065,CDM,401,RC,77065,CPT,OUTPATIENT,,,502,326.3,TC|LT,441.76,88,,353.41,,,0,"percent of total billed charges","88% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",158.29,175,,,,,0,"fee schedule","175% of CMS fee schedule",46.99,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee sv",316.26,63,,253.01,,,0,"percent of total billed charges","63% of total billed charges",76.81,15.3,,61.45,,,0,"percent of total billed charges","15.3% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,346.38,69,,,,,0,"fee schedule","69% of total billed charges",502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",90.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",354.2,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.34,100,,,,,0,"fee schedule","100% of LI fee schedule",33.79,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.53,100,,,,,0,"fee schedule",EAPG,59.31,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",189.25,37.7,,151.40,,,0,"percent of total billed charges","37.7% of total billed charges",189.25,37.7,,151.40,,,0,"percent of total billed charges","37.70% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.18,33.9,,136.14,,,0,"percent of total billed charges","33.9% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",391.56,78,,313.25,,,0,"percent of total billed charges","78% of total billed charges",91.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",414.65,82.6,,331.72,,,0,"percent of total billed charges","82.6% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",414.65,82.6,,331.72,,,0,"percent of total billed charges","82.6% of total billed charges",90.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",33.79,502,
"MG Mammo Digital Screening Bilateral.",40377067,CDM,403,RC,77067,CPT,OUTPATIENT,,,522,339.3,TC,459.36,88,,367.49,,,0,"percent of total billed charges","88% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",167.39,175,,,,,0,"fee schedule","175% of CMS fee schedule",46.99,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee sv",328.86,63,,263.09,,,0,"percent of total billed charges","63% of total billed charges",79.87,15.3,,63.90,,,0,"percent of total billed charges","15.3% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,360.18,69,,,,,0,"fee schedule","69% of total billed charges",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",374.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",93.4,100,,,,,0,"fee schedule","100% of LI fee schedule",33.79,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.53,100,,,,,0,"fee schedule",EAPG,59.31,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",196.79,37.7,,157.43,,,0,"percent of total billed charges","37.7% of total billed charges",196.79,37.7,,157.43,,,0,"percent of total billed charges","37.70% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",176.96,33.9,,141.57,,,0,"percent of total billed charges","33.9% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",407.16,78,,325.73,,,0,"percent of total billed charges","78% of total billed charges",96.77,101,,,,,0,"fee schedule","101% of CMS fee schedule ",431.17,82.6,,344.94,,,0,"percent of total billed charges","82.6% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",431.17,82.6,,344.94,,,0,"percent of total billed charges","82.6% of total billed charges",95.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",33.79,522,
"MG Mammo Digital Screening Left.",40377067,CDM,403,RC,77067,CPT,OUTPATIENT,,,522,339.3,TC,459.36,88,,367.49,,,0,"percent of total billed charges","88% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",167.39,175,,,,,0,"fee schedule","175% of CMS fee schedule",46.99,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee sv",328.86,63,,263.09,,,0,"percent of total billed charges","63% of total billed charges",79.87,15.3,,63.90,,,0,"percent of total billed charges","15.3% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,360.18,69,,,,,0,"fee schedule","69% of total billed charges",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",374.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",93.4,100,,,,,0,"fee schedule","100% of LI fee schedule",33.79,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.53,100,,,,,0,"fee schedule",EAPG,59.31,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",196.79,37.7,,157.43,,,0,"percent of total billed charges","37.7% of total billed charges",196.79,37.7,,157.43,,,0,"percent of total billed charges","37.70% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",176.96,33.9,,141.57,,,0,"percent of total billed charges","33.9% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",407.16,78,,325.73,,,0,"percent of total billed charges","78% of total billed charges",96.77,101,,,,,0,"fee schedule","101% of CMS fee schedule ",431.17,82.6,,344.94,,,0,"percent of total billed charges","82.6% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",431.17,82.6,,344.94,,,0,"percent of total billed charges","82.6% of total billed charges",95.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",33.79,522,
"MG Mammo Digital Screening Right.",40377067,CDM,403,RC,77067,CPT,OUTPATIENT,,,522,339.3,TC,459.36,88,,367.49,,,0,"percent of total billed charges","88% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",167.39,175,,,,,0,"fee schedule","175% of CMS fee schedule",46.99,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee sv",328.86,63,,263.09,,,0,"percent of total billed charges","63% of total billed charges",79.87,15.3,,63.90,,,0,"percent of total billed charges","15.3% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,360.18,69,,,,,0,"fee schedule","69% of total billed charges",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",374.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",93.4,100,,,,,0,"fee schedule","100% of LI fee schedule",33.79,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.53,100,,,,,0,"fee schedule",EAPG,59.31,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",196.79,37.7,,157.43,,,0,"percent of total billed charges","37.7% of total billed charges",196.79,37.7,,157.43,,,0,"percent of total billed charges","37.70% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",176.96,33.9,,141.57,,,0,"percent of total billed charges","33.9% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",407.16,78,,325.73,,,0,"percent of total billed charges","78% of total billed charges",96.77,101,,,,,0,"fee schedule","101% of CMS fee schedule ",431.17,82.6,,344.94,,,0,"percent of total billed charges","82.6% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",431.17,82.6,,344.94,,,0,"percent of total billed charges","82.6% of total billed charges",95.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",33.79,522,
"MG Mammo Diagnostic Bilateral w/ Tomo.",40177066,CDM,401,RC,77066,CPT,OUTPATIENT,,,1446,939.9,TC|50,1272.48,88,,1017.98,,,0,"percent of total billed charges","88% of total billed charges",116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,1446,100,,1156.80,,,0,"percent of total billed charges","100% of total billed charges",202.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",46.99,100,,,,,0,"fee schedule",EAPG,116.16,100,,,,,0,"fee schedule","100% of CMS fee sv",910.98,63,,728.78,,,0,"percent of total billed charges","63% of total billed charges",221.24,15.3,,176.99,,,0,"percent of total billed charges","15.3% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,997.74,69,,,,,0,"fee schedule","69% of total billed charges",1446,100,,1156.80,,,0,"percent of total billed charges","100% of total billed charges",115.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",1446,100,,1156.80,,,0,"percent of total billed charges","100% of total billed charges",116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",1446,100,,1156.80,,,0,"percent of total billed charges","100% of total billed charges",116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",452.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.23,100,,,,,0,"fee schedule","100% of LI fee schedule",33.79,100,,,,,0,"fee schedule",EAPG,116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.53,100,,,,,0,"fee schedule",EAPG,59.31,100,,,,,0,"fee schedule",EAPG,116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",545.14,37.7,,436.11,,,0,"percent of total billed charges","37.7% of total billed charges",545.14,37.7,,436.11,,,0,"percent of total billed charges","37.70% of total billed charges",116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",490.19,33.9,,392.15,,,0,"percent of total billed charges","33.9% of total billed charges",116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",1127.88,78,,902.30,,,0,"percent of total billed charges","78% of total billed charges",117.32,101,,,,,0,"fee schedule","101% of CMS fee schedule ",1194.4,82.6,,955.52,,,0,"percent of total billed charges","82.6% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",1194.4,82.6,,955.52,,,0,"percent of total billed charges","82.6% of total billed charges",116.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,1446,100,,1156.80,,,0,"percent of total billed charges","100% of total billed charges",33.79,1446,
"MG Mammo Diagnostic Left w/ Tomo.",40177065,CDM,401,RC,77065,CPT,OUTPATIENT,,,1158,752.7,TC|LT,1019.04,88,,815.23,,,0,"percent of total billed charges","88% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,1158,100,,926.40,,,0,"percent of total billed charges","100% of total billed charges",158.29,175,,,,,0,"fee schedule","175% of CMS fee schedule",46.99,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee sv",729.54,63,,583.63,,,0,"percent of total billed charges","63% of total billed charges",177.17,15.3,,141.74,,,0,"percent of total billed charges","15.3% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,799.02,69,,,,,0,"fee schedule","69% of total billed charges",1158,100,,926.40,,,0,"percent of total billed charges","100% of total billed charges",90.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",1158,100,,926.40,,,0,"percent of total billed charges","100% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",1158,100,,926.40,,,0,"percent of total billed charges","100% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",354.2,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.34,100,,,,,0,"fee schedule","100% of LI fee schedule",33.79,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.53,100,,,,,0,"fee schedule",EAPG,59.31,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",436.57,37.7,,349.26,,,0,"percent of total billed charges","37.7% of total billed charges",436.57,37.7,,349.26,,,0,"percent of total billed charges","37.70% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",392.56,33.9,,314.05,,,0,"percent of total billed charges","33.9% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",903.24,78,,722.59,,,0,"percent of total billed charges","78% of total billed charges",91.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",956.51,82.6,,765.21,,,0,"percent of total billed charges","82.6% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",956.51,82.6,,765.21,,,0,"percent of total billed charges","82.6% of total billed charges",90.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,1158,100,,926.40,,,0,"percent of total billed charges","100% of total billed charges",33.79,1158,
"MG Mammo Diagnostic Right w/ Tomo.",40177065,CDM,401,RC,77065,CPT,OUTPATIENT,,,1158,752.7,TC|LT,1019.04,88,,815.23,,,0,"percent of total billed charges","88% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,1158,100,,926.40,,,0,"percent of total billed charges","100% of total billed charges",158.29,175,,,,,0,"fee schedule","175% of CMS fee schedule",46.99,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee sv",729.54,63,,583.63,,,0,"percent of total billed charges","63% of total billed charges",177.17,15.3,,141.74,,,0,"percent of total billed charges","15.3% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,799.02,69,,,,,0,"fee schedule","69% of total billed charges",1158,100,,926.40,,,0,"percent of total billed charges","100% of total billed charges",90.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",1158,100,,926.40,,,0,"percent of total billed charges","100% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",1158,100,,926.40,,,0,"percent of total billed charges","100% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",354.2,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.34,100,,,,,0,"fee schedule","100% of LI fee schedule",33.79,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.53,100,,,,,0,"fee schedule",EAPG,59.31,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",436.57,37.7,,349.26,,,0,"percent of total billed charges","37.7% of total billed charges",436.57,37.7,,349.26,,,0,"percent of total billed charges","37.70% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",392.56,33.9,,314.05,,,0,"percent of total billed charges","33.9% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",903.24,78,,722.59,,,0,"percent of total billed charges","78% of total billed charges",91.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",956.51,82.6,,765.21,,,0,"percent of total billed charges","82.6% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",956.51,82.6,,765.21,,,0,"percent of total billed charges","82.6% of total billed charges",90.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,1158,100,,926.40,,,0,"percent of total billed charges","100% of total billed charges",33.79,1158,
"MG Mammo Implant Diag Bilateral w/ Tomo.",40177066,CDM,401,RC,77066,CPT,OUTPATIENT,,,1446,939.9,TC|50,1272.48,88,,1017.98,,,0,"percent of total billed charges","88% of total billed charges",116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,1446,100,,1156.80,,,0,"percent of total billed charges","100% of total billed charges",202.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",46.99,100,,,,,0,"fee schedule",EAPG,116.16,100,,,,,0,"fee schedule","100% of CMS fee sv",910.98,63,,728.78,,,0,"percent of total billed charges","63% of total billed charges",221.24,15.3,,176.99,,,0,"percent of total billed charges","15.3% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,997.74,69,,,,,0,"fee schedule","69% of total billed charges",1446,100,,1156.80,,,0,"percent of total billed charges","100% of total billed charges",115.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",1446,100,,1156.80,,,0,"percent of total billed charges","100% of total billed charges",116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",1446,100,,1156.80,,,0,"percent of total billed charges","100% of total billed charges",116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",452.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.23,100,,,,,0,"fee schedule","100% of LI fee schedule",33.79,100,,,,,0,"fee schedule",EAPG,116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.53,100,,,,,0,"fee schedule",EAPG,59.31,100,,,,,0,"fee schedule",EAPG,116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",545.14,37.7,,436.11,,,0,"percent of total billed charges","37.7% of total billed charges",545.14,37.7,,436.11,,,0,"percent of total billed charges","37.70% of total billed charges",116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",490.19,33.9,,392.15,,,0,"percent of total billed charges","33.9% of total billed charges",116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",1127.88,78,,902.30,,,0,"percent of total billed charges","78% of total billed charges",117.32,101,,,,,0,"fee schedule","101% of CMS fee schedule ",1194.4,82.6,,955.52,,,0,"percent of total billed charges","82.6% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",1194.4,82.6,,955.52,,,0,"percent of total billed charges","82.6% of total billed charges",116.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,1446,100,,1156.80,,,0,"percent of total billed charges","100% of total billed charges",33.79,1446,
"MG Mammo Implant Diag Left w/ Tomo.",40177065,CDM,401,RC,77065,CPT,OUTPATIENT,,,1158,752.7,TC|LT,1019.04,88,,815.23,,,0,"percent of total billed charges","88% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,1158,100,,926.40,,,0,"percent of total billed charges","100% of total billed charges",158.29,175,,,,,0,"fee schedule","175% of CMS fee schedule",46.99,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee sv",729.54,63,,583.63,,,0,"percent of total billed charges","63% of total billed charges",177.17,15.3,,141.74,,,0,"percent of total billed charges","15.3% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,799.02,69,,,,,0,"fee schedule","69% of total billed charges",1158,100,,926.40,,,0,"percent of total billed charges","100% of total billed charges",90.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",1158,100,,926.40,,,0,"percent of total billed charges","100% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",1158,100,,926.40,,,0,"percent of total billed charges","100% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",354.2,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.34,100,,,,,0,"fee schedule","100% of LI fee schedule",33.79,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.53,100,,,,,0,"fee schedule",EAPG,59.31,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",436.57,37.7,,349.26,,,0,"percent of total billed charges","37.7% of total billed charges",436.57,37.7,,349.26,,,0,"percent of total billed charges","37.70% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",392.56,33.9,,314.05,,,0,"percent of total billed charges","33.9% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",903.24,78,,722.59,,,0,"percent of total billed charges","78% of total billed charges",91.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",956.51,82.6,,765.21,,,0,"percent of total billed charges","82.6% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",956.51,82.6,,765.21,,,0,"percent of total billed charges","82.6% of total billed charges",90.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,1158,100,,926.40,,,0,"percent of total billed charges","100% of total billed charges",33.79,1158,
"MG Mammo Implant Diag Right w/ Tomo.",40177061,CDM,401,RC,77061,CPT,OUTPATIENT,,,1158,752.7,TC,1019.04,88,,815.23,,,0,"percent of total billed charges","88% of total billed charges",579,50,,463.20,,,0,"percent of total billed charges","50% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,1158,100,,926.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",729.54,63,,583.63,,,0,"percent of total billed charges","63% of total billed charges",177.17,15.3,,141.74,,,0,"percent of total billed charges","15.3% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,799.02,69,,,,,0,"fee schedule","69% of total billed charges",1158,100,,926.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1158,100,,926.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1158,100,,926.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",716.22,61.85,,572.98,,,0,"percent of total billed charges","61.5% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,579,50,,463.20,,,0,"percent of total billed charges","50% of total billed charges",372.88,32.2,,298.30,,,0,"percent of total billed charges","32.2% of total billed charges",33.79,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",46.53,100,,,,,0,"fee schedule",EAPG,59.31,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",436.57,37.7,,349.26,,,0,"percent of total billed charges","37.7% of total billed charges",436.57,37.7,,349.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",392.56,33.9,,314.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",903.24,78,,722.59,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",956.51,82.6,,765.21,,,0,"percent of total billed charges","82.6% of total billed charges",45.62,100,,,,,0,"fee schedule","100% of WA fee schedule",579,50,,463.20,,,0,"percent of total billed charges","50% of total billed charges",956.51,82.6,,765.21,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.62,100,,,,,0,"fee schedule",EAPG,1158,100,,926.40,,,0,"percent of total billed charges","100% of total billed charges",33.79,1158,
"MG Mammo Implant Digital Diag Bilateral.",40177066,CDM,401,RC,77066,CPT,OUTPATIENT,,,629,408.85,TC|50,553.52,88,,442.82,,,0,"percent of total billed charges","88% of total billed charges",116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,629,100,,503.20,,,0,"percent of total billed charges","100% of total billed charges",202.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",46.99,100,,,,,0,"fee schedule",EAPG,116.16,100,,,,,0,"fee schedule","100% of CMS fee sv",396.27,63,,317.02,,,0,"percent of total billed charges","63% of total billed charges",96.24,15.3,,76.99,,,0,"percent of total billed charges","15.3% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,434.01,69,,,,,0,"fee schedule","69% of total billed charges",629,100,,503.20,,,0,"percent of total billed charges","100% of total billed charges",115.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",629,100,,503.20,,,0,"percent of total billed charges","100% of total billed charges",116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",629,100,,503.20,,,0,"percent of total billed charges","100% of total billed charges",116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",452.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.23,100,,,,,0,"fee schedule","100% of LI fee schedule",33.79,100,,,,,0,"fee schedule",EAPG,116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.53,100,,,,,0,"fee schedule",EAPG,59.31,100,,,,,0,"fee schedule",EAPG,116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",237.13,37.7,,189.70,,,0,"percent of total billed charges","37.7% of total billed charges",237.13,37.7,,189.70,,,0,"percent of total billed charges","37.70% of total billed charges",116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",213.23,33.9,,170.58,,,0,"percent of total billed charges","33.9% of total billed charges",116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",490.62,78,,392.50,,,0,"percent of total billed charges","78% of total billed charges",117.32,101,,,,,0,"fee schedule","101% of CMS fee schedule ",519.55,82.6,,415.64,,,0,"percent of total billed charges","82.6% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,116.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",519.55,82.6,,415.64,,,0,"percent of total billed charges","82.6% of total billed charges",116.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,629,100,,503.20,,,0,"percent of total billed charges","100% of total billed charges",33.79,629,
"MG Mammo Implant Digital Diag Left.",40177065,CDM,401,RC,77065,CPT,OUTPATIENT,,,502,326.3,TC|LT,441.76,88,,353.41,,,0,"percent of total billed charges","88% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",158.29,175,,,,,0,"fee schedule","175% of CMS fee schedule",46.99,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee sv",316.26,63,,253.01,,,0,"percent of total billed charges","63% of total billed charges",76.81,15.3,,61.45,,,0,"percent of total billed charges","15.3% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,346.38,69,,,,,0,"fee schedule","69% of total billed charges",502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",90.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",354.2,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.34,100,,,,,0,"fee schedule","100% of LI fee schedule",33.79,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.53,100,,,,,0,"fee schedule",EAPG,59.31,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",189.25,37.7,,151.40,,,0,"percent of total billed charges","37.7% of total billed charges",189.25,37.7,,151.40,,,0,"percent of total billed charges","37.70% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.18,33.9,,136.14,,,0,"percent of total billed charges","33.9% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",391.56,78,,313.25,,,0,"percent of total billed charges","78% of total billed charges",91.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",414.65,82.6,,331.72,,,0,"percent of total billed charges","82.6% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",414.65,82.6,,331.72,,,0,"percent of total billed charges","82.6% of total billed charges",90.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",33.79,502,
"MG Mammo Implant Digital Diag Right.",40177065,CDM,401,RC,77065,CPT,OUTPATIENT,,,502,326.3,TC|LT,441.76,88,,353.41,,,0,"percent of total billed charges","88% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",158.29,175,,,,,0,"fee schedule","175% of CMS fee schedule",46.99,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee sv",316.26,63,,253.01,,,0,"percent of total billed charges","63% of total billed charges",76.81,15.3,,61.45,,,0,"percent of total billed charges","15.3% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,346.38,69,,,,,0,"fee schedule","69% of total billed charges",502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",90.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",354.2,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",88.34,100,,,,,0,"fee schedule","100% of LI fee schedule",33.79,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.53,100,,,,,0,"fee schedule",EAPG,59.31,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",189.25,37.7,,151.40,,,0,"percent of total billed charges","37.7% of total billed charges",189.25,37.7,,151.40,,,0,"percent of total billed charges","37.70% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.18,33.9,,136.14,,,0,"percent of total billed charges","33.9% of total billed charges",90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",391.56,78,,313.25,,,0,"percent of total billed charges","78% of total billed charges",91.53,101,,,,,0,"fee schedule","101% of CMS fee schedule ",414.65,82.6,,331.72,,,0,"percent of total billed charges","82.6% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,90.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",414.65,82.6,,331.72,,,0,"percent of total billed charges","82.6% of total billed charges",90.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",33.79,502,
"MG Mammo Implant Digital Screening Bil.",40377067,CDM,403,RC,77067,CPT,OUTPATIENT,,,629,408.85,TC,553.52,88,,442.82,,,0,"percent of total billed charges","88% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,629,100,,503.20,,,0,"percent of total billed charges","100% of total billed charges",167.39,175,,,,,0,"fee schedule","175% of CMS fee schedule",46.99,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee sv",396.27,63,,317.02,,,0,"percent of total billed charges","63% of total billed charges",96.24,15.3,,76.99,,,0,"percent of total billed charges","15.3% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,434.01,69,,,,,0,"fee schedule","69% of total billed charges",629,100,,503.20,,,0,"percent of total billed charges","100% of total billed charges",95.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",629,100,,503.20,,,0,"percent of total billed charges","100% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",629,100,,503.20,,,0,"percent of total billed charges","100% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",374.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",93.4,100,,,,,0,"fee schedule","100% of LI fee schedule",33.79,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.53,100,,,,,0,"fee schedule",EAPG,59.31,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",237.13,37.7,,189.70,,,0,"percent of total billed charges","37.7% of total billed charges",237.13,37.7,,189.70,,,0,"percent of total billed charges","37.70% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",213.23,33.9,,170.58,,,0,"percent of total billed charges","33.9% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",490.62,78,,392.50,,,0,"percent of total billed charges","78% of total billed charges",96.77,101,,,,,0,"fee schedule","101% of CMS fee schedule ",519.55,82.6,,415.64,,,0,"percent of total billed charges","82.6% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",519.55,82.6,,415.64,,,0,"percent of total billed charges","82.6% of total billed charges",95.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,629,100,,503.20,,,0,"percent of total billed charges","100% of total billed charges",33.79,629,
"MG Mammo Implant Digital Screening Lt.",40377067,CDM,403,RC,77067,CPT,OUTPATIENT,,,522,339.3,TC,459.36,88,,367.49,,,0,"percent of total billed charges","88% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",167.39,175,,,,,0,"fee schedule","175% of CMS fee schedule",46.99,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee sv",328.86,63,,263.09,,,0,"percent of total billed charges","63% of total billed charges",79.87,15.3,,63.90,,,0,"percent of total billed charges","15.3% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,360.18,69,,,,,0,"fee schedule","69% of total billed charges",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",374.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",93.4,100,,,,,0,"fee schedule","100% of LI fee schedule",33.79,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.53,100,,,,,0,"fee schedule",EAPG,59.31,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",196.79,37.7,,157.43,,,0,"percent of total billed charges","37.7% of total billed charges",196.79,37.7,,157.43,,,0,"percent of total billed charges","37.70% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",176.96,33.9,,141.57,,,0,"percent of total billed charges","33.9% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",407.16,78,,325.73,,,0,"percent of total billed charges","78% of total billed charges",96.77,101,,,,,0,"fee schedule","101% of CMS fee schedule ",431.17,82.6,,344.94,,,0,"percent of total billed charges","82.6% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",431.17,82.6,,344.94,,,0,"percent of total billed charges","82.6% of total billed charges",95.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",33.79,522,
"MG Mammo Implant Digital Screening Rt.",40377067,CDM,403,RC,77067,CPT,OUTPATIENT,,,522,339.3,TC,459.36,88,,367.49,,,0,"percent of total billed charges","88% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",167.39,175,,,,,0,"fee schedule","175% of CMS fee schedule",46.99,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee sv",328.86,63,,263.09,,,0,"percent of total billed charges","63% of total billed charges",79.87,15.3,,63.90,,,0,"percent of total billed charges","15.3% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,360.18,69,,,,,0,"fee schedule","69% of total billed charges",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",374.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",93.4,100,,,,,0,"fee schedule","100% of LI fee schedule",33.79,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.53,100,,,,,0,"fee schedule",EAPG,59.31,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",196.79,37.7,,157.43,,,0,"percent of total billed charges","37.7% of total billed charges",196.79,37.7,,157.43,,,0,"percent of total billed charges","37.70% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",176.96,33.9,,141.57,,,0,"percent of total billed charges","33.9% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",407.16,78,,325.73,,,0,"percent of total billed charges","78% of total billed charges",96.77,101,,,,,0,"fee schedule","101% of CMS fee schedule ",431.17,82.6,,344.94,,,0,"percent of total billed charges","82.6% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",431.17,82.6,,344.94,,,0,"percent of total billed charges","82.6% of total billed charges",95.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",33.79,522,
"MG Mammo Implant Screening Bil w/ Tomo.",40377067,CDM,403,RC,77067,CPT,OUTPATIENT,,,522,339.3,TC,459.36,88,,367.49,,,0,"percent of total billed charges","88% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",167.39,175,,,,,0,"fee schedule","175% of CMS fee schedule",46.99,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee sv",328.86,63,,263.09,,,0,"percent of total billed charges","63% of total billed charges",79.87,15.3,,63.90,,,0,"percent of total billed charges","15.3% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,360.18,69,,,,,0,"fee schedule","69% of total billed charges",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",374.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",93.4,100,,,,,0,"fee schedule","100% of LI fee schedule",33.79,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.53,100,,,,,0,"fee schedule",EAPG,59.31,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",196.79,37.7,,157.43,,,0,"percent of total billed charges","37.7% of total billed charges",196.79,37.7,,157.43,,,0,"percent of total billed charges","37.70% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",176.96,33.9,,141.57,,,0,"percent of total billed charges","33.9% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",407.16,78,,325.73,,,0,"percent of total billed charges","78% of total billed charges",96.77,101,,,,,0,"fee schedule","101% of CMS fee schedule ",431.17,82.6,,344.94,,,0,"percent of total billed charges","82.6% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",431.17,82.6,,344.94,,,0,"percent of total billed charges","82.6% of total billed charges",95.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",33.79,522,
"MG Mammo Screening Bilateral",40377067,CDM,403,RC,77067,CPT,OUTPATIENT,,,522,339.3,TC,459.36,88,,367.49,,,0,"percent of total billed charges","88% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",167.39,175,,,,,0,"fee schedule","175% of CMS fee schedule",46.99,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee sv",328.86,63,,263.09,,,0,"percent of total billed charges","63% of total billed charges",79.87,15.3,,63.90,,,0,"percent of total billed charges","15.3% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,360.18,69,,,,,0,"fee schedule","69% of total billed charges",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",374.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",93.4,100,,,,,0,"fee schedule","100% of LI fee schedule",33.79,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.53,100,,,,,0,"fee schedule",EAPG,59.31,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",196.79,37.7,,157.43,,,0,"percent of total billed charges","37.7% of total billed charges",196.79,37.7,,157.43,,,0,"percent of total billed charges","37.70% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",176.96,33.9,,141.57,,,0,"percent of total billed charges","33.9% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",407.16,78,,325.73,,,0,"percent of total billed charges","78% of total billed charges",96.77,101,,,,,0,"fee schedule","101% of CMS fee schedule ",431.17,82.6,,344.94,,,0,"percent of total billed charges","82.6% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",431.17,82.6,,344.94,,,0,"percent of total billed charges","82.6% of total billed charges",95.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",33.79,522,
"MG Mammo Implant Screening Lt w/ Tomo.",40377067,CDM,403,RC,77067,CPT,OUTPATIENT,,,522,339.3,TC,459.36,88,,367.49,,,0,"percent of total billed charges","88% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",167.39,175,,,,,0,"fee schedule","175% of CMS fee schedule",46.99,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee sv",328.86,63,,263.09,,,0,"percent of total billed charges","63% of total billed charges",79.87,15.3,,63.90,,,0,"percent of total billed charges","15.3% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,360.18,69,,,,,0,"fee schedule","69% of total billed charges",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",374.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",93.4,100,,,,,0,"fee schedule","100% of LI fee schedule",33.79,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.53,100,,,,,0,"fee schedule",EAPG,59.31,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",196.79,37.7,,157.43,,,0,"percent of total billed charges","37.7% of total billed charges",196.79,37.7,,157.43,,,0,"percent of total billed charges","37.70% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",176.96,33.9,,141.57,,,0,"percent of total billed charges","33.9% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",407.16,78,,325.73,,,0,"percent of total billed charges","78% of total billed charges",96.77,101,,,,,0,"fee schedule","101% of CMS fee schedule ",431.17,82.6,,344.94,,,0,"percent of total billed charges","82.6% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",431.17,82.6,,344.94,,,0,"percent of total billed charges","82.6% of total billed charges",95.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",33.79,522,
"MG Mammo Implant Screening Rt w/ Tomo.",40377067,CDM,403,RC,77067,CPT,OUTPATIENT,,,522,339.3,TC,459.36,88,,367.49,,,0,"percent of total billed charges","88% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",167.39,175,,,,,0,"fee schedule","175% of CMS fee schedule",46.99,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee sv",328.86,63,,263.09,,,0,"percent of total billed charges","63% of total billed charges",79.87,15.3,,63.90,,,0,"percent of total billed charges","15.3% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,360.18,69,,,,,0,"fee schedule","69% of total billed charges",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",374.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",93.4,100,,,,,0,"fee schedule","100% of LI fee schedule",33.79,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.53,100,,,,,0,"fee schedule",EAPG,59.31,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",196.79,37.7,,157.43,,,0,"percent of total billed charges","37.7% of total billed charges",196.79,37.7,,157.43,,,0,"percent of total billed charges","37.70% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",176.96,33.9,,141.57,,,0,"percent of total billed charges","33.9% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",407.16,78,,325.73,,,0,"percent of total billed charges","78% of total billed charges",96.77,101,,,,,0,"fee schedule","101% of CMS fee schedule ",431.17,82.6,,344.94,,,0,"percent of total billed charges","82.6% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",431.17,82.6,,344.94,,,0,"percent of total billed charges","82.6% of total billed charges",95.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",33.79,522,
"MG Mammo Screening Left w/ Tomo.",40377067,CDM,403,RC,77067,CPT,OUTPATIENT,,,522,339.3,TC,459.36,88,,367.49,,,0,"percent of total billed charges","88% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",167.39,175,,,,,0,"fee schedule","175% of CMS fee schedule",46.99,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee sv",328.86,63,,263.09,,,0,"percent of total billed charges","63% of total billed charges",79.87,15.3,,63.90,,,0,"percent of total billed charges","15.3% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,360.18,69,,,,,0,"fee schedule","69% of total billed charges",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",374.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",93.4,100,,,,,0,"fee schedule","100% of LI fee schedule",33.79,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.53,100,,,,,0,"fee schedule",EAPG,59.31,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",196.79,37.7,,157.43,,,0,"percent of total billed charges","37.7% of total billed charges",196.79,37.7,,157.43,,,0,"percent of total billed charges","37.70% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",176.96,33.9,,141.57,,,0,"percent of total billed charges","33.9% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",407.16,78,,325.73,,,0,"percent of total billed charges","78% of total billed charges",96.77,101,,,,,0,"fee schedule","101% of CMS fee schedule ",431.17,82.6,,344.94,,,0,"percent of total billed charges","82.6% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",431.17,82.6,,344.94,,,0,"percent of total billed charges","82.6% of total billed charges",95.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",33.79,522,
"MG Mammo Screening Right w/ Tomo.",40377067,CDM,403,RC,77067,CPT,OUTPATIENT,,,522,339.3,TC,459.36,88,,367.49,,,0,"percent of total billed charges","88% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",167.39,175,,,,,0,"fee schedule","175% of CMS fee schedule",46.99,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee sv",328.86,63,,263.09,,,0,"percent of total billed charges","63% of total billed charges",79.87,15.3,,63.90,,,0,"percent of total billed charges","15.3% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,360.18,69,,,,,0,"fee schedule","69% of total billed charges",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",374.51,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",93.4,100,,,,,0,"fee schedule","100% of LI fee schedule",33.79,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",46.53,100,,,,,0,"fee schedule",EAPG,59.31,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",196.79,37.7,,157.43,,,0,"percent of total billed charges","37.7% of total billed charges",196.79,37.7,,157.43,,,0,"percent of total billed charges","37.70% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",176.96,33.9,,141.57,,,0,"percent of total billed charges","33.9% of total billed charges",95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",407.16,78,,325.73,,,0,"percent of total billed charges","78% of total billed charges",96.77,101,,,,,0,"fee schedule","101% of CMS fee schedule ",431.17,82.6,,344.94,,,0,"percent of total billed charges","82.6% of total billed charges",45.62,100,,,,,0,"fee schedule",EAPG,95.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",431.17,82.6,,344.94,,,0,"percent of total billed charges","82.6% of total billed charges",95.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.62,100,,,,,0,"fee schedule",EAPG,522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",33.79,522,
"MRA Abdomen w/ + w/o Contrast",618C8902,CDM,618,RC,C8902,CPT,OUTPATIENT,,,4989,3242.85,TC,4390.32,88,,3512.26,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.81,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",463.31,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3143.07,63,,2514.46,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",449.81,100,,,,,0,"fee schedule",EAPG,3442.41,69,,,,,0,"fee schedule","69% of total billed charges",4989,100,,3991.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4989,100,,3991.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4989,100,,3991.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.81,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",333.19,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",458.81,100,,,,,0,"fee schedule",EAPG,584.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1880.85,37.7,,1504.68,,,0,"percent of total billed charges","37.7% of total billed charges",1880.85,37.7,,1504.68,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1691.27,33.9,,1353.02,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3891.42,78,,3113.14,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4120.91,82.6,,3296.73,,,0,"percent of total billed charges","82.6% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4120.91,82.6,,3296.73,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.81,100,,,,,0,"fee schedule",EAPG,4989,100,,3991.20,,,0,"percent of total billed charges","100% of total billed charges",333.19,4989,
"MRA Abdomen w/ Contrast",618C8900,CDM,618,RC,74185,CPT,OUTPATIENT,,,3610,2346.5,TC,3176.8,88,,2541.44,,,0,"percent of total billed charges","88% of total billed charges",1805,50,,1444.00,,,0,"percent of total billed charges","50% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,3610,100,,2888.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.31,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2274.3,63,,1819.44,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",449.81,100,,,,,0,"fee schedule",EAPG,2490.9,69,,,,,0,"fee schedule","69% of total billed charges",3610,100,,2888.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3610,100,,2888.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3610,100,,2888.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2232.79,61.85,,1786.23,,,0,"percent of total billed charges","61.5% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,1805,50,,1444.00,,,0,"percent of total billed charges","50% of total billed charges",1162.42,32.2,,929.94,,,0,"percent of total billed charges","32.2% of total billed charges",333.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",458.81,100,,,,,0,"fee schedule",EAPG,584.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1360.97,37.7,,1088.78,,,0,"percent of total billed charges","37.7% of total billed charges",1360.97,37.7,,1088.78,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.79,33.9,,979.03,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2815.8,78,,2252.64,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2981.86,82.6,,2385.49,,,0,"percent of total billed charges","82.6% of total billed charges",449.81,100,,,,,0,"fee schedule","100% of WA fee schedule",1805,50,,1444.00,,,0,"percent of total billed charges","50% of total billed charges",2981.86,82.6,,2385.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.81,100,,,,,0,"fee schedule",EAPG,3610,100,,2888.00,,,0,"percent of total billed charges","100% of total billed charges",333.19,3610,
"MRA Abdomen w/o Contrast",61874185,CDM,618,RC,74185,CPT,OUTPATIENT,,,4989,3242.85,TC,4390.32,88,,3512.26,,,0,"percent of total billed charges","88% of total billed charges",2494.5,50,,1995.60,,,0,"percent of total billed charges","50% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.31,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3143.07,63,,2514.46,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",449.81,100,,,,,0,"fee schedule",EAPG,3442.41,69,,,,,0,"fee schedule","69% of total billed charges",4989,100,,3991.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4989,100,,3991.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4989,100,,3991.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3085.7,61.85,,2468.56,,,0,"percent of total billed charges","61.5% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,2494.5,50,,1995.60,,,0,"percent of total billed charges","50% of total billed charges",1606.46,32.2,,1285.17,,,0,"percent of total billed charges","32.2% of total billed charges",333.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",458.81,100,,,,,0,"fee schedule",EAPG,584.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1880.85,37.7,,1504.68,,,0,"percent of total billed charges","37.7% of total billed charges",1880.85,37.7,,1504.68,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1691.27,33.9,,1353.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3891.42,78,,3113.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4120.91,82.6,,3296.73,,,0,"percent of total billed charges","82.6% of total billed charges",449.81,100,,,,,0,"fee schedule","100% of WA fee schedule",2494.5,50,,1995.60,,,0,"percent of total billed charges","50% of total billed charges",4120.91,82.6,,3296.73,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.81,100,,,,,0,"fee schedule",EAPG,4989,100,,3991.20,,,0,"percent of total billed charges","100% of total billed charges",333.19,4989,
"MRA Chest w/ Contrast",618C8909,CDM,618,RC,C8909,CPT,OUTPATIENT,,,2649,1721.85,TC,2331.12,88,,1864.90,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.81,100,,,,,0,"fee schedule",EAPG,2649,100,,2119.20,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",463.31,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1668.87,63,,1335.10,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",449.81,100,,,,,0,"fee schedule",EAPG,1827.81,69,,,,,0,"fee schedule","69% of total billed charges",2649,100,,2119.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2649,100,,2119.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2649,100,,2119.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.81,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",333.19,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",458.81,100,,,,,0,"fee schedule",EAPG,584.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",998.67,37.7,,798.94,,,0,"percent of total billed charges","37.7% of total billed charges",998.67,37.7,,798.94,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",898.01,33.9,,718.41,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2066.22,78,,1652.98,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2188.07,82.6,,1750.46,,,0,"percent of total billed charges","82.6% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2188.07,82.6,,1750.46,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.81,100,,,,,0,"fee schedule",EAPG,2649,100,,2119.20,,,0,"percent of total billed charges","100% of total billed charges",333.19,2649,
"MRA Brain/Head w/ + w/o Contrast",61070546,CDM,610,RC,70546,CPT,OUTPATIENT,,,3782,2458.3,TC,3328.16,88,,2662.53,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.81,100,,,,,0,"fee schedule",EAPG,3782,100,,3025.60,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",463.31,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2382.66,63,,1906.13,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",449.81,100,,,,,0,"fee schedule",EAPG,2609.58,69,,,,,0,"fee schedule","69% of total billed charges",3782,100,,3025.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3782,100,,3025.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3782,100,,3025.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.81,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",333.19,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",458.81,100,,,,,0,"fee schedule",EAPG,584.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1425.81,37.7,,1140.65,,,0,"percent of total billed charges","37.7% of total billed charges",1425.81,37.7,,1140.65,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1282.1,33.9,,1025.68,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2949.96,78,,2359.97,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3123.93,82.6,,2499.14,,,0,"percent of total billed charges","82.6% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3123.93,82.6,,2499.14,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.81,100,,,,,0,"fee schedule",EAPG,3782,100,,3025.60,,,0,"percent of total billed charges","100% of total billed charges",333.19,3782,
"MRA Brain/Head w/ Contrast",61570545,CDM,615,RC,70545,CPT,OUTPATIENT,,,3782,2458.3,TC,3328.16,88,,2662.53,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.81,100,,,,,0,"fee schedule",EAPG,3782,100,,3025.60,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",463.31,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2382.66,63,,1906.13,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",449.81,100,,,,,0,"fee schedule",EAPG,2609.58,69,,,,,0,"fee schedule","69% of total billed charges",3782,100,,3025.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3782,100,,3025.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3782,100,,3025.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.81,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",333.19,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",458.81,100,,,,,0,"fee schedule",EAPG,584.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1425.81,37.7,,1140.65,,,0,"percent of total billed charges","37.7% of total billed charges",1425.81,37.7,,1140.65,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1282.1,33.9,,1025.68,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2949.96,78,,2359.97,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3123.93,82.6,,2499.14,,,0,"percent of total billed charges","82.6% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3123.93,82.6,,2499.14,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.81,100,,,,,0,"fee schedule",EAPG,3782,100,,3025.60,,,0,"percent of total billed charges","100% of total billed charges",333.19,3782,
"MRA Brain/Head w/o Contrast",61570544,CDM,615,RC,70544,CPT,OUTPATIENT,,,3112,2022.8,TC,2738.56,88,,2190.85,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.81,100,,,,,0,"fee schedule",EAPG,3112,100,,2489.60,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",463.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1960.56,63,,1568.45,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",449.81,100,,,,,0,"fee schedule",EAPG,2147.28,69,,,,,0,"fee schedule","69% of total billed charges",3112,100,,2489.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3112,100,,2489.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3112,100,,2489.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.81,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",333.19,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",458.81,100,,,,,0,"fee schedule",EAPG,584.76,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1173.22,37.7,,938.58,,,0,"percent of total billed charges","37.7% of total billed charges",1173.22,37.7,,938.58,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1054.97,33.9,,843.98,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2427.36,78,,1941.89,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2570.51,82.6,,2056.41,,,0,"percent of total billed charges","82.6% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2570.51,82.6,,2056.41,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.81,100,,,,,0,"fee schedule",EAPG,3112,100,,2489.60,,,0,"percent of total billed charges","100% of total billed charges",244.42,3112,
"MRA Lower Extremity w/ + w/o Cnt Left",616C8914,CDM,616,RC,73725,CPT,OUTPATIENT,,,3505,2278.25,TC|LT,3084.4,88,,2467.52,,,0,"percent of total billed charges","88% of total billed charges",1752.5,50,,1402.00,,,0,"percent of total billed charges","50% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,3505,100,,2804.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.31,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2208.15,63,,1766.52,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",449.81,100,,,,,0,"fee schedule",EAPG,2418.45,69,,,,,0,"fee schedule","69% of total billed charges",3505,100,,2804.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3505,100,,2804.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3505,100,,2804.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2167.84,61.85,,1734.27,,,0,"percent of total billed charges","61.5% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,1752.5,50,,1402.00,,,0,"percent of total billed charges","50% of total billed charges",1128.61,32.2,,902.89,,,0,"percent of total billed charges","32.2% of total billed charges",333.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",458.81,100,,,,,0,"fee schedule",EAPG,584.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1321.39,37.7,,1057.11,,,0,"percent of total billed charges","37.7% of total billed charges",1321.39,37.7,,1057.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1188.2,33.9,,950.56,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2733.9,78,,2187.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2895.13,82.6,,2316.10,,,0,"percent of total billed charges","82.6% of total billed charges",449.81,100,,,,,0,"fee schedule","100% of WA fee schedule",1752.5,50,,1402.00,,,0,"percent of total billed charges","50% of total billed charges",2895.13,82.6,,2316.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.81,100,,,,,0,"fee schedule",EAPG,3505,100,,2804.00,,,0,"percent of total billed charges","100% of total billed charges",333.19,3505,
"MRA Lower Extremity w/ + w/o Cnt Right",616C8914,CDM,616,RC,73725,CPT,OUTPATIENT,,,3505,2278.25,TC|LT,3084.4,88,,2467.52,,,0,"percent of total billed charges","88% of total billed charges",1752.5,50,,1402.00,,,0,"percent of total billed charges","50% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,3505,100,,2804.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.31,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2208.15,63,,1766.52,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",449.81,100,,,,,0,"fee schedule",EAPG,2418.45,69,,,,,0,"fee schedule","69% of total billed charges",3505,100,,2804.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3505,100,,2804.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3505,100,,2804.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2167.84,61.85,,1734.27,,,0,"percent of total billed charges","61.5% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,1752.5,50,,1402.00,,,0,"percent of total billed charges","50% of total billed charges",1128.61,32.2,,902.89,,,0,"percent of total billed charges","32.2% of total billed charges",333.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",458.81,100,,,,,0,"fee schedule",EAPG,584.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1321.39,37.7,,1057.11,,,0,"percent of total billed charges","37.7% of total billed charges",1321.39,37.7,,1057.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1188.2,33.9,,950.56,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2733.9,78,,2187.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2895.13,82.6,,2316.10,,,0,"percent of total billed charges","82.6% of total billed charges",449.81,100,,,,,0,"fee schedule","100% of WA fee schedule",1752.5,50,,1402.00,,,0,"percent of total billed charges","50% of total billed charges",2895.13,82.6,,2316.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.81,100,,,,,0,"fee schedule",EAPG,3505,100,,2804.00,,,0,"percent of total billed charges","100% of total billed charges",333.19,3505,
"MRA Lower Extremity w/ Contrast Left",61073725,CDM,610,RC,73725,CPT,OUTPATIENT,,,3505,2278.25,TC|LT,3084.4,88,,2467.52,,,0,"percent of total billed charges","88% of total billed charges",1752.5,50,,1402.00,,,0,"percent of total billed charges","50% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,3505,100,,2804.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.31,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2208.15,63,,1766.52,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",449.81,100,,,,,0,"fee schedule",EAPG,2418.45,69,,,,,0,"fee schedule","69% of total billed charges",3505,100,,2804.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3505,100,,2804.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3505,100,,2804.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2167.84,61.85,,1734.27,,,0,"percent of total billed charges","61.5% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,1752.5,50,,1402.00,,,0,"percent of total billed charges","50% of total billed charges",1128.61,32.2,,902.89,,,0,"percent of total billed charges","32.2% of total billed charges",333.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",458.81,100,,,,,0,"fee schedule",EAPG,584.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1321.39,37.7,,1057.11,,,0,"percent of total billed charges","37.7% of total billed charges",1321.39,37.7,,1057.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1188.2,33.9,,950.56,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2733.9,78,,2187.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2895.13,82.6,,2316.10,,,0,"percent of total billed charges","82.6% of total billed charges",449.81,100,,,,,0,"fee schedule","100% of WA fee schedule",1752.5,50,,1402.00,,,0,"percent of total billed charges","50% of total billed charges",2895.13,82.6,,2316.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.81,100,,,,,0,"fee schedule",EAPG,3505,100,,2804.00,,,0,"percent of total billed charges","100% of total billed charges",333.19,3505,
"MRA Lower Extremity w/ Contrast Right",616C8912,CDM,616,RC,,,OUTPATIENT,,,3505,2278.25,TC|RT,3084.4,88,,2467.52,,,0,"percent of total billed charges","88% of total billed charges",1752.5,50,,1402.00,,,0,"percent of total billed charges","50% of total billed charges",588.84,16.8,,471.07,,,0,"percent of total billed charges","16.8% of total billed charges",3505,100,,2804.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",606.51,17.304,,485.21,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2208.15,63,,1766.52,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",588.84,16.8,,471.07,,,0,"percent of total billed charges","16.8% of total billed charges",2418.45,69,,,,,0,"fee schedule","69% of total billed charges",3505,100,,2804.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3505,100,,2804.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3505,100,,2804.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2167.84,61.85,,1734.27,,,0,"percent of total billed charges","61.5% of total billed charges",588.84,16.8,,471.07,,,0,"percent of total billed charges","16.8% of total billed charges",1752.5,50,,1402.00,,,0,"percent of total billed charges","50% of total billed charges",1128.61,32.2,,902.89,,,0,"percent of total billed charges","32.2% of total billed charges",588.84,16.8,,471.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",600.62,17.136,,480.50,,,0,"percent of total billed charges","17.136% of total billed charges",765.49,21.84,,612.39,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1321.39,37.7,,1057.11,,,0,"percent of total billed charges","37.7% of total billed charges",1321.39,37.7,,1057.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1188.2,33.9,,950.56,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2733.9,78,,2187.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2895.13,82.6,,2316.10,,,0,"percent of total billed charges","82.6% of total billed charges",588.84,16.8,,471.07,,,0,"percent of total billed charges","16.8% of total billed charges",1752.5,50,,1402.00,,,0,"percent of total billed charges","50% of total billed charges",2895.13,82.6,,2316.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",588.84,16.8,,471.07,,,0,"percent of total billed charges","16.8% of total billed charges",3505,100,,2804.00,,,0,"percent of total billed charges","100% of total billed charges",588.84,3505,
"MRA Lower Extremity w/o Contrast Left",61673725,CDM,616,RC,73725,CPT,OUTPATIENT,,,3505,2278.25,TC|LT,3084.4,88,,2467.52,,,0,"percent of total billed charges","88% of total billed charges",1752.5,50,,1402.00,,,0,"percent of total billed charges","50% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,3505,100,,2804.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.31,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2208.15,63,,1766.52,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",449.81,100,,,,,0,"fee schedule",EAPG,2418.45,69,,,,,0,"fee schedule","69% of total billed charges",3505,100,,2804.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3505,100,,2804.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3505,100,,2804.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2167.84,61.85,,1734.27,,,0,"percent of total billed charges","61.5% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,1752.5,50,,1402.00,,,0,"percent of total billed charges","50% of total billed charges",1128.61,32.2,,902.89,,,0,"percent of total billed charges","32.2% of total billed charges",333.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",458.81,100,,,,,0,"fee schedule",EAPG,584.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1321.39,37.7,,1057.11,,,0,"percent of total billed charges","37.7% of total billed charges",1321.39,37.7,,1057.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1188.2,33.9,,950.56,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2733.9,78,,2187.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2895.13,82.6,,2316.10,,,0,"percent of total billed charges","82.6% of total billed charges",449.81,100,,,,,0,"fee schedule","100% of WA fee schedule",1752.5,50,,1402.00,,,0,"percent of total billed charges","50% of total billed charges",2895.13,82.6,,2316.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.81,100,,,,,0,"fee schedule",EAPG,3505,100,,2804.00,,,0,"percent of total billed charges","100% of total billed charges",333.19,3505,
"MRA Lower Extremity w/o Contrast Right",61073725,CDM,610,RC,73725,CPT,OUTPATIENT,,,3505,2278.25,TC|LT,3084.4,88,,2467.52,,,0,"percent of total billed charges","88% of total billed charges",1752.5,50,,1402.00,,,0,"percent of total billed charges","50% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,3505,100,,2804.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.31,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2208.15,63,,1766.52,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",449.81,100,,,,,0,"fee schedule",EAPG,2418.45,69,,,,,0,"fee schedule","69% of total billed charges",3505,100,,2804.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3505,100,,2804.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3505,100,,2804.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2167.84,61.85,,1734.27,,,0,"percent of total billed charges","61.5% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,1752.5,50,,1402.00,,,0,"percent of total billed charges","50% of total billed charges",1128.61,32.2,,902.89,,,0,"percent of total billed charges","32.2% of total billed charges",333.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",458.81,100,,,,,0,"fee schedule",EAPG,584.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1321.39,37.7,,1057.11,,,0,"percent of total billed charges","37.7% of total billed charges",1321.39,37.7,,1057.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1188.2,33.9,,950.56,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2733.9,78,,2187.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2895.13,82.6,,2316.10,,,0,"percent of total billed charges","82.6% of total billed charges",449.81,100,,,,,0,"fee schedule","100% of WA fee schedule",1752.5,50,,1402.00,,,0,"percent of total billed charges","50% of total billed charges",2895.13,82.6,,2316.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.81,100,,,,,0,"fee schedule",EAPG,3505,100,,2804.00,,,0,"percent of total billed charges","100% of total billed charges",333.19,3505,
"MRA Neck w/ + w/o Contrast",61570549,CDM,615,RC,70549,CPT,OUTPATIENT,,,4326,2811.9,TC,3806.88,88,,3045.50,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.81,100,,,,,0,"fee schedule",EAPG,4326,100,,3460.80,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",463.31,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2725.38,63,,2180.30,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",449.81,100,,,,,0,"fee schedule",EAPG,2984.94,69,,,,,0,"fee schedule","69% of total billed charges",4326,100,,3460.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4326,100,,3460.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4326,100,,3460.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.81,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",333.19,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",458.81,100,,,,,0,"fee schedule",EAPG,584.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1630.9,37.7,,1304.72,,,0,"percent of total billed charges","37.7% of total billed charges",1630.9,37.7,,1304.72,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1466.51,33.9,,1173.21,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3374.28,78,,2699.42,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3573.28,82.6,,2858.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3573.28,82.6,,2858.62,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.81,100,,,,,0,"fee schedule",EAPG,4326,100,,3460.80,,,0,"percent of total billed charges","100% of total billed charges",333.19,4326,
"MRA Neck w/ Contrast",61570548,CDM,615,RC,70548,CPT,OUTPATIENT,,,3782,2458.3,TC,3328.16,88,,2662.53,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.81,100,,,,,0,"fee schedule",EAPG,3782,100,,3025.60,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",463.31,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2382.66,63,,1906.13,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",449.81,100,,,,,0,"fee schedule",EAPG,2609.58,69,,,,,0,"fee schedule","69% of total billed charges",3782,100,,3025.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3782,100,,3025.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3782,100,,3025.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.81,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",333.19,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",458.81,100,,,,,0,"fee schedule",EAPG,584.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1425.81,37.7,,1140.65,,,0,"percent of total billed charges","37.7% of total billed charges",1425.81,37.7,,1140.65,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1282.1,33.9,,1025.68,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2949.96,78,,2359.97,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3123.93,82.6,,2499.14,,,0,"percent of total billed charges","82.6% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3123.93,82.6,,2499.14,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.81,100,,,,,0,"fee schedule",EAPG,3782,100,,3025.60,,,0,"percent of total billed charges","100% of total billed charges",333.19,3782,
"MRA Neck w/o Contrast",61570547,CDM,615,RC,70547,CPT,OUTPATIENT,,,3438,2234.7,TC,3025.44,88,,2420.35,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.81,100,,,,,0,"fee schedule",EAPG,3438,100,,2750.40,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",463.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2165.94,63,,1732.75,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",449.81,100,,,,,0,"fee schedule",EAPG,2372.22,69,,,,,0,"fee schedule","69% of total billed charges",3438,100,,2750.40,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3438,100,,2750.40,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3438,100,,2750.40,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.81,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",333.19,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",458.81,100,,,,,0,"fee schedule",EAPG,584.76,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1296.13,37.7,,1036.90,,,0,"percent of total billed charges","37.7% of total billed charges",1296.13,37.7,,1036.90,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1165.48,33.9,,932.38,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2681.64,78,,2145.31,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2839.79,82.6,,2271.83,,,0,"percent of total billed charges","82.6% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2839.79,82.6,,2271.83,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.81,100,,,,,0,"fee schedule",EAPG,3438,100,,2750.40,,,0,"percent of total billed charges","100% of total billed charges",244.42,3438,
"MRA Pelvis w/ + w/o Contrast",618C8920,CDM,618,RC,72198,CPT,OUTPATIENT,,,3205,2083.25,TC,2820.4,88,,2256.32,,,0,"percent of total billed charges","88% of total billed charges",1602.5,50,,1282.00,,,0,"percent of total billed charges","50% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,3205,100,,2564.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.31,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2019.15,63,,1615.32,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",449.81,100,,,,,0,"fee schedule",EAPG,2211.45,69,,,,,0,"fee schedule","69% of total billed charges",3205,100,,2564.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3205,100,,2564.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3205,100,,2564.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1982.29,61.85,,1585.83,,,0,"percent of total billed charges","61.5% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,1602.5,50,,1282.00,,,0,"percent of total billed charges","50% of total billed charges",1032.01,32.2,,825.61,,,0,"percent of total billed charges","32.2% of total billed charges",333.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",458.81,100,,,,,0,"fee schedule",EAPG,584.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1208.29,37.7,,966.63,,,0,"percent of total billed charges","37.7% of total billed charges",1208.29,37.7,,966.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1086.5,33.9,,869.20,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2499.9,78,,1999.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2647.33,82.6,,2117.86,,,0,"percent of total billed charges","82.6% of total billed charges",449.81,100,,,,,0,"fee schedule","100% of WA fee schedule",1602.5,50,,1282.00,,,0,"percent of total billed charges","50% of total billed charges",2647.33,82.6,,2117.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.81,100,,,,,0,"fee schedule",EAPG,3205,100,,2564.00,,,0,"percent of total billed charges","100% of total billed charges",333.19,3205,
"MRA Pelvis w/ Contrast",61872198,CDM,618,RC,,,OUTPATIENT,,,3205,2083.25,TC,2820.4,88,,2256.32,,,0,"percent of total billed charges","88% of total billed charges",1602.5,50,,1282.00,,,0,"percent of total billed charges","50% of total billed charges",538.44,16.8,,430.75,,,0,"percent of total billed charges","16.8% of total billed charges",3205,100,,2564.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",554.59,17.304,,443.67,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2019.15,63,,1615.32,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",538.44,16.8,,430.75,,,0,"percent of total billed charges","16.8% of total billed charges",2211.45,69,,,,,0,"fee schedule","69% of total billed charges",3205,100,,2564.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3205,100,,2564.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3205,100,,2564.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1982.29,61.85,,1585.83,,,0,"percent of total billed charges","61.5% of total billed charges",538.44,16.8,,430.75,,,0,"percent of total billed charges","16.8% of total billed charges",1602.5,50,,1282.00,,,0,"percent of total billed charges","50% of total billed charges",1032.01,32.2,,825.61,,,0,"percent of total billed charges","32.2% of total billed charges",538.44,16.8,,430.75,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",549.21,17.136,,439.37,,,0,"percent of total billed charges","17.136% of total billed charges",699.97,21.84,,559.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1208.29,37.7,,966.63,,,0,"percent of total billed charges","37.7% of total billed charges",1208.29,37.7,,966.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1086.5,33.9,,869.20,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2499.9,78,,1999.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2647.33,82.6,,2117.86,,,0,"percent of total billed charges","82.6% of total billed charges",538.44,16.8,,430.75,,,0,"percent of total billed charges","16.8% of total billed charges",1602.5,50,,1282.00,,,0,"percent of total billed charges","50% of total billed charges",2647.33,82.6,,2117.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",538.44,16.8,,430.75,,,0,"percent of total billed charges","16.8% of total billed charges",3205,100,,2564.00,,,0,"percent of total billed charges","100% of total billed charges",538.44,3205,
"MRA Pelvis w/o Contrast",61872198,CDM,618,RC,72198,CPT,OUTPATIENT,,,3205,2083.25,TC,2820.4,88,,2256.32,,,0,"percent of total billed charges","88% of total billed charges",1602.5,50,,1282.00,,,0,"percent of total billed charges","50% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,3205,100,,2564.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.31,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2019.15,63,,1615.32,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",449.81,100,,,,,0,"fee schedule",EAPG,2211.45,69,,,,,0,"fee schedule","69% of total billed charges",3205,100,,2564.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3205,100,,2564.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3205,100,,2564.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1982.29,61.85,,1585.83,,,0,"percent of total billed charges","61.5% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,1602.5,50,,1282.00,,,0,"percent of total billed charges","50% of total billed charges",1032.01,32.2,,825.61,,,0,"percent of total billed charges","32.2% of total billed charges",333.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",458.81,100,,,,,0,"fee schedule",EAPG,584.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1208.29,37.7,,966.63,,,0,"percent of total billed charges","37.7% of total billed charges",1208.29,37.7,,966.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1086.5,33.9,,869.20,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2499.9,78,,1999.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2647.33,82.6,,2117.86,,,0,"percent of total billed charges","82.6% of total billed charges",449.81,100,,,,,0,"fee schedule","100% of WA fee schedule",1602.5,50,,1282.00,,,0,"percent of total billed charges","50% of total billed charges",2647.33,82.6,,2117.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.81,100,,,,,0,"fee schedule",EAPG,3205,100,,2564.00,,,0,"percent of total billed charges","100% of total billed charges",333.19,3205,
"MRA Upper Extremity w/ + w/o Cnt Left",61073225,CDM,610,RC,73225,CPT,OUTPATIENT,,,5244,3408.6,TC|LT,4614.72,88,,3691.78,,,0,"percent of total billed charges","88% of total billed charges",2622,50,,2097.60,,,0,"percent of total billed charges","50% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.31,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3303.72,63,,2642.98,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",449.81,100,,,,,0,"fee schedule",EAPG,3618.36,69,,,,,0,"fee schedule","69% of total billed charges",5244,100,,4195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5244,100,,4195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5244,100,,4195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3243.41,61.85,,2594.73,,,0,"percent of total billed charges","61.5% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,2622,50,,2097.60,,,0,"percent of total billed charges","50% of total billed charges",1688.57,32.2,,1350.86,,,0,"percent of total billed charges","32.2% of total billed charges",333.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",458.81,100,,,,,0,"fee schedule",EAPG,584.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1976.99,37.7,,1581.59,,,0,"percent of total billed charges","37.7% of total billed charges",1976.99,37.7,,1581.59,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1777.72,33.9,,1422.18,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4090.32,78,,3272.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4331.54,82.6,,3465.23,,,0,"percent of total billed charges","82.6% of total billed charges",449.81,100,,,,,0,"fee schedule","100% of WA fee schedule",2622,50,,2097.60,,,0,"percent of total billed charges","50% of total billed charges",4331.54,82.6,,3465.23,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.81,100,,,,,0,"fee schedule",EAPG,5244,100,,4195.20,,,0,"percent of total billed charges","100% of total billed charges",333.19,5244,
"MRA Upper Extremity w/ + w/o Cnt Right",61073225,CDM,610,RC,73225,CPT,OUTPATIENT,,,6456,4196.4,TC|LT,5681.28,88,,4545.02,,,0,"percent of total billed charges","88% of total billed charges",3228,50,,2582.40,,,0,"percent of total billed charges","50% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.31,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",4067.28,63,,3253.82,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",449.81,100,,,,,0,"fee schedule",EAPG,4454.64,69,,,,,0,"fee schedule","69% of total billed charges",6456,100,,5164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6456,100,,5164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6456,100,,5164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3993.04,61.85,,3194.43,,,0,"percent of total billed charges","61.5% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,3228,50,,2582.40,,,0,"percent of total billed charges","50% of total billed charges",2078.83,32.2,,1663.06,,,0,"percent of total billed charges","32.2% of total billed charges",333.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",458.81,100,,,,,0,"fee schedule",EAPG,584.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2433.91,37.7,,1947.13,,,0,"percent of total billed charges","37.7% of total billed charges",2433.91,37.7,,1947.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2188.58,33.9,,1750.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5035.68,78,,4028.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5332.66,82.6,,4266.13,,,0,"percent of total billed charges","82.6% of total billed charges",449.81,100,,,,,0,"fee schedule","100% of WA fee schedule",3228,50,,2582.40,,,0,"percent of total billed charges","50% of total billed charges",5332.66,82.6,,4266.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.81,100,,,,,0,"fee schedule",EAPG,6456,100,,5164.80,,,0,"percent of total billed charges","100% of total billed charges",333.19,6456,
"MRA Upper Extremity w/ Contrast Left",61073225,CDM,610,RC,73225,CPT,OUTPATIENT,,,5031,3270.15,TC|LT,4427.28,88,,3541.82,,,0,"percent of total billed charges","88% of total billed charges",2515.5,50,,2012.40,,,0,"percent of total billed charges","50% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.31,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3169.53,63,,2535.62,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",449.81,100,,,,,0,"fee schedule",EAPG,3471.39,69,,,,,0,"fee schedule","69% of total billed charges",5031,100,,4024.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5031,100,,4024.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5031,100,,4024.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3111.67,61.85,,2489.34,,,0,"percent of total billed charges","61.5% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,2515.5,50,,2012.40,,,0,"percent of total billed charges","50% of total billed charges",1619.98,32.2,,1295.98,,,0,"percent of total billed charges","32.2% of total billed charges",333.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",458.81,100,,,,,0,"fee schedule",EAPG,584.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1896.69,37.7,,1517.35,,,0,"percent of total billed charges","37.7% of total billed charges",1896.69,37.7,,1517.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1705.51,33.9,,1364.41,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3924.18,78,,3139.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4155.61,82.6,,3324.49,,,0,"percent of total billed charges","82.6% of total billed charges",449.81,100,,,,,0,"fee schedule","100% of WA fee schedule",2515.5,50,,2012.40,,,0,"percent of total billed charges","50% of total billed charges",4155.61,82.6,,3324.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.81,100,,,,,0,"fee schedule",EAPG,5031,100,,4024.80,,,0,"percent of total billed charges","100% of total billed charges",333.19,5031,
"MRA Upper Extremity w/ Contrast Right",61073225,CDM,610,RC,73225,CPT,OUTPATIENT,,,5031,3270.15,TC|LT,4427.28,88,,3541.82,,,0,"percent of total billed charges","88% of total billed charges",2515.5,50,,2012.40,,,0,"percent of total billed charges","50% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.31,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3169.53,63,,2535.62,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",449.81,100,,,,,0,"fee schedule",EAPG,3471.39,69,,,,,0,"fee schedule","69% of total billed charges",5031,100,,4024.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5031,100,,4024.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5031,100,,4024.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3111.67,61.85,,2489.34,,,0,"percent of total billed charges","61.5% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,2515.5,50,,2012.40,,,0,"percent of total billed charges","50% of total billed charges",1619.98,32.2,,1295.98,,,0,"percent of total billed charges","32.2% of total billed charges",333.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",458.81,100,,,,,0,"fee schedule",EAPG,584.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1896.69,37.7,,1517.35,,,0,"percent of total billed charges","37.7% of total billed charges",1896.69,37.7,,1517.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1705.51,33.9,,1364.41,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3924.18,78,,3139.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4155.61,82.6,,3324.49,,,0,"percent of total billed charges","82.6% of total billed charges",449.81,100,,,,,0,"fee schedule","100% of WA fee schedule",2515.5,50,,2012.40,,,0,"percent of total billed charges","50% of total billed charges",4155.61,82.6,,3324.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.81,100,,,,,0,"fee schedule",EAPG,5031,100,,4024.80,,,0,"percent of total billed charges","100% of total billed charges",333.19,5031,
"MRA Upper Extremity w/o Contrast Left",61073225,CDM,610,RC,73225,CPT,OUTPATIENT,,,4710,3061.5,TC|LT,4144.8,88,,3315.84,,,0,"percent of total billed charges","88% of total billed charges",2355,50,,1884.00,,,0,"percent of total billed charges","50% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.31,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2967.3,63,,2373.84,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",449.81,100,,,,,0,"fee schedule",EAPG,3249.9,69,,,,,0,"fee schedule","69% of total billed charges",4710,100,,3768.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4710,100,,3768.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4710,100,,3768.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2913.14,61.85,,2330.51,,,0,"percent of total billed charges","61.5% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,2355,50,,1884.00,,,0,"percent of total billed charges","50% of total billed charges",1516.62,32.2,,1213.30,,,0,"percent of total billed charges","32.2% of total billed charges",333.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",458.81,100,,,,,0,"fee schedule",EAPG,584.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1775.67,37.7,,1420.54,,,0,"percent of total billed charges","37.7% of total billed charges",1775.67,37.7,,1420.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1596.69,33.9,,1277.35,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3673.8,78,,2939.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3890.46,82.6,,3112.37,,,0,"percent of total billed charges","82.6% of total billed charges",449.81,100,,,,,0,"fee schedule","100% of WA fee schedule",2355,50,,1884.00,,,0,"percent of total billed charges","50% of total billed charges",3890.46,82.6,,3112.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.81,100,,,,,0,"fee schedule",EAPG,4710,100,,3768.00,,,0,"percent of total billed charges","100% of total billed charges",333.19,4710,
"MRA Upper Extremity w/o Contrast Right",61073225,CDM,610,RC,73225,CPT,OUTPATIENT,,,4710,3061.5,TC|LT,4144.8,88,,3315.84,,,0,"percent of total billed charges","88% of total billed charges",2355,50,,1884.00,,,0,"percent of total billed charges","50% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.31,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2967.3,63,,2373.84,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",449.81,100,,,,,0,"fee schedule",EAPG,3249.9,69,,,,,0,"fee schedule","69% of total billed charges",4710,100,,3768.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4710,100,,3768.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4710,100,,3768.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2913.14,61.85,,2330.51,,,0,"percent of total billed charges","61.5% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,2355,50,,1884.00,,,0,"percent of total billed charges","50% of total billed charges",1516.62,32.2,,1213.30,,,0,"percent of total billed charges","32.2% of total billed charges",333.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",458.81,100,,,,,0,"fee schedule",EAPG,584.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1775.67,37.7,,1420.54,,,0,"percent of total billed charges","37.7% of total billed charges",1775.67,37.7,,1420.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1596.69,33.9,,1277.35,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3673.8,78,,2939.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3890.46,82.6,,3112.37,,,0,"percent of total billed charges","82.6% of total billed charges",449.81,100,,,,,0,"fee schedule","100% of WA fee schedule",2355,50,,1884.00,,,0,"percent of total billed charges","50% of total billed charges",3890.46,82.6,,3112.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.81,100,,,,,0,"fee schedule",EAPG,4710,100,,3768.00,,,0,"percent of total billed charges","100% of total billed charges",333.19,4710,
"MRA Brain/Head w/o Contrast Ltd",61570544,CDM,615,RC,70544,CPT,OUTPATIENT,,,3112,2022.8,TC,2738.56,88,,2190.85,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.81,100,,,,,0,"fee schedule",EAPG,3112,100,,2489.60,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",463.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1960.56,63,,1568.45,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",449.81,100,,,,,0,"fee schedule",EAPG,2147.28,69,,,,,0,"fee schedule","69% of total billed charges",3112,100,,2489.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3112,100,,2489.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3112,100,,2489.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.81,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",333.19,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",458.81,100,,,,,0,"fee schedule",EAPG,584.76,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1173.22,37.7,,938.58,,,0,"percent of total billed charges","37.7% of total billed charges",1173.22,37.7,,938.58,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1054.97,33.9,,843.98,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2427.36,78,,1941.89,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2570.51,82.6,,2056.41,,,0,"percent of total billed charges","82.6% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2570.51,82.6,,2056.41,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.81,100,,,,,0,"fee schedule",EAPG,3112,100,,2489.60,,,0,"percent of total billed charges","100% of total billed charges",244.42,3112,
"MRI Abdomen w/ + w/o Contrast",61074183,CDM,610,RC,74183,CPT,OUTPATIENT,,,1573,1022.45,TC,1384.24,88,,1107.39,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1573,100,,1258.40,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",990.99,63,,792.79,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,1085.37,69,,,,,0,"fee schedule","69% of total billed charges",1573,100,,1258.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1573,100,,1258.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1573,100,,1258.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.02,37.7,,474.42,,,0,"percent of total billed charges","37.7% of total billed charges",593.02,37.7,,474.42,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",533.25,33.9,,426.60,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1226.94,78,,981.55,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1299.3,82.6,,1039.44,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1299.3,82.6,,1039.44,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1573,100,,1258.40,,,0,"percent of total billed charges","100% of total billed charges",297.79,1573,
"MRI Abdomen w/ Contrast",61074182,CDM,610,RC,74182,CPT,OUTPATIENT,,,1573,1022.45,TC,1384.24,88,,1107.39,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1573,100,,1258.40,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",990.99,63,,792.79,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,1085.37,69,,,,,0,"fee schedule","69% of total billed charges",1573,100,,1258.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1573,100,,1258.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1573,100,,1258.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.02,37.7,,474.42,,,0,"percent of total billed charges","37.7% of total billed charges",593.02,37.7,,474.42,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",533.25,33.9,,426.60,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1226.94,78,,981.55,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1299.3,82.6,,1039.44,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1299.3,82.6,,1039.44,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1573,100,,1258.40,,,0,"percent of total billed charges","100% of total billed charges",297.79,1573,
"MRI Abdomen w/o Contrast",61074181,CDM,610,RC,74181,CPT,OUTPATIENT,,,1084,704.6,TC,953.92,88,,763.14,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1084,100,,867.20,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",682.92,63,,546.34,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,747.96,69,,,,,0,"fee schedule","69% of total billed charges",1084,100,,867.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1084,100,,867.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1084,100,,867.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.67,37.7,,326.94,,,0,"percent of total billed charges","37.7% of total billed charges",408.67,37.7,,326.94,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.48,33.9,,293.98,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",845.52,78,,676.42,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",895.38,82.6,,716.30,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",895.38,82.6,,716.30,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1084,100,,867.20,,,0,"percent of total billed charges","100% of total billed charges",169.94,1084,
"MRI Ankle w/ + w/o Contrast Left",61073723,CDM,610,RC,73723,CPT,OUTPATIENT,,,1488,967.2,TC|LT,1309.44,88,,1047.55,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1488,100,,1190.40,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",937.44,63,,749.95,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,1026.72,69,,,,,0,"fee schedule","69% of total billed charges",1488,100,,1190.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1488,100,,1190.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1488,100,,1190.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.98,37.7,,448.78,,,0,"percent of total billed charges","37.7% of total billed charges",560.98,37.7,,448.78,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",504.43,33.9,,403.54,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1160.64,78,,928.51,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1229.09,82.6,,983.27,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1229.09,82.6,,983.27,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1488,100,,1190.40,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Ankle w/ + w/o Contrast Right",61073723,CDM,610,RC,73723,CPT,OUTPATIENT,,,1488,967.2,TC|LT,1309.44,88,,1047.55,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1488,100,,1190.40,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",937.44,63,,749.95,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,1026.72,69,,,,,0,"fee schedule","69% of total billed charges",1488,100,,1190.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1488,100,,1190.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1488,100,,1190.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.98,37.7,,448.78,,,0,"percent of total billed charges","37.7% of total billed charges",560.98,37.7,,448.78,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",504.43,33.9,,403.54,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1160.64,78,,928.51,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1229.09,82.6,,983.27,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1229.09,82.6,,983.27,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1488,100,,1190.40,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Ankle w/ Contrast Left",61073722,CDM,610,RC,73722,CPT,OUTPATIENT,,,1279,831.35,TC|LT,1125.52,88,,900.42,,,0,"percent of total billed charges","88% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",1429.15,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",805.77,63,,644.62,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,882.51,69,,,,,0,"fee schedule","69% of total billed charges",1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",2905.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",482.18,37.7,,385.74,,,0,"percent of total billed charges","37.7% of total billed charges",482.18,37.7,,385.74,,,0,"percent of total billed charges","37.70% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",433.58,33.9,,346.86,,,0,"percent of total billed charges","33.9% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",997.62,78,,798.10,,,0,"percent of total billed charges","78% of total billed charges",824.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056.45,82.6,,845.16,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056.45,82.6,,845.16,,,0,"percent of total billed charges","82.6% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",297.79,2905.43,
"MRI Ankle w/ Contrast Right",61073722,CDM,610,RC,73722,CPT,OUTPATIENT,,,1279,831.35,TC|LT,1125.52,88,,900.42,,,0,"percent of total billed charges","88% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",1429.15,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",805.77,63,,644.62,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,882.51,69,,,,,0,"fee schedule","69% of total billed charges",1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",2905.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",482.18,37.7,,385.74,,,0,"percent of total billed charges","37.7% of total billed charges",482.18,37.7,,385.74,,,0,"percent of total billed charges","37.70% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",433.58,33.9,,346.86,,,0,"percent of total billed charges","33.9% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",997.62,78,,798.10,,,0,"percent of total billed charges","78% of total billed charges",824.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056.45,82.6,,845.16,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056.45,82.6,,845.16,,,0,"percent of total billed charges","82.6% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",297.79,2905.43,
"MRI Ankle w/o Contrast Left",61073721,CDM,610,RC,73721,CPT,OUTPATIENT,,,1056,686.4,TC|LT,929.28,88,,743.42,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.28,63,,532.22,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,728.64,69,,,,,0,"fee schedule","69% of total billed charges",1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",398.11,37.7,,318.49,,,0,"percent of total billed charges","37.7% of total billed charges",398.11,37.7,,318.49,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",357.98,33.9,,286.38,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",823.68,78,,658.94,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",872.26,82.6,,697.81,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",872.26,82.6,,697.81,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",169.94,1056,
"MRI Ankle w/o Contrast Right",61073721,CDM,610,RC,73721,CPT,OUTPATIENT,,,1056,686.4,TC|LT,929.28,88,,743.42,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.28,63,,532.22,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,728.64,69,,,,,0,"fee schedule","69% of total billed charges",1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",398.11,37.7,,318.49,,,0,"percent of total billed charges","37.7% of total billed charges",398.11,37.7,,318.49,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",357.98,33.9,,286.38,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",823.68,78,,658.94,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",872.26,82.6,,697.81,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",872.26,82.6,,697.81,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",169.94,1056,
"MRI Brain w/ + w/o Contrast",61170553,CDM,611,RC,70553,CPT,OUTPATIENT,,,1637,1064.05,TC,1440.56,88,,1152.45,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1637,100,,1309.60,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1031.31,63,,825.05,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,1129.53,69,,,,,0,"fee schedule","69% of total billed charges",1637,100,,1309.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1637,100,,1309.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1637,100,,1309.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",617.15,37.7,,493.72,,,0,"percent of total billed charges","37.7% of total billed charges",617.15,37.7,,493.72,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.94,33.9,,443.95,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1276.86,78,,1021.49,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1352.16,82.6,,1081.73,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1352.16,82.6,,1081.73,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1637,100,,1309.60,,,0,"percent of total billed charges","100% of total billed charges",297.79,1637,
"MRI Brain w/ Contrast",61170552,CDM,611,RC,70552,CPT,OUTPATIENT,,,859,558.35,TC,755.92,88,,604.74,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,859,100,,687.20,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",541.17,63,,432.94,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,592.71,69,,,,,0,"fee schedule","69% of total billed charges",859,100,,687.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859,100,,687.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859,100,,687.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",323.84,37.7,,259.07,,,0,"percent of total billed charges","37.7% of total billed charges",323.84,37.7,,259.07,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",291.2,33.9,,232.96,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",670.02,78,,536.02,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",709.53,82.6,,567.62,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",709.53,82.6,,567.62,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,859,100,,687.20,,,0,"percent of total billed charges","100% of total billed charges",291.2,1495.48,
"MRI Brain w/o Contrast",61170551,CDM,611,RC,70551,CPT,OUTPATIENT,,,1127,732.55,TC,991.76,88,,793.41,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",710.01,63,,568.01,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,777.63,69,,,,,0,"fee schedule","69% of total billed charges",1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",424.88,37.7,,339.90,,,0,"percent of total billed charges","37.7% of total billed charges",424.88,37.7,,339.90,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",382.05,33.9,,305.64,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.06,78,,703.25,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",930.9,82.6,,744.72,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",930.9,82.6,,744.72,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",169.94,1127,
"MRI Breast w/ + w/o Contrast Bilateral",61077049,CDM,610,RC,77049,CPT,OUTPATIENT,,,3471,2256.15,TC,3054.48,88,,2443.58,,,0,"percent of total billed charges","88% of total billed charges",1735.5,50,,1388.40,,,0,"percent of total billed charges","50% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,3471,100,,2776.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2186.73,63,,1749.38,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,2394.99,69,,,,,0,"fee schedule","69% of total billed charges",3471,100,,2776.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3471,100,,2776.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3471,100,,2776.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2146.81,61.85,,1717.45,,,0,"percent of total billed charges","61.5% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,1735.5,50,,1388.40,,,0,"percent of total billed charges","50% of total billed charges",1117.66,32.2,,894.13,,,0,"percent of total billed charges","32.2% of total billed charges",297.79,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1308.57,37.7,,1046.86,,,0,"percent of total billed charges","37.7% of total billed charges",1308.57,37.7,,1046.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1176.67,33.9,,941.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2707.38,78,,2165.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2867.05,82.6,,2293.64,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,1735.5,50,,1388.40,,,0,"percent of total billed charges","50% of total billed charges",2867.05,82.6,,2293.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",402.01,100,,,,,0,"fee schedule",EAPG,3471,100,,2776.80,,,0,"percent of total billed charges","100% of total billed charges",297.79,3471,
"MRI Breast w/o Contrast Bilateral",61077047,CDM,610,RC,77047,CPT,OUTPATIENT,,,1724,1120.6,TC,1517.12,88,,1213.70,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1724,100,,1379.20,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1086.12,63,,868.90,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,1189.56,69,,,,,0,"fee schedule","69% of total billed charges",1724,100,,1379.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1724,100,,1379.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1724,100,,1379.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",649.95,37.7,,519.96,,,0,"percent of total billed charges","37.7% of total billed charges",649.95,37.7,,519.96,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",584.44,33.9,,467.55,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1344.72,78,,1075.78,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1424.02,82.6,,1139.22,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1424.02,82.6,,1139.22,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1724,100,,1379.20,,,0,"percent of total billed charges","100% of total billed charges",169.94,1724,
"MRI Chest w/ + w/o Contrast",61071552,CDM,610,RC,71552,CPT,OUTPATIENT,,,1637,1064.05,TC,1440.56,88,,1152.45,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1637,100,,1309.60,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1031.31,63,,825.05,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,1129.53,69,,,,,0,"fee schedule","69% of total billed charges",1637,100,,1309.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1637,100,,1309.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1637,100,,1309.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",617.15,37.7,,493.72,,,0,"percent of total billed charges","37.7% of total billed charges",617.15,37.7,,493.72,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.94,33.9,,443.95,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1276.86,78,,1021.49,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1352.16,82.6,,1081.73,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1352.16,82.6,,1081.73,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1637,100,,1309.60,,,0,"percent of total billed charges","100% of total billed charges",297.79,1637,
"MRI Chest w/ Contrast",61071550,CDM,610,RC,71550,CPT,OUTPATIENT,,,1072,696.8,TC,943.36,88,,754.69,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1072,100,,857.60,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",675.36,63,,540.29,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,739.68,69,,,,,0,"fee schedule","69% of total billed charges",1072,100,,857.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1072,100,,857.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1072,100,,857.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",404.14,37.7,,323.31,,,0,"percent of total billed charges","37.7% of total billed charges",404.14,37.7,,323.31,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",363.41,33.9,,290.73,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",836.16,78,,668.93,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",885.47,82.6,,708.38,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",885.47,82.6,,708.38,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1072,100,,857.60,,,0,"percent of total billed charges","100% of total billed charges",169.94,1072,
"MRI Chest w/o Contrast",61071550,CDM,610,RC,71550,CPT,OUTPATIENT,,,1072,696.8,TC,943.36,88,,754.69,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1072,100,,857.60,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",675.36,63,,540.29,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,739.68,69,,,,,0,"fee schedule","69% of total billed charges",1072,100,,857.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1072,100,,857.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1072,100,,857.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",404.14,37.7,,323.31,,,0,"percent of total billed charges","37.7% of total billed charges",404.14,37.7,,323.31,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",363.41,33.9,,290.73,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",836.16,78,,668.93,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",885.47,82.6,,708.38,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",885.47,82.6,,708.38,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1072,100,,857.60,,,0,"percent of total billed charges","100% of total billed charges",169.94,1072,
"MRI Elbow w/ + w/o Contrast Left",61073223,CDM,610,RC,73223,CPT,OUTPATIENT,,,1561,1014.65,TC|LT,1373.68,88,,1098.94,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",983.43,63,,786.74,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,1077.09,69,,,,,0,"fee schedule","69% of total billed charges",1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",588.5,37.7,,470.80,,,0,"percent of total billed charges","37.7% of total billed charges",588.5,37.7,,470.80,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",529.18,33.9,,423.34,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.58,78,,974.06,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1289.39,82.6,,1031.51,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1289.39,82.6,,1031.51,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",297.79,1561,
"MRI Elbow w/ + w/o Contrast Right",61073223,CDM,610,RC,73223,CPT,OUTPATIENT,,,1561,1014.65,TC|LT,1373.68,88,,1098.94,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",983.43,63,,786.74,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,1077.09,69,,,,,0,"fee schedule","69% of total billed charges",1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",588.5,37.7,,470.80,,,0,"percent of total billed charges","37.7% of total billed charges",588.5,37.7,,470.80,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",529.18,33.9,,423.34,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.58,78,,974.06,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1289.39,82.6,,1031.51,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1289.39,82.6,,1031.51,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",297.79,1561,
"MRI Elbow w/ Contrast Left",61073222,CDM,610,RC,73222,CPT,OUTPATIENT,,,1343,872.95,TC|LT,1181.84,88,,945.47,,,0,"percent of total billed charges","88% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",1429.15,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",846.09,63,,676.87,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,926.67,69,,,,,0,"fee schedule","69% of total billed charges",1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",2905.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",506.31,37.7,,405.05,,,0,"percent of total billed charges","37.7% of total billed charges",506.31,37.7,,405.05,,,0,"percent of total billed charges","37.70% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",455.28,33.9,,364.22,,,0,"percent of total billed charges","33.9% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1047.54,78,,838.03,,,0,"percent of total billed charges","78% of total billed charges",824.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1109.32,82.6,,887.46,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1109.32,82.6,,887.46,,,0,"percent of total billed charges","82.6% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",297.79,2905.43,
"MRI Elbow w/ Contrast Right",61073222,CDM,610,RC,73222,CPT,OUTPATIENT,,,1343,872.95,TC|LT,1181.84,88,,945.47,,,0,"percent of total billed charges","88% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",1429.15,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",846.09,63,,676.87,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,926.67,69,,,,,0,"fee schedule","69% of total billed charges",1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",2905.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",506.31,37.7,,405.05,,,0,"percent of total billed charges","37.7% of total billed charges",506.31,37.7,,405.05,,,0,"percent of total billed charges","37.70% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",455.28,33.9,,364.22,,,0,"percent of total billed charges","33.9% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1047.54,78,,838.03,,,0,"percent of total billed charges","78% of total billed charges",824.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1109.32,82.6,,887.46,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1109.32,82.6,,887.46,,,0,"percent of total billed charges","82.6% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",297.79,2905.43,
"MRI Elbow w/o Contrast Left",61073221,CDM,610,RC,73221,CPT,OUTPATIENT,,,1107,719.55,TC|LT,974.16,88,,779.33,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1107,100,,885.60,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",697.41,63,,557.93,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,763.83,69,,,,,0,"fee schedule","69% of total billed charges",1107,100,,885.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1107,100,,885.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1107,100,,885.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",417.34,37.7,,333.87,,,0,"percent of total billed charges","37.7% of total billed charges",417.34,37.7,,333.87,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",375.27,33.9,,300.22,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",863.46,78,,690.77,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",914.38,82.6,,731.50,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",914.38,82.6,,731.50,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1107,100,,885.60,,,0,"percent of total billed charges","100% of total billed charges",169.94,1107,
"MRI Elbow w/o Contrast Right",61073221,CDM,610,RC,73221,CPT,OUTPATIENT,,,1107,719.55,TC|LT,974.16,88,,779.33,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1107,100,,885.60,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",697.41,63,,557.93,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,763.83,69,,,,,0,"fee schedule","69% of total billed charges",1107,100,,885.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1107,100,,885.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1107,100,,885.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",417.34,37.7,,333.87,,,0,"percent of total billed charges","37.7% of total billed charges",417.34,37.7,,333.87,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",375.27,33.9,,300.22,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",863.46,78,,690.77,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",914.38,82.6,,731.50,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",914.38,82.6,,731.50,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1107,100,,885.60,,,0,"percent of total billed charges","100% of total billed charges",169.94,1107,
"MRI Face Neck Orbit w/ + w/o Contrast",61070543,CDM,610,RC,70543,CPT,OUTPATIENT,,,1558,1012.7,TC,1371.04,88,,1096.83,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1558,100,,1246.40,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",981.54,63,,785.23,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,1075.02,69,,,,,0,"fee schedule","69% of total billed charges",1558,100,,1246.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558,100,,1246.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558,100,,1246.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",587.37,37.7,,469.90,,,0,"percent of total billed charges","37.7% of total billed charges",587.37,37.7,,469.90,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",528.16,33.9,,422.53,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1215.24,78,,972.19,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1286.91,82.6,,1029.53,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1286.91,82.6,,1029.53,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1558,100,,1246.40,,,0,"percent of total billed charges","100% of total billed charges",297.79,1558,
"MRI Face Neck Orbit w/ Contrast",61070542,CDM,610,RC,70542,CPT,OUTPATIENT,,,1558,1012.7,TC,1371.04,88,,1096.83,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1558,100,,1246.40,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",981.54,63,,785.23,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,1075.02,69,,,,,0,"fee schedule","69% of total billed charges",1558,100,,1246.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558,100,,1246.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558,100,,1246.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",587.37,37.7,,469.90,,,0,"percent of total billed charges","37.7% of total billed charges",587.37,37.7,,469.90,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",528.16,33.9,,422.53,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1215.24,78,,972.19,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1286.91,82.6,,1029.53,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1286.91,82.6,,1029.53,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1558,100,,1246.40,,,0,"percent of total billed charges","100% of total billed charges",297.79,1558,
"MRI Face Neck Orbit w/o Contrast",61070540,CDM,610,RC,70540,CPT,OUTPATIENT,,,1155,750.75,TC,1016.4,88,,813.12,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1155,100,,924.00,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",727.65,63,,582.12,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,796.95,69,,,,,0,"fee schedule","69% of total billed charges",1155,100,,924.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1155,100,,924.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1155,100,,924.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",435.44,37.7,,348.35,,,0,"percent of total billed charges","37.7% of total billed charges",435.44,37.7,,348.35,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",391.55,33.9,,313.24,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",900.9,78,,720.72,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",954.03,82.6,,763.22,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",954.03,82.6,,763.22,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1155,100,,924.00,,,0,"percent of total billed charges","100% of total billed charges",169.94,1155,
"MRI Foot w/ + w/o Contrast Left",61073720,CDM,610,RC,73720,CPT,OUTPATIENT,,,1127,732.55,TC|LT,991.76,88,,793.41,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",710.01,63,,568.01,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,777.63,69,,,,,0,"fee schedule","69% of total billed charges",1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",424.88,37.7,,339.90,,,0,"percent of total billed charges","37.7% of total billed charges",424.88,37.7,,339.90,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",382.05,33.9,,305.64,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.06,78,,703.25,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",930.9,82.6,,744.72,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",930.9,82.6,,744.72,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Foot w/ + w/o Contrast Right",61073720,CDM,610,RC,73720,CPT,OUTPATIENT,,,1127,732.55,TC|LT,991.76,88,,793.41,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",710.01,63,,568.01,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,777.63,69,,,,,0,"fee schedule","69% of total billed charges",1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",424.88,37.7,,339.90,,,0,"percent of total billed charges","37.7% of total billed charges",424.88,37.7,,339.90,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",382.05,33.9,,305.64,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.06,78,,703.25,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",930.9,82.6,,744.72,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",930.9,82.6,,744.72,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Foot w/ Contrast Left",61073719,CDM,610,RC,73719,CPT,OUTPATIENT,,,1171,761.15,TC|LT,1030.48,88,,824.38,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737.73,63,,590.18,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,807.99,69,,,,,0,"fee schedule","69% of total billed charges",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.7% of total billed charges",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",396.97,33.9,,317.58,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",913.38,78,,730.70,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Foot w/ Contrast Right",61073719,CDM,610,RC,73719,CPT,OUTPATIENT,,,1171,761.15,TC|LT,1030.48,88,,824.38,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737.73,63,,590.18,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,807.99,69,,,,,0,"fee schedule","69% of total billed charges",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.7% of total billed charges",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",396.97,33.9,,317.58,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",913.38,78,,730.70,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Foot w/o Contrast Left",61073718,CDM,610,RC,73718,CPT,OUTPATIENT,,,880,572,TC|LT,774.4,88,,619.52,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.4,63,,443.52,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,607.2,69,,,,,0,"fee schedule","69% of total billed charges",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",331.76,37.7,,265.41,,,0,"percent of total billed charges","37.7% of total billed charges",331.76,37.7,,265.41,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.32,33.9,,238.66,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.4,78,,549.12,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.88,82.6,,581.50,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.88,82.6,,581.50,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",169.94,934.9,
"MRI Foot w/o Contrast Right",61073718,CDM,610,RC,73718,CPT,OUTPATIENT,,,880,572,TC|LT,774.4,88,,619.52,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.4,63,,443.52,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,607.2,69,,,,,0,"fee schedule","69% of total billed charges",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",331.76,37.7,,265.41,,,0,"percent of total billed charges","37.7% of total billed charges",331.76,37.7,,265.41,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.32,33.9,,238.66,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.4,78,,549.12,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.88,82.6,,581.50,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.88,82.6,,581.50,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",169.94,934.9,
"MRI Hand w/ + w/o Contrast Left",61073220,CDM,610,RC,73220,CPT,OUTPATIENT,,,1382,898.3,TC|LT,1216.16,88,,972.93,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",870.66,63,,696.53,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,953.58,69,,,,,0,"fee schedule","69% of total billed charges",1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",521.01,37.7,,416.81,,,0,"percent of total billed charges","37.7% of total billed charges",521.01,37.7,,416.81,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",468.5,33.9,,374.80,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1077.96,78,,862.37,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1141.53,82.6,,913.22,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1141.53,82.6,,913.22,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Hand w/ + w/o Contrast Right",61073220,CDM,610,RC,73220,CPT,OUTPATIENT,,,1382,898.3,TC|LT,1216.16,88,,972.93,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",870.66,63,,696.53,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,953.58,69,,,,,0,"fee schedule","69% of total billed charges",1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",521.01,37.7,,416.81,,,0,"percent of total billed charges","37.7% of total billed charges",521.01,37.7,,416.81,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",468.5,33.9,,374.80,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1077.96,78,,862.37,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1141.53,82.6,,913.22,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1141.53,82.6,,913.22,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Hand w/ Contrast Left",61073219,CDM,610,RC,73219,CPT,OUTPATIENT,,,1171,761.15,TC|LT,1030.48,88,,824.38,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737.73,63,,590.18,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,807.99,69,,,,,0,"fee schedule","69% of total billed charges",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.7% of total billed charges",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",396.97,33.9,,317.58,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",913.38,78,,730.70,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Hand w/ Contrast Right",61073219,CDM,610,RC,73219,CPT,OUTPATIENT,,,1171,761.15,TC|LT,1030.48,88,,824.38,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737.73,63,,590.18,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,807.99,69,,,,,0,"fee schedule","69% of total billed charges",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.7% of total billed charges",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",396.97,33.9,,317.58,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",913.38,78,,730.70,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Hand w/o Contrast Left",61073218,CDM,610,RC,73218,CPT,OUTPATIENT,,,880,572,TC|LT,774.4,88,,619.52,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.4,63,,443.52,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,607.2,69,,,,,0,"fee schedule","69% of total billed charges",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",331.76,37.7,,265.41,,,0,"percent of total billed charges","37.7% of total billed charges",331.76,37.7,,265.41,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.32,33.9,,238.66,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.4,78,,549.12,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.88,82.6,,581.50,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.88,82.6,,581.50,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",169.94,934.9,
"MRI Hand w/o Contrast Right",61073218,CDM,610,RC,73218,CPT,OUTPATIENT,,,880,572,TC|LT,774.4,88,,619.52,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.4,63,,443.52,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,607.2,69,,,,,0,"fee schedule","69% of total billed charges",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",331.76,37.7,,265.41,,,0,"percent of total billed charges","37.7% of total billed charges",331.76,37.7,,265.41,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.32,33.9,,238.66,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.4,78,,549.12,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.88,82.6,,581.50,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.88,82.6,,581.50,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",169.94,934.9,
"MRI Hip w/ + w/o Contrast Left",61073723,CDM,610,RC,73723,CPT,OUTPATIENT,,,1488,967.2,TC|LT,1309.44,88,,1047.55,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1488,100,,1190.40,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",937.44,63,,749.95,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,1026.72,69,,,,,0,"fee schedule","69% of total billed charges",1488,100,,1190.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1488,100,,1190.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1488,100,,1190.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.98,37.7,,448.78,,,0,"percent of total billed charges","37.7% of total billed charges",560.98,37.7,,448.78,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",504.43,33.9,,403.54,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1160.64,78,,928.51,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1229.09,82.6,,983.27,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1229.09,82.6,,983.27,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1488,100,,1190.40,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Hip w/ + w/o Contrast Right",61073723,CDM,610,RC,73723,CPT,OUTPATIENT,,,1488,967.2,TC|LT,1309.44,88,,1047.55,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1488,100,,1190.40,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",937.44,63,,749.95,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,1026.72,69,,,,,0,"fee schedule","69% of total billed charges",1488,100,,1190.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1488,100,,1190.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1488,100,,1190.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.98,37.7,,448.78,,,0,"percent of total billed charges","37.7% of total billed charges",560.98,37.7,,448.78,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",504.43,33.9,,403.54,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1160.64,78,,928.51,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1229.09,82.6,,983.27,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1229.09,82.6,,983.27,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1488,100,,1190.40,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Hip w/ Contrast Left",61073722,CDM,610,RC,73722,CPT,OUTPATIENT,,,1279,831.35,TC|LT,1125.52,88,,900.42,,,0,"percent of total billed charges","88% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",1429.15,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",805.77,63,,644.62,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,882.51,69,,,,,0,"fee schedule","69% of total billed charges",1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",2905.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",482.18,37.7,,385.74,,,0,"percent of total billed charges","37.7% of total billed charges",482.18,37.7,,385.74,,,0,"percent of total billed charges","37.70% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",433.58,33.9,,346.86,,,0,"percent of total billed charges","33.9% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",997.62,78,,798.10,,,0,"percent of total billed charges","78% of total billed charges",824.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056.45,82.6,,845.16,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056.45,82.6,,845.16,,,0,"percent of total billed charges","82.6% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",297.79,2905.43,
"MRI Hip w/ Contrast Right",61073722,CDM,610,RC,73722,CPT,OUTPATIENT,,,1279,831.35,TC|LT,1125.52,88,,900.42,,,0,"percent of total billed charges","88% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",1429.15,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",805.77,63,,644.62,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,882.51,69,,,,,0,"fee schedule","69% of total billed charges",1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",2905.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",482.18,37.7,,385.74,,,0,"percent of total billed charges","37.7% of total billed charges",482.18,37.7,,385.74,,,0,"percent of total billed charges","37.70% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",433.58,33.9,,346.86,,,0,"percent of total billed charges","33.9% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",997.62,78,,798.10,,,0,"percent of total billed charges","78% of total billed charges",824.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056.45,82.6,,845.16,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056.45,82.6,,845.16,,,0,"percent of total billed charges","82.6% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",297.79,2905.43,
"MRI Hip w/o Contrast Left",61073721,CDM,610,RC,73721,CPT,OUTPATIENT,,,1056,686.4,TC|LT,929.28,88,,743.42,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.28,63,,532.22,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,728.64,69,,,,,0,"fee schedule","69% of total billed charges",1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",398.11,37.7,,318.49,,,0,"percent of total billed charges","37.7% of total billed charges",398.11,37.7,,318.49,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",357.98,33.9,,286.38,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",823.68,78,,658.94,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",872.26,82.6,,697.81,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",872.26,82.6,,697.81,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",169.94,1056,
"MRI Hip w/o Contrast Right",61073721,CDM,610,RC,73721,CPT,OUTPATIENT,,,1056,686.4,TC|LT,929.28,88,,743.42,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.28,63,,532.22,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,728.64,69,,,,,0,"fee schedule","69% of total billed charges",1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",398.11,37.7,,318.49,,,0,"percent of total billed charges","37.7% of total billed charges",398.11,37.7,,318.49,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",357.98,33.9,,286.38,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",823.68,78,,658.94,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",872.26,82.6,,697.81,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",872.26,82.6,,697.81,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",169.94,1056,
"MRI Knee w/ + w/o Contrast Left",61073723,CDM,610,RC,73723,CPT,OUTPATIENT,,,1488,967.2,TC|LT,1309.44,88,,1047.55,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1488,100,,1190.40,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",937.44,63,,749.95,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,1026.72,69,,,,,0,"fee schedule","69% of total billed charges",1488,100,,1190.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1488,100,,1190.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1488,100,,1190.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.98,37.7,,448.78,,,0,"percent of total billed charges","37.7% of total billed charges",560.98,37.7,,448.78,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",504.43,33.9,,403.54,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1160.64,78,,928.51,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1229.09,82.6,,983.27,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1229.09,82.6,,983.27,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1488,100,,1190.40,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Knee w/ + w/o Contrast Right",61073723,CDM,610,RC,73723,CPT,OUTPATIENT,,,1488,967.2,TC|LT,1309.44,88,,1047.55,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1488,100,,1190.40,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",937.44,63,,749.95,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,1026.72,69,,,,,0,"fee schedule","69% of total billed charges",1488,100,,1190.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1488,100,,1190.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1488,100,,1190.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.98,37.7,,448.78,,,0,"percent of total billed charges","37.7% of total billed charges",560.98,37.7,,448.78,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",504.43,33.9,,403.54,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1160.64,78,,928.51,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1229.09,82.6,,983.27,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1229.09,82.6,,983.27,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1488,100,,1190.40,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Knee w/ Contrast Left",61073722,CDM,610,RC,73722,CPT,OUTPATIENT,,,1279,831.35,TC|LT,1125.52,88,,900.42,,,0,"percent of total billed charges","88% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",1429.15,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",805.77,63,,644.62,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,882.51,69,,,,,0,"fee schedule","69% of total billed charges",1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",2905.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",482.18,37.7,,385.74,,,0,"percent of total billed charges","37.7% of total billed charges",482.18,37.7,,385.74,,,0,"percent of total billed charges","37.70% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",433.58,33.9,,346.86,,,0,"percent of total billed charges","33.9% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",997.62,78,,798.10,,,0,"percent of total billed charges","78% of total billed charges",824.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056.45,82.6,,845.16,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056.45,82.6,,845.16,,,0,"percent of total billed charges","82.6% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",297.79,2905.43,
"MRI Knee w/ Contrast Right",61073722,CDM,610,RC,73722,CPT,OUTPATIENT,,,1279,831.35,TC|LT,1125.52,88,,900.42,,,0,"percent of total billed charges","88% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",1429.15,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",805.77,63,,644.62,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,882.51,69,,,,,0,"fee schedule","69% of total billed charges",1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",2905.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",482.18,37.7,,385.74,,,0,"percent of total billed charges","37.7% of total billed charges",482.18,37.7,,385.74,,,0,"percent of total billed charges","37.70% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",433.58,33.9,,346.86,,,0,"percent of total billed charges","33.9% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",997.62,78,,798.10,,,0,"percent of total billed charges","78% of total billed charges",824.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056.45,82.6,,845.16,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056.45,82.6,,845.16,,,0,"percent of total billed charges","82.6% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",297.79,2905.43,
"MRI Knee w/o Contrast Left",61073721,CDM,610,RC,73721,CPT,OUTPATIENT,,,1056,686.4,TC|LT,929.28,88,,743.42,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.28,63,,532.22,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,728.64,69,,,,,0,"fee schedule","69% of total billed charges",1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",398.11,37.7,,318.49,,,0,"percent of total billed charges","37.7% of total billed charges",398.11,37.7,,318.49,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",357.98,33.9,,286.38,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",823.68,78,,658.94,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",872.26,82.6,,697.81,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",872.26,82.6,,697.81,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",169.94,1056,
"MRI Knee w/o Contrast Right",61073721,CDM,610,RC,73721,CPT,OUTPATIENT,,,1056,686.4,TC|LT,929.28,88,,743.42,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.28,63,,532.22,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,728.64,69,,,,,0,"fee schedule","69% of total billed charges",1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",398.11,37.7,,318.49,,,0,"percent of total billed charges","37.7% of total billed charges",398.11,37.7,,318.49,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",357.98,33.9,,286.38,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",823.68,78,,658.94,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",872.26,82.6,,697.81,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",872.26,82.6,,697.81,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",169.94,1056,
"MRI Lower Extremity w/ + w/o Cnt Bilat",61073720,CDM,610,RC,73720,CPT,OUTPATIENT,,,1127,732.55,TC|LT,991.76,88,,793.41,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",710.01,63,,568.01,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,777.63,69,,,,,0,"fee schedule","69% of total billed charges",1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",424.88,37.7,,339.90,,,0,"percent of total billed charges","37.7% of total billed charges",424.88,37.7,,339.90,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",382.05,33.9,,305.64,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.06,78,,703.25,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",930.9,82.6,,744.72,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",930.9,82.6,,744.72,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Lower Extremity w/ Contrast Bilat",61073719,CDM,610,RC,73719,CPT,OUTPATIENT,,,1171,761.15,TC|LT,1030.48,88,,824.38,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737.73,63,,590.18,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,807.99,69,,,,,0,"fee schedule","69% of total billed charges",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.7% of total billed charges",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",396.97,33.9,,317.58,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",913.38,78,,730.70,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Lower Extremity w/o Contrast Bilat",61073718,CDM,610,RC,73718,CPT,OUTPATIENT,,,880,572,TC|LT,774.4,88,,619.52,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.4,63,,443.52,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,607.2,69,,,,,0,"fee schedule","69% of total billed charges",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",331.76,37.7,,265.41,,,0,"percent of total billed charges","37.7% of total billed charges",331.76,37.7,,265.41,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.32,33.9,,238.66,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.4,78,,549.12,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.88,82.6,,581.50,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.88,82.6,,581.50,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",169.94,934.9,
"MRI Pelvis w/ + w/o Contrast",61072197,CDM,610,RC,72197,CPT,OUTPATIENT,,,1179,766.35,TC,1037.52,88,,830.02,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1179,100,,943.20,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",742.77,63,,594.22,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,813.51,69,,,,,0,"fee schedule","69% of total billed charges",1179,100,,943.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1179,100,,943.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1179,100,,943.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",444.48,37.7,,355.58,,,0,"percent of total billed charges","37.7% of total billed charges",444.48,37.7,,355.58,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",399.68,33.9,,319.74,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",919.62,78,,735.70,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",973.85,82.6,,779.08,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",973.85,82.6,,779.08,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1179,100,,943.20,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Pelvis w/ Contrast",61072196,CDM,610,RC,72196,CPT,OUTPATIENT,,,1179,766.35,TC,1037.52,88,,830.02,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1179,100,,943.20,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",742.77,63,,594.22,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,813.51,69,,,,,0,"fee schedule","69% of total billed charges",1179,100,,943.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1179,100,,943.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1179,100,,943.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",444.48,37.7,,355.58,,,0,"percent of total billed charges","37.7% of total billed charges",444.48,37.7,,355.58,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",399.68,33.9,,319.74,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",919.62,78,,735.70,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",973.85,82.6,,779.08,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",973.85,82.6,,779.08,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1179,100,,943.20,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Pelvis w/o Contrast",61072195,CDM,610,RC,72195,CPT,OUTPATIENT,,,1127,732.55,TC,991.76,88,,793.41,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",710.01,63,,568.01,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,777.63,69,,,,,0,"fee schedule","69% of total billed charges",1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",424.88,37.7,,339.90,,,0,"percent of total billed charges","37.7% of total billed charges",424.88,37.7,,339.90,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",382.05,33.9,,305.64,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.06,78,,703.25,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",930.9,82.6,,744.72,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",930.9,82.6,,744.72,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",169.94,1127,
"MRI Shoulder w/ + w/o Contrast Left",61073223,CDM,610,RC,73223,CPT,OUTPATIENT,,,1561,1014.65,TC|LT,1373.68,88,,1098.94,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",983.43,63,,786.74,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,1077.09,69,,,,,0,"fee schedule","69% of total billed charges",1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",588.5,37.7,,470.80,,,0,"percent of total billed charges","37.7% of total billed charges",588.5,37.7,,470.80,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",529.18,33.9,,423.34,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.58,78,,974.06,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1289.39,82.6,,1031.51,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1289.39,82.6,,1031.51,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",297.79,1561,
"MRI Shoulder w/ + w/o Contrast Right",61073223,CDM,610,RC,73223,CPT,OUTPATIENT,,,1561,1014.65,TC|LT,1373.68,88,,1098.94,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",983.43,63,,786.74,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,1077.09,69,,,,,0,"fee schedule","69% of total billed charges",1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",588.5,37.7,,470.80,,,0,"percent of total billed charges","37.7% of total billed charges",588.5,37.7,,470.80,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",529.18,33.9,,423.34,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.58,78,,974.06,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1289.39,82.6,,1031.51,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1289.39,82.6,,1031.51,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",297.79,1561,
"MRI Shoulder w/ Contrast Left",61073222,CDM,610,RC,73222,CPT,OUTPATIENT,,,1343,872.95,TC|LT,1181.84,88,,945.47,,,0,"percent of total billed charges","88% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",1429.15,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",846.09,63,,676.87,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,926.67,69,,,,,0,"fee schedule","69% of total billed charges",1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",2905.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",506.31,37.7,,405.05,,,0,"percent of total billed charges","37.7% of total billed charges",506.31,37.7,,405.05,,,0,"percent of total billed charges","37.70% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",455.28,33.9,,364.22,,,0,"percent of total billed charges","33.9% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1047.54,78,,838.03,,,0,"percent of total billed charges","78% of total billed charges",824.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1109.32,82.6,,887.46,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1109.32,82.6,,887.46,,,0,"percent of total billed charges","82.6% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",297.79,2905.43,
"MRI Shoulder w/ Contrast Right",61073222,CDM,610,RC,73222,CPT,OUTPATIENT,,,1343,872.95,TC|LT,1181.84,88,,945.47,,,0,"percent of total billed charges","88% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",1429.15,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",846.09,63,,676.87,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,926.67,69,,,,,0,"fee schedule","69% of total billed charges",1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",2905.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",506.31,37.7,,405.05,,,0,"percent of total billed charges","37.7% of total billed charges",506.31,37.7,,405.05,,,0,"percent of total billed charges","37.70% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",455.28,33.9,,364.22,,,0,"percent of total billed charges","33.9% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1047.54,78,,838.03,,,0,"percent of total billed charges","78% of total billed charges",824.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1109.32,82.6,,887.46,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1109.32,82.6,,887.46,,,0,"percent of total billed charges","82.6% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",297.79,2905.43,
"MRI Shoulder w/o Contrast Left",61073221,CDM,610,RC,73221,CPT,OUTPATIENT,,,1107,719.55,TC|LT,974.16,88,,779.33,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1107,100,,885.60,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",697.41,63,,557.93,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,763.83,69,,,,,0,"fee schedule","69% of total billed charges",1107,100,,885.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1107,100,,885.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1107,100,,885.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",417.34,37.7,,333.87,,,0,"percent of total billed charges","37.7% of total billed charges",417.34,37.7,,333.87,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",375.27,33.9,,300.22,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",863.46,78,,690.77,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",914.38,82.6,,731.50,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",914.38,82.6,,731.50,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1107,100,,885.60,,,0,"percent of total billed charges","100% of total billed charges",169.94,1107,
"MRI Shoulder w/o Contrast Right",61073221,CDM,610,RC,73221,CPT,OUTPATIENT,,,1107,719.55,TC|LT,974.16,88,,779.33,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1107,100,,885.60,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",697.41,63,,557.93,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,763.83,69,,,,,0,"fee schedule","69% of total billed charges",1107,100,,885.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1107,100,,885.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1107,100,,885.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",417.34,37.7,,333.87,,,0,"percent of total billed charges","37.7% of total billed charges",417.34,37.7,,333.87,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",375.27,33.9,,300.22,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",863.46,78,,690.77,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",914.38,82.6,,731.50,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",914.38,82.6,,731.50,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1107,100,,885.60,,,0,"percent of total billed charges","100% of total billed charges",169.94,1107,
"MRI Spine Cervical w/ + w/o Contrast",61272156,CDM,612,RC,72156,CPT,OUTPATIENT,,,1883,1223.95,TC,1657.04,88,,1325.63,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1883,100,,1506.40,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1186.29,63,,949.03,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,1299.27,69,,,,,0,"fee schedule","69% of total billed charges",1883,100,,1506.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1883,100,,1506.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1883,100,,1506.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",709.89,37.7,,567.91,,,0,"percent of total billed charges","37.7% of total billed charges",709.89,37.7,,567.91,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.34,33.9,,510.67,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1468.74,78,,1174.99,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1555.36,82.6,,1244.29,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1555.36,82.6,,1244.29,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1883,100,,1506.40,,,0,"percent of total billed charges","100% of total billed charges",297.79,1883,
"MRI Spine Cervical w/ Contrast",61272142,CDM,612,RC,72142,CPT,OUTPATIENT,,,1714,1114.1,TC,1508.32,88,,1206.66,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1714,100,,1371.20,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1079.82,63,,863.86,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,1182.66,69,,,,,0,"fee schedule","69% of total billed charges",1714,100,,1371.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1714,100,,1371.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1714,100,,1371.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",646.18,37.7,,516.94,,,0,"percent of total billed charges","37.7% of total billed charges",646.18,37.7,,516.94,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",581.05,33.9,,464.84,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1336.92,78,,1069.54,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1415.76,82.6,,1132.61,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1415.76,82.6,,1132.61,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1714,100,,1371.20,,,0,"percent of total billed charges","100% of total billed charges",297.79,1714,
"MRI Spine Cervical w/o Contrast",61272141,CDM,612,RC,72141,CPT,OUTPATIENT,,,1637,1064.05,TC,1440.56,88,,1152.45,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1637,100,,1309.60,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1031.31,63,,825.05,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,1129.53,69,,,,,0,"fee schedule","69% of total billed charges",1637,100,,1309.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1637,100,,1309.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1637,100,,1309.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",617.15,37.7,,493.72,,,0,"percent of total billed charges","37.7% of total billed charges",617.15,37.7,,493.72,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.94,33.9,,443.95,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1276.86,78,,1021.49,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1352.16,82.6,,1081.73,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1352.16,82.6,,1081.73,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1637,100,,1309.60,,,0,"percent of total billed charges","100% of total billed charges",169.94,1637,
"MRI Spine Lumbar w/ + w/o Contrast",61272158,CDM,612,RC,72158,CPT,OUTPATIENT,,,1501,975.65,TC,1320.88,88,,1056.70,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1501,100,,1200.80,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",945.63,63,,756.50,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,1035.69,69,,,,,0,"fee schedule","69% of total billed charges",1501,100,,1200.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1501,100,,1200.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1501,100,,1200.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",565.88,37.7,,452.70,,,0,"percent of total billed charges","37.7% of total billed charges",565.88,37.7,,452.70,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",508.84,33.9,,407.07,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1170.78,78,,936.62,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.83,82.6,,991.86,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.83,82.6,,991.86,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1501,100,,1200.80,,,0,"percent of total billed charges","100% of total billed charges",297.79,1501,
"MRI Spine Lumbar w/ Contrast",61272149,CDM,612,RC,72149,CPT,OUTPATIENT,,,1348,876.2,TC,1186.24,88,,948.99,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1348,100,,1078.40,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",849.24,63,,679.39,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,930.12,69,,,,,0,"fee schedule","69% of total billed charges",1348,100,,1078.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1348,100,,1078.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1348,100,,1078.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",508.2,37.7,,406.56,,,0,"percent of total billed charges","37.7% of total billed charges",508.2,37.7,,406.56,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",456.97,33.9,,365.58,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1051.44,78,,841.15,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1113.45,82.6,,890.76,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1113.45,82.6,,890.76,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1348,100,,1078.40,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Spine Lumbar w/o Contrast",61272148,CDM,612,RC,72148,CPT,OUTPATIENT,,,1443,937.95,TC,1269.84,88,,1015.87,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1443,100,,1154.40,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",909.09,63,,727.27,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,995.67,69,,,,,0,"fee schedule","69% of total billed charges",1443,100,,1154.40,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1443,100,,1154.40,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1443,100,,1154.40,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",544.01,37.7,,435.21,,,0,"percent of total billed charges","37.7% of total billed charges",544.01,37.7,,435.21,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",489.18,33.9,,391.34,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1125.54,78,,900.43,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1191.92,82.6,,953.54,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1191.92,82.6,,953.54,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1443,100,,1154.40,,,0,"percent of total billed charges","100% of total billed charges",169.94,1443,
"MRI Spine Thoracic w/ + w/o Contrast",61272157,CDM,612,RC,72157,CPT,OUTPATIENT,,,1729,1123.85,TC,1521.52,88,,1217.22,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1729,100,,1383.20,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1089.27,63,,871.42,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,1193.01,69,,,,,0,"fee schedule","69% of total billed charges",1729,100,,1383.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1729,100,,1383.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1729,100,,1383.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",651.83,37.7,,521.46,,,0,"percent of total billed charges","37.7% of total billed charges",651.83,37.7,,521.46,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",586.13,33.9,,468.90,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1348.62,78,,1078.90,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1428.15,82.6,,1142.52,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1428.15,82.6,,1142.52,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1729,100,,1383.20,,,0,"percent of total billed charges","100% of total billed charges",297.79,1729,
"MRI Spine Thoracic w/ Contrast",61272147,CDM,612,RC,72147,CPT,OUTPATIENT,,,1494,971.1,TC,1314.72,88,,1051.78,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",941.22,63,,752.98,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,1030.86,69,,,,,0,"fee schedule","69% of total billed charges",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",563.24,37.7,,450.59,,,0,"percent of total billed charges","37.7% of total billed charges",563.24,37.7,,450.59,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",506.47,33.9,,405.18,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1165.32,78,,932.26,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1234.04,82.6,,987.23,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1234.04,82.6,,987.23,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Spine Thoracic w/o Contrast",61272146,CDM,612,RC,72146,CPT,OUTPATIENT,,,1501,975.65,TC,1320.88,88,,1056.70,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1501,100,,1200.80,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",945.63,63,,756.50,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,1035.69,69,,,,,0,"fee schedule","69% of total billed charges",1501,100,,1200.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1501,100,,1200.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1501,100,,1200.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",565.88,37.7,,452.70,,,0,"percent of total billed charges","37.7% of total billed charges",565.88,37.7,,452.70,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",508.84,33.9,,407.07,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1170.78,78,,936.62,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.83,82.6,,991.86,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.83,82.6,,991.86,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1501,100,,1200.80,,,0,"percent of total billed charges","100% of total billed charges",169.94,1501,
"MRI TMJ",61070336,CDM,610,RC,70336,CPT,OUTPATIENT,,,652,423.8,TC,573.76,88,,459.01,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,652,100,,521.60,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.76,63,,328.61,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,449.88,69,,,,,0,"fee schedule","69% of total billed charges",652,100,,521.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652,100,,521.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652,100,,521.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",245.8,37.7,,196.64,,,0,"percent of total billed charges","37.7% of total billed charges",245.8,37.7,,196.64,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.03,33.9,,176.82,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",508.56,78,,406.85,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",538.55,82.6,,430.84,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",538.55,82.6,,430.84,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,652,100,,521.60,,,0,"percent of total billed charges","100% of total billed charges",169.94,934.9,
"MRI Wrist w/ + w/o Contrast Left",61073223,CDM,610,RC,73223,CPT,OUTPATIENT,,,1561,1014.65,TC|LT,1373.68,88,,1098.94,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",983.43,63,,786.74,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,1077.09,69,,,,,0,"fee schedule","69% of total billed charges",1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",588.5,37.7,,470.80,,,0,"percent of total billed charges","37.7% of total billed charges",588.5,37.7,,470.80,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",529.18,33.9,,423.34,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.58,78,,974.06,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1289.39,82.6,,1031.51,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1289.39,82.6,,1031.51,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",297.79,1561,
"MRI Wrist w/ + w/o Contrast Right",61073223,CDM,610,RC,73223,CPT,OUTPATIENT,,,1561,1014.65,TC|LT,1373.68,88,,1098.94,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",983.43,63,,786.74,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,1077.09,69,,,,,0,"fee schedule","69% of total billed charges",1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",588.5,37.7,,470.80,,,0,"percent of total billed charges","37.7% of total billed charges",588.5,37.7,,470.80,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",529.18,33.9,,423.34,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.58,78,,974.06,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1289.39,82.6,,1031.51,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1289.39,82.6,,1031.51,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",297.79,1561,
"MRI Wrist w/ Contrast Left",61073222,CDM,610,RC,73222,CPT,OUTPATIENT,,,1343,872.95,TC|LT,1181.84,88,,945.47,,,0,"percent of total billed charges","88% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",1429.15,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",846.09,63,,676.87,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,926.67,69,,,,,0,"fee schedule","69% of total billed charges",1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",2905.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",506.31,37.7,,405.05,,,0,"percent of total billed charges","37.7% of total billed charges",506.31,37.7,,405.05,,,0,"percent of total billed charges","37.70% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",455.28,33.9,,364.22,,,0,"percent of total billed charges","33.9% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1047.54,78,,838.03,,,0,"percent of total billed charges","78% of total billed charges",824.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1109.32,82.6,,887.46,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1109.32,82.6,,887.46,,,0,"percent of total billed charges","82.6% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",297.79,2905.43,
"MRI Wrist w/ Contrast Right",61073222,CDM,610,RC,73222,CPT,OUTPATIENT,,,1343,872.95,TC|LT,1181.84,88,,945.47,,,0,"percent of total billed charges","88% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",1429.15,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",846.09,63,,676.87,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,926.67,69,,,,,0,"fee schedule","69% of total billed charges",1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",2905.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",506.31,37.7,,405.05,,,0,"percent of total billed charges","37.7% of total billed charges",506.31,37.7,,405.05,,,0,"percent of total billed charges","37.70% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",455.28,33.9,,364.22,,,0,"percent of total billed charges","33.9% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1047.54,78,,838.03,,,0,"percent of total billed charges","78% of total billed charges",824.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1109.32,82.6,,887.46,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1109.32,82.6,,887.46,,,0,"percent of total billed charges","82.6% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1343,100,,1074.40,,,0,"percent of total billed charges","100% of total billed charges",297.79,2905.43,
"MRI Wrist w/o Contrast Left",61073221,CDM,610,RC,73221,CPT,OUTPATIENT,,,1107,719.55,TC|LT,974.16,88,,779.33,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1107,100,,885.60,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",697.41,63,,557.93,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,763.83,69,,,,,0,"fee schedule","69% of total billed charges",1107,100,,885.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1107,100,,885.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1107,100,,885.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",417.34,37.7,,333.87,,,0,"percent of total billed charges","37.7% of total billed charges",417.34,37.7,,333.87,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",375.27,33.9,,300.22,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",863.46,78,,690.77,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",914.38,82.6,,731.50,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",914.38,82.6,,731.50,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1107,100,,885.60,,,0,"percent of total billed charges","100% of total billed charges",169.94,1107,
"MRI Wrist w/o Contrast Right",61073221,CDM,610,RC,73221,CPT,OUTPATIENT,,,1107,719.55,TC|LT,974.16,88,,779.33,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1107,100,,885.60,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",697.41,63,,557.93,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,763.83,69,,,,,0,"fee schedule","69% of total billed charges",1107,100,,885.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1107,100,,885.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1107,100,,885.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",417.34,37.7,,333.87,,,0,"percent of total billed charges","37.7% of total billed charges",417.34,37.7,,333.87,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",375.27,33.9,,300.22,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",863.46,78,,690.77,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",914.38,82.6,,731.50,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",914.38,82.6,,731.50,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1107,100,,885.60,,,0,"percent of total billed charges","100% of total billed charges",169.94,1107,
"MRI Brachial Plexus w/ + w/o Contrast",61073220,CDM,610,RC,73220,CPT,OUTPATIENT,,,,,TC|LT,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",402.01,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",414.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",402.01,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",297.79,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",402.01,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",402.01,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",297.79,620,
"MRI Breast w/ + w/o Contrast Left",61077048,CDM,610,RC,77048,CPT,OUTPATIENT,,,2078,1350.7,TC|LT,1828.64,88,,1462.91,,,0,"percent of total billed charges","88% of total billed charges",1039,50,,831.20,,,0,"percent of total billed charges","50% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,2078,100,,1662.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1309.14,63,,1047.31,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,1433.82,69,,,,,0,"fee schedule","69% of total billed charges",2078,100,,1662.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2078,100,,1662.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2078,100,,1662.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1285.24,61.85,,1028.19,,,0,"percent of total billed charges","61.5% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,1039,50,,831.20,,,0,"percent of total billed charges","50% of total billed charges",669.12,32.2,,535.30,,,0,"percent of total billed charges","32.2% of total billed charges",297.79,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",783.41,37.7,,626.73,,,0,"percent of total billed charges","37.7% of total billed charges",783.41,37.7,,626.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",704.44,33.9,,563.55,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1620.84,78,,1296.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1716.43,82.6,,1373.14,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,1039,50,,831.20,,,0,"percent of total billed charges","50% of total billed charges",1716.43,82.6,,1373.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",402.01,100,,,,,0,"fee schedule",EAPG,2078,100,,1662.40,,,0,"percent of total billed charges","100% of total billed charges",297.79,2078,
"MRI Breast w/ + w/o Contrast Right",61077048,CDM,610,RC,77048,CPT,OUTPATIENT,,,2078,1350.7,TC|LT,1828.64,88,,1462.91,,,0,"percent of total billed charges","88% of total billed charges",1039,50,,831.20,,,0,"percent of total billed charges","50% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,2078,100,,1662.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1309.14,63,,1047.31,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,1433.82,69,,,,,0,"fee schedule","69% of total billed charges",2078,100,,1662.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2078,100,,1662.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2078,100,,1662.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1285.24,61.85,,1028.19,,,0,"percent of total billed charges","61.5% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,1039,50,,831.20,,,0,"percent of total billed charges","50% of total billed charges",669.12,32.2,,535.30,,,0,"percent of total billed charges","32.2% of total billed charges",297.79,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",783.41,37.7,,626.73,,,0,"percent of total billed charges","37.7% of total billed charges",783.41,37.7,,626.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",704.44,33.9,,563.55,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1620.84,78,,1296.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1716.43,82.6,,1373.14,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,1039,50,,831.20,,,0,"percent of total billed charges","50% of total billed charges",1716.43,82.6,,1373.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",402.01,100,,,,,0,"fee schedule",EAPG,2078,100,,1662.40,,,0,"percent of total billed charges","100% of total billed charges",297.79,2078,
"MRI Bone Marrow w/o Contrast",61077084,CDM,610,RC,77084,CPT,OUTPATIENT,,,2703,1756.95,TC,2378.64,88,,1902.91,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,2703,100,,2162.40,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1702.89,63,,1362.31,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,1865.07,69,,,,,0,"fee schedule","69% of total billed charges",2703,100,,2162.40,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2703,100,,2162.40,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2703,100,,2162.40,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1019.03,37.7,,815.22,,,0,"percent of total billed charges","37.7% of total billed charges",1019.03,37.7,,815.22,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",916.32,33.9,,733.06,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2108.34,78,,1686.67,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2232.68,82.6,,1786.14,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2232.68,82.6,,1786.14,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,2703,100,,2162.40,,,0,"percent of total billed charges","100% of total billed charges",169.94,2703,
"MRI Brain w/ Contrast Ltd",61170552,CDM,611,RC,70552,CPT,OUTPATIENT,,,859,558.35,TC,755.92,88,,604.74,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,859,100,,687.20,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",541.17,63,,432.94,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,592.71,69,,,,,0,"fee schedule","69% of total billed charges",859,100,,687.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859,100,,687.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859,100,,687.20,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",323.84,37.7,,259.07,,,0,"percent of total billed charges","37.7% of total billed charges",323.84,37.7,,259.07,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",291.2,33.9,,232.96,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",670.02,78,,536.02,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",709.53,82.6,,567.62,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",709.53,82.6,,567.62,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,859,100,,687.20,,,0,"percent of total billed charges","100% of total billed charges",291.2,1495.48,
"MRI Breast w/o Contrast Left",61077046,CDM,610,RC,77046,CPT,OUTPATIENT,,,1342,872.3,TC|LT,1180.96,88,,944.77,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1342,100,,1073.60,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",845.46,63,,676.37,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,925.98,69,,,,,0,"fee schedule","69% of total billed charges",1342,100,,1073.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1342,100,,1073.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1342,100,,1073.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",505.93,37.7,,404.74,,,0,"percent of total billed charges","37.7% of total billed charges",505.93,37.7,,404.74,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",454.94,33.9,,363.95,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1046.76,78,,837.41,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1108.49,82.6,,886.79,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1108.49,82.6,,886.79,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1342,100,,1073.60,,,0,"percent of total billed charges","100% of total billed charges",169.94,1342,
"MRI Breast w/o Contrast Right",61077046,CDM,610,RC,77046,CPT,OUTPATIENT,,,1342,872.3,TC|LT,1180.96,88,,944.77,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1342,100,,1073.60,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",845.46,63,,676.37,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,925.98,69,,,,,0,"fee schedule","69% of total billed charges",1342,100,,1073.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1342,100,,1073.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1342,100,,1073.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",505.93,37.7,,404.74,,,0,"percent of total billed charges","37.7% of total billed charges",505.93,37.7,,404.74,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",454.94,33.9,,363.95,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1046.76,78,,837.41,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1108.49,82.6,,886.79,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1108.49,82.6,,886.79,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,1342,100,,1073.60,,,0,"percent of total billed charges","100% of total billed charges",169.94,1342,
"MRI Femur w/ + w/o Contrast Lt",61073720,CDM,610,RC,73720,CPT,OUTPATIENT,,,1127,732.55,TC|LT,991.76,88,,793.41,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",710.01,63,,568.01,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,777.63,69,,,,,0,"fee schedule","69% of total billed charges",1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",424.88,37.7,,339.90,,,0,"percent of total billed charges","37.7% of total billed charges",424.88,37.7,,339.90,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",382.05,33.9,,305.64,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.06,78,,703.25,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",930.9,82.6,,744.72,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",930.9,82.6,,744.72,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Femur w/ + w/o Contrast Rt",61073720,CDM,610,RC,73720,CPT,OUTPATIENT,,,1127,732.55,TC|LT,991.76,88,,793.41,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",710.01,63,,568.01,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,777.63,69,,,,,0,"fee schedule","69% of total billed charges",1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",424.88,37.7,,339.90,,,0,"percent of total billed charges","37.7% of total billed charges",424.88,37.7,,339.90,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",382.05,33.9,,305.64,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.06,78,,703.25,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",930.9,82.6,,744.72,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",930.9,82.6,,744.72,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Femur w/o Contrast Lt",61073718,CDM,610,RC,73718,CPT,OUTPATIENT,,,880,572,TC|LT,774.4,88,,619.52,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.4,63,,443.52,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,607.2,69,,,,,0,"fee schedule","69% of total billed charges",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",331.76,37.7,,265.41,,,0,"percent of total billed charges","37.7% of total billed charges",331.76,37.7,,265.41,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.32,33.9,,238.66,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.4,78,,549.12,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.88,82.6,,581.50,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.88,82.6,,581.50,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",169.94,934.9,
"MRI Femur w/o Contrast Rt",61073718,CDM,610,RC,73718,CPT,OUTPATIENT,,,880,572,TC|LT,774.4,88,,619.52,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.4,63,,443.52,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,607.2,69,,,,,0,"fee schedule","69% of total billed charges",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",331.76,37.7,,265.41,,,0,"percent of total billed charges","37.7% of total billed charges",331.76,37.7,,265.41,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.32,33.9,,238.66,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.4,78,,549.12,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.88,82.6,,581.50,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.88,82.6,,581.50,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",169.94,934.9,
"MRI Forearm w/ + w/o Contrast Lt",61073220,CDM,610,RC,73220,CPT,OUTPATIENT,,,1382,898.3,TC|LT,1216.16,88,,972.93,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",870.66,63,,696.53,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,953.58,69,,,,,0,"fee schedule","69% of total billed charges",1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",521.01,37.7,,416.81,,,0,"percent of total billed charges","37.7% of total billed charges",521.01,37.7,,416.81,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",468.5,33.9,,374.80,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1077.96,78,,862.37,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1141.53,82.6,,913.22,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1141.53,82.6,,913.22,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Forearm w/ + w/o Contrast Rt",61073220,CDM,610,RC,73220,CPT,OUTPATIENT,,,1382,898.3,TC|LT,1216.16,88,,972.93,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",870.66,63,,696.53,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,953.58,69,,,,,0,"fee schedule","69% of total billed charges",1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",521.01,37.7,,416.81,,,0,"percent of total billed charges","37.7% of total billed charges",521.01,37.7,,416.81,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",468.5,33.9,,374.80,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1077.96,78,,862.37,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1141.53,82.6,,913.22,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1141.53,82.6,,913.22,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Forearm w/o Contrast Lt",61073218,CDM,610,RC,73218,CPT,OUTPATIENT,,,880,572,TC|LT,774.4,88,,619.52,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.4,63,,443.52,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,607.2,69,,,,,0,"fee schedule","69% of total billed charges",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",331.76,37.7,,265.41,,,0,"percent of total billed charges","37.7% of total billed charges",331.76,37.7,,265.41,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.32,33.9,,238.66,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.4,78,,549.12,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.88,82.6,,581.50,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.88,82.6,,581.50,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",169.94,934.9,
"MRI Forearm w/o Contrast Rt",61073218,CDM,610,RC,73218,CPT,OUTPATIENT,,,880,572,TC|LT,774.4,88,,619.52,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.4,63,,443.52,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,607.2,69,,,,,0,"fee schedule","69% of total billed charges",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",331.76,37.7,,265.41,,,0,"percent of total billed charges","37.7% of total billed charges",331.76,37.7,,265.41,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.32,33.9,,238.66,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.4,78,,549.12,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.88,82.6,,581.50,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.88,82.6,,581.50,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",169.94,934.9,
"MRI Humerus w/ + w/o Contrast Rt",61073719,CDM,610,RC,73719,CPT,OUTPATIENT,,,1171,761.15,TC|LT,1030.48,88,,824.38,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737.73,63,,590.18,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,807.99,69,,,,,0,"fee schedule","69% of total billed charges",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.7% of total billed charges",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",396.97,33.9,,317.58,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",913.38,78,,730.70,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Humerus w/ + w/o Contrsat Lt",61073220,CDM,610,RC,73220,CPT,OUTPATIENT,,,1382,898.3,TC|LT,1216.16,88,,972.93,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",870.66,63,,696.53,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,953.58,69,,,,,0,"fee schedule","69% of total billed charges",1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",521.01,37.7,,416.81,,,0,"percent of total billed charges","37.7% of total billed charges",521.01,37.7,,416.81,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",468.5,33.9,,374.80,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1077.96,78,,862.37,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1141.53,82.6,,913.22,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1141.53,82.6,,913.22,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Humerus w/o Contrast Lt",61073719,CDM,610,RC,73719,CPT,OUTPATIENT,,,1171,761.15,TC|LT,1030.48,88,,824.38,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737.73,63,,590.18,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,807.99,69,,,,,0,"fee schedule","69% of total billed charges",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.7% of total billed charges",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",396.97,33.9,,317.58,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",913.38,78,,730.70,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Humerus w/o Contrast Rt",61073719,CDM,610,RC,73719,CPT,OUTPATIENT,,,1171,761.15,TC|LT,1030.48,88,,824.38,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737.73,63,,590.18,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,807.99,69,,,,,0,"fee schedule","69% of total billed charges",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.7% of total billed charges",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",396.97,33.9,,317.58,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",913.38,78,,730.70,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI IAC w/ + w/o Contrast",61170553,CDM,611,RC,70553,CPT,OUTPATIENT,,,1637,1064.05,TC,1440.56,88,,1152.45,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1637,100,,1309.60,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1031.31,63,,825.05,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,1129.53,69,,,,,0,"fee schedule","69% of total billed charges",1637,100,,1309.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1637,100,,1309.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1637,100,,1309.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",617.15,37.7,,493.72,,,0,"percent of total billed charges","37.7% of total billed charges",617.15,37.7,,493.72,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.94,33.9,,443.95,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1276.86,78,,1021.49,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1352.16,82.6,,1081.73,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1352.16,82.6,,1081.73,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1637,100,,1309.60,,,0,"percent of total billed charges","100% of total billed charges",297.79,1637,
"MRI Pituitary w/ + w/o Contrast",61170553,CDM,611,RC,70553,CPT,OUTPATIENT,,,1637,1064.05,TC,1440.56,88,,1152.45,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1637,100,,1309.60,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1031.31,63,,825.05,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,1129.53,69,,,,,0,"fee schedule","69% of total billed charges",1637,100,,1309.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1637,100,,1309.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1637,100,,1309.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",617.15,37.7,,493.72,,,0,"percent of total billed charges","37.7% of total billed charges",617.15,37.7,,493.72,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.94,33.9,,443.95,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1276.86,78,,1021.49,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1352.16,82.6,,1081.73,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1352.16,82.6,,1081.73,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1637,100,,1309.60,,,0,"percent of total billed charges","100% of total billed charges",297.79,1637,
"MRI Tibia w/ + w/o Contrast Lt",61073720,CDM,610,RC,73720,CPT,OUTPATIENT,,,1127,732.55,TC|LT,991.76,88,,793.41,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",710.01,63,,568.01,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,777.63,69,,,,,0,"fee schedule","69% of total billed charges",1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",424.88,37.7,,339.90,,,0,"percent of total billed charges","37.7% of total billed charges",424.88,37.7,,339.90,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",382.05,33.9,,305.64,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.06,78,,703.25,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",930.9,82.6,,744.72,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",930.9,82.6,,744.72,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Tibia w/ + w/o Contrast Rt",61073720,CDM,610,RC,73720,CPT,OUTPATIENT,,,1127,732.55,TC|LT,991.76,88,,793.41,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",710.01,63,,568.01,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,777.63,69,,,,,0,"fee schedule","69% of total billed charges",1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",424.88,37.7,,339.90,,,0,"percent of total billed charges","37.7% of total billed charges",424.88,37.7,,339.90,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",382.05,33.9,,305.64,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.06,78,,703.25,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",930.9,82.6,,744.72,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",930.9,82.6,,744.72,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1127,100,,901.60,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Tibia w/ Contrast Lt",61073719,CDM,610,RC,73719,CPT,OUTPATIENT,,,1171,761.15,TC|LT,1030.48,88,,824.38,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737.73,63,,590.18,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,807.99,69,,,,,0,"fee schedule","69% of total billed charges",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.7% of total billed charges",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",396.97,33.9,,317.58,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",913.38,78,,730.70,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Tibia w/ Contrast Rt",61073719,CDM,610,RC,73719,CPT,OUTPATIENT,,,1171,761.15,TC|LT,1030.48,88,,824.38,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737.73,63,,590.18,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,807.99,69,,,,,0,"fee schedule","69% of total billed charges",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.7% of total billed charges",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",396.97,33.9,,317.58,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",913.38,78,,730.70,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Tibia w/o Contrast Lt",61073718,CDM,610,RC,73718,CPT,OUTPATIENT,,,880,572,TC|LT,774.4,88,,619.52,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.4,63,,443.52,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,607.2,69,,,,,0,"fee schedule","69% of total billed charges",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",331.76,37.7,,265.41,,,0,"percent of total billed charges","37.7% of total billed charges",331.76,37.7,,265.41,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.32,33.9,,238.66,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.4,78,,549.12,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.88,82.6,,581.50,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.88,82.6,,581.50,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",169.94,934.9,
"MRI Tibia w/o Contrast Rt",61073718,CDM,610,RC,73718,CPT,OUTPATIENT,,,880,572,TC|LT,774.4,88,,619.52,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.4,63,,443.52,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,607.2,69,,,,,0,"fee schedule","69% of total billed charges",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",331.76,37.7,,265.41,,,0,"percent of total billed charges","37.7% of total billed charges",331.76,37.7,,265.41,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.32,33.9,,238.66,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.4,78,,549.12,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.88,82.6,,581.50,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.88,82.6,,581.50,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",169.94,934.9,
"MRI Femur w/ Contrast Lt",61073719,CDM,610,RC,73719,CPT,OUTPATIENT,,,1171,761.15,TC|LT,1030.48,88,,824.38,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737.73,63,,590.18,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,807.99,69,,,,,0,"fee schedule","69% of total billed charges",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.7% of total billed charges",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",396.97,33.9,,317.58,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",913.38,78,,730.70,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Femur w/ Contrast Rt",61073719,CDM,610,RC,73719,CPT,OUTPATIENT,,,1171,761.15,TC|LT,1030.48,88,,824.38,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737.73,63,,590.18,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,807.99,69,,,,,0,"fee schedule","69% of total billed charges",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.7% of total billed charges",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",396.97,33.9,,317.58,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",913.38,78,,730.70,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Forearm w/ Contrast Lt",61073219,CDM,610,RC,73219,CPT,OUTPATIENT,,,1171,761.15,TC|LT,1030.48,88,,824.38,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737.73,63,,590.18,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,807.99,69,,,,,0,"fee schedule","69% of total billed charges",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.7% of total billed charges",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",396.97,33.9,,317.58,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",913.38,78,,730.70,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Forearm w/ Contrast Rt",61073219,CDM,610,RC,73219,CPT,OUTPATIENT,,,1171,761.15,TC|LT,1030.48,88,,824.38,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737.73,63,,590.18,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,807.99,69,,,,,0,"fee schedule","69% of total billed charges",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.7% of total billed charges",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",396.97,33.9,,317.58,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",913.38,78,,730.70,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Humerus w/ Contrast Lt",61073219,CDM,610,RC,73219,CPT,OUTPATIENT,,,1171,761.15,TC|LT,1030.48,88,,824.38,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737.73,63,,590.18,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,807.99,69,,,,,0,"fee schedule","69% of total billed charges",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.7% of total billed charges",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",396.97,33.9,,317.58,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",913.38,78,,730.70,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Humerus w/ Contrast Rt",61073219,CDM,610,RC,73219,CPT,OUTPATIENT,,,1171,761.15,TC|LT,1030.48,88,,824.38,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737.73,63,,590.18,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,807.99,69,,,,,0,"fee schedule","69% of total billed charges",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.7% of total billed charges",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",396.97,33.9,,317.58,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",913.38,78,,730.70,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Humerus w/ + w/o Contrast Left",61073220,CDM,610,RC,73220,CPT,OUTPATIENT,,,1382,898.3,TC|LT,1216.16,88,,972.93,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",870.66,63,,696.53,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,953.58,69,,,,,0,"fee schedule","69% of total billed charges",1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",521.01,37.7,,416.81,,,0,"percent of total billed charges","37.7% of total billed charges",521.01,37.7,,416.81,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",468.5,33.9,,374.80,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1077.96,78,,862.37,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1141.53,82.6,,913.22,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1141.53,82.6,,913.22,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Humerus w/ + w/o Contrast Right",61073220,CDM,610,RC,73220,CPT,OUTPATIENT,,,1382,898.3,TC|LT,1216.16,88,,972.93,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",870.66,63,,696.53,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,953.58,69,,,,,0,"fee schedule","69% of total billed charges",1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",521.01,37.7,,416.81,,,0,"percent of total billed charges","37.7% of total billed charges",521.01,37.7,,416.81,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",468.5,33.9,,374.80,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1077.96,78,,862.37,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1141.53,82.6,,913.22,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1141.53,82.6,,913.22,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Humerus w/o Contrast Left",61073218,CDM,610,RC,73218,CPT,OUTPATIENT,,,880,572,TC|LT,774.4,88,,619.52,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.4,63,,443.52,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,607.2,69,,,,,0,"fee schedule","69% of total billed charges",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",331.76,37.7,,265.41,,,0,"percent of total billed charges","37.7% of total billed charges",331.76,37.7,,265.41,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.32,33.9,,238.66,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.4,78,,549.12,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.88,82.6,,581.50,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.88,82.6,,581.50,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",169.94,934.9,
"MRI Humerus w/o Contrast Right",61073218,CDM,610,RC,73218,CPT,OUTPATIENT,,,880,572,TC|LT,774.4,88,,619.52,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",236.31,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.4,63,,443.52,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",229.43,100,,,,,0,"fee schedule",EAPG,607.2,69,,,,,0,"fee schedule","69% of total billed charges",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.94,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.01,100,,,,,0,"fee schedule",EAPG,298.25,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",331.76,37.7,,265.41,,,0,"percent of total billed charges","37.7% of total billed charges",331.76,37.7,,265.41,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.32,33.9,,238.66,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.4,78,,549.12,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.88,82.6,,581.50,,,0,"percent of total billed charges","82.6% of total billed charges",229.43,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.88,82.6,,581.50,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.43,100,,,,,0,"fee schedule",EAPG,880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",169.94,934.9,
"MRI Femur w/ Contrast Left",61073719,CDM,610,RC,73719,CPT,OUTPATIENT,,,1171,761.15,TC|LT,1030.48,88,,824.38,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737.73,63,,590.18,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,807.99,69,,,,,0,"fee schedule","69% of total billed charges",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.7% of total billed charges",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",396.97,33.9,,317.58,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",913.38,78,,730.70,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Femur w/ Contrast Right",61073719,CDM,610,RC,73719,CPT,OUTPATIENT,,,1171,761.15,TC|LT,1030.48,88,,824.38,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737.73,63,,590.18,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,807.99,69,,,,,0,"fee schedule","69% of total billed charges",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.7% of total billed charges",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",396.97,33.9,,317.58,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",913.38,78,,730.70,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Forearm w/ Contrast Left",61073219,CDM,610,RC,73219,CPT,OUTPATIENT,,,1171,761.15,TC|LT,1030.48,88,,824.38,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737.73,63,,590.18,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,807.99,69,,,,,0,"fee schedule","69% of total billed charges",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.7% of total billed charges",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",396.97,33.9,,317.58,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",913.38,78,,730.70,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Forearm w/ Contrast Right",61073219,CDM,610,RC,73219,CPT,OUTPATIENT,,,1171,761.15,TC|LT,1030.48,88,,824.38,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737.73,63,,590.18,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,807.99,69,,,,,0,"fee schedule","69% of total billed charges",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.7% of total billed charges",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",396.97,33.9,,317.58,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",913.38,78,,730.70,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Humerus w/ Contrast Left",61073219,CDM,610,RC,73219,CPT,OUTPATIENT,,,1171,761.15,TC|LT,1030.48,88,,824.38,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737.73,63,,590.18,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,807.99,69,,,,,0,"fee schedule","69% of total billed charges",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.7% of total billed charges",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",396.97,33.9,,317.58,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",913.38,78,,730.70,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRI Humerus w/ Contrast Right",61073219,CDM,610,RC,73219,CPT,OUTPATIENT,,,1171,761.15,TC|LT,1030.48,88,,824.38,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",414.07,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737.73,63,,590.18,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",402.01,100,,,,,0,"fee schedule",EAPG,807.99,69,,,,,0,"fee schedule","69% of total billed charges",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.79,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.05,100,,,,,0,"fee schedule",EAPG,522.62,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.7% of total billed charges",441.47,37.7,,353.18,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",396.97,33.9,,317.58,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",913.38,78,,730.70,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",402.01,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.25,82.6,,773.80,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.01,100,,,,,0,"fee schedule",EAPG,1171,100,,936.80,,,0,"percent of total billed charges","100% of total billed charges",297.79,1495.48,
"MRV Pelvis w/ Contrast",61872198,CDM,618,RC,72198,CPT,OUTPATIENT,,,3205,2083.25,TC,2820.4,88,,2256.32,,,0,"percent of total billed charges","88% of total billed charges",1602.5,50,,1282.00,,,0,"percent of total billed charges","50% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,3205,100,,2564.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.31,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2019.15,63,,1615.32,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",449.81,100,,,,,0,"fee schedule",EAPG,2211.45,69,,,,,0,"fee schedule","69% of total billed charges",3205,100,,2564.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3205,100,,2564.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3205,100,,2564.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1982.29,61.85,,1585.83,,,0,"percent of total billed charges","61.5% of total billed charges",449.81,100,,,,,0,"fee schedule",EAPG,1602.5,50,,1282.00,,,0,"percent of total billed charges","50% of total billed charges",1032.01,32.2,,825.61,,,0,"percent of total billed charges","32.2% of total billed charges",333.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",458.81,100,,,,,0,"fee schedule",EAPG,584.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1208.29,37.7,,966.63,,,0,"percent of total billed charges","37.7% of total billed charges",1208.29,37.7,,966.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1086.5,33.9,,869.20,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2499.9,78,,1999.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2647.33,82.6,,2117.86,,,0,"percent of total billed charges","82.6% of total billed charges",449.81,100,,,,,0,"fee schedule","100% of WA fee schedule",1602.5,50,,1282.00,,,0,"percent of total billed charges","50% of total billed charges",2647.33,82.6,,2117.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.81,100,,,,,0,"fee schedule",EAPG,3205,100,,2564.00,,,0,"percent of total billed charges","100% of total billed charges",333.19,3205,
"NM Bone Imaging Limited Injection",34178300,CDM,341,RC,78300,CPT,OUTPATIENT,,,1944,1263.6,TC,1710.72,88,,1368.58,,,0,"percent of total billed charges","88% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,1944,100,,1555.20,,,0,"percent of total billed charges","100% of total billed charges",736.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",356.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1224.72,63,,979.78,,,0,"percent of total billed charges","63% of total billed charges",297.43,15.3,,237.94,,,0,"percent of total billed charges","15.3% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,1341.36,69,,,,,0,"fee schedule","69% of total billed charges",1944,100,,1555.20,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1944,100,,1555.20,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1944,100,,1555.20,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1532.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352.65,100,,,,,0,"fee schedule",EAPG,449.45,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",732.89,37.7,,586.31,,,0,"percent of total billed charges","37.7% of total billed charges",732.89,37.7,,586.31,,,0,"percent of total billed charges","37.70% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",659.02,33.9,,527.22,,,0,"percent of total billed charges","33.9% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1516.32,78,,1213.06,,,0,"percent of total billed charges","78% of total billed charges",424.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1605.74,82.6,,1284.59,,,0,"percent of total billed charges","82.6% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1605.74,82.6,,1284.59,,,0,"percent of total billed charges","82.6% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,1944,100,,1555.20,,,0,"percent of total billed charges","100% of total billed charges",256.1,1944,
"NM Bone Imaging Multiple Areas Injection",34178305,CDM,341,RC,78305,CPT,OUTPATIENT,,,2757,1792.05,TC,2426.16,88,,1940.93,,,0,"percent of total billed charges","88% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,2757,100,,2205.60,,,0,"percent of total billed charges","100% of total billed charges",736.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",356.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1736.91,63,,1389.53,,,0,"percent of total billed charges","63% of total billed charges",421.82,15.3,,337.46,,,0,"percent of total billed charges","15.3% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,1902.33,69,,,,,0,"fee schedule","69% of total billed charges",2757,100,,2205.60,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2757,100,,2205.60,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2757,100,,2205.60,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1532.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352.65,100,,,,,0,"fee schedule",EAPG,449.45,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1039.39,37.7,,831.51,,,0,"percent of total billed charges","37.7% of total billed charges",1039.39,37.7,,831.51,,,0,"percent of total billed charges","37.70% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",934.62,33.9,,747.70,,,0,"percent of total billed charges","33.9% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2150.46,78,,1720.37,,,0,"percent of total billed charges","78% of total billed charges",424.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2277.28,82.6,,1821.82,,,0,"percent of total billed charges","82.6% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2277.28,82.6,,1821.82,,,0,"percent of total billed charges","82.6% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,2757,100,,2205.60,,,0,"percent of total billed charges","100% of total billed charges",256.1,2757,
"NM Bone Imaging Whole Body Injection",34178306,CDM,341,RC,78306,CPT,OUTPATIENT,,,3207,2084.55,TC,2822.16,88,,2257.73,,,0,"percent of total billed charges","88% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,3207,100,,2565.60,,,0,"percent of total billed charges","100% of total billed charges",736.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",356.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2020.41,63,,1616.33,,,0,"percent of total billed charges","63% of total billed charges",490.67,15.3,,392.54,,,0,"percent of total billed charges","15.3% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,2212.83,69,,,,,0,"fee schedule","69% of total billed charges",3207,100,,2565.60,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3207,100,,2565.60,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3207,100,,2565.60,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1532.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352.65,100,,,,,0,"fee schedule",EAPG,449.45,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1209.04,37.7,,967.23,,,0,"percent of total billed charges","37.7% of total billed charges",1209.04,37.7,,967.23,,,0,"percent of total billed charges","37.70% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1087.17,33.9,,869.74,,,0,"percent of total billed charges","33.9% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2501.46,78,,2001.17,,,0,"percent of total billed charges","78% of total billed charges",424.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2648.98,82.6,,2119.18,,,0,"percent of total billed charges","82.6% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2648.98,82.6,,2119.18,,,0,"percent of total billed charges","82.6% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,3207,100,,2565.60,,,0,"percent of total billed charges","100% of total billed charges",256.1,3207,
"NM Bone Marrow Imaging Limited",34178102,CDM,341,RC,78102,CPT,OUTPATIENT,,,1585,1030.25,TC,1394.8,88,,1115.84,,,0,"percent of total billed charges","88% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,1585,100,,1268.00,,,0,"percent of total billed charges","100% of total billed charges",736.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",356.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",998.55,63,,798.84,,,0,"percent of total billed charges","63% of total billed charges",242.51,15.3,,194.01,,,0,"percent of total billed charges","15.3% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,1093.65,69,,,,,0,"fee schedule","69% of total billed charges",1585,100,,1268.00,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1585,100,,1268.00,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1585,100,,1268.00,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1532.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352.65,100,,,,,0,"fee schedule",EAPG,449.45,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",597.55,37.7,,478.04,,,0,"percent of total billed charges","37.7% of total billed charges",597.55,37.7,,478.04,,,0,"percent of total billed charges","37.70% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",537.32,33.9,,429.86,,,0,"percent of total billed charges","33.9% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1236.3,78,,989.04,,,0,"percent of total billed charges","78% of total billed charges",424.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1309.21,82.6,,1047.37,,,0,"percent of total billed charges","82.6% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1309.21,82.6,,1047.37,,,0,"percent of total billed charges","82.6% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,1585,100,,1268.00,,,0,"percent of total billed charges","100% of total billed charges",242.51,1585,
"NM Bone Spect",34178803,CDM,341,RC,78803,CPT,OUTPATIENT,,,3201,2080.65,TC,2816.88,88,,2253.50,,,0,"percent of total billed charges","88% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,3201,100,,2560.80,,,0,"percent of total billed charges","100% of total billed charges",2534.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",894.83,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2016.63,63,,1613.30,,,0,"percent of total billed charges","63% of total billed charges",489.75,15.3,,391.80,,,0,"percent of total billed charges","15.3% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,2208.69,69,,,,,0,"fee schedule","69% of total billed charges",3201,100,,2560.80,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3201,100,,2560.80,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3201,100,,2560.80,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",5305.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1387.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.53,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.14,100,,,,,0,"fee schedule",EAPG,1129.4,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1206.78,37.7,,965.42,,,0,"percent of total billed charges","37.7% of total billed charges",1206.78,37.7,,965.42,,,0,"percent of total billed charges","37.70% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1085.14,33.9,,868.11,,,0,"percent of total billed charges","33.9% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2496.78,78,,1997.42,,,0,"percent of total billed charges","78% of total billed charges",1462.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2644.03,82.6,,2115.22,,,0,"percent of total billed charges","82.6% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2644.03,82.6,,2115.22,,,0,"percent of total billed charges","82.6% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,3201,100,,2560.80,,,0,"percent of total billed charges","100% of total billed charges",489.75,5305.42,
"NM Bone Three Phase Study Injection/Scan",34178315,CDM,341,RC,78315,CPT,OUTPATIENT,,,3055,1985.75,TC,2688.4,88,,2150.72,,,0,"percent of total billed charges","88% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,3055,100,,2444.00,,,0,"percent of total billed charges","100% of total billed charges",736.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",356.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1924.65,63,,1539.72,,,0,"percent of total billed charges","63% of total billed charges",467.42,15.3,,373.94,,,0,"percent of total billed charges","15.3% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,2107.95,69,,,,,0,"fee schedule","69% of total billed charges",3055,100,,2444.00,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3055,100,,2444.00,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3055,100,,2444.00,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1532.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352.65,100,,,,,0,"fee schedule",EAPG,449.45,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1151.74,37.7,,921.39,,,0,"percent of total billed charges","37.7% of total billed charges",1151.74,37.7,,921.39,,,0,"percent of total billed charges","37.70% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.65,33.9,,828.52,,,0,"percent of total billed charges","33.9% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2382.9,78,,1906.32,,,0,"percent of total billed charges","78% of total billed charges",424.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2523.43,82.6,,2018.74,,,0,"percent of total billed charges","82.6% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2523.43,82.6,,2018.74,,,0,"percent of total billed charges","82.6% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,3055,100,,2444.00,,,0,"percent of total billed charges","100% of total billed charges",256.1,3055,
"NM Brain Imaging Vascular Flow Only",34178601,CDM,341,RC,78601,CPT,OUTPATIENT,,,4005,2603.25,TC,3524.4,88,,2819.52,,,0,"percent of total billed charges","88% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,4005,100,,3204.00,,,0,"percent of total billed charges","100% of total billed charges",736.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",356.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2523.15,63,,2018.52,,,0,"percent of total billed charges","63% of total billed charges",612.77,15.3,,490.22,,,0,"percent of total billed charges","15.3% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,2763.45,69,,,,,0,"fee schedule","69% of total billed charges",4005,100,,3204.00,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4005,100,,3204.00,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4005,100,,3204.00,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1532.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352.65,100,,,,,0,"fee schedule",EAPG,449.45,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1509.89,37.7,,1207.91,,,0,"percent of total billed charges","37.7% of total billed charges",1509.89,37.7,,1207.91,,,0,"percent of total billed charges","37.70% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1357.7,33.9,,1086.16,,,0,"percent of total billed charges","33.9% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3123.9,78,,2499.12,,,0,"percent of total billed charges","78% of total billed charges",424.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3308.13,82.6,,2646.50,,,0,"percent of total billed charges","82.6% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3308.13,82.6,,2646.50,,,0,"percent of total billed charges","82.6% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,4005,100,,3204.00,,,0,"percent of total billed charges","100% of total billed charges",256.1,4005,
"NM Brain Spect",34178803,CDM,341,RC,78803,CPT,OUTPATIENT,,,5099,3314.35,TC,4487.12,88,,3589.70,,,0,"percent of total billed charges","88% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",2534.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",894.83,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3212.37,63,,2569.90,,,0,"percent of total billed charges","63% of total billed charges",780.15,15.3,,624.12,,,0,"percent of total billed charges","15.3% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,3518.31,69,,,,,0,"fee schedule","69% of total billed charges",5099,100,,4079.20,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5099,100,,4079.20,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5099,100,,4079.20,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",5305.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1387.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.53,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.14,100,,,,,0,"fee schedule",EAPG,1129.4,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1922.32,37.7,,1537.86,,,0,"percent of total billed charges","37.7% of total billed charges",1922.32,37.7,,1537.86,,,0,"percent of total billed charges","37.70% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1728.56,33.9,,1382.85,,,0,"percent of total billed charges","33.9% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3977.22,78,,3181.78,,,0,"percent of total billed charges","78% of total billed charges",1462.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4211.77,82.6,,3369.42,,,0,"percent of total billed charges","82.6% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4211.77,82.6,,3369.42,,,0,"percent of total billed charges","82.6% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,5099,100,,4079.20,,,0,"percent of total billed charges","100% of total billed charges",643.53,5305.42,
"NM Cardiac MUGA",34178472,CDM,341,RC,78472,CPT,OUTPATIENT,,,2716,1765.4,TC,2390.08,88,,1912.06,,,0,"percent of total billed charges","88% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,2716,100,,2172.80,,,0,"percent of total billed charges","100% of total billed charges",736.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",356.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1711.08,63,,1368.86,,,0,"percent of total billed charges","63% of total billed charges",415.55,15.3,,332.44,,,0,"percent of total billed charges","15.3% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,1874.04,69,,,,,0,"fee schedule","69% of total billed charges",2716,100,,2172.80,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2716,100,,2172.80,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2716,100,,2172.80,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1532.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352.65,100,,,,,0,"fee schedule",EAPG,449.45,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1023.93,37.7,,819.14,,,0,"percent of total billed charges","37.7% of total billed charges",1023.93,37.7,,819.14,,,0,"percent of total billed charges","37.70% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",920.72,33.9,,736.58,,,0,"percent of total billed charges","33.9% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2118.48,78,,1694.78,,,0,"percent of total billed charges","78% of total billed charges",424.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2243.42,82.6,,1794.74,,,0,"percent of total billed charges","82.6% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2243.42,82.6,,1794.74,,,0,"percent of total billed charges","82.6% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,2716,100,,2172.80,,,0,"percent of total billed charges","100% of total billed charges",256.1,2716,
"NM Cerebrospinal Fluid Leakage Detection",34178650,CDM,341,RC,78650,CPT,OUTPATIENT,,,3078,2000.7,TC,2708.64,88,,2166.91,,,0,"percent of total billed charges","88% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,3078,100,,2462.40,,,0,"percent of total billed charges","100% of total billed charges",2534.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",894.83,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1939.14,63,,1551.31,,,0,"percent of total billed charges","63% of total billed charges",470.93,15.3,,376.74,,,0,"percent of total billed charges","15.3% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,2123.82,69,,,,,0,"fee schedule","69% of total billed charges",3078,100,,2462.40,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3078,100,,2462.40,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3078,100,,2462.40,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",5305.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1387.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.53,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.14,100,,,,,0,"fee schedule",EAPG,1129.4,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1160.41,37.7,,928.33,,,0,"percent of total billed charges","37.7% of total billed charges",1160.41,37.7,,928.33,,,0,"percent of total billed charges","37.70% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1043.44,33.9,,834.75,,,0,"percent of total billed charges","33.9% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2400.84,78,,1920.67,,,0,"percent of total billed charges","78% of total billed charges",1462.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2542.43,82.6,,2033.94,,,0,"percent of total billed charges","82.6% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2542.43,82.6,,2033.94,,,0,"percent of total billed charges","82.6% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,3078,100,,2462.40,,,0,"percent of total billed charges","100% of total billed charges",470.93,5305.42,
"NM CT Tumor Loc Multiple Areas Spect",34078832,CDM,340,RC,78832,CPT,OUTPATIENT,,,4900,3185,TC,4312,88,,3449.60,,,0,"percent of total billed charges","88% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",2792.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",894.83,100,,,,,0,"fee schedule",EAPG,1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3087,63,,2469.60,,,0,"percent of total billed charges","63% of total billed charges",749.7,15.3,,599.76,,,0,"percent of total billed charges","15.3% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,3381,69,,,,,0,"fee schedule","69% of total billed charges",4900,100,,3920.00,,,0,"percent of total billed charges","100% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4900,100,,3920.00,,,0,"percent of total billed charges","100% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4900,100,,3920.00,,,0,"percent of total billed charges","100% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",6013.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1572.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.53,100,,,,,0,"fee schedule",EAPG,1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.14,100,,,,,0,"fee schedule",EAPG,1129.4,100,,,,,0,"fee schedule",EAPG,1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1847.3,37.7,,1477.84,,,0,"percent of total billed charges","37.7% of total billed charges",1847.3,37.7,,1477.84,,,0,"percent of total billed charges","37.70% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1661.1,33.9,,1328.88,,,0,"percent of total billed charges","33.9% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3822,78,,3057.60,,,0,"percent of total billed charges","78% of total billed charges",1611.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4047.4,82.6,,3237.92,,,0,"percent of total billed charges","82.6% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4047.4,82.6,,3237.92,,,0,"percent of total billed charges","82.6% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,4900,100,,3920.00,,,0,"percent of total billed charges","100% of total billed charges",643.53,6013.92,
"NM CT Tumor Loc Single Area Spect",34078830,CDM,340,RC,78830,CPT,OUTPATIENT,,,3738,2429.7,TC,3289.44,88,,2631.55,,,0,"percent of total billed charges","88% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,3738,100,,2990.40,,,0,"percent of total billed charges","100% of total billed charges",2534.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",894.83,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2354.94,63,,1883.95,,,0,"percent of total billed charges","63% of total billed charges",571.91,15.3,,457.53,,,0,"percent of total billed charges","15.3% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,2579.22,69,,,,,0,"fee schedule","69% of total billed charges",3738,100,,2990.40,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3738,100,,2990.40,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3738,100,,2990.40,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",5305.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1387.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.53,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.14,100,,,,,0,"fee schedule",EAPG,1129.4,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1409.23,37.7,,1127.38,,,0,"percent of total billed charges","37.7% of total billed charges",1409.23,37.7,,1127.38,,,0,"percent of total billed charges","37.70% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1267.18,33.9,,1013.74,,,0,"percent of total billed charges","33.9% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2915.64,78,,2332.51,,,0,"percent of total billed charges","78% of total billed charges",1462.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3087.59,82.6,,2470.07,,,0,"percent of total billed charges","82.6% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3087.59,82.6,,2470.07,,,0,"percent of total billed charges","82.6% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,3738,100,,2990.40,,,0,"percent of total billed charges","100% of total billed charges",571.91,5305.42,
"NM Gastric Emptying Study",34178264,CDM,341,RC,78264,CPT,OUTPATIENT,,,2964,1926.6,TC,2608.32,88,,2086.66,,,0,"percent of total billed charges","88% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,2964,100,,2371.20,,,0,"percent of total billed charges","100% of total billed charges",736.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",356.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1867.32,63,,1493.86,,,0,"percent of total billed charges","63% of total billed charges",453.49,15.3,,362.79,,,0,"percent of total billed charges","15.3% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,2045.16,69,,,,,0,"fee schedule","69% of total billed charges",2964,100,,2371.20,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2964,100,,2371.20,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2964,100,,2371.20,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1532.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352.65,100,,,,,0,"fee schedule",EAPG,449.45,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1117.43,37.7,,893.94,,,0,"percent of total billed charges","37.7% of total billed charges",1117.43,37.7,,893.94,,,0,"percent of total billed charges","37.70% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1004.8,33.9,,803.84,,,0,"percent of total billed charges","33.9% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2311.92,78,,1849.54,,,0,"percent of total billed charges","78% of total billed charges",424.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2448.26,82.6,,1958.61,,,0,"percent of total billed charges","82.6% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2448.26,82.6,,1958.61,,,0,"percent of total billed charges","82.6% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,2964,100,,2371.20,,,0,"percent of total billed charges","100% of total billed charges",256.1,2964,
"NM Gastroesophageal Reflux Study",34078262,CDM,340,RC,78262,CPT,OUTPATIENT,,,2418,1571.7,TC,2127.84,88,,1702.27,,,0,"percent of total billed charges","88% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,2418,100,,1934.40,,,0,"percent of total billed charges","100% of total billed charges",736.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",356.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1523.34,63,,1218.67,,,0,"percent of total billed charges","63% of total billed charges",369.95,15.3,,295.96,,,0,"percent of total billed charges","15.3% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,1668.42,69,,,,,0,"fee schedule","69% of total billed charges",2418,100,,1934.40,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2418,100,,1934.40,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2418,100,,1934.40,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1532.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352.65,100,,,,,0,"fee schedule",EAPG,449.45,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",911.59,37.7,,729.27,,,0,"percent of total billed charges","37.7% of total billed charges",911.59,37.7,,729.27,,,0,"percent of total billed charges","37.70% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",819.7,33.9,,655.76,,,0,"percent of total billed charges","33.9% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1886.04,78,,1508.83,,,0,"percent of total billed charges","78% of total billed charges",424.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1997.27,82.6,,1597.82,,,0,"percent of total billed charges","82.6% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1997.27,82.6,,1597.82,,,0,"percent of total billed charges","82.6% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,2418,100,,1934.40,,,0,"percent of total billed charges","100% of total billed charges",256.1,2418,
"NM Gastrointestinal Blood Loss Imaging",34178278,CDM,341,RC,78278,CPT,OUTPATIENT,,,3139,2040.35,TC,2762.32,88,,2209.86,,,0,"percent of total billed charges","88% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,3139,100,,2511.20,,,0,"percent of total billed charges","100% of total billed charges",736.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",894.83,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1977.57,63,,1582.06,,,0,"percent of total billed charges","63% of total billed charges",480.27,15.3,,384.22,,,0,"percent of total billed charges","15.3% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,2165.91,69,,,,,0,"fee schedule","69% of total billed charges",3139,100,,2511.20,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3139,100,,2511.20,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3139,100,,2511.20,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1532.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.53,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.14,100,,,,,0,"fee schedule",EAPG,1129.4,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1183.4,37.7,,946.72,,,0,"percent of total billed charges","37.7% of total billed charges",1183.4,37.7,,946.72,,,0,"percent of total billed charges","37.70% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1064.12,33.9,,851.30,,,0,"percent of total billed charges","33.9% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2448.42,78,,1958.74,,,0,"percent of total billed charges","78% of total billed charges",424.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2592.81,82.6,,2074.25,,,0,"percent of total billed charges","82.6% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2592.81,82.6,,2074.25,,,0,"percent of total billed charges","82.6% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,3139,100,,2511.20,,,0,"percent of total billed charges","100% of total billed charges",400.53,3139,
"NM Hepatobiliary Imaging Injection/Scan",34178227,CDM,341,RC,78227,CPT,OUTPATIENT,,,5528,3593.2,TC|26,4864.64,88,,3891.71,,,0,"percent of total billed charges","88% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",964.76,175,,,,,0,"fee schedule","175% of CMS fee schedule",356.1,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3482.64,63,,2786.11,,,0,"percent of total billed charges","63% of total billed charges",845.78,15.3,,676.62,,,0,"percent of total billed charges","15.3% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,3814.32,69,,,,,0,"fee schedule","69% of total billed charges",5528,100,,4422.40,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5528,100,,4422.40,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5528,100,,4422.40,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",1988.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",519.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.1,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352.65,100,,,,,0,"fee schedule",EAPG,449.45,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2084.06,37.7,,1667.25,,,0,"percent of total billed charges","37.7% of total billed charges",2084.06,37.7,,1667.25,,,0,"percent of total billed charges","37.70% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1873.99,33.9,,1499.19,,,0,"percent of total billed charges","33.9% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4311.84,78,,3449.47,,,0,"percent of total billed charges","78% of total billed charges",556.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4566.13,82.6,,3652.90,,,0,"percent of total billed charges","82.6% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4566.13,82.6,,3652.90,,,0,"percent of total billed charges","82.6% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,5528,100,,4422.40,,,0,"percent of total billed charges","100% of total billed charges",256.1,5528,
"NM Hepatobiliary Imaging w/ Drug",34178227,CDM,341,RC,78227,CPT,OUTPATIENT,,,5528,3593.2,TC|26,4864.64,88,,3891.71,,,0,"percent of total billed charges","88% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",964.76,175,,,,,0,"fee schedule","175% of CMS fee schedule",356.1,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3482.64,63,,2786.11,,,0,"percent of total billed charges","63% of total billed charges",845.78,15.3,,676.62,,,0,"percent of total billed charges","15.3% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,3814.32,69,,,,,0,"fee schedule","69% of total billed charges",5528,100,,4422.40,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5528,100,,4422.40,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5528,100,,4422.40,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",1988.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",519.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.1,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352.65,100,,,,,0,"fee schedule",EAPG,449.45,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2084.06,37.7,,1667.25,,,0,"percent of total billed charges","37.7% of total billed charges",2084.06,37.7,,1667.25,,,0,"percent of total billed charges","37.70% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1873.99,33.9,,1499.19,,,0,"percent of total billed charges","33.9% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4311.84,78,,3449.47,,,0,"percent of total billed charges","78% of total billed charges",556.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4566.13,82.6,,3652.90,,,0,"percent of total billed charges","82.6% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4566.13,82.6,,3652.90,,,0,"percent of total billed charges","82.6% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,5528,100,,4422.40,,,0,"percent of total billed charges","100% of total billed charges",256.1,5528,
"NM Intestine Imaging Meckels",34078290,CDM,340,RC,78290,CPT,OUTPATIENT,,,2879,1871.35,TC,2533.52,88,,2026.82,,,0,"percent of total billed charges","88% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,2879,100,,2303.20,,,0,"percent of total billed charges","100% of total billed charges",736.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",356.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1813.77,63,,1451.02,,,0,"percent of total billed charges","63% of total billed charges",440.49,15.3,,352.39,,,0,"percent of total billed charges","15.3% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,1986.51,69,,,,,0,"fee schedule","69% of total billed charges",2879,100,,2303.20,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2879,100,,2303.20,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2879,100,,2303.20,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1532.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352.65,100,,,,,0,"fee schedule",EAPG,449.45,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1085.38,37.7,,868.30,,,0,"percent of total billed charges","37.7% of total billed charges",1085.38,37.7,,868.30,,,0,"percent of total billed charges","37.70% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",975.98,33.9,,780.78,,,0,"percent of total billed charges","33.9% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2245.62,78,,1796.50,,,0,"percent of total billed charges","78% of total billed charges",424.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2378.05,82.6,,1902.44,,,0,"percent of total billed charges","82.6% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2378.05,82.6,,1902.44,,,0,"percent of total billed charges","82.6% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,2879,100,,2303.20,,,0,"percent of total billed charges","100% of total billed charges",256.1,2879,
"NM Kidney Imaging Single w/ Pharm",34078708,CDM,340,RC,78708,CPT,OUTPATIENT,,,3823,2484.95,TC,3364.24,88,,2691.39,,,0,"percent of total billed charges","88% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,3823,100,,3058.40,,,0,"percent of total billed charges","100% of total billed charges",964.76,175,,,,,0,"fee schedule","175% of CMS fee schedule",356.1,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2408.49,63,,1926.79,,,0,"percent of total billed charges","63% of total billed charges",584.92,15.3,,467.94,,,0,"percent of total billed charges","15.3% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,2637.87,69,,,,,0,"fee schedule","69% of total billed charges",3823,100,,3058.40,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3823,100,,3058.40,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3823,100,,3058.40,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",1988.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",519.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.1,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352.65,100,,,,,0,"fee schedule",EAPG,449.45,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1441.27,37.7,,1153.02,,,0,"percent of total billed charges","37.7% of total billed charges",1441.27,37.7,,1153.02,,,0,"percent of total billed charges","37.70% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1296,33.9,,1036.80,,,0,"percent of total billed charges","33.9% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2981.94,78,,2385.55,,,0,"percent of total billed charges","78% of total billed charges",556.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3157.8,82.6,,2526.24,,,0,"percent of total billed charges","82.6% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3157.8,82.6,,2526.24,,,0,"percent of total billed charges","82.6% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,3823,100,,3058.40,,,0,"percent of total billed charges","100% of total billed charges",256.1,3823,
"NM Liver Imaging Spect",34078803,CDM,340,RC,78803,CPT,OUTPATIENT,,,3738,2429.7,TC,3289.44,88,,2631.55,,,0,"percent of total billed charges","88% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,3738,100,,2990.40,,,0,"percent of total billed charges","100% of total billed charges",2534.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",894.83,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2354.94,63,,1883.95,,,0,"percent of total billed charges","63% of total billed charges",571.91,15.3,,457.53,,,0,"percent of total billed charges","15.3% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,2579.22,69,,,,,0,"fee schedule","69% of total billed charges",3738,100,,2990.40,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3738,100,,2990.40,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3738,100,,2990.40,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",5305.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1387.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.53,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.14,100,,,,,0,"fee schedule",EAPG,1129.4,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1409.23,37.7,,1127.38,,,0,"percent of total billed charges","37.7% of total billed charges",1409.23,37.7,,1127.38,,,0,"percent of total billed charges","37.70% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1267.18,33.9,,1013.74,,,0,"percent of total billed charges","33.9% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2915.64,78,,2332.51,,,0,"percent of total billed charges","78% of total billed charges",1462.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3087.59,82.6,,2470.07,,,0,"percent of total billed charges","82.6% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3087.59,82.6,,2470.07,,,0,"percent of total billed charges","82.6% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,3738,100,,2990.40,,,0,"percent of total billed charges","100% of total billed charges",571.91,5305.42,
"NM Liver Imaging Static",34178201,CDM,341,RC,78201,CPT,OUTPATIENT,,,3297,2143.05,TC,2901.36,88,,2321.09,,,0,"percent of total billed charges","88% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,3297,100,,2637.60,,,0,"percent of total billed charges","100% of total billed charges",964.76,175,,,,,0,"fee schedule","175% of CMS fee schedule",894.83,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2077.11,63,,1661.69,,,0,"percent of total billed charges","63% of total billed charges",504.44,15.3,,403.55,,,0,"percent of total billed charges","15.3% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,2274.93,69,,,,,0,"fee schedule","69% of total billed charges",3297,100,,2637.60,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3297,100,,2637.60,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3297,100,,2637.60,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",1988.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",519.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.53,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.14,100,,,,,0,"fee schedule",EAPG,1129.4,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1242.97,37.7,,994.38,,,0,"percent of total billed charges","37.7% of total billed charges",1242.97,37.7,,994.38,,,0,"percent of total billed charges","37.70% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1117.68,33.9,,894.14,,,0,"percent of total billed charges","33.9% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2571.66,78,,2057.33,,,0,"percent of total billed charges","78% of total billed charges",556.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2723.32,82.6,,2178.66,,,0,"percent of total billed charges","82.6% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2723.32,82.6,,2178.66,,,0,"percent of total billed charges","82.6% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,3297,100,,2637.60,,,0,"percent of total billed charges","100% of total billed charges",504.44,3297,
"NM Lymphoscintigraphy",34178195,CDM,341,RC,78195,CPT,OUTPATIENT,,,1713,1113.45,TC,1507.44,88,,1205.95,,,0,"percent of total billed charges","88% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,1713,100,,1370.40,,,0,"percent of total billed charges","100% of total billed charges",964.76,175,,,,,0,"fee schedule","175% of CMS fee schedule",894.83,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1079.19,63,,863.35,,,0,"percent of total billed charges","63% of total billed charges",262.09,15.3,,209.67,,,0,"percent of total billed charges","15.3% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,1181.97,69,,,,,0,"fee schedule","69% of total billed charges",1713,100,,1370.40,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1713,100,,1370.40,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1713,100,,1370.40,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",1988.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",519.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.53,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.14,100,,,,,0,"fee schedule",EAPG,1129.4,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",645.8,37.7,,516.64,,,0,"percent of total billed charges","37.7% of total billed charges",645.8,37.7,,516.64,,,0,"percent of total billed charges","37.70% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",580.71,33.9,,464.57,,,0,"percent of total billed charges","33.9% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1336.14,78,,1068.91,,,0,"percent of total billed charges","78% of total billed charges",556.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1414.94,82.6,,1131.95,,,0,"percent of total billed charges","82.6% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1414.94,82.6,,1131.95,,,0,"percent of total billed charges","82.6% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,1713,100,,1370.40,,,0,"percent of total billed charges","100% of total billed charges",262.09,1988.19,
"NM Lung Perfusion Imaging",34078580,CDM,340,RC,78580,CPT,OUTPATIENT,,,702,456.3,TC,617.76,88,,494.21,,,0,"percent of total billed charges","88% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,702,100,,561.60,,,0,"percent of total billed charges","100% of total billed charges",736.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",894.83,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",442.26,63,,353.81,,,0,"percent of total billed charges","63% of total billed charges",107.41,15.3,,85.93,,,0,"percent of total billed charges","15.3% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,484.38,69,,,,,0,"fee schedule","69% of total billed charges",702,100,,561.60,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",702,100,,561.60,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",702,100,,561.60,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1532.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.53,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.14,100,,,,,0,"fee schedule",EAPG,1129.4,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",264.65,37.7,,211.72,,,0,"percent of total billed charges","37.7% of total billed charges",264.65,37.7,,211.72,,,0,"percent of total billed charges","37.70% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",237.98,33.9,,190.38,,,0,"percent of total billed charges","33.9% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",547.56,78,,438.05,,,0,"percent of total billed charges","78% of total billed charges",424.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579.85,82.6,,463.88,,,0,"percent of total billed charges","82.6% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579.85,82.6,,463.88,,,0,"percent of total billed charges","82.6% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,702,100,,561.60,,,0,"percent of total billed charges","100% of total billed charges",107.41,1532.05,
"NM Lung Perfusion Differential Imaging",34178597,CDM,341,RC,78597,CPT,OUTPATIENT,,,4765,3097.25,TC,4193.2,88,,3354.56,,,0,"percent of total billed charges","88% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",736.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",894.83,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3001.95,63,,2401.56,,,0,"percent of total billed charges","63% of total billed charges",729.05,15.3,,583.24,,,0,"percent of total billed charges","15.3% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,3287.85,69,,,,,0,"fee schedule","69% of total billed charges",4765,100,,3812.00,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4765,100,,3812.00,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4765,100,,3812.00,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1532.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.53,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.14,100,,,,,0,"fee schedule",EAPG,1129.4,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1796.41,37.7,,1437.13,,,0,"percent of total billed charges","37.7% of total billed charges",1796.41,37.7,,1437.13,,,0,"percent of total billed charges","37.70% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1615.34,33.9,,1292.27,,,0,"percent of total billed charges","33.9% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3716.7,78,,2973.36,,,0,"percent of total billed charges","78% of total billed charges",424.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3935.89,82.6,,3148.71,,,0,"percent of total billed charges","82.6% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3935.89,82.6,,3148.71,,,0,"percent of total billed charges","82.6% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,4765,100,,3812.00,,,0,"percent of total billed charges","100% of total billed charges",400.53,4765,
"NM Lung Vent/Perf Differential Imaging",34178598,CDM,341,RC,78598,CPT,OUTPATIENT,,,5824,3785.6,TC,5125.12,88,,4100.10,,,0,"percent of total billed charges","88% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",964.76,175,,,,,0,"fee schedule","175% of CMS fee schedule",894.83,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3669.12,63,,2935.30,,,0,"percent of total billed charges","63% of total billed charges",891.07,15.3,,712.86,,,0,"percent of total billed charges","15.3% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,4018.56,69,,,,,0,"fee schedule","69% of total billed charges",5824,100,,4659.20,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5824,100,,4659.20,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5824,100,,4659.20,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",1988.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",519.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.53,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.14,100,,,,,0,"fee schedule",EAPG,1129.4,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2195.65,37.7,,1756.52,,,0,"percent of total billed charges","37.7% of total billed charges",2195.65,37.7,,1756.52,,,0,"percent of total billed charges","37.70% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1974.34,33.9,,1579.47,,,0,"percent of total billed charges","33.9% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4542.72,78,,3634.18,,,0,"percent of total billed charges","78% of total billed charges",556.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4810.62,82.6,,3848.50,,,0,"percent of total billed charges","82.6% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4810.62,82.6,,3848.50,,,0,"percent of total billed charges","82.6% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,5824,100,,4659.20,,,0,"percent of total billed charges","100% of total billed charges",519.79,5824,
"NM Lung Vent/Perf Imaging",34178582,CDM,341,RC,78582,CPT,OUTPATIENT,,,5294,3441.1,TC,4658.72,88,,3726.98,,,0,"percent of total billed charges","88% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",964.76,175,,,,,0,"fee schedule","175% of CMS fee schedule",894.83,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3335.22,63,,2668.18,,,0,"percent of total billed charges","63% of total billed charges",809.98,15.3,,647.98,,,0,"percent of total billed charges","15.3% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,3652.86,69,,,,,0,"fee schedule","69% of total billed charges",5294,100,,4235.20,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5294,100,,4235.20,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5294,100,,4235.20,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",1988.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",519.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.53,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.14,100,,,,,0,"fee schedule",EAPG,1129.4,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1995.84,37.7,,1596.67,,,0,"percent of total billed charges","37.7% of total billed charges",1995.84,37.7,,1596.67,,,0,"percent of total billed charges","37.70% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1794.67,33.9,,1435.74,,,0,"percent of total billed charges","33.9% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4129.32,78,,3303.46,,,0,"percent of total billed charges","78% of total billed charges",556.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4372.84,82.6,,3498.27,,,0,"percent of total billed charges","82.6% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4372.84,82.6,,3498.27,,,0,"percent of total billed charges","82.6% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,5294,100,,4235.20,,,0,"percent of total billed charges","100% of total billed charges",519.79,5294,
"NM Myocardial SPECT Rest and Stress",34178452,CDM,340,RC,78452,CPT,OUTPATIENT,,,5947,3865.55,TC,5233.36,88,,4186.69,,,0,"percent of total billed charges","88% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",2534.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",894.83,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3746.61,63,,2997.29,,,0,"percent of total billed charges","63% of total billed charges",909.89,15.3,,727.91,,,0,"percent of total billed charges","15.3% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,4103.43,69,,,,,0,"fee schedule","69% of total billed charges",5947,100,,4757.60,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5947,100,,4757.60,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5947,100,,4757.60,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",5305.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1387.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.53,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.14,100,,,,,0,"fee schedule",EAPG,1129.4,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2242.02,37.7,,1793.62,,,0,"percent of total billed charges","37.7% of total billed charges",2242.02,37.7,,1793.62,,,0,"percent of total billed charges","37.70% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2016.03,33.9,,1612.82,,,0,"percent of total billed charges","33.9% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4638.66,78,,3710.93,,,0,"percent of total billed charges","78% of total billed charges",1462.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4912.22,82.6,,3929.78,,,0,"percent of total billed charges","82.6% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4912.22,82.6,,3929.78,,,0,"percent of total billed charges","82.6% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,5947,100,,4757.60,,,0,"percent of total billed charges","100% of total billed charges",643.53,5947,
"NM Myocardial Planar Single Study",34178481,CDM,340,RC,78481,CPT,OUTPATIENT,,,2612,1697.8,TC,2298.56,88,,1838.85,,,0,"percent of total billed charges","88% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,2612,100,,2089.60,,,0,"percent of total billed charges","100% of total billed charges",964.76,175,,,,,0,"fee schedule","175% of CMS fee schedule",356.1,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.56,63,,1316.45,,,0,"percent of total billed charges","63% of total billed charges",399.64,15.3,,319.71,,,0,"percent of total billed charges","15.3% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,1802.28,69,,,,,0,"fee schedule","69% of total billed charges",2612,100,,2089.60,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2612,100,,2089.60,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2612,100,,2089.60,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",1988.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",519.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.1,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352.65,100,,,,,0,"fee schedule",EAPG,449.45,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",984.72,37.7,,787.78,,,0,"percent of total billed charges","37.7% of total billed charges",984.72,37.7,,787.78,,,0,"percent of total billed charges","37.70% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",885.47,33.9,,708.38,,,0,"percent of total billed charges","33.9% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2037.36,78,,1629.89,,,0,"percent of total billed charges","78% of total billed charges",556.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2157.51,82.6,,1726.01,,,0,"percent of total billed charges","82.6% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2157.51,82.6,,1726.01,,,0,"percent of total billed charges","82.6% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,2612,100,,2089.60,,,0,"percent of total billed charges","100% of total billed charges",256.1,2612,
"NM Myocardial SPECT Single Study",34178451,CDM,340,RC,78451,CPT,OUTPATIENT,,,5078,3300.7,TC,4468.64,88,,3574.91,,,0,"percent of total billed charges","88% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",2534.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",894.83,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3199.14,63,,2559.31,,,0,"percent of total billed charges","63% of total billed charges",776.93,15.3,,621.54,,,0,"percent of total billed charges","15.3% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,3503.82,69,,,,,0,"fee schedule","69% of total billed charges",5078,100,,4062.40,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5078,100,,4062.40,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5078,100,,4062.40,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",5305.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1387.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.53,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.14,100,,,,,0,"fee schedule",EAPG,1129.4,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1914.41,37.7,,1531.53,,,0,"percent of total billed charges","37.7% of total billed charges",1914.41,37.7,,1531.53,,,0,"percent of total billed charges","37.70% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1721.44,33.9,,1377.15,,,0,"percent of total billed charges","33.9% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3960.84,78,,3168.67,,,0,"percent of total billed charges","78% of total billed charges",1462.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4194.43,82.6,,3355.54,,,0,"percent of total billed charges","82.6% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4194.43,82.6,,3355.54,,,0,"percent of total billed charges","82.6% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,5078,100,,4062.40,,,0,"percent of total billed charges","100% of total billed charges",643.53,5305.42,
"NM Parathyroid Imaging Injection/Scan",34178070,CDM,341,RC,78070,CPT,OUTPATIENT,,,2648,1721.2,TC,2330.24,88,,1864.19,,,0,"percent of total billed charges","88% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,2648,100,,2118.40,,,0,"percent of total billed charges","100% of total billed charges",736.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",894.83,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1668.24,63,,1334.59,,,0,"percent of total billed charges","63% of total billed charges",405.14,15.3,,324.11,,,0,"percent of total billed charges","15.3% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,1827.12,69,,,,,0,"fee schedule","69% of total billed charges",2648,100,,2118.40,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2648,100,,2118.40,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2648,100,,2118.40,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1532.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.53,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.14,100,,,,,0,"fee schedule",EAPG,1129.4,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",998.3,37.7,,798.64,,,0,"percent of total billed charges","37.7% of total billed charges",998.3,37.7,,798.64,,,0,"percent of total billed charges","37.70% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",897.67,33.9,,718.14,,,0,"percent of total billed charges","33.9% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2065.44,78,,1652.35,,,0,"percent of total billed charges","78% of total billed charges",424.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2187.25,82.6,,1749.80,,,0,"percent of total billed charges","82.6% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2187.25,82.6,,1749.80,,,0,"percent of total billed charges","82.6% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,2648,100,,2118.40,,,0,"percent of total billed charges","100% of total billed charges",400.53,2648,
"NM Parathyroid Imaging w/ Spect Inj/Scan",34078071,CDM,340,RC,78071,CPT,OUTPATIENT,,,2009,1305.85,TC,1767.92,88,,1414.34,,,0,"percent of total billed charges","88% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,2009,100,,1607.20,,,0,"percent of total billed charges","100% of total billed charges",736.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",356.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1265.67,63,,1012.54,,,0,"percent of total billed charges","63% of total billed charges",307.38,15.3,,245.90,,,0,"percent of total billed charges","15.3% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,1386.21,69,,,,,0,"fee schedule","69% of total billed charges",2009,100,,1607.20,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2009,100,,1607.20,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2009,100,,1607.20,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1532.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352.65,100,,,,,0,"fee schedule",EAPG,449.45,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",757.39,37.7,,605.91,,,0,"percent of total billed charges","37.7% of total billed charges",757.39,37.7,,605.91,,,0,"percent of total billed charges","37.70% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",681.05,33.9,,544.84,,,0,"percent of total billed charges","33.9% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1567.02,78,,1253.62,,,0,"percent of total billed charges","78% of total billed charges",424.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1659.43,82.6,,1327.54,,,0,"percent of total billed charges","82.6% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1659.43,82.6,,1327.54,,,0,"percent of total billed charges","82.6% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,2009,100,,1607.20,,,0,"percent of total billed charges","100% of total billed charges",256.1,2009,
"NM Placement Interstitial Device/Marker",33377778,CDM,333,RC,77778,CPT,OUTPATIENT,,,11253,7314.45,TC,9902.64,88,,7922.11,,,0,"percent of total billed charges","88% of total billed charges",731.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1299.09,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",1279.75,175,,,,,0,"fee schedule","175% of CMS fee schedule",1338.06,100,,,,,0,"fee schedule",EAPG,731.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7089.39,63,,5671.51,,,0,"percent of total billed charges","63% of total billed charges",1721.71,15.3,,1377.37,,,0,"percent of total billed charges","15.3% of total billed charges",1299.09,100,,,,,0,"fee schedule",EAPG,7764.57,69,,,,,0,"fee schedule","69% of total billed charges",11253,100,,9002.40,,,0,"percent of total billed charges","100% of total billed charges",731.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11253,100,,9002.40,,,0,"percent of total billed charges","100% of total billed charges",731.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11253,100,,9002.40,,,0,"percent of total billed charges","100% of total billed charges",731.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",2878.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1299.09,100,,,,,0,"fee schedule",EAPG,731.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",752.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",962.29,100,,,,,0,"fee schedule",EAPG,731.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1325.07,100,,,,,0,"fee schedule",EAPG,1688.81,100,,,,,0,"fee schedule",EAPG,731.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4242.38,37.7,,3393.90,,,0,"percent of total billed charges","37.7% of total billed charges",4242.38,37.7,,3393.90,,,0,"percent of total billed charges","37.70% of total billed charges",731.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3814.77,33.9,,3051.82,,,0,"percent of total billed charges","33.9% of total billed charges",731.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8777.34,78,,7021.87,,,0,"percent of total billed charges","78% of total billed charges",738.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9294.98,82.6,,7435.98,,,0,"percent of total billed charges","82.6% of total billed charges",1299.09,100,,,,,0,"fee schedule",EAPG,731.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9294.98,82.6,,7435.98,,,0,"percent of total billed charges","82.6% of total billed charges",731.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1299.09,100,,,,,0,"fee schedule",EAPG,11253,100,,9002.40,,,0,"percent of total billed charges","100% of total billed charges",731.28,11253,
"NM Radiopharm Therapy IV Admin",34279101,CDM,342,RC,79101,CPT,OUTPATIENT,,,1897,1233.05,TC,1669.36,88,,1335.49,,,0,"percent of total billed charges","88% of total billed charges",253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",281.42,100,,,,,0,"fee schedule",EAPG,1897,100,,1517.60,,,0,"percent of total billed charges","100% of total billed charges",444.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",289.87,100,,,,,0,"fee schedule",EAPG,253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1195.11,63,,956.09,,,0,"percent of total billed charges","63% of total billed charges",290.24,15.3,,232.19,,,0,"percent of total billed charges","15.3% of total billed charges",281.42,100,,,,,0,"fee schedule",EAPG,1308.93,69,,,,,0,"fee schedule","69% of total billed charges",1897,100,,1517.60,,,0,"percent of total billed charges","100% of total billed charges",253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1897,100,,1517.60,,,0,"percent of total billed charges","100% of total billed charges",253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1897,100,,1517.60,,,0,"percent of total billed charges","100% of total billed charges",253.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",1014.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",281.42,100,,,,,0,"fee schedule",EAPG,253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",208.46,100,,,,,0,"fee schedule",EAPG,253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287.05,100,,,,,0,"fee schedule",EAPG,365.85,100,,,,,0,"fee schedule",EAPG,253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",715.17,37.7,,572.14,,,0,"percent of total billed charges","37.7% of total billed charges",715.17,37.7,,572.14,,,0,"percent of total billed charges","37.70% of total billed charges",253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.08,33.9,,514.46,,,0,"percent of total billed charges","33.9% of total billed charges",253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1479.66,78,,1183.73,,,0,"percent of total billed charges","78% of total billed charges",256.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1566.92,82.6,,1253.54,,,0,"percent of total billed charges","82.6% of total billed charges",281.42,100,,,,,0,"fee schedule",EAPG,253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1566.92,82.6,,1253.54,,,0,"percent of total billed charges","82.6% of total billed charges",253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",281.42,100,,,,,0,"fee schedule",EAPG,1897,100,,1517.60,,,0,"percent of total billed charges","100% of total billed charges",208.46,1897,
"NM Radiopharm Therapy Oral Admin",34079005,CDM,340,RC,79005,CPT,OUTPATIENT,,,1827,1187.55,TC,1607.76,88,,1286.21,,,0,"percent of total billed charges","88% of total billed charges",253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",281.42,100,,,,,0,"fee schedule",EAPG,1827,100,,1461.60,,,0,"percent of total billed charges","100% of total billed charges",444.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",289.87,100,,,,,0,"fee schedule",EAPG,253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1151.01,63,,920.81,,,0,"percent of total billed charges","63% of total billed charges",279.53,15.3,,223.62,,,0,"percent of total billed charges","15.3% of total billed charges",281.42,100,,,,,0,"fee schedule",EAPG,1260.63,69,,,,,0,"fee schedule","69% of total billed charges",1827,100,,1461.60,,,0,"percent of total billed charges","100% of total billed charges",253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1827,100,,1461.60,,,0,"percent of total billed charges","100% of total billed charges",253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1827,100,,1461.60,,,0,"percent of total billed charges","100% of total billed charges",253.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",1014.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",281.42,100,,,,,0,"fee schedule",EAPG,253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",208.46,100,,,,,0,"fee schedule",EAPG,253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287.05,100,,,,,0,"fee schedule",EAPG,365.85,100,,,,,0,"fee schedule",EAPG,253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",688.78,37.7,,551.02,,,0,"percent of total billed charges","37.7% of total billed charges",688.78,37.7,,551.02,,,0,"percent of total billed charges","37.70% of total billed charges",253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",619.35,33.9,,495.48,,,0,"percent of total billed charges","33.9% of total billed charges",253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1425.06,78,,1140.05,,,0,"percent of total billed charges","78% of total billed charges",256.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1509.1,82.6,,1207.28,,,0,"percent of total billed charges","82.6% of total billed charges",281.42,100,,,,,0,"fee schedule",EAPG,253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1509.1,82.6,,1207.28,,,0,"percent of total billed charges","82.6% of total billed charges",253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",281.42,100,,,,,0,"fee schedule",EAPG,1827,100,,1461.60,,,0,"percent of total billed charges","100% of total billed charges",208.46,1827,
"NM Radiopharm Therapy Oral Admin EO",34079005,CDM,340,RC,79005,CPT,OUTPATIENT,,,1827,1187.55,TC,1607.76,88,,1286.21,,,0,"percent of total billed charges","88% of total billed charges",253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",281.42,100,,,,,0,"fee schedule",EAPG,1827,100,,1461.60,,,0,"percent of total billed charges","100% of total billed charges",444.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",289.87,100,,,,,0,"fee schedule",EAPG,253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1151.01,63,,920.81,,,0,"percent of total billed charges","63% of total billed charges",279.53,15.3,,223.62,,,0,"percent of total billed charges","15.3% of total billed charges",281.42,100,,,,,0,"fee schedule",EAPG,1260.63,69,,,,,0,"fee schedule","69% of total billed charges",1827,100,,1461.60,,,0,"percent of total billed charges","100% of total billed charges",253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1827,100,,1461.60,,,0,"percent of total billed charges","100% of total billed charges",253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1827,100,,1461.60,,,0,"percent of total billed charges","100% of total billed charges",253.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",1014.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",281.42,100,,,,,0,"fee schedule",EAPG,253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",208.46,100,,,,,0,"fee schedule",EAPG,253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287.05,100,,,,,0,"fee schedule",EAPG,365.85,100,,,,,0,"fee schedule",EAPG,253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",688.78,37.7,,551.02,,,0,"percent of total billed charges","37.7% of total billed charges",688.78,37.7,,551.02,,,0,"percent of total billed charges","37.70% of total billed charges",253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",619.35,33.9,,495.48,,,0,"percent of total billed charges","33.9% of total billed charges",253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1425.06,78,,1140.05,,,0,"percent of total billed charges","78% of total billed charges",256.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1509.1,82.6,,1207.28,,,0,"percent of total billed charges","82.6% of total billed charges",281.42,100,,,,,0,"fee schedule",EAPG,253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1509.1,82.6,,1207.28,,,0,"percent of total billed charges","82.6% of total billed charges",253.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",281.42,100,,,,,0,"fee schedule",EAPG,1827,100,,1461.60,,,0,"percent of total billed charges","100% of total billed charges",208.46,1827,
"NM Shunt Evaluation CSF",34178645,CDM,341,RC,78645,CPT,OUTPATIENT,,,2446,1589.9,TC,2152.48,88,,1721.98,,,0,"percent of total billed charges","88% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,2446,100,,1956.80,,,0,"percent of total billed charges","100% of total billed charges",964.76,175,,,,,0,"fee schedule","175% of CMS fee schedule",894.83,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1540.98,63,,1232.78,,,0,"percent of total billed charges","63% of total billed charges",374.24,15.3,,299.39,,,0,"percent of total billed charges","15.3% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,1687.74,69,,,,,0,"fee schedule","69% of total billed charges",2446,100,,1956.80,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2446,100,,1956.80,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2446,100,,1956.80,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",1988.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",519.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.53,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.14,100,,,,,0,"fee schedule",EAPG,1129.4,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",922.14,37.7,,737.71,,,0,"percent of total billed charges","37.7% of total billed charges",922.14,37.7,,737.71,,,0,"percent of total billed charges","37.70% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",829.19,33.9,,663.35,,,0,"percent of total billed charges","33.9% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1907.88,78,,1526.30,,,0,"percent of total billed charges","78% of total billed charges",556.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2020.4,82.6,,1616.32,,,0,"percent of total billed charges","82.6% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2020.4,82.6,,1616.32,,,0,"percent of total billed charges","82.6% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,2446,100,,1956.80,,,0,"percent of total billed charges","100% of total billed charges",374.24,2446,
"NM Sentinel Node",34178195,CDM,341,RC,78195,CPT,OUTPATIENT,,,1713,1113.45,TC,1507.44,88,,1205.95,,,0,"percent of total billed charges","88% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,1713,100,,1370.40,,,0,"percent of total billed charges","100% of total billed charges",964.76,175,,,,,0,"fee schedule","175% of CMS fee schedule",894.83,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1079.19,63,,863.35,,,0,"percent of total billed charges","63% of total billed charges",262.09,15.3,,209.67,,,0,"percent of total billed charges","15.3% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,1181.97,69,,,,,0,"fee schedule","69% of total billed charges",1713,100,,1370.40,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1713,100,,1370.40,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1713,100,,1370.40,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",1988.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",519.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.53,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.14,100,,,,,0,"fee schedule",EAPG,1129.4,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",645.8,37.7,,516.64,,,0,"percent of total billed charges","37.7% of total billed charges",645.8,37.7,,516.64,,,0,"percent of total billed charges","37.70% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",580.71,33.9,,464.57,,,0,"percent of total billed charges","33.9% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1336.14,78,,1068.91,,,0,"percent of total billed charges","78% of total billed charges",556.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1414.94,82.6,,1131.95,,,0,"percent of total billed charges","82.6% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1414.94,82.6,,1131.95,,,0,"percent of total billed charges","82.6% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,1713,100,,1370.40,,,0,"percent of total billed charges","100% of total billed charges",262.09,1988.19,
"NM Spleen Img w/ or w/o Vascular Flow",34178185,CDM,341,RC,78185,CPT,OUTPATIENT,,,1673,1087.45,TC,1472.24,88,,1177.79,,,0,"percent of total billed charges","88% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,1673,100,,1338.40,,,0,"percent of total billed charges","100% of total billed charges",736.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",356.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1053.99,63,,843.19,,,0,"percent of total billed charges","63% of total billed charges",255.97,15.3,,204.78,,,0,"percent of total billed charges","15.3% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,1154.37,69,,,,,0,"fee schedule","69% of total billed charges",1673,100,,1338.40,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1673,100,,1338.40,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1673,100,,1338.40,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1532.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352.65,100,,,,,0,"fee schedule",EAPG,449.45,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",630.72,37.7,,504.58,,,0,"percent of total billed charges","37.7% of total billed charges",630.72,37.7,,504.58,,,0,"percent of total billed charges","37.70% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",567.15,33.9,,453.72,,,0,"percent of total billed charges","33.9% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1304.94,78,,1043.95,,,0,"percent of total billed charges","78% of total billed charges",424.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1381.9,82.6,,1105.52,,,0,"percent of total billed charges","82.6% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1381.9,82.6,,1105.52,,,0,"percent of total billed charges","82.6% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,1673,100,,1338.40,,,0,"percent of total billed charges","100% of total billed charges",255.97,1673,
"NM Thyroid Cancer Imaging Whole Body",34178018,CDM,341,RC,78018,CPT,OUTPATIENT,,,3881,2522.65,TC,3415.28,88,,2732.22,,,0,"percent of total billed charges","88% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,3881,100,,3104.80,,,0,"percent of total billed charges","100% of total billed charges",964.76,175,,,,,0,"fee schedule","175% of CMS fee schedule",356.1,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2445.03,63,,1956.02,,,0,"percent of total billed charges","63% of total billed charges",593.79,15.3,,475.03,,,0,"percent of total billed charges","15.3% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,2677.89,69,,,,,0,"fee schedule","69% of total billed charges",3881,100,,3104.80,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3881,100,,3104.80,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3881,100,,3104.80,,,0,"percent of total billed charges","100% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",1988.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",519.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.1,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352.65,100,,,,,0,"fee schedule",EAPG,449.45,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1463.14,37.7,,1170.51,,,0,"percent of total billed charges","37.7% of total billed charges",1463.14,37.7,,1170.51,,,0,"percent of total billed charges","37.70% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1315.66,33.9,,1052.53,,,0,"percent of total billed charges","33.9% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3027.18,78,,2421.74,,,0,"percent of total billed charges","78% of total billed charges",556.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3205.71,82.6,,2564.57,,,0,"percent of total billed charges","82.6% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3205.71,82.6,,2564.57,,,0,"percent of total billed charges","82.6% of total billed charges",551.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,3881,100,,3104.80,,,0,"percent of total billed charges","100% of total billed charges",256.1,3881,
"NM Tumor Loc Spect",34178803,CDM,341,RC,78803,CPT,OUTPATIENT,,,6020,3913,TC,5297.6,88,,4238.08,,,0,"percent of total billed charges","88% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",2534.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",894.83,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3792.6,63,,3034.08,,,0,"percent of total billed charges","63% of total billed charges",921.06,15.3,,736.85,,,0,"percent of total billed charges","15.3% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,4153.8,69,,,,,0,"fee schedule","69% of total billed charges",6020,100,,4816.00,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6020,100,,4816.00,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6020,100,,4816.00,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",5305.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1387.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.53,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.14,100,,,,,0,"fee schedule",EAPG,1129.4,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2269.54,37.7,,1815.63,,,0,"percent of total billed charges","37.7% of total billed charges",2269.54,37.7,,1815.63,,,0,"percent of total billed charges","37.70% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2040.78,33.9,,1632.62,,,0,"percent of total billed charges","33.9% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4695.6,78,,3756.48,,,0,"percent of total billed charges","78% of total billed charges",1462.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4972.52,82.6,,3978.02,,,0,"percent of total billed charges","82.6% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4972.52,82.6,,3978.02,,,0,"percent of total billed charges","82.6% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,6020,100,,4816.00,,,0,"percent of total billed charges","100% of total billed charges",643.53,6020,
"NM Tumor Loc Limited",34178800,CDM,341,RC,78800,CPT,OUTPATIENT,,,4023,2614.95,TC,3540.24,88,,2832.19,,,0,"percent of total billed charges","88% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,4023,100,,3218.40,,,0,"percent of total billed charges","100% of total billed charges",736.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",894.83,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2534.49,63,,2027.59,,,0,"percent of total billed charges","63% of total billed charges",615.52,15.3,,492.42,,,0,"percent of total billed charges","15.3% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,2775.87,69,,,,,0,"fee schedule","69% of total billed charges",4023,100,,3218.40,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4023,100,,3218.40,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4023,100,,3218.40,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1532.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.53,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.14,100,,,,,0,"fee schedule",EAPG,1129.4,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1516.67,37.7,,1213.34,,,0,"percent of total billed charges","37.7% of total billed charges",1516.67,37.7,,1213.34,,,0,"percent of total billed charges","37.70% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1363.8,33.9,,1091.04,,,0,"percent of total billed charges","33.9% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3137.94,78,,2510.35,,,0,"percent of total billed charges","78% of total billed charges",424.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3323,82.6,,2658.40,,,0,"percent of total billed charges","82.6% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3323,82.6,,2658.40,,,0,"percent of total billed charges","82.6% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,4023,100,,3218.40,,,0,"percent of total billed charges","100% of total billed charges",400.53,4023,
"NM Tumor Loc Multiple Areas",34178801,CDM,341,RC,78801,CPT,OUTPATIENT,,,4660,3029,TC,4100.8,88,,3280.64,,,0,"percent of total billed charges","88% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,4660,100,,3728.00,,,0,"percent of total billed charges","100% of total billed charges",736.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",894.83,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2935.8,63,,2348.64,,,0,"percent of total billed charges","63% of total billed charges",712.98,15.3,,570.38,,,0,"percent of total billed charges","15.3% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,3215.4,69,,,,,0,"fee schedule","69% of total billed charges",4660,100,,3728.00,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4660,100,,3728.00,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4660,100,,3728.00,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1532.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.53,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.14,100,,,,,0,"fee schedule",EAPG,1129.4,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1756.82,37.7,,1405.46,,,0,"percent of total billed charges","37.7% of total billed charges",1756.82,37.7,,1405.46,,,0,"percent of total billed charges","37.70% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1579.74,33.9,,1263.79,,,0,"percent of total billed charges","33.9% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3634.8,78,,2907.84,,,0,"percent of total billed charges","78% of total billed charges",424.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3849.16,82.6,,3079.33,,,0,"percent of total billed charges","82.6% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3849.16,82.6,,3079.33,,,0,"percent of total billed charges","82.6% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,4660,100,,3728.00,,,0,"percent of total billed charges","100% of total billed charges",400.53,4660,
"NM Tumor Loc Whole Body 1 Day",34178802,CDM,341,RC,78802,CPT,OUTPATIENT,,,4900,3185,TC,4312,88,,3449.60,,,0,"percent of total billed charges","88% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",2534.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",894.83,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3087,63,,2469.60,,,0,"percent of total billed charges","63% of total billed charges",749.7,15.3,,599.76,,,0,"percent of total billed charges","15.3% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,3381,69,,,,,0,"fee schedule","69% of total billed charges",4900,100,,3920.00,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4900,100,,3920.00,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4900,100,,3920.00,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",5305.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1387.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.53,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.14,100,,,,,0,"fee schedule",EAPG,1129.4,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1847.3,37.7,,1477.84,,,0,"percent of total billed charges","37.7% of total billed charges",1847.3,37.7,,1477.84,,,0,"percent of total billed charges","37.70% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1661.1,33.9,,1328.88,,,0,"percent of total billed charges","33.9% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3822,78,,3057.60,,,0,"percent of total billed charges","78% of total billed charges",1462.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4047.4,82.6,,3237.92,,,0,"percent of total billed charges","82.6% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4047.4,82.6,,3237.92,,,0,"percent of total billed charges","82.6% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,4900,100,,3920.00,,,0,"percent of total billed charges","100% of total billed charges",643.53,5305.42,
"NM Tumor Loc Whole Body 2+ Days",34178804,CDM,341,RC,78804,CPT,OUTPATIENT,,,18662,12130.3,TC,16422.56,88,,13138.05,,,0,"percent of total billed charges","88% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",2534.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",894.83,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11757.06,63,,9405.65,,,0,"percent of total billed charges","63% of total billed charges",2855.29,15.3,,2284.23,,,0,"percent of total billed charges","15.3% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,12876.78,69,,,,,0,"fee schedule","69% of total billed charges",18662,100,,14929.60,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18662,100,,14929.60,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18662,100,,14929.60,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",5305.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1387.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.53,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.14,100,,,,,0,"fee schedule",EAPG,1129.4,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7035.57,37.7,,5628.46,,,0,"percent of total billed charges","37.7% of total billed charges",7035.57,37.7,,5628.46,,,0,"percent of total billed charges","37.70% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6326.42,33.9,,5061.14,,,0,"percent of total billed charges","33.9% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14556.36,78,,11645.09,,,0,"percent of total billed charges","78% of total billed charges",1462.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15414.81,82.6,,12331.85,,,0,"percent of total billed charges","82.6% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15414.81,82.6,,12331.85,,,0,"percent of total billed charges","82.6% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,18662,100,,14929.60,,,0,"percent of total billed charges","100% of total billed charges",643.53,18662,
"NM Thyroid Imaging",34078013,CDM,340,RC,78013,CPT,OUTPATIENT,,,4387,2851.55,TC,3860.56,88,,3088.45,,,0,"percent of total billed charges","88% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,4387,100,,3509.60,,,0,"percent of total billed charges","100% of total billed charges",736.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",356.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2763.81,63,,2211.05,,,0,"percent of total billed charges","63% of total billed charges",671.21,15.3,,536.97,,,0,"percent of total billed charges","15.3% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,3027.03,69,,,,,0,"fee schedule","69% of total billed charges",4387,100,,3509.60,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4387,100,,3509.60,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4387,100,,3509.60,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1532.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352.65,100,,,,,0,"fee schedule",EAPG,449.45,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1653.9,37.7,,1323.12,,,0,"percent of total billed charges","37.7% of total billed charges",1653.9,37.7,,1323.12,,,0,"percent of total billed charges","37.70% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1487.19,33.9,,1189.75,,,0,"percent of total billed charges","33.9% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3421.86,78,,2737.49,,,0,"percent of total billed charges","78% of total billed charges",424.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3623.66,82.6,,2898.93,,,0,"percent of total billed charges","82.6% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3623.66,82.6,,2898.93,,,0,"percent of total billed charges","82.6% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,4387,100,,3509.60,,,0,"percent of total billed charges","100% of total billed charges",256.1,4387,
"NM Thyroid Uptake Single/Multi",34178014,CDM,341,RC,78014,CPT,OUTPATIENT,,,4860,3159,TC,4276.8,88,,3421.44,,,0,"percent of total billed charges","88% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",736.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",356.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3061.8,63,,2449.44,,,0,"percent of total billed charges","63% of total billed charges",743.58,15.3,,594.86,,,0,"percent of total billed charges","15.3% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,3353.4,69,,,,,0,"fee schedule","69% of total billed charges",4860,100,,3888.00,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4860,100,,3888.00,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4860,100,,3888.00,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1532.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352.65,100,,,,,0,"fee schedule",EAPG,449.45,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1832.22,37.7,,1465.78,,,0,"percent of total billed charges","37.7% of total billed charges",1832.22,37.7,,1465.78,,,0,"percent of total billed charges","37.70% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1647.54,33.9,,1318.03,,,0,"percent of total billed charges","33.9% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3790.8,78,,3032.64,,,0,"percent of total billed charges","78% of total billed charges",424.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4014.36,82.6,,3211.49,,,0,"percent of total billed charges","82.6% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4014.36,82.6,,3211.49,,,0,"percent of total billed charges","82.6% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,4860,100,,3888.00,,,0,"percent of total billed charges","100% of total billed charges",256.1,4860,
"NM Thyroid Image w/Uptk Sng/Mlt Scan",34178012,CDM,341,RC,78012,CPT,OUTPATIENT,,,1458,947.7,TC,1283.04,88,,1026.43,,,0,"percent of total billed charges","88% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,1458,100,,1166.40,,,0,"percent of total billed charges","100% of total billed charges",736.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",356.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",918.54,63,,734.83,,,0,"percent of total billed charges","63% of total billed charges",223.07,15.3,,178.46,,,0,"percent of total billed charges","15.3% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,1006.02,69,,,,,0,"fee schedule","69% of total billed charges",1458,100,,1166.40,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1458,100,,1166.40,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1458,100,,1166.40,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1532.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352.65,100,,,,,0,"fee schedule",EAPG,449.45,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",549.67,37.7,,439.74,,,0,"percent of total billed charges","37.7% of total billed charges",549.67,37.7,,439.74,,,0,"percent of total billed charges","37.70% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",494.26,33.9,,395.41,,,0,"percent of total billed charges","33.9% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1137.24,78,,909.79,,,0,"percent of total billed charges","78% of total billed charges",424.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1204.31,82.6,,963.45,,,0,"percent of total billed charges","82.6% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1204.31,82.6,,963.45,,,0,"percent of total billed charges","82.6% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,1458,100,,1166.40,,,0,"percent of total billed charges","100% of total billed charges",223.07,1532.05,
"NM Tumor Loc Multiple Areas Spect",34078831,CDM,340,RC,78831,CPT,OUTPATIENT,,,4660,3029,TC,4100.8,88,,3280.64,,,0,"percent of total billed charges","88% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,4660,100,,3728.00,,,0,"percent of total billed charges","100% of total billed charges",2534.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",894.83,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2935.8,63,,2348.64,,,0,"percent of total billed charges","63% of total billed charges",712.98,15.3,,570.38,,,0,"percent of total billed charges","15.3% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,3215.4,69,,,,,0,"fee schedule","69% of total billed charges",4660,100,,3728.00,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4660,100,,3728.00,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4660,100,,3728.00,,,0,"percent of total billed charges","100% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS fee schedule",5305.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1387.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.53,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.14,100,,,,,0,"fee schedule",EAPG,1129.4,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1756.82,37.7,,1405.46,,,0,"percent of total billed charges","37.7% of total billed charges",1756.82,37.7,,1405.46,,,0,"percent of total billed charges","37.70% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1579.74,33.9,,1263.79,,,0,"percent of total billed charges","33.9% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3634.8,78,,2907.84,,,0,"percent of total billed charges","78% of total billed charges",1462.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3849.16,82.6,,3079.33,,,0,"percent of total billed charges","82.6% of total billed charges",868.77,100,,,,,0,"fee schedule",EAPG,1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3849.16,82.6,,3079.33,,,0,"percent of total billed charges","82.6% of total billed charges",1448.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,100,,,,,0,"fee schedule",EAPG,4660,100,,3728.00,,,0,"percent of total billed charges","100% of total billed charges",643.53,5305.42,
"PET Brain Imaging Metabolic Evaluation",40478608,CDM,404,RC,78608,CPT,OUTPATIENT,,,7557,4912.05,TC,6650.16,88,,5320.13,,,0,"percent of total billed charges","88% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1179.63,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",2792.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",1215.02,100,,,,,0,"fee schedule",EAPG,1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4760.91,63,,3808.73,,,0,"percent of total billed charges","63% of total billed charges",1156.22,15.3,,924.98,,,0,"percent of total billed charges","15.3% of total billed charges",1179.63,100,,,,,0,"fee schedule",EAPG,5214.33,69,,,,,0,"fee schedule","69% of total billed charges",7557,100,,6045.60,,,0,"percent of total billed charges","100% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7557,100,,6045.60,,,0,"percent of total billed charges","100% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7557,100,,6045.60,,,0,"percent of total billed charges","100% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",6013.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1179.63,100,,,,,0,"fee schedule",EAPG,1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1572.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.8,100,,,,,0,"fee schedule",EAPG,1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1203.22,100,,,,,0,"fee schedule",EAPG,1533.52,100,,,,,0,"fee schedule",EAPG,1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2848.99,37.7,,2279.19,,,0,"percent of total billed charges","37.7% of total billed charges",2848.99,37.7,,2279.19,,,0,"percent of total billed charges","37.70% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2561.82,33.9,,2049.46,,,0,"percent of total billed charges","33.9% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5894.46,78,,4715.57,,,0,"percent of total billed charges","78% of total billed charges",1611.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6242.08,82.6,,4993.66,,,0,"percent of total billed charges","82.6% of total billed charges",1179.63,100,,,,,0,"fee schedule",EAPG,1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6242.08,82.6,,4993.66,,,0,"percent of total billed charges","82.6% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1179.63,100,,,,,0,"fee schedule",EAPG,7557,100,,6045.60,,,0,"percent of total billed charges","100% of total billed charges",873.8,7557,
"PET CT Limited Area",40478814,CDM,404,RC,78814,CPT,OUTPATIENT,,,658,427.7,TC,579.04,88,,463.23,,,0,"percent of total billed charges","88% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1179.63,100,,,,,0,"fee schedule",EAPG,658,100,,526.40,,,0,"percent of total billed charges","100% of total billed charges",2792.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",1215.02,100,,,,,0,"fee schedule",EAPG,1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",414.54,63,,331.63,,,0,"percent of total billed charges","63% of total billed charges",100.67,15.3,,80.54,,,0,"percent of total billed charges","15.3% of total billed charges",1179.63,100,,,,,0,"fee schedule",EAPG,454.02,69,,,,,0,"fee schedule","69% of total billed charges",658,100,,526.40,,,0,"percent of total billed charges","100% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658,100,,526.40,,,0,"percent of total billed charges","100% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658,100,,526.40,,,0,"percent of total billed charges","100% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",6013.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1179.63,100,,,,,0,"fee schedule",EAPG,1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1572.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.8,100,,,,,0,"fee schedule",EAPG,1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1203.22,100,,,,,0,"fee schedule",EAPG,1533.52,100,,,,,0,"fee schedule",EAPG,1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",248.07,37.7,,198.46,,,0,"percent of total billed charges","37.7% of total billed charges",248.07,37.7,,198.46,,,0,"percent of total billed charges","37.70% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",223.06,33.9,,178.45,,,0,"percent of total billed charges","33.9% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",513.24,78,,410.59,,,0,"percent of total billed charges","78% of total billed charges",1611.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",543.51,82.6,,434.81,,,0,"percent of total billed charges","82.6% of total billed charges",1179.63,100,,,,,0,"fee schedule",EAPG,1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",543.51,82.6,,434.81,,,0,"percent of total billed charges","82.6% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1179.63,100,,,,,0,"fee schedule",EAPG,658,100,,526.40,,,0,"percent of total billed charges","100% of total billed charges",100.67,6013.92,
"PET CT Skull Base to Midthigh",40478815,CDM,404,RC,78815,CPT,OUTPATIENT,,,7693,5000.45,TC,6769.84,88,,5415.87,,,0,"percent of total billed charges","88% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1179.63,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",2792.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",1215.02,100,,,,,0,"fee schedule",EAPG,1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4846.59,63,,3877.27,,,0,"percent of total billed charges","63% of total billed charges",1177.03,15.3,,941.62,,,0,"percent of total billed charges","15.3% of total billed charges",1179.63,100,,,,,0,"fee schedule",EAPG,5308.17,69,,,,,0,"fee schedule","69% of total billed charges",7693,100,,6154.40,,,0,"percent of total billed charges","100% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7693,100,,6154.40,,,0,"percent of total billed charges","100% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7693,100,,6154.40,,,0,"percent of total billed charges","100% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",6013.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1179.63,100,,,,,0,"fee schedule",EAPG,1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1572.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.8,100,,,,,0,"fee schedule",EAPG,1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1203.22,100,,,,,0,"fee schedule",EAPG,1533.52,100,,,,,0,"fee schedule",EAPG,1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2900.26,37.7,,2320.21,,,0,"percent of total billed charges","37.7% of total billed charges",2900.26,37.7,,2320.21,,,0,"percent of total billed charges","37.70% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2607.93,33.9,,2086.34,,,0,"percent of total billed charges","33.9% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6000.54,78,,4800.43,,,0,"percent of total billed charges","78% of total billed charges",1611.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6354.42,82.6,,5083.54,,,0,"percent of total billed charges","82.6% of total billed charges",1179.63,100,,,,,0,"fee schedule",EAPG,1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6354.42,82.6,,5083.54,,,0,"percent of total billed charges","82.6% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1179.63,100,,,,,0,"fee schedule",EAPG,7693,100,,6154.40,,,0,"percent of total billed charges","100% of total billed charges",873.8,7693,
"PET CT Whole Body",40478816,CDM,404,RC,78816,CPT,OUTPATIENT,,,9897,6433.05,TC,8709.36,88,,6967.49,,,0,"percent of total billed charges","88% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1179.63,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",2792.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",1215.02,100,,,,,0,"fee schedule",EAPG,1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6235.11,63,,4988.09,,,0,"percent of total billed charges","63% of total billed charges",1514.24,15.3,,1211.39,,,0,"percent of total billed charges","15.3% of total billed charges",1179.63,100,,,,,0,"fee schedule",EAPG,6828.93,69,,,,,0,"fee schedule","69% of total billed charges",9897,100,,7917.60,,,0,"percent of total billed charges","100% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9897,100,,7917.60,,,0,"percent of total billed charges","100% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9897,100,,7917.60,,,0,"percent of total billed charges","100% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",6013.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1179.63,100,,,,,0,"fee schedule",EAPG,1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1572.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.8,100,,,,,0,"fee schedule",EAPG,1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1203.22,100,,,,,0,"fee schedule",EAPG,1533.52,100,,,,,0,"fee schedule",EAPG,1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3731.17,37.7,,2984.94,,,0,"percent of total billed charges","37.7% of total billed charges",3731.17,37.7,,2984.94,,,0,"percent of total billed charges","37.70% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3355.08,33.9,,2684.06,,,0,"percent of total billed charges","33.9% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7719.66,78,,6175.73,,,0,"percent of total billed charges","78% of total billed charges",1611.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8174.92,82.6,,6539.94,,,0,"percent of total billed charges","82.6% of total billed charges",1179.63,100,,,,,0,"fee schedule",EAPG,1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8174.92,82.6,,6539.94,,,0,"percent of total billed charges","82.6% of total billed charges",1595.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1179.63,100,,,,,0,"fee schedule",EAPG,9897,100,,7917.60,,,0,"percent of total billed charges","100% of total billed charges",873.8,9897,
"US Abdomen Complete",40276700,CDM,402,RC,76700,CPT,OUTPATIENT,,,1152,748.8,TC,1013.76,88,,811.01,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,1152,100,,921.60,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",155.82,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",725.76,63,,580.61,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",151.28,100,,,,,0,"fee schedule",EAPG,794.88,69,,,,,0,"fee schedule","69% of total billed charges",1152,100,,921.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1152,100,,921.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1152,100,,921.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",112.06,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.31,100,,,,,0,"fee schedule",EAPG,196.67,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",434.3,37.7,,347.44,,,0,"percent of total billed charges","37.7% of total billed charges",434.3,37.7,,347.44,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.53,33.9,,312.42,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",898.56,78,,718.85,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",951.55,82.6,,761.24,,,0,"percent of total billed charges","82.6% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",951.55,82.6,,761.24,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,1152,100,,921.60,,,0,"percent of total billed charges","100% of total billed charges",112.06,1152,
"US Abdomen Limited",40276705,CDM,402,RC,76705,CPT,OUTPATIENT,,,594,386.1,TC,522.72,88,,418.18,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,594,100,,475.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",374.22,63,,299.38,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,409.86,69,,,,,0,"fee schedule","69% of total billed charges",594,100,,475.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",594,100,,475.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",594,100,,475.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",223.94,37.7,,179.15,,,0,"percent of total billed charges","37.7% of total billed charges",223.94,37.7,,179.15,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",201.37,33.9,,161.10,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",463.32,78,,370.66,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",490.64,82.6,,392.51,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",490.64,82.6,,392.51,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,594,100,,475.20,,,0,"percent of total billed charges","100% of total billed charges",73.81,594,
"US Aorta IVC Iliac Duplex Complete",92193978,CDM,921,RC,93978,CPT,OUTPATIENT,,,774,503.1,TC,681.12,88,,544.90,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,774,100,,619.20,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",155.82,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",487.62,63,,390.10,,,0,"percent of total billed charges","63% of total billed charges",118.42,15.3,,94.74,,,0,"percent of total billed charges","15.3% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,534.06,69,,,,,0,"fee schedule","69% of total billed charges",774,100,,619.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",774,100,,619.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",774,100,,619.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",112.06,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.31,100,,,,,0,"fee schedule",EAPG,196.67,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",291.8,37.7,,233.44,,,0,"percent of total billed charges","37.7% of total billed charges",291.8,37.7,,233.44,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",262.39,33.9,,209.91,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",603.72,78,,482.98,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",639.32,82.6,,511.46,,,0,"percent of total billed charges","82.6% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",639.32,82.6,,511.46,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,774,100,,619.20,,,0,"percent of total billed charges","100% of total billed charges",112.06,934.9,
"US Aorta IVC Iliac Duplex Limited",92193979,CDM,921,RC,93979,CPT,OUTPATIENT,,,1075,698.75,TC,946,88,,756.80,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,1075,100,,860.00,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",677.25,63,,541.80,,,0,"percent of total billed charges","63% of total billed charges",164.48,15.3,,131.58,,,0,"percent of total billed charges","15.3% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,741.75,69,,,,,0,"fee schedule","69% of total billed charges",1075,100,,860.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1075,100,,860.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1075,100,,860.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",405.28,37.7,,324.22,,,0,"percent of total billed charges","37.7% of total billed charges",405.28,37.7,,324.22,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",364.43,33.9,,291.54,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",838.5,78,,670.80,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",887.95,82.6,,710.36,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",887.95,82.6,,710.36,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,1075,100,,860.00,,,0,"percent of total billed charges","100% of total billed charges",73.81,1075,
"US Art/Vein Abd/Pelvis/Scrotal Complete",92193975,CDM,921,RC,93975,CPT,OUTPATIENT,,,911,592.15,TC,801.68,88,,641.34,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,911,100,,728.80,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",155.82,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",573.93,63,,459.14,,,0,"percent of total billed charges","63% of total billed charges",139.38,15.3,,111.50,,,0,"percent of total billed charges","15.3% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,628.59,69,,,,,0,"fee schedule","69% of total billed charges",911,100,,728.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",911,100,,728.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",911,100,,728.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",112.06,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.31,100,,,,,0,"fee schedule",EAPG,196.67,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",343.45,37.7,,274.76,,,0,"percent of total billed charges","37.7% of total billed charges",343.45,37.7,,274.76,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",308.83,33.9,,247.06,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",710.58,78,,568.46,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",752.49,82.6,,601.99,,,0,"percent of total billed charges","82.6% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",752.49,82.6,,601.99,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,911,100,,728.80,,,0,"percent of total billed charges","100% of total billed charges",112.06,934.9,
"US Art/Vein Abd/Pelvis/Scrotal Limited",92193976,CDM,921,RC,93976,CPT,OUTPATIENT,,,774,503.1,TC,681.12,88,,544.90,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,774,100,,619.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",155.82,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",487.62,63,,390.10,,,0,"percent of total billed charges","63% of total billed charges",118.42,15.3,,94.74,,,0,"percent of total billed charges","15.3% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,534.06,69,,,,,0,"fee schedule","69% of total billed charges",774,100,,619.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",774,100,,619.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",774,100,,619.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",112.06,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.31,100,,,,,0,"fee schedule",EAPG,196.67,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",291.8,37.7,,233.44,,,0,"percent of total billed charges","37.7% of total billed charges",291.8,37.7,,233.44,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",262.39,33.9,,209.91,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",603.72,78,,482.98,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",639.32,82.6,,511.46,,,0,"percent of total billed charges","82.6% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",639.32,82.6,,511.46,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,774,100,,619.20,,,0,"percent of total billed charges","100% of total billed charges",112.06,774,
"US AAA Screening",40276706,CDM,402,RC,76706,CPT,OUTPATIENT,,,1403,911.95,TC,1234.64,88,,987.71,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,1403,100,,1122.40,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",883.89,63,,707.11,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,968.07,69,,,,,0,"fee schedule","69% of total billed charges",1403,100,,1122.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1403,100,,1122.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1403,100,,1122.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",528.93,37.7,,423.14,,,0,"percent of total billed charges","37.7% of total billed charges",528.93,37.7,,423.14,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",475.62,33.9,,380.50,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1094.34,78,,875.47,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1158.88,82.6,,927.10,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1158.88,82.6,,927.10,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,1403,100,,1122.40,,,0,"percent of total billed charges","100% of total billed charges",73.81,1403,
"US Axilla",40276882,CDM,402,RC,76882,CPT,OUTPATIENT,,,445,289.25,TC,391.6,88,,313.28,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,445,100,,356.00,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.35,63,,224.28,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,307.05,69,,,,,0,"fee schedule","69% of total billed charges",445,100,,356.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",445,100,,356.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",445,100,,356.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",167.77,37.7,,134.22,,,0,"percent of total billed charges","37.7% of total billed charges",167.77,37.7,,134.22,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.86,33.9,,120.69,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",347.1,78,,277.68,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.57,82.6,,294.06,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.57,82.6,,294.06,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,445,100,,356.00,,,0,"percent of total billed charges","100% of total billed charges",73.81,445,
"US Biopsy Renal Left",40250200,CDM,402,RC,50200,CPT,OUTPATIENT,,,1613,1048.45,TC|LT,1419.44,88,,1135.55,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1359.89,100,,,,,0,"fee schedule",EAPG,1613,100,,1290.40,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1400.69,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1016.19,63,,812.95,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",1359.89,100,,,,,0,"fee schedule",EAPG,1112.97,69,,,,,0,"fee schedule","69% of total billed charges",1613,100,,1290.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1613,100,,1290.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1613,100,,1290.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1359.89,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1007.32,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1387.09,100,,,,,0,"fee schedule",EAPG,1767.86,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",608.1,37.7,,486.48,,,0,"percent of total billed charges","37.7% of total billed charges",608.1,37.7,,486.48,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",546.81,33.9,,437.45,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1258.14,78,,1006.51,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1332.34,82.6,,1065.87,,,0,"percent of total billed charges","82.6% of total billed charges",1359.89,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1332.34,82.6,,1065.87,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1359.89,100,,,,,0,"fee schedule",EAPG,1613,100,,1290.40,,,0,"percent of total billed charges","100% of total billed charges",235,5715.97,
"US Biopsy Renal Right",40250200,CDM,402,RC,50200,CPT,OUTPATIENT,,,1613,1048.45,TC|LT,1419.44,88,,1135.55,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1359.89,100,,,,,0,"fee schedule",EAPG,1613,100,,1290.40,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1400.69,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1016.19,63,,812.95,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",1359.89,100,,,,,0,"fee schedule",EAPG,1112.97,69,,,,,0,"fee schedule","69% of total billed charges",1613,100,,1290.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1613,100,,1290.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1613,100,,1290.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1359.89,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1007.32,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1387.09,100,,,,,0,"fee schedule",EAPG,1767.86,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",608.1,37.7,,486.48,,,0,"percent of total billed charges","37.7% of total billed charges",608.1,37.7,,486.48,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",546.81,33.9,,437.45,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1258.14,78,,1006.51,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1332.34,82.6,,1065.87,,,0,"percent of total billed charges","82.6% of total billed charges",1359.89,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1332.34,82.6,,1065.87,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1359.89,100,,,,,0,"fee schedule",EAPG,1613,100,,1290.40,,,0,"percent of total billed charges","100% of total billed charges",235,5715.97,
"US Breast Complete Left",40276641,CDM,402,RC,76641,CPT,OUTPATIENT,,,718,466.7,TC|LT,631.84,88,,505.47,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",452.34,63,,361.87,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,495.42,69,,,,,0,"fee schedule","69% of total billed charges",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.69,37.7,,216.55,,,0,"percent of total billed charges","37.7% of total billed charges",270.69,37.7,,216.55,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",243.4,33.9,,194.72,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.04,78,,448.03,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.07,82.6,,474.46,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.07,82.6,,474.46,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",73.81,718,
"US Breast Complete Right",40276641,CDM,402,RC,76641,CPT,OUTPATIENT,,,718,466.7,TC|LT,631.84,88,,505.47,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",452.34,63,,361.87,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,495.42,69,,,,,0,"fee schedule","69% of total billed charges",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.69,37.7,,216.55,,,0,"percent of total billed charges","37.7% of total billed charges",270.69,37.7,,216.55,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",243.4,33.9,,194.72,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.04,78,,448.03,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.07,82.6,,474.46,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.07,82.6,,474.46,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",73.81,718,
"US Breast Limited Left",40276642,CDM,402,RC,76642,CPT,OUTPATIENT,,,718,466.7,TC|LT,631.84,88,,505.47,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",452.34,63,,361.87,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,495.42,69,,,,,0,"fee schedule","69% of total billed charges",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.69,37.7,,216.55,,,0,"percent of total billed charges","37.7% of total billed charges",270.69,37.7,,216.55,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",243.4,33.9,,194.72,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.04,78,,448.03,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.07,82.6,,474.46,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.07,82.6,,474.46,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",73.81,718,
"US Breast Limited Right",40276642,CDM,402,RC,76642,CPT,OUTPATIENT,,,718,466.7,TC|LT,631.84,88,,505.47,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",452.34,63,,361.87,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,495.42,69,,,,,0,"fee schedule","69% of total billed charges",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.69,37.7,,216.55,,,0,"percent of total billed charges","37.7% of total billed charges",270.69,37.7,,216.55,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",243.4,33.9,,194.72,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.04,78,,448.03,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.07,82.6,,474.46,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.07,82.6,,474.46,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",73.81,718,
"US Breast Complete Left.",40276641,CDM,402,RC,76641,CPT,OUTPATIENT,,,718,466.7,TC|LT,631.84,88,,505.47,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",452.34,63,,361.87,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,495.42,69,,,,,0,"fee schedule","69% of total billed charges",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.69,37.7,,216.55,,,0,"percent of total billed charges","37.7% of total billed charges",270.69,37.7,,216.55,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",243.4,33.9,,194.72,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.04,78,,448.03,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.07,82.6,,474.46,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.07,82.6,,474.46,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",73.81,718,
"US Breast Complete Right.",40276641,CDM,402,RC,76641,CPT,OUTPATIENT,,,718,466.7,TC|LT,631.84,88,,505.47,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",452.34,63,,361.87,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,495.42,69,,,,,0,"fee schedule","69% of total billed charges",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.69,37.7,,216.55,,,0,"percent of total billed charges","37.7% of total billed charges",270.69,37.7,,216.55,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",243.4,33.9,,194.72,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.04,78,,448.03,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.07,82.6,,474.46,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.07,82.6,,474.46,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",73.81,718,
"US Breast Limited Left.",40276641,CDM,402,RC,76641,CPT,OUTPATIENT,,,718,466.7,TC|LT,631.84,88,,505.47,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",452.34,63,,361.87,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,495.42,69,,,,,0,"fee schedule","69% of total billed charges",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.69,37.7,,216.55,,,0,"percent of total billed charges","37.7% of total billed charges",270.69,37.7,,216.55,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",243.4,33.9,,194.72,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.04,78,,448.03,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.07,82.6,,474.46,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.07,82.6,,474.46,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",73.81,718,
"US Breast Limited",40276641,CDM,402,RC,76641,CPT,OUTPATIENT,,,718,466.7,TC|LT,631.84,88,,505.47,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",452.34,63,,361.87,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,495.42,69,,,,,0,"fee schedule","69% of total billed charges",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.69,37.7,,216.55,,,0,"percent of total billed charges","37.7% of total billed charges",270.69,37.7,,216.55,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",243.4,33.9,,194.72,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.04,78,,448.03,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.07,82.6,,474.46,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.07,82.6,,474.46,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",73.81,718,
"US Breast Complete Left w/ BIRAD.",40276641,CDM,402,RC,76641,CPT,OUTPATIENT,,,718,466.7,TC|LT,631.84,88,,505.47,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",452.34,63,,361.87,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,495.42,69,,,,,0,"fee schedule","69% of total billed charges",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.69,37.7,,216.55,,,0,"percent of total billed charges","37.7% of total billed charges",270.69,37.7,,216.55,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",243.4,33.9,,194.72,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.04,78,,448.03,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.07,82.6,,474.46,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.07,82.6,,474.46,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",73.81,718,
"US Breast Complete Right w/ BIRAD.",40276641,CDM,402,RC,76641,CPT,OUTPATIENT,,,718,466.7,TC|LT,631.84,88,,505.47,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",452.34,63,,361.87,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,495.42,69,,,,,0,"fee schedule","69% of total billed charges",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.69,37.7,,216.55,,,0,"percent of total billed charges","37.7% of total billed charges",270.69,37.7,,216.55,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",243.4,33.9,,194.72,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.04,78,,448.03,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.07,82.6,,474.46,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.07,82.6,,474.46,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",73.81,718,
"US Breast Limited Left w/ BIRAD.",40276642,CDM,402,RC,76642,CPT,OUTPATIENT,,,718,466.7,TC|LT,631.84,88,,505.47,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",452.34,63,,361.87,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,495.42,69,,,,,0,"fee schedule","69% of total billed charges",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.69,37.7,,216.55,,,0,"percent of total billed charges","37.7% of total billed charges",270.69,37.7,,216.55,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",243.4,33.9,,194.72,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.04,78,,448.03,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.07,82.6,,474.46,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.07,82.6,,474.46,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",73.81,718,
"US Breast Limited Right w/ BIRAD.",40276642,CDM,402,RC,76642,CPT,OUTPATIENT,,,718,466.7,TC|LT,631.84,88,,505.47,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",452.34,63,,361.87,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,495.42,69,,,,,0,"fee schedule","69% of total billed charges",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.69,37.7,,216.55,,,0,"percent of total billed charges","37.7% of total billed charges",270.69,37.7,,216.55,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",243.4,33.9,,194.72,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.04,78,,448.03,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.07,82.6,,474.46,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.07,82.6,,474.46,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",73.81,718,
"US Breast Complete Bilat.",40276641,CDM,402,RC,76641,CPT,OUTPATIENT,,,2029,1318.85,TC|LT,1785.52,88,,1428.42,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,2029,100,,1623.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1278.27,63,,1022.62,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,1400.01,69,,,,,0,"fee schedule","69% of total billed charges",2029,100,,1623.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2029,100,,1623.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2029,100,,1623.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",764.93,37.7,,611.94,,,0,"percent of total billed charges","37.7% of total billed charges",764.93,37.7,,611.94,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",687.83,33.9,,550.26,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1582.62,78,,1266.10,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1675.95,82.6,,1340.76,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1675.95,82.6,,1340.76,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,2029,100,,1623.20,,,0,"percent of total billed charges","100% of total billed charges",73.81,2029,
"US Breast Limited Bilat",40276642,CDM,402,RC,76642,CPT,OUTPATIENT,,,1469,954.85,TC|LT,1292.72,88,,1034.18,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,1469,100,,1175.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",925.47,63,,740.38,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,1013.61,69,,,,,0,"fee schedule","69% of total billed charges",1469,100,,1175.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1469,100,,1175.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1469,100,,1175.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",553.81,37.7,,443.05,,,0,"percent of total billed charges","37.7% of total billed charges",553.81,37.7,,443.05,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.99,33.9,,398.39,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1145.82,78,,916.66,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1213.39,82.6,,970.71,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1213.39,82.6,,970.71,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,1469,100,,1175.20,,,0,"percent of total billed charges","100% of total billed charges",73.81,1469,
"US Carotid Duplex Bilateral",92193880,CDM,921,RC,93880,CPT,OUTPATIENT,,,1507,979.55,TC,1326.16,88,,1060.93,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,1507,100,,1205.60,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",155.82,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",949.41,63,,759.53,,,0,"percent of total billed charges","63% of total billed charges",230.57,15.3,,184.46,,,0,"percent of total billed charges","15.3% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,1039.83,69,,,,,0,"fee schedule","69% of total billed charges",1507,100,,1205.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1507,100,,1205.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1507,100,,1205.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",112.06,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.31,100,,,,,0,"fee schedule",EAPG,196.67,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.14,37.7,,454.51,,,0,"percent of total billed charges","37.7% of total billed charges",568.14,37.7,,454.51,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510.87,33.9,,408.70,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1175.46,78,,940.37,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1244.78,82.6,,995.82,,,0,"percent of total billed charges","82.6% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1244.78,82.6,,995.82,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,1507,100,,1205.60,,,0,"percent of total billed charges","100% of total billed charges",112.06,1507,
"US Chest",40276604,CDM,402,RC,76604,CPT,OUTPATIENT,,,595,386.75,TC,523.6,88,,418.88,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,595,100,,476.00,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",374.85,63,,299.88,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,410.55,69,,,,,0,"fee schedule","69% of total billed charges",595,100,,476.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",595,100,,476.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",595,100,,476.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.32,37.7,,179.46,,,0,"percent of total billed charges","37.7% of total billed charges",224.32,37.7,,179.46,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",201.71,33.9,,161.37,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",464.1,78,,371.28,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",491.47,82.6,,393.18,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",491.47,82.6,,393.18,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,595,100,,476.00,,,0,"percent of total billed charges","100% of total billed charges",73.81,595,
"US Carotid Duplex Unilat/Limited",92193882,CDM,921,RC,93882,CPT,OUTPATIENT,,,1341,871.65,TC,1180.08,88,,944.06,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,1341,100,,1072.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.83,63,,675.86,,,0,"percent of total billed charges","63% of total billed charges",205.17,15.3,,164.14,,,0,"percent of total billed charges","15.3% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,925.29,69,,,,,0,"fee schedule","69% of total billed charges",1341,100,,1072.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1341,100,,1072.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1341,100,,1072.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",505.56,37.7,,404.45,,,0,"percent of total billed charges","37.7% of total billed charges",505.56,37.7,,404.45,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",454.6,33.9,,363.68,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.98,78,,836.78,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1107.67,82.6,,886.14,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1107.67,82.6,,886.14,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,1341,100,,1072.80,,,0,"percent of total billed charges","100% of total billed charges",73.81,1341,
"US Duplex Hemodialysis Access",92193990,CDM,921,RC,93990,CPT,OUTPATIENT,,,1270,825.5,TC,1117.6,88,,894.08,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,1270,100,,1016.00,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",800.1,63,,640.08,,,0,"percent of total billed charges","63% of total billed charges",194.31,15.3,,155.45,,,0,"percent of total billed charges","15.3% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,876.3,69,,,,,0,"fee schedule","69% of total billed charges",1270,100,,1016.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1270,100,,1016.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1270,100,,1016.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",478.79,37.7,,383.03,,,0,"percent of total billed charges","37.7% of total billed charges",478.79,37.7,,383.03,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",430.53,33.9,,344.42,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",990.6,78,,792.48,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1049.02,82.6,,839.22,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1049.02,82.6,,839.22,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,1270,100,,1016.00,,,0,"percent of total billed charges","100% of total billed charges",73.81,1270,
"US Encephalogram",40276506,CDM,402,RC,76506,CPT,OUTPATIENT,,,843,547.95,TC,741.84,88,,593.47,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,843,100,,674.40,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",531.09,63,,424.87,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,581.67,69,,,,,0,"fee schedule","69% of total billed charges",843,100,,674.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",843,100,,674.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",843,100,,674.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",317.81,37.7,,254.25,,,0,"percent of total billed charges","37.7% of total billed charges",317.81,37.7,,254.25,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",285.78,33.9,,228.62,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",657.54,78,,526.03,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",696.32,82.6,,557.06,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",696.32,82.6,,557.06,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,843,100,,674.40,,,0,"percent of total billed charges","100% of total billed charges",73.81,843,
"US Extremity Nonvascular Limited Left",40276882,CDM,402,RC,76882,CPT,OUTPATIENT,,,445,289.25,TC,391.6,88,,313.28,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,445,100,,356.00,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.35,63,,224.28,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,307.05,69,,,,,0,"fee schedule","69% of total billed charges",445,100,,356.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",445,100,,356.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",445,100,,356.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",167.77,37.7,,134.22,,,0,"percent of total billed charges","37.7% of total billed charges",167.77,37.7,,134.22,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.86,33.9,,120.69,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",347.1,78,,277.68,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.57,82.6,,294.06,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.57,82.6,,294.06,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,445,100,,356.00,,,0,"percent of total billed charges","100% of total billed charges",73.81,445,
"US Extremity Nonvascular Limited Right",40276882,CDM,402,RC,76882,CPT,OUTPATIENT,,,445,289.25,TC,391.6,88,,313.28,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,445,100,,356.00,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.35,63,,224.28,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,307.05,69,,,,,0,"fee schedule","69% of total billed charges",445,100,,356.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",445,100,,356.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",445,100,,356.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",167.77,37.7,,134.22,,,0,"percent of total billed charges","37.7% of total billed charges",167.77,37.7,,134.22,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.86,33.9,,120.69,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",347.1,78,,277.68,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.57,82.6,,294.06,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.57,82.6,,294.06,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,445,100,,356.00,,,0,"percent of total billed charges","100% of total billed charges",73.81,445,
"US Extremity Nonvascular Complete Bilat",40276881,CDM,402,RC,76881,CPT,OUTPATIENT,,,674,438.1,TC,593.12,88,,474.50,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,674,100,,539.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",424.62,63,,339.70,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,465.06,69,,,,,0,"fee schedule","69% of total billed charges",674,100,,539.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",674,100,,539.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",674,100,,539.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",254.1,37.7,,203.28,,,0,"percent of total billed charges","37.7% of total billed charges",254.1,37.7,,203.28,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",228.49,33.9,,182.79,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",525.72,78,,420.58,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.72,82.6,,445.38,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.72,82.6,,445.38,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,674,100,,539.20,,,0,"percent of total billed charges","100% of total billed charges",73.81,674,
"US Extremity Nonvascular Limited Bilat",40276882,CDM,402,RC,76882,CPT,OUTPATIENT,,,445,289.25,TC,391.6,88,,313.28,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,445,100,,356.00,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.35,63,,224.28,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,307.05,69,,,,,0,"fee schedule","69% of total billed charges",445,100,,356.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",445,100,,356.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",445,100,,356.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",167.77,37.7,,134.22,,,0,"percent of total billed charges","37.7% of total billed charges",167.77,37.7,,134.22,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.86,33.9,,120.69,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",347.1,78,,277.68,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.57,82.6,,294.06,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.57,82.6,,294.06,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,445,100,,356.00,,,0,"percent of total billed charges","100% of total billed charges",73.81,445,
"US Echo 2D Complete",48093306,CDM,480,RC,93306,CPT,OUTPATIENT,,,3256,2116.4,TC,2865.28,88,,2292.22,,,0,"percent of total billed charges","88% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,3256,100,,2604.80,,,0,"percent of total billed charges","100% of total billed charges",984.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",430.64,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2051.28,63,,1641.02,,,0,"percent of total billed charges","63% of total billed charges",498.17,15.3,,398.54,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,2246.64,69,,,,,0,"fee schedule","69% of total billed charges",3256,100,,2604.80,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3256,100,,2604.80,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3256,100,,2604.80,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1961.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.7,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1227.51,37.7,,982.01,,,0,"percent of total billed charges","37.7% of total billed charges",1227.51,37.7,,982.01,,,0,"percent of total billed charges","37.70% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1103.78,33.9,,883.02,,,0,"percent of total billed charges","33.9% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2539.68,78,,2031.74,,,0,"percent of total billed charges","78% of total billed charges",568.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2689.46,82.6,,2151.57,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2689.46,82.6,,2151.57,,,0,"percent of total billed charges","82.6% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,3256,100,,2604.80,,,0,"percent of total billed charges","100% of total billed charges",309.7,3256,
"US Echo 2D Limited w/ Contrast",480C8924,CDM,480,RC,,,OUTPATIENT,,,1012,657.8,TC,890.56,88,,712.45,,,0,"percent of total billed charges","88% of total billed charges",506,50,,404.80,,,0,"percent of total billed charges","50% of total billed charges",170.02,16.8,,136.02,,,0,"percent of total billed charges","16.8% of total billed charges",1012,100,,809.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",175.12,17.304,,140.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",637.56,63,,510.05,,,0,"percent of total billed charges","63% of total billed charges",154.84,15.3,,123.87,,,0,"percent of total billed charges","15.3% of total billed charges",170.02,16.8,,136.02,,,0,"percent of total billed charges","16.8% of total billed charges",698.28,69,,,,,0,"fee schedule","69% of total billed charges",1012,100,,809.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1012,100,,809.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1012,100,,809.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",625.92,61.85,,500.74,,,0,"percent of total billed charges","61.5% of total billed charges",170.02,16.8,,136.02,,,0,"percent of total billed charges","16.8% of total billed charges",506,50,,404.80,,,0,"percent of total billed charges","50% of total billed charges",325.86,32.2,,260.69,,,0,"percent of total billed charges","32.2% of total billed charges",170.02,16.8,,136.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.42,17.136,,138.74,,,0,"percent of total billed charges","17.136% of total billed charges",221.02,21.84,,176.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",381.52,37.7,,305.22,,,0,"percent of total billed charges","37.7% of total billed charges",381.52,37.7,,305.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",343.07,33.9,,274.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",789.36,78,,631.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.91,82.6,,668.73,,,0,"percent of total billed charges","82.6% of total billed charges",170.02,16.8,,136.02,,,0,"percent of total billed charges","16.8% of total billed charges",506,50,,404.80,,,0,"percent of total billed charges","50% of total billed charges",835.91,82.6,,668.73,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.02,16.8,,136.02,,,0,"percent of total billed charges","16.8% of total billed charges",1012,100,,809.60,,,0,"percent of total billed charges","100% of total billed charges",154.84,1012,
"US Echo Doppler Complete",48093320,CDM,480,RC,93320,CPT,OUTPATIENT,,,644,418.6,TC,566.72,88,,453.38,,,0,"percent of total billed charges","88% of total billed charges",322,50,,257.60,,,0,"percent of total billed charges","50% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,644,100,,515.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",430.64,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",405.72,63,,324.58,,,0,"percent of total billed charges","63% of total billed charges",98.53,15.3,,78.82,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,444.36,69,,,,,0,"fee schedule","69% of total billed charges",644,100,,515.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",644,100,,515.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",644,100,,515.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",398.31,61.85,,318.65,,,0,"percent of total billed charges","61.5% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,322,50,,257.60,,,0,"percent of total billed charges","50% of total billed charges",207.37,32.2,,165.90,,,0,"percent of total billed charges","32.2% of total billed charges",309.7,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",242.79,37.7,,194.23,,,0,"percent of total billed charges","37.7% of total billed charges",242.79,37.7,,194.23,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",218.32,33.9,,174.66,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",502.32,78,,401.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",531.94,82.6,,425.55,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,322,50,,257.60,,,0,"percent of total billed charges","50% of total billed charges",531.94,82.6,,425.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.1,100,,,,,0,"fee schedule",EAPG,644,100,,515.20,,,0,"percent of total billed charges","100% of total billed charges",98.53,644,
"US Echocardiogram Complete w/ Color",48093306,CDM,480,RC,93306,CPT,OUTPATIENT,,,3256,2116.4,TC,2865.28,88,,2292.22,,,0,"percent of total billed charges","88% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,3256,100,,2604.80,,,0,"percent of total billed charges","100% of total billed charges",984.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",430.64,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2051.28,63,,1641.02,,,0,"percent of total billed charges","63% of total billed charges",498.17,15.3,,398.54,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,2246.64,69,,,,,0,"fee schedule","69% of total billed charges",3256,100,,2604.80,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3256,100,,2604.80,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3256,100,,2604.80,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1961.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.7,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1227.51,37.7,,982.01,,,0,"percent of total billed charges","37.7% of total billed charges",1227.51,37.7,,982.01,,,0,"percent of total billed charges","37.70% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1103.78,33.9,,883.02,,,0,"percent of total billed charges","33.9% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2539.68,78,,2031.74,,,0,"percent of total billed charges","78% of total billed charges",568.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2689.46,82.6,,2151.57,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2689.46,82.6,,2151.57,,,0,"percent of total billed charges","82.6% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,3256,100,,2604.80,,,0,"percent of total billed charges","100% of total billed charges",309.7,3256,
"US Echo 2D Limited",48093308,CDM,480,RC,93308,CPT,OUTPATIENT,,,911,592.15,TC,801.68,88,,641.34,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,911,100,,728.80,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",430.64,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",573.93,63,,459.14,,,0,"percent of total billed charges","63% of total billed charges",139.38,15.3,,111.50,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,628.59,69,,,,,0,"fee schedule","69% of total billed charges",911,100,,728.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",911,100,,728.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",911,100,,728.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.7,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",343.45,37.7,,274.76,,,0,"percent of total billed charges","37.7% of total billed charges",343.45,37.7,,274.76,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",308.83,33.9,,247.06,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",710.58,78,,568.46,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",752.49,82.6,,601.99,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",752.49,82.6,,601.99,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,911,100,,728.80,,,0,"percent of total billed charges","100% of total billed charges",139.38,934.9,
"US Echo Congenital Complete",48393303,CDM,483,RC,93303,CPT,OUTPATIENT,,,2422,1574.3,TC,2131.36,88,,1705.09,,,0,"percent of total billed charges","88% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,2422,100,,1937.60,,,0,"percent of total billed charges","100% of total billed charges",984.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",430.64,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1525.86,63,,1220.69,,,0,"percent of total billed charges","63% of total billed charges",370.57,15.3,,296.46,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,1671.18,69,,,,,0,"fee schedule","69% of total billed charges",2422,100,,1937.60,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2422,100,,1937.60,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2422,100,,1937.60,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1961.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.7,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",913.09,37.7,,730.47,,,0,"percent of total billed charges","37.7% of total billed charges",913.09,37.7,,730.47,,,0,"percent of total billed charges","37.70% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",821.06,33.9,,656.85,,,0,"percent of total billed charges","33.9% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1889.16,78,,1511.33,,,0,"percent of total billed charges","78% of total billed charges",568.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2000.57,82.6,,1600.46,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2000.57,82.6,,1600.46,,,0,"percent of total billed charges","82.6% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,2422,100,,1937.60,,,0,"percent of total billed charges","100% of total billed charges",309.7,2422,
"US Echo Congenital Limited",48093304,CDM,480,RC,93304,CPT,OUTPATIENT,,,1987,1291.55,TC,1748.56,88,,1398.85,,,0,"percent of total billed charges","88% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,1987,100,,1589.60,,,0,"percent of total billed charges","100% of total billed charges",984.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",430.64,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1251.81,63,,1001.45,,,0,"percent of total billed charges","63% of total billed charges",304.01,15.3,,243.21,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,1371.03,69,,,,,0,"fee schedule","69% of total billed charges",1987,100,,1589.60,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1987,100,,1589.60,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1987,100,,1589.60,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1961.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.7,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",749.1,37.7,,599.28,,,0,"percent of total billed charges","37.7% of total billed charges",749.1,37.7,,599.28,,,0,"percent of total billed charges","37.70% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.59,33.9,,538.87,,,0,"percent of total billed charges","33.9% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1549.86,78,,1239.89,,,0,"percent of total billed charges","78% of total billed charges",568.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1641.26,82.6,,1313.01,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1641.26,82.6,,1313.01,,,0,"percent of total billed charges","82.6% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,1987,100,,1589.60,,,0,"percent of total billed charges","100% of total billed charges",304.01,1987,
"US Echo Doppler Limited",48093321,CDM,480,RC,93321,CPT,OUTPATIENT,,,441,286.65,TC,388.08,88,,310.46,,,0,"percent of total billed charges","88% of total billed charges",220.5,50,,176.40,,,0,"percent of total billed charges","50% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",430.64,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",277.83,63,,222.26,,,0,"percent of total billed charges","63% of total billed charges",67.47,15.3,,53.98,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,304.29,69,,,,,0,"fee schedule","69% of total billed charges",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.76,61.85,,218.21,,,0,"percent of total billed charges","61.5% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,220.5,50,,176.40,,,0,"percent of total billed charges","50% of total billed charges",142,32.2,,113.60,,,0,"percent of total billed charges","32.2% of total billed charges",309.7,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",166.26,37.7,,133.01,,,0,"percent of total billed charges","37.7% of total billed charges",166.26,37.7,,133.01,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",149.5,33.9,,119.60,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",343.98,78,,275.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",364.27,82.6,,291.42,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,220.5,50,,176.40,,,0,"percent of total billed charges","50% of total billed charges",364.27,82.6,,291.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.1,100,,,,,0,"fee schedule",EAPG,441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",67.47,543.53,
"US Echo w/ Contrast Comp w/ Color Dopp",483C8929,CDM,483,RC,,,OUTPATIENT,,,3531,2295.15,TC,3107.28,88,,2485.82,,,0,"percent of total billed charges","88% of total billed charges",1765.5,50,,1412.40,,,0,"percent of total billed charges","50% of total billed charges",593.21,16.8,,474.57,,,0,"percent of total billed charges","16.8% of total billed charges",3531,100,,2824.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",611,17.304,,488.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2224.53,63,,1779.62,,,0,"percent of total billed charges","63% of total billed charges",540.24,15.3,,432.19,,,0,"percent of total billed charges","15.3% of total billed charges",593.21,16.8,,474.57,,,0,"percent of total billed charges","16.8% of total billed charges",2436.39,69,,,,,0,"fee schedule","69% of total billed charges",3531,100,,2824.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3531,100,,2824.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3531,100,,2824.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2183.92,61.85,,1747.14,,,0,"percent of total billed charges","61.5% of total billed charges",593.21,16.8,,474.57,,,0,"percent of total billed charges","16.8% of total billed charges",1765.5,50,,1412.40,,,0,"percent of total billed charges","50% of total billed charges",1136.98,32.2,,909.58,,,0,"percent of total billed charges","32.2% of total billed charges",593.21,16.8,,474.57,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",605.07,17.136,,484.06,,,0,"percent of total billed charges","17.136% of total billed charges",771.17,21.84,,616.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1331.19,37.7,,1064.95,,,0,"percent of total billed charges","37.7% of total billed charges",1331.19,37.7,,1064.95,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1197.01,33.9,,957.61,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2754.18,78,,2203.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2916.61,82.6,,2333.29,,,0,"percent of total billed charges","82.6% of total billed charges",593.21,16.8,,474.57,,,0,"percent of total billed charges","16.8% of total billed charges",1765.5,50,,1412.40,,,0,"percent of total billed charges","50% of total billed charges",2916.61,82.6,,2333.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",593.21,16.8,,474.57,,,0,"percent of total billed charges","16.8% of total billed charges",3531,100,,2824.80,,,0,"percent of total billed charges","100% of total billed charges",540.24,3531,
"US Echo TEE",48093312,CDM,480,RC,93312,CPT,OUTPATIENT,,,2422,1574.3,TC,2131.36,88,,1705.09,,,0,"percent of total billed charges","88% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,2422,100,,1937.60,,,0,"percent of total billed charges","100% of total billed charges",984.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",430.64,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1525.86,63,,1220.69,,,0,"percent of total billed charges","63% of total billed charges",370.57,15.3,,296.46,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,1671.18,69,,,,,0,"fee schedule","69% of total billed charges",2422,100,,1937.60,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2422,100,,1937.60,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2422,100,,1937.60,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1961.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.7,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",913.09,37.7,,730.47,,,0,"percent of total billed charges","37.7% of total billed charges",913.09,37.7,,730.47,,,0,"percent of total billed charges","37.70% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",821.06,33.9,,656.85,,,0,"percent of total billed charges","33.9% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1889.16,78,,1511.33,,,0,"percent of total billed charges","78% of total billed charges",568.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2000.57,82.6,,1600.46,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2000.57,82.6,,1600.46,,,0,"percent of total billed charges","82.6% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,2422,100,,1937.60,,,0,"percent of total billed charges","100% of total billed charges",309.7,2422,
"US Echo TEE Congenital Anomalie",48093315,CDM,480,RC,93315,CPT,OUTPATIENT,,,1724,1120.6,TC,1517.12,88,,1213.70,,,0,"percent of total billed charges","88% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,1724,100,,1379.20,,,0,"percent of total billed charges","100% of total billed charges",984.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",430.64,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1086.12,63,,868.90,,,0,"percent of total billed charges","63% of total billed charges",263.77,15.3,,211.02,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,1189.56,69,,,,,0,"fee schedule","69% of total billed charges",1724,100,,1379.20,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1724,100,,1379.20,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1724,100,,1379.20,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1961.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.7,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",649.95,37.7,,519.96,,,0,"percent of total billed charges","37.7% of total billed charges",649.95,37.7,,519.96,,,0,"percent of total billed charges","37.70% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",584.44,33.9,,467.55,,,0,"percent of total billed charges","33.9% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1344.72,78,,1075.78,,,0,"percent of total billed charges","78% of total billed charges",568.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1424.02,82.6,,1139.22,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1424.02,82.6,,1139.22,,,0,"percent of total billed charges","82.6% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,1724,100,,1379.20,,,0,"percent of total billed charges","100% of total billed charges",263.77,1961.75,
"US Elastography Abdominal Organ",40276981,CDM,402,RC,76981,CPT,OUTPATIENT,,,374,243.1,,329.12,88,,263.30,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,374,100,,299.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",235.62,63,,188.50,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,258.06,69,,,,,0,"fee schedule","69% of total billed charges",374,100,,299.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",374,100,,299.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",374,100,,299.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",141,37.7,,112.80,,,0,"percent of total billed charges","37.7% of total billed charges",141,37.7,,112.80,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",126.79,33.9,,101.43,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",291.72,78,,233.38,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",308.92,82.6,,247.14,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",308.92,82.6,,247.14,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,374,100,,299.20,,,0,"percent of total billed charges","100% of total billed charges",73.81,442.69,
"US Elastography 1st Target Lesion",40246982,CDM,402,RC,76982,CPT,OUTPATIENT,,,374,243.1,TC,329.12,88,,263.30,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,374,100,,299.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",235.62,63,,188.50,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,258.06,69,,,,,0,"fee schedule","69% of total billed charges",374,100,,299.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",374,100,,299.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",374,100,,299.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",141,37.7,,112.80,,,0,"percent of total billed charges","37.7% of total billed charges",141,37.7,,112.80,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",126.79,33.9,,101.43,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",291.72,78,,233.38,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",308.92,82.6,,247.14,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",308.92,82.6,,247.14,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,374,100,,299.20,,,0,"percent of total billed charges","100% of total billed charges",73.81,442.69,
"US Fetal Biophysical Profile w/ Non-Str",40276818,CDM,402,RC,76818,CPT,OUTPATIENT,,,551,358.15,TC,484.88,88,,387.90,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.6,100,,,,,0,"fee schedule",EAPG,551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",94.35,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",347.13,63,,277.70,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",91.6,100,,,,,0,"fee schedule",EAPG,380.19,69,,,,,0,"fee schedule","69% of total billed charges",551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.6,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",67.85,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",93.43,100,,,,,0,"fee schedule",EAPG,119.08,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",207.73,37.7,,166.18,,,0,"percent of total billed charges","37.7% of total billed charges",207.73,37.7,,166.18,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",186.79,33.9,,149.43,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",429.78,78,,343.82,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",455.13,82.6,,364.10,,,0,"percent of total billed charges","82.6% of total billed charges",91.6,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",455.13,82.6,,364.10,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.6,100,,,,,0,"fee schedule",EAPG,551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",67.85,551,
"US Fetal Biophysical Profile w/o N-Str",40276818,CDM,402,RC,76818,CPT,OUTPATIENT,,,551,358.15,TC,484.88,88,,387.90,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.6,100,,,,,0,"fee schedule",EAPG,551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",94.35,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",347.13,63,,277.70,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",91.6,100,,,,,0,"fee schedule",EAPG,380.19,69,,,,,0,"fee schedule","69% of total billed charges",551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.6,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",67.85,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",93.43,100,,,,,0,"fee schedule",EAPG,119.08,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",207.73,37.7,,166.18,,,0,"percent of total billed charges","37.7% of total billed charges",207.73,37.7,,166.18,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",186.79,33.9,,149.43,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",429.78,78,,343.82,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",455.13,82.6,,364.10,,,0,"percent of total billed charges","82.6% of total billed charges",91.6,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",455.13,82.6,,364.10,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.6,100,,,,,0,"fee schedule",EAPG,551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",67.85,551,
"US Guided Vascular Access",40276937,CDM,402,RC,76937,CPT,OUTPATIENT,,,1317,856.05,TC,1158.96,88,,927.17,,,0,"percent of total billed charges","88% of total billed charges",658.5,50,,526.80,,,0,"percent of total billed charges","50% of total billed charges",101.95,100,,,,,0,"fee schedule",EAPG,1317,100,,1053.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.01,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",829.71,63,,663.77,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",101.95,100,,,,,0,"fee schedule",EAPG,908.73,69,,,,,0,"fee schedule","69% of total billed charges",1317,100,,1053.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1317,100,,1053.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1317,100,,1053.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",814.56,61.85,,651.65,,,0,"percent of total billed charges","61.5% of total billed charges",101.95,100,,,,,0,"fee schedule",EAPG,658.5,50,,526.80,,,0,"percent of total billed charges","50% of total billed charges",424.07,32.2,,339.26,,,0,"percent of total billed charges","32.2% of total billed charges",75.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",103.99,100,,,,,0,"fee schedule",EAPG,132.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",496.51,37.7,,397.21,,,0,"percent of total billed charges","37.7% of total billed charges",496.51,37.7,,397.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",446.46,33.9,,357.17,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1027.26,78,,821.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1087.84,82.6,,870.27,,,0,"percent of total billed charges","82.6% of total billed charges",101.95,100,,,,,0,"fee schedule",EAPG,658.5,50,,526.80,,,0,"percent of total billed charges","50% of total billed charges",1087.84,82.6,,870.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.95,100,,,,,0,"fee schedule",EAPG,1317,100,,1053.60,,,0,"percent of total billed charges","100% of total billed charges",75.52,1317,
"US Guided Amniocentesis",40276946,CDM,402,RC,76946,CPT,OUTPATIENT,,,741,481.65,TC,652.08,88,,521.66,,,0,"percent of total billed charges","88% of total billed charges",370.5,50,,296.40,,,0,"percent of total billed charges","50% of total billed charges",101.95,100,,,,,0,"fee schedule",EAPG,741,100,,592.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.01,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",466.83,63,,373.46,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",101.95,100,,,,,0,"fee schedule",EAPG,511.29,69,,,,,0,"fee schedule","69% of total billed charges",741,100,,592.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741,100,,592.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741,100,,592.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.31,61.85,,366.65,,,0,"percent of total billed charges","61.5% of total billed charges",101.95,100,,,,,0,"fee schedule",EAPG,370.5,50,,296.40,,,0,"percent of total billed charges","50% of total billed charges",238.6,32.2,,190.88,,,0,"percent of total billed charges","32.2% of total billed charges",75.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",103.99,100,,,,,0,"fee schedule",EAPG,132.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",279.36,37.7,,223.49,,,0,"percent of total billed charges","37.7% of total billed charges",279.36,37.7,,223.49,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",251.2,33.9,,200.96,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",577.98,78,,462.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",612.07,82.6,,489.66,,,0,"percent of total billed charges","82.6% of total billed charges",101.95,100,,,,,0,"fee schedule",EAPG,370.5,50,,296.40,,,0,"percent of total billed charges","50% of total billed charges",612.07,82.6,,489.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.95,100,,,,,0,"fee schedule",EAPG,741,100,,592.80,,,0,"percent of total billed charges","100% of total billed charges",75.52,741,
"US Guided Needle Placement",40276942,CDM,402,RC,76942,CPT,OUTPATIENT,,,1155,750.75,TC,1016.4,88,,813.12,,,0,"percent of total billed charges","88% of total billed charges",577.5,50,,462.00,,,0,"percent of total billed charges","50% of total billed charges",101.95,100,,,,,0,"fee schedule",EAPG,1155,100,,924.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.01,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",727.65,63,,582.12,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",101.95,100,,,,,0,"fee schedule",EAPG,796.95,69,,,,,0,"fee schedule","69% of total billed charges",1155,100,,924.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1155,100,,924.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1155,100,,924.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",714.37,61.85,,571.50,,,0,"percent of total billed charges","61.5% of total billed charges",101.95,100,,,,,0,"fee schedule",EAPG,577.5,50,,462.00,,,0,"percent of total billed charges","50% of total billed charges",371.91,32.2,,297.53,,,0,"percent of total billed charges","32.2% of total billed charges",75.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",103.99,100,,,,,0,"fee schedule",EAPG,132.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",435.44,37.7,,348.35,,,0,"percent of total billed charges","37.7% of total billed charges",435.44,37.7,,348.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",391.55,33.9,,313.24,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",900.9,78,,720.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",954.03,82.6,,763.22,,,0,"percent of total billed charges","82.6% of total billed charges",101.95,100,,,,,0,"fee schedule",EAPG,577.5,50,,462.00,,,0,"percent of total billed charges","50% of total billed charges",954.03,82.6,,763.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.95,100,,,,,0,"fee schedule",EAPG,1155,100,,924.00,,,0,"percent of total billed charges","100% of total billed charges",75.52,1155,
"US Guided Foreign Body Removal",40210120,CDM,402,RC,10120,CPT,OUTPATIENT,,,1350,877.5,TC,1188,88,,950.40,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,1350,100,,1080.00,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",850.5,63,,680.40,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",147.32,100,,,,,0,"fee schedule",EAPG,931.5,69,,,,,0,"fee schedule","69% of total billed charges",1350,100,,1080.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1350,100,,1080.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1350,100,,1080.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.13,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",508.95,37.7,,407.16,,,0,"percent of total billed charges","37.7% of total billed charges",508.95,37.7,,407.16,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",457.65,33.9,,366.12,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1053,78,,842.40,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1115.1,82.6,,892.08,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1115.1,82.6,,892.08,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,1350,100,,1080.00,,,0,"percent of total billed charges","100% of total billed charges",109.13,1404.97,
"US Guided Breast Biopsy Left",40219083,CDM,402,RC,19083,CPT,OUTPATIENT,,,4506,2928.9,LT,3965.28,88,,3172.22,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,4506,100,,3604.80,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1298.41,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2838.78,63,,2271.02,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",1260.59,100,,,,,0,"fee schedule",EAPG,3109.14,69,,,,,0,"fee schedule","69% of total billed charges",4506,100,,3604.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4506,100,,3604.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4506,100,,3604.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",933.77,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1285.8,100,,,,,0,"fee schedule",EAPG,1638.77,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1698.76,37.7,,1359.01,,,0,"percent of total billed charges","37.7% of total billed charges",1698.76,37.7,,1359.01,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1527.53,33.9,,1222.02,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3514.68,78,,2811.74,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3721.96,82.6,,2977.57,,,0,"percent of total billed charges","82.6% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3721.96,82.6,,2977.57,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,4506,100,,3604.80,,,0,"percent of total billed charges","100% of total billed charges",235,5715.97,
"US Guided Breast Biopsy Right",40219083,CDM,402,RC,19083,CPT,OUTPATIENT,,,4506,2928.9,LT,3965.28,88,,3172.22,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,4506,100,,3604.80,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1298.41,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2838.78,63,,2271.02,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",1260.59,100,,,,,0,"fee schedule",EAPG,3109.14,69,,,,,0,"fee schedule","69% of total billed charges",4506,100,,3604.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4506,100,,3604.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4506,100,,3604.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",933.77,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1285.8,100,,,,,0,"fee schedule",EAPG,1638.77,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1698.76,37.7,,1359.01,,,0,"percent of total billed charges","37.7% of total billed charges",1698.76,37.7,,1359.01,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1527.53,33.9,,1222.02,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3514.68,78,,2811.74,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3721.96,82.6,,2977.57,,,0,"percent of total billed charges","82.6% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3721.96,82.6,,2977.57,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,4506,100,,3604.80,,,0,"percent of total billed charges","100% of total billed charges",235,5715.97,
"US Guided Liver Biopsy",92147000,CDM,921,RC,47000,CPT,OUTPATIENT,,,4288,2787.2,TC,3773.44,88,,3018.75,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,4288,100,,3430.40,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",685.84,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2701.44,63,,2161.15,,,0,"percent of total billed charges","63% of total billed charges",656.06,15.3,,524.85,,,0,"percent of total billed charges","15.3% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,2958.72,69,,,,,0,"fee schedule","69% of total billed charges",4288,100,,3430.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4288,100,,3430.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4288,100,,3430.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",493.23,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",679.18,100,,,,,0,"fee schedule",EAPG,865.63,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1616.58,37.7,,1293.26,,,0,"percent of total billed charges","37.7% of total billed charges",1616.58,37.7,,1293.26,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1453.63,33.9,,1162.90,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3344.64,78,,2675.71,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3541.89,82.6,,2833.51,,,0,"percent of total billed charges","82.6% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3541.89,82.6,,2833.51,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,4288,100,,3430.40,,,0,"percent of total billed charges","100% of total billed charges",493.23,5715.97,
"US Guided Pancreas Biopsy",38648102,CDM,386,RC,48102,CPT,OUTPATIENT,,,1353,879.45,TC,1190.64,88,,952.51,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,1353,100,,1082.40,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",685.84,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",852.39,63,,681.91,,,0,"percent of total billed charges","63% of total billed charges",207.01,15.3,,165.61,,,0,"percent of total billed charges","15.3% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,933.57,69,,,,,0,"fee schedule","69% of total billed charges",1353,100,,1082.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353,100,,1082.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353,100,,1082.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",679.18,100,,,,,0,"fee schedule",EAPG,865.63,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510.08,37.7,,408.06,,,0,"percent of total billed charges","37.7% of total billed charges",510.08,37.7,,408.06,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",458.67,33.9,,366.94,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055.34,78,,844.27,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1117.58,82.6,,894.06,,,0,"percent of total billed charges","82.6% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1117.58,82.6,,894.06,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,1353,100,,1082.40,,,0,"percent of total billed charges","100% of total billed charges",207.01,5715.97,
"US Guided Thyroid Biopsy",35260100,CDM,402,RC,60100,CPT,OUTPATIENT,,,2054,1335.1,,1807.52,88,,1446.02,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.92,100,,,,,0,"fee schedule",EAPG,2054,100,,1643.20,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",585.99,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1294.02,63,,1035.22,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",568.92,100,,,,,0,"fee schedule",EAPG,1417.26,69,,,,,0,"fee schedule","69% of total billed charges",2054,100,,1643.20,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054,100,,1643.20,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054,100,,1643.20,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.92,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",421.42,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",580.3,100,,,,,0,"fee schedule",EAPG,739.6,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",774.36,37.7,,619.49,,,0,"percent of total billed charges","37.7% of total billed charges",774.36,37.7,,619.49,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",696.31,33.9,,557.05,,,0,"percent of total billed charges","33.9% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1602.12,78,,1281.70,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1696.6,82.6,,1357.28,,,0,"percent of total billed charges","82.6% of total billed charges",568.92,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1696.6,82.6,,1357.28,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.92,100,,,,,0,"fee schedule",EAPG,2054,100,,1643.20,,,0,"percent of total billed charges","100% of total billed charges",235,2526.76,
"US Head/Neck Soft Tissue",40276536,CDM,402,RC,76536,CPT,OUTPATIENT,,,587,381.55,TC,516.56,88,,413.25,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,587,100,,469.60,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",369.81,63,,295.85,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,405.03,69,,,,,0,"fee schedule","69% of total billed charges",587,100,,469.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",587,100,,469.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",587,100,,469.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.3,37.7,,177.04,,,0,"percent of total billed charges","37.7% of total billed charges",221.3,37.7,,177.04,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",198.99,33.9,,159.19,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",457.86,78,,366.29,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",484.86,82.6,,387.89,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",484.86,82.6,,387.89,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,587,100,,469.60,,,0,"percent of total billed charges","100% of total billed charges",73.81,587,
"US Hips Infant Dynamic",40276885,CDM,402,RC,76885,CPT,OUTPATIENT,,,607,394.55,TC,534.16,88,,427.33,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,607,100,,485.60,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",382.41,63,,305.93,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,418.83,69,,,,,0,"fee schedule","69% of total billed charges",607,100,,485.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",607,100,,485.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",607,100,,485.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",228.84,37.7,,183.07,,,0,"percent of total billed charges","37.7% of total billed charges",228.84,37.7,,183.07,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",205.77,33.9,,164.62,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",473.46,78,,378.77,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",501.38,82.6,,401.10,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",501.38,82.6,,401.10,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,607,100,,485.60,,,0,"percent of total billed charges","100% of total billed charges",73.81,607,
"US Hysterosonogram",40276831,CDM,402,RC,76831,CPT,OUTPATIENT,,,636,413.4,TC,559.68,88,,447.74,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,636,100,,508.80,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",155.82,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.68,63,,320.54,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",151.28,100,,,,,0,"fee schedule",EAPG,438.84,69,,,,,0,"fee schedule","69% of total billed charges",636,100,,508.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",636,100,,508.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",636,100,,508.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",112.06,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.31,100,,,,,0,"fee schedule",EAPG,196.67,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",239.77,37.7,,191.82,,,0,"percent of total billed charges","37.7% of total billed charges",239.77,37.7,,191.82,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",215.6,33.9,,172.48,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",496.08,78,,396.86,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",525.34,82.6,,420.27,,,0,"percent of total billed charges","82.6% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",525.34,82.6,,420.27,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,636,100,,508.80,,,0,"percent of total billed charges","100% of total billed charges",112.06,934.9,
"US Intraoperative",40276998,CDM,402,RC,76998,CPT,OUTPATIENT,,,1222,794.3,TC,1075.36,88,,860.29,,,0,"percent of total billed charges","88% of total billed charges",611,50,,488.80,,,0,"percent of total billed charges","50% of total billed charges",101.95,100,,,,,0,"fee schedule",EAPG,1222,100,,977.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.01,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",769.86,63,,615.89,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",101.95,100,,,,,0,"fee schedule",EAPG,843.18,69,,,,,0,"fee schedule","69% of total billed charges",1222,100,,977.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1222,100,,977.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1222,100,,977.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",755.81,61.85,,604.65,,,0,"percent of total billed charges","61.5% of total billed charges",101.95,100,,,,,0,"fee schedule",EAPG,611,50,,488.80,,,0,"percent of total billed charges","50% of total billed charges",393.48,32.2,,314.78,,,0,"percent of total billed charges","32.2% of total billed charges",75.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",103.99,100,,,,,0,"fee schedule",EAPG,132.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",460.69,37.7,,368.55,,,0,"percent of total billed charges","37.7% of total billed charges",460.69,37.7,,368.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.26,33.9,,331.41,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",953.16,78,,762.53,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1009.37,82.6,,807.50,,,0,"percent of total billed charges","82.6% of total billed charges",101.95,100,,,,,0,"fee schedule",EAPG,611,50,,488.80,,,0,"percent of total billed charges","50% of total billed charges",1009.37,82.6,,807.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.95,100,,,,,0,"fee schedule",EAPG,1222,100,,977.60,,,0,"percent of total billed charges","100% of total billed charges",75.52,1222,
"US Intraoperative EO",40276998,CDM,402,RC,76998,CPT,OUTPATIENT,,,1222,794.3,TC,1075.36,88,,860.29,,,0,"percent of total billed charges","88% of total billed charges",611,50,,488.80,,,0,"percent of total billed charges","50% of total billed charges",101.95,100,,,,,0,"fee schedule",EAPG,1222,100,,977.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.01,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",769.86,63,,615.89,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",101.95,100,,,,,0,"fee schedule",EAPG,843.18,69,,,,,0,"fee schedule","69% of total billed charges",1222,100,,977.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1222,100,,977.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1222,100,,977.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",755.81,61.85,,604.65,,,0,"percent of total billed charges","61.5% of total billed charges",101.95,100,,,,,0,"fee schedule",EAPG,611,50,,488.80,,,0,"percent of total billed charges","50% of total billed charges",393.48,32.2,,314.78,,,0,"percent of total billed charges","32.2% of total billed charges",75.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",103.99,100,,,,,0,"fee schedule",EAPG,132.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",460.69,37.7,,368.55,,,0,"percent of total billed charges","37.7% of total billed charges",460.69,37.7,,368.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.26,33.9,,331.41,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",953.16,78,,762.53,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1009.37,82.6,,807.50,,,0,"percent of total billed charges","82.6% of total billed charges",101.95,100,,,,,0,"fee schedule",EAPG,611,50,,488.80,,,0,"percent of total billed charges","50% of total billed charges",1009.37,82.6,,807.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.95,100,,,,,0,"fee schedule",EAPG,1222,100,,977.60,,,0,"percent of total billed charges","100% of total billed charges",75.52,1222,
"US Kidney Transplant w/ Doppler",40276776,CDM,402,RC,76776,CPT,OUTPATIENT,,,551,358.15,TC,484.88,88,,387.90,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",347.13,63,,277.70,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,380.19,69,,,,,0,"fee schedule","69% of total billed charges",551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",207.73,37.7,,166.18,,,0,"percent of total billed charges","37.7% of total billed charges",207.73,37.7,,166.18,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",186.79,33.9,,149.43,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",429.78,78,,343.82,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",455.13,82.6,,364.10,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",455.13,82.6,,364.10,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",73.81,551,
"US Lower Ext Arterial Duplex Bilateral",92193925,CDM,921,RC,93925,CPT,OUTPATIENT,,,973,632.45,TC,856.24,88,,684.99,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,973,100,,778.40,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",155.82,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",612.99,63,,490.39,,,0,"percent of total billed charges","63% of total billed charges",148.87,15.3,,119.10,,,0,"percent of total billed charges","15.3% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,671.37,69,,,,,0,"fee schedule","69% of total billed charges",973,100,,778.40,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",973,100,,778.40,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",973,100,,778.40,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",112.06,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.31,100,,,,,0,"fee schedule",EAPG,196.67,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",366.82,37.7,,293.46,,,0,"percent of total billed charges","37.7% of total billed charges",366.82,37.7,,293.46,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",329.85,33.9,,263.88,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",758.94,78,,607.15,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",803.7,82.6,,642.96,,,0,"percent of total billed charges","82.6% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",803.7,82.6,,642.96,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,973,100,,778.40,,,0,"percent of total billed charges","100% of total billed charges",112.06,973,
"US Lower Ext Arterial Duplex Left",92193926,CDM,921,RC,93926,CPT,OUTPATIENT,,,634,412.1,TC,557.92,88,,446.34,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,634,100,,507.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",399.42,63,,319.54,,,0,"percent of total billed charges","63% of total billed charges",97,15.3,,77.60,,,0,"percent of total billed charges","15.3% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,437.46,69,,,,,0,"fee schedule","69% of total billed charges",634,100,,507.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",634,100,,507.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",634,100,,507.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",239.02,37.7,,191.22,,,0,"percent of total billed charges","37.7% of total billed charges",239.02,37.7,,191.22,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",214.93,33.9,,171.94,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",494.52,78,,395.62,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",523.68,82.6,,418.94,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",523.68,82.6,,418.94,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,634,100,,507.20,,,0,"percent of total billed charges","100% of total billed charges",73.81,634,
"US Lower Ext Arterial Duplex Right",40293926,CDM,921,RC,93926,CPT,OUTPATIENT,,,634,412.1,TC|RT,557.92,88,,446.34,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,634,100,,507.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",399.42,63,,319.54,,,0,"percent of total billed charges","63% of total billed charges",97,15.3,,77.60,,,0,"percent of total billed charges","15.3% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,437.46,69,,,,,0,"fee schedule","69% of total billed charges",634,100,,507.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",634,100,,507.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",634,100,,507.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",239.02,37.7,,191.22,,,0,"percent of total billed charges","37.7% of total billed charges",239.02,37.7,,191.22,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",214.93,33.9,,171.94,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",494.52,78,,395.62,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",523.68,82.6,,418.94,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",523.68,82.6,,418.94,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,634,100,,507.20,,,0,"percent of total billed charges","100% of total billed charges",73.81,634,
"US Lower Ext Venous Duplex Bilateral",92193970,CDM,921,RC,93970,CPT,OUTPATIENT,,,1984,1289.6,TC,1745.92,88,,1396.74,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,1984,100,,1587.20,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",155.82,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1249.92,63,,999.94,,,0,"percent of total billed charges","63% of total billed charges",303.55,15.3,,242.84,,,0,"percent of total billed charges","15.3% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,1368.96,69,,,,,0,"fee schedule","69% of total billed charges",1984,100,,1587.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1984,100,,1587.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1984,100,,1587.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",112.06,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.31,100,,,,,0,"fee schedule",EAPG,196.67,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",747.97,37.7,,598.38,,,0,"percent of total billed charges","37.7% of total billed charges",747.97,37.7,,598.38,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672.58,33.9,,538.06,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1547.52,78,,1238.02,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1638.78,82.6,,1311.02,,,0,"percent of total billed charges","82.6% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1638.78,82.6,,1311.02,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,1984,100,,1587.20,,,0,"percent of total billed charges","100% of total billed charges",112.06,1984,
"US Lower Ext Venous Duplex Left",92193971,CDM,921,RC,93971,CPT,OUTPATIENT,,,1461,949.65,TC|LT,1285.68,88,,1028.54,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",920.43,63,,736.34,,,0,"percent of total billed charges","63% of total billed charges",223.53,15.3,,178.82,,,0,"percent of total billed charges","15.3% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,1008.09,69,,,,,0,"fee schedule","69% of total billed charges",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",550.8,37.7,,440.64,,,0,"percent of total billed charges","37.7% of total billed charges",550.8,37.7,,440.64,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",495.28,33.9,,396.22,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1139.58,78,,911.66,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1206.79,82.6,,965.43,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1206.79,82.6,,965.43,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",73.81,1461,
"US Lower Ext Venous Duplex Right",92193971,CDM,921,RC,93971,CPT,OUTPATIENT,,,1461,949.65,TC|LT,1285.68,88,,1028.54,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",920.43,63,,736.34,,,0,"percent of total billed charges","63% of total billed charges",223.53,15.3,,178.82,,,0,"percent of total billed charges","15.3% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,1008.09,69,,,,,0,"fee schedule","69% of total billed charges",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",550.8,37.7,,440.64,,,0,"percent of total billed charges","37.7% of total billed charges",550.8,37.7,,440.64,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",495.28,33.9,,396.22,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1139.58,78,,911.66,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1206.79,82.6,,965.43,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1206.79,82.6,,965.43,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",73.81,1461,
"US LE Eval Venous Insufficiency Bilat",92193970,CDM,921,RC,93970,CPT,OUTPATIENT,,,1984,1289.6,TC,1745.92,88,,1396.74,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,1984,100,,1587.20,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",155.82,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1249.92,63,,999.94,,,0,"percent of total billed charges","63% of total billed charges",303.55,15.3,,242.84,,,0,"percent of total billed charges","15.3% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,1368.96,69,,,,,0,"fee schedule","69% of total billed charges",1984,100,,1587.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1984,100,,1587.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1984,100,,1587.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",112.06,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.31,100,,,,,0,"fee schedule",EAPG,196.67,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",747.97,37.7,,598.38,,,0,"percent of total billed charges","37.7% of total billed charges",747.97,37.7,,598.38,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672.58,33.9,,538.06,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1547.52,78,,1238.02,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1638.78,82.6,,1311.02,,,0,"percent of total billed charges","82.6% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1638.78,82.6,,1311.02,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,1984,100,,1587.20,,,0,"percent of total billed charges","100% of total billed charges",112.06,1984,
"US LE Eval Venous Insufficiency Left",92193971,CDM,921,RC,93971,CPT,OUTPATIENT,,,1461,949.65,TC|LT,1285.68,88,,1028.54,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",920.43,63,,736.34,,,0,"percent of total billed charges","63% of total billed charges",223.53,15.3,,178.82,,,0,"percent of total billed charges","15.3% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,1008.09,69,,,,,0,"fee schedule","69% of total billed charges",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",550.8,37.7,,440.64,,,0,"percent of total billed charges","37.7% of total billed charges",550.8,37.7,,440.64,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",495.28,33.9,,396.22,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1139.58,78,,911.66,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1206.79,82.6,,965.43,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1206.79,82.6,,965.43,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",73.81,1461,
"US LE Eval Venous Insufficiency Right",92193971,CDM,921,RC,93971,CPT,OUTPATIENT,,,1461,949.65,TC|LT,1285.68,88,,1028.54,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",920.43,63,,736.34,,,0,"percent of total billed charges","63% of total billed charges",223.53,15.3,,178.82,,,0,"percent of total billed charges","15.3% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,1008.09,69,,,,,0,"fee schedule","69% of total billed charges",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",550.8,37.7,,440.64,,,0,"percent of total billed charges","37.7% of total billed charges",550.8,37.7,,440.64,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",495.28,33.9,,396.22,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1139.58,78,,911.66,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1206.79,82.6,,965.43,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1206.79,82.6,,965.43,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",73.81,1461,
"US OB Less Thn 14 wks w/TVS if indicated",40276801,CDM,402,RC,76801,CPT,OUTPATIENT,,,551,358.15,TC,484.88,88,,387.90,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.6,100,,,,,0,"fee schedule",EAPG,551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",94.35,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",347.13,63,,277.70,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",91.6,100,,,,,0,"fee schedule",EAPG,380.19,69,,,,,0,"fee schedule","69% of total billed charges",551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.6,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",67.85,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",93.43,100,,,,,0,"fee schedule",EAPG,119.08,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",207.73,37.7,,166.18,,,0,"percent of total billed charges","37.7% of total billed charges",207.73,37.7,,166.18,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",186.79,33.9,,149.43,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",429.78,78,,343.82,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",455.13,82.6,,364.10,,,0,"percent of total billed charges","82.6% of total billed charges",91.6,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",455.13,82.6,,364.10,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.6,100,,,,,0,"fee schedule",EAPG,551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",67.85,551,
"US OB Greater Than 14 Weeks",40276805,CDM,402,RC,76805,CPT,OUTPATIENT,,,1056,686.4,TC,929.28,88,,743.42,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.6,100,,,,,0,"fee schedule",EAPG,1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",94.35,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.28,63,,532.22,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",91.6,100,,,,,0,"fee schedule",EAPG,728.64,69,,,,,0,"fee schedule","69% of total billed charges",1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.6,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",67.85,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",93.43,100,,,,,0,"fee schedule",EAPG,119.08,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",398.11,37.7,,318.49,,,0,"percent of total billed charges","37.7% of total billed charges",398.11,37.7,,318.49,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",357.98,33.9,,286.38,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",823.68,78,,658.94,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",872.26,82.6,,697.81,,,0,"percent of total billed charges","82.6% of total billed charges",91.6,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",872.26,82.6,,697.81,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.6,100,,,,,0,"fee schedule",EAPG,1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",67.85,1056,
"US OB Follow Up",40276816,CDM,402,RC,76816,CPT,OUTPATIENT,,,1021,663.65,TC,898.48,88,,718.78,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.6,100,,,,,0,"fee schedule",EAPG,1021,100,,816.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",94.35,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.23,63,,514.58,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",91.6,100,,,,,0,"fee schedule",EAPG,704.49,69,,,,,0,"fee schedule","69% of total billed charges",1021,100,,816.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1021,100,,816.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1021,100,,816.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.6,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",67.85,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",93.43,100,,,,,0,"fee schedule",EAPG,119.08,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",384.92,37.7,,307.94,,,0,"percent of total billed charges","37.7% of total billed charges",384.92,37.7,,307.94,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",346.12,33.9,,276.90,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",796.38,78,,637.10,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",843.35,82.6,,674.68,,,0,"percent of total billed charges","82.6% of total billed charges",91.6,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",843.35,82.6,,674.68,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.6,100,,,,,0,"fee schedule",EAPG,1021,100,,816.80,,,0,"percent of total billed charges","100% of total billed charges",67.85,1021,
"US OB Limited",40276815,CDM,402,RC,76815,CPT,OUTPATIENT,,,551,358.15,TC,484.88,88,,387.90,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.6,100,,,,,0,"fee schedule",EAPG,551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",94.35,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",347.13,63,,277.70,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",91.6,100,,,,,0,"fee schedule",EAPG,380.19,69,,,,,0,"fee schedule","69% of total billed charges",551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.6,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",67.85,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",93.43,100,,,,,0,"fee schedule",EAPG,119.08,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",207.73,37.7,,166.18,,,0,"percent of total billed charges","37.7% of total billed charges",207.73,37.7,,166.18,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",186.79,33.9,,149.43,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",429.78,78,,343.82,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",455.13,82.6,,364.10,,,0,"percent of total billed charges","82.6% of total billed charges",91.6,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",455.13,82.6,,364.10,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.6,100,,,,,0,"fee schedule",EAPG,551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",67.85,551,
"US OB Nuchal Measure 1st Trimester",40276813,CDM,402,RC,76813,CPT,OUTPATIENT,,,976,634.4,TC,858.88,88,,687.10,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.6,100,,,,,0,"fee schedule",EAPG,976,100,,780.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",94.35,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",614.88,63,,491.90,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",91.6,100,,,,,0,"fee schedule",EAPG,673.44,69,,,,,0,"fee schedule","69% of total billed charges",976,100,,780.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",976,100,,780.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",976,100,,780.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.6,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",67.85,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",93.43,100,,,,,0,"fee schedule",EAPG,119.08,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.95,37.7,,294.36,,,0,"percent of total billed charges","37.7% of total billed charges",367.95,37.7,,294.36,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.86,33.9,,264.69,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",761.28,78,,609.02,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",806.18,82.6,,644.94,,,0,"percent of total billed charges","82.6% of total billed charges",91.6,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",806.18,82.6,,644.94,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.6,100,,,,,0,"fee schedule",EAPG,976,100,,780.80,,,0,"percent of total billed charges","100% of total billed charges",67.85,976,
"US OB Limited w/ Biophysical Profile",40276815,CDM,402,RC,76815,CPT,OUTPATIENT,,,716,465.4,TC,630.08,88,,504.06,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.6,100,,,,,0,"fee schedule",EAPG,716,100,,572.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",94.35,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",451.08,63,,360.86,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",91.6,100,,,,,0,"fee schedule",EAPG,494.04,69,,,,,0,"fee schedule","69% of total billed charges",716,100,,572.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",716,100,,572.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",716,100,,572.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.6,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",67.85,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",93.43,100,,,,,0,"fee schedule",EAPG,119.08,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",269.93,37.7,,215.94,,,0,"percent of total billed charges","37.7% of total billed charges",269.93,37.7,,215.94,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",242.72,33.9,,194.18,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",558.48,78,,446.78,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591.42,82.6,,473.14,,,0,"percent of total billed charges","82.6% of total billed charges",91.6,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591.42,82.6,,473.14,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.6,100,,,,,0,"fee schedule",EAPG,716,100,,572.80,,,0,"percent of total billed charges","100% of total billed charges",67.85,716,
"US Paracentesis",40249083,CDM,402,RC,49083,CPT,OUTPATIENT,,,1994,1296.1,TC,1754.72,88,,1403.78,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,1994,100,,1595.20,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",685.84,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1256.22,63,,1004.98,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",665.87,100,,,,,0,"fee schedule",EAPG,1375.86,69,,,,,0,"fee schedule","69% of total billed charges",1994,100,,1595.20,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1994,100,,1595.20,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1994,100,,1595.20,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",493.23,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",679.18,100,,,,,0,"fee schedule",EAPG,865.63,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",751.74,37.7,,601.39,,,0,"percent of total billed charges","37.7% of total billed charges",751.74,37.7,,601.39,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",675.97,33.9,,540.78,,,0,"percent of total billed charges","33.9% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1555.32,78,,1244.26,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1647.04,82.6,,1317.63,,,0,"percent of total billed charges","82.6% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1647.04,82.6,,1317.63,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,1994,100,,1595.20,,,0,"percent of total billed charges","100% of total billed charges",235,3289.02,
"US Pelvis Comp w/Transvag if indicated",40276856,CDM,402,RC,76856,CPT,OUTPATIENT,,,1071,696.15,TC,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",155.82,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",151.28,100,,,,,0,"fee schedule",EAPG,738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",112.06,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.31,100,,,,,0,"fee schedule",EAPG,196.67,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",112.06,1071,
"US Pelvis Ltd w/Transvag if indicated",40276857,CDM,402,RC,76857,CPT,OUTPATIENT,,,512,332.8,TC,450.56,88,,360.45,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,512,100,,409.60,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",322.56,63,,258.05,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,353.28,69,,,,,0,"fee schedule","69% of total billed charges",512,100,,409.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512,100,,409.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512,100,,409.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",193.02,37.7,,154.42,,,0,"percent of total billed charges","37.7% of total billed charges",193.02,37.7,,154.42,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.57,33.9,,138.86,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",399.36,78,,319.49,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",422.91,82.6,,338.33,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",422.91,82.6,,338.33,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,512,100,,409.60,,,0,"percent of total billed charges","100% of total billed charges",73.81,512,
"US Pseudoaneurysm Compression Repair",40276936,CDM,402,RC,76936,CPT,OUTPATIENT,,,3047,1980.55,TC,2681.36,88,,2145.09,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",161.97,100,,,,,0,"fee schedule",EAPG,3047,100,,2437.60,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",166.83,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1919.61,63,,1535.69,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",161.97,100,,,,,0,"fee schedule",EAPG,2102.43,69,,,,,0,"fee schedule","69% of total billed charges",3047,100,,2437.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3047,100,,2437.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3047,100,,2437.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",161.97,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",119.98,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",165.21,100,,,,,0,"fee schedule",EAPG,210.57,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1148.72,37.7,,918.98,,,0,"percent of total billed charges","37.7% of total billed charges",1148.72,37.7,,918.98,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1032.93,33.9,,826.34,,,0,"percent of total billed charges","33.9% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2376.66,78,,1901.33,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2516.82,82.6,,2013.46,,,0,"percent of total billed charges","82.6% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2516.82,82.6,,2013.46,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",161.97,100,,,,,0,"fee schedule",EAPG,3047,100,,2437.60,,,0,"percent of total billed charges","100% of total billed charges",119.98,3047,
"US Retroperitoneal Complete",40276770,CDM,402,RC,76770,CPT,OUTPATIENT,,,1368,889.2,TC,1203.84,88,,963.07,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,1368,100,,1094.40,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",155.82,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.84,63,,689.47,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",151.28,100,,,,,0,"fee schedule",EAPG,943.92,69,,,,,0,"fee schedule","69% of total billed charges",1368,100,,1094.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1368,100,,1094.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1368,100,,1094.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",112.06,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.31,100,,,,,0,"fee schedule",EAPG,196.67,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",515.74,37.7,,412.59,,,0,"percent of total billed charges","37.7% of total billed charges",515.74,37.7,,412.59,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",463.75,33.9,,371.00,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1067.04,78,,853.63,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1129.97,82.6,,903.98,,,0,"percent of total billed charges","82.6% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1129.97,82.6,,903.98,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,1368,100,,1094.40,,,0,"percent of total billed charges","100% of total billed charges",112.06,1368,
"US Retroperitoneal Limited",40276775,CDM,402,RC,76775,CPT,OUTPATIENT,,,903,586.95,TC,794.64,88,,635.71,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,903,100,,722.40,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.89,63,,455.11,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,623.07,69,,,,,0,"fee schedule","69% of total billed charges",903,100,,722.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903,100,,722.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903,100,,722.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",340.43,37.7,,272.34,,,0,"percent of total billed charges","37.7% of total billed charges",340.43,37.7,,272.34,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",306.12,33.9,,244.90,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",704.34,78,,563.47,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",745.88,82.6,,596.70,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",745.88,82.6,,596.70,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,903,100,,722.40,,,0,"percent of total billed charges","100% of total billed charges",73.81,903,
"US Segmental Pressures LE 3+ Lvls Bilat",92193923,CDM,921,RC,93923,CPT,OUTPATIENT,,,973,632.45,TC,856.24,88,,684.99,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.99,100,,,,,0,"fee schedule",EAPG,973,100,,778.40,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",155.52,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",612.99,63,,490.39,,,0,"percent of total billed charges","63% of total billed charges",148.87,15.3,,119.10,,,0,"percent of total billed charges","15.3% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,671.37,69,,,,,0,"fee schedule","69% of total billed charges",973,100,,778.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",973,100,,778.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",973,100,,778.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.99,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.84,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.01,100,,,,,0,"fee schedule",EAPG,196.29,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",366.82,37.7,,293.46,,,0,"percent of total billed charges","37.7% of total billed charges",366.82,37.7,,293.46,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",329.85,33.9,,263.88,,,0,"percent of total billed charges","33.9% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",758.94,78,,607.15,,,0,"percent of total billed charges","78% of total billed charges",160.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",803.7,82.6,,642.96,,,0,"percent of total billed charges","82.6% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",803.7,82.6,,642.96,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.99,100,,,,,0,"fee schedule",EAPG,973,100,,778.40,,,0,"percent of total billed charges","100% of total billed charges",111.84,973,
"US Segmental Pressures LE 1-2 Lvls Bilat",92193922,CDM,921,RC,93922,CPT,OUTPATIENT,,,676,439.4,TC,594.88,88,,475.90,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,676,100,,540.80,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",425.88,63,,340.70,,,0,"percent of total billed charges","63% of total billed charges",103.43,15.3,,82.74,,,0,"percent of total billed charges","15.3% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,466.44,69,,,,,0,"fee schedule","69% of total billed charges",676,100,,540.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",676,100,,540.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",676,100,,540.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",254.85,37.7,,203.88,,,0,"percent of total billed charges","37.7% of total billed charges",254.85,37.7,,203.88,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.16,33.9,,183.33,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",527.28,78,,421.82,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",558.38,82.6,,446.70,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",558.38,82.6,,446.70,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,676,100,,540.80,,,0,"percent of total billed charges","100% of total billed charges",73.81,676,
"US Scrotum (Contents) w/ Doppler if ind",40276870,CDM,402,RC,76870,CPT,OUTPATIENT,,,1027,667.55,TC,903.76,88,,723.01,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,1027,100,,821.60,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.01,63,,517.61,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,708.63,69,,,,,0,"fee schedule","69% of total billed charges",1027,100,,821.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1027,100,,821.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1027,100,,821.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",387.18,37.7,,309.74,,,0,"percent of total billed charges","37.7% of total billed charges",387.18,37.7,,309.74,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.15,33.9,,278.52,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",801.06,78,,640.85,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",848.3,82.6,,678.64,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",848.3,82.6,,678.64,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,1027,100,,821.60,,,0,"percent of total billed charges","100% of total billed charges",73.81,1027,
"US Spinal Canal",40276800,CDM,402,RC,76800,CPT,OUTPATIENT,,,810,526.5,TC,712.8,88,,570.24,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,810,100,,648.00,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510.3,63,,408.24,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,558.9,69,,,,,0,"fee schedule","69% of total billed charges",810,100,,648.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",810,100,,648.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",810,100,,648.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",305.37,37.7,,244.30,,,0,"percent of total billed charges","37.7% of total billed charges",305.37,37.7,,244.30,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",274.59,33.9,,219.67,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",631.8,78,,505.44,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",669.06,82.6,,535.25,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",669.06,82.6,,535.25,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,810,100,,648.00,,,0,"percent of total billed charges","100% of total billed charges",73.81,810,
"US Segmental Pressures (ABI) w/ Exercise",92193924,CDM,921,RC,93924,CPT,OUTPATIENT,,,718,466.7,TC,631.84,88,,505.47,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",452.34,63,,361.87,,,0,"percent of total billed charges","63% of total billed charges",109.85,15.3,,87.88,,,0,"percent of total billed charges","15.3% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,495.42,69,,,,,0,"fee schedule","69% of total billed charges",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.69,37.7,,216.55,,,0,"percent of total billed charges","37.7% of total billed charges",270.69,37.7,,216.55,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",243.4,33.9,,194.72,,,0,"percent of total billed charges","33.9% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.04,78,,448.03,,,0,"percent of total billed charges","78% of total billed charges",160.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.07,82.6,,474.46,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.07,82.6,,474.46,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,718,100,,574.40,,,0,"percent of total billed charges","100% of total billed charges",73.81,1074.33,
"US Stress Echo Pharm",48093350,CDM,480,RC,93350,CPT,OUTPATIENT,,,1887,1226.55,TC,1660.56,88,,1328.45,,,0,"percent of total billed charges","88% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,1887,100,,1509.60,,,0,"percent of total billed charges","100% of total billed charges",984.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",430.64,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1188.81,63,,951.05,,,0,"percent of total billed charges","63% of total billed charges",288.71,15.3,,230.97,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,1302.03,69,,,,,0,"fee schedule","69% of total billed charges",1887,100,,1509.60,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1887,100,,1509.60,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1887,100,,1509.60,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1961.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.7,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",711.4,37.7,,569.12,,,0,"percent of total billed charges","37.7% of total billed charges",711.4,37.7,,569.12,,,0,"percent of total billed charges","37.70% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",639.69,33.9,,511.75,,,0,"percent of total billed charges","33.9% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1471.86,78,,1177.49,,,0,"percent of total billed charges","78% of total billed charges",568.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.66,82.6,,1246.93,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.66,82.6,,1246.93,,,0,"percent of total billed charges","82.6% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,1887,100,,1509.60,,,0,"percent of total billed charges","100% of total billed charges",288.71,1961.75,
"US Stress Echo Treadmill",48093350,CDM,480,RC,93350,CPT,OUTPATIENT,,,1887,1226.55,TC,1660.56,88,,1328.45,,,0,"percent of total billed charges","88% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,1887,100,,1509.60,,,0,"percent of total billed charges","100% of total billed charges",984.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",430.64,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1188.81,63,,951.05,,,0,"percent of total billed charges","63% of total billed charges",288.71,15.3,,230.97,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,1302.03,69,,,,,0,"fee schedule","69% of total billed charges",1887,100,,1509.60,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1887,100,,1509.60,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1887,100,,1509.60,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1961.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.7,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",711.4,37.7,,569.12,,,0,"percent of total billed charges","37.7% of total billed charges",711.4,37.7,,569.12,,,0,"percent of total billed charges","37.70% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",639.69,33.9,,511.75,,,0,"percent of total billed charges","33.9% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1471.86,78,,1177.49,,,0,"percent of total billed charges","78% of total billed charges",568.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.66,82.6,,1246.93,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.66,82.6,,1246.93,,,0,"percent of total billed charges","82.6% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,1887,100,,1509.60,,,0,"percent of total billed charges","100% of total billed charges",288.71,1961.75,
"US Stress Test",48093017,CDM,480,RC,93017,CPT,OUTPATIENT,,,970,630.5,TC,853.6,88,,682.88,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.99,100,,,,,0,"fee schedule",EAPG,970,100,,776.00,,,0,"percent of total billed charges","100% of total billed charges",560.25,175,,,,,0,"fee schedule","175% of CMS fee schedule",155.52,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",611.1,63,,488.88,,,0,"percent of total billed charges","63% of total billed charges",148.41,15.3,,118.73,,,0,"percent of total billed charges","15.3% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,669.3,69,,,,,0,"fee schedule","69% of total billed charges",970,100,,776.00,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",970,100,,776.00,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",970,100,,776.00,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.99,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.84,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.01,100,,,,,0,"fee schedule",EAPG,196.29,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",365.69,37.7,,292.55,,,0,"percent of total billed charges","37.7% of total billed charges",365.69,37.7,,292.55,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",328.83,33.9,,263.06,,,0,"percent of total billed charges","33.9% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",756.6,78,,605.28,,,0,"percent of total billed charges","78% of total billed charges",323.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",801.22,82.6,,640.98,,,0,"percent of total billed charges","82.6% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",801.22,82.6,,640.98,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.99,100,,,,,0,"fee schedule",EAPG,970,100,,776.00,,,0,"percent of total billed charges","100% of total billed charges",111.84,1074.33,
N/A,40276536,CDM,402,RC,76536,CPT,OUTPATIENT,,,617,401.05,TC,542.96,88,,434.37,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,617,100,,493.60,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",388.71,63,,310.97,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,425.73,69,,,,,0,"fee schedule","69% of total billed charges",617,100,,493.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",617,100,,493.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",617,100,,493.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",232.61,37.7,,186.09,,,0,"percent of total billed charges","37.7% of total billed charges",232.61,37.7,,186.09,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",209.16,33.9,,167.33,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",481.26,78,,385.01,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509.64,82.6,,407.71,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509.64,82.6,,407.71,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,617,100,,493.60,,,0,"percent of total billed charges","100% of total billed charges",73.81,617,
"US Soft Tissue Abd/Pel",40276705,CDM,402,RC,76705,CPT,OUTPATIENT,,,594,386.1,TC,522.72,88,,418.18,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,594,100,,475.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",374.22,63,,299.38,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,409.86,69,,,,,0,"fee schedule","69% of total billed charges",594,100,,475.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",594,100,,475.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",594,100,,475.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",223.94,37.7,,179.15,,,0,"percent of total billed charges","37.7% of total billed charges",223.94,37.7,,179.15,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",201.37,33.9,,161.10,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",463.32,78,,370.66,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",490.64,82.6,,392.51,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",490.64,82.6,,392.51,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,594,100,,475.20,,,0,"percent of total billed charges","100% of total billed charges",73.81,594,
"US Soft Tissue Thorax",40276604,CDM,402,RC,76604,CPT,OUTPATIENT,,,595,386.75,TC,523.6,88,,418.88,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,595,100,,476.00,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",374.85,63,,299.88,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,410.55,69,,,,,0,"fee schedule","69% of total billed charges",595,100,,476.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",595,100,,476.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",595,100,,476.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.32,37.7,,179.46,,,0,"percent of total billed charges","37.7% of total billed charges",224.32,37.7,,179.46,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",201.71,33.9,,161.37,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",464.1,78,,371.28,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",491.47,82.6,,393.18,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",491.47,82.6,,393.18,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,595,100,,476.00,,,0,"percent of total billed charges","100% of total billed charges",73.81,595,
"US Thoracentesis",40276942,CDM,402,RC,76942,CPT,OUTPATIENT,,,1155,750.75,TC,1016.4,88,,813.12,,,0,"percent of total billed charges","88% of total billed charges",577.5,50,,462.00,,,0,"percent of total billed charges","50% of total billed charges",101.95,100,,,,,0,"fee schedule",EAPG,1155,100,,924.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.01,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",727.65,63,,582.12,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",101.95,100,,,,,0,"fee schedule",EAPG,796.95,69,,,,,0,"fee schedule","69% of total billed charges",1155,100,,924.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1155,100,,924.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1155,100,,924.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",714.37,61.85,,571.50,,,0,"percent of total billed charges","61.5% of total billed charges",101.95,100,,,,,0,"fee schedule",EAPG,577.5,50,,462.00,,,0,"percent of total billed charges","50% of total billed charges",371.91,32.2,,297.53,,,0,"percent of total billed charges","32.2% of total billed charges",75.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",103.99,100,,,,,0,"fee schedule",EAPG,132.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",435.44,37.7,,348.35,,,0,"percent of total billed charges","37.7% of total billed charges",435.44,37.7,,348.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",391.55,33.9,,313.24,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",900.9,78,,720.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",954.03,82.6,,763.22,,,0,"percent of total billed charges","82.6% of total billed charges",101.95,100,,,,,0,"fee schedule",EAPG,577.5,50,,462.00,,,0,"percent of total billed charges","50% of total billed charges",954.03,82.6,,763.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.95,100,,,,,0,"fee schedule",EAPG,1155,100,,924.00,,,0,"percent of total billed charges","100% of total billed charges",75.52,1155,
"US Transcranial Doppler Complete",92193886,CDM,921,RC,93886,CPT,OUTPATIENT,,,1333,866.45,TC,1173.04,88,,938.43,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,1333,100,,1066.40,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",155.82,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",839.79,63,,671.83,,,0,"percent of total billed charges","63% of total billed charges",203.95,15.3,,163.16,,,0,"percent of total billed charges","15.3% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,919.77,69,,,,,0,"fee schedule","69% of total billed charges",1333,100,,1066.40,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1333,100,,1066.40,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1333,100,,1066.40,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",112.06,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.31,100,,,,,0,"fee schedule",EAPG,196.67,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",502.54,37.7,,402.03,,,0,"percent of total billed charges","37.7% of total billed charges",502.54,37.7,,402.03,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",451.89,33.9,,361.51,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1039.74,78,,831.79,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.06,82.6,,880.85,,,0,"percent of total billed charges","82.6% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.06,82.6,,880.85,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,1333,100,,1066.40,,,0,"percent of total billed charges","100% of total billed charges",112.06,1333,
"US Transvaginal Non-OB",40276830,CDM,402,RC,76830,CPT,OUTPATIENT,,,784,509.6,TC,689.92,88,,551.94,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,784,100,,627.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",493.92,63,,395.14,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,540.96,69,,,,,0,"fee schedule","69% of total billed charges",784,100,,627.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",784,100,,627.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",784,100,,627.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",295.57,37.7,,236.46,,,0,"percent of total billed charges","37.7% of total billed charges",295.57,37.7,,236.46,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.78,33.9,,212.62,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",611.52,78,,489.22,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.58,82.6,,518.06,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.58,82.6,,518.06,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,784,100,,627.20,,,0,"percent of total billed charges","100% of total billed charges",73.81,784,
"US Transcranial Doppler Limited",40293888,CDM,402,RC,93888,CPT,OUTPATIENT,,,767,498.55,TC,674.96,88,,539.97,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,767,100,,613.60,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",483.21,63,,386.57,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,529.23,69,,,,,0,"fee schedule","69% of total billed charges",767,100,,613.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",767,100,,613.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",767,100,,613.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.16,37.7,,231.33,,,0,"percent of total billed charges","37.7% of total billed charges",289.16,37.7,,231.33,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.01,33.9,,208.01,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",598.26,78,,478.61,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",633.54,82.6,,506.83,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",633.54,82.6,,506.83,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,767,100,,613.60,,,0,"percent of total billed charges","100% of total billed charges",73.81,767,
"US Thyroid Biopsy",40276942,CDM,402,RC,76942,CPT,OUTPATIENT,,,1155,750.75,TC,1016.4,88,,813.12,,,0,"percent of total billed charges","88% of total billed charges",577.5,50,,462.00,,,0,"percent of total billed charges","50% of total billed charges",101.95,100,,,,,0,"fee schedule",EAPG,1155,100,,924.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.01,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",727.65,63,,582.12,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",101.95,100,,,,,0,"fee schedule",EAPG,796.95,69,,,,,0,"fee schedule","69% of total billed charges",1155,100,,924.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1155,100,,924.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1155,100,,924.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",714.37,61.85,,571.50,,,0,"percent of total billed charges","61.5% of total billed charges",101.95,100,,,,,0,"fee schedule",EAPG,577.5,50,,462.00,,,0,"percent of total billed charges","50% of total billed charges",371.91,32.2,,297.53,,,0,"percent of total billed charges","32.2% of total billed charges",75.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",103.99,100,,,,,0,"fee schedule",EAPG,132.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",435.44,37.7,,348.35,,,0,"percent of total billed charges","37.7% of total billed charges",435.44,37.7,,348.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",391.55,33.9,,313.24,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",900.9,78,,720.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",954.03,82.6,,763.22,,,0,"percent of total billed charges","82.6% of total billed charges",101.95,100,,,,,0,"fee schedule",EAPG,577.5,50,,462.00,,,0,"percent of total billed charges","50% of total billed charges",954.03,82.6,,763.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.95,100,,,,,0,"fee schedule",EAPG,1155,100,,924.00,,,0,"percent of total billed charges","100% of total billed charges",75.52,1155,
"US Upper Ext Arterial Duplex Bilateral",92193930,CDM,921,RC,93930,CPT,OUTPATIENT,,,1072,696.8,TC,943.36,88,,754.69,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,1072,100,,857.60,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",675.36,63,,540.29,,,0,"percent of total billed charges","63% of total billed charges",164.02,15.3,,131.22,,,0,"percent of total billed charges","15.3% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,739.68,69,,,,,0,"fee schedule","69% of total billed charges",1072,100,,857.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1072,100,,857.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1072,100,,857.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",404.14,37.7,,323.31,,,0,"percent of total billed charges","37.7% of total billed charges",404.14,37.7,,323.31,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",363.41,33.9,,290.73,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",836.16,78,,668.93,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",885.47,82.6,,708.38,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",885.47,82.6,,708.38,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,1072,100,,857.60,,,0,"percent of total billed charges","100% of total billed charges",73.81,1072,
"US Upper Ext Arterial Duplex Left",92193931,CDM,921,RC,93931,CPT,OUTPATIENT,,,864,561.6,TC|LT,760.32,88,,608.26,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,864,100,,691.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",544.32,63,,435.46,,,0,"percent of total billed charges","63% of total billed charges",132.19,15.3,,105.75,,,0,"percent of total billed charges","15.3% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,596.16,69,,,,,0,"fee schedule","69% of total billed charges",864,100,,691.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",864,100,,691.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",864,100,,691.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",325.73,37.7,,260.58,,,0,"percent of total billed charges","37.7% of total billed charges",325.73,37.7,,260.58,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",292.9,33.9,,234.32,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.92,78,,539.14,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",713.66,82.6,,570.93,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",713.66,82.6,,570.93,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,864,100,,691.20,,,0,"percent of total billed charges","100% of total billed charges",73.81,864,
"US Upper Ext Arterial Duplex Right",92193931,CDM,921,RC,93931,CPT,OUTPATIENT,,,864,561.6,TC|LT,760.32,88,,608.26,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,864,100,,691.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",544.32,63,,435.46,,,0,"percent of total billed charges","63% of total billed charges",132.19,15.3,,105.75,,,0,"percent of total billed charges","15.3% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,596.16,69,,,,,0,"fee schedule","69% of total billed charges",864,100,,691.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",864,100,,691.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",864,100,,691.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",325.73,37.7,,260.58,,,0,"percent of total billed charges","37.7% of total billed charges",325.73,37.7,,260.58,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",292.9,33.9,,234.32,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.92,78,,539.14,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",713.66,82.6,,570.93,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",713.66,82.6,,570.93,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,864,100,,691.20,,,0,"percent of total billed charges","100% of total billed charges",73.81,864,
"US Upper Ext Venous Duplex Bilateral",92193970,CDM,921,RC,93970,CPT,OUTPATIENT,,,1984,1289.6,TC,1745.92,88,,1396.74,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,1984,100,,1587.20,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",155.82,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1249.92,63,,999.94,,,0,"percent of total billed charges","63% of total billed charges",303.55,15.3,,242.84,,,0,"percent of total billed charges","15.3% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,1368.96,69,,,,,0,"fee schedule","69% of total billed charges",1984,100,,1587.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1984,100,,1587.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1984,100,,1587.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",112.06,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.31,100,,,,,0,"fee schedule",EAPG,196.67,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",747.97,37.7,,598.38,,,0,"percent of total billed charges","37.7% of total billed charges",747.97,37.7,,598.38,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672.58,33.9,,538.06,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1547.52,78,,1238.02,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1638.78,82.6,,1311.02,,,0,"percent of total billed charges","82.6% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1638.78,82.6,,1311.02,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,1984,100,,1587.20,,,0,"percent of total billed charges","100% of total billed charges",112.06,1984,
"US Upper Ext Venous Duplex Left",92193971,CDM,921,RC,93971,CPT,OUTPATIENT,,,1461,949.65,TC|LT,1285.68,88,,1028.54,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",920.43,63,,736.34,,,0,"percent of total billed charges","63% of total billed charges",223.53,15.3,,178.82,,,0,"percent of total billed charges","15.3% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,1008.09,69,,,,,0,"fee schedule","69% of total billed charges",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",550.8,37.7,,440.64,,,0,"percent of total billed charges","37.7% of total billed charges",550.8,37.7,,440.64,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",495.28,33.9,,396.22,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1139.58,78,,911.66,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1206.79,82.6,,965.43,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1206.79,82.6,,965.43,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",73.81,1461,
"US Upper Ext Venous Duplex Right",92193971,CDM,921,RC,93971,CPT,OUTPATIENT,,,1461,949.65,TC|LT,1285.68,88,,1028.54,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",920.43,63,,736.34,,,0,"percent of total billed charges","63% of total billed charges",223.53,15.3,,178.82,,,0,"percent of total billed charges","15.3% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,1008.09,69,,,,,0,"fee schedule","69% of total billed charges",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",550.8,37.7,,440.64,,,0,"percent of total billed charges","37.7% of total billed charges",550.8,37.7,,440.64,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",495.28,33.9,,396.22,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1139.58,78,,911.66,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1206.79,82.6,,965.43,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1206.79,82.6,,965.43,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",73.81,1461,
"US Vessel Mapping for Dialysis",40293985,CDM,402,RC,93985,CPT,OUTPATIENT,,,998,648.7,TC,878.24,88,,702.59,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,998,100,,798.40,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",628.74,63,,502.99,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,688.62,69,,,,,0,"fee schedule","69% of total billed charges",998,100,,798.40,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",998,100,,798.40,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",998,100,,798.40,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",376.25,37.7,,301.00,,,0,"percent of total billed charges","37.7% of total billed charges",376.25,37.7,,301.00,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.32,33.9,,270.66,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",778.44,78,,622.75,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",824.35,82.6,,659.48,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule","100% of WA fee schedule",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",824.35,82.6,,659.48,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,998,100,,798.40,,,0,"percent of total billed charges","100% of total billed charges",73.81,998,
"US Vessel Mapping for Hemo Access",40293985,CDM,402,RC,93985,CPT,OUTPATIENT,,,1351,878.15,TC,1188.88,88,,951.10,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,1351,100,,1080.80,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",851.13,63,,680.90,,,0,"percent of total billed charges","63% of total billed charges",235,100,,,,,0,"case rate","pays based on per visit rate",99.65,100,,,,,0,"fee schedule",EAPG,932.19,69,,,,,0,"fee schedule","69% of total billed charges",1351,100,,1080.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1351,100,,1080.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1351,100,,1080.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509.33,37.7,,407.46,,,0,"percent of total billed charges","37.7% of total billed charges",509.33,37.7,,407.46,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",457.99,33.9,,366.39,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1053.78,78,,843.02,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1115.93,82.6,,892.74,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule","100% of WA fee schedule",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1115.93,82.6,,892.74,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,1351,100,,1080.80,,,0,"percent of total billed charges","100% of total billed charges",73.81,1351,
"XR AC Joints Bilateral",32073050,CDM,320,RC,73050,CPT,OUTPATIENT,,,1215,789.75,TC,1069.2,88,,855.36,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1215,100,,972.00,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",765.45,63,,612.36,,,0,"percent of total billed charges","63% of total billed charges",185.9,15.3,,148.72,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,838.35,69,,,,,0,"fee schedule","69% of total billed charges",1215,100,,972.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1215,100,,972.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1215,100,,972.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",458.06,37.7,,366.45,,,0,"percent of total billed charges","37.7% of total billed charges",458.06,37.7,,366.45,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",411.89,33.9,,329.51,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",947.7,78,,758.16,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1003.59,82.6,,802.87,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1003.59,82.6,,802.87,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1215,100,,972.00,,,0,"percent of total billed charges","100% of total billed charges",38.21,1215,
"XR Abdomen KUB 1 View",32074000,CDM,320,RC,74018,CPT,OUTPATIENT,,,968,629.2,TC,851.84,88,,681.47,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,968,100,,774.40,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",609.84,63,,487.87,,,0,"percent of total billed charges","63% of total billed charges",148.1,15.3,,118.48,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,667.92,69,,,,,0,"fee schedule","69% of total billed charges",968,100,,774.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",968,100,,774.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",968,100,,774.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",364.94,37.7,,291.95,,,0,"percent of total billed charges","37.7% of total billed charges",364.94,37.7,,291.95,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",328.15,33.9,,262.52,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",755.04,78,,604.03,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",799.57,82.6,,639.66,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",799.57,82.6,,639.66,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,968,100,,774.40,,,0,"percent of total billed charges","100% of total billed charges",38.21,968,
"XR Abdomen Complete w Decub and/or Erect",32074020,CDM,320,RC,74019,CPT,OUTPATIENT,,,1796,1167.4,TC,1580.48,88,,1264.38,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1796,100,,1436.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1131.48,63,,905.18,,,0,"percent of total billed charges","63% of total billed charges",274.79,15.3,,219.83,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1239.24,69,,,,,0,"fee schedule","69% of total billed charges",1796,100,,1436.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1796,100,,1436.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1796,100,,1436.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",677.09,37.7,,541.67,,,0,"percent of total billed charges","37.7% of total billed charges",677.09,37.7,,541.67,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",608.84,33.9,,487.07,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1400.88,78,,1120.70,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1483.5,82.6,,1186.80,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1483.5,82.6,,1186.80,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1796,100,,1436.80,,,0,"percent of total billed charges","100% of total billed charges",38.21,1796,
"XR Abdomen Series + Chest 1 View",32074022,CDM,320,RC,74022,CPT,OUTPATIENT,,,2321,1508.65,TC,2042.48,88,,1633.98,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,2321,100,,1856.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1462.23,63,,1169.78,,,0,"percent of total billed charges","63% of total billed charges",355.11,15.3,,284.09,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1601.49,69,,,,,0,"fee schedule","69% of total billed charges",2321,100,,1856.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2321,100,,1856.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2321,100,,1856.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.02,37.7,,700.02,,,0,"percent of total billed charges","37.7% of total billed charges",875.02,37.7,,700.02,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.82,33.9,,629.46,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1810.38,78,,1448.30,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1917.15,82.6,,1533.72,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1917.15,82.6,,1533.72,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,2321,100,,1856.80,,,0,"percent of total billed charges","100% of total billed charges",38.21,2321,
"XR Ankle 2 Views Left",32073600,CDM,320,RC,73600,CPT,OUTPATIENT,,,671,436.15,TC|LT,590.48,88,,472.38,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",422.73,63,,338.18,,,0,"percent of total billed charges","63% of total billed charges",102.66,15.3,,82.13,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,462.99,69,,,,,0,"fee schedule","69% of total billed charges",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.97,37.7,,202.38,,,0,"percent of total billed charges","37.7% of total billed charges",252.97,37.7,,202.38,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",227.47,33.9,,181.98,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",523.38,78,,418.70,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.25,82.6,,443.40,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.25,82.6,,443.40,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",38.21,671,
"XR Ankle 2 Views Right",32073600,CDM,320,RC,73600,CPT,OUTPATIENT,,,671,436.15,TC|LT,590.48,88,,472.38,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",422.73,63,,338.18,,,0,"percent of total billed charges","63% of total billed charges",102.66,15.3,,82.13,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,462.99,69,,,,,0,"fee schedule","69% of total billed charges",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.97,37.7,,202.38,,,0,"percent of total billed charges","37.7% of total billed charges",252.97,37.7,,202.38,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",227.47,33.9,,181.98,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",523.38,78,,418.70,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.25,82.6,,443.40,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.25,82.6,,443.40,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",38.21,671,
"XR Ankle Complete 3+ Views Bilateral",32073610,CDM,320,RC,73610,CPT,OUTPATIENT,,,1173,762.45,TC,1032.24,88,,825.79,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1173,100,,938.40,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",738.99,63,,591.19,,,0,"percent of total billed charges","63% of total billed charges",179.47,15.3,,143.58,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,809.37,69,,,,,0,"fee schedule","69% of total billed charges",1173,100,,938.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1173,100,,938.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1173,100,,938.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",442.22,37.7,,353.78,,,0,"percent of total billed charges","37.7% of total billed charges",442.22,37.7,,353.78,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397.65,33.9,,318.12,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",914.94,78,,731.95,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",968.9,82.6,,775.12,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",968.9,82.6,,775.12,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1173,100,,938.40,,,0,"percent of total billed charges","100% of total billed charges",38.21,1173,
"XR Ankle Complete 3+ Views Left",32073610,CDM,320,RC,73610,CPT,OUTPATIENT,,,1173,762.45,TC,1032.24,88,,825.79,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1173,100,,938.40,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",738.99,63,,591.19,,,0,"percent of total billed charges","63% of total billed charges",179.47,15.3,,143.58,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,809.37,69,,,,,0,"fee schedule","69% of total billed charges",1173,100,,938.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1173,100,,938.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1173,100,,938.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",442.22,37.7,,353.78,,,0,"percent of total billed charges","37.7% of total billed charges",442.22,37.7,,353.78,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397.65,33.9,,318.12,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",914.94,78,,731.95,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",968.9,82.6,,775.12,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",968.9,82.6,,775.12,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1173,100,,938.40,,,0,"percent of total billed charges","100% of total billed charges",38.21,1173,
"XR Ankle Complete 3+ Views Right",32073610,CDM,320,RC,73610,CPT,OUTPATIENT,,,1173,762.45,TC,1032.24,88,,825.79,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1173,100,,938.40,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",738.99,63,,591.19,,,0,"percent of total billed charges","63% of total billed charges",179.47,15.3,,143.58,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,809.37,69,,,,,0,"fee schedule","69% of total billed charges",1173,100,,938.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1173,100,,938.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1173,100,,938.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",442.22,37.7,,353.78,,,0,"percent of total billed charges","37.7% of total billed charges",442.22,37.7,,353.78,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397.65,33.9,,318.12,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",914.94,78,,731.95,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",968.9,82.6,,775.12,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",968.9,82.6,,775.12,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1173,100,,938.40,,,0,"percent of total billed charges","100% of total billed charges",38.21,1173,
"XR Arthrogram Injection Hip Left",32273525,CDM,322,RC,73525,CPT,OUTPATIENT,,,1743,1132.95,TC|LT,1533.84,88,,1227.07,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1743,100,,1394.40,,,0,"percent of total billed charges","100% of total billed charges",686.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1098.09,63,,878.47,,,0,"percent of total billed charges","63% of total billed charges",266.68,15.3,,213.34,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,1202.67,69,,,,,0,"fee schedule","69% of total billed charges",1743,100,,1394.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1743,100,,1394.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1743,100,,1394.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",657.11,37.7,,525.69,,,0,"percent of total billed charges","37.7% of total billed charges",657.11,37.7,,525.69,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",590.88,33.9,,472.70,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1359.54,78,,1087.63,,,0,"percent of total billed charges","78% of total billed charges",396.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1439.72,82.6,,1151.78,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1439.72,82.6,,1151.78,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1743,100,,1394.40,,,0,"percent of total billed charges","100% of total billed charges",80.56,1743,
"XR Arthrogram Injection Hip Right",32273525,CDM,322,RC,73525,CPT,OUTPATIENT,,,1743,1132.95,TC|LT,1533.84,88,,1227.07,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1743,100,,1394.40,,,0,"percent of total billed charges","100% of total billed charges",686.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1098.09,63,,878.47,,,0,"percent of total billed charges","63% of total billed charges",266.68,15.3,,213.34,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,1202.67,69,,,,,0,"fee schedule","69% of total billed charges",1743,100,,1394.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1743,100,,1394.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1743,100,,1394.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",657.11,37.7,,525.69,,,0,"percent of total billed charges","37.7% of total billed charges",657.11,37.7,,525.69,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",590.88,33.9,,472.70,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1359.54,78,,1087.63,,,0,"percent of total billed charges","78% of total billed charges",396.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1439.72,82.6,,1151.78,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1439.72,82.6,,1151.78,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1743,100,,1394.40,,,0,"percent of total billed charges","100% of total billed charges",80.56,1743,
"XR Arthrogram Injection Knee Left",32273580,CDM,322,RC,73580,CPT,OUTPATIENT,,,1452,943.8,TC|LT,1277.76,88,,1022.21,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1452,100,,1161.60,,,0,"percent of total billed charges","100% of total billed charges",686.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",914.76,63,,731.81,,,0,"percent of total billed charges","63% of total billed charges",222.16,15.3,,177.73,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,1001.88,69,,,,,0,"fee schedule","69% of total billed charges",1452,100,,1161.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1452,100,,1161.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1452,100,,1161.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",547.4,37.7,,437.92,,,0,"percent of total billed charges","37.7% of total billed charges",547.4,37.7,,437.92,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",492.23,33.9,,393.78,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1132.56,78,,906.05,,,0,"percent of total billed charges","78% of total billed charges",396.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1199.35,82.6,,959.48,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1199.35,82.6,,959.48,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1452,100,,1161.60,,,0,"percent of total billed charges","100% of total billed charges",80.56,1495.49,
"XR Arthrogram Injection Knee Right",32273580,CDM,322,RC,73580,CPT,OUTPATIENT,,,1452,943.8,TC|LT,1277.76,88,,1022.21,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1452,100,,1161.60,,,0,"percent of total billed charges","100% of total billed charges",686.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",914.76,63,,731.81,,,0,"percent of total billed charges","63% of total billed charges",222.16,15.3,,177.73,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,1001.88,69,,,,,0,"fee schedule","69% of total billed charges",1452,100,,1161.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1452,100,,1161.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1452,100,,1161.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",547.4,37.7,,437.92,,,0,"percent of total billed charges","37.7% of total billed charges",547.4,37.7,,437.92,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",492.23,33.9,,393.78,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1132.56,78,,906.05,,,0,"percent of total billed charges","78% of total billed charges",396.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1199.35,82.6,,959.48,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1199.35,82.6,,959.48,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1452,100,,1161.60,,,0,"percent of total billed charges","100% of total billed charges",80.56,1495.49,
"XR Arthrogram Injection Shoulder Left",32273040,CDM,322,RC,73040,CPT,OUTPATIENT,,,1452,943.8,TC|LT,1277.76,88,,1022.21,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1452,100,,1161.60,,,0,"percent of total billed charges","100% of total billed charges",686.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",914.76,63,,731.81,,,0,"percent of total billed charges","63% of total billed charges",222.16,15.3,,177.73,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,1001.88,69,,,,,0,"fee schedule","69% of total billed charges",1452,100,,1161.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1452,100,,1161.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1452,100,,1161.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",547.4,37.7,,437.92,,,0,"percent of total billed charges","37.7% of total billed charges",547.4,37.7,,437.92,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",492.23,33.9,,393.78,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1132.56,78,,906.05,,,0,"percent of total billed charges","78% of total billed charges",396.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1199.35,82.6,,959.48,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1199.35,82.6,,959.48,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1452,100,,1161.60,,,0,"percent of total billed charges","100% of total billed charges",80.56,1495.49,
"XR Arthrogram Injection Shoulder Right",32273040,CDM,322,RC,73040,CPT,OUTPATIENT,,,1452,943.8,TC|LT,1277.76,88,,1022.21,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1452,100,,1161.60,,,0,"percent of total billed charges","100% of total billed charges",686.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",914.76,63,,731.81,,,0,"percent of total billed charges","63% of total billed charges",222.16,15.3,,177.73,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,1001.88,69,,,,,0,"fee schedule","69% of total billed charges",1452,100,,1161.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1452,100,,1161.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1452,100,,1161.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",547.4,37.7,,437.92,,,0,"percent of total billed charges","37.7% of total billed charges",547.4,37.7,,437.92,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",492.23,33.9,,393.78,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1132.56,78,,906.05,,,0,"percent of total billed charges","78% of total billed charges",396.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1199.35,82.6,,959.48,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1199.35,82.6,,959.48,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1452,100,,1161.60,,,0,"percent of total billed charges","100% of total billed charges",80.56,1495.49,
"XR Arthrogram Injection Wrist Left",32273115,CDM,322,RC,73115,CPT,OUTPATIENT,,,1452,943.8,TC|LT,1277.76,88,,1022.21,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1452,100,,1161.60,,,0,"percent of total billed charges","100% of total billed charges",686.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",914.76,63,,731.81,,,0,"percent of total billed charges","63% of total billed charges",222.16,15.3,,177.73,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,1001.88,69,,,,,0,"fee schedule","69% of total billed charges",1452,100,,1161.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1452,100,,1161.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1452,100,,1161.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",547.4,37.7,,437.92,,,0,"percent of total billed charges","37.7% of total billed charges",547.4,37.7,,437.92,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",492.23,33.9,,393.78,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1132.56,78,,906.05,,,0,"percent of total billed charges","78% of total billed charges",396.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1199.35,82.6,,959.48,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1199.35,82.6,,959.48,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1452,100,,1161.60,,,0,"percent of total billed charges","100% of total billed charges",80.56,1495.49,
"XR Arthrogram Injection Wrist Right",32273115,CDM,322,RC,73115,CPT,OUTPATIENT,,,1452,943.8,TC|LT,1277.76,88,,1022.21,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1452,100,,1161.60,,,0,"percent of total billed charges","100% of total billed charges",686.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",914.76,63,,731.81,,,0,"percent of total billed charges","63% of total billed charges",222.16,15.3,,177.73,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,1001.88,69,,,,,0,"fee schedule","69% of total billed charges",1452,100,,1161.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1452,100,,1161.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1452,100,,1161.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",547.4,37.7,,437.92,,,0,"percent of total billed charges","37.7% of total billed charges",547.4,37.7,,437.92,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",492.23,33.9,,393.78,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1132.56,78,,906.05,,,0,"percent of total billed charges","78% of total billed charges",396.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1199.35,82.6,,959.48,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1199.35,82.6,,959.48,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1452,100,,1161.60,,,0,"percent of total billed charges","100% of total billed charges",80.56,1495.49,
"XR Angio Extremity in OR SI Left",32375710,CDM,323,RC,75710,CPT,OUTPATIENT,,,10983,7138.95,TC|LT,9665.04,88,,7732.03,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5689.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",1694.66,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6919.29,63,,5535.43,,,0,"percent of total billed charges","63% of total billed charges",1680.4,15.3,,1344.32,,,0,"percent of total billed charges","15.3% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,7578.27,69,,,,,0,"fee schedule","69% of total billed charges",10983,100,,8786.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10983,100,,8786.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10983,100,,8786.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1218.74,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1678.2,100,,,,,0,"fee schedule",EAPG,2138.89,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4140.59,37.7,,3312.47,,,0,"percent of total billed charges","37.7% of total billed charges",4140.59,37.7,,3312.47,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3723.24,33.9,,2978.59,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8566.74,78,,6853.39,,,0,"percent of total billed charges","78% of total billed charges",3283.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9071.96,82.6,,7257.57,,,0,"percent of total billed charges","82.6% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9071.96,82.6,,7257.57,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,10983,100,,8786.40,,,0,"percent of total billed charges","100% of total billed charges",1218.74,11625.58,
"XR Angio Extremity in OR SI Right",36075710,CDM,360,RC,75710,CPT,OUTPATIENT,,,10983,7138.95,TC|RT,9665.04,88,,7732.03,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5689.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",1694.66,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6919.29,63,,5535.43,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,7578.27,69,,,,,0,"fee schedule","69% of total billed charges",10983,100,,8786.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10983,100,,8786.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10983,100,,8786.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1218.74,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1678.2,100,,,,,0,"fee schedule",EAPG,2138.89,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4140.59,37.7,,3312.47,,,0,"percent of total billed charges","37.7% of total billed charges",4140.59,37.7,,3312.47,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3723.24,33.9,,2978.59,,,0,"percent of total billed charges","33.9% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8566.74,78,,6853.39,,,0,"percent of total billed charges","78% of total billed charges",3283.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9071.96,82.6,,7257.57,,,0,"percent of total billed charges","82.6% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9071.96,82.6,,7257.57,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,10983,100,,8786.40,,,0,"percent of total billed charges","100% of total billed charges",1218.74,11625.58,
"XR Abdomen 2 Views",32074019,CDM,320,RC,74019,CPT,OUTPATIENT,,,1589,1032.85,TC,1398.32,88,,1118.66,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1589,100,,1271.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1001.07,63,,800.86,,,0,"percent of total billed charges","63% of total billed charges",243.12,15.3,,194.50,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1096.41,69,,,,,0,"fee schedule","69% of total billed charges",1589,100,,1271.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589,100,,1271.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589,100,,1271.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",599.05,37.7,,479.24,,,0,"percent of total billed charges","37.7% of total billed charges",599.05,37.7,,479.24,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",538.67,33.9,,430.94,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.42,78,,991.54,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1312.51,82.6,,1050.01,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1312.51,82.6,,1050.01,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1589,100,,1271.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1589,
"XR Abdomen 3 Views",32074021,CDM,320,RC,74021,CPT,OUTPATIENT,,,1885,1225.25,TC,1658.8,88,,1327.04,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1885,100,,1508.00,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1187.55,63,,950.04,,,0,"percent of total billed charges","63% of total billed charges",288.41,15.3,,230.73,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1300.65,69,,,,,0,"fee schedule","69% of total billed charges",1885,100,,1508.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1885,100,,1508.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1885,100,,1508.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",710.65,37.7,,568.52,,,0,"percent of total billed charges","37.7% of total billed charges",710.65,37.7,,568.52,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",639.02,33.9,,511.22,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1470.3,78,,1176.24,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1557.01,82.6,,1245.61,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1557.01,82.6,,1245.61,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1885,100,,1508.00,,,0,"percent of total billed charges","100% of total billed charges",38.21,1885,
"XR Barium Enema Complete",32074270,CDM,320,RC,74270,CPT,OUTPATIENT,,,2910,1891.5,TC,2560.8,88,,2048.64,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,2910,100,,2328.00,,,0,"percent of total billed charges","100% of total billed charges",327.95,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1833.3,63,,1466.64,,,0,"percent of total billed charges","63% of total billed charges",445.23,15.3,,356.18,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,2007.9,69,,,,,0,"fee schedule","69% of total billed charges",2910,100,,2328.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2910,100,,2328.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2910,100,,2328.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1097.07,37.7,,877.66,,,0,"percent of total billed charges","37.7% of total billed charges",1097.07,37.7,,877.66,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",986.49,33.9,,789.19,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2269.8,78,,1815.84,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2403.66,82.6,,1922.93,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2403.66,82.6,,1922.93,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,2910,100,,2328.00,,,0,"percent of total billed charges","100% of total billed charges",80.56,2910,
"XR Barium Enema w/ Air Complete",32074280,CDM,320,RC,74280,CPT,OUTPATIENT,,,3405,2213.25,TC,2996.4,88,,2397.12,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,3405,100,,2724.00,,,0,"percent of total billed charges","100% of total billed charges",327.95,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2145.15,63,,1716.12,,,0,"percent of total billed charges","63% of total billed charges",520.97,15.3,,416.78,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,2349.45,69,,,,,0,"fee schedule","69% of total billed charges",3405,100,,2724.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3405,100,,2724.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3405,100,,2724.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1283.69,37.7,,1026.95,,,0,"percent of total billed charges","37.7% of total billed charges",1283.69,37.7,,1026.95,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1154.3,33.9,,923.44,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2655.9,78,,2124.72,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2812.53,82.6,,2250.02,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2812.53,82.6,,2250.02,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,3405,100,,2724.00,,,0,"percent of total billed charges","100% of total billed charges",80.56,3405,
"XR Bone Age Studies",32077072,CDM,320,RC,77072,CPT,OUTPATIENT,,,1429,928.85,TC,1257.52,88,,1006.02,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1429,100,,1143.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",900.27,63,,720.22,,,0,"percent of total billed charges","63% of total billed charges",218.64,15.3,,174.91,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,986.01,69,,,,,0,"fee schedule","69% of total billed charges",1429,100,,1143.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1429,100,,1143.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1429,100,,1143.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",538.73,37.7,,430.98,,,0,"percent of total billed charges","37.7% of total billed charges",538.73,37.7,,430.98,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",484.43,33.9,,387.54,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1114.62,78,,891.70,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1180.35,82.6,,944.28,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1180.35,82.6,,944.28,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1429,100,,1143.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1429,
"XR Bone Length Studies Scanograms",32077073,CDM,320,RC,77073,CPT,OUTPATIENT,,,1079,701.35,TC,949.52,88,,759.62,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1079,100,,863.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",679.77,63,,543.82,,,0,"percent of total billed charges","63% of total billed charges",165.09,15.3,,132.07,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,744.51,69,,,,,0,"fee schedule","69% of total billed charges",1079,100,,863.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1079,100,,863.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1079,100,,863.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",406.78,37.7,,325.42,,,0,"percent of total billed charges","37.7% of total billed charges",406.78,37.7,,325.42,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",365.78,33.9,,292.62,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",841.62,78,,673.30,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891.25,82.6,,713.00,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891.25,82.6,,713.00,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1079,100,,863.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1079,
"XR Barium Enema Therapeutic",32074283,CDM,320,RC,74283,CPT,OUTPATIENT,,,3255,2115.75,TC,2864.4,88,,2291.52,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,3255,100,,2604.00,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2050.65,63,,1640.52,,,0,"percent of total billed charges","63% of total billed charges",498.02,15.3,,398.42,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,2245.95,69,,,,,0,"fee schedule","69% of total billed charges",3255,100,,2604.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3255,100,,2604.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3255,100,,2604.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1227.14,37.7,,981.71,,,0,"percent of total billed charges","37.7% of total billed charges",1227.14,37.7,,981.71,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1103.45,33.9,,882.76,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2538.9,78,,2031.12,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2688.63,82.6,,2150.90,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2688.63,82.6,,2150.90,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,3255,100,,2604.00,,,0,"percent of total billed charges","100% of total billed charges",80.56,3255,
"XR Chest 2 Views",32471046,CDM,324,RC,71046,CPT,OUTPATIENT,,,1034,672.1,TC,909.92,88,,727.94,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1034,100,,827.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",651.42,63,,521.14,,,0,"percent of total billed charges","63% of total billed charges",158.2,15.3,,126.56,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,713.46,69,,,,,0,"fee schedule","69% of total billed charges",1034,100,,827.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1034,100,,827.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1034,100,,827.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",389.82,37.7,,311.86,,,0,"percent of total billed charges","37.7% of total billed charges",389.82,37.7,,311.86,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350.53,33.9,,280.42,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",806.52,78,,645.22,,,0,"percent of total billed charges","78% of total billed charges",93.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",854.08,82.6,,683.26,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",854.08,82.6,,683.26,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1034,100,,827.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1034,
"XR Calcaneous Bilateral",32073650,CDM,320,RC,73650,CPT,OUTPATIENT,,,679,441.35,TC,597.52,88,,478.02,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",427.77,63,,342.22,,,0,"percent of total billed charges","63% of total billed charges",103.89,15.3,,83.11,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,468.51,69,,,,,0,"fee schedule","69% of total billed charges",679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.98,37.7,,204.78,,,0,"percent of total billed charges","37.7% of total billed charges",255.98,37.7,,204.78,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",230.18,33.9,,184.14,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",529.62,78,,423.70,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.85,82.6,,448.68,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.85,82.6,,448.68,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,679,
"XR Calcaneous Left",32073650,CDM,320,RC,73650,CPT,OUTPATIENT,,,679,441.35,TC,597.52,88,,478.02,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",427.77,63,,342.22,,,0,"percent of total billed charges","63% of total billed charges",103.89,15.3,,83.11,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,468.51,69,,,,,0,"fee schedule","69% of total billed charges",679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.98,37.7,,204.78,,,0,"percent of total billed charges","37.7% of total billed charges",255.98,37.7,,204.78,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",230.18,33.9,,184.14,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",529.62,78,,423.70,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.85,82.6,,448.68,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.85,82.6,,448.68,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,679,
"XR Calcaneous Right",32073650,CDM,320,RC,73650,CPT,OUTPATIENT,,,679,441.35,TC,597.52,88,,478.02,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",427.77,63,,342.22,,,0,"percent of total billed charges","63% of total billed charges",103.89,15.3,,83.11,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,468.51,69,,,,,0,"fee schedule","69% of total billed charges",679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.98,37.7,,204.78,,,0,"percent of total billed charges","37.7% of total billed charges",255.98,37.7,,204.78,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",230.18,33.9,,184.14,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",529.62,78,,423.70,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.85,82.6,,448.68,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.85,82.6,,448.68,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,679,
"XR Chest 1 View Frontal",32471045,CDM,324,RC,71045,CPT,OUTPATIENT,,,1240,806,TC,1091.2,88,,872.96,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1240,100,,992.00,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",781.2,63,,624.96,,,0,"percent of total billed charges","63% of total billed charges",189.72,15.3,,151.78,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,855.6,69,,,,,0,"fee schedule","69% of total billed charges",1240,100,,992.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1240,100,,992.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1240,100,,992.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",467.48,37.7,,373.98,,,0,"percent of total billed charges","37.7% of total billed charges",467.48,37.7,,373.98,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.36,33.9,,336.29,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.2,78,,773.76,,,0,"percent of total billed charges","78% of total billed charges",93.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1024.24,82.6,,819.39,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1024.24,82.6,,819.39,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1240,100,,992.00,,,0,"percent of total billed charges","100% of total billed charges",38.21,1240,
"XR Chest 2 Views w/ Apical Lordotic",32071047,CDM,320,RC,71047,CPT,OUTPATIENT,,,2217,1441.05,TC,1950.96,88,,1560.77,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,2217,100,,1773.60,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1396.71,63,,1117.37,,,0,"percent of total billed charges","63% of total billed charges",339.2,15.3,,271.36,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1529.73,69,,,,,0,"fee schedule","69% of total billed charges",2217,100,,1773.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2217,100,,1773.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2217,100,,1773.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",835.81,37.7,,668.65,,,0,"percent of total billed charges","37.7% of total billed charges",835.81,37.7,,668.65,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",751.56,33.9,,601.25,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1729.26,78,,1383.41,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1831.24,82.6,,1464.99,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1831.24,82.6,,1464.99,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,2217,100,,1773.60,,,0,"percent of total billed charges","100% of total billed charges",38.21,2217,
"XR Chest 2 Views w/ Fluoroscopy",32471046,CDM,324,RC,71046,CPT,OUTPATIENT,,,1034,672.1,TC,909.92,88,,727.94,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1034,100,,827.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",651.42,63,,521.14,,,0,"percent of total billed charges","63% of total billed charges",158.2,15.3,,126.56,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,713.46,69,,,,,0,"fee schedule","69% of total billed charges",1034,100,,827.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1034,100,,827.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1034,100,,827.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",389.82,37.7,,311.86,,,0,"percent of total billed charges","37.7% of total billed charges",389.82,37.7,,311.86,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350.53,33.9,,280.42,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",806.52,78,,645.22,,,0,"percent of total billed charges","78% of total billed charges",93.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",854.08,82.6,,683.26,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",854.08,82.6,,683.26,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1034,100,,827.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1034,
"XR Chest 2 Views w/ Obliques",32471022,CDM,324,RC,71048,CPT,OUTPATIENT,,,1523,989.95,TC,1340.24,88,,1072.19,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1523,100,,1218.40,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",959.49,63,,767.59,,,0,"percent of total billed charges","63% of total billed charges",233.02,15.3,,186.42,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1050.87,69,,,,,0,"fee schedule","69% of total billed charges",1523,100,,1218.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1523,100,,1218.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1523,100,,1218.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",574.17,37.7,,459.34,,,0,"percent of total billed charges","37.7% of total billed charges",574.17,37.7,,459.34,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",516.3,33.9,,413.04,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1187.94,78,,950.35,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1258,82.6,,1006.40,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1258,82.6,,1006.40,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1523,100,,1218.40,,,0,"percent of total billed charges","100% of total billed charges",38.21,1523,
"XR Chest Decubitus",32471045,CDM,324,RC,71045,CPT,OUTPATIENT,,,1034,672.1,TC,909.92,88,,727.94,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1034,100,,827.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",651.42,63,,521.14,,,0,"percent of total billed charges","63% of total billed charges",158.2,15.3,,126.56,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,713.46,69,,,,,0,"fee schedule","69% of total billed charges",1034,100,,827.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1034,100,,827.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1034,100,,827.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",389.82,37.7,,311.86,,,0,"percent of total billed charges","37.7% of total billed charges",389.82,37.7,,311.86,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350.53,33.9,,280.42,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",806.52,78,,645.22,,,0,"percent of total billed charges","78% of total billed charges",93.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",854.08,82.6,,683.26,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",854.08,82.6,,683.26,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1034,100,,827.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1034,
"XR Chest 4+ Views",32471048,CDM,324,RC,71048,CPT,OUTPATIENT,,,1523,989.95,TC,1340.24,88,,1072.19,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1523,100,,1218.40,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",959.49,63,,767.59,,,0,"percent of total billed charges","63% of total billed charges",233.02,15.3,,186.42,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1050.87,69,,,,,0,"fee schedule","69% of total billed charges",1523,100,,1218.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1523,100,,1218.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1523,100,,1218.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",574.17,37.7,,459.34,,,0,"percent of total billed charges","37.7% of total billed charges",574.17,37.7,,459.34,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",516.3,33.9,,413.04,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1187.94,78,,950.35,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1258,82.6,,1006.40,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1258,82.6,,1006.40,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1523,100,,1218.40,,,0,"percent of total billed charges","100% of total billed charges",38.21,1523,
"XR Cholangiogram in OR",32074300,CDM,320,RC,74300,CPT,OUTPATIENT,,,3436,2233.4,TC,3023.68,88,,2418.94,,,0,"percent of total billed charges","88% of total billed charges",1718,50,,1374.40,,,0,"percent of total billed charges","50% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,3436,100,,2748.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2164.68,63,,1731.74,,,0,"percent of total billed charges","63% of total billed charges",525.71,15.3,,420.57,,,0,"percent of total billed charges","15.3% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,2370.84,69,,,,,0,"fee schedule","69% of total billed charges",3436,100,,2748.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3436,100,,2748.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3436,100,,2748.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2125.17,61.85,,1700.14,,,0,"percent of total billed charges","61.5% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,1718,50,,1374.40,,,0,"percent of total billed charges","50% of total billed charges",1106.39,32.2,,885.11,,,0,"percent of total billed charges","32.2% of total billed charges",119.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",165.21,100,,,,,0,"fee schedule",EAPG,210.57,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1295.37,37.7,,1036.30,,,0,"percent of total billed charges","37.7% of total billed charges",1295.37,37.7,,1036.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1164.8,33.9,,931.84,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2680.08,78,,2144.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2838.14,82.6,,2270.51,,,0,"percent of total billed charges","82.6% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,1718,50,,1374.40,,,0,"percent of total billed charges","50% of total billed charges",2838.14,82.6,,2270.51,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",161.97,100,,,,,0,"fee schedule",EAPG,3436,100,,2748.80,,,0,"percent of total billed charges","100% of total billed charges",119.98,3436,
"XR Clavicle Left",32073000,CDM,320,RC,73000,CPT,OUTPATIENT,,,1009,655.85,TC|LT,887.92,88,,710.34,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1009,100,,807.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",635.67,63,,508.54,,,0,"percent of total billed charges","63% of total billed charges",154.38,15.3,,123.50,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,696.21,69,,,,,0,"fee schedule","69% of total billed charges",1009,100,,807.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1009,100,,807.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1009,100,,807.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",380.39,37.7,,304.31,,,0,"percent of total billed charges","37.7% of total billed charges",380.39,37.7,,304.31,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.05,33.9,,273.64,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",787.02,78,,629.62,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",833.43,82.6,,666.74,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",833.43,82.6,,666.74,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1009,100,,807.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1009,
"XR Clavicle Right",32073000,CDM,320,RC,73000,CPT,OUTPATIENT,,,1009,655.85,TC|LT,887.92,88,,710.34,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1009,100,,807.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",635.67,63,,508.54,,,0,"percent of total billed charges","63% of total billed charges",154.38,15.3,,123.50,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,696.21,69,,,,,0,"fee schedule","69% of total billed charges",1009,100,,807.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1009,100,,807.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1009,100,,807.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",380.39,37.7,,304.31,,,0,"percent of total billed charges","37.7% of total billed charges",380.39,37.7,,304.31,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.05,33.9,,273.64,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",787.02,78,,629.62,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",833.43,82.6,,666.74,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",833.43,82.6,,666.74,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1009,100,,807.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1009,
N/A,32071010,CDM,320,RC,71045,CPT,OUTPATIENT,,,1134,737.1,TC,997.92,88,,798.34,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1134,100,,907.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",714.42,63,,571.54,,,0,"percent of total billed charges","63% of total billed charges",173.5,15.3,,138.80,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,782.46,69,,,,,0,"fee schedule","69% of total billed charges",1134,100,,907.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1134,100,,907.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1134,100,,907.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",427.52,37.7,,342.02,,,0,"percent of total billed charges","37.7% of total billed charges",427.52,37.7,,342.02,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",384.43,33.9,,307.54,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",884.52,78,,707.62,,,0,"percent of total billed charges","78% of total billed charges",93.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",936.68,82.6,,749.34,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",936.68,82.6,,749.34,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1134,100,,907.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1134,
"XR Cystogram",32074430,CDM,320,RC,74430,CPT,OUTPATIENT,,,1138,739.7,TC,1001.44,88,,801.15,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1138,100,,910.40,,,0,"percent of total billed charges","100% of total billed charges",686.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",716.94,63,,573.55,,,0,"percent of total billed charges","63% of total billed charges",174.11,15.3,,139.29,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,785.22,69,,,,,0,"fee schedule","69% of total billed charges",1138,100,,910.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1138,100,,910.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1138,100,,910.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",429.03,37.7,,343.22,,,0,"percent of total billed charges","37.7% of total billed charges",429.03,37.7,,343.22,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",385.78,33.9,,308.62,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",887.64,78,,710.11,,,0,"percent of total billed charges","78% of total billed charges",396.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",939.99,82.6,,751.99,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",939.99,82.6,,751.99,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1138,100,,910.40,,,0,"percent of total billed charges","100% of total billed charges",80.56,1495.49,
"XR Chest 1 View",32471045,CDM,324,RC,71045,CPT,OUTPATIENT,,,1240,806,TC,1091.2,88,,872.96,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1240,100,,992.00,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",781.2,63,,624.96,,,0,"percent of total billed charges","63% of total billed charges",189.72,15.3,,151.78,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,855.6,69,,,,,0,"fee schedule","69% of total billed charges",1240,100,,992.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1240,100,,992.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1240,100,,992.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",467.48,37.7,,373.98,,,0,"percent of total billed charges","37.7% of total billed charges",467.48,37.7,,373.98,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.36,33.9,,336.29,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.2,78,,773.76,,,0,"percent of total billed charges","78% of total billed charges",93.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1024.24,82.6,,819.39,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1024.24,82.6,,819.39,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1240,100,,992.00,,,0,"percent of total billed charges","100% of total billed charges",38.21,1240,
"XR Chest 1 View",32471045,CDM,324,RC,71045,CPT,OUTPATIENT,,,1240,806,TC,1091.2,88,,872.96,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1240,100,,992.00,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",781.2,63,,624.96,,,0,"percent of total billed charges","63% of total billed charges",189.72,15.3,,151.78,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,855.6,69,,,,,0,"fee schedule","69% of total billed charges",1240,100,,992.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1240,100,,992.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1240,100,,992.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",467.48,37.7,,373.98,,,0,"percent of total billed charges","37.7% of total billed charges",467.48,37.7,,373.98,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.36,33.9,,336.29,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.2,78,,773.76,,,0,"percent of total billed charges","78% of total billed charges",93.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1024.24,82.6,,819.39,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1024.24,82.6,,819.39,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1240,100,,992.00,,,0,"percent of total billed charges","100% of total billed charges",38.21,1240,
"XR Cholangiogram in OR EO",32074300,CDM,320,RC,74300,CPT,OUTPATIENT,,,3436,2233.4,TC,3023.68,88,,2418.94,,,0,"percent of total billed charges","88% of total billed charges",1718,50,,1374.40,,,0,"percent of total billed charges","50% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,3436,100,,2748.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2164.68,63,,1731.74,,,0,"percent of total billed charges","63% of total billed charges",525.71,15.3,,420.57,,,0,"percent of total billed charges","15.3% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,2370.84,69,,,,,0,"fee schedule","69% of total billed charges",3436,100,,2748.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3436,100,,2748.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3436,100,,2748.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2125.17,61.85,,1700.14,,,0,"percent of total billed charges","61.5% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,1718,50,,1374.40,,,0,"percent of total billed charges","50% of total billed charges",1106.39,32.2,,885.11,,,0,"percent of total billed charges","32.2% of total billed charges",119.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",165.21,100,,,,,0,"fee schedule",EAPG,210.57,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1295.37,37.7,,1036.30,,,0,"percent of total billed charges","37.7% of total billed charges",1295.37,37.7,,1036.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1164.8,33.9,,931.84,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2680.08,78,,2144.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2838.14,82.6,,2270.51,,,0,"percent of total billed charges","82.6% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,1718,50,,1374.40,,,0,"percent of total billed charges","50% of total billed charges",2838.14,82.6,,2270.51,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",161.97,100,,,,,0,"fee schedule",EAPG,3436,100,,2748.80,,,0,"percent of total billed charges","100% of total billed charges",119.98,3436,
"XR Drainage Perc Cath Placement",32075989,CDM,320,RC,75989,CPT,OUTPATIENT,,,1888,1227.2,TC,1661.44,88,,1329.15,,,0,"percent of total billed charges","88% of total billed charges",944,50,,755.20,,,0,"percent of total billed charges","50% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,1888,100,,1510.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1189.44,63,,951.55,,,0,"percent of total billed charges","63% of total billed charges",288.86,15.3,,231.09,,,0,"percent of total billed charges","15.3% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,1302.72,69,,,,,0,"fee schedule","69% of total billed charges",1888,100,,1510.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1888,100,,1510.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1888,100,,1510.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1167.73,61.85,,934.18,,,0,"percent of total billed charges","61.5% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,944,50,,755.20,,,0,"percent of total billed charges","50% of total billed charges",607.94,32.2,,486.35,,,0,"percent of total billed charges","32.2% of total billed charges",119.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",165.21,100,,,,,0,"fee schedule",EAPG,210.57,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",711.78,37.7,,569.42,,,0,"percent of total billed charges","37.7% of total billed charges",711.78,37.7,,569.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",640.03,33.9,,512.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1472.64,78,,1178.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1559.49,82.6,,1247.59,,,0,"percent of total billed charges","82.6% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,944,50,,755.20,,,0,"percent of total billed charges","50% of total billed charges",1559.49,82.6,,1247.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",161.97,100,,,,,0,"fee schedule",EAPG,1888,100,,1510.40,,,0,"percent of total billed charges","100% of total billed charges",119.98,1888,
"XR Elbow 2 Views Bilateral",32073070,CDM,320,RC,73070,CPT,OUTPATIENT,,,771,501.15,TC,678.48,88,,542.78,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,771,100,,616.80,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",485.73,63,,388.58,,,0,"percent of total billed charges","63% of total billed charges",117.96,15.3,,94.37,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,531.99,69,,,,,0,"fee schedule","69% of total billed charges",771,100,,616.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",771,100,,616.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",771,100,,616.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.67,37.7,,232.54,,,0,"percent of total billed charges","37.7% of total billed charges",290.67,37.7,,232.54,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",261.37,33.9,,209.10,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",601.38,78,,481.10,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",636.85,82.6,,509.48,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",636.85,82.6,,509.48,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,771,100,,616.80,,,0,"percent of total billed charges","100% of total billed charges",38.21,771,
"XR Elbow 2 Views Left",32073070,CDM,320,RC,73070,CPT,OUTPATIENT,,,771,501.15,TC,678.48,88,,542.78,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,771,100,,616.80,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",485.73,63,,388.58,,,0,"percent of total billed charges","63% of total billed charges",117.96,15.3,,94.37,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,531.99,69,,,,,0,"fee schedule","69% of total billed charges",771,100,,616.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",771,100,,616.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",771,100,,616.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.67,37.7,,232.54,,,0,"percent of total billed charges","37.7% of total billed charges",290.67,37.7,,232.54,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",261.37,33.9,,209.10,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",601.38,78,,481.10,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",636.85,82.6,,509.48,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",636.85,82.6,,509.48,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,771,100,,616.80,,,0,"percent of total billed charges","100% of total billed charges",38.21,771,
"XR Elbow 2 Views Right",32073070,CDM,320,RC,73070,CPT,OUTPATIENT,,,771,501.15,TC,678.48,88,,542.78,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,771,100,,616.80,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",485.73,63,,388.58,,,0,"percent of total billed charges","63% of total billed charges",117.96,15.3,,94.37,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,531.99,69,,,,,0,"fee schedule","69% of total billed charges",771,100,,616.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",771,100,,616.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",771,100,,616.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.67,37.7,,232.54,,,0,"percent of total billed charges","37.7% of total billed charges",290.67,37.7,,232.54,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",261.37,33.9,,209.10,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",601.38,78,,481.10,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",636.85,82.6,,509.48,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",636.85,82.6,,509.48,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,771,100,,616.80,,,0,"percent of total billed charges","100% of total billed charges",38.21,771,
"XR Elbow Complete 3+ Views Bilateral",32073080,CDM,320,RC,73080,CPT,OUTPATIENT,,,1084,704.6,TC,953.92,88,,763.14,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1084,100,,867.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",682.92,63,,546.34,,,0,"percent of total billed charges","63% of total billed charges",165.85,15.3,,132.68,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,747.96,69,,,,,0,"fee schedule","69% of total billed charges",1084,100,,867.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1084,100,,867.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1084,100,,867.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.67,37.7,,326.94,,,0,"percent of total billed charges","37.7% of total billed charges",408.67,37.7,,326.94,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.48,33.9,,293.98,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",845.52,78,,676.42,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",895.38,82.6,,716.30,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",895.38,82.6,,716.30,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1084,100,,867.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1084,
"XR Elbow Complete 3+ Views Left",32073080,CDM,320,RC,73080,CPT,OUTPATIENT,,,1084,704.6,TC,953.92,88,,763.14,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1084,100,,867.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",682.92,63,,546.34,,,0,"percent of total billed charges","63% of total billed charges",165.85,15.3,,132.68,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,747.96,69,,,,,0,"fee schedule","69% of total billed charges",1084,100,,867.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1084,100,,867.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1084,100,,867.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.67,37.7,,326.94,,,0,"percent of total billed charges","37.7% of total billed charges",408.67,37.7,,326.94,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.48,33.9,,293.98,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",845.52,78,,676.42,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",895.38,82.6,,716.30,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",895.38,82.6,,716.30,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1084,100,,867.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1084,
"XR Elbow Complete 3+ Views Right",32073080,CDM,320,RC,73080,CPT,OUTPATIENT,,,1084,704.6,TC,953.92,88,,763.14,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1084,100,,867.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",682.92,63,,546.34,,,0,"percent of total billed charges","63% of total billed charges",165.85,15.3,,132.68,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,747.96,69,,,,,0,"fee schedule","69% of total billed charges",1084,100,,867.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1084,100,,867.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1084,100,,867.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.67,37.7,,326.94,,,0,"percent of total billed charges","37.7% of total billed charges",408.67,37.7,,326.94,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.48,33.9,,293.98,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",845.52,78,,676.42,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",895.38,82.6,,716.30,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",895.38,82.6,,716.30,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1084,100,,867.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1084,
"XR Esophagus",32074220,CDM,320,RC,74220,CPT,OUTPATIENT,,,1389,902.85,TC,1222.32,88,,977.86,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1389,100,,1111.20,,,0,"percent of total billed charges","100% of total billed charges",327.95,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.07,63,,700.06,,,0,"percent of total billed charges","63% of total billed charges",212.52,15.3,,170.02,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,958.41,69,,,,,0,"fee schedule","69% of total billed charges",1389,100,,1111.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1389,100,,1111.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1389,100,,1111.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",523.65,37.7,,418.92,,,0,"percent of total billed charges","37.7% of total billed charges",523.65,37.7,,418.92,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",470.87,33.9,,376.70,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1083.42,78,,866.74,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1147.31,82.6,,917.85,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1147.31,82.6,,917.85,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1389,100,,1111.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1389,
"XR Esophagus Dilation",32074360,CDM,320,RC,74360,CPT,OUTPATIENT,,,1626,1056.9,TC,1430.88,88,,1144.70,,,0,"percent of total billed charges","88% of total billed charges",813,50,,650.40,,,0,"percent of total billed charges","50% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,1626,100,,1300.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1024.38,63,,819.50,,,0,"percent of total billed charges","63% of total billed charges",248.78,15.3,,199.02,,,0,"percent of total billed charges","15.3% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,1121.94,69,,,,,0,"fee schedule","69% of total billed charges",1626,100,,1300.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1626,100,,1300.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1626,100,,1300.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1005.68,61.85,,804.54,,,0,"percent of total billed charges","61.5% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,813,50,,650.40,,,0,"percent of total billed charges","50% of total billed charges",523.57,32.2,,418.86,,,0,"percent of total billed charges","32.2% of total billed charges",119.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",165.21,100,,,,,0,"fee schedule",EAPG,210.57,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",613,37.7,,490.40,,,0,"percent of total billed charges","37.7% of total billed charges",613,37.7,,490.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",551.21,33.9,,440.97,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1268.28,78,,1014.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1343.08,82.6,,1074.46,,,0,"percent of total billed charges","82.6% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,813,50,,650.40,,,0,"percent of total billed charges","50% of total billed charges",1343.08,82.6,,1074.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",161.97,100,,,,,0,"fee schedule",EAPG,1626,100,,1300.80,,,0,"percent of total billed charges","100% of total billed charges",119.98,1626,
"XR Esophagus w/ Air Contrast",32074221,CDM,320,RC,74221,CPT,OUTPATIENT,,,1389,902.85,TC,1222.32,88,,977.86,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1389,100,,1111.20,,,0,"percent of total billed charges","100% of total billed charges",327.95,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.07,63,,700.06,,,0,"percent of total billed charges","63% of total billed charges",212.52,15.3,,170.02,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,958.41,69,,,,,0,"fee schedule","69% of total billed charges",1389,100,,1111.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1389,100,,1111.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1389,100,,1111.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",523.65,37.7,,418.92,,,0,"percent of total billed charges","37.7% of total billed charges",523.65,37.7,,418.92,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",470.87,33.9,,376.70,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1083.42,78,,866.74,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1147.31,82.6,,917.85,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1147.31,82.6,,917.85,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1389,100,,1111.20,,,0,"percent of total billed charges","100% of total billed charges",80.56,1389,
"XR Facial Bones < 3 Views",32070140,CDM,320,RC,70140,CPT,OUTPATIENT,,,563,365.95,TC,495.44,88,,396.35,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,563,100,,450.40,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",354.69,63,,283.75,,,0,"percent of total billed charges","63% of total billed charges",86.14,15.3,,68.91,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,388.47,69,,,,,0,"fee schedule","69% of total billed charges",563,100,,450.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",563,100,,450.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",563,100,,450.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",212.25,37.7,,169.80,,,0,"percent of total billed charges","37.7% of total billed charges",212.25,37.7,,169.80,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.86,33.9,,152.69,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",439.14,78,,351.31,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465.04,82.6,,372.03,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465.04,82.6,,372.03,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,563,100,,450.40,,,0,"percent of total billed charges","100% of total billed charges",38.21,563,
"XR Facial Bones 3+ Views",32070150,CDM,320,RC,70150,CPT,OUTPATIENT,,,1404,912.6,TC,1235.52,88,,988.42,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1404,100,,1123.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",884.52,63,,707.62,,,0,"percent of total billed charges","63% of total billed charges",214.81,15.3,,171.85,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,968.76,69,,,,,0,"fee schedule","69% of total billed charges",1404,100,,1123.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1404,100,,1123.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1404,100,,1123.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",529.31,37.7,,423.45,,,0,"percent of total billed charges","37.7% of total billed charges",529.31,37.7,,423.45,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",475.96,33.9,,380.77,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1095.12,78,,876.10,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1159.7,82.6,,927.76,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1159.7,82.6,,927.76,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1404,100,,1123.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1404,
"XR Finger(s) 2+ Views Left",32073140,CDM,320,RC,73140,CPT,OUTPATIENT,,,729,473.85,TC|LT,641.52,88,,513.22,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,729,100,,583.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",459.27,63,,367.42,,,0,"percent of total billed charges","63% of total billed charges",111.54,15.3,,89.23,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,503.01,69,,,,,0,"fee schedule","69% of total billed charges",729,100,,583.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",729,100,,583.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",729,100,,583.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",274.83,37.7,,219.86,,,0,"percent of total billed charges","37.7% of total billed charges",274.83,37.7,,219.86,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",247.13,33.9,,197.70,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.62,78,,454.90,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",602.15,82.6,,481.72,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",602.15,82.6,,481.72,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,729,100,,583.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,729,
"XR Finger(s) 2+ Views Right",32073140,CDM,320,RC,73140,CPT,OUTPATIENT,,,729,473.85,TC|LT,641.52,88,,513.22,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,729,100,,583.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",459.27,63,,367.42,,,0,"percent of total billed charges","63% of total billed charges",111.54,15.3,,89.23,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,503.01,69,,,,,0,"fee schedule","69% of total billed charges",729,100,,583.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",729,100,,583.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",729,100,,583.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",274.83,37.7,,219.86,,,0,"percent of total billed charges","37.7% of total billed charges",274.83,37.7,,219.86,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",247.13,33.9,,197.70,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.62,78,,454.90,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",602.15,82.6,,481.72,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",602.15,82.6,,481.72,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,729,100,,583.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,729,
"XR Fluoro Guidance Needle Loc Spine",32077003,CDM,320,RC,77003,CPT,OUTPATIENT,,,2860,1859,TC,2516.8,88,,2013.44,,,0,"percent of total billed charges","88% of total billed charges",1430,50,,1144.00,,,0,"percent of total billed charges","50% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,2860,100,,2288.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1801.8,63,,1441.44,,,0,"percent of total billed charges","63% of total billed charges",437.58,15.3,,350.06,,,0,"percent of total billed charges","15.3% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,1973.4,69,,,,,0,"fee schedule","69% of total billed charges",2860,100,,2288.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2860,100,,2288.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2860,100,,2288.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1768.91,61.85,,1415.13,,,0,"percent of total billed charges","61.5% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,1430,50,,1144.00,,,0,"percent of total billed charges","50% of total billed charges",920.92,32.2,,736.74,,,0,"percent of total billed charges","32.2% of total billed charges",119.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",165.21,100,,,,,0,"fee schedule",EAPG,210.57,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1078.22,37.7,,862.58,,,0,"percent of total billed charges","37.7% of total billed charges",1078.22,37.7,,862.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",969.54,33.9,,775.63,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2230.8,78,,1784.64,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2362.36,82.6,,1889.89,,,0,"percent of total billed charges","82.6% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,1430,50,,1144.00,,,0,"percent of total billed charges","50% of total billed charges",2362.36,82.6,,1889.89,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",161.97,100,,,,,0,"fee schedule",EAPG,2860,100,,2288.00,,,0,"percent of total billed charges","100% of total billed charges",119.98,2860,
"XR Fluoro Guidance Needle Placement",32076000,CDM,320,RC,76000,CPT,OUTPATIENT,,,1765,1147.25,TC,1553.2,88,,1242.56,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1765,100,,1412.00,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1111.95,63,,889.56,,,0,"percent of total billed charges","63% of total billed charges",270.05,15.3,,216.04,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,1217.85,69,,,,,0,"fee schedule","69% of total billed charges",1765,100,,1412.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1765,100,,1412.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1765,100,,1412.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.41,37.7,,532.33,,,0,"percent of total billed charges","37.7% of total billed charges",665.41,37.7,,532.33,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",598.34,33.9,,478.67,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1376.7,78,,1101.36,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1457.89,82.6,,1166.31,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1457.89,82.6,,1166.31,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1765,100,,1412.00,,,0,"percent of total billed charges","100% of total billed charges",80.56,1765,
"XR Foot 2 Views Bilateral",32073620,CDM,320,RC,73620,CPT,OUTPATIENT,,,843,547.95,TC,741.84,88,,593.47,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,843,100,,674.40,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",531.09,63,,424.87,,,0,"percent of total billed charges","63% of total billed charges",128.98,15.3,,103.18,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,581.67,69,,,,,0,"fee schedule","69% of total billed charges",843,100,,674.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",843,100,,674.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",843,100,,674.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",317.81,37.7,,254.25,,,0,"percent of total billed charges","37.7% of total billed charges",317.81,37.7,,254.25,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",285.78,33.9,,228.62,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",657.54,78,,526.03,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",696.32,82.6,,557.06,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",696.32,82.6,,557.06,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,843,100,,674.40,,,0,"percent of total billed charges","100% of total billed charges",38.21,843,
"XR Foot 2 Views Left",32073620,CDM,320,RC,73620,CPT,OUTPATIENT,,,843,547.95,TC,741.84,88,,593.47,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,843,100,,674.40,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",531.09,63,,424.87,,,0,"percent of total billed charges","63% of total billed charges",128.98,15.3,,103.18,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,581.67,69,,,,,0,"fee schedule","69% of total billed charges",843,100,,674.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",843,100,,674.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",843,100,,674.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",317.81,37.7,,254.25,,,0,"percent of total billed charges","37.7% of total billed charges",317.81,37.7,,254.25,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",285.78,33.9,,228.62,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",657.54,78,,526.03,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",696.32,82.6,,557.06,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",696.32,82.6,,557.06,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,843,100,,674.40,,,0,"percent of total billed charges","100% of total billed charges",38.21,843,
"XR Foot 2 Views Right",32073620,CDM,320,RC,73620,CPT,OUTPATIENT,,,843,547.95,TC,741.84,88,,593.47,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,843,100,,674.40,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",531.09,63,,424.87,,,0,"percent of total billed charges","63% of total billed charges",128.98,15.3,,103.18,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,581.67,69,,,,,0,"fee schedule","69% of total billed charges",843,100,,674.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",843,100,,674.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",843,100,,674.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",317.81,37.7,,254.25,,,0,"percent of total billed charges","37.7% of total billed charges",317.81,37.7,,254.25,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",285.78,33.9,,228.62,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",657.54,78,,526.03,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",696.32,82.6,,557.06,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",696.32,82.6,,557.06,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,843,100,,674.40,,,0,"percent of total billed charges","100% of total billed charges",38.21,843,
"XR Foot Complete 3+ Views Bilateral",32073630,CDM,320,RC,73630,CPT,OUTPATIENT,,,1165,757.25,TC|50,1025.2,88,,820.16,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1165,100,,932.00,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",733.95,63,,587.16,,,0,"percent of total billed charges","63% of total billed charges",178.25,15.3,,142.60,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,803.85,69,,,,,0,"fee schedule","69% of total billed charges",1165,100,,932.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1165,100,,932.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1165,100,,932.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",439.21,37.7,,351.37,,,0,"percent of total billed charges","37.7% of total billed charges",439.21,37.7,,351.37,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394.94,33.9,,315.95,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",908.7,78,,726.96,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",962.29,82.6,,769.83,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",962.29,82.6,,769.83,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1165,100,,932.00,,,0,"percent of total billed charges","100% of total billed charges",38.21,1165,
"XR Foot Complete 3+ Views Left",32073630,CDM,320,RC,73630,CPT,OUTPATIENT,,,1165,757.25,TC|50,1025.2,88,,820.16,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1165,100,,932.00,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",733.95,63,,587.16,,,0,"percent of total billed charges","63% of total billed charges",178.25,15.3,,142.60,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,803.85,69,,,,,0,"fee schedule","69% of total billed charges",1165,100,,932.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1165,100,,932.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1165,100,,932.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",439.21,37.7,,351.37,,,0,"percent of total billed charges","37.7% of total billed charges",439.21,37.7,,351.37,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394.94,33.9,,315.95,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",908.7,78,,726.96,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",962.29,82.6,,769.83,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",962.29,82.6,,769.83,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1165,100,,932.00,,,0,"percent of total billed charges","100% of total billed charges",38.21,1165,
"XR Foot Complete 3+ Views Right",32073630,CDM,320,RC,73630,CPT,OUTPATIENT,,,1165,757.25,TC|50,1025.2,88,,820.16,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1165,100,,932.00,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",733.95,63,,587.16,,,0,"percent of total billed charges","63% of total billed charges",178.25,15.3,,142.60,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,803.85,69,,,,,0,"fee schedule","69% of total billed charges",1165,100,,932.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1165,100,,932.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1165,100,,932.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",439.21,37.7,,351.37,,,0,"percent of total billed charges","37.7% of total billed charges",439.21,37.7,,351.37,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394.94,33.9,,315.95,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",908.7,78,,726.96,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",962.29,82.6,,769.83,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",962.29,82.6,,769.83,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1165,100,,932.00,,,0,"percent of total billed charges","100% of total billed charges",38.21,1165,
"XR Forearm 2 Views Bilateral",32073090,CDM,320,RC,73090,CPT,OUTPATIENT,,,717,466.05,TC,630.96,88,,504.77,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,717,100,,573.60,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",451.71,63,,361.37,,,0,"percent of total billed charges","63% of total billed charges",109.7,15.3,,87.76,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,494.73,69,,,,,0,"fee schedule","69% of total billed charges",717,100,,573.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",717,100,,573.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",717,100,,573.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.31,37.7,,216.25,,,0,"percent of total billed charges","37.7% of total billed charges",270.31,37.7,,216.25,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",243.06,33.9,,194.45,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",559.26,78,,447.41,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",592.24,82.6,,473.79,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",592.24,82.6,,473.79,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,717,100,,573.60,,,0,"percent of total billed charges","100% of total billed charges",38.21,717,
"XR Forearm 2 Views Left",32073090,CDM,320,RC,73090,CPT,OUTPATIENT,,,717,466.05,TC,630.96,88,,504.77,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,717,100,,573.60,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",451.71,63,,361.37,,,0,"percent of total billed charges","63% of total billed charges",109.7,15.3,,87.76,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,494.73,69,,,,,0,"fee schedule","69% of total billed charges",717,100,,573.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",717,100,,573.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",717,100,,573.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.31,37.7,,216.25,,,0,"percent of total billed charges","37.7% of total billed charges",270.31,37.7,,216.25,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",243.06,33.9,,194.45,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",559.26,78,,447.41,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",592.24,82.6,,473.79,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",592.24,82.6,,473.79,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,717,100,,573.60,,,0,"percent of total billed charges","100% of total billed charges",38.21,717,
"XR Forearm 2 Views Right",32073090,CDM,320,RC,73090,CPT,OUTPATIENT,,,717,466.05,TC,630.96,88,,504.77,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,717,100,,573.60,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",451.71,63,,361.37,,,0,"percent of total billed charges","63% of total billed charges",109.7,15.3,,87.76,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,494.73,69,,,,,0,"fee schedule","69% of total billed charges",717,100,,573.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",717,100,,573.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",717,100,,573.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.31,37.7,,216.25,,,0,"percent of total billed charges","37.7% of total billed charges",270.31,37.7,,216.25,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",243.06,33.9,,194.45,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",559.26,78,,447.41,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",592.24,82.6,,473.79,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",592.24,82.6,,473.79,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,717,100,,573.60,,,0,"percent of total billed charges","100% of total billed charges",38.21,717,
"XR Foreign Body Localization Eye",32070030,CDM,320,RC,70030,CPT,OUTPATIENT,,,1344,873.6,TC,1182.72,88,,946.18,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1344,100,,1075.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",846.72,63,,677.38,,,0,"percent of total billed charges","63% of total billed charges",205.63,15.3,,164.50,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,927.36,69,,,,,0,"fee schedule","69% of total billed charges",1344,100,,1075.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1344,100,,1075.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1344,100,,1075.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",506.69,37.7,,405.35,,,0,"percent of total billed charges","37.7% of total billed charges",506.69,37.7,,405.35,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",455.62,33.9,,364.50,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1048.32,78,,838.66,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1110.14,82.6,,888.11,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1110.14,82.6,,888.11,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1344,100,,1075.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1344,
"XR Foreign Body Localization Child 1 Vw",32076010,CDM,320,RC,76010,CPT,OUTPATIENT,,,918,596.7,TC,807.84,88,,646.27,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,918,100,,734.40,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",578.34,63,,462.67,,,0,"percent of total billed charges","63% of total billed charges",140.45,15.3,,112.36,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,633.42,69,,,,,0,"fee schedule","69% of total billed charges",918,100,,734.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",918,100,,734.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",918,100,,734.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",346.09,37.7,,276.87,,,0,"percent of total billed charges","37.7% of total billed charges",346.09,37.7,,276.87,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",311.2,33.9,,248.96,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",716.04,78,,572.83,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",758.27,82.6,,606.62,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",758.27,82.6,,606.62,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,918,100,,734.40,,,0,"percent of total billed charges","100% of total billed charges",38.21,918,
"XR Fluoroscopy  per Hour",32076000,CDM,320,RC,76000,CPT,OUTPATIENT,,,1765,1147.25,TC,1553.2,88,,1242.56,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1765,100,,1412.00,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1111.95,63,,889.56,,,0,"percent of total billed charges","63% of total billed charges",270.05,15.3,,216.04,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,1217.85,69,,,,,0,"fee schedule","69% of total billed charges",1765,100,,1412.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1765,100,,1412.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1765,100,,1412.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.41,37.7,,532.33,,,0,"percent of total billed charges","37.7% of total billed charges",665.41,37.7,,532.33,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",598.34,33.9,,478.67,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1376.7,78,,1101.36,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1457.89,82.6,,1166.31,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1457.89,82.6,,1166.31,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1765,100,,1412.00,,,0,"percent of total billed charges","100% of total billed charges",80.56,1765,
"XR Femur 2 Views Left",32073552,CDM,320,RC,73552,CPT,OUTPATIENT,,,913,593.45,TC|LT,803.44,88,,642.75,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,913,100,,730.40,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",575.19,63,,460.15,,,0,"percent of total billed charges","63% of total billed charges",139.69,15.3,,111.75,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,629.97,69,,,,,0,"fee schedule","69% of total billed charges",913,100,,730.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",913,100,,730.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",913,100,,730.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",344.2,37.7,,275.36,,,0,"percent of total billed charges","37.7% of total billed charges",344.2,37.7,,275.36,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.51,33.9,,247.61,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",712.14,78,,569.71,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",754.14,82.6,,603.31,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",754.14,82.6,,603.31,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,913,100,,730.40,,,0,"percent of total billed charges","100% of total billed charges",38.21,913,
"XR Femur 2 Views Right",32073552,CDM,320,RC,73552,CPT,OUTPATIENT,,,913,593.45,TC|LT,803.44,88,,642.75,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,913,100,,730.40,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",575.19,63,,460.15,,,0,"percent of total billed charges","63% of total billed charges",139.69,15.3,,111.75,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,629.97,69,,,,,0,"fee schedule","69% of total billed charges",913,100,,730.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",913,100,,730.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",913,100,,730.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",344.2,37.7,,275.36,,,0,"percent of total billed charges","37.7% of total billed charges",344.2,37.7,,275.36,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.51,33.9,,247.61,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",712.14,78,,569.71,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",754.14,82.6,,603.31,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",754.14,82.6,,603.31,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,913,100,,730.40,,,0,"percent of total billed charges","100% of total billed charges",38.21,913,
"XR Femur 2 Views Bilat",32073521,CDM,320,RC,73521,CPT,OUTPATIENT,,,1217,791.05,TC,1070.96,88,,856.77,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1217,100,,973.60,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",766.71,63,,613.37,,,0,"percent of total billed charges","63% of total billed charges",186.2,15.3,,148.96,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,839.73,69,,,,,0,"fee schedule","69% of total billed charges",1217,100,,973.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217,100,,973.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217,100,,973.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",458.81,37.7,,367.05,,,0,"percent of total billed charges","37.7% of total billed charges",458.81,37.7,,367.05,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.56,33.9,,330.05,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",949.26,78,,759.41,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1005.24,82.6,,804.19,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1005.24,82.6,,804.19,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1217,100,,973.60,,,0,"percent of total billed charges","100% of total billed charges",38.21,1217,
"XR Hand 2 Views Bilateral",32073120,CDM,320,RC,73120,CPT,OUTPATIENT,,,806,523.9,TC,709.28,88,,567.42,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",507.78,63,,406.22,,,0,"percent of total billed charges","63% of total billed charges",123.32,15.3,,98.66,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,556.14,69,,,,,0,"fee schedule","69% of total billed charges",806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",303.86,37.7,,243.09,,,0,"percent of total billed charges","37.7% of total billed charges",303.86,37.7,,243.09,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",273.23,33.9,,218.58,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",628.68,78,,502.94,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.76,82.6,,532.61,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.76,82.6,,532.61,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",38.21,806,
"XR Hand 2 Views Left",32073120,CDM,320,RC,73120,CPT,OUTPATIENT,,,806,523.9,TC,709.28,88,,567.42,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",507.78,63,,406.22,,,0,"percent of total billed charges","63% of total billed charges",123.32,15.3,,98.66,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,556.14,69,,,,,0,"fee schedule","69% of total billed charges",806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",303.86,37.7,,243.09,,,0,"percent of total billed charges","37.7% of total billed charges",303.86,37.7,,243.09,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",273.23,33.9,,218.58,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",628.68,78,,502.94,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.76,82.6,,532.61,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.76,82.6,,532.61,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",38.21,806,
"XR Hand 2 Views Right",32073120,CDM,320,RC,73120,CPT,OUTPATIENT,,,806,523.9,TC,709.28,88,,567.42,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",507.78,63,,406.22,,,0,"percent of total billed charges","63% of total billed charges",123.32,15.3,,98.66,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,556.14,69,,,,,0,"fee schedule","69% of total billed charges",806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",303.86,37.7,,243.09,,,0,"percent of total billed charges","37.7% of total billed charges",303.86,37.7,,243.09,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",273.23,33.9,,218.58,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",628.68,78,,502.94,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.76,82.6,,532.61,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.76,82.6,,532.61,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",38.21,806,
"XR Hand Complete 3+ Views Bilateral",32073130,CDM,320,RC,73130,CPT,OUTPATIENT,,,1096,712.4,TC|50,964.48,88,,771.58,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1096,100,,876.80,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",690.48,63,,552.38,,,0,"percent of total billed charges","63% of total billed charges",167.69,15.3,,134.15,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,756.24,69,,,,,0,"fee schedule","69% of total billed charges",1096,100,,876.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1096,100,,876.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1096,100,,876.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",413.19,37.7,,330.55,,,0,"percent of total billed charges","37.7% of total billed charges",413.19,37.7,,330.55,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",371.54,33.9,,297.23,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",854.88,78,,683.90,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",905.3,82.6,,724.24,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",905.3,82.6,,724.24,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1096,100,,876.80,,,0,"percent of total billed charges","100% of total billed charges",38.21,1096,
"XR Hand Complete 3+ Views Left",32073130,CDM,320,RC,73130,CPT,OUTPATIENT,,,1096,712.4,TC|50,964.48,88,,771.58,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1096,100,,876.80,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",690.48,63,,552.38,,,0,"percent of total billed charges","63% of total billed charges",167.69,15.3,,134.15,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,756.24,69,,,,,0,"fee schedule","69% of total billed charges",1096,100,,876.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1096,100,,876.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1096,100,,876.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",413.19,37.7,,330.55,,,0,"percent of total billed charges","37.7% of total billed charges",413.19,37.7,,330.55,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",371.54,33.9,,297.23,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",854.88,78,,683.90,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",905.3,82.6,,724.24,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",905.3,82.6,,724.24,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1096,100,,876.80,,,0,"percent of total billed charges","100% of total billed charges",38.21,1096,
"XR Hand Complete 3+ Views Right",32073130,CDM,320,RC,73130,CPT,OUTPATIENT,,,1096,712.4,TC|50,964.48,88,,771.58,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1096,100,,876.80,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",690.48,63,,552.38,,,0,"percent of total billed charges","63% of total billed charges",167.69,15.3,,134.15,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,756.24,69,,,,,0,"fee schedule","69% of total billed charges",1096,100,,876.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1096,100,,876.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1096,100,,876.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",413.19,37.7,,330.55,,,0,"percent of total billed charges","37.7% of total billed charges",413.19,37.7,,330.55,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",371.54,33.9,,297.23,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",854.88,78,,683.90,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",905.3,82.6,,724.24,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",905.3,82.6,,724.24,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1096,100,,876.80,,,0,"percent of total billed charges","100% of total billed charges",38.21,1096,
"XR Hip 1 View Left",32073501,CDM,320,RC,73501,CPT,OUTPATIENT,,,782,508.3,TC|LT,688.16,88,,550.53,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",492.66,63,,394.13,,,0,"percent of total billed charges","63% of total billed charges",119.65,15.3,,95.72,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,539.58,69,,,,,0,"fee schedule","69% of total billed charges",782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.81,37.7,,235.85,,,0,"percent of total billed charges","37.7% of total billed charges",294.81,37.7,,235.85,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.1,33.9,,212.08,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",609.96,78,,487.97,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",645.93,82.6,,516.74,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",645.93,82.6,,516.74,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",38.21,782,
"XR Hip 1 View Right",32073501,CDM,320,RC,73501,CPT,OUTPATIENT,,,782,508.3,TC|LT,688.16,88,,550.53,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",492.66,63,,394.13,,,0,"percent of total billed charges","63% of total billed charges",119.65,15.3,,95.72,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,539.58,69,,,,,0,"fee schedule","69% of total billed charges",782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.81,37.7,,235.85,,,0,"percent of total billed charges","37.7% of total billed charges",294.81,37.7,,235.85,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.1,33.9,,212.08,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",609.96,78,,487.97,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",645.93,82.6,,516.74,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",645.93,82.6,,516.74,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,782,100,,625.60,,,0,"percent of total billed charges","100% of total billed charges",38.21,782,
"XR Humerus Left",32073060,CDM,320,RC,73060,CPT,OUTPATIENT,,,845,549.25,TC|LT,743.6,88,,594.88,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,845,100,,676.00,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",532.35,63,,425.88,,,0,"percent of total billed charges","63% of total billed charges",129.29,15.3,,103.43,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,583.05,69,,,,,0,"fee schedule","69% of total billed charges",845,100,,676.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",845,100,,676.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",845,100,,676.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",318.57,37.7,,254.86,,,0,"percent of total billed charges","37.7% of total billed charges",318.57,37.7,,254.86,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",286.46,33.9,,229.17,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",659.1,78,,527.28,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",697.97,82.6,,558.38,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",697.97,82.6,,558.38,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,845,100,,676.00,,,0,"percent of total billed charges","100% of total billed charges",38.21,845,
"XR Humerus Right",32073060,CDM,320,RC,73060,CPT,OUTPATIENT,,,845,549.25,TC|LT,743.6,88,,594.88,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,845,100,,676.00,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",532.35,63,,425.88,,,0,"percent of total billed charges","63% of total billed charges",129.29,15.3,,103.43,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,583.05,69,,,,,0,"fee schedule","69% of total billed charges",845,100,,676.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",845,100,,676.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",845,100,,676.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",318.57,37.7,,254.86,,,0,"percent of total billed charges","37.7% of total billed charges",318.57,37.7,,254.86,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",286.46,33.9,,229.17,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",659.1,78,,527.28,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",697.97,82.6,,558.38,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",697.97,82.6,,558.38,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,845,100,,676.00,,,0,"percent of total billed charges","100% of total billed charges",38.21,845,
"XR Hip 2-3 Views Left",32073502,CDM,320,RC,73502,CPT,OUTPATIENT,,,1159,753.35,LT,1019.92,88,,815.94,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1159,100,,927.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",730.17,63,,584.14,,,0,"percent of total billed charges","63% of total billed charges",177.33,15.3,,141.86,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,799.71,69,,,,,0,"fee schedule","69% of total billed charges",1159,100,,927.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1159,100,,927.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1159,100,,927.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",436.94,37.7,,349.55,,,0,"percent of total billed charges","37.7% of total billed charges",436.94,37.7,,349.55,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.9,33.9,,314.32,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",904.02,78,,723.22,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",957.33,82.6,,765.86,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",957.33,82.6,,765.86,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1159,100,,927.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1159,
"XR Hip 2-3 Views Right",32073502,CDM,320,RC,73502,CPT,OUTPATIENT,,,1159,753.35,LT,1019.92,88,,815.94,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1159,100,,927.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",730.17,63,,584.14,,,0,"percent of total billed charges","63% of total billed charges",177.33,15.3,,141.86,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,799.71,69,,,,,0,"fee schedule","69% of total billed charges",1159,100,,927.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1159,100,,927.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1159,100,,927.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",436.94,37.7,,349.55,,,0,"percent of total billed charges","37.7% of total billed charges",436.94,37.7,,349.55,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.9,33.9,,314.32,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",904.02,78,,723.22,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",957.33,82.6,,765.86,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",957.33,82.6,,765.86,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1159,100,,927.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1159,
"XR Hip 2-3 Views w/AP Pelvis Left",32073502,CDM,320,RC,73502,CPT,OUTPATIENT,,,1159,753.35,LT,1019.92,88,,815.94,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1159,100,,927.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",730.17,63,,584.14,,,0,"percent of total billed charges","63% of total billed charges",177.33,15.3,,141.86,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,799.71,69,,,,,0,"fee schedule","69% of total billed charges",1159,100,,927.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1159,100,,927.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1159,100,,927.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",436.94,37.7,,349.55,,,0,"percent of total billed charges","37.7% of total billed charges",436.94,37.7,,349.55,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.9,33.9,,314.32,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",904.02,78,,723.22,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",957.33,82.6,,765.86,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",957.33,82.6,,765.86,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1159,100,,927.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1159,
"XR Hip 2-3 Views w/AP Pelvis Right",32073502,CDM,320,RC,73502,CPT,OUTPATIENT,,,1159,753.35,LT,1019.92,88,,815.94,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1159,100,,927.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",730.17,63,,584.14,,,0,"percent of total billed charges","63% of total billed charges",177.33,15.3,,141.86,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,799.71,69,,,,,0,"fee schedule","69% of total billed charges",1159,100,,927.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1159,100,,927.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1159,100,,927.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",436.94,37.7,,349.55,,,0,"percent of total billed charges","37.7% of total billed charges",436.94,37.7,,349.55,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.9,33.9,,314.32,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",904.02,78,,723.22,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",957.33,82.6,,765.86,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",957.33,82.6,,765.86,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1159,100,,927.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1159,
"XR Hip 4+ Views w/AP Pelvis Left",32073503,CDM,320,RC,73503,CPT,OUTPATIENT,,,1739,1130.35,TC|LT,1530.32,88,,1224.26,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1739,100,,1391.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1095.57,63,,876.46,,,0,"percent of total billed charges","63% of total billed charges",266.07,15.3,,212.86,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1199.91,69,,,,,0,"fee schedule","69% of total billed charges",1739,100,,1391.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1739,100,,1391.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1739,100,,1391.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",655.6,37.7,,524.48,,,0,"percent of total billed charges","37.7% of total billed charges",655.6,37.7,,524.48,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",589.52,33.9,,471.62,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1356.42,78,,1085.14,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1436.41,82.6,,1149.13,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1436.41,82.6,,1149.13,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1739,100,,1391.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1739,
"XR Hips 2 Views Bilat",32073521,CDM,320,RC,73521,CPT,OUTPATIENT,,,1217,791.05,TC,1070.96,88,,856.77,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1217,100,,973.60,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",766.71,63,,613.37,,,0,"percent of total billed charges","63% of total billed charges",186.2,15.3,,148.96,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,839.73,69,,,,,0,"fee schedule","69% of total billed charges",1217,100,,973.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217,100,,973.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217,100,,973.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",458.81,37.7,,367.05,,,0,"percent of total billed charges","37.7% of total billed charges",458.81,37.7,,367.05,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.56,33.9,,330.05,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",949.26,78,,759.41,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1005.24,82.6,,804.19,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1005.24,82.6,,804.19,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1217,100,,973.60,,,0,"percent of total billed charges","100% of total billed charges",38.21,1217,
"XR Hips 2 Views w/AP Pelvis Bilat",32073521,CDM,320,RC,73521,CPT,OUTPATIENT,,,1217,791.05,TC,1070.96,88,,856.77,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1217,100,,973.60,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",766.71,63,,613.37,,,0,"percent of total billed charges","63% of total billed charges",186.2,15.3,,148.96,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,839.73,69,,,,,0,"fee schedule","69% of total billed charges",1217,100,,973.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217,100,,973.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217,100,,973.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",458.81,37.7,,367.05,,,0,"percent of total billed charges","37.7% of total billed charges",458.81,37.7,,367.05,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.56,33.9,,330.05,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",949.26,78,,759.41,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1005.24,82.6,,804.19,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1005.24,82.6,,804.19,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1217,100,,973.60,,,0,"percent of total billed charges","100% of total billed charges",38.21,1217,
"XR Hips 3-4 Views w/AP Pelvis Bilat",32073522,CDM,320,RC,73522,CPT,OUTPATIENT,,,1217,791.05,TC,1070.96,88,,856.77,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1217,100,,973.60,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",766.71,63,,613.37,,,0,"percent of total billed charges","63% of total billed charges",186.2,15.3,,148.96,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,839.73,69,,,,,0,"fee schedule","69% of total billed charges",1217,100,,973.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217,100,,973.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217,100,,973.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",458.81,37.7,,367.05,,,0,"percent of total billed charges","37.7% of total billed charges",458.81,37.7,,367.05,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.56,33.9,,330.05,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",949.26,78,,759.41,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1005.24,82.6,,804.19,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1005.24,82.6,,804.19,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1217,100,,973.60,,,0,"percent of total billed charges","100% of total billed charges",38.21,1217,
"XR Hips 5+ Views w/AP Pelvis Bilat",32073523,CDM,320,RC,73523,CPT,OUTPATIENT,,,2435,1582.75,TC,2142.8,88,,1714.24,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,2435,100,,1948.00,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1534.05,63,,1227.24,,,0,"percent of total billed charges","63% of total billed charges",372.56,15.3,,298.05,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1680.15,69,,,,,0,"fee schedule","69% of total billed charges",2435,100,,1948.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2435,100,,1948.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2435,100,,1948.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",918,37.7,,734.40,,,0,"percent of total billed charges","37.7% of total billed charges",918,37.7,,734.40,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",825.47,33.9,,660.38,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1899.3,78,,1519.44,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2011.31,82.6,,1609.05,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2011.31,82.6,,1609.05,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,2435,100,,1948.00,,,0,"percent of total billed charges","100% of total billed charges",38.21,2435,
"XR IVP",32074400,CDM,320,RC,74400,CPT,OUTPATIENT,,,1189,772.85,TC,1046.32,88,,837.06,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1189,100,,951.20,,,0,"percent of total billed charges","100% of total billed charges",327.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",749.07,63,,599.26,,,0,"percent of total billed charges","63% of total billed charges",181.92,15.3,,145.54,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,820.41,69,,,,,0,"fee schedule","69% of total billed charges",1189,100,,951.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1189,100,,951.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1189,100,,951.20,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",448.25,37.7,,358.60,,,0,"percent of total billed charges","37.7% of total billed charges",448.25,37.7,,358.60,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",403.07,33.9,,322.46,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",927.42,78,,741.94,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",982.11,82.6,,785.69,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",982.11,82.6,,785.69,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1189,100,,951.20,,,0,"percent of total billed charges","100% of total billed charges",80.56,1189,
"XR Joint/Bursa Major Arthr/Asp/Inj Left",32027096,CDM,320,RC,27096,CPT,OUTPATIENT,,,1382,898.3,LT,1216.16,88,,972.93,,,0,"percent of total billed charges","88% of total billed charges",691,50,,552.80,,,0,"percent of total billed charges","50% of total billed charges",443.75,100,,,,,0,"fee schedule",EAPG,1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",457.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",870.66,63,,696.53,,,0,"percent of total billed charges","63% of total billed charges",211.45,15.3,,169.16,,,0,"percent of total billed charges","15.3% of total billed charges",443.75,100,,,,,0,"fee schedule",EAPG,953.58,69,,,,,0,"fee schedule","69% of total billed charges",1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",854.77,61.85,,683.82,,,0,"percent of total billed charges","61.5% of total billed charges",443.75,100,,,,,0,"fee schedule",EAPG,691,50,,552.80,,,0,"percent of total billed charges","50% of total billed charges",445,32.2,,356.00,,,0,"percent of total billed charges","32.2% of total billed charges",328.7,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",452.63,100,,,,,0,"fee schedule",EAPG,576.88,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",521.01,37.7,,416.81,,,0,"percent of total billed charges","37.7% of total billed charges",521.01,37.7,,416.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",468.5,33.9,,374.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1077.96,78,,862.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1141.53,82.6,,913.22,,,0,"percent of total billed charges","82.6% of total billed charges",443.75,100,,,,,0,"fee schedule","100% of WA fee schedule",691,50,,552.80,,,0,"percent of total billed charges","50% of total billed charges",1141.53,82.6,,913.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",443.75,100,,,,,0,"fee schedule",EAPG,1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",211.45,1382,
"XR Knee 1 or 2 Views Bilateral",32073560,CDM,320,RC,73560,CPT,OUTPATIENT,,,1031,670.15,TC,907.28,88,,725.82,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1031,100,,824.80,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",649.53,63,,519.62,,,0,"percent of total billed charges","63% of total billed charges",157.74,15.3,,126.19,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,711.39,69,,,,,0,"fee schedule","69% of total billed charges",1031,100,,824.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1031,100,,824.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1031,100,,824.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",388.69,37.7,,310.95,,,0,"percent of total billed charges","37.7% of total billed charges",388.69,37.7,,310.95,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",349.51,33.9,,279.61,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",804.18,78,,643.34,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",851.61,82.6,,681.29,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",851.61,82.6,,681.29,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1031,100,,824.80,,,0,"percent of total billed charges","100% of total billed charges",38.21,1031,
"XR Knee 1 or 2 Views Left",32073560,CDM,320,RC,73560,CPT,OUTPATIENT,,,1031,670.15,TC,907.28,88,,725.82,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1031,100,,824.80,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",649.53,63,,519.62,,,0,"percent of total billed charges","63% of total billed charges",157.74,15.3,,126.19,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,711.39,69,,,,,0,"fee schedule","69% of total billed charges",1031,100,,824.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1031,100,,824.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1031,100,,824.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",388.69,37.7,,310.95,,,0,"percent of total billed charges","37.7% of total billed charges",388.69,37.7,,310.95,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",349.51,33.9,,279.61,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",804.18,78,,643.34,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",851.61,82.6,,681.29,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",851.61,82.6,,681.29,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1031,100,,824.80,,,0,"percent of total billed charges","100% of total billed charges",38.21,1031,
"XR Knee 1 or 2 Views Right",32073560,CDM,320,RC,73560,CPT,OUTPATIENT,,,1031,670.15,TC,907.28,88,,725.82,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1031,100,,824.80,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",649.53,63,,519.62,,,0,"percent of total billed charges","63% of total billed charges",157.74,15.3,,126.19,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,711.39,69,,,,,0,"fee schedule","69% of total billed charges",1031,100,,824.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1031,100,,824.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1031,100,,824.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",388.69,37.7,,310.95,,,0,"percent of total billed charges","37.7% of total billed charges",388.69,37.7,,310.95,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",349.51,33.9,,279.61,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",804.18,78,,643.34,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",851.61,82.6,,681.29,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",851.61,82.6,,681.29,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1031,100,,824.80,,,0,"percent of total billed charges","100% of total billed charges",38.21,1031,
"XR Knee 3 Views Bilateral",32073562,CDM,320,RC,73562,CPT,OUTPATIENT,,,1274,828.1,TC|50,1121.12,88,,896.90,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1274,100,,1019.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",802.62,63,,642.10,,,0,"percent of total billed charges","63% of total billed charges",194.92,15.3,,155.94,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,879.06,69,,,,,0,"fee schedule","69% of total billed charges",1274,100,,1019.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1274,100,,1019.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1274,100,,1019.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",480.3,37.7,,384.24,,,0,"percent of total billed charges","37.7% of total billed charges",480.3,37.7,,384.24,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",431.89,33.9,,345.51,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",993.72,78,,794.98,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1052.32,82.6,,841.86,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1052.32,82.6,,841.86,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1274,100,,1019.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1274,
"XR Knee 3 Views",32073562,CDM,320,RC,73562,CPT,OUTPATIENT,,,1274,828.1,TC|50,1121.12,88,,896.90,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1274,100,,1019.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",802.62,63,,642.10,,,0,"percent of total billed charges","63% of total billed charges",194.92,15.3,,155.94,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,879.06,69,,,,,0,"fee schedule","69% of total billed charges",1274,100,,1019.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1274,100,,1019.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1274,100,,1019.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",480.3,37.7,,384.24,,,0,"percent of total billed charges","37.7% of total billed charges",480.3,37.7,,384.24,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",431.89,33.9,,345.51,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",993.72,78,,794.98,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1052.32,82.6,,841.86,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1052.32,82.6,,841.86,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1274,100,,1019.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1274,
"XR Knee 3 Views",32073562,CDM,320,RC,73562,CPT,OUTPATIENT,,,1274,828.1,TC|50,1121.12,88,,896.90,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1274,100,,1019.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",802.62,63,,642.10,,,0,"percent of total billed charges","63% of total billed charges",194.92,15.3,,155.94,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,879.06,69,,,,,0,"fee schedule","69% of total billed charges",1274,100,,1019.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1274,100,,1019.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1274,100,,1019.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",480.3,37.7,,384.24,,,0,"percent of total billed charges","37.7% of total billed charges",480.3,37.7,,384.24,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",431.89,33.9,,345.51,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",993.72,78,,794.98,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1052.32,82.6,,841.86,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1052.32,82.6,,841.86,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1274,100,,1019.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1274,
"XR Knee Complete 4+ Views Bilateral",32073564,CDM,320,RC,73564,CPT,OUTPATIENT,,,1467,953.55,50|TC,1290.96,88,,1032.77,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1467,100,,1173.60,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",924.21,63,,739.37,,,0,"percent of total billed charges","63% of total billed charges",224.45,15.3,,179.56,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1012.23,69,,,,,0,"fee schedule","69% of total billed charges",1467,100,,1173.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1467,100,,1173.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1467,100,,1173.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",553.06,37.7,,442.45,,,0,"percent of total billed charges","37.7% of total billed charges",553.06,37.7,,442.45,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.31,33.9,,397.85,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1144.26,78,,915.41,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1211.74,82.6,,969.39,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1211.74,82.6,,969.39,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1467,100,,1173.60,,,0,"percent of total billed charges","100% of total billed charges",38.21,1467,
"XR Knee Complete 4+ Views Left",32073564,CDM,320,RC,73564,CPT,OUTPATIENT,,,1467,953.55,50|TC,1290.96,88,,1032.77,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1467,100,,1173.60,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",924.21,63,,739.37,,,0,"percent of total billed charges","63% of total billed charges",224.45,15.3,,179.56,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1012.23,69,,,,,0,"fee schedule","69% of total billed charges",1467,100,,1173.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1467,100,,1173.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1467,100,,1173.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",553.06,37.7,,442.45,,,0,"percent of total billed charges","37.7% of total billed charges",553.06,37.7,,442.45,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.31,33.9,,397.85,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1144.26,78,,915.41,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1211.74,82.6,,969.39,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1211.74,82.6,,969.39,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1467,100,,1173.60,,,0,"percent of total billed charges","100% of total billed charges",38.21,1467,
"XR Knee Complete 4+ Views Right",32073564,CDM,320,RC,73564,CPT,OUTPATIENT,,,1467,953.55,50|TC,1290.96,88,,1032.77,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1467,100,,1173.60,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",924.21,63,,739.37,,,0,"percent of total billed charges","63% of total billed charges",224.45,15.3,,179.56,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1012.23,69,,,,,0,"fee schedule","69% of total billed charges",1467,100,,1173.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1467,100,,1173.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1467,100,,1173.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",553.06,37.7,,442.45,,,0,"percent of total billed charges","37.7% of total billed charges",553.06,37.7,,442.45,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.31,33.9,,397.85,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1144.26,78,,915.41,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1211.74,82.6,,969.39,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1211.74,82.6,,969.39,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1467,100,,1173.60,,,0,"percent of total billed charges","100% of total billed charges",38.21,1467,
"XR Knee 1 View Standing AP Bilateral",32073565,CDM,320,RC,73565,CPT,OUTPATIENT,,,1207,784.55,TC,1062.16,88,,849.73,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1207,100,,965.60,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",760.41,63,,608.33,,,0,"percent of total billed charges","63% of total billed charges",184.67,15.3,,147.74,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,832.83,69,,,,,0,"fee schedule","69% of total billed charges",1207,100,,965.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1207,100,,965.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1207,100,,965.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",455.04,37.7,,364.03,,,0,"percent of total billed charges","37.7% of total billed charges",455.04,37.7,,364.03,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.17,33.9,,327.34,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",941.46,78,,753.17,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",996.98,82.6,,797.58,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",996.98,82.6,,797.58,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1207,100,,965.60,,,0,"percent of total billed charges","100% of total billed charges",38.21,1207,
"XR Lower Extremity Infant (0-1yr) Bilat",32073592,CDM,320,RC,73592,CPT,OUTPATIENT,,,409,265.85,TC|50,359.92,88,,287.94,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",257.67,63,,206.14,,,0,"percent of total billed charges","63% of total billed charges",62.58,15.3,,50.06,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,282.21,69,,,,,0,"fee schedule","69% of total billed charges",409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.19,37.7,,123.35,,,0,"percent of total billed charges","37.7% of total billed charges",154.19,37.7,,123.35,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",138.65,33.9,,110.92,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",319.02,78,,255.22,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",337.83,82.6,,270.26,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",337.83,82.6,,270.26,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,409,
"XR Lower Extremity Infant (0-1yr) Left",32073592,CDM,320,RC,73592,CPT,OUTPATIENT,,,409,265.85,TC|50,359.92,88,,287.94,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",257.67,63,,206.14,,,0,"percent of total billed charges","63% of total billed charges",62.58,15.3,,50.06,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,282.21,69,,,,,0,"fee schedule","69% of total billed charges",409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.19,37.7,,123.35,,,0,"percent of total billed charges","37.7% of total billed charges",154.19,37.7,,123.35,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",138.65,33.9,,110.92,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",319.02,78,,255.22,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",337.83,82.6,,270.26,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",337.83,82.6,,270.26,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,409,
"XR Lower Extremity Infant (0-1yr) Right",32073592,CDM,320,RC,73592,CPT,OUTPATIENT,,,409,265.85,TC|50,359.92,88,,287.94,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",257.67,63,,206.14,,,0,"percent of total billed charges","63% of total billed charges",62.58,15.3,,50.06,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,282.21,69,,,,,0,"fee schedule","69% of total billed charges",409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.19,37.7,,123.35,,,0,"percent of total billed charges","37.7% of total billed charges",154.19,37.7,,123.35,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",138.65,33.9,,110.92,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",319.02,78,,255.22,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",337.83,82.6,,270.26,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",337.83,82.6,,270.26,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,409,
"Spinal puncture, lumbar, diagnostic",32062270,CDM,320,RC,62270,CPT,OUTPATIENT,,,1632,1060.8,TC,1436.16,88,,1148.93,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1632,100,,1305.60,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1028.16,63,,822.53,,,0,"percent of total billed charges","63% of total billed charges",249.7,15.3,,199.76,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,1126.08,69,,,,,0,"fee schedule","69% of total billed charges",1632,100,,1305.60,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1632,100,,1305.60,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1632,100,,1305.60,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",570.86,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",615.26,37.7,,492.21,,,0,"percent of total billed charges","37.7% of total billed charges",615.26,37.7,,492.21,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",553.25,33.9,,442.60,,,0,"percent of total billed charges","33.9% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1272.96,78,,1018.37,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1348.03,82.6,,1078.42,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1348.03,82.6,,1078.42,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1632,100,,1305.60,,,0,"percent of total billed charges","100% of total billed charges",249.7,2578.03,
"XR Lumbar Puncture Diagnostic",32062328,CDM,320,RC,62328,CPT,OUTPATIENT,,,1632,1060.8,TC,1436.16,88,,1148.93,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1632,100,,1305.60,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1028.16,63,,822.53,,,0,"percent of total billed charges","63% of total billed charges",249.7,15.3,,199.76,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,1126.08,69,,,,,0,"fee schedule","69% of total billed charges",1632,100,,1305.60,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1632,100,,1305.60,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1632,100,,1305.60,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",570.86,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",615.26,37.7,,492.21,,,0,"percent of total billed charges","37.7% of total billed charges",615.26,37.7,,492.21,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",553.25,33.9,,442.60,,,0,"percent of total billed charges","33.9% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1272.96,78,,1018.37,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1348.03,82.6,,1078.42,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1348.03,82.6,,1078.42,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1632,100,,1305.60,,,0,"percent of total billed charges","100% of total billed charges",249.7,2578.03,
"XR Mandible Complete 4+ Views",32070110,CDM,320,RC,70110,CPT,OUTPATIENT,,,1192,774.8,TC,1048.96,88,,839.17,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1192,100,,953.60,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",750.96,63,,600.77,,,0,"percent of total billed charges","63% of total billed charges",182.38,15.3,,145.90,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,822.48,69,,,,,0,"fee schedule","69% of total billed charges",1192,100,,953.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1192,100,,953.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1192,100,,953.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.38,37.7,,359.50,,,0,"percent of total billed charges","37.7% of total billed charges",449.38,37.7,,359.50,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",404.09,33.9,,323.27,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",929.76,78,,743.81,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",984.59,82.6,,787.67,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",984.59,82.6,,787.67,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1192,100,,953.60,,,0,"percent of total billed charges","100% of total billed charges",38.21,1192,
"XR Mandible Less Than 4 Views",32070100,CDM,320,RC,70100,CPT,OUTPATIENT,,,711,462.15,TC,625.68,88,,500.54,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,711,100,,568.80,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",447.93,63,,358.34,,,0,"percent of total billed charges","63% of total billed charges",108.78,15.3,,87.02,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,490.59,69,,,,,0,"fee schedule","69% of total billed charges",711,100,,568.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",711,100,,568.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",711,100,,568.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",268.05,37.7,,214.44,,,0,"percent of total billed charges","37.7% of total billed charges",268.05,37.7,,214.44,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",241.03,33.9,,192.82,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.58,78,,443.66,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",587.29,82.6,,469.83,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",587.29,82.6,,469.83,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,711,100,,568.80,,,0,"percent of total billed charges","100% of total billed charges",38.21,711,
"XR Mastoids Complete",32070130,CDM,320,RC,70130,CPT,OUTPATIENT,,,1164,756.6,TC,1024.32,88,,819.46,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1164,100,,931.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",733.32,63,,586.66,,,0,"percent of total billed charges","63% of total billed charges",178.09,15.3,,142.47,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,803.16,69,,,,,0,"fee schedule","69% of total billed charges",1164,100,,931.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1164,100,,931.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1164,100,,931.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",438.83,37.7,,351.06,,,0,"percent of total billed charges","37.7% of total billed charges",438.83,37.7,,351.06,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394.6,33.9,,315.68,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.92,78,,726.34,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",961.46,82.6,,769.17,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",961.46,82.6,,769.17,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1164,100,,931.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1164,
"XR Myelogram Cervical Spine",32062302,CDM,320,RC,62302,CPT,OUTPATIENT,,,5238,3404.7,TC,4609.44,88,,3687.55,,,0,"percent of total billed charges","88% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",528.24,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",1429.16,175,,,,,0,"fee schedule","175% of CMS fee schedule",544.08,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3299.94,63,,2639.95,,,0,"percent of total billed charges","63% of total billed charges",801.41,15.3,,641.13,,,0,"percent of total billed charges","15.3% of total billed charges",528.24,100,,,,,0,"fee schedule",EAPG,3614.22,69,,,,,0,"fee schedule","69% of total billed charges",5238,100,,4190.40,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5238,100,,4190.40,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5238,100,,4190.40,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",2905.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",528.24,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",391.29,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",538.8,100,,,,,0,"fee schedule",EAPG,686.71,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1974.73,37.7,,1579.78,,,0,"percent of total billed charges","37.7% of total billed charges",1974.73,37.7,,1579.78,,,0,"percent of total billed charges","37.70% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1775.68,33.9,,1420.54,,,0,"percent of total billed charges","33.9% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4085.64,78,,3268.51,,,0,"percent of total billed charges","78% of total billed charges",824.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4326.59,82.6,,3461.27,,,0,"percent of total billed charges","82.6% of total billed charges",528.24,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4326.59,82.6,,3461.27,,,0,"percent of total billed charges","82.6% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",528.24,100,,,,,0,"fee schedule",EAPG,5238,100,,4190.40,,,0,"percent of total billed charges","100% of total billed charges",391.29,5238,
"XR Myelogram Lumbosacral Spine",32062304,CDM,320,RC,62304,CPT,OUTPATIENT,,,5100,3315,TC,4488,88,,3590.40,,,0,"percent of total billed charges","88% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",528.24,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",1429.16,175,,,,,0,"fee schedule","175% of CMS fee schedule",544.08,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3213,63,,2570.40,,,0,"percent of total billed charges","63% of total billed charges",780.3,15.3,,624.24,,,0,"percent of total billed charges","15.3% of total billed charges",528.24,100,,,,,0,"fee schedule",EAPG,3519,69,,,,,0,"fee schedule","69% of total billed charges",5100,100,,4080.00,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5100,100,,4080.00,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5100,100,,4080.00,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",2905.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",528.24,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",391.29,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",538.8,100,,,,,0,"fee schedule",EAPG,686.71,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1922.7,37.7,,1538.16,,,0,"percent of total billed charges","37.7% of total billed charges",1922.7,37.7,,1538.16,,,0,"percent of total billed charges","37.70% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1728.9,33.9,,1383.12,,,0,"percent of total billed charges","33.9% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3978,78,,3182.40,,,0,"percent of total billed charges","78% of total billed charges",824.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4212.6,82.6,,3370.08,,,0,"percent of total billed charges","82.6% of total billed charges",528.24,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4212.6,82.6,,3370.08,,,0,"percent of total billed charges","82.6% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",528.24,100,,,,,0,"fee schedule",EAPG,5100,100,,4080.00,,,0,"percent of total billed charges","100% of total billed charges",391.29,5100,
"XR Myelogram Thoracic Spine",32062303,CDM,320,RC,62303,CPT,OUTPATIENT,,,4162,2705.3,TC,3662.56,88,,2930.05,,,0,"percent of total billed charges","88% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",528.24,100,,,,,0,"fee schedule",EAPG,4162,100,,3329.60,,,0,"percent of total billed charges","100% of total billed charges",1429.16,175,,,,,0,"fee schedule","175% of CMS fee schedule",544.08,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2622.06,63,,2097.65,,,0,"percent of total billed charges","63% of total billed charges",636.79,15.3,,509.43,,,0,"percent of total billed charges","15.3% of total billed charges",528.24,100,,,,,0,"fee schedule",EAPG,2871.78,69,,,,,0,"fee schedule","69% of total billed charges",4162,100,,3329.60,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4162,100,,3329.60,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4162,100,,3329.60,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",2905.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",528.24,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",391.29,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",538.8,100,,,,,0,"fee schedule",EAPG,686.71,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1569.07,37.7,,1255.26,,,0,"percent of total billed charges","37.7% of total billed charges",1569.07,37.7,,1255.26,,,0,"percent of total billed charges","37.70% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1410.92,33.9,,1128.74,,,0,"percent of total billed charges","33.9% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3246.36,78,,2597.09,,,0,"percent of total billed charges","78% of total billed charges",824.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3437.81,82.6,,2750.25,,,0,"percent of total billed charges","82.6% of total billed charges",528.24,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3437.81,82.6,,2750.25,,,0,"percent of total billed charges","82.6% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",528.24,100,,,,,0,"fee schedule",EAPG,4162,100,,3329.60,,,0,"percent of total billed charges","100% of total billed charges",391.29,4162,
"XR Myelogram 2 or More Regions w/ Inject",32062305,CDM,320,RC,62305,CPT,OUTPATIENT,,,5060,3289,TC,4452.8,88,,3562.24,,,0,"percent of total billed charges","88% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",528.24,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",1429.16,175,,,,,0,"fee schedule","175% of CMS fee schedule",544.08,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3187.8,63,,2550.24,,,0,"percent of total billed charges","63% of total billed charges",774.18,15.3,,619.34,,,0,"percent of total billed charges","15.3% of total billed charges",528.24,100,,,,,0,"fee schedule",EAPG,3491.4,69,,,,,0,"fee schedule","69% of total billed charges",5060,100,,4048.00,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5060,100,,4048.00,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5060,100,,4048.00,,,0,"percent of total billed charges","100% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",2905.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",528.24,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",391.29,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",538.8,100,,,,,0,"fee schedule",EAPG,686.71,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1907.62,37.7,,1526.10,,,0,"percent of total billed charges","37.7% of total billed charges",1907.62,37.7,,1526.10,,,0,"percent of total billed charges","37.70% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1715.34,33.9,,1372.27,,,0,"percent of total billed charges","33.9% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3946.8,78,,3157.44,,,0,"percent of total billed charges","78% of total billed charges",824.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4179.56,82.6,,3343.65,,,0,"percent of total billed charges","82.6% of total billed charges",528.24,100,,,,,0,"fee schedule",EAPG,816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4179.56,82.6,,3343.65,,,0,"percent of total billed charges","82.6% of total billed charges",816.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",528.24,100,,,,,0,"fee schedule",EAPG,5060,100,,4048.00,,,0,"percent of total billed charges","100% of total billed charges",391.29,5060,
"XR Nasal Bones 3+ Views",32070160,CDM,320,RC,70160,CPT,OUTPATIENT,,,1404,912.6,TC,1235.52,88,,988.42,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1404,100,,1123.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",884.52,63,,707.62,,,0,"percent of total billed charges","63% of total billed charges",214.81,15.3,,171.85,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,968.76,69,,,,,0,"fee schedule","69% of total billed charges",1404,100,,1123.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1404,100,,1123.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1404,100,,1123.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",529.31,37.7,,423.45,,,0,"percent of total billed charges","37.7% of total billed charges",529.31,37.7,,423.45,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",475.96,33.9,,380.77,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1095.12,78,,876.10,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1159.7,82.6,,927.76,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1159.7,82.6,,927.76,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1404,100,,1123.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1404,
"XR Neck Soft Tissue",32070360,CDM,320,RC,70360,CPT,OUTPATIENT,,,816,530.4,TC,718.08,88,,574.46,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,816,100,,652.80,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",514.08,63,,411.26,,,0,"percent of total billed charges","63% of total billed charges",124.85,15.3,,99.88,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,563.04,69,,,,,0,"fee schedule","69% of total billed charges",816,100,,652.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",816,100,,652.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",816,100,,652.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.63,37.7,,246.10,,,0,"percent of total billed charges","37.7% of total billed charges",307.63,37.7,,246.10,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",276.62,33.9,,221.30,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",636.48,78,,509.18,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",674.02,82.6,,539.22,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",674.02,82.6,,539.22,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,816,100,,652.80,,,0,"percent of total billed charges","100% of total billed charges",38.21,816,
"XR Nerve Block Inj",32064450,CDM,320,RC,64450,CPT,OUTPATIENT,,,1746,1134.9,TC,1536.48,88,,1229.18,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,1746,100,,1396.80,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1099.98,63,,879.98,,,0,"percent of total billed charges","63% of total billed charges",267.14,15.3,,213.71,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,1204.74,69,,,,,0,"fee schedule","69% of total billed charges",1746,100,,1396.80,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1746,100,,1396.80,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1746,100,,1396.80,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.52,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.24,37.7,,526.59,,,0,"percent of total billed charges","37.7% of total billed charges",658.24,37.7,,526.59,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591.89,33.9,,473.51,,,0,"percent of total billed charges","33.9% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1361.88,78,,1089.50,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1442.2,82.6,,1153.76,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1442.2,82.6,,1153.76,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,1746,100,,1396.80,,,0,"percent of total billed charges","100% of total billed charges",267.14,2578.03,
"XR Osseous Survey Complete",32077075,CDM,320,RC,77075,CPT,OUTPATIENT,,,1739,1130.35,TC,1530.32,88,,1224.26,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1739,100,,1391.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1095.57,63,,876.46,,,0,"percent of total billed charges","63% of total billed charges",266.07,15.3,,212.86,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,1199.91,69,,,,,0,"fee schedule","69% of total billed charges",1739,100,,1391.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1739,100,,1391.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1739,100,,1391.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",655.6,37.7,,524.48,,,0,"percent of total billed charges","37.7% of total billed charges",655.6,37.7,,524.48,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",589.52,33.9,,471.62,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1356.42,78,,1085.14,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1436.41,82.6,,1149.13,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1436.41,82.6,,1149.13,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1739,100,,1391.20,,,0,"percent of total billed charges","100% of total billed charges",80.56,1739,
"XR Osseous Survey Infant",32077076,CDM,320,RC,77076,CPT,OUTPATIENT,,,1994,1296.1,TC,1754.72,88,,1403.78,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1994,100,,1595.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1256.22,63,,1004.98,,,0,"percent of total billed charges","63% of total billed charges",305.08,15.3,,244.06,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1375.86,69,,,,,0,"fee schedule","69% of total billed charges",1994,100,,1595.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1994,100,,1595.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1994,100,,1595.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",751.74,37.7,,601.39,,,0,"percent of total billed charges","37.7% of total billed charges",751.74,37.7,,601.39,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",675.97,33.9,,540.78,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1555.32,78,,1244.26,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1647.04,82.6,,1317.63,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1647.04,82.6,,1317.63,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1994,100,,1595.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1994,
"XR Osseous Survey Limited",32077074,CDM,320,RC,77074,CPT,OUTPATIENT,,,580,377,TC,510.4,88,,408.32,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,580,100,,464.00,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",365.4,63,,292.32,,,0,"percent of total billed charges","63% of total billed charges",88.74,15.3,,70.99,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,400.2,69,,,,,0,"fee schedule","69% of total billed charges",580,100,,464.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",580,100,,464.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",580,100,,464.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.66,37.7,,174.93,,,0,"percent of total billed charges","37.7% of total billed charges",218.66,37.7,,174.93,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",196.62,33.9,,157.30,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",452.4,78,,361.92,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",479.08,82.6,,383.26,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",479.08,82.6,,383.26,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,580,100,,464.00,,,0,"percent of total billed charges","100% of total billed charges",38.21,580,
"XR Orbits Complete",32070200,CDM,320,RC,70200,CPT,OUTPATIENT,,,1410,916.5,TC,1240.8,88,,992.64,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1410,100,,1128.00,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",888.3,63,,710.64,,,0,"percent of total billed charges","63% of total billed charges",215.73,15.3,,172.58,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,972.9,69,,,,,0,"fee schedule","69% of total billed charges",1410,100,,1128.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1410,100,,1128.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1410,100,,1128.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",531.57,37.7,,425.26,,,0,"percent of total billed charges","37.7% of total billed charges",531.57,37.7,,425.26,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",477.99,33.9,,382.39,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1099.8,78,,879.84,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1164.66,82.6,,931.73,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1164.66,82.6,,931.73,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1410,100,,1128.00,,,0,"percent of total billed charges","100% of total billed charges",38.21,1410,
"XR Pelvis 1 or 2 Views",32072170,CDM,320,RC,72170,CPT,OUTPATIENT,,,850,552.5,TC,748,88,,598.40,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,850,100,,680.00,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",535.5,63,,428.40,,,0,"percent of total billed charges","63% of total billed charges",130.05,15.3,,104.04,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,586.5,69,,,,,0,"fee schedule","69% of total billed charges",850,100,,680.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",850,100,,680.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",850,100,,680.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320.45,37.7,,256.36,,,0,"percent of total billed charges","37.7% of total billed charges",320.45,37.7,,256.36,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",288.15,33.9,,230.52,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",663,78,,530.40,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",702.1,82.6,,561.68,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",702.1,82.6,,561.68,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,850,100,,680.00,,,0,"percent of total billed charges","100% of total billed charges",38.21,850,
"XR Pelvis Complete 3+ Views",32072190,CDM,320,RC,72190,CPT,OUTPATIENT,,,1123,729.95,TC,988.24,88,,790.59,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1123,100,,898.40,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",707.49,63,,565.99,,,0,"percent of total billed charges","63% of total billed charges",171.82,15.3,,137.46,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,774.87,69,,,,,0,"fee schedule","69% of total billed charges",1123,100,,898.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1123,100,,898.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1123,100,,898.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",423.37,37.7,,338.70,,,0,"percent of total billed charges","37.7% of total billed charges",423.37,37.7,,338.70,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",380.7,33.9,,304.56,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.94,78,,700.75,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",927.6,82.6,,742.08,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",927.6,82.6,,742.08,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1123,100,,898.40,,,0,"percent of total billed charges","100% of total billed charges",38.21,1123,
"XR Placement CVAD w/ Fluoro",32077001,CDM,320,RC,77001,CPT,OUTPATIENT,,,1418,921.7,TC,1247.84,88,,998.27,,,0,"percent of total billed charges","88% of total billed charges",709,50,,567.20,,,0,"percent of total billed charges","50% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,1418,100,,1134.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",893.34,63,,714.67,,,0,"percent of total billed charges","63% of total billed charges",216.95,15.3,,173.56,,,0,"percent of total billed charges","15.3% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,978.42,69,,,,,0,"fee schedule","69% of total billed charges",1418,100,,1134.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1418,100,,1134.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1418,100,,1134.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",877.03,61.85,,701.62,,,0,"percent of total billed charges","61.5% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,709,50,,567.20,,,0,"percent of total billed charges","50% of total billed charges",456.6,32.2,,365.28,,,0,"percent of total billed charges","32.2% of total billed charges",119.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",165.21,100,,,,,0,"fee schedule",EAPG,210.57,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",534.59,37.7,,427.67,,,0,"percent of total billed charges","37.7% of total billed charges",534.59,37.7,,427.67,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",480.7,33.9,,384.56,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.04,78,,884.83,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1171.27,82.6,,937.02,,,0,"percent of total billed charges","82.6% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,709,50,,567.20,,,0,"percent of total billed charges","50% of total billed charges",1171.27,82.6,,937.02,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",161.97,100,,,,,0,"fee schedule",EAPG,1418,100,,1134.40,,,0,"percent of total billed charges","100% of total billed charges",119.98,1418,
"XR Pyelostogram",32074425,CDM,320,RC,74425,CPT,OUTPATIENT,,,3117,2026.05,TC,2742.96,88,,2194.37,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,3117,100,,2493.60,,,0,"percent of total billed charges","100% of total billed charges",686.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1963.71,63,,1570.97,,,0,"percent of total billed charges","63% of total billed charges",476.9,15.3,,381.52,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,2150.73,69,,,,,0,"fee schedule","69% of total billed charges",3117,100,,2493.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3117,100,,2493.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3117,100,,2493.60,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1175.11,37.7,,940.09,,,0,"percent of total billed charges","37.7% of total billed charges",1175.11,37.7,,940.09,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056.66,33.9,,845.33,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2431.26,78,,1945.01,,,0,"percent of total billed charges","78% of total billed charges",396.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2574.64,82.6,,2059.71,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2574.64,82.6,,2059.71,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,3117,100,,2493.60,,,0,"percent of total billed charges","100% of total billed charges",80.56,3117,
"XR Ribs 2 Views Left",32071100,CDM,320,RC,71100,CPT,OUTPATIENT,,,1307,849.55,TC|LT,1150.16,88,,920.13,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1307,100,,1045.60,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",823.41,63,,658.73,,,0,"percent of total billed charges","63% of total billed charges",199.97,15.3,,159.98,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,901.83,69,,,,,0,"fee schedule","69% of total billed charges",1307,100,,1045.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1307,100,,1045.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1307,100,,1045.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",492.74,37.7,,394.19,,,0,"percent of total billed charges","37.7% of total billed charges",492.74,37.7,,394.19,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.07,33.9,,354.46,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1019.46,78,,815.57,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1079.58,82.6,,863.66,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1079.58,82.6,,863.66,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1307,100,,1045.60,,,0,"percent of total billed charges","100% of total billed charges",38.21,1307,
"XR Ribs 2 Views Right",32071100,CDM,320,RC,71100,CPT,OUTPATIENT,,,1684,1094.6,TC|LT,1481.92,88,,1185.54,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1684,100,,1347.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1060.92,63,,848.74,,,0,"percent of total billed charges","63% of total billed charges",257.65,15.3,,206.12,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1161.96,69,,,,,0,"fee schedule","69% of total billed charges",1684,100,,1347.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1684,100,,1347.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1684,100,,1347.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",634.87,37.7,,507.90,,,0,"percent of total billed charges","37.7% of total billed charges",634.87,37.7,,507.90,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",570.88,33.9,,456.70,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1313.52,78,,1050.82,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1390.98,82.6,,1112.78,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1390.98,82.6,,1112.78,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1684,100,,1347.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1684,
"XR Ribs 3 Views Bilateral",32071110,CDM,320,RC,71110,CPT,OUTPATIENT,,,1361,884.65,TC,1197.68,88,,958.14,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1361,100,,1088.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",857.43,63,,685.94,,,0,"percent of total billed charges","63% of total billed charges",208.23,15.3,,166.58,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,939.09,69,,,,,0,"fee schedule","69% of total billed charges",1361,100,,1088.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1361,100,,1088.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1361,100,,1088.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",513.1,37.7,,410.48,,,0,"percent of total billed charges","37.7% of total billed charges",513.1,37.7,,410.48,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",461.38,33.9,,369.10,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1061.58,78,,849.26,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1124.19,82.6,,899.35,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1124.19,82.6,,899.35,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1361,100,,1088.80,,,0,"percent of total billed charges","100% of total billed charges",38.21,1361,
"XR Ribs w/ PA Chest Left",32071101,CDM,320,RC,71101,CPT,OUTPATIENT,,,1684,1094.6,TC|LT,1481.92,88,,1185.54,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1684,100,,1347.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1060.92,63,,848.74,,,0,"percent of total billed charges","63% of total billed charges",257.65,15.3,,206.12,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1161.96,69,,,,,0,"fee schedule","69% of total billed charges",1684,100,,1347.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1684,100,,1347.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1684,100,,1347.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",634.87,37.7,,507.90,,,0,"percent of total billed charges","37.7% of total billed charges",634.87,37.7,,507.90,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",570.88,33.9,,456.70,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1313.52,78,,1050.82,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1390.98,82.6,,1112.78,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1390.98,82.6,,1112.78,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1684,100,,1347.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1684,
"XR Ribs w/ PA Chest Right",32071101,CDM,320,RC,71101,CPT,OUTPATIENT,,,1684,1094.6,TC|LT,1481.92,88,,1185.54,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1684,100,,1347.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1060.92,63,,848.74,,,0,"percent of total billed charges","63% of total billed charges",257.65,15.3,,206.12,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1161.96,69,,,,,0,"fee schedule","69% of total billed charges",1684,100,,1347.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1684,100,,1347.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1684,100,,1347.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",634.87,37.7,,507.90,,,0,"percent of total billed charges","37.7% of total billed charges",634.87,37.7,,507.90,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",570.88,33.9,,456.70,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1313.52,78,,1050.82,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1390.98,82.6,,1112.78,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1390.98,82.6,,1112.78,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1684,100,,1347.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1684,
"XR Ribs 3 Views Left",32071101,CDM,320,RC,71101,CPT,OUTPATIENT,,,1684,1094.6,TC|LT,1481.92,88,,1185.54,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1684,100,,1347.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1060.92,63,,848.74,,,0,"percent of total billed charges","63% of total billed charges",257.65,15.3,,206.12,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1161.96,69,,,,,0,"fee schedule","69% of total billed charges",1684,100,,1347.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1684,100,,1347.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1684,100,,1347.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",634.87,37.7,,507.90,,,0,"percent of total billed charges","37.7% of total billed charges",634.87,37.7,,507.90,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",570.88,33.9,,456.70,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1313.52,78,,1050.82,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1390.98,82.6,,1112.78,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1390.98,82.6,,1112.78,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1684,100,,1347.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1684,
"XR Ribs 3 Views Right",32071101,CDM,320,RC,71101,CPT,OUTPATIENT,,,1684,1094.6,TC|LT,1481.92,88,,1185.54,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1684,100,,1347.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1060.92,63,,848.74,,,0,"percent of total billed charges","63% of total billed charges",257.65,15.3,,206.12,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1161.96,69,,,,,0,"fee schedule","69% of total billed charges",1684,100,,1347.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1684,100,,1347.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1684,100,,1347.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",634.87,37.7,,507.90,,,0,"percent of total billed charges","37.7% of total billed charges",634.87,37.7,,507.90,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",570.88,33.9,,456.70,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1313.52,78,,1050.82,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1390.98,82.6,,1112.78,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1390.98,82.6,,1112.78,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1684,100,,1347.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1684,
"XR Stress Application Joint(s) Uni/Bilat",32077071,CDM,320,RC,77071,CPT,OUTPATIENT,,,279,181.35,TC,245.52,88,,196.42,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.87,16.8,,37.50,,,0,"percent of total billed charges","16.8% of total billed charges",279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",48.28,17.304,,38.62,,,0,"percent of total billed charges","17.304% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",175.77,63,,140.62,,,0,"percent of total billed charges","63% of total billed charges",42.69,15.3,,34.15,,,0,"percent of total billed charges","15.3% of total billed charges",46.87,16.8,,37.50,,,0,"percent of total billed charges","16.8% of total billed charges",192.51,69,,,,,0,"fee schedule","69% of total billed charges",279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.87,16.8,,37.50,,,0,"percent of total billed charges","16.8% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.87,16.8,,37.50,,,0,"percent of total billed charges","16.8% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.81,17.136,,38.25,,,0,"percent of total billed charges","17.136% of total billed charges",60.93,21.84,,48.74,,,0,"percent of total billed charges","21.84% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.18,37.7,,84.14,,,0,"percent of total billed charges","37.7% of total billed charges",105.18,37.7,,84.14,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",94.58,33.9,,75.66,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",217.62,78,,174.10,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",230.45,82.6,,184.36,,,0,"percent of total billed charges","82.6% of total billed charges",46.87,16.8,,37.50,,,0,"percent of total billed charges","16.8% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",230.45,82.6,,184.36,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.87,16.8,,37.50,,,0,"percent of total billed charges","16.8% of total billed charges",279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",42.69,328.65,
"XR Sacroiliac Joints 3+ Views",32072202,CDM,320,RC,72202,CPT,OUTPATIENT,,,942,612.3,TC,828.96,88,,663.17,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,942,100,,753.60,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.46,63,,474.77,,,0,"percent of total billed charges","63% of total billed charges",144.13,15.3,,115.30,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,649.98,69,,,,,0,"fee schedule","69% of total billed charges",942,100,,753.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",942,100,,753.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",942,100,,753.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.13,37.7,,284.10,,,0,"percent of total billed charges","37.7% of total billed charges",355.13,37.7,,284.10,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",319.34,33.9,,255.47,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",734.76,78,,587.81,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",778.09,82.6,,622.47,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",778.09,82.6,,622.47,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,942,100,,753.60,,,0,"percent of total billed charges","100% of total billed charges",38.21,942,
"XR Sacrum/Coccyx 2+ Views",32072220,CDM,320,RC,72220,CPT,OUTPATIENT,,,1131,735.15,TC,995.28,88,,796.22,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1131,100,,904.80,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",712.53,63,,570.02,,,0,"percent of total billed charges","63% of total billed charges",173.04,15.3,,138.43,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,780.39,69,,,,,0,"fee schedule","69% of total billed charges",1131,100,,904.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1131,100,,904.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1131,100,,904.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.39,37.7,,341.11,,,0,"percent of total billed charges","37.7% of total billed charges",426.39,37.7,,341.11,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",383.41,33.9,,306.73,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",882.18,78,,705.74,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",934.21,82.6,,747.37,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",934.21,82.6,,747.37,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1131,100,,904.80,,,0,"percent of total billed charges","100% of total billed charges",38.21,1131,
"XR Scapula Left",32073010,CDM,320,RC,73010,CPT,OUTPATIENT,,,1010,656.5,TC|LT,888.8,88,,711.04,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1010,100,,808.00,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",636.3,63,,509.04,,,0,"percent of total billed charges","63% of total billed charges",154.53,15.3,,123.62,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,696.9,69,,,,,0,"fee schedule","69% of total billed charges",1010,100,,808.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1010,100,,808.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1010,100,,808.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",380.77,37.7,,304.62,,,0,"percent of total billed charges","37.7% of total billed charges",380.77,37.7,,304.62,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.39,33.9,,273.91,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",787.8,78,,630.24,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",834.26,82.6,,667.41,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",834.26,82.6,,667.41,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1010,100,,808.00,,,0,"percent of total billed charges","100% of total billed charges",38.21,1010,
"XR Scapula Right",32073010,CDM,320,RC,73010,CPT,OUTPATIENT,,,1010,656.5,TC|LT,888.8,88,,711.04,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1010,100,,808.00,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",636.3,63,,509.04,,,0,"percent of total billed charges","63% of total billed charges",154.53,15.3,,123.62,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,696.9,69,,,,,0,"fee schedule","69% of total billed charges",1010,100,,808.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1010,100,,808.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1010,100,,808.00,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",380.77,37.7,,304.62,,,0,"percent of total billed charges","37.7% of total billed charges",380.77,37.7,,304.62,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.39,33.9,,273.91,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",787.8,78,,630.24,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",834.26,82.6,,667.41,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",834.26,82.6,,667.41,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1010,100,,808.00,,,0,"percent of total billed charges","100% of total billed charges",38.21,1010,
"XR Shoulder 1 View Left",32073020,CDM,320,RC,73020,CPT,OUTPATIENT,,,773,502.45,TC|LT,680.24,88,,544.19,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,773,100,,618.40,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",486.99,63,,389.59,,,0,"percent of total billed charges","63% of total billed charges",118.27,15.3,,94.62,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,533.37,69,,,,,0,"fee schedule","69% of total billed charges",773,100,,618.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",773,100,,618.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",773,100,,618.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",291.42,37.7,,233.14,,,0,"percent of total billed charges","37.7% of total billed charges",291.42,37.7,,233.14,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",262.05,33.9,,209.64,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",602.94,78,,482.35,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.5,82.6,,510.80,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.5,82.6,,510.80,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,773,100,,618.40,,,0,"percent of total billed charges","100% of total billed charges",38.21,773,
"XR Shoulder 1 View Right",32073020,CDM,320,RC,73020,CPT,OUTPATIENT,,,773,502.45,TC|LT,680.24,88,,544.19,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,773,100,,618.40,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",486.99,63,,389.59,,,0,"percent of total billed charges","63% of total billed charges",118.27,15.3,,94.62,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,533.37,69,,,,,0,"fee schedule","69% of total billed charges",773,100,,618.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",773,100,,618.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",773,100,,618.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",291.42,37.7,,233.14,,,0,"percent of total billed charges","37.7% of total billed charges",291.42,37.7,,233.14,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",262.05,33.9,,209.64,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",602.94,78,,482.35,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.5,82.6,,510.80,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.5,82.6,,510.80,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,773,100,,618.40,,,0,"percent of total billed charges","100% of total billed charges",38.21,773,
"XR Shoulder Complete 2+ Views Left",32073030,CDM,320,RC,73030,CPT,OUTPATIENT,,,1278,830.7,TC|LT,1124.64,88,,899.71,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1278,100,,1022.40,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",805.14,63,,644.11,,,0,"percent of total billed charges","63% of total billed charges",195.53,15.3,,156.42,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,881.82,69,,,,,0,"fee schedule","69% of total billed charges",1278,100,,1022.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1278,100,,1022.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1278,100,,1022.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",481.81,37.7,,385.45,,,0,"percent of total billed charges","37.7% of total billed charges",481.81,37.7,,385.45,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",433.24,33.9,,346.59,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",996.84,78,,797.47,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055.63,82.6,,844.50,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055.63,82.6,,844.50,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1278,100,,1022.40,,,0,"percent of total billed charges","100% of total billed charges",38.21,1278,
"XR Shoulder Complete 2+ Views Right",32073030,CDM,320,RC,73030,CPT,OUTPATIENT,,,1278,830.7,TC|LT,1124.64,88,,899.71,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1278,100,,1022.40,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",805.14,63,,644.11,,,0,"percent of total billed charges","63% of total billed charges",195.53,15.3,,156.42,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,881.82,69,,,,,0,"fee schedule","69% of total billed charges",1278,100,,1022.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1278,100,,1022.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1278,100,,1022.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",481.81,37.7,,385.45,,,0,"percent of total billed charges","37.7% of total billed charges",481.81,37.7,,385.45,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",433.24,33.9,,346.59,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",996.84,78,,797.47,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055.63,82.6,,844.50,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055.63,82.6,,844.50,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1278,100,,1022.40,,,0,"percent of total billed charges","100% of total billed charges",38.21,1278,
"XR Sinuses Paranasal < 3 Views",32070210,CDM,320,RC,70210,CPT,OUTPATIENT,,,350,227.5,TC,308,88,,246.40,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",220.5,63,,176.40,,,0,"percent of total billed charges","63% of total billed charges",53.55,15.3,,42.84,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,241.5,69,,,,,0,"fee schedule","69% of total billed charges",350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",131.95,37.7,,105.56,,,0,"percent of total billed charges","37.7% of total billed charges",131.95,37.7,,105.56,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.65,33.9,,94.92,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",273,78,,218.40,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.1,82.6,,231.28,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.1,82.6,,231.28,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",38.21,350,
"XR Sinuses Paranasal Complete",32070220,CDM,320,RC,70220,CPT,OUTPATIENT,,,1671,1086.15,TC,1470.48,88,,1176.38,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1671,100,,1336.80,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1052.73,63,,842.18,,,0,"percent of total billed charges","63% of total billed charges",255.66,15.3,,204.53,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1152.99,69,,,,,0,"fee schedule","69% of total billed charges",1671,100,,1336.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1671,100,,1336.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1671,100,,1336.80,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",629.97,37.7,,503.98,,,0,"percent of total billed charges","37.7% of total billed charges",629.97,37.7,,503.98,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",566.47,33.9,,453.18,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1303.38,78,,1042.70,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1380.25,82.6,,1104.20,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1380.25,82.6,,1104.20,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1671,100,,1336.80,,,0,"percent of total billed charges","100% of total billed charges",38.21,1671,
"XR Skull < 4 Views",32070250,CDM,320,RC,70250,CPT,OUTPATIENT,,,973,632.45,TC,856.24,88,,684.99,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,973,100,,778.40,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",612.99,63,,490.39,,,0,"percent of total billed charges","63% of total billed charges",148.87,15.3,,119.10,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,671.37,69,,,,,0,"fee schedule","69% of total billed charges",973,100,,778.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",973,100,,778.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",973,100,,778.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",366.82,37.7,,293.46,,,0,"percent of total billed charges","37.7% of total billed charges",366.82,37.7,,293.46,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",329.85,33.9,,263.88,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",758.94,78,,607.15,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",803.7,82.6,,642.96,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",803.7,82.6,,642.96,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,973,100,,778.40,,,0,"percent of total billed charges","100% of total billed charges",38.21,973,
"XR Skull Complete",32070260,CDM,320,RC,70260,CPT,OUTPATIENT,,,1943,1262.95,TC,1709.84,88,,1367.87,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1943,100,,1554.40,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1224.09,63,,979.27,,,0,"percent of total billed charges","63% of total billed charges",297.28,15.3,,237.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1340.67,69,,,,,0,"fee schedule","69% of total billed charges",1943,100,,1554.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943,100,,1554.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943,100,,1554.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",732.51,37.7,,586.01,,,0,"percent of total billed charges","37.7% of total billed charges",732.51,37.7,,586.01,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.68,33.9,,526.94,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1515.54,78,,1212.43,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1604.92,82.6,,1283.94,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1604.92,82.6,,1283.94,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1943,100,,1554.40,,,0,"percent of total billed charges","100% of total billed charges",38.21,1943,
"XR Small Bowel via Enteroclysis Tube",32074251,CDM,320,RC,74251,CPT,OUTPATIENT,,,3407,2214.55,TC,2998.16,88,,2398.53,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,3407,100,,2725.60,,,0,"percent of total billed charges","100% of total billed charges",327.95,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2146.41,63,,1717.13,,,0,"percent of total billed charges","63% of total billed charges",521.27,15.3,,417.02,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,2350.83,69,,,,,0,"fee schedule","69% of total billed charges",3407,100,,2725.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3407,100,,2725.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3407,100,,2725.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1284.44,37.7,,1027.55,,,0,"percent of total billed charges","37.7% of total billed charges",1284.44,37.7,,1027.55,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1154.97,33.9,,923.98,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2657.46,78,,2125.97,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2814.18,82.6,,2251.34,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2814.18,82.6,,2251.34,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,3407,100,,2725.60,,,0,"percent of total billed charges","100% of total billed charges",80.56,3407,
"XR Small Bowel w/ Multiple Series",32074250,CDM,320,RC,74250,CPT,OUTPATIENT,,,2902,1886.3,TC,2553.76,88,,2043.01,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,2902,100,,2321.60,,,0,"percent of total billed charges","100% of total billed charges",327.95,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1828.26,63,,1462.61,,,0,"percent of total billed charges","63% of total billed charges",444.01,15.3,,355.21,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,2002.38,69,,,,,0,"fee schedule","69% of total billed charges",2902,100,,2321.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2902,100,,2321.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2902,100,,2321.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1094.05,37.7,,875.24,,,0,"percent of total billed charges","37.7% of total billed charges",1094.05,37.7,,875.24,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",983.78,33.9,,787.02,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2263.56,78,,1810.85,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2397.05,82.6,,1917.64,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2397.05,82.6,,1917.64,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,2902,100,,2321.60,,,0,"percent of total billed charges","100% of total billed charges",80.56,2902,
"XR Spine Cervical 1 View",32072020,CDM,320,RC,72020,CPT,OUTPATIENT,,,723,469.95,TC,636.24,88,,508.99,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,723,100,,578.40,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",455.49,63,,364.39,,,0,"percent of total billed charges","63% of total billed charges",110.62,15.3,,88.50,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,498.87,69,,,,,0,"fee schedule","69% of total billed charges",723,100,,578.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",723,100,,578.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",723,100,,578.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.57,37.7,,218.06,,,0,"percent of total billed charges","37.7% of total billed charges",272.57,37.7,,218.06,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",245.1,33.9,,196.08,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",563.94,78,,451.15,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",597.2,82.6,,477.76,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",597.2,82.6,,477.76,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,723,100,,578.40,,,0,"percent of total billed charges","100% of total billed charges",38.21,723,
"XR Spine Lumbar 1 View",32072020,CDM,320,RC,72020,CPT,OUTPATIENT,,,723,469.95,TC,636.24,88,,508.99,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,723,100,,578.40,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",455.49,63,,364.39,,,0,"percent of total billed charges","63% of total billed charges",110.62,15.3,,88.50,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,498.87,69,,,,,0,"fee schedule","69% of total billed charges",723,100,,578.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",723,100,,578.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",723,100,,578.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.57,37.7,,218.06,,,0,"percent of total billed charges","37.7% of total billed charges",272.57,37.7,,218.06,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",245.1,33.9,,196.08,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",563.94,78,,451.15,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",597.2,82.6,,477.76,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",597.2,82.6,,477.76,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,723,100,,578.40,,,0,"percent of total billed charges","100% of total billed charges",38.21,723,
"XR Spine Cervical 2 or 3 Views",32072040,CDM,320,RC,72040,CPT,OUTPATIENT,,,1470,955.5,TC,1293.6,88,,1034.88,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1470,100,,1176.00,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",926.1,63,,740.88,,,0,"percent of total billed charges","63% of total billed charges",224.91,15.3,,179.93,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1014.3,69,,,,,0,"fee schedule","69% of total billed charges",1470,100,,1176.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1470,100,,1176.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1470,100,,1176.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.19,37.7,,443.35,,,0,"percent of total billed charges","37.7% of total billed charges",554.19,37.7,,443.35,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",498.33,33.9,,398.66,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1146.6,78,,917.28,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1214.22,82.6,,971.38,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1214.22,82.6,,971.38,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1470,100,,1176.00,,,0,"percent of total billed charges","100% of total billed charges",38.21,1470,
"XR Spine Cervical 4 or 5 Views",32072050,CDM,320,RC,72050,CPT,OUTPATIENT,,,2061,1339.65,TC,1813.68,88,,1450.94,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,2061,100,,1648.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1298.43,63,,1038.74,,,0,"percent of total billed charges","63% of total billed charges",315.33,15.3,,252.26,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1422.09,69,,,,,0,"fee schedule","69% of total billed charges",2061,100,,1648.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2061,100,,1648.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2061,100,,1648.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",777,37.7,,621.60,,,0,"percent of total billed charges","37.7% of total billed charges",777,37.7,,621.60,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",698.68,33.9,,558.94,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1607.58,78,,1286.06,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1702.39,82.6,,1361.91,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1702.39,82.6,,1361.91,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,2061,100,,1648.80,,,0,"percent of total billed charges","100% of total billed charges",38.21,2061,
"XR Spine Cervical 6+ Views",32072052,CDM,320,RC,72052,CPT,OUTPATIENT,,,1882,1223.3,TC,1656.16,88,,1324.93,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1882,100,,1505.60,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1185.66,63,,948.53,,,0,"percent of total billed charges","63% of total billed charges",287.95,15.3,,230.36,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1298.58,69,,,,,0,"fee schedule","69% of total billed charges",1882,100,,1505.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1882,100,,1505.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1882,100,,1505.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",709.51,37.7,,567.61,,,0,"percent of total billed charges","37.7% of total billed charges",709.51,37.7,,567.61,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638,33.9,,510.40,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1467.96,78,,1174.37,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1554.53,82.6,,1243.62,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1554.53,82.6,,1243.62,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1882,100,,1505.60,,,0,"percent of total billed charges","100% of total billed charges",38.21,1882,
"XR Spine Lumbosacral 2 or 3 Views",32072100,CDM,320,RC,72100,CPT,OUTPATIENT,,,1911,1242.15,TC,1681.68,88,,1345.34,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1911,100,,1528.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1203.93,63,,963.14,,,0,"percent of total billed charges","63% of total billed charges",292.38,15.3,,233.90,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1318.59,69,,,,,0,"fee schedule","69% of total billed charges",1911,100,,1528.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1911,100,,1528.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1911,100,,1528.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",720.45,37.7,,576.36,,,0,"percent of total billed charges","37.7% of total billed charges",720.45,37.7,,576.36,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.83,33.9,,518.26,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1490.58,78,,1192.46,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1578.49,82.6,,1262.79,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1578.49,82.6,,1262.79,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1911,100,,1528.80,,,0,"percent of total billed charges","100% of total billed charges",38.21,1911,
"XR Spine Lumbosacral Bending 2-3 Views",32072120,CDM,320,RC,72120,CPT,OUTPATIENT,,,1483,963.95,TC,1305.04,88,,1044.03,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1483,100,,1186.40,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",934.29,63,,747.43,,,0,"percent of total billed charges","63% of total billed charges",226.9,15.3,,181.52,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1023.27,69,,,,,0,"fee schedule","69% of total billed charges",1483,100,,1186.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1483,100,,1186.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1483,100,,1186.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",559.09,37.7,,447.27,,,0,"percent of total billed charges","37.7% of total billed charges",559.09,37.7,,447.27,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",502.74,33.9,,402.19,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1156.74,78,,925.39,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1224.96,82.6,,979.97,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1224.96,82.6,,979.97,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1483,100,,1186.40,,,0,"percent of total billed charges","100% of total billed charges",38.21,1483,
"XR Spine Lumbosacral w/ Bending 6+ Views",32072114,CDM,320,RC,72114,CPT,OUTPATIENT,,,2434,1582.1,TC,2141.92,88,,1713.54,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,2434,100,,1947.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1533.42,63,,1226.74,,,0,"percent of total billed charges","63% of total billed charges",372.4,15.3,,297.92,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1679.46,69,,,,,0,"fee schedule","69% of total billed charges",2434,100,,1947.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2434,100,,1947.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2434,100,,1947.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",917.62,37.7,,734.10,,,0,"percent of total billed charges","37.7% of total billed charges",917.62,37.7,,734.10,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",825.13,33.9,,660.10,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1898.52,78,,1518.82,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2010.48,82.6,,1608.38,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2010.48,82.6,,1608.38,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,2434,100,,1947.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,2434,
"XR Spine Lumbosacral 4+ Views",32072110,CDM,320,RC,72110,CPT,OUTPATIENT,,,2506,1628.9,TC,2205.28,88,,1764.22,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,2506,100,,2004.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1578.78,63,,1263.02,,,0,"percent of total billed charges","63% of total billed charges",383.42,15.3,,306.74,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1729.14,69,,,,,0,"fee schedule","69% of total billed charges",2506,100,,2004.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2506,100,,2004.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2506,100,,2004.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",944.76,37.7,,755.81,,,0,"percent of total billed charges","37.7% of total billed charges",944.76,37.7,,755.81,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",849.53,33.9,,679.62,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1954.68,78,,1563.74,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2069.96,82.6,,1655.97,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2069.96,82.6,,1655.97,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,2506,100,,2004.80,,,0,"percent of total billed charges","100% of total billed charges",38.21,2506,
"XR Spine Thoracic 2 Views",32072070,CDM,320,RC,72070,CPT,OUTPATIENT,,,1284,834.6,TC,1129.92,88,,903.94,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1284,100,,1027.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",808.92,63,,647.14,,,0,"percent of total billed charges","63% of total billed charges",196.45,15.3,,157.16,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,885.96,69,,,,,0,"fee schedule","69% of total billed charges",1284,100,,1027.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1284,100,,1027.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1284,100,,1027.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",484.07,37.7,,387.26,,,0,"percent of total billed charges","37.7% of total billed charges",484.07,37.7,,387.26,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",435.28,33.9,,348.22,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1001.52,78,,801.22,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1060.58,82.6,,848.46,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1060.58,82.6,,848.46,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1284,100,,1027.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1284,
"XR Spine Thoracic 3 Views",32072072,CDM,320,RC,72072,CPT,OUTPATIENT,,,1552,1008.8,TC,1365.76,88,,1092.61,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1552,100,,1241.60,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",977.76,63,,782.21,,,0,"percent of total billed charges","63% of total billed charges",237.46,15.3,,189.97,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1070.88,69,,,,,0,"fee schedule","69% of total billed charges",1552,100,,1241.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1552,100,,1241.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1552,100,,1241.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",585.1,37.7,,468.08,,,0,"percent of total billed charges","37.7% of total billed charges",585.1,37.7,,468.08,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",526.13,33.9,,420.90,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1210.56,78,,968.45,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1281.95,82.6,,1025.56,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1281.95,82.6,,1025.56,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1552,100,,1241.60,,,0,"percent of total billed charges","100% of total billed charges",38.21,1552,
"XR Spine Thoracic 4+ Views",32072074,CDM,320,RC,72074,CPT,OUTPATIENT,,,1724,1120.6,TC,1517.12,88,,1213.70,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1724,100,,1379.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1086.12,63,,868.90,,,0,"percent of total billed charges","63% of total billed charges",263.77,15.3,,211.02,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1189.56,69,,,,,0,"fee schedule","69% of total billed charges",1724,100,,1379.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1724,100,,1379.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1724,100,,1379.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",649.95,37.7,,519.96,,,0,"percent of total billed charges","37.7% of total billed charges",649.95,37.7,,519.96,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",584.44,33.9,,467.55,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1344.72,78,,1075.78,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1424.02,82.6,,1139.22,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1424.02,82.6,,1139.22,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1724,100,,1379.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1724,
"XR Spine Thoracolumbar 2+ Views",32072080,CDM,320,RC,72080,CPT,OUTPATIENT,,,1152,748.8,TC,1013.76,88,,811.01,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1152,100,,921.60,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",725.76,63,,580.61,,,0,"percent of total billed charges","63% of total billed charges",176.26,15.3,,141.01,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,794.88,69,,,,,0,"fee schedule","69% of total billed charges",1152,100,,921.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1152,100,,921.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1152,100,,921.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",434.3,37.7,,347.44,,,0,"percent of total billed charges","37.7% of total billed charges",434.3,37.7,,347.44,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.53,33.9,,312.42,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",898.56,78,,718.85,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",951.55,82.6,,761.24,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",951.55,82.6,,761.24,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1152,100,,921.60,,,0,"percent of total billed charges","100% of total billed charges",38.21,1152,
"XR Sternoclavicular Joint(s)",32071130,CDM,320,RC,71130,CPT,OUTPATIENT,,,1662,1080.3,TC,1462.56,88,,1170.05,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1662,100,,1329.60,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1047.06,63,,837.65,,,0,"percent of total billed charges","63% of total billed charges",254.29,15.3,,203.43,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1146.78,69,,,,,0,"fee schedule","69% of total billed charges",1662,100,,1329.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1662,100,,1329.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1662,100,,1329.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",626.57,37.7,,501.26,,,0,"percent of total billed charges","37.7% of total billed charges",626.57,37.7,,501.26,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",563.42,33.9,,450.74,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1296.36,78,,1037.09,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1372.81,82.6,,1098.25,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1372.81,82.6,,1098.25,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1662,100,,1329.60,,,0,"percent of total billed charges","100% of total billed charges",38.21,1662,
"XR Sternum 2+ Views",32071120,CDM,320,RC,71120,CPT,OUTPATIENT,,,1152,748.8,TC,1013.76,88,,811.01,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1152,100,,921.60,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",725.76,63,,580.61,,,0,"percent of total billed charges","63% of total billed charges",176.26,15.3,,141.01,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,794.88,69,,,,,0,"fee schedule","69% of total billed charges",1152,100,,921.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1152,100,,921.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1152,100,,921.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",434.3,37.7,,347.44,,,0,"percent of total billed charges","37.7% of total billed charges",434.3,37.7,,347.44,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.53,33.9,,312.42,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",898.56,78,,718.85,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",951.55,82.6,,761.24,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",951.55,82.6,,761.24,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1152,100,,921.60,,,0,"percent of total billed charges","100% of total billed charges",38.21,1152,
"Swallowing function, with cineradiography/videoradiography",32074230,CDM,320,RC,74230,CPT,OUTPATIENT,,,1317,856.05,TC,1158.96,88,,927.17,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1317,100,,1053.60,,,0,"percent of total billed charges","100% of total billed charges",327.95,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",829.71,63,,663.77,,,0,"percent of total billed charges","63% of total billed charges",201.5,15.3,,161.20,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,908.73,69,,,,,0,"fee schedule","69% of total billed charges",1317,100,,1053.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1317,100,,1053.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1317,100,,1053.60,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",496.51,37.7,,397.21,,,0,"percent of total billed charges","37.7% of total billed charges",496.51,37.7,,397.21,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",446.46,33.9,,357.17,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1027.26,78,,821.81,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1087.84,82.6,,870.27,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1087.84,82.6,,870.27,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1317,100,,1053.60,,,0,"percent of total billed charges","100% of total billed charges",80.56,1317,
"XR Sinus Tract/Fistulagram",32076080,CDM,320,RC,76080,CPT,OUTPATIENT,,,1960,1274,TC,1724.8,88,,1379.84,,,0,"percent of total billed charges","88% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1960,100,,1568.00,,,0,"percent of total billed charges","100% of total billed charges",984.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1234.8,63,,987.84,,,0,"percent of total billed charges","63% of total billed charges",299.88,15.3,,239.90,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,1352.4,69,,,,,0,"fee schedule","69% of total billed charges",1960,100,,1568.00,,,0,"percent of total billed charges","100% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1960,100,,1568.00,,,0,"percent of total billed charges","100% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1960,100,,1568.00,,,0,"percent of total billed charges","100% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",1961.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",738.92,37.7,,591.14,,,0,"percent of total billed charges","37.7% of total billed charges",738.92,37.7,,591.14,,,0,"percent of total billed charges","37.70% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",664.44,33.9,,531.55,,,0,"percent of total billed charges","33.9% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1528.8,78,,1223.04,,,0,"percent of total billed charges","78% of total billed charges",568.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1618.96,82.6,,1295.17,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1618.96,82.6,,1295.17,,,0,"percent of total billed charges","82.6% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1960,100,,1568.00,,,0,"percent of total billed charges","100% of total billed charges",80.56,1961.75,
"XR Spine Scoliosis 4-5 Views",32072083,CDM,320,RC,72083,CPT,OUTPATIENT,,,2536,1648.4,TC,2231.68,88,,1785.34,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,2536,100,,2028.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1597.68,63,,1278.14,,,0,"percent of total billed charges","63% of total billed charges",388.01,15.3,,310.41,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1749.84,69,,,,,0,"fee schedule","69% of total billed charges",2536,100,,2028.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2536,100,,2028.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2536,100,,2028.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",956.07,37.7,,764.86,,,0,"percent of total billed charges","37.7% of total billed charges",956.07,37.7,,764.86,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.7,33.9,,687.76,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.08,78,,1582.46,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2094.74,82.6,,1675.79,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2094.74,82.6,,1675.79,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,2536,100,,2028.80,,,0,"percent of total billed charges","100% of total billed charges",38.21,2536,
"XR Spine Scoliosis 1 View",32072081,CDM,320,RC,72081,CPT,OUTPATIENT,,,1268,824.2,TC,1115.84,88,,892.67,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1268,100,,1014.40,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",798.84,63,,639.07,,,0,"percent of total billed charges","63% of total billed charges",194,15.3,,155.20,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,874.92,69,,,,,0,"fee schedule","69% of total billed charges",1268,100,,1014.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1268,100,,1014.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1268,100,,1014.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",478.04,37.7,,382.43,,,0,"percent of total billed charges","37.7% of total billed charges",478.04,37.7,,382.43,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",429.85,33.9,,343.88,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",989.04,78,,791.23,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1047.37,82.6,,837.90,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1047.37,82.6,,837.90,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1268,100,,1014.40,,,0,"percent of total billed charges","100% of total billed charges",38.21,1268,
"XR Spine Scoliosis 2-3 Views",32072082,CDM,320,RC,72082,CPT,OUTPATIENT,,,1268,824.2,TC,1115.84,88,,892.67,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1268,100,,1014.40,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",798.84,63,,639.07,,,0,"percent of total billed charges","63% of total billed charges",194,15.3,,155.20,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,874.92,69,,,,,0,"fee schedule","69% of total billed charges",1268,100,,1014.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1268,100,,1014.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1268,100,,1014.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",478.04,37.7,,382.43,,,0,"percent of total billed charges","37.7% of total billed charges",478.04,37.7,,382.43,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",429.85,33.9,,343.88,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",989.04,78,,791.23,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1047.37,82.6,,837.90,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1047.37,82.6,,837.90,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1268,100,,1014.40,,,0,"percent of total billed charges","100% of total billed charges",38.21,1268,
"XR Spine Scoliosis 6+ Views",32072084,CDM,320,RC,72084,CPT,OUTPATIENT,,,2536,1648.4,TC,2231.68,88,,1785.34,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,2536,100,,2028.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1597.68,63,,1278.14,,,0,"percent of total billed charges","63% of total billed charges",388.01,15.3,,310.41,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1749.84,69,,,,,0,"fee schedule","69% of total billed charges",2536,100,,2028.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2536,100,,2028.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2536,100,,2028.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",956.07,37.7,,764.86,,,0,"percent of total billed charges","37.7% of total billed charges",956.07,37.7,,764.86,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.7,33.9,,687.76,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.08,78,,1582.46,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2094.74,82.6,,1675.79,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2094.74,82.6,,1675.79,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,2536,100,,2028.80,,,0,"percent of total billed charges","100% of total billed charges",38.21,2536,
"XR Surgical Specimen",32076098,CDM,320,RC,76098,CPT,OUTPATIENT,,,2255,1465.75,TC|LT,1984.4,88,,1587.52,,,0,"percent of total billed charges","88% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,2255,100,,1804.00,,,0,"percent of total billed charges","100% of total billed charges",984.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1420.65,63,,1136.52,,,0,"percent of total billed charges","63% of total billed charges",345.02,15.3,,276.02,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,1555.95,69,,,,,0,"fee schedule","69% of total billed charges",2255,100,,1804.00,,,0,"percent of total billed charges","100% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2255,100,,1804.00,,,0,"percent of total billed charges","100% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2255,100,,1804.00,,,0,"percent of total billed charges","100% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",1961.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",850.14,37.7,,680.11,,,0,"percent of total billed charges","37.7% of total billed charges",850.14,37.7,,680.11,,,0,"percent of total billed charges","37.70% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",764.45,33.9,,611.56,,,0,"percent of total billed charges","33.9% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1758.9,78,,1407.12,,,0,"percent of total billed charges","78% of total billed charges",568.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1862.63,82.6,,1490.10,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1862.63,82.6,,1490.10,,,0,"percent of total billed charges","82.6% of total billed charges",562.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,2255,100,,1804.00,,,0,"percent of total billed charges","100% of total billed charges",80.56,2255,
"XR Spine 1 View Specify Level",32072020,CDM,320,RC,72020,CPT,OUTPATIENT,,,723,469.95,TC,636.24,88,,508.99,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,723,100,,578.40,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",455.49,63,,364.39,,,0,"percent of total billed charges","63% of total billed charges",110.62,15.3,,88.50,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,498.87,69,,,,,0,"fee schedule","69% of total billed charges",723,100,,578.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",723,100,,578.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",723,100,,578.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.57,37.7,,218.06,,,0,"percent of total billed charges","37.7% of total billed charges",272.57,37.7,,218.06,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",245.1,33.9,,196.08,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",563.94,78,,451.15,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",597.2,82.6,,477.76,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",597.2,82.6,,477.76,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,723,100,,578.40,,,0,"percent of total billed charges","100% of total billed charges",38.21,723,
"XR Spinal Puncture Diagnostic",32062270,CDM,320,RC,62270,CPT,OUTPATIENT,,,1600,1040,TC,1408,88,,1126.40,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1600,100,,1280.00,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1008,63,,806.40,,,0,"percent of total billed charges","63% of total billed charges",244.8,15.3,,195.84,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,1104,69,,,,,0,"fee schedule","69% of total billed charges",1600,100,,1280.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1600,100,,1280.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1600,100,,1280.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",570.86,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",603.2,37.7,,482.56,,,0,"percent of total billed charges","37.7% of total billed charges",603.2,37.7,,482.56,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",542.4,33.9,,433.92,,,0,"percent of total billed charges","33.9% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1248,78,,998.40,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1321.6,82.6,,1057.28,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1321.6,82.6,,1057.28,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1600,100,,1280.00,,,0,"percent of total billed charges","100% of total billed charges",244.8,2578.03,
"XR Spinal Puncture Therapeutic",32062272,CDM,320,RC,62272,CPT,OUTPATIENT,,,1600,1040,TC,1408,88,,1126.40,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1600,100,,1280.00,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1008,63,,806.40,,,0,"percent of total billed charges","63% of total billed charges",244.8,15.3,,195.84,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,1104,69,,,,,0,"fee schedule","69% of total billed charges",1600,100,,1280.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1600,100,,1280.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1600,100,,1280.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",570.86,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",603.2,37.7,,482.56,,,0,"percent of total billed charges","37.7% of total billed charges",603.2,37.7,,482.56,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",542.4,33.9,,433.92,,,0,"percent of total billed charges","33.9% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1248,78,,998.40,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1321.6,82.6,,1057.28,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1321.6,82.6,,1057.28,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1600,100,,1280.00,,,0,"percent of total billed charges","100% of total billed charges",244.8,2578.03,
"XR Shoulder Complete 2+ Views Bilat",32073050,CDM,320,RC,73050,CPT,OUTPATIENT,,,1215,789.75,TC,1069.2,88,,855.36,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1215,100,,972.00,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",765.45,63,,612.36,,,0,"percent of total billed charges","63% of total billed charges",185.9,15.3,,148.72,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,838.35,69,,,,,0,"fee schedule","69% of total billed charges",1215,100,,972.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1215,100,,972.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1215,100,,972.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",458.06,37.7,,366.45,,,0,"percent of total billed charges","37.7% of total billed charges",458.06,37.7,,366.45,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",411.89,33.9,,329.51,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",947.7,78,,758.16,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1003.59,82.6,,802.87,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1003.59,82.6,,802.87,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1215,100,,972.00,,,0,"percent of total billed charges","100% of total billed charges",38.21,1215,
"XR Spine 1 View",32072020,CDM,320,RC,72020,CPT,OUTPATIENT,,,723,469.95,TC,636.24,88,,508.99,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,723,100,,578.40,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",455.49,63,,364.39,,,0,"percent of total billed charges","63% of total billed charges",110.62,15.3,,88.50,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,498.87,69,,,,,0,"fee schedule","69% of total billed charges",723,100,,578.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",723,100,,578.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",723,100,,578.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.57,37.7,,218.06,,,0,"percent of total billed charges","37.7% of total billed charges",272.57,37.7,,218.06,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",245.1,33.9,,196.08,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",563.94,78,,451.15,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",597.2,82.6,,477.76,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",597.2,82.6,,477.76,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,723,100,,578.40,,,0,"percent of total billed charges","100% of total billed charges",38.21,723,
"XR SI Joint Inj",32027096,CDM,320,RC,27096,CPT,OUTPATIENT,,,1056,686.4,LT,929.28,88,,743.42,,,0,"percent of total billed charges","88% of total billed charges",528,50,,422.40,,,0,"percent of total billed charges","50% of total billed charges",443.75,100,,,,,0,"fee schedule",EAPG,1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",457.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",665.28,63,,532.22,,,0,"percent of total billed charges","63% of total billed charges",161.57,15.3,,129.26,,,0,"percent of total billed charges","15.3% of total billed charges",443.75,100,,,,,0,"fee schedule",EAPG,728.64,69,,,,,0,"fee schedule","69% of total billed charges",1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",653.14,61.85,,522.51,,,0,"percent of total billed charges","61.5% of total billed charges",443.75,100,,,,,0,"fee schedule",EAPG,528,50,,422.40,,,0,"percent of total billed charges","50% of total billed charges",340.03,32.2,,272.02,,,0,"percent of total billed charges","32.2% of total billed charges",328.7,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",452.63,100,,,,,0,"fee schedule",EAPG,576.88,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",398.11,37.7,,318.49,,,0,"percent of total billed charges","37.7% of total billed charges",398.11,37.7,,318.49,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",357.98,33.9,,286.38,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",823.68,78,,658.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",872.26,82.6,,697.81,,,0,"percent of total billed charges","82.6% of total billed charges",443.75,100,,,,,0,"fee schedule","100% of WA fee schedule",528,50,,422.40,,,0,"percent of total billed charges","50% of total billed charges",872.26,82.6,,697.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",443.75,100,,,,,0,"fee schedule",EAPG,1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",161.57,1056,
"XR Spine Puncture Therapeutic CSF Drain",32062329,CDM,320,RC,62329,CPT,OUTPATIENT,,,1632,1060.8,TC,1436.16,88,,1148.93,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1632,100,,1305.60,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1028.16,63,,822.53,,,0,"percent of total billed charges","63% of total billed charges",249.7,15.3,,199.76,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,1126.08,69,,,,,0,"fee schedule","69% of total billed charges",1632,100,,1305.60,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1632,100,,1305.60,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1632,100,,1305.60,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",570.86,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",615.26,37.7,,492.21,,,0,"percent of total billed charges","37.7% of total billed charges",615.26,37.7,,492.21,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",553.25,33.9,,442.60,,,0,"percent of total billed charges","33.9% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1272.96,78,,1018.37,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1348.03,82.6,,1078.42,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1348.03,82.6,,1078.42,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1632,100,,1305.60,,,0,"percent of total billed charges","100% of total billed charges",249.7,2578.03,
"XR TMJ Open and Closed Bilateral",32070330,CDM,320,RC,70330,CPT,OUTPATIENT,,,1917,1246.05,TC,1686.96,88,,1349.57,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1917,100,,1533.60,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1207.71,63,,966.17,,,0,"percent of total billed charges","63% of total billed charges",293.3,15.3,,234.64,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,1322.73,69,,,,,0,"fee schedule","69% of total billed charges",1917,100,,1533.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1917,100,,1533.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1917,100,,1533.60,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",722.71,37.7,,578.17,,,0,"percent of total billed charges","37.7% of total billed charges",722.71,37.7,,578.17,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",649.86,33.9,,519.89,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1495.26,78,,1196.21,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1583.44,82.6,,1266.75,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1583.44,82.6,,1266.75,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1917,100,,1533.60,,,0,"percent of total billed charges","100% of total billed charges",38.21,1917,
"XR Tibia/Fibula Bilateral",32073590,CDM,320,RC,73590,CPT,OUTPATIENT,,,1099,714.35,TC,967.12,88,,773.70,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1099,100,,879.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",692.37,63,,553.90,,,0,"percent of total billed charges","63% of total billed charges",168.15,15.3,,134.52,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,758.31,69,,,,,0,"fee schedule","69% of total billed charges",1099,100,,879.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1099,100,,879.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1099,100,,879.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",414.32,37.7,,331.46,,,0,"percent of total billed charges","37.7% of total billed charges",414.32,37.7,,331.46,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",372.56,33.9,,298.05,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",857.22,78,,685.78,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.77,82.6,,726.22,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.77,82.6,,726.22,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1099,100,,879.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1099,
"XR Tibia/Fibula Left",32073590,CDM,320,RC,73590,CPT,OUTPATIENT,,,1099,714.35,TC,967.12,88,,773.70,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1099,100,,879.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",692.37,63,,553.90,,,0,"percent of total billed charges","63% of total billed charges",168.15,15.3,,134.52,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,758.31,69,,,,,0,"fee schedule","69% of total billed charges",1099,100,,879.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1099,100,,879.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1099,100,,879.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",414.32,37.7,,331.46,,,0,"percent of total billed charges","37.7% of total billed charges",414.32,37.7,,331.46,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",372.56,33.9,,298.05,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",857.22,78,,685.78,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.77,82.6,,726.22,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.77,82.6,,726.22,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1099,100,,879.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1099,
"XR Tibia/Fibula Right",32073590,CDM,320,RC,73590,CPT,OUTPATIENT,,,1099,714.35,TC,967.12,88,,773.70,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1099,100,,879.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",692.37,63,,553.90,,,0,"percent of total billed charges","63% of total billed charges",168.15,15.3,,134.52,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,758.31,69,,,,,0,"fee schedule","69% of total billed charges",1099,100,,879.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1099,100,,879.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1099,100,,879.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",414.32,37.7,,331.46,,,0,"percent of total billed charges","37.7% of total billed charges",414.32,37.7,,331.46,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",372.56,33.9,,298.05,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",857.22,78,,685.78,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.77,82.6,,726.22,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.77,82.6,,726.22,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1099,100,,879.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,1099,
"XR Toe(s) 2+ Views Left",32073660,CDM,320,RC,73660,CPT,OUTPATIENT,,,783,508.95,TC|LT,689.04,88,,551.23,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,783,100,,626.40,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",493.29,63,,394.63,,,0,"percent of total billed charges","63% of total billed charges",119.8,15.3,,95.84,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,540.27,69,,,,,0,"fee schedule","69% of total billed charges",783,100,,626.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",783,100,,626.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",783,100,,626.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",295.19,37.7,,236.15,,,0,"percent of total billed charges","37.7% of total billed charges",295.19,37.7,,236.15,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.44,33.9,,212.35,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",610.74,78,,488.59,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",646.76,82.6,,517.41,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",646.76,82.6,,517.41,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,783,100,,626.40,,,0,"percent of total billed charges","100% of total billed charges",38.21,783,
"XR Toe(s) 2+ Views Right",32073660,CDM,320,RC,73660,CPT,OUTPATIENT,,,783,508.95,TC|LT,689.04,88,,551.23,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,783,100,,626.40,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",493.29,63,,394.63,,,0,"percent of total billed charges","63% of total billed charges",119.8,15.3,,95.84,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,540.27,69,,,,,0,"fee schedule","69% of total billed charges",783,100,,626.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",783,100,,626.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",783,100,,626.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",295.19,37.7,,236.15,,,0,"percent of total billed charges","37.7% of total billed charges",295.19,37.7,,236.15,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.44,33.9,,212.35,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",610.74,78,,488.59,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",646.76,82.6,,517.41,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",646.76,82.6,,517.41,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,783,100,,626.40,,,0,"percent of total billed charges","100% of total billed charges",38.21,783,
"XR Toes 2+ Views 3rd Digit Left",32073660,CDM,320,RC,73660,CPT,OUTPATIENT,,,970,630.5,TC|LT,853.6,88,,682.88,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,970,100,,776.00,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",611.1,63,,488.88,,,0,"percent of total billed charges","63% of total billed charges",148.41,15.3,,118.73,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,669.3,69,,,,,0,"fee schedule","69% of total billed charges",970,100,,776.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",970,100,,776.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",970,100,,776.00,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",365.69,37.7,,292.55,,,0,"percent of total billed charges","37.7% of total billed charges",365.69,37.7,,292.55,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",328.83,33.9,,263.06,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",756.6,78,,605.28,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",801.22,82.6,,640.98,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",801.22,82.6,,640.98,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,970,100,,776.00,,,0,"percent of total billed charges","100% of total billed charges",38.21,970,
"XR Transforaminal Inj C/T Spine 1L",76162321,CDM,761,RC,64479,CPT,OUTPATIENT,,,1383,898.95,,1217.04,88,,973.63,,,0,"percent of total billed charges","88% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1383,100,,1106.40,,,0,"percent of total billed charges","100% of total billed charges",1626.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",871.29,63,,697.03,,,0,"percent of total billed charges","63% of total billed charges",211.6,15.3,,169.28,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,954.27,69,,,,,0,"fee schedule","69% of total billed charges",1383,100,,1106.40,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1383,100,,1106.40,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1383,100,,1106.40,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3341.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",570.86,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",521.39,37.7,,417.11,,,0,"percent of total billed charges","37.7% of total billed charges",521.39,37.7,,417.11,,,0,"percent of total billed charges","37.70% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",468.84,33.9,,375.07,,,0,"percent of total billed charges","33.9% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1078.74,78,,862.99,,,0,"percent of total billed charges","78% of total billed charges",938.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1142.36,82.6,,913.89,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1142.36,82.6,,913.89,,,0,"percent of total billed charges","82.6% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1383,100,,1106.40,,,0,"percent of total billed charges","100% of total billed charges",211.6,3341.26,
"XR Transforaminal Inj L/S Spine 1L",36062323,CDM,360,RC,64483,CPT,OUTPATIENT,,,1383,898.95,,1217.04,88,,973.63,,,0,"percent of total billed charges","88% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1383,100,,1106.40,,,0,"percent of total billed charges","100% of total billed charges",1626.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",871.29,63,,697.03,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,954.27,69,,,,,0,"fee schedule","69% of total billed charges",1383,100,,1106.40,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1383,100,,1106.40,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1383,100,,1106.40,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3341.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",570.86,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",521.39,37.7,,417.11,,,0,"percent of total billed charges","37.7% of total billed charges",521.39,37.7,,417.11,,,0,"percent of total billed charges","37.70% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",468.84,33.9,,375.07,,,0,"percent of total billed charges","33.9% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1078.74,78,,862.99,,,0,"percent of total billed charges","78% of total billed charges",938.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1142.36,82.6,,913.89,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1142.36,82.6,,913.89,,,0,"percent of total billed charges","82.6% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1383,100,,1106.40,,,0,"percent of total billed charges","100% of total billed charges",468.84,3367,
"XR Upper Extremity Infant (0-1yr) Bilat",32073092,CDM,320,RC,73092,CPT,OUTPATIENT,,,409,265.85,TC,359.92,88,,287.94,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",257.67,63,,206.14,,,0,"percent of total billed charges","63% of total billed charges",62.58,15.3,,50.06,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,282.21,69,,,,,0,"fee schedule","69% of total billed charges",409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.19,37.7,,123.35,,,0,"percent of total billed charges","37.7% of total billed charges",154.19,37.7,,123.35,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",138.65,33.9,,110.92,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",319.02,78,,255.22,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",337.83,82.6,,270.26,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",337.83,82.6,,270.26,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,442.69,
"XR Upper Extremity Infant (0-1yr) Left",32073092,CDM,320,RC,73092,CPT,OUTPATIENT,,,409,265.85,TC,359.92,88,,287.94,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",257.67,63,,206.14,,,0,"percent of total billed charges","63% of total billed charges",62.58,15.3,,50.06,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,282.21,69,,,,,0,"fee schedule","69% of total billed charges",409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.19,37.7,,123.35,,,0,"percent of total billed charges","37.7% of total billed charges",154.19,37.7,,123.35,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",138.65,33.9,,110.92,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",319.02,78,,255.22,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",337.83,82.6,,270.26,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",337.83,82.6,,270.26,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,442.69,
"XR Upper Extremity Infant (0-1yr) Right",32073092,CDM,320,RC,73092,CPT,OUTPATIENT,,,409,265.85,TC,359.92,88,,287.94,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",257.67,63,,206.14,,,0,"percent of total billed charges","63% of total billed charges",62.58,15.3,,50.06,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,282.21,69,,,,,0,"fee schedule","69% of total billed charges",409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.19,37.7,,123.35,,,0,"percent of total billed charges","37.7% of total billed charges",154.19,37.7,,123.35,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",138.65,33.9,,110.92,,,0,"percent of total billed charges","33.9% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",319.02,78,,255.22,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",337.83,82.6,,270.26,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",337.83,82.6,,270.26,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,442.69,
"XR Upper GI",32074240,CDM,320,RC,74240,CPT,OUTPATIENT,,,3331,2165.15,TC,2931.28,88,,2345.02,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,3331,100,,2664.80,,,0,"percent of total billed charges","100% of total billed charges",327.95,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2098.53,63,,1678.82,,,0,"percent of total billed charges","63% of total billed charges",509.64,15.3,,407.71,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,2298.39,69,,,,,0,"fee schedule","69% of total billed charges",3331,100,,2664.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3331,100,,2664.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3331,100,,2664.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1255.79,37.7,,1004.63,,,0,"percent of total billed charges","37.7% of total billed charges",1255.79,37.7,,1004.63,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1129.21,33.9,,903.37,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2598.18,78,,2078.54,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2751.41,82.6,,2201.13,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2751.41,82.6,,2201.13,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,3331,100,,2664.80,,,0,"percent of total billed charges","100% of total billed charges",80.56,3331,
"XR Upper GI + KUB",32074240,CDM,320,RC,74240,CPT,OUTPATIENT,,,1120,728,TC,985.6,88,,788.48,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1120,100,,896.00,,,0,"percent of total billed charges","100% of total billed charges",327.95,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",705.6,63,,564.48,,,0,"percent of total billed charges","63% of total billed charges",171.36,15.3,,137.09,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,772.8,69,,,,,0,"fee schedule","69% of total billed charges",1120,100,,896.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1120,100,,896.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1120,100,,896.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",422.24,37.7,,337.79,,,0,"percent of total billed charges","37.7% of total billed charges",422.24,37.7,,337.79,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",379.68,33.9,,303.74,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.6,78,,698.88,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",925.12,82.6,,740.10,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",925.12,82.6,,740.10,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1120,100,,896.00,,,0,"percent of total billed charges","100% of total billed charges",80.56,1120,
"XR Upper GI w/ Air Contrast",32074246,CDM,320,RC,74246,CPT,OUTPATIENT,,,3390,2203.5,TC,2983.2,88,,2386.56,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,3390,100,,2712.00,,,0,"percent of total billed charges","100% of total billed charges",327.95,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2135.7,63,,1708.56,,,0,"percent of total billed charges","63% of total billed charges",518.67,15.3,,414.94,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,2339.1,69,,,,,0,"fee schedule","69% of total billed charges",3390,100,,2712.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3390,100,,2712.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3390,100,,2712.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1278.03,37.7,,1022.42,,,0,"percent of total billed charges","37.7% of total billed charges",1278.03,37.7,,1022.42,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1149.21,33.9,,919.37,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2644.2,78,,2115.36,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2800.14,82.6,,2240.11,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2800.14,82.6,,2240.11,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,3390,100,,2712.00,,,0,"percent of total billed charges","100% of total billed charges",80.56,3390,
"XR Upper GI w/ Air Contrast + KUB",32074246,CDM,320,RC,74246,CPT,OUTPATIENT,,,3050,1982.5,TC,2684,88,,2147.20,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,3050,100,,2440.00,,,0,"percent of total billed charges","100% of total billed charges",327.95,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1921.5,63,,1537.20,,,0,"percent of total billed charges","63% of total billed charges",466.65,15.3,,373.32,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,2104.5,69,,,,,0,"fee schedule","69% of total billed charges",3050,100,,2440.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3050,100,,2440.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3050,100,,2440.00,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1149.85,37.7,,919.88,,,0,"percent of total billed charges","37.7% of total billed charges",1149.85,37.7,,919.88,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033.95,33.9,,827.16,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2379,78,,1903.20,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2519.3,82.6,,2015.44,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2519.3,82.6,,2015.44,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,3050,100,,2440.00,,,0,"percent of total billed charges","100% of total billed charges",80.56,3050,
"XR Upper GI w/ Air w/ Small Bowel",32074246,CDM,320,RC,74246,CPT,OUTPATIENT,,,3456,2246.4,TC,3041.28,88,,2433.02,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,3456,100,,2764.80,,,0,"percent of total billed charges","100% of total billed charges",327.95,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2177.28,63,,1741.82,,,0,"percent of total billed charges","63% of total billed charges",528.77,15.3,,423.02,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,2384.64,69,,,,,0,"fee schedule","69% of total billed charges",3456,100,,2764.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3456,100,,2764.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3456,100,,2764.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1302.91,37.7,,1042.33,,,0,"percent of total billed charges","37.7% of total billed charges",1302.91,37.7,,1042.33,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171.58,33.9,,937.26,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2695.68,78,,2156.54,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2854.66,82.6,,2283.73,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2854.66,82.6,,2283.73,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,3456,100,,2764.80,,,0,"percent of total billed charges","100% of total billed charges",80.56,3456,
"XR Upper GI w/ Small Bowel",3207420,CDM,320,RC,74240,CPT,OUTPATIENT,,,1846,1199.9,TC,1624.48,88,,1299.58,,,0,"percent of total billed charges","88% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1846,100,,1476.80,,,0,"percent of total billed charges","100% of total billed charges",327.95,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1162.98,63,,930.38,,,0,"percent of total billed charges","63% of total billed charges",282.44,15.3,,225.95,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,1273.74,69,,,,,0,"fee schedule","69% of total billed charges",1846,100,,1476.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1846,100,,1476.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1846,100,,1476.80,,,0,"percent of total billed charges","100% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",725.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",695.94,37.7,,556.75,,,0,"percent of total billed charges","37.7% of total billed charges",695.94,37.7,,556.75,,,0,"percent of total billed charges","37.70% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",625.79,33.9,,500.63,,,0,"percent of total billed charges","33.9% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1439.88,78,,1151.90,,,0,"percent of total billed charges","78% of total billed charges",189.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1524.8,82.6,,1219.84,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1524.8,82.6,,1219.84,,,0,"percent of total billed charges","82.6% of total billed charges",187.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1846,100,,1476.80,,,0,"percent of total billed charges","100% of total billed charges",80.56,1846,
"XR Urography Retrograde Left",32074420,CDM,320,RC,74420,CPT,OUTPATIENT,,,2238,1454.7,TC,1969.44,88,,1575.55,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,2238,100,,1790.40,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1409.94,63,,1127.95,,,0,"percent of total billed charges","63% of total billed charges",342.41,15.3,,273.93,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,1544.22,69,,,,,0,"fee schedule","69% of total billed charges",2238,100,,1790.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2238,100,,1790.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2238,100,,1790.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",843.73,37.7,,674.98,,,0,"percent of total billed charges","37.7% of total billed charges",843.73,37.7,,674.98,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",758.68,33.9,,606.94,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1745.64,78,,1396.51,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1848.59,82.6,,1478.87,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1848.59,82.6,,1478.87,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,2238,100,,1790.40,,,0,"percent of total billed charges","100% of total billed charges",80.56,2238,
"XR Urography Retrograde Right",32074420,CDM,320,RC,74420,CPT,OUTPATIENT,,,2238,1454.7,TC,1969.44,88,,1575.55,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,2238,100,,1790.40,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1409.94,63,,1127.95,,,0,"percent of total billed charges","63% of total billed charges",342.41,15.3,,273.93,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,1544.22,69,,,,,0,"fee schedule","69% of total billed charges",2238,100,,1790.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2238,100,,1790.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2238,100,,1790.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",843.73,37.7,,674.98,,,0,"percent of total billed charges","37.7% of total billed charges",843.73,37.7,,674.98,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",758.68,33.9,,606.94,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1745.64,78,,1396.51,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1848.59,82.6,,1478.87,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1848.59,82.6,,1478.87,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,2238,100,,1790.40,,,0,"percent of total billed charges","100% of total billed charges",80.56,2238,
"XR Urography Retrograde w/ or w/o KUB",32074420,CDM,320,RC,74420,CPT,OUTPATIENT,,,2238,1454.7,TC,1969.44,88,,1575.55,,,0,"percent of total billed charges","88% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,2238,100,,1790.40,,,0,"percent of total billed charges","100% of total billed charges",686.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1409.94,63,,1127.95,,,0,"percent of total billed charges","63% of total billed charges",342.41,15.3,,273.93,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,1544.22,69,,,,,0,"fee schedule","69% of total billed charges",2238,100,,1790.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2238,100,,1790.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2238,100,,1790.40,,,0,"percent of total billed charges","100% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",1495.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",843.73,37.7,,674.98,,,0,"percent of total billed charges","37.7% of total billed charges",843.73,37.7,,674.98,,,0,"percent of total billed charges","37.70% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",758.68,33.9,,606.94,,,0,"percent of total billed charges","33.9% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1745.64,78,,1396.51,,,0,"percent of total billed charges","78% of total billed charges",396.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1848.59,82.6,,1478.87,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1848.59,82.6,,1478.87,,,0,"percent of total billed charges","82.6% of total billed charges",392.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,2238,100,,1790.40,,,0,"percent of total billed charges","100% of total billed charges",80.56,2238,
"XR Voiding Urethrocystography",32074455,CDM,320,RC,74455,CPT,OUTPATIENT,,,1402,911.3,TC,1233.76,88,,987.01,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1402,100,,1121.60,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",883.26,63,,706.61,,,0,"percent of total billed charges","63% of total billed charges",214.51,15.3,,171.61,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,967.38,69,,,,,0,"fee schedule","69% of total billed charges",1402,100,,1121.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1402,100,,1121.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1402,100,,1121.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.56,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",528.55,37.7,,422.84,,,0,"percent of total billed charges","37.7% of total billed charges",528.55,37.7,,422.84,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",475.28,33.9,,380.22,,,0,"percent of total billed charges","33.9% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1093.56,78,,874.85,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1158.05,82.6,,926.44,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1158.05,82.6,,926.44,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,1402,100,,1121.60,,,0,"percent of total billed charges","100% of total billed charges",80.56,1402,
"XR Wrist 2 Views Bilateral",32073100,CDM,320,RC,73100,CPT,OUTPATIENT,,,774,503.1,TC,681.12,88,,544.90,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,774,100,,619.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",487.62,63,,390.10,,,0,"percent of total billed charges","63% of total billed charges",118.42,15.3,,94.74,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,534.06,69,,,,,0,"fee schedule","69% of total billed charges",774,100,,619.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",774,100,,619.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",774,100,,619.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",291.8,37.7,,233.44,,,0,"percent of total billed charges","37.7% of total billed charges",291.8,37.7,,233.44,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",262.39,33.9,,209.91,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",603.72,78,,482.98,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",639.32,82.6,,511.46,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",639.32,82.6,,511.46,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,774,100,,619.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,774,
"XR Wrist 2 Views Left",32073100,CDM,320,RC,73100,CPT,OUTPATIENT,,,774,503.1,TC,681.12,88,,544.90,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,774,100,,619.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",487.62,63,,390.10,,,0,"percent of total billed charges","63% of total billed charges",118.42,15.3,,94.74,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,534.06,69,,,,,0,"fee schedule","69% of total billed charges",774,100,,619.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",774,100,,619.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",774,100,,619.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",291.8,37.7,,233.44,,,0,"percent of total billed charges","37.7% of total billed charges",291.8,37.7,,233.44,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",262.39,33.9,,209.91,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",603.72,78,,482.98,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",639.32,82.6,,511.46,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",639.32,82.6,,511.46,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,774,100,,619.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,774,
"XR Wrist 2 Views Right",32073100,CDM,320,RC,73100,CPT,OUTPATIENT,,,774,503.1,TC,681.12,88,,544.90,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,774,100,,619.20,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",487.62,63,,390.10,,,0,"percent of total billed charges","63% of total billed charges",118.42,15.3,,94.74,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,534.06,69,,,,,0,"fee schedule","69% of total billed charges",774,100,,619.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",774,100,,619.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",774,100,,619.20,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",291.8,37.7,,233.44,,,0,"percent of total billed charges","37.7% of total billed charges",291.8,37.7,,233.44,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",262.39,33.9,,209.91,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",603.72,78,,482.98,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",639.32,82.6,,511.46,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",639.32,82.6,,511.46,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,774,100,,619.20,,,0,"percent of total billed charges","100% of total billed charges",38.21,774,
"XR Wrist Complete 3+ Views Bilateral",32073110,CDM,320,RC,73110,CPT,OUTPATIENT,,,1073,697.45,TC,944.24,88,,755.39,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1073,100,,858.40,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",675.99,63,,540.79,,,0,"percent of total billed charges","63% of total billed charges",164.17,15.3,,131.34,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,740.37,69,,,,,0,"fee schedule","69% of total billed charges",1073,100,,858.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1073,100,,858.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1073,100,,858.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",404.52,37.7,,323.62,,,0,"percent of total billed charges","37.7% of total billed charges",404.52,37.7,,323.62,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",363.75,33.9,,291.00,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",836.94,78,,669.55,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.3,82.6,,709.04,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.3,82.6,,709.04,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1073,100,,858.40,,,0,"percent of total billed charges","100% of total billed charges",38.21,1073,
"XR Wrist Complete 3+ Views Left",32073110,CDM,320,RC,73110,CPT,OUTPATIENT,,,1073,697.45,TC,944.24,88,,755.39,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1073,100,,858.40,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",675.99,63,,540.79,,,0,"percent of total billed charges","63% of total billed charges",164.17,15.3,,131.34,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,740.37,69,,,,,0,"fee schedule","69% of total billed charges",1073,100,,858.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1073,100,,858.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1073,100,,858.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",404.52,37.7,,323.62,,,0,"percent of total billed charges","37.7% of total billed charges",404.52,37.7,,323.62,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",363.75,33.9,,291.00,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",836.94,78,,669.55,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.3,82.6,,709.04,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.3,82.6,,709.04,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1073,100,,858.40,,,0,"percent of total billed charges","100% of total billed charges",38.21,1073,
"XR Wrist Complete 3+ Views Right",32073110,CDM,320,RC,73110,CPT,OUTPATIENT,,,1073,697.45,TC,944.24,88,,755.39,,,0,"percent of total billed charges","88% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1073,100,,858.40,,,0,"percent of total billed charges","100% of total billed charges",162.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",53.13,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",675.99,63,,540.79,,,0,"percent of total billed charges","63% of total billed charges",164.17,15.3,,131.34,,,0,"percent of total billed charges","15.3% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,740.37,69,,,,,0,"fee schedule","69% of total billed charges",1073,100,,858.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1073,100,,858.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1073,100,,858.40,,,0,"percent of total billed charges","100% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",328.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.21,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.61,100,,,,,0,"fee schedule",EAPG,67.05,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",404.52,37.7,,323.62,,,0,"percent of total billed charges","37.7% of total billed charges",404.52,37.7,,323.62,,,0,"percent of total billed charges","37.70% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",363.75,33.9,,291.00,,,0,"percent of total billed charges","33.9% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",836.94,78,,669.55,,,0,"percent of total billed charges","78% of total billed charges",93.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.3,82.6,,709.04,,,0,"percent of total billed charges","82.6% of total billed charges",51.58,100,,,,,0,"fee schedule",EAPG,92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.3,82.6,,709.04,,,0,"percent of total billed charges","82.6% of total billed charges",92.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.58,100,,,,,0,"fee schedule",EAPG,1073,100,,858.40,,,0,"percent of total billed charges","100% of total billed charges",38.21,1073,
"BR-CAD MRI LESION",6100159T,CDM,610,RC,,,OUTPATIENT,,,403,261.95,TC,354.64,88,,283.71,,,0,"percent of total billed charges","88% of total billed charges",201.5,50,,161.20,,,0,"percent of total billed charges","50% of total billed charges",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.74,17.304,,55.79,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.89,63,,203.11,,,0,"percent of total billed charges","63% of total billed charges",620,100,,,,,0,"case rate","pays based on per visit rate",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",278.07,69,,,,,0,"fee schedule","69% of total billed charges",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",249.26,61.85,,199.41,,,0,"percent of total billed charges","61.5% of total billed charges",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",201.5,50,,161.20,,,0,"percent of total billed charges","50% of total billed charges",129.77,32.2,,103.82,,,0,"percent of total billed charges","32.2% of total billed charges",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.06,17.136,,55.25,,,0,"percent of total billed charges","17.136% of total billed charges",88.02,21.84,,70.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.7% of total billed charges",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.62,33.9,,109.30,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",314.34,78,,251.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",201.5,50,,161.20,,,0,"percent of total billed charges","50% of total billed charges",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",67.7,620,
"31575 BRONCHOSCOPY LARYNGOSCOPY CHARGE",76131575,CDM,761,RC,31575,CPT,OUTPATIENT,,,750,487.5,,660,88,,528.00,,,0,"percent of total billed charges","88% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,750,100,,600.00,,,0,"percent of total billed charges","100% of total billed charges",353.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",472.5,63,,378.00,,,0,"percent of total billed charges","63% of total billed charges",114.75,15.3,,91.80,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,517.5,69,,,,,0,"fee schedule","69% of total billed charges",750,100,,600.00,,,0,"percent of total billed charges","100% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",750,100,,600.00,,,0,"percent of total billed charges","100% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",750,100,,600.00,,,0,"percent of total billed charges","100% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",667.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",174.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.15,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",282.75,37.7,,226.20,,,0,"percent of total billed charges","37.7% of total billed charges",282.75,37.7,,226.20,,,0,"percent of total billed charges","37.70% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",254.25,33.9,,203.40,,,0,"percent of total billed charges","33.9% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",585,78,,468.00,,,0,"percent of total billed charges","78% of total billed charges",204.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",619.5,82.6,,495.60,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",619.5,82.6,,495.60,,,0,"percent of total billed charges","82.6% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,750,100,,600.00,,,0,"percent of total billed charges","100% of total billed charges",74.15,750,
"BRONCHOSCOPY DIAGNOSTIC",36100000,CDM,361,RC,,,OUTPATIENT,,,1911,1242.15,,1681.68,88,,1345.34,,,0,"percent of total billed charges","88% of total billed charges",955.5,50,,764.40,,,0,"percent of total billed charges","50% of total billed charges",321.05,16.8,,256.84,,,0,"percent of total billed charges","16.8% of total billed charges",1911,100,,1528.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",330.68,17.304,,264.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1203.93,63,,963.14,,,0,"percent of total billed charges","63% of total billed charges",292.38,15.3,,233.90,,,0,"percent of total billed charges","15.3% of total billed charges",321.05,16.8,,256.84,,,0,"percent of total billed charges","16.8% of total billed charges",1318.59,69,,,,,0,"fee schedule","69% of total billed charges",1911,100,,1528.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1911,100,,1528.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1911,100,,1528.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1181.95,61.85,,945.56,,,0,"percent of total billed charges","61.5% of total billed charges",321.05,16.8,,256.84,,,0,"percent of total billed charges","16.8% of total billed charges",955.5,50,,764.40,,,0,"percent of total billed charges","50% of total billed charges",615.34,32.2,,492.27,,,0,"percent of total billed charges","32.2% of total billed charges",321.05,16.8,,256.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",327.47,17.136,,261.98,,,0,"percent of total billed charges","17.136% of total billed charges",417.36,21.84,,333.89,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",720.45,37.7,,576.36,,,0,"percent of total billed charges","37.7% of total billed charges",720.45,37.7,,576.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",647.83,33.9,,518.26,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.58,78,,1192.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1578.49,82.6,,1262.79,,,0,"percent of total billed charges","82.6% of total billed charges",321.05,16.8,,256.84,,,0,"percent of total billed charges","16.8% of total billed charges",955.5,50,,764.40,,,0,"percent of total billed charges","50% of total billed charges",1578.49,82.6,,1262.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",321.05,16.8,,256.84,,,0,"percent of total billed charges","16.8% of total billed charges",1911,100,,1528.80,,,0,"percent of total billed charges","100% of total billed charges",292.38,1911,
"BRONCHOSCOPY THERAPEUTIC",36100001,CDM,361,RC,,,OUTPATIENT,,,804,522.6,,707.52,88,,566.02,,,0,"percent of total billed charges","88% of total billed charges",402,50,,321.60,,,0,"percent of total billed charges","50% of total billed charges",135.07,16.8,,108.06,,,0,"percent of total billed charges","16.8% of total billed charges",804,100,,643.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",139.12,17.304,,111.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",506.52,63,,405.22,,,0,"percent of total billed charges","63% of total billed charges",123.01,15.3,,98.41,,,0,"percent of total billed charges","15.3% of total billed charges",135.07,16.8,,108.06,,,0,"percent of total billed charges","16.8% of total billed charges",554.76,69,,,,,0,"fee schedule","69% of total billed charges",804,100,,643.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",804,100,,643.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",804,100,,643.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",497.27,61.85,,397.82,,,0,"percent of total billed charges","61.5% of total billed charges",135.07,16.8,,108.06,,,0,"percent of total billed charges","16.8% of total billed charges",402,50,,321.60,,,0,"percent of total billed charges","50% of total billed charges",258.89,32.2,,207.11,,,0,"percent of total billed charges","32.2% of total billed charges",135.07,16.8,,108.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.77,17.136,,110.22,,,0,"percent of total billed charges","17.136% of total billed charges",175.59,21.84,,140.47,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",303.11,37.7,,242.49,,,0,"percent of total billed charges","37.7% of total billed charges",303.11,37.7,,242.49,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.56,33.9,,218.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",627.12,78,,501.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",664.1,82.6,,531.28,,,0,"percent of total billed charges","82.6% of total billed charges",135.07,16.8,,108.06,,,0,"percent of total billed charges","16.8% of total billed charges",402,50,,321.60,,,0,"percent of total billed charges","50% of total billed charges",664.1,82.6,,531.28,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",135.07,16.8,,108.06,,,0,"percent of total billed charges","16.8% of total billed charges",804,100,,643.20,,,0,"percent of total billed charges","100% of total billed charges",123.01,804,
"PULSE OX SINGLE DETERMINATION",46094760,CDM,460,RC,94760,CPT,OUTPATIENT,,,146,94.9,,128.48,88,,102.78,,,0,"percent of total billed charges","88% of total billed charges",73,50,,58.40,,,0,"percent of total billed charges","50% of total billed charges",24.53,16.8,,19.62,,,0,"percent of total billed charges","16.8% of total billed charges",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.26,17.304,,20.21,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.98,63,,73.58,,,0,"percent of total billed charges","63% of total billed charges",22.34,15.3,,17.87,,,0,"percent of total billed charges","15.3% of total billed charges",24.53,16.8,,19.62,,,0,"percent of total billed charges","16.8% of total billed charges",100.74,69,,,,,0,"fee schedule","69% of total billed charges",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.3,61.85,,72.24,,,0,"percent of total billed charges","61.5% of total billed charges",24.53,16.8,,19.62,,,0,"percent of total billed charges","16.8% of total billed charges",73,50,,58.40,,,0,"percent of total billed charges","50% of total billed charges",47.01,32.2,,37.61,,,0,"percent of total billed charges","32.2% of total billed charges",24.53,16.8,,19.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.02,17.136,,20.02,,,0,"percent of total billed charges","17.136% of total billed charges",31.89,21.84,,25.51,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",55.04,37.7,,44.03,,,0,"percent of total billed charges","37.7% of total billed charges",55.04,37.7,,44.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.49,33.9,,39.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.88,78,,91.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",120.6,82.6,,96.48,,,0,"percent of total billed charges","82.6% of total billed charges",24.53,16.8,,19.62,,,0,"percent of total billed charges","16.8% of total billed charges",73,50,,58.40,,,0,"percent of total billed charges","50% of total billed charges",120.6,82.6,,96.48,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.53,16.8,,19.62,,,0,"percent of total billed charges","16.8% of total billed charges",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",22.34,146,
"PULSE OX MULTIPLE DETERM",46094761,CDM,410,RC,94761,CPT,OUTPATIENT,,,319,207.35,,280.72,88,,224.58,,,0,"percent of total billed charges","88% of total billed charges",159.5,50,,127.60,,,0,"percent of total billed charges","50% of total billed charges",53.59,16.8,,42.87,,,0,"percent of total billed charges","16.8% of total billed charges",319,100,,255.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",55.2,17.304,,44.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",200.97,63,,160.78,,,0,"percent of total billed charges","63% of total billed charges",48.81,15.3,,39.05,,,0,"percent of total billed charges","15.3% of total billed charges",53.59,16.8,,42.87,,,0,"percent of total billed charges","16.8% of total billed charges",220.11,69,,,,,0,"fee schedule","69% of total billed charges",319,100,,255.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",319,100,,255.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",319,100,,255.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",197.3,61.85,,157.84,,,0,"percent of total billed charges","61.5% of total billed charges",53.59,16.8,,42.87,,,0,"percent of total billed charges","16.8% of total billed charges",159.5,50,,127.60,,,0,"percent of total billed charges","50% of total billed charges",102.72,32.2,,82.18,,,0,"percent of total billed charges","32.2% of total billed charges",53.59,16.8,,42.87,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",54.66,17.136,,43.73,,,0,"percent of total billed charges","17.136% of total billed charges",69.67,21.84,,55.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",120.26,37.7,,96.21,,,0,"percent of total billed charges","37.7% of total billed charges",120.26,37.7,,96.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",108.14,33.9,,86.51,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.82,78,,199.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.49,82.6,,210.79,,,0,"percent of total billed charges","82.6% of total billed charges",53.59,16.8,,42.87,,,0,"percent of total billed charges","16.8% of total billed charges",159.5,50,,127.60,,,0,"percent of total billed charges","50% of total billed charges",263.49,82.6,,210.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.59,16.8,,42.87,,,0,"percent of total billed charges","16.8% of total billed charges",319,100,,255.20,,,0,"percent of total billed charges","100% of total billed charges",48.81,319,
"ABG PUNCTURE",30036600,CDM,300,RC,36600,CPT,OUTPATIENT,,,564,366.6,,496.32,88,,397.06,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",54.44,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.32,63,,284.26,,,0,"percent of total billed charges","63% of total billed charges",86.29,15.3,,69.03,,,0,"percent of total billed charges","15.3% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,389.16,69,,,,,0,"fee schedule","69% of total billed charges",564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.15,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",53.92,100,,,,,0,"fee schedule",EAPG,68.72,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",212.63,37.7,,170.10,,,0,"percent of total billed charges","37.7% of total billed charges",212.63,37.7,,170.10,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191.2,33.9,,152.96,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",439.92,78,,351.94,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465.86,82.6,,372.69,,,0,"percent of total billed charges","82.6% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465.86,82.6,,372.69,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",39.15,564,
"NASOTRACHEAL ASPIRATION",94031720,CDM,940,RC,31720,CPT,OUTPATIENT,,,708,460.2,,623.04,88,,498.43,,,0,"percent of total billed charges","88% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,708,100,,566.40,,,0,"percent of total billed charges","100% of total billed charges",380.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",48.3,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",446.04,63,,356.83,,,0,"percent of total billed charges","63% of total billed charges",108.32,15.3,,86.66,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,488.52,69,,,,,0,"fee schedule","69% of total billed charges",708,100,,566.40,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",708,100,,566.40,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",708,100,,566.40,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",763.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.73,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",266.92,37.7,,213.54,,,0,"percent of total billed charges","37.7% of total billed charges",266.92,37.7,,213.54,,,0,"percent of total billed charges","37.70% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",240.01,33.9,,192.01,,,0,"percent of total billed charges","33.9% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",552.24,78,,441.79,,,0,"percent of total billed charges","78% of total billed charges",219.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",584.81,82.6,,467.85,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",584.81,82.6,,467.85,,,0,"percent of total billed charges","82.6% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,708,100,,566.40,,,0,"percent of total billed charges","100% of total billed charges",34.73,763.26,
"INITIAL SVN/MDI",41094640,CDM,410,RC,94640,CPT,OUTPATIENT,,,806,523.9,76,709.28,88,,567.42,,,0,"percent of total billed charges","88% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",380.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",507.78,63,,406.22,,,0,"percent of total billed charges","63% of total billed charges",123.32,15.3,,98.66,,,0,"percent of total billed charges","15.3% of total billed charges",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",556.14,69,,,,,0,"fee schedule","69% of total billed charges",806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",763.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.61,102,,,,,0,"fee schedule","102% of WA fee schedule",7.15,130,,,,,0,"fee schedule","130% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",303.86,37.7,,243.09,,,0,"percent of total billed charges","37.7% of total billed charges",303.86,37.7,,243.09,,,0,"percent of total billed charges","37.70% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",273.23,33.9,,218.58,,,0,"percent of total billed charges","33.9% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",628.68,78,,502.94,,,0,"percent of total billed charges","78% of total billed charges",219.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.76,82.6,,532.61,,,0,"percent of total billed charges","82.6% of total billed charges",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.76,82.6,,532.61,,,0,"percent of total billed charges","82.6% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",5.5,806,
"VENT/BIPAP Subsequent DAY",41094003,CDM,410,RC,94003,CPT,OUTPATIENT,,,2978,1935.7,,2620.64,88,,2096.51,,,0,"percent of total billed charges","88% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579.9,100,,,,,0,"fee schedule",EAPG,2978,100,,2382.40,,,0,"percent of total billed charges","100% of total billed charges",1118.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",597.3,100,,,,,0,"fee schedule",EAPG,639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1876.14,63,,1500.91,,,0,"percent of total billed charges","63% of total billed charges",455.63,15.3,,364.50,,,0,"percent of total billed charges","15.3% of total billed charges",579.9,100,,,,,0,"fee schedule",EAPG,2054.82,69,,,,,0,"fee schedule","69% of total billed charges",2978,100,,2382.40,,,0,"percent of total billed charges","100% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2978,100,,2382.40,,,0,"percent of total billed charges","100% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2978,100,,2382.40,,,0,"percent of total billed charges","100% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",1971.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579.9,100,,,,,0,"fee schedule",EAPG,639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",515.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",429.56,100,,,,,0,"fee schedule",EAPG,639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591.5,100,,,,,0,"fee schedule",EAPG,753.87,100,,,,,0,"fee schedule",EAPG,639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1122.71,37.7,,898.17,,,0,"percent of total billed charges","37.7% of total billed charges",1122.71,37.7,,898.17,,,0,"percent of total billed charges","37.70% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1009.54,33.9,,807.63,,,0,"percent of total billed charges","33.9% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2322.84,78,,1858.27,,,0,"percent of total billed charges","78% of total billed charges",645.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2459.83,82.6,,1967.86,,,0,"percent of total billed charges","82.6% of total billed charges",579.9,100,,,,,0,"fee schedule","100% of WA fee schedule",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2459.83,82.6,,1967.86,,,0,"percent of total billed charges","82.6% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579.9,100,,,,,0,"fee schedule",EAPG,2978,100,,2382.40,,,0,"percent of total billed charges","100% of total billed charges",429.56,2978,
"INCENTIVE SPIROM INSTRUCTION",41094799,CDM,410,RC,94799,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",48.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",34.73,60.96,
"BIPAP/CPAP INIT  MGMT",41094660,CDM,410,RC,94660,CPT,OUTPATIENT,,,2978,1935.7,,2620.64,88,,2096.51,,,0,"percent of total billed charges","88% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.78,100,,,,,0,"fee schedule",EAPG,2978,100,,2382.40,,,0,"percent of total billed charges","100% of total billed charges",380.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",115.13,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1876.14,63,,1500.91,,,0,"percent of total billed charges","63% of total billed charges",455.63,15.3,,364.50,,,0,"percent of total billed charges","15.3% of total billed charges",111.78,100,,,,,0,"fee schedule",EAPG,2054.82,69,,,,,0,"fee schedule","69% of total billed charges",2978,100,,2382.40,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2978,100,,2382.40,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2978,100,,2382.40,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",763.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.78,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",82.8,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",114.01,100,,,,,0,"fee schedule",EAPG,145.31,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1122.71,37.7,,898.17,,,0,"percent of total billed charges","37.7% of total billed charges",1122.71,37.7,,898.17,,,0,"percent of total billed charges","37.70% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1009.54,33.9,,807.63,,,0,"percent of total billed charges","33.9% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2322.84,78,,1858.27,,,0,"percent of total billed charges","78% of total billed charges",219.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2459.83,82.6,,1967.86,,,0,"percent of total billed charges","82.6% of total billed charges",111.78,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2459.83,82.6,,1967.86,,,0,"percent of total billed charges","82.6% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.78,100,,,,,0,"fee schedule",EAPG,2978,100,,2382.40,,,0,"percent of total billed charges","100% of total billed charges",82.8,2978,
"SVN/MDI/IPPB SUBSEQUENT",41094640,CDM,410,RC,94640,CPT,OUTPATIENT,,,707,459.55,76,622.16,88,,497.73,,,0,"percent of total billed charges","88% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",380.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",445.41,63,,356.33,,,0,"percent of total billed charges","63% of total billed charges",108.17,15.3,,86.54,,,0,"percent of total billed charges","15.3% of total billed charges",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",487.83,69,,,,,0,"fee schedule","69% of total billed charges",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",763.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.61,102,,,,,0,"fee schedule","102% of WA fee schedule",7.15,130,,,,,0,"fee schedule","130% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",266.54,37.7,,213.23,,,0,"percent of total billed charges","37.7% of total billed charges",266.54,37.7,,213.23,,,0,"percent of total billed charges","37.70% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",239.67,33.9,,191.74,,,0,"percent of total billed charges","33.9% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",551.46,78,,441.17,,,0,"percent of total billed charges","78% of total billed charges",219.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",583.98,82.6,,467.18,,,0,"percent of total billed charges","82.6% of total billed charges",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",583.98,82.6,,467.18,,,0,"percent of total billed charges","82.6% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",5.5,763.26,
"RT Carbon Monoxide Diffusion DLC CHARGE",46094729,CDM,460,RC,94729,CPT,OUTPATIENT,,,266,172.9,,234.08,88,,187.26,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.89,100,,,,,0,"fee schedule",EAPG,266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",167.58,63,,134.06,,,0,"percent of total billed charges","63% of total billed charges",40.7,15.3,,32.56,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,183.54,69,,,,,0,"fee schedule","69% of total billed charges",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",100.28,37.7,,80.22,,,0,"percent of total billed charges","37.7% of total billed charges",100.28,37.7,,80.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.17,33.9,,72.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.48,78,,165.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",219.72,82.6,,175.78,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",219.72,82.6,,175.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.89,100,,,,,0,"fee schedule",EAPG,266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",34.73,266,
CPR,48192950,CDM,481,RC,92950,CPT,OUTPATIENT,,,1022,664.3,,899.36,88,,719.49,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818.62,100,,,,,0,"fee schedule",EAPG,1022,100,,817.60,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",843.18,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.86,63,,515.09,,,0,"percent of total billed charges","63% of total billed charges",156.37,15.3,,125.10,,,0,"percent of total billed charges","15.3% of total billed charges",818.62,100,,,,,0,"fee schedule",EAPG,705.18,69,,,,,0,"fee schedule","69% of total billed charges",1022,100,,817.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022,100,,817.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022,100,,817.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818.62,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",606.38,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",834.99,100,,,,,0,"fee schedule",EAPG,1064.21,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",385.29,37.7,,308.23,,,0,"percent of total billed charges","37.7% of total billed charges",385.29,37.7,,308.23,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",346.46,33.9,,277.17,,,0,"percent of total billed charges","33.9% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",797.16,78,,637.73,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.17,82.6,,675.34,,,0,"percent of total billed charges","82.6% of total billed charges",818.62,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.17,82.6,,675.34,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818.62,100,,,,,0,"fee schedule",EAPG,1022,100,,817.60,,,0,"percent of total billed charges","100% of total billed charges",156.37,1074.33,
"CONT INHAL TX EA ADD HOUR",41094645,CDM,410,RC,94645,CPT,OUTPATIENT,,,743,482.95,,653.84,88,,523.07,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.89,100,,,,,0,"fee schedule",EAPG,743,100,,594.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",468.09,63,,374.47,,,0,"percent of total billed charges","63% of total billed charges",113.68,15.3,,90.94,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,512.67,69,,,,,0,"fee schedule","69% of total billed charges",743,100,,594.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",743,100,,594.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",743,100,,594.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",280.11,37.7,,224.09,,,0,"percent of total billed charges","37.7% of total billed charges",280.11,37.7,,224.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",251.88,33.9,,201.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.54,78,,463.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",613.72,82.6,,490.98,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",613.72,82.6,,490.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.89,100,,,,,0,"fee schedule",EAPG,743,100,,594.40,,,0,"percent of total billed charges","100% of total billed charges",34.73,743,
"CPT PERC/VIBRATE INIT",41094667,CDM,410,RC,94667,CPT,OUTPATIENT,,,707,459.55,,622.16,88,,497.73,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14.24,100,,,,,0,"fee schedule","100% of WA fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",14.24,100,,,,,0,"fee schedule","100% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",445.41,63,,356.33,,,0,"percent of total billed charges","63% of total billed charges",108.17,15.3,,86.54,,,0,"percent of total billed charges","15.3% of total billed charges",14.24,100,,,,,0,"fee schedule","100% of WA fee schedule",487.83,69,,,,,0,"fee schedule","69% of total billed charges",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14.24,100,,,,,0,"fee schedule","100% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14.24,100,,,,,0,"fee schedule","100% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14.52,102,,,,,0,"fee schedule","102% of WA fee schedule",18.51,130,,,,,0,"fee schedule","130% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",266.54,37.7,,213.23,,,0,"percent of total billed charges","37.7% of total billed charges",266.54,37.7,,213.23,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",239.67,33.9,,191.74,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",551.46,78,,441.17,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",583.98,82.6,,467.18,,,0,"percent of total billed charges","82.6% of total billed charges",14.24,100,,,,,0,"fee schedule","100% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",583.98,82.6,,467.18,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14.24,100,,,,,0,"fee schedule","100% of WA fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",14.24,707,
"RT CPAP Initial CHARGE",41094660,CDM,410,RC,94660,CPT,OUTPATIENT,,,2978,1935.7,,2620.64,88,,2096.51,,,0,"percent of total billed charges","88% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.78,100,,,,,0,"fee schedule",EAPG,2978,100,,2382.40,,,0,"percent of total billed charges","100% of total billed charges",380.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",115.13,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1876.14,63,,1500.91,,,0,"percent of total billed charges","63% of total billed charges",455.63,15.3,,364.50,,,0,"percent of total billed charges","15.3% of total billed charges",111.78,100,,,,,0,"fee schedule",EAPG,2054.82,69,,,,,0,"fee schedule","69% of total billed charges",2978,100,,2382.40,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2978,100,,2382.40,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2978,100,,2382.40,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",763.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.78,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",82.8,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",114.01,100,,,,,0,"fee schedule",EAPG,145.31,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1122.71,37.7,,898.17,,,0,"percent of total billed charges","37.7% of total billed charges",1122.71,37.7,,898.17,,,0,"percent of total billed charges","37.70% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1009.54,33.9,,807.63,,,0,"percent of total billed charges","33.9% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2322.84,78,,1858.27,,,0,"percent of total billed charges","78% of total billed charges",219.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2459.83,82.6,,1967.86,,,0,"percent of total billed charges","82.6% of total billed charges",111.78,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2459.83,82.6,,1967.86,,,0,"percent of total billed charges","82.6% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.78,100,,,,,0,"fee schedule",EAPG,2978,100,,2382.40,,,0,"percent of total billed charges","100% of total billed charges",82.8,2978,
"VENT/BIPAP SUBSEQUENT DAY",41094003,CDM,410,RC,94003,CPT,OUTPATIENT,,,2978,1935.7,,2620.64,88,,2096.51,,,0,"percent of total billed charges","88% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579.9,100,,,,,0,"fee schedule",EAPG,2978,100,,2382.40,,,0,"percent of total billed charges","100% of total billed charges",1118.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",597.3,100,,,,,0,"fee schedule",EAPG,639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1876.14,63,,1500.91,,,0,"percent of total billed charges","63% of total billed charges",455.63,15.3,,364.50,,,0,"percent of total billed charges","15.3% of total billed charges",579.9,100,,,,,0,"fee schedule",EAPG,2054.82,69,,,,,0,"fee schedule","69% of total billed charges",2978,100,,2382.40,,,0,"percent of total billed charges","100% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2978,100,,2382.40,,,0,"percent of total billed charges","100% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2978,100,,2382.40,,,0,"percent of total billed charges","100% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",1971.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579.9,100,,,,,0,"fee schedule",EAPG,639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",515.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",429.56,100,,,,,0,"fee schedule",EAPG,639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591.5,100,,,,,0,"fee schedule",EAPG,753.87,100,,,,,0,"fee schedule",EAPG,639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1122.71,37.7,,898.17,,,0,"percent of total billed charges","37.7% of total billed charges",1122.71,37.7,,898.17,,,0,"percent of total billed charges","37.70% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1009.54,33.9,,807.63,,,0,"percent of total billed charges","33.9% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2322.84,78,,1858.27,,,0,"percent of total billed charges","78% of total billed charges",645.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2459.83,82.6,,1967.86,,,0,"percent of total billed charges","82.6% of total billed charges",579.9,100,,,,,0,"fee schedule","100% of WA fee schedule",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2459.83,82.6,,1967.86,,,0,"percent of total billed charges","82.6% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579.9,100,,,,,0,"fee schedule",EAPG,2978,100,,2382.40,,,0,"percent of total billed charges","100% of total billed charges",429.56,2978,
"CONT INHAL TX FIRST HOUR",41094644,CDM,410,RC,94644,CPT,OUTPATIENT,,,785,510.25,,690.8,88,,552.64,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",48.3,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",494.55,63,,395.64,,,0,"percent of total billed charges","63% of total billed charges",120.11,15.3,,96.09,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,541.65,69,,,,,0,"fee schedule","69% of total billed charges",785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.73,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",295.95,37.7,,236.76,,,0,"percent of total billed charges","37.7% of total billed charges",295.95,37.7,,236.76,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",266.12,33.9,,212.90,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",612.3,78,,489.84,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",648.41,82.6,,518.73,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",648.41,82.6,,518.73,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",34.73,785,
"END TIDAL CO2 INITIAL DAY",46094770,CDM,460,RC,94799,CPT,OUTPATIENT,,,1017,661.05,,894.96,88,,715.97,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,1017,100,,813.60,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",48.3,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",640.71,63,,512.57,,,0,"percent of total billed charges","63% of total billed charges",155.6,15.3,,124.48,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,701.73,69,,,,,0,"fee schedule","69% of total billed charges",1017,100,,813.60,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1017,100,,813.60,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1017,100,,813.60,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.73,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",383.41,37.7,,306.73,,,0,"percent of total billed charges","37.7% of total billed charges",383.41,37.7,,306.73,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",344.76,33.9,,275.81,,,0,"percent of total billed charges","33.9% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",793.26,78,,634.61,,,0,"percent of total billed charges","78% of total billed charges",160.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",840.04,82.6,,672.03,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",840.04,82.6,,672.03,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,1017,100,,813.60,,,0,"percent of total billed charges","100% of total billed charges",34.73,1017,
"RT EDUCATION/ INSTRUCTION (15 MIN)",41098961,CDM,410,RC,98961,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",42.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.64,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",42.2,100,,,,,0,"fee schedule",EAPG,53.79,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",30.64,53.79,
"RESP TX  RESP FUNCTION 15MIN",410G0238,CDM,410,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.7% of total billed charges",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.55,33.9,,42.04,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"RESP TX  RESP FUNCTION 15MIN",410G0238,CDM,410,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.7% of total billed charges",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.55,33.9,,42.04,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"FLUTTER VALVE INITIAL",41094667,CDM,410,RC,94667,CPT,OUTPATIENT,,,707,459.55,,622.16,88,,497.73,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14.24,100,,,,,0,"fee schedule","100% of WA fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",14.24,100,,,,,0,"fee schedule","100% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",445.41,63,,356.33,,,0,"percent of total billed charges","63% of total billed charges",108.17,15.3,,86.54,,,0,"percent of total billed charges","15.3% of total billed charges",14.24,100,,,,,0,"fee schedule","100% of WA fee schedule",487.83,69,,,,,0,"fee schedule","69% of total billed charges",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14.24,100,,,,,0,"fee schedule","100% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14.24,100,,,,,0,"fee schedule","100% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14.52,102,,,,,0,"fee schedule","102% of WA fee schedule",18.51,130,,,,,0,"fee schedule","130% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",266.54,37.7,,213.23,,,0,"percent of total billed charges","37.7% of total billed charges",266.54,37.7,,213.23,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",239.67,33.9,,191.74,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",551.46,78,,441.17,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",583.98,82.6,,467.18,,,0,"percent of total billed charges","82.6% of total billed charges",14.24,100,,,,,0,"fee schedule","100% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",583.98,82.6,,467.18,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14.24,100,,,,,0,"fee schedule","100% of WA fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",14.24,707,
"FLUTTER VALVE SUB",41094668,CDM,410,RC,94668,CPT,OUTPATIENT,,,423,274.95,,372.24,88,,297.79,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",423,100,,338.40,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",266.49,63,,213.19,,,0,"percent of total billed charges","63% of total billed charges",64.72,15.3,,51.78,,,0,"percent of total billed charges","15.3% of total billed charges",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",291.87,69,,,,,0,"fee schedule","69% of total billed charges",423,100,,338.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",423,100,,338.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",423,100,,338.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22.65,102,,,,,0,"fee schedule","102% of WA fee schedule",28.87,130,,,,,0,"fee schedule","130% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",159.47,37.7,,127.58,,,0,"percent of total billed charges","37.7% of total billed charges",159.47,37.7,,127.58,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",143.4,33.9,,114.72,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",329.94,78,,263.95,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",349.4,82.6,,279.52,,,0,"percent of total billed charges","82.6% of total billed charges",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",349.4,82.6,,279.52,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22.21,100,,,,,0,"fee schedule","100% of WA fee schedule",423,100,,338.40,,,0,"percent of total billed charges","100% of total billed charges",22.21,454.8,
"HGB QUANT TRANSCUTANEOUS",30088738,CDM,300,RC,88738,CPT,OUTPATIENT,,,50,32.5,,44,88,,35.20,,,0,"percent of total billed charges","88% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",8.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.23,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.5,63,,25.20,,,0,"percent of total billed charges","63% of total billed charges",7.65,15.3,,6.12,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,34.5,69,,,,,0,"fee schedule","69% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.2,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.01,100,,,,,0,"fee schedule","100% of LI fee schedule",3.76,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.7% of total billed charges",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.70% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.95,33.9,,13.56,,,0,"percent of total billed charges","33.9% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",39,78,,31.20,,,0,"percent of total billed charges","78% of total billed charges",5.07,101,,,,,0,"fee schedule","101% of CMS fee schedule ",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",5.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",3.76,50,
"INTUBATION EMERGENCY",92000001,CDM,410,RC,31500,CPT,OUTPATIENT,,,614,399.1,,540.32,88,,432.26,,,0,"percent of total billed charges","88% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818.62,100,,,,,0,"fee schedule",EAPG,614,100,,491.20,,,0,"percent of total billed charges","100% of total billed charges",435.98,175,,,,,0,"fee schedule","175% of CMS fee schedule",843.18,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",386.82,63,,309.46,,,0,"percent of total billed charges","63% of total billed charges",93.94,15.3,,75.15,,,0,"percent of total billed charges","15.3% of total billed charges",818.62,100,,,,,0,"fee schedule",EAPG,423.66,69,,,,,0,"fee schedule","69% of total billed charges",614,100,,491.20,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",614,100,,491.20,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",614,100,,491.20,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",859.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818.62,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",606.38,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",834.99,100,,,,,0,"fee schedule",EAPG,1064.21,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",231.48,37.7,,185.18,,,0,"percent of total billed charges","37.7% of total billed charges",231.48,37.7,,185.18,,,0,"percent of total billed charges","37.70% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",208.15,33.9,,166.52,,,0,"percent of total billed charges","33.9% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",478.92,78,,383.14,,,0,"percent of total billed charges","78% of total billed charges",251.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",507.16,82.6,,405.73,,,0,"percent of total billed charges","82.6% of total billed charges",818.62,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",507.16,82.6,,405.73,,,0,"percent of total billed charges","82.6% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818.62,100,,,,,0,"fee schedule",EAPG,614,100,,491.20,,,0,"percent of total billed charges","100% of total billed charges",93.94,1064.21,
"RESP TX LUNG STRENGTH 15MIN",410G0237,CDM,410,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.7% of total billed charges",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.55,33.9,,42.04,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"RESP TX LUNG STRENGTH 15MIN",410G0237,CDM,410,RC,,,OUTPATIENT,,,156,101.4,,137.28,88,,109.82,,,0,"percent of total billed charges","88% of total billed charges",78,50,,62.40,,,0,"percent of total billed charges","50% of total billed charges",26.21,16.8,,20.97,,,0,"percent of total billed charges","16.8% of total billed charges",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.99,17.304,,21.59,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.28,63,,78.62,,,0,"percent of total billed charges","63% of total billed charges",23.87,15.3,,19.10,,,0,"percent of total billed charges","15.3% of total billed charges",26.21,16.8,,20.97,,,0,"percent of total billed charges","16.8% of total billed charges",107.64,69,,,,,0,"fee schedule","69% of total billed charges",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.21,16.8,,20.97,,,0,"percent of total billed charges","16.8% of total billed charges",78,50,,62.40,,,0,"percent of total billed charges","50% of total billed charges",50.23,32.2,,40.18,,,0,"percent of total billed charges","32.2% of total billed charges",26.21,16.8,,20.97,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.73,17.136,,21.38,,,0,"percent of total billed charges","17.136% of total billed charges",34.07,21.84,,27.26,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.81,37.7,,47.05,,,0,"percent of total billed charges","37.7% of total billed charges",58.81,37.7,,47.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.88,33.9,,42.30,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",121.68,78,,97.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.86,82.6,,103.09,,,0,"percent of total billed charges","82.6% of total billed charges",26.21,16.8,,20.97,,,0,"percent of total billed charges","16.8% of total billed charges",78,50,,62.40,,,0,"percent of total billed charges","50% of total billed charges",128.86,82.6,,103.09,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.21,16.8,,20.97,,,0,"percent of total billed charges","16.8% of total billed charges",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",23.87,156,
"DEMO/EVAL GEN/NEBUL/MDI/IPPB",41094664,CDM,410,RC,94664,CPT,OUTPATIENT,,,707,459.55,,622.16,88,,497.73,,,0,"percent of total billed charges","88% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",380.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",48.3,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",445.41,63,,356.33,,,0,"percent of total billed charges","63% of total billed charges",108.17,15.3,,86.54,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,487.83,69,,,,,0,"fee schedule","69% of total billed charges",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",763.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.73,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",266.54,37.7,,213.23,,,0,"percent of total billed charges","37.7% of total billed charges",266.54,37.7,,213.23,,,0,"percent of total billed charges","37.70% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",239.67,33.9,,191.74,,,0,"percent of total billed charges","33.9% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",551.46,78,,441.17,,,0,"percent of total billed charges","78% of total billed charges",219.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",583.98,82.6,,467.18,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",583.98,82.6,,467.18,,,0,"percent of total billed charges","82.6% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",34.73,763.26,
"BRONCHOSPASM CHALL/EXPOS",46094070,CDM,460,RC,94070,CPT,OUTPATIENT,,,1168,759.2,,1027.84,88,,822.27,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.19,100,,,,,0,"fee schedule",EAPG,1168,100,,934.40,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",94.95,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.84,63,,588.67,,,0,"percent of total billed charges","63% of total billed charges",178.7,15.3,,142.96,,,0,"percent of total billed charges","15.3% of total billed charges",92.19,100,,,,,0,"fee schedule",EAPG,805.92,69,,,,,0,"fee schedule","69% of total billed charges",1168,100,,934.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1168,100,,934.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1168,100,,934.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.19,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",68.29,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",94.03,100,,,,,0,"fee schedule",EAPG,119.84,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",440.34,37.7,,352.27,,,0,"percent of total billed charges","37.7% of total billed charges",440.34,37.7,,352.27,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",395.95,33.9,,316.76,,,0,"percent of total billed charges","33.9% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",911.04,78,,728.83,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",964.77,82.6,,771.82,,,0,"percent of total billed charges","82.6% of total billed charges",92.19,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",964.77,82.6,,771.82,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.19,100,,,,,0,"fee schedule",EAPG,1168,100,,934.40,,,0,"percent of total billed charges","100% of total billed charges",68.29,1168,
"AEROSOL HHN NEBTX INIT",41094640,CDM,410,RC,94640,CPT,OUTPATIENT,,,707,459.55,76,622.16,88,,497.73,,,0,"percent of total billed charges","88% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",380.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",445.41,63,,356.33,,,0,"percent of total billed charges","63% of total billed charges",108.17,15.3,,86.54,,,0,"percent of total billed charges","15.3% of total billed charges",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",487.83,69,,,,,0,"fee schedule","69% of total billed charges",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",763.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.61,102,,,,,0,"fee schedule","102% of WA fee schedule",7.15,130,,,,,0,"fee schedule","130% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",266.54,37.7,,213.23,,,0,"percent of total billed charges","37.7% of total billed charges",266.54,37.7,,213.23,,,0,"percent of total billed charges","37.70% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",239.67,33.9,,191.74,,,0,"percent of total billed charges","33.9% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",551.46,78,,441.17,,,0,"percent of total billed charges","78% of total billed charges",219.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",583.98,82.6,,467.18,,,0,"percent of total billed charges","82.6% of total billed charges",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",583.98,82.6,,467.18,,,0,"percent of total billed charges","82.6% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",5.5,763.26,
"PULSE OXIMETRY CONT OVERNIGHT",46094762,CDM,460,RC,94762,CPT,OUTPATIENT,,,501,325.65,,440.88,88,,352.70,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,501,100,,400.80,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",48.3,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",315.63,63,,252.50,,,0,"percent of total billed charges","63% of total billed charges",76.65,15.3,,61.32,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,345.69,69,,,,,0,"fee schedule","69% of total billed charges",501,100,,400.80,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",501,100,,400.80,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",501,100,,400.80,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.73,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",188.88,37.7,,151.10,,,0,"percent of total billed charges","37.7% of total billed charges",188.88,37.7,,151.10,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.84,33.9,,135.87,,,0,"percent of total billed charges","33.9% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.78,78,,312.62,,,0,"percent of total billed charges","78% of total billed charges",160.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",413.83,82.6,,331.06,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",413.83,82.6,,331.06,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,501,100,,400.80,,,0,"percent of total billed charges","100% of total billed charges",34.73,566.91,
"02 MANAGEMENT",41094799,CDM,410,RC,94799,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",48.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",34.73,60.96,
"OXYGEN DAILY",27200001,CDM,272,RC,,,OUTPATIENT,,,1034,672.1,,909.92,88,,727.94,,,0,"percent of total billed charges","88% of total billed charges",517,50,,413.60,,,0,"percent of total billed charges","50% of total billed charges",173.71,16.8,,138.97,,,0,"percent of total billed charges","16.8% of total billed charges",1034,100,,827.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.92,17.304,,143.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",651.42,63,,521.14,,,0,"percent of total billed charges","63% of total billed charges",158.2,15.3,,126.56,,,0,"percent of total billed charges","15.3% of total billed charges",173.71,16.8,,138.97,,,0,"percent of total billed charges","16.8% of total billed charges",713.46,69,,,,,0,"fee schedule","69% of total billed charges",1034,100,,827.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1034,100,,827.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1034,100,,827.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",173.71,16.8,,138.97,,,0,"percent of total billed charges","16.8% of total billed charges",517,50,,413.60,,,0,"percent of total billed charges","50% of total billed charges",332.95,32.2,,266.36,,,0,"percent of total billed charges","32.2% of total billed charges",173.71,16.8,,138.97,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",177.19,17.136,,141.75,,,0,"percent of total billed charges","17.136% of total billed charges",225.83,21.84,,180.66,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",389.82,37.7,,311.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",806.52,78,,645.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",854.08,82.6,,683.26,,,0,"percent of total billed charges","82.6% of total billed charges",173.71,16.8,,138.97,,,0,"percent of total billed charges","16.8% of total billed charges",517,50,,413.60,,,0,"percent of total billed charges","50% of total billed charges",854.08,82.6,,683.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.71,16.8,,138.97,,,0,"percent of total billed charges","16.8% of total billed charges",1034,100,,827.20,,,0,"percent of total billed charges","100% of total billed charges",158.2,1034,
"02 MANAGEMENT",41094799,CDM,410,RC,94799,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",48.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",34.73,60.96,
"PULSE OX MULTIPLE DETERM",46094761,CDM,460,RC,94761,CPT,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"RT Pulse Oximetry, Single Day CHARGE",46094760,CDM,460,RC,94760,CPT,OUTPATIENT,,,153,99.45,,134.64,88,,107.71,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.7,16.8,,20.56,,,0,"percent of total billed charges","16.8% of total billed charges",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.48,17.304,,21.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",96.39,63,,77.11,,,0,"percent of total billed charges","63% of total billed charges",23.41,15.3,,18.73,,,0,"percent of total billed charges","15.3% of total billed charges",25.7,16.8,,20.56,,,0,"percent of total billed charges","16.8% of total billed charges",105.57,69,,,,,0,"fee schedule","69% of total billed charges",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25.7,16.8,,20.56,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25.7,16.8,,20.56,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.22,17.136,,20.98,,,0,"percent of total billed charges","17.136% of total billed charges",33.42,21.84,,26.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.68,37.7,,46.14,,,0,"percent of total billed charges","37.7% of total billed charges",57.68,37.7,,46.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.87,33.9,,41.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",119.34,78,,95.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.38,82.6,,101.10,,,0,"percent of total billed charges","82.6% of total billed charges",25.7,16.8,,20.56,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.38,82.6,,101.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.7,16.8,,20.56,,,0,"percent of total billed charges","16.8% of total billed charges",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",23.41,153,
"Plethysmography/Body Box",46094726,CDM,460,RC,94726,CPT,OUTPATIENT,,,347,225.55,,305.36,88,,244.29,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.19,100,,,,,0,"fee schedule",EAPG,347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",560.25,175,,,,,0,"fee schedule","175% of CMS fee schedule",94.95,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.61,63,,174.89,,,0,"percent of total billed charges","63% of total billed charges",53.09,15.3,,42.47,,,0,"percent of total billed charges","15.3% of total billed charges",92.19,100,,,,,0,"fee schedule",EAPG,239.43,69,,,,,0,"fee schedule","69% of total billed charges",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.19,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",68.29,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",94.03,100,,,,,0,"fee schedule",EAPG,119.84,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",130.82,37.7,,104.66,,,0,"percent of total billed charges","37.7% of total billed charges",130.82,37.7,,104.66,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",117.63,33.9,,94.10,,,0,"percent of total billed charges","33.9% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.66,78,,216.53,,,0,"percent of total billed charges","78% of total billed charges",323.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",286.62,82.6,,229.30,,,0,"percent of total billed charges","82.6% of total billed charges",92.19,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",286.62,82.6,,229.30,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.19,100,,,,,0,"fee schedule",EAPG,347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",53.09,1074.33,
"PULSE OX SINGLE DETERMINATION",46094760,CDM,460,RC,94760,CPT,OUTPATIENT,,,153,99.45,,134.64,88,,107.71,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.7,16.8,,20.56,,,0,"percent of total billed charges","16.8% of total billed charges",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.48,17.304,,21.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",96.39,63,,77.11,,,0,"percent of total billed charges","63% of total billed charges",23.41,15.3,,18.73,,,0,"percent of total billed charges","15.3% of total billed charges",25.7,16.8,,20.56,,,0,"percent of total billed charges","16.8% of total billed charges",105.57,69,,,,,0,"fee schedule","69% of total billed charges",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25.7,16.8,,20.56,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25.7,16.8,,20.56,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.22,17.136,,20.98,,,0,"percent of total billed charges","17.136% of total billed charges",33.42,21.84,,26.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.68,37.7,,46.14,,,0,"percent of total billed charges","37.7% of total billed charges",57.68,37.7,,46.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.87,33.9,,41.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",119.34,78,,95.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.38,82.6,,101.10,,,0,"percent of total billed charges","82.6% of total billed charges",25.7,16.8,,20.56,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.38,82.6,,101.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.7,16.8,,20.56,,,0,"percent of total billed charges","16.8% of total billed charges",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",23.41,153,
"SPIROM PP B-D P/F STUDY",46094060,CDM,460,RC,94060,CPT,OUTPATIENT,,,1286,835.9,,1131.68,88,,905.34,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.19,100,,,,,0,"fee schedule",EAPG,1286,100,,1028.80,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",94.95,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",810.18,63,,648.14,,,0,"percent of total billed charges","63% of total billed charges",196.76,15.3,,157.41,,,0,"percent of total billed charges","15.3% of total billed charges",92.19,100,,,,,0,"fee schedule",EAPG,887.34,69,,,,,0,"fee schedule","69% of total billed charges",1286,100,,1028.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1286,100,,1028.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1286,100,,1028.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.19,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",68.29,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",94.03,100,,,,,0,"fee schedule",EAPG,119.84,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",484.82,37.7,,387.86,,,0,"percent of total billed charges","37.7% of total billed charges",484.82,37.7,,387.86,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",435.95,33.9,,348.76,,,0,"percent of total billed charges","33.9% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1003.08,78,,802.46,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1062.24,82.6,,849.79,,,0,"percent of total billed charges","82.6% of total billed charges",92.19,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1062.24,82.6,,849.79,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.19,100,,,,,0,"fee schedule",EAPG,1286,100,,1028.80,,,0,"percent of total billed charges","100% of total billed charges",68.29,1286,
"SIMPLE SPIROMETRY",46094010,CDM,460,RC,94010,CPT,OUTPATIENT,,,659,428.35,,579.92,88,,463.94,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,659,100,,527.20,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",48.3,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",415.17,63,,332.14,,,0,"percent of total billed charges","63% of total billed charges",100.83,15.3,,80.66,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,454.71,69,,,,,0,"fee schedule","69% of total billed charges",659,100,,527.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",659,100,,527.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",659,100,,527.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.73,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",248.44,37.7,,198.75,,,0,"percent of total billed charges","37.7% of total billed charges",248.44,37.7,,198.75,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",223.4,33.9,,178.72,,,0,"percent of total billed charges","33.9% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",514.02,78,,411.22,,,0,"percent of total billed charges","78% of total billed charges",160.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",544.33,82.6,,435.46,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",544.33,82.6,,435.46,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,659,100,,527.20,,,0,"percent of total billed charges","100% of total billed charges",34.73,659,
"Pressurized or nonpressurized inhalation treatment for acute",41094640,CDM,410,RC,94640,CPT,OUTPATIENT,,,211,137.15,76,185.68,88,,148.54,,,0,"percent of total billed charges","88% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",380.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.93,63,,106.34,,,0,"percent of total billed charges","63% of total billed charges",32.28,15.3,,25.82,,,0,"percent of total billed charges","15.3% of total billed charges",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",145.59,69,,,,,0,"fee schedule","69% of total billed charges",211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",763.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.61,102,,,,,0,"fee schedule","102% of WA fee schedule",7.15,130,,,,,0,"fee schedule","130% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",79.55,37.7,,63.64,,,0,"percent of total billed charges","37.7% of total billed charges",79.55,37.7,,63.64,,,0,"percent of total billed charges","37.70% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",71.53,33.9,,57.22,,,0,"percent of total billed charges","33.9% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",164.58,78,,131.66,,,0,"percent of total billed charges","78% of total billed charges",219.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",174.29,82.6,,139.43,,,0,"percent of total billed charges","82.6% of total billed charges",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",174.29,82.6,,139.43,,,0,"percent of total billed charges","82.6% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",5.5,763.26,
N/A,TMP600138,CDM,410,RC,94640,CPT,OUTPATIENT,,,707,459.55,,622.16,88,,497.73,,,0,"percent of total billed charges","88% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",380.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",445.41,63,,356.33,,,0,"percent of total billed charges","63% of total billed charges",108.17,15.3,,86.54,,,0,"percent of total billed charges","15.3% of total billed charges",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",487.83,69,,,,,0,"fee schedule","69% of total billed charges",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",763.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.61,102,,,,,0,"fee schedule","102% of WA fee schedule",7.15,130,,,,,0,"fee schedule","130% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",266.54,37.7,,213.23,,,0,"percent of total billed charges","37.7% of total billed charges",266.54,37.7,,213.23,,,0,"percent of total billed charges","37.70% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",239.67,33.9,,191.74,,,0,"percent of total billed charges","33.9% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",551.46,78,,441.17,,,0,"percent of total billed charges","78% of total billed charges",219.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",583.98,82.6,,467.18,,,0,"percent of total billed charges","82.6% of total billed charges",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",583.98,82.6,,467.18,,,0,"percent of total billed charges","82.6% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",5.5,763.26,
"VENTILATOR MGMT EA SUB DAY",41094003,CDM,410,RC,94003,CPT,OUTPATIENT,,,2459,1598.35,,2163.92,88,,1731.14,,,0,"percent of total billed charges","88% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579.9,100,,,,,0,"fee schedule",EAPG,2459,100,,1967.20,,,0,"percent of total billed charges","100% of total billed charges",1118.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",597.3,100,,,,,0,"fee schedule",EAPG,639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1549.17,63,,1239.34,,,0,"percent of total billed charges","63% of total billed charges",376.23,15.3,,300.98,,,0,"percent of total billed charges","15.3% of total billed charges",579.9,100,,,,,0,"fee schedule",EAPG,1696.71,69,,,,,0,"fee schedule","69% of total billed charges",2459,100,,1967.20,,,0,"percent of total billed charges","100% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2459,100,,1967.20,,,0,"percent of total billed charges","100% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2459,100,,1967.20,,,0,"percent of total billed charges","100% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",1971.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579.9,100,,,,,0,"fee schedule",EAPG,639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",515.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",429.56,100,,,,,0,"fee schedule",EAPG,639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591.5,100,,,,,0,"fee schedule",EAPG,753.87,100,,,,,0,"fee schedule",EAPG,639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",927.04,37.7,,741.63,,,0,"percent of total billed charges","37.7% of total billed charges",927.04,37.7,,741.63,,,0,"percent of total billed charges","37.70% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",833.6,33.9,,666.88,,,0,"percent of total billed charges","33.9% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1918.02,78,,1534.42,,,0,"percent of total billed charges","78% of total billed charges",645.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2031.13,82.6,,1624.90,,,0,"percent of total billed charges","82.6% of total billed charges",579.9,100,,,,,0,"fee schedule","100% of WA fee schedule",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2031.13,82.6,,1624.90,,,0,"percent of total billed charges","82.6% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579.9,100,,,,,0,"fee schedule",EAPG,2459,100,,1967.20,,,0,"percent of total billed charges","100% of total billed charges",376.23,2459,
"TOTAL VITAL CAPACITY",46094150,CDM,460,RC,94150,CPT,OUTPATIENT,,,692,449.8,,608.96,88,,487.17,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,692,100,,553.60,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",48.3,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",435.96,63,,348.77,,,0,"percent of total billed charges","63% of total billed charges",105.88,15.3,,84.70,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,477.48,69,,,,,0,"fee schedule","69% of total billed charges",692,100,,553.60,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",692,100,,553.60,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",692,100,,553.60,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.73,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.88,37.7,,208.70,,,0,"percent of total billed charges","37.7% of total billed charges",260.88,37.7,,208.70,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.59,33.9,,187.67,,,0,"percent of total billed charges","33.9% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",539.76,78,,431.81,,,0,"percent of total billed charges","78% of total billed charges",160.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",571.59,82.6,,457.27,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",571.59,82.6,,457.27,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,692,100,,553.60,,,0,"percent of total billed charges","100% of total billed charges",34.73,692,
"VENT MGMT FIRST DAY",41094002,CDM,410,RC,94002,CPT,OUTPATIENT,,,2978,1935.7,,2620.64,88,,2096.51,,,0,"percent of total billed charges","88% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579.9,100,,,,,0,"fee schedule",EAPG,2978,100,,2382.40,,,0,"percent of total billed charges","100% of total billed charges",1118.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",597.3,100,,,,,0,"fee schedule",EAPG,639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1876.14,63,,1500.91,,,0,"percent of total billed charges","63% of total billed charges",455.63,15.3,,364.50,,,0,"percent of total billed charges","15.3% of total billed charges",579.9,100,,,,,0,"fee schedule",EAPG,2054.82,69,,,,,0,"fee schedule","69% of total billed charges",2978,100,,2382.40,,,0,"percent of total billed charges","100% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2978,100,,2382.40,,,0,"percent of total billed charges","100% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2978,100,,2382.40,,,0,"percent of total billed charges","100% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",1971.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579.9,100,,,,,0,"fee schedule",EAPG,639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",515.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",429.56,100,,,,,0,"fee schedule",EAPG,639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591.5,100,,,,,0,"fee schedule",EAPG,753.87,100,,,,,0,"fee schedule",EAPG,639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1122.71,37.7,,898.17,,,0,"percent of total billed charges","37.7% of total billed charges",1122.71,37.7,,898.17,,,0,"percent of total billed charges","37.70% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1009.54,33.9,,807.63,,,0,"percent of total billed charges","33.9% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2322.84,78,,1858.27,,,0,"percent of total billed charges","78% of total billed charges",645.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2459.83,82.6,,1967.86,,,0,"percent of total billed charges","82.6% of total billed charges",579.9,100,,,,,0,"fee schedule",EAPG,639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2459.83,82.6,,1967.86,,,0,"percent of total billed charges","82.6% of total billed charges",639.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579.9,100,,,,,0,"fee schedule",EAPG,2978,100,,2382.40,,,0,"percent of total billed charges","100% of total billed charges",429.56,2978,
"DYSPH ASSESS W/VIDEO FL",44092611X,CDM,440,RC,92611,CPT,OUTPATIENT,,,1367,888.55,GN,1202.96,88,,962.37,,,0,"percent of total billed charges","88% of total billed charges",93.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.76,100,,,,,0,"fee schedule",EAPG,1367,100,,1093.60,,,0,"percent of total billed charges","100% of total billed charges",161.65,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,93.52,100,,,,,0,"fee schedule","100% of CMS fee sv",861.21,63,,688.97,,,0,"percent of total billed charges","63% of total billed charges",209.15,15.3,,167.32,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,943.23,69,,,,,0,"fee schedule","69% of total billed charges",1367,100,,1093.60,,,0,"percent of total billed charges","100% of total billed charges",92.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",1367,100,,1093.60,,,0,"percent of total billed charges","100% of total billed charges",93.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",1367,100,,1093.60,,,0,"percent of total billed charges","100% of total billed charges",93.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",358.29,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",108.76,100,,,,,0,"fee schedule",EAPG,93.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.9,100,,,,,0,"fee schedule","100% of LI fee schedule",80.56,100,,,,,0,"fee schedule",EAPG,93.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,93.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",515.36,37.7,,412.29,,,0,"percent of total billed charges","37.7% of total billed charges",515.36,37.7,,412.29,,,0,"percent of total billed charges","37.70% of total billed charges",93.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",463.41,33.9,,370.73,,,0,"percent of total billed charges","33.9% of total billed charges",93.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",1066.26,78,,853.01,,,0,"percent of total billed charges","78% of total billed charges",94.46,101,,,,,0,"fee schedule","101% of CMS fee schedule ",1129.14,82.6,,903.31,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,93.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",1129.14,82.6,,903.31,,,0,"percent of total billed charges","82.6% of total billed charges",93.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.76,100,,,,,0,"fee schedule",EAPG,1367,100,,1093.60,,,0,"percent of total billed charges","100% of total billed charges",80.56,1367,
"SPEECH/LANG THERAPY/-GN",44092507X,CDM,440,RC,92507,CPT,OUTPATIENT,,,452,293.8,GN,397.76,88,,318.21,,,0,"percent of total billed charges","88% of total billed charges",77.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.79,100,,,,,0,"fee schedule","100% of WA fee schedule",452,100,,361.60,,,0,"percent of total billed charges","100% of total billed charges",134.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",44.79,100,,,,,0,"fee schedule","100% of WA fee schedule",77.61,100,,,,,0,"fee schedule","100% of CMS fee sv",284.76,63,,227.81,,,0,"percent of total billed charges","63% of total billed charges",69.16,15.3,,55.33,,,0,"percent of total billed charges","15.3% of total billed charges",44.79,100,,,,,0,"fee schedule","100% of WA fee schedule",311.88,69,,,,,0,"fee schedule","69% of total billed charges",452,100,,361.60,,,0,"percent of total billed charges","100% of total billed charges",77.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",452,100,,361.60,,,0,"percent of total billed charges","100% of total billed charges",77.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",452,100,,361.60,,,0,"percent of total billed charges","100% of total billed charges",77.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",298.89,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",44.79,100,,,,,0,"fee schedule","100% of WA fee schedule",77.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.42,100,,,,,0,"fee schedule","100% of LI fee schedule",44.79,100,,,,,0,"fee schedule","100% of WA fee schedule",77.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.69,102,,,,,0,"fee schedule","102% of WA fee schedule",58.23,130,,,,,0,"fee schedule","130% of WA fee schedule",77.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.4,37.7,,136.32,,,0,"percent of total billed charges","37.7% of total billed charges",170.4,37.7,,136.32,,,0,"percent of total billed charges","37.70% of total billed charges",77.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",153.23,33.9,,122.58,,,0,"percent of total billed charges","33.9% of total billed charges",77.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",352.56,78,,282.05,,,0,"percent of total billed charges","78% of total billed charges",78.39,101,,,,,0,"fee schedule","101% of CMS fee schedule ",373.35,82.6,,298.68,,,0,"percent of total billed charges","82.6% of total billed charges",44.79,100,,,,,0,"fee schedule","100% of WA fee schedule",77.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",373.35,82.6,,298.68,,,0,"percent of total billed charges","82.6% of total billed charges",77.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.79,100,,,,,0,"fee schedule","100% of WA fee schedule",452,100,,361.60,,,0,"percent of total billed charges","100% of total billed charges",44.79,452,
"DYSPH/FEED DYSFN TRMT/-GN",44092526X,CDM,440,RC,92526,CPT,OUTPATIENT,,,452,293.8,GN,397.76,88,,318.21,,,0,"percent of total billed charges","88% of total billed charges",86.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",452,100,,361.60,,,0,"percent of total billed charges","100% of total billed charges",150.01,175,,,,,0,"fee schedule","175% of CMS fee schedule",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",86.22,100,,,,,0,"fee schedule","100% of CMS fee sv",284.76,63,,227.81,,,0,"percent of total billed charges","63% of total billed charges",69.16,15.3,,55.33,,,0,"percent of total billed charges","15.3% of total billed charges",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",311.88,69,,,,,0,"fee schedule","69% of total billed charges",452,100,,361.60,,,0,"percent of total billed charges","100% of total billed charges",85.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",452,100,,361.60,,,0,"percent of total billed charges","100% of total billed charges",86.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",452,100,,361.60,,,0,"percent of total billed charges","100% of total billed charges",86.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",331.32,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",86.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",84.83,100,,,,,0,"fee schedule","100% of LI fee schedule",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",86.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.92,102,,,,,0,"fee schedule","102% of WA fee schedule",64.9,130,,,,,0,"fee schedule","130% of WA fee schedule",86.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",170.4,37.7,,136.32,,,0,"percent of total billed charges","37.7% of total billed charges",170.4,37.7,,136.32,,,0,"percent of total billed charges","37.70% of total billed charges",86.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",153.23,33.9,,122.58,,,0,"percent of total billed charges","33.9% of total billed charges",86.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",352.56,78,,282.05,,,0,"percent of total billed charges","78% of total billed charges",87.08,101,,,,,0,"fee schedule","101% of CMS fee schedule ",373.35,82.6,,298.68,,,0,"percent of total billed charges","82.6% of total billed charges",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",86.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",373.35,82.6,,298.68,,,0,"percent of total billed charges","82.6% of total billed charges",86.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",452,100,,361.60,,,0,"percent of total billed charges","100% of total billed charges",49.92,452,
"DYSPH/ORAL FEED EVAL/-GN",44092610X,CDM,440,RC,92610,CPT,OUTPATIENT,,,1436,933.4,GN,1263.68,88,,1010.94,,,0,"percent of total billed charges","88% of total billed charges",70.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",1436,100,,1148.80,,,0,"percent of total billed charges","100% of total billed charges",123.01,175,,,,,0,"fee schedule","175% of CMS fee schedule",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",70.95,100,,,,,0,"fee schedule","100% of CMS fee sv",904.68,63,,723.74,,,0,"percent of total billed charges","63% of total billed charges",219.71,15.3,,175.77,,,0,"percent of total billed charges","15.3% of total billed charges",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",990.84,69,,,,,0,"fee schedule","69% of total billed charges",1436,100,,1148.80,,,0,"percent of total billed charges","100% of total billed charges",70.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",1436,100,,1148.80,,,0,"percent of total billed charges","100% of total billed charges",70.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",1436,100,,1148.80,,,0,"percent of total billed charges","100% of total billed charges",70.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",270.47,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",70.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.91,100,,,,,0,"fee schedule","100% of LI fee schedule",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",70.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.92,102,,,,,0,"fee schedule","102% of WA fee schedule",64.9,130,,,,,0,"fee schedule","130% of WA fee schedule",70.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",541.37,37.7,,433.10,,,0,"percent of total billed charges","37.7% of total billed charges",541.37,37.7,,433.10,,,0,"percent of total billed charges","37.70% of total billed charges",70.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",486.8,33.9,,389.44,,,0,"percent of total billed charges","33.9% of total billed charges",70.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",1120.08,78,,896.06,,,0,"percent of total billed charges","78% of total billed charges",71.66,101,,,,,0,"fee schedule","101% of CMS fee schedule ",1186.14,82.6,,948.91,,,0,"percent of total billed charges","82.6% of total billed charges",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",70.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",1186.14,82.6,,948.91,,,0,"percent of total billed charges","82.6% of total billed charges",70.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",1436,100,,1148.80,,,0,"percent of total billed charges","100% of total billed charges",49.92,1436,
"EVAL SPEECH FLUENCY",44492521X,CDM,444,RC,92521,CPT,OUTPATIENT,,,679,441.35,GN,597.52,88,,478.02,,,0,"percent of total billed charges","88% of total billed charges",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.01,100,,,,,0,"fee schedule","100% of WA fee schedule",679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",234.85,175,,,,,0,"fee schedule","175% of CMS fee schedule",78.01,100,,,,,0,"fee schedule","100% of WA fee schedule",135.19,100,,,,,0,"fee schedule","100% of CMS fee sv",427.77,63,,342.22,,,0,"percent of total billed charges","63% of total billed charges",103.89,15.3,,83.11,,,0,"percent of total billed charges","15.3% of total billed charges",78.01,100,,,,,0,"fee schedule","100% of WA fee schedule",468.51,69,,,,,0,"fee schedule","69% of total billed charges",679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",134.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",523.07,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",78.01,100,,,,,0,"fee schedule","100% of WA fee schedule",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",133.09,100,,,,,0,"fee schedule","100% of LI fee schedule",78.01,100,,,,,0,"fee schedule","100% of WA fee schedule",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.57,102,,,,,0,"fee schedule","102% of WA fee schedule",101.41,130,,,,,0,"fee schedule","130% of WA fee schedule",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",255.98,37.7,,204.78,,,0,"percent of total billed charges","37.7% of total billed charges",255.98,37.7,,204.78,,,0,"percent of total billed charges","37.70% of total billed charges",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",230.18,33.9,,184.14,,,0,"percent of total billed charges","33.9% of total billed charges",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",529.62,78,,423.70,,,0,"percent of total billed charges","78% of total billed charges",136.54,101,,,,,0,"fee schedule","101% of CMS fee schedule ",560.85,82.6,,448.68,,,0,"percent of total billed charges","82.6% of total billed charges",78.01,100,,,,,0,"fee schedule","100% of WA fee schedule",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",560.85,82.6,,448.68,,,0,"percent of total billed charges","82.6% of total billed charges",135.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.01,100,,,,,0,"fee schedule","100% of WA fee schedule",679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",78.01,679,
"EVAL USE/FIT VOICE PROSTH/GN",44192597X,CDM,440,RC,92597,CPT,OUTPATIENT,,,2333,1516.45,GN,2053.04,88,,1642.43,,,0,"percent of total billed charges","88% of total billed charges",73.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.95,100,,,,,0,"fee schedule","100% of WA fee schedule",2333,100,,1866.40,,,0,"percent of total billed charges","100% of total billed charges",127.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",41.95,100,,,,,0,"fee schedule","100% of WA fee schedule",73.42,100,,,,,0,"fee schedule","100% of CMS fee sv",1469.79,63,,1175.83,,,0,"percent of total billed charges","63% of total billed charges",356.95,15.3,,285.56,,,0,"percent of total billed charges","15.3% of total billed charges",41.95,100,,,,,0,"fee schedule","100% of WA fee schedule",1609.77,69,,,,,0,"fee schedule","69% of total billed charges",2333,100,,1866.40,,,0,"percent of total billed charges","100% of total billed charges",72.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",2333,100,,1866.40,,,0,"percent of total billed charges","100% of total billed charges",73.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",2333,100,,1866.40,,,0,"percent of total billed charges","100% of total billed charges",73.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",277.31,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",41.95,100,,,,,0,"fee schedule","100% of WA fee schedule",73.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.29,100,,,,,0,"fee schedule","100% of LI fee schedule",41.95,100,,,,,0,"fee schedule","100% of WA fee schedule",73.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.79,102,,,,,0,"fee schedule","102% of WA fee schedule",54.54,130,,,,,0,"fee schedule","130% of WA fee schedule",73.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",879.54,37.7,,703.63,,,0,"percent of total billed charges","37.7% of total billed charges",879.54,37.7,,703.63,,,0,"percent of total billed charges","37.70% of total billed charges",73.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",790.89,33.9,,632.71,,,0,"percent of total billed charges","33.9% of total billed charges",73.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",1819.74,78,,1455.79,,,0,"percent of total billed charges","78% of total billed charges",74.15,101,,,,,0,"fee schedule","101% of CMS fee schedule ",1927.06,82.6,,1541.65,,,0,"percent of total billed charges","82.6% of total billed charges",41.95,100,,,,,0,"fee schedule","100% of WA fee schedule",73.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",1927.06,82.6,,1541.65,,,0,"percent of total billed charges","82.6% of total billed charges",73.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.95,100,,,,,0,"fee schedule","100% of WA fee schedule",2333,100,,1866.40,,,0,"percent of total billed charges","100% of total billed charges",41.95,2333,
"MODIFY/TRAIN VOICE PROSTHETIC",44092609X,CDM,440,RC,92609,CPT,OUTPATIENT,,,508,330.2,GN,447.04,88,,357.63,,,0,"percent of total billed charges","88% of total billed charges",105.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.93,100,,,,,0,"fee schedule","100% of WA fee schedule",508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",183.21,175,,,,,0,"fee schedule","175% of CMS fee schedule",60.93,100,,,,,0,"fee schedule","100% of WA fee schedule",105.35,100,,,,,0,"fee schedule","100% of CMS fee sv",320.04,63,,256.03,,,0,"percent of total billed charges","63% of total billed charges",77.72,15.3,,62.18,,,0,"percent of total billed charges","15.3% of total billed charges",60.93,100,,,,,0,"fee schedule","100% of WA fee schedule",350.52,69,,,,,0,"fee schedule","69% of total billed charges",508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",104.69,100,,,,,0,"fee schedule","100% of CMS fee schedule",508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",105.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",105.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",409.5,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",60.93,100,,,,,0,"fee schedule","100% of WA fee schedule",105.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",103.57,100,,,,,0,"fee schedule","100% of LI fee schedule",60.93,100,,,,,0,"fee schedule","100% of WA fee schedule",105.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.15,102,,,,,0,"fee schedule","102% of WA fee schedule",79.21,130,,,,,0,"fee schedule","130% of WA fee schedule",105.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",191.52,37.7,,153.22,,,0,"percent of total billed charges","37.7% of total billed charges",191.52,37.7,,153.22,,,0,"percent of total billed charges","37.70% of total billed charges",105.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",172.21,33.9,,137.77,,,0,"percent of total billed charges","33.9% of total billed charges",105.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",396.24,78,,316.99,,,0,"percent of total billed charges","78% of total billed charges",106.4,101,,,,,0,"fee schedule","101% of CMS fee schedule ",419.61,82.6,,335.69,,,0,"percent of total billed charges","82.6% of total billed charges",60.93,100,,,,,0,"fee schedule","100% of WA fee schedule",105.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",419.61,82.6,,335.69,,,0,"percent of total billed charges","82.6% of total billed charges",105.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.93,100,,,,,0,"fee schedule","100% of WA fee schedule",508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",60.93,508,
"SPEECH THERAPY GROUP",44092508X,CDM,440,RC,92508,CPT,OUTPATIENT,,,217,141.05,GN,190.96,88,,152.77,,,0,"percent of total billed charges","88% of total billed charges",24.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.05,100,,,,,0,"fee schedule","100% of WA fee schedule",217,100,,173.60,,,0,"percent of total billed charges","100% of total billed charges",43.16,175,,,,,0,"fee schedule","175% of CMS fee schedule",14.05,100,,,,,0,"fee schedule","100% of WA fee schedule",24.83,100,,,,,0,"fee schedule","100% of CMS fee sv",136.71,63,,109.37,,,0,"percent of total billed charges","63% of total billed charges",33.2,15.3,,26.56,,,0,"percent of total billed charges","15.3% of total billed charges",14.05,100,,,,,0,"fee schedule","100% of WA fee schedule",149.73,69,,,,,0,"fee schedule","69% of total billed charges",217,100,,173.60,,,0,"percent of total billed charges","100% of total billed charges",24.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",217,100,,173.60,,,0,"percent of total billed charges","100% of total billed charges",24.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",217,100,,173.60,,,0,"percent of total billed charges","100% of total billed charges",24.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.37,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",14.05,100,,,,,0,"fee schedule","100% of WA fee schedule",24.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.39,100,,,,,0,"fee schedule","100% of LI fee schedule",14.05,100,,,,,0,"fee schedule","100% of WA fee schedule",24.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.33,102,,,,,0,"fee schedule","102% of WA fee schedule",18.27,130,,,,,0,"fee schedule","130% of WA fee schedule",24.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.81,37.7,,65.45,,,0,"percent of total billed charges","37.7% of total billed charges",81.81,37.7,,65.45,,,0,"percent of total billed charges","37.70% of total billed charges",24.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.56,33.9,,58.85,,,0,"percent of total billed charges","33.9% of total billed charges",24.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",169.26,78,,135.41,,,0,"percent of total billed charges","78% of total billed charges",25.08,101,,,,,0,"fee schedule","101% of CMS fee schedule ",179.24,82.6,,143.39,,,0,"percent of total billed charges","82.6% of total billed charges",14.05,100,,,,,0,"fee schedule","100% of WA fee schedule",24.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",179.24,82.6,,143.39,,,0,"percent of total billed charges","82.6% of total billed charges",24.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.05,100,,,,,0,"fee schedule","100% of WA fee schedule",217,100,,173.60,,,0,"percent of total billed charges","100% of total billed charges",14.05,217,
"EVAL SPEECH DEVICE ADD 30MIN",44092608X,CDM,440,RC,92608,CPT,OUTPATIENT,,,334,217.1,GN,293.92,88,,235.14,,,0,"percent of total billed charges","88% of total billed charges",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.66,100,,,,,0,"fee schedule","100% of WA fee schedule",334,100,,267.20,,,0,"percent of total billed charges","100% of total billed charges",86.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",28.66,100,,,,,0,"fee schedule","100% of WA fee schedule",49.61,100,,,,,0,"fee schedule","100% of CMS fee sv",210.42,63,,168.34,,,0,"percent of total billed charges","63% of total billed charges",51.1,15.3,,40.88,,,0,"percent of total billed charges","15.3% of total billed charges",28.66,100,,,,,0,"fee schedule","100% of WA fee schedule",230.46,69,,,,,0,"fee schedule","69% of total billed charges",334,100,,267.20,,,0,"percent of total billed charges","100% of total billed charges",49.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",334,100,,267.20,,,0,"percent of total billed charges","100% of total billed charges",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",334,100,,267.20,,,0,"percent of total billed charges","100% of total billed charges",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",196.18,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",28.66,100,,,,,0,"fee schedule","100% of WA fee schedule",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.77,100,,,,,0,"fee schedule","100% of LI fee schedule",28.66,100,,,,,0,"fee schedule","100% of WA fee schedule",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.23,102,,,,,0,"fee schedule","102% of WA fee schedule",37.26,130,,,,,0,"fee schedule","130% of WA fee schedule",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",125.92,37.7,,100.74,,,0,"percent of total billed charges","37.7% of total billed charges",125.92,37.7,,100.74,,,0,"percent of total billed charges","37.70% of total billed charges",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.23,33.9,,90.58,,,0,"percent of total billed charges","33.9% of total billed charges",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",260.52,78,,208.42,,,0,"percent of total billed charges","78% of total billed charges",50.11,101,,,,,0,"fee schedule","101% of CMS fee schedule ",275.88,82.6,,220.70,,,0,"percent of total billed charges","82.6% of total billed charges",28.66,100,,,,,0,"fee schedule","100% of WA fee schedule",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",275.88,82.6,,220.70,,,0,"percent of total billed charges","82.6% of total billed charges",49.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.66,100,,,,,0,"fee schedule","100% of WA fee schedule",334,100,,267.20,,,0,"percent of total billed charges","100% of total billed charges",28.66,334,
"EVAL SPEECH DEVICE INITIAL HR",44092607X,CDM,440,RC,92607,CPT,OUTPATIENT,,,741,481.65,GN,652.08,88,,521.66,,,0,"percent of total billed charges","88% of total billed charges",126.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.07,100,,,,,0,"fee schedule","100% of WA fee schedule",741,100,,592.80,,,0,"percent of total billed charges","100% of total billed charges",219.68,175,,,,,0,"fee schedule","175% of CMS fee schedule",73.07,100,,,,,0,"fee schedule","100% of WA fee schedule",126.35,100,,,,,0,"fee schedule","100% of CMS fee sv",466.83,63,,373.46,,,0,"percent of total billed charges","63% of total billed charges",113.37,15.3,,90.70,,,0,"percent of total billed charges","15.3% of total billed charges",73.07,100,,,,,0,"fee schedule","100% of WA fee schedule",511.29,69,,,,,0,"fee schedule","69% of total billed charges",741,100,,592.80,,,0,"percent of total billed charges","100% of total billed charges",125.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",741,100,,592.80,,,0,"percent of total billed charges","100% of total billed charges",126.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",741,100,,592.80,,,0,"percent of total billed charges","100% of total billed charges",126.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",489.68,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",73.07,100,,,,,0,"fee schedule","100% of WA fee schedule",126.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.25,100,,,,,0,"fee schedule","100% of LI fee schedule",73.07,100,,,,,0,"fee schedule","100% of WA fee schedule",126.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.53,102,,,,,0,"fee schedule","102% of WA fee schedule",94.99,130,,,,,0,"fee schedule","130% of WA fee schedule",126.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",279.36,37.7,,223.49,,,0,"percent of total billed charges","37.7% of total billed charges",279.36,37.7,,223.49,,,0,"percent of total billed charges","37.70% of total billed charges",126.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.2,33.9,,200.96,,,0,"percent of total billed charges","33.9% of total billed charges",126.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",577.98,78,,462.38,,,0,"percent of total billed charges","78% of total billed charges",127.61,101,,,,,0,"fee schedule","101% of CMS fee schedule ",612.07,82.6,,489.66,,,0,"percent of total billed charges","82.6% of total billed charges",73.07,100,,,,,0,"fee schedule","100% of WA fee schedule",126.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",612.07,82.6,,489.66,,,0,"percent of total billed charges","82.6% of total billed charges",126.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.07,100,,,,,0,"fee schedule","100% of WA fee schedule",741,100,,592.80,,,0,"percent of total billed charges","100% of total billed charges",73.07,741,
"APHASIA ASSESS/REP/HR/-GN",44096105X,CDM,440,RC,96105,CPT,OUTPATIENT,,,1713,1113.45,GN,1507.44,88,,1205.95,,,0,"percent of total billed charges","88% of total billed charges",97.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",521.69,100,,,,,0,"fee schedule",EAPG,1713,100,,1370.40,,,0,"percent of total billed charges","100% of total billed charges",168.12,175,,,,,0,"fee schedule","175% of CMS fee schedule",537.34,100,,,,,0,"fee schedule",EAPG,97.22,100,,,,,0,"fee schedule","100% of CMS fee sv",1079.19,63,,863.35,,,0,"percent of total billed charges","63% of total billed charges",262.09,15.3,,209.67,,,0,"percent of total billed charges","15.3% of total billed charges",521.69,100,,,,,0,"fee schedule",EAPG,1181.97,69,,,,,0,"fee schedule","69% of total billed charges",1713,100,,1370.40,,,0,"percent of total billed charges","100% of total billed charges",96.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",1713,100,,1370.40,,,0,"percent of total billed charges","100% of total billed charges",97.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",1713,100,,1370.40,,,0,"percent of total billed charges","100% of total billed charges",97.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",386.94,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",521.69,100,,,,,0,"fee schedule",EAPG,97.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.76,100,,,,,0,"fee schedule","100% of LI fee schedule",386.44,100,,,,,0,"fee schedule",EAPG,97.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",532.13,100,,,,,0,"fee schedule",EAPG,678.2,100,,,,,0,"fee schedule",EAPG,97.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",645.8,37.7,,516.64,,,0,"percent of total billed charges","37.7% of total billed charges",645.8,37.7,,516.64,,,0,"percent of total billed charges","37.70% of total billed charges",97.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",580.71,33.9,,464.57,,,0,"percent of total billed charges","33.9% of total billed charges",97.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",1336.14,78,,1068.91,,,0,"percent of total billed charges","78% of total billed charges",98.19,101,,,,,0,"fee schedule","101% of CMS fee schedule ",1414.94,82.6,,1131.95,,,0,"percent of total billed charges","82.6% of total billed charges",521.69,100,,,,,0,"fee schedule","100% of WA fee schedule",97.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",1414.94,82.6,,1131.95,,,0,"percent of total billed charges","82.6% of total billed charges",97.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",521.69,100,,,,,0,"fee schedule",EAPG,1713,100,,1370.40,,,0,"percent of total billed charges","100% of total billed charges",95.76,1713,
"EVAL SPEECH DEVICE ADD 30MIN",44092608X,CDM,440,RC,92608,CPT,OUTPATIENT,,,334,217.1,GN,293.92,88,,235.14,,,0,"percent of total billed charges","88% of total billed charges",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.66,100,,,,,0,"fee schedule","100% of WA fee schedule",334,100,,267.20,,,0,"percent of total billed charges","100% of total billed charges",86.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",28.66,100,,,,,0,"fee schedule","100% of WA fee schedule",49.61,100,,,,,0,"fee schedule","100% of CMS fee sv",210.42,63,,168.34,,,0,"percent of total billed charges","63% of total billed charges",51.1,15.3,,40.88,,,0,"percent of total billed charges","15.3% of total billed charges",28.66,100,,,,,0,"fee schedule","100% of WA fee schedule",230.46,69,,,,,0,"fee schedule","69% of total billed charges",334,100,,267.20,,,0,"percent of total billed charges","100% of total billed charges",49.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",334,100,,267.20,,,0,"percent of total billed charges","100% of total billed charges",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",334,100,,267.20,,,0,"percent of total billed charges","100% of total billed charges",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",196.18,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",28.66,100,,,,,0,"fee schedule","100% of WA fee schedule",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.77,100,,,,,0,"fee schedule","100% of LI fee schedule",28.66,100,,,,,0,"fee schedule","100% of WA fee schedule",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.23,102,,,,,0,"fee schedule","102% of WA fee schedule",37.26,130,,,,,0,"fee schedule","130% of WA fee schedule",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",125.92,37.7,,100.74,,,0,"percent of total billed charges","37.7% of total billed charges",125.92,37.7,,100.74,,,0,"percent of total billed charges","37.70% of total billed charges",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",113.23,33.9,,90.58,,,0,"percent of total billed charges","33.9% of total billed charges",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",260.52,78,,208.42,,,0,"percent of total billed charges","78% of total billed charges",50.11,101,,,,,0,"fee schedule","101% of CMS fee schedule ",275.88,82.6,,220.70,,,0,"percent of total billed charges","82.6% of total billed charges",28.66,100,,,,,0,"fee schedule","100% of WA fee schedule",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",275.88,82.6,,220.70,,,0,"percent of total billed charges","82.6% of total billed charges",49.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.66,100,,,,,0,"fee schedule","100% of WA fee schedule",334,100,,267.20,,,0,"percent of total billed charges","100% of total billed charges",28.66,334,
"MODIFY/TRAIN VOICE PROSTHETIC",44092609X,CDM,440,RC,92609,CPT,OUTPATIENT,,,508,330.2,GN,447.04,88,,357.63,,,0,"percent of total billed charges","88% of total billed charges",105.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.93,100,,,,,0,"fee schedule","100% of WA fee schedule",508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",183.21,175,,,,,0,"fee schedule","175% of CMS fee schedule",60.93,100,,,,,0,"fee schedule","100% of WA fee schedule",105.35,100,,,,,0,"fee schedule","100% of CMS fee sv",320.04,63,,256.03,,,0,"percent of total billed charges","63% of total billed charges",77.72,15.3,,62.18,,,0,"percent of total billed charges","15.3% of total billed charges",60.93,100,,,,,0,"fee schedule","100% of WA fee schedule",350.52,69,,,,,0,"fee schedule","69% of total billed charges",508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",104.69,100,,,,,0,"fee schedule","100% of CMS fee schedule",508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",105.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",105.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",409.5,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",60.93,100,,,,,0,"fee schedule","100% of WA fee schedule",105.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",103.57,100,,,,,0,"fee schedule","100% of LI fee schedule",60.93,100,,,,,0,"fee schedule","100% of WA fee schedule",105.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.15,102,,,,,0,"fee schedule","102% of WA fee schedule",79.21,130,,,,,0,"fee schedule","130% of WA fee schedule",105.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",191.52,37.7,,153.22,,,0,"percent of total billed charges","37.7% of total billed charges",191.52,37.7,,153.22,,,0,"percent of total billed charges","37.70% of total billed charges",105.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",172.21,33.9,,137.77,,,0,"percent of total billed charges","33.9% of total billed charges",105.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",396.24,78,,316.99,,,0,"percent of total billed charges","78% of total billed charges",106.4,101,,,,,0,"fee schedule","101% of CMS fee schedule ",419.61,82.6,,335.69,,,0,"percent of total billed charges","82.6% of total billed charges",60.93,100,,,,,0,"fee schedule","100% of WA fee schedule",105.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",419.61,82.6,,335.69,,,0,"percent of total billed charges","82.6% of total billed charges",105.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.93,100,,,,,0,"fee schedule","100% of WA fee schedule",508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",60.93,508,
"COGNITIVE TEST PER HOUR",44096125X,CDM,440,RC,96125,CPT,OUTPATIENT,,,1102,716.3,GN,969.76,88,,775.81,,,0,"percent of total billed charges","88% of total billed charges",103.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",521.69,100,,,,,0,"fee schedule",EAPG,1102,100,,881.60,,,0,"percent of total billed charges","100% of total billed charges",180.16,175,,,,,0,"fee schedule","175% of CMS fee schedule",537.34,100,,,,,0,"fee schedule",EAPG,103.93,100,,,,,0,"fee schedule","100% of CMS fee sv",694.26,63,,555.41,,,0,"percent of total billed charges","63% of total billed charges",168.61,15.3,,134.89,,,0,"percent of total billed charges","15.3% of total billed charges",521.69,100,,,,,0,"fee schedule",EAPG,760.38,69,,,,,0,"fee schedule","69% of total billed charges",1102,100,,881.60,,,0,"percent of total billed charges","100% of total billed charges",102.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",1102,100,,881.60,,,0,"percent of total billed charges","100% of total billed charges",103.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",1102,100,,881.60,,,0,"percent of total billed charges","100% of total billed charges",103.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",409.05,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",521.69,100,,,,,0,"fee schedule",EAPG,103.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",102.29,100,,,,,0,"fee schedule","100% of LI fee schedule",386.44,100,,,,,0,"fee schedule",EAPG,103.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",532.13,100,,,,,0,"fee schedule",EAPG,678.2,100,,,,,0,"fee schedule",EAPG,103.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",415.45,37.7,,332.36,,,0,"percent of total billed charges","37.7% of total billed charges",415.45,37.7,,332.36,,,0,"percent of total billed charges","37.70% of total billed charges",103.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",373.58,33.9,,298.86,,,0,"percent of total billed charges","33.9% of total billed charges",103.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",859.56,78,,687.65,,,0,"percent of total billed charges","78% of total billed charges",104.97,101,,,,,0,"fee schedule","101% of CMS fee schedule ",910.25,82.6,,728.20,,,0,"percent of total billed charges","82.6% of total billed charges",521.69,100,,,,,0,"fee schedule",EAPG,103.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",910.25,82.6,,728.20,,,0,"percent of total billed charges","82.6% of total billed charges",103.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",521.69,100,,,,,0,"fee schedule",EAPG,1102,100,,881.60,,,0,"percent of total billed charges","100% of total billed charges",102.29,1102,
"EVAL SPEECH FLUENCY",44492521X,CDM,444,RC,92521,CPT,OUTPATIENT,,,679,441.35,GN,597.52,88,,478.02,,,0,"percent of total billed charges","88% of total billed charges",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.01,100,,,,,0,"fee schedule","100% of WA fee schedule",679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",234.85,175,,,,,0,"fee schedule","175% of CMS fee schedule",78.01,100,,,,,0,"fee schedule","100% of WA fee schedule",135.19,100,,,,,0,"fee schedule","100% of CMS fee sv",427.77,63,,342.22,,,0,"percent of total billed charges","63% of total billed charges",103.89,15.3,,83.11,,,0,"percent of total billed charges","15.3% of total billed charges",78.01,100,,,,,0,"fee schedule","100% of WA fee schedule",468.51,69,,,,,0,"fee schedule","69% of total billed charges",679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",134.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",523.07,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",78.01,100,,,,,0,"fee schedule","100% of WA fee schedule",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",133.09,100,,,,,0,"fee schedule","100% of LI fee schedule",78.01,100,,,,,0,"fee schedule","100% of WA fee schedule",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.57,102,,,,,0,"fee schedule","102% of WA fee schedule",101.41,130,,,,,0,"fee schedule","130% of WA fee schedule",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",255.98,37.7,,204.78,,,0,"percent of total billed charges","37.7% of total billed charges",255.98,37.7,,204.78,,,0,"percent of total billed charges","37.70% of total billed charges",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",230.18,33.9,,184.14,,,0,"percent of total billed charges","33.9% of total billed charges",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",529.62,78,,423.70,,,0,"percent of total billed charges","78% of total billed charges",136.54,101,,,,,0,"fee schedule","101% of CMS fee schedule ",560.85,82.6,,448.68,,,0,"percent of total billed charges","82.6% of total billed charges",78.01,100,,,,,0,"fee schedule","100% of WA fee schedule",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",560.85,82.6,,448.68,,,0,"percent of total billed charges","82.6% of total billed charges",135.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.01,100,,,,,0,"fee schedule","100% of WA fee schedule",679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",78.01,679,
"EVAL SOUND PROD",44492522X,CDM,444,RC,92522,CPT,OUTPATIENT,,,679,441.35,GN,597.52,88,,478.02,,,0,"percent of total billed charges","88% of total billed charges",112.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.91,100,,,,,0,"fee schedule","100% of WA fee schedule",679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",195.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",64.91,100,,,,,0,"fee schedule","100% of WA fee schedule",112.96,100,,,,,0,"fee schedule","100% of CMS fee sv",427.77,63,,342.22,,,0,"percent of total billed charges","63% of total billed charges",103.89,15.3,,83.11,,,0,"percent of total billed charges","15.3% of total billed charges",64.91,100,,,,,0,"fee schedule","100% of WA fee schedule",468.51,69,,,,,0,"fee schedule","69% of total billed charges",679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",111.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",112.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",112.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",436.7,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",64.91,100,,,,,0,"fee schedule","100% of WA fee schedule",112.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",111.21,100,,,,,0,"fee schedule","100% of LI fee schedule",64.91,100,,,,,0,"fee schedule","100% of WA fee schedule",112.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.21,102,,,,,0,"fee schedule","102% of WA fee schedule",84.38,130,,,,,0,"fee schedule","130% of WA fee schedule",112.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",255.98,37.7,,204.78,,,0,"percent of total billed charges","37.7% of total billed charges",255.98,37.7,,204.78,,,0,"percent of total billed charges","37.70% of total billed charges",112.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",230.18,33.9,,184.14,,,0,"percent of total billed charges","33.9% of total billed charges",112.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",529.62,78,,423.70,,,0,"percent of total billed charges","78% of total billed charges",114.09,101,,,,,0,"fee schedule","101% of CMS fee schedule ",560.85,82.6,,448.68,,,0,"percent of total billed charges","82.6% of total billed charges",64.91,100,,,,,0,"fee schedule","100% of WA fee schedule",112.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",560.85,82.6,,448.68,,,0,"percent of total billed charges","82.6% of total billed charges",113.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.91,100,,,,,0,"fee schedule","100% of WA fee schedule",679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",64.91,679,
"EVAL SOUND PROD W/ LANG COMP",44492523X,CDM,444,RC,92523,CPT,OUTPATIENT,,,874,568.1,GN,769.12,88,,615.30,,,0,"percent of total billed charges","88% of total billed charges",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",133.62,100,,,,,0,"fee schedule","100% of WA fee schedule",874,100,,699.20,,,0,"percent of total billed charges","100% of total billed charges",402.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",133.62,100,,,,,0,"fee schedule","100% of WA fee schedule",231.78,100,,,,,0,"fee schedule","100% of CMS fee sv",550.62,63,,440.50,,,0,"percent of total billed charges","63% of total billed charges",133.72,15.3,,106.98,,,0,"percent of total billed charges","15.3% of total billed charges",133.62,100,,,,,0,"fee schedule","100% of WA fee schedule",603.06,69,,,,,0,"fee schedule","69% of total billed charges",874,100,,699.20,,,0,"percent of total billed charges","100% of total billed charges",230.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",874,100,,699.20,,,0,"percent of total billed charges","100% of total billed charges",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",874,100,,699.20,,,0,"percent of total billed charges","100% of total billed charges",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",899.56,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",133.62,100,,,,,0,"fee schedule","100% of WA fee schedule",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",228.18,100,,,,,0,"fee schedule","100% of LI fee schedule",133.62,100,,,,,0,"fee schedule","100% of WA fee schedule",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.29,102,,,,,0,"fee schedule","102% of WA fee schedule",173.71,130,,,,,0,"fee schedule","130% of WA fee schedule",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",329.5,37.7,,263.60,,,0,"percent of total billed charges","37.7% of total billed charges",329.5,37.7,,263.60,,,0,"percent of total billed charges","37.70% of total billed charges",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",296.29,33.9,,237.03,,,0,"percent of total billed charges","33.9% of total billed charges",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",681.72,78,,545.38,,,0,"percent of total billed charges","78% of total billed charges",234.1,101,,,,,0,"fee schedule","101% of CMS fee schedule ",721.92,82.6,,577.54,,,0,"percent of total billed charges","82.6% of total billed charges",133.62,100,,,,,0,"fee schedule","100% of WA fee schedule",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",721.92,82.6,,577.54,,,0,"percent of total billed charges","82.6% of total billed charges",231.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",133.62,100,,,,,0,"fee schedule","100% of WA fee schedule",874,100,,699.20,,,0,"percent of total billed charges","100% of total billed charges",133.62,899.56,
"EVAL SOUND PROD W/ LANG COMP",44492523X,CDM,444,RC,92523,CPT,OUTPATIENT,,,874,568.1,GN,769.12,88,,615.30,,,0,"percent of total billed charges","88% of total billed charges",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",133.62,100,,,,,0,"fee schedule","100% of WA fee schedule",874,100,,699.20,,,0,"percent of total billed charges","100% of total billed charges",402.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",133.62,100,,,,,0,"fee schedule","100% of WA fee schedule",231.78,100,,,,,0,"fee schedule","100% of CMS fee sv",550.62,63,,440.50,,,0,"percent of total billed charges","63% of total billed charges",133.72,15.3,,106.98,,,0,"percent of total billed charges","15.3% of total billed charges",133.62,100,,,,,0,"fee schedule","100% of WA fee schedule",603.06,69,,,,,0,"fee schedule","69% of total billed charges",874,100,,699.20,,,0,"percent of total billed charges","100% of total billed charges",230.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",874,100,,699.20,,,0,"percent of total billed charges","100% of total billed charges",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",874,100,,699.20,,,0,"percent of total billed charges","100% of total billed charges",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",899.56,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",133.62,100,,,,,0,"fee schedule","100% of WA fee schedule",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",228.18,100,,,,,0,"fee schedule","100% of LI fee schedule",133.62,100,,,,,0,"fee schedule","100% of WA fee schedule",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.29,102,,,,,0,"fee schedule","102% of WA fee schedule",173.71,130,,,,,0,"fee schedule","130% of WA fee schedule",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",329.5,37.7,,263.60,,,0,"percent of total billed charges","37.7% of total billed charges",329.5,37.7,,263.60,,,0,"percent of total billed charges","37.70% of total billed charges",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",296.29,33.9,,237.03,,,0,"percent of total billed charges","33.9% of total billed charges",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",681.72,78,,545.38,,,0,"percent of total billed charges","78% of total billed charges",234.1,101,,,,,0,"fee schedule","101% of CMS fee schedule ",721.92,82.6,,577.54,,,0,"percent of total billed charges","82.6% of total billed charges",133.62,100,,,,,0,"fee schedule","100% of WA fee schedule",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",721.92,82.6,,577.54,,,0,"percent of total billed charges","82.6% of total billed charges",231.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",133.62,100,,,,,0,"fee schedule","100% of WA fee schedule",874,100,,699.20,,,0,"percent of total billed charges","100% of total billed charges",133.62,899.56,
"ANALYSIS QUAL VOICE  RESONANC",44492524X,CDM,444,RC,92524,CPT,OUTPATIENT,,,679,441.35,GN,597.52,88,,478.02,,,0,"percent of total billed charges","88% of total billed charges",111.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.15,100,,,,,0,"fee schedule","100% of WA fee schedule",679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",192.64,175,,,,,0,"fee schedule","175% of CMS fee schedule",64.15,100,,,,,0,"fee schedule","100% of WA fee schedule",111.23,100,,,,,0,"fee schedule","100% of CMS fee sv",427.77,63,,342.22,,,0,"percent of total billed charges","63% of total billed charges",103.89,15.3,,83.11,,,0,"percent of total billed charges","15.3% of total billed charges",64.15,100,,,,,0,"fee schedule","100% of WA fee schedule",468.51,69,,,,,0,"fee schedule","69% of total billed charges",679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",110.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",111.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",111.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",427.56,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",64.15,100,,,,,0,"fee schedule","100% of WA fee schedule",111.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.52,100,,,,,0,"fee schedule","100% of LI fee schedule",64.15,100,,,,,0,"fee schedule","100% of WA fee schedule",111.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.43,102,,,,,0,"fee schedule","102% of WA fee schedule",83.4,130,,,,,0,"fee schedule","130% of WA fee schedule",111.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",255.98,37.7,,204.78,,,0,"percent of total billed charges","37.7% of total billed charges",255.98,37.7,,204.78,,,0,"percent of total billed charges","37.70% of total billed charges",111.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",230.18,33.9,,184.14,,,0,"percent of total billed charges","33.9% of total billed charges",111.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",529.62,78,,423.70,,,0,"percent of total billed charges","78% of total billed charges",112.34,101,,,,,0,"fee schedule","101% of CMS fee schedule ",560.85,82.6,,448.68,,,0,"percent of total billed charges","82.6% of total billed charges",64.15,100,,,,,0,"fee schedule","100% of WA fee schedule",111.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",560.85,82.6,,448.68,,,0,"percent of total billed charges","82.6% of total billed charges",111.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.15,100,,,,,0,"fee schedule","100% of WA fee schedule",679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",64.15,679,
N/A,,,440,RC,,,OUTPATIENT,,,255,165.75,,224.4,88,,179.52,,,0,"percent of total billed charges","88% of total billed charges",127.5,50,,102.00,,,0,"percent of total billed charges","50% of total billed charges",42.84,16.8,,34.27,,,0,"percent of total billed charges","16.8% of total billed charges",255,100,,204.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.13,17.304,,35.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.65,63,,128.52,,,0,"percent of total billed charges","63% of total billed charges",39.02,15.3,,31.22,,,0,"percent of total billed charges","15.3% of total billed charges",42.84,16.8,,34.27,,,0,"percent of total billed charges","16.8% of total billed charges",175.95,69,,,,,0,"fee schedule","69% of total billed charges",255,100,,204.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",255,100,,204.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",255,100,,204.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",42.84,16.8,,34.27,,,0,"percent of total billed charges","16.8% of total billed charges",127.5,50,,102.00,,,0,"percent of total billed charges","50% of total billed charges",82.11,32.2,,65.69,,,0,"percent of total billed charges","32.2% of total billed charges",42.84,16.8,,34.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.7,17.136,,34.96,,,0,"percent of total billed charges","17.136% of total billed charges",55.69,21.84,,44.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",96.14,37.7,,76.91,,,0,"percent of total billed charges","37.7% of total billed charges",96.14,37.7,,76.91,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.45,33.9,,69.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",198.9,78,,159.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",210.63,82.6,,168.50,,,0,"percent of total billed charges","82.6% of total billed charges",42.84,16.8,,34.27,,,0,"percent of total billed charges","16.8% of total billed charges",127.5,50,,102.00,,,0,"percent of total billed charges","50% of total billed charges",210.63,82.6,,168.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.84,16.8,,34.27,,,0,"percent of total billed charges","16.8% of total billed charges",255,100,,204.00,,,0,"percent of total billed charges","100% of total billed charges",39.02,255,
"95782 POLYSOM <6 YEARS 4/>PARAMETERS",92095782,CDM,920,RC,95782,CPT,OUTPATIENT,,,8189,5322.85,TC,7206.32,88,,5765.06,,,0,"percent of total billed charges","88% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.53,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",1866.21,175,,,,,0,"fee schedule","175% of CMS fee schedule",707.12,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5159.07,63,,4127.26,,,0,"percent of total billed charges","63% of total billed charges",1252.92,15.3,,1002.34,,,0,"percent of total billed charges","15.3% of total billed charges",686.53,100,,,,,0,"fee schedule",EAPG,5650.41,69,,,,,0,"fee schedule","69% of total billed charges",8189,100,,6551.20,,,0,"percent of total billed charges","100% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8189,100,,6551.20,,,0,"percent of total billed charges","100% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8189,100,,6551.20,,,0,"percent of total billed charges","100% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",3736.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.53,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",976.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",508.54,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",700.26,100,,,,,0,"fee schedule",EAPG,892.49,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3087.25,37.7,,2469.80,,,0,"percent of total billed charges","37.7% of total billed charges",3087.25,37.7,,2469.80,,,0,"percent of total billed charges","37.70% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2776.07,33.9,,2220.86,,,0,"percent of total billed charges","33.9% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6387.42,78,,5109.94,,,0,"percent of total billed charges","78% of total billed charges",1077.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6764.11,82.6,,5411.29,,,0,"percent of total billed charges","82.6% of total billed charges",686.53,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6764.11,82.6,,5411.29,,,0,"percent of total billed charges","82.6% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.53,100,,,,,0,"fee schedule",EAPG,8189,100,,6551.20,,,0,"percent of total billed charges","100% of total billed charges",508.54,8189,
"95783 POLYSOM <6YRS CPAP 4/> PARM",92095783,CDM,920,RC,95783,CPT,OUTPATIENT,,,8609,5595.85,TC,7575.92,88,,6060.74,,,0,"percent of total billed charges","88% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.53,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",1866.21,175,,,,,0,"fee schedule","175% of CMS fee schedule",707.12,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5423.67,63,,4338.94,,,0,"percent of total billed charges","63% of total billed charges",1317.18,15.3,,1053.74,,,0,"percent of total billed charges","15.3% of total billed charges",686.53,100,,,,,0,"fee schedule",EAPG,5940.21,69,,,,,0,"fee schedule","69% of total billed charges",8609,100,,6887.20,,,0,"percent of total billed charges","100% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8609,100,,6887.20,,,0,"percent of total billed charges","100% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8609,100,,6887.20,,,0,"percent of total billed charges","100% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",3736.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.53,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",976.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",508.54,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",700.26,100,,,,,0,"fee schedule",EAPG,892.49,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3245.59,37.7,,2596.47,,,0,"percent of total billed charges","37.7% of total billed charges",3245.59,37.7,,2596.47,,,0,"percent of total billed charges","37.70% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2918.45,33.9,,2334.76,,,0,"percent of total billed charges","33.9% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6715.02,78,,5372.02,,,0,"percent of total billed charges","78% of total billed charges",1077.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7111.03,82.6,,5688.82,,,0,"percent of total billed charges","82.6% of total billed charges",686.53,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7111.03,82.6,,5688.82,,,0,"percent of total billed charges","82.6% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.53,100,,,,,0,"fee schedule",EAPG,8609,100,,6887.20,,,0,"percent of total billed charges","100% of total billed charges",508.54,8609,
"95805 MULTIPLE SLEEP LATENCY STUDY- TECH CHARGE",92095805,CDM,920,RC,95805,CPT,OUTPATIENT,,,5479,3561.35,TC,4821.52,88,,3857.22,,,0,"percent of total billed charges","88% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.53,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",956.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",707.12,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3451.77,63,,2761.42,,,0,"percent of total billed charges","63% of total billed charges",838.29,15.3,,670.63,,,0,"percent of total billed charges","15.3% of total billed charges",686.53,100,,,,,0,"fee schedule",EAPG,3780.51,69,,,,,0,"fee schedule","69% of total billed charges",5479,100,,4383.20,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5479,100,,4383.20,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5479,100,,4383.20,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1981.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.53,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",518.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",508.54,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",700.26,100,,,,,0,"fee schedule",EAPG,892.49,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2065.58,37.7,,1652.46,,,0,"percent of total billed charges","37.7% of total billed charges",2065.58,37.7,,1652.46,,,0,"percent of total billed charges","37.70% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1857.38,33.9,,1485.90,,,0,"percent of total billed charges","33.9% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4273.62,78,,3418.90,,,0,"percent of total billed charges","78% of total billed charges",552.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4525.65,82.6,,3620.52,,,0,"percent of total billed charges","82.6% of total billed charges",686.53,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4525.65,82.6,,3620.52,,,0,"percent of total billed charges","82.6% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.53,100,,,,,0,"fee schedule",EAPG,5479,100,,4383.20,,,0,"percent of total billed charges","100% of total billed charges",508.54,5479,
"95806 SLEEP STUDY UNATTENDED",96095806,CDM,920,RC,95806,CPT,OUTPATIENT,,,947,615.55,,833.36,88,,666.69,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",127.33,100,,,,,0,"fee schedule",EAPG,947,100,,757.60,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",131.15,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",596.61,63,,477.29,,,0,"percent of total billed charges","63% of total billed charges",144.89,15.3,,115.91,,,0,"percent of total billed charges","15.3% of total billed charges",127.33,100,,,,,0,"fee schedule",EAPG,653.43,69,,,,,0,"fee schedule","69% of total billed charges",947,100,,757.60,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",947,100,,757.60,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",947,100,,757.60,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",127.33,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",94.32,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",129.88,100,,,,,0,"fee schedule",EAPG,165.54,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",357.02,37.7,,285.62,,,0,"percent of total billed charges","37.7% of total billed charges",357.02,37.7,,285.62,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",321.03,33.9,,256.82,,,0,"percent of total billed charges","33.9% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",738.66,78,,590.93,,,0,"percent of total billed charges","78% of total billed charges",160.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",782.22,82.6,,625.78,,,0,"percent of total billed charges","82.6% of total billed charges",127.33,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",782.22,82.6,,625.78,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",127.33,100,,,,,0,"fee schedule",EAPG,947,100,,757.60,,,0,"percent of total billed charges","100% of total billed charges",94.32,947,
"95810 POLYSOMMOGRAPHY CHARGE",92095810,CDM,920,RC,95810,CPT,OUTPATIENT,,,8189,5322.85,TC,7206.32,88,,5765.06,,,0,"percent of total billed charges","88% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.53,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",1866.21,175,,,,,0,"fee schedule","175% of CMS fee schedule",707.12,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5159.07,63,,4127.26,,,0,"percent of total billed charges","63% of total billed charges",1252.92,15.3,,1002.34,,,0,"percent of total billed charges","15.3% of total billed charges",686.53,100,,,,,0,"fee schedule",EAPG,5650.41,69,,,,,0,"fee schedule","69% of total billed charges",8189,100,,6551.20,,,0,"percent of total billed charges","100% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8189,100,,6551.20,,,0,"percent of total billed charges","100% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8189,100,,6551.20,,,0,"percent of total billed charges","100% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",3736.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.53,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",976.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",508.54,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",700.26,100,,,,,0,"fee schedule",EAPG,892.49,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3087.25,37.7,,2469.80,,,0,"percent of total billed charges","37.7% of total billed charges",3087.25,37.7,,2469.80,,,0,"percent of total billed charges","37.70% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2776.07,33.9,,2220.86,,,0,"percent of total billed charges","33.9% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6387.42,78,,5109.94,,,0,"percent of total billed charges","78% of total billed charges",1077.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6764.11,82.6,,5411.29,,,0,"percent of total billed charges","82.6% of total billed charges",686.53,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6764.11,82.6,,5411.29,,,0,"percent of total billed charges","82.6% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.53,100,,,,,0,"fee schedule",EAPG,8189,100,,6551.20,,,0,"percent of total billed charges","100% of total billed charges",508.54,8189,
"95811 POLYSOMMOGRAPHY w/ CPAP CHARGE",92095811,CDM,920,RC,95811,CPT,OUTPATIENT,,,8609,5595.85,TC,7575.92,88,,6060.74,,,0,"percent of total billed charges","88% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.53,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",1866.21,175,,,,,0,"fee schedule","175% of CMS fee schedule",707.12,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5423.67,63,,4338.94,,,0,"percent of total billed charges","63% of total billed charges",1317.18,15.3,,1053.74,,,0,"percent of total billed charges","15.3% of total billed charges",686.53,100,,,,,0,"fee schedule",EAPG,5940.21,69,,,,,0,"fee schedule","69% of total billed charges",8609,100,,6887.20,,,0,"percent of total billed charges","100% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8609,100,,6887.20,,,0,"percent of total billed charges","100% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8609,100,,6887.20,,,0,"percent of total billed charges","100% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",3736.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.53,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",976.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",508.54,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",700.26,100,,,,,0,"fee schedule",EAPG,892.49,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3245.59,37.7,,2596.47,,,0,"percent of total billed charges","37.7% of total billed charges",3245.59,37.7,,2596.47,,,0,"percent of total billed charges","37.70% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2918.45,33.9,,2334.76,,,0,"percent of total billed charges","33.9% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6715.02,78,,5372.02,,,0,"percent of total billed charges","78% of total billed charges",1077.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7111.03,82.6,,5688.82,,,0,"percent of total billed charges","82.6% of total billed charges",686.53,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7111.03,82.6,,5688.82,,,0,"percent of total billed charges","82.6% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.53,100,,,,,0,"fee schedule",EAPG,8609,100,,6887.20,,,0,"percent of total billed charges","100% of total billed charges",508.54,8609,
"G0399 HOME SLEEP STUDY, CHARGE",920G0399,CDM,920,RC,,,OUTPATIENT,,,947,615.55,,833.36,88,,666.69,,,0,"percent of total billed charges","88% of total billed charges",473.5,50,,378.80,,,0,"percent of total billed charges","50% of total billed charges",159.1,16.8,,127.28,,,0,"percent of total billed charges","16.8% of total billed charges",947,100,,757.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",163.87,17.304,,131.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",596.61,63,,477.29,,,0,"percent of total billed charges","63% of total billed charges",144.89,15.3,,115.91,,,0,"percent of total billed charges","15.3% of total billed charges",159.1,16.8,,127.28,,,0,"percent of total billed charges","16.8% of total billed charges",653.43,69,,,,,0,"fee schedule","69% of total billed charges",947,100,,757.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",947,100,,757.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",947,100,,757.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",159.1,16.8,,127.28,,,0,"percent of total billed charges","16.8% of total billed charges",473.5,50,,378.80,,,0,"percent of total billed charges","50% of total billed charges",304.93,32.2,,243.94,,,0,"percent of total billed charges","32.2% of total billed charges",159.1,16.8,,127.28,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.28,17.136,,129.82,,,0,"percent of total billed charges","17.136% of total billed charges",206.82,21.84,,165.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",357.02,37.7,,285.62,,,0,"percent of total billed charges","37.7% of total billed charges",357.02,37.7,,285.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",321.03,33.9,,256.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",738.66,78,,590.93,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",782.22,82.6,,625.78,,,0,"percent of total billed charges","82.6% of total billed charges",159.1,16.8,,127.28,,,0,"percent of total billed charges","16.8% of total billed charges",473.5,50,,378.80,,,0,"percent of total billed charges","50% of total billed charges",782.22,82.6,,625.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.1,16.8,,127.28,,,0,"percent of total billed charges","16.8% of total billed charges",947,100,,757.60,,,0,"percent of total billed charges","100% of total billed charges",144.89,947,
"HOME SLEEP TEST TYPE 3 UNATT",920G0399,CDM,920,RC,,,OUTPATIENT,,,947,615.55,,833.36,88,,666.69,,,0,"percent of total billed charges","88% of total billed charges",473.5,50,,378.80,,,0,"percent of total billed charges","50% of total billed charges",159.1,16.8,,127.28,,,0,"percent of total billed charges","16.8% of total billed charges",947,100,,757.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",163.87,17.304,,131.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",596.61,63,,477.29,,,0,"percent of total billed charges","63% of total billed charges",144.89,15.3,,115.91,,,0,"percent of total billed charges","15.3% of total billed charges",159.1,16.8,,127.28,,,0,"percent of total billed charges","16.8% of total billed charges",653.43,69,,,,,0,"fee schedule","69% of total billed charges",947,100,,757.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",947,100,,757.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",947,100,,757.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",159.1,16.8,,127.28,,,0,"percent of total billed charges","16.8% of total billed charges",473.5,50,,378.80,,,0,"percent of total billed charges","50% of total billed charges",304.93,32.2,,243.94,,,0,"percent of total billed charges","32.2% of total billed charges",159.1,16.8,,127.28,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.28,17.136,,129.82,,,0,"percent of total billed charges","17.136% of total billed charges",206.82,21.84,,165.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",357.02,37.7,,285.62,,,0,"percent of total billed charges","37.7% of total billed charges",357.02,37.7,,285.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",321.03,33.9,,256.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",738.66,78,,590.93,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",782.22,82.6,,625.78,,,0,"percent of total billed charges","82.6% of total billed charges",159.1,16.8,,127.28,,,0,"percent of total billed charges","16.8% of total billed charges",473.5,50,,378.80,,,0,"percent of total billed charges","50% of total billed charges",782.22,82.6,,625.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.1,16.8,,127.28,,,0,"percent of total billed charges","16.8% of total billed charges",947,100,,757.60,,,0,"percent of total billed charges","100% of total billed charges",144.89,947,
"1 HA FIT FEE AUDIENT",470V5241,CDM,470,RC,,,OUTPATIENT,,,208,135.2,,183.04,88,,146.43,,,0,"percent of total billed charges","88% of total billed charges",104,50,,83.20,,,0,"percent of total billed charges","50% of total billed charges",34.94,16.8,,27.95,,,0,"percent of total billed charges","16.8% of total billed charges",208,100,,166.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.99,17.304,,28.79,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",131.04,63,,104.83,,,0,"percent of total billed charges","63% of total billed charges",31.82,15.3,,25.46,,,0,"percent of total billed charges","15.3% of total billed charges",34.94,16.8,,27.95,,,0,"percent of total billed charges","16.8% of total billed charges",143.52,69,,,,,0,"fee schedule","69% of total billed charges",208,100,,166.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208,100,,166.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208,100,,166.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.94,16.8,,27.95,,,0,"percent of total billed charges","16.8% of total billed charges",104,50,,83.20,,,0,"percent of total billed charges","50% of total billed charges",66.98,32.2,,53.58,,,0,"percent of total billed charges","32.2% of total billed charges",34.94,16.8,,27.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.64,17.136,,28.51,,,0,"percent of total billed charges","17.136% of total billed charges",45.43,21.84,,36.34,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.42,37.7,,62.74,,,0,"percent of total billed charges","37.7% of total billed charges",78.42,37.7,,62.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.51,33.9,,56.41,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.24,78,,129.79,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",171.81,82.6,,137.45,,,0,"percent of total billed charges","82.6% of total billed charges",34.94,16.8,,27.95,,,0,"percent of total billed charges","16.8% of total billed charges",104,50,,83.20,,,0,"percent of total billed charges","50% of total billed charges",171.81,82.6,,137.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.94,16.8,,27.95,,,0,"percent of total billed charges","16.8% of total billed charges",208,100,,166.40,,,0,"percent of total billed charges","100% of total billed charges",31.82,208,
"1 HA FITTING/CHECKING",470V5011,CDM,470,RC,,,OUTPATIENT,,,586,380.9,,515.68,88,,412.54,,,0,"percent of total billed charges","88% of total billed charges",293,50,,234.40,,,0,"percent of total billed charges","50% of total billed charges",98.45,16.8,,78.76,,,0,"percent of total billed charges","16.8% of total billed charges",586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.4,17.304,,81.12,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",369.18,63,,295.34,,,0,"percent of total billed charges","63% of total billed charges",89.66,15.3,,71.73,,,0,"percent of total billed charges","15.3% of total billed charges",98.45,16.8,,78.76,,,0,"percent of total billed charges","16.8% of total billed charges",404.34,69,,,,,0,"fee schedule","69% of total billed charges",586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",98.45,16.8,,78.76,,,0,"percent of total billed charges","16.8% of total billed charges",293,50,,234.40,,,0,"percent of total billed charges","50% of total billed charges",188.69,32.2,,150.95,,,0,"percent of total billed charges","32.2% of total billed charges",98.45,16.8,,78.76,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",100.42,17.136,,80.34,,,0,"percent of total billed charges","17.136% of total billed charges",127.98,21.84,,102.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",220.92,37.7,,176.74,,,0,"percent of total billed charges","37.7% of total billed charges",220.92,37.7,,176.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",198.65,33.9,,158.92,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",457.08,78,,365.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",484.04,82.6,,387.23,,,0,"percent of total billed charges","82.6% of total billed charges",98.45,16.8,,78.76,,,0,"percent of total billed charges","16.8% of total billed charges",293,50,,234.40,,,0,"percent of total billed charges","50% of total billed charges",484.04,82.6,,387.23,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.45,16.8,,78.76,,,0,"percent of total billed charges","16.8% of total billed charges",586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",89.66,586,
"2 HA FITTING/CHECKING",470V5011,CDM,470,RC,,,OUTPATIENT,,,986,640.9,,867.68,88,,694.14,,,0,"percent of total billed charges","88% of total billed charges",493,50,,394.40,,,0,"percent of total billed charges","50% of total billed charges",165.65,16.8,,132.52,,,0,"percent of total billed charges","16.8% of total billed charges",986,100,,788.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.62,17.304,,136.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",621.18,63,,496.94,,,0,"percent of total billed charges","63% of total billed charges",150.86,15.3,,120.69,,,0,"percent of total billed charges","15.3% of total billed charges",165.65,16.8,,132.52,,,0,"percent of total billed charges","16.8% of total billed charges",680.34,69,,,,,0,"fee schedule","69% of total billed charges",986,100,,788.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",986,100,,788.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",986,100,,788.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",165.65,16.8,,132.52,,,0,"percent of total billed charges","16.8% of total billed charges",493,50,,394.40,,,0,"percent of total billed charges","50% of total billed charges",317.49,32.2,,253.99,,,0,"percent of total billed charges","32.2% of total billed charges",165.65,16.8,,132.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.96,17.136,,135.17,,,0,"percent of total billed charges","17.136% of total billed charges",215.34,21.84,,172.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",371.72,37.7,,297.38,,,0,"percent of total billed charges","37.7% of total billed charges",371.72,37.7,,297.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",334.25,33.9,,267.40,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",769.08,78,,615.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",814.44,82.6,,651.55,,,0,"percent of total billed charges","82.6% of total billed charges",165.65,16.8,,132.52,,,0,"percent of total billed charges","16.8% of total billed charges",493,50,,394.40,,,0,"percent of total billed charges","50% of total billed charges",814.44,82.6,,651.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.65,16.8,,132.52,,,0,"percent of total billed charges","16.8% of total billed charges",986,100,,788.80,,,0,"percent of total billed charges","100% of total billed charges",150.86,986,
"2 HA'S FIT FEE AUDIENT",470V5160,CDM,470,RC,,,OUTPATIENT,,,184,119.6,,161.92,88,,129.54,,,0,"percent of total billed charges","88% of total billed charges",92,50,,73.60,,,0,"percent of total billed charges","50% of total billed charges",30.91,16.8,,24.73,,,0,"percent of total billed charges","16.8% of total billed charges",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.84,17.304,,25.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.92,63,,92.74,,,0,"percent of total billed charges","63% of total billed charges",28.15,15.3,,22.52,,,0,"percent of total billed charges","15.3% of total billed charges",30.91,16.8,,24.73,,,0,"percent of total billed charges","16.8% of total billed charges",126.96,69,,,,,0,"fee schedule","69% of total billed charges",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.91,16.8,,24.73,,,0,"percent of total billed charges","16.8% of total billed charges",92,50,,73.60,,,0,"percent of total billed charges","50% of total billed charges",59.25,32.2,,47.40,,,0,"percent of total billed charges","32.2% of total billed charges",30.91,16.8,,24.73,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.53,17.136,,25.22,,,0,"percent of total billed charges","17.136% of total billed charges",40.19,21.84,,32.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.37,37.7,,55.50,,,0,"percent of total billed charges","37.7% of total billed charges",69.37,37.7,,55.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.38,33.9,,49.90,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",143.52,78,,114.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.98,82.6,,121.58,,,0,"percent of total billed charges","82.6% of total billed charges",30.91,16.8,,24.73,,,0,"percent of total billed charges","16.8% of total billed charges",92,50,,73.60,,,0,"percent of total billed charges","50% of total billed charges",151.98,82.6,,121.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.91,16.8,,24.73,,,0,"percent of total billed charges","16.8% of total billed charges",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",28.15,184,
"69210 CERUMEN REMOVAL CHARGE",47069210,CDM,470,RC,69210,CPT,OUTPATIENT,,,393,255.45,,345.84,88,,276.67,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.02,16.8,,52.82,,,0,"percent of total billed charges","16.8% of total billed charges",393,100,,314.40,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",68,17.304,,54.40,,,0,"percent of total billed charges","17.304% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",247.59,63,,198.07,,,0,"percent of total billed charges","63% of total billed charges",60.13,15.3,,48.10,,,0,"percent of total billed charges","15.3% of total billed charges",66.02,16.8,,52.82,,,0,"percent of total billed charges","16.8% of total billed charges",271.17,69,,,,,0,"fee schedule","69% of total billed charges",393,100,,314.40,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",393,100,,314.40,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",393,100,,314.40,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.02,16.8,,52.82,,,0,"percent of total billed charges","16.8% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.02,16.8,,52.82,,,0,"percent of total billed charges","16.8% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",67.34,17.136,,53.87,,,0,"percent of total billed charges","17.136% of total billed charges",85.83,21.84,,68.66,,,0,"percent of total billed charges","21.84% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.16,37.7,,118.53,,,0,"percent of total billed charges","37.7% of total billed charges",148.16,37.7,,118.53,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",133.23,33.9,,106.58,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",306.54,78,,245.23,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",324.62,82.6,,259.70,,,0,"percent of total billed charges","82.6% of total billed charges",66.02,16.8,,52.82,,,0,"percent of total billed charges","16.8% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",324.62,82.6,,259.70,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.02,16.8,,52.82,,,0,"percent of total billed charges","16.8% of total billed charges",393,100,,314.40,,,0,"percent of total billed charges","100% of total billed charges",59.11,393,
"SPEECH THERAPY GROUP",44092508,CDM,440,RC,92508,CPT,OUTPATIENT,,,226,146.9,GN,198.88,88,,159.10,,,0,"percent of total billed charges","88% of total billed charges",24.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.05,100,,,,,0,"fee schedule","100% of WA fee schedule",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",43.16,175,,,,,0,"fee schedule","175% of CMS fee schedule",14.05,100,,,,,0,"fee schedule","100% of WA fee schedule",24.83,100,,,,,0,"fee schedule","100% of CMS fee sv",142.38,63,,113.90,,,0,"percent of total billed charges","63% of total billed charges",34.58,15.3,,27.66,,,0,"percent of total billed charges","15.3% of total billed charges",14.05,100,,,,,0,"fee schedule","100% of WA fee schedule",155.94,69,,,,,0,"fee schedule","69% of total billed charges",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",24.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",24.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",24.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.37,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",14.05,100,,,,,0,"fee schedule","100% of WA fee schedule",24.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.39,100,,,,,0,"fee schedule","100% of LI fee schedule",14.05,100,,,,,0,"fee schedule","100% of WA fee schedule",24.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.33,102,,,,,0,"fee schedule","102% of WA fee schedule",18.27,130,,,,,0,"fee schedule","130% of WA fee schedule",24.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.2,37.7,,68.16,,,0,"percent of total billed charges","37.7% of total billed charges",85.2,37.7,,68.16,,,0,"percent of total billed charges","37.70% of total billed charges",24.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.61,33.9,,61.29,,,0,"percent of total billed charges","33.9% of total billed charges",24.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",176.28,78,,141.02,,,0,"percent of total billed charges","78% of total billed charges",25.08,101,,,,,0,"fee schedule","101% of CMS fee schedule ",186.68,82.6,,149.34,,,0,"percent of total billed charges","82.6% of total billed charges",14.05,100,,,,,0,"fee schedule","100% of WA fee schedule",24.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",186.68,82.6,,149.34,,,0,"percent of total billed charges","82.6% of total billed charges",24.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",14.05,100,,,,,0,"fee schedule","100% of WA fee schedule",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",14.05,226,
"SPEECH/LANG THERAPY/-GN",44092507,CDM,440,RC,92507,CPT,OUTPATIENT,,,470,305.5,GN,413.6,88,,330.88,,,0,"percent of total billed charges","88% of total billed charges",77.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.79,100,,,,,0,"fee schedule","100% of WA fee schedule",470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",134.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",44.79,100,,,,,0,"fee schedule","100% of WA fee schedule",77.61,100,,,,,0,"fee schedule","100% of CMS fee sv",296.1,63,,236.88,,,0,"percent of total billed charges","63% of total billed charges",71.91,15.3,,57.53,,,0,"percent of total billed charges","15.3% of total billed charges",44.79,100,,,,,0,"fee schedule","100% of WA fee schedule",324.3,69,,,,,0,"fee schedule","69% of total billed charges",470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",77.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",77.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",77.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",298.89,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",44.79,100,,,,,0,"fee schedule","100% of WA fee schedule",77.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.42,100,,,,,0,"fee schedule","100% of LI fee schedule",44.79,100,,,,,0,"fee schedule","100% of WA fee schedule",77.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.69,102,,,,,0,"fee schedule","102% of WA fee schedule",58.23,130,,,,,0,"fee schedule","130% of WA fee schedule",77.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",177.19,37.7,,141.75,,,0,"percent of total billed charges","37.7% of total billed charges",177.19,37.7,,141.75,,,0,"percent of total billed charges","37.70% of total billed charges",77.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",159.33,33.9,,127.46,,,0,"percent of total billed charges","33.9% of total billed charges",77.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",366.6,78,,293.28,,,0,"percent of total billed charges","78% of total billed charges",78.39,101,,,,,0,"fee schedule","101% of CMS fee schedule ",388.22,82.6,,310.58,,,0,"percent of total billed charges","82.6% of total billed charges",44.79,100,,,,,0,"fee schedule","100% of WA fee schedule",77.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",388.22,82.6,,310.58,,,0,"percent of total billed charges","82.6% of total billed charges",77.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.79,100,,,,,0,"fee schedule","100% of WA fee schedule",470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",44.79,470,
"EVAL SOUND PROD",44492522,CDM,444,RC,92522,CPT,OUTPATIENT,,,707,459.55,GN,622.16,88,,497.73,,,0,"percent of total billed charges","88% of total billed charges",112.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.91,100,,,,,0,"fee schedule","100% of WA fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",195.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",64.91,100,,,,,0,"fee schedule","100% of WA fee schedule",112.96,100,,,,,0,"fee schedule","100% of CMS fee sv",445.41,63,,356.33,,,0,"percent of total billed charges","63% of total billed charges",108.17,15.3,,86.54,,,0,"percent of total billed charges","15.3% of total billed charges",64.91,100,,,,,0,"fee schedule","100% of WA fee schedule",487.83,69,,,,,0,"fee schedule","69% of total billed charges",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",111.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",112.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",112.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",436.7,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",64.91,100,,,,,0,"fee schedule","100% of WA fee schedule",112.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",111.21,100,,,,,0,"fee schedule","100% of LI fee schedule",64.91,100,,,,,0,"fee schedule","100% of WA fee schedule",112.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.21,102,,,,,0,"fee schedule","102% of WA fee schedule",84.38,130,,,,,0,"fee schedule","130% of WA fee schedule",112.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",266.54,37.7,,213.23,,,0,"percent of total billed charges","37.7% of total billed charges",266.54,37.7,,213.23,,,0,"percent of total billed charges","37.70% of total billed charges",112.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",239.67,33.9,,191.74,,,0,"percent of total billed charges","33.9% of total billed charges",112.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",551.46,78,,441.17,,,0,"percent of total billed charges","78% of total billed charges",114.09,101,,,,,0,"fee schedule","101% of CMS fee schedule ",583.98,82.6,,467.18,,,0,"percent of total billed charges","82.6% of total billed charges",64.91,100,,,,,0,"fee schedule","100% of WA fee schedule",112.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",583.98,82.6,,467.18,,,0,"percent of total billed charges","82.6% of total billed charges",113.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.91,100,,,,,0,"fee schedule","100% of WA fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",64.91,707,
"EVAL SOUND PROD W/ LANG COMP",44492523,CDM,444,RC,92523,CPT,OUTPATIENT,,,909,590.85,GN,799.92,88,,639.94,,,0,"percent of total billed charges","88% of total billed charges",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",133.62,100,,,,,0,"fee schedule","100% of WA fee schedule",909,100,,727.20,,,0,"percent of total billed charges","100% of total billed charges",402.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",133.62,100,,,,,0,"fee schedule","100% of WA fee schedule",231.78,100,,,,,0,"fee schedule","100% of CMS fee sv",572.67,63,,458.14,,,0,"percent of total billed charges","63% of total billed charges",139.08,15.3,,111.26,,,0,"percent of total billed charges","15.3% of total billed charges",133.62,100,,,,,0,"fee schedule","100% of WA fee schedule",627.21,69,,,,,0,"fee schedule","69% of total billed charges",909,100,,727.20,,,0,"percent of total billed charges","100% of total billed charges",230.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",909,100,,727.20,,,0,"percent of total billed charges","100% of total billed charges",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",909,100,,727.20,,,0,"percent of total billed charges","100% of total billed charges",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",899.56,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",133.62,100,,,,,0,"fee schedule","100% of WA fee schedule",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",228.18,100,,,,,0,"fee schedule","100% of LI fee schedule",133.62,100,,,,,0,"fee schedule","100% of WA fee schedule",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.29,102,,,,,0,"fee schedule","102% of WA fee schedule",173.71,130,,,,,0,"fee schedule","130% of WA fee schedule",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",342.69,37.7,,274.15,,,0,"percent of total billed charges","37.7% of total billed charges",342.69,37.7,,274.15,,,0,"percent of total billed charges","37.70% of total billed charges",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",308.15,33.9,,246.52,,,0,"percent of total billed charges","33.9% of total billed charges",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",709.02,78,,567.22,,,0,"percent of total billed charges","78% of total billed charges",234.1,101,,,,,0,"fee schedule","101% of CMS fee schedule ",750.83,82.6,,600.66,,,0,"percent of total billed charges","82.6% of total billed charges",133.62,100,,,,,0,"fee schedule","100% of WA fee schedule",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",750.83,82.6,,600.66,,,0,"percent of total billed charges","82.6% of total billed charges",231.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",133.62,100,,,,,0,"fee schedule","100% of WA fee schedule",909,100,,727.20,,,0,"percent of total billed charges","100% of total billed charges",133.62,909,
"DYSPH/FEED DYSFN TRMT/-GN",44092526,CDM,440,RC,92526,CPT,OUTPATIENT,,,470,305.5,GN,413.6,88,,330.88,,,0,"percent of total billed charges","88% of total billed charges",86.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",150.01,175,,,,,0,"fee schedule","175% of CMS fee schedule",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",86.22,100,,,,,0,"fee schedule","100% of CMS fee sv",296.1,63,,236.88,,,0,"percent of total billed charges","63% of total billed charges",71.91,15.3,,57.53,,,0,"percent of total billed charges","15.3% of total billed charges",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",324.3,69,,,,,0,"fee schedule","69% of total billed charges",470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",85.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",86.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",86.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",331.32,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",86.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",84.83,100,,,,,0,"fee schedule","100% of LI fee schedule",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",86.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.92,102,,,,,0,"fee schedule","102% of WA fee schedule",64.9,130,,,,,0,"fee schedule","130% of WA fee schedule",86.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",177.19,37.7,,141.75,,,0,"percent of total billed charges","37.7% of total billed charges",177.19,37.7,,141.75,,,0,"percent of total billed charges","37.70% of total billed charges",86.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",159.33,33.9,,127.46,,,0,"percent of total billed charges","33.9% of total billed charges",86.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",366.6,78,,293.28,,,0,"percent of total billed charges","78% of total billed charges",87.08,101,,,,,0,"fee schedule","101% of CMS fee schedule ",388.22,82.6,,310.58,,,0,"percent of total billed charges","82.6% of total billed charges",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",86.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",388.22,82.6,,310.58,,,0,"percent of total billed charges","82.6% of total billed charges",86.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",49.92,470,
"EVAL SPEECH FLUENCY",44492521,CDM,444,RC,92521,CPT,OUTPATIENT,,,707,459.55,GN,622.16,88,,497.73,,,0,"percent of total billed charges","88% of total billed charges",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.01,100,,,,,0,"fee schedule","100% of WA fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",234.85,175,,,,,0,"fee schedule","175% of CMS fee schedule",78.01,100,,,,,0,"fee schedule","100% of WA fee schedule",135.19,100,,,,,0,"fee schedule","100% of CMS fee sv",445.41,63,,356.33,,,0,"percent of total billed charges","63% of total billed charges",108.17,15.3,,86.54,,,0,"percent of total billed charges","15.3% of total billed charges",78.01,100,,,,,0,"fee schedule","100% of WA fee schedule",487.83,69,,,,,0,"fee schedule","69% of total billed charges",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",134.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",523.07,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",78.01,100,,,,,0,"fee schedule","100% of WA fee schedule",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",133.09,100,,,,,0,"fee schedule","100% of LI fee schedule",78.01,100,,,,,0,"fee schedule","100% of WA fee schedule",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.57,102,,,,,0,"fee schedule","102% of WA fee schedule",101.41,130,,,,,0,"fee schedule","130% of WA fee schedule",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",266.54,37.7,,213.23,,,0,"percent of total billed charges","37.7% of total billed charges",266.54,37.7,,213.23,,,0,"percent of total billed charges","37.70% of total billed charges",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",239.67,33.9,,191.74,,,0,"percent of total billed charges","33.9% of total billed charges",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",551.46,78,,441.17,,,0,"percent of total billed charges","78% of total billed charges",136.54,101,,,,,0,"fee schedule","101% of CMS fee schedule ",583.98,82.6,,467.18,,,0,"percent of total billed charges","82.6% of total billed charges",78.01,100,,,,,0,"fee schedule","100% of WA fee schedule",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",583.98,82.6,,467.18,,,0,"percent of total billed charges","82.6% of total billed charges",135.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.01,100,,,,,0,"fee schedule","100% of WA fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",78.01,707,
"ANALYSIS QUAL VOICE  RESONANC",44492524,CDM,444,RC,92524,CPT,OUTPATIENT,,,707,459.55,GN,622.16,88,,497.73,,,0,"percent of total billed charges","88% of total billed charges",111.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.15,100,,,,,0,"fee schedule","100% of WA fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",192.64,175,,,,,0,"fee schedule","175% of CMS fee schedule",64.15,100,,,,,0,"fee schedule","100% of WA fee schedule",111.23,100,,,,,0,"fee schedule","100% of CMS fee sv",445.41,63,,356.33,,,0,"percent of total billed charges","63% of total billed charges",108.17,15.3,,86.54,,,0,"percent of total billed charges","15.3% of total billed charges",64.15,100,,,,,0,"fee schedule","100% of WA fee schedule",487.83,69,,,,,0,"fee schedule","69% of total billed charges",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",110.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",111.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",111.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",427.56,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",64.15,100,,,,,0,"fee schedule","100% of WA fee schedule",111.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.52,100,,,,,0,"fee schedule","100% of LI fee schedule",64.15,100,,,,,0,"fee schedule","100% of WA fee schedule",111.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.43,102,,,,,0,"fee schedule","102% of WA fee schedule",83.4,130,,,,,0,"fee schedule","130% of WA fee schedule",111.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",266.54,37.7,,213.23,,,0,"percent of total billed charges","37.7% of total billed charges",266.54,37.7,,213.23,,,0,"percent of total billed charges","37.70% of total billed charges",111.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",239.67,33.9,,191.74,,,0,"percent of total billed charges","33.9% of total billed charges",111.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",551.46,78,,441.17,,,0,"percent of total billed charges","78% of total billed charges",112.34,101,,,,,0,"fee schedule","101% of CMS fee schedule ",583.98,82.6,,467.18,,,0,"percent of total billed charges","82.6% of total billed charges",64.15,100,,,,,0,"fee schedule","100% of WA fee schedule",111.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",583.98,82.6,,467.18,,,0,"percent of total billed charges","82.6% of total billed charges",111.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.15,100,,,,,0,"fee schedule","100% of WA fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",64.15,707,
"PURE TONE,AIR/INDUSTRIAL",44092552,CDM,440,RC,92552,CPT,OUTPATIENT,,,32,20.8,GN,28.16,88,,22.53,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.18,100,,,,,0,"fee schedule",EAPG,32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",32.11,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",20.16,63,,16.13,,,0,"percent of total billed charges","63% of total billed charges",4.9,15.3,,3.92,,,0,"percent of total billed charges","15.3% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,22.08,69,,,,,0,"fee schedule","69% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.18,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.09,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.8,100,,,,,0,"fee schedule",EAPG,40.53,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.7% of total billed charges",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10.85,33.9,,8.68,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.96,78,,19.97,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.18,100,,,,,0,"fee schedule",EAPG,32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",4.9,454.8,
"EVOKED OAE EMISSIONS SCREEN",44092558,CDM,440,RC,92558,CPT,OUTPATIENT,,,54,35.1,GN,47.52,88,,38.02,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.18,100,,,,,0,"fee schedule",EAPG,54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.11,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.26,15.3,,6.61,,,0,"percent of total billed charges","15.3% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,37.26,69,,,,,0,"fee schedule","69% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",31.18,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.09,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",31.8,100,,,,,0,"fee schedule",EAPG,40.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",20.36,37.7,,16.29,,,0,"percent of total billed charges","37.7% of total billed charges",20.36,37.7,,16.29,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.31,33.9,,14.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.12,78,,33.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.6,82.6,,35.68,,,0,"percent of total billed charges","82.6% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",44.6,82.6,,35.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.18,100,,,,,0,"fee schedule",EAPG,54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",8.26,54,
"TYMPS ACOSTIC REFLEXES 15 MIN",47192550,CDM,471,RC,92550,CPT,OUTPATIENT,,,246,159.9,,216.48,88,,173.18,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",75.82,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.98,63,,123.98,,,0,"percent of total billed charges","63% of total billed charges",37.64,15.3,,30.11,,,0,"percent of total billed charges","15.3% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,169.74,69,,,,,0,"fee schedule","69% of total billed charges",246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",54.53,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75.09,100,,,,,0,"fee schedule",EAPG,95.7,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.74,37.7,,74.19,,,0,"percent of total billed charges","37.7% of total billed charges",92.74,37.7,,74.19,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",83.39,33.9,,66.71,,,0,"percent of total billed charges","33.9% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191.88,78,,153.50,,,0,"percent of total billed charges","78% of total billed charges",160.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",203.2,82.6,,162.56,,,0,"percent of total billed charges","82.6% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",203.2,82.6,,162.56,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",37.64,566.92,
"PURE TONE HEARING TEST AIR",47092551,CDM,470,RC,92551,CPT,OUTPATIENT,,,184,119.6,,161.92,88,,129.54,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.18,100,,,,,0,"fee schedule",EAPG,184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.11,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",115.92,63,,92.74,,,0,"percent of total billed charges","63% of total billed charges",28.15,15.3,,22.52,,,0,"percent of total billed charges","15.3% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,126.96,69,,,,,0,"fee schedule","69% of total billed charges",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",31.18,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.09,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",31.8,100,,,,,0,"fee schedule",EAPG,40.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",69.37,37.7,,55.50,,,0,"percent of total billed charges","37.7% of total billed charges",69.37,37.7,,55.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.38,33.9,,49.90,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",143.52,78,,114.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.98,82.6,,121.58,,,0,"percent of total billed charges","82.6% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",151.98,82.6,,121.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.18,100,,,,,0,"fee schedule",EAPG,184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",23.09,184,
"PT AIR ONLY THRESHOLD 15 MIN",47192552,CDM,471,RC,92552,CPT,OUTPATIENT,,,369,239.85,,324.72,88,,259.78,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.18,100,,,,,0,"fee schedule",EAPG,369,100,,295.20,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",32.11,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",232.47,63,,185.98,,,0,"percent of total billed charges","63% of total billed charges",56.46,15.3,,45.17,,,0,"percent of total billed charges","15.3% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,254.61,69,,,,,0,"fee schedule","69% of total billed charges",369,100,,295.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",369,100,,295.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",369,100,,295.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.18,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.09,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.8,100,,,,,0,"fee schedule",EAPG,40.53,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",139.11,37.7,,111.29,,,0,"percent of total billed charges","37.7% of total billed charges",139.11,37.7,,111.29,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.09,33.9,,100.07,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287.82,78,,230.26,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",304.79,82.6,,243.83,,,0,"percent of total billed charges","82.6% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",304.79,82.6,,243.83,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.18,100,,,,,0,"fee schedule",EAPG,369,100,,295.20,,,0,"percent of total billed charges","100% of total billed charges",23.09,454.8,
"PURE TONE AIR  BONE CONDUCT",47192553,CDM,471,RC,92553,CPT,OUTPATIENT,,,369,239.85,,324.72,88,,259.78,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,369,100,,295.20,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",75.82,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",232.47,63,,185.98,,,0,"percent of total billed charges","63% of total billed charges",56.46,15.3,,45.17,,,0,"percent of total billed charges","15.3% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,254.61,69,,,,,0,"fee schedule","69% of total billed charges",369,100,,295.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",369,100,,295.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",369,100,,295.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",54.53,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75.09,100,,,,,0,"fee schedule",EAPG,95.7,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",139.11,37.7,,111.29,,,0,"percent of total billed charges","37.7% of total billed charges",139.11,37.7,,111.29,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.09,33.9,,100.07,,,0,"percent of total billed charges","33.9% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287.82,78,,230.26,,,0,"percent of total billed charges","78% of total billed charges",160.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",304.79,82.6,,243.83,,,0,"percent of total billed charges","82.6% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",304.79,82.6,,243.83,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,369,100,,295.20,,,0,"percent of total billed charges","100% of total billed charges",54.53,566.92,
"SPEECH AUDIO THRESHOLD 15 MIN",47192555,CDM,471,RC,92555,CPT,OUTPATIENT,,,191,124.15,,168.08,88,,134.46,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.18,100,,,,,0,"fee schedule",EAPG,191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",32.11,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",120.33,63,,96.26,,,0,"percent of total billed charges","63% of total billed charges",29.22,15.3,,23.38,,,0,"percent of total billed charges","15.3% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,131.79,69,,,,,0,"fee schedule","69% of total billed charges",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.18,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.09,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.8,100,,,,,0,"fee schedule",EAPG,40.53,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",72.01,37.7,,57.61,,,0,"percent of total billed charges","37.7% of total billed charges",72.01,37.7,,57.61,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.75,33.9,,51.80,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.98,78,,119.18,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",157.77,82.6,,126.22,,,0,"percent of total billed charges","82.6% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",157.77,82.6,,126.22,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.18,100,,,,,0,"fee schedule",EAPG,191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",23.09,191,
"SP THRESHOLD/DISCRIM 15 MIN",47192556,CDM,471,RC,92556,CPT,OUTPATIENT,,,304,197.6,,267.52,88,,214.02,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.18,100,,,,,0,"fee schedule",EAPG,304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",32.11,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191.52,63,,153.22,,,0,"percent of total billed charges","63% of total billed charges",46.51,15.3,,37.21,,,0,"percent of total billed charges","15.3% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,209.76,69,,,,,0,"fee schedule","69% of total billed charges",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.18,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.09,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.8,100,,,,,0,"fee schedule",EAPG,40.53,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",114.61,37.7,,91.69,,,0,"percent of total billed charges","37.7% of total billed charges",114.61,37.7,,91.69,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",103.06,33.9,,82.45,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",237.12,78,,189.70,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",251.1,82.6,,200.88,,,0,"percent of total billed charges","82.6% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",251.1,82.6,,200.88,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.18,100,,,,,0,"fee schedule",EAPG,304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",23.09,304,
"COMP AUDIO EVAL AIR,BONE,SPEEC",47192557,CDM,471,RC,92557,CPT,OUTPATIENT,,,274,178.1,,241.12,88,,192.90,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,274,100,,219.20,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",75.82,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",172.62,63,,138.10,,,0,"percent of total billed charges","63% of total billed charges",41.92,15.3,,33.54,,,0,"percent of total billed charges","15.3% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,189.06,69,,,,,0,"fee schedule","69% of total billed charges",274,100,,219.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",274,100,,219.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",274,100,,219.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",54.53,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75.09,100,,,,,0,"fee schedule",EAPG,95.7,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",103.3,37.7,,82.64,,,0,"percent of total billed charges","37.7% of total billed charges",103.3,37.7,,82.64,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.89,33.9,,74.31,,,0,"percent of total billed charges","33.9% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",213.72,78,,170.98,,,0,"percent of total billed charges","78% of total billed charges",160.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",226.32,82.6,,181.06,,,0,"percent of total billed charges","82.6% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",226.32,82.6,,181.06,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,274,100,,219.20,,,0,"percent of total billed charges","100% of total billed charges",41.92,566.92,
"ACOUSTIC REFLEX DECAY TEST",44092569,CDM,440,RC,92569,CPT,OUTPATIENT,,,117,76.05,GN,102.96,88,,82.37,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.66,16.8,,15.73,,,0,"percent of total billed charges","16.8% of total billed charges",117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.25,17.304,,16.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",73.71,63,,58.97,,,0,"percent of total billed charges","63% of total billed charges",17.9,15.3,,14.32,,,0,"percent of total billed charges","15.3% of total billed charges",19.66,16.8,,15.73,,,0,"percent of total billed charges","16.8% of total billed charges",80.73,69,,,,,0,"fee schedule","69% of total billed charges",117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.66,16.8,,15.73,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.66,16.8,,15.73,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.05,17.136,,16.04,,,0,"percent of total billed charges","17.136% of total billed charges",25.55,21.84,,20.44,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.11,37.7,,35.29,,,0,"percent of total billed charges","37.7% of total billed charges",44.11,37.7,,35.29,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.66,33.9,,31.73,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.26,78,,73.01,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",96.64,82.6,,77.31,,,0,"percent of total billed charges","82.6% of total billed charges",19.66,16.8,,15.73,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",96.64,82.6,,77.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.66,16.8,,15.73,,,0,"percent of total billed charges","16.8% of total billed charges",117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",17.9,117,
"STENGER TEST, PURE TONE",47092565,CDM,470,RC,92565,CPT,OUTPATIENT,,,137,89.05,,120.56,88,,96.45,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.18,100,,,,,0,"fee schedule",EAPG,137,100,,109.60,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",32.11,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",86.31,63,,69.05,,,0,"percent of total billed charges","63% of total billed charges",20.96,15.3,,16.77,,,0,"percent of total billed charges","15.3% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,94.53,69,,,,,0,"fee schedule","69% of total billed charges",137,100,,109.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",137,100,,109.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",137,100,,109.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.18,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.09,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.8,100,,,,,0,"fee schedule",EAPG,40.53,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.65,37.7,,41.32,,,0,"percent of total billed charges","37.7% of total billed charges",51.65,37.7,,41.32,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.44,33.9,,37.15,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",106.86,78,,85.49,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",113.16,82.6,,90.53,,,0,"percent of total billed charges","82.6% of total billed charges",31.18,100,,,,,0,"fee schedule","100% of WA fee schedule",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",113.16,82.6,,90.53,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.18,100,,,,,0,"fee schedule",EAPG,137,100,,109.60,,,0,"percent of total billed charges","100% of total billed charges",20.96,137.47,
"TYMPANOMETRY (15 MINUTES)",47192567,CDM,471,RC,92567,CPT,OUTPATIENT,,,94,61.1,TC,82.72,88,,66.18,,,0,"percent of total billed charges","88% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.18,100,,,,,0,"fee schedule",EAPG,94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",71.58,175,,,,,0,"fee schedule","175% of CMS fee schedule",32.11,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.22,63,,47.38,,,0,"percent of total billed charges","63% of total billed charges",14.38,15.3,,11.50,,,0,"percent of total billed charges","15.3% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,64.86,69,,,,,0,"fee schedule","69% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.18,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.09,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.8,100,,,,,0,"fee schedule",EAPG,40.53,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.44,37.7,,28.35,,,0,"percent of total billed charges","37.7% of total billed charges",35.44,37.7,,28.35,,,0,"percent of total billed charges","37.70% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.87,33.9,,25.50,,,0,"percent of total billed charges","33.9% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.32,78,,58.66,,,0,"percent of total billed charges","78% of total billed charges",41.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.18,100,,,,,0,"fee schedule",EAPG,94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",14.38,137.47,
"TYMPS REFLEXES DECAY 15 MIN",47092570,CDM,470,RC,92570,CPT,OUTPATIENT,,,253,164.45,,222.64,88,,178.11,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",75.82,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",159.39,63,,127.51,,,0,"percent of total billed charges","63% of total billed charges",38.71,15.3,,30.97,,,0,"percent of total billed charges","15.3% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,174.57,69,,,,,0,"fee schedule","69% of total billed charges",253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",54.53,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75.09,100,,,,,0,"fee schedule",EAPG,95.7,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",95.38,37.7,,76.30,,,0,"percent of total billed charges","37.7% of total billed charges",95.38,37.7,,76.30,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.77,33.9,,68.62,,,0,"percent of total billed charges","33.9% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",197.34,78,,157.87,,,0,"percent of total billed charges","78% of total billed charges",160.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",208.98,82.6,,167.18,,,0,"percent of total billed charges","82.6% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",208.98,82.6,,167.18,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",38.71,566.92,
"VISUAL REINFOR AUDIO 30 MIN",47192579,CDM,471,RC,92579,CPT,OUTPATIENT,,,314,204.1,,276.32,88,,221.06,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,314,100,,251.20,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",75.82,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",197.82,63,,158.26,,,0,"percent of total billed charges","63% of total billed charges",48.04,15.3,,38.43,,,0,"percent of total billed charges","15.3% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,216.66,69,,,,,0,"fee schedule","69% of total billed charges",314,100,,251.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",314,100,,251.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",314,100,,251.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",54.53,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75.09,100,,,,,0,"fee schedule",EAPG,95.7,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.38,37.7,,94.70,,,0,"percent of total billed charges","37.7% of total billed charges",118.38,37.7,,94.70,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",106.45,33.9,,85.16,,,0,"percent of total billed charges","33.9% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.92,78,,195.94,,,0,"percent of total billed charges","78% of total billed charges",160.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",259.36,82.6,,207.49,,,0,"percent of total billed charges","82.6% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",259.36,82.6,,207.49,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,314,100,,251.20,,,0,"percent of total billed charges","100% of total billed charges",48.04,566.92,
N/A,,,440,RC,,,OUTPATIENT,,,489,317.85,,430.32,88,,344.26,,,0,"percent of total billed charges","88% of total billed charges",244.5,50,,195.60,,,0,"percent of total billed charges","50% of total billed charges",82.15,16.8,,65.72,,,0,"percent of total billed charges","16.8% of total billed charges",489,100,,391.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.62,17.304,,67.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",308.07,63,,246.46,,,0,"percent of total billed charges","63% of total billed charges",74.82,15.3,,59.86,,,0,"percent of total billed charges","15.3% of total billed charges",82.15,16.8,,65.72,,,0,"percent of total billed charges","16.8% of total billed charges",337.41,69,,,,,0,"fee schedule","69% of total billed charges",489,100,,391.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",489,100,,391.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",489,100,,391.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",82.15,16.8,,65.72,,,0,"percent of total billed charges","16.8% of total billed charges",244.5,50,,195.60,,,0,"percent of total billed charges","50% of total billed charges",157.46,32.2,,125.97,,,0,"percent of total billed charges","32.2% of total billed charges",82.15,16.8,,65.72,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",83.8,17.136,,67.04,,,0,"percent of total billed charges","17.136% of total billed charges",106.8,21.84,,85.44,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",184.35,37.7,,147.48,,,0,"percent of total billed charges","37.7% of total billed charges",184.35,37.7,,147.48,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.77,33.9,,132.62,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",381.42,78,,305.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.91,82.6,,323.13,,,0,"percent of total billed charges","82.6% of total billed charges",82.15,16.8,,65.72,,,0,"percent of total billed charges","16.8% of total billed charges",244.5,50,,195.60,,,0,"percent of total billed charges","50% of total billed charges",403.91,82.6,,323.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.15,16.8,,65.72,,,0,"percent of total billed charges","16.8% of total billed charges",489,100,,391.20,,,0,"percent of total billed charges","100% of total billed charges",74.82,489,
DPOAE,44092588,CDM,440,RC,92588,CPT,OUTPATIENT,,,527,342.55,GN,463.76,88,,371.01,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,527,100,,421.60,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",75.82,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",332.01,63,,265.61,,,0,"percent of total billed charges","63% of total billed charges",80.63,15.3,,64.50,,,0,"percent of total billed charges","15.3% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,363.63,69,,,,,0,"fee schedule","69% of total billed charges",527,100,,421.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",527,100,,421.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",527,100,,421.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",54.53,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75.09,100,,,,,0,"fee schedule",EAPG,95.7,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",198.68,37.7,,158.94,,,0,"percent of total billed charges","37.7% of total billed charges",198.68,37.7,,158.94,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",178.65,33.9,,142.92,,,0,"percent of total billed charges","33.9% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",411.06,78,,328.85,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",435.3,82.6,,348.24,,,0,"percent of total billed charges","82.6% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",435.3,82.6,,348.24,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,527,100,,421.60,,,0,"percent of total billed charges","100% of total billed charges",54.53,1074.33,
"CENTRAL AUD FUNC TEST 1 HR",44092589,CDM,440,RC,92589,CPT,OUTPATIENT,,,127,82.55,,111.76,88,,89.41,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.34,16.8,,17.07,,,0,"percent of total billed charges","16.8% of total billed charges",127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.98,17.304,,17.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.01,63,,64.01,,,0,"percent of total billed charges","63% of total billed charges",19.43,15.3,,15.54,,,0,"percent of total billed charges","15.3% of total billed charges",21.34,16.8,,17.07,,,0,"percent of total billed charges","16.8% of total billed charges",87.63,69,,,,,0,"fee schedule","69% of total billed charges",127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.34,16.8,,17.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.34,16.8,,17.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.76,17.136,,17.41,,,0,"percent of total billed charges","17.136% of total billed charges",27.74,21.84,,22.19,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.88,37.7,,38.30,,,0,"percent of total billed charges","37.7% of total billed charges",47.88,37.7,,38.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.05,33.9,,34.44,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",99.06,78,,79.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.9,82.6,,83.92,,,0,"percent of total billed charges","82.6% of total billed charges",21.34,16.8,,17.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.9,82.6,,83.92,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.34,16.8,,17.07,,,0,"percent of total billed charges","16.8% of total billed charges",127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",19.43,127,
"CONDITIONED PLAY AUDIO 30 MIN",47192582,CDM,471,RC,92582,CPT,OUTPATIENT,,,563,365.95,,495.44,88,,396.35,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,563,100,,450.40,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",75.82,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",354.69,63,,283.75,,,0,"percent of total billed charges","63% of total billed charges",86.14,15.3,,68.91,,,0,"percent of total billed charges","15.3% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,388.47,69,,,,,0,"fee schedule","69% of total billed charges",563,100,,450.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",563,100,,450.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",563,100,,450.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",54.53,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75.09,100,,,,,0,"fee schedule",EAPG,95.7,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",212.25,37.7,,169.80,,,0,"percent of total billed charges","37.7% of total billed charges",212.25,37.7,,169.80,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.86,33.9,,152.69,,,0,"percent of total billed charges","33.9% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",439.14,78,,351.31,,,0,"percent of total billed charges","78% of total billed charges",160.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465.04,82.6,,372.03,,,0,"percent of total billed charges","82.6% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465.04,82.6,,372.03,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,563,100,,450.40,,,0,"percent of total billed charges","100% of total billed charges",54.53,566.92,
"INFANT HEARING SCREEN",47092587,CDM,470,RC,92587,CPT,OUTPATIENT,,,320,208,,281.6,88,,225.28,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",75.82,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",201.6,63,,161.28,,,0,"percent of total billed charges","63% of total billed charges",48.96,15.3,,39.17,,,0,"percent of total billed charges","15.3% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,220.8,69,,,,,0,"fee schedule","69% of total billed charges",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",54.53,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75.09,100,,,,,0,"fee schedule",EAPG,95.7,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",120.64,37.7,,96.51,,,0,"percent of total billed charges","37.7% of total billed charges",120.64,37.7,,96.51,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.48,33.9,,86.78,,,0,"percent of total billed charges","33.9% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",249.6,78,,199.68,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",264.32,82.6,,211.46,,,0,"percent of total billed charges","82.6% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",264.32,82.6,,211.46,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",48.96,1074.33,
"OTOACOUSTIC EMISSIONS 30 MIN",47192587,CDM,471,RC,92587,CPT,OUTPATIENT,,,369,239.85,TC,324.72,88,,259.78,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,369,100,,295.20,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",75.82,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",232.47,63,,185.98,,,0,"percent of total billed charges","63% of total billed charges",56.46,15.3,,45.17,,,0,"percent of total billed charges","15.3% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,254.61,69,,,,,0,"fee schedule","69% of total billed charges",369,100,,295.20,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",369,100,,295.20,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",369,100,,295.20,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",54.53,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75.09,100,,,,,0,"fee schedule",EAPG,95.7,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",139.11,37.7,,111.29,,,0,"percent of total billed charges","37.7% of total billed charges",139.11,37.7,,111.29,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.09,33.9,,100.07,,,0,"percent of total billed charges","33.9% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287.82,78,,230.26,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",304.79,82.6,,243.83,,,0,"percent of total billed charges","82.6% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",304.79,82.6,,243.83,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,369,100,,295.20,,,0,"percent of total billed charges","100% of total billed charges",54.53,1074.33,
"EVAL USE/FIT VOICE PROSTH/GN",44192597,CDM,440,RC,92597,CPT,OUTPATIENT,,,2427,1577.55,,2135.76,88,,1708.61,,,0,"percent of total billed charges","88% of total billed charges",73.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.95,100,,,,,0,"fee schedule","100% of WA fee schedule",2427,100,,1941.60,,,0,"percent of total billed charges","100% of total billed charges",127.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",41.95,100,,,,,0,"fee schedule","100% of WA fee schedule",73.42,100,,,,,0,"fee schedule","100% of CMS fee sv",1529.01,63,,1223.21,,,0,"percent of total billed charges","63% of total billed charges",371.33,15.3,,297.06,,,0,"percent of total billed charges","15.3% of total billed charges",41.95,100,,,,,0,"fee schedule","100% of WA fee schedule",1674.63,69,,,,,0,"fee schedule","69% of total billed charges",2427,100,,1941.60,,,0,"percent of total billed charges","100% of total billed charges",72.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",2427,100,,1941.60,,,0,"percent of total billed charges","100% of total billed charges",73.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",2427,100,,1941.60,,,0,"percent of total billed charges","100% of total billed charges",73.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",277.31,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",41.95,100,,,,,0,"fee schedule","100% of WA fee schedule",73.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.29,100,,,,,0,"fee schedule","100% of LI fee schedule",41.95,100,,,,,0,"fee schedule","100% of WA fee schedule",73.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.79,102,,,,,0,"fee schedule","102% of WA fee schedule",54.54,130,,,,,0,"fee schedule","130% of WA fee schedule",73.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",914.98,37.7,,731.98,,,0,"percent of total billed charges","37.7% of total billed charges",914.98,37.7,,731.98,,,0,"percent of total billed charges","37.70% of total billed charges",73.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",822.75,33.9,,658.20,,,0,"percent of total billed charges","33.9% of total billed charges",73.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",1893.06,78,,1514.45,,,0,"percent of total billed charges","78% of total billed charges",74.15,101,,,,,0,"fee schedule","101% of CMS fee schedule ",2004.7,82.6,,1603.76,,,0,"percent of total billed charges","82.6% of total billed charges",41.95,100,,,,,0,"fee schedule","100% of WA fee schedule",73.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",2004.7,82.6,,1603.76,,,0,"percent of total billed charges","82.6% of total billed charges",73.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.95,100,,,,,0,"fee schedule","100% of WA fee schedule",2427,100,,1941.60,,,0,"percent of total billed charges","100% of total billed charges",41.95,2427,
"CI INIT STIM/UNDER 7 1 HR",44092601,CDM,440,RC,92601,CPT,OUTPATIENT,,,1033,671.45,GN,909.04,88,,727.23,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,1033,100,,826.40,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.74,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",650.79,63,,520.63,,,0,"percent of total billed charges","63% of total billed charges",158.05,15.3,,126.44,,,0,"percent of total billed charges","15.3% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,712.77,69,,,,,0,"fee schedule","69% of total billed charges",1033,100,,826.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033,100,,826.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033,100,,826.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",25.7,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.4,100,,,,,0,"fee schedule",EAPG,45.11,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",389.44,37.7,,311.55,,,0,"percent of total billed charges","37.7% of total billed charges",389.44,37.7,,311.55,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350.19,33.9,,280.15,,,0,"percent of total billed charges","33.9% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",805.74,78,,644.59,,,0,"percent of total billed charges","78% of total billed charges",160.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",853.26,82.6,,682.61,,,0,"percent of total billed charges","82.6% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",853.26,82.6,,682.61,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,1033,100,,826.40,,,0,"percent of total billed charges","100% of total billed charges",25.7,1033,
"CI PROGRAM UNDER 7 1HR",44092602,CDM,440,RC,92602,CPT,OUTPATIENT,,,1033,671.45,,909.04,88,,727.23,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,1033,100,,826.40,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.74,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",650.79,63,,520.63,,,0,"percent of total billed charges","63% of total billed charges",158.05,15.3,,126.44,,,0,"percent of total billed charges","15.3% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,712.77,69,,,,,0,"fee schedule","69% of total billed charges",1033,100,,826.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033,100,,826.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033,100,,826.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",25.7,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.4,100,,,,,0,"fee schedule",EAPG,45.11,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",389.44,37.7,,311.55,,,0,"percent of total billed charges","37.7% of total billed charges",389.44,37.7,,311.55,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350.19,33.9,,280.15,,,0,"percent of total billed charges","33.9% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",805.74,78,,644.59,,,0,"percent of total billed charges","78% of total billed charges",160.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",853.26,82.6,,682.61,,,0,"percent of total billed charges","82.6% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",853.26,82.6,,682.61,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,1033,100,,826.40,,,0,"percent of total billed charges","100% of total billed charges",25.7,1033,
"DIAG ANALYSIS COCH.IMPLANT",44092603,CDM,440,RC,92603,CPT,OUTPATIENT,,,1033,671.45,,909.04,88,,727.23,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,1033,100,,826.40,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.74,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",650.79,63,,520.63,,,0,"percent of total billed charges","63% of total billed charges",158.05,15.3,,126.44,,,0,"percent of total billed charges","15.3% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,712.77,69,,,,,0,"fee schedule","69% of total billed charges",1033,100,,826.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033,100,,826.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033,100,,826.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",25.7,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.4,100,,,,,0,"fee schedule",EAPG,45.11,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",389.44,37.7,,311.55,,,0,"percent of total billed charges","37.7% of total billed charges",389.44,37.7,,311.55,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350.19,33.9,,280.15,,,0,"percent of total billed charges","33.9% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",805.74,78,,644.59,,,0,"percent of total billed charges","78% of total billed charges",160.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",853.26,82.6,,682.61,,,0,"percent of total billed charges","82.6% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",853.26,82.6,,682.61,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,1033,100,,826.40,,,0,"percent of total billed charges","100% of total billed charges",25.7,1033,
"SUBSEQUENT PROGRAM AGE 7+",47092604,CDM,470,RC,92604,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.7,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.74,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.7,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.7,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25.7,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",35.4,100,,,,,0,"fee schedule",EAPG,45.11,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.7,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.7,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",25.7,45.11,
"MODIFY/TRAIN VOICE PROSTHETIC",44092609,CDM,440,RC,92609,CPT,OUTPATIENT,,,528,343.2,,464.64,88,,371.71,,,0,"percent of total billed charges","88% of total billed charges",105.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.93,100,,,,,0,"fee schedule","100% of WA fee schedule",528,100,,422.40,,,0,"percent of total billed charges","100% of total billed charges",183.21,175,,,,,0,"fee schedule","175% of CMS fee schedule",60.93,100,,,,,0,"fee schedule","100% of WA fee schedule",105.35,100,,,,,0,"fee schedule","100% of CMS fee sv",332.64,63,,266.11,,,0,"percent of total billed charges","63% of total billed charges",80.78,15.3,,64.62,,,0,"percent of total billed charges","15.3% of total billed charges",60.93,100,,,,,0,"fee schedule","100% of WA fee schedule",364.32,69,,,,,0,"fee schedule","69% of total billed charges",528,100,,422.40,,,0,"percent of total billed charges","100% of total billed charges",104.69,100,,,,,0,"fee schedule","100% of CMS fee schedule",528,100,,422.40,,,0,"percent of total billed charges","100% of total billed charges",105.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",528,100,,422.40,,,0,"percent of total billed charges","100% of total billed charges",105.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",409.5,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",60.93,100,,,,,0,"fee schedule","100% of WA fee schedule",105.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",103.57,100,,,,,0,"fee schedule","100% of LI fee schedule",60.93,100,,,,,0,"fee schedule","100% of WA fee schedule",105.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",62.15,102,,,,,0,"fee schedule","102% of WA fee schedule",79.21,130,,,,,0,"fee schedule","130% of WA fee schedule",105.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",199.06,37.7,,159.25,,,0,"percent of total billed charges","37.7% of total billed charges",199.06,37.7,,159.25,,,0,"percent of total billed charges","37.70% of total billed charges",105.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",178.99,33.9,,143.19,,,0,"percent of total billed charges","33.9% of total billed charges",105.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",411.84,78,,329.47,,,0,"percent of total billed charges","78% of total billed charges",106.4,101,,,,,0,"fee schedule","101% of CMS fee schedule ",436.13,82.6,,348.90,,,0,"percent of total billed charges","82.6% of total billed charges",60.93,100,,,,,0,"fee schedule","100% of WA fee schedule",105.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",436.13,82.6,,348.90,,,0,"percent of total billed charges","82.6% of total billed charges",105.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.93,100,,,,,0,"fee schedule","100% of WA fee schedule",528,100,,422.40,,,0,"percent of total billed charges","100% of total billed charges",60.93,528,
"EVAL SPEECH DEVICE INITIAL HR",44092607,CDM,440,RC,92607,CPT,OUTPATIENT,,,770,500.5,,677.6,88,,542.08,,,0,"percent of total billed charges","88% of total billed charges",126.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.07,100,,,,,0,"fee schedule","100% of WA fee schedule",770,100,,616.00,,,0,"percent of total billed charges","100% of total billed charges",219.68,175,,,,,0,"fee schedule","175% of CMS fee schedule",73.07,100,,,,,0,"fee schedule","100% of WA fee schedule",126.35,100,,,,,0,"fee schedule","100% of CMS fee sv",485.1,63,,388.08,,,0,"percent of total billed charges","63% of total billed charges",117.81,15.3,,94.25,,,0,"percent of total billed charges","15.3% of total billed charges",73.07,100,,,,,0,"fee schedule","100% of WA fee schedule",531.3,69,,,,,0,"fee schedule","69% of total billed charges",770,100,,616.00,,,0,"percent of total billed charges","100% of total billed charges",125.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",770,100,,616.00,,,0,"percent of total billed charges","100% of total billed charges",126.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",770,100,,616.00,,,0,"percent of total billed charges","100% of total billed charges",126.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",489.68,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",73.07,100,,,,,0,"fee schedule","100% of WA fee schedule",126.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.25,100,,,,,0,"fee schedule","100% of LI fee schedule",73.07,100,,,,,0,"fee schedule","100% of WA fee schedule",126.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.53,102,,,,,0,"fee schedule","102% of WA fee schedule",94.99,130,,,,,0,"fee schedule","130% of WA fee schedule",126.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",290.29,37.7,,232.23,,,0,"percent of total billed charges","37.7% of total billed charges",290.29,37.7,,232.23,,,0,"percent of total billed charges","37.70% of total billed charges",126.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",261.03,33.9,,208.82,,,0,"percent of total billed charges","33.9% of total billed charges",126.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",600.6,78,,480.48,,,0,"percent of total billed charges","78% of total billed charges",127.61,101,,,,,0,"fee schedule","101% of CMS fee schedule ",636.02,82.6,,508.82,,,0,"percent of total billed charges","82.6% of total billed charges",73.07,100,,,,,0,"fee schedule","100% of WA fee schedule",126.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",636.02,82.6,,508.82,,,0,"percent of total billed charges","82.6% of total billed charges",126.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.07,100,,,,,0,"fee schedule","100% of WA fee schedule",770,100,,616.00,,,0,"percent of total billed charges","100% of total billed charges",73.07,770,
"EVAL SPEECH DEVICE ADD 30MIN",44092608,CDM,440,RC,92608,CPT,OUTPATIENT,,,348,226.2,,306.24,88,,244.99,,,0,"percent of total billed charges","88% of total billed charges",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.66,100,,,,,0,"fee schedule","100% of WA fee schedule",348,100,,278.40,,,0,"percent of total billed charges","100% of total billed charges",86.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",28.66,100,,,,,0,"fee schedule","100% of WA fee schedule",49.61,100,,,,,0,"fee schedule","100% of CMS fee sv",219.24,63,,175.39,,,0,"percent of total billed charges","63% of total billed charges",53.24,15.3,,42.59,,,0,"percent of total billed charges","15.3% of total billed charges",28.66,100,,,,,0,"fee schedule","100% of WA fee schedule",240.12,69,,,,,0,"fee schedule","69% of total billed charges",348,100,,278.40,,,0,"percent of total billed charges","100% of total billed charges",49.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",348,100,,278.40,,,0,"percent of total billed charges","100% of total billed charges",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",348,100,,278.40,,,0,"percent of total billed charges","100% of total billed charges",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",196.18,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",28.66,100,,,,,0,"fee schedule","100% of WA fee schedule",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.77,100,,,,,0,"fee schedule","100% of LI fee schedule",28.66,100,,,,,0,"fee schedule","100% of WA fee schedule",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.23,102,,,,,0,"fee schedule","102% of WA fee schedule",37.26,130,,,,,0,"fee schedule","130% of WA fee schedule",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",131.2,37.7,,104.96,,,0,"percent of total billed charges","37.7% of total billed charges",131.2,37.7,,104.96,,,0,"percent of total billed charges","37.70% of total billed charges",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",117.97,33.9,,94.38,,,0,"percent of total billed charges","33.9% of total billed charges",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",271.44,78,,217.15,,,0,"percent of total billed charges","78% of total billed charges",50.11,101,,,,,0,"fee schedule","101% of CMS fee schedule ",287.45,82.6,,229.96,,,0,"percent of total billed charges","82.6% of total billed charges",28.66,100,,,,,0,"fee schedule","100% of WA fee schedule",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",287.45,82.6,,229.96,,,0,"percent of total billed charges","82.6% of total billed charges",49.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.66,100,,,,,0,"fee schedule","100% of WA fee schedule",348,100,,278.40,,,0,"percent of total billed charges","100% of total billed charges",28.66,348,
"92603 CI Programming Initial, pt >7y.o.",47092603,CDM,470,RC,92603,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.7,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.74,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.7,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.7,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25.7,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",35.4,100,,,,,0,"fee schedule",EAPG,45.11,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.7,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.7,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",25.7,45.11,
"DYSPH/ORAL FEED EVAL/-GN",44092610,CDM,440,RC,92610,CPT,OUTPATIENT,,,1492,969.8,,1312.96,88,,1050.37,,,0,"percent of total billed charges","88% of total billed charges",70.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",1492,100,,1193.60,,,0,"percent of total billed charges","100% of total billed charges",123.01,175,,,,,0,"fee schedule","175% of CMS fee schedule",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",70.95,100,,,,,0,"fee schedule","100% of CMS fee sv",939.96,63,,751.97,,,0,"percent of total billed charges","63% of total billed charges",228.28,15.3,,182.62,,,0,"percent of total billed charges","15.3% of total billed charges",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",1029.48,69,,,,,0,"fee schedule","69% of total billed charges",1492,100,,1193.60,,,0,"percent of total billed charges","100% of total billed charges",70.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",1492,100,,1193.60,,,0,"percent of total billed charges","100% of total billed charges",70.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",1492,100,,1193.60,,,0,"percent of total billed charges","100% of total billed charges",70.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",270.47,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",70.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.91,100,,,,,0,"fee schedule","100% of LI fee schedule",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",70.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.92,102,,,,,0,"fee schedule","102% of WA fee schedule",64.9,130,,,,,0,"fee schedule","130% of WA fee schedule",70.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",562.48,37.7,,449.98,,,0,"percent of total billed charges","37.7% of total billed charges",562.48,37.7,,449.98,,,0,"percent of total billed charges","37.70% of total billed charges",70.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",505.79,33.9,,404.63,,,0,"percent of total billed charges","33.9% of total billed charges",70.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",1163.76,78,,931.01,,,0,"percent of total billed charges","78% of total billed charges",71.66,101,,,,,0,"fee schedule","101% of CMS fee schedule ",1232.39,82.6,,985.91,,,0,"percent of total billed charges","82.6% of total billed charges",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",70.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",1232.39,82.6,,985.91,,,0,"percent of total billed charges","82.6% of total billed charges",70.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",1492,100,,1193.60,,,0,"percent of total billed charges","100% of total billed charges",49.92,1492,
"DYSPH ASSESS W/VIDEO FL",44092611,CDM,440,RC,92611,CPT,OUTPATIENT,,,1421,923.65,,1250.48,88,,1000.38,,,0,"percent of total billed charges","88% of total billed charges",93.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.76,100,,,,,0,"fee schedule",EAPG,1421,100,,1136.80,,,0,"percent of total billed charges","100% of total billed charges",161.65,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,93.52,100,,,,,0,"fee schedule","100% of CMS fee sv",895.23,63,,716.18,,,0,"percent of total billed charges","63% of total billed charges",217.41,15.3,,173.93,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,980.49,69,,,,,0,"fee schedule","69% of total billed charges",1421,100,,1136.80,,,0,"percent of total billed charges","100% of total billed charges",92.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",1421,100,,1136.80,,,0,"percent of total billed charges","100% of total billed charges",93.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",1421,100,,1136.80,,,0,"percent of total billed charges","100% of total billed charges",93.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",358.29,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",108.76,100,,,,,0,"fee schedule",EAPG,93.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.9,100,,,,,0,"fee schedule","100% of LI fee schedule",80.56,100,,,,,0,"fee schedule",EAPG,93.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,93.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",535.72,37.7,,428.58,,,0,"percent of total billed charges","37.7% of total billed charges",535.72,37.7,,428.58,,,0,"percent of total billed charges","37.70% of total billed charges",93.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",481.72,33.9,,385.38,,,0,"percent of total billed charges","33.9% of total billed charges",93.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",1108.38,78,,886.70,,,0,"percent of total billed charges","78% of total billed charges",94.46,101,,,,,0,"fee schedule","101% of CMS fee schedule ",1173.75,82.6,,939.00,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,93.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",1173.75,82.6,,939.00,,,0,"percent of total billed charges","82.6% of total billed charges",93.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.76,100,,,,,0,"fee schedule",EAPG,1421,100,,1136.80,,,0,"percent of total billed charges","100% of total billed charges",80.56,1421,
"EVAL OF AUDITORY REHAB STATUS",44092626,CDM,440,RC,92626,CPT,OUTPATIENT,,,466,302.9,,410.08,88,,328.06,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.06,100,,,,,0,"fee schedule","100% of WA fee schedule",466,100,,372.80,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",51.06,100,,,,,0,"fee schedule","100% of WA fee schedule",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",293.58,63,,234.86,,,0,"percent of total billed charges","63% of total billed charges",71.3,15.3,,57.04,,,0,"percent of total billed charges","15.3% of total billed charges",51.06,100,,,,,0,"fee schedule","100% of WA fee schedule",321.54,69,,,,,0,"fee schedule","69% of total billed charges",466,100,,372.80,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",466,100,,372.80,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",466,100,,372.80,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.06,100,,,,,0,"fee schedule","100% of WA fee schedule",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.06,100,,,,,0,"fee schedule","100% of WA fee schedule",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.08,102,,,,,0,"fee schedule","102% of WA fee schedule",66.38,130,,,,,0,"fee schedule","130% of WA fee schedule",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",175.68,37.7,,140.54,,,0,"percent of total billed charges","37.7% of total billed charges",175.68,37.7,,140.54,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",157.97,33.9,,126.38,,,0,"percent of total billed charges","33.9% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",363.48,78,,290.78,,,0,"percent of total billed charges","78% of total billed charges",160.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",384.92,82.6,,307.94,,,0,"percent of total billed charges","82.6% of total billed charges",51.06,100,,,,,0,"fee schedule","100% of WA fee schedule",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",384.92,82.6,,307.94,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.06,100,,,,,0,"fee schedule","100% of WA fee schedule",466,100,,372.80,,,0,"percent of total billed charges","100% of total billed charges",51.06,566.92,
"AURAL REHAB EVAL ADDT 15 MIN",44092627,CDM,440,RC,92627,CPT,OUTPATIENT,,,212,137.8,,186.56,88,,149.25,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.96,100,,,,,0,"fee schedule","100% of WA fee schedule",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.96,100,,,,,0,"fee schedule","100% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",133.56,63,,106.85,,,0,"percent of total billed charges","63% of total billed charges",32.44,15.3,,25.95,,,0,"percent of total billed charges","15.3% of total billed charges",11.96,100,,,,,0,"fee schedule","100% of WA fee schedule",146.28,69,,,,,0,"fee schedule","69% of total billed charges",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.96,100,,,,,0,"fee schedule","100% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.96,100,,,,,0,"fee schedule","100% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",12.2,102,,,,,0,"fee schedule","102% of WA fee schedule",15.55,130,,,,,0,"fee schedule","130% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",79.92,37.7,,63.94,,,0,"percent of total billed charges","37.7% of total billed charges",79.92,37.7,,63.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.87,33.9,,57.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.36,78,,132.29,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",175.11,82.6,,140.09,,,0,"percent of total billed charges","82.6% of total billed charges",11.96,100,,,,,0,"fee schedule","100% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",175.11,82.6,,140.09,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.96,100,,,,,0,"fee schedule","100% of WA fee schedule",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",11.96,212,
"AUDITORY FUNCTION TEST 1ST HR",47092620,CDM,470,RC,92620,CPT,OUTPATIENT,,,699,454.35,,615.12,88,,492.10,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",208.14,100,,,,,0,"fee schedule",EAPG,699,100,,559.20,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",214.38,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",440.37,63,,352.30,,,0,"percent of total billed charges","63% of total billed charges",106.95,15.3,,85.56,,,0,"percent of total billed charges","15.3% of total billed charges",208.14,100,,,,,0,"fee schedule",EAPG,482.31,69,,,,,0,"fee schedule","69% of total billed charges",699,100,,559.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",699,100,,559.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",699,100,,559.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",208.14,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.17,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",212.3,100,,,,,0,"fee schedule",EAPG,270.58,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",263.52,37.7,,210.82,,,0,"percent of total billed charges","37.7% of total billed charges",263.52,37.7,,210.82,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",236.96,33.9,,189.57,,,0,"percent of total billed charges","33.9% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",545.22,78,,436.18,,,0,"percent of total billed charges","78% of total billed charges",160.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",577.37,82.6,,461.90,,,0,"percent of total billed charges","82.6% of total billed charges",208.14,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",577.37,82.6,,461.90,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",208.14,100,,,,,0,"fee schedule",EAPG,699,100,,559.20,,,0,"percent of total billed charges","100% of total billed charges",106.95,699,
"AUD FUNCTION TEST/ADDL 15 MIN",47092621,CDM,470,RC,92621,CPT,OUTPATIENT,,,164,106.6,,144.32,88,,115.46,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.14,100,,,,,0,"fee schedule",EAPG,164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",214.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",103.32,63,,82.66,,,0,"percent of total billed charges","63% of total billed charges",25.09,15.3,,20.07,,,0,"percent of total billed charges","15.3% of total billed charges",208.14,100,,,,,0,"fee schedule",EAPG,113.16,69,,,,,0,"fee schedule","69% of total billed charges",164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",208.14,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",154.17,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",212.3,100,,,,,0,"fee schedule",EAPG,270.58,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",61.83,37.7,,49.46,,,0,"percent of total billed charges","37.7% of total billed charges",61.83,37.7,,49.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",55.6,33.9,,44.48,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.92,78,,102.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",135.46,82.6,,108.37,,,0,"percent of total billed charges","82.6% of total billed charges",208.14,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",135.46,82.6,,108.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.14,100,,,,,0,"fee schedule",EAPG,164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",25.09,270.58,
"TINNITUS ASSESSMENT",47192625,CDM,471,RC,92625,CPT,OUTPATIENT,,,522,339.3,,459.36,88,,367.49,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",75.82,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",328.86,63,,263.09,,,0,"percent of total billed charges","63% of total billed charges",79.87,15.3,,63.90,,,0,"percent of total billed charges","15.3% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,360.18,69,,,,,0,"fee schedule","69% of total billed charges",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",54.53,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75.09,100,,,,,0,"fee schedule",EAPG,95.7,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",196.79,37.7,,157.43,,,0,"percent of total billed charges","37.7% of total billed charges",196.79,37.7,,157.43,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",176.96,33.9,,141.57,,,0,"percent of total billed charges","33.9% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",407.16,78,,325.73,,,0,"percent of total billed charges","78% of total billed charges",160.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",431.17,82.6,,344.94,,,0,"percent of total billed charges","82.6% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",431.17,82.6,,344.94,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",54.53,566.92,
"EVAL AURAL REHAB STATUS 1ST HR",47092626,CDM,470,RC,92626,CPT,OUTPATIENT,,,496,322.4,,436.48,88,,349.18,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.06,100,,,,,0,"fee schedule","100% of WA fee schedule",496,100,,396.80,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",51.06,100,,,,,0,"fee schedule","100% of WA fee schedule",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",312.48,63,,249.98,,,0,"percent of total billed charges","63% of total billed charges",75.89,15.3,,60.71,,,0,"percent of total billed charges","15.3% of total billed charges",51.06,100,,,,,0,"fee schedule","100% of WA fee schedule",342.24,69,,,,,0,"fee schedule","69% of total billed charges",496,100,,396.80,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",496,100,,396.80,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",496,100,,396.80,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.06,100,,,,,0,"fee schedule","100% of WA fee schedule",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.06,100,,,,,0,"fee schedule","100% of WA fee schedule",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.08,102,,,,,0,"fee schedule","102% of WA fee schedule",66.38,130,,,,,0,"fee schedule","130% of WA fee schedule",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",186.99,37.7,,149.59,,,0,"percent of total billed charges","37.7% of total billed charges",186.99,37.7,,149.59,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.14,33.9,,134.51,,,0,"percent of total billed charges","33.9% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",386.88,78,,309.50,,,0,"percent of total billed charges","78% of total billed charges",160.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.7,82.6,,327.76,,,0,"percent of total billed charges","82.6% of total billed charges",51.06,100,,,,,0,"fee schedule","100% of WA fee schedule",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.7,82.6,,327.76,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.06,100,,,,,0,"fee schedule","100% of WA fee schedule",496,100,,396.80,,,0,"percent of total billed charges","100% of total billed charges",51.06,566.92,
"EVAL AURAL REHAB STATUS ADD 15",47092627,CDM,470,RC,92627,CPT,OUTPATIENT,,,212,137.8,,186.56,88,,149.25,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.96,100,,,,,0,"fee schedule","100% of WA fee schedule",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.96,100,,,,,0,"fee schedule","100% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",133.56,63,,106.85,,,0,"percent of total billed charges","63% of total billed charges",32.44,15.3,,25.95,,,0,"percent of total billed charges","15.3% of total billed charges",11.96,100,,,,,0,"fee schedule","100% of WA fee schedule",146.28,69,,,,,0,"fee schedule","69% of total billed charges",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.96,100,,,,,0,"fee schedule","100% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.96,100,,,,,0,"fee schedule","100% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",12.2,102,,,,,0,"fee schedule","102% of WA fee schedule",15.55,130,,,,,0,"fee schedule","130% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",79.92,37.7,,63.94,,,0,"percent of total billed charges","37.7% of total billed charges",79.92,37.7,,63.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.87,33.9,,57.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.36,78,,132.29,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",175.11,82.6,,140.09,,,0,"percent of total billed charges","82.6% of total billed charges",11.96,100,,,,,0,"fee schedule","100% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",175.11,82.6,,140.09,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.96,100,,,,,0,"fee schedule","100% of WA fee schedule",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",11.96,212,
"AURAL REHAB PRE LINGUAL 1 HR",44092630,CDM,440,RC,92630,CPT,OUTPATIENT,,,1581,1027.65,,1391.28,88,,1113.02,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.1,100,,,,,0,"fee schedule",EAPG,1581,100,,1264.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.97,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",996.03,63,,796.82,,,0,"percent of total billed charges","63% of total billed charges",241.89,15.3,,193.51,,,0,"percent of total billed charges","15.3% of total billed charges",29.1,100,,,,,0,"fee schedule",EAPG,1090.89,69,,,,,0,"fee schedule","69% of total billed charges",1581,100,,1264.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1581,100,,1264.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1581,100,,1264.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.55,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",29.68,100,,,,,0,"fee schedule",EAPG,37.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",596.04,37.7,,476.83,,,0,"percent of total billed charges","37.7% of total billed charges",596.04,37.7,,476.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",535.96,33.9,,428.77,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1233.18,78,,986.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1305.91,82.6,,1044.73,,,0,"percent of total billed charges","82.6% of total billed charges",29.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1305.91,82.6,,1044.73,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.1,100,,,,,0,"fee schedule",EAPG,1581,100,,1264.80,,,0,"percent of total billed charges","100% of total billed charges",21.55,1581,
"AURAL REHAB POST-LING 1HR",44092633,CDM,440,RC,92633,CPT,OUTPATIENT,,,1581,1027.65,,1391.28,88,,1113.02,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.1,100,,,,,0,"fee schedule",EAPG,1581,100,,1264.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.97,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",996.03,63,,796.82,,,0,"percent of total billed charges","63% of total billed charges",241.89,15.3,,193.51,,,0,"percent of total billed charges","15.3% of total billed charges",29.1,100,,,,,0,"fee schedule",EAPG,1090.89,69,,,,,0,"fee schedule","69% of total billed charges",1581,100,,1264.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1581,100,,1264.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1581,100,,1264.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.55,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",29.68,100,,,,,0,"fee schedule",EAPG,37.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",596.04,37.7,,476.83,,,0,"percent of total billed charges","37.7% of total billed charges",596.04,37.7,,476.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",535.96,33.9,,428.77,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1233.18,78,,986.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1305.91,82.6,,1044.73,,,0,"percent of total billed charges","82.6% of total billed charges",29.1,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1305.91,82.6,,1044.73,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.1,100,,,,,0,"fee schedule",EAPG,1581,100,,1264.80,,,0,"percent of total billed charges","100% of total billed charges",21.55,1581,
"APHASIA ASSESS/REP/HR/-GN",44096105,CDM,440,RC,96105,CPT,OUTPATIENT,,,1782,1158.3,,1568.16,88,,1254.53,,,0,"percent of total billed charges","88% of total billed charges",97.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",521.69,100,,,,,0,"fee schedule",EAPG,1782,100,,1425.60,,,0,"percent of total billed charges","100% of total billed charges",168.12,175,,,,,0,"fee schedule","175% of CMS fee schedule",537.34,100,,,,,0,"fee schedule",EAPG,97.22,100,,,,,0,"fee schedule","100% of CMS fee sv",1122.66,63,,898.13,,,0,"percent of total billed charges","63% of total billed charges",272.65,15.3,,218.12,,,0,"percent of total billed charges","15.3% of total billed charges",521.69,100,,,,,0,"fee schedule",EAPG,1229.58,69,,,,,0,"fee schedule","69% of total billed charges",1782,100,,1425.60,,,0,"percent of total billed charges","100% of total billed charges",96.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",1782,100,,1425.60,,,0,"percent of total billed charges","100% of total billed charges",97.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",1782,100,,1425.60,,,0,"percent of total billed charges","100% of total billed charges",97.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",386.94,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",521.69,100,,,,,0,"fee schedule",EAPG,97.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.76,100,,,,,0,"fee schedule","100% of LI fee schedule",386.44,100,,,,,0,"fee schedule",EAPG,97.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",532.13,100,,,,,0,"fee schedule",EAPG,678.2,100,,,,,0,"fee schedule",EAPG,97.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",671.81,37.7,,537.45,,,0,"percent of total billed charges","37.7% of total billed charges",671.81,37.7,,537.45,,,0,"percent of total billed charges","37.70% of total billed charges",97.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",604.1,33.9,,483.28,,,0,"percent of total billed charges","33.9% of total billed charges",97.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",1389.96,78,,1111.97,,,0,"percent of total billed charges","78% of total billed charges",98.19,101,,,,,0,"fee schedule","101% of CMS fee schedule ",1471.93,82.6,,1177.54,,,0,"percent of total billed charges","82.6% of total billed charges",521.69,100,,,,,0,"fee schedule","100% of WA fee schedule",97.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",1471.93,82.6,,1177.54,,,0,"percent of total billed charges","82.6% of total billed charges",97.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",521.69,100,,,,,0,"fee schedule",EAPG,1782,100,,1425.60,,,0,"percent of total billed charges","100% of total billed charges",95.76,1782,
"COGNITIVE TEST PER HOUR",44096125,CDM,440,RC,96125,CPT,OUTPATIENT,,,1146,744.9,,1008.48,88,,806.78,,,0,"percent of total billed charges","88% of total billed charges",103.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",521.69,100,,,,,0,"fee schedule",EAPG,1146,100,,916.80,,,0,"percent of total billed charges","100% of total billed charges",180.16,175,,,,,0,"fee schedule","175% of CMS fee schedule",537.34,100,,,,,0,"fee schedule",EAPG,103.93,100,,,,,0,"fee schedule","100% of CMS fee sv",721.98,63,,577.58,,,0,"percent of total billed charges","63% of total billed charges",175.34,15.3,,140.27,,,0,"percent of total billed charges","15.3% of total billed charges",521.69,100,,,,,0,"fee schedule",EAPG,790.74,69,,,,,0,"fee schedule","69% of total billed charges",1146,100,,916.80,,,0,"percent of total billed charges","100% of total billed charges",102.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",1146,100,,916.80,,,0,"percent of total billed charges","100% of total billed charges",103.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",1146,100,,916.80,,,0,"percent of total billed charges","100% of total billed charges",103.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",409.05,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",521.69,100,,,,,0,"fee schedule",EAPG,103.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",102.29,100,,,,,0,"fee schedule","100% of LI fee schedule",386.44,100,,,,,0,"fee schedule",EAPG,103.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",532.13,100,,,,,0,"fee schedule",EAPG,678.2,100,,,,,0,"fee schedule",EAPG,103.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",432.04,37.7,,345.63,,,0,"percent of total billed charges","37.7% of total billed charges",432.04,37.7,,345.63,,,0,"percent of total billed charges","37.70% of total billed charges",103.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",388.49,33.9,,310.79,,,0,"percent of total billed charges","33.9% of total billed charges",103.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",893.88,78,,715.10,,,0,"percent of total billed charges","78% of total billed charges",104.97,101,,,,,0,"fee schedule","101% of CMS fee schedule ",946.6,82.6,,757.28,,,0,"percent of total billed charges","82.6% of total billed charges",521.69,100,,,,,0,"fee schedule",EAPG,103.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",946.6,82.6,,757.28,,,0,"percent of total billed charges","82.6% of total billed charges",103.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",521.69,100,,,,,0,"fee schedule",EAPG,1146,100,,916.80,,,0,"percent of total billed charges","100% of total billed charges",102.29,1146,
N/A,,,440,RC,,,OUTPATIENT,,,267,173.55,,234.96,88,,187.97,,,0,"percent of total billed charges","88% of total billed charges",133.5,50,,106.80,,,0,"percent of total billed charges","50% of total billed charges",44.86,16.8,,35.89,,,0,"percent of total billed charges","16.8% of total billed charges",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.2,17.304,,36.96,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.21,63,,134.57,,,0,"percent of total billed charges","63% of total billed charges",40.85,15.3,,32.68,,,0,"percent of total billed charges","15.3% of total billed charges",44.86,16.8,,35.89,,,0,"percent of total billed charges","16.8% of total billed charges",184.23,69,,,,,0,"fee schedule","69% of total billed charges",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",44.86,16.8,,35.89,,,0,"percent of total billed charges","16.8% of total billed charges",133.5,50,,106.80,,,0,"percent of total billed charges","50% of total billed charges",85.97,32.2,,68.78,,,0,"percent of total billed charges","32.2% of total billed charges",44.86,16.8,,35.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.75,17.136,,36.60,,,0,"percent of total billed charges","17.136% of total billed charges",58.31,21.84,,46.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",100.66,37.7,,80.53,,,0,"percent of total billed charges","37.7% of total billed charges",100.66,37.7,,80.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.51,33.9,,72.41,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.26,78,,166.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",220.54,82.6,,176.43,,,0,"percent of total billed charges","82.6% of total billed charges",44.86,16.8,,35.89,,,0,"percent of total billed charges","16.8% of total billed charges",133.5,50,,106.80,,,0,"percent of total billed charges","50% of total billed charges",220.54,82.6,,176.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.86,16.8,,35.89,,,0,"percent of total billed charges","16.8% of total billed charges",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",40.85,267,
"Cognitive Skills Development Intial 15 min",44097129,CDM,440,RC,97129,CPT,OUTPATIENT,,,272,176.8,,239.36,88,,191.49,,,0,"percent of total billed charges","88% of total billed charges",22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,272,100,,217.60,,,0,"percent of total billed charges","100% of total billed charges",38.59,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.83,100,,,,,0,"fee schedule",EAPG,22.22,100,,,,,0,"fee schedule","100% of CMS fee sv",171.36,63,,137.09,,,0,"percent of total billed charges","63% of total billed charges",41.62,15.3,,33.30,,,0,"percent of total billed charges","15.3% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,187.68,69,,,,,0,"fee schedule","69% of total billed charges",272,100,,217.60,,,0,"percent of total billed charges","100% of total billed charges",22.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",272,100,,217.60,,,0,"percent of total billed charges","100% of total billed charges",22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",272,100,,217.60,,,0,"percent of total billed charges","100% of total billed charges",22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",89.01,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.95,100,,,,,0,"fee schedule","100% of LI fee schedule",25.77,100,,,,,0,"fee schedule",EAPG,22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.48,100,,,,,0,"fee schedule",EAPG,45.23,100,,,,,0,"fee schedule",EAPG,22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",102.54,37.7,,82.03,,,0,"percent of total billed charges","37.7% of total billed charges",102.54,37.7,,82.03,,,0,"percent of total billed charges","37.70% of total billed charges",22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",92.21,33.9,,73.77,,,0,"percent of total billed charges","33.9% of total billed charges",22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",212.16,78,,169.73,,,0,"percent of total billed charges","78% of total billed charges",22.44,101,,,,,0,"fee schedule","101% of CMS fee schedule ",224.67,82.6,,179.74,,,0,"percent of total billed charges","82.6% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",224.67,82.6,,179.74,,,0,"percent of total billed charges","82.6% of total billed charges",22.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,272,100,,217.60,,,0,"percent of total billed charges","100% of total billed charges",21.95,272,
N/A,44097130,CDM,440,RC,97130,CPT,OUTPATIENT,,,158,102.7,,139.04,88,,111.23,,,0,"percent of total billed charges","88% of total billed charges",21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",36.8,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.83,100,,,,,0,"fee schedule",EAPG,21.2,100,,,,,0,"fee schedule","100% of CMS fee sv",99.54,63,,79.63,,,0,"percent of total billed charges","63% of total billed charges",24.17,15.3,,19.34,,,0,"percent of total billed charges","15.3% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,109.02,69,,,,,0,"fee schedule","69% of total billed charges",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",21.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",84.99,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.95,100,,,,,0,"fee schedule","100% of LI fee schedule",25.77,100,,,,,0,"fee schedule",EAPG,21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.48,100,,,,,0,"fee schedule",EAPG,45.23,100,,,,,0,"fee schedule",EAPG,21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",59.57,37.7,,47.66,,,0,"percent of total billed charges","37.7% of total billed charges",59.57,37.7,,47.66,,,0,"percent of total billed charges","37.70% of total billed charges",21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",53.56,33.9,,42.85,,,0,"percent of total billed charges","33.9% of total billed charges",21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",123.24,78,,98.59,,,0,"percent of total billed charges","78% of total billed charges",21.41,101,,,,,0,"fee schedule","101% of CMS fee schedule ",130.51,82.6,,104.41,,,0,"percent of total billed charges","82.6% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,21.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",130.51,82.6,,104.41,,,0,"percent of total billed charges","82.6% of total billed charges",21.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",20.95,158,
"OFFICE VISIT LEVEL 2",47099202,CDM,470,RC,99202,CPT,OUTPATIENT,,,217,141.05,,190.96,88,,152.77,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.46,16.8,,29.17,,,0,"percent of total billed charges","16.8% of total billed charges",217,100,,173.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.55,17.304,,30.04,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.71,63,,109.37,,,0,"percent of total billed charges","63% of total billed charges",33.2,15.3,,26.56,,,0,"percent of total billed charges","15.3% of total billed charges",36.46,16.8,,29.17,,,0,"percent of total billed charges","16.8% of total billed charges",149.73,69,,,,,0,"fee schedule","69% of total billed charges",217,100,,173.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",217,100,,173.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",217,100,,173.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.46,16.8,,29.17,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.46,16.8,,29.17,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.19,17.136,,29.75,,,0,"percent of total billed charges","17.136% of total billed charges",47.39,21.84,,37.91,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.81,37.7,,65.45,,,0,"percent of total billed charges","37.7% of total billed charges",81.81,37.7,,65.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",169.26,78,,135.41,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.24,82.6,,143.39,,,0,"percent of total billed charges","82.6% of total billed charges",36.46,16.8,,29.17,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.24,82.6,,143.39,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.46,16.8,,29.17,,,0,"percent of total billed charges","16.8% of total billed charges",217,100,,173.60,,,0,"percent of total billed charges","100% of total billed charges",33.2,217,
"BATTERIES 40 CELLS",470V5266,CDM,470,RC,,,OUTPATIENT,,,91,59.15,,80.08,88,,64.06,,,0,"percent of total billed charges","88% of total billed charges",45.5,50,,36.40,,,0,"percent of total billed charges","50% of total billed charges",15.29,16.8,,12.23,,,0,"percent of total billed charges","16.8% of total billed charges",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.75,17.304,,12.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.33,63,,45.86,,,0,"percent of total billed charges","63% of total billed charges",13.92,15.3,,11.14,,,0,"percent of total billed charges","15.3% of total billed charges",15.29,16.8,,12.23,,,0,"percent of total billed charges","16.8% of total billed charges",62.79,69,,,,,0,"fee schedule","69% of total billed charges",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.29,16.8,,12.23,,,0,"percent of total billed charges","16.8% of total billed charges",45.5,50,,36.40,,,0,"percent of total billed charges","50% of total billed charges",29.3,32.2,,23.44,,,0,"percent of total billed charges","32.2% of total billed charges",15.29,16.8,,12.23,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.59,17.136,,12.47,,,0,"percent of total billed charges","17.136% of total billed charges",19.87,21.84,,15.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.31,37.7,,27.45,,,0,"percent of total billed charges","37.7% of total billed charges",34.31,37.7,,27.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.85,33.9,,24.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.98,78,,56.78,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.17,82.6,,60.14,,,0,"percent of total billed charges","82.6% of total billed charges",15.29,16.8,,12.23,,,0,"percent of total billed charges","16.8% of total billed charges",45.5,50,,36.40,,,0,"percent of total billed charges","50% of total billed charges",75.17,82.6,,60.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.29,16.8,,12.23,,,0,"percent of total billed charges","16.8% of total billed charges",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",13.92,91,
"ANALYSIS QUAL VOICE  RESONANC",44492524X,CDM,444,RC,92524,CPT,OUTPATIENT,,,707,459.55,,622.16,88,,497.73,,,0,"percent of total billed charges","88% of total billed charges",111.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.15,100,,,,,0,"fee schedule","100% of WA fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",192.64,175,,,,,0,"fee schedule","175% of CMS fee schedule",64.15,100,,,,,0,"fee schedule","100% of WA fee schedule",111.23,100,,,,,0,"fee schedule","100% of CMS fee sv",445.41,63,,356.33,,,0,"percent of total billed charges","63% of total billed charges",108.17,15.3,,86.54,,,0,"percent of total billed charges","15.3% of total billed charges",64.15,100,,,,,0,"fee schedule","100% of WA fee schedule",487.83,69,,,,,0,"fee schedule","69% of total billed charges",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",110.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",111.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",111.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",427.56,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",64.15,100,,,,,0,"fee schedule","100% of WA fee schedule",111.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",109.52,100,,,,,0,"fee schedule","100% of LI fee schedule",64.15,100,,,,,0,"fee schedule","100% of WA fee schedule",111.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.43,102,,,,,0,"fee schedule","102% of WA fee schedule",83.4,130,,,,,0,"fee schedule","130% of WA fee schedule",111.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",266.54,37.7,,213.23,,,0,"percent of total billed charges","37.7% of total billed charges",266.54,37.7,,213.23,,,0,"percent of total billed charges","37.70% of total billed charges",111.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",239.67,33.9,,191.74,,,0,"percent of total billed charges","33.9% of total billed charges",111.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",551.46,78,,441.17,,,0,"percent of total billed charges","78% of total billed charges",112.34,101,,,,,0,"fee schedule","101% of CMS fee schedule ",583.98,82.6,,467.18,,,0,"percent of total billed charges","82.6% of total billed charges",64.15,100,,,,,0,"fee schedule","100% of WA fee schedule",111.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",583.98,82.6,,467.18,,,0,"percent of total billed charges","82.6% of total billed charges",111.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.15,100,,,,,0,"fee schedule","100% of WA fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",64.15,707,
"DYSPH/ORAL FEED EVAL/-GN",44092610X,CDM,440,RC,92610,CPT,OUTPATIENT,,,1492,969.8,,1312.96,88,,1050.37,,,0,"percent of total billed charges","88% of total billed charges",70.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",1492,100,,1193.60,,,0,"percent of total billed charges","100% of total billed charges",123.01,175,,,,,0,"fee schedule","175% of CMS fee schedule",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",70.95,100,,,,,0,"fee schedule","100% of CMS fee sv",939.96,63,,751.97,,,0,"percent of total billed charges","63% of total billed charges",228.28,15.3,,182.62,,,0,"percent of total billed charges","15.3% of total billed charges",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",1029.48,69,,,,,0,"fee schedule","69% of total billed charges",1492,100,,1193.60,,,0,"percent of total billed charges","100% of total billed charges",70.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",1492,100,,1193.60,,,0,"percent of total billed charges","100% of total billed charges",70.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",1492,100,,1193.60,,,0,"percent of total billed charges","100% of total billed charges",70.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",270.47,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",70.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",69.91,100,,,,,0,"fee schedule","100% of LI fee schedule",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",70.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.92,102,,,,,0,"fee schedule","102% of WA fee schedule",64.9,130,,,,,0,"fee schedule","130% of WA fee schedule",70.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",562.48,37.7,,449.98,,,0,"percent of total billed charges","37.7% of total billed charges",562.48,37.7,,449.98,,,0,"percent of total billed charges","37.70% of total billed charges",70.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",505.79,33.9,,404.63,,,0,"percent of total billed charges","33.9% of total billed charges",70.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",1163.76,78,,931.01,,,0,"percent of total billed charges","78% of total billed charges",71.66,101,,,,,0,"fee schedule","101% of CMS fee schedule ",1232.39,82.6,,985.91,,,0,"percent of total billed charges","82.6% of total billed charges",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",70.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",1232.39,82.6,,985.91,,,0,"percent of total billed charges","82.6% of total billed charges",70.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",1492,100,,1193.60,,,0,"percent of total billed charges","100% of total billed charges",49.92,1492,
"EVAL USE/FIT VOICE PROSTH/GN",44192597X,CDM,440,RC,92597,CPT,OUTPATIENT,,,2427,1577.55,,2135.76,88,,1708.61,,,0,"percent of total billed charges","88% of total billed charges",73.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.95,100,,,,,0,"fee schedule","100% of WA fee schedule",2427,100,,1941.60,,,0,"percent of total billed charges","100% of total billed charges",127.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",41.95,100,,,,,0,"fee schedule","100% of WA fee schedule",73.42,100,,,,,0,"fee schedule","100% of CMS fee sv",1529.01,63,,1223.21,,,0,"percent of total billed charges","63% of total billed charges",371.33,15.3,,297.06,,,0,"percent of total billed charges","15.3% of total billed charges",41.95,100,,,,,0,"fee schedule","100% of WA fee schedule",1674.63,69,,,,,0,"fee schedule","69% of total billed charges",2427,100,,1941.60,,,0,"percent of total billed charges","100% of total billed charges",72.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",2427,100,,1941.60,,,0,"percent of total billed charges","100% of total billed charges",73.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",2427,100,,1941.60,,,0,"percent of total billed charges","100% of total billed charges",73.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",277.31,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",41.95,100,,,,,0,"fee schedule","100% of WA fee schedule",73.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.29,100,,,,,0,"fee schedule","100% of LI fee schedule",41.95,100,,,,,0,"fee schedule","100% of WA fee schedule",73.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",42.79,102,,,,,0,"fee schedule","102% of WA fee schedule",54.54,130,,,,,0,"fee schedule","130% of WA fee schedule",73.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",914.98,37.7,,731.98,,,0,"percent of total billed charges","37.7% of total billed charges",914.98,37.7,,731.98,,,0,"percent of total billed charges","37.70% of total billed charges",73.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",822.75,33.9,,658.20,,,0,"percent of total billed charges","33.9% of total billed charges",73.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",1893.06,78,,1514.45,,,0,"percent of total billed charges","78% of total billed charges",74.15,101,,,,,0,"fee schedule","101% of CMS fee schedule ",2004.7,82.6,,1603.76,,,0,"percent of total billed charges","82.6% of total billed charges",41.95,100,,,,,0,"fee schedule","100% of WA fee schedule",73.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",2004.7,82.6,,1603.76,,,0,"percent of total billed charges","82.6% of total billed charges",73.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",41.95,100,,,,,0,"fee schedule","100% of WA fee schedule",2427,100,,1941.60,,,0,"percent of total billed charges","100% of total billed charges",41.95,2427,
"DYSPH ASSESS W/VIDEO FL",44092611X,CDM,440,RC,92611,CPT,OUTPATIENT,,,1421,923.65,,1250.48,88,,1000.38,,,0,"percent of total billed charges","88% of total billed charges",93.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.76,100,,,,,0,"fee schedule",EAPG,1421,100,,1136.80,,,0,"percent of total billed charges","100% of total billed charges",161.65,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,93.52,100,,,,,0,"fee schedule","100% of CMS fee sv",895.23,63,,716.18,,,0,"percent of total billed charges","63% of total billed charges",217.41,15.3,,173.93,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,980.49,69,,,,,0,"fee schedule","69% of total billed charges",1421,100,,1136.80,,,0,"percent of total billed charges","100% of total billed charges",92.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",1421,100,,1136.80,,,0,"percent of total billed charges","100% of total billed charges",93.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",1421,100,,1136.80,,,0,"percent of total billed charges","100% of total billed charges",93.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",358.29,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",108.76,100,,,,,0,"fee schedule",EAPG,93.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",91.9,100,,,,,0,"fee schedule","100% of LI fee schedule",80.56,100,,,,,0,"fee schedule",EAPG,93.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,93.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",535.72,37.7,,428.58,,,0,"percent of total billed charges","37.7% of total billed charges",535.72,37.7,,428.58,,,0,"percent of total billed charges","37.70% of total billed charges",93.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",481.72,33.9,,385.38,,,0,"percent of total billed charges","33.9% of total billed charges",93.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",1108.38,78,,886.70,,,0,"percent of total billed charges","78% of total billed charges",94.46,101,,,,,0,"fee schedule","101% of CMS fee schedule ",1173.75,82.6,,939.00,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,93.52,100,,,,,0,"fee schedule","100% of CMS fee schedule",1173.75,82.6,,939.00,,,0,"percent of total billed charges","82.6% of total billed charges",93.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.76,100,,,,,0,"fee schedule",EAPG,1421,100,,1136.80,,,0,"percent of total billed charges","100% of total billed charges",80.56,1421,
"HA REPAIR/RECASE MANUF",470V5299,CDM,470,RC,,,OUTPATIENT,,,404,262.6,,355.52,88,,284.42,,,0,"percent of total billed charges","88% of total billed charges",202,50,,161.60,,,0,"percent of total billed charges","50% of total billed charges",67.87,16.8,,54.30,,,0,"percent of total billed charges","16.8% of total billed charges",404,100,,323.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.91,17.304,,55.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",254.52,63,,203.62,,,0,"percent of total billed charges","63% of total billed charges",61.81,15.3,,49.45,,,0,"percent of total billed charges","15.3% of total billed charges",67.87,16.8,,54.30,,,0,"percent of total billed charges","16.8% of total billed charges",278.76,69,,,,,0,"fee schedule","69% of total billed charges",404,100,,323.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",404,100,,323.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",404,100,,323.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",249.87,61.85,,199.90,,,0,"percent of total billed charges","61.5% of total billed charges",67.87,16.8,,54.30,,,0,"percent of total billed charges","16.8% of total billed charges",202,50,,161.60,,,0,"percent of total billed charges","50% of total billed charges",130.09,32.2,,104.07,,,0,"percent of total billed charges","32.2% of total billed charges",67.87,16.8,,54.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.23,17.136,,55.38,,,0,"percent of total billed charges","17.136% of total billed charges",88.23,21.84,,70.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",152.31,37.7,,121.85,,,0,"percent of total billed charges","37.7% of total billed charges",152.31,37.7,,121.85,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.96,33.9,,109.57,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",315.12,78,,252.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",333.7,82.6,,266.96,,,0,"percent of total billed charges","82.6% of total billed charges",67.87,16.8,,54.30,,,0,"percent of total billed charges","16.8% of total billed charges",202,50,,161.60,,,0,"percent of total billed charges","50% of total billed charges",333.7,82.6,,266.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.87,16.8,,54.30,,,0,"percent of total billed charges","16.8% of total billed charges",404,100,,323.20,,,0,"percent of total billed charges","100% of total billed charges",61.81,404,
"REPLACEMENT EARMOLD",470V5264,CDM,470,RC,,,OUTPATIENT,,,58,37.7,,51.04,88,,40.83,,,0,"percent of total billed charges","88% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.04,17.304,,8.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.54,63,,29.23,,,0,"percent of total billed charges","63% of total billed charges",8.87,15.3,,7.10,,,0,"percent of total billed charges","15.3% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",40.02,69,,,,,0,"fee schedule","69% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.87,61.85,,28.70,,,0,"percent of total billed charges","61.5% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",18.68,32.2,,14.94,,,0,"percent of total billed charges","32.2% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.94,17.136,,7.95,,,0,"percent of total billed charges","17.136% of total billed charges",12.67,21.84,,10.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.87,37.7,,17.50,,,0,"percent of total billed charges","37.7% of total billed charges",21.87,37.7,,17.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.66,33.9,,15.73,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.24,78,,36.19,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",8.87,58,
"SPEECH RE-EVALUATION",440S9152,CDM,440,RC,,,OUTPATIENT,,,338,219.7,,297.44,88,,237.95,,,0,"percent of total billed charges","88% of total billed charges",169,50,,135.20,,,0,"percent of total billed charges","50% of total billed charges",56.78,16.8,,45.42,,,0,"percent of total billed charges","16.8% of total billed charges",338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.49,17.304,,46.79,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",212.94,63,,170.35,,,0,"percent of total billed charges","63% of total billed charges",51.71,15.3,,41.37,,,0,"percent of total billed charges","15.3% of total billed charges",56.78,16.8,,45.42,,,0,"percent of total billed charges","16.8% of total billed charges",233.22,69,,,,,0,"fee schedule","69% of total billed charges",338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.05,61.85,,167.24,,,0,"percent of total billed charges","61.5% of total billed charges",56.78,16.8,,45.42,,,0,"percent of total billed charges","16.8% of total billed charges",169,50,,135.20,,,0,"percent of total billed charges","50% of total billed charges",108.84,32.2,,87.07,,,0,"percent of total billed charges","32.2% of total billed charges",56.78,16.8,,45.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.92,17.136,,46.34,,,0,"percent of total billed charges","17.136% of total billed charges",73.82,21.84,,59.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.43,37.7,,101.94,,,0,"percent of total billed charges","37.7% of total billed charges",127.43,37.7,,101.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.58,33.9,,91.66,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.64,78,,210.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",279.19,82.6,,223.35,,,0,"percent of total billed charges","82.6% of total billed charges",56.78,16.8,,45.42,,,0,"percent of total billed charges","16.8% of total billed charges",169,50,,135.20,,,0,"percent of total billed charges","50% of total billed charges",279.19,82.6,,223.35,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.78,16.8,,45.42,,,0,"percent of total billed charges","16.8% of total billed charges",338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",51.71,338,
N/A,,,440,RC,,,OUTPATIENT,,,267,173.55,,234.96,88,,187.97,,,0,"percent of total billed charges","88% of total billed charges",133.5,50,,106.80,,,0,"percent of total billed charges","50% of total billed charges",44.86,16.8,,35.89,,,0,"percent of total billed charges","16.8% of total billed charges",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.2,17.304,,36.96,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.21,63,,134.57,,,0,"percent of total billed charges","63% of total billed charges",40.85,15.3,,32.68,,,0,"percent of total billed charges","15.3% of total billed charges",44.86,16.8,,35.89,,,0,"percent of total billed charges","16.8% of total billed charges",184.23,69,,,,,0,"fee schedule","69% of total billed charges",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.14,61.85,,132.11,,,0,"percent of total billed charges","61.5% of total billed charges",44.86,16.8,,35.89,,,0,"percent of total billed charges","16.8% of total billed charges",133.5,50,,106.80,,,0,"percent of total billed charges","50% of total billed charges",85.97,32.2,,68.78,,,0,"percent of total billed charges","32.2% of total billed charges",44.86,16.8,,35.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.75,17.136,,36.60,,,0,"percent of total billed charges","17.136% of total billed charges",58.31,21.84,,46.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",100.66,37.7,,80.53,,,0,"percent of total billed charges","37.7% of total billed charges",100.66,37.7,,80.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.51,33.9,,72.41,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.26,78,,166.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",220.54,82.6,,176.43,,,0,"percent of total billed charges","82.6% of total billed charges",44.86,16.8,,35.89,,,0,"percent of total billed charges","16.8% of total billed charges",133.5,50,,106.80,,,0,"percent of total billed charges","50% of total billed charges",220.54,82.6,,176.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.86,16.8,,35.89,,,0,"percent of total billed charges","16.8% of total billed charges",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",40.85,267,
"EVAL SPEECH DEVICE INITIAL HR",44092607X,CDM,440,RC,92607,CPT,OUTPATIENT,,,770,500.5,,677.6,88,,542.08,,,0,"percent of total billed charges","88% of total billed charges",126.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.07,100,,,,,0,"fee schedule","100% of WA fee schedule",770,100,,616.00,,,0,"percent of total billed charges","100% of total billed charges",219.68,175,,,,,0,"fee schedule","175% of CMS fee schedule",73.07,100,,,,,0,"fee schedule","100% of WA fee schedule",126.35,100,,,,,0,"fee schedule","100% of CMS fee sv",485.1,63,,388.08,,,0,"percent of total billed charges","63% of total billed charges",117.81,15.3,,94.25,,,0,"percent of total billed charges","15.3% of total billed charges",73.07,100,,,,,0,"fee schedule","100% of WA fee schedule",531.3,69,,,,,0,"fee schedule","69% of total billed charges",770,100,,616.00,,,0,"percent of total billed charges","100% of total billed charges",125.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",770,100,,616.00,,,0,"percent of total billed charges","100% of total billed charges",126.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",770,100,,616.00,,,0,"percent of total billed charges","100% of total billed charges",126.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",489.68,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",73.07,100,,,,,0,"fee schedule","100% of WA fee schedule",126.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.25,100,,,,,0,"fee schedule","100% of LI fee schedule",73.07,100,,,,,0,"fee schedule","100% of WA fee schedule",126.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",74.53,102,,,,,0,"fee schedule","102% of WA fee schedule",94.99,130,,,,,0,"fee schedule","130% of WA fee schedule",126.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",290.29,37.7,,232.23,,,0,"percent of total billed charges","37.7% of total billed charges",290.29,37.7,,232.23,,,0,"percent of total billed charges","37.70% of total billed charges",126.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",261.03,33.9,,208.82,,,0,"percent of total billed charges","33.9% of total billed charges",126.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",600.6,78,,480.48,,,0,"percent of total billed charges","78% of total billed charges",127.61,101,,,,,0,"fee schedule","101% of CMS fee schedule ",636.02,82.6,,508.82,,,0,"percent of total billed charges","82.6% of total billed charges",73.07,100,,,,,0,"fee schedule","100% of WA fee schedule",126.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",636.02,82.6,,508.82,,,0,"percent of total billed charges","82.6% of total billed charges",126.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.07,100,,,,,0,"fee schedule","100% of WA fee schedule",770,100,,616.00,,,0,"percent of total billed charges","100% of total billed charges",73.07,770,
"EVAL SPEECH DEVICE ADD 30MIN",44092608X,CDM,440,RC,92608,CPT,OUTPATIENT,,,348,226.2,,306.24,88,,244.99,,,0,"percent of total billed charges","88% of total billed charges",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.66,100,,,,,0,"fee schedule","100% of WA fee schedule",348,100,,278.40,,,0,"percent of total billed charges","100% of total billed charges",86.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",28.66,100,,,,,0,"fee schedule","100% of WA fee schedule",49.61,100,,,,,0,"fee schedule","100% of CMS fee sv",219.24,63,,175.39,,,0,"percent of total billed charges","63% of total billed charges",53.24,15.3,,42.59,,,0,"percent of total billed charges","15.3% of total billed charges",28.66,100,,,,,0,"fee schedule","100% of WA fee schedule",240.12,69,,,,,0,"fee schedule","69% of total billed charges",348,100,,278.40,,,0,"percent of total billed charges","100% of total billed charges",49.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",348,100,,278.40,,,0,"percent of total billed charges","100% of total billed charges",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",348,100,,278.40,,,0,"percent of total billed charges","100% of total billed charges",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",196.18,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",28.66,100,,,,,0,"fee schedule","100% of WA fee schedule",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.77,100,,,,,0,"fee schedule","100% of LI fee schedule",28.66,100,,,,,0,"fee schedule","100% of WA fee schedule",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.23,102,,,,,0,"fee schedule","102% of WA fee schedule",37.26,130,,,,,0,"fee schedule","130% of WA fee schedule",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",131.2,37.7,,104.96,,,0,"percent of total billed charges","37.7% of total billed charges",131.2,37.7,,104.96,,,0,"percent of total billed charges","37.70% of total billed charges",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",117.97,33.9,,94.38,,,0,"percent of total billed charges","33.9% of total billed charges",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",271.44,78,,217.15,,,0,"percent of total billed charges","78% of total billed charges",50.11,101,,,,,0,"fee schedule","101% of CMS fee schedule ",287.45,82.6,,229.96,,,0,"percent of total billed charges","82.6% of total billed charges",28.66,100,,,,,0,"fee schedule","100% of WA fee schedule",49.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",287.45,82.6,,229.96,,,0,"percent of total billed charges","82.6% of total billed charges",49.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.66,100,,,,,0,"fee schedule","100% of WA fee schedule",348,100,,278.40,,,0,"percent of total billed charges","100% of total billed charges",28.66,348,
"EVAL SPEECH FLUENCY",44492521X,CDM,444,RC,92521,CPT,OUTPATIENT,,,707,459.55,,622.16,88,,497.73,,,0,"percent of total billed charges","88% of total billed charges",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.01,100,,,,,0,"fee schedule","100% of WA fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",234.85,175,,,,,0,"fee schedule","175% of CMS fee schedule",78.01,100,,,,,0,"fee schedule","100% of WA fee schedule",135.19,100,,,,,0,"fee schedule","100% of CMS fee sv",445.41,63,,356.33,,,0,"percent of total billed charges","63% of total billed charges",108.17,15.3,,86.54,,,0,"percent of total billed charges","15.3% of total billed charges",78.01,100,,,,,0,"fee schedule","100% of WA fee schedule",487.83,69,,,,,0,"fee schedule","69% of total billed charges",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",134.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",523.07,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",78.01,100,,,,,0,"fee schedule","100% of WA fee schedule",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",133.09,100,,,,,0,"fee schedule","100% of LI fee schedule",78.01,100,,,,,0,"fee schedule","100% of WA fee schedule",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",79.57,102,,,,,0,"fee schedule","102% of WA fee schedule",101.41,130,,,,,0,"fee schedule","130% of WA fee schedule",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",266.54,37.7,,213.23,,,0,"percent of total billed charges","37.7% of total billed charges",266.54,37.7,,213.23,,,0,"percent of total billed charges","37.70% of total billed charges",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",239.67,33.9,,191.74,,,0,"percent of total billed charges","33.9% of total billed charges",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",551.46,78,,441.17,,,0,"percent of total billed charges","78% of total billed charges",136.54,101,,,,,0,"fee schedule","101% of CMS fee schedule ",583.98,82.6,,467.18,,,0,"percent of total billed charges","82.6% of total billed charges",78.01,100,,,,,0,"fee schedule","100% of WA fee schedule",135.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",583.98,82.6,,467.18,,,0,"percent of total billed charges","82.6% of total billed charges",135.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",78.01,100,,,,,0,"fee schedule","100% of WA fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",78.01,707,
"EVAL SOUND PROD",44492522X,CDM,444,RC,92522,CPT,OUTPATIENT,,,707,459.55,,622.16,88,,497.73,,,0,"percent of total billed charges","88% of total billed charges",112.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.91,100,,,,,0,"fee schedule","100% of WA fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",195.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",64.91,100,,,,,0,"fee schedule","100% of WA fee schedule",112.96,100,,,,,0,"fee schedule","100% of CMS fee sv",445.41,63,,356.33,,,0,"percent of total billed charges","63% of total billed charges",108.17,15.3,,86.54,,,0,"percent of total billed charges","15.3% of total billed charges",64.91,100,,,,,0,"fee schedule","100% of WA fee schedule",487.83,69,,,,,0,"fee schedule","69% of total billed charges",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",111.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",112.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",112.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",436.7,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",64.91,100,,,,,0,"fee schedule","100% of WA fee schedule",112.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",111.21,100,,,,,0,"fee schedule","100% of LI fee schedule",64.91,100,,,,,0,"fee schedule","100% of WA fee schedule",112.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.21,102,,,,,0,"fee schedule","102% of WA fee schedule",84.38,130,,,,,0,"fee schedule","130% of WA fee schedule",112.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",266.54,37.7,,213.23,,,0,"percent of total billed charges","37.7% of total billed charges",266.54,37.7,,213.23,,,0,"percent of total billed charges","37.70% of total billed charges",112.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",239.67,33.9,,191.74,,,0,"percent of total billed charges","33.9% of total billed charges",112.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",551.46,78,,441.17,,,0,"percent of total billed charges","78% of total billed charges",114.09,101,,,,,0,"fee schedule","101% of CMS fee schedule ",583.98,82.6,,467.18,,,0,"percent of total billed charges","82.6% of total billed charges",64.91,100,,,,,0,"fee schedule","100% of WA fee schedule",112.96,100,,,,,0,"fee schedule","100% of CMS fee schedule",583.98,82.6,,467.18,,,0,"percent of total billed charges","82.6% of total billed charges",113.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",64.91,100,,,,,0,"fee schedule","100% of WA fee schedule",707,100,,565.60,,,0,"percent of total billed charges","100% of total billed charges",64.91,707,
"EVAL SOUND PROD W/ LANG COMP",44492523X,CDM,444,RC,92523,CPT,OUTPATIENT,,,909,590.85,,799.92,88,,639.94,,,0,"percent of total billed charges","88% of total billed charges",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",133.62,100,,,,,0,"fee schedule","100% of WA fee schedule",909,100,,727.20,,,0,"percent of total billed charges","100% of total billed charges",402.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",133.62,100,,,,,0,"fee schedule","100% of WA fee schedule",231.78,100,,,,,0,"fee schedule","100% of CMS fee sv",572.67,63,,458.14,,,0,"percent of total billed charges","63% of total billed charges",139.08,15.3,,111.26,,,0,"percent of total billed charges","15.3% of total billed charges",133.62,100,,,,,0,"fee schedule","100% of WA fee schedule",627.21,69,,,,,0,"fee schedule","69% of total billed charges",909,100,,727.20,,,0,"percent of total billed charges","100% of total billed charges",230.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",909,100,,727.20,,,0,"percent of total billed charges","100% of total billed charges",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",909,100,,727.20,,,0,"percent of total billed charges","100% of total billed charges",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",899.56,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",133.62,100,,,,,0,"fee schedule","100% of WA fee schedule",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",228.18,100,,,,,0,"fee schedule","100% of LI fee schedule",133.62,100,,,,,0,"fee schedule","100% of WA fee schedule",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",136.29,102,,,,,0,"fee schedule","102% of WA fee schedule",173.71,130,,,,,0,"fee schedule","130% of WA fee schedule",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",342.69,37.7,,274.15,,,0,"percent of total billed charges","37.7% of total billed charges",342.69,37.7,,274.15,,,0,"percent of total billed charges","37.70% of total billed charges",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",308.15,33.9,,246.52,,,0,"percent of total billed charges","33.9% of total billed charges",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",709.02,78,,567.22,,,0,"percent of total billed charges","78% of total billed charges",234.1,101,,,,,0,"fee schedule","101% of CMS fee schedule ",750.83,82.6,,600.66,,,0,"percent of total billed charges","82.6% of total billed charges",133.62,100,,,,,0,"fee schedule","100% of WA fee schedule",231.78,100,,,,,0,"fee schedule","100% of CMS fee schedule",750.83,82.6,,600.66,,,0,"percent of total billed charges","82.6% of total billed charges",231.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",133.62,100,,,,,0,"fee schedule","100% of WA fee schedule",909,100,,727.20,,,0,"percent of total billed charges","100% of total billed charges",133.62,909,
"APHASIA ASSESS/REP/HR/-GN",44096105X,CDM,440,RC,96105,CPT,OUTPATIENT,,,1782,1158.3,,1568.16,88,,1254.53,,,0,"percent of total billed charges","88% of total billed charges",97.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",521.69,100,,,,,0,"fee schedule",EAPG,1782,100,,1425.60,,,0,"percent of total billed charges","100% of total billed charges",168.12,175,,,,,0,"fee schedule","175% of CMS fee schedule",537.34,100,,,,,0,"fee schedule",EAPG,97.22,100,,,,,0,"fee schedule","100% of CMS fee sv",1122.66,63,,898.13,,,0,"percent of total billed charges","63% of total billed charges",272.65,15.3,,218.12,,,0,"percent of total billed charges","15.3% of total billed charges",521.69,100,,,,,0,"fee schedule",EAPG,1229.58,69,,,,,0,"fee schedule","69% of total billed charges",1782,100,,1425.60,,,0,"percent of total billed charges","100% of total billed charges",96.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",1782,100,,1425.60,,,0,"percent of total billed charges","100% of total billed charges",97.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",1782,100,,1425.60,,,0,"percent of total billed charges","100% of total billed charges",97.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",386.94,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",521.69,100,,,,,0,"fee schedule",EAPG,97.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",95.76,100,,,,,0,"fee schedule","100% of LI fee schedule",386.44,100,,,,,0,"fee schedule",EAPG,97.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",532.13,100,,,,,0,"fee schedule",EAPG,678.2,100,,,,,0,"fee schedule",EAPG,97.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",671.81,37.7,,537.45,,,0,"percent of total billed charges","37.7% of total billed charges",671.81,37.7,,537.45,,,0,"percent of total billed charges","37.70% of total billed charges",97.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",604.1,33.9,,483.28,,,0,"percent of total billed charges","33.9% of total billed charges",97.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",1389.96,78,,1111.97,,,0,"percent of total billed charges","78% of total billed charges",98.19,101,,,,,0,"fee schedule","101% of CMS fee schedule ",1471.93,82.6,,1177.54,,,0,"percent of total billed charges","82.6% of total billed charges",521.69,100,,,,,0,"fee schedule","100% of WA fee schedule",97.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",1471.93,82.6,,1177.54,,,0,"percent of total billed charges","82.6% of total billed charges",97.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",521.69,100,,,,,0,"fee schedule",EAPG,1782,100,,1425.60,,,0,"percent of total billed charges","100% of total billed charges",95.76,1782,
"COGNITIVE TEST PER HOUR",44096125X,CDM,440,RC,96125,CPT,OUTPATIENT,,,1146,744.9,,1008.48,88,,806.78,,,0,"percent of total billed charges","88% of total billed charges",103.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",521.69,100,,,,,0,"fee schedule",EAPG,1146,100,,916.80,,,0,"percent of total billed charges","100% of total billed charges",180.16,175,,,,,0,"fee schedule","175% of CMS fee schedule",537.34,100,,,,,0,"fee schedule",EAPG,103.93,100,,,,,0,"fee schedule","100% of CMS fee sv",721.98,63,,577.58,,,0,"percent of total billed charges","63% of total billed charges",175.34,15.3,,140.27,,,0,"percent of total billed charges","15.3% of total billed charges",521.69,100,,,,,0,"fee schedule",EAPG,790.74,69,,,,,0,"fee schedule","69% of total billed charges",1146,100,,916.80,,,0,"percent of total billed charges","100% of total billed charges",102.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",1146,100,,916.80,,,0,"percent of total billed charges","100% of total billed charges",103.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",1146,100,,916.80,,,0,"percent of total billed charges","100% of total billed charges",103.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",409.05,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",521.69,100,,,,,0,"fee schedule",EAPG,103.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",102.29,100,,,,,0,"fee schedule","100% of LI fee schedule",386.44,100,,,,,0,"fee schedule",EAPG,103.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",532.13,100,,,,,0,"fee schedule",EAPG,678.2,100,,,,,0,"fee schedule",EAPG,103.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",432.04,37.7,,345.63,,,0,"percent of total billed charges","37.7% of total billed charges",432.04,37.7,,345.63,,,0,"percent of total billed charges","37.70% of total billed charges",103.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",388.49,33.9,,310.79,,,0,"percent of total billed charges","33.9% of total billed charges",103.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",893.88,78,,715.10,,,0,"percent of total billed charges","78% of total billed charges",104.97,101,,,,,0,"fee schedule","101% of CMS fee schedule ",946.6,82.6,,757.28,,,0,"percent of total billed charges","82.6% of total billed charges",521.69,100,,,,,0,"fee schedule",EAPG,103.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",946.6,82.6,,757.28,,,0,"percent of total billed charges","82.6% of total billed charges",103.99,100,,,,,0,"fee schedule","100% of CMS fee schedule",521.69,100,,,,,0,"fee schedule",EAPG,1146,100,,916.80,,,0,"percent of total billed charges","100% of total billed charges",102.29,1146,
"DYSPH/FEED DYSFN TRMT/-GN",44092526X,CDM,440,RC,92526,CPT,OUTPATIENT,,,470,305.5,,413.6,88,,330.88,,,0,"percent of total billed charges","88% of total billed charges",86.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",150.01,175,,,,,0,"fee schedule","175% of CMS fee schedule",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",86.22,100,,,,,0,"fee schedule","100% of CMS fee sv",296.1,63,,236.88,,,0,"percent of total billed charges","63% of total billed charges",71.91,15.3,,57.53,,,0,"percent of total billed charges","15.3% of total billed charges",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",324.3,69,,,,,0,"fee schedule","69% of total billed charges",470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",85.72,100,,,,,0,"fee schedule","100% of CMS fee schedule",470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",86.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",86.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",331.32,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",86.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",84.83,100,,,,,0,"fee schedule","100% of LI fee schedule",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",86.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",50.92,102,,,,,0,"fee schedule","102% of WA fee schedule",64.9,130,,,,,0,"fee schedule","130% of WA fee schedule",86.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",177.19,37.7,,141.75,,,0,"percent of total billed charges","37.7% of total billed charges",177.19,37.7,,141.75,,,0,"percent of total billed charges","37.70% of total billed charges",86.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",159.33,33.9,,127.46,,,0,"percent of total billed charges","33.9% of total billed charges",86.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",366.6,78,,293.28,,,0,"percent of total billed charges","78% of total billed charges",87.08,101,,,,,0,"fee schedule","101% of CMS fee schedule ",388.22,82.6,,310.58,,,0,"percent of total billed charges","82.6% of total billed charges",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",86.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",388.22,82.6,,310.58,,,0,"percent of total billed charges","82.6% of total billed charges",86.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.92,100,,,,,0,"fee schedule","100% of WA fee schedule",470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",49.92,470,
"SPEECH/LANG THERAPY/-GN",44092507X,CDM,440,RC,92507,CPT,OUTPATIENT,,,470,305.5,,413.6,88,,330.88,,,0,"percent of total billed charges","88% of total billed charges",77.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.79,100,,,,,0,"fee schedule","100% of WA fee schedule",470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",134.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",44.79,100,,,,,0,"fee schedule","100% of WA fee schedule",77.61,100,,,,,0,"fee schedule","100% of CMS fee sv",296.1,63,,236.88,,,0,"percent of total billed charges","63% of total billed charges",71.91,15.3,,57.53,,,0,"percent of total billed charges","15.3% of total billed charges",44.79,100,,,,,0,"fee schedule","100% of WA fee schedule",324.3,69,,,,,0,"fee schedule","69% of total billed charges",470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",77.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",77.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",77.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",298.89,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",44.79,100,,,,,0,"fee schedule","100% of WA fee schedule",77.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",76.42,100,,,,,0,"fee schedule","100% of LI fee schedule",44.79,100,,,,,0,"fee schedule","100% of WA fee schedule",77.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.69,102,,,,,0,"fee schedule","102% of WA fee schedule",58.23,130,,,,,0,"fee schedule","130% of WA fee schedule",77.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",177.19,37.7,,141.75,,,0,"percent of total billed charges","37.7% of total billed charges",177.19,37.7,,141.75,,,0,"percent of total billed charges","37.70% of total billed charges",77.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",159.33,33.9,,127.46,,,0,"percent of total billed charges","33.9% of total billed charges",77.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",366.6,78,,293.28,,,0,"percent of total billed charges","78% of total billed charges",78.39,101,,,,,0,"fee schedule","101% of CMS fee schedule ",388.22,82.6,,310.58,,,0,"percent of total billed charges","82.6% of total billed charges",44.79,100,,,,,0,"fee schedule","100% of WA fee schedule",77.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",388.22,82.6,,310.58,,,0,"percent of total billed charges","82.6% of total billed charges",77.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",44.79,100,,,,,0,"fee schedule","100% of WA fee schedule",470,100,,376.00,,,0,"percent of total billed charges","100% of total billed charges",44.79,470,
"H A REPAIR VISIT LEFT",470V5014,CDM,470,RC,,,OUTPATIENT,,,191,124.15,,168.08,88,,134.46,,,0,"percent of total billed charges","88% of total billed charges",95.5,50,,76.40,,,0,"percent of total billed charges","50% of total billed charges",32.09,16.8,,25.67,,,0,"percent of total billed charges","16.8% of total billed charges",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.05,17.304,,26.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",120.33,63,,96.26,,,0,"percent of total billed charges","63% of total billed charges",29.22,15.3,,23.38,,,0,"percent of total billed charges","15.3% of total billed charges",32.09,16.8,,25.67,,,0,"percent of total billed charges","16.8% of total billed charges",131.79,69,,,,,0,"fee schedule","69% of total billed charges",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",118.13,61.85,,94.50,,,0,"percent of total billed charges","61.5% of total billed charges",32.09,16.8,,25.67,,,0,"percent of total billed charges","16.8% of total billed charges",95.5,50,,76.40,,,0,"percent of total billed charges","50% of total billed charges",61.5,32.2,,49.20,,,0,"percent of total billed charges","32.2% of total billed charges",32.09,16.8,,25.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.73,17.136,,26.18,,,0,"percent of total billed charges","17.136% of total billed charges",41.71,21.84,,33.37,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",72.01,37.7,,57.61,,,0,"percent of total billed charges","37.7% of total billed charges",72.01,37.7,,57.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.75,33.9,,51.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",148.98,78,,119.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.77,82.6,,126.22,,,0,"percent of total billed charges","82.6% of total billed charges",32.09,16.8,,25.67,,,0,"percent of total billed charges","16.8% of total billed charges",95.5,50,,76.40,,,0,"percent of total billed charges","50% of total billed charges",157.77,82.6,,126.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.09,16.8,,25.67,,,0,"percent of total billed charges","16.8% of total billed charges",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",29.22,191,
"H A REPAIR VISIT RIGHT",470V5014,CDM,470,RC,,,OUTPATIENT,,,191,124.15,,168.08,88,,134.46,,,0,"percent of total billed charges","88% of total billed charges",95.5,50,,76.40,,,0,"percent of total billed charges","50% of total billed charges",32.09,16.8,,25.67,,,0,"percent of total billed charges","16.8% of total billed charges",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.05,17.304,,26.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",120.33,63,,96.26,,,0,"percent of total billed charges","63% of total billed charges",29.22,15.3,,23.38,,,0,"percent of total billed charges","15.3% of total billed charges",32.09,16.8,,25.67,,,0,"percent of total billed charges","16.8% of total billed charges",131.79,69,,,,,0,"fee schedule","69% of total billed charges",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",118.13,61.85,,94.50,,,0,"percent of total billed charges","61.5% of total billed charges",32.09,16.8,,25.67,,,0,"percent of total billed charges","16.8% of total billed charges",95.5,50,,76.40,,,0,"percent of total billed charges","50% of total billed charges",61.5,32.2,,49.20,,,0,"percent of total billed charges","32.2% of total billed charges",32.09,16.8,,25.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.73,17.136,,26.18,,,0,"percent of total billed charges","17.136% of total billed charges",41.71,21.84,,33.37,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",72.01,37.7,,57.61,,,0,"percent of total billed charges","37.7% of total billed charges",72.01,37.7,,57.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.75,33.9,,51.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",148.98,78,,119.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.77,82.6,,126.22,,,0,"percent of total billed charges","82.6% of total billed charges",32.09,16.8,,25.67,,,0,"percent of total billed charges","16.8% of total billed charges",95.5,50,,76.40,,,0,"percent of total billed charges","50% of total billed charges",157.77,82.6,,126.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.09,16.8,,25.67,,,0,"percent of total billed charges","16.8% of total billed charges",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",29.22,191,
"BINAURAL DISPENSING FEE",470V5160,CDM,470,RC,,,OUTPATIENT,,,2238,1454.7,,1969.44,88,,1575.55,,,0,"percent of total billed charges","88% of total billed charges",1119,50,,895.20,,,0,"percent of total billed charges","50% of total billed charges",375.98,16.8,,300.78,,,0,"percent of total billed charges","16.8% of total billed charges",2238,100,,1790.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.26,17.304,,309.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1409.94,63,,1127.95,,,0,"percent of total billed charges","63% of total billed charges",342.41,15.3,,273.93,,,0,"percent of total billed charges","15.3% of total billed charges",375.98,16.8,,300.78,,,0,"percent of total billed charges","16.8% of total billed charges",1544.22,69,,,,,0,"fee schedule","69% of total billed charges",2238,100,,1790.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2238,100,,1790.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2238,100,,1790.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1384.2,61.85,,1107.36,,,0,"percent of total billed charges","61.5% of total billed charges",375.98,16.8,,300.78,,,0,"percent of total billed charges","16.8% of total billed charges",1119,50,,895.20,,,0,"percent of total billed charges","50% of total billed charges",720.64,32.2,,576.51,,,0,"percent of total billed charges","32.2% of total billed charges",375.98,16.8,,300.78,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",383.5,17.136,,306.80,,,0,"percent of total billed charges","17.136% of total billed charges",488.78,21.84,,391.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.73,37.7,,674.98,,,0,"percent of total billed charges","37.7% of total billed charges",843.73,37.7,,674.98,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",758.68,33.9,,606.94,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1745.64,78,,1396.51,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1848.59,82.6,,1478.87,,,0,"percent of total billed charges","82.6% of total billed charges",375.98,16.8,,300.78,,,0,"percent of total billed charges","16.8% of total billed charges",1119,50,,895.20,,,0,"percent of total billed charges","50% of total billed charges",1848.59,82.6,,1478.87,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",375.98,16.8,,300.78,,,0,"percent of total billed charges","16.8% of total billed charges",2238,100,,1790.40,,,0,"percent of total billed charges","100% of total billed charges",342.41,2238,
"V5260 Digital Binaural ITE Essential",470V5260ESS,CDM,470,RC,,,OUTPATIENT,,,1536,998.4,,1351.68,88,,1081.34,,,0,"percent of total billed charges","88% of total billed charges",768,50,,614.40,,,0,"percent of total billed charges","50% of total billed charges",258.05,16.8,,206.44,,,0,"percent of total billed charges","16.8% of total billed charges",1536,100,,1228.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",265.79,17.304,,212.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",967.68,63,,774.14,,,0,"percent of total billed charges","63% of total billed charges",235.01,15.3,,188.01,,,0,"percent of total billed charges","15.3% of total billed charges",258.05,16.8,,206.44,,,0,"percent of total billed charges","16.8% of total billed charges",1059.84,69,,,,,0,"fee schedule","69% of total billed charges",1536,100,,1228.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1536,100,,1228.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1536,100,,1228.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",950.02,61.85,,760.02,,,0,"percent of total billed charges","61.5% of total billed charges",258.05,16.8,,206.44,,,0,"percent of total billed charges","16.8% of total billed charges",768,50,,614.40,,,0,"percent of total billed charges","50% of total billed charges",494.59,32.2,,395.67,,,0,"percent of total billed charges","32.2% of total billed charges",258.05,16.8,,206.44,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.21,17.136,,210.57,,,0,"percent of total billed charges","17.136% of total billed charges",335.46,21.84,,268.37,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.07,37.7,,463.26,,,0,"percent of total billed charges","37.7% of total billed charges",579.07,37.7,,463.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",520.7,33.9,,416.56,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1198.08,78,,958.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1268.74,82.6,,1014.99,,,0,"percent of total billed charges","82.6% of total billed charges",258.05,16.8,,206.44,,,0,"percent of total billed charges","16.8% of total billed charges",768,50,,614.40,,,0,"percent of total billed charges","50% of total billed charges",1268.74,82.6,,1014.99,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.05,16.8,,206.44,,,0,"percent of total billed charges","16.8% of total billed charges",1536,100,,1228.80,,,0,"percent of total billed charges","100% of total billed charges",235.01,1536,
"EAR IMPRESSION, EACH EAR",470V5275,CDM,470,RC,,,OUTPATIENT,,,66,42.9,,58.08,88,,46.46,,,0,"percent of total billed charges","88% of total billed charges",33,50,,26.40,,,0,"percent of total billed charges","50% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.42,17.304,,9.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.58,63,,33.26,,,0,"percent of total billed charges","63% of total billed charges",10.1,15.3,,8.08,,,0,"percent of total billed charges","15.3% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",45.54,69,,,,,0,"fee schedule","69% of total billed charges",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.82,61.85,,32.66,,,0,"percent of total billed charges","61.5% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",33,50,,26.40,,,0,"percent of total billed charges","50% of total billed charges",21.25,32.2,,17.00,,,0,"percent of total billed charges","32.2% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.31,17.136,,9.05,,,0,"percent of total billed charges","17.136% of total billed charges",14.41,21.84,,11.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.88,37.7,,19.90,,,0,"percent of total billed charges","37.7% of total billed charges",24.88,37.7,,19.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.37,33.9,,17.90,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.48,78,,41.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",54.52,82.6,,43.62,,,0,"percent of total billed charges","82.6% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",33,50,,26.40,,,0,"percent of total billed charges","50% of total billed charges",54.52,82.6,,43.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",10.1,66,
"SERVICE BEYOND COVERAGE",470V5299,CDM,470,RC,,,OUTPATIENT,,,38,24.7,,33.44,88,,26.75,,,0,"percent of total billed charges","88% of total billed charges",19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.58,17.304,,5.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.94,63,,19.15,,,0,"percent of total billed charges","63% of total billed charges",5.81,15.3,,4.65,,,0,"percent of total billed charges","15.3% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",26.22,69,,,,,0,"fee schedule","69% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.5,61.85,,18.80,,,0,"percent of total billed charges","61.5% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",12.24,32.2,,9.79,,,0,"percent of total billed charges","32.2% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.51,17.136,,5.21,,,0,"percent of total billed charges","17.136% of total billed charges",8.3,21.84,,6.64,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.33,37.7,,11.46,,,0,"percent of total billed charges","37.7% of total billed charges",14.33,37.7,,11.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.88,33.9,,10.30,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.64,78,,23.71,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",5.81,38,
"V5020 CONFORMITY EVALUATION CHARGE",470V5020,CDM,470,RC,,,OUTPATIENT,,,74,48.1,,65.12,88,,52.10,,,0,"percent of total billed charges","88% of total billed charges",37,50,,29.60,,,0,"percent of total billed charges","50% of total billed charges",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.8,17.304,,10.24,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.62,63,,37.30,,,0,"percent of total billed charges","63% of total billed charges",11.32,15.3,,9.06,,,0,"percent of total billed charges","15.3% of total billed charges",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",51.06,69,,,,,0,"fee schedule","69% of total billed charges",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.77,61.85,,36.62,,,0,"percent of total billed charges","61.5% of total billed charges",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",37,50,,29.60,,,0,"percent of total billed charges","50% of total billed charges",23.83,32.2,,19.06,,,0,"percent of total billed charges","32.2% of total billed charges",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.68,17.136,,10.14,,,0,"percent of total billed charges","17.136% of total billed charges",16.16,21.84,,12.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.9,37.7,,22.32,,,0,"percent of total billed charges","37.7% of total billed charges",27.9,37.7,,22.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.09,33.9,,20.07,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.72,78,,46.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.12,82.6,,48.90,,,0,"percent of total billed charges","82.6% of total billed charges",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",37,50,,29.60,,,0,"percent of total billed charges","50% of total billed charges",61.12,82.6,,48.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",11.32,74,
"CIRCUIT ANESTHESIA BREATHING HOSE 96",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"CLEAR W/ VENTS 1.50",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"CONNECTOR PLEUR-EVAC CHEST DRAINAGE 3/8 Y CONNECTOR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"DRAPE FEMORAL ANGIOGRAPHY 80 X 159",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"DRAIN PENROSE SURGICAL W/ SAFTEY PIN STERILE FLAT 1/4 18",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"DRESSING KERRAMAX CARE 5 X 6IN",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING TEGADERM ABSORBENT ACRYLIC CLEAR 5-7/8 X 6",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"DRESSING TEGADERM CLEAR ACRYLIC 7.5 X 8",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"E-Z CLEAN ELECTROSURGICAL ELECTRODE BLADE PTFE COATED 4",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"FLAT W/ VENTS CLEAR 1",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"FUSEID-DT-WO-WHITE 4X4.5  3",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"GENTAMICIN REAGENT EMIT 2000",ORSUP0023,CDM,272,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"KANGAROO NASOGASTIC FEEDING TUBE W/STYLET 8FR 43",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"NEEDLE SPINAL PECAN STERILE 25GAX6.1",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"OXYMASK ADULT 7FT 1-40 LPM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,52,33.8,,45.76,88,,36.61,,,0,"percent of total billed charges","88% of total billed charges",26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,17.304,,7.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.76,63,,26.21,,,0,"percent of total billed charges","63% of total billed charges",7.96,15.3,,6.37,,,0,"percent of total billed charges","15.3% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",35.88,69,,,,,0,"fee schedule","69% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.16,61.85,,25.73,,,0,"percent of total billed charges","61.5% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",16.74,32.2,,13.39,,,0,"percent of total billed charges","32.2% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.91,17.136,,7.13,,,0,"percent of total billed charges","17.136% of total billed charges",11.36,21.84,,9.09,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.6,37.7,,15.68,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",40.56,78,,32.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",7.96,52,
"OXYMASK ADULT 14 UNIVERSAL OXYGEN MASK",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"ROUND W/ VENTS CLEAR .75",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SILICONE PENROSE DRAIN 12X0.25",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SUTURE PROLENE MONO BLUE 6-0 18IN PC-3",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SYRINGE W/NEEDLE 22GX1.5",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"TUBING PRESSURE MONITORING MALE/MALE 72",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"WATERPROOF TAPE 1X10YD",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"%A1C PERF VER I",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"%A1C PERF VER II",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"1-LAYER FOLEY CATH TRAY W/BAG 16FR",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"1-LAYER FOLY CATH TRAY W/URINE METER 16FR 10ML",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"1-LAYER FOLY CATH TRAY W/TEMP-SENSOR 16FR 10ML",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"1.0MM TI MF CORTEX SCREW SELF-TAPPING W/FLUTES 5MM",ORSUP0027,CDM,278,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",1086.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.7% of total billed charges",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1180.06,33.9,,944.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"1.5MM TI ADAPTION PLATE 20 HOLES/90MM",ORSUP0026,CDM,278,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",1002.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.7% of total billed charges",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1089.55,33.9,,871.64,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"1.5MM TI MF CORTEX SCREW SELF-TAPPING W/FLUTES 4MM",ORSUP0022,CDM,278,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",751.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.7% of total billed charges",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",816.99,33.9,,653.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"1.5X4MM XDRIVE TF SD SCREW",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"10-PANEL DIP CARDS",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"10MM ROUNDED STIFF SNARE",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"12 MM AND STAPLER CANNULA LONG",ORSUP0041,CDM,272,RC,,,OUTPATIENT,,,8034,5222.1,,7069.92,88,,5655.94,,,0,"percent of total billed charges","88% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1390.2,17.304,,1112.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5061.42,63,,4049.14,,,0,"percent of total billed charges","63% of total billed charges",1229.2,15.3,,983.36,,,0,"percent of total billed charges","15.3% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",5543.46,69,,,,,0,"fee schedule","69% of total billed charges",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4969.03,61.85,,3975.22,,,0,"percent of total billed charges","61.5% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",2586.95,32.2,,2069.56,,,0,"percent of total billed charges","32.2% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1376.71,17.136,,1101.37,,,0,"percent of total billed charges","17.136% of total billed charges",1754.63,21.84,,1403.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3028.82,37.7,,2423.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6266.52,78,,5013.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6636.08,82.6,,5308.86,,,0,"percent of total billed charges","82.6% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",6636.08,82.6,,5308.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",1229.2,8034,
"12 MM AND STAPLER CANNULA",ORSUP0040,CDM,272,RC,,,OUTPATIENT,,,7766,5047.9,,6834.08,88,,5467.26,,,0,"percent of total billed charges","88% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1343.83,17.304,,1075.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4892.58,63,,3914.06,,,0,"percent of total billed charges","63% of total billed charges",1188.2,15.3,,950.56,,,0,"percent of total billed charges","15.3% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",5358.54,69,,,,,0,"fee schedule","69% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4803.27,61.85,,3842.62,,,0,"percent of total billed charges","61.5% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",2500.65,32.2,,2000.52,,,0,"percent of total billed charges","32.2% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1330.78,17.136,,1064.62,,,0,"percent of total billed charges","17.136% of total billed charges",1696.09,21.84,,1356.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2927.78,37.7,,2342.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6057.48,78,,4845.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",1188.2,7766,
"12 MM AND STAPLER BLUNT OBTURATOR LONG",ORSUP0030,CDM,272,RC,,,OUTPATIENT,,,5088,3307.2,,4477.44,88,,3581.95,,,0,"percent of total billed charges","88% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",880.43,17.304,,704.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3205.44,63,,2564.35,,,0,"percent of total billed charges","63% of total billed charges",778.46,15.3,,622.77,,,0,"percent of total billed charges","15.3% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",3510.72,69,,,,,0,"fee schedule","69% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3146.93,61.85,,2517.54,,,0,"percent of total billed charges","61.5% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",1638.34,32.2,,1310.67,,,0,"percent of total billed charges","32.2% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",871.88,17.136,,697.50,,,0,"percent of total billed charges","17.136% of total billed charges",1111.22,21.84,,888.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1918.18,37.7,,1534.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3968.64,78,,3174.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",778.46,5088,
"12 MM AND STAPLER BLUNT OBTURATOR",ORSUP0029,CDM,272,RC,,,OUTPATIENT,,,4820,3133,,4241.6,88,,3393.28,,,0,"percent of total billed charges","88% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",834.05,17.304,,667.24,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3036.6,63,,2429.28,,,0,"percent of total billed charges","63% of total billed charges",737.46,15.3,,589.97,,,0,"percent of total billed charges","15.3% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",3325.8,69,,,,,0,"fee schedule","69% of total billed charges",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2981.17,61.85,,2384.94,,,0,"percent of total billed charges","61.5% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",1552.04,32.2,,1241.63,,,0,"percent of total billed charges","32.2% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",825.96,17.136,,660.77,,,0,"percent of total billed charges","17.136% of total billed charges",1052.69,21.84,,842.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1817.14,37.7,,1453.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3759.6,78,,3007.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3981.32,82.6,,3185.06,,,0,"percent of total billed charges","82.6% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",3981.32,82.6,,3185.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",737.46,4820,
"12-8 MM REDUCER",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"18.5 BURR PLATE",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"2 SARS ANTIGEN FLUORESCENT IMMUNOASSAY (FIA)",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"2-0 KNOT PUSHER/SUTURE CUTTER AND SLOTTED CANNULA",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,927,602.55,,815.76,88,,652.61,,,0,"percent of total billed charges","88% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.41,17.304,,128.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.01,63,,467.21,,,0,"percent of total billed charges","63% of total billed charges",141.83,15.3,,113.46,,,0,"percent of total billed charges","15.3% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",639.63,69,,,,,0,"fee schedule","69% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",573.35,61.85,,458.68,,,0,"percent of total billed charges","61.5% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",298.49,32.2,,238.79,,,0,"percent of total billed charges","32.2% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.85,17.136,,127.08,,,0,"percent of total billed charges","17.136% of total billed charges",202.46,21.84,,161.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",349.48,37.7,,279.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",723.06,78,,578.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",141.83,927,
"25 OH VITAMIN D TOTAL CAL",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"25 OH VITAMIN D TOTAL RGT",ORSUP0032,CDM,272,RC,,,OUTPATIENT,,,5624,3655.6,,4949.12,88,,3959.30,,,0,"percent of total billed charges","88% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",973.18,17.304,,778.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3543.12,63,,2834.50,,,0,"percent of total billed charges","63% of total billed charges",860.47,15.3,,688.38,,,0,"percent of total billed charges","15.3% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",3880.56,69,,,,,0,"fee schedule","69% of total billed charges",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3478.44,61.85,,2782.75,,,0,"percent of total billed charges","61.5% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",1810.93,32.2,,1448.74,,,0,"percent of total billed charges","32.2% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",963.73,17.136,,770.98,,,0,"percent of total billed charges","17.136% of total billed charges",1228.28,21.84,,982.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2120.25,37.7,,1696.20,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4386.72,78,,3509.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4645.42,82.6,,3716.34,,,0,"percent of total billed charges","82.6% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",4645.42,82.6,,3716.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",860.47,5624,
"4.75MM ALPHAVENT + OMEGA",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.94,17.304,,85.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.23,61.85,,305.78,,,0,"percent of total billed charges","61.5% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",199,32.2,,159.20,,,0,"percent of total billed charges","32.2% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.136,,84.72,,,0,"percent of total billed charges","17.136% of total billed charges",134.97,21.84,,107.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,618,
"4MM EMERGENCY SCREW",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"5-8 MM CANNULA SEAL",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"5.5MM XL PEAR BUR",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,464,301.6,,408.32,88,,326.66,,,0,"percent of total billed charges","88% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.29,17.304,,64.23,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.32,63,,233.86,,,0,"percent of total billed charges","63% of total billed charges",70.99,15.3,,56.79,,,0,"percent of total billed charges","15.3% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",320.16,69,,,,,0,"fee schedule","69% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",286.98,61.85,,229.58,,,0,"percent of total billed charges","61.5% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",149.41,32.2,,119.53,,,0,"percent of total billed charges","32.2% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.51,17.136,,63.61,,,0,"percent of total billed charges","17.136% of total billed charges",101.34,21.84,,81.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",174.93,37.7,,139.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",361.92,78,,289.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",70.99,464,
"8 MM HASSON CONE",ORSUP0031,CDM,272,RC,,,OUTPATIENT,,,5356,3481.4,,4713.28,88,,3770.62,,,0,"percent of total billed charges","88% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",926.8,17.304,,741.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3374.28,63,,2699.42,,,0,"percent of total billed charges","63% of total billed charges",819.47,15.3,,655.58,,,0,"percent of total billed charges","15.3% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",3695.64,69,,,,,0,"fee schedule","69% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3312.69,61.85,,2650.15,,,0,"percent of total billed charges","61.5% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",1724.63,32.2,,1379.70,,,0,"percent of total billed charges","32.2% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",917.8,17.136,,734.24,,,0,"percent of total billed charges","17.136% of total billed charges",1169.75,21.84,,935.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4177.68,78,,3342.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",819.47,5356,
"8 MM INSTRUMENT CANNULA LONG",ORSUP0026,CDM,272,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"8 MM BLUNT OBTURATOR LONG",ORSUP0025,CDM,272,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"8 MM BLADELESS OBTURATOR",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"8 MM BLADELESS OBTURATOR LONG",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"8MM FORCE BIPOLAR IS4000",ORSUP0075,CDM,272,RC,,,OUTPATIENT,,,17407,11314.55,,15318.16,88,,12254.53,,,0,"percent of total billed charges","88% of total billed charges",8703.5,50,,6962.80,,,0,"percent of total billed charges","50% of total billed charges",2924.38,16.8,,2339.50,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3012.11,17.304,,2409.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10966.41,63,,8773.13,,,0,"percent of total billed charges","63% of total billed charges",2663.27,15.3,,2130.62,,,0,"percent of total billed charges","15.3% of total billed charges",2924.38,16.8,,2339.50,,,0,"percent of total billed charges","16.8% of total billed charges",12010.83,69,,,,,0,"fee schedule","69% of total billed charges",17407,100,,13925.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17407,100,,13925.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17407,100,,13925.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10766.23,61.85,,8612.98,,,0,"percent of total billed charges","61.5% of total billed charges",2924.38,16.8,,2339.50,,,0,"percent of total billed charges","16.8% of total billed charges",8703.5,50,,6962.80,,,0,"percent of total billed charges","50% of total billed charges",5605.05,32.2,,4484.04,,,0,"percent of total billed charges","32.2% of total billed charges",2924.38,16.8,,2339.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2982.86,17.136,,2386.29,,,0,"percent of total billed charges","17.136% of total billed charges",3801.69,21.84,,3041.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6562.44,37.7,,5249.95,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13577.46,78,,10861.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14378.18,82.6,,11502.54,,,0,"percent of total billed charges","82.6% of total billed charges",2924.38,16.8,,2339.50,,,0,"percent of total billed charges","16.8% of total billed charges",8703.5,50,,6962.80,,,0,"percent of total billed charges","50% of total billed charges",14378.18,82.6,,11502.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2924.38,16.8,,2339.50,,,0,"percent of total billed charges","16.8% of total billed charges",17407,100,,13925.60,,,0,"percent of total billed charges","100% of total billed charges",2663.27,17407,
"A-HCV 100 WELLS US",ORSUP0026,CDM,272,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"A-HCV CAL BOX/1 SET",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"A-HIV 1+2 100 WELLS",ORSUP0023,CDM,272,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"A-HIV 1+2 CAL",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"A1C CONTROL (STRECK)",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"ABDOMINAL BINDER 12IN XXL",ORSUP0003,CDM,270,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"ABDOMINAL BINDER 12IN XL",ORSUP0003,CDM,270,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"ABDOMINAL BINDER 12IN LARGE",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"ABDOMINAL BINDER 10IN UNIVERSAL",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"ABL 90 SOLUTION PACK",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"ABL-90 SC 800/30 BG LYT OXY MET QC",ORSUP0037,CDM,272,RC,,,OUTPATIENT,,,6963,4525.95,,6127.44,88,,4901.95,,,0,"percent of total billed charges","88% of total billed charges",3481.5,50,,2785.20,,,0,"percent of total billed charges","50% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1204.88,17.304,,963.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4386.69,63,,3509.35,,,0,"percent of total billed charges","63% of total billed charges",1065.34,15.3,,852.27,,,0,"percent of total billed charges","15.3% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",4804.47,69,,,,,0,"fee schedule","69% of total billed charges",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4306.62,61.85,,3445.30,,,0,"percent of total billed charges","61.5% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",3481.5,50,,2785.20,,,0,"percent of total billed charges","50% of total billed charges",2242.09,32.2,,1793.67,,,0,"percent of total billed charges","32.2% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1193.18,17.136,,954.54,,,0,"percent of total billed charges","17.136% of total billed charges",1520.72,21.84,,1216.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2625.05,37.7,,2100.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5431.14,78,,4344.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5751.44,82.6,,4601.15,,,0,"percent of total billed charges","82.6% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",3481.5,50,,2785.20,,,0,"percent of total billed charges","50% of total billed charges",5751.44,82.6,,4601.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",1065.34,6963,
"ABLATOR ASPIRATING 90 DEG MULTI PORT",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"ABLATOR COOLCUT 90 DEGREE",ORSUP0010,CDM,270,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"ABO/RH CONFIRMED LABELS",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,17.304,,49.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.28,61.85,,178.62,,,0,"percent of total billed charges","61.5% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",116.24,32.2,,92.99,,,0,"percent of total billed charges","32.2% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.86,17.136,,49.49,,,0,"percent of total billed charges","17.136% of total billed charges",78.84,21.84,,63.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,361,
"ABSORBER CO2",448248,CDM,270,RC,,,OUTPATIENT,,,205,133.25,,180.4,88,,144.32,,,0,"percent of total billed charges","88% of total billed charges",102.5,50,,82.00,,,0,"percent of total billed charges","50% of total billed charges",34.44,16.8,,27.55,,,0,"percent of total billed charges","16.8% of total billed charges",205,100,,164.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.47,17.304,,28.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.15,63,,103.32,,,0,"percent of total billed charges","63% of total billed charges",31.37,15.3,,25.10,,,0,"percent of total billed charges","15.3% of total billed charges",34.44,16.8,,27.55,,,0,"percent of total billed charges","16.8% of total billed charges",141.45,69,,,,,0,"fee schedule","69% of total billed charges",205,100,,164.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",205,100,,164.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",205,100,,164.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.79,61.85,,101.43,,,0,"percent of total billed charges","61.5% of total billed charges",34.44,16.8,,27.55,,,0,"percent of total billed charges","16.8% of total billed charges",102.5,50,,82.00,,,0,"percent of total billed charges","50% of total billed charges",66.01,32.2,,52.81,,,0,"percent of total billed charges","32.2% of total billed charges",34.44,16.8,,27.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.13,17.136,,28.10,,,0,"percent of total billed charges","17.136% of total billed charges",44.77,21.84,,35.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.29,37.7,,61.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",159.9,78,,127.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",169.33,82.6,,135.46,,,0,"percent of total billed charges","82.6% of total billed charges",34.44,16.8,,27.55,,,0,"percent of total billed charges","16.8% of total billed charges",102.5,50,,82.00,,,0,"percent of total billed charges","50% of total billed charges",169.33,82.6,,135.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,16.8,,27.55,,,0,"percent of total billed charges","16.8% of total billed charges",205,100,,164.00,,,0,"percent of total billed charges","100% of total billed charges",31.37,205,
"ABSTACK FIXATION DEVICE 30TACK",ORSUP0026,CDM,270,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"ACAPELLA DH GREEN MTHPC",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"ACAPELLA DM BLUE MTH PC",ORSUP0004,CDM,270,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"ACCESSRAIL PLATFORM (STANDARD BLADE)",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"ACCESS CANNULA BIOPSY KIT 19GA",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"ACCESS FERRITN 2X50 DET",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"ACCESS CORTISOL 2X50 DET",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"ACCESS RUBELLA IGG 2X50 DET",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"ACCESS HYBERITECH PSA RGT KIT 2X50",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"ACCESS PTH 2X50 DET",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"ACCESS FOLATE 2X50 DET",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"ACCESS 25 OH VIT D",ORSUP0024,CDM,272,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"ACCESS B12 CAL",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"ACCESS FERRITAN CALS",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"ACCESS TESTOSTERONE CAL S0-S5",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"ACCESS CORTISOL S0-S5",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"ACCESS RUBELLA IGG CALS",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"ACCESS HYBERITECH PS CAL KIT",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"ACCESS PTH CAL S0-S5",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"ACCESS FOLATE CAL S0-S5",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"ACCESS FOLATE CAL S0",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"ACCUCATH 18GA 2.25IN CATH",460860,CDM,272,RC,,,OUTPATIENT,,,347,225.55,,305.36,88,,244.29,,,0,"percent of total billed charges","88% of total billed charges",173.5,50,,138.80,,,0,"percent of total billed charges","50% of total billed charges",58.3,16.8,,46.64,,,0,"percent of total billed charges","16.8% of total billed charges",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.04,17.304,,48.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",218.61,63,,174.89,,,0,"percent of total billed charges","63% of total billed charges",53.09,15.3,,42.47,,,0,"percent of total billed charges","15.3% of total billed charges",58.3,16.8,,46.64,,,0,"percent of total billed charges","16.8% of total billed charges",239.43,69,,,,,0,"fee schedule","69% of total billed charges",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",214.62,61.85,,171.70,,,0,"percent of total billed charges","61.5% of total billed charges",58.3,16.8,,46.64,,,0,"percent of total billed charges","16.8% of total billed charges",173.5,50,,138.80,,,0,"percent of total billed charges","50% of total billed charges",111.73,32.2,,89.38,,,0,"percent of total billed charges","32.2% of total billed charges",58.3,16.8,,46.64,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.46,17.136,,47.57,,,0,"percent of total billed charges","17.136% of total billed charges",75.78,21.84,,60.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",130.82,37.7,,104.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",270.66,78,,216.53,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",286.62,82.6,,229.30,,,0,"percent of total billed charges","82.6% of total billed charges",58.3,16.8,,46.64,,,0,"percent of total billed charges","16.8% of total billed charges",173.5,50,,138.80,,,0,"percent of total billed charges","50% of total billed charges",286.62,82.6,,229.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.3,16.8,,46.64,,,0,"percent of total billed charges","16.8% of total billed charges",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",53.09,347,
"ACCUCATH 18GA X 1.25",484409,CDM,272,RC,,,OUTPATIENT,,,182,118.3,,160.16,88,,128.13,,,0,"percent of total billed charges","88% of total billed charges",91,50,,72.80,,,0,"percent of total billed charges","50% of total billed charges",30.58,16.8,,24.46,,,0,"percent of total billed charges","16.8% of total billed charges",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.49,17.304,,25.19,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.66,63,,91.73,,,0,"percent of total billed charges","63% of total billed charges",27.85,15.3,,22.28,,,0,"percent of total billed charges","15.3% of total billed charges",30.58,16.8,,24.46,,,0,"percent of total billed charges","16.8% of total billed charges",125.58,69,,,,,0,"fee schedule","69% of total billed charges",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.57,61.85,,90.06,,,0,"percent of total billed charges","61.5% of total billed charges",30.58,16.8,,24.46,,,0,"percent of total billed charges","16.8% of total billed charges",91,50,,72.80,,,0,"percent of total billed charges","50% of total billed charges",58.6,32.2,,46.88,,,0,"percent of total billed charges","32.2% of total billed charges",30.58,16.8,,24.46,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.19,17.136,,24.95,,,0,"percent of total billed charges","17.136% of total billed charges",39.75,21.84,,31.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",68.61,37.7,,54.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",141.96,78,,113.57,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",150.33,82.6,,120.26,,,0,"percent of total billed charges","82.6% of total billed charges",30.58,16.8,,24.46,,,0,"percent of total billed charges","16.8% of total billed charges",91,50,,72.80,,,0,"percent of total billed charges","50% of total billed charges",150.33,82.6,,120.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.58,16.8,,24.46,,,0,"percent of total billed charges","16.8% of total billed charges",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",27.85,182,
"ACCUCATH 20GA 1.25IN CATH",460859,CDM,272,RC,,,OUTPATIENT,,,182,118.3,,160.16,88,,128.13,,,0,"percent of total billed charges","88% of total billed charges",91,50,,72.80,,,0,"percent of total billed charges","50% of total billed charges",30.58,16.8,,24.46,,,0,"percent of total billed charges","16.8% of total billed charges",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.49,17.304,,25.19,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.66,63,,91.73,,,0,"percent of total billed charges","63% of total billed charges",27.85,15.3,,22.28,,,0,"percent of total billed charges","15.3% of total billed charges",30.58,16.8,,24.46,,,0,"percent of total billed charges","16.8% of total billed charges",125.58,69,,,,,0,"fee schedule","69% of total billed charges",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.57,61.85,,90.06,,,0,"percent of total billed charges","61.5% of total billed charges",30.58,16.8,,24.46,,,0,"percent of total billed charges","16.8% of total billed charges",91,50,,72.80,,,0,"percent of total billed charges","50% of total billed charges",58.6,32.2,,46.88,,,0,"percent of total billed charges","32.2% of total billed charges",30.58,16.8,,24.46,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.19,17.136,,24.95,,,0,"percent of total billed charges","17.136% of total billed charges",39.75,21.84,,31.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",68.61,37.7,,54.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",141.96,78,,113.57,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",150.33,82.6,,120.26,,,0,"percent of total billed charges","82.6% of total billed charges",30.58,16.8,,24.46,,,0,"percent of total billed charges","16.8% of total billed charges",91,50,,72.80,,,0,"percent of total billed charges","50% of total billed charges",150.33,82.6,,120.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.58,16.8,,24.46,,,0,"percent of total billed charges","16.8% of total billed charges",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",27.85,182,
"ACCUCATH 22GA X1.25",484412,CDM,272,RC,,,OUTPATIENT,,,182,118.3,,160.16,88,,128.13,,,0,"percent of total billed charges","88% of total billed charges",91,50,,72.80,,,0,"percent of total billed charges","50% of total billed charges",30.58,16.8,,24.46,,,0,"percent of total billed charges","16.8% of total billed charges",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.49,17.304,,25.19,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.66,63,,91.73,,,0,"percent of total billed charges","63% of total billed charges",27.85,15.3,,22.28,,,0,"percent of total billed charges","15.3% of total billed charges",30.58,16.8,,24.46,,,0,"percent of total billed charges","16.8% of total billed charges",125.58,69,,,,,0,"fee schedule","69% of total billed charges",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.57,61.85,,90.06,,,0,"percent of total billed charges","61.5% of total billed charges",30.58,16.8,,24.46,,,0,"percent of total billed charges","16.8% of total billed charges",91,50,,72.80,,,0,"percent of total billed charges","50% of total billed charges",58.6,32.2,,46.88,,,0,"percent of total billed charges","32.2% of total billed charges",30.58,16.8,,24.46,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.19,17.136,,24.95,,,0,"percent of total billed charges","17.136% of total billed charges",39.75,21.84,,31.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",68.61,37.7,,54.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",141.96,78,,113.57,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",150.33,82.6,,120.26,,,0,"percent of total billed charges","82.6% of total billed charges",30.58,16.8,,24.46,,,0,"percent of total billed charges","16.8% of total billed charges",91,50,,72.80,,,0,"percent of total billed charges","50% of total billed charges",150.33,82.6,,120.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.58,16.8,,24.46,,,0,"percent of total billed charges","16.8% of total billed charges",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",27.85,182,
"ACCUCHECK QC + LM2",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"ACCUCHECK QC + LM3",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"ACCUCATH 20GA X 2.25",484408,CDM,272,RC,,,OUTPATIENT,,,347,225.55,,305.36,88,,244.29,,,0,"percent of total billed charges","88% of total billed charges",173.5,50,,138.80,,,0,"percent of total billed charges","50% of total billed charges",58.3,16.8,,46.64,,,0,"percent of total billed charges","16.8% of total billed charges",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.04,17.304,,48.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",218.61,63,,174.89,,,0,"percent of total billed charges","63% of total billed charges",53.09,15.3,,42.47,,,0,"percent of total billed charges","15.3% of total billed charges",58.3,16.8,,46.64,,,0,"percent of total billed charges","16.8% of total billed charges",239.43,69,,,,,0,"fee schedule","69% of total billed charges",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",214.62,61.85,,171.70,,,0,"percent of total billed charges","61.5% of total billed charges",58.3,16.8,,46.64,,,0,"percent of total billed charges","16.8% of total billed charges",173.5,50,,138.80,,,0,"percent of total billed charges","50% of total billed charges",111.73,32.2,,89.38,,,0,"percent of total billed charges","32.2% of total billed charges",58.3,16.8,,46.64,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.46,17.136,,47.57,,,0,"percent of total billed charges","17.136% of total billed charges",75.78,21.84,,60.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",130.82,37.7,,104.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",270.66,78,,216.53,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",286.62,82.6,,229.30,,,0,"percent of total billed charges","82.6% of total billed charges",58.3,16.8,,46.64,,,0,"percent of total billed charges","16.8% of total billed charges",173.5,50,,138.80,,,0,"percent of total billed charges","50% of total billed charges",286.62,82.6,,229.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.3,16.8,,46.64,,,0,"percent of total billed charges","16.8% of total billed charges",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",53.09,347,
"ACCUCHEK LINEARITY KIT",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"ACCU-MEASURE RECEPTICAL CANISTER WITH TANDEM TUBE 250ML",ORSUP0002,CDM,278,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.7% of total billed charges",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.92,33.9,,27.94,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"ACE BANDAGE NS 4",490010,CDM,270,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.95,61.85,,3.96,,,0,"percent of total billed charges","61.5% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"ACE BANDAGE NS DOUBLE 6",490011,CDM,270,RC,,,OUTPATIENT,,,29,18.85,,25.52,88,,20.42,,,0,"percent of total billed charges","88% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.02,17.304,,4.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.27,63,,14.62,,,0,"percent of total billed charges","63% of total billed charges",4.44,15.3,,3.55,,,0,"percent of total billed charges","15.3% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",20.01,69,,,,,0,"fee schedule","69% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.94,61.85,,14.35,,,0,"percent of total billed charges","61.5% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",9.34,32.2,,7.47,,,0,"percent of total billed charges","32.2% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.97,17.136,,3.98,,,0,"percent of total billed charges","17.136% of total billed charges",6.33,21.84,,5.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.93,37.7,,8.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,78,,18.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",4.44,29,
"ACE BANDAGE STERILE 2",490012,CDM,272,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"ACE BANDAGE STERILE 3",490013,CDM,272,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"ACE BANDAGE STERILE 4",490014,CDM,272,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"ACE BANDAGE STERILE 6",490015,CDM,272,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"ACETABULAR REAMER BASKET (ALL SIZES)",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
ACETONE-ALCOHOL,ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"ACET / 5 PACK / 90 SLDS",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"ACL KIT DISPOSABLE",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1185,770.25,,1042.8,88,,834.24,,,0,"percent of total billed charges","88% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",205.05,17.304,,164.04,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",746.55,63,,597.24,,,0,"percent of total billed charges","63% of total billed charges",181.31,15.3,,145.05,,,0,"percent of total billed charges","15.3% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",817.65,69,,,,,0,"fee schedule","69% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.92,61.85,,586.34,,,0,"percent of total billed charges","61.5% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",381.57,32.2,,305.26,,,0,"percent of total billed charges","32.2% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",203.06,17.136,,162.45,,,0,"percent of total billed charges","17.136% of total billed charges",258.8,21.84,,207.04,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",446.75,37.7,,357.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",924.3,78,,739.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",181.31,1185,
"ACL DISPOSABLE PACK SOFT TISSUE FIXATION",ORSUP0023,CDM,272,RC,,,OUTPATIENT,,,2472,1606.8,,2175.36,88,,1740.29,,,0,"percent of total billed charges","88% of total billed charges",1236,50,,988.80,,,0,"percent of total billed charges","50% of total billed charges",415.3,16.8,,332.24,,,0,"percent of total billed charges","16.8% of total billed charges",2472,100,,1977.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",427.75,17.304,,342.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1557.36,63,,1245.89,,,0,"percent of total billed charges","63% of total billed charges",378.22,15.3,,302.58,,,0,"percent of total billed charges","15.3% of total billed charges",415.3,16.8,,332.24,,,0,"percent of total billed charges","16.8% of total billed charges",1705.68,69,,,,,0,"fee schedule","69% of total billed charges",2472,100,,1977.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2472,100,,1977.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2472,100,,1977.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1528.93,61.85,,1223.14,,,0,"percent of total billed charges","61.5% of total billed charges",415.3,16.8,,332.24,,,0,"percent of total billed charges","16.8% of total billed charges",1236,50,,988.80,,,0,"percent of total billed charges","50% of total billed charges",795.98,32.2,,636.78,,,0,"percent of total billed charges","32.2% of total billed charges",415.3,16.8,,332.24,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",423.6,17.136,,338.88,,,0,"percent of total billed charges","17.136% of total billed charges",539.88,21.84,,431.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",931.94,37.7,,745.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1928.16,78,,1542.53,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2041.87,82.6,,1633.50,,,0,"percent of total billed charges","82.6% of total billed charges",415.3,16.8,,332.24,,,0,"percent of total billed charges","16.8% of total billed charges",1236,50,,988.80,,,0,"percent of total billed charges","50% of total billed charges",2041.87,82.6,,1633.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",415.3,16.8,,332.24,,,0,"percent of total billed charges","16.8% of total billed charges",2472,100,,1977.60,,,0,"percent of total billed charges","100% of total billed charges",378.22,2472,
"ACORN 9.0MM",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"ADAPTER PRN VALVE SAFSITE RV-1000NC",81445,CDM,272,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"ADAPTER SPK Y TYPE",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"ADAPTER VIAL UNIVERSAL ACTIVATED",83500,CDM,270,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"ADAPTER BRONCHOSCOPE EDGE SINGLE PACK",ORSUP0009,CDM,270,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"ADAPTER MDI",ORSUP0010,CDM,270,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"ADAPTIC 3X3",139411,CDM,270,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"ADAPTER CELLULAR LATITUDE 3G USB",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"ADAPTER PERFUSION Y",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"ADAPTER PERITONEAL CATH 2 PART",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"ADAPTIC NON-ADHERENT GAUZE 1 X 36",490017,CDM,270,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"ADAPTER MULTI-TAP A23 SIZE 3 AAC",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"ADAPT BARRIER PASTE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"ADHESIVE SURGICAL LIQUID 2/3CC UNIT DOSE STERILE",184569,CDM,272,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"ADHESIVE BENZOIN TINCTURE COMPOUND 'STERI-STRIP'",158598,CDM,270,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"ADHESIVE DERMABOND HIGH VISOSITY TOPCIAL SKIN",83647,CDM,272,RC,,,OUTPATIENT,,,149,96.85,,131.12,88,,104.90,,,0,"percent of total billed charges","88% of total billed charges",74.5,50,,59.60,,,0,"percent of total billed charges","50% of total billed charges",25.03,16.8,,20.02,,,0,"percent of total billed charges","16.8% of total billed charges",149,100,,119.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.78,17.304,,20.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",93.87,63,,75.10,,,0,"percent of total billed charges","63% of total billed charges",22.8,15.3,,18.24,,,0,"percent of total billed charges","15.3% of total billed charges",25.03,16.8,,20.02,,,0,"percent of total billed charges","16.8% of total billed charges",102.81,69,,,,,0,"fee schedule","69% of total billed charges",149,100,,119.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",149,100,,119.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",149,100,,119.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.16,61.85,,73.73,,,0,"percent of total billed charges","61.5% of total billed charges",25.03,16.8,,20.02,,,0,"percent of total billed charges","16.8% of total billed charges",74.5,50,,59.60,,,0,"percent of total billed charges","50% of total billed charges",47.98,32.2,,38.38,,,0,"percent of total billed charges","32.2% of total billed charges",25.03,16.8,,20.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.53,17.136,,20.42,,,0,"percent of total billed charges","17.136% of total billed charges",32.54,21.84,,26.03,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",56.17,37.7,,44.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.22,78,,92.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",123.07,82.6,,98.46,,,0,"percent of total billed charges","82.6% of total billed charges",25.03,16.8,,20.02,,,0,"percent of total billed charges","16.8% of total billed charges",74.5,50,,59.60,,,0,"percent of total billed charges","50% of total billed charges",123.07,82.6,,98.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.03,16.8,,20.02,,,0,"percent of total billed charges","16.8% of total billed charges",149,100,,119.20,,,0,"percent of total billed charges","100% of total billed charges",22.8,149,
"ADHESIVE OCTYLBOND 0.7ML SURGICAL 6 BX/CS",326767,CDM,272,RC,,,OUTPATIENT,,,124,80.6,,109.12,88,,87.30,,,0,"percent of total billed charges","88% of total billed charges",62,50,,49.60,,,0,"percent of total billed charges","50% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.46,17.304,,17.17,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.12,63,,62.50,,,0,"percent of total billed charges","63% of total billed charges",18.97,15.3,,15.18,,,0,"percent of total billed charges","15.3% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",85.56,69,,,,,0,"fee schedule","69% of total billed charges",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.69,61.85,,61.35,,,0,"percent of total billed charges","61.5% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",62,50,,49.60,,,0,"percent of total billed charges","50% of total billed charges",39.93,32.2,,31.94,,,0,"percent of total billed charges","32.2% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.25,17.136,,17.00,,,0,"percent of total billed charges","17.136% of total billed charges",27.08,21.84,,21.66,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.75,37.7,,37.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",96.72,78,,77.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",102.42,82.6,,81.94,,,0,"percent of total billed charges","82.6% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",62,50,,49.60,,,0,"percent of total billed charges","50% of total billed charges",102.42,82.6,,81.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",18.97,124,
"ADHESIVE WOUND CLOSURE BANDAGE",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"ADJUSTABLE COAXIAL BX  18GX11CM",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"ADMINISTRATION SET BLOOD AND FLUID",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"ADSON 4-3/4 1x2 TEETH",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"ADULT ANESTHESIA BREATHING CIRCUIT",309181,CDM,272,RC,,,OUTPATIENT,,,37,24.05,,32.56,88,,26.05,,,0,"percent of total billed charges","88% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.4,17.304,,5.12,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.31,63,,18.65,,,0,"percent of total billed charges","63% of total billed charges",5.66,15.3,,4.53,,,0,"percent of total billed charges","15.3% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",25.53,69,,,,,0,"fee schedule","69% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.88,61.85,,18.30,,,0,"percent of total billed charges","61.5% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",11.91,32.2,,9.53,,,0,"percent of total billed charges","32.2% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.34,17.136,,5.07,,,0,"percent of total billed charges","17.136% of total billed charges",8.08,21.84,,6.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.95,37.7,,11.16,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.86,78,,23.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",5.66,37,
"ADVANCER ROTOBLASTER",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"ADVANTAGE FIT SYSTEM TVT",ORSUP0014,CDM,270,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"Supplies:ADVANCED SERRENITY 14 PTA BALLOON 3MM X 8CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,800,520,,704,88,,563.20,,,0,"percent of total billed charges","88% of total billed charges",400,50,,320.00,,,0,"percent of total billed charges","50% of total billed charges",134.4,16.8,,107.52,,,0,"percent of total billed charges","16.8% of total billed charges",800,100,,640.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.43,17.304,,110.74,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",504,63,,403.20,,,0,"percent of total billed charges","63% of total billed charges",122.4,15.3,,97.92,,,0,"percent of total billed charges","15.3% of total billed charges",134.4,16.8,,107.52,,,0,"percent of total billed charges","16.8% of total billed charges",552,69,,,,,0,"fee schedule","69% of total billed charges",800,100,,640.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",800,100,,640.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",800,100,,640.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.8,61.85,,395.84,,,0,"percent of total billed charges","61.5% of total billed charges",134.4,16.8,,107.52,,,0,"percent of total billed charges","16.8% of total billed charges",400,50,,320.00,,,0,"percent of total billed charges","50% of total billed charges",257.6,32.2,,206.08,,,0,"percent of total billed charges","32.2% of total billed charges",134.4,16.8,,107.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.09,17.136,,109.67,,,0,"percent of total billed charges","17.136% of total billed charges",174.72,21.84,,139.78,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.6,37.7,,241.28,,,0,"percent of total billed charges","37.7% of total billed charges",301.6,37.7,,241.28,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",271.2,33.9,,216.96,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",624,78,,499.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",660.8,82.6,,528.64,,,0,"percent of total billed charges","82.6% of total billed charges",134.4,16.8,,107.52,,,0,"percent of total billed charges","16.8% of total billed charges",400,50,,320.00,,,0,"percent of total billed charges","50% of total billed charges",660.8,82.6,,528.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.4,16.8,,107.52,,,0,"percent of total billed charges","16.8% of total billed charges",800,100,,640.00,,,0,"percent of total billed charges","100% of total billed charges",122.4,800,
"ADVANCED SERRENITY 14 PTA BALLOON 2MM X 8CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,800,520,,704,88,,563.20,,,0,"percent of total billed charges","88% of total billed charges",400,50,,320.00,,,0,"percent of total billed charges","50% of total billed charges",134.4,16.8,,107.52,,,0,"percent of total billed charges","16.8% of total billed charges",800,100,,640.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.43,17.304,,110.74,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",504,63,,403.20,,,0,"percent of total billed charges","63% of total billed charges",122.4,15.3,,97.92,,,0,"percent of total billed charges","15.3% of total billed charges",134.4,16.8,,107.52,,,0,"percent of total billed charges","16.8% of total billed charges",552,69,,,,,0,"fee schedule","69% of total billed charges",800,100,,640.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",800,100,,640.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",800,100,,640.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.8,61.85,,395.84,,,0,"percent of total billed charges","61.5% of total billed charges",134.4,16.8,,107.52,,,0,"percent of total billed charges","16.8% of total billed charges",400,50,,320.00,,,0,"percent of total billed charges","50% of total billed charges",257.6,32.2,,206.08,,,0,"percent of total billed charges","32.2% of total billed charges",134.4,16.8,,107.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.09,17.136,,109.67,,,0,"percent of total billed charges","17.136% of total billed charges",174.72,21.84,,139.78,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.6,37.7,,241.28,,,0,"percent of total billed charges","37.7% of total billed charges",301.6,37.7,,241.28,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",271.2,33.9,,216.96,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",624,78,,499.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",660.8,82.6,,528.64,,,0,"percent of total billed charges","82.6% of total billed charges",134.4,16.8,,107.52,,,0,"percent of total billed charges","16.8% of total billed charges",400,50,,320.00,,,0,"percent of total billed charges","50% of total billed charges",660.8,82.6,,528.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.4,16.8,,107.52,,,0,"percent of total billed charges","16.8% of total billed charges",800,100,,640.00,,,0,"percent of total billed charges","100% of total billed charges",122.4,800,
"ADVANCED 35LP PTA BALLOON 5MM X 12CM",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,450,292.5,,396,88,,316.80,,,0,"percent of total billed charges","88% of total billed charges",225,50,,180.00,,,0,"percent of total billed charges","50% of total billed charges",75.6,16.8,,60.48,,,0,"percent of total billed charges","16.8% of total billed charges",450,100,,360.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.87,17.304,,62.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",283.5,63,,226.80,,,0,"percent of total billed charges","63% of total billed charges",68.85,15.3,,55.08,,,0,"percent of total billed charges","15.3% of total billed charges",75.6,16.8,,60.48,,,0,"percent of total billed charges","16.8% of total billed charges",310.5,69,,,,,0,"fee schedule","69% of total billed charges",450,100,,360.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",450,100,,360.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",450,100,,360.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",278.33,61.85,,222.66,,,0,"percent of total billed charges","61.5% of total billed charges",75.6,16.8,,60.48,,,0,"percent of total billed charges","16.8% of total billed charges",225,50,,180.00,,,0,"percent of total billed charges","50% of total billed charges",144.9,32.2,,115.92,,,0,"percent of total billed charges","32.2% of total billed charges",75.6,16.8,,60.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.11,17.136,,61.69,,,0,"percent of total billed charges","17.136% of total billed charges",98.28,21.84,,78.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",169.65,37.7,,135.72,,,0,"percent of total billed charges","37.7% of total billed charges",169.65,37.7,,135.72,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",152.55,33.9,,122.04,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",351,78,,280.80,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",371.7,82.6,,297.36,,,0,"percent of total billed charges","82.6% of total billed charges",75.6,16.8,,60.48,,,0,"percent of total billed charges","16.8% of total billed charges",225,50,,180.00,,,0,"percent of total billed charges","50% of total billed charges",371.7,82.6,,297.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.6,16.8,,60.48,,,0,"percent of total billed charges","16.8% of total billed charges",450,100,,360.00,,,0,"percent of total billed charges","100% of total billed charges",68.85,450,
"ADVANCED 35LP PTA BALLOON 5MM X 8CM",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,450,292.5,,396,88,,316.80,,,0,"percent of total billed charges","88% of total billed charges",225,50,,180.00,,,0,"percent of total billed charges","50% of total billed charges",75.6,16.8,,60.48,,,0,"percent of total billed charges","16.8% of total billed charges",450,100,,360.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.87,17.304,,62.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",283.5,63,,226.80,,,0,"percent of total billed charges","63% of total billed charges",68.85,15.3,,55.08,,,0,"percent of total billed charges","15.3% of total billed charges",75.6,16.8,,60.48,,,0,"percent of total billed charges","16.8% of total billed charges",310.5,69,,,,,0,"fee schedule","69% of total billed charges",450,100,,360.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",450,100,,360.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",450,100,,360.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",278.33,61.85,,222.66,,,0,"percent of total billed charges","61.5% of total billed charges",75.6,16.8,,60.48,,,0,"percent of total billed charges","16.8% of total billed charges",225,50,,180.00,,,0,"percent of total billed charges","50% of total billed charges",144.9,32.2,,115.92,,,0,"percent of total billed charges","32.2% of total billed charges",75.6,16.8,,60.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.11,17.136,,61.69,,,0,"percent of total billed charges","17.136% of total billed charges",98.28,21.84,,78.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",169.65,37.7,,135.72,,,0,"percent of total billed charges","37.7% of total billed charges",169.65,37.7,,135.72,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",152.55,33.9,,122.04,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",351,78,,280.80,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",371.7,82.6,,297.36,,,0,"percent of total billed charges","82.6% of total billed charges",75.6,16.8,,60.48,,,0,"percent of total billed charges","16.8% of total billed charges",225,50,,180.00,,,0,"percent of total billed charges","50% of total billed charges",371.7,82.6,,297.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.6,16.8,,60.48,,,0,"percent of total billed charges","16.8% of total billed charges",450,100,,360.00,,,0,"percent of total billed charges","100% of total billed charges",68.85,450,
"ADVANCED 35LP PTA BALLOON 6MM X 12CM",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,450,292.5,,396,88,,316.80,,,0,"percent of total billed charges","88% of total billed charges",225,50,,180.00,,,0,"percent of total billed charges","50% of total billed charges",75.6,16.8,,60.48,,,0,"percent of total billed charges","16.8% of total billed charges",450,100,,360.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.87,17.304,,62.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",283.5,63,,226.80,,,0,"percent of total billed charges","63% of total billed charges",68.85,15.3,,55.08,,,0,"percent of total billed charges","15.3% of total billed charges",75.6,16.8,,60.48,,,0,"percent of total billed charges","16.8% of total billed charges",310.5,69,,,,,0,"fee schedule","69% of total billed charges",450,100,,360.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",450,100,,360.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",450,100,,360.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",278.33,61.85,,222.66,,,0,"percent of total billed charges","61.5% of total billed charges",75.6,16.8,,60.48,,,0,"percent of total billed charges","16.8% of total billed charges",225,50,,180.00,,,0,"percent of total billed charges","50% of total billed charges",144.9,32.2,,115.92,,,0,"percent of total billed charges","32.2% of total billed charges",75.6,16.8,,60.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.11,17.136,,61.69,,,0,"percent of total billed charges","17.136% of total billed charges",98.28,21.84,,78.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",169.65,37.7,,135.72,,,0,"percent of total billed charges","37.7% of total billed charges",169.65,37.7,,135.72,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",152.55,33.9,,122.04,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",351,78,,280.80,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",371.7,82.6,,297.36,,,0,"percent of total billed charges","82.6% of total billed charges",75.6,16.8,,60.48,,,0,"percent of total billed charges","16.8% of total billed charges",225,50,,180.00,,,0,"percent of total billed charges","50% of total billed charges",371.7,82.6,,297.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.6,16.8,,60.48,,,0,"percent of total billed charges","16.8% of total billed charges",450,100,,360.00,,,0,"percent of total billed charges","100% of total billed charges",68.85,450,
"ADVANCED 35LP PTA BALLOON 7MM X 6CM",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,450,292.5,,396,88,,316.80,,,0,"percent of total billed charges","88% of total billed charges",225,50,,180.00,,,0,"percent of total billed charges","50% of total billed charges",75.6,16.8,,60.48,,,0,"percent of total billed charges","16.8% of total billed charges",450,100,,360.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.87,17.304,,62.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",283.5,63,,226.80,,,0,"percent of total billed charges","63% of total billed charges",68.85,15.3,,55.08,,,0,"percent of total billed charges","15.3% of total billed charges",75.6,16.8,,60.48,,,0,"percent of total billed charges","16.8% of total billed charges",310.5,69,,,,,0,"fee schedule","69% of total billed charges",450,100,,360.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",450,100,,360.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",450,100,,360.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",278.33,61.85,,222.66,,,0,"percent of total billed charges","61.5% of total billed charges",75.6,16.8,,60.48,,,0,"percent of total billed charges","16.8% of total billed charges",225,50,,180.00,,,0,"percent of total billed charges","50% of total billed charges",144.9,32.2,,115.92,,,0,"percent of total billed charges","32.2% of total billed charges",75.6,16.8,,60.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.11,17.136,,61.69,,,0,"percent of total billed charges","17.136% of total billed charges",98.28,21.84,,78.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",169.65,37.7,,135.72,,,0,"percent of total billed charges","37.7% of total billed charges",169.65,37.7,,135.72,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",152.55,33.9,,122.04,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",351,78,,280.80,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",371.7,82.6,,297.36,,,0,"percent of total billed charges","82.6% of total billed charges",75.6,16.8,,60.48,,,0,"percent of total billed charges","16.8% of total billed charges",225,50,,180.00,,,0,"percent of total billed charges","50% of total billed charges",371.7,82.6,,297.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.6,16.8,,60.48,,,0,"percent of total billed charges","16.8% of total billed charges",450,100,,360.00,,,0,"percent of total billed charges","100% of total billed charges",68.85,450,
"ADVANCED 35LP PTA BALLOON 8MM X 6CM",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,450,292.5,,396,88,,316.80,,,0,"percent of total billed charges","88% of total billed charges",225,50,,180.00,,,0,"percent of total billed charges","50% of total billed charges",75.6,16.8,,60.48,,,0,"percent of total billed charges","16.8% of total billed charges",450,100,,360.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.87,17.304,,62.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",283.5,63,,226.80,,,0,"percent of total billed charges","63% of total billed charges",68.85,15.3,,55.08,,,0,"percent of total billed charges","15.3% of total billed charges",75.6,16.8,,60.48,,,0,"percent of total billed charges","16.8% of total billed charges",310.5,69,,,,,0,"fee schedule","69% of total billed charges",450,100,,360.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",450,100,,360.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",450,100,,360.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",278.33,61.85,,222.66,,,0,"percent of total billed charges","61.5% of total billed charges",75.6,16.8,,60.48,,,0,"percent of total billed charges","16.8% of total billed charges",225,50,,180.00,,,0,"percent of total billed charges","50% of total billed charges",144.9,32.2,,115.92,,,0,"percent of total billed charges","32.2% of total billed charges",75.6,16.8,,60.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.11,17.136,,61.69,,,0,"percent of total billed charges","17.136% of total billed charges",98.28,21.84,,78.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",169.65,37.7,,135.72,,,0,"percent of total billed charges","37.7% of total billed charges",169.65,37.7,,135.72,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",152.55,33.9,,122.04,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",351,78,,280.80,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",371.7,82.6,,297.36,,,0,"percent of total billed charges","82.6% of total billed charges",75.6,16.8,,60.48,,,0,"percent of total billed charges","16.8% of total billed charges",225,50,,180.00,,,0,"percent of total billed charges","50% of total billed charges",371.7,82.6,,297.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.6,16.8,,60.48,,,0,"percent of total billed charges","16.8% of total billed charges",450,100,,360.00,,,0,"percent of total billed charges","100% of total billed charges",68.85,450,
"ADVINCULA ALLY ADAPTER DRAPE",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,721,468.65,,634.48,88,,507.58,,,0,"percent of total billed charges","88% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.76,17.304,,99.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.23,63,,363.38,,,0,"percent of total billed charges","63% of total billed charges",110.31,15.3,,88.25,,,0,"percent of total billed charges","15.3% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",497.49,69,,,,,0,"fee schedule","69% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",445.94,61.85,,356.75,,,0,"percent of total billed charges","61.5% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",232.16,32.2,,185.73,,,0,"percent of total billed charges","32.2% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",123.55,17.136,,98.84,,,0,"percent of total billed charges","17.136% of total billed charges",157.47,21.84,,125.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",271.82,37.7,,217.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",562.38,78,,449.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",595.55,82.6,,476.44,,,0,"percent of total billed charges","82.6% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",595.55,82.6,,476.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",110.31,721,
"AEROCHAMBER MASK SMALL",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"AEROSPRAY HEMATOLOGY STAT REAGENT A",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"AEROSPRAY HEMATOLOGY STAT REAGENT B THIAZIN STAIN",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"AEROSPRAY HEMATOLOGY STAT REAGENT C EOSIN STAIN",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"AEROSPRAYREAGENT GRADE METHANOL",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"AEROSOL TEE ADAPTER",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"AF541 FACE MASK MEDIUM",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,515,334.75,,453.2,88,,362.56,,,0,"percent of total billed charges","88% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.12,17.304,,71.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",324.45,63,,259.56,,,0,"percent of total billed charges","63% of total billed charges",78.8,15.3,,63.04,,,0,"percent of total billed charges","15.3% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",355.35,69,,,,,0,"fee schedule","69% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",318.53,61.85,,254.82,,,0,"percent of total billed charges","61.5% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",165.83,32.2,,132.66,,,0,"percent of total billed charges","32.2% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.25,17.136,,70.60,,,0,"percent of total billed charges","17.136% of total billed charges",112.48,21.84,,89.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",194.16,37.7,,155.33,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",401.7,78,,321.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",78.8,515,
"AF541 FACE MASK SMALL",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,515,334.75,,453.2,88,,362.56,,,0,"percent of total billed charges","88% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.12,17.304,,71.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",324.45,63,,259.56,,,0,"percent of total billed charges","63% of total billed charges",78.8,15.3,,63.04,,,0,"percent of total billed charges","15.3% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",355.35,69,,,,,0,"fee schedule","69% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",318.53,61.85,,254.82,,,0,"percent of total billed charges","61.5% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",165.83,32.2,,132.66,,,0,"percent of total billed charges","32.2% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.25,17.136,,70.60,,,0,"percent of total billed charges","17.136% of total billed charges",112.48,21.84,,89.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",194.16,37.7,,155.33,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",401.7,78,,321.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",78.8,515,
"AF541 FACE MASK LARGE",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,515,334.75,,453.2,88,,362.56,,,0,"percent of total billed charges","88% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.12,17.304,,71.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",324.45,63,,259.56,,,0,"percent of total billed charges","63% of total billed charges",78.8,15.3,,63.04,,,0,"percent of total billed charges","15.3% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",355.35,69,,,,,0,"fee schedule","69% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",318.53,61.85,,254.82,,,0,"percent of total billed charges","61.5% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",165.83,32.2,,132.66,,,0,"percent of total billed charges","32.2% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.25,17.136,,70.60,,,0,"percent of total billed charges","17.136% of total billed charges",112.48,21.84,,89.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",194.16,37.7,,155.33,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",401.7,78,,321.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",78.8,515,
"AFFIRMAGEN 3% 2X10ML",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"AFFIRMAGEN 0.08% 2X10ML",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"AFFIRMAGEN 0.8% 3X10ML",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"AGAR BRUCELLA WITH SHEEP BLOOD HEMIN VITAMIN K",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"AHB BIOCLONE GREEN 15X10ML",ORSUP0024,CDM,272,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"AICD SINGLE CHAMBER2",CATH00071,CDM,275,RC,,,OUTPATIENT,,,201174,130763.1,,177033.12,88,,141626.50,,,0,"percent of total billed charges","88% of total billed charges",100587,50,,80469.60,,,0,"percent of total billed charges","50% of total billed charges",33797.23,16.8,,27037.78,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34811.15,17.304,,27848.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126739.62,63,,101391.70,,,0,"percent of total billed charges","63% of total billed charges",30779.62,15.3,,24623.70,,,0,"percent of total billed charges","15.3% of total billed charges",33797.23,16.8,,27037.78,,,0,"percent of total billed charges","16.8% of total billed charges",138810.06,69,,,,,0,"fee schedule","69% of total billed charges",201174,100,,160939.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201174,100,,160939.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201174,100,,160939.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124426.12,61.85,,99540.90,,,0,"percent of total billed charges","61.5% of total billed charges",33797.23,16.8,,27037.78,,,0,"percent of total billed charges","16.8% of total billed charges",100587,50,,80469.60,,,0,"percent of total billed charges","50% of total billed charges",64778.03,32.2,,51822.42,,,0,"percent of total billed charges","32.2% of total billed charges",62766.29,100,,,,,0,"fee schedule",EAPG,0.02,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",34473.18,17.136,,27578.54,,,0,"percent of total billed charges","17.136% of total billed charges",43936.4,21.84,,35149.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",75842.6,37.7,,60674.08,,,0,"percent of total billed charges","37.7% of total billed charges",75842.6,37.7,,60674.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",68197.99,33.9,,54558.39,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",156915.72,78,,125532.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166169.72,82.6,,132935.78,,,0,"percent of total billed charges","82.6% of total billed charges",33797.23,16.8,,27037.78,,,0,"percent of total billed charges","16.8% of total billed charges",100587,50,,80469.60,,,0,"percent of total billed charges","50% of total billed charges",166169.72,82.6,,132935.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33797.23,16.8,,27037.78,,,0,"percent of total billed charges","16.8% of total billed charges",201174,100,,160939.20,,,0,"percent of total billed charges","100% of total billed charges",0.02,201174,
"AIR SHEET LAT COMFORT GLIDE BLEND 40X80",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"AIR REGULATOR W/HOSE BARB OUTLET",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,464,301.6,,408.32,88,,326.66,,,0,"percent of total billed charges","88% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.29,17.304,,64.23,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.32,63,,233.86,,,0,"percent of total billed charges","63% of total billed charges",70.99,15.3,,56.79,,,0,"percent of total billed charges","15.3% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",320.16,69,,,,,0,"fee schedule","69% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",286.98,61.85,,229.58,,,0,"percent of total billed charges","61.5% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",149.41,32.2,,119.53,,,0,"percent of total billed charges","32.2% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.51,17.136,,63.61,,,0,"percent of total billed charges","17.136% of total billed charges",101.34,21.84,,81.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",174.93,37.7,,139.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",361.92,78,,289.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",70.99,464,
"AIR+ ALL-INSIDE MENISCAL REPAIR SYSTEM CURVED DOWN",ORSUP0023,CDM,278,RC,,,OUTPATIENT,,,2472,1606.8,,2175.36,88,,1740.29,,,0,"percent of total billed charges","88% of total billed charges",1236,50,,988.80,,,0,"percent of total billed charges","50% of total billed charges",415.3,16.8,,332.24,,,0,"percent of total billed charges","16.8% of total billed charges",2472,100,,1977.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",427.75,17.304,,342.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1557.36,63,,1245.89,,,0,"percent of total billed charges","63% of total billed charges",378.22,15.3,,302.58,,,0,"percent of total billed charges","15.3% of total billed charges",415.3,16.8,,332.24,,,0,"percent of total billed charges","16.8% of total billed charges",1705.68,69,,,,,0,"fee schedule","69% of total billed charges",2472,100,,1977.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2472,100,,1977.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2472,100,,1977.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1528.93,61.85,,1223.14,,,0,"percent of total billed charges","61.5% of total billed charges",415.3,16.8,,332.24,,,0,"percent of total billed charges","16.8% of total billed charges",1236,50,,988.80,,,0,"percent of total billed charges","50% of total billed charges",795.98,32.2,,636.78,,,0,"percent of total billed charges","32.2% of total billed charges",771.26,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",423.6,17.136,,338.88,,,0,"percent of total billed charges","17.136% of total billed charges",539.88,21.84,,431.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",931.94,37.7,,745.55,,,0,"percent of total billed charges","37.7% of total billed charges",931.94,37.7,,745.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",838.01,33.9,,670.41,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1928.16,78,,1542.53,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2041.87,82.6,,1633.50,,,0,"percent of total billed charges","82.6% of total billed charges",415.3,16.8,,332.24,,,0,"percent of total billed charges","16.8% of total billed charges",1236,50,,988.80,,,0,"percent of total billed charges","50% of total billed charges",2041.87,82.6,,1633.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",415.3,16.8,,332.24,,,0,"percent of total billed charges","16.8% of total billed charges",2472,100,,1977.60,,,0,"percent of total billed charges","100% of total billed charges",378.22,2472,
"AIRWAY EXCHANGE CATHETER 19 FR",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"AIRWAY CATH-GUIDE 90MM",113109,CDM,272,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"AIRWAY CATH-GUIDE 80MM",57983,CDM,272,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"AIRWAY CATH-GUIDE 70MM",119055,CDM,272,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"AIRWAY CATH-GUIDE 60MM",119151,CDM,272,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"AIRWAY CATH-GUIDE 55MM",119767,CDM,272,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"AIRWAY NASOPHARYNGEAL 34 FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"AIRWAY NASOPHARYNGEAL 32 FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"AIRWAY NASOPHARYNGEAL 30 FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"AIRWAY NASOPHARYNGEAL 28 FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"AIRWAY CATH-GUIDE 120MM",119769,CDM,272,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"AIRWAY BERMAN 110MM CATH-GUIDE",119768,CDM,272,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"AIRWAY GUEDEL 100MM CATH-GUIDE",58076,CDM,272,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"AIRWAY ESOPHAGEAL 3 LMA SUPREME",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"AIRWAY ESOPHAGEAL 5 LMA SUPREME",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"AIRWAY EXCHANGER CATHETER",83141,CDM,272,RC,,,OUTPATIENT,,,473,307.45,,416.24,88,,332.99,,,0,"percent of total billed charges","88% of total billed charges",236.5,50,,189.20,,,0,"percent of total billed charges","50% of total billed charges",79.46,16.8,,63.57,,,0,"percent of total billed charges","16.8% of total billed charges",473,100,,378.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.85,17.304,,65.48,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",297.99,63,,238.39,,,0,"percent of total billed charges","63% of total billed charges",72.37,15.3,,57.90,,,0,"percent of total billed charges","15.3% of total billed charges",79.46,16.8,,63.57,,,0,"percent of total billed charges","16.8% of total billed charges",326.37,69,,,,,0,"fee schedule","69% of total billed charges",473,100,,378.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",473,100,,378.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",473,100,,378.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.55,61.85,,234.04,,,0,"percent of total billed charges","61.5% of total billed charges",79.46,16.8,,63.57,,,0,"percent of total billed charges","16.8% of total billed charges",236.5,50,,189.20,,,0,"percent of total billed charges","50% of total billed charges",152.31,32.2,,121.85,,,0,"percent of total billed charges","32.2% of total billed charges",79.46,16.8,,63.57,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.05,17.136,,64.84,,,0,"percent of total billed charges","17.136% of total billed charges",103.3,21.84,,82.64,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",178.32,37.7,,142.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",368.94,78,,295.15,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",390.7,82.6,,312.56,,,0,"percent of total billed charges","82.6% of total billed charges",79.46,16.8,,63.57,,,0,"percent of total billed charges","16.8% of total billed charges",236.5,50,,189.20,,,0,"percent of total billed charges","50% of total billed charges",390.7,82.6,,312.56,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.46,16.8,,63.57,,,0,"percent of total billed charges","16.8% of total billed charges",473,100,,378.40,,,0,"percent of total billed charges","100% of total billed charges",72.37,473,
"AIRWAY LMA CLASSIC 4",65463,CDM,272,RC,,,OUTPATIENT,,,1803,1171.95,,1586.64,88,,1269.31,,,0,"percent of total billed charges","88% of total billed charges",901.5,50,,721.20,,,0,"percent of total billed charges","50% of total billed charges",302.9,16.8,,242.32,,,0,"percent of total billed charges","16.8% of total billed charges",1803,100,,1442.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",311.99,17.304,,249.59,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1135.89,63,,908.71,,,0,"percent of total billed charges","63% of total billed charges",275.86,15.3,,220.69,,,0,"percent of total billed charges","15.3% of total billed charges",302.9,16.8,,242.32,,,0,"percent of total billed charges","16.8% of total billed charges",1244.07,69,,,,,0,"fee schedule","69% of total billed charges",1803,100,,1442.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1803,100,,1442.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1803,100,,1442.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1115.16,61.85,,892.13,,,0,"percent of total billed charges","61.5% of total billed charges",302.9,16.8,,242.32,,,0,"percent of total billed charges","16.8% of total billed charges",901.5,50,,721.20,,,0,"percent of total billed charges","50% of total billed charges",580.57,32.2,,464.46,,,0,"percent of total billed charges","32.2% of total billed charges",302.9,16.8,,242.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",308.96,17.136,,247.17,,,0,"percent of total billed charges","17.136% of total billed charges",393.78,21.84,,315.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",679.73,37.7,,543.78,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1406.34,78,,1125.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1489.28,82.6,,1191.42,,,0,"percent of total billed charges","82.6% of total billed charges",302.9,16.8,,242.32,,,0,"percent of total billed charges","16.8% of total billed charges",901.5,50,,721.20,,,0,"percent of total billed charges","50% of total billed charges",1489.28,82.6,,1191.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.9,16.8,,242.32,,,0,"percent of total billed charges","16.8% of total billed charges",1803,100,,1442.40,,,0,"percent of total billed charges","100% of total billed charges",275.86,1803,
"AIRWAY NASOPHARYNGEAL 24 FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"AIRWAY NASOPHARYNGEAL 26 FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"AIRWAY NASOPHARYNGEAL 36 FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"AIRWAY ESOPHAGEAL 4 LMA SUPREME",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"AIRWAY NASOPHARYNGEAL  20 FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"AIRWAY NASOPHARYNGEAL 22 FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"AIRWAY LARYNGEAL FLEXIBLE SZ 4",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"ALARM ELITE POSEY",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"ALARIS IV EXT ANTI SIPHON FEMALE LUERS",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"ALBUMIN / 5 PACK / 250 SLIDES",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"ALBUSTIX URINE STRIPS",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"ALC/AMON CONTROL 1 6X3ML",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"ALC/AMON CONTROL 3 6X3ML",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"ALCOHOL PREP PAD STERILE",413928,CDM,272,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"ALCOHOL ISO GALLON",131026,CDM,272,RC,,,OUTPATIENT,,,193,125.45,,169.84,88,,135.87,,,0,"percent of total billed charges","88% of total billed charges",96.5,50,,77.20,,,0,"percent of total billed charges","50% of total billed charges",32.42,16.8,,25.94,,,0,"percent of total billed charges","16.8% of total billed charges",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.4,17.304,,26.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",121.59,63,,97.27,,,0,"percent of total billed charges","63% of total billed charges",29.53,15.3,,23.62,,,0,"percent of total billed charges","15.3% of total billed charges",32.42,16.8,,25.94,,,0,"percent of total billed charges","16.8% of total billed charges",133.17,69,,,,,0,"fee schedule","69% of total billed charges",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",119.37,61.85,,95.50,,,0,"percent of total billed charges","61.5% of total billed charges",32.42,16.8,,25.94,,,0,"percent of total billed charges","16.8% of total billed charges",96.5,50,,77.20,,,0,"percent of total billed charges","50% of total billed charges",62.15,32.2,,49.72,,,0,"percent of total billed charges","32.2% of total billed charges",32.42,16.8,,25.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.07,17.136,,26.46,,,0,"percent of total billed charges","17.136% of total billed charges",42.15,21.84,,33.72,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",72.76,37.7,,58.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",150.54,78,,120.43,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.42,82.6,,127.54,,,0,"percent of total billed charges","82.6% of total billed charges",32.42,16.8,,25.94,,,0,"percent of total billed charges","16.8% of total billed charges",96.5,50,,77.20,,,0,"percent of total billed charges","50% of total billed charges",159.42,82.6,,127.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.42,16.8,,25.94,,,0,"percent of total billed charges","16.8% of total billed charges",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",29.53,193,
"ALCOHOL / 5 PACK / 90 SLIDES",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"ALCOHOL ETHYL 100%",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"ALCOHOL WIPES MAMMO",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"ALEXIS O WOUND PROTECTOR/RETRACTOR",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"ALEXIS SMALL LAP SYSTEM",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1185,770.25,,1042.8,88,,834.24,,,0,"percent of total billed charges","88% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",205.05,17.304,,164.04,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",746.55,63,,597.24,,,0,"percent of total billed charges","63% of total billed charges",181.31,15.3,,145.05,,,0,"percent of total billed charges","15.3% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",817.65,69,,,,,0,"fee schedule","69% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.92,61.85,,586.34,,,0,"percent of total billed charges","61.5% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",381.57,32.2,,305.26,,,0,"percent of total billed charges","32.2% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",203.06,17.136,,162.45,,,0,"percent of total billed charges","17.136% of total billed charges",258.8,21.84,,207.04,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",446.75,37.7,,357.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",924.3,78,,739.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",181.31,1185,
"ALEXIS WOUND PROTECTOR/RETRACTOR LARGE",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,464,301.6,,408.32,88,,326.66,,,0,"percent of total billed charges","88% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.29,17.304,,64.23,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.32,63,,233.86,,,0,"percent of total billed charges","63% of total billed charges",70.99,15.3,,56.79,,,0,"percent of total billed charges","15.3% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",320.16,69,,,,,0,"fee schedule","69% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",286.98,61.85,,229.58,,,0,"percent of total billed charges","61.5% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",149.41,32.2,,119.53,,,0,"percent of total billed charges","32.2% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.51,17.136,,63.61,,,0,"percent of total billed charges","17.136% of total billed charges",101.34,21.84,,81.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",174.93,37.7,,139.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",361.92,78,,289.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",70.99,464,
"ALLEN BOW FRAME HEAD/ARM PROTECTORS (DISPOSABLE)",490026,CDM,270,RC,,,OUTPATIENT,,,413,268.45,,363.44,88,,290.75,,,0,"percent of total billed charges","88% of total billed charges",206.5,50,,165.20,,,0,"percent of total billed charges","50% of total billed charges",69.38,16.8,,55.50,,,0,"percent of total billed charges","16.8% of total billed charges",413,100,,330.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.47,17.304,,57.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",260.19,63,,208.15,,,0,"percent of total billed charges","63% of total billed charges",63.19,15.3,,50.55,,,0,"percent of total billed charges","15.3% of total billed charges",69.38,16.8,,55.50,,,0,"percent of total billed charges","16.8% of total billed charges",284.97,69,,,,,0,"fee schedule","69% of total billed charges",413,100,,330.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",413,100,,330.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",413,100,,330.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.44,61.85,,204.35,,,0,"percent of total billed charges","61.5% of total billed charges",69.38,16.8,,55.50,,,0,"percent of total billed charges","16.8% of total billed charges",206.5,50,,165.20,,,0,"percent of total billed charges","50% of total billed charges",132.99,32.2,,106.39,,,0,"percent of total billed charges","32.2% of total billed charges",69.38,16.8,,55.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.77,17.136,,56.62,,,0,"percent of total billed charges","17.136% of total billed charges",90.2,21.84,,72.16,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",155.7,37.7,,124.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",322.14,78,,257.71,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",341.14,82.6,,272.91,,,0,"percent of total billed charges","82.6% of total billed charges",69.38,16.8,,55.50,,,0,"percent of total billed charges","16.8% of total billed charges",206.5,50,,165.20,,,0,"percent of total billed charges","50% of total billed charges",341.14,82.6,,272.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.38,16.8,,55.50,,,0,"percent of total billed charges","16.8% of total billed charges",413,100,,330.40,,,0,"percent of total billed charges","100% of total billed charges",63.19,413,
"ALLEN MEDICAL SHOULDER TABLE HEAD RESTRAINT (DISPOSABLE)",490027,CDM,270,RC,,,OUTPATIENT,,,182,118.3,,160.16,88,,128.13,,,0,"percent of total billed charges","88% of total billed charges",91,50,,72.80,,,0,"percent of total billed charges","50% of total billed charges",30.58,16.8,,24.46,,,0,"percent of total billed charges","16.8% of total billed charges",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.49,17.304,,25.19,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.66,63,,91.73,,,0,"percent of total billed charges","63% of total billed charges",27.85,15.3,,22.28,,,0,"percent of total billed charges","15.3% of total billed charges",30.58,16.8,,24.46,,,0,"percent of total billed charges","16.8% of total billed charges",125.58,69,,,,,0,"fee schedule","69% of total billed charges",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.57,61.85,,90.06,,,0,"percent of total billed charges","61.5% of total billed charges",30.58,16.8,,24.46,,,0,"percent of total billed charges","16.8% of total billed charges",91,50,,72.80,,,0,"percent of total billed charges","50% of total billed charges",58.6,32.2,,46.88,,,0,"percent of total billed charges","32.2% of total billed charges",30.58,16.8,,24.46,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.19,17.136,,24.95,,,0,"percent of total billed charges","17.136% of total billed charges",39.75,21.84,,31.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",68.61,37.7,,54.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",141.96,78,,113.57,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",150.33,82.6,,120.26,,,0,"percent of total billed charges","82.6% of total billed charges",30.58,16.8,,24.46,,,0,"percent of total billed charges","16.8% of total billed charges",91,50,,72.80,,,0,"percent of total billed charges","50% of total billed charges",150.33,82.6,,120.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.58,16.8,,24.46,,,0,"percent of total billed charges","16.8% of total billed charges",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",27.85,182,
"ALLODERM TISSUE THICK MED PERF",ORSUP0117,CDM,270,RC,,,OUTPATIENT,,,30261,19669.65,,26629.68,88,,21303.74,,,0,"percent of total billed charges","88% of total billed charges",15130.5,50,,12104.40,,,0,"percent of total billed charges","50% of total billed charges",5083.85,16.8,,4067.08,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5236.36,17.304,,4189.09,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",19064.43,63,,15251.54,,,0,"percent of total billed charges","63% of total billed charges",4629.93,15.3,,3703.94,,,0,"percent of total billed charges","15.3% of total billed charges",5083.85,16.8,,4067.08,,,0,"percent of total billed charges","16.8% of total billed charges",20880.09,69,,,,,0,"fee schedule","69% of total billed charges",30261,100,,24208.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30261,100,,24208.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30261,100,,24208.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18716.43,61.85,,14973.14,,,0,"percent of total billed charges","61.5% of total billed charges",5083.85,16.8,,4067.08,,,0,"percent of total billed charges","16.8% of total billed charges",15130.5,50,,12104.40,,,0,"percent of total billed charges","50% of total billed charges",9744.04,32.2,,7795.23,,,0,"percent of total billed charges","32.2% of total billed charges",5083.85,16.8,,4067.08,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5185.52,17.136,,4148.42,,,0,"percent of total billed charges","17.136% of total billed charges",6609,21.84,,5287.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11408.4,37.7,,9126.72,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23603.58,78,,18882.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",24995.59,82.6,,19996.47,,,0,"percent of total billed charges","82.6% of total billed charges",5083.85,16.8,,4067.08,,,0,"percent of total billed charges","16.8% of total billed charges",15130.5,50,,12104.40,,,0,"percent of total billed charges","50% of total billed charges",24995.59,82.6,,19996.47,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5083.85,16.8,,4067.08,,,0,"percent of total billed charges","16.8% of total billed charges",30261,100,,24208.80,,,0,"percent of total billed charges","100% of total billed charges",4629.93,30261,
"ALLODERM MESH CONTOUR MED",ORSUP0139,CDM,278,RC,,,OUTPATIENT,,,36421,23673.65,,32050.48,88,,25640.38,,,0,"percent of total billed charges","88% of total billed charges",18210.5,50,,14568.40,,,0,"percent of total billed charges","50% of total billed charges",6118.73,16.8,,4894.98,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6302.29,17.304,,5041.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22945.23,63,,18356.18,,,0,"percent of total billed charges","63% of total billed charges",5572.41,15.3,,4457.93,,,0,"percent of total billed charges","15.3% of total billed charges",6118.73,16.8,,4894.98,,,0,"percent of total billed charges","16.8% of total billed charges",25130.49,69,,,,,0,"fee schedule","69% of total billed charges",36421,100,,29136.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36421,100,,29136.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36421,100,,29136.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22526.39,61.85,,18021.11,,,0,"percent of total billed charges","61.5% of total billed charges",6118.73,16.8,,4894.98,,,0,"percent of total billed charges","16.8% of total billed charges",18210.5,50,,14568.40,,,0,"percent of total billed charges","50% of total billed charges",11727.56,32.2,,9382.05,,,0,"percent of total billed charges","32.2% of total billed charges",11363.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",6241.1,17.136,,4992.88,,,0,"percent of total billed charges","17.136% of total billed charges",7954.35,21.84,,6363.48,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",13730.72,37.7,,10984.58,,,0,"percent of total billed charges","37.7% of total billed charges",13730.72,37.7,,10984.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",12346.72,33.9,,9877.38,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",28408.38,78,,22726.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",30083.75,82.6,,24067.00,,,0,"percent of total billed charges","82.6% of total billed charges",6118.73,16.8,,4894.98,,,0,"percent of total billed charges","16.8% of total billed charges",18210.5,50,,14568.40,,,0,"percent of total billed charges","50% of total billed charges",30083.75,82.6,,24067.00,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6118.73,16.8,,4894.98,,,0,"percent of total billed charges","16.8% of total billed charges",36421,100,,29136.80,,,0,"percent of total billed charges","100% of total billed charges",4695,36421,
"ALLODERM MESH RECTANGLE 8X200",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"ALLODERM MESH 4 X16 THIN",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"ALLODERM MESH CONTOUR SM THIN",ORSUP0076,CDM,278,RC,,,OUTPATIENT,,,17675,11488.75,,15554,88,,12443.20,,,0,"percent of total billed charges","88% of total billed charges",8837.5,50,,7070.00,,,0,"percent of total billed charges","50% of total billed charges",2969.4,16.8,,2375.52,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3058.48,17.304,,2446.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11135.25,63,,8908.20,,,0,"percent of total billed charges","63% of total billed charges",2704.28,15.3,,2163.42,,,0,"percent of total billed charges","15.3% of total billed charges",2969.4,16.8,,2375.52,,,0,"percent of total billed charges","16.8% of total billed charges",12195.75,69,,,,,0,"fee schedule","69% of total billed charges",17675,100,,14140.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17675,100,,14140.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17675,100,,14140.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10931.99,61.85,,8745.59,,,0,"percent of total billed charges","61.5% of total billed charges",2969.4,16.8,,2375.52,,,0,"percent of total billed charges","16.8% of total billed charges",8837.5,50,,7070.00,,,0,"percent of total billed charges","50% of total billed charges",5691.35,32.2,,4553.08,,,0,"percent of total billed charges","32.2% of total billed charges",5514.6,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3028.79,17.136,,2423.03,,,0,"percent of total billed charges","17.136% of total billed charges",3860.22,21.84,,3088.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",6663.48,37.7,,5330.78,,,0,"percent of total billed charges","37.7% of total billed charges",6663.48,37.7,,5330.78,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",5991.83,33.9,,4793.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",13786.5,78,,11029.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14599.55,82.6,,11679.64,,,0,"percent of total billed charges","82.6% of total billed charges",2969.4,16.8,,2375.52,,,0,"percent of total billed charges","16.8% of total billed charges",8837.5,50,,7070.00,,,0,"percent of total billed charges","50% of total billed charges",14599.55,82.6,,11679.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2969.4,16.8,,2375.52,,,0,"percent of total billed charges","16.8% of total billed charges",17675,100,,14140.00,,,0,"percent of total billed charges","100% of total billed charges",2704.28,17675,
"ALLODERM MESH 6 X 16 THIN",ORSUP0094,CDM,278,RC,,,OUTPATIENT,,,22763,14795.95,,20031.44,88,,16025.15,,,0,"percent of total billed charges","88% of total billed charges",11381.5,50,,9105.20,,,0,"percent of total billed charges","50% of total billed charges",3824.18,16.8,,3059.34,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3938.91,17.304,,3151.13,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14340.69,63,,11472.55,,,0,"percent of total billed charges","63% of total billed charges",3482.74,15.3,,2786.19,,,0,"percent of total billed charges","15.3% of total billed charges",3824.18,16.8,,3059.34,,,0,"percent of total billed charges","16.8% of total billed charges",15706.47,69,,,,,0,"fee schedule","69% of total billed charges",22763,100,,18210.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22763,100,,18210.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22763,100,,18210.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14078.92,61.85,,11263.14,,,0,"percent of total billed charges","61.5% of total billed charges",3824.18,16.8,,3059.34,,,0,"percent of total billed charges","16.8% of total billed charges",11381.5,50,,9105.20,,,0,"percent of total billed charges","50% of total billed charges",7329.69,32.2,,5863.75,,,0,"percent of total billed charges","32.2% of total billed charges",7102.06,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3900.67,17.136,,3120.54,,,0,"percent of total billed charges","17.136% of total billed charges",4971.44,21.84,,3977.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",8581.65,37.7,,6865.32,,,0,"percent of total billed charges","37.7% of total billed charges",8581.65,37.7,,6865.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",7716.66,33.9,,6173.33,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",17755.14,78,,14204.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",18802.24,82.6,,15041.79,,,0,"percent of total billed charges","82.6% of total billed charges",3824.18,16.8,,3059.34,,,0,"percent of total billed charges","16.8% of total billed charges",11381.5,50,,9105.20,,,0,"percent of total billed charges","50% of total billed charges",18802.24,82.6,,15041.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3824.18,16.8,,3059.34,,,0,"percent of total billed charges","16.8% of total billed charges",22763,100,,18210.40,,,0,"percent of total billed charges","100% of total billed charges",3482.74,22763,
"ALLOMATRIX-C 3CC",ORSUP0059,CDM,278,RC,,,OUTPATIENT,,,10094,6561.1,,8882.72,88,,7106.18,,,0,"percent of total billed charges","88% of total billed charges",5047,50,,4037.60,,,0,"percent of total billed charges","50% of total billed charges",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1746.67,17.304,,1397.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6359.22,63,,5087.38,,,0,"percent of total billed charges","63% of total billed charges",1544.38,15.3,,1235.50,,,0,"percent of total billed charges","15.3% of total billed charges",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",6964.86,69,,,,,0,"fee schedule","69% of total billed charges",10094,100,,8075.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10094,100,,8075.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10094,100,,8075.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6243.14,61.85,,4994.51,,,0,"percent of total billed charges","61.5% of total billed charges",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",5047,50,,4037.60,,,0,"percent of total billed charges","50% of total billed charges",3250.27,32.2,,2600.22,,,0,"percent of total billed charges","32.2% of total billed charges",3149.33,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1729.71,17.136,,1383.77,,,0,"percent of total billed charges","17.136% of total billed charges",2204.53,21.84,,1763.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3805.44,37.7,,3044.35,,,0,"percent of total billed charges","37.7% of total billed charges",3805.44,37.7,,3044.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3421.87,33.9,,2737.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7873.32,78,,6298.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8337.64,82.6,,6670.11,,,0,"percent of total billed charges","82.6% of total billed charges",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",5047,50,,4037.60,,,0,"percent of total billed charges","50% of total billed charges",8337.64,82.6,,6670.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",10094,100,,8075.20,,,0,"percent of total billed charges","100% of total billed charges",1544.38,10094,
"ALLOMATRIC-C 5CC",ORSUP0063,CDM,278,RC,,,OUTPATIENT,,,6798,4418.7,,5982.24,88,,4785.79,,,0,"percent of total billed charges","88% of total billed charges",3399,50,,2719.20,,,0,"percent of total billed charges","50% of total billed charges",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1176.33,17.304,,941.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4282.74,63,,3426.19,,,0,"percent of total billed charges","63% of total billed charges",1040.09,15.3,,832.07,,,0,"percent of total billed charges","15.3% of total billed charges",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",4690.62,69,,,,,0,"fee schedule","69% of total billed charges",6798,100,,5438.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6798,100,,5438.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6798,100,,5438.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4204.56,61.85,,3363.65,,,0,"percent of total billed charges","61.5% of total billed charges",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",3399,50,,2719.20,,,0,"percent of total billed charges","50% of total billed charges",2188.96,32.2,,1751.17,,,0,"percent of total billed charges","32.2% of total billed charges",2120.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1164.91,17.136,,931.93,,,0,"percent of total billed charges","17.136% of total billed charges",1484.68,21.84,,1187.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2562.85,37.7,,2050.28,,,0,"percent of total billed charges","37.7% of total billed charges",2562.85,37.7,,2050.28,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2304.52,33.9,,1843.62,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5302.44,78,,4241.95,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5615.15,82.6,,4492.12,,,0,"percent of total billed charges","82.6% of total billed charges",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",3399,50,,2719.20,,,0,"percent of total billed charges","50% of total billed charges",5615.15,82.6,,4492.12,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",6798,100,,5438.40,,,0,"percent of total billed charges","100% of total billed charges",1040.09,6798,
"ALLOMATRIX-C 10CC",ORSUP0059,CDM,278,RC,,,OUTPATIENT,,,10094,6561.1,,8882.72,88,,7106.18,,,0,"percent of total billed charges","88% of total billed charges",5047,50,,4037.60,,,0,"percent of total billed charges","50% of total billed charges",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1746.67,17.304,,1397.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6359.22,63,,5087.38,,,0,"percent of total billed charges","63% of total billed charges",1544.38,15.3,,1235.50,,,0,"percent of total billed charges","15.3% of total billed charges",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",6964.86,69,,,,,0,"fee schedule","69% of total billed charges",10094,100,,8075.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10094,100,,8075.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10094,100,,8075.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6243.14,61.85,,4994.51,,,0,"percent of total billed charges","61.5% of total billed charges",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",5047,50,,4037.60,,,0,"percent of total billed charges","50% of total billed charges",3250.27,32.2,,2600.22,,,0,"percent of total billed charges","32.2% of total billed charges",3149.33,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1729.71,17.136,,1383.77,,,0,"percent of total billed charges","17.136% of total billed charges",2204.53,21.84,,1763.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3805.44,37.7,,3044.35,,,0,"percent of total billed charges","37.7% of total billed charges",3805.44,37.7,,3044.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3421.87,33.9,,2737.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7873.32,78,,6298.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8337.64,82.6,,6670.11,,,0,"percent of total billed charges","82.6% of total billed charges",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",5047,50,,4037.60,,,0,"percent of total billed charges","50% of total billed charges",8337.64,82.6,,6670.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",10094,100,,8075.20,,,0,"percent of total billed charges","100% of total billed charges",1544.38,10094,
"ALLOMATRIX-C 30CC",ORSUP0059,CDM,278,RC,,,OUTPATIENT,,,10094,6561.1,,8882.72,88,,7106.18,,,0,"percent of total billed charges","88% of total billed charges",5047,50,,4037.60,,,0,"percent of total billed charges","50% of total billed charges",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1746.67,17.304,,1397.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6359.22,63,,5087.38,,,0,"percent of total billed charges","63% of total billed charges",1544.38,15.3,,1235.50,,,0,"percent of total billed charges","15.3% of total billed charges",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",6964.86,69,,,,,0,"fee schedule","69% of total billed charges",10094,100,,8075.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10094,100,,8075.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10094,100,,8075.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6243.14,61.85,,4994.51,,,0,"percent of total billed charges","61.5% of total billed charges",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",5047,50,,4037.60,,,0,"percent of total billed charges","50% of total billed charges",3250.27,32.2,,2600.22,,,0,"percent of total billed charges","32.2% of total billed charges",3149.33,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1729.71,17.136,,1383.77,,,0,"percent of total billed charges","17.136% of total billed charges",2204.53,21.84,,1763.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3805.44,37.7,,3044.35,,,0,"percent of total billed charges","37.7% of total billed charges",3805.44,37.7,,3044.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3421.87,33.9,,2737.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7873.32,78,,6298.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8337.64,82.6,,6670.11,,,0,"percent of total billed charges","82.6% of total billed charges",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",5047,50,,4037.60,,,0,"percent of total billed charges","50% of total billed charges",8337.64,82.6,,6670.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",10094,100,,8075.20,,,0,"percent of total billed charges","100% of total billed charges",1544.38,10094,
"ALPHAVENT 4.75 PEEK SUTURE ANCHOR",ORSUP0019,CDM,278,RC,,,OUTPATIENT,,,1648,1071.2,,1450.24,88,,1160.19,,,0,"percent of total billed charges","88% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",285.17,17.304,,228.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1038.24,63,,830.59,,,0,"percent of total billed charges","63% of total billed charges",252.14,15.3,,201.71,,,0,"percent of total billed charges","15.3% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1137.12,69,,,,,0,"fee schedule","69% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.29,61.85,,815.43,,,0,"percent of total billed charges","61.5% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",530.66,32.2,,424.53,,,0,"percent of total billed charges","32.2% of total billed charges",514.18,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",282.4,17.136,,225.92,,,0,"percent of total billed charges","17.136% of total billed charges",359.92,21.84,,287.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",621.3,37.7,,497.04,,,0,"percent of total billed charges","37.7% of total billed charges",621.3,37.7,,497.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",558.67,33.9,,446.94,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1285.44,78,,1028.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1361.25,82.6,,1089.00,,,0,"percent of total billed charges","82.6% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",1361.25,82.6,,1089.00,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",252.14,1648,
"ALPHAVENT 5.5 PEEK SUTURE ANCHOR",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,927,602.55,,815.76,88,,652.61,,,0,"percent of total billed charges","88% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.41,17.304,,128.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.01,63,,467.21,,,0,"percent of total billed charges","63% of total billed charges",141.83,15.3,,113.46,,,0,"percent of total billed charges","15.3% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",639.63,69,,,,,0,"fee schedule","69% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",573.35,61.85,,458.68,,,0,"percent of total billed charges","61.5% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",298.49,32.2,,238.79,,,0,"percent of total billed charges","32.2% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.85,17.136,,127.08,,,0,"percent of total billed charges","17.136% of total billed charges",202.46,21.84,,161.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",349.48,37.7,,279.58,,,0,"percent of total billed charges","37.7% of total billed charges",349.48,37.7,,279.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",314.25,33.9,,251.40,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",723.06,78,,578.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",141.83,927,
"ALTV 300 SLIDES",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"AMBU BAG ADULT",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"AMBU BAG PEDIATRIC",490037,CDM,270,RC,,,OUTPATIENT,,,237,154.05,,208.56,88,,166.85,,,0,"percent of total billed charges","88% of total billed charges",118.5,50,,94.80,,,0,"percent of total billed charges","50% of total billed charges",39.82,16.8,,31.86,,,0,"percent of total billed charges","16.8% of total billed charges",237,100,,189.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.01,17.304,,32.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",149.31,63,,119.45,,,0,"percent of total billed charges","63% of total billed charges",36.26,15.3,,29.01,,,0,"percent of total billed charges","15.3% of total billed charges",39.82,16.8,,31.86,,,0,"percent of total billed charges","16.8% of total billed charges",163.53,69,,,,,0,"fee schedule","69% of total billed charges",237,100,,189.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",237,100,,189.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",237,100,,189.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",146.58,61.85,,117.26,,,0,"percent of total billed charges","61.5% of total billed charges",39.82,16.8,,31.86,,,0,"percent of total billed charges","16.8% of total billed charges",118.5,50,,94.80,,,0,"percent of total billed charges","50% of total billed charges",76.31,32.2,,61.05,,,0,"percent of total billed charges","32.2% of total billed charges",39.82,16.8,,31.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.61,17.136,,32.49,,,0,"percent of total billed charges","17.136% of total billed charges",51.76,21.84,,41.41,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",89.35,37.7,,71.48,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",184.86,78,,147.89,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",195.76,82.6,,156.61,,,0,"percent of total billed charges","82.6% of total billed charges",39.82,16.8,,31.86,,,0,"percent of total billed charges","16.8% of total billed charges",118.5,50,,94.80,,,0,"percent of total billed charges","50% of total billed charges",195.76,82.6,,156.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.82,16.8,,31.86,,,0,"percent of total billed charges","16.8% of total billed charges",237,100,,189.60,,,0,"percent of total billed charges","100% of total billed charges",36.26,237,
"AMNISURE TEST KIT",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"AMNISURE QC POS \\T\\ NEG",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"AMNIOCORD 3X5 CM",ORSUP0067,CDM,278,RC,,,OUTPATIENT,,,11742,7632.3,,10332.96,88,,8266.37,,,0,"percent of total billed charges","88% of total billed charges",5871,50,,4696.80,,,0,"percent of total billed charges","50% of total billed charges",1972.66,16.8,,1578.13,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2031.84,17.304,,1625.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7397.46,63,,5917.97,,,0,"percent of total billed charges","63% of total billed charges",1796.53,15.3,,1437.22,,,0,"percent of total billed charges","15.3% of total billed charges",1972.66,16.8,,1578.13,,,0,"percent of total billed charges","16.8% of total billed charges",8101.98,69,,,,,0,"fee schedule","69% of total billed charges",11742,100,,9393.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11742,100,,9393.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11742,100,,9393.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7262.43,61.85,,5809.94,,,0,"percent of total billed charges","61.5% of total billed charges",1972.66,16.8,,1578.13,,,0,"percent of total billed charges","16.8% of total billed charges",5871,50,,4696.80,,,0,"percent of total billed charges","50% of total billed charges",3780.92,32.2,,3024.74,,,0,"percent of total billed charges","32.2% of total billed charges",3663.5,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2012.11,17.136,,1609.69,,,0,"percent of total billed charges","17.136% of total billed charges",2564.45,21.84,,2051.56,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4426.73,37.7,,3541.38,,,0,"percent of total billed charges","37.7% of total billed charges",4426.73,37.7,,3541.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3980.54,33.9,,3184.43,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",9158.76,78,,7327.01,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9698.89,82.6,,7759.11,,,0,"percent of total billed charges","82.6% of total billed charges",1972.66,16.8,,1578.13,,,0,"percent of total billed charges","16.8% of total billed charges",5871,50,,4696.80,,,0,"percent of total billed charges","50% of total billed charges",9698.89,82.6,,7759.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1972.66,16.8,,1578.13,,,0,"percent of total billed charges","16.8% of total billed charges",11742,100,,9393.60,,,0,"percent of total billed charges","100% of total billed charges",1796.53,11742,
"AMPLATZ GUIDEWIRE 0.038X150CM",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"AMSORB CO2",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"AMYLASE / 5 PACK / 300 SLIDES",ORSUP0019,CDM,272,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"ANAEROGEN OXOID 2.5L SACHET",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"ANAEROBIC LKV BLOOD AGAR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"ANCHOR WEDGE3.0MM WITH NO. 2 FORCE FIBER",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"ANCHOR 2.9X12.5MM PUSH-LOCK BIO-COMP",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",751.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.7% of total billed charges",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",816.99,33.9,,653.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"ANCHOR BIOCOMPOSITE 5.5",ORSUP0018,CDM,278,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",605.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.7% of total billed charges",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",658.34,33.9,,526.67,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"ANCHOR PUSH LOCK 4.5MM",ORSUP0019,CDM,278,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",668.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.7% of total billed charges",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",726.14,33.9,,580.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"ANCHOR SUTURE FASTAK WITH HANDLE AND #2 FIBERWIRE, 2.8X11.7MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"ANCHOR SUTURE SWIVELOCK 4.75X19.1",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",751.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.7% of total billed charges",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",816.99,33.9,,653.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"ANCHOR W/ORTHOCORD HEALIX TI",ORSUP0024,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"ANESTHESIA CIRCUIT ADULT",490040,CDM,270,RC,,,OUTPATIENT,,,115,74.75,,101.2,88,,80.96,,,0,"percent of total billed charges","88% of total billed charges",57.5,50,,46.00,,,0,"percent of total billed charges","50% of total billed charges",19.32,16.8,,15.46,,,0,"percent of total billed charges","16.8% of total billed charges",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.9,17.304,,15.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",72.45,63,,57.96,,,0,"percent of total billed charges","63% of total billed charges",17.6,15.3,,14.08,,,0,"percent of total billed charges","15.3% of total billed charges",19.32,16.8,,15.46,,,0,"percent of total billed charges","16.8% of total billed charges",79.35,69,,,,,0,"fee schedule","69% of total billed charges",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.13,61.85,,56.90,,,0,"percent of total billed charges","61.5% of total billed charges",19.32,16.8,,15.46,,,0,"percent of total billed charges","16.8% of total billed charges",57.5,50,,46.00,,,0,"percent of total billed charges","50% of total billed charges",37.03,32.2,,29.62,,,0,"percent of total billed charges","32.2% of total billed charges",19.32,16.8,,15.46,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.71,17.136,,15.77,,,0,"percent of total billed charges","17.136% of total billed charges",25.12,21.84,,20.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.36,37.7,,34.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",89.7,78,,71.76,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",94.99,82.6,,75.99,,,0,"percent of total billed charges","82.6% of total billed charges",19.32,16.8,,15.46,,,0,"percent of total billed charges","16.8% of total billed charges",57.5,50,,46.00,,,0,"percent of total billed charges","50% of total billed charges",94.99,82.6,,75.99,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.32,16.8,,15.46,,,0,"percent of total billed charges","16.8% of total billed charges",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",17.6,115,
"ANESTHESIA CIRCUIT PEDIATRIC",490041,CDM,270,RC,,,OUTPATIENT,,,59,38.35,,51.92,88,,41.54,,,0,"percent of total billed charges","88% of total billed charges",29.5,50,,23.60,,,0,"percent of total billed charges","50% of total billed charges",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.21,17.304,,8.17,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.17,63,,29.74,,,0,"percent of total billed charges","63% of total billed charges",9.03,15.3,,7.22,,,0,"percent of total billed charges","15.3% of total billed charges",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",40.71,69,,,,,0,"fee schedule","69% of total billed charges",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.49,61.85,,29.19,,,0,"percent of total billed charges","61.5% of total billed charges",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",29.5,50,,23.60,,,0,"percent of total billed charges","50% of total billed charges",19,32.2,,15.20,,,0,"percent of total billed charges","32.2% of total billed charges",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.11,17.136,,8.09,,,0,"percent of total billed charges","17.136% of total billed charges",12.89,21.84,,10.31,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.24,37.7,,17.79,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.02,78,,36.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.73,82.6,,38.98,,,0,"percent of total billed charges","82.6% of total billed charges",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",29.5,50,,23.60,,,0,"percent of total billed charges","50% of total billed charges",48.73,82.6,,38.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",9.03,59,
"ANESTHESIA CO2 FILTER",490042,CDM,270,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"ANESTHESIA CO2 SAMPLING LINE",490043,CDM,270,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"ANESTHESIA MASK ADULT",490044,CDM,270,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"ANESTHESIA MASK PEDIATRIC",490045,CDM,270,RC,,,OUTPATIENT,,,28,18.2,,24.64,88,,19.71,,,0,"percent of total billed charges","88% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.85,17.304,,3.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.64,63,,14.11,,,0,"percent of total billed charges","63% of total billed charges",4.28,15.3,,3.42,,,0,"percent of total billed charges","15.3% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",19.32,69,,,,,0,"fee schedule","69% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.32,61.85,,13.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",9.02,32.2,,7.22,,,0,"percent of total billed charges","32.2% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.8,17.136,,3.84,,,0,"percent of total billed charges","17.136% of total billed charges",6.12,21.84,,4.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.56,37.7,,8.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.84,78,,17.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",4.28,28,
"ANGIOSEAL EVOLUTION 6FR",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"ANGIOTOUCH HAND CONTROLLER KIT",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"ANGIOJET ULTRA POWER PULSE KIT",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"ANGIOJET SOLENT PROXI 6FR 90CM",ORSUP0093,CDM,272,RC,,,OUTPATIENT,,,17304,11247.6,,15227.52,88,,12182.02,,,0,"percent of total billed charges","88% of total billed charges",8652,50,,6921.60,,,0,"percent of total billed charges","50% of total billed charges",2907.07,16.8,,2325.66,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2994.28,17.304,,2395.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10901.52,63,,8721.22,,,0,"percent of total billed charges","63% of total billed charges",2647.51,15.3,,2118.01,,,0,"percent of total billed charges","15.3% of total billed charges",2907.07,16.8,,2325.66,,,0,"percent of total billed charges","16.8% of total billed charges",11939.76,69,,,,,0,"fee schedule","69% of total billed charges",17304,100,,13843.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17304,100,,13843.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17304,100,,13843.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10702.52,61.85,,8562.02,,,0,"percent of total billed charges","61.5% of total billed charges",2907.07,16.8,,2325.66,,,0,"percent of total billed charges","16.8% of total billed charges",8652,50,,6921.60,,,0,"percent of total billed charges","50% of total billed charges",5571.89,32.2,,4457.51,,,0,"percent of total billed charges","32.2% of total billed charges",2907.07,16.8,,2325.66,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2965.21,17.136,,2372.17,,,0,"percent of total billed charges","17.136% of total billed charges",3779.19,21.84,,3023.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6523.61,37.7,,5218.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13497.12,78,,10797.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14293.1,82.6,,11434.48,,,0,"percent of total billed charges","82.6% of total billed charges",2907.07,16.8,,2325.66,,,0,"percent of total billed charges","16.8% of total billed charges",8652,50,,6921.60,,,0,"percent of total billed charges","50% of total billed charges",14293.1,82.6,,11434.48,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2907.07,16.8,,2325.66,,,0,"percent of total billed charges","16.8% of total billed charges",17304,100,,13843.20,,,0,"percent of total billed charges","100% of total billed charges",2647.51,17304,
"ANGIOJET SOLENT PROXI 6FR X 90CM",ORSUP0059,CDM,272,RC,,,OUTPATIENT,,,10094,6561.1,,8882.72,88,,7106.18,,,0,"percent of total billed charges","88% of total billed charges",5047,50,,4037.60,,,0,"percent of total billed charges","50% of total billed charges",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1746.67,17.304,,1397.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6359.22,63,,5087.38,,,0,"percent of total billed charges","63% of total billed charges",1544.38,15.3,,1235.50,,,0,"percent of total billed charges","15.3% of total billed charges",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",6964.86,69,,,,,0,"fee schedule","69% of total billed charges",10094,100,,8075.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10094,100,,8075.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10094,100,,8075.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6243.14,61.85,,4994.51,,,0,"percent of total billed charges","61.5% of total billed charges",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",5047,50,,4037.60,,,0,"percent of total billed charges","50% of total billed charges",3250.27,32.2,,2600.22,,,0,"percent of total billed charges","32.2% of total billed charges",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1729.71,17.136,,1383.77,,,0,"percent of total billed charges","17.136% of total billed charges",2204.53,21.84,,1763.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3805.44,37.7,,3044.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7873.32,78,,6298.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8337.64,82.6,,6670.11,,,0,"percent of total billed charges","82.6% of total billed charges",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",5047,50,,4037.60,,,0,"percent of total billed charges","50% of total billed charges",8337.64,82.6,,6670.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",10094,100,,8075.20,,,0,"percent of total billed charges","100% of total billed charges",1544.38,10094,
"ANSPACH EMAX 2 HIGH FLOW IRRIGATION TUBE STERILE",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"ANTI KELL  MONOCLONIAL   1X5ML",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"ANTI D BIOCLONE 15/PK",ORSUP0027,CDM,272,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"ANTI E BIOCLONE  1X5ML",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"ANTI A BIOCLONE  15X10ML",ORSUP0031,CDM,272,RC,,,OUTPATIENT,,,5356,3481.4,,4713.28,88,,3770.62,,,0,"percent of total billed charges","88% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",926.8,17.304,,741.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3374.28,63,,2699.42,,,0,"percent of total billed charges","63% of total billed charges",819.47,15.3,,655.58,,,0,"percent of total billed charges","15.3% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",3695.64,69,,,,,0,"fee schedule","69% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3312.69,61.85,,2650.15,,,0,"percent of total billed charges","61.5% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",1724.63,32.2,,1379.70,,,0,"percent of total billed charges","32.2% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",917.8,17.136,,734.24,,,0,"percent of total billed charges","17.136% of total billed charges",1169.75,21.84,,935.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4177.68,78,,3342.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",819.47,5356,
"ANTI- IGG  GREEN",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"ANTI-A 1 LECTIN 3ML",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"ANTI-FYA 3ML",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"ANTI-A BIOCLONE 3 X 10ML",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"ANTI-B BIOCLONE 3 X 10ML",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"ANTI-D BIOCLONE 3 X 10ML",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"ANTI-HUMAN BIOCLONE GRN 15 X 10ML",ORSUP0032,CDM,272,RC,,,OUTPATIENT,,,5624,3655.6,,4949.12,88,,3959.30,,,0,"percent of total billed charges","88% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",973.18,17.304,,778.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3543.12,63,,2834.50,,,0,"percent of total billed charges","63% of total billed charges",860.47,15.3,,688.38,,,0,"percent of total billed charges","15.3% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",3880.56,69,,,,,0,"fee schedule","69% of total billed charges",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3478.44,61.85,,2782.75,,,0,"percent of total billed charges","61.5% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",1810.93,32.2,,1448.74,,,0,"percent of total billed charges","32.2% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",963.73,17.136,,770.98,,,0,"percent of total billed charges","17.136% of total billed charges",1228.28,21.84,,982.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2120.25,37.7,,1696.20,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4386.72,78,,3509.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4645.42,82.6,,3716.34,,,0,"percent of total billed charges","82.6% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",4645.42,82.6,,3716.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",860.47,5624,
"APOLLO PROBE MP50",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"APPLICATOR SEPP BENZOIN PEEL PK",120490,CDM,270,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"APPLICATOR BLOOD SMEAR",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"APPLIER MULTIPLE CLIP MED/LRG",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"APPLIER MULTIPLE CLIP LARGE WI",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"APPLIER CLIP SML LIGACLIP ENDO MULTI TI 20 MCS20",10299,CDM,272,RC,,,OUTPATIENT,,,367,238.55,,322.96,88,,258.37,,,0,"percent of total billed charges","88% of total billed charges",183.5,50,,146.80,,,0,"percent of total billed charges","50% of total billed charges",61.66,16.8,,49.33,,,0,"percent of total billed charges","16.8% of total billed charges",367,100,,293.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.51,17.304,,50.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.21,63,,184.97,,,0,"percent of total billed charges","63% of total billed charges",56.15,15.3,,44.92,,,0,"percent of total billed charges","15.3% of total billed charges",61.66,16.8,,49.33,,,0,"percent of total billed charges","16.8% of total billed charges",253.23,69,,,,,0,"fee schedule","69% of total billed charges",367,100,,293.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",367,100,,293.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",367,100,,293.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",226.99,61.85,,181.59,,,0,"percent of total billed charges","61.5% of total billed charges",61.66,16.8,,49.33,,,0,"percent of total billed charges","16.8% of total billed charges",183.5,50,,146.80,,,0,"percent of total billed charges","50% of total billed charges",118.17,32.2,,94.54,,,0,"percent of total billed charges","32.2% of total billed charges",61.66,16.8,,49.33,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.89,17.136,,50.31,,,0,"percent of total billed charges","17.136% of total billed charges",80.15,21.84,,64.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",138.36,37.7,,110.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",286.26,78,,229.01,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",303.14,82.6,,242.51,,,0,"percent of total billed charges","82.6% of total billed charges",61.66,16.8,,49.33,,,0,"percent of total billed charges","16.8% of total billed charges",183.5,50,,146.80,,,0,"percent of total billed charges","50% of total billed charges",303.14,82.6,,242.51,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.66,16.8,,49.33,,,0,"percent of total billed charges","16.8% of total billed charges",367,100,,293.60,,,0,"percent of total billed charges","100% of total billed charges",56.15,367,
"APPLIER CLIP ENDOSCOPIC ROTATING 5MM MED/LG ALLPORT",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"APPLIER CLIP MED LIGACLIP ENDO MULTI TI 20 MCM20",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"APPLICATOR FLOSEAL LAPSCP XLONG ENDO 5MM",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"APPLICATOR FLOSEAL LAP XLONG ENDO 5MM",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"APPLICATOR TISSEEL",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"APPLICATOR SILVER NITRATE/POTASSIUM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"APPLICATOR FIBRIN SEALANT L40CM DIA 5MM RIGID W/ SNAPLOCK DU",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,412,267.8,,362.56,88,,290.05,,,0,"percent of total billed charges","88% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.29,17.304,,57.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",259.56,63,,207.65,,,0,"percent of total billed charges","63% of total billed charges",63.04,15.3,,50.43,,,0,"percent of total billed charges","15.3% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",284.28,69,,,,,0,"fee schedule","69% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",254.82,61.85,,203.86,,,0,"percent of total billed charges","61.5% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",132.66,32.2,,106.13,,,0,"percent of total billed charges","32.2% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.6,17.136,,56.48,,,0,"percent of total billed charges","17.136% of total billed charges",89.98,21.84,,71.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",155.32,37.7,,124.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",321.36,78,,257.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",63.04,412,
"DRESSING AQUAPLAST 6 X 9",ORSUP0019,CDM,270,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"AQUASONIC ULTRASOUND GEL THICK 0.25L",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"AQUAFLEX ULTRASOUND GEL PADS",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"ARCTIC GEL UNIVERSAL PAD",ORSUP0023,CDM,272,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"ARCTIC GEL SMALL KIT",ORSUP0048,CDM,272,RC,,,OUTPATIENT,,,9909,6440.85,,8719.92,88,,6975.94,,,0,"percent of total billed charges","88% of total billed charges",4954.5,50,,3963.60,,,0,"percent of total billed charges","50% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1714.65,17.304,,1371.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6242.67,63,,4994.14,,,0,"percent of total billed charges","63% of total billed charges",1516.08,15.3,,1212.86,,,0,"percent of total billed charges","15.3% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",6837.21,69,,,,,0,"fee schedule","69% of total billed charges",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6128.72,61.85,,4902.98,,,0,"percent of total billed charges","61.5% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",4954.5,50,,3963.60,,,0,"percent of total billed charges","50% of total billed charges",3190.7,32.2,,2552.56,,,0,"percent of total billed charges","32.2% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1698.01,17.136,,1358.41,,,0,"percent of total billed charges","17.136% of total billed charges",2164.13,21.84,,1731.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3735.69,37.7,,2988.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7729.02,78,,6183.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8184.83,82.6,,6547.86,,,0,"percent of total billed charges","82.6% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",4954.5,50,,3963.60,,,0,"percent of total billed charges","50% of total billed charges",8184.83,82.6,,6547.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",1516.08,9909,
"ARCTIC GEL MEDIUM KIT",ORSUP0048,CDM,272,RC,,,OUTPATIENT,,,9909,6440.85,,8719.92,88,,6975.94,,,0,"percent of total billed charges","88% of total billed charges",4954.5,50,,3963.60,,,0,"percent of total billed charges","50% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1714.65,17.304,,1371.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6242.67,63,,4994.14,,,0,"percent of total billed charges","63% of total billed charges",1516.08,15.3,,1212.86,,,0,"percent of total billed charges","15.3% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",6837.21,69,,,,,0,"fee schedule","69% of total billed charges",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6128.72,61.85,,4902.98,,,0,"percent of total billed charges","61.5% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",4954.5,50,,3963.60,,,0,"percent of total billed charges","50% of total billed charges",3190.7,32.2,,2552.56,,,0,"percent of total billed charges","32.2% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1698.01,17.136,,1358.41,,,0,"percent of total billed charges","17.136% of total billed charges",2164.13,21.84,,1731.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3735.69,37.7,,2988.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7729.02,78,,6183.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8184.83,82.6,,6547.86,,,0,"percent of total billed charges","82.6% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",4954.5,50,,3963.60,,,0,"percent of total billed charges","50% of total billed charges",8184.83,82.6,,6547.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",1516.08,9909,
"ARCTIC GEL LARGE KIT",ORSUP0048,CDM,272,RC,,,OUTPATIENT,,,9909,6440.85,,8719.92,88,,6975.94,,,0,"percent of total billed charges","88% of total billed charges",4954.5,50,,3963.60,,,0,"percent of total billed charges","50% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1714.65,17.304,,1371.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6242.67,63,,4994.14,,,0,"percent of total billed charges","63% of total billed charges",1516.08,15.3,,1212.86,,,0,"percent of total billed charges","15.3% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",6837.21,69,,,,,0,"fee schedule","69% of total billed charges",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6128.72,61.85,,4902.98,,,0,"percent of total billed charges","61.5% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",4954.5,50,,3963.60,,,0,"percent of total billed charges","50% of total billed charges",3190.7,32.2,,2552.56,,,0,"percent of total billed charges","32.2% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1698.01,17.136,,1358.41,,,0,"percent of total billed charges","17.136% of total billed charges",2164.13,21.84,,1731.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3735.69,37.7,,2988.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7729.02,78,,6183.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8184.83,82.6,,6547.86,,,0,"percent of total billed charges","82.6% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",4954.5,50,,3963.60,,,0,"percent of total billed charges","50% of total billed charges",8184.83,82.6,,6547.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",1516.08,9909,
"ARGYLE UMBILICAL CATH SINGLE LUMEN 5FR 15IN",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"ARISTA AH 3G",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"ARISTA AH 5G",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"ARROWS GENESIS FOR STERRAD",328037,CDM,272,RC,,,OUTPATIENT,,,232,150.8,,204.16,88,,163.33,,,0,"percent of total billed charges","88% of total billed charges",116,50,,92.80,,,0,"percent of total billed charges","50% of total billed charges",38.98,16.8,,31.18,,,0,"percent of total billed charges","16.8% of total billed charges",232,100,,185.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.15,17.304,,32.12,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",146.16,63,,116.93,,,0,"percent of total billed charges","63% of total billed charges",35.5,15.3,,28.40,,,0,"percent of total billed charges","15.3% of total billed charges",38.98,16.8,,31.18,,,0,"percent of total billed charges","16.8% of total billed charges",160.08,69,,,,,0,"fee schedule","69% of total billed charges",232,100,,185.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",232,100,,185.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",232,100,,185.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",143.49,61.85,,114.79,,,0,"percent of total billed charges","61.5% of total billed charges",38.98,16.8,,31.18,,,0,"percent of total billed charges","16.8% of total billed charges",116,50,,92.80,,,0,"percent of total billed charges","50% of total billed charges",74.7,32.2,,59.76,,,0,"percent of total billed charges","32.2% of total billed charges",38.98,16.8,,31.18,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.76,17.136,,31.81,,,0,"percent of total billed charges","17.136% of total billed charges",50.67,21.84,,40.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",87.46,37.7,,69.97,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",180.96,78,,144.77,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.63,82.6,,153.30,,,0,"percent of total billed charges","82.6% of total billed charges",38.98,16.8,,31.18,,,0,"percent of total billed charges","16.8% of total billed charges",116,50,,92.80,,,0,"percent of total billed charges","50% of total billed charges",191.63,82.6,,153.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.98,16.8,,31.18,,,0,"percent of total billed charges","16.8% of total billed charges",232,100,,185.60,,,0,"percent of total billed charges","100% of total billed charges",35.5,232,
"ARTHROSCOPY PAK",441785,CDM,270,RC,,,OUTPATIENT,,,1017,661.05,,894.96,88,,715.97,,,0,"percent of total billed charges","88% of total billed charges",508.5,50,,406.80,,,0,"percent of total billed charges","50% of total billed charges",170.86,16.8,,136.69,,,0,"percent of total billed charges","16.8% of total billed charges",1017,100,,813.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",175.98,17.304,,140.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",640.71,63,,512.57,,,0,"percent of total billed charges","63% of total billed charges",155.6,15.3,,124.48,,,0,"percent of total billed charges","15.3% of total billed charges",170.86,16.8,,136.69,,,0,"percent of total billed charges","16.8% of total billed charges",701.73,69,,,,,0,"fee schedule","69% of total billed charges",1017,100,,813.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1017,100,,813.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1017,100,,813.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.01,61.85,,503.21,,,0,"percent of total billed charges","61.5% of total billed charges",170.86,16.8,,136.69,,,0,"percent of total billed charges","16.8% of total billed charges",508.5,50,,406.80,,,0,"percent of total billed charges","50% of total billed charges",327.47,32.2,,261.98,,,0,"percent of total billed charges","32.2% of total billed charges",170.86,16.8,,136.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",174.27,17.136,,139.42,,,0,"percent of total billed charges","17.136% of total billed charges",222.11,21.84,,177.69,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",383.41,37.7,,306.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",793.26,78,,634.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",840.04,82.6,,672.03,,,0,"percent of total billed charges","82.6% of total billed charges",170.86,16.8,,136.69,,,0,"percent of total billed charges","16.8% of total billed charges",508.5,50,,406.80,,,0,"percent of total billed charges","50% of total billed charges",840.04,82.6,,672.03,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.86,16.8,,136.69,,,0,"percent of total billed charges","16.8% of total billed charges",1017,100,,813.60,,,0,"percent of total billed charges","100% of total billed charges",155.6,1017,
"ARTHREX AMNION MATRIX CORD 3CM X 6CM",ORSUP0094,CDM,270,RC,,,OUTPATIENT,,,22763,14795.95,,20031.44,88,,16025.15,,,0,"percent of total billed charges","88% of total billed charges",11381.5,50,,9105.20,,,0,"percent of total billed charges","50% of total billed charges",3824.18,16.8,,3059.34,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3938.91,17.304,,3151.13,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14340.69,63,,11472.55,,,0,"percent of total billed charges","63% of total billed charges",3482.74,15.3,,2786.19,,,0,"percent of total billed charges","15.3% of total billed charges",3824.18,16.8,,3059.34,,,0,"percent of total billed charges","16.8% of total billed charges",15706.47,69,,,,,0,"fee schedule","69% of total billed charges",22763,100,,18210.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22763,100,,18210.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22763,100,,18210.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14078.92,61.85,,11263.14,,,0,"percent of total billed charges","61.5% of total billed charges",3824.18,16.8,,3059.34,,,0,"percent of total billed charges","16.8% of total billed charges",11381.5,50,,9105.20,,,0,"percent of total billed charges","50% of total billed charges",7329.69,32.2,,5863.75,,,0,"percent of total billed charges","32.2% of total billed charges",3824.18,16.8,,3059.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3900.67,17.136,,3120.54,,,0,"percent of total billed charges","17.136% of total billed charges",4971.44,21.84,,3977.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8581.65,37.7,,6865.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17755.14,78,,14204.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",18802.24,82.6,,15041.79,,,0,"percent of total billed charges","82.6% of total billed charges",3824.18,16.8,,3059.34,,,0,"percent of total billed charges","16.8% of total billed charges",11381.5,50,,9105.20,,,0,"percent of total billed charges","50% of total billed charges",18802.24,82.6,,15041.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3824.18,16.8,,3059.34,,,0,"percent of total billed charges","16.8% of total billed charges",22763,100,,18210.40,,,0,"percent of total billed charges","100% of total billed charges",3482.74,22763,
"ARTHREX AMNION MATRIX THICK 3CM X 4CM",ORSUP0065,CDM,270,RC,,,OUTPATIENT,,,14729,9573.85,,12961.52,88,,10369.22,,,0,"percent of total billed charges","88% of total billed charges",7364.5,50,,5891.60,,,0,"percent of total billed charges","50% of total billed charges",2474.47,16.8,,1979.58,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2548.71,17.304,,2038.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9279.27,63,,7423.42,,,0,"percent of total billed charges","63% of total billed charges",2253.54,15.3,,1802.83,,,0,"percent of total billed charges","15.3% of total billed charges",2474.47,16.8,,1979.58,,,0,"percent of total billed charges","16.8% of total billed charges",10163.01,69,,,,,0,"fee schedule","69% of total billed charges",14729,100,,11783.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14729,100,,11783.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14729,100,,11783.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9109.89,61.85,,7287.91,,,0,"percent of total billed charges","61.5% of total billed charges",2474.47,16.8,,1979.58,,,0,"percent of total billed charges","16.8% of total billed charges",7364.5,50,,5891.60,,,0,"percent of total billed charges","50% of total billed charges",4742.74,32.2,,3794.19,,,0,"percent of total billed charges","32.2% of total billed charges",2474.47,16.8,,1979.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2523.96,17.136,,2019.17,,,0,"percent of total billed charges","17.136% of total billed charges",3216.81,21.84,,2573.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5552.83,37.7,,4442.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11488.62,78,,9190.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12166.15,82.6,,9732.92,,,0,"percent of total billed charges","82.6% of total billed charges",2474.47,16.8,,1979.58,,,0,"percent of total billed charges","16.8% of total billed charges",7364.5,50,,5891.60,,,0,"percent of total billed charges","50% of total billed charges",12166.15,82.6,,9732.92,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2474.47,16.8,,1979.58,,,0,"percent of total billed charges","16.8% of total billed charges",14729,100,,11783.20,,,0,"percent of total billed charges","100% of total billed charges",2253.54,14729,
"ARTHREX ANGEL BMC KIT",ORSUP0034,CDM,270,RC,,,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1065.75,17.304,,852.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",942.33,15.3,,753.86,,,0,"percent of total billed charges","15.3% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3809.34,61.85,,3047.47,,,0,"percent of total billed charges","61.5% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1983.2,32.2,,1586.56,,,0,"percent of total billed charges","32.2% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1055.41,17.136,,844.33,,,0,"percent of total billed charges","17.136% of total billed charges",1345.13,21.84,,1076.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",942.33,6159,
"ARTHREX ANGEL SYSTEM CPRP PROCESSING SET",ORSUP0021,CDM,270,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"ARTHREX ANKLE DISTRACTOR STRAP (DISPOSABLE)",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"ARTHREX BIOCARTILAGE 1CC",ORSUP0059,CDM,278,RC,,,OUTPATIENT,,,6180,4017,,5438.4,88,,4350.72,,,0,"percent of total billed charges","88% of total billed charges",3090,50,,2472.00,,,0,"percent of total billed charges","50% of total billed charges",1038.24,16.8,,830.59,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1069.39,17.304,,855.51,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3893.4,63,,3114.72,,,0,"percent of total billed charges","63% of total billed charges",945.54,15.3,,756.43,,,0,"percent of total billed charges","15.3% of total billed charges",1038.24,16.8,,830.59,,,0,"percent of total billed charges","16.8% of total billed charges",4264.2,69,,,,,0,"fee schedule","69% of total billed charges",6180,100,,4944.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6180,100,,4944.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6180,100,,4944.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3822.33,61.85,,3057.86,,,0,"percent of total billed charges","61.5% of total billed charges",1038.24,16.8,,830.59,,,0,"percent of total billed charges","16.8% of total billed charges",3090,50,,2472.00,,,0,"percent of total billed charges","50% of total billed charges",1989.96,32.2,,1591.97,,,0,"percent of total billed charges","32.2% of total billed charges",1928.16,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1059,17.136,,847.20,,,0,"percent of total billed charges","17.136% of total billed charges",1349.71,21.84,,1079.77,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2329.86,37.7,,1863.89,,,0,"percent of total billed charges","37.7% of total billed charges",2329.86,37.7,,1863.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2095.02,33.9,,1676.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820.4,78,,3856.32,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5104.68,82.6,,4083.74,,,0,"percent of total billed charges","82.6% of total billed charges",1038.24,16.8,,830.59,,,0,"percent of total billed charges","16.8% of total billed charges",3090,50,,2472.00,,,0,"percent of total billed charges","50% of total billed charges",5104.68,82.6,,4083.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1038.24,16.8,,830.59,,,0,"percent of total billed charges","16.8% of total billed charges",6180,100,,4944.00,,,0,"percent of total billed charges","100% of total billed charges",945.54,6180,
"ARTHREX BIOCARTILAGE MIX DELIVERY SYSTEM",ORSUP0022,CDM,270,RC,,,OUTPATIENT,,,2266,1472.9,,1994.08,88,,1595.26,,,0,"percent of total billed charges","88% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",392.11,17.304,,313.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1427.58,63,,1142.06,,,0,"percent of total billed charges","63% of total billed charges",346.7,15.3,,277.36,,,0,"percent of total billed charges","15.3% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1563.54,69,,,,,0,"fee schedule","69% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1401.52,61.85,,1121.22,,,0,"percent of total billed charges","61.5% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",729.65,32.2,,583.72,,,0,"percent of total billed charges","32.2% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",388.3,17.136,,310.64,,,0,"percent of total billed charges","17.136% of total billed charges",494.89,21.84,,395.91,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",854.28,37.7,,683.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1767.48,78,,1413.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1871.72,82.6,,1497.38,,,0,"percent of total billed charges","82.6% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",1871.72,82.6,,1497.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",346.7,2266,
"ARTHREX STIMUBLAST GEL 1CC",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"ARTHREX STIMUBLAST PASTE 1CC",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"ARTHREX STIMUBLAST PUTTY 1CC",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"ARTHREX SUTURE LASSO 45 DEGREE CURVE RIGHT",ORSUP0014,CDM,270,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"ASAHI  GRAN SLAM 0.14 X 180CM WIRE",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"ASAHI CONFIANZA.014 X 180CM WIRE",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"ASAHI SION STRAIGHT WIRE BLUE 014X190CM",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"ASAHI FIELDER WIRE XT 014X190CM",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"ASPEN PEDIATRIC COLLAR SHORT SZ PD1",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"ASPEN PEDIATRIC COLLAR REGULAR SZ PD3",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"ASPEN PEDIATRIC COLLAR SZ PD5",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"ASPIRATION/ANTICOAGULATION SET",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"ASPIRATION NEEDLE,BRONCOSCOPY",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"ASPIRATE PROBE (01-008409B)",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,17.304,,49.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.28,61.85,,178.62,,,0,"percent of total billed charges","61.5% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",116.24,32.2,,92.99,,,0,"percent of total billed charges","32.2% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.86,17.136,,49.49,,,0,"percent of total billed charges","17.136% of total billed charges",78.84,21.84,,63.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,361,
"ASPIRA PERITONEAL GRAINAGE CATH INSERTION KIT",ORSUP0043,CDM,278,RC,,,OUTPATIENT,,,6592,4284.8,,5800.96,88,,4640.77,,,0,"percent of total billed charges","88% of total billed charges",3296,50,,2636.80,,,0,"percent of total billed charges","50% of total billed charges",1107.46,16.8,,885.97,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1140.68,17.304,,912.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4152.96,63,,3322.37,,,0,"percent of total billed charges","63% of total billed charges",1008.58,15.3,,806.86,,,0,"percent of total billed charges","15.3% of total billed charges",1107.46,16.8,,885.97,,,0,"percent of total billed charges","16.8% of total billed charges",4548.48,69,,,,,0,"fee schedule","69% of total billed charges",6592,100,,5273.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6592,100,,5273.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6592,100,,5273.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4077.15,61.85,,3261.72,,,0,"percent of total billed charges","61.5% of total billed charges",1107.46,16.8,,885.97,,,0,"percent of total billed charges","16.8% of total billed charges",3296,50,,2636.80,,,0,"percent of total billed charges","50% of total billed charges",2122.62,32.2,,1698.10,,,0,"percent of total billed charges","32.2% of total billed charges",2056.7,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1129.61,17.136,,903.69,,,0,"percent of total billed charges","17.136% of total billed charges",1439.69,21.84,,1151.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2485.18,37.7,,1988.14,,,0,"percent of total billed charges","37.7% of total billed charges",2485.18,37.7,,1988.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2234.69,33.9,,1787.75,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5141.76,78,,4113.41,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5444.99,82.6,,4355.99,,,0,"percent of total billed charges","82.6% of total billed charges",1107.46,16.8,,885.97,,,0,"percent of total billed charges","16.8% of total billed charges",3296,50,,2636.80,,,0,"percent of total billed charges","50% of total billed charges",5444.99,82.6,,4355.99,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1107.46,16.8,,885.97,,,0,"percent of total billed charges","16.8% of total billed charges",6592,100,,5273.60,,,0,"percent of total billed charges","100% of total billed charges",1008.58,6592,
"ASPIRATION TUBING SET",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"ASSURANCE CLIP 16MM",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,464,301.6,,408.32,88,,326.66,,,0,"percent of total billed charges","88% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.29,17.304,,64.23,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.32,63,,233.86,,,0,"percent of total billed charges","63% of total billed charges",70.99,15.3,,56.79,,,0,"percent of total billed charges","15.3% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",320.16,69,,,,,0,"fee schedule","69% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",286.98,61.85,,229.58,,,0,"percent of total billed charges","61.5% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",149.41,32.2,,119.53,,,0,"percent of total billed charges","32.2% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.51,17.136,,63.61,,,0,"percent of total billed charges","17.136% of total billed charges",101.34,21.84,,81.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",174.93,37.7,,139.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",361.92,78,,289.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",70.99,464,
"ATHLETIC SUPPORTER ADULT SMALL 26-32",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"ATHLETIC SUPPORTER ADULT MED 33-38",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"ATHLETIC SUPPORTER ADULT LRG 39-44",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"ATRA SUMP",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"ATTEST RAPID READOUT 1296F",10225,CDM,270,RC,,,OUTPATIENT,,,1136,738.4,,999.68,88,,799.74,,,0,"percent of total billed charges","88% of total billed charges",568,50,,454.40,,,0,"percent of total billed charges","50% of total billed charges",190.85,16.8,,152.68,,,0,"percent of total billed charges","16.8% of total billed charges",1136,100,,908.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",196.57,17.304,,157.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",715.68,63,,572.54,,,0,"percent of total billed charges","63% of total billed charges",173.81,15.3,,139.05,,,0,"percent of total billed charges","15.3% of total billed charges",190.85,16.8,,152.68,,,0,"percent of total billed charges","16.8% of total billed charges",783.84,69,,,,,0,"fee schedule","69% of total billed charges",1136,100,,908.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1136,100,,908.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1136,100,,908.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",702.62,61.85,,562.10,,,0,"percent of total billed charges","61.5% of total billed charges",190.85,16.8,,152.68,,,0,"percent of total billed charges","16.8% of total billed charges",568,50,,454.40,,,0,"percent of total billed charges","50% of total billed charges",365.79,32.2,,292.63,,,0,"percent of total billed charges","32.2% of total billed charges",190.85,16.8,,152.68,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.66,17.136,,155.73,,,0,"percent of total billed charges","17.136% of total billed charges",248.1,21.84,,198.48,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",428.27,37.7,,342.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",886.08,78,,708.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",938.34,82.6,,750.67,,,0,"percent of total billed charges","82.6% of total billed charges",190.85,16.8,,152.68,,,0,"percent of total billed charges","16.8% of total billed charges",568,50,,454.40,,,0,"percent of total billed charges","50% of total billed charges",938.34,82.6,,750.67,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",190.85,16.8,,152.68,,,0,"percent of total billed charges","16.8% of total billed charges",1136,100,,908.80,,,0,"percent of total billed charges","100% of total billed charges",173.81,1136,
"ATTENDS HEAVEY ABSORBENCY BRIEFS MED",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"AUTION CHECK PLUS(LOW\\T\\HIGH)25ML",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"AUTIONI 9EB STRIPS",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"AUTOCLAVE TAPE",103688,CDM,270,RC,,,OUTPATIENT,,,52,33.8,,45.76,88,,36.61,,,0,"percent of total billed charges","88% of total billed charges",26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,17.304,,7.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.76,63,,26.21,,,0,"percent of total billed charges","63% of total billed charges",7.96,15.3,,6.37,,,0,"percent of total billed charges","15.3% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",35.88,69,,,,,0,"fee schedule","69% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.16,61.85,,25.73,,,0,"percent of total billed charges","61.5% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",16.74,32.2,,13.39,,,0,"percent of total billed charges","32.2% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.91,17.136,,7.13,,,0,"percent of total billed charges","17.136% of total billed charges",11.36,21.84,,9.09,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.6,37.7,,15.68,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",40.56,78,,32.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",7.96,52,
"AUTOTROL PLUS B LEVEL 1",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"AUTOTROL PLUS B LEVEL 2",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"AUTOTROL PLUS B LEVEL 3",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"AVANOS RAPID UREASE TEST",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"AVANOS CLO TEST",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"AVITENE 1 GRAM 6/BOX",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"AVITENE SHEETS 70MM X 70MM",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"AVOX-4 CO-OXIMETER CTRL LEVEL 3X10X1 7ML",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"AXIS II URS SU MODEL E NORM DEFL",ORSUP0034,CDM,272,RC,,,OUTPATIENT,,,4738,3079.7,,4169.44,88,,3335.55,,,0,"percent of total billed charges","88% of total billed charges",2369,50,,1895.20,,,0,"percent of total billed charges","50% of total billed charges",795.98,16.8,,636.78,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",819.86,17.304,,655.89,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2984.94,63,,2387.95,,,0,"percent of total billed charges","63% of total billed charges",724.91,15.3,,579.93,,,0,"percent of total billed charges","15.3% of total billed charges",795.98,16.8,,636.78,,,0,"percent of total billed charges","16.8% of total billed charges",3269.22,69,,,,,0,"fee schedule","69% of total billed charges",4738,100,,3790.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4738,100,,3790.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4738,100,,3790.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2930.45,61.85,,2344.36,,,0,"percent of total billed charges","61.5% of total billed charges",795.98,16.8,,636.78,,,0,"percent of total billed charges","16.8% of total billed charges",2369,50,,1895.20,,,0,"percent of total billed charges","50% of total billed charges",1525.64,32.2,,1220.51,,,0,"percent of total billed charges","32.2% of total billed charges",795.98,16.8,,636.78,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",811.9,17.136,,649.52,,,0,"percent of total billed charges","17.136% of total billed charges",1034.78,21.84,,827.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1786.23,37.7,,1428.98,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3695.64,78,,2956.51,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3913.59,82.6,,3130.87,,,0,"percent of total billed charges","82.6% of total billed charges",795.98,16.8,,636.78,,,0,"percent of total billed charges","16.8% of total billed charges",2369,50,,1895.20,,,0,"percent of total billed charges","50% of total billed charges",3913.59,82.6,,3130.87,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",795.98,16.8,,636.78,,,0,"percent of total billed charges","16.8% of total billed charges",4738,100,,3790.40,,,0,"percent of total billed charges","100% of total billed charges",724.91,4738,
"Anesthesia Level 1 First 30 Min",ANES220006,CDM,370,RC,,,OUTPATIENT,,,1156,751.4,,1017.28,88,,813.82,,,0,"percent of total billed charges","88% of total billed charges",578,50,,462.40,,,0,"percent of total billed charges","50% of total billed charges",194.21,16.8,,155.37,,,0,"percent of total billed charges","16.8% of total billed charges",1156,100,,924.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",200.03,17.304,,160.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",728.28,63,,582.62,,,0,"percent of total billed charges","63% of total billed charges",176.87,15.3,,141.50,,,0,"percent of total billed charges","15.3% of total billed charges",194.21,16.8,,155.37,,,0,"percent of total billed charges","16.8% of total billed charges",797.64,69,,,,,0,"fee schedule","69% of total billed charges",1156,100,,924.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1156,100,,924.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1156,100,,924.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",714.99,61.85,,571.99,,,0,"percent of total billed charges","61.5% of total billed charges",194.21,16.8,,155.37,,,0,"percent of total billed charges","16.8% of total billed charges",578,50,,462.40,,,0,"percent of total billed charges","50% of total billed charges",372.23,32.2,,297.78,,,0,"percent of total billed charges","32.2% of total billed charges",194.21,16.8,,155.37,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",198.09,17.136,,158.47,,,0,"percent of total billed charges","17.136% of total billed charges",252.47,21.84,,201.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",435.81,37.7,,348.65,,,0,"percent of total billed charges","37.7% of total billed charges",435.81,37.7,,348.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",391.88,33.9,,313.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",901.68,78,,721.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",954.86,82.6,,763.89,,,0,"percent of total billed charges","82.6% of total billed charges",194.21,16.8,,155.37,,,0,"percent of total billed charges","16.8% of total billed charges",578,50,,462.40,,,0,"percent of total billed charges","50% of total billed charges",954.86,82.6,,763.89,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.21,16.8,,155.37,,,0,"percent of total billed charges","16.8% of total billed charges",1156,100,,924.80,,,0,"percent of total billed charges","100% of total billed charges",176.87,1156,
"Anesthesia Level 1 Ea Addt'l 15 Min",ANES220007,CDM,370,RC,,,OUTPATIENT,,,453,294.45,,398.64,88,,318.91,,,0,"percent of total billed charges","88% of total billed charges",226.5,50,,181.20,,,0,"percent of total billed charges","50% of total billed charges",76.1,16.8,,60.88,,,0,"percent of total billed charges","16.8% of total billed charges",453,100,,362.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.39,17.304,,62.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",285.39,63,,228.31,,,0,"percent of total billed charges","63% of total billed charges",69.31,15.3,,55.45,,,0,"percent of total billed charges","15.3% of total billed charges",76.1,16.8,,60.88,,,0,"percent of total billed charges","16.8% of total billed charges",312.57,69,,,,,0,"fee schedule","69% of total billed charges",453,100,,362.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",453,100,,362.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",453,100,,362.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",280.18,61.85,,224.14,,,0,"percent of total billed charges","61.5% of total billed charges",76.1,16.8,,60.88,,,0,"percent of total billed charges","16.8% of total billed charges",226.5,50,,181.20,,,0,"percent of total billed charges","50% of total billed charges",145.87,32.2,,116.70,,,0,"percent of total billed charges","32.2% of total billed charges",76.1,16.8,,60.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.63,17.136,,62.10,,,0,"percent of total billed charges","17.136% of total billed charges",98.94,21.84,,79.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.78,37.7,,136.62,,,0,"percent of total billed charges","37.7% of total billed charges",170.78,37.7,,136.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",153.57,33.9,,122.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.34,78,,282.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",374.18,82.6,,299.34,,,0,"percent of total billed charges","82.6% of total billed charges",76.1,16.8,,60.88,,,0,"percent of total billed charges","16.8% of total billed charges",226.5,50,,181.20,,,0,"percent of total billed charges","50% of total billed charges",374.18,82.6,,299.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.1,16.8,,60.88,,,0,"percent of total billed charges","16.8% of total billed charges",453,100,,362.40,,,0,"percent of total billed charges","100% of total billed charges",69.31,453,
"Anesthesia Level 2 First 30 Min",ANES220008,CDM,370,RC,,,OUTPATIENT,,,1822,1184.3,,1603.36,88,,1282.69,,,0,"percent of total billed charges","88% of total billed charges",911,50,,728.80,,,0,"percent of total billed charges","50% of total billed charges",306.1,16.8,,244.88,,,0,"percent of total billed charges","16.8% of total billed charges",1822,100,,1457.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",315.28,17.304,,252.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1147.86,63,,918.29,,,0,"percent of total billed charges","63% of total billed charges",278.77,15.3,,223.02,,,0,"percent of total billed charges","15.3% of total billed charges",306.1,16.8,,244.88,,,0,"percent of total billed charges","16.8% of total billed charges",1257.18,69,,,,,0,"fee schedule","69% of total billed charges",1822,100,,1457.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822,100,,1457.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822,100,,1457.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1126.91,61.85,,901.53,,,0,"percent of total billed charges","61.5% of total billed charges",306.1,16.8,,244.88,,,0,"percent of total billed charges","16.8% of total billed charges",911,50,,728.80,,,0,"percent of total billed charges","50% of total billed charges",586.68,32.2,,469.34,,,0,"percent of total billed charges","32.2% of total billed charges",306.1,16.8,,244.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",312.22,17.136,,249.78,,,0,"percent of total billed charges","17.136% of total billed charges",397.92,21.84,,318.34,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",686.89,37.7,,549.51,,,0,"percent of total billed charges","37.7% of total billed charges",686.89,37.7,,549.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",617.66,33.9,,494.13,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1421.16,78,,1136.93,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1504.97,82.6,,1203.98,,,0,"percent of total billed charges","82.6% of total billed charges",306.1,16.8,,244.88,,,0,"percent of total billed charges","16.8% of total billed charges",911,50,,728.80,,,0,"percent of total billed charges","50% of total billed charges",1504.97,82.6,,1203.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",306.1,16.8,,244.88,,,0,"percent of total billed charges","16.8% of total billed charges",1822,100,,1457.60,,,0,"percent of total billed charges","100% of total billed charges",278.77,1822,
"Anesthesia Level 2 Ea Addt'l 15 Min",ANES220009,CDM,370,RC,,,OUTPATIENT,,,453,294.45,,398.64,88,,318.91,,,0,"percent of total billed charges","88% of total billed charges",226.5,50,,181.20,,,0,"percent of total billed charges","50% of total billed charges",76.1,16.8,,60.88,,,0,"percent of total billed charges","16.8% of total billed charges",453,100,,362.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.39,17.304,,62.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",285.39,63,,228.31,,,0,"percent of total billed charges","63% of total billed charges",69.31,15.3,,55.45,,,0,"percent of total billed charges","15.3% of total billed charges",76.1,16.8,,60.88,,,0,"percent of total billed charges","16.8% of total billed charges",312.57,69,,,,,0,"fee schedule","69% of total billed charges",453,100,,362.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",453,100,,362.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",453,100,,362.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",280.18,61.85,,224.14,,,0,"percent of total billed charges","61.5% of total billed charges",76.1,16.8,,60.88,,,0,"percent of total billed charges","16.8% of total billed charges",226.5,50,,181.20,,,0,"percent of total billed charges","50% of total billed charges",145.87,32.2,,116.70,,,0,"percent of total billed charges","32.2% of total billed charges",76.1,16.8,,60.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.63,17.136,,62.10,,,0,"percent of total billed charges","17.136% of total billed charges",98.94,21.84,,79.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.78,37.7,,136.62,,,0,"percent of total billed charges","37.7% of total billed charges",170.78,37.7,,136.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",153.57,33.9,,122.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.34,78,,282.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",374.18,82.6,,299.34,,,0,"percent of total billed charges","82.6% of total billed charges",76.1,16.8,,60.88,,,0,"percent of total billed charges","16.8% of total billed charges",226.5,50,,181.20,,,0,"percent of total billed charges","50% of total billed charges",374.18,82.6,,299.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.1,16.8,,60.88,,,0,"percent of total billed charges","16.8% of total billed charges",453,100,,362.40,,,0,"percent of total billed charges","100% of total billed charges",69.31,453,
"Anesthesia Level 3 First 30 Min",ANES220010,CDM,370,RC,,,OUTPATIENT,,,2862,1860.3,,2518.56,88,,2014.85,,,0,"percent of total billed charges","88% of total billed charges",1431,50,,1144.80,,,0,"percent of total billed charges","50% of total billed charges",480.82,16.8,,384.66,,,0,"percent of total billed charges","16.8% of total billed charges",2862,100,,2289.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",495.24,17.304,,396.19,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1803.06,63,,1442.45,,,0,"percent of total billed charges","63% of total billed charges",437.89,15.3,,350.31,,,0,"percent of total billed charges","15.3% of total billed charges",480.82,16.8,,384.66,,,0,"percent of total billed charges","16.8% of total billed charges",1974.78,69,,,,,0,"fee schedule","69% of total billed charges",2862,100,,2289.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2862,100,,2289.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2862,100,,2289.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1770.15,61.85,,1416.12,,,0,"percent of total billed charges","61.5% of total billed charges",480.82,16.8,,384.66,,,0,"percent of total billed charges","16.8% of total billed charges",1431,50,,1144.80,,,0,"percent of total billed charges","50% of total billed charges",921.56,32.2,,737.25,,,0,"percent of total billed charges","32.2% of total billed charges",480.82,16.8,,384.66,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",490.43,17.136,,392.34,,,0,"percent of total billed charges","17.136% of total billed charges",625.06,21.84,,500.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1078.97,37.7,,863.18,,,0,"percent of total billed charges","37.7% of total billed charges",1078.97,37.7,,863.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.22,33.9,,776.18,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2232.36,78,,1785.89,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2364.01,82.6,,1891.21,,,0,"percent of total billed charges","82.6% of total billed charges",480.82,16.8,,384.66,,,0,"percent of total billed charges","16.8% of total billed charges",1431,50,,1144.80,,,0,"percent of total billed charges","50% of total billed charges",2364.01,82.6,,1891.21,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",480.82,16.8,,384.66,,,0,"percent of total billed charges","16.8% of total billed charges",2862,100,,2289.60,,,0,"percent of total billed charges","100% of total billed charges",437.89,2862,
"Anesthesia Level 3 Ea Addt'l 15 min",ANES220011,CDM,370,RC,,,OUTPATIENT,,,756,491.4,,665.28,88,,532.22,,,0,"percent of total billed charges","88% of total billed charges",378,50,,302.40,,,0,"percent of total billed charges","50% of total billed charges",127.01,16.8,,101.61,,,0,"percent of total billed charges","16.8% of total billed charges",756,100,,604.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",130.82,17.304,,104.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",476.28,63,,381.02,,,0,"percent of total billed charges","63% of total billed charges",115.67,15.3,,92.54,,,0,"percent of total billed charges","15.3% of total billed charges",127.01,16.8,,101.61,,,0,"percent of total billed charges","16.8% of total billed charges",521.64,69,,,,,0,"fee schedule","69% of total billed charges",756,100,,604.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",756,100,,604.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",756,100,,604.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",467.59,61.85,,374.07,,,0,"percent of total billed charges","61.5% of total billed charges",127.01,16.8,,101.61,,,0,"percent of total billed charges","16.8% of total billed charges",378,50,,302.40,,,0,"percent of total billed charges","50% of total billed charges",243.43,32.2,,194.74,,,0,"percent of total billed charges","32.2% of total billed charges",127.01,16.8,,101.61,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.55,17.136,,103.64,,,0,"percent of total billed charges","17.136% of total billed charges",165.11,21.84,,132.09,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",285.01,37.7,,228.01,,,0,"percent of total billed charges","37.7% of total billed charges",285.01,37.7,,228.01,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",256.28,33.9,,205.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.68,78,,471.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",624.46,82.6,,499.57,,,0,"percent of total billed charges","82.6% of total billed charges",127.01,16.8,,101.61,,,0,"percent of total billed charges","16.8% of total billed charges",378,50,,302.40,,,0,"percent of total billed charges","50% of total billed charges",624.46,82.6,,499.57,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.01,16.8,,101.61,,,0,"percent of total billed charges","16.8% of total billed charges",756,100,,604.80,,,0,"percent of total billed charges","100% of total billed charges",115.67,756,
"B12 CALIBRATOR",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"B12 / FOLATE RGT PK3/200 TESTS",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"BABCOCK GRASPER TIP 5MM",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"BACITRACIN OINTMENT",490075,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"BACITRACIN B-10 (NOT TAXO)",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BACK TABLE COVER STERILE",490076,CDM,272,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"BACK TABLE COVER, STERILE Z",490077,CDM,272,RC,,,OUTPATIENT,,,124,80.6,,109.12,88,,87.30,,,0,"percent of total billed charges","88% of total billed charges",62,50,,49.60,,,0,"percent of total billed charges","50% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.46,17.304,,17.17,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.12,63,,62.50,,,0,"percent of total billed charges","63% of total billed charges",18.97,15.3,,15.18,,,0,"percent of total billed charges","15.3% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",85.56,69,,,,,0,"fee schedule","69% of total billed charges",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.69,61.85,,61.35,,,0,"percent of total billed charges","61.5% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",62,50,,49.60,,,0,"percent of total billed charges","50% of total billed charges",39.93,32.2,,31.94,,,0,"percent of total billed charges","32.2% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.25,17.136,,17.00,,,0,"percent of total billed charges","17.136% of total billed charges",27.08,21.84,,21.66,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.75,37.7,,37.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",96.72,78,,77.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",102.42,82.6,,81.94,,,0,"percent of total billed charges","82.6% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",62,50,,49.60,,,0,"percent of total billed charges","50% of total billed charges",102.42,82.6,,81.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",18.97,124,
"BACK TABLE COVER HEAVEY DUTY 72",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"BACTOSHIELD CHLORHEXIDINE GLUCONATE 4%  4-OZ",130573,CDM,270,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"BACT/ALERT PF PLUS",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,77,50.05,,67.76,88,,54.21,,,0,"percent of total billed charges","88% of total billed charges",38.5,50,,30.80,,,0,"percent of total billed charges","50% of total billed charges",12.94,16.8,,10.35,,,0,"percent of total billed charges","16.8% of total billed charges",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.32,17.304,,10.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.51,63,,38.81,,,0,"percent of total billed charges","63% of total billed charges",11.78,15.3,,9.42,,,0,"percent of total billed charges","15.3% of total billed charges",12.94,16.8,,10.35,,,0,"percent of total billed charges","16.8% of total billed charges",53.13,69,,,,,0,"fee schedule","69% of total billed charges",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.62,61.85,,38.10,,,0,"percent of total billed charges","61.5% of total billed charges",12.94,16.8,,10.35,,,0,"percent of total billed charges","16.8% of total billed charges",38.5,50,,30.80,,,0,"percent of total billed charges","50% of total billed charges",24.79,32.2,,19.83,,,0,"percent of total billed charges","32.2% of total billed charges",12.94,16.8,,10.35,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.19,17.136,,10.55,,,0,"percent of total billed charges","17.136% of total billed charges",16.82,21.84,,13.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.03,37.7,,23.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",60.06,78,,48.05,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.6,82.6,,50.88,,,0,"percent of total billed charges","82.6% of total billed charges",12.94,16.8,,10.35,,,0,"percent of total billed charges","16.8% of total billed charges",38.5,50,,30.80,,,0,"percent of total billed charges","50% of total billed charges",63.6,82.6,,50.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.94,16.8,,10.35,,,0,"percent of total billed charges","16.8% of total billed charges",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",11.78,77,
"BACTISTAPH LATEX AGGLUTINATION TEST KIT",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BACTERIAL VIRAL FILTERS",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"BACT/ALERT FN PLUS",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"BAG DRAIN METER URINE 350CC",151964,CDM,270,RC,,,OUTPATIENT,,,45,29.25,,39.6,88,,31.68,,,0,"percent of total billed charges","88% of total billed charges",22.5,50,,18.00,,,0,"percent of total billed charges","50% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.79,17.304,,6.23,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.35,63,,22.68,,,0,"percent of total billed charges","63% of total billed charges",6.89,15.3,,5.51,,,0,"percent of total billed charges","15.3% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",31.05,69,,,,,0,"fee schedule","69% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.83,61.85,,22.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",22.5,50,,18.00,,,0,"percent of total billed charges","50% of total billed charges",14.49,32.2,,11.59,,,0,"percent of total billed charges","32.2% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.71,17.136,,6.17,,,0,"percent of total billed charges","17.136% of total billed charges",9.83,21.84,,7.86,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.97,37.7,,13.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.1,78,,28.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",22.5,50,,18.00,,,0,"percent of total billed charges","50% of total billed charges",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",6.89,45,
"BAG URINARY DRAINAGE 4000ML",151969,CDM,270,RC,,,OUTPATIENT,,,29,18.85,,25.52,88,,20.42,,,0,"percent of total billed charges","88% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.02,17.304,,4.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.27,63,,14.62,,,0,"percent of total billed charges","63% of total billed charges",4.44,15.3,,3.55,,,0,"percent of total billed charges","15.3% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",20.01,69,,,,,0,"fee schedule","69% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.94,61.85,,14.35,,,0,"percent of total billed charges","61.5% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",9.34,32.2,,7.47,,,0,"percent of total billed charges","32.2% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.97,17.136,,3.98,,,0,"percent of total billed charges","17.136% of total billed charges",6.33,21.84,,5.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.93,37.7,,8.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,78,,18.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",4.44,29,
"BAG EXTERNAL DRAINAGE NEURO",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"BAG CLEAR POLY 6519 1.25M",187664,CDM,270,RC,,,OUTPATIENT,,,170,110.5,,149.6,88,,119.68,,,0,"percent of total billed charges","88% of total billed charges",85,50,,68.00,,,0,"percent of total billed charges","50% of total billed charges",28.56,16.8,,22.85,,,0,"percent of total billed charges","16.8% of total billed charges",170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.42,17.304,,23.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",107.1,63,,85.68,,,0,"percent of total billed charges","63% of total billed charges",26.01,15.3,,20.81,,,0,"percent of total billed charges","15.3% of total billed charges",28.56,16.8,,22.85,,,0,"percent of total billed charges","16.8% of total billed charges",117.3,69,,,,,0,"fee schedule","69% of total billed charges",170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.15,61.85,,84.12,,,0,"percent of total billed charges","61.5% of total billed charges",28.56,16.8,,22.85,,,0,"percent of total billed charges","16.8% of total billed charges",85,50,,68.00,,,0,"percent of total billed charges","50% of total billed charges",54.74,32.2,,43.79,,,0,"percent of total billed charges","32.2% of total billed charges",28.56,16.8,,22.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.13,17.136,,23.30,,,0,"percent of total billed charges","17.136% of total billed charges",37.13,21.84,,29.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",64.09,37.7,,51.27,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",132.6,78,,106.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",140.42,82.6,,112.34,,,0,"percent of total billed charges","82.6% of total billed charges",28.56,16.8,,22.85,,,0,"percent of total billed charges","16.8% of total billed charges",85,50,,68.00,,,0,"percent of total billed charges","50% of total billed charges",140.42,82.6,,112.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.56,16.8,,22.85,,,0,"percent of total billed charges","16.8% of total billed charges",170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",26.01,170,
"BAG CLEAR PATIENT SET-UP WITH DRAWSTING 12X16",282390,CDM,270,RC,,,OUTPATIENT,,,351,228.15,,308.88,88,,247.10,,,0,"percent of total billed charges","88% of total billed charges",175.5,50,,140.40,,,0,"percent of total billed charges","50% of total billed charges",58.97,16.8,,47.18,,,0,"percent of total billed charges","16.8% of total billed charges",351,100,,280.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.74,17.304,,48.59,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.13,63,,176.90,,,0,"percent of total billed charges","63% of total billed charges",53.7,15.3,,42.96,,,0,"percent of total billed charges","15.3% of total billed charges",58.97,16.8,,47.18,,,0,"percent of total billed charges","16.8% of total billed charges",242.19,69,,,,,0,"fee schedule","69% of total billed charges",351,100,,280.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",351,100,,280.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",351,100,,280.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",217.09,61.85,,173.67,,,0,"percent of total billed charges","61.5% of total billed charges",58.97,16.8,,47.18,,,0,"percent of total billed charges","16.8% of total billed charges",175.5,50,,140.40,,,0,"percent of total billed charges","50% of total billed charges",113.02,32.2,,90.42,,,0,"percent of total billed charges","32.2% of total billed charges",58.97,16.8,,47.18,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.15,17.136,,48.12,,,0,"percent of total billed charges","17.136% of total billed charges",76.66,21.84,,61.33,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",132.33,37.7,,105.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",273.78,78,,219.02,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",289.93,82.6,,231.94,,,0,"percent of total billed charges","82.6% of total billed charges",58.97,16.8,,47.18,,,0,"percent of total billed charges","16.8% of total billed charges",175.5,50,,140.40,,,0,"percent of total billed charges","50% of total billed charges",289.93,82.6,,231.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.97,16.8,,47.18,,,0,"percent of total billed charges","16.8% of total billed charges",351,100,,280.80,,,0,"percent of total billed charges","100% of total billed charges",53.7,351,
"BAG AUTOCLAVE BIOHAZARD 25X35",311019,CDM,270,RC,,,OUTPATIENT,,,1916,1245.4,,1686.08,88,,1348.86,,,0,"percent of total billed charges","88% of total billed charges",958,50,,766.40,,,0,"percent of total billed charges","50% of total billed charges",321.89,16.8,,257.51,,,0,"percent of total billed charges","16.8% of total billed charges",1916,100,,1532.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.54,17.304,,265.23,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1207.08,63,,965.66,,,0,"percent of total billed charges","63% of total billed charges",293.15,15.3,,234.52,,,0,"percent of total billed charges","15.3% of total billed charges",321.89,16.8,,257.51,,,0,"percent of total billed charges","16.8% of total billed charges",1322.04,69,,,,,0,"fee schedule","69% of total billed charges",1916,100,,1532.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1916,100,,1532.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1916,100,,1532.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185.05,61.85,,948.04,,,0,"percent of total billed charges","61.5% of total billed charges",321.89,16.8,,257.51,,,0,"percent of total billed charges","16.8% of total billed charges",958,50,,766.40,,,0,"percent of total billed charges","50% of total billed charges",616.95,32.2,,493.56,,,0,"percent of total billed charges","32.2% of total billed charges",321.89,16.8,,257.51,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",328.33,17.136,,262.66,,,0,"percent of total billed charges","17.136% of total billed charges",418.45,21.84,,334.76,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",722.33,37.7,,577.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1494.48,78,,1195.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1582.62,82.6,,1266.10,,,0,"percent of total billed charges","82.6% of total billed charges",321.89,16.8,,257.51,,,0,"percent of total billed charges","16.8% of total billed charges",958,50,,766.40,,,0,"percent of total billed charges","50% of total billed charges",1582.62,82.6,,1266.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",321.89,16.8,,257.51,,,0,"percent of total billed charges","16.8% of total billed charges",1916,100,,1532.80,,,0,"percent of total billed charges","100% of total billed charges",293.15,1916,
"BAG BEDSIDE",30760,CDM,270,RC,,,OUTPATIENT,,,240,156,,211.2,88,,168.96,,,0,"percent of total billed charges","88% of total billed charges",120,50,,96.00,,,0,"percent of total billed charges","50% of total billed charges",40.32,16.8,,32.26,,,0,"percent of total billed charges","16.8% of total billed charges",240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.53,17.304,,33.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.2,63,,120.96,,,0,"percent of total billed charges","63% of total billed charges",36.72,15.3,,29.38,,,0,"percent of total billed charges","15.3% of total billed charges",40.32,16.8,,32.26,,,0,"percent of total billed charges","16.8% of total billed charges",165.6,69,,,,,0,"fee schedule","69% of total billed charges",240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",148.44,61.85,,118.75,,,0,"percent of total billed charges","61.5% of total billed charges",40.32,16.8,,32.26,,,0,"percent of total billed charges","16.8% of total billed charges",120,50,,96.00,,,0,"percent of total billed charges","50% of total billed charges",77.28,32.2,,61.82,,,0,"percent of total billed charges","32.2% of total billed charges",40.32,16.8,,32.26,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.13,17.136,,32.90,,,0,"percent of total billed charges","17.136% of total billed charges",52.42,21.84,,41.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",90.48,37.7,,72.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",187.2,78,,149.76,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",198.24,82.6,,158.59,,,0,"percent of total billed charges","82.6% of total billed charges",40.32,16.8,,32.26,,,0,"percent of total billed charges","16.8% of total billed charges",120,50,,96.00,,,0,"percent of total billed charges","50% of total billed charges",198.24,82.6,,158.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.32,16.8,,32.26,,,0,"percent of total billed charges","16.8% of total billed charges",240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",36.72,240,
"BAG CLEAR 30X12X8 1 MIL",225836,CDM,270,RC,,,OUTPATIENT,,,295,191.75,,259.6,88,,207.68,,,0,"percent of total billed charges","88% of total billed charges",147.5,50,,118.00,,,0,"percent of total billed charges","50% of total billed charges",49.56,16.8,,39.65,,,0,"percent of total billed charges","16.8% of total billed charges",295,100,,236.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.05,17.304,,40.84,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.85,63,,148.68,,,0,"percent of total billed charges","63% of total billed charges",45.14,15.3,,36.11,,,0,"percent of total billed charges","15.3% of total billed charges",49.56,16.8,,39.65,,,0,"percent of total billed charges","16.8% of total billed charges",203.55,69,,,,,0,"fee schedule","69% of total billed charges",295,100,,236.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",295,100,,236.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",295,100,,236.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",182.46,61.85,,145.97,,,0,"percent of total billed charges","61.5% of total billed charges",49.56,16.8,,39.65,,,0,"percent of total billed charges","16.8% of total billed charges",147.5,50,,118.00,,,0,"percent of total billed charges","50% of total billed charges",94.99,32.2,,75.99,,,0,"percent of total billed charges","32.2% of total billed charges",49.56,16.8,,39.65,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.55,17.136,,40.44,,,0,"percent of total billed charges","17.136% of total billed charges",64.43,21.84,,51.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",111.22,37.7,,88.98,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",230.1,78,,184.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",243.67,82.6,,194.94,,,0,"percent of total billed charges","82.6% of total billed charges",49.56,16.8,,39.65,,,0,"percent of total billed charges","16.8% of total billed charges",147.5,50,,118.00,,,0,"percent of total billed charges","50% of total billed charges",243.67,82.6,,194.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.56,16.8,,39.65,,,0,"percent of total billed charges","16.8% of total billed charges",295,100,,236.00,,,0,"percent of total billed charges","100% of total billed charges",45.14,295,
"BAG DRAWSTRING, 40X40, 2.5MIL LIGHT BLUE",289071,CDM,270,RC,,,OUTPATIENT,,,560,364,,492.8,88,,394.24,,,0,"percent of total billed charges","88% of total billed charges",280,50,,224.00,,,0,"percent of total billed charges","50% of total billed charges",94.08,16.8,,75.26,,,0,"percent of total billed charges","16.8% of total billed charges",560,100,,448.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",96.9,17.304,,77.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",352.8,63,,282.24,,,0,"percent of total billed charges","63% of total billed charges",85.68,15.3,,68.54,,,0,"percent of total billed charges","15.3% of total billed charges",94.08,16.8,,75.26,,,0,"percent of total billed charges","16.8% of total billed charges",386.4,69,,,,,0,"fee schedule","69% of total billed charges",560,100,,448.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",560,100,,448.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",560,100,,448.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",346.36,61.85,,277.09,,,0,"percent of total billed charges","61.5% of total billed charges",94.08,16.8,,75.26,,,0,"percent of total billed charges","16.8% of total billed charges",280,50,,224.00,,,0,"percent of total billed charges","50% of total billed charges",180.32,32.2,,144.26,,,0,"percent of total billed charges","32.2% of total billed charges",94.08,16.8,,75.26,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.96,17.136,,76.77,,,0,"percent of total billed charges","17.136% of total billed charges",122.3,21.84,,97.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",211.12,37.7,,168.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",436.8,78,,349.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",462.56,82.6,,370.05,,,0,"percent of total billed charges","82.6% of total billed charges",94.08,16.8,,75.26,,,0,"percent of total billed charges","16.8% of total billed charges",280,50,,224.00,,,0,"percent of total billed charges","50% of total billed charges",462.56,82.6,,370.05,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",94.08,16.8,,75.26,,,0,"percent of total billed charges","16.8% of total billed charges",560,100,,448.00,,,0,"percent of total billed charges","100% of total billed charges",85.68,560,
"BAG EMESIS CLEAN UP TWIST",306408,CDM,270,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"BAG GARMENT STANDARD",187726,CDM,270,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"BAG HEMETRIC DRAIN REPLACEMENT",ORSUP0019,CDM,270,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"BAG LEG URINE MED STERILE",186571,CDM,272,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.37,61.85,,9.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"BAG PERSONAL BELONGING 20X18 CLEAR",73244,CDM,270,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"BAG PRESSURE INFUSER 500ML W/STOPCOCK",192422,CDM,270,RC,,,OUTPATIENT,,,79,51.35,,69.52,88,,55.62,,,0,"percent of total billed charges","88% of total billed charges",39.5,50,,31.60,,,0,"percent of total billed charges","50% of total billed charges",13.27,16.8,,10.62,,,0,"percent of total billed charges","16.8% of total billed charges",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.67,17.304,,10.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.77,63,,39.82,,,0,"percent of total billed charges","63% of total billed charges",12.09,15.3,,9.67,,,0,"percent of total billed charges","15.3% of total billed charges",13.27,16.8,,10.62,,,0,"percent of total billed charges","16.8% of total billed charges",54.51,69,,,,,0,"fee schedule","69% of total billed charges",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.86,61.85,,39.09,,,0,"percent of total billed charges","61.5% of total billed charges",13.27,16.8,,10.62,,,0,"percent of total billed charges","16.8% of total billed charges",39.5,50,,31.60,,,0,"percent of total billed charges","50% of total billed charges",25.44,32.2,,20.35,,,0,"percent of total billed charges","32.2% of total billed charges",13.27,16.8,,10.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.54,17.136,,10.83,,,0,"percent of total billed charges","17.136% of total billed charges",17.25,21.84,,13.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.78,37.7,,23.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",61.62,78,,49.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",65.25,82.6,,52.20,,,0,"percent of total billed charges","82.6% of total billed charges",13.27,16.8,,10.62,,,0,"percent of total billed charges","16.8% of total billed charges",39.5,50,,31.60,,,0,"percent of total billed charges","50% of total billed charges",65.25,82.6,,52.20,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.27,16.8,,10.62,,,0,"percent of total billed charges","16.8% of total billed charges",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",12.09,79,
"BAG ZIPLOC 10 X 13 PLASTIC",188405,CDM,270,RC,,,OUTPATIENT,,,43,27.95,,37.84,88,,30.27,,,0,"percent of total billed charges","88% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.44,17.304,,5.95,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.09,63,,21.67,,,0,"percent of total billed charges","63% of total billed charges",6.58,15.3,,5.26,,,0,"percent of total billed charges","15.3% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",29.67,69,,,,,0,"fee schedule","69% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.6,61.85,,21.28,,,0,"percent of total billed charges","61.5% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",13.85,32.2,,11.08,,,0,"percent of total billed charges","32.2% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.37,17.136,,5.90,,,0,"percent of total billed charges","17.136% of total billed charges",9.39,21.84,,7.51,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.21,37.7,,12.97,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",33.54,78,,26.83,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.52,82.6,,28.42,,,0,"percent of total billed charges","82.6% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",35.52,82.6,,28.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",6.58,43,
"BAG ZIPLOCK",13913,CDM,270,RC,,,OUTPATIENT,,,29,18.85,,25.52,88,,20.42,,,0,"percent of total billed charges","88% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.02,17.304,,4.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.27,63,,14.62,,,0,"percent of total billed charges","63% of total billed charges",4.44,15.3,,3.55,,,0,"percent of total billed charges","15.3% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",20.01,69,,,,,0,"fee schedule","69% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.94,61.85,,14.35,,,0,"percent of total billed charges","61.5% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",9.34,32.2,,7.47,,,0,"percent of total billed charges","32.2% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.97,17.136,,3.98,,,0,"percent of total billed charges","17.136% of total billed charges",6.33,21.84,,5.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.93,37.7,,8.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,78,,18.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",4.44,29,
"BAG POLYPROPYLENE 19X23 IN RED",ORSUP0015,CDM,270,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"BAG RETRIEVAL10MM SPECIMEN",ORSUP0009,CDM,270,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"BAG REFILL FLEXISEAL FECAL COLLECTOR",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"BAG 10MM RETRIEVAL ENDO",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BAG 5MM RETRIEVAL  ENDO",ORSUP0010,CDM,270,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"BAG SET-UP LEMANS",ORSUP0010,CDM,270,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"BAG BILE REG 19 OZ W/T-TUBE ADPT  RUBBER BELTS",167238,CDM,270,RC,,,OUTPATIENT,,,63,40.95,,55.44,88,,44.35,,,0,"percent of total billed charges","88% of total billed charges",31.5,50,,25.20,,,0,"percent of total billed charges","50% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.9,17.304,,8.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.69,63,,31.75,,,0,"percent of total billed charges","63% of total billed charges",9.64,15.3,,7.71,,,0,"percent of total billed charges","15.3% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",43.47,69,,,,,0,"fee schedule","69% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.97,61.85,,31.18,,,0,"percent of total billed charges","61.5% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",31.5,50,,25.20,,,0,"percent of total billed charges","50% of total billed charges",20.29,32.2,,16.23,,,0,"percent of total billed charges","32.2% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.8,17.136,,8.64,,,0,"percent of total billed charges","17.136% of total billed charges",13.76,21.84,,11.01,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.75,37.7,,19.00,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",49.14,78,,39.31,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.04,82.6,,41.63,,,0,"percent of total billed charges","82.6% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",31.5,50,,25.20,,,0,"percent of total billed charges","50% of total billed charges",52.04,82.6,,41.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",9.64,63,
"BAG LEG MEDIUM",490080,CDM,270,RC,,,OUTPATIENT,,,22,14.3,,19.36,88,,15.49,,,0,"percent of total billed charges","88% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.81,17.304,,3.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.86,63,,11.09,,,0,"percent of total billed charges","63% of total billed charges",3.37,15.3,,2.70,,,0,"percent of total billed charges","15.3% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",15.18,69,,,,,0,"fee schedule","69% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.61,61.85,,10.89,,,0,"percent of total billed charges","61.5% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",7.08,32.2,,5.66,,,0,"percent of total billed charges","32.2% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.77,17.136,,3.02,,,0,"percent of total billed charges","17.136% of total billed charges",4.8,21.84,,3.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.29,37.7,,6.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.16,78,,13.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",3.37,22,
"BAG LEG LARGE",490079,CDM,270,RC,,,OUTPATIENT,,,22,14.3,,19.36,88,,15.49,,,0,"percent of total billed charges","88% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.81,17.304,,3.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.86,63,,11.09,,,0,"percent of total billed charges","63% of total billed charges",3.37,15.3,,2.70,,,0,"percent of total billed charges","15.3% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",15.18,69,,,,,0,"fee schedule","69% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.61,61.85,,10.89,,,0,"percent of total billed charges","61.5% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",7.08,32.2,,5.66,,,0,"percent of total billed charges","32.2% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.77,17.136,,3.02,,,0,"percent of total billed charges","17.136% of total billed charges",4.8,21.84,,3.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.29,37.7,,6.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.16,78,,13.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",3.37,22,
"BAG DECANTER IV FLUID SPIKE",490078,CDM,270,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"BAG PT BELONGINGS",490081,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"BAG ZIPLOCK 9 X 12",490083,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"BAG BIOHAZARD SPECIMEN TRANSPORT 6 X 9",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BAG BIOHAZARD SPECIMEN TRANSPORT 12 X 15",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BAG LEG TWIST VALVE MED 20 OZ",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BAG LEG TWIST VALVE LG 32 OZ",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BAG LEG EX-TUBING 18 MED 20OZ",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BAG,DRAWSTRING 40X40 2.5MIL RED",284320,CDM,270,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"BAIR HUGGER BLANKET",490085,CDM,272,RC,,,OUTPATIENT,,,46,29.9,,40.48,88,,32.38,,,0,"percent of total billed charges","88% of total billed charges",23,50,,18.40,,,0,"percent of total billed charges","50% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.96,17.304,,6.37,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.98,63,,23.18,,,0,"percent of total billed charges","63% of total billed charges",7.04,15.3,,5.63,,,0,"percent of total billed charges","15.3% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",31.74,69,,,,,0,"fee schedule","69% of total billed charges",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.45,61.85,,22.76,,,0,"percent of total billed charges","61.5% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",23,50,,18.40,,,0,"percent of total billed charges","50% of total billed charges",14.81,32.2,,11.85,,,0,"percent of total billed charges","32.2% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.88,17.136,,6.30,,,0,"percent of total billed charges","17.136% of total billed charges",10.05,21.84,,8.04,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.34,37.7,,13.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.88,78,,28.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38,82.6,,30.40,,,0,"percent of total billed charges","82.6% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",23,50,,18.40,,,0,"percent of total billed charges","50% of total billed charges",38,82.6,,30.40,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",7.04,46,
"BALLOON REPLACEMENT 18FR",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"BALLOON CRE ESOPHAGEAL         5850",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"BALLOON DILATION 10MM HURRICANE RX",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"BALLOON DILATION 8MM HURRICANE RX",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"BALLOON DILATION 4MM HURRICANE RX",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"BALLOON DILAT L2CM L180CM OD5.8FR ODSEC4MM INFL UP TO 12 ATM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"BALLOON DILATION 6MM HURRICANE RX",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"BALLOON DILATION 6MM X 2 HURRICAN RX",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"BALLOON OCCLUSION CATH SET UPJ",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"BALLOON CATH TREK 4.0X20MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON CATH TREK 4.0X12MM 1012278-12",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON CATH TREK 3.0X20MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON CATH TREK 3.0X12MM 1012274-12",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON CATH TREK 3.5 X20MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON CATH TREK 3.5X12MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON CATH TREK 3.25X20MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON CATH TREK 3.25X12MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON CATH MINI TREK 2.0X20MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON CATH MINI TREK 2.0X12MM 1012270-12",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"BALLOON CATH TREK 2.75X20MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON CATH TREK 2.75X15MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON CATH TREK 2.75X12MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON CATH TREK 2.5X20MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON CATH TREK 2.5X15MM 1012405-15",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON CATH TREK 2.5X12MM 1012272-12",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON CATH TREK 2.25X20MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON CATH TREK 2.25X15MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON CATH TREK 2.25X12MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON CATH MINI TREK 1.20MM X 12MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC  5.0 X 20MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC  5.0 X 15MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC  4.0 X 8MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC  4.0 X 20MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC  4.0 X 15MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC  4.0 X 12MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC  4.5 X 8MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC  4.5 X 15MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC  3.0 X 20MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC  3.0 X 15MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC  3.0 X 12MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC  3.75 X 8MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC  3.75 X 20MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC  3.75 X 15MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC  3.5 X 20MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC  3.5 X 15MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC  3.5 X 12MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC  3.25 X 8MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC  3.25 X 20MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC  3.25 X 15MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC  3.25 X 12MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC   2.0 X 8MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC  2.0 X 15MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC  2.0 X 12MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC  2.75 X 15MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC  2.75 X 12MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC  2.5 X 20MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC  2.5 X 15MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC  2.5 X 12MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC  2.25 X 8MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC  2.25 X 15MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC  2.25 X 12MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON TREK NC  1.5 X 8MM  RX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON ATLAS 12X40X75",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"BALLOON 12MMX2CMX75CM 6.5",ORSUP0018,CDM,278,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",605.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.7% of total billed charges",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",658.34,33.9,,526.67,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"BALLOON EMERGE 3.00 X 12",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON EMERGE 3.5 X 12",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON EMERGE MR 2X12MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON EMERGE MR 2.5X12MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON EMERGE MR 2.25MMX15MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON EMERGE MR 2.25 X 12",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON CATH TREK 3.0X30MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON COYOTE OTW  2.5X220MM  150CM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON MUSTANG  8.0X60MM 135CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"BALLOON MUSTANG  9.0X40MM  135CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"BALLOON MUSTANG  9.0X20MM  135CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"BALLOON MUSTANG 7.0X60 135CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"BALLOON MUSTANG .035 7.0X40 135CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"BALLOON MUSTANG .035 7.0X20 135CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"BALLOON MUSTANG .035 6.0X40 135CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"BALLOON MUSTANG .035 6.0X20 135CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"BALLOON MUSTANG 4.0 X 200 X 135",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"BALLOON MUSTANG  3.0X40MM  135CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"BALLOON MUSTANG  3.0X20MM  135CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"BALLOON MUSTANG  3.0X200MM  135CM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON MUSTANG  3.0X100MM  135CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"BALLOON MUSTANG  10.0X40MM  135CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"BALLOON MUSTANG  10.0X20MM  135CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"BALLOON XXL 12-2 5.8 75CM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON MUSTANG .035 5.0X40 135CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"BALLOON PERIPHERAL CUTTING",ORSUP0026,CDM,278,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",1253.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.7% of total billed charges",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1361.76,33.9,,1089.41,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"BALLOON 3.0X4MM 135CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"BALLOON STERLING 2.5X100X150",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"BALLOON 14MM X 2CM X 75CM",ORSUP0018,CDM,278,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",605.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.7% of total billed charges",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",658.34,33.9,,526.67,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"BALLOON 30 ATM 7X4X50CM",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"BALLOON ATLAS 14X40X75",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"BALLOON CUTTING WOLVERINE 2.5 X 10",ORSUP0027,CDM,278,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",1336.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.7% of total billed charges",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1452.62,33.9,,1162.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"BALLOON CUTTING WOLVERINE 2.75X15",ORSUP0028,CDM,278,RC,,,OUTPATIENT,,,4553,2959.45,,4006.64,88,,3205.31,,,0,"percent of total billed charges","88% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",787.85,17.304,,630.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2868.39,63,,2294.71,,,0,"percent of total billed charges","63% of total billed charges",696.61,15.3,,557.29,,,0,"percent of total billed charges","15.3% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",3141.57,69,,,,,0,"fee schedule","69% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2816.03,61.85,,2252.82,,,0,"percent of total billed charges","61.5% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",1466.07,32.2,,1172.86,,,0,"percent of total billed charges","32.2% of total billed charges",1420.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",780.2,17.136,,624.16,,,0,"percent of total billed charges","17.136% of total billed charges",994.38,21.84,,795.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.7% of total billed charges",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1543.47,33.9,,1234.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3551.34,78,,2841.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",696.61,4553,
"BALLOON CUTTING WOLVERINE 3.0 X 10",ORSUP0028,CDM,278,RC,,,OUTPATIENT,,,4553,2959.45,,4006.64,88,,3205.31,,,0,"percent of total billed charges","88% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",787.85,17.304,,630.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2868.39,63,,2294.71,,,0,"percent of total billed charges","63% of total billed charges",696.61,15.3,,557.29,,,0,"percent of total billed charges","15.3% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",3141.57,69,,,,,0,"fee schedule","69% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2816.03,61.85,,2252.82,,,0,"percent of total billed charges","61.5% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",1466.07,32.2,,1172.86,,,0,"percent of total billed charges","32.2% of total billed charges",1420.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",780.2,17.136,,624.16,,,0,"percent of total billed charges","17.136% of total billed charges",994.38,21.84,,795.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.7% of total billed charges",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1543.47,33.9,,1234.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3551.34,78,,2841.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",696.61,4553,
"BALLOON CUTTING WOLVERINE 3.0 X 15",ORSUP0028,CDM,278,RC,,,OUTPATIENT,,,4553,2959.45,,4006.64,88,,3205.31,,,0,"percent of total billed charges","88% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",787.85,17.304,,630.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2868.39,63,,2294.71,,,0,"percent of total billed charges","63% of total billed charges",696.61,15.3,,557.29,,,0,"percent of total billed charges","15.3% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",3141.57,69,,,,,0,"fee schedule","69% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2816.03,61.85,,2252.82,,,0,"percent of total billed charges","61.5% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",1466.07,32.2,,1172.86,,,0,"percent of total billed charges","32.2% of total billed charges",1420.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",780.2,17.136,,624.16,,,0,"percent of total billed charges","17.136% of total billed charges",994.38,21.84,,795.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.7% of total billed charges",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1543.47,33.9,,1234.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3551.34,78,,2841.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",696.61,4553,
"BALLOON CUTTING WOLVERINE 3.5 X 15",ORSUP0028,CDM,278,RC,,,OUTPATIENT,,,4553,2959.45,,4006.64,88,,3205.31,,,0,"percent of total billed charges","88% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",787.85,17.304,,630.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2868.39,63,,2294.71,,,0,"percent of total billed charges","63% of total billed charges",696.61,15.3,,557.29,,,0,"percent of total billed charges","15.3% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",3141.57,69,,,,,0,"fee schedule","69% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2816.03,61.85,,2252.82,,,0,"percent of total billed charges","61.5% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",1466.07,32.2,,1172.86,,,0,"percent of total billed charges","32.2% of total billed charges",1420.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",780.2,17.136,,624.16,,,0,"percent of total billed charges","17.136% of total billed charges",994.38,21.84,,795.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.7% of total billed charges",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1543.47,33.9,,1234.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3551.34,78,,2841.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",696.61,4553,
"BALLOON EMERGE 3.0 X 20MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON EMERGE MR 4.0MM X 8MM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"BALLOON MUSTANG 7.0MM X 100 135CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"BALLOON NC EMERGE 2.0 X 12MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 2.0 X 15MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 2.25 X 12MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 2.25 X 15MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 2.25 X 20MM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"BALLOON NC EMERGE 2.25 X 8MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 2.5 X 12MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 2.5 X 15MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 2.5 X 20MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 2.5 X 8MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 2.75 X 12MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 2.75 X 15MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 2.75 X 8MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 3.0 X 12MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 3.0 X 15MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 3.0 X 20MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 3.0 X 8MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 3.25 X 12MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 3.25 X 15MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 3.25 X 8MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON NC EMERGE 3.5 X 12MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 3.5 X 15MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 3.5 X 20MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 3.5 X 8MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 3.75 X 12MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 3.75 X 15MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 3.75 X 20MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 3.75 X 8MM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"BALLOON NC EMERGE 4.0 X 12MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 4.0 X 15MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 4.0 X 20MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 4.0 X 8MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 4.5 X 12MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 4.5 X 15MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 4.5 X 20MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 4.5 X 8MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 5.0 X 15MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 5.0 X 8MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 5.5 X 12MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 5.5 X 15MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON NC EMERGE 5.5 X 20MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON STERLING 3.0X100MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"BALLOON STERLING 4.0X100MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"BALLOON PRE PERITIONEAL DISTENTION W BULB",ORSUP0025,CDM,278,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",1169.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.7% of total billed charges",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.91,33.9,,1016.73,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"BALLOON EXTRACTOR PRO RX 12-15 MM",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON EXTRACTOR PRO RX 15 - 18 MM ABOVE",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLOON KYPHOPLASTY KIT 15/3",ORSUP0084,CDM,278,RC,,,OUTPATIENT,,,19817,12881.05,,17438.96,88,,13951.17,,,0,"percent of total billed charges","88% of total billed charges",9908.5,50,,7926.80,,,0,"percent of total billed charges","50% of total billed charges",3329.26,16.8,,2663.41,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3429.13,17.304,,2743.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12484.71,63,,9987.77,,,0,"percent of total billed charges","63% of total billed charges",3032,15.3,,2425.60,,,0,"percent of total billed charges","15.3% of total billed charges",3329.26,16.8,,2663.41,,,0,"percent of total billed charges","16.8% of total billed charges",13673.73,69,,,,,0,"fee schedule","69% of total billed charges",19817,100,,15853.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19817,100,,15853.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19817,100,,15853.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12256.81,61.85,,9805.45,,,0,"percent of total billed charges","61.5% of total billed charges",3329.26,16.8,,2663.41,,,0,"percent of total billed charges","16.8% of total billed charges",9908.5,50,,7926.80,,,0,"percent of total billed charges","50% of total billed charges",6381.07,32.2,,5104.86,,,0,"percent of total billed charges","32.2% of total billed charges",6182.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3395.84,17.136,,2716.67,,,0,"percent of total billed charges","17.136% of total billed charges",4328.03,21.84,,3462.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",7471.01,37.7,,5976.81,,,0,"percent of total billed charges","37.7% of total billed charges",7471.01,37.7,,5976.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",6717.96,33.9,,5374.37,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",15457.26,78,,12365.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16368.84,82.6,,13095.07,,,0,"percent of total billed charges","82.6% of total billed charges",3329.26,16.8,,2663.41,,,0,"percent of total billed charges","16.8% of total billed charges",9908.5,50,,7926.80,,,0,"percent of total billed charges","50% of total billed charges",16368.84,82.6,,13095.07,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3329.26,16.8,,2663.41,,,0,"percent of total billed charges","16.8% of total billed charges",19817,100,,15853.60,,,0,"percent of total billed charges","100% of total billed charges",3032,19817,
"BALLOON SPACEMAKER PRO STRUCTURE",ORSUP0053,CDM,272,RC,,,OUTPATIENT,,,11248,7311.2,,9898.24,88,,7918.59,,,0,"percent of total billed charges","88% of total billed charges",5624,50,,4499.20,,,0,"percent of total billed charges","50% of total billed charges",1889.66,16.8,,1511.73,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1946.35,17.304,,1557.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7086.24,63,,5668.99,,,0,"percent of total billed charges","63% of total billed charges",1720.94,15.3,,1376.75,,,0,"percent of total billed charges","15.3% of total billed charges",1889.66,16.8,,1511.73,,,0,"percent of total billed charges","16.8% of total billed charges",7761.12,69,,,,,0,"fee schedule","69% of total billed charges",11248,100,,8998.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11248,100,,8998.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11248,100,,8998.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6956.89,61.85,,5565.51,,,0,"percent of total billed charges","61.5% of total billed charges",1889.66,16.8,,1511.73,,,0,"percent of total billed charges","16.8% of total billed charges",5624,50,,4499.20,,,0,"percent of total billed charges","50% of total billed charges",3621.86,32.2,,2897.49,,,0,"percent of total billed charges","32.2% of total billed charges",1889.66,16.8,,1511.73,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1927.46,17.136,,1541.97,,,0,"percent of total billed charges","17.136% of total billed charges",2456.56,21.84,,1965.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4240.5,37.7,,3392.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8773.44,78,,7018.75,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9290.85,82.6,,7432.68,,,0,"percent of total billed charges","82.6% of total billed charges",1889.66,16.8,,1511.73,,,0,"percent of total billed charges","16.8% of total billed charges",5624,50,,4499.20,,,0,"percent of total billed charges","50% of total billed charges",9290.85,82.6,,7432.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1889.66,16.8,,1511.73,,,0,"percent of total billed charges","16.8% of total billed charges",11248,100,,8998.40,,,0,"percent of total billed charges","100% of total billed charges",1720.94,11248,
"BALLOON DIAL URETERAL 7FR/10CM",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"BALLOON DIALATOR",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BALLON CATH INFLATION DEVICE",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"BALLOON DILATOR CRE WG 10-12MM",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"BALLOON EUPHORA RX 1.5 X 12",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON EUPHORA RX 2.0 X 12",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"BALLOON EUPHORA RX 2.0 X 15",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON EUPHORA RX 2.5 X 12",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON EUPHORA RX 2.5 X 15",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"BALLOON EUPHORA RX 2.5 X 20",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON EUPHORA RX 3.0 X 12",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON EUPHORA RX 3.0 X 15",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"BALLOON EUPHORA RX 3.0 X 20",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
N/A,ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"BALLOON EUPHORA RX 3.5 X 20",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON EUPHORA RX 4.0 X 15",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"BALLOON EUPHORA RX 4.0 X 20",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"BALLOON SPRINTER LEGEND 1.25 X 10",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"BALLOON NC EUPHORA RX 2.0 X 12",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"BALLOON NC EUPHORA RX 2.25 X 15",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"BALLOON NC EUPHORA RX 2.5 X 15",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON NC EUPHORA RX 2.5 X 20",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON NC EUPHORA RX 2.75 X 12",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"BALLOON NC EUPHORA RX 3.0 X 8",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"BALLOON NC EUPHORA RX 3.0 X 12",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"BALLOON NC EUPHORA RX 3.0 X 15",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"BALLOON NC EUPHORA RX 3.0 X 20",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
N/A,ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"BALLOON NC EUPHORA RX 3.25 X 15",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"BALLOON NC EUPHORA RX 3.25 X 20",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"BALLOON NC EUPHORA RX 3.5 X 8",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON NC EUPHORA RX 3.5 X 12",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON NC EUPHORA RX 3.5 X 20",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"BALLOON NC EUPHORA RX 3.75 X 15",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"BALLOON NC EUPHORA RX 4.0 X 12",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
N/A,ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BALLOON NC EUPHORA RX 4.5 X 12",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"BALLOON DES STELLAREX 4 X 40 X 135CM",ORSUP0045,CDM,272,RC,,,OUTPATIENT,,,7004,4552.6,,6163.52,88,,4930.82,,,0,"percent of total billed charges","88% of total billed charges",3502,50,,2801.60,,,0,"percent of total billed charges","50% of total billed charges",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1211.97,17.304,,969.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4412.52,63,,3530.02,,,0,"percent of total billed charges","63% of total billed charges",1071.61,15.3,,857.29,,,0,"percent of total billed charges","15.3% of total billed charges",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",4832.76,69,,,,,0,"fee schedule","69% of total billed charges",7004,100,,5603.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7004,100,,5603.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7004,100,,5603.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4331.97,61.85,,3465.58,,,0,"percent of total billed charges","61.5% of total billed charges",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",3502,50,,2801.60,,,0,"percent of total billed charges","50% of total billed charges",2255.29,32.2,,1804.23,,,0,"percent of total billed charges","32.2% of total billed charges",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1200.21,17.136,,960.17,,,0,"percent of total billed charges","17.136% of total billed charges",1529.67,21.84,,1223.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2640.51,37.7,,2112.41,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5463.12,78,,4370.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5785.3,82.6,,4628.24,,,0,"percent of total billed charges","82.6% of total billed charges",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",3502,50,,2801.60,,,0,"percent of total billed charges","50% of total billed charges",5785.3,82.6,,4628.24,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",7004,100,,5603.20,,,0,"percent of total billed charges","100% of total billed charges",1071.61,7004,
"BALLOON DES STELLAREX 5 X 40 X 135CM",ORSUP0063,CDM,272,RC,,,OUTPATIENT,,,10980,7137,,9662.4,88,,7729.92,,,0,"percent of total billed charges","88% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1899.98,17.304,,1519.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6917.4,63,,5533.92,,,0,"percent of total billed charges","63% of total billed charges",1679.94,15.3,,1343.95,,,0,"percent of total billed charges","15.3% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",7576.2,69,,,,,0,"fee schedule","69% of total billed charges",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6791.13,61.85,,5432.90,,,0,"percent of total billed charges","61.5% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",3535.56,32.2,,2828.45,,,0,"percent of total billed charges","32.2% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1881.53,17.136,,1505.22,,,0,"percent of total billed charges","17.136% of total billed charges",2398.03,21.84,,1918.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4139.46,37.7,,3311.57,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8564.4,78,,6851.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9069.48,82.6,,7255.58,,,0,"percent of total billed charges","82.6% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",9069.48,82.6,,7255.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",1679.94,10980,
"BALLOON DES STELLAREX 5 X 80 X 135CM",ORSUP0045,CDM,272,RC,,,OUTPATIENT,,,7004,4552.6,,6163.52,88,,4930.82,,,0,"percent of total billed charges","88% of total billed charges",3502,50,,2801.60,,,0,"percent of total billed charges","50% of total billed charges",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1211.97,17.304,,969.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4412.52,63,,3530.02,,,0,"percent of total billed charges","63% of total billed charges",1071.61,15.3,,857.29,,,0,"percent of total billed charges","15.3% of total billed charges",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",4832.76,69,,,,,0,"fee schedule","69% of total billed charges",7004,100,,5603.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7004,100,,5603.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7004,100,,5603.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4331.97,61.85,,3465.58,,,0,"percent of total billed charges","61.5% of total billed charges",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",3502,50,,2801.60,,,0,"percent of total billed charges","50% of total billed charges",2255.29,32.2,,1804.23,,,0,"percent of total billed charges","32.2% of total billed charges",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1200.21,17.136,,960.17,,,0,"percent of total billed charges","17.136% of total billed charges",1529.67,21.84,,1223.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2640.51,37.7,,2112.41,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5463.12,78,,4370.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5785.3,82.6,,4628.24,,,0,"percent of total billed charges","82.6% of total billed charges",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",3502,50,,2801.60,,,0,"percent of total billed charges","50% of total billed charges",5785.3,82.6,,4628.24,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",7004,100,,5603.20,,,0,"percent of total billed charges","100% of total billed charges",1071.61,7004,
"BALLOON DES STELLAREX 6 X 40 X 135CM",ORSUP0052,CDM,272,RC,,,OUTPATIENT,,,10980,7137,,9662.4,88,,7729.92,,,0,"percent of total billed charges","88% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1899.98,17.304,,1519.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6917.4,63,,5533.92,,,0,"percent of total billed charges","63% of total billed charges",1679.94,15.3,,1343.95,,,0,"percent of total billed charges","15.3% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",7576.2,69,,,,,0,"fee schedule","69% of total billed charges",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6791.13,61.85,,5432.90,,,0,"percent of total billed charges","61.5% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",3535.56,32.2,,2828.45,,,0,"percent of total billed charges","32.2% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1881.53,17.136,,1505.22,,,0,"percent of total billed charges","17.136% of total billed charges",2398.03,21.84,,1918.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4139.46,37.7,,3311.57,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8564.4,78,,6851.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9069.48,82.6,,7255.58,,,0,"percent of total billed charges","82.6% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",9069.48,82.6,,7255.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",1679.94,10980,
"BALLOON DES STELLAREX 6 X 60 X 135CM",ORSUP0037,CDM,272,RC,,,OUTPATIENT,,,6963,4525.95,,6127.44,88,,4901.95,,,0,"percent of total billed charges","88% of total billed charges",3481.5,50,,2785.20,,,0,"percent of total billed charges","50% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1204.88,17.304,,963.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4386.69,63,,3509.35,,,0,"percent of total billed charges","63% of total billed charges",1065.34,15.3,,852.27,,,0,"percent of total billed charges","15.3% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",4804.47,69,,,,,0,"fee schedule","69% of total billed charges",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4306.62,61.85,,3445.30,,,0,"percent of total billed charges","61.5% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",3481.5,50,,2785.20,,,0,"percent of total billed charges","50% of total billed charges",2242.09,32.2,,1793.67,,,0,"percent of total billed charges","32.2% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1193.18,17.136,,954.54,,,0,"percent of total billed charges","17.136% of total billed charges",1520.72,21.84,,1216.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2625.05,37.7,,2100.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5431.14,78,,4344.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5751.44,82.6,,4601.15,,,0,"percent of total billed charges","82.6% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",3481.5,50,,2785.20,,,0,"percent of total billed charges","50% of total billed charges",5751.44,82.6,,4601.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",1065.34,6963,
"BALLOON DES STELLAREX 6 X 80 X 135CM",ORSUP0045,CDM,272,RC,,,OUTPATIENT,,,7004,4552.6,,6163.52,88,,4930.82,,,0,"percent of total billed charges","88% of total billed charges",3502,50,,2801.60,,,0,"percent of total billed charges","50% of total billed charges",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1211.97,17.304,,969.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4412.52,63,,3530.02,,,0,"percent of total billed charges","63% of total billed charges",1071.61,15.3,,857.29,,,0,"percent of total billed charges","15.3% of total billed charges",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",4832.76,69,,,,,0,"fee schedule","69% of total billed charges",7004,100,,5603.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7004,100,,5603.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7004,100,,5603.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4331.97,61.85,,3465.58,,,0,"percent of total billed charges","61.5% of total billed charges",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",3502,50,,2801.60,,,0,"percent of total billed charges","50% of total billed charges",2255.29,32.2,,1804.23,,,0,"percent of total billed charges","32.2% of total billed charges",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1200.21,17.136,,960.17,,,0,"percent of total billed charges","17.136% of total billed charges",1529.67,21.84,,1223.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2640.51,37.7,,2112.41,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5463.12,78,,4370.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5785.3,82.6,,4628.24,,,0,"percent of total billed charges","82.6% of total billed charges",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",3502,50,,2801.60,,,0,"percent of total billed charges","50% of total billed charges",5785.3,82.6,,4628.24,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",7004,100,,5603.20,,,0,"percent of total billed charges","100% of total billed charges",1071.61,7004,
"BALLOON DES STELLAREX 4 X 100 X 135CM",ORSUP0039,CDM,272,RC,,,OUTPATIENT,,,5768,3749.2,,5075.84,88,,4060.67,,,0,"percent of total billed charges","88% of total billed charges",2884,50,,2307.20,,,0,"percent of total billed charges","50% of total billed charges",969.02,16.8,,775.22,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",998.09,17.304,,798.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3633.84,63,,2907.07,,,0,"percent of total billed charges","63% of total billed charges",882.5,15.3,,706.00,,,0,"percent of total billed charges","15.3% of total billed charges",969.02,16.8,,775.22,,,0,"percent of total billed charges","16.8% of total billed charges",3979.92,69,,,,,0,"fee schedule","69% of total billed charges",5768,100,,4614.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5768,100,,4614.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5768,100,,4614.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3567.51,61.85,,2854.01,,,0,"percent of total billed charges","61.5% of total billed charges",969.02,16.8,,775.22,,,0,"percent of total billed charges","16.8% of total billed charges",2884,50,,2307.20,,,0,"percent of total billed charges","50% of total billed charges",1857.3,32.2,,1485.84,,,0,"percent of total billed charges","32.2% of total billed charges",969.02,16.8,,775.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",988.4,17.136,,790.72,,,0,"percent of total billed charges","17.136% of total billed charges",1259.73,21.84,,1007.78,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2174.54,37.7,,1739.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4499.04,78,,3599.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4764.37,82.6,,3811.50,,,0,"percent of total billed charges","82.6% of total billed charges",969.02,16.8,,775.22,,,0,"percent of total billed charges","16.8% of total billed charges",2884,50,,2307.20,,,0,"percent of total billed charges","50% of total billed charges",4764.37,82.6,,3811.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",969.02,16.8,,775.22,,,0,"percent of total billed charges","16.8% of total billed charges",5768,100,,4614.40,,,0,"percent of total billed charges","100% of total billed charges",882.5,5768,
N/A,ORSUP0048,CDM,272,RC,,,OUTPATIENT,,,7622,4954.3,,6707.36,88,,5365.89,,,0,"percent of total billed charges","88% of total billed charges",3811,50,,3048.80,,,0,"percent of total billed charges","50% of total billed charges",1280.5,16.8,,1024.40,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1318.91,17.304,,1055.13,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4801.86,63,,3841.49,,,0,"percent of total billed charges","63% of total billed charges",1166.17,15.3,,932.94,,,0,"percent of total billed charges","15.3% of total billed charges",1280.5,16.8,,1024.40,,,0,"percent of total billed charges","16.8% of total billed charges",5259.18,69,,,,,0,"fee schedule","69% of total billed charges",7622,100,,6097.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7622,100,,6097.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7622,100,,6097.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4714.21,61.85,,3771.37,,,0,"percent of total billed charges","61.5% of total billed charges",1280.5,16.8,,1024.40,,,0,"percent of total billed charges","16.8% of total billed charges",3811,50,,3048.80,,,0,"percent of total billed charges","50% of total billed charges",2454.28,32.2,,1963.42,,,0,"percent of total billed charges","32.2% of total billed charges",1280.5,16.8,,1024.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1306.11,17.136,,1044.89,,,0,"percent of total billed charges","17.136% of total billed charges",1664.64,21.84,,1331.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2873.49,37.7,,2298.79,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5945.16,78,,4756.13,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6295.77,82.6,,5036.62,,,0,"percent of total billed charges","82.6% of total billed charges",1280.5,16.8,,1024.40,,,0,"percent of total billed charges","16.8% of total billed charges",3811,50,,3048.80,,,0,"percent of total billed charges","50% of total billed charges",6295.77,82.6,,5036.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1280.5,16.8,,1024.40,,,0,"percent of total billed charges","16.8% of total billed charges",7622,100,,6097.60,,,0,"percent of total billed charges","100% of total billed charges",1166.17,7622,
"BALLOON DES STELLAREX 6 X 100 X 135CM",ORSUP0048,CDM,272,RC,,,OUTPATIENT,,,9909,6440.85,,8719.92,88,,6975.94,,,0,"percent of total billed charges","88% of total billed charges",4954.5,50,,3963.60,,,0,"percent of total billed charges","50% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1714.65,17.304,,1371.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6242.67,63,,4994.14,,,0,"percent of total billed charges","63% of total billed charges",1516.08,15.3,,1212.86,,,0,"percent of total billed charges","15.3% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",6837.21,69,,,,,0,"fee schedule","69% of total billed charges",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6128.72,61.85,,4902.98,,,0,"percent of total billed charges","61.5% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",4954.5,50,,3963.60,,,0,"percent of total billed charges","50% of total billed charges",3190.7,32.2,,2552.56,,,0,"percent of total billed charges","32.2% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1698.01,17.136,,1358.41,,,0,"percent of total billed charges","17.136% of total billed charges",2164.13,21.84,,1731.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3735.69,37.7,,2988.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7729.02,78,,6183.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8184.83,82.6,,6547.86,,,0,"percent of total billed charges","82.6% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",4954.5,50,,3963.60,,,0,"percent of total billed charges","50% of total billed charges",8184.83,82.6,,6547.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",1516.08,9909,
N/A,ORSUP0056,CDM,272,RC,,,OUTPATIENT,,,12319,8007.35,,10840.72,88,,8672.58,,,0,"percent of total billed charges","88% of total billed charges",6159.5,50,,4927.60,,,0,"percent of total billed charges","50% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2131.68,17.304,,1705.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7760.97,63,,6208.78,,,0,"percent of total billed charges","63% of total billed charges",1884.81,15.3,,1507.85,,,0,"percent of total billed charges","15.3% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",8500.11,69,,,,,0,"fee schedule","69% of total billed charges",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7619.3,61.85,,6095.44,,,0,"percent of total billed charges","61.5% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",6159.5,50,,4927.60,,,0,"percent of total billed charges","50% of total billed charges",3966.72,32.2,,3173.38,,,0,"percent of total billed charges","32.2% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2110.98,17.136,,1688.78,,,0,"percent of total billed charges","17.136% of total billed charges",2690.47,21.84,,2152.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4644.26,37.7,,3715.41,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9608.82,78,,7687.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10175.49,82.6,,8140.39,,,0,"percent of total billed charges","82.6% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",6159.5,50,,4927.60,,,0,"percent of total billed charges","50% of total billed charges",10175.49,82.6,,8140.39,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",1884.81,12319,
"BALLOON DES STELLAREX 5 X 120 X 135CM",ORSUP0044,CDM,272,RC,,,OUTPATIENT,,,8837,5744.05,,7776.56,88,,6221.25,,,0,"percent of total billed charges","88% of total billed charges",4418.5,50,,3534.80,,,0,"percent of total billed charges","50% of total billed charges",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1529.15,17.304,,1223.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5567.31,63,,4453.85,,,0,"percent of total billed charges","63% of total billed charges",1352.06,15.3,,1081.65,,,0,"percent of total billed charges","15.3% of total billed charges",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",6097.53,69,,,,,0,"fee schedule","69% of total billed charges",8837,100,,7069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8837,100,,7069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8837,100,,7069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5465.68,61.85,,4372.54,,,0,"percent of total billed charges","61.5% of total billed charges",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",4418.5,50,,3534.80,,,0,"percent of total billed charges","50% of total billed charges",2845.51,32.2,,2276.41,,,0,"percent of total billed charges","32.2% of total billed charges",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.31,17.136,,1211.45,,,0,"percent of total billed charges","17.136% of total billed charges",1930,21.84,,1544.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3331.55,37.7,,2665.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6892.86,78,,5514.29,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7299.36,82.6,,5839.49,,,0,"percent of total billed charges","82.6% of total billed charges",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",4418.5,50,,3534.80,,,0,"percent of total billed charges","50% of total billed charges",7299.36,82.6,,5839.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",8837,100,,7069.60,,,0,"percent of total billed charges","100% of total billed charges",1352.06,8837,
"BALLOON DES STELLAREX 6 X 120 X 135CM",ORSUP0040,CDM,272,RC,,,OUTPATIENT,,,5974,3883.1,,5257.12,88,,4205.70,,,0,"percent of total billed charges","88% of total billed charges",2987,50,,2389.60,,,0,"percent of total billed charges","50% of total billed charges",1003.63,16.8,,802.90,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1033.74,17.304,,826.99,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3763.62,63,,3010.90,,,0,"percent of total billed charges","63% of total billed charges",914.02,15.3,,731.22,,,0,"percent of total billed charges","15.3% of total billed charges",1003.63,16.8,,802.90,,,0,"percent of total billed charges","16.8% of total billed charges",4122.06,69,,,,,0,"fee schedule","69% of total billed charges",5974,100,,4779.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5974,100,,4779.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5974,100,,4779.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3694.92,61.85,,2955.94,,,0,"percent of total billed charges","61.5% of total billed charges",1003.63,16.8,,802.90,,,0,"percent of total billed charges","16.8% of total billed charges",2987,50,,2389.60,,,0,"percent of total billed charges","50% of total billed charges",1923.63,32.2,,1538.90,,,0,"percent of total billed charges","32.2% of total billed charges",1003.63,16.8,,802.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1023.7,17.136,,818.96,,,0,"percent of total billed charges","17.136% of total billed charges",1304.72,21.84,,1043.78,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2252.2,37.7,,1801.76,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4659.72,78,,3727.78,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4934.52,82.6,,3947.62,,,0,"percent of total billed charges","82.6% of total billed charges",1003.63,16.8,,802.90,,,0,"percent of total billed charges","16.8% of total billed charges",2987,50,,2389.60,,,0,"percent of total billed charges","50% of total billed charges",4934.52,82.6,,3947.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1003.63,16.8,,802.90,,,0,"percent of total billed charges","16.8% of total billed charges",5974,100,,4779.20,,,0,"percent of total billed charges","100% of total billed charges",914.02,5974,
"BALLOON BAKRI POSTPARTUM",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"BALLOON INFLATION DEVICE",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"BALLOON PROFILE PTA DIALATION CATH 5FR X 135CM",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.94,17.304,,85.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.23,61.85,,305.78,,,0,"percent of total billed charges","61.5% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",199,32.2,,159.20,,,0,"percent of total billed charges","32.2% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.136,,84.72,,,0,"percent of total billed charges","17.136% of total billed charges",134.97,21.84,,107.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,618,
"BALLOON COYOTE 3.0X60X150",ORSUP0018,CDM,278,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",605.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.7% of total billed charges",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",658.34,33.9,,526.67,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"BALLOON COYOTE 4.0X60X150",ORSUP0018,CDM,278,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",605.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.7% of total billed charges",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",658.34,33.9,,526.67,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"BALLOON COLPO PNEUMO OCCLUDER",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"BALL THERABAND PRO SERIES EXERCISE BALL BLUE 30IN",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"BALLOON PTA 8MM X 4CM X 135CM",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.94,17.304,,85.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.23,61.85,,305.78,,,0,"percent of total billed charges","61.5% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",199,32.2,,159.20,,,0,"percent of total billed charges","32.2% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.136,,84.72,,,0,"percent of total billed charges","17.136% of total billed charges",134.97,21.84,,107.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,618,
"BALLOON COYOTE OTW 2.5X60X150",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1030,669.5,,906.4,88,,725.12,,,0,"percent of total billed charges","88% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.23,17.304,,142.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.9,63,,519.12,,,0,"percent of total billed charges","63% of total billed charges",157.59,15.3,,126.07,,,0,"percent of total billed charges","15.3% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",710.7,69,,,,,0,"fee schedule","69% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",637.06,61.85,,509.65,,,0,"percent of total billed charges","61.5% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",331.66,32.2,,265.33,,,0,"percent of total billed charges","32.2% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.5,17.136,,141.20,,,0,"percent of total billed charges","17.136% of total billed charges",224.95,21.84,,179.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",388.31,37.7,,310.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",803.4,78,,642.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",157.59,1030,
"BALLOON COYOTE OTW 2X60X150",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1030,669.5,,906.4,88,,725.12,,,0,"percent of total billed charges","88% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.23,17.304,,142.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.9,63,,519.12,,,0,"percent of total billed charges","63% of total billed charges",157.59,15.3,,126.07,,,0,"percent of total billed charges","15.3% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",710.7,69,,,,,0,"fee schedule","69% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",637.06,61.85,,509.65,,,0,"percent of total billed charges","61.5% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",331.66,32.2,,265.33,,,0,"percent of total billed charges","32.2% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.5,17.136,,141.20,,,0,"percent of total billed charges","17.136% of total billed charges",224.95,21.84,,179.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",388.31,37.7,,310.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",803.4,78,,642.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",157.59,1030,
"BALLOON COYOTE OTW 1.5X40X150",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1030,669.5,,906.4,88,,725.12,,,0,"percent of total billed charges","88% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.23,17.304,,142.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.9,63,,519.12,,,0,"percent of total billed charges","63% of total billed charges",157.59,15.3,,126.07,,,0,"percent of total billed charges","15.3% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",710.7,69,,,,,0,"fee schedule","69% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",637.06,61.85,,509.65,,,0,"percent of total billed charges","61.5% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",331.66,32.2,,265.33,,,0,"percent of total billed charges","32.2% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.5,17.136,,141.20,,,0,"percent of total billed charges","17.136% of total billed charges",224.95,21.84,,179.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",388.31,37.7,,310.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",803.4,78,,642.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",157.59,1030,
"BALOON CATH MUSTANG OVER THE WIRE 6.0MM X 60MM  135CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"BANDAGE KLING 6IN STERILE",41529,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"BANDAGE KLING 4 INCH",41544,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"BANDAGE KLING 3IN STERILE",57215,CDM,272,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"BANDAGE KLING 2IN STERILE",41545,CDM,272,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"BANDAGE KERLIX ROLL 4.5IN STERILE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BANDAGE ACE 6IN DOUBLE LENGTH",187186,CDM,270,RC,,,OUTPATIENT,,,31,20.15,,27.28,88,,21.82,,,0,"percent of total billed charges","88% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.36,17.304,,4.29,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.53,63,,15.62,,,0,"percent of total billed charges","63% of total billed charges",4.74,15.3,,3.79,,,0,"percent of total billed charges","15.3% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",21.39,69,,,,,0,"fee schedule","69% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.17,61.85,,15.34,,,0,"percent of total billed charges","61.5% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",9.98,32.2,,7.98,,,0,"percent of total billed charges","32.2% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.31,17.136,,4.25,,,0,"percent of total billed charges","17.136% of total billed charges",6.77,21.84,,5.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.69,37.7,,9.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.18,78,,19.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.61,82.6,,20.49,,,0,"percent of total billed charges","82.6% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",25.61,82.6,,20.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",4.74,31,
"BANDAGE ELASTIC  ACE 6 INCH STER S/CLOSE",10172,CDM,272,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"BANDAGE ELASTIC ACE 4 INCH STER S/CLOSE",10171,CDM,272,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"BANDAGE ELASTIC  ACE 3 INCH STER S/CLOSE",94742,CDM,272,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"BAND ID SECURITY YELLOW",ORSUP0013,CDM,270,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"BAND ID TYPENEX SYSTEM GREEN",ORSUP0013,CDM,270,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"BAND ID W/LABEL ADULT INTELLIDOT",ORSUP0019,CDM,270,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"BANDAGE ELASTIC  ACE 2 INCH STER S/CLOSE",94538,CDM,272,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"BANDAGE ELASTIC 3 INCH NONSTER",10506,CDM,270,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"BANDAGE ELASTIC 4 INCH NONSTER",10507,CDM,270,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"BANDAGE ELASTIC 6 INCH NONSTER",10508,CDM,270,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"BANDAGE ESMARK 4IN X 9FT LATEX FREE",13902,CDM,270,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.37,61.85,,9.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"BANDAGE ESMARK 6 INCH X 9 FEET LATEX FREE",80677,CDM,270,RC,,,OUTPATIENT,,,25,16.25,,22,88,,17.60,,,0,"percent of total billed charges","88% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,17.304,,3.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.75,63,,12.60,,,0,"percent of total billed charges","63% of total billed charges",3.83,15.3,,3.06,,,0,"percent of total billed charges","15.3% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",17.25,69,,,,,0,"fee schedule","69% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.46,61.85,,12.37,,,0,"percent of total billed charges","61.5% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",8.05,32.2,,6.44,,,0,"percent of total billed charges","32.2% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.28,17.136,,3.42,,,0,"percent of total billed charges","17.136% of total billed charges",5.46,21.84,,4.37,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.43,37.7,,7.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.5,78,,15.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",3.83,25,
"BANDAID 2X4",61479,CDM,270,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"BAND ELECTRODE FOR RESECTOSCOPE",ORSUP0041,CDM,272,RC,,,OUTPATIENT,,,8034,5222.1,,7069.92,88,,5655.94,,,0,"percent of total billed charges","88% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1390.2,17.304,,1112.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5061.42,63,,4049.14,,,0,"percent of total billed charges","63% of total billed charges",1229.2,15.3,,983.36,,,0,"percent of total billed charges","15.3% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",5543.46,69,,,,,0,"fee schedule","69% of total billed charges",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4969.03,61.85,,3975.22,,,0,"percent of total billed charges","61.5% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",2586.95,32.2,,2069.56,,,0,"percent of total billed charges","32.2% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1376.71,17.136,,1101.37,,,0,"percent of total billed charges","17.136% of total billed charges",1754.63,21.84,,1403.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3028.82,37.7,,2423.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6266.52,78,,5013.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6636.08,82.6,,5308.86,,,0,"percent of total billed charges","82.6% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",6636.08,82.6,,5308.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",1229.2,8034,
"BANDAGE ESMARK 6'' X 9''",490092,CDM,270,RC,,,OUTPATIENT,,,30,19.5,,26.4,88,,21.12,,,0,"percent of total billed charges","88% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.19,17.304,,4.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.9,63,,15.12,,,0,"percent of total billed charges","63% of total billed charges",4.59,15.3,,3.67,,,0,"percent of total billed charges","15.3% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",20.7,69,,,,,0,"fee schedule","69% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.56,61.85,,14.85,,,0,"percent of total billed charges","61.5% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",9.66,32.2,,7.73,,,0,"percent of total billed charges","32.2% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.14,17.136,,4.11,,,0,"percent of total billed charges","17.136% of total billed charges",6.55,21.84,,5.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.31,37.7,,9.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.4,78,,18.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",4.59,30,
"BANDAGE ESMARK 4'' X 9''",490091,CDM,270,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"BANDAGE COBAN 2''",490090,CDM,270,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.95,61.85,,3.96,,,0,"percent of total billed charges","61.5% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"BANDAGE ACE 2''",490089,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"BAND-AID 2 X 4",490094,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"BANDAGE KIT COMPR2 9.25 X 12.5",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"BANDAGING KIT COMPRIFORE LF  4 LAYER",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"BANDAGE KIT COMPRI2  LITE COMPRESSION 2 LAYER WRAP",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"BANDAGE 3IN ELASTIC SELF CLOSURE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BANDAGE 4IN ELASTIC SELF CLOSURE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BANDAGE 6IN ELASTIC SELF CLOSURE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BANDAGE KIT COMPRI2 7.08IN X 12.5IN",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"BANDAGE TUBULAR ELASTIC DRESSING 4IN X 25YD",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"BANDAGE NS SELF ADHERENT COHESIVE WRAP TAN 4IN X 5YD",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BANDAGE COFLEX COHESIVE HAND TEAR 2 RED",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BANDAGE COBAN NONSTERILE ASSORTED COLORS 1 INCH",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BANDAGE COBAN NONSTERILE ASSORTED COLORS 3 INCH",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BANDAGE TUBE SZ 5",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"BANDAGE TUBE SZ10",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"BARD MONOPTY BIOPSY INSTRUMENT KIT - 16G NEEDLE",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"BARIUM-LIQUID POLIBAR",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"BARIUM STRAWS",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"BARRIER FILM NO STING",9366,CDM,270,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"BASIN WASH",11864,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"BASIN EMESIS 500 CC 9IN MAUVE",152060,CDM,272,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"BASIN WASH 7.5QT GRAPHITE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BASIN SENSOR COVER FOR AER",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"BASKET ZERO TIP STONE 3.0 FR",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"BASKET ZERO TIP M0063901040",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"BASKET/CRUSHER GALLSTONE 3.0CM",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"BASKET TRAPEZOID 1.5 X 3",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"BASKET LITHOTRIPTOR TRAPEZOID RX 5.0CM/2.5CM/3.2MM",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"BASKET TRAPEZOID 2 X 4",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"BASKET STONE SEGURA 3FR",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"BASKET BAGLEY HELICAL STONE 340 122",ORSUP0021,CDM,270,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"BASKET FORCEP SPIRAL DISP 10MM",ORSUP0024,CDM,270,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"BATH PATIENT CARE FRAG-FREE",490097,CDM,270,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"BATTERY ALKALINE SIZE D",10415,CDM,270,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"BATTERY ALKALINE SIZE AA",10412,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"BATTERY # 72 1Q DISPOSABLE",ORSUP0010,CDM,270,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"BATTERY N SIZE 1.5 V",490098,CDM,270,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"BAYONETTED ANNULOTOMY KNIFE",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"BD COLLECTION TUBE CLOT ACTIVATOR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BEAST INJECTABLE PUTTY 1.0CC",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,1854,1205.1,,1631.52,88,,1305.22,,,0,"percent of total billed charges","88% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",320.82,17.304,,256.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1168.02,63,,934.42,,,0,"percent of total billed charges","63% of total billed charges",283.66,15.3,,226.93,,,0,"percent of total billed charges","15.3% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1279.26,69,,,,,0,"fee schedule","69% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1146.7,61.85,,917.36,,,0,"percent of total billed charges","61.5% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",596.99,32.2,,477.59,,,0,"percent of total billed charges","32.2% of total billed charges",578.45,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",317.7,17.136,,254.16,,,0,"percent of total billed charges","17.136% of total billed charges",404.91,21.84,,323.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",698.96,37.7,,559.17,,,0,"percent of total billed charges","37.7% of total billed charges",698.96,37.7,,559.17,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",628.51,33.9,,502.81,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1446.12,78,,1156.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1531.4,82.6,,1225.12,,,0,"percent of total billed charges","82.6% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",1531.4,82.6,,1225.12,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",283.66,1854,
"BEAST INJECTABLE PUTTY 2.5CC",ORSUP0029,CDM,278,RC,,,OUTPATIENT,,,3708,2410.2,,3263.04,88,,2610.43,,,0,"percent of total billed charges","88% of total billed charges",1854,50,,1483.20,,,0,"percent of total billed charges","50% of total billed charges",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",3708,100,,2966.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",641.63,17.304,,513.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2336.04,63,,1868.83,,,0,"percent of total billed charges","63% of total billed charges",567.32,15.3,,453.86,,,0,"percent of total billed charges","15.3% of total billed charges",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",2558.52,69,,,,,0,"fee schedule","69% of total billed charges",3708,100,,2966.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3708,100,,2966.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3708,100,,2966.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2293.4,61.85,,1834.72,,,0,"percent of total billed charges","61.5% of total billed charges",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",1854,50,,1483.20,,,0,"percent of total billed charges","50% of total billed charges",1193.98,32.2,,955.18,,,0,"percent of total billed charges","32.2% of total billed charges",1156.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",635.4,17.136,,508.32,,,0,"percent of total billed charges","17.136% of total billed charges",809.83,21.84,,647.86,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1397.92,37.7,,1118.34,,,0,"percent of total billed charges","37.7% of total billed charges",1397.92,37.7,,1118.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1257.01,33.9,,1005.61,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2892.24,78,,2313.79,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3062.81,82.6,,2450.25,,,0,"percent of total billed charges","82.6% of total billed charges",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",1854,50,,1483.20,,,0,"percent of total billed charges","50% of total billed charges",3062.81,82.6,,2450.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",3708,100,,2966.40,,,0,"percent of total billed charges","100% of total billed charges",567.32,3708,
"BEAVER BLADE 377081",490100,CDM,272,RC,,,OUTPATIENT,,,89,57.85,,78.32,88,,62.66,,,0,"percent of total billed charges","88% of total billed charges",44.5,50,,35.60,,,0,"percent of total billed charges","50% of total billed charges",14.95,16.8,,11.96,,,0,"percent of total billed charges","16.8% of total billed charges",89,100,,71.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.4,17.304,,12.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.07,63,,44.86,,,0,"percent of total billed charges","63% of total billed charges",13.62,15.3,,10.90,,,0,"percent of total billed charges","15.3% of total billed charges",14.95,16.8,,11.96,,,0,"percent of total billed charges","16.8% of total billed charges",61.41,69,,,,,0,"fee schedule","69% of total billed charges",89,100,,71.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89,100,,71.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89,100,,71.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",55.05,61.85,,44.04,,,0,"percent of total billed charges","61.5% of total billed charges",14.95,16.8,,11.96,,,0,"percent of total billed charges","16.8% of total billed charges",44.5,50,,35.60,,,0,"percent of total billed charges","50% of total billed charges",28.66,32.2,,22.93,,,0,"percent of total billed charges","32.2% of total billed charges",14.95,16.8,,11.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.25,17.136,,12.20,,,0,"percent of total billed charges","17.136% of total billed charges",19.44,21.84,,15.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",33.55,37.7,,26.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",69.42,78,,55.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",73.51,82.6,,58.81,,,0,"percent of total billed charges","82.6% of total billed charges",14.95,16.8,,11.96,,,0,"percent of total billed charges","16.8% of total billed charges",44.5,50,,35.60,,,0,"percent of total billed charges","50% of total billed charges",73.51,82.6,,58.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.95,16.8,,11.96,,,0,"percent of total billed charges","16.8% of total billed charges",89,100,,71.20,,,0,"percent of total billed charges","100% of total billed charges",13.62,89,
"BEAVER  FLAT MINI-MINISCUS BLADE HANDLE 4MM",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"BEDPAN STACKABLE DISP MAUVE",10916,CDM,272,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"BEDPAN FRACTURE GRAPHITE",94599,CDM,272,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"BED PAN",490102,CDM,270,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"BELT 72 POSEY WHITE COTTON GAIT",68794,CDM,270,RC,,,OUTPATIENT,,,54,35.1,,47.52,88,,38.02,,,0,"percent of total billed charges","88% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.34,17.304,,7.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.02,63,,27.22,,,0,"percent of total billed charges","63% of total billed charges",8.26,15.3,,6.61,,,0,"percent of total billed charges","15.3% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",37.26,69,,,,,0,"fee schedule","69% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.4,61.85,,26.72,,,0,"percent of total billed charges","61.5% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",17.39,32.2,,13.91,,,0,"percent of total billed charges","32.2% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.25,17.136,,7.40,,,0,"percent of total billed charges","17.136% of total billed charges",11.79,21.84,,9.43,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.36,37.7,,16.29,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",42.12,78,,33.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.6,82.6,,35.68,,,0,"percent of total billed charges","82.6% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",44.6,82.6,,35.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",8.26,54,
"BELT SANITARY",187177,CDM,272,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"BELT FETAL MONITOR TRANSDUCER 1.5IN X 36IN",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BENDALE ARMBOARDS",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"BENTSON WIRE GUIDE 20CM DISTAL FLEXIBILITY",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"BENZOIN COMPOUND TINCTURE, 2 OZ",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"BERMAN AIRWAYS 70MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"BETADINE SOLUTION 8OZ",185329,CDM,270,RC,,,OUTPATIENT,,,25,16.25,,22,88,,17.60,,,0,"percent of total billed charges","88% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,17.304,,3.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.75,63,,12.60,,,0,"percent of total billed charges","63% of total billed charges",3.83,15.3,,3.06,,,0,"percent of total billed charges","15.3% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",17.25,69,,,,,0,"fee schedule","69% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.46,61.85,,12.37,,,0,"percent of total billed charges","61.5% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",8.05,32.2,,6.44,,,0,"percent of total billed charges","32.2% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.28,17.136,,3.42,,,0,"percent of total billed charges","17.136% of total billed charges",5.46,21.84,,4.37,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.43,37.7,,7.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.5,78,,15.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",3.83,25,
"BETADINE 10% 2 OZ PREP SOLUTION",490104,CDM,270,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"BETADINE 5% PREP SOLUTION (EYES ONLY)",490105,CDM,270,RC,,,OUTPATIENT,,,111,72.15,,97.68,88,,78.14,,,0,"percent of total billed charges","88% of total billed charges",55.5,50,,44.40,,,0,"percent of total billed charges","50% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.21,17.304,,15.37,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.93,63,,55.94,,,0,"percent of total billed charges","63% of total billed charges",16.98,15.3,,13.58,,,0,"percent of total billed charges","15.3% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",76.59,69,,,,,0,"fee schedule","69% of total billed charges",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.65,61.85,,54.92,,,0,"percent of total billed charges","61.5% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",55.5,50,,44.40,,,0,"percent of total billed charges","50% of total billed charges",35.74,32.2,,28.59,,,0,"percent of total billed charges","32.2% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.02,17.136,,15.22,,,0,"percent of total billed charges","17.136% of total billed charges",24.24,21.84,,19.39,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.85,37.7,,33.48,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",86.58,78,,69.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.69,82.6,,73.35,,,0,"percent of total billed charges","82.6% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",55.5,50,,44.40,,,0,"percent of total billed charges","50% of total billed charges",91.69,82.6,,73.35,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",16.98,111,
"BETADINE WET PREP",490106,CDM,270,RC,,,OUTPATIENT,,,24,15.6,,21.12,88,,16.90,,,0,"percent of total billed charges","88% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.15,17.304,,3.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.12,63,,12.10,,,0,"percent of total billed charges","63% of total billed charges",3.67,15.3,,2.94,,,0,"percent of total billed charges","15.3% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",16.56,69,,,,,0,"fee schedule","69% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.84,61.85,,11.87,,,0,"percent of total billed charges","61.5% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",7.73,32.2,,6.18,,,0,"percent of total billed charges","32.2% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.11,17.136,,3.29,,,0,"percent of total billed charges","17.136% of total billed charges",5.24,21.84,,4.19,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.05,37.7,,7.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.72,78,,14.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,24,
"BETA LACTAM REAGENT DISK",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BILE BAG",490107,CDM,270,RC,,,OUTPATIENT,,,35,22.75,,30.8,88,,24.64,,,0,"percent of total billed charges","88% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.06,17.304,,4.85,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.05,63,,17.64,,,0,"percent of total billed charges","63% of total billed charges",5.36,15.3,,4.29,,,0,"percent of total billed charges","15.3% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",24.15,69,,,,,0,"fee schedule","69% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.65,61.85,,17.32,,,0,"percent of total billed charges","61.5% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",11.27,32.2,,9.02,,,0,"percent of total billed charges","32.2% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,17.136,,4.80,,,0,"percent of total billed charges","17.136% of total billed charges",7.64,21.84,,6.11,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.2,37.7,,10.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",27.3,78,,21.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.91,82.6,,23.13,,,0,"percent of total billed charges","82.6% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",28.91,82.6,,23.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",5.36,35,
"BINDER ABDOMINAL 3XL 12INX82-100IN",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"BINDER ABDOMINAL SUPPORT 10IN",ORSUP0003,CDM,270,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"BINDER ABDOMINAL 9 IN 3 PANEL 45-62IN",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"BINDER ABDOMINAL 9IN 62-74 XL",ORSUP0003,CDM,270,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"BINDER LARGE BREAST",ORSUP0003,CDM,270,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"BINDER ABDOMINAL 12IN XXL",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"BINDER ABDOMINAL 12IN XL",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"BIOBRACE 5 X 250MM",ORSUP0069,CDM,278,RC,,,OUTPATIENT,,,12154,7900.1,,10695.52,88,,8556.42,,,0,"percent of total billed charges","88% of total billed charges",6077,50,,4861.60,,,0,"percent of total billed charges","50% of total billed charges",2041.87,16.8,,1633.50,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2103.13,17.304,,1682.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7657.02,63,,6125.62,,,0,"percent of total billed charges","63% of total billed charges",1859.56,15.3,,1487.65,,,0,"percent of total billed charges","15.3% of total billed charges",2041.87,16.8,,1633.50,,,0,"percent of total billed charges","16.8% of total billed charges",8386.26,69,,,,,0,"fee schedule","69% of total billed charges",12154,100,,9723.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12154,100,,9723.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12154,100,,9723.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7517.25,61.85,,6013.80,,,0,"percent of total billed charges","61.5% of total billed charges",2041.87,16.8,,1633.50,,,0,"percent of total billed charges","16.8% of total billed charges",6077,50,,4861.60,,,0,"percent of total billed charges","50% of total billed charges",3913.59,32.2,,3130.87,,,0,"percent of total billed charges","32.2% of total billed charges",3792.05,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2082.71,17.136,,1666.17,,,0,"percent of total billed charges","17.136% of total billed charges",2654.43,21.84,,2123.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4582.06,37.7,,3665.65,,,0,"percent of total billed charges","37.7% of total billed charges",4582.06,37.7,,3665.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4120.21,33.9,,3296.17,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",9480.12,78,,7584.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10039.2,82.6,,8031.36,,,0,"percent of total billed charges","82.6% of total billed charges",2041.87,16.8,,1633.50,,,0,"percent of total billed charges","16.8% of total billed charges",6077,50,,4861.60,,,0,"percent of total billed charges","50% of total billed charges",10039.2,82.6,,8031.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2041.87,16.8,,1633.50,,,0,"percent of total billed charges","16.8% of total billed charges",12154,100,,9723.20,,,0,"percent of total billed charges","100% of total billed charges",1859.56,12154,
"BIOBRACE 23 X 30MM",ORSUP0098,CDM,278,RC,,,OUTPATIENT,,,18128,11783.2,,15952.64,88,,12762.11,,,0,"percent of total billed charges","88% of total billed charges",9064,50,,7251.20,,,0,"percent of total billed charges","50% of total billed charges",3045.5,16.8,,2436.40,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3136.87,17.304,,2509.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11420.64,63,,9136.51,,,0,"percent of total billed charges","63% of total billed charges",2773.58,15.3,,2218.86,,,0,"percent of total billed charges","15.3% of total billed charges",3045.5,16.8,,2436.40,,,0,"percent of total billed charges","16.8% of total billed charges",12508.32,69,,,,,0,"fee schedule","69% of total billed charges",18128,100,,14502.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18128,100,,14502.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18128,100,,14502.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11212.17,61.85,,8969.74,,,0,"percent of total billed charges","61.5% of total billed charges",3045.5,16.8,,2436.40,,,0,"percent of total billed charges","16.8% of total billed charges",9064,50,,7251.20,,,0,"percent of total billed charges","50% of total billed charges",5837.22,32.2,,4669.78,,,0,"percent of total billed charges","32.2% of total billed charges",5655.94,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3106.41,17.136,,2485.13,,,0,"percent of total billed charges","17.136% of total billed charges",3959.16,21.84,,3167.33,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",6834.26,37.7,,5467.41,,,0,"percent of total billed charges","37.7% of total billed charges",6834.26,37.7,,5467.41,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",6145.39,33.9,,4916.31,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",14139.84,78,,11311.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14973.73,82.6,,11978.98,,,0,"percent of total billed charges","82.6% of total billed charges",3045.5,16.8,,2436.40,,,0,"percent of total billed charges","16.8% of total billed charges",9064,50,,7251.20,,,0,"percent of total billed charges","50% of total billed charges",14973.73,82.6,,11978.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3045.5,16.8,,2436.40,,,0,"percent of total billed charges","16.8% of total billed charges",18128,100,,14502.40,,,0,"percent of total billed charges","100% of total billed charges",2773.58,18128,
"BIOCARTILEDGE 1CC",ORSUP0041,CDM,278,RC,,,OUTPATIENT,,,6180,4017,,5438.4,88,,4350.72,,,0,"percent of total billed charges","88% of total billed charges",3090,50,,2472.00,,,0,"percent of total billed charges","50% of total billed charges",1038.24,16.8,,830.59,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1069.39,17.304,,855.51,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3893.4,63,,3114.72,,,0,"percent of total billed charges","63% of total billed charges",945.54,15.3,,756.43,,,0,"percent of total billed charges","15.3% of total billed charges",1038.24,16.8,,830.59,,,0,"percent of total billed charges","16.8% of total billed charges",4264.2,69,,,,,0,"fee schedule","69% of total billed charges",6180,100,,4944.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6180,100,,4944.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6180,100,,4944.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3822.33,61.85,,3057.86,,,0,"percent of total billed charges","61.5% of total billed charges",1038.24,16.8,,830.59,,,0,"percent of total billed charges","16.8% of total billed charges",3090,50,,2472.00,,,0,"percent of total billed charges","50% of total billed charges",1989.96,32.2,,1591.97,,,0,"percent of total billed charges","32.2% of total billed charges",1928.16,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1059,17.136,,847.20,,,0,"percent of total billed charges","17.136% of total billed charges",1349.71,21.84,,1079.77,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2329.86,37.7,,1863.89,,,0,"percent of total billed charges","37.7% of total billed charges",2329.86,37.7,,1863.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2095.02,33.9,,1676.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820.4,78,,3856.32,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5104.68,82.6,,4083.74,,,0,"percent of total billed charges","82.6% of total billed charges",1038.24,16.8,,830.59,,,0,"percent of total billed charges","16.8% of total billed charges",3090,50,,2472.00,,,0,"percent of total billed charges","50% of total billed charges",5104.68,82.6,,4083.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1038.24,16.8,,830.59,,,0,"percent of total billed charges","16.8% of total billed charges",6180,100,,4944.00,,,0,"percent of total billed charges","100% of total billed charges",945.54,6180,
"BOPCONNEKT WOUND MATRIX 1.5X1.5CM",636Q41611515,CDM,636,RC,,,OUTPATIENT,,,18746,12184.9,,16496.48,88,,13197.18,,,0,"percent of total billed charges","88% of total billed charges",9373,50,,7498.40,,,0,"percent of total billed charges","50% of total billed charges",3149.33,16.8,,2519.46,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3243.81,17.304,,2595.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11809.98,63,,9447.98,,,0,"percent of total billed charges","63% of total billed charges",2868.14,15.3,,2294.51,,,0,"percent of total billed charges","15.3% of total billed charges",3149.33,16.8,,2519.46,,,0,"percent of total billed charges","16.8% of total billed charges",12934.74,69,,,,,0,"fee schedule","69% of total billed charges",18746,100,,14996.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18746,100,,14996.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18746,100,,14996.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11594.4,61.85,,9275.52,,,0,"percent of total billed charges","61.5% of total billed charges",3149.33,16.8,,2519.46,,,0,"percent of total billed charges","16.8% of total billed charges",9373,50,,7498.40,,,0,"percent of total billed charges","50% of total billed charges",6036.21,32.2,,4828.97,,,0,"percent of total billed charges","32.2% of total billed charges",3149.33,16.8,,2519.46,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3212.31,17.136,,2569.85,,,0,"percent of total billed charges","17.136% of total billed charges",4094.13,21.84,,3275.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",7067.24,37.7,,5653.79,,,0,"percent of total billed charges","37.7% of total billed charges",7067.24,37.7,,5653.79,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",6354.89,33.9,,5083.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",14621.88,78,,11697.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3149.33,16.8,,2519.46,,,0,"percent of total billed charges","16.8% of total billed charges",9373,50,,7498.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3149.33,16.8,,2519.46,,,0,"percent of total billed charges","16.8% of total billed charges",18746,100,,14996.80,,,0,"percent of total billed charges","100% of total billed charges",2868.14,18746,
"COLLAGEN WOUND MATRIX 2X2CM",636Q416122,CDM,636,RC,,,OUTPATIENT,,,37492,24369.8,,32992.96,88,,26394.37,,,0,"percent of total billed charges","88% of total billed charges",18746,50,,14996.80,,,0,"percent of total billed charges","50% of total billed charges",6298.66,16.8,,5038.93,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6487.62,17.304,,5190.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",23619.96,63,,18895.97,,,0,"percent of total billed charges","63% of total billed charges",5736.28,15.3,,4589.02,,,0,"percent of total billed charges","15.3% of total billed charges",6298.66,16.8,,5038.93,,,0,"percent of total billed charges","16.8% of total billed charges",25869.48,69,,,,,0,"fee schedule","69% of total billed charges",37492,100,,29993.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37492,100,,29993.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37492,100,,29993.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23188.8,61.85,,18551.04,,,0,"percent of total billed charges","61.5% of total billed charges",6298.66,16.8,,5038.93,,,0,"percent of total billed charges","16.8% of total billed charges",18746,50,,14996.80,,,0,"percent of total billed charges","50% of total billed charges",12072.42,32.2,,9657.94,,,0,"percent of total billed charges","32.2% of total billed charges",6298.66,16.8,,5038.93,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6424.63,17.136,,5139.70,,,0,"percent of total billed charges","17.136% of total billed charges",8188.25,21.84,,6550.60,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",14134.48,37.7,,11307.58,,,0,"percent of total billed charges","37.7% of total billed charges",14134.48,37.7,,11307.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",12709.79,33.9,,10167.83,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",29243.76,78,,23395.01,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6298.66,16.8,,5038.93,,,0,"percent of total billed charges","16.8% of total billed charges",18746,50,,14996.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6298.66,16.8,,5038.93,,,0,"percent of total billed charges","16.8% of total billed charges",37492,100,,29993.60,,,0,"percent of total billed charges","100% of total billed charges",4695,37492,
BIOFILTER,ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"BIOGLUE SYRINGE 10ML",ORSUP0031,CDM,278,RC,,,OUTPATIENT,,,5356,3481.4,,4713.28,88,,3770.62,,,0,"percent of total billed charges","88% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",926.8,17.304,,741.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3374.28,63,,2699.42,,,0,"percent of total billed charges","63% of total billed charges",819.47,15.3,,655.58,,,0,"percent of total billed charges","15.3% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",3695.64,69,,,,,0,"fee schedule","69% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3312.69,61.85,,2650.15,,,0,"percent of total billed charges","61.5% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",1724.63,32.2,,1379.70,,,0,"percent of total billed charges","32.2% of total billed charges",1671.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",917.8,17.136,,734.24,,,0,"percent of total billed charges","17.136% of total billed charges",1169.75,21.84,,935.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.7% of total billed charges",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1815.68,33.9,,1452.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4177.68,78,,3342.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",819.47,5356,
"BIOGLUE SYRINGE 5ML",ORSUP0028,CDM,278,RC,,,OUTPATIENT,,,4553,2959.45,,4006.64,88,,3205.31,,,0,"percent of total billed charges","88% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",787.85,17.304,,630.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2868.39,63,,2294.71,,,0,"percent of total billed charges","63% of total billed charges",696.61,15.3,,557.29,,,0,"percent of total billed charges","15.3% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",3141.57,69,,,,,0,"fee schedule","69% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2816.03,61.85,,2252.82,,,0,"percent of total billed charges","61.5% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",1466.07,32.2,,1172.86,,,0,"percent of total billed charges","32.2% of total billed charges",1420.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",780.2,17.136,,624.16,,,0,"percent of total billed charges","17.136% of total billed charges",994.38,21.84,,795.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.7% of total billed charges",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1543.47,33.9,,1234.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3551.34,78,,2841.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",696.61,4553,
"BIOGEL GLOVS SZ 7",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"BIOHAZZARD LINER RED 24X24 13MIC ROLL",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BIOLOGICAL INDICATORS BIOSIGN",490109,CDM,270,RC,,,OUTPATIENT,,,767,498.55,,674.96,88,,539.97,,,0,"percent of total billed charges","88% of total billed charges",383.5,50,,306.80,,,0,"percent of total billed charges","50% of total billed charges",128.86,16.8,,103.09,,,0,"percent of total billed charges","16.8% of total billed charges",767,100,,613.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",132.72,17.304,,106.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",483.21,63,,386.57,,,0,"percent of total billed charges","63% of total billed charges",117.35,15.3,,93.88,,,0,"percent of total billed charges","15.3% of total billed charges",128.86,16.8,,103.09,,,0,"percent of total billed charges","16.8% of total billed charges",529.23,69,,,,,0,"fee schedule","69% of total billed charges",767,100,,613.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",767,100,,613.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",767,100,,613.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",474.39,61.85,,379.51,,,0,"percent of total billed charges","61.5% of total billed charges",128.86,16.8,,103.09,,,0,"percent of total billed charges","16.8% of total billed charges",383.5,50,,306.80,,,0,"percent of total billed charges","50% of total billed charges",246.97,32.2,,197.58,,,0,"percent of total billed charges","32.2% of total billed charges",128.86,16.8,,103.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",131.43,17.136,,105.14,,,0,"percent of total billed charges","17.136% of total billed charges",167.51,21.84,,134.01,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",289.16,37.7,,231.33,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",598.26,78,,478.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",633.54,82.6,,506.83,,,0,"percent of total billed charges","82.6% of total billed charges",128.86,16.8,,103.09,,,0,"percent of total billed charges","16.8% of total billed charges",383.5,50,,306.80,,,0,"percent of total billed charges","50% of total billed charges",633.54,82.6,,506.83,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.86,16.8,,103.09,,,0,"percent of total billed charges","16.8% of total billed charges",767,100,,613.60,,,0,"percent of total billed charges","100% of total billed charges",117.35,767,
"BIOLOGICAL GRAVITY ATTEST",490108,CDM,270,RC,,,OUTPATIENT,,,30,19.5,,26.4,88,,21.12,,,0,"percent of total billed charges","88% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.19,17.304,,4.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.9,63,,15.12,,,0,"percent of total billed charges","63% of total billed charges",4.59,15.3,,3.67,,,0,"percent of total billed charges","15.3% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",20.7,69,,,,,0,"fee schedule","69% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.56,61.85,,14.85,,,0,"percent of total billed charges","61.5% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",9.66,32.2,,7.73,,,0,"percent of total billed charges","32.2% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.14,17.136,,4.11,,,0,"percent of total billed charges","17.136% of total billed charges",6.55,21.84,,5.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.31,37.7,,9.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.4,78,,18.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",4.59,30,
"BIOLOGICAL STEAM ATTEST",490110,CDM,270,RC,,,OUTPATIENT,,,81,52.65,,71.28,88,,57.02,,,0,"percent of total billed charges","88% of total billed charges",40.5,50,,32.40,,,0,"percent of total billed charges","50% of total billed charges",13.61,16.8,,10.89,,,0,"percent of total billed charges","16.8% of total billed charges",81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.02,17.304,,11.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.03,63,,40.82,,,0,"percent of total billed charges","63% of total billed charges",12.39,15.3,,9.91,,,0,"percent of total billed charges","15.3% of total billed charges",13.61,16.8,,10.89,,,0,"percent of total billed charges","16.8% of total billed charges",55.89,69,,,,,0,"fee schedule","69% of total billed charges",81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.1,61.85,,40.08,,,0,"percent of total billed charges","61.5% of total billed charges",13.61,16.8,,10.89,,,0,"percent of total billed charges","16.8% of total billed charges",40.5,50,,32.40,,,0,"percent of total billed charges","50% of total billed charges",26.08,32.2,,20.86,,,0,"percent of total billed charges","32.2% of total billed charges",13.61,16.8,,10.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.88,17.136,,11.10,,,0,"percent of total billed charges","17.136% of total billed charges",17.69,21.84,,14.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.54,37.7,,24.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",63.18,78,,50.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",66.91,82.6,,53.53,,,0,"percent of total billed charges","82.6% of total billed charges",13.61,16.8,,10.89,,,0,"percent of total billed charges","16.8% of total billed charges",40.5,50,,32.40,,,0,"percent of total billed charges","50% of total billed charges",66.91,82.6,,53.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.61,16.8,,10.89,,,0,"percent of total billed charges","16.8% of total billed charges",81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",12.39,81,
"BIOMET ZIPTIGHT ANKLE FIXATOR",ORSUP0035,CDM,272,RC,,,OUTPATIENT,,,4820,3133,,4241.6,88,,3393.28,,,0,"percent of total billed charges","88% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",834.05,17.304,,667.24,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3036.6,63,,2429.28,,,0,"percent of total billed charges","63% of total billed charges",737.46,15.3,,589.97,,,0,"percent of total billed charges","15.3% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",3325.8,69,,,,,0,"fee schedule","69% of total billed charges",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2981.17,61.85,,2384.94,,,0,"percent of total billed charges","61.5% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",1552.04,32.2,,1241.63,,,0,"percent of total billed charges","32.2% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",825.96,17.136,,660.77,,,0,"percent of total billed charges","17.136% of total billed charges",1052.69,21.84,,842.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1817.14,37.7,,1453.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3759.6,78,,3007.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3981.32,82.6,,3185.06,,,0,"percent of total billed charges","82.6% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",3981.32,82.6,,3185.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",737.46,4820,
"BIOMET ACL LONG PINS",ORSUP0018,CDM,272,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"BIOMET JUGGERKNOT MINI 1.0MM",ORSUP0018,CDM,278,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",605.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.7% of total billed charges",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",658.34,33.9,,526.67,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"BIOMET JUGGERKNOT SOFT ANCHOR 1.4MM",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"BIOMET JUGGERKNOT SOFT ANCHOR 2.9MM",ORSUP0019,CDM,278,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",668.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.7% of total billed charges",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",726.14,33.9,,580.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"BIOMET TOGGLELOC W/ZIPLOOP #7",ORSUP0030,CDM,278,RC,,,OUTPATIENT,,,3914,2544.1,,3444.32,88,,2755.46,,,0,"percent of total billed charges","88% of total billed charges",1957,50,,1565.60,,,0,"percent of total billed charges","50% of total billed charges",657.55,16.8,,526.04,,,0,"percent of total billed charges","16.8% of total billed charges",3914,100,,3131.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",677.28,17.304,,541.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2465.82,63,,1972.66,,,0,"percent of total billed charges","63% of total billed charges",598.84,15.3,,479.07,,,0,"percent of total billed charges","15.3% of total billed charges",657.55,16.8,,526.04,,,0,"percent of total billed charges","16.8% of total billed charges",2700.66,69,,,,,0,"fee schedule","69% of total billed charges",3914,100,,3131.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3914,100,,3131.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3914,100,,3131.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2420.81,61.85,,1936.65,,,0,"percent of total billed charges","61.5% of total billed charges",657.55,16.8,,526.04,,,0,"percent of total billed charges","16.8% of total billed charges",1957,50,,1565.60,,,0,"percent of total billed charges","50% of total billed charges",1260.31,32.2,,1008.25,,,0,"percent of total billed charges","32.2% of total billed charges",1221.17,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",670.7,17.136,,536.56,,,0,"percent of total billed charges","17.136% of total billed charges",854.82,21.84,,683.86,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1475.58,37.7,,1180.46,,,0,"percent of total billed charges","37.7% of total billed charges",1475.58,37.7,,1180.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1326.85,33.9,,1061.48,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3052.92,78,,2442.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3232.96,82.6,,2586.37,,,0,"percent of total billed charges","82.6% of total billed charges",657.55,16.8,,526.04,,,0,"percent of total billed charges","16.8% of total billed charges",1957,50,,1565.60,,,0,"percent of total billed charges","50% of total billed charges",3232.96,82.6,,2586.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",657.55,16.8,,526.04,,,0,"percent of total billed charges","16.8% of total billed charges",3914,100,,3131.20,,,0,"percent of total billed charges","100% of total billed charges",598.84,3914,
"BIOMET BURR HOLE COVER",ORSUP0021,CDM,278,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",605.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.7% of total billed charges",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",658.34,33.9,,526.67,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"BIOPSY EXCISOR FISHER CONE",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"BIOPSY PUNCH DISPOSABLE ASSORTED SIZES",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BIOPSY PUNCH DISPOSABLE 4MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BIOPSY PUNCH DISPOSABLE 5MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BIOPSY PUNCH DISPOSABLE 8MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BIOPSY PUNCH DERMAL 4MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BIOPSY PUNCH ARGENT DERMAL 3.5MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BIOSWIVELLOCK 4.5 CLOSED EYE",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"BIPOLAR TUBE SET",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"BIRKETT GRASPER/DISSECTOR TIP",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"BIT 1.6MM DRILL",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"BIT DRILL 1.1MM",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,927,602.55,,815.76,88,,652.61,,,0,"percent of total billed charges","88% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.41,17.304,,128.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.01,63,,467.21,,,0,"percent of total billed charges","63% of total billed charges",141.83,15.3,,113.46,,,0,"percent of total billed charges","15.3% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",639.63,69,,,,,0,"fee schedule","69% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",573.35,61.85,,458.68,,,0,"percent of total billed charges","61.5% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",298.49,32.2,,238.79,,,0,"percent of total billed charges","32.2% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.85,17.136,,127.08,,,0,"percent of total billed charges","17.136% of total billed charges",202.46,21.84,,161.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",349.48,37.7,,279.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",723.06,78,,578.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",141.83,927,
"BIT DRILL 3.2MM  X 145MM  (QC)",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"BIT DRILL 3.2MM CANNULATED",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"BIT DRILL 90MMX1.8MM J LTCH",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"BIT DRILL CANNULATED STAINLESS STEEL 7MM DIA",ORSUP0026,CDM,272,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"BIT DRILL CANNULTD 2.0MM QUIC COUPLNG 150MM/20MM",ORSUP0024,CDM,272,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"BIT DRILL J LATCH STRYKER 1.5MM 75MM/50MM",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"BIT DRILL LG L300MM OD7.3MM QC",ORSUP0040,CDM,272,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"BIT DRILL QUICK COUPLE 310.67",ORSUP0030,CDM,272,RC,,,OUTPATIENT,,,5088,3307.2,,4477.44,88,,3581.95,,,0,"percent of total billed charges","88% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",880.43,17.304,,704.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3205.44,63,,2564.35,,,0,"percent of total billed charges","63% of total billed charges",778.46,15.3,,622.77,,,0,"percent of total billed charges","15.3% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",3510.72,69,,,,,0,"fee schedule","69% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3146.93,61.85,,2517.54,,,0,"percent of total billed charges","61.5% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",1638.34,32.2,,1310.67,,,0,"percent of total billed charges","32.2% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",871.88,17.136,,697.50,,,0,"percent of total billed charges","17.136% of total billed charges",1111.22,21.84,,888.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1918.18,37.7,,1534.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3968.64,78,,3174.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",778.46,5088,
"BIT DRILL QUICK COUPLING 2.5MM DIA 110/85MM L",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1185,770.25,,1042.8,88,,834.24,,,0,"percent of total billed charges","88% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",205.05,17.304,,164.04,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",746.55,63,,597.24,,,0,"percent of total billed charges","63% of total billed charges",181.31,15.3,,145.05,,,0,"percent of total billed charges","15.3% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",817.65,69,,,,,0,"fee schedule","69% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.92,61.85,,586.34,,,0,"percent of total billed charges","61.5% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",381.57,32.2,,305.26,,,0,"percent of total billed charges","32.2% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",203.06,17.136,,162.45,,,0,"percent of total billed charges","17.136% of total billed charges",258.8,21.84,,207.04,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",446.75,37.7,,357.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",924.3,78,,739.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",181.31,1185,
"BIT DRILL QUICK COUPLING 2.7MM DIA 125/100MM L",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BIT DRILL QUICK COUPLING 2.8MM DIA 165MM LENGTH",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"BIT DRILL QUICK COUPLING 3.5MM DIA 110/85MM L N/S",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"BIT DRILL QUICK COUPLING 4.5MM D 145/120MM L N/S",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"BIT DRILL THREE FLUTED 4.0MM DIA 195MM/170MM L",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BIT DRILL THREE FLUTED CALIBRATED 4.0MM 260/65MM",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"BIT DRILL 0.76MM W/STOP 10MM",ORSUP0018,CDM,272,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"BITE BLOCKS",308822,CDM,270,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.95,61.85,,3.96,,,0,"percent of total billed charges","61.5% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"BITE BLOCK DENTAL PROP LARGE ADULT",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,927,602.55,,815.76,88,,652.61,,,0,"percent of total billed charges","88% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.41,17.304,,128.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.01,63,,467.21,,,0,"percent of total billed charges","63% of total billed charges",141.83,15.3,,113.46,,,0,"percent of total billed charges","15.3% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",639.63,69,,,,,0,"fee schedule","69% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",573.35,61.85,,458.68,,,0,"percent of total billed charges","61.5% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",298.49,32.2,,238.79,,,0,"percent of total billed charges","32.2% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.85,17.136,,127.08,,,0,"percent of total billed charges","17.136% of total billed charges",202.46,21.84,,161.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",349.48,37.7,,279.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",723.06,78,,578.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",141.83,927,
"BLACK CAN LINER .90 MIL 24X32 500/CS",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"BLADE 120MM HELICAL",ORSUP0024,CDM,278,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",1086.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.7% of total billed charges",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1180.06,33.9,,944.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"BLADE HELICAL 115MM",ORSUP0024,CDM,278,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",1086.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.7% of total billed charges",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1180.06,33.9,,944.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"BLADE HELICAL 11MM",ORSUP0022,CDM,278,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",919.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.7% of total billed charges",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",998.69,33.9,,798.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"BLADE MICRO ST STRYKER",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"BLADE SAW 31.0X9.0",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"BLADE MED BONE MILL 5.0MM",ORSUP0023,CDM,272,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"BLADE 12 SURG STAINLESS STEEL",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"BLADE SAW SAGITTAL DUAL STR 25MM X 1.27MM X 90MM",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"BLADE AGGRESSIVE PLUS 5.0",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"BLADE 2296-033-526",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"BLADE SAW NEXBEN KNEE",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"BLADE SAW SAGITTAL DUAL STR 18MM X 1.27MM X 90MM",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"BLADE SAW 18.5X9",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"BLADE ARTHRO 4.5 SYNOVATOR",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"BLADE ARTHRO INCISER 3.5MM",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"BLADE BONECUTTER FULL RADIUS 4.5MM",ORSUP0018,CDM,272,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"BLADE INCISOR PLUS ELITE 4.5MM",ORSUP0025,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"BLADE RAD 40",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"BLADE SAW SHORT NARROW 15MM X 7MM",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"BLADE SHAVER  4.0MM SINUS W/IRRIGATION",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"BLADE TRI-CUT XPS 4.0MM  5/BX",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"BLADE SURGICAL CLIPPER 3M",54459,CDM,272,RC,,,OUTPATIENT,,,21,13.65,,18.48,88,,14.78,,,0,"percent of total billed charges","88% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.63,17.304,,2.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.23,63,,10.58,,,0,"percent of total billed charges","63% of total billed charges",3.21,15.3,,2.57,,,0,"percent of total billed charges","15.3% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",14.49,69,,,,,0,"fee schedule","69% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.99,61.85,,10.39,,,0,"percent of total billed charges","61.5% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",6.76,32.2,,5.41,,,0,"percent of total billed charges","32.2% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.6,17.136,,2.88,,,0,"percent of total billed charges","17.136% of total billed charges",4.59,21.84,,3.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.92,37.7,,6.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.38,78,,13.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",3.21,21,
"BLADE SURGICAL SIZE 11",148397,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"BLADE SURGICAL SZ 10 RIB-BACK CARBON STEEL",10182,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"BLADE BEAVER TYMPANOPLATSTY",32669,CDM,272,RC,,,OUTPATIENT,,,115,74.75,,101.2,88,,80.96,,,0,"percent of total billed charges","88% of total billed charges",57.5,50,,46.00,,,0,"percent of total billed charges","50% of total billed charges",19.32,16.8,,15.46,,,0,"percent of total billed charges","16.8% of total billed charges",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.9,17.304,,15.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",72.45,63,,57.96,,,0,"percent of total billed charges","63% of total billed charges",17.6,15.3,,14.08,,,0,"percent of total billed charges","15.3% of total billed charges",19.32,16.8,,15.46,,,0,"percent of total billed charges","16.8% of total billed charges",79.35,69,,,,,0,"fee schedule","69% of total billed charges",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.13,61.85,,56.90,,,0,"percent of total billed charges","61.5% of total billed charges",19.32,16.8,,15.46,,,0,"percent of total billed charges","16.8% of total billed charges",57.5,50,,46.00,,,0,"percent of total billed charges","50% of total billed charges",37.03,32.2,,29.62,,,0,"percent of total billed charges","32.2% of total billed charges",19.32,16.8,,15.46,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.71,17.136,,15.77,,,0,"percent of total billed charges","17.136% of total billed charges",25.12,21.84,,20.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.36,37.7,,34.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",89.7,78,,71.76,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",94.99,82.6,,75.99,,,0,"percent of total billed charges","82.6% of total billed charges",19.32,16.8,,15.46,,,0,"percent of total billed charges","16.8% of total billed charges",57.5,50,,46.00,,,0,"percent of total billed charges","50% of total billed charges",94.99,82.6,,75.99,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.32,16.8,,15.46,,,0,"percent of total billed charges","16.8% of total billed charges",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",17.6,115,
"BLADE BEAVER 6400",120153,CDM,272,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"BLADDER COMPRESSION",ORSUP0013,CDM,270,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"BLADE LARYN BRITEPRO SOLO MAC 4 DISP F/O 10/BX",424997,CDM,272,RC,,,OUTPATIENT,,,101,65.65,,88.88,88,,71.10,,,0,"percent of total billed charges","88% of total billed charges",50.5,50,,40.40,,,0,"percent of total billed charges","50% of total billed charges",16.97,16.8,,13.58,,,0,"percent of total billed charges","16.8% of total billed charges",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.48,17.304,,13.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.63,63,,50.90,,,0,"percent of total billed charges","63% of total billed charges",15.45,15.3,,12.36,,,0,"percent of total billed charges","15.3% of total billed charges",16.97,16.8,,13.58,,,0,"percent of total billed charges","16.8% of total billed charges",69.69,69,,,,,0,"fee schedule","69% of total billed charges",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,61.85,,49.98,,,0,"percent of total billed charges","61.5% of total billed charges",16.97,16.8,,13.58,,,0,"percent of total billed charges","16.8% of total billed charges",50.5,50,,40.40,,,0,"percent of total billed charges","50% of total billed charges",32.52,32.2,,26.02,,,0,"percent of total billed charges","32.2% of total billed charges",16.97,16.8,,13.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.31,17.136,,13.85,,,0,"percent of total billed charges","17.136% of total billed charges",22.06,21.84,,17.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.08,37.7,,30.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",78.78,78,,63.02,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",83.43,82.6,,66.74,,,0,"percent of total billed charges","82.6% of total billed charges",16.97,16.8,,13.58,,,0,"percent of total billed charges","16.8% of total billed charges",50.5,50,,40.40,,,0,"percent of total billed charges","50% of total billed charges",83.43,82.6,,66.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.97,16.8,,13.58,,,0,"percent of total billed charges","16.8% of total billed charges",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",15.45,101,
"BLADE LARYN MAC SZ 3",461575,CDM,272,RC,,,OUTPATIENT,,,392,254.8,,344.96,88,,275.97,,,0,"percent of total billed charges","88% of total billed charges",196,50,,156.80,,,0,"percent of total billed charges","50% of total billed charges",65.86,16.8,,52.69,,,0,"percent of total billed charges","16.8% of total billed charges",392,100,,313.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.83,17.304,,54.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",246.96,63,,197.57,,,0,"percent of total billed charges","63% of total billed charges",59.98,15.3,,47.98,,,0,"percent of total billed charges","15.3% of total billed charges",65.86,16.8,,52.69,,,0,"percent of total billed charges","16.8% of total billed charges",270.48,69,,,,,0,"fee schedule","69% of total billed charges",392,100,,313.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",392,100,,313.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",392,100,,313.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",242.45,61.85,,193.96,,,0,"percent of total billed charges","61.5% of total billed charges",65.86,16.8,,52.69,,,0,"percent of total billed charges","16.8% of total billed charges",196,50,,156.80,,,0,"percent of total billed charges","50% of total billed charges",126.22,32.2,,100.98,,,0,"percent of total billed charges","32.2% of total billed charges",65.86,16.8,,52.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.17,17.136,,53.74,,,0,"percent of total billed charges","17.136% of total billed charges",85.61,21.84,,68.49,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",147.78,37.7,,118.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",305.76,78,,244.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",323.79,82.6,,259.03,,,0,"percent of total billed charges","82.6% of total billed charges",65.86,16.8,,52.69,,,0,"percent of total billed charges","16.8% of total billed charges",196,50,,156.80,,,0,"percent of total billed charges","50% of total billed charges",323.79,82.6,,259.03,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",65.86,16.8,,52.69,,,0,"percent of total billed charges","16.8% of total billed charges",392,100,,313.60,,,0,"percent of total billed charges","100% of total billed charges",59.98,392,
"BLADE LARYNG DISP BRITE PRO FIBER OPTIC  MILLER 2",440193,CDM,272,RC,,,OUTPATIENT,,,392,254.8,,344.96,88,,275.97,,,0,"percent of total billed charges","88% of total billed charges",196,50,,156.80,,,0,"percent of total billed charges","50% of total billed charges",65.86,16.8,,52.69,,,0,"percent of total billed charges","16.8% of total billed charges",392,100,,313.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.83,17.304,,54.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",246.96,63,,197.57,,,0,"percent of total billed charges","63% of total billed charges",59.98,15.3,,47.98,,,0,"percent of total billed charges","15.3% of total billed charges",65.86,16.8,,52.69,,,0,"percent of total billed charges","16.8% of total billed charges",270.48,69,,,,,0,"fee schedule","69% of total billed charges",392,100,,313.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",392,100,,313.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",392,100,,313.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",242.45,61.85,,193.96,,,0,"percent of total billed charges","61.5% of total billed charges",65.86,16.8,,52.69,,,0,"percent of total billed charges","16.8% of total billed charges",196,50,,156.80,,,0,"percent of total billed charges","50% of total billed charges",126.22,32.2,,100.98,,,0,"percent of total billed charges","32.2% of total billed charges",65.86,16.8,,52.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.17,17.136,,53.74,,,0,"percent of total billed charges","17.136% of total billed charges",85.61,21.84,,68.49,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",147.78,37.7,,118.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",305.76,78,,244.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",323.79,82.6,,259.03,,,0,"percent of total billed charges","82.6% of total billed charges",65.86,16.8,,52.69,,,0,"percent of total billed charges","16.8% of total billed charges",196,50,,156.80,,,0,"percent of total billed charges","50% of total billed charges",323.79,82.6,,259.03,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",65.86,16.8,,52.69,,,0,"percent of total billed charges","16.8% of total billed charges",392,100,,313.60,,,0,"percent of total billed charges","100% of total billed charges",59.98,392,
"BLADE LARYNG DISP BRITE PRO FIBER OPTIC MAC  2",440195,CDM,272,RC,,,OUTPATIENT,,,344,223.6,,302.72,88,,242.18,,,0,"percent of total billed charges","88% of total billed charges",172,50,,137.60,,,0,"percent of total billed charges","50% of total billed charges",57.79,16.8,,46.23,,,0,"percent of total billed charges","16.8% of total billed charges",344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.53,17.304,,47.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",216.72,63,,173.38,,,0,"percent of total billed charges","63% of total billed charges",52.63,15.3,,42.10,,,0,"percent of total billed charges","15.3% of total billed charges",57.79,16.8,,46.23,,,0,"percent of total billed charges","16.8% of total billed charges",237.36,69,,,,,0,"fee schedule","69% of total billed charges",344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",212.76,61.85,,170.21,,,0,"percent of total billed charges","61.5% of total billed charges",57.79,16.8,,46.23,,,0,"percent of total billed charges","16.8% of total billed charges",172,50,,137.60,,,0,"percent of total billed charges","50% of total billed charges",110.77,32.2,,88.62,,,0,"percent of total billed charges","32.2% of total billed charges",57.79,16.8,,46.23,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.95,17.136,,47.16,,,0,"percent of total billed charges","17.136% of total billed charges",75.13,21.84,,60.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",129.69,37.7,,103.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",268.32,78,,214.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",284.14,82.6,,227.31,,,0,"percent of total billed charges","82.6% of total billed charges",57.79,16.8,,46.23,,,0,"percent of total billed charges","16.8% of total billed charges",172,50,,137.60,,,0,"percent of total billed charges","50% of total billed charges",284.14,82.6,,227.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.79,16.8,,46.23,,,0,"percent of total billed charges","16.8% of total billed charges",344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",52.63,344,
"BLADE OPTIC MILLER SIZE 3",442567,CDM,272,RC,,,OUTPATIENT,,,392,254.8,,344.96,88,,275.97,,,0,"percent of total billed charges","88% of total billed charges",196,50,,156.80,,,0,"percent of total billed charges","50% of total billed charges",65.86,16.8,,52.69,,,0,"percent of total billed charges","16.8% of total billed charges",392,100,,313.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.83,17.304,,54.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",246.96,63,,197.57,,,0,"percent of total billed charges","63% of total billed charges",59.98,15.3,,47.98,,,0,"percent of total billed charges","15.3% of total billed charges",65.86,16.8,,52.69,,,0,"percent of total billed charges","16.8% of total billed charges",270.48,69,,,,,0,"fee schedule","69% of total billed charges",392,100,,313.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",392,100,,313.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",392,100,,313.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",242.45,61.85,,193.96,,,0,"percent of total billed charges","61.5% of total billed charges",65.86,16.8,,52.69,,,0,"percent of total billed charges","16.8% of total billed charges",196,50,,156.80,,,0,"percent of total billed charges","50% of total billed charges",126.22,32.2,,100.98,,,0,"percent of total billed charges","32.2% of total billed charges",65.86,16.8,,52.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.17,17.136,,53.74,,,0,"percent of total billed charges","17.136% of total billed charges",85.61,21.84,,68.49,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",147.78,37.7,,118.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",305.76,78,,244.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",323.79,82.6,,259.03,,,0,"percent of total billed charges","82.6% of total billed charges",65.86,16.8,,52.69,,,0,"percent of total billed charges","16.8% of total billed charges",196,50,,156.80,,,0,"percent of total billed charges","50% of total billed charges",323.79,82.6,,259.03,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",65.86,16.8,,52.69,,,0,"percent of total billed charges","16.8% of total billed charges",392,100,,313.60,,,0,"percent of total billed charges","100% of total billed charges",59.98,392,
"BLADE, LARYN, BRITEPRO SOLO , MAC 3, DISP, F/O 10/BX",420521,CDM,272,RC,,,OUTPATIENT,,,101,65.65,,88.88,88,,71.10,,,0,"percent of total billed charges","88% of total billed charges",50.5,50,,40.40,,,0,"percent of total billed charges","50% of total billed charges",16.97,16.8,,13.58,,,0,"percent of total billed charges","16.8% of total billed charges",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.48,17.304,,13.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.63,63,,50.90,,,0,"percent of total billed charges","63% of total billed charges",15.45,15.3,,12.36,,,0,"percent of total billed charges","15.3% of total billed charges",16.97,16.8,,13.58,,,0,"percent of total billed charges","16.8% of total billed charges",69.69,69,,,,,0,"fee schedule","69% of total billed charges",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,61.85,,49.98,,,0,"percent of total billed charges","61.5% of total billed charges",16.97,16.8,,13.58,,,0,"percent of total billed charges","16.8% of total billed charges",50.5,50,,40.40,,,0,"percent of total billed charges","50% of total billed charges",32.52,32.2,,26.02,,,0,"percent of total billed charges","32.2% of total billed charges",16.97,16.8,,13.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.31,17.136,,13.85,,,0,"percent of total billed charges","17.136% of total billed charges",22.06,21.84,,17.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.08,37.7,,30.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",78.78,78,,63.02,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",83.43,82.6,,66.74,,,0,"percent of total billed charges","82.6% of total billed charges",16.97,16.8,,13.58,,,0,"percent of total billed charges","16.8% of total billed charges",50.5,50,,40.40,,,0,"percent of total billed charges","50% of total billed charges",83.43,82.6,,66.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.97,16.8,,13.58,,,0,"percent of total billed charges","16.8% of total billed charges",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",15.45,101,
"BLADE DERMATOME 252 PADGETT",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"BLADDER SLING LYNX",ORSUP0051,CDM,278,RC,,,OUTPATIENT,,,10712,6962.8,,9426.56,88,,7541.25,,,0,"percent of total billed charges","88% of total billed charges",5356,50,,4284.80,,,0,"percent of total billed charges","50% of total billed charges",1799.62,16.8,,1439.70,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1853.6,17.304,,1482.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6748.56,63,,5398.85,,,0,"percent of total billed charges","63% of total billed charges",1638.94,15.3,,1311.15,,,0,"percent of total billed charges","15.3% of total billed charges",1799.62,16.8,,1439.70,,,0,"percent of total billed charges","16.8% of total billed charges",7391.28,69,,,,,0,"fee schedule","69% of total billed charges",10712,100,,8569.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10712,100,,8569.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10712,100,,8569.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6625.37,61.85,,5300.30,,,0,"percent of total billed charges","61.5% of total billed charges",1799.62,16.8,,1439.70,,,0,"percent of total billed charges","16.8% of total billed charges",5356,50,,4284.80,,,0,"percent of total billed charges","50% of total billed charges",3449.26,32.2,,2759.41,,,0,"percent of total billed charges","32.2% of total billed charges",3342.14,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1835.61,17.136,,1468.49,,,0,"percent of total billed charges","17.136% of total billed charges",2339.5,21.84,,1871.60,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4038.42,37.7,,3230.74,,,0,"percent of total billed charges","37.7% of total billed charges",4038.42,37.7,,3230.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3631.37,33.9,,2905.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",8355.36,78,,6684.29,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8848.11,82.6,,7078.49,,,0,"percent of total billed charges","82.6% of total billed charges",1799.62,16.8,,1439.70,,,0,"percent of total billed charges","16.8% of total billed charges",5356,50,,4284.80,,,0,"percent of total billed charges","50% of total billed charges",8848.11,82.6,,7078.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1799.62,16.8,,1439.70,,,0,"percent of total billed charges","16.8% of total billed charges",10712,100,,8569.60,,,0,"percent of total billed charges","100% of total billed charges",1638.94,10712,
"BLADE SAGITTAL 18 X 1.27 X 100",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"BLADE SHAVER AGGRESSIVE ENT",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BLADE #15 SURGICAL SAFETY",490128,CDM,272,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"BLADE #11 SURGICAL SAFETY",490127,CDM,272,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"BLADE #10 SURGICAL SAFETY",490126,CDM,272,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"BLADE #20 SURGICAL SAFETY",490129,CDM,272,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"BLADE SAW 2296-33-125",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"BLADE SAW CRESCENTIC 38MM",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BLADE SAW CRESCENTIC 51MM",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BLADE SAGITTAL 6113-127-090",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"BLADE SAGITTAL 31MM X 9.0MM",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,17.304,,49.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.28,61.85,,178.62,,,0,"percent of total billed charges","61.5% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",116.24,32.2,,92.99,,,0,"percent of total billed charges","32.2% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.86,17.136,,49.49,,,0,"percent of total billed charges","17.136% of total billed charges",78.84,21.84,,63.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,361,
"BLADE SAGITTAL 25MM X 5.5MM",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,17.304,,49.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.28,61.85,,178.62,,,0,"percent of total billed charges","61.5% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",116.24,32.2,,92.99,,,0,"percent of total billed charges","32.2% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.86,17.136,,49.49,,,0,"percent of total billed charges","17.136% of total billed charges",78.84,21.84,,63.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,361,
"BLADE SAGITTAL 18MM X 5.5MM",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"BLADE SAGITTAL 18.5MM X 9.0MM",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,17.304,,49.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.28,61.85,,178.62,,,0,"percent of total billed charges","61.5% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",116.24,32.2,,92.99,,,0,"percent of total billed charges","32.2% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.86,17.136,,49.49,,,0,"percent of total billed charges","17.136% of total billed charges",78.84,21.84,,63.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,361,
"BLADE MYRINGOTOMY",490135,CDM,272,RC,,,OUTPATIENT,,,43,27.95,,37.84,88,,30.27,,,0,"percent of total billed charges","88% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.44,17.304,,5.95,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.09,63,,21.67,,,0,"percent of total billed charges","63% of total billed charges",6.58,15.3,,5.26,,,0,"percent of total billed charges","15.3% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",29.67,69,,,,,0,"fee schedule","69% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.6,61.85,,21.28,,,0,"percent of total billed charges","61.5% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",13.85,32.2,,11.08,,,0,"percent of total billed charges","32.2% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.37,17.136,,5.90,,,0,"percent of total billed charges","17.136% of total billed charges",9.39,21.84,,7.51,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.21,37.7,,12.97,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",33.54,78,,26.83,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.52,82.6,,28.42,,,0,"percent of total billed charges","82.6% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",35.52,82.6,,28.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",6.58,43,
"BLADE MAXI L124",490134,CDM,272,RC,,,OUTPATIENT,,,571,371.15,,502.48,88,,401.98,,,0,"percent of total billed charges","88% of total billed charges",285.5,50,,228.40,,,0,"percent of total billed charges","50% of total billed charges",95.93,16.8,,76.74,,,0,"percent of total billed charges","16.8% of total billed charges",571,100,,456.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.81,17.304,,79.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.73,63,,287.78,,,0,"percent of total billed charges","63% of total billed charges",87.36,15.3,,69.89,,,0,"percent of total billed charges","15.3% of total billed charges",95.93,16.8,,76.74,,,0,"percent of total billed charges","16.8% of total billed charges",393.99,69,,,,,0,"fee schedule","69% of total billed charges",571,100,,456.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",571,100,,456.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",571,100,,456.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.16,61.85,,282.53,,,0,"percent of total billed charges","61.5% of total billed charges",95.93,16.8,,76.74,,,0,"percent of total billed charges","16.8% of total billed charges",285.5,50,,228.40,,,0,"percent of total billed charges","50% of total billed charges",183.86,32.2,,147.09,,,0,"percent of total billed charges","32.2% of total billed charges",95.93,16.8,,76.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.85,17.136,,78.28,,,0,"percent of total billed charges","17.136% of total billed charges",124.71,21.84,,99.77,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",215.27,37.7,,172.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",445.38,78,,356.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",471.65,82.6,,377.32,,,0,"percent of total billed charges","82.6% of total billed charges",95.93,16.8,,76.74,,,0,"percent of total billed charges","16.8% of total billed charges",285.5,50,,228.40,,,0,"percent of total billed charges","50% of total billed charges",471.65,82.6,,377.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.93,16.8,,76.74,,,0,"percent of total billed charges","16.8% of total billed charges",571,100,,456.80,,,0,"percent of total billed charges","100% of total billed charges",87.36,571,
"BLADDER SLING OBTRYX II",ORSUP0049,CDM,278,RC,,,OUTPATIENT,,,10176,6614.4,,8954.88,88,,7163.90,,,0,"percent of total billed charges","88% of total billed charges",5088,50,,4070.40,,,0,"percent of total billed charges","50% of total billed charges",1709.57,16.8,,1367.66,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1760.86,17.304,,1408.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6410.88,63,,5128.70,,,0,"percent of total billed charges","63% of total billed charges",1556.93,15.3,,1245.54,,,0,"percent of total billed charges","15.3% of total billed charges",1709.57,16.8,,1367.66,,,0,"percent of total billed charges","16.8% of total billed charges",7021.44,69,,,,,0,"fee schedule","69% of total billed charges",10176,100,,8140.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10176,100,,8140.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10176,100,,8140.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6293.86,61.85,,5035.09,,,0,"percent of total billed charges","61.5% of total billed charges",1709.57,16.8,,1367.66,,,0,"percent of total billed charges","16.8% of total billed charges",5088,50,,4070.40,,,0,"percent of total billed charges","50% of total billed charges",3276.67,32.2,,2621.34,,,0,"percent of total billed charges","32.2% of total billed charges",3174.91,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1743.76,17.136,,1395.01,,,0,"percent of total billed charges","17.136% of total billed charges",2222.44,21.84,,1777.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3836.35,37.7,,3069.08,,,0,"percent of total billed charges","37.7% of total billed charges",3836.35,37.7,,3069.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3449.66,33.9,,2759.73,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7937.28,78,,6349.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8405.38,82.6,,6724.30,,,0,"percent of total billed charges","82.6% of total billed charges",1709.57,16.8,,1367.66,,,0,"percent of total billed charges","16.8% of total billed charges",5088,50,,4070.40,,,0,"percent of total billed charges","50% of total billed charges",8405.38,82.6,,6724.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1709.57,16.8,,1367.66,,,0,"percent of total billed charges","16.8% of total billed charges",10176,100,,8140.80,,,0,"percent of total billed charges","100% of total billed charges",1556.93,10176,
"BLADE BEAVER 9081",490132,CDM,272,RC,,,OUTPATIENT,,,124,80.6,,109.12,88,,87.30,,,0,"percent of total billed charges","88% of total billed charges",62,50,,49.60,,,0,"percent of total billed charges","50% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.46,17.304,,17.17,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.12,63,,62.50,,,0,"percent of total billed charges","63% of total billed charges",18.97,15.3,,15.18,,,0,"percent of total billed charges","15.3% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",85.56,69,,,,,0,"fee schedule","69% of total billed charges",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.69,61.85,,61.35,,,0,"percent of total billed charges","61.5% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",62,50,,49.60,,,0,"percent of total billed charges","50% of total billed charges",39.93,32.2,,31.94,,,0,"percent of total billed charges","32.2% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.25,17.136,,17.00,,,0,"percent of total billed charges","17.136% of total billed charges",27.08,21.84,,21.66,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.75,37.7,,37.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",96.72,78,,77.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",102.42,82.6,,81.94,,,0,"percent of total billed charges","82.6% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",62,50,,49.60,,,0,"percent of total billed charges","50% of total billed charges",102.42,82.6,,81.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",18.97,124,
"BLADE BEAVER 6700",490131,CDM,272,RC,,,OUTPATIENT,,,42,27.3,,36.96,88,,29.57,,,0,"percent of total billed charges","88% of total billed charges",21,50,,16.80,,,0,"percent of total billed charges","50% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.27,17.304,,5.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.46,63,,21.17,,,0,"percent of total billed charges","63% of total billed charges",6.43,15.3,,5.14,,,0,"percent of total billed charges","15.3% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",28.98,69,,,,,0,"fee schedule","69% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.98,61.85,,20.78,,,0,"percent of total billed charges","61.5% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",21,50,,16.80,,,0,"percent of total billed charges","50% of total billed charges",13.52,32.2,,10.82,,,0,"percent of total billed charges","32.2% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.2,17.136,,5.76,,,0,"percent of total billed charges","17.136% of total billed charges",9.17,21.84,,7.34,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",32.76,78,,26.21,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",21,50,,16.80,,,0,"percent of total billed charges","50% of total billed charges",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",6.43,42,
"BLADE BEAVER MINI 6600",490133,CDM,272,RC,,,OUTPATIENT,,,130,84.5,,114.4,88,,91.52,,,0,"percent of total billed charges","88% of total billed charges",65,50,,52.00,,,0,"percent of total billed charges","50% of total billed charges",21.84,16.8,,17.47,,,0,"percent of total billed charges","16.8% of total billed charges",130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.5,17.304,,18.00,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.9,63,,65.52,,,0,"percent of total billed charges","63% of total billed charges",19.89,15.3,,15.91,,,0,"percent of total billed charges","15.3% of total billed charges",21.84,16.8,,17.47,,,0,"percent of total billed charges","16.8% of total billed charges",89.7,69,,,,,0,"fee schedule","69% of total billed charges",130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.41,61.85,,64.33,,,0,"percent of total billed charges","61.5% of total billed charges",21.84,16.8,,17.47,,,0,"percent of total billed charges","16.8% of total billed charges",65,50,,52.00,,,0,"percent of total billed charges","50% of total billed charges",41.86,32.2,,33.49,,,0,"percent of total billed charges","32.2% of total billed charges",21.84,16.8,,17.47,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.28,17.136,,17.82,,,0,"percent of total billed charges","17.136% of total billed charges",28.39,21.84,,22.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",49.01,37.7,,39.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.4,78,,81.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",107.38,82.6,,85.90,,,0,"percent of total billed charges","82.6% of total billed charges",21.84,16.8,,17.47,,,0,"percent of total billed charges","16.8% of total billed charges",65,50,,52.00,,,0,"percent of total billed charges","50% of total billed charges",107.38,82.6,,85.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.84,16.8,,17.47,,,0,"percent of total billed charges","16.8% of total billed charges",130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",19.89,130,
"BLADE FULL RADIUS 2.5MM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"BLADE SAW 18X5.5MM DUAL CUT HAMMERTOE",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"BLADE PRECISION THIN LONG NARROW 25MM X 5.5MM",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"BLADE SAGITTAL 21MM X 90MM X 1.27MM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"BLAKE DRAIN 15 FR ROUND",ORSUP0003,CDM,270,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"BLANKET CARDIAC BAIR HUGGER",14176,CDM,272,RC,,,OUTPATIENT,,,249,161.85,,219.12,88,,175.30,,,0,"percent of total billed charges","88% of total billed charges",124.5,50,,99.60,,,0,"percent of total billed charges","50% of total billed charges",41.83,16.8,,33.46,,,0,"percent of total billed charges","16.8% of total billed charges",249,100,,199.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.09,17.304,,34.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.87,63,,125.50,,,0,"percent of total billed charges","63% of total billed charges",38.1,15.3,,30.48,,,0,"percent of total billed charges","15.3% of total billed charges",41.83,16.8,,33.46,,,0,"percent of total billed charges","16.8% of total billed charges",171.81,69,,,,,0,"fee schedule","69% of total billed charges",249,100,,199.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",249,100,,199.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",249,100,,199.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",154.01,61.85,,123.21,,,0,"percent of total billed charges","61.5% of total billed charges",41.83,16.8,,33.46,,,0,"percent of total billed charges","16.8% of total billed charges",124.5,50,,99.60,,,0,"percent of total billed charges","50% of total billed charges",80.18,32.2,,64.14,,,0,"percent of total billed charges","32.2% of total billed charges",41.83,16.8,,33.46,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.67,17.136,,34.14,,,0,"percent of total billed charges","17.136% of total billed charges",54.38,21.84,,43.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",93.87,37.7,,75.10,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",194.22,78,,155.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",205.67,82.6,,164.54,,,0,"percent of total billed charges","82.6% of total billed charges",41.83,16.8,,33.46,,,0,"percent of total billed charges","16.8% of total billed charges",124.5,50,,99.60,,,0,"percent of total billed charges","50% of total billed charges",205.67,82.6,,164.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.83,16.8,,33.46,,,0,"percent of total billed charges","16.8% of total billed charges",249,100,,199.20,,,0,"percent of total billed charges","100% of total billed charges",38.1,249,
"BLANKET WARMING FULL BODY",11956,CDM,272,RC,,,OUTPATIENT,,,40,26,,35.2,88,,28.16,,,0,"percent of total billed charges","88% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.92,17.304,,5.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.2,63,,20.16,,,0,"percent of total billed charges","63% of total billed charges",6.12,15.3,,4.90,,,0,"percent of total billed charges","15.3% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",27.6,69,,,,,0,"fee schedule","69% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.74,61.85,,19.79,,,0,"percent of total billed charges","61.5% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",12.88,32.2,,10.30,,,0,"percent of total billed charges","32.2% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.85,17.136,,5.48,,,0,"percent of total billed charges","17.136% of total billed charges",8.74,21.84,,6.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.08,37.7,,12.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",31.2,78,,24.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",6.12,40,
"BLANKET WARMING UNDERBODY CARDIAC 188X91 CM",258716,CDM,272,RC,,,OUTPATIENT,,,220,143,,193.6,88,,154.88,,,0,"percent of total billed charges","88% of total billed charges",110,50,,88.00,,,0,"percent of total billed charges","50% of total billed charges",36.96,16.8,,29.57,,,0,"percent of total billed charges","16.8% of total billed charges",220,100,,176.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.07,17.304,,30.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.6,63,,110.88,,,0,"percent of total billed charges","63% of total billed charges",33.66,15.3,,26.93,,,0,"percent of total billed charges","15.3% of total billed charges",36.96,16.8,,29.57,,,0,"percent of total billed charges","16.8% of total billed charges",151.8,69,,,,,0,"fee schedule","69% of total billed charges",220,100,,176.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",220,100,,176.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",220,100,,176.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.07,61.85,,108.86,,,0,"percent of total billed charges","61.5% of total billed charges",36.96,16.8,,29.57,,,0,"percent of total billed charges","16.8% of total billed charges",110,50,,88.00,,,0,"percent of total billed charges","50% of total billed charges",70.84,32.2,,56.67,,,0,"percent of total billed charges","32.2% of total billed charges",36.96,16.8,,29.57,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.7,17.136,,30.16,,,0,"percent of total billed charges","17.136% of total billed charges",48.05,21.84,,38.44,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",82.94,37.7,,66.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",171.6,78,,137.28,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.72,82.6,,145.38,,,0,"percent of total billed charges","82.6% of total billed charges",36.96,16.8,,29.57,,,0,"percent of total billed charges","16.8% of total billed charges",110,50,,88.00,,,0,"percent of total billed charges","50% of total billed charges",181.72,82.6,,145.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.96,16.8,,29.57,,,0,"percent of total billed charges","16.8% of total billed charges",220,100,,176.00,,,0,"percent of total billed charges","100% of total billed charges",33.66,220,
"BLANKET HYPOTHERMIA LG",10742,CDM,272,RC,,,OUTPATIENT,,,80,52,,70.4,88,,56.32,,,0,"percent of total billed charges","88% of total billed charges",40,50,,32.00,,,0,"percent of total billed charges","50% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.84,17.304,,11.07,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.4,63,,40.32,,,0,"percent of total billed charges","63% of total billed charges",12.24,15.3,,9.79,,,0,"percent of total billed charges","15.3% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",55.2,69,,,,,0,"fee schedule","69% of total billed charges",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.48,61.85,,39.58,,,0,"percent of total billed charges","61.5% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",40,50,,32.00,,,0,"percent of total billed charges","50% of total billed charges",25.76,32.2,,20.61,,,0,"percent of total billed charges","32.2% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.71,17.136,,10.97,,,0,"percent of total billed charges","17.136% of total billed charges",17.47,21.84,,13.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.16,37.7,,24.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",62.4,78,,49.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",66.08,82.6,,52.86,,,0,"percent of total billed charges","82.6% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",40,50,,32.00,,,0,"percent of total billed charges","50% of total billed charges",66.08,82.6,,52.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",12.24,80,
"BLANKET WARMING BODY LOWER SINGLE USE 58IN X 34IN",12094,CDM,272,RC,,,OUTPATIENT,,,58,37.7,,51.04,88,,40.83,,,0,"percent of total billed charges","88% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.04,17.304,,8.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.54,63,,29.23,,,0,"percent of total billed charges","63% of total billed charges",8.87,15.3,,7.10,,,0,"percent of total billed charges","15.3% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",40.02,69,,,,,0,"fee schedule","69% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.87,61.85,,28.70,,,0,"percent of total billed charges","61.5% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",18.68,32.2,,14.94,,,0,"percent of total billed charges","32.2% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.94,17.136,,7.95,,,0,"percent of total billed charges","17.136% of total billed charges",12.67,21.84,,10.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.87,37.7,,17.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",45.24,78,,36.19,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",8.87,58,
"BLANKET COVERLET BELLA  9 X 11",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BLANKET TORSO BAIR HUGGER",490158,CDM,272,RC,,,OUTPATIENT,,,43,27.95,,37.84,88,,30.27,,,0,"percent of total billed charges","88% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.44,17.304,,5.95,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.09,63,,21.67,,,0,"percent of total billed charges","63% of total billed charges",6.58,15.3,,5.26,,,0,"percent of total billed charges","15.3% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",29.67,69,,,,,0,"fee schedule","69% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.6,61.85,,21.28,,,0,"percent of total billed charges","61.5% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",13.85,32.2,,11.08,,,0,"percent of total billed charges","32.2% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.37,17.136,,5.90,,,0,"percent of total billed charges","17.136% of total billed charges",9.39,21.84,,7.51,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.21,37.7,,12.97,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",33.54,78,,26.83,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.52,82.6,,28.42,,,0,"percent of total billed charges","82.6% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",35.52,82.6,,28.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",6.58,43,
"BLANKET LITHOTOMY UNDERBODY",490155,CDM,272,RC,,,OUTPATIENT,,,1653,1074.45,,1454.64,88,,1163.71,,,0,"percent of total billed charges","88% of total billed charges",826.5,50,,661.20,,,0,"percent of total billed charges","50% of total billed charges",277.7,16.8,,222.16,,,0,"percent of total billed charges","16.8% of total billed charges",1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",286.04,17.304,,228.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1041.39,63,,833.11,,,0,"percent of total billed charges","63% of total billed charges",252.91,15.3,,202.33,,,0,"percent of total billed charges","15.3% of total billed charges",277.7,16.8,,222.16,,,0,"percent of total billed charges","16.8% of total billed charges",1140.57,69,,,,,0,"fee schedule","69% of total billed charges",1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1022.38,61.85,,817.90,,,0,"percent of total billed charges","61.5% of total billed charges",277.7,16.8,,222.16,,,0,"percent of total billed charges","16.8% of total billed charges",826.5,50,,661.20,,,0,"percent of total billed charges","50% of total billed charges",532.27,32.2,,425.82,,,0,"percent of total billed charges","32.2% of total billed charges",277.7,16.8,,222.16,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",283.26,17.136,,226.61,,,0,"percent of total billed charges","17.136% of total billed charges",361.02,21.84,,288.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",623.18,37.7,,498.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1289.34,78,,1031.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1365.38,82.6,,1092.30,,,0,"percent of total billed charges","82.6% of total billed charges",277.7,16.8,,222.16,,,0,"percent of total billed charges","16.8% of total billed charges",826.5,50,,661.20,,,0,"percent of total billed charges","50% of total billed charges",1365.38,82.6,,1092.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",277.7,16.8,,222.16,,,0,"percent of total billed charges","16.8% of total billed charges",1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",252.91,1653,
"BLANKET UNDERBODY ADULT",490159,CDM,272,RC,,,OUTPATIENT,,,141,91.65,,124.08,88,,99.26,,,0,"percent of total billed charges","88% of total billed charges",70.5,50,,56.40,,,0,"percent of total billed charges","50% of total billed charges",23.69,16.8,,18.95,,,0,"percent of total billed charges","16.8% of total billed charges",141,100,,112.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.4,17.304,,19.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.83,63,,71.06,,,0,"percent of total billed charges","63% of total billed charges",21.57,15.3,,17.26,,,0,"percent of total billed charges","15.3% of total billed charges",23.69,16.8,,18.95,,,0,"percent of total billed charges","16.8% of total billed charges",97.29,69,,,,,0,"fee schedule","69% of total billed charges",141,100,,112.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",141,100,,112.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",141,100,,112.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.21,61.85,,69.77,,,0,"percent of total billed charges","61.5% of total billed charges",23.69,16.8,,18.95,,,0,"percent of total billed charges","16.8% of total billed charges",70.5,50,,56.40,,,0,"percent of total billed charges","50% of total billed charges",45.4,32.2,,36.32,,,0,"percent of total billed charges","32.2% of total billed charges",23.69,16.8,,18.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.16,17.136,,19.33,,,0,"percent of total billed charges","17.136% of total billed charges",30.79,21.84,,24.63,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",53.16,37.7,,42.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",109.98,78,,87.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",116.47,82.6,,93.18,,,0,"percent of total billed charges","82.6% of total billed charges",23.69,16.8,,18.95,,,0,"percent of total billed charges","16.8% of total billed charges",70.5,50,,56.40,,,0,"percent of total billed charges","50% of total billed charges",116.47,82.6,,93.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.69,16.8,,18.95,,,0,"percent of total billed charges","16.8% of total billed charges",141,100,,112.80,,,0,"percent of total billed charges","100% of total billed charges",21.57,141,
"BLANKET SPINAL UNDERBODY",490157,CDM,272,RC,,,OUTPATIENT,,,210,136.5,,184.8,88,,147.84,,,0,"percent of total billed charges","88% of total billed charges",105,50,,84.00,,,0,"percent of total billed charges","50% of total billed charges",35.28,16.8,,28.22,,,0,"percent of total billed charges","16.8% of total billed charges",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.34,17.304,,29.07,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",132.3,63,,105.84,,,0,"percent of total billed charges","63% of total billed charges",32.13,15.3,,25.70,,,0,"percent of total billed charges","15.3% of total billed charges",35.28,16.8,,28.22,,,0,"percent of total billed charges","16.8% of total billed charges",144.9,69,,,,,0,"fee schedule","69% of total billed charges",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.89,61.85,,103.91,,,0,"percent of total billed charges","61.5% of total billed charges",35.28,16.8,,28.22,,,0,"percent of total billed charges","16.8% of total billed charges",105,50,,84.00,,,0,"percent of total billed charges","50% of total billed charges",67.62,32.2,,54.10,,,0,"percent of total billed charges","32.2% of total billed charges",35.28,16.8,,28.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.99,17.136,,28.79,,,0,"percent of total billed charges","17.136% of total billed charges",45.86,21.84,,36.69,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",79.17,37.7,,63.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",163.8,78,,131.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.46,82.6,,138.77,,,0,"percent of total billed charges","82.6% of total billed charges",35.28,16.8,,28.22,,,0,"percent of total billed charges","16.8% of total billed charges",105,50,,84.00,,,0,"percent of total billed charges","50% of total billed charges",173.46,82.6,,138.77,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.28,16.8,,28.22,,,0,"percent of total billed charges","16.8% of total billed charges",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",32.13,210,
"BLANKET UPPER BODY",490160,CDM,272,RC,,,OUTPATIENT,,,43,27.95,,37.84,88,,30.27,,,0,"percent of total billed charges","88% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.44,17.304,,5.95,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.09,63,,21.67,,,0,"percent of total billed charges","63% of total billed charges",6.58,15.3,,5.26,,,0,"percent of total billed charges","15.3% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",29.67,69,,,,,0,"fee schedule","69% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.6,61.85,,21.28,,,0,"percent of total billed charges","61.5% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",13.85,32.2,,11.08,,,0,"percent of total billed charges","32.2% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.37,17.136,,5.90,,,0,"percent of total billed charges","17.136% of total billed charges",9.39,21.84,,7.51,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.21,37.7,,12.97,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",33.54,78,,26.83,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.52,82.6,,28.42,,,0,"percent of total billed charges","82.6% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",35.52,82.6,,28.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",6.58,43,
"BLANKET MULTI-ACCESS",490156,CDM,272,RC,,,OUTPATIENT,,,37,24.05,,32.56,88,,26.05,,,0,"percent of total billed charges","88% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.4,17.304,,5.12,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.31,63,,18.65,,,0,"percent of total billed charges","63% of total billed charges",5.66,15.3,,4.53,,,0,"percent of total billed charges","15.3% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",25.53,69,,,,,0,"fee schedule","69% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.88,61.85,,18.30,,,0,"percent of total billed charges","61.5% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",11.91,32.2,,9.53,,,0,"percent of total billed charges","32.2% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.34,17.136,,5.07,,,0,"percent of total billed charges","17.136% of total billed charges",8.08,21.84,,6.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.95,37.7,,11.16,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.86,78,,23.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",5.66,37,
"BLANKET WARMING UPPER BODY",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BLEACH CLOROX GERMICIDAL 121 OZ",182952,CDM,270,RC,,,OUTPATIENT,,,33,21.45,,29.04,88,,23.23,,,0,"percent of total billed charges","88% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,17.304,,4.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.79,63,,16.63,,,0,"percent of total billed charges","63% of total billed charges",5.05,15.3,,4.04,,,0,"percent of total billed charges","15.3% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",22.77,69,,,,,0,"fee schedule","69% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.41,61.85,,16.33,,,0,"percent of total billed charges","61.5% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",10.63,32.2,,8.50,,,0,"percent of total billed charges","32.2% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.65,17.136,,4.52,,,0,"percent of total billed charges","17.136% of total billed charges",7.21,21.84,,5.77,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.44,37.7,,9.95,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25.74,78,,20.59,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",5.05,33,
"BLOCK ILIUM TRICORTICAL 16MM",ORSUP0028,CDM,278,RC,,,OUTPATIENT,,,4553,2959.45,,4006.64,88,,3205.31,,,0,"percent of total billed charges","88% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",787.85,17.304,,630.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2868.39,63,,2294.71,,,0,"percent of total billed charges","63% of total billed charges",696.61,15.3,,557.29,,,0,"percent of total billed charges","15.3% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",3141.57,69,,,,,0,"fee schedule","69% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2816.03,61.85,,2252.82,,,0,"percent of total billed charges","61.5% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",1466.07,32.2,,1172.86,,,0,"percent of total billed charges","32.2% of total billed charges",1420.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",780.2,17.136,,624.16,,,0,"percent of total billed charges","17.136% of total billed charges",994.38,21.84,,795.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.7% of total billed charges",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1543.47,33.9,,1234.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3551.34,78,,2841.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",696.61,4553,
"BLOCK BITE ENDOSCOPY W/ STRAP DISPOSABLE",184405,CDM,270,RC,,,OUTPATIENT,,,23,14.95,,20.24,88,,16.19,,,0,"percent of total billed charges","88% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.98,17.304,,3.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.49,63,,11.59,,,0,"percent of total billed charges","63% of total billed charges",3.52,15.3,,2.82,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",15.87,69,,,,,0,"fee schedule","69% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.23,61.85,,11.38,,,0,"percent of total billed charges","61.5% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",7.41,32.2,,5.93,,,0,"percent of total billed charges","32.2% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.94,17.136,,3.15,,,0,"percent of total billed charges","17.136% of total billed charges",5.02,21.84,,4.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.94,78,,14.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",3.52,23,
"BLOCK ECHO 80MM",ORSUP0017,CDM,270,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"BLOCKER XIA 3 TI",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"BLOODSTOP iX HEMOSTATIC 2 X 4",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"AGAR BLOOD SLANT WITH SHEEP BLOOD",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BLOX ENDOSCOPIC BITE BLOCK WITH ELASTIC STRAP 54FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BLUE FIBER CABLE KIT",ORSUP0068,CDM,272,RC,,,OUTPATIENT,,,13658,8877.7,,12019.04,88,,9615.23,,,0,"percent of total billed charges","88% of total billed charges",6829,50,,5463.20,,,0,"percent of total billed charges","50% of total billed charges",2294.54,16.8,,1835.63,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2363.38,17.304,,1890.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8604.54,63,,6883.63,,,0,"percent of total billed charges","63% of total billed charges",2089.67,15.3,,1671.74,,,0,"percent of total billed charges","15.3% of total billed charges",2294.54,16.8,,1835.63,,,0,"percent of total billed charges","16.8% of total billed charges",9424.02,69,,,,,0,"fee schedule","69% of total billed charges",13658,100,,10926.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13658,100,,10926.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13658,100,,10926.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8447.47,61.85,,6757.98,,,0,"percent of total billed charges","61.5% of total billed charges",2294.54,16.8,,1835.63,,,0,"percent of total billed charges","16.8% of total billed charges",6829,50,,5463.20,,,0,"percent of total billed charges","50% of total billed charges",4397.88,32.2,,3518.30,,,0,"percent of total billed charges","32.2% of total billed charges",2294.54,16.8,,1835.63,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2340.43,17.136,,1872.34,,,0,"percent of total billed charges","17.136% of total billed charges",2982.91,21.84,,2386.33,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5149.07,37.7,,4119.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10653.24,78,,8522.59,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11281.51,82.6,,9025.21,,,0,"percent of total billed charges","82.6% of total billed charges",2294.54,16.8,,1835.63,,,0,"percent of total billed charges","16.8% of total billed charges",6829,50,,5463.20,,,0,"percent of total billed charges","50% of total billed charges",11281.51,82.6,,9025.21,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2294.54,16.8,,1835.63,,,0,"percent of total billed charges","16.8% of total billed charges",13658,100,,10926.40,,,0,"percent of total billed charges","100% of total billed charges",2089.67,13658,
"BNDG ELASTIC 4 INCH",56101,CDM,270,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"BNP REAGENT KIT",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,72,46.8,,63.36,88,,50.69,,,0,"percent of total billed charges","88% of total billed charges",36,50,,28.80,,,0,"percent of total billed charges","50% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.46,17.304,,9.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.36,63,,36.29,,,0,"percent of total billed charges","63% of total billed charges",11.02,15.3,,8.82,,,0,"percent of total billed charges","15.3% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",49.68,69,,,,,0,"fee schedule","69% of total billed charges",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.53,61.85,,35.62,,,0,"percent of total billed charges","61.5% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",36,50,,28.80,,,0,"percent of total billed charges","50% of total billed charges",23.18,32.2,,18.54,,,0,"percent of total billed charges","32.2% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.34,17.136,,9.87,,,0,"percent of total billed charges","17.136% of total billed charges",15.72,21.84,,12.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",27.14,37.7,,21.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",56.16,78,,44.93,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.47,82.6,,47.58,,,0,"percent of total billed charges","82.6% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",36,50,,28.80,,,0,"percent of total billed charges","50% of total billed charges",59.47,82.6,,47.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",11.02,72,
"BNP CALIBRATOR",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,412,267.8,,362.56,88,,290.05,,,0,"percent of total billed charges","88% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.29,17.304,,57.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",259.56,63,,207.65,,,0,"percent of total billed charges","63% of total billed charges",63.04,15.3,,50.43,,,0,"percent of total billed charges","15.3% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",284.28,69,,,,,0,"fee schedule","69% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",254.82,61.85,,203.86,,,0,"percent of total billed charges","61.5% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",132.66,32.2,,106.13,,,0,"percent of total billed charges","32.2% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.6,17.136,,56.48,,,0,"percent of total billed charges","17.136% of total billed charges",89.98,21.84,,71.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",155.32,37.7,,124.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",321.36,78,,257.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",63.04,412,
"BODY WASH KINDEST KARE",202813,CDM,270,RC,,,OUTPATIENT,,,45,29.25,,39.6,88,,31.68,,,0,"percent of total billed charges","88% of total billed charges",22.5,50,,18.00,,,0,"percent of total billed charges","50% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.79,17.304,,6.23,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.35,63,,22.68,,,0,"percent of total billed charges","63% of total billed charges",6.89,15.3,,5.51,,,0,"percent of total billed charges","15.3% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",31.05,69,,,,,0,"fee schedule","69% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.83,61.85,,22.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",22.5,50,,18.00,,,0,"percent of total billed charges","50% of total billed charges",14.49,32.2,,11.59,,,0,"percent of total billed charges","32.2% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.71,17.136,,6.17,,,0,"percent of total billed charges","17.136% of total billed charges",9.83,21.84,,7.86,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.97,37.7,,13.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.1,78,,28.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",22.5,50,,18.00,,,0,"percent of total billed charges","50% of total billed charges",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",6.89,45,
"BOLT LOCKING 4.9MMX34MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BOLT LOCKING 4.9MMX42MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BONE CEMET K11402PHX HVR",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"BONE SYNTHETIC CHRONOS BETA-TCP STRIP 100MM X 25MM X 3MM-STERILE 07.801.101.99S",ORSUP0036,CDM,278,RC,,,OUTPATIENT,,,6695,4351.75,,5891.6,88,,4713.28,,,0,"percent of total billed charges","88% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1158.5,17.304,,926.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4217.85,63,,3374.28,,,0,"percent of total billed charges","63% of total billed charges",1024.34,15.3,,819.47,,,0,"percent of total billed charges","15.3% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",4619.55,69,,,,,0,"fee schedule","69% of total billed charges",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4140.86,61.85,,3312.69,,,0,"percent of total billed charges","61.5% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",2155.79,32.2,,1724.63,,,0,"percent of total billed charges","32.2% of total billed charges",2088.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1147.26,17.136,,917.81,,,0,"percent of total billed charges","17.136% of total billed charges",1462.19,21.84,,1169.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2524.02,37.7,,2019.22,,,0,"percent of total billed charges","37.7% of total billed charges",2524.02,37.7,,2019.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2269.61,33.9,,1815.69,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5222.1,78,,4177.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5530.07,82.6,,4424.06,,,0,"percent of total billed charges","82.6% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",5530.07,82.6,,4424.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",1024.34,6695,
"BONE COLLAGEN GRAFT MATRIX XL BLOCK LRG",ORSUP0037,CDM,278,RC,,,OUTPATIENT,,,6963,4525.95,,6127.44,88,,4901.95,,,0,"percent of total billed charges","88% of total billed charges",3481.5,50,,2785.20,,,0,"percent of total billed charges","50% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1204.88,17.304,,963.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4386.69,63,,3509.35,,,0,"percent of total billed charges","63% of total billed charges",1065.34,15.3,,852.27,,,0,"percent of total billed charges","15.3% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",4804.47,69,,,,,0,"fee schedule","69% of total billed charges",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4306.62,61.85,,3445.30,,,0,"percent of total billed charges","61.5% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",3481.5,50,,2785.20,,,0,"percent of total billed charges","50% of total billed charges",2242.09,32.2,,1793.67,,,0,"percent of total billed charges","32.2% of total billed charges",2172.46,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1193.18,17.136,,954.54,,,0,"percent of total billed charges","17.136% of total billed charges",1520.72,21.84,,1216.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2625.05,37.7,,2100.04,,,0,"percent of total billed charges","37.7% of total billed charges",2625.05,37.7,,2100.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2360.46,33.9,,1888.37,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5431.14,78,,4344.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5751.44,82.6,,4601.15,,,0,"percent of total billed charges","82.6% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",3481.5,50,,2785.20,,,0,"percent of total billed charges","50% of total billed charges",5751.44,82.6,,4601.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",1065.34,6963,
"BONE GRAFT SUBSTITUTE  SM DFCT DBM ORTHOBLEN",ORSUP0031,CDM,278,RC,,,OUTPATIENT,,,5356,3481.4,,4713.28,88,,3770.62,,,0,"percent of total billed charges","88% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",926.8,17.304,,741.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3374.28,63,,2699.42,,,0,"percent of total billed charges","63% of total billed charges",819.47,15.3,,655.58,,,0,"percent of total billed charges","15.3% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",3695.64,69,,,,,0,"fee schedule","69% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3312.69,61.85,,2650.15,,,0,"percent of total billed charges","61.5% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",1724.63,32.2,,1379.70,,,0,"percent of total billed charges","32.2% of total billed charges",1671.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",917.8,17.136,,734.24,,,0,"percent of total billed charges","17.136% of total billed charges",1169.75,21.84,,935.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.7% of total billed charges",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1815.68,33.9,,1452.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4177.68,78,,3342.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",819.47,5356,
"BONE SUB VITOSS STRIP 10CC",ORSUP0047,CDM,278,RC,,,OUTPATIENT,,,9641,6266.65,,8484.08,88,,6787.26,,,0,"percent of total billed charges","88% of total billed charges",4820.5,50,,3856.40,,,0,"percent of total billed charges","50% of total billed charges",1619.69,16.8,,1295.75,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1668.28,17.304,,1334.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6073.83,63,,4859.06,,,0,"percent of total billed charges","63% of total billed charges",1475.07,15.3,,1180.06,,,0,"percent of total billed charges","15.3% of total billed charges",1619.69,16.8,,1295.75,,,0,"percent of total billed charges","16.8% of total billed charges",6652.29,69,,,,,0,"fee schedule","69% of total billed charges",9641,100,,7712.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9641,100,,7712.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9641,100,,7712.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5962.96,61.85,,4770.37,,,0,"percent of total billed charges","61.5% of total billed charges",1619.69,16.8,,1295.75,,,0,"percent of total billed charges","16.8% of total billed charges",4820.5,50,,3856.40,,,0,"percent of total billed charges","50% of total billed charges",3104.4,32.2,,2483.52,,,0,"percent of total billed charges","32.2% of total billed charges",3007.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1652.08,17.136,,1321.66,,,0,"percent of total billed charges","17.136% of total billed charges",2105.59,21.84,,1684.47,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3634.66,37.7,,2907.73,,,0,"percent of total billed charges","37.7% of total billed charges",3634.66,37.7,,2907.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3268.3,33.9,,2614.64,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7519.98,78,,6015.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7963.47,82.6,,6370.78,,,0,"percent of total billed charges","82.6% of total billed charges",1619.69,16.8,,1295.75,,,0,"percent of total billed charges","16.8% of total billed charges",4820.5,50,,3856.40,,,0,"percent of total billed charges","50% of total billed charges",7963.47,82.6,,6370.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1619.69,16.8,,1295.75,,,0,"percent of total billed charges","16.8% of total billed charges",9641,100,,7712.80,,,0,"percent of total billed charges","100% of total billed charges",1475.07,9641,
"BONE BIOPSY 11 GUAGE 306-115",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"BONE BIOPSY 13 GUAGE 306-135",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"BONE BIOPSY KYPHYX",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"BONE TAMP KIT 20/3",ORSUP0092,CDM,272,RC,,,OUTPATIENT,,,19817,12881.05,,17438.96,88,,13951.17,,,0,"percent of total billed charges","88% of total billed charges",9908.5,50,,7926.80,,,0,"percent of total billed charges","50% of total billed charges",3329.26,16.8,,2663.41,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3429.13,17.304,,2743.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12484.71,63,,9987.77,,,0,"percent of total billed charges","63% of total billed charges",3032,15.3,,2425.60,,,0,"percent of total billed charges","15.3% of total billed charges",3329.26,16.8,,2663.41,,,0,"percent of total billed charges","16.8% of total billed charges",13673.73,69,,,,,0,"fee schedule","69% of total billed charges",19817,100,,15853.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19817,100,,15853.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19817,100,,15853.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12256.81,61.85,,9805.45,,,0,"percent of total billed charges","61.5% of total billed charges",3329.26,16.8,,2663.41,,,0,"percent of total billed charges","16.8% of total billed charges",9908.5,50,,7926.80,,,0,"percent of total billed charges","50% of total billed charges",6381.07,32.2,,5104.86,,,0,"percent of total billed charges","32.2% of total billed charges",3329.26,16.8,,2663.41,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3395.84,17.136,,2716.67,,,0,"percent of total billed charges","17.136% of total billed charges",4328.03,21.84,,3462.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7471.01,37.7,,5976.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15457.26,78,,12365.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16368.84,82.6,,13095.07,,,0,"percent of total billed charges","82.6% of total billed charges",3329.26,16.8,,2663.41,,,0,"percent of total billed charges","16.8% of total billed charges",9908.5,50,,7926.80,,,0,"percent of total billed charges","50% of total billed charges",16368.84,82.6,,13095.07,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3329.26,16.8,,2663.41,,,0,"percent of total billed charges","16.8% of total billed charges",19817,100,,15853.60,,,0,"percent of total billed charges","100% of total billed charges",3032,19817,
"BONE TAMP KIT 15/3 1 STEP",ORSUP0098,CDM,272,RC,,,OUTPATIENT,,,23834,15492.1,,20973.92,88,,16779.14,,,0,"percent of total billed charges","88% of total billed charges",11917,50,,9533.60,,,0,"percent of total billed charges","50% of total billed charges",4004.11,16.8,,3203.29,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4124.24,17.304,,3299.39,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15015.42,63,,12012.34,,,0,"percent of total billed charges","63% of total billed charges",3646.6,15.3,,2917.28,,,0,"percent of total billed charges","15.3% of total billed charges",4004.11,16.8,,3203.29,,,0,"percent of total billed charges","16.8% of total billed charges",16445.46,69,,,,,0,"fee schedule","69% of total billed charges",23834,100,,19067.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23834,100,,19067.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23834,100,,19067.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14741.33,61.85,,11793.06,,,0,"percent of total billed charges","61.5% of total billed charges",4004.11,16.8,,3203.29,,,0,"percent of total billed charges","16.8% of total billed charges",11917,50,,9533.60,,,0,"percent of total billed charges","50% of total billed charges",7674.55,32.2,,6139.64,,,0,"percent of total billed charges","32.2% of total billed charges",4004.11,16.8,,3203.29,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4084.19,17.136,,3267.35,,,0,"percent of total billed charges","17.136% of total billed charges",5205.35,21.84,,4164.28,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8985.42,37.7,,7188.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18590.52,78,,14872.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19686.88,82.6,,15749.50,,,0,"percent of total billed charges","82.6% of total billed charges",4004.11,16.8,,3203.29,,,0,"percent of total billed charges","16.8% of total billed charges",11917,50,,9533.60,,,0,"percent of total billed charges","50% of total billed charges",19686.88,82.6,,15749.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4004.11,16.8,,3203.29,,,0,"percent of total billed charges","16.8% of total billed charges",23834,100,,19067.20,,,0,"percent of total billed charges","100% of total billed charges",3646.6,23834,
"BONE TAMP KIT 15/3",ORSUP0105,CDM,272,RC,,,OUTPATIENT,,,19817,12881.05,,17438.96,88,,13951.17,,,0,"percent of total billed charges","88% of total billed charges",9908.5,50,,7926.80,,,0,"percent of total billed charges","50% of total billed charges",3329.26,16.8,,2663.41,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3429.13,17.304,,2743.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12484.71,63,,9987.77,,,0,"percent of total billed charges","63% of total billed charges",3032,15.3,,2425.60,,,0,"percent of total billed charges","15.3% of total billed charges",3329.26,16.8,,2663.41,,,0,"percent of total billed charges","16.8% of total billed charges",13673.73,69,,,,,0,"fee schedule","69% of total billed charges",19817,100,,15853.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19817,100,,15853.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19817,100,,15853.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12256.81,61.85,,9805.45,,,0,"percent of total billed charges","61.5% of total billed charges",3329.26,16.8,,2663.41,,,0,"percent of total billed charges","16.8% of total billed charges",9908.5,50,,7926.80,,,0,"percent of total billed charges","50% of total billed charges",6381.07,32.2,,5104.86,,,0,"percent of total billed charges","32.2% of total billed charges",3329.26,16.8,,2663.41,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3395.84,17.136,,2716.67,,,0,"percent of total billed charges","17.136% of total billed charges",4328.03,21.84,,3462.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7471.01,37.7,,5976.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15457.26,78,,12365.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16368.84,82.6,,13095.07,,,0,"percent of total billed charges","82.6% of total billed charges",3329.26,16.8,,2663.41,,,0,"percent of total billed charges","16.8% of total billed charges",9908.5,50,,7926.80,,,0,"percent of total billed charges","50% of total billed charges",16368.84,82.6,,13095.07,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3329.26,16.8,,2663.41,,,0,"percent of total billed charges","16.8% of total billed charges",19817,100,,15853.60,,,0,"percent of total billed charges","100% of total billed charges",3032,19817,
"BONE WAX 2.5G",13777,CDM,272,RC,,,OUTPATIENT,,,48,31.2,,42.24,88,,33.79,,,0,"percent of total billed charges","88% of total billed charges",24,50,,19.20,,,0,"percent of total billed charges","50% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.31,17.304,,6.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.24,63,,24.19,,,0,"percent of total billed charges","63% of total billed charges",7.34,15.3,,5.87,,,0,"percent of total billed charges","15.3% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",33.12,69,,,,,0,"fee schedule","69% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.69,61.85,,23.75,,,0,"percent of total billed charges","61.5% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",24,50,,19.20,,,0,"percent of total billed charges","50% of total billed charges",15.46,32.2,,12.37,,,0,"percent of total billed charges","32.2% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.23,17.136,,6.58,,,0,"percent of total billed charges","17.136% of total billed charges",10.48,21.84,,8.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.1,37.7,,14.48,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",37.44,78,,29.95,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.65,82.6,,31.72,,,0,"percent of total billed charges","82.6% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",24,50,,19.20,,,0,"percent of total billed charges","50% of total billed charges",39.65,82.6,,31.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",7.34,48,
"BONE CEMENT",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.94,17.304,,85.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.23,61.85,,305.78,,,0,"percent of total billed charges","61.5% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",199,32.2,,159.20,,,0,"percent of total billed charges","32.2% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.136,,84.72,,,0,"percent of total billed charges","17.136% of total billed charges",134.97,21.84,,107.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.7% of total billed charges",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.5,33.9,,167.60,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,618,
"BONE PUTTY DBX",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"BONE TAMP KIT 20/3 1 STEP",ORSUP0125,CDM,272,RC,,,OUTPATIENT,,,23896,15532.4,,21028.48,88,,16822.78,,,0,"percent of total billed charges","88% of total billed charges",11948,50,,9558.40,,,0,"percent of total billed charges","50% of total billed charges",4014.53,16.8,,3211.62,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4134.96,17.304,,3307.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15054.48,63,,12043.58,,,0,"percent of total billed charges","63% of total billed charges",3656.09,15.3,,2924.87,,,0,"percent of total billed charges","15.3% of total billed charges",4014.53,16.8,,3211.62,,,0,"percent of total billed charges","16.8% of total billed charges",16488.24,69,,,,,0,"fee schedule","69% of total billed charges",23896,100,,19116.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23896,100,,19116.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23896,100,,19116.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14779.68,61.85,,11823.74,,,0,"percent of total billed charges","61.5% of total billed charges",4014.53,16.8,,3211.62,,,0,"percent of total billed charges","16.8% of total billed charges",11948,50,,9558.40,,,0,"percent of total billed charges","50% of total billed charges",7694.51,32.2,,6155.61,,,0,"percent of total billed charges","32.2% of total billed charges",4014.53,16.8,,3211.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4094.82,17.136,,3275.86,,,0,"percent of total billed charges","17.136% of total billed charges",5218.89,21.84,,4175.11,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9008.79,37.7,,7207.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18638.88,78,,14911.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19738.1,82.6,,15790.48,,,0,"percent of total billed charges","82.6% of total billed charges",4014.53,16.8,,3211.62,,,0,"percent of total billed charges","16.8% of total billed charges",11948,50,,9558.40,,,0,"percent of total billed charges","50% of total billed charges",19738.1,82.6,,15790.48,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4014.53,16.8,,3211.62,,,0,"percent of total billed charges","16.8% of total billed charges",23896,100,,19116.80,,,0,"percent of total billed charges","100% of total billed charges",3656.09,23896,
"BONE PIN 3.2 X 110MM",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,515,334.75,,453.2,88,,362.56,,,0,"percent of total billed charges","88% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.12,17.304,,71.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",324.45,63,,259.56,,,0,"percent of total billed charges","63% of total billed charges",78.8,15.3,,63.04,,,0,"percent of total billed charges","15.3% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",355.35,69,,,,,0,"fee schedule","69% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",318.53,61.85,,254.82,,,0,"percent of total billed charges","61.5% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",165.83,32.2,,132.66,,,0,"percent of total billed charges","32.2% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.25,17.136,,70.60,,,0,"percent of total billed charges","17.136% of total billed charges",112.48,21.84,,89.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.16,37.7,,155.33,,,0,"percent of total billed charges","37.7% of total billed charges",194.16,37.7,,155.33,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",174.59,33.9,,139.67,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",401.7,78,,321.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",78.8,515,
"BONE PIN 3.2 X 140MM",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BONE PIN 4.0 X 110MM",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,515,334.75,,453.2,88,,362.56,,,0,"percent of total billed charges","88% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.12,17.304,,71.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",324.45,63,,259.56,,,0,"percent of total billed charges","63% of total billed charges",78.8,15.3,,63.04,,,0,"percent of total billed charges","15.3% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",355.35,69,,,,,0,"fee schedule","69% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",318.53,61.85,,254.82,,,0,"percent of total billed charges","61.5% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",165.83,32.2,,132.66,,,0,"percent of total billed charges","32.2% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.25,17.136,,70.60,,,0,"percent of total billed charges","17.136% of total billed charges",112.48,21.84,,89.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.16,37.7,,155.33,,,0,"percent of total billed charges","37.7% of total billed charges",194.16,37.7,,155.33,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",174.59,33.9,,139.67,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",401.7,78,,321.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",78.8,515,
"BONE PIN 4.0 X 140MM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1030,669.5,,906.4,88,,725.12,,,0,"percent of total billed charges","88% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.23,17.304,,142.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.9,63,,519.12,,,0,"percent of total billed charges","63% of total billed charges",157.59,15.3,,126.07,,,0,"percent of total billed charges","15.3% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",710.7,69,,,,,0,"fee schedule","69% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",637.06,61.85,,509.65,,,0,"percent of total billed charges","61.5% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",331.66,32.2,,265.33,,,0,"percent of total billed charges","32.2% of total billed charges",321.36,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",176.5,17.136,,141.20,,,0,"percent of total billed charges","17.136% of total billed charges",224.95,21.84,,179.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",388.31,37.7,,310.65,,,0,"percent of total billed charges","37.7% of total billed charges",388.31,37.7,,310.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",349.17,33.9,,279.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",803.4,78,,642.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",157.59,1030,
"BONE PIN 4.0 X 170MM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1030,669.5,,906.4,88,,725.12,,,0,"percent of total billed charges","88% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.23,17.304,,142.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.9,63,,519.12,,,0,"percent of total billed charges","63% of total billed charges",157.59,15.3,,126.07,,,0,"percent of total billed charges","15.3% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",710.7,69,,,,,0,"fee schedule","69% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",637.06,61.85,,509.65,,,0,"percent of total billed charges","61.5% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",331.66,32.2,,265.33,,,0,"percent of total billed charges","32.2% of total billed charges",321.36,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",176.5,17.136,,141.20,,,0,"percent of total billed charges","17.136% of total billed charges",224.95,21.84,,179.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",388.31,37.7,,310.65,,,0,"percent of total billed charges","37.7% of total billed charges",388.31,37.7,,310.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",349.17,33.9,,279.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",803.4,78,,642.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",157.59,1030,
"BONE CEMENT WITH MIXER",ORSUP0023,CDM,278,RC,,,OUTPATIENT,,,2472,1606.8,,2175.36,88,,1740.29,,,0,"percent of total billed charges","88% of total billed charges",1236,50,,988.80,,,0,"percent of total billed charges","50% of total billed charges",415.3,16.8,,332.24,,,0,"percent of total billed charges","16.8% of total billed charges",2472,100,,1977.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",427.75,17.304,,342.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1557.36,63,,1245.89,,,0,"percent of total billed charges","63% of total billed charges",378.22,15.3,,302.58,,,0,"percent of total billed charges","15.3% of total billed charges",415.3,16.8,,332.24,,,0,"percent of total billed charges","16.8% of total billed charges",1705.68,69,,,,,0,"fee schedule","69% of total billed charges",2472,100,,1977.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2472,100,,1977.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2472,100,,1977.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1528.93,61.85,,1223.14,,,0,"percent of total billed charges","61.5% of total billed charges",415.3,16.8,,332.24,,,0,"percent of total billed charges","16.8% of total billed charges",1236,50,,988.80,,,0,"percent of total billed charges","50% of total billed charges",795.98,32.2,,636.78,,,0,"percent of total billed charges","32.2% of total billed charges",771.26,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",423.6,17.136,,338.88,,,0,"percent of total billed charges","17.136% of total billed charges",539.88,21.84,,431.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",931.94,37.7,,745.55,,,0,"percent of total billed charges","37.7% of total billed charges",931.94,37.7,,745.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",838.01,33.9,,670.41,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1928.16,78,,1542.53,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2041.87,82.6,,1633.50,,,0,"percent of total billed charges","82.6% of total billed charges",415.3,16.8,,332.24,,,0,"percent of total billed charges","16.8% of total billed charges",1236,50,,988.80,,,0,"percent of total billed charges","50% of total billed charges",2041.87,82.6,,1633.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",415.3,16.8,,332.24,,,0,"percent of total billed charges","16.8% of total billed charges",2472,100,,1977.60,,,0,"percent of total billed charges","100% of total billed charges",378.22,2472,
"BONE MATRIX VIVIGEN FORMABLE CELLULAR 5CC",ORSUP0087,CDM,278,RC,,,OUTPATIENT,,,20621,13403.65,,18146.48,88,,14517.18,,,0,"percent of total billed charges","88% of total billed charges",10310.5,50,,8248.40,,,0,"percent of total billed charges","50% of total billed charges",3464.33,16.8,,2771.46,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3568.26,17.304,,2854.61,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12991.23,63,,10392.98,,,0,"percent of total billed charges","63% of total billed charges",3155.01,15.3,,2524.01,,,0,"percent of total billed charges","15.3% of total billed charges",3464.33,16.8,,2771.46,,,0,"percent of total billed charges","16.8% of total billed charges",14228.49,69,,,,,0,"fee schedule","69% of total billed charges",20621,100,,16496.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20621,100,,16496.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20621,100,,16496.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12754.09,61.85,,10203.27,,,0,"percent of total billed charges","61.5% of total billed charges",3464.33,16.8,,2771.46,,,0,"percent of total billed charges","16.8% of total billed charges",10310.5,50,,8248.40,,,0,"percent of total billed charges","50% of total billed charges",6639.96,32.2,,5311.97,,,0,"percent of total billed charges","32.2% of total billed charges",6433.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3533.61,17.136,,2826.89,,,0,"percent of total billed charges","17.136% of total billed charges",4503.63,21.84,,3602.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",7774.12,37.7,,6219.30,,,0,"percent of total billed charges","37.7% of total billed charges",7774.12,37.7,,6219.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",6990.52,33.9,,5592.42,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",16084.38,78,,12867.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17032.95,82.6,,13626.36,,,0,"percent of total billed charges","82.6% of total billed charges",3464.33,16.8,,2771.46,,,0,"percent of total billed charges","16.8% of total billed charges",10310.5,50,,8248.40,,,0,"percent of total billed charges","50% of total billed charges",17032.95,82.6,,13626.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3464.33,16.8,,2771.46,,,0,"percent of total billed charges","16.8% of total billed charges",20621,100,,16496.80,,,0,"percent of total billed charges","100% of total billed charges",3155.01,20621,
"BONE MATRIX 2.5CC V92",ORSUP0061,CDM,278,RC,,,OUTPATIENT,,,13658,8877.7,,12019.04,88,,9615.23,,,0,"percent of total billed charges","88% of total billed charges",6829,50,,5463.20,,,0,"percent of total billed charges","50% of total billed charges",2294.54,16.8,,1835.63,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2363.38,17.304,,1890.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8604.54,63,,6883.63,,,0,"percent of total billed charges","63% of total billed charges",2089.67,15.3,,1671.74,,,0,"percent of total billed charges","15.3% of total billed charges",2294.54,16.8,,1835.63,,,0,"percent of total billed charges","16.8% of total billed charges",9424.02,69,,,,,0,"fee schedule","69% of total billed charges",13658,100,,10926.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13658,100,,10926.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13658,100,,10926.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8447.47,61.85,,6757.98,,,0,"percent of total billed charges","61.5% of total billed charges",2294.54,16.8,,1835.63,,,0,"percent of total billed charges","16.8% of total billed charges",6829,50,,5463.20,,,0,"percent of total billed charges","50% of total billed charges",4397.88,32.2,,3518.30,,,0,"percent of total billed charges","32.2% of total billed charges",4261.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2340.43,17.136,,1872.34,,,0,"percent of total billed charges","17.136% of total billed charges",2982.91,21.84,,2386.33,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",5149.07,37.7,,4119.26,,,0,"percent of total billed charges","37.7% of total billed charges",5149.07,37.7,,4119.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4630.06,33.9,,3704.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",10653.24,78,,8522.59,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11281.51,82.6,,9025.21,,,0,"percent of total billed charges","82.6% of total billed charges",2294.54,16.8,,1835.63,,,0,"percent of total billed charges","16.8% of total billed charges",6829,50,,5463.20,,,0,"percent of total billed charges","50% of total billed charges",11281.51,82.6,,9025.21,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2294.54,16.8,,1835.63,,,0,"percent of total billed charges","16.8% of total billed charges",13658,100,,10926.40,,,0,"percent of total billed charges","100% of total billed charges",2089.67,13658,
"JAMSHIDI BONE MARROW TRAY 4 NEEDLE",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"BONE MATRIX 1.0CC",ORSUP0035,CDM,278,RC,,,OUTPATIENT,,,4944,3213.6,,4350.72,88,,3480.58,,,0,"percent of total billed charges","88% of total billed charges",2472,50,,1977.60,,,0,"percent of total billed charges","50% of total billed charges",830.59,16.8,,664.47,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",855.51,17.304,,684.41,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3114.72,63,,2491.78,,,0,"percent of total billed charges","63% of total billed charges",756.43,15.3,,605.14,,,0,"percent of total billed charges","15.3% of total billed charges",830.59,16.8,,664.47,,,0,"percent of total billed charges","16.8% of total billed charges",3411.36,69,,,,,0,"fee schedule","69% of total billed charges",4944,100,,3955.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4944,100,,3955.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4944,100,,3955.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3057.86,61.85,,2446.29,,,0,"percent of total billed charges","61.5% of total billed charges",830.59,16.8,,664.47,,,0,"percent of total billed charges","16.8% of total billed charges",2472,50,,1977.60,,,0,"percent of total billed charges","50% of total billed charges",1591.97,32.2,,1273.58,,,0,"percent of total billed charges","32.2% of total billed charges",1542.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",847.2,17.136,,677.76,,,0,"percent of total billed charges","17.136% of total billed charges",1079.77,21.84,,863.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1863.89,37.7,,1491.11,,,0,"percent of total billed charges","37.7% of total billed charges",1863.89,37.7,,1491.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1676.02,33.9,,1340.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3856.32,78,,3085.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4083.74,82.6,,3266.99,,,0,"percent of total billed charges","82.6% of total billed charges",830.59,16.8,,664.47,,,0,"percent of total billed charges","16.8% of total billed charges",2472,50,,1977.60,,,0,"percent of total billed charges","50% of total billed charges",4083.74,82.6,,3266.99,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",830.59,16.8,,664.47,,,0,"percent of total billed charges","16.8% of total billed charges",4944,100,,3955.20,,,0,"percent of total billed charges","100% of total billed charges",756.43,4944,
"10160 PUNCT ASP-ABSCSS/EHMA/BULLA/CYST CHARGE",9704052,CDM,272,RC,,,OUTPATIENT,,,1494,971.1,,1314.72,88,,1051.78,,,0,"percent of total billed charges","88% of total billed charges",747,50,,597.60,,,0,"percent of total billed charges","50% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.52,17.304,,206.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",941.22,63,,752.98,,,0,"percent of total billed charges","63% of total billed charges",228.58,15.3,,182.86,,,0,"percent of total billed charges","15.3% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",1030.86,69,,,,,0,"fee schedule","69% of total billed charges",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",924.04,61.85,,739.23,,,0,"percent of total billed charges","61.5% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",747,50,,597.60,,,0,"percent of total billed charges","50% of total billed charges",481.07,32.2,,384.86,,,0,"percent of total billed charges","32.2% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",256.01,17.136,,204.81,,,0,"percent of total billed charges","17.136% of total billed charges",326.29,21.84,,261.03,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",563.24,37.7,,450.59,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1165.32,78,,932.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1234.04,82.6,,987.23,,,0,"percent of total billed charges","82.6% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",747,50,,597.60,,,0,"percent of total billed charges","50% of total billed charges",1234.04,82.6,,987.23,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",228.58,1494,
"BOOK ATTEST LOG 1266",110250,CDM,270,RC,,,OUTPATIENT,,,73,47.45,,64.24,88,,51.39,,,0,"percent of total billed charges","88% of total billed charges",36.5,50,,29.20,,,0,"percent of total billed charges","50% of total billed charges",12.26,16.8,,9.81,,,0,"percent of total billed charges","16.8% of total billed charges",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.63,17.304,,10.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.99,63,,36.79,,,0,"percent of total billed charges","63% of total billed charges",11.17,15.3,,8.94,,,0,"percent of total billed charges","15.3% of total billed charges",12.26,16.8,,9.81,,,0,"percent of total billed charges","16.8% of total billed charges",50.37,69,,,,,0,"fee schedule","69% of total billed charges",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.15,61.85,,36.12,,,0,"percent of total billed charges","61.5% of total billed charges",12.26,16.8,,9.81,,,0,"percent of total billed charges","16.8% of total billed charges",36.5,50,,29.20,,,0,"percent of total billed charges","50% of total billed charges",23.51,32.2,,18.81,,,0,"percent of total billed charges","32.2% of total billed charges",12.26,16.8,,9.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.51,17.136,,10.01,,,0,"percent of total billed charges","17.136% of total billed charges",15.94,21.84,,12.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",27.52,37.7,,22.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",56.94,78,,45.55,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",12.26,16.8,,9.81,,,0,"percent of total billed charges","16.8% of total billed charges",36.5,50,,29.20,,,0,"percent of total billed charges","50% of total billed charges",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.26,16.8,,9.81,,,0,"percent of total billed charges","16.8% of total billed charges",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",11.17,73,
"BOOT CONTOUR 2 WALKER SM",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"BOOT CONTOUR 2 WALKER MED",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"BOOT CONTOUR 2 WALKER LRG",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"BOOT CAST ROCKER XL",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BOOT AIR WALKER PROCARE SMALL",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"BOOT AIR WALKER PROCARE MEDIUM",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"BOOT AIR WALKER PROCARE LARGE",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"BOOT AIR WALKER PROCARE XLARGE",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"BOOT BLACK DELUX LEG TALL SZ SM",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"BOOT BLACK DELIX LEG TALL SZ MED",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"BOOT BLACK DELUX LEG TALL SZ LRG",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"BOTTLE MEDLINE SOLIDIFIER 16000 CC",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"BOUFFANT HAT WHITE 24",490169,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"BOWIE-DICK TEST",490171,CDM,270,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"BOX MEMBRANE  K",ORSUP0024,CDM,270,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"BOX MEMBRANE Ca",ORSUP0024,CDM,270,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"BOX MEMBRANE pCO2",ORSUP0019,CDM,270,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"BOX MEMBRANE pO2",ORSUP0019,CDM,270,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"BRACE KNEE POST OP TSCOPE PREMIER",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"BREAST EXPANDER ARTOURA HI PRO",ORSUP0015,CDM,270,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"BREAST IMPLANT, NATRELLE INSPIRA SCM ---",ORSUP0034,CDM,278,RC,,,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1065.75,17.304,,852.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",942.33,15.3,,753.86,,,0,"percent of total billed charges","15.3% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3809.34,61.85,,3047.47,,,0,"percent of total billed charges","61.5% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1983.2,32.2,,1586.56,,,0,"percent of total billed charges","32.2% of total billed charges",1921.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1055.41,17.136,,844.33,,,0,"percent of total billed charges","17.136% of total billed charges",1345.13,21.84,,1076.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",942.33,6159,
"BREATHING CIRCUITS W/MASK",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BREATHING CIRCUITS",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"BREIF CLOTHLIKE XXL",454639,CDM,270,RC,,,OUTPATIENT,,,98,63.7,,86.24,88,,68.99,,,0,"percent of total billed charges","88% of total billed charges",49,50,,39.20,,,0,"percent of total billed charges","50% of total billed charges",16.46,16.8,,13.17,,,0,"percent of total billed charges","16.8% of total billed charges",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.96,17.304,,13.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.74,63,,49.39,,,0,"percent of total billed charges","63% of total billed charges",14.99,15.3,,11.99,,,0,"percent of total billed charges","15.3% of total billed charges",16.46,16.8,,13.17,,,0,"percent of total billed charges","16.8% of total billed charges",67.62,69,,,,,0,"fee schedule","69% of total billed charges",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.61,61.85,,48.49,,,0,"percent of total billed charges","61.5% of total billed charges",16.46,16.8,,13.17,,,0,"percent of total billed charges","16.8% of total billed charges",49,50,,39.20,,,0,"percent of total billed charges","50% of total billed charges",31.56,32.2,,25.25,,,0,"percent of total billed charges","32.2% of total billed charges",16.46,16.8,,13.17,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.79,17.136,,13.43,,,0,"percent of total billed charges","17.136% of total billed charges",21.4,21.84,,17.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.95,37.7,,29.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",76.44,78,,61.15,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.95,82.6,,64.76,,,0,"percent of total billed charges","82.6% of total billed charges",16.46,16.8,,13.17,,,0,"percent of total billed charges","16.8% of total billed charges",49,50,,39.20,,,0,"percent of total billed charges","50% of total billed charges",80.95,82.6,,64.76,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.46,16.8,,13.17,,,0,"percent of total billed charges","16.8% of total billed charges",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",14.99,98,
"BRIEFS ADULT",428709,CDM,270,RC,,,OUTPATIENT,,,74,48.1,,65.12,88,,52.10,,,0,"percent of total billed charges","88% of total billed charges",37,50,,29.60,,,0,"percent of total billed charges","50% of total billed charges",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.8,17.304,,10.24,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.62,63,,37.30,,,0,"percent of total billed charges","63% of total billed charges",11.32,15.3,,9.06,,,0,"percent of total billed charges","15.3% of total billed charges",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",51.06,69,,,,,0,"fee schedule","69% of total billed charges",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.77,61.85,,36.62,,,0,"percent of total billed charges","61.5% of total billed charges",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",37,50,,29.60,,,0,"percent of total billed charges","50% of total billed charges",23.83,32.2,,19.06,,,0,"percent of total billed charges","32.2% of total billed charges",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.68,17.136,,10.14,,,0,"percent of total billed charges","17.136% of total billed charges",16.16,21.84,,12.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",27.9,37.7,,22.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",57.72,78,,46.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.12,82.6,,48.90,,,0,"percent of total billed charges","82.6% of total billed charges",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",37,50,,29.60,,,0,"percent of total billed charges","50% of total billed charges",61.12,82.6,,48.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",11.32,74,
"BRIEF ADULT ULTRAPLUS LARGE",271657,CDM,272,RC,,,OUTPATIENT,,,63,40.95,,55.44,88,,44.35,,,0,"percent of total billed charges","88% of total billed charges",31.5,50,,25.20,,,0,"percent of total billed charges","50% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.9,17.304,,8.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.69,63,,31.75,,,0,"percent of total billed charges","63% of total billed charges",9.64,15.3,,7.71,,,0,"percent of total billed charges","15.3% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",43.47,69,,,,,0,"fee schedule","69% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.97,61.85,,31.18,,,0,"percent of total billed charges","61.5% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",31.5,50,,25.20,,,0,"percent of total billed charges","50% of total billed charges",20.29,32.2,,16.23,,,0,"percent of total billed charges","32.2% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.8,17.136,,8.64,,,0,"percent of total billed charges","17.136% of total billed charges",13.76,21.84,,11.01,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.75,37.7,,19.00,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",49.14,78,,39.31,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.04,82.6,,41.63,,,0,"percent of total billed charges","82.6% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",31.5,50,,25.20,,,0,"percent of total billed charges","50% of total billed charges",52.04,82.6,,41.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",9.64,63,
"BRIEF MESH PANTY LARGE",30390,CDM,272,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"BRIEFS  ADULT MEDIUM",129198,CDM,272,RC,,,OUTPATIENT,,,46,29.9,,40.48,88,,32.38,,,0,"percent of total billed charges","88% of total billed charges",23,50,,18.40,,,0,"percent of total billed charges","50% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.96,17.304,,6.37,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.98,63,,23.18,,,0,"percent of total billed charges","63% of total billed charges",7.04,15.3,,5.63,,,0,"percent of total billed charges","15.3% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",31.74,69,,,,,0,"fee schedule","69% of total billed charges",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.45,61.85,,22.76,,,0,"percent of total billed charges","61.5% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",23,50,,18.40,,,0,"percent of total billed charges","50% of total billed charges",14.81,32.2,,11.85,,,0,"percent of total billed charges","32.2% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.88,17.136,,6.30,,,0,"percent of total billed charges","17.136% of total billed charges",10.05,21.84,,8.04,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.34,37.7,,13.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.88,78,,28.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38,82.6,,30.40,,,0,"percent of total billed charges","82.6% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",23,50,,18.40,,,0,"percent of total billed charges","50% of total billed charges",38,82.6,,30.40,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",7.04,46,
"BRIEFS FIT RIGHT PLUS XL",443101,CDM,272,RC,,,OUTPATIENT,,,72,46.8,,63.36,88,,50.69,,,0,"percent of total billed charges","88% of total billed charges",36,50,,28.80,,,0,"percent of total billed charges","50% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.46,17.304,,9.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.36,63,,36.29,,,0,"percent of total billed charges","63% of total billed charges",11.02,15.3,,8.82,,,0,"percent of total billed charges","15.3% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",49.68,69,,,,,0,"fee schedule","69% of total billed charges",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.53,61.85,,35.62,,,0,"percent of total billed charges","61.5% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",36,50,,28.80,,,0,"percent of total billed charges","50% of total billed charges",23.18,32.2,,18.54,,,0,"percent of total billed charges","32.2% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.34,17.136,,9.87,,,0,"percent of total billed charges","17.136% of total billed charges",15.72,21.84,,12.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",27.14,37.7,,21.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",56.16,78,,44.93,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.47,82.6,,47.58,,,0,"percent of total billed charges","82.6% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",36,50,,28.80,,,0,"percent of total billed charges","50% of total billed charges",59.47,82.6,,47.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",11.02,72,
"BRIEF ATTENTDS XL BREATHABLE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BRIEFS ATTENDS BREATHABLE SIDE PANELS MED",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BRIEF ATTENDS MED BREATHABLE 32-44",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"BRITEBLADE PRO S/USE FIBRE OPTIC MILLER 1.5",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"BRUSH SCRUB E Z W/O DETERGENT",142531,CDM,270,RC,,,OUTPATIENT,,,70,45.5,,61.6,88,,49.28,,,0,"percent of total billed charges","88% of total billed charges",35,50,,28.00,,,0,"percent of total billed charges","50% of total billed charges",11.76,16.8,,9.41,,,0,"percent of total billed charges","16.8% of total billed charges",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.11,17.304,,9.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.1,63,,35.28,,,0,"percent of total billed charges","63% of total billed charges",10.71,15.3,,8.57,,,0,"percent of total billed charges","15.3% of total billed charges",11.76,16.8,,9.41,,,0,"percent of total billed charges","16.8% of total billed charges",48.3,69,,,,,0,"fee schedule","69% of total billed charges",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.3,61.85,,34.64,,,0,"percent of total billed charges","61.5% of total billed charges",11.76,16.8,,9.41,,,0,"percent of total billed charges","16.8% of total billed charges",35,50,,28.00,,,0,"percent of total billed charges","50% of total billed charges",22.54,32.2,,18.03,,,0,"percent of total billed charges","32.2% of total billed charges",11.76,16.8,,9.41,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,17.136,,9.60,,,0,"percent of total billed charges","17.136% of total billed charges",15.29,21.84,,12.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.39,37.7,,21.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",54.6,78,,43.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.82,82.6,,46.26,,,0,"percent of total billed charges","82.6% of total billed charges",11.76,16.8,,9.41,,,0,"percent of total billed charges","16.8% of total billed charges",35,50,,28.00,,,0,"percent of total billed charges","50% of total billed charges",57.82,82.6,,46.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.76,16.8,,9.41,,,0,"percent of total billed charges","16.8% of total billed charges",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",10.71,70,
"BRUSH SCRUB EZ 4% CHG",22089,CDM,270,RC,,,OUTPATIENT,,,90,58.5,,79.2,88,,63.36,,,0,"percent of total billed charges","88% of total billed charges",45,50,,36.00,,,0,"percent of total billed charges","50% of total billed charges",15.12,16.8,,12.10,,,0,"percent of total billed charges","16.8% of total billed charges",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.57,17.304,,12.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.7,63,,45.36,,,0,"percent of total billed charges","63% of total billed charges",13.77,15.3,,11.02,,,0,"percent of total billed charges","15.3% of total billed charges",15.12,16.8,,12.10,,,0,"percent of total billed charges","16.8% of total billed charges",62.1,69,,,,,0,"fee schedule","69% of total billed charges",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",55.67,61.85,,44.54,,,0,"percent of total billed charges","61.5% of total billed charges",15.12,16.8,,12.10,,,0,"percent of total billed charges","16.8% of total billed charges",45,50,,36.00,,,0,"percent of total billed charges","50% of total billed charges",28.98,32.2,,23.18,,,0,"percent of total billed charges","32.2% of total billed charges",15.12,16.8,,12.10,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.42,17.136,,12.34,,,0,"percent of total billed charges","17.136% of total billed charges",19.66,21.84,,15.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",33.93,37.7,,27.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",70.2,78,,56.16,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.34,82.6,,59.47,,,0,"percent of total billed charges","82.6% of total billed charges",15.12,16.8,,12.10,,,0,"percent of total billed charges","16.8% of total billed charges",45,50,,36.00,,,0,"percent of total billed charges","50% of total billed charges",74.34,82.6,,59.47,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.12,16.8,,12.10,,,0,"percent of total billed charges","16.8% of total billed charges",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",13.77,90,
"BRUSH SCRUB SURGICAL W/IODOPHOR",159107,CDM,270,RC,,,OUTPATIENT,,,78,50.7,,68.64,88,,54.91,,,0,"percent of total billed charges","88% of total billed charges",39,50,,31.20,,,0,"percent of total billed charges","50% of total billed charges",13.1,16.8,,10.48,,,0,"percent of total billed charges","16.8% of total billed charges",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.5,17.304,,10.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.14,63,,39.31,,,0,"percent of total billed charges","63% of total billed charges",11.93,15.3,,9.54,,,0,"percent of total billed charges","15.3% of total billed charges",13.1,16.8,,10.48,,,0,"percent of total billed charges","16.8% of total billed charges",53.82,69,,,,,0,"fee schedule","69% of total billed charges",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.24,61.85,,38.59,,,0,"percent of total billed charges","61.5% of total billed charges",13.1,16.8,,10.48,,,0,"percent of total billed charges","16.8% of total billed charges",39,50,,31.20,,,0,"percent of total billed charges","50% of total billed charges",25.12,32.2,,20.10,,,0,"percent of total billed charges","32.2% of total billed charges",13.1,16.8,,10.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.37,17.136,,10.70,,,0,"percent of total billed charges","17.136% of total billed charges",17.04,21.84,,13.63,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.41,37.7,,23.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",60.84,78,,48.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",13.1,16.8,,10.48,,,0,"percent of total billed charges","16.8% of total billed charges",39,50,,31.20,,,0,"percent of total billed charges","50% of total billed charges",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.1,16.8,,10.48,,,0,"percent of total billed charges","16.8% of total billed charges",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",11.93,78,
"BRUSH CLEANING LARGE COMBINATION",315811,CDM,270,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"BRUSH ALGER (COMP UNIT W/BURR)",ORSUP0010,CDM,270,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"BRUSH CHANNEL OPENING",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BRUSH CYTOLOGY BC-15C DISPOSABLE STERILE",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"BRUSH SURG SCRUB BD E-Z SCRUB NAIL CLEAN",357302,CDM,270,RC,,,OUTPATIENT,,,80,52,,70.4,88,,56.32,,,0,"percent of total billed charges","88% of total billed charges",40,50,,32.00,,,0,"percent of total billed charges","50% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.84,17.304,,11.07,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.4,63,,40.32,,,0,"percent of total billed charges","63% of total billed charges",12.24,15.3,,9.79,,,0,"percent of total billed charges","15.3% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",55.2,69,,,,,0,"fee schedule","69% of total billed charges",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.48,61.85,,39.58,,,0,"percent of total billed charges","61.5% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",40,50,,32.00,,,0,"percent of total billed charges","50% of total billed charges",25.76,32.2,,20.61,,,0,"percent of total billed charges","32.2% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.71,17.136,,10.97,,,0,"percent of total billed charges","17.136% of total billed charges",17.47,21.84,,13.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.16,37.7,,24.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",62.4,78,,49.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",66.08,82.6,,52.86,,,0,"percent of total billed charges","82.6% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",40,50,,32.00,,,0,"percent of total billed charges","50% of total billed charges",66.08,82.6,,52.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",12.24,80,
"BRUSH SURGICAL SCRUB DRY NAIL CLEANER WITHOUT DETERGENT STER",315288,CDM,272,RC,,,OUTPATIENT,,,58,37.7,,51.04,88,,40.83,,,0,"percent of total billed charges","88% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.04,17.304,,8.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.54,63,,29.23,,,0,"percent of total billed charges","63% of total billed charges",8.87,15.3,,7.10,,,0,"percent of total billed charges","15.3% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",40.02,69,,,,,0,"fee schedule","69% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.87,61.85,,28.70,,,0,"percent of total billed charges","61.5% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",18.68,32.2,,14.94,,,0,"percent of total billed charges","32.2% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.94,17.136,,7.95,,,0,"percent of total billed charges","17.136% of total billed charges",12.67,21.84,,10.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.87,37.7,,17.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",45.24,78,,36.19,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",8.87,58,
"BRUSH RX CYSTOLOGY",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BRUSH TOOTHETTE",186602,CDM,272,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"CLEANING TOOTHBRUSH",490343,CDM,270,RC,,,OUTPATIENT,,,53,34.45,,46.64,88,,37.31,,,0,"percent of total billed charges","88% of total billed charges",26.5,50,,21.20,,,0,"percent of total billed charges","50% of total billed charges",8.9,16.8,,7.12,,,0,"percent of total billed charges","16.8% of total billed charges",53,100,,42.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.17,17.304,,7.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.39,63,,26.71,,,0,"percent of total billed charges","63% of total billed charges",8.11,15.3,,6.49,,,0,"percent of total billed charges","15.3% of total billed charges",8.9,16.8,,7.12,,,0,"percent of total billed charges","16.8% of total billed charges",36.57,69,,,,,0,"fee schedule","69% of total billed charges",53,100,,42.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53,100,,42.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53,100,,42.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.78,61.85,,26.22,,,0,"percent of total billed charges","61.5% of total billed charges",8.9,16.8,,7.12,,,0,"percent of total billed charges","16.8% of total billed charges",26.5,50,,21.20,,,0,"percent of total billed charges","50% of total billed charges",17.07,32.2,,13.66,,,0,"percent of total billed charges","32.2% of total billed charges",8.9,16.8,,7.12,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.08,17.136,,7.26,,,0,"percent of total billed charges","17.136% of total billed charges",11.58,21.84,,9.26,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.98,37.7,,15.98,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.34,78,,33.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.78,82.6,,35.02,,,0,"percent of total billed charges","82.6% of total billed charges",8.9,16.8,,7.12,,,0,"percent of total billed charges","16.8% of total billed charges",26.5,50,,21.20,,,0,"percent of total billed charges","50% of total billed charges",43.78,82.6,,35.02,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.9,16.8,,7.12,,,0,"percent of total billed charges","16.8% of total billed charges",53,100,,42.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,53,
"BRUSH ENDOSOPIC DUAL END CHANNEL",ORSUP0001,CDM,278,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.7% of total billed charges",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.93,33.9,,12.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BTL .45%SALINE SOLUTION 1L",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,464,301.6,,408.32,88,,326.66,,,0,"percent of total billed charges","88% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.29,17.304,,64.23,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.32,63,,233.86,,,0,"percent of total billed charges","63% of total billed charges",70.99,15.3,,56.79,,,0,"percent of total billed charges","15.3% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",320.16,69,,,,,0,"fee schedule","69% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",286.98,61.85,,229.58,,,0,"percent of total billed charges","61.5% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",149.41,32.2,,119.53,,,0,"percent of total billed charges","32.2% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.51,17.136,,63.61,,,0,"percent of total billed charges","17.136% of total billed charges",101.34,21.84,,81.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",174.93,37.7,,139.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",361.92,78,,289.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",70.99,464,
"BUBBLE HUMIDIFIERS, PREFILLED",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"BUBBLE CPAP SYSTEM INFANT",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,412,267.8,,362.56,88,,290.05,,,0,"percent of total billed charges","88% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.29,17.304,,57.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",259.56,63,,207.65,,,0,"percent of total billed charges","63% of total billed charges",63.04,15.3,,50.43,,,0,"percent of total billed charges","15.3% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",284.28,69,,,,,0,"fee schedule","69% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",254.82,61.85,,203.86,,,0,"percent of total billed charges","61.5% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",132.66,32.2,,106.13,,,0,"percent of total billed charges","32.2% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.6,17.136,,56.48,,,0,"percent of total billed charges","17.136% of total billed charges",89.98,21.84,,71.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",155.32,37.7,,124.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",321.36,78,,257.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",63.04,412,
"BUBC / 5 PACK / 300 SLIDES",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"BUCKETS PLASTER",119912,CDM,270,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.9,61.85,,7.92,,,0,"percent of total billed charges","61.5% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"BULB LARYNGOSCOPE W/A 06000U",131122,CDM,270,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"BULB SYRINGE",490174,CDM,272,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"BULB SYRINGE 60ML STERILE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"BULB HALOGEN MACROVIEW OTOSCOPE 3.5V",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"BUR 4.0MM OVAL SOLID CARBIDE  EXTRA LONG",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"BUR ACROMIOBLASTER 4.0",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"BUR OVAL 8 FLUTE 4.0 X 13CM",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"BUR ROUND FLUTED 4.0MM",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BUR ROUND TAPERED 1.0MM ELITE",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"BUR ROUND FLUTED 6.0MM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"BUR ROUND FLUTED 3.0MM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"BUR ROUND FLUTED 2.0MM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"BUR ROUND DIAMOND 4.0MM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"BUR ROUND DIAMOND 3.0MM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"BUR ROUND DIAMOND 2.0MM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"BUR ROUND DIAMOND 1.0MM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"BUR ROUND FLUTED DIAMOND 2.0",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"BUR ROUND 5.0MM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"BUR ROUND FLUTED 4MM",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.94,17.304,,85.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.23,61.85,,305.78,,,0,"percent of total billed charges","61.5% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",199,32.2,,159.20,,,0,"percent of total billed charges","32.2% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.136,,84.72,,,0,"percent of total billed charges","17.136% of total billed charges",134.97,21.84,,107.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,618,
"BURR HOLE BENT 13MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BURR HOLE COVER 17MM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"BURR TI LOW PROFILE NEURO HOLE COVER 12MM DIA",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BURR TI LOW PROFILE NEURO HOLE COVER 17MM DIA",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BURR TI LOW PROFILE NEURO HOLE COVER FOR SHUNT 17MM",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"BURR ROTABLATOR 2.0MM",ORSUP0031,CDM,278,RC,,,OUTPATIENT,,,5356,3481.4,,4713.28,88,,3770.62,,,0,"percent of total billed charges","88% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",926.8,17.304,,741.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3374.28,63,,2699.42,,,0,"percent of total billed charges","63% of total billed charges",819.47,15.3,,655.58,,,0,"percent of total billed charges","15.3% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",3695.64,69,,,,,0,"fee schedule","69% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3312.69,61.85,,2650.15,,,0,"percent of total billed charges","61.5% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",1724.63,32.2,,1379.70,,,0,"percent of total billed charges","32.2% of total billed charges",1671.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",917.8,17.136,,734.24,,,0,"percent of total billed charges","17.136% of total billed charges",1169.75,21.84,,935.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.7% of total billed charges",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1815.68,33.9,,1452.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4177.68,78,,3342.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",819.47,5356,
"BURR SURG L9CM OD6MM LEGEND BALL",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"BURR SURG OD2.5MM TB T16 LEGEND",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BURR OVAL 4.0MM",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"BURR 5.0 MM",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"BURR HOLE COVER CONTOURED NEURO 3MM 12MM DIA 1.5MM SYS CP TITANIUM",ORSUP0015,CDM,270,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"BURR OVAL 8 FLUTE 4.0MM X 13CM",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"BURR ROUND 8 FLUTE 5.0MM X 13CM",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"BURR BONE FLUTED 5MM ROUND",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"BURR OVAL 4.0MM 8-FLUTE",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"BURR BARREL 4.0MM 6-FLUTE",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"BURR SYNOVIAL 6MM",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"BURR ROUND DIAMOND 4.5MM",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.94,17.304,,85.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.23,61.85,,305.78,,,0,"percent of total billed charges","61.5% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",199,32.2,,159.20,,,0,"percent of total billed charges","32.2% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.136,,84.72,,,0,"percent of total billed charges","17.136% of total billed charges",134.97,21.84,,107.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,618,
"BUTTON DOG BONE",ORSUP0018,CDM,278,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",605.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.7% of total billed charges",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",658.34,33.9,,526.67,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"BYPASS HEAT \\T\\ MOISTURE EXCHANGE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"C DIFF QUIK CHEK",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"C- REAMER 11MM",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"C-ARM DRAPE, COMPLETE COVERAGE",490205,CDM,270,RC,,,OUTPATIENT,,,102,66.3,,89.76,88,,71.81,,,0,"percent of total billed charges","88% of total billed charges",51,50,,40.80,,,0,"percent of total billed charges","50% of total billed charges",17.14,16.8,,13.71,,,0,"percent of total billed charges","16.8% of total billed charges",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.304,,14.12,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.26,63,,51.41,,,0,"percent of total billed charges","63% of total billed charges",15.61,15.3,,12.49,,,0,"percent of total billed charges","15.3% of total billed charges",17.14,16.8,,13.71,,,0,"percent of total billed charges","16.8% of total billed charges",70.38,69,,,,,0,"fee schedule","69% of total billed charges",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.09,61.85,,50.47,,,0,"percent of total billed charges","61.5% of total billed charges",17.14,16.8,,13.71,,,0,"percent of total billed charges","16.8% of total billed charges",51,50,,40.80,,,0,"percent of total billed charges","50% of total billed charges",32.84,32.2,,26.27,,,0,"percent of total billed charges","32.2% of total billed charges",17.14,16.8,,13.71,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.48,17.136,,13.98,,,0,"percent of total billed charges","17.136% of total billed charges",22.28,21.84,,17.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.45,37.7,,30.76,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",79.56,78,,63.65,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.25,82.6,,67.40,,,0,"percent of total billed charges","82.6% of total billed charges",17.14,16.8,,13.71,,,0,"percent of total billed charges","16.8% of total billed charges",51,50,,40.80,,,0,"percent of total billed charges","50% of total billed charges",84.25,82.6,,67.40,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.14,16.8,,13.71,,,0,"percent of total billed charges","16.8% of total billed charges",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",15.61,102,
"C-ARM COVER BANDED BAG 30X30",490204,CDM,270,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"C-DIFF/EPI GX IVD CARTRIDGES",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"C-LINE VERI STIM III",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"C-REAMER 8MM ARTHREX",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"C-REAMER 7MM ARTHREX",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"C-REAMER 9MM",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"C-REAMER 10MM",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"C-Section Level 3 Charge First 30 Min",SUR200054,CDM,360,RC,,,OUTPATIENT,,,8294,5391.1,,7298.72,88,,5838.98,,,0,"percent of total billed charges","88% of total billed charges",4147,50,,3317.60,,,0,"percent of total billed charges","50% of total billed charges",1393.39,16.8,,1114.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1435.19,17.304,,1148.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5225.22,63,,4180.18,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",1393.39,16.8,,1114.71,,,0,"percent of total billed charges","16.8% of total billed charges",5722.86,69,,,,,0,"fee schedule","69% of total billed charges",8294,100,,6635.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8294,100,,6635.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8294,100,,6635.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5129.84,61.85,,4103.87,,,0,"percent of total billed charges","61.5% of total billed charges",1393.39,16.8,,1114.71,,,0,"percent of total billed charges","16.8% of total billed charges",4147,50,,3317.60,,,0,"percent of total billed charges","50% of total billed charges",2670.67,32.2,,2136.54,,,0,"percent of total billed charges","32.2% of total billed charges",1393.39,16.8,,1114.71,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1421.26,17.136,,1137.01,,,0,"percent of total billed charges","17.136% of total billed charges",1811.41,21.84,,1449.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3126.84,37.7,,2501.47,,,0,"percent of total billed charges","37.7% of total billed charges",3126.84,37.7,,2501.47,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2811.67,33.9,,2249.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6469.32,78,,5175.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6850.84,82.6,,5480.67,,,0,"percent of total billed charges","82.6% of total billed charges",1393.39,16.8,,1114.71,,,0,"percent of total billed charges","16.8% of total billed charges",4147,50,,3317.60,,,0,"percent of total billed charges","50% of total billed charges",6850.84,82.6,,5480.67,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1393.39,16.8,,1114.71,,,0,"percent of total billed charges","16.8% of total billed charges",8294,100,,6635.20,,,0,"percent of total billed charges","100% of total billed charges",1393.39,8294,
"C-Section Level 3 Charge ea addt'l 15 min",SUR200055,CDM,360,RC,,,OUTPATIENT,,,3319,2157.35,,2920.72,88,,2336.58,,,0,"percent of total billed charges","88% of total billed charges",1659.5,50,,1327.60,,,0,"percent of total billed charges","50% of total billed charges",557.59,16.8,,446.07,,,0,"percent of total billed charges","16.8% of total billed charges",3319,100,,2655.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",574.32,17.304,,459.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2090.97,63,,1672.78,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",557.59,16.8,,446.07,,,0,"percent of total billed charges","16.8% of total billed charges",2290.11,69,,,,,0,"fee schedule","69% of total billed charges",3319,100,,2655.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3319,100,,2655.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3319,100,,2655.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2052.8,61.85,,1642.24,,,0,"percent of total billed charges","61.5% of total billed charges",557.59,16.8,,446.07,,,0,"percent of total billed charges","16.8% of total billed charges",1659.5,50,,1327.60,,,0,"percent of total billed charges","50% of total billed charges",1068.72,32.2,,854.98,,,0,"percent of total billed charges","32.2% of total billed charges",557.59,16.8,,446.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",568.74,17.136,,454.99,,,0,"percent of total billed charges","17.136% of total billed charges",724.87,21.84,,579.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1251.26,37.7,,1001.01,,,0,"percent of total billed charges","37.7% of total billed charges",1251.26,37.7,,1001.01,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1125.14,33.9,,900.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2588.82,78,,2071.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2741.49,82.6,,2193.19,,,0,"percent of total billed charges","82.6% of total billed charges",557.59,16.8,,446.07,,,0,"percent of total billed charges","16.8% of total billed charges",1659.5,50,,1327.60,,,0,"percent of total billed charges","50% of total billed charges",2741.49,82.6,,2193.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",557.59,16.8,,446.07,,,0,"percent of total billed charges","16.8% of total billed charges",3319,100,,2655.20,,,0,"percent of total billed charges","100% of total billed charges",557.59,3367,
"C9733 Non-Ophthalmic Fluorescent Vascular Angiography",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1043,677.95,,917.84,88,,734.27,,,0,"percent of total billed charges","88% of total billed charges",521.5,50,,417.20,,,0,"percent of total billed charges","50% of total billed charges",175.22,16.8,,140.18,,,0,"percent of total billed charges","16.8% of total billed charges",1043,100,,834.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",180.48,17.304,,144.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",657.09,63,,525.67,,,0,"percent of total billed charges","63% of total billed charges",159.58,15.3,,127.66,,,0,"percent of total billed charges","15.3% of total billed charges",175.22,16.8,,140.18,,,0,"percent of total billed charges","16.8% of total billed charges",719.67,69,,,,,0,"fee schedule","69% of total billed charges",1043,100,,834.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1043,100,,834.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1043,100,,834.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",645.1,61.85,,516.08,,,0,"percent of total billed charges","61.5% of total billed charges",175.22,16.8,,140.18,,,0,"percent of total billed charges","16.8% of total billed charges",521.5,50,,417.20,,,0,"percent of total billed charges","50% of total billed charges",335.85,32.2,,268.68,,,0,"percent of total billed charges","32.2% of total billed charges",325.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",178.73,17.136,,142.98,,,0,"percent of total billed charges","17.136% of total billed charges",227.79,21.84,,182.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",393.21,37.7,,314.57,,,0,"percent of total billed charges","37.7% of total billed charges",393.21,37.7,,314.57,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.58,33.9,,282.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",813.54,78,,650.83,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",861.52,82.6,,689.22,,,0,"percent of total billed charges","82.6% of total billed charges",175.22,16.8,,140.18,,,0,"percent of total billed charges","16.8% of total billed charges",521.5,50,,417.20,,,0,"percent of total billed charges","50% of total billed charges",861.52,82.6,,689.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",175.22,16.8,,140.18,,,0,"percent of total billed charges","16.8% of total billed charges",1043,100,,834.40,,,0,"percent of total billed charges","100% of total billed charges",159.58,1043,
"CABLE W/CRIMP 1.7MM 750MM STERILE",ORSUP0021,CDM,278,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",835.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.7% of total billed charges",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",907.84,33.9,,726.27,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"CABLE INTERFACE  FOR DX W/AUTO ID  CATHETERS",ORSUP0023,CDM,272,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"CABLE INTERFACE FOR CURRENT NAV THERAPEUTIC CATH",ORSUP0023,CDM,272,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"CABLE INTERFACE FOR VARIABLE LASSO NAV CATH",ORSUP0023,CDM,272,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"CABLE INTERFACE  FOR EXISTING DX CATHETER BLUE PORT",ORSUP0023,CDM,272,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"CABLE CATH 6FT 10PIN",ORSUP0018,CDM,272,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"CABLE INTERFACE FOR THEMCOOL SF CATHETER",ORSUP0023,CDM,272,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"CABLE ECO-LASSO",ORSUP0023,CDM,270,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"CABLE PACING 5FR",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"CABLE SLEEVE 2.0",ORSUP0013,CDM,270,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CABLE SLEEVE HOW 1.6",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CABLE 1.6 DALL MILES",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"CABLE COBALT CHROME 2.0MM",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CADD MEDICATION RESERVOIR CASSETTE 100ML",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"CADD EXTENSION SET 60",ORSUP0001,CDM,278,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.7% of total billed charges",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.2,33.9,,9.76,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"CAGE CAPSTONE 8X22MM",ORSUP0073,CDM,278,RC,,,OUTPATIENT,,,16871,10966.15,,14846.48,88,,11877.18,,,0,"percent of total billed charges","88% of total billed charges",8435.5,50,,6748.40,,,0,"percent of total billed charges","50% of total billed charges",2834.33,16.8,,2267.46,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2919.36,17.304,,2335.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10628.73,63,,8502.98,,,0,"percent of total billed charges","63% of total billed charges",2581.26,15.3,,2065.01,,,0,"percent of total billed charges","15.3% of total billed charges",2834.33,16.8,,2267.46,,,0,"percent of total billed charges","16.8% of total billed charges",11640.99,69,,,,,0,"fee schedule","69% of total billed charges",16871,100,,13496.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16871,100,,13496.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16871,100,,13496.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10434.71,61.85,,8347.77,,,0,"percent of total billed charges","61.5% of total billed charges",2834.33,16.8,,2267.46,,,0,"percent of total billed charges","16.8% of total billed charges",8435.5,50,,6748.40,,,0,"percent of total billed charges","50% of total billed charges",5432.46,32.2,,4345.97,,,0,"percent of total billed charges","32.2% of total billed charges",5263.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2891.01,17.136,,2312.81,,,0,"percent of total billed charges","17.136% of total billed charges",3684.63,21.84,,2947.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",6360.37,37.7,,5088.30,,,0,"percent of total billed charges","37.7% of total billed charges",6360.37,37.7,,5088.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",5719.27,33.9,,4575.42,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",13159.38,78,,10527.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13935.45,82.6,,11148.36,,,0,"percent of total billed charges","82.6% of total billed charges",2834.33,16.8,,2267.46,,,0,"percent of total billed charges","16.8% of total billed charges",8435.5,50,,6748.40,,,0,"percent of total billed charges","50% of total billed charges",13935.45,82.6,,11148.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2834.33,16.8,,2267.46,,,0,"percent of total billed charges","16.8% of total billed charges",16871,100,,13496.80,,,0,"percent of total billed charges","100% of total billed charges",2581.26,16871,
"CAGE CAPSTONE 8X26MM",ORSUP0073,CDM,278,RC,,,OUTPATIENT,,,16871,10966.15,,14846.48,88,,11877.18,,,0,"percent of total billed charges","88% of total billed charges",8435.5,50,,6748.40,,,0,"percent of total billed charges","50% of total billed charges",2834.33,16.8,,2267.46,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2919.36,17.304,,2335.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10628.73,63,,8502.98,,,0,"percent of total billed charges","63% of total billed charges",2581.26,15.3,,2065.01,,,0,"percent of total billed charges","15.3% of total billed charges",2834.33,16.8,,2267.46,,,0,"percent of total billed charges","16.8% of total billed charges",11640.99,69,,,,,0,"fee schedule","69% of total billed charges",16871,100,,13496.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16871,100,,13496.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16871,100,,13496.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10434.71,61.85,,8347.77,,,0,"percent of total billed charges","61.5% of total billed charges",2834.33,16.8,,2267.46,,,0,"percent of total billed charges","16.8% of total billed charges",8435.5,50,,6748.40,,,0,"percent of total billed charges","50% of total billed charges",5432.46,32.2,,4345.97,,,0,"percent of total billed charges","32.2% of total billed charges",5263.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2891.01,17.136,,2312.81,,,0,"percent of total billed charges","17.136% of total billed charges",3684.63,21.84,,2947.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",6360.37,37.7,,5088.30,,,0,"percent of total billed charges","37.7% of total billed charges",6360.37,37.7,,5088.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",5719.27,33.9,,4575.42,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",13159.38,78,,10527.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13935.45,82.6,,11148.36,,,0,"percent of total billed charges","82.6% of total billed charges",2834.33,16.8,,2267.46,,,0,"percent of total billed charges","16.8% of total billed charges",8435.5,50,,6748.40,,,0,"percent of total billed charges","50% of total billed charges",13935.45,82.6,,11148.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2834.33,16.8,,2267.46,,,0,"percent of total billed charges","16.8% of total billed charges",16871,100,,13496.80,,,0,"percent of total billed charges","100% of total billed charges",2581.26,16871,
"CAGE WAVE D 9MM X 24MM 6 DEG",ORSUP0164,CDM,278,RC,,,OUTPATIENT,,,37760,24544,,33228.8,88,,26583.04,,,0,"percent of total billed charges","88% of total billed charges",18880,50,,15104.00,,,0,"percent of total billed charges","50% of total billed charges",6343.68,16.8,,5074.94,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6533.99,17.304,,5227.19,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",23788.8,63,,19031.04,,,0,"percent of total billed charges","63% of total billed charges",5777.28,15.3,,4621.82,,,0,"percent of total billed charges","15.3% of total billed charges",6343.68,16.8,,5074.94,,,0,"percent of total billed charges","16.8% of total billed charges",26054.4,69,,,,,0,"fee schedule","69% of total billed charges",37760,100,,30208.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37760,100,,30208.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37760,100,,30208.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23354.56,61.85,,18683.65,,,0,"percent of total billed charges","61.5% of total billed charges",6343.68,16.8,,5074.94,,,0,"percent of total billed charges","16.8% of total billed charges",18880,50,,15104.00,,,0,"percent of total billed charges","50% of total billed charges",12158.72,32.2,,9726.98,,,0,"percent of total billed charges","32.2% of total billed charges",11781.12,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",6470.55,17.136,,5176.44,,,0,"percent of total billed charges","17.136% of total billed charges",8246.78,21.84,,6597.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",14235.52,37.7,,11388.42,,,0,"percent of total billed charges","37.7% of total billed charges",14235.52,37.7,,11388.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",12800.64,33.9,,10240.51,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",29452.8,78,,23562.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",31189.76,82.6,,24951.81,,,0,"percent of total billed charges","82.6% of total billed charges",6343.68,16.8,,5074.94,,,0,"percent of total billed charges","16.8% of total billed charges",18880,50,,15104.00,,,0,"percent of total billed charges","50% of total billed charges",31189.76,82.6,,24951.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6343.68,16.8,,5074.94,,,0,"percent of total billed charges","16.8% of total billed charges",37760,100,,30208.00,,,0,"percent of total billed charges","100% of total billed charges",4695,37760,
"CAL 1 SOL 200 ML US",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"CAL 2 SOLN",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CAL KIT 11 BX / 1 SET / 6 BTLS",ORSUP0023,CDM,272,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"CAL KIT 13 BOX / 1 SET / 6 BTLS",ORSUP0023,CDM,272,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"CAL KIT 24 BOX / 1 SET / 6 BTLS",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CAL ASSAY LVL 1 DILUENT",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"CAL ASSAY LVL 2 DILUENT",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"CALCIUM / 5 PACK / 300 SLIDES",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CALCIUM ARSENAZO R1 4X15ML",ORSUP0043,CDM,272,RC,,,OUTPATIENT,,,8570,5570.5,,7541.6,88,,6033.28,,,0,"percent of total billed charges","88% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1482.95,17.304,,1186.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5399.1,63,,4319.28,,,0,"percent of total billed charges","63% of total billed charges",1311.21,15.3,,1048.97,,,0,"percent of total billed charges","15.3% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",5913.3,69,,,,,0,"fee schedule","69% of total billed charges",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5300.55,61.85,,4240.44,,,0,"percent of total billed charges","61.5% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",2759.54,32.2,,2207.63,,,0,"percent of total billed charges","32.2% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1468.56,17.136,,1174.85,,,0,"percent of total billed charges","17.136% of total billed charges",1871.69,21.84,,1497.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3230.89,37.7,,2584.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6684.6,78,,5347.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7078.82,82.6,,5663.06,,,0,"percent of total billed charges","82.6% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",7078.82,82.6,,5663.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",1311.21,8570,
"CALIBRATOR S CAL FP",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"CALIB SOLN Hb",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CALIBRATOR S-CAL FOR COULTER MODELS S-PLUS 45\\T\\ 6",ORSUP0019,CDM,272,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"CALIBRATOR KIT 29",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CALIBRATOR INTACT PARATHYROID HORMONE",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"CALIBRATOR TOTAL T4",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CALIBRATOR KIT",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"CALIBRATOR KIT 31",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CALIBRATOR KIT 32 BX/3 SETS",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CALL KIT 12 BOX / 1 SET / 6 BTLS",ORSUP0023,CDM,272,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"CAMPY JEJUNI SUBSP ATCC CULTI LOOPS 33291",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CAMPYGEN COMPACT SACHET",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CANCELLOUS BONE CHIPS 30CC",ORSUP0031,CDM,278,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",1253.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.7% of total billed charges",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1361.76,33.9,,1089.41,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"CANCELLOUS BONE CHIPS 15CC",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"CANCELLOUS BONE CHIPS 5CC",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,1185,770.25,,1042.8,88,,834.24,,,0,"percent of total billed charges","88% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",205.05,17.304,,164.04,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",746.55,63,,597.24,,,0,"percent of total billed charges","63% of total billed charges",181.31,15.3,,145.05,,,0,"percent of total billed charges","15.3% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",817.65,69,,,,,0,"fee schedule","69% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.92,61.85,,586.34,,,0,"percent of total billed charges","61.5% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",381.57,32.2,,305.26,,,0,"percent of total billed charges","32.2% of total billed charges",369.72,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",203.06,17.136,,162.45,,,0,"percent of total billed charges","17.136% of total billed charges",258.8,21.84,,207.04,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",446.75,37.7,,357.40,,,0,"percent of total billed charges","37.7% of total billed charges",446.75,37.7,,357.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",401.72,33.9,,321.38,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",924.3,78,,739.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",181.31,1185,
"CANCELLOUS CHIPS 10CC LIFENET",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"CANISTER DISP THIN WALL 1500CC",152483,CDM,272,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"CANISTER INFO VAC 500ML W/O GEL",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"CANNULA ARTERIAL FEMORAL 20FR",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"CANNULA NASAL O2 INFANT 7FT",259257,CDM,272,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"CANNULA CORONARY STR 6MM",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CANNULA CVD NASAL TIPS PEDI",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CANNULA MEDTRONIC  METAL-TIP ARTERIAL 20FR",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"CANNULA ART PU L32CM OD 12FR ODSEC18MM TXTRD BALN RETRGD ANTI",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CANNULA AORTIC REFUSION 22FR",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"CANNULA VENOUS 38FR RT ANGLE",ORSUP0025,CDM,272,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"CANNULA PRFSN PU L32CM L18MM OD14FR RETROPLEGIA RETR RC2014M",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CANNULA RETROGRADE 14FR",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CANNULA CARDIOPLEGIA 12FR",ORSUP0031,CDM,272,RC,,,OUTPATIENT,,,5356,3481.4,,4713.28,88,,3770.62,,,0,"percent of total billed charges","88% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",926.8,17.304,,741.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3374.28,63,,2699.42,,,0,"percent of total billed charges","63% of total billed charges",819.47,15.3,,655.58,,,0,"percent of total billed charges","15.3% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",3695.64,69,,,,,0,"fee schedule","69% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3312.69,61.85,,2650.15,,,0,"percent of total billed charges","61.5% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",1724.63,32.2,,1379.70,,,0,"percent of total billed charges","32.2% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",917.8,17.136,,734.24,,,0,"percent of total billed charges","17.136% of total billed charges",1169.75,21.84,,935.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4177.68,78,,3342.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",819.47,5356,
"CANNULA ARTERIAL FEMORAL 22FR",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"CANNULA ERCP RAPID EXCHANGE TAPERED TIP",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"CANNULA RAPID EXC TAPER ERCP",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"CANNULA RX XL",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"CANNULA ERCP CONTOUR  ULTRA TPR 5FR 210CM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"CANN 22FR AORTIC CURVED",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"CANNULA 8MM INSTRUMENT",ORSUP0024,CDM,272,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"CANNULA AORTIC PERFUSION",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"CANNULA ARTERIAL EOPA 22FR",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"CANNULA ARTERIAL EOPA 24FR",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"CANNULA BTN 3CM 12MM ARTHX PSPRT BTN CANN",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"CANNULA CORONARY PROFUSION",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CANNULA CORONARY RIGHT ANGLE 4MM",ORSUP0024,CDM,272,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"CANNULA CORONARY RT. ANGLE 6MM",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CANNULA CURVED 100MM 20G 10MM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"CANNULA CURVED 20G",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CANNULA DLP MALLEABLE SINGLE STAGE VENOUS 28FR",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"CANNULA DLP MALLEABLE SINGLE STAGE VENOUS 30FR",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"CANNULA DLP MALLEABLE SINGLE STAGE VENOUS 32FR",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"CANNULA DUAL STAGE VENOUS DRAINAGE 32/40",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"CANNULA PASSPORT 10X3",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"CANNULA PRFSN 11IN 22FR AOR 45D SHRT WRE REINFORCE SUT BMP",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"CANNISTER BERKLEY",490197,CDM,270,RC,,,OUTPATIENT,,,52,33.8,,45.76,88,,36.61,,,0,"percent of total billed charges","88% of total billed charges",26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,17.304,,7.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.76,63,,26.21,,,0,"percent of total billed charges","63% of total billed charges",7.96,15.3,,6.37,,,0,"percent of total billed charges","15.3% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",35.88,69,,,,,0,"fee schedule","69% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.16,61.85,,25.73,,,0,"percent of total billed charges","61.5% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",16.74,32.2,,13.39,,,0,"percent of total billed charges","32.2% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.91,17.136,,7.13,,,0,"percent of total billed charges","17.136% of total billed charges",11.36,21.84,,9.09,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.6,37.7,,15.68,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",40.56,78,,32.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",7.96,52,
"CANNULA 7MM TWIST-IN ARTHREX",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
N/A,ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"CANNULA CO2 SAMPLING AND O2 DELIVERY",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"CANNULA NASAL 14 FT",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"CANNULAS 7 FT LUMEN TUBING",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"CANNULAS 14 FT SOFT CUSHION",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"CANNULAS, OPTIFLOW PLUS",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"CANNULA DRI-LOK THREADED 8.0MM X 75MM",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"CANNULA GATEWAY SILICONE  8MM X 30MM",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"CANNULA W/CHIN STRAP LG",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"CANNULA W/CHIN STRAP SM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"CANNULA W/CHIN STRAP MED",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"CAP END",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CAP END TI T40 0 EXT STRDRV RECESS STRL TIB NAIL",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CAP END TI TIBIAL NAILS-EX T40 STARDRIVE GRAY/0MM EXT",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CAP END TI TIBIAL NAILS-EX T40 STARDRIVE GRAY/10MM EXT",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CAP END TI TIBIAL NAILS-EX T40 STARDRIVE GRAY/15MM EXT",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CAP END TI TIBIAL NAILS-EX T40 STARDRIVE GRAY/5MM EXT",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CAP PROTCT F/ FIX PIN SM 4.0MM",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CAP LOCKING",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"CAP LOCKING TI PANGEA",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"CAP FULL HEAD NON-ST.",188351,CDM,270,RC,,,OUTPATIENT,,,355,230.75,,312.4,88,,249.92,,,0,"percent of total billed charges","88% of total billed charges",177.5,50,,142.00,,,0,"percent of total billed charges","50% of total billed charges",59.64,16.8,,47.71,,,0,"percent of total billed charges","16.8% of total billed charges",355,100,,284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.43,17.304,,49.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.65,63,,178.92,,,0,"percent of total billed charges","63% of total billed charges",54.32,15.3,,43.46,,,0,"percent of total billed charges","15.3% of total billed charges",59.64,16.8,,47.71,,,0,"percent of total billed charges","16.8% of total billed charges",244.95,69,,,,,0,"fee schedule","69% of total billed charges",355,100,,284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",355,100,,284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",355,100,,284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",219.57,61.85,,175.66,,,0,"percent of total billed charges","61.5% of total billed charges",59.64,16.8,,47.71,,,0,"percent of total billed charges","16.8% of total billed charges",177.5,50,,142.00,,,0,"percent of total billed charges","50% of total billed charges",114.31,32.2,,91.45,,,0,"percent of total billed charges","32.2% of total billed charges",59.64,16.8,,47.71,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.83,17.136,,48.66,,,0,"percent of total billed charges","17.136% of total billed charges",77.53,21.84,,62.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",133.84,37.7,,107.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",276.9,78,,221.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",293.23,82.6,,234.58,,,0,"percent of total billed charges","82.6% of total billed charges",59.64,16.8,,47.71,,,0,"percent of total billed charges","16.8% of total billed charges",177.5,50,,142.00,,,0,"percent of total billed charges","50% of total billed charges",293.23,82.6,,234.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.64,16.8,,47.71,,,0,"percent of total billed charges","16.8% of total billed charges",355,100,,284.00,,,0,"percent of total billed charges","100% of total billed charges",54.32,355,
"CAP BOUF 24 INCH BTFLY",174257,CDM,272,RC,,,OUTPATIENT,,,96,62.4,,84.48,88,,67.58,,,0,"percent of total billed charges","88% of total billed charges",48,50,,38.40,,,0,"percent of total billed charges","50% of total billed charges",16.13,16.8,,12.90,,,0,"percent of total billed charges","16.8% of total billed charges",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.61,17.304,,13.29,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.48,63,,48.38,,,0,"percent of total billed charges","63% of total billed charges",14.69,15.3,,11.75,,,0,"percent of total billed charges","15.3% of total billed charges",16.13,16.8,,12.90,,,0,"percent of total billed charges","16.8% of total billed charges",66.24,69,,,,,0,"fee schedule","69% of total billed charges",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.38,61.85,,47.50,,,0,"percent of total billed charges","61.5% of total billed charges",16.13,16.8,,12.90,,,0,"percent of total billed charges","16.8% of total billed charges",48,50,,38.40,,,0,"percent of total billed charges","50% of total billed charges",30.91,32.2,,24.73,,,0,"percent of total billed charges","32.2% of total billed charges",16.13,16.8,,12.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.45,17.136,,13.16,,,0,"percent of total billed charges","17.136% of total billed charges",20.97,21.84,,16.78,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.19,37.7,,28.95,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",74.88,78,,59.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",16.13,16.8,,12.90,,,0,"percent of total billed charges","16.8% of total billed charges",48,50,,38.40,,,0,"percent of total billed charges","50% of total billed charges",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.13,16.8,,12.90,,,0,"percent of total billed charges","16.8% of total billed charges",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",14.69,96,
"CAP BOUF FLORAL LG",148400,CDM,272,RC,,,OUTPATIENT,,,339,220.35,,298.32,88,,238.66,,,0,"percent of total billed charges","88% of total billed charges",169.5,50,,135.60,,,0,"percent of total billed charges","50% of total billed charges",56.95,16.8,,45.56,,,0,"percent of total billed charges","16.8% of total billed charges",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.66,17.304,,46.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.57,63,,170.86,,,0,"percent of total billed charges","63% of total billed charges",51.87,15.3,,41.50,,,0,"percent of total billed charges","15.3% of total billed charges",56.95,16.8,,45.56,,,0,"percent of total billed charges","16.8% of total billed charges",233.91,69,,,,,0,"fee schedule","69% of total billed charges",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.67,61.85,,167.74,,,0,"percent of total billed charges","61.5% of total billed charges",56.95,16.8,,45.56,,,0,"percent of total billed charges","16.8% of total billed charges",169.5,50,,135.60,,,0,"percent of total billed charges","50% of total billed charges",109.16,32.2,,87.33,,,0,"percent of total billed charges","32.2% of total billed charges",56.95,16.8,,45.56,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.09,17.136,,46.47,,,0,"percent of total billed charges","17.136% of total billed charges",74.04,21.84,,59.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",127.8,37.7,,102.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",264.42,78,,211.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",280.01,82.6,,224.01,,,0,"percent of total billed charges","82.6% of total billed charges",56.95,16.8,,45.56,,,0,"percent of total billed charges","16.8% of total billed charges",169.5,50,,135.60,,,0,"percent of total billed charges","50% of total billed charges",280.01,82.6,,224.01,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.95,16.8,,45.56,,,0,"percent of total billed charges","16.8% of total billed charges",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",51.87,339,
"CAP BOUFFANT 21 INCH",426171,CDM,272,RC,,,OUTPATIENT,,,21,13.65,,18.48,88,,14.78,,,0,"percent of total billed charges","88% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.63,17.304,,2.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.23,63,,10.58,,,0,"percent of total billed charges","63% of total billed charges",3.21,15.3,,2.57,,,0,"percent of total billed charges","15.3% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",14.49,69,,,,,0,"fee schedule","69% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.99,61.85,,10.39,,,0,"percent of total billed charges","61.5% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",6.76,32.2,,5.41,,,0,"percent of total billed charges","32.2% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.6,17.136,,2.88,,,0,"percent of total billed charges","17.136% of total billed charges",4.59,21.84,,3.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.92,37.7,,6.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.38,78,,13.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",3.21,21,
"CAP BOUFFANT 24 INCH",240620,CDM,272,RC,,,OUTPATIENT,,,23,14.95,,20.24,88,,16.19,,,0,"percent of total billed charges","88% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.98,17.304,,3.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.49,63,,11.59,,,0,"percent of total billed charges","63% of total billed charges",3.52,15.3,,2.82,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",15.87,69,,,,,0,"fee schedule","69% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.23,61.85,,11.38,,,0,"percent of total billed charges","61.5% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",7.41,32.2,,5.93,,,0,"percent of total billed charges","32.2% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.94,17.136,,3.15,,,0,"percent of total billed charges","17.136% of total billed charges",5.02,21.84,,4.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.94,78,,14.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",3.52,23,
"CAP ENDO SMART",ORSUP0017,CDM,270,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"CAP MEDC SURGEON BLUE TIES",484298,CDM,270,RC,,,OUTPATIENT,,,88,57.2,,77.44,88,,61.95,,,0,"percent of total billed charges","88% of total billed charges",44,50,,35.20,,,0,"percent of total billed charges","50% of total billed charges",14.78,16.8,,11.82,,,0,"percent of total billed charges","16.8% of total billed charges",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.23,17.304,,12.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",55.44,63,,44.35,,,0,"percent of total billed charges","63% of total billed charges",13.46,15.3,,10.77,,,0,"percent of total billed charges","15.3% of total billed charges",14.78,16.8,,11.82,,,0,"percent of total billed charges","16.8% of total billed charges",60.72,69,,,,,0,"fee schedule","69% of total billed charges",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54.43,61.85,,43.54,,,0,"percent of total billed charges","61.5% of total billed charges",14.78,16.8,,11.82,,,0,"percent of total billed charges","16.8% of total billed charges",44,50,,35.20,,,0,"percent of total billed charges","50% of total billed charges",28.34,32.2,,22.67,,,0,"percent of total billed charges","32.2% of total billed charges",14.78,16.8,,11.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.08,17.136,,12.06,,,0,"percent of total billed charges","17.136% of total billed charges",19.22,21.84,,15.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",33.18,37.7,,26.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",68.64,78,,54.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",14.78,16.8,,11.82,,,0,"percent of total billed charges","16.8% of total billed charges",44,50,,35.20,,,0,"percent of total billed charges","50% of total billed charges",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.78,16.8,,11.82,,,0,"percent of total billed charges","16.8% of total billed charges",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",13.46,88,
"CAP NURSE LRG 24 INCH",258009,CDM,270,RC,,,OUTPATIENT,,,136,88.4,,119.68,88,,95.74,,,0,"percent of total billed charges","88% of total billed charges",68,50,,54.40,,,0,"percent of total billed charges","50% of total billed charges",22.85,16.8,,18.28,,,0,"percent of total billed charges","16.8% of total billed charges",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.53,17.304,,18.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.68,63,,68.54,,,0,"percent of total billed charges","63% of total billed charges",20.81,15.3,,16.65,,,0,"percent of total billed charges","15.3% of total billed charges",22.85,16.8,,18.28,,,0,"percent of total billed charges","16.8% of total billed charges",93.84,69,,,,,0,"fee schedule","69% of total billed charges",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.12,61.85,,67.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.85,16.8,,18.28,,,0,"percent of total billed charges","16.8% of total billed charges",68,50,,54.40,,,0,"percent of total billed charges","50% of total billed charges",43.79,32.2,,35.03,,,0,"percent of total billed charges","32.2% of total billed charges",22.85,16.8,,18.28,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.3,17.136,,18.64,,,0,"percent of total billed charges","17.136% of total billed charges",29.7,21.84,,23.76,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",51.27,37.7,,41.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",106.08,78,,84.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.34,82.6,,89.87,,,0,"percent of total billed charges","82.6% of total billed charges",22.85,16.8,,18.28,,,0,"percent of total billed charges","16.8% of total billed charges",68,50,,54.40,,,0,"percent of total billed charges","50% of total billed charges",112.34,82.6,,89.87,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.85,16.8,,18.28,,,0,"percent of total billed charges","16.8% of total billed charges",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",20.81,136,
"CAP RED SURGERY BOUFFANT",318250,CDM,270,RC,,,OUTPATIENT,,,25,16.25,,22,88,,17.60,,,0,"percent of total billed charges","88% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,17.304,,3.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.75,63,,12.60,,,0,"percent of total billed charges","63% of total billed charges",3.83,15.3,,3.06,,,0,"percent of total billed charges","15.3% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",17.25,69,,,,,0,"fee schedule","69% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.46,61.85,,12.37,,,0,"percent of total billed charges","61.5% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",8.05,32.2,,6.44,,,0,"percent of total billed charges","32.2% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.28,17.136,,3.42,,,0,"percent of total billed charges","17.136% of total billed charges",5.46,21.84,,4.37,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.43,37.7,,7.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.5,78,,15.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",3.83,25,
"CAP SURGEON TIE BACK LF BLUE",411923,CDM,270,RC,,,OUTPATIENT,,,63,40.95,,55.44,88,,44.35,,,0,"percent of total billed charges","88% of total billed charges",31.5,50,,25.20,,,0,"percent of total billed charges","50% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.9,17.304,,8.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.69,63,,31.75,,,0,"percent of total billed charges","63% of total billed charges",9.64,15.3,,7.71,,,0,"percent of total billed charges","15.3% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",43.47,69,,,,,0,"fee schedule","69% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.97,61.85,,31.18,,,0,"percent of total billed charges","61.5% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",31.5,50,,25.20,,,0,"percent of total billed charges","50% of total billed charges",20.29,32.2,,16.23,,,0,"percent of total billed charges","32.2% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.8,17.136,,8.64,,,0,"percent of total billed charges","17.136% of total billed charges",13.76,21.84,,11.01,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.75,37.7,,19.00,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",49.14,78,,39.31,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.04,82.6,,41.63,,,0,"percent of total billed charges","82.6% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",31.5,50,,25.20,,,0,"percent of total billed charges","50% of total billed charges",52.04,82.6,,41.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",9.64,63,
"CAP 12/13MM BLD COL TB.GREEN",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"CAP SURGICAL NURSE",490202,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"CAP BOUFFANT PINK RIBBON",490201,CDM,272,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"CAPE PATIENT DISPOSABLE ONE SIZE FITS MOST DARK BLUE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CAPS BOUFFANT GREEN",454884,CDM,270,RC,,,OUTPATIENT,,,104,67.6,,91.52,88,,73.22,,,0,"percent of total billed charges","88% of total billed charges",52,50,,41.60,,,0,"percent of total billed charges","50% of total billed charges",17.47,16.8,,13.98,,,0,"percent of total billed charges","16.8% of total billed charges",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,17.304,,14.40,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",65.52,63,,52.42,,,0,"percent of total billed charges","63% of total billed charges",15.91,15.3,,12.73,,,0,"percent of total billed charges","15.3% of total billed charges",17.47,16.8,,13.98,,,0,"percent of total billed charges","16.8% of total billed charges",71.76,69,,,,,0,"fee schedule","69% of total billed charges",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.32,61.85,,51.46,,,0,"percent of total billed charges","61.5% of total billed charges",17.47,16.8,,13.98,,,0,"percent of total billed charges","16.8% of total billed charges",52,50,,41.60,,,0,"percent of total billed charges","50% of total billed charges",33.49,32.2,,26.79,,,0,"percent of total billed charges","32.2% of total billed charges",17.47,16.8,,13.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.136,,14.26,,,0,"percent of total billed charges","17.136% of total billed charges",22.71,21.84,,18.17,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39.21,37.7,,31.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",81.12,78,,64.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.9,82.6,,68.72,,,0,"percent of total billed charges","82.6% of total billed charges",17.47,16.8,,13.98,,,0,"percent of total billed charges","16.8% of total billed charges",52,50,,41.60,,,0,"percent of total billed charges","50% of total billed charges",85.9,82.6,,68.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.47,16.8,,13.98,,,0,"percent of total billed charges","16.8% of total billed charges",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",15.91,104,
"CAPS FOR URINE TUBES",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CAPTIVATOR POLYPECTOMY SNARE",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CAPTIVATOR II 10MM ROUNDED STIFF",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"CAPTIVATOR II 15MM ROUNDED STIFF",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CAPTIVATOR II 25MM ROUNDED STIFF",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"CAPTIVATOR II 33MM EXTRA LARGE ROUNDED STIFF",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"CARD FLASH STEAM INDICATOR",490203,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"CARDIAC MARKER LT+ 1C",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"CARDIAC MARKER LT+ 3",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"CARDIAC CONTROL 1",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"CARDIAC CONTROL 2",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"CAROTID BYPASS SHUNT 12FR",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"CARTRIDGE SENSOR 02 FOR 7900 VENTILATOR",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CARTRIDGE COLLAGEN/ADP PFA-100 20/PK",ORSUP0017,CDM,270,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"CARTRIDGE  RED",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CART COVERS",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"CARTRIDGE BLACK INK 108R00727",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CARTRIDGE REPRO TNR DELL BLK 1700 1700N 1710 1710N - UNIVERSAL TONER CARTRIDGE COMPATIBLE WITH IBM I",ORSUP0009,CDM,270,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"CARTRIDGE REPRO TNR HIGH YIELD HP BLK M4555 MFP M601N M601DN M602DN M602N LSRJT ENTRP 600",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"CARTRIDGE REPRO TNR HIGH YIELD HP BLK P4014 P4014DN P4014N P4015 P4015DN P4015N P4515 LSRJT",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"CARTRIDGE TONER 460",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CARTRIDGE TONER LEXMARK E260DN 35000 PAGE YIELD",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CARTRIDGES TROPHON SONEX-HL",ORSUP0011,CDM,270,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CARTRIDGE EPI TEST",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"CARTER THOMASON CLOSURE SYSTEM",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CASCADE URETERAL STENT 6FR X 26CM",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.7% of total billed charges",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.46,33.9,,69.97,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"CASCADE URETERAL STENT 6FR X 24CM",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.7% of total billed charges",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.46,33.9,,69.97,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"CASCADE URETERAL STENT 6FR X 22CM",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.7% of total billed charges",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.75,33.9,,83.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"CASCADE URETERAL STENT 4.9FR X 24CM",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.7% of total billed charges",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.46,33.9,,69.97,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"CASCADE URETERAL STENT 4.9FR X 26CM",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.7% of total billed charges",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.46,33.9,,69.97,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"CASE CART COVERS XL",490207,CDM,270,RC,,,OUTPATIENT,,,52,33.8,,45.76,88,,36.61,,,0,"percent of total billed charges","88% of total billed charges",26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,17.304,,7.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.76,63,,26.21,,,0,"percent of total billed charges","63% of total billed charges",7.96,15.3,,6.37,,,0,"percent of total billed charges","15.3% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",35.88,69,,,,,0,"fee schedule","69% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.16,61.85,,25.73,,,0,"percent of total billed charges","61.5% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",16.74,32.2,,13.39,,,0,"percent of total billed charges","32.2% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.91,17.136,,7.13,,,0,"percent of total billed charges","17.136% of total billed charges",11.36,21.84,,9.09,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.6,37.7,,15.68,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",40.56,78,,32.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",7.96,52,
"CASE CART COVER",490206,CDM,270,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"CASSETTES STERRAD             10113",37074,CDM,272,RC,,,OUTPATIENT,,,653,424.45,,574.64,88,,459.71,,,0,"percent of total billed charges","88% of total billed charges",326.5,50,,261.20,,,0,"percent of total billed charges","50% of total billed charges",109.7,16.8,,87.76,,,0,"percent of total billed charges","16.8% of total billed charges",653,100,,522.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",113,17.304,,90.40,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",411.39,63,,329.11,,,0,"percent of total billed charges","63% of total billed charges",99.91,15.3,,79.93,,,0,"percent of total billed charges","15.3% of total billed charges",109.7,16.8,,87.76,,,0,"percent of total billed charges","16.8% of total billed charges",450.57,69,,,,,0,"fee schedule","69% of total billed charges",653,100,,522.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",653,100,,522.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",653,100,,522.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.88,61.85,,323.10,,,0,"percent of total billed charges","61.5% of total billed charges",109.7,16.8,,87.76,,,0,"percent of total billed charges","16.8% of total billed charges",326.5,50,,261.20,,,0,"percent of total billed charges","50% of total billed charges",210.27,32.2,,168.22,,,0,"percent of total billed charges","32.2% of total billed charges",109.7,16.8,,87.76,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",111.9,17.136,,89.52,,,0,"percent of total billed charges","17.136% of total billed charges",142.62,21.84,,114.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",246.18,37.7,,196.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",509.34,78,,407.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.38,82.6,,431.50,,,0,"percent of total billed charges","82.6% of total billed charges",109.7,16.8,,87.76,,,0,"percent of total billed charges","16.8% of total billed charges",326.5,50,,261.20,,,0,"percent of total billed charges","50% of total billed charges",539.38,82.6,,431.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",109.7,16.8,,87.76,,,0,"percent of total billed charges","16.8% of total billed charges",653,100,,522.40,,,0,"percent of total billed charges","100% of total billed charges",99.91,653,
"CASSETTE STERIL 5 CYCLE STERRAD NX",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CASSETTE DRAPE",490208,CDM,270,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.9,61.85,,7.92,,,0,"percent of total billed charges","61.5% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"CASTING TAPE 2'' PINK",490211,CDM,270,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.37,61.85,,9.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"CASTING TAPE 2'' BLUE",490210,CDM,270,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.37,61.85,,9.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"CAST PADDING 4''",490209,CDM,270,RC,,,OUTPATIENT,,,136,88.4,,119.68,88,,95.74,,,0,"percent of total billed charges","88% of total billed charges",68,50,,54.40,,,0,"percent of total billed charges","50% of total billed charges",22.85,16.8,,18.28,,,0,"percent of total billed charges","16.8% of total billed charges",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.53,17.304,,18.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.68,63,,68.54,,,0,"percent of total billed charges","63% of total billed charges",20.81,15.3,,16.65,,,0,"percent of total billed charges","15.3% of total billed charges",22.85,16.8,,18.28,,,0,"percent of total billed charges","16.8% of total billed charges",93.84,69,,,,,0,"fee schedule","69% of total billed charges",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.12,61.85,,67.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.85,16.8,,18.28,,,0,"percent of total billed charges","16.8% of total billed charges",68,50,,54.40,,,0,"percent of total billed charges","50% of total billed charges",43.79,32.2,,35.03,,,0,"percent of total billed charges","32.2% of total billed charges",22.85,16.8,,18.28,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.3,17.136,,18.64,,,0,"percent of total billed charges","17.136% of total billed charges",29.7,21.84,,23.76,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",51.27,37.7,,41.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",106.08,78,,84.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.34,82.6,,89.87,,,0,"percent of total billed charges","82.6% of total billed charges",22.85,16.8,,18.28,,,0,"percent of total billed charges","16.8% of total billed charges",68,50,,54.40,,,0,"percent of total billed charges","50% of total billed charges",112.34,82.6,,89.87,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.85,16.8,,18.28,,,0,"percent of total billed charges","16.8% of total billed charges",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",20.81,136,
"CAT 5FR TRANS 4.0 RADIAL",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"CATARRHAL IS TEST DISC",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATALASE REAGENT DROPPER",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CATH IV AUTOGUARD PINK 20G X 1.16IN",66578,CDM,272,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"CATH IV 24G X .75 IN AUTOGUARD YELLOW",167583,CDM,272,RC,,,OUTPATIENT,,,637,414.05,,560.56,88,,448.45,,,0,"percent of total billed charges","88% of total billed charges",318.5,50,,254.80,,,0,"percent of total billed charges","50% of total billed charges",107.02,16.8,,85.62,,,0,"percent of total billed charges","16.8% of total billed charges",637,100,,509.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.23,17.304,,88.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",401.31,63,,321.05,,,0,"percent of total billed charges","63% of total billed charges",97.46,15.3,,77.97,,,0,"percent of total billed charges","15.3% of total billed charges",107.02,16.8,,85.62,,,0,"percent of total billed charges","16.8% of total billed charges",439.53,69,,,,,0,"fee schedule","69% of total billed charges",637,100,,509.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",637,100,,509.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",637,100,,509.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",393.98,61.85,,315.18,,,0,"percent of total billed charges","61.5% of total billed charges",107.02,16.8,,85.62,,,0,"percent of total billed charges","16.8% of total billed charges",318.5,50,,254.80,,,0,"percent of total billed charges","50% of total billed charges",205.11,32.2,,164.09,,,0,"percent of total billed charges","32.2% of total billed charges",107.02,16.8,,85.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",109.16,17.136,,87.33,,,0,"percent of total billed charges","17.136% of total billed charges",139.12,21.84,,111.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",240.15,37.7,,192.12,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",496.86,78,,397.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",526.16,82.6,,420.93,,,0,"percent of total billed charges","82.6% of total billed charges",107.02,16.8,,85.62,,,0,"percent of total billed charges","16.8% of total billed charges",318.5,50,,254.80,,,0,"percent of total billed charges","50% of total billed charges",526.16,82.6,,420.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",107.02,16.8,,85.62,,,0,"percent of total billed charges","16.8% of total billed charges",637,100,,509.60,,,0,"percent of total billed charges","100% of total billed charges",97.46,637,
"CATH IV AUTOGUARD BLUE 22GA X 1IN",142892,CDM,272,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"CATH IV 14G3.25IN ANGIOCATH",185920,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"CATH IV AUTOGUARD GRN 18GA X 1.16IN",142894,CDM,272,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"CATH IV INSYTE 16 X 1.77",79758,CDM,272,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"CATH IV AUTOGUARD GRAY 16G X 1.16IN",142893,CDM,272,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"CATH IV AUTOGUARD SHIELDED 14gx1.75",88087,CDM,272,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"CATH FOLEY 5CC 12FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CATH URETH RED RUBBER 8FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CATH URETH RED RUBBER 18FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CATH URETH RED RUBBER 14FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CATH ROBINSON 10 FR",8490,CDM,272,RC,,,OUTPATIENT,,,24,15.6,,21.12,88,,16.90,,,0,"percent of total billed charges","88% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.15,17.304,,3.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.12,63,,12.10,,,0,"percent of total billed charges","63% of total billed charges",3.67,15.3,,2.94,,,0,"percent of total billed charges","15.3% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",16.56,69,,,,,0,"fee schedule","69% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.84,61.85,,11.87,,,0,"percent of total billed charges","61.5% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",7.73,32.2,,6.18,,,0,"percent of total billed charges","32.2% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.11,17.136,,3.29,,,0,"percent of total billed charges","17.136% of total billed charges",5.24,21.84,,4.19,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.05,37.7,,7.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.72,78,,14.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,24,
"CATH COUNCIL 2W 5CC 18FR",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"CATH FOLEY 16FR 5CC 3 WAY",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH FOLEY 20FR 30CC 2WAY",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CATH FOLEY LUB 18FR 5CC 2WAY COUDE TIP",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH UTILITY RED 8FR",39736,CDM,272,RC,,,OUTPATIENT,,,24,15.6,,21.12,88,,16.90,,,0,"percent of total billed charges","88% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.15,17.304,,3.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.12,63,,12.10,,,0,"percent of total billed charges","63% of total billed charges",3.67,15.3,,2.94,,,0,"percent of total billed charges","15.3% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",16.56,69,,,,,0,"fee schedule","69% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.84,61.85,,11.87,,,0,"percent of total billed charges","61.5% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",7.73,32.2,,6.18,,,0,"percent of total billed charges","32.2% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.11,17.136,,3.29,,,0,"percent of total billed charges","17.136% of total billed charges",5.24,21.84,,4.19,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.05,37.7,,7.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.72,78,,14.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,24,
"CATH BALLOON CRE 6-7-8 MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CATH BALLOON DILATION CRE 8-9-10MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CATH BALLOON DILATATION CRE WIRE GUIDED 15-18MM",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"CATHERTER BALLOON L180CM L5.5CM OD 15-18MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CATH BLN DILATATION CRE WIRE GD 12-15MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CATH BLN DILATATION CRE WIRE GD 10-12MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CATH SINUS BALLOON 7MM X 16MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CATHETER BALLOON DILATATION ULTRASOUND BRONCHOSCOPE",ORSUP0019,CDM,278,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",668.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.7% of total billed charges",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",726.14,33.9,,580.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"CATHETER BALLOON SINUS SOLO PRO RELIEVA 6MM D X 16MM L",ORSUP0025,CDM,278,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",1169.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.7% of total billed charges",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.91,33.9,,1016.73,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"CATHETER SOUNDSTAR 8FR 90CM",ORSUP0063,CDM,278,RC,,,OUTPATIENT,,,14193,9225.45,,12489.84,88,,9991.87,,,0,"percent of total billed charges","88% of total billed charges",7096.5,50,,5677.20,,,0,"percent of total billed charges","50% of total billed charges",2384.42,16.8,,1907.54,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2455.96,17.304,,1964.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8941.59,63,,7153.27,,,0,"percent of total billed charges","63% of total billed charges",2171.53,15.3,,1737.22,,,0,"percent of total billed charges","15.3% of total billed charges",2384.42,16.8,,1907.54,,,0,"percent of total billed charges","16.8% of total billed charges",9793.17,69,,,,,0,"fee schedule","69% of total billed charges",14193,100,,11354.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14193,100,,11354.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14193,100,,11354.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8778.37,61.85,,7022.70,,,0,"percent of total billed charges","61.5% of total billed charges",2384.42,16.8,,1907.54,,,0,"percent of total billed charges","16.8% of total billed charges",7096.5,50,,5677.20,,,0,"percent of total billed charges","50% of total billed charges",4570.15,32.2,,3656.12,,,0,"percent of total billed charges","32.2% of total billed charges",4428.22,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2432.11,17.136,,1945.69,,,0,"percent of total billed charges","17.136% of total billed charges",3099.75,21.84,,2479.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",5350.76,37.7,,4280.61,,,0,"percent of total billed charges","37.7% of total billed charges",5350.76,37.7,,4280.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4811.43,33.9,,3849.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",11070.54,78,,8856.43,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11723.42,82.6,,9378.74,,,0,"percent of total billed charges","82.6% of total billed charges",2384.42,16.8,,1907.54,,,0,"percent of total billed charges","16.8% of total billed charges",7096.5,50,,5677.20,,,0,"percent of total billed charges","50% of total billed charges",11723.42,82.6,,9378.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2384.42,16.8,,1907.54,,,0,"percent of total billed charges","16.8% of total billed charges",14193,100,,11354.40,,,0,"percent of total billed charges","100% of total billed charges",2171.53,14193,
"CATH EP 5FR 120CM CRD-2 QUADRIPOLAR SUPREME",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"CATH EP BLAZER DUODECAPOLAR SUPER LARGE",ORSUP0040,CDM,278,RC,,,OUTPATIENT,,,7766,5047.9,,6834.08,88,,5467.26,,,0,"percent of total billed charges","88% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1343.83,17.304,,1075.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4892.58,63,,3914.06,,,0,"percent of total billed charges","63% of total billed charges",1188.2,15.3,,950.56,,,0,"percent of total billed charges","15.3% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",5358.54,69,,,,,0,"fee schedule","69% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4803.27,61.85,,3842.62,,,0,"percent of total billed charges","61.5% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",2500.65,32.2,,2000.52,,,0,"percent of total billed charges","32.2% of total billed charges",2422.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1330.78,17.136,,1064.62,,,0,"percent of total billed charges","17.136% of total billed charges",1696.09,21.84,,1356.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2927.78,37.7,,2342.22,,,0,"percent of total billed charges","37.7% of total billed charges",2927.78,37.7,,2342.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2632.67,33.9,,2106.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6057.48,78,,4845.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",1188.2,7766,
"CATH EZ STEER NAV D-F",ORSUP0054,CDM,278,RC,,,OUTPATIENT,,,11515,7484.75,,10133.2,88,,8106.56,,,0,"percent of total billed charges","88% of total billed charges",5757.5,50,,4606.00,,,0,"percent of total billed charges","50% of total billed charges",1934.52,16.8,,1547.62,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1992.56,17.304,,1594.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7254.45,63,,5803.56,,,0,"percent of total billed charges","63% of total billed charges",1761.8,15.3,,1409.44,,,0,"percent of total billed charges","15.3% of total billed charges",1934.52,16.8,,1547.62,,,0,"percent of total billed charges","16.8% of total billed charges",7945.35,69,,,,,0,"fee schedule","69% of total billed charges",11515,100,,9212.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11515,100,,9212.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11515,100,,9212.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7122.03,61.85,,5697.62,,,0,"percent of total billed charges","61.5% of total billed charges",1934.52,16.8,,1547.62,,,0,"percent of total billed charges","16.8% of total billed charges",5757.5,50,,4606.00,,,0,"percent of total billed charges","50% of total billed charges",3707.83,32.2,,2966.26,,,0,"percent of total billed charges","32.2% of total billed charges",3592.68,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1973.21,17.136,,1578.57,,,0,"percent of total billed charges","17.136% of total billed charges",2514.88,21.84,,2011.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4341.16,37.7,,3472.93,,,0,"percent of total billed charges","37.7% of total billed charges",4341.16,37.7,,3472.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3903.59,33.9,,3122.87,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",8981.7,78,,7185.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9511.39,82.6,,7609.11,,,0,"percent of total billed charges","82.6% of total billed charges",1934.52,16.8,,1547.62,,,0,"percent of total billed charges","16.8% of total billed charges",5757.5,50,,4606.00,,,0,"percent of total billed charges","50% of total billed charges",9511.39,82.6,,7609.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1934.52,16.8,,1547.62,,,0,"percent of total billed charges","16.8% of total billed charges",11515,100,,9212.00,,,0,"percent of total billed charges","100% of total billed charges",1761.8,11515,
"CATH EP THMCL SMTCH SF BID TC D-F",ORSUP0083,CDM,278,RC,,,OUTPATIENT,,,19549,12706.85,,17203.12,88,,13762.50,,,0,"percent of total billed charges","88% of total billed charges",9774.5,50,,7819.60,,,0,"percent of total billed charges","50% of total billed charges",3284.23,16.8,,2627.38,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3382.76,17.304,,2706.21,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12315.87,63,,9852.70,,,0,"percent of total billed charges","63% of total billed charges",2991,15.3,,2392.80,,,0,"percent of total billed charges","15.3% of total billed charges",3284.23,16.8,,2627.38,,,0,"percent of total billed charges","16.8% of total billed charges",13488.81,69,,,,,0,"fee schedule","69% of total billed charges",19549,100,,15639.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19549,100,,15639.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19549,100,,15639.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12091.06,61.85,,9672.85,,,0,"percent of total billed charges","61.5% of total billed charges",3284.23,16.8,,2627.38,,,0,"percent of total billed charges","16.8% of total billed charges",9774.5,50,,7819.60,,,0,"percent of total billed charges","50% of total billed charges",6294.78,32.2,,5035.82,,,0,"percent of total billed charges","32.2% of total billed charges",6099.29,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3349.92,17.136,,2679.94,,,0,"percent of total billed charges","17.136% of total billed charges",4269.5,21.84,,3415.60,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",7369.97,37.7,,5895.98,,,0,"percent of total billed charges","37.7% of total billed charges",7369.97,37.7,,5895.98,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",6627.11,33.9,,5301.69,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",15248.22,78,,12198.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16147.47,82.6,,12917.98,,,0,"percent of total billed charges","82.6% of total billed charges",3284.23,16.8,,2627.38,,,0,"percent of total billed charges","16.8% of total billed charges",9774.5,50,,7819.60,,,0,"percent of total billed charges","50% of total billed charges",16147.47,82.6,,12917.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3284.23,16.8,,2627.38,,,0,"percent of total billed charges","16.8% of total billed charges",19549,100,,15639.20,,,0,"percent of total billed charges","100% of total billed charges",2991,19549,
"CATHETER PENTARAY NAV ECO 2 F-CURVE",ORSUP0048,CDM,272,RC,,,OUTPATIENT,,,9909,6440.85,,8719.92,88,,6975.94,,,0,"percent of total billed charges","88% of total billed charges",4954.5,50,,3963.60,,,0,"percent of total billed charges","50% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1714.65,17.304,,1371.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6242.67,63,,4994.14,,,0,"percent of total billed charges","63% of total billed charges",1516.08,15.3,,1212.86,,,0,"percent of total billed charges","15.3% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",6837.21,69,,,,,0,"fee schedule","69% of total billed charges",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6128.72,61.85,,4902.98,,,0,"percent of total billed charges","61.5% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",4954.5,50,,3963.60,,,0,"percent of total billed charges","50% of total billed charges",3190.7,32.2,,2552.56,,,0,"percent of total billed charges","32.2% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1698.01,17.136,,1358.41,,,0,"percent of total billed charges","17.136% of total billed charges",2164.13,21.84,,1731.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3735.69,37.7,,2988.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7729.02,78,,6183.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8184.83,82.6,,6547.86,,,0,"percent of total billed charges","82.6% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",4954.5,50,,3963.60,,,0,"percent of total billed charges","50% of total billed charges",8184.83,82.6,,6547.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",1516.08,9909,
"CATH GUIDE RADIAL TIGER 4.0 6FR",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"CATH GLIDE 5FR ST 038 100CM",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH ANGIO SPR TRQ HYDRO STR TPR 5F.038 65CM",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH 5FR 65CM ANGLED TIP     32 136",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH GLIDE ANGLED TAPER 5FR",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH GLIDE ANGLED 65CM",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"CATH GLIDE STRAIGHT 120CM 4F",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH DELIVERY PXSLIM ..025-90",ORSUP0029,CDM,278,RC,,,OUTPATIENT,,,4820,3133,,4241.6,88,,3393.28,,,0,"percent of total billed charges","88% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",834.05,17.304,,667.24,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3036.6,63,,2429.28,,,0,"percent of total billed charges","63% of total billed charges",737.46,15.3,,589.97,,,0,"percent of total billed charges","15.3% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",3325.8,69,,,,,0,"fee schedule","69% of total billed charges",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2981.17,61.85,,2384.94,,,0,"percent of total billed charges","61.5% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",1552.04,32.2,,1241.63,,,0,"percent of total billed charges","32.2% of total billed charges",1503.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",825.96,17.136,,660.77,,,0,"percent of total billed charges","17.136% of total billed charges",1052.69,21.84,,842.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1817.14,37.7,,1453.71,,,0,"percent of total billed charges","37.7% of total billed charges",1817.14,37.7,,1453.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1633.98,33.9,,1307.18,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3759.6,78,,3007.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3981.32,82.6,,3185.06,,,0,"percent of total billed charges","82.6% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",3981.32,82.6,,3185.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",737.46,4820,
"CATH GUIDE 110 DEGREE SINUS RELIEVA",ORSUP0019,CDM,278,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",668.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.7% of total billed charges",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",726.14,33.9,,580.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"CATH GUIDE 6F EBU375",ORSUP0004,CDM,278,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.7% of total billed charges",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.85,33.9,,72.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"CATH GUIDE 70 DEGREE SINUS RELIEVA",ORSUP0019,CDM,278,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",668.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.7% of total billed charges",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",726.14,33.9,,580.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"CATH GUIDE LAUNCHER 5F IMA",ORSUP0004,CDM,278,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.7% of total billed charges",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.85,33.9,,72.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"CATH GUIDE LAUNCHER 6F AL.75",ORSUP0004,CDM,278,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.7% of total billed charges",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.85,33.9,,72.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"CATH GUIDE LAUNCHER 6F AL1.0",ORSUP0004,CDM,278,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.7% of total billed charges",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.85,33.9,,72.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"CATH GUIDE LAUNCHER 6F AL2.0",ORSUP0004,CDM,278,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.7% of total billed charges",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.85,33.9,,72.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"CATH GUIDE LAUNCHER 6F AR1.0",ORSUP0004,CDM,278,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.7% of total billed charges",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.85,33.9,,72.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"CATH GUIDE LAUNCHER 6F EBU3.0",ORSUP0004,CDM,278,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.7% of total billed charges",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.85,33.9,,72.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"CATH GUIDE LAUNCHER 6F EBU3.5",ORSUP0004,CDM,278,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.7% of total billed charges",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.85,33.9,,72.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"CATH GUIDE LAUNCHER 6F EBU4.0",ORSUP0004,CDM,278,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.7% of total billed charges",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.85,33.9,,72.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"CATH GUIDE LAUNCHER 6F IMA",ORSUP0004,CDM,278,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.7% of total billed charges",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.85,33.9,,72.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"CATH GUIDE LAUNCHER 6F JL3.5",ORSUP0004,CDM,278,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.7% of total billed charges",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.85,33.9,,72.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"CATH GUIDE LAUNCHER 6F JL4.0",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH GUIDE LAUNCHER 6F JR4.0",ORSUP0004,CDM,278,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.7% of total billed charges",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.85,33.9,,72.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"CATH GUIDE LAUNCHER 6F LCB",ORSUP0004,CDM,278,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.7% of total billed charges",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.85,33.9,,72.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"CATH RITESITE",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"CATH TRAILBLAZER .014X135CM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH TRAILBLAZER .014X150CM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH TRAILBLAZER .035X135CM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH TRAILBLAZER .035X150CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATH TRAILBLAZER .035X90CM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATHETER GUIDELINER 5FR",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",751.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.7% of total billed charges",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",816.99,33.9,,653.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"CATHETER GUIDELINER 6FR",ORSUP0022,CDM,278,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",919.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.7% of total billed charges",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",998.69,33.9,,798.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"CATHETER PIGTAIL SIZING 100CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATHETER TURNPIKE GOLD 5FR 135CM",ORSUP0024,CDM,278,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",1086.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.7% of total billed charges",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1180.06,33.9,,944.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"CATH DIALYSIS 19FR",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"CATH DIALYSIS 24FR",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"CATH PERFORATOR RIGID",ORSUP0025,CDM,272,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"CATHETER CODMAN EXTERNAL DRAINAGE",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CATH MEDI TECH FLEX APD 8FR",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"CATH MEDI TECH FLEX APD 12FR",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"CATH SET APD FLEXIMA REGULAR 10FR",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"CATHETER LAVAGE SINUS",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATHETER INFUSION 4FR 135CM 10CM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH GROSHONG DUAL LUMEN 9.5 FR",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",751.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.7% of total billed charges",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",816.99,33.9,,653.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"CATH SWAN-GANZ 5FR",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH THERMODILUTION 7FR",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"CATH INFUSION TRELLIS 8FR 120CM",ORSUP0054,CDM,278,RC,,,OUTPATIENT,,,11515,7484.75,,10133.2,88,,8106.56,,,0,"percent of total billed charges","88% of total billed charges",5757.5,50,,4606.00,,,0,"percent of total billed charges","50% of total billed charges",1934.52,16.8,,1547.62,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1992.56,17.304,,1594.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7254.45,63,,5803.56,,,0,"percent of total billed charges","63% of total billed charges",1761.8,15.3,,1409.44,,,0,"percent of total billed charges","15.3% of total billed charges",1934.52,16.8,,1547.62,,,0,"percent of total billed charges","16.8% of total billed charges",7945.35,69,,,,,0,"fee schedule","69% of total billed charges",11515,100,,9212.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11515,100,,9212.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11515,100,,9212.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7122.03,61.85,,5697.62,,,0,"percent of total billed charges","61.5% of total billed charges",1934.52,16.8,,1547.62,,,0,"percent of total billed charges","16.8% of total billed charges",5757.5,50,,4606.00,,,0,"percent of total billed charges","50% of total billed charges",3707.83,32.2,,2966.26,,,0,"percent of total billed charges","32.2% of total billed charges",3592.68,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1973.21,17.136,,1578.57,,,0,"percent of total billed charges","17.136% of total billed charges",2514.88,21.84,,2011.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4341.16,37.7,,3472.93,,,0,"percent of total billed charges","37.7% of total billed charges",4341.16,37.7,,3472.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3903.59,33.9,,3122.87,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",8981.7,78,,7185.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9511.39,82.6,,7609.11,,,0,"percent of total billed charges","82.6% of total billed charges",1934.52,16.8,,1547.62,,,0,"percent of total billed charges","16.8% of total billed charges",5757.5,50,,4606.00,,,0,"percent of total billed charges","50% of total billed charges",9511.39,82.6,,7609.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1934.52,16.8,,1547.62,,,0,"percent of total billed charges","16.8% of total billed charges",11515,100,,9212.00,,,0,"percent of total billed charges","100% of total billed charges",1761.8,11515,
"CATH EAGLE EYE IVUS IMAGING",ORSUP0026,CDM,278,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",1253.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.7% of total billed charges",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1361.76,33.9,,1089.41,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"CATH INTRAVASCULAR ULTRASOUND IMAGING VISIONS PV 8.2F 90CM",ORSUP0031,CDM,278,RC,,,OUTPATIENT,,,5356,3481.4,,4713.28,88,,3770.62,,,0,"percent of total billed charges","88% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",926.8,17.304,,741.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3374.28,63,,2699.42,,,0,"percent of total billed charges","63% of total billed charges",819.47,15.3,,655.58,,,0,"percent of total billed charges","15.3% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",3695.64,69,,,,,0,"fee schedule","69% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3312.69,61.85,,2650.15,,,0,"percent of total billed charges","61.5% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",1724.63,32.2,,1379.70,,,0,"percent of total billed charges","32.2% of total billed charges",1671.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",917.8,17.136,,734.24,,,0,"percent of total billed charges","17.136% of total billed charges",1169.75,21.84,,935.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.7% of total billed charges",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1815.68,33.9,,1452.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4177.68,78,,3342.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",819.47,5356,
"CATH PIONEER 6FR 120CM",ORSUP0070,CDM,278,RC,,,OUTPATIENT,,,16068,10444.2,,14139.84,88,,11311.87,,,0,"percent of total billed charges","88% of total billed charges",8034,50,,6427.20,,,0,"percent of total billed charges","50% of total billed charges",2699.42,16.8,,2159.54,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2780.41,17.304,,2224.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10122.84,63,,8098.27,,,0,"percent of total billed charges","63% of total billed charges",2458.4,15.3,,1966.72,,,0,"percent of total billed charges","15.3% of total billed charges",2699.42,16.8,,2159.54,,,0,"percent of total billed charges","16.8% of total billed charges",11086.92,69,,,,,0,"fee schedule","69% of total billed charges",16068,100,,12854.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16068,100,,12854.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16068,100,,12854.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9938.06,61.85,,7950.45,,,0,"percent of total billed charges","61.5% of total billed charges",2699.42,16.8,,2159.54,,,0,"percent of total billed charges","16.8% of total billed charges",8034,50,,6427.20,,,0,"percent of total billed charges","50% of total billed charges",5173.9,32.2,,4139.12,,,0,"percent of total billed charges","32.2% of total billed charges",5013.22,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2753.41,17.136,,2202.73,,,0,"percent of total billed charges","17.136% of total billed charges",3509.25,21.84,,2807.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",6057.64,37.7,,4846.11,,,0,"percent of total billed charges","37.7% of total billed charges",6057.64,37.7,,4846.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",5447.05,33.9,,4357.64,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",12533.04,78,,10026.43,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13272.17,82.6,,10617.74,,,0,"percent of total billed charges","82.6% of total billed charges",2699.42,16.8,,2159.54,,,0,"percent of total billed charges","16.8% of total billed charges",8034,50,,6427.20,,,0,"percent of total billed charges","50% of total billed charges",13272.17,82.6,,10617.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.42,16.8,,2159.54,,,0,"percent of total billed charges","16.8% of total billed charges",16068,100,,12854.40,,,0,"percent of total billed charges","100% of total billed charges",2458.4,16068,
"CATH BALLOON CODA 10FR 32MM X 100CM",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",751.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.7% of total billed charges",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",816.99,33.9,,653.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"CATH BALLOON 6FR DOUBLE LUMEN 90CM",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH INTRODUCER HYDRPHL  6FR 90CM RADOPQ BND",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"CATH BALLOON INTRA AORT MEGA 7.5F 40CC",ORSUP0031,CDM,278,RC,,,OUTPATIENT,,,5356,3481.4,,4713.28,88,,3770.62,,,0,"percent of total billed charges","88% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",926.8,17.304,,741.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3374.28,63,,2699.42,,,0,"percent of total billed charges","63% of total billed charges",819.47,15.3,,655.58,,,0,"percent of total billed charges","15.3% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",3695.64,69,,,,,0,"fee schedule","69% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3312.69,61.85,,2650.15,,,0,"percent of total billed charges","61.5% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",1724.63,32.2,,1379.70,,,0,"percent of total billed charges","32.2% of total billed charges",1671.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",917.8,17.136,,734.24,,,0,"percent of total billed charges","17.136% of total billed charges",1169.75,21.84,,935.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.7% of total billed charges",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1815.68,33.9,,1452.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4177.68,78,,3342.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",819.47,5356,
"CATHETER BALLOON 7.5FR 40CC INTRAATC LINEAR",ORSUP0028,CDM,278,RC,,,OUTPATIENT,,,4553,2959.45,,4006.64,88,,3205.31,,,0,"percent of total billed charges","88% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",787.85,17.304,,630.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2868.39,63,,2294.71,,,0,"percent of total billed charges","63% of total billed charges",696.61,15.3,,557.29,,,0,"percent of total billed charges","15.3% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",3141.57,69,,,,,0,"fee schedule","69% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2816.03,61.85,,2252.82,,,0,"percent of total billed charges","61.5% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",1466.07,32.2,,1172.86,,,0,"percent of total billed charges","32.2% of total billed charges",1420.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",780.2,17.136,,624.16,,,0,"percent of total billed charges","17.136% of total billed charges",994.38,21.84,,795.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.7% of total billed charges",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1543.47,33.9,,1234.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3551.34,78,,2841.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",696.61,4553,
"CATH CORONARY DILAT RX  TREK 4.0MMX08MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH CORONARY DILAT RX MINI TREK 4.0MM X 15MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH CORONARY DILAT RX MINI TREK 3.0MM X 15MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH CORONARY DILAT RX MINI TREK 3.50MM X 15MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH CORONARY DILAT RX MINI TREK 2.0MM X 08MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH CORONARY DILAT OTW TREK 2.0MMX06MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH CORONARY DILAT RX MINI TREK 2.0MM X 20MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH CORONARY DILAT RX MINI TREK 2.0MM X 15MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH CORONARY DILAT OTW TREK 2.0MMX15MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH CORONARY DILAT OTW TREK 2.0MMX12MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH CORONARY DILAT RX MINI TREK 2.5MM X 20MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH CORONARY DILAT RX MINI TREK 2.5MM X 15MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH CORONARY DILAT RX MINI TREK 1.50MMX08MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH CORONARY DILAT OTW 1.50 MMX06MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH CORONARY DILAT RX MINI TREK 1.5MM X 12MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH CORONARY DILAT OTW TREK 1.50MMX12MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH BALLOON MINI TREK OTW 1.20X8",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH BLN 135CM 2CM 8MM DORADO PERI NC 3 LUM PTCA DR13582",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"CATH BALLOON EMERGE RX 4.0X20",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATHETER BALLOON DIALATION 3.00MM X 15MM EMERGE",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CATH BALLOON EMERGE RX 2.0X20",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CATH BALLOON EMERGE RX 2.0X15",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CATH BALLOON DIL 6FR 2.5MM .07IN 144CM 20MM PTCA DL SHFT DSGN",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CATH BALLOON EMERGE 2.5X15",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CATH BALLOON EMERGE RX 2.25X20",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH BALLOON EMERGE RX 1.5X15",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH BALLOON STERLING OTW 9 X 3 135CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CATH BALLOON STERLING RX 8 X 10 80CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CATH BALLOON STERLING RX 7 X 10 80CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CATH BALLOON STERLING RX 6 X 10 80CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CATH BALLOON STERLING RX 5 X 15 80CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CATH BALLOON STERLING 5.5X40X135CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CATH BALLOON STERLING RX 4.5 X 30 135CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CATH BALN CTNG FLEXTOME 3.0 X 10MM DILATATION",ORSUP0028,CDM,278,RC,,,OUTPATIENT,,,4553,2959.45,,4006.64,88,,3205.31,,,0,"percent of total billed charges","88% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",787.85,17.304,,630.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2868.39,63,,2294.71,,,0,"percent of total billed charges","63% of total billed charges",696.61,15.3,,557.29,,,0,"percent of total billed charges","15.3% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",3141.57,69,,,,,0,"fee schedule","69% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2816.03,61.85,,2252.82,,,0,"percent of total billed charges","61.5% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",1466.07,32.2,,1172.86,,,0,"percent of total billed charges","32.2% of total billed charges",1420.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",780.2,17.136,,624.16,,,0,"percent of total billed charges","17.136% of total billed charges",994.38,21.84,,795.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.7% of total billed charges",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1543.47,33.9,,1234.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3551.34,78,,2841.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",696.61,4553,
"CATH BALN CTNG FLEXTOME 3.5 X 10MM DILATATION",ORSUP0027,CDM,278,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",1336.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.7% of total billed charges",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1452.62,33.9,,1162.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"CATH BALN CTNG FLEXTOME 3.25 X 15MM DILATATION",ORSUP0028,CDM,278,RC,,,OUTPATIENT,,,4553,2959.45,,4006.64,88,,3205.31,,,0,"percent of total billed charges","88% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",787.85,17.304,,630.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2868.39,63,,2294.71,,,0,"percent of total billed charges","63% of total billed charges",696.61,15.3,,557.29,,,0,"percent of total billed charges","15.3% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",3141.57,69,,,,,0,"fee schedule","69% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2816.03,61.85,,2252.82,,,0,"percent of total billed charges","61.5% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",1466.07,32.2,,1172.86,,,0,"percent of total billed charges","32.2% of total billed charges",1420.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",780.2,17.136,,624.16,,,0,"percent of total billed charges","17.136% of total billed charges",994.38,21.84,,795.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.7% of total billed charges",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1543.47,33.9,,1234.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3551.34,78,,2841.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",696.61,4553,
"CATH BALN CTNG FLEXTOME 3.25 X 10MM DILATATION",ORSUP0028,CDM,278,RC,,,OUTPATIENT,,,4553,2959.45,,4006.64,88,,3205.31,,,0,"percent of total billed charges","88% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",787.85,17.304,,630.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2868.39,63,,2294.71,,,0,"percent of total billed charges","63% of total billed charges",696.61,15.3,,557.29,,,0,"percent of total billed charges","15.3% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",3141.57,69,,,,,0,"fee schedule","69% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2816.03,61.85,,2252.82,,,0,"percent of total billed charges","61.5% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",1466.07,32.2,,1172.86,,,0,"percent of total billed charges","32.2% of total billed charges",1420.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",780.2,17.136,,624.16,,,0,"percent of total billed charges","17.136% of total billed charges",994.38,21.84,,795.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.7% of total billed charges",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1543.47,33.9,,1234.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3551.34,78,,2841.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",696.61,4553,
"CATH BALN CTNG FLEXTOME 2.75 X 15MM DILATATION",ORSUP0028,CDM,278,RC,,,OUTPATIENT,,,4553,2959.45,,4006.64,88,,3205.31,,,0,"percent of total billed charges","88% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",787.85,17.304,,630.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2868.39,63,,2294.71,,,0,"percent of total billed charges","63% of total billed charges",696.61,15.3,,557.29,,,0,"percent of total billed charges","15.3% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",3141.57,69,,,,,0,"fee schedule","69% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2816.03,61.85,,2252.82,,,0,"percent of total billed charges","61.5% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",1466.07,32.2,,1172.86,,,0,"percent of total billed charges","32.2% of total billed charges",1420.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",780.2,17.136,,624.16,,,0,"percent of total billed charges","17.136% of total billed charges",994.38,21.84,,795.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.7% of total billed charges",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1543.47,33.9,,1234.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3551.34,78,,2841.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",696.61,4553,
"CATH BALN CTNG FLEXTOME 3.0 X 15MM DILATATION",ORSUP0028,CDM,278,RC,,,OUTPATIENT,,,4553,2959.45,,4006.64,88,,3205.31,,,0,"percent of total billed charges","88% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",787.85,17.304,,630.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2868.39,63,,2294.71,,,0,"percent of total billed charges","63% of total billed charges",696.61,15.3,,557.29,,,0,"percent of total billed charges","15.3% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",3141.57,69,,,,,0,"fee schedule","69% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2816.03,61.85,,2252.82,,,0,"percent of total billed charges","61.5% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",1466.07,32.2,,1172.86,,,0,"percent of total billed charges","32.2% of total billed charges",1420.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",780.2,17.136,,624.16,,,0,"percent of total billed charges","17.136% of total billed charges",994.38,21.84,,795.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.7% of total billed charges",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1543.47,33.9,,1234.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3551.34,78,,2841.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",696.61,4553,
"CATH BALN CTNG FLEXTOME 2.0 X 15MM DILATATION",ORSUP0028,CDM,278,RC,,,OUTPATIENT,,,4553,2959.45,,4006.64,88,,3205.31,,,0,"percent of total billed charges","88% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",787.85,17.304,,630.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2868.39,63,,2294.71,,,0,"percent of total billed charges","63% of total billed charges",696.61,15.3,,557.29,,,0,"percent of total billed charges","15.3% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",3141.57,69,,,,,0,"fee schedule","69% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2816.03,61.85,,2252.82,,,0,"percent of total billed charges","61.5% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",1466.07,32.2,,1172.86,,,0,"percent of total billed charges","32.2% of total billed charges",1420.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",780.2,17.136,,624.16,,,0,"percent of total billed charges","17.136% of total billed charges",994.38,21.84,,795.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.7% of total billed charges",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1543.47,33.9,,1234.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3551.34,78,,2841.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",696.61,4553,
"CATH BALN CTNG FLEXTOME 2.0 X 10MM DILATATION",ORSUP0027,CDM,278,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",1336.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.7% of total billed charges",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1452.62,33.9,,1162.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"CATH BALN CTNG FLEXTOME 2.75 X 10MM DILATATION",ORSUP0028,CDM,278,RC,,,OUTPATIENT,,,4553,2959.45,,4006.64,88,,3205.31,,,0,"percent of total billed charges","88% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",787.85,17.304,,630.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2868.39,63,,2294.71,,,0,"percent of total billed charges","63% of total billed charges",696.61,15.3,,557.29,,,0,"percent of total billed charges","15.3% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",3141.57,69,,,,,0,"fee schedule","69% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2816.03,61.85,,2252.82,,,0,"percent of total billed charges","61.5% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",1466.07,32.2,,1172.86,,,0,"percent of total billed charges","32.2% of total billed charges",1420.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",780.2,17.136,,624.16,,,0,"percent of total billed charges","17.136% of total billed charges",994.38,21.84,,795.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.7% of total billed charges",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1543.47,33.9,,1234.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3551.34,78,,2841.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",696.61,4553,
"CATH BALN CTNG FLEXTOME 2.5 X 15MM DILATATION",ORSUP0028,CDM,278,RC,,,OUTPATIENT,,,4553,2959.45,,4006.64,88,,3205.31,,,0,"percent of total billed charges","88% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",787.85,17.304,,630.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2868.39,63,,2294.71,,,0,"percent of total billed charges","63% of total billed charges",696.61,15.3,,557.29,,,0,"percent of total billed charges","15.3% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",3141.57,69,,,,,0,"fee schedule","69% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2816.03,61.85,,2252.82,,,0,"percent of total billed charges","61.5% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",1466.07,32.2,,1172.86,,,0,"percent of total billed charges","32.2% of total billed charges",1420.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",780.2,17.136,,624.16,,,0,"percent of total billed charges","17.136% of total billed charges",994.38,21.84,,795.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.7% of total billed charges",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1543.47,33.9,,1234.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3551.34,78,,2841.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",696.61,4553,
"CATH BALN CTNG FLEXTOME 2.5 X 10MM DILATATION",ORSUP0027,CDM,278,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",1336.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.7% of total billed charges",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1452.62,33.9,,1162.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"CATH CONQUEST BALLOON 8 X 2",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CATH PTCA 50CM 2CM 5.5FR 7MM CONQUEST",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CATHETER BALLOON MUSTANG DIL 8MM 100MM 135CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATHETER BALLOON MUSTANG 6X150",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATHETER BALLOON MUSTANG 6 X 100 X 135",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATH BALLOON MUSTANG 5.0X80, 135CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATH BALLOON MUSTANG 5.0X60, 135CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATHETER MUSTANG BALLOON 5X20MM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATHETER MUSTANG BALLOON 5X150",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH BALLOON MUSTANG 5 X 100 X 135",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATH BALLOON MUSTANG 4.0X80, 135CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATH BALLOON MUSTANG 4.0X60, 135CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATH BALLOON MUSTANG 4.0X40, 135CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATH BALLOON MUSTANG 4.0 X 150 X 135",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH BALLOON MUSTANG 4.0X100, 135CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATHETER BALLOON MUSTANG DIL 12MM 40MM 135CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATHETER BALLOON MUSTANG DIL 12MM 20MM 135CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATH BALN 4CMX14MMX120CM 5.8FR .035IN 2XL STRL DI",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATHETER DILATATION XXL BLN 5.8F 14MM X 4CM 75CML",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CATH BALLOON CUTTING 8 X 2 135CM",ORSUP0026,CDM,278,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",1253.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.7% of total billed charges",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1361.76,33.9,,1089.41,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"CATH BALLOON CUTTING 7 X 2 135CM",ORSUP0027,CDM,278,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",1336.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.7% of total billed charges",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1452.62,33.9,,1162.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"CATH BALLOON STERLING OTW 5 X 100 135CM L",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CATH BALLOON STERLING RX 6 X 60 135CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CATH BALLOON STERLING RX 5 X 30 135CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CATH BALLOON STERLING RX 5.5 X 20 135CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CATH BALLOON STERLING RX 4 X 30 135CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CATH BALLOON STERLING RX 6 X 40 135CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CATH BALLOON STERLING RX 8 X 20 135CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CATH BALLOON STERLING RX 7 X 30 135CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CATH BALLOON STERLING RX 7 X 20 135CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CATH BALLOON STERLING RX 6 X 20 135CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CATH BALLOON STERLING RX 6.5 X 40 135CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CATH BALLOON STERLING RX 6.5 X 20 135CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CATH BALLOON STERLING RX 4 X 20 135CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CATH BALLOON STERLING RX 5 X 60 135CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CATH BALLOON STERLING 5.0X40X135CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CATH BALLOON STERLING RX 4 X 60 135CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CATH BALLOON STERLING RX 4 X 40 135CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CATH CONQUEST BALLOON 5X4X50",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"CATH SOEHENDRA BIL DIL 8.5 FR    SBDC 8.5",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH SOHENDRA BILIARY",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH BALLOON ATLAS 14X2X120CM",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"CATH BALLOON ATLAS 14X4X120CM",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"CATH BALLOON CONQUEST 6X4",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"CATH BALLOON CONQUEST 9X4X120",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CATH BALLOON EMERGE MR PUSH 8 X 1.50",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATH BALLOON MUSTANG 10X60X135CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATH BALLOON MUSTANG 8.0 X 80 X 135",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATH BALLOON MUSTANG 8.0X20X135CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATH BALLOON MUSTANG 8X40X135CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATH BALLOON MUSTANG 9X60X135CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATH BALLOON MUSTANG OTW 10X80X135CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATH CONQUEST 75 X 10MM X 4",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"CATH CONQUEST 75 X 9MM X 4",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CATH CONQUEST 7X4 BALLOON",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"CATH CONQUEST 8X4 BALLOON",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"CATH CONQUEST BALLOON 10X2X75",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CATH CONQUEST BALLOON 4X2X40",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"CATH CONQUEST BALLOON 4X2X80",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"CATH CONQUEST BALLOON 4X4X40",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"CATH CONQUEST BALLOON 5MM X 2CM X 50 CM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CATH CONQUEST BALLOON 6X4X50",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"CATH CONQUEST BALLOON 7 X 2",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CATH CONQUEST BALLOON 8X2X50",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"CATH CONQUEST BALLOON 8X4X50",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"CATH CONQUEST BALLOON 9X2X75",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CATH CORONARY DILATION MINI TREK 1.5MM 20MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH MUSTANG OVER THE WIRE 6.00MM X 80MM 135CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATH RELIANT 46 STENT",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",751.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.7% of total billed charges",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",816.99,33.9,,653.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"CATHETER BALLOON DIALATION 4MM 75CM",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"CATHETER CONQUEST 6F",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"CATH ATHRCM 145CM 1.25MM DIAMONDBACK 360 MICRO CRWN 7MM",ORSUP0101,CDM,278,RC,,,OUTPATIENT,,,19014,12359.1,,16732.32,88,,13385.86,,,0,"percent of total billed charges","88% of total billed charges",9507,50,,7605.60,,,0,"percent of total billed charges","50% of total billed charges",3194.35,16.8,,2555.48,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3290.18,17.304,,2632.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11978.82,63,,9583.06,,,0,"percent of total billed charges","63% of total billed charges",2909.14,15.3,,2327.31,,,0,"percent of total billed charges","15.3% of total billed charges",3194.35,16.8,,2555.48,,,0,"percent of total billed charges","16.8% of total billed charges",13119.66,69,,,,,0,"fee schedule","69% of total billed charges",19014,100,,15211.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19014,100,,15211.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19014,100,,15211.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11760.16,61.85,,9408.13,,,0,"percent of total billed charges","61.5% of total billed charges",3194.35,16.8,,2555.48,,,0,"percent of total billed charges","16.8% of total billed charges",9507,50,,7605.60,,,0,"percent of total billed charges","50% of total billed charges",6122.51,32.2,,4898.01,,,0,"percent of total billed charges","32.2% of total billed charges",5932.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3258.24,17.136,,2606.59,,,0,"percent of total billed charges","17.136% of total billed charges",4152.66,21.84,,3322.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",7168.28,37.7,,5734.62,,,0,"percent of total billed charges","37.7% of total billed charges",7168.28,37.7,,5734.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",6445.75,33.9,,5156.60,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",14830.92,78,,11864.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15705.56,82.6,,12564.45,,,0,"percent of total billed charges","82.6% of total billed charges",3194.35,16.8,,2555.48,,,0,"percent of total billed charges","16.8% of total billed charges",9507,50,,7605.60,,,0,"percent of total billed charges","50% of total billed charges",15705.56,82.6,,12564.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3194.35,16.8,,2555.48,,,0,"percent of total billed charges","16.8% of total billed charges",19014,100,,15211.20,,,0,"percent of total billed charges","100% of total billed charges",2909.14,19014,
"CATH MICROCROWN 60CM 1.25X7MM 4FR DMDBACK PERPH",ORSUP0089,CDM,278,RC,,,OUTPATIENT,,,21156,13751.4,,18617.28,88,,14893.82,,,0,"percent of total billed charges","88% of total billed charges",10578,50,,8462.40,,,0,"percent of total billed charges","50% of total billed charges",3554.21,16.8,,2843.37,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3660.83,17.304,,2928.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13328.28,63,,10662.62,,,0,"percent of total billed charges","63% of total billed charges",3236.87,15.3,,2589.50,,,0,"percent of total billed charges","15.3% of total billed charges",3554.21,16.8,,2843.37,,,0,"percent of total billed charges","16.8% of total billed charges",14597.64,69,,,,,0,"fee schedule","69% of total billed charges",21156,100,,16924.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21156,100,,16924.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21156,100,,16924.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13084.99,61.85,,10467.99,,,0,"percent of total billed charges","61.5% of total billed charges",3554.21,16.8,,2843.37,,,0,"percent of total billed charges","16.8% of total billed charges",10578,50,,8462.40,,,0,"percent of total billed charges","50% of total billed charges",6812.23,32.2,,5449.78,,,0,"percent of total billed charges","32.2% of total billed charges",6600.67,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3625.29,17.136,,2900.23,,,0,"percent of total billed charges","17.136% of total billed charges",4620.47,21.84,,3696.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",7975.81,37.7,,6380.65,,,0,"percent of total billed charges","37.7% of total billed charges",7975.81,37.7,,6380.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",7171.88,33.9,,5737.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",16501.68,78,,13201.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17474.86,82.6,,13979.89,,,0,"percent of total billed charges","82.6% of total billed charges",3554.21,16.8,,2843.37,,,0,"percent of total billed charges","16.8% of total billed charges",10578,50,,8462.40,,,0,"percent of total billed charges","50% of total billed charges",17474.86,82.6,,13979.89,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3554.21,16.8,,2843.37,,,0,"percent of total billed charges","16.8% of total billed charges",21156,100,,16924.80,,,0,"percent of total billed charges","100% of total billed charges",3236.87,21156,
"CATHETER STEALTH SOLID 1.50MM",ORSUP0080,CDM,278,RC,,,OUTPATIENT,,,18746,12184.9,,16496.48,88,,13197.18,,,0,"percent of total billed charges","88% of total billed charges",9373,50,,7498.40,,,0,"percent of total billed charges","50% of total billed charges",3149.33,16.8,,2519.46,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3243.81,17.304,,2595.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11809.98,63,,9447.98,,,0,"percent of total billed charges","63% of total billed charges",2868.14,15.3,,2294.51,,,0,"percent of total billed charges","15.3% of total billed charges",3149.33,16.8,,2519.46,,,0,"percent of total billed charges","16.8% of total billed charges",12934.74,69,,,,,0,"fee schedule","69% of total billed charges",18746,100,,14996.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18746,100,,14996.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18746,100,,14996.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11594.4,61.85,,9275.52,,,0,"percent of total billed charges","61.5% of total billed charges",3149.33,16.8,,2519.46,,,0,"percent of total billed charges","16.8% of total billed charges",9373,50,,7498.40,,,0,"percent of total billed charges","50% of total billed charges",6036.21,32.2,,4828.97,,,0,"percent of total billed charges","32.2% of total billed charges",5848.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3212.31,17.136,,2569.85,,,0,"percent of total billed charges","17.136% of total billed charges",4094.13,21.84,,3275.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",7067.24,37.7,,5653.79,,,0,"percent of total billed charges","37.7% of total billed charges",7067.24,37.7,,5653.79,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",6354.89,33.9,,5083.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",14621.88,78,,11697.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15484.2,82.6,,12387.36,,,0,"percent of total billed charges","82.6% of total billed charges",3149.33,16.8,,2519.46,,,0,"percent of total billed charges","16.8% of total billed charges",9373,50,,7498.40,,,0,"percent of total billed charges","50% of total billed charges",15484.2,82.6,,12387.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3149.33,16.8,,2519.46,,,0,"percent of total billed charges","16.8% of total billed charges",18746,100,,14996.80,,,0,"percent of total billed charges","100% of total billed charges",2868.14,18746,
"CATHETER STEALTH SOLID 2.00MM",ORSUP0111,CDM,278,RC,,,OUTPATIENT,,,20888,13577.2,,18381.44,88,,14705.15,,,0,"percent of total billed charges","88% of total billed charges",10444,50,,8355.20,,,0,"percent of total billed charges","50% of total billed charges",3509.18,16.8,,2807.34,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3614.46,17.304,,2891.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13159.44,63,,10527.55,,,0,"percent of total billed charges","63% of total billed charges",3195.86,15.3,,2556.69,,,0,"percent of total billed charges","15.3% of total billed charges",3509.18,16.8,,2807.34,,,0,"percent of total billed charges","16.8% of total billed charges",14412.72,69,,,,,0,"fee schedule","69% of total billed charges",20888,100,,16710.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20888,100,,16710.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20888,100,,16710.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12919.23,61.85,,10335.38,,,0,"percent of total billed charges","61.5% of total billed charges",3509.18,16.8,,2807.34,,,0,"percent of total billed charges","16.8% of total billed charges",10444,50,,8355.20,,,0,"percent of total billed charges","50% of total billed charges",6725.94,32.2,,5380.75,,,0,"percent of total billed charges","32.2% of total billed charges",6517.06,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3579.37,17.136,,2863.50,,,0,"percent of total billed charges","17.136% of total billed charges",4561.94,21.84,,3649.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",7874.78,37.7,,6299.82,,,0,"percent of total billed charges","37.7% of total billed charges",7874.78,37.7,,6299.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",7081.03,33.9,,5664.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",16292.64,78,,13034.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17253.49,82.6,,13802.79,,,0,"percent of total billed charges","82.6% of total billed charges",3509.18,16.8,,2807.34,,,0,"percent of total billed charges","16.8% of total billed charges",10444,50,,8355.20,,,0,"percent of total billed charges","50% of total billed charges",17253.49,82.6,,13802.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3509.18,16.8,,2807.34,,,0,"percent of total billed charges","16.8% of total billed charges",20888,100,,16710.40,,,0,"percent of total billed charges","100% of total billed charges",3195.86,20888,
"CATH LUTONIX BALLOON DRUG COATED .035 130CM 5X40MM",ORSUP0045,CDM,278,RC,,,OUTPATIENT,,,9105,5918.25,,8012.4,88,,6409.92,,,0,"percent of total billed charges","88% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1575.53,17.304,,1260.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5736.15,63,,4588.92,,,0,"percent of total billed charges","63% of total billed charges",1393.07,15.3,,1114.46,,,0,"percent of total billed charges","15.3% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",6282.45,69,,,,,0,"fee schedule","69% of total billed charges",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5631.44,61.85,,4505.15,,,0,"percent of total billed charges","61.5% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",2931.81,32.2,,2345.45,,,0,"percent of total billed charges","32.2% of total billed charges",2840.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1560.23,17.136,,1248.18,,,0,"percent of total billed charges","17.136% of total billed charges",1988.53,21.84,,1590.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3432.59,37.7,,2746.07,,,0,"percent of total billed charges","37.7% of total billed charges",3432.59,37.7,,2746.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3086.6,33.9,,2469.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7101.9,78,,5681.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7520.73,82.6,,6016.58,,,0,"percent of total billed charges","82.6% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",7520.73,82.6,,6016.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",1393.07,9105,
"CATH LUTONIX BALLOON DRUG COATED .035 130CM 6X40MM",ORSUP0045,CDM,278,RC,,,OUTPATIENT,,,9105,5918.25,,8012.4,88,,6409.92,,,0,"percent of total billed charges","88% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1575.53,17.304,,1260.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5736.15,63,,4588.92,,,0,"percent of total billed charges","63% of total billed charges",1393.07,15.3,,1114.46,,,0,"percent of total billed charges","15.3% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",6282.45,69,,,,,0,"fee schedule","69% of total billed charges",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5631.44,61.85,,4505.15,,,0,"percent of total billed charges","61.5% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",2931.81,32.2,,2345.45,,,0,"percent of total billed charges","32.2% of total billed charges",2840.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1560.23,17.136,,1248.18,,,0,"percent of total billed charges","17.136% of total billed charges",1988.53,21.84,,1590.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3432.59,37.7,,2746.07,,,0,"percent of total billed charges","37.7% of total billed charges",3432.59,37.7,,2746.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3086.6,33.9,,2469.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7101.9,78,,5681.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7520.73,82.6,,6016.58,,,0,"percent of total billed charges","82.6% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",7520.73,82.6,,6016.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",1393.07,9105,
"CATH LUTONIX BALLOON DRUG COATED .035 130CM 6X60MM",ORSUP0045,CDM,278,RC,,,OUTPATIENT,,,9105,5918.25,,8012.4,88,,6409.92,,,0,"percent of total billed charges","88% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1575.53,17.304,,1260.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5736.15,63,,4588.92,,,0,"percent of total billed charges","63% of total billed charges",1393.07,15.3,,1114.46,,,0,"percent of total billed charges","15.3% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",6282.45,69,,,,,0,"fee schedule","69% of total billed charges",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5631.44,61.85,,4505.15,,,0,"percent of total billed charges","61.5% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",2931.81,32.2,,2345.45,,,0,"percent of total billed charges","32.2% of total billed charges",2840.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1560.23,17.136,,1248.18,,,0,"percent of total billed charges","17.136% of total billed charges",1988.53,21.84,,1590.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3432.59,37.7,,2746.07,,,0,"percent of total billed charges","37.7% of total billed charges",3432.59,37.7,,2746.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3086.6,33.9,,2469.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7101.9,78,,5681.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7520.73,82.6,,6016.58,,,0,"percent of total billed charges","82.6% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",7520.73,82.6,,6016.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",1393.07,9105,
"CATH LUTONIX BALLOON DRUG COATED .035 130CM 7X40MM",ORSUP0045,CDM,278,RC,,,OUTPATIENT,,,9105,5918.25,,8012.4,88,,6409.92,,,0,"percent of total billed charges","88% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1575.53,17.304,,1260.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5736.15,63,,4588.92,,,0,"percent of total billed charges","63% of total billed charges",1393.07,15.3,,1114.46,,,0,"percent of total billed charges","15.3% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",6282.45,69,,,,,0,"fee schedule","69% of total billed charges",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5631.44,61.85,,4505.15,,,0,"percent of total billed charges","61.5% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",2931.81,32.2,,2345.45,,,0,"percent of total billed charges","32.2% of total billed charges",2840.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1560.23,17.136,,1248.18,,,0,"percent of total billed charges","17.136% of total billed charges",1988.53,21.84,,1590.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3432.59,37.7,,2746.07,,,0,"percent of total billed charges","37.7% of total billed charges",3432.59,37.7,,2746.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3086.6,33.9,,2469.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7101.9,78,,5681.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7520.73,82.6,,6016.58,,,0,"percent of total billed charges","82.6% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",7520.73,82.6,,6016.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",1393.07,9105,
"CATH LUTONIX BALLOON DRUG COATED.035 130CM 4X100MM",ORSUP0045,CDM,278,RC,,,OUTPATIENT,,,9105,5918.25,,8012.4,88,,6409.92,,,0,"percent of total billed charges","88% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1575.53,17.304,,1260.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5736.15,63,,4588.92,,,0,"percent of total billed charges","63% of total billed charges",1393.07,15.3,,1114.46,,,0,"percent of total billed charges","15.3% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",6282.45,69,,,,,0,"fee schedule","69% of total billed charges",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5631.44,61.85,,4505.15,,,0,"percent of total billed charges","61.5% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",2931.81,32.2,,2345.45,,,0,"percent of total billed charges","32.2% of total billed charges",2840.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1560.23,17.136,,1248.18,,,0,"percent of total billed charges","17.136% of total billed charges",1988.53,21.84,,1590.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3432.59,37.7,,2746.07,,,0,"percent of total billed charges","37.7% of total billed charges",3432.59,37.7,,2746.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3086.6,33.9,,2469.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7101.9,78,,5681.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7520.73,82.6,,6016.58,,,0,"percent of total billed charges","82.6% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",7520.73,82.6,,6016.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",1393.07,9105,
"CATH LUTONIX BALLOON DRUG COATED.035 130CM 5X100MM",ORSUP0045,CDM,278,RC,,,OUTPATIENT,,,9105,5918.25,,8012.4,88,,6409.92,,,0,"percent of total billed charges","88% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1575.53,17.304,,1260.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5736.15,63,,4588.92,,,0,"percent of total billed charges","63% of total billed charges",1393.07,15.3,,1114.46,,,0,"percent of total billed charges","15.3% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",6282.45,69,,,,,0,"fee schedule","69% of total billed charges",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5631.44,61.85,,4505.15,,,0,"percent of total billed charges","61.5% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",2931.81,32.2,,2345.45,,,0,"percent of total billed charges","32.2% of total billed charges",2840.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1560.23,17.136,,1248.18,,,0,"percent of total billed charges","17.136% of total billed charges",1988.53,21.84,,1590.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3432.59,37.7,,2746.07,,,0,"percent of total billed charges","37.7% of total billed charges",3432.59,37.7,,2746.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3086.6,33.9,,2469.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7101.9,78,,5681.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7520.73,82.6,,6016.58,,,0,"percent of total billed charges","82.6% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",7520.73,82.6,,6016.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",1393.07,9105,
"CATH LUTONIX BALLOON DRUG COATED.035 130CM 5X150MM",ORSUP0051,CDM,278,RC,,,OUTPATIENT,,,10712,6962.8,,9426.56,88,,7541.25,,,0,"percent of total billed charges","88% of total billed charges",5356,50,,4284.80,,,0,"percent of total billed charges","50% of total billed charges",1799.62,16.8,,1439.70,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1853.6,17.304,,1482.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6748.56,63,,5398.85,,,0,"percent of total billed charges","63% of total billed charges",1638.94,15.3,,1311.15,,,0,"percent of total billed charges","15.3% of total billed charges",1799.62,16.8,,1439.70,,,0,"percent of total billed charges","16.8% of total billed charges",7391.28,69,,,,,0,"fee schedule","69% of total billed charges",10712,100,,8569.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10712,100,,8569.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10712,100,,8569.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6625.37,61.85,,5300.30,,,0,"percent of total billed charges","61.5% of total billed charges",1799.62,16.8,,1439.70,,,0,"percent of total billed charges","16.8% of total billed charges",5356,50,,4284.80,,,0,"percent of total billed charges","50% of total billed charges",3449.26,32.2,,2759.41,,,0,"percent of total billed charges","32.2% of total billed charges",3342.14,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1835.61,17.136,,1468.49,,,0,"percent of total billed charges","17.136% of total billed charges",2339.5,21.84,,1871.60,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4038.42,37.7,,3230.74,,,0,"percent of total billed charges","37.7% of total billed charges",4038.42,37.7,,3230.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3631.37,33.9,,2905.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",8355.36,78,,6684.29,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8848.11,82.6,,7078.49,,,0,"percent of total billed charges","82.6% of total billed charges",1799.62,16.8,,1439.70,,,0,"percent of total billed charges","16.8% of total billed charges",5356,50,,4284.80,,,0,"percent of total billed charges","50% of total billed charges",8848.11,82.6,,7078.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1799.62,16.8,,1439.70,,,0,"percent of total billed charges","16.8% of total billed charges",10712,100,,8569.60,,,0,"percent of total billed charges","100% of total billed charges",1638.94,10712,
"CATH LUTONIX BALLOON DRUG COATED.035 130CM 6X100MM",ORSUP0045,CDM,278,RC,,,OUTPATIENT,,,9105,5918.25,,8012.4,88,,6409.92,,,0,"percent of total billed charges","88% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1575.53,17.304,,1260.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5736.15,63,,4588.92,,,0,"percent of total billed charges","63% of total billed charges",1393.07,15.3,,1114.46,,,0,"percent of total billed charges","15.3% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",6282.45,69,,,,,0,"fee schedule","69% of total billed charges",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5631.44,61.85,,4505.15,,,0,"percent of total billed charges","61.5% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",2931.81,32.2,,2345.45,,,0,"percent of total billed charges","32.2% of total billed charges",2840.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1560.23,17.136,,1248.18,,,0,"percent of total billed charges","17.136% of total billed charges",1988.53,21.84,,1590.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3432.59,37.7,,2746.07,,,0,"percent of total billed charges","37.7% of total billed charges",3432.59,37.7,,2746.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3086.6,33.9,,2469.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7101.9,78,,5681.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7520.73,82.6,,6016.58,,,0,"percent of total billed charges","82.6% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",7520.73,82.6,,6016.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",1393.07,9105,
"CATH LUTONIX BALLOON DRUG COATED.035 130CM 6X150MM",ORSUP0051,CDM,278,RC,,,OUTPATIENT,,,10712,6962.8,,9426.56,88,,7541.25,,,0,"percent of total billed charges","88% of total billed charges",5356,50,,4284.80,,,0,"percent of total billed charges","50% of total billed charges",1799.62,16.8,,1439.70,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1853.6,17.304,,1482.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6748.56,63,,5398.85,,,0,"percent of total billed charges","63% of total billed charges",1638.94,15.3,,1311.15,,,0,"percent of total billed charges","15.3% of total billed charges",1799.62,16.8,,1439.70,,,0,"percent of total billed charges","16.8% of total billed charges",7391.28,69,,,,,0,"fee schedule","69% of total billed charges",10712,100,,8569.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10712,100,,8569.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10712,100,,8569.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6625.37,61.85,,5300.30,,,0,"percent of total billed charges","61.5% of total billed charges",1799.62,16.8,,1439.70,,,0,"percent of total billed charges","16.8% of total billed charges",5356,50,,4284.80,,,0,"percent of total billed charges","50% of total billed charges",3449.26,32.2,,2759.41,,,0,"percent of total billed charges","32.2% of total billed charges",3342.14,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1835.61,17.136,,1468.49,,,0,"percent of total billed charges","17.136% of total billed charges",2339.5,21.84,,1871.60,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4038.42,37.7,,3230.74,,,0,"percent of total billed charges","37.7% of total billed charges",4038.42,37.7,,3230.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3631.37,33.9,,2905.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",8355.36,78,,6684.29,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8848.11,82.6,,7078.49,,,0,"percent of total billed charges","82.6% of total billed charges",1799.62,16.8,,1439.70,,,0,"percent of total billed charges","16.8% of total billed charges",5356,50,,4284.80,,,0,"percent of total billed charges","50% of total billed charges",8848.11,82.6,,7078.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1799.62,16.8,,1439.70,,,0,"percent of total billed charges","16.8% of total billed charges",10712,100,,8569.60,,,0,"percent of total billed charges","100% of total billed charges",1638.94,10712,
"CATHETER INFUSION 5FR 135CM 50CM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH UNI-FUSE INFUSION 5FR 135CM X 30CM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH INFUSOR 5 FR 135 X 10CM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH INFUSION 4FR 135CM 20CM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATHETER FOGARTY THROMBECTOMY 8/10 8CM",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATHETER VENOUS THOMBECTOMY 8FR 80CM L",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH THROMBECTOMY FOGARTY GRAFT 5FR 50CM L",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"CATHETER EMBOLECTOMY ARTERIAL PURPLE 2FR 60CM L",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"CATH CLOT ADHERENT 4F 6MM 80CM L",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"CATH EKOSONIC 1250CM-135CM",ORSUP0074,CDM,278,RC,,,OUTPATIENT,,,17139,11140.35,,15082.32,88,,12065.86,,,0,"percent of total billed charges","88% of total billed charges",8569.5,50,,6855.60,,,0,"percent of total billed charges","50% of total billed charges",2879.35,16.8,,2303.48,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2965.73,17.304,,2372.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10797.57,63,,8638.06,,,0,"percent of total billed charges","63% of total billed charges",2622.27,15.3,,2097.82,,,0,"percent of total billed charges","15.3% of total billed charges",2879.35,16.8,,2303.48,,,0,"percent of total billed charges","16.8% of total billed charges",11825.91,69,,,,,0,"fee schedule","69% of total billed charges",17139,100,,13711.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17139,100,,13711.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17139,100,,13711.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10600.47,61.85,,8480.38,,,0,"percent of total billed charges","61.5% of total billed charges",2879.35,16.8,,2303.48,,,0,"percent of total billed charges","16.8% of total billed charges",8569.5,50,,6855.60,,,0,"percent of total billed charges","50% of total billed charges",5518.76,32.2,,4415.01,,,0,"percent of total billed charges","32.2% of total billed charges",5347.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2936.94,17.136,,2349.55,,,0,"percent of total billed charges","17.136% of total billed charges",3743.16,21.84,,2994.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",6461.4,37.7,,5169.12,,,0,"percent of total billed charges","37.7% of total billed charges",6461.4,37.7,,5169.12,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",5810.12,33.9,,4648.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",13368.42,78,,10694.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14156.81,82.6,,11325.45,,,0,"percent of total billed charges","82.6% of total billed charges",2879.35,16.8,,2303.48,,,0,"percent of total billed charges","16.8% of total billed charges",8569.5,50,,6855.60,,,0,"percent of total billed charges","50% of total billed charges",14156.81,82.6,,11325.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2879.35,16.8,,2303.48,,,0,"percent of total billed charges","16.8% of total billed charges",17139,100,,13711.20,,,0,"percent of total billed charges","100% of total billed charges",2622.27,17139,
"CATH THROMBECTOMY #A4548",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"CATH CLOSED SUCTION 14FR 2205",10534,CDM,272,RC,,,OUTPATIENT,,,111,72.15,,97.68,88,,78.14,,,0,"percent of total billed charges","88% of total billed charges",55.5,50,,44.40,,,0,"percent of total billed charges","50% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.21,17.304,,15.37,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.93,63,,55.94,,,0,"percent of total billed charges","63% of total billed charges",16.98,15.3,,13.58,,,0,"percent of total billed charges","15.3% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",76.59,69,,,,,0,"fee schedule","69% of total billed charges",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.65,61.85,,54.92,,,0,"percent of total billed charges","61.5% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",55.5,50,,44.40,,,0,"percent of total billed charges","50% of total billed charges",35.74,32.2,,28.59,,,0,"percent of total billed charges","32.2% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.02,17.136,,15.22,,,0,"percent of total billed charges","17.136% of total billed charges",24.24,21.84,,19.39,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.85,37.7,,33.48,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",86.58,78,,69.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.69,82.6,,73.35,,,0,"percent of total billed charges","82.6% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",55.5,50,,44.40,,,0,"percent of total billed charges","50% of total billed charges",91.69,82.6,,73.35,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",16.98,111,
"CATH YANKAUER SUCTION OPEN TIP",184424,CDM,272,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"CATH SUCTION 14FR",184985,CDM,272,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"CATH  GLOVE 8FR",184982,CDM,272,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"CATHETER BALLOON INTRA AORTIC MEGA  IABP 50CC",ORSUP0035,CDM,272,RC,,,OUTPATIENT,,,6427,4177.55,,5655.76,88,,4524.61,,,0,"percent of total billed charges","88% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1112.13,17.304,,889.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4049.01,63,,3239.21,,,0,"percent of total billed charges","63% of total billed charges",983.33,15.3,,786.66,,,0,"percent of total billed charges","15.3% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4434.63,69,,,,,0,"fee schedule","69% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3975.1,61.85,,3180.08,,,0,"percent of total billed charges","61.5% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",2069.49,32.2,,1655.59,,,0,"percent of total billed charges","32.2% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1101.33,17.136,,881.06,,,0,"percent of total billed charges","17.136% of total billed charges",1403.66,21.84,,1122.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5013.06,78,,4010.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",983.33,6427,
"CATHETER SILVER SOAKER 10 INCH",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"CATHETER PUSHING 3FR. 170CM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"CATHETER VENTRICULAR HAKIM",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"CATH BILIARY DILATIN 6FR SBDC 6",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"CATH EXCHANGE 8.0 X 45CM X 1.6",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"CATH AIRWAY EXCHANGE 7MM AND UP",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"CATH AIRWAY EXCHANGE 5MM AND UP",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"CATH CEREBRAL SPR TRQ 20 MRK BND PGT 5F 110CM",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATH DIAG JR4 4FR .038 125CM",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATHER SZ AUROUS NYL L100CM OD5FR PGTL",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATH PROBE ESCPC OD7FR ELCTCHMST",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"CATHETER ELECTROHEMOSTASIS/INJECT BIPLR 10F 210CM",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"CATH CHOLANGIOGY 6FR 40CM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"CATH 4FR X 40CM CHOLANGIOGRAPHY \\T\\ BILIARY",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"CATH CANNULA ERCP 5 4 3",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"CATH ANGIO 5FR PIGTAIL 125CM",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"CATH ANGIO CS VERTBRAL 5F 75CM",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATH ANGIO JL4 5F 125CM",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH ASPIRATION PRIORTY ONE 7F",ORSUP0024,CDM,272,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"CATH DIAG 5F MPA",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH DIAG EP 120CM 2.5-2MM REPOSABLE",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATH LT HEART VENT 18FR",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH SUBCUTANEOUS PASSER 60MM DISPOSABLE",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CATH SYSTEM CSF LUMBOPERITONEAL",ORSUP0028,CDM,272,RC,,,OUTPATIENT,,,4553,2959.45,,4006.64,88,,3205.31,,,0,"percent of total billed charges","88% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",787.85,17.304,,630.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2868.39,63,,2294.71,,,0,"percent of total billed charges","63% of total billed charges",696.61,15.3,,557.29,,,0,"percent of total billed charges","15.3% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",3141.57,69,,,,,0,"fee schedule","69% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2816.03,61.85,,2252.82,,,0,"percent of total billed charges","61.5% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",1466.07,32.2,,1172.86,,,0,"percent of total billed charges","32.2% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",780.2,17.136,,624.16,,,0,"percent of total billed charges","17.136% of total billed charges",994.38,21.84,,795.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3551.34,78,,2841.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",696.61,4553,
"CATH SYSTEM NEXIVA DIFFUSICS 22G X 1IN",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATHETER  6FR QUAD HIS F CURVE",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"CATHETER BIDIRECTIONAL CS D-F CURVE",ORSUP0024,CDM,272,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"CATHETER EDGE 180 EXTENDED WORKING CHANNEL",ORSUP0025,CDM,272,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"CATHETER EDGE 90 EXTENDED WORKING CHANNEL",ORSUP0025,CDM,272,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"CATHETER GUIDE SINUS",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"CATHETER KIT SNAP SHUNT VENTRICULAR",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"CATHETER RIVULET SNAP SHUNT VENTRICULAR  6CM",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"CATHETER RIVULET SNAP SHUNT VENTRICULAR  7CM",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"CATHETER VENTRICULAR",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"CATH BILIARY PROBE 5F",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"CATH IV 20 X 1.88",79761,CDM,272,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"CATH TPN/BROVIAC DBL LUMEN",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH THORACIC 36FR RT ANGLE",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"CATH THORASIC 32FR STRAIGHT",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"CATH SUPRAPUBIC 18FR O'BRIEN",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATH SUPRAPUBIC BALLOON 16FR",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"CATH SUCTION 10FR DELEE",490265,CDM,272,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"CATH RIVAL PTA 135-5-10 5FR",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATH RIVAL PTA 135-4-10-5FR",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATH RIVAL PTA 135-3-10 5FR",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATH SWAN PERITONEAL DIALYSIS",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH PALINDROME HSI KIT 33CM",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CATH PALINDROME W/HEP 14FR 19M",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"CATH OLIVE TIP 6FR",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH MAHURKUR ELITE 12F X 20CM",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"CATH MAHURKER 12FRX16CM CURVED",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"CATH CHOLANGIO BALLOON",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH KUMPE 5FR X 40 X .035 NB",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"CATH GROSHONG 8FR SINGLE LUMEN",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATH GLIDEPATH 19CM DIALYSIS",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"CATH GLIDEPATH 15 CM DIALYSIS",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"CATH GLIDEPATH 14.5FR X 23CM",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"CATH GLIDEPATH 14.5FR X 27CM",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"CATH DRAINAGE DAWSON-MUELLER",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH CONQUEST40 PTA 75-4-4-6FR",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CATH CONQUEST 8MM X 4CM PTA",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"CATH CONQUEST PTA 75-5-4-7F",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"CATH CONQUEST PTA 75-6-4-6F",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"CATH CLOSUREFAST PROC KIT",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CATH SECURE",490264,CDM,272,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"CATH PALINDROME SI KIT 55CM",ORSUP0025,CDM,272,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"CATH,FOLEY SILICONE 16FR 30CC",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH BALLOON SPACEMAKER PLUS",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATH CARSON COUDE 22 FR",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH BERENSTEIN 5F/140CM/.035B",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CATH, FOLEY 16FR SILICONE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CATH-ANGIO LEVEL 5",CATH00052,CDM,278,RC,,,OUTPATIENT,,,3721,2418.65,,3274.48,88,,2619.58,,,0,"percent of total billed charges","88% of total billed charges",1860.5,50,,1488.40,,,0,"percent of total billed charges","50% of total billed charges",625.13,16.8,,500.10,,,0,"percent of total billed charges","16.8% of total billed charges",3721,100,,2976.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",643.88,17.304,,515.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2344.23,63,,1875.38,,,0,"percent of total billed charges","63% of total billed charges",569.31,15.3,,455.45,,,0,"percent of total billed charges","15.3% of total billed charges",625.13,16.8,,500.10,,,0,"percent of total billed charges","16.8% of total billed charges",2567.49,69,,,,,0,"fee schedule","69% of total billed charges",3721,100,,2976.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3721,100,,2976.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3721,100,,2976.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2301.44,61.85,,1841.15,,,0,"percent of total billed charges","61.5% of total billed charges",625.13,16.8,,500.10,,,0,"percent of total billed charges","16.8% of total billed charges",1860.5,50,,1488.40,,,0,"percent of total billed charges","50% of total billed charges",1198.16,32.2,,958.53,,,0,"percent of total billed charges","32.2% of total billed charges",1160.95,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",637.63,17.136,,510.10,,,0,"percent of total billed charges","17.136% of total billed charges",812.67,21.84,,650.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1402.82,37.7,,1122.26,,,0,"percent of total billed charges","37.7% of total billed charges",1402.82,37.7,,1122.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1261.42,33.9,,1009.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2902.38,78,,2321.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3073.55,82.6,,2458.84,,,0,"percent of total billed charges","82.6% of total billed charges",625.13,16.8,,500.10,,,0,"percent of total billed charges","16.8% of total billed charges",1860.5,50,,1488.40,,,0,"percent of total billed charges","50% of total billed charges",3073.55,82.6,,2458.84,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",625.13,16.8,,500.10,,,0,"percent of total billed charges","16.8% of total billed charges",3721,100,,2976.80,,,0,"percent of total billed charges","100% of total billed charges",569.31,3721,
"CATH EP DIG/ABL 3D 2",CATH00068,CDM,272,RC,,,OUTPATIENT,,,23045,14979.25,,20279.6,88,,16223.68,,,0,"percent of total billed charges","88% of total billed charges",11522.5,50,,9218.00,,,0,"percent of total billed charges","50% of total billed charges",3871.56,16.8,,3097.25,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3987.71,17.304,,3190.17,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14518.35,63,,11614.68,,,0,"percent of total billed charges","63% of total billed charges",3525.89,15.3,,2820.71,,,0,"percent of total billed charges","15.3% of total billed charges",3871.56,16.8,,3097.25,,,0,"percent of total billed charges","16.8% of total billed charges",15901.05,69,,,,,0,"fee schedule","69% of total billed charges",23045,100,,18436.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23045,100,,18436.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23045,100,,18436.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14253.33,61.85,,11402.66,,,0,"percent of total billed charges","61.5% of total billed charges",3871.56,16.8,,3097.25,,,0,"percent of total billed charges","16.8% of total billed charges",11522.5,50,,9218.00,,,0,"percent of total billed charges","50% of total billed charges",7420.49,32.2,,5936.39,,,0,"percent of total billed charges","32.2% of total billed charges",3871.56,16.8,,3097.25,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3948.99,17.136,,3159.19,,,0,"percent of total billed charges","17.136% of total billed charges",5033.03,21.84,,4026.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8687.97,37.7,,6950.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17975.1,78,,14380.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19035.17,82.6,,15228.14,,,0,"percent of total billed charges","82.6% of total billed charges",3871.56,16.8,,3097.25,,,0,"percent of total billed charges","16.8% of total billed charges",11522.5,50,,9218.00,,,0,"percent of total billed charges","50% of total billed charges",19035.17,82.6,,15228.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3871.56,16.8,,3097.25,,,0,"percent of total billed charges","16.8% of total billed charges",23045,100,,18436.00,,,0,"percent of total billed charges","100% of total billed charges",3525.89,23045,
"CATH TROCAR 16IN 20FR  CS/10",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"CATH GUIDE LAUNCHER 6F AR2.0",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATHETER STEALTH SOLID 1.25MM",ORSUP0087,CDM,278,RC,,,OUTPATIENT,,,15800,10270,,13904,88,,11123.20,,,0,"percent of total billed charges","88% of total billed charges",7900,50,,6320.00,,,0,"percent of total billed charges","50% of total billed charges",2654.4,16.8,,2123.52,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2734.03,17.304,,2187.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9954,63,,7963.20,,,0,"percent of total billed charges","63% of total billed charges",2417.4,15.3,,1933.92,,,0,"percent of total billed charges","15.3% of total billed charges",2654.4,16.8,,2123.52,,,0,"percent of total billed charges","16.8% of total billed charges",10902,69,,,,,0,"fee schedule","69% of total billed charges",15800,100,,12640.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15800,100,,12640.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15800,100,,12640.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9772.3,61.85,,7817.84,,,0,"percent of total billed charges","61.5% of total billed charges",2654.4,16.8,,2123.52,,,0,"percent of total billed charges","16.8% of total billed charges",7900,50,,6320.00,,,0,"percent of total billed charges","50% of total billed charges",5087.6,32.2,,4070.08,,,0,"percent of total billed charges","32.2% of total billed charges",4929.6,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2707.49,17.136,,2165.99,,,0,"percent of total billed charges","17.136% of total billed charges",3450.72,21.84,,2760.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",5956.6,37.7,,4765.28,,,0,"percent of total billed charges","37.7% of total billed charges",5956.6,37.7,,4765.28,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356.2,33.9,,4284.96,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",12324,78,,9859.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13050.8,82.6,,10440.64,,,0,"percent of total billed charges","82.6% of total billed charges",2654.4,16.8,,2123.52,,,0,"percent of total billed charges","16.8% of total billed charges",7900,50,,6320.00,,,0,"percent of total billed charges","50% of total billed charges",13050.8,82.6,,10440.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.4,16.8,,2123.52,,,0,"percent of total billed charges","16.8% of total billed charges",15800,100,,12640.00,,,0,"percent of total billed charges","100% of total billed charges",2417.4,15800,
"CATH PACING 5FR FLOW DIRECTED 5FR 110CM",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH GUIDE LAUNCHER 6F HSI",ORSUP0004,CDM,278,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.7% of total billed charges",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.85,33.9,,72.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"CATH CORONARY DILAT RX MINI TREK 2.5MM X 08MM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATH MICRO GUIDE FINE CROSS 150CM",ORSUP0026,CDM,272,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"CATH CXI SUPPORT 2.3FR X 150CM STRAIGHT",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CATH CXI SUPPORT 4FR X 135CM",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CATH EXTRACTION PRONTO CATHETER V4 5.5FR",ORSUP0024,CDM,272,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"CATH GUIDE LAUNCHER 6F HSII",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"CATH KIT INFANT/NEO 5 FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CATHETER KIT EXTENDED COIL",ORSUP0024,CDM,272,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"CATH RESOLVE LOCKING DRAIN 8FR X 25CM",ORSUP0010,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"CATH 5FR PERFORMA CARDIAC IM",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH 6FR PERFORMA CARDIAC IM",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"CATH 5FR PERFORMA STRAIGHT PIG MIV RAD",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH THORACIC 28 FR TROCAR",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"CATH SOS OMNI SOFT-VU 5FR X 80CM",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH POWERLINE MICROINTRODUCER KIT",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1185,770.25,,1042.8,88,,834.24,,,0,"percent of total billed charges","88% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",205.05,17.304,,164.04,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",746.55,63,,597.24,,,0,"percent of total billed charges","63% of total billed charges",181.31,15.3,,145.05,,,0,"percent of total billed charges","15.3% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",817.65,69,,,,,0,"fee schedule","69% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.92,61.85,,586.34,,,0,"percent of total billed charges","61.5% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",381.57,32.2,,305.26,,,0,"percent of total billed charges","32.2% of total billed charges",369.72,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",203.06,17.136,,162.45,,,0,"percent of total billed charges","17.136% of total billed charges",258.8,21.84,,207.04,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",446.75,37.7,,357.40,,,0,"percent of total billed charges","37.7% of total billed charges",446.75,37.7,,357.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",401.72,33.9,,321.38,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",924.3,78,,739.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",181.31,1185,
"VISIONS PV.014P IVUS CATH",ORSUP0033,CDM,272,RC,,,OUTPATIENT,,,4532,2945.8,,3988.16,88,,3190.53,,,0,"percent of total billed charges","88% of total billed charges",2266,50,,1812.80,,,0,"percent of total billed charges","50% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",784.22,17.304,,627.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2855.16,63,,2284.13,,,0,"percent of total billed charges","63% of total billed charges",693.4,15.3,,554.72,,,0,"percent of total billed charges","15.3% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",3127.08,69,,,,,0,"fee schedule","69% of total billed charges",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2803.04,61.85,,2242.43,,,0,"percent of total billed charges","61.5% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",2266,50,,1812.80,,,0,"percent of total billed charges","50% of total billed charges",1459.3,32.2,,1167.44,,,0,"percent of total billed charges","32.2% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",776.6,17.136,,621.28,,,0,"percent of total billed charges","17.136% of total billed charges",989.79,21.84,,791.83,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1708.56,37.7,,1366.85,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3534.96,78,,2827.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3743.43,82.6,,2994.74,,,0,"percent of total billed charges","82.6% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",2266,50,,1812.80,,,0,"percent of total billed charges","50% of total billed charges",3743.43,82.6,,2994.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",693.4,4532,
"CATH RESOLVE LOCKING DRAIN 6.5FR X 25CM",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"CATH TRAY 16 FR SILICONE DRAIN BAG FOLEY LF",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CATH LUBRI-SIL FOLEY 3 WAY 16 FR 5ML",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH TORCON NB ADVANTAGE 5FR X 90CM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"CATH LOW PROFILE PTA BALLOON 7MMX4CM",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"CATH LOW PROFILE PTA BALLOON 5MMX8CM",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"CATH KIT ORAL SUCTION",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"CATH STATLOCK STABILIZER 6-8FR",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH LOCKING DRAINAGE 10FR",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"CATH HYSTEROSALPINGOGRAM",ORSUP0003,CDM,278,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.7% of total billed charges",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.14,33.9,,54.51,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"CATH RIM 5FR TORCON",ORSUP0002,CDM,278,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.7% of total billed charges",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.43,33.9,,36.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATHETER LOW PROFILE DIALATION 5FR",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,464,301.6,,408.32,88,,326.66,,,0,"percent of total billed charges","88% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.29,17.304,,64.23,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.32,63,,233.86,,,0,"percent of total billed charges","63% of total billed charges",70.99,15.3,,56.79,,,0,"percent of total billed charges","15.3% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",320.16,69,,,,,0,"fee schedule","69% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",286.98,61.85,,229.58,,,0,"percent of total billed charges","61.5% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",149.41,32.2,,119.53,,,0,"percent of total billed charges","32.2% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.51,17.136,,63.61,,,0,"percent of total billed charges","17.136% of total billed charges",101.34,21.84,,81.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",174.93,37.7,,139.94,,,0,"percent of total billed charges","37.7% of total billed charges",174.93,37.7,,139.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.3,33.9,,125.84,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",361.92,78,,289.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",70.99,464,
"CATH DRAINAGE MULTI-PURPOSE 8.5FR X 25CM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"CATH BERENSTEIN 4FR X 65CM",ORSUP0004,CDM,278,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.7% of total billed charges",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.85,33.9,,72.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"CATHETER SAF-T-IMA Y ADAPTER PINK 20GA",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CATHETER SAF-TIMA Y ADAPTER BLUE 22GA",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CATHETER SAF-T-IMA Y ADAPTER YELLOW 24GA",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CATH ANGIOGRPAHIC 5FR X 65CM",ORSUP0002,CDM,278,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.7% of total billed charges",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.43,33.9,,36.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
N/A,ORSUP0002,CDM,278,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.7% of total billed charges",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.43,33.9,,36.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATHETER MICRO SUPERSELECTIVE CANTATA 2.8",ORSUP0021,CDM,278,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",835.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.7% of total billed charges",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",907.84,33.9,,726.27,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"CATHETER INFUSION SET MULTI SIDE-PORT",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"CATH CXI SUPPORT 2.3FR",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"CATH ANGIO RADIAL TIG 4.0 6FR",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"CATH ANGIO SARAH RADIAL 6FR",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"CATH DRAINAGE MALECOT SUPRAPUBIC SET 16FR",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,17.304,,49.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.28,61.85,,178.62,,,0,"percent of total billed charges","61.5% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",116.24,32.2,,92.99,,,0,"percent of total billed charges","32.2% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.86,17.136,,49.49,,,0,"percent of total billed charges","17.136% of total billed charges",78.84,21.84,,63.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,361,
"CATH BALLOON DIALTION LOW PROFILE 5FR",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.94,17.304,,85.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.23,61.85,,305.78,,,0,"percent of total billed charges","61.5% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",199,32.2,,159.20,,,0,"percent of total billed charges","32.2% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.136,,84.72,,,0,"percent of total billed charges","17.136% of total billed charges",134.97,21.84,,107.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.7% of total billed charges",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.5,33.9,,167.60,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,618,
"CATHETER NAVVUS II MICRO335CM",ORSUP0029,CDM,278,RC,,,OUTPATIENT,,,4820,3133,,4241.6,88,,3393.28,,,0,"percent of total billed charges","88% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",834.05,17.304,,667.24,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3036.6,63,,2429.28,,,0,"percent of total billed charges","63% of total billed charges",737.46,15.3,,589.97,,,0,"percent of total billed charges","15.3% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",3325.8,69,,,,,0,"fee schedule","69% of total billed charges",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2981.17,61.85,,2384.94,,,0,"percent of total billed charges","61.5% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",1552.04,32.2,,1241.63,,,0,"percent of total billed charges","32.2% of total billed charges",1503.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",825.96,17.136,,660.77,,,0,"percent of total billed charges","17.136% of total billed charges",1052.69,21.84,,842.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1817.14,37.7,,1453.71,,,0,"percent of total billed charges","37.7% of total billed charges",1817.14,37.7,,1453.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1633.98,33.9,,1307.18,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3759.6,78,,3007.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3981.32,82.6,,3185.06,,,0,"percent of total billed charges","82.6% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",3981.32,82.6,,3185.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",737.46,4820,
"CATHETER BALLOON DIALATION 18MM/19MM/20MM",ORSUP0019,CDM,278,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",668.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.7% of total billed charges",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",726.14,33.9,,580.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"CATH ARGYLE STRT 35 FR X 20",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH DIAG CARDIO 6FR 3DRC INFI",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH DIAG CARDIO 6FR MPA2 100CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH FOGARTY BILLIARY 5FR",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATH FOGARTY BILLIARY 6FR",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CATHETER EMBOLECTOMY FOGARTY 4FR",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"CATHETER CXI SUPPORT 2.6FR ANGLED",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"CATH PIGTAIL 5FR 65CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH 5FR JR  3.5 100CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH 5FR JR 4 125CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH 5FR JR 4.5 100CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH 5FR JR 4 100CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH 5FR AL 1.0 100CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH 5FR AL 2.0 100CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH 5FR AR 1.0 100CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH 5FR AR 2.0 100CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH 5FR MPA 100CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH 5FR MPA2 100CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH 5FR 3DRC 100CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH 5FR RCB 100CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH 5FR LCB 100CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH 5FR IM 100CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH 5FR ANG PIGTAIL 100CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH 6FR ULTRA 4.0 RADIAL",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"CATH 5FR TRANS 3.5 RADIAL",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"CATH 5FR TRANS 4.0 RADIAL",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"CATH 6FR ULTRA 3.50 RADIAL",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"CATH 6FR TRANS 4.0 RADIAL",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"CATH 5FR ULTRA 4.5 RADIAL",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"CATH RF ABLATION 6FR 100CM",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"CATHETER 3-WAY 22FR",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH FOLEY SIL-ELAST 14FR 10",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CATH FOLEY  COUDE LATEX 16FR 10ML",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CATH FOLEY COUDE LATEX 18FR 10ML",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CATH FOLEY COUDE LATEX 20FR 10ML",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CATH FOLEY SILICONE 12FR 10ML LF",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CATH FOLEY SILICONE 16FR 10ML LF",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CATH FOLEY SILICONE 18FR 10 ML LF",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CATH FOLEY SILICONE 20FR 10 ML LF",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CATH FOLEY SILICONE 22FR 10 ML LF",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CATH FOLEY SILICONE 24FR 10 ML LF",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CATH FOLEY SILICONE 8FR 3ML LF",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH FOLEY LATEX 8FR 3ML",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CATH FOLEY LATEX 10FR 3ML",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CATH FOLEY LATEX 24FR 10ML",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CATH FOLEY LATEX 30FR 10ML",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CATH RED RUBBER STRL 10FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CATH RED RUBBER STRL 16FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CATH RED RUBBER STRL 20FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CATH FOLEY SIL-ELAST 14FR 17",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CATH SLIT SET",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CATH SET PLEURAL \\T\\ PERITONEAL",ORSUP0026,CDM,272,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"CATH ALL SILICON FOLEY 24FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CATH CARSON COUDE 18FR",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH FOLEY 2 WAY 20FR",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH FOLEY 2 WAY 22FR",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH FOLEY 2 WAY 24FR",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH COUDE 3 WAY 24FR 30CC",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH BIPOLAR TEMP W/ SHROUDED PINS",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"CATH GUIDE LAUNCHER 6FR AL 1.75",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH GUIDE LAUNCHER 6FR 3DRC",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH GUIDE LAUNCHER 6FR JR 4.5",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH GUIDE LAUNCHER 6FR MP1",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH GUIDE LAUNCHER 6FR MP2",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH GUIDE LAUNCHER 6FR MB2",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH GUIDE LAUNCHER 5FR JL 4.0 SIDEHOLES",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH GUIDE LAUNCHER 5FR AL 1.75",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH GUIDE LAUNCHER 5FR JR 4.0 SIDEHOLES",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH GUIDE LAUNCHER 5FR JR 4.5",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH GUIDE LAUNCHER 5FR 3DRC",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH GUIDE LAUNCHER 5FR AR 1.0",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH GUIDE LAUNCHER 5FR AR 2.0",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH GUIDE LAUNCHER 5FR MP1",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH GUIDE LAUNCHER 5FR MP2",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH GUIDE LAUNCHER 5FR MB2",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CATH COBRA 2 5FRX90CM",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"CATH PIGTAIL 5FRX65CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH ANGIO OMNI FLUSH5FRX90CM",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"CATH HEADHUNTER 5FR",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH BERENSTEIN 6FRX65CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH THORACIC STRIAGHT 32FR",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATH GRAINAGE MULTIPURPOSE 14FR X 25",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"CATH COBRA 5FR X 100CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CATHETER STRAIGHT MARKER 5FR X 100CM",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"CATH INFUSION SET 5FR X 7CM",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"CATH CXI SUPPORT 018 2.6FR X 150CM ANG",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"CATH CXI SUPPORT 014 2.3FR X 65CM STR",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CATH PTA BALLOON 6MM X 2CM X 135CM",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,464,301.6,,408.32,88,,326.66,,,0,"percent of total billed charges","88% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.29,17.304,,64.23,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.32,63,,233.86,,,0,"percent of total billed charges","63% of total billed charges",70.99,15.3,,56.79,,,0,"percent of total billed charges","15.3% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",320.16,69,,,,,0,"fee schedule","69% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",286.98,61.85,,229.58,,,0,"percent of total billed charges","61.5% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",149.41,32.2,,119.53,,,0,"percent of total billed charges","32.2% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.51,17.136,,63.61,,,0,"percent of total billed charges","17.136% of total billed charges",101.34,21.84,,81.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",174.93,37.7,,139.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",361.92,78,,289.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",70.99,464,
"CATH PTA BALLOON 4MM X 8CM X 135CM",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,464,301.6,,408.32,88,,326.66,,,0,"percent of total billed charges","88% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.29,17.304,,64.23,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.32,63,,233.86,,,0,"percent of total billed charges","63% of total billed charges",70.99,15.3,,56.79,,,0,"percent of total billed charges","15.3% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",320.16,69,,,,,0,"fee schedule","69% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",286.98,61.85,,229.58,,,0,"percent of total billed charges","61.5% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",149.41,32.2,,119.53,,,0,"percent of total billed charges","32.2% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.51,17.136,,63.61,,,0,"percent of total billed charges","17.136% of total billed charges",101.34,21.84,,81.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",174.93,37.7,,139.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",361.92,78,,289.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",70.99,464,
"CATH PTA BALLOON 5MM X 6CM X 135CM",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,464,301.6,,408.32,88,,326.66,,,0,"percent of total billed charges","88% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.29,17.304,,64.23,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.32,63,,233.86,,,0,"percent of total billed charges","63% of total billed charges",70.99,15.3,,56.79,,,0,"percent of total billed charges","15.3% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",320.16,69,,,,,0,"fee schedule","69% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",286.98,61.85,,229.58,,,0,"percent of total billed charges","61.5% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",149.41,32.2,,119.53,,,0,"percent of total billed charges","32.2% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.51,17.136,,63.61,,,0,"percent of total billed charges","17.136% of total billed charges",101.34,21.84,,81.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",174.93,37.7,,139.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",361.92,78,,289.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",70.99,464,
"CATH PTA BALLOON 5MM X 10CM X 135CM",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,464,301.6,,408.32,88,,326.66,,,0,"percent of total billed charges","88% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.29,17.304,,64.23,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.32,63,,233.86,,,0,"percent of total billed charges","63% of total billed charges",70.99,15.3,,56.79,,,0,"percent of total billed charges","15.3% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",320.16,69,,,,,0,"fee schedule","69% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",286.98,61.85,,229.58,,,0,"percent of total billed charges","61.5% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",149.41,32.2,,119.53,,,0,"percent of total billed charges","32.2% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.51,17.136,,63.61,,,0,"percent of total billed charges","17.136% of total billed charges",101.34,21.84,,81.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",174.93,37.7,,139.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",361.92,78,,289.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",70.99,464,
"CATH PTA BALLOON 6MM X 6CM X 135CM",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,464,301.6,,408.32,88,,326.66,,,0,"percent of total billed charges","88% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.29,17.304,,64.23,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.32,63,,233.86,,,0,"percent of total billed charges","63% of total billed charges",70.99,15.3,,56.79,,,0,"percent of total billed charges","15.3% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",320.16,69,,,,,0,"fee schedule","69% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",286.98,61.85,,229.58,,,0,"percent of total billed charges","61.5% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",149.41,32.2,,119.53,,,0,"percent of total billed charges","32.2% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.51,17.136,,63.61,,,0,"percent of total billed charges","17.136% of total billed charges",101.34,21.84,,81.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",174.93,37.7,,139.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",361.92,78,,289.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",70.99,464,
"CATH PTA BALLOON 7MM X 10CM X 135CM",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,464,301.6,,408.32,88,,326.66,,,0,"percent of total billed charges","88% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.29,17.304,,64.23,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.32,63,,233.86,,,0,"percent of total billed charges","63% of total billed charges",70.99,15.3,,56.79,,,0,"percent of total billed charges","15.3% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",320.16,69,,,,,0,"fee schedule","69% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",286.98,61.85,,229.58,,,0,"percent of total billed charges","61.5% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",149.41,32.2,,119.53,,,0,"percent of total billed charges","32.2% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.51,17.136,,63.61,,,0,"percent of total billed charges","17.136% of total billed charges",101.34,21.84,,81.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",174.93,37.7,,139.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",361.92,78,,289.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",70.99,464,
"CATH PTA BALLOON 6MM X 10CM X 135CM",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,464,301.6,,408.32,88,,326.66,,,0,"percent of total billed charges","88% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.29,17.304,,64.23,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.32,63,,233.86,,,0,"percent of total billed charges","63% of total billed charges",70.99,15.3,,56.79,,,0,"percent of total billed charges","15.3% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",320.16,69,,,,,0,"fee schedule","69% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",286.98,61.85,,229.58,,,0,"percent of total billed charges","61.5% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",149.41,32.2,,119.53,,,0,"percent of total billed charges","32.2% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.51,17.136,,63.61,,,0,"percent of total billed charges","17.136% of total billed charges",101.34,21.84,,81.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",174.93,37.7,,139.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",361.92,78,,289.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",70.99,464,
"CATH PTA BALLOON 8MM X 8CM X135CM",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,464,301.6,,408.32,88,,326.66,,,0,"percent of total billed charges","88% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.29,17.304,,64.23,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.32,63,,233.86,,,0,"percent of total billed charges","63% of total billed charges",70.99,15.3,,56.79,,,0,"percent of total billed charges","15.3% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",320.16,69,,,,,0,"fee schedule","69% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",286.98,61.85,,229.58,,,0,"percent of total billed charges","61.5% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",149.41,32.2,,119.53,,,0,"percent of total billed charges","32.2% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.51,17.136,,63.61,,,0,"percent of total billed charges","17.136% of total billed charges",101.34,21.84,,81.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",174.93,37.7,,139.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",361.92,78,,289.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",70.99,464,
"CATH PTA BALLOON 10MM X 4CM",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.94,17.304,,85.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.23,61.85,,305.78,,,0,"percent of total billed charges","61.5% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",199,32.2,,159.20,,,0,"percent of total billed charges","32.2% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.136,,84.72,,,0,"percent of total billed charges","17.136% of total billed charges",134.97,21.84,,107.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,618,
"CATH ANG CXI 135CM",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,824,535.6,,725.12,88,,580.10,,,0,"percent of total billed charges","88% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.58,17.304,,114.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",519.12,63,,415.30,,,0,"percent of total billed charges","63% of total billed charges",126.07,15.3,,100.86,,,0,"percent of total billed charges","15.3% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",568.56,69,,,,,0,"fee schedule","69% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.64,61.85,,407.71,,,0,"percent of total billed charges","61.5% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",265.33,32.2,,212.26,,,0,"percent of total billed charges","32.2% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",141.2,17.136,,112.96,,,0,"percent of total billed charges","17.136% of total billed charges",179.96,21.84,,143.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",310.65,37.7,,248.52,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",642.72,78,,514.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",126.07,824,
"CATH OMNI FLUSH 5FRX80CM",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"CATH SIMMONS SIDEWINDER 2 X 100CM",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"CATH BERENSTEIN 5FR X 100CM",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"CATH DRAINAGE PIGTAIL 8FR X 30CM",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,17.304,,49.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.28,61.85,,178.62,,,0,"percent of total billed charges","61.5% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",116.24,32.2,,92.99,,,0,"percent of total billed charges","32.2% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.86,17.136,,49.49,,,0,"percent of total billed charges","17.136% of total billed charges",78.84,21.84,,63.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,361,
"CATH BERENSTEIN 6FR X 100CM",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"CATH CONQUEST 8MM X 60MM",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"CATH DIAG CARDIO 5FR MPB2 INFI",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"CATH CHOLANGIOGRAM 11 DISP",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,17.304,,49.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.28,61.85,,178.62,,,0,"percent of total billed charges","61.5% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",116.24,32.2,,92.99,,,0,"percent of total billed charges","32.2% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.86,17.136,,49.49,,,0,"percent of total billed charges","17.136% of total billed charges",78.84,21.84,,63.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,361,
"CATH KIT CENTRAL VENOUS",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"CATH SERENITY DILATION BALLOON 2.0MMX100MM",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1030,669.5,,906.4,88,,725.12,,,0,"percent of total billed charges","88% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.23,17.304,,142.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.9,63,,519.12,,,0,"percent of total billed charges","63% of total billed charges",157.59,15.3,,126.07,,,0,"percent of total billed charges","15.3% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",710.7,69,,,,,0,"fee schedule","69% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",637.06,61.85,,509.65,,,0,"percent of total billed charges","61.5% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",331.66,32.2,,265.33,,,0,"percent of total billed charges","32.2% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.5,17.136,,141.20,,,0,"percent of total billed charges","17.136% of total billed charges",224.95,21.84,,179.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",388.31,37.7,,310.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",803.4,78,,642.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",157.59,1030,
"CATH SERENITY DILATION BALLOON 20MMX220MM",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1030,669.5,,906.4,88,,725.12,,,0,"percent of total billed charges","88% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.23,17.304,,142.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.9,63,,519.12,,,0,"percent of total billed charges","63% of total billed charges",157.59,15.3,,126.07,,,0,"percent of total billed charges","15.3% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",710.7,69,,,,,0,"fee schedule","69% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",637.06,61.85,,509.65,,,0,"percent of total billed charges","61.5% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",331.66,32.2,,265.33,,,0,"percent of total billed charges","32.2% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.5,17.136,,141.20,,,0,"percent of total billed charges","17.136% of total billed charges",224.95,21.84,,179.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",388.31,37.7,,310.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",803.4,78,,642.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",157.59,1030,
"CATH SERENITY DILATION BALLOON 2.0MMX40MM",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1030,669.5,,906.4,88,,725.12,,,0,"percent of total billed charges","88% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.23,17.304,,142.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.9,63,,519.12,,,0,"percent of total billed charges","63% of total billed charges",157.59,15.3,,126.07,,,0,"percent of total billed charges","15.3% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",710.7,69,,,,,0,"fee schedule","69% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",637.06,61.85,,509.65,,,0,"percent of total billed charges","61.5% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",331.66,32.2,,265.33,,,0,"percent of total billed charges","32.2% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.5,17.136,,141.20,,,0,"percent of total billed charges","17.136% of total billed charges",224.95,21.84,,179.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",388.31,37.7,,310.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",803.4,78,,642.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",157.59,1030,
"CATH SERENITY DILATION BALLOON 2.0MMX60MM",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1030,669.5,,906.4,88,,725.12,,,0,"percent of total billed charges","88% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.23,17.304,,142.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.9,63,,519.12,,,0,"percent of total billed charges","63% of total billed charges",157.59,15.3,,126.07,,,0,"percent of total billed charges","15.3% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",710.7,69,,,,,0,"fee schedule","69% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",637.06,61.85,,509.65,,,0,"percent of total billed charges","61.5% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",331.66,32.2,,265.33,,,0,"percent of total billed charges","32.2% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.5,17.136,,141.20,,,0,"percent of total billed charges","17.136% of total billed charges",224.95,21.84,,179.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",388.31,37.7,,310.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",803.4,78,,642.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",157.59,1030,
"CATH SERENITY DILATION BALLOON 3.0X100MM",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1030,669.5,,906.4,88,,725.12,,,0,"percent of total billed charges","88% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.23,17.304,,142.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.9,63,,519.12,,,0,"percent of total billed charges","63% of total billed charges",157.59,15.3,,126.07,,,0,"percent of total billed charges","15.3% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",710.7,69,,,,,0,"fee schedule","69% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",637.06,61.85,,509.65,,,0,"percent of total billed charges","61.5% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",331.66,32.2,,265.33,,,0,"percent of total billed charges","32.2% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.5,17.136,,141.20,,,0,"percent of total billed charges","17.136% of total billed charges",224.95,21.84,,179.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",388.31,37.7,,310.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",803.4,78,,642.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",157.59,1030,
"CATH SERENITY DILATION BALLOON 3.0MMX20MM",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1030,669.5,,906.4,88,,725.12,,,0,"percent of total billed charges","88% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.23,17.304,,142.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.9,63,,519.12,,,0,"percent of total billed charges","63% of total billed charges",157.59,15.3,,126.07,,,0,"percent of total billed charges","15.3% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",710.7,69,,,,,0,"fee schedule","69% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",637.06,61.85,,509.65,,,0,"percent of total billed charges","61.5% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",331.66,32.2,,265.33,,,0,"percent of total billed charges","32.2% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.5,17.136,,141.20,,,0,"percent of total billed charges","17.136% of total billed charges",224.95,21.84,,179.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",388.31,37.7,,310.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",803.4,78,,642.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",157.59,1030,
"CATH SERENITY DILATION BALLOON 3.0MMX220MM",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1030,669.5,,906.4,88,,725.12,,,0,"percent of total billed charges","88% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.23,17.304,,142.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.9,63,,519.12,,,0,"percent of total billed charges","63% of total billed charges",157.59,15.3,,126.07,,,0,"percent of total billed charges","15.3% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",710.7,69,,,,,0,"fee schedule","69% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",637.06,61.85,,509.65,,,0,"percent of total billed charges","61.5% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",331.66,32.2,,265.33,,,0,"percent of total billed charges","32.2% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.5,17.136,,141.20,,,0,"percent of total billed charges","17.136% of total billed charges",224.95,21.84,,179.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",388.31,37.7,,310.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",803.4,78,,642.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",157.59,1030,
"CATH SERENITY DILATION BALLOON 3.0X40MM",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1030,669.5,,906.4,88,,725.12,,,0,"percent of total billed charges","88% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.23,17.304,,142.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.9,63,,519.12,,,0,"percent of total billed charges","63% of total billed charges",157.59,15.3,,126.07,,,0,"percent of total billed charges","15.3% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",710.7,69,,,,,0,"fee schedule","69% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",637.06,61.85,,509.65,,,0,"percent of total billed charges","61.5% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",331.66,32.2,,265.33,,,0,"percent of total billed charges","32.2% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.5,17.136,,141.20,,,0,"percent of total billed charges","17.136% of total billed charges",224.95,21.84,,179.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",388.31,37.7,,310.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",803.4,78,,642.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",157.59,1030,
"CATH SERENITY DILATION BALLOON 3.0MMX60MM",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1030,669.5,,906.4,88,,725.12,,,0,"percent of total billed charges","88% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.23,17.304,,142.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.9,63,,519.12,,,0,"percent of total billed charges","63% of total billed charges",157.59,15.3,,126.07,,,0,"percent of total billed charges","15.3% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",710.7,69,,,,,0,"fee schedule","69% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",637.06,61.85,,509.65,,,0,"percent of total billed charges","61.5% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",331.66,32.2,,265.33,,,0,"percent of total billed charges","32.2% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.5,17.136,,141.20,,,0,"percent of total billed charges","17.136% of total billed charges",224.95,21.84,,179.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",388.31,37.7,,310.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",803.4,78,,642.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",157.59,1030,
"CATH SERENITY DILATION BALLOON 4.0MMX40MM",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1030,669.5,,906.4,88,,725.12,,,0,"percent of total billed charges","88% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.23,17.304,,142.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.9,63,,519.12,,,0,"percent of total billed charges","63% of total billed charges",157.59,15.3,,126.07,,,0,"percent of total billed charges","15.3% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",710.7,69,,,,,0,"fee schedule","69% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",637.06,61.85,,509.65,,,0,"percent of total billed charges","61.5% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",331.66,32.2,,265.33,,,0,"percent of total billed charges","32.2% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.5,17.136,,141.20,,,0,"percent of total billed charges","17.136% of total billed charges",224.95,21.84,,179.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",388.31,37.7,,310.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",803.4,78,,642.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",157.59,1030,
"CATH SERENITY DILATION BALLOON 4.0MMX60MM",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1030,669.5,,906.4,88,,725.12,,,0,"percent of total billed charges","88% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.23,17.304,,142.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.9,63,,519.12,,,0,"percent of total billed charges","63% of total billed charges",157.59,15.3,,126.07,,,0,"percent of total billed charges","15.3% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",710.7,69,,,,,0,"fee schedule","69% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",637.06,61.85,,509.65,,,0,"percent of total billed charges","61.5% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",331.66,32.2,,265.33,,,0,"percent of total billed charges","32.2% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.5,17.136,,141.20,,,0,"percent of total billed charges","17.136% of total billed charges",224.95,21.84,,179.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",388.31,37.7,,310.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",803.4,78,,642.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",157.59,1030,
"CATH SERENITY DILATION BALLOON 4.0MMX100M",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1030,669.5,,906.4,88,,725.12,,,0,"percent of total billed charges","88% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.23,17.304,,142.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.9,63,,519.12,,,0,"percent of total billed charges","63% of total billed charges",157.59,15.3,,126.07,,,0,"percent of total billed charges","15.3% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",710.7,69,,,,,0,"fee schedule","69% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",637.06,61.85,,509.65,,,0,"percent of total billed charges","61.5% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",331.66,32.2,,265.33,,,0,"percent of total billed charges","32.2% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.5,17.136,,141.20,,,0,"percent of total billed charges","17.136% of total billed charges",224.95,21.84,,179.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",388.31,37.7,,310.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",803.4,78,,642.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",157.59,1030,
"CATH SERENITY DILATION BALLOON 4.0MM X 220MM",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1030,669.5,,906.4,88,,725.12,,,0,"percent of total billed charges","88% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.23,17.304,,142.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.9,63,,519.12,,,0,"percent of total billed charges","63% of total billed charges",157.59,15.3,,126.07,,,0,"percent of total billed charges","15.3% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",710.7,69,,,,,0,"fee schedule","69% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",637.06,61.85,,509.65,,,0,"percent of total billed charges","61.5% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",331.66,32.2,,265.33,,,0,"percent of total billed charges","32.2% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.5,17.136,,141.20,,,0,"percent of total billed charges","17.136% of total billed charges",224.95,21.84,,179.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",388.31,37.7,,310.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",803.4,78,,642.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",157.59,1030,
N/A,ORSUP0070,CDM,278,RC,,,OUTPATIENT,,,12360,8034,,10876.8,88,,8701.44,,,0,"percent of total billed charges","88% of total billed charges",6180,50,,4944.00,,,0,"percent of total billed charges","50% of total billed charges",2076.48,16.8,,1661.18,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2138.77,17.304,,1711.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7786.8,63,,6229.44,,,0,"percent of total billed charges","63% of total billed charges",1891.08,15.3,,1512.86,,,0,"percent of total billed charges","15.3% of total billed charges",2076.48,16.8,,1661.18,,,0,"percent of total billed charges","16.8% of total billed charges",8528.4,69,,,,,0,"fee schedule","69% of total billed charges",12360,100,,9888.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12360,100,,9888.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12360,100,,9888.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7644.66,61.85,,6115.73,,,0,"percent of total billed charges","61.5% of total billed charges",2076.48,16.8,,1661.18,,,0,"percent of total billed charges","16.8% of total billed charges",6180,50,,4944.00,,,0,"percent of total billed charges","50% of total billed charges",3979.92,32.2,,3183.94,,,0,"percent of total billed charges","32.2% of total billed charges",3856.32,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2118.01,17.136,,1694.41,,,0,"percent of total billed charges","17.136% of total billed charges",2699.42,21.84,,2159.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4659.72,37.7,,3727.78,,,0,"percent of total billed charges","37.7% of total billed charges",4659.72,37.7,,3727.78,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4190.04,33.9,,3352.03,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",9640.8,78,,7712.64,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10209.36,82.6,,8167.49,,,0,"percent of total billed charges","82.6% of total billed charges",2076.48,16.8,,1661.18,,,0,"percent of total billed charges","16.8% of total billed charges",6180,50,,4944.00,,,0,"percent of total billed charges","50% of total billed charges",10209.36,82.6,,8167.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2076.48,16.8,,1661.18,,,0,"percent of total billed charges","16.8% of total billed charges",12360,100,,9888.00,,,0,"percent of total billed charges","100% of total billed charges",1891.08,12360,
"CATH DIAMOND BACK EXCHANGE 2.00 SOLID",ORSUP0070,CDM,278,RC,,,OUTPATIENT,,,12360,8034,,10876.8,88,,8701.44,,,0,"percent of total billed charges","88% of total billed charges",6180,50,,4944.00,,,0,"percent of total billed charges","50% of total billed charges",2076.48,16.8,,1661.18,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2138.77,17.304,,1711.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7786.8,63,,6229.44,,,0,"percent of total billed charges","63% of total billed charges",1891.08,15.3,,1512.86,,,0,"percent of total billed charges","15.3% of total billed charges",2076.48,16.8,,1661.18,,,0,"percent of total billed charges","16.8% of total billed charges",8528.4,69,,,,,0,"fee schedule","69% of total billed charges",12360,100,,9888.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12360,100,,9888.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12360,100,,9888.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7644.66,61.85,,6115.73,,,0,"percent of total billed charges","61.5% of total billed charges",2076.48,16.8,,1661.18,,,0,"percent of total billed charges","16.8% of total billed charges",6180,50,,4944.00,,,0,"percent of total billed charges","50% of total billed charges",3979.92,32.2,,3183.94,,,0,"percent of total billed charges","32.2% of total billed charges",3856.32,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2118.01,17.136,,1694.41,,,0,"percent of total billed charges","17.136% of total billed charges",2699.42,21.84,,2159.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4659.72,37.7,,3727.78,,,0,"percent of total billed charges","37.7% of total billed charges",4659.72,37.7,,3727.78,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4190.04,33.9,,3352.03,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",9640.8,78,,7712.64,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10209.36,82.6,,8167.49,,,0,"percent of total billed charges","82.6% of total billed charges",2076.48,16.8,,1661.18,,,0,"percent of total billed charges","16.8% of total billed charges",6180,50,,4944.00,,,0,"percent of total billed charges","50% of total billed charges",10209.36,82.6,,8167.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2076.48,16.8,,1661.18,,,0,"percent of total billed charges","16.8% of total billed charges",12360,100,,9888.00,,,0,"percent of total billed charges","100% of total billed charges",1891.08,12360,
"CATH CONQUEST BALLOON 6X20X50",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"CATH CXI SUPPORT STRAIGHT 2.3X014X135",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,1854,1205.1,,1631.52,88,,1305.22,,,0,"percent of total billed charges","88% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",320.82,17.304,,256.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1168.02,63,,934.42,,,0,"percent of total billed charges","63% of total billed charges",283.66,15.3,,226.93,,,0,"percent of total billed charges","15.3% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1279.26,69,,,,,0,"fee schedule","69% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1146.7,61.85,,917.36,,,0,"percent of total billed charges","61.5% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",596.99,32.2,,477.59,,,0,"percent of total billed charges","32.2% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.7,17.136,,254.16,,,0,"percent of total billed charges","17.136% of total billed charges",404.91,21.84,,323.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",698.96,37.7,,559.17,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1446.12,78,,1156.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1531.4,82.6,,1225.12,,,0,"percent of total billed charges","82.6% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",1531.4,82.6,,1225.12,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",283.66,1854,
"CATH CXI SUPPORT ANGLED 2.6X018X135",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,927,602.55,,815.76,88,,652.61,,,0,"percent of total billed charges","88% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.41,17.304,,128.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.01,63,,467.21,,,0,"percent of total billed charges","63% of total billed charges",141.83,15.3,,113.46,,,0,"percent of total billed charges","15.3% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",639.63,69,,,,,0,"fee schedule","69% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",573.35,61.85,,458.68,,,0,"percent of total billed charges","61.5% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",298.49,32.2,,238.79,,,0,"percent of total billed charges","32.2% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.85,17.136,,127.08,,,0,"percent of total billed charges","17.136% of total billed charges",202.46,21.84,,161.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",349.48,37.7,,279.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",723.06,78,,578.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",141.83,927,
"CATH RDC 5FR X 65CM",ORSUP0002,CDM,278,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.7% of total billed charges",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.92,33.9,,27.94,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"CATH RADIOFOCUSED NON TAPER 4X65X0.38",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,515,334.75,,453.2,88,,362.56,,,0,"percent of total billed charges","88% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.12,17.304,,71.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",324.45,63,,259.56,,,0,"percent of total billed charges","63% of total billed charges",78.8,15.3,,63.04,,,0,"percent of total billed charges","15.3% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",355.35,69,,,,,0,"fee schedule","69% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",318.53,61.85,,254.82,,,0,"percent of total billed charges","61.5% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",165.83,32.2,,132.66,,,0,"percent of total billed charges","32.2% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.25,17.136,,70.60,,,0,"percent of total billed charges","17.136% of total billed charges",112.48,21.84,,89.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",194.16,37.7,,155.33,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",401.7,78,,321.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",78.8,515,
"CATH ZELANTE DVT 8FR X 105CM",ORSUP0101,CDM,272,RC,,,OUTPATIENT,,,18952,12318.8,,16677.76,88,,13342.21,,,0,"percent of total billed charges","88% of total billed charges",9476,50,,7580.80,,,0,"percent of total billed charges","50% of total billed charges",3183.94,16.8,,2547.15,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3279.45,17.304,,2623.56,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11939.76,63,,9551.81,,,0,"percent of total billed charges","63% of total billed charges",2899.66,15.3,,2319.73,,,0,"percent of total billed charges","15.3% of total billed charges",3183.94,16.8,,2547.15,,,0,"percent of total billed charges","16.8% of total billed charges",13076.88,69,,,,,0,"fee schedule","69% of total billed charges",18952,100,,15161.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18952,100,,15161.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18952,100,,15161.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11721.81,61.85,,9377.45,,,0,"percent of total billed charges","61.5% of total billed charges",3183.94,16.8,,2547.15,,,0,"percent of total billed charges","16.8% of total billed charges",9476,50,,7580.80,,,0,"percent of total billed charges","50% of total billed charges",6102.54,32.2,,4882.03,,,0,"percent of total billed charges","32.2% of total billed charges",3183.94,16.8,,2547.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3247.61,17.136,,2598.09,,,0,"percent of total billed charges","17.136% of total billed charges",4139.12,21.84,,3311.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7144.9,37.7,,5715.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14782.56,78,,11826.05,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15654.35,82.6,,12523.48,,,0,"percent of total billed charges","82.6% of total billed charges",3183.94,16.8,,2547.15,,,0,"percent of total billed charges","16.8% of total billed charges",9476,50,,7580.80,,,0,"percent of total billed charges","50% of total billed charges",15654.35,82.6,,12523.48,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3183.94,16.8,,2547.15,,,0,"percent of total billed charges","16.8% of total billed charges",18952,100,,15161.60,,,0,"percent of total billed charges","100% of total billed charges",2899.66,18952,
"CATH THORACIC 24FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"CATH ANGIO 5FR ROYALFLUSH PIG 70CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"CATH CXI SUPPORT",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,824,535.6,,725.12,88,,580.10,,,0,"percent of total billed charges","88% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.58,17.304,,114.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",519.12,63,,415.30,,,0,"percent of total billed charges","63% of total billed charges",126.07,15.3,,100.86,,,0,"percent of total billed charges","15.3% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",568.56,69,,,,,0,"fee schedule","69% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.64,61.85,,407.71,,,0,"percent of total billed charges","61.5% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",265.33,32.2,,212.26,,,0,"percent of total billed charges","32.2% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",141.2,17.136,,112.96,,,0,"percent of total billed charges","17.136% of total billed charges",179.96,21.84,,143.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",310.65,37.7,,248.52,,,0,"percent of total billed charges","37.7% of total billed charges",310.65,37.7,,248.52,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",279.34,33.9,,223.47,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.72,78,,514.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",126.07,824,
"CATH SOFT-VUE KUMPE 5FR X 40CM",ORSUP0004,CDM,278,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.7% of total billed charges",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.83,33.9,,55.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"CATH TRAY POWERLINE DUAL LUMEN 5FR",ORSUP0044,CDM,278,RC,,,OUTPATIENT,,,6798,4418.7,,5982.24,88,,4785.79,,,0,"percent of total billed charges","88% of total billed charges",3399,50,,2719.20,,,0,"percent of total billed charges","50% of total billed charges",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1176.33,17.304,,941.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4282.74,63,,3426.19,,,0,"percent of total billed charges","63% of total billed charges",1040.09,15.3,,832.07,,,0,"percent of total billed charges","15.3% of total billed charges",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",4690.62,69,,,,,0,"fee schedule","69% of total billed charges",6798,100,,5438.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6798,100,,5438.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6798,100,,5438.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4204.56,61.85,,3363.65,,,0,"percent of total billed charges","61.5% of total billed charges",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",3399,50,,2719.20,,,0,"percent of total billed charges","50% of total billed charges",2188.96,32.2,,1751.17,,,0,"percent of total billed charges","32.2% of total billed charges",2120.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1164.91,17.136,,931.93,,,0,"percent of total billed charges","17.136% of total billed charges",1484.68,21.84,,1187.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2562.85,37.7,,2050.28,,,0,"percent of total billed charges","37.7% of total billed charges",2562.85,37.7,,2050.28,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2304.52,33.9,,1843.62,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5302.44,78,,4241.95,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5615.15,82.6,,4492.12,,,0,"percent of total billed charges","82.6% of total billed charges",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",3399,50,,2719.20,,,0,"percent of total billed charges","50% of total billed charges",5615.15,82.6,,4492.12,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",6798,100,,5438.40,,,0,"percent of total billed charges","100% of total billed charges",1040.09,6798,
"CATH MARINER BER 4FR X 150CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,824,535.6,,725.12,88,,580.10,,,0,"percent of total billed charges","88% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.58,17.304,,114.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",519.12,63,,415.30,,,0,"percent of total billed charges","63% of total billed charges",126.07,15.3,,100.86,,,0,"percent of total billed charges","15.3% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",568.56,69,,,,,0,"fee schedule","69% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.64,61.85,,407.71,,,0,"percent of total billed charges","61.5% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",265.33,32.2,,212.26,,,0,"percent of total billed charges","32.2% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",141.2,17.136,,112.96,,,0,"percent of total billed charges","17.136% of total billed charges",179.96,21.84,,143.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",310.65,37.7,,248.52,,,0,"percent of total billed charges","37.7% of total billed charges",310.65,37.7,,248.52,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",279.34,33.9,,223.47,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.72,78,,514.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",126.07,824,
"CATH MARINER BER 4FR X 110CM",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,412,267.8,,362.56,88,,290.05,,,0,"percent of total billed charges","88% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.29,17.304,,57.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",259.56,63,,207.65,,,0,"percent of total billed charges","63% of total billed charges",63.04,15.3,,50.43,,,0,"percent of total billed charges","15.3% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",284.28,69,,,,,0,"fee schedule","69% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",254.82,61.85,,203.86,,,0,"percent of total billed charges","61.5% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",132.66,32.2,,106.13,,,0,"percent of total billed charges","32.2% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.6,17.136,,56.48,,,0,"percent of total billed charges","17.136% of total billed charges",89.98,21.84,,71.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.32,37.7,,124.26,,,0,"percent of total billed charges","37.7% of total billed charges",155.32,37.7,,124.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",139.67,33.9,,111.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",321.36,78,,257.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",63.04,412,
"CATH MARINER HEADHUNTER 4FR X 130CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,824,535.6,,725.12,88,,580.10,,,0,"percent of total billed charges","88% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.58,17.304,,114.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",519.12,63,,415.30,,,0,"percent of total billed charges","63% of total billed charges",126.07,15.3,,100.86,,,0,"percent of total billed charges","15.3% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",568.56,69,,,,,0,"fee schedule","69% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.64,61.85,,407.71,,,0,"percent of total billed charges","61.5% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",265.33,32.2,,212.26,,,0,"percent of total billed charges","32.2% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",141.2,17.136,,112.96,,,0,"percent of total billed charges","17.136% of total billed charges",179.96,21.84,,143.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",310.65,37.7,,248.52,,,0,"percent of total billed charges","37.7% of total billed charges",310.65,37.7,,248.52,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",279.34,33.9,,223.47,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.72,78,,514.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",126.07,824,
"CATJ 5FR JR 4 100CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CAUTERY SCRATCH PAD",186960,CDM,270,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.95,61.85,,3.96,,,0,"percent of total billed charges","61.5% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"CAUTERY ROCKERSWITCH PENCIL W/O HOLSTER STRL DISP.",187626,CDM,270,RC,,,OUTPATIENT,,,42,27.3,,36.96,88,,29.57,,,0,"percent of total billed charges","88% of total billed charges",21,50,,16.80,,,0,"percent of total billed charges","50% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.27,17.304,,5.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.46,63,,21.17,,,0,"percent of total billed charges","63% of total billed charges",6.43,15.3,,5.14,,,0,"percent of total billed charges","15.3% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",28.98,69,,,,,0,"fee schedule","69% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.98,61.85,,20.78,,,0,"percent of total billed charges","61.5% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",21,50,,16.80,,,0,"percent of total billed charges","50% of total billed charges",13.52,32.2,,10.82,,,0,"percent of total billed charges","32.2% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.2,17.136,,5.76,,,0,"percent of total billed charges","17.136% of total billed charges",9.17,21.84,,7.34,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",32.76,78,,26.21,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",21,50,,16.80,,,0,"percent of total billed charges","50% of total billed charges",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",6.43,42,
"CAUTERY ELECTRODE EXT",62315,CDM,270,RC,,,OUTPATIENT,,,342,222.3,,300.96,88,,240.77,,,0,"percent of total billed charges","88% of total billed charges",171,50,,136.80,,,0,"percent of total billed charges","50% of total billed charges",57.46,16.8,,45.97,,,0,"percent of total billed charges","16.8% of total billed charges",342,100,,273.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.18,17.304,,47.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",215.46,63,,172.37,,,0,"percent of total billed charges","63% of total billed charges",52.33,15.3,,41.86,,,0,"percent of total billed charges","15.3% of total billed charges",57.46,16.8,,45.97,,,0,"percent of total billed charges","16.8% of total billed charges",235.98,69,,,,,0,"fee schedule","69% of total billed charges",342,100,,273.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",342,100,,273.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",342,100,,273.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.53,61.85,,169.22,,,0,"percent of total billed charges","61.5% of total billed charges",57.46,16.8,,45.97,,,0,"percent of total billed charges","16.8% of total billed charges",171,50,,136.80,,,0,"percent of total billed charges","50% of total billed charges",110.12,32.2,,88.10,,,0,"percent of total billed charges","32.2% of total billed charges",57.46,16.8,,45.97,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.61,17.136,,46.89,,,0,"percent of total billed charges","17.136% of total billed charges",74.69,21.84,,59.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",128.93,37.7,,103.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",266.76,78,,213.41,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",282.49,82.6,,225.99,,,0,"percent of total billed charges","82.6% of total billed charges",57.46,16.8,,45.97,,,0,"percent of total billed charges","16.8% of total billed charges",171,50,,136.80,,,0,"percent of total billed charges","50% of total billed charges",282.49,82.6,,225.99,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.46,16.8,,45.97,,,0,"percent of total billed charges","16.8% of total billed charges",342,100,,273.60,,,0,"percent of total billed charges","100% of total billed charges",52.33,342,
"CAUTERY MONOPOLAR 5MM SINGLE SITE",ORSUP0039,CDM,272,RC,,,OUTPATIENT,,,7498,4873.7,,6598.24,88,,5278.59,,,0,"percent of total billed charges","88% of total billed charges",3749,50,,2999.20,,,0,"percent of total billed charges","50% of total billed charges",1259.66,16.8,,1007.73,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1297.45,17.304,,1037.96,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4723.74,63,,3778.99,,,0,"percent of total billed charges","63% of total billed charges",1147.19,15.3,,917.75,,,0,"percent of total billed charges","15.3% of total billed charges",1259.66,16.8,,1007.73,,,0,"percent of total billed charges","16.8% of total billed charges",5173.62,69,,,,,0,"fee schedule","69% of total billed charges",7498,100,,5998.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7498,100,,5998.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7498,100,,5998.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4637.51,61.85,,3710.01,,,0,"percent of total billed charges","61.5% of total billed charges",1259.66,16.8,,1007.73,,,0,"percent of total billed charges","16.8% of total billed charges",3749,50,,2999.20,,,0,"percent of total billed charges","50% of total billed charges",2414.36,32.2,,1931.49,,,0,"percent of total billed charges","32.2% of total billed charges",1259.66,16.8,,1007.73,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1284.86,17.136,,1027.89,,,0,"percent of total billed charges","17.136% of total billed charges",1637.56,21.84,,1310.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2826.75,37.7,,2261.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5848.44,78,,4678.75,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6193.35,82.6,,4954.68,,,0,"percent of total billed charges","82.6% of total billed charges",1259.66,16.8,,1007.73,,,0,"percent of total billed charges","16.8% of total billed charges",3749,50,,2999.20,,,0,"percent of total billed charges","50% of total billed charges",6193.35,82.6,,4954.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1259.66,16.8,,1007.73,,,0,"percent of total billed charges","16.8% of total billed charges",7498,100,,5998.40,,,0,"percent of total billed charges","100% of total billed charges",1147.19,7498,
"CAUTERY TIP ELECTRODE 0012",490312,CDM,270,RC,,,OUTPATIENT,,,25,16.25,,22,88,,17.60,,,0,"percent of total billed charges","88% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,17.304,,3.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.75,63,,12.60,,,0,"percent of total billed charges","63% of total billed charges",3.83,15.3,,3.06,,,0,"percent of total billed charges","15.3% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",17.25,69,,,,,0,"fee schedule","69% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.46,61.85,,12.37,,,0,"percent of total billed charges","61.5% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",8.05,32.2,,6.44,,,0,"percent of total billed charges","32.2% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.28,17.136,,3.42,,,0,"percent of total billed charges","17.136% of total billed charges",5.46,21.84,,4.37,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.43,37.7,,7.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.5,78,,15.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",3.83,25,
"CAUTERY TIPS NEEDLE POINT 0013",490316,CDM,272,RC,,,OUTPATIENT,,,27,17.55,,23.76,88,,19.01,,,0,"percent of total billed charges","88% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.67,17.304,,3.74,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.01,63,,13.61,,,0,"percent of total billed charges","63% of total billed charges",4.13,15.3,,3.30,,,0,"percent of total billed charges","15.3% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",18.63,69,,,,,0,"fee schedule","69% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.7,61.85,,13.36,,,0,"percent of total billed charges","61.5% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",8.69,32.2,,6.95,,,0,"percent of total billed charges","32.2% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.63,17.136,,3.70,,,0,"percent of total billed charges","17.136% of total billed charges",5.9,21.84,,4.72,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.18,37.7,,8.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.06,78,,16.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.3,82.6,,17.84,,,0,"percent of total billed charges","82.6% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",22.3,82.6,,17.84,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",4.13,27,
"CAUTERY TIP CLEANER",490311,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"CAUTERY TIP ELECTRODE 0012M",490313,CDM,270,RC,,,OUTPATIENT,,,24,15.6,,21.12,88,,16.90,,,0,"percent of total billed charges","88% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.15,17.304,,3.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.12,63,,12.10,,,0,"percent of total billed charges","63% of total billed charges",3.67,15.3,,2.94,,,0,"percent of total billed charges","15.3% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",16.56,69,,,,,0,"fee schedule","69% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.84,61.85,,11.87,,,0,"percent of total billed charges","61.5% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",7.73,32.2,,6.18,,,0,"percent of total billed charges","32.2% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.11,17.136,,3.29,,,0,"percent of total billed charges","17.136% of total billed charges",5.24,21.84,,4.19,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.05,37.7,,7.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.72,78,,14.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,24,
"CAUTERY TIP ELECTRODE 0014M",490314,CDM,270,RC,,,OUTPATIENT,,,31,20.15,,27.28,88,,21.82,,,0,"percent of total billed charges","88% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.36,17.304,,4.29,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.53,63,,15.62,,,0,"percent of total billed charges","63% of total billed charges",4.74,15.3,,3.79,,,0,"percent of total billed charges","15.3% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",21.39,69,,,,,0,"fee schedule","69% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.17,61.85,,15.34,,,0,"percent of total billed charges","61.5% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",9.98,32.2,,7.98,,,0,"percent of total billed charges","32.2% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.31,17.136,,4.25,,,0,"percent of total billed charges","17.136% of total billed charges",6.77,21.84,,5.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.69,37.7,,9.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.18,78,,19.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.61,82.6,,20.49,,,0,"percent of total billed charges","82.6% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",25.61,82.6,,20.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",4.74,31,
"CAUTERY TIP NEEDLE PT. 0013MD",490315,CDM,272,RC,,,OUTPATIENT,,,46,29.9,,40.48,88,,32.38,,,0,"percent of total billed charges","88% of total billed charges",23,50,,18.40,,,0,"percent of total billed charges","50% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.96,17.304,,6.37,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.98,63,,23.18,,,0,"percent of total billed charges","63% of total billed charges",7.04,15.3,,5.63,,,0,"percent of total billed charges","15.3% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",31.74,69,,,,,0,"fee schedule","69% of total billed charges",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.45,61.85,,22.76,,,0,"percent of total billed charges","61.5% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",23,50,,18.40,,,0,"percent of total billed charges","50% of total billed charges",14.81,32.2,,11.85,,,0,"percent of total billed charges","32.2% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.88,17.136,,6.30,,,0,"percent of total billed charges","17.136% of total billed charges",10.05,21.84,,8.04,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.34,37.7,,13.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.88,78,,28.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38,82.6,,30.40,,,0,"percent of total billed charges","82.6% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",23,50,,18.40,,,0,"percent of total billed charges","50% of total billed charges",38,82.6,,30.40,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",7.04,46,
"CAUTERY PENCIL ROCKER W/HOLDER",490309,CDM,270,RC,,,OUTPATIENT,,,38,24.7,,33.44,88,,26.75,,,0,"percent of total billed charges","88% of total billed charges",19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.58,17.304,,5.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.94,63,,19.15,,,0,"percent of total billed charges","63% of total billed charges",5.81,15.3,,4.65,,,0,"percent of total billed charges","15.3% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",26.22,69,,,,,0,"fee schedule","69% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.5,61.85,,18.80,,,0,"percent of total billed charges","61.5% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",12.24,32.2,,9.79,,,0,"percent of total billed charges","32.2% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.51,17.136,,5.21,,,0,"percent of total billed charges","17.136% of total billed charges",8.3,21.84,,6.64,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.33,37.7,,11.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.64,78,,23.71,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",5.81,38,
"CAUTERY BLADE NONSTICK PTFE COATED 2.5",490304,CDM,272,RC,,,OUTPATIENT,,,26,16.9,,22.88,88,,18.30,,,0,"percent of total billed charges","88% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.5,17.304,,3.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.38,63,,13.10,,,0,"percent of total billed charges","63% of total billed charges",3.98,15.3,,3.18,,,0,"percent of total billed charges","15.3% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",17.94,69,,,,,0,"fee schedule","69% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.08,61.85,,12.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",8.37,32.2,,6.70,,,0,"percent of total billed charges","32.2% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.46,17.136,,3.57,,,0,"percent of total billed charges","17.136% of total billed charges",5.68,21.84,,4.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.8,37.7,,7.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.28,78,,16.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",3.98,26,
"CAUTERY BLADE NONSTICK PTFE COATED 6",490305,CDM,272,RC,,,OUTPATIENT,,,29,18.85,,25.52,88,,20.42,,,0,"percent of total billed charges","88% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.02,17.304,,4.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.27,63,,14.62,,,0,"percent of total billed charges","63% of total billed charges",4.44,15.3,,3.55,,,0,"percent of total billed charges","15.3% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",20.01,69,,,,,0,"fee schedule","69% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.94,61.85,,14.35,,,0,"percent of total billed charges","61.5% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",9.34,32.2,,7.47,,,0,"percent of total billed charges","32.2% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.97,17.136,,3.98,,,0,"percent of total billed charges","17.136% of total billed charges",6.33,21.84,,5.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.93,37.7,,8.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,78,,18.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",4.44,29,
"CAUTERY MICROSURGICAL NEEDLE TIP",490306,CDM,272,RC,,,OUTPATIENT,,,182,118.3,,160.16,88,,128.13,,,0,"percent of total billed charges","88% of total billed charges",91,50,,72.80,,,0,"percent of total billed charges","50% of total billed charges",30.58,16.8,,24.46,,,0,"percent of total billed charges","16.8% of total billed charges",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.49,17.304,,25.19,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.66,63,,91.73,,,0,"percent of total billed charges","63% of total billed charges",27.85,15.3,,22.28,,,0,"percent of total billed charges","15.3% of total billed charges",30.58,16.8,,24.46,,,0,"percent of total billed charges","16.8% of total billed charges",125.58,69,,,,,0,"fee schedule","69% of total billed charges",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.57,61.85,,90.06,,,0,"percent of total billed charges","61.5% of total billed charges",30.58,16.8,,24.46,,,0,"percent of total billed charges","16.8% of total billed charges",91,50,,72.80,,,0,"percent of total billed charges","50% of total billed charges",58.6,32.2,,46.88,,,0,"percent of total billed charges","32.2% of total billed charges",30.58,16.8,,24.46,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.19,17.136,,24.95,,,0,"percent of total billed charges","17.136% of total billed charges",39.75,21.84,,31.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",68.61,37.7,,54.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",141.96,78,,113.57,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",150.33,82.6,,120.26,,,0,"percent of total billed charges","82.6% of total billed charges",30.58,16.8,,24.46,,,0,"percent of total billed charges","16.8% of total billed charges",91,50,,72.80,,,0,"percent of total billed charges","50% of total billed charges",150.33,82.6,,120.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.58,16.8,,24.46,,,0,"percent of total billed charges","16.8% of total billed charges",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",27.85,182,
"CAUTERY NEEDLE TIP",490307,CDM,272,RC,,,OUTPATIENT,,,34,22.1,,29.92,88,,23.94,,,0,"percent of total billed charges","88% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.88,17.304,,4.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.42,63,,17.14,,,0,"percent of total billed charges","63% of total billed charges",5.2,15.3,,4.16,,,0,"percent of total billed charges","15.3% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",23.46,69,,,,,0,"fee schedule","69% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.03,61.85,,16.82,,,0,"percent of total billed charges","61.5% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",10.95,32.2,,8.76,,,0,"percent of total billed charges","32.2% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.83,17.136,,4.66,,,0,"percent of total billed charges","17.136% of total billed charges",7.43,21.84,,5.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.82,37.7,,10.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.52,78,,21.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",5.2,34,
"CAUTERY PENCIL W/ HOLDER",490310,CDM,270,RC,,,OUTPATIENT,,,71,46.15,,62.48,88,,49.98,,,0,"percent of total billed charges","88% of total billed charges",35.5,50,,28.40,,,0,"percent of total billed charges","50% of total billed charges",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.29,17.304,,9.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.73,63,,35.78,,,0,"percent of total billed charges","63% of total billed charges",10.86,15.3,,8.69,,,0,"percent of total billed charges","15.3% of total billed charges",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",48.99,69,,,,,0,"fee schedule","69% of total billed charges",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.91,61.85,,35.13,,,0,"percent of total billed charges","61.5% of total billed charges",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",35.5,50,,28.40,,,0,"percent of total billed charges","50% of total billed charges",22.86,32.2,,18.29,,,0,"percent of total billed charges","32.2% of total billed charges",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.17,17.136,,9.74,,,0,"percent of total billed charges","17.136% of total billed charges",15.51,21.84,,12.41,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.77,37.7,,21.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",55.38,78,,44.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.65,82.6,,46.92,,,0,"percent of total billed charges","82.6% of total billed charges",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",35.5,50,,28.40,,,0,"percent of total billed charges","50% of total billed charges",58.65,82.6,,46.92,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",10.86,71,
"CAYENNE MEDICAL APERFIX-II CANNULATED TIBIAL IMPLANT 10MM X",ORSUP0026,CDM,278,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",1253.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.7% of total billed charges",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1361.76,33.9,,1089.41,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"CAYENNE MEDICAL APERFIX-II CANNULATED TIBIAL IMPLANT 11MM X",ORSUP0026,CDM,278,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",1253.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.7% of total billed charges",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1361.76,33.9,,1089.41,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"CAYENNE MEDICAL APERFIX-II CANNULATED TIBIAL IMPLANT 9MM X 3",ORSUP0026,CDM,278,RC,,,OUTPATIENT,,,3090,2008.5,,2719.2,88,,2175.36,,,0,"percent of total billed charges","88% of total billed charges",1545,50,,1236.00,,,0,"percent of total billed charges","50% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",534.69,17.304,,427.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1946.7,63,,1557.36,,,0,"percent of total billed charges","63% of total billed charges",472.77,15.3,,378.22,,,0,"percent of total billed charges","15.3% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",2132.1,69,,,,,0,"fee schedule","69% of total billed charges",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1911.17,61.85,,1528.94,,,0,"percent of total billed charges","61.5% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",1545,50,,1236.00,,,0,"percent of total billed charges","50% of total billed charges",994.98,32.2,,795.98,,,0,"percent of total billed charges","32.2% of total billed charges",964.08,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",529.5,17.136,,423.60,,,0,"percent of total billed charges","17.136% of total billed charges",674.86,21.84,,539.89,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1164.93,37.7,,931.94,,,0,"percent of total billed charges","37.7% of total billed charges",1164.93,37.7,,931.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1047.51,33.9,,838.01,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410.2,78,,1928.16,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2552.34,82.6,,2041.87,,,0,"percent of total billed charges","82.6% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",1545,50,,1236.00,,,0,"percent of total billed charges","50% of total billed charges",2552.34,82.6,,2041.87,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",472.77,3090,
"CAYENNE MEDICAL APERFIX-II TIBIAL IMPLANT 8MM X 30MM",ORSUP0026,CDM,278,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",1253.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.7% of total billed charges",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1361.76,33.9,,1089.41,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"CBD FITZGIBBONS CATH SET",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"CD HORIZON SOLERA 4.75MM SPINAL SYSTEM",ORSUP0031,CDM,278,RC,,,OUTPATIENT,,,5356,3481.4,,4713.28,88,,3770.62,,,0,"percent of total billed charges","88% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",926.8,17.304,,741.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3374.28,63,,2699.42,,,0,"percent of total billed charges","63% of total billed charges",819.47,15.3,,655.58,,,0,"percent of total billed charges","15.3% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",3695.64,69,,,,,0,"fee schedule","69% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3312.69,61.85,,2650.15,,,0,"percent of total billed charges","61.5% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",1724.63,32.2,,1379.70,,,0,"percent of total billed charges","32.2% of total billed charges",1671.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",917.8,17.136,,734.24,,,0,"percent of total billed charges","17.136% of total billed charges",1169.75,21.84,,935.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.7% of total billed charges",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1815.68,33.9,,1452.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4177.68,78,,3342.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",819.47,5356,
"CD HORIZON X10 CROSSLINK MULTI-SPAN PLATE",ORSUP0029,CDM,278,RC,,,OUTPATIENT,,,4820,3133,,4241.6,88,,3393.28,,,0,"percent of total billed charges","88% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",834.05,17.304,,667.24,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3036.6,63,,2429.28,,,0,"percent of total billed charges","63% of total billed charges",737.46,15.3,,589.97,,,0,"percent of total billed charges","15.3% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",3325.8,69,,,,,0,"fee schedule","69% of total billed charges",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2981.17,61.85,,2384.94,,,0,"percent of total billed charges","61.5% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",1552.04,32.2,,1241.63,,,0,"percent of total billed charges","32.2% of total billed charges",1503.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",825.96,17.136,,660.77,,,0,"percent of total billed charges","17.136% of total billed charges",1052.69,21.84,,842.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1817.14,37.7,,1453.71,,,0,"percent of total billed charges","37.7% of total billed charges",1817.14,37.7,,1453.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1633.98,33.9,,1307.18,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3759.6,78,,3007.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3981.32,82.6,,3185.06,,,0,"percent of total billed charges","82.6% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",3981.32,82.6,,3185.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",737.46,4820,
"CELL LYSE D X H FP",ORSUP0019,CDM,270,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"CELL SAVER 5 FAST PACK          260",ORSUP0013,CDM,270,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CELL CHEX 4X2.OML LVL 1\\T\\2 (4/PK)",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CELL ADAPTER",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"CELL SAVER TUBING HAR-A-1000",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CELLPACK DCL 20L",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"CELLERATERX SURGICAL POWDER",ORSUP0022,CDM,270,RC,,,OUTPATIENT,,,2266,1472.9,,1994.08,88,,1595.26,,,0,"percent of total billed charges","88% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",392.11,17.304,,313.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1427.58,63,,1142.06,,,0,"percent of total billed charges","63% of total billed charges",346.7,15.3,,277.36,,,0,"percent of total billed charges","15.3% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1563.54,69,,,,,0,"fee schedule","69% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1401.52,61.85,,1121.22,,,0,"percent of total billed charges","61.5% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",729.65,32.2,,583.72,,,0,"percent of total billed charges","32.2% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",388.3,17.136,,310.64,,,0,"percent of total billed charges","17.136% of total billed charges",494.89,21.84,,395.91,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",854.28,37.7,,683.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1767.48,78,,1413.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1871.72,82.6,,1497.38,,,0,"percent of total billed charges","82.6% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",1871.72,82.6,,1497.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",346.7,2266,
"CEMENT BONE RADIOPAQUE 40G. FULL DOSE STER 10/PK",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"CEMENT BONE SIMPLEX ANTIBIOTIC",ORSUP0019,CDM,278,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",668.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.7% of total billed charges",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",726.14,33.9,,580.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"CEMENT BONE PALACOS",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"CEMENT BONE PALACOS W/GENTIMICIN",ORSUP0018,CDM,278,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",605.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.7% of total billed charges",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",658.34,33.9,,526.67,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"CEMENT BONE SIMPLEX HV US 10 PK",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CEMENT BONE KYPHX SINGLE",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"CEMENT KYPHON MIXING BOWL",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CEMENT MIXER W/FEMORAL NOZZEL",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"CEMENT BONE SIMPLEX HV W/GENTAMICIM",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"CEMENT BONE BIOMET R 1X40US",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CERVICAL DISC 6MM M ARTIFICIA",ORSUP0145,CDM,278,RC,,,OUTPATIENT,,,36689,23847.85,,32286.32,88,,25829.06,,,0,"percent of total billed charges","88% of total billed charges",18344.5,50,,14675.60,,,0,"percent of total billed charges","50% of total billed charges",6163.75,16.8,,4931.00,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6348.66,17.304,,5078.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",23114.07,63,,18491.26,,,0,"percent of total billed charges","63% of total billed charges",5613.42,15.3,,4490.74,,,0,"percent of total billed charges","15.3% of total billed charges",6163.75,16.8,,4931.00,,,0,"percent of total billed charges","16.8% of total billed charges",25315.41,69,,,,,0,"fee schedule","69% of total billed charges",36689,100,,29351.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36689,100,,29351.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36689,100,,29351.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22692.15,61.85,,18153.72,,,0,"percent of total billed charges","61.5% of total billed charges",6163.75,16.8,,4931.00,,,0,"percent of total billed charges","16.8% of total billed charges",18344.5,50,,14675.60,,,0,"percent of total billed charges","50% of total billed charges",11813.86,32.2,,9451.09,,,0,"percent of total billed charges","32.2% of total billed charges",11446.97,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",6287.03,17.136,,5029.62,,,0,"percent of total billed charges","17.136% of total billed charges",8012.88,21.84,,6410.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",13831.75,37.7,,11065.40,,,0,"percent of total billed charges","37.7% of total billed charges",13831.75,37.7,,11065.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",12437.57,33.9,,9950.06,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",28617.42,78,,22893.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",30305.11,82.6,,24244.09,,,0,"percent of total billed charges","82.6% of total billed charges",6163.75,16.8,,4931.00,,,0,"percent of total billed charges","16.8% of total billed charges",18344.5,50,,14675.60,,,0,"percent of total billed charges","50% of total billed charges",30305.11,82.6,,24244.09,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6163.75,16.8,,4931.00,,,0,"percent of total billed charges","16.8% of total billed charges",36689,100,,29351.20,,,0,"percent of total billed charges","100% of total billed charges",4695,36689,
"CERVICAL RIPENING BALLOON W/STYLET",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,17.304,,49.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.28,61.85,,178.62,,,0,"percent of total billed charges","61.5% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",116.24,32.2,,92.99,,,0,"percent of total billed charges","32.2% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.86,17.136,,49.49,,,0,"percent of total billed charges","17.136% of total billed charges",78.84,21.84,,63.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.7% of total billed charges",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",122.38,33.9,,97.90,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,361,
"CHANNEL DRAIN ROUND 32FR",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"CHANNEL BRUSH 16IN 18FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"CHANNEL BRUSH 12IN 12FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"CHANNEL BRUSH 8IN 19FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"CHANNEL BRUSH 24IN 22.35MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"CHANNEL BRUSH TAPERED 18IN",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"CHANNEL BRUSH DIAG 6 LONG",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"CHANNEL BRUSH 6 X 0.079",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"CHANNEL BRUSH8",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"CHARCOAL SELECTIVE MEDIUM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CHECKPOINT 3.5MM HEX X 15 MM STERILE",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"CHECK STRIP SET",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CHECK FLO HEMOSTASIS ASSEMBLY",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CHECKFLO ANSL1 6FR X 55CM SHEATH",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"CHECKPOINT3.5MM HEX IMPACTION",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,927,602.55,,815.76,88,,652.61,,,0,"percent of total billed charges","88% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.41,17.304,,128.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.01,63,,467.21,,,0,"percent of total billed charges","63% of total billed charges",141.83,15.3,,113.46,,,0,"percent of total billed charges","15.3% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",639.63,69,,,,,0,"fee schedule","69% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",573.35,61.85,,458.68,,,0,"percent of total billed charges","61.5% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",298.49,32.2,,238.79,,,0,"percent of total billed charges","32.2% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.85,17.136,,127.08,,,0,"percent of total billed charges","17.136% of total billed charges",202.46,21.84,,161.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",349.48,37.7,,279.58,,,0,"percent of total billed charges","37.7% of total billed charges",349.48,37.7,,279.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",314.25,33.9,,251.40,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",723.06,78,,578.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",141.83,927,
"CHEMSTRIP INFORM II METER",490327,CDM,270,RC,,,OUTPATIENT,,,142,92.3,,124.96,88,,99.97,,,0,"percent of total billed charges","88% of total billed charges",71,50,,56.80,,,0,"percent of total billed charges","50% of total billed charges",23.86,16.8,,19.09,,,0,"percent of total billed charges","16.8% of total billed charges",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.57,17.304,,19.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.46,63,,71.57,,,0,"percent of total billed charges","63% of total billed charges",21.73,15.3,,17.38,,,0,"percent of total billed charges","15.3% of total billed charges",23.86,16.8,,19.09,,,0,"percent of total billed charges","16.8% of total billed charges",97.98,69,,,,,0,"fee schedule","69% of total billed charges",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.83,61.85,,70.26,,,0,"percent of total billed charges","61.5% of total billed charges",23.86,16.8,,19.09,,,0,"percent of total billed charges","16.8% of total billed charges",71,50,,56.80,,,0,"percent of total billed charges","50% of total billed charges",45.72,32.2,,36.58,,,0,"percent of total billed charges","32.2% of total billed charges",23.86,16.8,,19.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.33,17.136,,19.46,,,0,"percent of total billed charges","17.136% of total billed charges",31.01,21.84,,24.81,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",53.53,37.7,,42.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",110.76,78,,88.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",117.29,82.6,,93.83,,,0,"percent of total billed charges","82.6% of total billed charges",23.86,16.8,,19.09,,,0,"percent of total billed charges","16.8% of total billed charges",71,50,,56.80,,,0,"percent of total billed charges","50% of total billed charges",117.29,82.6,,93.83,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.86,16.8,,19.09,,,0,"percent of total billed charges","16.8% of total billed charges",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",21.73,142,
"CHEMO SPILL KITS",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"CHEST TUBE AND TRAYS THAL-QUICK 20 FR",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CHIPS CALCANEOUS 5CC RADIATED",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,824,535.6,,725.12,88,,580.10,,,0,"percent of total billed charges","88% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.58,17.304,,114.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",519.12,63,,415.30,,,0,"percent of total billed charges","63% of total billed charges",126.07,15.3,,100.86,,,0,"percent of total billed charges","15.3% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",568.56,69,,,,,0,"fee schedule","69% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.64,61.85,,407.71,,,0,"percent of total billed charges","61.5% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",265.33,32.2,,212.26,,,0,"percent of total billed charges","32.2% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",141.2,17.136,,112.96,,,0,"percent of total billed charges","17.136% of total billed charges",179.96,21.84,,143.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",310.65,37.7,,248.52,,,0,"percent of total billed charges","37.7% of total billed charges",310.65,37.7,,248.52,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",279.34,33.9,,223.47,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.72,78,,514.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",126.07,824,
"CHIPS CANCELLOUS 15CC 1.7-10MM",ORSUP0019,CDM,278,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",668.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.7% of total billed charges",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",726.14,33.9,,580.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"CHLORAPREP WITH TINT 26ML APPLICATOR",227580,CDM,270,RC,,,OUTPATIENT,,,1155,750.75,,1016.4,88,,813.12,,,0,"percent of total billed charges","88% of total billed charges",577.5,50,,462.00,,,0,"percent of total billed charges","50% of total billed charges",194.04,16.8,,155.23,,,0,"percent of total billed charges","16.8% of total billed charges",1155,100,,924.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",199.86,17.304,,159.89,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",727.65,63,,582.12,,,0,"percent of total billed charges","63% of total billed charges",176.72,15.3,,141.38,,,0,"percent of total billed charges","15.3% of total billed charges",194.04,16.8,,155.23,,,0,"percent of total billed charges","16.8% of total billed charges",796.95,69,,,,,0,"fee schedule","69% of total billed charges",1155,100,,924.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1155,100,,924.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1155,100,,924.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",714.37,61.85,,571.50,,,0,"percent of total billed charges","61.5% of total billed charges",194.04,16.8,,155.23,,,0,"percent of total billed charges","16.8% of total billed charges",577.5,50,,462.00,,,0,"percent of total billed charges","50% of total billed charges",371.91,32.2,,297.53,,,0,"percent of total billed charges","32.2% of total billed charges",194.04,16.8,,155.23,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",197.92,17.136,,158.34,,,0,"percent of total billed charges","17.136% of total billed charges",252.25,21.84,,201.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",435.44,37.7,,348.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",900.9,78,,720.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",954.03,82.6,,763.22,,,0,"percent of total billed charges","82.6% of total billed charges",194.04,16.8,,155.23,,,0,"percent of total billed charges","16.8% of total billed charges",577.5,50,,462.00,,,0,"percent of total billed charges","50% of total billed charges",954.03,82.6,,763.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.04,16.8,,155.23,,,0,"percent of total billed charges","16.8% of total billed charges",1155,100,,924.00,,,0,"percent of total billed charges","100% of total billed charges",176.72,1155,
"CHLORAPREP TINTED 10.5ML",225137,CDM,270,RC,,,OUTPATIENT,,,44,28.6,,38.72,88,,30.98,,,0,"percent of total billed charges","88% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.61,17.304,,6.09,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.72,63,,22.18,,,0,"percent of total billed charges","63% of total billed charges",6.73,15.3,,5.38,,,0,"percent of total billed charges","15.3% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",30.36,69,,,,,0,"fee schedule","69% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.21,61.85,,21.77,,,0,"percent of total billed charges","61.5% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",14.17,32.2,,11.34,,,0,"percent of total billed charges","32.2% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.54,17.136,,6.03,,,0,"percent of total billed charges","17.136% of total billed charges",9.61,21.84,,7.69,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.59,37.7,,13.27,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.32,78,,27.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",6.73,44,
"CHLORAPREP APPLICATOR 10.5ML ORG TINT",252154,CDM,270,RC,,,OUTPATIENT,,,44,28.6,,38.72,88,,30.98,,,0,"percent of total billed charges","88% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.61,17.304,,6.09,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.72,63,,22.18,,,0,"percent of total billed charges","63% of total billed charges",6.73,15.3,,5.38,,,0,"percent of total billed charges","15.3% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",30.36,69,,,,,0,"fee schedule","69% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.21,61.85,,21.77,,,0,"percent of total billed charges","61.5% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",14.17,32.2,,11.34,,,0,"percent of total billed charges","32.2% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.54,17.136,,6.03,,,0,"percent of total billed charges","17.136% of total billed charges",9.61,21.84,,7.69,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.59,37.7,,13.27,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.32,78,,27.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",6.73,44,
"CHLORAPREP APPLICATOR 26ML ORG TINT",252158,CDM,270,RC,,,OUTPATIENT,,,81,52.65,,71.28,88,,57.02,,,0,"percent of total billed charges","88% of total billed charges",40.5,50,,32.40,,,0,"percent of total billed charges","50% of total billed charges",13.61,16.8,,10.89,,,0,"percent of total billed charges","16.8% of total billed charges",81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.02,17.304,,11.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.03,63,,40.82,,,0,"percent of total billed charges","63% of total billed charges",12.39,15.3,,9.91,,,0,"percent of total billed charges","15.3% of total billed charges",13.61,16.8,,10.89,,,0,"percent of total billed charges","16.8% of total billed charges",55.89,69,,,,,0,"fee schedule","69% of total billed charges",81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.1,61.85,,40.08,,,0,"percent of total billed charges","61.5% of total billed charges",13.61,16.8,,10.89,,,0,"percent of total billed charges","16.8% of total billed charges",40.5,50,,32.40,,,0,"percent of total billed charges","50% of total billed charges",26.08,32.2,,20.86,,,0,"percent of total billed charges","32.2% of total billed charges",13.61,16.8,,10.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.88,17.136,,11.10,,,0,"percent of total billed charges","17.136% of total billed charges",17.69,21.84,,14.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.54,37.7,,24.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",63.18,78,,50.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",66.91,82.6,,53.53,,,0,"percent of total billed charges","82.6% of total billed charges",13.61,16.8,,10.89,,,0,"percent of total billed charges","16.8% of total billed charges",40.5,50,,32.40,,,0,"percent of total billed charges","50% of total billed charges",66.91,82.6,,53.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.61,16.8,,10.89,,,0,"percent of total billed charges","16.8% of total billed charges",81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",12.39,81,
"CHLORAPREP APPLICATOR 3ML",84585,CDM,270,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"CHLORHEXIDINE PREP 4% 4 OZ",490333,CDM,270,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"CHLORAPREP SWB STICK APPLICATOR 1.75ML",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CHLORIDE CL-/5 PK / 250 SLDS INCL URINE",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
CHLORIDE,ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CHLORAPREP 3ML HI-LITE ORANGE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"CHLORAPREP TRIPLE 5 25ML SWABSTICK",ORSUP0001,CDM,278,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.7% of total billed charges",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.2,33.9,,9.76,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"CHOCOLATE AGAR W BACITRACIN",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"AGAR MEDIUM CHOCOLATE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CHOLE TRAY",326392,CDM,270,RC,,,OUTPATIENT,,,297,193.05,,261.36,88,,209.09,,,0,"percent of total billed charges","88% of total billed charges",148.5,50,,118.80,,,0,"percent of total billed charges","50% of total billed charges",49.9,16.8,,39.92,,,0,"percent of total billed charges","16.8% of total billed charges",297,100,,237.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.39,17.304,,41.11,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",187.11,63,,149.69,,,0,"percent of total billed charges","63% of total billed charges",45.44,15.3,,36.35,,,0,"percent of total billed charges","15.3% of total billed charges",49.9,16.8,,39.92,,,0,"percent of total billed charges","16.8% of total billed charges",204.93,69,,,,,0,"fee schedule","69% of total billed charges",297,100,,237.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",297,100,,237.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",297,100,,237.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.69,61.85,,146.95,,,0,"percent of total billed charges","61.5% of total billed charges",49.9,16.8,,39.92,,,0,"percent of total billed charges","16.8% of total billed charges",148.5,50,,118.80,,,0,"percent of total billed charges","50% of total billed charges",95.63,32.2,,76.50,,,0,"percent of total billed charges","32.2% of total billed charges",49.9,16.8,,39.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.89,17.136,,40.71,,,0,"percent of total billed charges","17.136% of total billed charges",64.86,21.84,,51.89,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",111.97,37.7,,89.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",231.66,78,,185.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",245.32,82.6,,196.26,,,0,"percent of total billed charges","82.6% of total billed charges",49.9,16.8,,39.92,,,0,"percent of total billed charges","16.8% of total billed charges",148.5,50,,118.80,,,0,"percent of total billed charges","50% of total billed charges",245.32,82.6,,196.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.9,16.8,,39.92,,,0,"percent of total billed charges","16.8% of total billed charges",297,100,,237.60,,,0,"percent of total billed charges","100% of total billed charges",45.44,297,
"CHOLESTEROL /5 PACK / 300 SLDS",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"CHOLANGIOGRAM CATH 23CM",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CINCHPAD ENDOSCOPE TRANSPORT BAG",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CIRCUIT ANES PEDIATRIC BREATHING LF",291739,CDM,270,RC,,,OUTPATIENT,,,50,32.5,,44,88,,35.20,,,0,"percent of total billed charges","88% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.65,17.304,,6.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.5,63,,25.20,,,0,"percent of total billed charges","63% of total billed charges",7.65,15.3,,6.12,,,0,"percent of total billed charges","15.3% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",34.5,69,,,,,0,"fee schedule","69% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.93,61.85,,24.74,,,0,"percent of total billed charges","61.5% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",16.1,32.2,,12.88,,,0,"percent of total billed charges","32.2% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.57,17.136,,6.86,,,0,"percent of total billed charges","17.136% of total billed charges",10.92,21.84,,8.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39,78,,31.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",7.65,50,
"CIRCUIT ADULT ANES. BREATHING",291740,CDM,272,RC,,,OUTPATIENT,,,65,42.25,,57.2,88,,45.76,,,0,"percent of total billed charges","88% of total billed charges",32.5,50,,26.00,,,0,"percent of total billed charges","50% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.25,17.304,,9.00,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.95,63,,32.76,,,0,"percent of total billed charges","63% of total billed charges",9.95,15.3,,7.96,,,0,"percent of total billed charges","15.3% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",44.85,69,,,,,0,"fee schedule","69% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.2,61.85,,32.16,,,0,"percent of total billed charges","61.5% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",32.5,50,,26.00,,,0,"percent of total billed charges","50% of total billed charges",20.93,32.2,,16.74,,,0,"percent of total billed charges","32.2% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.14,17.136,,8.91,,,0,"percent of total billed charges","17.136% of total billed charges",14.2,21.84,,11.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.51,37.7,,19.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.7,78,,40.56,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",32.5,50,,26.00,,,0,"percent of total billed charges","50% of total billed charges",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",9.95,65,
"CIRCUIT HIGH FLOW DISPOSABLE INCLUDES WATER PATH",ORSUP0025,CDM,272,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"CIRCUIT VENT CV-4",ORSUP0024,CDM,272,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"CATH SUPRAPUBIC BALLOON 10FR",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CK / 5 PACK / 90 SLIDES",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CLAMP ADJ  DISTAL RADIUS FIXATOR 4.0 MM",ORSUP0030,CDM,278,RC,,,OUTPATIENT,,,5088,3307.2,,4477.44,88,,3581.95,,,0,"percent of total billed charges","88% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",880.43,17.304,,704.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3205.44,63,,2564.35,,,0,"percent of total billed charges","63% of total billed charges",778.46,15.3,,622.77,,,0,"percent of total billed charges","15.3% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",3510.72,69,,,,,0,"fee schedule","69% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3146.93,61.85,,2517.54,,,0,"percent of total billed charges","61.5% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",1638.34,32.2,,1310.67,,,0,"percent of total billed charges","32.2% of total billed charges",1587.46,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",871.88,17.136,,697.50,,,0,"percent of total billed charges","17.136% of total billed charges",1111.22,21.84,,888.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1918.18,37.7,,1534.54,,,0,"percent of total billed charges","37.7% of total billed charges",1918.18,37.7,,1534.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1724.83,33.9,,1379.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3968.64,78,,3174.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",778.46,5088,
"CLAMP COMBINATION FOR LARGE EXTERNAL FIXATORS",ORSUP0026,CDM,278,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",1253.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.7% of total billed charges",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1361.76,33.9,,1089.41,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"CLAMP LARGE MULTI-PIN 4 POS MR SAFE",ORSUP0027,CDM,278,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",1336.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.7% of total billed charges",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1452.62,33.9,,1162.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"CLAMP TUBE TI LOW PROFILE NEURO ADAPTION PLATE 20 HOLES",ORSUP0024,CDM,278,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",1086.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.7% of total billed charges",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1180.06,33.9,,944.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"CLAMP TUBE TI LOW PROFILE NEURO BOX PLATE 10MM X 16MM/4 HOLES",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"CLAMP--UMBILICAL CORD",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"CLEANSER SKIN EXIDINE 4 OZ",185640,CDM,270,RC,,,OUTPATIENT,,,22,14.3,,19.36,88,,15.49,,,0,"percent of total billed charges","88% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.81,17.304,,3.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.86,63,,11.09,,,0,"percent of total billed charges","63% of total billed charges",3.37,15.3,,2.70,,,0,"percent of total billed charges","15.3% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",15.18,69,,,,,0,"fee schedule","69% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.61,61.85,,10.89,,,0,"percent of total billed charges","61.5% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",7.08,32.2,,5.66,,,0,"percent of total billed charges","32.2% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.77,17.136,,3.02,,,0,"percent of total billed charges","17.136% of total billed charges",4.8,21.84,,3.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.29,37.7,,6.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.16,78,,13.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",3.37,22,
"CLEANSER AVAGARD",44748,CDM,270,RC,,,OUTPATIENT,,,288,187.2,,253.44,88,,202.75,,,0,"percent of total billed charges","88% of total billed charges",144,50,,115.20,,,0,"percent of total billed charges","50% of total billed charges",48.38,16.8,,38.70,,,0,"percent of total billed charges","16.8% of total billed charges",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.84,17.304,,39.87,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.44,63,,145.15,,,0,"percent of total billed charges","63% of total billed charges",44.06,15.3,,35.25,,,0,"percent of total billed charges","15.3% of total billed charges",48.38,16.8,,38.70,,,0,"percent of total billed charges","16.8% of total billed charges",198.72,69,,,,,0,"fee schedule","69% of total billed charges",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.13,61.85,,142.50,,,0,"percent of total billed charges","61.5% of total billed charges",48.38,16.8,,38.70,,,0,"percent of total billed charges","16.8% of total billed charges",144,50,,115.20,,,0,"percent of total billed charges","50% of total billed charges",92.74,32.2,,74.19,,,0,"percent of total billed charges","32.2% of total billed charges",48.38,16.8,,38.70,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.35,17.136,,39.48,,,0,"percent of total billed charges","17.136% of total billed charges",62.9,21.84,,50.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",108.58,37.7,,86.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",224.64,78,,179.71,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",237.89,82.6,,190.31,,,0,"percent of total billed charges","82.6% of total billed charges",48.38,16.8,,38.70,,,0,"percent of total billed charges","16.8% of total billed charges",144,50,,115.20,,,0,"percent of total billed charges","50% of total billed charges",237.89,82.6,,190.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.38,16.8,,38.70,,,0,"percent of total billed charges","16.8% of total billed charges",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",44.06,288,
"CLEANSER WOUND SUR CLENS",186980,CDM,270,RC,,,OUTPATIENT,,,74,48.1,,65.12,88,,52.10,,,0,"percent of total billed charges","88% of total billed charges",37,50,,29.60,,,0,"percent of total billed charges","50% of total billed charges",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.8,17.304,,10.24,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.62,63,,37.30,,,0,"percent of total billed charges","63% of total billed charges",11.32,15.3,,9.06,,,0,"percent of total billed charges","15.3% of total billed charges",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",51.06,69,,,,,0,"fee schedule","69% of total billed charges",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.77,61.85,,36.62,,,0,"percent of total billed charges","61.5% of total billed charges",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",37,50,,29.60,,,0,"percent of total billed charges","50% of total billed charges",23.83,32.2,,19.06,,,0,"percent of total billed charges","32.2% of total billed charges",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.68,17.136,,10.14,,,0,"percent of total billed charges","17.136% of total billed charges",16.16,21.84,,12.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",27.9,37.7,,22.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",57.72,78,,46.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.12,82.6,,48.90,,,0,"percent of total billed charges","82.6% of total billed charges",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",37,50,,29.60,,,0,"percent of total billed charges","50% of total billed charges",61.12,82.6,,48.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",11.32,74,
"CLEANER DISINFECTANT CIDEX OPA SOLUTION GALLON",160748,CDM,270,RC,,,OUTPATIENT,,,163,105.95,,143.44,88,,114.75,,,0,"percent of total billed charges","88% of total billed charges",81.5,50,,65.20,,,0,"percent of total billed charges","50% of total billed charges",27.38,16.8,,21.90,,,0,"percent of total billed charges","16.8% of total billed charges",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.21,17.304,,22.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",102.69,63,,82.15,,,0,"percent of total billed charges","63% of total billed charges",24.94,15.3,,19.95,,,0,"percent of total billed charges","15.3% of total billed charges",27.38,16.8,,21.90,,,0,"percent of total billed charges","16.8% of total billed charges",112.47,69,,,,,0,"fee schedule","69% of total billed charges",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",100.82,61.85,,80.66,,,0,"percent of total billed charges","61.5% of total billed charges",27.38,16.8,,21.90,,,0,"percent of total billed charges","16.8% of total billed charges",81.5,50,,65.20,,,0,"percent of total billed charges","50% of total billed charges",52.49,32.2,,41.99,,,0,"percent of total billed charges","32.2% of total billed charges",27.38,16.8,,21.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.93,17.136,,22.34,,,0,"percent of total billed charges","17.136% of total billed charges",35.6,21.84,,28.48,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",61.45,37.7,,49.16,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",127.14,78,,101.71,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.64,82.6,,107.71,,,0,"percent of total billed charges","82.6% of total billed charges",27.38,16.8,,21.90,,,0,"percent of total billed charges","16.8% of total billed charges",81.5,50,,65.20,,,0,"percent of total billed charges","50% of total billed charges",134.64,82.6,,107.71,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.38,16.8,,21.90,,,0,"percent of total billed charges","16.8% of total billed charges",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",24.94,163,
"CLEAN B SOLUTION",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"CLEANER OXYCIDE DISINFECTANT 96 OZ CS/2",442557,CDM,270,RC,,,OUTPATIENT,,,430,279.5,,378.4,88,,302.72,,,0,"percent of total billed charges","88% of total billed charges",215,50,,172.00,,,0,"percent of total billed charges","50% of total billed charges",72.24,16.8,,57.79,,,0,"percent of total billed charges","16.8% of total billed charges",430,100,,344.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.41,17.304,,59.53,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",270.9,63,,216.72,,,0,"percent of total billed charges","63% of total billed charges",65.79,15.3,,52.63,,,0,"percent of total billed charges","15.3% of total billed charges",72.24,16.8,,57.79,,,0,"percent of total billed charges","16.8% of total billed charges",296.7,69,,,,,0,"fee schedule","69% of total billed charges",430,100,,344.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",430,100,,344.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",430,100,,344.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",265.96,61.85,,212.77,,,0,"percent of total billed charges","61.5% of total billed charges",72.24,16.8,,57.79,,,0,"percent of total billed charges","16.8% of total billed charges",215,50,,172.00,,,0,"percent of total billed charges","50% of total billed charges",138.46,32.2,,110.77,,,0,"percent of total billed charges","32.2% of total billed charges",72.24,16.8,,57.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",73.68,17.136,,58.94,,,0,"percent of total billed charges","17.136% of total billed charges",93.91,21.84,,75.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",162.11,37.7,,129.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",335.4,78,,268.32,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",355.18,82.6,,284.14,,,0,"percent of total billed charges","82.6% of total billed charges",72.24,16.8,,57.79,,,0,"percent of total billed charges","16.8% of total billed charges",215,50,,172.00,,,0,"percent of total billed charges","50% of total billed charges",355.18,82.6,,284.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",72.24,16.8,,57.79,,,0,"percent of total billed charges","16.8% of total billed charges",430,100,,344.00,,,0,"percent of total billed charges","100% of total billed charges",65.79,430,
"CLEANING SOLUTION",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CLEAR DRAWSTRING BAG",285644,CDM,270,RC,,,OUTPATIENT,,,525,341.25,,462,88,,369.60,,,0,"percent of total billed charges","88% of total billed charges",262.5,50,,210.00,,,0,"percent of total billed charges","50% of total billed charges",88.2,16.8,,70.56,,,0,"percent of total billed charges","16.8% of total billed charges",525,100,,420.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.85,17.304,,72.68,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",330.75,63,,264.60,,,0,"percent of total billed charges","63% of total billed charges",80.33,15.3,,64.26,,,0,"percent of total billed charges","15.3% of total billed charges",88.2,16.8,,70.56,,,0,"percent of total billed charges","16.8% of total billed charges",362.25,69,,,,,0,"fee schedule","69% of total billed charges",525,100,,420.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",525,100,,420.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",525,100,,420.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",324.71,61.85,,259.77,,,0,"percent of total billed charges","61.5% of total billed charges",88.2,16.8,,70.56,,,0,"percent of total billed charges","16.8% of total billed charges",262.5,50,,210.00,,,0,"percent of total billed charges","50% of total billed charges",169.05,32.2,,135.24,,,0,"percent of total billed charges","32.2% of total billed charges",88.2,16.8,,70.56,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.96,17.136,,71.97,,,0,"percent of total billed charges","17.136% of total billed charges",114.66,21.84,,91.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",197.93,37.7,,158.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",409.5,78,,327.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",433.65,82.6,,346.92,,,0,"percent of total billed charges","82.6% of total billed charges",88.2,16.8,,70.56,,,0,"percent of total billed charges","16.8% of total billed charges",262.5,50,,210.00,,,0,"percent of total billed charges","50% of total billed charges",433.65,82.6,,346.92,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.2,16.8,,70.56,,,0,"percent of total billed charges","16.8% of total billed charges",525,100,,420.00,,,0,"percent of total billed charges","100% of total billed charges",80.33,525,
"CLEARIFY VISUALIZATION SYSTEM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"CLEARIFY VISUALIZATIOIN SYS",ORSUP0010,CDM,270,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"CLEANING BRUSH ENDOSCOPE",490342,CDM,270,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"CLEANER AUTOCLAVE",490341,CDM,270,RC,,,OUTPATIENT,,,270,175.5,,237.6,88,,190.08,,,0,"percent of total billed charges","88% of total billed charges",135,50,,108.00,,,0,"percent of total billed charges","50% of total billed charges",45.36,16.8,,36.29,,,0,"percent of total billed charges","16.8% of total billed charges",270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.72,17.304,,37.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.1,63,,136.08,,,0,"percent of total billed charges","63% of total billed charges",41.31,15.3,,33.05,,,0,"percent of total billed charges","15.3% of total billed charges",45.36,16.8,,36.29,,,0,"percent of total billed charges","16.8% of total billed charges",186.3,69,,,,,0,"fee schedule","69% of total billed charges",270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",167,61.85,,133.60,,,0,"percent of total billed charges","61.5% of total billed charges",45.36,16.8,,36.29,,,0,"percent of total billed charges","16.8% of total billed charges",135,50,,108.00,,,0,"percent of total billed charges","50% of total billed charges",86.94,32.2,,69.55,,,0,"percent of total billed charges","32.2% of total billed charges",45.36,16.8,,36.29,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.27,17.136,,37.02,,,0,"percent of total billed charges","17.136% of total billed charges",58.97,21.84,,47.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.79,37.7,,81.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",210.6,78,,168.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.02,82.6,,178.42,,,0,"percent of total billed charges","82.6% of total billed charges",45.36,16.8,,36.29,,,0,"percent of total billed charges","16.8% of total billed charges",135,50,,108.00,,,0,"percent of total billed charges","50% of total billed charges",223.02,82.6,,178.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.36,16.8,,36.29,,,0,"percent of total billed charges","16.8% of total billed charges",270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",41.31,270,
"CLEANING BRUSH FAN TIP 12IN 15FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"CLEANING BRUSH FAN TIP 18IN 12FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"CLEAN BATH",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,515,334.75,,453.2,88,,362.56,,,0,"percent of total billed charges","88% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.12,17.304,,71.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",324.45,63,,259.56,,,0,"percent of total billed charges","63% of total billed charges",78.8,15.3,,63.04,,,0,"percent of total billed charges","15.3% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",355.35,69,,,,,0,"fee schedule","69% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",318.53,61.85,,254.82,,,0,"percent of total billed charges","61.5% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",165.83,32.2,,132.66,,,0,"percent of total billed charges","32.2% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.25,17.136,,70.60,,,0,"percent of total billed charges","17.136% of total billed charges",112.48,21.84,,89.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",194.16,37.7,,155.33,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",401.7,78,,321.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",78.8,515,
"CLIPS FILSHIE",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CLIP VASC CLS W/ APPL STARCLOSE 6FR",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CLIP RESOLUTION HEMOSTASIS CLIPPING DEVICE",ORSUP0014,CDM,270,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CLIP APPLIER MED/LRG 5MM DA VINCI",ORSUP0027,CDM,272,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"CLIP APPLIER MEDIUM LARGE HEM-O-LOK",ORSUP0038,CDM,272,RC,,,OUTPATIENT,,,7231,4700.15,,6363.28,88,,5090.62,,,0,"percent of total billed charges","88% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1251.25,17.304,,1001.00,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4555.53,63,,3644.42,,,0,"percent of total billed charges","63% of total billed charges",1106.34,15.3,,885.07,,,0,"percent of total billed charges","15.3% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4989.39,69,,,,,0,"fee schedule","69% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4472.37,61.85,,3577.90,,,0,"percent of total billed charges","61.5% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",2328.38,32.2,,1862.70,,,0,"percent of total billed charges","32.2% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1239.1,17.136,,991.28,,,0,"percent of total billed charges","17.136% of total billed charges",1579.25,21.84,,1263.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5640.18,78,,4512.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",1106.34,7231,
"CLIP HEMOSTASIS RESOLUTION 360  11MM JAW SPAN",ORSUP0060,CDM,270,RC,,,OUTPATIENT,,,13390,8703.5,,11783.2,88,,9426.56,,,0,"percent of total billed charges","88% of total billed charges",6695,50,,5356.00,,,0,"percent of total billed charges","50% of total billed charges",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2317.01,17.304,,1853.61,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8435.7,63,,6748.56,,,0,"percent of total billed charges","63% of total billed charges",2048.67,15.3,,1638.94,,,0,"percent of total billed charges","15.3% of total billed charges",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",9239.1,69,,,,,0,"fee schedule","69% of total billed charges",13390,100,,10712.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13390,100,,10712.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13390,100,,10712.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8281.72,61.85,,6625.38,,,0,"percent of total billed charges","61.5% of total billed charges",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",6695,50,,5356.00,,,0,"percent of total billed charges","50% of total billed charges",4311.58,32.2,,3449.26,,,0,"percent of total billed charges","32.2% of total billed charges",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2294.51,17.136,,1835.61,,,0,"percent of total billed charges","17.136% of total billed charges",2924.38,21.84,,2339.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5048.03,37.7,,4038.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10444.2,78,,8355.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11060.14,82.6,,8848.11,,,0,"percent of total billed charges","82.6% of total billed charges",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",6695,50,,5356.00,,,0,"percent of total billed charges","50% of total billed charges",11060.14,82.6,,8848.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",13390,100,,10712.00,,,0,"percent of total billed charges","100% of total billed charges",2048.67,13390,
"CLIP M5",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"CLIP MED LG INTERN HEM-O-LOK POLYMER",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CLIPS MINI (ZIM)             57 003",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CLIPS RESOLUTION 360",ORSUP0019,CDM,270,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"CLIP APPLIER POLY SURGICLIP",ORSUP0009,CDM,270,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"CLIP HEMOSTASIS INSTINCT 7FR",ORSUP0009,CDM,270,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"CLIPPER BLADES DISP STANDARD",490350,CDM,272,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"CLIPPER BLADE (DISPOSABLE)",490349,CDM,272,RC,,,OUTPATIENT,,,30,19.5,,26.4,88,,21.12,,,0,"percent of total billed charges","88% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.19,17.304,,4.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.9,63,,15.12,,,0,"percent of total billed charges","63% of total billed charges",4.59,15.3,,3.67,,,0,"percent of total billed charges","15.3% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",20.7,69,,,,,0,"fee schedule","69% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.56,61.85,,14.85,,,0,"percent of total billed charges","61.5% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",9.66,32.2,,7.73,,,0,"percent of total billed charges","32.2% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.14,17.136,,4.11,,,0,"percent of total billed charges","17.136% of total billed charges",6.55,21.84,,5.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.31,37.7,,9.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.4,78,,18.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",4.59,30,
N/A,ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"CLIPPER BLADES NARROW RED",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"CLOSURE DEVICE MYNX GRIP VASULAR 5F (ORDER MULTIPLES OF 10 EA)",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"CLOSURES SKIN STERI STRIP 1/8X",143131,CDM,272,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"CLOSURES SKIN STERI STRIP 1/4X",153087,CDM,272,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"CLOSURES SKIN STERI STRIP 1/2X",167683,CDM,272,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"CLOSURES SAFETY TAINER-TOPS",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"CLOSTRIDIUM DIFFICILE TOXIN AB",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CLOSURE DEVICE PERCLOSE PROSTYLE",ORSUP0019,CDM,272,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"CLOSED SUCTION CATH 12FR",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"CLOSED SUCTION CATH 10FR",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"CLOSED SUCTION CATH 14FR",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"CLOTH MICROFIBER CLEANING LT GREEN 12 X 12",ORSUP0011,CDM,270,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CLOT TRAC COAG CONTR. ABNORMAL",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CLOT TRAC COAG CONTR. NORMAL",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CO2 TRAP FOR MONITOR",ORSUP0020,CDM,270,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"CO2 GAS CAL I (34BAR)",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CO2 ANAEROPOACK GAS GENERATING SYSTEM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"CO2 CANNISTER FOR NOVASURE",490353,CDM,270,RC,,,OUTPATIENT,,,82,53.3,,72.16,88,,57.73,,,0,"percent of total billed charges","88% of total billed charges",41,50,,32.80,,,0,"percent of total billed charges","50% of total billed charges",13.78,16.8,,11.02,,,0,"percent of total billed charges","16.8% of total billed charges",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.19,17.304,,11.35,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.66,63,,41.33,,,0,"percent of total billed charges","63% of total billed charges",12.55,15.3,,10.04,,,0,"percent of total billed charges","15.3% of total billed charges",13.78,16.8,,11.02,,,0,"percent of total billed charges","16.8% of total billed charges",56.58,69,,,,,0,"fee schedule","69% of total billed charges",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.72,61.85,,40.58,,,0,"percent of total billed charges","61.5% of total billed charges",13.78,16.8,,11.02,,,0,"percent of total billed charges","16.8% of total billed charges",41,50,,32.80,,,0,"percent of total billed charges","50% of total billed charges",26.4,32.2,,21.12,,,0,"percent of total billed charges","32.2% of total billed charges",13.78,16.8,,11.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.05,17.136,,11.24,,,0,"percent of total billed charges","17.136% of total billed charges",17.91,21.84,,14.33,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.91,37.7,,24.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",63.96,78,,51.17,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.73,82.6,,54.18,,,0,"percent of total billed charges","82.6% of total billed charges",13.78,16.8,,11.02,,,0,"percent of total billed charges","16.8% of total billed charges",41,50,,32.80,,,0,"percent of total billed charges","50% of total billed charges",67.73,82.6,,54.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.78,16.8,,11.02,,,0,"percent of total billed charges","16.8% of total billed charges",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",12.55,82,
"CO2 INDICATOR 30MM",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"COAGULATING SHEARS LCS15",ORSUP0015,CDM,270,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"COAGUCHEK XS PT TEST STRIPS",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"COAG-SENSE PT2 PT/INR TEST STRIP KIT",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"COAXIAL ACHIEVE SZ11 AUTO BIOPSY SYS",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"COBAN 1X5YDS TAN",434879,CDM,270,RC,,,OUTPATIENT,,,104,67.6,,91.52,88,,73.22,,,0,"percent of total billed charges","88% of total billed charges",52,50,,41.60,,,0,"percent of total billed charges","50% of total billed charges",17.47,16.8,,13.98,,,0,"percent of total billed charges","16.8% of total billed charges",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,17.304,,14.40,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",65.52,63,,52.42,,,0,"percent of total billed charges","63% of total billed charges",15.91,15.3,,12.73,,,0,"percent of total billed charges","15.3% of total billed charges",17.47,16.8,,13.98,,,0,"percent of total billed charges","16.8% of total billed charges",71.76,69,,,,,0,"fee schedule","69% of total billed charges",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.32,61.85,,51.46,,,0,"percent of total billed charges","61.5% of total billed charges",17.47,16.8,,13.98,,,0,"percent of total billed charges","16.8% of total billed charges",52,50,,41.60,,,0,"percent of total billed charges","50% of total billed charges",33.49,32.2,,26.79,,,0,"percent of total billed charges","32.2% of total billed charges",17.47,16.8,,13.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.136,,14.26,,,0,"percent of total billed charges","17.136% of total billed charges",22.71,21.84,,18.17,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39.21,37.7,,31.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",81.12,78,,64.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.9,82.6,,68.72,,,0,"percent of total billed charges","82.6% of total billed charges",17.47,16.8,,13.98,,,0,"percent of total billed charges","16.8% of total billed charges",52,50,,41.60,,,0,"percent of total billed charges","50% of total billed charges",85.9,82.6,,68.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.47,16.8,,13.98,,,0,"percent of total billed charges","16.8% of total billed charges",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",15.91,104,
"COBAN 2X5YDS TAN",434878,CDM,270,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.37,61.85,,9.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"COBAN NS 1",490355,CDM,270,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"COBAN NS 4",490356,CDM,270,RC,,,OUTPATIENT,,,26,16.9,,22.88,88,,18.30,,,0,"percent of total billed charges","88% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.5,17.304,,3.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.38,63,,13.10,,,0,"percent of total billed charges","63% of total billed charges",3.98,15.3,,3.18,,,0,"percent of total billed charges","15.3% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",17.94,69,,,,,0,"fee schedule","69% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.08,61.85,,12.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",8.37,32.2,,6.70,,,0,"percent of total billed charges","32.2% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.46,17.136,,3.57,,,0,"percent of total billed charges","17.136% of total billed charges",5.68,21.84,,4.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.8,37.7,,7.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.28,78,,16.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",3.98,26,
"COBAN 2 LAYER COMPRESSION SYSTEM 2LAYER",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"COBAS FLUID PACK",ORSUP0025,CDM,272,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"COBLATOR WAND T\\T\\A",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"COBLATOR WAND TURBS",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"COBRA TOOTH GRASPER",ORSUP0016,CDM,270,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"COBRA TOOTH GRASPER DISPOSABLE",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"COBRA 3-PLATE EMG ENDOTRACHEAL NEUROMONITORING TUBE 7MM",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,1854,1205.1,,1631.52,88,,1305.22,,,0,"percent of total billed charges","88% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",320.82,17.304,,256.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1168.02,63,,934.42,,,0,"percent of total billed charges","63% of total billed charges",283.66,15.3,,226.93,,,0,"percent of total billed charges","15.3% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1279.26,69,,,,,0,"fee schedule","69% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1146.7,61.85,,917.36,,,0,"percent of total billed charges","61.5% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",596.99,32.2,,477.59,,,0,"percent of total billed charges","32.2% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.7,17.136,,254.16,,,0,"percent of total billed charges","17.136% of total billed charges",404.91,21.84,,323.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",698.96,37.7,,559.17,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1446.12,78,,1156.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1531.4,82.6,,1225.12,,,0,"percent of total billed charges","82.6% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",1531.4,82.6,,1225.12,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",283.66,1854,
"COBRA 3-PLATE EMG ENDOTRACHEAL NEUROMONITORING TUBE 6MM",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,1854,1205.1,,1631.52,88,,1305.22,,,0,"percent of total billed charges","88% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",320.82,17.304,,256.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1168.02,63,,934.42,,,0,"percent of total billed charges","63% of total billed charges",283.66,15.3,,226.93,,,0,"percent of total billed charges","15.3% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1279.26,69,,,,,0,"fee schedule","69% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1146.7,61.85,,917.36,,,0,"percent of total billed charges","61.5% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",596.99,32.2,,477.59,,,0,"percent of total billed charges","32.2% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.7,17.136,,254.16,,,0,"percent of total billed charges","17.136% of total billed charges",404.91,21.84,,323.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",698.96,37.7,,559.17,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1446.12,78,,1156.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1531.4,82.6,,1225.12,,,0,"percent of total billed charges","82.6% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",1531.4,82.6,,1225.12,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",283.66,1854,
"COBRA 3-PLATE EMG ENDOTRACHEAL NEUROMONITORING TUBE 8MM",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,1854,1205.1,,1631.52,88,,1305.22,,,0,"percent of total billed charges","88% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",320.82,17.304,,256.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1168.02,63,,934.42,,,0,"percent of total billed charges","63% of total billed charges",283.66,15.3,,226.93,,,0,"percent of total billed charges","15.3% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1279.26,69,,,,,0,"fee schedule","69% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1146.7,61.85,,917.36,,,0,"percent of total billed charges","61.5% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",596.99,32.2,,477.59,,,0,"percent of total billed charges","32.2% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.7,17.136,,254.16,,,0,"percent of total billed charges","17.136% of total billed charges",404.91,21.84,,323.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",698.96,37.7,,559.17,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1446.12,78,,1156.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1531.4,82.6,,1225.12,,,0,"percent of total billed charges","82.6% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",1531.4,82.6,,1225.12,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",283.66,1854,
"CODMAN PERFORATOR, DISP",ORSUP0010,CDM,270,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"CODMAN PATTIES 1/2 X 1",490359,CDM,270,RC,,,OUTPATIENT,,,119,77.35,,104.72,88,,83.78,,,0,"percent of total billed charges","88% of total billed charges",59.5,50,,47.60,,,0,"percent of total billed charges","50% of total billed charges",19.99,16.8,,15.99,,,0,"percent of total billed charges","16.8% of total billed charges",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.59,17.304,,16.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.97,63,,59.98,,,0,"percent of total billed charges","63% of total billed charges",18.21,15.3,,14.57,,,0,"percent of total billed charges","15.3% of total billed charges",19.99,16.8,,15.99,,,0,"percent of total billed charges","16.8% of total billed charges",82.11,69,,,,,0,"fee schedule","69% of total billed charges",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",73.6,61.85,,58.88,,,0,"percent of total billed charges","61.5% of total billed charges",19.99,16.8,,15.99,,,0,"percent of total billed charges","16.8% of total billed charges",59.5,50,,47.60,,,0,"percent of total billed charges","50% of total billed charges",38.32,32.2,,30.66,,,0,"percent of total billed charges","32.2% of total billed charges",19.99,16.8,,15.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.39,17.136,,16.31,,,0,"percent of total billed charges","17.136% of total billed charges",25.99,21.84,,20.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",92.82,78,,74.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",19.99,16.8,,15.99,,,0,"percent of total billed charges","16.8% of total billed charges",59.5,50,,47.60,,,0,"percent of total billed charges","50% of total billed charges",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.99,16.8,,15.99,,,0,"percent of total billed charges","16.8% of total billed charges",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",18.21,119,
"CODMAN SURGICAL STRIPS 1/2 X 6",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"COLLAR VISTA TX  SETADULT",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"COLLECTOR URINE/STOOL SPECIMEN 24OZ 700CC",143165,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"COLLAR PEDS SET PD2 ASPEN",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"COLLAR PEDS SET PD4 ASPEN",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"COLLAR PEDS SET PD5 ASPEN",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"COLLECTOR PIN WORM W/PADDLE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"COLONIC 18/20 BALLOON DIALATOR",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"COLONIC 15/18 BALLOON DIALATOR",ORSUP0013,CDM,270,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"COLORIMETER STANDARD SET",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"COLOR-CODED GUEDEL AIRWAY CHILD 60MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"COLORIMETRIC CO2 DETECTOR",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"COLORIMETRIC CO2 PEDIATRIC",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"AGAR COLUMBI CNA W/SHEEP BLOOD MEDIUM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"COLUMN DRAPE",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CONCENTRATED WASHING SOLUTION 3(1L BTL)",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CONCHASMART CIRCUIT W/HEATED WIRE SINGLE LIMB ADULT",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"CONCHASMART CIRCUIT W/HEATED WIRE DUAL LIMB ADULT",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"CONCHASMART CIRCUIT ADULT NIV",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"CONDOM CATH SMALL",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"CONDOM CATH MED",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"CONDOM CATH LARGE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"CONMED ULTRABLATOR 90 DEGREE",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,721,468.65,,634.48,88,,507.58,,,0,"percent of total billed charges","88% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.76,17.304,,99.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.23,63,,363.38,,,0,"percent of total billed charges","63% of total billed charges",110.31,15.3,,88.25,,,0,"percent of total billed charges","15.3% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",497.49,69,,,,,0,"fee schedule","69% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",445.94,61.85,,356.75,,,0,"percent of total billed charges","61.5% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",232.16,32.2,,185.73,,,0,"percent of total billed charges","32.2% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",123.55,17.136,,98.84,,,0,"percent of total billed charges","17.136% of total billed charges",157.47,21.84,,125.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",271.82,37.7,,217.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",562.38,78,,449.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",595.55,82.6,,476.44,,,0,"percent of total billed charges","82.6% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",595.55,82.6,,476.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",110.31,721,
"CONNECTOR SYRINGE TIP",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"CONNECTOR W/LL 3/8 X 3/8 X 3/8",ORSUP0009,CDM,270,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"CONNECTOR STRAIGHT",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"CONNECTOR 5-IN-1",490379,CDM,270,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"CONNECTOR CROSS XIA 3 MULTI AXIAL",ORSUP0024,CDM,278,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",919.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.7% of total billed charges",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",998.69,33.9,,798.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"CONNECTOR TUBING STERILE 5 IN 1 STRAIGHT",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CONQUEST PTA BALLOON 9X2X50",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"CONTROL FLUID BODY 12 X 3.5 ML",ORSUP0021,CDM,270,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"CONTAINER GRADUATE 32OZ",12015,CDM,270,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.9,61.85,,7.92,,,0,"percent of total billed charges","61.5% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"CONTAINER SHARP IN ROOM W/UNWINDER",313712,CDM,270,RC,,,OUTPATIENT,,,39,25.35,,34.32,88,,27.46,,,0,"percent of total billed charges","88% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.75,17.304,,5.40,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.57,63,,19.66,,,0,"percent of total billed charges","63% of total billed charges",5.97,15.3,,4.78,,,0,"percent of total billed charges","15.3% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",26.91,69,,,,,0,"fee schedule","69% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.12,61.85,,19.30,,,0,"percent of total billed charges","61.5% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",12.56,32.2,,10.05,,,0,"percent of total billed charges","32.2% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.68,17.136,,5.34,,,0,"percent of total billed charges","17.136% of total billed charges",8.52,21.84,,6.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.42,78,,24.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",5.97,39,
"CONTRAST DEFINITY DE4",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CONTROL LATRON FP",ORSUP0015,CDM,270,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"CONTROLS 6C",ORSUP0016,CDM,270,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"CONTAINER SPECIMEN PREFILLED W/10% FORMALIN 90ML",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CONTROL D-DMR HI LO 1ML COAG",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CONTROL DIRECT CHECK - NORMAL",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"CONTROL HEMOSIL CALIBRATION PLASMA",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"CONTROL LIQUID UNASSAYED LEVEL I 25 X 10ML",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"CONTROL LIQUID UNASSAYED LEVEL II 25 X 10ML",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"CONTROL MULTIQUAL ASSAYED 1 3CC",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CONTROL MULTIQUAL ASSAYED LEVEL 3 3CC",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CONTROL URINE CHEMISTRY LIQUICHEK LEVEL 1 12X10ML",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CONTROL URINE CHEMISTRY LIQUICHEK LEVEL 2 12X10ML",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CONTRAST INJECTION LINE 10 HIGH PRESSURE",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CONTROLS HMS RED/YELLOW",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CONTAINER DENTURE",143701,CDM,272,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"CONTAINER SPECIMEN 32 OZ MED.",490392,CDM,270,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"CONTAINER SPECIMEN 165 OZ LG",490391,CDM,270,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"CONTOUR RELOAD CR40B REGULAR",ORSUP0013,CDM,270,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CONTOUR RELOAD CR40G THICK",ORSUP0013,CDM,270,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CONTAINER DENTURE CUP W/LID",490381,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"CONTAINER HAZARDOUS WASTE BLACK 2 GALLON",490382,CDM,270,RC,,,OUTPATIENT,,,76,49.4,,66.88,88,,53.50,,,0,"percent of total billed charges","88% of total billed charges",38,50,,30.40,,,0,"percent of total billed charges","50% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.15,17.304,,10.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.88,63,,38.30,,,0,"percent of total billed charges","63% of total billed charges",11.63,15.3,,9.30,,,0,"percent of total billed charges","15.3% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",52.44,69,,,,,0,"fee schedule","69% of total billed charges",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.01,61.85,,37.61,,,0,"percent of total billed charges","61.5% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",38,50,,30.40,,,0,"percent of total billed charges","50% of total billed charges",24.47,32.2,,19.58,,,0,"percent of total billed charges","32.2% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.02,17.136,,10.42,,,0,"percent of total billed charges","17.136% of total billed charges",16.6,21.84,,13.28,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.65,37.7,,22.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",59.28,78,,47.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.78,82.6,,50.22,,,0,"percent of total billed charges","82.6% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",38,50,,30.40,,,0,"percent of total billed charges","50% of total billed charges",62.78,82.6,,50.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",11.63,76,
"CONTAINER SHARP (LIGHT RED)",490384,CDM,270,RC,,,OUTPATIENT,,,39,25.35,,34.32,88,,27.46,,,0,"percent of total billed charges","88% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.75,17.304,,5.40,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.57,63,,19.66,,,0,"percent of total billed charges","63% of total billed charges",5.97,15.3,,4.78,,,0,"percent of total billed charges","15.3% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",26.91,69,,,,,0,"fee schedule","69% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.12,61.85,,19.30,,,0,"percent of total billed charges","61.5% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",12.56,32.2,,10.05,,,0,"percent of total billed charges","32.2% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.68,17.136,,5.34,,,0,"percent of total billed charges","17.136% of total billed charges",8.52,21.84,,6.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.42,78,,24.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",5.97,39,
"CONTAINER SHARP 12 GALLON",490387,CDM,270,RC,,,OUTPATIENT,,,184,119.6,,161.92,88,,129.54,,,0,"percent of total billed charges","88% of total billed charges",92,50,,73.60,,,0,"percent of total billed charges","50% of total billed charges",30.91,16.8,,24.73,,,0,"percent of total billed charges","16.8% of total billed charges",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.84,17.304,,25.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.92,63,,92.74,,,0,"percent of total billed charges","63% of total billed charges",28.15,15.3,,22.52,,,0,"percent of total billed charges","15.3% of total billed charges",30.91,16.8,,24.73,,,0,"percent of total billed charges","16.8% of total billed charges",126.96,69,,,,,0,"fee schedule","69% of total billed charges",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.8,61.85,,91.04,,,0,"percent of total billed charges","61.5% of total billed charges",30.91,16.8,,24.73,,,0,"percent of total billed charges","16.8% of total billed charges",92,50,,73.60,,,0,"percent of total billed charges","50% of total billed charges",59.25,32.2,,47.40,,,0,"percent of total billed charges","32.2% of total billed charges",30.91,16.8,,24.73,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.53,17.136,,25.22,,,0,"percent of total billed charges","17.136% of total billed charges",40.19,21.84,,32.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",69.37,37.7,,55.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",143.52,78,,114.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.98,82.6,,121.58,,,0,"percent of total billed charges","82.6% of total billed charges",30.91,16.8,,24.73,,,0,"percent of total billed charges","16.8% of total billed charges",92,50,,73.60,,,0,"percent of total billed charges","50% of total billed charges",151.98,82.6,,121.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.91,16.8,,24.73,,,0,"percent of total billed charges","16.8% of total billed charges",184,100,,147.20,,,0,"percent of total billed charges","100% of total billed charges",28.15,184,
"CONTAINER SHARP O.R. STAND 18 GALLON",490388,CDM,270,RC,,,OUTPATIENT,,,200,130,,176,88,,140.80,,,0,"percent of total billed charges","88% of total billed charges",100,50,,80.00,,,0,"percent of total billed charges","50% of total billed charges",33.6,16.8,,26.88,,,0,"percent of total billed charges","16.8% of total billed charges",200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,17.304,,27.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126,63,,100.80,,,0,"percent of total billed charges","63% of total billed charges",30.6,15.3,,24.48,,,0,"percent of total billed charges","15.3% of total billed charges",33.6,16.8,,26.88,,,0,"percent of total billed charges","16.8% of total billed charges",138,69,,,,,0,"fee schedule","69% of total billed charges",200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",123.7,61.85,,98.96,,,0,"percent of total billed charges","61.5% of total billed charges",33.6,16.8,,26.88,,,0,"percent of total billed charges","16.8% of total billed charges",100,50,,80.00,,,0,"percent of total billed charges","50% of total billed charges",64.4,32.2,,51.52,,,0,"percent of total billed charges","32.2% of total billed charges",33.6,16.8,,26.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.27,17.136,,27.42,,,0,"percent of total billed charges","17.136% of total billed charges",43.68,21.84,,34.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.4,37.7,,60.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156,78,,124.80,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.2,82.6,,132.16,,,0,"percent of total billed charges","82.6% of total billed charges",33.6,16.8,,26.88,,,0,"percent of total billed charges","16.8% of total billed charges",100,50,,80.00,,,0,"percent of total billed charges","50% of total billed charges",165.2,82.6,,132.16,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.6,16.8,,26.88,,,0,"percent of total billed charges","16.8% of total billed charges",200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",30.6,200,
"CONTAINER SPECIMAN NS W/LID 4 OZ",490389,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"CONTRAST SYRINGE DUAL-PORT KIT",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CONTAINER 24 HOUR URINE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CONTROL IMMUNOASSAY PLUS LIQUICHECK LVL 2 12X5ML",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CONTACT NIPPLE SHIELD STERILE 24MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CONTACT NIPPLE SHIELD NONSTERILE 20MM SZ SM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CONTROLS ALBA Q-CHEK SWB",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,721,468.65,,634.48,88,,507.58,,,0,"percent of total billed charges","88% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.76,17.304,,99.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.23,63,,363.38,,,0,"percent of total billed charges","63% of total billed charges",110.31,15.3,,88.25,,,0,"percent of total billed charges","15.3% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",497.49,69,,,,,0,"fee schedule","69% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",445.94,61.85,,356.75,,,0,"percent of total billed charges","61.5% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",232.16,32.2,,185.73,,,0,"percent of total billed charges","32.2% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",123.55,17.136,,98.84,,,0,"percent of total billed charges","17.136% of total billed charges",157.47,21.84,,125.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",271.82,37.7,,217.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",562.38,78,,449.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",595.55,82.6,,476.44,,,0,"percent of total billed charges","82.6% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",595.55,82.6,,476.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",110.31,721,
"CONTROLS AVOX-4 CO-OXIMETER",ORSUP0025,CDM,272,RC,,,OUTPATIENT,,,2884,1874.6,,2537.92,88,,2030.34,,,0,"percent of total billed charges","88% of total billed charges",1442,50,,1153.60,,,0,"percent of total billed charges","50% of total billed charges",484.51,16.8,,387.61,,,0,"percent of total billed charges","16.8% of total billed charges",2884,100,,2307.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",499.05,17.304,,399.24,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1816.92,63,,1453.54,,,0,"percent of total billed charges","63% of total billed charges",441.25,15.3,,353.00,,,0,"percent of total billed charges","15.3% of total billed charges",484.51,16.8,,387.61,,,0,"percent of total billed charges","16.8% of total billed charges",1989.96,69,,,,,0,"fee schedule","69% of total billed charges",2884,100,,2307.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2884,100,,2307.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2884,100,,2307.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1783.75,61.85,,1427.00,,,0,"percent of total billed charges","61.5% of total billed charges",484.51,16.8,,387.61,,,0,"percent of total billed charges","16.8% of total billed charges",1442,50,,1153.60,,,0,"percent of total billed charges","50% of total billed charges",928.65,32.2,,742.92,,,0,"percent of total billed charges","32.2% of total billed charges",484.51,16.8,,387.61,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.2,17.136,,395.36,,,0,"percent of total billed charges","17.136% of total billed charges",629.87,21.84,,503.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1087.27,37.7,,869.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2249.52,78,,1799.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2382.18,82.6,,1905.74,,,0,"percent of total billed charges","82.6% of total billed charges",484.51,16.8,,387.61,,,0,"percent of total billed charges","16.8% of total billed charges",1442,50,,1153.60,,,0,"percent of total billed charges","50% of total billed charges",2382.18,82.6,,1905.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",484.51,16.8,,387.61,,,0,"percent of total billed charges","16.8% of total billed charges",2884,100,,2307.20,,,0,"percent of total billed charges","100% of total billed charges",441.25,2884,
"CONTROL FLU/RSV/SARS-COV-2 POSITIVE",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"CONTROL FLU/RSV/SARS-COV-2 NEGATIVE",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"CONTROL CT/NG EXTERNAL RUN NEGATIVE",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"CONTROL CT/NG EXTERNAL RUN POSITIVE",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"CONTROL MSRA/SA EXTERNAL RUN NEGATIVE",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2060,1339,,1812.8,88,,1450.24,,,0,"percent of total billed charges","88% of total billed charges",1030,50,,824.00,,,0,"percent of total billed charges","50% of total billed charges",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",356.46,17.304,,285.17,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1297.8,63,,1038.24,,,0,"percent of total billed charges","63% of total billed charges",315.18,15.3,,252.14,,,0,"percent of total billed charges","15.3% of total billed charges",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",1421.4,69,,,,,0,"fee schedule","69% of total billed charges",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1274.11,61.85,,1019.29,,,0,"percent of total billed charges","61.5% of total billed charges",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",1030,50,,824.00,,,0,"percent of total billed charges","50% of total billed charges",663.32,32.2,,530.66,,,0,"percent of total billed charges","32.2% of total billed charges",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",353,17.136,,282.40,,,0,"percent of total billed charges","17.136% of total billed charges",449.9,21.84,,359.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",776.62,37.7,,621.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1606.8,78,,1285.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1701.56,82.6,,1361.25,,,0,"percent of total billed charges","82.6% of total billed charges",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",1030,50,,824.00,,,0,"percent of total billed charges","50% of total billed charges",1701.56,82.6,,1361.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",315.18,2060,
"CONTROL MSRA/SA EXTERNAL RUN POSITIVE",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2060,1339,,1812.8,88,,1450.24,,,0,"percent of total billed charges","88% of total billed charges",1030,50,,824.00,,,0,"percent of total billed charges","50% of total billed charges",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",356.46,17.304,,285.17,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1297.8,63,,1038.24,,,0,"percent of total billed charges","63% of total billed charges",315.18,15.3,,252.14,,,0,"percent of total billed charges","15.3% of total billed charges",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",1421.4,69,,,,,0,"fee schedule","69% of total billed charges",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1274.11,61.85,,1019.29,,,0,"percent of total billed charges","61.5% of total billed charges",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",1030,50,,824.00,,,0,"percent of total billed charges","50% of total billed charges",663.32,32.2,,530.66,,,0,"percent of total billed charges","32.2% of total billed charges",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",353,17.136,,282.40,,,0,"percent of total billed charges","17.136% of total billed charges",449.9,21.84,,359.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",776.62,37.7,,621.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1606.8,78,,1285.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1701.56,82.6,,1361.25,,,0,"percent of total billed charges","82.6% of total billed charges",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",1030,50,,824.00,,,0,"percent of total billed charges","50% of total billed charges",1701.56,82.6,,1361.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",315.18,2060,
"CONTROL CLOSTRIDIUM DIFFICILE POSITIVE",ORSUP0018,CDM,272,RC,,,OUTPATIENT,,,1494,971.1,,1314.72,88,,1051.78,,,0,"percent of total billed charges","88% of total billed charges",747,50,,597.60,,,0,"percent of total billed charges","50% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.52,17.304,,206.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",941.22,63,,752.98,,,0,"percent of total billed charges","63% of total billed charges",228.58,15.3,,182.86,,,0,"percent of total billed charges","15.3% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",1030.86,69,,,,,0,"fee schedule","69% of total billed charges",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",924.04,61.85,,739.23,,,0,"percent of total billed charges","61.5% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",747,50,,597.60,,,0,"percent of total billed charges","50% of total billed charges",481.07,32.2,,384.86,,,0,"percent of total billed charges","32.2% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",256.01,17.136,,204.81,,,0,"percent of total billed charges","17.136% of total billed charges",326.29,21.84,,261.03,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",563.24,37.7,,450.59,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1165.32,78,,932.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1234.04,82.6,,987.23,,,0,"percent of total billed charges","82.6% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",747,50,,597.60,,,0,"percent of total billed charges","50% of total billed charges",1234.04,82.6,,987.23,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",228.58,1494,
"CONTROL CLOSTRIDIUM DIFFICILE NEGATIVE",ORSUP0018,CDM,272,RC,,,OUTPATIENT,,,1494,971.1,,1314.72,88,,1051.78,,,0,"percent of total billed charges","88% of total billed charges",747,50,,597.60,,,0,"percent of total billed charges","50% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.52,17.304,,206.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",941.22,63,,752.98,,,0,"percent of total billed charges","63% of total billed charges",228.58,15.3,,182.86,,,0,"percent of total billed charges","15.3% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",1030.86,69,,,,,0,"fee schedule","69% of total billed charges",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",924.04,61.85,,739.23,,,0,"percent of total billed charges","61.5% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",747,50,,597.60,,,0,"percent of total billed charges","50% of total billed charges",481.07,32.2,,384.86,,,0,"percent of total billed charges","32.2% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",256.01,17.136,,204.81,,,0,"percent of total billed charges","17.136% of total billed charges",326.29,21.84,,261.03,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",563.24,37.7,,450.59,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1165.32,78,,932.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1234.04,82.6,,987.23,,,0,"percent of total billed charges","82.6% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",747,50,,597.60,,,0,"percent of total billed charges","50% of total billed charges",1234.04,82.6,,987.23,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",228.58,1494,
"CONTROL GBS EXTERNAL RUN NEGATIVE",ORSUP0019,CDM,272,RC,,,OUTPATIENT,,,1648,1071.2,,1450.24,88,,1160.19,,,0,"percent of total billed charges","88% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",285.17,17.304,,228.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1038.24,63,,830.59,,,0,"percent of total billed charges","63% of total billed charges",252.14,15.3,,201.71,,,0,"percent of total billed charges","15.3% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1137.12,69,,,,,0,"fee schedule","69% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.29,61.85,,815.43,,,0,"percent of total billed charges","61.5% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",530.66,32.2,,424.53,,,0,"percent of total billed charges","32.2% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",282.4,17.136,,225.92,,,0,"percent of total billed charges","17.136% of total billed charges",359.92,21.84,,287.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",621.3,37.7,,497.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1285.44,78,,1028.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1361.25,82.6,,1089.00,,,0,"percent of total billed charges","82.6% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",1361.25,82.6,,1089.00,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",252.14,1648,
"CONTROL GBS EXTERNAL RUN POSITIVE",ORSUP0019,CDM,272,RC,,,OUTPATIENT,,,1648,1071.2,,1450.24,88,,1160.19,,,0,"percent of total billed charges","88% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",285.17,17.304,,228.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1038.24,63,,830.59,,,0,"percent of total billed charges","63% of total billed charges",252.14,15.3,,201.71,,,0,"percent of total billed charges","15.3% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1137.12,69,,,,,0,"fee schedule","69% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.29,61.85,,815.43,,,0,"percent of total billed charges","61.5% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",530.66,32.2,,424.53,,,0,"percent of total billed charges","32.2% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",282.4,17.136,,225.92,,,0,"percent of total billed charges","17.136% of total billed charges",359.92,21.84,,287.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",621.3,37.7,,497.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1285.44,78,,1028.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1361.25,82.6,,1089.00,,,0,"percent of total billed charges","82.6% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",1361.25,82.6,,1089.00,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",252.14,1648,
"CONTROL INFLUENZA/RSV NEGATIVE",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,927,602.55,,815.76,88,,652.61,,,0,"percent of total billed charges","88% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.41,17.304,,128.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.01,63,,467.21,,,0,"percent of total billed charges","63% of total billed charges",141.83,15.3,,113.46,,,0,"percent of total billed charges","15.3% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",639.63,69,,,,,0,"fee schedule","69% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",573.35,61.85,,458.68,,,0,"percent of total billed charges","61.5% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",298.49,32.2,,238.79,,,0,"percent of total billed charges","32.2% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.85,17.136,,127.08,,,0,"percent of total billed charges","17.136% of total billed charges",202.46,21.84,,161.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",349.48,37.7,,279.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",723.06,78,,578.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",141.83,927,
"CONTROL INFLUENZA/RSV POSITIVE",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1030,669.5,,906.4,88,,725.12,,,0,"percent of total billed charges","88% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.23,17.304,,142.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.9,63,,519.12,,,0,"percent of total billed charges","63% of total billed charges",157.59,15.3,,126.07,,,0,"percent of total billed charges","15.3% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",710.7,69,,,,,0,"fee schedule","69% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",637.06,61.85,,509.65,,,0,"percent of total billed charges","61.5% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",331.66,32.2,,265.33,,,0,"percent of total billed charges","32.2% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.5,17.136,,141.20,,,0,"percent of total billed charges","17.136% of total billed charges",224.95,21.84,,179.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",388.31,37.7,,310.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",803.4,78,,642.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",157.59,1030,
"CONTROL INFLUENZA A/B POSITIVE",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,927,602.55,,815.76,88,,652.61,,,0,"percent of total billed charges","88% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.41,17.304,,128.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.01,63,,467.21,,,0,"percent of total billed charges","63% of total billed charges",141.83,15.3,,113.46,,,0,"percent of total billed charges","15.3% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",639.63,69,,,,,0,"fee schedule","69% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",573.35,61.85,,458.68,,,0,"percent of total billed charges","61.5% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",298.49,32.2,,238.79,,,0,"percent of total billed charges","32.2% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.85,17.136,,127.08,,,0,"percent of total billed charges","17.136% of total billed charges",202.46,21.84,,161.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",349.48,37.7,,279.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",723.06,78,,578.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",141.83,927,
"CONTROL NATROL RSV POSITIVE",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,927,602.55,,815.76,88,,652.61,,,0,"percent of total billed charges","88% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.41,17.304,,128.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.01,63,,467.21,,,0,"percent of total billed charges","63% of total billed charges",141.83,15.3,,113.46,,,0,"percent of total billed charges","15.3% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",639.63,69,,,,,0,"fee schedule","69% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",573.35,61.85,,458.68,,,0,"percent of total billed charges","61.5% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",298.49,32.2,,238.79,,,0,"percent of total billed charges","32.2% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.85,17.136,,127.08,,,0,"percent of total billed charges","17.136% of total billed charges",202.46,21.84,,161.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",349.48,37.7,,279.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",723.06,78,,578.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",141.83,927,
"CONTROL NATROL SARS-RELATED COVID 2",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,824,535.6,,725.12,88,,580.10,,,0,"percent of total billed charges","88% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.58,17.304,,114.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",519.12,63,,415.30,,,0,"percent of total billed charges","63% of total billed charges",126.07,15.3,,100.86,,,0,"percent of total billed charges","15.3% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",568.56,69,,,,,0,"fee schedule","69% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.64,61.85,,407.71,,,0,"percent of total billed charges","61.5% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",265.33,32.2,,212.26,,,0,"percent of total billed charges","32.2% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",141.2,17.136,,112.96,,,0,"percent of total billed charges","17.136% of total billed charges",179.96,21.84,,143.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",310.65,37.7,,248.52,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",642.72,78,,514.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",126.07,824,
"COOLCUT 45 BALL ELECTRODE ARTHROSCOPY 45",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"COOMB CONTROL 1X10ML",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.94,17.304,,85.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.23,61.85,,305.78,,,0,"percent of total billed charges","61.5% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",199,32.2,,159.20,,,0,"percent of total billed charges","32.2% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.136,,84.72,,,0,"percent of total billed charges","17.136% of total billed charges",134.97,21.84,,107.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,618,
"COOX/MSS VERIFICATION MATERIAL",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"COPAN UTM VIRAL SPECIMEN COLLECTION KIT",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"COPAN NASOPHARYNEAL SWAB",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"CORKSCREW BIO FT WITH FIBERWIRE 5.5",ORSUP0019,CDM,278,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",668.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.7% of total billed charges",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",726.14,33.9,,580.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"CORKSCREW FT 4.5 X 14MM",ORSUP0018,CDM,278,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",605.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.7% of total billed charges",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",658.34,33.9,,526.67,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"CORKSCREW ANCHOR 4.5 PEEK",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CORNER PROTECTORS",412950,CDM,270,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"CORRECT MED LABELING SYSTEM",490396,CDM,270,RC,,,OUTPATIENT,,,25,16.25,,22,88,,17.60,,,0,"percent of total billed charges","88% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,17.304,,3.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.75,63,,12.60,,,0,"percent of total billed charges","63% of total billed charges",3.83,15.3,,3.06,,,0,"percent of total billed charges","15.3% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",17.25,69,,,,,0,"fee schedule","69% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.46,61.85,,12.37,,,0,"percent of total billed charges","61.5% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",8.05,32.2,,6.44,,,0,"percent of total billed charges","32.2% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.28,17.136,,3.42,,,0,"percent of total billed charges","17.136% of total billed charges",5.46,21.84,,4.37,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.43,37.7,,7.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.5,78,,15.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",3.83,25,
"CORTICAL SCREW 2.3MM 16MM TRX2.3-16",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"CORTICAL SCREW 2.3MM 18MM TRX2.3-18",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"CORTICAL SCREW 2.3MM 20MM TRX2.3-20",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"CORTEX SCREWS TITANIUM SELF TAPPING 1.3MM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"REAGENT CORTISOL",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"CALIBRATOR CORTISOL",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"CORTICAL SCREW",ORSUP0022,CDM,278,RC,,,OUTPATIENT,,,2266,1472.9,,1994.08,88,,1595.26,,,0,"percent of total billed charges","88% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",392.11,17.304,,313.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1427.58,63,,1142.06,,,0,"percent of total billed charges","63% of total billed charges",346.7,15.3,,277.36,,,0,"percent of total billed charges","15.3% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1563.54,69,,,,,0,"fee schedule","69% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1401.52,61.85,,1121.22,,,0,"percent of total billed charges","61.5% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",729.65,32.2,,583.72,,,0,"percent of total billed charges","32.2% of total billed charges",706.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",388.3,17.136,,310.64,,,0,"percent of total billed charges","17.136% of total billed charges",494.89,21.84,,395.91,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",854.28,37.7,,683.42,,,0,"percent of total billed charges","37.7% of total billed charges",854.28,37.7,,683.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",768.17,33.9,,614.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1767.48,78,,1413.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1871.72,82.6,,1497.38,,,0,"percent of total billed charges","82.6% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",1871.72,82.6,,1497.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",346.7,2266,
"COSTAL CARTILAGE TISSUE GRAFT",ORSUP0026,CDM,272,RC,,,OUTPATIENT,,,3090,2008.5,,2719.2,88,,2175.36,,,0,"percent of total billed charges","88% of total billed charges",1545,50,,1236.00,,,0,"percent of total billed charges","50% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",534.69,17.304,,427.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1946.7,63,,1557.36,,,0,"percent of total billed charges","63% of total billed charges",472.77,15.3,,378.22,,,0,"percent of total billed charges","15.3% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",2132.1,69,,,,,0,"fee schedule","69% of total billed charges",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1911.17,61.85,,1528.94,,,0,"percent of total billed charges","61.5% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",1545,50,,1236.00,,,0,"percent of total billed charges","50% of total billed charges",994.98,32.2,,795.98,,,0,"percent of total billed charges","32.2% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",529.5,17.136,,423.60,,,0,"percent of total billed charges","17.136% of total billed charges",674.86,21.84,,539.89,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1164.93,37.7,,931.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2410.2,78,,1928.16,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2552.34,82.6,,2041.87,,,0,"percent of total billed charges","82.6% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",1545,50,,1236.00,,,0,"percent of total billed charges","50% of total billed charges",2552.34,82.6,,2041.87,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",472.77,3090,
"COTTONOIDS 1/4 X 3",266544,CDM,270,RC,,,OUTPATIENT,,,21,13.65,,18.48,88,,14.78,,,0,"percent of total billed charges","88% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.63,17.304,,2.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.23,63,,10.58,,,0,"percent of total billed charges","63% of total billed charges",3.21,15.3,,2.57,,,0,"percent of total billed charges","15.3% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",14.49,69,,,,,0,"fee schedule","69% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.99,61.85,,10.39,,,0,"percent of total billed charges","61.5% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",6.76,32.2,,5.41,,,0,"percent of total billed charges","32.2% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.6,17.136,,2.88,,,0,"percent of total billed charges","17.136% of total billed charges",4.59,21.84,,3.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.92,37.7,,6.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.38,78,,13.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",3.21,21,
"COTTON BALL LARGE 2000/CS   2323",55284,CDM,270,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"COTTON ROLL STERILE LARGE 1LB",380401,CDM,272,RC,,,OUTPATIENT,,,34,22.1,,29.92,88,,23.94,,,0,"percent of total billed charges","88% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.88,17.304,,4.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.42,63,,17.14,,,0,"percent of total billed charges","63% of total billed charges",5.2,15.3,,4.16,,,0,"percent of total billed charges","15.3% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",23.46,69,,,,,0,"fee schedule","69% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.03,61.85,,16.82,,,0,"percent of total billed charges","61.5% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",10.95,32.2,,8.76,,,0,"percent of total billed charges","32.2% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.83,17.136,,4.66,,,0,"percent of total billed charges","17.136% of total billed charges",7.43,21.84,,5.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.82,37.7,,10.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.52,78,,21.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",5.2,34,
"COTTON UMBILICAL TAPE U-10T",490401,CDM,270,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"COTTON BALLS",490398,CDM,270,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"COTTON ROLL",490399,CDM,270,RC,,,OUTPATIENT,,,26,16.9,,22.88,88,,18.30,,,0,"percent of total billed charges","88% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.5,17.304,,3.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.38,63,,13.10,,,0,"percent of total billed charges","63% of total billed charges",3.98,15.3,,3.18,,,0,"percent of total billed charges","15.3% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",17.94,69,,,,,0,"fee schedule","69% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.08,61.85,,12.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",8.37,32.2,,6.70,,,0,"percent of total billed charges","32.2% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.46,17.136,,3.57,,,0,"percent of total billed charges","17.136% of total billed charges",5.68,21.84,,4.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.8,37.7,,7.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.28,78,,16.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",3.98,26,
"COTTON UMBILICAL TAPE (U11T)",490400,CDM,270,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"COTTONOID 1 X 3",490402,CDM,270,RC,,,OUTPATIENT,,,125,81.25,,110,88,,88.00,,,0,"percent of total billed charges","88% of total billed charges",62.5,50,,50.00,,,0,"percent of total billed charges","50% of total billed charges",21,16.8,,16.80,,,0,"percent of total billed charges","16.8% of total billed charges",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.63,17.304,,17.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.75,63,,63.00,,,0,"percent of total billed charges","63% of total billed charges",19.13,15.3,,15.30,,,0,"percent of total billed charges","15.3% of total billed charges",21,16.8,,16.80,,,0,"percent of total billed charges","16.8% of total billed charges",86.25,69,,,,,0,"fee schedule","69% of total billed charges",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.31,61.85,,61.85,,,0,"percent of total billed charges","61.5% of total billed charges",21,16.8,,16.80,,,0,"percent of total billed charges","16.8% of total billed charges",62.5,50,,50.00,,,0,"percent of total billed charges","50% of total billed charges",40.25,32.2,,32.20,,,0,"percent of total billed charges","32.2% of total billed charges",21,16.8,,16.80,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.42,17.136,,17.14,,,0,"percent of total billed charges","17.136% of total billed charges",27.3,21.84,,21.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47.13,37.7,,37.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",97.5,78,,78.00,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.25,82.6,,82.60,,,0,"percent of total billed charges","82.6% of total billed charges",21,16.8,,16.80,,,0,"percent of total billed charges","16.8% of total billed charges",62.5,50,,50.00,,,0,"percent of total billed charges","50% of total billed charges",103.25,82.6,,82.60,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,16.8,,16.80,,,0,"percent of total billed charges","16.8% of total billed charges",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",19.13,125,
"COTTONOID 1/2 X 3",490403,CDM,270,RC,,,OUTPATIENT,,,111,72.15,,97.68,88,,78.14,,,0,"percent of total billed charges","88% of total billed charges",55.5,50,,44.40,,,0,"percent of total billed charges","50% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.21,17.304,,15.37,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.93,63,,55.94,,,0,"percent of total billed charges","63% of total billed charges",16.98,15.3,,13.58,,,0,"percent of total billed charges","15.3% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",76.59,69,,,,,0,"fee schedule","69% of total billed charges",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.65,61.85,,54.92,,,0,"percent of total billed charges","61.5% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",55.5,50,,44.40,,,0,"percent of total billed charges","50% of total billed charges",35.74,32.2,,28.59,,,0,"percent of total billed charges","32.2% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.02,17.136,,15.22,,,0,"percent of total billed charges","17.136% of total billed charges",24.24,21.84,,19.39,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.85,37.7,,33.48,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",86.58,78,,69.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.69,82.6,,73.35,,,0,"percent of total billed charges","82.6% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",55.5,50,,44.40,,,0,"percent of total billed charges","50% of total billed charges",91.69,82.6,,73.35,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",16.98,111,
"COTTON BALLS LARGE STERILE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"COUNTER NEEDLE MAGNETIC SMALL",201025,CDM,272,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"COUNTER NEEDLE MAGNETIC LARGE",185522,CDM,272,RC,,,OUTPATIENT,,,22,14.3,,19.36,88,,15.49,,,0,"percent of total billed charges","88% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.81,17.304,,3.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.86,63,,11.09,,,0,"percent of total billed charges","63% of total billed charges",3.37,15.3,,2.70,,,0,"percent of total billed charges","15.3% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",15.18,69,,,,,0,"fee schedule","69% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.61,61.85,,10.89,,,0,"percent of total billed charges","61.5% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",7.08,32.2,,5.66,,,0,"percent of total billed charges","32.2% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.77,17.136,,3.02,,,0,"percent of total billed charges","17.136% of total billed charges",4.8,21.84,,3.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.29,37.7,,6.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.16,78,,13.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",3.37,22,
"COUNTER NEEDLE DOUBLE MAGNET 60CT LF",429240,CDM,272,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"COUNTER SPONGE 4050 CLEAR BACK",10440,CDM,270,RC,,,OUTPATIENT,,,375,243.75,,330,88,,264.00,,,0,"percent of total billed charges","88% of total billed charges",187.5,50,,150.00,,,0,"percent of total billed charges","50% of total billed charges",63,16.8,,50.40,,,0,"percent of total billed charges","16.8% of total billed charges",375,100,,300.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,17.304,,51.91,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",236.25,63,,189.00,,,0,"percent of total billed charges","63% of total billed charges",57.38,15.3,,45.90,,,0,"percent of total billed charges","15.3% of total billed charges",63,16.8,,50.40,,,0,"percent of total billed charges","16.8% of total billed charges",258.75,69,,,,,0,"fee schedule","69% of total billed charges",375,100,,300.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",375,100,,300.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",375,100,,300.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.94,61.85,,185.55,,,0,"percent of total billed charges","61.5% of total billed charges",63,16.8,,50.40,,,0,"percent of total billed charges","16.8% of total billed charges",187.5,50,,150.00,,,0,"percent of total billed charges","50% of total billed charges",120.75,32.2,,96.60,,,0,"percent of total billed charges","32.2% of total billed charges",63,16.8,,50.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.26,17.136,,51.41,,,0,"percent of total billed charges","17.136% of total billed charges",81.9,21.84,,65.52,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",141.38,37.7,,113.10,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",292.5,78,,234.00,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",309.75,82.6,,247.80,,,0,"percent of total billed charges","82.6% of total billed charges",63,16.8,,50.40,,,0,"percent of total billed charges","16.8% of total billed charges",187.5,50,,150.00,,,0,"percent of total billed charges","50% of total billed charges",309.75,82.6,,247.80,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",63,16.8,,50.40,,,0,"percent of total billed charges","16.8% of total billed charges",375,100,,300.00,,,0,"percent of total billed charges","100% of total billed charges",57.38,375,
"COVADERM 4 X 10",490404,CDM,271,RC,,,OUTPATIENT,,,24,15.6,,21.12,88,,16.90,,,0,"percent of total billed charges","88% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.15,17.304,,3.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.12,63,,12.10,,,0,"percent of total billed charges","63% of total billed charges",3.67,15.3,,2.94,,,0,"percent of total billed charges","15.3% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",16.56,69,,,,,0,"fee schedule","69% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.84,61.85,,11.87,,,0,"percent of total billed charges","61.5% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",7.73,32.2,,6.18,,,0,"percent of total billed charges","32.2% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.11,17.136,,3.29,,,0,"percent of total billed charges","17.136% of total billed charges",5.24,21.84,,4.19,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.05,37.7,,7.24,,,0,"percent of total billed charges","37.7% of total billed charges",9.05,37.7,,7.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.14,33.9,,6.51,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.72,78,,14.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,24,
"COVADERM 6 X 8",490406,CDM,271,RC,,,OUTPATIENT,,,26,16.9,,22.88,88,,18.30,,,0,"percent of total billed charges","88% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.5,17.304,,3.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.38,63,,13.10,,,0,"percent of total billed charges","63% of total billed charges",3.98,15.3,,3.18,,,0,"percent of total billed charges","15.3% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",17.94,69,,,,,0,"fee schedule","69% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.08,61.85,,12.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",8.37,32.2,,6.70,,,0,"percent of total billed charges","32.2% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.46,17.136,,3.57,,,0,"percent of total billed charges","17.136% of total billed charges",5.68,21.84,,4.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.8,37.7,,7.84,,,0,"percent of total billed charges","37.7% of total billed charges",9.8,37.7,,7.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.81,33.9,,7.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.28,78,,16.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",3.98,26,
"COVER BOOT X-LARGE KNEE HI",91900,CDM,270,RC,,,OUTPATIENT,,,279,181.35,,245.52,88,,196.42,,,0,"percent of total billed charges","88% of total billed charges",139.5,50,,111.60,,,0,"percent of total billed charges","50% of total billed charges",46.87,16.8,,37.50,,,0,"percent of total billed charges","16.8% of total billed charges",279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.28,17.304,,38.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",175.77,63,,140.62,,,0,"percent of total billed charges","63% of total billed charges",42.69,15.3,,34.15,,,0,"percent of total billed charges","15.3% of total billed charges",46.87,16.8,,37.50,,,0,"percent of total billed charges","16.8% of total billed charges",192.51,69,,,,,0,"fee schedule","69% of total billed charges",279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",172.56,61.85,,138.05,,,0,"percent of total billed charges","61.5% of total billed charges",46.87,16.8,,37.50,,,0,"percent of total billed charges","16.8% of total billed charges",139.5,50,,111.60,,,0,"percent of total billed charges","50% of total billed charges",89.84,32.2,,71.87,,,0,"percent of total billed charges","32.2% of total billed charges",46.87,16.8,,37.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.81,17.136,,38.25,,,0,"percent of total billed charges","17.136% of total billed charges",60.93,21.84,,48.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",105.18,37.7,,84.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",217.62,78,,174.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",230.45,82.6,,184.36,,,0,"percent of total billed charges","82.6% of total billed charges",46.87,16.8,,37.50,,,0,"percent of total billed charges","16.8% of total billed charges",139.5,50,,111.60,,,0,"percent of total billed charges","50% of total billed charges",230.45,82.6,,184.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.87,16.8,,37.50,,,0,"percent of total billed charges","16.8% of total billed charges",279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",42.69,279,
"COVERALL XX-LRG ELASTIC CUFF/ANKLE",171680,CDM,270,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.95,61.85,,3.96,,,0,"percent of total billed charges","61.5% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"COVER TABLE 44X90 STERILE",13992,CDM,272,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"COVER SHOE EXTRA LARGE",186774,CDM,270,RC,,,OUTPATIENT,,,118,76.7,,103.84,88,,83.07,,,0,"percent of total billed charges","88% of total billed charges",59,50,,47.20,,,0,"percent of total billed charges","50% of total billed charges",19.82,16.8,,15.86,,,0,"percent of total billed charges","16.8% of total billed charges",118,100,,94.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.42,17.304,,16.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.34,63,,59.47,,,0,"percent of total billed charges","63% of total billed charges",18.05,15.3,,14.44,,,0,"percent of total billed charges","15.3% of total billed charges",19.82,16.8,,15.86,,,0,"percent of total billed charges","16.8% of total billed charges",81.42,69,,,,,0,"fee schedule","69% of total billed charges",118,100,,94.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",118,100,,94.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",118,100,,94.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",72.98,61.85,,58.38,,,0,"percent of total billed charges","61.5% of total billed charges",19.82,16.8,,15.86,,,0,"percent of total billed charges","16.8% of total billed charges",59,50,,47.20,,,0,"percent of total billed charges","50% of total billed charges",38,32.2,,30.40,,,0,"percent of total billed charges","32.2% of total billed charges",19.82,16.8,,15.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.22,17.136,,16.18,,,0,"percent of total billed charges","17.136% of total billed charges",25.77,21.84,,20.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",44.49,37.7,,35.59,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",92.04,78,,73.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.47,82.6,,77.98,,,0,"percent of total billed charges","82.6% of total billed charges",19.82,16.8,,15.86,,,0,"percent of total billed charges","16.8% of total billed charges",59,50,,47.20,,,0,"percent of total billed charges","50% of total billed charges",97.47,82.6,,77.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.82,16.8,,15.86,,,0,"percent of total billed charges","16.8% of total billed charges",118,100,,94.40,,,0,"percent of total billed charges","100% of total billed charges",18.05,118,
"COVER MAYO STAND STERILE",151783,CDM,272,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"COVER LIGHT HANDLE PACK STRL",308949,CDM,270,RC,,,OUTPATIENT,,,358,232.7,,315.04,88,,252.03,,,0,"percent of total billed charges","88% of total billed charges",179,50,,143.20,,,0,"percent of total billed charges","50% of total billed charges",60.14,16.8,,48.11,,,0,"percent of total billed charges","16.8% of total billed charges",358,100,,286.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.95,17.304,,49.56,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",225.54,63,,180.43,,,0,"percent of total billed charges","63% of total billed charges",54.77,15.3,,43.82,,,0,"percent of total billed charges","15.3% of total billed charges",60.14,16.8,,48.11,,,0,"percent of total billed charges","16.8% of total billed charges",247.02,69,,,,,0,"fee schedule","69% of total billed charges",358,100,,286.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",358,100,,286.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",358,100,,286.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.42,61.85,,177.14,,,0,"percent of total billed charges","61.5% of total billed charges",60.14,16.8,,48.11,,,0,"percent of total billed charges","16.8% of total billed charges",179,50,,143.20,,,0,"percent of total billed charges","50% of total billed charges",115.28,32.2,,92.22,,,0,"percent of total billed charges","32.2% of total billed charges",60.14,16.8,,48.11,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.35,17.136,,49.08,,,0,"percent of total billed charges","17.136% of total billed charges",78.19,21.84,,62.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",134.97,37.7,,107.98,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",279.24,78,,223.39,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.71,82.6,,236.57,,,0,"percent of total billed charges","82.6% of total billed charges",60.14,16.8,,48.11,,,0,"percent of total billed charges","16.8% of total billed charges",179,50,,143.20,,,0,"percent of total billed charges","50% of total billed charges",295.71,82.6,,236.57,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.14,16.8,,48.11,,,0,"percent of total billed charges","16.8% of total billed charges",358,100,,286.40,,,0,"percent of total billed charges","100% of total billed charges",54.77,358,
"COVER WARMING BODY UPPER DUAL PRT SGL USE 78INX21IN",161041,CDM,270,RC,,,OUTPATIENT,,,58,37.7,,51.04,88,,40.83,,,0,"percent of total billed charges","88% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.04,17.304,,8.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.54,63,,29.23,,,0,"percent of total billed charges","63% of total billed charges",8.87,15.3,,7.10,,,0,"percent of total billed charges","15.3% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",40.02,69,,,,,0,"fee schedule","69% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.87,61.85,,28.70,,,0,"percent of total billed charges","61.5% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",18.68,32.2,,14.94,,,0,"percent of total billed charges","32.2% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.94,17.136,,7.95,,,0,"percent of total billed charges","17.136% of total billed charges",12.67,21.84,,10.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.87,37.7,,17.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",45.24,78,,36.19,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",8.87,58,
"COVER ARMBOARD W STRAP",301783,CDM,270,RC,,,OUTPATIENT,,,727,472.55,,639.76,88,,511.81,,,0,"percent of total billed charges","88% of total billed charges",363.5,50,,290.80,,,0,"percent of total billed charges","50% of total billed charges",122.14,16.8,,97.71,,,0,"percent of total billed charges","16.8% of total billed charges",727,100,,581.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",125.8,17.304,,100.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.01,63,,366.41,,,0,"percent of total billed charges","63% of total billed charges",111.23,15.3,,88.98,,,0,"percent of total billed charges","15.3% of total billed charges",122.14,16.8,,97.71,,,0,"percent of total billed charges","16.8% of total billed charges",501.63,69,,,,,0,"fee schedule","69% of total billed charges",727,100,,581.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",727,100,,581.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",727,100,,581.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.65,61.85,,359.72,,,0,"percent of total billed charges","61.5% of total billed charges",122.14,16.8,,97.71,,,0,"percent of total billed charges","16.8% of total billed charges",363.5,50,,290.80,,,0,"percent of total billed charges","50% of total billed charges",234.09,32.2,,187.27,,,0,"percent of total billed charges","32.2% of total billed charges",122.14,16.8,,97.71,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.58,17.136,,99.66,,,0,"percent of total billed charges","17.136% of total billed charges",158.78,21.84,,127.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",274.08,37.7,,219.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",567.06,78,,453.65,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",600.5,82.6,,480.40,,,0,"percent of total billed charges","82.6% of total billed charges",122.14,16.8,,97.71,,,0,"percent of total billed charges","16.8% of total billed charges",363.5,50,,290.80,,,0,"percent of total billed charges","50% of total billed charges",600.5,82.6,,480.40,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",122.14,16.8,,97.71,,,0,"percent of total billed charges","16.8% of total billed charges",727,100,,581.60,,,0,"percent of total billed charges","100% of total billed charges",111.23,727,
"COVER BOOT FLUID SHIELD NSKID XLG",316668,CDM,270,RC,,,OUTPATIENT,,,810,526.5,,712.8,88,,570.24,,,0,"percent of total billed charges","88% of total billed charges",405,50,,324.00,,,0,"percent of total billed charges","50% of total billed charges",136.08,16.8,,108.86,,,0,"percent of total billed charges","16.8% of total billed charges",810,100,,648.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",140.16,17.304,,112.13,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.3,63,,408.24,,,0,"percent of total billed charges","63% of total billed charges",123.93,15.3,,99.14,,,0,"percent of total billed charges","15.3% of total billed charges",136.08,16.8,,108.86,,,0,"percent of total billed charges","16.8% of total billed charges",558.9,69,,,,,0,"fee schedule","69% of total billed charges",810,100,,648.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",810,100,,648.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",810,100,,648.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",500.99,61.85,,400.79,,,0,"percent of total billed charges","61.5% of total billed charges",136.08,16.8,,108.86,,,0,"percent of total billed charges","16.8% of total billed charges",405,50,,324.00,,,0,"percent of total billed charges","50% of total billed charges",260.82,32.2,,208.66,,,0,"percent of total billed charges","32.2% of total billed charges",136.08,16.8,,108.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.8,17.136,,111.04,,,0,"percent of total billed charges","17.136% of total billed charges",176.9,21.84,,141.52,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",305.37,37.7,,244.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",631.8,78,,505.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",669.06,82.6,,535.25,,,0,"percent of total billed charges","82.6% of total billed charges",136.08,16.8,,108.86,,,0,"percent of total billed charges","16.8% of total billed charges",405,50,,324.00,,,0,"percent of total billed charges","50% of total billed charges",669.06,82.6,,535.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.08,16.8,,108.86,,,0,"percent of total billed charges","16.8% of total billed charges",810,100,,648.00,,,0,"percent of total billed charges","100% of total billed charges",123.93,810,
"COVER GLIDESCOPE SZ 3 0574-0100",ORSUP0003,CDM,270,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"COVER HEAD THERMO-LITE TEC",186430,CDM,270,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"COVER PERINEAL POST",443453,CDM,270,RC,,,OUTPATIENT,,,521,338.65,,458.48,88,,366.78,,,0,"percent of total billed charges","88% of total billed charges",260.5,50,,208.40,,,0,"percent of total billed charges","50% of total billed charges",87.53,16.8,,70.02,,,0,"percent of total billed charges","16.8% of total billed charges",521,100,,416.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.15,17.304,,72.12,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",328.23,63,,262.58,,,0,"percent of total billed charges","63% of total billed charges",79.71,15.3,,63.77,,,0,"percent of total billed charges","15.3% of total billed charges",87.53,16.8,,70.02,,,0,"percent of total billed charges","16.8% of total billed charges",359.49,69,,,,,0,"fee schedule","69% of total billed charges",521,100,,416.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",521,100,,416.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",521,100,,416.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",322.24,61.85,,257.79,,,0,"percent of total billed charges","61.5% of total billed charges",87.53,16.8,,70.02,,,0,"percent of total billed charges","16.8% of total billed charges",260.5,50,,208.40,,,0,"percent of total billed charges","50% of total billed charges",167.76,32.2,,134.21,,,0,"percent of total billed charges","32.2% of total billed charges",87.53,16.8,,70.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.28,17.136,,71.42,,,0,"percent of total billed charges","17.136% of total billed charges",113.79,21.84,,91.03,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",196.42,37.7,,157.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",406.38,78,,325.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",430.35,82.6,,344.28,,,0,"percent of total billed charges","82.6% of total billed charges",87.53,16.8,,70.02,,,0,"percent of total billed charges","16.8% of total billed charges",260.5,50,,208.40,,,0,"percent of total billed charges","50% of total billed charges",430.35,82.6,,344.28,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.53,16.8,,70.02,,,0,"percent of total billed charges","16.8% of total billed charges",521,100,,416.80,,,0,"percent of total billed charges","100% of total billed charges",79.71,521,
"COVER PROBE DISP 5031",143309,CDM,270,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"COVER ROLL STRETCH 2'' X 10YDS",174440,CDM,270,RC,,,OUTPATIENT,,,73,47.45,,64.24,88,,51.39,,,0,"percent of total billed charges","88% of total billed charges",36.5,50,,29.20,,,0,"percent of total billed charges","50% of total billed charges",12.26,16.8,,9.81,,,0,"percent of total billed charges","16.8% of total billed charges",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.63,17.304,,10.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.99,63,,36.79,,,0,"percent of total billed charges","63% of total billed charges",11.17,15.3,,8.94,,,0,"percent of total billed charges","15.3% of total billed charges",12.26,16.8,,9.81,,,0,"percent of total billed charges","16.8% of total billed charges",50.37,69,,,,,0,"fee schedule","69% of total billed charges",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.15,61.85,,36.12,,,0,"percent of total billed charges","61.5% of total billed charges",12.26,16.8,,9.81,,,0,"percent of total billed charges","16.8% of total billed charges",36.5,50,,29.20,,,0,"percent of total billed charges","50% of total billed charges",23.51,32.2,,18.81,,,0,"percent of total billed charges","32.2% of total billed charges",12.26,16.8,,9.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.51,17.136,,10.01,,,0,"percent of total billed charges","17.136% of total billed charges",15.94,21.84,,12.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",27.52,37.7,,22.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",56.94,78,,45.55,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",12.26,16.8,,9.81,,,0,"percent of total billed charges","16.8% of total billed charges",36.5,50,,29.20,,,0,"percent of total billed charges","50% of total billed charges",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.26,16.8,,9.81,,,0,"percent of total billed charges","16.8% of total billed charges",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",11.17,73,
"COVER SHOE EXTRA TRACTION NON-CONDUCTIVE X-LARGE",227877,CDM,270,RC,,,OUTPATIENT,,,65,42.25,,57.2,88,,45.76,,,0,"percent of total billed charges","88% of total billed charges",32.5,50,,26.00,,,0,"percent of total billed charges","50% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.25,17.304,,9.00,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.95,63,,32.76,,,0,"percent of total billed charges","63% of total billed charges",9.95,15.3,,7.96,,,0,"percent of total billed charges","15.3% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",44.85,69,,,,,0,"fee schedule","69% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.2,61.85,,32.16,,,0,"percent of total billed charges","61.5% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",32.5,50,,26.00,,,0,"percent of total billed charges","50% of total billed charges",20.93,32.2,,16.74,,,0,"percent of total billed charges","32.2% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.14,17.136,,8.91,,,0,"percent of total billed charges","17.136% of total billed charges",14.2,21.84,,11.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.51,37.7,,19.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.7,78,,40.56,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",32.5,50,,26.00,,,0,"percent of total billed charges","50% of total billed charges",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",9.95,65,
"COVER TIP CAPS TWIN W/ VENTS ORANGE",324314,CDM,270,RC,,,OUTPATIENT,,,166,107.9,,146.08,88,,116.86,,,0,"percent of total billed charges","88% of total billed charges",83,50,,66.40,,,0,"percent of total billed charges","50% of total billed charges",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.72,17.304,,22.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.58,63,,83.66,,,0,"percent of total billed charges","63% of total billed charges",25.4,15.3,,20.32,,,0,"percent of total billed charges","15.3% of total billed charges",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",114.54,69,,,,,0,"fee schedule","69% of total billed charges",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",102.67,61.85,,82.14,,,0,"percent of total billed charges","61.5% of total billed charges",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",83,50,,66.40,,,0,"percent of total billed charges","50% of total billed charges",53.45,32.2,,42.76,,,0,"percent of total billed charges","32.2% of total billed charges",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.45,17.136,,22.76,,,0,"percent of total billed charges","17.136% of total billed charges",36.25,21.84,,29.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",62.58,37.7,,50.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",129.48,78,,103.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.12,82.6,,109.70,,,0,"percent of total billed charges","82.6% of total billed charges",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",83,50,,66.40,,,0,"percent of total billed charges","50% of total billed charges",137.12,82.6,,109.70,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",25.4,166,
"COVER TIP CAPS TWIN W/ VENTS RED",324312,CDM,270,RC,,,OUTPATIENT,,,139,90.35,,122.32,88,,97.86,,,0,"percent of total billed charges","88% of total billed charges",69.5,50,,55.60,,,0,"percent of total billed charges","50% of total billed charges",23.35,16.8,,18.68,,,0,"percent of total billed charges","16.8% of total billed charges",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.05,17.304,,19.24,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.57,63,,70.06,,,0,"percent of total billed charges","63% of total billed charges",21.27,15.3,,17.02,,,0,"percent of total billed charges","15.3% of total billed charges",23.35,16.8,,18.68,,,0,"percent of total billed charges","16.8% of total billed charges",95.91,69,,,,,0,"fee schedule","69% of total billed charges",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.97,61.85,,68.78,,,0,"percent of total billed charges","61.5% of total billed charges",23.35,16.8,,18.68,,,0,"percent of total billed charges","16.8% of total billed charges",69.5,50,,55.60,,,0,"percent of total billed charges","50% of total billed charges",44.76,32.2,,35.81,,,0,"percent of total billed charges","32.2% of total billed charges",23.35,16.8,,18.68,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.82,17.136,,19.06,,,0,"percent of total billed charges","17.136% of total billed charges",30.36,21.84,,24.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",52.4,37.7,,41.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",108.42,78,,86.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,82.6,,91.85,,,0,"percent of total billed charges","82.6% of total billed charges",23.35,16.8,,18.68,,,0,"percent of total billed charges","16.8% of total billed charges",69.5,50,,55.60,,,0,"percent of total billed charges","50% of total billed charges",114.81,82.6,,91.85,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.35,16.8,,18.68,,,0,"percent of total billed charges","16.8% of total billed charges",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",21.27,139,
"COVER TIP CAPS TWIN W/ VENTS YELLOW",324313,CDM,270,RC,,,OUTPATIENT,,,166,107.9,,146.08,88,,116.86,,,0,"percent of total billed charges","88% of total billed charges",83,50,,66.40,,,0,"percent of total billed charges","50% of total billed charges",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.72,17.304,,22.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.58,63,,83.66,,,0,"percent of total billed charges","63% of total billed charges",25.4,15.3,,20.32,,,0,"percent of total billed charges","15.3% of total billed charges",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",114.54,69,,,,,0,"fee schedule","69% of total billed charges",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",102.67,61.85,,82.14,,,0,"percent of total billed charges","61.5% of total billed charges",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",83,50,,66.40,,,0,"percent of total billed charges","50% of total billed charges",53.45,32.2,,42.76,,,0,"percent of total billed charges","32.2% of total billed charges",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.45,17.136,,22.76,,,0,"percent of total billed charges","17.136% of total billed charges",36.25,21.84,,29.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",62.58,37.7,,50.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",129.48,78,,103.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.12,82.6,,109.70,,,0,"percent of total billed charges","82.6% of total billed charges",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",83,50,,66.40,,,0,"percent of total billed charges","50% of total billed charges",137.12,82.6,,109.70,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",25.4,166,
"COVERALL DISP XL BLU",10270,CDM,270,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"COVERALL DISPOSABLE LARGE WHITE",277558,CDM,270,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"COVERALL DISPOSABLE XXXL WHITE",324993,CDM,270,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"COVERLET BELLA BLANKET",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"COVERS EAR SANITARY LARGE",ORSUP0013,CDM,270,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"COVERALL XL (BUNNYSUIT)",490408,CDM,270,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"COVER ROLL STRETCH",490407,CDM,270,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"COVERALLS XL",490409,CDM,270,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"COVER GLASS",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"CPAP NASAL MASK INFANT MED",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"CPAP NASAL MASK INFANT LARGE",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"CPAP/BI-PAP TUBING 6' L",ORSUP0001,CDM,278,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.7% of total billed charges",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.2,33.9,,9.76,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"CRBM/ 5 PACK / 90 SLIDES",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"CREAM HAND PETROLEUM BASED W/ALOE 2OZ",143336,CDM,270,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"CREAM SKIN REPAIR REMEDY 2 OZ TUBE",322110,CDM,270,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"CRICOTHYROTOMY KIT COOK",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"CRICOTHYROTOMY KIT 4.0",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2060,1339,,1812.8,88,,1450.24,,,0,"percent of total billed charges","88% of total billed charges",1030,50,,824.00,,,0,"percent of total billed charges","50% of total billed charges",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",356.46,17.304,,285.17,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1297.8,63,,1038.24,,,0,"percent of total billed charges","63% of total billed charges",315.18,15.3,,252.14,,,0,"percent of total billed charges","15.3% of total billed charges",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",1421.4,69,,,,,0,"fee schedule","69% of total billed charges",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1274.11,61.85,,1019.29,,,0,"percent of total billed charges","61.5% of total billed charges",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",1030,50,,824.00,,,0,"percent of total billed charges","50% of total billed charges",663.32,32.2,,530.66,,,0,"percent of total billed charges","32.2% of total billed charges",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",353,17.136,,282.40,,,0,"percent of total billed charges","17.136% of total billed charges",449.9,21.84,,359.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",776.62,37.7,,621.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1606.8,78,,1285.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1701.56,82.6,,1361.25,,,0,"percent of total billed charges","82.6% of total billed charges",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",1030,50,,824.00,,,0,"percent of total billed charges","50% of total billed charges",1701.56,82.6,,1361.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",315.18,2060,
"CROSSFLOW OUTFLOW CASSETTE TUBING",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.7% of total billed charges",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.75,33.9,,83.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"CRP PERF VERIFIER I BX / 6 SET",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"CRP PERF VERIFIER II BX / 6 SET",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"CRP / 5 PACK / 90 SLIDES",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CRUTCH ALUM ADJ ADULT MED 300LB CAP",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CRUTCH ALUM ADJ TALL ADULT 300LB CAP",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CRUTCH ALUM ADJ YOUTH 300LB CAP",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CS5 FAST PACK, 225ML BOWL",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CS5 FAST PACK, 125ML BOWL",ORSUP0015,CDM,270,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"CSF PROTEIN / 5 PACK / 90 SLIDES",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CT/NG GX IVD CARTRIDGES",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"CT/NG EXTERNAL RUN CONTROLS POSITIVE NG",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"CUFF B/P INFANT 1-TUBE BAYONET",241436,CDM,270,RC,,,OUTPATIENT,,,21,13.65,,18.48,88,,14.78,,,0,"percent of total billed charges","88% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.63,17.304,,2.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.23,63,,10.58,,,0,"percent of total billed charges","63% of total billed charges",3.21,15.3,,2.57,,,0,"percent of total billed charges","15.3% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",14.49,69,,,,,0,"fee schedule","69% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.99,61.85,,10.39,,,0,"percent of total billed charges","61.5% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",6.76,32.2,,5.41,,,0,"percent of total billed charges","32.2% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.6,17.136,,2.88,,,0,"percent of total billed charges","17.136% of total billed charges",4.59,21.84,,3.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.92,37.7,,6.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.38,78,,13.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",3.21,21,
"CUFF B/P CHILD 1-TUBE BAYONET",241434,CDM,270,RC,,,OUTPATIENT,,,21,13.65,,18.48,88,,14.78,,,0,"percent of total billed charges","88% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.63,17.304,,2.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.23,63,,10.58,,,0,"percent of total billed charges","63% of total billed charges",3.21,15.3,,2.57,,,0,"percent of total billed charges","15.3% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",14.49,69,,,,,0,"fee schedule","69% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.99,61.85,,10.39,,,0,"percent of total billed charges","61.5% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",6.76,32.2,,5.41,,,0,"percent of total billed charges","32.2% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.6,17.136,,2.88,,,0,"percent of total billed charges","17.136% of total billed charges",4.59,21.84,,3.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.92,37.7,,6.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.38,78,,13.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",3.21,21,
"CUFF B/P SM ADULT 1-TUBE BAYONET",241440,CDM,270,RC,,,OUTPATIENT,,,21,13.65,,18.48,88,,14.78,,,0,"percent of total billed charges","88% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.63,17.304,,2.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.23,63,,10.58,,,0,"percent of total billed charges","63% of total billed charges",3.21,15.3,,2.57,,,0,"percent of total billed charges","15.3% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",14.49,69,,,,,0,"fee schedule","69% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.99,61.85,,10.39,,,0,"percent of total billed charges","61.5% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",6.76,32.2,,5.41,,,0,"percent of total billed charges","32.2% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.6,17.136,,2.88,,,0,"percent of total billed charges","17.136% of total billed charges",4.59,21.84,,3.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.92,37.7,,6.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.38,78,,13.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",3.21,21,
"CUFF BLOOD PRESSURE ADULT LONG",260743,CDM,270,RC,,,OUTPATIENT,,,23,14.95,,20.24,88,,16.19,,,0,"percent of total billed charges","88% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.98,17.304,,3.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.49,63,,11.59,,,0,"percent of total billed charges","63% of total billed charges",3.52,15.3,,2.82,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",15.87,69,,,,,0,"fee schedule","69% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.23,61.85,,11.38,,,0,"percent of total billed charges","61.5% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",7.41,32.2,,5.93,,,0,"percent of total billed charges","32.2% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.94,17.136,,3.15,,,0,"percent of total billed charges","17.136% of total billed charges",5.02,21.84,,4.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.94,78,,14.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",3.52,23,
"CUFF BP ADULT LARGE 1 TUBE DISPOSABLE",236638,CDM,270,RC,,,OUTPATIENT,,,24,15.6,,21.12,88,,16.90,,,0,"percent of total billed charges","88% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.15,17.304,,3.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.12,63,,12.10,,,0,"percent of total billed charges","63% of total billed charges",3.67,15.3,,2.94,,,0,"percent of total billed charges","15.3% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",16.56,69,,,,,0,"fee schedule","69% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.84,61.85,,11.87,,,0,"percent of total billed charges","61.5% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",7.73,32.2,,6.18,,,0,"percent of total billed charges","32.2% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.11,17.136,,3.29,,,0,"percent of total billed charges","17.136% of total billed charges",5.24,21.84,,4.19,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.05,37.7,,7.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.72,78,,14.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,24,
"CUFF BP ADULT REG 1 TUBE DISPOSABLE",236637,CDM,270,RC,,,OUTPATIENT,,,21,13.65,,18.48,88,,14.78,,,0,"percent of total billed charges","88% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.63,17.304,,2.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.23,63,,10.58,,,0,"percent of total billed charges","63% of total billed charges",3.21,15.3,,2.57,,,0,"percent of total billed charges","15.3% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",14.49,69,,,,,0,"fee schedule","69% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.99,61.85,,10.39,,,0,"percent of total billed charges","61.5% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",6.76,32.2,,5.41,,,0,"percent of total billed charges","32.2% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.6,17.136,,2.88,,,0,"percent of total billed charges","17.136% of total billed charges",4.59,21.84,,3.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.92,37.7,,6.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.38,78,,13.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",3.21,21,
"CUFF 24'' SINGLE TOURNIQUET",274458,CDM,270,RC,,,OUTPATIENT,,,1790,1163.5,,1575.2,88,,1260.16,,,0,"percent of total billed charges","88% of total billed charges",895,50,,716.00,,,0,"percent of total billed charges","50% of total billed charges",300.72,16.8,,240.58,,,0,"percent of total billed charges","16.8% of total billed charges",1790,100,,1432.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309.74,17.304,,247.79,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1127.7,63,,902.16,,,0,"percent of total billed charges","63% of total billed charges",273.87,15.3,,219.10,,,0,"percent of total billed charges","15.3% of total billed charges",300.72,16.8,,240.58,,,0,"percent of total billed charges","16.8% of total billed charges",1235.1,69,,,,,0,"fee schedule","69% of total billed charges",1790,100,,1432.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1790,100,,1432.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1790,100,,1432.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1107.12,61.85,,885.70,,,0,"percent of total billed charges","61.5% of total billed charges",300.72,16.8,,240.58,,,0,"percent of total billed charges","16.8% of total billed charges",895,50,,716.00,,,0,"percent of total billed charges","50% of total billed charges",576.38,32.2,,461.10,,,0,"percent of total billed charges","32.2% of total billed charges",300.72,16.8,,240.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",306.73,17.136,,245.38,,,0,"percent of total billed charges","17.136% of total billed charges",390.94,21.84,,312.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",674.83,37.7,,539.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1396.2,78,,1116.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1478.54,82.6,,1182.83,,,0,"percent of total billed charges","82.6% of total billed charges",300.72,16.8,,240.58,,,0,"percent of total billed charges","16.8% of total billed charges",895,50,,716.00,,,0,"percent of total billed charges","50% of total billed charges",1478.54,82.6,,1182.83,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",300.72,16.8,,240.58,,,0,"percent of total billed charges","16.8% of total billed charges",1790,100,,1432.00,,,0,"percent of total billed charges","100% of total billed charges",273.87,1790,
"CUFF TOURNIQUET DL PRT SNGL BLDR 18 W/POSLINKCON",239720,CDM,270,RC,,,OUTPATIENT,,,82,53.3,,72.16,88,,57.73,,,0,"percent of total billed charges","88% of total billed charges",41,50,,32.80,,,0,"percent of total billed charges","50% of total billed charges",13.78,16.8,,11.02,,,0,"percent of total billed charges","16.8% of total billed charges",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.19,17.304,,11.35,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.66,63,,41.33,,,0,"percent of total billed charges","63% of total billed charges",12.55,15.3,,10.04,,,0,"percent of total billed charges","15.3% of total billed charges",13.78,16.8,,11.02,,,0,"percent of total billed charges","16.8% of total billed charges",56.58,69,,,,,0,"fee schedule","69% of total billed charges",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.72,61.85,,40.58,,,0,"percent of total billed charges","61.5% of total billed charges",13.78,16.8,,11.02,,,0,"percent of total billed charges","16.8% of total billed charges",41,50,,32.80,,,0,"percent of total billed charges","50% of total billed charges",26.4,32.2,,21.12,,,0,"percent of total billed charges","32.2% of total billed charges",13.78,16.8,,11.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.05,17.136,,11.24,,,0,"percent of total billed charges","17.136% of total billed charges",17.91,21.84,,14.33,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.91,37.7,,24.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",63.96,78,,51.17,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.73,82.6,,54.18,,,0,"percent of total billed charges","82.6% of total billed charges",13.78,16.8,,11.02,,,0,"percent of total billed charges","16.8% of total billed charges",41,50,,32.80,,,0,"percent of total billed charges","50% of total billed charges",67.73,82.6,,54.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.78,16.8,,11.02,,,0,"percent of total billed charges","16.8% of total billed charges",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",12.55,82,
"CUFF TOURNIQUET DL PRT SNGL BLDR 34 W/POSLINKCON",239722R,CDM,270,RC,,,OUTPATIENT,,,80,52,,70.4,88,,56.32,,,0,"percent of total billed charges","88% of total billed charges",40,50,,32.00,,,0,"percent of total billed charges","50% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.84,17.304,,11.07,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.4,63,,40.32,,,0,"percent of total billed charges","63% of total billed charges",12.24,15.3,,9.79,,,0,"percent of total billed charges","15.3% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",55.2,69,,,,,0,"fee schedule","69% of total billed charges",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.48,61.85,,39.58,,,0,"percent of total billed charges","61.5% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",40,50,,32.00,,,0,"percent of total billed charges","50% of total billed charges",25.76,32.2,,20.61,,,0,"percent of total billed charges","32.2% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.71,17.136,,10.97,,,0,"percent of total billed charges","17.136% of total billed charges",17.47,21.84,,13.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.16,37.7,,24.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",62.4,78,,49.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",66.08,82.6,,52.86,,,0,"percent of total billed charges","82.6% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",40,50,,32.00,,,0,"percent of total billed charges","50% of total billed charges",66.08,82.6,,52.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",12.24,80,
"CUFF 12IN SINGLE TOURNIQUET",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"CUFF 34IN SINGLE TOURNEQUET",ORSUP0019,CDM,272,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"CUFF 44IN SINGLE TOURNIQUET",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"CUFF BP SOFT ADULT LONG 2 TUBE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CUFFED ENDO TUBE W/STYLET 3.5MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"CUFFED ENDO TUBE W/STYLET 3.0MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"CUFFED ENDO TUBE W/STYLET 2.5MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"CULTURETTES BACTISWAB",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CUP SPECIMEN STERILE 4 OZ",89412,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"CUP TOOTH GRASPER TIP",ORSUP0016,CDM,270,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"CURETTE 9 CURV",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CURETTE EAR FLEX LOOP POLYPROP 4MM LEAD N/S DISP",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CURETTE SIZE 2",ORSUP0023,CDM,272,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"CURETTE LUSK SZ 4 DISP",490419,CDM,272,RC,,,OUTPATIENT,,,509,330.85,,447.92,88,,358.34,,,0,"percent of total billed charges","88% of total billed charges",254.5,50,,203.60,,,0,"percent of total billed charges","50% of total billed charges",85.51,16.8,,68.41,,,0,"percent of total billed charges","16.8% of total billed charges",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.08,17.304,,70.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",320.67,63,,256.54,,,0,"percent of total billed charges","63% of total billed charges",77.88,15.3,,62.30,,,0,"percent of total billed charges","15.3% of total billed charges",85.51,16.8,,68.41,,,0,"percent of total billed charges","16.8% of total billed charges",351.21,69,,,,,0,"fee schedule","69% of total billed charges",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",314.82,61.85,,251.86,,,0,"percent of total billed charges","61.5% of total billed charges",85.51,16.8,,68.41,,,0,"percent of total billed charges","16.8% of total billed charges",254.5,50,,203.60,,,0,"percent of total billed charges","50% of total billed charges",163.9,32.2,,131.12,,,0,"percent of total billed charges","32.2% of total billed charges",85.51,16.8,,68.41,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.22,17.136,,69.78,,,0,"percent of total billed charges","17.136% of total billed charges",111.17,21.84,,88.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",191.89,37.7,,153.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",397.02,78,,317.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",420.43,82.6,,336.34,,,0,"percent of total billed charges","82.6% of total billed charges",85.51,16.8,,68.41,,,0,"percent of total billed charges","16.8% of total billed charges",254.5,50,,203.60,,,0,"percent of total billed charges","50% of total billed charges",420.43,82.6,,336.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.51,16.8,,68.41,,,0,"percent of total billed charges","16.8% of total billed charges",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",77.88,509,
"CURETTE STERILE DISP DERMAL INTEGRA 4MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CURETTE EAR 4MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CURETTE EAR LIGHTED VERSALOOP 2.5MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CURETTE EAR INFANT(BLUE) SINGLE ENDED 2MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CURETTE EAR INFANT(GRN) SINGLE ENDED 3MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CURETTE EAR LIGHTED WAVE 2.5MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CURITY AMNIOCENTTESIS TRAY 20GAX3.5IN",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"CUROS STRIPS",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"CURRETTE LATITUDE",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"CURRETTE VACUUM 7MM FLEX",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CURRETTE EAR CERA SPOON ADULT 4MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CURRETTE EAR LIGHTED ASSORTED TIP SIZES",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CURRETTE BIOPSY ENDOCERVICAL RETANGULAR TIP",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CURRETTE EAR MICROLOOP 3MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CUSTOM PERFUSION PACK",ORSUP0028,CDM,270,RC,,,OUTPATIENT,,,4553,2959.45,,4006.64,88,,3205.31,,,0,"percent of total billed charges","88% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",787.85,17.304,,630.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2868.39,63,,2294.71,,,0,"percent of total billed charges","63% of total billed charges",696.61,15.3,,557.29,,,0,"percent of total billed charges","15.3% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",3141.57,69,,,,,0,"fee schedule","69% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2816.03,61.85,,2252.82,,,0,"percent of total billed charges","61.5% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",1466.07,32.2,,1172.86,,,0,"percent of total billed charges","32.2% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",780.2,17.136,,624.16,,,0,"percent of total billed charges","17.136% of total billed charges",994.38,21.84,,795.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3551.34,78,,2841.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",696.61,4553,
"CUSTOM FOOT AND ANKLE PACK",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,17.304,,49.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.28,61.85,,178.62,,,0,"percent of total billed charges","61.5% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",116.24,32.2,,92.99,,,0,"percent of total billed charges","32.2% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.86,17.136,,49.49,,,0,"percent of total billed charges","17.136% of total billed charges",78.84,21.84,,63.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,361,
"CUTTER FLIP 2-6.5MM",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"CUTTER FLIP 9MM",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"CUTTER MENISCUS FULLRADIUS 4.5",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"CUTTER LINEAR TITANIUM 55MM",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"CUTTER RELOAD LINEAR BLUE 75MM",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"CUTTER RELOAD LINEAR BLUE 55MM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"CUTTER VASC/THIN ENDOPAT RELO",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CUTTER LINEAR THICK TISSUE 75M",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"CUTTER LINEAR ARTICULATING ECHELON 45",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"CUTTER ENDOSCOPIC LINEAR ARTICULATING 35MM WHITE",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"CUTTER DUAL EDGE 3.5MM",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"CUTTER 4.0MM SERRATED",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"CUTTER 3.5MM SERRATED",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"CUTTER AGGRESSIVE 2.5MM",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"CUVETTES ACL TOP 2400/BX 600 STRIPS",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"CUVETTES DISPOSABLE SQUARE",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"CUVETTES FS",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"CVD  EXTENDED MICRO TIP 4/CS",ORSUP0025,CDM,272,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"CYTOMAX II CYTOLOGY BRUSH",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"D AND E CYLINDER ROLLING CART",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"D AND E OXYGEN WRENCH",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"D-DIMER HS",ORSUP0031,CDM,270,RC,,,OUTPATIENT,,,5356,3481.4,,4713.28,88,,3770.62,,,0,"percent of total billed charges","88% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",926.8,17.304,,741.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3374.28,63,,2699.42,,,0,"percent of total billed charges","63% of total billed charges",819.47,15.3,,655.58,,,0,"percent of total billed charges","15.3% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",3695.64,69,,,,,0,"fee schedule","69% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3312.69,61.85,,2650.15,,,0,"percent of total billed charges","61.5% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",1724.63,32.2,,1379.70,,,0,"percent of total billed charges","32.2% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",917.8,17.136,,734.24,,,0,"percent of total billed charges","17.136% of total billed charges",1169.75,21.84,,935.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4177.68,78,,3342.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",819.47,5356,
"D-STAT KIT",ORSUP0016,CDM,270,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"D5W  ELECTROLYTE #48 500ML",56163,CDM,272,RC,,,OUTPATIENT,,,23,14.95,,20.24,88,,16.19,,,0,"percent of total billed charges","88% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.98,17.304,,3.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.49,63,,11.59,,,0,"percent of total billed charges","63% of total billed charges",3.52,15.3,,2.82,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",15.87,69,,,,,0,"fee schedule","69% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.23,61.85,,11.38,,,0,"percent of total billed charges","61.5% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",7.41,32.2,,5.93,,,0,"percent of total billed charges","32.2% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.94,17.136,,3.15,,,0,"percent of total billed charges","17.136% of total billed charges",5.02,21.84,,4.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.94,78,,14.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",3.52,23,
"D5W IV SOL 500ml",CATH00005,CDM,250,RC,,,OUTPATIENT,,,439,285.35,,386.32,88,,309.06,,,0,"percent of total billed charges","88% of total billed charges",219.5,50,,175.60,,,0,"percent of total billed charges","50% of total billed charges",73.75,16.8,,59.00,,,0,"percent of total billed charges","16.8% of total billed charges",439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.96,17.304,,60.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.57,63,,221.26,,,0,"percent of total billed charges","63% of total billed charges",67.17,15.3,,53.74,,,0,"percent of total billed charges","15.3% of total billed charges",73.75,16.8,,59.00,,,0,"percent of total billed charges","16.8% of total billed charges",302.91,69,,,,,0,"fee schedule","69% of total billed charges",439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",271.52,61.85,,217.22,,,0,"percent of total billed charges","61.5% of total billed charges",73.75,16.8,,59.00,,,0,"percent of total billed charges","16.8% of total billed charges",219.5,50,,175.60,,,0,"percent of total billed charges","50% of total billed charges",141.36,32.2,,113.09,,,0,"percent of total billed charges","32.2% of total billed charges",73.75,16.8,,59.00,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.23,17.136,,60.18,,,0,"percent of total billed charges","17.136% of total billed charges",95.88,21.84,,76.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",165.5,37.7,,132.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",342.42,78,,273.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",362.61,82.6,,290.09,,,0,"percent of total billed charges","82.6% of total billed charges",73.75,16.8,,59.00,,,0,"percent of total billed charges","16.8% of total billed charges",219.5,50,,175.60,,,0,"percent of total billed charges","50% of total billed charges",362.61,82.6,,290.09,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",73.75,16.8,,59.00,,,0,"percent of total billed charges","16.8% of total billed charges",439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",67.17,439,
"DA VINCI ENDO WRIST SUCTION IRRIGATOR",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"DATASCOPE EKG PAPER",490423,CDM,270,RC,,,OUTPATIENT,,,37,24.05,,32.56,88,,26.05,,,0,"percent of total billed charges","88% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.4,17.304,,5.12,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.31,63,,18.65,,,0,"percent of total billed charges","63% of total billed charges",5.66,15.3,,4.53,,,0,"percent of total billed charges","15.3% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",25.53,69,,,,,0,"fee schedule","69% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.88,61.85,,18.30,,,0,"percent of total billed charges","61.5% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",11.91,32.2,,9.53,,,0,"percent of total billed charges","32.2% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.34,17.136,,5.07,,,0,"percent of total billed charges","17.136% of total billed charges",8.08,21.84,,6.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.95,37.7,,11.16,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.86,78,,23.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",5.66,37,
"DBM MATRIX 2.5CM X 5CM",ORSUP0044,CDM,278,RC,,,OUTPATIENT,,,8837,5744.05,,7776.56,88,,6221.25,,,0,"percent of total billed charges","88% of total billed charges",4418.5,50,,3534.80,,,0,"percent of total billed charges","50% of total billed charges",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1529.15,17.304,,1223.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5567.31,63,,4453.85,,,0,"percent of total billed charges","63% of total billed charges",1352.06,15.3,,1081.65,,,0,"percent of total billed charges","15.3% of total billed charges",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",6097.53,69,,,,,0,"fee schedule","69% of total billed charges",8837,100,,7069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8837,100,,7069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8837,100,,7069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5465.68,61.85,,4372.54,,,0,"percent of total billed charges","61.5% of total billed charges",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",4418.5,50,,3534.80,,,0,"percent of total billed charges","50% of total billed charges",2845.51,32.2,,2276.41,,,0,"percent of total billed charges","32.2% of total billed charges",2757.14,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1514.31,17.136,,1211.45,,,0,"percent of total billed charges","17.136% of total billed charges",1930,21.84,,1544.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3331.55,37.7,,2665.24,,,0,"percent of total billed charges","37.7% of total billed charges",3331.55,37.7,,2665.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2995.74,33.9,,2396.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6892.86,78,,5514.29,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7299.36,82.6,,5839.49,,,0,"percent of total billed charges","82.6% of total billed charges",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",4418.5,50,,3534.80,,,0,"percent of total billed charges","50% of total billed charges",7299.36,82.6,,5839.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",8837,100,,7069.60,,,0,"percent of total billed charges","100% of total billed charges",1352.06,8837,
"DBM MATRIX 5CC ORTHOBLEND SMALL DEFGRAFTON",ORSUP0031,CDM,278,RC,,,OUTPATIENT,,,5356,3481.4,,4713.28,88,,3770.62,,,0,"percent of total billed charges","88% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",926.8,17.304,,741.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3374.28,63,,2699.42,,,0,"percent of total billed charges","63% of total billed charges",819.47,15.3,,655.58,,,0,"percent of total billed charges","15.3% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",3695.64,69,,,,,0,"fee schedule","69% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3312.69,61.85,,2650.15,,,0,"percent of total billed charges","61.5% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",1724.63,32.2,,1379.70,,,0,"percent of total billed charges","32.2% of total billed charges",1671.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",917.8,17.136,,734.24,,,0,"percent of total billed charges","17.136% of total billed charges",1169.75,21.84,,935.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.7% of total billed charges",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1815.68,33.9,,1452.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4177.68,78,,3342.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",819.47,5356,
"DEBRISOFT WOUND DEBRIDEMENT 10X10CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"DEBRISOFT LOLLY DEBRIDEMENT",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"DECONTAMINANT RNASE DISPLACE",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"DECONTAM GLOVE SIZE SMALL",490424,CDM,270,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"DEFIB PADS",490425,CDM,270,RC,,,OUTPATIENT,,,43,27.95,,37.84,88,,30.27,,,0,"percent of total billed charges","88% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.44,17.304,,5.95,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.09,63,,21.67,,,0,"percent of total billed charges","63% of total billed charges",6.58,15.3,,5.26,,,0,"percent of total billed charges","15.3% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",29.67,69,,,,,0,"fee schedule","69% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.6,61.85,,21.28,,,0,"percent of total billed charges","61.5% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",13.85,32.2,,11.08,,,0,"percent of total billed charges","32.2% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.37,17.136,,5.90,,,0,"percent of total billed charges","17.136% of total billed charges",9.39,21.84,,7.51,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.21,37.7,,12.97,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",33.54,78,,26.83,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.52,82.6,,28.42,,,0,"percent of total billed charges","82.6% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",35.52,82.6,,28.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",6.58,43,
"DEFIB PADS ADULT RADIOLUCENT W/LEADS-OUT PACKAGING",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"DEFIB PADS PEDIATRIC RADIOLUCENT W/LEADS-OUT PACKAGING",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"DEIONIZED WATER FILTER",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2266,1472.9,,1994.08,88,,1595.26,,,0,"percent of total billed charges","88% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",392.11,17.304,,313.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1427.58,63,,1142.06,,,0,"percent of total billed charges","63% of total billed charges",346.7,15.3,,277.36,,,0,"percent of total billed charges","15.3% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1563.54,69,,,,,0,"fee schedule","69% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1401.52,61.85,,1121.22,,,0,"percent of total billed charges","61.5% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",729.65,32.2,,583.72,,,0,"percent of total billed charges","32.2% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",388.3,17.136,,310.64,,,0,"percent of total billed charges","17.136% of total billed charges",494.89,21.84,,395.91,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",854.28,37.7,,683.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1767.48,78,,1413.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1871.72,82.6,,1497.38,,,0,"percent of total billed charges","82.6% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",1871.72,82.6,,1497.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",346.7,2266,
"DENSICHEK PLUS CALIBRARATION STANDARD",ORSUP0010,CDM,270,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"DENVER SPLINT 1500 SERIES MINI",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"DENVER NASAL SPLINT KIT LARGE LARGE",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"DEODORANT 1.5 OZ  ANTIPERSPIRANT LF",10194,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
DERMABOND,236127,CDM,272,RC,,,OUTPATIENT,,,587,381.55,,516.56,88,,413.25,,,0,"percent of total billed charges","88% of total billed charges",293.5,50,,234.80,,,0,"percent of total billed charges","50% of total billed charges",98.62,16.8,,78.90,,,0,"percent of total billed charges","16.8% of total billed charges",587,100,,469.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.57,17.304,,81.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",369.81,63,,295.85,,,0,"percent of total billed charges","63% of total billed charges",89.81,15.3,,71.85,,,0,"percent of total billed charges","15.3% of total billed charges",98.62,16.8,,78.90,,,0,"percent of total billed charges","16.8% of total billed charges",405.03,69,,,,,0,"fee schedule","69% of total billed charges",587,100,,469.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",587,100,,469.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",587,100,,469.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.06,61.85,,290.45,,,0,"percent of total billed charges","61.5% of total billed charges",98.62,16.8,,78.90,,,0,"percent of total billed charges","16.8% of total billed charges",293.5,50,,234.80,,,0,"percent of total billed charges","50% of total billed charges",189.01,32.2,,151.21,,,0,"percent of total billed charges","32.2% of total billed charges",98.62,16.8,,78.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",100.59,17.136,,80.47,,,0,"percent of total billed charges","17.136% of total billed charges",128.2,21.84,,102.56,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",221.3,37.7,,177.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",457.86,78,,366.29,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",484.86,82.6,,387.89,,,0,"percent of total billed charges","82.6% of total billed charges",98.62,16.8,,78.90,,,0,"percent of total billed charges","16.8% of total billed charges",293.5,50,,234.80,,,0,"percent of total billed charges","50% of total billed charges",484.86,82.6,,387.89,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.62,16.8,,78.90,,,0,"percent of total billed charges","16.8% of total billed charges",587,100,,469.60,,,0,"percent of total billed charges","100% of total billed charges",89.81,587,
"DERMACARRIERS 1.5:1",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"DERMABOND PRINEO SKIN CLOSURE",490427,CDM,270,RC,,,OUTPATIENT,,,760,494,,668.8,88,,535.04,,,0,"percent of total billed charges","88% of total billed charges",380,50,,304.00,,,0,"percent of total billed charges","50% of total billed charges",127.68,16.8,,102.14,,,0,"percent of total billed charges","16.8% of total billed charges",760,100,,608.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",131.51,17.304,,105.21,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",478.8,63,,383.04,,,0,"percent of total billed charges","63% of total billed charges",116.28,15.3,,93.02,,,0,"percent of total billed charges","15.3% of total billed charges",127.68,16.8,,102.14,,,0,"percent of total billed charges","16.8% of total billed charges",524.4,69,,,,,0,"fee schedule","69% of total billed charges",760,100,,608.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",760,100,,608.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",760,100,,608.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.06,61.85,,376.05,,,0,"percent of total billed charges","61.5% of total billed charges",127.68,16.8,,102.14,,,0,"percent of total billed charges","16.8% of total billed charges",380,50,,304.00,,,0,"percent of total billed charges","50% of total billed charges",244.72,32.2,,195.78,,,0,"percent of total billed charges","32.2% of total billed charges",127.68,16.8,,102.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",130.23,17.136,,104.18,,,0,"percent of total billed charges","17.136% of total billed charges",165.98,21.84,,132.78,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",286.52,37.7,,229.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",592.8,78,,474.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",627.76,82.6,,502.21,,,0,"percent of total billed charges","82.6% of total billed charges",127.68,16.8,,102.14,,,0,"percent of total billed charges","16.8% of total billed charges",380,50,,304.00,,,0,"percent of total billed charges","50% of total billed charges",627.76,82.6,,502.21,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.68,16.8,,102.14,,,0,"percent of total billed charges","16.8% of total billed charges",760,100,,608.00,,,0,"percent of total billed charges","100% of total billed charges",116.28,760,
"DERMATOME BLADE",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"DERMABOND SKIN ADHESIVE",490428,CDM,270,RC,,,OUTPATIENT,,,1912,1242.8,,1682.56,88,,1346.05,,,0,"percent of total billed charges","88% of total billed charges",956,50,,764.80,,,0,"percent of total billed charges","50% of total billed charges",321.22,16.8,,256.98,,,0,"percent of total billed charges","16.8% of total billed charges",1912,100,,1529.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",330.85,17.304,,264.68,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1204.56,63,,963.65,,,0,"percent of total billed charges","63% of total billed charges",292.54,15.3,,234.03,,,0,"percent of total billed charges","15.3% of total billed charges",321.22,16.8,,256.98,,,0,"percent of total billed charges","16.8% of total billed charges",1319.28,69,,,,,0,"fee schedule","69% of total billed charges",1912,100,,1529.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1912,100,,1529.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1912,100,,1529.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1182.57,61.85,,946.06,,,0,"percent of total billed charges","61.5% of total billed charges",321.22,16.8,,256.98,,,0,"percent of total billed charges","16.8% of total billed charges",956,50,,764.80,,,0,"percent of total billed charges","50% of total billed charges",615.66,32.2,,492.53,,,0,"percent of total billed charges","32.2% of total billed charges",321.22,16.8,,256.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",327.64,17.136,,262.11,,,0,"percent of total billed charges","17.136% of total billed charges",417.58,21.84,,334.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",720.82,37.7,,576.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1491.36,78,,1193.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1579.31,82.6,,1263.45,,,0,"percent of total billed charges","82.6% of total billed charges",321.22,16.8,,256.98,,,0,"percent of total billed charges","16.8% of total billed charges",956,50,,764.80,,,0,"percent of total billed charges","50% of total billed charges",1579.31,82.6,,1263.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",321.22,16.8,,256.98,,,0,"percent of total billed charges","16.8% of total billed charges",1912,100,,1529.60,,,0,"percent of total billed charges","100% of total billed charges",292.54,1912,
"DESICCANT PACKS BX / 2 SETS",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"DESICCANT STRG BX / 6 SACHETS",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"DESOXYCHOLATE BACTIDROP 10%",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DETERGENT INTERCEPT",311586,CDM,270,RC,,,OUTPATIENT,,,909,590.85,,799.92,88,,639.94,,,0,"percent of total billed charges","88% of total billed charges",454.5,50,,363.60,,,0,"percent of total billed charges","50% of total billed charges",152.71,16.8,,122.17,,,0,"percent of total billed charges","16.8% of total billed charges",909,100,,727.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.29,17.304,,125.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",572.67,63,,458.14,,,0,"percent of total billed charges","63% of total billed charges",139.08,15.3,,111.26,,,0,"percent of total billed charges","15.3% of total billed charges",152.71,16.8,,122.17,,,0,"percent of total billed charges","16.8% of total billed charges",627.21,69,,,,,0,"fee schedule","69% of total billed charges",909,100,,727.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",909,100,,727.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",909,100,,727.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",562.22,61.85,,449.78,,,0,"percent of total billed charges","61.5% of total billed charges",152.71,16.8,,122.17,,,0,"percent of total billed charges","16.8% of total billed charges",454.5,50,,363.60,,,0,"percent of total billed charges","50% of total billed charges",292.7,32.2,,234.16,,,0,"percent of total billed charges","32.2% of total billed charges",152.71,16.8,,122.17,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.77,17.136,,124.62,,,0,"percent of total billed charges","17.136% of total billed charges",198.53,21.84,,158.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",342.69,37.7,,274.15,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",709.02,78,,567.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",750.83,82.6,,600.66,,,0,"percent of total billed charges","82.6% of total billed charges",152.71,16.8,,122.17,,,0,"percent of total billed charges","16.8% of total billed charges",454.5,50,,363.60,,,0,"percent of total billed charges","50% of total billed charges",750.83,82.6,,600.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",152.71,16.8,,122.17,,,0,"percent of total billed charges","16.8% of total billed charges",909,100,,727.20,,,0,"percent of total billed charges","100% of total billed charges",139.08,909,
"DETERGENT LOW SUDS LIQUID",14272,CDM,270,RC,,,OUTPATIENT,,,105,68.25,,92.4,88,,73.92,,,0,"percent of total billed charges","88% of total billed charges",52.5,50,,42.00,,,0,"percent of total billed charges","50% of total billed charges",17.64,16.8,,14.11,,,0,"percent of total billed charges","16.8% of total billed charges",105,100,,84.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.17,17.304,,14.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",66.15,63,,52.92,,,0,"percent of total billed charges","63% of total billed charges",16.07,15.3,,12.86,,,0,"percent of total billed charges","15.3% of total billed charges",17.64,16.8,,14.11,,,0,"percent of total billed charges","16.8% of total billed charges",72.45,69,,,,,0,"fee schedule","69% of total billed charges",105,100,,84.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",105,100,,84.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",105,100,,84.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.94,61.85,,51.95,,,0,"percent of total billed charges","61.5% of total billed charges",17.64,16.8,,14.11,,,0,"percent of total billed charges","16.8% of total billed charges",52.5,50,,42.00,,,0,"percent of total billed charges","50% of total billed charges",33.81,32.2,,27.05,,,0,"percent of total billed charges","32.2% of total billed charges",17.64,16.8,,14.11,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.99,17.136,,14.39,,,0,"percent of total billed charges","17.136% of total billed charges",22.93,21.84,,18.34,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39.59,37.7,,31.67,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",81.9,78,,65.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.73,82.6,,69.38,,,0,"percent of total billed charges","82.6% of total billed charges",17.64,16.8,,14.11,,,0,"percent of total billed charges","16.8% of total billed charges",52.5,50,,42.00,,,0,"percent of total billed charges","50% of total billed charges",86.73,82.6,,69.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.64,16.8,,14.11,,,0,"percent of total billed charges","16.8% of total billed charges",105,100,,84.00,,,0,"percent of total billed charges","100% of total billed charges",16.07,105,
"DETERGENT NEPTUNE DOCKING",278934,CDM,270,RC,,,OUTPATIENT,,,1658,1077.7,,1459.04,88,,1167.23,,,0,"percent of total billed charges","88% of total billed charges",829,50,,663.20,,,0,"percent of total billed charges","50% of total billed charges",278.54,16.8,,222.83,,,0,"percent of total billed charges","16.8% of total billed charges",1658,100,,1326.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",286.9,17.304,,229.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.54,63,,835.63,,,0,"percent of total billed charges","63% of total billed charges",253.67,15.3,,202.94,,,0,"percent of total billed charges","15.3% of total billed charges",278.54,16.8,,222.83,,,0,"percent of total billed charges","16.8% of total billed charges",1144.02,69,,,,,0,"fee schedule","69% of total billed charges",1658,100,,1326.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1658,100,,1326.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1658,100,,1326.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1025.47,61.85,,820.38,,,0,"percent of total billed charges","61.5% of total billed charges",278.54,16.8,,222.83,,,0,"percent of total billed charges","16.8% of total billed charges",829,50,,663.20,,,0,"percent of total billed charges","50% of total billed charges",533.88,32.2,,427.10,,,0,"percent of total billed charges","32.2% of total billed charges",278.54,16.8,,222.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",284.11,17.136,,227.29,,,0,"percent of total billed charges","17.136% of total billed charges",362.11,21.84,,289.69,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",625.07,37.7,,500.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1293.24,78,,1034.59,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1369.51,82.6,,1095.61,,,0,"percent of total billed charges","82.6% of total billed charges",278.54,16.8,,222.83,,,0,"percent of total billed charges","16.8% of total billed charges",829,50,,663.20,,,0,"percent of total billed charges","50% of total billed charges",1369.51,82.6,,1095.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",278.54,16.8,,222.83,,,0,"percent of total billed charges","16.8% of total billed charges",1658,100,,1326.40,,,0,"percent of total billed charges","100% of total billed charges",253.67,1658,
"DEVICE BONE FILLER KYPHX",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"DEVICE SPIDER EMB 40X320 FX",ORSUP0038,CDM,278,RC,,,OUTPATIENT,,,7231,4700.15,,6363.28,88,,5090.62,,,0,"percent of total billed charges","88% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1251.25,17.304,,1001.00,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4555.53,63,,3644.42,,,0,"percent of total billed charges","63% of total billed charges",1106.34,15.3,,885.07,,,0,"percent of total billed charges","15.3% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4989.39,69,,,,,0,"fee schedule","69% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4472.37,61.85,,3577.90,,,0,"percent of total billed charges","61.5% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",2328.38,32.2,,1862.70,,,0,"percent of total billed charges","32.2% of total billed charges",2256.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1239.1,17.136,,991.28,,,0,"percent of total billed charges","17.136% of total billed charges",1579.25,21.84,,1263.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.7% of total billed charges",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2451.31,33.9,,1961.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5640.18,78,,4512.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",1106.34,7231,
"DEVICE SPIDER EMB 70X320 FX",ORSUP0038,CDM,278,RC,,,OUTPATIENT,,,7231,4700.15,,6363.28,88,,5090.62,,,0,"percent of total billed charges","88% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1251.25,17.304,,1001.00,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4555.53,63,,3644.42,,,0,"percent of total billed charges","63% of total billed charges",1106.34,15.3,,885.07,,,0,"percent of total billed charges","15.3% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4989.39,69,,,,,0,"fee schedule","69% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4472.37,61.85,,3577.90,,,0,"percent of total billed charges","61.5% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",2328.38,32.2,,1862.70,,,0,"percent of total billed charges","32.2% of total billed charges",2256.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1239.1,17.136,,991.28,,,0,"percent of total billed charges","17.136% of total billed charges",1579.25,21.84,,1263.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.7% of total billed charges",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2451.31,33.9,,1961.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5640.18,78,,4512.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",1106.34,7231,
"DEVICE PROGRAMMER PATIENT",ORSUP0030,CDM,278,RC,,,OUTPATIENT,,,5088,3307.2,,4477.44,88,,3581.95,,,0,"percent of total billed charges","88% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",880.43,17.304,,704.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3205.44,63,,2564.35,,,0,"percent of total billed charges","63% of total billed charges",778.46,15.3,,622.77,,,0,"percent of total billed charges","15.3% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",3510.72,69,,,,,0,"fee schedule","69% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3146.93,61.85,,2517.54,,,0,"percent of total billed charges","61.5% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",1638.34,32.2,,1310.67,,,0,"percent of total billed charges","32.2% of total billed charges",1587.46,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",871.88,17.136,,697.50,,,0,"percent of total billed charges","17.136% of total billed charges",1111.22,21.84,,888.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1918.18,37.7,,1534.54,,,0,"percent of total billed charges","37.7% of total billed charges",1918.18,37.7,,1534.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1724.83,33.9,,1379.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3968.64,78,,3174.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",778.46,5088,
"DEVICE MRI POWERPORT W/ 8 FR ATTACHABLE CHRONOFLEX CATH",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,1854,1205.1,,1631.52,88,,1305.22,,,0,"percent of total billed charges","88% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",320.82,17.304,,256.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1168.02,63,,934.42,,,0,"percent of total billed charges","63% of total billed charges",283.66,15.3,,226.93,,,0,"percent of total billed charges","15.3% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1279.26,69,,,,,0,"fee schedule","69% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1146.7,61.85,,917.36,,,0,"percent of total billed charges","61.5% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",596.99,32.2,,477.59,,,0,"percent of total billed charges","32.2% of total billed charges",578.45,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",317.7,17.136,,254.16,,,0,"percent of total billed charges","17.136% of total billed charges",404.91,21.84,,323.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",698.96,37.7,,559.17,,,0,"percent of total billed charges","37.7% of total billed charges",698.96,37.7,,559.17,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",628.51,33.9,,502.81,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1446.12,78,,1156.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1531.4,82.6,,1225.12,,,0,"percent of total billed charges","82.6% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",1531.4,82.6,,1225.12,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",283.66,1854,
"DEVICE XPOSE ACCESS",ORSUP0028,CDM,272,RC,,,OUTPATIENT,,,4553,2959.45,,4006.64,88,,3205.31,,,0,"percent of total billed charges","88% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",787.85,17.304,,630.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2868.39,63,,2294.71,,,0,"percent of total billed charges","63% of total billed charges",696.61,15.3,,557.29,,,0,"percent of total billed charges","15.3% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",3141.57,69,,,,,0,"fee schedule","69% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2816.03,61.85,,2252.82,,,0,"percent of total billed charges","61.5% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",1466.07,32.2,,1172.86,,,0,"percent of total billed charges","32.2% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",780.2,17.136,,624.16,,,0,"percent of total billed charges","17.136% of total billed charges",994.38,21.84,,795.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3551.34,78,,2841.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",696.61,4553,
"DEVICE TYPE SAFE SEGMENT PIERCING",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"DEVICE ENDO STITCH SUTURING",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"DEVICE CATHETER SECUREMENT STATLOCK",257379,CDM,272,RC,,,OUTPATIENT,,,25,16.25,,22,88,,17.60,,,0,"percent of total billed charges","88% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,17.304,,3.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.75,63,,12.60,,,0,"percent of total billed charges","63% of total billed charges",3.83,15.3,,3.06,,,0,"percent of total billed charges","15.3% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",17.25,69,,,,,0,"fee schedule","69% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.46,61.85,,12.37,,,0,"percent of total billed charges","61.5% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",8.05,32.2,,6.44,,,0,"percent of total billed charges","32.2% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.28,17.136,,3.42,,,0,"percent of total billed charges","17.136% of total billed charges",5.46,21.84,,4.37,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.43,37.7,,7.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.5,78,,15.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",3.83,25,
"DEVICE FASTFIX 360 CURVED MENISCAL REPAIR SYS",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"DEVICE GELPORT HAND ACCESS",ORSUP0025,CDM,272,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"DEVICE LATERAL TRACTION",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"DEVICE SINUS BALLOON INFLATION",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"DEVICE HEMOSTATIC L38CM XL ARISTA AH",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"DEX 5% LACTATED RINGERS POT CHR 20MEQ 1000ML PB",153419,CDM,272,RC,,,OUTPATIENT,,,30,19.5,,26.4,88,,21.12,,,0,"percent of total billed charges","88% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.19,17.304,,4.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.9,63,,15.12,,,0,"percent of total billed charges","63% of total billed charges",4.59,15.3,,3.67,,,0,"percent of total billed charges","15.3% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",20.7,69,,,,,0,"fee schedule","69% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.56,61.85,,14.85,,,0,"percent of total billed charges","61.5% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",9.66,32.2,,7.73,,,0,"percent of total billed charges","32.2% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.14,17.136,,4.11,,,0,"percent of total billed charges","17.136% of total billed charges",6.55,21.84,,5.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.31,37.7,,9.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.4,78,,18.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",4.59,30,
"DEXTROSE 5% INJECTION 250ML BAG",161239,CDM,258,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.9,61.85,,7.92,,,0,"percent of total billed charges","61.5% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"DEXTROSE 5% INJECTION 500ML BAG",161241,CDM,258,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"DIAPERS LITTLE MOVERS SZ-3",184375,CDM,272,RC,,,OUTPATIENT,,,28,18.2,,24.64,88,,19.71,,,0,"percent of total billed charges","88% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.85,17.304,,3.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.64,63,,14.11,,,0,"percent of total billed charges","63% of total billed charges",4.28,15.3,,3.42,,,0,"percent of total billed charges","15.3% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",19.32,69,,,,,0,"fee schedule","69% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.32,61.85,,13.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",9.02,32.2,,7.22,,,0,"percent of total billed charges","32.2% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.8,17.136,,3.84,,,0,"percent of total billed charges","17.136% of total billed charges",6.12,21.84,,4.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.56,37.7,,8.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.84,78,,17.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",4.28,28,
"DIAPERS LITTLE MOVERS SZ-4",184376,CDM,272,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"DIESSE MINI-CUBE PAPER",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"DIESSE MINICUBE TRNSPNDR 1000T",ORSUP0038,CDM,272,RC,,,OUTPATIENT,,,5562,3615.3,,4894.56,88,,3915.65,,,0,"percent of total billed charges","88% of total billed charges",2781,50,,2224.80,,,0,"percent of total billed charges","50% of total billed charges",934.42,16.8,,747.54,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",962.45,17.304,,769.96,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3504.06,63,,2803.25,,,0,"percent of total billed charges","63% of total billed charges",850.99,15.3,,680.79,,,0,"percent of total billed charges","15.3% of total billed charges",934.42,16.8,,747.54,,,0,"percent of total billed charges","16.8% of total billed charges",3837.78,69,,,,,0,"fee schedule","69% of total billed charges",5562,100,,4449.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5562,100,,4449.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5562,100,,4449.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3440.1,61.85,,2752.08,,,0,"percent of total billed charges","61.5% of total billed charges",934.42,16.8,,747.54,,,0,"percent of total billed charges","16.8% of total billed charges",2781,50,,2224.80,,,0,"percent of total billed charges","50% of total billed charges",1790.96,32.2,,1432.77,,,0,"percent of total billed charges","32.2% of total billed charges",934.42,16.8,,747.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",953.1,17.136,,762.48,,,0,"percent of total billed charges","17.136% of total billed charges",1214.74,21.84,,971.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2096.87,37.7,,1677.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4338.36,78,,3470.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4594.21,82.6,,3675.37,,,0,"percent of total billed charges","82.6% of total billed charges",934.42,16.8,,747.54,,,0,"percent of total billed charges","16.8% of total billed charges",2781,50,,2224.80,,,0,"percent of total billed charges","50% of total billed charges",4594.21,82.6,,3675.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",934.42,16.8,,747.54,,,0,"percent of total billed charges","16.8% of total billed charges",5562,100,,4449.60,,,0,"percent of total billed charges","100% of total billed charges",850.99,5562,
"DIESSE MINICUBE TRNSPNDR 500T",ORSUP0026,CDM,272,RC,,,OUTPATIENT,,,3090,2008.5,,2719.2,88,,2175.36,,,0,"percent of total billed charges","88% of total billed charges",1545,50,,1236.00,,,0,"percent of total billed charges","50% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",534.69,17.304,,427.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1946.7,63,,1557.36,,,0,"percent of total billed charges","63% of total billed charges",472.77,15.3,,378.22,,,0,"percent of total billed charges","15.3% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",2132.1,69,,,,,0,"fee schedule","69% of total billed charges",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1911.17,61.85,,1528.94,,,0,"percent of total billed charges","61.5% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",1545,50,,1236.00,,,0,"percent of total billed charges","50% of total billed charges",994.98,32.2,,795.98,,,0,"percent of total billed charges","32.2% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",529.5,17.136,,423.60,,,0,"percent of total billed charges","17.136% of total billed charges",674.86,21.84,,539.89,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1164.93,37.7,,931.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2410.2,78,,1928.16,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2552.34,82.6,,2041.87,,,0,"percent of total billed charges","82.6% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",1545,50,,1236.00,,,0,"percent of total billed charges","50% of total billed charges",2552.34,82.6,,2041.87,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",472.77,3090,
"DIFF D X H FP PACK",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"DIFF-SAFE 101",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DIGOXIN / 5 PACK / 90 SLIDES",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"DILATOR NOTTINGHAM ON-STEP 12F-18F  X 70CM",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"DILATOR 8FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"DILATOR 6FR STANDARD",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DILATOR 5FR STANDARD",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DILATOR 18FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DILATOR 20FR",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"DILATOR 16FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DILATOR 10 FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"DILATOR 12 FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"DILATOR 14 FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"DILUENT RED BLOOD CELL FOR MTS GEL SYSTEM 4X125ML",ORSUP0014,CDM,270,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"DILUENT PACK 1 BX / 3 PACKS",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"DILUENT PACK 2 BX / 3 PACKS",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"DILUENT PACK 3 BX / 3 PACKS",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"DIRECT INJECTION 10CC",ORSUP0113,CDM,278,RC,,,OUTPATIENT,,,23834,15492.1,,20973.92,88,,16779.14,,,0,"percent of total billed charges","88% of total billed charges",11917,50,,9533.60,,,0,"percent of total billed charges","50% of total billed charges",4004.11,16.8,,3203.29,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4124.24,17.304,,3299.39,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15015.42,63,,12012.34,,,0,"percent of total billed charges","63% of total billed charges",3646.6,15.3,,2917.28,,,0,"percent of total billed charges","15.3% of total billed charges",4004.11,16.8,,3203.29,,,0,"percent of total billed charges","16.8% of total billed charges",16445.46,69,,,,,0,"fee schedule","69% of total billed charges",23834,100,,19067.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23834,100,,19067.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23834,100,,19067.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14741.33,61.85,,11793.06,,,0,"percent of total billed charges","61.5% of total billed charges",4004.11,16.8,,3203.29,,,0,"percent of total billed charges","16.8% of total billed charges",11917,50,,9533.60,,,0,"percent of total billed charges","50% of total billed charges",7674.55,32.2,,6139.64,,,0,"percent of total billed charges","32.2% of total billed charges",7436.21,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",4084.19,17.136,,3267.35,,,0,"percent of total billed charges","17.136% of total billed charges",5205.35,21.84,,4164.28,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",8985.42,37.7,,7188.34,,,0,"percent of total billed charges","37.7% of total billed charges",8985.42,37.7,,7188.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",8079.73,33.9,,6463.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",18590.52,78,,14872.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19686.88,82.6,,15749.50,,,0,"percent of total billed charges","82.6% of total billed charges",4004.11,16.8,,3203.29,,,0,"percent of total billed charges","16.8% of total billed charges",11917,50,,9533.60,,,0,"percent of total billed charges","50% of total billed charges",19686.88,82.6,,15749.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4004.11,16.8,,3203.29,,,0,"percent of total billed charges","16.8% of total billed charges",23834,100,,19067.20,,,0,"percent of total billed charges","100% of total billed charges",3646.6,23834,
"DIRECT HDL / 5 PACK / 300 SLDS",ORSUP0019,CDM,272,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"DISCONTINUED MESH DEXON 7979-00",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"DISECTOR 3.5",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"DISINFECTANT TF-8 HIGH LEVEL",484299,CDM,270,RC,,,OUTPATIENT,,,3133,2036.45,,2757.04,88,,2205.63,,,0,"percent of total billed charges","88% of total billed charges",1566.5,50,,1253.20,,,0,"percent of total billed charges","50% of total billed charges",526.34,16.8,,421.07,,,0,"percent of total billed charges","16.8% of total billed charges",3133,100,,2506.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",542.13,17.304,,433.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1973.79,63,,1579.03,,,0,"percent of total billed charges","63% of total billed charges",479.35,15.3,,383.48,,,0,"percent of total billed charges","15.3% of total billed charges",526.34,16.8,,421.07,,,0,"percent of total billed charges","16.8% of total billed charges",2161.77,69,,,,,0,"fee schedule","69% of total billed charges",3133,100,,2506.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3133,100,,2506.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3133,100,,2506.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1937.76,61.85,,1550.21,,,0,"percent of total billed charges","61.5% of total billed charges",526.34,16.8,,421.07,,,0,"percent of total billed charges","16.8% of total billed charges",1566.5,50,,1253.20,,,0,"percent of total billed charges","50% of total billed charges",1008.83,32.2,,807.06,,,0,"percent of total billed charges","32.2% of total billed charges",526.34,16.8,,421.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",536.87,17.136,,429.50,,,0,"percent of total billed charges","17.136% of total billed charges",684.25,21.84,,547.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1181.14,37.7,,944.91,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2443.74,78,,1954.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2587.86,82.6,,2070.29,,,0,"percent of total billed charges","82.6% of total billed charges",526.34,16.8,,421.07,,,0,"percent of total billed charges","16.8% of total billed charges",1566.5,50,,1253.20,,,0,"percent of total billed charges","50% of total billed charges",2587.86,82.6,,2070.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",526.34,16.8,,421.07,,,0,"percent of total billed charges","16.8% of total billed charges",3133,100,,2506.40,,,0,"percent of total billed charges","100% of total billed charges",479.35,3133,
"DISINFECTANT SONEX-HL TROPHON 80 ML",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"DISPOSABLE NS OR TOWEL",490432,CDM,270,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"DISPOSABLE STERILE OR TOWELS",490433,CDM,272,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.9,61.85,,7.92,,,0,"percent of total billed charges","61.5% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"CATH WHISTLE TIP URET 7FR RT",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"DISPOSABLE FILTER CONCENTRATOR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DISPOSABLE INFUSION ABGS 1000ML",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"DISP LARYNGOSCOPE BLADE \\T\\ HANDLE 30MM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"DISP LARYNGOSCOPE BLADE \\T\\ HANDLE #2",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"DISP LARYNGOSCOPE BLADE \\T\\ HANDLE #00",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"DISP LARYNGOSCOPE BLADE \\T\\ HANDLE #4",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"DISP LARYNGOSCOPE BLADE \\T\\ HANDLE 20MM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"DISP RIGID CURETTE 16MM CURVED",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"DISP RIGID CURETTE 7MM STRIAGHT",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"DISSECTING TOOL L9CM OD6MM LEGEND BALL",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"DISSECTING TOOL MIDAS REX  8TD114",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"DISSECTING TOOL #9BA75",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"DISSECTING TOOL #9BA60",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"DISSECTING TOOL #14MH30",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"DISSECTING TOOL #26BA60",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"DISSECTING TOOL #T9MH25",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"DISSECTING TOOL #T9MH25D",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"DISSECTING TOOL T12",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"DISSECTINT TOOLS M-8",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"DISSECTOR CURVED BLADE",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"DISSECTING TOOL #9BA40D",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"DISSECTING TOOL #F2/8TA23",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"DISSECTING TOOL #9BA40",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"DISSECTING TOOL #14BA40",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"DISSECTOR MARYLAND 5MM DA VINCI",ORSUP0027,CDM,272,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"DISSECTOR TIP RIGHT ANGLE 5MM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"DO NOT USE LABEL",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,464,301.6,,408.32,88,,326.66,,,0,"percent of total billed charges","88% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.29,17.304,,64.23,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.32,63,,233.86,,,0,"percent of total billed charges","63% of total billed charges",70.99,15.3,,56.79,,,0,"percent of total billed charges","15.3% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",320.16,69,,,,,0,"fee schedule","69% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",286.98,61.85,,229.58,,,0,"percent of total billed charges","61.5% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",149.41,32.2,,119.53,,,0,"percent of total billed charges","32.2% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.51,17.136,,63.61,,,0,"percent of total billed charges","17.136% of total billed charges",101.34,21.84,,81.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",174.93,37.7,,139.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",361.92,78,,289.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",70.99,464,
"DOC EXTN  WIRE",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"DOPPLER PENCIL 8.1",ORSUP0014,CDM,270,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"DORNHOFFER TOTAL MIDDLE EAR",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"DORNIER SINGLEFLEX 270 HOLMIUM FLAT TIP FIBER",ORSUP0025,CDM,272,RC,,,OUTPATIENT,,,1494,971.1,,1314.72,88,,1051.78,,,0,"percent of total billed charges","88% of total billed charges",747,50,,597.60,,,0,"percent of total billed charges","50% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.52,17.304,,206.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",941.22,63,,752.98,,,0,"percent of total billed charges","63% of total billed charges",228.58,15.3,,182.86,,,0,"percent of total billed charges","15.3% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",1030.86,69,,,,,0,"fee schedule","69% of total billed charges",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",924.04,61.85,,739.23,,,0,"percent of total billed charges","61.5% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",747,50,,597.60,,,0,"percent of total billed charges","50% of total billed charges",481.07,32.2,,384.86,,,0,"percent of total billed charges","32.2% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",256.01,17.136,,204.81,,,0,"percent of total billed charges","17.136% of total billed charges",326.29,21.84,,261.03,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",563.24,37.7,,450.59,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1165.32,78,,932.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1234.04,82.6,,987.23,,,0,"percent of total billed charges","82.6% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",747,50,,597.60,,,0,"percent of total billed charges","50% of total billed charges",1234.04,82.6,,987.23,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",228.58,1494,
"DORNIER SINGLEFLEX 400 HOLMIUM FLAT TIP FIBER",ORSUP0025,CDM,272,RC,,,OUTPATIENT,,,1648,1071.2,,1450.24,88,,1160.19,,,0,"percent of total billed charges","88% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",285.17,17.304,,228.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1038.24,63,,830.59,,,0,"percent of total billed charges","63% of total billed charges",252.14,15.3,,201.71,,,0,"percent of total billed charges","15.3% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1137.12,69,,,,,0,"fee schedule","69% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.29,61.85,,815.43,,,0,"percent of total billed charges","61.5% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",530.66,32.2,,424.53,,,0,"percent of total billed charges","32.2% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",282.4,17.136,,225.92,,,0,"percent of total billed charges","17.136% of total billed charges",359.92,21.84,,287.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",621.3,37.7,,497.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1285.44,78,,1028.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1361.25,82.6,,1089.00,,,0,"percent of total billed charges","82.6% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",1361.25,82.6,,1089.00,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",252.14,1648,
"DORNIER SINGLEFLEX 1000 HOLMIUM FLAT TIP FIBER",ORSUP0039,CDM,272,RC,,,OUTPATIENT,,,5768,3749.2,,5075.84,88,,4060.67,,,0,"percent of total billed charges","88% of total billed charges",2884,50,,2307.20,,,0,"percent of total billed charges","50% of total billed charges",969.02,16.8,,775.22,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",998.09,17.304,,798.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3633.84,63,,2907.07,,,0,"percent of total billed charges","63% of total billed charges",882.5,15.3,,706.00,,,0,"percent of total billed charges","15.3% of total billed charges",969.02,16.8,,775.22,,,0,"percent of total billed charges","16.8% of total billed charges",3979.92,69,,,,,0,"fee schedule","69% of total billed charges",5768,100,,4614.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5768,100,,4614.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5768,100,,4614.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3567.51,61.85,,2854.01,,,0,"percent of total billed charges","61.5% of total billed charges",969.02,16.8,,775.22,,,0,"percent of total billed charges","16.8% of total billed charges",2884,50,,2307.20,,,0,"percent of total billed charges","50% of total billed charges",1857.3,32.2,,1485.84,,,0,"percent of total billed charges","32.2% of total billed charges",969.02,16.8,,775.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",988.4,17.136,,790.72,,,0,"percent of total billed charges","17.136% of total billed charges",1259.73,21.84,,1007.78,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2174.54,37.7,,1739.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4499.04,78,,3599.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4764.37,82.6,,3811.50,,,0,"percent of total billed charges","82.6% of total billed charges",969.02,16.8,,775.22,,,0,"percent of total billed charges","16.8% of total billed charges",2884,50,,2307.20,,,0,"percent of total billed charges","50% of total billed charges",4764.37,82.6,,3811.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",969.02,16.8,,775.22,,,0,"percent of total billed charges","16.8% of total billed charges",5768,100,,4614.40,,,0,"percent of total billed charges","100% of total billed charges",882.5,5768,
"DOUBLECUT 4.0MM",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"DOUBLECUT CURVED 4.0MM",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"DOUBLE BASIN PACK",433366,CDM,270,RC,,,OUTPATIENT,,,58,37.7,,51.04,88,,40.83,,,0,"percent of total billed charges","88% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.04,17.304,,8.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.54,63,,29.23,,,0,"percent of total billed charges","63% of total billed charges",8.87,15.3,,7.10,,,0,"percent of total billed charges","15.3% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",40.02,69,,,,,0,"fee schedule","69% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.87,61.85,,28.70,,,0,"percent of total billed charges","61.5% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",18.68,32.2,,14.94,,,0,"percent of total billed charges","32.2% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.94,17.136,,7.95,,,0,"percent of total billed charges","17.136% of total billed charges",12.67,21.84,,10.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.87,37.7,,17.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",45.24,78,,36.19,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",8.87,58,
"DR DONS ARM CANOE FOAM",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.94,17.304,,85.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.23,61.85,,305.78,,,0,"percent of total billed charges","61.5% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",199,32.2,,159.20,,,0,"percent of total billed charges","32.2% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.136,,84.72,,,0,"percent of total billed charges","17.136% of total billed charges",134.97,21.84,,107.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,618,
"DRAIN BLAKE 24FR SILICONE 4 CHANNEL",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"DRAIN J P 10MM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"DRAIN ROUND 10  0070210",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"DRAIN ROUND FULL FLUTED 15FR",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"DRIAN BLAKE FLAT 7F",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"DRAIN PENROSE 5/8",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRAINAGE BAG W/ANTI RELUX VALVE FOR LIMITORR",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"DRAIN BLAKE RND FLUTED STR 19FR",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"DRAIN SILICONE FLAT 10MM FULL PERFORATION STRL",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"HEMOVAC MINI 7MM",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"DRAIN BAG 2000CC",490436,CDM,270,RC,,,OUTPATIENT,,,22,14.3,,19.36,88,,15.49,,,0,"percent of total billed charges","88% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.81,17.304,,3.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.86,63,,11.09,,,0,"percent of total billed charges","63% of total billed charges",3.37,15.3,,2.70,,,0,"percent of total billed charges","15.3% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",15.18,69,,,,,0,"fee schedule","69% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.61,61.85,,10.89,,,0,"percent of total billed charges","61.5% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",7.08,32.2,,5.66,,,0,"percent of total billed charges","32.2% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.77,17.136,,3.02,,,0,"percent of total billed charges","17.136% of total billed charges",4.8,21.84,,3.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.29,37.7,,6.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.16,78,,13.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",3.37,22,
"DRAIN BAG 4000CC",490437,CDM,270,RC,,,OUTPATIENT,,,42,27.3,,36.96,88,,29.57,,,0,"percent of total billed charges","88% of total billed charges",21,50,,16.80,,,0,"percent of total billed charges","50% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.27,17.304,,5.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.46,63,,21.17,,,0,"percent of total billed charges","63% of total billed charges",6.43,15.3,,5.14,,,0,"percent of total billed charges","15.3% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",28.98,69,,,,,0,"fee schedule","69% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.98,61.85,,20.78,,,0,"percent of total billed charges","61.5% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",21,50,,16.80,,,0,"percent of total billed charges","50% of total billed charges",13.52,32.2,,10.82,,,0,"percent of total billed charges","32.2% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.2,17.136,,5.76,,,0,"percent of total billed charges","17.136% of total billed charges",9.17,21.84,,7.34,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",32.76,78,,26.21,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",21,50,,16.80,,,0,"percent of total billed charges","50% of total billed charges",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",6.43,42,
"DRAIN BLAKE 7 MM FLAT",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"DRAIN BAG CYSTO/UROLOGY",490438,CDM,270,RC,,,OUTPATIENT,,,85,55.25,,74.8,88,,59.84,,,0,"percent of total billed charges","88% of total billed charges",42.5,50,,34.00,,,0,"percent of total billed charges","50% of total billed charges",14.28,16.8,,11.42,,,0,"percent of total billed charges","16.8% of total billed charges",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.71,17.304,,11.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.55,63,,42.84,,,0,"percent of total billed charges","63% of total billed charges",13.01,15.3,,10.41,,,0,"percent of total billed charges","15.3% of total billed charges",14.28,16.8,,11.42,,,0,"percent of total billed charges","16.8% of total billed charges",58.65,69,,,,,0,"fee schedule","69% of total billed charges",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.57,61.85,,42.06,,,0,"percent of total billed charges","61.5% of total billed charges",14.28,16.8,,11.42,,,0,"percent of total billed charges","16.8% of total billed charges",42.5,50,,34.00,,,0,"percent of total billed charges","50% of total billed charges",27.37,32.2,,21.90,,,0,"percent of total billed charges","32.2% of total billed charges",14.28,16.8,,11.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.57,17.136,,11.66,,,0,"percent of total billed charges","17.136% of total billed charges",18.56,21.84,,14.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",32.05,37.7,,25.64,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",66.3,78,,53.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.21,82.6,,56.17,,,0,"percent of total billed charges","82.6% of total billed charges",14.28,16.8,,11.42,,,0,"percent of total billed charges","16.8% of total billed charges",42.5,50,,34.00,,,0,"percent of total billed charges","50% of total billed charges",70.21,82.6,,56.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.28,16.8,,11.42,,,0,"percent of total billed charges","16.8% of total billed charges",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",13.01,85,
"DRAIN BLAKE 10FR",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"DRAIN BLAKE 15FR",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"DRAIN BLAKE 19FR",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"DRAIN BULB",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"DRAIN PENROSE",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRAIN CHEST VALVE SET",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"DRAINAGE SET 10.2FR X 25CM",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"DRAIN CATTELL T-TUBE 20 FR",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"DRAIN BAG ANTI-REFLUX L/F 2000ML",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRAIN BAG 4L A/R LL SLIDE TAP",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRAINAGE KIT PLEURAL W/Bottle",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"DRAPE TOP 102X53 STERILE",187597,CDM,272,RC,,,OUTPATIENT,,,45,29.25,,39.6,88,,31.68,,,0,"percent of total billed charges","88% of total billed charges",22.5,50,,18.00,,,0,"percent of total billed charges","50% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.79,17.304,,6.23,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.35,63,,22.68,,,0,"percent of total billed charges","63% of total billed charges",6.89,15.3,,5.51,,,0,"percent of total billed charges","15.3% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",31.05,69,,,,,0,"fee schedule","69% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.83,61.85,,22.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",22.5,50,,18.00,,,0,"percent of total billed charges","50% of total billed charges",14.49,32.2,,11.59,,,0,"percent of total billed charges","32.2% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.71,17.136,,6.17,,,0,"percent of total billed charges","17.136% of total billed charges",9.83,21.84,,7.86,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.97,37.7,,13.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.1,78,,28.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",22.5,50,,18.00,,,0,"percent of total billed charges","50% of total billed charges",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",6.89,45,
"DRAPE T LAPARO TRANS STERILE",13980,CDM,272,RC,,,OUTPATIENT,,,37,24.05,,32.56,88,,26.05,,,0,"percent of total billed charges","88% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.4,17.304,,5.12,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.31,63,,18.65,,,0,"percent of total billed charges","63% of total billed charges",5.66,15.3,,4.53,,,0,"percent of total billed charges","15.3% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",25.53,69,,,,,0,"fee schedule","69% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.88,61.85,,18.30,,,0,"percent of total billed charges","61.5% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",11.91,32.2,,9.53,,,0,"percent of total billed charges","32.2% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.34,17.136,,5.07,,,0,"percent of total billed charges","17.136% of total billed charges",8.08,21.84,,6.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.95,37.7,,11.16,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.86,78,,23.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",5.66,37,
"DRAPE LAPAROTOMY PED STERILE",71070,CDM,272,RC,,,OUTPATIENT,,,30,19.5,,26.4,88,,21.12,,,0,"percent of total billed charges","88% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.19,17.304,,4.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.9,63,,15.12,,,0,"percent of total billed charges","63% of total billed charges",4.59,15.3,,3.67,,,0,"percent of total billed charges","15.3% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",20.7,69,,,,,0,"fee schedule","69% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.56,61.85,,14.85,,,0,"percent of total billed charges","61.5% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",9.66,32.2,,7.73,,,0,"percent of total billed charges","32.2% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.14,17.136,,4.11,,,0,"percent of total billed charges","17.136% of total billed charges",6.55,21.84,,5.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.31,37.7,,9.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.4,78,,18.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",4.59,30,
"DRAPE EYE PCH FEN INC STERILE",187598,CDM,272,RC,,,OUTPATIENT,,,85,55.25,,74.8,88,,59.84,,,0,"percent of total billed charges","88% of total billed charges",42.5,50,,34.00,,,0,"percent of total billed charges","50% of total billed charges",14.28,16.8,,11.42,,,0,"percent of total billed charges","16.8% of total billed charges",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.71,17.304,,11.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.55,63,,42.84,,,0,"percent of total billed charges","63% of total billed charges",13.01,15.3,,10.41,,,0,"percent of total billed charges","15.3% of total billed charges",14.28,16.8,,11.42,,,0,"percent of total billed charges","16.8% of total billed charges",58.65,69,,,,,0,"fee schedule","69% of total billed charges",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.57,61.85,,42.06,,,0,"percent of total billed charges","61.5% of total billed charges",14.28,16.8,,11.42,,,0,"percent of total billed charges","16.8% of total billed charges",42.5,50,,34.00,,,0,"percent of total billed charges","50% of total billed charges",27.37,32.2,,21.90,,,0,"percent of total billed charges","32.2% of total billed charges",14.28,16.8,,11.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.57,17.136,,11.66,,,0,"percent of total billed charges","17.136% of total billed charges",18.56,21.84,,14.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",32.05,37.7,,25.64,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",66.3,78,,53.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.21,82.6,,56.17,,,0,"percent of total billed charges","82.6% of total billed charges",14.28,16.8,,11.42,,,0,"percent of total billed charges","16.8% of total billed charges",42.5,50,,34.00,,,0,"percent of total billed charges","50% of total billed charges",70.21,82.6,,56.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.28,16.8,,11.42,,,0,"percent of total billed charges","16.8% of total billed charges",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",13.01,85,
"DRAPE EXTREMITY 89X128 STERILE",85013,CDM,272,RC,,,OUTPATIENT,,,46,29.9,,40.48,88,,32.38,,,0,"percent of total billed charges","88% of total billed charges",23,50,,18.40,,,0,"percent of total billed charges","50% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.96,17.304,,6.37,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.98,63,,23.18,,,0,"percent of total billed charges","63% of total billed charges",7.04,15.3,,5.63,,,0,"percent of total billed charges","15.3% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",31.74,69,,,,,0,"fee schedule","69% of total billed charges",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.45,61.85,,22.76,,,0,"percent of total billed charges","61.5% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",23,50,,18.40,,,0,"percent of total billed charges","50% of total billed charges",14.81,32.2,,11.85,,,0,"percent of total billed charges","32.2% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.88,17.136,,6.30,,,0,"percent of total billed charges","17.136% of total billed charges",10.05,21.84,,8.04,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.34,37.7,,13.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.88,78,,28.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38,82.6,,30.40,,,0,"percent of total billed charges","82.6% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",23,50,,18.40,,,0,"percent of total billed charges","50% of total billed charges",38,82.6,,30.40,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",7.04,46,
"DRAPE EENT SPLIT STERILE",76842,CDM,272,RC,,,OUTPATIENT,,,58,37.7,,51.04,88,,40.83,,,0,"percent of total billed charges","88% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.04,17.304,,8.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.54,63,,29.23,,,0,"percent of total billed charges","63% of total billed charges",8.87,15.3,,7.10,,,0,"percent of total billed charges","15.3% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",40.02,69,,,,,0,"fee schedule","69% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.87,61.85,,28.70,,,0,"percent of total billed charges","61.5% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",18.68,32.2,,14.94,,,0,"percent of total billed charges","32.2% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.94,17.136,,7.95,,,0,"percent of total billed charges","17.136% of total billed charges",12.67,21.84,,10.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.87,37.7,,17.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",45.24,78,,36.19,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",8.87,58,
"DRAPE SHEET CRANIOTOMY",45633,CDM,270,RC,,,OUTPATIENT,,,97,63.05,,85.36,88,,68.29,,,0,"percent of total billed charges","88% of total billed charges",48.5,50,,38.80,,,0,"percent of total billed charges","50% of total billed charges",16.3,16.8,,13.04,,,0,"percent of total billed charges","16.8% of total billed charges",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.78,17.304,,13.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.11,63,,48.89,,,0,"percent of total billed charges","63% of total billed charges",14.84,15.3,,11.87,,,0,"percent of total billed charges","15.3% of total billed charges",16.3,16.8,,13.04,,,0,"percent of total billed charges","16.8% of total billed charges",66.93,69,,,,,0,"fee schedule","69% of total billed charges",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.99,61.85,,47.99,,,0,"percent of total billed charges","61.5% of total billed charges",16.3,16.8,,13.04,,,0,"percent of total billed charges","16.8% of total billed charges",48.5,50,,38.80,,,0,"percent of total billed charges","50% of total billed charges",31.23,32.2,,24.98,,,0,"percent of total billed charges","32.2% of total billed charges",16.3,16.8,,13.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.62,17.136,,13.30,,,0,"percent of total billed charges","17.136% of total billed charges",21.18,21.84,,16.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.57,37.7,,29.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.66,78,,60.53,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.12,82.6,,64.10,,,0,"percent of total billed charges","82.6% of total billed charges",16.3,16.8,,13.04,,,0,"percent of total billed charges","16.8% of total billed charges",48.5,50,,38.80,,,0,"percent of total billed charges","50% of total billed charges",80.12,82.6,,64.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.3,16.8,,13.04,,,0,"percent of total billed charges","16.8% of total billed charges",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",14.84,97,
"DRAPE EXTREMITY BLATRL STERILE",13983,CDM,272,RC,,,OUTPATIENT,,,71,46.15,,62.48,88,,49.98,,,0,"percent of total billed charges","88% of total billed charges",35.5,50,,28.40,,,0,"percent of total billed charges","50% of total billed charges",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.29,17.304,,9.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.73,63,,35.78,,,0,"percent of total billed charges","63% of total billed charges",10.86,15.3,,8.69,,,0,"percent of total billed charges","15.3% of total billed charges",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",48.99,69,,,,,0,"fee schedule","69% of total billed charges",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.91,61.85,,35.13,,,0,"percent of total billed charges","61.5% of total billed charges",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",35.5,50,,28.40,,,0,"percent of total billed charges","50% of total billed charges",22.86,32.2,,18.29,,,0,"percent of total billed charges","32.2% of total billed charges",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.17,17.136,,9.74,,,0,"percent of total billed charges","17.136% of total billed charges",15.51,21.84,,12.41,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.77,37.7,,21.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",55.38,78,,44.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.65,82.6,,46.92,,,0,"percent of total billed charges","82.6% of total billed charges",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",35.5,50,,28.40,,,0,"percent of total billed charges","50% of total billed charges",58.65,82.6,,46.92,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",10.86,71,
"DRAPE LAP CHOLE W/TROUGHS STERILE",44547,CDM,272,RC,,,OUTPATIENT,,,105,68.25,,92.4,88,,73.92,,,0,"percent of total billed charges","88% of total billed charges",52.5,50,,42.00,,,0,"percent of total billed charges","50% of total billed charges",17.64,16.8,,14.11,,,0,"percent of total billed charges","16.8% of total billed charges",105,100,,84.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.17,17.304,,14.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",66.15,63,,52.92,,,0,"percent of total billed charges","63% of total billed charges",16.07,15.3,,12.86,,,0,"percent of total billed charges","15.3% of total billed charges",17.64,16.8,,14.11,,,0,"percent of total billed charges","16.8% of total billed charges",72.45,69,,,,,0,"fee schedule","69% of total billed charges",105,100,,84.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",105,100,,84.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",105,100,,84.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.94,61.85,,51.95,,,0,"percent of total billed charges","61.5% of total billed charges",17.64,16.8,,14.11,,,0,"percent of total billed charges","16.8% of total billed charges",52.5,50,,42.00,,,0,"percent of total billed charges","50% of total billed charges",33.81,32.2,,27.05,,,0,"percent of total billed charges","32.2% of total billed charges",17.64,16.8,,14.11,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.99,17.136,,14.39,,,0,"percent of total billed charges","17.136% of total billed charges",22.93,21.84,,18.34,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39.59,37.7,,31.67,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",81.9,78,,65.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.73,82.6,,69.38,,,0,"percent of total billed charges","82.6% of total billed charges",17.64,16.8,,14.11,,,0,"percent of total billed charges","16.8% of total billed charges",52.5,50,,42.00,,,0,"percent of total billed charges","50% of total billed charges",86.73,82.6,,69.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.64,16.8,,14.11,,,0,"percent of total billed charges","16.8% of total billed charges",105,100,,84.00,,,0,"percent of total billed charges","100% of total billed charges",16.07,105,
"DRAPE STERI INCISE IOBAN 2 23IN X 33 IN",39549,CDM,272,RC,,,OUTPATIENT,,,94,61.1,,82.72,88,,66.18,,,0,"percent of total billed charges","88% of total billed charges",47,50,,37.60,,,0,"percent of total billed charges","50% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.27,17.304,,13.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.22,63,,47.38,,,0,"percent of total billed charges","63% of total billed charges",14.38,15.3,,11.50,,,0,"percent of total billed charges","15.3% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",64.86,69,,,,,0,"fee schedule","69% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.14,61.85,,46.51,,,0,"percent of total billed charges","61.5% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",47,50,,37.60,,,0,"percent of total billed charges","50% of total billed charges",30.27,32.2,,24.22,,,0,"percent of total billed charges","32.2% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.11,17.136,,12.89,,,0,"percent of total billed charges","17.136% of total billed charges",20.53,21.84,,16.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.44,37.7,,28.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",73.32,78,,58.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",47,50,,37.60,,,0,"percent of total billed charges","50% of total billed charges",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",14.38,94,
"DRAPE ISO. 125-7/8IN  88-3/4IN",186728,CDM,270,RC,,,OUTPATIENT,,,197,128.05,,173.36,88,,138.69,,,0,"percent of total billed charges","88% of total billed charges",98.5,50,,78.80,,,0,"percent of total billed charges","50% of total billed charges",33.1,16.8,,26.48,,,0,"percent of total billed charges","16.8% of total billed charges",197,100,,157.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.09,17.304,,27.27,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.11,63,,99.29,,,0,"percent of total billed charges","63% of total billed charges",30.14,15.3,,24.11,,,0,"percent of total billed charges","15.3% of total billed charges",33.1,16.8,,26.48,,,0,"percent of total billed charges","16.8% of total billed charges",135.93,69,,,,,0,"fee schedule","69% of total billed charges",197,100,,157.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",197,100,,157.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",197,100,,157.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",121.84,61.85,,97.47,,,0,"percent of total billed charges","61.5% of total billed charges",33.1,16.8,,26.48,,,0,"percent of total billed charges","16.8% of total billed charges",98.5,50,,78.80,,,0,"percent of total billed charges","50% of total billed charges",63.43,32.2,,50.74,,,0,"percent of total billed charges","32.2% of total billed charges",33.1,16.8,,26.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.76,17.136,,27.01,,,0,"percent of total billed charges","17.136% of total billed charges",43.02,21.84,,34.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",74.27,37.7,,59.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",153.66,78,,122.93,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.72,82.6,,130.18,,,0,"percent of total billed charges","82.6% of total billed charges",33.1,16.8,,26.48,,,0,"percent of total billed charges","16.8% of total billed charges",98.5,50,,78.80,,,0,"percent of total billed charges","50% of total billed charges",162.72,82.6,,130.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.1,16.8,,26.48,,,0,"percent of total billed charges","16.8% of total billed charges",197,100,,157.60,,,0,"percent of total billed charges","100% of total billed charges",30.14,197,
"DRAPE STERI 16X16 3M",111107,CDM,272,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"DRAPE SURGICAL STERI INSTR PCH",184756,CDM,272,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"DRAPE SURGICAL STERI IRRG PCH",161359,CDM,272,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"DRAPE U-SHAPED  47 1/8 X 51 1/6",87955,CDM,270,RC,,,OUTPATIENT,,,76,49.4,,66.88,88,,53.50,,,0,"percent of total billed charges","88% of total billed charges",38,50,,30.40,,,0,"percent of total billed charges","50% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.15,17.304,,10.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.88,63,,38.30,,,0,"percent of total billed charges","63% of total billed charges",11.63,15.3,,9.30,,,0,"percent of total billed charges","15.3% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",52.44,69,,,,,0,"fee schedule","69% of total billed charges",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.01,61.85,,37.61,,,0,"percent of total billed charges","61.5% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",38,50,,30.40,,,0,"percent of total billed charges","50% of total billed charges",24.47,32.2,,19.58,,,0,"percent of total billed charges","32.2% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.02,17.136,,10.42,,,0,"percent of total billed charges","17.136% of total billed charges",16.6,21.84,,13.28,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.65,37.7,,22.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",59.28,78,,47.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.78,82.6,,50.22,,,0,"percent of total billed charges","82.6% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",38,50,,30.40,,,0,"percent of total billed charges","50% of total billed charges",62.78,82.6,,50.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",11.63,76,
"DRAPE SURGICAL W/TWL 17 5/8X23",161364,CDM,270,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.95,61.85,,3.96,,,0,"percent of total billed charges","61.5% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"DRAPE INSTRUMENT MAGNETIC 16 X 20 LARGE DISP",14368,CDM,270,RC,,,OUTPATIENT,,,70,45.5,,61.6,88,,49.28,,,0,"percent of total billed charges","88% of total billed charges",35,50,,28.00,,,0,"percent of total billed charges","50% of total billed charges",11.76,16.8,,9.41,,,0,"percent of total billed charges","16.8% of total billed charges",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.11,17.304,,9.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.1,63,,35.28,,,0,"percent of total billed charges","63% of total billed charges",10.71,15.3,,8.57,,,0,"percent of total billed charges","15.3% of total billed charges",11.76,16.8,,9.41,,,0,"percent of total billed charges","16.8% of total billed charges",48.3,69,,,,,0,"fee schedule","69% of total billed charges",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.3,61.85,,34.64,,,0,"percent of total billed charges","61.5% of total billed charges",11.76,16.8,,9.41,,,0,"percent of total billed charges","16.8% of total billed charges",35,50,,28.00,,,0,"percent of total billed charges","50% of total billed charges",22.54,32.2,,18.03,,,0,"percent of total billed charges","32.2% of total billed charges",11.76,16.8,,9.41,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,17.136,,9.60,,,0,"percent of total billed charges","17.136% of total billed charges",15.29,21.84,,12.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.39,37.7,,21.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",54.6,78,,43.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.82,82.6,,46.26,,,0,"percent of total billed charges","82.6% of total billed charges",11.76,16.8,,9.41,,,0,"percent of total billed charges","16.8% of total billed charges",35,50,,28.00,,,0,"percent of total billed charges","50% of total billed charges",57.82,82.6,,46.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.76,16.8,,9.41,,,0,"percent of total billed charges","16.8% of total billed charges",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",10.71,70,
"DRAPE STERI 34X36",45598,CDM,272,RC,,,OUTPATIENT,,,39,25.35,,34.32,88,,27.46,,,0,"percent of total billed charges","88% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.75,17.304,,5.40,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.57,63,,19.66,,,0,"percent of total billed charges","63% of total billed charges",5.97,15.3,,4.78,,,0,"percent of total billed charges","15.3% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",26.91,69,,,,,0,"fee schedule","69% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.12,61.85,,19.30,,,0,"percent of total billed charges","61.5% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",12.56,32.2,,10.05,,,0,"percent of total billed charges","32.2% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.68,17.136,,5.34,,,0,"percent of total billed charges","17.136% of total billed charges",8.52,21.84,,6.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.42,78,,24.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",5.97,39,
"DRAPE INCISE IOBAN 2 35",56110,CDM,270,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"DRAPE C-ARM IMAGE INTENSIFIER 18IN X 9IN X 20IN",153536,CDM,270,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.37,61.85,,9.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"DRAPE U/ SHT SPLIT PLAS STERIL",11515,CDM,272,RC,,,OUTPATIENT,,,44,28.6,,38.72,88,,30.98,,,0,"percent of total billed charges","88% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.61,17.304,,6.09,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.72,63,,22.18,,,0,"percent of total billed charges","63% of total billed charges",6.73,15.3,,5.38,,,0,"percent of total billed charges","15.3% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",30.36,69,,,,,0,"fee schedule","69% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.21,61.85,,21.77,,,0,"percent of total billed charges","61.5% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",14.17,32.2,,11.34,,,0,"percent of total billed charges","32.2% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.54,17.136,,6.03,,,0,"percent of total billed charges","17.136% of total billed charges",9.61,21.84,,7.69,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.59,37.7,,13.27,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.32,78,,27.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",6.73,44,
"DRAPE FLUOROSCAN",185998,CDM,270,RC,,,OUTPATIENT,,,74,48.1,,65.12,88,,52.10,,,0,"percent of total billed charges","88% of total billed charges",37,50,,29.60,,,0,"percent of total billed charges","50% of total billed charges",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.8,17.304,,10.24,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.62,63,,37.30,,,0,"percent of total billed charges","63% of total billed charges",11.32,15.3,,9.06,,,0,"percent of total billed charges","15.3% of total billed charges",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",51.06,69,,,,,0,"fee schedule","69% of total billed charges",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.77,61.85,,36.62,,,0,"percent of total billed charges","61.5% of total billed charges",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",37,50,,29.60,,,0,"percent of total billed charges","50% of total billed charges",23.83,32.2,,19.06,,,0,"percent of total billed charges","32.2% of total billed charges",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.68,17.136,,10.14,,,0,"percent of total billed charges","17.136% of total billed charges",16.16,21.84,,12.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",27.9,37.7,,22.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",57.72,78,,46.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.12,82.6,,48.90,,,0,"percent of total billed charges","82.6% of total billed charges",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",37,50,,29.60,,,0,"percent of total billed charges","50% of total billed charges",61.12,82.6,,48.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",11.32,74,
"DRAPE ARTHRO W/POUCH STERILE",71075,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"DRAPE SURGICAL STERI APERTURE",143573,CDM,272,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"DRAPE STERI 23IN X 17IN  #1050",35049,CDM,272,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.37,61.85,,9.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"DRAPE STERI BAG ISOLATION 20IN X 20IN",137707,CDM,272,RC,,,OUTPATIENT,,,24,15.6,,21.12,88,,16.90,,,0,"percent of total billed charges","88% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.15,17.304,,3.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.12,63,,12.10,,,0,"percent of total billed charges","63% of total billed charges",3.67,15.3,,2.94,,,0,"percent of total billed charges","15.3% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",16.56,69,,,,,0,"fee schedule","69% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.84,61.85,,11.87,,,0,"percent of total billed charges","61.5% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",7.73,32.2,,6.18,,,0,"percent of total billed charges","32.2% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.11,17.136,,3.29,,,0,"percent of total billed charges","17.136% of total billed charges",5.24,21.84,,4.19,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.05,37.7,,7.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.72,78,,14.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,24,
"DRAPE C-ARM SUPER 96/98 12INCH",268542,CDM,270,RC,,,OUTPATIENT,,,66,42.9,,58.08,88,,46.46,,,0,"percent of total billed charges","88% of total billed charges",33,50,,26.40,,,0,"percent of total billed charges","50% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.42,17.304,,9.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.58,63,,33.26,,,0,"percent of total billed charges","63% of total billed charges",10.1,15.3,,8.08,,,0,"percent of total billed charges","15.3% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",45.54,69,,,,,0,"fee schedule","69% of total billed charges",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.82,61.85,,32.66,,,0,"percent of total billed charges","61.5% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",33,50,,26.40,,,0,"percent of total billed charges","50% of total billed charges",21.25,32.2,,17.00,,,0,"percent of total billed charges","32.2% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.31,17.136,,9.05,,,0,"percent of total billed charges","17.136% of total billed charges",14.41,21.84,,11.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.88,37.7,,19.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",51.48,78,,41.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",54.52,82.6,,43.62,,,0,"percent of total billed charges","82.6% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",33,50,,26.40,,,0,"percent of total billed charges","50% of total billed charges",54.52,82.6,,43.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",10.1,66,
"DRAPE C-ARMOUR KIT",428695,CDM,270,RC,,,OUTPATIENT,,,388,252.2,,341.44,88,,273.15,,,0,"percent of total billed charges","88% of total billed charges",194,50,,155.20,,,0,"percent of total billed charges","50% of total billed charges",65.18,16.8,,52.14,,,0,"percent of total billed charges","16.8% of total billed charges",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.14,17.304,,53.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",244.44,63,,195.55,,,0,"percent of total billed charges","63% of total billed charges",59.36,15.3,,47.49,,,0,"percent of total billed charges","15.3% of total billed charges",65.18,16.8,,52.14,,,0,"percent of total billed charges","16.8% of total billed charges",267.72,69,,,,,0,"fee schedule","69% of total billed charges",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",239.98,61.85,,191.98,,,0,"percent of total billed charges","61.5% of total billed charges",65.18,16.8,,52.14,,,0,"percent of total billed charges","16.8% of total billed charges",194,50,,155.20,,,0,"percent of total billed charges","50% of total billed charges",124.94,32.2,,99.95,,,0,"percent of total billed charges","32.2% of total billed charges",65.18,16.8,,52.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",66.49,17.136,,53.19,,,0,"percent of total billed charges","17.136% of total billed charges",84.74,21.84,,67.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",146.28,37.7,,117.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.64,78,,242.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",320.49,82.6,,256.39,,,0,"percent of total billed charges","82.6% of total billed charges",65.18,16.8,,52.14,,,0,"percent of total billed charges","16.8% of total billed charges",194,50,,155.20,,,0,"percent of total billed charges","50% of total billed charges",320.49,82.6,,256.39,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",65.18,16.8,,52.14,,,0,"percent of total billed charges","16.8% of total billed charges",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",59.36,388,
"DRAPE CASSETTE XRAY",40176,CDM,270,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"DRAPE INSTRUMENT ARM DA VINCI",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"DRAPE LAP W/POUCH",301931,CDM,270,RC,,,OUTPATIENT,,,72,46.8,,63.36,88,,50.69,,,0,"percent of total billed charges","88% of total billed charges",36,50,,28.80,,,0,"percent of total billed charges","50% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.46,17.304,,9.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.36,63,,36.29,,,0,"percent of total billed charges","63% of total billed charges",11.02,15.3,,8.82,,,0,"percent of total billed charges","15.3% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",49.68,69,,,,,0,"fee schedule","69% of total billed charges",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.53,61.85,,35.62,,,0,"percent of total billed charges","61.5% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",36,50,,28.80,,,0,"percent of total billed charges","50% of total billed charges",23.18,32.2,,18.54,,,0,"percent of total billed charges","32.2% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.34,17.136,,9.87,,,0,"percent of total billed charges","17.136% of total billed charges",15.72,21.84,,12.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",27.14,37.7,,21.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",56.16,78,,44.93,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.47,82.6,,47.58,,,0,"percent of total billed charges","82.6% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",36,50,,28.80,,,0,"percent of total billed charges","50% of total billed charges",59.47,82.6,,47.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",11.02,72,
"DRAPE LAP WITH FLUID POUCH",380111,CDM,270,RC,,,OUTPATIENT,,,117,76.05,,102.96,88,,82.37,,,0,"percent of total billed charges","88% of total billed charges",58.5,50,,46.80,,,0,"percent of total billed charges","50% of total billed charges",19.66,16.8,,15.73,,,0,"percent of total billed charges","16.8% of total billed charges",117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.25,17.304,,16.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",73.71,63,,58.97,,,0,"percent of total billed charges","63% of total billed charges",17.9,15.3,,14.32,,,0,"percent of total billed charges","15.3% of total billed charges",19.66,16.8,,15.73,,,0,"percent of total billed charges","16.8% of total billed charges",80.73,69,,,,,0,"fee schedule","69% of total billed charges",117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",72.36,61.85,,57.89,,,0,"percent of total billed charges","61.5% of total billed charges",19.66,16.8,,15.73,,,0,"percent of total billed charges","16.8% of total billed charges",58.5,50,,46.80,,,0,"percent of total billed charges","50% of total billed charges",37.67,32.2,,30.14,,,0,"percent of total billed charges","32.2% of total billed charges",19.66,16.8,,15.73,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.05,17.136,,16.04,,,0,"percent of total billed charges","17.136% of total billed charges",25.55,21.84,,20.44,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",44.11,37.7,,35.29,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",91.26,78,,73.01,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",96.64,82.6,,77.31,,,0,"percent of total billed charges","82.6% of total billed charges",19.66,16.8,,15.73,,,0,"percent of total billed charges","16.8% of total billed charges",58.5,50,,46.80,,,0,"percent of total billed charges","50% of total billed charges",96.64,82.6,,77.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.66,16.8,,15.73,,,0,"percent of total billed charges","16.8% of total billed charges",117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",17.9,117,
"DRAPE LEICA MICROSCOPE",171791,CDM,270,RC,,,OUTPATIENT,,,2600,1690,,2288,88,,1830.40,,,0,"percent of total billed charges","88% of total billed charges",1300,50,,1040.00,,,0,"percent of total billed charges","50% of total billed charges",436.8,16.8,,349.44,,,0,"percent of total billed charges","16.8% of total billed charges",2600,100,,2080.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,17.304,,359.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1638,63,,1310.40,,,0,"percent of total billed charges","63% of total billed charges",397.8,15.3,,318.24,,,0,"percent of total billed charges","15.3% of total billed charges",436.8,16.8,,349.44,,,0,"percent of total billed charges","16.8% of total billed charges",1794,69,,,,,0,"fee schedule","69% of total billed charges",2600,100,,2080.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2600,100,,2080.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2600,100,,2080.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1608.1,61.85,,1286.48,,,0,"percent of total billed charges","61.5% of total billed charges",436.8,16.8,,349.44,,,0,"percent of total billed charges","16.8% of total billed charges",1300,50,,1040.00,,,0,"percent of total billed charges","50% of total billed charges",837.2,32.2,,669.76,,,0,"percent of total billed charges","32.2% of total billed charges",436.8,16.8,,349.44,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",445.54,17.136,,356.43,,,0,"percent of total billed charges","17.136% of total billed charges",567.84,21.84,,454.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",980.2,37.7,,784.16,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2028,78,,1622.40,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2147.6,82.6,,1718.08,,,0,"percent of total billed charges","82.6% of total billed charges",436.8,16.8,,349.44,,,0,"percent of total billed charges","16.8% of total billed charges",1300,50,,1040.00,,,0,"percent of total billed charges","50% of total billed charges",2147.6,82.6,,1718.08,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",436.8,16.8,,349.44,,,0,"percent of total billed charges","16.8% of total billed charges",2600,100,,2080.00,,,0,"percent of total billed charges","100% of total billed charges",397.8,2600,
"DRAPE MICROSCOPE 326026 ZEISS IGS",101004,CDM,270,RC,,,OUTPATIENT,,,228,148.2,,200.64,88,,160.51,,,0,"percent of total billed charges","88% of total billed charges",114,50,,91.20,,,0,"percent of total billed charges","50% of total billed charges",38.3,16.8,,30.64,,,0,"percent of total billed charges","16.8% of total billed charges",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.45,17.304,,31.56,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",143.64,63,,114.91,,,0,"percent of total billed charges","63% of total billed charges",34.88,15.3,,27.90,,,0,"percent of total billed charges","15.3% of total billed charges",38.3,16.8,,30.64,,,0,"percent of total billed charges","16.8% of total billed charges",157.32,69,,,,,0,"fee schedule","69% of total billed charges",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",141.02,61.85,,112.82,,,0,"percent of total billed charges","61.5% of total billed charges",38.3,16.8,,30.64,,,0,"percent of total billed charges","16.8% of total billed charges",114,50,,91.20,,,0,"percent of total billed charges","50% of total billed charges",73.42,32.2,,58.74,,,0,"percent of total billed charges","32.2% of total billed charges",38.3,16.8,,30.64,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.07,17.136,,31.26,,,0,"percent of total billed charges","17.136% of total billed charges",49.8,21.84,,39.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",85.96,37.7,,68.77,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",177.84,78,,142.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",188.33,82.6,,150.66,,,0,"percent of total billed charges","82.6% of total billed charges",38.3,16.8,,30.64,,,0,"percent of total billed charges","16.8% of total billed charges",114,50,,91.20,,,0,"percent of total billed charges","50% of total billed charges",188.33,82.6,,150.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.3,16.8,,30.64,,,0,"percent of total billed charges","16.8% of total billed charges",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",34.88,228,
"DRAPE MICROSCOPE LEICA 54X120",205092,CDM,270,RC,,,OUTPATIENT,,,192,124.8,,168.96,88,,135.17,,,0,"percent of total billed charges","88% of total billed charges",96,50,,76.80,,,0,"percent of total billed charges","50% of total billed charges",32.26,16.8,,25.81,,,0,"percent of total billed charges","16.8% of total billed charges",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.22,17.304,,26.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",120.96,63,,96.77,,,0,"percent of total billed charges","63% of total billed charges",29.38,15.3,,23.50,,,0,"percent of total billed charges","15.3% of total billed charges",32.26,16.8,,25.81,,,0,"percent of total billed charges","16.8% of total billed charges",132.48,69,,,,,0,"fee schedule","69% of total billed charges",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",118.75,61.85,,95.00,,,0,"percent of total billed charges","61.5% of total billed charges",32.26,16.8,,25.81,,,0,"percent of total billed charges","16.8% of total billed charges",96,50,,76.80,,,0,"percent of total billed charges","50% of total billed charges",61.82,32.2,,49.46,,,0,"percent of total billed charges","32.2% of total billed charges",32.26,16.8,,25.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.9,17.136,,26.32,,,0,"percent of total billed charges","17.136% of total billed charges",41.93,21.84,,33.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",72.38,37.7,,57.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",149.76,78,,119.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.59,82.6,,126.87,,,0,"percent of total billed charges","82.6% of total billed charges",32.26,16.8,,25.81,,,0,"percent of total billed charges","16.8% of total billed charges",96,50,,76.80,,,0,"percent of total billed charges","50% of total billed charges",158.59,82.6,,126.87,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.26,16.8,,25.81,,,0,"percent of total billed charges","16.8% of total billed charges",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",29.38,192,
"DRAPE SHOULDER ARTHROSCOPY DRAIN",30879,CDM,270,RC,,,OUTPATIENT,,,213,138.45,,187.44,88,,149.95,,,0,"percent of total billed charges","88% of total billed charges",106.5,50,,85.20,,,0,"percent of total billed charges","50% of total billed charges",35.78,16.8,,28.62,,,0,"percent of total billed charges","16.8% of total billed charges",213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.86,17.304,,29.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.19,63,,107.35,,,0,"percent of total billed charges","63% of total billed charges",32.59,15.3,,26.07,,,0,"percent of total billed charges","15.3% of total billed charges",35.78,16.8,,28.62,,,0,"percent of total billed charges","16.8% of total billed charges",146.97,69,,,,,0,"fee schedule","69% of total billed charges",213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",131.74,61.85,,105.39,,,0,"percent of total billed charges","61.5% of total billed charges",35.78,16.8,,28.62,,,0,"percent of total billed charges","16.8% of total billed charges",106.5,50,,85.20,,,0,"percent of total billed charges","50% of total billed charges",68.59,32.2,,54.87,,,0,"percent of total billed charges","32.2% of total billed charges",35.78,16.8,,28.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.5,17.136,,29.20,,,0,"percent of total billed charges","17.136% of total billed charges",46.52,21.84,,37.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.3,37.7,,64.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",166.14,78,,132.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",175.94,82.6,,140.75,,,0,"percent of total billed charges","82.6% of total billed charges",35.78,16.8,,28.62,,,0,"percent of total billed charges","16.8% of total billed charges",106.5,50,,85.20,,,0,"percent of total billed charges","50% of total billed charges",175.94,82.6,,140.75,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.78,16.8,,28.62,,,0,"percent of total billed charges","16.8% of total billed charges",213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",32.59,213,
"DRAPE SHOULDER BEACH CHAIR 159INX105IN",380103,CDM,270,RC,,,OUTPATIENT,,,192,124.8,,168.96,88,,135.17,,,0,"percent of total billed charges","88% of total billed charges",96,50,,76.80,,,0,"percent of total billed charges","50% of total billed charges",32.26,16.8,,25.81,,,0,"percent of total billed charges","16.8% of total billed charges",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.22,17.304,,26.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",120.96,63,,96.77,,,0,"percent of total billed charges","63% of total billed charges",29.38,15.3,,23.50,,,0,"percent of total billed charges","15.3% of total billed charges",32.26,16.8,,25.81,,,0,"percent of total billed charges","16.8% of total billed charges",132.48,69,,,,,0,"fee schedule","69% of total billed charges",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",118.75,61.85,,95.00,,,0,"percent of total billed charges","61.5% of total billed charges",32.26,16.8,,25.81,,,0,"percent of total billed charges","16.8% of total billed charges",96,50,,76.80,,,0,"percent of total billed charges","50% of total billed charges",61.82,32.2,,49.46,,,0,"percent of total billed charges","32.2% of total billed charges",32.26,16.8,,25.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.9,17.136,,26.32,,,0,"percent of total billed charges","17.136% of total billed charges",41.93,21.84,,33.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",72.38,37.7,,57.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",149.76,78,,119.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.59,82.6,,126.87,,,0,"percent of total billed charges","82.6% of total billed charges",32.26,16.8,,25.81,,,0,"percent of total billed charges","16.8% of total billed charges",96,50,,76.80,,,0,"percent of total billed charges","50% of total billed charges",158.59,82.6,,126.87,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.26,16.8,,25.81,,,0,"percent of total billed charges","16.8% of total billed charges",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",29.38,192,
"DRAPE SPLIT CV CLR ANES STERILE",244839,CDM,272,RC,,,OUTPATIENT,,,1521,988.65,,1338.48,88,,1070.78,,,0,"percent of total billed charges","88% of total billed charges",760.5,50,,608.40,,,0,"percent of total billed charges","50% of total billed charges",255.53,16.8,,204.42,,,0,"percent of total billed charges","16.8% of total billed charges",1521,100,,1216.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.19,17.304,,210.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",958.23,63,,766.58,,,0,"percent of total billed charges","63% of total billed charges",232.71,15.3,,186.17,,,0,"percent of total billed charges","15.3% of total billed charges",255.53,16.8,,204.42,,,0,"percent of total billed charges","16.8% of total billed charges",1049.49,69,,,,,0,"fee schedule","69% of total billed charges",1521,100,,1216.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1521,100,,1216.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1521,100,,1216.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",940.74,61.85,,752.59,,,0,"percent of total billed charges","61.5% of total billed charges",255.53,16.8,,204.42,,,0,"percent of total billed charges","16.8% of total billed charges",760.5,50,,608.40,,,0,"percent of total billed charges","50% of total billed charges",489.76,32.2,,391.81,,,0,"percent of total billed charges","32.2% of total billed charges",255.53,16.8,,204.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",260.64,17.136,,208.51,,,0,"percent of total billed charges","17.136% of total billed charges",332.19,21.84,,265.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",573.42,37.7,,458.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1186.38,78,,949.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1256.35,82.6,,1005.08,,,0,"percent of total billed charges","82.6% of total billed charges",255.53,16.8,,204.42,,,0,"percent of total billed charges","16.8% of total billed charges",760.5,50,,608.40,,,0,"percent of total billed charges","50% of total billed charges",1256.35,82.6,,1005.08,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.53,16.8,,204.42,,,0,"percent of total billed charges","16.8% of total billed charges",1521,100,,1216.80,,,0,"percent of total billed charges","100% of total billed charges",232.71,1521,
"DRAPE SURG L26INXW18IN 2.75 IN FEN STRL",278796,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"DRAPE THYROID SOFT STERILE",13981,CDM,272,RC,,,OUTPATIENT,,,61,39.65,,53.68,88,,42.94,,,0,"percent of total billed charges","88% of total billed charges",30.5,50,,24.40,,,0,"percent of total billed charges","50% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.56,17.304,,8.45,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.43,63,,30.74,,,0,"percent of total billed charges","63% of total billed charges",9.33,15.3,,7.46,,,0,"percent of total billed charges","15.3% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",42.09,69,,,,,0,"fee schedule","69% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.73,61.85,,30.18,,,0,"percent of total billed charges","61.5% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",30.5,50,,24.40,,,0,"percent of total billed charges","50% of total billed charges",19.64,32.2,,15.71,,,0,"percent of total billed charges","32.2% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.45,17.136,,8.36,,,0,"percent of total billed charges","17.136% of total billed charges",13.32,21.84,,10.66,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23,37.7,,18.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47.58,78,,38.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.39,82.6,,40.31,,,0,"percent of total billed charges","82.6% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",30.5,50,,24.40,,,0,"percent of total billed charges","50% of total billed charges",50.39,82.6,,40.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",9.33,61,
"DRAPE THYROID TIBURON",323746,CDM,270,RC,,,OUTPATIENT,,,40,26,,35.2,88,,28.16,,,0,"percent of total billed charges","88% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.92,17.304,,5.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.2,63,,20.16,,,0,"percent of total billed charges","63% of total billed charges",6.12,15.3,,4.90,,,0,"percent of total billed charges","15.3% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",27.6,69,,,,,0,"fee schedule","69% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.74,61.85,,19.79,,,0,"percent of total billed charges","61.5% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",12.88,32.2,,10.30,,,0,"percent of total billed charges","32.2% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.85,17.136,,5.48,,,0,"percent of total billed charges","17.136% of total billed charges",8.74,21.84,,6.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.08,37.7,,12.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",31.2,78,,24.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",6.12,40,
"DRAPE UNDERBUTTOCKS PCH STERILE",85055,CDM,272,RC,,,OUTPATIENT,,,23,14.95,,20.24,88,,16.19,,,0,"percent of total billed charges","88% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.98,17.304,,3.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.49,63,,11.59,,,0,"percent of total billed charges","63% of total billed charges",3.52,15.3,,2.82,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",15.87,69,,,,,0,"fee schedule","69% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.23,61.85,,11.38,,,0,"percent of total billed charges","61.5% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",7.41,32.2,,5.93,,,0,"percent of total billed charges","32.2% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.94,17.136,,3.15,,,0,"percent of total billed charges","17.136% of total billed charges",5.02,21.84,,4.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.94,78,,14.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",3.52,23,
"DRAPE UTIL TAPE 15X26 2EA/PK",62237,CDM,270,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"DRAPE UNDER BUTTOCKS W/DRAIN",490460,CDM,270,RC,,,OUTPATIENT,,,22,14.3,,19.36,88,,15.49,,,0,"percent of total billed charges","88% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.81,17.304,,3.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.86,63,,11.09,,,0,"percent of total billed charges","63% of total billed charges",3.37,15.3,,2.70,,,0,"percent of total billed charges","15.3% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",15.18,69,,,,,0,"fee schedule","69% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.61,61.85,,10.89,,,0,"percent of total billed charges","61.5% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",7.08,32.2,,5.66,,,0,"percent of total billed charges","32.2% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.77,17.136,,3.02,,,0,"percent of total billed charges","17.136% of total billed charges",4.8,21.84,,3.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.29,37.7,,6.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.16,78,,13.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",3.37,22,
"DRAPE SPLIT SHEET W/ADHESIVE",490459,CDM,270,RC,,,OUTPATIENT,,,46,29.9,,40.48,88,,32.38,,,0,"percent of total billed charges","88% of total billed charges",23,50,,18.40,,,0,"percent of total billed charges","50% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.96,17.304,,6.37,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.98,63,,23.18,,,0,"percent of total billed charges","63% of total billed charges",7.04,15.3,,5.63,,,0,"percent of total billed charges","15.3% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",31.74,69,,,,,0,"fee schedule","69% of total billed charges",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.45,61.85,,22.76,,,0,"percent of total billed charges","61.5% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",23,50,,18.40,,,0,"percent of total billed charges","50% of total billed charges",14.81,32.2,,11.85,,,0,"percent of total billed charges","32.2% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.88,17.136,,6.30,,,0,"percent of total billed charges","17.136% of total billed charges",10.05,21.84,,8.04,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.34,37.7,,13.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.88,78,,28.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38,82.6,,30.40,,,0,"percent of total billed charges","82.6% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",23,50,,18.40,,,0,"percent of total billed charges","50% of total billed charges",38,82.6,,30.40,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",7.04,46,
"PACK SHOULDER ARTHROSCOPY",491017,CDM,270,RC,,,OUTPATIENT,,,172,111.8,,151.36,88,,121.09,,,0,"percent of total billed charges","88% of total billed charges",86,50,,68.80,,,0,"percent of total billed charges","50% of total billed charges",28.9,16.8,,23.12,,,0,"percent of total billed charges","16.8% of total billed charges",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.76,17.304,,23.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",108.36,63,,86.69,,,0,"percent of total billed charges","63% of total billed charges",26.32,15.3,,21.06,,,0,"percent of total billed charges","15.3% of total billed charges",28.9,16.8,,23.12,,,0,"percent of total billed charges","16.8% of total billed charges",118.68,69,,,,,0,"fee schedule","69% of total billed charges",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.38,61.85,,85.10,,,0,"percent of total billed charges","61.5% of total billed charges",28.9,16.8,,23.12,,,0,"percent of total billed charges","16.8% of total billed charges",86,50,,68.80,,,0,"percent of total billed charges","50% of total billed charges",55.38,32.2,,44.30,,,0,"percent of total billed charges","32.2% of total billed charges",28.9,16.8,,23.12,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.47,17.136,,23.58,,,0,"percent of total billed charges","17.136% of total billed charges",37.56,21.84,,30.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",64.84,37.7,,51.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",134.16,78,,107.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.07,82.6,,113.66,,,0,"percent of total billed charges","82.6% of total billed charges",28.9,16.8,,23.12,,,0,"percent of total billed charges","16.8% of total billed charges",86,50,,68.80,,,0,"percent of total billed charges","50% of total billed charges",142.07,82.6,,113.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.9,16.8,,23.12,,,0,"percent of total billed charges","16.8% of total billed charges",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",26.32,172,
"DRAPE SHEET PEDIATRIC",490458,CDM,270,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"DRAPE MICROSCOPE FOR LEICA",ORSUP0004,CDM,270,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"DRAPE MICROSCOPE",490455,CDM,270,RC,,,OUTPATIENT,,,99,64.35,,87.12,88,,69.70,,,0,"percent of total billed charges","88% of total billed charges",49.5,50,,39.60,,,0,"percent of total billed charges","50% of total billed charges",16.63,16.8,,13.30,,,0,"percent of total billed charges","16.8% of total billed charges",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.13,17.304,,13.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.37,63,,49.90,,,0,"percent of total billed charges","63% of total billed charges",15.15,15.3,,12.12,,,0,"percent of total billed charges","15.3% of total billed charges",16.63,16.8,,13.30,,,0,"percent of total billed charges","16.8% of total billed charges",68.31,69,,,,,0,"fee schedule","69% of total billed charges",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.23,61.85,,48.98,,,0,"percent of total billed charges","61.5% of total billed charges",16.63,16.8,,13.30,,,0,"percent of total billed charges","16.8% of total billed charges",49.5,50,,39.60,,,0,"percent of total billed charges","50% of total billed charges",31.88,32.2,,25.50,,,0,"percent of total billed charges","32.2% of total billed charges",16.63,16.8,,13.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.96,17.136,,13.57,,,0,"percent of total billed charges","17.136% of total billed charges",21.62,21.84,,17.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",37.32,37.7,,29.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.22,78,,61.78,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",16.63,16.8,,13.30,,,0,"percent of total billed charges","16.8% of total billed charges",49.5,50,,39.60,,,0,"percent of total billed charges","50% of total billed charges",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.63,16.8,,13.30,,,0,"percent of total billed charges","16.8% of total billed charges",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",15.15,99,
"DRAPE MAGNETIC",490453,CDM,270,RC,,,OUTPATIENT,,,56,36.4,,49.28,88,,39.42,,,0,"percent of total billed charges","88% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.69,17.304,,7.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.28,63,,28.22,,,0,"percent of total billed charges","63% of total billed charges",8.57,15.3,,6.86,,,0,"percent of total billed charges","15.3% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",38.64,69,,,,,0,"fee schedule","69% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.64,61.85,,27.71,,,0,"percent of total billed charges","61.5% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",18.03,32.2,,14.42,,,0,"percent of total billed charges","32.2% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.6,17.136,,7.68,,,0,"percent of total billed charges","17.136% of total billed charges",12.23,21.84,,9.78,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.11,37.7,,16.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.68,78,,34.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",8.57,56,
"DRAPE MAGNETIC 10 X 16",490454,CDM,270,RC,,,OUTPATIENT,,,48,31.2,,42.24,88,,33.79,,,0,"percent of total billed charges","88% of total billed charges",24,50,,19.20,,,0,"percent of total billed charges","50% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.31,17.304,,6.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.24,63,,24.19,,,0,"percent of total billed charges","63% of total billed charges",7.34,15.3,,5.87,,,0,"percent of total billed charges","15.3% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",33.12,69,,,,,0,"fee schedule","69% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.69,61.85,,23.75,,,0,"percent of total billed charges","61.5% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",24,50,,19.20,,,0,"percent of total billed charges","50% of total billed charges",15.46,32.2,,12.37,,,0,"percent of total billed charges","32.2% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.23,17.136,,6.58,,,0,"percent of total billed charges","17.136% of total billed charges",10.48,21.84,,8.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.1,37.7,,14.48,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",37.44,78,,29.95,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.65,82.6,,31.72,,,0,"percent of total billed charges","82.6% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",24,50,,19.20,,,0,"percent of total billed charges","50% of total billed charges",39.65,82.6,,31.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",7.34,48,
"DRAPE INCISE IOBAN 10.5 X 8",490451,CDM,270,RC,,,OUTPATIENT,,,30,19.5,,26.4,88,,21.12,,,0,"percent of total billed charges","88% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.19,17.304,,4.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.9,63,,15.12,,,0,"percent of total billed charges","63% of total billed charges",4.59,15.3,,3.67,,,0,"percent of total billed charges","15.3% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",20.7,69,,,,,0,"fee schedule","69% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.56,61.85,,14.85,,,0,"percent of total billed charges","61.5% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",9.66,32.2,,7.73,,,0,"percent of total billed charges","32.2% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.14,17.136,,4.11,,,0,"percent of total billed charges","17.136% of total billed charges",6.55,21.84,,5.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.31,37.7,,9.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.4,78,,18.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",4.59,30,
"DRAPE HIP W/ CLEAR LEG POCKETS",490450,CDM,270,RC,,,OUTPATIENT,,,144,93.6,,126.72,88,,101.38,,,0,"percent of total billed charges","88% of total billed charges",72,50,,57.60,,,0,"percent of total billed charges","50% of total billed charges",24.19,16.8,,19.35,,,0,"percent of total billed charges","16.8% of total billed charges",144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.92,17.304,,19.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.72,63,,72.58,,,0,"percent of total billed charges","63% of total billed charges",22.03,15.3,,17.62,,,0,"percent of total billed charges","15.3% of total billed charges",24.19,16.8,,19.35,,,0,"percent of total billed charges","16.8% of total billed charges",99.36,69,,,,,0,"fee schedule","69% of total billed charges",144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.06,61.85,,71.25,,,0,"percent of total billed charges","61.5% of total billed charges",24.19,16.8,,19.35,,,0,"percent of total billed charges","16.8% of total billed charges",72,50,,57.60,,,0,"percent of total billed charges","50% of total billed charges",46.37,32.2,,37.10,,,0,"percent of total billed charges","32.2% of total billed charges",24.19,16.8,,19.35,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.68,17.136,,19.74,,,0,"percent of total billed charges","17.136% of total billed charges",31.45,21.84,,25.16,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",54.29,37.7,,43.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",112.32,78,,89.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",118.94,82.6,,95.15,,,0,"percent of total billed charges","82.6% of total billed charges",24.19,16.8,,19.35,,,0,"percent of total billed charges","16.8% of total billed charges",72,50,,57.60,,,0,"percent of total billed charges","50% of total billed charges",118.94,82.6,,95.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.19,16.8,,19.35,,,0,"percent of total billed charges","16.8% of total billed charges",144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",22.03,144,
"DRAPE SHEET ARTHRO W/POUCH",490457,CDM,270,RC,,,OUTPATIENT,,,238,154.7,,209.44,88,,167.55,,,0,"percent of total billed charges","88% of total billed charges",119,50,,95.20,,,0,"percent of total billed charges","50% of total billed charges",39.98,16.8,,31.98,,,0,"percent of total billed charges","16.8% of total billed charges",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.18,17.304,,32.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",149.94,63,,119.95,,,0,"percent of total billed charges","63% of total billed charges",36.41,15.3,,29.13,,,0,"percent of total billed charges","15.3% of total billed charges",39.98,16.8,,31.98,,,0,"percent of total billed charges","16.8% of total billed charges",164.22,69,,,,,0,"fee schedule","69% of total billed charges",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",147.2,61.85,,117.76,,,0,"percent of total billed charges","61.5% of total billed charges",39.98,16.8,,31.98,,,0,"percent of total billed charges","16.8% of total billed charges",119,50,,95.20,,,0,"percent of total billed charges","50% of total billed charges",76.64,32.2,,61.31,,,0,"percent of total billed charges","32.2% of total billed charges",39.98,16.8,,31.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.78,17.136,,32.62,,,0,"percent of total billed charges","17.136% of total billed charges",51.98,21.84,,41.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",89.73,37.7,,71.78,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",185.64,78,,148.51,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",196.59,82.6,,157.27,,,0,"percent of total billed charges","82.6% of total billed charges",39.98,16.8,,31.98,,,0,"percent of total billed charges","16.8% of total billed charges",119,50,,95.20,,,0,"percent of total billed charges","50% of total billed charges",196.59,82.6,,157.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.98,16.8,,31.98,,,0,"percent of total billed charges","16.8% of total billed charges",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",36.41,238,
"DRAPE C-ARM COVER MINI",490447,CDM,270,RC,,,OUTPATIENT,,,149,96.85,,131.12,88,,104.90,,,0,"percent of total billed charges","88% of total billed charges",74.5,50,,59.60,,,0,"percent of total billed charges","50% of total billed charges",25.03,16.8,,20.02,,,0,"percent of total billed charges","16.8% of total billed charges",149,100,,119.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.78,17.304,,20.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",93.87,63,,75.10,,,0,"percent of total billed charges","63% of total billed charges",22.8,15.3,,18.24,,,0,"percent of total billed charges","15.3% of total billed charges",25.03,16.8,,20.02,,,0,"percent of total billed charges","16.8% of total billed charges",102.81,69,,,,,0,"fee schedule","69% of total billed charges",149,100,,119.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",149,100,,119.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",149,100,,119.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.16,61.85,,73.73,,,0,"percent of total billed charges","61.5% of total billed charges",25.03,16.8,,20.02,,,0,"percent of total billed charges","16.8% of total billed charges",74.5,50,,59.60,,,0,"percent of total billed charges","50% of total billed charges",47.98,32.2,,38.38,,,0,"percent of total billed charges","32.2% of total billed charges",25.03,16.8,,20.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.53,17.136,,20.42,,,0,"percent of total billed charges","17.136% of total billed charges",32.54,21.84,,26.03,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",56.17,37.7,,44.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.22,78,,92.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",123.07,82.6,,98.46,,,0,"percent of total billed charges","82.6% of total billed charges",25.03,16.8,,20.02,,,0,"percent of total billed charges","16.8% of total billed charges",74.5,50,,59.60,,,0,"percent of total billed charges","50% of total billed charges",123.07,82.6,,98.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.03,16.8,,20.02,,,0,"percent of total billed charges","16.8% of total billed charges",149,100,,119.20,,,0,"percent of total billed charges","100% of total billed charges",22.8,149,
"DRAPE C-ARMOR",490448,CDM,270,RC,,,OUTPATIENT,,,331,215.15,,291.28,88,,233.02,,,0,"percent of total billed charges","88% of total billed charges",165.5,50,,132.40,,,0,"percent of total billed charges","50% of total billed charges",55.61,16.8,,44.49,,,0,"percent of total billed charges","16.8% of total billed charges",331,100,,264.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.28,17.304,,45.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.53,63,,166.82,,,0,"percent of total billed charges","63% of total billed charges",50.64,15.3,,40.51,,,0,"percent of total billed charges","15.3% of total billed charges",55.61,16.8,,44.49,,,0,"percent of total billed charges","16.8% of total billed charges",228.39,69,,,,,0,"fee schedule","69% of total billed charges",331,100,,264.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331,100,,264.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331,100,,264.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.72,61.85,,163.78,,,0,"percent of total billed charges","61.5% of total billed charges",55.61,16.8,,44.49,,,0,"percent of total billed charges","16.8% of total billed charges",165.5,50,,132.40,,,0,"percent of total billed charges","50% of total billed charges",106.58,32.2,,85.26,,,0,"percent of total billed charges","32.2% of total billed charges",55.61,16.8,,44.49,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.72,17.136,,45.38,,,0,"percent of total billed charges","17.136% of total billed charges",72.29,21.84,,57.83,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",124.79,37.7,,99.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",258.18,78,,206.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",273.41,82.6,,218.73,,,0,"percent of total billed charges","82.6% of total billed charges",55.61,16.8,,44.49,,,0,"percent of total billed charges","16.8% of total billed charges",165.5,50,,132.40,,,0,"percent of total billed charges","50% of total billed charges",273.41,82.6,,218.73,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",55.61,16.8,,44.49,,,0,"percent of total billed charges","16.8% of total billed charges",331,100,,264.80,,,0,"percent of total billed charges","100% of total billed charges",50.64,331,
"DRAPE BILATERAL LIMB",490446,CDM,270,RC,,,OUTPATIENT,,,61,39.65,,53.68,88,,42.94,,,0,"percent of total billed charges","88% of total billed charges",30.5,50,,24.40,,,0,"percent of total billed charges","50% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.56,17.304,,8.45,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.43,63,,30.74,,,0,"percent of total billed charges","63% of total billed charges",9.33,15.3,,7.46,,,0,"percent of total billed charges","15.3% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",42.09,69,,,,,0,"fee schedule","69% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.73,61.85,,30.18,,,0,"percent of total billed charges","61.5% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",30.5,50,,24.40,,,0,"percent of total billed charges","50% of total billed charges",19.64,32.2,,15.71,,,0,"percent of total billed charges","32.2% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.45,17.136,,8.36,,,0,"percent of total billed charges","17.136% of total billed charges",13.32,21.84,,10.66,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23,37.7,,18.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47.58,78,,38.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.39,82.6,,40.31,,,0,"percent of total billed charges","82.6% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",30.5,50,,24.40,,,0,"percent of total billed charges","50% of total billed charges",50.39,82.6,,40.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",9.33,61,
"DRAPE LARGE STERILE",490452,CDM,272,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"DRAPE C-ARM DELUXE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"DRAPE KIT RIO",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"DRAPE MICROSCOPE LEICA M690 M655",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"DRAPE SURGICAL FENESTRATED 18X26 STERILE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRAPE NONFENESTRATED 18X26",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRAPE SHEET NONSTERILE 40X48",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRAPE HALD SHEET STERILE 60X44",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRAPE PACEMAKER 87 X 135",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"DRAPE THREE-QUARTER ABSORBENT 53 X 77",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"DRAPE BILATERAL LIMB STERILE",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"DRESSING POLY MEM 4X5",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"DRESSING TRNSP TEGADERM 2 3/8X",147857,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"DRESSING TRANSPARENT WOUND STERILE 20CM X 15CM",11223,CDM,272,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"DRESSING NON-ADHERENT 3 X 8 STERILE",141644,CDM,272,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"DRESSING ADAPTIC 3 X 16",100411,CDM,270,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"DRESSING TEGADERM 2X2 1/4",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING TEGADERM WINDOW3 X 3",143630,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"DRESSING TRANS TEGADERM 1.75X1.75",167972,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"DRESSING XEROFORM 1X8",33787,CDM,272,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"DRESSING ABD PAD 8 X 7 1/2 STERILE",32824,CDM,272,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"DRESSING GAUZE 12-PLY 4 X 4 (2'S) STER",36529,CDM,272,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"DRESSING GAUZE BORDER 4X4",204725,CDM,270,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"DRESSING PETROLATUM 3 X 36",329989,CDM,270,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"DRESSING TEGADERM CHG 4 X 4 3/4",423603,CDM,270,RC,,,OUTPATIENT,,,56,36.4,,49.28,88,,39.42,,,0,"percent of total billed charges","88% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.69,17.304,,7.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.28,63,,28.22,,,0,"percent of total billed charges","63% of total billed charges",8.57,15.3,,6.86,,,0,"percent of total billed charges","15.3% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",38.64,69,,,,,0,"fee schedule","69% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.64,61.85,,27.71,,,0,"percent of total billed charges","61.5% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",18.03,32.2,,14.42,,,0,"percent of total billed charges","32.2% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.6,17.136,,7.68,,,0,"percent of total billed charges","17.136% of total billed charges",12.23,21.84,,9.78,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.11,37.7,,16.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.68,78,,34.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",8.57,56,
"DRESSING MONTGOMERY STRAP 7 1/4IN X 11 1/8IN STERIL",161395,CDM,272,RC,,,OUTPATIENT,,,98,63.7,,86.24,88,,68.99,,,0,"percent of total billed charges","88% of total billed charges",49,50,,39.20,,,0,"percent of total billed charges","50% of total billed charges",16.46,16.8,,13.17,,,0,"percent of total billed charges","16.8% of total billed charges",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.96,17.304,,13.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.74,63,,49.39,,,0,"percent of total billed charges","63% of total billed charges",14.99,15.3,,11.99,,,0,"percent of total billed charges","15.3% of total billed charges",16.46,16.8,,13.17,,,0,"percent of total billed charges","16.8% of total billed charges",67.62,69,,,,,0,"fee schedule","69% of total billed charges",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.61,61.85,,48.49,,,0,"percent of total billed charges","61.5% of total billed charges",16.46,16.8,,13.17,,,0,"percent of total billed charges","16.8% of total billed charges",49,50,,39.20,,,0,"percent of total billed charges","50% of total billed charges",31.56,32.2,,25.25,,,0,"percent of total billed charges","32.2% of total billed charges",16.46,16.8,,13.17,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.79,17.136,,13.43,,,0,"percent of total billed charges","17.136% of total billed charges",21.4,21.84,,17.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.95,37.7,,29.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",76.44,78,,61.15,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.95,82.6,,64.76,,,0,"percent of total billed charges","82.6% of total billed charges",16.46,16.8,,13.17,,,0,"percent of total billed charges","16.8% of total billed charges",49,50,,39.20,,,0,"percent of total billed charges","50% of total billed charges",80.95,82.6,,64.76,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.46,16.8,,13.17,,,0,"percent of total billed charges","16.8% of total billed charges",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",14.99,98,
"DRESSING XEROFORM 5X9",10129,CDM,272,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"AQUACEL FOAM DRESSING 4X4IN",402619,CDM,272,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"DRESSING SQUIBB DUODERM XTHIN",143629,CDM,272,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"DRESSING WOUND GEL DUODERM 15G",185219,CDM,272,RC,,,OUTPATIENT,,,24,15.6,,21.12,88,,16.90,,,0,"percent of total billed charges","88% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.15,17.304,,3.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.12,63,,12.10,,,0,"percent of total billed charges","63% of total billed charges",3.67,15.3,,2.94,,,0,"percent of total billed charges","15.3% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",16.56,69,,,,,0,"fee schedule","69% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.84,61.85,,11.87,,,0,"percent of total billed charges","61.5% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",7.73,32.2,,6.18,,,0,"percent of total billed charges","32.2% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.11,17.136,,3.29,,,0,"percent of total billed charges","17.136% of total billed charges",5.24,21.84,,4.19,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.05,37.7,,7.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.72,78,,14.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,24,
"DRESSING DUODERM SIGNAL 6 X 7",82767,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"DRESSING AQUACEL AG SURG HYDRFIBR W/SILVER 3.5X14IN",364599,CDM,272,RC,,,OUTPATIENT,,,293,190.45,,257.84,88,,206.27,,,0,"percent of total billed charges","88% of total billed charges",146.5,50,,117.20,,,0,"percent of total billed charges","50% of total billed charges",49.22,16.8,,39.38,,,0,"percent of total billed charges","16.8% of total billed charges",293,100,,234.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.7,17.304,,40.56,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",184.59,63,,147.67,,,0,"percent of total billed charges","63% of total billed charges",44.83,15.3,,35.86,,,0,"percent of total billed charges","15.3% of total billed charges",49.22,16.8,,39.38,,,0,"percent of total billed charges","16.8% of total billed charges",202.17,69,,,,,0,"fee schedule","69% of total billed charges",293,100,,234.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",293,100,,234.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",293,100,,234.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.22,61.85,,144.98,,,0,"percent of total billed charges","61.5% of total billed charges",49.22,16.8,,39.38,,,0,"percent of total billed charges","16.8% of total billed charges",146.5,50,,117.20,,,0,"percent of total billed charges","50% of total billed charges",94.35,32.2,,75.48,,,0,"percent of total billed charges","32.2% of total billed charges",49.22,16.8,,39.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.21,17.136,,40.17,,,0,"percent of total billed charges","17.136% of total billed charges",63.99,21.84,,51.19,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",110.46,37.7,,88.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",228.54,78,,182.83,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",242.02,82.6,,193.62,,,0,"percent of total billed charges","82.6% of total billed charges",49.22,16.8,,39.38,,,0,"percent of total billed charges","16.8% of total billed charges",146.5,50,,117.20,,,0,"percent of total billed charges","50% of total billed charges",242.02,82.6,,193.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.22,16.8,,39.38,,,0,"percent of total billed charges","16.8% of total billed charges",293,100,,234.40,,,0,"percent of total billed charges","100% of total billed charges",44.83,293,
"DRESSING AQUACELL AG SURGICAL COVER 3.5 X 12'' W/SILVER",409666,CDM,270,RC,,,OUTPATIENT,,,332,215.8,,292.16,88,,233.73,,,0,"percent of total billed charges","88% of total billed charges",166,50,,132.80,,,0,"percent of total billed charges","50% of total billed charges",55.78,16.8,,44.62,,,0,"percent of total billed charges","16.8% of total billed charges",332,100,,265.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.45,17.304,,45.96,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.16,63,,167.33,,,0,"percent of total billed charges","63% of total billed charges",50.8,15.3,,40.64,,,0,"percent of total billed charges","15.3% of total billed charges",55.78,16.8,,44.62,,,0,"percent of total billed charges","16.8% of total billed charges",229.08,69,,,,,0,"fee schedule","69% of total billed charges",332,100,,265.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",332,100,,265.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",332,100,,265.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",205.34,61.85,,164.27,,,0,"percent of total billed charges","61.5% of total billed charges",55.78,16.8,,44.62,,,0,"percent of total billed charges","16.8% of total billed charges",166,50,,132.80,,,0,"percent of total billed charges","50% of total billed charges",106.9,32.2,,85.52,,,0,"percent of total billed charges","32.2% of total billed charges",55.78,16.8,,44.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.89,17.136,,45.51,,,0,"percent of total billed charges","17.136% of total billed charges",72.51,21.84,,58.01,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",125.16,37.7,,100.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",258.96,78,,207.17,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",274.23,82.6,,219.38,,,0,"percent of total billed charges","82.6% of total billed charges",55.78,16.8,,44.62,,,0,"percent of total billed charges","16.8% of total billed charges",166,50,,132.80,,,0,"percent of total billed charges","50% of total billed charges",274.23,82.6,,219.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",55.78,16.8,,44.62,,,0,"percent of total billed charges","16.8% of total billed charges",332,100,,265.60,,,0,"percent of total billed charges","100% of total billed charges",50.8,332,
"DRESSING AD AQUACEL SURG W/SILVER 3.5X6",364597,CDM,272,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"DRESSING COVADERM 4 X 4",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING COVADERM 4 X 14",184557,CDM,272,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"DRESSING COVADERM 4 X 10",184556,CDM,272,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"DRESSING ASSEMBLY WHITE LARGE",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"DRESSING IV STR GUARDIVA HEOMSTATIC",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"DRESSING SINU-FOAM",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"DRESSING SORBAVIEW PERIPH 2.625 X 3.563",422645,CDM,272,RC,,,OUTPATIENT,,,21,13.65,,18.48,88,,14.78,,,0,"percent of total billed charges","88% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.63,17.304,,2.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.23,63,,10.58,,,0,"percent of total billed charges","63% of total billed charges",3.21,15.3,,2.57,,,0,"percent of total billed charges","15.3% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",14.49,69,,,,,0,"fee schedule","69% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.99,61.85,,10.39,,,0,"percent of total billed charges","61.5% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",6.76,32.2,,5.41,,,0,"percent of total billed charges","32.2% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.6,17.136,,2.88,,,0,"percent of total billed charges","17.136% of total billed charges",4.59,21.84,,3.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.92,37.7,,6.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.38,78,,13.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",3.21,21,
"DRESSING VAC ABTHERA SENSAT  R.A.C ABDOMINAL",ORSUP0023,CDM,272,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"DRESSING VAC LG SENSATRAC GRANUFOAM",ORSUP0024,CDM,272,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"DRESSING VAC MED SENSATRAC GRANUFOAM",ORSUP0025,CDM,272,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"DRESSING VAC SM SENSATRAC GRANUFOAM",ORSUP0023,CDM,272,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"DRESSING VAC XL SENSATRAC GRANUFOAM",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"DRESSING VASELINE 3 X 9",490477,CDM,270,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"DRESSING VASELINE 1/2 X 72",490476,CDM,270,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"DRESSING PRIMAPORE 11 3/4 X 4",490474,CDM,270,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"DRESSING OWENS SILK 3X8",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING MEROCEL DOYLE NASAL",490470,CDM,270,RC,,,OUTPATIENT,,,211,137.15,,185.68,88,,148.54,,,0,"percent of total billed charges","88% of total billed charges",105.5,50,,84.40,,,0,"percent of total billed charges","50% of total billed charges",35.45,16.8,,28.36,,,0,"percent of total billed charges","16.8% of total billed charges",211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.51,17.304,,29.21,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",132.93,63,,106.34,,,0,"percent of total billed charges","63% of total billed charges",32.28,15.3,,25.82,,,0,"percent of total billed charges","15.3% of total billed charges",35.45,16.8,,28.36,,,0,"percent of total billed charges","16.8% of total billed charges",145.59,69,,,,,0,"fee schedule","69% of total billed charges",211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",130.5,61.85,,104.40,,,0,"percent of total billed charges","61.5% of total billed charges",35.45,16.8,,28.36,,,0,"percent of total billed charges","16.8% of total billed charges",105.5,50,,84.40,,,0,"percent of total billed charges","50% of total billed charges",67.94,32.2,,54.35,,,0,"percent of total billed charges","32.2% of total billed charges",35.45,16.8,,28.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.16,17.136,,28.93,,,0,"percent of total billed charges","17.136% of total billed charges",46.08,21.84,,36.86,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",79.55,37.7,,63.64,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",164.58,78,,131.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",174.29,82.6,,139.43,,,0,"percent of total billed charges","82.6% of total billed charges",35.45,16.8,,28.36,,,0,"percent of total billed charges","16.8% of total billed charges",105.5,50,,84.40,,,0,"percent of total billed charges","50% of total billed charges",174.29,82.6,,139.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.45,16.8,,28.36,,,0,"percent of total billed charges","16.8% of total billed charges",211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",32.28,211,
"DRESSING MEPITEL 3X4",490469,CDM,270,RC,,,OUTPATIENT,,,48,31.2,,42.24,88,,33.79,,,0,"percent of total billed charges","88% of total billed charges",24,50,,19.20,,,0,"percent of total billed charges","50% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.31,17.304,,6.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.24,63,,24.19,,,0,"percent of total billed charges","63% of total billed charges",7.34,15.3,,5.87,,,0,"percent of total billed charges","15.3% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",33.12,69,,,,,0,"fee schedule","69% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.69,61.85,,23.75,,,0,"percent of total billed charges","61.5% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",24,50,,19.20,,,0,"percent of total billed charges","50% of total billed charges",15.46,32.2,,12.37,,,0,"percent of total billed charges","32.2% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.23,17.136,,6.58,,,0,"percent of total billed charges","17.136% of total billed charges",10.48,21.84,,8.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.1,37.7,,14.48,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",37.44,78,,29.95,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.65,82.6,,31.72,,,0,"percent of total billed charges","82.6% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",24,50,,19.20,,,0,"percent of total billed charges","50% of total billed charges",39.65,82.6,,31.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",7.34,48,
"DRESSING MEPILEX LITE 4X4 FOAM",490468,CDM,270,RC,,,OUTPATIENT,,,25,16.25,,22,88,,17.60,,,0,"percent of total billed charges","88% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,17.304,,3.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.75,63,,12.60,,,0,"percent of total billed charges","63% of total billed charges",3.83,15.3,,3.06,,,0,"percent of total billed charges","15.3% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",17.25,69,,,,,0,"fee schedule","69% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.46,61.85,,12.37,,,0,"percent of total billed charges","61.5% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",8.05,32.2,,6.44,,,0,"percent of total billed charges","32.2% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.28,17.136,,3.42,,,0,"percent of total billed charges","17.136% of total billed charges",5.46,21.84,,4.37,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.43,37.7,,7.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.5,78,,15.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",3.83,25,
"DRESSING GRANUFOAM SILVER MED",ORSUP0010,CDM,270,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"DRESSING DUODERM XTHIN 3X3",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,24,15.6,,21.12,88,,16.90,,,0,"percent of total billed charges","88% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.15,17.304,,3.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.12,63,,12.10,,,0,"percent of total billed charges","63% of total billed charges",3.67,15.3,,2.94,,,0,"percent of total billed charges","15.3% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",16.56,69,,,,,0,"fee schedule","69% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.84,61.85,,11.87,,,0,"percent of total billed charges","61.5% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",7.73,32.2,,6.18,,,0,"percent of total billed charges","32.2% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.11,17.136,,3.29,,,0,"percent of total billed charges","17.136% of total billed charges",5.24,21.84,,4.19,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.05,37.7,,7.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.72,78,,14.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,24,
"DRESSING AQUACELL 10'' SLIM",490462,CDM,270,RC,,,OUTPATIENT,,,387,251.55,,340.56,88,,272.45,,,0,"percent of total billed charges","88% of total billed charges",193.5,50,,154.80,,,0,"percent of total billed charges","50% of total billed charges",65.02,16.8,,52.02,,,0,"percent of total billed charges","16.8% of total billed charges",387,100,,309.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",66.97,17.304,,53.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",243.81,63,,195.05,,,0,"percent of total billed charges","63% of total billed charges",59.21,15.3,,47.37,,,0,"percent of total billed charges","15.3% of total billed charges",65.02,16.8,,52.02,,,0,"percent of total billed charges","16.8% of total billed charges",267.03,69,,,,,0,"fee schedule","69% of total billed charges",387,100,,309.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",387,100,,309.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",387,100,,309.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",239.36,61.85,,191.49,,,0,"percent of total billed charges","61.5% of total billed charges",65.02,16.8,,52.02,,,0,"percent of total billed charges","16.8% of total billed charges",193.5,50,,154.80,,,0,"percent of total billed charges","50% of total billed charges",124.61,32.2,,99.69,,,0,"percent of total billed charges","32.2% of total billed charges",65.02,16.8,,52.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",66.32,17.136,,53.06,,,0,"percent of total billed charges","17.136% of total billed charges",84.52,21.84,,67.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",145.9,37.7,,116.72,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",301.86,78,,241.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",319.66,82.6,,255.73,,,0,"percent of total billed charges","82.6% of total billed charges",65.02,16.8,,52.02,,,0,"percent of total billed charges","16.8% of total billed charges",193.5,50,,154.80,,,0,"percent of total billed charges","50% of total billed charges",319.66,82.6,,255.73,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",65.02,16.8,,52.02,,,0,"percent of total billed charges","16.8% of total billed charges",387,100,,309.60,,,0,"percent of total billed charges","100% of total billed charges",59.21,387,
"DRESSING AQUACEL AG 4X4.7 XTRA",490461,CDM,270,RC,,,OUTPATIENT,,,99,64.35,,87.12,88,,69.70,,,0,"percent of total billed charges","88% of total billed charges",49.5,50,,39.60,,,0,"percent of total billed charges","50% of total billed charges",16.63,16.8,,13.30,,,0,"percent of total billed charges","16.8% of total billed charges",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.13,17.304,,13.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.37,63,,49.90,,,0,"percent of total billed charges","63% of total billed charges",15.15,15.3,,12.12,,,0,"percent of total billed charges","15.3% of total billed charges",16.63,16.8,,13.30,,,0,"percent of total billed charges","16.8% of total billed charges",68.31,69,,,,,0,"fee schedule","69% of total billed charges",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.23,61.85,,48.98,,,0,"percent of total billed charges","61.5% of total billed charges",16.63,16.8,,13.30,,,0,"percent of total billed charges","16.8% of total billed charges",49.5,50,,39.60,,,0,"percent of total billed charges","50% of total billed charges",31.88,32.2,,25.50,,,0,"percent of total billed charges","32.2% of total billed charges",16.63,16.8,,13.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.96,17.136,,13.57,,,0,"percent of total billed charges","17.136% of total billed charges",21.62,21.84,,17.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",37.32,37.7,,29.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.22,78,,61.78,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",16.63,16.8,,13.30,,,0,"percent of total billed charges","16.8% of total billed charges",49.5,50,,39.60,,,0,"percent of total billed charges","50% of total billed charges",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.63,16.8,,13.30,,,0,"percent of total billed charges","16.8% of total billed charges",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",15.15,99,
"COVADERM 4 X 4",490405,CDM,271,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.7% of total billed charges",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.07,33.9,,3.26,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"DRESSING HYDROFERA BLUE CLASSIC FOAM 4 X 4",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING CUTIMED SORBACT 4IN X 4IN PADS",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING CUTIMED OFF-LOADERS",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"DRESSING PRIMASEAL POST OP 3.5 X 4",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"DRESSING PROMOGRAN PRISMA AG 4.34IN",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"DRESSING KERRAFOAM 6 X 6IN NO BOARDER",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING KERRAFOAM GENTLE BORDER 3X3",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING KERRAFOAM GENTLE BORDER 5X5",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING KERRAFOAM LRG SACRAL 9X10",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING KERRAFOAM GENTLE BORDER HEEL",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING KERRAMAX CARE 4X4",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING KERRAMAX CARE 4X9",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING KERRAMAX CARE 8X9",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING PURACOL ULTRA POWDER",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"DRESSING PURACOL PLUS AG 2X2",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING KERRALITE COOL 2X2",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING KERRACEL AG 4X5",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"DRESSING PURACOL PLUS 2X2",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING PROMOGRAN 4.34IN",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING CUTIMED SORBACT 2 3/4 X 3 3/8",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING AQUACEL AG ROPE 39IN X 18IN",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"DRESSING KERRACONTACT AG3+ 4X8",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"DRESSING KERRAMAX GENTLE 4X4  W/BORDER",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING COVADERM PLUS 2IN X 2IN",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING KIT COMPRIFORE COMPRESSION 4 LAYER",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"DRESSING KERRAFOAM GENTLE BORDER 4X4IN",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING 4IN X 4IN ALLEVYN GENTLE BORDER LITE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING WOUND HONEY 2X2",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING 4IN X 4IN ALLEVYN GENTLE BORDER",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING STERILE ISLAND WOUND",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING DERMATAC DRAPE",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"DRESSING ALLEVYN SMALL SACRUM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING ALLEVYN LARGE SACRUM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING ENDOFORM COLLAGEN HIGH FLOW 2' X 2'",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"DRESSING ANTIMICROBIALE ENDOFORM COLLAGEN4 X 5 HIGH FLOW",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"DRESSING HYDROFERA BLUE READY TRANSFER 4 X 5",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING HYDROFERA BLUE READY TRANSFER 8 X 8",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"DRESSING HYDROFERA BLUE READY-BORDERED 2.5 X 2.5",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"DRESSING HYDROFERA BLUE READY-BORDERED 3.9 X 3.9",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"DRESSING FENESTRATED DERMAL TEMPLATE 2X2",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"DRESSING KERRAFOAM 4X10",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING KERRAFOAM 4X12",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING ALLEVYIN GB LITE 2X2",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING ALLEVYIN GENTLE BORDER 3X3",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING HYPAFIX GENTLE TOUCH 5CMX5",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"DRESSING AQUACEL AG ANTIMICROBIAL 4X5",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"DRESSING TRANSPARENT IV3000 4X5.5CM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING KIT PICO 7 NEG PRESSURE WOUND THERAPY 10X20CM",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"DRESSING TEGADERM IV 4X6-1/8",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING SORBAVIEW SHIELD SECURMENT 3.75X6.25",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DRESSING AQUACEL AG ADVANTAGE 3.5 X 4 IN",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"DRESSING AQUACEL AG ADVANTAGE 3.5 X 6 IN",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"DRESSING AQUACEL AG ADVANTAGE 3.5 X 10 IN",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"DRESSING AQUACEL AG ADVANTAGE 3.5 X 12 IN",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"DRESSING AQUACEL AG ADVANTAGE 3.5 X 14 IN",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"DRESSING SACHET SUPER 4X4",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"DRESSING HYDROFERA TUNNELING 9MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"DRESSING FOAM ANTIBACTERIAL 4X4",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"DRESSING ANTIBACTERIAL HEAVEY DRAINAGE 6X6",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"DRESSING FOAM SACRAL  SM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"DRESSING FOAM ADHESIVE BORDER 12.5 1 12.5CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"DRESSING IODOPHOR FOAM WITH IODINE 6 X 9",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"DRESSING XEROFORM 2X2",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"DRESSING ALLEVYN LIFE ADHESIVE FOAM 5X5",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"DRESSING ALLEVYN LIFE ADHESIVE FOAM 4X4",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"DRESSING ALLEVYN LIFE ADHESIVE FOAM 6X6",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"DRESSING OPTIFOAM GENTLE AG+ POST OP 4X8",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"DRESSING OPTIFOAM GENTLE AG+ POST OP 4X10",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"DRI LOK THREADED CANNULA 6.5X90",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"DRILL BIT 310.29",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"DRILL MINI ACUTRAK 2, LONG",ORSUP0019,CDM,272,RC,,,OUTPATIENT,,,1648,1071.2,,1450.24,88,,1160.19,,,0,"percent of total billed charges","88% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",285.17,17.304,,228.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1038.24,63,,830.59,,,0,"percent of total billed charges","63% of total billed charges",252.14,15.3,,201.71,,,0,"percent of total billed charges","15.3% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1137.12,69,,,,,0,"fee schedule","69% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.29,61.85,,815.43,,,0,"percent of total billed charges","61.5% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",530.66,32.2,,424.53,,,0,"percent of total billed charges","32.2% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",282.4,17.136,,225.92,,,0,"percent of total billed charges","17.136% of total billed charges",359.92,21.84,,287.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",621.3,37.7,,497.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1285.44,78,,1028.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1361.25,82.6,,1089.00,,,0,"percent of total billed charges","82.6% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",1361.25,82.6,,1089.00,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",252.14,1648,
"DRILL BIT  LONG 2.5MM GOLD",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"DRILL PRECISION NEURO 3.0MMX3.8MM",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"DRILL BIT F.A.S.T. 2.0MM",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"DRILL BIT 2.5",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"DRILL 2.5MM",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"DRILL BIT  1.5 X 6 W/STOP     317.16",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"DRILL BIT  1.5MM",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,721,468.65,,634.48,88,,507.58,,,0,"percent of total billed charges","88% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.76,17.304,,99.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.23,63,,363.38,,,0,"percent of total billed charges","63% of total billed charges",110.31,15.3,,88.25,,,0,"percent of total billed charges","15.3% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",497.49,69,,,,,0,"fee schedule","69% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",445.94,61.85,,356.75,,,0,"percent of total billed charges","61.5% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",232.16,32.2,,185.73,,,0,"percent of total billed charges","32.2% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",123.55,17.136,,98.84,,,0,"percent of total billed charges","17.136% of total billed charges",157.47,21.84,,125.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",271.82,37.7,,217.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",562.38,78,,449.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",595.55,82.6,,476.44,,,0,"percent of total billed charges","82.6% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",595.55,82.6,,476.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",110.31,721,
"DRILL BIT  MINI QUICK COUPLING 1.8MM",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"DRILL BIT  QIK COUPLE 100MM X 2MM",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"DRILL BIT 1.0MM",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"DRILL BIT 1.8MM X 110MM",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"DRILL BIT 11MM",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"DRILL BIT 2.0MM 310.201",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"DRILL BIT 2.4MM",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"DRILL BIT 4.3MM",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"DRILL BIT CANNULATED LARGE QC/300MM",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"DRILL BIT QC 1.5MM",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"DRILL BIT QC 2.0MM",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,927,602.55,,815.76,88,,652.61,,,0,"percent of total billed charges","88% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.41,17.304,,128.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.01,63,,467.21,,,0,"percent of total billed charges","63% of total billed charges",141.83,15.3,,113.46,,,0,"percent of total billed charges","15.3% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",639.63,69,,,,,0,"fee schedule","69% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",573.35,61.85,,458.68,,,0,"percent of total billed charges","61.5% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",298.49,32.2,,238.79,,,0,"percent of total billed charges","32.2% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.85,17.136,,127.08,,,0,"percent of total billed charges","17.136% of total billed charges",202.46,21.84,,161.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",349.48,37.7,,279.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",723.06,78,,578.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",141.83,927,
"DRILL BIT QC 3.2MM",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"DRILL BIT STANDARD 1.9MM MFT-072-19",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"DRILL BIT STANDARD 2.4MM MFT-072-24",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"DRILL BIT STANDARD 2.7MM MFT-072-27",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"DRILL BIT W/DEPTH 2.0MM",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"DRILL BIT WITH STOP 0.70MM AND 0.76MM 3MM STRYKER J-LATCH 316.13",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"DRILLBIT FLUTED 3 2.7MM 125MM/100MM OSCILLATI",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"DRILL BIT",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"DRILL BIT RADIOLUCENT 4.2MM",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"DRILL BIT 3FLUTE 4.2 145MM",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"DRILL STEP FOR PUSHLOCK",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"DRILL SET",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"DRILL BIT LEGEND TOOL 14CM 3MM",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"DRILL BIT 3.3MM",490481,CDM,272,RC,,,OUTPATIENT,,,443,287.95,,389.84,88,,311.87,,,0,"percent of total billed charges","88% of total billed charges",221.5,50,,177.20,,,0,"percent of total billed charges","50% of total billed charges",74.42,16.8,,59.54,,,0,"percent of total billed charges","16.8% of total billed charges",443,100,,354.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.66,17.304,,61.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",279.09,63,,223.27,,,0,"percent of total billed charges","63% of total billed charges",67.78,15.3,,54.22,,,0,"percent of total billed charges","15.3% of total billed charges",74.42,16.8,,59.54,,,0,"percent of total billed charges","16.8% of total billed charges",305.67,69,,,,,0,"fee schedule","69% of total billed charges",443,100,,354.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",443,100,,354.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",443,100,,354.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",274,61.85,,219.20,,,0,"percent of total billed charges","61.5% of total billed charges",74.42,16.8,,59.54,,,0,"percent of total billed charges","16.8% of total billed charges",221.5,50,,177.20,,,0,"percent of total billed charges","50% of total billed charges",142.65,32.2,,114.12,,,0,"percent of total billed charges","32.2% of total billed charges",74.42,16.8,,59.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.91,17.136,,60.73,,,0,"percent of total billed charges","17.136% of total billed charges",96.75,21.84,,77.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",167.01,37.7,,133.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",345.54,78,,276.43,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.92,82.6,,292.74,,,0,"percent of total billed charges","82.6% of total billed charges",74.42,16.8,,59.54,,,0,"percent of total billed charges","16.8% of total billed charges",221.5,50,,177.20,,,0,"percent of total billed charges","50% of total billed charges",365.92,82.6,,292.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.42,16.8,,59.54,,,0,"percent of total billed charges","16.8% of total billed charges",443,100,,354.40,,,0,"percent of total billed charges","100% of total billed charges",67.78,443,
"DRILL BIT 2.9MM",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"DRILL BIT PIECE",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,824,535.6,,725.12,88,,580.10,,,0,"percent of total billed charges","88% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.58,17.304,,114.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",519.12,63,,415.30,,,0,"percent of total billed charges","63% of total billed charges",126.07,15.3,,100.86,,,0,"percent of total billed charges","15.3% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",568.56,69,,,,,0,"fee schedule","69% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.64,61.85,,407.71,,,0,"percent of total billed charges","61.5% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",265.33,32.2,,212.26,,,0,"percent of total billed charges","32.2% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",141.2,17.136,,112.96,,,0,"percent of total billed charges","17.136% of total billed charges",179.96,21.84,,143.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",310.65,37.7,,248.52,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",642.72,78,,514.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",126.07,824,
"DRIVER NEEDLE LARGE SUTURE CUT",ORSUP0057,CDM,272,RC,,,OUTPATIENT,,,12587,8181.55,,11076.56,88,,8861.25,,,0,"percent of total billed charges","88% of total billed charges",6293.5,50,,5034.80,,,0,"percent of total billed charges","50% of total billed charges",2114.62,16.8,,1691.70,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2178.05,17.304,,1742.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7929.81,63,,6343.85,,,0,"percent of total billed charges","63% of total billed charges",1925.81,15.3,,1540.65,,,0,"percent of total billed charges","15.3% of total billed charges",2114.62,16.8,,1691.70,,,0,"percent of total billed charges","16.8% of total billed charges",8685.03,69,,,,,0,"fee schedule","69% of total billed charges",12587,100,,10069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12587,100,,10069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12587,100,,10069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7785.06,61.85,,6228.05,,,0,"percent of total billed charges","61.5% of total billed charges",2114.62,16.8,,1691.70,,,0,"percent of total billed charges","16.8% of total billed charges",6293.5,50,,5034.80,,,0,"percent of total billed charges","50% of total billed charges",4053.01,32.2,,3242.41,,,0,"percent of total billed charges","32.2% of total billed charges",2114.62,16.8,,1691.70,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2156.91,17.136,,1725.53,,,0,"percent of total billed charges","17.136% of total billed charges",2749,21.84,,2199.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4745.3,37.7,,3796.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9817.86,78,,7854.29,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10396.86,82.6,,8317.49,,,0,"percent of total billed charges","82.6% of total billed charges",2114.62,16.8,,1691.70,,,0,"percent of total billed charges","16.8% of total billed charges",6293.5,50,,5034.80,,,0,"percent of total billed charges","50% of total billed charges",10396.86,82.6,,8317.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2114.62,16.8,,1691.70,,,0,"percent of total billed charges","16.8% of total billed charges",12587,100,,10069.60,,,0,"percent of total billed charges","100% of total billed charges",1925.81,12587,
"DRIVER NEEDLE MEGA",ORSUP0053,CDM,272,RC,,,OUTPATIENT,,,11248,7311.2,,9898.24,88,,7918.59,,,0,"percent of total billed charges","88% of total billed charges",5624,50,,4499.20,,,0,"percent of total billed charges","50% of total billed charges",1889.66,16.8,,1511.73,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1946.35,17.304,,1557.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7086.24,63,,5668.99,,,0,"percent of total billed charges","63% of total billed charges",1720.94,15.3,,1376.75,,,0,"percent of total billed charges","15.3% of total billed charges",1889.66,16.8,,1511.73,,,0,"percent of total billed charges","16.8% of total billed charges",7761.12,69,,,,,0,"fee schedule","69% of total billed charges",11248,100,,8998.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11248,100,,8998.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11248,100,,8998.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6956.89,61.85,,5565.51,,,0,"percent of total billed charges","61.5% of total billed charges",1889.66,16.8,,1511.73,,,0,"percent of total billed charges","16.8% of total billed charges",5624,50,,4499.20,,,0,"percent of total billed charges","50% of total billed charges",3621.86,32.2,,2897.49,,,0,"percent of total billed charges","32.2% of total billed charges",1889.66,16.8,,1511.73,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1927.46,17.136,,1541.97,,,0,"percent of total billed charges","17.136% of total billed charges",2456.56,21.84,,1965.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4240.5,37.7,,3392.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8773.44,78,,7018.75,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9290.85,82.6,,7432.68,,,0,"percent of total billed charges","82.6% of total billed charges",1889.66,16.8,,1511.73,,,0,"percent of total billed charges","16.8% of total billed charges",5624,50,,4499.20,,,0,"percent of total billed charges","50% of total billed charges",9290.85,82.6,,7432.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1889.66,16.8,,1511.73,,,0,"percent of total billed charges","16.8% of total billed charges",11248,100,,8998.40,,,0,"percent of total billed charges","100% of total billed charges",1720.94,11248,
"DRUM UNIT",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"DRYLINE WATER TRAP",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"DSG TRANSPARENT TEGADERM 8X12",10521,CDM,270,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"DSG  ADAPTIC 3X3",73917,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"DSG ADAPTIC 3X3 50/BX",327635,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"DSG ELASTIC NET SIZE  6",81632,CDM,270,RC,,,OUTPATIENT,,,141,91.65,,124.08,88,,99.26,,,0,"percent of total billed charges","88% of total billed charges",70.5,50,,56.40,,,0,"percent of total billed charges","50% of total billed charges",23.69,16.8,,18.95,,,0,"percent of total billed charges","16.8% of total billed charges",141,100,,112.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.4,17.304,,19.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.83,63,,71.06,,,0,"percent of total billed charges","63% of total billed charges",21.57,15.3,,17.26,,,0,"percent of total billed charges","15.3% of total billed charges",23.69,16.8,,18.95,,,0,"percent of total billed charges","16.8% of total billed charges",97.29,69,,,,,0,"fee schedule","69% of total billed charges",141,100,,112.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",141,100,,112.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",141,100,,112.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.21,61.85,,69.77,,,0,"percent of total billed charges","61.5% of total billed charges",23.69,16.8,,18.95,,,0,"percent of total billed charges","16.8% of total billed charges",70.5,50,,56.40,,,0,"percent of total billed charges","50% of total billed charges",45.4,32.2,,36.32,,,0,"percent of total billed charges","32.2% of total billed charges",23.69,16.8,,18.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.16,17.136,,19.33,,,0,"percent of total billed charges","17.136% of total billed charges",30.79,21.84,,24.63,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",53.16,37.7,,42.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",109.98,78,,87.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",116.47,82.6,,93.18,,,0,"percent of total billed charges","82.6% of total billed charges",23.69,16.8,,18.95,,,0,"percent of total billed charges","16.8% of total billed charges",70.5,50,,56.40,,,0,"percent of total billed charges","50% of total billed charges",116.47,82.6,,93.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.69,16.8,,18.95,,,0,"percent of total billed charges","16.8% of total billed charges",141,100,,112.80,,,0,"percent of total billed charges","100% of total billed charges",21.57,141,
"DSG GAUZE VASELINE 6X36 41316",56119,CDM,270,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.95,61.85,,3.96,,,0,"percent of total billed charges","61.5% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"DSG AQUACEL AG HYDROFIBER 3.5X10",313292,CDM,272,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.9,61.85,,7.92,,,0,"percent of total billed charges","61.5% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"DTIBC PERF VER 1 BOX / 6 VIALS",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"DTIBC PERF VER II BOX / 6 VIALS",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"DTIBC REAGENT BOX / 300T",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DUAL CUT BLADE   4125-127-090",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"DUAL ELECTRODE PAD ADULT",490487,CDM,270,RC,,,OUTPATIENT,,,58,37.7,,51.04,88,,40.83,,,0,"percent of total billed charges","88% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.04,17.304,,8.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.54,63,,29.23,,,0,"percent of total billed charges","63% of total billed charges",8.87,15.3,,7.10,,,0,"percent of total billed charges","15.3% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",40.02,69,,,,,0,"fee schedule","69% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.87,61.85,,28.70,,,0,"percent of total billed charges","61.5% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",18.68,32.2,,14.94,,,0,"percent of total billed charges","32.2% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.94,17.136,,7.95,,,0,"percent of total billed charges","17.136% of total billed charges",12.67,21.84,,10.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.87,37.7,,17.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",45.24,78,,36.19,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",8.87,58,
"DURASEAL DURAL SEALANT SYSTEM 5ML",ORSUP0028,CDM,278,RC,,,OUTPATIENT,,,4553,2959.45,,4006.64,88,,3205.31,,,0,"percent of total billed charges","88% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",787.85,17.304,,630.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2868.39,63,,2294.71,,,0,"percent of total billed charges","63% of total billed charges",696.61,15.3,,557.29,,,0,"percent of total billed charges","15.3% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",3141.57,69,,,,,0,"fee schedule","69% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2816.03,61.85,,2252.82,,,0,"percent of total billed charges","61.5% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",1466.07,32.2,,1172.86,,,0,"percent of total billed charges","32.2% of total billed charges",1420.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",780.2,17.136,,624.16,,,0,"percent of total billed charges","17.136% of total billed charges",994.38,21.84,,795.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.7% of total billed charges",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1543.47,33.9,,1234.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3551.34,78,,2841.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",696.61,4553,
"DURACLIP REPOSITIONABLE HEMOSTASIS CLIP",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"DURAPREP AND IODOPHOR REMOVER LOTION",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"DUREPAIR 1 X 3",ORSUP0019,CDM,278,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",668.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.7% of total billed charges",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",726.14,33.9,,580.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"DUREPAIR 2 X 2",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"DUREPAIR 3 X 3",ORSUP0032,CDM,278,RC,,,OUTPATIENT,,,5624,3655.6,,4949.12,88,,3959.30,,,0,"percent of total billed charges","88% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",973.18,17.304,,778.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3543.12,63,,2834.50,,,0,"percent of total billed charges","63% of total billed charges",860.47,15.3,,688.38,,,0,"percent of total billed charges","15.3% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",3880.56,69,,,,,0,"fee schedule","69% of total billed charges",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3478.44,61.85,,2782.75,,,0,"percent of total billed charges","61.5% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",1810.93,32.2,,1448.74,,,0,"percent of total billed charges","32.2% of total billed charges",1754.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",963.73,17.136,,770.98,,,0,"percent of total billed charges","17.136% of total billed charges",1228.28,21.84,,982.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2120.25,37.7,,1696.20,,,0,"percent of total billed charges","37.7% of total billed charges",2120.25,37.7,,1696.20,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1906.54,33.9,,1525.23,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4386.72,78,,3509.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4645.42,82.6,,3716.34,,,0,"percent of total billed charges","82.6% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",4645.42,82.6,,3716.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",860.47,5624,
"DUREPAIR 4 X 5",ORSUP0036,CDM,278,RC,,,OUTPATIENT,,,6695,4351.75,,5891.6,88,,4713.28,,,0,"percent of total billed charges","88% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1158.5,17.304,,926.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4217.85,63,,3374.28,,,0,"percent of total billed charges","63% of total billed charges",1024.34,15.3,,819.47,,,0,"percent of total billed charges","15.3% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",4619.55,69,,,,,0,"fee schedule","69% of total billed charges",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4140.86,61.85,,3312.69,,,0,"percent of total billed charges","61.5% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",2155.79,32.2,,1724.63,,,0,"percent of total billed charges","32.2% of total billed charges",2088.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1147.26,17.136,,917.81,,,0,"percent of total billed charges","17.136% of total billed charges",1462.19,21.84,,1169.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2524.02,37.7,,2019.22,,,0,"percent of total billed charges","37.7% of total billed charges",2524.02,37.7,,2019.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2269.61,33.9,,1815.69,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5222.1,78,,4177.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5530.07,82.6,,4424.06,,,0,"percent of total billed charges","82.6% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",5530.07,82.6,,4424.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",1024.34,6695,
"DUST COVER SELF SEAL 6X10",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"DUST COVER SELF SEAL 8X12",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"DUST COVER SELF SEAL 16X22",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"DUST COVER SELF SEAL 24X30",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"DVR ANATOMIC SHORT LEFT",ORSUP0045,CDM,278,RC,,,OUTPATIENT,,,9105,5918.25,,8012.4,88,,6409.92,,,0,"percent of total billed charges","88% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1575.53,17.304,,1260.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5736.15,63,,4588.92,,,0,"percent of total billed charges","63% of total billed charges",1393.07,15.3,,1114.46,,,0,"percent of total billed charges","15.3% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",6282.45,69,,,,,0,"fee schedule","69% of total billed charges",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5631.44,61.85,,4505.15,,,0,"percent of total billed charges","61.5% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",2931.81,32.2,,2345.45,,,0,"percent of total billed charges","32.2% of total billed charges",2840.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1560.23,17.136,,1248.18,,,0,"percent of total billed charges","17.136% of total billed charges",1988.53,21.84,,1590.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3432.59,37.7,,2746.07,,,0,"percent of total billed charges","37.7% of total billed charges",3432.59,37.7,,2746.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3086.6,33.9,,2469.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7101.9,78,,5681.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7520.73,82.6,,6016.58,,,0,"percent of total billed charges","82.6% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",7520.73,82.6,,6016.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",1393.07,9105,
"DX FIXED 4 POLE",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"DXH RETIC PACK",ORSUP0021,CDM,270,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"DYNANITE NiTiSTAPLE W/INST 11X10L",ORSUP0047,CDM,278,RC,,,OUTPATIENT,,,7416,4820.4,,6526.08,88,,5220.86,,,0,"percent of total billed charges","88% of total billed charges",3708,50,,2966.40,,,0,"percent of total billed charges","50% of total billed charges",1245.89,16.8,,996.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1283.26,17.304,,1026.61,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4672.08,63,,3737.66,,,0,"percent of total billed charges","63% of total billed charges",1134.65,15.3,,907.72,,,0,"percent of total billed charges","15.3% of total billed charges",1245.89,16.8,,996.71,,,0,"percent of total billed charges","16.8% of total billed charges",5117.04,69,,,,,0,"fee schedule","69% of total billed charges",7416,100,,5932.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7416,100,,5932.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7416,100,,5932.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4586.8,61.85,,3669.44,,,0,"percent of total billed charges","61.5% of total billed charges",1245.89,16.8,,996.71,,,0,"percent of total billed charges","16.8% of total billed charges",3708,50,,2966.40,,,0,"percent of total billed charges","50% of total billed charges",2387.95,32.2,,1910.36,,,0,"percent of total billed charges","32.2% of total billed charges",2313.79,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1270.81,17.136,,1016.65,,,0,"percent of total billed charges","17.136% of total billed charges",1619.65,21.84,,1295.72,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2795.83,37.7,,2236.66,,,0,"percent of total billed charges","37.7% of total billed charges",2795.83,37.7,,2236.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2514.02,33.9,,2011.22,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5784.48,78,,4627.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6125.62,82.6,,4900.50,,,0,"percent of total billed charges","82.6% of total billed charges",1245.89,16.8,,996.71,,,0,"percent of total billed charges","16.8% of total billed charges",3708,50,,2966.40,,,0,"percent of total billed charges","50% of total billed charges",6125.62,82.6,,4900.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1245.89,16.8,,996.71,,,0,"percent of total billed charges","16.8% of total billed charges",7416,100,,5932.80,,,0,"percent of total billed charges","100% of total billed charges",1134.65,7416,
"DYNANITE NiTiSTAPLE W/INST 15X15L",ORSUP0065,CDM,278,RC,,,OUTPATIENT,,,11330,7364.5,,9970.4,88,,7976.32,,,0,"percent of total billed charges","88% of total billed charges",5665,50,,4532.00,,,0,"percent of total billed charges","50% of total billed charges",1903.44,16.8,,1522.75,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1960.54,17.304,,1568.43,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7137.9,63,,5710.32,,,0,"percent of total billed charges","63% of total billed charges",1733.49,15.3,,1386.79,,,0,"percent of total billed charges","15.3% of total billed charges",1903.44,16.8,,1522.75,,,0,"percent of total billed charges","16.8% of total billed charges",7817.7,69,,,,,0,"fee schedule","69% of total billed charges",11330,100,,9064.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11330,100,,9064.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11330,100,,9064.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7007.61,61.85,,5606.09,,,0,"percent of total billed charges","61.5% of total billed charges",1903.44,16.8,,1522.75,,,0,"percent of total billed charges","16.8% of total billed charges",5665,50,,4532.00,,,0,"percent of total billed charges","50% of total billed charges",3648.26,32.2,,2918.61,,,0,"percent of total billed charges","32.2% of total billed charges",3534.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1941.51,17.136,,1553.21,,,0,"percent of total billed charges","17.136% of total billed charges",2474.47,21.84,,1979.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4271.41,37.7,,3417.13,,,0,"percent of total billed charges","37.7% of total billed charges",4271.41,37.7,,3417.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3840.87,33.9,,3072.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",8837.4,78,,7069.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9358.58,82.6,,7486.86,,,0,"percent of total billed charges","82.6% of total billed charges",1903.44,16.8,,1522.75,,,0,"percent of total billed charges","16.8% of total billed charges",5665,50,,4532.00,,,0,"percent of total billed charges","50% of total billed charges",9358.58,82.6,,7486.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1903.44,16.8,,1522.75,,,0,"percent of total billed charges","16.8% of total billed charges",11330,100,,9064.00,,,0,"percent of total billed charges","100% of total billed charges",1733.49,11330,
"E-Z SCRUB MOUNTING SOAM DISPENSER",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"E-Z CLEAN DISP LAPAROSCOPIC ELECTRODE 13.5 INCH",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"EA-IO NEEDLE + STABILIZER KIT 15GA X 15MM",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,927,602.55,,815.76,88,,652.61,,,0,"percent of total billed charges","88% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.41,17.304,,128.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.01,63,,467.21,,,0,"percent of total billed charges","63% of total billed charges",141.83,15.3,,113.46,,,0,"percent of total billed charges","15.3% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",639.63,69,,,,,0,"fee schedule","69% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",573.35,61.85,,458.68,,,0,"percent of total billed charges","61.5% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",298.49,32.2,,238.79,,,0,"percent of total billed charges","32.2% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.85,17.136,,127.08,,,0,"percent of total billed charges","17.136% of total billed charges",202.46,21.84,,161.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",349.48,37.7,,279.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",723.06,78,,578.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",141.83,927,
"EAR CURETTES DISP #4888",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"EAR TIP INFANT 5.0MM GREEN",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"EAR TIP INFANT 5.5MM BLUE",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"EAR TUBE 1.14 REUTER BOBBIN",ORSUP0004,CDM,270,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"EAR PROSTHESIS SHEEHY 1.17MM",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"EAR TUBE 1.27 REUTER BOBBIN",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"EAR WICK MEROCEL",490496,CDM,270,RC,,,OUTPATIENT,,,37,24.05,,32.56,88,,26.05,,,0,"percent of total billed charges","88% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.4,17.304,,5.12,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.31,63,,18.65,,,0,"percent of total billed charges","63% of total billed charges",5.66,15.3,,4.53,,,0,"percent of total billed charges","15.3% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",25.53,69,,,,,0,"fee schedule","69% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.88,61.85,,18.30,,,0,"percent of total billed charges","61.5% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",11.91,32.2,,9.53,,,0,"percent of total billed charges","32.2% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.34,17.136,,5.07,,,0,"percent of total billed charges","17.136% of total billed charges",8.08,21.84,,6.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.95,37.7,,11.16,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.86,78,,23.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",5.66,37,
"EAR TUBE SHEEHY 1.27MM VENT",ORSUP0004,CDM,270,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"EAR TUBE SHEEHY TOP 3ML",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"EAR TUBE ACTIVENT GOODE T",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,17.304,,49.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.28,61.85,,178.62,,,0,"percent of total billed charges","61.5% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",116.24,32.2,,92.99,,,0,"percent of total billed charges","32.2% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.86,17.136,,49.49,,,0,"percent of total billed charges","17.136% of total billed charges",78.84,21.84,,63.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,361,
"LIGHTED EAR CURETTE REPLACEMENT LIGHT",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"EAR/ULCER SYRINGE 3OZ STERILE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"EARTIP KIT FLANGED MUSHROOM/UIMBRELLA SHAPED",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"EASY CAP II CO2 DETECTOR PEDIATRIC",ORSUP00002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"ECG LEADS DISP (TELE)",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.94,17.304,,85.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.23,61.85,,305.78,,,0,"percent of total billed charges","61.5% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",199,32.2,,159.20,,,0,"percent of total billed charges","32.2% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.136,,84.72,,,0,"percent of total billed charges","17.136% of total billed charges",134.97,21.84,,107.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,618,
"ECHELON FLEX POWERED PLUS STAPLER 45MM SINGLE USE LATEX FREE",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"ECHELON STAPLER RELOAD 45MM BLUE",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,927,602.55,,815.76,88,,652.61,,,0,"percent of total billed charges","88% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.41,17.304,,128.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.01,63,,467.21,,,0,"percent of total billed charges","63% of total billed charges",141.83,15.3,,113.46,,,0,"percent of total billed charges","15.3% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",639.63,69,,,,,0,"fee schedule","69% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",573.35,61.85,,458.68,,,0,"percent of total billed charges","61.5% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",298.49,32.2,,238.79,,,0,"percent of total billed charges","32.2% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.85,17.136,,127.08,,,0,"percent of total billed charges","17.136% of total billed charges",202.46,21.84,,161.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",349.48,37.7,,279.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",723.06,78,,578.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",141.83,927,
"ECHELON STAPLER RELOAD 45MM GREEN",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,927,602.55,,815.76,88,,652.61,,,0,"percent of total billed charges","88% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.41,17.304,,128.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.01,63,,467.21,,,0,"percent of total billed charges","63% of total billed charges",141.83,15.3,,113.46,,,0,"percent of total billed charges","15.3% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",639.63,69,,,,,0,"fee schedule","69% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",573.35,61.85,,458.68,,,0,"percent of total billed charges","61.5% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",298.49,32.2,,238.79,,,0,"percent of total billed charges","32.2% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.85,17.136,,127.08,,,0,"percent of total billed charges","17.136% of total billed charges",202.46,21.84,,161.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",349.48,37.7,,279.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",723.06,78,,578.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",141.83,927,
"ECLIPSE NITINOL STONE RETREIVAL BASKET TIPLESS",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,824,535.6,,725.12,88,,580.10,,,0,"percent of total billed charges","88% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.58,17.304,,114.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",519.12,63,,415.30,,,0,"percent of total billed charges","63% of total billed charges",126.07,15.3,,100.86,,,0,"percent of total billed charges","15.3% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",568.56,69,,,,,0,"fee schedule","69% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.64,61.85,,407.71,,,0,"percent of total billed charges","61.5% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",265.33,32.2,,212.26,,,0,"percent of total billed charges","32.2% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",141.2,17.136,,112.96,,,0,"percent of total billed charges","17.136% of total billed charges",179.96,21.84,,143.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",310.65,37.7,,248.52,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",642.72,78,,514.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",126.07,824,
"EIKENELLA CORRODENS ATCC CULTI LOOPS 1152",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"EKG BUTTONS",490497,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"ELECTRODE MENISCETOMY",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"ELECTRODE BLADE 2.5IN STRL DISP",153659,CDM,272,RC,,,OUTPATIENT,,,34,22.1,,29.92,88,,23.94,,,0,"percent of total billed charges","88% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.88,17.304,,4.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.42,63,,17.14,,,0,"percent of total billed charges","63% of total billed charges",5.2,15.3,,4.16,,,0,"percent of total billed charges","15.3% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",23.46,69,,,,,0,"fee schedule","69% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.03,61.85,,16.82,,,0,"percent of total billed charges","61.5% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",10.95,32.2,,8.76,,,0,"percent of total billed charges","32.2% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.83,17.136,,4.66,,,0,"percent of total billed charges","17.136% of total billed charges",7.43,21.84,,5.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.82,37.7,,10.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.52,78,,21.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",5.2,34,
"ELECTRODE BLADE EXTENDED 6.50IN STERILE DISPOSABLE",143721,CDM,272,RC,,,OUTPATIENT,,,39,25.35,,34.32,88,,27.46,,,0,"percent of total billed charges","88% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.75,17.304,,5.40,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.57,63,,19.66,,,0,"percent of total billed charges","63% of total billed charges",5.97,15.3,,4.78,,,0,"percent of total billed charges","15.3% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",26.91,69,,,,,0,"fee schedule","69% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.12,61.85,,19.30,,,0,"percent of total billed charges","61.5% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",12.56,32.2,,10.05,,,0,"percent of total billed charges","32.2% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.68,17.136,,5.34,,,0,"percent of total billed charges","17.136% of total billed charges",8.52,21.84,,6.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.42,78,,24.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",5.97,39,
"ELECTRODE FETAL MONITOR SPIRAL",ORSUP0011,CDM,270,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"ELECTRODE ECG ADLT SNAP RADIOLUCENT RT630",115654,CDM,270,RC,,,OUTPATIENT,,,30,19.5,,26.4,88,,21.12,,,0,"percent of total billed charges","88% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.19,17.304,,4.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.9,63,,15.12,,,0,"percent of total billed charges","63% of total billed charges",4.59,15.3,,3.67,,,0,"percent of total billed charges","15.3% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",20.7,69,,,,,0,"fee schedule","69% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.56,61.85,,14.85,,,0,"percent of total billed charges","61.5% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",9.66,32.2,,7.73,,,0,"percent of total billed charges","32.2% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.14,17.136,,4.11,,,0,"percent of total billed charges","17.136% of total billed charges",6.55,21.84,,5.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.31,37.7,,9.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.4,78,,18.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",4.59,30,
"ELECTRODE ECG TAB Q-TRACE VINYL GEL ADULT",11128,CDM,270,RC,,,OUTPATIENT,,,829,538.85,,729.52,88,,583.62,,,0,"percent of total billed charges","88% of total billed charges",414.5,50,,331.60,,,0,"percent of total billed charges","50% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",143.45,17.304,,114.76,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.27,63,,417.82,,,0,"percent of total billed charges","63% of total billed charges",126.84,15.3,,101.47,,,0,"percent of total billed charges","15.3% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",572.01,69,,,,,0,"fee schedule","69% of total billed charges",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",512.74,61.85,,410.19,,,0,"percent of total billed charges","61.5% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",414.5,50,,331.60,,,0,"percent of total billed charges","50% of total billed charges",266.94,32.2,,213.55,,,0,"percent of total billed charges","32.2% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.06,17.136,,113.65,,,0,"percent of total billed charges","17.136% of total billed charges",181.05,21.84,,144.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",312.53,37.7,,250.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",646.62,78,,517.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",684.75,82.6,,547.80,,,0,"percent of total billed charges","82.6% of total billed charges",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",414.5,50,,331.60,,,0,"percent of total billed charges","50% of total billed charges",684.75,82.6,,547.80,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",139.27,16.8,,111.42,,,0,"percent of total billed charges","16.8% of total billed charges",829,100,,663.20,,,0,"percent of total billed charges","100% of total billed charges",126.84,829,
"ELECTRODE MULTIPURP FOAM",73396,CDM,270,RC,,,OUTPATIENT,,,145,94.25,,127.6,88,,102.08,,,0,"percent of total billed charges","88% of total billed charges",72.5,50,,58.00,,,0,"percent of total billed charges","50% of total billed charges",24.36,16.8,,19.49,,,0,"percent of total billed charges","16.8% of total billed charges",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.09,17.304,,20.07,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.35,63,,73.08,,,0,"percent of total billed charges","63% of total billed charges",22.19,15.3,,17.75,,,0,"percent of total billed charges","15.3% of total billed charges",24.36,16.8,,19.49,,,0,"percent of total billed charges","16.8% of total billed charges",100.05,69,,,,,0,"fee schedule","69% of total billed charges",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.68,61.85,,71.74,,,0,"percent of total billed charges","61.5% of total billed charges",24.36,16.8,,19.49,,,0,"percent of total billed charges","16.8% of total billed charges",72.5,50,,58.00,,,0,"percent of total billed charges","50% of total billed charges",46.69,32.2,,37.35,,,0,"percent of total billed charges","32.2% of total billed charges",24.36,16.8,,19.49,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.85,17.136,,19.88,,,0,"percent of total billed charges","17.136% of total billed charges",31.67,21.84,,25.34,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",54.67,37.7,,43.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",113.1,78,,90.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",119.77,82.6,,95.82,,,0,"percent of total billed charges","82.6% of total billed charges",24.36,16.8,,19.49,,,0,"percent of total billed charges","16.8% of total billed charges",72.5,50,,58.00,,,0,"percent of total billed charges","50% of total billed charges",119.77,82.6,,95.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.36,16.8,,19.49,,,0,"percent of total billed charges","16.8% of total billed charges",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",22.19,145,
"ELECTRODES MONITORING ECG",202866,CDM,270,RC,,,OUTPATIENT,,,522,339.3,,459.36,88,,367.49,,,0,"percent of total billed charges","88% of total billed charges",261,50,,208.80,,,0,"percent of total billed charges","50% of total billed charges",87.7,16.8,,70.16,,,0,"percent of total billed charges","16.8% of total billed charges",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.33,17.304,,72.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",328.86,63,,263.09,,,0,"percent of total billed charges","63% of total billed charges",79.87,15.3,,63.90,,,0,"percent of total billed charges","15.3% of total billed charges",87.7,16.8,,70.16,,,0,"percent of total billed charges","16.8% of total billed charges",360.18,69,,,,,0,"fee schedule","69% of total billed charges",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",322.86,61.85,,258.29,,,0,"percent of total billed charges","61.5% of total billed charges",87.7,16.8,,70.16,,,0,"percent of total billed charges","16.8% of total billed charges",261,50,,208.80,,,0,"percent of total billed charges","50% of total billed charges",168.08,32.2,,134.46,,,0,"percent of total billed charges","32.2% of total billed charges",87.7,16.8,,70.16,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.45,17.136,,71.56,,,0,"percent of total billed charges","17.136% of total billed charges",114,21.84,,91.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",196.79,37.7,,157.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",407.16,78,,325.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",431.17,82.6,,344.94,,,0,"percent of total billed charges","82.6% of total billed charges",87.7,16.8,,70.16,,,0,"percent of total billed charges","16.8% of total billed charges",261,50,,208.80,,,0,"percent of total billed charges","50% of total billed charges",431.17,82.6,,344.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.7,16.8,,70.16,,,0,"percent of total billed charges","16.8% of total billed charges",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",79.87,522,
"ELECTRODE ECG FOAM RADIOTRANSLUCENT 855",172711,CDM,270,RC,,,OUTPATIENT,,,497,323.05,,437.36,88,,349.89,,,0,"percent of total billed charges","88% of total billed charges",248.5,50,,198.80,,,0,"percent of total billed charges","50% of total billed charges",83.5,16.8,,66.80,,,0,"percent of total billed charges","16.8% of total billed charges",497,100,,397.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",86,17.304,,68.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.11,63,,250.49,,,0,"percent of total billed charges","63% of total billed charges",76.04,15.3,,60.83,,,0,"percent of total billed charges","15.3% of total billed charges",83.5,16.8,,66.80,,,0,"percent of total billed charges","16.8% of total billed charges",342.93,69,,,,,0,"fee schedule","69% of total billed charges",497,100,,397.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",497,100,,397.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",497,100,,397.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",307.39,61.85,,245.91,,,0,"percent of total billed charges","61.5% of total billed charges",83.5,16.8,,66.80,,,0,"percent of total billed charges","16.8% of total billed charges",248.5,50,,198.80,,,0,"percent of total billed charges","50% of total billed charges",160.03,32.2,,128.02,,,0,"percent of total billed charges","32.2% of total billed charges",83.5,16.8,,66.80,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.17,17.136,,68.14,,,0,"percent of total billed charges","17.136% of total billed charges",108.54,21.84,,86.83,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",187.37,37.7,,149.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",387.66,78,,310.13,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",410.52,82.6,,328.42,,,0,"percent of total billed charges","82.6% of total billed charges",83.5,16.8,,66.80,,,0,"percent of total billed charges","16.8% of total billed charges",248.5,50,,198.80,,,0,"percent of total billed charges","50% of total billed charges",410.52,82.6,,328.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",83.5,16.8,,66.80,,,0,"percent of total billed charges","16.8% of total billed charges",497,100,,397.60,,,0,"percent of total billed charges","100% of total billed charges",76.04,497,
"ELECTRO LUBE ANTI STICK SOLUTION",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"ELECTRODE PEDIATRIC DEFIB RADIOLUCENT",448880,CDM,270,RC,,,OUTPATIENT,,,109,70.85,,95.92,88,,76.74,,,0,"percent of total billed charges","88% of total billed charges",54.5,50,,43.60,,,0,"percent of total billed charges","50% of total billed charges",18.31,16.8,,14.65,,,0,"percent of total billed charges","16.8% of total billed charges",109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.86,17.304,,15.09,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.67,63,,54.94,,,0,"percent of total billed charges","63% of total billed charges",16.68,15.3,,13.34,,,0,"percent of total billed charges","15.3% of total billed charges",18.31,16.8,,14.65,,,0,"percent of total billed charges","16.8% of total billed charges",75.21,69,,,,,0,"fee schedule","69% of total billed charges",109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.42,61.85,,53.94,,,0,"percent of total billed charges","61.5% of total billed charges",18.31,16.8,,14.65,,,0,"percent of total billed charges","16.8% of total billed charges",54.5,50,,43.60,,,0,"percent of total billed charges","50% of total billed charges",35.1,32.2,,28.08,,,0,"percent of total billed charges","32.2% of total billed charges",18.31,16.8,,14.65,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.68,17.136,,14.94,,,0,"percent of total billed charges","17.136% of total billed charges",23.81,21.84,,19.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.09,37.7,,32.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",85.02,78,,68.02,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.03,82.6,,72.02,,,0,"percent of total billed charges","82.6% of total billed charges",18.31,16.8,,14.65,,,0,"percent of total billed charges","16.8% of total billed charges",54.5,50,,43.60,,,0,"percent of total billed charges","50% of total billed charges",90.03,82.6,,72.02,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.31,16.8,,14.65,,,0,"percent of total billed charges","16.8% of total billed charges",109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",16.68,109,
"ELECTRODE QUADTODE",ORSUP0014,CDM,270,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"ELECTRODE LOOP 26F",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"ELECTRD RESECTION CYLINDER VAPORTRODE",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"ELECTRODE ROLLER 24-28FR",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"ELECTRODE BALL 5MM",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"ELECTRODE NIM STIMULATOR",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"ELECTRODE KNIFE 24FR",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"ELECTRODE ELECSURG LOP HI FREQ A22207C",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"ELECTRODES RFD",ORSUP0024,CDM,272,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"ELECTRODE ROLLER 24-28FR HF",ORSUP0016,CDM,270,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"ELECTRODE NIMS NEEDLE SET",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"ELECTRODE MEGAFINE NEEDLE 0118",490505,CDM,272,RC,,,OUTPATIENT,,,94,61.1,,82.72,88,,66.18,,,0,"percent of total billed charges","88% of total billed charges",47,50,,37.60,,,0,"percent of total billed charges","50% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.27,17.304,,13.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.22,63,,47.38,,,0,"percent of total billed charges","63% of total billed charges",14.38,15.3,,11.50,,,0,"percent of total billed charges","15.3% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",64.86,69,,,,,0,"fee schedule","69% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.14,61.85,,46.51,,,0,"percent of total billed charges","61.5% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",47,50,,37.60,,,0,"percent of total billed charges","50% of total billed charges",30.27,32.2,,24.22,,,0,"percent of total billed charges","32.2% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.11,17.136,,12.89,,,0,"percent of total billed charges","17.136% of total billed charges",20.53,21.84,,16.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.44,37.7,,28.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",73.32,78,,58.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",47,50,,37.60,,,0,"percent of total billed charges","50% of total billed charges",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",14.38,94,
"ELECTRODE LOOP SMALL 24FR 0.2",ORSUP0016,CDM,270,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"ELECTRODE LOOP LARGE 24FR 0.2",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"ELECTRODE 24FR CUTTING LOOP",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"ELECTRODE PAIRED 4 CHANNEL",ORSUP0013,CDM,270,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"ELECTRODE 27FR CUTTING LOOP",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"ELECTRODE BUTTON 24-28 FR",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"ELECTRODE LOOP LLETZ 10 X 10MM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
N/A,ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"ELECTRODE CLEAN COAT L-HOOK",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,515,334.75,,453.2,88,,362.56,,,0,"percent of total billed charges","88% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.12,17.304,,71.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",324.45,63,,259.56,,,0,"percent of total billed charges","63% of total billed charges",78.8,15.3,,63.04,,,0,"percent of total billed charges","15.3% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",355.35,69,,,,,0,"fee schedule","69% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",318.53,61.85,,254.82,,,0,"percent of total billed charges","61.5% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",165.83,32.2,,132.66,,,0,"percent of total billed charges","32.2% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.25,17.136,,70.60,,,0,"percent of total billed charges","17.136% of total billed charges",112.48,21.84,,89.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",194.16,37.7,,155.33,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",401.7,78,,321.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",78.8,515,
"ELECTRODE BALL JOIMAX LEGATO",ORSUP0018,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"ELECTRODE ECG GENERAL MONITORING FOAM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"ELECTRODE PEDI/NEONATOR FOAM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"ELECTROD ECG STRESS/DIAPHORETIC FOAM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"ELECTRODE VITAL STIM ADULT SIZE PK OF 12",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"ELECTRODE PERFORMA CLOTH 2IN X 3.5IN PK OF 4",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"ELECTRODE RADIOTRANSLUCENT FOAM MEDGEL",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"ELECTRODE 24FR COAGULATING",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"ELECTRODE 24FR ROLLER 5MM",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"ELEPHANT EAR WASH KIT",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"ELEVATOR LEG FOAM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"ELEVIEW 5 AMP 10ML",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,412,267.8,,362.56,88,,290.05,,,0,"percent of total billed charges","88% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.29,17.304,,57.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",259.56,63,,207.65,,,0,"percent of total billed charges","63% of total billed charges",63.04,15.3,,50.43,,,0,"percent of total billed charges","15.3% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",284.28,69,,,,,0,"fee schedule","69% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",254.82,61.85,,203.86,,,0,"percent of total billed charges","61.5% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",132.66,32.2,,106.13,,,0,"percent of total billed charges","32.2% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.6,17.136,,56.48,,,0,"percent of total billed charges","17.136% of total billed charges",89.98,21.84,,71.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",155.32,37.7,,124.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",321.36,78,,257.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",63.04,412,
"ELITE IRRIGATION SLEEVE 7CM",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,17.304,,49.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.28,61.85,,178.62,,,0,"percent of total billed charges","61.5% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",116.24,32.2,,92.99,,,0,"percent of total billed charges","32.2% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.86,17.136,,49.49,,,0,"percent of total billed charges","17.136% of total billed charges",78.84,21.84,,63.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,361,
"EMBOLISM RETRACT DETACH COIL 14CM X 6MM",ORSUP0027,CDM,272,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"EMBOLISM RETRACT DETACH COIL 14CM X 8MM",ORSUP0027,CDM,272,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"EMBOLISM RETRACT DETACH COIL 14CM X 10MM",ORSUP0027,CDM,272,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"EMBOLISM RETRACT DETACH COIL 14CM 12MM",ORSUP0027,CDM,272,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"EMBOSPHERE 2ML SYRINGE BLUE",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1185,770.25,,1042.8,88,,834.24,,,0,"percent of total billed charges","88% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",205.05,17.304,,164.04,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",746.55,63,,597.24,,,0,"percent of total billed charges","63% of total billed charges",181.31,15.3,,145.05,,,0,"percent of total billed charges","15.3% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",817.65,69,,,,,0,"fee schedule","69% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.92,61.85,,586.34,,,0,"percent of total billed charges","61.5% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",381.57,32.2,,305.26,,,0,"percent of total billed charges","32.2% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",203.06,17.136,,162.45,,,0,"percent of total billed charges","17.136% of total billed charges",258.8,21.84,,207.04,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",446.75,37.7,,357.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",924.3,78,,739.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",181.31,1185,
"ENCORE 26 BALLOON INFLATION DEVICE W/ASSESSORIES",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"ENCORE 26 INFLATOR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"ENDO VIV SAFTEY PEG KIT 20FR",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"ENDO SCISSORS",ORSUP0023,CDM,272,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
ENDOSWABS,ORSUP0018,CDM,270,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"ENDOZYME SPONGE",109034,CDM,270,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"ENDOSCOPE 8.5MM  ALIGNMENT TARGET",ORSUP0023,CDM,272,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"ENDOSTITCH V-LOC 2-0  6LP",ORSUP0011,CDM,270,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"ENDOTRACH TUBE 9.0 NIM",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"ENDOTRACH TUBE 8MM NIM",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"ENDOTRACH TUBE 7MM NIM",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"ENDOTRACH TUBE 6MM NIM",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"ENDOTRACH TUBE 5MM NIM",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"ENDOGRASPER, ROTICULATING",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"ENDOBUTTON PAC ACCESSORY KIT",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"ENDO APPLICATOR FOR FLOSEAL",ORSUP0010,CDM,270,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"ENDO POUCH/BAG 5X7 10MM  750ML",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"ENDOSTITCH POLYSORB ES9 DYED",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
ENDOSTITCH,ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"ENDO RETRACTOR FAN",ORSUP0013,CDM,270,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
ENDOCLOSE,ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"ENDOAVITEVE PUSHER",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"ENDOLOOP VICRYL 0 EJ10G",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"Echelon Linear Cutter Reload 60MM BUE",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1455,945.75,,1280.4,88,,1024.32,,,0,"percent of total billed charges","88% of total billed charges",727.5,50,,582.00,,,0,"percent of total billed charges","50% of total billed charges",244.44,16.8,,195.55,,,0,"percent of total billed charges","16.8% of total billed charges",1455,100,,1164.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",251.77,17.304,,201.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",916.65,63,,733.32,,,0,"percent of total billed charges","63% of total billed charges",222.62,15.3,,178.10,,,0,"percent of total billed charges","15.3% of total billed charges",244.44,16.8,,195.55,,,0,"percent of total billed charges","16.8% of total billed charges",1003.95,69,,,,,0,"fee schedule","69% of total billed charges",1455,100,,1164.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1455,100,,1164.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1455,100,,1164.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",899.92,61.85,,719.94,,,0,"percent of total billed charges","61.5% of total billed charges",244.44,16.8,,195.55,,,0,"percent of total billed charges","16.8% of total billed charges",727.5,50,,582.00,,,0,"percent of total billed charges","50% of total billed charges",468.51,32.2,,374.81,,,0,"percent of total billed charges","32.2% of total billed charges",244.44,16.8,,195.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",249.33,17.136,,199.46,,,0,"percent of total billed charges","17.136% of total billed charges",317.77,21.84,,254.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",548.54,37.7,,438.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1134.9,78,,907.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.83,82.6,,961.46,,,0,"percent of total billed charges","82.6% of total billed charges",244.44,16.8,,195.55,,,0,"percent of total billed charges","16.8% of total billed charges",727.5,50,,582.00,,,0,"percent of total billed charges","50% of total billed charges",1201.83,82.6,,961.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",244.44,16.8,,195.55,,,0,"percent of total billed charges","16.8% of total billed charges",1455,100,,1164.00,,,0,"percent of total billed charges","100% of total billed charges",222.62,1455,
"ENDOARMOR GOWNS",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"ENDOPATH XCEL BLADELESS TROCAR 15MM X 100MM",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"ENFLOW FLUID WARMER CARTRIDGE",490525,CDM,270,RC,,,OUTPATIENT,,,111,72.15,,97.68,88,,78.14,,,0,"percent of total billed charges","88% of total billed charges",55.5,50,,44.40,,,0,"percent of total billed charges","50% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.21,17.304,,15.37,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.93,63,,55.94,,,0,"percent of total billed charges","63% of total billed charges",16.98,15.3,,13.58,,,0,"percent of total billed charges","15.3% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",76.59,69,,,,,0,"fee schedule","69% of total billed charges",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.65,61.85,,54.92,,,0,"percent of total billed charges","61.5% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",55.5,50,,44.40,,,0,"percent of total billed charges","50% of total billed charges",35.74,32.2,,28.59,,,0,"percent of total billed charges","32.2% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.02,17.136,,15.22,,,0,"percent of total billed charges","17.136% of total billed charges",24.24,21.84,,19.39,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.85,37.7,,33.48,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",86.58,78,,69.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.69,82.6,,73.35,,,0,"percent of total billed charges","82.6% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",55.5,50,,44.40,,,0,"percent of total billed charges","50% of total billed charges",91.69,82.6,,73.35,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",16.98,111,
"ENSEAL 5MM ART TISS SEALER",ORSUP0032,CDM,272,RC,,,OUTPATIENT,,,5624,3655.6,,4949.12,88,,3959.30,,,0,"percent of total billed charges","88% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",973.18,17.304,,778.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3543.12,63,,2834.50,,,0,"percent of total billed charges","63% of total billed charges",860.47,15.3,,688.38,,,0,"percent of total billed charges","15.3% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",3880.56,69,,,,,0,"fee schedule","69% of total billed charges",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3478.44,61.85,,2782.75,,,0,"percent of total billed charges","61.5% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",1810.93,32.2,,1448.74,,,0,"percent of total billed charges","32.2% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",963.73,17.136,,770.98,,,0,"percent of total billed charges","17.136% of total billed charges",1228.28,21.84,,982.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2120.25,37.7,,1696.20,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4386.72,78,,3509.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4645.42,82.6,,3716.34,,,0,"percent of total billed charges","82.6% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",4645.42,82.6,,3716.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",860.47,5624,
"ENSURE HIGH PROTEIN CHOCOLATE",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"ENSURE HIGH PROTEIN VANILLA",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"ENTEROCOCCUS CASSELIFLAVUS ATCC 700327",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"ENTERO FAECALIS ATCC CULTI LOOPS 29212",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"ENTERO HORMAECHEI ATCC CULTI LOOPS 700323",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"ENVELOPE NO 10 REGULAR",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"ENVELOPE NO 10 WINDOW",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"ENVELOPE YAKIMA REGIONAL WH",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"ENZYMATIC SOLUTION B91",12171,CDM,270,RC,,,OUTPATIENT,,,127,82.55,,111.76,88,,89.41,,,0,"percent of total billed charges","88% of total billed charges",63.5,50,,50.80,,,0,"percent of total billed charges","50% of total billed charges",21.34,16.8,,17.07,,,0,"percent of total billed charges","16.8% of total billed charges",127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.98,17.304,,17.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.01,63,,64.01,,,0,"percent of total billed charges","63% of total billed charges",19.43,15.3,,15.54,,,0,"percent of total billed charges","15.3% of total billed charges",21.34,16.8,,17.07,,,0,"percent of total billed charges","16.8% of total billed charges",87.63,69,,,,,0,"fee schedule","69% of total billed charges",127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.55,61.85,,62.84,,,0,"percent of total billed charges","61.5% of total billed charges",21.34,16.8,,17.07,,,0,"percent of total billed charges","16.8% of total billed charges",63.5,50,,50.80,,,0,"percent of total billed charges","50% of total billed charges",40.89,32.2,,32.71,,,0,"percent of total billed charges","32.2% of total billed charges",21.34,16.8,,17.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.76,17.136,,17.41,,,0,"percent of total billed charges","17.136% of total billed charges",27.74,21.84,,22.19,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47.88,37.7,,38.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",99.06,78,,79.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.9,82.6,,83.92,,,0,"percent of total billed charges","82.6% of total billed charges",21.34,16.8,,17.07,,,0,"percent of total billed charges","16.8% of total billed charges",63.5,50,,50.80,,,0,"percent of total billed charges","50% of total billed charges",104.9,82.6,,83.92,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.34,16.8,,17.07,,,0,"percent of total billed charges","16.8% of total billed charges",127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",19.43,127,
"ENZYMATIC CLEANING SPONGE",490526,CDM,270,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"ENZYMATIC DETERGENT NEPTUNE",490527,CDM,270,RC,,,OUTPATIENT,,,441,286.65,,388.08,88,,310.46,,,0,"percent of total billed charges","88% of total billed charges",220.5,50,,176.40,,,0,"percent of total billed charges","50% of total billed charges",74.09,16.8,,59.27,,,0,"percent of total billed charges","16.8% of total billed charges",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.31,17.304,,61.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",277.83,63,,222.26,,,0,"percent of total billed charges","63% of total billed charges",67.47,15.3,,53.98,,,0,"percent of total billed charges","15.3% of total billed charges",74.09,16.8,,59.27,,,0,"percent of total billed charges","16.8% of total billed charges",304.29,69,,,,,0,"fee schedule","69% of total billed charges",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.76,61.85,,218.21,,,0,"percent of total billed charges","61.5% of total billed charges",74.09,16.8,,59.27,,,0,"percent of total billed charges","16.8% of total billed charges",220.5,50,,176.40,,,0,"percent of total billed charges","50% of total billed charges",142,32.2,,113.60,,,0,"percent of total billed charges","32.2% of total billed charges",74.09,16.8,,59.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.57,17.136,,60.46,,,0,"percent of total billed charges","17.136% of total billed charges",96.31,21.84,,77.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",166.26,37.7,,133.01,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",343.98,78,,275.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",364.27,82.6,,291.42,,,0,"percent of total billed charges","82.6% of total billed charges",74.09,16.8,,59.27,,,0,"percent of total billed charges","16.8% of total billed charges",220.5,50,,176.40,,,0,"percent of total billed charges","50% of total billed charges",364.27,82.6,,291.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.09,16.8,,59.27,,,0,"percent of total billed charges","16.8% of total billed charges",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",67.47,441,
"ENZYME SPONGE",490529,CDM,270,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"EPICORD SHEET 2X3 CM",636Q418723,CDM,636,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"EPICORD SHEET 3X5 CM",636Q418735,CDM,636,RC,,,OUTPATIENT,,,16686,10845.9,,14683.68,88,,11746.94,,,0,"percent of total billed charges","88% of total billed charges",8343,50,,6674.40,,,0,"percent of total billed charges","50% of total billed charges",2803.25,16.8,,2242.60,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2887.35,17.304,,2309.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10512.18,63,,8409.74,,,0,"percent of total billed charges","63% of total billed charges",2552.96,15.3,,2042.37,,,0,"percent of total billed charges","15.3% of total billed charges",2803.25,16.8,,2242.60,,,0,"percent of total billed charges","16.8% of total billed charges",11513.34,69,,,,,0,"fee schedule","69% of total billed charges",16686,100,,13348.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16686,100,,13348.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16686,100,,13348.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10320.29,61.85,,8256.23,,,0,"percent of total billed charges","61.5% of total billed charges",2803.25,16.8,,2242.60,,,0,"percent of total billed charges","16.8% of total billed charges",8343,50,,6674.40,,,0,"percent of total billed charges","50% of total billed charges",5372.89,32.2,,4298.31,,,0,"percent of total billed charges","32.2% of total billed charges",2803.25,16.8,,2242.60,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2859.31,17.136,,2287.45,,,0,"percent of total billed charges","17.136% of total billed charges",3644.22,21.84,,2915.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",6290.62,37.7,,5032.50,,,0,"percent of total billed charges","37.7% of total billed charges",6290.62,37.7,,5032.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",5656.55,33.9,,4525.24,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",13015.08,78,,10412.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2803.25,16.8,,2242.60,,,0,"percent of total billed charges","16.8% of total billed charges",8343,50,,6674.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2803.25,16.8,,2242.60,,,0,"percent of total billed charges","16.8% of total billed charges",16686,100,,13348.80,,,0,"percent of total billed charges","100% of total billed charges",2552.96,16686,
"EPICORD EXPANDABLE MEMBRANE 2X3 CM",636Q418723,CDM,636,RC,,,OUTPATIENT,,,7210,4686.5,,6344.8,88,,5075.84,,,0,"percent of total billed charges","88% of total billed charges",3605,50,,2884.00,,,0,"percent of total billed charges","50% of total billed charges",1211.28,16.8,,969.02,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1247.62,17.304,,998.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4542.3,63,,3633.84,,,0,"percent of total billed charges","63% of total billed charges",1103.13,15.3,,882.50,,,0,"percent of total billed charges","15.3% of total billed charges",1211.28,16.8,,969.02,,,0,"percent of total billed charges","16.8% of total billed charges",4974.9,69,,,,,0,"fee schedule","69% of total billed charges",7210,100,,5768.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7210,100,,5768.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7210,100,,5768.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4459.39,61.85,,3567.51,,,0,"percent of total billed charges","61.5% of total billed charges",1211.28,16.8,,969.02,,,0,"percent of total billed charges","16.8% of total billed charges",3605,50,,2884.00,,,0,"percent of total billed charges","50% of total billed charges",2321.62,32.2,,1857.30,,,0,"percent of total billed charges","32.2% of total billed charges",1211.28,16.8,,969.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1235.51,17.136,,988.41,,,0,"percent of total billed charges","17.136% of total billed charges",1574.66,21.84,,1259.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2718.17,37.7,,2174.54,,,0,"percent of total billed charges","37.7% of total billed charges",2718.17,37.7,,2174.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2444.19,33.9,,1955.35,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5623.8,78,,4499.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.28,16.8,,969.02,,,0,"percent of total billed charges","16.8% of total billed charges",3605,50,,2884.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.28,16.8,,969.02,,,0,"percent of total billed charges","16.8% of total billed charges",7210,100,,5768.00,,,0,"percent of total billed charges","100% of total billed charges",1103.13,7210,
"EPICORD EXPANDABLE MEMBRANE 2X2 CM",636Q418722,CDM,636,RC,,,OUTPATIENT,,,5150,3347.5,,4532,88,,3625.60,,,0,"percent of total billed charges","88% of total billed charges",2575,50,,2060.00,,,0,"percent of total billed charges","50% of total billed charges",865.2,16.8,,692.16,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",891.16,17.304,,712.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3244.5,63,,2595.60,,,0,"percent of total billed charges","63% of total billed charges",787.95,15.3,,630.36,,,0,"percent of total billed charges","15.3% of total billed charges",865.2,16.8,,692.16,,,0,"percent of total billed charges","16.8% of total billed charges",3553.5,69,,,,,0,"fee schedule","69% of total billed charges",5150,100,,4120.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5150,100,,4120.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5150,100,,4120.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3185.28,61.85,,2548.22,,,0,"percent of total billed charges","61.5% of total billed charges",865.2,16.8,,692.16,,,0,"percent of total billed charges","16.8% of total billed charges",2575,50,,2060.00,,,0,"percent of total billed charges","50% of total billed charges",1658.3,32.2,,1326.64,,,0,"percent of total billed charges","32.2% of total billed charges",865.2,16.8,,692.16,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",882.5,17.136,,706.00,,,0,"percent of total billed charges","17.136% of total billed charges",1124.76,21.84,,899.81,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1941.55,37.7,,1553.24,,,0,"percent of total billed charges","37.7% of total billed charges",1941.55,37.7,,1553.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1745.85,33.9,,1396.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,78,,3213.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",865.2,16.8,,692.16,,,0,"percent of total billed charges","16.8% of total billed charges",2575,50,,2060.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",865.2,16.8,,692.16,,,0,"percent of total billed charges","16.8% of total billed charges",5150,100,,4120.00,,,0,"percent of total billed charges","100% of total billed charges",787.95,5150,
"EPICORD SHEET 1X2 CM",636Q418712,CDM,636,RC,,,OUTPATIENT,,,4738,3079.7,,4169.44,88,,3335.55,,,0,"percent of total billed charges","88% of total billed charges",2369,50,,1895.20,,,0,"percent of total billed charges","50% of total billed charges",795.98,16.8,,636.78,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",819.86,17.304,,655.89,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2984.94,63,,2387.95,,,0,"percent of total billed charges","63% of total billed charges",724.91,15.3,,579.93,,,0,"percent of total billed charges","15.3% of total billed charges",795.98,16.8,,636.78,,,0,"percent of total billed charges","16.8% of total billed charges",3269.22,69,,,,,0,"fee schedule","69% of total billed charges",4738,100,,3790.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4738,100,,3790.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4738,100,,3790.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2930.45,61.85,,2344.36,,,0,"percent of total billed charges","61.5% of total billed charges",795.98,16.8,,636.78,,,0,"percent of total billed charges","16.8% of total billed charges",2369,50,,1895.20,,,0,"percent of total billed charges","50% of total billed charges",1525.64,32.2,,1220.51,,,0,"percent of total billed charges","32.2% of total billed charges",795.98,16.8,,636.78,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",811.9,17.136,,649.52,,,0,"percent of total billed charges","17.136% of total billed charges",1034.78,21.84,,827.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1786.23,37.7,,1428.98,,,0,"percent of total billed charges","37.7% of total billed charges",1786.23,37.7,,1428.98,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1606.18,33.9,,1284.94,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3695.64,78,,2956.51,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",795.98,16.8,,636.78,,,0,"percent of total billed charges","16.8% of total billed charges",2369,50,,1895.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",795.98,16.8,,636.78,,,0,"percent of total billed charges","16.8% of total billed charges",4738,100,,3790.40,,,0,"percent of total billed charges","100% of total billed charges",724.91,4738,
"EPIDISC CATHTER",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"Supplies:EPIDURAL SPINAL TRAY TOUHY WINGED 17G X 3.5",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,400,260,,352,88,,281.60,,,0,"percent of total billed charges","88% of total billed charges",200,50,,160.00,,,0,"percent of total billed charges","50% of total billed charges",67.2,16.8,,53.76,,,0,"percent of total billed charges","16.8% of total billed charges",400,100,,320.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.22,17.304,,55.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",252,63,,201.60,,,0,"percent of total billed charges","63% of total billed charges",61.2,15.3,,48.96,,,0,"percent of total billed charges","15.3% of total billed charges",67.2,16.8,,53.76,,,0,"percent of total billed charges","16.8% of total billed charges",276,69,,,,,0,"fee schedule","69% of total billed charges",400,100,,320.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",400,100,,320.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",400,100,,320.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",247.4,61.85,,197.92,,,0,"percent of total billed charges","61.5% of total billed charges",67.2,16.8,,53.76,,,0,"percent of total billed charges","16.8% of total billed charges",200,50,,160.00,,,0,"percent of total billed charges","50% of total billed charges",128.8,32.2,,103.04,,,0,"percent of total billed charges","32.2% of total billed charges",67.2,16.8,,53.76,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.54,17.136,,54.83,,,0,"percent of total billed charges","17.136% of total billed charges",87.36,21.84,,69.89,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",150.8,37.7,,120.64,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",312,78,,249.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",330.4,82.6,,264.32,,,0,"percent of total billed charges","82.6% of total billed charges",67.2,16.8,,53.76,,,0,"percent of total billed charges","16.8% of total billed charges",200,50,,160.00,,,0,"percent of total billed charges","50% of total billed charges",330.4,82.6,,264.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.2,16.8,,53.76,,,0,"percent of total billed charges","16.8% of total billed charges",400,100,,320.00,,,0,"percent of total billed charges","100% of total billed charges",61.2,400,
"EPIFIX MESH SHEET 4X4.5 CM",636Q4186445,CDM,636,RC,,,OUTPATIENT,,,7231,4700.15,,6363.28,88,,5090.62,,,0,"percent of total billed charges","88% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1251.25,17.304,,1001.00,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4555.53,63,,3644.42,,,0,"percent of total billed charges","63% of total billed charges",1106.34,15.3,,885.07,,,0,"percent of total billed charges","15.3% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4989.39,69,,,,,0,"fee schedule","69% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4472.37,61.85,,3577.90,,,0,"percent of total billed charges","61.5% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",2328.38,32.2,,1862.70,,,0,"percent of total billed charges","32.2% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1239.1,17.136,,991.28,,,0,"percent of total billed charges","17.136% of total billed charges",1579.25,21.84,,1263.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.7% of total billed charges",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2451.31,33.9,,1961.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5640.18,78,,4512.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",1106.34,7231,
"EPIFIX SHEET 2X2 CM",636Q418622,CDM,636,RC,,,OUTPATIENT,,,5356,3481.4,,4713.28,88,,3770.62,,,0,"percent of total billed charges","88% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",926.8,17.304,,741.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3374.28,63,,2699.42,,,0,"percent of total billed charges","63% of total billed charges",819.47,15.3,,655.58,,,0,"percent of total billed charges","15.3% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",3695.64,69,,,,,0,"fee schedule","69% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3312.69,61.85,,2650.15,,,0,"percent of total billed charges","61.5% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",1724.63,32.2,,1379.70,,,0,"percent of total billed charges","32.2% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",917.8,17.136,,734.24,,,0,"percent of total billed charges","17.136% of total billed charges",1169.75,21.84,,935.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.7% of total billed charges",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1815.68,33.9,,1452.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4177.68,78,,3342.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",819.47,5356,
"EPIFIX SHEET 4X4 CM",636Q418644,CDM,636,RC,,,OUTPATIENT,,,14420,9373,,12689.6,88,,10151.68,,,0,"percent of total billed charges","88% of total billed charges",7210,50,,5768.00,,,0,"percent of total billed charges","50% of total billed charges",2422.56,16.8,,1938.05,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2495.24,17.304,,1996.19,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9084.6,63,,7267.68,,,0,"percent of total billed charges","63% of total billed charges",2206.26,15.3,,1765.01,,,0,"percent of total billed charges","15.3% of total billed charges",2422.56,16.8,,1938.05,,,0,"percent of total billed charges","16.8% of total billed charges",9949.8,69,,,,,0,"fee schedule","69% of total billed charges",14420,100,,11536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14420,100,,11536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14420,100,,11536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8918.77,61.85,,7135.02,,,0,"percent of total billed charges","61.5% of total billed charges",2422.56,16.8,,1938.05,,,0,"percent of total billed charges","16.8% of total billed charges",7210,50,,5768.00,,,0,"percent of total billed charges","50% of total billed charges",4643.24,32.2,,3714.59,,,0,"percent of total billed charges","32.2% of total billed charges",2422.56,16.8,,1938.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2471.01,17.136,,1976.81,,,0,"percent of total billed charges","17.136% of total billed charges",3149.33,21.84,,2519.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",5436.34,37.7,,4349.07,,,0,"percent of total billed charges","37.7% of total billed charges",5436.34,37.7,,4349.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4888.38,33.9,,3910.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",11247.6,78,,8998.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2422.56,16.8,,1938.05,,,0,"percent of total billed charges","16.8% of total billed charges",7210,50,,5768.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2422.56,16.8,,1938.05,,,0,"percent of total billed charges","16.8% of total billed charges",14420,100,,11536.00,,,0,"percent of total billed charges","100% of total billed charges",2206.26,14420,
"EPIFIX SHEET 5X6 CM",636Q418656,CDM,636,RC,,,OUTPATIENT,,,26986,17540.9,,23747.68,88,,18998.14,,,0,"percent of total billed charges","88% of total billed charges",13493,50,,10794.40,,,0,"percent of total billed charges","50% of total billed charges",4533.65,16.8,,3626.92,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4669.66,17.304,,3735.73,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17001.18,63,,13600.94,,,0,"percent of total billed charges","63% of total billed charges",4128.86,15.3,,3303.09,,,0,"percent of total billed charges","15.3% of total billed charges",4533.65,16.8,,3626.92,,,0,"percent of total billed charges","16.8% of total billed charges",18620.34,69,,,,,0,"fee schedule","69% of total billed charges",26986,100,,21588.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26986,100,,21588.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26986,100,,21588.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16690.84,61.85,,13352.67,,,0,"percent of total billed charges","61.5% of total billed charges",4533.65,16.8,,3626.92,,,0,"percent of total billed charges","16.8% of total billed charges",13493,50,,10794.40,,,0,"percent of total billed charges","50% of total billed charges",8689.49,32.2,,6951.59,,,0,"percent of total billed charges","32.2% of total billed charges",4533.65,16.8,,3626.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4624.32,17.136,,3699.46,,,0,"percent of total billed charges","17.136% of total billed charges",5893.74,21.84,,4714.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",10173.72,37.7,,8138.98,,,0,"percent of total billed charges","37.7% of total billed charges",10173.72,37.7,,8138.98,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",9148.25,33.9,,7318.60,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",21049.08,78,,16839.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4533.65,16.8,,3626.92,,,0,"percent of total billed charges","16.8% of total billed charges",13493,50,,10794.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4533.65,16.8,,3626.92,,,0,"percent of total billed charges","16.8% of total billed charges",26986,100,,21588.80,,,0,"percent of total billed charges","100% of total billed charges",4128.86,26986,
"EPIFIX MICRONIZED 160MG",636Q4145,CDM,636,RC,,,OUTPATIENT,,,14008,9105.2,,12327.04,88,,9861.63,,,0,"percent of total billed charges","88% of total billed charges",7004,50,,5603.20,,,0,"percent of total billed charges","50% of total billed charges",2353.34,16.8,,1882.67,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2423.94,17.304,,1939.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8825.04,63,,7060.03,,,0,"percent of total billed charges","63% of total billed charges",2143.22,15.3,,1714.58,,,0,"percent of total billed charges","15.3% of total billed charges",2353.34,16.8,,1882.67,,,0,"percent of total billed charges","16.8% of total billed charges",9665.52,69,,,,,0,"fee schedule","69% of total billed charges",14008,100,,11206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14008,100,,11206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14008,100,,11206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8663.95,61.85,,6931.16,,,0,"percent of total billed charges","61.5% of total billed charges",2353.34,16.8,,1882.67,,,0,"percent of total billed charges","16.8% of total billed charges",7004,50,,5603.20,,,0,"percent of total billed charges","50% of total billed charges",4510.58,32.2,,3608.46,,,0,"percent of total billed charges","32.2% of total billed charges",2353.34,16.8,,1882.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2400.41,17.136,,1920.33,,,0,"percent of total billed charges","17.136% of total billed charges",3059.35,21.84,,2447.48,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",5281.02,37.7,,4224.82,,,0,"percent of total billed charges","37.7% of total billed charges",5281.02,37.7,,4224.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4748.71,33.9,,3798.97,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",10926.24,78,,8740.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2353.34,16.8,,1882.67,,,0,"percent of total billed charges","16.8% of total billed charges",7004,50,,5603.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2353.34,16.8,,1882.67,,,0,"percent of total billed charges","16.8% of total billed charges",14008,100,,11206.40,,,0,"percent of total billed charges","100% of total billed charges",2143.22,14008,
"EPIFIX SHEET 3X4 CM",636Q418634,CDM,636,RC,,,OUTPATIENT,,,12360,8034,,10876.8,88,,8701.44,,,0,"percent of total billed charges","88% of total billed charges",6180,50,,4944.00,,,0,"percent of total billed charges","50% of total billed charges",2076.48,16.8,,1661.18,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2138.77,17.304,,1711.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7786.8,63,,6229.44,,,0,"percent of total billed charges","63% of total billed charges",1891.08,15.3,,1512.86,,,0,"percent of total billed charges","15.3% of total billed charges",2076.48,16.8,,1661.18,,,0,"percent of total billed charges","16.8% of total billed charges",8528.4,69,,,,,0,"fee schedule","69% of total billed charges",12360,100,,9888.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12360,100,,9888.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12360,100,,9888.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7644.66,61.85,,6115.73,,,0,"percent of total billed charges","61.5% of total billed charges",2076.48,16.8,,1661.18,,,0,"percent of total billed charges","16.8% of total billed charges",6180,50,,4944.00,,,0,"percent of total billed charges","50% of total billed charges",3979.92,32.2,,3183.94,,,0,"percent of total billed charges","32.2% of total billed charges",2076.48,16.8,,1661.18,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2118.01,17.136,,1694.41,,,0,"percent of total billed charges","17.136% of total billed charges",2699.42,21.84,,2159.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4659.72,37.7,,3727.78,,,0,"percent of total billed charges","37.7% of total billed charges",4659.72,37.7,,3727.78,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4190.04,33.9,,3352.03,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",9640.8,78,,7712.64,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2076.48,16.8,,1661.18,,,0,"percent of total billed charges","16.8% of total billed charges",6180,50,,4944.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2076.48,16.8,,1661.18,,,0,"percent of total billed charges","16.8% of total billed charges",12360,100,,9888.00,,,0,"percent of total billed charges","100% of total billed charges",1891.08,12360,
"EPIFIX SHEET 2X4 CM",636Q418624,CDM,636,RC,,,OUTPATIENT,,,7004,4552.6,,6163.52,88,,4930.82,,,0,"percent of total billed charges","88% of total billed charges",3502,50,,2801.60,,,0,"percent of total billed charges","50% of total billed charges",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1211.97,17.304,,969.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4412.52,63,,3530.02,,,0,"percent of total billed charges","63% of total billed charges",1071.61,15.3,,857.29,,,0,"percent of total billed charges","15.3% of total billed charges",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",4832.76,69,,,,,0,"fee schedule","69% of total billed charges",7004,100,,5603.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7004,100,,5603.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7004,100,,5603.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4331.97,61.85,,3465.58,,,0,"percent of total billed charges","61.5% of total billed charges",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",3502,50,,2801.60,,,0,"percent of total billed charges","50% of total billed charges",2255.29,32.2,,1804.23,,,0,"percent of total billed charges","32.2% of total billed charges",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1200.21,17.136,,960.17,,,0,"percent of total billed charges","17.136% of total billed charges",1529.67,21.84,,1223.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2640.51,37.7,,2112.41,,,0,"percent of total billed charges","37.7% of total billed charges",2640.51,37.7,,2112.41,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2374.36,33.9,,1899.49,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5463.12,78,,4370.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",3502,50,,2801.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",7004,100,,5603.20,,,0,"percent of total billed charges","100% of total billed charges",1071.61,7004,
"EPIFIX SHEET 2X3 CM",636Q418623,CDM,636,RC,,,OUTPATIENT,,,6180,4017,,5438.4,88,,4350.72,,,0,"percent of total billed charges","88% of total billed charges",3090,50,,2472.00,,,0,"percent of total billed charges","50% of total billed charges",1038.24,16.8,,830.59,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1069.39,17.304,,855.51,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3893.4,63,,3114.72,,,0,"percent of total billed charges","63% of total billed charges",945.54,15.3,,756.43,,,0,"percent of total billed charges","15.3% of total billed charges",1038.24,16.8,,830.59,,,0,"percent of total billed charges","16.8% of total billed charges",4264.2,69,,,,,0,"fee schedule","69% of total billed charges",6180,100,,4944.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6180,100,,4944.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6180,100,,4944.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3822.33,61.85,,3057.86,,,0,"percent of total billed charges","61.5% of total billed charges",1038.24,16.8,,830.59,,,0,"percent of total billed charges","16.8% of total billed charges",3090,50,,2472.00,,,0,"percent of total billed charges","50% of total billed charges",1989.96,32.2,,1591.97,,,0,"percent of total billed charges","32.2% of total billed charges",1038.24,16.8,,830.59,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1059,17.136,,847.20,,,0,"percent of total billed charges","17.136% of total billed charges",1349.71,21.84,,1079.77,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2329.86,37.7,,1863.89,,,0,"percent of total billed charges","37.7% of total billed charges",2329.86,37.7,,1863.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2095.02,33.9,,1676.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820.4,78,,3856.32,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1038.24,16.8,,830.59,,,0,"percent of total billed charges","16.8% of total billed charges",3090,50,,2472.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1038.24,16.8,,830.59,,,0,"percent of total billed charges","16.8% of total billed charges",6180,100,,4944.00,,,0,"percent of total billed charges","100% of total billed charges",945.54,6180,
"EPOC BGEM TEST CARDS",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"EPOC CARE-FILL CAPLRY",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"ESCHERICHIA COLI ATCC CULTI LOOPS 25922",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"ESCHERICHIA COLI ATCC CULTI LOOPS 35218",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"ESMARK BANDAGE 4 X 9",490530,CDM,270,RC,,,OUTPATIENT,,,27,17.55,,23.76,88,,19.01,,,0,"percent of total billed charges","88% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.67,17.304,,3.74,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.01,63,,13.61,,,0,"percent of total billed charges","63% of total billed charges",4.13,15.3,,3.30,,,0,"percent of total billed charges","15.3% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",18.63,69,,,,,0,"fee schedule","69% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.7,61.85,,13.36,,,0,"percent of total billed charges","61.5% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",8.69,32.2,,6.95,,,0,"percent of total billed charges","32.2% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.63,17.136,,3.70,,,0,"percent of total billed charges","17.136% of total billed charges",5.9,21.84,,4.72,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.18,37.7,,8.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.06,78,,16.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.3,82.6,,17.84,,,0,"percent of total billed charges","82.6% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",22.3,82.6,,17.84,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",4.13,27,
"ESOPHAGEAL DIALATOR 18MM",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"ESOPH BALLOON 8MM/24FR",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"ESOPH BALL DILATOR 6-8MM",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"ESOPH BALL DILATOR 10-12MM",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"ESOPH BALL DILATOR 12-15MM",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"ESR CONTROL CHEX (STRECK)",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"ESR VACUUM TUBES (STRECK)",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"ESR PAPER (STRECK)",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"ET TAPE II HOLDER",184769,CDM,270,RC,,,OUTPATIENT,,,1521,988.65,,1338.48,88,,1070.78,,,0,"percent of total billed charges","88% of total billed charges",760.5,50,,608.40,,,0,"percent of total billed charges","50% of total billed charges",255.53,16.8,,204.42,,,0,"percent of total billed charges","16.8% of total billed charges",1521,100,,1216.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.19,17.304,,210.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",958.23,63,,766.58,,,0,"percent of total billed charges","63% of total billed charges",232.71,15.3,,186.17,,,0,"percent of total billed charges","15.3% of total billed charges",255.53,16.8,,204.42,,,0,"percent of total billed charges","16.8% of total billed charges",1049.49,69,,,,,0,"fee schedule","69% of total billed charges",1521,100,,1216.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1521,100,,1216.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1521,100,,1216.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",940.74,61.85,,752.59,,,0,"percent of total billed charges","61.5% of total billed charges",255.53,16.8,,204.42,,,0,"percent of total billed charges","16.8% of total billed charges",760.5,50,,608.40,,,0,"percent of total billed charges","50% of total billed charges",489.76,32.2,,391.81,,,0,"percent of total billed charges","32.2% of total billed charges",255.53,16.8,,204.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",260.64,17.136,,208.51,,,0,"percent of total billed charges","17.136% of total billed charges",332.19,21.84,,265.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",573.42,37.7,,458.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1186.38,78,,949.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1256.35,82.6,,1005.08,,,0,"percent of total billed charges","82.6% of total billed charges",255.53,16.8,,204.42,,,0,"percent of total billed charges","16.8% of total billed charges",760.5,50,,608.40,,,0,"percent of total billed charges","50% of total billed charges",1256.35,82.6,,1005.08,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.53,16.8,,204.42,,,0,"percent of total billed charges","16.8% of total billed charges",1521,100,,1216.80,,,0,"percent of total billed charges","100% of total billed charges",232.71,1521,
"ET TUBE CUFFED 7.5MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"ETCO2 NASAL CANNULAS",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"ETHB12LT TROCAR XCEL BLADELESS REPROCESSED",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"ETHIBOND EXCEL 0 CT-1 30 (X424H)",490536,CDM,270,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"ETHIBOND EXCEL 1 CT-1 (X425H)",490537,CDM,270,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"ETHILON 2-0 FS (664H)",490539,CDM,270,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"ETHILON 3-0 FSL (1671H)",490540,CDM,270,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.9,61.85,,7.92,,,0,"percent of total billed charges","61.5% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"ETHILON 3-0 PC-5 (1893G)",490541,CDM,270,RC,,,OUTPATIENT,,,112,72.8,,98.56,88,,78.85,,,0,"percent of total billed charges","88% of total billed charges",56,50,,44.80,,,0,"percent of total billed charges","50% of total billed charges",18.82,16.8,,15.06,,,0,"percent of total billed charges","16.8% of total billed charges",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.38,17.304,,15.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.56,63,,56.45,,,0,"percent of total billed charges","63% of total billed charges",17.14,15.3,,13.71,,,0,"percent of total billed charges","15.3% of total billed charges",18.82,16.8,,15.06,,,0,"percent of total billed charges","16.8% of total billed charges",77.28,69,,,,,0,"fee schedule","69% of total billed charges",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.27,61.85,,55.42,,,0,"percent of total billed charges","61.5% of total billed charges",18.82,16.8,,15.06,,,0,"percent of total billed charges","16.8% of total billed charges",56,50,,44.80,,,0,"percent of total billed charges","50% of total billed charges",36.06,32.2,,28.85,,,0,"percent of total billed charges","32.2% of total billed charges",18.82,16.8,,15.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.19,17.136,,15.35,,,0,"percent of total billed charges","17.136% of total billed charges",24.46,21.84,,19.57,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",42.22,37.7,,33.78,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",87.36,78,,69.89,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.51,82.6,,74.01,,,0,"percent of total billed charges","82.6% of total billed charges",18.82,16.8,,15.06,,,0,"percent of total billed charges","16.8% of total billed charges",56,50,,44.80,,,0,"percent of total billed charges","50% of total billed charges",92.51,82.6,,74.01,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.82,16.8,,15.06,,,0,"percent of total billed charges","16.8% of total billed charges",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",17.14,112,
"ETHILON 5-0 PC-5 (1895G)",490543,CDM,270,RC,,,OUTPATIENT,,,37,24.05,,32.56,88,,26.05,,,0,"percent of total billed charges","88% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.4,17.304,,5.12,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.31,63,,18.65,,,0,"percent of total billed charges","63% of total billed charges",5.66,15.3,,4.53,,,0,"percent of total billed charges","15.3% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",25.53,69,,,,,0,"fee schedule","69% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.88,61.85,,18.30,,,0,"percent of total billed charges","61.5% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",11.91,32.2,,9.53,,,0,"percent of total billed charges","32.2% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.34,17.136,,5.07,,,0,"percent of total billed charges","17.136% of total billed charges",8.08,21.84,,6.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.95,37.7,,11.16,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.86,78,,23.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",5.66,37,
"ETHILON 6-0 P-3 (1698G)",490544,CDM,270,RC,,,OUTPATIENT,,,37,24.05,,32.56,88,,26.05,,,0,"percent of total billed charges","88% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.4,17.304,,5.12,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.31,63,,18.65,,,0,"percent of total billed charges","63% of total billed charges",5.66,15.3,,4.53,,,0,"percent of total billed charges","15.3% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",25.53,69,,,,,0,"fee schedule","69% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.88,61.85,,18.30,,,0,"percent of total billed charges","61.5% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",11.91,32.2,,9.53,,,0,"percent of total billed charges","32.2% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.34,17.136,,5.07,,,0,"percent of total billed charges","17.136% of total billed charges",8.08,21.84,,6.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.95,37.7,,11.16,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.86,78,,23.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",5.66,37,
"ETHYL ACETATE",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"EUROTROL GAS ISE LEVEL 1",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"EUROTROL HCT LEVEL A",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"EUROTROL HCT LEVEL B",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"EUROTROL CALIBRATION VERIF FLUID",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"EUROTROL HCT CAL VERIFICATION",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"EVAC 70 XTRA W/ INTEGRATED CABLE",ORSUP0019,CDM,270,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"EVACUATOR SILICONE 100CC 7MM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"EVACUATION BOTTLE 1000ML",ORSUP0002,CDM,372,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.7% of total billed charges",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.43,33.9,,36.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"EVACUATION DRAINAGE BOTTLE 1000ML",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"EVIVA STEREOTATIC GUIDED BREAST BIOPSY SYS 9G X 13CM 20M",ORSUP0018,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"EVQ FLOW VALVE PROCESSING SENSOR",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"EXACTO COLD SNARE",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"EXCALIBUR 4.0",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"EXCYTE ESR TUBES",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"EXCYTE ESR CONTROL LOG",ORSUP0018,CDM,272,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"EXOSHAPE FEMORAL IMPLANT FASTENER 8MM X 21MM",ORSUP0031,CDM,272,RC,,,OUTPATIENT,,,4120,2678,,3625.6,88,,2900.48,,,0,"percent of total billed charges","88% of total billed charges",2060,50,,1648.00,,,0,"percent of total billed charges","50% of total billed charges",692.16,16.8,,553.73,,,0,"percent of total billed charges","16.8% of total billed charges",4120,100,,3296.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",712.92,17.304,,570.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2595.6,63,,2076.48,,,0,"percent of total billed charges","63% of total billed charges",630.36,15.3,,504.29,,,0,"percent of total billed charges","15.3% of total billed charges",692.16,16.8,,553.73,,,0,"percent of total billed charges","16.8% of total billed charges",2842.8,69,,,,,0,"fee schedule","69% of total billed charges",4120,100,,3296.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4120,100,,3296.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4120,100,,3296.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2548.22,61.85,,2038.58,,,0,"percent of total billed charges","61.5% of total billed charges",692.16,16.8,,553.73,,,0,"percent of total billed charges","16.8% of total billed charges",2060,50,,1648.00,,,0,"percent of total billed charges","50% of total billed charges",1326.64,32.2,,1061.31,,,0,"percent of total billed charges","32.2% of total billed charges",692.16,16.8,,553.73,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",706,17.136,,564.80,,,0,"percent of total billed charges","17.136% of total billed charges",899.81,21.84,,719.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1553.24,37.7,,1242.59,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3213.6,78,,2570.88,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3403.12,82.6,,2722.50,,,0,"percent of total billed charges","82.6% of total billed charges",692.16,16.8,,553.73,,,0,"percent of total billed charges","16.8% of total billed charges",2060,50,,1648.00,,,0,"percent of total billed charges","50% of total billed charges",3403.12,82.6,,2722.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",692.16,16.8,,553.73,,,0,"percent of total billed charges","16.8% of total billed charges",4120,100,,3296.00,,,0,"percent of total billed charges","100% of total billed charges",630.36,4120,
"EXOSHAPE FEMORAL IMPLANT FASTENER 10MM X 21MM",ORSUP0031,CDM,272,RC,,,OUTPATIENT,,,4120,2678,,3625.6,88,,2900.48,,,0,"percent of total billed charges","88% of total billed charges",2060,50,,1648.00,,,0,"percent of total billed charges","50% of total billed charges",692.16,16.8,,553.73,,,0,"percent of total billed charges","16.8% of total billed charges",4120,100,,3296.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",712.92,17.304,,570.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2595.6,63,,2076.48,,,0,"percent of total billed charges","63% of total billed charges",630.36,15.3,,504.29,,,0,"percent of total billed charges","15.3% of total billed charges",692.16,16.8,,553.73,,,0,"percent of total billed charges","16.8% of total billed charges",2842.8,69,,,,,0,"fee schedule","69% of total billed charges",4120,100,,3296.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4120,100,,3296.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4120,100,,3296.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2548.22,61.85,,2038.58,,,0,"percent of total billed charges","61.5% of total billed charges",692.16,16.8,,553.73,,,0,"percent of total billed charges","16.8% of total billed charges",2060,50,,1648.00,,,0,"percent of total billed charges","50% of total billed charges",1326.64,32.2,,1061.31,,,0,"percent of total billed charges","32.2% of total billed charges",692.16,16.8,,553.73,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",706,17.136,,564.80,,,0,"percent of total billed charges","17.136% of total billed charges",899.81,21.84,,719.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1553.24,37.7,,1242.59,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3213.6,78,,2570.88,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3403.12,82.6,,2722.50,,,0,"percent of total billed charges","82.6% of total billed charges",692.16,16.8,,553.73,,,0,"percent of total billed charges","16.8% of total billed charges",2060,50,,1648.00,,,0,"percent of total billed charges","50% of total billed charges",3403.12,82.6,,2722.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",692.16,16.8,,553.73,,,0,"percent of total billed charges","16.8% of total billed charges",4120,100,,3296.00,,,0,"percent of total billed charges","100% of total billed charges",630.36,4120,
"EXOSHAPE FEMORAL IMPLANT FASTENER 9MM X 21MM",ORSUP0031,CDM,272,RC,,,OUTPATIENT,,,4120,2678,,3625.6,88,,2900.48,,,0,"percent of total billed charges","88% of total billed charges",2060,50,,1648.00,,,0,"percent of total billed charges","50% of total billed charges",692.16,16.8,,553.73,,,0,"percent of total billed charges","16.8% of total billed charges",4120,100,,3296.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",712.92,17.304,,570.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2595.6,63,,2076.48,,,0,"percent of total billed charges","63% of total billed charges",630.36,15.3,,504.29,,,0,"percent of total billed charges","15.3% of total billed charges",692.16,16.8,,553.73,,,0,"percent of total billed charges","16.8% of total billed charges",2842.8,69,,,,,0,"fee schedule","69% of total billed charges",4120,100,,3296.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4120,100,,3296.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4120,100,,3296.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2548.22,61.85,,2038.58,,,0,"percent of total billed charges","61.5% of total billed charges",692.16,16.8,,553.73,,,0,"percent of total billed charges","16.8% of total billed charges",2060,50,,1648.00,,,0,"percent of total billed charges","50% of total billed charges",1326.64,32.2,,1061.31,,,0,"percent of total billed charges","32.2% of total billed charges",692.16,16.8,,553.73,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",706,17.136,,564.80,,,0,"percent of total billed charges","17.136% of total billed charges",899.81,21.84,,719.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1553.24,37.7,,1242.59,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3213.6,78,,2570.88,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3403.12,82.6,,2722.50,,,0,"percent of total billed charges","82.6% of total billed charges",692.16,16.8,,553.73,,,0,"percent of total billed charges","16.8% of total billed charges",2060,50,,1648.00,,,0,"percent of total billed charges","50% of total billed charges",3403.12,82.6,,2722.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",692.16,16.8,,553.73,,,0,"percent of total billed charges","16.8% of total billed charges",4120,100,,3296.00,,,0,"percent of total billed charges","100% of total billed charges",630.36,4120,
"EXOSHAPE FEMORAL IMPLANT FASTENER 11MM X 21MM",ORSUP0031,CDM,272,RC,,,OUTPATIENT,,,4120,2678,,3625.6,88,,2900.48,,,0,"percent of total billed charges","88% of total billed charges",2060,50,,1648.00,,,0,"percent of total billed charges","50% of total billed charges",692.16,16.8,,553.73,,,0,"percent of total billed charges","16.8% of total billed charges",4120,100,,3296.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",712.92,17.304,,570.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2595.6,63,,2076.48,,,0,"percent of total billed charges","63% of total billed charges",630.36,15.3,,504.29,,,0,"percent of total billed charges","15.3% of total billed charges",692.16,16.8,,553.73,,,0,"percent of total billed charges","16.8% of total billed charges",2842.8,69,,,,,0,"fee schedule","69% of total billed charges",4120,100,,3296.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4120,100,,3296.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4120,100,,3296.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2548.22,61.85,,2038.58,,,0,"percent of total billed charges","61.5% of total billed charges",692.16,16.8,,553.73,,,0,"percent of total billed charges","16.8% of total billed charges",2060,50,,1648.00,,,0,"percent of total billed charges","50% of total billed charges",1326.64,32.2,,1061.31,,,0,"percent of total billed charges","32.2% of total billed charges",692.16,16.8,,553.73,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",706,17.136,,564.80,,,0,"percent of total billed charges","17.136% of total billed charges",899.81,21.84,,719.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1553.24,37.7,,1242.59,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3213.6,78,,2570.88,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3403.12,82.6,,2722.50,,,0,"percent of total billed charges","82.6% of total billed charges",692.16,16.8,,553.73,,,0,"percent of total billed charges","16.8% of total billed charges",2060,50,,1648.00,,,0,"percent of total billed charges","50% of total billed charges",3403.12,82.6,,2722.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",692.16,16.8,,553.73,,,0,"percent of total billed charges","16.8% of total billed charges",4120,100,,3296.00,,,0,"percent of total billed charges","100% of total billed charges",630.36,4120,
"FILTRATION SYSTEM PEDIATRIC-ADULT EXPIRATORY",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"EXPRESS BONE BIOPSY DEVISE TAPERED SZ 2",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"EXTENDER FLEX W/CAPD SAMPLE PORTS",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"EXTRACTOR RX 9-12MM",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"EXTRACTOR RX 12-15",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"EXTRACTOR RX 15-18MM",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"EXTREMITY ICE PACK",490549,CDM,270,RC,,,OUTPATIENT,,,21,13.65,,18.48,88,,14.78,,,0,"percent of total billed charges","88% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.63,17.304,,2.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.23,63,,10.58,,,0,"percent of total billed charges","63% of total billed charges",3.21,15.3,,2.57,,,0,"percent of total billed charges","15.3% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",14.49,69,,,,,0,"fee schedule","69% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.99,61.85,,10.39,,,0,"percent of total billed charges","61.5% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",6.76,32.2,,5.41,,,0,"percent of total billed charges","32.2% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.6,17.136,,2.88,,,0,"percent of total billed charges","17.136% of total billed charges",4.59,21.84,,3.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.92,37.7,,6.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.38,78,,13.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",3.21,21,
"EXTREMITIES GUIDE",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,464,301.6,,408.32,88,,326.66,,,0,"percent of total billed charges","88% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.29,17.304,,64.23,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.32,63,,233.86,,,0,"percent of total billed charges","63% of total billed charges",70.99,15.3,,56.79,,,0,"percent of total billed charges","15.3% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",320.16,69,,,,,0,"fee schedule","69% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",286.98,61.85,,229.58,,,0,"percent of total billed charges","61.5% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",149.41,32.2,,119.53,,,0,"percent of total billed charges","32.2% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.51,17.136,,63.61,,,0,"percent of total billed charges","17.136% of total billed charges",101.34,21.84,,81.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",174.93,37.7,,139.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",361.92,78,,289.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",70.99,464,
"EXUDERM SATIN HYDROCOLLOID",ORSUP001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"EYE PROTECTOR",53731,CDM,270,RC,,,OUTPATIENT,,,46,29.9,,40.48,88,,32.38,,,0,"percent of total billed charges","88% of total billed charges",23,50,,18.40,,,0,"percent of total billed charges","50% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.96,17.304,,6.37,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.98,63,,23.18,,,0,"percent of total billed charges","63% of total billed charges",7.04,15.3,,5.63,,,0,"percent of total billed charges","15.3% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",31.74,69,,,,,0,"fee schedule","69% of total billed charges",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.45,61.85,,22.76,,,0,"percent of total billed charges","61.5% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",23,50,,18.40,,,0,"percent of total billed charges","50% of total billed charges",14.81,32.2,,11.85,,,0,"percent of total billed charges","32.2% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.88,17.136,,6.30,,,0,"percent of total billed charges","17.136% of total billed charges",10.05,21.84,,8.04,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.34,37.7,,13.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.88,78,,28.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38,82.6,,30.40,,,0,"percent of total billed charges","82.6% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",23,50,,18.40,,,0,"percent of total billed charges","50% of total billed charges",38,82.6,,30.40,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",7.04,46,
"EYE 1045 DRAPE",490550,CDM,270,RC,,,OUTPATIENT,,,60,39,,52.8,88,,42.24,,,0,"percent of total billed charges","88% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.38,17.304,,8.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.8,63,,30.24,,,0,"percent of total billed charges","63% of total billed charges",9.18,15.3,,7.34,,,0,"percent of total billed charges","15.3% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",41.4,69,,,,,0,"fee schedule","69% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.11,61.85,,29.69,,,0,"percent of total billed charges","61.5% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",19.32,32.2,,15.46,,,0,"percent of total billed charges","32.2% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.28,17.136,,8.22,,,0,"percent of total billed charges","17.136% of total billed charges",13.1,21.84,,10.48,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,37.7,,18.10,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.8,78,,37.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.56,82.6,,39.65,,,0,"percent of total billed charges","82.6% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",49.56,82.6,,39.65,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",9.18,60,
"EYE CAPSULAR TENSION RING",ORSUP0019,CDM,270,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"EYE CHROMIC GUT 7-0 TG100-8 (1744G)",490555,CDM,270,RC,,,OUTPATIENT,,,198,128.7,,174.24,88,,139.39,,,0,"percent of total billed charges","88% of total billed charges",99,50,,79.20,,,0,"percent of total billed charges","50% of total billed charges",33.26,16.8,,26.61,,,0,"percent of total billed charges","16.8% of total billed charges",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.26,17.304,,27.41,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.74,63,,99.79,,,0,"percent of total billed charges","63% of total billed charges",30.29,15.3,,24.23,,,0,"percent of total billed charges","15.3% of total billed charges",33.26,16.8,,26.61,,,0,"percent of total billed charges","16.8% of total billed charges",136.62,69,,,,,0,"fee schedule","69% of total billed charges",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",122.46,61.85,,97.97,,,0,"percent of total billed charges","61.5% of total billed charges",33.26,16.8,,26.61,,,0,"percent of total billed charges","16.8% of total billed charges",99,50,,79.20,,,0,"percent of total billed charges","50% of total billed charges",63.76,32.2,,51.01,,,0,"percent of total billed charges","32.2% of total billed charges",33.26,16.8,,26.61,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.93,17.136,,27.14,,,0,"percent of total billed charges","17.136% of total billed charges",43.24,21.84,,34.59,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",74.65,37.7,,59.72,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",154.44,78,,123.55,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",163.55,82.6,,130.84,,,0,"percent of total billed charges","82.6% of total billed charges",33.26,16.8,,26.61,,,0,"percent of total billed charges","16.8% of total billed charges",99,50,,79.20,,,0,"percent of total billed charges","50% of total billed charges",163.55,82.6,,130.84,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.26,16.8,,26.61,,,0,"percent of total billed charges","16.8% of total billed charges",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",30.29,198,
"EYE INFINITY VITRECTOMY PAK 23G",490556,CDM,270,RC,,,OUTPATIENT,,,1653,1074.45,,1454.64,88,,1163.71,,,0,"percent of total billed charges","88% of total billed charges",826.5,50,,661.20,,,0,"percent of total billed charges","50% of total billed charges",277.7,16.8,,222.16,,,0,"percent of total billed charges","16.8% of total billed charges",1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",286.04,17.304,,228.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1041.39,63,,833.11,,,0,"percent of total billed charges","63% of total billed charges",252.91,15.3,,202.33,,,0,"percent of total billed charges","15.3% of total billed charges",277.7,16.8,,222.16,,,0,"percent of total billed charges","16.8% of total billed charges",1140.57,69,,,,,0,"fee schedule","69% of total billed charges",1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1022.38,61.85,,817.90,,,0,"percent of total billed charges","61.5% of total billed charges",277.7,16.8,,222.16,,,0,"percent of total billed charges","16.8% of total billed charges",826.5,50,,661.20,,,0,"percent of total billed charges","50% of total billed charges",532.27,32.2,,425.82,,,0,"percent of total billed charges","32.2% of total billed charges",277.7,16.8,,222.16,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",283.26,17.136,,226.61,,,0,"percent of total billed charges","17.136% of total billed charges",361.02,21.84,,288.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",623.18,37.7,,498.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1289.34,78,,1031.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1365.38,82.6,,1092.30,,,0,"percent of total billed charges","82.6% of total billed charges",277.7,16.8,,222.16,,,0,"percent of total billed charges","16.8% of total billed charges",826.5,50,,661.20,,,0,"percent of total billed charges","50% of total billed charges",1365.38,82.6,,1092.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",277.7,16.8,,222.16,,,0,"percent of total billed charges","16.8% of total billed charges",1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",252.91,1653,
"EYE INSTRUMENT WIPE",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"EYE LENS (SN60WF)",ORSUP0014,CDM,276,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"EYE NYLON 10-0 AU-5",490561,CDM,270,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"EYE NYLON 10-0 CU-5",490562,CDM,270,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"EYE NYLON 9-0 CU-1",490563,CDM,270,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"EYE PACK",490564,CDM,270,RC,,,OUTPATIENT,,,1090,708.5,,959.2,88,,767.36,,,0,"percent of total billed charges","88% of total billed charges",545,50,,436.00,,,0,"percent of total billed charges","50% of total billed charges",183.12,16.8,,146.50,,,0,"percent of total billed charges","16.8% of total billed charges",1090,100,,872.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",188.61,17.304,,150.89,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",686.7,63,,549.36,,,0,"percent of total billed charges","63% of total billed charges",166.77,15.3,,133.42,,,0,"percent of total billed charges","15.3% of total billed charges",183.12,16.8,,146.50,,,0,"percent of total billed charges","16.8% of total billed charges",752.1,69,,,,,0,"fee schedule","69% of total billed charges",1090,100,,872.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1090,100,,872.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1090,100,,872.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.17,61.85,,539.34,,,0,"percent of total billed charges","61.5% of total billed charges",183.12,16.8,,146.50,,,0,"percent of total billed charges","16.8% of total billed charges",545,50,,436.00,,,0,"percent of total billed charges","50% of total billed charges",350.98,32.2,,280.78,,,0,"percent of total billed charges","32.2% of total billed charges",183.12,16.8,,146.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",186.78,17.136,,149.42,,,0,"percent of total billed charges","17.136% of total billed charges",238.06,21.84,,190.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",410.93,37.7,,328.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",850.2,78,,680.16,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",900.34,82.6,,720.27,,,0,"percent of total billed charges","82.6% of total billed charges",183.12,16.8,,146.50,,,0,"percent of total billed charges","16.8% of total billed charges",545,50,,436.00,,,0,"percent of total billed charges","50% of total billed charges",900.34,82.6,,720.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.12,16.8,,146.50,,,0,"percent of total billed charges","16.8% of total billed charges",1090,100,,872.00,,,0,"percent of total billed charges","100% of total billed charges",166.77,1090,
"EYE PLAIN GUT 6-0 TG140-8 (1735G)",490566,CDM,270,RC,,,OUTPATIENT,,,196,127.4,,172.48,88,,137.98,,,0,"percent of total billed charges","88% of total billed charges",98,50,,78.40,,,0,"percent of total billed charges","50% of total billed charges",32.93,16.8,,26.34,,,0,"percent of total billed charges","16.8% of total billed charges",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.92,17.304,,27.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",123.48,63,,98.78,,,0,"percent of total billed charges","63% of total billed charges",29.99,15.3,,23.99,,,0,"percent of total billed charges","15.3% of total billed charges",32.93,16.8,,26.34,,,0,"percent of total billed charges","16.8% of total billed charges",135.24,69,,,,,0,"fee schedule","69% of total billed charges",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",121.23,61.85,,96.98,,,0,"percent of total billed charges","61.5% of total billed charges",32.93,16.8,,26.34,,,0,"percent of total billed charges","16.8% of total billed charges",98,50,,78.40,,,0,"percent of total billed charges","50% of total billed charges",63.11,32.2,,50.49,,,0,"percent of total billed charges","32.2% of total billed charges",32.93,16.8,,26.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.59,17.136,,26.87,,,0,"percent of total billed charges","17.136% of total billed charges",42.81,21.84,,34.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",73.89,37.7,,59.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",152.88,78,,122.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",161.9,82.6,,129.52,,,0,"percent of total billed charges","82.6% of total billed charges",32.93,16.8,,26.34,,,0,"percent of total billed charges","16.8% of total billed charges",98,50,,78.40,,,0,"percent of total billed charges","50% of total billed charges",161.9,82.6,,129.52,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.93,16.8,,26.34,,,0,"percent of total billed charges","16.8% of total billed charges",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",29.99,196,
"EYE POLY 10-0 SC-5",490567,CDM,270,RC,,,OUTPATIENT,,,248,161.2,,218.24,88,,174.59,,,0,"percent of total billed charges","88% of total billed charges",124,50,,99.20,,,0,"percent of total billed charges","50% of total billed charges",41.66,16.8,,33.33,,,0,"percent of total billed charges","16.8% of total billed charges",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.91,17.304,,34.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.24,63,,124.99,,,0,"percent of total billed charges","63% of total billed charges",37.94,15.3,,30.35,,,0,"percent of total billed charges","15.3% of total billed charges",41.66,16.8,,33.33,,,0,"percent of total billed charges","16.8% of total billed charges",171.12,69,,,,,0,"fee schedule","69% of total billed charges",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",153.39,61.85,,122.71,,,0,"percent of total billed charges","61.5% of total billed charges",41.66,16.8,,33.33,,,0,"percent of total billed charges","16.8% of total billed charges",124,50,,99.20,,,0,"percent of total billed charges","50% of total billed charges",79.86,32.2,,63.89,,,0,"percent of total billed charges","32.2% of total billed charges",41.66,16.8,,33.33,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.5,17.136,,34.00,,,0,"percent of total billed charges","17.136% of total billed charges",54.16,21.84,,43.33,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",93.5,37.7,,74.80,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",193.44,78,,154.75,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.85,82.6,,163.88,,,0,"percent of total billed charges","82.6% of total billed charges",41.66,16.8,,33.33,,,0,"percent of total billed charges","16.8% of total billed charges",124,50,,99.20,,,0,"percent of total billed charges","50% of total billed charges",204.85,82.6,,163.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.66,16.8,,33.33,,,0,"percent of total billed charges","16.8% of total billed charges",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",37.94,248,
"EYE PROLENE 6-0 C-1 (8307H)",490568,CDM,270,RC,,,OUTPATIENT,,,98,63.7,,86.24,88,,68.99,,,0,"percent of total billed charges","88% of total billed charges",49,50,,39.20,,,0,"percent of total billed charges","50% of total billed charges",16.46,16.8,,13.17,,,0,"percent of total billed charges","16.8% of total billed charges",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.96,17.304,,13.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.74,63,,49.39,,,0,"percent of total billed charges","63% of total billed charges",14.99,15.3,,11.99,,,0,"percent of total billed charges","15.3% of total billed charges",16.46,16.8,,13.17,,,0,"percent of total billed charges","16.8% of total billed charges",67.62,69,,,,,0,"fee schedule","69% of total billed charges",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.61,61.85,,48.49,,,0,"percent of total billed charges","61.5% of total billed charges",16.46,16.8,,13.17,,,0,"percent of total billed charges","16.8% of total billed charges",49,50,,39.20,,,0,"percent of total billed charges","50% of total billed charges",31.56,32.2,,25.25,,,0,"percent of total billed charges","32.2% of total billed charges",16.46,16.8,,13.17,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.79,17.136,,13.43,,,0,"percent of total billed charges","17.136% of total billed charges",21.4,21.84,,17.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.95,37.7,,29.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",76.44,78,,61.15,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.95,82.6,,64.76,,,0,"percent of total billed charges","82.6% of total billed charges",16.46,16.8,,13.17,,,0,"percent of total billed charges","16.8% of total billed charges",49,50,,39.20,,,0,"percent of total billed charges","50% of total billed charges",80.95,82.6,,64.76,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.46,16.8,,13.17,,,0,"percent of total billed charges","16.8% of total billed charges",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",14.99,98,
"EYE SILK 6-0 PC-1",490569,CDM,270,RC,,,OUTPATIENT,,,44,28.6,,38.72,88,,30.98,,,0,"percent of total billed charges","88% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.61,17.304,,6.09,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.72,63,,22.18,,,0,"percent of total billed charges","63% of total billed charges",6.73,15.3,,5.38,,,0,"percent of total billed charges","15.3% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",30.36,69,,,,,0,"fee schedule","69% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.21,61.85,,21.77,,,0,"percent of total billed charges","61.5% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",14.17,32.2,,11.34,,,0,"percent of total billed charges","32.2% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.54,17.136,,6.03,,,0,"percent of total billed charges","17.136% of total billed charges",9.61,21.84,,7.69,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.59,37.7,,13.27,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.32,78,,27.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",6.73,44,
"EYE TORIC LENS (SN6AT3)",ORSUP0027,CDM,276,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",1336.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.7% of total billed charges",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1452.62,33.9,,1162.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"EYE TORIC LENS (SN6AT4)",ORSUP0027,CDM,276,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",1336.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.7% of total billed charges",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1452.62,33.9,,1162.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"EYE TORIC LENS (SN6AT5)",ORSUP0027,CDM,276,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",1336.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.7% of total billed charges",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1452.62,33.9,,1162.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"EYE TORIC LENS (SN6AT6)",ORSUP0027,CDM,276,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",1336.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.7% of total billed charges",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1452.62,33.9,,1162.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"EYE TORIC LENS (SN6AT7)",ORSUP0027,CDM,276,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",1336.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.7% of total billed charges",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1452.62,33.9,,1162.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"EYE TORIC LENS (SN6AT8)",ORSUP0027,CDM,276,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",1336.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.7% of total billed charges",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1452.62,33.9,,1162.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"EYE TORIC LENS (SN6AT9)",ORSUP0027,CDM,276,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",1336.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.7% of total billed charges",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1452.62,33.9,,1162.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"EYE VICRYL 6-0 P-1 (J489H)",490577,CDM,270,RC,,,OUTPATIENT,,,35,22.75,,30.8,88,,24.64,,,0,"percent of total billed charges","88% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.06,17.304,,4.85,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.05,63,,17.64,,,0,"percent of total billed charges","63% of total billed charges",5.36,15.3,,4.29,,,0,"percent of total billed charges","15.3% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",24.15,69,,,,,0,"fee schedule","69% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.65,61.85,,17.32,,,0,"percent of total billed charges","61.5% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",11.27,32.2,,9.02,,,0,"percent of total billed charges","32.2% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,17.136,,4.80,,,0,"percent of total billed charges","17.136% of total billed charges",7.64,21.84,,6.11,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.2,37.7,,10.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",27.3,78,,21.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.91,82.6,,23.13,,,0,"percent of total billed charges","82.6% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",28.91,82.6,,23.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",5.36,35,
"EYE VICRYL 6-0 S-14 (J570G)",490578,CDM,270,RC,,,OUTPATIENT,,,108,70.2,,95.04,88,,76.03,,,0,"percent of total billed charges","88% of total billed charges",54,50,,43.20,,,0,"percent of total billed charges","50% of total billed charges",18.14,16.8,,14.51,,,0,"percent of total billed charges","16.8% of total billed charges",108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.69,17.304,,14.95,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.04,63,,54.43,,,0,"percent of total billed charges","63% of total billed charges",16.52,15.3,,13.22,,,0,"percent of total billed charges","15.3% of total billed charges",18.14,16.8,,14.51,,,0,"percent of total billed charges","16.8% of total billed charges",74.52,69,,,,,0,"fee schedule","69% of total billed charges",108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",66.8,61.85,,53.44,,,0,"percent of total billed charges","61.5% of total billed charges",18.14,16.8,,14.51,,,0,"percent of total billed charges","16.8% of total billed charges",54,50,,43.20,,,0,"percent of total billed charges","50% of total billed charges",34.78,32.2,,27.82,,,0,"percent of total billed charges","32.2% of total billed charges",18.14,16.8,,14.51,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.51,17.136,,14.81,,,0,"percent of total billed charges","17.136% of total billed charges",23.59,21.84,,18.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",40.72,37.7,,32.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",84.24,78,,67.39,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.21,82.6,,71.37,,,0,"percent of total billed charges","82.6% of total billed charges",18.14,16.8,,14.51,,,0,"percent of total billed charges","16.8% of total billed charges",54,50,,43.20,,,0,"percent of total billed charges","50% of total billed charges",89.21,82.6,,71.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.14,16.8,,14.51,,,0,"percent of total billed charges","16.8% of total billed charges",108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",16.52,108,
"EYE VICRYL 7-0 TG140-8 (J566G)",490579,CDM,270,RC,,,OUTPATIENT,,,124,80.6,,109.12,88,,87.30,,,0,"percent of total billed charges","88% of total billed charges",62,50,,49.60,,,0,"percent of total billed charges","50% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.46,17.304,,17.17,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.12,63,,62.50,,,0,"percent of total billed charges","63% of total billed charges",18.97,15.3,,15.18,,,0,"percent of total billed charges","15.3% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",85.56,69,,,,,0,"fee schedule","69% of total billed charges",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.69,61.85,,61.35,,,0,"percent of total billed charges","61.5% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",62,50,,49.60,,,0,"percent of total billed charges","50% of total billed charges",39.93,32.2,,31.94,,,0,"percent of total billed charges","32.2% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.25,17.136,,17.00,,,0,"percent of total billed charges","17.136% of total billed charges",27.08,21.84,,21.66,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.75,37.7,,37.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",96.72,78,,77.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",102.42,82.6,,81.94,,,0,"percent of total billed charges","82.6% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",62,50,,49.60,,,0,"percent of total billed charges","50% of total billed charges",102.42,82.6,,81.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",18.97,124,
"EYE VICRYL 8-0 BV130-4 (J405G)",490580,CDM,270,RC,,,OUTPATIENT,,,143,92.95,,125.84,88,,100.67,,,0,"percent of total billed charges","88% of total billed charges",71.5,50,,57.20,,,0,"percent of total billed charges","50% of total billed charges",24.02,16.8,,19.22,,,0,"percent of total billed charges","16.8% of total billed charges",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.74,17.304,,19.79,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.09,63,,72.07,,,0,"percent of total billed charges","63% of total billed charges",21.88,15.3,,17.50,,,0,"percent of total billed charges","15.3% of total billed charges",24.02,16.8,,19.22,,,0,"percent of total billed charges","16.8% of total billed charges",98.67,69,,,,,0,"fee schedule","69% of total billed charges",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.45,61.85,,70.76,,,0,"percent of total billed charges","61.5% of total billed charges",24.02,16.8,,19.22,,,0,"percent of total billed charges","16.8% of total billed charges",71.5,50,,57.20,,,0,"percent of total billed charges","50% of total billed charges",46.05,32.2,,36.84,,,0,"percent of total billed charges","32.2% of total billed charges",24.02,16.8,,19.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.5,17.136,,19.60,,,0,"percent of total billed charges","17.136% of total billed charges",31.23,21.84,,24.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",53.91,37.7,,43.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",111.54,78,,89.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",24.02,16.8,,19.22,,,0,"percent of total billed charges","16.8% of total billed charges",71.5,50,,57.20,,,0,"percent of total billed charges","50% of total billed charges",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.02,16.8,,19.22,,,0,"percent of total billed charges","16.8% of total billed charges",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",21.88,143,
"EYE VICRYL 8-0 TG140-6 (J974G)",490581,CDM,270,RC,,,OUTPATIENT,,,160,104,,140.8,88,,112.64,,,0,"percent of total billed charges","88% of total billed charges",80,50,,64.00,,,0,"percent of total billed charges","50% of total billed charges",26.88,16.8,,21.50,,,0,"percent of total billed charges","16.8% of total billed charges",160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.69,17.304,,22.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",100.8,63,,80.64,,,0,"percent of total billed charges","63% of total billed charges",24.48,15.3,,19.58,,,0,"percent of total billed charges","15.3% of total billed charges",26.88,16.8,,21.50,,,0,"percent of total billed charges","16.8% of total billed charges",110.4,69,,,,,0,"fee schedule","69% of total billed charges",160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.96,61.85,,79.17,,,0,"percent of total billed charges","61.5% of total billed charges",26.88,16.8,,21.50,,,0,"percent of total billed charges","16.8% of total billed charges",80,50,,64.00,,,0,"percent of total billed charges","50% of total billed charges",51.52,32.2,,41.22,,,0,"percent of total billed charges","32.2% of total billed charges",26.88,16.8,,21.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.42,17.136,,21.94,,,0,"percent of total billed charges","17.136% of total billed charges",34.94,21.84,,27.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",60.32,37.7,,48.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",124.8,78,,99.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",132.16,82.6,,105.73,,,0,"percent of total billed charges","82.6% of total billed charges",26.88,16.8,,21.50,,,0,"percent of total billed charges","16.8% of total billed charges",80,50,,64.00,,,0,"percent of total billed charges","50% of total billed charges",132.16,82.6,,105.73,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.88,16.8,,21.50,,,0,"percent of total billed charges","16.8% of total billed charges",160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",24.48,160,
"EYE BURR 5MM",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"EYE BURR 10MM",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"EYE PATCH ADULT BLACK",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"EYESHEILDS DISPOSABLE",490582,CDM,270,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"EZ-FIL SEVOFLURANE VAPORIZER BOTTLE ADAPTER",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"EZ-IO NEEDLE + STABILIZER KIT 15GA X 45MM",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,927,602.55,,815.76,88,,652.61,,,0,"percent of total billed charges","88% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.41,17.304,,128.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.01,63,,467.21,,,0,"percent of total billed charges","63% of total billed charges",141.83,15.3,,113.46,,,0,"percent of total billed charges","15.3% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",639.63,69,,,,,0,"fee schedule","69% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",573.35,61.85,,458.68,,,0,"percent of total billed charges","61.5% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",298.49,32.2,,238.79,,,0,"percent of total billed charges","32.2% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.85,17.136,,127.08,,,0,"percent of total billed charges","17.136% of total billed charges",202.46,21.84,,161.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",349.48,37.7,,279.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",723.06,78,,578.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",141.83,927,
"EZ-IO NEEDLE + STABILIZER KIT 15GA X 25MM",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,927,602.55,,815.76,88,,652.61,,,0,"percent of total billed charges","88% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.41,17.304,,128.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.01,63,,467.21,,,0,"percent of total billed charges","63% of total billed charges",141.83,15.3,,113.46,,,0,"percent of total billed charges","15.3% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",639.63,69,,,,,0,"fee schedule","69% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",573.35,61.85,,458.68,,,0,"percent of total billed charges","61.5% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",298.49,32.2,,238.79,,,0,"percent of total billed charges","32.2% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.85,17.136,,127.08,,,0,"percent of total billed charges","17.136% of total billed charges",202.46,21.84,,161.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",349.48,37.7,,279.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",723.06,78,,578.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",141.83,927,
"EZ-IO PROCEDURE TRAY INFANT/PED 15MM",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1185,770.25,,1042.8,88,,834.24,,,0,"percent of total billed charges","88% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",205.05,17.304,,164.04,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",746.55,63,,597.24,,,0,"percent of total billed charges","63% of total billed charges",181.31,15.3,,145.05,,,0,"percent of total billed charges","15.3% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",817.65,69,,,,,0,"fee schedule","69% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.92,61.85,,586.34,,,0,"percent of total billed charges","61.5% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",381.57,32.2,,305.26,,,0,"percent of total billed charges","32.2% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",203.06,17.136,,162.45,,,0,"percent of total billed charges","17.136% of total billed charges",258.8,21.84,,207.04,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",446.75,37.7,,357.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",924.3,78,,739.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",181.31,1185,
"EZDILATE BALLOON DILATORS 6X4",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"EZDILATE KIT URETERAL 12FRX10",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"F \\T\\ P WIGGLEPAD CANNULA",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"FABRIC SAUVAGE",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"FACTOR DILUENT",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"FALL RISK BAND",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"FALOPE RING 8MM W/TROCAR DISP",ORSUP0011,CDM,270,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"FAST FIND GRID",ORSUP0016,CDM,270,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"KIT FECAL COLLECTION FLEXISEAL FMS",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"FEEDING TUBE GASTROSTOMY MICKEY 20FR",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"FEMORAL CORTICAL STRUT HALVED M/L",ORSUP0037,CDM,278,RC,,,OUTPATIENT,,,6963,4525.95,,6127.44,88,,4901.95,,,0,"percent of total billed charges","88% of total billed charges",3481.5,50,,2785.20,,,0,"percent of total billed charges","50% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1204.88,17.304,,963.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4386.69,63,,3509.35,,,0,"percent of total billed charges","63% of total billed charges",1065.34,15.3,,852.27,,,0,"percent of total billed charges","15.3% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",4804.47,69,,,,,0,"fee schedule","69% of total billed charges",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4306.62,61.85,,3445.30,,,0,"percent of total billed charges","61.5% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",3481.5,50,,2785.20,,,0,"percent of total billed charges","50% of total billed charges",2242.09,32.2,,1793.67,,,0,"percent of total billed charges","32.2% of total billed charges",2172.46,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1193.18,17.136,,954.54,,,0,"percent of total billed charges","17.136% of total billed charges",1520.72,21.84,,1216.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2625.05,37.7,,2100.04,,,0,"percent of total billed charges","37.7% of total billed charges",2625.05,37.7,,2100.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2360.46,33.9,,1888.37,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5431.14,78,,4344.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5751.44,82.6,,4601.15,,,0,"percent of total billed charges","82.6% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",3481.5,50,,2785.20,,,0,"percent of total billed charges","50% of total billed charges",5751.44,82.6,,4601.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",1065.34,6963,
"FEMORAL HEAD 44MM",ORSUP0032,CDM,278,RC,,,OUTPATIENT,,,5624,3655.6,,4949.12,88,,3959.30,,,0,"percent of total billed charges","88% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",973.18,17.304,,778.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3543.12,63,,2834.50,,,0,"percent of total billed charges","63% of total billed charges",860.47,15.3,,688.38,,,0,"percent of total billed charges","15.3% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",3880.56,69,,,,,0,"fee schedule","69% of total billed charges",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3478.44,61.85,,2782.75,,,0,"percent of total billed charges","61.5% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",1810.93,32.2,,1448.74,,,0,"percent of total billed charges","32.2% of total billed charges",1754.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",963.73,17.136,,770.98,,,0,"percent of total billed charges","17.136% of total billed charges",1228.28,21.84,,982.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2120.25,37.7,,1696.20,,,0,"percent of total billed charges","37.7% of total billed charges",2120.25,37.7,,1696.20,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1906.54,33.9,,1525.23,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4386.72,78,,3509.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4645.42,82.6,,3716.34,,,0,"percent of total billed charges","82.6% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",4645.42,82.6,,3716.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",860.47,5624,
"FEMOSTOP GOLD COMPRESSION DEVICE",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"FENESTRATED BIPOLAR FORCEPS",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"FERKEL THIGH PAD DISP.",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.94,17.304,,85.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.23,61.85,,305.78,,,0,"percent of total billed charges","61.5% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",199,32.2,,159.20,,,0,"percent of total billed charges","32.2% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.136,,84.72,,,0,"percent of total billed charges","17.136% of total billed charges",134.97,21.84,,107.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,618,
"REAGENT FERRITIN ORCLNL",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"FERRITIN CALIBRATOR ORCLNL",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"FETAL SCREEN II FMH KIT",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1185,770.25,,1042.8,88,,834.24,,,0,"percent of total billed charges","88% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",205.05,17.304,,164.04,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",746.55,63,,597.24,,,0,"percent of total billed charges","63% of total billed charges",181.31,15.3,,145.05,,,0,"percent of total billed charges","15.3% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",817.65,69,,,,,0,"fee schedule","69% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.92,61.85,,586.34,,,0,"percent of total billed charges","61.5% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",381.57,32.2,,305.26,,,0,"percent of total billed charges","32.2% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",203.06,17.136,,162.45,,,0,"percent of total billed charges","17.136% of total billed charges",258.8,21.84,,207.04,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",446.75,37.7,,357.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",924.3,78,,739.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",181.31,1185,
"FIBER LASER DISP 270 MICRONS",ORSUP0031,CDM,272,RC,,,OUTPATIENT,,,5356,3481.4,,4713.28,88,,3770.62,,,0,"percent of total billed charges","88% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",926.8,17.304,,741.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3374.28,63,,2699.42,,,0,"percent of total billed charges","63% of total billed charges",819.47,15.3,,655.58,,,0,"percent of total billed charges","15.3% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",3695.64,69,,,,,0,"fee schedule","69% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3312.69,61.85,,2650.15,,,0,"percent of total billed charges","61.5% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",1724.63,32.2,,1379.70,,,0,"percent of total billed charges","32.2% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",917.8,17.136,,734.24,,,0,"percent of total billed charges","17.136% of total billed charges",1169.75,21.84,,935.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4177.68,78,,3342.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",819.47,5356,
"FIBERLINK 0 BLUE",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"FIBERSTICK #2 FIBERWIRE #2 50 INCH BLUE ONE END STIFF 12 INCH",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
FIBERWIRE,ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"FIBERWIRE # 2 TAPER",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"FIBERWIRE 3-0",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"FIBERWIRE MENISCUS REPAIR SUTURE",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"FIBERLOOP WITH STRAIGHT NEEDLE #2",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"FIBERTAPE  2MM 7 INCH (BLUE) W/EA END TAPERED TO #2 FIBERWIRE",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"FIBERGLASS CAST 5",490597,CDM,270,RC,,,OUTPATIENT,,,50,32.5,,44,88,,35.20,,,0,"percent of total billed charges","88% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.65,17.304,,6.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.5,63,,25.20,,,0,"percent of total billed charges","63% of total billed charges",7.65,15.3,,6.12,,,0,"percent of total billed charges","15.3% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",34.5,69,,,,,0,"fee schedule","69% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.93,61.85,,24.74,,,0,"percent of total billed charges","61.5% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",16.1,32.2,,12.88,,,0,"percent of total billed charges","32.2% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.57,17.136,,6.86,,,0,"percent of total billed charges","17.136% of total billed charges",10.92,21.84,,8.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39,78,,31.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",7.65,50,
"FIBERLOOP 4-0 T-13 TAPERED NEEDLE",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"FICHER CONE BIOSPY WIRE, LG",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"FILLER CERAMENT BONE VOID 5CC",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"FILL KIT UNIVERSAL",490600,CDM,270,RC,,,OUTPATIENT,,,90,58.5,,79.2,88,,63.36,,,0,"percent of total billed charges","88% of total billed charges",45,50,,36.00,,,0,"percent of total billed charges","50% of total billed charges",15.12,16.8,,12.10,,,0,"percent of total billed charges","16.8% of total billed charges",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.57,17.304,,12.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.7,63,,45.36,,,0,"percent of total billed charges","63% of total billed charges",13.77,15.3,,11.02,,,0,"percent of total billed charges","15.3% of total billed charges",15.12,16.8,,12.10,,,0,"percent of total billed charges","16.8% of total billed charges",62.1,69,,,,,0,"fee schedule","69% of total billed charges",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",55.67,61.85,,44.54,,,0,"percent of total billed charges","61.5% of total billed charges",15.12,16.8,,12.10,,,0,"percent of total billed charges","16.8% of total billed charges",45,50,,36.00,,,0,"percent of total billed charges","50% of total billed charges",28.98,32.2,,23.18,,,0,"percent of total billed charges","32.2% of total billed charges",15.12,16.8,,12.10,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.42,17.136,,12.34,,,0,"percent of total billed charges","17.136% of total billed charges",19.66,21.84,,15.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",33.93,37.7,,27.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",70.2,78,,56.16,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.34,82.6,,59.47,,,0,"percent of total billed charges","82.6% of total billed charges",15.12,16.8,,12.10,,,0,"percent of total billed charges","16.8% of total billed charges",45,50,,36.00,,,0,"percent of total billed charges","50% of total billed charges",74.34,82.6,,59.47,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.12,16.8,,12.10,,,0,"percent of total billed charges","16.8% of total billed charges",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",13.77,90,
"FILSHIE CLIPS",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"FILTERWIRE 300CM",ORSUP0038,CDM,278,RC,,,OUTPATIENT,,,7231,4700.15,,6363.28,88,,5090.62,,,0,"percent of total billed charges","88% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1251.25,17.304,,1001.00,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4555.53,63,,3644.42,,,0,"percent of total billed charges","63% of total billed charges",1106.34,15.3,,885.07,,,0,"percent of total billed charges","15.3% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4989.39,69,,,,,0,"fee schedule","69% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4472.37,61.85,,3577.90,,,0,"percent of total billed charges","61.5% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",2328.38,32.2,,1862.70,,,0,"percent of total billed charges","32.2% of total billed charges",2256.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1239.1,17.136,,991.28,,,0,"percent of total billed charges","17.136% of total billed charges",1579.25,21.84,,1263.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.7% of total billed charges",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2451.31,33.9,,1961.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5640.18,78,,4512.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",1106.34,7231,
"FILTER FEMORAL DENALI",ORSUP0042,CDM,278,RC,,,OUTPATIENT,,,8302,5396.3,,7305.76,88,,5844.61,,,0,"percent of total billed charges","88% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1436.58,17.304,,1149.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5230.26,63,,4184.21,,,0,"percent of total billed charges","63% of total billed charges",1270.21,15.3,,1016.17,,,0,"percent of total billed charges","15.3% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",5728.38,69,,,,,0,"fee schedule","69% of total billed charges",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5134.79,61.85,,4107.83,,,0,"percent of total billed charges","61.5% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",2673.24,32.2,,2138.59,,,0,"percent of total billed charges","32.2% of total billed charges",2590.22,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1422.63,17.136,,1138.10,,,0,"percent of total billed charges","17.136% of total billed charges",1813.16,21.84,,1450.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3129.85,37.7,,2503.88,,,0,"percent of total billed charges","37.7% of total billed charges",3129.85,37.7,,2503.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2814.38,33.9,,2251.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6475.56,78,,5180.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6857.45,82.6,,5485.96,,,0,"percent of total billed charges","82.6% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",6857.45,82.6,,5485.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",1270.21,8302,
"FILTER JUGULAR DENALI",ORSUP0040,CDM,278,RC,,,OUTPATIENT,,,7766,5047.9,,6834.08,88,,5467.26,,,0,"percent of total billed charges","88% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1343.83,17.304,,1075.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4892.58,63,,3914.06,,,0,"percent of total billed charges","63% of total billed charges",1188.2,15.3,,950.56,,,0,"percent of total billed charges","15.3% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",5358.54,69,,,,,0,"fee schedule","69% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4803.27,61.85,,3842.62,,,0,"percent of total billed charges","61.5% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",2500.65,32.2,,2000.52,,,0,"percent of total billed charges","32.2% of total billed charges",2422.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1330.78,17.136,,1064.62,,,0,"percent of total billed charges","17.136% of total billed charges",1696.09,21.84,,1356.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2927.78,37.7,,2342.22,,,0,"percent of total billed charges","37.7% of total billed charges",2927.78,37.7,,2342.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2632.67,33.9,,2106.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6057.48,78,,4845.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",1188.2,7766,
"FILTER 1.2 MICRON EXT SET NON-DEHP",185667,CDM,270,RC,,,OUTPATIENT,,,52,33.8,,45.76,88,,36.61,,,0,"percent of total billed charges","88% of total billed charges",26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,17.304,,7.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.76,63,,26.21,,,0,"percent of total billed charges","63% of total billed charges",7.96,15.3,,6.37,,,0,"percent of total billed charges","15.3% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",35.88,69,,,,,0,"fee schedule","69% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.16,61.85,,25.73,,,0,"percent of total billed charges","61.5% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",16.74,32.2,,13.39,,,0,"percent of total billed charges","32.2% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.91,17.136,,7.13,,,0,"percent of total billed charges","17.136% of total billed charges",11.36,21.84,,9.09,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.6,37.7,,15.68,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",40.56,78,,32.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",7.96,52,
"FILTER GENESIS NON CELLULOSE",ORSUP0011,CDM,270,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"FILTER BACTERIA",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"FILTER AIR OLYMPUS SCOPE 8 PER CASE",ORSUP0013,CDM,270,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"FILTER DSD REPLACEMENT 0.45 MICRON WA",ORSUP0013,CDM,270,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"FILTER IRRIGATION TUBE",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"FILTER WATER OLYMPUS",ORSUP0018,CDM,270,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"FILTER CONCENTRATOR",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"FILTER PROBE CIRCUMFERENTIAL OD2.3MM X L220CM",ORSUP0053,CDM,272,RC,,,OUTPATIENT,,,11248,7311.2,,9898.24,88,,7918.59,,,0,"percent of total billed charges","88% of total billed charges",5624,50,,4499.20,,,0,"percent of total billed charges","50% of total billed charges",1889.66,16.8,,1511.73,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1946.35,17.304,,1557.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7086.24,63,,5668.99,,,0,"percent of total billed charges","63% of total billed charges",1720.94,15.3,,1376.75,,,0,"percent of total billed charges","15.3% of total billed charges",1889.66,16.8,,1511.73,,,0,"percent of total billed charges","16.8% of total billed charges",7761.12,69,,,,,0,"fee schedule","69% of total billed charges",11248,100,,8998.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11248,100,,8998.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11248,100,,8998.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6956.89,61.85,,5565.51,,,0,"percent of total billed charges","61.5% of total billed charges",1889.66,16.8,,1511.73,,,0,"percent of total billed charges","16.8% of total billed charges",5624,50,,4499.20,,,0,"percent of total billed charges","50% of total billed charges",3621.86,32.2,,2897.49,,,0,"percent of total billed charges","32.2% of total billed charges",1889.66,16.8,,1511.73,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1927.46,17.136,,1541.97,,,0,"percent of total billed charges","17.136% of total billed charges",2456.56,21.84,,1965.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4240.5,37.7,,3392.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8773.44,78,,7018.75,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9290.85,82.6,,7432.68,,,0,"percent of total billed charges","82.6% of total billed charges",1889.66,16.8,,1511.73,,,0,"percent of total billed charges","16.8% of total billed charges",5624,50,,4499.20,,,0,"percent of total billed charges","50% of total billed charges",9290.85,82.6,,7432.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1889.66,16.8,,1511.73,,,0,"percent of total billed charges","16.8% of total billed charges",11248,100,,8998.40,,,0,"percent of total billed charges","100% of total billed charges",1720.94,11248,
"FILTER SET VENA CAVA",ORSUP0043,CDM,278,RC,,,OUTPATIENT,,,8570,5570.5,,7541.6,88,,6033.28,,,0,"percent of total billed charges","88% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1482.95,17.304,,1186.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5399.1,63,,4319.28,,,0,"percent of total billed charges","63% of total billed charges",1311.21,15.3,,1048.97,,,0,"percent of total billed charges","15.3% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",5913.3,69,,,,,0,"fee schedule","69% of total billed charges",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5300.55,61.85,,4240.44,,,0,"percent of total billed charges","61.5% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",2759.54,32.2,,2207.63,,,0,"percent of total billed charges","32.2% of total billed charges",2673.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1468.56,17.136,,1174.85,,,0,"percent of total billed charges","17.136% of total billed charges",1871.69,21.84,,1497.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3230.89,37.7,,2584.71,,,0,"percent of total billed charges","37.7% of total billed charges",3230.89,37.7,,2584.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2905.23,33.9,,2324.18,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6684.6,78,,5347.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7078.82,82.6,,5663.06,,,0,"percent of total billed charges","82.6% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",7078.82,82.6,,5663.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",1311.21,8570,
"FILTER VMS CHARCOAL",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"FINGER SPLINT PADDED CURVED 6 SZ M",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"FINGER SPLINT PADDED CURVED 4",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"FINGER STAX ASSORTED SIZES",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.7% of total billed charges",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.46,33.9,,69.97,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"FIOS FIRST ENTRY KII 12MM X 100MM Z THREAD.",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"FIXATOR LOW PROFILE WRIST 3MM X 4MM",ORSUP0043,CDM,278,RC,,,OUTPATIENT,,,8570,5570.5,,7541.6,88,,6033.28,,,0,"percent of total billed charges","88% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1482.95,17.304,,1186.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5399.1,63,,4319.28,,,0,"percent of total billed charges","63% of total billed charges",1311.21,15.3,,1048.97,,,0,"percent of total billed charges","15.3% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",5913.3,69,,,,,0,"fee schedule","69% of total billed charges",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5300.55,61.85,,4240.44,,,0,"percent of total billed charges","61.5% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",2759.54,32.2,,2207.63,,,0,"percent of total billed charges","32.2% of total billed charges",2673.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1468.56,17.136,,1174.85,,,0,"percent of total billed charges","17.136% of total billed charges",1871.69,21.84,,1497.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3230.89,37.7,,2584.71,,,0,"percent of total billed charges","37.7% of total billed charges",3230.89,37.7,,2584.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2905.23,33.9,,2324.18,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6684.6,78,,5347.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7078.82,82.6,,5663.06,,,0,"percent of total billed charges","82.6% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",7078.82,82.6,,5663.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",1311.21,8570,
"FIXED FLANGE PVC NASAL AIRWAY",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"FLEXOR ANSEL CATH 5FR X 90CM",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,515,334.75,,453.2,88,,362.56,,,0,"percent of total billed charges","88% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.12,17.304,,71.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",324.45,63,,259.56,,,0,"percent of total billed charges","63% of total billed charges",78.8,15.3,,63.04,,,0,"percent of total billed charges","15.3% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",355.35,69,,,,,0,"fee schedule","69% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",318.53,61.85,,254.82,,,0,"percent of total billed charges","61.5% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",165.83,32.2,,132.66,,,0,"percent of total billed charges","32.2% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.25,17.136,,70.60,,,0,"percent of total billed charges","17.136% of total billed charges",112.48,21.84,,89.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.16,37.7,,155.33,,,0,"percent of total billed charges","37.7% of total billed charges",194.16,37.7,,155.33,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",174.59,33.9,,139.67,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",401.7,78,,321.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",78.8,515,
"FLIPCUTTER II SU 10.0",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"FLIPCUTTER II SU 6.0MM",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"FLIPCUTTER II SU 7.0",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"FLIPCUTTER II SU 8.5MM",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"FLIPCUTTER II SU 9.5MM",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"FLIPCUTTER II SU 8.0",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"FLIPCUTTER II SU 10.5",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"FLIPCUTTER II SU 11.0",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"FLOLINK ACCESS DEVICE MP1000-C",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"FLOSEAL HEMOSTATIC MATRIX 10ML",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.94,17.304,,85.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.23,61.85,,305.78,,,0,"percent of total billed charges","61.5% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",199,32.2,,159.20,,,0,"percent of total billed charges","32.2% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.136,,84.72,,,0,"percent of total billed charges","17.136% of total billed charges",134.97,21.84,,107.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.7% of total billed charges",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.5,33.9,,167.60,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,618,
"FLOSEAL HEMOSTATIC MATRIX 5ML",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"FLOSEAL MATRIX FULL STERILE PREP 5ML",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"FLOSEAL MALLEABLE TIP ENDO APPLICATOR",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"FLOSEAL VHSD 10ML",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"FLOSTEADY DISP TUBE SET",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"FLOSEAL 5ML HEMOSTATIC MATRIX",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"FLOW SENSOR",ORSUP0017,CDM,270,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"FLOW CONTROL SWITCH HIGH PRESSURE 12000PSI",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"FLUENT KIT",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2060,1339,,1812.8,88,,1450.24,,,0,"percent of total billed charges","88% of total billed charges",1030,50,,824.00,,,0,"percent of total billed charges","50% of total billed charges",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",356.46,17.304,,285.17,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1297.8,63,,1038.24,,,0,"percent of total billed charges","63% of total billed charges",315.18,15.3,,252.14,,,0,"percent of total billed charges","15.3% of total billed charges",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",1421.4,69,,,,,0,"fee schedule","69% of total billed charges",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1274.11,61.85,,1019.29,,,0,"percent of total billed charges","61.5% of total billed charges",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",1030,50,,824.00,,,0,"percent of total billed charges","50% of total billed charges",663.32,32.2,,530.66,,,0,"percent of total billed charges","32.2% of total billed charges",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",353,17.136,,282.40,,,0,"percent of total billed charges","17.136% of total billed charges",449.9,21.84,,359.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",776.62,37.7,,621.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1606.8,78,,1285.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1701.56,82.6,,1361.25,,,0,"percent of total billed charges","82.6% of total billed charges",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",1030,50,,824.00,,,0,"percent of total billed charges","50% of total billed charges",1701.56,82.6,,1361.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",315.18,2060,
"FLUID SILICONE .5OZ",ORSUP0011,CDM,270,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"FLUORESCENCE IMAGING PACK",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"FLYTE SURGICOOL HOOD",ORSUP0035,CDM,272,RC,,,OUTPATIENT,,,6427,4177.55,,5655.76,88,,4524.61,,,0,"percent of total billed charges","88% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1112.13,17.304,,889.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4049.01,63,,3239.21,,,0,"percent of total billed charges","63% of total billed charges",983.33,15.3,,786.66,,,0,"percent of total billed charges","15.3% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4434.63,69,,,,,0,"fee schedule","69% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3975.1,61.85,,3180.08,,,0,"percent of total billed charges","61.5% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",2069.49,32.2,,1655.59,,,0,"percent of total billed charges","32.2% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1101.33,17.136,,881.06,,,0,"percent of total billed charges","17.136% of total billed charges",1403.66,21.84,,1122.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5013.06,78,,4010.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",983.33,6427,
"FLYTE POWER CABLE",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,721,468.65,,634.48,88,,507.58,,,0,"percent of total billed charges","88% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.76,17.304,,99.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.23,63,,363.38,,,0,"percent of total billed charges","63% of total billed charges",110.31,15.3,,88.25,,,0,"percent of total billed charges","15.3% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",497.49,69,,,,,0,"fee schedule","69% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",445.94,61.85,,356.75,,,0,"percent of total billed charges","61.5% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",232.16,32.2,,185.73,,,0,"percent of total billed charges","32.2% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",123.55,17.136,,98.84,,,0,"percent of total billed charges","17.136% of total billed charges",157.47,21.84,,125.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",271.82,37.7,,217.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",562.38,78,,449.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",595.55,82.6,,476.44,,,0,"percent of total billed charges","82.6% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",595.55,82.6,,476.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",110.31,721,
"FOAM EXIDINE CHG SOLUTION 4% CHG",273722,CDM,270,RC,,,OUTPATIENT,,,115,74.75,,101.2,88,,80.96,,,0,"percent of total billed charges","88% of total billed charges",57.5,50,,46.00,,,0,"percent of total billed charges","50% of total billed charges",19.32,16.8,,15.46,,,0,"percent of total billed charges","16.8% of total billed charges",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.9,17.304,,15.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",72.45,63,,57.96,,,0,"percent of total billed charges","63% of total billed charges",17.6,15.3,,14.08,,,0,"percent of total billed charges","15.3% of total billed charges",19.32,16.8,,15.46,,,0,"percent of total billed charges","16.8% of total billed charges",79.35,69,,,,,0,"fee schedule","69% of total billed charges",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.13,61.85,,56.90,,,0,"percent of total billed charges","61.5% of total billed charges",19.32,16.8,,15.46,,,0,"percent of total billed charges","16.8% of total billed charges",57.5,50,,46.00,,,0,"percent of total billed charges","50% of total billed charges",37.03,32.2,,29.62,,,0,"percent of total billed charges","32.2% of total billed charges",19.32,16.8,,15.46,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.71,17.136,,15.77,,,0,"percent of total billed charges","17.136% of total billed charges",25.12,21.84,,20.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.36,37.7,,34.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",89.7,78,,71.76,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",94.99,82.6,,75.99,,,0,"percent of total billed charges","82.6% of total billed charges",19.32,16.8,,15.46,,,0,"percent of total billed charges","16.8% of total billed charges",57.5,50,,46.00,,,0,"percent of total billed charges","50% of total billed charges",94.99,82.6,,75.99,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.32,16.8,,15.46,,,0,"percent of total billed charges","16.8% of total billed charges",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",17.6,115,
"FOAM HEAD POSITIONER ADULT",490609,CDM,270,RC,,,OUTPATIENT,,,38,24.7,,33.44,88,,26.75,,,0,"percent of total billed charges","88% of total billed charges",19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.58,17.304,,5.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.94,63,,19.15,,,0,"percent of total billed charges","63% of total billed charges",5.81,15.3,,4.65,,,0,"percent of total billed charges","15.3% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",26.22,69,,,,,0,"fee schedule","69% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.5,61.85,,18.80,,,0,"percent of total billed charges","61.5% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",12.24,32.2,,9.79,,,0,"percent of total billed charges","32.2% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.51,17.136,,5.21,,,0,"percent of total billed charges","17.136% of total billed charges",8.3,21.84,,6.64,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.33,37.7,,11.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.64,78,,23.71,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",5.81,38,
"FOLATE 100 WELLS",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"FOLATE CAL BOX / 1 SET",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"FOLEY CATHETER TRAY",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"FORCEPS PLATE HOLDING  1MM SYSTEM",ORSUP0019,CDM,278,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",668.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.7% of total billed charges",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",726.14,33.9,,580.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"FORCEPS ENDO LF HOT BIOP POLYPECT ENDO",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"FORCEPS BIOPSY",ORSUP0027,CDM,272,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"FORCEPS RADIAL JAW 2.8MM BIOSPY",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"FORCEP BIOPSY PRE-MARKED",ORSUP0026,CDM,272,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"FORCEP BIPOLAR MARYLAND DA VINCI",173497,CDM,272,RC,,,OUTPATIENT,,,13752,8938.8,,12101.76,88,,9681.41,,,0,"percent of total billed charges","88% of total billed charges",6876,50,,5500.80,,,0,"percent of total billed charges","50% of total billed charges",2310.34,16.8,,1848.27,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2379.65,17.304,,1903.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8663.76,63,,6931.01,,,0,"percent of total billed charges","63% of total billed charges",2104.06,15.3,,1683.25,,,0,"percent of total billed charges","15.3% of total billed charges",2310.34,16.8,,1848.27,,,0,"percent of total billed charges","16.8% of total billed charges",9488.88,69,,,,,0,"fee schedule","69% of total billed charges",13752,100,,11001.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13752,100,,11001.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13752,100,,11001.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8505.61,61.85,,6804.49,,,0,"percent of total billed charges","61.5% of total billed charges",2310.34,16.8,,1848.27,,,0,"percent of total billed charges","16.8% of total billed charges",6876,50,,5500.80,,,0,"percent of total billed charges","50% of total billed charges",4428.14,32.2,,3542.51,,,0,"percent of total billed charges","32.2% of total billed charges",2310.34,16.8,,1848.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2356.54,17.136,,1885.23,,,0,"percent of total billed charges","17.136% of total billed charges",3003.44,21.84,,2402.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5184.5,37.7,,4147.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10726.56,78,,8581.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11359.15,82.6,,9087.32,,,0,"percent of total billed charges","82.6% of total billed charges",2310.34,16.8,,1848.27,,,0,"percent of total billed charges","16.8% of total billed charges",6876,50,,5500.80,,,0,"percent of total billed charges","50% of total billed charges",11359.15,82.6,,9087.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2310.34,16.8,,1848.27,,,0,"percent of total billed charges","16.8% of total billed charges",13752,100,,11001.60,,,0,"percent of total billed charges","100% of total billed charges",2104.06,13752,
"FORCEP CADIERE ROBOTIC",280465,CDM,272,RC,,,OUTPATIENT,,,1653,1074.45,,1454.64,88,,1163.71,,,0,"percent of total billed charges","88% of total billed charges",826.5,50,,661.20,,,0,"percent of total billed charges","50% of total billed charges",277.7,16.8,,222.16,,,0,"percent of total billed charges","16.8% of total billed charges",1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",286.04,17.304,,228.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1041.39,63,,833.11,,,0,"percent of total billed charges","63% of total billed charges",252.91,15.3,,202.33,,,0,"percent of total billed charges","15.3% of total billed charges",277.7,16.8,,222.16,,,0,"percent of total billed charges","16.8% of total billed charges",1140.57,69,,,,,0,"fee schedule","69% of total billed charges",1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1022.38,61.85,,817.90,,,0,"percent of total billed charges","61.5% of total billed charges",277.7,16.8,,222.16,,,0,"percent of total billed charges","16.8% of total billed charges",826.5,50,,661.20,,,0,"percent of total billed charges","50% of total billed charges",532.27,32.2,,425.82,,,0,"percent of total billed charges","32.2% of total billed charges",277.7,16.8,,222.16,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",283.26,17.136,,226.61,,,0,"percent of total billed charges","17.136% of total billed charges",361.02,21.84,,288.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",623.18,37.7,,498.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1289.34,78,,1031.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1365.38,82.6,,1092.30,,,0,"percent of total billed charges","82.6% of total billed charges",277.7,16.8,,222.16,,,0,"percent of total billed charges","16.8% of total billed charges",826.5,50,,661.20,,,0,"percent of total billed charges","50% of total billed charges",1365.38,82.6,,1092.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",277.7,16.8,,222.16,,,0,"percent of total billed charges","16.8% of total billed charges",1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",252.91,1653,
"FORCEP DEBAKEY ROBOTIC",280483,CDM,272,RC,,,OUTPATIENT,,,9422,6124.3,,8291.36,88,,6633.09,,,0,"percent of total billed charges","88% of total billed charges",4711,50,,3768.80,,,0,"percent of total billed charges","50% of total billed charges",1582.9,16.8,,1266.32,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1630.38,17.304,,1304.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5935.86,63,,4748.69,,,0,"percent of total billed charges","63% of total billed charges",1441.57,15.3,,1153.26,,,0,"percent of total billed charges","15.3% of total billed charges",1582.9,16.8,,1266.32,,,0,"percent of total billed charges","16.8% of total billed charges",6501.18,69,,,,,0,"fee schedule","69% of total billed charges",9422,100,,7537.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9422,100,,7537.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9422,100,,7537.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5827.51,61.85,,4662.01,,,0,"percent of total billed charges","61.5% of total billed charges",1582.9,16.8,,1266.32,,,0,"percent of total billed charges","16.8% of total billed charges",4711,50,,3768.80,,,0,"percent of total billed charges","50% of total billed charges",3033.88,32.2,,2427.10,,,0,"percent of total billed charges","32.2% of total billed charges",1582.9,16.8,,1266.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1614.55,17.136,,1291.64,,,0,"percent of total billed charges","17.136% of total billed charges",2057.76,21.84,,1646.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3552.09,37.7,,2841.67,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7349.16,78,,5879.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7782.57,82.6,,6226.06,,,0,"percent of total billed charges","82.6% of total billed charges",1582.9,16.8,,1266.32,,,0,"percent of total billed charges","16.8% of total billed charges",4711,50,,3768.80,,,0,"percent of total billed charges","50% of total billed charges",7782.57,82.6,,6226.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1582.9,16.8,,1266.32,,,0,"percent of total billed charges","16.8% of total billed charges",9422,100,,7537.60,,,0,"percent of total billed charges","100% of total billed charges",1441.57,9422,
"FORCEP FENESTRATED BIOPOLAR ROBOTIC",280455,CDM,272,RC,,,OUTPATIENT,,,13752,8938.8,,12101.76,88,,9681.41,,,0,"percent of total billed charges","88% of total billed charges",6876,50,,5500.80,,,0,"percent of total billed charges","50% of total billed charges",2310.34,16.8,,1848.27,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2379.65,17.304,,1903.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8663.76,63,,6931.01,,,0,"percent of total billed charges","63% of total billed charges",2104.06,15.3,,1683.25,,,0,"percent of total billed charges","15.3% of total billed charges",2310.34,16.8,,1848.27,,,0,"percent of total billed charges","16.8% of total billed charges",9488.88,69,,,,,0,"fee schedule","69% of total billed charges",13752,100,,11001.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13752,100,,11001.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13752,100,,11001.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8505.61,61.85,,6804.49,,,0,"percent of total billed charges","61.5% of total billed charges",2310.34,16.8,,1848.27,,,0,"percent of total billed charges","16.8% of total billed charges",6876,50,,5500.80,,,0,"percent of total billed charges","50% of total billed charges",4428.14,32.2,,3542.51,,,0,"percent of total billed charges","32.2% of total billed charges",2310.34,16.8,,1848.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2356.54,17.136,,1885.23,,,0,"percent of total billed charges","17.136% of total billed charges",3003.44,21.84,,2402.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5184.5,37.7,,4147.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10726.56,78,,8581.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11359.15,82.6,,9087.32,,,0,"percent of total billed charges","82.6% of total billed charges",2310.34,16.8,,1848.27,,,0,"percent of total billed charges","16.8% of total billed charges",6876,50,,5500.80,,,0,"percent of total billed charges","50% of total billed charges",11359.15,82.6,,9087.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2310.34,16.8,,1848.27,,,0,"percent of total billed charges","16.8% of total billed charges",13752,100,,11001.60,,,0,"percent of total billed charges","100% of total billed charges",2104.06,13752,
"FORCEP LONG TIP ROBOTIC",280488,CDM,272,RC,,,OUTPATIENT,,,12478,8110.7,,10980.64,88,,8784.51,,,0,"percent of total billed charges","88% of total billed charges",6239,50,,4991.20,,,0,"percent of total billed charges","50% of total billed charges",2096.3,16.8,,1677.04,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2159.19,17.304,,1727.35,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7861.14,63,,6288.91,,,0,"percent of total billed charges","63% of total billed charges",1909.13,15.3,,1527.30,,,0,"percent of total billed charges","15.3% of total billed charges",2096.3,16.8,,1677.04,,,0,"percent of total billed charges","16.8% of total billed charges",8609.82,69,,,,,0,"fee schedule","69% of total billed charges",12478,100,,9982.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12478,100,,9982.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12478,100,,9982.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7717.64,61.85,,6174.11,,,0,"percent of total billed charges","61.5% of total billed charges",2096.3,16.8,,1677.04,,,0,"percent of total billed charges","16.8% of total billed charges",6239,50,,4991.20,,,0,"percent of total billed charges","50% of total billed charges",4017.92,32.2,,3214.34,,,0,"percent of total billed charges","32.2% of total billed charges",2096.3,16.8,,1677.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2138.23,17.136,,1710.58,,,0,"percent of total billed charges","17.136% of total billed charges",2725.2,21.84,,2180.16,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4704.21,37.7,,3763.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9732.84,78,,7786.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10306.83,82.6,,8245.46,,,0,"percent of total billed charges","82.6% of total billed charges",2096.3,16.8,,1677.04,,,0,"percent of total billed charges","16.8% of total billed charges",6239,50,,4991.20,,,0,"percent of total billed charges","50% of total billed charges",10306.83,82.6,,8245.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2096.3,16.8,,1677.04,,,0,"percent of total billed charges","16.8% of total billed charges",12478,100,,9982.40,,,0,"percent of total billed charges","100% of total billed charges",1909.13,12478,
"FORCEP TENACULUM DA VINCI",173505,CDM,272,RC,,,OUTPATIENT,,,11204,7282.6,,9859.52,88,,7887.62,,,0,"percent of total billed charges","88% of total billed charges",5602,50,,4481.60,,,0,"percent of total billed charges","50% of total billed charges",1882.27,16.8,,1505.82,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1938.74,17.304,,1550.99,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7058.52,63,,5646.82,,,0,"percent of total billed charges","63% of total billed charges",1714.21,15.3,,1371.37,,,0,"percent of total billed charges","15.3% of total billed charges",1882.27,16.8,,1505.82,,,0,"percent of total billed charges","16.8% of total billed charges",7730.76,69,,,,,0,"fee schedule","69% of total billed charges",11204,100,,8963.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11204,100,,8963.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11204,100,,8963.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6929.67,61.85,,5543.74,,,0,"percent of total billed charges","61.5% of total billed charges",1882.27,16.8,,1505.82,,,0,"percent of total billed charges","16.8% of total billed charges",5602,50,,4481.60,,,0,"percent of total billed charges","50% of total billed charges",3607.69,32.2,,2886.15,,,0,"percent of total billed charges","32.2% of total billed charges",1882.27,16.8,,1505.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1919.92,17.136,,1535.94,,,0,"percent of total billed charges","17.136% of total billed charges",2446.95,21.84,,1957.56,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4223.91,37.7,,3379.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8739.12,78,,6991.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9254.5,82.6,,7403.60,,,0,"percent of total billed charges","82.6% of total billed charges",1882.27,16.8,,1505.82,,,0,"percent of total billed charges","16.8% of total billed charges",5602,50,,4481.60,,,0,"percent of total billed charges","50% of total billed charges",9254.5,82.6,,7403.60,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1882.27,16.8,,1505.82,,,0,"percent of total billed charges","16.8% of total billed charges",11204,100,,8963.20,,,0,"percent of total billed charges","100% of total billed charges",1714.21,11204,
"FORCEPS 5MM CADIERE",408626,CDM,272,RC,,,OUTPATIENT,,,3875,2518.75,,3410,88,,2728.00,,,0,"percent of total billed charges","88% of total billed charges",1937.5,50,,1550.00,,,0,"percent of total billed charges","50% of total billed charges",651,16.8,,520.80,,,0,"percent of total billed charges","16.8% of total billed charges",3875,100,,3100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670.53,17.304,,536.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2441.25,63,,1953.00,,,0,"percent of total billed charges","63% of total billed charges",592.88,15.3,,474.30,,,0,"percent of total billed charges","15.3% of total billed charges",651,16.8,,520.80,,,0,"percent of total billed charges","16.8% of total billed charges",2673.75,69,,,,,0,"fee schedule","69% of total billed charges",3875,100,,3100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3875,100,,3100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3875,100,,3100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2396.69,61.85,,1917.35,,,0,"percent of total billed charges","61.5% of total billed charges",651,16.8,,520.80,,,0,"percent of total billed charges","16.8% of total billed charges",1937.5,50,,1550.00,,,0,"percent of total billed charges","50% of total billed charges",1247.75,32.2,,998.20,,,0,"percent of total billed charges","32.2% of total billed charges",651,16.8,,520.80,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",664.02,17.136,,531.22,,,0,"percent of total billed charges","17.136% of total billed charges",846.3,21.84,,677.04,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1460.88,37.7,,1168.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3022.5,78,,2418.00,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3200.75,82.6,,2560.60,,,0,"percent of total billed charges","82.6% of total billed charges",651,16.8,,520.80,,,0,"percent of total billed charges","16.8% of total billed charges",1937.5,50,,1550.00,,,0,"percent of total billed charges","50% of total billed charges",3200.75,82.6,,2560.60,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",651,16.8,,520.80,,,0,"percent of total billed charges","16.8% of total billed charges",3875,100,,3100.00,,,0,"percent of total billed charges","100% of total billed charges",592.88,3875,
"FORCEPS BIOPSY RADIAL JAW 23.8MM",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"FORCEPS RESCUE COMBO GRASPING",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"FORCEPS SUPER TRAX BIOPSY",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"FORCEPS MOLLY 5MM 33CM GYRUS",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"FORCEP BIPOLAR MOLLY 5MM",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"FORCEPS HOT BIOPSY OVAL CUP",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"FORCEPS CUTTING 5MM GYRUS",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"FORCEPS GRASPING TRIPOD 230CM",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"FORCEPS BIOPSY BROCH DISP",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"FORCEP 33CM BIPOLAR CUTTING",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"FORCEP CUTTING 10MM GYRUS",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"FORCEP BIOPSY OVAL CUP DISP",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"FORCEPS HALSTED MOQUITO 5 CURVED MIRROR FINISH",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"FORCEPS HALSTED MOQUITO 5 STRAIGHT MIRROR FINISH",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"FORMULA VITAL AF 1.2 CAL VANILLA",ORSUP0010,CDM,270,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"FORMULA PIVOT 1.5 1000ML",ORSUP0010,CDM,270,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"FORMULA 1000ML VITAL HIGH PROTEIN",ORSUP0010,CDM,270,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"FORM PRE SURGERY INSTRUCTIONS OR-20S",ORSUP0001,CDM,271,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.7% of total billed charges",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.2,33.9,,9.76,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"FRAME EYE SHIELD PLASTIC OPTICAL GRD ASSRT COLORS",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"FRANKLIN CHOLANGIOGRAPHY ST",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"FREE T3 100 WELLS",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"FREE T3 CAL BOX / 3 SETS",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"FREE T4 100 WELLS",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"FREE T4 CAL BOX / 3 SETS",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"FRIDGE TEMP RECORDER CHART BLOOD BANK",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"FS ASSAY DISPOSAL LINERS BX10",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"FS HUMIDIFICATION PACKS BOX / 6",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"FS MICROTIPS BX / 4096",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"FS SLIDE DISPOSAL LINERS BX10",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"FSH 100 WELLS",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"FSH CALIBRATOR BOX / 1 SET",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"FT-31 SENSITIVITY SOLUTION SWEET",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"FT-31 FIT TEST SOLUTION SWEET",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"G-TUBE REPLACEMENT 18F",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"G-TUBE REPLACEMENT 24FR",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"G-TUBE PLACEMENT  KIT 14FR",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"G-TUBE PLACEMENT  KIT 16FR",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"GAMMA ELU-KIT II",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"GARDNERELLA VAGNALIS ATCC CULTI LOOPS 14018",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"GARMENT CALF 28 INCH",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"GASPAK EZ GAS GENERATING SYSTEM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"GASTROSTOMY MIC-KEY TUBE 18FR",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"GASTRIC LAVAGE",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"GASTRIC BUTTON 18FR. 1.7CM",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"GASTRIC BUTTON 24FR 2.4CM",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"GASTRIC BUTTON 24FR 3.4CM",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"GASTRIC BUTTON 24FR 1.7CM",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"GASTROCULT APPLICATOR STICKS",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"GASTROINTESTINAL ANCHOR SET",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"GASTROTOMY TUBE W/ENFIT 16FR",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"GASTROTOMY TUBE W/ENFIT 20FR",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"GAUZE SURGICOUNT 16 PLY 4X4 STERILE",428966,CDM,272,RC,,,OUTPATIENT,,,40,26,,35.2,88,,28.16,,,0,"percent of total billed charges","88% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.92,17.304,,5.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.2,63,,20.16,,,0,"percent of total billed charges","63% of total billed charges",6.12,15.3,,4.90,,,0,"percent of total billed charges","15.3% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",27.6,69,,,,,0,"fee schedule","69% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.74,61.85,,19.79,,,0,"percent of total billed charges","61.5% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",12.88,32.2,,10.30,,,0,"percent of total billed charges","32.2% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.85,17.136,,5.48,,,0,"percent of total billed charges","17.136% of total billed charges",8.74,21.84,,6.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.08,37.7,,12.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",31.2,78,,24.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",6.12,40,
"GAUZE XRAY DOUBLE 12 PLY 8X4 STERILE",429535,CDM,272,RC,,,OUTPATIENT,,,49,31.85,,43.12,88,,34.50,,,0,"percent of total billed charges","88% of total billed charges",24.5,50,,19.60,,,0,"percent of total billed charges","50% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.48,17.304,,6.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.87,63,,24.70,,,0,"percent of total billed charges","63% of total billed charges",7.5,15.3,,6.00,,,0,"percent of total billed charges","15.3% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",33.81,69,,,,,0,"fee schedule","69% of total billed charges",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.31,61.85,,24.25,,,0,"percent of total billed charges","61.5% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",24.5,50,,19.60,,,0,"percent of total billed charges","50% of total billed charges",15.78,32.2,,12.62,,,0,"percent of total billed charges","32.2% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.4,17.136,,6.72,,,0,"percent of total billed charges","17.136% of total billed charges",10.7,21.84,,8.56,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.47,37.7,,14.78,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.22,78,,30.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.47,82.6,,32.38,,,0,"percent of total billed charges","82.6% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",24.5,50,,19.60,,,0,"percent of total billed charges","50% of total billed charges",40.47,82.6,,32.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",7.5,49,
"GAUZE PACKING VAGINAL 2",201027,CDM,270,RC,,,OUTPATIENT,,,54,35.1,,47.52,88,,38.02,,,0,"percent of total billed charges","88% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.34,17.304,,7.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.02,63,,27.22,,,0,"percent of total billed charges","63% of total billed charges",8.26,15.3,,6.61,,,0,"percent of total billed charges","15.3% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",37.26,69,,,,,0,"fee schedule","69% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.4,61.85,,26.72,,,0,"percent of total billed charges","61.5% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",17.39,32.2,,13.91,,,0,"percent of total billed charges","32.2% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.25,17.136,,7.40,,,0,"percent of total billed charges","17.136% of total billed charges",11.79,21.84,,9.43,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.36,37.7,,16.29,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",42.12,78,,33.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.6,82.6,,35.68,,,0,"percent of total billed charges","82.6% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",44.6,82.6,,35.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",8.26,54,
"GAUZE - 1   TUBE GAUZE",106492,CDM,270,RC,,,OUTPATIENT,,,160,104,,140.8,88,,112.64,,,0,"percent of total billed charges","88% of total billed charges",80,50,,64.00,,,0,"percent of total billed charges","50% of total billed charges",26.88,16.8,,21.50,,,0,"percent of total billed charges","16.8% of total billed charges",160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.69,17.304,,22.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",100.8,63,,80.64,,,0,"percent of total billed charges","63% of total billed charges",24.48,15.3,,19.58,,,0,"percent of total billed charges","15.3% of total billed charges",26.88,16.8,,21.50,,,0,"percent of total billed charges","16.8% of total billed charges",110.4,69,,,,,0,"fee schedule","69% of total billed charges",160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.96,61.85,,79.17,,,0,"percent of total billed charges","61.5% of total billed charges",26.88,16.8,,21.50,,,0,"percent of total billed charges","16.8% of total billed charges",80,50,,64.00,,,0,"percent of total billed charges","50% of total billed charges",51.52,32.2,,41.22,,,0,"percent of total billed charges","32.2% of total billed charges",26.88,16.8,,21.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.42,17.136,,21.94,,,0,"percent of total billed charges","17.136% of total billed charges",34.94,21.84,,27.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",60.32,37.7,,48.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",124.8,78,,99.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",132.16,82.6,,105.73,,,0,"percent of total billed charges","82.6% of total billed charges",26.88,16.8,,21.50,,,0,"percent of total billed charges","16.8% of total billed charges",80,50,,64.00,,,0,"percent of total billed charges","50% of total billed charges",132.16,82.6,,105.73,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.88,16.8,,21.50,,,0,"percent of total billed charges","16.8% of total billed charges",160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",24.48,160,
"GAUZE - 5/8   TUBE GAUZE",106491,CDM,270,RC,,,OUTPATIENT,,,128,83.2,,112.64,88,,90.11,,,0,"percent of total billed charges","88% of total billed charges",64,50,,51.20,,,0,"percent of total billed charges","50% of total billed charges",21.5,16.8,,17.20,,,0,"percent of total billed charges","16.8% of total billed charges",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.15,17.304,,17.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.64,63,,64.51,,,0,"percent of total billed charges","63% of total billed charges",19.58,15.3,,15.66,,,0,"percent of total billed charges","15.3% of total billed charges",21.5,16.8,,17.20,,,0,"percent of total billed charges","16.8% of total billed charges",88.32,69,,,,,0,"fee schedule","69% of total billed charges",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.17,61.85,,63.34,,,0,"percent of total billed charges","61.5% of total billed charges",21.5,16.8,,17.20,,,0,"percent of total billed charges","16.8% of total billed charges",64,50,,51.20,,,0,"percent of total billed charges","50% of total billed charges",41.22,32.2,,32.98,,,0,"percent of total billed charges","32.2% of total billed charges",21.5,16.8,,17.20,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.93,17.136,,17.54,,,0,"percent of total billed charges","17.136% of total billed charges",27.96,21.84,,22.37,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",48.26,37.7,,38.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",99.84,78,,79.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.73,82.6,,84.58,,,0,"percent of total billed charges","82.6% of total billed charges",21.5,16.8,,17.20,,,0,"percent of total billed charges","16.8% of total billed charges",64,50,,51.20,,,0,"percent of total billed charges","50% of total billed charges",105.73,82.6,,84.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.5,16.8,,17.20,,,0,"percent of total billed charges","16.8% of total billed charges",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",19.58,128,
"GAUZE 2X2 NON STERILE",204548,CDM,272,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"GAUZE BORDER 4 X 10",141608,CDM,270,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"GAUZE BORDER 4 X 14",141609,CDM,270,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.95,61.85,,3.96,,,0,"percent of total billed charges","61.5% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"GAUZE PACKING 2X5 IODOFORM",11221,CDM,270,RC,,,OUTPATIENT,,,41,26.65,,36.08,88,,28.86,,,0,"percent of total billed charges","88% of total billed charges",20.5,50,,16.40,,,0,"percent of total billed charges","50% of total billed charges",6.89,16.8,,5.51,,,0,"percent of total billed charges","16.8% of total billed charges",41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.09,17.304,,5.67,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.83,63,,20.66,,,0,"percent of total billed charges","63% of total billed charges",6.27,15.3,,5.02,,,0,"percent of total billed charges","15.3% of total billed charges",6.89,16.8,,5.51,,,0,"percent of total billed charges","16.8% of total billed charges",28.29,69,,,,,0,"fee schedule","69% of total billed charges",41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.36,61.85,,20.29,,,0,"percent of total billed charges","61.5% of total billed charges",6.89,16.8,,5.51,,,0,"percent of total billed charges","16.8% of total billed charges",20.5,50,,16.40,,,0,"percent of total billed charges","50% of total billed charges",13.2,32.2,,10.56,,,0,"percent of total billed charges","32.2% of total billed charges",6.89,16.8,,5.51,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.03,17.136,,5.62,,,0,"percent of total billed charges","17.136% of total billed charges",8.95,21.84,,7.16,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.46,37.7,,12.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",31.98,78,,25.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.87,82.6,,27.10,,,0,"percent of total billed charges","82.6% of total billed charges",6.89,16.8,,5.51,,,0,"percent of total billed charges","16.8% of total billed charges",20.5,50,,16.40,,,0,"percent of total billed charges","50% of total billed charges",33.87,82.6,,27.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.89,16.8,,5.51,,,0,"percent of total billed charges","16.8% of total billed charges",41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",6.27,41,
"GAUZE PACKING IODOFORM 1 X 5 YD STERILE",41534,CDM,272,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"GAUZE PACKING PLAIN 1/2 X 5 YD STERILE",11217,CDM,272,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"GAUZE PACKING PLAIN 1/4 X 5 YD STERILE",41535,CDM,272,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"GAUZE TUBULAR #7",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"GBS GX IVD CARTRIDGES (GROUP B STREP)",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"GDWR ORTHO L450MM OD2.8MM THRD TROC PT",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"GDWR WALLSTENT/WALLFLEX SUPER STIFF .035",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"GDWR LUNDERQUIST 260CM",ORSUP0022,CDM,278,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",919.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.7% of total billed charges",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",998.69,33.9,,798.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"GDWR MEIR 300CM",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"GDWR SURG L350 OD2.8MM ORTHO",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"GECKO NASAL PADS ADULT S",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"GEL WOUND THERAHONEY 0.5 OZ",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"GEL MEDIHONEY STERILE 0.5OZ",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"GEL POINT MINI ADVANCED ACCESS PLATEFORM",ORSUP0029,CDM,272,RC,,,OUTPATIENT,,,3708,2410.2,,3263.04,88,,2610.43,,,0,"percent of total billed charges","88% of total billed charges",1854,50,,1483.20,,,0,"percent of total billed charges","50% of total billed charges",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",3708,100,,2966.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",641.63,17.304,,513.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2336.04,63,,1868.83,,,0,"percent of total billed charges","63% of total billed charges",567.32,15.3,,453.86,,,0,"percent of total billed charges","15.3% of total billed charges",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",2558.52,69,,,,,0,"fee schedule","69% of total billed charges",3708,100,,2966.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3708,100,,2966.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3708,100,,2966.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2293.4,61.85,,1834.72,,,0,"percent of total billed charges","61.5% of total billed charges",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",1854,50,,1483.20,,,0,"percent of total billed charges","50% of total billed charges",1193.98,32.2,,955.18,,,0,"percent of total billed charges","32.2% of total billed charges",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",635.4,17.136,,508.32,,,0,"percent of total billed charges","17.136% of total billed charges",809.83,21.84,,647.86,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1397.92,37.7,,1118.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2892.24,78,,2313.79,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3062.81,82.6,,2450.25,,,0,"percent of total billed charges","82.6% of total billed charges",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",1854,50,,1483.20,,,0,"percent of total billed charges","50% of total billed charges",3062.81,82.6,,2450.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",3708,100,,2966.40,,,0,"percent of total billed charges","100% of total billed charges",567.32,3708,
"GELPORT HAND ACCESS DEVICE",ORSUP0026,CDM,272,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"GELPORT POA",ORSUP0011,CDM,270,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"GENERATOR ANAEROBIC ATMOSPHERE",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"GENTAMICIN REAGENT BOX/300T",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"GENTAMICIN CAL",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"GGT/5 PACK / 250 SLIDES",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"GIRDLE 3X",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,412,267.8,,362.56,88,,290.05,,,0,"percent of total billed charges","88% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.29,17.304,,57.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",259.56,63,,207.65,,,0,"percent of total billed charges","63% of total billed charges",63.04,15.3,,50.43,,,0,"percent of total billed charges","15.3% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",284.28,69,,,,,0,"fee schedule","69% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",254.82,61.85,,203.86,,,0,"percent of total billed charges","61.5% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",132.66,32.2,,106.13,,,0,"percent of total billed charges","32.2% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.6,17.136,,56.48,,,0,"percent of total billed charges","17.136% of total billed charges",89.98,21.84,,71.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",155.32,37.7,,124.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",321.36,78,,257.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",63.04,412,
"GIRDLE 4X",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,412,267.8,,362.56,88,,290.05,,,0,"percent of total billed charges","88% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.29,17.304,,57.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",259.56,63,,207.65,,,0,"percent of total billed charges","63% of total billed charges",63.04,15.3,,50.43,,,0,"percent of total billed charges","15.3% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",284.28,69,,,,,0,"fee schedule","69% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",254.82,61.85,,203.86,,,0,"percent of total billed charges","61.5% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",132.66,32.2,,106.13,,,0,"percent of total billed charges","32.2% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.6,17.136,,56.48,,,0,"percent of total billed charges","17.136% of total billed charges",89.98,21.84,,71.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",155.32,37.7,,124.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",321.36,78,,257.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",63.04,412,
"GIRDLE 2X",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,17.304,,49.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.28,61.85,,178.62,,,0,"percent of total billed charges","61.5% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",116.24,32.2,,92.99,,,0,"percent of total billed charges","32.2% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.86,17.136,,49.49,,,0,"percent of total billed charges","17.136% of total billed charges",78.84,21.84,,63.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,361,
"GIRDLE XL",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,17.304,,49.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.28,61.85,,178.62,,,0,"percent of total billed charges","61.5% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",116.24,32.2,,92.99,,,0,"percent of total billed charges","32.2% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.86,17.136,,49.49,,,0,"percent of total billed charges","17.136% of total billed charges",78.84,21.84,,63.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,361,
"GLASSES SAFETY POLYCARB CLEAR",284024,CDM,270,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"GLICESCOPE AVL LOPRO S4",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"GLIDESCOPE BLADE MAC S3",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"GLIDECATH 4FR AT 120CM",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"GLIDEWIRE 180CM STIFF AT",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"GLIDEWIRE ADVANTAGE ANGLED 260CM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"GLIDEWIRE HYDROPHILIC COATED 0.035 150CM REF STR",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"GLIDEWIRE HYDROPHILIC COATED 0.035 3CM REF ANG",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"GLIDESHEATH SLENDER SS KIT",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"GLIDEWIRE SURGLIDE .035X150",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"GLIDEWIRE ZIP .035X150CM STR",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"GLIDEWIRE ANGLED 0.035 X 80CM X 3CM",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"GLIDESHEATH SLENDER 6FR",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"GLIDESHEATH SLENDER 5FR",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"GLIDEWIRE RADIOFOCUS 0.018 X 180CM",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"GLIDESCOPE AVL LOPRO S3",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"GLIDESCOPE BLADE STAT #2",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"GLIDEWIRE STIFF GLIDEWIRE 035 X 150",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,412,267.8,,362.56,88,,290.05,,,0,"percent of total billed charges","88% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.29,17.304,,57.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",259.56,63,,207.65,,,0,"percent of total billed charges","63% of total billed charges",63.04,15.3,,50.43,,,0,"percent of total billed charges","15.3% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",284.28,69,,,,,0,"fee schedule","69% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",254.82,61.85,,203.86,,,0,"percent of total billed charges","61.5% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",132.66,32.2,,106.13,,,0,"percent of total billed charges","32.2% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.6,17.136,,56.48,,,0,"percent of total billed charges","17.136% of total billed charges",89.98,21.84,,71.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.32,37.7,,124.26,,,0,"percent of total billed charges","37.7% of total billed charges",155.32,37.7,,124.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",139.67,33.9,,111.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",321.36,78,,257.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",63.04,412,
"CATH NON TAPER ANGLE 5FR X 90CM",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,17.304,,49.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.28,61.85,,178.62,,,0,"percent of total billed charges","61.5% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",116.24,32.2,,92.99,,,0,"percent of total billed charges","32.2% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.86,17.136,,49.49,,,0,"percent of total billed charges","17.136% of total billed charges",78.84,21.84,,63.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.7% of total billed charges",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",122.38,33.9,,97.90,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,361,
"GLOVE 16IN LONG TEXTURED AMBIDEXTROUS DECONTAM LARGE",426754,CDM,270,RC,,,OUTPATIENT,,,339,220.35,,298.32,88,,238.66,,,0,"percent of total billed charges","88% of total billed charges",169.5,50,,135.60,,,0,"percent of total billed charges","50% of total billed charges",56.95,16.8,,45.56,,,0,"percent of total billed charges","16.8% of total billed charges",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.66,17.304,,46.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.57,63,,170.86,,,0,"percent of total billed charges","63% of total billed charges",51.87,15.3,,41.50,,,0,"percent of total billed charges","15.3% of total billed charges",56.95,16.8,,45.56,,,0,"percent of total billed charges","16.8% of total billed charges",233.91,69,,,,,0,"fee schedule","69% of total billed charges",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.67,61.85,,167.74,,,0,"percent of total billed charges","61.5% of total billed charges",56.95,16.8,,45.56,,,0,"percent of total billed charges","16.8% of total billed charges",169.5,50,,135.60,,,0,"percent of total billed charges","50% of total billed charges",109.16,32.2,,87.33,,,0,"percent of total billed charges","32.2% of total billed charges",56.95,16.8,,45.56,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.09,17.136,,46.47,,,0,"percent of total billed charges","17.136% of total billed charges",74.04,21.84,,59.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",127.8,37.7,,102.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",264.42,78,,211.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",280.01,82.6,,224.01,,,0,"percent of total billed charges","82.6% of total billed charges",56.95,16.8,,45.56,,,0,"percent of total billed charges","16.8% of total billed charges",169.5,50,,135.60,,,0,"percent of total billed charges","50% of total billed charges",280.01,82.6,,224.01,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.95,16.8,,45.56,,,0,"percent of total billed charges","16.8% of total billed charges",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",51.87,339,
"GLOVE 16IN LONG TEXTURED AMBIDEXTROUS DECONTAM MED",426743,CDM,270,RC,,,OUTPATIENT,,,339,220.35,,298.32,88,,238.66,,,0,"percent of total billed charges","88% of total billed charges",169.5,50,,135.60,,,0,"percent of total billed charges","50% of total billed charges",56.95,16.8,,45.56,,,0,"percent of total billed charges","16.8% of total billed charges",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.66,17.304,,46.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.57,63,,170.86,,,0,"percent of total billed charges","63% of total billed charges",51.87,15.3,,41.50,,,0,"percent of total billed charges","15.3% of total billed charges",56.95,16.8,,45.56,,,0,"percent of total billed charges","16.8% of total billed charges",233.91,69,,,,,0,"fee schedule","69% of total billed charges",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.67,61.85,,167.74,,,0,"percent of total billed charges","61.5% of total billed charges",56.95,16.8,,45.56,,,0,"percent of total billed charges","16.8% of total billed charges",169.5,50,,135.60,,,0,"percent of total billed charges","50% of total billed charges",109.16,32.2,,87.33,,,0,"percent of total billed charges","32.2% of total billed charges",56.95,16.8,,45.56,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.09,17.136,,46.47,,,0,"percent of total billed charges","17.136% of total billed charges",74.04,21.84,,59.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",127.8,37.7,,102.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",264.42,78,,211.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",280.01,82.6,,224.01,,,0,"percent of total billed charges","82.6% of total billed charges",56.95,16.8,,45.56,,,0,"percent of total billed charges","16.8% of total billed charges",169.5,50,,135.60,,,0,"percent of total billed charges","50% of total billed charges",280.01,82.6,,224.01,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.95,16.8,,45.56,,,0,"percent of total billed charges","16.8% of total billed charges",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",51.87,339,
"GLOVE BIOGEL SURGEONS SZ 7",144141,CDM,270,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"GLOVE BIOGEL SURGEONS SZ 8",144143,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"GLOVE EXAM LATEX PF LG 12IN EUDERMIC",173533,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"GLOVE EXAM LATEX PF MED 12IN EUDERMIC",161890,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"GLOVE EXAM LTX ALOE PF TXT MED",176506,CDM,270,RC,,,OUTPATIENT,,,38,24.7,,33.44,88,,26.75,,,0,"percent of total billed charges","88% of total billed charges",19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.58,17.304,,5.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.94,63,,19.15,,,0,"percent of total billed charges","63% of total billed charges",5.81,15.3,,4.65,,,0,"percent of total billed charges","15.3% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",26.22,69,,,,,0,"fee schedule","69% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.5,61.85,,18.80,,,0,"percent of total billed charges","61.5% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",12.24,32.2,,9.79,,,0,"percent of total billed charges","32.2% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.51,17.136,,5.21,,,0,"percent of total billed charges","17.136% of total billed charges",8.3,21.84,,6.64,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.33,37.7,,11.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.64,78,,23.71,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",5.81,38,
"GLOVE EXAM NITRILE ALOE PF TXT MED",426119,CDM,270,RC,,,OUTPATIENT,,,60,39,,52.8,88,,42.24,,,0,"percent of total billed charges","88% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.38,17.304,,8.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.8,63,,30.24,,,0,"percent of total billed charges","63% of total billed charges",9.18,15.3,,7.34,,,0,"percent of total billed charges","15.3% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",41.4,69,,,,,0,"fee schedule","69% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.11,61.85,,29.69,,,0,"percent of total billed charges","61.5% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",19.32,32.2,,15.46,,,0,"percent of total billed charges","32.2% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.28,17.136,,8.22,,,0,"percent of total billed charges","17.136% of total billed charges",13.1,21.84,,10.48,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,37.7,,18.10,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.8,78,,37.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.56,82.6,,39.65,,,0,"percent of total billed charges","82.6% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",49.56,82.6,,39.65,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",9.18,60,
"GLOVE EXAM NITRILE CSPRO EXT CUFF MED",445078,CDM,270,RC,,,OUTPATIENT,,,136,88.4,,119.68,88,,95.74,,,0,"percent of total billed charges","88% of total billed charges",68,50,,54.40,,,0,"percent of total billed charges","50% of total billed charges",22.85,16.8,,18.28,,,0,"percent of total billed charges","16.8% of total billed charges",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.53,17.304,,18.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.68,63,,68.54,,,0,"percent of total billed charges","63% of total billed charges",20.81,15.3,,16.65,,,0,"percent of total billed charges","15.3% of total billed charges",22.85,16.8,,18.28,,,0,"percent of total billed charges","16.8% of total billed charges",93.84,69,,,,,0,"fee schedule","69% of total billed charges",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.12,61.85,,67.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.85,16.8,,18.28,,,0,"percent of total billed charges","16.8% of total billed charges",68,50,,54.40,,,0,"percent of total billed charges","50% of total billed charges",43.79,32.2,,35.03,,,0,"percent of total billed charges","32.2% of total billed charges",22.85,16.8,,18.28,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.3,17.136,,18.64,,,0,"percent of total billed charges","17.136% of total billed charges",29.7,21.84,,23.76,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",51.27,37.7,,41.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",106.08,78,,84.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.34,82.6,,89.87,,,0,"percent of total billed charges","82.6% of total billed charges",22.85,16.8,,18.28,,,0,"percent of total billed charges","16.8% of total billed charges",68,50,,54.40,,,0,"percent of total billed charges","50% of total billed charges",112.34,82.6,,89.87,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.85,16.8,,18.28,,,0,"percent of total billed charges","16.8% of total billed charges",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",20.81,136,
"GLOVE EXAM NITRILE CSPRO EXT CUFF SM",445079,CDM,270,RC,,,OUTPATIENT,,,136,88.4,,119.68,88,,95.74,,,0,"percent of total billed charges","88% of total billed charges",68,50,,54.40,,,0,"percent of total billed charges","50% of total billed charges",22.85,16.8,,18.28,,,0,"percent of total billed charges","16.8% of total billed charges",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.53,17.304,,18.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.68,63,,68.54,,,0,"percent of total billed charges","63% of total billed charges",20.81,15.3,,16.65,,,0,"percent of total billed charges","15.3% of total billed charges",22.85,16.8,,18.28,,,0,"percent of total billed charges","16.8% of total billed charges",93.84,69,,,,,0,"fee schedule","69% of total billed charges",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.12,61.85,,67.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.85,16.8,,18.28,,,0,"percent of total billed charges","16.8% of total billed charges",68,50,,54.40,,,0,"percent of total billed charges","50% of total billed charges",43.79,32.2,,35.03,,,0,"percent of total billed charges","32.2% of total billed charges",22.85,16.8,,18.28,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.3,17.136,,18.64,,,0,"percent of total billed charges","17.136% of total billed charges",29.7,21.84,,23.76,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",51.27,37.7,,41.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",106.08,78,,84.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.34,82.6,,89.87,,,0,"percent of total billed charges","82.6% of total billed charges",22.85,16.8,,18.28,,,0,"percent of total billed charges","16.8% of total billed charges",68,50,,54.40,,,0,"percent of total billed charges","50% of total billed charges",112.34,82.6,,89.87,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.85,16.8,,18.28,,,0,"percent of total billed charges","16.8% of total billed charges",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",20.81,136,
"GLOVE EXAM NITRILE PF LF LARGE",410225,CDM,270,RC,,,OUTPATIENT,,,61,39.65,,53.68,88,,42.94,,,0,"percent of total billed charges","88% of total billed charges",30.5,50,,24.40,,,0,"percent of total billed charges","50% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.56,17.304,,8.45,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.43,63,,30.74,,,0,"percent of total billed charges","63% of total billed charges",9.33,15.3,,7.46,,,0,"percent of total billed charges","15.3% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",42.09,69,,,,,0,"fee schedule","69% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.73,61.85,,30.18,,,0,"percent of total billed charges","61.5% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",30.5,50,,24.40,,,0,"percent of total billed charges","50% of total billed charges",19.64,32.2,,15.71,,,0,"percent of total billed charges","32.2% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.45,17.136,,8.36,,,0,"percent of total billed charges","17.136% of total billed charges",13.32,21.84,,10.66,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23,37.7,,18.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47.58,78,,38.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.39,82.6,,40.31,,,0,"percent of total billed charges","82.6% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",30.5,50,,24.40,,,0,"percent of total billed charges","50% of total billed charges",50.39,82.6,,40.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",9.33,61,
"GLOVE EXAM NITRILE PF LF MED",410231,CDM,270,RC,,,OUTPATIENT,,,61,39.65,,53.68,88,,42.94,,,0,"percent of total billed charges","88% of total billed charges",30.5,50,,24.40,,,0,"percent of total billed charges","50% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.56,17.304,,8.45,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.43,63,,30.74,,,0,"percent of total billed charges","63% of total billed charges",9.33,15.3,,7.46,,,0,"percent of total billed charges","15.3% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",42.09,69,,,,,0,"fee schedule","69% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.73,61.85,,30.18,,,0,"percent of total billed charges","61.5% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",30.5,50,,24.40,,,0,"percent of total billed charges","50% of total billed charges",19.64,32.2,,15.71,,,0,"percent of total billed charges","32.2% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.45,17.136,,8.36,,,0,"percent of total billed charges","17.136% of total billed charges",13.32,21.84,,10.66,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23,37.7,,18.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47.58,78,,38.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.39,82.6,,40.31,,,0,"percent of total billed charges","82.6% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",30.5,50,,24.40,,,0,"percent of total billed charges","50% of total billed charges",50.39,82.6,,40.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",9.33,61,
"GLOVE EXAM NITRILE PF LF SMALL",410224,CDM,270,RC,,,OUTPATIENT,,,61,39.65,,53.68,88,,42.94,,,0,"percent of total billed charges","88% of total billed charges",30.5,50,,24.40,,,0,"percent of total billed charges","50% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.56,17.304,,8.45,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.43,63,,30.74,,,0,"percent of total billed charges","63% of total billed charges",9.33,15.3,,7.46,,,0,"percent of total billed charges","15.3% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",42.09,69,,,,,0,"fee schedule","69% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.73,61.85,,30.18,,,0,"percent of total billed charges","61.5% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",30.5,50,,24.40,,,0,"percent of total billed charges","50% of total billed charges",19.64,32.2,,15.71,,,0,"percent of total billed charges","32.2% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.45,17.136,,8.36,,,0,"percent of total billed charges","17.136% of total billed charges",13.32,21.84,,10.66,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23,37.7,,18.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47.58,78,,38.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.39,82.6,,40.31,,,0,"percent of total billed charges","82.6% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",30.5,50,,24.40,,,0,"percent of total billed charges","50% of total billed charges",50.39,82.6,,40.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",9.33,61,
"GLOVE EXAM NITRILE PF LF X-LARGE",410223,CDM,270,RC,,,OUTPATIENT,,,60,39,,52.8,88,,42.24,,,0,"percent of total billed charges","88% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.38,17.304,,8.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.8,63,,30.24,,,0,"percent of total billed charges","63% of total billed charges",9.18,15.3,,7.34,,,0,"percent of total billed charges","15.3% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",41.4,69,,,,,0,"fee schedule","69% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.11,61.85,,29.69,,,0,"percent of total billed charges","61.5% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",19.32,32.2,,15.46,,,0,"percent of total billed charges","32.2% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.28,17.136,,8.22,,,0,"percent of total billed charges","17.136% of total billed charges",13.1,21.84,,10.48,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,37.7,,18.10,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.8,78,,37.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.56,82.6,,39.65,,,0,"percent of total billed charges","82.6% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",49.56,82.6,,39.65,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",9.18,60,
"GLOVE EXAM POWDER FREE X SMALL",418113,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"GLOVE EXAM STER SINGLE MD",10145,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"GLOVE RADIATION 8.0",286485,CDM,270,RC,,,OUTPATIENT,,,248,161.2,,218.24,88,,174.59,,,0,"percent of total billed charges","88% of total billed charges",124,50,,99.20,,,0,"percent of total billed charges","50% of total billed charges",41.66,16.8,,33.33,,,0,"percent of total billed charges","16.8% of total billed charges",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.91,17.304,,34.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.24,63,,124.99,,,0,"percent of total billed charges","63% of total billed charges",37.94,15.3,,30.35,,,0,"percent of total billed charges","15.3% of total billed charges",41.66,16.8,,33.33,,,0,"percent of total billed charges","16.8% of total billed charges",171.12,69,,,,,0,"fee schedule","69% of total billed charges",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",153.39,61.85,,122.71,,,0,"percent of total billed charges","61.5% of total billed charges",41.66,16.8,,33.33,,,0,"percent of total billed charges","16.8% of total billed charges",124,50,,99.20,,,0,"percent of total billed charges","50% of total billed charges",79.86,32.2,,63.89,,,0,"percent of total billed charges","32.2% of total billed charges",41.66,16.8,,33.33,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.5,17.136,,34.00,,,0,"percent of total billed charges","17.136% of total billed charges",54.16,21.84,,43.33,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",93.5,37.7,,74.80,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",193.44,78,,154.75,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.85,82.6,,163.88,,,0,"percent of total billed charges","82.6% of total billed charges",41.66,16.8,,33.33,,,0,"percent of total billed charges","16.8% of total billed charges",124,50,,99.20,,,0,"percent of total billed charges","50% of total billed charges",204.85,82.6,,163.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.66,16.8,,33.33,,,0,"percent of total billed charges","16.8% of total billed charges",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",37.94,248,
"GLOVE SENSICARE NITRIL ICE XSMALL",317075,CDM,270,RC,,,OUTPATIENT,,,75,48.75,,66,88,,52.80,,,0,"percent of total billed charges","88% of total billed charges",37.5,50,,30.00,,,0,"percent of total billed charges","50% of total billed charges",12.6,16.8,,10.08,,,0,"percent of total billed charges","16.8% of total billed charges",75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.98,17.304,,10.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.25,63,,37.80,,,0,"percent of total billed charges","63% of total billed charges",11.48,15.3,,9.18,,,0,"percent of total billed charges","15.3% of total billed charges",12.6,16.8,,10.08,,,0,"percent of total billed charges","16.8% of total billed charges",51.75,69,,,,,0,"fee schedule","69% of total billed charges",75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.39,61.85,,37.11,,,0,"percent of total billed charges","61.5% of total billed charges",12.6,16.8,,10.08,,,0,"percent of total billed charges","16.8% of total billed charges",37.5,50,,30.00,,,0,"percent of total billed charges","50% of total billed charges",24.15,32.2,,19.32,,,0,"percent of total billed charges","32.2% of total billed charges",12.6,16.8,,10.08,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.85,17.136,,10.28,,,0,"percent of total billed charges","17.136% of total billed charges",16.38,21.84,,13.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.28,37.7,,22.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.5,78,,46.80,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.95,82.6,,49.56,,,0,"percent of total billed charges","82.6% of total billed charges",12.6,16.8,,10.08,,,0,"percent of total billed charges","16.8% of total billed charges",37.5,50,,30.00,,,0,"percent of total billed charges","50% of total billed charges",61.95,82.6,,49.56,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,16.8,,10.08,,,0,"percent of total billed charges","16.8% of total billed charges",75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",11.48,75,
"GLOVE SURG 6.0 PROTEXIS PI CLASSIC LF PF",361762,CDM,270,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"GLOVE SURG 6.0 PROTEXIS PI MICRO PF",361798,CDM,270,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"GLOVE SURG 6.0 PROTEXIS PI PF BLUE UNDERGLOVE",361782,CDM,270,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"GLOVE SURG 6.0 PROTEXIS PI PF LF",410516,CDM,270,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"GLOVE SURG 6.5 PROTEXIS PI CLASSIC LF PF",411074,CDM,270,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"GLOVE SURG 6.5 PROTEXIS PI MICRO PF",361799,CDM,270,RC,,,OUTPATIENT,,,675,438.75,,594,88,,475.20,,,0,"percent of total billed charges","88% of total billed charges",337.5,50,,270.00,,,0,"percent of total billed charges","50% of total billed charges",113.4,16.8,,90.72,,,0,"percent of total billed charges","16.8% of total billed charges",675,100,,540.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",116.8,17.304,,93.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",425.25,63,,340.20,,,0,"percent of total billed charges","63% of total billed charges",103.28,15.3,,82.62,,,0,"percent of total billed charges","15.3% of total billed charges",113.4,16.8,,90.72,,,0,"percent of total billed charges","16.8% of total billed charges",465.75,69,,,,,0,"fee schedule","69% of total billed charges",675,100,,540.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",675,100,,540.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",675,100,,540.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.49,61.85,,333.99,,,0,"percent of total billed charges","61.5% of total billed charges",113.4,16.8,,90.72,,,0,"percent of total billed charges","16.8% of total billed charges",337.5,50,,270.00,,,0,"percent of total billed charges","50% of total billed charges",217.35,32.2,,173.88,,,0,"percent of total billed charges","32.2% of total billed charges",113.4,16.8,,90.72,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.67,17.136,,92.54,,,0,"percent of total billed charges","17.136% of total billed charges",147.42,21.84,,117.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",254.48,37.7,,203.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",526.5,78,,421.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",557.55,82.6,,446.04,,,0,"percent of total billed charges","82.6% of total billed charges",113.4,16.8,,90.72,,,0,"percent of total billed charges","16.8% of total billed charges",337.5,50,,270.00,,,0,"percent of total billed charges","50% of total billed charges",557.55,82.6,,446.04,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.4,16.8,,90.72,,,0,"percent of total billed charges","16.8% of total billed charges",675,100,,540.00,,,0,"percent of total billed charges","100% of total billed charges",103.28,675,
"GLOVE SURG 6.5 PROTEXIS PI PF BLUE UNDERGLOVE",361784,CDM,270,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"GLOVE SURG 6.5 PROTEXIS PI PF LF",416801,CDM,270,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"GLOVE SURG 7.0 PROTEXIS PI CLASSIC LF PF",361763,CDM,270,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"GLOVE SURG 7.0 PROTEXIS PI MICRO PF",361800,CDM,270,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"GLOVE SURG 7.0 PROTEXIS PI PF BLUE UNDERGLOVE",361785,CDM,270,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"GLOVE SURG 7.0 PROTEXIS PI PF LF",403840,CDM,270,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"GLOVE SURG 7.5 PROTEXIS PI CLASSIC LF PF",361764,CDM,270,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"GLOVE SURG 7.5 PROTEXIS PI ORTHO PF",188666,CDM,270,RC,,,OUTPATIENT,,,504,327.6,,443.52,88,,354.82,,,0,"percent of total billed charges","88% of total billed charges",252,50,,201.60,,,0,"percent of total billed charges","50% of total billed charges",84.67,16.8,,67.74,,,0,"percent of total billed charges","16.8% of total billed charges",504,100,,403.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.21,17.304,,69.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.52,63,,254.02,,,0,"percent of total billed charges","63% of total billed charges",77.11,15.3,,61.69,,,0,"percent of total billed charges","15.3% of total billed charges",84.67,16.8,,67.74,,,0,"percent of total billed charges","16.8% of total billed charges",347.76,69,,,,,0,"fee schedule","69% of total billed charges",504,100,,403.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",504,100,,403.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",504,100,,403.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",311.72,61.85,,249.38,,,0,"percent of total billed charges","61.5% of total billed charges",84.67,16.8,,67.74,,,0,"percent of total billed charges","16.8% of total billed charges",252,50,,201.60,,,0,"percent of total billed charges","50% of total billed charges",162.29,32.2,,129.83,,,0,"percent of total billed charges","32.2% of total billed charges",84.67,16.8,,67.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.37,17.136,,69.10,,,0,"percent of total billed charges","17.136% of total billed charges",110.07,21.84,,88.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",190.01,37.7,,152.01,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",393.12,78,,314.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",416.3,82.6,,333.04,,,0,"percent of total billed charges","82.6% of total billed charges",84.67,16.8,,67.74,,,0,"percent of total billed charges","16.8% of total billed charges",252,50,,201.60,,,0,"percent of total billed charges","50% of total billed charges",416.3,82.6,,333.04,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.67,16.8,,67.74,,,0,"percent of total billed charges","16.8% of total billed charges",504,100,,403.20,,,0,"percent of total billed charges","100% of total billed charges",77.11,504,
"GLOVE SURG 7.5 PROTEXIS PI PF BLUE UNDERGLOVE",361786,CDM,270,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"GLOVE SURG 7.5 PROTEXIS PI PF LF",414123,CDM,270,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"GLOVE SURG 8.0 PROTEXIS PI CLASSIC LF PF",361765,CDM,270,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"GLOVE SURG 8.0 PROTEXIS PI PF BLUE UNDERGLOVE",361787,CDM,270,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"GLOVE SURG 8.0 PROTEXIS PI PF LF",403843,CDM,270,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"GLOVE SURG 8.5 PROTEXIS PI CLASSIC LF PF",361766,CDM,270,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"GLOVE SURG 8.5 PROTEXIS PI PF BLUE UNDERGLOVE",361789,CDM,270,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"GLOVE SURG 8.5 PROTEXIS PI PF LF",403842,CDM,270,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"GLOVE SURG EUDERMIC 8.0",278962,CDM,270,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"GLOVE SURG SENSICARE ORTHO SZ 6",286359,CDM,270,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"GLOVE SURGEON LATEX TRI-FOLD SIZE 7",161967,CDM,270,RC,,,OUTPATIENT,,,99,64.35,,87.12,88,,69.70,,,0,"percent of total billed charges","88% of total billed charges",49.5,50,,39.60,,,0,"percent of total billed charges","50% of total billed charges",16.63,16.8,,13.30,,,0,"percent of total billed charges","16.8% of total billed charges",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.13,17.304,,13.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.37,63,,49.90,,,0,"percent of total billed charges","63% of total billed charges",15.15,15.3,,12.12,,,0,"percent of total billed charges","15.3% of total billed charges",16.63,16.8,,13.30,,,0,"percent of total billed charges","16.8% of total billed charges",68.31,69,,,,,0,"fee schedule","69% of total billed charges",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.23,61.85,,48.98,,,0,"percent of total billed charges","61.5% of total billed charges",16.63,16.8,,13.30,,,0,"percent of total billed charges","16.8% of total billed charges",49.5,50,,39.60,,,0,"percent of total billed charges","50% of total billed charges",31.88,32.2,,25.50,,,0,"percent of total billed charges","32.2% of total billed charges",16.63,16.8,,13.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.96,17.136,,13.57,,,0,"percent of total billed charges","17.136% of total billed charges",21.62,21.84,,17.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",37.32,37.7,,29.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.22,78,,61.78,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",16.63,16.8,,13.30,,,0,"percent of total billed charges","16.8% of total billed charges",49.5,50,,39.60,,,0,"percent of total billed charges","50% of total billed charges",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.63,16.8,,13.30,,,0,"percent of total billed charges","16.8% of total billed charges",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",15.15,99,
"GLOVE SURGICAL 7.5 LATEX STERILE BIOGEL POWDER FREE BEADED C",11254,CDM,272,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"GLOVES OATMEAL RESTORE NITRILE SMALL",484956,CDM,270,RC,,,OUTPATIENT,,,87,56.55,,76.56,88,,61.25,,,0,"percent of total billed charges","88% of total billed charges",43.5,50,,34.80,,,0,"percent of total billed charges","50% of total billed charges",14.62,16.8,,11.70,,,0,"percent of total billed charges","16.8% of total billed charges",87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.05,17.304,,12.04,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",54.81,63,,43.85,,,0,"percent of total billed charges","63% of total billed charges",13.31,15.3,,10.65,,,0,"percent of total billed charges","15.3% of total billed charges",14.62,16.8,,11.70,,,0,"percent of total billed charges","16.8% of total billed charges",60.03,69,,,,,0,"fee schedule","69% of total billed charges",87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.81,61.85,,43.05,,,0,"percent of total billed charges","61.5% of total billed charges",14.62,16.8,,11.70,,,0,"percent of total billed charges","16.8% of total billed charges",43.5,50,,34.80,,,0,"percent of total billed charges","50% of total billed charges",28.01,32.2,,22.41,,,0,"percent of total billed charges","32.2% of total billed charges",14.62,16.8,,11.70,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.91,17.136,,11.93,,,0,"percent of total billed charges","17.136% of total billed charges",19,21.84,,15.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",32.8,37.7,,26.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",67.86,78,,54.29,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.86,82.6,,57.49,,,0,"percent of total billed charges","82.6% of total billed charges",14.62,16.8,,11.70,,,0,"percent of total billed charges","16.8% of total billed charges",43.5,50,,34.80,,,0,"percent of total billed charges","50% of total billed charges",71.86,82.6,,57.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.62,16.8,,11.70,,,0,"percent of total billed charges","16.8% of total billed charges",87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",13.31,87,
"GLOVE ULTRADERM SIZE 7 1/2",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"GLOVES ULTRADERM SIZE 6 1/2",490672,CDM,270,RC,,,OUTPATIENT,,,446,289.9,,392.48,88,,313.98,,,0,"percent of total billed charges","88% of total billed charges",223,50,,178.40,,,0,"percent of total billed charges","50% of total billed charges",74.93,16.8,,59.94,,,0,"percent of total billed charges","16.8% of total billed charges",446,100,,356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.18,17.304,,61.74,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",280.98,63,,224.78,,,0,"percent of total billed charges","63% of total billed charges",68.24,15.3,,54.59,,,0,"percent of total billed charges","15.3% of total billed charges",74.93,16.8,,59.94,,,0,"percent of total billed charges","16.8% of total billed charges",307.74,69,,,,,0,"fee schedule","69% of total billed charges",446,100,,356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",446,100,,356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",446,100,,356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",275.85,61.85,,220.68,,,0,"percent of total billed charges","61.5% of total billed charges",74.93,16.8,,59.94,,,0,"percent of total billed charges","16.8% of total billed charges",223,50,,178.40,,,0,"percent of total billed charges","50% of total billed charges",143.61,32.2,,114.89,,,0,"percent of total billed charges","32.2% of total billed charges",74.93,16.8,,59.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.43,17.136,,61.14,,,0,"percent of total billed charges","17.136% of total billed charges",97.41,21.84,,77.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",168.14,37.7,,134.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",347.88,78,,278.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",368.4,82.6,,294.72,,,0,"percent of total billed charges","82.6% of total billed charges",74.93,16.8,,59.94,,,0,"percent of total billed charges","16.8% of total billed charges",223,50,,178.40,,,0,"percent of total billed charges","50% of total billed charges",368.4,82.6,,294.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.93,16.8,,59.94,,,0,"percent of total billed charges","16.8% of total billed charges",446,100,,356.80,,,0,"percent of total billed charges","100% of total billed charges",68.24,446,
"GLOVE, PROTEXIS PI SZ 8",490665,CDM,270,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"GLOVE, PROTEXIS PI SZ 7",490664,CDM,270,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"GLOVE, PROTEXIS SMT SZ 6",490668,CDM,270,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"GLOVE, PROTEXIS PI SZ 9",490667,CDM,270,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"GLOVE, PROTEXIS PI SZ 8 1/2",490666,CDM,270,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"GLOVE, PROTEXIS PI SZ 6 1/2",490663,CDM,270,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"GLOVE PROTEXIS PI SZ 7 1/2",490651,CDM,270,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"GLOVE, BIOGEL SZ 9",490656,CDM,270,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"GLOVE, SENSICARE SZ 8 W/ALOE",490671,CDM,270,RC,,,OUTPATIENT,,,525,341.25,,462,88,,369.60,,,0,"percent of total billed charges","88% of total billed charges",262.5,50,,210.00,,,0,"percent of total billed charges","50% of total billed charges",88.2,16.8,,70.56,,,0,"percent of total billed charges","16.8% of total billed charges",525,100,,420.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.85,17.304,,72.68,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",330.75,63,,264.60,,,0,"percent of total billed charges","63% of total billed charges",80.33,15.3,,64.26,,,0,"percent of total billed charges","15.3% of total billed charges",88.2,16.8,,70.56,,,0,"percent of total billed charges","16.8% of total billed charges",362.25,69,,,,,0,"fee schedule","69% of total billed charges",525,100,,420.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",525,100,,420.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",525,100,,420.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",324.71,61.85,,259.77,,,0,"percent of total billed charges","61.5% of total billed charges",88.2,16.8,,70.56,,,0,"percent of total billed charges","16.8% of total billed charges",262.5,50,,210.00,,,0,"percent of total billed charges","50% of total billed charges",169.05,32.2,,135.24,,,0,"percent of total billed charges","32.2% of total billed charges",88.2,16.8,,70.56,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.96,17.136,,71.97,,,0,"percent of total billed charges","17.136% of total billed charges",114.66,21.84,,91.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",197.93,37.7,,158.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",409.5,78,,327.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",433.65,82.6,,346.92,,,0,"percent of total billed charges","82.6% of total billed charges",88.2,16.8,,70.56,,,0,"percent of total billed charges","16.8% of total billed charges",262.5,50,,210.00,,,0,"percent of total billed charges","50% of total billed charges",433.65,82.6,,346.92,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.2,16.8,,70.56,,,0,"percent of total billed charges","16.8% of total billed charges",525,100,,420.00,,,0,"percent of total billed charges","100% of total billed charges",80.33,525,
"GLOVE, SENSICARE SZ 7 W/ALOE",490670,CDM,270,RC,,,OUTPATIENT,,,525,341.25,,462,88,,369.60,,,0,"percent of total billed charges","88% of total billed charges",262.5,50,,210.00,,,0,"percent of total billed charges","50% of total billed charges",88.2,16.8,,70.56,,,0,"percent of total billed charges","16.8% of total billed charges",525,100,,420.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.85,17.304,,72.68,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",330.75,63,,264.60,,,0,"percent of total billed charges","63% of total billed charges",80.33,15.3,,64.26,,,0,"percent of total billed charges","15.3% of total billed charges",88.2,16.8,,70.56,,,0,"percent of total billed charges","16.8% of total billed charges",362.25,69,,,,,0,"fee schedule","69% of total billed charges",525,100,,420.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",525,100,,420.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",525,100,,420.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",324.71,61.85,,259.77,,,0,"percent of total billed charges","61.5% of total billed charges",88.2,16.8,,70.56,,,0,"percent of total billed charges","16.8% of total billed charges",262.5,50,,210.00,,,0,"percent of total billed charges","50% of total billed charges",169.05,32.2,,135.24,,,0,"percent of total billed charges","32.2% of total billed charges",88.2,16.8,,70.56,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.96,17.136,,71.97,,,0,"percent of total billed charges","17.136% of total billed charges",114.66,21.84,,91.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",197.93,37.7,,158.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",409.5,78,,327.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",433.65,82.6,,346.92,,,0,"percent of total billed charges","82.6% of total billed charges",88.2,16.8,,70.56,,,0,"percent of total billed charges","16.8% of total billed charges",262.5,50,,210.00,,,0,"percent of total billed charges","50% of total billed charges",433.65,82.6,,346.92,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.2,16.8,,70.56,,,0,"percent of total billed charges","16.8% of total billed charges",525,100,,420.00,,,0,"percent of total billed charges","100% of total billed charges",80.33,525,
"GLOVE, SENSICARE SZ 6.5 W/ALOE",490669,CDM,270,RC,,,OUTPATIENT,,,525,341.25,,462,88,,369.60,,,0,"percent of total billed charges","88% of total billed charges",262.5,50,,210.00,,,0,"percent of total billed charges","50% of total billed charges",88.2,16.8,,70.56,,,0,"percent of total billed charges","16.8% of total billed charges",525,100,,420.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.85,17.304,,72.68,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",330.75,63,,264.60,,,0,"percent of total billed charges","63% of total billed charges",80.33,15.3,,64.26,,,0,"percent of total billed charges","15.3% of total billed charges",88.2,16.8,,70.56,,,0,"percent of total billed charges","16.8% of total billed charges",362.25,69,,,,,0,"fee schedule","69% of total billed charges",525,100,,420.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",525,100,,420.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",525,100,,420.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",324.71,61.85,,259.77,,,0,"percent of total billed charges","61.5% of total billed charges",88.2,16.8,,70.56,,,0,"percent of total billed charges","16.8% of total billed charges",262.5,50,,210.00,,,0,"percent of total billed charges","50% of total billed charges",169.05,32.2,,135.24,,,0,"percent of total billed charges","32.2% of total billed charges",88.2,16.8,,70.56,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.96,17.136,,71.97,,,0,"percent of total billed charges","17.136% of total billed charges",114.66,21.84,,91.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",197.93,37.7,,158.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",409.5,78,,327.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",433.65,82.6,,346.92,,,0,"percent of total billed charges","82.6% of total billed charges",88.2,16.8,,70.56,,,0,"percent of total billed charges","16.8% of total billed charges",262.5,50,,210.00,,,0,"percent of total billed charges","50% of total billed charges",433.65,82.6,,346.92,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.2,16.8,,70.56,,,0,"percent of total billed charges","16.8% of total billed charges",525,100,,420.00,,,0,"percent of total billed charges","100% of total billed charges",80.33,525,
"GLOVE SENSICARE UNDERGLOVE 7.5",490653,CDM,270,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"GLOVE NEU-THERA 7 1/2 PROTEXIS",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"GLOVE, ORTHOPEDIC SZ 8",490660,CDM,270,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"GLOVE, PROTEXIS PI ORTHO SZ 7",490662,CDM,270,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"GLOVE, PROTEXIS PI ORTHO 7 1/2",490661,CDM,270,RC,,,OUTPATIENT,,,602,391.3,,529.76,88,,423.81,,,0,"percent of total billed charges","88% of total billed charges",301,50,,240.80,,,0,"percent of total billed charges","50% of total billed charges",101.14,16.8,,80.91,,,0,"percent of total billed charges","16.8% of total billed charges",602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.17,17.304,,83.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.26,63,,303.41,,,0,"percent of total billed charges","63% of total billed charges",92.11,15.3,,73.69,,,0,"percent of total billed charges","15.3% of total billed charges",101.14,16.8,,80.91,,,0,"percent of total billed charges","16.8% of total billed charges",415.38,69,,,,,0,"fee schedule","69% of total billed charges",602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.34,61.85,,297.87,,,0,"percent of total billed charges","61.5% of total billed charges",101.14,16.8,,80.91,,,0,"percent of total billed charges","16.8% of total billed charges",301,50,,240.80,,,0,"percent of total billed charges","50% of total billed charges",193.84,32.2,,155.07,,,0,"percent of total billed charges","32.2% of total billed charges",101.14,16.8,,80.91,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.16,17.136,,82.53,,,0,"percent of total billed charges","17.136% of total billed charges",131.48,21.84,,105.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",226.95,37.7,,181.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",469.56,78,,375.65,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",497.25,82.6,,397.80,,,0,"percent of total billed charges","82.6% of total billed charges",101.14,16.8,,80.91,,,0,"percent of total billed charges","16.8% of total billed charges",301,50,,240.80,,,0,"percent of total billed charges","50% of total billed charges",497.25,82.6,,397.80,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.14,16.8,,80.91,,,0,"percent of total billed charges","16.8% of total billed charges",602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",92.11,602,
"GLOVE NEU-THERA 8 PROTEXIS",490649,CDM,270,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.95,61.85,,3.96,,,0,"percent of total billed charges","61.5% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"GLOVE NEU-THERA 7 PROTEXIS",490648,CDM,270,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.95,61.85,,3.96,,,0,"percent of total billed charges","61.5% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"GLOVE BIOGLE PI ORTHO 7.5",490645,CDM,270,RC,,,OUTPATIENT,,,684,444.6,,601.92,88,,481.54,,,0,"percent of total billed charges","88% of total billed charges",342,50,,273.60,,,0,"percent of total billed charges","50% of total billed charges",114.91,16.8,,91.93,,,0,"percent of total billed charges","16.8% of total billed charges",684,100,,547.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",118.36,17.304,,94.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",430.92,63,,344.74,,,0,"percent of total billed charges","63% of total billed charges",104.65,15.3,,83.72,,,0,"percent of total billed charges","15.3% of total billed charges",114.91,16.8,,91.93,,,0,"percent of total billed charges","16.8% of total billed charges",471.96,69,,,,,0,"fee schedule","69% of total billed charges",684,100,,547.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",684,100,,547.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",684,100,,547.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",423.05,61.85,,338.44,,,0,"percent of total billed charges","61.5% of total billed charges",114.91,16.8,,91.93,,,0,"percent of total billed charges","16.8% of total billed charges",342,50,,273.60,,,0,"percent of total billed charges","50% of total billed charges",220.25,32.2,,176.20,,,0,"percent of total billed charges","32.2% of total billed charges",114.91,16.8,,91.93,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",117.21,17.136,,93.77,,,0,"percent of total billed charges","17.136% of total billed charges",149.39,21.84,,119.51,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",257.87,37.7,,206.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",533.52,78,,426.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",564.98,82.6,,451.98,,,0,"percent of total billed charges","82.6% of total billed charges",114.91,16.8,,91.93,,,0,"percent of total billed charges","16.8% of total billed charges",342,50,,273.60,,,0,"percent of total billed charges","50% of total billed charges",564.98,82.6,,451.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.91,16.8,,91.93,,,0,"percent of total billed charges","16.8% of total billed charges",684,100,,547.20,,,0,"percent of total billed charges","100% of total billed charges",104.65,684,
"GLOVE SZ 8 PI ORTHO PRO BIOGEL",490654,CDM,270,RC,,,OUTPATIENT,,,684,444.6,,601.92,88,,481.54,,,0,"percent of total billed charges","88% of total billed charges",342,50,,273.60,,,0,"percent of total billed charges","50% of total billed charges",114.91,16.8,,91.93,,,0,"percent of total billed charges","16.8% of total billed charges",684,100,,547.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",118.36,17.304,,94.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",430.92,63,,344.74,,,0,"percent of total billed charges","63% of total billed charges",104.65,15.3,,83.72,,,0,"percent of total billed charges","15.3% of total billed charges",114.91,16.8,,91.93,,,0,"percent of total billed charges","16.8% of total billed charges",471.96,69,,,,,0,"fee schedule","69% of total billed charges",684,100,,547.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",684,100,,547.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",684,100,,547.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",423.05,61.85,,338.44,,,0,"percent of total billed charges","61.5% of total billed charges",114.91,16.8,,91.93,,,0,"percent of total billed charges","16.8% of total billed charges",342,50,,273.60,,,0,"percent of total billed charges","50% of total billed charges",220.25,32.2,,176.20,,,0,"percent of total billed charges","32.2% of total billed charges",114.91,16.8,,91.93,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",117.21,17.136,,93.77,,,0,"percent of total billed charges","17.136% of total billed charges",149.39,21.84,,119.51,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",257.87,37.7,,206.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",533.52,78,,426.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",564.98,82.6,,451.98,,,0,"percent of total billed charges","82.6% of total billed charges",114.91,16.8,,91.93,,,0,"percent of total billed charges","16.8% of total billed charges",342,50,,273.60,,,0,"percent of total billed charges","50% of total billed charges",564.98,82.6,,451.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.91,16.8,,91.93,,,0,"percent of total billed charges","16.8% of total billed charges",684,100,,547.20,,,0,"percent of total billed charges","100% of total billed charges",104.65,684,
"GLOVE BIOGEL UNDERGLOVE SZ 8.5",490644,CDM,270,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"GLOVE NEU-THERA 8.5 PROTEXIS",490650,CDM,270,RC,,,OUTPATIENT,,,376,244.4,,330.88,88,,264.70,,,0,"percent of total billed charges","88% of total billed charges",188,50,,150.40,,,0,"percent of total billed charges","50% of total billed charges",63.17,16.8,,50.54,,,0,"percent of total billed charges","16.8% of total billed charges",376,100,,300.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",65.06,17.304,,52.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",236.88,63,,189.50,,,0,"percent of total billed charges","63% of total billed charges",57.53,15.3,,46.02,,,0,"percent of total billed charges","15.3% of total billed charges",63.17,16.8,,50.54,,,0,"percent of total billed charges","16.8% of total billed charges",259.44,69,,,,,0,"fee schedule","69% of total billed charges",376,100,,300.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",376,100,,300.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",376,100,,300.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",232.56,61.85,,186.05,,,0,"percent of total billed charges","61.5% of total billed charges",63.17,16.8,,50.54,,,0,"percent of total billed charges","16.8% of total billed charges",188,50,,150.40,,,0,"percent of total billed charges","50% of total billed charges",121.07,32.2,,96.86,,,0,"percent of total billed charges","32.2% of total billed charges",63.17,16.8,,50.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.43,17.136,,51.54,,,0,"percent of total billed charges","17.136% of total billed charges",82.12,21.84,,65.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",141.75,37.7,,113.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",293.28,78,,234.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",310.58,82.6,,248.46,,,0,"percent of total billed charges","82.6% of total billed charges",63.17,16.8,,50.54,,,0,"percent of total billed charges","16.8% of total billed charges",188,50,,150.40,,,0,"percent of total billed charges","50% of total billed charges",310.58,82.6,,248.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.17,16.8,,50.54,,,0,"percent of total billed charges","16.8% of total billed charges",376,100,,300.80,,,0,"percent of total billed charges","100% of total billed charges",57.53,376,
"GLOVE, EXAM SMALL NITRILE",490659,CDM,270,RC,,,OUTPATIENT,,,50,32.5,,44,88,,35.20,,,0,"percent of total billed charges","88% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.65,17.304,,6.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.5,63,,25.20,,,0,"percent of total billed charges","63% of total billed charges",7.65,15.3,,6.12,,,0,"percent of total billed charges","15.3% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",34.5,69,,,,,0,"fee schedule","69% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.93,61.85,,24.74,,,0,"percent of total billed charges","61.5% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",16.1,32.2,,12.88,,,0,"percent of total billed charges","32.2% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.57,17.136,,6.86,,,0,"percent of total billed charges","17.136% of total billed charges",10.92,21.84,,8.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39,78,,31.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",7.65,50,
"GLOVE, EXAM MEDIUM NITRILE",490658,CDM,270,RC,,,OUTPATIENT,,,50,32.5,,44,88,,35.20,,,0,"percent of total billed charges","88% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.65,17.304,,6.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.5,63,,25.20,,,0,"percent of total billed charges","63% of total billed charges",7.65,15.3,,6.12,,,0,"percent of total billed charges","15.3% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",34.5,69,,,,,0,"fee schedule","69% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.93,61.85,,24.74,,,0,"percent of total billed charges","61.5% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",16.1,32.2,,12.88,,,0,"percent of total billed charges","32.2% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.57,17.136,,6.86,,,0,"percent of total billed charges","17.136% of total billed charges",10.92,21.84,,8.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39,78,,31.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",7.65,50,
"GLOVE, EXAM LARGE NITRILE",490657,CDM,270,RC,,,OUTPATIENT,,,50,32.5,,44,88,,35.20,,,0,"percent of total billed charges","88% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.65,17.304,,6.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.5,63,,25.20,,,0,"percent of total billed charges","63% of total billed charges",7.65,15.3,,6.12,,,0,"percent of total billed charges","15.3% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",34.5,69,,,,,0,"fee schedule","69% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.93,61.85,,24.74,,,0,"percent of total billed charges","61.5% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",16.1,32.2,,12.88,,,0,"percent of total billed charges","32.2% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.57,17.136,,6.86,,,0,"percent of total billed charges","17.136% of total billed charges",10.92,21.84,,8.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39,78,,31.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",7.65,50,
"GLOVE BIOGEL SYN SURG 6 1/2",490640,CDM,270,RC,,,OUTPATIENT,,,171,111.15,,150.48,88,,120.38,,,0,"percent of total billed charges","88% of total billed charges",85.5,50,,68.40,,,0,"percent of total billed charges","50% of total billed charges",28.73,16.8,,22.98,,,0,"percent of total billed charges","16.8% of total billed charges",171,100,,136.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.59,17.304,,23.67,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",107.73,63,,86.18,,,0,"percent of total billed charges","63% of total billed charges",26.16,15.3,,20.93,,,0,"percent of total billed charges","15.3% of total billed charges",28.73,16.8,,22.98,,,0,"percent of total billed charges","16.8% of total billed charges",117.99,69,,,,,0,"fee schedule","69% of total billed charges",171,100,,136.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",171,100,,136.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",171,100,,136.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.76,61.85,,84.61,,,0,"percent of total billed charges","61.5% of total billed charges",28.73,16.8,,22.98,,,0,"percent of total billed charges","16.8% of total billed charges",85.5,50,,68.40,,,0,"percent of total billed charges","50% of total billed charges",55.06,32.2,,44.05,,,0,"percent of total billed charges","32.2% of total billed charges",28.73,16.8,,22.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.3,17.136,,23.44,,,0,"percent of total billed charges","17.136% of total billed charges",37.35,21.84,,29.88,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",64.47,37.7,,51.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",133.38,78,,106.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",141.25,82.6,,113.00,,,0,"percent of total billed charges","82.6% of total billed charges",28.73,16.8,,22.98,,,0,"percent of total billed charges","16.8% of total billed charges",85.5,50,,68.40,,,0,"percent of total billed charges","50% of total billed charges",141.25,82.6,,113.00,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.73,16.8,,22.98,,,0,"percent of total billed charges","16.8% of total billed charges",171,100,,136.80,,,0,"percent of total billed charges","100% of total billed charges",26.16,171,
"GLOVE BIOGEL LTX FREE SZ 9",490639,CDM,270,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"GLOVE BIOGEL SZ 8 LTX FREE",490643,CDM,270,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"GLOVE BIOGEL SZ 7 SURGEON",490642,CDM,270,RC,,,OUTPATIENT,,,466,302.9,,410.08,88,,328.06,,,0,"percent of total billed charges","88% of total billed charges",233,50,,186.40,,,0,"percent of total billed charges","50% of total billed charges",78.29,16.8,,62.63,,,0,"percent of total billed charges","16.8% of total billed charges",466,100,,372.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.64,17.304,,64.51,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",293.58,63,,234.86,,,0,"percent of total billed charges","63% of total billed charges",71.3,15.3,,57.04,,,0,"percent of total billed charges","15.3% of total billed charges",78.29,16.8,,62.63,,,0,"percent of total billed charges","16.8% of total billed charges",321.54,69,,,,,0,"fee schedule","69% of total billed charges",466,100,,372.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",466,100,,372.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",466,100,,372.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",288.22,61.85,,230.58,,,0,"percent of total billed charges","61.5% of total billed charges",78.29,16.8,,62.63,,,0,"percent of total billed charges","16.8% of total billed charges",233,50,,186.40,,,0,"percent of total billed charges","50% of total billed charges",150.05,32.2,,120.04,,,0,"percent of total billed charges","32.2% of total billed charges",78.29,16.8,,62.63,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.85,17.136,,63.88,,,0,"percent of total billed charges","17.136% of total billed charges",101.77,21.84,,81.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",175.68,37.7,,140.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",363.48,78,,290.78,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",384.92,82.6,,307.94,,,0,"percent of total billed charges","82.6% of total billed charges",78.29,16.8,,62.63,,,0,"percent of total billed charges","16.8% of total billed charges",233,50,,186.40,,,0,"percent of total billed charges","50% of total billed charges",384.92,82.6,,307.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.29,16.8,,62.63,,,0,"percent of total billed charges","16.8% of total billed charges",466,100,,372.80,,,0,"percent of total billed charges","100% of total billed charges",71.3,466,
"GLOVE BIOGEL SZ 7 1/2 SURG LF",490641,CDM,270,RC,,,OUTPATIENT,,,684,444.6,,601.92,88,,481.54,,,0,"percent of total billed charges","88% of total billed charges",342,50,,273.60,,,0,"percent of total billed charges","50% of total billed charges",114.91,16.8,,91.93,,,0,"percent of total billed charges","16.8% of total billed charges",684,100,,547.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",118.36,17.304,,94.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",430.92,63,,344.74,,,0,"percent of total billed charges","63% of total billed charges",104.65,15.3,,83.72,,,0,"percent of total billed charges","15.3% of total billed charges",114.91,16.8,,91.93,,,0,"percent of total billed charges","16.8% of total billed charges",471.96,69,,,,,0,"fee schedule","69% of total billed charges",684,100,,547.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",684,100,,547.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",684,100,,547.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",423.05,61.85,,338.44,,,0,"percent of total billed charges","61.5% of total billed charges",114.91,16.8,,91.93,,,0,"percent of total billed charges","16.8% of total billed charges",342,50,,273.60,,,0,"percent of total billed charges","50% of total billed charges",220.25,32.2,,176.20,,,0,"percent of total billed charges","32.2% of total billed charges",114.91,16.8,,91.93,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",117.21,17.136,,93.77,,,0,"percent of total billed charges","17.136% of total billed charges",149.39,21.84,,119.51,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",257.87,37.7,,206.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",533.52,78,,426.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",564.98,82.6,,451.98,,,0,"percent of total billed charges","82.6% of total billed charges",114.91,16.8,,91.93,,,0,"percent of total billed charges","16.8% of total billed charges",342,50,,273.60,,,0,"percent of total billed charges","50% of total billed charges",564.98,82.6,,451.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.91,16.8,,91.93,,,0,"percent of total billed charges","16.8% of total billed charges",684,100,,547.20,,,0,"percent of total billed charges","100% of total billed charges",104.65,684,
"GLOVE SURG SENSICARE ALOE LF SZ 8.5",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"GLOVE SENSICARE PI SURGICAL LF SIZE 9",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"GLOVE SENSICARE NEOPRENE SURGICAL PF LF SIZE9",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"GLOVE SENSICARE PI GREEN  PF LF SIZE 6",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"GLOVE SENSICARE PI GREEN PF LF SIZE 6.5",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"GLOVE SENSICARE PI GREEN PF LF SIZE 7",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"GLOVE SENSICARE PI GREEN PF LF SIZE 7.5",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"GLOVE SENSICARE PI GREEN PF LF SIZE 8",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"GLOVE SENSICARE PI GREEN PF LF SIZE 8.5",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"GLOVE SENSICARE PI SLT LF SIZE 6",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"GLOVE SENSICARE PI SLT LF SIZE 6.5",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"GLOVE SURGICAL DERMASSURE GREEN STERILE SZ 8",ORSUP0001,CDM,278,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.7% of total billed charges",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.2,33.9,,9.76,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"GLOVE SURGICAL SENSICARE PI GREEN SZ 9",ORSUP0001,CDM,278,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.7% of total billed charges",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.2,33.9,,9.76,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"GLOW AND TELL TAPE, VASCUTAPE",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"GLUCOSE CONTROL INFORM II",490674,CDM,270,RC,,,OUTPATIENT,,,29,18.85,,25.52,88,,20.42,,,0,"percent of total billed charges","88% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.02,17.304,,4.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.27,63,,14.62,,,0,"percent of total billed charges","63% of total billed charges",4.44,15.3,,3.55,,,0,"percent of total billed charges","15.3% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",20.01,69,,,,,0,"fee schedule","69% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.94,61.85,,14.35,,,0,"percent of total billed charges","61.5% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",9.34,32.2,,7.47,,,0,"percent of total billed charges","32.2% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.97,17.136,,3.98,,,0,"percent of total billed charges","17.136% of total billed charges",6.33,21.84,,5.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.93,37.7,,8.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,78,,18.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",4.44,29,
"GLUCOSE DRINK 50GM ORANGE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"GLUCOSE DRINK 75GM ORANGE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"GLUCOSE DRINK 100GM ORANGE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"GLYCINE 1.5% 3000ML 2B7317",490675,CDM,270,RC,,,OUTPATIENT,,,50,32.5,,44,88,,35.20,,,0,"percent of total billed charges","88% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.65,17.304,,6.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.5,63,,25.20,,,0,"percent of total billed charges","63% of total billed charges",7.65,15.3,,6.12,,,0,"percent of total billed charges","15.3% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",34.5,69,,,,,0,"fee schedule","69% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.93,61.85,,24.74,,,0,"percent of total billed charges","61.5% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",16.1,32.2,,12.88,,,0,"percent of total billed charges","32.2% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.57,17.136,,6.86,,,0,"percent of total billed charges","17.136% of total billed charges",10.92,21.84,,8.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39,78,,31.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",7.65,50,
"GOODE EAR T-TUBE MODIFIED,",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"GOWN SLEEVE STERILE W/CSR WRAP 1/P",76844,CDM,272,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"GOWN SURG XL FABRIC REINFORCED AURORA",202422,CDM,270,RC,,,OUTPATIENT,,,34,22.1,,29.92,88,,23.94,,,0,"percent of total billed charges","88% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.88,17.304,,4.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.42,63,,17.14,,,0,"percent of total billed charges","63% of total billed charges",5.2,15.3,,4.16,,,0,"percent of total billed charges","15.3% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",23.46,69,,,,,0,"fee schedule","69% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.03,61.85,,16.82,,,0,"percent of total billed charges","61.5% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",10.95,32.2,,8.76,,,0,"percent of total billed charges","32.2% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.83,17.136,,4.66,,,0,"percent of total billed charges","17.136% of total billed charges",7.43,21.84,,5.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.82,37.7,,10.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.52,78,,21.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",5.2,34,
"GOWN SURG LG FABRIC REINFORCED AURORA",202423,CDM,270,RC,,,OUTPATIENT,,,33,21.45,,29.04,88,,23.23,,,0,"percent of total billed charges","88% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,17.304,,4.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.79,63,,16.63,,,0,"percent of total billed charges","63% of total billed charges",5.05,15.3,,4.04,,,0,"percent of total billed charges","15.3% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",22.77,69,,,,,0,"fee schedule","69% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.41,61.85,,16.33,,,0,"percent of total billed charges","61.5% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",10.63,32.2,,8.50,,,0,"percent of total billed charges","32.2% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.65,17.136,,4.52,,,0,"percent of total billed charges","17.136% of total billed charges",7.21,21.84,,5.77,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.44,37.7,,9.95,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25.74,78,,20.59,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",5.05,33,
"GOWN REINFORCED XXLARGE",206807,CDM,270,RC,,,OUTPATIENT,,,54,35.1,,47.52,88,,38.02,,,0,"percent of total billed charges","88% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.34,17.304,,7.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.02,63,,27.22,,,0,"percent of total billed charges","63% of total billed charges",8.26,15.3,,6.61,,,0,"percent of total billed charges","15.3% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",37.26,69,,,,,0,"fee schedule","69% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.4,61.85,,26.72,,,0,"percent of total billed charges","61.5% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",17.39,32.2,,13.91,,,0,"percent of total billed charges","32.2% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.25,17.136,,7.40,,,0,"percent of total billed charges","17.136% of total billed charges",11.79,21.84,,9.43,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.36,37.7,,16.29,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",42.12,78,,33.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.6,82.6,,35.68,,,0,"percent of total billed charges","82.6% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",44.6,82.6,,35.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",8.26,54,
"GOWN FLEXIBLE BLUE BAIR PAWS 51 X 64",312363,CDM,270,RC,,,OUTPATIENT,,,133,86.45,,117.04,88,,93.63,,,0,"percent of total billed charges","88% of total billed charges",66.5,50,,53.20,,,0,"percent of total billed charges","50% of total billed charges",22.34,16.8,,17.87,,,0,"percent of total billed charges","16.8% of total billed charges",133,100,,106.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.01,17.304,,18.41,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",83.79,63,,67.03,,,0,"percent of total billed charges","63% of total billed charges",20.35,15.3,,16.28,,,0,"percent of total billed charges","15.3% of total billed charges",22.34,16.8,,17.87,,,0,"percent of total billed charges","16.8% of total billed charges",91.77,69,,,,,0,"fee schedule","69% of total billed charges",133,100,,106.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",133,100,,106.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",133,100,,106.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.26,61.85,,65.81,,,0,"percent of total billed charges","61.5% of total billed charges",22.34,16.8,,17.87,,,0,"percent of total billed charges","16.8% of total billed charges",66.5,50,,53.20,,,0,"percent of total billed charges","50% of total billed charges",42.83,32.2,,34.26,,,0,"percent of total billed charges","32.2% of total billed charges",22.34,16.8,,17.87,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.79,17.136,,18.23,,,0,"percent of total billed charges","17.136% of total billed charges",29.05,21.84,,23.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.14,37.7,,40.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",103.74,78,,82.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",109.86,82.6,,87.89,,,0,"percent of total billed charges","82.6% of total billed charges",22.34,16.8,,17.87,,,0,"percent of total billed charges","16.8% of total billed charges",66.5,50,,53.20,,,0,"percent of total billed charges","50% of total billed charges",109.86,82.6,,87.89,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.34,16.8,,17.87,,,0,"percent of total billed charges","16.8% of total billed charges",133,100,,106.40,,,0,"percent of total billed charges","100% of total billed charges",20.35,133,
"GOWN SURGICAL SMALL ECLIPSE",245422,CDM,270,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"GOWN PREVENTION PLUS XLONG/XLARGE STRL",13998,CDM,270,RC,,,OUTPATIENT,,,31,20.15,,27.28,88,,21.82,,,0,"percent of total billed charges","88% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.36,17.304,,4.29,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.53,63,,15.62,,,0,"percent of total billed charges","63% of total billed charges",4.74,15.3,,3.79,,,0,"percent of total billed charges","15.3% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",21.39,69,,,,,0,"fee schedule","69% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.17,61.85,,15.34,,,0,"percent of total billed charges","61.5% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",9.98,32.2,,7.98,,,0,"percent of total billed charges","32.2% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.31,17.136,,4.25,,,0,"percent of total billed charges","17.136% of total billed charges",6.77,21.84,,5.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.69,37.7,,9.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.18,78,,19.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.61,82.6,,20.49,,,0,"percent of total billed charges","82.6% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",25.61,82.6,,20.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",4.74,31,
"GOWN FLEXIBLE BLUE BAIR PAWS XL 51 X 122",313143,CDM,270,RC,,,OUTPATIENT,,,163,105.95,,143.44,88,,114.75,,,0,"percent of total billed charges","88% of total billed charges",81.5,50,,65.20,,,0,"percent of total billed charges","50% of total billed charges",27.38,16.8,,21.90,,,0,"percent of total billed charges","16.8% of total billed charges",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.21,17.304,,22.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",102.69,63,,82.15,,,0,"percent of total billed charges","63% of total billed charges",24.94,15.3,,19.95,,,0,"percent of total billed charges","15.3% of total billed charges",27.38,16.8,,21.90,,,0,"percent of total billed charges","16.8% of total billed charges",112.47,69,,,,,0,"fee schedule","69% of total billed charges",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",100.82,61.85,,80.66,,,0,"percent of total billed charges","61.5% of total billed charges",27.38,16.8,,21.90,,,0,"percent of total billed charges","16.8% of total billed charges",81.5,50,,65.20,,,0,"percent of total billed charges","50% of total billed charges",52.49,32.2,,41.99,,,0,"percent of total billed charges","32.2% of total billed charges",27.38,16.8,,21.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.93,17.136,,22.34,,,0,"percent of total billed charges","17.136% of total billed charges",35.6,21.84,,28.48,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",61.45,37.7,,49.16,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",127.14,78,,101.71,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.64,82.6,,107.71,,,0,"percent of total billed charges","82.6% of total billed charges",27.38,16.8,,21.90,,,0,"percent of total billed charges","16.8% of total billed charges",81.5,50,,65.20,,,0,"percent of total billed charges","50% of total billed charges",134.64,82.6,,107.71,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.38,16.8,,21.90,,,0,"percent of total billed charges","16.8% of total billed charges",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",24.94,163,
"GOWN HYDROTHERAPY XL",188003,CDM,270,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"GOWN ISOLATION",443099,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"GOWN ISOLATION  SIDE TIES",464231,CDM,270,RC,,,OUTPATIENT,,,61,39.65,,53.68,88,,42.94,,,0,"percent of total billed charges","88% of total billed charges",30.5,50,,24.40,,,0,"percent of total billed charges","50% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.56,17.304,,8.45,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.43,63,,30.74,,,0,"percent of total billed charges","63% of total billed charges",9.33,15.3,,7.46,,,0,"percent of total billed charges","15.3% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",42.09,69,,,,,0,"fee schedule","69% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.73,61.85,,30.18,,,0,"percent of total billed charges","61.5% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",30.5,50,,24.40,,,0,"percent of total billed charges","50% of total billed charges",19.64,32.2,,15.71,,,0,"percent of total billed charges","32.2% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.45,17.136,,8.36,,,0,"percent of total billed charges","17.136% of total billed charges",13.32,21.84,,10.66,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23,37.7,,18.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47.58,78,,38.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.39,82.6,,40.31,,,0,"percent of total billed charges","82.6% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",30.5,50,,24.40,,,0,"percent of total billed charges","50% of total billed charges",50.39,82.6,,40.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",9.33,61,
"GOWN ISOLATION BLUE X-LARGE",431549,CDM,270,RC,,,OUTPATIENT,,,34,22.1,,29.92,88,,23.94,,,0,"percent of total billed charges","88% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.88,17.304,,4.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.42,63,,17.14,,,0,"percent of total billed charges","63% of total billed charges",5.2,15.3,,4.16,,,0,"percent of total billed charges","15.3% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",23.46,69,,,,,0,"fee schedule","69% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.03,61.85,,16.82,,,0,"percent of total billed charges","61.5% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",10.95,32.2,,8.76,,,0,"percent of total billed charges","32.2% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.83,17.136,,4.66,,,0,"percent of total billed charges","17.136% of total billed charges",7.43,21.84,,5.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.82,37.7,,10.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.52,78,,21.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",5.2,34,
"GOWN ROYALSILK LARGE",321602,CDM,270,RC,,,OUTPATIENT,,,381,247.65,,335.28,88,,268.22,,,0,"percent of total billed charges","88% of total billed charges",190.5,50,,152.40,,,0,"percent of total billed charges","50% of total billed charges",64.01,16.8,,51.21,,,0,"percent of total billed charges","16.8% of total billed charges",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",65.93,17.304,,52.74,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",240.03,63,,192.02,,,0,"percent of total billed charges","63% of total billed charges",58.29,15.3,,46.63,,,0,"percent of total billed charges","15.3% of total billed charges",64.01,16.8,,51.21,,,0,"percent of total billed charges","16.8% of total billed charges",262.89,69,,,,,0,"fee schedule","69% of total billed charges",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",235.65,61.85,,188.52,,,0,"percent of total billed charges","61.5% of total billed charges",64.01,16.8,,51.21,,,0,"percent of total billed charges","16.8% of total billed charges",190.5,50,,152.40,,,0,"percent of total billed charges","50% of total billed charges",122.68,32.2,,98.14,,,0,"percent of total billed charges","32.2% of total billed charges",64.01,16.8,,51.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",65.29,17.136,,52.23,,,0,"percent of total billed charges","17.136% of total billed charges",83.21,21.84,,66.57,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",143.64,37.7,,114.91,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",297.18,78,,237.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",314.71,82.6,,251.77,,,0,"percent of total billed charges","82.6% of total billed charges",64.01,16.8,,51.21,,,0,"percent of total billed charges","16.8% of total billed charges",190.5,50,,152.40,,,0,"percent of total billed charges","50% of total billed charges",314.71,82.6,,251.77,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.01,16.8,,51.21,,,0,"percent of total billed charges","16.8% of total billed charges",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",58.29,381,
"GOWN SURG XXL XLONG IMPERVIOUS BREATHABLE",9272,CDM,270,RC,,,OUTPATIENT,,,73,47.45,,64.24,88,,51.39,,,0,"percent of total billed charges","88% of total billed charges",36.5,50,,29.20,,,0,"percent of total billed charges","50% of total billed charges",12.26,16.8,,9.81,,,0,"percent of total billed charges","16.8% of total billed charges",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.63,17.304,,10.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.99,63,,36.79,,,0,"percent of total billed charges","63% of total billed charges",11.17,15.3,,8.94,,,0,"percent of total billed charges","15.3% of total billed charges",12.26,16.8,,9.81,,,0,"percent of total billed charges","16.8% of total billed charges",50.37,69,,,,,0,"fee schedule","69% of total billed charges",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.15,61.85,,36.12,,,0,"percent of total billed charges","61.5% of total billed charges",12.26,16.8,,9.81,,,0,"percent of total billed charges","16.8% of total billed charges",36.5,50,,29.20,,,0,"percent of total billed charges","50% of total billed charges",23.51,32.2,,18.81,,,0,"percent of total billed charges","32.2% of total billed charges",12.26,16.8,,9.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.51,17.136,,10.01,,,0,"percent of total billed charges","17.136% of total billed charges",15.94,21.84,,12.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",27.52,37.7,,22.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",56.94,78,,45.55,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",12.26,16.8,,9.81,,,0,"percent of total billed charges","16.8% of total billed charges",36.5,50,,29.20,,,0,"percent of total billed charges","50% of total billed charges",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.26,16.8,,9.81,,,0,"percent of total billed charges","16.8% of total billed charges",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",11.17,73,
"GOWNS LATEX-FREE ISOLATION",130657,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"GOWN, SURGICAL XL STERILE",490685,CDM,272,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"GOWN, LARGE STERILE",490683,CDM,272,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.9,61.85,,7.92,,,0,"percent of total billed charges","61.5% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"GOWN, MICROCOOL SPECIALTY XLG",490684,CDM,270,RC,,,OUTPATIENT,,,33,21.45,,29.04,88,,23.23,,,0,"percent of total billed charges","88% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,17.304,,4.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.79,63,,16.63,,,0,"percent of total billed charges","63% of total billed charges",5.05,15.3,,4.04,,,0,"percent of total billed charges","15.3% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",22.77,69,,,,,0,"fee schedule","69% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.41,61.85,,16.33,,,0,"percent of total billed charges","61.5% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",10.63,32.2,,8.50,,,0,"percent of total billed charges","32.2% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.65,17.136,,4.52,,,0,"percent of total billed charges","17.136% of total billed charges",7.21,21.84,,5.77,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.44,37.7,,9.95,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25.74,78,,20.59,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",5.05,33,
"GOWN IMPERV XL ISOLATION",490677,CDM,270,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"GOWN ISOLATION YELLOW UNIVERSL",490679,CDM,270,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"GOWN IMPERVIOUS BLUE ISOLATION",490678,CDM,270,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"GOWN SIZE LARGE",490680,CDM,270,RC,,,OUTPATIENT,,,21,13.65,,18.48,88,,14.78,,,0,"percent of total billed charges","88% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.63,17.304,,2.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.23,63,,10.58,,,0,"percent of total billed charges","63% of total billed charges",3.21,15.3,,2.57,,,0,"percent of total billed charges","15.3% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",14.49,69,,,,,0,"fee schedule","69% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.99,61.85,,10.39,,,0,"percent of total billed charges","61.5% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",6.76,32.2,,5.41,,,0,"percent of total billed charges","32.2% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.6,17.136,,2.88,,,0,"percent of total billed charges","17.136% of total billed charges",4.59,21.84,,3.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.92,37.7,,6.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.38,78,,13.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",3.21,21,
"GOWN SIZE XL",490681,CDM,270,RC,,,OUTPATIENT,,,28,18.2,,24.64,88,,19.71,,,0,"percent of total billed charges","88% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.85,17.304,,3.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.64,63,,14.11,,,0,"percent of total billed charges","63% of total billed charges",4.28,15.3,,3.42,,,0,"percent of total billed charges","15.3% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",19.32,69,,,,,0,"fee schedule","69% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.32,61.85,,13.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",9.02,32.2,,7.22,,,0,"percent of total billed charges","32.2% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.8,17.136,,3.84,,,0,"percent of total billed charges","17.136% of total billed charges",6.12,21.84,,4.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.56,37.7,,8.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.84,78,,17.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",4.28,28,
"GOWN XLONG SIZE XL",490682,CDM,270,RC,,,OUTPATIENT,,,50,32.5,,44,88,,35.20,,,0,"percent of total billed charges","88% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.65,17.304,,6.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.5,63,,25.20,,,0,"percent of total billed charges","63% of total billed charges",7.65,15.3,,6.12,,,0,"percent of total billed charges","15.3% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",34.5,69,,,,,0,"fee schedule","69% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.93,61.85,,24.74,,,0,"percent of total billed charges","61.5% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",16.1,32.2,,12.88,,,0,"percent of total billed charges","32.2% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.57,17.136,,6.86,,,0,"percent of total billed charges","17.136% of total billed charges",10.92,21.84,,8.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39,78,,31.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",7.65,50,
"GOWN SURGICAL LRG STERILE AURORA",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"GOWN SURGICAL XL STERILE AURORA",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"GOWN CHEMO IMPERVIOUS BLUE UNIVERSAL",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"GOWN CHEMO IMPERVIOUS BLUE XLARGE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"GOWN CHEMOPLUS BLUE MED",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"GOWN CHEMO BREATHABLE FILM KNIT CUFFS BLUE LRG",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"GOWN STERILE LVL4 3XL",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"GRABBER GRASPER TIP",ORSUP0016,CDM,270,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"GRABBER TIP DISPOSABLE",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"GRAFTBOLT TIBIAL 8MM",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",751.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.7% of total billed charges",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",816.99,33.9,,653.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"GRAFT - GRAFTLINK",ORSUP0058,CDM,278,RC,,,OUTPATIENT,,,12854,8355.1,,11311.52,88,,9049.22,,,0,"percent of total billed charges","88% of total billed charges",6427,50,,5141.60,,,0,"percent of total billed charges","50% of total billed charges",2159.47,16.8,,1727.58,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2224.26,17.304,,1779.41,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8098.02,63,,6478.42,,,0,"percent of total billed charges","63% of total billed charges",1966.66,15.3,,1573.33,,,0,"percent of total billed charges","15.3% of total billed charges",2159.47,16.8,,1727.58,,,0,"percent of total billed charges","16.8% of total billed charges",8869.26,69,,,,,0,"fee schedule","69% of total billed charges",12854,100,,10283.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12854,100,,10283.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12854,100,,10283.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7950.2,61.85,,6360.16,,,0,"percent of total billed charges","61.5% of total billed charges",2159.47,16.8,,1727.58,,,0,"percent of total billed charges","16.8% of total billed charges",6427,50,,5141.60,,,0,"percent of total billed charges","50% of total billed charges",4138.99,32.2,,3311.19,,,0,"percent of total billed charges","32.2% of total billed charges",4010.45,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2202.66,17.136,,1762.13,,,0,"percent of total billed charges","17.136% of total billed charges",2807.31,21.84,,2245.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4845.96,37.7,,3876.77,,,0,"percent of total billed charges","37.7% of total billed charges",4845.96,37.7,,3876.77,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4357.51,33.9,,3486.01,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",10026.12,78,,8020.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10617.4,82.6,,8493.92,,,0,"percent of total billed charges","82.6% of total billed charges",2159.47,16.8,,1727.58,,,0,"percent of total billed charges","16.8% of total billed charges",6427,50,,5141.60,,,0,"percent of total billed charges","50% of total billed charges",10617.4,82.6,,8493.92,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2159.47,16.8,,1727.58,,,0,"percent of total billed charges","16.8% of total billed charges",12854,100,,10283.20,,,0,"percent of total billed charges","100% of total billed charges",1966.66,12854,
"GRAFT BN FEM HD SM FRZDR ASEP 44MM",ORSUP0035,CDM,278,RC,,,OUTPATIENT,,,6427,4177.55,,5655.76,88,,4524.61,,,0,"percent of total billed charges","88% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1112.13,17.304,,889.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4049.01,63,,3239.21,,,0,"percent of total billed charges","63% of total billed charges",983.33,15.3,,786.66,,,0,"percent of total billed charges","15.3% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4434.63,69,,,,,0,"fee schedule","69% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3975.1,61.85,,3180.08,,,0,"percent of total billed charges","61.5% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",2069.49,32.2,,1655.59,,,0,"percent of total billed charges","32.2% of total billed charges",2005.22,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1101.33,17.136,,881.06,,,0,"percent of total billed charges","17.136% of total billed charges",1403.66,21.84,,1122.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.7% of total billed charges",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2178.75,33.9,,1743.00,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5013.06,78,,4010.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",983.33,6427,
"GRAFT BN FRZDR CNFRM CB 17MM",ORSUP0027,CDM,278,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",1336.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.7% of total billed charges",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1452.62,33.9,,1162.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"GRAFT VASC BOVINE COLLGN 7MMX40CM",ORSUP0036,CDM,278,RC,,,OUTPATIENT,,,6695,4351.75,,5891.6,88,,4713.28,,,0,"percent of total billed charges","88% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1158.5,17.304,,926.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4217.85,63,,3374.28,,,0,"percent of total billed charges","63% of total billed charges",1024.34,15.3,,819.47,,,0,"percent of total billed charges","15.3% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",4619.55,69,,,,,0,"fee schedule","69% of total billed charges",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4140.86,61.85,,3312.69,,,0,"percent of total billed charges","61.5% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",2155.79,32.2,,1724.63,,,0,"percent of total billed charges","32.2% of total billed charges",2088.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1147.26,17.136,,917.81,,,0,"percent of total billed charges","17.136% of total billed charges",1462.19,21.84,,1169.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2524.02,37.7,,2019.22,,,0,"percent of total billed charges","37.7% of total billed charges",2524.02,37.7,,2019.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2269.61,33.9,,1815.69,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5222.1,78,,4177.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5530.07,82.6,,4424.06,,,0,"percent of total billed charges","82.6% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",5530.07,82.6,,4424.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",1024.34,6695,
"GRAFT CV FELT PTFE 6X6IN 15X15CM",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",751.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.7% of total billed charges",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",816.99,33.9,,653.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"GRAFT TISSUE REPAIR XENFORM",ORSUP0042,CDM,278,RC,,,OUTPATIENT,,,8302,5396.3,,7305.76,88,,5844.61,,,0,"percent of total billed charges","88% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1436.58,17.304,,1149.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5230.26,63,,4184.21,,,0,"percent of total billed charges","63% of total billed charges",1270.21,15.3,,1016.17,,,0,"percent of total billed charges","15.3% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",5728.38,69,,,,,0,"fee schedule","69% of total billed charges",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5134.79,61.85,,4107.83,,,0,"percent of total billed charges","61.5% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",2673.24,32.2,,2138.59,,,0,"percent of total billed charges","32.2% of total billed charges",2590.22,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1422.63,17.136,,1138.10,,,0,"percent of total billed charges","17.136% of total billed charges",1813.16,21.84,,1450.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3129.85,37.7,,2503.88,,,0,"percent of total billed charges","37.7% of total billed charges",3129.85,37.7,,2503.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2814.38,33.9,,2251.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6475.56,78,,5180.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6857.45,82.6,,5485.96,,,0,"percent of total billed charges","82.6% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",6857.45,82.6,,5485.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",1270.21,8302,
"GRAFT BONE BIOACTIVE SUBSITIUTE VITOSS BA",ORSUP0045,CDM,278,RC,,,OUTPATIENT,,,9105,5918.25,,8012.4,88,,6409.92,,,0,"percent of total billed charges","88% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1575.53,17.304,,1260.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5736.15,63,,4588.92,,,0,"percent of total billed charges","63% of total billed charges",1393.07,15.3,,1114.46,,,0,"percent of total billed charges","15.3% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",6282.45,69,,,,,0,"fee schedule","69% of total billed charges",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5631.44,61.85,,4505.15,,,0,"percent of total billed charges","61.5% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",2931.81,32.2,,2345.45,,,0,"percent of total billed charges","32.2% of total billed charges",2840.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1560.23,17.136,,1248.18,,,0,"percent of total billed charges","17.136% of total billed charges",1988.53,21.84,,1590.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3432.59,37.7,,2746.07,,,0,"percent of total billed charges","37.7% of total billed charges",3432.59,37.7,,2746.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3086.6,33.9,,2469.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7101.9,78,,5681.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7520.73,82.6,,6016.58,,,0,"percent of total billed charges","82.6% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",7520.73,82.6,,6016.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",1393.07,9105,
"GRAFT BOVINE 6 X 30 STANDARD",ORSUP0035,CDM,278,RC,,,OUTPATIENT,,,6427,4177.55,,5655.76,88,,4524.61,,,0,"percent of total billed charges","88% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1112.13,17.304,,889.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4049.01,63,,3239.21,,,0,"percent of total billed charges","63% of total billed charges",983.33,15.3,,786.66,,,0,"percent of total billed charges","15.3% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4434.63,69,,,,,0,"fee schedule","69% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3975.1,61.85,,3180.08,,,0,"percent of total billed charges","61.5% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",2069.49,32.2,,1655.59,,,0,"percent of total billed charges","32.2% of total billed charges",2005.22,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1101.33,17.136,,881.06,,,0,"percent of total billed charges","17.136% of total billed charges",1403.66,21.84,,1122.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.7% of total billed charges",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2178.75,33.9,,1743.00,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5013.06,78,,4010.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",983.33,6427,
"GRAFT DISTAFLO 6MM X 80CM",ORSUP0047,CDM,278,RC,,,OUTPATIENT,,,9641,6266.65,,8484.08,88,,6787.26,,,0,"percent of total billed charges","88% of total billed charges",4820.5,50,,3856.40,,,0,"percent of total billed charges","50% of total billed charges",1619.69,16.8,,1295.75,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1668.28,17.304,,1334.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6073.83,63,,4859.06,,,0,"percent of total billed charges","63% of total billed charges",1475.07,15.3,,1180.06,,,0,"percent of total billed charges","15.3% of total billed charges",1619.69,16.8,,1295.75,,,0,"percent of total billed charges","16.8% of total billed charges",6652.29,69,,,,,0,"fee schedule","69% of total billed charges",9641,100,,7712.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9641,100,,7712.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9641,100,,7712.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5962.96,61.85,,4770.37,,,0,"percent of total billed charges","61.5% of total billed charges",1619.69,16.8,,1295.75,,,0,"percent of total billed charges","16.8% of total billed charges",4820.5,50,,3856.40,,,0,"percent of total billed charges","50% of total billed charges",3104.4,32.2,,2483.52,,,0,"percent of total billed charges","32.2% of total billed charges",3007.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1652.08,17.136,,1321.66,,,0,"percent of total billed charges","17.136% of total billed charges",2105.59,21.84,,1684.47,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3634.66,37.7,,2907.73,,,0,"percent of total billed charges","37.7% of total billed charges",3634.66,37.7,,2907.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3268.3,33.9,,2614.64,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7519.98,78,,6015.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7963.47,82.6,,6370.78,,,0,"percent of total billed charges","82.6% of total billed charges",1619.69,16.8,,1295.75,,,0,"percent of total billed charges","16.8% of total billed charges",4820.5,50,,3856.40,,,0,"percent of total billed charges","50% of total billed charges",7963.47,82.6,,6370.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1619.69,16.8,,1295.75,,,0,"percent of total billed charges","16.8% of total billed charges",9641,100,,7712.80,,,0,"percent of total billed charges","100% of total billed charges",1475.07,9641,
"GRAFT FLEX 8X70 CM",ORSUP0036,CDM,278,RC,,,OUTPATIENT,,,6695,4351.75,,5891.6,88,,4713.28,,,0,"percent of total billed charges","88% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1158.5,17.304,,926.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4217.85,63,,3374.28,,,0,"percent of total billed charges","63% of total billed charges",1024.34,15.3,,819.47,,,0,"percent of total billed charges","15.3% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",4619.55,69,,,,,0,"fee schedule","69% of total billed charges",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4140.86,61.85,,3312.69,,,0,"percent of total billed charges","61.5% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",2155.79,32.2,,1724.63,,,0,"percent of total billed charges","32.2% of total billed charges",2088.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1147.26,17.136,,917.81,,,0,"percent of total billed charges","17.136% of total billed charges",1462.19,21.84,,1169.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2524.02,37.7,,2019.22,,,0,"percent of total billed charges","37.7% of total billed charges",2524.02,37.7,,2019.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2269.61,33.9,,1815.69,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5222.1,78,,4177.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5530.07,82.6,,4424.06,,,0,"percent of total billed charges","82.6% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",5530.07,82.6,,4424.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",1024.34,6695,
"GRAFT FLEX 6MM",ORSUP0033,CDM,278,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",1838.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.7% of total billed charges",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1997.39,33.9,,1597.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"GRAFT VASCULAR IMPRA 7 X 10",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"GRAFT HEMASHIELD 28MMX15CM",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"GRAFT 10MM X 15CM HEMASHIELD",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"GRAFT 32MM X 15CM HEMASHIELD",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"GRAFT CV 15CMX18MM HMSH G MCVL DBL VLR M002020951080",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"GRAFT HEMASHIELD 14 X 8 AORTIC VASCULAR BIFUREATED",ORSUP0023,CDM,278,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",1002.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.7% of total billed charges",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1089.55,33.9,,871.64,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"GRAFT HEMASHIELD 16 X 8",ORSUP0022,CDM,278,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",919.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.7% of total billed charges",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",998.69,33.9,,798.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"GRAFT HEMASHIELD 18 X 9",ORSUP0025,CDM,278,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",1169.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.7% of total billed charges",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.91,33.9,,1016.73,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"GRAFT HEMASHIELD 28MM X 10MM X 50CM",ORSUP0042,CDM,278,RC,,,OUTPATIENT,,,8302,5396.3,,7305.76,88,,5844.61,,,0,"percent of total billed charges","88% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1436.58,17.304,,1149.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5230.26,63,,4184.21,,,0,"percent of total billed charges","63% of total billed charges",1270.21,15.3,,1016.17,,,0,"percent of total billed charges","15.3% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",5728.38,69,,,,,0,"fee schedule","69% of total billed charges",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5134.79,61.85,,4107.83,,,0,"percent of total billed charges","61.5% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",2673.24,32.2,,2138.59,,,0,"percent of total billed charges","32.2% of total billed charges",2590.22,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1422.63,17.136,,1138.10,,,0,"percent of total billed charges","17.136% of total billed charges",1813.16,21.84,,1450.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3129.85,37.7,,2503.88,,,0,"percent of total billed charges","37.7% of total billed charges",3129.85,37.7,,2503.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2814.38,33.9,,2251.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6475.56,78,,5180.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6857.45,82.6,,5485.96,,,0,"percent of total billed charges","82.6% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",6857.45,82.6,,5485.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",1270.21,8302,
"GRAFT HEMASHIELD 30MM X 10MM X 50CM",ORSUP0042,CDM,278,RC,,,OUTPATIENT,,,8302,5396.3,,7305.76,88,,5844.61,,,0,"percent of total billed charges","88% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1436.58,17.304,,1149.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5230.26,63,,4184.21,,,0,"percent of total billed charges","63% of total billed charges",1270.21,15.3,,1016.17,,,0,"percent of total billed charges","15.3% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",5728.38,69,,,,,0,"fee schedule","69% of total billed charges",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5134.79,61.85,,4107.83,,,0,"percent of total billed charges","61.5% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",2673.24,32.2,,2138.59,,,0,"percent of total billed charges","32.2% of total billed charges",2590.22,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1422.63,17.136,,1138.10,,,0,"percent of total billed charges","17.136% of total billed charges",1813.16,21.84,,1450.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3129.85,37.7,,2503.88,,,0,"percent of total billed charges","37.7% of total billed charges",3129.85,37.7,,2503.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2814.38,33.9,,2251.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6475.56,78,,5180.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6857.45,82.6,,5485.96,,,0,"percent of total billed charges","82.6% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",6857.45,82.6,,5485.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",1270.21,8302,
"GRAFT HEMASHIELD 32MM X 10MM X 50CM",ORSUP0042,CDM,278,RC,,,OUTPATIENT,,,8302,5396.3,,7305.76,88,,5844.61,,,0,"percent of total billed charges","88% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1436.58,17.304,,1149.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5230.26,63,,4184.21,,,0,"percent of total billed charges","63% of total billed charges",1270.21,15.3,,1016.17,,,0,"percent of total billed charges","15.3% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",5728.38,69,,,,,0,"fee schedule","69% of total billed charges",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5134.79,61.85,,4107.83,,,0,"percent of total billed charges","61.5% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",2673.24,32.2,,2138.59,,,0,"percent of total billed charges","32.2% of total billed charges",2590.22,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1422.63,17.136,,1138.10,,,0,"percent of total billed charges","17.136% of total billed charges",1813.16,21.84,,1450.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3129.85,37.7,,2503.88,,,0,"percent of total billed charges","37.7% of total billed charges",3129.85,37.7,,2503.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2814.38,33.9,,2251.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6475.56,78,,5180.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6857.45,82.6,,5485.96,,,0,"percent of total billed charges","82.6% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",6857.45,82.6,,5485.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",1270.21,8302,
"GRAFT HEMASHIELD 34MM X 10MM X50CM",ORSUP0042,CDM,278,RC,,,OUTPATIENT,,,8302,5396.3,,7305.76,88,,5844.61,,,0,"percent of total billed charges","88% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1436.58,17.304,,1149.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5230.26,63,,4184.21,,,0,"percent of total billed charges","63% of total billed charges",1270.21,15.3,,1016.17,,,0,"percent of total billed charges","15.3% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",5728.38,69,,,,,0,"fee schedule","69% of total billed charges",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5134.79,61.85,,4107.83,,,0,"percent of total billed charges","61.5% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",2673.24,32.2,,2138.59,,,0,"percent of total billed charges","32.2% of total billed charges",2590.22,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1422.63,17.136,,1138.10,,,0,"percent of total billed charges","17.136% of total billed charges",1813.16,21.84,,1450.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3129.85,37.7,,2503.88,,,0,"percent of total billed charges","37.7% of total billed charges",3129.85,37.7,,2503.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2814.38,33.9,,2251.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6475.56,78,,5180.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6857.45,82.6,,5485.96,,,0,"percent of total billed charges","82.6% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",6857.45,82.6,,5485.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",1270.21,8302,
"GRAFT KNITTED DBL VELOUR 24MM X 15CM",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"GRAFT VAS 8MM X 60CM HEMASHLD KNITTED DBL VLR",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",751.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.7% of total billed charges",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",816.99,33.9,,653.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"GRAFT VAS BIF 20 X 10 X 40CM HEMASHLD KNITTED DBL VLR",ORSUP0029,CDM,278,RC,,,OUTPATIENT,,,4820,3133,,4241.6,88,,3393.28,,,0,"percent of total billed charges","88% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",834.05,17.304,,667.24,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3036.6,63,,2429.28,,,0,"percent of total billed charges","63% of total billed charges",737.46,15.3,,589.97,,,0,"percent of total billed charges","15.3% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",3325.8,69,,,,,0,"fee schedule","69% of total billed charges",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2981.17,61.85,,2384.94,,,0,"percent of total billed charges","61.5% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",1552.04,32.2,,1241.63,,,0,"percent of total billed charges","32.2% of total billed charges",1503.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",825.96,17.136,,660.77,,,0,"percent of total billed charges","17.136% of total billed charges",1052.69,21.84,,842.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1817.14,37.7,,1453.71,,,0,"percent of total billed charges","37.7% of total billed charges",1817.14,37.7,,1453.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1633.98,33.9,,1307.18,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3759.6,78,,3007.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3981.32,82.6,,3185.06,,,0,"percent of total billed charges","82.6% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",3981.32,82.6,,3185.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",737.46,4820,
"GRAFT VASC WOVEN 30MM X 15CM",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",751.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.7% of total billed charges",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",816.99,33.9,,653.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"GRAFT VASCULAR 6MM X 10CM",ORSUP0019,CDM,278,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",668.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.7% of total billed charges",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",726.14,33.9,,580.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"GRAFT/STRIP DBX FLEX",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"GRAFT JACKET TENDON REPAIR",ORSUP0125,CDM,636,RC,,,OUTPATIENT,,,31065,20192.25,,27337.2,88,,21869.76,,,0,"percent of total billed charges","88% of total billed charges",15532.5,50,,12426.00,,,0,"percent of total billed charges","50% of total billed charges",5218.92,16.8,,4175.14,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5375.49,17.304,,4300.39,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",19570.95,63,,15656.76,,,0,"percent of total billed charges","63% of total billed charges",4752.95,15.3,,3802.36,,,0,"percent of total billed charges","15.3% of total billed charges",5218.92,16.8,,4175.14,,,0,"percent of total billed charges","16.8% of total billed charges",21434.85,69,,,,,0,"fee schedule","69% of total billed charges",31065,100,,24852.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31065,100,,24852.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31065,100,,24852.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19213.7,61.85,,15370.96,,,0,"percent of total billed charges","61.5% of total billed charges",5218.92,16.8,,4175.14,,,0,"percent of total billed charges","16.8% of total billed charges",15532.5,50,,12426.00,,,0,"percent of total billed charges","50% of total billed charges",10002.93,32.2,,8002.34,,,0,"percent of total billed charges","32.2% of total billed charges",5218.92,16.8,,4175.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5323.3,17.136,,4258.64,,,0,"percent of total billed charges","17.136% of total billed charges",6784.6,21.84,,5427.68,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",11711.51,37.7,,9369.21,,,0,"percent of total billed charges","37.7% of total billed charges",11711.51,37.7,,9369.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",10531.04,33.9,,8424.83,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",24230.7,78,,19384.56,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5218.92,16.8,,4175.14,,,0,"percent of total billed charges","16.8% of total billed charges",15532.5,50,,12426.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5218.92,16.8,,4175.14,,,0,"percent of total billed charges","16.8% of total billed charges",31065,100,,24852.00,,,0,"percent of total billed charges","100% of total billed charges",4695,31065,
"GRAFT SURGISIS GOLD 7 X 20",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"GRAFT SURGISIS 20 X 20",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"GRAFT SURGISIS 7 X 10 1S",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"GRAFT SURGISIS GOLD 13 X 22",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"GRAFT JACKET MAXFORCE 4 X 7 CM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"GRAFT HERNIA REPAIR COLLEMED",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"GRAFT GORTEX 8MM X 50CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"GRAFT GORTEX 20MM X 40CM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"GRAFT GORTEX 16MM X 40CM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"GRAFT GORTEX 6MM X 70CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"GRAFT BIODESIGN OTO 2.5 X 2.5",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1185,770.25,,1042.8,88,,834.24,,,0,"percent of total billed charges","88% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",205.05,17.304,,164.04,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",746.55,63,,597.24,,,0,"percent of total billed charges","63% of total billed charges",181.31,15.3,,145.05,,,0,"percent of total billed charges","15.3% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",817.65,69,,,,,0,"fee schedule","69% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.92,61.85,,586.34,,,0,"percent of total billed charges","61.5% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",381.57,32.2,,305.26,,,0,"percent of total billed charges","32.2% of total billed charges",369.72,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",203.06,17.136,,162.45,,,0,"percent of total billed charges","17.136% of total billed charges",258.8,21.84,,207.04,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",446.75,37.7,,357.40,,,0,"percent of total billed charges","37.7% of total billed charges",446.75,37.7,,357.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",401.72,33.9,,321.38,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",924.3,78,,739.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",181.31,1185,
"GRAFT ANTERIOR TIBIALIS TENDON",ORSUP0046,CDM,278,RC,,,OUTPATIENT,,,7000,4550,,6160,88,,4928.00,,,0,"percent of total billed charges","88% of total billed charges",3500,50,,2800.00,,,0,"percent of total billed charges","50% of total billed charges",1176,16.8,,940.80,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1211.28,17.304,,969.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4410,63,,3528.00,,,0,"percent of total billed charges","63% of total billed charges",1071,15.3,,856.80,,,0,"percent of total billed charges","15.3% of total billed charges",1176,16.8,,940.80,,,0,"percent of total billed charges","16.8% of total billed charges",4830,69,,,,,0,"fee schedule","69% of total billed charges",7000,100,,5600.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7000,100,,5600.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7000,100,,5600.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4329.5,61.85,,3463.60,,,0,"percent of total billed charges","61.5% of total billed charges",1176,16.8,,940.80,,,0,"percent of total billed charges","16.8% of total billed charges",3500,50,,2800.00,,,0,"percent of total billed charges","50% of total billed charges",2254,32.2,,1803.20,,,0,"percent of total billed charges","32.2% of total billed charges",2184,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1199.52,17.136,,959.62,,,0,"percent of total billed charges","17.136% of total billed charges",1528.8,21.84,,1223.04,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2639,37.7,,2111.20,,,0,"percent of total billed charges","37.7% of total billed charges",2639,37.7,,2111.20,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2373,33.9,,1898.40,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5460,78,,4368.00,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5782,82.6,,4625.60,,,0,"percent of total billed charges","82.6% of total billed charges",1176,16.8,,940.80,,,0,"percent of total billed charges","16.8% of total billed charges",3500,50,,2800.00,,,0,"percent of total billed charges","50% of total billed charges",5782,82.6,,4625.60,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1176,16.8,,940.80,,,0,"percent of total billed charges","16.8% of total billed charges",7000,100,,5600.00,,,0,"percent of total billed charges","100% of total billed charges",1071,7000,
"GRAFT VITOSS BIMODAL FOAM PACK 10CC",ORSUP0054,CDM,278,RC,,,OUTPATIENT,,,11515,7484.75,,10133.2,88,,8106.56,,,0,"percent of total billed charges","88% of total billed charges",5757.5,50,,4606.00,,,0,"percent of total billed charges","50% of total billed charges",1934.52,16.8,,1547.62,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1992.56,17.304,,1594.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7254.45,63,,5803.56,,,0,"percent of total billed charges","63% of total billed charges",1761.8,15.3,,1409.44,,,0,"percent of total billed charges","15.3% of total billed charges",1934.52,16.8,,1547.62,,,0,"percent of total billed charges","16.8% of total billed charges",7945.35,69,,,,,0,"fee schedule","69% of total billed charges",11515,100,,9212.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11515,100,,9212.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11515,100,,9212.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7122.03,61.85,,5697.62,,,0,"percent of total billed charges","61.5% of total billed charges",1934.52,16.8,,1547.62,,,0,"percent of total billed charges","16.8% of total billed charges",5757.5,50,,4606.00,,,0,"percent of total billed charges","50% of total billed charges",3707.83,32.2,,2966.26,,,0,"percent of total billed charges","32.2% of total billed charges",3592.68,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1973.21,17.136,,1578.57,,,0,"percent of total billed charges","17.136% of total billed charges",2514.88,21.84,,2011.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4341.16,37.7,,3472.93,,,0,"percent of total billed charges","37.7% of total billed charges",4341.16,37.7,,3472.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3903.59,33.9,,3122.87,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",8981.7,78,,7185.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9511.39,82.6,,7609.11,,,0,"percent of total billed charges","82.6% of total billed charges",1934.52,16.8,,1547.62,,,0,"percent of total billed charges","16.8% of total billed charges",5757.5,50,,4606.00,,,0,"percent of total billed charges","50% of total billed charges",9511.39,82.6,,7609.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1934.52,16.8,,1547.62,,,0,"percent of total billed charges","16.8% of total billed charges",11515,100,,9212.00,,,0,"percent of total billed charges","100% of total billed charges",1761.8,11515,
"GRAFT IFUSE BONE MEDIUM",ORSUP0193,CDM,278,RC,,,OUTPATIENT,,,33578,21825.7,,29548.64,88,,23638.91,,,0,"percent of total billed charges","88% of total billed charges",16789,50,,13431.20,,,0,"percent of total billed charges","50% of total billed charges",5641.1,16.8,,4512.88,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5810.34,17.304,,4648.27,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",21154.14,63,,16923.31,,,0,"percent of total billed charges","63% of total billed charges",5137.43,15.3,,4109.94,,,0,"percent of total billed charges","15.3% of total billed charges",5641.1,16.8,,4512.88,,,0,"percent of total billed charges","16.8% of total billed charges",23168.82,69,,,,,0,"fee schedule","69% of total billed charges",33578,100,,26862.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33578,100,,26862.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33578,100,,26862.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20767.99,61.85,,16614.39,,,0,"percent of total billed charges","61.5% of total billed charges",5641.1,16.8,,4512.88,,,0,"percent of total billed charges","16.8% of total billed charges",16789,50,,13431.20,,,0,"percent of total billed charges","50% of total billed charges",10812.12,32.2,,8649.70,,,0,"percent of total billed charges","32.2% of total billed charges",10476.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",5753.93,17.136,,4603.14,,,0,"percent of total billed charges","17.136% of total billed charges",7333.44,21.84,,5866.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",12658.91,37.7,,10127.13,,,0,"percent of total billed charges","37.7% of total billed charges",12658.91,37.7,,10127.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",11382.94,33.9,,9106.35,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",26190.84,78,,20952.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",27735.43,82.6,,22188.34,,,0,"percent of total billed charges","82.6% of total billed charges",5641.1,16.8,,4512.88,,,0,"percent of total billed charges","16.8% of total billed charges",16789,50,,13431.20,,,0,"percent of total billed charges","50% of total billed charges",27735.43,82.6,,22188.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5641.1,16.8,,4512.88,,,0,"percent of total billed charges","16.8% of total billed charges",33578,100,,26862.40,,,0,"percent of total billed charges","100% of total billed charges",4695,33578,
"GRAFIX PRIME DISC 16 MM",636Q413316,CDM,636,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.7% of total billed charges",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",907.84,33.9,,726.27,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"GRAFIX PRIME 2X3 CM",636Q413323,CDM,636,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.7% of total billed charges",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1997.39,33.9,,1597.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"GRAFIX PRIME 3X4 CM",636Q413334,CDM,636,RC,,,OUTPATIENT,,,6798,4418.7,,5982.24,88,,4785.79,,,0,"percent of total billed charges","88% of total billed charges",3399,50,,2719.20,,,0,"percent of total billed charges","50% of total billed charges",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1176.33,17.304,,941.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4282.74,63,,3426.19,,,0,"percent of total billed charges","63% of total billed charges",1040.09,15.3,,832.07,,,0,"percent of total billed charges","15.3% of total billed charges",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",4690.62,69,,,,,0,"fee schedule","69% of total billed charges",6798,100,,5438.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6798,100,,5438.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6798,100,,5438.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4204.56,61.85,,3363.65,,,0,"percent of total billed charges","61.5% of total billed charges",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",3399,50,,2719.20,,,0,"percent of total billed charges","50% of total billed charges",2188.96,32.2,,1751.17,,,0,"percent of total billed charges","32.2% of total billed charges",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1164.91,17.136,,931.93,,,0,"percent of total billed charges","17.136% of total billed charges",1484.68,21.84,,1187.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2562.85,37.7,,2050.28,,,0,"percent of total billed charges","37.7% of total billed charges",2562.85,37.7,,2050.28,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2304.52,33.9,,1843.62,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5302.44,78,,4241.95,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",3399,50,,2719.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",6798,100,,5438.40,,,0,"percent of total billed charges","100% of total billed charges",1040.09,6798,
"GRAFT GRACILIS D=5.5 L-280MM",ORSUP0037,CDM,278,RC,,,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1065.75,17.304,,852.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",942.33,15.3,,753.86,,,0,"percent of total billed charges","15.3% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3809.34,61.85,,3047.47,,,0,"percent of total billed charges","61.5% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1983.2,32.2,,1586.56,,,0,"percent of total billed charges","32.2% of total billed charges",1921.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1055.41,17.136,,844.33,,,0,"percent of total billed charges","17.136% of total billed charges",1345.13,21.84,,1076.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",942.33,6159,
"GRAFT VIVIGEN GRAFT",ORSUP0074,CDM,278,RC,,,OUTPATIENT,,,14997,9748.05,,13197.36,88,,10557.89,,,0,"percent of total billed charges","88% of total billed charges",7498.5,50,,5998.80,,,0,"percent of total billed charges","50% of total billed charges",2519.5,16.8,,2015.60,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2595.08,17.304,,2076.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9448.11,63,,7558.49,,,0,"percent of total billed charges","63% of total billed charges",2294.54,15.3,,1835.63,,,0,"percent of total billed charges","15.3% of total billed charges",2519.5,16.8,,2015.60,,,0,"percent of total billed charges","16.8% of total billed charges",10347.93,69,,,,,0,"fee schedule","69% of total billed charges",14997,100,,11997.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14997,100,,11997.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14997,100,,11997.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9275.64,61.85,,7420.51,,,0,"percent of total billed charges","61.5% of total billed charges",2519.5,16.8,,2015.60,,,0,"percent of total billed charges","16.8% of total billed charges",7498.5,50,,5998.80,,,0,"percent of total billed charges","50% of total billed charges",4829.03,32.2,,3863.22,,,0,"percent of total billed charges","32.2% of total billed charges",4679.06,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2569.89,17.136,,2055.91,,,0,"percent of total billed charges","17.136% of total billed charges",3275.34,21.84,,2620.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",5653.87,37.7,,4523.10,,,0,"percent of total billed charges","37.7% of total billed charges",5653.87,37.7,,4523.10,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",5083.98,33.9,,4067.18,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",11697.66,78,,9358.13,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12387.52,82.6,,9910.02,,,0,"percent of total billed charges","82.6% of total billed charges",2519.5,16.8,,2015.60,,,0,"percent of total billed charges","16.8% of total billed charges",7498.5,50,,5998.80,,,0,"percent of total billed charges","50% of total billed charges",12387.52,82.6,,9910.02,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2519.5,16.8,,2015.60,,,0,"percent of total billed charges","16.8% of total billed charges",14997,100,,11997.60,,,0,"percent of total billed charges","100% of total billed charges",2294.54,14997,
"GRAFT INFUSE BONE SMALL",ORSUP0096,CDM,278,RC,,,OUTPATIENT,,,23299,15144.35,,20503.12,88,,16402.50,,,0,"percent of total billed charges","88% of total billed charges",11649.5,50,,9319.60,,,0,"percent of total billed charges","50% of total billed charges",3914.23,16.8,,3131.38,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4031.66,17.304,,3225.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14678.37,63,,11742.70,,,0,"percent of total billed charges","63% of total billed charges",3564.75,15.3,,2851.80,,,0,"percent of total billed charges","15.3% of total billed charges",3914.23,16.8,,3131.38,,,0,"percent of total billed charges","16.8% of total billed charges",16076.31,69,,,,,0,"fee schedule","69% of total billed charges",23299,100,,18639.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23299,100,,18639.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23299,100,,18639.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14410.43,61.85,,11528.34,,,0,"percent of total billed charges","61.5% of total billed charges",3914.23,16.8,,3131.38,,,0,"percent of total billed charges","16.8% of total billed charges",11649.5,50,,9319.60,,,0,"percent of total billed charges","50% of total billed charges",7502.28,32.2,,6001.82,,,0,"percent of total billed charges","32.2% of total billed charges",7269.29,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3992.52,17.136,,3194.02,,,0,"percent of total billed charges","17.136% of total billed charges",5088.5,21.84,,4070.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",8783.72,37.7,,7026.98,,,0,"percent of total billed charges","37.7% of total billed charges",8783.72,37.7,,7026.98,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",7898.36,33.9,,6318.69,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",18173.22,78,,14538.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19244.97,82.6,,15395.98,,,0,"percent of total billed charges","82.6% of total billed charges",3914.23,16.8,,3131.38,,,0,"percent of total billed charges","16.8% of total billed charges",11649.5,50,,9319.60,,,0,"percent of total billed charges","50% of total billed charges",19244.97,82.6,,15395.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3914.23,16.8,,3131.38,,,0,"percent of total billed charges","16.8% of total billed charges",23299,100,,18639.20,,,0,"percent of total billed charges","100% of total billed charges",3564.75,23299,
"GRAFT INFUSE BONE LARGE",ORSUP0141,CDM,278,RC,,,OUTPATIENT,,,35350,22977.5,,31108,88,,24886.40,,,0,"percent of total billed charges","88% of total billed charges",17675,50,,14140.00,,,0,"percent of total billed charges","50% of total billed charges",5938.8,16.8,,4751.04,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6116.96,17.304,,4893.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22270.5,63,,17816.40,,,0,"percent of total billed charges","63% of total billed charges",5408.55,15.3,,4326.84,,,0,"percent of total billed charges","15.3% of total billed charges",5938.8,16.8,,4751.04,,,0,"percent of total billed charges","16.8% of total billed charges",24391.5,69,,,,,0,"fee schedule","69% of total billed charges",35350,100,,28280.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35350,100,,28280.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35350,100,,28280.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21863.98,61.85,,17491.18,,,0,"percent of total billed charges","61.5% of total billed charges",5938.8,16.8,,4751.04,,,0,"percent of total billed charges","16.8% of total billed charges",17675,50,,14140.00,,,0,"percent of total billed charges","50% of total billed charges",11382.7,32.2,,9106.16,,,0,"percent of total billed charges","32.2% of total billed charges",11029.2,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",6057.58,17.136,,4846.06,,,0,"percent of total billed charges","17.136% of total billed charges",7720.44,21.84,,6176.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",13326.95,37.7,,10661.56,,,0,"percent of total billed charges","37.7% of total billed charges",13326.95,37.7,,10661.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",11983.65,33.9,,9586.92,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",27573,78,,22058.40,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29199.1,82.6,,23359.28,,,0,"percent of total billed charges","82.6% of total billed charges",5938.8,16.8,,4751.04,,,0,"percent of total billed charges","16.8% of total billed charges",17675,50,,14140.00,,,0,"percent of total billed charges","50% of total billed charges",29199.1,82.6,,23359.28,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5938.8,16.8,,4751.04,,,0,"percent of total billed charges","16.8% of total billed charges",35350,100,,28280.00,,,0,"percent of total billed charges","100% of total billed charges",4695,35350,
"GRAFCO INFANT MEASURING TAPE PAPER 36IN",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"GRAFIX PL PRIME 3X3 CM",636Q4133PL33,CDM,636,RC,,,OUTPATIENT,,,6180,4017,,5438.4,88,,4350.72,,,0,"percent of total billed charges","88% of total billed charges",3090,50,,2472.00,,,0,"percent of total billed charges","50% of total billed charges",1038.24,16.8,,830.59,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1069.39,17.304,,855.51,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3893.4,63,,3114.72,,,0,"percent of total billed charges","63% of total billed charges",945.54,15.3,,756.43,,,0,"percent of total billed charges","15.3% of total billed charges",1038.24,16.8,,830.59,,,0,"percent of total billed charges","16.8% of total billed charges",4264.2,69,,,,,0,"fee schedule","69% of total billed charges",6180,100,,4944.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6180,100,,4944.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6180,100,,4944.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3822.33,61.85,,3057.86,,,0,"percent of total billed charges","61.5% of total billed charges",1038.24,16.8,,830.59,,,0,"percent of total billed charges","16.8% of total billed charges",3090,50,,2472.00,,,0,"percent of total billed charges","50% of total billed charges",1989.96,32.2,,1591.97,,,0,"percent of total billed charges","32.2% of total billed charges",1038.24,16.8,,830.59,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1059,17.136,,847.20,,,0,"percent of total billed charges","17.136% of total billed charges",1349.71,21.84,,1079.77,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2329.86,37.7,,1863.89,,,0,"percent of total billed charges","37.7% of total billed charges",2329.86,37.7,,1863.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2095.02,33.9,,1676.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820.4,78,,3856.32,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1038.24,16.8,,830.59,,,0,"percent of total billed charges","16.8% of total billed charges",3090,50,,2472.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1038.24,16.8,,830.59,,,0,"percent of total billed charges","16.8% of total billed charges",6180,100,,4944.00,,,0,"percent of total billed charges","100% of total billed charges",945.54,6180,
"GRAFIX PL PRIME 3X4 CM",636Q4133PL34,CDM,636,RC,,,OUTPATIENT,,,6798,4418.7,,5982.24,88,,4785.79,,,0,"percent of total billed charges","88% of total billed charges",3399,50,,2719.20,,,0,"percent of total billed charges","50% of total billed charges",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1176.33,17.304,,941.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4282.74,63,,3426.19,,,0,"percent of total billed charges","63% of total billed charges",1040.09,15.3,,832.07,,,0,"percent of total billed charges","15.3% of total billed charges",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",4690.62,69,,,,,0,"fee schedule","69% of total billed charges",6798,100,,5438.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6798,100,,5438.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6798,100,,5438.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4204.56,61.85,,3363.65,,,0,"percent of total billed charges","61.5% of total billed charges",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",3399,50,,2719.20,,,0,"percent of total billed charges","50% of total billed charges",2188.96,32.2,,1751.17,,,0,"percent of total billed charges","32.2% of total billed charges",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1164.91,17.136,,931.93,,,0,"percent of total billed charges","17.136% of total billed charges",1484.68,21.84,,1187.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2562.85,37.7,,2050.28,,,0,"percent of total billed charges","37.7% of total billed charges",2562.85,37.7,,2050.28,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2304.52,33.9,,1843.62,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5302.44,78,,4241.95,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",3399,50,,2719.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",6798,100,,5438.40,,,0,"percent of total billed charges","100% of total billed charges",1040.09,6798,
"GRAFIX PL PRIME DISC 16 MM",636Q4133PL16,CDM,636,RC,,,OUTPATIENT,,,2472,1606.8,,2175.36,88,,1740.29,,,0,"percent of total billed charges","88% of total billed charges",1236,50,,988.80,,,0,"percent of total billed charges","50% of total billed charges",415.3,16.8,,332.24,,,0,"percent of total billed charges","16.8% of total billed charges",2472,100,,1977.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",427.75,17.304,,342.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1557.36,63,,1245.89,,,0,"percent of total billed charges","63% of total billed charges",378.22,15.3,,302.58,,,0,"percent of total billed charges","15.3% of total billed charges",415.3,16.8,,332.24,,,0,"percent of total billed charges","16.8% of total billed charges",1705.68,69,,,,,0,"fee schedule","69% of total billed charges",2472,100,,1977.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2472,100,,1977.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2472,100,,1977.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1528.93,61.85,,1223.14,,,0,"percent of total billed charges","61.5% of total billed charges",415.3,16.8,,332.24,,,0,"percent of total billed charges","16.8% of total billed charges",1236,50,,988.80,,,0,"percent of total billed charges","50% of total billed charges",795.98,32.2,,636.78,,,0,"percent of total billed charges","32.2% of total billed charges",415.3,16.8,,332.24,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",423.6,17.136,,338.88,,,0,"percent of total billed charges","17.136% of total billed charges",539.88,21.84,,431.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",931.94,37.7,,745.55,,,0,"percent of total billed charges","37.7% of total billed charges",931.94,37.7,,745.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",838.01,33.9,,670.41,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1928.16,78,,1542.53,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",415.3,16.8,,332.24,,,0,"percent of total billed charges","16.8% of total billed charges",1236,50,,988.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",415.3,16.8,,332.24,,,0,"percent of total billed charges","16.8% of total billed charges",2472,100,,1977.60,,,0,"percent of total billed charges","100% of total billed charges",378.22,2472,
"GRAFIX PL XC 5X5",636Q4100PLXC55,CDM,636,RC,,,OUTPATIENT,,,13390,8703.5,,11783.2,88,,9426.56,,,0,"percent of total billed charges","88% of total billed charges",6695,50,,5356.00,,,0,"percent of total billed charges","50% of total billed charges",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2317.01,17.304,,1853.61,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8435.7,63,,6748.56,,,0,"percent of total billed charges","63% of total billed charges",2048.67,15.3,,1638.94,,,0,"percent of total billed charges","15.3% of total billed charges",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",9239.1,69,,,,,0,"fee schedule","69% of total billed charges",13390,100,,10712.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13390,100,,10712.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13390,100,,10712.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8281.72,61.85,,6625.38,,,0,"percent of total billed charges","61.5% of total billed charges",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",6695,50,,5356.00,,,0,"percent of total billed charges","50% of total billed charges",4311.58,32.2,,3449.26,,,0,"percent of total billed charges","32.2% of total billed charges",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2294.51,17.136,,1835.61,,,0,"percent of total billed charges","17.136% of total billed charges",2924.38,21.84,,2339.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",5048.03,37.7,,4038.42,,,0,"percent of total billed charges","37.7% of total billed charges",5048.03,37.7,,4038.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4539.21,33.9,,3631.37,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",10444.2,78,,8355.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",6695,50,,5356.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",13390,100,,10712.00,,,0,"percent of total billed charges","100% of total billed charges",2048.67,13390,
"GRAFIX PL PRIME 5X5 CM",636Q4133PL55,CDM,636,RC,,,OUTPATIENT,,,13390,8703.5,,11783.2,88,,9426.56,,,0,"percent of total billed charges","88% of total billed charges",6695,50,,5356.00,,,0,"percent of total billed charges","50% of total billed charges",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2317.01,17.304,,1853.61,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8435.7,63,,6748.56,,,0,"percent of total billed charges","63% of total billed charges",2048.67,15.3,,1638.94,,,0,"percent of total billed charges","15.3% of total billed charges",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",9239.1,69,,,,,0,"fee schedule","69% of total billed charges",13390,100,,10712.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13390,100,,10712.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13390,100,,10712.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8281.72,61.85,,6625.38,,,0,"percent of total billed charges","61.5% of total billed charges",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",6695,50,,5356.00,,,0,"percent of total billed charges","50% of total billed charges",4311.58,32.2,,3449.26,,,0,"percent of total billed charges","32.2% of total billed charges",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2294.51,17.136,,1835.61,,,0,"percent of total billed charges","17.136% of total billed charges",2924.38,21.84,,2339.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",5048.03,37.7,,4038.42,,,0,"percent of total billed charges","37.7% of total billed charges",5048.03,37.7,,4038.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4539.21,33.9,,3631.37,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",10444.2,78,,8355.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",6695,50,,5356.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",13390,100,,10712.00,,,0,"percent of total billed charges","100% of total billed charges",2048.67,13390,
"GRAM DECOLORIZER",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION CRYSTAL VIOLET",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"GRAM IODINE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"GRAM SAFRANIN",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"STOCKNG TED THIGH SM LNG",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"GRASPER SUT 30 DEGREE 1/EA",ORSUP0023,CDM,272,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"GRASPER 5MM FUNDUS",408634,CDM,272,RC,,,OUTPATIENT,,,3875,2518.75,,3410,88,,2728.00,,,0,"percent of total billed charges","88% of total billed charges",1937.5,50,,1550.00,,,0,"percent of total billed charges","50% of total billed charges",651,16.8,,520.80,,,0,"percent of total billed charges","16.8% of total billed charges",3875,100,,3100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670.53,17.304,,536.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2441.25,63,,1953.00,,,0,"percent of total billed charges","63% of total billed charges",592.88,15.3,,474.30,,,0,"percent of total billed charges","15.3% of total billed charges",651,16.8,,520.80,,,0,"percent of total billed charges","16.8% of total billed charges",2673.75,69,,,,,0,"fee schedule","69% of total billed charges",3875,100,,3100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3875,100,,3100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3875,100,,3100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2396.69,61.85,,1917.35,,,0,"percent of total billed charges","61.5% of total billed charges",651,16.8,,520.80,,,0,"percent of total billed charges","16.8% of total billed charges",1937.5,50,,1550.00,,,0,"percent of total billed charges","50% of total billed charges",1247.75,32.2,,998.20,,,0,"percent of total billed charges","32.2% of total billed charges",651,16.8,,520.80,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",664.02,17.136,,531.22,,,0,"percent of total billed charges","17.136% of total billed charges",846.3,21.84,,677.04,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1460.88,37.7,,1168.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3022.5,78,,2418.00,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3200.75,82.6,,2560.60,,,0,"percent of total billed charges","82.6% of total billed charges",651,16.8,,520.80,,,0,"percent of total billed charges","16.8% of total billed charges",1937.5,50,,1550.00,,,0,"percent of total billed charges","50% of total billed charges",3200.75,82.6,,2560.60,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",651,16.8,,520.80,,,0,"percent of total billed charges","16.8% of total billed charges",3875,100,,3100.00,,,0,"percent of total billed charges","100% of total billed charges",592.88,3875,
"GRASPER CROCODILE 5MM DA VINCI",337817,CDM,272,RC,,,OUTPATIENT,,,3689,2397.85,,3246.32,88,,2597.06,,,0,"percent of total billed charges","88% of total billed charges",1844.5,50,,1475.60,,,0,"percent of total billed charges","50% of total billed charges",619.75,16.8,,495.80,,,0,"percent of total billed charges","16.8% of total billed charges",3689,100,,2951.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",638.34,17.304,,510.67,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2324.07,63,,1859.26,,,0,"percent of total billed charges","63% of total billed charges",564.42,15.3,,451.54,,,0,"percent of total billed charges","15.3% of total billed charges",619.75,16.8,,495.80,,,0,"percent of total billed charges","16.8% of total billed charges",2545.41,69,,,,,0,"fee schedule","69% of total billed charges",3689,100,,2951.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3689,100,,2951.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3689,100,,2951.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2281.65,61.85,,1825.32,,,0,"percent of total billed charges","61.5% of total billed charges",619.75,16.8,,495.80,,,0,"percent of total billed charges","16.8% of total billed charges",1844.5,50,,1475.60,,,0,"percent of total billed charges","50% of total billed charges",1187.86,32.2,,950.29,,,0,"percent of total billed charges","32.2% of total billed charges",619.75,16.8,,495.80,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",632.15,17.136,,505.72,,,0,"percent of total billed charges","17.136% of total billed charges",805.68,21.84,,644.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1390.75,37.7,,1112.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2877.42,78,,2301.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3047.11,82.6,,2437.69,,,0,"percent of total billed charges","82.6% of total billed charges",619.75,16.8,,495.80,,,0,"percent of total billed charges","16.8% of total billed charges",1844.5,50,,1475.60,,,0,"percent of total billed charges","50% of total billed charges",3047.11,82.6,,2437.69,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",619.75,16.8,,495.80,,,0,"percent of total billed charges","16.8% of total billed charges",3689,100,,2951.20,,,0,"percent of total billed charges","100% of total billed charges",564.42,3689,
"GRASPER ENDOWRIST PROGRASP DA VINCI",173496,CDM,272,RC,,,OUTPATIENT,,,11204,7282.6,,9859.52,88,,7887.62,,,0,"percent of total billed charges","88% of total billed charges",5602,50,,4481.60,,,0,"percent of total billed charges","50% of total billed charges",1882.27,16.8,,1505.82,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1938.74,17.304,,1550.99,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7058.52,63,,5646.82,,,0,"percent of total billed charges","63% of total billed charges",1714.21,15.3,,1371.37,,,0,"percent of total billed charges","15.3% of total billed charges",1882.27,16.8,,1505.82,,,0,"percent of total billed charges","16.8% of total billed charges",7730.76,69,,,,,0,"fee schedule","69% of total billed charges",11204,100,,8963.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11204,100,,8963.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11204,100,,8963.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6929.67,61.85,,5543.74,,,0,"percent of total billed charges","61.5% of total billed charges",1882.27,16.8,,1505.82,,,0,"percent of total billed charges","16.8% of total billed charges",5602,50,,4481.60,,,0,"percent of total billed charges","50% of total billed charges",3607.69,32.2,,2886.15,,,0,"percent of total billed charges","32.2% of total billed charges",1882.27,16.8,,1505.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1919.92,17.136,,1535.94,,,0,"percent of total billed charges","17.136% of total billed charges",2446.95,21.84,,1957.56,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4223.91,37.7,,3379.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8739.12,78,,6991.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9254.5,82.6,,7403.60,,,0,"percent of total billed charges","82.6% of total billed charges",1882.27,16.8,,1505.82,,,0,"percent of total billed charges","16.8% of total billed charges",5602,50,,4481.60,,,0,"percent of total billed charges","50% of total billed charges",9254.5,82.6,,7403.60,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1882.27,16.8,,1505.82,,,0,"percent of total billed charges","16.8% of total billed charges",11204,100,,8963.20,,,0,"percent of total billed charges","100% of total billed charges",1714.21,11204,
"GRASPER LAP SHORT ATRAUMATIC",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"GRASPER DELTA WIRE 3.2 FR",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"GRASPER CLUTCH , MINILAP",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"GRASPER ALLIGATOR , MINILAP",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"GRASPER TIP LONG FENESTRATED",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"GRFT VASCULAR L1INXW1IN FLT STRL",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"GUARDIVA CHG PATCH 1.5MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"GUARDIVA CHG PATCH 7.0MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"GUIDE PIN 2.5MM DIA W/THREAD 230MM LENGTH",ORSUP0004,CDM,278,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.7% of total billed charges",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.85,33.9,,72.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"GUIDE WIRE 2.8MM",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"GUIDE WIRE NON-THREADED 2.0MM X 230MM",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,17.304,,49.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.28,61.85,,178.62,,,0,"percent of total billed charges","61.5% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",116.24,32.2,,92.99,,,0,"percent of total billed charges","32.2% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.86,17.136,,49.49,,,0,"percent of total billed charges","17.136% of total billed charges",78.84,21.84,,63.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.7% of total billed charges",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",122.38,33.9,,97.90,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,361,
"GUIDEWIRE CALIBRATED 3.2MM 300MM",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"GUIDEWIRE ALL STAR .014",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"GUIDEWIRE HT PILOT.014X300CM",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"GUIDEWIRE PILOT 50 300CM",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"GUIDEWIRE PILOT 200 300CM",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"GUIDEWIRE ASAHI MIRACLE BROS 6 300CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"GUIDEWIRE ASAHI CONFIANZA .014 X 300 CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"GUIDEWIRE FIELDER XT 300CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"GUIDEWIRE ASAHI MIRACLE BROS 12 300CM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"GUIDEWIRE ASAHI CONFIANZA PRO 9 300CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"GUIDE WIRE SUPER STIFF .035 /260",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"GUIDEWIRE BENTSON STRAIGHT 0.35",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"GUIDEWIRE HYDROPHILIC",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"GUIDEWIRE BENTSON",ORSUP0002,CDM,278,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.7% of total billed charges",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.43,33.9,,36.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"GUIDE WIRE PROWATER FLEX 180CM",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"GUIDEWIRE FIXED J .025 X 150CM",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"GUIDEWIRE RUNTHROUGH NS 0.014DIA 180CM",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"GUIDEWIRE STIFF STRAIGHT .035X45",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"GUIDEWIRE HYDRA JAGWIRE",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"GUIDEWIRE .025/450 JAGWIRE",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"GUIDEWIRE 300CM HITORQ",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"GUIDEWIRE ROTABLATOR .014",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"GUIDE EXTENSION GUIDEZILLA 6F",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",751.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.7% of total billed charges",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",816.99,33.9,,653.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"GUIDEWIRE PRESSURE VERRATA 300CM J-TIP",ORSUP0025,CDM,278,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",1169.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.7% of total billed charges",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.91,33.9,,1016.73,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"GUIDEWIRE TAD II 260CM",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"GUIDEWIRE TIGER 300CM",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"GUIDEWIRE VASC 200CM VIPER DIAMONDBACK",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"GUIDEWIRE VASC VIPERWIRE FLEX .014 TIP",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"GUIDE SOFT TISSUE 2.0/2.5",ORSUP0018,CDM,272,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"GUIDE PIN DRILL TIP 3.5MM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"GUIDE WIRE BALL TIP",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"GUIDEWIRE J-WIRE .018 X 145CM",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"GUIDEWIRE STIFF SHAFT .035 150",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"GUIDE WIRE 900.721 NON-THREAD",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"GUIDEWIRE AMPLATZ 0.35 145CM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"GUIDEWIRE LEVEL 7",CATH00067,CDM,272,RC,,,OUTPATIENT,,,2372,1541.8,,2087.36,88,,1669.89,,,0,"percent of total billed charges","88% of total billed charges",1186,50,,948.80,,,0,"percent of total billed charges","50% of total billed charges",398.5,16.8,,318.80,,,0,"percent of total billed charges","16.8% of total billed charges",2372,100,,1897.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",410.45,17.304,,328.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1494.36,63,,1195.49,,,0,"percent of total billed charges","63% of total billed charges",362.92,15.3,,290.34,,,0,"percent of total billed charges","15.3% of total billed charges",398.5,16.8,,318.80,,,0,"percent of total billed charges","16.8% of total billed charges",1636.68,69,,,,,0,"fee schedule","69% of total billed charges",2372,100,,1897.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2372,100,,1897.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2372,100,,1897.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1467.08,61.85,,1173.66,,,0,"percent of total billed charges","61.5% of total billed charges",398.5,16.8,,318.80,,,0,"percent of total billed charges","16.8% of total billed charges",1186,50,,948.80,,,0,"percent of total billed charges","50% of total billed charges",763.78,32.2,,611.02,,,0,"percent of total billed charges","32.2% of total billed charges",398.5,16.8,,318.80,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",406.47,17.136,,325.18,,,0,"percent of total billed charges","17.136% of total billed charges",518.04,21.84,,414.43,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",894.24,37.7,,715.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1850.16,78,,1480.13,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1959.27,82.6,,1567.42,,,0,"percent of total billed charges","82.6% of total billed charges",398.5,16.8,,318.80,,,0,"percent of total billed charges","16.8% of total billed charges",1186,50,,948.80,,,0,"percent of total billed charges","50% of total billed charges",1959.27,82.6,,1567.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",398.5,16.8,,318.80,,,0,"percent of total billed charges","16.8% of total billed charges",2372,100,,1897.60,,,0,"percent of total billed charges","100% of total billed charges",362.92,2372,
"GUIDE SHEATH A-KIT SLENDER 10CM",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"GUIDWIRE VASCULAR J TIP .025  PTFE COATED 150CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"GUIDEWIRE PILOT 50 0.014' X 300CM J",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"GUIDEWIRE HI TOURQUE",ORSUP0003,CDM,278,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.7% of total billed charges",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.43,33.9,,36.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"GUIDEWIRE 300CM HITORQ STRAIGHT TIP",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"GUIDEWIRE W/TROCAR TIP 2.35MM X 200MM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"GUIDEWIRE COPE 60CM 0.018",ORSUP0004,CDM,278,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.7% of total billed charges",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.85,33.9,,72.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"GUIDEWIRE COBRA 1 5FR X 90CM SOFT-VU",ORSUP0003,CDM,278,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.7% of total billed charges",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.14,33.9,,54.51,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"GUIDEWIRE VIPER WIRE 0.014 X 335CM",ORSUP0028,CDM,278,RC,,,OUTPATIENT,,,4553,2959.45,,4006.64,88,,3205.31,,,0,"percent of total billed charges","88% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",787.85,17.304,,630.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2868.39,63,,2294.71,,,0,"percent of total billed charges","63% of total billed charges",696.61,15.3,,557.29,,,0,"percent of total billed charges","15.3% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",3141.57,69,,,,,0,"fee schedule","69% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2816.03,61.85,,2252.82,,,0,"percent of total billed charges","61.5% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",1466.07,32.2,,1172.86,,,0,"percent of total billed charges","32.2% of total billed charges",1420.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",780.2,17.136,,624.16,,,0,"percent of total billed charges","17.136% of total billed charges",994.38,21.84,,795.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.7% of total billed charges",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1543.47,33.9,,1234.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3551.34,78,,2841.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",696.61,4553,
"GUIDEWIRE AMPLATZ .035 X 80",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"GUIDEWIRE FATHOM 14 STRIAGHT 200CMX10CM",ORSUP0018,CDM,278,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",605.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.7% of total billed charges",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",658.34,33.9,,526.67,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"GUIDEWIRE FATHOM 14 STRAIGHT 300CMX10CM",ORSUP0018,CDM,278,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",605.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.7% of total billed charges",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",658.34,33.9,,526.67,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"GUIDEWIRE HI-TORQUE 190CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"GUIDEWIRE HI-TORQUE PILOT 50 190CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"GUIDEWIRE STRAIGHT TIP SHORT TAPER",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"GUIDEWIRE PTCA MIRACLEBROS 300",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"GUIDEWIRE PTCA MIRABLEBROS 300CM X 0.014CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"GUIDEWIRE HI TORQUE IRON MAN 190CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"GUIDEWIRE CLOSUREFAST DOUBLE ENDED 150CM",ORSUP0002,CDM,278,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.7% of total billed charges",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.43,33.9,,36.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"GUIDEWIRE MAILMAN STRAIGHT CATH 0.014 X 182CM",ORSUP0021,CDM,278,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",835.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.7% of total billed charges",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",907.84,33.9,,726.27,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"GUIDEWIRE J-TIP .035 175CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"GUIDEWIRE J-TIP .035 260CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"GUIDEWIRE J-TIP .035 150CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"GUIDEWIRE V-14 018X300CM SHORT TAPER STR TIP",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"GUIDEWIRE NITREX V04 80CM",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"GUIDEWIRE HYDROPHILIC UNIGLIDE .018 X 260CM",ORSUP0002,CDM,278,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.7% of total billed charges",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.43,33.9,,36.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"GUIDEWIRE MICRO HYDROPHILIC COATING .014 X 13.5CM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"GUIDEWIRE ASAHI MIRABLE BROS 12 190CM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"GUIDEWIRE J 035X180CM",ORSUP0002,CDM,278,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.7% of total billed charges",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.43,33.9,,36.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"GUIDEWIRE HIGH-TORQUE PILOT 014X190CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"GUIDEWIRE HIGH-TORQUE COMMAND ES WIRE 014X300CM",ORSUP0025,CDM,278,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",1169.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.7% of total billed charges",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.91,33.9,,1016.73,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"GUIDEWIRE VNUS 025 X 260CM",ORSUP0002,CDM,278,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.7% of total billed charges",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.43,33.9,,36.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"GUIDEWIRE ROADRUNNER 0.014 X 300CM",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"GUIDEWIRE CTO 25GA .014 X 300CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,824,535.6,,725.12,88,,580.10,,,0,"percent of total billed charges","88% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.58,17.304,,114.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",519.12,63,,415.30,,,0,"percent of total billed charges","63% of total billed charges",126.07,15.3,,100.86,,,0,"percent of total billed charges","15.3% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",568.56,69,,,,,0,"fee schedule","69% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.64,61.85,,407.71,,,0,"percent of total billed charges","61.5% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",265.33,32.2,,212.26,,,0,"percent of total billed charges","32.2% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",141.2,17.136,,112.96,,,0,"percent of total billed charges","17.136% of total billed charges",179.96,21.84,,143.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",310.65,37.7,,248.52,,,0,"percent of total billed charges","37.7% of total billed charges",310.65,37.7,,248.52,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",279.34,33.9,,223.47,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.72,78,,514.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",126.07,824,
"GUIDEWIRE CTO 18GA .014 X 300CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,824,535.6,,725.12,88,,580.10,,,0,"percent of total billed charges","88% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.58,17.304,,114.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",519.12,63,,415.30,,,0,"percent of total billed charges","63% of total billed charges",126.07,15.3,,100.86,,,0,"percent of total billed charges","15.3% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",568.56,69,,,,,0,"fee schedule","69% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.64,61.85,,407.71,,,0,"percent of total billed charges","61.5% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",265.33,32.2,,212.26,,,0,"percent of total billed charges","32.2% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",141.2,17.136,,112.96,,,0,"percent of total billed charges","17.136% of total billed charges",179.96,21.84,,143.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",310.65,37.7,,248.52,,,0,"percent of total billed charges","37.7% of total billed charges",310.65,37.7,,248.52,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",279.34,33.9,,223.47,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.72,78,,514.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",126.07,824,
"GUIDEWIRE AMPLATZ STIFF 035 X 260CM",ORSUP0002,CDM,278,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.7% of total billed charges",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.43,33.9,,36.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"GUIDEWIRE AMPLATZ035 X 300CM",ORSUP0004,CDM,278,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.7% of total billed charges",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.85,33.9,,72.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"GUIDEWIRE MARKED TIP REUSABLE TIP 210CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.94,17.304,,85.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.23,61.85,,305.78,,,0,"percent of total billed charges","61.5% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",199,32.2,,159.20,,,0,"percent of total billed charges","32.2% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.136,,84.72,,,0,"percent of total billed charges","17.136% of total billed charges",134.97,21.84,,107.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.7% of total billed charges",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.5,33.9,,167.60,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,618,
"GUIDEWIRE BENTSON 035 X 145",ORSUP0002,CDM,278,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.7% of total billed charges",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.92,33.9,,27.94,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"GUIDEWIRE 0.035 X 175CM J-TIP",ORSUP0002,CDM,278,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.7% of total billed charges",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.92,33.9,,27.94,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"GYNEMESH PS SOFT MESH",ORSUP0026,CDM,278,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",1253.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.7% of total billed charges",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1361.76,33.9,,1089.41,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"GYRUS SCISSOR",ORSUP0009,CDM,270,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"H-S PARTIAL 90 DEG ROUND OFFSET",ORSUP0027,CDM,278,RC,,,OUTPATIENT,,,3296,2142.4,,2900.48,88,,2320.38,,,0,"percent of total billed charges","88% of total billed charges",1648,50,,1318.40,,,0,"percent of total billed charges","50% of total billed charges",553.73,16.8,,442.98,,,0,"percent of total billed charges","16.8% of total billed charges",3296,100,,2636.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",570.34,17.304,,456.27,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2076.48,63,,1661.18,,,0,"percent of total billed charges","63% of total billed charges",504.29,15.3,,403.43,,,0,"percent of total billed charges","15.3% of total billed charges",553.73,16.8,,442.98,,,0,"percent of total billed charges","16.8% of total billed charges",2274.24,69,,,,,0,"fee schedule","69% of total billed charges",3296,100,,2636.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3296,100,,2636.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3296,100,,2636.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2038.58,61.85,,1630.86,,,0,"percent of total billed charges","61.5% of total billed charges",553.73,16.8,,442.98,,,0,"percent of total billed charges","16.8% of total billed charges",1648,50,,1318.40,,,0,"percent of total billed charges","50% of total billed charges",1061.31,32.2,,849.05,,,0,"percent of total billed charges","32.2% of total billed charges",1028.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",564.8,17.136,,451.84,,,0,"percent of total billed charges","17.136% of total billed charges",719.85,21.84,,575.88,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1242.59,37.7,,994.07,,,0,"percent of total billed charges","37.7% of total billed charges",1242.59,37.7,,994.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1117.34,33.9,,893.87,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2570.88,78,,2056.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2722.5,82.6,,2178.00,,,0,"percent of total billed charges","82.6% of total billed charges",553.73,16.8,,442.98,,,0,"percent of total billed charges","16.8% of total billed charges",1648,50,,1318.40,,,0,"percent of total billed charges","50% of total billed charges",2722.5,82.6,,2178.00,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.73,16.8,,442.98,,,0,"percent of total billed charges","16.8% of total billed charges",3296,100,,2636.80,,,0,"percent of total billed charges","100% of total billed charges",504.29,3296,
"H/A PARTIAL 90 DEG SQUARE",ORSUP0026,CDM,278,RC,,,OUTPATIENT,,,3090,2008.5,,2719.2,88,,2175.36,,,0,"percent of total billed charges","88% of total billed charges",1545,50,,1236.00,,,0,"percent of total billed charges","50% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",534.69,17.304,,427.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1946.7,63,,1557.36,,,0,"percent of total billed charges","63% of total billed charges",472.77,15.3,,378.22,,,0,"percent of total billed charges","15.3% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",2132.1,69,,,,,0,"fee schedule","69% of total billed charges",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1911.17,61.85,,1528.94,,,0,"percent of total billed charges","61.5% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",1545,50,,1236.00,,,0,"percent of total billed charges","50% of total billed charges",994.98,32.2,,795.98,,,0,"percent of total billed charges","32.2% of total billed charges",964.08,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",529.5,17.136,,423.60,,,0,"percent of total billed charges","17.136% of total billed charges",674.86,21.84,,539.89,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1164.93,37.7,,931.94,,,0,"percent of total billed charges","37.7% of total billed charges",1164.93,37.7,,931.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1047.51,33.9,,838.01,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410.2,78,,1928.16,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2552.34,82.6,,2041.87,,,0,"percent of total billed charges","82.6% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",1545,50,,1236.00,,,0,"percent of total billed charges","50% of total billed charges",2552.34,82.6,,2041.87,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",472.77,3090,
"HAEMOPHILUS INFLUENZAE ATCC CULTI LOOPS 33533",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"HANDLE LARYNGOSCOPE LED REUSABLE",483466,CDM,272,RC,,,OUTPATIENT,,,1006,653.9,,885.28,88,,708.22,,,0,"percent of total billed charges","88% of total billed charges",503,50,,402.40,,,0,"percent of total billed charges","50% of total billed charges",169.01,16.8,,135.21,,,0,"percent of total billed charges","16.8% of total billed charges",1006,100,,804.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",174.08,17.304,,139.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",633.78,63,,507.02,,,0,"percent of total billed charges","63% of total billed charges",153.92,15.3,,123.14,,,0,"percent of total billed charges","15.3% of total billed charges",169.01,16.8,,135.21,,,0,"percent of total billed charges","16.8% of total billed charges",694.14,69,,,,,0,"fee schedule","69% of total billed charges",1006,100,,804.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1006,100,,804.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1006,100,,804.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",622.21,61.85,,497.77,,,0,"percent of total billed charges","61.5% of total billed charges",169.01,16.8,,135.21,,,0,"percent of total billed charges","16.8% of total billed charges",503,50,,402.40,,,0,"percent of total billed charges","50% of total billed charges",323.93,32.2,,259.14,,,0,"percent of total billed charges","32.2% of total billed charges",169.01,16.8,,135.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",172.39,17.136,,137.91,,,0,"percent of total billed charges","17.136% of total billed charges",219.71,21.84,,175.77,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",379.26,37.7,,303.41,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",784.68,78,,627.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",830.96,82.6,,664.77,,,0,"percent of total billed charges","82.6% of total billed charges",169.01,16.8,,135.21,,,0,"percent of total billed charges","16.8% of total billed charges",503,50,,402.40,,,0,"percent of total billed charges","50% of total billed charges",830.96,82.6,,664.77,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",169.01,16.8,,135.21,,,0,"percent of total billed charges","16.8% of total billed charges",1006,100,,804.80,,,0,"percent of total billed charges","100% of total billed charges",153.92,1006,
"HANDLE SUCTION YANKAUER W/ BULB TIP",10343,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"HAND CONTROLLER ACIST",431981,CDM,270,RC,,,OUTPATIENT,,,2314,1504.1,,2036.32,88,,1629.06,,,0,"percent of total billed charges","88% of total billed charges",1157,50,,925.60,,,0,"percent of total billed charges","50% of total billed charges",388.75,16.8,,311.00,,,0,"percent of total billed charges","16.8% of total billed charges",2314,100,,1851.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",400.41,17.304,,320.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1457.82,63,,1166.26,,,0,"percent of total billed charges","63% of total billed charges",354.04,15.3,,283.23,,,0,"percent of total billed charges","15.3% of total billed charges",388.75,16.8,,311.00,,,0,"percent of total billed charges","16.8% of total billed charges",1596.66,69,,,,,0,"fee schedule","69% of total billed charges",2314,100,,1851.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2314,100,,1851.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2314,100,,1851.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1431.21,61.85,,1144.97,,,0,"percent of total billed charges","61.5% of total billed charges",388.75,16.8,,311.00,,,0,"percent of total billed charges","16.8% of total billed charges",1157,50,,925.60,,,0,"percent of total billed charges","50% of total billed charges",745.11,32.2,,596.09,,,0,"percent of total billed charges","32.2% of total billed charges",388.75,16.8,,311.00,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",396.53,17.136,,317.22,,,0,"percent of total billed charges","17.136% of total billed charges",505.38,21.84,,404.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",872.38,37.7,,697.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1804.92,78,,1443.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1911.36,82.6,,1529.09,,,0,"percent of total billed charges","82.6% of total billed charges",388.75,16.8,,311.00,,,0,"percent of total billed charges","16.8% of total billed charges",1157,50,,925.60,,,0,"percent of total billed charges","50% of total billed charges",1911.36,82.6,,1529.09,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",388.75,16.8,,311.00,,,0,"percent of total billed charges","16.8% of total billed charges",2314,100,,1851.20,,,0,"percent of total billed charges","100% of total billed charges",354.04,2314,
"HAND DRAPE AURORA",277007,CDM,270,RC,,,OUTPATIENT,,,65,42.25,,57.2,88,,45.76,,,0,"percent of total billed charges","88% of total billed charges",32.5,50,,26.00,,,0,"percent of total billed charges","50% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.25,17.304,,9.00,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.95,63,,32.76,,,0,"percent of total billed charges","63% of total billed charges",9.95,15.3,,7.96,,,0,"percent of total billed charges","15.3% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",44.85,69,,,,,0,"fee schedule","69% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.2,61.85,,32.16,,,0,"percent of total billed charges","61.5% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",32.5,50,,26.00,,,0,"percent of total billed charges","50% of total billed charges",20.93,32.2,,16.74,,,0,"percent of total billed charges","32.2% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.14,17.136,,8.91,,,0,"percent of total billed charges","17.136% of total billed charges",14.2,21.84,,11.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.51,37.7,,19.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.7,78,,40.56,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",32.5,50,,26.00,,,0,"percent of total billed charges","50% of total billed charges",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",9.95,65,
"HANDLE HARMONIC ACE 36CM ERG",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"HANDLE GUIDE CATHETER SIDEKICK LOW PROFILE",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"HANDPIECE MARCELLATOR GYRUS",ORSUP0011,CDM,270,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"HANDPIECE GSU",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"HAND LOTION 4 OZ",490722,CDM,270,RC,,,OUTPATIENT,,,265,172.25,,233.2,88,,186.56,,,0,"percent of total billed charges","88% of total billed charges",132.5,50,,106.00,,,0,"percent of total billed charges","50% of total billed charges",44.52,16.8,,35.62,,,0,"percent of total billed charges","16.8% of total billed charges",265,100,,212.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.86,17.304,,36.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.95,63,,133.56,,,0,"percent of total billed charges","63% of total billed charges",40.55,15.3,,32.44,,,0,"percent of total billed charges","15.3% of total billed charges",44.52,16.8,,35.62,,,0,"percent of total billed charges","16.8% of total billed charges",182.85,69,,,,,0,"fee schedule","69% of total billed charges",265,100,,212.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",265,100,,212.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",265,100,,212.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",163.9,61.85,,131.12,,,0,"percent of total billed charges","61.5% of total billed charges",44.52,16.8,,35.62,,,0,"percent of total billed charges","16.8% of total billed charges",132.5,50,,106.00,,,0,"percent of total billed charges","50% of total billed charges",85.33,32.2,,68.26,,,0,"percent of total billed charges","32.2% of total billed charges",44.52,16.8,,35.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.41,17.136,,36.33,,,0,"percent of total billed charges","17.136% of total billed charges",57.88,21.84,,46.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",99.91,37.7,,79.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",206.7,78,,165.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",218.89,82.6,,175.11,,,0,"percent of total billed charges","82.6% of total billed charges",44.52,16.8,,35.62,,,0,"percent of total billed charges","16.8% of total billed charges",132.5,50,,106.00,,,0,"percent of total billed charges","50% of total billed charges",218.89,82.6,,175.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.52,16.8,,35.62,,,0,"percent of total billed charges","16.8% of total billed charges",265,100,,212.00,,,0,"percent of total billed charges","100% of total billed charges",40.55,265,
"HAND SKIN PROTECTANT OINTMENT 2.5 OZ",490723,CDM,270,RC,,,OUTPATIENT,,,58,37.7,,51.04,88,,40.83,,,0,"percent of total billed charges","88% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.04,17.304,,8.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.54,63,,29.23,,,0,"percent of total billed charges","63% of total billed charges",8.87,15.3,,7.10,,,0,"percent of total billed charges","15.3% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",40.02,69,,,,,0,"fee schedule","69% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.87,61.85,,28.70,,,0,"percent of total billed charges","61.5% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",18.68,32.2,,14.94,,,0,"percent of total billed charges","32.2% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.94,17.136,,7.95,,,0,"percent of total billed charges","17.136% of total billed charges",12.67,21.84,,10.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.87,37.7,,17.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",45.24,78,,36.19,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",8.87,58,
"HARMONIC HAND SWITCHING ADAPTOR",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"HARMONIC SCALPLE 36CM CVD WITH PISTOL HANKLE",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"HB CALIBRATOR",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"HBA1C REAGENT",ORSUP0041,CDM,272,RC,,,OUTPATIENT,,,8034,5222.1,,7069.92,88,,5655.94,,,0,"percent of total billed charges","88% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1390.2,17.304,,1112.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5061.42,63,,4049.14,,,0,"percent of total billed charges","63% of total billed charges",1229.2,15.3,,983.36,,,0,"percent of total billed charges","15.3% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",5543.46,69,,,,,0,"fee schedule","69% of total billed charges",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4969.03,61.85,,3975.22,,,0,"percent of total billed charges","61.5% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",2586.95,32.2,,2069.56,,,0,"percent of total billed charges","32.2% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1376.71,17.136,,1101.37,,,0,"percent of total billed charges","17.136% of total billed charges",1754.63,21.84,,1403.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3028.82,37.7,,2423.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6266.52,78,,5013.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6636.08,82.6,,5308.86,,,0,"percent of total billed charges","82.6% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",6636.08,82.6,,5308.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",1229.2,8034,
"HBA1C ADVANCED",ORSUP0046,CDM,272,RC,,,OUTPATIENT,,,9373,6092.45,,8248.24,88,,6598.59,,,0,"percent of total billed charges","88% of total billed charges",4686.5,50,,3749.20,,,0,"percent of total billed charges","50% of total billed charges",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1621.9,17.304,,1297.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5904.99,63,,4723.99,,,0,"percent of total billed charges","63% of total billed charges",1434.07,15.3,,1147.26,,,0,"percent of total billed charges","15.3% of total billed charges",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",6467.37,69,,,,,0,"fee schedule","69% of total billed charges",9373,100,,7498.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9373,100,,7498.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9373,100,,7498.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5797.2,61.85,,4637.76,,,0,"percent of total billed charges","61.5% of total billed charges",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",4686.5,50,,3749.20,,,0,"percent of total billed charges","50% of total billed charges",3018.11,32.2,,2414.49,,,0,"percent of total billed charges","32.2% of total billed charges",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1606.16,17.136,,1284.93,,,0,"percent of total billed charges","17.136% of total billed charges",2047.06,21.84,,1637.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3533.62,37.7,,2826.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7310.94,78,,5848.75,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7742.1,82.6,,6193.68,,,0,"percent of total billed charges","82.6% of total billed charges",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",4686.5,50,,3749.20,,,0,"percent of total billed charges","50% of total billed charges",7742.1,82.6,,6193.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",9373,100,,7498.40,,,0,"percent of total billed charges","100% of total billed charges",1434.07,9373,
"HBSAG CALIBRATOR",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"HCG CARDS TEST KIT",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"HEAD MOP MICROFIBER DISPOSABLE",190318,CDM,270,RC,,,OUTPATIENT,,,21,13.65,,18.48,88,,14.78,,,0,"percent of total billed charges","88% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.63,17.304,,2.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.23,63,,10.58,,,0,"percent of total billed charges","63% of total billed charges",3.21,15.3,,2.57,,,0,"percent of total billed charges","15.3% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",14.49,69,,,,,0,"fee schedule","69% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.99,61.85,,10.39,,,0,"percent of total billed charges","61.5% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",6.76,32.2,,5.41,,,0,"percent of total billed charges","32.2% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.6,17.136,,2.88,,,0,"percent of total billed charges","17.136% of total billed charges",4.59,21.84,,3.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.92,37.7,,6.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.38,78,,13.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",3.21,21,
"HEART VALVE A \\T\\ B",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"HEAT EXCHANGER FOR LEVEL 1",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"HEATER WIRE ADAPTERS 850",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.94,17.304,,85.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.23,61.85,,305.78,,,0,"percent of total billed charges","61.5% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",199,32.2,,159.20,,,0,"percent of total billed charges","32.2% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.136,,84.72,,,0,"percent of total billed charges","17.136% of total billed charges",134.97,21.84,,107.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,618,
"HEATED WIRE CIRCUIT BIPAP/CPAP",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"HEAT AND MOISTURE EXCHANGE ADULT STRIAGHT",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"HEGAR-BAUMGARTNER NEEDLE HOLDER 5-1/4",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"HEIMLICH VALVE",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,17.304,,49.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.28,61.85,,178.62,,,0,"percent of total billed charges","61.5% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",116.24,32.2,,92.99,,,0,"percent of total billed charges","32.2% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.86,17.136,,49.49,,,0,"percent of total billed charges","17.136% of total billed charges",78.84,21.84,,63.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,361,
"HELICAL STONE BASKET 3FR 5CM TIP",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"HELICAL STONE BASKET 3FR 14CM",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"HELIXED TRI-PORT 4.0 LIPO CANNULA",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,17.304,,49.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.28,61.85,,178.62,,,0,"percent of total billed charges","61.5% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",116.24,32.2,,92.99,,,0,"percent of total billed charges","32.2% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.86,17.136,,49.49,,,0,"percent of total billed charges","17.136% of total billed charges",78.84,21.84,,63.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,361,
"HEMA TK STN PK MDFD WRGHT GMS",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"HEMOCHRON CUVETTES TESTS",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"HEMOCONCENTRATOR PERFUSION PAK",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"HEMOSTASIS AVITENE 70 X 35MM",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"HEMOSPRAY ENDOSCOPY HEMOSTAT HEMO-7",ORSUP0067,CDM,272,RC,,,OUTPATIENT,,,13390,8703.5,,11783.2,88,,9426.56,,,0,"percent of total billed charges","88% of total billed charges",6695,50,,5356.00,,,0,"percent of total billed charges","50% of total billed charges",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2317.01,17.304,,1853.61,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8435.7,63,,6748.56,,,0,"percent of total billed charges","63% of total billed charges",2048.67,15.3,,1638.94,,,0,"percent of total billed charges","15.3% of total billed charges",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",9239.1,69,,,,,0,"fee schedule","69% of total billed charges",13390,100,,10712.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13390,100,,10712.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13390,100,,10712.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8281.72,61.85,,6625.38,,,0,"percent of total billed charges","61.5% of total billed charges",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",6695,50,,5356.00,,,0,"percent of total billed charges","50% of total billed charges",4311.58,32.2,,3449.26,,,0,"percent of total billed charges","32.2% of total billed charges",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2294.51,17.136,,1835.61,,,0,"percent of total billed charges","17.136% of total billed charges",2924.38,21.84,,2339.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5048.03,37.7,,4038.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10444.2,78,,8355.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11060.14,82.6,,8848.11,,,0,"percent of total billed charges","82.6% of total billed charges",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",6695,50,,5356.00,,,0,"percent of total billed charges","50% of total billed charges",11060.14,82.6,,8848.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",13390,100,,10712.00,,,0,"percent of total billed charges","100% of total billed charges",2048.67,13390,
"HEMOSIL SYNTHASIL REAGENT",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"HEMOSIL THROMBIN Q.F.A. REAG",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"HEMOSIL NORMAL CONTROL 1",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"HEMOSIL ABNORMAL CONTROL 3",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"HEMOSIL LOW FIBRINOGEN CONTROL",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"HEMOSIL CONTAINER WASTE",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"HEMOSIL CTS FILTER",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"HEMOCUE FECAL OCCULT BLOOD SLIDE TEST SYSTEM",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"HEMO LOK WECK ENDO 5MM CLIP APPLIER",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,17407,11314.55,,15318.16,88,,12254.53,,,0,"percent of total billed charges","88% of total billed charges",8703.5,50,,6962.80,,,0,"percent of total billed charges","50% of total billed charges",2924.38,16.8,,2339.50,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3012.11,17.304,,2409.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10966.41,63,,8773.13,,,0,"percent of total billed charges","63% of total billed charges",2663.27,15.3,,2130.62,,,0,"percent of total billed charges","15.3% of total billed charges",2924.38,16.8,,2339.50,,,0,"percent of total billed charges","16.8% of total billed charges",12010.83,69,,,,,0,"fee schedule","69% of total billed charges",17407,100,,13925.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17407,100,,13925.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17407,100,,13925.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10766.23,61.85,,8612.98,,,0,"percent of total billed charges","61.5% of total billed charges",2924.38,16.8,,2339.50,,,0,"percent of total billed charges","16.8% of total billed charges",8703.5,50,,6962.80,,,0,"percent of total billed charges","50% of total billed charges",5605.05,32.2,,4484.04,,,0,"percent of total billed charges","32.2% of total billed charges",2924.38,16.8,,2339.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2982.86,17.136,,2386.29,,,0,"percent of total billed charges","17.136% of total billed charges",3801.69,21.84,,3041.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6562.44,37.7,,5249.95,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13577.46,78,,10861.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14378.18,82.6,,11502.54,,,0,"percent of total billed charges","82.6% of total billed charges",2924.38,16.8,,2339.50,,,0,"percent of total billed charges","16.8% of total billed charges",8703.5,50,,6962.80,,,0,"percent of total billed charges","50% of total billed charges",14378.18,82.6,,11502.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2924.38,16.8,,2339.50,,,0,"percent of total billed charges","16.8% of total billed charges",17407,100,,13925.60,,,0,"percent of total billed charges","100% of total billed charges",2663.27,17407,
"HEMOSIL HIGH ABNORMAL CONTROL - ASSAYED",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,464,301.6,,408.32,88,,326.66,,,0,"percent of total billed charges","88% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.29,17.304,,64.23,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.32,63,,233.86,,,0,"percent of total billed charges","63% of total billed charges",70.99,15.3,,56.79,,,0,"percent of total billed charges","15.3% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",320.16,69,,,,,0,"fee schedule","69% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",286.98,61.85,,229.58,,,0,"percent of total billed charges","61.5% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",149.41,32.2,,119.53,,,0,"percent of total billed charges","32.2% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.51,17.136,,63.61,,,0,"percent of total billed charges","17.136% of total billed charges",101.34,21.84,,81.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",174.93,37.7,,139.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",361.92,78,,289.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",70.99,464,
"HEMOSIL NORMAL CONTROL - ASSAYED",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,412,267.8,,362.56,88,,290.05,,,0,"percent of total billed charges","88% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.29,17.304,,57.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",259.56,63,,207.65,,,0,"percent of total billed charges","63% of total billed charges",63.04,15.3,,50.43,,,0,"percent of total billed charges","15.3% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",284.28,69,,,,,0,"fee schedule","69% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",254.82,61.85,,203.86,,,0,"percent of total billed charges","61.5% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",132.66,32.2,,106.13,,,0,"percent of total billed charges","32.2% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.6,17.136,,56.48,,,0,"percent of total billed charges","17.136% of total billed charges",89.98,21.84,,71.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",155.32,37.7,,124.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",321.36,78,,257.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",63.04,412,
"HEMOSIL RECOMBIPLASTIN 2G, 5 X 20 ML",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,515,334.75,,453.2,88,,362.56,,,0,"percent of total billed charges","88% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.12,17.304,,71.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",324.45,63,,259.56,,,0,"percent of total billed charges","63% of total billed charges",78.8,15.3,,63.04,,,0,"percent of total billed charges","15.3% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",355.35,69,,,,,0,"fee schedule","69% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",318.53,61.85,,254.82,,,0,"percent of total billed charges","61.5% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",165.83,32.2,,132.66,,,0,"percent of total billed charges","32.2% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.25,17.136,,70.60,,,0,"percent of total billed charges","17.136% of total billed charges",112.48,21.84,,89.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",194.16,37.7,,155.33,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",401.7,78,,321.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",78.8,515,
N/A,ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"HEPARIN SODIUM 2000",201580,CDM,272,RC,,,OUTPATIENT,,,45,29.25,,39.6,88,,31.68,,,0,"percent of total billed charges","88% of total billed charges",22.5,50,,18.00,,,0,"percent of total billed charges","50% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.79,17.304,,6.23,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.35,63,,22.68,,,0,"percent of total billed charges","63% of total billed charges",6.89,15.3,,5.51,,,0,"percent of total billed charges","15.3% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",31.05,69,,,,,0,"fee schedule","69% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.83,61.85,,22.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",22.5,50,,18.00,,,0,"percent of total billed charges","50% of total billed charges",14.49,32.2,,11.59,,,0,"percent of total billed charges","32.2% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.71,17.136,,6.17,,,0,"percent of total billed charges","17.136% of total billed charges",9.83,21.84,,7.86,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.97,37.7,,13.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.1,78,,28.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",22.5,50,,18.00,,,0,"percent of total billed charges","50% of total billed charges",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",6.89,45,
"HEPARIN CALIBRATORS",ORSUP0025,CDM,270,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"HEX WRENCH 7-6CM",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"HI SAM DIL A (ON) 100WLS",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"HI SAM DIL B (ON) 100WLS",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"HI-FI PASSING LOOP",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"HIBICLENS 4 OZ",490734,CDM,270,RC,,,OUTPATIENT,,,37,24.05,,32.56,88,,26.05,,,0,"percent of total billed charges","88% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.4,17.304,,5.12,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.31,63,,18.65,,,0,"percent of total billed charges","63% of total billed charges",5.66,15.3,,4.53,,,0,"percent of total billed charges","15.3% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",25.53,69,,,,,0,"fee schedule","69% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.88,61.85,,18.30,,,0,"percent of total billed charges","61.5% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",11.91,32.2,,9.53,,,0,"percent of total billed charges","32.2% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.34,17.136,,5.07,,,0,"percent of total billed charges","17.136% of total billed charges",8.08,21.84,,6.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.95,37.7,,11.16,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.86,78,,23.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",5.66,37,
"HIGH-FIDELITY FOAM EAR PLUGS MRI SAFE",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"HIP ACETABULAR DOME HOLE PLUG",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"HIP BIPOLAR UHR 28X47MM",ORSUP0056,CDM,278,RC,,,OUTPATIENT,,,12319,8007.35,,10840.72,88,,8672.58,,,0,"percent of total billed charges","88% of total billed charges",6159.5,50,,4927.60,,,0,"percent of total billed charges","50% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2131.68,17.304,,1705.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7760.97,63,,6208.78,,,0,"percent of total billed charges","63% of total billed charges",1884.81,15.3,,1507.85,,,0,"percent of total billed charges","15.3% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",8500.11,69,,,,,0,"fee schedule","69% of total billed charges",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7619.3,61.85,,6095.44,,,0,"percent of total billed charges","61.5% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",6159.5,50,,4927.60,,,0,"percent of total billed charges","50% of total billed charges",3966.72,32.2,,3173.38,,,0,"percent of total billed charges","32.2% of total billed charges",3843.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2110.98,17.136,,1688.78,,,0,"percent of total billed charges","17.136% of total billed charges",2690.47,21.84,,2152.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4644.26,37.7,,3715.41,,,0,"percent of total billed charges","37.7% of total billed charges",4644.26,37.7,,3715.41,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4176.14,33.9,,3340.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",9608.82,78,,7687.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10175.49,82.6,,8140.39,,,0,"percent of total billed charges","82.6% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",6159.5,50,,4927.60,,,0,"percent of total billed charges","50% of total billed charges",10175.49,82.6,,8140.39,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",1884.81,12319,
"HIP BIPOLAR UHR 28X51MM",ORSUP0056,CDM,278,RC,,,OUTPATIENT,,,12319,8007.35,,10840.72,88,,8672.58,,,0,"percent of total billed charges","88% of total billed charges",6159.5,50,,4927.60,,,0,"percent of total billed charges","50% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2131.68,17.304,,1705.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7760.97,63,,6208.78,,,0,"percent of total billed charges","63% of total billed charges",1884.81,15.3,,1507.85,,,0,"percent of total billed charges","15.3% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",8500.11,69,,,,,0,"fee schedule","69% of total billed charges",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7619.3,61.85,,6095.44,,,0,"percent of total billed charges","61.5% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",6159.5,50,,4927.60,,,0,"percent of total billed charges","50% of total billed charges",3966.72,32.2,,3173.38,,,0,"percent of total billed charges","32.2% of total billed charges",3843.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2110.98,17.136,,1688.78,,,0,"percent of total billed charges","17.136% of total billed charges",2690.47,21.84,,2152.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4644.26,37.7,,3715.41,,,0,"percent of total billed charges","37.7% of total billed charges",4644.26,37.7,,3715.41,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4176.14,33.9,,3340.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",9608.82,78,,7687.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10175.49,82.6,,8140.39,,,0,"percent of total billed charges","82.6% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",6159.5,50,,4927.60,,,0,"percent of total billed charges","50% of total billed charges",10175.49,82.6,,8140.39,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",1884.81,12319,
"HIP CUP PRIMARY TRITANIUM HEMI CLUSTER HOLE  58MM",ORSUP0040,CDM,278,RC,,,OUTPATIENT,,,7766,5047.9,,6834.08,88,,5467.26,,,0,"percent of total billed charges","88% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1343.83,17.304,,1075.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4892.58,63,,3914.06,,,0,"percent of total billed charges","63% of total billed charges",1188.2,15.3,,950.56,,,0,"percent of total billed charges","15.3% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",5358.54,69,,,,,0,"fee schedule","69% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4803.27,61.85,,3842.62,,,0,"percent of total billed charges","61.5% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",2500.65,32.2,,2000.52,,,0,"percent of total billed charges","32.2% of total billed charges",2422.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1330.78,17.136,,1064.62,,,0,"percent of total billed charges","17.136% of total billed charges",1696.09,21.84,,1356.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2927.78,37.7,,2342.22,,,0,"percent of total billed charges","37.7% of total billed charges",2927.78,37.7,,2342.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2632.67,33.9,,2106.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6057.48,78,,4845.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",1188.2,7766,
"HIP HEAD C-TAPER COCR LFIT 28MM/+5",ORSUP0045,CDM,278,RC,,,OUTPATIENT,,,9105,5918.25,,8012.4,88,,6409.92,,,0,"percent of total billed charges","88% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1575.53,17.304,,1260.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5736.15,63,,4588.92,,,0,"percent of total billed charges","63% of total billed charges",1393.07,15.3,,1114.46,,,0,"percent of total billed charges","15.3% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",6282.45,69,,,,,0,"fee schedule","69% of total billed charges",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5631.44,61.85,,4505.15,,,0,"percent of total billed charges","61.5% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",2931.81,32.2,,2345.45,,,0,"percent of total billed charges","32.2% of total billed charges",2840.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1560.23,17.136,,1248.18,,,0,"percent of total billed charges","17.136% of total billed charges",1988.53,21.84,,1590.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3432.59,37.7,,2746.07,,,0,"percent of total billed charges","37.7% of total billed charges",3432.59,37.7,,2746.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3086.6,33.9,,2469.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7101.9,78,,5681.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7520.73,82.6,,6016.58,,,0,"percent of total billed charges","82.6% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",7520.73,82.6,,6016.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",1393.07,9105,
"HIP HEAD V40 BIOLOX DELTA 36MM/+7.6",ORSUP0035,CDM,278,RC,,,OUTPATIENT,,,6427,4177.55,,5655.76,88,,4524.61,,,0,"percent of total billed charges","88% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1112.13,17.304,,889.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4049.01,63,,3239.21,,,0,"percent of total billed charges","63% of total billed charges",983.33,15.3,,786.66,,,0,"percent of total billed charges","15.3% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4434.63,69,,,,,0,"fee schedule","69% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3975.1,61.85,,3180.08,,,0,"percent of total billed charges","61.5% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",2069.49,32.2,,1655.59,,,0,"percent of total billed charges","32.2% of total billed charges",2005.22,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1101.33,17.136,,881.06,,,0,"percent of total billed charges","17.136% of total billed charges",1403.66,21.84,,1122.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.7% of total billed charges",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2178.75,33.9,,1743.00,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5013.06,78,,4010.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",983.33,6427,
"HIP HEAD V40 BIOLOX DELTA 36MM/1",ORSUP0093,CDM,278,RC,,,OUTPATIENT,,,22495,14621.75,,19795.6,88,,15836.48,,,0,"percent of total billed charges","88% of total billed charges",11247.5,50,,8998.00,,,0,"percent of total billed charges","50% of total billed charges",3779.16,16.8,,3023.33,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3892.53,17.304,,3114.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14171.85,63,,11337.48,,,0,"percent of total billed charges","63% of total billed charges",3441.74,15.3,,2753.39,,,0,"percent of total billed charges","15.3% of total billed charges",3779.16,16.8,,3023.33,,,0,"percent of total billed charges","16.8% of total billed charges",15521.55,69,,,,,0,"fee schedule","69% of total billed charges",22495,100,,17996.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22495,100,,17996.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22495,100,,17996.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13913.16,61.85,,11130.53,,,0,"percent of total billed charges","61.5% of total billed charges",3779.16,16.8,,3023.33,,,0,"percent of total billed charges","16.8% of total billed charges",11247.5,50,,8998.00,,,0,"percent of total billed charges","50% of total billed charges",7243.39,32.2,,5794.71,,,0,"percent of total billed charges","32.2% of total billed charges",7018.44,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3854.74,17.136,,3083.79,,,0,"percent of total billed charges","17.136% of total billed charges",4912.91,21.84,,3930.33,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",8480.62,37.7,,6784.50,,,0,"percent of total billed charges","37.7% of total billed charges",8480.62,37.7,,6784.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",7625.81,33.9,,6100.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",17546.1,78,,14036.88,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",18580.87,82.6,,14864.70,,,0,"percent of total billed charges","82.6% of total billed charges",3779.16,16.8,,3023.33,,,0,"percent of total billed charges","16.8% of total billed charges",11247.5,50,,8998.00,,,0,"percent of total billed charges","50% of total billed charges",18580.87,82.6,,14864.70,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3779.16,16.8,,3023.33,,,0,"percent of total billed charges","16.8% of total billed charges",22495,100,,17996.00,,,0,"percent of total billed charges","100% of total billed charges",3441.74,22495,
"HIP HEAD V40 BIOLOX DELTA 36MM/-2.6",ORSUP0035,CDM,278,RC,,,OUTPATIENT,,,6427,4177.55,,5655.76,88,,4524.61,,,0,"percent of total billed charges","88% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1112.13,17.304,,889.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4049.01,63,,3239.21,,,0,"percent of total billed charges","63% of total billed charges",983.33,15.3,,786.66,,,0,"percent of total billed charges","15.3% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4434.63,69,,,,,0,"fee schedule","69% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3975.1,61.85,,3180.08,,,0,"percent of total billed charges","61.5% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",2069.49,32.2,,1655.59,,,0,"percent of total billed charges","32.2% of total billed charges",2005.22,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1101.33,17.136,,881.06,,,0,"percent of total billed charges","17.136% of total billed charges",1403.66,21.84,,1122.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.7% of total billed charges",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2178.75,33.9,,1743.00,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5013.06,78,,4010.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",983.33,6427,
"HIP INSERT TRIDENT 0 DEG X3 32MM ID 623-00-32E",ORSUP0035,CDM,278,RC,,,OUTPATIENT,,,6427,4177.55,,5655.76,88,,4524.61,,,0,"percent of total billed charges","88% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1112.13,17.304,,889.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4049.01,63,,3239.21,,,0,"percent of total billed charges","63% of total billed charges",983.33,15.3,,786.66,,,0,"percent of total billed charges","15.3% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4434.63,69,,,,,0,"fee schedule","69% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3975.1,61.85,,3180.08,,,0,"percent of total billed charges","61.5% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",2069.49,32.2,,1655.59,,,0,"percent of total billed charges","32.2% of total billed charges",2005.22,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1101.33,17.136,,881.06,,,0,"percent of total billed charges","17.136% of total billed charges",1403.66,21.84,,1122.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.7% of total billed charges",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2178.75,33.9,,1743.00,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5013.06,78,,4010.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",983.33,6427,
"HIP INSERT TRIDENT 0 DEG X3 36MM ID 623-00-36F",ORSUP0086,CDM,278,RC,,,OUTPATIENT,,,20621,13403.65,,18146.48,88,,14517.18,,,0,"percent of total billed charges","88% of total billed charges",10310.5,50,,8248.40,,,0,"percent of total billed charges","50% of total billed charges",3464.33,16.8,,2771.46,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3568.26,17.304,,2854.61,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12991.23,63,,10392.98,,,0,"percent of total billed charges","63% of total billed charges",3155.01,15.3,,2524.01,,,0,"percent of total billed charges","15.3% of total billed charges",3464.33,16.8,,2771.46,,,0,"percent of total billed charges","16.8% of total billed charges",14228.49,69,,,,,0,"fee schedule","69% of total billed charges",20621,100,,16496.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20621,100,,16496.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20621,100,,16496.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12754.09,61.85,,10203.27,,,0,"percent of total billed charges","61.5% of total billed charges",3464.33,16.8,,2771.46,,,0,"percent of total billed charges","16.8% of total billed charges",10310.5,50,,8248.40,,,0,"percent of total billed charges","50% of total billed charges",6639.96,32.2,,5311.97,,,0,"percent of total billed charges","32.2% of total billed charges",6433.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3533.61,17.136,,2826.89,,,0,"percent of total billed charges","17.136% of total billed charges",4503.63,21.84,,3602.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",7774.12,37.7,,6219.30,,,0,"percent of total billed charges","37.7% of total billed charges",7774.12,37.7,,6219.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",6990.52,33.9,,5592.42,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",16084.38,78,,12867.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17032.95,82.6,,13626.36,,,0,"percent of total billed charges","82.6% of total billed charges",3464.33,16.8,,2771.46,,,0,"percent of total billed charges","16.8% of total billed charges",10310.5,50,,8248.40,,,0,"percent of total billed charges","50% of total billed charges",17032.95,82.6,,13626.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3464.33,16.8,,2771.46,,,0,"percent of total billed charges","16.8% of total billed charges",20621,100,,16496.80,,,0,"percent of total billed charges","100% of total billed charges",3155.01,20621,
"HIP INSERT TRIDENT 10 DEG X3 36MM ID 623-10-36E",ORSUP0035,CDM,278,RC,,,OUTPATIENT,,,6427,4177.55,,5655.76,88,,4524.61,,,0,"percent of total billed charges","88% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1112.13,17.304,,889.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4049.01,63,,3239.21,,,0,"percent of total billed charges","63% of total billed charges",983.33,15.3,,786.66,,,0,"percent of total billed charges","15.3% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4434.63,69,,,,,0,"fee schedule","69% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3975.1,61.85,,3180.08,,,0,"percent of total billed charges","61.5% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",2069.49,32.2,,1655.59,,,0,"percent of total billed charges","32.2% of total billed charges",2005.22,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1101.33,17.136,,881.06,,,0,"percent of total billed charges","17.136% of total billed charges",1403.66,21.84,,1122.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.7% of total billed charges",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2178.75,33.9,,1743.00,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5013.06,78,,4010.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",983.33,6427,
"HIP SHELL TRIDENT PSL HA CLUSTER 50MM",ORSUP0092,CDM,278,RC,,,OUTPATIENT,,,21960,14274,,19324.8,88,,15459.84,,,0,"percent of total billed charges","88% of total billed charges",10980,50,,8784.00,,,0,"percent of total billed charges","50% of total billed charges",3689.28,16.8,,2951.42,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3799.96,17.304,,3039.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13834.8,63,,11067.84,,,0,"percent of total billed charges","63% of total billed charges",3359.88,15.3,,2687.90,,,0,"percent of total billed charges","15.3% of total billed charges",3689.28,16.8,,2951.42,,,0,"percent of total billed charges","16.8% of total billed charges",15152.4,69,,,,,0,"fee schedule","69% of total billed charges",21960,100,,17568.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21960,100,,17568.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21960,100,,17568.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13582.26,61.85,,10865.81,,,0,"percent of total billed charges","61.5% of total billed charges",3689.28,16.8,,2951.42,,,0,"percent of total billed charges","16.8% of total billed charges",10980,50,,8784.00,,,0,"percent of total billed charges","50% of total billed charges",7071.12,32.2,,5656.90,,,0,"percent of total billed charges","32.2% of total billed charges",6851.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3763.07,17.136,,3010.46,,,0,"percent of total billed charges","17.136% of total billed charges",4796.06,21.84,,3836.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",8278.92,37.7,,6623.14,,,0,"percent of total billed charges","37.7% of total billed charges",8278.92,37.7,,6623.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",7444.44,33.9,,5955.55,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",17128.8,78,,13703.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",18138.96,82.6,,14511.17,,,0,"percent of total billed charges","82.6% of total billed charges",3689.28,16.8,,2951.42,,,0,"percent of total billed charges","16.8% of total billed charges",10980,50,,8784.00,,,0,"percent of total billed charges","50% of total billed charges",18138.96,82.6,,14511.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3689.28,16.8,,2951.42,,,0,"percent of total billed charges","16.8% of total billed charges",21960,100,,17568.00,,,0,"percent of total billed charges","100% of total billed charges",3359.88,21960,
"HIP SHELL TRIDENT PSL HA CLUSTER 52MM",ORSUP0030,CDM,278,RC,,,OUTPATIENT,,,5088,3307.2,,4477.44,88,,3581.95,,,0,"percent of total billed charges","88% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",880.43,17.304,,704.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3205.44,63,,2564.35,,,0,"percent of total billed charges","63% of total billed charges",778.46,15.3,,622.77,,,0,"percent of total billed charges","15.3% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",3510.72,69,,,,,0,"fee schedule","69% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3146.93,61.85,,2517.54,,,0,"percent of total billed charges","61.5% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",1638.34,32.2,,1310.67,,,0,"percent of total billed charges","32.2% of total billed charges",1587.46,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",871.88,17.136,,697.50,,,0,"percent of total billed charges","17.136% of total billed charges",1111.22,21.84,,888.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1918.18,37.7,,1534.54,,,0,"percent of total billed charges","37.7% of total billed charges",1918.18,37.7,,1534.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1724.83,33.9,,1379.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3968.64,78,,3174.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",778.46,5088,
"HIP SHELL TRIDENT PSL HA SOLID BACK 52MM",ORSUP0030,CDM,278,RC,,,OUTPATIENT,,,5088,3307.2,,4477.44,88,,3581.95,,,0,"percent of total billed charges","88% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",880.43,17.304,,704.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3205.44,63,,2564.35,,,0,"percent of total billed charges","63% of total billed charges",778.46,15.3,,622.77,,,0,"percent of total billed charges","15.3% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",3510.72,69,,,,,0,"fee schedule","69% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3146.93,61.85,,2517.54,,,0,"percent of total billed charges","61.5% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",1638.34,32.2,,1310.67,,,0,"percent of total billed charges","32.2% of total billed charges",1587.46,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",871.88,17.136,,697.50,,,0,"percent of total billed charges","17.136% of total billed charges",1111.22,21.84,,888.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1918.18,37.7,,1534.54,,,0,"percent of total billed charges","37.7% of total billed charges",1918.18,37.7,,1534.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1724.83,33.9,,1379.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3968.64,78,,3174.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",778.46,5088,
"HIP SHELL TRIDENT PSL HA SOLID BACK 54MM",ORSUP0030,CDM,278,RC,,,OUTPATIENT,,,5088,3307.2,,4477.44,88,,3581.95,,,0,"percent of total billed charges","88% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",880.43,17.304,,704.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3205.44,63,,2564.35,,,0,"percent of total billed charges","63% of total billed charges",778.46,15.3,,622.77,,,0,"percent of total billed charges","15.3% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",3510.72,69,,,,,0,"fee schedule","69% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3146.93,61.85,,2517.54,,,0,"percent of total billed charges","61.5% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",1638.34,32.2,,1310.67,,,0,"percent of total billed charges","32.2% of total billed charges",1587.46,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",871.88,17.136,,697.50,,,0,"percent of total billed charges","17.136% of total billed charges",1111.22,21.84,,888.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1918.18,37.7,,1534.54,,,0,"percent of total billed charges","37.7% of total billed charges",1918.18,37.7,,1534.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1724.83,33.9,,1379.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3968.64,78,,3174.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",778.46,5088,
"HIP SLEEVE CABLE SM W/BEAD",ORSUP0019,CDM,278,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",668.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.7% of total billed charges",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",726.14,33.9,,580.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"HIP STEM ACCOLADE II 127 DEG SIZE 3",ORSUP0075,CDM,278,RC,,,OUTPATIENT,,,15265,9922.25,,13433.2,88,,10746.56,,,0,"percent of total billed charges","88% of total billed charges",7632.5,50,,6106.00,,,0,"percent of total billed charges","50% of total billed charges",2564.52,16.8,,2051.62,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2641.46,17.304,,2113.17,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9616.95,63,,7693.56,,,0,"percent of total billed charges","63% of total billed charges",2335.55,15.3,,1868.44,,,0,"percent of total billed charges","15.3% of total billed charges",2564.52,16.8,,2051.62,,,0,"percent of total billed charges","16.8% of total billed charges",10532.85,69,,,,,0,"fee schedule","69% of total billed charges",15265,100,,12212.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15265,100,,12212.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15265,100,,12212.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9441.4,61.85,,7553.12,,,0,"percent of total billed charges","61.5% of total billed charges",2564.52,16.8,,2051.62,,,0,"percent of total billed charges","16.8% of total billed charges",7632.5,50,,6106.00,,,0,"percent of total billed charges","50% of total billed charges",4915.33,32.2,,3932.26,,,0,"percent of total billed charges","32.2% of total billed charges",4762.68,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2615.81,17.136,,2092.65,,,0,"percent of total billed charges","17.136% of total billed charges",3333.88,21.84,,2667.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",5754.91,37.7,,4603.93,,,0,"percent of total billed charges","37.7% of total billed charges",5754.91,37.7,,4603.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",5174.84,33.9,,4139.87,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",11906.7,78,,9525.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12608.89,82.6,,10087.11,,,0,"percent of total billed charges","82.6% of total billed charges",2564.52,16.8,,2051.62,,,0,"percent of total billed charges","16.8% of total billed charges",7632.5,50,,6106.00,,,0,"percent of total billed charges","50% of total billed charges",12608.89,82.6,,10087.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2564.52,16.8,,2051.62,,,0,"percent of total billed charges","16.8% of total billed charges",15265,100,,12212.00,,,0,"percent of total billed charges","100% of total billed charges",2335.55,15265,
"HIP STEM ACCOLADE II 127 DEG SIZE 4",ORSUP0069,CDM,278,RC,,,OUTPATIENT,,,15800,10270,,13904,88,,11123.20,,,0,"percent of total billed charges","88% of total billed charges",7900,50,,6320.00,,,0,"percent of total billed charges","50% of total billed charges",2654.4,16.8,,2123.52,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2734.03,17.304,,2187.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9954,63,,7963.20,,,0,"percent of total billed charges","63% of total billed charges",2417.4,15.3,,1933.92,,,0,"percent of total billed charges","15.3% of total billed charges",2654.4,16.8,,2123.52,,,0,"percent of total billed charges","16.8% of total billed charges",10902,69,,,,,0,"fee schedule","69% of total billed charges",15800,100,,12640.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15800,100,,12640.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15800,100,,12640.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9772.3,61.85,,7817.84,,,0,"percent of total billed charges","61.5% of total billed charges",2654.4,16.8,,2123.52,,,0,"percent of total billed charges","16.8% of total billed charges",7900,50,,6320.00,,,0,"percent of total billed charges","50% of total billed charges",5087.6,32.2,,4070.08,,,0,"percent of total billed charges","32.2% of total billed charges",4929.6,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2707.49,17.136,,2165.99,,,0,"percent of total billed charges","17.136% of total billed charges",3450.72,21.84,,2760.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",5956.6,37.7,,4765.28,,,0,"percent of total billed charges","37.7% of total billed charges",5956.6,37.7,,4765.28,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356.2,33.9,,4284.96,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",12324,78,,9859.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13050.8,82.6,,10440.64,,,0,"percent of total billed charges","82.6% of total billed charges",2654.4,16.8,,2123.52,,,0,"percent of total billed charges","16.8% of total billed charges",7900,50,,6320.00,,,0,"percent of total billed charges","50% of total billed charges",13050.8,82.6,,10440.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.4,16.8,,2123.52,,,0,"percent of total billed charges","16.8% of total billed charges",15800,100,,12640.00,,,0,"percent of total billed charges","100% of total billed charges",2417.4,15800,
"HIP STEM ACCOLADE II 127 DEG SIZE 5",ORSUP0069,CDM,278,RC,,,OUTPATIENT,,,15800,10270,,13904,88,,11123.20,,,0,"percent of total billed charges","88% of total billed charges",7900,50,,6320.00,,,0,"percent of total billed charges","50% of total billed charges",2654.4,16.8,,2123.52,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2734.03,17.304,,2187.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9954,63,,7963.20,,,0,"percent of total billed charges","63% of total billed charges",2417.4,15.3,,1933.92,,,0,"percent of total billed charges","15.3% of total billed charges",2654.4,16.8,,2123.52,,,0,"percent of total billed charges","16.8% of total billed charges",10902,69,,,,,0,"fee schedule","69% of total billed charges",15800,100,,12640.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15800,100,,12640.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15800,100,,12640.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9772.3,61.85,,7817.84,,,0,"percent of total billed charges","61.5% of total billed charges",2654.4,16.8,,2123.52,,,0,"percent of total billed charges","16.8% of total billed charges",7900,50,,6320.00,,,0,"percent of total billed charges","50% of total billed charges",5087.6,32.2,,4070.08,,,0,"percent of total billed charges","32.2% of total billed charges",4929.6,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2707.49,17.136,,2165.99,,,0,"percent of total billed charges","17.136% of total billed charges",3450.72,21.84,,2760.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",5956.6,37.7,,4765.28,,,0,"percent of total billed charges","37.7% of total billed charges",5956.6,37.7,,4765.28,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356.2,33.9,,4284.96,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",12324,78,,9859.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13050.8,82.6,,10440.64,,,0,"percent of total billed charges","82.6% of total billed charges",2654.4,16.8,,2123.52,,,0,"percent of total billed charges","16.8% of total billed charges",7900,50,,6320.00,,,0,"percent of total billed charges","50% of total billed charges",13050.8,82.6,,10440.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.4,16.8,,2123.52,,,0,"percent of total billed charges","16.8% of total billed charges",15800,100,,12640.00,,,0,"percent of total billed charges","100% of total billed charges",2417.4,15800,
"HIP STEM ACCOLADE II 127 DEG SIZE 6",ORSUP0069,CDM,278,RC,,,OUTPATIENT,,,15800,10270,,13904,88,,11123.20,,,0,"percent of total billed charges","88% of total billed charges",7900,50,,6320.00,,,0,"percent of total billed charges","50% of total billed charges",2654.4,16.8,,2123.52,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2734.03,17.304,,2187.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9954,63,,7963.20,,,0,"percent of total billed charges","63% of total billed charges",2417.4,15.3,,1933.92,,,0,"percent of total billed charges","15.3% of total billed charges",2654.4,16.8,,2123.52,,,0,"percent of total billed charges","16.8% of total billed charges",10902,69,,,,,0,"fee schedule","69% of total billed charges",15800,100,,12640.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15800,100,,12640.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15800,100,,12640.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9772.3,61.85,,7817.84,,,0,"percent of total billed charges","61.5% of total billed charges",2654.4,16.8,,2123.52,,,0,"percent of total billed charges","16.8% of total billed charges",7900,50,,6320.00,,,0,"percent of total billed charges","50% of total billed charges",5087.6,32.2,,4070.08,,,0,"percent of total billed charges","32.2% of total billed charges",4929.6,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2707.49,17.136,,2165.99,,,0,"percent of total billed charges","17.136% of total billed charges",3450.72,21.84,,2760.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",5956.6,37.7,,4765.28,,,0,"percent of total billed charges","37.7% of total billed charges",5956.6,37.7,,4765.28,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356.2,33.9,,4284.96,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",12324,78,,9859.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13050.8,82.6,,10440.64,,,0,"percent of total billed charges","82.6% of total billed charges",2654.4,16.8,,2123.52,,,0,"percent of total billed charges","16.8% of total billed charges",7900,50,,6320.00,,,0,"percent of total billed charges","50% of total billed charges",13050.8,82.6,,10440.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.4,16.8,,2123.52,,,0,"percent of total billed charges","16.8% of total billed charges",15800,100,,12640.00,,,0,"percent of total billed charges","100% of total billed charges",2417.4,15800,
"HIP STEM OMNIFIT HFX SIZE #10 6070-1035A",ORSUP0035,CDM,278,RC,,,OUTPATIENT,,,6427,4177.55,,5655.76,88,,4524.61,,,0,"percent of total billed charges","88% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1112.13,17.304,,889.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4049.01,63,,3239.21,,,0,"percent of total billed charges","63% of total billed charges",983.33,15.3,,786.66,,,0,"percent of total billed charges","15.3% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4434.63,69,,,,,0,"fee schedule","69% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3975.1,61.85,,3180.08,,,0,"percent of total billed charges","61.5% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",2069.49,32.2,,1655.59,,,0,"percent of total billed charges","32.2% of total billed charges",2005.22,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1101.33,17.136,,881.06,,,0,"percent of total billed charges","17.136% of total billed charges",1403.66,21.84,,1122.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.7% of total billed charges",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2178.75,33.9,,1743.00,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5013.06,78,,4010.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",983.33,6427,
"HIP SHEET",490735,CDM,270,RC,,,OUTPATIENT,,,121,78.65,,106.48,88,,85.18,,,0,"percent of total billed charges","88% of total billed charges",60.5,50,,48.40,,,0,"percent of total billed charges","50% of total billed charges",20.33,16.8,,16.26,,,0,"percent of total billed charges","16.8% of total billed charges",121,100,,96.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.94,17.304,,16.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.23,63,,60.98,,,0,"percent of total billed charges","63% of total billed charges",18.51,15.3,,14.81,,,0,"percent of total billed charges","15.3% of total billed charges",20.33,16.8,,16.26,,,0,"percent of total billed charges","16.8% of total billed charges",83.49,69,,,,,0,"fee schedule","69% of total billed charges",121,100,,96.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",121,100,,96.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",121,100,,96.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.84,61.85,,59.87,,,0,"percent of total billed charges","61.5% of total billed charges",20.33,16.8,,16.26,,,0,"percent of total billed charges","16.8% of total billed charges",60.5,50,,48.40,,,0,"percent of total billed charges","50% of total billed charges",38.96,32.2,,31.17,,,0,"percent of total billed charges","32.2% of total billed charges",20.33,16.8,,16.26,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.73,17.136,,16.58,,,0,"percent of total billed charges","17.136% of total billed charges",26.43,21.84,,21.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",45.62,37.7,,36.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",94.38,78,,75.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",99.95,82.6,,79.96,,,0,"percent of total billed charges","82.6% of total billed charges",20.33,16.8,,16.26,,,0,"percent of total billed charges","16.8% of total billed charges",60.5,50,,48.40,,,0,"percent of total billed charges","50% of total billed charges",99.95,82.6,,79.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.33,16.8,,16.26,,,0,"percent of total billed charges","16.8% of total billed charges",121,100,,96.80,,,0,"percent of total billed charges","100% of total billed charges",18.51,121,
"HIPPURATE DISC",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"HIV ALERE COMBO EXTERNAL CONTROL SET",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"HMS CARTRIDGE YELLOW ACT",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"HOLDER ENDOTRACHAEL TUBE",185461,CDM,272,RC,,,OUTPATIENT,,,74,48.1,,65.12,88,,52.10,,,0,"percent of total billed charges","88% of total billed charges",37,50,,29.60,,,0,"percent of total billed charges","50% of total billed charges",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.8,17.304,,10.24,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.62,63,,37.30,,,0,"percent of total billed charges","63% of total billed charges",11.32,15.3,,9.06,,,0,"percent of total billed charges","15.3% of total billed charges",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",51.06,69,,,,,0,"fee schedule","69% of total billed charges",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.77,61.85,,36.62,,,0,"percent of total billed charges","61.5% of total billed charges",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",37,50,,29.60,,,0,"percent of total billed charges","50% of total billed charges",23.83,32.2,,19.06,,,0,"percent of total billed charges","32.2% of total billed charges",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.68,17.136,,10.14,,,0,"percent of total billed charges","17.136% of total billed charges",16.16,21.84,,12.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",27.9,37.7,,22.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",57.72,78,,46.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.12,82.6,,48.90,,,0,"percent of total billed charges","82.6% of total billed charges",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",37,50,,29.60,,,0,"percent of total billed charges","50% of total billed charges",61.12,82.6,,48.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",11.32,74,
"HOLDER TRACH TUBE MWH 686",154485,CDM,272,RC,,,OUTPATIENT,,,23,14.95,,20.24,88,,16.19,,,0,"percent of total billed charges","88% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.98,17.304,,3.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.49,63,,11.59,,,0,"percent of total billed charges","63% of total billed charges",3.52,15.3,,2.82,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",15.87,69,,,,,0,"fee schedule","69% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.23,61.85,,11.38,,,0,"percent of total billed charges","61.5% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",7.41,32.2,,5.93,,,0,"percent of total billed charges","32.2% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.94,17.136,,3.15,,,0,"percent of total billed charges","17.136% of total billed charges",5.02,21.84,,4.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.94,78,,14.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",3.52,23,
"HOLMIUM MICRON LASER 600",ORSUP0014,CDM,270,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"HOLMIUM MICRON LASER FIBER 200",ORSUP0018,CDM,270,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"HOLMIUM MICRON LASER 1000",ORSUP0015,CDM,270,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"HOOD SURGICAL T5",266308,CDM,272,RC,,,OUTPATIENT,,,210,136.5,,184.8,88,,147.84,,,0,"percent of total billed charges","88% of total billed charges",105,50,,84.00,,,0,"percent of total billed charges","50% of total billed charges",35.28,16.8,,28.22,,,0,"percent of total billed charges","16.8% of total billed charges",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.34,17.304,,29.07,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",132.3,63,,105.84,,,0,"percent of total billed charges","63% of total billed charges",32.13,15.3,,25.70,,,0,"percent of total billed charges","15.3% of total billed charges",35.28,16.8,,28.22,,,0,"percent of total billed charges","16.8% of total billed charges",144.9,69,,,,,0,"fee schedule","69% of total billed charges",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.89,61.85,,103.91,,,0,"percent of total billed charges","61.5% of total billed charges",35.28,16.8,,28.22,,,0,"percent of total billed charges","16.8% of total billed charges",105,50,,84.00,,,0,"percent of total billed charges","50% of total billed charges",67.62,32.2,,54.10,,,0,"percent of total billed charges","32.2% of total billed charges",35.28,16.8,,28.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.99,17.136,,28.79,,,0,"percent of total billed charges","17.136% of total billed charges",45.86,21.84,,36.69,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",79.17,37.7,,63.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",163.8,78,,131.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.46,82.6,,138.77,,,0,"percent of total billed charges","82.6% of total billed charges",35.28,16.8,,28.22,,,0,"percent of total billed charges","16.8% of total billed charges",105,50,,84.00,,,0,"percent of total billed charges","50% of total billed charges",173.46,82.6,,138.77,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.28,16.8,,28.22,,,0,"percent of total billed charges","16.8% of total billed charges",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",32.13,210,
"HOOK SHEPHERDS GREENBERG",ORSUP0015,CDM,270,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"HOOK CAUTERY MONOPOLAR 5MM DA VINCI",337819,CDM,272,RC,,,OUTPATIENT,,,4030,2619.5,,3546.4,88,,2837.12,,,0,"percent of total billed charges","88% of total billed charges",2015,50,,1612.00,,,0,"percent of total billed charges","50% of total billed charges",677.04,16.8,,541.63,,,0,"percent of total billed charges","16.8% of total billed charges",4030,100,,3224.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",697.35,17.304,,557.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2538.9,63,,2031.12,,,0,"percent of total billed charges","63% of total billed charges",616.59,15.3,,493.27,,,0,"percent of total billed charges","15.3% of total billed charges",677.04,16.8,,541.63,,,0,"percent of total billed charges","16.8% of total billed charges",2780.7,69,,,,,0,"fee schedule","69% of total billed charges",4030,100,,3224.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4030,100,,3224.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4030,100,,3224.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2492.56,61.85,,1994.05,,,0,"percent of total billed charges","61.5% of total billed charges",677.04,16.8,,541.63,,,0,"percent of total billed charges","16.8% of total billed charges",2015,50,,1612.00,,,0,"percent of total billed charges","50% of total billed charges",1297.66,32.2,,1038.13,,,0,"percent of total billed charges","32.2% of total billed charges",677.04,16.8,,541.63,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",690.58,17.136,,552.46,,,0,"percent of total billed charges","17.136% of total billed charges",880.15,21.84,,704.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1519.31,37.7,,1215.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3143.4,78,,2514.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3328.78,82.6,,2663.02,,,0,"percent of total billed charges","82.6% of total billed charges",677.04,16.8,,541.63,,,0,"percent of total billed charges","16.8% of total billed charges",2015,50,,1612.00,,,0,"percent of total billed charges","50% of total billed charges",3328.78,82.6,,2663.02,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",677.04,16.8,,541.63,,,0,"percent of total billed charges","16.8% of total billed charges",4030,100,,3224.00,,,0,"percent of total billed charges","100% of total billed charges",616.59,4030,
"HOOK CAUTERY PERMANENT DA VINCI",173500,CDM,272,RC,,,OUTPATIENT,,,10186,6620.9,,8963.68,88,,7170.94,,,0,"percent of total billed charges","88% of total billed charges",5093,50,,4074.40,,,0,"percent of total billed charges","50% of total billed charges",1711.25,16.8,,1369.00,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1762.59,17.304,,1410.07,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6417.18,63,,5133.74,,,0,"percent of total billed charges","63% of total billed charges",1558.46,15.3,,1246.77,,,0,"percent of total billed charges","15.3% of total billed charges",1711.25,16.8,,1369.00,,,0,"percent of total billed charges","16.8% of total billed charges",7028.34,69,,,,,0,"fee schedule","69% of total billed charges",10186,100,,8148.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10186,100,,8148.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10186,100,,8148.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6300.04,61.85,,5040.03,,,0,"percent of total billed charges","61.5% of total billed charges",1711.25,16.8,,1369.00,,,0,"percent of total billed charges","16.8% of total billed charges",5093,50,,4074.40,,,0,"percent of total billed charges","50% of total billed charges",3279.89,32.2,,2623.91,,,0,"percent of total billed charges","32.2% of total billed charges",1711.25,16.8,,1369.00,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1745.47,17.136,,1396.38,,,0,"percent of total billed charges","17.136% of total billed charges",2224.62,21.84,,1779.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3840.12,37.7,,3072.10,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7945.08,78,,6356.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8413.64,82.6,,6730.91,,,0,"percent of total billed charges","82.6% of total billed charges",1711.25,16.8,,1369.00,,,0,"percent of total billed charges","16.8% of total billed charges",5093,50,,4074.40,,,0,"percent of total billed charges","50% of total billed charges",8413.64,82.6,,6730.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1711.25,16.8,,1369.00,,,0,"percent of total billed charges","16.8% of total billed charges",10186,100,,8148.80,,,0,"percent of total billed charges","100% of total billed charges",1558.46,10186,
"HOOK ELECTRODE",490739,CDM,270,RC,,,OUTPATIENT,,,317,206.05,,278.96,88,,223.17,,,0,"percent of total billed charges","88% of total billed charges",158.5,50,,126.80,,,0,"percent of total billed charges","50% of total billed charges",53.26,16.8,,42.61,,,0,"percent of total billed charges","16.8% of total billed charges",317,100,,253.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54.85,17.304,,43.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",199.71,63,,159.77,,,0,"percent of total billed charges","63% of total billed charges",48.5,15.3,,38.80,,,0,"percent of total billed charges","15.3% of total billed charges",53.26,16.8,,42.61,,,0,"percent of total billed charges","16.8% of total billed charges",218.73,69,,,,,0,"fee schedule","69% of total billed charges",317,100,,253.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",317,100,,253.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",317,100,,253.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",196.06,61.85,,156.85,,,0,"percent of total billed charges","61.5% of total billed charges",53.26,16.8,,42.61,,,0,"percent of total billed charges","16.8% of total billed charges",158.5,50,,126.80,,,0,"percent of total billed charges","50% of total billed charges",102.07,32.2,,81.66,,,0,"percent of total billed charges","32.2% of total billed charges",53.26,16.8,,42.61,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",54.32,17.136,,43.46,,,0,"percent of total billed charges","17.136% of total billed charges",69.23,21.84,,55.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",119.51,37.7,,95.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",247.26,78,,197.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.84,82.6,,209.47,,,0,"percent of total billed charges","82.6% of total billed charges",53.26,16.8,,42.61,,,0,"percent of total billed charges","16.8% of total billed charges",158.5,50,,126.80,,,0,"percent of total billed charges","50% of total billed charges",261.84,82.6,,209.47,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.26,16.8,,42.61,,,0,"percent of total billed charges","16.8% of total billed charges",317,100,,253.60,,,0,"percent of total billed charges","100% of total billed charges",48.5,317,
"HOOK SCISSOR TIP",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"HOOP SHIMS",ORSUP0030,CDM,272,RC,,,OUTPATIENT,,,5088,3307.2,,4477.44,88,,3581.95,,,0,"percent of total billed charges","88% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",880.43,17.304,,704.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3205.44,63,,2564.35,,,0,"percent of total billed charges","63% of total billed charges",778.46,15.3,,622.77,,,0,"percent of total billed charges","15.3% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",3510.72,69,,,,,0,"fee schedule","69% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3146.93,61.85,,2517.54,,,0,"percent of total billed charges","61.5% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",1638.34,32.2,,1310.67,,,0,"percent of total billed charges","32.2% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",871.88,17.136,,697.50,,,0,"percent of total billed charges","17.136% of total billed charges",1111.22,21.84,,888.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1918.18,37.7,,1534.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3968.64,78,,3174.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",778.46,5088,
"HOT PACK",490741,CDM,270,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
HOVERMATT,177695,CDM,272,RC,,,OUTPATIENT,,,5959,3873.35,,5243.92,88,,4195.14,,,0,"percent of total billed charges","88% of total billed charges",2979.5,50,,2383.60,,,0,"percent of total billed charges","50% of total billed charges",1001.11,16.8,,800.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1031.15,17.304,,824.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3754.17,63,,3003.34,,,0,"percent of total billed charges","63% of total billed charges",911.73,15.3,,729.38,,,0,"percent of total billed charges","15.3% of total billed charges",1001.11,16.8,,800.89,,,0,"percent of total billed charges","16.8% of total billed charges",4111.71,69,,,,,0,"fee schedule","69% of total billed charges",5959,100,,4767.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5959,100,,4767.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5959,100,,4767.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3685.64,61.85,,2948.51,,,0,"percent of total billed charges","61.5% of total billed charges",1001.11,16.8,,800.89,,,0,"percent of total billed charges","16.8% of total billed charges",2979.5,50,,2383.60,,,0,"percent of total billed charges","50% of total billed charges",1918.8,32.2,,1535.04,,,0,"percent of total billed charges","32.2% of total billed charges",1001.11,16.8,,800.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1021.13,17.136,,816.90,,,0,"percent of total billed charges","17.136% of total billed charges",1301.45,21.84,,1041.16,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2246.54,37.7,,1797.23,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4648.02,78,,3718.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4922.13,82.6,,3937.70,,,0,"percent of total billed charges","82.6% of total billed charges",1001.11,16.8,,800.89,,,0,"percent of total billed charges","16.8% of total billed charges",2979.5,50,,2383.60,,,0,"percent of total billed charges","50% of total billed charges",4922.13,82.6,,3937.70,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1001.11,16.8,,800.89,,,0,"percent of total billed charges","16.8% of total billed charges",5959,100,,4767.20,,,0,"percent of total billed charges","100% of total billed charges",911.73,5959,
"HOVERMATT 39'' SINGLE USE",490742,CDM,270,RC,,,OUTPATIENT,,,848,551.2,,746.24,88,,596.99,,,0,"percent of total billed charges","88% of total billed charges",424,50,,339.20,,,0,"percent of total billed charges","50% of total billed charges",142.46,16.8,,113.97,,,0,"percent of total billed charges","16.8% of total billed charges",848,100,,678.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",146.74,17.304,,117.39,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",534.24,63,,427.39,,,0,"percent of total billed charges","63% of total billed charges",129.74,15.3,,103.79,,,0,"percent of total billed charges","15.3% of total billed charges",142.46,16.8,,113.97,,,0,"percent of total billed charges","16.8% of total billed charges",585.12,69,,,,,0,"fee schedule","69% of total billed charges",848,100,,678.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",848,100,,678.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",848,100,,678.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",524.49,61.85,,419.59,,,0,"percent of total billed charges","61.5% of total billed charges",142.46,16.8,,113.97,,,0,"percent of total billed charges","16.8% of total billed charges",424,50,,339.20,,,0,"percent of total billed charges","50% of total billed charges",273.06,32.2,,218.45,,,0,"percent of total billed charges","32.2% of total billed charges",142.46,16.8,,113.97,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",145.31,17.136,,116.25,,,0,"percent of total billed charges","17.136% of total billed charges",185.2,21.84,,148.16,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",319.7,37.7,,255.76,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",661.44,78,,529.15,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",700.45,82.6,,560.36,,,0,"percent of total billed charges","82.6% of total billed charges",142.46,16.8,,113.97,,,0,"percent of total billed charges","16.8% of total billed charges",424,50,,339.20,,,0,"percent of total billed charges","50% of total billed charges",700.45,82.6,,560.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.46,16.8,,113.97,,,0,"percent of total billed charges","16.8% of total billed charges",848,100,,678.40,,,0,"percent of total billed charges","100% of total billed charges",129.74,848,
"HOW BONE PLUG SMALL",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"HOW BONE PLUG LARGE",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"HOW BONE PLUG MEDIUM",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"HUMIDITY CONTROL PKS BX / 2 SETS",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"HUMIDIFIER BUBBLE AQUAPAK",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"HVLP CUFFED ORAL/NASAL W/MURPHY EYE 9.0",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"HY-TAPE 1",490749,CDM,270,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"HYCOIR KOVA SLIDES URINE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"HYDRATOME RX 44 W/450CM WIRE",ORSUP0024,CDM,272,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"HYDROGEN PEROXIDE 4 OZ",490748,CDM,270,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"HYDROGEN PEROXIDE",490747,CDM,270,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"HYDROCHLORIC ACID SOLUTION 1",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"HYDROGEN PEROXIDE 3% 4oz",ORSUP0001,CDM,250,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"HYFIN VENT CHEST SEAL ORIGINAL VERSION",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"I-GEL SUPRAGLOTTIC AIRWAY ADULT SZ 3",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"I-GEL SUPRAGLOTTIC AIRWAY ADULT SZ4",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"I-GEL SUPRAGLOTTIC AIRWAY ADULT SZ 5",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"I-GEL SUPRAGLOTTIC AIRWAY SZ 2",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"I-GEL SUPRAGLOTTIC AIRWAY INFANT",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"ICALCIUM ELECTRODE",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"ICE BAG LARGE FILLABLE",241613,CDM,270,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.95,61.85,,3.96,,,0,"percent of total billed charges","61.5% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"ICE BAG SMALL FILLABLE",241612,CDM,270,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.95,61.85,,3.96,,,0,"percent of total billed charges","61.5% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"ICONIX SPEED WITH 1 STRAND 1.2MM % 1 STRAND 2.0MM",ORSUP0030,CDM,278,RC,,,OUTPATIENT,,,3914,2544.1,,3444.32,88,,2755.46,,,0,"percent of total billed charges","88% of total billed charges",1957,50,,1565.60,,,0,"percent of total billed charges","50% of total billed charges",657.55,16.8,,526.04,,,0,"percent of total billed charges","16.8% of total billed charges",3914,100,,3131.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",677.28,17.304,,541.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2465.82,63,,1972.66,,,0,"percent of total billed charges","63% of total billed charges",598.84,15.3,,479.07,,,0,"percent of total billed charges","15.3% of total billed charges",657.55,16.8,,526.04,,,0,"percent of total billed charges","16.8% of total billed charges",2700.66,69,,,,,0,"fee schedule","69% of total billed charges",3914,100,,3131.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3914,100,,3131.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3914,100,,3131.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2420.81,61.85,,1936.65,,,0,"percent of total billed charges","61.5% of total billed charges",657.55,16.8,,526.04,,,0,"percent of total billed charges","16.8% of total billed charges",1957,50,,1565.60,,,0,"percent of total billed charges","50% of total billed charges",1260.31,32.2,,1008.25,,,0,"percent of total billed charges","32.2% of total billed charges",1221.17,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",670.7,17.136,,536.56,,,0,"percent of total billed charges","17.136% of total billed charges",854.82,21.84,,683.86,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1475.58,37.7,,1180.46,,,0,"percent of total billed charges","37.7% of total billed charges",1475.58,37.7,,1180.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1326.85,33.9,,1061.48,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3052.92,78,,2442.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3232.96,82.6,,2586.37,,,0,"percent of total billed charges","82.6% of total billed charges",657.55,16.8,,526.04,,,0,"percent of total billed charges","16.8% of total billed charges",1957,50,,1565.60,,,0,"percent of total billed charges","50% of total billed charges",3232.96,82.6,,2586.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",657.55,16.8,,526.04,,,0,"percent of total billed charges","16.8% of total billed charges",3914,100,,3131.20,,,0,"percent of total billed charges","100% of total billed charges",598.84,3914,
"ICONIX 1.4MM ANCHOR W/ 1.2MM XBRAID",ORSUP0023,CDM,278,RC,,,OUTPATIENT,,,2472,1606.8,,2175.36,88,,1740.29,,,0,"percent of total billed charges","88% of total billed charges",1236,50,,988.80,,,0,"percent of total billed charges","50% of total billed charges",415.3,16.8,,332.24,,,0,"percent of total billed charges","16.8% of total billed charges",2472,100,,1977.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",427.75,17.304,,342.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1557.36,63,,1245.89,,,0,"percent of total billed charges","63% of total billed charges",378.22,15.3,,302.58,,,0,"percent of total billed charges","15.3% of total billed charges",415.3,16.8,,332.24,,,0,"percent of total billed charges","16.8% of total billed charges",1705.68,69,,,,,0,"fee schedule","69% of total billed charges",2472,100,,1977.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2472,100,,1977.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2472,100,,1977.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1528.93,61.85,,1223.14,,,0,"percent of total billed charges","61.5% of total billed charges",415.3,16.8,,332.24,,,0,"percent of total billed charges","16.8% of total billed charges",1236,50,,988.80,,,0,"percent of total billed charges","50% of total billed charges",795.98,32.2,,636.78,,,0,"percent of total billed charges","32.2% of total billed charges",771.26,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",423.6,17.136,,338.88,,,0,"percent of total billed charges","17.136% of total billed charges",539.88,21.84,,431.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",931.94,37.7,,745.55,,,0,"percent of total billed charges","37.7% of total billed charges",931.94,37.7,,745.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",838.01,33.9,,670.41,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1928.16,78,,1542.53,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2041.87,82.6,,1633.50,,,0,"percent of total billed charges","82.6% of total billed charges",415.3,16.8,,332.24,,,0,"percent of total billed charges","16.8% of total billed charges",1236,50,,988.80,,,0,"percent of total billed charges","50% of total billed charges",2041.87,82.6,,1633.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",415.3,16.8,,332.24,,,0,"percent of total billed charges","16.8% of total billed charges",2472,100,,1977.60,,,0,"percent of total billed charges","100% of total billed charges",378.22,2472,
"ICONIX 2.3MM ANCHOR FORCE FIBER SUTURE",ORSUP0022,CDM,278,RC,,,OUTPATIENT,,,2266,1472.9,,1994.08,88,,1595.26,,,0,"percent of total billed charges","88% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",392.11,17.304,,313.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1427.58,63,,1142.06,,,0,"percent of total billed charges","63% of total billed charges",346.7,15.3,,277.36,,,0,"percent of total billed charges","15.3% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1563.54,69,,,,,0,"fee schedule","69% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1401.52,61.85,,1121.22,,,0,"percent of total billed charges","61.5% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",729.65,32.2,,583.72,,,0,"percent of total billed charges","32.2% of total billed charges",706.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",388.3,17.136,,310.64,,,0,"percent of total billed charges","17.136% of total billed charges",494.89,21.84,,395.91,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",854.28,37.7,,683.42,,,0,"percent of total billed charges","37.7% of total billed charges",854.28,37.7,,683.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",768.17,33.9,,614.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1767.48,78,,1413.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1871.72,82.6,,1497.38,,,0,"percent of total billed charges","82.6% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",1871.72,82.6,,1497.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",346.7,2266,
"ICONIX 2.3MM ANCHOR 2.0MM XBRAID TT SUTURE",ORSUP0023,CDM,278,RC,,,OUTPATIENT,,,2472,1606.8,,2175.36,88,,1740.29,,,0,"percent of total billed charges","88% of total billed charges",1236,50,,988.80,,,0,"percent of total billed charges","50% of total billed charges",415.3,16.8,,332.24,,,0,"percent of total billed charges","16.8% of total billed charges",2472,100,,1977.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",427.75,17.304,,342.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1557.36,63,,1245.89,,,0,"percent of total billed charges","63% of total billed charges",378.22,15.3,,302.58,,,0,"percent of total billed charges","15.3% of total billed charges",415.3,16.8,,332.24,,,0,"percent of total billed charges","16.8% of total billed charges",1705.68,69,,,,,0,"fee schedule","69% of total billed charges",2472,100,,1977.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2472,100,,1977.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2472,100,,1977.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1528.93,61.85,,1223.14,,,0,"percent of total billed charges","61.5% of total billed charges",415.3,16.8,,332.24,,,0,"percent of total billed charges","16.8% of total billed charges",1236,50,,988.80,,,0,"percent of total billed charges","50% of total billed charges",795.98,32.2,,636.78,,,0,"percent of total billed charges","32.2% of total billed charges",771.26,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",423.6,17.136,,338.88,,,0,"percent of total billed charges","17.136% of total billed charges",539.88,21.84,,431.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",931.94,37.7,,745.55,,,0,"percent of total billed charges","37.7% of total billed charges",931.94,37.7,,745.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",838.01,33.9,,670.41,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1928.16,78,,1542.53,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2041.87,82.6,,1633.50,,,0,"percent of total billed charges","82.6% of total billed charges",415.3,16.8,,332.24,,,0,"percent of total billed charges","16.8% of total billed charges",1236,50,,988.80,,,0,"percent of total billed charges","50% of total billed charges",2041.87,82.6,,1633.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",415.3,16.8,,332.24,,,0,"percent of total billed charges","16.8% of total billed charges",2472,100,,1977.60,,,0,"percent of total billed charges","100% of total billed charges",378.22,2472,
"ID BLOOD BANDS YELLOW",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"ILLUMINATION SYSTEM GLOBUS",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"IMMERSION OIL",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"IMMOBILIZER SPECIALTY SHOULDER  LARGE",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"IMMOBILIZER SHOULDER LG FEMALE",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"IMMOBILIZER SLINGSHOPT 2 SHOULDER MED",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"IMMOBILIZER SLINGSHOPT 2 SHOULDER LARGE",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"IMMUNOSTAT EHEC",ORSUP0020,CDM,270,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"IMMUNOCARD GIARDIA CRYPTO",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"IMMUNO WASH FLUID BX / 30 BTLS",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"IMMUNOASSAY PLUS CONTROL LVL 3",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"IMMUNOLOGY CONTROL LVL 1",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"IMMUNOLOGY CONTROL LVL 3",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"IMMUNOLOGY LEVEL 2",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"IMPLANT SCREW CORTICAL 2.5MM X 18MM L",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"IMPLANT SCREW CORTICAL 2.5MM X 22MM L",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"IMPLANT BLADE HELICAL 105MM TI NL NS",ORSUP0024,CDM,278,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",1086.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.7% of total billed charges",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1180.06,33.9,,944.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"IMPLANT BLADE HELICAL TITANIUM 90MML",ORSUP0024,CDM,278,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",1086.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.7% of total billed charges",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1180.06,33.9,,944.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"IMPLANT BLADE HELICAL TITANIUM 95MML",ORSUP0024,CDM,278,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",1086.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.7% of total billed charges",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1180.06,33.9,,944.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"IMPLANT HEAD 3-D TITANIUM",ORSUP0022,CDM,278,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",919.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.7% of total billed charges",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",998.69,33.9,,798.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"IMPLANT LOCKING CAP 3-D HEAD TITANIUM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"IMPLANT PEG SMOOTH 2.0MM X 16MM L",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"IMPLANT PEG SMOOTH 2.0MM X 24MM L",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"IMPLANT PLATE LCP 3.5MM 6 HOLES 85MM L",ORSUP0025,CDM,278,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",1169.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.7% of total billed charges",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.91,33.9,,1016.73,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"IMPLANT PLATE LCP 3.5MM 8 HOLES 111MM L",ORSUP0022,CDM,278,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",919.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.7% of total billed charges",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",998.69,33.9,,798.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"IMPLANT ROD SOFT TI CURVED 6MM X 45MM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"IMPLANT ROD SOFT TI CURVED 6MM X 55MM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"IMPLANT ROD SOFT TI CURVED 6MM X 65MM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"IMPLANT ROD SOFT TI CURVED 6MM X 75MM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"IMPLANT ROD SOFT TITANIUM 6MM X 50MM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"IMPLANT ROUND SYNMESH 495.356",ORSUP0071,CDM,278,RC,,,OUTPATIENT,,,16336,10618.4,,14375.68,88,,11500.54,,,0,"percent of total billed charges","88% of total billed charges",8168,50,,6534.40,,,0,"percent of total billed charges","50% of total billed charges",2744.45,16.8,,2195.56,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2826.78,17.304,,2261.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10291.68,63,,8233.34,,,0,"percent of total billed charges","63% of total billed charges",2499.41,15.3,,1999.53,,,0,"percent of total billed charges","15.3% of total billed charges",2744.45,16.8,,2195.56,,,0,"percent of total billed charges","16.8% of total billed charges",11271.84,69,,,,,0,"fee schedule","69% of total billed charges",16336,100,,13068.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16336,100,,13068.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16336,100,,13068.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10103.82,61.85,,8083.06,,,0,"percent of total billed charges","61.5% of total billed charges",2744.45,16.8,,2195.56,,,0,"percent of total billed charges","16.8% of total billed charges",8168,50,,6534.40,,,0,"percent of total billed charges","50% of total billed charges",5260.19,32.2,,4208.15,,,0,"percent of total billed charges","32.2% of total billed charges",5096.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2799.34,17.136,,2239.47,,,0,"percent of total billed charges","17.136% of total billed charges",3567.78,21.84,,2854.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",6158.67,37.7,,4926.94,,,0,"percent of total billed charges","37.7% of total billed charges",6158.67,37.7,,4926.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",5537.9,33.9,,4430.32,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",12742.08,78,,10193.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13493.54,82.6,,10794.83,,,0,"percent of total billed charges","82.6% of total billed charges",2744.45,16.8,,2195.56,,,0,"percent of total billed charges","16.8% of total billed charges",8168,50,,6534.40,,,0,"percent of total billed charges","50% of total billed charges",13493.54,82.6,,10794.83,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2744.45,16.8,,2195.56,,,0,"percent of total billed charges","16.8% of total billed charges",16336,100,,13068.80,,,0,"percent of total billed charges","100% of total billed charges",2499.41,16336,
"IMPLANT SCREW CANNULATED 16MM THD 7.3MM X 40MM L",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"IMPLANT SCREW CANNULATED 16MM THD 7.3MM X 55MM L",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"IMPLANT SCREW CANNULATED 16MM THD 7.3MM X 60MM L",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"IMPLANT SCREW CANNULATED 16MM THD 7.3MM X 80MM L",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"IMPLANT SCREW CANNULATED 16MM THD 7.3MM X 85MM L",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"IMPLANT SCREW CANNULATED 16MM THD 7.3MM X 90MM L",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"IMPLANT SCREW CANNULATED 7.3MM D 32MM THD 100MML",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"IMPLANT SCREW CANNULATED 7.3MM D 32MM THD 105MML",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"IMPLANT SCREW CANNULATED 7.3MM D 32MM THD 110MML",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"IMPLANT SCREW CANNULATED 7.3MM D 32MM THD 115MML",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"IMPLANT SCREW CANNULATED 7.3MM D 32MM THD 80MML",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"IMPLANT SCREW CANNULATED 7.3MM D 32MM THD 90MML",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"IMPLANT SCREW CANNULATED LONG THREAD 4.0MM 42MM",ORSUP0018,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"IMPLANT SCREW CANNULATED SHORT THREAD 4.0MM 28MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"IMPLANT SCREW CANNULATED SHORT THREAD 4.0MM 30MM",ORSUP0018,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"IMPLANT SCREW CANNULATED SHORT THREAD 4.0MM 34MM",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",751.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.7% of total billed charges",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",816.99,33.9,,653.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"IMPLANT SCREW CANNULATED SHORT THREAD 4.0MM 36MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"IMPLANT SCREW CANNULATED SHORT THREAD 4.0MM 40MM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"IMPLANT SCREW CANNULATED SHORT THREAD 4.0MM 44MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"IMPLANT SCREW CANNULATED SHORT THREAD 4.0MM 50MM",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",751.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.7% of total billed charges",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",816.99,33.9,,653.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"IMPLANT SCREW CORTEX SELF TAP 3.5MM DIA 14MM L",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.94,17.304,,85.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.23,61.85,,305.78,,,0,"percent of total billed charges","61.5% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",199,32.2,,159.20,,,0,"percent of total billed charges","32.2% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.136,,84.72,,,0,"percent of total billed charges","17.136% of total billed charges",134.97,21.84,,107.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.7% of total billed charges",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.5,33.9,,167.60,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,618,
"IMPLANT SCREW CORTEX SELF TAP 3.5MM DIA 16MM L",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,721,468.65,,634.48,88,,507.58,,,0,"percent of total billed charges","88% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.76,17.304,,99.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.23,63,,363.38,,,0,"percent of total billed charges","63% of total billed charges",110.31,15.3,,88.25,,,0,"percent of total billed charges","15.3% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",497.49,69,,,,,0,"fee schedule","69% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",445.94,61.85,,356.75,,,0,"percent of total billed charges","61.5% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",232.16,32.2,,185.73,,,0,"percent of total billed charges","32.2% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",123.55,17.136,,98.84,,,0,"percent of total billed charges","17.136% of total billed charges",157.47,21.84,,125.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",271.82,37.7,,217.46,,,0,"percent of total billed charges","37.7% of total billed charges",271.82,37.7,,217.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",244.42,33.9,,195.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",562.38,78,,449.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",595.55,82.6,,476.44,,,0,"percent of total billed charges","82.6% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",595.55,82.6,,476.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",110.31,721,
"IMPLANT SCREW CORTEX SELF TAP 3.5MM DIA 18MM L",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.7% of total billed charges",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.14,33.9,,54.51,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"IMPLANT SCREW CORTEX SELF TAP 3.5MM DIA 22MM L",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"IMPLANT SCREW CORTEX SELF TAP 3.5MM DIA 24MM L",ORSUP0003,CDM,278,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.7% of total billed charges",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.14,33.9,,54.51,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"IMPLANT SCREW CORTEX SELF TAP 3.5MM DIA 28MM L",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"IMPLANT SCREW CORTEX SELF TAP 3.5MM DIA 32MM L",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"IMPLANT SCREW CORTEX SELF TAP 3.5MM DIA 36MM L",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"IMPLANT SCREW CORTEX SELF TAP 3.5MM DIA 45MM L",ORSUP0003,CDM,278,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.7% of total billed charges",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.14,33.9,,54.51,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"IMPLANT SCREW CORTEX SELF TAP 3.5MM DIA 50MM L",ORSUP0003,CDM,278,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.7% of total billed charges",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.14,33.9,,54.51,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"IMPLANT SCREW CORTEX SLF TAP 3.5MMX55MML",ORSUP0003,CDM,278,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.7% of total billed charges",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.14,33.9,,54.51,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"IMPLANT SCREW CORTEX TITAN SELF-TAP 3.5MM X 14MML",ORSUP0003,CDM,278,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.7% of total billed charges",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.14,33.9,,54.51,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"IMPLANT SCREW CORTICAL 2.5MM X 14MM L",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"IMPLANT SCREW CORTICAL 2.5MM X 16MM L",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"IMPLANT SCREW CORTICAL 2.5MM X 24MM L",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"IMPLANT SCREW CORTICAL 2.5MM X 26MM L",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"IMPLANT SCREW LOCKING STAR DRIVE SLF TP 3.5X 10MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"IMPLANT SCREW LOCKING STAR DRIVE SLF TP 3.5X 12MM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"IMPLANT SCREW LOCKING STAR DRIVE SLF TP 3.5X 14MM",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,1854,1205.1,,1631.52,88,,1305.22,,,0,"percent of total billed charges","88% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",320.82,17.304,,256.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1168.02,63,,934.42,,,0,"percent of total billed charges","63% of total billed charges",283.66,15.3,,226.93,,,0,"percent of total billed charges","15.3% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1279.26,69,,,,,0,"fee schedule","69% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1146.7,61.85,,917.36,,,0,"percent of total billed charges","61.5% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",596.99,32.2,,477.59,,,0,"percent of total billed charges","32.2% of total billed charges",578.45,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",317.7,17.136,,254.16,,,0,"percent of total billed charges","17.136% of total billed charges",404.91,21.84,,323.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",698.96,37.7,,559.17,,,0,"percent of total billed charges","37.7% of total billed charges",698.96,37.7,,559.17,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",628.51,33.9,,502.81,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1446.12,78,,1156.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1531.4,82.6,,1225.12,,,0,"percent of total billed charges","82.6% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",1531.4,82.6,,1225.12,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",283.66,1854,
"IMPLANT SCREW LOCKING STAR DRIVE SLF TP 3.5X 18MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"IMPLANT SCREW LOCKING STAR DRIVE SLF TP 3.5X 20MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"IMPLANT SCREW LOCKING STAR DRIVE SLF TP 3.5X 24MM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"IMPLANT SCREW LOCKING STAR DRIVE SLF TP 3.5X 26MM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"IMPLANT SCREW LOCKING STAR DRIVE SLF TP 3.5X 34MM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"IMPLANT SCREW LOCKING STAR DRIVE SLF TP 3.5X 36MM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"IMPLANT TRANSCONNECTOR LO PROFL 42-55MM 6MM ROD",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"IMPLANT WASHER 7MM DIA",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.7% of total billed charges",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.85,33.9,,72.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"IMPLANT BONE MATRIX DBX DEMINERALIZED 5CC",ORSUP0034,CDM,278,RC,,,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1065.75,17.304,,852.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",942.33,15.3,,753.86,,,0,"percent of total billed charges","15.3% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3809.34,61.85,,3047.47,,,0,"percent of total billed charges","61.5% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1983.2,32.2,,1586.56,,,0,"percent of total billed charges","32.2% of total billed charges",1921.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1055.41,17.136,,844.33,,,0,"percent of total billed charges","17.136% of total billed charges",1345.13,21.84,,1076.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",942.33,6159,
"IMPLANT BONE MATRIX DBX DEMINERALIZED 1CC",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"IMPLANT BONE MATRIX DBX DEMINERALIZED 10CC",ORSUP0036,CDM,278,RC,,,OUTPATIENT,,,6695,4351.75,,5891.6,88,,4713.28,,,0,"percent of total billed charges","88% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1158.5,17.304,,926.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4217.85,63,,3374.28,,,0,"percent of total billed charges","63% of total billed charges",1024.34,15.3,,819.47,,,0,"percent of total billed charges","15.3% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",4619.55,69,,,,,0,"fee schedule","69% of total billed charges",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4140.86,61.85,,3312.69,,,0,"percent of total billed charges","61.5% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",2155.79,32.2,,1724.63,,,0,"percent of total billed charges","32.2% of total billed charges",2088.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1147.26,17.136,,917.81,,,0,"percent of total billed charges","17.136% of total billed charges",1462.19,21.84,,1169.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2524.02,37.7,,2019.22,,,0,"percent of total billed charges","37.7% of total billed charges",2524.02,37.7,,2019.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2269.61,33.9,,1815.69,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5222.1,78,,4177.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5530.07,82.6,,4424.06,,,0,"percent of total billed charges","82.6% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",5530.07,82.6,,4424.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",1024.34,6695,
"IMPLANT BONE \\T\\ PUTTY MIX DBX 5CC BONE CHIP",ORSUP0032,CDM,278,RC,,,OUTPATIENT,,,5624,3655.6,,4949.12,88,,3959.30,,,0,"percent of total billed charges","88% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",973.18,17.304,,778.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3543.12,63,,2834.50,,,0,"percent of total billed charges","63% of total billed charges",860.47,15.3,,688.38,,,0,"percent of total billed charges","15.3% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",3880.56,69,,,,,0,"fee schedule","69% of total billed charges",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3478.44,61.85,,2782.75,,,0,"percent of total billed charges","61.5% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",1810.93,32.2,,1448.74,,,0,"percent of total billed charges","32.2% of total billed charges",1754.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",963.73,17.136,,770.98,,,0,"percent of total billed charges","17.136% of total billed charges",1228.28,21.84,,982.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2120.25,37.7,,1696.20,,,0,"percent of total billed charges","37.7% of total billed charges",2120.25,37.7,,1696.20,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1906.54,33.9,,1525.23,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4386.72,78,,3509.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4645.42,82.6,,3716.34,,,0,"percent of total billed charges","82.6% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",4645.42,82.6,,3716.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",860.47,5624,
"IMPLANT BONE SPACER TPLIF 13MM",ORSUP0104,CDM,278,RC,,,OUTPATIENT,,,25441,16536.65,,22388.08,88,,17910.46,,,0,"percent of total billed charges","88% of total billed charges",12720.5,50,,10176.40,,,0,"percent of total billed charges","50% of total billed charges",4274.09,16.8,,3419.27,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4402.31,17.304,,3521.85,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",16027.83,63,,12822.26,,,0,"percent of total billed charges","63% of total billed charges",3892.47,15.3,,3113.98,,,0,"percent of total billed charges","15.3% of total billed charges",4274.09,16.8,,3419.27,,,0,"percent of total billed charges","16.8% of total billed charges",17554.29,69,,,,,0,"fee schedule","69% of total billed charges",25441,100,,20352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25441,100,,20352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25441,100,,20352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15735.26,61.85,,12588.21,,,0,"percent of total billed charges","61.5% of total billed charges",4274.09,16.8,,3419.27,,,0,"percent of total billed charges","16.8% of total billed charges",12720.5,50,,10176.40,,,0,"percent of total billed charges","50% of total billed charges",8192,32.2,,6553.60,,,0,"percent of total billed charges","32.2% of total billed charges",7937.59,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",4359.57,17.136,,3487.66,,,0,"percent of total billed charges","17.136% of total billed charges",5556.31,21.84,,4445.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",9591.26,37.7,,7673.01,,,0,"percent of total billed charges","37.7% of total billed charges",9591.26,37.7,,7673.01,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",8624.5,33.9,,6899.60,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",19843.98,78,,15875.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",21014.27,82.6,,16811.42,,,0,"percent of total billed charges","82.6% of total billed charges",4274.09,16.8,,3419.27,,,0,"percent of total billed charges","16.8% of total billed charges",12720.5,50,,10176.40,,,0,"percent of total billed charges","50% of total billed charges",21014.27,82.6,,16811.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4274.09,16.8,,3419.27,,,0,"percent of total billed charges","16.8% of total billed charges",25441,100,,20352.80,,,0,"percent of total billed charges","100% of total billed charges",3892.47,25441,
"IMPLANT DUREPAIR 1 X 1",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"IMPLANT GAIT MEDIUM 30-100-02",ORSUP0026,CDM,278,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",1253.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.7% of total billed charges",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1361.76,33.9,,1089.41,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"IMPLANT ROD SOFT TI CURVED 6MM X 85MM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"IMPLANT ZERO-P 14MM SCREW 04.617.814",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"IMPLANT PIN GUIDE TIBIAL 2.4MM",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"IMPLANT PIN GUIDE W/SUTURE EYE 2.4MM",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"IMPLANT CPR MINI SCORPION DX",ORSUP0033,CDM,272,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"IMPLANT SCREW CORTICAL 2.5MM X 20MM L",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"INCENTIVE SPIROMETER 2500ML",ORSUP0001,CDM,278,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.7% of total billed charges",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.2,33.9,,9.76,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"INCISOR PLUS ELITE POWER-MINI DISP 2.9",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"INCYTO C CHIP HEMACYTOMETER",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"INDEFLATOR CATH",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"INDICATOR STEAM BOWIE-DICK TEST W/EARLY WARN SHT",53129,CDM,270,RC,,,OUTPATIENT,,,26,16.9,,22.88,88,,18.30,,,0,"percent of total billed charges","88% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.5,17.304,,3.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.38,63,,13.10,,,0,"percent of total billed charges","63% of total billed charges",3.98,15.3,,3.18,,,0,"percent of total billed charges","15.3% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",17.94,69,,,,,0,"fee schedule","69% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.08,61.85,,12.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",8.37,32.2,,6.70,,,0,"percent of total billed charges","32.2% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.46,17.136,,3.57,,,0,"percent of total billed charges","17.136% of total billed charges",5.68,21.84,,4.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.8,37.7,,7.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.28,78,,16.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",3.98,26,
"INDICATOR VERIFY ALL CLEAN TEST WASHER",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.37,61.85,,9.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"INDICATOR STER CYCLESURE BIO STERRAD",151254,CDM,272,RC,,,OUTPATIENT,,,108,70.2,,95.04,88,,76.03,,,0,"percent of total billed charges","88% of total billed charges",54,50,,43.20,,,0,"percent of total billed charges","50% of total billed charges",18.14,16.8,,14.51,,,0,"percent of total billed charges","16.8% of total billed charges",108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.69,17.304,,14.95,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.04,63,,54.43,,,0,"percent of total billed charges","63% of total billed charges",16.52,15.3,,13.22,,,0,"percent of total billed charges","15.3% of total billed charges",18.14,16.8,,14.51,,,0,"percent of total billed charges","16.8% of total billed charges",74.52,69,,,,,0,"fee schedule","69% of total billed charges",108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",66.8,61.85,,53.44,,,0,"percent of total billed charges","61.5% of total billed charges",18.14,16.8,,14.51,,,0,"percent of total billed charges","16.8% of total billed charges",54,50,,43.20,,,0,"percent of total billed charges","50% of total billed charges",34.78,32.2,,27.82,,,0,"percent of total billed charges","32.2% of total billed charges",18.14,16.8,,14.51,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.51,17.136,,14.81,,,0,"percent of total billed charges","17.136% of total billed charges",23.59,21.84,,18.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",40.72,37.7,,32.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",84.24,78,,67.39,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.21,82.6,,71.37,,,0,"percent of total billed charges","82.6% of total billed charges",18.14,16.8,,14.51,,,0,"percent of total billed charges","16.8% of total billed charges",54,50,,43.20,,,0,"percent of total billed charges","50% of total billed charges",89.21,82.6,,71.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.14,16.8,,14.51,,,0,"percent of total billed charges","16.8% of total billed charges",108,100,,86.40,,,0,"percent of total billed charges","100% of total billed charges",16.52,108,
"INDICATOR STERILIZATION 'ATTEST' FOR STEAM 50/BX",151257,CDM,272,RC,,,OUTPATIENT,,,730,474.5,,642.4,88,,513.92,,,0,"percent of total billed charges","88% of total billed charges",365,50,,292.00,,,0,"percent of total billed charges","50% of total billed charges",122.64,16.8,,98.11,,,0,"percent of total billed charges","16.8% of total billed charges",730,100,,584.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.32,17.304,,101.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",459.9,63,,367.92,,,0,"percent of total billed charges","63% of total billed charges",111.69,15.3,,89.35,,,0,"percent of total billed charges","15.3% of total billed charges",122.64,16.8,,98.11,,,0,"percent of total billed charges","16.8% of total billed charges",503.7,69,,,,,0,"fee schedule","69% of total billed charges",730,100,,584.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",730,100,,584.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",730,100,,584.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",451.51,61.85,,361.21,,,0,"percent of total billed charges","61.5% of total billed charges",122.64,16.8,,98.11,,,0,"percent of total billed charges","16.8% of total billed charges",365,50,,292.00,,,0,"percent of total billed charges","50% of total billed charges",235.06,32.2,,188.05,,,0,"percent of total billed charges","32.2% of total billed charges",122.64,16.8,,98.11,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",125.09,17.136,,100.07,,,0,"percent of total billed charges","17.136% of total billed charges",159.43,21.84,,127.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",275.21,37.7,,220.17,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",569.4,78,,455.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.98,82.6,,482.38,,,0,"percent of total billed charges","82.6% of total billed charges",122.64,16.8,,98.11,,,0,"percent of total billed charges","16.8% of total billed charges",365,50,,292.00,,,0,"percent of total billed charges","50% of total billed charges",602.98,82.6,,482.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",122.64,16.8,,98.11,,,0,"percent of total billed charges","16.8% of total billed charges",730,100,,584.00,,,0,"percent of total billed charges","100% of total billed charges",111.69,730,
"INDICATOR STERILIZATION INTEGRATOR STEAM W/EXTEND",65209,CDM,272,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"INDICATOR STERILIZATION INTEGRATOR STEAM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,344,223.6,,302.72,88,,242.18,,,0,"percent of total billed charges","88% of total billed charges",172,50,,137.60,,,0,"percent of total billed charges","50% of total billed charges",57.79,16.8,,46.23,,,0,"percent of total billed charges","16.8% of total billed charges",344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.53,17.304,,47.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",216.72,63,,173.38,,,0,"percent of total billed charges","63% of total billed charges",52.63,15.3,,42.10,,,0,"percent of total billed charges","15.3% of total billed charges",57.79,16.8,,46.23,,,0,"percent of total billed charges","16.8% of total billed charges",237.36,69,,,,,0,"fee schedule","69% of total billed charges",344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",212.76,61.85,,170.21,,,0,"percent of total billed charges","61.5% of total billed charges",57.79,16.8,,46.23,,,0,"percent of total billed charges","16.8% of total billed charges",172,50,,137.60,,,0,"percent of total billed charges","50% of total billed charges",110.77,32.2,,88.62,,,0,"percent of total billed charges","32.2% of total billed charges",57.79,16.8,,46.23,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.95,17.136,,47.16,,,0,"percent of total billed charges","17.136% of total billed charges",75.13,21.84,,60.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",129.69,37.7,,103.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",268.32,78,,214.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",284.14,82.6,,227.31,,,0,"percent of total billed charges","82.6% of total billed charges",57.79,16.8,,46.23,,,0,"percent of total billed charges","16.8% of total billed charges",172,50,,137.60,,,0,"percent of total billed charges","50% of total billed charges",284.14,82.6,,227.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.79,16.8,,46.23,,,0,"percent of total billed charges","16.8% of total billed charges",344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",52.63,344,
"INDICATOR ANAEROBIC 100",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"INFANT TRANSPORT WARMER MATTRESS",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"INFANT HEARING TEST PREMIE CLEAR 3.5-5MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"INFANT ALRMING BANDS",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"INFANT HEADGEAR 40-45CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"INFANT CHIN STRAP 38-44CM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"INFANT HEADGEAR 35-40CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"INFANT CHIN STRAP 32-38CM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"INFANT BONNET 17-22CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"INFANT CHIN STRAP 20-26CM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"INFANT BONNET 22-25CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"INFANT NASAL MASK SZ SMALL",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"INFLATION DEVICE ENCORE 26",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"INFLATION DEVICE HI-PRESSURE",ORSUP0011,CDM,270,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"RING INFLATABLE 17X15",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"INFUSION BAG 500ML DISPOSABLE",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"inkINK AND PAPER COMBO",179599,CDM,270,RC,,,OUTPATIENT,,,2521,1638.65,,2218.48,88,,1774.78,,,0,"percent of total billed charges","88% of total billed charges",1260.5,50,,1008.40,,,0,"percent of total billed charges","50% of total billed charges",423.53,16.8,,338.82,,,0,"percent of total billed charges","16.8% of total billed charges",2521,100,,2016.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",436.23,17.304,,348.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1588.23,63,,1270.58,,,0,"percent of total billed charges","63% of total billed charges",385.71,15.3,,308.57,,,0,"percent of total billed charges","15.3% of total billed charges",423.53,16.8,,338.82,,,0,"percent of total billed charges","16.8% of total billed charges",1739.49,69,,,,,0,"fee schedule","69% of total billed charges",2521,100,,2016.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2521,100,,2016.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2521,100,,2016.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1559.24,61.85,,1247.39,,,0,"percent of total billed charges","61.5% of total billed charges",423.53,16.8,,338.82,,,0,"percent of total billed charges","16.8% of total billed charges",1260.5,50,,1008.40,,,0,"percent of total billed charges","50% of total billed charges",811.76,32.2,,649.41,,,0,"percent of total billed charges","32.2% of total billed charges",423.53,16.8,,338.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",432,17.136,,345.60,,,0,"percent of total billed charges","17.136% of total billed charges",550.59,21.84,,440.47,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",950.42,37.7,,760.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1966.38,78,,1573.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2082.35,82.6,,1665.88,,,0,"percent of total billed charges","82.6% of total billed charges",423.53,16.8,,338.82,,,0,"percent of total billed charges","16.8% of total billed charges",1260.5,50,,1008.40,,,0,"percent of total billed charges","50% of total billed charges",2082.35,82.6,,1665.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",423.53,16.8,,338.82,,,0,"percent of total billed charges","16.8% of total billed charges",2521,100,,2016.80,,,0,"percent of total billed charges","100% of total billed charges",385.71,2521,
"INK SOLID MAGENTA 108R00724",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"INK SOLID YELLOW 108R00725",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"INLET GASKET",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"PRECISION SYSTEMS STANDARD 100",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"INLET CONNECTOR GASKET-ABL-90",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"INLET GASKET W/ HOLDER",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"INNER AXON NUT",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"INSERTER TIP F/MEDIUM \\T\\ MEDIUM DEEP IMPLANTS 5MM HEIGHT-STER",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"INSERT SUTURE HOLDING",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"INSERTION KIT FIDELITY 7.5FR",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"INSERTION KIT 8FR",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"INSERTION KIT IAB 50CC",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"INSTRUMENT MAXTORQUE 2.7MM DRILL BIT (GOLD) CSS-072-27",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"INSTRUMENT WIPES MERCOCEL",490759,CDM,272,RC,,,OUTPATIENT,,,446,289.9,,392.48,88,,313.98,,,0,"percent of total billed charges","88% of total billed charges",223,50,,178.40,,,0,"percent of total billed charges","50% of total billed charges",74.93,16.8,,59.94,,,0,"percent of total billed charges","16.8% of total billed charges",446,100,,356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.18,17.304,,61.74,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",280.98,63,,224.78,,,0,"percent of total billed charges","63% of total billed charges",68.24,15.3,,54.59,,,0,"percent of total billed charges","15.3% of total billed charges",74.93,16.8,,59.94,,,0,"percent of total billed charges","16.8% of total billed charges",307.74,69,,,,,0,"fee schedule","69% of total billed charges",446,100,,356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",446,100,,356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",446,100,,356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",275.85,61.85,,220.68,,,0,"percent of total billed charges","61.5% of total billed charges",74.93,16.8,,59.94,,,0,"percent of total billed charges","16.8% of total billed charges",223,50,,178.40,,,0,"percent of total billed charges","50% of total billed charges",143.61,32.2,,114.89,,,0,"percent of total billed charges","32.2% of total billed charges",74.93,16.8,,59.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.43,17.136,,61.14,,,0,"percent of total billed charges","17.136% of total billed charges",97.41,21.84,,77.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",168.14,37.7,,134.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",347.88,78,,278.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",368.4,82.6,,294.72,,,0,"percent of total billed charges","82.6% of total billed charges",74.93,16.8,,59.94,,,0,"percent of total billed charges","16.8% of total billed charges",223,50,,178.40,,,0,"percent of total billed charges","50% of total billed charges",368.4,82.6,,294.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.93,16.8,,59.94,,,0,"percent of total billed charges","16.8% of total billed charges",446,100,,356.80,,,0,"percent of total billed charges","100% of total billed charges",68.24,446,
"INSTRUMENT TRACKER EM ENT",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"INSTRUMENT MILK",490752,CDM,270,RC,,,OUTPATIENT,,,247,160.55,,217.36,88,,173.89,,,0,"percent of total billed charges","88% of total billed charges",123.5,50,,98.80,,,0,"percent of total billed charges","50% of total billed charges",41.5,16.8,,33.20,,,0,"percent of total billed charges","16.8% of total billed charges",247,100,,197.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.74,17.304,,34.19,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.61,63,,124.49,,,0,"percent of total billed charges","63% of total billed charges",37.79,15.3,,30.23,,,0,"percent of total billed charges","15.3% of total billed charges",41.5,16.8,,33.20,,,0,"percent of total billed charges","16.8% of total billed charges",170.43,69,,,,,0,"fee schedule","69% of total billed charges",247,100,,197.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",247,100,,197.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",247,100,,197.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",152.77,61.85,,122.22,,,0,"percent of total billed charges","61.5% of total billed charges",41.5,16.8,,33.20,,,0,"percent of total billed charges","16.8% of total billed charges",123.5,50,,98.80,,,0,"percent of total billed charges","50% of total billed charges",79.53,32.2,,63.62,,,0,"percent of total billed charges","32.2% of total billed charges",41.5,16.8,,33.20,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.33,17.136,,33.86,,,0,"percent of total billed charges","17.136% of total billed charges",53.94,21.84,,43.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",93.12,37.7,,74.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",192.66,78,,154.13,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.02,82.6,,163.22,,,0,"percent of total billed charges","82.6% of total billed charges",41.5,16.8,,33.20,,,0,"percent of total billed charges","16.8% of total billed charges",123.5,50,,98.80,,,0,"percent of total billed charges","50% of total billed charges",204.02,82.6,,163.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.5,16.8,,33.20,,,0,"percent of total billed charges","16.8% of total billed charges",247,100,,197.60,,,0,"percent of total billed charges","100% of total billed charges",37.79,247,
"INSTRUMENT TIP PROTECTOR .50 W X 1",490753,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"INSTRUMENT TIP PROTECTOR 3/4 W X 1 L",490754,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"INSTRUMENT TIP PROTECTOR 3/8 W X 1 L",490755,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"INSTRUMENT TIP PROTECTOR 5/8 W X 1 L",490756,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"INSTRUMENT TIP PROTECTOR DUO ORANGE",490757,CDM,272,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"INSTRUMENT ARM DRAPE",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"INSTURMENT BRIGHTNER",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"INSTRUMENT TIP CAPS CLEAR 1.5",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"INSTRUMENT TRAY LABEL W/ MONTH/DATES",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"INSTANT HOT PACKS 4X9",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"INSTRUMENT POUCH 3-POCKET",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"INSUFFLATION NEEDLE",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"INSULATED BOVIE TIP ELECTRODE  50/CS",105187,CDM,272,RC,,,OUTPATIENT,,,48,31.2,,42.24,88,,33.79,,,0,"percent of total billed charges","88% of total billed charges",24,50,,19.20,,,0,"percent of total billed charges","50% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.31,17.304,,6.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.24,63,,24.19,,,0,"percent of total billed charges","63% of total billed charges",7.34,15.3,,5.87,,,0,"percent of total billed charges","15.3% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",33.12,69,,,,,0,"fee schedule","69% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.69,61.85,,23.75,,,0,"percent of total billed charges","61.5% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",24,50,,19.20,,,0,"percent of total billed charges","50% of total billed charges",15.46,32.2,,12.37,,,0,"percent of total billed charges","32.2% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.23,17.136,,6.58,,,0,"percent of total billed charges","17.136% of total billed charges",10.48,21.84,,8.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.1,37.7,,14.48,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",37.44,78,,29.95,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.65,82.6,,31.72,,,0,"percent of total billed charges","82.6% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",24,50,,19.20,,,0,"percent of total billed charges","50% of total billed charges",39.65,82.6,,31.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",7.34,48,
"INSULATED COATED BOVIE BLADE 50/CASE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"INSUFLATION TUBING HEATED",ORSUP0031,CDM,272,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"INTERCEED ABSORB ADHES BARR 3 X 4",ORSUP0018,CDM,278,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",605.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.7% of total billed charges",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",658.34,33.9,,526.67,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"INTERJECT SCLEROTHERAPY NDL 23G",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"INTERCEPT DETERGENT WIPES",490761,CDM,270,RC,,,OUTPATIENT,,,144,93.6,,126.72,88,,101.38,,,0,"percent of total billed charges","88% of total billed charges",72,50,,57.60,,,0,"percent of total billed charges","50% of total billed charges",24.19,16.8,,19.35,,,0,"percent of total billed charges","16.8% of total billed charges",144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.92,17.304,,19.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.72,63,,72.58,,,0,"percent of total billed charges","63% of total billed charges",22.03,15.3,,17.62,,,0,"percent of total billed charges","15.3% of total billed charges",24.19,16.8,,19.35,,,0,"percent of total billed charges","16.8% of total billed charges",99.36,69,,,,,0,"fee schedule","69% of total billed charges",144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.06,61.85,,71.25,,,0,"percent of total billed charges","61.5% of total billed charges",24.19,16.8,,19.35,,,0,"percent of total billed charges","16.8% of total billed charges",72,50,,57.60,,,0,"percent of total billed charges","50% of total billed charges",46.37,32.2,,37.10,,,0,"percent of total billed charges","32.2% of total billed charges",24.19,16.8,,19.35,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.68,17.136,,19.74,,,0,"percent of total billed charges","17.136% of total billed charges",31.45,21.84,,25.16,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",54.29,37.7,,43.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",112.32,78,,89.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",118.94,82.6,,95.15,,,0,"percent of total billed charges","82.6% of total billed charges",24.19,16.8,,19.35,,,0,"percent of total billed charges","16.8% of total billed charges",72,50,,57.60,,,0,"percent of total billed charges","50% of total billed charges",118.94,82.6,,95.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.19,16.8,,19.35,,,0,"percent of total billed charges","16.8% of total billed charges",144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",22.03,144,
"INTERPULSE HANDPIECE W/SUCTION",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"INTERNAL BRACE (LISFRANC)",ORSUP0046,CDM,278,RC,,,OUTPATIENT,,,9373,6092.45,,8248.24,88,,6598.59,,,0,"percent of total billed charges","88% of total billed charges",4686.5,50,,3749.20,,,0,"percent of total billed charges","50% of total billed charges",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1621.9,17.304,,1297.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5904.99,63,,4723.99,,,0,"percent of total billed charges","63% of total billed charges",1434.07,15.3,,1147.26,,,0,"percent of total billed charges","15.3% of total billed charges",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",6467.37,69,,,,,0,"fee schedule","69% of total billed charges",9373,100,,7498.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9373,100,,7498.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9373,100,,7498.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5797.2,61.85,,4637.76,,,0,"percent of total billed charges","61.5% of total billed charges",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",4686.5,50,,3749.20,,,0,"percent of total billed charges","50% of total billed charges",3018.11,32.2,,2414.49,,,0,"percent of total billed charges","32.2% of total billed charges",2924.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1606.16,17.136,,1284.93,,,0,"percent of total billed charges","17.136% of total billed charges",2047.06,21.84,,1637.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3533.62,37.7,,2826.90,,,0,"percent of total billed charges","37.7% of total billed charges",3533.62,37.7,,2826.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3177.45,33.9,,2541.96,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7310.94,78,,5848.75,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7742.1,82.6,,6193.68,,,0,"percent of total billed charges","82.6% of total billed charges",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",4686.5,50,,3749.20,,,0,"percent of total billed charges","50% of total billed charges",7742.1,82.6,,6193.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",9373,100,,7498.40,,,0,"percent of total billed charges","100% of total billed charges",1434.07,9373,
"INTRODUCER SHEATH 11.5 FR",ORSUP0030,CDM,278,RC,,,OUTPATIENT,,,5088,3307.2,,4477.44,88,,3581.95,,,0,"percent of total billed charges","88% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",880.43,17.304,,704.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3205.44,63,,2564.35,,,0,"percent of total billed charges","63% of total billed charges",778.46,15.3,,622.77,,,0,"percent of total billed charges","15.3% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",3510.72,69,,,,,0,"fee schedule","69% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3146.93,61.85,,2517.54,,,0,"percent of total billed charges","61.5% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",1638.34,32.2,,1310.67,,,0,"percent of total billed charges","32.2% of total billed charges",1587.46,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",871.88,17.136,,697.50,,,0,"percent of total billed charges","17.136% of total billed charges",1111.22,21.84,,888.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1918.18,37.7,,1534.54,,,0,"percent of total billed charges","37.7% of total billed charges",1918.18,37.7,,1534.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1724.83,33.9,,1379.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3968.64,78,,3174.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",778.46,5088,
"INTRODUCER FAST-CATH 8.5F SL 1 80CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"INTRODUCER 6FR 14CM",ORSUP0003,CDM,278,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.7% of total billed charges",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.14,33.9,,54.51,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"INTRO ANSEL2 7FR 45CM",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"INTRO ANSEL1 7FR 45CM",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"INTRO ANSEL3 6FR 45CM",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"INTRODUCER SHEATH ANSEL 1 5FR",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"INTRODUCER CATH SHEATH BRITE TIP 7F .035IN 90CM L",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"INTRODUCER CATH SHEATH BRITE TIP 7F .035IN 55CM L",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"INTRO RAABE 7FR 70CM",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"INTRO BALKIN 6FR 40CM",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"INTRODUCER CHECK-FLO  16FR X 30CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"INTRODUCER SHEATH FLEXOR 7FR 90CM X 100 IN",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"INTRODUCER FLEX RAABE 5FR",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"INTRO CHECK FLO XL 22FR 25CM",ORSUP0019,CDM,278,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",668.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.7% of total billed charges",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",726.14,33.9,,580.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"INTRODUCER 4FR LONG",ORSUP0002,CDM,278,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.7% of total billed charges",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.43,33.9,,36.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"INTRODUCER ACCESSORY 14 GUAGE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"INTRODUCER FLEX-GLIDE ET TUBE",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
N/A,ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"INTRODUCER SHEATH AVANTI 5FR 23CM",ORSUP0003,CDM,278,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.7% of total billed charges",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.14,33.9,,54.51,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"INTRODUCER GLIDE SHEATH 6FR",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"INTRODUCER WITH MINI GUIDEWIRE 5.5CMCORDIS",ORSUP0003,CDM,278,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.7% of total billed charges",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.14,33.9,,54.51,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"INTRODUCER CHECK FLO  6FR",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"INTRODUCER TUOHY BORST SIDE ARM 6FR",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"INTRODUCER SHEATH SPLITTABLE 7FR X 13CM",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"INTRODUCER SERTERA (BREAST BX)",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"INTRODUCER PEELAWAY 5FR",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"INTRODUCER MICRO SHEATH 6FR",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"INTRODUCER BOUGIE PEDIATRIC 10FR",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"INTRODUCER BOUGIE ADULT 15FR",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"IO STABELIZER KIT",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"IODINE SCRUB SOLUTION 4 OZ",490765,CDM,270,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"IODINE PREP SOLUTION 4 OZ.",490764,CDM,270,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"IOGONE IODINE REMOVER PREP PADS",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"IPASS 3 DIAMOND TIP",ORSUP0023,CDM,272,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"IQ CAL PACK",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"IQ CONTROL/FOCUS SET",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"IQ LAMINA BOTTLES",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"IRIS DILUENT PACK",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"IRIS SYSTEM CLEANSER PACK",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"IRON / 5 PACK / 300 SLIDES",ORSUP0019,CDM,272,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"IRRIGATOR SUCTION W/TIP",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"IRRIGATOR ENDOWRIST",336598,CDM,272,RC,,,OUTPATIENT,,,1819,1182.35,,1600.72,88,,1280.58,,,0,"percent of total billed charges","88% of total billed charges",909.5,50,,727.60,,,0,"percent of total billed charges","50% of total billed charges",305.59,16.8,,244.47,,,0,"percent of total billed charges","16.8% of total billed charges",1819,100,,1455.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",314.76,17.304,,251.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1145.97,63,,916.78,,,0,"percent of total billed charges","63% of total billed charges",278.31,15.3,,222.65,,,0,"percent of total billed charges","15.3% of total billed charges",305.59,16.8,,244.47,,,0,"percent of total billed charges","16.8% of total billed charges",1255.11,69,,,,,0,"fee schedule","69% of total billed charges",1819,100,,1455.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1819,100,,1455.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1819,100,,1455.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1125.05,61.85,,900.04,,,0,"percent of total billed charges","61.5% of total billed charges",305.59,16.8,,244.47,,,0,"percent of total billed charges","16.8% of total billed charges",909.5,50,,727.60,,,0,"percent of total billed charges","50% of total billed charges",585.72,32.2,,468.58,,,0,"percent of total billed charges","32.2% of total billed charges",305.59,16.8,,244.47,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",311.7,17.136,,249.36,,,0,"percent of total billed charges","17.136% of total billed charges",397.27,21.84,,317.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",685.76,37.7,,548.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1418.82,78,,1135.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1502.49,82.6,,1201.99,,,0,"percent of total billed charges","82.6% of total billed charges",305.59,16.8,,244.47,,,0,"percent of total billed charges","16.8% of total billed charges",909.5,50,,727.60,,,0,"percent of total billed charges","50% of total billed charges",1502.49,82.6,,1201.99,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",305.59,16.8,,244.47,,,0,"percent of total billed charges","16.8% of total billed charges",1819,100,,1455.20,,,0,"percent of total billed charges","100% of total billed charges",278.31,1819,
"IRRIGATOR SUCTION 5MM DA VINCI",337821,CDM,272,RC,,,OUTPATIENT,,,2356,1531.4,,2073.28,88,,1658.62,,,0,"percent of total billed charges","88% of total billed charges",1178,50,,942.40,,,0,"percent of total billed charges","50% of total billed charges",395.81,16.8,,316.65,,,0,"percent of total billed charges","16.8% of total billed charges",2356,100,,1884.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",407.68,17.304,,326.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1484.28,63,,1187.42,,,0,"percent of total billed charges","63% of total billed charges",360.47,15.3,,288.38,,,0,"percent of total billed charges","15.3% of total billed charges",395.81,16.8,,316.65,,,0,"percent of total billed charges","16.8% of total billed charges",1625.64,69,,,,,0,"fee schedule","69% of total billed charges",2356,100,,1884.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2356,100,,1884.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2356,100,,1884.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1457.19,61.85,,1165.75,,,0,"percent of total billed charges","61.5% of total billed charges",395.81,16.8,,316.65,,,0,"percent of total billed charges","16.8% of total billed charges",1178,50,,942.40,,,0,"percent of total billed charges","50% of total billed charges",758.63,32.2,,606.90,,,0,"percent of total billed charges","32.2% of total billed charges",395.81,16.8,,316.65,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.72,17.136,,322.98,,,0,"percent of total billed charges","17.136% of total billed charges",514.55,21.84,,411.64,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",888.21,37.7,,710.57,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1837.68,78,,1470.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1946.06,82.6,,1556.85,,,0,"percent of total billed charges","82.6% of total billed charges",395.81,16.8,,316.65,,,0,"percent of total billed charges","16.8% of total billed charges",1178,50,,942.40,,,0,"percent of total billed charges","50% of total billed charges",1946.06,82.6,,1556.85,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",395.81,16.8,,316.65,,,0,"percent of total billed charges","16.8% of total billed charges",2356,100,,1884.80,,,0,"percent of total billed charges","100% of total billed charges",360.47,2356,
"IRRIGATION CASSETTE HUMMER DIS",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"IRRESEPT JET LAVAGE",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,927,602.55,,815.76,88,,652.61,,,0,"percent of total billed charges","88% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.41,17.304,,128.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.01,63,,467.21,,,0,"percent of total billed charges","63% of total billed charges",141.83,15.3,,113.46,,,0,"percent of total billed charges","15.3% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",639.63,69,,,,,0,"fee schedule","69% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",573.35,61.85,,458.68,,,0,"percent of total billed charges","61.5% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",298.49,32.2,,238.79,,,0,"percent of total billed charges","32.2% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.85,17.136,,127.08,,,0,"percent of total billed charges","17.136% of total billed charges",202.46,21.84,,161.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",349.48,37.7,,279.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",723.06,78,,578.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",141.83,927,
"IRRESEPT LAVAGE 150ML",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"ISE MID STANDARD 4X2000ML",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"ISE REFERENCE 4X1000ML",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"ISE INTERNAL REFERENCE 2X25ML",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"ISE LOW SERUM STANDARD 4X100ML",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"ISE HIGH SERUM STANDARD 4X100ML",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"ISE LOW/HIHGH SERUM 4X100ML",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"ISE NA+/K+ SELECTIVITY CHECK",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"ISOLATION DRAPE",490768,CDM,270,RC,,,OUTPATIENT,,,362,235.3,,318.56,88,,254.85,,,0,"percent of total billed charges","88% of total billed charges",181,50,,144.80,,,0,"percent of total billed charges","50% of total billed charges",60.82,16.8,,48.66,,,0,"percent of total billed charges","16.8% of total billed charges",362,100,,289.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.64,17.304,,50.11,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",228.06,63,,182.45,,,0,"percent of total billed charges","63% of total billed charges",55.39,15.3,,44.31,,,0,"percent of total billed charges","15.3% of total billed charges",60.82,16.8,,48.66,,,0,"percent of total billed charges","16.8% of total billed charges",249.78,69,,,,,0,"fee schedule","69% of total billed charges",362,100,,289.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",362,100,,289.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",362,100,,289.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.9,61.85,,179.12,,,0,"percent of total billed charges","61.5% of total billed charges",60.82,16.8,,48.66,,,0,"percent of total billed charges","16.8% of total billed charges",181,50,,144.80,,,0,"percent of total billed charges","50% of total billed charges",116.56,32.2,,93.25,,,0,"percent of total billed charges","32.2% of total billed charges",60.82,16.8,,48.66,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.03,17.136,,49.62,,,0,"percent of total billed charges","17.136% of total billed charges",79.06,21.84,,63.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",136.47,37.7,,109.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",282.36,78,,225.89,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",299.01,82.6,,239.21,,,0,"percent of total billed charges","82.6% of total billed charges",60.82,16.8,,48.66,,,0,"percent of total billed charges","16.8% of total billed charges",181,50,,144.80,,,0,"percent of total billed charges","50% of total billed charges",299.01,82.6,,239.21,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.82,16.8,,48.66,,,0,"percent of total billed charges","16.8% of total billed charges",362,100,,289.60,,,0,"percent of total billed charges","100% of total billed charges",55.39,362,
"ISOSORB LIQUID TREATMENT",490769,CDM,270,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"ISTAT KAOLIN ACT CARTRIDGE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"ISTAT ACT CONTROL LEVEL 1",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"ISTAT ACT CONTROL LEVEL 2",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"IV CLEARLINK HAND PUMP BLOOD SET",84809,CDM,270,RC,,,OUTPATIENT,,,78,50.7,,68.64,88,,54.91,,,0,"percent of total billed charges","88% of total billed charges",39,50,,31.20,,,0,"percent of total billed charges","50% of total billed charges",13.1,16.8,,10.48,,,0,"percent of total billed charges","16.8% of total billed charges",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.5,17.304,,10.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.14,63,,39.31,,,0,"percent of total billed charges","63% of total billed charges",11.93,15.3,,9.54,,,0,"percent of total billed charges","15.3% of total billed charges",13.1,16.8,,10.48,,,0,"percent of total billed charges","16.8% of total billed charges",53.82,69,,,,,0,"fee schedule","69% of total billed charges",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.24,61.85,,38.59,,,0,"percent of total billed charges","61.5% of total billed charges",13.1,16.8,,10.48,,,0,"percent of total billed charges","16.8% of total billed charges",39,50,,31.20,,,0,"percent of total billed charges","50% of total billed charges",25.12,32.2,,20.10,,,0,"percent of total billed charges","32.2% of total billed charges",13.1,16.8,,10.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.37,17.136,,10.70,,,0,"percent of total billed charges","17.136% of total billed charges",17.04,21.84,,13.63,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.41,37.7,,23.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",60.84,78,,48.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",13.1,16.8,,10.48,,,0,"percent of total billed charges","16.8% of total billed charges",39,50,,31.20,,,0,"percent of total billed charges","50% of total billed charges",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.1,16.8,,10.48,,,0,"percent of total billed charges","16.8% of total billed charges",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",11.93,78,
"IV REPLACEMENT CAP",490773,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"IV START KIT W/ PVP PREP PAD AND DRESSING",432487,CDM,272,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"IV START KIT",490774,CDM,272,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"IV START KIT KIT NEONATAL",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"JACKSON FRAME KIT",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"JACKSON REES MODIFICATION CIRCUITS",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"JACKSON FRAME KIT W/O HEAD REST",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"JADA SYSTEM",ORSUP0043,CDM,272,RC,,,OUTPATIENT,,,6592,4284.8,,5800.96,88,,4640.77,,,0,"percent of total billed charges","88% of total billed charges",3296,50,,2636.80,,,0,"percent of total billed charges","50% of total billed charges",1107.46,16.8,,885.97,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1140.68,17.304,,912.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4152.96,63,,3322.37,,,0,"percent of total billed charges","63% of total billed charges",1008.58,15.3,,806.86,,,0,"percent of total billed charges","15.3% of total billed charges",1107.46,16.8,,885.97,,,0,"percent of total billed charges","16.8% of total billed charges",4548.48,69,,,,,0,"fee schedule","69% of total billed charges",6592,100,,5273.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6592,100,,5273.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6592,100,,5273.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4077.15,61.85,,3261.72,,,0,"percent of total billed charges","61.5% of total billed charges",1107.46,16.8,,885.97,,,0,"percent of total billed charges","16.8% of total billed charges",3296,50,,2636.80,,,0,"percent of total billed charges","50% of total billed charges",2122.62,32.2,,1698.10,,,0,"percent of total billed charges","32.2% of total billed charges",1107.46,16.8,,885.97,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1129.61,17.136,,903.69,,,0,"percent of total billed charges","17.136% of total billed charges",1439.69,21.84,,1151.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2485.18,37.7,,1988.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5141.76,78,,4113.41,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5444.99,82.6,,4355.99,,,0,"percent of total billed charges","82.6% of total billed charges",1107.46,16.8,,885.97,,,0,"percent of total billed charges","16.8% of total billed charges",3296,50,,2636.80,,,0,"percent of total billed charges","50% of total billed charges",5444.99,82.6,,4355.99,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1107.46,16.8,,885.97,,,0,"percent of total billed charges","16.8% of total billed charges",6592,100,,5273.60,,,0,"percent of total billed charges","100% of total billed charges",1008.58,6592,
"JAGWIRE HYDRA ST .035 450 CM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"JAGWIRE HYDRA ANG 260 CM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"JAGWIRE .025 X 260CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"JEJUNAL FEEDING TUBE 12FR",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,721,468.65,,634.48,88,,507.58,,,0,"percent of total billed charges","88% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.76,17.304,,99.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.23,63,,363.38,,,0,"percent of total billed charges","63% of total billed charges",110.31,15.3,,88.25,,,0,"percent of total billed charges","15.3% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",497.49,69,,,,,0,"fee schedule","69% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",445.94,61.85,,356.75,,,0,"percent of total billed charges","61.5% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",232.16,32.2,,185.73,,,0,"percent of total billed charges","32.2% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",123.55,17.136,,98.84,,,0,"percent of total billed charges","17.136% of total billed charges",157.47,21.84,,125.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",271.82,37.7,,217.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",562.38,78,,449.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",595.55,82.6,,476.44,,,0,"percent of total billed charges","82.6% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",595.55,82.6,,476.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",110.31,721,
"JEJUNAL FEEDING TUBE 16FR",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,721,468.65,,634.48,88,,507.58,,,0,"percent of total billed charges","88% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.76,17.304,,99.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.23,63,,363.38,,,0,"percent of total billed charges","63% of total billed charges",110.31,15.3,,88.25,,,0,"percent of total billed charges","15.3% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",497.49,69,,,,,0,"fee schedule","69% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",445.94,61.85,,356.75,,,0,"percent of total billed charges","61.5% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",232.16,32.2,,185.73,,,0,"percent of total billed charges","32.2% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",123.55,17.136,,98.84,,,0,"percent of total billed charges","17.136% of total billed charges",157.47,21.84,,125.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",271.82,37.7,,217.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",562.38,78,,449.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",595.55,82.6,,476.44,,,0,"percent of total billed charges","82.6% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",595.55,82.6,,476.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",110.31,721,
"JEWELERS FORCEPS",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,17.304,,49.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.28,61.85,,178.62,,,0,"percent of total billed charges","61.5% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",116.24,32.2,,92.99,,,0,"percent of total billed charges","32.2% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.86,17.136,,49.49,,,0,"percent of total billed charges","17.136% of total billed charges",78.84,21.84,,63.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,361,
"JOIMAX VAPOR FLEX PROBE 320",ORSUP0024,CDM,272,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"JOIMAX TESSYS ACCESS KIT",ORSUP0031,CDM,272,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"JOIMAX PUMP TUBING",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"JOIMAX HORIZONTAL DRAPE",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"JOIMAX CAMERA COVER",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"JOIMAX NDL AND GUIDEWIRE 150",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"JOIMAX DIAMOND ABRASSOR 3.5",ORSUP0023,CDM,272,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"JOIMAX VAPOR FLEX PROBE 250",ORSUP0024,CDM,272,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"JOIMAX NDL AND GUIDEWIRE 230",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"JOIMAX DIAMOND ABRASOR 4.5",ORSUP0026,CDM,272,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"JOIMAX OLIVE CUTTER",ORSUP0024,CDM,272,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"JOIMAX DEFLECTOR DIA ABRASOR",ORSUP0027,CDM,272,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"JST KIT",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"JUMPSUIT SURGICAL IMPERMEABLE PLYTHYLN W/TIE UNIV",168590,CDM,270,RC,,,OUTPATIENT,,,89,57.85,,78.32,88,,62.66,,,0,"percent of total billed charges","88% of total billed charges",44.5,50,,35.60,,,0,"percent of total billed charges","50% of total billed charges",14.95,16.8,,11.96,,,0,"percent of total billed charges","16.8% of total billed charges",89,100,,71.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.4,17.304,,12.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.07,63,,44.86,,,0,"percent of total billed charges","63% of total billed charges",13.62,15.3,,10.90,,,0,"percent of total billed charges","15.3% of total billed charges",14.95,16.8,,11.96,,,0,"percent of total billed charges","16.8% of total billed charges",61.41,69,,,,,0,"fee schedule","69% of total billed charges",89,100,,71.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89,100,,71.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89,100,,71.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",55.05,61.85,,44.04,,,0,"percent of total billed charges","61.5% of total billed charges",14.95,16.8,,11.96,,,0,"percent of total billed charges","16.8% of total billed charges",44.5,50,,35.60,,,0,"percent of total billed charges","50% of total billed charges",28.66,32.2,,22.93,,,0,"percent of total billed charges","32.2% of total billed charges",14.95,16.8,,11.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.25,17.136,,12.20,,,0,"percent of total billed charges","17.136% of total billed charges",19.44,21.84,,15.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",33.55,37.7,,26.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",69.42,78,,55.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",73.51,82.6,,58.81,,,0,"percent of total billed charges","82.6% of total billed charges",14.95,16.8,,11.96,,,0,"percent of total billed charges","16.8% of total billed charges",44.5,50,,35.60,,,0,"percent of total billed charges","50% of total billed charges",73.51,82.6,,58.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.95,16.8,,11.96,,,0,"percent of total billed charges","16.8% of total billed charges",89,100,,71.20,,,0,"percent of total billed charges","100% of total billed charges",13.62,89,
"JURGAN PIN BALL W062",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"JURGAN PIN BALL W045",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"JURGEN BALL .062",ORSUP0002,CDM,278,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.7% of total billed charges",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.43,33.9,,36.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"K WIRE 1.5MM",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"K WIRE 2.5MM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"K-WIRE .028X4IN",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"K-WIRE .035X4IN",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"K-WIRE .045X4IN",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"K-WIRE .062 1/16X9IN",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"K-WIRE .062X4IN",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"K-WIRE 1.1 X 100MM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"K-WIRE 1.60",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"K-WIRE PIN .062",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"K-WIRE PIN .045",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"K-WIRE .062 BRASSELER",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"K-WIRE .054 BRASSELER",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"K-WIRE .045 BRASSELER",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"K-WIRE .035 BRASSELER",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"K-WIRE .045X9",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"K-WIRE 2MM SMOOTH",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"K-WIRE 0.054 X 6 NON STERILE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"K-WIRE 0.045 X 6 NON STERILE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"EPUMP 1000ML SAFETY SCREW SPIKE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"KELLER FUNNEL 2",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,721,468.65,,634.48,88,,507.58,,,0,"percent of total billed charges","88% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.76,17.304,,99.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.23,63,,363.38,,,0,"percent of total billed charges","63% of total billed charges",110.31,15.3,,88.25,,,0,"percent of total billed charges","15.3% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",497.49,69,,,,,0,"fee schedule","69% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",445.94,61.85,,356.75,,,0,"percent of total billed charges","61.5% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",232.16,32.2,,185.73,,,0,"percent of total billed charges","32.2% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",123.55,17.136,,98.84,,,0,"percent of total billed charges","17.136% of total billed charges",157.47,21.84,,125.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",271.82,37.7,,217.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",562.38,78,,449.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",595.55,82.6,,476.44,,,0,"percent of total billed charges","82.6% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",595.55,82.6,,476.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",110.31,721,
"KERLIX 4.5",490777,CDM,270,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"KEY METER HT314 TRANSONIC",ORSUP0027,CDM,270,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
KIMWIPES,ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"KIT GASTRO TUBE INITIAL PUSH 20FR",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"KIT GASTROSTOMY INITIAL W/GASTRO INTRN BOLSTR 20F",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"KIT PERICARDIAL(PERI-VAC)",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"KIT LUMBAR EXTERNAL DRAINAGE",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"KIT CATHETER PLEURAL 16F INTRODUCER 5 IN 1 CNNCTR",ORSUP0023,CDM,278,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",1002.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.7% of total billed charges",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1089.55,33.9,,871.64,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"KIT DRAINAGE PLEURX W/500ML VACUUM BT \\T\\ PROCDR PK",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"KIT MIDLINE POWERGLIDE FULL 18G 8CM",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"KIT MIDLINE POWERGLIDE FULL 20G 8CM",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"KIT TRACH BLUE RHINO PERCUTANEOUS 6MM",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",751.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.7% of total billed charges",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",816.99,33.9,,653.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"KIT MICROPUNCTURE 4F G48002",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"KIT CATH INSERTION IAB 8F 40CC W/DATASCOPE CONN",ORSUP0026,CDM,278,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",1253.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.7% of total billed charges",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1361.76,33.9,,1089.41,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"KIT TUNNELER SHEATH 8INX17GA",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"KIT GYNECARE TVT ABD. GUIDE",ORSUP0027,CDM,278,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",1336.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.7% of total billed charges",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1452.62,33.9,,1162.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"KIT TRANS-OBTURATOR TAPE ARIS SURGICAL",ORSUP0033,CDM,278,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",1838.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.7% of total billed charges",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1997.39,33.9,,1597.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"KIT MICROSNARE 7MM",ORSUP0024,CDM,278,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",1086.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.7% of total billed charges",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1180.06,33.9,,944.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"KIT PBP2 MRSA RAPID LATEX SLIDE AGGLUTINATION",ORSUP0024,CDM,270,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"KIT SUCTION CATH N GLOVE 10FR",11984,CDM,272,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"KIT BEDSIDE CARE ENDOSCOPY",320533,CDM,272,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.9,61.85,,7.92,,,0,"percent of total billed charges","61.5% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"KIT BEDSIDE CLEANING INCL 16OZ BOWL  SPONGE",463127,CDM,272,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"KIT CHG",461921,CDM,270,RC,,,OUTPATIENT,,,54,35.1,,47.52,88,,38.02,,,0,"percent of total billed charges","88% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.34,17.304,,7.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.02,63,,27.22,,,0,"percent of total billed charges","63% of total billed charges",8.26,15.3,,6.61,,,0,"percent of total billed charges","15.3% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",37.26,69,,,,,0,"fee schedule","69% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.4,61.85,,26.72,,,0,"percent of total billed charges","61.5% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",17.39,32.2,,13.91,,,0,"percent of total billed charges","32.2% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.25,17.136,,7.40,,,0,"percent of total billed charges","17.136% of total billed charges",11.79,21.84,,9.43,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.36,37.7,,16.29,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",42.12,78,,33.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.6,82.6,,35.68,,,0,"percent of total billed charges","82.6% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",44.6,82.6,,35.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",8.26,54,
"KIT DEFENDO SINGLE USE VALVE AND CONNECTOR",411911,CDM,272,RC,,,OUTPATIENT,,,60,39,,52.8,88,,42.24,,,0,"percent of total billed charges","88% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.38,17.304,,8.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.8,63,,30.24,,,0,"percent of total billed charges","63% of total billed charges",9.18,15.3,,7.34,,,0,"percent of total billed charges","15.3% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",41.4,69,,,,,0,"fee schedule","69% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.11,61.85,,29.69,,,0,"percent of total billed charges","61.5% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",19.32,32.2,,15.46,,,0,"percent of total billed charges","32.2% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.28,17.136,,8.22,,,0,"percent of total billed charges","17.136% of total billed charges",13.1,21.84,,10.48,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,37.7,,18.10,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.8,78,,37.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.56,82.6,,39.65,,,0,"percent of total billed charges","82.6% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",49.56,82.6,,39.65,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",9.18,60,
"KIT DISP ACCESSORY 3ARM IS3000 5P",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"KIT DISP ACCESSORY 4ARM IS3000 5P",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"KIT IV START CHLOROSCRUB TEGADERM",280796,CDM,270,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"KIT IV START W/CHLORAPREP AMPULE",324582,CDM,270,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"KIT PROCEDURE EDGE FT 90 DEGREE",ORSUP0035,CDM,270,RC,,,OUTPATIENT,,,6427,4177.55,,5655.76,88,,4524.61,,,0,"percent of total billed charges","88% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1112.13,17.304,,889.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4049.01,63,,3239.21,,,0,"percent of total billed charges","63% of total billed charges",983.33,15.3,,786.66,,,0,"percent of total billed charges","15.3% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4434.63,69,,,,,0,"fee schedule","69% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3975.1,61.85,,3180.08,,,0,"percent of total billed charges","61.5% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",2069.49,32.2,,1655.59,,,0,"percent of total billed charges","32.2% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1101.33,17.136,,881.06,,,0,"percent of total billed charges","17.136% of total billed charges",1403.66,21.84,,1122.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5013.06,78,,4010.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",983.33,6427,
"KIT TURNOVER CUSTOM",431986,CDM,270,RC,,,OUTPATIENT,,,104,67.6,,91.52,88,,73.22,,,0,"percent of total billed charges","88% of total billed charges",52,50,,41.60,,,0,"percent of total billed charges","50% of total billed charges",17.47,16.8,,13.98,,,0,"percent of total billed charges","16.8% of total billed charges",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,17.304,,14.40,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",65.52,63,,52.42,,,0,"percent of total billed charges","63% of total billed charges",15.91,15.3,,12.73,,,0,"percent of total billed charges","15.3% of total billed charges",17.47,16.8,,13.98,,,0,"percent of total billed charges","16.8% of total billed charges",71.76,69,,,,,0,"fee schedule","69% of total billed charges",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.32,61.85,,51.46,,,0,"percent of total billed charges","61.5% of total billed charges",17.47,16.8,,13.98,,,0,"percent of total billed charges","16.8% of total billed charges",52,50,,41.60,,,0,"percent of total billed charges","50% of total billed charges",33.49,32.2,,26.79,,,0,"percent of total billed charges","32.2% of total billed charges",17.47,16.8,,13.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.136,,14.26,,,0,"percent of total billed charges","17.136% of total billed charges",22.71,21.84,,18.17,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39.21,37.7,,31.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",81.12,78,,64.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.9,82.6,,68.72,,,0,"percent of total billed charges","82.6% of total billed charges",17.47,16.8,,13.98,,,0,"percent of total billed charges","16.8% of total billed charges",52,50,,41.60,,,0,"percent of total billed charges","50% of total billed charges",85.9,82.6,,68.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.47,16.8,,13.98,,,0,"percent of total billed charges","16.8% of total billed charges",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",15.91,104,
"KIT TEST HCG COMBO QUICKVUE LATERAL FLOW PREGNANCY",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"KIT CALAS CRYPTOCOCCAL ANTIGEN",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"KIT FECAL CONCENTRATOE",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"KIT TUNNELER/SHEATH T11X12",ORSUP0015,CDM,270,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"KIT EXPANSION CATH ON Q SOAKER 3.25",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"KIT SURGIFOAM POWDER",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"KIT EPIDURAL CATH 19GA X 60CM CONT NRV BLK LTX FR",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"KIT CEMENT OPTIVAC  80GRAM",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"KIT CRANIAL ACCESS",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"KIT VESSEL HARVEST HEMOPRO VH-3000",ORSUP0035,CDM,272,RC,,,OUTPATIENT,,,6427,4177.55,,5655.76,88,,4524.61,,,0,"percent of total billed charges","88% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1112.13,17.304,,889.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4049.01,63,,3239.21,,,0,"percent of total billed charges","63% of total billed charges",983.33,15.3,,786.66,,,0,"percent of total billed charges","15.3% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4434.63,69,,,,,0,"fee schedule","69% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3975.1,61.85,,3180.08,,,0,"percent of total billed charges","61.5% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",2069.49,32.2,,1655.59,,,0,"percent of total billed charges","32.2% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1101.33,17.136,,881.06,,,0,"percent of total billed charges","17.136% of total billed charges",1403.66,21.84,,1122.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5013.06,78,,4010.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",983.33,6427,
"KIT GELFOAM THROMBIN PLUS",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"KIT GELFOAM PLUS",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"KIT EVAC 3-SPRING 400ML LRG 3/16 INCH W/TROCAR",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"KIT EVAC 3-SPRING 400ML MED 1/8 INCH W/TROCAR",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"KIT MIDSTREAM CATCH",1019,CDM,272,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"KIT ACP SERIES II",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"KIT ARTERIAL LINE KIT",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"KIT BIO-TENODESIS DISPOSABLE  STERILE",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"KIT BLOWER/MISTER",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"KIT BREAST PUMP W/FILTER UNIVERSAL REUSABLE",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"KIT EDGE 180 PROCEDURE",ORSUP0035,CDM,272,RC,,,OUTPATIENT,,,6427,4177.55,,5655.76,88,,4524.61,,,0,"percent of total billed charges","88% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1112.13,17.304,,889.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4049.01,63,,3239.21,,,0,"percent of total billed charges","63% of total billed charges",983.33,15.3,,786.66,,,0,"percent of total billed charges","15.3% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4434.63,69,,,,,0,"fee schedule","69% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3975.1,61.85,,3180.08,,,0,"percent of total billed charges","61.5% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",2069.49,32.2,,1655.59,,,0,"percent of total billed charges","32.2% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1101.33,17.136,,881.06,,,0,"percent of total billed charges","17.136% of total billed charges",1403.66,21.84,,1122.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5013.06,78,,4010.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",983.33,6427,
"KIT EDGE 45 PROCEDURE",ORSUP0035,CDM,272,RC,,,OUTPATIENT,,,6427,4177.55,,5655.76,88,,4524.61,,,0,"percent of total billed charges","88% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1112.13,17.304,,889.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4049.01,63,,3239.21,,,0,"percent of total billed charges","63% of total billed charges",983.33,15.3,,786.66,,,0,"percent of total billed charges","15.3% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4434.63,69,,,,,0,"fee schedule","69% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3975.1,61.85,,3180.08,,,0,"percent of total billed charges","61.5% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",2069.49,32.2,,1655.59,,,0,"percent of total billed charges","32.2% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1101.33,17.136,,881.06,,,0,"percent of total billed charges","17.136% of total billed charges",1403.66,21.84,,1122.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5013.06,78,,4010.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",983.33,6427,
"KIT EDGE 90 PROCEDURE",ORSUP0033,CDM,272,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"KIT EMG NEEDLE",ORSUP0031,CDM,272,RC,,,OUTPATIENT,,,5356,3481.4,,4713.28,88,,3770.62,,,0,"percent of total billed charges","88% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",926.8,17.304,,741.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3374.28,63,,2699.42,,,0,"percent of total billed charges","63% of total billed charges",819.47,15.3,,655.58,,,0,"percent of total billed charges","15.3% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",3695.64,69,,,,,0,"fee schedule","69% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3312.69,61.85,,2650.15,,,0,"percent of total billed charges","61.5% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",1724.63,32.2,,1379.70,,,0,"percent of total billed charges","32.2% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",917.8,17.136,,734.24,,,0,"percent of total billed charges","17.136% of total billed charges",1169.75,21.84,,935.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4177.68,78,,3342.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",819.47,5356,
"KIT ENT",ORSUP0051,CDM,272,RC,,,OUTPATIENT,,,10712,6962.8,,9426.56,88,,7541.25,,,0,"percent of total billed charges","88% of total billed charges",5356,50,,4284.80,,,0,"percent of total billed charges","50% of total billed charges",1799.62,16.8,,1439.70,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1853.6,17.304,,1482.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6748.56,63,,5398.85,,,0,"percent of total billed charges","63% of total billed charges",1638.94,15.3,,1311.15,,,0,"percent of total billed charges","15.3% of total billed charges",1799.62,16.8,,1439.70,,,0,"percent of total billed charges","16.8% of total billed charges",7391.28,69,,,,,0,"fee schedule","69% of total billed charges",10712,100,,8569.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10712,100,,8569.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10712,100,,8569.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6625.37,61.85,,5300.30,,,0,"percent of total billed charges","61.5% of total billed charges",1799.62,16.8,,1439.70,,,0,"percent of total billed charges","16.8% of total billed charges",5356,50,,4284.80,,,0,"percent of total billed charges","50% of total billed charges",3449.26,32.2,,2759.41,,,0,"percent of total billed charges","32.2% of total billed charges",1799.62,16.8,,1439.70,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1835.61,17.136,,1468.49,,,0,"percent of total billed charges","17.136% of total billed charges",2339.5,21.84,,1871.60,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4038.42,37.7,,3230.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8355.36,78,,6684.29,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8848.11,82.6,,7078.49,,,0,"percent of total billed charges","82.6% of total billed charges",1799.62,16.8,,1439.70,,,0,"percent of total billed charges","16.8% of total billed charges",5356,50,,4284.80,,,0,"percent of total billed charges","50% of total billed charges",8848.11,82.6,,7078.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1799.62,16.8,,1439.70,,,0,"percent of total billed charges","16.8% of total billed charges",10712,100,,8569.60,,,0,"percent of total billed charges","100% of total billed charges",1638.94,10712,
"KIT FECAL MGMT FLEXI-SEAL FMS",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"KIT INTRA CRANIAL MONITOR 110-4B",ORSUP0029,CDM,272,RC,,,OUTPATIENT,,,4820,3133,,4241.6,88,,3393.28,,,0,"percent of total billed charges","88% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",834.05,17.304,,667.24,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3036.6,63,,2429.28,,,0,"percent of total billed charges","63% of total billed charges",737.46,15.3,,589.97,,,0,"percent of total billed charges","15.3% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",3325.8,69,,,,,0,"fee schedule","69% of total billed charges",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2981.17,61.85,,2384.94,,,0,"percent of total billed charges","61.5% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",1552.04,32.2,,1241.63,,,0,"percent of total billed charges","32.2% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",825.96,17.136,,660.77,,,0,"percent of total billed charges","17.136% of total billed charges",1052.69,21.84,,842.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1817.14,37.7,,1453.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3759.6,78,,3007.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3981.32,82.6,,3185.06,,,0,"percent of total billed charges","82.6% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",3981.32,82.6,,3185.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",737.46,4820,
"KIT KYPHO 15/3 ADDITIONAL FX",ORSUP0045,CDM,272,RC,,,OUTPATIENT,,,9105,5918.25,,8012.4,88,,6409.92,,,0,"percent of total billed charges","88% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1575.53,17.304,,1260.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5736.15,63,,4588.92,,,0,"percent of total billed charges","63% of total billed charges",1393.07,15.3,,1114.46,,,0,"percent of total billed charges","15.3% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",6282.45,69,,,,,0,"fee schedule","69% of total billed charges",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5631.44,61.85,,4505.15,,,0,"percent of total billed charges","61.5% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",2931.81,32.2,,2345.45,,,0,"percent of total billed charges","32.2% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1560.23,17.136,,1248.18,,,0,"percent of total billed charges","17.136% of total billed charges",1988.53,21.84,,1590.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3432.59,37.7,,2746.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7101.9,78,,5681.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7520.73,82.6,,6016.58,,,0,"percent of total billed charges","82.6% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",7520.73,82.6,,6016.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",1393.07,9105,
"KIT LOCATABLE GUIDE",ORSUP0031,CDM,272,RC,,,OUTPATIENT,,,5356,3481.4,,4713.28,88,,3770.62,,,0,"percent of total billed charges","88% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",926.8,17.304,,741.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3374.28,63,,2699.42,,,0,"percent of total billed charges","63% of total billed charges",819.47,15.3,,655.58,,,0,"percent of total billed charges","15.3% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",3695.64,69,,,,,0,"fee schedule","69% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3312.69,61.85,,2650.15,,,0,"percent of total billed charges","61.5% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",1724.63,32.2,,1379.70,,,0,"percent of total billed charges","32.2% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",917.8,17.136,,734.24,,,0,"percent of total billed charges","17.136% of total billed charges",1169.75,21.84,,935.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4177.68,78,,3342.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",819.47,5356,
"KIT MAX ACCESS",ORSUP0044,CDM,272,RC,,,OUTPATIENT,,,8837,5744.05,,7776.56,88,,6221.25,,,0,"percent of total billed charges","88% of total billed charges",4418.5,50,,3534.80,,,0,"percent of total billed charges","50% of total billed charges",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1529.15,17.304,,1223.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5567.31,63,,4453.85,,,0,"percent of total billed charges","63% of total billed charges",1352.06,15.3,,1081.65,,,0,"percent of total billed charges","15.3% of total billed charges",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",6097.53,69,,,,,0,"fee schedule","69% of total billed charges",8837,100,,7069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8837,100,,7069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8837,100,,7069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5465.68,61.85,,4372.54,,,0,"percent of total billed charges","61.5% of total billed charges",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",4418.5,50,,3534.80,,,0,"percent of total billed charges","50% of total billed charges",2845.51,32.2,,2276.41,,,0,"percent of total billed charges","32.2% of total billed charges",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.31,17.136,,1211.45,,,0,"percent of total billed charges","17.136% of total billed charges",1930,21.84,,1544.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3331.55,37.7,,2665.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6892.86,78,,5514.29,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7299.36,82.6,,5839.49,,,0,"percent of total billed charges","82.6% of total billed charges",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",4418.5,50,,3534.80,,,0,"percent of total billed charges","50% of total billed charges",7299.36,82.6,,5839.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",8837,100,,7069.60,,,0,"percent of total billed charges","100% of total billed charges",1352.06,8837,
"KIT MULTI LUMEN 7FR X 30CM",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"KIT NUVASIVE XLIF",ORSUP0032,CDM,272,RC,,,OUTPATIENT,,,5624,3655.6,,4949.12,88,,3959.30,,,0,"percent of total billed charges","88% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",973.18,17.304,,778.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3543.12,63,,2834.50,,,0,"percent of total billed charges","63% of total billed charges",860.47,15.3,,688.38,,,0,"percent of total billed charges","15.3% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",3880.56,69,,,,,0,"fee schedule","69% of total billed charges",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3478.44,61.85,,2782.75,,,0,"percent of total billed charges","61.5% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",1810.93,32.2,,1448.74,,,0,"percent of total billed charges","32.2% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",963.73,17.136,,770.98,,,0,"percent of total billed charges","17.136% of total billed charges",1228.28,21.84,,982.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2120.25,37.7,,1696.20,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4386.72,78,,3509.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4645.42,82.6,,3716.34,,,0,"percent of total billed charges","82.6% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",4645.42,82.6,,3716.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",860.47,5624,
"KIT POSTCRANIAL PRESS.MONITOR",ORSUP0031,CDM,272,RC,,,OUTPATIENT,,,5356,3481.4,,4713.28,88,,3770.62,,,0,"percent of total billed charges","88% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",926.8,17.304,,741.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3374.28,63,,2699.42,,,0,"percent of total billed charges","63% of total billed charges",819.47,15.3,,655.58,,,0,"percent of total billed charges","15.3% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",3695.64,69,,,,,0,"fee schedule","69% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3312.69,61.85,,2650.15,,,0,"percent of total billed charges","61.5% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",1724.63,32.2,,1379.70,,,0,"percent of total billed charges","32.2% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",917.8,17.136,,734.24,,,0,"percent of total billed charges","17.136% of total billed charges",1169.75,21.84,,935.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4177.68,78,,3342.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",819.47,5356,
"KIT ROBOT ACCESORY 3-ARM",308440,CDM,272,RC,,,OUTPATIENT,,,1653,1074.45,,1454.64,88,,1163.71,,,0,"percent of total billed charges","88% of total billed charges",826.5,50,,661.20,,,0,"percent of total billed charges","50% of total billed charges",277.7,16.8,,222.16,,,0,"percent of total billed charges","16.8% of total billed charges",1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",286.04,17.304,,228.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1041.39,63,,833.11,,,0,"percent of total billed charges","63% of total billed charges",252.91,15.3,,202.33,,,0,"percent of total billed charges","15.3% of total billed charges",277.7,16.8,,222.16,,,0,"percent of total billed charges","16.8% of total billed charges",1140.57,69,,,,,0,"fee schedule","69% of total billed charges",1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1022.38,61.85,,817.90,,,0,"percent of total billed charges","61.5% of total billed charges",277.7,16.8,,222.16,,,0,"percent of total billed charges","16.8% of total billed charges",826.5,50,,661.20,,,0,"percent of total billed charges","50% of total billed charges",532.27,32.2,,425.82,,,0,"percent of total billed charges","32.2% of total billed charges",277.7,16.8,,222.16,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",283.26,17.136,,226.61,,,0,"percent of total billed charges","17.136% of total billed charges",361.02,21.84,,288.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",623.18,37.7,,498.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1289.34,78,,1031.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1365.38,82.6,,1092.30,,,0,"percent of total billed charges","82.6% of total billed charges",277.7,16.8,,222.16,,,0,"percent of total billed charges","16.8% of total billed charges",826.5,50,,661.20,,,0,"percent of total billed charges","50% of total billed charges",1365.38,82.6,,1092.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",277.7,16.8,,222.16,,,0,"percent of total billed charges","16.8% of total billed charges",1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",252.91,1653,
"KIT ROBOT ACCESORY 4-ARM",308441,CDM,272,RC,,,OUTPATIENT,,,2150,1397.5,,1892,88,,1513.60,,,0,"percent of total billed charges","88% of total billed charges",1075,50,,860.00,,,0,"percent of total billed charges","50% of total billed charges",361.2,16.8,,288.96,,,0,"percent of total billed charges","16.8% of total billed charges",2150,100,,1720.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.04,17.304,,297.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1354.5,63,,1083.60,,,0,"percent of total billed charges","63% of total billed charges",328.95,15.3,,263.16,,,0,"percent of total billed charges","15.3% of total billed charges",361.2,16.8,,288.96,,,0,"percent of total billed charges","16.8% of total billed charges",1483.5,69,,,,,0,"fee schedule","69% of total billed charges",2150,100,,1720.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2150,100,,1720.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2150,100,,1720.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1329.78,61.85,,1063.82,,,0,"percent of total billed charges","61.5% of total billed charges",361.2,16.8,,288.96,,,0,"percent of total billed charges","16.8% of total billed charges",1075,50,,860.00,,,0,"percent of total billed charges","50% of total billed charges",692.3,32.2,,553.84,,,0,"percent of total billed charges","32.2% of total billed charges",361.2,16.8,,288.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",368.42,17.136,,294.74,,,0,"percent of total billed charges","17.136% of total billed charges",469.56,21.84,,375.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",810.55,37.7,,648.44,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1677,78,,1341.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1775.9,82.6,,1420.72,,,0,"percent of total billed charges","82.6% of total billed charges",361.2,16.8,,288.96,,,0,"percent of total billed charges","16.8% of total billed charges",1075,50,,860.00,,,0,"percent of total billed charges","50% of total billed charges",1775.9,82.6,,1420.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",361.2,16.8,,288.96,,,0,"percent of total billed charges","16.8% of total billed charges",2150,100,,1720.00,,,0,"percent of total billed charges","100% of total billed charges",328.95,2150,
"KIT RUMI KOH-EFFICIENT 3.0CM",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"KIT RUMI KOH-EFFICIENT 3.5CM",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"KIT SKIN CLOSURE DERMABOND PRINEO 22CM",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"KIT SNARE RETRIEVAL 30MM",ORSUP0027,CDM,272,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"KIT TRIMANO BEACH CHAIR BX/6",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"KIT TURNOVER",480705,CDM,272,RC,,,OUTPATIENT,,,112,72.8,,98.56,88,,78.85,,,0,"percent of total billed charges","88% of total billed charges",56,50,,44.80,,,0,"percent of total billed charges","50% of total billed charges",18.82,16.8,,15.06,,,0,"percent of total billed charges","16.8% of total billed charges",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.38,17.304,,15.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.56,63,,56.45,,,0,"percent of total billed charges","63% of total billed charges",17.14,15.3,,13.71,,,0,"percent of total billed charges","15.3% of total billed charges",18.82,16.8,,15.06,,,0,"percent of total billed charges","16.8% of total billed charges",77.28,69,,,,,0,"fee schedule","69% of total billed charges",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.27,61.85,,55.42,,,0,"percent of total billed charges","61.5% of total billed charges",18.82,16.8,,15.06,,,0,"percent of total billed charges","16.8% of total billed charges",56,50,,44.80,,,0,"percent of total billed charges","50% of total billed charges",36.06,32.2,,28.85,,,0,"percent of total billed charges","32.2% of total billed charges",18.82,16.8,,15.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.19,17.136,,15.35,,,0,"percent of total billed charges","17.136% of total billed charges",24.46,21.84,,19.57,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",42.22,37.7,,33.78,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",87.36,78,,69.89,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.51,82.6,,74.01,,,0,"percent of total billed charges","82.6% of total billed charges",18.82,16.8,,15.06,,,0,"percent of total billed charges","16.8% of total billed charges",56,50,,44.80,,,0,"percent of total billed charges","50% of total billed charges",92.51,82.6,,74.01,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.82,16.8,,15.06,,,0,"percent of total billed charges","16.8% of total billed charges",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",17.14,112,
"KIT VIZADISC HIP PROCEDURE TRACKING  STERILE (23 IN A PK)",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"KIT SHAVE PERSONAL",74775,CDM,272,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"KIT DISP INSTRUMENT SUTURETAK MINI",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"KIT ENDOVIVE STANDARD PEG  20F PULL",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"KIT ERGOPACK TRIPLE LUMEN 7FR",ORSUP0014,CDM,270,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"KIT MICROPUNTURE 4 FR",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"KIT MICROPUNCTURE 5FR",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"KIT PILLOW PRONEVIEW HELMENT",490793,CDM,270,RC,,,OUTPATIENT,,,372,241.8,,327.36,88,,261.89,,,0,"percent of total billed charges","88% of total billed charges",186,50,,148.80,,,0,"percent of total billed charges","50% of total billed charges",62.5,16.8,,50.00,,,0,"percent of total billed charges","16.8% of total billed charges",372,100,,297.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.37,17.304,,51.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",234.36,63,,187.49,,,0,"percent of total billed charges","63% of total billed charges",56.92,15.3,,45.54,,,0,"percent of total billed charges","15.3% of total billed charges",62.5,16.8,,50.00,,,0,"percent of total billed charges","16.8% of total billed charges",256.68,69,,,,,0,"fee schedule","69% of total billed charges",372,100,,297.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372,100,,297.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372,100,,297.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",230.08,61.85,,184.06,,,0,"percent of total billed charges","61.5% of total billed charges",62.5,16.8,,50.00,,,0,"percent of total billed charges","16.8% of total billed charges",186,50,,148.80,,,0,"percent of total billed charges","50% of total billed charges",119.78,32.2,,95.82,,,0,"percent of total billed charges","32.2% of total billed charges",62.5,16.8,,50.00,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.75,17.136,,51.00,,,0,"percent of total billed charges","17.136% of total billed charges",81.24,21.84,,64.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",140.24,37.7,,112.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",290.16,78,,232.13,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",307.27,82.6,,245.82,,,0,"percent of total billed charges","82.6% of total billed charges",62.5,16.8,,50.00,,,0,"percent of total billed charges","16.8% of total billed charges",186,50,,148.80,,,0,"percent of total billed charges","50% of total billed charges",307.27,82.6,,245.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.5,16.8,,50.00,,,0,"percent of total billed charges","16.8% of total billed charges",372,100,,297.60,,,0,"percent of total billed charges","100% of total billed charges",56.92,372,
"KIT PICC 7 FR IMPREGNATED",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"KIT JEJUNOSTOMY FLEXIFLO 10 FR",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"KIT INSERTION, PERITONEAL",ORSUP0016,CDM,270,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"KIT INLET CLOSESURE DEVICE",ORSUP0014,CDM,270,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"KIT EAR DRESSING GLASSCOCK PED",490784,CDM,270,RC,,,OUTPATIENT,,,73,47.45,,64.24,88,,51.39,,,0,"percent of total billed charges","88% of total billed charges",36.5,50,,29.20,,,0,"percent of total billed charges","50% of total billed charges",12.26,16.8,,9.81,,,0,"percent of total billed charges","16.8% of total billed charges",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.63,17.304,,10.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.99,63,,36.79,,,0,"percent of total billed charges","63% of total billed charges",11.17,15.3,,8.94,,,0,"percent of total billed charges","15.3% of total billed charges",12.26,16.8,,9.81,,,0,"percent of total billed charges","16.8% of total billed charges",50.37,69,,,,,0,"fee schedule","69% of total billed charges",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.15,61.85,,36.12,,,0,"percent of total billed charges","61.5% of total billed charges",12.26,16.8,,9.81,,,0,"percent of total billed charges","16.8% of total billed charges",36.5,50,,29.20,,,0,"percent of total billed charges","50% of total billed charges",23.51,32.2,,18.81,,,0,"percent of total billed charges","32.2% of total billed charges",12.26,16.8,,9.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.51,17.136,,10.01,,,0,"percent of total billed charges","17.136% of total billed charges",15.94,21.84,,12.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",27.52,37.7,,22.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",56.94,78,,45.55,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",12.26,16.8,,9.81,,,0,"percent of total billed charges","16.8% of total billed charges",36.5,50,,29.20,,,0,"percent of total billed charges","50% of total billed charges",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.26,16.8,,9.81,,,0,"percent of total billed charges","16.8% of total billed charges",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",11.17,73,
"KIT EAR DRESS GLASSCOCK ADULT",490783,CDM,270,RC,,,OUTPATIENT,,,72,46.8,,63.36,88,,50.69,,,0,"percent of total billed charges","88% of total billed charges",36,50,,28.80,,,0,"percent of total billed charges","50% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.46,17.304,,9.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.36,63,,36.29,,,0,"percent of total billed charges","63% of total billed charges",11.02,15.3,,8.82,,,0,"percent of total billed charges","15.3% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",49.68,69,,,,,0,"fee schedule","69% of total billed charges",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.53,61.85,,35.62,,,0,"percent of total billed charges","61.5% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",36,50,,28.80,,,0,"percent of total billed charges","50% of total billed charges",23.18,32.2,,18.54,,,0,"percent of total billed charges","32.2% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.34,17.136,,9.87,,,0,"percent of total billed charges","17.136% of total billed charges",15.72,21.84,,12.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",27.14,37.7,,21.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",56.16,78,,44.93,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.47,82.6,,47.58,,,0,"percent of total billed charges","82.6% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",36,50,,28.80,,,0,"percent of total billed charges","50% of total billed charges",59.47,82.6,,47.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",11.02,72,
"KIT CHEST TUBE DISPOSABLE",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"KIT CATHETER MULTI LUMEN",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"KIT CATH SWAN NECK 2 CUFF LFT",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"KIT ANTI-FOG",490778,CDM,270,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"KIT BIOCARTILAGE SMALL JOINT",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1185,770.25,,1042.8,88,,834.24,,,0,"percent of total billed charges","88% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",205.05,17.304,,164.04,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",746.55,63,,597.24,,,0,"percent of total billed charges","63% of total billed charges",181.31,15.3,,145.05,,,0,"percent of total billed charges","15.3% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",817.65,69,,,,,0,"fee schedule","69% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.92,61.85,,586.34,,,0,"percent of total billed charges","61.5% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",381.57,32.2,,305.26,,,0,"percent of total billed charges","32.2% of total billed charges",369.72,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",203.06,17.136,,162.45,,,0,"percent of total billed charges","17.136% of total billed charges",258.8,21.84,,207.04,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",446.75,37.7,,357.40,,,0,"percent of total billed charges","37.7% of total billed charges",446.75,37.7,,357.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",401.72,33.9,,321.38,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",924.3,78,,739.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",181.31,1185,
"KIT STAPH AUREUS ATTC 25923",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"KIT BLOOD GAS 3M W/POINT LOC",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"KIT MICROPUNTURE 5FR",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"KIT DISPOSABLE FOR 2.9MM SHORT PUSH LOCK",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"KIT SYNDN-EZ TITANIUM",ORSUP0027,CDM,272,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"KIT ESCHERICHIA COLI TEST LATEX",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"KIT FULL ALTRIX SMALL COLDER",ORSUP0025,CDM,272,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"KIT FULL ALTRIX LARGE COLDER",ORSUP0025,CDM,272,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"KIT PERICARDIOCEN STRAIGHT 6FR",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"KIT BLOOD GAS 1ML LUER SLIP SYRINGE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"KIT SINGLE LUMEN 16G X 20CM CVC",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"KIT ANGIOPLASTY INSERTION TOOL",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"KIT URETHRAL RED RUBBER CATH W/O BAG",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"KIT ENDOVIVE STANDARD PEG 24FR",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,464,301.6,,408.32,88,,326.66,,,0,"percent of total billed charges","88% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.29,17.304,,64.23,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.32,63,,233.86,,,0,"percent of total billed charges","63% of total billed charges",70.99,15.3,,56.79,,,0,"percent of total billed charges","15.3% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",320.16,69,,,,,0,"fee schedule","69% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",286.98,61.85,,229.58,,,0,"percent of total billed charges","61.5% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",149.41,32.2,,119.53,,,0,"percent of total billed charges","32.2% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.51,17.136,,63.61,,,0,"percent of total billed charges","17.136% of total billed charges",101.34,21.84,,81.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",174.93,37.7,,139.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",361.92,78,,289.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",70.99,464,
"LAP KITTNER",490794,CDM,270,RC,,,OUTPATIENT,,,115,74.75,,101.2,88,,80.96,,,0,"percent of total billed charges","88% of total billed charges",57.5,50,,46.00,,,0,"percent of total billed charges","50% of total billed charges",19.32,16.8,,15.46,,,0,"percent of total billed charges","16.8% of total billed charges",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.9,17.304,,15.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",72.45,63,,57.96,,,0,"percent of total billed charges","63% of total billed charges",17.6,15.3,,14.08,,,0,"percent of total billed charges","15.3% of total billed charges",19.32,16.8,,15.46,,,0,"percent of total billed charges","16.8% of total billed charges",79.35,69,,,,,0,"fee schedule","69% of total billed charges",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.13,61.85,,56.90,,,0,"percent of total billed charges","61.5% of total billed charges",19.32,16.8,,15.46,,,0,"percent of total billed charges","16.8% of total billed charges",57.5,50,,46.00,,,0,"percent of total billed charges","50% of total billed charges",37.03,32.2,,29.62,,,0,"percent of total billed charges","32.2% of total billed charges",19.32,16.8,,15.46,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.71,17.136,,15.77,,,0,"percent of total billed charges","17.136% of total billed charges",25.12,21.84,,20.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.36,37.7,,34.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",89.7,78,,71.76,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",94.99,82.6,,75.99,,,0,"percent of total billed charges","82.6% of total billed charges",19.32,16.8,,15.46,,,0,"percent of total billed charges","16.8% of total billed charges",57.5,50,,46.00,,,0,"percent of total billed charges","50% of total billed charges",94.99,82.6,,75.99,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.32,16.8,,15.46,,,0,"percent of total billed charges","16.8% of total billed charges",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",17.6,115,
"KIWI PROCUP VAGINAL SUCTION DEVICE",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"KIWI OMNICUP SUCTION SYSTEM",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"KLEENSPEC VAGINAL LIGHTED",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"KLENZYME DETERGENT",490795,CDM,270,RC,,,OUTPATIENT,,,557,362.05,,490.16,88,,392.13,,,0,"percent of total billed charges","88% of total billed charges",278.5,50,,222.80,,,0,"percent of total billed charges","50% of total billed charges",93.58,16.8,,74.86,,,0,"percent of total billed charges","16.8% of total billed charges",557,100,,445.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",96.38,17.304,,77.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",350.91,63,,280.73,,,0,"percent of total billed charges","63% of total billed charges",85.22,15.3,,68.18,,,0,"percent of total billed charges","15.3% of total billed charges",93.58,16.8,,74.86,,,0,"percent of total billed charges","16.8% of total billed charges",384.33,69,,,,,0,"fee schedule","69% of total billed charges",557,100,,445.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",557,100,,445.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",557,100,,445.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",344.5,61.85,,275.60,,,0,"percent of total billed charges","61.5% of total billed charges",93.58,16.8,,74.86,,,0,"percent of total billed charges","16.8% of total billed charges",278.5,50,,222.80,,,0,"percent of total billed charges","50% of total billed charges",179.35,32.2,,143.48,,,0,"percent of total billed charges","32.2% of total billed charges",93.58,16.8,,74.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.45,17.136,,76.36,,,0,"percent of total billed charges","17.136% of total billed charges",121.65,21.84,,97.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.99,37.7,,167.99,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",434.46,78,,347.57,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",460.08,82.6,,368.06,,,0,"percent of total billed charges","82.6% of total billed charges",93.58,16.8,,74.86,,,0,"percent of total billed charges","16.8% of total billed charges",278.5,50,,222.80,,,0,"percent of total billed charges","50% of total billed charges",460.08,82.6,,368.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",93.58,16.8,,74.86,,,0,"percent of total billed charges","16.8% of total billed charges",557,100,,445.60,,,0,"percent of total billed charges","100% of total billed charges",85.22,557,
"KLING GAUZE STERILE 3",490796,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"KNEE BASEPLATE TIB TRIATHLON PRIM 4",ORSUP0088,CDM,278,RC,,,OUTPATIENT,,,20888,13577.2,,18381.44,88,,14705.15,,,0,"percent of total billed charges","88% of total billed charges",10444,50,,8355.20,,,0,"percent of total billed charges","50% of total billed charges",3509.18,16.8,,2807.34,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3614.46,17.304,,2891.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13159.44,63,,10527.55,,,0,"percent of total billed charges","63% of total billed charges",3195.86,15.3,,2556.69,,,0,"percent of total billed charges","15.3% of total billed charges",3509.18,16.8,,2807.34,,,0,"percent of total billed charges","16.8% of total billed charges",14412.72,69,,,,,0,"fee schedule","69% of total billed charges",20888,100,,16710.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20888,100,,16710.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20888,100,,16710.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12919.23,61.85,,10335.38,,,0,"percent of total billed charges","61.5% of total billed charges",3509.18,16.8,,2807.34,,,0,"percent of total billed charges","16.8% of total billed charges",10444,50,,8355.20,,,0,"percent of total billed charges","50% of total billed charges",6725.94,32.2,,5380.75,,,0,"percent of total billed charges","32.2% of total billed charges",6517.06,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3579.37,17.136,,2863.50,,,0,"percent of total billed charges","17.136% of total billed charges",4561.94,21.84,,3649.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",7874.78,37.7,,6299.82,,,0,"percent of total billed charges","37.7% of total billed charges",7874.78,37.7,,6299.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",7081.03,33.9,,5664.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",16292.64,78,,13034.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17253.49,82.6,,13802.79,,,0,"percent of total billed charges","82.6% of total billed charges",3509.18,16.8,,2807.34,,,0,"percent of total billed charges","16.8% of total billed charges",10444,50,,8355.20,,,0,"percent of total billed charges","50% of total billed charges",17253.49,82.6,,13802.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3509.18,16.8,,2807.34,,,0,"percent of total billed charges","16.8% of total billed charges",20888,100,,16710.40,,,0,"percent of total billed charges","100% of total billed charges",3195.86,20888,
"KNEE BASEPLATE TIB TRIATHLON PRIM 5",ORSUP0088,CDM,278,RC,,,OUTPATIENT,,,20888,13577.2,,18381.44,88,,14705.15,,,0,"percent of total billed charges","88% of total billed charges",10444,50,,8355.20,,,0,"percent of total billed charges","50% of total billed charges",3509.18,16.8,,2807.34,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3614.46,17.304,,2891.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13159.44,63,,10527.55,,,0,"percent of total billed charges","63% of total billed charges",3195.86,15.3,,2556.69,,,0,"percent of total billed charges","15.3% of total billed charges",3509.18,16.8,,2807.34,,,0,"percent of total billed charges","16.8% of total billed charges",14412.72,69,,,,,0,"fee schedule","69% of total billed charges",20888,100,,16710.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20888,100,,16710.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20888,100,,16710.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12919.23,61.85,,10335.38,,,0,"percent of total billed charges","61.5% of total billed charges",3509.18,16.8,,2807.34,,,0,"percent of total billed charges","16.8% of total billed charges",10444,50,,8355.20,,,0,"percent of total billed charges","50% of total billed charges",6725.94,32.2,,5380.75,,,0,"percent of total billed charges","32.2% of total billed charges",6517.06,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3579.37,17.136,,2863.50,,,0,"percent of total billed charges","17.136% of total billed charges",4561.94,21.84,,3649.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",7874.78,37.7,,6299.82,,,0,"percent of total billed charges","37.7% of total billed charges",7874.78,37.7,,6299.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",7081.03,33.9,,5664.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",16292.64,78,,13034.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17253.49,82.6,,13802.79,,,0,"percent of total billed charges","82.6% of total billed charges",3509.18,16.8,,2807.34,,,0,"percent of total billed charges","16.8% of total billed charges",10444,50,,8355.20,,,0,"percent of total billed charges","50% of total billed charges",17253.49,82.6,,13802.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3509.18,16.8,,2807.34,,,0,"percent of total billed charges","16.8% of total billed charges",20888,100,,16710.40,,,0,"percent of total billed charges","100% of total billed charges",3195.86,20888,
"KNEE BASEPLATE TIB TRIATHLON PRIM 6",ORSUP0088,CDM,278,RC,,,OUTPATIENT,,,20888,13577.2,,18381.44,88,,14705.15,,,0,"percent of total billed charges","88% of total billed charges",10444,50,,8355.20,,,0,"percent of total billed charges","50% of total billed charges",3509.18,16.8,,2807.34,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3614.46,17.304,,2891.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13159.44,63,,10527.55,,,0,"percent of total billed charges","63% of total billed charges",3195.86,15.3,,2556.69,,,0,"percent of total billed charges","15.3% of total billed charges",3509.18,16.8,,2807.34,,,0,"percent of total billed charges","16.8% of total billed charges",14412.72,69,,,,,0,"fee schedule","69% of total billed charges",20888,100,,16710.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20888,100,,16710.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20888,100,,16710.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12919.23,61.85,,10335.38,,,0,"percent of total billed charges","61.5% of total billed charges",3509.18,16.8,,2807.34,,,0,"percent of total billed charges","16.8% of total billed charges",10444,50,,8355.20,,,0,"percent of total billed charges","50% of total billed charges",6725.94,32.2,,5380.75,,,0,"percent of total billed charges","32.2% of total billed charges",6517.06,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3579.37,17.136,,2863.50,,,0,"percent of total billed charges","17.136% of total billed charges",4561.94,21.84,,3649.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",7874.78,37.7,,6299.82,,,0,"percent of total billed charges","37.7% of total billed charges",7874.78,37.7,,6299.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",7081.03,33.9,,5664.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",16292.64,78,,13034.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17253.49,82.6,,13802.79,,,0,"percent of total billed charges","82.6% of total billed charges",3509.18,16.8,,2807.34,,,0,"percent of total billed charges","16.8% of total billed charges",10444,50,,8355.20,,,0,"percent of total billed charges","50% of total billed charges",17253.49,82.6,,13802.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3509.18,16.8,,2807.34,,,0,"percent of total billed charges","16.8% of total billed charges",20888,100,,16710.40,,,0,"percent of total billed charges","100% of total billed charges",3195.86,20888,
"KNEE FEMORAL TRIATHLON CR BEADED W/PA 5517-F-401",ORSUP0065,CDM,278,RC,,,OUTPATIENT,,,14729,9573.85,,12961.52,88,,10369.22,,,0,"percent of total billed charges","88% of total billed charges",7364.5,50,,5891.60,,,0,"percent of total billed charges","50% of total billed charges",2474.47,16.8,,1979.58,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2548.71,17.304,,2038.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9279.27,63,,7423.42,,,0,"percent of total billed charges","63% of total billed charges",2253.54,15.3,,1802.83,,,0,"percent of total billed charges","15.3% of total billed charges",2474.47,16.8,,1979.58,,,0,"percent of total billed charges","16.8% of total billed charges",10163.01,69,,,,,0,"fee schedule","69% of total billed charges",14729,100,,11783.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14729,100,,11783.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14729,100,,11783.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9109.89,61.85,,7287.91,,,0,"percent of total billed charges","61.5% of total billed charges",2474.47,16.8,,1979.58,,,0,"percent of total billed charges","16.8% of total billed charges",7364.5,50,,5891.60,,,0,"percent of total billed charges","50% of total billed charges",4742.74,32.2,,3794.19,,,0,"percent of total billed charges","32.2% of total billed charges",4595.45,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2523.96,17.136,,2019.17,,,0,"percent of total billed charges","17.136% of total billed charges",3216.81,21.84,,2573.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",5552.83,37.7,,4442.26,,,0,"percent of total billed charges","37.7% of total billed charges",5552.83,37.7,,4442.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4993.13,33.9,,3994.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",11488.62,78,,9190.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12166.15,82.6,,9732.92,,,0,"percent of total billed charges","82.6% of total billed charges",2474.47,16.8,,1979.58,,,0,"percent of total billed charges","16.8% of total billed charges",7364.5,50,,5891.60,,,0,"percent of total billed charges","50% of total billed charges",12166.15,82.6,,9732.92,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2474.47,16.8,,1979.58,,,0,"percent of total billed charges","16.8% of total billed charges",14729,100,,11783.20,,,0,"percent of total billed charges","100% of total billed charges",2253.54,14729,
"KNEE FEMORAL TRIATHLON CR BEADED W/PA 5517-F-402",ORSUP0065,CDM,278,RC,,,OUTPATIENT,,,14729,9573.85,,12961.52,88,,10369.22,,,0,"percent of total billed charges","88% of total billed charges",7364.5,50,,5891.60,,,0,"percent of total billed charges","50% of total billed charges",2474.47,16.8,,1979.58,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2548.71,17.304,,2038.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9279.27,63,,7423.42,,,0,"percent of total billed charges","63% of total billed charges",2253.54,15.3,,1802.83,,,0,"percent of total billed charges","15.3% of total billed charges",2474.47,16.8,,1979.58,,,0,"percent of total billed charges","16.8% of total billed charges",10163.01,69,,,,,0,"fee schedule","69% of total billed charges",14729,100,,11783.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14729,100,,11783.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14729,100,,11783.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9109.89,61.85,,7287.91,,,0,"percent of total billed charges","61.5% of total billed charges",2474.47,16.8,,1979.58,,,0,"percent of total billed charges","16.8% of total billed charges",7364.5,50,,5891.60,,,0,"percent of total billed charges","50% of total billed charges",4742.74,32.2,,3794.19,,,0,"percent of total billed charges","32.2% of total billed charges",4595.45,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2523.96,17.136,,2019.17,,,0,"percent of total billed charges","17.136% of total billed charges",3216.81,21.84,,2573.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",5552.83,37.7,,4442.26,,,0,"percent of total billed charges","37.7% of total billed charges",5552.83,37.7,,4442.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4993.13,33.9,,3994.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",11488.62,78,,9190.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12166.15,82.6,,9732.92,,,0,"percent of total billed charges","82.6% of total billed charges",2474.47,16.8,,1979.58,,,0,"percent of total billed charges","16.8% of total billed charges",7364.5,50,,5891.60,,,0,"percent of total billed charges","50% of total billed charges",12166.15,82.6,,9732.92,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2474.47,16.8,,1979.58,,,0,"percent of total billed charges","16.8% of total billed charges",14729,100,,11783.20,,,0,"percent of total billed charges","100% of total billed charges",2253.54,14729,
"KNEE FEMORAL TRIATHLON CR BEADED W/PA 5517-F-501",ORSUP0065,CDM,278,RC,,,OUTPATIENT,,,14729,9573.85,,12961.52,88,,10369.22,,,0,"percent of total billed charges","88% of total billed charges",7364.5,50,,5891.60,,,0,"percent of total billed charges","50% of total billed charges",2474.47,16.8,,1979.58,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2548.71,17.304,,2038.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9279.27,63,,7423.42,,,0,"percent of total billed charges","63% of total billed charges",2253.54,15.3,,1802.83,,,0,"percent of total billed charges","15.3% of total billed charges",2474.47,16.8,,1979.58,,,0,"percent of total billed charges","16.8% of total billed charges",10163.01,69,,,,,0,"fee schedule","69% of total billed charges",14729,100,,11783.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14729,100,,11783.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14729,100,,11783.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9109.89,61.85,,7287.91,,,0,"percent of total billed charges","61.5% of total billed charges",2474.47,16.8,,1979.58,,,0,"percent of total billed charges","16.8% of total billed charges",7364.5,50,,5891.60,,,0,"percent of total billed charges","50% of total billed charges",4742.74,32.2,,3794.19,,,0,"percent of total billed charges","32.2% of total billed charges",4595.45,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2523.96,17.136,,2019.17,,,0,"percent of total billed charges","17.136% of total billed charges",3216.81,21.84,,2573.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",5552.83,37.7,,4442.26,,,0,"percent of total billed charges","37.7% of total billed charges",5552.83,37.7,,4442.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4993.13,33.9,,3994.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",11488.62,78,,9190.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12166.15,82.6,,9732.92,,,0,"percent of total billed charges","82.6% of total billed charges",2474.47,16.8,,1979.58,,,0,"percent of total billed charges","16.8% of total billed charges",7364.5,50,,5891.60,,,0,"percent of total billed charges","50% of total billed charges",12166.15,82.6,,9732.92,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2474.47,16.8,,1979.58,,,0,"percent of total billed charges","16.8% of total billed charges",14729,100,,11783.20,,,0,"percent of total billed charges","100% of total billed charges",2253.54,14729,
"KNEE FEMORAL TRIATHLON CR BEADED W/PA 5517-F-601",ORSUP0065,CDM,278,RC,,,OUTPATIENT,,,14729,9573.85,,12961.52,88,,10369.22,,,0,"percent of total billed charges","88% of total billed charges",7364.5,50,,5891.60,,,0,"percent of total billed charges","50% of total billed charges",2474.47,16.8,,1979.58,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2548.71,17.304,,2038.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9279.27,63,,7423.42,,,0,"percent of total billed charges","63% of total billed charges",2253.54,15.3,,1802.83,,,0,"percent of total billed charges","15.3% of total billed charges",2474.47,16.8,,1979.58,,,0,"percent of total billed charges","16.8% of total billed charges",10163.01,69,,,,,0,"fee schedule","69% of total billed charges",14729,100,,11783.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14729,100,,11783.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14729,100,,11783.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9109.89,61.85,,7287.91,,,0,"percent of total billed charges","61.5% of total billed charges",2474.47,16.8,,1979.58,,,0,"percent of total billed charges","16.8% of total billed charges",7364.5,50,,5891.60,,,0,"percent of total billed charges","50% of total billed charges",4742.74,32.2,,3794.19,,,0,"percent of total billed charges","32.2% of total billed charges",4595.45,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2523.96,17.136,,2019.17,,,0,"percent of total billed charges","17.136% of total billed charges",3216.81,21.84,,2573.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",5552.83,37.7,,4442.26,,,0,"percent of total billed charges","37.7% of total billed charges",5552.83,37.7,,4442.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4993.13,33.9,,3994.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",11488.62,78,,9190.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12166.15,82.6,,9732.92,,,0,"percent of total billed charges","82.6% of total billed charges",2474.47,16.8,,1979.58,,,0,"percent of total billed charges","16.8% of total billed charges",7364.5,50,,5891.60,,,0,"percent of total billed charges","50% of total billed charges",12166.15,82.6,,9732.92,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2474.47,16.8,,1979.58,,,0,"percent of total billed charges","16.8% of total billed charges",14729,100,,11783.20,,,0,"percent of total billed charges","100% of total billed charges",2253.54,14729,
"KNEE FEMORAL TRIATHLON CR CEMENTED #5 L",ORSUP0140,CDM,278,RC,,,OUTPATIENT,,,35082,22803.3,,30872.16,88,,24697.73,,,0,"percent of total billed charges","88% of total billed charges",17541,50,,14032.80,,,0,"percent of total billed charges","50% of total billed charges",5893.78,16.8,,4715.02,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6070.59,17.304,,4856.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22101.66,63,,17681.33,,,0,"percent of total billed charges","63% of total billed charges",5367.55,15.3,,4294.04,,,0,"percent of total billed charges","15.3% of total billed charges",5893.78,16.8,,4715.02,,,0,"percent of total billed charges","16.8% of total billed charges",24206.58,69,,,,,0,"fee schedule","69% of total billed charges",35082,100,,28065.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35082,100,,28065.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35082,100,,28065.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21698.22,61.85,,17358.58,,,0,"percent of total billed charges","61.5% of total billed charges",5893.78,16.8,,4715.02,,,0,"percent of total billed charges","16.8% of total billed charges",17541,50,,14032.80,,,0,"percent of total billed charges","50% of total billed charges",11296.4,32.2,,9037.12,,,0,"percent of total billed charges","32.2% of total billed charges",10945.58,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",6011.65,17.136,,4809.32,,,0,"percent of total billed charges","17.136% of total billed charges",7661.91,21.84,,6129.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",13225.91,37.7,,10580.73,,,0,"percent of total billed charges","37.7% of total billed charges",13225.91,37.7,,10580.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",11892.8,33.9,,9514.24,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",27363.96,78,,21891.17,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28977.73,82.6,,23182.18,,,0,"percent of total billed charges","82.6% of total billed charges",5893.78,16.8,,4715.02,,,0,"percent of total billed charges","16.8% of total billed charges",17541,50,,14032.80,,,0,"percent of total billed charges","50% of total billed charges",28977.73,82.6,,23182.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5893.78,16.8,,4715.02,,,0,"percent of total billed charges","16.8% of total billed charges",35082,100,,28065.60,,,0,"percent of total billed charges","100% of total billed charges",4695,35082,
"KNEE FEMORAL TRIATHLON CR CEMENTED #5 R",ORSUP0140,CDM,278,RC,,,OUTPATIENT,,,35082,22803.3,,30872.16,88,,24697.73,,,0,"percent of total billed charges","88% of total billed charges",17541,50,,14032.80,,,0,"percent of total billed charges","50% of total billed charges",5893.78,16.8,,4715.02,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6070.59,17.304,,4856.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22101.66,63,,17681.33,,,0,"percent of total billed charges","63% of total billed charges",5367.55,15.3,,4294.04,,,0,"percent of total billed charges","15.3% of total billed charges",5893.78,16.8,,4715.02,,,0,"percent of total billed charges","16.8% of total billed charges",24206.58,69,,,,,0,"fee schedule","69% of total billed charges",35082,100,,28065.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35082,100,,28065.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35082,100,,28065.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21698.22,61.85,,17358.58,,,0,"percent of total billed charges","61.5% of total billed charges",5893.78,16.8,,4715.02,,,0,"percent of total billed charges","16.8% of total billed charges",17541,50,,14032.80,,,0,"percent of total billed charges","50% of total billed charges",11296.4,32.2,,9037.12,,,0,"percent of total billed charges","32.2% of total billed charges",10945.58,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",6011.65,17.136,,4809.32,,,0,"percent of total billed charges","17.136% of total billed charges",7661.91,21.84,,6129.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",13225.91,37.7,,10580.73,,,0,"percent of total billed charges","37.7% of total billed charges",13225.91,37.7,,10580.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",11892.8,33.9,,9514.24,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",27363.96,78,,21891.17,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28977.73,82.6,,23182.18,,,0,"percent of total billed charges","82.6% of total billed charges",5893.78,16.8,,4715.02,,,0,"percent of total billed charges","16.8% of total billed charges",17541,50,,14032.80,,,0,"percent of total billed charges","50% of total billed charges",28977.73,82.6,,23182.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5893.78,16.8,,4715.02,,,0,"percent of total billed charges","16.8% of total billed charges",35082,100,,28065.60,,,0,"percent of total billed charges","100% of total billed charges",4695,35082,
"KNEE PATELLA TRIATHLON ASYMMETRIC X3 5551-G-320",ORSUP0056,CDM,278,RC,,,OUTPATIENT,,,12319,8007.35,,10840.72,88,,8672.58,,,0,"percent of total billed charges","88% of total billed charges",6159.5,50,,4927.60,,,0,"percent of total billed charges","50% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2131.68,17.304,,1705.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7760.97,63,,6208.78,,,0,"percent of total billed charges","63% of total billed charges",1884.81,15.3,,1507.85,,,0,"percent of total billed charges","15.3% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",8500.11,69,,,,,0,"fee schedule","69% of total billed charges",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7619.3,61.85,,6095.44,,,0,"percent of total billed charges","61.5% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",6159.5,50,,4927.60,,,0,"percent of total billed charges","50% of total billed charges",3966.72,32.2,,3173.38,,,0,"percent of total billed charges","32.2% of total billed charges",3843.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2110.98,17.136,,1688.78,,,0,"percent of total billed charges","17.136% of total billed charges",2690.47,21.84,,2152.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4644.26,37.7,,3715.41,,,0,"percent of total billed charges","37.7% of total billed charges",4644.26,37.7,,3715.41,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4176.14,33.9,,3340.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",9608.82,78,,7687.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10175.49,82.6,,8140.39,,,0,"percent of total billed charges","82.6% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",6159.5,50,,4927.60,,,0,"percent of total billed charges","50% of total billed charges",10175.49,82.6,,8140.39,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",1884.81,12319,
"KNEE PATELLA TRIATHLON ASYMMETRIC X3 5551-G-350",ORSUP0056,CDM,278,RC,,,OUTPATIENT,,,12319,8007.35,,10840.72,88,,8672.58,,,0,"percent of total billed charges","88% of total billed charges",6159.5,50,,4927.60,,,0,"percent of total billed charges","50% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2131.68,17.304,,1705.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7760.97,63,,6208.78,,,0,"percent of total billed charges","63% of total billed charges",1884.81,15.3,,1507.85,,,0,"percent of total billed charges","15.3% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",8500.11,69,,,,,0,"fee schedule","69% of total billed charges",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7619.3,61.85,,6095.44,,,0,"percent of total billed charges","61.5% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",6159.5,50,,4927.60,,,0,"percent of total billed charges","50% of total billed charges",3966.72,32.2,,3173.38,,,0,"percent of total billed charges","32.2% of total billed charges",3843.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2110.98,17.136,,1688.78,,,0,"percent of total billed charges","17.136% of total billed charges",2690.47,21.84,,2152.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4644.26,37.7,,3715.41,,,0,"percent of total billed charges","37.7% of total billed charges",4644.26,37.7,,3715.41,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4176.14,33.9,,3340.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",9608.82,78,,7687.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10175.49,82.6,,8140.39,,,0,"percent of total billed charges","82.6% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",6159.5,50,,4927.60,,,0,"percent of total billed charges","50% of total billed charges",10175.49,82.6,,8140.39,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",1884.81,12319,
"KNEE PATELLA TRIATHLON ASYMMETRIC X3 5551-G-381",ORSUP0056,CDM,278,RC,,,OUTPATIENT,,,12319,8007.35,,10840.72,88,,8672.58,,,0,"percent of total billed charges","88% of total billed charges",6159.5,50,,4927.60,,,0,"percent of total billed charges","50% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2131.68,17.304,,1705.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7760.97,63,,6208.78,,,0,"percent of total billed charges","63% of total billed charges",1884.81,15.3,,1507.85,,,0,"percent of total billed charges","15.3% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",8500.11,69,,,,,0,"fee schedule","69% of total billed charges",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7619.3,61.85,,6095.44,,,0,"percent of total billed charges","61.5% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",6159.5,50,,4927.60,,,0,"percent of total billed charges","50% of total billed charges",3966.72,32.2,,3173.38,,,0,"percent of total billed charges","32.2% of total billed charges",3843.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2110.98,17.136,,1688.78,,,0,"percent of total billed charges","17.136% of total billed charges",2690.47,21.84,,2152.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4644.26,37.7,,3715.41,,,0,"percent of total billed charges","37.7% of total billed charges",4644.26,37.7,,3715.41,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4176.14,33.9,,3340.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",9608.82,78,,7687.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10175.49,82.6,,8140.39,,,0,"percent of total billed charges","82.6% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",6159.5,50,,4927.60,,,0,"percent of total billed charges","50% of total billed charges",10175.49,82.6,,8140.39,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",1884.81,12319,
"KNEE PATELLA TRIATHLON SYMMETRIC X3 5550-G-319",ORSUP0056,CDM,278,RC,,,OUTPATIENT,,,12319,8007.35,,10840.72,88,,8672.58,,,0,"percent of total billed charges","88% of total billed charges",6159.5,50,,4927.60,,,0,"percent of total billed charges","50% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2131.68,17.304,,1705.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7760.97,63,,6208.78,,,0,"percent of total billed charges","63% of total billed charges",1884.81,15.3,,1507.85,,,0,"percent of total billed charges","15.3% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",8500.11,69,,,,,0,"fee schedule","69% of total billed charges",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7619.3,61.85,,6095.44,,,0,"percent of total billed charges","61.5% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",6159.5,50,,4927.60,,,0,"percent of total billed charges","50% of total billed charges",3966.72,32.2,,3173.38,,,0,"percent of total billed charges","32.2% of total billed charges",3843.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2110.98,17.136,,1688.78,,,0,"percent of total billed charges","17.136% of total billed charges",2690.47,21.84,,2152.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4644.26,37.7,,3715.41,,,0,"percent of total billed charges","37.7% of total billed charges",4644.26,37.7,,3715.41,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4176.14,33.9,,3340.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",9608.82,78,,7687.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10175.49,82.6,,8140.39,,,0,"percent of total billed charges","82.6% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",6159.5,50,,4927.60,,,0,"percent of total billed charges","50% of total billed charges",10175.49,82.6,,8140.39,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",1884.81,12319,
"KNEE PATELLA TRIATHLON SYMMETRIC X3 5550-G-360",ORSUP0056,CDM,278,RC,,,OUTPATIENT,,,12319,8007.35,,10840.72,88,,8672.58,,,0,"percent of total billed charges","88% of total billed charges",6159.5,50,,4927.60,,,0,"percent of total billed charges","50% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2131.68,17.304,,1705.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7760.97,63,,6208.78,,,0,"percent of total billed charges","63% of total billed charges",1884.81,15.3,,1507.85,,,0,"percent of total billed charges","15.3% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",8500.11,69,,,,,0,"fee schedule","69% of total billed charges",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7619.3,61.85,,6095.44,,,0,"percent of total billed charges","61.5% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",6159.5,50,,4927.60,,,0,"percent of total billed charges","50% of total billed charges",3966.72,32.2,,3173.38,,,0,"percent of total billed charges","32.2% of total billed charges",3843.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2110.98,17.136,,1688.78,,,0,"percent of total billed charges","17.136% of total billed charges",2690.47,21.84,,2152.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4644.26,37.7,,3715.41,,,0,"percent of total billed charges","37.7% of total billed charges",4644.26,37.7,,3715.41,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4176.14,33.9,,3340.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",9608.82,78,,7687.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10175.49,82.6,,8140.39,,,0,"percent of total billed charges","82.6% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",6159.5,50,,4927.60,,,0,"percent of total billed charges","50% of total billed charges",10175.49,82.6,,8140.39,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",1884.81,12319,
"KNEE TIBIAL INSERT X3 TRIATHLON CS SIZE4 9MM",ORSUP0105,CDM,278,RC,,,OUTPATIENT,,,25709,16710.85,,22623.92,88,,18099.14,,,0,"percent of total billed charges","88% of total billed charges",12854.5,50,,10283.60,,,0,"percent of total billed charges","50% of total billed charges",4319.11,16.8,,3455.29,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4448.69,17.304,,3558.95,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",16196.67,63,,12957.34,,,0,"percent of total billed charges","63% of total billed charges",3933.48,15.3,,3146.78,,,0,"percent of total billed charges","15.3% of total billed charges",4319.11,16.8,,3455.29,,,0,"percent of total billed charges","16.8% of total billed charges",17739.21,69,,,,,0,"fee schedule","69% of total billed charges",25709,100,,20567.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25709,100,,20567.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25709,100,,20567.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15901.02,61.85,,12720.82,,,0,"percent of total billed charges","61.5% of total billed charges",4319.11,16.8,,3455.29,,,0,"percent of total billed charges","16.8% of total billed charges",12854.5,50,,10283.60,,,0,"percent of total billed charges","50% of total billed charges",8278.3,32.2,,6622.64,,,0,"percent of total billed charges","32.2% of total billed charges",8021.21,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",4405.49,17.136,,3524.39,,,0,"percent of total billed charges","17.136% of total billed charges",5614.85,21.84,,4491.88,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",9692.29,37.7,,7753.83,,,0,"percent of total billed charges","37.7% of total billed charges",9692.29,37.7,,7753.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",8715.35,33.9,,6972.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",20053.02,78,,16042.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",21235.63,82.6,,16988.50,,,0,"percent of total billed charges","82.6% of total billed charges",4319.11,16.8,,3455.29,,,0,"percent of total billed charges","16.8% of total billed charges",12854.5,50,,10283.60,,,0,"percent of total billed charges","50% of total billed charges",21235.63,82.6,,16988.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4319.11,16.8,,3455.29,,,0,"percent of total billed charges","16.8% of total billed charges",25709,100,,20567.20,,,0,"percent of total billed charges","100% of total billed charges",3933.48,25709,
"KNEE TIBIAL INSERT X3 TRIATHLON CS SIZE5 11MM",ORSUP0105,CDM,278,RC,,,OUTPATIENT,,,25709,16710.85,,22623.92,88,,18099.14,,,0,"percent of total billed charges","88% of total billed charges",12854.5,50,,10283.60,,,0,"percent of total billed charges","50% of total billed charges",4319.11,16.8,,3455.29,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4448.69,17.304,,3558.95,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",16196.67,63,,12957.34,,,0,"percent of total billed charges","63% of total billed charges",3933.48,15.3,,3146.78,,,0,"percent of total billed charges","15.3% of total billed charges",4319.11,16.8,,3455.29,,,0,"percent of total billed charges","16.8% of total billed charges",17739.21,69,,,,,0,"fee schedule","69% of total billed charges",25709,100,,20567.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25709,100,,20567.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25709,100,,20567.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15901.02,61.85,,12720.82,,,0,"percent of total billed charges","61.5% of total billed charges",4319.11,16.8,,3455.29,,,0,"percent of total billed charges","16.8% of total billed charges",12854.5,50,,10283.60,,,0,"percent of total billed charges","50% of total billed charges",8278.3,32.2,,6622.64,,,0,"percent of total billed charges","32.2% of total billed charges",8021.21,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",4405.49,17.136,,3524.39,,,0,"percent of total billed charges","17.136% of total billed charges",5614.85,21.84,,4491.88,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",9692.29,37.7,,7753.83,,,0,"percent of total billed charges","37.7% of total billed charges",9692.29,37.7,,7753.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",8715.35,33.9,,6972.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",20053.02,78,,16042.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",21235.63,82.6,,16988.50,,,0,"percent of total billed charges","82.6% of total billed charges",4319.11,16.8,,3455.29,,,0,"percent of total billed charges","16.8% of total billed charges",12854.5,50,,10283.60,,,0,"percent of total billed charges","50% of total billed charges",21235.63,82.6,,16988.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4319.11,16.8,,3455.29,,,0,"percent of total billed charges","16.8% of total billed charges",25709,100,,20567.20,,,0,"percent of total billed charges","100% of total billed charges",3933.48,25709,
"KNEE TIBIAL INSERT X3 TRIATHLON CS SIZE5 9MM",ORSUP0105,CDM,278,RC,,,OUTPATIENT,,,25709,16710.85,,22623.92,88,,18099.14,,,0,"percent of total billed charges","88% of total billed charges",12854.5,50,,10283.60,,,0,"percent of total billed charges","50% of total billed charges",4319.11,16.8,,3455.29,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4448.69,17.304,,3558.95,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",16196.67,63,,12957.34,,,0,"percent of total billed charges","63% of total billed charges",3933.48,15.3,,3146.78,,,0,"percent of total billed charges","15.3% of total billed charges",4319.11,16.8,,3455.29,,,0,"percent of total billed charges","16.8% of total billed charges",17739.21,69,,,,,0,"fee schedule","69% of total billed charges",25709,100,,20567.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25709,100,,20567.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25709,100,,20567.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15901.02,61.85,,12720.82,,,0,"percent of total billed charges","61.5% of total billed charges",4319.11,16.8,,3455.29,,,0,"percent of total billed charges","16.8% of total billed charges",12854.5,50,,10283.60,,,0,"percent of total billed charges","50% of total billed charges",8278.3,32.2,,6622.64,,,0,"percent of total billed charges","32.2% of total billed charges",8021.21,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",4405.49,17.136,,3524.39,,,0,"percent of total billed charges","17.136% of total billed charges",5614.85,21.84,,4491.88,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",9692.29,37.7,,7753.83,,,0,"percent of total billed charges","37.7% of total billed charges",9692.29,37.7,,7753.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",8715.35,33.9,,6972.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",20053.02,78,,16042.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",21235.63,82.6,,16988.50,,,0,"percent of total billed charges","82.6% of total billed charges",4319.11,16.8,,3455.29,,,0,"percent of total billed charges","16.8% of total billed charges",12854.5,50,,10283.60,,,0,"percent of total billed charges","50% of total billed charges",21235.63,82.6,,16988.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4319.11,16.8,,3455.29,,,0,"percent of total billed charges","16.8% of total billed charges",25709,100,,20567.20,,,0,"percent of total billed charges","100% of total billed charges",3933.48,25709,
"KNEE TIBIAL INSERT X3 TRIATHLON CS SIZE6 13MM",ORSUP0105,CDM,278,RC,,,OUTPATIENT,,,25709,16710.85,,22623.92,88,,18099.14,,,0,"percent of total billed charges","88% of total billed charges",12854.5,50,,10283.60,,,0,"percent of total billed charges","50% of total billed charges",4319.11,16.8,,3455.29,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4448.69,17.304,,3558.95,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",16196.67,63,,12957.34,,,0,"percent of total billed charges","63% of total billed charges",3933.48,15.3,,3146.78,,,0,"percent of total billed charges","15.3% of total billed charges",4319.11,16.8,,3455.29,,,0,"percent of total billed charges","16.8% of total billed charges",17739.21,69,,,,,0,"fee schedule","69% of total billed charges",25709,100,,20567.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25709,100,,20567.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25709,100,,20567.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15901.02,61.85,,12720.82,,,0,"percent of total billed charges","61.5% of total billed charges",4319.11,16.8,,3455.29,,,0,"percent of total billed charges","16.8% of total billed charges",12854.5,50,,10283.60,,,0,"percent of total billed charges","50% of total billed charges",8278.3,32.2,,6622.64,,,0,"percent of total billed charges","32.2% of total billed charges",8021.21,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",4405.49,17.136,,3524.39,,,0,"percent of total billed charges","17.136% of total billed charges",5614.85,21.84,,4491.88,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",9692.29,37.7,,7753.83,,,0,"percent of total billed charges","37.7% of total billed charges",9692.29,37.7,,7753.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",8715.35,33.9,,6972.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",20053.02,78,,16042.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",21235.63,82.6,,16988.50,,,0,"percent of total billed charges","82.6% of total billed charges",4319.11,16.8,,3455.29,,,0,"percent of total billed charges","16.8% of total billed charges",12854.5,50,,10283.60,,,0,"percent of total billed charges","50% of total billed charges",21235.63,82.6,,16988.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4319.11,16.8,,3455.29,,,0,"percent of total billed charges","16.8% of total billed charges",25709,100,,20567.20,,,0,"percent of total billed charges","100% of total billed charges",3933.48,25709,
"KNEE TIBIAL INSERT X3 TRIATHLON CS SIZE6 9MM",ORSUP0105,CDM,278,RC,,,OUTPATIENT,,,25709,16710.85,,22623.92,88,,18099.14,,,0,"percent of total billed charges","88% of total billed charges",12854.5,50,,10283.60,,,0,"percent of total billed charges","50% of total billed charges",4319.11,16.8,,3455.29,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4448.69,17.304,,3558.95,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",16196.67,63,,12957.34,,,0,"percent of total billed charges","63% of total billed charges",3933.48,15.3,,3146.78,,,0,"percent of total billed charges","15.3% of total billed charges",4319.11,16.8,,3455.29,,,0,"percent of total billed charges","16.8% of total billed charges",17739.21,69,,,,,0,"fee schedule","69% of total billed charges",25709,100,,20567.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25709,100,,20567.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25709,100,,20567.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15901.02,61.85,,12720.82,,,0,"percent of total billed charges","61.5% of total billed charges",4319.11,16.8,,3455.29,,,0,"percent of total billed charges","16.8% of total billed charges",12854.5,50,,10283.60,,,0,"percent of total billed charges","50% of total billed charges",8278.3,32.2,,6622.64,,,0,"percent of total billed charges","32.2% of total billed charges",8021.21,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",4405.49,17.136,,3524.39,,,0,"percent of total billed charges","17.136% of total billed charges",5614.85,21.84,,4491.88,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",9692.29,37.7,,7753.83,,,0,"percent of total billed charges","37.7% of total billed charges",9692.29,37.7,,7753.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",8715.35,33.9,,6972.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",20053.02,78,,16042.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",21235.63,82.6,,16988.50,,,0,"percent of total billed charges","82.6% of total billed charges",4319.11,16.8,,3455.29,,,0,"percent of total billed charges","16.8% of total billed charges",12854.5,50,,10283.60,,,0,"percent of total billed charges","50% of total billed charges",21235.63,82.6,,16988.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4319.11,16.8,,3455.29,,,0,"percent of total billed charges","16.8% of total billed charges",25709,100,,20567.20,,,0,"percent of total billed charges","100% of total billed charges",3933.48,25709,
"KNEE ARTHROSCOPY",326390,CDM,270,RC,,,OUTPATIENT,,,646,419.9,,568.48,88,,454.78,,,0,"percent of total billed charges","88% of total billed charges",323,50,,258.40,,,0,"percent of total billed charges","50% of total billed charges",108.53,16.8,,86.82,,,0,"percent of total billed charges","16.8% of total billed charges",646,100,,516.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",111.78,17.304,,89.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",406.98,63,,325.58,,,0,"percent of total billed charges","63% of total billed charges",98.84,15.3,,79.07,,,0,"percent of total billed charges","15.3% of total billed charges",108.53,16.8,,86.82,,,0,"percent of total billed charges","16.8% of total billed charges",445.74,69,,,,,0,"fee schedule","69% of total billed charges",646,100,,516.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",646,100,,516.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",646,100,,516.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",399.55,61.85,,319.64,,,0,"percent of total billed charges","61.5% of total billed charges",108.53,16.8,,86.82,,,0,"percent of total billed charges","16.8% of total billed charges",323,50,,258.40,,,0,"percent of total billed charges","50% of total billed charges",208.01,32.2,,166.41,,,0,"percent of total billed charges","32.2% of total billed charges",108.53,16.8,,86.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.7,17.136,,88.56,,,0,"percent of total billed charges","17.136% of total billed charges",141.09,21.84,,112.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",243.54,37.7,,194.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",503.88,78,,403.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",533.6,82.6,,426.88,,,0,"percent of total billed charges","82.6% of total billed charges",108.53,16.8,,86.82,,,0,"percent of total billed charges","16.8% of total billed charges",323,50,,258.40,,,0,"percent of total billed charges","50% of total billed charges",533.6,82.6,,426.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",108.53,16.8,,86.82,,,0,"percent of total billed charges","16.8% of total billed charges",646,100,,516.80,,,0,"percent of total billed charges","100% of total billed charges",98.84,646,
"KNEE BRACE 22IN",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,17.304,,49.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.28,61.85,,178.62,,,0,"percent of total billed charges","61.5% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",116.24,32.2,,92.99,,,0,"percent of total billed charges","32.2% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.86,17.136,,49.49,,,0,"percent of total billed charges","17.136% of total billed charges",78.84,21.84,,63.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,361,
"KNEE VIZADISC",ORSUP0018,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"KNIFE MYRO DISP            14 11000",35489,CDM,272,RC,,,OUTPATIENT,,,77,50.05,,67.76,88,,54.21,,,0,"percent of total billed charges","88% of total billed charges",38.5,50,,30.80,,,0,"percent of total billed charges","50% of total billed charges",12.94,16.8,,10.35,,,0,"percent of total billed charges","16.8% of total billed charges",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.32,17.304,,10.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.51,63,,38.81,,,0,"percent of total billed charges","63% of total billed charges",11.78,15.3,,9.42,,,0,"percent of total billed charges","15.3% of total billed charges",12.94,16.8,,10.35,,,0,"percent of total billed charges","16.8% of total billed charges",53.13,69,,,,,0,"fee schedule","69% of total billed charges",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.62,61.85,,38.10,,,0,"percent of total billed charges","61.5% of total billed charges",12.94,16.8,,10.35,,,0,"percent of total billed charges","16.8% of total billed charges",38.5,50,,30.80,,,0,"percent of total billed charges","50% of total billed charges",24.79,32.2,,19.83,,,0,"percent of total billed charges","32.2% of total billed charges",12.94,16.8,,10.35,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.19,17.136,,10.55,,,0,"percent of total billed charges","17.136% of total billed charges",16.82,21.84,,13.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.03,37.7,,23.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",60.06,78,,48.05,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.6,82.6,,50.88,,,0,"percent of total billed charges","82.6% of total billed charges",12.94,16.8,,10.35,,,0,"percent of total billed charges","16.8% of total billed charges",38.5,50,,30.80,,,0,"percent of total billed charges","50% of total billed charges",63.6,82.6,,50.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.94,16.8,,10.35,,,0,"percent of total billed charges","16.8% of total billed charges",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",11.78,77,
"KNIFE MYRINGOTOMY SICKLE BLADE DISPOSABLE",50040,CDM,272,RC,,,OUTPATIENT,,,138,89.7,,121.44,88,,97.15,,,0,"percent of total billed charges","88% of total billed charges",69,50,,55.20,,,0,"percent of total billed charges","50% of total billed charges",23.18,16.8,,18.54,,,0,"percent of total billed charges","16.8% of total billed charges",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.88,17.304,,19.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.94,63,,69.55,,,0,"percent of total billed charges","63% of total billed charges",21.11,15.3,,16.89,,,0,"percent of total billed charges","15.3% of total billed charges",23.18,16.8,,18.54,,,0,"percent of total billed charges","16.8% of total billed charges",95.22,69,,,,,0,"fee schedule","69% of total billed charges",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.35,61.85,,68.28,,,0,"percent of total billed charges","61.5% of total billed charges",23.18,16.8,,18.54,,,0,"percent of total billed charges","16.8% of total billed charges",69,50,,55.20,,,0,"percent of total billed charges","50% of total billed charges",44.44,32.2,,35.55,,,0,"percent of total billed charges","32.2% of total billed charges",23.18,16.8,,18.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.65,17.136,,18.92,,,0,"percent of total billed charges","17.136% of total billed charges",30.14,21.84,,24.11,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",52.03,37.7,,41.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",107.64,78,,86.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.99,82.6,,91.19,,,0,"percent of total billed charges","82.6% of total billed charges",23.18,16.8,,18.54,,,0,"percent of total billed charges","16.8% of total billed charges",69,50,,55.20,,,0,"percent of total billed charges","50% of total billed charges",113.99,82.6,,91.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.18,16.8,,18.54,,,0,"percent of total billed charges","16.8% of total billed charges",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",21.11,138,
"KNIFE HALF-ROUND",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"KNIFE COLD",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"KNOTLESS TIGHTROPE SS ARTHREX",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"KNOTILUS 2.4X11.3MM DRILL",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,824,535.6,,725.12,88,,580.10,,,0,"percent of total billed charges","88% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.58,17.304,,114.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",519.12,63,,415.30,,,0,"percent of total billed charges","63% of total billed charges",126.07,15.3,,100.86,,,0,"percent of total billed charges","15.3% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",568.56,69,,,,,0,"fee schedule","69% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.64,61.85,,407.71,,,0,"percent of total billed charges","61.5% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",265.33,32.2,,212.26,,,0,"percent of total billed charges","32.2% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",141.2,17.136,,112.96,,,0,"percent of total billed charges","17.136% of total billed charges",179.96,21.84,,143.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",310.65,37.7,,248.52,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",642.72,78,,514.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",126.07,824,
"KNOTILUS 2.4X11.3MM PEEK KNOTLESS ANCHOR",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,1854,1205.1,,1631.52,88,,1305.22,,,0,"percent of total billed charges","88% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",320.82,17.304,,256.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1168.02,63,,934.42,,,0,"percent of total billed charges","63% of total billed charges",283.66,15.3,,226.93,,,0,"percent of total billed charges","15.3% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1279.26,69,,,,,0,"fee schedule","69% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1146.7,61.85,,917.36,,,0,"percent of total billed charges","61.5% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",596.99,32.2,,477.59,,,0,"percent of total billed charges","32.2% of total billed charges",578.45,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",317.7,17.136,,254.16,,,0,"percent of total billed charges","17.136% of total billed charges",404.91,21.84,,323.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",698.96,37.7,,559.17,,,0,"percent of total billed charges","37.7% of total billed charges",698.96,37.7,,559.17,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",628.51,33.9,,502.81,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1446.12,78,,1156.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1531.4,82.6,,1225.12,,,0,"percent of total billed charges","82.6% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",1531.4,82.6,,1225.12,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",283.66,1854,
"KONIG HARTMEN MOSQUITO STRAIGHT FORCEPS",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"KUMAR T-ANCHORS",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"KUMAR CATHETER 19G NEEDLE",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"KWIK STIK CAMPYLOBACTER FETUS SUBSP ATCC 27374",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"KWIRE 1.6MM SS",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
KWIRE,ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"KY JELLY STERILE 2 OZ",490820,CDM,272,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"KYPHOPAK EXPR 1ST FRACTURE KIT BLN 10CC 15CC 20CC",ORSUP0081,CDM,272,RC,,,OUTPATIENT,,,19014,12359.1,,16732.32,88,,13385.86,,,0,"percent of total billed charges","88% of total billed charges",9507,50,,7605.60,,,0,"percent of total billed charges","50% of total billed charges",3194.35,16.8,,2555.48,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3290.18,17.304,,2632.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11978.82,63,,9583.06,,,0,"percent of total billed charges","63% of total billed charges",2909.14,15.3,,2327.31,,,0,"percent of total billed charges","15.3% of total billed charges",3194.35,16.8,,2555.48,,,0,"percent of total billed charges","16.8% of total billed charges",13119.66,69,,,,,0,"fee schedule","69% of total billed charges",19014,100,,15211.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19014,100,,15211.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19014,100,,15211.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11760.16,61.85,,9408.13,,,0,"percent of total billed charges","61.5% of total billed charges",3194.35,16.8,,2555.48,,,0,"percent of total billed charges","16.8% of total billed charges",9507,50,,7605.60,,,0,"percent of total billed charges","50% of total billed charges",6122.51,32.2,,4898.01,,,0,"percent of total billed charges","32.2% of total billed charges",3194.35,16.8,,2555.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3258.24,17.136,,2606.59,,,0,"percent of total billed charges","17.136% of total billed charges",4152.66,21.84,,3322.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7168.28,37.7,,5734.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14830.92,78,,11864.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15705.56,82.6,,12564.45,,,0,"percent of total billed charges","82.6% of total billed charges",3194.35,16.8,,2555.48,,,0,"percent of total billed charges","16.8% of total billed charges",9507,50,,7605.60,,,0,"percent of total billed charges","50% of total billed charges",15705.56,82.6,,12564.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3194.35,16.8,,2555.48,,,0,"percent of total billed charges","16.8% of total billed charges",19014,100,,15211.20,,,0,"percent of total billed charges","100% of total billed charges",2909.14,19014,
"KYPHOPAK 15/3 ADD FX KIT",ORSUP0087,CDM,272,RC,,,OUTPATIENT,,,20621,13403.65,,18146.48,88,,14517.18,,,0,"percent of total billed charges","88% of total billed charges",10310.5,50,,8248.40,,,0,"percent of total billed charges","50% of total billed charges",3464.33,16.8,,2771.46,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3568.26,17.304,,2854.61,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12991.23,63,,10392.98,,,0,"percent of total billed charges","63% of total billed charges",3155.01,15.3,,2524.01,,,0,"percent of total billed charges","15.3% of total billed charges",3464.33,16.8,,2771.46,,,0,"percent of total billed charges","16.8% of total billed charges",14228.49,69,,,,,0,"fee schedule","69% of total billed charges",20621,100,,16496.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20621,100,,16496.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20621,100,,16496.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12754.09,61.85,,10203.27,,,0,"percent of total billed charges","61.5% of total billed charges",3464.33,16.8,,2771.46,,,0,"percent of total billed charges","16.8% of total billed charges",10310.5,50,,8248.40,,,0,"percent of total billed charges","50% of total billed charges",6639.96,32.2,,5311.97,,,0,"percent of total billed charges","32.2% of total billed charges",3464.33,16.8,,2771.46,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3533.61,17.136,,2826.89,,,0,"percent of total billed charges","17.136% of total billed charges",4503.63,21.84,,3602.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7774.12,37.7,,6219.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16084.38,78,,12867.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17032.95,82.6,,13626.36,,,0,"percent of total billed charges","82.6% of total billed charges",3464.33,16.8,,2771.46,,,0,"percent of total billed charges","16.8% of total billed charges",10310.5,50,,8248.40,,,0,"percent of total billed charges","50% of total billed charges",17032.95,82.6,,13626.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3464.33,16.8,,2771.46,,,0,"percent of total billed charges","16.8% of total billed charges",20621,100,,16496.80,,,0,"percent of total billed charges","100% of total billed charges",3155.01,20621,
"KYPHOPAK 20/3 1ST FX",ORSUP0071,CDM,272,RC,,,OUTPATIENT,,,16336,10618.4,,14375.68,88,,11500.54,,,0,"percent of total billed charges","88% of total billed charges",8168,50,,6534.40,,,0,"percent of total billed charges","50% of total billed charges",2744.45,16.8,,2195.56,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2826.78,17.304,,2261.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10291.68,63,,8233.34,,,0,"percent of total billed charges","63% of total billed charges",2499.41,15.3,,1999.53,,,0,"percent of total billed charges","15.3% of total billed charges",2744.45,16.8,,2195.56,,,0,"percent of total billed charges","16.8% of total billed charges",11271.84,69,,,,,0,"fee schedule","69% of total billed charges",16336,100,,13068.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16336,100,,13068.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16336,100,,13068.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10103.82,61.85,,8083.06,,,0,"percent of total billed charges","61.5% of total billed charges",2744.45,16.8,,2195.56,,,0,"percent of total billed charges","16.8% of total billed charges",8168,50,,6534.40,,,0,"percent of total billed charges","50% of total billed charges",5260.19,32.2,,4208.15,,,0,"percent of total billed charges","32.2% of total billed charges",2744.45,16.8,,2195.56,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2799.34,17.136,,2239.47,,,0,"percent of total billed charges","17.136% of total billed charges",3567.78,21.84,,2854.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6158.67,37.7,,4926.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12742.08,78,,10193.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13493.54,82.6,,10794.83,,,0,"percent of total billed charges","82.6% of total billed charges",2744.45,16.8,,2195.56,,,0,"percent of total billed charges","16.8% of total billed charges",8168,50,,6534.40,,,0,"percent of total billed charges","50% of total billed charges",13493.54,82.6,,10794.83,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2744.45,16.8,,2195.56,,,0,"percent of total billed charges","16.8% of total billed charges",16336,100,,13068.80,,,0,"percent of total billed charges","100% of total billed charges",2499.41,16336,
"KYPHON XPANDER II 20/3 ADDITIONAL FX",ORSUP0056,CDM,272,RC,,,OUTPATIENT,,,9476,6159.4,,8338.88,88,,6671.10,,,0,"percent of total billed charges","88% of total billed charges",4738,50,,3790.40,,,0,"percent of total billed charges","50% of total billed charges",1591.97,16.8,,1273.58,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1639.73,17.304,,1311.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5969.88,63,,4775.90,,,0,"percent of total billed charges","63% of total billed charges",1449.83,15.3,,1159.86,,,0,"percent of total billed charges","15.3% of total billed charges",1591.97,16.8,,1273.58,,,0,"percent of total billed charges","16.8% of total billed charges",6538.44,69,,,,,0,"fee schedule","69% of total billed charges",9476,100,,7580.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9476,100,,7580.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9476,100,,7580.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5860.91,61.85,,4688.73,,,0,"percent of total billed charges","61.5% of total billed charges",1591.97,16.8,,1273.58,,,0,"percent of total billed charges","16.8% of total billed charges",4738,50,,3790.40,,,0,"percent of total billed charges","50% of total billed charges",3051.27,32.2,,2441.02,,,0,"percent of total billed charges","32.2% of total billed charges",1591.97,16.8,,1273.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1623.81,17.136,,1299.05,,,0,"percent of total billed charges","17.136% of total billed charges",2069.56,21.84,,1655.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3572.45,37.7,,2857.96,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7391.28,78,,5913.02,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7827.18,82.6,,6261.74,,,0,"percent of total billed charges","82.6% of total billed charges",1591.97,16.8,,1273.58,,,0,"percent of total billed charges","16.8% of total billed charges",4738,50,,3790.40,,,0,"percent of total billed charges","50% of total billed charges",7827.18,82.6,,6261.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1591.97,16.8,,1273.58,,,0,"percent of total billed charges","16.8% of total billed charges",9476,100,,7580.80,,,0,"percent of total billed charges","100% of total billed charges",1449.83,9476,
"LAB COAT XL BLUE",490821,CDM,270,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.95,61.85,,3.96,,,0,"percent of total billed charges","61.5% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"LAB JACKET MEDIUM WHITE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"LAB JACKET LARGE WHITE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"LAB JACKET MEDIUM BLUE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"LAB JACKET LARGE BLUE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"LAB JACKET XL WHITE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"LAB JACKET XXL WHITE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"LAB COAT XXL BLUE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"LAB JACKET SMALL WHITE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"LABEL MEDICATION ADDED",187814,CDM,270,RC,,,OUTPATIENT,,,162,105.3,,142.56,88,,114.05,,,0,"percent of total billed charges","88% of total billed charges",81,50,,64.80,,,0,"percent of total billed charges","50% of total billed charges",27.22,16.8,,21.78,,,0,"percent of total billed charges","16.8% of total billed charges",162,100,,129.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.03,17.304,,22.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",102.06,63,,81.65,,,0,"percent of total billed charges","63% of total billed charges",24.79,15.3,,19.83,,,0,"percent of total billed charges","15.3% of total billed charges",27.22,16.8,,21.78,,,0,"percent of total billed charges","16.8% of total billed charges",111.78,69,,,,,0,"fee schedule","69% of total billed charges",162,100,,129.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162,100,,129.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162,100,,129.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",100.2,61.85,,80.16,,,0,"percent of total billed charges","61.5% of total billed charges",27.22,16.8,,21.78,,,0,"percent of total billed charges","16.8% of total billed charges",81,50,,64.80,,,0,"percent of total billed charges","50% of total billed charges",52.16,32.2,,41.73,,,0,"percent of total billed charges","32.2% of total billed charges",27.22,16.8,,21.78,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.76,17.136,,22.21,,,0,"percent of total billed charges","17.136% of total billed charges",35.38,21.84,,28.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",61.07,37.7,,48.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.36,78,,101.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",133.81,82.6,,107.05,,,0,"percent of total billed charges","82.6% of total billed charges",27.22,16.8,,21.78,,,0,"percent of total billed charges","16.8% of total billed charges",81,50,,64.80,,,0,"percent of total billed charges","50% of total billed charges",133.81,82.6,,107.05,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.22,16.8,,21.78,,,0,"percent of total billed charges","16.8% of total billed charges",162,100,,129.60,,,0,"percent of total billed charges","100% of total billed charges",24.79,162,
"LABEL ''ALLERGIC: ___ ___'' 5-1/2X1 WHITE/RED",131027,CDM,270,RC,,,OUTPATIENT,,,32,20.8,,28.16,88,,22.53,,,0,"percent of total billed charges","88% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.54,17.304,,4.43,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.16,63,,16.13,,,0,"percent of total billed charges","63% of total billed charges",4.9,15.3,,3.92,,,0,"percent of total billed charges","15.3% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",22.08,69,,,,,0,"fee schedule","69% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.79,61.85,,15.83,,,0,"percent of total billed charges","61.5% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",10.3,32.2,,8.24,,,0,"percent of total billed charges","32.2% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.48,17.136,,4.38,,,0,"percent of total billed charges","17.136% of total billed charges",6.99,21.84,,5.59,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.96,78,,19.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",4.9,32,
"LABEL ALLERGIC 1X500IN WHITE/RED",9782,CDM,270,RC,,,OUTPATIENT,,,21,13.65,,18.48,88,,14.78,,,0,"percent of total billed charges","88% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.63,17.304,,2.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.23,63,,10.58,,,0,"percent of total billed charges","63% of total billed charges",3.21,15.3,,2.57,,,0,"percent of total billed charges","15.3% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",14.49,69,,,,,0,"fee schedule","69% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.99,61.85,,10.39,,,0,"percent of total billed charges","61.5% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",6.76,32.2,,5.41,,,0,"percent of total billed charges","32.2% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.6,17.136,,2.88,,,0,"percent of total billed charges","17.136% of total billed charges",4.59,21.84,,3.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.92,37.7,,6.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.38,78,,13.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",3.21,21,
"LABEL ANES LIDO L1.5INXW.5IN ST. JOHNS RL",44849,CDM,270,RC,,,OUTPATIENT,,,26,16.9,,22.88,88,,18.30,,,0,"percent of total billed charges","88% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.5,17.304,,3.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.38,63,,13.10,,,0,"percent of total billed charges","63% of total billed charges",3.98,15.3,,3.18,,,0,"percent of total billed charges","15.3% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",17.94,69,,,,,0,"fee schedule","69% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.08,61.85,,12.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",8.37,32.2,,6.70,,,0,"percent of total billed charges","32.2% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.46,17.136,,3.57,,,0,"percent of total billed charges","17.136% of total billed charges",5.68,21.84,,4.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.8,37.7,,7.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.28,78,,16.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",3.98,26,
"LABEL ANESTHESIA ST. JOHNS FENTANYL L1 1/2INXW1/2IN ROLL",44846,CDM,270,RC,,,OUTPATIENT,,,23,14.95,,20.24,88,,16.19,,,0,"percent of total billed charges","88% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.98,17.304,,3.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.49,63,,11.59,,,0,"percent of total billed charges","63% of total billed charges",3.52,15.3,,2.82,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",15.87,69,,,,,0,"fee schedule","69% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.23,61.85,,11.38,,,0,"percent of total billed charges","61.5% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",7.41,32.2,,5.93,,,0,"percent of total billed charges","32.2% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.94,17.136,,3.15,,,0,"percent of total billed charges","17.136% of total billed charges",5.02,21.84,,4.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.94,78,,14.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",3.52,23,
"LABEL ANESTHESIA ST. JOHNS VERSED L1 1/2INXW1/2IN ROLL",44847,CDM,270,RC,,,OUTPATIENT,,,26,16.9,,22.88,88,,18.30,,,0,"percent of total billed charges","88% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.5,17.304,,3.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.38,63,,13.10,,,0,"percent of total billed charges","63% of total billed charges",3.98,15.3,,3.18,,,0,"percent of total billed charges","15.3% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",17.94,69,,,,,0,"fee schedule","69% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.08,61.85,,12.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",8.37,32.2,,6.70,,,0,"percent of total billed charges","32.2% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.46,17.136,,3.57,,,0,"percent of total billed charges","17.136% of total billed charges",5.68,21.84,,4.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.8,37.7,,7.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.28,78,,16.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",3.98,26,
"LABEL MEDPLUS 4X1/4X6 WHITE",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"LABEL MEDPLUS 4X1/4X6 YELLOW",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"LABEL DRUG SUFENTANIL",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"LABEL  DRUG ______ MG/ML",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"LABEL DRUG BUPIVICAINE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"LABEL DRUG  LIDOCAINE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"LABEL DRUG ROPIVACAINE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"LABEL DRUG EPHEDRINE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"LABEL DRUG FENTANYL",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"LABEL 2-PART CLEAN/DIRTY",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"LACTATE MEMBRANE",ORSUP0014,CDM,270,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
LANCET,490823,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"LAP SPONGE 36 X 36 X-RAY",490825,CDM,270,RC,,,OUTPATIENT,,,24,15.6,,21.12,88,,16.90,,,0,"percent of total billed charges","88% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.15,17.304,,3.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.12,63,,12.10,,,0,"percent of total billed charges","63% of total billed charges",3.67,15.3,,2.94,,,0,"percent of total billed charges","15.3% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",16.56,69,,,,,0,"fee schedule","69% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.84,61.85,,11.87,,,0,"percent of total billed charges","61.5% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",7.73,32.2,,6.18,,,0,"percent of total billed charges","32.2% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.11,17.136,,3.29,,,0,"percent of total billed charges","17.136% of total billed charges",5.24,21.84,,4.19,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.05,37.7,,7.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.72,78,,14.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,24,
"LAP RETRACTOR SMALL ALEXIS",ORSUP0009,CDM,270,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"LAPAROSCOPIC BLADE SYSTEM",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"LAPAROSCOPIC L-HOOK BLUE PTFE BLACK INSULATION",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,17.304,,49.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.28,61.85,,178.62,,,0,"percent of total billed charges","61.5% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",116.24,32.2,,92.99,,,0,"percent of total billed charges","32.2% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.86,17.136,,49.49,,,0,"percent of total billed charges","17.136% of total billed charges",78.84,21.84,,63.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,361,
"LARGE C-ARM DRAPE",490827,CDM,270,RC,,,OUTPATIENT,,,26,16.9,,22.88,88,,18.30,,,0,"percent of total billed charges","88% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.5,17.304,,3.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.38,63,,13.10,,,0,"percent of total billed charges","63% of total billed charges",3.98,15.3,,3.18,,,0,"percent of total billed charges","15.3% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",17.94,69,,,,,0,"fee schedule","69% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.08,61.85,,12.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",8.37,32.2,,6.70,,,0,"percent of total billed charges","32.2% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.46,17.136,,3.57,,,0,"percent of total billed charges","17.136% of total billed charges",5.68,21.84,,4.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.8,37.7,,7.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.28,78,,16.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",3.98,26,
"LARGE CLIP APPLIER",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"LARYNGECTOMY TUBE SHILEY SZ 10",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"LARYNGOSCOPE BRITEBLADE PRO MAC SIZE 4",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"LARYNGO SHEATH COVER",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"LARYNGEAL MASK SZ 1",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"LARYNGEAL MASK SZ 1.5",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"LARYNGEAL MASK SZ 2",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"LARYNGEAL MASK SZ 2.5",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"LARYNGOSCOPES BLADE MAC 3",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"LARYNGEAL AIRWAY TUBING SZ 5",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"LASER MICRON 400 SINGLE USE",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"LASSO RIGHT TIGHTCURVE 25DEG",ORSUP0011,CDM,270,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"LASSO LEFT 25DEG TIGHTCURVE",ORSUP0011,CDM,270,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"LASSO POLYPECTOMY SNARE OVAL 10MM 230CM HOT/COLD",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"LASSO POLYPECTOMY SNARE OVAL 15MM 230CM HOT/COLD",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"LAUNCHER PTCA GUIDE 6FR JR40 SIDE HOLE",ORSUP0004,CDM,278,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.7% of total billed charges",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.85,33.9,,72.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"LBL CERNER GENERAL DT PB 2X1 YELLOW",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"LDH / 5 PACK / 250 SLDS",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"LEAD TENDRILL STS 65CM",ORSUP0023,CDM,272,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"LEAD WIRE SET 5",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"LEAD PMKR NON-TRN L3",CATH00033,CDM,275,RC,,,OUTPATIENT,,,9957,6472.05,,8762.16,88,,7009.73,,,0,"percent of total billed charges","88% of total billed charges",4978.5,50,,3982.80,,,0,"percent of total billed charges","50% of total billed charges",1672.78,16.8,,1338.22,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1722.96,17.304,,1378.37,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6272.91,63,,5018.33,,,0,"percent of total billed charges","63% of total billed charges",1523.42,15.3,,1218.74,,,0,"percent of total billed charges","15.3% of total billed charges",1672.78,16.8,,1338.22,,,0,"percent of total billed charges","16.8% of total billed charges",6870.33,69,,,,,0,"fee schedule","69% of total billed charges",9957,100,,7965.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9957,100,,7965.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9957,100,,7965.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6158.4,61.85,,4926.72,,,0,"percent of total billed charges","61.5% of total billed charges",1672.78,16.8,,1338.22,,,0,"percent of total billed charges","16.8% of total billed charges",4978.5,50,,3982.80,,,0,"percent of total billed charges","50% of total billed charges",3206.15,32.2,,2564.92,,,0,"percent of total billed charges","32.2% of total billed charges",3106.58,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1706.23,17.136,,1364.98,,,0,"percent of total billed charges","17.136% of total billed charges",2174.61,21.84,,1739.69,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3753.79,37.7,,3003.03,,,0,"percent of total billed charges","37.7% of total billed charges",3753.79,37.7,,3003.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3375.42,33.9,,2700.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766.46,78,,6213.17,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8224.48,82.6,,6579.58,,,0,"percent of total billed charges","82.6% of total billed charges",1672.78,16.8,,1338.22,,,0,"percent of total billed charges","16.8% of total billed charges",4978.5,50,,3982.80,,,0,"percent of total billed charges","50% of total billed charges",8224.48,82.6,,6579.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1672.78,16.8,,1338.22,,,0,"percent of total billed charges","16.8% of total billed charges",9957,100,,7965.60,,,0,"percent of total billed charges","100% of total billed charges",1523.42,9957,
"LEADWIRE SPU 5-LEAD GRAB AHA 39",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"LEG HOLDER DISPOSABLE PAD",490830,CDM,270,RC,,,OUTPATIENT,,,512,332.8,,450.56,88,,360.45,,,0,"percent of total billed charges","88% of total billed charges",256,50,,204.80,,,0,"percent of total billed charges","50% of total billed charges",86.02,16.8,,68.82,,,0,"percent of total billed charges","16.8% of total billed charges",512,100,,409.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.6,17.304,,70.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",322.56,63,,258.05,,,0,"percent of total billed charges","63% of total billed charges",78.34,15.3,,62.67,,,0,"percent of total billed charges","15.3% of total billed charges",86.02,16.8,,68.82,,,0,"percent of total billed charges","16.8% of total billed charges",353.28,69,,,,,0,"fee schedule","69% of total billed charges",512,100,,409.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",512,100,,409.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",512,100,,409.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",316.67,61.85,,253.34,,,0,"percent of total billed charges","61.5% of total billed charges",86.02,16.8,,68.82,,,0,"percent of total billed charges","16.8% of total billed charges",256,50,,204.80,,,0,"percent of total billed charges","50% of total billed charges",164.86,32.2,,131.89,,,0,"percent of total billed charges","32.2% of total billed charges",86.02,16.8,,68.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.74,17.136,,70.19,,,0,"percent of total billed charges","17.136% of total billed charges",111.82,21.84,,89.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",193.02,37.7,,154.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",399.36,78,,319.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.91,82.6,,338.33,,,0,"percent of total billed charges","82.6% of total billed charges",86.02,16.8,,68.82,,,0,"percent of total billed charges","16.8% of total billed charges",256,50,,204.80,,,0,"percent of total billed charges","50% of total billed charges",422.91,82.6,,338.33,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.02,16.8,,68.82,,,0,"percent of total billed charges","16.8% of total billed charges",512,100,,409.60,,,0,"percent of total billed charges","100% of total billed charges",78.34,512,
"LEGEND 8CM 1.1MM TAPERED",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"LEGEND BIT DRILL",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"LEGEND M-52 DISSECTING TOOL",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"LEGEND M-51 DISSECTING TOOL",ORSUP0009,CDM,270,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"LEGGING CLEAR 1PAIR STERILE",236095,CDM,272,RC,,,OUTPATIENT,,,31,20.15,,27.28,88,,21.82,,,0,"percent of total billed charges","88% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.36,17.304,,4.29,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.53,63,,15.62,,,0,"percent of total billed charges","63% of total billed charges",4.74,15.3,,3.79,,,0,"percent of total billed charges","15.3% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",21.39,69,,,,,0,"fee schedule","69% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.17,61.85,,15.34,,,0,"percent of total billed charges","61.5% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",9.98,32.2,,7.98,,,0,"percent of total billed charges","32.2% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.31,17.136,,4.25,,,0,"percent of total billed charges","17.136% of total billed charges",6.77,21.84,,5.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.69,37.7,,9.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.18,78,,19.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.61,82.6,,20.49,,,0,"percent of total billed charges","82.6% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",25.61,82.6,,20.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",4.74,31,
"LEGGINGS W/ 6CUFF 29X43 STERILE",31497,CDM,272,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"PACK, LEGGINGS",491026,CDM,270,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"LEICA MICROSCOPE DRAPE",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"LENS PAPER",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"LH 100 WELLS",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"LH CALIBRATOR BOX / 1 SET",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"LIDOCAINE 0.4% HCL IN 5% DEXTROSE INJ 500ML PB",148080,CDM,272,RC,,,OUTPATIENT,,,37,24.05,,32.56,88,,26.05,,,0,"percent of total billed charges","88% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.4,17.304,,5.12,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.31,63,,18.65,,,0,"percent of total billed charges","63% of total billed charges",5.66,15.3,,4.53,,,0,"percent of total billed charges","15.3% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",25.53,69,,,,,0,"fee schedule","69% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.88,61.85,,18.30,,,0,"percent of total billed charges","61.5% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",11.91,32.2,,9.53,,,0,"percent of total billed charges","32.2% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.34,17.136,,5.07,,,0,"percent of total billed charges","17.136% of total billed charges",8.08,21.84,,6.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.95,37.7,,11.16,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.86,78,,23.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",5.66,37,
"LIGASURE TISSUE FUSION INSTRUMENT",ORSUP0102,CDM,272,RC,,,OUTPATIENT,,,24905,16188.25,,21916.4,88,,17533.12,,,0,"percent of total billed charges","88% of total billed charges",12452.5,50,,9962.00,,,0,"percent of total billed charges","50% of total billed charges",4184.04,16.8,,3347.23,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4309.56,17.304,,3447.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15690.15,63,,12552.12,,,0,"percent of total billed charges","63% of total billed charges",3810.47,15.3,,3048.38,,,0,"percent of total billed charges","15.3% of total billed charges",4184.04,16.8,,3347.23,,,0,"percent of total billed charges","16.8% of total billed charges",17184.45,69,,,,,0,"fee schedule","69% of total billed charges",24905,100,,19924.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24905,100,,19924.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24905,100,,19924.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15403.74,61.85,,12322.99,,,0,"percent of total billed charges","61.5% of total billed charges",4184.04,16.8,,3347.23,,,0,"percent of total billed charges","16.8% of total billed charges",12452.5,50,,9962.00,,,0,"percent of total billed charges","50% of total billed charges",8019.41,32.2,,6415.53,,,0,"percent of total billed charges","32.2% of total billed charges",4184.04,16.8,,3347.23,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4267.72,17.136,,3414.18,,,0,"percent of total billed charges","17.136% of total billed charges",5439.25,21.84,,4351.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9389.19,37.7,,7511.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19425.9,78,,15540.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",20571.53,82.6,,16457.22,,,0,"percent of total billed charges","82.6% of total billed charges",4184.04,16.8,,3347.23,,,0,"percent of total billed charges","16.8% of total billed charges",12452.5,50,,9962.00,,,0,"percent of total billed charges","50% of total billed charges",20571.53,82.6,,16457.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4184.04,16.8,,3347.23,,,0,"percent of total billed charges","16.8% of total billed charges",24905,100,,19924.00,,,0,"percent of total billed charges","100% of total billed charges",3810.47,24905,
"LIGASURE MARYLAND JAW 44CM",ORSUP0033,CDM,272,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"LIGASURE MARYLAND CURVED TIP",ORSUP0026,CDM,272,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"LIGATOR 9.5-13MM 6 SHOOTER SAEED",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"LIGATOR MULTIBAND SAEED SIX SHOOTR W/EXTD OPPI-VU",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"LIGATOR MULTI BAND",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"LIGATURE ENDOLOOP",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"LIGASURE TISSUE FUSION INSTRUM",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"LIGASURE 5MM BLUNT TIP",ORSUP0029,CDM,270,RC,,,OUTPATIENT,,,4820,3133,,4241.6,88,,3393.28,,,0,"percent of total billed charges","88% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",834.05,17.304,,667.24,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3036.6,63,,2429.28,,,0,"percent of total billed charges","63% of total billed charges",737.46,15.3,,589.97,,,0,"percent of total billed charges","15.3% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",3325.8,69,,,,,0,"fee schedule","69% of total billed charges",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2981.17,61.85,,2384.94,,,0,"percent of total billed charges","61.5% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",1552.04,32.2,,1241.63,,,0,"percent of total billed charges","32.2% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",825.96,17.136,,660.77,,,0,"percent of total billed charges","17.136% of total billed charges",1052.69,21.84,,842.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1817.14,37.7,,1453.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3759.6,78,,3007.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3981.32,82.6,,3185.06,,,0,"percent of total billed charges","82.6% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",3981.32,82.6,,3185.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",737.46,4820,
"LIGASURE ADVANCE PISTOL LF5544",ORSUP0009,CDM,270,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"LIGASURE 5MM BLUNT TIP LF1837",ORSUP0020,CDM,270,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"LIGHT CABLE",ORSUP0025,CDM,270,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"LIM BROTH/TODD HEWITT BROTH W/COLSTN",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"LIMITORR VOLUME LIMITING EVD 20ML",ORSUP0025,CDM,272,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"LINER SUCTION CANNISTER 3000CC",152487,CDM,272,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"LINER BIOHAZARD RED 24X23 1.3 MIL CS/500",104656,CDM,270,RC,,,OUTPATIENT,,,266,172.9,,234.08,88,,187.26,,,0,"percent of total billed charges","88% of total billed charges",133,50,,106.40,,,0,"percent of total billed charges","50% of total billed charges",44.69,16.8,,35.75,,,0,"percent of total billed charges","16.8% of total billed charges",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.03,17.304,,36.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",167.58,63,,134.06,,,0,"percent of total billed charges","63% of total billed charges",40.7,15.3,,32.56,,,0,"percent of total billed charges","15.3% of total billed charges",44.69,16.8,,35.75,,,0,"percent of total billed charges","16.8% of total billed charges",183.54,69,,,,,0,"fee schedule","69% of total billed charges",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",164.52,61.85,,131.62,,,0,"percent of total billed charges","61.5% of total billed charges",44.69,16.8,,35.75,,,0,"percent of total billed charges","16.8% of total billed charges",133,50,,106.40,,,0,"percent of total billed charges","50% of total billed charges",85.65,32.2,,68.52,,,0,"percent of total billed charges","32.2% of total billed charges",44.69,16.8,,35.75,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.58,17.136,,36.46,,,0,"percent of total billed charges","17.136% of total billed charges",58.09,21.84,,46.47,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",100.28,37.7,,80.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",207.48,78,,165.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",219.72,82.6,,175.78,,,0,"percent of total billed charges","82.6% of total billed charges",44.69,16.8,,35.75,,,0,"percent of total billed charges","16.8% of total billed charges",133,50,,106.40,,,0,"percent of total billed charges","50% of total billed charges",219.72,82.6,,175.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.69,16.8,,35.75,,,0,"percent of total billed charges","16.8% of total billed charges",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",40.7,266,
"LINEAR CUTTER 75MM PROXIMATE",ORSUP0010,CDM,270,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"LINEAR CUTTER 55MM TLC55",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"LINED BREAST BINDER SMALL LAVENDER",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"LINED BREAST BINDER MED LIGHT BLUE",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"LINED BREAST BINER LRG PINK",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"LINEAR CUTTER 75 MM SELECTABLE WITH 3D STAPLES",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,412,267.8,,362.56,88,,290.05,,,0,"percent of total billed charges","88% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.29,17.304,,57.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",259.56,63,,207.65,,,0,"percent of total billed charges","63% of total billed charges",63.04,15.3,,50.43,,,0,"percent of total billed charges","15.3% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",284.28,69,,,,,0,"fee schedule","69% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",254.82,61.85,,203.86,,,0,"percent of total billed charges","61.5% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",132.66,32.2,,106.13,,,0,"percent of total billed charges","32.2% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.6,17.136,,56.48,,,0,"percent of total billed charges","17.136% of total billed charges",89.98,21.84,,71.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",155.32,37.7,,124.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",321.36,78,,257.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",63.04,412,
"LINEAR CUTTER 75 MM SELECTABLE RELOADS",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.94,17.304,,85.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.23,61.85,,305.78,,,0,"percent of total billed charges","61.5% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",199,32.2,,159.20,,,0,"percent of total billed charges","32.2% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.136,,84.72,,,0,"percent of total billed charges","17.136% of total billed charges",134.97,21.84,,107.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,618,
"LINK TIGER",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"LIP BALM",490840,CDM,270,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"LIPO SUCTION TUBING",490841,CDM,272,RC,,,OUTPATIENT,,,44,28.6,,38.72,88,,30.98,,,0,"percent of total billed charges","88% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.61,17.304,,6.09,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.72,63,,22.18,,,0,"percent of total billed charges","63% of total billed charges",6.73,15.3,,5.38,,,0,"percent of total billed charges","15.3% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",30.36,69,,,,,0,"fee schedule","69% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.21,61.85,,21.77,,,0,"percent of total billed charges","61.5% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",14.17,32.2,,11.34,,,0,"percent of total billed charges","32.2% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.54,17.136,,6.03,,,0,"percent of total billed charges","17.136% of total billed charges",9.61,21.84,,7.69,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.59,37.7,,13.27,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.32,78,,27.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",6.73,44,
"LIPO ASPIRATION TUBING SET",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"LIQ PERF VERIFIER I BX / 6 BTLS",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"LIQ PERF VERIFIER II BX / 6 BTLS",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"LIQUID DESCALER 1GL",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"LITHIUM / 5 PACK / 300 SLDS",ORSUP0026,CDM,272,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
LITHIUM,ORSUP0024,CDM,272,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"LIVER ACCESS AND BIOPSY SET",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,1854,1205.1,,1631.52,88,,1305.22,,,0,"percent of total billed charges","88% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",320.82,17.304,,256.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1168.02,63,,934.42,,,0,"percent of total billed charges","63% of total billed charges",283.66,15.3,,226.93,,,0,"percent of total billed charges","15.3% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1279.26,69,,,,,0,"fee schedule","69% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1146.7,61.85,,917.36,,,0,"percent of total billed charges","61.5% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",596.99,32.2,,477.59,,,0,"percent of total billed charges","32.2% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.7,17.136,,254.16,,,0,"percent of total billed charges","17.136% of total billed charges",404.91,21.84,,323.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",698.96,37.7,,559.17,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1446.12,78,,1156.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1531.4,82.6,,1225.12,,,0,"percent of total billed charges","82.6% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",1531.4,82.6,,1225.12,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",283.66,1854,
"LIVER ACCESS \\T\\ BIOPSY SET KIT",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2060,1339,,1812.8,88,,1450.24,,,0,"percent of total billed charges","88% of total billed charges",1030,50,,824.00,,,0,"percent of total billed charges","50% of total billed charges",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",356.46,17.304,,285.17,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1297.8,63,,1038.24,,,0,"percent of total billed charges","63% of total billed charges",315.18,15.3,,252.14,,,0,"percent of total billed charges","15.3% of total billed charges",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",1421.4,69,,,,,0,"fee schedule","69% of total billed charges",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1274.11,61.85,,1019.29,,,0,"percent of total billed charges","61.5% of total billed charges",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",1030,50,,824.00,,,0,"percent of total billed charges","50% of total billed charges",663.32,32.2,,530.66,,,0,"percent of total billed charges","32.2% of total billed charges",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",353,17.136,,282.40,,,0,"percent of total billed charges","17.136% of total billed charges",449.9,21.84,,359.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",776.62,37.7,,621.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1606.8,78,,1285.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1701.56,82.6,,1361.25,,,0,"percent of total billed charges","82.6% of total billed charges",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",1030,50,,824.00,,,0,"percent of total billed charges","50% of total billed charges",1701.56,82.6,,1361.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",315.18,2060,
"LMA UNIQUE AIRWAY MASK NEONATE/INFANT SZ 1",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"LMA MASK  SIZE 2",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"LMA MASK  SIZE 2.5",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"LMA SZ 3",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"LMA MASK SZ 5",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"LOC POWER 19G X 3/4",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"LOOP ELECTRODE RESECTION 26F 30DEG",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"LOOP TIGER",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"LOOP INOCULATING BLUE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"LOTION BABY  2 OZ",420393,CDM,272,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"LOW SUDS DETERGENT",490844,CDM,270,RC,,,OUTPATIENT,,,235,152.75,,206.8,88,,165.44,,,0,"percent of total billed charges","88% of total billed charges",117.5,50,,94.00,,,0,"percent of total billed charges","50% of total billed charges",39.48,16.8,,31.58,,,0,"percent of total billed charges","16.8% of total billed charges",235,100,,188.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.66,17.304,,32.53,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",148.05,63,,118.44,,,0,"percent of total billed charges","63% of total billed charges",35.96,15.3,,28.77,,,0,"percent of total billed charges","15.3% of total billed charges",39.48,16.8,,31.58,,,0,"percent of total billed charges","16.8% of total billed charges",162.15,69,,,,,0,"fee schedule","69% of total billed charges",235,100,,188.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",235,100,,188.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",235,100,,188.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",145.35,61.85,,116.28,,,0,"percent of total billed charges","61.5% of total billed charges",39.48,16.8,,31.58,,,0,"percent of total billed charges","16.8% of total billed charges",117.5,50,,94.00,,,0,"percent of total billed charges","50% of total billed charges",75.67,32.2,,60.54,,,0,"percent of total billed charges","32.2% of total billed charges",39.48,16.8,,31.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.27,17.136,,32.22,,,0,"percent of total billed charges","17.136% of total billed charges",51.32,21.84,,41.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",88.6,37.7,,70.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",183.3,78,,146.64,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.11,82.6,,155.29,,,0,"percent of total billed charges","82.6% of total billed charges",39.48,16.8,,31.58,,,0,"percent of total billed charges","16.8% of total billed charges",117.5,50,,94.00,,,0,"percent of total billed charges","50% of total billed charges",194.11,82.6,,155.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.48,16.8,,31.58,,,0,"percent of total billed charges","16.8% of total billed charges",235,100,,188.00,,,0,"percent of total billed charges","100% of total billed charges",35.96,235,
"LTS-D AIRWAY SZ 3",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"LTS-D AIRWAY SZ 4",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"LUBRICANT/DIFFUSER AIR PACK #PA100-A",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"LUBRICANT INSTRUMENT 1GL",ORSUP0004,CDM,270,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"LUBRICANT JELLY 4 OZ FLIP TOP TUBE",264030,CDM,270,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"LUBRICANT ROTAGLIDE (BX/6)",ORSUP0011,CDM,270,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"LUBRICANT VIPERSLIDE",ORSUP0011,CDM,270,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"LUBRICANT TYPE 2 LITHIUM (59-006981C)",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"LUER ADAPTER",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"LUGOL'S IODINE SOLUTION",490846,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"LUMBAR PUNCTURE TRAY INFANT/PED 22G X 1.5",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"LUMBAR PUNTURE TRAY ADULT 20 X 3.5",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"Laser Vaporization of Prostate Charge",SUR200053,CDM,360,RC,,,OUTPATIENT,,,13934,9057.1,,12261.92,88,,9809.54,,,0,"percent of total billed charges","88% of total billed charges",6967,50,,5573.60,,,0,"percent of total billed charges","50% of total billed charges",2340.91,16.8,,1872.73,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2411.14,17.304,,1928.91,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8778.42,63,,7022.74,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",2340.91,16.8,,1872.73,,,0,"percent of total billed charges","16.8% of total billed charges",9614.46,69,,,,,0,"fee schedule","69% of total billed charges",13934,100,,11147.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13934,100,,11147.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13934,100,,11147.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8618.18,61.85,,6894.54,,,0,"percent of total billed charges","61.5% of total billed charges",2340.91,16.8,,1872.73,,,0,"percent of total billed charges","16.8% of total billed charges",6967,50,,5573.60,,,0,"percent of total billed charges","50% of total billed charges",4486.75,32.2,,3589.40,,,0,"percent of total billed charges","32.2% of total billed charges",2340.91,16.8,,1872.73,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2387.73,17.136,,1910.18,,,0,"percent of total billed charges","17.136% of total billed charges",3043.19,21.84,,2434.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",5253.12,37.7,,4202.50,,,0,"percent of total billed charges","37.7% of total billed charges",5253.12,37.7,,4202.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4723.63,33.9,,3778.90,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",10868.52,78,,8694.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11509.48,82.6,,9207.58,,,0,"percent of total billed charges","82.6% of total billed charges",2340.91,16.8,,1872.73,,,0,"percent of total billed charges","16.8% of total billed charges",6967,50,,5573.60,,,0,"percent of total billed charges","50% of total billed charges",11509.48,82.6,,9207.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2340.91,16.8,,1872.73,,,0,"percent of total billed charges","16.8% of total billed charges",13934,100,,11147.20,,,0,"percent of total billed charges","100% of total billed charges",2340.91,13934,
"Lithotripsy Charge",SUR200016,CDM,360,RC,,,OUTPATIENT,,,11612,7547.8,,10218.56,88,,8174.85,,,0,"percent of total billed charges","88% of total billed charges",5806,50,,4644.80,,,0,"percent of total billed charges","50% of total billed charges",1950.82,16.8,,1560.66,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2009.34,17.304,,1607.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7315.56,63,,5852.45,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",1950.82,16.8,,1560.66,,,0,"percent of total billed charges","16.8% of total billed charges",8012.28,69,,,,,0,"fee schedule","69% of total billed charges",11612,100,,9289.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11612,100,,9289.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11612,100,,9289.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7182.02,61.85,,5745.62,,,0,"percent of total billed charges","61.5% of total billed charges",1950.82,16.8,,1560.66,,,0,"percent of total billed charges","16.8% of total billed charges",5806,50,,4644.80,,,0,"percent of total billed charges","50% of total billed charges",3739.06,32.2,,2991.25,,,0,"percent of total billed charges","32.2% of total billed charges",1950.82,16.8,,1560.66,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1989.83,17.136,,1591.86,,,0,"percent of total billed charges","17.136% of total billed charges",2536.06,21.84,,2028.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4377.72,37.7,,3502.18,,,0,"percent of total billed charges","37.7% of total billed charges",4377.72,37.7,,3502.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3936.47,33.9,,3149.18,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",9057.36,78,,7245.89,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9591.51,82.6,,7673.21,,,0,"percent of total billed charges","82.6% of total billed charges",1950.82,16.8,,1560.66,,,0,"percent of total billed charges","16.8% of total billed charges",5806,50,,4644.80,,,0,"percent of total billed charges","50% of total billed charges",9591.51,82.6,,7673.21,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1950.82,16.8,,1560.66,,,0,"percent of total billed charges","16.8% of total billed charges",11612,100,,9289.60,,,0,"percent of total billed charges","100% of total billed charges",1950.82,11612,
"Lithotripsy Bilat Charge",SUR200017,CDM,360,RC,,,OUTPATIENT,,,15262,9920.3,,13430.56,88,,10744.45,,,0,"percent of total billed charges","88% of total billed charges",7631,50,,6104.80,,,0,"percent of total billed charges","50% of total billed charges",2564.02,16.8,,2051.22,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2640.94,17.304,,2112.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9615.06,63,,7692.05,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",2564.02,16.8,,2051.22,,,0,"percent of total billed charges","16.8% of total billed charges",10530.78,69,,,,,0,"fee schedule","69% of total billed charges",15262,100,,12209.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15262,100,,12209.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15262,100,,12209.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9439.55,61.85,,7551.64,,,0,"percent of total billed charges","61.5% of total billed charges",2564.02,16.8,,2051.22,,,0,"percent of total billed charges","16.8% of total billed charges",7631,50,,6104.80,,,0,"percent of total billed charges","50% of total billed charges",4914.36,32.2,,3931.49,,,0,"percent of total billed charges","32.2% of total billed charges",2564.02,16.8,,2051.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2615.3,17.136,,2092.24,,,0,"percent of total billed charges","17.136% of total billed charges",3333.22,21.84,,2666.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",5753.77,37.7,,4603.02,,,0,"percent of total billed charges","37.7% of total billed charges",5753.77,37.7,,4603.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",5173.82,33.9,,4139.06,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",11904.36,78,,9523.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12606.41,82.6,,10085.13,,,0,"percent of total billed charges","82.6% of total billed charges",2564.02,16.8,,2051.22,,,0,"percent of total billed charges","16.8% of total billed charges",7631,50,,6104.80,,,0,"percent of total billed charges","50% of total billed charges",12606.41,82.6,,10085.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2564.02,16.8,,2051.22,,,0,"percent of total billed charges","16.8% of total billed charges",15262,100,,12209.60,,,0,"percent of total billed charges","100% of total billed charges",2564.02,15262,
"AGAR MEDIUM MACCONKEY",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"MACINTOSH OPTIC LARNYGO BLADE DISP #0",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"MACINTOSH OPTIC LARNYGO BLADE DISP #1",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"MACROPLASTIQUE ENDO NEEDLE",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"MACROPLASTIQUE IMPLANT",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"MACROPLASTIQUE ADMIN DEVICE",ORSUP0019,CDM,272,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"MACROPHARMA PHLEBOTOMY BAGS LUER LOCK",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"MAGELLAN SHEATH 12/14FR X 35CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.94,17.304,,85.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.23,61.85,,305.78,,,0,"percent of total billed charges","61.5% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",199,32.2,,159.20,,,0,"percent of total billed charges","32.2% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.136,,84.72,,,0,"percent of total billed charges","17.136% of total billed charges",134.97,21.84,,107.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.7% of total billed charges",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.5,33.9,,167.60,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,618,
"MAGNETIC INSTRUMENT DRAPE 10 X 16",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"MAINTENANCE KT",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"MAINTENANCE PK BOX / 2 PACKS",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"MAKO BLADE STANDARD",ORSUP0018,CDM,272,RC,,,OUTPATIENT,,,1494,971.1,,1314.72,88,,1051.78,,,0,"percent of total billed charges","88% of total billed charges",747,50,,597.60,,,0,"percent of total billed charges","50% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.52,17.304,,206.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",941.22,63,,752.98,,,0,"percent of total billed charges","63% of total billed charges",228.58,15.3,,182.86,,,0,"percent of total billed charges","15.3% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",1030.86,69,,,,,0,"fee schedule","69% of total billed charges",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",924.04,61.85,,739.23,,,0,"percent of total billed charges","61.5% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",747,50,,597.60,,,0,"percent of total billed charges","50% of total billed charges",481.07,32.2,,384.86,,,0,"percent of total billed charges","32.2% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",256.01,17.136,,204.81,,,0,"percent of total billed charges","17.136% of total billed charges",326.29,21.84,,261.03,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",563.24,37.7,,450.59,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1165.32,78,,932.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1234.04,82.6,,987.23,,,0,"percent of total billed charges","82.6% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",747,50,,597.60,,,0,"percent of total billed charges","50% of total billed charges",1234.04,82.6,,987.23,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",228.58,1494,
"MAKO BLADE NARROW",ORSUP0018,CDM,272,RC,,,OUTPATIENT,,,1494,971.1,,1314.72,88,,1051.78,,,0,"percent of total billed charges","88% of total billed charges",747,50,,597.60,,,0,"percent of total billed charges","50% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.52,17.304,,206.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",941.22,63,,752.98,,,0,"percent of total billed charges","63% of total billed charges",228.58,15.3,,182.86,,,0,"percent of total billed charges","15.3% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",1030.86,69,,,,,0,"fee schedule","69% of total billed charges",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",924.04,61.85,,739.23,,,0,"percent of total billed charges","61.5% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",747,50,,597.60,,,0,"percent of total billed charges","50% of total billed charges",481.07,32.2,,384.86,,,0,"percent of total billed charges","32.2% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",256.01,17.136,,204.81,,,0,"percent of total billed charges","17.136% of total billed charges",326.29,21.84,,261.03,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",563.24,37.7,,450.59,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1165.32,78,,932.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1234.04,82.6,,987.23,,,0,"percent of total billed charges","82.6% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",747,50,,597.60,,,0,"percent of total billed charges","50% of total billed charges",1234.04,82.6,,987.23,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",228.58,1494,
"MALB PERF VER I BOX / 6 BTLS",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"MALB PERF VER II BOX / 6 BTLS",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"MALB REAGENT BOX / 300T",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"MANIFOLD NEPTUNE 4- PORT",209202,CDM,272,RC,,,OUTPATIENT,,,166,107.9,,146.08,88,,116.86,,,0,"percent of total billed charges","88% of total billed charges",83,50,,66.40,,,0,"percent of total billed charges","50% of total billed charges",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.72,17.304,,22.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.58,63,,83.66,,,0,"percent of total billed charges","63% of total billed charges",25.4,15.3,,20.32,,,0,"percent of total billed charges","15.3% of total billed charges",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",114.54,69,,,,,0,"fee schedule","69% of total billed charges",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",102.67,61.85,,82.14,,,0,"percent of total billed charges","61.5% of total billed charges",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",83,50,,66.40,,,0,"percent of total billed charges","50% of total billed charges",53.45,32.2,,42.76,,,0,"percent of total billed charges","32.2% of total billed charges",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.45,17.136,,22.76,,,0,"percent of total billed charges","17.136% of total billed charges",36.25,21.84,,29.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",62.58,37.7,,50.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",129.48,78,,103.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.12,82.6,,109.70,,,0,"percent of total billed charges","82.6% of total billed charges",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",83,50,,66.40,,,0,"percent of total billed charges","50% of total billed charges",137.12,82.6,,109.70,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",25.4,166,
"MANIPULATOR UTERINE ENDOPATH ST",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"MANIFOLD 4 PORT",278531,CDM,272,RC,,,OUTPATIENT,,,166,107.9,,146.08,88,,116.86,,,0,"percent of total billed charges","88% of total billed charges",83,50,,66.40,,,0,"percent of total billed charges","50% of total billed charges",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.72,17.304,,22.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.58,63,,83.66,,,0,"percent of total billed charges","63% of total billed charges",25.4,15.3,,20.32,,,0,"percent of total billed charges","15.3% of total billed charges",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",114.54,69,,,,,0,"fee schedule","69% of total billed charges",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",102.67,61.85,,82.14,,,0,"percent of total billed charges","61.5% of total billed charges",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",83,50,,66.40,,,0,"percent of total billed charges","50% of total billed charges",53.45,32.2,,42.76,,,0,"percent of total billed charges","32.2% of total billed charges",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.45,17.136,,22.76,,,0,"percent of total billed charges","17.136% of total billed charges",36.25,21.84,,29.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",62.58,37.7,,50.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",129.48,78,,103.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.12,82.6,,109.70,,,0,"percent of total billed charges","82.6% of total billed charges",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",83,50,,66.40,,,0,"percent of total billed charges","50% of total billed charges",137.12,82.6,,109.70,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",25.4,166,
"MANIPULATOR UTERINE LAVENDER",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"MANIPULATOR UTERINE STANDARD RETRACTOR /ELEVATOR",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"MANIPULATOR VCARE UTERINE LARGE 37MM",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"MANIFOLD SINGLE PORT NEPTUNE",490851,CDM,272,RC,,,OUTPATIENT,,,71,46.15,,62.48,88,,49.98,,,0,"percent of total billed charges","88% of total billed charges",35.5,50,,28.40,,,0,"percent of total billed charges","50% of total billed charges",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.29,17.304,,9.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.73,63,,35.78,,,0,"percent of total billed charges","63% of total billed charges",10.86,15.3,,8.69,,,0,"percent of total billed charges","15.3% of total billed charges",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",48.99,69,,,,,0,"fee schedule","69% of total billed charges",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.91,61.85,,35.13,,,0,"percent of total billed charges","61.5% of total billed charges",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",35.5,50,,28.40,,,0,"percent of total billed charges","50% of total billed charges",22.86,32.2,,18.29,,,0,"percent of total billed charges","32.2% of total billed charges",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.17,17.136,,9.74,,,0,"percent of total billed charges","17.136% of total billed charges",15.51,21.84,,12.41,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.77,37.7,,21.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",55.38,78,,44.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.65,82.6,,46.92,,,0,"percent of total billed charges","82.6% of total billed charges",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",35.5,50,,28.40,,,0,"percent of total billed charges","50% of total billed charges",58.65,82.6,,46.92,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",10.86,71,
"MANIFOLD 4-PORT NEPTUNE",490850,CDM,272,RC,,,OUTPATIENT,,,151,98.15,,132.88,88,,106.30,,,0,"percent of total billed charges","88% of total billed charges",75.5,50,,60.40,,,0,"percent of total billed charges","50% of total billed charges",25.37,16.8,,20.30,,,0,"percent of total billed charges","16.8% of total billed charges",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.13,17.304,,20.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.13,63,,76.10,,,0,"percent of total billed charges","63% of total billed charges",23.1,15.3,,18.48,,,0,"percent of total billed charges","15.3% of total billed charges",25.37,16.8,,20.30,,,0,"percent of total billed charges","16.8% of total billed charges",104.19,69,,,,,0,"fee schedule","69% of total billed charges",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",93.39,61.85,,74.71,,,0,"percent of total billed charges","61.5% of total billed charges",25.37,16.8,,20.30,,,0,"percent of total billed charges","16.8% of total billed charges",75.5,50,,60.40,,,0,"percent of total billed charges","50% of total billed charges",48.62,32.2,,38.90,,,0,"percent of total billed charges","32.2% of total billed charges",25.37,16.8,,20.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.88,17.136,,20.70,,,0,"percent of total billed charges","17.136% of total billed charges",32.98,21.84,,26.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",56.93,37.7,,45.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",117.78,78,,94.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.73,82.6,,99.78,,,0,"percent of total billed charges","82.6% of total billed charges",25.37,16.8,,20.30,,,0,"percent of total billed charges","16.8% of total billed charges",75.5,50,,60.40,,,0,"percent of total billed charges","50% of total billed charges",124.73,82.6,,99.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.37,16.8,,20.30,,,0,"percent of total billed charges","16.8% of total billed charges",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",23.1,151,
"MANIFOLD BT2000 KIT",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"MANIFOLD CUSTOM KITS",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"MAP BD MICROTUBE MAP",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"MARKER ENDOSCOPIC COLON SPOT BLACK",ORSUP0019,CDM,272,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"MARKER HYDRO-MARK 15 GA BUTTERFLY",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"MARKER ULTRASOUND ULTRACLIP RIBBON",ORSUP0019,CDM,278,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",668.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.7% of total billed charges",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",726.14,33.9,,580.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"MARKER ULTRASOUND ULTRACLIP WING",ORSUP0019,CDM,278,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",668.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.7% of total billed charges",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",726.14,33.9,,580.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"MARKER DELIVER KIT",ORSUP0010,CDM,270,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"MARKER MOLE SPEED-D-RING 1/2 ID SEMI-OPAQUE 100/BX",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"MARKER SCAR SPEE-D-LINE 1MM SEMI-OPAQUE STRETCH 120/BX",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"MARKER SKIN SPOT INSIN SOFT \\T\\ STRETCHY 327CM",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"MARKER,SKIN,PREP-RESISTANT,NON-STERILE",420398,CDM,272,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"MARKER COBRA FIDUCIAL",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"MARKING PEN NS",490852,CDM,270,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"MARKING PEN STERILE",490853,CDM,272,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.95,61.85,,3.96,,,0,"percent of total billed charges","61.5% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"MARKER BIOPSY SITE TITANIUM FOR EVIVA 13CM",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"MARKER BIOPSY SITE TUMARK VISION 18G",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"MARKER NIPPLE 23MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"MARKER SCAR",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"MARKER LUMP",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"MARKER CT GUIDELINE",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"MARKED SPRING WIRE GUIDE",ORSUP0002,CDM,278,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.7% of total billed charges",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.92,33.9,,27.94,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"MARLEX MESH PERFIX PLUG SMALL",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"MARLEX MESH PERFIX PLUG LARGE",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"MARLEX MESH 2 X 4",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"MARLEX MESH 10 X 14",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"MARLEX MESH 1 X 4",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"MARLEX MESH 3 X 6",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"MARQUEE DISPOSABLE CORE BIOPSY KIT 20GA",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,17.304,,49.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.28,61.85,,178.62,,,0,"percent of total billed charges","61.5% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",116.24,32.2,,92.99,,,0,"percent of total billed charges","32.2% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.86,17.136,,49.49,,,0,"percent of total billed charges","17.136% of total billed charges",78.84,21.84,,63.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.7% of total billed charges",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",122.38,33.9,,97.90,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,361,
"MARYLAND FORCEP TIP SINGLE USE",ORSUP0009,CDM,270,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"MARYLAND BIPOLAR FORCEPS",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"MARYLAND JAW LAPAROSCOPIC DEVICE",ORSUP0029,CDM,272,RC,,,OUTPATIENT,,,3708,2410.2,,3263.04,88,,2610.43,,,0,"percent of total billed charges","88% of total billed charges",1854,50,,1483.20,,,0,"percent of total billed charges","50% of total billed charges",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",3708,100,,2966.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",641.63,17.304,,513.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2336.04,63,,1868.83,,,0,"percent of total billed charges","63% of total billed charges",567.32,15.3,,453.86,,,0,"percent of total billed charges","15.3% of total billed charges",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",2558.52,69,,,,,0,"fee schedule","69% of total billed charges",3708,100,,2966.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3708,100,,2966.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3708,100,,2966.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2293.4,61.85,,1834.72,,,0,"percent of total billed charges","61.5% of total billed charges",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",1854,50,,1483.20,,,0,"percent of total billed charges","50% of total billed charges",1193.98,32.2,,955.18,,,0,"percent of total billed charges","32.2% of total billed charges",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",635.4,17.136,,508.32,,,0,"percent of total billed charges","17.136% of total billed charges",809.83,21.84,,647.86,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1397.92,37.7,,1118.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2892.24,78,,2313.79,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3062.81,82.6,,2450.25,,,0,"percent of total billed charges","82.6% of total billed charges",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",1854,50,,1483.20,,,0,"percent of total billed charges","50% of total billed charges",3062.81,82.6,,2450.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",3708,100,,2966.40,,,0,"percent of total billed charges","100% of total billed charges",567.32,3708,
"MAS LIQUID ASSAY URINALYSIS CONTROLS #1",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"MAS LIQUID ASSAY URINALYSIS CONTROLS #3",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"MASIMO HEMOGLOBIN SENSOR",ORSUP0059,CDM,272,RC,,,OUTPATIENT,,,13122,8529.3,,11547.36,88,,9237.89,,,0,"percent of total billed charges","88% of total billed charges",6561,50,,5248.80,,,0,"percent of total billed charges","50% of total billed charges",2204.5,16.8,,1763.60,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2270.63,17.304,,1816.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8266.86,63,,6613.49,,,0,"percent of total billed charges","63% of total billed charges",2007.67,15.3,,1606.14,,,0,"percent of total billed charges","15.3% of total billed charges",2204.5,16.8,,1763.60,,,0,"percent of total billed charges","16.8% of total billed charges",9054.18,69,,,,,0,"fee schedule","69% of total billed charges",13122,100,,10497.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13122,100,,10497.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13122,100,,10497.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8115.96,61.85,,6492.77,,,0,"percent of total billed charges","61.5% of total billed charges",2204.5,16.8,,1763.60,,,0,"percent of total billed charges","16.8% of total billed charges",6561,50,,5248.80,,,0,"percent of total billed charges","50% of total billed charges",4225.28,32.2,,3380.22,,,0,"percent of total billed charges","32.2% of total billed charges",2204.5,16.8,,1763.60,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2248.59,17.136,,1798.87,,,0,"percent of total billed charges","17.136% of total billed charges",2865.84,21.84,,2292.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4946.99,37.7,,3957.59,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10235.16,78,,8188.13,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10838.77,82.6,,8671.02,,,0,"percent of total billed charges","82.6% of total billed charges",2204.5,16.8,,1763.60,,,0,"percent of total billed charges","16.8% of total billed charges",6561,50,,5248.80,,,0,"percent of total billed charges","50% of total billed charges",10838.77,82.6,,8671.02,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2204.5,16.8,,1763.60,,,0,"percent of total billed charges","16.8% of total billed charges",13122,100,,10497.60,,,0,"percent of total billed charges","100% of total billed charges",2007.67,13122,
"MASK FLUID SHIELD",184559,CDM,270,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"MASK ANTI-FOG",308741,CDM,270,RC,,,OUTPATIENT,,,110,71.5,,96.8,88,,77.44,,,0,"percent of total billed charges","88% of total billed charges",55,50,,44.00,,,0,"percent of total billed charges","50% of total billed charges",18.48,16.8,,14.78,,,0,"percent of total billed charges","16.8% of total billed charges",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.03,17.304,,15.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.3,63,,55.44,,,0,"percent of total billed charges","63% of total billed charges",16.83,15.3,,13.46,,,0,"percent of total billed charges","15.3% of total billed charges",18.48,16.8,,14.78,,,0,"percent of total billed charges","16.8% of total billed charges",75.9,69,,,,,0,"fee schedule","69% of total billed charges",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.04,61.85,,54.43,,,0,"percent of total billed charges","61.5% of total billed charges",18.48,16.8,,14.78,,,0,"percent of total billed charges","16.8% of total billed charges",55,50,,44.00,,,0,"percent of total billed charges","50% of total billed charges",35.42,32.2,,28.34,,,0,"percent of total billed charges","32.2% of total billed charges",18.48,16.8,,14.78,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.85,17.136,,15.08,,,0,"percent of total billed charges","17.136% of total billed charges",24.02,21.84,,19.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.47,37.7,,33.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",85.8,78,,68.64,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.86,82.6,,72.69,,,0,"percent of total billed charges","82.6% of total billed charges",18.48,16.8,,14.78,,,0,"percent of total billed charges","16.8% of total billed charges",55,50,,44.00,,,0,"percent of total billed charges","50% of total billed charges",90.86,82.6,,72.69,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.48,16.8,,14.78,,,0,"percent of total billed charges","16.8% of total billed charges",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",16.83,110,
"MASK BILI REG",279859,CDM,270,RC,,,OUTPATIENT,,,30,19.5,,26.4,88,,21.12,,,0,"percent of total billed charges","88% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.19,17.304,,4.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.9,63,,15.12,,,0,"percent of total billed charges","63% of total billed charges",4.59,15.3,,3.67,,,0,"percent of total billed charges","15.3% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",20.7,69,,,,,0,"fee schedule","69% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.56,61.85,,14.85,,,0,"percent of total billed charges","61.5% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",9.66,32.2,,7.73,,,0,"percent of total billed charges","32.2% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.14,17.136,,4.11,,,0,"percent of total billed charges","17.136% of total billed charges",6.55,21.84,,5.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.31,37.7,,9.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.4,78,,18.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",4.59,30,
"MASK CONE BLUE",331613,CDM,270,RC,,,OUTPATIENT,,,57,37.05,,50.16,88,,40.13,,,0,"percent of total billed charges","88% of total billed charges",28.5,50,,22.80,,,0,"percent of total billed charges","50% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.86,17.304,,7.89,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.91,63,,28.73,,,0,"percent of total billed charges","63% of total billed charges",8.72,15.3,,6.98,,,0,"percent of total billed charges","15.3% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",39.33,69,,,,,0,"fee schedule","69% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.25,61.85,,28.20,,,0,"percent of total billed charges","61.5% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",28.5,50,,22.80,,,0,"percent of total billed charges","50% of total billed charges",18.35,32.2,,14.68,,,0,"percent of total billed charges","32.2% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.77,17.136,,7.82,,,0,"percent of total billed charges","17.136% of total billed charges",12.45,21.84,,9.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.49,37.7,,17.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",44.46,78,,35.57,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.08,82.6,,37.66,,,0,"percent of total billed charges","82.6% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",28.5,50,,22.80,,,0,"percent of total billed charges","50% of total billed charges",47.08,82.6,,37.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",8.72,57,
"MASK CRANIAL",ORSUP0023,CDM,270,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"MASK FULL VENTED LARGE",451634,CDM,270,RC,,,OUTPATIENT,,,1765,1147.25,,1553.2,88,,1242.56,,,0,"percent of total billed charges","88% of total billed charges",882.5,50,,706.00,,,0,"percent of total billed charges","50% of total billed charges",296.52,16.8,,237.22,,,0,"percent of total billed charges","16.8% of total billed charges",1765,100,,1412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",305.42,17.304,,244.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1111.95,63,,889.56,,,0,"percent of total billed charges","63% of total billed charges",270.05,15.3,,216.04,,,0,"percent of total billed charges","15.3% of total billed charges",296.52,16.8,,237.22,,,0,"percent of total billed charges","16.8% of total billed charges",1217.85,69,,,,,0,"fee schedule","69% of total billed charges",1765,100,,1412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1765,100,,1412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1765,100,,1412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1091.65,61.85,,873.32,,,0,"percent of total billed charges","61.5% of total billed charges",296.52,16.8,,237.22,,,0,"percent of total billed charges","16.8% of total billed charges",882.5,50,,706.00,,,0,"percent of total billed charges","50% of total billed charges",568.33,32.2,,454.66,,,0,"percent of total billed charges","32.2% of total billed charges",296.52,16.8,,237.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.45,17.136,,241.96,,,0,"percent of total billed charges","17.136% of total billed charges",385.48,21.84,,308.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",665.41,37.7,,532.33,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1376.7,78,,1101.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1457.89,82.6,,1166.31,,,0,"percent of total billed charges","82.6% of total billed charges",296.52,16.8,,237.22,,,0,"percent of total billed charges","16.8% of total billed charges",882.5,50,,706.00,,,0,"percent of total billed charges","50% of total billed charges",1457.89,82.6,,1166.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",296.52,16.8,,237.22,,,0,"percent of total billed charges","16.8% of total billed charges",1765,100,,1412.00,,,0,"percent of total billed charges","100% of total billed charges",270.05,1765,
"MASK FULL VENTED MEDIUM",451635,CDM,270,RC,,,OUTPATIENT,,,1765,1147.25,,1553.2,88,,1242.56,,,0,"percent of total billed charges","88% of total billed charges",882.5,50,,706.00,,,0,"percent of total billed charges","50% of total billed charges",296.52,16.8,,237.22,,,0,"percent of total billed charges","16.8% of total billed charges",1765,100,,1412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",305.42,17.304,,244.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1111.95,63,,889.56,,,0,"percent of total billed charges","63% of total billed charges",270.05,15.3,,216.04,,,0,"percent of total billed charges","15.3% of total billed charges",296.52,16.8,,237.22,,,0,"percent of total billed charges","16.8% of total billed charges",1217.85,69,,,,,0,"fee schedule","69% of total billed charges",1765,100,,1412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1765,100,,1412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1765,100,,1412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1091.65,61.85,,873.32,,,0,"percent of total billed charges","61.5% of total billed charges",296.52,16.8,,237.22,,,0,"percent of total billed charges","16.8% of total billed charges",882.5,50,,706.00,,,0,"percent of total billed charges","50% of total billed charges",568.33,32.2,,454.66,,,0,"percent of total billed charges","32.2% of total billed charges",296.52,16.8,,237.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.45,17.136,,241.96,,,0,"percent of total billed charges","17.136% of total billed charges",385.48,21.84,,308.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",665.41,37.7,,532.33,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1376.7,78,,1101.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1457.89,82.6,,1166.31,,,0,"percent of total billed charges","82.6% of total billed charges",296.52,16.8,,237.22,,,0,"percent of total billed charges","16.8% of total billed charges",882.5,50,,706.00,,,0,"percent of total billed charges","50% of total billed charges",1457.89,82.6,,1166.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",296.52,16.8,,237.22,,,0,"percent of total billed charges","16.8% of total billed charges",1765,100,,1412.00,,,0,"percent of total billed charges","100% of total billed charges",270.05,1765,
"MASK FULL VENTED SMALL",451636,CDM,270,RC,,,OUTPATIENT,,,1765,1147.25,,1553.2,88,,1242.56,,,0,"percent of total billed charges","88% of total billed charges",882.5,50,,706.00,,,0,"percent of total billed charges","50% of total billed charges",296.52,16.8,,237.22,,,0,"percent of total billed charges","16.8% of total billed charges",1765,100,,1412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",305.42,17.304,,244.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1111.95,63,,889.56,,,0,"percent of total billed charges","63% of total billed charges",270.05,15.3,,216.04,,,0,"percent of total billed charges","15.3% of total billed charges",296.52,16.8,,237.22,,,0,"percent of total billed charges","16.8% of total billed charges",1217.85,69,,,,,0,"fee schedule","69% of total billed charges",1765,100,,1412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1765,100,,1412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1765,100,,1412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1091.65,61.85,,873.32,,,0,"percent of total billed charges","61.5% of total billed charges",296.52,16.8,,237.22,,,0,"percent of total billed charges","16.8% of total billed charges",882.5,50,,706.00,,,0,"percent of total billed charges","50% of total billed charges",568.33,32.2,,454.66,,,0,"percent of total billed charges","32.2% of total billed charges",296.52,16.8,,237.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.45,17.136,,241.96,,,0,"percent of total billed charges","17.136% of total billed charges",385.48,21.84,,308.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",665.41,37.7,,532.33,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1376.7,78,,1101.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1457.89,82.6,,1166.31,,,0,"percent of total billed charges","82.6% of total billed charges",296.52,16.8,,237.22,,,0,"percent of total billed charges","16.8% of total billed charges",882.5,50,,706.00,,,0,"percent of total billed charges","50% of total billed charges",1457.89,82.6,,1166.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",296.52,16.8,,237.22,,,0,"percent of total billed charges","16.8% of total billed charges",1765,100,,1412.00,,,0,"percent of total billed charges","100% of total billed charges",270.05,1765,
"MASK ISOLATION",114393,CDM,270,RC,,,OUTPATIENT,,,28,18.2,,24.64,88,,19.71,,,0,"percent of total billed charges","88% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.85,17.304,,3.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.64,63,,14.11,,,0,"percent of total billed charges","63% of total billed charges",4.28,15.3,,3.42,,,0,"percent of total billed charges","15.3% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",19.32,69,,,,,0,"fee schedule","69% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.32,61.85,,13.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",9.02,32.2,,7.22,,,0,"percent of total billed charges","32.2% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.8,17.136,,3.84,,,0,"percent of total billed charges","17.136% of total billed charges",6.12,21.84,,4.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.56,37.7,,8.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.84,78,,17.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",4.28,28,
"MASK OXY02 ADULT TUBE 7 FOOT LATEX FREE",192730,CDM,270,RC,,,OUTPATIENT,,,48,31.2,,42.24,88,,33.79,,,0,"percent of total billed charges","88% of total billed charges",24,50,,19.20,,,0,"percent of total billed charges","50% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.31,17.304,,6.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.24,63,,24.19,,,0,"percent of total billed charges","63% of total billed charges",7.34,15.3,,5.87,,,0,"percent of total billed charges","15.3% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",33.12,69,,,,,0,"fee schedule","69% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.69,61.85,,23.75,,,0,"percent of total billed charges","61.5% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",24,50,,19.20,,,0,"percent of total billed charges","50% of total billed charges",15.46,32.2,,12.37,,,0,"percent of total billed charges","32.2% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.23,17.136,,6.58,,,0,"percent of total billed charges","17.136% of total billed charges",10.48,21.84,,8.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.1,37.7,,14.48,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",37.44,78,,29.95,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.65,82.6,,31.72,,,0,"percent of total billed charges","82.6% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",24,50,,19.20,,,0,"percent of total billed charges","50% of total billed charges",39.65,82.6,,31.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",7.34,48,
"MASK RESP PARTICULATE REG TYPE N95",7775,CDM,270,RC,,,OUTPATIENT,,,87,56.55,,76.56,88,,61.25,,,0,"percent of total billed charges","88% of total billed charges",43.5,50,,34.80,,,0,"percent of total billed charges","50% of total billed charges",14.62,16.8,,11.70,,,0,"percent of total billed charges","16.8% of total billed charges",87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.05,17.304,,12.04,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",54.81,63,,43.85,,,0,"percent of total billed charges","63% of total billed charges",13.31,15.3,,10.65,,,0,"percent of total billed charges","15.3% of total billed charges",14.62,16.8,,11.70,,,0,"percent of total billed charges","16.8% of total billed charges",60.03,69,,,,,0,"fee schedule","69% of total billed charges",87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.81,61.85,,43.05,,,0,"percent of total billed charges","61.5% of total billed charges",14.62,16.8,,11.70,,,0,"percent of total billed charges","16.8% of total billed charges",43.5,50,,34.80,,,0,"percent of total billed charges","50% of total billed charges",28.01,32.2,,22.41,,,0,"percent of total billed charges","32.2% of total billed charges",14.62,16.8,,11.70,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.91,17.136,,11.93,,,0,"percent of total billed charges","17.136% of total billed charges",19,21.84,,15.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",32.8,37.7,,26.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",67.86,78,,54.29,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.86,82.6,,57.49,,,0,"percent of total billed charges","82.6% of total billed charges",14.62,16.8,,11.70,,,0,"percent of total billed charges","16.8% of total billed charges",43.5,50,,34.80,,,0,"percent of total billed charges","50% of total billed charges",71.86,82.6,,57.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.62,16.8,,11.70,,,0,"percent of total billed charges","16.8% of total billed charges",87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",13.31,87,
"MASK RESPIRATOR N95 SMALL",65630,CDM,270,RC,,,OUTPATIENT,,,107,69.55,,94.16,88,,75.33,,,0,"percent of total billed charges","88% of total billed charges",53.5,50,,42.80,,,0,"percent of total billed charges","50% of total billed charges",17.98,16.8,,14.38,,,0,"percent of total billed charges","16.8% of total billed charges",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.52,17.304,,14.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.41,63,,53.93,,,0,"percent of total billed charges","63% of total billed charges",16.37,15.3,,13.10,,,0,"percent of total billed charges","15.3% of total billed charges",17.98,16.8,,14.38,,,0,"percent of total billed charges","16.8% of total billed charges",73.83,69,,,,,0,"fee schedule","69% of total billed charges",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",66.18,61.85,,52.94,,,0,"percent of total billed charges","61.5% of total billed charges",17.98,16.8,,14.38,,,0,"percent of total billed charges","16.8% of total billed charges",53.5,50,,42.80,,,0,"percent of total billed charges","50% of total billed charges",34.45,32.2,,27.56,,,0,"percent of total billed charges","32.2% of total billed charges",17.98,16.8,,14.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.34,17.136,,14.67,,,0,"percent of total billed charges","17.136% of total billed charges",23.37,21.84,,18.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",40.34,37.7,,32.27,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",83.46,78,,66.77,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.38,82.6,,70.70,,,0,"percent of total billed charges","82.6% of total billed charges",17.98,16.8,,14.38,,,0,"percent of total billed charges","16.8% of total billed charges",53.5,50,,42.80,,,0,"percent of total billed charges","50% of total billed charges",88.38,82.6,,70.70,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.98,16.8,,14.38,,,0,"percent of total billed charges","16.8% of total billed charges",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",16.37,107,
"MASK RESPIRATOR TB N-95 PLUS",429496,CDM,270,RC,,,OUTPATIENT,,,125,81.25,,110,88,,88.00,,,0,"percent of total billed charges","88% of total billed charges",62.5,50,,50.00,,,0,"percent of total billed charges","50% of total billed charges",21,16.8,,16.80,,,0,"percent of total billed charges","16.8% of total billed charges",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.63,17.304,,17.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.75,63,,63.00,,,0,"percent of total billed charges","63% of total billed charges",19.13,15.3,,15.30,,,0,"percent of total billed charges","15.3% of total billed charges",21,16.8,,16.80,,,0,"percent of total billed charges","16.8% of total billed charges",86.25,69,,,,,0,"fee schedule","69% of total billed charges",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.31,61.85,,61.85,,,0,"percent of total billed charges","61.5% of total billed charges",21,16.8,,16.80,,,0,"percent of total billed charges","16.8% of total billed charges",62.5,50,,50.00,,,0,"percent of total billed charges","50% of total billed charges",40.25,32.2,,32.20,,,0,"percent of total billed charges","32.2% of total billed charges",21,16.8,,16.80,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.42,17.136,,17.14,,,0,"percent of total billed charges","17.136% of total billed charges",27.3,21.84,,21.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47.13,37.7,,37.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",97.5,78,,78.00,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.25,82.6,,82.60,,,0,"percent of total billed charges","82.6% of total billed charges",21,16.8,,16.80,,,0,"percent of total billed charges","16.8% of total billed charges",62.5,50,,50.00,,,0,"percent of total billed charges","50% of total billed charges",103.25,82.6,,82.60,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,16.8,,16.80,,,0,"percent of total billed charges","16.8% of total billed charges",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",19.13,125,
"MASK SENTRI ADULT ETCO2",430817,CDM,270,RC,,,OUTPATIENT,,,25,16.25,,22,88,,17.60,,,0,"percent of total billed charges","88% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,17.304,,3.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.75,63,,12.60,,,0,"percent of total billed charges","63% of total billed charges",3.83,15.3,,3.06,,,0,"percent of total billed charges","15.3% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",17.25,69,,,,,0,"fee schedule","69% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.46,61.85,,12.37,,,0,"percent of total billed charges","61.5% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",8.05,32.2,,6.44,,,0,"percent of total billed charges","32.2% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.28,17.136,,3.42,,,0,"percent of total billed charges","17.136% of total billed charges",5.46,21.84,,4.37,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.43,37.7,,7.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.5,78,,15.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",3.83,25,
"MASK SURGICAL DUCKBILL BLUE",145390,CDM,270,RC,,,OUTPATIENT,,,42,27.3,,36.96,88,,29.57,,,0,"percent of total billed charges","88% of total billed charges",21,50,,16.80,,,0,"percent of total billed charges","50% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.27,17.304,,5.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.46,63,,21.17,,,0,"percent of total billed charges","63% of total billed charges",6.43,15.3,,5.14,,,0,"percent of total billed charges","15.3% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",28.98,69,,,,,0,"fee schedule","69% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.98,61.85,,20.78,,,0,"percent of total billed charges","61.5% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",21,50,,16.80,,,0,"percent of total billed charges","50% of total billed charges",13.52,32.2,,10.82,,,0,"percent of total billed charges","32.2% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.2,17.136,,5.76,,,0,"percent of total billed charges","17.136% of total billed charges",9.17,21.84,,7.34,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",32.76,78,,26.21,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",21,50,,16.80,,,0,"percent of total billed charges","50% of total billed charges",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",6.43,42,
"MASK SURGICAL HIGH FILTER HYPO-ALLERGENIC WHITE",163796,CDM,270,RC,,,OUTPATIENT,,,52,33.8,,45.76,88,,36.61,,,0,"percent of total billed charges","88% of total billed charges",26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,17.304,,7.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.76,63,,26.21,,,0,"percent of total billed charges","63% of total billed charges",7.96,15.3,,6.37,,,0,"percent of total billed charges","15.3% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",35.88,69,,,,,0,"fee schedule","69% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.16,61.85,,25.73,,,0,"percent of total billed charges","61.5% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",16.74,32.2,,13.39,,,0,"percent of total billed charges","32.2% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.91,17.136,,7.13,,,0,"percent of total billed charges","17.136% of total billed charges",11.36,21.84,,9.09,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.6,37.7,,15.68,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",40.56,78,,32.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",7.96,52,
"MASK SURGICAL TIE-ON",168884,CDM,270,RC,,,OUTPATIENT,,,38,24.7,,33.44,88,,26.75,,,0,"percent of total billed charges","88% of total billed charges",19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.58,17.304,,5.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.94,63,,19.15,,,0,"percent of total billed charges","63% of total billed charges",5.81,15.3,,4.65,,,0,"percent of total billed charges","15.3% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",26.22,69,,,,,0,"fee schedule","69% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.5,61.85,,18.80,,,0,"percent of total billed charges","61.5% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",12.24,32.2,,9.79,,,0,"percent of total billed charges","32.2% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.51,17.136,,5.21,,,0,"percent of total billed charges","17.136% of total billed charges",8.3,21.84,,6.64,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.33,37.7,,11.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.64,78,,23.71,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",5.81,38,
"MASK SURGICAL TIE-ON O.R.",155891,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"MASK W/FACE SHIELD AND EAR LOOPS L/F",48219,CDM,270,RC,,,OUTPATIENT,,,142,92.3,,124.96,88,,99.97,,,0,"percent of total billed charges","88% of total billed charges",71,50,,56.80,,,0,"percent of total billed charges","50% of total billed charges",23.86,16.8,,19.09,,,0,"percent of total billed charges","16.8% of total billed charges",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.57,17.304,,19.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.46,63,,71.57,,,0,"percent of total billed charges","63% of total billed charges",21.73,15.3,,17.38,,,0,"percent of total billed charges","15.3% of total billed charges",23.86,16.8,,19.09,,,0,"percent of total billed charges","16.8% of total billed charges",97.98,69,,,,,0,"fee schedule","69% of total billed charges",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.83,61.85,,70.26,,,0,"percent of total billed charges","61.5% of total billed charges",23.86,16.8,,19.09,,,0,"percent of total billed charges","16.8% of total billed charges",71,50,,56.80,,,0,"percent of total billed charges","50% of total billed charges",45.72,32.2,,36.58,,,0,"percent of total billed charges","32.2% of total billed charges",23.86,16.8,,19.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.33,17.136,,19.46,,,0,"percent of total billed charges","17.136% of total billed charges",31.01,21.84,,24.81,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",53.53,37.7,,42.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",110.76,78,,88.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",117.29,82.6,,93.83,,,0,"percent of total billed charges","82.6% of total billed charges",23.86,16.8,,19.09,,,0,"percent of total billed charges","16.8% of total billed charges",71,50,,56.80,,,0,"percent of total billed charges","50% of total billed charges",117.29,82.6,,93.83,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.86,16.8,,19.09,,,0,"percent of total billed charges","16.8% of total billed charges",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",21.73,142,
"MASK OXYGEN PEDI MED 7FT ELONG",15903,CDM,272,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"MASK NON-REBREATHING W/SAFETY VENT",274295,CDM,272,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"MASK TRACHEOSTOMY ADULT DISP",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"MASK FACE TODDLER   KING SYSTEMS",45801,CDM,272,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"MASK FACE MED ADULT SZ 5",42410,CDM,272,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"MASK ANES CHILD/SM ADULT SIZE 4",104739,CDM,272,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"MASK LARYNGEAL DISP SZ 4 ADLT",268594,CDM,272,RC,,,OUTPATIENT,,,57,37.05,,50.16,88,,40.13,,,0,"percent of total billed charges","88% of total billed charges",28.5,50,,22.80,,,0,"percent of total billed charges","50% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.86,17.304,,7.89,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.91,63,,28.73,,,0,"percent of total billed charges","63% of total billed charges",8.72,15.3,,6.98,,,0,"percent of total billed charges","15.3% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",39.33,69,,,,,0,"fee schedule","69% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.25,61.85,,28.20,,,0,"percent of total billed charges","61.5% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",28.5,50,,22.80,,,0,"percent of total billed charges","50% of total billed charges",18.35,32.2,,14.68,,,0,"percent of total billed charges","32.2% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.77,17.136,,7.82,,,0,"percent of total billed charges","17.136% of total billed charges",12.45,21.84,,9.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.49,37.7,,17.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",44.46,78,,35.57,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.08,82.6,,37.66,,,0,"percent of total billed charges","82.6% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",28.5,50,,22.80,,,0,"percent of total billed charges","50% of total billed charges",47.08,82.6,,37.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",8.72,57,
"MASK LMA UNIQUE SZ 3 STD",223373,CDM,272,RC,,,OUTPATIENT,,,56,36.4,,49.28,88,,39.42,,,0,"percent of total billed charges","88% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.69,17.304,,7.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.28,63,,28.22,,,0,"percent of total billed charges","63% of total billed charges",8.57,15.3,,6.86,,,0,"percent of total billed charges","15.3% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",38.64,69,,,,,0,"fee schedule","69% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.64,61.85,,27.71,,,0,"percent of total billed charges","61.5% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",18.03,32.2,,14.42,,,0,"percent of total billed charges","32.2% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.6,17.136,,7.68,,,0,"percent of total billed charges","17.136% of total billed charges",12.23,21.84,,9.78,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.11,37.7,,16.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.68,78,,34.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",8.57,56,
"MASK LMA UNIQUE SZ 4 STD",223374,CDM,272,RC,,,OUTPATIENT,,,56,36.4,,49.28,88,,39.42,,,0,"percent of total billed charges","88% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.69,17.304,,7.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.28,63,,28.22,,,0,"percent of total billed charges","63% of total billed charges",8.57,15.3,,6.86,,,0,"percent of total billed charges","15.3% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",38.64,69,,,,,0,"fee schedule","69% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.64,61.85,,27.71,,,0,"percent of total billed charges","61.5% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",18.03,32.2,,14.42,,,0,"percent of total billed charges","32.2% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.6,17.136,,7.68,,,0,"percent of total billed charges","17.136% of total billed charges",12.23,21.84,,9.78,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.11,37.7,,16.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.68,78,,34.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",8.57,56,
"MASK LMA UNIQUE SZ 5 STD",223375,CDM,272,RC,,,OUTPATIENT,,,56,36.4,,49.28,88,,39.42,,,0,"percent of total billed charges","88% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.69,17.304,,7.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.28,63,,28.22,,,0,"percent of total billed charges","63% of total billed charges",8.57,15.3,,6.86,,,0,"percent of total billed charges","15.3% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",38.64,69,,,,,0,"fee schedule","69% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.64,61.85,,27.71,,,0,"percent of total billed charges","61.5% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",18.03,32.2,,14.42,,,0,"percent of total billed charges","32.2% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.6,17.136,,7.68,,,0,"percent of total billed charges","17.136% of total billed charges",12.23,21.84,,9.78,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.11,37.7,,16.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.68,78,,34.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",8.57,56,
"MASK OXYGEN ADULT MED 7FT ELONG",100485,CDM,272,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"MASK FACE SURGICAL W/ TIES",490864,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"MASK FACE MOLDED",490863,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"MASK SURGICAL ANTI-FOG",490865,CDM,270,RC,,,OUTPATIENT,,,39,25.35,,34.32,88,,27.46,,,0,"percent of total billed charges","88% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.75,17.304,,5.40,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.57,63,,19.66,,,0,"percent of total billed charges","63% of total billed charges",5.97,15.3,,4.78,,,0,"percent of total billed charges","15.3% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",26.91,69,,,,,0,"fee schedule","69% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.12,61.85,,19.30,,,0,"percent of total billed charges","61.5% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",12.56,32.2,,10.05,,,0,"percent of total billed charges","32.2% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.68,17.136,,5.34,,,0,"percent of total billed charges","17.136% of total billed charges",8.52,21.84,,6.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.42,78,,24.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",5.97,39,
"MASK LARYNGEAL DISP SZ 3 PED/ADLT",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"MASK N95 PARTICULATE 9205+",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"MASK AEROSOL",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"MASK FULL NONVENTED",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"MASK FULL NONVENTED SMALL",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"MASK FULL NONVENTED LARGE",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"MASK ANESTHESIA TOP VALVE CHILD SZ 3",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"MASK ANESTHESIA TOP VALVE CHILD SZ 4",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"MASK AEROSOL ENLONGATED ADULT",ORSUP0001,CDM,278,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.7% of total billed charges",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.2,33.9,,9.76,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"MASK OXYGEN ENLONGATED ADULT",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"MASTISOL APPLICATOR 2/3CC",490867,CDM,272,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
MASTISOL,490866,CDM,270,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"MAT ECP SUCTIONER",ORSUP0009,CDM,270,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"MAT MOBILE AIR TRANSFER 39IN X 81IN",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"MATCH HEAD LONG 3.0 X 16CM",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2266,1472.9,,1994.08,88,,1595.26,,,0,"percent of total billed charges","88% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",392.11,17.304,,313.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1427.58,63,,1142.06,,,0,"percent of total billed charges","63% of total billed charges",346.7,15.3,,277.36,,,0,"percent of total billed charges","15.3% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1563.54,69,,,,,0,"fee schedule","69% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1401.52,61.85,,1121.22,,,0,"percent of total billed charges","61.5% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",729.65,32.2,,583.72,,,0,"percent of total billed charges","32.2% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",388.3,17.136,,310.64,,,0,"percent of total billed charges","17.136% of total billed charges",494.89,21.84,,395.91,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",854.28,37.7,,683.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1767.48,78,,1413.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1871.72,82.6,,1497.38,,,0,"percent of total billed charges","82.6% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",1871.72,82.6,,1497.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",346.7,2266,
"MATERNITY PACKS",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
MATRIX,ORSUP0044,CDM,278,RC,,,OUTPATIENT,,,8837,5744.05,,7776.56,88,,6221.25,,,0,"percent of total billed charges","88% of total billed charges",4418.5,50,,3534.80,,,0,"percent of total billed charges","50% of total billed charges",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1529.15,17.304,,1223.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5567.31,63,,4453.85,,,0,"percent of total billed charges","63% of total billed charges",1352.06,15.3,,1081.65,,,0,"percent of total billed charges","15.3% of total billed charges",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",6097.53,69,,,,,0,"fee schedule","69% of total billed charges",8837,100,,7069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8837,100,,7069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8837,100,,7069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5465.68,61.85,,4372.54,,,0,"percent of total billed charges","61.5% of total billed charges",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",4418.5,50,,3534.80,,,0,"percent of total billed charges","50% of total billed charges",2845.51,32.2,,2276.41,,,0,"percent of total billed charges","32.2% of total billed charges",2757.14,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1514.31,17.136,,1211.45,,,0,"percent of total billed charges","17.136% of total billed charges",1930,21.84,,1544.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3331.55,37.7,,2665.24,,,0,"percent of total billed charges","37.7% of total billed charges",3331.55,37.7,,2665.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2995.74,33.9,,2396.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6892.86,78,,5514.29,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7299.36,82.6,,5839.49,,,0,"percent of total billed charges","82.6% of total billed charges",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",4418.5,50,,3534.80,,,0,"percent of total billed charges","50% of total billed charges",7299.36,82.6,,5839.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",8837,100,,7069.60,,,0,"percent of total billed charges","100% of total billed charges",1352.06,8837,
"MATRIX BONE CELLULAR OSTEOCEL 1CC",ORSUP0022,CDM,278,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",919.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.7% of total billed charges",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",998.69,33.9,,798.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"MATRIX MICRO 200MG",ORSUP0030,CDM,272,RC,,,OUTPATIENT,,,3914,2544.1,,3444.32,88,,2755.46,,,0,"percent of total billed charges","88% of total billed charges",1957,50,,1565.60,,,0,"percent of total billed charges","50% of total billed charges",657.55,16.8,,526.04,,,0,"percent of total billed charges","16.8% of total billed charges",3914,100,,3131.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",677.28,17.304,,541.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2465.82,63,,1972.66,,,0,"percent of total billed charges","63% of total billed charges",598.84,15.3,,479.07,,,0,"percent of total billed charges","15.3% of total billed charges",657.55,16.8,,526.04,,,0,"percent of total billed charges","16.8% of total billed charges",2700.66,69,,,,,0,"fee schedule","69% of total billed charges",3914,100,,3131.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3914,100,,3131.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3914,100,,3131.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2420.81,61.85,,1936.65,,,0,"percent of total billed charges","61.5% of total billed charges",657.55,16.8,,526.04,,,0,"percent of total billed charges","16.8% of total billed charges",1957,50,,1565.60,,,0,"percent of total billed charges","50% of total billed charges",1260.31,32.2,,1008.25,,,0,"percent of total billed charges","32.2% of total billed charges",657.55,16.8,,526.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",670.7,17.136,,536.56,,,0,"percent of total billed charges","17.136% of total billed charges",854.82,21.84,,683.86,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1475.58,37.7,,1180.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3052.92,78,,2442.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3232.96,82.6,,2586.37,,,0,"percent of total billed charges","82.6% of total billed charges",657.55,16.8,,526.04,,,0,"percent of total billed charges","16.8% of total billed charges",1957,50,,1565.60,,,0,"percent of total billed charges","50% of total billed charges",3232.96,82.6,,2586.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",657.55,16.8,,526.04,,,0,"percent of total billed charges","16.8% of total billed charges",3914,100,,3131.20,,,0,"percent of total billed charges","100% of total billed charges",598.84,3914,
"MATRIX CYTAL WOUND 5 X 5CM",ORSUP0036,CDM,278,RC,,,OUTPATIENT,,,5150,3347.5,,4532,88,,3625.60,,,0,"percent of total billed charges","88% of total billed charges",2575,50,,2060.00,,,0,"percent of total billed charges","50% of total billed charges",865.2,16.8,,692.16,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",891.16,17.304,,712.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3244.5,63,,2595.60,,,0,"percent of total billed charges","63% of total billed charges",787.95,15.3,,630.36,,,0,"percent of total billed charges","15.3% of total billed charges",865.2,16.8,,692.16,,,0,"percent of total billed charges","16.8% of total billed charges",3553.5,69,,,,,0,"fee schedule","69% of total billed charges",5150,100,,4120.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5150,100,,4120.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5150,100,,4120.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3185.28,61.85,,2548.22,,,0,"percent of total billed charges","61.5% of total billed charges",865.2,16.8,,692.16,,,0,"percent of total billed charges","16.8% of total billed charges",2575,50,,2060.00,,,0,"percent of total billed charges","50% of total billed charges",1658.3,32.2,,1326.64,,,0,"percent of total billed charges","32.2% of total billed charges",1606.8,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",882.5,17.136,,706.00,,,0,"percent of total billed charges","17.136% of total billed charges",1124.76,21.84,,899.81,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1941.55,37.7,,1553.24,,,0,"percent of total billed charges","37.7% of total billed charges",1941.55,37.7,,1553.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1745.85,33.9,,1396.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,78,,3213.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4253.9,82.6,,3403.12,,,0,"percent of total billed charges","82.6% of total billed charges",865.2,16.8,,692.16,,,0,"percent of total billed charges","16.8% of total billed charges",2575,50,,2060.00,,,0,"percent of total billed charges","50% of total billed charges",4253.9,82.6,,3403.12,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",865.2,16.8,,692.16,,,0,"percent of total billed charges","16.8% of total billed charges",5150,100,,4120.00,,,0,"percent of total billed charges","100% of total billed charges",787.95,5150,
"MATTING DYCEM NON-SLIP",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"MAXTRIX BONE CELLULAR 10CC",ORSUP0089,CDM,278,RC,,,OUTPATIENT,,,21156,13751.4,,18617.28,88,,14893.82,,,0,"percent of total billed charges","88% of total billed charges",10578,50,,8462.40,,,0,"percent of total billed charges","50% of total billed charges",3554.21,16.8,,2843.37,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3660.83,17.304,,2928.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13328.28,63,,10662.62,,,0,"percent of total billed charges","63% of total billed charges",3236.87,15.3,,2589.50,,,0,"percent of total billed charges","15.3% of total billed charges",3554.21,16.8,,2843.37,,,0,"percent of total billed charges","16.8% of total billed charges",14597.64,69,,,,,0,"fee schedule","69% of total billed charges",21156,100,,16924.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21156,100,,16924.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21156,100,,16924.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13084.99,61.85,,10467.99,,,0,"percent of total billed charges","61.5% of total billed charges",3554.21,16.8,,2843.37,,,0,"percent of total billed charges","16.8% of total billed charges",10578,50,,8462.40,,,0,"percent of total billed charges","50% of total billed charges",6812.23,32.2,,5449.78,,,0,"percent of total billed charges","32.2% of total billed charges",6600.67,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3625.29,17.136,,2900.23,,,0,"percent of total billed charges","17.136% of total billed charges",4620.47,21.84,,3696.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",7975.81,37.7,,6380.65,,,0,"percent of total billed charges","37.7% of total billed charges",7975.81,37.7,,6380.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",7171.88,33.9,,5737.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",16501.68,78,,13201.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17474.86,82.6,,13979.89,,,0,"percent of total billed charges","82.6% of total billed charges",3554.21,16.8,,2843.37,,,0,"percent of total billed charges","16.8% of total billed charges",10578,50,,8462.40,,,0,"percent of total billed charges","50% of total billed charges",17474.86,82.6,,13979.89,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3554.21,16.8,,2843.37,,,0,"percent of total billed charges","16.8% of total billed charges",21156,100,,16924.80,,,0,"percent of total billed charges","100% of total billed charges",3236.87,21156,
"MCGRATH MAC BLADE SIZE 2",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"MCGRATH MAC BLADE SIZE 3",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"MCGRATH MAC BLADE SIZE 4",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"MDI INLINE ADAPTER 22MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"MDI INLINE ADAPTER 22MM OD/15MM ID",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"MEASUREMENT CART RAPIDPOINT 500",ORSUP0028,CDM,272,RC,,,OUTPATIENT,,,4553,2959.45,,4006.64,88,,3205.31,,,0,"percent of total billed charges","88% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",787.85,17.304,,630.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2868.39,63,,2294.71,,,0,"percent of total billed charges","63% of total billed charges",696.61,15.3,,557.29,,,0,"percent of total billed charges","15.3% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",3141.57,69,,,,,0,"fee schedule","69% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2816.03,61.85,,2252.82,,,0,"percent of total billed charges","61.5% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",1466.07,32.2,,1172.86,,,0,"percent of total billed charges","32.2% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",780.2,17.136,,624.16,,,0,"percent of total billed charges","17.136% of total billed charges",994.38,21.84,,795.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3551.34,78,,2841.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",696.61,4553,
"MEDIA PLATE SENSITIVITY MUELLER HINTON AGAR 150 X 15MM",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"MEDIA ILLUMIGENE C DIFF CTL",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"MEDIPORE TAPE 3",490869,CDM,270,RC,,,OUTPATIENT,,,89,57.85,,78.32,88,,62.66,,,0,"percent of total billed charges","88% of total billed charges",44.5,50,,35.60,,,0,"percent of total billed charges","50% of total billed charges",14.95,16.8,,11.96,,,0,"percent of total billed charges","16.8% of total billed charges",89,100,,71.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.4,17.304,,12.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.07,63,,44.86,,,0,"percent of total billed charges","63% of total billed charges",13.62,15.3,,10.90,,,0,"percent of total billed charges","15.3% of total billed charges",14.95,16.8,,11.96,,,0,"percent of total billed charges","16.8% of total billed charges",61.41,69,,,,,0,"fee schedule","69% of total billed charges",89,100,,71.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89,100,,71.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89,100,,71.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",55.05,61.85,,44.04,,,0,"percent of total billed charges","61.5% of total billed charges",14.95,16.8,,11.96,,,0,"percent of total billed charges","16.8% of total billed charges",44.5,50,,35.60,,,0,"percent of total billed charges","50% of total billed charges",28.66,32.2,,22.93,,,0,"percent of total billed charges","32.2% of total billed charges",14.95,16.8,,11.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.25,17.136,,12.20,,,0,"percent of total billed charges","17.136% of total billed charges",19.44,21.84,,15.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",33.55,37.7,,26.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",69.42,78,,55.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",73.51,82.6,,58.81,,,0,"percent of total billed charges","82.6% of total billed charges",14.95,16.8,,11.96,,,0,"percent of total billed charges","16.8% of total billed charges",44.5,50,,35.60,,,0,"percent of total billed charges","50% of total billed charges",73.51,82.6,,58.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.95,16.8,,11.96,,,0,"percent of total billed charges","16.8% of total billed charges",89,100,,71.20,,,0,"percent of total billed charges","100% of total billed charges",13.62,89,
"MEDIA PLATE SENSITIVITY MUELLER HINTON AGAR W/5% SHEEP BLD 1",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"MEDIGRIP E",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"MEDIGRIP F",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"MEDIGRIP G",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"MEDIUM LARGE CLIP APPLIER",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"MEDTOX PAPER",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"MEGATIP L-WIRE DISP 0620M",490872,CDM,272,RC,,,OUTPATIENT,,,128,83.2,,112.64,88,,90.11,,,0,"percent of total billed charges","88% of total billed charges",64,50,,51.20,,,0,"percent of total billed charges","50% of total billed charges",21.5,16.8,,17.20,,,0,"percent of total billed charges","16.8% of total billed charges",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.15,17.304,,17.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.64,63,,64.51,,,0,"percent of total billed charges","63% of total billed charges",19.58,15.3,,15.66,,,0,"percent of total billed charges","15.3% of total billed charges",21.5,16.8,,17.20,,,0,"percent of total billed charges","16.8% of total billed charges",88.32,69,,,,,0,"fee schedule","69% of total billed charges",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.17,61.85,,63.34,,,0,"percent of total billed charges","61.5% of total billed charges",21.5,16.8,,17.20,,,0,"percent of total billed charges","16.8% of total billed charges",64,50,,51.20,,,0,"percent of total billed charges","50% of total billed charges",41.22,32.2,,32.98,,,0,"percent of total billed charges","32.2% of total billed charges",21.5,16.8,,17.20,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.93,17.136,,17.54,,,0,"percent of total billed charges","17.136% of total billed charges",27.96,21.84,,22.37,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",48.26,37.7,,38.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",99.84,78,,79.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.73,82.6,,84.58,,,0,"percent of total billed charges","82.6% of total billed charges",21.5,16.8,,17.20,,,0,"percent of total billed charges","16.8% of total billed charges",64,50,,51.20,,,0,"percent of total billed charges","50% of total billed charges",105.73,82.6,,84.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.5,16.8,,17.20,,,0,"percent of total billed charges","16.8% of total billed charges",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",19.58,128,
"MEGATIP CURVED BLADE DISP 0619",490871,CDM,272,RC,,,OUTPATIENT,,,128,83.2,,112.64,88,,90.11,,,0,"percent of total billed charges","88% of total billed charges",64,50,,51.20,,,0,"percent of total billed charges","50% of total billed charges",21.5,16.8,,17.20,,,0,"percent of total billed charges","16.8% of total billed charges",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.15,17.304,,17.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.64,63,,64.51,,,0,"percent of total billed charges","63% of total billed charges",19.58,15.3,,15.66,,,0,"percent of total billed charges","15.3% of total billed charges",21.5,16.8,,17.20,,,0,"percent of total billed charges","16.8% of total billed charges",88.32,69,,,,,0,"fee schedule","69% of total billed charges",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.17,61.85,,63.34,,,0,"percent of total billed charges","61.5% of total billed charges",21.5,16.8,,17.20,,,0,"percent of total billed charges","16.8% of total billed charges",64,50,,51.20,,,0,"percent of total billed charges","50% of total billed charges",41.22,32.2,,32.98,,,0,"percent of total billed charges","32.2% of total billed charges",21.5,16.8,,17.20,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.93,17.136,,17.54,,,0,"percent of total billed charges","17.136% of total billed charges",27.96,21.84,,22.37,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",48.26,37.7,,38.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",99.84,78,,79.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.73,82.6,,84.58,,,0,"percent of total billed charges","82.6% of total billed charges",21.5,16.8,,17.20,,,0,"percent of total billed charges","16.8% of total billed charges",64,50,,51.20,,,0,"percent of total billed charges","50% of total billed charges",105.73,82.6,,84.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.5,16.8,,17.20,,,0,"percent of total billed charges","16.8% of total billed charges",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",19.58,128,
"MEGA SUTURE CUT NEEDLE DRIVER",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"MEGA NEEDLE DRIVER",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"MEMBRANING KIT FOR TC SENSORS",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"MEMBRANE RESTORE 1X1CM",ORSUP0020,CDM,270,RC,,,OUTPATIENT,,,1854,1205.1,,1631.52,88,,1305.22,,,0,"percent of total billed charges","88% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",320.82,17.304,,256.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1168.02,63,,934.42,,,0,"percent of total billed charges","63% of total billed charges",283.66,15.3,,226.93,,,0,"percent of total billed charges","15.3% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1279.26,69,,,,,0,"fee schedule","69% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1146.7,61.85,,917.36,,,0,"percent of total billed charges","61.5% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",596.99,32.2,,477.59,,,0,"percent of total billed charges","32.2% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.7,17.136,,254.16,,,0,"percent of total billed charges","17.136% of total billed charges",404.91,21.84,,323.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",698.96,37.7,,559.17,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1446.12,78,,1156.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1531.4,82.6,,1225.12,,,0,"percent of total billed charges","82.6% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",1531.4,82.6,,1225.12,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",283.66,1854,
"MEMBRANE RESTORE 2X2CM",ORSUP0020,CDM,270,RC,,,OUTPATIENT,,,6798,4418.7,,5982.24,88,,4785.79,,,0,"percent of total billed charges","88% of total billed charges",3399,50,,2719.20,,,0,"percent of total billed charges","50% of total billed charges",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1176.33,17.304,,941.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4282.74,63,,3426.19,,,0,"percent of total billed charges","63% of total billed charges",1040.09,15.3,,832.07,,,0,"percent of total billed charges","15.3% of total billed charges",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",4690.62,69,,,,,0,"fee schedule","69% of total billed charges",6798,100,,5438.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6798,100,,5438.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6798,100,,5438.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4204.56,61.85,,3363.65,,,0,"percent of total billed charges","61.5% of total billed charges",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",3399,50,,2719.20,,,0,"percent of total billed charges","50% of total billed charges",2188.96,32.2,,1751.17,,,0,"percent of total billed charges","32.2% of total billed charges",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1164.91,17.136,,931.93,,,0,"percent of total billed charges","17.136% of total billed charges",1484.68,21.84,,1187.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2562.85,37.7,,2050.28,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5302.44,78,,4241.95,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5615.15,82.6,,4492.12,,,0,"percent of total billed charges","82.6% of total billed charges",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",3399,50,,2719.20,,,0,"percent of total billed charges","50% of total billed charges",5615.15,82.6,,4492.12,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",6798,100,,5438.40,,,0,"percent of total billed charges","100% of total billed charges",1040.09,6798,
"MEMBRANE RESTORE 2X3CM",ORSUP0020,CDM,270,RC,,,OUTPATIENT,,,10094,6561.1,,8882.72,88,,7106.18,,,0,"percent of total billed charges","88% of total billed charges",5047,50,,4037.60,,,0,"percent of total billed charges","50% of total billed charges",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1746.67,17.304,,1397.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6359.22,63,,5087.38,,,0,"percent of total billed charges","63% of total billed charges",1544.38,15.3,,1235.50,,,0,"percent of total billed charges","15.3% of total billed charges",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",6964.86,69,,,,,0,"fee schedule","69% of total billed charges",10094,100,,8075.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10094,100,,8075.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10094,100,,8075.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6243.14,61.85,,4994.51,,,0,"percent of total billed charges","61.5% of total billed charges",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",5047,50,,4037.60,,,0,"percent of total billed charges","50% of total billed charges",3250.27,32.2,,2600.22,,,0,"percent of total billed charges","32.2% of total billed charges",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1729.71,17.136,,1383.77,,,0,"percent of total billed charges","17.136% of total billed charges",2204.53,21.84,,1763.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3805.44,37.7,,3044.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7873.32,78,,6298.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8337.64,82.6,,6670.11,,,0,"percent of total billed charges","82.6% of total billed charges",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",5047,50,,4037.60,,,0,"percent of total billed charges","50% of total billed charges",8337.64,82.6,,6670.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",10094,100,,8075.20,,,0,"percent of total billed charges","100% of total billed charges",1544.38,10094,
"MERCEDES 4.0MM LIPO CANNNULA",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,17.304,,49.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.28,61.85,,178.62,,,0,"percent of total billed charges","61.5% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",116.24,32.2,,92.99,,,0,"percent of total billed charges","32.2% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.86,17.136,,49.49,,,0,"percent of total billed charges","17.136% of total billed charges",78.84,21.84,,63.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,361,
"MERIDIAN PTFE/NITINOL GUIDE WIRE HYDROPHILIC TIP 0.035IN X 1",ORSUP0004,CDM,278,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.7% of total billed charges",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.83,33.9,,55.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"MERSILENE 4-0 FS-2 (R633H)",490873,CDM,270,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"MERSILENE 5 BP (RS20)",490874,CDM,270,RC,,,OUTPATIENT,,,304,197.6,,267.52,88,,214.02,,,0,"percent of total billed charges","88% of total billed charges",152,50,,121.60,,,0,"percent of total billed charges","50% of total billed charges",51.07,16.8,,40.86,,,0,"percent of total billed charges","16.8% of total billed charges",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.6,17.304,,42.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.52,63,,153.22,,,0,"percent of total billed charges","63% of total billed charges",46.51,15.3,,37.21,,,0,"percent of total billed charges","15.3% of total billed charges",51.07,16.8,,40.86,,,0,"percent of total billed charges","16.8% of total billed charges",209.76,69,,,,,0,"fee schedule","69% of total billed charges",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",188.02,61.85,,150.42,,,0,"percent of total billed charges","61.5% of total billed charges",51.07,16.8,,40.86,,,0,"percent of total billed charges","16.8% of total billed charges",152,50,,121.60,,,0,"percent of total billed charges","50% of total billed charges",97.89,32.2,,78.31,,,0,"percent of total billed charges","32.2% of total billed charges",51.07,16.8,,40.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.09,17.136,,41.67,,,0,"percent of total billed charges","17.136% of total billed charges",66.39,21.84,,53.11,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",114.61,37.7,,91.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",237.12,78,,189.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",251.1,82.6,,200.88,,,0,"percent of total billed charges","82.6% of total billed charges",51.07,16.8,,40.86,,,0,"percent of total billed charges","16.8% of total billed charges",152,50,,121.60,,,0,"percent of total billed charges","50% of total billed charges",251.1,82.6,,200.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.07,16.8,,40.86,,,0,"percent of total billed charges","16.8% of total billed charges",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",46.51,304,
"MESH VICRYL WOVEN 12 X 12",ORSUP0038,CDM,278,RC,,,OUTPATIENT,,,7231,4700.15,,6363.28,88,,5090.62,,,0,"percent of total billed charges","88% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1251.25,17.304,,1001.00,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4555.53,63,,3644.42,,,0,"percent of total billed charges","63% of total billed charges",1106.34,15.3,,885.07,,,0,"percent of total billed charges","15.3% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4989.39,69,,,,,0,"fee schedule","69% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4472.37,61.85,,3577.90,,,0,"percent of total billed charges","61.5% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",2328.38,32.2,,1862.70,,,0,"percent of total billed charges","32.2% of total billed charges",2256.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1239.1,17.136,,991.28,,,0,"percent of total billed charges","17.136% of total billed charges",1579.25,21.84,,1263.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.7% of total billed charges",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2451.31,33.9,,1961.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5640.18,78,,4512.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",1106.34,7231,
"MESH VENTRIO LRG OVAL",ORSUP0032,CDM,278,RC,,,OUTPATIENT,,,5624,3655.6,,4949.12,88,,3959.30,,,0,"percent of total billed charges","88% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",973.18,17.304,,778.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3543.12,63,,2834.50,,,0,"percent of total billed charges","63% of total billed charges",860.47,15.3,,688.38,,,0,"percent of total billed charges","15.3% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",3880.56,69,,,,,0,"fee schedule","69% of total billed charges",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3478.44,61.85,,2782.75,,,0,"percent of total billed charges","61.5% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",1810.93,32.2,,1448.74,,,0,"percent of total billed charges","32.2% of total billed charges",1754.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",963.73,17.136,,770.98,,,0,"percent of total billed charges","17.136% of total billed charges",1228.28,21.84,,982.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2120.25,37.7,,1696.20,,,0,"percent of total billed charges","37.7% of total billed charges",2120.25,37.7,,1696.20,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1906.54,33.9,,1525.23,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4386.72,78,,3509.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4645.42,82.6,,3716.34,,,0,"percent of total billed charges","82.6% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",4645.42,82.6,,3716.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",860.47,5624,
"MESH PROGRIP LAPAROSCOPIC SELF-FIXATING  5.9 X 3.9",ORSUP0040,CDM,278,RC,,,OUTPATIENT,,,3708,2410.2,,3263.04,88,,2610.43,,,0,"percent of total billed charges","88% of total billed charges",1854,50,,1483.20,,,0,"percent of total billed charges","50% of total billed charges",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",3708,100,,2966.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",641.63,17.304,,513.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2336.04,63,,1868.83,,,0,"percent of total billed charges","63% of total billed charges",567.32,15.3,,453.86,,,0,"percent of total billed charges","15.3% of total billed charges",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",2558.52,69,,,,,0,"fee schedule","69% of total billed charges",3708,100,,2966.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3708,100,,2966.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3708,100,,2966.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2293.4,61.85,,1834.72,,,0,"percent of total billed charges","61.5% of total billed charges",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",1854,50,,1483.20,,,0,"percent of total billed charges","50% of total billed charges",1193.98,32.2,,955.18,,,0,"percent of total billed charges","32.2% of total billed charges",1156.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",635.4,17.136,,508.32,,,0,"percent of total billed charges","17.136% of total billed charges",809.83,21.84,,647.86,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1397.92,37.7,,1118.34,,,0,"percent of total billed charges","37.7% of total billed charges",1397.92,37.7,,1118.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1257.01,33.9,,1005.61,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2892.24,78,,2313.79,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3062.81,82.6,,2450.25,,,0,"percent of total billed charges","82.6% of total billed charges",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",1854,50,,1483.20,,,0,"percent of total billed charges","50% of total billed charges",3062.81,82.6,,2450.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",3708,100,,2966.40,,,0,"percent of total billed charges","100% of total billed charges",567.32,3708,
"MESH SURG PARIETX PROGRIP 15X10CM LAPSCP",ORSUP0026,CDM,278,RC,,,OUTPATIENT,,,3090,2008.5,,2719.2,88,,2175.36,,,0,"percent of total billed charges","88% of total billed charges",1545,50,,1236.00,,,0,"percent of total billed charges","50% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",534.69,17.304,,427.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1946.7,63,,1557.36,,,0,"percent of total billed charges","63% of total billed charges",472.77,15.3,,378.22,,,0,"percent of total billed charges","15.3% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",2132.1,69,,,,,0,"fee schedule","69% of total billed charges",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1911.17,61.85,,1528.94,,,0,"percent of total billed charges","61.5% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",1545,50,,1236.00,,,0,"percent of total billed charges","50% of total billed charges",994.98,32.2,,795.98,,,0,"percent of total billed charges","32.2% of total billed charges",964.08,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",529.5,17.136,,423.60,,,0,"percent of total billed charges","17.136% of total billed charges",674.86,21.84,,539.89,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1164.93,37.7,,931.94,,,0,"percent of total billed charges","37.7% of total billed charges",1164.93,37.7,,931.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1047.51,33.9,,838.01,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410.2,78,,1928.16,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2552.34,82.6,,2041.87,,,0,"percent of total billed charges","82.6% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",1545,50,,1236.00,,,0,"percent of total billed charges","50% of total billed charges",2552.34,82.6,,2041.87,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",472.77,3090,
"MESH TEM3015G",ORSUP0024,CDM,278,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",1086.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.7% of total billed charges",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1180.06,33.9,,944.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"MESH MARLEX FLAT SHEET 10 X 14 STRL",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"MESH VENTRIO MED OVAL",ORSUP0027,CDM,278,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",1336.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.7% of total billed charges",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1452.62,33.9,,1162.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"MESH VENTRIO SM OVAL",ORSUP0022,CDM,278,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",919.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.7% of total billed charges",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",998.69,33.9,,798.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"MESH HERNIA BARD 3D MAX  RIGHT MEDIUM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"MESH ATRIUM KEYHOLE      1010306 02",ORSUP0002,CDM,278,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.7% of total billed charges",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.43,33.9,,36.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"MESH SURG VENTRALIGHT ST 6 IN HERNIA 4 CONN LOPRO LTWT MFL S",ORSUP0046,CDM,278,RC,,,OUTPATIENT,,,7210,4686.5,,6344.8,88,,5075.84,,,0,"percent of total billed charges","88% of total billed charges",3605,50,,2884.00,,,0,"percent of total billed charges","50% of total billed charges",1211.28,16.8,,969.02,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1247.62,17.304,,998.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4542.3,63,,3633.84,,,0,"percent of total billed charges","63% of total billed charges",1103.13,15.3,,882.50,,,0,"percent of total billed charges","15.3% of total billed charges",1211.28,16.8,,969.02,,,0,"percent of total billed charges","16.8% of total billed charges",4974.9,69,,,,,0,"fee schedule","69% of total billed charges",7210,100,,5768.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7210,100,,5768.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7210,100,,5768.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4459.39,61.85,,3567.51,,,0,"percent of total billed charges","61.5% of total billed charges",1211.28,16.8,,969.02,,,0,"percent of total billed charges","16.8% of total billed charges",3605,50,,2884.00,,,0,"percent of total billed charges","50% of total billed charges",2321.62,32.2,,1857.30,,,0,"percent of total billed charges","32.2% of total billed charges",2249.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1235.51,17.136,,988.41,,,0,"percent of total billed charges","17.136% of total billed charges",1574.66,21.84,,1259.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2718.17,37.7,,2174.54,,,0,"percent of total billed charges","37.7% of total billed charges",2718.17,37.7,,2174.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2444.19,33.9,,1955.35,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5623.8,78,,4499.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5955.46,82.6,,4764.37,,,0,"percent of total billed charges","82.6% of total billed charges",1211.28,16.8,,969.02,,,0,"percent of total billed charges","16.8% of total billed charges",3605,50,,2884.00,,,0,"percent of total billed charges","50% of total billed charges",5955.46,82.6,,4764.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1211.28,16.8,,969.02,,,0,"percent of total billed charges","16.8% of total billed charges",7210,100,,5768.00,,,0,"percent of total billed charges","100% of total billed charges",1103.13,7210,
"MESH TITANIUM 3D  80MMX80MM 6MM 1.5MM SYS CP TITANIUM",ORSUP0034,CDM,278,RC,,,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1065.75,17.304,,852.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",942.33,15.3,,753.86,,,0,"percent of total billed charges","15.3% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3809.34,61.85,,3047.47,,,0,"percent of total billed charges","61.5% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1983.2,32.2,,1586.56,,,0,"percent of total billed charges","32.2% of total billed charges",1921.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1055.41,17.136,,844.33,,,0,"percent of total billed charges","17.136% of total billed charges",1345.13,21.84,,1076.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",942.33,6159,
"MESH VENTRALIGHT 10INX13IN ELLIPSE",ORSUP0075,CDM,278,RC,,,OUTPATIENT,,,17407,11314.55,,15318.16,88,,12254.53,,,0,"percent of total billed charges","88% of total billed charges",8703.5,50,,6962.80,,,0,"percent of total billed charges","50% of total billed charges",2924.38,16.8,,2339.50,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3012.11,17.304,,2409.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10966.41,63,,8773.13,,,0,"percent of total billed charges","63% of total billed charges",2663.27,15.3,,2130.62,,,0,"percent of total billed charges","15.3% of total billed charges",2924.38,16.8,,2339.50,,,0,"percent of total billed charges","16.8% of total billed charges",12010.83,69,,,,,0,"fee schedule","69% of total billed charges",17407,100,,13925.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17407,100,,13925.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17407,100,,13925.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10766.23,61.85,,8612.98,,,0,"percent of total billed charges","61.5% of total billed charges",2924.38,16.8,,2339.50,,,0,"percent of total billed charges","16.8% of total billed charges",8703.5,50,,6962.80,,,0,"percent of total billed charges","50% of total billed charges",5605.05,32.2,,4484.04,,,0,"percent of total billed charges","32.2% of total billed charges",5430.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2982.86,17.136,,2386.29,,,0,"percent of total billed charges","17.136% of total billed charges",3801.69,21.84,,3041.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",6562.44,37.7,,5249.95,,,0,"percent of total billed charges","37.7% of total billed charges",6562.44,37.7,,5249.95,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",5900.97,33.9,,4720.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",13577.46,78,,10861.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14378.18,82.6,,11502.54,,,0,"percent of total billed charges","82.6% of total billed charges",2924.38,16.8,,2339.50,,,0,"percent of total billed charges","16.8% of total billed charges",8703.5,50,,6962.80,,,0,"percent of total billed charges","50% of total billed charges",14378.18,82.6,,11502.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2924.38,16.8,,2339.50,,,0,"percent of total billed charges","16.8% of total billed charges",17407,100,,13925.60,,,0,"percent of total billed charges","100% of total billed charges",2663.27,17407,
"MESH VENTRALIGHT ST 4.5IN HRN 2 CONN LOPRO LTWT MFL",ORSUP0033,CDM,278,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",1838.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.7% of total billed charges",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1997.39,33.9,,1597.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"MESH VENTRALIGHT W/ ECHO 6 X 10",ORSUP0051,CDM,278,RC,,,OUTPATIENT,,,10712,6962.8,,9426.56,88,,7541.25,,,0,"percent of total billed charges","88% of total billed charges",5356,50,,4284.80,,,0,"percent of total billed charges","50% of total billed charges",1799.62,16.8,,1439.70,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1853.6,17.304,,1482.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6748.56,63,,5398.85,,,0,"percent of total billed charges","63% of total billed charges",1638.94,15.3,,1311.15,,,0,"percent of total billed charges","15.3% of total billed charges",1799.62,16.8,,1439.70,,,0,"percent of total billed charges","16.8% of total billed charges",7391.28,69,,,,,0,"fee schedule","69% of total billed charges",10712,100,,8569.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10712,100,,8569.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10712,100,,8569.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6625.37,61.85,,5300.30,,,0,"percent of total billed charges","61.5% of total billed charges",1799.62,16.8,,1439.70,,,0,"percent of total billed charges","16.8% of total billed charges",5356,50,,4284.80,,,0,"percent of total billed charges","50% of total billed charges",3449.26,32.2,,2759.41,,,0,"percent of total billed charges","32.2% of total billed charges",3342.14,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1835.61,17.136,,1468.49,,,0,"percent of total billed charges","17.136% of total billed charges",2339.5,21.84,,1871.60,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4038.42,37.7,,3230.74,,,0,"percent of total billed charges","37.7% of total billed charges",4038.42,37.7,,3230.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3631.37,33.9,,2905.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",8355.36,78,,6684.29,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8848.11,82.6,,7078.49,,,0,"percent of total billed charges","82.6% of total billed charges",1799.62,16.8,,1439.70,,,0,"percent of total billed charges","16.8% of total billed charges",5356,50,,4284.80,,,0,"percent of total billed charges","50% of total billed charges",8848.11,82.6,,7078.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1799.62,16.8,,1439.70,,,0,"percent of total billed charges","16.8% of total billed charges",10712,100,,8569.60,,,0,"percent of total billed charges","100% of total billed charges",1638.94,10712,
"MESH PANITES",437611,CDM,272,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"MESH VENTRALIGHT ST 4.5IN CIRCL",ORSUP0031,CDM,278,RC,,,OUTPATIENT,,,5356,3481.4,,4713.28,88,,3770.62,,,0,"percent of total billed charges","88% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",926.8,17.304,,741.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3374.28,63,,2699.42,,,0,"percent of total billed charges","63% of total billed charges",819.47,15.3,,655.58,,,0,"percent of total billed charges","15.3% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",3695.64,69,,,,,0,"fee schedule","69% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3312.69,61.85,,2650.15,,,0,"percent of total billed charges","61.5% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",1724.63,32.2,,1379.70,,,0,"percent of total billed charges","32.2% of total billed charges",1671.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",917.8,17.136,,734.24,,,0,"percent of total billed charges","17.136% of total billed charges",1169.75,21.84,,935.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.7% of total billed charges",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1815.68,33.9,,1452.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4177.68,78,,3342.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",819.47,5356,
"MESH SURGISIS 13 X 22",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"MESH COMPOSITE PARIETEX 9CM RD",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"MESH OVAL PATCH SMALL",ORSUP0025,CDM,278,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",1169.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.7% of total billed charges",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.91,33.9,,1016.73,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"MESH OVAL 6X8 PROCEED",ORSUP0033,CDM,278,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",1838.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.7% of total billed charges",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1997.39,33.9,,1597.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"MESH OVAL MEDIUM VENTRIO",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"MESH OVAL 4X6 PROCEED",ORSUP0023,CDM,278,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",1002.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.7% of total billed charges",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1089.55,33.9,,871.64,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"MESH MK PATCH 4IN MED CIRCLE",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"MESH MK PATCH 3IN SM CIRCLE",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"MESH OVAL PATCH LRG",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"MESH DUAL 15 X 19 X 1",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"MESH DUAL 7.5 X 10.0",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"MESH DUAL 7.5 X 10.5 X 1.0",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"MESH CIRCLE LARGE HERNIA PATCH",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"MESH COMPOSITE PARIETEX 12CM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"MESH COMPOSEX EX 7 X 9",ORSUP0040,CDM,278,RC,,,OUTPATIENT,,,7766,5047.9,,6834.08,88,,5467.26,,,0,"percent of total billed charges","88% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1343.83,17.304,,1075.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4892.58,63,,3914.06,,,0,"percent of total billed charges","63% of total billed charges",1188.2,15.3,,950.56,,,0,"percent of total billed charges","15.3% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",5358.54,69,,,,,0,"fee schedule","69% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4803.27,61.85,,3842.62,,,0,"percent of total billed charges","61.5% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",2500.65,32.2,,2000.52,,,0,"percent of total billed charges","32.2% of total billed charges",2422.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1330.78,17.136,,1064.62,,,0,"percent of total billed charges","17.136% of total billed charges",1696.09,21.84,,1356.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2927.78,37.7,,2342.22,,,0,"percent of total billed charges","37.7% of total billed charges",2927.78,37.7,,2342.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2632.67,33.9,,2106.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6057.48,78,,4845.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",1188.2,7766,
"MESH COMPOSEX EX 6 X 8",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"MESH CIRCLE SMALL HERNIA REP",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"MESH ALYTE Y",ORSUP0032,CDM,278,RC,,,OUTPATIENT,,,5624,3655.6,,4949.12,88,,3959.30,,,0,"percent of total billed charges","88% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",973.18,17.304,,778.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3543.12,63,,2834.50,,,0,"percent of total billed charges","63% of total billed charges",860.47,15.3,,688.38,,,0,"percent of total billed charges","15.3% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",3880.56,69,,,,,0,"fee schedule","69% of total billed charges",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3478.44,61.85,,2782.75,,,0,"percent of total billed charges","61.5% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",1810.93,32.2,,1448.74,,,0,"percent of total billed charges","32.2% of total billed charges",1754.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",963.73,17.136,,770.98,,,0,"percent of total billed charges","17.136% of total billed charges",1228.28,21.84,,982.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2120.25,37.7,,1696.20,,,0,"percent of total billed charges","37.7% of total billed charges",2120.25,37.7,,1696.20,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1906.54,33.9,,1525.23,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4386.72,78,,3509.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4645.42,82.6,,3716.34,,,0,"percent of total billed charges","82.6% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",4645.42,82.6,,3716.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",860.47,5624,
"MESH 3D MAX LARGE LEFT",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"MESH 3D MAX LARGE RIGHT",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"MESH ATRIUM 2 X 4        1000204 00",ORSUP0004,CDM,278,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.7% of total billed charges",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.14,33.9,,54.51,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"MESH PROGRIP 12 X 8CM LEFT",ORSUP0021,CDM,278,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",668.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.7% of total billed charges",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",726.14,33.9,,580.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"MESH PROGRIP 12 X 8CM RIGHT",ORSUP0021,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"MESH COMPOSITE PCO PARIETEX 20CM X 15CM",ORSUP0037,CDM,278,RC,,,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1065.75,17.304,,852.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",942.33,15.3,,753.86,,,0,"percent of total billed charges","15.3% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3809.34,61.85,,3047.47,,,0,"percent of total billed charges","61.5% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1983.2,32.2,,1586.56,,,0,"percent of total billed charges","32.2% of total billed charges",1921.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1055.41,17.136,,844.33,,,0,"percent of total billed charges","17.136% of total billed charges",1345.13,21.84,,1076.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",942.33,6159,
"MESH 2 X 4 RECTANGLE",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,412,267.8,,362.56,88,,290.05,,,0,"percent of total billed charges","88% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.29,17.304,,57.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",259.56,63,,207.65,,,0,"percent of total billed charges","63% of total billed charges",63.04,15.3,,50.43,,,0,"percent of total billed charges","15.3% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",284.28,69,,,,,0,"fee schedule","69% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",254.82,61.85,,203.86,,,0,"percent of total billed charges","61.5% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",132.66,32.2,,106.13,,,0,"percent of total billed charges","32.2% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.6,17.136,,56.48,,,0,"percent of total billed charges","17.136% of total billed charges",89.98,21.84,,71.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",155.32,37.7,,124.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",321.36,78,,257.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",63.04,412,
"MESH 3 X 6",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,721,468.65,,634.48,88,,507.58,,,0,"percent of total billed charges","88% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.76,17.304,,99.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.23,63,,363.38,,,0,"percent of total billed charges","63% of total billed charges",110.31,15.3,,88.25,,,0,"percent of total billed charges","15.3% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",497.49,69,,,,,0,"fee schedule","69% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",445.94,61.85,,356.75,,,0,"percent of total billed charges","61.5% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",232.16,32.2,,185.73,,,0,"percent of total billed charges","32.2% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",123.55,17.136,,98.84,,,0,"percent of total billed charges","17.136% of total billed charges",157.47,21.84,,125.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",271.82,37.7,,217.46,,,0,"percent of total billed charges","37.7% of total billed charges",271.82,37.7,,217.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",244.42,33.9,,195.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",562.38,78,,449.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",595.55,82.6,,476.44,,,0,"percent of total billed charges","82.6% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",595.55,82.6,,476.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",110.31,721,
"MESH PANTIES 2XL",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"MESH VENTRALEX SMALL",ORSUP0033,CDM,278,RC,,,OUTPATIENT,,,4532,2945.8,,3988.16,88,,3190.53,,,0,"percent of total billed charges","88% of total billed charges",2266,50,,1812.80,,,0,"percent of total billed charges","50% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",784.22,17.304,,627.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2855.16,63,,2284.13,,,0,"percent of total billed charges","63% of total billed charges",693.4,15.3,,554.72,,,0,"percent of total billed charges","15.3% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",3127.08,69,,,,,0,"fee schedule","69% of total billed charges",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2803.04,61.85,,2242.43,,,0,"percent of total billed charges","61.5% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",2266,50,,1812.80,,,0,"percent of total billed charges","50% of total billed charges",1459.3,32.2,,1167.44,,,0,"percent of total billed charges","32.2% of total billed charges",1413.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",776.6,17.136,,621.28,,,0,"percent of total billed charges","17.136% of total billed charges",989.79,21.84,,791.83,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1708.56,37.7,,1366.85,,,0,"percent of total billed charges","37.7% of total billed charges",1708.56,37.7,,1366.85,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1536.35,33.9,,1229.08,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3534.96,78,,2827.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3743.43,82.6,,2994.74,,,0,"percent of total billed charges","82.6% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",2266,50,,1812.80,,,0,"percent of total billed charges","50% of total billed charges",3743.43,82.6,,2994.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",693.4,4532,
"MESH VENTRALEX MED",ORSUP0031,CDM,278,RC,,,OUTPATIENT,,,5356,3481.4,,4713.28,88,,3770.62,,,0,"percent of total billed charges","88% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",926.8,17.304,,741.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3374.28,63,,2699.42,,,0,"percent of total billed charges","63% of total billed charges",819.47,15.3,,655.58,,,0,"percent of total billed charges","15.3% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",3695.64,69,,,,,0,"fee schedule","69% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3312.69,61.85,,2650.15,,,0,"percent of total billed charges","61.5% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",1724.63,32.2,,1379.70,,,0,"percent of total billed charges","32.2% of total billed charges",1671.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",917.8,17.136,,734.24,,,0,"percent of total billed charges","17.136% of total billed charges",1169.75,21.84,,935.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.7% of total billed charges",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1815.68,33.9,,1452.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4177.68,78,,3342.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",819.47,5356,
"MESH VENTRALEX LARGE",ORSUP0056,CDM,278,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",1838.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.7% of total billed charges",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1997.39,33.9,,1597.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"MESH VENTRALIGHT ST ECHO 2 4X6",ORSUP0035,CDM,278,RC,,,OUTPATIENT,,,6427,4177.55,,5655.76,88,,4524.61,,,0,"percent of total billed charges","88% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1112.13,17.304,,889.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4049.01,63,,3239.21,,,0,"percent of total billed charges","63% of total billed charges",983.33,15.3,,786.66,,,0,"percent of total billed charges","15.3% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4434.63,69,,,,,0,"fee schedule","69% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3975.1,61.85,,3180.08,,,0,"percent of total billed charges","61.5% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",2069.49,32.2,,1655.59,,,0,"percent of total billed charges","32.2% of total billed charges",2005.22,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1101.33,17.136,,881.06,,,0,"percent of total billed charges","17.136% of total billed charges",1403.66,21.84,,1122.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.7% of total billed charges",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2178.75,33.9,,1743.00,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5013.06,78,,4010.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",983.33,6427,
"MESH COMPOSITE PARIETEX 30X20CM",ORSUP0070,CDM,278,RC,,,OUTPATIENT,,,16068,10444.2,,14139.84,88,,11311.87,,,0,"percent of total billed charges","88% of total billed charges",8034,50,,6427.20,,,0,"percent of total billed charges","50% of total billed charges",2699.42,16.8,,2159.54,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2780.41,17.304,,2224.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10122.84,63,,8098.27,,,0,"percent of total billed charges","63% of total billed charges",2458.4,15.3,,1966.72,,,0,"percent of total billed charges","15.3% of total billed charges",2699.42,16.8,,2159.54,,,0,"percent of total billed charges","16.8% of total billed charges",11086.92,69,,,,,0,"fee schedule","69% of total billed charges",16068,100,,12854.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16068,100,,12854.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16068,100,,12854.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9938.06,61.85,,7950.45,,,0,"percent of total billed charges","61.5% of total billed charges",2699.42,16.8,,2159.54,,,0,"percent of total billed charges","16.8% of total billed charges",8034,50,,6427.20,,,0,"percent of total billed charges","50% of total billed charges",5173.9,32.2,,4139.12,,,0,"percent of total billed charges","32.2% of total billed charges",5013.22,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2753.41,17.136,,2202.73,,,0,"percent of total billed charges","17.136% of total billed charges",3509.25,21.84,,2807.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",6057.64,37.7,,4846.11,,,0,"percent of total billed charges","37.7% of total billed charges",6057.64,37.7,,4846.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",5447.05,33.9,,4357.64,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",12533.04,78,,10026.43,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13272.17,82.6,,10617.74,,,0,"percent of total billed charges","82.6% of total billed charges",2699.42,16.8,,2159.54,,,0,"percent of total billed charges","16.8% of total billed charges",8034,50,,6427.20,,,0,"percent of total billed charges","50% of total billed charges",13272.17,82.6,,10617.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.42,16.8,,2159.54,,,0,"percent of total billed charges","16.8% of total billed charges",16068,100,,12854.40,,,0,"percent of total billed charges","100% of total billed charges",2458.4,16068,
"MESH VENTRALIGHT 4X6",ORSUP0031,CDM,278,RC,,,OUTPATIENT,,,4120,2678,,3625.6,88,,2900.48,,,0,"percent of total billed charges","88% of total billed charges",2060,50,,1648.00,,,0,"percent of total billed charges","50% of total billed charges",692.16,16.8,,553.73,,,0,"percent of total billed charges","16.8% of total billed charges",4120,100,,3296.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",712.92,17.304,,570.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2595.6,63,,2076.48,,,0,"percent of total billed charges","63% of total billed charges",630.36,15.3,,504.29,,,0,"percent of total billed charges","15.3% of total billed charges",692.16,16.8,,553.73,,,0,"percent of total billed charges","16.8% of total billed charges",2842.8,69,,,,,0,"fee schedule","69% of total billed charges",4120,100,,3296.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4120,100,,3296.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4120,100,,3296.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2548.22,61.85,,2038.58,,,0,"percent of total billed charges","61.5% of total billed charges",692.16,16.8,,553.73,,,0,"percent of total billed charges","16.8% of total billed charges",2060,50,,1648.00,,,0,"percent of total billed charges","50% of total billed charges",1326.64,32.2,,1061.31,,,0,"percent of total billed charges","32.2% of total billed charges",1285.44,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",706,17.136,,564.80,,,0,"percent of total billed charges","17.136% of total billed charges",899.81,21.84,,719.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1553.24,37.7,,1242.59,,,0,"percent of total billed charges","37.7% of total billed charges",1553.24,37.7,,1242.59,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1396.68,33.9,,1117.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3213.6,78,,2570.88,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3403.12,82.6,,2722.50,,,0,"percent of total billed charges","82.6% of total billed charges",692.16,16.8,,553.73,,,0,"percent of total billed charges","16.8% of total billed charges",2060,50,,1648.00,,,0,"percent of total billed charges","50% of total billed charges",3403.12,82.6,,2722.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",692.16,16.8,,553.73,,,0,"percent of total billed charges","16.8% of total billed charges",4120,100,,3296.00,,,0,"percent of total billed charges","100% of total billed charges",630.36,4120,
"MESH 3DMAX LEFT XLARGE",ORSUP0019,CDM,278,RC,,,OUTPATIENT,,,1648,1071.2,,1450.24,88,,1160.19,,,0,"percent of total billed charges","88% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",285.17,17.304,,228.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1038.24,63,,830.59,,,0,"percent of total billed charges","63% of total billed charges",252.14,15.3,,201.71,,,0,"percent of total billed charges","15.3% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1137.12,69,,,,,0,"fee schedule","69% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.29,61.85,,815.43,,,0,"percent of total billed charges","61.5% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",530.66,32.2,,424.53,,,0,"percent of total billed charges","32.2% of total billed charges",514.18,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",282.4,17.136,,225.92,,,0,"percent of total billed charges","17.136% of total billed charges",359.92,21.84,,287.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",621.3,37.7,,497.04,,,0,"percent of total billed charges","37.7% of total billed charges",621.3,37.7,,497.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",558.67,33.9,,446.94,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1285.44,78,,1028.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1361.25,82.6,,1089.00,,,0,"percent of total billed charges","82.6% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",1361.25,82.6,,1089.00,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",252.14,1648,
"MESH 3DMAX RIGHT XLARGE",ORSUP0019,CDM,278,RC,,,OUTPATIENT,,,1648,1071.2,,1450.24,88,,1160.19,,,0,"percent of total billed charges","88% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",285.17,17.304,,228.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1038.24,63,,830.59,,,0,"percent of total billed charges","63% of total billed charges",252.14,15.3,,201.71,,,0,"percent of total billed charges","15.3% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1137.12,69,,,,,0,"fee schedule","69% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.29,61.85,,815.43,,,0,"percent of total billed charges","61.5% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",530.66,32.2,,424.53,,,0,"percent of total billed charges","32.2% of total billed charges",514.18,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",282.4,17.136,,225.92,,,0,"percent of total billed charges","17.136% of total billed charges",359.92,21.84,,287.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",621.3,37.7,,497.04,,,0,"percent of total billed charges","37.7% of total billed charges",621.3,37.7,,497.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",558.67,33.9,,446.94,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1285.44,78,,1028.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1361.25,82.6,,1089.00,,,0,"percent of total billed charges","82.6% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",1361.25,82.6,,1089.00,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",252.14,1648,
"MESH VENTRALIGHT ST W/ECHO PS 6X8",ORSUP0059,CDM,278,RC,,,OUTPATIENT,,,10094,6561.1,,8882.72,88,,7106.18,,,0,"percent of total billed charges","88% of total billed charges",5047,50,,4037.60,,,0,"percent of total billed charges","50% of total billed charges",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1746.67,17.304,,1397.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6359.22,63,,5087.38,,,0,"percent of total billed charges","63% of total billed charges",1544.38,15.3,,1235.50,,,0,"percent of total billed charges","15.3% of total billed charges",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",6964.86,69,,,,,0,"fee schedule","69% of total billed charges",10094,100,,8075.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10094,100,,8075.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10094,100,,8075.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6243.14,61.85,,4994.51,,,0,"percent of total billed charges","61.5% of total billed charges",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",5047,50,,4037.60,,,0,"percent of total billed charges","50% of total billed charges",3250.27,32.2,,2600.22,,,0,"percent of total billed charges","32.2% of total billed charges",3149.33,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1729.71,17.136,,1383.77,,,0,"percent of total billed charges","17.136% of total billed charges",2204.53,21.84,,1763.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3805.44,37.7,,3044.35,,,0,"percent of total billed charges","37.7% of total billed charges",3805.44,37.7,,3044.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3421.87,33.9,,2737.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7873.32,78,,6298.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8337.64,82.6,,6670.11,,,0,"percent of total billed charges","82.6% of total billed charges",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",5047,50,,4037.60,,,0,"percent of total billed charges","50% of total billed charges",8337.64,82.6,,6670.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",10094,100,,8075.20,,,0,"percent of total billed charges","100% of total billed charges",1544.38,10094,
"METHANOL (CERTIFIED ACS)",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"METHANOL 70%",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,464,301.6,,408.32,88,,326.66,,,0,"percent of total billed charges","88% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.29,17.304,,64.23,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.32,63,,233.86,,,0,"percent of total billed charges","63% of total billed charges",70.99,15.3,,56.79,,,0,"percent of total billed charges","15.3% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",320.16,69,,,,,0,"fee schedule","69% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",286.98,61.85,,229.58,,,0,"percent of total billed charges","61.5% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",149.41,32.2,,119.53,,,0,"percent of total billed charges","32.2% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.51,17.136,,63.61,,,0,"percent of total billed charges","17.136% of total billed charges",101.34,21.84,,81.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",174.93,37.7,,139.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",361.92,78,,289.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",70.99,464,
"METRICIDE OPA SOLUTION",490898,CDM,270,RC,,,OUTPATIENT,,,684,444.6,,601.92,88,,481.54,,,0,"percent of total billed charges","88% of total billed charges",342,50,,273.60,,,0,"percent of total billed charges","50% of total billed charges",114.91,16.8,,91.93,,,0,"percent of total billed charges","16.8% of total billed charges",684,100,,547.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",118.36,17.304,,94.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",430.92,63,,344.74,,,0,"percent of total billed charges","63% of total billed charges",104.65,15.3,,83.72,,,0,"percent of total billed charges","15.3% of total billed charges",114.91,16.8,,91.93,,,0,"percent of total billed charges","16.8% of total billed charges",471.96,69,,,,,0,"fee schedule","69% of total billed charges",684,100,,547.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",684,100,,547.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",684,100,,547.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",423.05,61.85,,338.44,,,0,"percent of total billed charges","61.5% of total billed charges",114.91,16.8,,91.93,,,0,"percent of total billed charges","16.8% of total billed charges",342,50,,273.60,,,0,"percent of total billed charges","50% of total billed charges",220.25,32.2,,176.20,,,0,"percent of total billed charges","32.2% of total billed charges",114.91,16.8,,91.93,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",117.21,17.136,,93.77,,,0,"percent of total billed charges","17.136% of total billed charges",149.39,21.84,,119.51,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",257.87,37.7,,206.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",533.52,78,,426.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",564.98,82.6,,451.98,,,0,"percent of total billed charges","82.6% of total billed charges",114.91,16.8,,91.93,,,0,"percent of total billed charges","16.8% of total billed charges",342,50,,273.60,,,0,"percent of total billed charges","50% of total billed charges",564.98,82.6,,451.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.91,16.8,,91.93,,,0,"percent of total billed charges","16.8% of total billed charges",684,100,,547.20,,,0,"percent of total billed charges","100% of total billed charges",104.65,684,
"METRIZYME ENZYMATIC CLEANER",490900,CDM,270,RC,,,OUTPATIENT,,,287,186.55,,252.56,88,,202.05,,,0,"percent of total billed charges","88% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.66,17.304,,39.73,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",180.81,63,,144.65,,,0,"percent of total billed charges","63% of total billed charges",43.91,15.3,,35.13,,,0,"percent of total billed charges","15.3% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",198.03,69,,,,,0,"fee schedule","69% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",177.51,61.85,,142.01,,,0,"percent of total billed charges","61.5% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",92.41,32.2,,73.93,,,0,"percent of total billed charges","32.2% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.18,17.136,,39.34,,,0,"percent of total billed charges","17.136% of total billed charges",62.68,21.84,,50.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",223.86,78,,179.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",143.5,50,,114.80,,,0,"percent of total billed charges","50% of total billed charges",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.22,16.8,,38.58,,,0,"percent of total billed charges","16.8% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",43.91,287,
"METRICIDE TEST STRIPS",490899,CDM,270,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"METZEMBAUM SCISSOR TIP",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"MICKEY G TUBE 18 FR LAP KIT",ORSUP0019,CDM,272,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"MICROCATHETER THREADER OTW",ORSUP0032,CDM,278,RC,,,OUTPATIENT,,,5624,3655.6,,4949.12,88,,3959.30,,,0,"percent of total billed charges","88% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",973.18,17.304,,778.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3543.12,63,,2834.50,,,0,"percent of total billed charges","63% of total billed charges",860.47,15.3,,688.38,,,0,"percent of total billed charges","15.3% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",3880.56,69,,,,,0,"fee schedule","69% of total billed charges",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3478.44,61.85,,2782.75,,,0,"percent of total billed charges","61.5% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",1810.93,32.2,,1448.74,,,0,"percent of total billed charges","32.2% of total billed charges",1754.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",963.73,17.136,,770.98,,,0,"percent of total billed charges","17.136% of total billed charges",1228.28,21.84,,982.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2120.25,37.7,,1696.20,,,0,"percent of total billed charges","37.7% of total billed charges",2120.25,37.7,,1696.20,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1906.54,33.9,,1525.23,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4386.72,78,,3509.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4645.42,82.6,,3716.34,,,0,"percent of total billed charges","82.6% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",4645.42,82.6,,3716.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",860.47,5624,
"MICROPUNCTURE PEDAL INTRO SET",ORSUP0009,CDM,270,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"MICRO METZENBAUM SCISSOR TIP",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"MICRO KILL BLEACH WIPE",490904,CDM,270,RC,,,OUTPATIENT,,,96,62.4,,84.48,88,,67.58,,,0,"percent of total billed charges","88% of total billed charges",48,50,,38.40,,,0,"percent of total billed charges","50% of total billed charges",16.13,16.8,,12.90,,,0,"percent of total billed charges","16.8% of total billed charges",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.61,17.304,,13.29,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.48,63,,48.38,,,0,"percent of total billed charges","63% of total billed charges",14.69,15.3,,11.75,,,0,"percent of total billed charges","15.3% of total billed charges",16.13,16.8,,12.90,,,0,"percent of total billed charges","16.8% of total billed charges",66.24,69,,,,,0,"fee schedule","69% of total billed charges",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.38,61.85,,47.50,,,0,"percent of total billed charges","61.5% of total billed charges",16.13,16.8,,12.90,,,0,"percent of total billed charges","16.8% of total billed charges",48,50,,38.40,,,0,"percent of total billed charges","50% of total billed charges",30.91,32.2,,24.73,,,0,"percent of total billed charges","32.2% of total billed charges",16.13,16.8,,12.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.45,17.136,,13.16,,,0,"percent of total billed charges","17.136% of total billed charges",20.97,21.84,,16.78,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.19,37.7,,28.95,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",74.88,78,,59.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",16.13,16.8,,12.90,,,0,"percent of total billed charges","16.8% of total billed charges",48,50,,38.40,,,0,"percent of total billed charges","50% of total billed charges",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.13,16.8,,12.90,,,0,"percent of total billed charges","16.8% of total billed charges",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",14.69,96,
"MICRO INTRODUCER SHEATH SET (CLOSURE FAST)",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"MICRONESTER COIL 14CM X 4MM",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"MICRONESTER15CM X 8MM",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"MICRONESTER 14CM X 6MM",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"MICROCATHETER CANTATA 2.9F/110",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"MICROPUNTURE SET 5FR",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"MICROTAINER CAPILARY BLOOD COLLECTOR GREEN EXTENDER",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"MICRO BLOOD COLLECTING TUBES",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"MICRO MATRIX 500MG",ORSUP0043,CDM,278,RC,,,OUTPATIENT,,,6592,4284.8,,5800.96,88,,4640.77,,,0,"percent of total billed charges","88% of total billed charges",3296,50,,2636.80,,,0,"percent of total billed charges","50% of total billed charges",1107.46,16.8,,885.97,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1140.68,17.304,,912.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4152.96,63,,3322.37,,,0,"percent of total billed charges","63% of total billed charges",1008.58,15.3,,806.86,,,0,"percent of total billed charges","15.3% of total billed charges",1107.46,16.8,,885.97,,,0,"percent of total billed charges","16.8% of total billed charges",4548.48,69,,,,,0,"fee schedule","69% of total billed charges",6592,100,,5273.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6592,100,,5273.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6592,100,,5273.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4077.15,61.85,,3261.72,,,0,"percent of total billed charges","61.5% of total billed charges",1107.46,16.8,,885.97,,,0,"percent of total billed charges","16.8% of total billed charges",3296,50,,2636.80,,,0,"percent of total billed charges","50% of total billed charges",2122.62,32.2,,1698.10,,,0,"percent of total billed charges","32.2% of total billed charges",2056.7,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1129.61,17.136,,903.69,,,0,"percent of total billed charges","17.136% of total billed charges",1439.69,21.84,,1151.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2485.18,37.7,,1988.14,,,0,"percent of total billed charges","37.7% of total billed charges",2485.18,37.7,,1988.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2234.69,33.9,,1787.75,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5141.76,78,,4113.41,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5444.99,82.6,,4355.99,,,0,"percent of total billed charges","82.6% of total billed charges",1107.46,16.8,,885.97,,,0,"percent of total billed charges","16.8% of total billed charges",3296,50,,2636.80,,,0,"percent of total billed charges","50% of total billed charges",5444.99,82.6,,4355.99,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1107.46,16.8,,885.97,,,0,"percent of total billed charges","16.8% of total billed charges",6592,100,,5273.60,,,0,"percent of total billed charges","100% of total billed charges",1008.58,6592,
"MICRO MATRIX 1000MG",ORSUP0072,CDM,278,RC,,,OUTPATIENT,,,12772,8301.8,,11239.36,88,,8991.49,,,0,"percent of total billed charges","88% of total billed charges",6386,50,,5108.80,,,0,"percent of total billed charges","50% of total billed charges",2145.7,16.8,,1716.56,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2210.07,17.304,,1768.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8046.36,63,,6437.09,,,0,"percent of total billed charges","63% of total billed charges",1954.12,15.3,,1563.30,,,0,"percent of total billed charges","15.3% of total billed charges",2145.7,16.8,,1716.56,,,0,"percent of total billed charges","16.8% of total billed charges",8812.68,69,,,,,0,"fee schedule","69% of total billed charges",12772,100,,10217.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12772,100,,10217.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12772,100,,10217.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7899.48,61.85,,6319.58,,,0,"percent of total billed charges","61.5% of total billed charges",2145.7,16.8,,1716.56,,,0,"percent of total billed charges","16.8% of total billed charges",6386,50,,5108.80,,,0,"percent of total billed charges","50% of total billed charges",4112.58,32.2,,3290.06,,,0,"percent of total billed charges","32.2% of total billed charges",3984.86,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2188.61,17.136,,1750.89,,,0,"percent of total billed charges","17.136% of total billed charges",2789.4,21.84,,2231.52,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4815.04,37.7,,3852.03,,,0,"percent of total billed charges","37.7% of total billed charges",4815.04,37.7,,3852.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4329.71,33.9,,3463.77,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",9962.16,78,,7969.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10549.67,82.6,,8439.74,,,0,"percent of total billed charges","82.6% of total billed charges",2145.7,16.8,,1716.56,,,0,"percent of total billed charges","16.8% of total billed charges",6386,50,,5108.80,,,0,"percent of total billed charges","50% of total billed charges",10549.67,82.6,,8439.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2145.7,16.8,,1716.56,,,0,"percent of total billed charges","16.8% of total billed charges",12772,100,,10217.60,,,0,"percent of total billed charges","100% of total billed charges",1954.12,12772,
"MICROCENTRIFUGE TUBES",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"MICROLARYNGEAL ENDO TRACH TUBE CUFFED 4.0MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"MICROLARYNGEAL ENDO TRACH TUBE CUFFED 5.0MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"MICROLARYNGEAL ENDOTRACHEAL TUBE 6MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"MICROTOME CARTILAGE CUTTER",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"MICROSTREAM FILTER LINES",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"MICS SYSTEM IRRIGATION CLIP",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,927,602.55,,815.76,88,,652.61,,,0,"percent of total billed charges","88% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.41,17.304,,128.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.01,63,,467.21,,,0,"percent of total billed charges","63% of total billed charges",141.83,15.3,,113.46,,,0,"percent of total billed charges","15.3% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",639.63,69,,,,,0,"fee schedule","69% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",573.35,61.85,,458.68,,,0,"percent of total billed charges","61.5% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",298.49,32.2,,238.79,,,0,"percent of total billed charges","32.2% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.85,17.136,,127.08,,,0,"percent of total billed charges","17.136% of total billed charges",202.46,21.84,,161.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",349.48,37.7,,279.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",723.06,78,,578.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",141.83,927,
"MICS BALL BURR 5.7MM",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.94,17.304,,85.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.23,61.85,,305.78,,,0,"percent of total billed charges","61.5% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",199,32.2,,159.20,,,0,"percent of total billed charges","32.2% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.136,,84.72,,,0,"percent of total billed charges","17.136% of total billed charges",134.97,21.84,,107.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,618,
"MIDLINE NASAL TUBING 100MM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"MIDLINE NASAL TUBING 50MM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"MIDLINE NASAL TUBING 70MM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"MINITIP SWABS FLOCKED",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"MINI ENDOCUT SCISSORS",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"MINI C-ARM PAPER",490907,CDM,270,RC,,,OUTPATIENT,,,151,98.15,,132.88,88,,106.30,,,0,"percent of total billed charges","88% of total billed charges",75.5,50,,60.40,,,0,"percent of total billed charges","50% of total billed charges",25.37,16.8,,20.30,,,0,"percent of total billed charges","16.8% of total billed charges",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.13,17.304,,20.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.13,63,,76.10,,,0,"percent of total billed charges","63% of total billed charges",23.1,15.3,,18.48,,,0,"percent of total billed charges","15.3% of total billed charges",25.37,16.8,,20.30,,,0,"percent of total billed charges","16.8% of total billed charges",104.19,69,,,,,0,"fee schedule","69% of total billed charges",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",93.39,61.85,,74.71,,,0,"percent of total billed charges","61.5% of total billed charges",25.37,16.8,,20.30,,,0,"percent of total billed charges","16.8% of total billed charges",75.5,50,,60.40,,,0,"percent of total billed charges","50% of total billed charges",48.62,32.2,,38.90,,,0,"percent of total billed charges","32.2% of total billed charges",25.37,16.8,,20.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.88,17.136,,20.70,,,0,"percent of total billed charges","17.136% of total billed charges",32.98,21.84,,26.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",56.93,37.7,,45.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",117.78,78,,94.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.73,82.6,,99.78,,,0,"percent of total billed charges","82.6% of total billed charges",25.37,16.8,,20.30,,,0,"percent of total billed charges","16.8% of total billed charges",75.5,50,,60.40,,,0,"percent of total billed charges","50% of total billed charges",124.73,82.6,,99.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.37,16.8,,20.30,,,0,"percent of total billed charges","16.8% of total billed charges",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",23.1,151,
"MIRODRY WOUND MATRIX A2031 10X5",636A2031105,CDM,636,RC,,,OUTPATIENT,,,22454,14595.1,,19759.52,88,,15807.62,,,0,"percent of total billed charges","88% of total billed charges",11227,50,,8981.60,,,0,"percent of total billed charges","50% of total billed charges",3772.27,16.8,,3017.82,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3885.44,17.304,,3108.35,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14146.02,63,,11316.82,,,0,"percent of total billed charges","63% of total billed charges",3435.46,15.3,,2748.37,,,0,"percent of total billed charges","15.3% of total billed charges",3772.27,16.8,,3017.82,,,0,"percent of total billed charges","16.8% of total billed charges",15493.26,69,,,,,0,"fee schedule","69% of total billed charges",22454,100,,17963.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22454,100,,17963.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22454,100,,17963.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13887.8,61.85,,11110.24,,,0,"percent of total billed charges","61.5% of total billed charges",3772.27,16.8,,3017.82,,,0,"percent of total billed charges","16.8% of total billed charges",11227,50,,8981.60,,,0,"percent of total billed charges","50% of total billed charges",7230.19,32.2,,5784.15,,,0,"percent of total billed charges","32.2% of total billed charges",3772.27,16.8,,3017.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3847.72,17.136,,3078.18,,,0,"percent of total billed charges","17.136% of total billed charges",4903.95,21.84,,3923.16,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",8465.16,37.7,,6772.13,,,0,"percent of total billed charges","37.7% of total billed charges",8465.16,37.7,,6772.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",7611.91,33.9,,6089.53,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",17514.12,78,,14011.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3772.27,16.8,,3017.82,,,0,"percent of total billed charges","16.8% of total billed charges",11227,50,,8981.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3772.27,16.8,,3017.82,,,0,"percent of total billed charges","16.8% of total billed charges",22454,100,,17963.20,,,0,"percent of total billed charges","100% of total billed charges",3435.46,22454,
"MIRO 3D WOUND MATRIX A2025 5X5X2",636A2025552,CDM,636,RC,,,OUTPATIENT,,,11742,7632.3,,10332.96,88,,8266.37,,,0,"percent of total billed charges","88% of total billed charges",5871,50,,4696.80,,,0,"percent of total billed charges","50% of total billed charges",1972.66,16.8,,1578.13,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2031.84,17.304,,1625.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7397.46,63,,5917.97,,,0,"percent of total billed charges","63% of total billed charges",1796.53,15.3,,1437.22,,,0,"percent of total billed charges","15.3% of total billed charges",1972.66,16.8,,1578.13,,,0,"percent of total billed charges","16.8% of total billed charges",8101.98,69,,,,,0,"fee schedule","69% of total billed charges",11742,100,,9393.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11742,100,,9393.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11742,100,,9393.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7262.43,61.85,,5809.94,,,0,"percent of total billed charges","61.5% of total billed charges",1972.66,16.8,,1578.13,,,0,"percent of total billed charges","16.8% of total billed charges",5871,50,,4696.80,,,0,"percent of total billed charges","50% of total billed charges",3780.92,32.2,,3024.74,,,0,"percent of total billed charges","32.2% of total billed charges",1972.66,16.8,,1578.13,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2012.11,17.136,,1609.69,,,0,"percent of total billed charges","17.136% of total billed charges",2564.45,21.84,,2051.56,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4426.73,37.7,,3541.38,,,0,"percent of total billed charges","37.7% of total billed charges",4426.73,37.7,,3541.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3980.54,33.9,,3184.43,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",9158.76,78,,7327.01,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1972.66,16.8,,1578.13,,,0,"percent of total billed charges","16.8% of total billed charges",5871,50,,4696.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1972.66,16.8,,1578.13,,,0,"percent of total billed charges","16.8% of total billed charges",11742,100,,9393.60,,,0,"percent of total billed charges","100% of total billed charges",1796.53,11742,
"MIRODRY WOUND MATRIX A2031 2X2",636A203122,CDM,636,RC,,,OUTPATIENT,,,5356,3481.4,,4713.28,88,,3770.62,,,0,"percent of total billed charges","88% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",926.8,17.304,,741.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3374.28,63,,2699.42,,,0,"percent of total billed charges","63% of total billed charges",819.47,15.3,,655.58,,,0,"percent of total billed charges","15.3% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",3695.64,69,,,,,0,"fee schedule","69% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3312.69,61.85,,2650.15,,,0,"percent of total billed charges","61.5% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",1724.63,32.2,,1379.70,,,0,"percent of total billed charges","32.2% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",917.8,17.136,,734.24,,,0,"percent of total billed charges","17.136% of total billed charges",1169.75,21.84,,935.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.7% of total billed charges",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1815.68,33.9,,1452.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4177.68,78,,3342.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",819.47,5356,
"MIRO 3D WOUND MATRIX A2025 2X2X2",636A2025222,CDM,636,RC,,,OUTPATIENT,,,5562,3615.3,,4894.56,88,,3915.65,,,0,"percent of total billed charges","88% of total billed charges",2781,50,,2224.80,,,0,"percent of total billed charges","50% of total billed charges",934.42,16.8,,747.54,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",962.45,17.304,,769.96,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3504.06,63,,2803.25,,,0,"percent of total billed charges","63% of total billed charges",850.99,15.3,,680.79,,,0,"percent of total billed charges","15.3% of total billed charges",934.42,16.8,,747.54,,,0,"percent of total billed charges","16.8% of total billed charges",3837.78,69,,,,,0,"fee schedule","69% of total billed charges",5562,100,,4449.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5562,100,,4449.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5562,100,,4449.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3440.1,61.85,,2752.08,,,0,"percent of total billed charges","61.5% of total billed charges",934.42,16.8,,747.54,,,0,"percent of total billed charges","16.8% of total billed charges",2781,50,,2224.80,,,0,"percent of total billed charges","50% of total billed charges",1790.96,32.2,,1432.77,,,0,"percent of total billed charges","32.2% of total billed charges",934.42,16.8,,747.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",953.1,17.136,,762.48,,,0,"percent of total billed charges","17.136% of total billed charges",1214.74,21.84,,971.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2096.87,37.7,,1677.50,,,0,"percent of total billed charges","37.7% of total billed charges",2096.87,37.7,,1677.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1885.52,33.9,,1508.42,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4338.36,78,,3470.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",934.42,16.8,,747.54,,,0,"percent of total billed charges","16.8% of total billed charges",2781,50,,2224.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",934.42,16.8,,747.54,,,0,"percent of total billed charges","16.8% of total billed charges",5562,100,,4449.60,,,0,"percent of total billed charges","100% of total billed charges",850.99,5562,
"MIRO 3D WOUND MATRIX A2025 3X3X2",636A2025332,CDM,636,RC,,,OUTPATIENT,,,6592,4284.8,,5800.96,88,,4640.77,,,0,"percent of total billed charges","88% of total billed charges",3296,50,,2636.80,,,0,"percent of total billed charges","50% of total billed charges",1107.46,16.8,,885.97,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1140.68,17.304,,912.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4152.96,63,,3322.37,,,0,"percent of total billed charges","63% of total billed charges",1008.58,15.3,,806.86,,,0,"percent of total billed charges","15.3% of total billed charges",1107.46,16.8,,885.97,,,0,"percent of total billed charges","16.8% of total billed charges",4548.48,69,,,,,0,"fee schedule","69% of total billed charges",6592,100,,5273.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6592,100,,5273.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6592,100,,5273.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4077.15,61.85,,3261.72,,,0,"percent of total billed charges","61.5% of total billed charges",1107.46,16.8,,885.97,,,0,"percent of total billed charges","16.8% of total billed charges",3296,50,,2636.80,,,0,"percent of total billed charges","50% of total billed charges",2122.62,32.2,,1698.10,,,0,"percent of total billed charges","32.2% of total billed charges",1107.46,16.8,,885.97,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1129.61,17.136,,903.69,,,0,"percent of total billed charges","17.136% of total billed charges",1439.69,21.84,,1151.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2485.18,37.7,,1988.14,,,0,"percent of total billed charges","37.7% of total billed charges",2485.18,37.7,,1988.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2234.69,33.9,,1787.75,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5141.76,78,,4113.41,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1107.46,16.8,,885.97,,,0,"percent of total billed charges","16.8% of total billed charges",3296,50,,2636.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1107.46,16.8,,885.97,,,0,"percent of total billed charges","16.8% of total billed charges",6592,100,,5273.60,,,0,"percent of total billed charges","100% of total billed charges",1008.58,6592,
"MIRO 3D WOUND MATRIX A2025 4X4X2",636A2025442,CDM,636,RC,,,OUTPATIENT,,,5562,3615.3,,4894.56,88,,3915.65,,,0,"percent of total billed charges","88% of total billed charges",2781,50,,2224.80,,,0,"percent of total billed charges","50% of total billed charges",934.42,16.8,,747.54,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",962.45,17.304,,769.96,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3504.06,63,,2803.25,,,0,"percent of total billed charges","63% of total billed charges",850.99,15.3,,680.79,,,0,"percent of total billed charges","15.3% of total billed charges",934.42,16.8,,747.54,,,0,"percent of total billed charges","16.8% of total billed charges",3837.78,69,,,,,0,"fee schedule","69% of total billed charges",5562,100,,4449.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5562,100,,4449.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5562,100,,4449.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3440.1,61.85,,2752.08,,,0,"percent of total billed charges","61.5% of total billed charges",934.42,16.8,,747.54,,,0,"percent of total billed charges","16.8% of total billed charges",2781,50,,2224.80,,,0,"percent of total billed charges","50% of total billed charges",1790.96,32.2,,1432.77,,,0,"percent of total billed charges","32.2% of total billed charges",934.42,16.8,,747.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",953.1,17.136,,762.48,,,0,"percent of total billed charges","17.136% of total billed charges",1214.74,21.84,,971.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2096.87,37.7,,1677.50,,,0,"percent of total billed charges","37.7% of total billed charges",2096.87,37.7,,1677.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1885.52,33.9,,1508.42,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4338.36,78,,3470.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",934.42,16.8,,747.54,,,0,"percent of total billed charges","16.8% of total billed charges",2781,50,,2224.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",934.42,16.8,,747.54,,,0,"percent of total billed charges","16.8% of total billed charges",5562,100,,4449.60,,,0,"percent of total billed charges","100% of total billed charges",850.99,5562,
"MIRO 3D WOUND MATRIX A2025 7X5X2",636A2025752,CDM,636,RC,,,OUTPATIENT,,,15450,10042.5,,13596,88,,10876.80,,,0,"percent of total billed charges","88% of total billed charges",7725,50,,6180.00,,,0,"percent of total billed charges","50% of total billed charges",2595.6,16.8,,2076.48,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2673.47,17.304,,2138.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9733.5,63,,7786.80,,,0,"percent of total billed charges","63% of total billed charges",2363.85,15.3,,1891.08,,,0,"percent of total billed charges","15.3% of total billed charges",2595.6,16.8,,2076.48,,,0,"percent of total billed charges","16.8% of total billed charges",10660.5,69,,,,,0,"fee schedule","69% of total billed charges",15450,100,,12360.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15450,100,,12360.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15450,100,,12360.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9555.83,61.85,,7644.66,,,0,"percent of total billed charges","61.5% of total billed charges",2595.6,16.8,,2076.48,,,0,"percent of total billed charges","16.8% of total billed charges",7725,50,,6180.00,,,0,"percent of total billed charges","50% of total billed charges",4974.9,32.2,,3979.92,,,0,"percent of total billed charges","32.2% of total billed charges",2595.6,16.8,,2076.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2647.51,17.136,,2118.01,,,0,"percent of total billed charges","17.136% of total billed charges",3374.28,21.84,,2699.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",5824.65,37.7,,4659.72,,,0,"percent of total billed charges","37.7% of total billed charges",5824.65,37.7,,4659.72,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",5237.55,33.9,,4190.04,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",12051,78,,9640.80,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2595.6,16.8,,2076.48,,,0,"percent of total billed charges","16.8% of total billed charges",7725,50,,6180.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2595.6,16.8,,2076.48,,,0,"percent of total billed charges","16.8% of total billed charges",15450,100,,12360.00,,,0,"percent of total billed charges","100% of total billed charges",2363.85,15450,
"MIRO 3D WOUND MATRIX A2025 10X5X2",636A20251052,CDM,636,RC,,,OUTPATIENT,,,23072,14996.8,,20303.36,88,,16242.69,,,0,"percent of total billed charges","88% of total billed charges",11536,50,,9228.80,,,0,"percent of total billed charges","50% of total billed charges",3876.1,16.8,,3100.88,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3992.38,17.304,,3193.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14535.36,63,,11628.29,,,0,"percent of total billed charges","63% of total billed charges",3530.02,15.3,,2824.02,,,0,"percent of total billed charges","15.3% of total billed charges",3876.1,16.8,,3100.88,,,0,"percent of total billed charges","16.8% of total billed charges",15919.68,69,,,,,0,"fee schedule","69% of total billed charges",23072,100,,18457.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23072,100,,18457.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23072,100,,18457.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14270.03,61.85,,11416.02,,,0,"percent of total billed charges","61.5% of total billed charges",3876.1,16.8,,3100.88,,,0,"percent of total billed charges","16.8% of total billed charges",11536,50,,9228.80,,,0,"percent of total billed charges","50% of total billed charges",7429.18,32.2,,5943.34,,,0,"percent of total billed charges","32.2% of total billed charges",3876.1,16.8,,3100.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3953.62,17.136,,3162.90,,,0,"percent of total billed charges","17.136% of total billed charges",5038.92,21.84,,4031.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",8698.14,37.7,,6958.51,,,0,"percent of total billed charges","37.7% of total billed charges",8698.14,37.7,,6958.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",7821.41,33.9,,6257.13,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",17996.16,78,,14396.93,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3876.1,16.8,,3100.88,,,0,"percent of total billed charges","16.8% of total billed charges",11536,50,,9228.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3876.1,16.8,,3100.88,,,0,"percent of total billed charges","16.8% of total billed charges",23072,100,,18457.60,,,0,"percent of total billed charges","100% of total billed charges",3530.02,23072,
"MIROTRACT WOUND MATRIX A2029 3X5",636A202935,CDM,636,RC,,,OUTPATIENT,,,6592,4284.8,,5800.96,88,,4640.77,,,0,"percent of total billed charges","88% of total billed charges",3296,50,,2636.80,,,0,"percent of total billed charges","50% of total billed charges",1107.46,16.8,,885.97,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1140.68,17.304,,912.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4152.96,63,,3322.37,,,0,"percent of total billed charges","63% of total billed charges",1008.58,15.3,,806.86,,,0,"percent of total billed charges","15.3% of total billed charges",1107.46,16.8,,885.97,,,0,"percent of total billed charges","16.8% of total billed charges",4548.48,69,,,,,0,"fee schedule","69% of total billed charges",6592,100,,5273.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6592,100,,5273.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6592,100,,5273.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4077.15,61.85,,3261.72,,,0,"percent of total billed charges","61.5% of total billed charges",1107.46,16.8,,885.97,,,0,"percent of total billed charges","16.8% of total billed charges",3296,50,,2636.80,,,0,"percent of total billed charges","50% of total billed charges",2122.62,32.2,,1698.10,,,0,"percent of total billed charges","32.2% of total billed charges",1107.46,16.8,,885.97,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1129.61,17.136,,903.69,,,0,"percent of total billed charges","17.136% of total billed charges",1439.69,21.84,,1151.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2485.18,37.7,,1988.14,,,0,"percent of total billed charges","37.7% of total billed charges",2485.18,37.7,,1988.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2234.69,33.9,,1787.75,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5141.76,78,,4113.41,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1107.46,16.8,,885.97,,,0,"percent of total billed charges","16.8% of total billed charges",3296,50,,2636.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1107.46,16.8,,885.97,,,0,"percent of total billed charges","16.8% of total billed charges",6592,100,,5273.60,,,0,"percent of total billed charges","100% of total billed charges",1008.58,6592,
"MIROTRACT WOUND MATRIX A2029 3X9",636A202939,CDM,636,RC,,,OUTPATIENT,,,7622,4954.3,,6707.36,88,,5365.89,,,0,"percent of total billed charges","88% of total billed charges",3811,50,,3048.80,,,0,"percent of total billed charges","50% of total billed charges",1280.5,16.8,,1024.40,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1318.91,17.304,,1055.13,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4801.86,63,,3841.49,,,0,"percent of total billed charges","63% of total billed charges",1166.17,15.3,,932.94,,,0,"percent of total billed charges","15.3% of total billed charges",1280.5,16.8,,1024.40,,,0,"percent of total billed charges","16.8% of total billed charges",5259.18,69,,,,,0,"fee schedule","69% of total billed charges",7622,100,,6097.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7622,100,,6097.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7622,100,,6097.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4714.21,61.85,,3771.37,,,0,"percent of total billed charges","61.5% of total billed charges",1280.5,16.8,,1024.40,,,0,"percent of total billed charges","16.8% of total billed charges",3811,50,,3048.80,,,0,"percent of total billed charges","50% of total billed charges",2454.28,32.2,,1963.42,,,0,"percent of total billed charges","32.2% of total billed charges",1280.5,16.8,,1024.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1306.11,17.136,,1044.89,,,0,"percent of total billed charges","17.136% of total billed charges",1664.64,21.84,,1331.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2873.49,37.7,,2298.79,,,0,"percent of total billed charges","37.7% of total billed charges",2873.49,37.7,,2298.79,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2583.86,33.9,,2067.09,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5945.16,78,,4756.13,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1280.5,16.8,,1024.40,,,0,"percent of total billed charges","16.8% of total billed charges",3811,50,,3048.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1280.5,16.8,,1024.40,,,0,"percent of total billed charges","16.8% of total billed charges",7622,100,,6097.60,,,0,"percent of total billed charges","100% of total billed charges",1166.17,7622,
"MIROTRACT WOUND MATRIX A2029 5X5",636A202955,CDM,636,RC,,,OUTPATIENT,,,7004,4552.6,,6163.52,88,,4930.82,,,0,"percent of total billed charges","88% of total billed charges",3502,50,,2801.60,,,0,"percent of total billed charges","50% of total billed charges",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1211.97,17.304,,969.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4412.52,63,,3530.02,,,0,"percent of total billed charges","63% of total billed charges",1071.61,15.3,,857.29,,,0,"percent of total billed charges","15.3% of total billed charges",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",4832.76,69,,,,,0,"fee schedule","69% of total billed charges",7004,100,,5603.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7004,100,,5603.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7004,100,,5603.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4331.97,61.85,,3465.58,,,0,"percent of total billed charges","61.5% of total billed charges",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",3502,50,,2801.60,,,0,"percent of total billed charges","50% of total billed charges",2255.29,32.2,,1804.23,,,0,"percent of total billed charges","32.2% of total billed charges",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1200.21,17.136,,960.17,,,0,"percent of total billed charges","17.136% of total billed charges",1529.67,21.84,,1223.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2640.51,37.7,,2112.41,,,0,"percent of total billed charges","37.7% of total billed charges",2640.51,37.7,,2112.41,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2374.36,33.9,,1899.49,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5463.12,78,,4370.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",3502,50,,2801.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",7004,100,,5603.20,,,0,"percent of total billed charges","100% of total billed charges",1071.61,7004,
"MIROTRACT WOUND MATRIX A2029 5X9",636A202959,CDM,636,RC,,,OUTPATIENT,,,8034,5222.1,,7069.92,88,,5655.94,,,0,"percent of total billed charges","88% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1390.2,17.304,,1112.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5061.42,63,,4049.14,,,0,"percent of total billed charges","63% of total billed charges",1229.2,15.3,,983.36,,,0,"percent of total billed charges","15.3% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",5543.46,69,,,,,0,"fee schedule","69% of total billed charges",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4969.03,61.85,,3975.22,,,0,"percent of total billed charges","61.5% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",2586.95,32.2,,2069.56,,,0,"percent of total billed charges","32.2% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1376.71,17.136,,1101.37,,,0,"percent of total billed charges","17.136% of total billed charges",1754.63,21.84,,1403.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3028.82,37.7,,2423.06,,,0,"percent of total billed charges","37.7% of total billed charges",3028.82,37.7,,2423.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2723.53,33.9,,2178.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6266.52,78,,5013.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",1229.2,8034,
"MIRODRY WOUND MATRIX A2031 3X3",636A203133,CDM,636,RC,,,OUTPATIENT,,,6386,4150.9,,5619.68,88,,4495.74,,,0,"percent of total billed charges","88% of total billed charges",3193,50,,2554.40,,,0,"percent of total billed charges","50% of total billed charges",1072.85,16.8,,858.28,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1105.03,17.304,,884.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4023.18,63,,3218.54,,,0,"percent of total billed charges","63% of total billed charges",977.06,15.3,,781.65,,,0,"percent of total billed charges","15.3% of total billed charges",1072.85,16.8,,858.28,,,0,"percent of total billed charges","16.8% of total billed charges",4406.34,69,,,,,0,"fee schedule","69% of total billed charges",6386,100,,5108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6386,100,,5108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6386,100,,5108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3949.74,61.85,,3159.79,,,0,"percent of total billed charges","61.5% of total billed charges",1072.85,16.8,,858.28,,,0,"percent of total billed charges","16.8% of total billed charges",3193,50,,2554.40,,,0,"percent of total billed charges","50% of total billed charges",2056.29,32.2,,1645.03,,,0,"percent of total billed charges","32.2% of total billed charges",1072.85,16.8,,858.28,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1094.3,17.136,,875.44,,,0,"percent of total billed charges","17.136% of total billed charges",1394.7,21.84,,1115.76,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2407.52,37.7,,1926.02,,,0,"percent of total billed charges","37.7% of total billed charges",2407.52,37.7,,1926.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2164.85,33.9,,1731.88,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4981.08,78,,3984.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1072.85,16.8,,858.28,,,0,"percent of total billed charges","16.8% of total billed charges",3193,50,,2554.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1072.85,16.8,,858.28,,,0,"percent of total billed charges","16.8% of total billed charges",6386,100,,5108.80,,,0,"percent of total billed charges","100% of total billed charges",977.06,6386,
"MIRODRY WOUND MATRIX A2031 4X4",636A203144,CDM,636,RC,,,OUTPATIENT,,,7416,4820.4,,6526.08,88,,5220.86,,,0,"percent of total billed charges","88% of total billed charges",3708,50,,2966.40,,,0,"percent of total billed charges","50% of total billed charges",1245.89,16.8,,996.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1283.26,17.304,,1026.61,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4672.08,63,,3737.66,,,0,"percent of total billed charges","63% of total billed charges",1134.65,15.3,,907.72,,,0,"percent of total billed charges","15.3% of total billed charges",1245.89,16.8,,996.71,,,0,"percent of total billed charges","16.8% of total billed charges",5117.04,69,,,,,0,"fee schedule","69% of total billed charges",7416,100,,5932.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7416,100,,5932.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7416,100,,5932.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4586.8,61.85,,3669.44,,,0,"percent of total billed charges","61.5% of total billed charges",1245.89,16.8,,996.71,,,0,"percent of total billed charges","16.8% of total billed charges",3708,50,,2966.40,,,0,"percent of total billed charges","50% of total billed charges",2387.95,32.2,,1910.36,,,0,"percent of total billed charges","32.2% of total billed charges",1245.89,16.8,,996.71,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.81,17.136,,1016.65,,,0,"percent of total billed charges","17.136% of total billed charges",1619.65,21.84,,1295.72,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2795.83,37.7,,2236.66,,,0,"percent of total billed charges","37.7% of total billed charges",2795.83,37.7,,2236.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2514.02,33.9,,2011.22,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5784.48,78,,4627.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1245.89,16.8,,996.71,,,0,"percent of total billed charges","16.8% of total billed charges",3708,50,,2966.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1245.89,16.8,,996.71,,,0,"percent of total billed charges","16.8% of total billed charges",7416,100,,5932.80,,,0,"percent of total billed charges","100% of total billed charges",1134.65,7416,
"MIRODRY WOUND MATRIX A2031 5X5",636A203155,CDM,636,RC,,,OUTPATIENT,,,11536,7498.4,,10151.68,88,,8121.34,,,0,"percent of total billed charges","88% of total billed charges",5768,50,,4614.40,,,0,"percent of total billed charges","50% of total billed charges",1938.05,16.8,,1550.44,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1996.19,17.304,,1596.95,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7267.68,63,,5814.14,,,0,"percent of total billed charges","63% of total billed charges",1765.01,15.3,,1412.01,,,0,"percent of total billed charges","15.3% of total billed charges",1938.05,16.8,,1550.44,,,0,"percent of total billed charges","16.8% of total billed charges",7959.84,69,,,,,0,"fee schedule","69% of total billed charges",11536,100,,9228.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11536,100,,9228.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11536,100,,9228.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7135.02,61.85,,5708.02,,,0,"percent of total billed charges","61.5% of total billed charges",1938.05,16.8,,1550.44,,,0,"percent of total billed charges","16.8% of total billed charges",5768,50,,4614.40,,,0,"percent of total billed charges","50% of total billed charges",3714.59,32.2,,2971.67,,,0,"percent of total billed charges","32.2% of total billed charges",1938.05,16.8,,1550.44,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1976.81,17.136,,1581.45,,,0,"percent of total billed charges","17.136% of total billed charges",2519.46,21.84,,2015.57,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4349.07,37.7,,3479.26,,,0,"percent of total billed charges","37.7% of total billed charges",4349.07,37.7,,3479.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3910.7,33.9,,3128.56,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",8998.08,78,,7198.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1938.05,16.8,,1550.44,,,0,"percent of total billed charges","16.8% of total billed charges",5768,50,,4614.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1938.05,16.8,,1550.44,,,0,"percent of total billed charges","16.8% of total billed charges",11536,100,,9228.80,,,0,"percent of total billed charges","100% of total billed charges",1765.01,11536,
"MIRODRY WOUND MATRIX A2031 7X5",636A203175,CDM,636,RC,,,OUTPATIENT,,,15244,9908.6,,13414.72,88,,10731.78,,,0,"percent of total billed charges","88% of total billed charges",7622,50,,6097.60,,,0,"percent of total billed charges","50% of total billed charges",2560.99,16.8,,2048.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2637.82,17.304,,2110.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9603.72,63,,7682.98,,,0,"percent of total billed charges","63% of total billed charges",2332.33,15.3,,1865.86,,,0,"percent of total billed charges","15.3% of total billed charges",2560.99,16.8,,2048.79,,,0,"percent of total billed charges","16.8% of total billed charges",10518.36,69,,,,,0,"fee schedule","69% of total billed charges",15244,100,,12195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15244,100,,12195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15244,100,,12195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9428.41,61.85,,7542.73,,,0,"percent of total billed charges","61.5% of total billed charges",2560.99,16.8,,2048.79,,,0,"percent of total billed charges","16.8% of total billed charges",7622,50,,6097.60,,,0,"percent of total billed charges","50% of total billed charges",4908.57,32.2,,3926.86,,,0,"percent of total billed charges","32.2% of total billed charges",2560.99,16.8,,2048.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2612.21,17.136,,2089.77,,,0,"percent of total billed charges","17.136% of total billed charges",3329.29,21.84,,2663.43,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",5746.99,37.7,,4597.59,,,0,"percent of total billed charges","37.7% of total billed charges",5746.99,37.7,,4597.59,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",5167.72,33.9,,4134.18,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",11890.32,78,,9512.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2560.99,16.8,,2048.79,,,0,"percent of total billed charges","16.8% of total billed charges",7622,50,,6097.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2560.99,16.8,,2048.79,,,0,"percent of total billed charges","16.8% of total billed charges",15244,100,,12195.20,,,0,"percent of total billed charges","100% of total billed charges",2332.33,15244,
"MISTY FAST SMALL-VOLUME NEBULIZER",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"MITRAL VALVE SS#81217115",ORSUP0080,CDM,278,RC,,,OUTPATIENT,,,18746,12184.9,,16496.48,88,,13197.18,,,0,"percent of total billed charges","88% of total billed charges",9373,50,,7498.40,,,0,"percent of total billed charges","50% of total billed charges",3149.33,16.8,,2519.46,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3243.81,17.304,,2595.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11809.98,63,,9447.98,,,0,"percent of total billed charges","63% of total billed charges",2868.14,15.3,,2294.51,,,0,"percent of total billed charges","15.3% of total billed charges",3149.33,16.8,,2519.46,,,0,"percent of total billed charges","16.8% of total billed charges",12934.74,69,,,,,0,"fee schedule","69% of total billed charges",18746,100,,14996.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18746,100,,14996.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18746,100,,14996.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11594.4,61.85,,9275.52,,,0,"percent of total billed charges","61.5% of total billed charges",3149.33,16.8,,2519.46,,,0,"percent of total billed charges","16.8% of total billed charges",9373,50,,7498.40,,,0,"percent of total billed charges","50% of total billed charges",6036.21,32.2,,4828.97,,,0,"percent of total billed charges","32.2% of total billed charges",5848.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3212.31,17.136,,2569.85,,,0,"percent of total billed charges","17.136% of total billed charges",4094.13,21.84,,3275.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",7067.24,37.7,,5653.79,,,0,"percent of total billed charges","37.7% of total billed charges",7067.24,37.7,,5653.79,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",6354.89,33.9,,5083.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",14621.88,78,,11697.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15484.2,82.6,,12387.36,,,0,"percent of total billed charges","82.6% of total billed charges",3149.33,16.8,,2519.46,,,0,"percent of total billed charges","16.8% of total billed charges",9373,50,,7498.40,,,0,"percent of total billed charges","50% of total billed charges",15484.2,82.6,,12387.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3149.33,16.8,,2519.46,,,0,"percent of total billed charges","16.8% of total billed charges",18746,100,,14996.80,,,0,"percent of total billed charges","100% of total billed charges",2868.14,18746,
"MIXING BOWL W/SPATULA",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"MIXING BOWL VACUUM",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"MIXING BAR SPIRAL",ORSUP0018,CDM,272,RC,,,OUTPATIENT,,,1494,971.1,,1314.72,88,,1051.78,,,0,"percent of total billed charges","88% of total billed charges",747,50,,597.60,,,0,"percent of total billed charges","50% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.52,17.304,,206.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",941.22,63,,752.98,,,0,"percent of total billed charges","63% of total billed charges",228.58,15.3,,182.86,,,0,"percent of total billed charges","15.3% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",1030.86,69,,,,,0,"fee schedule","69% of total billed charges",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",924.04,61.85,,739.23,,,0,"percent of total billed charges","61.5% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",747,50,,597.60,,,0,"percent of total billed charges","50% of total billed charges",481.07,32.2,,384.86,,,0,"percent of total billed charges","32.2% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",256.01,17.136,,204.81,,,0,"percent of total billed charges","17.136% of total billed charges",326.29,21.84,,261.03,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",563.24,37.7,,450.59,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1165.32,78,,932.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1234.04,82.6,,987.23,,,0,"percent of total billed charges","82.6% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",747,50,,597.60,,,0,"percent of total billed charges","50% of total billed charges",1234.04,82.6,,987.23,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",228.58,1494,
"MLA TIPS 1-5 ML",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"MLA TIPS 10-200",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"MLA TIPS 201-1000",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"MODULE OPEN HEART",ORSUP0018,CDM,270,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"MOISTURIZER MOUTH .5 OZ",80175,CDM,272,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"MOJAVE CAMEL MAT MAXIMUM ADSORBENT LARGE",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"MOLE MARKER",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"MONOCRYL 0 CT1 Y346H",207894,CDM,272,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"MONOCRYL PLUS UD 3-0 27 PS-1",241144,CDM,272,RC,,,OUTPATIENT,,,48,31.2,,42.24,88,,33.79,,,0,"percent of total billed charges","88% of total billed charges",24,50,,19.20,,,0,"percent of total billed charges","50% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.31,17.304,,6.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.24,63,,24.19,,,0,"percent of total billed charges","63% of total billed charges",7.34,15.3,,5.87,,,0,"percent of total billed charges","15.3% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",33.12,69,,,,,0,"fee schedule","69% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.69,61.85,,23.75,,,0,"percent of total billed charges","61.5% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",24,50,,19.20,,,0,"percent of total billed charges","50% of total billed charges",15.46,32.2,,12.37,,,0,"percent of total billed charges","32.2% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.23,17.136,,6.58,,,0,"percent of total billed charges","17.136% of total billed charges",10.48,21.84,,8.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.1,37.7,,14.48,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",37.44,78,,29.95,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.65,82.6,,31.72,,,0,"percent of total billed charges","82.6% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",24,50,,19.20,,,0,"percent of total billed charges","50% of total billed charges",39.65,82.6,,31.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",7.34,48,
"MONOCRYL 0 SH (Y318H)",490910,CDM,272,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"MONOCRYL 3-0 PS-2 (Y427H)",490911,CDM,272,RC,,,OUTPATIENT,,,44,28.6,,38.72,88,,30.98,,,0,"percent of total billed charges","88% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.61,17.304,,6.09,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.72,63,,22.18,,,0,"percent of total billed charges","63% of total billed charges",6.73,15.3,,5.38,,,0,"percent of total billed charges","15.3% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",30.36,69,,,,,0,"fee schedule","69% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.21,61.85,,21.77,,,0,"percent of total billed charges","61.5% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",14.17,32.2,,11.34,,,0,"percent of total billed charges","32.2% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.54,17.136,,6.03,,,0,"percent of total billed charges","17.136% of total billed charges",9.61,21.84,,7.69,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.59,37.7,,13.27,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.32,78,,27.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",6.73,44,
"MONOCRYL 3-0 SH (Y316H)",490912,CDM,272,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"MONOCRYL 4-0 P-3 (Y494G)",490913,CDM,272,RC,,,OUTPATIENT,,,44,28.6,,38.72,88,,30.98,,,0,"percent of total billed charges","88% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.61,17.304,,6.09,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.72,63,,22.18,,,0,"percent of total billed charges","63% of total billed charges",6.73,15.3,,5.38,,,0,"percent of total billed charges","15.3% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",30.36,69,,,,,0,"fee schedule","69% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.21,61.85,,21.77,,,0,"percent of total billed charges","61.5% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",14.17,32.2,,11.34,,,0,"percent of total billed charges","32.2% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.54,17.136,,6.03,,,0,"percent of total billed charges","17.136% of total billed charges",9.61,21.84,,7.69,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.59,37.7,,13.27,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.32,78,,27.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",6.73,44,
"MONOCRYL 4-0 PS-2 (Y496G)",490914,CDM,272,RC,,,OUTPATIENT,,,44,28.6,,38.72,88,,30.98,,,0,"percent of total billed charges","88% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.61,17.304,,6.09,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.72,63,,22.18,,,0,"percent of total billed charges","63% of total billed charges",6.73,15.3,,5.38,,,0,"percent of total billed charges","15.3% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",30.36,69,,,,,0,"fee schedule","69% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.21,61.85,,21.77,,,0,"percent of total billed charges","61.5% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",14.17,32.2,,11.34,,,0,"percent of total billed charges","32.2% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.54,17.136,,6.03,,,0,"percent of total billed charges","17.136% of total billed charges",9.61,21.84,,7.69,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.59,37.7,,13.27,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.32,78,,27.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",6.73,44,
"MONODERM 2-0 (YA-2024Q)",490915,CDM,272,RC,,,OUTPATIENT,,,269,174.85,,236.72,88,,189.38,,,0,"percent of total billed charges","88% of total billed charges",134.5,50,,107.60,,,0,"percent of total billed charges","50% of total billed charges",45.19,16.8,,36.15,,,0,"percent of total billed charges","16.8% of total billed charges",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.55,17.304,,37.24,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",169.47,63,,135.58,,,0,"percent of total billed charges","63% of total billed charges",41.16,15.3,,32.93,,,0,"percent of total billed charges","15.3% of total billed charges",45.19,16.8,,36.15,,,0,"percent of total billed charges","16.8% of total billed charges",185.61,69,,,,,0,"fee schedule","69% of total billed charges",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.38,61.85,,133.10,,,0,"percent of total billed charges","61.5% of total billed charges",45.19,16.8,,36.15,,,0,"percent of total billed charges","16.8% of total billed charges",134.5,50,,107.60,,,0,"percent of total billed charges","50% of total billed charges",86.62,32.2,,69.30,,,0,"percent of total billed charges","32.2% of total billed charges",45.19,16.8,,36.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.1,17.136,,36.88,,,0,"percent of total billed charges","17.136% of total billed charges",58.75,21.84,,47.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.41,37.7,,81.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.82,78,,167.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",222.19,82.6,,177.75,,,0,"percent of total billed charges","82.6% of total billed charges",45.19,16.8,,36.15,,,0,"percent of total billed charges","16.8% of total billed charges",134.5,50,,107.60,,,0,"percent of total billed charges","50% of total billed charges",222.19,82.6,,177.75,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.19,16.8,,36.15,,,0,"percent of total billed charges","16.8% of total billed charges",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",41.16,269,
"MONO RAPID TEST KIT",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"MONOPOLAR CURVED SCISSOR",ORSUP0019,CDM,272,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"MONOJECT TRACE CHEMOTHERAPY CONTAINER HINGED LID YELLOW 12GL",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"MONSEL'S SOLUTION",490916,CDM,270,RC,,,OUTPATIENT,,,101,65.65,,88.88,88,,71.10,,,0,"percent of total billed charges","88% of total billed charges",50.5,50,,40.40,,,0,"percent of total billed charges","50% of total billed charges",16.97,16.8,,13.58,,,0,"percent of total billed charges","16.8% of total billed charges",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.48,17.304,,13.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.63,63,,50.90,,,0,"percent of total billed charges","63% of total billed charges",15.45,15.3,,12.36,,,0,"percent of total billed charges","15.3% of total billed charges",16.97,16.8,,13.58,,,0,"percent of total billed charges","16.8% of total billed charges",69.69,69,,,,,0,"fee schedule","69% of total billed charges",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,61.85,,49.98,,,0,"percent of total billed charges","61.5% of total billed charges",16.97,16.8,,13.58,,,0,"percent of total billed charges","16.8% of total billed charges",50.5,50,,40.40,,,0,"percent of total billed charges","50% of total billed charges",32.52,32.2,,26.02,,,0,"percent of total billed charges","32.2% of total billed charges",16.97,16.8,,13.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.31,17.136,,13.85,,,0,"percent of total billed charges","17.136% of total billed charges",22.06,21.84,,17.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.08,37.7,,30.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",78.78,78,,63.02,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",83.43,82.6,,66.74,,,0,"percent of total billed charges","82.6% of total billed charges",16.97,16.8,,13.58,,,0,"percent of total billed charges","16.8% of total billed charges",50.5,50,,40.40,,,0,"percent of total billed charges","50% of total billed charges",83.43,82.6,,66.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.97,16.8,,13.58,,,0,"percent of total billed charges","16.8% of total billed charges",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",15.45,101,
"MOP HEAD, MICROFIBER",490917,CDM,270,RC,,,OUTPATIENT,,,28,18.2,,24.64,88,,19.71,,,0,"percent of total billed charges","88% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.85,17.304,,3.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.64,63,,14.11,,,0,"percent of total billed charges","63% of total billed charges",4.28,15.3,,3.42,,,0,"percent of total billed charges","15.3% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",19.32,69,,,,,0,"fee schedule","69% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.32,61.85,,13.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",9.02,32.2,,7.22,,,0,"percent of total billed charges","32.2% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.8,17.136,,3.84,,,0,"percent of total billed charges","17.136% of total billed charges",6.12,21.84,,4.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.56,37.7,,8.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.84,78,,17.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",4.28,28,
"MOUTHPIECE EZ GUARD",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"MOUTHWASH 2OZ  96/CS",175451,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"MOUTHWASH NON-ALCOHOLIC 4 OZ",168903,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"MOUTH PROP LARGE ADULT DISP",490918,CDM,270,RC,,,OUTPATIENT,,,54,35.1,,47.52,88,,38.02,,,0,"percent of total billed charges","88% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.34,17.304,,7.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.02,63,,27.22,,,0,"percent of total billed charges","63% of total billed charges",8.26,15.3,,6.61,,,0,"percent of total billed charges","15.3% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",37.26,69,,,,,0,"fee schedule","69% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.4,61.85,,26.72,,,0,"percent of total billed charges","61.5% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",17.39,32.2,,13.91,,,0,"percent of total billed charges","32.2% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.25,17.136,,7.40,,,0,"percent of total billed charges","17.136% of total billed charges",11.79,21.84,,9.43,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.36,37.7,,16.29,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",42.12,78,,33.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.6,82.6,,35.68,,,0,"percent of total billed charges","82.6% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",44.6,82.6,,35.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",8.26,54,
"MRI DUAL SYRINGE PACK",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"MRI MAGNA PLUS",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2060,1339,,1812.8,88,,1450.24,,,0,"percent of total billed charges","88% of total billed charges",1030,50,,824.00,,,0,"percent of total billed charges","50% of total billed charges",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",356.46,17.304,,285.17,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1297.8,63,,1038.24,,,0,"percent of total billed charges","63% of total billed charges",315.18,15.3,,252.14,,,0,"percent of total billed charges","15.3% of total billed charges",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",1421.4,69,,,,,0,"fee schedule","69% of total billed charges",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1274.11,61.85,,1019.29,,,0,"percent of total billed charges","61.5% of total billed charges",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",1030,50,,824.00,,,0,"percent of total billed charges","50% of total billed charges",663.32,32.2,,530.66,,,0,"percent of total billed charges","32.2% of total billed charges",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",353,17.136,,282.40,,,0,"percent of total billed charges","17.136% of total billed charges",449.9,21.84,,359.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",776.62,37.7,,621.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1606.8,78,,1285.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1701.56,82.6,,1361.25,,,0,"percent of total billed charges","82.6% of total billed charges",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",1030,50,,824.00,,,0,"percent of total billed charges","50% of total billed charges",1701.56,82.6,,1361.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",346.08,16.8,,276.86,,,0,"percent of total billed charges","16.8% of total billed charges",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",315.18,2060,
"MRSA SELECT",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"MRSA NXG IVD GX",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"MTS BUFFRD GEL CARD 5 X 20",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"MTS ABD MONO GROUP 5 X 20",ORSUP0027,CDM,272,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"MTS PROVUE ROUND DILUENT 2+",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"MUCOUS SPECIMEN TRAP SUCTION",490919,CDM,270,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.95,61.85,,3.96,,,0,"percent of total billed charges","61.5% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"MUCOSAL ATOMIZER  3ML SYRINGE",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"MUCUS/SPECIMEN TRAP 10FR STERILE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"MULTIQUAL UNASSYD 1",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"MULTIQUAL UNASSYD 3",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"MULTI HOLE 3.0 LIPO CANNULA",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,17.304,,49.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.28,61.85,,178.62,,,0,"percent of total billed charges","61.5% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",116.24,32.2,,92.99,,,0,"percent of total billed charges","32.2% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.86,17.136,,49.49,,,0,"percent of total billed charges","17.136% of total billed charges",78.84,21.84,,63.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,361,
"MULTI HOLE CANNULA",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,17.304,,49.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.28,61.85,,178.62,,,0,"percent of total billed charges","61.5% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",116.24,32.2,,92.99,,,0,"percent of total billed charges","32.2% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.86,17.136,,49.49,,,0,"percent of total billed charges","17.136% of total billed charges",78.84,21.84,,63.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,361,
"MUREX PYR W/REAGENT 100/PK",ORSUP0011,CDM,270,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"MUSTANG OVER THE WIRE 5FR 4.0MM X 20MM 135CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"MYCOBACTERIA ANTIBIOTIC SUPPLE",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"MYLAR CIAD HT TUBES",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"MYOSURE TISSUE REMOVAL",ORSUP0046,CDM,270,RC,,,OUTPATIENT,,,7210,4686.5,,6344.8,88,,5075.84,,,0,"percent of total billed charges","88% of total billed charges",3605,50,,2884.00,,,0,"percent of total billed charges","50% of total billed charges",1211.28,16.8,,969.02,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1247.62,17.304,,998.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4542.3,63,,3633.84,,,0,"percent of total billed charges","63% of total billed charges",1103.13,15.3,,882.50,,,0,"percent of total billed charges","15.3% of total billed charges",1211.28,16.8,,969.02,,,0,"percent of total billed charges","16.8% of total billed charges",4974.9,69,,,,,0,"fee schedule","69% of total billed charges",7210,100,,5768.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7210,100,,5768.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7210,100,,5768.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4459.39,61.85,,3567.51,,,0,"percent of total billed charges","61.5% of total billed charges",1211.28,16.8,,969.02,,,0,"percent of total billed charges","16.8% of total billed charges",3605,50,,2884.00,,,0,"percent of total billed charges","50% of total billed charges",2321.62,32.2,,1857.30,,,0,"percent of total billed charges","32.2% of total billed charges",1211.28,16.8,,969.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1235.51,17.136,,988.41,,,0,"percent of total billed charges","17.136% of total billed charges",1574.66,21.84,,1259.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2718.17,37.7,,2174.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5623.8,78,,4499.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5955.46,82.6,,4764.37,,,0,"percent of total billed charges","82.6% of total billed charges",1211.28,16.8,,969.02,,,0,"percent of total billed charges","16.8% of total billed charges",3605,50,,2884.00,,,0,"percent of total billed charges","50% of total billed charges",5955.46,82.6,,4764.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1211.28,16.8,,969.02,,,0,"percent of total billed charges","16.8% of total billed charges",7210,100,,5768.00,,,0,"percent of total billed charges","100% of total billed charges",1103.13,7210,
"MYOSURE LITE TISSUE REMOVAL DEVICE",ORSUP0029,CDM,272,RC,,,OUTPATIENT,,,3708,2410.2,,3263.04,88,,2610.43,,,0,"percent of total billed charges","88% of total billed charges",1854,50,,1483.20,,,0,"percent of total billed charges","50% of total billed charges",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",3708,100,,2966.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",641.63,17.304,,513.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2336.04,63,,1868.83,,,0,"percent of total billed charges","63% of total billed charges",567.32,15.3,,453.86,,,0,"percent of total billed charges","15.3% of total billed charges",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",2558.52,69,,,,,0,"fee schedule","69% of total billed charges",3708,100,,2966.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3708,100,,2966.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3708,100,,2966.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2293.4,61.85,,1834.72,,,0,"percent of total billed charges","61.5% of total billed charges",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",1854,50,,1483.20,,,0,"percent of total billed charges","50% of total billed charges",1193.98,32.2,,955.18,,,0,"percent of total billed charges","32.2% of total billed charges",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",635.4,17.136,,508.32,,,0,"percent of total billed charges","17.136% of total billed charges",809.83,21.84,,647.86,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1397.92,37.7,,1118.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2892.24,78,,2313.79,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3062.81,82.6,,2450.25,,,0,"percent of total billed charges","82.6% of total billed charges",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",1854,50,,1483.20,,,0,"percent of total billed charges","50% of total billed charges",3062.81,82.6,,2450.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",3708,100,,2966.40,,,0,"percent of total billed charges","100% of total billed charges",567.32,3708,
"MYOSURE XL",ORSUP0113,CDM,272,RC,,,OUTPATIENT,,,21218,13791.7,,18671.84,88,,14937.47,,,0,"percent of total billed charges","88% of total billed charges",10609,50,,8487.20,,,0,"percent of total billed charges","50% of total billed charges",3564.62,16.8,,2851.70,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3671.56,17.304,,2937.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13367.34,63,,10693.87,,,0,"percent of total billed charges","63% of total billed charges",3246.35,15.3,,2597.08,,,0,"percent of total billed charges","15.3% of total billed charges",3564.62,16.8,,2851.70,,,0,"percent of total billed charges","16.8% of total billed charges",14640.42,69,,,,,0,"fee schedule","69% of total billed charges",21218,100,,16974.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21218,100,,16974.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21218,100,,16974.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13123.33,61.85,,10498.66,,,0,"percent of total billed charges","61.5% of total billed charges",3564.62,16.8,,2851.70,,,0,"percent of total billed charges","16.8% of total billed charges",10609,50,,8487.20,,,0,"percent of total billed charges","50% of total billed charges",6832.2,32.2,,5465.76,,,0,"percent of total billed charges","32.2% of total billed charges",3564.62,16.8,,2851.70,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3635.92,17.136,,2908.74,,,0,"percent of total billed charges","17.136% of total billed charges",4634.01,21.84,,3707.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7999.19,37.7,,6399.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16550.04,78,,13240.03,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17526.07,82.6,,14020.86,,,0,"percent of total billed charges","82.6% of total billed charges",3564.62,16.8,,2851.70,,,0,"percent of total billed charges","16.8% of total billed charges",10609,50,,8487.20,,,0,"percent of total billed charges","50% of total billed charges",17526.07,82.6,,14020.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3564.62,16.8,,2851.70,,,0,"percent of total billed charges","16.8% of total billed charges",21218,100,,16974.40,,,0,"percent of total billed charges","100% of total billed charges",3246.35,21218,
"NA MEMBRANE",ORSUP0024,CDM,270,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"NA+ ELECTRODE",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"NAIL 12MM TI CANNUL TIBIAL 300MM-STERILE",ORSUP0040,CDM,278,RC,,,OUTPATIENT,,,7766,5047.9,,6834.08,88,,5467.26,,,0,"percent of total billed charges","88% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1343.83,17.304,,1075.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4892.58,63,,3914.06,,,0,"percent of total billed charges","63% of total billed charges",1188.2,15.3,,950.56,,,0,"percent of total billed charges","15.3% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",5358.54,69,,,,,0,"fee schedule","69% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4803.27,61.85,,3842.62,,,0,"percent of total billed charges","61.5% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",2500.65,32.2,,2000.52,,,0,"percent of total billed charges","32.2% of total billed charges",2422.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1330.78,17.136,,1064.62,,,0,"percent of total billed charges","17.136% of total billed charges",1696.09,21.84,,1356.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2927.78,37.7,,2342.22,,,0,"percent of total billed charges","37.7% of total billed charges",2927.78,37.7,,2342.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2632.67,33.9,,2106.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6057.48,78,,4845.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",1188.2,7766,
"NAIL CANN",ORSUP0048,CDM,278,RC,,,OUTPATIENT,,,9909,6440.85,,8719.92,88,,6975.94,,,0,"percent of total billed charges","88% of total billed charges",4954.5,50,,3963.60,,,0,"percent of total billed charges","50% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1714.65,17.304,,1371.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6242.67,63,,4994.14,,,0,"percent of total billed charges","63% of total billed charges",1516.08,15.3,,1212.86,,,0,"percent of total billed charges","15.3% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",6837.21,69,,,,,0,"fee schedule","69% of total billed charges",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6128.72,61.85,,4902.98,,,0,"percent of total billed charges","61.5% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",4954.5,50,,3963.60,,,0,"percent of total billed charges","50% of total billed charges",3190.7,32.2,,2552.56,,,0,"percent of total billed charges","32.2% of total billed charges",3091.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1698.01,17.136,,1358.41,,,0,"percent of total billed charges","17.136% of total billed charges",2164.13,21.84,,1731.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3735.69,37.7,,2988.55,,,0,"percent of total billed charges","37.7% of total billed charges",3735.69,37.7,,2988.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3359.15,33.9,,2687.32,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7729.02,78,,6183.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8184.83,82.6,,6547.86,,,0,"percent of total billed charges","82.6% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",4954.5,50,,3963.60,,,0,"percent of total billed charges","50% of total billed charges",8184.83,82.6,,6547.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",1516.08,9909,
"NAIL FIX 12MM /125 DEG 170MM",ORSUP0039,CDM,278,RC,,,OUTPATIENT,,,7498,4873.7,,6598.24,88,,5278.59,,,0,"percent of total billed charges","88% of total billed charges",3749,50,,2999.20,,,0,"percent of total billed charges","50% of total billed charges",1259.66,16.8,,1007.73,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1297.45,17.304,,1037.96,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4723.74,63,,3778.99,,,0,"percent of total billed charges","63% of total billed charges",1147.19,15.3,,917.75,,,0,"percent of total billed charges","15.3% of total billed charges",1259.66,16.8,,1007.73,,,0,"percent of total billed charges","16.8% of total billed charges",5173.62,69,,,,,0,"fee schedule","69% of total billed charges",7498,100,,5998.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7498,100,,5998.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7498,100,,5998.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4637.51,61.85,,3710.01,,,0,"percent of total billed charges","61.5% of total billed charges",1259.66,16.8,,1007.73,,,0,"percent of total billed charges","16.8% of total billed charges",3749,50,,2999.20,,,0,"percent of total billed charges","50% of total billed charges",2414.36,32.2,,1931.49,,,0,"percent of total billed charges","32.2% of total billed charges",2339.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1284.86,17.136,,1027.89,,,0,"percent of total billed charges","17.136% of total billed charges",1637.56,21.84,,1310.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2826.75,37.7,,2261.40,,,0,"percent of total billed charges","37.7% of total billed charges",2826.75,37.7,,2261.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2541.82,33.9,,2033.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5848.44,78,,4678.75,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6193.35,82.6,,4954.68,,,0,"percent of total billed charges","82.6% of total billed charges",1259.66,16.8,,1007.73,,,0,"percent of total billed charges","16.8% of total billed charges",3749,50,,2999.20,,,0,"percent of total billed charges","50% of total billed charges",6193.35,82.6,,4954.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1259.66,16.8,,1007.73,,,0,"percent of total billed charges","16.8% of total billed charges",7498,100,,5998.40,,,0,"percent of total billed charges","100% of total billed charges",1147.19,7498,
"NAIL FIXATION CANN TROCH TI 11MM/130 170MM",ORSUP0039,CDM,278,RC,,,OUTPATIENT,,,7498,4873.7,,6598.24,88,,5278.59,,,0,"percent of total billed charges","88% of total billed charges",3749,50,,2999.20,,,0,"percent of total billed charges","50% of total billed charges",1259.66,16.8,,1007.73,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1297.45,17.304,,1037.96,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4723.74,63,,3778.99,,,0,"percent of total billed charges","63% of total billed charges",1147.19,15.3,,917.75,,,0,"percent of total billed charges","15.3% of total billed charges",1259.66,16.8,,1007.73,,,0,"percent of total billed charges","16.8% of total billed charges",5173.62,69,,,,,0,"fee schedule","69% of total billed charges",7498,100,,5998.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7498,100,,5998.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7498,100,,5998.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4637.51,61.85,,3710.01,,,0,"percent of total billed charges","61.5% of total billed charges",1259.66,16.8,,1007.73,,,0,"percent of total billed charges","16.8% of total billed charges",3749,50,,2999.20,,,0,"percent of total billed charges","50% of total billed charges",2414.36,32.2,,1931.49,,,0,"percent of total billed charges","32.2% of total billed charges",2339.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1284.86,17.136,,1027.89,,,0,"percent of total billed charges","17.136% of total billed charges",1637.56,21.84,,1310.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2826.75,37.7,,2261.40,,,0,"percent of total billed charges","37.7% of total billed charges",2826.75,37.7,,2261.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2541.82,33.9,,2033.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5848.44,78,,4678.75,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6193.35,82.6,,4954.68,,,0,"percent of total billed charges","82.6% of total billed charges",1259.66,16.8,,1007.73,,,0,"percent of total billed charges","16.8% of total billed charges",3749,50,,2999.20,,,0,"percent of total billed charges","50% of total billed charges",6193.35,82.6,,4954.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1259.66,16.8,,1007.73,,,0,"percent of total billed charges","16.8% of total billed charges",7498,100,,5998.40,,,0,"percent of total billed charges","100% of total billed charges",1147.19,7498,
"NAIL IM L285MM OD9MM TIB",ORSUP0041,CDM,278,RC,,,OUTPATIENT,,,8034,5222.1,,7069.92,88,,5655.94,,,0,"percent of total billed charges","88% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1390.2,17.304,,1112.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5061.42,63,,4049.14,,,0,"percent of total billed charges","63% of total billed charges",1229.2,15.3,,983.36,,,0,"percent of total billed charges","15.3% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",5543.46,69,,,,,0,"fee schedule","69% of total billed charges",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4969.03,61.85,,3975.22,,,0,"percent of total billed charges","61.5% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",2586.95,32.2,,2069.56,,,0,"percent of total billed charges","32.2% of total billed charges",2506.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1376.71,17.136,,1101.37,,,0,"percent of total billed charges","17.136% of total billed charges",1754.63,21.84,,1403.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3028.82,37.7,,2423.06,,,0,"percent of total billed charges","37.7% of total billed charges",3028.82,37.7,,2423.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2723.53,33.9,,2178.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6266.52,78,,5013.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6636.08,82.6,,5308.86,,,0,"percent of total billed charges","82.6% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",6636.08,82.6,,5308.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",1229.2,8034,
"NAIL IM L315MM OD11MM TIB",ORSUP0042,CDM,278,RC,,,OUTPATIENT,,,8302,5396.3,,7305.76,88,,5844.61,,,0,"percent of total billed charges","88% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1436.58,17.304,,1149.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5230.26,63,,4184.21,,,0,"percent of total billed charges","63% of total billed charges",1270.21,15.3,,1016.17,,,0,"percent of total billed charges","15.3% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",5728.38,69,,,,,0,"fee schedule","69% of total billed charges",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5134.79,61.85,,4107.83,,,0,"percent of total billed charges","61.5% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",2673.24,32.2,,2138.59,,,0,"percent of total billed charges","32.2% of total billed charges",2590.22,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1422.63,17.136,,1138.10,,,0,"percent of total billed charges","17.136% of total billed charges",1813.16,21.84,,1450.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3129.85,37.7,,2503.88,,,0,"percent of total billed charges","37.7% of total billed charges",3129.85,37.7,,2503.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2814.38,33.9,,2251.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6475.56,78,,5180.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6857.45,82.6,,5485.96,,,0,"percent of total billed charges","82.6% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",6857.45,82.6,,5485.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",1270.21,8302,
"NAIL IM L315MM OD9MM TIB",ORSUP0043,CDM,278,RC,,,OUTPATIENT,,,8570,5570.5,,7541.6,88,,6033.28,,,0,"percent of total billed charges","88% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1482.95,17.304,,1186.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5399.1,63,,4319.28,,,0,"percent of total billed charges","63% of total billed charges",1311.21,15.3,,1048.97,,,0,"percent of total billed charges","15.3% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",5913.3,69,,,,,0,"fee schedule","69% of total billed charges",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5300.55,61.85,,4240.44,,,0,"percent of total billed charges","61.5% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",2759.54,32.2,,2207.63,,,0,"percent of total billed charges","32.2% of total billed charges",2673.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1468.56,17.136,,1174.85,,,0,"percent of total billed charges","17.136% of total billed charges",1871.69,21.84,,1497.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3230.89,37.7,,2584.71,,,0,"percent of total billed charges","37.7% of total billed charges",3230.89,37.7,,2584.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2905.23,33.9,,2324.18,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6684.6,78,,5347.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7078.82,82.6,,5663.06,,,0,"percent of total billed charges","82.6% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",7078.82,82.6,,5663.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",1311.21,8570,
"NAIL IM L360MM OD9MM TIB",ORSUP0049,CDM,278,RC,,,OUTPATIENT,,,10176,6614.4,,8954.88,88,,7163.90,,,0,"percent of total billed charges","88% of total billed charges",5088,50,,4070.40,,,0,"percent of total billed charges","50% of total billed charges",1709.57,16.8,,1367.66,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1760.86,17.304,,1408.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6410.88,63,,5128.70,,,0,"percent of total billed charges","63% of total billed charges",1556.93,15.3,,1245.54,,,0,"percent of total billed charges","15.3% of total billed charges",1709.57,16.8,,1367.66,,,0,"percent of total billed charges","16.8% of total billed charges",7021.44,69,,,,,0,"fee schedule","69% of total billed charges",10176,100,,8140.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10176,100,,8140.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10176,100,,8140.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6293.86,61.85,,5035.09,,,0,"percent of total billed charges","61.5% of total billed charges",1709.57,16.8,,1367.66,,,0,"percent of total billed charges","16.8% of total billed charges",5088,50,,4070.40,,,0,"percent of total billed charges","50% of total billed charges",3276.67,32.2,,2621.34,,,0,"percent of total billed charges","32.2% of total billed charges",3174.91,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1743.76,17.136,,1395.01,,,0,"percent of total billed charges","17.136% of total billed charges",2222.44,21.84,,1777.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3836.35,37.7,,3069.08,,,0,"percent of total billed charges","37.7% of total billed charges",3836.35,37.7,,3069.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3449.66,33.9,,2759.73,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7937.28,78,,6349.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8405.38,82.6,,6724.30,,,0,"percent of total billed charges","82.6% of total billed charges",1709.57,16.8,,1367.66,,,0,"percent of total billed charges","16.8% of total billed charges",5088,50,,4070.40,,,0,"percent of total billed charges","50% of total billed charges",8405.38,82.6,,6724.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1709.57,16.8,,1367.66,,,0,"percent of total billed charges","16.8% of total billed charges",10176,100,,8140.80,,,0,"percent of total billed charges","100% of total billed charges",1556.93,10176,
"NAIL IM L375MM OD11MM TIB",ORSUP0040,CDM,278,RC,,,OUTPATIENT,,,7766,5047.9,,6834.08,88,,5467.26,,,0,"percent of total billed charges","88% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1343.83,17.304,,1075.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4892.58,63,,3914.06,,,0,"percent of total billed charges","63% of total billed charges",1188.2,15.3,,950.56,,,0,"percent of total billed charges","15.3% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",5358.54,69,,,,,0,"fee schedule","69% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4803.27,61.85,,3842.62,,,0,"percent of total billed charges","61.5% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",2500.65,32.2,,2000.52,,,0,"percent of total billed charges","32.2% of total billed charges",2422.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1330.78,17.136,,1064.62,,,0,"percent of total billed charges","17.136% of total billed charges",1696.09,21.84,,1356.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2927.78,37.7,,2342.22,,,0,"percent of total billed charges","37.7% of total billed charges",2927.78,37.7,,2342.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2632.67,33.9,,2106.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6057.48,78,,4845.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",1188.2,7766,
"NAIL IM TI L270MM OD9MM NAIL-EX TIB CNULA STRL",ORSUP0040,CDM,278,RC,,,OUTPATIENT,,,7766,5047.9,,6834.08,88,,5467.26,,,0,"percent of total billed charges","88% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1343.83,17.304,,1075.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4892.58,63,,3914.06,,,0,"percent of total billed charges","63% of total billed charges",1188.2,15.3,,950.56,,,0,"percent of total billed charges","15.3% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",5358.54,69,,,,,0,"fee schedule","69% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4803.27,61.85,,3842.62,,,0,"percent of total billed charges","61.5% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",2500.65,32.2,,2000.52,,,0,"percent of total billed charges","32.2% of total billed charges",2422.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1330.78,17.136,,1064.62,,,0,"percent of total billed charges","17.136% of total billed charges",1696.09,21.84,,1356.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2927.78,37.7,,2342.22,,,0,"percent of total billed charges","37.7% of total billed charges",2927.78,37.7,,2342.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2632.67,33.9,,2106.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6057.48,78,,4845.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",1188.2,7766,
"NAIL TIBIAL 10MM TI CANNULATED - EX/330MM",ORSUP0041,CDM,278,RC,,,OUTPATIENT,,,8034,5222.1,,7069.92,88,,5655.94,,,0,"percent of total billed charges","88% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1390.2,17.304,,1112.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5061.42,63,,4049.14,,,0,"percent of total billed charges","63% of total billed charges",1229.2,15.3,,983.36,,,0,"percent of total billed charges","15.3% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",5543.46,69,,,,,0,"fee schedule","69% of total billed charges",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4969.03,61.85,,3975.22,,,0,"percent of total billed charges","61.5% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",2586.95,32.2,,2069.56,,,0,"percent of total billed charges","32.2% of total billed charges",2506.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1376.71,17.136,,1101.37,,,0,"percent of total billed charges","17.136% of total billed charges",1754.63,21.84,,1403.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3028.82,37.7,,2423.06,,,0,"percent of total billed charges","37.7% of total billed charges",3028.82,37.7,,2423.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2723.53,33.9,,2178.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6266.52,78,,5013.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6636.08,82.6,,5308.86,,,0,"percent of total billed charges","82.6% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",6636.08,82.6,,5308.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",1229.2,8034,
"NAIL TIBIAL 10MM TI CANNULATED - EX/360MM",ORSUP0041,CDM,278,RC,,,OUTPATIENT,,,8034,5222.1,,7069.92,88,,5655.94,,,0,"percent of total billed charges","88% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1390.2,17.304,,1112.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5061.42,63,,4049.14,,,0,"percent of total billed charges","63% of total billed charges",1229.2,15.3,,983.36,,,0,"percent of total billed charges","15.3% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",5543.46,69,,,,,0,"fee schedule","69% of total billed charges",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4969.03,61.85,,3975.22,,,0,"percent of total billed charges","61.5% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",2586.95,32.2,,2069.56,,,0,"percent of total billed charges","32.2% of total billed charges",2506.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1376.71,17.136,,1101.37,,,0,"percent of total billed charges","17.136% of total billed charges",1754.63,21.84,,1403.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3028.82,37.7,,2423.06,,,0,"percent of total billed charges","37.7% of total billed charges",3028.82,37.7,,2423.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2723.53,33.9,,2178.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6266.52,78,,5013.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6636.08,82.6,,5308.86,,,0,"percent of total billed charges","82.6% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",6636.08,82.6,,5308.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",1229.2,8034,
"NAIL TROCHANTERIC 11MM X 380MM LT.",ORSUP0048,CDM,278,RC,,,OUTPATIENT,,,9909,6440.85,,8719.92,88,,6975.94,,,0,"percent of total billed charges","88% of total billed charges",4954.5,50,,3963.60,,,0,"percent of total billed charges","50% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1714.65,17.304,,1371.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6242.67,63,,4994.14,,,0,"percent of total billed charges","63% of total billed charges",1516.08,15.3,,1212.86,,,0,"percent of total billed charges","15.3% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",6837.21,69,,,,,0,"fee schedule","69% of total billed charges",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6128.72,61.85,,4902.98,,,0,"percent of total billed charges","61.5% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",4954.5,50,,3963.60,,,0,"percent of total billed charges","50% of total billed charges",3190.7,32.2,,2552.56,,,0,"percent of total billed charges","32.2% of total billed charges",3091.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1698.01,17.136,,1358.41,,,0,"percent of total billed charges","17.136% of total billed charges",2164.13,21.84,,1731.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3735.69,37.7,,2988.55,,,0,"percent of total billed charges","37.7% of total billed charges",3735.69,37.7,,2988.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3359.15,33.9,,2687.32,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7729.02,78,,6183.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8184.83,82.6,,6547.86,,,0,"percent of total billed charges","82.6% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",4954.5,50,,3963.60,,,0,"percent of total billed charges","50% of total billed charges",8184.83,82.6,,6547.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",1516.08,9909,
"NALC AMPUOLES",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"NAMIC CARDIO PRODUCURE KIT",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"NAMIC FLEXCIL TUBING 30",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"NAMIC HIGH PRESSURE BRAIDED TUBING",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"NANOPASS SUTURE MANAGER REACH  CRESCENT",ORSUP0018,CDM,272,RC,,,OUTPATIENT,,,1494,971.1,,1314.72,88,,1051.78,,,0,"percent of total billed charges","88% of total billed charges",747,50,,597.60,,,0,"percent of total billed charges","50% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.52,17.304,,206.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",941.22,63,,752.98,,,0,"percent of total billed charges","63% of total billed charges",228.58,15.3,,182.86,,,0,"percent of total billed charges","15.3% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",1030.86,69,,,,,0,"fee schedule","69% of total billed charges",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",924.04,61.85,,739.23,,,0,"percent of total billed charges","61.5% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",747,50,,597.60,,,0,"percent of total billed charges","50% of total billed charges",481.07,32.2,,384.86,,,0,"percent of total billed charges","32.2% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",256.01,17.136,,204.81,,,0,"percent of total billed charges","17.136% of total billed charges",326.29,21.84,,261.03,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",563.24,37.7,,450.59,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1165.32,78,,932.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1234.04,82.6,,987.23,,,0,"percent of total billed charges","82.6% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",747,50,,597.60,,,0,"percent of total billed charges","50% of total billed charges",1234.04,82.6,,987.23,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",228.58,1494,
"NANOPASS REACH 45 DEGREE RIGHT",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,1854,1205.1,,1631.52,88,,1305.22,,,0,"percent of total billed charges","88% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",320.82,17.304,,256.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1168.02,63,,934.42,,,0,"percent of total billed charges","63% of total billed charges",283.66,15.3,,226.93,,,0,"percent of total billed charges","15.3% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1279.26,69,,,,,0,"fee schedule","69% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1146.7,61.85,,917.36,,,0,"percent of total billed charges","61.5% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",596.99,32.2,,477.59,,,0,"percent of total billed charges","32.2% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.7,17.136,,254.16,,,0,"percent of total billed charges","17.136% of total billed charges",404.91,21.84,,323.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",698.96,37.7,,559.17,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1446.12,78,,1156.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1531.4,82.6,,1225.12,,,0,"percent of total billed charges","82.6% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",1531.4,82.6,,1225.12,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",283.66,1854,
"NANOPASS REACH 45 DEGREE LEFT",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,1854,1205.1,,1631.52,88,,1305.22,,,0,"percent of total billed charges","88% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",320.82,17.304,,256.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1168.02,63,,934.42,,,0,"percent of total billed charges","63% of total billed charges",283.66,15.3,,226.93,,,0,"percent of total billed charges","15.3% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1279.26,69,,,,,0,"fee schedule","69% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1146.7,61.85,,917.36,,,0,"percent of total billed charges","61.5% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",596.99,32.2,,477.59,,,0,"percent of total billed charges","32.2% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.7,17.136,,254.16,,,0,"percent of total billed charges","17.136% of total billed charges",404.91,21.84,,323.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",698.96,37.7,,559.17,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1446.12,78,,1156.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1531.4,82.6,,1225.12,,,0,"percent of total billed charges","82.6% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",1531.4,82.6,,1225.12,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",283.66,1854,
"NASAL OXYGEN CANNULA 7FT.",274766,CDM,272,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"NASAL TAMPON 5.5CM RR500",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"NASAL SPLINT ENT DENVER SMALL",ORSUP0004,CDM,270,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"NASAL SPLINT ENT DENVER LARGE",ORSUP0004,CDM,270,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"NASAL CANNULA",490920,CDM,272,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.37,61.85,,9.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"NASAL RAE ENDOTRACHEAL TUBE CUFFED SIZE 6.0MM",490921,CDM,272,RC,,,OUTPATIENT,,,63,40.95,,55.44,88,,44.35,,,0,"percent of total billed charges","88% of total billed charges",31.5,50,,25.20,,,0,"percent of total billed charges","50% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.9,17.304,,8.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.69,63,,31.75,,,0,"percent of total billed charges","63% of total billed charges",9.64,15.3,,7.71,,,0,"percent of total billed charges","15.3% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",43.47,69,,,,,0,"fee schedule","69% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.97,61.85,,31.18,,,0,"percent of total billed charges","61.5% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",31.5,50,,25.20,,,0,"percent of total billed charges","50% of total billed charges",20.29,32.2,,16.23,,,0,"percent of total billed charges","32.2% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.8,17.136,,8.64,,,0,"percent of total billed charges","17.136% of total billed charges",13.76,21.84,,11.01,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.75,37.7,,19.00,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",49.14,78,,39.31,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.04,82.6,,41.63,,,0,"percent of total billed charges","82.6% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",31.5,50,,25.20,,,0,"percent of total billed charges","50% of total billed charges",52.04,82.6,,41.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",9.64,63,
"NASAL RAE ENDOTRACHEAL TUBE CUFFED SIZE 6.5MM",490922,CDM,272,RC,,,OUTPATIENT,,,63,40.95,,55.44,88,,44.35,,,0,"percent of total billed charges","88% of total billed charges",31.5,50,,25.20,,,0,"percent of total billed charges","50% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.9,17.304,,8.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.69,63,,31.75,,,0,"percent of total billed charges","63% of total billed charges",9.64,15.3,,7.71,,,0,"percent of total billed charges","15.3% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",43.47,69,,,,,0,"fee schedule","69% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.97,61.85,,31.18,,,0,"percent of total billed charges","61.5% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",31.5,50,,25.20,,,0,"percent of total billed charges","50% of total billed charges",20.29,32.2,,16.23,,,0,"percent of total billed charges","32.2% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.8,17.136,,8.64,,,0,"percent of total billed charges","17.136% of total billed charges",13.76,21.84,,11.01,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.75,37.7,,19.00,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",49.14,78,,39.31,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.04,82.6,,41.63,,,0,"percent of total billed charges","82.6% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",31.5,50,,25.20,,,0,"percent of total billed charges","50% of total billed charges",52.04,82.6,,41.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",9.64,63,
"NASAL RAE ENDOTRACHEAL TUBE CUFFED SIZE 7.0MM",490923,CDM,272,RC,,,OUTPATIENT,,,63,40.95,,55.44,88,,44.35,,,0,"percent of total billed charges","88% of total billed charges",31.5,50,,25.20,,,0,"percent of total billed charges","50% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.9,17.304,,8.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.69,63,,31.75,,,0,"percent of total billed charges","63% of total billed charges",9.64,15.3,,7.71,,,0,"percent of total billed charges","15.3% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",43.47,69,,,,,0,"fee schedule","69% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.97,61.85,,31.18,,,0,"percent of total billed charges","61.5% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",31.5,50,,25.20,,,0,"percent of total billed charges","50% of total billed charges",20.29,32.2,,16.23,,,0,"percent of total billed charges","32.2% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.8,17.136,,8.64,,,0,"percent of total billed charges","17.136% of total billed charges",13.76,21.84,,11.01,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.75,37.7,,19.00,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",49.14,78,,39.31,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.04,82.6,,41.63,,,0,"percent of total billed charges","82.6% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",31.5,50,,25.20,,,0,"percent of total billed charges","50% of total billed charges",52.04,82.6,,41.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",9.64,63,
"NASAL RAE ENDOTRACHEAL TUBE CUFFED SIZE 7.5MM",490924,CDM,272,RC,,,OUTPATIENT,,,63,40.95,,55.44,88,,44.35,,,0,"percent of total billed charges","88% of total billed charges",31.5,50,,25.20,,,0,"percent of total billed charges","50% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.9,17.304,,8.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.69,63,,31.75,,,0,"percent of total billed charges","63% of total billed charges",9.64,15.3,,7.71,,,0,"percent of total billed charges","15.3% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",43.47,69,,,,,0,"fee schedule","69% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.97,61.85,,31.18,,,0,"percent of total billed charges","61.5% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",31.5,50,,25.20,,,0,"percent of total billed charges","50% of total billed charges",20.29,32.2,,16.23,,,0,"percent of total billed charges","32.2% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.8,17.136,,8.64,,,0,"percent of total billed charges","17.136% of total billed charges",13.76,21.84,,11.01,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.75,37.7,,19.00,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",49.14,78,,39.31,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.04,82.6,,41.63,,,0,"percent of total billed charges","82.6% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",31.5,50,,25.20,,,0,"percent of total billed charges","50% of total billed charges",52.04,82.6,,41.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",9.64,63,
"NASAL RAE ENDOTRACHEAL TUBE CUFFED SIZE 8.0MM",490925,CDM,272,RC,,,OUTPATIENT,,,63,40.95,,55.44,88,,44.35,,,0,"percent of total billed charges","88% of total billed charges",31.5,50,,25.20,,,0,"percent of total billed charges","50% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.9,17.304,,8.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.69,63,,31.75,,,0,"percent of total billed charges","63% of total billed charges",9.64,15.3,,7.71,,,0,"percent of total billed charges","15.3% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",43.47,69,,,,,0,"fee schedule","69% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.97,61.85,,31.18,,,0,"percent of total billed charges","61.5% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",31.5,50,,25.20,,,0,"percent of total billed charges","50% of total billed charges",20.29,32.2,,16.23,,,0,"percent of total billed charges","32.2% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.8,17.136,,8.64,,,0,"percent of total billed charges","17.136% of total billed charges",13.76,21.84,,11.01,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.75,37.7,,19.00,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",49.14,78,,39.31,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.04,82.6,,41.63,,,0,"percent of total billed charges","82.6% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",31.5,50,,25.20,,,0,"percent of total billed charges","50% of total billed charges",52.04,82.6,,41.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",9.64,63,
"NASAL RAE ENDOTRACHEAL TUBE UNCUFFED SIZE 5.0MM",490926,CDM,272,RC,,,OUTPATIENT,,,44,28.6,,38.72,88,,30.98,,,0,"percent of total billed charges","88% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.61,17.304,,6.09,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.72,63,,22.18,,,0,"percent of total billed charges","63% of total billed charges",6.73,15.3,,5.38,,,0,"percent of total billed charges","15.3% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",30.36,69,,,,,0,"fee schedule","69% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.21,61.85,,21.77,,,0,"percent of total billed charges","61.5% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",14.17,32.2,,11.34,,,0,"percent of total billed charges","32.2% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.54,17.136,,6.03,,,0,"percent of total billed charges","17.136% of total billed charges",9.61,21.84,,7.69,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.59,37.7,,13.27,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.32,78,,27.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",6.73,44,
"NASAL RAE ENDOTRACHEAL TUBE UNCUFFED SIZE 6.0MM",490927,CDM,272,RC,,,OUTPATIENT,,,42,27.3,,36.96,88,,29.57,,,0,"percent of total billed charges","88% of total billed charges",21,50,,16.80,,,0,"percent of total billed charges","50% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.27,17.304,,5.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.46,63,,21.17,,,0,"percent of total billed charges","63% of total billed charges",6.43,15.3,,5.14,,,0,"percent of total billed charges","15.3% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",28.98,69,,,,,0,"fee schedule","69% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.98,61.85,,20.78,,,0,"percent of total billed charges","61.5% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",21,50,,16.80,,,0,"percent of total billed charges","50% of total billed charges",13.52,32.2,,10.82,,,0,"percent of total billed charges","32.2% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.2,17.136,,5.76,,,0,"percent of total billed charges","17.136% of total billed charges",9.17,21.84,,7.34,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",32.76,78,,26.21,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",21,50,,16.80,,,0,"percent of total billed charges","50% of total billed charges",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",6.43,42,
"NASAL ALAR FAST SPO2 SENSOR",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"NASAL MASK W/HEAD STRAP SM",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,412,267.8,,362.56,88,,290.05,,,0,"percent of total billed charges","88% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.29,17.304,,57.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",259.56,63,,207.65,,,0,"percent of total billed charges","63% of total billed charges",63.04,15.3,,50.43,,,0,"percent of total billed charges","15.3% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",284.28,69,,,,,0,"fee schedule","69% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",254.82,61.85,,203.86,,,0,"percent of total billed charges","61.5% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",132.66,32.2,,106.13,,,0,"percent of total billed charges","32.2% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.6,17.136,,56.48,,,0,"percent of total billed charges","17.136% of total billed charges",89.98,21.84,,71.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",155.32,37.7,,124.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",321.36,78,,257.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",63.04,412,
"NASAL MASK W/HEAD STRAP MED",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,412,267.8,,362.56,88,,290.05,,,0,"percent of total billed charges","88% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.29,17.304,,57.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",259.56,63,,207.65,,,0,"percent of total billed charges","63% of total billed charges",63.04,15.3,,50.43,,,0,"percent of total billed charges","15.3% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",284.28,69,,,,,0,"fee schedule","69% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",254.82,61.85,,203.86,,,0,"percent of total billed charges","61.5% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",132.66,32.2,,106.13,,,0,"percent of total billed charges","32.2% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.6,17.136,,56.48,,,0,"percent of total billed charges","17.136% of total billed charges",89.98,21.84,,71.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",155.32,37.7,,124.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",321.36,78,,257.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",63.04,412,
"NASAL MASK W/HEAD STRAP LG",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,412,267.8,,362.56,88,,290.05,,,0,"percent of total billed charges","88% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.29,17.304,,57.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",259.56,63,,207.65,,,0,"percent of total billed charges","63% of total billed charges",63.04,15.3,,50.43,,,0,"percent of total billed charges","15.3% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",284.28,69,,,,,0,"fee schedule","69% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",254.82,61.85,,203.86,,,0,"percent of total billed charges","61.5% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",132.66,32.2,,106.13,,,0,"percent of total billed charges","32.2% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.6,17.136,,56.48,,,0,"percent of total billed charges","17.136% of total billed charges",89.98,21.84,,71.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",155.32,37.7,,124.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",321.36,78,,257.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",63.04,412,
"NASAL MASK W/HEAD STRAP XL",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,412,267.8,,362.56,88,,290.05,,,0,"percent of total billed charges","88% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.29,17.304,,57.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",259.56,63,,207.65,,,0,"percent of total billed charges","63% of total billed charges",63.04,15.3,,50.43,,,0,"percent of total billed charges","15.3% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",284.28,69,,,,,0,"fee schedule","69% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",254.82,61.85,,203.86,,,0,"percent of total billed charges","61.5% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",132.66,32.2,,106.13,,,0,"percent of total billed charges","32.2% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.6,17.136,,56.48,,,0,"percent of total billed charges","17.136% of total billed charges",89.98,21.84,,71.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",155.32,37.7,,124.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",321.36,78,,257.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",63.04,412,
"NASAL CANNULA 7' ADULT",ORSUP0001,CDM,278,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.7% of total billed charges",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.2,33.9,,9.76,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"NASAL CANNULA 7' PEDIATRIC",ORSUP0001,CDM,278,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.7% of total billed charges",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.2,33.9,,9.76,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"NASAL CANNULA 14' ADULT",ORSUP0001,CDM,278,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.7% of total billed charges",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.2,33.9,,9.76,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"NASAL TUBE BRIDLE PRO SYS 12FR",ORSUP0019,CDM,272,RC,,,OUTPATIENT,,,1648,1071.2,,1450.24,88,,1160.19,,,0,"percent of total billed charges","88% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",285.17,17.304,,228.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1038.24,63,,830.59,,,0,"percent of total billed charges","63% of total billed charges",252.14,15.3,,201.71,,,0,"percent of total billed charges","15.3% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1137.12,69,,,,,0,"fee schedule","69% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.29,61.85,,815.43,,,0,"percent of total billed charges","61.5% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",530.66,32.2,,424.53,,,0,"percent of total billed charges","32.2% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",282.4,17.136,,225.92,,,0,"percent of total billed charges","17.136% of total billed charges",359.92,21.84,,287.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",621.3,37.7,,497.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1285.44,78,,1028.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1361.25,82.6,,1089.00,,,0,"percent of total billed charges","82.6% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",1361.25,82.6,,1089.00,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",252.14,1648,
"NASOGASTRIC TUBE HOLDER ADULT",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"NASOGASTRIC TUBE HOLDERS",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"NATELSON TUBE 250UL 150MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"NATROL CT/NG PANEL",ORSUP0038,CDM,272,RC,,,OUTPATIENT,,,5562,3615.3,,4894.56,88,,3915.65,,,0,"percent of total billed charges","88% of total billed charges",2781,50,,2224.80,,,0,"percent of total billed charges","50% of total billed charges",934.42,16.8,,747.54,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",962.45,17.304,,769.96,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3504.06,63,,2803.25,,,0,"percent of total billed charges","63% of total billed charges",850.99,15.3,,680.79,,,0,"percent of total billed charges","15.3% of total billed charges",934.42,16.8,,747.54,,,0,"percent of total billed charges","16.8% of total billed charges",3837.78,69,,,,,0,"fee schedule","69% of total billed charges",5562,100,,4449.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5562,100,,4449.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5562,100,,4449.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3440.1,61.85,,2752.08,,,0,"percent of total billed charges","61.5% of total billed charges",934.42,16.8,,747.54,,,0,"percent of total billed charges","16.8% of total billed charges",2781,50,,2224.80,,,0,"percent of total billed charges","50% of total billed charges",1790.96,32.2,,1432.77,,,0,"percent of total billed charges","32.2% of total billed charges",934.42,16.8,,747.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",953.1,17.136,,762.48,,,0,"percent of total billed charges","17.136% of total billed charges",1214.74,21.84,,971.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2096.87,37.7,,1677.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4338.36,78,,3470.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4594.21,82.6,,3675.37,,,0,"percent of total billed charges","82.6% of total billed charges",934.42,16.8,,747.54,,,0,"percent of total billed charges","16.8% of total billed charges",2781,50,,2224.80,,,0,"percent of total billed charges","50% of total billed charges",4594.21,82.6,,3675.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",934.42,16.8,,747.54,,,0,"percent of total billed charges","16.8% of total billed charges",5562,100,,4449.60,,,0,"percent of total billed charges","100% of total billed charges",850.99,5562,
"NAVAIGATION PIN 3X100",ORSUP0031,CDM,272,RC,,,OUTPATIENT,,,5356,3481.4,,4713.28,88,,3770.62,,,0,"percent of total billed charges","88% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",926.8,17.304,,741.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3374.28,63,,2699.42,,,0,"percent of total billed charges","63% of total billed charges",819.47,15.3,,655.58,,,0,"percent of total billed charges","15.3% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",3695.64,69,,,,,0,"fee schedule","69% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3312.69,61.85,,2650.15,,,0,"percent of total billed charges","61.5% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",1724.63,32.2,,1379.70,,,0,"percent of total billed charges","32.2% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",917.8,17.136,,734.24,,,0,"percent of total billed charges","17.136% of total billed charges",1169.75,21.84,,935.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4177.68,78,,3342.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",819.47,5356,
"NAVIGATION PIN 3MMX150MM 6007-003-150",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"NDL SYSTEM STERNAL CABLE W/CUTTING EDGE",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"NDL SAFETY 25G X 1",24207,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"NDL 1/2 CIRC TAPER MAYO 216705",45111,CDM,270,RC,,,OUTPATIENT,,,22,14.3,,19.36,88,,15.49,,,0,"percent of total billed charges","88% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.81,17.304,,3.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.86,63,,11.09,,,0,"percent of total billed charges","63% of total billed charges",3.37,15.3,,2.70,,,0,"percent of total billed charges","15.3% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",15.18,69,,,,,0,"fee schedule","69% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.61,61.85,,10.89,,,0,"percent of total billed charges","61.5% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",7.08,32.2,,5.66,,,0,"percent of total billed charges","32.2% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.77,17.136,,3.02,,,0,"percent of total billed charges","17.136% of total billed charges",4.8,21.84,,3.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.29,37.7,,6.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.16,78,,13.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",3.37,22,
"NDL INJ 25G CARR-LOCKE ENDO",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"NDL SPINAL 22GX3.5",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"NDL SPINAL WHITACRE 25G X 3.5",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"NDL QUICK CORE 18GAX15CM",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"NDLS BLUNT",54943,CDM,272,RC,,,OUTPATIENT,,,142,92.3,,124.96,88,,99.97,,,0,"percent of total billed charges","88% of total billed charges",71,50,,56.80,,,0,"percent of total billed charges","50% of total billed charges",23.86,16.8,,19.09,,,0,"percent of total billed charges","16.8% of total billed charges",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.57,17.304,,19.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.46,63,,71.57,,,0,"percent of total billed charges","63% of total billed charges",21.73,15.3,,17.38,,,0,"percent of total billed charges","15.3% of total billed charges",23.86,16.8,,19.09,,,0,"percent of total billed charges","16.8% of total billed charges",97.98,69,,,,,0,"fee schedule","69% of total billed charges",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.83,61.85,,70.26,,,0,"percent of total billed charges","61.5% of total billed charges",23.86,16.8,,19.09,,,0,"percent of total billed charges","16.8% of total billed charges",71,50,,56.80,,,0,"percent of total billed charges","50% of total billed charges",45.72,32.2,,36.58,,,0,"percent of total billed charges","32.2% of total billed charges",23.86,16.8,,19.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.33,17.136,,19.46,,,0,"percent of total billed charges","17.136% of total billed charges",31.01,21.84,,24.81,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",53.53,37.7,,42.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",110.76,78,,88.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",117.29,82.6,,93.83,,,0,"percent of total billed charges","82.6% of total billed charges",23.86,16.8,,19.09,,,0,"percent of total billed charges","16.8% of total billed charges",71,50,,56.80,,,0,"percent of total billed charges","50% of total billed charges",117.29,82.6,,93.83,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.86,16.8,,19.09,,,0,"percent of total billed charges","16.8% of total billed charges",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",21.73,142,
"NEBULIZER MASK",490931,CDM,270,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"NEBULIZER TUBING",490932,CDM,272,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"NEBULIZER TUBING W/TEE ADAPTER AND MOUTHPIECE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"NEBULIZER MISTY W/MASK",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"NEBULIZER MISTY W/MOUTHPIECE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"NEBULIZER W/028 ADAPTER AND WATER",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"NEBULIZER, SIDESTREAM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"NEBULIZER W/ADULT MASK 7'",ORSUP0001,CDM,278,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.7% of total billed charges",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.2,33.9,,9.76,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"NEEDLE PORT A CATH .75INX20GA POWERLOC",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"NEEDLE SPECIAL USE 27GX1-1/4",145558,CDM,272,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"NEEDLE 25G X 5/8IN SHIELDING SUBCUT SAFETY GLIDE",145466,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"NEEDLE 23G X 1IN SHIELDING IM SAFETY GLIDE",168913,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"NEEDLE 22G X 1 1/2IN SHIELDING IM SAFETY GLIDE",145464,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"NEEDLE SHIELDING SUBCUT SAFETY GLIDE 21G X 1IN",168956,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"NEEDLE REGULAR BEVEL 18GX1 1/2",168943,CDM,272,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"NEEDLE FILTER 1.5 19GAGE",156007,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"NEEDLE 30G X 1IN REG BEVEL POLY HUB DISP",155955,CDM,272,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"NEEDLE SPECIAL USE 16GAX1 1/2",145556,CDM,272,RC,,,OUTPATIENT,,,124,80.6,,109.12,88,,87.30,,,0,"percent of total billed charges","88% of total billed charges",62,50,,49.60,,,0,"percent of total billed charges","50% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.46,17.304,,17.17,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.12,63,,62.50,,,0,"percent of total billed charges","63% of total billed charges",18.97,15.3,,15.18,,,0,"percent of total billed charges","15.3% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",85.56,69,,,,,0,"fee schedule","69% of total billed charges",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.69,61.85,,61.35,,,0,"percent of total billed charges","61.5% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",62,50,,49.60,,,0,"percent of total billed charges","50% of total billed charges",39.93,32.2,,31.94,,,0,"percent of total billed charges","32.2% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.25,17.136,,17.00,,,0,"percent of total billed charges","17.136% of total billed charges",27.08,21.84,,21.66,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.75,37.7,,37.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",96.72,78,,77.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",102.42,82.6,,81.94,,,0,"percent of total billed charges","82.6% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",62,50,,49.60,,,0,"percent of total billed charges","50% of total billed charges",102.42,82.6,,81.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",18.97,124,
"NEEDLE BLUNT 16G X 1 1/2 ALUMINUM HUB DISPOSABLE",155997,CDM,272,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"NEEDLE 24IN PROLENE SUTURE 7-0 BLUE MONO DOUBLE ARM BV175-6",453270,CDM,272,RC,,,OUTPATIENT,,,398,258.7,,350.24,88,,280.19,,,0,"percent of total billed charges","88% of total billed charges",199,50,,159.20,,,0,"percent of total billed charges","50% of total billed charges",66.86,16.8,,53.49,,,0,"percent of total billed charges","16.8% of total billed charges",398,100,,318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.87,17.304,,55.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",250.74,63,,200.59,,,0,"percent of total billed charges","63% of total billed charges",60.89,15.3,,48.71,,,0,"percent of total billed charges","15.3% of total billed charges",66.86,16.8,,53.49,,,0,"percent of total billed charges","16.8% of total billed charges",274.62,69,,,,,0,"fee schedule","69% of total billed charges",398,100,,318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",398,100,,318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",398,100,,318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",246.16,61.85,,196.93,,,0,"percent of total billed charges","61.5% of total billed charges",66.86,16.8,,53.49,,,0,"percent of total billed charges","16.8% of total billed charges",199,50,,159.20,,,0,"percent of total billed charges","50% of total billed charges",128.16,32.2,,102.53,,,0,"percent of total billed charges","32.2% of total billed charges",66.86,16.8,,53.49,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.2,17.136,,54.56,,,0,"percent of total billed charges","17.136% of total billed charges",86.92,21.84,,69.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",150.05,37.7,,120.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",310.44,78,,248.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",328.75,82.6,,263.00,,,0,"percent of total billed charges","82.6% of total billed charges",66.86,16.8,,53.49,,,0,"percent of total billed charges","16.8% of total billed charges",199,50,,159.20,,,0,"percent of total billed charges","50% of total billed charges",328.75,82.6,,263.00,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",66.86,16.8,,53.49,,,0,"percent of total billed charges","16.8% of total billed charges",398,100,,318.40,,,0,"percent of total billed charges","100% of total billed charges",60.89,398,
"NEEDLE 30 TICRON SUTURE COATED BRAIDED POLYSTER BLUE 0 CV-300",453269,CDM,272,RC,,,OUTPATIENT,,,89,57.85,,78.32,88,,62.66,,,0,"percent of total billed charges","88% of total billed charges",44.5,50,,35.60,,,0,"percent of total billed charges","50% of total billed charges",14.95,16.8,,11.96,,,0,"percent of total billed charges","16.8% of total billed charges",89,100,,71.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.4,17.304,,12.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.07,63,,44.86,,,0,"percent of total billed charges","63% of total billed charges",13.62,15.3,,10.90,,,0,"percent of total billed charges","15.3% of total billed charges",14.95,16.8,,11.96,,,0,"percent of total billed charges","16.8% of total billed charges",61.41,69,,,,,0,"fee schedule","69% of total billed charges",89,100,,71.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89,100,,71.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89,100,,71.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",55.05,61.85,,44.04,,,0,"percent of total billed charges","61.5% of total billed charges",14.95,16.8,,11.96,,,0,"percent of total billed charges","16.8% of total billed charges",44.5,50,,35.60,,,0,"percent of total billed charges","50% of total billed charges",28.66,32.2,,22.93,,,0,"percent of total billed charges","32.2% of total billed charges",14.95,16.8,,11.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.25,17.136,,12.20,,,0,"percent of total billed charges","17.136% of total billed charges",19.44,21.84,,15.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",33.55,37.7,,26.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",69.42,78,,55.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",73.51,82.6,,58.81,,,0,"percent of total billed charges","82.6% of total billed charges",14.95,16.8,,11.96,,,0,"percent of total billed charges","16.8% of total billed charges",44.5,50,,35.60,,,0,"percent of total billed charges","50% of total billed charges",73.51,82.6,,58.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.95,16.8,,11.96,,,0,"percent of total billed charges","16.8% of total billed charges",89,100,,71.20,,,0,"percent of total billed charges","100% of total billed charges",13.62,89,
"NEEDLE HYPO 30G 3/4",185489,CDM,272,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"NEEDLE POINT CAUTERY",446688,CDM,272,RC,,,OUTPATIENT,,,306,198.9,,269.28,88,,215.42,,,0,"percent of total billed charges","88% of total billed charges",153,50,,122.40,,,0,"percent of total billed charges","50% of total billed charges",51.41,16.8,,41.13,,,0,"percent of total billed charges","16.8% of total billed charges",306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.304,,42.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",192.78,63,,154.22,,,0,"percent of total billed charges","63% of total billed charges",46.82,15.3,,37.46,,,0,"percent of total billed charges","15.3% of total billed charges",51.41,16.8,,41.13,,,0,"percent of total billed charges","16.8% of total billed charges",211.14,69,,,,,0,"fee schedule","69% of total billed charges",306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",189.26,61.85,,151.41,,,0,"percent of total billed charges","61.5% of total billed charges",51.41,16.8,,41.13,,,0,"percent of total billed charges","16.8% of total billed charges",153,50,,122.40,,,0,"percent of total billed charges","50% of total billed charges",98.53,32.2,,78.82,,,0,"percent of total billed charges","32.2% of total billed charges",51.41,16.8,,41.13,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.44,17.136,,41.95,,,0,"percent of total billed charges","17.136% of total billed charges",66.83,21.84,,53.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",115.36,37.7,,92.29,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",238.68,78,,190.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.76,82.6,,202.21,,,0,"percent of total billed charges","82.6% of total billed charges",51.41,16.8,,41.13,,,0,"percent of total billed charges","16.8% of total billed charges",153,50,,122.40,,,0,"percent of total billed charges","50% of total billed charges",252.76,82.6,,202.21,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.41,16.8,,41.13,,,0,"percent of total billed charges","16.8% of total billed charges",306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",46.82,306,
"NEEDLE SAFETY CART 21 X 1",180422,CDM,272,RC,,,OUTPATIENT,,,158,102.7,,139.04,88,,111.23,,,0,"percent of total billed charges","88% of total billed charges",79,50,,63.20,,,0,"percent of total billed charges","50% of total billed charges",26.54,16.8,,21.23,,,0,"percent of total billed charges","16.8% of total billed charges",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.34,17.304,,21.87,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",99.54,63,,79.63,,,0,"percent of total billed charges","63% of total billed charges",24.17,15.3,,19.34,,,0,"percent of total billed charges","15.3% of total billed charges",26.54,16.8,,21.23,,,0,"percent of total billed charges","16.8% of total billed charges",109.02,69,,,,,0,"fee schedule","69% of total billed charges",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.72,61.85,,78.18,,,0,"percent of total billed charges","61.5% of total billed charges",26.54,16.8,,21.23,,,0,"percent of total billed charges","16.8% of total billed charges",79,50,,63.20,,,0,"percent of total billed charges","50% of total billed charges",50.88,32.2,,40.70,,,0,"percent of total billed charges","32.2% of total billed charges",26.54,16.8,,21.23,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.07,17.136,,21.66,,,0,"percent of total billed charges","17.136% of total billed charges",34.51,21.84,,27.61,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",59.57,37.7,,47.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",123.24,78,,98.59,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",130.51,82.6,,104.41,,,0,"percent of total billed charges","82.6% of total billed charges",26.54,16.8,,21.23,,,0,"percent of total billed charges","16.8% of total billed charges",79,50,,63.20,,,0,"percent of total billed charges","50% of total billed charges",130.51,82.6,,104.41,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.54,16.8,,21.23,,,0,"percent of total billed charges","16.8% of total billed charges",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",24.17,158,
"NEEDLE SAFETY CART 22 X 1",180420,CDM,272,RC,,,OUTPATIENT,,,124,80.6,,109.12,88,,87.30,,,0,"percent of total billed charges","88% of total billed charges",62,50,,49.60,,,0,"percent of total billed charges","50% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.46,17.304,,17.17,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.12,63,,62.50,,,0,"percent of total billed charges","63% of total billed charges",18.97,15.3,,15.18,,,0,"percent of total billed charges","15.3% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",85.56,69,,,,,0,"fee schedule","69% of total billed charges",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.69,61.85,,61.35,,,0,"percent of total billed charges","61.5% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",62,50,,49.60,,,0,"percent of total billed charges","50% of total billed charges",39.93,32.2,,31.94,,,0,"percent of total billed charges","32.2% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.25,17.136,,17.00,,,0,"percent of total billed charges","17.136% of total billed charges",27.08,21.84,,21.66,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.75,37.7,,37.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",96.72,78,,77.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",102.42,82.6,,81.94,,,0,"percent of total billed charges","82.6% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",62,50,,49.60,,,0,"percent of total billed charges","50% of total billed charges",102.42,82.6,,81.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",18.97,124,
"NEEDLE SET EZ-IO PEDI 15MM 15GA",ORSUP0027,CDM,272,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"NEEDLE BLOOD COLLECTION W/LUER ADAPTER 21G 12",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"NEEDLE KNIFE ESCPC XL L5MM OD5FR ODSEC.035IN 3LUM C CHNL",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"NEEDLE 13GA 5IN",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"NEEDLE 18IN V-LOC 180 ABSORBABLE WOUND CLOSURE DEVICE 2-0 GREEN V-20",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"NEEDLE BRK 89CM",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"NEEDLE DRIVER LARGE DA VINCI",173494,CDM,272,RC,,,OUTPATIENT,,,11204,7282.6,,9859.52,88,,7887.62,,,0,"percent of total billed charges","88% of total billed charges",5602,50,,4481.60,,,0,"percent of total billed charges","50% of total billed charges",1882.27,16.8,,1505.82,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1938.74,17.304,,1550.99,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7058.52,63,,5646.82,,,0,"percent of total billed charges","63% of total billed charges",1714.21,15.3,,1371.37,,,0,"percent of total billed charges","15.3% of total billed charges",1882.27,16.8,,1505.82,,,0,"percent of total billed charges","16.8% of total billed charges",7730.76,69,,,,,0,"fee schedule","69% of total billed charges",11204,100,,8963.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11204,100,,8963.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11204,100,,8963.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6929.67,61.85,,5543.74,,,0,"percent of total billed charges","61.5% of total billed charges",1882.27,16.8,,1505.82,,,0,"percent of total billed charges","16.8% of total billed charges",5602,50,,4481.60,,,0,"percent of total billed charges","50% of total billed charges",3607.69,32.2,,2886.15,,,0,"percent of total billed charges","32.2% of total billed charges",1882.27,16.8,,1505.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1919.92,17.136,,1535.94,,,0,"percent of total billed charges","17.136% of total billed charges",2446.95,21.84,,1957.56,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4223.91,37.7,,3379.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8739.12,78,,6991.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9254.5,82.6,,7403.60,,,0,"percent of total billed charges","82.6% of total billed charges",1882.27,16.8,,1505.82,,,0,"percent of total billed charges","16.8% of total billed charges",5602,50,,4481.60,,,0,"percent of total billed charges","50% of total billed charges",9254.5,82.6,,7403.60,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1882.27,16.8,,1505.82,,,0,"percent of total billed charges","16.8% of total billed charges",11204,100,,8963.20,,,0,"percent of total billed charges","100% of total billed charges",1714.21,11204,
"NEEDLE DRIVER SUTURE CUT DAVINGCI",312623,CDM,272,RC,,,OUTPATIENT,,,12223,7944.95,,10756.24,88,,8604.99,,,0,"percent of total billed charges","88% of total billed charges",6111.5,50,,4889.20,,,0,"percent of total billed charges","50% of total billed charges",2053.46,16.8,,1642.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2115.07,17.304,,1692.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7700.49,63,,6160.39,,,0,"percent of total billed charges","63% of total billed charges",1870.12,15.3,,1496.10,,,0,"percent of total billed charges","15.3% of total billed charges",2053.46,16.8,,1642.77,,,0,"percent of total billed charges","16.8% of total billed charges",8433.87,69,,,,,0,"fee schedule","69% of total billed charges",12223,100,,9778.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12223,100,,9778.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12223,100,,9778.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7559.93,61.85,,6047.94,,,0,"percent of total billed charges","61.5% of total billed charges",2053.46,16.8,,1642.77,,,0,"percent of total billed charges","16.8% of total billed charges",6111.5,50,,4889.20,,,0,"percent of total billed charges","50% of total billed charges",3935.81,32.2,,3148.65,,,0,"percent of total billed charges","32.2% of total billed charges",2053.46,16.8,,1642.77,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2094.53,17.136,,1675.62,,,0,"percent of total billed charges","17.136% of total billed charges",2669.5,21.84,,2135.60,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4608.07,37.7,,3686.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9533.94,78,,7627.15,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10096.2,82.6,,8076.96,,,0,"percent of total billed charges","82.6% of total billed charges",2053.46,16.8,,1642.77,,,0,"percent of total billed charges","16.8% of total billed charges",6111.5,50,,4889.20,,,0,"percent of total billed charges","50% of total billed charges",10096.2,82.6,,8076.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2053.46,16.8,,1642.77,,,0,"percent of total billed charges","16.8% of total billed charges",12223,100,,9778.40,,,0,"percent of total billed charges","100% of total billed charges",1870.12,12223,
"NEEDLE ELECTRODE EASY CLEAN 6 INCH",63742,CDM,272,RC,,,OUTPATIENT,,,40,26,,35.2,88,,28.16,,,0,"percent of total billed charges","88% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.92,17.304,,5.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.2,63,,20.16,,,0,"percent of total billed charges","63% of total billed charges",6.12,15.3,,4.90,,,0,"percent of total billed charges","15.3% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",27.6,69,,,,,0,"fee schedule","69% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.74,61.85,,19.79,,,0,"percent of total billed charges","61.5% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",12.88,32.2,,10.30,,,0,"percent of total billed charges","32.2% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.85,17.136,,5.48,,,0,"percent of total billed charges","17.136% of total billed charges",8.74,21.84,,6.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.08,37.7,,12.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",31.2,78,,24.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",6.12,40,
"NEEDLE KNEE SCORPION",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"NEEDLE MULTIFIRE SCORPION STRL",ORSUP0037,CDM,272,RC,,,OUTPATIENT,,,5356,3481.4,,4713.28,88,,3770.62,,,0,"percent of total billed charges","88% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",926.8,17.304,,741.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3374.28,63,,2699.42,,,0,"percent of total billed charges","63% of total billed charges",819.47,15.3,,655.58,,,0,"percent of total billed charges","15.3% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",3695.64,69,,,,,0,"fee schedule","69% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3312.69,61.85,,2650.15,,,0,"percent of total billed charges","61.5% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",1724.63,32.2,,1379.70,,,0,"percent of total billed charges","32.2% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",917.8,17.136,,734.24,,,0,"percent of total billed charges","17.136% of total billed charges",1169.75,21.84,,935.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4177.68,78,,3342.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",819.47,5356,
"NEEDLE SUREFIRE SCORPION",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"NEEDLES SUPER TRAX BIOPSY",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"NEEDLE 5.0FRX25CM RNG BILI DISP",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"NEEDLE 16.5CM 5FR 15CM ENDO BILI RING",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"NEEDLE SPINAL SINGLE USE 20GX3",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"NEEDLE SPINAL DISP 20GA X 6 PLASTIC HUB",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"NEEDLE 11GAX6IN MARRW BULLET TP",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"NEEDLE BIOPSY COAXIAL ADJUST 20GX15CM W/19G INTRO",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"NEEDLE JAMSHIDI 8GA",185481,CDM,272,RC,,,OUTPATIENT,,,157,102.05,,138.16,88,,110.53,,,0,"percent of total billed charges","88% of total billed charges",78.5,50,,62.80,,,0,"percent of total billed charges","50% of total billed charges",26.38,16.8,,21.10,,,0,"percent of total billed charges","16.8% of total billed charges",157,100,,125.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.17,17.304,,21.74,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.91,63,,79.13,,,0,"percent of total billed charges","63% of total billed charges",24.02,15.3,,19.22,,,0,"percent of total billed charges","15.3% of total billed charges",26.38,16.8,,21.10,,,0,"percent of total billed charges","16.8% of total billed charges",108.33,69,,,,,0,"fee schedule","69% of total billed charges",157,100,,125.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",157,100,,125.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",157,100,,125.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.1,61.85,,77.68,,,0,"percent of total billed charges","61.5% of total billed charges",26.38,16.8,,21.10,,,0,"percent of total billed charges","16.8% of total billed charges",78.5,50,,62.80,,,0,"percent of total billed charges","50% of total billed charges",50.55,32.2,,40.44,,,0,"percent of total billed charges","32.2% of total billed charges",26.38,16.8,,21.10,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.9,17.136,,21.52,,,0,"percent of total billed charges","17.136% of total billed charges",34.29,21.84,,27.43,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",59.19,37.7,,47.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",122.46,78,,97.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.68,82.6,,103.74,,,0,"percent of total billed charges","82.6% of total billed charges",26.38,16.8,,21.10,,,0,"percent of total billed charges","16.8% of total billed charges",78.5,50,,62.80,,,0,"percent of total billed charges","50% of total billed charges",129.68,82.6,,103.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.38,16.8,,21.10,,,0,"percent of total billed charges","16.8% of total billed charges",157,100,,125.60,,,0,"percent of total billed charges","100% of total billed charges",24.02,157,
"NEEDLE 14GA X 120MM INSUFF DISP",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"NEEDLE LABORIE DIS200",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"NEEDLE QUICK-CORE BIOPSY 16G",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"NEEDLE SET EZ-IO ADULT 25MM 15GA",ORSUP0027,CDM,272,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"NEEDLE TRANSSEPTAL BRK-1 XS",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"NEEDLE FLEXITIP SCLEROTHERAPY",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"NEEDLE ELECTRODE 4'' 0016AM",490949,CDM,272,RC,,,OUTPATIENT,,,31,20.15,,27.28,88,,21.82,,,0,"percent of total billed charges","88% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.36,17.304,,4.29,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.53,63,,15.62,,,0,"percent of total billed charges","63% of total billed charges",4.74,15.3,,3.79,,,0,"percent of total billed charges","15.3% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",21.39,69,,,,,0,"fee schedule","69% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.17,61.85,,15.34,,,0,"percent of total billed charges","61.5% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",9.98,32.2,,7.98,,,0,"percent of total billed charges","32.2% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.31,17.136,,4.25,,,0,"percent of total billed charges","17.136% of total billed charges",6.77,21.84,,5.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.69,37.7,,9.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.18,78,,19.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.61,82.6,,20.49,,,0,"percent of total billed charges","82.6% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",25.61,82.6,,20.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",4.74,31,
"NEEDLE MAYO 1/2 CIRCLE TROCAR",490965,CDM,272,RC,,,OUTPATIENT,,,23,14.95,,20.24,88,,16.19,,,0,"percent of total billed charges","88% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.98,17.304,,3.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.49,63,,11.59,,,0,"percent of total billed charges","63% of total billed charges",3.52,15.3,,2.82,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",15.87,69,,,,,0,"fee schedule","69% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.23,61.85,,11.38,,,0,"percent of total billed charges","61.5% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",7.41,32.2,,5.93,,,0,"percent of total billed charges","32.2% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.94,17.136,,3.15,,,0,"percent of total billed charges","17.136% of total billed charges",5.02,21.84,,4.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.94,78,,14.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",3.52,23,
"NEEDLE MAYO 1/2 TROCAR",490966,CDM,272,RC,,,OUTPATIENT,,,40,26,,35.2,88,,28.16,,,0,"percent of total billed charges","88% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.92,17.304,,5.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.2,63,,20.16,,,0,"percent of total billed charges","63% of total billed charges",6.12,15.3,,4.90,,,0,"percent of total billed charges","15.3% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",27.6,69,,,,,0,"fee schedule","69% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.74,61.85,,19.79,,,0,"percent of total billed charges","61.5% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",12.88,32.2,,10.30,,,0,"percent of total billed charges","32.2% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.85,17.136,,5.48,,,0,"percent of total billed charges","17.136% of total billed charges",8.74,21.84,,6.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.08,37.7,,12.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",31.2,78,,24.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",6.12,40,
"NEEDLE MAYO CATGUT 1/2 CIRCLE",490967,CDM,272,RC,,,OUTPATIENT,,,23,14.95,,20.24,88,,16.19,,,0,"percent of total billed charges","88% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.98,17.304,,3.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.49,63,,11.59,,,0,"percent of total billed charges","63% of total billed charges",3.52,15.3,,2.82,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",15.87,69,,,,,0,"fee schedule","69% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.23,61.85,,11.38,,,0,"percent of total billed charges","61.5% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",7.41,32.2,,5.93,,,0,"percent of total billed charges","32.2% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.94,17.136,,3.15,,,0,"percent of total billed charges","17.136% of total billed charges",5.02,21.84,,4.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.94,78,,14.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",3.52,23,
"NEEDLE BIOPSY MAX CORE 18GX25C",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"NEEDLE BIOPSY MAX CORE 18G 20C",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"NEEDLE JAM SHIDI XIA PRECISION",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,726,471.9,,638.88,88,,511.10,,,0,"percent of total billed charges","88% of total billed charges",363,50,,290.40,,,0,"percent of total billed charges","50% of total billed charges",121.97,16.8,,97.58,,,0,"percent of total billed charges","16.8% of total billed charges",726,100,,580.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",125.63,17.304,,100.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",457.38,63,,365.90,,,0,"percent of total billed charges","63% of total billed charges",111.08,15.3,,88.86,,,0,"percent of total billed charges","15.3% of total billed charges",121.97,16.8,,97.58,,,0,"percent of total billed charges","16.8% of total billed charges",500.94,69,,,,,0,"fee schedule","69% of total billed charges",726,100,,580.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",726,100,,580.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",726,100,,580.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.03,61.85,,359.22,,,0,"percent of total billed charges","61.5% of total billed charges",121.97,16.8,,97.58,,,0,"percent of total billed charges","16.8% of total billed charges",363,50,,290.40,,,0,"percent of total billed charges","50% of total billed charges",233.77,32.2,,187.02,,,0,"percent of total billed charges","32.2% of total billed charges",121.97,16.8,,97.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.41,17.136,,99.53,,,0,"percent of total billed charges","17.136% of total billed charges",158.56,21.84,,126.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",273.7,37.7,,218.96,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",566.28,78,,453.02,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",599.68,82.6,,479.74,,,0,"percent of total billed charges","82.6% of total billed charges",121.97,16.8,,97.58,,,0,"percent of total billed charges","16.8% of total billed charges",363,50,,290.40,,,0,"percent of total billed charges","50% of total billed charges",599.68,82.6,,479.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",121.97,16.8,,97.58,,,0,"percent of total billed charges","16.8% of total billed charges",726,100,,580.80,,,0,"percent of total billed charges","100% of total billed charges",111.08,726,
"NEEDLE ECHOBLOCK 21X4",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"NEEDLE COUNTER",490947,CDM,272,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"NEEDLE ELECTRODE 6'' 0016M",490950,CDM,272,RC,,,OUTPATIENT,,,32,20.8,,28.16,88,,22.53,,,0,"percent of total billed charges","88% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.54,17.304,,4.43,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.16,63,,16.13,,,0,"percent of total billed charges","63% of total billed charges",4.9,15.3,,3.92,,,0,"percent of total billed charges","15.3% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",22.08,69,,,,,0,"fee schedule","69% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.79,61.85,,15.83,,,0,"percent of total billed charges","61.5% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",10.3,32.2,,8.24,,,0,"percent of total billed charges","32.2% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.48,17.136,,4.38,,,0,"percent of total billed charges","17.136% of total billed charges",6.99,21.84,,5.59,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.96,78,,19.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",4.9,32,
"NEEDLE JAMSHIDI SOFT TIS BIOPS",490964,CDM,272,RC,,,OUTPATIENT,,,65,42.25,,57.2,88,,45.76,,,0,"percent of total billed charges","88% of total billed charges",32.5,50,,26.00,,,0,"percent of total billed charges","50% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.25,17.304,,9.00,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.95,63,,32.76,,,0,"percent of total billed charges","63% of total billed charges",9.95,15.3,,7.96,,,0,"percent of total billed charges","15.3% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",44.85,69,,,,,0,"fee schedule","69% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.2,61.85,,32.16,,,0,"percent of total billed charges","61.5% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",32.5,50,,26.00,,,0,"percent of total billed charges","50% of total billed charges",20.93,32.2,,16.74,,,0,"percent of total billed charges","32.2% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.14,17.136,,8.91,,,0,"percent of total billed charges","17.136% of total billed charges",14.2,21.84,,11.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.51,37.7,,19.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.7,78,,40.56,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",32.5,50,,26.00,,,0,"percent of total billed charges","50% of total billed charges",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",9.95,65,
"NEEDLE 18 GA X 1 1/2''SAFTEY",490934,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"NEEDLE BOX 20 COUNT",490945,CDM,272,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"NEEDLE HYPO 21G (DEMILL)",490958,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"NEEDLE HYPO 25G",490960,CDM,272,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"NEEDLE HYPO 30G",490962,CDM,272,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"NEEDLE PROTECTION DEVICE POINT-LOK",490970,CDM,272,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"NEEDLE PERCUTANEOUS 21G X 7CM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"NEEDLE PERCOUTANEOUS ENTRY 21G",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"NEEDLE BIOPSY 18G 9CM LONG QUICK CORE",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"NEEDLE INJECTION 25G 5MM 230CM 2.8MM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"NEEDLE SURGEON 1/2 CIRCLE TAPER .040",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"NEEDLE BIOPSY 20G X 15CM LNG",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"NEEDLE BIOPSY 20G X 9CM",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"NEEDLE BIOPSY 18G X 6 X 1",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"NEEDLE BIOPSY 20G X 9CM -10T",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"NEEDLE BIOPSY CORCA 18 X 25",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"NEEDLE SPINAL 25G X 4.69IN",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"NEEDLE #2 FIBERLOOP CURVED",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"NEEDLE TUOHY EPIDURAL 17G X 5",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"NEEDLE TUOHY EPIDURAL 20G X 3.5",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"NEEDLE TUOHY EPIDURAL 22G X 3.5",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"NEEDLE TUOHY EPIDURAL 22G X 5",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"NEEDLE EZ-IO PEDIATRIC 15G",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"NEEDLE HUBER 20G X .75 WHIN SAFE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"NEEDLE GUIDE 9G EVIVA",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"NEEDLE BIOPSY SYSTEM 20G X 15CM CORVOCET",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"NEEDLE BIOPSY SYSTEM 20G X 20CM CORVOCET",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"NEEDLE BIOPSY COAXIAL 20G X 20",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"NEEDLE BIOPSY COAXIAL 18 X 20 X 20MM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"NEEDLE BIOPSY SET QUICK CORE 18 X 15 X 20MM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"NEEDLE BIOPSY SYSTEM 18G X 15CM CORVOCET",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"NEEDLE BIOPSY ACHIEVE 18G X 11CM",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"NEEDLE BIOPSY SET QUICK CORE 20 X 15 X 10MM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"NEEDLE SPINAL WHITCARE HIGH FLOW PENCIL POINT 25G X 5IN",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"NEEDLE ASPIRATION CHIBA",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"NEEDLE ULTRASOUND INSULATED 21X4",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"NEEDLE BIOPSY SET 13G X 10CM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"NEEDLE ULTRASOUND INSULATED 21G X 6",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"NEEDLE COAXIAL ADJUSTABLE 20GA",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,412,267.8,,362.56,88,,290.05,,,0,"percent of total billed charges","88% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.29,17.304,,57.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",259.56,63,,207.65,,,0,"percent of total billed charges","63% of total billed charges",63.04,15.3,,50.43,,,0,"percent of total billed charges","15.3% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",284.28,69,,,,,0,"fee schedule","69% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",254.82,61.85,,203.86,,,0,"percent of total billed charges","61.5% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",132.66,32.2,,106.13,,,0,"percent of total billed charges","32.2% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.6,17.136,,56.48,,,0,"percent of total billed charges","17.136% of total billed charges",89.98,21.84,,71.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",155.32,37.7,,124.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",321.36,78,,257.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",63.04,412,
"NEEDLE PERC ENTRY THIN WALL 21GAX15CM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"NEEDLE 360 DEGREE SUTURE PASSER",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,824,535.6,,725.12,88,,580.10,,,0,"percent of total billed charges","88% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.58,17.304,,114.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",519.12,63,,415.30,,,0,"percent of total billed charges","63% of total billed charges",126.07,15.3,,100.86,,,0,"percent of total billed charges","15.3% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",568.56,69,,,,,0,"fee schedule","69% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.64,61.85,,407.71,,,0,"percent of total billed charges","61.5% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",265.33,32.2,,212.26,,,0,"percent of total billed charges","32.2% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",141.2,17.136,,112.96,,,0,"percent of total billed charges","17.136% of total billed charges",179.96,21.84,,143.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",310.65,37.7,,248.52,,,0,"percent of total billed charges","37.7% of total billed charges",310.65,37.7,,248.52,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",279.34,33.9,,223.47,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.72,78,,514.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",126.07,824,
"NEEDLE JAMSHIDI 10GA X 9",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"NEEDLE BIOPSY J-TYPE BONE MARROW 11GA 6IN",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"NEEDLE SAFTEY 3ML 25X1",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"NEEDLE SAFTEY 3ML 25X5/8",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"NEEDLE INFUSION SET 21GA (FOR USE WITH FILL KIT)",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"NEEDLE VENIPUNCTURE BLOOD COLLECTTION DECIVE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"NEEDLE BIOPSY COAXIAL TEMNO (ACT) 19GA",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,17.304,,49.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.28,61.85,,178.62,,,0,"percent of total billed charges","61.5% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",116.24,32.2,,92.99,,,0,"percent of total billed charges","32.2% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.86,17.136,,49.49,,,0,"percent of total billed charges","17.136% of total billed charges",78.84,21.84,,63.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,361,
"NEEDLE MICROPUNTURE SET 4FR",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"NEEDLE HOLDER WEBSTER 15MM SMOOTH JAW",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"NEEDLE REGULAR BEVEL 20GX1 IN",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"NEEDLE BIOPSY 20G X 9CM ECHO TIP",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"NEEDLE SPINAL WHITACRE GRAY 27GA",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"NEEDLE SPINAL QUINCKE BEVEL TAN 25GAX3.5",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"NEEDLE PROBLOCK 22X50",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"NEEDLE PROBLOCK 22X80",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"NEEDLE ECHOTISMINSULATED 21X4",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"NEEDLE SPECIAL USE 27GX1.25",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"NEEDLE NONINSULATED ULTRASND 21GX6",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"NEEDLE SCORPION WITH MEGA LOADER",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1150,747.5,,1012,88,,809.60,,,0,"percent of total billed charges","88% of total billed charges",575,50,,460.00,,,0,"percent of total billed charges","50% of total billed charges",193.2,16.8,,154.56,,,0,"percent of total billed charges","16.8% of total billed charges",1150,100,,920.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",199,17.304,,159.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",724.5,63,,579.60,,,0,"percent of total billed charges","63% of total billed charges",175.95,15.3,,140.76,,,0,"percent of total billed charges","15.3% of total billed charges",193.2,16.8,,154.56,,,0,"percent of total billed charges","16.8% of total billed charges",793.5,69,,,,,0,"fee schedule","69% of total billed charges",1150,100,,920.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1150,100,,920.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1150,100,,920.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",711.28,61.85,,569.02,,,0,"percent of total billed charges","61.5% of total billed charges",193.2,16.8,,154.56,,,0,"percent of total billed charges","16.8% of total billed charges",575,50,,460.00,,,0,"percent of total billed charges","50% of total billed charges",370.3,32.2,,296.24,,,0,"percent of total billed charges","32.2% of total billed charges",193.2,16.8,,154.56,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",197.06,17.136,,157.65,,,0,"percent of total billed charges","17.136% of total billed charges",251.16,21.84,,200.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",433.55,37.7,,346.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",897,78,,717.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",949.9,82.6,,759.92,,,0,"percent of total billed charges","82.6% of total billed charges",193.2,16.8,,154.56,,,0,"percent of total billed charges","16.8% of total billed charges",575,50,,460.00,,,0,"percent of total billed charges","50% of total billed charges",949.9,82.6,,759.92,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",193.2,16.8,,154.56,,,0,"percent of total billed charges","16.8% of total billed charges",1150,100,,920.00,,,0,"percent of total billed charges","100% of total billed charges",175.95,1150,
"NEELDE MICROPUNCTURE 5FR",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"NEISSERIA GONORRHOEAE ATCC CULTI LOOPS 49981",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"LAMP PENLON LARGE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"NEONATE MASK UNSCENTED SZ 2",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"NEOSTIM TRIPLE LAYER 2X2CM",636Q426522,CDM,636,RC,,,OUTPATIENT,,,30076,19549.4,,26466.88,88,,21173.50,,,0,"percent of total billed charges","88% of total billed charges",15038,50,,12030.40,,,0,"percent of total billed charges","50% of total billed charges",5052.77,16.8,,4042.22,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5204.35,17.304,,4163.48,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18947.88,63,,15158.30,,,0,"percent of total billed charges","63% of total billed charges",4601.63,15.3,,3681.30,,,0,"percent of total billed charges","15.3% of total billed charges",5052.77,16.8,,4042.22,,,0,"percent of total billed charges","16.8% of total billed charges",20752.44,69,,,,,0,"fee schedule","69% of total billed charges",30076,100,,24060.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30076,100,,24060.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30076,100,,24060.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18602.01,61.85,,14881.61,,,0,"percent of total billed charges","61.5% of total billed charges",5052.77,16.8,,4042.22,,,0,"percent of total billed charges","16.8% of total billed charges",15038,50,,12030.40,,,0,"percent of total billed charges","50% of total billed charges",9684.47,32.2,,7747.58,,,0,"percent of total billed charges","32.2% of total billed charges",5052.77,16.8,,4042.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5153.82,17.136,,4123.06,,,0,"percent of total billed charges","17.136% of total billed charges",6568.6,21.84,,5254.88,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",11338.65,37.7,,9070.92,,,0,"percent of total billed charges","37.7% of total billed charges",11338.65,37.7,,9070.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",10195.76,33.9,,8156.61,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",23459.28,78,,18767.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5052.77,16.8,,4042.22,,,0,"percent of total billed charges","16.8% of total billed charges",15038,50,,12030.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5052.77,16.8,,4042.22,,,0,"percent of total billed charges","16.8% of total billed charges",30076,100,,24060.80,,,0,"percent of total billed charges","100% of total billed charges",4601.63,30076,
"NEOSTIM TRIPLE LAYER 2X3CM",636Q426523,CDM,636,RC,,,OUTPATIENT,,,44908,29190.2,,39519.04,88,,31615.23,,,0,"percent of total billed charges","88% of total billed charges",22454,50,,17963.20,,,0,"percent of total billed charges","50% of total billed charges",7544.54,16.8,,6035.63,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7770.88,17.304,,6216.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",28292.04,63,,22633.63,,,0,"percent of total billed charges","63% of total billed charges",6870.92,15.3,,5496.74,,,0,"percent of total billed charges","15.3% of total billed charges",7544.54,16.8,,6035.63,,,0,"percent of total billed charges","16.8% of total billed charges",30986.52,69,,,,,0,"fee schedule","69% of total billed charges",44908,100,,35926.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44908,100,,35926.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44908,100,,35926.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27775.6,61.85,,22220.48,,,0,"percent of total billed charges","61.5% of total billed charges",7544.54,16.8,,6035.63,,,0,"percent of total billed charges","16.8% of total billed charges",22454,50,,17963.20,,,0,"percent of total billed charges","50% of total billed charges",14460.38,32.2,,11568.30,,,0,"percent of total billed charges","32.2% of total billed charges",7544.54,16.8,,6035.63,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7695.43,17.136,,6156.34,,,0,"percent of total billed charges","17.136% of total billed charges",9807.91,21.84,,7846.33,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",16930.32,37.7,,13544.26,,,0,"percent of total billed charges","37.7% of total billed charges",16930.32,37.7,,13544.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",15223.81,33.9,,12179.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",35028.24,78,,28022.59,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7544.54,16.8,,6035.63,,,0,"percent of total billed charges","16.8% of total billed charges",22454,50,,17963.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7544.54,16.8,,6035.63,,,0,"percent of total billed charges","16.8% of total billed charges",44908,100,,35926.40,,,0,"percent of total billed charges","100% of total billed charges",4695,44908,
"NEPTUNE E-SEP CAUTERY",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"NEPTUNE HEPA FILTER",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,824,535.6,,725.12,88,,580.10,,,0,"percent of total billed charges","88% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.58,17.304,,114.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",519.12,63,,415.30,,,0,"percent of total billed charges","63% of total billed charges",126.07,15.3,,100.86,,,0,"percent of total billed charges","15.3% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",568.56,69,,,,,0,"fee schedule","69% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.64,61.85,,407.71,,,0,"percent of total billed charges","61.5% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",265.33,32.2,,212.26,,,0,"percent of total billed charges","32.2% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",141.2,17.136,,112.96,,,0,"percent of total billed charges","17.136% of total billed charges",179.96,21.84,,143.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",310.65,37.7,,248.52,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",642.72,78,,514.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",126.07,824,
"NESTER EMBOLIZATION COIL",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"NESTER EMBOLISM COIL 14CM X 8MM",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"NESTER EMBOLISM COIL 14CM X 6MM",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"NESTER EMBOLISM COIL 20CM X 14MM",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"NESTER EMBOLISM COIL 14CM X 4MM",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"NESTER EMBOLISM COIL 20CM X 10MM",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"NESTER EMBOLISM COIL 20CM X 16MM",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"NESTER EMBOLISM COIL 20CM X 12MM",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"NESTER EMBOLIZATION COIL 8MM X 7MCM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.94,17.304,,85.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.23,61.85,,305.78,,,0,"percent of total billed charges","61.5% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",199,32.2,,159.20,,,0,"percent of total billed charges","32.2% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.136,,84.72,,,0,"percent of total billed charges","17.136% of total billed charges",134.97,21.84,,107.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.7% of total billed charges",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.5,33.9,,167.60,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,618,
"NESTER EMBOLIZATION COIL 16MM X 20CM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.94,17.304,,85.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.23,61.85,,305.78,,,0,"percent of total billed charges","61.5% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",199,32.2,,159.20,,,0,"percent of total billed charges","32.2% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.136,,84.72,,,0,"percent of total billed charges","17.136% of total billed charges",134.97,21.84,,107.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.7% of total billed charges",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.5,33.9,,167.60,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,618,
"NESTER EMBOLISM COIL 8X7MM",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.94,17.304,,85.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.23,61.85,,305.78,,,0,"percent of total billed charges","61.5% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",199,32.2,,159.20,,,0,"percent of total billed charges","32.2% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.136,,84.72,,,0,"percent of total billed charges","17.136% of total billed charges",134.97,21.84,,107.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,618,
"NEURO PLATE 4X2 HOLES SQUARE SEG 6MM 1.5MM SYS CP TITANIUM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"NEURO PLATE 5X2 HOLES CURVED SQUARE SEG 6MM 1.5MM SYS CP TITANIUM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"NEURO PLATE LOW PROF 3X2 HOLES SQUARE SEFMENT  6MM 1.5MM SYS CP TITANIUM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"NEURO PLATE LOW PROFIELE STRAIGHT 16 HOLE CP TITANIUM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"NEURO PLATE LOW PROFILE  SQUARE 6MM 1.5MM SYSTEM CP TITANIUM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"NEURO PLATE LOW PROFILE  STRAIGHT 4 HOLE  REGULAR CP TITANIUM",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"NEURO PLATE LOW PROFILE NEURO PLATE  STRAIGHT 4HOLE  X-LONG  CP TITANIUM",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
NEURO,326391,CDM,270,RC,,,OUTPATIENT,,,1243,807.95,,1093.84,88,,875.07,,,0,"percent of total billed charges","88% of total billed charges",621.5,50,,497.20,,,0,"percent of total billed charges","50% of total billed charges",208.82,16.8,,167.06,,,0,"percent of total billed charges","16.8% of total billed charges",1243,100,,994.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",215.09,17.304,,172.07,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",783.09,63,,626.47,,,0,"percent of total billed charges","63% of total billed charges",190.18,15.3,,152.14,,,0,"percent of total billed charges","15.3% of total billed charges",208.82,16.8,,167.06,,,0,"percent of total billed charges","16.8% of total billed charges",857.67,69,,,,,0,"fee schedule","69% of total billed charges",1243,100,,994.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1243,100,,994.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1243,100,,994.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",768.8,61.85,,615.04,,,0,"percent of total billed charges","61.5% of total billed charges",208.82,16.8,,167.06,,,0,"percent of total billed charges","16.8% of total billed charges",621.5,50,,497.20,,,0,"percent of total billed charges","50% of total billed charges",400.25,32.2,,320.20,,,0,"percent of total billed charges","32.2% of total billed charges",208.82,16.8,,167.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",213,17.136,,170.40,,,0,"percent of total billed charges","17.136% of total billed charges",271.47,21.84,,217.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",468.61,37.7,,374.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",969.54,78,,775.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1026.72,82.6,,821.38,,,0,"percent of total billed charges","82.6% of total billed charges",208.82,16.8,,167.06,,,0,"percent of total billed charges","16.8% of total billed charges",621.5,50,,497.20,,,0,"percent of total billed charges","50% of total billed charges",1026.72,82.6,,821.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.82,16.8,,167.06,,,0,"percent of total billed charges","16.8% of total billed charges",1243,100,,994.40,,,0,"percent of total billed charges","100% of total billed charges",190.18,1243,
"NEURO MODULE LOW PROFILE  COMPLETE",ORSUP0026,CDM,272,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"NEUTRAL BUFFERED FORMALIN 10% 1GL",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"NEW LOT LABEL YELLOW",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"NEXIVA DIFFUSICS CLOSED IV CATH 20GX1",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"NEXIVA DIFFUSICS CLOSED IV CATH 18GX1.25",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"NEXIVA 22G X 1 W/MAX ZERO",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"BACTIDROP NINHYDRIN",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"NIO ADULT AUTOMATIC INTRAOSSEOUS DEVICE 15G",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,721,468.65,,634.48,88,,507.58,,,0,"percent of total billed charges","88% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.76,17.304,,99.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.23,63,,363.38,,,0,"percent of total billed charges","63% of total billed charges",110.31,15.3,,88.25,,,0,"percent of total billed charges","15.3% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",497.49,69,,,,,0,"fee schedule","69% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",445.94,61.85,,356.75,,,0,"percent of total billed charges","61.5% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",232.16,32.2,,185.73,,,0,"percent of total billed charges","32.2% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",123.55,17.136,,98.84,,,0,"percent of total billed charges","17.136% of total billed charges",157.47,21.84,,125.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",271.82,37.7,,217.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",562.38,78,,449.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",595.55,82.6,,476.44,,,0,"percent of total billed charges","82.6% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",595.55,82.6,,476.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",110.31,721,
"NIO PEDIATRIC AUTOMATIC INTRAOSSEOUS DEVICE 18",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,721,468.65,,634.48,88,,507.58,,,0,"percent of total billed charges","88% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.76,17.304,,99.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.23,63,,363.38,,,0,"percent of total billed charges","63% of total billed charges",110.31,15.3,,88.25,,,0,"percent of total billed charges","15.3% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",497.49,69,,,,,0,"fee schedule","69% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",445.94,61.85,,356.75,,,0,"percent of total billed charges","61.5% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",232.16,32.2,,185.73,,,0,"percent of total billed charges","32.2% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",123.55,17.136,,98.84,,,0,"percent of total billed charges","17.136% of total billed charges",157.47,21.84,,125.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",271.82,37.7,,217.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",562.38,78,,449.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",595.55,82.6,,476.44,,,0,"percent of total billed charges","82.6% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",595.55,82.6,,476.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",110.31,721,
"NIO GO IO INTRAOSSEOUS START KIT",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"NIO INFANT INTRAOSSEOUS DEVICE",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,721,468.65,,634.48,88,,507.58,,,0,"percent of total billed charges","88% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.76,17.304,,99.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.23,63,,363.38,,,0,"percent of total billed charges","63% of total billed charges",110.31,15.3,,88.25,,,0,"percent of total billed charges","15.3% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",497.49,69,,,,,0,"fee schedule","69% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",445.94,61.85,,356.75,,,0,"percent of total billed charges","61.5% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",232.16,32.2,,185.73,,,0,"percent of total billed charges","32.2% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",123.55,17.136,,98.84,,,0,"percent of total billed charges","17.136% of total billed charges",157.47,21.84,,125.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",271.82,37.7,,217.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",562.38,78,,449.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",595.55,82.6,,476.44,,,0,"percent of total billed charges","82.6% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",595.55,82.6,,476.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",110.31,721,
"NIPPLE \\T\\ NUT ADAPTERS",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"NITINOL GUIDE PIN 1.1MM",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"NITROCEFIN DISC",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"NO RINSE SHAMPOO (FRAGRANCE)",95895,CDM,272,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"NONINVASIVE CIRCUIT",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"NOTTINGHAM 6/12F DILATOR",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"NOVASURE DISP DEVICE",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"NOVA TEMPERATURE PROBE 9FR 400 SERIES",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"NOVOSORB BTM 5X5",ORSUP0035,CDM,278,RC,,,OUTPATIENT,,,4944,3213.6,,4350.72,88,,3480.58,,,0,"percent of total billed charges","88% of total billed charges",2472,50,,1977.60,,,0,"percent of total billed charges","50% of total billed charges",830.59,16.8,,664.47,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",855.51,17.304,,684.41,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3114.72,63,,2491.78,,,0,"percent of total billed charges","63% of total billed charges",756.43,15.3,,605.14,,,0,"percent of total billed charges","15.3% of total billed charges",830.59,16.8,,664.47,,,0,"percent of total billed charges","16.8% of total billed charges",3411.36,69,,,,,0,"fee schedule","69% of total billed charges",4944,100,,3955.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4944,100,,3955.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4944,100,,3955.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3057.86,61.85,,2446.29,,,0,"percent of total billed charges","61.5% of total billed charges",830.59,16.8,,664.47,,,0,"percent of total billed charges","16.8% of total billed charges",2472,50,,1977.60,,,0,"percent of total billed charges","50% of total billed charges",1591.97,32.2,,1273.58,,,0,"percent of total billed charges","32.2% of total billed charges",1542.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",847.2,17.136,,677.76,,,0,"percent of total billed charges","17.136% of total billed charges",1079.77,21.84,,863.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1863.89,37.7,,1491.11,,,0,"percent of total billed charges","37.7% of total billed charges",1863.89,37.7,,1491.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1676.02,33.9,,1340.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3856.32,78,,3085.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4083.74,82.6,,3266.99,,,0,"percent of total billed charges","82.6% of total billed charges",830.59,16.8,,664.47,,,0,"percent of total billed charges","16.8% of total billed charges",2472,50,,1977.60,,,0,"percent of total billed charges","50% of total billed charges",4083.74,82.6,,3266.99,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",830.59,16.8,,664.47,,,0,"percent of total billed charges","16.8% of total billed charges",4944,100,,3955.20,,,0,"percent of total billed charges","100% of total billed charges",756.43,4944,
"NOVOSORB BTM 10X10",ORSUP0044,CDM,278,RC,,,OUTPATIENT,,,6798,4418.7,,5982.24,88,,4785.79,,,0,"percent of total billed charges","88% of total billed charges",3399,50,,2719.20,,,0,"percent of total billed charges","50% of total billed charges",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1176.33,17.304,,941.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4282.74,63,,3426.19,,,0,"percent of total billed charges","63% of total billed charges",1040.09,15.3,,832.07,,,0,"percent of total billed charges","15.3% of total billed charges",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",4690.62,69,,,,,0,"fee schedule","69% of total billed charges",6798,100,,5438.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6798,100,,5438.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6798,100,,5438.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4204.56,61.85,,3363.65,,,0,"percent of total billed charges","61.5% of total billed charges",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",3399,50,,2719.20,,,0,"percent of total billed charges","50% of total billed charges",2188.96,32.2,,1751.17,,,0,"percent of total billed charges","32.2% of total billed charges",2120.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1164.91,17.136,,931.93,,,0,"percent of total billed charges","17.136% of total billed charges",1484.68,21.84,,1187.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2562.85,37.7,,2050.28,,,0,"percent of total billed charges","37.7% of total billed charges",2562.85,37.7,,2050.28,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2304.52,33.9,,1843.62,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5302.44,78,,4241.95,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5615.15,82.6,,4492.12,,,0,"percent of total billed charges","82.6% of total billed charges",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",3399,50,,2719.20,,,0,"percent of total billed charges","50% of total billed charges",5615.15,82.6,,4492.12,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1142.06,16.8,,913.65,,,0,"percent of total billed charges","16.8% of total billed charges",6798,100,,5438.40,,,0,"percent of total billed charges","100% of total billed charges",1040.09,6798,
"NOVOSORB BTM 10CM X 20CM",ORSUP0075,CDM,278,RC,,,OUTPATIENT,,,13390,8703.5,,11783.2,88,,9426.56,,,0,"percent of total billed charges","88% of total billed charges",6695,50,,5356.00,,,0,"percent of total billed charges","50% of total billed charges",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2317.01,17.304,,1853.61,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8435.7,63,,6748.56,,,0,"percent of total billed charges","63% of total billed charges",2048.67,15.3,,1638.94,,,0,"percent of total billed charges","15.3% of total billed charges",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",9239.1,69,,,,,0,"fee schedule","69% of total billed charges",13390,100,,10712.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13390,100,,10712.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13390,100,,10712.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8281.72,61.85,,6625.38,,,0,"percent of total billed charges","61.5% of total billed charges",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",6695,50,,5356.00,,,0,"percent of total billed charges","50% of total billed charges",4311.58,32.2,,3449.26,,,0,"percent of total billed charges","32.2% of total billed charges",4177.68,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2294.51,17.136,,1835.61,,,0,"percent of total billed charges","17.136% of total billed charges",2924.38,21.84,,2339.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",5048.03,37.7,,4038.42,,,0,"percent of total billed charges","37.7% of total billed charges",5048.03,37.7,,4038.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4539.21,33.9,,3631.37,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",10444.2,78,,8355.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11060.14,82.6,,8848.11,,,0,"percent of total billed charges","82.6% of total billed charges",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",6695,50,,5356.00,,,0,"percent of total billed charges","50% of total billed charges",11060.14,82.6,,8848.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",13390,100,,10712.00,,,0,"percent of total billed charges","100% of total billed charges",2048.67,13390,
"NS IRRIGATION 1500ML 2F7125",490980,CDM,272,RC,,,OUTPATIENT,,,39,25.35,,34.32,88,,27.46,,,0,"percent of total billed charges","88% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.75,17.304,,5.40,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.57,63,,19.66,,,0,"percent of total billed charges","63% of total billed charges",5.97,15.3,,4.78,,,0,"percent of total billed charges","15.3% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",26.91,69,,,,,0,"fee schedule","69% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.12,61.85,,19.30,,,0,"percent of total billed charges","61.5% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",12.56,32.2,,10.05,,,0,"percent of total billed charges","32.2% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.68,17.136,,5.34,,,0,"percent of total billed charges","17.136% of total billed charges",8.52,21.84,,6.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.42,78,,24.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",5.97,39,
"NS IRRIGATION 500ML 2F7123",490981,CDM,272,RC,,,OUTPATIENT,,,25,16.25,,22,88,,17.60,,,0,"percent of total billed charges","88% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,17.304,,3.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.75,63,,12.60,,,0,"percent of total billed charges","63% of total billed charges",3.83,15.3,,3.06,,,0,"percent of total billed charges","15.3% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",17.25,69,,,,,0,"fee schedule","69% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.46,61.85,,12.37,,,0,"percent of total billed charges","61.5% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",8.05,32.2,,6.44,,,0,"percent of total billed charges","32.2% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.28,17.136,,3.42,,,0,"percent of total billed charges","17.136% of total billed charges",5.46,21.84,,4.37,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.43,37.7,,7.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.5,78,,15.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",3.83,25,
"NUGAUZE IODINE 1''",490982,CDM,270,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"NUT PANGEA USS  499.294",ORSUP0021,CDM,278,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",835.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.7% of total billed charges",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",907.84,33.9,,726.27,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"NUVASIVE CAGE 10 X 22 X 60",ORSUP0101,CDM,278,RC,,,OUTPATIENT,,,24638,16014.7,,21681.44,88,,17345.15,,,0,"percent of total billed charges","88% of total billed charges",12319,50,,9855.20,,,0,"percent of total billed charges","50% of total billed charges",4139.18,16.8,,3311.34,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4263.36,17.304,,3410.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15521.94,63,,12417.55,,,0,"percent of total billed charges","63% of total billed charges",3769.61,15.3,,3015.69,,,0,"percent of total billed charges","15.3% of total billed charges",4139.18,16.8,,3311.34,,,0,"percent of total billed charges","16.8% of total billed charges",17000.22,69,,,,,0,"fee schedule","69% of total billed charges",24638,100,,19710.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24638,100,,19710.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24638,100,,19710.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15238.6,61.85,,12190.88,,,0,"percent of total billed charges","61.5% of total billed charges",4139.18,16.8,,3311.34,,,0,"percent of total billed charges","16.8% of total billed charges",12319,50,,9855.20,,,0,"percent of total billed charges","50% of total billed charges",7933.44,32.2,,6346.75,,,0,"percent of total billed charges","32.2% of total billed charges",7687.06,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",4221.97,17.136,,3377.58,,,0,"percent of total billed charges","17.136% of total billed charges",5380.94,21.84,,4304.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",9288.53,37.7,,7430.82,,,0,"percent of total billed charges","37.7% of total billed charges",9288.53,37.7,,7430.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",8352.28,33.9,,6681.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",19217.64,78,,15374.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",20350.99,82.6,,16280.79,,,0,"percent of total billed charges","82.6% of total billed charges",4139.18,16.8,,3311.34,,,0,"percent of total billed charges","16.8% of total billed charges",12319,50,,9855.20,,,0,"percent of total billed charges","50% of total billed charges",20350.99,82.6,,16280.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4139.18,16.8,,3311.34,,,0,"percent of total billed charges","16.8% of total billed charges",24638,100,,19710.40,,,0,"percent of total billed charges","100% of total billed charges",3769.61,24638,
"NUVASIVE CAGE 13 X 45 X 12",ORSUP0101,CDM,278,RC,,,OUTPATIENT,,,24638,16014.7,,21681.44,88,,17345.15,,,0,"percent of total billed charges","88% of total billed charges",12319,50,,9855.20,,,0,"percent of total billed charges","50% of total billed charges",4139.18,16.8,,3311.34,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4263.36,17.304,,3410.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15521.94,63,,12417.55,,,0,"percent of total billed charges","63% of total billed charges",3769.61,15.3,,3015.69,,,0,"percent of total billed charges","15.3% of total billed charges",4139.18,16.8,,3311.34,,,0,"percent of total billed charges","16.8% of total billed charges",17000.22,69,,,,,0,"fee schedule","69% of total billed charges",24638,100,,19710.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24638,100,,19710.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24638,100,,19710.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15238.6,61.85,,12190.88,,,0,"percent of total billed charges","61.5% of total billed charges",4139.18,16.8,,3311.34,,,0,"percent of total billed charges","16.8% of total billed charges",12319,50,,9855.20,,,0,"percent of total billed charges","50% of total billed charges",7933.44,32.2,,6346.75,,,0,"percent of total billed charges","32.2% of total billed charges",7687.06,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",4221.97,17.136,,3377.58,,,0,"percent of total billed charges","17.136% of total billed charges",5380.94,21.84,,4304.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",9288.53,37.7,,7430.82,,,0,"percent of total billed charges","37.7% of total billed charges",9288.53,37.7,,7430.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",8352.28,33.9,,6681.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",19217.64,78,,15374.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",20350.99,82.6,,16280.79,,,0,"percent of total billed charges","82.6% of total billed charges",4139.18,16.8,,3311.34,,,0,"percent of total billed charges","16.8% of total billed charges",12319,50,,9855.20,,,0,"percent of total billed charges","50% of total billed charges",20350.99,82.6,,16280.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4139.18,16.8,,3311.34,,,0,"percent of total billed charges","16.8% of total billed charges",24638,100,,19710.40,,,0,"percent of total billed charges","100% of total billed charges",3769.61,24638,
"NUVASIVE CAGE 22 X 10 X 50",ORSUP0101,CDM,278,RC,,,OUTPATIENT,,,24638,16014.7,,21681.44,88,,17345.15,,,0,"percent of total billed charges","88% of total billed charges",12319,50,,9855.20,,,0,"percent of total billed charges","50% of total billed charges",4139.18,16.8,,3311.34,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4263.36,17.304,,3410.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15521.94,63,,12417.55,,,0,"percent of total billed charges","63% of total billed charges",3769.61,15.3,,3015.69,,,0,"percent of total billed charges","15.3% of total billed charges",4139.18,16.8,,3311.34,,,0,"percent of total billed charges","16.8% of total billed charges",17000.22,69,,,,,0,"fee schedule","69% of total billed charges",24638,100,,19710.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24638,100,,19710.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24638,100,,19710.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15238.6,61.85,,12190.88,,,0,"percent of total billed charges","61.5% of total billed charges",4139.18,16.8,,3311.34,,,0,"percent of total billed charges","16.8% of total billed charges",12319,50,,9855.20,,,0,"percent of total billed charges","50% of total billed charges",7933.44,32.2,,6346.75,,,0,"percent of total billed charges","32.2% of total billed charges",7687.06,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",4221.97,17.136,,3377.58,,,0,"percent of total billed charges","17.136% of total billed charges",5380.94,21.84,,4304.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",9288.53,37.7,,7430.82,,,0,"percent of total billed charges","37.7% of total billed charges",9288.53,37.7,,7430.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",8352.28,33.9,,6681.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",19217.64,78,,15374.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",20350.99,82.6,,16280.79,,,0,"percent of total billed charges","82.6% of total billed charges",4139.18,16.8,,3311.34,,,0,"percent of total billed charges","16.8% of total billed charges",12319,50,,9855.20,,,0,"percent of total billed charges","50% of total billed charges",20350.99,82.6,,16280.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4139.18,16.8,,3311.34,,,0,"percent of total billed charges","16.8% of total billed charges",24638,100,,19710.40,,,0,"percent of total billed charges","100% of total billed charges",3769.61,24638,
"NUVASIVE CAGE 22 X 12 X 50",ORSUP0101,CDM,278,RC,,,OUTPATIENT,,,24638,16014.7,,21681.44,88,,17345.15,,,0,"percent of total billed charges","88% of total billed charges",12319,50,,9855.20,,,0,"percent of total billed charges","50% of total billed charges",4139.18,16.8,,3311.34,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4263.36,17.304,,3410.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15521.94,63,,12417.55,,,0,"percent of total billed charges","63% of total billed charges",3769.61,15.3,,3015.69,,,0,"percent of total billed charges","15.3% of total billed charges",4139.18,16.8,,3311.34,,,0,"percent of total billed charges","16.8% of total billed charges",17000.22,69,,,,,0,"fee schedule","69% of total billed charges",24638,100,,19710.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24638,100,,19710.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24638,100,,19710.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15238.6,61.85,,12190.88,,,0,"percent of total billed charges","61.5% of total billed charges",4139.18,16.8,,3311.34,,,0,"percent of total billed charges","16.8% of total billed charges",12319,50,,9855.20,,,0,"percent of total billed charges","50% of total billed charges",7933.44,32.2,,6346.75,,,0,"percent of total billed charges","32.2% of total billed charges",7687.06,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",4221.97,17.136,,3377.58,,,0,"percent of total billed charges","17.136% of total billed charges",5380.94,21.84,,4304.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",9288.53,37.7,,7430.82,,,0,"percent of total billed charges","37.7% of total billed charges",9288.53,37.7,,7430.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",8352.28,33.9,,6681.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",19217.64,78,,15374.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",20350.99,82.6,,16280.79,,,0,"percent of total billed charges","82.6% of total billed charges",4139.18,16.8,,3311.34,,,0,"percent of total billed charges","16.8% of total billed charges",12319,50,,9855.20,,,0,"percent of total billed charges","50% of total billed charges",20350.99,82.6,,16280.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4139.18,16.8,,3311.34,,,0,"percent of total billed charges","16.8% of total billed charges",24638,100,,19710.40,,,0,"percent of total billed charges","100% of total billed charges",3769.61,24638,
"Neuro Monitoring Charge",SUR200052,CDM,360,RC,,,OUTPATIENT,,,19906,12938.9,,17517.28,88,,14013.82,,,0,"percent of total billed charges","88% of total billed charges",9953,50,,7962.40,,,0,"percent of total billed charges","50% of total billed charges",3344.21,16.8,,2675.37,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3444.53,17.304,,2755.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12540.78,63,,10032.62,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",3344.21,16.8,,2675.37,,,0,"percent of total billed charges","16.8% of total billed charges",13735.14,69,,,,,0,"fee schedule","69% of total billed charges",19906,100,,15924.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19906,100,,15924.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19906,100,,15924.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12311.86,61.85,,9849.49,,,0,"percent of total billed charges","61.5% of total billed charges",3344.21,16.8,,2675.37,,,0,"percent of total billed charges","16.8% of total billed charges",9953,50,,7962.40,,,0,"percent of total billed charges","50% of total billed charges",6409.73,32.2,,5127.78,,,0,"percent of total billed charges","32.2% of total billed charges",3344.21,16.8,,2675.37,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3411.09,17.136,,2728.87,,,0,"percent of total billed charges","17.136% of total billed charges",4347.47,21.84,,3477.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",7504.56,37.7,,6003.65,,,0,"percent of total billed charges","37.7% of total billed charges",7504.56,37.7,,6003.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",6748.13,33.9,,5398.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",15526.68,78,,12421.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16442.36,82.6,,13153.89,,,0,"percent of total billed charges","82.6% of total billed charges",3344.21,16.8,,2675.37,,,0,"percent of total billed charges","16.8% of total billed charges",9953,50,,7962.40,,,0,"percent of total billed charges","50% of total billed charges",16442.36,82.6,,13153.89,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3344.21,16.8,,2675.37,,,0,"percent of total billed charges","16.8% of total billed charges",19906,100,,15924.80,,,0,"percent of total billed charges","100% of total billed charges",3344.21,19906,
"O2 HUMIDIFER",490983,CDM,270,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"O3 REGIONAL SENSOR LARGE",ORSUP0032,CDM,270,RC,,,OUTPATIENT,,,5624,3655.6,,4949.12,88,,3959.30,,,0,"percent of total billed charges","88% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",973.18,17.304,,778.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3543.12,63,,2834.50,,,0,"percent of total billed charges","63% of total billed charges",860.47,15.3,,688.38,,,0,"percent of total billed charges","15.3% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",3880.56,69,,,,,0,"fee schedule","69% of total billed charges",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3478.44,61.85,,2782.75,,,0,"percent of total billed charges","61.5% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",1810.93,32.2,,1448.74,,,0,"percent of total billed charges","32.2% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",963.73,17.136,,770.98,,,0,"percent of total billed charges","17.136% of total billed charges",1228.28,21.84,,982.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2120.25,37.7,,1696.20,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4386.72,78,,3509.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4645.42,82.6,,3716.34,,,0,"percent of total billed charges","82.6% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",4645.42,82.6,,3716.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",860.47,5624,
"OAES ENHANCEMENT ANTIBODY 15 X 10ML",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"OASIS WOUND MATRIX 3X3.5 CM",636Q4102335,CDM,636,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"OASIS ULTRA TRI-LAYER MATRIX 3X3.5 CM",636Q4124335,CDM,636,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"OASYS BLOCKER",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"OASYS DRILL BIT 2.5",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"OBTRYX TRANSOBTURATOR SLING",ORSUP0033,CDM,278,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",1838.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.7% of total billed charges",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1997.39,33.9,,1597.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"OBTURATOR 8MM BLADELESS",267290,CDM,272,RC,,,OUTPATIENT,,,207,134.55,,182.16,88,,145.73,,,0,"percent of total billed charges","88% of total billed charges",103.5,50,,82.80,,,0,"percent of total billed charges","50% of total billed charges",34.78,16.8,,27.82,,,0,"percent of total billed charges","16.8% of total billed charges",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.82,17.304,,28.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",130.41,63,,104.33,,,0,"percent of total billed charges","63% of total billed charges",31.67,15.3,,25.34,,,0,"percent of total billed charges","15.3% of total billed charges",34.78,16.8,,27.82,,,0,"percent of total billed charges","16.8% of total billed charges",142.83,69,,,,,0,"fee schedule","69% of total billed charges",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,61.85,,102.42,,,0,"percent of total billed charges","61.5% of total billed charges",34.78,16.8,,27.82,,,0,"percent of total billed charges","16.8% of total billed charges",103.5,50,,82.80,,,0,"percent of total billed charges","50% of total billed charges",66.65,32.2,,53.32,,,0,"percent of total billed charges","32.2% of total billed charges",34.78,16.8,,27.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.47,17.136,,28.38,,,0,"percent of total billed charges","17.136% of total billed charges",45.21,21.84,,36.17,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",78.04,37.7,,62.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",161.46,78,,129.17,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.98,82.6,,136.78,,,0,"percent of total billed charges","82.6% of total billed charges",34.78,16.8,,27.82,,,0,"percent of total billed charges","16.8% of total billed charges",103.5,50,,82.80,,,0,"percent of total billed charges","50% of total billed charges",170.98,82.6,,136.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,16.8,,27.82,,,0,"percent of total billed charges","16.8% of total billed charges",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",31.67,207,
"OBTURATOR W/LASER TVT",490984,CDM,270,RC,,,OUTPATIENT,,,687,446.55,,604.56,88,,483.65,,,0,"percent of total billed charges","88% of total billed charges",343.5,50,,274.80,,,0,"percent of total billed charges","50% of total billed charges",115.42,16.8,,92.34,,,0,"percent of total billed charges","16.8% of total billed charges",687,100,,549.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",118.88,17.304,,95.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",432.81,63,,346.25,,,0,"percent of total billed charges","63% of total billed charges",105.11,15.3,,84.09,,,0,"percent of total billed charges","15.3% of total billed charges",115.42,16.8,,92.34,,,0,"percent of total billed charges","16.8% of total billed charges",474.03,69,,,,,0,"fee schedule","69% of total billed charges",687,100,,549.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",687,100,,549.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",687,100,,549.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",424.91,61.85,,339.93,,,0,"percent of total billed charges","61.5% of total billed charges",115.42,16.8,,92.34,,,0,"percent of total billed charges","16.8% of total billed charges",343.5,50,,274.80,,,0,"percent of total billed charges","50% of total billed charges",221.21,32.2,,176.97,,,0,"percent of total billed charges","32.2% of total billed charges",115.42,16.8,,92.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",117.72,17.136,,94.18,,,0,"percent of total billed charges","17.136% of total billed charges",150.04,21.84,,120.03,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",259,37.7,,207.20,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",535.86,78,,428.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",567.46,82.6,,453.97,,,0,"percent of total billed charges","82.6% of total billed charges",115.42,16.8,,92.34,,,0,"percent of total billed charges","16.8% of total billed charges",343.5,50,,274.80,,,0,"percent of total billed charges","50% of total billed charges",567.46,82.6,,453.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.42,16.8,,92.34,,,0,"percent of total billed charges","16.8% of total billed charges",687,100,,549.60,,,0,"percent of total billed charges","100% of total billed charges",105.11,687,
"OCC FUSION SYSTEM 8MMX4.5MM 04.601.108",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"OCU-FILM COVERS",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"OINTMENT BACITRACIN WITH ZINC 0.9GM FOIL PACKET",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"OLCOTT TORQUE DEVICE",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"OMEGA KNOTLESS ANCHOR SYSTEM SINGLE 4.75MM",ORSUP0030,CDM,278,RC,,,OUTPATIENT,,,3914,2544.1,,3444.32,88,,2755.46,,,0,"percent of total billed charges","88% of total billed charges",1957,50,,1565.60,,,0,"percent of total billed charges","50% of total billed charges",657.55,16.8,,526.04,,,0,"percent of total billed charges","16.8% of total billed charges",3914,100,,3131.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",677.28,17.304,,541.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2465.82,63,,1972.66,,,0,"percent of total billed charges","63% of total billed charges",598.84,15.3,,479.07,,,0,"percent of total billed charges","15.3% of total billed charges",657.55,16.8,,526.04,,,0,"percent of total billed charges","16.8% of total billed charges",2700.66,69,,,,,0,"fee schedule","69% of total billed charges",3914,100,,3131.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3914,100,,3131.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3914,100,,3131.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2420.81,61.85,,1936.65,,,0,"percent of total billed charges","61.5% of total billed charges",657.55,16.8,,526.04,,,0,"percent of total billed charges","16.8% of total billed charges",1957,50,,1565.60,,,0,"percent of total billed charges","50% of total billed charges",1260.31,32.2,,1008.25,,,0,"percent of total billed charges","32.2% of total billed charges",1221.17,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",670.7,17.136,,536.56,,,0,"percent of total billed charges","17.136% of total billed charges",854.82,21.84,,683.86,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1475.58,37.7,,1180.46,,,0,"percent of total billed charges","37.7% of total billed charges",1475.58,37.7,,1180.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1326.85,33.9,,1061.48,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3052.92,78,,2442.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3232.96,82.6,,2586.37,,,0,"percent of total billed charges","82.6% of total billed charges",657.55,16.8,,526.04,,,0,"percent of total billed charges","16.8% of total billed charges",1957,50,,1565.60,,,0,"percent of total billed charges","50% of total billed charges",3232.96,82.6,,2586.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",657.55,16.8,,526.04,,,0,"percent of total billed charges","16.8% of total billed charges",3914,100,,3131.20,,,0,"percent of total billed charges","100% of total billed charges",598.84,3914,
"OMEGA 4.75MM PEEK KNOTLESS ANCHOR DOUBLE",ORSUP0045,CDM,278,RC,,,OUTPATIENT,,,7004,4552.6,,6163.52,88,,4930.82,,,0,"percent of total billed charges","88% of total billed charges",3502,50,,2801.60,,,0,"percent of total billed charges","50% of total billed charges",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1211.97,17.304,,969.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4412.52,63,,3530.02,,,0,"percent of total billed charges","63% of total billed charges",1071.61,15.3,,857.29,,,0,"percent of total billed charges","15.3% of total billed charges",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",4832.76,69,,,,,0,"fee schedule","69% of total billed charges",7004,100,,5603.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7004,100,,5603.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7004,100,,5603.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4331.97,61.85,,3465.58,,,0,"percent of total billed charges","61.5% of total billed charges",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",3502,50,,2801.60,,,0,"percent of total billed charges","50% of total billed charges",2255.29,32.2,,1804.23,,,0,"percent of total billed charges","32.2% of total billed charges",2185.25,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1200.21,17.136,,960.17,,,0,"percent of total billed charges","17.136% of total billed charges",1529.67,21.84,,1223.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2640.51,37.7,,2112.41,,,0,"percent of total billed charges","37.7% of total billed charges",2640.51,37.7,,2112.41,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2374.36,33.9,,1899.49,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5463.12,78,,4370.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5785.3,82.6,,4628.24,,,0,"percent of total billed charges","82.6% of total billed charges",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",3502,50,,2801.60,,,0,"percent of total billed charges","50% of total billed charges",5785.3,82.6,,4628.24,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",7004,100,,5603.20,,,0,"percent of total billed charges","100% of total billed charges",1071.61,7004,
"OMEGA 6.5MM PEEK KNOTLESS ANCHOR SINGLE",ORSUP0029,CDM,278,RC,,,OUTPATIENT,,,3708,2410.2,,3263.04,88,,2610.43,,,0,"percent of total billed charges","88% of total billed charges",1854,50,,1483.20,,,0,"percent of total billed charges","50% of total billed charges",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",3708,100,,2966.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",641.63,17.304,,513.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2336.04,63,,1868.83,,,0,"percent of total billed charges","63% of total billed charges",567.32,15.3,,453.86,,,0,"percent of total billed charges","15.3% of total billed charges",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",2558.52,69,,,,,0,"fee schedule","69% of total billed charges",3708,100,,2966.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3708,100,,2966.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3708,100,,2966.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2293.4,61.85,,1834.72,,,0,"percent of total billed charges","61.5% of total billed charges",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",1854,50,,1483.20,,,0,"percent of total billed charges","50% of total billed charges",1193.98,32.2,,955.18,,,0,"percent of total billed charges","32.2% of total billed charges",1156.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",635.4,17.136,,508.32,,,0,"percent of total billed charges","17.136% of total billed charges",809.83,21.84,,647.86,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1397.92,37.7,,1118.34,,,0,"percent of total billed charges","37.7% of total billed charges",1397.92,37.7,,1118.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1257.01,33.9,,1005.61,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2892.24,78,,2313.79,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3062.81,82.6,,2450.25,,,0,"percent of total billed charges","82.6% of total billed charges",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",1854,50,,1483.20,,,0,"percent of total billed charges","50% of total billed charges",3062.81,82.6,,2450.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",622.94,16.8,,498.35,,,0,"percent of total billed charges","16.8% of total billed charges",3708,100,,2966.40,,,0,"percent of total billed charges","100% of total billed charges",567.32,3708,
"OMNIPAQUE 350 50ML BOTTLE",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"OMNIPAQUE 350 75ML BOTTLE",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"OMNIPAQUE 350 100ML BOTTLE",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"OMNI FLUSH 5FR X 65CM",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"ON-Q C-BLOCK 600ML DUAL SELECT A FLOW",ORSUP0023,CDM,278,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",1002.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.7% of total billed charges",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1089.55,33.9,,871.64,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"ON-Q  PAINBUSTER 12.5CM",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"ON-Q C-BLOC CB6004",ORSUP0026,CDM,272,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"ONE TOUCH LIFESCAN CONTROL SOLUTION",490985,CDM,270,RC,,,OUTPATIENT,,,77,50.05,,67.76,88,,54.21,,,0,"percent of total billed charges","88% of total billed charges",38.5,50,,30.80,,,0,"percent of total billed charges","50% of total billed charges",12.94,16.8,,10.35,,,0,"percent of total billed charges","16.8% of total billed charges",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.32,17.304,,10.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.51,63,,38.81,,,0,"percent of total billed charges","63% of total billed charges",11.78,15.3,,9.42,,,0,"percent of total billed charges","15.3% of total billed charges",12.94,16.8,,10.35,,,0,"percent of total billed charges","16.8% of total billed charges",53.13,69,,,,,0,"fee schedule","69% of total billed charges",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.62,61.85,,38.10,,,0,"percent of total billed charges","61.5% of total billed charges",12.94,16.8,,10.35,,,0,"percent of total billed charges","16.8% of total billed charges",38.5,50,,30.80,,,0,"percent of total billed charges","50% of total billed charges",24.79,32.2,,19.83,,,0,"percent of total billed charges","32.2% of total billed charges",12.94,16.8,,10.35,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.19,17.136,,10.55,,,0,"percent of total billed charges","17.136% of total billed charges",16.82,21.84,,13.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.03,37.7,,23.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",60.06,78,,48.05,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.6,82.6,,50.88,,,0,"percent of total billed charges","82.6% of total billed charges",12.94,16.8,,10.35,,,0,"percent of total billed charges","16.8% of total billed charges",38.5,50,,30.80,,,0,"percent of total billed charges","50% of total billed charges",63.6,82.6,,50.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.94,16.8,,10.35,,,0,"percent of total billed charges","16.8% of total billed charges",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",11.78,77,
"OPEN BIOINDICTIVE IMPLANT 1 LARGE",ORSUP0087,CDM,278,RC,,,OUTPATIENT,,,15862,10310.3,,13958.56,88,,11166.85,,,0,"percent of total billed charges","88% of total billed charges",7931,50,,6344.80,,,0,"percent of total billed charges","50% of total billed charges",2664.82,16.8,,2131.86,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2744.76,17.304,,2195.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9993.06,63,,7994.45,,,0,"percent of total billed charges","63% of total billed charges",2426.89,15.3,,1941.51,,,0,"percent of total billed charges","15.3% of total billed charges",2664.82,16.8,,2131.86,,,0,"percent of total billed charges","16.8% of total billed charges",10944.78,69,,,,,0,"fee schedule","69% of total billed charges",15862,100,,12689.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15862,100,,12689.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15862,100,,12689.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9810.65,61.85,,7848.52,,,0,"percent of total billed charges","61.5% of total billed charges",2664.82,16.8,,2131.86,,,0,"percent of total billed charges","16.8% of total billed charges",7931,50,,6344.80,,,0,"percent of total billed charges","50% of total billed charges",5107.56,32.2,,4086.05,,,0,"percent of total billed charges","32.2% of total billed charges",4948.94,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2718.11,17.136,,2174.49,,,0,"percent of total billed charges","17.136% of total billed charges",3464.26,21.84,,2771.41,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",5979.97,37.7,,4783.98,,,0,"percent of total billed charges","37.7% of total billed charges",5979.97,37.7,,4783.98,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",5377.22,33.9,,4301.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",12372.36,78,,9897.89,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13102.01,82.6,,10481.61,,,0,"percent of total billed charges","82.6% of total billed charges",2664.82,16.8,,2131.86,,,0,"percent of total billed charges","16.8% of total billed charges",7931,50,,6344.80,,,0,"percent of total billed charges","50% of total billed charges",13102.01,82.6,,10481.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2664.82,16.8,,2131.86,,,0,"percent of total billed charges","16.8% of total billed charges",15862,100,,12689.60,,,0,"percent of total billed charges","100% of total billed charges",2426.89,15862,
"OPTIVAC KIT 120 GRAM TRIPLE MIX",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"OPTICHAMBER DIAMOND SPACER",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"OPTIFLOW JR BREATHING CIRCUIT",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"OPTIFLOW PLUS OXYGEN CANNULA SZ5",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"OPTIFLOW PLUS OXYGEN CANNULA SZ L",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"OR Level 1 First 30 Min",SUR200034,CDM,360,RC,,,OUTPATIENT,,,4976,3234.4,,4378.88,88,,3503.10,,,0,"percent of total billed charges","88% of total billed charges",2488,50,,1990.40,,,0,"percent of total billed charges","50% of total billed charges",835.97,16.8,,668.78,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",861.05,17.304,,688.84,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3134.88,63,,2507.90,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",835.97,16.8,,668.78,,,0,"percent of total billed charges","16.8% of total billed charges",3433.44,69,,,,,0,"fee schedule","69% of total billed charges",4976,100,,3980.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4976,100,,3980.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4976,100,,3980.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3077.66,61.85,,2462.13,,,0,"percent of total billed charges","61.5% of total billed charges",835.97,16.8,,668.78,,,0,"percent of total billed charges","16.8% of total billed charges",2488,50,,1990.40,,,0,"percent of total billed charges","50% of total billed charges",1602.27,32.2,,1281.82,,,0,"percent of total billed charges","32.2% of total billed charges",835.97,16.8,,668.78,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",852.69,17.136,,682.15,,,0,"percent of total billed charges","17.136% of total billed charges",1086.76,21.84,,869.41,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1875.95,37.7,,1500.76,,,0,"percent of total billed charges","37.7% of total billed charges",1875.95,37.7,,1500.76,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1686.86,33.9,,1349.49,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3881.28,78,,3105.02,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4110.18,82.6,,3288.14,,,0,"percent of total billed charges","82.6% of total billed charges",835.97,16.8,,668.78,,,0,"percent of total billed charges","16.8% of total billed charges",2488,50,,1990.40,,,0,"percent of total billed charges","50% of total billed charges",4110.18,82.6,,3288.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.97,16.8,,668.78,,,0,"percent of total billed charges","16.8% of total billed charges",4976,100,,3980.80,,,0,"percent of total billed charges","100% of total billed charges",835.97,4976,
"OR Level 1 Ea Addt'l 15 Min",SUR200035,CDM,360,RC,,,OUTPATIENT,,,3319,2157.35,,2920.72,88,,2336.58,,,0,"percent of total billed charges","88% of total billed charges",1659.5,50,,1327.60,,,0,"percent of total billed charges","50% of total billed charges",557.59,16.8,,446.07,,,0,"percent of total billed charges","16.8% of total billed charges",3319,100,,2655.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",574.32,17.304,,459.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2090.97,63,,1672.78,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",557.59,16.8,,446.07,,,0,"percent of total billed charges","16.8% of total billed charges",2290.11,69,,,,,0,"fee schedule","69% of total billed charges",3319,100,,2655.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3319,100,,2655.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3319,100,,2655.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2052.8,61.85,,1642.24,,,0,"percent of total billed charges","61.5% of total billed charges",557.59,16.8,,446.07,,,0,"percent of total billed charges","16.8% of total billed charges",1659.5,50,,1327.60,,,0,"percent of total billed charges","50% of total billed charges",1068.72,32.2,,854.98,,,0,"percent of total billed charges","32.2% of total billed charges",557.59,16.8,,446.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",568.74,17.136,,454.99,,,0,"percent of total billed charges","17.136% of total billed charges",724.87,21.84,,579.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1251.26,37.7,,1001.01,,,0,"percent of total billed charges","37.7% of total billed charges",1251.26,37.7,,1001.01,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1125.14,33.9,,900.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2588.82,78,,2071.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2741.49,82.6,,2193.19,,,0,"percent of total billed charges","82.6% of total billed charges",557.59,16.8,,446.07,,,0,"percent of total billed charges","16.8% of total billed charges",1659.5,50,,1327.60,,,0,"percent of total billed charges","50% of total billed charges",2741.49,82.6,,2193.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",557.59,16.8,,446.07,,,0,"percent of total billed charges","16.8% of total billed charges",3319,100,,2655.20,,,0,"percent of total billed charges","100% of total billed charges",557.59,3367,
"OR Level 2 First 30 Min",SUR200036,CDM,360,RC,,,OUTPATIENT,,,6635,4312.75,,5838.8,88,,4671.04,,,0,"percent of total billed charges","88% of total billed charges",3317.5,50,,2654.00,,,0,"percent of total billed charges","50% of total billed charges",1114.68,16.8,,891.74,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1148.12,17.304,,918.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4180.05,63,,3344.04,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",1114.68,16.8,,891.74,,,0,"percent of total billed charges","16.8% of total billed charges",4578.15,69,,,,,0,"fee schedule","69% of total billed charges",6635,100,,5308.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6635,100,,5308.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6635,100,,5308.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4103.75,61.85,,3283.00,,,0,"percent of total billed charges","61.5% of total billed charges",1114.68,16.8,,891.74,,,0,"percent of total billed charges","16.8% of total billed charges",3317.5,50,,2654.00,,,0,"percent of total billed charges","50% of total billed charges",2136.47,32.2,,1709.18,,,0,"percent of total billed charges","32.2% of total billed charges",1114.68,16.8,,891.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1136.97,17.136,,909.58,,,0,"percent of total billed charges","17.136% of total billed charges",1449.08,21.84,,1159.26,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2501.4,37.7,,2001.12,,,0,"percent of total billed charges","37.7% of total billed charges",2501.4,37.7,,2001.12,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2249.27,33.9,,1799.42,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5175.3,78,,4140.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5480.51,82.6,,4384.41,,,0,"percent of total billed charges","82.6% of total billed charges",1114.68,16.8,,891.74,,,0,"percent of total billed charges","16.8% of total billed charges",3317.5,50,,2654.00,,,0,"percent of total billed charges","50% of total billed charges",5480.51,82.6,,4384.41,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1114.68,16.8,,891.74,,,0,"percent of total billed charges","16.8% of total billed charges",6635,100,,5308.00,,,0,"percent of total billed charges","100% of total billed charges",1114.68,6635,
"OR Level 2 Ea Addt'l 15 Min",SUR200037,CDM,360,RC,,,OUTPATIENT,,,3319,2157.35,,2920.72,88,,2336.58,,,0,"percent of total billed charges","88% of total billed charges",1659.5,50,,1327.60,,,0,"percent of total billed charges","50% of total billed charges",557.59,16.8,,446.07,,,0,"percent of total billed charges","16.8% of total billed charges",3319,100,,2655.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",574.32,17.304,,459.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2090.97,63,,1672.78,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",557.59,16.8,,446.07,,,0,"percent of total billed charges","16.8% of total billed charges",2290.11,69,,,,,0,"fee schedule","69% of total billed charges",3319,100,,2655.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3319,100,,2655.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3319,100,,2655.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2052.8,61.85,,1642.24,,,0,"percent of total billed charges","61.5% of total billed charges",557.59,16.8,,446.07,,,0,"percent of total billed charges","16.8% of total billed charges",1659.5,50,,1327.60,,,0,"percent of total billed charges","50% of total billed charges",1068.72,32.2,,854.98,,,0,"percent of total billed charges","32.2% of total billed charges",557.59,16.8,,446.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",568.74,17.136,,454.99,,,0,"percent of total billed charges","17.136% of total billed charges",724.87,21.84,,579.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1251.26,37.7,,1001.01,,,0,"percent of total billed charges","37.7% of total billed charges",1251.26,37.7,,1001.01,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1125.14,33.9,,900.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2588.82,78,,2071.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2741.49,82.6,,2193.19,,,0,"percent of total billed charges","82.6% of total billed charges",557.59,16.8,,446.07,,,0,"percent of total billed charges","16.8% of total billed charges",1659.5,50,,1327.60,,,0,"percent of total billed charges","50% of total billed charges",2741.49,82.6,,2193.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",557.59,16.8,,446.07,,,0,"percent of total billed charges","16.8% of total billed charges",3319,100,,2655.20,,,0,"percent of total billed charges","100% of total billed charges",557.59,3367,
"OR Level 3 First 30 Min",SUR200038,CDM,360,RC,,,OUTPATIENT,,,8294,5391.1,,7298.72,88,,5838.98,,,0,"percent of total billed charges","88% of total billed charges",4147,50,,3317.60,,,0,"percent of total billed charges","50% of total billed charges",1393.39,16.8,,1114.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1435.19,17.304,,1148.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5225.22,63,,4180.18,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",1393.39,16.8,,1114.71,,,0,"percent of total billed charges","16.8% of total billed charges",5722.86,69,,,,,0,"fee schedule","69% of total billed charges",8294,100,,6635.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8294,100,,6635.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8294,100,,6635.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5129.84,61.85,,4103.87,,,0,"percent of total billed charges","61.5% of total billed charges",1393.39,16.8,,1114.71,,,0,"percent of total billed charges","16.8% of total billed charges",4147,50,,3317.60,,,0,"percent of total billed charges","50% of total billed charges",2670.67,32.2,,2136.54,,,0,"percent of total billed charges","32.2% of total billed charges",1393.39,16.8,,1114.71,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1421.26,17.136,,1137.01,,,0,"percent of total billed charges","17.136% of total billed charges",1811.41,21.84,,1449.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3126.84,37.7,,2501.47,,,0,"percent of total billed charges","37.7% of total billed charges",3126.84,37.7,,2501.47,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2811.67,33.9,,2249.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6469.32,78,,5175.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6850.84,82.6,,5480.67,,,0,"percent of total billed charges","82.6% of total billed charges",1393.39,16.8,,1114.71,,,0,"percent of total billed charges","16.8% of total billed charges",4147,50,,3317.60,,,0,"percent of total billed charges","50% of total billed charges",6850.84,82.6,,5480.67,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1393.39,16.8,,1114.71,,,0,"percent of total billed charges","16.8% of total billed charges",8294,100,,6635.20,,,0,"percent of total billed charges","100% of total billed charges",1393.39,8294,
"OR Level 3 Ea Addt'l 15 Min",SUR200039,CDM,360,RC,,,OUTPATIENT,,,3319,2157.35,,2920.72,88,,2336.58,,,0,"percent of total billed charges","88% of total billed charges",1659.5,50,,1327.60,,,0,"percent of total billed charges","50% of total billed charges",557.59,16.8,,446.07,,,0,"percent of total billed charges","16.8% of total billed charges",3319,100,,2655.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",574.32,17.304,,459.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2090.97,63,,1672.78,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",557.59,16.8,,446.07,,,0,"percent of total billed charges","16.8% of total billed charges",2290.11,69,,,,,0,"fee schedule","69% of total billed charges",3319,100,,2655.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3319,100,,2655.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3319,100,,2655.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2052.8,61.85,,1642.24,,,0,"percent of total billed charges","61.5% of total billed charges",557.59,16.8,,446.07,,,0,"percent of total billed charges","16.8% of total billed charges",1659.5,50,,1327.60,,,0,"percent of total billed charges","50% of total billed charges",1068.72,32.2,,854.98,,,0,"percent of total billed charges","32.2% of total billed charges",557.59,16.8,,446.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",568.74,17.136,,454.99,,,0,"percent of total billed charges","17.136% of total billed charges",724.87,21.84,,579.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1251.26,37.7,,1001.01,,,0,"percent of total billed charges","37.7% of total billed charges",1251.26,37.7,,1001.01,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1125.14,33.9,,900.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2588.82,78,,2071.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2741.49,82.6,,2193.19,,,0,"percent of total billed charges","82.6% of total billed charges",557.59,16.8,,446.07,,,0,"percent of total billed charges","16.8% of total billed charges",1659.5,50,,1327.60,,,0,"percent of total billed charges","50% of total billed charges",2741.49,82.6,,2193.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",557.59,16.8,,446.07,,,0,"percent of total billed charges","16.8% of total billed charges",3319,100,,2655.20,,,0,"percent of total billed charges","100% of total billed charges",557.59,3367,
"OR Level 4 First 30 Min",SUR200040,CDM,360,RC,,,OUTPATIENT,,,11115,7224.75,,9781.2,88,,7824.96,,,0,"percent of total billed charges","88% of total billed charges",5557.5,50,,4446.00,,,0,"percent of total billed charges","50% of total billed charges",1867.32,16.8,,1493.86,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1923.34,17.304,,1538.67,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7002.45,63,,5601.96,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",1867.32,16.8,,1493.86,,,0,"percent of total billed charges","16.8% of total billed charges",7669.35,69,,,,,0,"fee schedule","69% of total billed charges",11115,100,,8892.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11115,100,,8892.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11115,100,,8892.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6874.63,61.85,,5499.70,,,0,"percent of total billed charges","61.5% of total billed charges",1867.32,16.8,,1493.86,,,0,"percent of total billed charges","16.8% of total billed charges",5557.5,50,,4446.00,,,0,"percent of total billed charges","50% of total billed charges",3579.03,32.2,,2863.22,,,0,"percent of total billed charges","32.2% of total billed charges",1867.32,16.8,,1493.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1904.67,17.136,,1523.74,,,0,"percent of total billed charges","17.136% of total billed charges",2427.52,21.84,,1942.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4190.36,37.7,,3352.29,,,0,"percent of total billed charges","37.7% of total billed charges",4190.36,37.7,,3352.29,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3767.99,33.9,,3014.39,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",8669.7,78,,6935.76,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9180.99,82.6,,7344.79,,,0,"percent of total billed charges","82.6% of total billed charges",1867.32,16.8,,1493.86,,,0,"percent of total billed charges","16.8% of total billed charges",5557.5,50,,4446.00,,,0,"percent of total billed charges","50% of total billed charges",9180.99,82.6,,7344.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1867.32,16.8,,1493.86,,,0,"percent of total billed charges","16.8% of total billed charges",11115,100,,8892.00,,,0,"percent of total billed charges","100% of total billed charges",1867.32,11115,
"OR Level 4 Ea Addt'l 15 Min",SUR200041,CDM,360,RC,,,OUTPATIENT,,,3319,2157.35,,2920.72,88,,2336.58,,,0,"percent of total billed charges","88% of total billed charges",1659.5,50,,1327.60,,,0,"percent of total billed charges","50% of total billed charges",557.59,16.8,,446.07,,,0,"percent of total billed charges","16.8% of total billed charges",3319,100,,2655.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",574.32,17.304,,459.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2090.97,63,,1672.78,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",557.59,16.8,,446.07,,,0,"percent of total billed charges","16.8% of total billed charges",2290.11,69,,,,,0,"fee schedule","69% of total billed charges",3319,100,,2655.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3319,100,,2655.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3319,100,,2655.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2052.8,61.85,,1642.24,,,0,"percent of total billed charges","61.5% of total billed charges",557.59,16.8,,446.07,,,0,"percent of total billed charges","16.8% of total billed charges",1659.5,50,,1327.60,,,0,"percent of total billed charges","50% of total billed charges",1068.72,32.2,,854.98,,,0,"percent of total billed charges","32.2% of total billed charges",557.59,16.8,,446.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",568.74,17.136,,454.99,,,0,"percent of total billed charges","17.136% of total billed charges",724.87,21.84,,579.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1251.26,37.7,,1001.01,,,0,"percent of total billed charges","37.7% of total billed charges",1251.26,37.7,,1001.01,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1125.14,33.9,,900.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2588.82,78,,2071.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2741.49,82.6,,2193.19,,,0,"percent of total billed charges","82.6% of total billed charges",557.59,16.8,,446.07,,,0,"percent of total billed charges","16.8% of total billed charges",1659.5,50,,1327.60,,,0,"percent of total billed charges","50% of total billed charges",2741.49,82.6,,2193.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",557.59,16.8,,446.07,,,0,"percent of total billed charges","16.8% of total billed charges",3319,100,,2655.20,,,0,"percent of total billed charges","100% of total billed charges",557.59,3367,
"OR Level 5 First 30 Min",SUR200050,CDM,360,RC,,,OUTPATIENT,,,16587,10781.55,,14596.56,88,,11677.25,,,0,"percent of total billed charges","88% of total billed charges",8293.5,50,,6634.80,,,0,"percent of total billed charges","50% of total billed charges",2786.62,16.8,,2229.30,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2870.21,17.304,,2296.17,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10449.81,63,,8359.85,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",2786.62,16.8,,2229.30,,,0,"percent of total billed charges","16.8% of total billed charges",11445.03,69,,,,,0,"fee schedule","69% of total billed charges",16587,100,,13269.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16587,100,,13269.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16587,100,,13269.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10259.06,61.85,,8207.25,,,0,"percent of total billed charges","61.5% of total billed charges",2786.62,16.8,,2229.30,,,0,"percent of total billed charges","16.8% of total billed charges",8293.5,50,,6634.80,,,0,"percent of total billed charges","50% of total billed charges",5341.01,32.2,,4272.81,,,0,"percent of total billed charges","32.2% of total billed charges",2786.62,16.8,,2229.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2842.35,17.136,,2273.88,,,0,"percent of total billed charges","17.136% of total billed charges",3622.6,21.84,,2898.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",6253.3,37.7,,5002.64,,,0,"percent of total billed charges","37.7% of total billed charges",6253.3,37.7,,5002.64,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",5622.99,33.9,,4498.39,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",12937.86,78,,10350.29,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13700.86,82.6,,10960.69,,,0,"percent of total billed charges","82.6% of total billed charges",2786.62,16.8,,2229.30,,,0,"percent of total billed charges","16.8% of total billed charges",8293.5,50,,6634.80,,,0,"percent of total billed charges","50% of total billed charges",13700.86,82.6,,10960.69,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2786.62,16.8,,2229.30,,,0,"percent of total billed charges","16.8% of total billed charges",16587,100,,13269.60,,,0,"percent of total billed charges","100% of total billed charges",2786.62,16587,
"ORAL AIRWAY SIZE 10",490986,CDM,272,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"ORAL AIRWAY SIZE 5",490987,CDM,272,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"ORAL AIRWAY SIZE 6",490988,CDM,272,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"ORAL AIRWAY SIZE 7",490989,CDM,272,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"ORAL AIRWAY SIZE 8",490990,CDM,272,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"ORAL AIRWAY SIZE 9",490991,CDM,272,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"ORAL MURPHY ENDOTRACHEAL TUBE CUFFED SIZE 6.0MM",490992,CDM,272,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.37,61.85,,9.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"ORAL MURPHY ENDOTRACHEAL TUBE CUFFED SIZE 6.5MM",490993,CDM,272,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.37,61.85,,9.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"ORAL MURPHY ENDOTRACHEAL TUBE CUFFED SIZE 7.0MM",490994,CDM,272,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.37,61.85,,9.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"ORAL MURPHY ENDOTRACHEAL TUBE CUFFED SIZE 7.5MM",490995,CDM,272,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"ORAL MURPHY ENDOTRACHEAL TUBE CUFFED SIZE 8.0MM",490996,CDM,272,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.37,61.85,,9.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"ORAL MURPHY ENDOTRACHEAL TUBE CUFFED SIZE 8.5MM",490997,CDM,272,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.37,61.85,,9.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"ORAL MURPHY ENDOTRACHEAL TUBE CUFFED SIZE 9.0MM",490998,CDM,272,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.37,61.85,,9.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"ORANGE TOP PARA-PAK C \\T\\ S STOOL TRNASPORT",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"ORBIS SURGICAL GOWN XL- XLONG",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"ORGANIZER SUT GABBY FRATER F/ VLV",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"ORTHO EXTREMITY",326417,CDM,270,RC,,,OUTPATIENT,,,630,409.5,,554.4,88,,443.52,,,0,"percent of total billed charges","88% of total billed charges",315,50,,252.00,,,0,"percent of total billed charges","50% of total billed charges",105.84,16.8,,84.67,,,0,"percent of total billed charges","16.8% of total billed charges",630,100,,504.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",109.02,17.304,,87.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",396.9,63,,317.52,,,0,"percent of total billed charges","63% of total billed charges",96.39,15.3,,77.11,,,0,"percent of total billed charges","15.3% of total billed charges",105.84,16.8,,84.67,,,0,"percent of total billed charges","16.8% of total billed charges",434.7,69,,,,,0,"fee schedule","69% of total billed charges",630,100,,504.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",630,100,,504.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",630,100,,504.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.66,61.85,,311.73,,,0,"percent of total billed charges","61.5% of total billed charges",105.84,16.8,,84.67,,,0,"percent of total billed charges","16.8% of total billed charges",315,50,,252.00,,,0,"percent of total billed charges","50% of total billed charges",202.86,32.2,,162.29,,,0,"percent of total billed charges","32.2% of total billed charges",105.84,16.8,,84.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",107.96,17.136,,86.37,,,0,"percent of total billed charges","17.136% of total billed charges",137.59,21.84,,110.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",237.51,37.7,,190.01,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",491.4,78,,393.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",520.38,82.6,,416.30,,,0,"percent of total billed charges","82.6% of total billed charges",105.84,16.8,,84.67,,,0,"percent of total billed charges","16.8% of total billed charges",315,50,,252.00,,,0,"percent of total billed charges","50% of total billed charges",520.38,82.6,,416.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.84,16.8,,84.67,,,0,"percent of total billed charges","16.8% of total billed charges",630,100,,504.00,,,0,"percent of total billed charges","100% of total billed charges",96.39,630,
"ORTHO-EVAC CB II W/ 3/16INDRAIN",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"ORTHOLOCK EX-PIN 3X110 6007-103-110",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"ORTHOPAT KIT",ORSUP0027,CDM,272,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"ORTHO-GLASS SPLINT 3",490999,CDM,270,RC,,,OUTPATIENT,,,41,26.65,,36.08,88,,28.86,,,0,"percent of total billed charges","88% of total billed charges",20.5,50,,16.40,,,0,"percent of total billed charges","50% of total billed charges",6.89,16.8,,5.51,,,0,"percent of total billed charges","16.8% of total billed charges",41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.09,17.304,,5.67,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.83,63,,20.66,,,0,"percent of total billed charges","63% of total billed charges",6.27,15.3,,5.02,,,0,"percent of total billed charges","15.3% of total billed charges",6.89,16.8,,5.51,,,0,"percent of total billed charges","16.8% of total billed charges",28.29,69,,,,,0,"fee schedule","69% of total billed charges",41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.36,61.85,,20.29,,,0,"percent of total billed charges","61.5% of total billed charges",6.89,16.8,,5.51,,,0,"percent of total billed charges","16.8% of total billed charges",20.5,50,,16.40,,,0,"percent of total billed charges","50% of total billed charges",13.2,32.2,,10.56,,,0,"percent of total billed charges","32.2% of total billed charges",6.89,16.8,,5.51,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.03,17.136,,5.62,,,0,"percent of total billed charges","17.136% of total billed charges",8.95,21.84,,7.16,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.46,37.7,,12.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",31.98,78,,25.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.87,82.6,,27.10,,,0,"percent of total billed charges","82.6% of total billed charges",6.89,16.8,,5.51,,,0,"percent of total billed charges","16.8% of total billed charges",20.5,50,,16.40,,,0,"percent of total billed charges","50% of total billed charges",33.87,82.6,,27.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.89,16.8,,5.51,,,0,"percent of total billed charges","16.8% of total billed charges",41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",6.27,41,
"ORTHO-GLASS SPLINT 4",491000,CDM,270,RC,,,OUTPATIENT,,,49,31.85,,43.12,88,,34.50,,,0,"percent of total billed charges","88% of total billed charges",24.5,50,,19.60,,,0,"percent of total billed charges","50% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.48,17.304,,6.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.87,63,,24.70,,,0,"percent of total billed charges","63% of total billed charges",7.5,15.3,,6.00,,,0,"percent of total billed charges","15.3% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",33.81,69,,,,,0,"fee schedule","69% of total billed charges",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.31,61.85,,24.25,,,0,"percent of total billed charges","61.5% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",24.5,50,,19.60,,,0,"percent of total billed charges","50% of total billed charges",15.78,32.2,,12.62,,,0,"percent of total billed charges","32.2% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.4,17.136,,6.72,,,0,"percent of total billed charges","17.136% of total billed charges",10.7,21.84,,8.56,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.47,37.7,,14.78,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.22,78,,30.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.47,82.6,,32.38,,,0,"percent of total billed charges","82.6% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",24.5,50,,19.60,,,0,"percent of total billed charges","50% of total billed charges",40.47,82.6,,32.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",7.5,49,
"ORTHO-GLASS SPLINT 5",491001,CDM,270,RC,,,OUTPATIENT,,,56,36.4,,49.28,88,,39.42,,,0,"percent of total billed charges","88% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.69,17.304,,7.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.28,63,,28.22,,,0,"percent of total billed charges","63% of total billed charges",8.57,15.3,,6.86,,,0,"percent of total billed charges","15.3% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",38.64,69,,,,,0,"fee schedule","69% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.64,61.85,,27.71,,,0,"percent of total billed charges","61.5% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",18.03,32.2,,14.42,,,0,"percent of total billed charges","32.2% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.6,17.136,,7.68,,,0,"percent of total billed charges","17.136% of total billed charges",12.23,21.84,,9.78,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.11,37.7,,16.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.68,78,,34.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",8.57,56,
"OSOM MONO RAPID TESTS",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"OSSICULAR RECONSTRUCTION IMPLANT 9MMNON-MALLEABLE",ORSUP0028,CDM,278,RC,,,OUTPATIENT,,,3502,2276.3,,3081.76,88,,2465.41,,,0,"percent of total billed charges","88% of total billed charges",1751,50,,1400.80,,,0,"percent of total billed charges","50% of total billed charges",588.34,16.8,,470.67,,,0,"percent of total billed charges","16.8% of total billed charges",3502,100,,2801.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",605.99,17.304,,484.79,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2206.26,63,,1765.01,,,0,"percent of total billed charges","63% of total billed charges",535.81,15.3,,428.65,,,0,"percent of total billed charges","15.3% of total billed charges",588.34,16.8,,470.67,,,0,"percent of total billed charges","16.8% of total billed charges",2416.38,69,,,,,0,"fee schedule","69% of total billed charges",3502,100,,2801.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3502,100,,2801.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3502,100,,2801.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2165.99,61.85,,1732.79,,,0,"percent of total billed charges","61.5% of total billed charges",588.34,16.8,,470.67,,,0,"percent of total billed charges","16.8% of total billed charges",1751,50,,1400.80,,,0,"percent of total billed charges","50% of total billed charges",1127.64,32.2,,902.11,,,0,"percent of total billed charges","32.2% of total billed charges",1092.62,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",600.1,17.136,,480.08,,,0,"percent of total billed charges","17.136% of total billed charges",764.84,21.84,,611.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1320.25,37.7,,1056.20,,,0,"percent of total billed charges","37.7% of total billed charges",1320.25,37.7,,1056.20,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1187.18,33.9,,949.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2731.56,78,,2185.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2892.65,82.6,,2314.12,,,0,"percent of total billed charges","82.6% of total billed charges",588.34,16.8,,470.67,,,0,"percent of total billed charges","16.8% of total billed charges",1751,50,,1400.80,,,0,"percent of total billed charges","50% of total billed charges",2892.65,82.6,,2314.12,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",588.34,16.8,,470.67,,,0,"percent of total billed charges","16.8% of total billed charges",3502,100,,2801.60,,,0,"percent of total billed charges","100% of total billed charges",535.81,3502,
"OSSICULAR PROSTHESIS H/A NOTCHED",ORSUP0150,CDM,278,RC,,,OUTPATIENT,,,29458,19147.7,,25923.04,88,,20738.43,,,0,"percent of total billed charges","88% of total billed charges",14729,50,,11783.20,,,0,"percent of total billed charges","50% of total billed charges",4948.94,16.8,,3959.15,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5097.41,17.304,,4077.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18558.54,63,,14846.83,,,0,"percent of total billed charges","63% of total billed charges",4507.07,15.3,,3605.66,,,0,"percent of total billed charges","15.3% of total billed charges",4948.94,16.8,,3959.15,,,0,"percent of total billed charges","16.8% of total billed charges",20326.02,69,,,,,0,"fee schedule","69% of total billed charges",29458,100,,23566.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29458,100,,23566.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29458,100,,23566.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18219.77,61.85,,14575.82,,,0,"percent of total billed charges","61.5% of total billed charges",4948.94,16.8,,3959.15,,,0,"percent of total billed charges","16.8% of total billed charges",14729,50,,11783.20,,,0,"percent of total billed charges","50% of total billed charges",9485.48,32.2,,7588.38,,,0,"percent of total billed charges","32.2% of total billed charges",9190.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",5047.92,17.136,,4038.34,,,0,"percent of total billed charges","17.136% of total billed charges",6433.63,21.84,,5146.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",11105.67,37.7,,8884.54,,,0,"percent of total billed charges","37.7% of total billed charges",11105.67,37.7,,8884.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",9986.26,33.9,,7989.01,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",22977.24,78,,18381.79,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",24332.31,82.6,,19465.85,,,0,"percent of total billed charges","82.6% of total billed charges",4948.94,16.8,,3959.15,,,0,"percent of total billed charges","16.8% of total billed charges",14729,50,,11783.20,,,0,"percent of total billed charges","50% of total billed charges",24332.31,82.6,,19465.85,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4948.94,16.8,,3959.15,,,0,"percent of total billed charges","16.8% of total billed charges",29458,100,,23566.40,,,0,"percent of total billed charges","100% of total billed charges",4507.07,29458,
"OSTEOCEL 5CC",ORSUP0059,CDM,278,RC,,,OUTPATIENT,,,13122,8529.3,,11547.36,88,,9237.89,,,0,"percent of total billed charges","88% of total billed charges",6561,50,,5248.80,,,0,"percent of total billed charges","50% of total billed charges",2204.5,16.8,,1763.60,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2270.63,17.304,,1816.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8266.86,63,,6613.49,,,0,"percent of total billed charges","63% of total billed charges",2007.67,15.3,,1606.14,,,0,"percent of total billed charges","15.3% of total billed charges",2204.5,16.8,,1763.60,,,0,"percent of total billed charges","16.8% of total billed charges",9054.18,69,,,,,0,"fee schedule","69% of total billed charges",13122,100,,10497.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13122,100,,10497.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13122,100,,10497.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8115.96,61.85,,6492.77,,,0,"percent of total billed charges","61.5% of total billed charges",2204.5,16.8,,1763.60,,,0,"percent of total billed charges","16.8% of total billed charges",6561,50,,5248.80,,,0,"percent of total billed charges","50% of total billed charges",4225.28,32.2,,3380.22,,,0,"percent of total billed charges","32.2% of total billed charges",4094.06,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2248.59,17.136,,1798.87,,,0,"percent of total billed charges","17.136% of total billed charges",2865.84,21.84,,2292.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4946.99,37.7,,3957.59,,,0,"percent of total billed charges","37.7% of total billed charges",4946.99,37.7,,3957.59,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4448.36,33.9,,3558.69,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",10235.16,78,,8188.13,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10838.77,82.6,,8671.02,,,0,"percent of total billed charges","82.6% of total billed charges",2204.5,16.8,,1763.60,,,0,"percent of total billed charges","16.8% of total billed charges",6561,50,,5248.80,,,0,"percent of total billed charges","50% of total billed charges",10838.77,82.6,,8671.02,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2204.5,16.8,,1763.60,,,0,"percent of total billed charges","16.8% of total billed charges",13122,100,,10497.60,,,0,"percent of total billed charges","100% of total billed charges",2007.67,13122,
"OTH STER SUPP LVL 1",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"OTH STER SUPP LVL 2",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"OTH STER SUPP LVL 3",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"OTH STER SUPP LVL 4",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"OTH STER SUPP LVL 5",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"OTH STER SUPP LVL 6",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"OTH STER SUPP LVL 7",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"OTH STER SUPP LVL 8",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"OTH STER SUPP LVL 9",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"OTH STER SUPP LVL 10",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"OWENS DRESSING 8 X 12",491009,CDM,270,RC,,,OUTPATIENT,,,172,111.8,,151.36,88,,121.09,,,0,"percent of total billed charges","88% of total billed charges",86,50,,68.80,,,0,"percent of total billed charges","50% of total billed charges",28.9,16.8,,23.12,,,0,"percent of total billed charges","16.8% of total billed charges",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.76,17.304,,23.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",108.36,63,,86.69,,,0,"percent of total billed charges","63% of total billed charges",26.32,15.3,,21.06,,,0,"percent of total billed charges","15.3% of total billed charges",28.9,16.8,,23.12,,,0,"percent of total billed charges","16.8% of total billed charges",118.68,69,,,,,0,"fee schedule","69% of total billed charges",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.38,61.85,,85.10,,,0,"percent of total billed charges","61.5% of total billed charges",28.9,16.8,,23.12,,,0,"percent of total billed charges","16.8% of total billed charges",86,50,,68.80,,,0,"percent of total billed charges","50% of total billed charges",55.38,32.2,,44.30,,,0,"percent of total billed charges","32.2% of total billed charges",28.9,16.8,,23.12,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.47,17.136,,23.58,,,0,"percent of total billed charges","17.136% of total billed charges",37.56,21.84,,30.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",64.84,37.7,,51.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",134.16,78,,107.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.07,82.6,,113.66,,,0,"percent of total billed charges","82.6% of total billed charges",28.9,16.8,,23.12,,,0,"percent of total billed charges","16.8% of total billed charges",86,50,,68.80,,,0,"percent of total billed charges","50% of total billed charges",142.07,82.6,,113.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.9,16.8,,23.12,,,0,"percent of total billed charges","16.8% of total billed charges",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",26.32,172,
"OXICHROME REAGENT",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"OXISENSOR NEONATAL N25",9713,CDM,270,RC,,,OUTPATIENT,,,83,53.95,,73.04,88,,58.43,,,0,"percent of total billed charges","88% of total billed charges",41.5,50,,33.20,,,0,"percent of total billed charges","50% of total billed charges",13.94,16.8,,11.15,,,0,"percent of total billed charges","16.8% of total billed charges",83,100,,66.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.36,17.304,,11.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.29,63,,41.83,,,0,"percent of total billed charges","63% of total billed charges",12.7,15.3,,10.16,,,0,"percent of total billed charges","15.3% of total billed charges",13.94,16.8,,11.15,,,0,"percent of total billed charges","16.8% of total billed charges",57.27,69,,,,,0,"fee schedule","69% of total billed charges",83,100,,66.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",83,100,,66.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",83,100,,66.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.34,61.85,,41.07,,,0,"percent of total billed charges","61.5% of total billed charges",13.94,16.8,,11.15,,,0,"percent of total billed charges","16.8% of total billed charges",41.5,50,,33.20,,,0,"percent of total billed charges","50% of total billed charges",26.73,32.2,,21.38,,,0,"percent of total billed charges","32.2% of total billed charges",13.94,16.8,,11.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.22,17.136,,11.38,,,0,"percent of total billed charges","17.136% of total billed charges",18.13,21.84,,14.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",31.29,37.7,,25.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",64.74,78,,51.79,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.56,82.6,,54.85,,,0,"percent of total billed charges","82.6% of total billed charges",13.94,16.8,,11.15,,,0,"percent of total billed charges","16.8% of total billed charges",41.5,50,,33.20,,,0,"percent of total billed charges","50% of total billed charges",68.56,82.6,,54.85,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.94,16.8,,11.15,,,0,"percent of total billed charges","16.8% of total billed charges",83,100,,66.40,,,0,"percent of total billed charges","100% of total billed charges",12.7,83,
"OXISENSOR PEDS MASIMO LNCS",491010,CDM,270,RC,,,OUTPATIENT,,,78,50.7,,68.64,88,,54.91,,,0,"percent of total billed charges","88% of total billed charges",39,50,,31.20,,,0,"percent of total billed charges","50% of total billed charges",13.1,16.8,,10.48,,,0,"percent of total billed charges","16.8% of total billed charges",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.5,17.304,,10.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.14,63,,39.31,,,0,"percent of total billed charges","63% of total billed charges",11.93,15.3,,9.54,,,0,"percent of total billed charges","15.3% of total billed charges",13.1,16.8,,10.48,,,0,"percent of total billed charges","16.8% of total billed charges",53.82,69,,,,,0,"fee schedule","69% of total billed charges",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.24,61.85,,38.59,,,0,"percent of total billed charges","61.5% of total billed charges",13.1,16.8,,10.48,,,0,"percent of total billed charges","16.8% of total billed charges",39,50,,31.20,,,0,"percent of total billed charges","50% of total billed charges",25.12,32.2,,20.10,,,0,"percent of total billed charges","32.2% of total billed charges",13.1,16.8,,10.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.37,17.136,,10.70,,,0,"percent of total billed charges","17.136% of total billed charges",17.04,21.84,,13.63,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.41,37.7,,23.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",60.84,78,,48.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",13.1,16.8,,10.48,,,0,"percent of total billed charges","16.8% of total billed charges",39,50,,31.20,,,0,"percent of total billed charges","50% of total billed charges",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.1,16.8,,10.48,,,0,"percent of total billed charges","16.8% of total billed charges",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",11.93,78,
OXYGENATOR,ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"OXYGEN MASK ADULT",491011,CDM,270,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"OXYGEN MASK PEDIATRIC",491012,CDM,270,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.95,61.85,,3.96,,,0,"percent of total billed charges","61.5% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"OXYGEN PRESSURE REGULATORS",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,824,535.6,,725.12,88,,580.10,,,0,"percent of total billed charges","88% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.58,17.304,,114.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",519.12,63,,415.30,,,0,"percent of total billed charges","63% of total billed charges",126.07,15.3,,100.86,,,0,"percent of total billed charges","15.3% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",568.56,69,,,,,0,"fee schedule","69% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.64,61.85,,407.71,,,0,"percent of total billed charges","61.5% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",265.33,32.2,,212.26,,,0,"percent of total billed charges","32.2% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",141.2,17.136,,112.96,,,0,"percent of total billed charges","17.136% of total billed charges",179.96,21.84,,143.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",310.65,37.7,,248.52,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",642.72,78,,514.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",126.07,824,
"OXYGEN REGULATOR",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"OXYSENSOR NEONATEL/ADULT",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"PACEMAKER PACKS",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"PACING LEAD TEMP TRANSVENOUS",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"PACKING NASAL 4.5CM MEROCEL 2000",85344,CDM,278,RC,,,OUTPATIENT,,,54,35.1,,47.52,88,,38.02,,,0,"percent of total billed charges","88% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.34,17.304,,7.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.02,63,,27.22,,,0,"percent of total billed charges","63% of total billed charges",8.26,15.3,,6.61,,,0,"percent of total billed charges","15.3% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",37.26,69,,,,,0,"fee schedule","69% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.4,61.85,,26.72,,,0,"percent of total billed charges","61.5% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",17.39,32.2,,13.91,,,0,"percent of total billed charges","32.2% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.25,17.136,,7.40,,,0,"percent of total billed charges","17.136% of total billed charges",11.79,21.84,,9.43,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.36,37.7,,16.29,,,0,"percent of total billed charges","37.7% of total billed charges",20.36,37.7,,16.29,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.31,33.9,,14.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.12,78,,33.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.6,82.6,,35.68,,,0,"percent of total billed charges","82.6% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",44.6,82.6,,35.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",8.26,54,
"PACKING NASAL MEROCEL LONG   470404",36612,CDM,278,RC,,,OUTPATIENT,,,62,40.3,,54.56,88,,43.65,,,0,"percent of total billed charges","88% of total billed charges",31,50,,24.80,,,0,"percent of total billed charges","50% of total billed charges",10.42,16.8,,8.34,,,0,"percent of total billed charges","16.8% of total billed charges",62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.73,17.304,,8.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.06,63,,31.25,,,0,"percent of total billed charges","63% of total billed charges",9.49,15.3,,7.59,,,0,"percent of total billed charges","15.3% of total billed charges",10.42,16.8,,8.34,,,0,"percent of total billed charges","16.8% of total billed charges",42.78,69,,,,,0,"fee schedule","69% of total billed charges",62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.35,61.85,,30.68,,,0,"percent of total billed charges","61.5% of total billed charges",10.42,16.8,,8.34,,,0,"percent of total billed charges","16.8% of total billed charges",31,50,,24.80,,,0,"percent of total billed charges","50% of total billed charges",19.96,32.2,,15.97,,,0,"percent of total billed charges","32.2% of total billed charges",10.42,16.8,,8.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.62,17.136,,8.50,,,0,"percent of total billed charges","17.136% of total billed charges",13.54,21.84,,10.83,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.37,37.7,,18.70,,,0,"percent of total billed charges","37.7% of total billed charges",23.37,37.7,,18.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.02,33.9,,16.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.36,78,,38.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.21,82.6,,40.97,,,0,"percent of total billed charges","82.6% of total billed charges",10.42,16.8,,8.34,,,0,"percent of total billed charges","16.8% of total billed charges",31,50,,24.80,,,0,"percent of total billed charges","50% of total billed charges",51.21,82.6,,40.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.42,16.8,,8.34,,,0,"percent of total billed charges","16.8% of total billed charges",62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",9.49,62,
"PACK SHOULDER DRAPE POUCH",61523,CDM,270,RC,,,OUTPATIENT,,,152,98.8,,133.76,88,,107.01,,,0,"percent of total billed charges","88% of total billed charges",76,50,,60.80,,,0,"percent of total billed charges","50% of total billed charges",25.54,16.8,,20.43,,,0,"percent of total billed charges","16.8% of total billed charges",152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.3,17.304,,21.04,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.76,63,,76.61,,,0,"percent of total billed charges","63% of total billed charges",23.26,15.3,,18.61,,,0,"percent of total billed charges","15.3% of total billed charges",25.54,16.8,,20.43,,,0,"percent of total billed charges","16.8% of total billed charges",104.88,69,,,,,0,"fee schedule","69% of total billed charges",152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",94.01,61.85,,75.21,,,0,"percent of total billed charges","61.5% of total billed charges",25.54,16.8,,20.43,,,0,"percent of total billed charges","16.8% of total billed charges",76,50,,60.80,,,0,"percent of total billed charges","50% of total billed charges",48.94,32.2,,39.15,,,0,"percent of total billed charges","32.2% of total billed charges",25.54,16.8,,20.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.05,17.136,,20.84,,,0,"percent of total billed charges","17.136% of total billed charges",33.2,21.84,,26.56,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",57.3,37.7,,45.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",118.56,78,,94.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",125.55,82.6,,100.44,,,0,"percent of total billed charges","82.6% of total billed charges",25.54,16.8,,20.43,,,0,"percent of total billed charges","16.8% of total billed charges",76,50,,60.80,,,0,"percent of total billed charges","50% of total billed charges",125.55,82.6,,100.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.54,16.8,,20.43,,,0,"percent of total billed charges","16.8% of total billed charges",152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",23.26,152,
"PACKING GAUZE IODOFORM 1/4 IN X 5 YARDS",8041,CDM,270,RC,,,OUTPATIENT,,,27,17.55,,23.76,88,,19.01,,,0,"percent of total billed charges","88% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.67,17.304,,3.74,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.01,63,,13.61,,,0,"percent of total billed charges","63% of total billed charges",4.13,15.3,,3.30,,,0,"percent of total billed charges","15.3% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",18.63,69,,,,,0,"fee schedule","69% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.7,61.85,,13.36,,,0,"percent of total billed charges","61.5% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",8.69,32.2,,6.95,,,0,"percent of total billed charges","32.2% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.63,17.136,,3.70,,,0,"percent of total billed charges","17.136% of total billed charges",5.9,21.84,,4.72,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.18,37.7,,8.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.06,78,,16.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.3,82.6,,17.84,,,0,"percent of total billed charges","82.6% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",22.3,82.6,,17.84,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",4.13,27,
"PACK LITHOTOMY PK I",44967,CDM,270,RC,,,OUTPATIENT,,,41,26.65,,36.08,88,,28.86,,,0,"percent of total billed charges","88% of total billed charges",20.5,50,,16.40,,,0,"percent of total billed charges","50% of total billed charges",6.89,16.8,,5.51,,,0,"percent of total billed charges","16.8% of total billed charges",41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.09,17.304,,5.67,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.83,63,,20.66,,,0,"percent of total billed charges","63% of total billed charges",6.27,15.3,,5.02,,,0,"percent of total billed charges","15.3% of total billed charges",6.89,16.8,,5.51,,,0,"percent of total billed charges","16.8% of total billed charges",28.29,69,,,,,0,"fee schedule","69% of total billed charges",41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.36,61.85,,20.29,,,0,"percent of total billed charges","61.5% of total billed charges",6.89,16.8,,5.51,,,0,"percent of total billed charges","16.8% of total billed charges",20.5,50,,16.40,,,0,"percent of total billed charges","50% of total billed charges",13.2,32.2,,10.56,,,0,"percent of total billed charges","32.2% of total billed charges",6.89,16.8,,5.51,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.03,17.136,,5.62,,,0,"percent of total billed charges","17.136% of total billed charges",8.95,21.84,,7.16,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.46,37.7,,12.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",31.98,78,,25.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.87,82.6,,27.10,,,0,"percent of total billed charges","82.6% of total billed charges",6.89,16.8,,5.51,,,0,"percent of total billed charges","16.8% of total billed charges",20.5,50,,16.40,,,0,"percent of total billed charges","50% of total billed charges",33.87,82.6,,27.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.89,16.8,,5.51,,,0,"percent of total billed charges","16.8% of total billed charges",41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",6.27,41,
"PACK BOWIE DICK TEST",312427,CDM,270,RC,,,OUTPATIENT,,,760,494,,668.8,88,,535.04,,,0,"percent of total billed charges","88% of total billed charges",380,50,,304.00,,,0,"percent of total billed charges","50% of total billed charges",127.68,16.8,,102.14,,,0,"percent of total billed charges","16.8% of total billed charges",760,100,,608.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",131.51,17.304,,105.21,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",478.8,63,,383.04,,,0,"percent of total billed charges","63% of total billed charges",116.28,15.3,,93.02,,,0,"percent of total billed charges","15.3% of total billed charges",127.68,16.8,,102.14,,,0,"percent of total billed charges","16.8% of total billed charges",524.4,69,,,,,0,"fee schedule","69% of total billed charges",760,100,,608.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",760,100,,608.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",760,100,,608.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.06,61.85,,376.05,,,0,"percent of total billed charges","61.5% of total billed charges",127.68,16.8,,102.14,,,0,"percent of total billed charges","16.8% of total billed charges",380,50,,304.00,,,0,"percent of total billed charges","50% of total billed charges",244.72,32.2,,195.78,,,0,"percent of total billed charges","32.2% of total billed charges",127.68,16.8,,102.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",130.23,17.136,,104.18,,,0,"percent of total billed charges","17.136% of total billed charges",165.98,21.84,,132.78,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",286.52,37.7,,229.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",592.8,78,,474.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",627.76,82.6,,502.21,,,0,"percent of total billed charges","82.6% of total billed charges",127.68,16.8,,102.14,,,0,"percent of total billed charges","16.8% of total billed charges",380,50,,304.00,,,0,"percent of total billed charges","50% of total billed charges",627.76,82.6,,502.21,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.68,16.8,,102.14,,,0,"percent of total billed charges","16.8% of total billed charges",760,100,,608.00,,,0,"percent of total billed charges","100% of total billed charges",116.28,760,
"PACK TEST RAPID 5 STEAM PLUS",261315,CDM,270,RC,,,OUTPATIENT,,,57,37.05,,50.16,88,,40.13,,,0,"percent of total billed charges","88% of total billed charges",28.5,50,,22.80,,,0,"percent of total billed charges","50% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.86,17.304,,7.89,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.91,63,,28.73,,,0,"percent of total billed charges","63% of total billed charges",8.72,15.3,,6.98,,,0,"percent of total billed charges","15.3% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",39.33,69,,,,,0,"fee schedule","69% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.25,61.85,,28.20,,,0,"percent of total billed charges","61.5% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",28.5,50,,22.80,,,0,"percent of total billed charges","50% of total billed charges",18.35,32.2,,14.68,,,0,"percent of total billed charges","32.2% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.77,17.136,,7.82,,,0,"percent of total billed charges","17.136% of total billed charges",12.45,21.84,,9.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.49,37.7,,17.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",44.46,78,,35.57,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.08,82.6,,37.66,,,0,"percent of total billed charges","82.6% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",28.5,50,,22.80,,,0,"percent of total billed charges","50% of total billed charges",47.08,82.6,,37.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",8.72,57,
"PACK ANGIO",ORSUP0010,CDM,270,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"PACK BASIC CUSTOM",445080,CDM,270,RC,,,OUTPATIENT,,,272,176.8,,239.36,88,,191.49,,,0,"percent of total billed charges","88% of total billed charges",136,50,,108.80,,,0,"percent of total billed charges","50% of total billed charges",45.7,16.8,,36.56,,,0,"percent of total billed charges","16.8% of total billed charges",272,100,,217.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.07,17.304,,37.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",171.36,63,,137.09,,,0,"percent of total billed charges","63% of total billed charges",41.62,15.3,,33.30,,,0,"percent of total billed charges","15.3% of total billed charges",45.7,16.8,,36.56,,,0,"percent of total billed charges","16.8% of total billed charges",187.68,69,,,,,0,"fee schedule","69% of total billed charges",272,100,,217.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",272,100,,217.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",272,100,,217.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.23,61.85,,134.58,,,0,"percent of total billed charges","61.5% of total billed charges",45.7,16.8,,36.56,,,0,"percent of total billed charges","16.8% of total billed charges",136,50,,108.80,,,0,"percent of total billed charges","50% of total billed charges",87.58,32.2,,70.06,,,0,"percent of total billed charges","32.2% of total billed charges",45.7,16.8,,36.56,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.61,17.136,,37.29,,,0,"percent of total billed charges","17.136% of total billed charges",59.4,21.84,,47.52,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",102.54,37.7,,82.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",212.16,78,,169.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.67,82.6,,179.74,,,0,"percent of total billed charges","82.6% of total billed charges",45.7,16.8,,36.56,,,0,"percent of total billed charges","16.8% of total billed charges",136,50,,108.80,,,0,"percent of total billed charges","50% of total billed charges",224.67,82.6,,179.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.7,16.8,,36.56,,,0,"percent of total billed charges","16.8% of total billed charges",272,100,,217.60,,,0,"percent of total billed charges","100% of total billed charges",41.62,272,
"PACK  TOWEL OR STERILE DISP GREEN DLX 20PK/CS",293791,CDM,272,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"PACK ARTHROSCOPY 29180",322036,CDM,270,RC,,,OUTPATIENT,,,148,96.2,,130.24,88,,104.19,,,0,"percent of total billed charges","88% of total billed charges",74,50,,59.20,,,0,"percent of total billed charges","50% of total billed charges",24.86,16.8,,19.89,,,0,"percent of total billed charges","16.8% of total billed charges",148,100,,118.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.61,17.304,,20.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",93.24,63,,74.59,,,0,"percent of total billed charges","63% of total billed charges",22.64,15.3,,18.11,,,0,"percent of total billed charges","15.3% of total billed charges",24.86,16.8,,19.89,,,0,"percent of total billed charges","16.8% of total billed charges",102.12,69,,,,,0,"fee schedule","69% of total billed charges",148,100,,118.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",148,100,,118.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",148,100,,118.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.54,61.85,,73.23,,,0,"percent of total billed charges","61.5% of total billed charges",24.86,16.8,,19.89,,,0,"percent of total billed charges","16.8% of total billed charges",74,50,,59.20,,,0,"percent of total billed charges","50% of total billed charges",47.66,32.2,,38.13,,,0,"percent of total billed charges","32.2% of total billed charges",24.86,16.8,,19.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.36,17.136,,20.29,,,0,"percent of total billed charges","17.136% of total billed charges",32.32,21.84,,25.86,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",55.8,37.7,,44.64,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",115.44,78,,92.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",122.25,82.6,,97.80,,,0,"percent of total billed charges","82.6% of total billed charges",24.86,16.8,,19.89,,,0,"percent of total billed charges","16.8% of total billed charges",74,50,,59.20,,,0,"percent of total billed charges","50% of total billed charges",122.25,82.6,,97.80,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.86,16.8,,19.89,,,0,"percent of total billed charges","16.8% of total billed charges",148,100,,118.40,,,0,"percent of total billed charges","100% of total billed charges",22.64,148,
"PACK ATTEST SUPER RAPID 5 STEAM-PLUS CHALLENGE",183381,CDM,270,RC,,,OUTPATIENT,,,1645,1069.25,,1447.6,88,,1158.08,,,0,"percent of total billed charges","88% of total billed charges",822.5,50,,658.00,,,0,"percent of total billed charges","50% of total billed charges",276.36,16.8,,221.09,,,0,"percent of total billed charges","16.8% of total billed charges",1645,100,,1316.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",284.65,17.304,,227.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1036.35,63,,829.08,,,0,"percent of total billed charges","63% of total billed charges",251.69,15.3,,201.35,,,0,"percent of total billed charges","15.3% of total billed charges",276.36,16.8,,221.09,,,0,"percent of total billed charges","16.8% of total billed charges",1135.05,69,,,,,0,"fee schedule","69% of total billed charges",1645,100,,1316.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1645,100,,1316.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1645,100,,1316.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1017.43,61.85,,813.94,,,0,"percent of total billed charges","61.5% of total billed charges",276.36,16.8,,221.09,,,0,"percent of total billed charges","16.8% of total billed charges",822.5,50,,658.00,,,0,"percent of total billed charges","50% of total billed charges",529.69,32.2,,423.75,,,0,"percent of total billed charges","32.2% of total billed charges",276.36,16.8,,221.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.89,17.136,,225.51,,,0,"percent of total billed charges","17.136% of total billed charges",359.27,21.84,,287.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",620.17,37.7,,496.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1283.1,78,,1026.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1358.77,82.6,,1087.02,,,0,"percent of total billed charges","82.6% of total billed charges",276.36,16.8,,221.09,,,0,"percent of total billed charges","16.8% of total billed charges",822.5,50,,658.00,,,0,"percent of total billed charges","50% of total billed charges",1358.77,82.6,,1087.02,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.36,16.8,,221.09,,,0,"percent of total billed charges","16.8% of total billed charges",1645,100,,1316.00,,,0,"percent of total billed charges","100% of total billed charges",251.69,1645,
"PACK BASIC",81780,CDM,270,RC,,,OUTPATIENT,,,42,27.3,,36.96,88,,29.57,,,0,"percent of total billed charges","88% of total billed charges",21,50,,16.80,,,0,"percent of total billed charges","50% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.27,17.304,,5.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.46,63,,21.17,,,0,"percent of total billed charges","63% of total billed charges",6.43,15.3,,5.14,,,0,"percent of total billed charges","15.3% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",28.98,69,,,,,0,"fee schedule","69% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.98,61.85,,20.78,,,0,"percent of total billed charges","61.5% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",21,50,,16.80,,,0,"percent of total billed charges","50% of total billed charges",13.52,32.2,,10.82,,,0,"percent of total billed charges","32.2% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.2,17.136,,5.76,,,0,"percent of total billed charges","17.136% of total billed charges",9.17,21.84,,7.34,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",32.76,78,,26.21,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",21,50,,16.80,,,0,"percent of total billed charges","50% of total billed charges",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",6.43,42,
"PACK CHS CYSTO",432173,CDM,270,RC,,,OUTPATIENT,,,248,161.2,,218.24,88,,174.59,,,0,"percent of total billed charges","88% of total billed charges",124,50,,99.20,,,0,"percent of total billed charges","50% of total billed charges",41.66,16.8,,33.33,,,0,"percent of total billed charges","16.8% of total billed charges",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.91,17.304,,34.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.24,63,,124.99,,,0,"percent of total billed charges","63% of total billed charges",37.94,15.3,,30.35,,,0,"percent of total billed charges","15.3% of total billed charges",41.66,16.8,,33.33,,,0,"percent of total billed charges","16.8% of total billed charges",171.12,69,,,,,0,"fee schedule","69% of total billed charges",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",153.39,61.85,,122.71,,,0,"percent of total billed charges","61.5% of total billed charges",41.66,16.8,,33.33,,,0,"percent of total billed charges","16.8% of total billed charges",124,50,,99.20,,,0,"percent of total billed charges","50% of total billed charges",79.86,32.2,,63.89,,,0,"percent of total billed charges","32.2% of total billed charges",41.66,16.8,,33.33,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.5,17.136,,34.00,,,0,"percent of total billed charges","17.136% of total billed charges",54.16,21.84,,43.33,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",93.5,37.7,,74.80,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",193.44,78,,154.75,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.85,82.6,,163.88,,,0,"percent of total billed charges","82.6% of total billed charges",41.66,16.8,,33.33,,,0,"percent of total billed charges","16.8% of total billed charges",124,50,,99.20,,,0,"percent of total billed charges","50% of total billed charges",204.85,82.6,,163.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.66,16.8,,33.33,,,0,"percent of total billed charges","16.8% of total billed charges",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",37.94,248,
"PACK CHS LARGE BASIN",432174,CDM,270,RC,,,OUTPATIENT,,,218,141.7,,191.84,88,,153.47,,,0,"percent of total billed charges","88% of total billed charges",109,50,,87.20,,,0,"percent of total billed charges","50% of total billed charges",36.62,16.8,,29.30,,,0,"percent of total billed charges","16.8% of total billed charges",218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.72,17.304,,30.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.34,63,,109.87,,,0,"percent of total billed charges","63% of total billed charges",33.35,15.3,,26.68,,,0,"percent of total billed charges","15.3% of total billed charges",36.62,16.8,,29.30,,,0,"percent of total billed charges","16.8% of total billed charges",150.42,69,,,,,0,"fee schedule","69% of total billed charges",218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.83,61.85,,107.86,,,0,"percent of total billed charges","61.5% of total billed charges",36.62,16.8,,29.30,,,0,"percent of total billed charges","16.8% of total billed charges",109,50,,87.20,,,0,"percent of total billed charges","50% of total billed charges",70.2,32.2,,56.16,,,0,"percent of total billed charges","32.2% of total billed charges",36.62,16.8,,29.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.36,17.136,,29.89,,,0,"percent of total billed charges","17.136% of total billed charges",47.61,21.84,,38.09,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",82.19,37.7,,65.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",170.04,78,,136.03,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",180.07,82.6,,144.06,,,0,"percent of total billed charges","82.6% of total billed charges",36.62,16.8,,29.30,,,0,"percent of total billed charges","16.8% of total billed charges",109,50,,87.20,,,0,"percent of total billed charges","50% of total billed charges",180.07,82.6,,144.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.62,16.8,,29.30,,,0,"percent of total billed charges","16.8% of total billed charges",218,100,,174.40,,,0,"percent of total billed charges","100% of total billed charges",33.35,218,
"PACK GI",182538,CDM,270,RC,,,OUTPATIENT,,,561,364.65,,493.68,88,,394.94,,,0,"percent of total billed charges","88% of total billed charges",280.5,50,,224.40,,,0,"percent of total billed charges","50% of total billed charges",94.25,16.8,,75.40,,,0,"percent of total billed charges","16.8% of total billed charges",561,100,,448.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.08,17.304,,77.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.43,63,,282.74,,,0,"percent of total billed charges","63% of total billed charges",85.83,15.3,,68.66,,,0,"percent of total billed charges","15.3% of total billed charges",94.25,16.8,,75.40,,,0,"percent of total billed charges","16.8% of total billed charges",387.09,69,,,,,0,"fee schedule","69% of total billed charges",561,100,,448.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",561,100,,448.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",561,100,,448.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",346.98,61.85,,277.58,,,0,"percent of total billed charges","61.5% of total billed charges",94.25,16.8,,75.40,,,0,"percent of total billed charges","16.8% of total billed charges",280.5,50,,224.40,,,0,"percent of total billed charges","50% of total billed charges",180.64,32.2,,144.51,,,0,"percent of total billed charges","32.2% of total billed charges",94.25,16.8,,75.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",96.13,17.136,,76.90,,,0,"percent of total billed charges","17.136% of total billed charges",122.52,21.84,,98.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",211.5,37.7,,169.20,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",437.58,78,,350.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.39,82.6,,370.71,,,0,"percent of total billed charges","82.6% of total billed charges",94.25,16.8,,75.40,,,0,"percent of total billed charges","16.8% of total billed charges",280.5,50,,224.40,,,0,"percent of total billed charges","50% of total billed charges",463.39,82.6,,370.71,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",94.25,16.8,,75.40,,,0,"percent of total billed charges","16.8% of total billed charges",561,100,,448.80,,,0,"percent of total billed charges","100% of total billed charges",85.83,561,
"PACK GYN CUSTOM",445081,CDM,270,RC,,,OUTPATIENT,,,563,365.95,,495.44,88,,396.35,,,0,"percent of total billed charges","88% of total billed charges",281.5,50,,225.20,,,0,"percent of total billed charges","50% of total billed charges",94.58,16.8,,75.66,,,0,"percent of total billed charges","16.8% of total billed charges",563,100,,450.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.42,17.304,,77.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",354.69,63,,283.75,,,0,"percent of total billed charges","63% of total billed charges",86.14,15.3,,68.91,,,0,"percent of total billed charges","15.3% of total billed charges",94.58,16.8,,75.66,,,0,"percent of total billed charges","16.8% of total billed charges",388.47,69,,,,,0,"fee schedule","69% of total billed charges",563,100,,450.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",563,100,,450.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",563,100,,450.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.22,61.85,,278.58,,,0,"percent of total billed charges","61.5% of total billed charges",94.58,16.8,,75.66,,,0,"percent of total billed charges","16.8% of total billed charges",281.5,50,,225.20,,,0,"percent of total billed charges","50% of total billed charges",181.29,32.2,,145.03,,,0,"percent of total billed charges","32.2% of total billed charges",94.58,16.8,,75.66,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",96.48,17.136,,77.18,,,0,"percent of total billed charges","17.136% of total billed charges",122.96,21.84,,98.37,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",212.25,37.7,,169.80,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",439.14,78,,351.31,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",465.04,82.6,,372.03,,,0,"percent of total billed charges","82.6% of total billed charges",94.58,16.8,,75.66,,,0,"percent of total billed charges","16.8% of total billed charges",281.5,50,,225.20,,,0,"percent of total billed charges","50% of total billed charges",465.04,82.6,,372.03,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",94.58,16.8,,75.66,,,0,"percent of total billed charges","16.8% of total billed charges",563,100,,450.40,,,0,"percent of total billed charges","100% of total billed charges",86.14,563,
"PACK HEART VALVE A  B",182555,CDM,272,RC,,,OUTPATIENT,,,2781,1807.65,,2447.28,88,,1957.82,,,0,"percent of total billed charges","88% of total billed charges",1390.5,50,,1112.40,,,0,"percent of total billed charges","50% of total billed charges",467.21,16.8,,373.77,,,0,"percent of total billed charges","16.8% of total billed charges",2781,100,,2224.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",481.22,17.304,,384.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1752.03,63,,1401.62,,,0,"percent of total billed charges","63% of total billed charges",425.49,15.3,,340.39,,,0,"percent of total billed charges","15.3% of total billed charges",467.21,16.8,,373.77,,,0,"percent of total billed charges","16.8% of total billed charges",1918.89,69,,,,,0,"fee schedule","69% of total billed charges",2781,100,,2224.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2781,100,,2224.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2781,100,,2224.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1720.05,61.85,,1376.04,,,0,"percent of total billed charges","61.5% of total billed charges",467.21,16.8,,373.77,,,0,"percent of total billed charges","16.8% of total billed charges",1390.5,50,,1112.40,,,0,"percent of total billed charges","50% of total billed charges",895.48,32.2,,716.38,,,0,"percent of total billed charges","32.2% of total billed charges",467.21,16.8,,373.77,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",476.55,17.136,,381.24,,,0,"percent of total billed charges","17.136% of total billed charges",607.37,21.84,,485.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1048.44,37.7,,838.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2169.18,78,,1735.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2297.11,82.6,,1837.69,,,0,"percent of total billed charges","82.6% of total billed charges",467.21,16.8,,373.77,,,0,"percent of total billed charges","16.8% of total billed charges",1390.5,50,,1112.40,,,0,"percent of total billed charges","50% of total billed charges",2297.11,82.6,,1837.69,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",467.21,16.8,,373.77,,,0,"percent of total billed charges","16.8% of total billed charges",2781,100,,2224.80,,,0,"percent of total billed charges","100% of total billed charges",425.49,2781,
"PACK IV START",228636,CDM,270,RC,,,OUTPATIENT,,,204,132.6,,179.52,88,,143.62,,,0,"percent of total billed charges","88% of total billed charges",102,50,,81.60,,,0,"percent of total billed charges","50% of total billed charges",34.27,16.8,,27.42,,,0,"percent of total billed charges","16.8% of total billed charges",204,100,,163.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.304,,28.24,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.52,63,,102.82,,,0,"percent of total billed charges","63% of total billed charges",31.21,15.3,,24.97,,,0,"percent of total billed charges","15.3% of total billed charges",34.27,16.8,,27.42,,,0,"percent of total billed charges","16.8% of total billed charges",140.76,69,,,,,0,"fee schedule","69% of total billed charges",204,100,,163.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",204,100,,163.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",204,100,,163.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.17,61.85,,100.94,,,0,"percent of total billed charges","61.5% of total billed charges",34.27,16.8,,27.42,,,0,"percent of total billed charges","16.8% of total billed charges",102,50,,81.60,,,0,"percent of total billed charges","50% of total billed charges",65.69,32.2,,52.55,,,0,"percent of total billed charges","32.2% of total billed charges",34.27,16.8,,27.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.96,17.136,,27.97,,,0,"percent of total billed charges","17.136% of total billed charges",44.55,21.84,,35.64,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",76.91,37.7,,61.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",159.12,78,,127.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.5,82.6,,134.80,,,0,"percent of total billed charges","82.6% of total billed charges",34.27,16.8,,27.42,,,0,"percent of total billed charges","16.8% of total billed charges",102,50,,81.60,,,0,"percent of total billed charges","50% of total billed charges",168.5,82.6,,134.80,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.27,16.8,,27.42,,,0,"percent of total billed charges","16.8% of total billed charges",204,100,,163.20,,,0,"percent of total billed charges","100% of total billed charges",31.21,204,
"PACK LAPAROSCOPY",182454,CDM,270,RC,,,OUTPATIENT,,,744,483.6,,654.72,88,,523.78,,,0,"percent of total billed charges","88% of total billed charges",372,50,,297.60,,,0,"percent of total billed charges","50% of total billed charges",124.99,16.8,,99.99,,,0,"percent of total billed charges","16.8% of total billed charges",744,100,,595.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.74,17.304,,102.99,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",468.72,63,,374.98,,,0,"percent of total billed charges","63% of total billed charges",113.83,15.3,,91.06,,,0,"percent of total billed charges","15.3% of total billed charges",124.99,16.8,,99.99,,,0,"percent of total billed charges","16.8% of total billed charges",513.36,69,,,,,0,"fee schedule","69% of total billed charges",744,100,,595.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",744,100,,595.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",744,100,,595.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",460.16,61.85,,368.13,,,0,"percent of total billed charges","61.5% of total billed charges",124.99,16.8,,99.99,,,0,"percent of total billed charges","16.8% of total billed charges",372,50,,297.60,,,0,"percent of total billed charges","50% of total billed charges",239.57,32.2,,191.66,,,0,"percent of total billed charges","32.2% of total billed charges",124.99,16.8,,99.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.49,17.136,,101.99,,,0,"percent of total billed charges","17.136% of total billed charges",162.49,21.84,,129.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",280.49,37.7,,224.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.32,78,,464.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",614.54,82.6,,491.63,,,0,"percent of total billed charges","82.6% of total billed charges",124.99,16.8,,99.99,,,0,"percent of total billed charges","16.8% of total billed charges",372,50,,297.60,,,0,"percent of total billed charges","50% of total billed charges",614.54,82.6,,491.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.99,16.8,,99.99,,,0,"percent of total billed charges","16.8% of total billed charges",744,100,,595.20,,,0,"percent of total billed charges","100% of total billed charges",113.83,744,
"PACK LAVH",253188,CDM,270,RC,,,OUTPATIENT,,,422,274.3,,371.36,88,,297.09,,,0,"percent of total billed charges","88% of total billed charges",211,50,,168.80,,,0,"percent of total billed charges","50% of total billed charges",70.9,16.8,,56.72,,,0,"percent of total billed charges","16.8% of total billed charges",422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",73.02,17.304,,58.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",265.86,63,,212.69,,,0,"percent of total billed charges","63% of total billed charges",64.57,15.3,,51.66,,,0,"percent of total billed charges","15.3% of total billed charges",70.9,16.8,,56.72,,,0,"percent of total billed charges","16.8% of total billed charges",291.18,69,,,,,0,"fee schedule","69% of total billed charges",422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.01,61.85,,208.81,,,0,"percent of total billed charges","61.5% of total billed charges",70.9,16.8,,56.72,,,0,"percent of total billed charges","16.8% of total billed charges",211,50,,168.80,,,0,"percent of total billed charges","50% of total billed charges",135.88,32.2,,108.70,,,0,"percent of total billed charges","32.2% of total billed charges",70.9,16.8,,56.72,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",72.31,17.136,,57.85,,,0,"percent of total billed charges","17.136% of total billed charges",92.16,21.84,,73.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",159.09,37.7,,127.27,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",329.16,78,,263.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.57,82.6,,278.86,,,0,"percent of total billed charges","82.6% of total billed charges",70.9,16.8,,56.72,,,0,"percent of total billed charges","16.8% of total billed charges",211,50,,168.80,,,0,"percent of total billed charges","50% of total billed charges",348.57,82.6,,278.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.9,16.8,,56.72,,,0,"percent of total billed charges","16.8% of total billed charges",422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",64.57,422,
"PACK NEURO",182542,CDM,270,RC,,,OUTPATIENT,,,1385,900.25,,1218.8,88,,975.04,,,0,"percent of total billed charges","88% of total billed charges",692.5,50,,554.00,,,0,"percent of total billed charges","50% of total billed charges",232.68,16.8,,186.14,,,0,"percent of total billed charges","16.8% of total billed charges",1385,100,,1108.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",239.66,17.304,,191.73,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",872.55,63,,698.04,,,0,"percent of total billed charges","63% of total billed charges",211.91,15.3,,169.53,,,0,"percent of total billed charges","15.3% of total billed charges",232.68,16.8,,186.14,,,0,"percent of total billed charges","16.8% of total billed charges",955.65,69,,,,,0,"fee schedule","69% of total billed charges",1385,100,,1108.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1385,100,,1108.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1385,100,,1108.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",856.62,61.85,,685.30,,,0,"percent of total billed charges","61.5% of total billed charges",232.68,16.8,,186.14,,,0,"percent of total billed charges","16.8% of total billed charges",692.5,50,,554.00,,,0,"percent of total billed charges","50% of total billed charges",445.97,32.2,,356.78,,,0,"percent of total billed charges","32.2% of total billed charges",232.68,16.8,,186.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",237.33,17.136,,189.86,,,0,"percent of total billed charges","17.136% of total billed charges",302.48,21.84,,241.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.15,37.7,,417.72,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1080.3,78,,864.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1144.01,82.6,,915.21,,,0,"percent of total billed charges","82.6% of total billed charges",232.68,16.8,,186.14,,,0,"percent of total billed charges","16.8% of total billed charges",692.5,50,,554.00,,,0,"percent of total billed charges","50% of total billed charges",1144.01,82.6,,915.21,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",232.68,16.8,,186.14,,,0,"percent of total billed charges","16.8% of total billed charges",1385,100,,1108.00,,,0,"percent of total billed charges","100% of total billed charges",211.91,1385,
"PACK OB MOM AND BABY",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"PACK OPEN HART 1  2",182556,CDM,270,RC,,,OUTPATIENT,,,3408,2215.2,,2999.04,88,,2399.23,,,0,"percent of total billed charges","88% of total billed charges",1704,50,,1363.20,,,0,"percent of total billed charges","50% of total billed charges",572.54,16.8,,458.03,,,0,"percent of total billed charges","16.8% of total billed charges",3408,100,,2726.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.72,17.304,,471.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2147.04,63,,1717.63,,,0,"percent of total billed charges","63% of total billed charges",521.42,15.3,,417.14,,,0,"percent of total billed charges","15.3% of total billed charges",572.54,16.8,,458.03,,,0,"percent of total billed charges","16.8% of total billed charges",2351.52,69,,,,,0,"fee schedule","69% of total billed charges",3408,100,,2726.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3408,100,,2726.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3408,100,,2726.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2107.85,61.85,,1686.28,,,0,"percent of total billed charges","61.5% of total billed charges",572.54,16.8,,458.03,,,0,"percent of total billed charges","16.8% of total billed charges",1704,50,,1363.20,,,0,"percent of total billed charges","50% of total billed charges",1097.38,32.2,,877.90,,,0,"percent of total billed charges","32.2% of total billed charges",572.54,16.8,,458.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",583.99,17.136,,467.19,,,0,"percent of total billed charges","17.136% of total billed charges",744.31,21.84,,595.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1284.82,37.7,,1027.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2658.24,78,,2126.59,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2815.01,82.6,,2252.01,,,0,"percent of total billed charges","82.6% of total billed charges",572.54,16.8,,458.03,,,0,"percent of total billed charges","16.8% of total billed charges",1704,50,,1363.20,,,0,"percent of total billed charges","50% of total billed charges",2815.01,82.6,,2252.01,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",572.54,16.8,,458.03,,,0,"percent of total billed charges","16.8% of total billed charges",3408,100,,2726.40,,,0,"percent of total billed charges","100% of total billed charges",521.42,3408,
"PACK ORTHO EXTREMITY",ORSUP0010,CDM,270,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"PACK PRINTING COLOR 8 1/2 X 11",ORSUP0013,CDM,270,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"PACK THORACIC TRAY",182550,CDM,270,RC,,,OUTPATIENT,,,1491,969.15,,1312.08,88,,1049.66,,,0,"percent of total billed charges","88% of total billed charges",745.5,50,,596.40,,,0,"percent of total billed charges","50% of total billed charges",250.49,16.8,,200.39,,,0,"percent of total billed charges","16.8% of total billed charges",1491,100,,1192.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,17.304,,206.40,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.33,63,,751.46,,,0,"percent of total billed charges","63% of total billed charges",228.12,15.3,,182.50,,,0,"percent of total billed charges","15.3% of total billed charges",250.49,16.8,,200.39,,,0,"percent of total billed charges","16.8% of total billed charges",1028.79,69,,,,,0,"fee schedule","69% of total billed charges",1491,100,,1192.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1491,100,,1192.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1491,100,,1192.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",922.18,61.85,,737.74,,,0,"percent of total billed charges","61.5% of total billed charges",250.49,16.8,,200.39,,,0,"percent of total billed charges","16.8% of total billed charges",745.5,50,,596.40,,,0,"percent of total billed charges","50% of total billed charges",480.1,32.2,,384.08,,,0,"percent of total billed charges","32.2% of total billed charges",250.49,16.8,,200.39,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.5,17.136,,204.40,,,0,"percent of total billed charges","17.136% of total billed charges",325.63,21.84,,260.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",562.11,37.7,,449.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1162.98,78,,930.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1231.57,82.6,,985.26,,,0,"percent of total billed charges","82.6% of total billed charges",250.49,16.8,,200.39,,,0,"percent of total billed charges","16.8% of total billed charges",745.5,50,,596.40,,,0,"percent of total billed charges","50% of total billed charges",1231.57,82.6,,985.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",250.49,16.8,,200.39,,,0,"percent of total billed charges","16.8% of total billed charges",1491,100,,1192.80,,,0,"percent of total billed charges","100% of total billed charges",228.12,1491,
"PACK TOTAL HIP",182548,CDM,270,RC,,,OUTPATIENT,,,1382,898.3,,1216.16,88,,972.93,,,0,"percent of total billed charges","88% of total billed charges",691,50,,552.80,,,0,"percent of total billed charges","50% of total billed charges",232.18,16.8,,185.74,,,0,"percent of total billed charges","16.8% of total billed charges",1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",239.14,17.304,,191.31,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",870.66,63,,696.53,,,0,"percent of total billed charges","63% of total billed charges",211.45,15.3,,169.16,,,0,"percent of total billed charges","15.3% of total billed charges",232.18,16.8,,185.74,,,0,"percent of total billed charges","16.8% of total billed charges",953.58,69,,,,,0,"fee schedule","69% of total billed charges",1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",854.77,61.85,,683.82,,,0,"percent of total billed charges","61.5% of total billed charges",232.18,16.8,,185.74,,,0,"percent of total billed charges","16.8% of total billed charges",691,50,,552.80,,,0,"percent of total billed charges","50% of total billed charges",445,32.2,,356.00,,,0,"percent of total billed charges","32.2% of total billed charges",232.18,16.8,,185.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",236.82,17.136,,189.46,,,0,"percent of total billed charges","17.136% of total billed charges",301.83,21.84,,241.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",521.01,37.7,,416.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1077.96,78,,862.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1141.53,82.6,,913.22,,,0,"percent of total billed charges","82.6% of total billed charges",232.18,16.8,,185.74,,,0,"percent of total billed charges","16.8% of total billed charges",691,50,,552.80,,,0,"percent of total billed charges","50% of total billed charges",1141.53,82.6,,913.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",232.18,16.8,,185.74,,,0,"percent of total billed charges","16.8% of total billed charges",1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",211.45,1382,
"PACK TOTAL KNEE",182549,CDM,270,RC,,,OUTPATIENT,,,1176,764.4,,1034.88,88,,827.90,,,0,"percent of total billed charges","88% of total billed charges",588,50,,470.40,,,0,"percent of total billed charges","50% of total billed charges",197.57,16.8,,158.06,,,0,"percent of total billed charges","16.8% of total billed charges",1176,100,,940.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",203.5,17.304,,162.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",740.88,63,,592.70,,,0,"percent of total billed charges","63% of total billed charges",179.93,15.3,,143.94,,,0,"percent of total billed charges","15.3% of total billed charges",197.57,16.8,,158.06,,,0,"percent of total billed charges","16.8% of total billed charges",811.44,69,,,,,0,"fee schedule","69% of total billed charges",1176,100,,940.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1176,100,,940.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1176,100,,940.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",727.36,61.85,,581.89,,,0,"percent of total billed charges","61.5% of total billed charges",197.57,16.8,,158.06,,,0,"percent of total billed charges","16.8% of total billed charges",588,50,,470.40,,,0,"percent of total billed charges","50% of total billed charges",378.67,32.2,,302.94,,,0,"percent of total billed charges","32.2% of total billed charges",197.57,16.8,,158.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",201.52,17.136,,161.22,,,0,"percent of total billed charges","17.136% of total billed charges",256.84,21.84,,205.47,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",443.35,37.7,,354.68,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",917.28,78,,733.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",971.38,82.6,,777.10,,,0,"percent of total billed charges","82.6% of total billed charges",197.57,16.8,,158.06,,,0,"percent of total billed charges","16.8% of total billed charges",588,50,,470.40,,,0,"percent of total billed charges","50% of total billed charges",971.38,82.6,,777.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",197.57,16.8,,158.06,,,0,"percent of total billed charges","16.8% of total billed charges",1176,100,,940.80,,,0,"percent of total billed charges","100% of total billed charges",179.93,1176,
"PACKET HOLTER MONITOR",ORSUP0011,CDM,270,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"PACKING IODOFORM 1/2X5",11219,CDM,270,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"PACKING IODOFORM 1/4 X 5",11218,CDM,270,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"PACK NASAL ANT STD RAPD RHINO 4.5CM",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"PACK PREMIUM CLOSURE FAST PROCEDURE",307951,CDM,272,RC,,,OUTPATIENT,,,740,481,,651.2,88,,520.96,,,0,"percent of total billed charges","88% of total billed charges",370,50,,296.00,,,0,"percent of total billed charges","50% of total billed charges",124.32,16.8,,99.46,,,0,"percent of total billed charges","16.8% of total billed charges",740,100,,592.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.05,17.304,,102.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",466.2,63,,372.96,,,0,"percent of total billed charges","63% of total billed charges",113.22,15.3,,90.58,,,0,"percent of total billed charges","15.3% of total billed charges",124.32,16.8,,99.46,,,0,"percent of total billed charges","16.8% of total billed charges",510.6,69,,,,,0,"fee schedule","69% of total billed charges",740,100,,592.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",740,100,,592.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",740,100,,592.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",457.69,61.85,,366.15,,,0,"percent of total billed charges","61.5% of total billed charges",124.32,16.8,,99.46,,,0,"percent of total billed charges","16.8% of total billed charges",370,50,,296.00,,,0,"percent of total billed charges","50% of total billed charges",238.28,32.2,,190.62,,,0,"percent of total billed charges","32.2% of total billed charges",124.32,16.8,,99.46,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.81,17.136,,101.45,,,0,"percent of total billed charges","17.136% of total billed charges",161.62,21.84,,129.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",278.98,37.7,,223.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",577.2,78,,461.76,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",611.24,82.6,,488.99,,,0,"percent of total billed charges","82.6% of total billed charges",124.32,16.8,,99.46,,,0,"percent of total billed charges","16.8% of total billed charges",370,50,,296.00,,,0,"percent of total billed charges","50% of total billed charges",611.24,82.6,,488.99,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,16.8,,99.46,,,0,"percent of total billed charges","16.8% of total billed charges",740,100,,592.00,,,0,"percent of total billed charges","100% of total billed charges",113.22,740,
"PACKING NASAL RAPID RHINO 7.5",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"PACKING VAGINAL STER  2X6",30540,CDM,272,RC,,,OUTPATIENT,,,50,32.5,,44,88,,35.20,,,0,"percent of total billed charges","88% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.65,17.304,,6.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.5,63,,25.20,,,0,"percent of total billed charges","63% of total billed charges",7.65,15.3,,6.12,,,0,"percent of total billed charges","15.3% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",34.5,69,,,,,0,"fee schedule","69% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.93,61.85,,24.74,,,0,"percent of total billed charges","61.5% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",16.1,32.2,,12.88,,,0,"percent of total billed charges","32.2% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.57,17.136,,6.86,,,0,"percent of total billed charges","17.136% of total billed charges",10.92,21.84,,8.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39,78,,31.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",7.65,50,
"PACK, LAPAROTOMY T-DRAPE",491025,CDM,270,RC,,,OUTPATIENT,,,43,27.95,,37.84,88,,30.27,,,0,"percent of total billed charges","88% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.44,17.304,,5.95,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.09,63,,21.67,,,0,"percent of total billed charges","63% of total billed charges",6.58,15.3,,5.26,,,0,"percent of total billed charges","15.3% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",29.67,69,,,,,0,"fee schedule","69% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.6,61.85,,21.28,,,0,"percent of total billed charges","61.5% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",13.85,32.2,,11.08,,,0,"percent of total billed charges","32.2% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.37,17.136,,5.90,,,0,"percent of total billed charges","17.136% of total billed charges",9.39,21.84,,7.51,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.21,37.7,,12.97,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",33.54,78,,26.83,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.52,82.6,,28.42,,,0,"percent of total billed charges","82.6% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",35.52,82.6,,28.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",6.58,43,
"PACK, THYROID DRAPE",491030,CDM,270,RC,,,OUTPATIENT,,,50,32.5,,44,88,,35.20,,,0,"percent of total billed charges","88% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.65,17.304,,6.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.5,63,,25.20,,,0,"percent of total billed charges","63% of total billed charges",7.65,15.3,,6.12,,,0,"percent of total billed charges","15.3% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",34.5,69,,,,,0,"fee schedule","69% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.93,61.85,,24.74,,,0,"percent of total billed charges","61.5% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",16.1,32.2,,12.88,,,0,"percent of total billed charges","32.2% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.57,17.136,,6.86,,,0,"percent of total billed charges","17.136% of total billed charges",10.92,21.84,,8.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39,78,,31.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",7.65,50,
"PACK NEURO CUSTOM",491016,CDM,270,RC,,,OUTPATIENT,,,1285,835.25,,1130.8,88,,904.64,,,0,"percent of total billed charges","88% of total billed charges",642.5,50,,514.00,,,0,"percent of total billed charges","50% of total billed charges",215.88,16.8,,172.70,,,0,"percent of total billed charges","16.8% of total billed charges",1285,100,,1028.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",222.36,17.304,,177.89,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",809.55,63,,647.64,,,0,"percent of total billed charges","63% of total billed charges",196.61,15.3,,157.29,,,0,"percent of total billed charges","15.3% of total billed charges",215.88,16.8,,172.70,,,0,"percent of total billed charges","16.8% of total billed charges",886.65,69,,,,,0,"fee schedule","69% of total billed charges",1285,100,,1028.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1285,100,,1028.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1285,100,,1028.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",794.77,61.85,,635.82,,,0,"percent of total billed charges","61.5% of total billed charges",215.88,16.8,,172.70,,,0,"percent of total billed charges","16.8% of total billed charges",642.5,50,,514.00,,,0,"percent of total billed charges","50% of total billed charges",413.77,32.2,,331.02,,,0,"percent of total billed charges","32.2% of total billed charges",215.88,16.8,,172.70,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",220.2,17.136,,176.16,,,0,"percent of total billed charges","17.136% of total billed charges",280.64,21.84,,224.51,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",484.45,37.7,,387.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1002.3,78,,801.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1061.41,82.6,,849.13,,,0,"percent of total billed charges","82.6% of total billed charges",215.88,16.8,,172.70,,,0,"percent of total billed charges","16.8% of total billed charges",642.5,50,,514.00,,,0,"percent of total billed charges","50% of total billed charges",1061.41,82.6,,849.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",215.88,16.8,,172.70,,,0,"percent of total billed charges","16.8% of total billed charges",1285,100,,1028.00,,,0,"percent of total billed charges","100% of total billed charges",196.61,1285,
"PACK, MINOR ORTHO",491029,CDM,270,RC,,,OUTPATIENT,,,555,360.75,,488.4,88,,390.72,,,0,"percent of total billed charges","88% of total billed charges",277.5,50,,222.00,,,0,"percent of total billed charges","50% of total billed charges",93.24,16.8,,74.59,,,0,"percent of total billed charges","16.8% of total billed charges",555,100,,444.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",96.04,17.304,,76.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",349.65,63,,279.72,,,0,"percent of total billed charges","63% of total billed charges",84.92,15.3,,67.94,,,0,"percent of total billed charges","15.3% of total billed charges",93.24,16.8,,74.59,,,0,"percent of total billed charges","16.8% of total billed charges",382.95,69,,,,,0,"fee schedule","69% of total billed charges",555,100,,444.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",555,100,,444.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",555,100,,444.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",343.27,61.85,,274.62,,,0,"percent of total billed charges","61.5% of total billed charges",93.24,16.8,,74.59,,,0,"percent of total billed charges","16.8% of total billed charges",277.5,50,,222.00,,,0,"percent of total billed charges","50% of total billed charges",178.71,32.2,,142.97,,,0,"percent of total billed charges","32.2% of total billed charges",93.24,16.8,,74.59,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.1,17.136,,76.08,,,0,"percent of total billed charges","17.136% of total billed charges",121.21,21.84,,96.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.24,37.7,,167.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",432.9,78,,346.32,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.43,82.6,,366.74,,,0,"percent of total billed charges","82.6% of total billed charges",93.24,16.8,,74.59,,,0,"percent of total billed charges","16.8% of total billed charges",277.5,50,,222.00,,,0,"percent of total billed charges","50% of total billed charges",458.43,82.6,,366.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",93.24,16.8,,74.59,,,0,"percent of total billed charges","16.8% of total billed charges",555,100,,444.00,,,0,"percent of total billed charges","100% of total billed charges",84.92,555,
"PACK, MAYO STAND COVER",491028,CDM,270,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"PACK, LITHOTOMY (PERI/GYN)",491027,CDM,270,RC,,,OUTPATIENT,,,59,38.35,,51.92,88,,41.54,,,0,"percent of total billed charges","88% of total billed charges",29.5,50,,23.60,,,0,"percent of total billed charges","50% of total billed charges",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.21,17.304,,8.17,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.17,63,,29.74,,,0,"percent of total billed charges","63% of total billed charges",9.03,15.3,,7.22,,,0,"percent of total billed charges","15.3% of total billed charges",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",40.71,69,,,,,0,"fee schedule","69% of total billed charges",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.49,61.85,,29.19,,,0,"percent of total billed charges","61.5% of total billed charges",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",29.5,50,,23.60,,,0,"percent of total billed charges","50% of total billed charges",19,32.2,,15.20,,,0,"percent of total billed charges","32.2% of total billed charges",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.11,17.136,,8.09,,,0,"percent of total billed charges","17.136% of total billed charges",12.89,21.84,,10.31,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.24,37.7,,17.79,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.02,78,,36.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.73,82.6,,38.98,,,0,"percent of total billed charges","82.6% of total billed charges",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",29.5,50,,23.60,,,0,"percent of total billed charges","50% of total billed charges",48.73,82.6,,38.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",9.03,59,
"PACK, LAPAROSCOPY/PELVISCOPY",491024,CDM,270,RC,,,OUTPATIENT,,,142,92.3,,124.96,88,,99.97,,,0,"percent of total billed charges","88% of total billed charges",71,50,,56.80,,,0,"percent of total billed charges","50% of total billed charges",23.86,16.8,,19.09,,,0,"percent of total billed charges","16.8% of total billed charges",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.57,17.304,,19.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.46,63,,71.57,,,0,"percent of total billed charges","63% of total billed charges",21.73,15.3,,17.38,,,0,"percent of total billed charges","15.3% of total billed charges",23.86,16.8,,19.09,,,0,"percent of total billed charges","16.8% of total billed charges",97.98,69,,,,,0,"fee schedule","69% of total billed charges",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.83,61.85,,70.26,,,0,"percent of total billed charges","61.5% of total billed charges",23.86,16.8,,19.09,,,0,"percent of total billed charges","16.8% of total billed charges",71,50,,56.80,,,0,"percent of total billed charges","50% of total billed charges",45.72,32.2,,36.58,,,0,"percent of total billed charges","32.2% of total billed charges",23.86,16.8,,19.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.33,17.136,,19.46,,,0,"percent of total billed charges","17.136% of total billed charges",31.01,21.84,,24.81,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",53.53,37.7,,42.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",110.76,78,,88.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",117.29,82.6,,93.83,,,0,"percent of total billed charges","82.6% of total billed charges",23.86,16.8,,19.09,,,0,"percent of total billed charges","16.8% of total billed charges",71,50,,56.80,,,0,"percent of total billed charges","50% of total billed charges",117.29,82.6,,93.83,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.86,16.8,,19.09,,,0,"percent of total billed charges","16.8% of total billed charges",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",21.73,142,
"PACK, LAP CHOLE",491023,CDM,270,RC,,,OUTPATIENT,,,396,257.4,,348.48,88,,278.78,,,0,"percent of total billed charges","88% of total billed charges",198,50,,158.40,,,0,"percent of total billed charges","50% of total billed charges",66.53,16.8,,53.22,,,0,"percent of total billed charges","16.8% of total billed charges",396,100,,316.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.52,17.304,,54.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",249.48,63,,199.58,,,0,"percent of total billed charges","63% of total billed charges",60.59,15.3,,48.47,,,0,"percent of total billed charges","15.3% of total billed charges",66.53,16.8,,53.22,,,0,"percent of total billed charges","16.8% of total billed charges",273.24,69,,,,,0,"fee schedule","69% of total billed charges",396,100,,316.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",396,100,,316.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",396,100,,316.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",244.93,61.85,,195.94,,,0,"percent of total billed charges","61.5% of total billed charges",66.53,16.8,,53.22,,,0,"percent of total billed charges","16.8% of total billed charges",198,50,,158.40,,,0,"percent of total billed charges","50% of total billed charges",127.51,32.2,,102.01,,,0,"percent of total billed charges","32.2% of total billed charges",66.53,16.8,,53.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.86,17.136,,54.29,,,0,"percent of total billed charges","17.136% of total billed charges",86.49,21.84,,69.19,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",149.29,37.7,,119.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",308.88,78,,247.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",327.1,82.6,,261.68,,,0,"percent of total billed charges","82.6% of total billed charges",66.53,16.8,,53.22,,,0,"percent of total billed charges","16.8% of total billed charges",198,50,,158.40,,,0,"percent of total billed charges","50% of total billed charges",327.1,82.6,,261.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",66.53,16.8,,53.22,,,0,"percent of total billed charges","16.8% of total billed charges",396,100,,316.80,,,0,"percent of total billed charges","100% of total billed charges",60.59,396,
"PACK, HEAD/NECK EENT IV",491022,CDM,270,RC,,,OUTPATIENT,,,97,63.05,,85.36,88,,68.29,,,0,"percent of total billed charges","88% of total billed charges",48.5,50,,38.80,,,0,"percent of total billed charges","50% of total billed charges",16.3,16.8,,13.04,,,0,"percent of total billed charges","16.8% of total billed charges",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.78,17.304,,13.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.11,63,,48.89,,,0,"percent of total billed charges","63% of total billed charges",14.84,15.3,,11.87,,,0,"percent of total billed charges","15.3% of total billed charges",16.3,16.8,,13.04,,,0,"percent of total billed charges","16.8% of total billed charges",66.93,69,,,,,0,"fee schedule","69% of total billed charges",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.99,61.85,,47.99,,,0,"percent of total billed charges","61.5% of total billed charges",16.3,16.8,,13.04,,,0,"percent of total billed charges","16.8% of total billed charges",48.5,50,,38.80,,,0,"percent of total billed charges","50% of total billed charges",31.23,32.2,,24.98,,,0,"percent of total billed charges","32.2% of total billed charges",16.3,16.8,,13.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.62,17.136,,13.30,,,0,"percent of total billed charges","17.136% of total billed charges",21.18,21.84,,16.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.57,37.7,,29.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.66,78,,60.53,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.12,82.6,,64.10,,,0,"percent of total billed charges","82.6% of total billed charges",16.3,16.8,,13.04,,,0,"percent of total billed charges","16.8% of total billed charges",48.5,50,,38.80,,,0,"percent of total billed charges","50% of total billed charges",80.12,82.6,,64.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.3,16.8,,13.04,,,0,"percent of total billed charges","16.8% of total billed charges",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",14.84,97,
"PACK, GENERAL LAP",491021,CDM,270,RC,,,OUTPATIENT,,,403,261.95,,354.64,88,,283.71,,,0,"percent of total billed charges","88% of total billed charges",201.5,50,,161.20,,,0,"percent of total billed charges","50% of total billed charges",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.74,17.304,,55.79,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.89,63,,203.11,,,0,"percent of total billed charges","63% of total billed charges",61.66,15.3,,49.33,,,0,"percent of total billed charges","15.3% of total billed charges",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",278.07,69,,,,,0,"fee schedule","69% of total billed charges",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",249.26,61.85,,199.41,,,0,"percent of total billed charges","61.5% of total billed charges",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",201.5,50,,161.20,,,0,"percent of total billed charges","50% of total billed charges",129.77,32.2,,103.82,,,0,"percent of total billed charges","32.2% of total billed charges",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.06,17.136,,55.25,,,0,"percent of total billed charges","17.136% of total billed charges",88.02,21.84,,70.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",314.34,78,,251.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",201.5,50,,161.20,,,0,"percent of total billed charges","50% of total billed charges",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.7,16.8,,54.16,,,0,"percent of total billed charges","16.8% of total billed charges",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",61.66,403,
"PACK, UNIVERSAL EXTREMITY DRAP",491031,CDM,270,RC,,,OUTPATIENT,,,45,29.25,,39.6,88,,31.68,,,0,"percent of total billed charges","88% of total billed charges",22.5,50,,18.00,,,0,"percent of total billed charges","50% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.79,17.304,,6.23,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.35,63,,22.68,,,0,"percent of total billed charges","63% of total billed charges",6.89,15.3,,5.51,,,0,"percent of total billed charges","15.3% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",31.05,69,,,,,0,"fee schedule","69% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.83,61.85,,22.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",22.5,50,,18.00,,,0,"percent of total billed charges","50% of total billed charges",14.49,32.2,,11.59,,,0,"percent of total billed charges","32.2% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.71,17.136,,6.17,,,0,"percent of total billed charges","17.136% of total billed charges",9.83,21.84,,7.86,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.97,37.7,,13.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.1,78,,28.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",22.5,50,,18.00,,,0,"percent of total billed charges","50% of total billed charges",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",6.89,45,
"PACK ENDOSCOPY",491015,CDM,270,RC,,,OUTPATIENT,,,78,50.7,,68.64,88,,54.91,,,0,"percent of total billed charges","88% of total billed charges",39,50,,31.20,,,0,"percent of total billed charges","50% of total billed charges",13.1,16.8,,10.48,,,0,"percent of total billed charges","16.8% of total billed charges",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.5,17.304,,10.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.14,63,,39.31,,,0,"percent of total billed charges","63% of total billed charges",11.93,15.3,,9.54,,,0,"percent of total billed charges","15.3% of total billed charges",13.1,16.8,,10.48,,,0,"percent of total billed charges","16.8% of total billed charges",53.82,69,,,,,0,"fee schedule","69% of total billed charges",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.24,61.85,,38.59,,,0,"percent of total billed charges","61.5% of total billed charges",13.1,16.8,,10.48,,,0,"percent of total billed charges","16.8% of total billed charges",39,50,,31.20,,,0,"percent of total billed charges","50% of total billed charges",25.12,32.2,,20.10,,,0,"percent of total billed charges","32.2% of total billed charges",13.1,16.8,,10.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.37,17.136,,10.70,,,0,"percent of total billed charges","17.136% of total billed charges",17.04,21.84,,13.63,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.41,37.7,,23.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",60.84,78,,48.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",13.1,16.8,,10.48,,,0,"percent of total billed charges","16.8% of total billed charges",39,50,,31.20,,,0,"percent of total billed charges","50% of total billed charges",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.1,16.8,,10.48,,,0,"percent of total billed charges","16.8% of total billed charges",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",11.93,78,
"PACK, C-SECTION STERILE",491019,CDM,272,RC,,,OUTPATIENT,,,539,350.35,,474.32,88,,379.46,,,0,"percent of total billed charges","88% of total billed charges",269.5,50,,215.60,,,0,"percent of total billed charges","50% of total billed charges",90.55,16.8,,72.44,,,0,"percent of total billed charges","16.8% of total billed charges",539,100,,431.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",93.27,17.304,,74.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",339.57,63,,271.66,,,0,"percent of total billed charges","63% of total billed charges",82.47,15.3,,65.98,,,0,"percent of total billed charges","15.3% of total billed charges",90.55,16.8,,72.44,,,0,"percent of total billed charges","16.8% of total billed charges",371.91,69,,,,,0,"fee schedule","69% of total billed charges",539,100,,431.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",539,100,,431.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",539,100,,431.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",333.37,61.85,,266.70,,,0,"percent of total billed charges","61.5% of total billed charges",90.55,16.8,,72.44,,,0,"percent of total billed charges","16.8% of total billed charges",269.5,50,,215.60,,,0,"percent of total billed charges","50% of total billed charges",173.56,32.2,,138.85,,,0,"percent of total billed charges","32.2% of total billed charges",90.55,16.8,,72.44,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.36,17.136,,73.89,,,0,"percent of total billed charges","17.136% of total billed charges",117.72,21.84,,94.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",203.2,37.7,,162.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",420.42,78,,336.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",445.21,82.6,,356.17,,,0,"percent of total billed charges","82.6% of total billed charges",90.55,16.8,,72.44,,,0,"percent of total billed charges","16.8% of total billed charges",269.5,50,,215.60,,,0,"percent of total billed charges","50% of total billed charges",445.21,82.6,,356.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.55,16.8,,72.44,,,0,"percent of total billed charges","16.8% of total billed charges",539,100,,431.20,,,0,"percent of total billed charges","100% of total billed charges",82.47,539,
"PACK DOUBLE BASIN",491014,CDM,270,RC,,,OUTPATIENT,,,64,41.6,,56.32,88,,45.06,,,0,"percent of total billed charges","88% of total billed charges",32,50,,25.60,,,0,"percent of total billed charges","50% of total billed charges",10.75,16.8,,8.60,,,0,"percent of total billed charges","16.8% of total billed charges",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.07,17.304,,8.86,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.32,63,,32.26,,,0,"percent of total billed charges","63% of total billed charges",9.79,15.3,,7.83,,,0,"percent of total billed charges","15.3% of total billed charges",10.75,16.8,,8.60,,,0,"percent of total billed charges","16.8% of total billed charges",44.16,69,,,,,0,"fee schedule","69% of total billed charges",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.58,61.85,,31.66,,,0,"percent of total billed charges","61.5% of total billed charges",10.75,16.8,,8.60,,,0,"percent of total billed charges","16.8% of total billed charges",32,50,,25.60,,,0,"percent of total billed charges","50% of total billed charges",20.61,32.2,,16.49,,,0,"percent of total billed charges","32.2% of total billed charges",10.75,16.8,,8.60,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.97,17.136,,8.78,,,0,"percent of total billed charges","17.136% of total billed charges",13.98,21.84,,11.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.13,37.7,,19.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",49.92,78,,39.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.86,82.6,,42.29,,,0,"percent of total billed charges","82.6% of total billed charges",10.75,16.8,,8.60,,,0,"percent of total billed charges","16.8% of total billed charges",32,50,,25.60,,,0,"percent of total billed charges","50% of total billed charges",52.86,82.6,,42.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.75,16.8,,8.60,,,0,"percent of total billed charges","16.8% of total billed charges",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",9.79,64,
"PACK, ARTHROSCOPY",491018,CDM,270,RC,,,OUTPATIENT,,,379,246.35,,333.52,88,,266.82,,,0,"percent of total billed charges","88% of total billed charges",189.5,50,,151.60,,,0,"percent of total billed charges","50% of total billed charges",63.67,16.8,,50.94,,,0,"percent of total billed charges","16.8% of total billed charges",379,100,,303.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",65.58,17.304,,52.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",238.77,63,,191.02,,,0,"percent of total billed charges","63% of total billed charges",57.99,15.3,,46.39,,,0,"percent of total billed charges","15.3% of total billed charges",63.67,16.8,,50.94,,,0,"percent of total billed charges","16.8% of total billed charges",261.51,69,,,,,0,"fee schedule","69% of total billed charges",379,100,,303.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",379,100,,303.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",379,100,,303.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",234.41,61.85,,187.53,,,0,"percent of total billed charges","61.5% of total billed charges",63.67,16.8,,50.94,,,0,"percent of total billed charges","16.8% of total billed charges",189.5,50,,151.60,,,0,"percent of total billed charges","50% of total billed charges",122.04,32.2,,97.63,,,0,"percent of total billed charges","32.2% of total billed charges",63.67,16.8,,50.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.95,17.136,,51.96,,,0,"percent of total billed charges","17.136% of total billed charges",82.77,21.84,,66.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",142.88,37.7,,114.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",295.62,78,,236.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.05,82.6,,250.44,,,0,"percent of total billed charges","82.6% of total billed charges",63.67,16.8,,50.94,,,0,"percent of total billed charges","16.8% of total billed charges",189.5,50,,151.60,,,0,"percent of total billed charges","50% of total billed charges",313.05,82.6,,250.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.67,16.8,,50.94,,,0,"percent of total billed charges","16.8% of total billed charges",379,100,,303.20,,,0,"percent of total billed charges","100% of total billed charges",57.99,379,
"PACK LAPAROSCOPY NO GOWNS",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"PACK PERFUSION CUSTOM TERUMO",ORSUP0045,CDM,272,RC,,,OUTPATIENT,,,7766,5047.9,,6834.08,88,,5467.26,,,0,"percent of total billed charges","88% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1343.83,17.304,,1075.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4892.58,63,,3914.06,,,0,"percent of total billed charges","63% of total billed charges",1188.2,15.3,,950.56,,,0,"percent of total billed charges","15.3% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",5358.54,69,,,,,0,"fee schedule","69% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4803.27,61.85,,3842.62,,,0,"percent of total billed charges","61.5% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",2500.65,32.2,,2000.52,,,0,"percent of total billed charges","32.2% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1330.78,17.136,,1064.62,,,0,"percent of total billed charges","17.136% of total billed charges",1696.09,21.84,,1356.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2927.78,37.7,,2342.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6057.48,78,,4845.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",1188.2,7766,
"PACK CAMPYLO",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"PACK TOTAL KNEE SUNNYSIDE",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"PACK CUSTOM TURNOVER ATH",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"PACK VARITHENA ADMIN",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"PAD R-2 ADULT 610",185683,CDM,270,RC,,,OUTPATIENT,,,224,145.6,,197.12,88,,157.70,,,0,"percent of total billed charges","88% of total billed charges",112,50,,89.60,,,0,"percent of total billed charges","50% of total billed charges",37.63,16.8,,30.10,,,0,"percent of total billed charges","16.8% of total billed charges",224,100,,179.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.76,17.304,,31.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",141.12,63,,112.90,,,0,"percent of total billed charges","63% of total billed charges",34.27,15.3,,27.42,,,0,"percent of total billed charges","15.3% of total billed charges",37.63,16.8,,30.10,,,0,"percent of total billed charges","16.8% of total billed charges",154.56,69,,,,,0,"fee schedule","69% of total billed charges",224,100,,179.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",224,100,,179.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",224,100,,179.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.54,61.85,,110.83,,,0,"percent of total billed charges","61.5% of total billed charges",37.63,16.8,,30.10,,,0,"percent of total billed charges","16.8% of total billed charges",112,50,,89.60,,,0,"percent of total billed charges","50% of total billed charges",72.13,32.2,,57.70,,,0,"percent of total billed charges","32.2% of total billed charges",37.63,16.8,,30.10,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.38,17.136,,30.70,,,0,"percent of total billed charges","17.136% of total billed charges",48.92,21.84,,39.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",84.45,37.7,,67.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",174.72,78,,139.78,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.02,82.6,,148.02,,,0,"percent of total billed charges","82.6% of total billed charges",37.63,16.8,,30.10,,,0,"percent of total billed charges","16.8% of total billed charges",112,50,,89.60,,,0,"percent of total billed charges","50% of total billed charges",185.02,82.6,,148.02,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.63,16.8,,30.10,,,0,"percent of total billed charges","16.8% of total billed charges",224,100,,179.20,,,0,"percent of total billed charges","100% of total billed charges",34.27,224,
"PAD UNDERCAST CRIMPED FINISH 6IN X 4YDS NON-STER",164170,CDM,270,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"PAD UNDERCAST CRIMPED FINISH 4IN X 4YDS NON-STER",164169,CDM,270,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"PAD DEFIB 4 1/2X4 1/2",145669,CDM,270,RC,,,OUTPATIENT,,,31,20.15,,27.28,88,,21.82,,,0,"percent of total billed charges","88% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.36,17.304,,4.29,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.53,63,,15.62,,,0,"percent of total billed charges","63% of total billed charges",4.74,15.3,,3.79,,,0,"percent of total billed charges","15.3% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",21.39,69,,,,,0,"fee schedule","69% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.17,61.85,,15.34,,,0,"percent of total billed charges","61.5% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",9.98,32.2,,7.98,,,0,"percent of total billed charges","32.2% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.31,17.136,,4.25,,,0,"percent of total billed charges","17.136% of total billed charges",6.77,21.84,,5.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.69,37.7,,9.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.18,78,,19.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.61,82.6,,20.49,,,0,"percent of total billed charges","82.6% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",25.61,82.6,,20.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",4.74,31,
"PAD GROUNDING ADULT REM 9IN",10470,CDM,270,RC,,,OUTPATIENT,,,34,22.1,,29.92,88,,23.94,,,0,"percent of total billed charges","88% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.88,17.304,,4.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.42,63,,17.14,,,0,"percent of total billed charges","63% of total billed charges",5.2,15.3,,4.16,,,0,"percent of total billed charges","15.3% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",23.46,69,,,,,0,"fee schedule","69% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.03,61.85,,16.82,,,0,"percent of total billed charges","61.5% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",10.95,32.2,,8.76,,,0,"percent of total billed charges","32.2% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.83,17.136,,4.66,,,0,"percent of total billed charges","17.136% of total billed charges",7.43,21.84,,5.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.82,37.7,,10.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.52,78,,21.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",5.2,34,
"PAD GROUNDING SINGLE ADULT NON-REM 9FT",7879,CDM,270,RC,,,OUTPATIENT,,,25,16.25,,22,88,,17.60,,,0,"percent of total billed charges","88% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,17.304,,3.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.75,63,,12.60,,,0,"percent of total billed charges","63% of total billed charges",3.83,15.3,,3.06,,,0,"percent of total billed charges","15.3% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",17.25,69,,,,,0,"fee schedule","69% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.46,61.85,,12.37,,,0,"percent of total billed charges","61.5% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",8.05,32.2,,6.44,,,0,"percent of total billed charges","32.2% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.28,17.136,,3.42,,,0,"percent of total billed charges","17.136% of total billed charges",5.46,21.84,,4.37,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.43,37.7,,7.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.5,78,,15.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",3.83,25,
"PAD GROUNDING ARGON THERMOGARD",124820,CDM,270,RC,,,OUTPATIENT,,,38,24.7,,33.44,88,,26.75,,,0,"percent of total billed charges","88% of total billed charges",19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.58,17.304,,5.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.94,63,,19.15,,,0,"percent of total billed charges","63% of total billed charges",5.81,15.3,,4.65,,,0,"percent of total billed charges","15.3% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",26.22,69,,,,,0,"fee schedule","69% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.5,61.85,,18.80,,,0,"percent of total billed charges","61.5% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",12.24,32.2,,9.79,,,0,"percent of total billed charges","32.2% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.51,17.136,,5.21,,,0,"percent of total billed charges","17.136% of total billed charges",8.3,21.84,,6.64,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.33,37.7,,11.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.64,78,,23.71,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",5.81,38,
"PAD  POVIDONE IODINE PREP",109428,CDM,270,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"PAD ANTI-FOG MR CLEAR",82817,CDM,270,RC,,,OUTPATIENT,,,23,14.95,,20.24,88,,16.19,,,0,"percent of total billed charges","88% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.98,17.304,,3.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.49,63,,11.59,,,0,"percent of total billed charges","63% of total billed charges",3.52,15.3,,2.82,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",15.87,69,,,,,0,"fee schedule","69% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.23,61.85,,11.38,,,0,"percent of total billed charges","61.5% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",7.41,32.2,,5.93,,,0,"percent of total billed charges","32.2% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.94,17.136,,3.15,,,0,"percent of total billed charges","17.136% of total billed charges",5.02,21.84,,4.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.94,78,,14.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",3.52,23,
"PAD ARCTIC GEL MEDIUM COOLING KIT",ORSUP0033,CDM,270,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"PAD ARCTIC SUN LARGE",ORSUP0033,CDM,270,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"PAD ARCTIC SUN SMALL",ORSUP0033,CDM,270,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"PAD ARCTIC SUN UNIVERSAL",ORSUP0020,CDM,270,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"PAD ELECTRODE DEFIB ONE STEP COMPLETE ZOLL",283912,CDM,270,RC,,,OUTPATIENT,,,3458,2247.7,,3043.04,88,,2434.43,,,0,"percent of total billed charges","88% of total billed charges",1729,50,,1383.20,,,0,"percent of total billed charges","50% of total billed charges",580.94,16.8,,464.75,,,0,"percent of total billed charges","16.8% of total billed charges",3458,100,,2766.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",598.37,17.304,,478.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2178.54,63,,1742.83,,,0,"percent of total billed charges","63% of total billed charges",529.07,15.3,,423.26,,,0,"percent of total billed charges","15.3% of total billed charges",580.94,16.8,,464.75,,,0,"percent of total billed charges","16.8% of total billed charges",2386.02,69,,,,,0,"fee schedule","69% of total billed charges",3458,100,,2766.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3458,100,,2766.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3458,100,,2766.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2138.77,61.85,,1711.02,,,0,"percent of total billed charges","61.5% of total billed charges",580.94,16.8,,464.75,,,0,"percent of total billed charges","16.8% of total billed charges",1729,50,,1383.20,,,0,"percent of total billed charges","50% of total billed charges",1113.48,32.2,,890.78,,,0,"percent of total billed charges","32.2% of total billed charges",580.94,16.8,,464.75,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",592.56,17.136,,474.05,,,0,"percent of total billed charges","17.136% of total billed charges",755.23,21.84,,604.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1303.67,37.7,,1042.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2697.24,78,,2157.79,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2856.31,82.6,,2285.05,,,0,"percent of total billed charges","82.6% of total billed charges",580.94,16.8,,464.75,,,0,"percent of total billed charges","16.8% of total billed charges",1729,50,,1383.20,,,0,"percent of total billed charges","50% of total billed charges",2856.31,82.6,,2285.05,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.94,16.8,,464.75,,,0,"percent of total billed charges","16.8% of total billed charges",3458,100,,2766.40,,,0,"percent of total billed charges","100% of total billed charges",529.07,3458,
"PAD AND WRAP KNEE POSITIONER DEMAYO 294-P",172348,CDM,272,RC,,,OUTPATIENT,,,506,328.9,,445.28,88,,356.22,,,0,"percent of total billed charges","88% of total billed charges",253,50,,202.40,,,0,"percent of total billed charges","50% of total billed charges",85.01,16.8,,68.01,,,0,"percent of total billed charges","16.8% of total billed charges",506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.56,17.304,,70.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",318.78,63,,255.02,,,0,"percent of total billed charges","63% of total billed charges",77.42,15.3,,61.94,,,0,"percent of total billed charges","15.3% of total billed charges",85.01,16.8,,68.01,,,0,"percent of total billed charges","16.8% of total billed charges",349.14,69,,,,,0,"fee schedule","69% of total billed charges",506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",312.96,61.85,,250.37,,,0,"percent of total billed charges","61.5% of total billed charges",85.01,16.8,,68.01,,,0,"percent of total billed charges","16.8% of total billed charges",253,50,,202.40,,,0,"percent of total billed charges","50% of total billed charges",162.93,32.2,,130.34,,,0,"percent of total billed charges","32.2% of total billed charges",85.01,16.8,,68.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.71,17.136,,69.37,,,0,"percent of total billed charges","17.136% of total billed charges",110.51,21.84,,88.41,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",190.76,37.7,,152.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",394.68,78,,315.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.96,82.6,,334.37,,,0,"percent of total billed charges","82.6% of total billed charges",85.01,16.8,,68.01,,,0,"percent of total billed charges","16.8% of total billed charges",253,50,,202.40,,,0,"percent of total billed charges","50% of total billed charges",417.96,82.6,,334.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.01,16.8,,68.01,,,0,"percent of total billed charges","16.8% of total billed charges",506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",77.42,506,
"PAD GROUNDING MONOPOLAR RETURN",288356,CDM,272,RC,,,OUTPATIENT,,,215,139.75,,189.2,88,,151.36,,,0,"percent of total billed charges","88% of total billed charges",107.5,50,,86.00,,,0,"percent of total billed charges","50% of total billed charges",36.12,16.8,,28.90,,,0,"percent of total billed charges","16.8% of total billed charges",215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.2,17.304,,29.76,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",135.45,63,,108.36,,,0,"percent of total billed charges","63% of total billed charges",32.9,15.3,,26.32,,,0,"percent of total billed charges","15.3% of total billed charges",36.12,16.8,,28.90,,,0,"percent of total billed charges","16.8% of total billed charges",148.35,69,,,,,0,"fee schedule","69% of total billed charges",215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",132.98,61.85,,106.38,,,0,"percent of total billed charges","61.5% of total billed charges",36.12,16.8,,28.90,,,0,"percent of total billed charges","16.8% of total billed charges",107.5,50,,86.00,,,0,"percent of total billed charges","50% of total billed charges",69.23,32.2,,55.38,,,0,"percent of total billed charges","32.2% of total billed charges",36.12,16.8,,28.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.84,17.136,,29.47,,,0,"percent of total billed charges","17.136% of total billed charges",46.96,21.84,,37.57,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",81.06,37.7,,64.85,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",167.7,78,,134.16,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",177.59,82.6,,142.07,,,0,"percent of total billed charges","82.6% of total billed charges",36.12,16.8,,28.90,,,0,"percent of total billed charges","16.8% of total billed charges",107.5,50,,86.00,,,0,"percent of total billed charges","50% of total billed charges",177.59,82.6,,142.07,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.12,16.8,,28.90,,,0,"percent of total billed charges","16.8% of total billed charges",215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",32.9,215,
"PAD KNEE INTELLI-FLO",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"PAD SANITARY PK OB NON241280",10211,CDM,272,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.95,61.85,,3.96,,,0,"percent of total billed charges","61.5% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"PAD POLAR KNEE/SHOULDER",ORSUP0004,CDM,270,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"PAD GROUNDING PEDIATRIC",491034,CDM,270,RC,,,OUTPATIENT,,,59,38.35,,51.92,88,,41.54,,,0,"percent of total billed charges","88% of total billed charges",29.5,50,,23.60,,,0,"percent of total billed charges","50% of total billed charges",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.21,17.304,,8.17,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.17,63,,29.74,,,0,"percent of total billed charges","63% of total billed charges",9.03,15.3,,7.22,,,0,"percent of total billed charges","15.3% of total billed charges",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",40.71,69,,,,,0,"fee schedule","69% of total billed charges",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.49,61.85,,29.19,,,0,"percent of total billed charges","61.5% of total billed charges",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",29.5,50,,23.60,,,0,"percent of total billed charges","50% of total billed charges",19,32.2,,15.20,,,0,"percent of total billed charges","32.2% of total billed charges",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.11,17.136,,8.09,,,0,"percent of total billed charges","17.136% of total billed charges",12.89,21.84,,10.31,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.24,37.7,,17.79,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.02,78,,36.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.73,82.6,,38.98,,,0,"percent of total billed charges","82.6% of total billed charges",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",29.5,50,,23.60,,,0,"percent of total billed charges","50% of total billed charges",48.73,82.6,,38.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",9.03,59,
"PAD GROUNDING ADULT",491033,CDM,270,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.37,61.85,,9.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"PAD BLUE CHUX",491032,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"PAD ABDOMINAL NONWOVEN CELLULOSE 5X9 STERILE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"PADDING CAST 3X4YD STERILE 100 COTTON",258308,CDM,272,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.95,61.85,,3.96,,,0,"percent of total billed charges","61.5% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"PADDING CAST 4 INCH STERILE",258307,CDM,272,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"PADDING CAST 6 INCH STERILE",258306,CDM,272,RC,,,OUTPATIENT,,,25,16.25,,22,88,,17.60,,,0,"percent of total billed charges","88% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,17.304,,3.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.75,63,,12.60,,,0,"percent of total billed charges","63% of total billed charges",3.83,15.3,,3.06,,,0,"percent of total billed charges","15.3% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",17.25,69,,,,,0,"fee schedule","69% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.46,61.85,,12.37,,,0,"percent of total billed charges","61.5% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",8.05,32.2,,6.44,,,0,"percent of total billed charges","32.2% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.28,17.136,,3.42,,,0,"percent of total billed charges","17.136% of total billed charges",5.46,21.84,,4.37,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.43,37.7,,7.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.5,78,,15.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",3.83,25,
"PADDING CAST SPLNT SYNTH RAYN 6INX4.0YD",361290,CDM,270,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"PADDING UNDERCAST WEBRIL 3 INCH",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"PAK CUSTOM PLEGIOX",ORSUP0017,CDM,270,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"PAK GI",326419,CDM,270,RC,,,OUTPATIENT,,,404,262.6,,355.52,88,,284.42,,,0,"percent of total billed charges","88% of total billed charges",202,50,,161.60,,,0,"percent of total billed charges","50% of total billed charges",67.87,16.8,,54.30,,,0,"percent of total billed charges","16.8% of total billed charges",404,100,,323.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.91,17.304,,55.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",254.52,63,,203.62,,,0,"percent of total billed charges","63% of total billed charges",61.81,15.3,,49.45,,,0,"percent of total billed charges","15.3% of total billed charges",67.87,16.8,,54.30,,,0,"percent of total billed charges","16.8% of total billed charges",278.76,69,,,,,0,"fee schedule","69% of total billed charges",404,100,,323.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",404,100,,323.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",404,100,,323.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",249.87,61.85,,199.90,,,0,"percent of total billed charges","61.5% of total billed charges",67.87,16.8,,54.30,,,0,"percent of total billed charges","16.8% of total billed charges",202,50,,161.60,,,0,"percent of total billed charges","50% of total billed charges",130.09,32.2,,104.07,,,0,"percent of total billed charges","32.2% of total billed charges",67.87,16.8,,54.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.23,17.136,,55.38,,,0,"percent of total billed charges","17.136% of total billed charges",88.23,21.84,,70.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",152.31,37.7,,121.85,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",315.12,78,,252.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",333.7,82.6,,266.96,,,0,"percent of total billed charges","82.6% of total billed charges",67.87,16.8,,54.30,,,0,"percent of total billed charges","16.8% of total billed charges",202,50,,161.60,,,0,"percent of total billed charges","50% of total billed charges",333.7,82.6,,266.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.87,16.8,,54.30,,,0,"percent of total billed charges","16.8% of total billed charges",404,100,,323.20,,,0,"percent of total billed charges","100% of total billed charges",61.81,404,
"PAK OPEN HEART  1  2",326407,CDM,270,RC,,,OUTPATIENT,,,3853,2504.45,,3390.64,88,,2712.51,,,0,"percent of total billed charges","88% of total billed charges",1926.5,50,,1541.20,,,0,"percent of total billed charges","50% of total billed charges",647.3,16.8,,517.84,,,0,"percent of total billed charges","16.8% of total billed charges",3853,100,,3082.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",666.72,17.304,,533.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2427.39,63,,1941.91,,,0,"percent of total billed charges","63% of total billed charges",589.51,15.3,,471.61,,,0,"percent of total billed charges","15.3% of total billed charges",647.3,16.8,,517.84,,,0,"percent of total billed charges","16.8% of total billed charges",2658.57,69,,,,,0,"fee schedule","69% of total billed charges",3853,100,,3082.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3853,100,,3082.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3853,100,,3082.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2383.08,61.85,,1906.46,,,0,"percent of total billed charges","61.5% of total billed charges",647.3,16.8,,517.84,,,0,"percent of total billed charges","16.8% of total billed charges",1926.5,50,,1541.20,,,0,"percent of total billed charges","50% of total billed charges",1240.67,32.2,,992.54,,,0,"percent of total billed charges","32.2% of total billed charges",647.3,16.8,,517.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",660.25,17.136,,528.20,,,0,"percent of total billed charges","17.136% of total billed charges",841.5,21.84,,673.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1452.58,37.7,,1162.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3005.34,78,,2404.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3182.58,82.6,,2546.06,,,0,"percent of total billed charges","82.6% of total billed charges",647.3,16.8,,517.84,,,0,"percent of total billed charges","16.8% of total billed charges",1926.5,50,,1541.20,,,0,"percent of total billed charges","50% of total billed charges",3182.58,82.6,,2546.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",647.3,16.8,,517.84,,,0,"percent of total billed charges","16.8% of total billed charges",3853,100,,3082.40,,,0,"percent of total billed charges","100% of total billed charges",589.51,3853,
"PAKC CUSTOM TURNOVER AASC",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"PANEL RAPID NH",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"PAPER EKG HEAT SENS NO GRID DUAL CHANL 50MM 100'",145755,CDM,270,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"PAPER DEFIB ZOLL 80MM PACK",180429,CDM,270,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"PAPER EKG THERMAL",242640,CDM,270,RC,,,OUTPATIENT,,,67,43.55,,58.96,88,,47.17,,,0,"percent of total billed charges","88% of total billed charges",33.5,50,,26.80,,,0,"percent of total billed charges","50% of total billed charges",11.26,16.8,,9.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.59,17.304,,9.27,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.21,63,,33.77,,,0,"percent of total billed charges","63% of total billed charges",10.25,15.3,,8.20,,,0,"percent of total billed charges","15.3% of total billed charges",11.26,16.8,,9.01,,,0,"percent of total billed charges","16.8% of total billed charges",46.23,69,,,,,0,"fee schedule","69% of total billed charges",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.44,61.85,,33.15,,,0,"percent of total billed charges","61.5% of total billed charges",11.26,16.8,,9.01,,,0,"percent of total billed charges","16.8% of total billed charges",33.5,50,,26.80,,,0,"percent of total billed charges","50% of total billed charges",21.57,32.2,,17.26,,,0,"percent of total billed charges","32.2% of total billed charges",11.26,16.8,,9.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.48,17.136,,9.18,,,0,"percent of total billed charges","17.136% of total billed charges",14.63,21.84,,11.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25.26,37.7,,20.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",52.26,78,,41.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",55.34,82.6,,44.27,,,0,"percent of total billed charges","82.6% of total billed charges",11.26,16.8,,9.01,,,0,"percent of total billed charges","16.8% of total billed charges",33.5,50,,26.80,,,0,"percent of total billed charges","50% of total billed charges",55.34,82.6,,44.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.26,16.8,,9.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",10.25,67,
"PAPER PRINTER THERMAL BAYER",171487,CDM,270,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.9,61.85,,7.92,,,0,"percent of total billed charges","61.5% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"PAPER FETAL MONITOR",79905,CDM,270,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.37,61.85,,9.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"PPR CPY 20# 92B LTR WE",156277,CDM,270,RC,,,OUTPATIENT,,,26,16.9,,22.88,88,,18.30,,,0,"percent of total billed charges","88% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.5,17.304,,3.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.38,63,,13.10,,,0,"percent of total billed charges","63% of total billed charges",3.98,15.3,,3.18,,,0,"percent of total billed charges","15.3% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",17.94,69,,,,,0,"fee schedule","69% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.08,61.85,,12.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",8.37,32.2,,6.70,,,0,"percent of total billed charges","32.2% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.46,17.136,,3.57,,,0,"percent of total billed charges","17.136% of total billed charges",5.68,21.84,,4.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.8,37.7,,7.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.28,78,,16.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",3.98,26,
"PAPER 112X45MM WHT RCD THRML",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"PAPER TAPE 1",491040,CDM,270,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"PAPER TAPE 1/2",491041,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"PAPER TAPE 2",491042,CDM,270,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"PAER,EXAM TABLE,SMOTTH,21X225",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"PAPER TABLE SMOOTH 18X225",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"PARALLEL VENTROFIX",ORSUP0022,CDM,278,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",919.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.7% of total billed charges",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",998.69,33.9,,798.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"PARTIAL IMMERSION THERMOMETER",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"PASTE ULTRASONIC COUPLING",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"PATCH VENTRALEX SMALL CIRCLE",ORSUP0026,CDM,278,RC,,,OUTPATIENT,,,3090,2008.5,,2719.2,88,,2175.36,,,0,"percent of total billed charges","88% of total billed charges",1545,50,,1236.00,,,0,"percent of total billed charges","50% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",534.69,17.304,,427.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1946.7,63,,1557.36,,,0,"percent of total billed charges","63% of total billed charges",472.77,15.3,,378.22,,,0,"percent of total billed charges","15.3% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",2132.1,69,,,,,0,"fee schedule","69% of total billed charges",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1911.17,61.85,,1528.94,,,0,"percent of total billed charges","61.5% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",1545,50,,1236.00,,,0,"percent of total billed charges","50% of total billed charges",994.98,32.2,,795.98,,,0,"percent of total billed charges","32.2% of total billed charges",964.08,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",529.5,17.136,,423.60,,,0,"percent of total billed charges","17.136% of total billed charges",674.86,21.84,,539.89,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1164.93,37.7,,931.94,,,0,"percent of total billed charges","37.7% of total billed charges",1164.93,37.7,,931.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1047.51,33.9,,838.01,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410.2,78,,1928.16,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2552.34,82.6,,2041.87,,,0,"percent of total billed charges","82.6% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",1545,50,,1236.00,,,0,"percent of total billed charges","50% of total billed charges",2552.34,82.6,,2041.87,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",472.77,3090,
"PATCH HERNIA VENTRALEX MED CIRCLE W/STRAP",ORSUP0022,CDM,278,RC,,,OUTPATIENT,,,2266,1472.9,,1994.08,88,,1595.26,,,0,"percent of total billed charges","88% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",392.11,17.304,,313.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1427.58,63,,1142.06,,,0,"percent of total billed charges","63% of total billed charges",346.7,15.3,,277.36,,,0,"percent of total billed charges","15.3% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1563.54,69,,,,,0,"fee schedule","69% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1401.52,61.85,,1121.22,,,0,"percent of total billed charges","61.5% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",729.65,32.2,,583.72,,,0,"percent of total billed charges","32.2% of total billed charges",706.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",388.3,17.136,,310.64,,,0,"percent of total billed charges","17.136% of total billed charges",494.89,21.84,,395.91,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",854.28,37.7,,683.42,,,0,"percent of total billed charges","37.7% of total billed charges",854.28,37.7,,683.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",768.17,33.9,,614.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1767.48,78,,1413.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1871.72,82.6,,1497.38,,,0,"percent of total billed charges","82.6% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",1871.72,82.6,,1497.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",346.7,2266,
"PATCH PERICARD BOV 10MMX5MM MEDCL ENCAP",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"PATCH GORTEX (CAROTIDS) 17025 15006",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"PATCH PERICARD  BOVINE SHEET 2X9",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"PATCH XENOSURE BOVINE  .8X8CM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"PATCH CARTO 3 SYSTEM EXTERNAL 6/SET",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"PATCH THROMBIX HEMOSTASIS",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"PATCH EVARREST 2X4 FIBRIN SEALANT",ORSUP0033,CDM,278,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",1838.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.7% of total billed charges",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1997.39,33.9,,1597.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"PATCH THROMBIX HEMOSTASIS SILVER",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"PATHODX EXTRACTION REAG #2   R62055",ORSUP0004,CDM,270,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"KIT PATHODX STREP A LATEX",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"LATEX B (STREP GROUPING)PINK R62031",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"PATHO DX GP C",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"PATHO DX GP F",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"PATHO DX GP G",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"PATHODX EXTRACTION REAG #3   R62060",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"PATHFINDER PLUS CONTINUOUS AND PULSATILEIRRIGATION BULB",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"PATHLOGY CONTAINER W/ LID 165oz",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"PATIENT GARMENT BAGS W/HANGER",420932,CDM,270,RC,,,OUTPATIENT,,,493,320.45,,433.84,88,,347.07,,,0,"percent of total billed charges","88% of total billed charges",246.5,50,,197.20,,,0,"percent of total billed charges","50% of total billed charges",82.82,16.8,,66.26,,,0,"percent of total billed charges","16.8% of total billed charges",493,100,,394.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.31,17.304,,68.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",310.59,63,,248.47,,,0,"percent of total billed charges","63% of total billed charges",75.43,15.3,,60.34,,,0,"percent of total billed charges","15.3% of total billed charges",82.82,16.8,,66.26,,,0,"percent of total billed charges","16.8% of total billed charges",340.17,69,,,,,0,"fee schedule","69% of total billed charges",493,100,,394.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",493,100,,394.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",493,100,,394.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",304.92,61.85,,243.94,,,0,"percent of total billed charges","61.5% of total billed charges",82.82,16.8,,66.26,,,0,"percent of total billed charges","16.8% of total billed charges",246.5,50,,197.20,,,0,"percent of total billed charges","50% of total billed charges",158.75,32.2,,127.00,,,0,"percent of total billed charges","32.2% of total billed charges",82.82,16.8,,66.26,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.48,17.136,,67.58,,,0,"percent of total billed charges","17.136% of total billed charges",107.67,21.84,,86.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",185.86,37.7,,148.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",384.54,78,,307.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",407.22,82.6,,325.78,,,0,"percent of total billed charges","82.6% of total billed charges",82.82,16.8,,66.26,,,0,"percent of total billed charges","16.8% of total billed charges",246.5,50,,197.20,,,0,"percent of total billed charges","50% of total billed charges",407.22,82.6,,325.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.82,16.8,,66.26,,,0,"percent of total billed charges","16.8% of total billed charges",493,100,,394.40,,,0,"percent of total billed charges","100% of total billed charges",75.43,493,
"PATIENT TRACKER AXIEM NON-INVA",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"PATIENT CARE KIT SPINAL JACKSO",491045,CDM,270,RC,,,OUTPATIENT,,,448,291.2,,394.24,88,,315.39,,,0,"percent of total billed charges","88% of total billed charges",224,50,,179.20,,,0,"percent of total billed charges","50% of total billed charges",75.26,16.8,,60.21,,,0,"percent of total billed charges","16.8% of total billed charges",448,100,,358.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.52,17.304,,62.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",282.24,63,,225.79,,,0,"percent of total billed charges","63% of total billed charges",68.54,15.3,,54.83,,,0,"percent of total billed charges","15.3% of total billed charges",75.26,16.8,,60.21,,,0,"percent of total billed charges","16.8% of total billed charges",309.12,69,,,,,0,"fee schedule","69% of total billed charges",448,100,,358.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",448,100,,358.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",448,100,,358.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",277.09,61.85,,221.67,,,0,"percent of total billed charges","61.5% of total billed charges",75.26,16.8,,60.21,,,0,"percent of total billed charges","16.8% of total billed charges",224,50,,179.20,,,0,"percent of total billed charges","50% of total billed charges",144.26,32.2,,115.41,,,0,"percent of total billed charges","32.2% of total billed charges",75.26,16.8,,60.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.77,17.136,,61.42,,,0,"percent of total billed charges","17.136% of total billed charges",97.84,21.84,,78.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",168.9,37.7,,135.12,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",349.44,78,,279.55,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.05,82.6,,296.04,,,0,"percent of total billed charges","82.6% of total billed charges",75.26,16.8,,60.21,,,0,"percent of total billed charges","16.8% of total billed charges",224,50,,179.20,,,0,"percent of total billed charges","50% of total billed charges",370.05,82.6,,296.04,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.26,16.8,,60.21,,,0,"percent of total billed charges","16.8% of total billed charges",448,100,,358.40,,,0,"percent of total billed charges","100% of total billed charges",68.54,448,
"PATTIES 1/4 X 1/4IN",186930,CDM,270,RC,,,OUTPATIENT,,,59,38.35,,51.92,88,,41.54,,,0,"percent of total billed charges","88% of total billed charges",29.5,50,,23.60,,,0,"percent of total billed charges","50% of total billed charges",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.21,17.304,,8.17,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.17,63,,29.74,,,0,"percent of total billed charges","63% of total billed charges",9.03,15.3,,7.22,,,0,"percent of total billed charges","15.3% of total billed charges",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",40.71,69,,,,,0,"fee schedule","69% of total billed charges",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.49,61.85,,29.19,,,0,"percent of total billed charges","61.5% of total billed charges",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",29.5,50,,23.60,,,0,"percent of total billed charges","50% of total billed charges",19,32.2,,15.20,,,0,"percent of total billed charges","32.2% of total billed charges",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.11,17.136,,8.09,,,0,"percent of total billed charges","17.136% of total billed charges",12.89,21.84,,10.31,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.24,37.7,,17.79,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.02,78,,36.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.73,82.6,,38.98,,,0,"percent of total billed charges","82.6% of total billed charges",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",29.5,50,,23.60,,,0,"percent of total billed charges","50% of total billed charges",48.73,82.6,,38.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",9.03,59,
"PATTIES SURGICAL 1/21/2",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"PDS II 0 CT-1 (Z340H)",491047,CDM,270,RC,,,OUTPATIENT,,,22,14.3,,19.36,88,,15.49,,,0,"percent of total billed charges","88% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.81,17.304,,3.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.86,63,,11.09,,,0,"percent of total billed charges","63% of total billed charges",3.37,15.3,,2.70,,,0,"percent of total billed charges","15.3% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",15.18,69,,,,,0,"fee schedule","69% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.61,61.85,,10.89,,,0,"percent of total billed charges","61.5% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",7.08,32.2,,5.66,,,0,"percent of total billed charges","32.2% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.77,17.136,,3.02,,,0,"percent of total billed charges","17.136% of total billed charges",4.8,21.84,,3.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.29,37.7,,6.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.16,78,,13.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",3.37,22,
"PEEL POUCH 3-1/2 X 22",491049,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"PEEL POUCH 3-1/2 X 9",491050,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"PEEL POUCH 5-1/4 X 10",491051,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"PEEL POUCH 5-1/4 X 15",491052,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"PEEL POUCH 7-1/2 X 13",491054,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"PEEL POUCH 8 X 16",491055,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"PEEL AND SEAL BUBBLE MAILER 6.75X9",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"PEEP VALVE, W/O ADAPTER 65MMX45MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"PEEP VALVES DISP",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"PEEP VALVE 19MM ID/ 22MM OD",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"PEG KIT PUSH",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"PEG KIT PUSH 20 FR SAFETY",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"PEG FULLY THREAD 2.5MM X 26MM",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"PEG FULLY THREAD 2.5MM X 24MM",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"PEG FULLY THREAD 2.5MM X 22MM",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"PEG FULLY THREAD 2.5MM X 20MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"PEG WRIST THRD TI F/ DVR 2.5X18MM",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"PEG FULLY THREAD 2.5MM X 18MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"PEG FULLY THREAD 2.5MM X 16MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"PEG FULLY THREAD 2.5MM X 14MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"PEG FULLY THREAD 2.5MM X 28MM",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"PEG FULLY THREAD 2.5MM X 10MM",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"PEG DRIVER F.A.S.T. INSERT 2.0",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"PEG KIT SAFETY 20FR PULL STYLE",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"PELVICOL 4X7",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",751.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.7% of total billed charges",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",816.99,33.9,,653.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"PEN SKIN MARKING REG TIP",61203,CDM,270,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"PENROSE DRAIN 3/4 X 18",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"PENROSE DRAIN 1/2 X 12",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"PENROSE DRAIN 1/4 X 12",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"PERCLOSE PROGLIDE 6FR",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"PERCARDIOCENTESIS KIT 8.5FR X 22CM",ORSUP0023,CDM,272,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"PERCUTANEOUS ENTRY THIN WALL",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"PERCUTANEOUS ENTRY THIN WALL 18G",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"PERFORATOR DRILL 14MM DISP",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"PERFUSION PAK",401278,CDM,272,RC,,,OUTPATIENT,,,3689,2397.85,,3246.32,88,,2597.06,,,0,"percent of total billed charges","88% of total billed charges",1844.5,50,,1475.60,,,0,"percent of total billed charges","50% of total billed charges",619.75,16.8,,495.80,,,0,"percent of total billed charges","16.8% of total billed charges",3689,100,,2951.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",638.34,17.304,,510.67,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2324.07,63,,1859.26,,,0,"percent of total billed charges","63% of total billed charges",564.42,15.3,,451.54,,,0,"percent of total billed charges","15.3% of total billed charges",619.75,16.8,,495.80,,,0,"percent of total billed charges","16.8% of total billed charges",2545.41,69,,,,,0,"fee schedule","69% of total billed charges",3689,100,,2951.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3689,100,,2951.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3689,100,,2951.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2281.65,61.85,,1825.32,,,0,"percent of total billed charges","61.5% of total billed charges",619.75,16.8,,495.80,,,0,"percent of total billed charges","16.8% of total billed charges",1844.5,50,,1475.60,,,0,"percent of total billed charges","50% of total billed charges",1187.86,32.2,,950.29,,,0,"percent of total billed charges","32.2% of total billed charges",619.75,16.8,,495.80,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",632.15,17.136,,505.72,,,0,"percent of total billed charges","17.136% of total billed charges",805.68,21.84,,644.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1390.75,37.7,,1112.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2877.42,78,,2301.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3047.11,82.6,,2437.69,,,0,"percent of total billed charges","82.6% of total billed charges",619.75,16.8,,495.80,,,0,"percent of total billed charges","16.8% of total billed charges",1844.5,50,,1475.60,,,0,"percent of total billed charges","50% of total billed charges",3047.11,82.6,,2437.69,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",619.75,16.8,,495.80,,,0,"percent of total billed charges","16.8% of total billed charges",3689,100,,2951.20,,,0,"percent of total billed charges","100% of total billed charges",564.42,3689,
"PERI STRIP DRY PROX 75",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"PERI STRIPS DRY STAPLE REINFORCEMENT",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"PERICARDIOCENTISIS TRAY LOCK",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.94,17.304,,85.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.23,61.85,,305.78,,,0,"percent of total billed charges","61.5% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",199,32.2,,159.20,,,0,"percent of total billed charges","32.2% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.136,,84.72,,,0,"percent of total billed charges","17.136% of total billed charges",134.97,21.84,,107.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,618,
"PERITONEAL DIALYSIS CATH 57CM",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,824,535.6,,725.12,88,,580.10,,,0,"percent of total billed charges","88% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.58,17.304,,114.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",519.12,63,,415.30,,,0,"percent of total billed charges","63% of total billed charges",126.07,15.3,,100.86,,,0,"percent of total billed charges","15.3% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",568.56,69,,,,,0,"fee schedule","69% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.64,61.85,,407.71,,,0,"percent of total billed charges","61.5% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",265.33,32.2,,212.26,,,0,"percent of total billed charges","32.2% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",141.2,17.136,,112.96,,,0,"percent of total billed charges","17.136% of total billed charges",179.96,21.84,,143.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",310.65,37.7,,248.52,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",642.72,78,,514.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",126.07,824,
"PERITONEAL DIALYSIS CATH 62CM",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,824,535.6,,725.12,88,,580.10,,,0,"percent of total billed charges","88% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.58,17.304,,114.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",519.12,63,,415.30,,,0,"percent of total billed charges","63% of total billed charges",126.07,15.3,,100.86,,,0,"percent of total billed charges","15.3% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",568.56,69,,,,,0,"fee schedule","69% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.64,61.85,,407.71,,,0,"percent of total billed charges","61.5% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",265.33,32.2,,212.26,,,0,"percent of total billed charges","32.2% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",141.2,17.136,,112.96,,,0,"percent of total billed charges","17.136% of total billed charges",179.96,21.84,,143.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",310.65,37.7,,248.52,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",642.72,78,,514.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",126.07,824,
"PERMANENT CAUTERY HOOK",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"PETRI DISH 100 X 15 STERILE",491060,CDM,272,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"PETRI DISH STACKABLE LID",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
PHENYTOIN,ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"PHOSPHORUS /5 PACK/300 SLDS",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"PICC 5F DL FULL MAX 3CG",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"PICC 4F SL FULL MAX 3SCG",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"PICC POWER  6FR TRIPLE LUMEN TRAY 3CG",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"PICC PROVENA 3F SL MAX 3CG",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"PICC PROVENA 5F SL MAX 3CG",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"PICC 4 FR SPECTRUM TURBO-JECT",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"PICC LINE SINGLELUMEN 4FR",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.94,17.304,,85.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.23,61.85,,305.78,,,0,"percent of total billed charges","61.5% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",199,32.2,,159.20,,,0,"percent of total billed charges","32.2% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.136,,84.72,,,0,"percent of total billed charges","17.136% of total billed charges",134.97,21.84,,107.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,618,
"PILLOW HEART POST OP 3811",ORSUP0014,CDM,270,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"PILLOW GENTLETOUCH 7 INCH HEADREST PILLOW WITH RIGHT INTUBATION SLOT",273324,CDM,270,RC,,,OUTPATIENT,,,49,31.85,,43.12,88,,34.50,,,0,"percent of total billed charges","88% of total billed charges",24.5,50,,19.60,,,0,"percent of total billed charges","50% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.48,17.304,,6.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.87,63,,24.70,,,0,"percent of total billed charges","63% of total billed charges",7.5,15.3,,6.00,,,0,"percent of total billed charges","15.3% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",33.81,69,,,,,0,"fee schedule","69% of total billed charges",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.31,61.85,,24.25,,,0,"percent of total billed charges","61.5% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",24.5,50,,19.60,,,0,"percent of total billed charges","50% of total billed charges",15.78,32.2,,12.62,,,0,"percent of total billed charges","32.2% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.4,17.136,,6.72,,,0,"percent of total billed charges","17.136% of total billed charges",10.7,21.84,,8.56,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.47,37.7,,14.78,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.22,78,,30.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.47,82.6,,32.38,,,0,"percent of total billed charges","82.6% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",24.5,50,,19.60,,,0,"percent of total billed charges","50% of total billed charges",40.47,82.6,,32.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",7.5,49,
"PILLOW PRONE POSITION ADULT",491063,CDM,270,RC,,,OUTPATIENT,,,61,39.65,,53.68,88,,42.94,,,0,"percent of total billed charges","88% of total billed charges",30.5,50,,24.40,,,0,"percent of total billed charges","50% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.56,17.304,,8.45,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.43,63,,30.74,,,0,"percent of total billed charges","63% of total billed charges",9.33,15.3,,7.46,,,0,"percent of total billed charges","15.3% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",42.09,69,,,,,0,"fee schedule","69% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.73,61.85,,30.18,,,0,"percent of total billed charges","61.5% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",30.5,50,,24.40,,,0,"percent of total billed charges","50% of total billed charges",19.64,32.2,,15.71,,,0,"percent of total billed charges","32.2% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.45,17.136,,8.36,,,0,"percent of total billed charges","17.136% of total billed charges",13.32,21.84,,10.66,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23,37.7,,18.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47.58,78,,38.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.39,82.6,,40.31,,,0,"percent of total billed charges","82.6% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",30.5,50,,24.40,,,0,"percent of total billed charges","50% of total billed charges",50.39,82.6,,40.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",9.33,61,
"PILL CRUSHER",491062,CDM,270,RC,,,OUTPATIENT,,,44,28.6,,38.72,88,,30.98,,,0,"percent of total billed charges","88% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.61,17.304,,6.09,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.72,63,,22.18,,,0,"percent of total billed charges","63% of total billed charges",6.73,15.3,,5.38,,,0,"percent of total billed charges","15.3% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",30.36,69,,,,,0,"fee schedule","69% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.21,61.85,,21.77,,,0,"percent of total billed charges","61.5% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",14.17,32.2,,11.34,,,0,"percent of total billed charges","32.2% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.54,17.136,,6.03,,,0,"percent of total billed charges","17.136% of total billed charges",9.61,21.84,,7.69,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.59,37.7,,13.27,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.32,78,,27.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",6.73,44,
"PILL CUTTER BLUE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"PIN GUIDE 230MM FOR 7MM",ORSUP00011,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"PIN MINI SPIKE DISPENSING",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"PINK PAD POSITIONER STANDARD",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"PINS DISP ADULT SKULL",ORSUP0004,CDM,278,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.7% of total billed charges",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.85,33.9,,72.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"PIPETTES STANDARD DISPOSABLE TRANSFER",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"PISTON MCGEE 3.5MM",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"PISTON .6X.9X4.0MM CUPPED",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"PISTON .6X1.0X4.0 CUPPED",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"PISTON .4X1.0X4.5 CUPPED",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"PISTON .4X1.0 X4.0MM CUPPED",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"PISTON .4X.9X4.5MM CUPPED",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"PISTON .4X.9X4.0MM CUPPED",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"PLAIN GUT 3-0 FN-2 (N862H)",491072,CDM,272,RC,,,OUTPATIENT,,,29,18.85,,25.52,88,,20.42,,,0,"percent of total billed charges","88% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.02,17.304,,4.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.27,63,,14.62,,,0,"percent of total billed charges","63% of total billed charges",4.44,15.3,,3.55,,,0,"percent of total billed charges","15.3% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",20.01,69,,,,,0,"fee schedule","69% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.94,61.85,,14.35,,,0,"percent of total billed charges","61.5% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",9.34,32.2,,7.47,,,0,"percent of total billed charges","32.2% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.97,17.136,,3.98,,,0,"percent of total billed charges","17.136% of total billed charges",6.33,21.84,,5.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.93,37.7,,8.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,78,,18.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",4.44,29,
"PLASMA SPATULA W/CORD 33CM",ORSUP0014,CDM,270,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"PLASMA HOOK",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"PLASTER SPLINT 4 X 15",491076,CDM,270,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"PLASMA OVERWRAPS-STANDARD SIZE",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,927,602.55,,815.76,88,,652.61,,,0,"percent of total billed charges","88% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.41,17.304,,128.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.01,63,,467.21,,,0,"percent of total billed charges","63% of total billed charges",141.83,15.3,,113.46,,,0,"percent of total billed charges","15.3% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",639.63,69,,,,,0,"fee schedule","69% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",573.35,61.85,,458.68,,,0,"percent of total billed charges","61.5% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",298.49,32.2,,238.79,,,0,"percent of total billed charges","32.2% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.85,17.136,,127.08,,,0,"percent of total billed charges","17.136% of total billed charges",202.46,21.84,,161.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",349.48,37.7,,279.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",723.06,78,,578.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",141.83,927,
"PLASTIC SLIDE HOLDER MAILER TRANSPOTER",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"PLASMA LOOP ELECTRODE",ORSUP0068,CDM,272,RC,,,OUTPATIENT,,,11948,7766.2,,10514.24,88,,8411.39,,,0,"percent of total billed charges","88% of total billed charges",5974,50,,4779.20,,,0,"percent of total billed charges","50% of total billed charges",2007.26,16.8,,1605.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2067.48,17.304,,1653.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7527.24,63,,6021.79,,,0,"percent of total billed charges","63% of total billed charges",1828.04,15.3,,1462.43,,,0,"percent of total billed charges","15.3% of total billed charges",2007.26,16.8,,1605.81,,,0,"percent of total billed charges","16.8% of total billed charges",8244.12,69,,,,,0,"fee schedule","69% of total billed charges",11948,100,,9558.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11948,100,,9558.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11948,100,,9558.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7389.84,61.85,,5911.87,,,0,"percent of total billed charges","61.5% of total billed charges",2007.26,16.8,,1605.81,,,0,"percent of total billed charges","16.8% of total billed charges",5974,50,,4779.20,,,0,"percent of total billed charges","50% of total billed charges",3847.26,32.2,,3077.81,,,0,"percent of total billed charges","32.2% of total billed charges",2007.26,16.8,,1605.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2047.41,17.136,,1637.93,,,0,"percent of total billed charges","17.136% of total billed charges",2609.44,21.84,,2087.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4504.4,37.7,,3603.52,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9319.44,78,,7455.55,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9869.05,82.6,,7895.24,,,0,"percent of total billed charges","82.6% of total billed charges",2007.26,16.8,,1605.81,,,0,"percent of total billed charges","16.8% of total billed charges",5974,50,,4779.20,,,0,"percent of total billed charges","50% of total billed charges",9869.05,82.6,,7895.24,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2007.26,16.8,,1605.81,,,0,"percent of total billed charges","16.8% of total billed charges",11948,100,,9558.40,,,0,"percent of total billed charges","100% of total billed charges",1828.04,11948,
"PLASTIC BAGS ZIP CLOSURE 12 X 15 CLEAR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"PLASTIC BAGS ZIP CLOSURE 3 CLEAR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"PLASTIC BAGS WITH ZIP CLOSURE CLEAR 10X12",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"PLATE DVR ANATOMIC WIDE HEAD LEFT W/FAST GIDES",ORSUP0023,CDM,278,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",1002.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.7% of total billed charges",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1089.55,33.9,,871.64,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"PLATE DVR ANATOMIC WIDE HEAD RIGHT W/FAST GIDES",ORSUP0023,CDM,278,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",1002.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.7% of total billed charges",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1089.55,33.9,,871.64,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"PLATE DVR ANATOMIC STANDARD RIGHT",ORSUP0043,CDM,278,RC,,,OUTPATIENT,,,8570,5570.5,,7541.6,88,,6033.28,,,0,"percent of total billed charges","88% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1482.95,17.304,,1186.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5399.1,63,,4319.28,,,0,"percent of total billed charges","63% of total billed charges",1311.21,15.3,,1048.97,,,0,"percent of total billed charges","15.3% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",5913.3,69,,,,,0,"fee schedule","69% of total billed charges",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5300.55,61.85,,4240.44,,,0,"percent of total billed charges","61.5% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",2759.54,32.2,,2207.63,,,0,"percent of total billed charges","32.2% of total billed charges",2673.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1468.56,17.136,,1174.85,,,0,"percent of total billed charges","17.136% of total billed charges",1871.69,21.84,,1497.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3230.89,37.7,,2584.71,,,0,"percent of total billed charges","37.7% of total billed charges",3230.89,37.7,,2584.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2905.23,33.9,,2324.18,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6684.6,78,,5347.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7078.82,82.6,,5663.06,,,0,"percent of total billed charges","82.6% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",7078.82,82.6,,5663.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",1311.21,8570,
"PLATE DVR ANATOMIC SHORT RIGHT",ORSUP0043,CDM,278,RC,,,OUTPATIENT,,,8570,5570.5,,7541.6,88,,6033.28,,,0,"percent of total billed charges","88% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1482.95,17.304,,1186.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5399.1,63,,4319.28,,,0,"percent of total billed charges","63% of total billed charges",1311.21,15.3,,1048.97,,,0,"percent of total billed charges","15.3% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",5913.3,69,,,,,0,"fee schedule","69% of total billed charges",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5300.55,61.85,,4240.44,,,0,"percent of total billed charges","61.5% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",2759.54,32.2,,2207.63,,,0,"percent of total billed charges","32.2% of total billed charges",2673.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1468.56,17.136,,1174.85,,,0,"percent of total billed charges","17.136% of total billed charges",1871.69,21.84,,1497.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3230.89,37.7,,2584.71,,,0,"percent of total billed charges","37.7% of total billed charges",3230.89,37.7,,2584.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2905.23,33.9,,2324.18,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6684.6,78,,5347.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7078.82,82.6,,5663.06,,,0,"percent of total billed charges","82.6% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",7078.82,82.6,,5663.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",1311.21,8570,
"PLATE 1/3 TUB LCP 6H 69MM W/COLLAR",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"PLATE 1/3 TUB LCP 7H 81MM W/COLLAR",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"PLATE 1/3 TUB LCP 8H 93MM W/COLLAR",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"PLATE 1-2 TMT STANDARD LEFT TMT-002-12ML",ORSUP0044,CDM,278,RC,,,OUTPATIENT,,,8837,5744.05,,7776.56,88,,6221.25,,,0,"percent of total billed charges","88% of total billed charges",4418.5,50,,3534.80,,,0,"percent of total billed charges","50% of total billed charges",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1529.15,17.304,,1223.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5567.31,63,,4453.85,,,0,"percent of total billed charges","63% of total billed charges",1352.06,15.3,,1081.65,,,0,"percent of total billed charges","15.3% of total billed charges",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",6097.53,69,,,,,0,"fee schedule","69% of total billed charges",8837,100,,7069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8837,100,,7069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8837,100,,7069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5465.68,61.85,,4372.54,,,0,"percent of total billed charges","61.5% of total billed charges",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",4418.5,50,,3534.80,,,0,"percent of total billed charges","50% of total billed charges",2845.51,32.2,,2276.41,,,0,"percent of total billed charges","32.2% of total billed charges",2757.14,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1514.31,17.136,,1211.45,,,0,"percent of total billed charges","17.136% of total billed charges",1930,21.84,,1544.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3331.55,37.7,,2665.24,,,0,"percent of total billed charges","37.7% of total billed charges",3331.55,37.7,,2665.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2995.74,33.9,,2396.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6892.86,78,,5514.29,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7299.36,82.6,,5839.49,,,0,"percent of total billed charges","82.6% of total billed charges",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",4418.5,50,,3534.80,,,0,"percent of total billed charges","50% of total billed charges",7299.36,82.6,,5839.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",8837,100,,7069.60,,,0,"percent of total billed charges","100% of total billed charges",1352.06,8837,
"PLATE 12-HOLE RIGHT SIDED 02.001.322",ORSUP0048,CDM,278,RC,,,OUTPATIENT,,,9909,6440.85,,8719.92,88,,6975.94,,,0,"percent of total billed charges","88% of total billed charges",4954.5,50,,3963.60,,,0,"percent of total billed charges","50% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1714.65,17.304,,1371.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6242.67,63,,4994.14,,,0,"percent of total billed charges","63% of total billed charges",1516.08,15.3,,1212.86,,,0,"percent of total billed charges","15.3% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",6837.21,69,,,,,0,"fee schedule","69% of total billed charges",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6128.72,61.85,,4902.98,,,0,"percent of total billed charges","61.5% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",4954.5,50,,3963.60,,,0,"percent of total billed charges","50% of total billed charges",3190.7,32.2,,2552.56,,,0,"percent of total billed charges","32.2% of total billed charges",3091.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1698.01,17.136,,1358.41,,,0,"percent of total billed charges","17.136% of total billed charges",2164.13,21.84,,1731.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3735.69,37.7,,2988.55,,,0,"percent of total billed charges","37.7% of total billed charges",3735.69,37.7,,2988.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3359.15,33.9,,2687.32,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7729.02,78,,6183.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8184.83,82.6,,6547.86,,,0,"percent of total billed charges","82.6% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",4954.5,50,,3963.60,,,0,"percent of total billed charges","50% of total billed charges",8184.83,82.6,,6547.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",1516.08,9909,
"PLATE 2 HOLE LOW PROFILE NEURO STRAIGHT",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"PLATE 2.4MM STR  6 HOLE",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"PLATE 2.7MM CONDYLAR LCP 7 HOLE",ORSUP0024,CDM,278,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",1086.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.7% of total billed charges",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1180.06,33.9,,944.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"PLATE 3.5MM LCP PROXIMAL HUMERUS 6H HEAD/3H SHAFT 241.903 241.903",ORSUP0044,CDM,278,RC,,,OUTPATIENT,,,8837,5744.05,,7776.56,88,,6221.25,,,0,"percent of total billed charges","88% of total billed charges",4418.5,50,,3534.80,,,0,"percent of total billed charges","50% of total billed charges",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1529.15,17.304,,1223.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5567.31,63,,4453.85,,,0,"percent of total billed charges","63% of total billed charges",1352.06,15.3,,1081.65,,,0,"percent of total billed charges","15.3% of total billed charges",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",6097.53,69,,,,,0,"fee schedule","69% of total billed charges",8837,100,,7069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8837,100,,7069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8837,100,,7069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5465.68,61.85,,4372.54,,,0,"percent of total billed charges","61.5% of total billed charges",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",4418.5,50,,3534.80,,,0,"percent of total billed charges","50% of total billed charges",2845.51,32.2,,2276.41,,,0,"percent of total billed charges","32.2% of total billed charges",2757.14,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1514.31,17.136,,1211.45,,,0,"percent of total billed charges","17.136% of total billed charges",1930,21.84,,1544.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3331.55,37.7,,2665.24,,,0,"percent of total billed charges","37.7% of total billed charges",3331.55,37.7,,2665.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2995.74,33.9,,2396.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6892.86,78,,5514.29,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7299.36,82.6,,5839.49,,,0,"percent of total billed charges","82.6% of total billed charges",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",4418.5,50,,3534.80,,,0,"percent of total billed charges","50% of total billed charges",7299.36,82.6,,5839.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",8837,100,,7069.60,,,0,"percent of total billed charges","100% of total billed charges",1352.06,8837,
"PLATE 4 HOLE Y",ORSUP0034,CDM,278,RC,,,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1065.75,17.304,,852.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",942.33,15.3,,753.86,,,0,"percent of total billed charges","15.3% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3809.34,61.85,,3047.47,,,0,"percent of total billed charges","61.5% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1983.2,32.2,,1586.56,,,0,"percent of total billed charges","32.2% of total billed charges",1921.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1055.41,17.136,,844.33,,,0,"percent of total billed charges","17.136% of total billed charges",1345.13,21.84,,1076.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",942.33,6159,
"PLATE 4.5MM CONDYLAR 6 HOLES/170MM-RIGHT",ORSUP0042,CDM,278,RC,,,OUTPATIENT,,,8302,5396.3,,7305.76,88,,5844.61,,,0,"percent of total billed charges","88% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1436.58,17.304,,1149.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5230.26,63,,4184.21,,,0,"percent of total billed charges","63% of total billed charges",1270.21,15.3,,1016.17,,,0,"percent of total billed charges","15.3% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",5728.38,69,,,,,0,"fee schedule","69% of total billed charges",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5134.79,61.85,,4107.83,,,0,"percent of total billed charges","61.5% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",2673.24,32.2,,2138.59,,,0,"percent of total billed charges","32.2% of total billed charges",2590.22,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1422.63,17.136,,1138.10,,,0,"percent of total billed charges","17.136% of total billed charges",1813.16,21.84,,1450.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3129.85,37.7,,2503.88,,,0,"percent of total billed charges","37.7% of total billed charges",3129.85,37.7,,2503.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2814.38,33.9,,2251.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6475.56,78,,5180.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6857.45,82.6,,5485.96,,,0,"percent of total billed charges","82.6% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",6857.45,82.6,,5485.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",1270.21,8302,
"PLATE 4.5MM CONDYLAR 8 HOLES/206MM-LEFT",ORSUP0043,CDM,278,RC,,,OUTPATIENT,,,8570,5570.5,,7541.6,88,,6033.28,,,0,"percent of total billed charges","88% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1482.95,17.304,,1186.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5399.1,63,,4319.28,,,0,"percent of total billed charges","63% of total billed charges",1311.21,15.3,,1048.97,,,0,"percent of total billed charges","15.3% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",5913.3,69,,,,,0,"fee schedule","69% of total billed charges",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5300.55,61.85,,4240.44,,,0,"percent of total billed charges","61.5% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",2759.54,32.2,,2207.63,,,0,"percent of total billed charges","32.2% of total billed charges",2673.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1468.56,17.136,,1174.85,,,0,"percent of total billed charges","17.136% of total billed charges",1871.69,21.84,,1497.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3230.89,37.7,,2584.71,,,0,"percent of total billed charges","37.7% of total billed charges",3230.89,37.7,,2584.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2905.23,33.9,,2324.18,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6684.6,78,,5347.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7078.82,82.6,,5663.06,,,0,"percent of total billed charges","82.6% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",7078.82,82.6,,5663.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",1311.21,8570,
"PLATE 9 HOLE 3.5MM",ORSUP0019,CDM,278,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",668.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.7% of total billed charges",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",726.14,33.9,,580.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"PLATE BNE 3.4MM T L133MM LCP LT PROX/TIB 8 HLE",ORSUP0041,CDM,278,RC,,,OUTPATIENT,,,8034,5222.1,,7069.92,88,,5655.94,,,0,"percent of total billed charges","88% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1390.2,17.304,,1112.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5061.42,63,,4049.14,,,0,"percent of total billed charges","63% of total billed charges",1229.2,15.3,,983.36,,,0,"percent of total billed charges","15.3% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",5543.46,69,,,,,0,"fee schedule","69% of total billed charges",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4969.03,61.85,,3975.22,,,0,"percent of total billed charges","61.5% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",2586.95,32.2,,2069.56,,,0,"percent of total billed charges","32.2% of total billed charges",2506.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1376.71,17.136,,1101.37,,,0,"percent of total billed charges","17.136% of total billed charges",1754.63,21.84,,1403.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3028.82,37.7,,2423.06,,,0,"percent of total billed charges","37.7% of total billed charges",3028.82,37.7,,2423.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2723.53,33.9,,2178.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6266.52,78,,5013.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6636.08,82.6,,5308.86,,,0,"percent of total billed charges","82.6% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",6636.08,82.6,,5308.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",1229.2,8034,
"PLATE BNE SM-5DD H28-40MM SYNEX THOR/LMBR",ORSUP0125,CDM,278,RC,,,OUTPATIENT,,,32404,21062.6,,28515.52,88,,22812.42,,,0,"percent of total billed charges","88% of total billed charges",16202,50,,12961.60,,,0,"percent of total billed charges","50% of total billed charges",5443.87,16.8,,4355.10,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5607.19,17.304,,4485.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20414.52,63,,16331.62,,,0,"percent of total billed charges","63% of total billed charges",4957.81,15.3,,3966.25,,,0,"percent of total billed charges","15.3% of total billed charges",5443.87,16.8,,4355.10,,,0,"percent of total billed charges","16.8% of total billed charges",22358.76,69,,,,,0,"fee schedule","69% of total billed charges",32404,100,,25923.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32404,100,,25923.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32404,100,,25923.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20041.87,61.85,,16033.50,,,0,"percent of total billed charges","61.5% of total billed charges",5443.87,16.8,,4355.10,,,0,"percent of total billed charges","16.8% of total billed charges",16202,50,,12961.60,,,0,"percent of total billed charges","50% of total billed charges",10434.09,32.2,,8347.27,,,0,"percent of total billed charges","32.2% of total billed charges",10110.05,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",5552.75,17.136,,4442.20,,,0,"percent of total billed charges","17.136% of total billed charges",7077.03,21.84,,5661.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",12216.31,37.7,,9773.05,,,0,"percent of total billed charges","37.7% of total billed charges",12216.31,37.7,,9773.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",10984.96,33.9,,8787.97,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",25275.12,78,,20220.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",26765.7,82.6,,21412.56,,,0,"percent of total billed charges","82.6% of total billed charges",5443.87,16.8,,4355.10,,,0,"percent of total billed charges","16.8% of total billed charges",16202,50,,12961.60,,,0,"percent of total billed charges","50% of total billed charges",26765.7,82.6,,21412.56,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5443.87,16.8,,4355.10,,,0,"percent of total billed charges","16.8% of total billed charges",32404,100,,25923.20,,,0,"percent of total billed charges","100% of total billed charges",4695,32404,
"PLATE BNE SS LNG L47MM LCP RT DIST VOLR RADL 4 HD HLE/SHFT H",ORSUP0027,CDM,278,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",1336.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.7% of total billed charges",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1452.62,33.9,,1162.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"PLATE BNE SS LNG L65MM LCP RT DIST VOLR RADL 4 HD HLE/SHFT H",ORSUP0026,CDM,278,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",1253.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.7% of total billed charges",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1361.76,33.9,,1089.41,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"PLATE BNE SS LNG L66MM LCP RT DIST VOLR RADL 5 HD HLE/SHFT H",ORSUP0026,CDM,278,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",1253.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.7% of total billed charges",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1361.76,33.9,,1089.41,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"PLATE BONE 3.5MM T L107MM LCP RT PROX TIB 6 HOLE",ORSUP0041,CDM,278,RC,,,OUTPATIENT,,,8034,5222.1,,7069.92,88,,5655.94,,,0,"percent of total billed charges","88% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1390.2,17.304,,1112.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5061.42,63,,4049.14,,,0,"percent of total billed charges","63% of total billed charges",1229.2,15.3,,983.36,,,0,"percent of total billed charges","15.3% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",5543.46,69,,,,,0,"fee schedule","69% of total billed charges",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4969.03,61.85,,3975.22,,,0,"percent of total billed charges","61.5% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",2586.95,32.2,,2069.56,,,0,"percent of total billed charges","32.2% of total billed charges",2506.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1376.71,17.136,,1101.37,,,0,"percent of total billed charges","17.136% of total billed charges",1754.63,21.84,,1403.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3028.82,37.7,,2423.06,,,0,"percent of total billed charges","37.7% of total billed charges",3028.82,37.7,,2423.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2723.53,33.9,,2178.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6266.52,78,,5013.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6636.08,82.6,,5308.86,,,0,"percent of total billed charges","82.6% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",6636.08,82.6,,5308.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",1229.2,8034,
"PLATE BONE L350MM LCP LEFT CONDYLAR 4.5MM CRV 16H",ORSUP0049,CDM,278,RC,,,OUTPATIENT,,,10176,6614.4,,8954.88,88,,7163.90,,,0,"percent of total billed charges","88% of total billed charges",5088,50,,4070.40,,,0,"percent of total billed charges","50% of total billed charges",1709.57,16.8,,1367.66,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1760.86,17.304,,1408.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6410.88,63,,5128.70,,,0,"percent of total billed charges","63% of total billed charges",1556.93,15.3,,1245.54,,,0,"percent of total billed charges","15.3% of total billed charges",1709.57,16.8,,1367.66,,,0,"percent of total billed charges","16.8% of total billed charges",7021.44,69,,,,,0,"fee schedule","69% of total billed charges",10176,100,,8140.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10176,100,,8140.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10176,100,,8140.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6293.86,61.85,,5035.09,,,0,"percent of total billed charges","61.5% of total billed charges",1709.57,16.8,,1367.66,,,0,"percent of total billed charges","16.8% of total billed charges",5088,50,,4070.40,,,0,"percent of total billed charges","50% of total billed charges",3276.67,32.2,,2621.34,,,0,"percent of total billed charges","32.2% of total billed charges",3174.91,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1743.76,17.136,,1395.01,,,0,"percent of total billed charges","17.136% of total billed charges",2222.44,21.84,,1777.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3836.35,37.7,,3069.08,,,0,"percent of total billed charges","37.7% of total billed charges",3836.35,37.7,,3069.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3449.66,33.9,,2759.73,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7937.28,78,,6349.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8405.38,82.6,,6724.30,,,0,"percent of total billed charges","82.6% of total billed charges",1709.57,16.8,,1367.66,,,0,"percent of total billed charges","16.8% of total billed charges",5088,50,,4070.40,,,0,"percent of total billed charges","50% of total billed charges",8405.38,82.6,,6724.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1709.57,16.8,,1367.66,,,0,"percent of total billed charges","16.8% of total billed charges",10176,100,,8140.80,,,0,"percent of total billed charges","100% of total billed charges",1556.93,10176,
"PLATE BONE SS L116MM LCP MDL DIST TIB 4 HOLE F/3.5MM SCR",ORSUP0041,CDM,278,RC,,,OUTPATIENT,,,8034,5222.1,,7069.92,88,,5655.94,,,0,"percent of total billed charges","88% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1390.2,17.304,,1112.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5061.42,63,,4049.14,,,0,"percent of total billed charges","63% of total billed charges",1229.2,15.3,,983.36,,,0,"percent of total billed charges","15.3% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",5543.46,69,,,,,0,"fee schedule","69% of total billed charges",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4969.03,61.85,,3975.22,,,0,"percent of total billed charges","61.5% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",2586.95,32.2,,2069.56,,,0,"percent of total billed charges","32.2% of total billed charges",2506.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1376.71,17.136,,1101.37,,,0,"percent of total billed charges","17.136% of total billed charges",1754.63,21.84,,1403.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3028.82,37.7,,2423.06,,,0,"percent of total billed charges","37.7% of total billed charges",3028.82,37.7,,2423.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2723.53,33.9,,2178.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6266.52,78,,5013.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6636.08,82.6,,5308.86,,,0,"percent of total billed charges","82.6% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",6636.08,82.6,,5308.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",1229.2,8034,
"PLATE BONE T 6.3 X 54MM 8 HOLE SHAFT 3 HOLE HEAD FOR 2.4MM SCREW",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"PLATE BONE VECTRA TI L41MM L32MM ANT CERV 2 LVL",ORSUP0034,CDM,278,RC,,,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1065.75,17.304,,852.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",942.33,15.3,,753.86,,,0,"percent of total billed charges","15.3% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3809.34,61.85,,3047.47,,,0,"percent of total billed charges","61.5% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1983.2,32.2,,1586.56,,,0,"percent of total billed charges","32.2% of total billed charges",1921.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1055.41,17.136,,844.33,,,0,"percent of total billed charges","17.136% of total billed charges",1345.13,21.84,,1076.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",942.33,6159,
"PLATE BONE VECTRA TI L49MM L40MM ANT CERV 2 LVL",ORSUP0041,CDM,278,RC,,,OUTPATIENT,,,8034,5222.1,,7069.92,88,,5655.94,,,0,"percent of total billed charges","88% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1390.2,17.304,,1112.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5061.42,63,,4049.14,,,0,"percent of total billed charges","63% of total billed charges",1229.2,15.3,,983.36,,,0,"percent of total billed charges","15.3% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",5543.46,69,,,,,0,"fee schedule","69% of total billed charges",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4969.03,61.85,,3975.22,,,0,"percent of total billed charges","61.5% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",2586.95,32.2,,2069.56,,,0,"percent of total billed charges","32.2% of total billed charges",2506.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1376.71,17.136,,1101.37,,,0,"percent of total billed charges","17.136% of total billed charges",1754.63,21.84,,1403.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3028.82,37.7,,2423.06,,,0,"percent of total billed charges","37.7% of total billed charges",3028.82,37.7,,2423.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2723.53,33.9,,2178.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6266.52,78,,5013.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6636.08,82.6,,5308.86,,,0,"percent of total billed charges","82.6% of total billed charges",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",4017,50,,3213.60,,,0,"percent of total billed charges","50% of total billed charges",6636.08,82.6,,5308.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.71,16.8,,1079.77,,,0,"percent of total billed charges","16.8% of total billed charges",8034,100,,6427.20,,,0,"percent of total billed charges","100% of total billed charges",1229.2,8034,
"PLATE BONE VECTRA TI L57MM L48MM CERV 3 LVL",ORSUP0036,CDM,278,RC,,,OUTPATIENT,,,6695,4351.75,,5891.6,88,,4713.28,,,0,"percent of total billed charges","88% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1158.5,17.304,,926.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4217.85,63,,3374.28,,,0,"percent of total billed charges","63% of total billed charges",1024.34,15.3,,819.47,,,0,"percent of total billed charges","15.3% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",4619.55,69,,,,,0,"fee schedule","69% of total billed charges",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4140.86,61.85,,3312.69,,,0,"percent of total billed charges","61.5% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",2155.79,32.2,,1724.63,,,0,"percent of total billed charges","32.2% of total billed charges",2088.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1147.26,17.136,,917.81,,,0,"percent of total billed charges","17.136% of total billed charges",1462.19,21.84,,1169.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2524.02,37.7,,2019.22,,,0,"percent of total billed charges","37.7% of total billed charges",2524.02,37.7,,2019.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2269.61,33.9,,1815.69,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5222.1,78,,4177.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5530.07,82.6,,4424.06,,,0,"percent of total billed charges","82.6% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",5530.07,82.6,,4424.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",1024.34,6695,
"PLATE BONE VECTRA TI L66MM L57MM ANT CERV 3 LVL",ORSUP0036,CDM,278,RC,,,OUTPATIENT,,,6695,4351.75,,5891.6,88,,4713.28,,,0,"percent of total billed charges","88% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1158.5,17.304,,926.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4217.85,63,,3374.28,,,0,"percent of total billed charges","63% of total billed charges",1024.34,15.3,,819.47,,,0,"percent of total billed charges","15.3% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",4619.55,69,,,,,0,"fee schedule","69% of total billed charges",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4140.86,61.85,,3312.69,,,0,"percent of total billed charges","61.5% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",2155.79,32.2,,1724.63,,,0,"percent of total billed charges","32.2% of total billed charges",2088.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1147.26,17.136,,917.81,,,0,"percent of total billed charges","17.136% of total billed charges",1462.19,21.84,,1169.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2524.02,37.7,,2019.22,,,0,"percent of total billed charges","37.7% of total billed charges",2524.02,37.7,,2019.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2269.61,33.9,,1815.69,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5222.1,78,,4177.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5530.07,82.6,,4424.06,,,0,"percent of total billed charges","82.6% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",5530.07,82.6,,4424.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",1024.34,6695,
"PLATE BOX TI LOW PROFILE NEURO 14MM 4 HOLES",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"PLATE CANCANEAL LOCKING 241.623",ORSUP0024,CDM,278,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",1086.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.7% of total billed charges",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1180.06,33.9,,944.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"PLATE DCP 2.4MM 6 HOLE",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"PLATE DHS SHORT BARREL 135 DEGREE 4 HOLE",ORSUP0022,CDM,278,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",919.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.7% of total billed charges",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",998.69,33.9,,798.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"PLATE DHS STANDARD BARREL 135 DEGREE 4 HOLE",ORSUP0022,CDM,278,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",919.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.7% of total billed charges",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",998.69,33.9,,798.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"PLATE DHS STANDARD BARREL 135 DEGREE 5 HOLE",ORSUP0022,CDM,278,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",919.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.7% of total billed charges",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",998.69,33.9,,798.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"PLATE LC-DCP TITANM 2.4MM X 31MM 4 HOLE",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"PLATE LCP 4.5MM 12 HOLE/224MM NARROW",ORSUP0025,CDM,278,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",1169.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.7% of total billed charges",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.91,33.9,,1016.73,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"PLATE LCP 4.5MM 14 HOLE/260MM BROAD",ORSUP0028,CDM,278,RC,,,OUTPATIENT,,,4553,2959.45,,4006.64,88,,3205.31,,,0,"percent of total billed charges","88% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",787.85,17.304,,630.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2868.39,63,,2294.71,,,0,"percent of total billed charges","63% of total billed charges",696.61,15.3,,557.29,,,0,"percent of total billed charges","15.3% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",3141.57,69,,,,,0,"fee schedule","69% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2816.03,61.85,,2252.82,,,0,"percent of total billed charges","61.5% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",1466.07,32.2,,1172.86,,,0,"percent of total billed charges","32.2% of total billed charges",1420.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",780.2,17.136,,624.16,,,0,"percent of total billed charges","17.136% of total billed charges",994.38,21.84,,795.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.7% of total billed charges",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1543.47,33.9,,1234.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3551.34,78,,2841.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",696.61,4553,
"PLATE LCP 4.5MM 6 HOLE/116MM NARROW",ORSUP0022,CDM,278,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",919.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.7% of total billed charges",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",998.69,33.9,,798.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"PLATE LCP NARROW 4.5 X 188MM X 10 HOLE",ORSUP0023,CDM,278,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",1002.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.7% of total billed charges",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1089.55,33.9,,871.64,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"PLATE LCP RECON 12 HOLE 168MM",ORSUP0028,CDM,278,RC,,,OUTPATIENT,,,4553,2959.45,,4006.64,88,,3205.31,,,0,"percent of total billed charges","88% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",787.85,17.304,,630.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2868.39,63,,2294.71,,,0,"percent of total billed charges","63% of total billed charges",696.61,15.3,,557.29,,,0,"percent of total billed charges","15.3% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",3141.57,69,,,,,0,"fee schedule","69% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2816.03,61.85,,2252.82,,,0,"percent of total billed charges","61.5% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",1466.07,32.2,,1172.86,,,0,"percent of total billed charges","32.2% of total billed charges",1420.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",780.2,17.136,,624.16,,,0,"percent of total billed charges","17.136% of total billed charges",994.38,21.84,,795.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.7% of total billed charges",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1543.47,33.9,,1234.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3551.34,78,,2841.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",696.61,4553,
"PLATE LEVEL 2",ORSUP0042,CDM,278,RC,,,OUTPATIENT,,,8302,5396.3,,7305.76,88,,5844.61,,,0,"percent of total billed charges","88% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1436.58,17.304,,1149.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5230.26,63,,4184.21,,,0,"percent of total billed charges","63% of total billed charges",1270.21,15.3,,1016.17,,,0,"percent of total billed charges","15.3% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",5728.38,69,,,,,0,"fee schedule","69% of total billed charges",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5134.79,61.85,,4107.83,,,0,"percent of total billed charges","61.5% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",2673.24,32.2,,2138.59,,,0,"percent of total billed charges","32.2% of total billed charges",2590.22,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1422.63,17.136,,1138.10,,,0,"percent of total billed charges","17.136% of total billed charges",1813.16,21.84,,1450.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3129.85,37.7,,2503.88,,,0,"percent of total billed charges","37.7% of total billed charges",3129.85,37.7,,2503.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2814.38,33.9,,2251.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6475.56,78,,5180.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6857.45,82.6,,5485.96,,,0,"percent of total billed charges","82.6% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",6857.45,82.6,,5485.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",1270.21,8302,
"PLATE LOCKING 5 HOLE TUBE",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"PLATE LOW PROFILE NEURO Y SHAPE",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"PLATE ONE LEVEL TITANIUM VECTRA 20MM",ORSUP0040,CDM,278,RC,,,OUTPATIENT,,,7766,5047.9,,6834.08,88,,5467.26,,,0,"percent of total billed charges","88% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1343.83,17.304,,1075.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4892.58,63,,3914.06,,,0,"percent of total billed charges","63% of total billed charges",1188.2,15.3,,950.56,,,0,"percent of total billed charges","15.3% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",5358.54,69,,,,,0,"fee schedule","69% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4803.27,61.85,,3842.62,,,0,"percent of total billed charges","61.5% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",2500.65,32.2,,2000.52,,,0,"percent of total billed charges","32.2% of total billed charges",2422.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1330.78,17.136,,1064.62,,,0,"percent of total billed charges","17.136% of total billed charges",1696.09,21.84,,1356.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2927.78,37.7,,2342.22,,,0,"percent of total billed charges","37.7% of total billed charges",2927.78,37.7,,2342.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2632.67,33.9,,2106.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6057.48,78,,4845.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",1188.2,7766,
"PLATE PEANUT STANDARD MFT-002-PM",ORSUP0037,CDM,278,RC,,,OUTPATIENT,,,6963,4525.95,,6127.44,88,,4901.95,,,0,"percent of total billed charges","88% of total billed charges",3481.5,50,,2785.20,,,0,"percent of total billed charges","50% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1204.88,17.304,,963.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4386.69,63,,3509.35,,,0,"percent of total billed charges","63% of total billed charges",1065.34,15.3,,852.27,,,0,"percent of total billed charges","15.3% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",4804.47,69,,,,,0,"fee schedule","69% of total billed charges",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4306.62,61.85,,3445.30,,,0,"percent of total billed charges","61.5% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",3481.5,50,,2785.20,,,0,"percent of total billed charges","50% of total billed charges",2242.09,32.2,,1793.67,,,0,"percent of total billed charges","32.2% of total billed charges",2172.46,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1193.18,17.136,,954.54,,,0,"percent of total billed charges","17.136% of total billed charges",1520.72,21.84,,1216.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2625.05,37.7,,2100.04,,,0,"percent of total billed charges","37.7% of total billed charges",2625.05,37.7,,2100.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2360.46,33.9,,1888.37,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5431.14,78,,4344.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5751.44,82.6,,4601.15,,,0,"percent of total billed charges","82.6% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",3481.5,50,,2785.20,,,0,"percent of total billed charges","50% of total billed charges",5751.44,82.6,,4601.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",1065.34,6963,
"PLATE RECON 3.5MM 5 HOLE",ORSUP0019,CDM,278,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",668.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.7% of total billed charges",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",726.14,33.9,,580.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"PLATE RECON 3.5MM 8H 112MM",ORSUP0029,CDM,278,RC,,,OUTPATIENT,,,4820,3133,,4241.6,88,,3393.28,,,0,"percent of total billed charges","88% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",834.05,17.304,,667.24,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3036.6,63,,2429.28,,,0,"percent of total billed charges","63% of total billed charges",737.46,15.3,,589.97,,,0,"percent of total billed charges","15.3% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",3325.8,69,,,,,0,"fee schedule","69% of total billed charges",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2981.17,61.85,,2384.94,,,0,"percent of total billed charges","61.5% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",1552.04,32.2,,1241.63,,,0,"percent of total billed charges","32.2% of total billed charges",1503.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",825.96,17.136,,660.77,,,0,"percent of total billed charges","17.136% of total billed charges",1052.69,21.84,,842.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1817.14,37.7,,1453.71,,,0,"percent of total billed charges","37.7% of total billed charges",1817.14,37.7,,1453.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1633.98,33.9,,1307.18,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3759.6,78,,3007.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3981.32,82.6,,3185.06,,,0,"percent of total billed charges","82.6% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",3981.32,82.6,,3185.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",737.46,4820,
"PLATE RECON LCP 3.5MM 10H 140MM",ORSUP0027,CDM,278,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",1336.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.7% of total billed charges",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1452.62,33.9,,1162.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"PLATE STANDARD LEFT MTP MTP-002-SL",ORSUP0040,CDM,278,RC,,,OUTPATIENT,,,7766,5047.9,,6834.08,88,,5467.26,,,0,"percent of total billed charges","88% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1343.83,17.304,,1075.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4892.58,63,,3914.06,,,0,"percent of total billed charges","63% of total billed charges",1188.2,15.3,,950.56,,,0,"percent of total billed charges","15.3% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",5358.54,69,,,,,0,"fee schedule","69% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4803.27,61.85,,3842.62,,,0,"percent of total billed charges","61.5% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",2500.65,32.2,,2000.52,,,0,"percent of total billed charges","32.2% of total billed charges",2422.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1330.78,17.136,,1064.62,,,0,"percent of total billed charges","17.136% of total billed charges",1696.09,21.84,,1356.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2927.78,37.7,,2342.22,,,0,"percent of total billed charges","37.7% of total billed charges",2927.78,37.7,,2342.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2632.67,33.9,,2106.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6057.48,78,,4845.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",1188.2,7766,
"PLATE STANDARD RIGHT MTP MTP-002-SR",ORSUP0040,CDM,278,RC,,,OUTPATIENT,,,7766,5047.9,,6834.08,88,,5467.26,,,0,"percent of total billed charges","88% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1343.83,17.304,,1075.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4892.58,63,,3914.06,,,0,"percent of total billed charges","63% of total billed charges",1188.2,15.3,,950.56,,,0,"percent of total billed charges","15.3% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",5358.54,69,,,,,0,"fee schedule","69% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4803.27,61.85,,3842.62,,,0,"percent of total billed charges","61.5% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",2500.65,32.2,,2000.52,,,0,"percent of total billed charges","32.2% of total billed charges",2422.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1330.78,17.136,,1064.62,,,0,"percent of total billed charges","17.136% of total billed charges",1696.09,21.84,,1356.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2927.78,37.7,,2342.22,,,0,"percent of total billed charges","37.7% of total billed charges",2927.78,37.7,,2342.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2632.67,33.9,,2106.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6057.48,78,,4845.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",1188.2,7766,
"PLATE STRUT TI LOW PROFILE NEURO 6 HOLES",ORSUP0022,CDM,278,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",919.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.7% of total billed charges",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",998.69,33.9,,798.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"PLATE STRUT TI LOW PROFILE NEURO 8 HOLES",ORSUP0025,CDM,278,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",1169.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.7% of total billed charges",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.91,33.9,,1016.73,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"PLATE T TITANIUM 1.5MM",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"PLATE T TITANM 2.4MM X 54MM 2 HOLE HEAD 8 HOLE SHAFT",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"PLATE THIN FLAP DBL Y",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"PLATE TITANIUM 2.0MM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"PLATE TITANIUM 6 HOLE 1.5MM",ORSUP0024,CDM,278,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",835.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.7% of total billed charges",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",907.84,33.9,,726.27,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"PLATE TITANIUM DCP 4 HOLE",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"PLATE TITANIUM T 3 HEAD 8 SHAFT",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"PLATE TUBULAR 10 HOLE",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"PLATE TUBULAR 12 HOLE",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"PLATE WIDE 2-HOLE",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"PLATE Y MFT-002-Y",ORSUP0040,CDM,278,RC,,,OUTPATIENT,,,7766,5047.9,,6834.08,88,,5467.26,,,0,"percent of total billed charges","88% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1343.83,17.304,,1075.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4892.58,63,,3914.06,,,0,"percent of total billed charges","63% of total billed charges",1188.2,15.3,,950.56,,,0,"percent of total billed charges","15.3% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",5358.54,69,,,,,0,"fee schedule","69% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4803.27,61.85,,3842.62,,,0,"percent of total billed charges","61.5% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",2500.65,32.2,,2000.52,,,0,"percent of total billed charges","32.2% of total billed charges",2422.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1330.78,17.136,,1064.62,,,0,"percent of total billed charges","17.136% of total billed charges",1696.09,21.84,,1356.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2927.78,37.7,,2342.22,,,0,"percent of total billed charges","37.7% of total billed charges",2927.78,37.7,,2342.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2632.67,33.9,,2106.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6057.48,78,,4845.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",1188.2,7766,
"PLATE Y TITANM 2.4MM X 56MM 3 HOLE HEAD 8 HOLE SHAFT",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"PLATES UNIVERSAL ORBITAL FLOOR  FOR 1.0MM SCREWS 420.40",ORSUP0033,CDM,278,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",1838.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.7% of total billed charges",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1997.39,33.9,,1597.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"PLATE 25MM 1 LEVEL",ORSUP0037,CDM,278,RC,,,OUTPATIENT,,,6963,4525.95,,6127.44,88,,4901.95,,,0,"percent of total billed charges","88% of total billed charges",3481.5,50,,2785.20,,,0,"percent of total billed charges","50% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1204.88,17.304,,963.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4386.69,63,,3509.35,,,0,"percent of total billed charges","63% of total billed charges",1065.34,15.3,,852.27,,,0,"percent of total billed charges","15.3% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",4804.47,69,,,,,0,"fee schedule","69% of total billed charges",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4306.62,61.85,,3445.30,,,0,"percent of total billed charges","61.5% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",3481.5,50,,2785.20,,,0,"percent of total billed charges","50% of total billed charges",2242.09,32.2,,1793.67,,,0,"percent of total billed charges","32.2% of total billed charges",2172.46,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1193.18,17.136,,954.54,,,0,"percent of total billed charges","17.136% of total billed charges",1520.72,21.84,,1216.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2625.05,37.7,,2100.04,,,0,"percent of total billed charges","37.7% of total billed charges",2625.05,37.7,,2100.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2360.46,33.9,,1888.37,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5431.14,78,,4344.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5751.44,82.6,,4601.15,,,0,"percent of total billed charges","82.6% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",3481.5,50,,2785.20,,,0,"percent of total billed charges","50% of total billed charges",5751.44,82.6,,4601.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",1065.34,6963,
"PLATE 3 LEVEL  57MM",ORSUP0043,CDM,278,RC,,,OUTPATIENT,,,8570,5570.5,,7541.6,88,,6033.28,,,0,"percent of total billed charges","88% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1482.95,17.304,,1186.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5399.1,63,,4319.28,,,0,"percent of total billed charges","63% of total billed charges",1311.21,15.3,,1048.97,,,0,"percent of total billed charges","15.3% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",5913.3,69,,,,,0,"fee schedule","69% of total billed charges",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5300.55,61.85,,4240.44,,,0,"percent of total billed charges","61.5% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",2759.54,32.2,,2207.63,,,0,"percent of total billed charges","32.2% of total billed charges",2673.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1468.56,17.136,,1174.85,,,0,"percent of total billed charges","17.136% of total billed charges",1871.69,21.84,,1497.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3230.89,37.7,,2584.71,,,0,"percent of total billed charges","37.7% of total billed charges",3230.89,37.7,,2584.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2905.23,33.9,,2324.18,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6684.6,78,,5347.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7078.82,82.6,,5663.06,,,0,"percent of total billed charges","82.6% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",7078.82,82.6,,5663.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",1311.21,8570,
"PLATE BONE VECTRA TI L39MM L30MM ANT CERV 2 LVL",ORSUP0035,CDM,278,RC,,,OUTPATIENT,,,6427,4177.55,,5655.76,88,,4524.61,,,0,"percent of total billed charges","88% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1112.13,17.304,,889.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4049.01,63,,3239.21,,,0,"percent of total billed charges","63% of total billed charges",983.33,15.3,,786.66,,,0,"percent of total billed charges","15.3% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4434.63,69,,,,,0,"fee schedule","69% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3975.1,61.85,,3180.08,,,0,"percent of total billed charges","61.5% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",2069.49,32.2,,1655.59,,,0,"percent of total billed charges","32.2% of total billed charges",2005.22,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1101.33,17.136,,881.06,,,0,"percent of total billed charges","17.136% of total billed charges",1403.66,21.84,,1122.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.7% of total billed charges",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2178.75,33.9,,1743.00,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5013.06,78,,4010.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",983.33,6427,
"PLATE BONE VECTRA TI L63MM L54MM ANT CERV 3 LVL",ORSUP0036,CDM,278,RC,,,OUTPATIENT,,,6695,4351.75,,5891.6,88,,4713.28,,,0,"percent of total billed charges","88% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1158.5,17.304,,926.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4217.85,63,,3374.28,,,0,"percent of total billed charges","63% of total billed charges",1024.34,15.3,,819.47,,,0,"percent of total billed charges","15.3% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",4619.55,69,,,,,0,"fee schedule","69% of total billed charges",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4140.86,61.85,,3312.69,,,0,"percent of total billed charges","61.5% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",2155.79,32.2,,1724.63,,,0,"percent of total billed charges","32.2% of total billed charges",2088.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1147.26,17.136,,917.81,,,0,"percent of total billed charges","17.136% of total billed charges",1462.19,21.84,,1169.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2524.02,37.7,,2019.22,,,0,"percent of total billed charges","37.7% of total billed charges",2524.02,37.7,,2019.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2269.61,33.9,,1815.69,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5222.1,78,,4177.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5530.07,82.6,,4424.06,,,0,"percent of total billed charges","82.6% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",5530.07,82.6,,4424.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",1024.34,6695,
"PLATE SYNTHES VECTRA 14MM 04.613.154",ORSUP0047,CDM,278,RC,,,OUTPATIENT,,,9641,6266.65,,8484.08,88,,6787.26,,,0,"percent of total billed charges","88% of total billed charges",4820.5,50,,3856.40,,,0,"percent of total billed charges","50% of total billed charges",1619.69,16.8,,1295.75,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1668.28,17.304,,1334.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6073.83,63,,4859.06,,,0,"percent of total billed charges","63% of total billed charges",1475.07,15.3,,1180.06,,,0,"percent of total billed charges","15.3% of total billed charges",1619.69,16.8,,1295.75,,,0,"percent of total billed charges","16.8% of total billed charges",6652.29,69,,,,,0,"fee schedule","69% of total billed charges",9641,100,,7712.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9641,100,,7712.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9641,100,,7712.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5962.96,61.85,,4770.37,,,0,"percent of total billed charges","61.5% of total billed charges",1619.69,16.8,,1295.75,,,0,"percent of total billed charges","16.8% of total billed charges",4820.5,50,,3856.40,,,0,"percent of total billed charges","50% of total billed charges",3104.4,32.2,,2483.52,,,0,"percent of total billed charges","32.2% of total billed charges",3007.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1652.08,17.136,,1321.66,,,0,"percent of total billed charges","17.136% of total billed charges",2105.59,21.84,,1684.47,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3634.66,37.7,,2907.73,,,0,"percent of total billed charges","37.7% of total billed charges",3634.66,37.7,,2907.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3268.3,33.9,,2614.64,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7519.98,78,,6015.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7963.47,82.6,,6370.78,,,0,"percent of total billed charges","82.6% of total billed charges",1619.69,16.8,,1295.75,,,0,"percent of total billed charges","16.8% of total billed charges",4820.5,50,,3856.40,,,0,"percent of total billed charges","50% of total billed charges",7963.47,82.6,,6370.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1619.69,16.8,,1295.75,,,0,"percent of total billed charges","16.8% of total billed charges",9641,100,,7712.80,,,0,"percent of total billed charges","100% of total billed charges",1475.07,9641,
"PLATE LEFT",ORSUP0024,CDM,278,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",1086.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.7% of total billed charges",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1180.06,33.9,,944.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"PLATE T TITANIUN  4X8",ORSUP0032,CDM,278,RC,,,OUTPATIENT,,,4553,2959.45,,4006.64,88,,3205.31,,,0,"percent of total billed charges","88% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",787.85,17.304,,630.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2868.39,63,,2294.71,,,0,"percent of total billed charges","63% of total billed charges",696.61,15.3,,557.29,,,0,"percent of total billed charges","15.3% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",3141.57,69,,,,,0,"fee schedule","69% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2816.03,61.85,,2252.82,,,0,"percent of total billed charges","61.5% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",1466.07,32.2,,1172.86,,,0,"percent of total billed charges","32.2% of total billed charges",1420.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",780.2,17.136,,624.16,,,0,"percent of total billed charges","17.136% of total billed charges",994.38,21.84,,795.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.7% of total billed charges",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1543.47,33.9,,1234.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3551.34,78,,2841.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",696.61,4553,
"PLATE 2.0 TITANIUM 6HL 36MM",ORSUP0034,CDM,278,RC,,,OUTPATIENT,,,4553,2959.45,,4006.64,88,,3205.31,,,0,"percent of total billed charges","88% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",787.85,17.304,,630.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2868.39,63,,2294.71,,,0,"percent of total billed charges","63% of total billed charges",696.61,15.3,,557.29,,,0,"percent of total billed charges","15.3% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",3141.57,69,,,,,0,"fee schedule","69% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2816.03,61.85,,2252.82,,,0,"percent of total billed charges","61.5% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",1466.07,32.2,,1172.86,,,0,"percent of total billed charges","32.2% of total billed charges",1420.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",780.2,17.136,,624.16,,,0,"percent of total billed charges","17.136% of total billed charges",994.38,21.84,,795.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.7% of total billed charges",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1543.47,33.9,,1234.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3551.34,78,,2841.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",696.61,4553,
"PLATE PROXIMAL HUMERUS 3.5MM 3HL 90MM LENGTH",ORSUP0082,CDM,278,RC,,,OUTPATIENT,,,19282,12533.3,,16968.16,88,,13574.53,,,0,"percent of total billed charges","88% of total billed charges",9641,50,,7712.80,,,0,"percent of total billed charges","50% of total billed charges",3239.38,16.8,,2591.50,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3336.56,17.304,,2669.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12147.66,63,,9718.13,,,0,"percent of total billed charges","63% of total billed charges",2950.15,15.3,,2360.12,,,0,"percent of total billed charges","15.3% of total billed charges",3239.38,16.8,,2591.50,,,0,"percent of total billed charges","16.8% of total billed charges",13304.58,69,,,,,0,"fee schedule","69% of total billed charges",19282,100,,15425.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19282,100,,15425.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19282,100,,15425.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11925.92,61.85,,9540.74,,,0,"percent of total billed charges","61.5% of total billed charges",3239.38,16.8,,2591.50,,,0,"percent of total billed charges","16.8% of total billed charges",9641,50,,7712.80,,,0,"percent of total billed charges","50% of total billed charges",6208.8,32.2,,4967.04,,,0,"percent of total billed charges","32.2% of total billed charges",6015.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3304.16,17.136,,2643.33,,,0,"percent of total billed charges","17.136% of total billed charges",4211.19,21.84,,3368.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",7269.31,37.7,,5815.45,,,0,"percent of total billed charges","37.7% of total billed charges",7269.31,37.7,,5815.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",6536.6,33.9,,5229.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",15039.96,78,,12031.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15926.93,82.6,,12741.54,,,0,"percent of total billed charges","82.6% of total billed charges",3239.38,16.8,,2591.50,,,0,"percent of total billed charges","16.8% of total billed charges",9641,50,,7712.80,,,0,"percent of total billed charges","50% of total billed charges",15926.93,82.6,,12741.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3239.38,16.8,,2591.50,,,0,"percent of total billed charges","16.8% of total billed charges",19282,100,,15425.60,,,0,"percent of total billed charges","100% of total billed charges",2950.15,19282,
"PLATELET ROTATOR TEMP CHART BLOOD BANK",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"PLEDGET POLYMER TFE SUT BUTTRESS 3/8 X 3/16 X 1/16",188053,CDM,272,RC,,,OUTPATIENT,,,29,18.85,,25.52,88,,20.42,,,0,"percent of total billed charges","88% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.02,17.304,,4.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.27,63,,14.62,,,0,"percent of total billed charges","63% of total billed charges",4.44,15.3,,3.55,,,0,"percent of total billed charges","15.3% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",20.01,69,,,,,0,"fee schedule","69% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.94,61.85,,14.35,,,0,"percent of total billed charges","61.5% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",9.34,32.2,,7.47,,,0,"percent of total billed charges","32.2% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.97,17.136,,3.98,,,0,"percent of total billed charges","17.136% of total billed charges",6.33,21.84,,5.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.93,37.7,,8.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,78,,18.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",4.44,29,
"PLEDGET TEFLON 1/4X1/8X1/16",120747,CDM,272,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"PLEUR-EVAC CHEST DRAIN DRY SUCTION SINGLE CHAMBER",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"PLIERS PLATE BENDING",408630,CDM,272,RC,,,OUTPATIENT,,,1224,795.6,,1077.12,88,,861.70,,,0,"percent of total billed charges","88% of total billed charges",612,50,,489.60,,,0,"percent of total billed charges","50% of total billed charges",205.63,16.8,,164.50,,,0,"percent of total billed charges","16.8% of total billed charges",1224,100,,979.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.8,17.304,,169.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",771.12,63,,616.90,,,0,"percent of total billed charges","63% of total billed charges",187.27,15.3,,149.82,,,0,"percent of total billed charges","15.3% of total billed charges",205.63,16.8,,164.50,,,0,"percent of total billed charges","16.8% of total billed charges",844.56,69,,,,,0,"fee schedule","69% of total billed charges",1224,100,,979.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1224,100,,979.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1224,100,,979.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",757.04,61.85,,605.63,,,0,"percent of total billed charges","61.5% of total billed charges",205.63,16.8,,164.50,,,0,"percent of total billed charges","16.8% of total billed charges",612,50,,489.60,,,0,"percent of total billed charges","50% of total billed charges",394.13,32.2,,315.30,,,0,"percent of total billed charges","32.2% of total billed charges",205.63,16.8,,164.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.74,17.136,,167.79,,,0,"percent of total billed charges","17.136% of total billed charges",267.32,21.84,,213.86,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",461.45,37.7,,369.16,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",954.72,78,,763.78,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1011.02,82.6,,808.82,,,0,"percent of total billed charges","82.6% of total billed charges",205.63,16.8,,164.50,,,0,"percent of total billed charges","16.8% of total billed charges",612,50,,489.60,,,0,"percent of total billed charges","50% of total billed charges",1011.02,82.6,,808.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",205.63,16.8,,164.50,,,0,"percent of total billed charges","16.8% of total billed charges",1224,100,,979.20,,,0,"percent of total billed charges","100% of total billed charges",187.27,1224,
"PLUG MARLEX LARGE 011297",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"PLUG PERFIX MEDIUM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"PLUG CATHETER  CAP STERILE",145854,CDM,272,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"PLUGS EAR DISP PK/200",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"PLUG AMPLATZER VASCULAR 10MM",ORSUP0031,CDM,272,RC,,,OUTPATIENT,,,5356,3481.4,,4713.28,88,,3770.62,,,0,"percent of total billed charges","88% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",926.8,17.304,,741.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3374.28,63,,2699.42,,,0,"percent of total billed charges","63% of total billed charges",819.47,15.3,,655.58,,,0,"percent of total billed charges","15.3% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",3695.64,69,,,,,0,"fee schedule","69% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3312.69,61.85,,2650.15,,,0,"percent of total billed charges","61.5% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",1724.63,32.2,,1379.70,,,0,"percent of total billed charges","32.2% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",917.8,17.136,,734.24,,,0,"percent of total billed charges","17.136% of total billed charges",1169.75,21.84,,935.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4177.68,78,,3342.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",819.47,5356,
"PLUG AMPLATZER VASCULAR 12MM",ORSUP0030,CDM,272,RC,,,OUTPATIENT,,,5088,3307.2,,4477.44,88,,3581.95,,,0,"percent of total billed charges","88% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",880.43,17.304,,704.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3205.44,63,,2564.35,,,0,"percent of total billed charges","63% of total billed charges",778.46,15.3,,622.77,,,0,"percent of total billed charges","15.3% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",3510.72,69,,,,,0,"fee schedule","69% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3146.93,61.85,,2517.54,,,0,"percent of total billed charges","61.5% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",1638.34,32.2,,1310.67,,,0,"percent of total billed charges","32.2% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",871.88,17.136,,697.50,,,0,"percent of total billed charges","17.136% of total billed charges",1111.22,21.84,,888.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1918.18,37.7,,1534.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3968.64,78,,3174.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",778.46,5088,
"PLUG AMPLATZER VASCULAR 6MM",ORSUP0031,CDM,272,RC,,,OUTPATIENT,,,5356,3481.4,,4713.28,88,,3770.62,,,0,"percent of total billed charges","88% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",926.8,17.304,,741.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3374.28,63,,2699.42,,,0,"percent of total billed charges","63% of total billed charges",819.47,15.3,,655.58,,,0,"percent of total billed charges","15.3% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",3695.64,69,,,,,0,"fee schedule","69% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3312.69,61.85,,2650.15,,,0,"percent of total billed charges","61.5% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",1724.63,32.2,,1379.70,,,0,"percent of total billed charges","32.2% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",917.8,17.136,,734.24,,,0,"percent of total billed charges","17.136% of total billed charges",1169.75,21.84,,935.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4177.68,78,,3342.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",819.47,5356,
"PLUG AMPLATZER VASCULAR 8MM",ORSUP0031,CDM,272,RC,,,OUTPATIENT,,,5356,3481.4,,4713.28,88,,3770.62,,,0,"percent of total billed charges","88% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",926.8,17.304,,741.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3374.28,63,,2699.42,,,0,"percent of total billed charges","63% of total billed charges",819.47,15.3,,655.58,,,0,"percent of total billed charges","15.3% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",3695.64,69,,,,,0,"fee schedule","69% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3312.69,61.85,,2650.15,,,0,"percent of total billed charges","61.5% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",1724.63,32.2,,1379.70,,,0,"percent of total billed charges","32.2% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",917.8,17.136,,734.24,,,0,"percent of total billed charges","17.136% of total billed charges",1169.75,21.84,,935.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4177.68,78,,3342.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",819.47,5356,
"PLUGS EAR MAGNAPLUGS MRI",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"PLUMEPEN SMOKE EVAC PENCIL",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"PNEUMOTHORAX CATH TROCAR SET",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1030,669.5,,906.4,88,,725.12,,,0,"percent of total billed charges","88% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.23,17.304,,142.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.9,63,,519.12,,,0,"percent of total billed charges","63% of total billed charges",157.59,15.3,,126.07,,,0,"percent of total billed charges","15.3% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",710.7,69,,,,,0,"fee schedule","69% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",637.06,61.85,,509.65,,,0,"percent of total billed charges","61.5% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",331.66,32.2,,265.33,,,0,"percent of total billed charges","32.2% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.5,17.136,,141.20,,,0,"percent of total billed charges","17.136% of total billed charges",224.95,21.84,,179.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",388.31,37.7,,310.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",803.4,78,,642.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",157.59,1030,
"PNEUMOTHORAX CATH  SET",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1185,770.25,,1042.8,88,,834.24,,,0,"percent of total billed charges","88% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",205.05,17.304,,164.04,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",746.55,63,,597.24,,,0,"percent of total billed charges","63% of total billed charges",181.31,15.3,,145.05,,,0,"percent of total billed charges","15.3% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",817.65,69,,,,,0,"fee schedule","69% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.92,61.85,,586.34,,,0,"percent of total billed charges","61.5% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",381.57,32.2,,305.26,,,0,"percent of total billed charges","32.2% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",203.06,17.136,,162.45,,,0,"percent of total billed charges","17.136% of total billed charges",258.8,21.84,,207.04,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",446.75,37.7,,357.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",924.3,78,,739.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",181.31,1185,
"PO2 ELECTRODE",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"POLAR CARE KODIAK",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"POLAR PUMP \\T\\ COOLER",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"POLAR CARE ANKLE PAD",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"POLAR CARE CUBE W/ KNEE \\T\\ SHOULDER PAD",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"POLYPSNARE LARGE             000472",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"POLYP ROTH NET",ORSUP0026,CDM,272,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"POLYVINYL ALCOHOL (PVA) FOAM PARTICLES",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"POOLED SCREEN 0.8% 2X10ML",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"POPE OTO-WICK 15MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"PORT POWER  (GROSHONG CATH) IMPL INFSN ISP MRI 8FR 1808560",ORSUP0027,CDM,278,RC,,,OUTPATIENT,,,1648,1071.2,,1450.24,88,,1160.19,,,0,"percent of total billed charges","88% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",285.17,17.304,,228.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1038.24,63,,830.59,,,0,"percent of total billed charges","63% of total billed charges",252.14,15.3,,201.71,,,0,"percent of total billed charges","15.3% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1137.12,69,,,,,0,"fee schedule","69% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.29,61.85,,815.43,,,0,"percent of total billed charges","61.5% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",530.66,32.2,,424.53,,,0,"percent of total billed charges","32.2% of total billed charges",514.18,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",282.4,17.136,,225.92,,,0,"percent of total billed charges","17.136% of total billed charges",359.92,21.84,,287.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",621.3,37.7,,497.04,,,0,"percent of total billed charges","37.7% of total billed charges",621.3,37.7,,497.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",558.67,33.9,,446.94,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1285.44,78,,1028.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1361.25,82.6,,1089.00,,,0,"percent of total billed charges","82.6% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",1361.25,82.6,,1089.00,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",252.14,1648,
"PORT SEAL ADJUSTABLE BIOPSY  5 PK",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"PORT SINGLE-SITE FOR 8.5MM ENDOSCOPE DA VINCI (SINGLE USE)",337818,CDM,272,RC,,,OUTPATIENT,,,1178,765.7,,1036.64,88,,829.31,,,0,"percent of total billed charges","88% of total billed charges",589,50,,471.20,,,0,"percent of total billed charges","50% of total billed charges",197.9,16.8,,158.32,,,0,"percent of total billed charges","16.8% of total billed charges",1178,100,,942.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",203.84,17.304,,163.07,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",742.14,63,,593.71,,,0,"percent of total billed charges","63% of total billed charges",180.23,15.3,,144.18,,,0,"percent of total billed charges","15.3% of total billed charges",197.9,16.8,,158.32,,,0,"percent of total billed charges","16.8% of total billed charges",812.82,69,,,,,0,"fee schedule","69% of total billed charges",1178,100,,942.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1178,100,,942.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1178,100,,942.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",728.59,61.85,,582.87,,,0,"percent of total billed charges","61.5% of total billed charges",197.9,16.8,,158.32,,,0,"percent of total billed charges","16.8% of total billed charges",589,50,,471.20,,,0,"percent of total billed charges","50% of total billed charges",379.32,32.2,,303.46,,,0,"percent of total billed charges","32.2% of total billed charges",197.9,16.8,,158.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",201.86,17.136,,161.49,,,0,"percent of total billed charges","17.136% of total billed charges",257.28,21.84,,205.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",444.11,37.7,,355.29,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",918.84,78,,735.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",973.03,82.6,,778.42,,,0,"percent of total billed charges","82.6% of total billed charges",197.9,16.8,,158.32,,,0,"percent of total billed charges","16.8% of total billed charges",589,50,,471.20,,,0,"percent of total billed charges","50% of total billed charges",973.03,82.6,,778.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",197.9,16.8,,158.32,,,0,"percent of total billed charges","16.8% of total billed charges",1178,100,,942.40,,,0,"percent of total billed charges","100% of total billed charges",180.23,1178,
"PORT SUTURE CLOSURE SUTURE PASSER II",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"PORT POWER SLIM",ORSUP0027,CDM,278,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",1086.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.7% of total billed charges",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1180.06,33.9,,944.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"PORT ACCESS KIT POWERLOC W/Y SITE 20G 3/4",ORSUP0002,CDM,278,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.7% of total billed charges",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.92,33.9,,27.94,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"POSITIONER LAMINECTOMY ARM CRADLE FOAM",179799,CDM,270,RC,,,OUTPATIENT,,,35,22.75,,30.8,88,,24.64,,,0,"percent of total billed charges","88% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.06,17.304,,4.85,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.05,63,,17.64,,,0,"percent of total billed charges","63% of total billed charges",5.36,15.3,,4.29,,,0,"percent of total billed charges","15.3% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",24.15,69,,,,,0,"fee schedule","69% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.65,61.85,,17.32,,,0,"percent of total billed charges","61.5% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",11.27,32.2,,9.02,,,0,"percent of total billed charges","32.2% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,17.136,,4.80,,,0,"percent of total billed charges","17.136% of total billed charges",7.64,21.84,,6.11,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.2,37.7,,10.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",27.3,78,,21.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.91,82.6,,23.13,,,0,"percent of total billed charges","82.6% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",28.91,82.6,,23.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",5.36,35,
"POST-OP SHOE WOMEN SMALL",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"POST-OP SHOE WOMEN MEDIUM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"POST-OP SHOE WOMEN LARGE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"POST-OP SHOE MEN SMALL",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"POST-OP SHOE MEN MEDIUM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"POST-OP SHOE MEN LARGE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"POST SURGICAL BREAST BINDER XLRG PINK FLORAL",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"POTASSIUM HYDROXIDE 10%",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"POTASSIUM /K+/5 PACK/250 SLDS",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
POTASSIUM,ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"POUCH TYVEK W/STERRAD IND. SELF-SEAL  6 X 12.5    CS/500",232458,CDM,270,RC,,,OUTPATIENT,,,597,388.05,,525.36,88,,420.29,,,0,"percent of total billed charges","88% of total billed charges",298.5,50,,238.80,,,0,"percent of total billed charges","50% of total billed charges",100.3,16.8,,80.24,,,0,"percent of total billed charges","16.8% of total billed charges",597,100,,477.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.3,17.304,,82.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",376.11,63,,300.89,,,0,"percent of total billed charges","63% of total billed charges",91.34,15.3,,73.07,,,0,"percent of total billed charges","15.3% of total billed charges",100.3,16.8,,80.24,,,0,"percent of total billed charges","16.8% of total billed charges",411.93,69,,,,,0,"fee schedule","69% of total billed charges",597,100,,477.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",597,100,,477.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",597,100,,477.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",369.24,61.85,,295.39,,,0,"percent of total billed charges","61.5% of total billed charges",100.3,16.8,,80.24,,,0,"percent of total billed charges","16.8% of total billed charges",298.5,50,,238.80,,,0,"percent of total billed charges","50% of total billed charges",192.23,32.2,,153.78,,,0,"percent of total billed charges","32.2% of total billed charges",100.3,16.8,,80.24,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",102.3,17.136,,81.84,,,0,"percent of total billed charges","17.136% of total billed charges",130.38,21.84,,104.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",225.07,37.7,,180.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",465.66,78,,372.53,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",493.12,82.6,,394.50,,,0,"percent of total billed charges","82.6% of total billed charges",100.3,16.8,,80.24,,,0,"percent of total billed charges","16.8% of total billed charges",298.5,50,,238.80,,,0,"percent of total billed charges","50% of total billed charges",493.12,82.6,,394.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",100.3,16.8,,80.24,,,0,"percent of total billed charges","16.8% of total billed charges",597,100,,477.60,,,0,"percent of total billed charges","100% of total billed charges",91.34,597,
"POUCH  STERILE 11IN X 4IN",290571,CDM,272,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"POUCH STERILIZATION  4.5 INCH X 11 INCH",287630,CDM,272,RC,,,OUTPATIENT,,,82,53.3,,72.16,88,,57.73,,,0,"percent of total billed charges","88% of total billed charges",41,50,,32.80,,,0,"percent of total billed charges","50% of total billed charges",13.78,16.8,,11.02,,,0,"percent of total billed charges","16.8% of total billed charges",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.19,17.304,,11.35,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.66,63,,41.33,,,0,"percent of total billed charges","63% of total billed charges",12.55,15.3,,10.04,,,0,"percent of total billed charges","15.3% of total billed charges",13.78,16.8,,11.02,,,0,"percent of total billed charges","16.8% of total billed charges",56.58,69,,,,,0,"fee schedule","69% of total billed charges",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.72,61.85,,40.58,,,0,"percent of total billed charges","61.5% of total billed charges",13.78,16.8,,11.02,,,0,"percent of total billed charges","16.8% of total billed charges",41,50,,32.80,,,0,"percent of total billed charges","50% of total billed charges",26.4,32.2,,21.12,,,0,"percent of total billed charges","32.2% of total billed charges",13.78,16.8,,11.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.05,17.136,,11.24,,,0,"percent of total billed charges","17.136% of total billed charges",17.91,21.84,,14.33,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.91,37.7,,24.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",63.96,78,,51.17,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.73,82.6,,54.18,,,0,"percent of total billed charges","82.6% of total billed charges",13.78,16.8,,11.02,,,0,"percent of total billed charges","16.8% of total billed charges",41,50,,32.80,,,0,"percent of total billed charges","50% of total billed charges",67.73,82.6,,54.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.78,16.8,,11.02,,,0,"percent of total billed charges","16.8% of total billed charges",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",12.55,82,
"POUCH STERILIZATION  5.25 X 10 SELF SEAL",288005,CDM,272,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"POUCH STERILIZATION  6 INCH X 15 INCH",287636,CDM,272,RC,,,OUTPATIENT,,,104,67.6,,91.52,88,,73.22,,,0,"percent of total billed charges","88% of total billed charges",52,50,,41.60,,,0,"percent of total billed charges","50% of total billed charges",17.47,16.8,,13.98,,,0,"percent of total billed charges","16.8% of total billed charges",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,17.304,,14.40,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",65.52,63,,52.42,,,0,"percent of total billed charges","63% of total billed charges",15.91,15.3,,12.73,,,0,"percent of total billed charges","15.3% of total billed charges",17.47,16.8,,13.98,,,0,"percent of total billed charges","16.8% of total billed charges",71.76,69,,,,,0,"fee schedule","69% of total billed charges",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.32,61.85,,51.46,,,0,"percent of total billed charges","61.5% of total billed charges",17.47,16.8,,13.98,,,0,"percent of total billed charges","16.8% of total billed charges",52,50,,41.60,,,0,"percent of total billed charges","50% of total billed charges",33.49,32.2,,26.79,,,0,"percent of total billed charges","32.2% of total billed charges",17.47,16.8,,13.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.136,,14.26,,,0,"percent of total billed charges","17.136% of total billed charges",22.71,21.84,,18.17,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39.21,37.7,,31.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",81.12,78,,64.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.9,82.6,,68.72,,,0,"percent of total billed charges","82.6% of total billed charges",17.47,16.8,,13.98,,,0,"percent of total billed charges","16.8% of total billed charges",52,50,,41.60,,,0,"percent of total billed charges","50% of total billed charges",85.9,82.6,,68.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.47,16.8,,13.98,,,0,"percent of total billed charges","16.8% of total billed charges",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",15.91,104,
"POUCH STERILIZATION 4 X 22",171710,CDM,272,RC,,,OUTPATIENT,,,139,90.35,,122.32,88,,97.86,,,0,"percent of total billed charges","88% of total billed charges",69.5,50,,55.60,,,0,"percent of total billed charges","50% of total billed charges",23.35,16.8,,18.68,,,0,"percent of total billed charges","16.8% of total billed charges",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.05,17.304,,19.24,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.57,63,,70.06,,,0,"percent of total billed charges","63% of total billed charges",21.27,15.3,,17.02,,,0,"percent of total billed charges","15.3% of total billed charges",23.35,16.8,,18.68,,,0,"percent of total billed charges","16.8% of total billed charges",95.91,69,,,,,0,"fee schedule","69% of total billed charges",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.97,61.85,,68.78,,,0,"percent of total billed charges","61.5% of total billed charges",23.35,16.8,,18.68,,,0,"percent of total billed charges","16.8% of total billed charges",69.5,50,,55.60,,,0,"percent of total billed charges","50% of total billed charges",44.76,32.2,,35.81,,,0,"percent of total billed charges","32.2% of total billed charges",23.35,16.8,,18.68,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.82,17.136,,19.06,,,0,"percent of total billed charges","17.136% of total billed charges",30.36,21.84,,24.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",52.4,37.7,,41.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",108.42,78,,86.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,82.6,,91.85,,,0,"percent of total billed charges","82.6% of total billed charges",23.35,16.8,,18.68,,,0,"percent of total billed charges","16.8% of total billed charges",69.5,50,,55.60,,,0,"percent of total billed charges","50% of total billed charges",114.81,82.6,,91.85,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.35,16.8,,18.68,,,0,"percent of total billed charges","16.8% of total billed charges",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",21.27,139,
"POUCH STERILIZATION 4 X 8",203171,CDM,272,RC,,,OUTPATIENT,,,94,61.1,,82.72,88,,66.18,,,0,"percent of total billed charges","88% of total billed charges",47,50,,37.60,,,0,"percent of total billed charges","50% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.27,17.304,,13.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.22,63,,47.38,,,0,"percent of total billed charges","63% of total billed charges",14.38,15.3,,11.50,,,0,"percent of total billed charges","15.3% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",64.86,69,,,,,0,"fee schedule","69% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.14,61.85,,46.51,,,0,"percent of total billed charges","61.5% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",47,50,,37.60,,,0,"percent of total billed charges","50% of total billed charges",30.27,32.2,,24.22,,,0,"percent of total billed charges","32.2% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.11,17.136,,12.89,,,0,"percent of total billed charges","17.136% of total billed charges",20.53,21.84,,16.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.44,37.7,,28.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",73.32,78,,58.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",47,50,,37.60,,,0,"percent of total billed charges","50% of total billed charges",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",14.38,94,
"POUCH STERILIZATION 8 X 13",204987,CDM,272,RC,,,OUTPATIENT,,,232,150.8,,204.16,88,,163.33,,,0,"percent of total billed charges","88% of total billed charges",116,50,,92.80,,,0,"percent of total billed charges","50% of total billed charges",38.98,16.8,,31.18,,,0,"percent of total billed charges","16.8% of total billed charges",232,100,,185.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.15,17.304,,32.12,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",146.16,63,,116.93,,,0,"percent of total billed charges","63% of total billed charges",35.5,15.3,,28.40,,,0,"percent of total billed charges","15.3% of total billed charges",38.98,16.8,,31.18,,,0,"percent of total billed charges","16.8% of total billed charges",160.08,69,,,,,0,"fee schedule","69% of total billed charges",232,100,,185.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",232,100,,185.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",232,100,,185.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",143.49,61.85,,114.79,,,0,"percent of total billed charges","61.5% of total billed charges",38.98,16.8,,31.18,,,0,"percent of total billed charges","16.8% of total billed charges",116,50,,92.80,,,0,"percent of total billed charges","50% of total billed charges",74.7,32.2,,59.76,,,0,"percent of total billed charges","32.2% of total billed charges",38.98,16.8,,31.18,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.76,17.136,,31.81,,,0,"percent of total billed charges","17.136% of total billed charges",50.67,21.84,,40.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",87.46,37.7,,69.97,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",180.96,78,,144.77,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.63,82.6,,153.30,,,0,"percent of total billed charges","82.6% of total billed charges",38.98,16.8,,31.18,,,0,"percent of total billed charges","16.8% of total billed charges",116,50,,92.80,,,0,"percent of total billed charges","50% of total billed charges",191.63,82.6,,153.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.98,16.8,,31.18,,,0,"percent of total billed charges","16.8% of total billed charges",232,100,,185.60,,,0,"percent of total billed charges","100% of total billed charges",35.5,232,
"POUCH ANAEROBE GENERATOR SMALL",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"POUCH SELF SEAL 3.5X5.25",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"POUCH SELF SEAL 4X11",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"POUCH SELF SEAL 12X15",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"POUCH SELF SEAL 13X18",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"POVIDONE IODINE LIQUID POUCHES 3/4 oz",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"POWERGLIDE PRO 18 GA X 10CM BASIC",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"POWERGLIDE PRO 18 GA X 10CM FULL",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"POWERGLIDE PRO 18 GA X 8CM BASIC",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"POWERGLIDE PRO 18GA X 8CM FULL",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"POWERGLIDE PRO 20 GA X 10CM BASIC",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"POWERGLIDE PRO 20 GA X 18CM FULL",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"POWERGLIDE PRO 20 GA X 8CM BASIC",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"POWERGLIDE PRO 20GA 10CM FULL",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"POWERGLIDE PRO 22GA X 8CM BASIC",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"POWERGLIDE PRO 22GA X 8CM FULL",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"POWERLINE MIDLINE KITS 20GA 10CM",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"POWER PORT MRI 8FR ATTACHABLE CATH",ORSUP0019,CDM,278,RC,,,OUTPATIENT,,,824,535.6,,725.12,88,,580.10,,,0,"percent of total billed charges","88% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.58,17.304,,114.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",519.12,63,,415.30,,,0,"percent of total billed charges","63% of total billed charges",126.07,15.3,,100.86,,,0,"percent of total billed charges","15.3% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",568.56,69,,,,,0,"fee schedule","69% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.64,61.85,,407.71,,,0,"percent of total billed charges","61.5% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",265.33,32.2,,212.26,,,0,"percent of total billed charges","32.2% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",141.2,17.136,,112.96,,,0,"percent of total billed charges","17.136% of total billed charges",179.96,21.84,,143.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",310.65,37.7,,248.52,,,0,"percent of total billed charges","37.7% of total billed charges",310.65,37.7,,248.52,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",279.34,33.9,,223.47,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.72,78,,514.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",126.07,824,
"POWER PULSE KIT",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"POWER PORT 8FR SNGL LUMEN BARD",ORSUP0026,CDM,270,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"POWER PORT 8 FR CLEARVIEW MRI",ORSUP0027,CDM,278,RC,,,OUTPATIENT,,,1648,1071.2,,1450.24,88,,1160.19,,,0,"percent of total billed charges","88% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",285.17,17.304,,228.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1038.24,63,,830.59,,,0,"percent of total billed charges","63% of total billed charges",252.14,15.3,,201.71,,,0,"percent of total billed charges","15.3% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1137.12,69,,,,,0,"fee schedule","69% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.29,61.85,,815.43,,,0,"percent of total billed charges","61.5% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",530.66,32.2,,424.53,,,0,"percent of total billed charges","32.2% of total billed charges",514.18,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",282.4,17.136,,225.92,,,0,"percent of total billed charges","17.136% of total billed charges",359.92,21.84,,287.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",621.3,37.7,,497.04,,,0,"percent of total billed charges","37.7% of total billed charges",621.3,37.7,,497.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",558.67,33.9,,446.94,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1285.44,78,,1028.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1361.25,82.6,,1089.00,,,0,"percent of total billed charges","82.6% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",1361.25,82.6,,1089.00,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",252.14,1648,
"POWER PICC KIT 5 FR",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"POWERLOC 20G X 3/4 INFUSION SET",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"POWER PORT OPEN-ENDED",ORSUP0027,CDM,278,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",1086.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.7% of total billed charges",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1180.06,33.9,,944.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"POWERLOC  20G X .75  SAFTEY INFUSION SET",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"POWERLOC INJECTABLE PORT ACCESS KIT 20GAX1",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"POWERLOC INJECTALE PORT ACCESS KIT 20GAX0.75",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"POWER DRIVER EZ-IO",ORSUP0019,CDM,272,RC,,,OUTPATIENT,,,1648,1071.2,,1450.24,88,,1160.19,,,0,"percent of total billed charges","88% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",285.17,17.304,,228.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1038.24,63,,830.59,,,0,"percent of total billed charges","63% of total billed charges",252.14,15.3,,201.71,,,0,"percent of total billed charges","15.3% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1137.12,69,,,,,0,"fee schedule","69% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.29,61.85,,815.43,,,0,"percent of total billed charges","61.5% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",530.66,32.2,,424.53,,,0,"percent of total billed charges","32.2% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",282.4,17.136,,225.92,,,0,"percent of total billed charges","17.136% of total billed charges",359.92,21.84,,287.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",621.3,37.7,,497.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1285.44,78,,1028.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1361.25,82.6,,1089.00,,,0,"percent of total billed charges","82.6% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",1361.25,82.6,,1089.00,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",252.14,1648,
"POWERLOC PORT ACCESS 20G X 1.5",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.7% of total billed charges",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.46,33.9,,69.97,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"POWERLOC PORT ACCESS 20G X 1",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.7% of total billed charges",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.46,33.9,,69.97,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"PRE-OP HAIR REMOVAL MITT",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"PRECISION 75MM SQUARE HEADED",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"PRECISION SPEED TAC",ORSUP0033,CDM,272,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"PRECISION NEURO DRILL (BURR)",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"PRECISION SYSTEMS STANDARD 500",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"PRECISION SYSTEMS STANDARD 1500",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"PREEMIE HEARING TEST EARTIPS 3MM PINK",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"PRELOADED 10FR X 7CM CENTER BEND SYSTEM",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1185,770.25,,1042.8,88,,834.24,,,0,"percent of total billed charges","88% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",205.05,17.304,,164.04,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",746.55,63,,597.24,,,0,"percent of total billed charges","63% of total billed charges",181.31,15.3,,145.05,,,0,"percent of total billed charges","15.3% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",817.65,69,,,,,0,"fee schedule","69% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.92,61.85,,586.34,,,0,"percent of total billed charges","61.5% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",381.57,32.2,,305.26,,,0,"percent of total billed charges","32.2% of total billed charges",369.72,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",203.06,17.136,,162.45,,,0,"percent of total billed charges","17.136% of total billed charges",258.8,21.84,,207.04,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",446.75,37.7,,357.40,,,0,"percent of total billed charges","37.7% of total billed charges",446.75,37.7,,357.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",401.72,33.9,,321.38,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",924.3,78,,739.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",181.31,1185,
"PREMIUM 40 CLIPPER BLADE ASSEMBLY 20 EA/CS",271045,CDM,272,RC,,,OUTPATIENT,,,61,39.65,,53.68,88,,42.94,,,0,"percent of total billed charges","88% of total billed charges",30.5,50,,24.40,,,0,"percent of total billed charges","50% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.56,17.304,,8.45,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.43,63,,30.74,,,0,"percent of total billed charges","63% of total billed charges",9.33,15.3,,7.46,,,0,"percent of total billed charges","15.3% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",42.09,69,,,,,0,"fee schedule","69% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.73,61.85,,30.18,,,0,"percent of total billed charges","61.5% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",30.5,50,,24.40,,,0,"percent of total billed charges","50% of total billed charges",19.64,32.2,,15.71,,,0,"percent of total billed charges","32.2% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.45,17.136,,8.36,,,0,"percent of total billed charges","17.136% of total billed charges",13.32,21.84,,10.66,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23,37.7,,18.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47.58,78,,38.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.39,82.6,,40.31,,,0,"percent of total billed charges","82.6% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",30.5,50,,24.40,,,0,"percent of total billed charges","50% of total billed charges",50.39,82.6,,40.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",9.33,61,
"PREOPERATIVE PREP CLOTHS WITH 2% CHG 2 CLOTHS PER PACK",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"PREP DURA PREP SURG SOL",169497,CDM,270,RC,,,OUTPATIENT,,,35,22.75,,30.8,88,,24.64,,,0,"percent of total billed charges","88% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.06,17.304,,4.85,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.05,63,,17.64,,,0,"percent of total billed charges","63% of total billed charges",5.36,15.3,,4.29,,,0,"percent of total billed charges","15.3% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",24.15,69,,,,,0,"fee schedule","69% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.65,61.85,,17.32,,,0,"percent of total billed charges","61.5% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",11.27,32.2,,9.02,,,0,"percent of total billed charges","32.2% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,17.136,,4.80,,,0,"percent of total billed charges","17.136% of total billed charges",7.64,21.84,,6.11,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.2,37.7,,10.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",27.3,78,,21.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.91,82.6,,23.13,,,0,"percent of total billed charges","82.6% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",28.91,82.6,,23.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",5.36,35,
"PRESOAK CLN PROLYSTICA ENZYM 4GL/CA",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"PRESSURE MONITORING TRANSDUCER",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"PRESSURE INFUSION BAG 3000ML",491089,CDM,270,RC,,,OUTPATIENT,,,111,72.15,,97.68,88,,78.14,,,0,"percent of total billed charges","88% of total billed charges",55.5,50,,44.40,,,0,"percent of total billed charges","50% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.21,17.304,,15.37,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.93,63,,55.94,,,0,"percent of total billed charges","63% of total billed charges",16.98,15.3,,13.58,,,0,"percent of total billed charges","15.3% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",76.59,69,,,,,0,"fee schedule","69% of total billed charges",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.65,61.85,,54.92,,,0,"percent of total billed charges","61.5% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",55.5,50,,44.40,,,0,"percent of total billed charges","50% of total billed charges",35.74,32.2,,28.59,,,0,"percent of total billed charges","32.2% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.02,17.136,,15.22,,,0,"percent of total billed charges","17.136% of total billed charges",24.24,21.84,,19.39,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.85,37.7,,33.48,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",86.58,78,,69.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.69,82.6,,73.35,,,0,"percent of total billed charges","82.6% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",55.5,50,,44.40,,,0,"percent of total billed charges","50% of total billed charges",91.69,82.6,,73.35,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",16.98,111,
"PRESSURE INFUSION BAG DISP 500ML",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"PREVENA PEEL \\T\\ PLACE 20CM",ORSUP0027,CDM,270,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"PRINT PACK THERMAL COLOR UPC-55",ORSUP0017,CDM,270,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"PRINTER PAPER THERMAL DSD/SSD",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"PRINTER PAPER PK PRINTER ROCHE",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"PRIORITY ONE ASPIRATION CATHETER",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",751.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.7% of total billed charges",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",816.99,33.9,,653.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"PRO-VENT PLUS 1ML DRY LITHIUM HEPARIN",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"PROBE RECTAL ESO 9FR",124296,CDM,270,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"PROBE BALL TIOP NUEROVISION",ORSUP0021,CDM,270,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"PROBE COVER 3-D 6 INCHX96 INCH WITH GEL",ORSUP0019,CDM,270,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"PROBE TEMP  ORAL/AXILLARY W/4' CORD",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"PROBE INCREMENTING 8225825",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"PROBE ARGON LAP HANDPIECE 5MM",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"PROBE ENDOSCOPIC INJECTION GOLD 7F 210CM L",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"PROBE GOLD 10FR (6016)",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"PROBE MUTING NIM SYSTEM",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"PROBE BICAP HEMOSTATIC 10 FR",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"PROBE BICAP HEMOSTATIC 7FR",ORSUP0011,CDM,270,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"PROBE STRAIGHTFIRE 2.3MMX220 FIAPC",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1185,770.25,,1042.8,88,,834.24,,,0,"percent of total billed charges","88% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",205.05,17.304,,164.04,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",746.55,63,,597.24,,,0,"percent of total billed charges","63% of total billed charges",181.31,15.3,,145.05,,,0,"percent of total billed charges","15.3% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",817.65,69,,,,,0,"fee schedule","69% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.92,61.85,,586.34,,,0,"percent of total billed charges","61.5% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",381.57,32.2,,305.26,,,0,"percent of total billed charges","32.2% of total billed charges",369.72,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",203.06,17.136,,162.45,,,0,"percent of total billed charges","17.136% of total billed charges",258.8,21.84,,207.04,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",446.75,37.7,,357.40,,,0,"percent of total billed charges","37.7% of total billed charges",446.75,37.7,,357.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",401.72,33.9,,321.38,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",924.3,78,,739.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",181.31,1185,
"PROBE-G RFID",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"PROBE TEMPERATURE 9FR STERILE ESOPHAGEAL/RECTAL",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"PROBE COVERS ECLIPSE NONSTERILE ULTRASOUND",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"PROBE STRIKE SHEATH",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"PROCISE MAX",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"PROCINCH 11MM CONCAVE SLOTTED BUTTON",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1185,770.25,,1042.8,88,,834.24,,,0,"percent of total billed charges","88% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",205.05,17.304,,164.04,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",746.55,63,,597.24,,,0,"percent of total billed charges","63% of total billed charges",181.31,15.3,,145.05,,,0,"percent of total billed charges","15.3% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",817.65,69,,,,,0,"fee schedule","69% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.92,61.85,,586.34,,,0,"percent of total billed charges","61.5% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",381.57,32.2,,305.26,,,0,"percent of total billed charges","32.2% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",203.06,17.136,,162.45,,,0,"percent of total billed charges","17.136% of total billed charges",258.8,21.84,,207.04,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",446.75,37.7,,357.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",924.3,78,,739.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",181.31,1185,
"PROCINCH 14MM CONCAVE SLOTTED BUTTON",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1185,770.25,,1042.8,88,,834.24,,,0,"percent of total billed charges","88% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",205.05,17.304,,164.04,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",746.55,63,,597.24,,,0,"percent of total billed charges","63% of total billed charges",181.31,15.3,,145.05,,,0,"percent of total billed charges","15.3% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",817.65,69,,,,,0,"fee schedule","69% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.92,61.85,,586.34,,,0,"percent of total billed charges","61.5% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",381.57,32.2,,305.26,,,0,"percent of total billed charges","32.2% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",203.06,17.136,,162.45,,,0,"percent of total billed charges","17.136% of total billed charges",258.8,21.84,,207.04,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",446.75,37.7,,357.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",924.3,78,,739.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",181.31,1185,
"PROCINCH 20MM CONCAVE SLOTTED BUTTON",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1185,770.25,,1042.8,88,,834.24,,,0,"percent of total billed charges","88% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",205.05,17.304,,164.04,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",746.55,63,,597.24,,,0,"percent of total billed charges","63% of total billed charges",181.31,15.3,,145.05,,,0,"percent of total billed charges","15.3% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",817.65,69,,,,,0,"fee schedule","69% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.92,61.85,,586.34,,,0,"percent of total billed charges","61.5% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",381.57,32.2,,305.26,,,0,"percent of total billed charges","32.2% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",203.06,17.136,,162.45,,,0,"percent of total billed charges","17.136% of total billed charges",258.8,21.84,,207.04,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",446.75,37.7,,357.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",924.3,78,,739.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",181.31,1185,
"PROCINCH 8X12MM FLAT SLOTTED BUTTON",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1030,669.5,,906.4,88,,725.12,,,0,"percent of total billed charges","88% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.23,17.304,,142.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.9,63,,519.12,,,0,"percent of total billed charges","63% of total billed charges",157.59,15.3,,126.07,,,0,"percent of total billed charges","15.3% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",710.7,69,,,,,0,"fee schedule","69% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",637.06,61.85,,509.65,,,0,"percent of total billed charges","61.5% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",331.66,32.2,,265.33,,,0,"percent of total billed charges","32.2% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.5,17.136,,141.20,,,0,"percent of total billed charges","17.136% of total billed charges",224.95,21.84,,179.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",388.31,37.7,,310.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",803.4,78,,642.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",157.59,1030,
"PROCINCH 14MM FLAT SLOTTED BUTTON",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1030,669.5,,906.4,88,,725.12,,,0,"percent of total billed charges","88% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.23,17.304,,142.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.9,63,,519.12,,,0,"percent of total billed charges","63% of total billed charges",157.59,15.3,,126.07,,,0,"percent of total billed charges","15.3% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",710.7,69,,,,,0,"fee schedule","69% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",637.06,61.85,,509.65,,,0,"percent of total billed charges","61.5% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",331.66,32.2,,265.33,,,0,"percent of total billed charges","32.2% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.5,17.136,,141.20,,,0,"percent of total billed charges","17.136% of total billed charges",224.95,21.84,,179.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",388.31,37.7,,310.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",803.4,78,,642.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",157.59,1030,
"PROFILE V URINE DRUG SCREEN",ORSUP0024,CDM,272,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"PROGRIP 16X12 LAPAROSCOPIC ANATOMICAL LEFT",ORSUP0028,CDM,278,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",1169.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.7% of total billed charges",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.91,33.9,,1016.73,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"PROGRIP 16X12 LAPAROSCOPIC ANATOMICAL RIGHT",ORSUP0028,CDM,278,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",1169.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.7% of total billed charges",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.91,33.9,,1016.73,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"PROGRASP FORCEPS",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"PROLEX E. COLI 0157",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"PROLENE 7-0 24 INCH BV-175-7",241018,CDM,272,RC,,,OUTPATIENT,,,176,114.4,,154.88,88,,123.90,,,0,"percent of total billed charges","88% of total billed charges",88,50,,70.40,,,0,"percent of total billed charges","50% of total billed charges",29.57,16.8,,23.66,,,0,"percent of total billed charges","16.8% of total billed charges",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.46,17.304,,24.37,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.88,63,,88.70,,,0,"percent of total billed charges","63% of total billed charges",26.93,15.3,,21.54,,,0,"percent of total billed charges","15.3% of total billed charges",29.57,16.8,,23.66,,,0,"percent of total billed charges","16.8% of total billed charges",121.44,69,,,,,0,"fee schedule","69% of total billed charges",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",108.86,61.85,,87.09,,,0,"percent of total billed charges","61.5% of total billed charges",29.57,16.8,,23.66,,,0,"percent of total billed charges","16.8% of total billed charges",88,50,,70.40,,,0,"percent of total billed charges","50% of total billed charges",56.67,32.2,,45.34,,,0,"percent of total billed charges","32.2% of total billed charges",29.57,16.8,,23.66,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.16,17.136,,24.13,,,0,"percent of total billed charges","17.136% of total billed charges",38.44,21.84,,30.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",66.35,37.7,,53.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",137.28,78,,109.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",145.38,82.6,,116.30,,,0,"percent of total billed charges","82.6% of total billed charges",29.57,16.8,,23.66,,,0,"percent of total billed charges","16.8% of total billed charges",88,50,,70.40,,,0,"percent of total billed charges","50% of total billed charges",145.38,82.6,,116.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.57,16.8,,23.66,,,0,"percent of total billed charges","16.8% of total billed charges",176,100,,140.80,,,0,"percent of total billed charges","100% of total billed charges",26.93,176,
"PROLENE 3-0 FSL (8675H)",491098,CDM,272,RC,,,OUTPATIENT,,,23,14.95,,20.24,88,,16.19,,,0,"percent of total billed charges","88% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.98,17.304,,3.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.49,63,,11.59,,,0,"percent of total billed charges","63% of total billed charges",3.52,15.3,,2.82,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",15.87,69,,,,,0,"fee schedule","69% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.23,61.85,,11.38,,,0,"percent of total billed charges","61.5% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",7.41,32.2,,5.93,,,0,"percent of total billed charges","32.2% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.94,17.136,,3.15,,,0,"percent of total billed charges","17.136% of total billed charges",5.02,21.84,,4.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.94,78,,14.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",3.52,23,
"PROLENE 5-0 C-1 (8890H)",491099,CDM,272,RC,,,OUTPATIENT,,,57,37.05,,50.16,88,,40.13,,,0,"percent of total billed charges","88% of total billed charges",28.5,50,,22.80,,,0,"percent of total billed charges","50% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.86,17.304,,7.89,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.91,63,,28.73,,,0,"percent of total billed charges","63% of total billed charges",8.72,15.3,,6.98,,,0,"percent of total billed charges","15.3% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",39.33,69,,,,,0,"fee schedule","69% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.25,61.85,,28.20,,,0,"percent of total billed charges","61.5% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",28.5,50,,22.80,,,0,"percent of total billed charges","50% of total billed charges",18.35,32.2,,14.68,,,0,"percent of total billed charges","32.2% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.77,17.136,,7.82,,,0,"percent of total billed charges","17.136% of total billed charges",12.45,21.84,,9.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.49,37.7,,17.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",44.46,78,,35.57,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.08,82.6,,37.66,,,0,"percent of total billed charges","82.6% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",28.5,50,,22.80,,,0,"percent of total billed charges","50% of total billed charges",47.08,82.6,,37.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",8.72,57,
"PROLENE 5-0 PS-3 (8681G)",491100,CDM,272,RC,,,OUTPATIENT,,,40,26,,35.2,88,,28.16,,,0,"percent of total billed charges","88% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.92,17.304,,5.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.2,63,,20.16,,,0,"percent of total billed charges","63% of total billed charges",6.12,15.3,,4.90,,,0,"percent of total billed charges","15.3% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",27.6,69,,,,,0,"fee schedule","69% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.74,61.85,,19.79,,,0,"percent of total billed charges","61.5% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",12.88,32.2,,10.30,,,0,"percent of total billed charges","32.2% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.85,17.136,,5.48,,,0,"percent of total billed charges","17.136% of total billed charges",8.74,21.84,,6.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.08,37.7,,12.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",31.2,78,,24.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",6.12,40,
"PROLENE 6-0 BV-1 (8806H)",491101,CDM,272,RC,,,OUTPATIENT,,,112,72.8,,98.56,88,,78.85,,,0,"percent of total billed charges","88% of total billed charges",56,50,,44.80,,,0,"percent of total billed charges","50% of total billed charges",18.82,16.8,,15.06,,,0,"percent of total billed charges","16.8% of total billed charges",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.38,17.304,,15.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.56,63,,56.45,,,0,"percent of total billed charges","63% of total billed charges",17.14,15.3,,13.71,,,0,"percent of total billed charges","15.3% of total billed charges",18.82,16.8,,15.06,,,0,"percent of total billed charges","16.8% of total billed charges",77.28,69,,,,,0,"fee schedule","69% of total billed charges",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.27,61.85,,55.42,,,0,"percent of total billed charges","61.5% of total billed charges",18.82,16.8,,15.06,,,0,"percent of total billed charges","16.8% of total billed charges",56,50,,44.80,,,0,"percent of total billed charges","50% of total billed charges",36.06,32.2,,28.85,,,0,"percent of total billed charges","32.2% of total billed charges",18.82,16.8,,15.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.19,17.136,,15.35,,,0,"percent of total billed charges","17.136% of total billed charges",24.46,21.84,,19.57,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",42.22,37.7,,33.78,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",87.36,78,,69.89,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.51,82.6,,74.01,,,0,"percent of total billed charges","82.6% of total billed charges",18.82,16.8,,15.06,,,0,"percent of total billed charges","16.8% of total billed charges",56,50,,44.80,,,0,"percent of total billed charges","50% of total billed charges",92.51,82.6,,74.01,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.82,16.8,,15.06,,,0,"percent of total billed charges","16.8% of total billed charges",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",17.14,112,
"PROLENE 6-0 P-3 (8695G)",491102,CDM,272,RC,,,OUTPATIENT,,,43,27.95,,37.84,88,,30.27,,,0,"percent of total billed charges","88% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.44,17.304,,5.95,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.09,63,,21.67,,,0,"percent of total billed charges","63% of total billed charges",6.58,15.3,,5.26,,,0,"percent of total billed charges","15.3% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",29.67,69,,,,,0,"fee schedule","69% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.6,61.85,,21.28,,,0,"percent of total billed charges","61.5% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",13.85,32.2,,11.08,,,0,"percent of total billed charges","32.2% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.37,17.136,,5.90,,,0,"percent of total billed charges","17.136% of total billed charges",9.39,21.84,,7.51,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.21,37.7,,12.97,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",33.54,78,,26.83,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.52,82.6,,28.42,,,0,"percent of total billed charges","82.6% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",35.52,82.6,,28.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",6.58,43,
"PROSTHESIS H/R PARTIAL 90DEGRE",ORSUP0023,CDM,270,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"PROTECTOR INST 2IN RND .312IN RETR RADPQ STM STRL GLPI LF",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"PROTACK FIXATION DEVICE BY COVIDIEN",ORSUP0026,CDM,272,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"PROTEUS MIRABILIS ATCC 12453 CULTI LOOPS",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"PROTOCOL C \\T\\ S KIT",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"MESH PHASIX ST RECTANGLE 3X4 IN",ORSUP0097,CDM,278,RC,,,OUTPATIENT,,,23566,15317.9,,20738.08,88,,16590.46,,,0,"percent of total billed charges","88% of total billed charges",11783,50,,9426.40,,,0,"percent of total billed charges","50% of total billed charges",3959.09,16.8,,3167.27,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4077.86,17.304,,3262.29,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14846.58,63,,11877.26,,,0,"percent of total billed charges","63% of total billed charges",3605.6,15.3,,2884.48,,,0,"percent of total billed charges","15.3% of total billed charges",3959.09,16.8,,3167.27,,,0,"percent of total billed charges","16.8% of total billed charges",16260.54,69,,,,,0,"fee schedule","69% of total billed charges",23566,100,,18852.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23566,100,,18852.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23566,100,,18852.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14575.57,61.85,,11660.46,,,0,"percent of total billed charges","61.5% of total billed charges",3959.09,16.8,,3167.27,,,0,"percent of total billed charges","16.8% of total billed charges",11783,50,,9426.40,,,0,"percent of total billed charges","50% of total billed charges",7588.25,32.2,,6070.60,,,0,"percent of total billed charges","32.2% of total billed charges",7352.59,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",4038.27,17.136,,3230.62,,,0,"percent of total billed charges","17.136% of total billed charges",5146.81,21.84,,4117.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",8884.38,37.7,,7107.50,,,0,"percent of total billed charges","37.7% of total billed charges",8884.38,37.7,,7107.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",7988.87,33.9,,6391.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",18381.48,78,,14705.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19465.52,82.6,,15572.42,,,0,"percent of total billed charges","82.6% of total billed charges",3959.09,16.8,,3167.27,,,0,"percent of total billed charges","16.8% of total billed charges",11783,50,,9426.40,,,0,"percent of total billed charges","50% of total billed charges",19465.52,82.6,,15572.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3959.09,16.8,,3167.27,,,0,"percent of total billed charges","16.8% of total billed charges",23566,100,,18852.80,,,0,"percent of total billed charges","100% of total billed charges",3605.6,23566,
"PSA 100 WELLS",ORSUP0018,CDM,272,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"PSA CALIBRATOR BOX /1 SET",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"PSI COMPACT REGULATORS",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1185,770.25,,1042.8,88,,834.24,,,0,"percent of total billed charges","88% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",205.05,17.304,,164.04,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",746.55,63,,597.24,,,0,"percent of total billed charges","63% of total billed charges",181.31,15.3,,145.05,,,0,"percent of total billed charges","15.3% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",817.65,69,,,,,0,"fee schedule","69% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.92,61.85,,586.34,,,0,"percent of total billed charges","61.5% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",381.57,32.2,,305.26,,,0,"percent of total billed charges","32.2% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",203.06,17.136,,162.45,,,0,"percent of total billed charges","17.136% of total billed charges",258.8,21.84,,207.04,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",446.75,37.7,,357.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",924.3,78,,739.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",181.31,1185,
"PT SLIPPER ADULT LARGE (BLUE)",491104,CDM,270,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"PT SLIPPER ADULT X-LARGE (BEIGE)",491105,CDM,270,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"PT SLIPPERS PEDIATRIC",491106,CDM,270,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"PUDDING VARIBAR MULTI DOSE F/ SWALLOW FUNC STDY 230ML",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"PULL UPS XXL",432709,CDM,272,RC,,,OUTPATIENT,,,116,75.4,,102.08,88,,81.66,,,0,"percent of total billed charges","88% of total billed charges",58,50,,46.40,,,0,"percent of total billed charges","50% of total billed charges",19.49,16.8,,15.59,,,0,"percent of total billed charges","16.8% of total billed charges",116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.07,17.304,,16.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",73.08,63,,58.46,,,0,"percent of total billed charges","63% of total billed charges",17.75,15.3,,14.20,,,0,"percent of total billed charges","15.3% of total billed charges",19.49,16.8,,15.59,,,0,"percent of total billed charges","16.8% of total billed charges",80.04,69,,,,,0,"fee schedule","69% of total billed charges",116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.75,61.85,,57.40,,,0,"percent of total billed charges","61.5% of total billed charges",19.49,16.8,,15.59,,,0,"percent of total billed charges","16.8% of total billed charges",58,50,,46.40,,,0,"percent of total billed charges","50% of total billed charges",37.35,32.2,,29.88,,,0,"percent of total billed charges","32.2% of total billed charges",19.49,16.8,,15.59,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.88,17.136,,15.90,,,0,"percent of total billed charges","17.136% of total billed charges",25.33,21.84,,20.26,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.73,37.7,,34.98,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",90.48,78,,72.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.82,82.6,,76.66,,,0,"percent of total billed charges","82.6% of total billed charges",19.49,16.8,,15.59,,,0,"percent of total billed charges","16.8% of total billed charges",58,50,,46.40,,,0,"percent of total billed charges","50% of total billed charges",95.82,82.6,,76.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.49,16.8,,15.59,,,0,"percent of total billed charges","16.8% of total billed charges",116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",17.75,116,
"PULLUPS XLG",231386,CDM,272,RC,,,OUTPATIENT,,,276,179.4,,242.88,88,,194.30,,,0,"percent of total billed charges","88% of total billed charges",138,50,,110.40,,,0,"percent of total billed charges","50% of total billed charges",46.37,16.8,,37.10,,,0,"percent of total billed charges","16.8% of total billed charges",276,100,,220.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.76,17.304,,38.21,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.88,63,,139.10,,,0,"percent of total billed charges","63% of total billed charges",42.23,15.3,,33.78,,,0,"percent of total billed charges","15.3% of total billed charges",46.37,16.8,,37.10,,,0,"percent of total billed charges","16.8% of total billed charges",190.44,69,,,,,0,"fee schedule","69% of total billed charges",276,100,,220.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",276,100,,220.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",276,100,,220.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.71,61.85,,136.57,,,0,"percent of total billed charges","61.5% of total billed charges",46.37,16.8,,37.10,,,0,"percent of total billed charges","16.8% of total billed charges",138,50,,110.40,,,0,"percent of total billed charges","50% of total billed charges",88.87,32.2,,71.10,,,0,"percent of total billed charges","32.2% of total billed charges",46.37,16.8,,37.10,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.3,17.136,,37.84,,,0,"percent of total billed charges","17.136% of total billed charges",60.28,21.84,,48.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.05,37.7,,83.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",215.28,78,,172.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.98,82.6,,182.38,,,0,"percent of total billed charges","82.6% of total billed charges",46.37,16.8,,37.10,,,0,"percent of total billed charges","16.8% of total billed charges",138,50,,110.40,,,0,"percent of total billed charges","50% of total billed charges",227.98,82.6,,182.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,16.8,,37.10,,,0,"percent of total billed charges","16.8% of total billed charges",276,100,,220.80,,,0,"percent of total billed charges","100% of total billed charges",42.23,276,
"PULMOGUARD KITS",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"PUMP TUBE SOLUTION",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"PUMP TUBE WASTE",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"PUMP TUBING ELECTRODE MODULE",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"PUMP PAIN ON Q PM036-A",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"PUMP SYSTEM ACROBAT MECHANICAL OFF",ORSUP0034,CDM,272,RC,,,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1065.75,17.304,,852.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",942.33,15.3,,753.86,,,0,"percent of total billed charges","15.3% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3809.34,61.85,,3047.47,,,0,"percent of total billed charges","61.5% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1983.2,32.2,,1586.56,,,0,"percent of total billed charges","32.2% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1055.41,17.136,,844.33,,,0,"percent of total billed charges","17.136% of total billed charges",1345.13,21.84,,1076.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",942.33,6159,
"DRESSING PURAPLY MZ 100 MG",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"DRESSING PURAPLY MZ 500 MG",ORSUP0038,CDM,272,RC,,,OUTPATIENT,,,5562,3615.3,,4894.56,88,,3915.65,,,0,"percent of total billed charges","88% of total billed charges",2781,50,,2224.80,,,0,"percent of total billed charges","50% of total billed charges",934.42,16.8,,747.54,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",962.45,17.304,,769.96,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3504.06,63,,2803.25,,,0,"percent of total billed charges","63% of total billed charges",850.99,15.3,,680.79,,,0,"percent of total billed charges","15.3% of total billed charges",934.42,16.8,,747.54,,,0,"percent of total billed charges","16.8% of total billed charges",3837.78,69,,,,,0,"fee schedule","69% of total billed charges",5562,100,,4449.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5562,100,,4449.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5562,100,,4449.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3440.1,61.85,,2752.08,,,0,"percent of total billed charges","61.5% of total billed charges",934.42,16.8,,747.54,,,0,"percent of total billed charges","16.8% of total billed charges",2781,50,,2224.80,,,0,"percent of total billed charges","50% of total billed charges",1790.96,32.2,,1432.77,,,0,"percent of total billed charges","32.2% of total billed charges",934.42,16.8,,747.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",953.1,17.136,,762.48,,,0,"percent of total billed charges","17.136% of total billed charges",1214.74,21.84,,971.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2096.87,37.7,,1677.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4338.36,78,,3470.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4594.21,82.6,,3675.37,,,0,"percent of total billed charges","82.6% of total billed charges",934.42,16.8,,747.54,,,0,"percent of total billed charges","16.8% of total billed charges",2781,50,,2224.80,,,0,"percent of total billed charges","50% of total billed charges",4594.21,82.6,,3675.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",934.42,16.8,,747.54,,,0,"percent of total billed charges","16.8% of total billed charges",5562,100,,4449.60,,,0,"percent of total billed charges","100% of total billed charges",850.99,5562,
"DRESSING PURAPLY MZ 1000 MG",ORSUP0063,CDM,272,RC,,,OUTPATIENT,,,10918,7096.7,,9607.84,88,,7686.27,,,0,"percent of total billed charges","88% of total billed charges",5459,50,,4367.20,,,0,"percent of total billed charges","50% of total billed charges",1834.22,16.8,,1467.38,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1889.25,17.304,,1511.40,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6878.34,63,,5502.67,,,0,"percent of total billed charges","63% of total billed charges",1670.45,15.3,,1336.36,,,0,"percent of total billed charges","15.3% of total billed charges",1834.22,16.8,,1467.38,,,0,"percent of total billed charges","16.8% of total billed charges",7533.42,69,,,,,0,"fee schedule","69% of total billed charges",10918,100,,8734.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10918,100,,8734.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10918,100,,8734.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6752.78,61.85,,5402.22,,,0,"percent of total billed charges","61.5% of total billed charges",1834.22,16.8,,1467.38,,,0,"percent of total billed charges","16.8% of total billed charges",5459,50,,4367.20,,,0,"percent of total billed charges","50% of total billed charges",3515.6,32.2,,2812.48,,,0,"percent of total billed charges","32.2% of total billed charges",1834.22,16.8,,1467.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1870.91,17.136,,1496.73,,,0,"percent of total billed charges","17.136% of total billed charges",2384.49,21.84,,1907.59,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4116.09,37.7,,3292.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8516.04,78,,6812.83,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9018.27,82.6,,7214.62,,,0,"percent of total billed charges","82.6% of total billed charges",1834.22,16.8,,1467.38,,,0,"percent of total billed charges","16.8% of total billed charges",5459,50,,4367.20,,,0,"percent of total billed charges","50% of total billed charges",9018.27,82.6,,7214.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1834.22,16.8,,1467.38,,,0,"percent of total billed charges","16.8% of total billed charges",10918,100,,8734.40,,,0,"percent of total billed charges","100% of total billed charges",1670.45,10918,
"PURAPLY AM XT EXTRA FENESTRATED 4.91X4.91 CM",636Q4197491,CDM,636,RC,,,OUTPATIENT,,,10171,6611.15,,8950.48,88,,7160.38,,,0,"percent of total billed charges","88% of total billed charges",5085.5,50,,4068.40,,,0,"percent of total billed charges","50% of total billed charges",1708.73,16.8,,1366.98,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1759.99,17.304,,1407.99,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6407.73,63,,5126.18,,,0,"percent of total billed charges","63% of total billed charges",1556.16,15.3,,1244.93,,,0,"percent of total billed charges","15.3% of total billed charges",1708.73,16.8,,1366.98,,,0,"percent of total billed charges","16.8% of total billed charges",7017.99,69,,,,,0,"fee schedule","69% of total billed charges",10171,100,,8136.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10171,100,,8136.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10171,100,,8136.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6290.76,61.85,,5032.61,,,0,"percent of total billed charges","61.5% of total billed charges",1708.73,16.8,,1366.98,,,0,"percent of total billed charges","16.8% of total billed charges",5085.5,50,,4068.40,,,0,"percent of total billed charges","50% of total billed charges",3275.06,32.2,,2620.05,,,0,"percent of total billed charges","32.2% of total billed charges",1708.73,16.8,,1366.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1742.9,17.136,,1394.32,,,0,"percent of total billed charges","17.136% of total billed charges",2221.35,21.84,,1777.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3834.47,37.7,,3067.58,,,0,"percent of total billed charges","37.7% of total billed charges",3834.47,37.7,,3067.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3447.97,33.9,,2758.38,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7933.38,78,,6346.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1708.73,16.8,,1366.98,,,0,"percent of total billed charges","16.8% of total billed charges",5085.5,50,,4068.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1708.73,16.8,,1366.98,,,0,"percent of total billed charges","16.8% of total billed charges",10171,100,,8136.80,,,0,"percent of total billed charges","100% of total billed charges",1556.16,10171,
"PURAPLY AM DISC 16 MM",636Q419616,CDM,636,RC,,,OUTPATIENT,,,2266,1472.9,,1994.08,88,,1595.26,,,0,"percent of total billed charges","88% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",392.11,17.304,,313.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1427.58,63,,1142.06,,,0,"percent of total billed charges","63% of total billed charges",346.7,15.3,,277.36,,,0,"percent of total billed charges","15.3% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1563.54,69,,,,,0,"fee schedule","69% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1401.52,61.85,,1121.22,,,0,"percent of total billed charges","61.5% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",729.65,32.2,,583.72,,,0,"percent of total billed charges","32.2% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",388.3,17.136,,310.64,,,0,"percent of total billed charges","17.136% of total billed charges",494.89,21.84,,395.91,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",854.28,37.7,,683.42,,,0,"percent of total billed charges","37.7% of total billed charges",854.28,37.7,,683.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",768.17,33.9,,614.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1767.48,78,,1413.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",346.7,2266,
"PURE ENZYMATIC DETERGENT-SPEARMINT FRESH SCENT",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"PUSHLOCK 2.9 PEEK 12.5",ORSUP0019,CDM,278,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",668.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.7% of total billed charges",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",726.14,33.9,,580.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"PUSHLOCK BIO COMPOSITE 3.5",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",751.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.7% of total billed charges",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",816.99,33.9,,653.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"PUSHLOCK BIOCOMPOSITE-4.5MM",ORSUP0052,CDM,278,RC,,,OUTPATIENT,,,10980,7137,,9662.4,88,,7729.92,,,0,"percent of total billed charges","88% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1899.98,17.304,,1519.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6917.4,63,,5533.92,,,0,"percent of total billed charges","63% of total billed charges",1679.94,15.3,,1343.95,,,0,"percent of total billed charges","15.3% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",7576.2,69,,,,,0,"fee schedule","69% of total billed charges",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6791.13,61.85,,5432.90,,,0,"percent of total billed charges","61.5% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",3535.56,32.2,,2828.45,,,0,"percent of total billed charges","32.2% of total billed charges",3425.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1881.53,17.136,,1505.22,,,0,"percent of total billed charges","17.136% of total billed charges",2398.03,21.84,,1918.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4139.46,37.7,,3311.57,,,0,"percent of total billed charges","37.7% of total billed charges",4139.46,37.7,,3311.57,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3722.22,33.9,,2977.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",8564.4,78,,6851.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9069.48,82.6,,7255.58,,,0,"percent of total billed charges","82.6% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",9069.48,82.6,,7255.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",1679.94,10980,
"PUSHER CUTTER KNOT FASTFIX STR DISP",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"PUSHER STENT PANC 4/5FR",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"PUTTY DBX 0.5CC",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"PUTTY DBX MIX 10CC",ORSUP0044,CDM,278,RC,,,OUTPATIENT,,,8837,5744.05,,7776.56,88,,6221.25,,,0,"percent of total billed charges","88% of total billed charges",4418.5,50,,3534.80,,,0,"percent of total billed charges","50% of total billed charges",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1529.15,17.304,,1223.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5567.31,63,,4453.85,,,0,"percent of total billed charges","63% of total billed charges",1352.06,15.3,,1081.65,,,0,"percent of total billed charges","15.3% of total billed charges",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",6097.53,69,,,,,0,"fee schedule","69% of total billed charges",8837,100,,7069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8837,100,,7069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8837,100,,7069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5465.68,61.85,,4372.54,,,0,"percent of total billed charges","61.5% of total billed charges",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",4418.5,50,,3534.80,,,0,"percent of total billed charges","50% of total billed charges",2845.51,32.2,,2276.41,,,0,"percent of total billed charges","32.2% of total billed charges",2757.14,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1514.31,17.136,,1211.45,,,0,"percent of total billed charges","17.136% of total billed charges",1930,21.84,,1544.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3331.55,37.7,,2665.24,,,0,"percent of total billed charges","37.7% of total billed charges",3331.55,37.7,,2665.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2995.74,33.9,,2396.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6892.86,78,,5514.29,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7299.36,82.6,,5839.49,,,0,"percent of total billed charges","82.6% of total billed charges",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",4418.5,50,,3534.80,,,0,"percent of total billed charges","50% of total billed charges",7299.36,82.6,,5839.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1484.62,16.8,,1187.70,,,0,"percent of total billed charges","16.8% of total billed charges",8837,100,,7069.60,,,0,"percent of total billed charges","100% of total billed charges",1352.06,8837,
"PUTTY MASTERGRAFT 1.5CC",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"PUTTY MASTERGRAFT 12CC",ORSUP0034,CDM,278,RC,,,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1065.75,17.304,,852.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",942.33,15.3,,753.86,,,0,"percent of total billed charges","15.3% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3809.34,61.85,,3047.47,,,0,"percent of total billed charges","61.5% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1983.2,32.2,,1586.56,,,0,"percent of total billed charges","32.2% of total billed charges",1921.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1055.41,17.136,,844.33,,,0,"percent of total billed charges","17.136% of total billed charges",1345.13,21.84,,1076.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",942.33,6159,
"PUTTY MASTERGRAFT 6CC",ORSUP0024,CDM,278,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",1086.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.7% of total billed charges",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1180.06,33.9,,944.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"PUTTY MASTERGRAFT 9CC",ORSUP0030,CDM,278,RC,,,OUTPATIENT,,,5088,3307.2,,4477.44,88,,3581.95,,,0,"percent of total billed charges","88% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",880.43,17.304,,704.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3205.44,63,,2564.35,,,0,"percent of total billed charges","63% of total billed charges",778.46,15.3,,622.77,,,0,"percent of total billed charges","15.3% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",3510.72,69,,,,,0,"fee schedule","69% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3146.93,61.85,,2517.54,,,0,"percent of total billed charges","61.5% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",1638.34,32.2,,1310.67,,,0,"percent of total billed charges","32.2% of total billed charges",1587.46,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",871.88,17.136,,697.50,,,0,"percent of total billed charges","17.136% of total billed charges",1111.22,21.84,,888.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1918.18,37.7,,1534.54,,,0,"percent of total billed charges","37.7% of total billed charges",1918.18,37.7,,1534.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1724.83,33.9,,1379.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3968.64,78,,3174.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",778.46,5088,
"PUTTY NORIAN 5CC STERILE",ORSUP0045,CDM,278,RC,,,OUTPATIENT,,,9105,5918.25,,8012.4,88,,6409.92,,,0,"percent of total billed charges","88% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1575.53,17.304,,1260.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5736.15,63,,4588.92,,,0,"percent of total billed charges","63% of total billed charges",1393.07,15.3,,1114.46,,,0,"percent of total billed charges","15.3% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",6282.45,69,,,,,0,"fee schedule","69% of total billed charges",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5631.44,61.85,,4505.15,,,0,"percent of total billed charges","61.5% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",2931.81,32.2,,2345.45,,,0,"percent of total billed charges","32.2% of total billed charges",2840.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1560.23,17.136,,1248.18,,,0,"percent of total billed charges","17.136% of total billed charges",1988.53,21.84,,1590.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3432.59,37.7,,2746.07,,,0,"percent of total billed charges","37.7% of total billed charges",3432.59,37.7,,2746.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3086.6,33.9,,2469.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7101.9,78,,5681.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7520.73,82.6,,6016.58,,,0,"percent of total billed charges","82.6% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",7520.73,82.6,,6016.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",1393.07,9105,
"PVA EMBO PARTICLES 700",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"PVA FOAM EMBOLISM 300",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"PVC NASOPHARYNEAL AIRWAY 7MM 28FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"PWRD CURVED CIRCULAR STAPLER 31MM X 18CM",ORSUP0024,CDM,272,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"PYR DISC WITH REAGENT",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"Q CARE ORAL CLEANSING AND SUCTION SYSTEM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
Q-TIPS,491107,CDM,270,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"QC ESR-CHEX LEVEL 1  2 CORE",ORSUP0011,CDM,270,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"QC+ LEVEL 1",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"QC5+ LEVEL 2",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"QC5+ LEVEL3",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"QFIX W/NEEDLE #0 SUTURE",ORSUP0022,CDM,278,RC,,,OUTPATIENT,,,2266,1472.9,,1994.08,88,,1595.26,,,0,"percent of total billed charges","88% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",392.11,17.304,,313.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1427.58,63,,1142.06,,,0,"percent of total billed charges","63% of total billed charges",346.7,15.3,,277.36,,,0,"percent of total billed charges","15.3% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1563.54,69,,,,,0,"fee schedule","69% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1401.52,61.85,,1121.22,,,0,"percent of total billed charges","61.5% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",729.65,32.2,,583.72,,,0,"percent of total billed charges","32.2% of total billed charges",706.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",388.3,17.136,,310.64,,,0,"percent of total billed charges","17.136% of total billed charges",494.89,21.84,,395.91,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",854.28,37.7,,683.42,,,0,"percent of total billed charges","37.7% of total billed charges",854.28,37.7,,683.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",768.17,33.9,,614.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1767.48,78,,1413.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1871.72,82.6,,1497.38,,,0,"percent of total billed charges","82.6% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",1871.72,82.6,,1497.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",346.7,2266,
"QUAD NAV",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"QUANTIFY ADVANCE LIQ CONTROL",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"QUEASE EASE",ORSUP0018,CDM,272,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"QUICK VUE HCG SERUM CONTROL",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"QUICK STIK",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"QUICK VUE CONTROL SOLUTION",491108,CDM,270,RC,,,OUTPATIENT,,,192,124.8,,168.96,88,,135.17,,,0,"percent of total billed charges","88% of total billed charges",96,50,,76.80,,,0,"percent of total billed charges","50% of total billed charges",32.26,16.8,,25.81,,,0,"percent of total billed charges","16.8% of total billed charges",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.22,17.304,,26.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",120.96,63,,96.77,,,0,"percent of total billed charges","63% of total billed charges",29.38,15.3,,23.50,,,0,"percent of total billed charges","15.3% of total billed charges",32.26,16.8,,25.81,,,0,"percent of total billed charges","16.8% of total billed charges",132.48,69,,,,,0,"fee schedule","69% of total billed charges",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",118.75,61.85,,95.00,,,0,"percent of total billed charges","61.5% of total billed charges",32.26,16.8,,25.81,,,0,"percent of total billed charges","16.8% of total billed charges",96,50,,76.80,,,0,"percent of total billed charges","50% of total billed charges",61.82,32.2,,49.46,,,0,"percent of total billed charges","32.2% of total billed charges",32.26,16.8,,25.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.9,17.136,,26.32,,,0,"percent of total billed charges","17.136% of total billed charges",41.93,21.84,,33.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",72.38,37.7,,57.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",149.76,78,,119.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.59,82.6,,126.87,,,0,"percent of total billed charges","82.6% of total billed charges",32.26,16.8,,25.81,,,0,"percent of total billed charges","16.8% of total billed charges",96,50,,76.80,,,0,"percent of total billed charges","50% of total billed charges",158.59,82.6,,126.87,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.26,16.8,,25.81,,,0,"percent of total billed charges","16.8% of total billed charges",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",29.38,192,
"QUICK VUE TEST KIT",491109,CDM,270,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"QUICKSET 5CC KIT",ORSUP0047,CDM,278,RC,,,OUTPATIENT,,,8302,5396.3,,7305.76,88,,5844.61,,,0,"percent of total billed charges","88% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1436.58,17.304,,1149.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5230.26,63,,4184.21,,,0,"percent of total billed charges","63% of total billed charges",1270.21,15.3,,1016.17,,,0,"percent of total billed charges","15.3% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",5728.38,69,,,,,0,"fee schedule","69% of total billed charges",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5134.79,61.85,,4107.83,,,0,"percent of total billed charges","61.5% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",2673.24,32.2,,2138.59,,,0,"percent of total billed charges","32.2% of total billed charges",2590.22,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1422.63,17.136,,1138.10,,,0,"percent of total billed charges","17.136% of total billed charges",1813.16,21.84,,1450.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3129.85,37.7,,2503.88,,,0,"percent of total billed charges","37.7% of total billed charges",3129.85,37.7,,2503.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2814.38,33.9,,2251.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6475.56,78,,5180.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6857.45,82.6,,5485.96,,,0,"percent of total billed charges","82.6% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",6857.45,82.6,,5485.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",1270.21,8302,
"QUICK CLEAR ASPIRATION DEVICE",ORSUP0060,CDM,272,RC,,,OUTPATIENT,,,10300,6695,,9064,88,,7251.20,,,0,"percent of total billed charges","88% of total billed charges",5150,50,,4120.00,,,0,"percent of total billed charges","50% of total billed charges",1730.4,16.8,,1384.32,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1782.31,17.304,,1425.85,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6489,63,,5191.20,,,0,"percent of total billed charges","63% of total billed charges",1575.9,15.3,,1260.72,,,0,"percent of total billed charges","15.3% of total billed charges",1730.4,16.8,,1384.32,,,0,"percent of total billed charges","16.8% of total billed charges",7107,69,,,,,0,"fee schedule","69% of total billed charges",10300,100,,8240.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10300,100,,8240.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10300,100,,8240.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6370.55,61.85,,5096.44,,,0,"percent of total billed charges","61.5% of total billed charges",1730.4,16.8,,1384.32,,,0,"percent of total billed charges","16.8% of total billed charges",5150,50,,4120.00,,,0,"percent of total billed charges","50% of total billed charges",3316.6,32.2,,2653.28,,,0,"percent of total billed charges","32.2% of total billed charges",1730.4,16.8,,1384.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1765.01,17.136,,1412.01,,,0,"percent of total billed charges","17.136% of total billed charges",2249.52,21.84,,1799.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3883.1,37.7,,3106.48,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8034,78,,6427.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8507.8,82.6,,6806.24,,,0,"percent of total billed charges","82.6% of total billed charges",1730.4,16.8,,1384.32,,,0,"percent of total billed charges","16.8% of total billed charges",5150,50,,4120.00,,,0,"percent of total billed charges","50% of total billed charges",8507.8,82.6,,6806.24,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1730.4,16.8,,1384.32,,,0,"percent of total billed charges","16.8% of total billed charges",10300,100,,8240.00,,,0,"percent of total billed charges","100% of total billed charges",1575.9,10300,
"R SYRINGE",ORSUP0026,CDM,272,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"R-X-FIX RAIL 2.75 INCH 03-5000",ORSUP0042,CDM,278,RC,,,OUTPATIENT,,,8302,5396.3,,7305.76,88,,5844.61,,,0,"percent of total billed charges","88% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1436.58,17.304,,1149.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5230.26,63,,4184.21,,,0,"percent of total billed charges","63% of total billed charges",1270.21,15.3,,1016.17,,,0,"percent of total billed charges","15.3% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",5728.38,69,,,,,0,"fee schedule","69% of total billed charges",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5134.79,61.85,,4107.83,,,0,"percent of total billed charges","61.5% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",2673.24,32.2,,2138.59,,,0,"percent of total billed charges","32.2% of total billed charges",2590.22,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1422.63,17.136,,1138.10,,,0,"percent of total billed charges","17.136% of total billed charges",1813.16,21.84,,1450.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3129.85,37.7,,2503.88,,,0,"percent of total billed charges","37.7% of total billed charges",3129.85,37.7,,2503.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2814.38,33.9,,2251.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6475.56,78,,5180.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6857.45,82.6,,5485.96,,,0,"percent of total billed charges","82.6% of total billed charges",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",4151,50,,3320.80,,,0,"percent of total billed charges","50% of total billed charges",6857.45,82.6,,5485.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1394.74,16.8,,1115.79,,,0,"percent of total billed charges","16.8% of total billed charges",8302,100,,6641.60,,,0,"percent of total billed charges","100% of total billed charges",1270.21,8302,
"RADIAL COLUMN PIN PLATE 3-HOLE RCP3",ORSUP0024,CDM,278,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",1086.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.7% of total billed charges",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1180.06,33.9,,944.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"RADIAL JAW 4 STD W/NEEDLE 240X2.8",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"RADIESSE 8046M0K1",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"RADIAL JAW 4 JUMBO W NEEDLE",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"RAPID ANA II SYSTEM IDS",ORSUP0018,CDM,270,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"RAPID RHINO 5.5 BILATERAL",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"RAPICIDE HIGH LEVEL A/B",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"RAPICIDE PA TEST STRIPS",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"RASP TEAR CUT 11x5MM",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"RAZOR SHAVE PREP FIX HEAD LF",10956,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"RCI AQUAPAK BUBBLE PREFILLED",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"RCI AQUAPAK NEBULIZERS W/WATER",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"RCI AQUAPAK NEBULIZERS W/028 ADAPTER",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"RCI STRAIGHT VENT CIRCUIT",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"RCI OXYGEN TUBING CONNECTORS",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"RCI NON-REBREATHER OXYGEN MASK PED",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"REAGENT ANTI JKA",ORSUP0024,CDM,270,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"REAGENT HYALURONIDASE TYPE I S 100MG",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"REAGENT PBS PH 6.8 DECONTAMINATION",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"REAGENT SPOT INDOLE  10ML",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"REAGENT ALKP",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"REAGENT AMMONIA",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"REAGENT AST",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"REAGENT B12",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"REAGENT BUN",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"REAGENT CREATININE",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"REAGENT ENZYMATIC C02",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"REAGENT GLUCOSE",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"REAGENT HBSAG",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"REAGENT LACTATE",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"REAGENT MAGNESIUM",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"REAGENT SALICYLATE",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"REAGENT TOTAL PROTEIN",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"REAGENT INTACT PARATHYROID HORMONE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"REAGENT LIPASE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"REAMER CONCAVE 20MM",ORSUP0018,CDM,272,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"REAMER CONVEX 24MM",ORSUP0018,CDM,272,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"REBELLA IGG 100 WELLS",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"RECORD PERIOPERATIVE",452430,CDM,270,RC,,,OUTPATIENT,,,158,102.7,,139.04,88,,111.23,,,0,"percent of total billed charges","88% of total billed charges",79,50,,63.20,,,0,"percent of total billed charges","50% of total billed charges",26.54,16.8,,21.23,,,0,"percent of total billed charges","16.8% of total billed charges",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.34,17.304,,21.87,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",99.54,63,,79.63,,,0,"percent of total billed charges","63% of total billed charges",24.17,15.3,,19.34,,,0,"percent of total billed charges","15.3% of total billed charges",26.54,16.8,,21.23,,,0,"percent of total billed charges","16.8% of total billed charges",109.02,69,,,,,0,"fee schedule","69% of total billed charges",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.72,61.85,,78.18,,,0,"percent of total billed charges","61.5% of total billed charges",26.54,16.8,,21.23,,,0,"percent of total billed charges","16.8% of total billed charges",79,50,,63.20,,,0,"percent of total billed charges","50% of total billed charges",50.88,32.2,,40.70,,,0,"percent of total billed charges","32.2% of total billed charges",26.54,16.8,,21.23,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.07,17.136,,21.66,,,0,"percent of total billed charges","17.136% of total billed charges",34.51,21.84,,27.61,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",59.57,37.7,,47.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",123.24,78,,98.59,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",130.51,82.6,,104.41,,,0,"percent of total billed charges","82.6% of total billed charges",26.54,16.8,,21.23,,,0,"percent of total billed charges","16.8% of total billed charges",79,50,,63.20,,,0,"percent of total billed charges","50% of total billed charges",130.51,82.6,,104.41,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.54,16.8,,21.23,,,0,"percent of total billed charges","16.8% of total billed charges",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",24.17,158,
"RECONSTITUTION DIL BOX/12 BTLS",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"REDUCER PLUG 8MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"REF MEMBRANE BOX",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"REFERENCE FLUID 300",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"REFERENCE FLUID 800",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"REFLEX HYBIRD CERVICAL PLATE GREEN 4.5X14MM",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"REFLEX HYBIRD FIXED BONE SCREW SELF TAPPING MAGENTA 4.0X14MM",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"REFLEX HYBIRD TEMP FIX PIN LONG",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"REFLEX HYBIRD VARIABLE BONE SCREWS SELF DRILLING  BLUE 4.0X14MM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"REFLEX ULTRA 45 W/ INTREGRATED CABLE",ORSUP0019,CDM,270,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"RELOAD TRH90 LINEAR STAPLER 90MM HEAVY WIRE FOR TLH90",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"RELOAD TRH60 LINEAR STAPLER 60MM HEAVY WIRE FOR TLH60",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"RELOAD TRH30 LINEAR STAPLER 30MM HEAVY WIRE FOR TLH30",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"RELOAD TR60 LINEAR STAPLER 60MM FOR TL60",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"RELOAD ECR60G ENDO LINEAR CUTTER 60 GREEN FOR ECHELON EC60",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"RELOAD BLUE ECHELON ENDO",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"RELOAD WHITE FOR ECHELON 45",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"RELOAD GREEN FOR ECHELON 45",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"RELOAD ECR60W ENDO LINEAR CUTTER 60 0",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"RELOAD STAPLER 12 MM TROCAR L60 MM ECHELON 60 ENDOPATH LINEA",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"RELOAD TR45W ENDO LINEAR CUTTER WHITE VASCULAR FOR ATW45",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"RELOAD ECHELON POWERED VASC STAPLER 35MM WHITE",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1346,874.9,,1184.48,88,,947.58,,,0,"percent of total billed charges","88% of total billed charges",673,50,,538.40,,,0,"percent of total billed charges","50% of total billed charges",226.13,16.8,,180.90,,,0,"percent of total billed charges","16.8% of total billed charges",1346,100,,1076.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",232.91,17.304,,186.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",847.98,63,,678.38,,,0,"percent of total billed charges","63% of total billed charges",205.94,15.3,,164.75,,,0,"percent of total billed charges","15.3% of total billed charges",226.13,16.8,,180.90,,,0,"percent of total billed charges","16.8% of total billed charges",928.74,69,,,,,0,"fee schedule","69% of total billed charges",1346,100,,1076.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1346,100,,1076.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1346,100,,1076.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",832.5,61.85,,666.00,,,0,"percent of total billed charges","61.5% of total billed charges",226.13,16.8,,180.90,,,0,"percent of total billed charges","16.8% of total billed charges",673,50,,538.40,,,0,"percent of total billed charges","50% of total billed charges",433.41,32.2,,346.73,,,0,"percent of total billed charges","32.2% of total billed charges",226.13,16.8,,180.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",230.65,17.136,,184.52,,,0,"percent of total billed charges","17.136% of total billed charges",293.97,21.84,,235.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",507.44,37.7,,405.95,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1049.88,78,,839.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1111.8,82.6,,889.44,,,0,"percent of total billed charges","82.6% of total billed charges",226.13,16.8,,180.90,,,0,"percent of total billed charges","16.8% of total billed charges",673,50,,538.40,,,0,"percent of total billed charges","50% of total billed charges",1111.8,82.6,,889.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",226.13,16.8,,180.90,,,0,"percent of total billed charges","16.8% of total billed charges",1346,100,,1076.80,,,0,"percent of total billed charges","100% of total billed charges",205.94,1346,
"RELOAD, STAPLER STANDARD 6R45B",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"RELOADS PROXIMATE CUTTER 75",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"RELOAD LINEAR 45MM WHITE",ORSUP0016,CDM,270,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"RELOAD, LINEAR CUTTER 75MM",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"RELOADS PROXIMATE LINEAR CUTTER GREEN 100MM",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"RELOAD SUREFORM 60 3.5 BLUE",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"RELOAD SUREFORM 4.3 GREEN",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"RELOAD SUREFORM 4.6 BLACK",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"RELOAD SUREFORM 45 3.5 BLUE",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"RELOAD SUREFORM 45 4.3 GREEN",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"RELOAD SUREFORM 45 4.6 BLACK",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"REMEDY ANTIFUNGAL POWDER 3OZ",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"REMEDY SKIN CREAM 2OZ",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"REMEDY ANTIFUNGAL OINTMENT",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"REMEDY SHAMPOO \\T\\ BODY WASH",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"REMOVER SKIN STAPLE",32122,CDM,270,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"REMOVER RESCUE NET FOREIGN BODY",ORSUP0025,CDM,272,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"REP BAND LF EXERCISE TUBING 100' BLUE",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"REP BAND LF EXERCISE TUBING 100' GREEN",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"REP BAND LF EXERCISE TUBING 100' ORANGE",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"REP BAND EXERCISE TUBING 100' PLUM",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"REP BAND BLUE LEVEL 4  4IN X 50YDS",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"REP BAND GREEN LEVEL 3 4IN X 50YDS",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"REP BAND PURPLE LEVEL 5 4IN X 50YDS",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"REPAIR KIT FYRITE CO2 AND O2 GAS ANALYZERS",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"RESECTOR 4.0MM",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"RESERVOIR  JACKSON-PRATT 100CC",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"RESERVOIR CSF OMMAYA 2.5CM",ORSUP0025,CDM,272,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"RESECTOR RADIUS 5.0MM STRYKER",ORSUP0003,CDM,270,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"RESECTOR 3.5MM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"RESECTOR 2.5MM",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"RESERVOIR HARD SHELL",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,412,267.8,,362.56,88,,290.05,,,0,"percent of total billed charges","88% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.29,17.304,,57.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",259.56,63,,207.65,,,0,"percent of total billed charges","63% of total billed charges",63.04,15.3,,50.43,,,0,"percent of total billed charges","15.3% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",284.28,69,,,,,0,"fee schedule","69% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",254.82,61.85,,203.86,,,0,"percent of total billed charges","61.5% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",132.66,32.2,,106.13,,,0,"percent of total billed charges","32.2% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.6,17.136,,56.48,,,0,"percent of total billed charges","17.136% of total billed charges",89.98,21.84,,71.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",155.32,37.7,,124.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",321.36,78,,257.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",63.04,412,
"RESPIRATORY PATIENT SET-UP BAG",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"RESSECTOR ANGLED 4.5",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"RESTORIS TRINITY CANCELLOUS SCREW (ALL SIZES)",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"RESTORIS Z BONE SCREW (ALL SIZES)",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"RESTORIS METAFIX STANDARD FEMORAL STEM (ALL SIZES)",ORSUP0034,CDM,278,RC,,,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1065.75,17.304,,852.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",942.33,15.3,,753.86,,,0,"percent of total billed charges","15.3% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3809.34,61.85,,3047.47,,,0,"percent of total billed charges","61.5% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1983.2,32.2,,1586.56,,,0,"percent of total billed charges","32.2% of total billed charges",1921.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1055.41,17.136,,844.33,,,0,"percent of total billed charges","17.136% of total billed charges",1345.13,21.84,,1076.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",942.33,6159,
"RESTORIS TRINITY HXLPE TAPER LINER (ALL SIZES)",ORSUP0052,CDM,278,RC,,,OUTPATIENT,,,10980,7137,,9662.4,88,,7729.92,,,0,"percent of total billed charges","88% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1899.98,17.304,,1519.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6917.4,63,,5533.92,,,0,"percent of total billed charges","63% of total billed charges",1679.94,15.3,,1343.95,,,0,"percent of total billed charges","15.3% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",7576.2,69,,,,,0,"fee schedule","69% of total billed charges",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6791.13,61.85,,5432.90,,,0,"percent of total billed charges","61.5% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",3535.56,32.2,,2828.45,,,0,"percent of total billed charges","32.2% of total billed charges",3425.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1881.53,17.136,,1505.22,,,0,"percent of total billed charges","17.136% of total billed charges",2398.03,21.84,,1918.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4139.46,37.7,,3311.57,,,0,"percent of total billed charges","37.7% of total billed charges",4139.46,37.7,,3311.57,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3722.22,33.9,,2977.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",8564.4,78,,6851.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9069.48,82.6,,7255.58,,,0,"percent of total billed charges","82.6% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",9069.48,82.6,,7255.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",1679.94,10980,
"RESTORIS TRINITY TAPER CUP (ALL SIZES)",ORSUP0057,CDM,278,RC,,,OUTPATIENT,,,12587,8181.55,,11076.56,88,,8861.25,,,0,"percent of total billed charges","88% of total billed charges",6293.5,50,,5034.80,,,0,"percent of total billed charges","50% of total billed charges",2114.62,16.8,,1691.70,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2178.05,17.304,,1742.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7929.81,63,,6343.85,,,0,"percent of total billed charges","63% of total billed charges",1925.81,15.3,,1540.65,,,0,"percent of total billed charges","15.3% of total billed charges",2114.62,16.8,,1691.70,,,0,"percent of total billed charges","16.8% of total billed charges",8685.03,69,,,,,0,"fee schedule","69% of total billed charges",12587,100,,10069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12587,100,,10069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12587,100,,10069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7785.06,61.85,,6228.05,,,0,"percent of total billed charges","61.5% of total billed charges",2114.62,16.8,,1691.70,,,0,"percent of total billed charges","16.8% of total billed charges",6293.5,50,,5034.80,,,0,"percent of total billed charges","50% of total billed charges",4053.01,32.2,,3242.41,,,0,"percent of total billed charges","32.2% of total billed charges",3927.14,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2156.91,17.136,,1725.53,,,0,"percent of total billed charges","17.136% of total billed charges",2749,21.84,,2199.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4745.3,37.7,,3796.24,,,0,"percent of total billed charges","37.7% of total billed charges",4745.3,37.7,,3796.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4266.99,33.9,,3413.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",9817.86,78,,7854.29,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10396.86,82.6,,8317.49,,,0,"percent of total billed charges","82.6% of total billed charges",2114.62,16.8,,1691.70,,,0,"percent of total billed charges","16.8% of total billed charges",6293.5,50,,5034.80,,,0,"percent of total billed charges","50% of total billed charges",10396.86,82.6,,8317.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2114.62,16.8,,1691.70,,,0,"percent of total billed charges","16.8% of total billed charges",12587,100,,10069.60,,,0,"percent of total billed charges","100% of total billed charges",1925.81,12587,
"RESTORIS METAFIX  LATERALIZED FEMORAL STEM (ALL SIZES)",ORSUP0034,CDM,278,RC,,,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1065.75,17.304,,852.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",942.33,15.3,,753.86,,,0,"percent of total billed charges","15.3% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3809.34,61.85,,3047.47,,,0,"percent of total billed charges","61.5% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1983.2,32.2,,1586.56,,,0,"percent of total billed charges","32.2% of total billed charges",1921.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1055.41,17.136,,844.33,,,0,"percent of total billed charges","17.136% of total billed charges",1345.13,21.84,,1076.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",942.33,6159,
"RESTORIS METAFIX COCR MODULAR HEAD (ALL SIZES)",ORSUP0018,CDM,278,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",605.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.7% of total billed charges",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",658.34,33.9,,526.67,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"RESTORIS Z ACETABULAR CUP (ALL SIZES)",ORSUP0057,CDM,278,RC,,,OUTPATIENT,,,12587,8181.55,,11076.56,88,,8861.25,,,0,"percent of total billed charges","88% of total billed charges",6293.5,50,,5034.80,,,0,"percent of total billed charges","50% of total billed charges",2114.62,16.8,,1691.70,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2178.05,17.304,,1742.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7929.81,63,,6343.85,,,0,"percent of total billed charges","63% of total billed charges",1925.81,15.3,,1540.65,,,0,"percent of total billed charges","15.3% of total billed charges",2114.62,16.8,,1691.70,,,0,"percent of total billed charges","16.8% of total billed charges",8685.03,69,,,,,0,"fee schedule","69% of total billed charges",12587,100,,10069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12587,100,,10069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12587,100,,10069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7785.06,61.85,,6228.05,,,0,"percent of total billed charges","61.5% of total billed charges",2114.62,16.8,,1691.70,,,0,"percent of total billed charges","16.8% of total billed charges",6293.5,50,,5034.80,,,0,"percent of total billed charges","50% of total billed charges",4053.01,32.2,,3242.41,,,0,"percent of total billed charges","32.2% of total billed charges",3927.14,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2156.91,17.136,,1725.53,,,0,"percent of total billed charges","17.136% of total billed charges",2749,21.84,,2199.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4745.3,37.7,,3796.24,,,0,"percent of total billed charges","37.7% of total billed charges",4745.3,37.7,,3796.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4266.99,33.9,,3413.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",9817.86,78,,7854.29,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10396.86,82.6,,8317.49,,,0,"percent of total billed charges","82.6% of total billed charges",2114.62,16.8,,1691.70,,,0,"percent of total billed charges","16.8% of total billed charges",6293.5,50,,5034.80,,,0,"percent of total billed charges","50% of total billed charges",10396.86,82.6,,8317.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2114.62,16.8,,1691.70,,,0,"percent of total billed charges","16.8% of total billed charges",12587,100,,10069.60,,,0,"percent of total billed charges","100% of total billed charges",1925.81,12587,
"RESTORIS Z ACETABULAR LINER (ALL SIZES)",ORSUP0052,CDM,278,RC,,,OUTPATIENT,,,10980,7137,,9662.4,88,,7729.92,,,0,"percent of total billed charges","88% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1899.98,17.304,,1519.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6917.4,63,,5533.92,,,0,"percent of total billed charges","63% of total billed charges",1679.94,15.3,,1343.95,,,0,"percent of total billed charges","15.3% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",7576.2,69,,,,,0,"fee schedule","69% of total billed charges",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6791.13,61.85,,5432.90,,,0,"percent of total billed charges","61.5% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",3535.56,32.2,,2828.45,,,0,"percent of total billed charges","32.2% of total billed charges",3425.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1881.53,17.136,,1505.22,,,0,"percent of total billed charges","17.136% of total billed charges",2398.03,21.84,,1918.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4139.46,37.7,,3311.57,,,0,"percent of total billed charges","37.7% of total billed charges",4139.46,37.7,,3311.57,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3722.22,33.9,,2977.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",8564.4,78,,6851.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9069.48,82.6,,7255.58,,,0,"percent of total billed charges","82.6% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",9069.48,82.6,,7255.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",1679.94,10980,
"RESTORIS Z FEMORAL HEAD (ALL SIZES)",ORSUP0018,CDM,278,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",605.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.7% of total billed charges",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",658.34,33.9,,526.67,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"RESTORIS Z FEMORAL STEM (ALL SIZES)",ORSUP0034,CDM,278,RC,,,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1065.75,17.304,,852.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",942.33,15.3,,753.86,,,0,"percent of total billed charges","15.3% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3809.34,61.85,,3047.47,,,0,"percent of total billed charges","61.5% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1983.2,32.2,,1586.56,,,0,"percent of total billed charges","32.2% of total billed charges",1921.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1055.41,17.136,,844.33,,,0,"percent of total billed charges","17.136% of total billed charges",1345.13,21.84,,1076.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",942.33,6159,
"RESTRAINT WITH QR BUCKLE STRAP NO LOCK WRIST",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"RESUS BAG INFANT w/MASK",111108,CDM,270,RC,,,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",47.5,50,,38.00,,,0,"percent of total billed charges","50% of total billed charges",15.96,16.8,,12.77,,,0,"percent of total billed charges","16.8% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.44,17.304,,13.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",15.96,16.8,,12.77,,,0,"percent of total billed charges","16.8% of total billed charges",65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.76,61.85,,47.01,,,0,"percent of total billed charges","61.5% of total billed charges",15.96,16.8,,12.77,,,0,"percent of total billed charges","16.8% of total billed charges",47.5,50,,38.00,,,0,"percent of total billed charges","50% of total billed charges",30.59,32.2,,24.47,,,0,"percent of total billed charges","32.2% of total billed charges",15.96,16.8,,12.77,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.28,17.136,,13.02,,,0,"percent of total billed charges","17.136% of total billed charges",20.75,21.84,,16.60,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",15.96,16.8,,12.77,,,0,"percent of total billed charges","16.8% of total billed charges",47.5,50,,38.00,,,0,"percent of total billed charges","50% of total billed charges",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.96,16.8,,12.77,,,0,"percent of total billed charges","16.8% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,95,
"RETAINER VISCERA GLASSMAN",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"RETRIEVER SOHENDRA STENT 10 FR",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"RETRIEVER SOHENDRA STENT  11.5 FR",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"RETRIEVER SOHENDRA STENT  8.5 FR",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"RETRIEVER SOHENDRA STENT  7FR",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"RETRACTOR GRASPING",ORSUP0057,CDM,272,RC,,,OUTPATIENT,,,12587,8181.55,,11076.56,88,,8861.25,,,0,"percent of total billed charges","88% of total billed charges",6293.5,50,,5034.80,,,0,"percent of total billed charges","50% of total billed charges",2114.62,16.8,,1691.70,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2178.05,17.304,,1742.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7929.81,63,,6343.85,,,0,"percent of total billed charges","63% of total billed charges",1925.81,15.3,,1540.65,,,0,"percent of total billed charges","15.3% of total billed charges",2114.62,16.8,,1691.70,,,0,"percent of total billed charges","16.8% of total billed charges",8685.03,69,,,,,0,"fee schedule","69% of total billed charges",12587,100,,10069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12587,100,,10069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12587,100,,10069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7785.06,61.85,,6228.05,,,0,"percent of total billed charges","61.5% of total billed charges",2114.62,16.8,,1691.70,,,0,"percent of total billed charges","16.8% of total billed charges",6293.5,50,,5034.80,,,0,"percent of total billed charges","50% of total billed charges",4053.01,32.2,,3242.41,,,0,"percent of total billed charges","32.2% of total billed charges",2114.62,16.8,,1691.70,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2156.91,17.136,,1725.53,,,0,"percent of total billed charges","17.136% of total billed charges",2749,21.84,,2199.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4745.3,37.7,,3796.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9817.86,78,,7854.29,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10396.86,82.6,,8317.49,,,0,"percent of total billed charges","82.6% of total billed charges",2114.62,16.8,,1691.70,,,0,"percent of total billed charges","16.8% of total billed charges",6293.5,50,,5034.80,,,0,"percent of total billed charges","50% of total billed charges",10396.86,82.6,,8317.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2114.62,16.8,,1691.70,,,0,"percent of total billed charges","16.8% of total billed charges",12587,100,,10069.60,,,0,"percent of total billed charges","100% of total billed charges",1925.81,12587,
"RETRIVER NET ROTH",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"RETRACTOR MED MOBIUS",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"RETRACTOR SML MOBIAS",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"RETROGRADE INTUBATION SET",ORSUP0015,CDM,270,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"RETRACTOR ALEXIS XLG MOBIUS",ORSUP0009,CDM,270,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"RETRACTOR CORD SILICONE",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,100,65,,88,88,,70.40,,,0,"percent of total billed charges","88% of total billed charges",50,50,,40.00,,,0,"percent of total billed charges","50% of total billed charges",16.8,16.8,,13.44,,,0,"percent of total billed charges","16.8% of total billed charges",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,17.304,,13.84,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",63,63,,50.40,,,0,"percent of total billed charges","63% of total billed charges",15.3,15.3,,12.24,,,0,"percent of total billed charges","15.3% of total billed charges",16.8,16.8,,13.44,,,0,"percent of total billed charges","16.8% of total billed charges",69,69,,,,,0,"fee schedule","69% of total billed charges",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.85,61.85,,49.48,,,0,"percent of total billed charges","61.5% of total billed charges",16.8,16.8,,13.44,,,0,"percent of total billed charges","16.8% of total billed charges",50,50,,40.00,,,0,"percent of total billed charges","50% of total billed charges",32.2,32.2,,25.76,,,0,"percent of total billed charges","32.2% of total billed charges",16.8,16.8,,13.44,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.14,17.136,,13.71,,,0,"percent of total billed charges","17.136% of total billed charges",21.84,21.84,,17.47,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",78,78,,62.40,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",16.8,16.8,,13.44,,,0,"percent of total billed charges","16.8% of total billed charges",50,50,,40.00,,,0,"percent of total billed charges","50% of total billed charges",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.8,16.8,,13.44,,,0,"percent of total billed charges","16.8% of total billed charges",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",15.3,100,
"REV KNEE BASEPLATE TRI TS SIZE 4",ORSUP0040,CDM,278,RC,,,OUTPATIENT,,,7766,5047.9,,6834.08,88,,5467.26,,,0,"percent of total billed charges","88% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1343.83,17.304,,1075.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4892.58,63,,3914.06,,,0,"percent of total billed charges","63% of total billed charges",1188.2,15.3,,950.56,,,0,"percent of total billed charges","15.3% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",5358.54,69,,,,,0,"fee schedule","69% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4803.27,61.85,,3842.62,,,0,"percent of total billed charges","61.5% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",2500.65,32.2,,2000.52,,,0,"percent of total billed charges","32.2% of total billed charges",2422.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1330.78,17.136,,1064.62,,,0,"percent of total billed charges","17.136% of total billed charges",1696.09,21.84,,1356.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2927.78,37.7,,2342.22,,,0,"percent of total billed charges","37.7% of total billed charges",2927.78,37.7,,2342.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2632.67,33.9,,2106.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6057.48,78,,4845.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",1188.2,7766,
"REV KNEE BASEPLATE TRI TS SIZE 6",ORSUP0040,CDM,278,RC,,,OUTPATIENT,,,7766,5047.9,,6834.08,88,,5467.26,,,0,"percent of total billed charges","88% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1343.83,17.304,,1075.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4892.58,63,,3914.06,,,0,"percent of total billed charges","63% of total billed charges",1188.2,15.3,,950.56,,,0,"percent of total billed charges","15.3% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",5358.54,69,,,,,0,"fee schedule","69% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4803.27,61.85,,3842.62,,,0,"percent of total billed charges","61.5% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",2500.65,32.2,,2000.52,,,0,"percent of total billed charges","32.2% of total billed charges",2422.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1330.78,17.136,,1064.62,,,0,"percent of total billed charges","17.136% of total billed charges",1696.09,21.84,,1356.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2927.78,37.7,,2342.22,,,0,"percent of total billed charges","37.7% of total billed charges",2927.78,37.7,,2342.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2632.67,33.9,,2106.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6057.48,78,,4845.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",1188.2,7766,
"RHINO 7.5CM ANTERIOR/POSTERIOR",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"RIGHT ANGLE DISSECTOR TIP 5MM",ORSUP0016,CDM,270,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"RIGID SUCTION CANISTER",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"RING PYSIO CARPENTIER EDWARDS",ORSUP0064,CDM,278,RC,,,OUTPATIENT,,,14461,9399.65,,12725.68,88,,10180.54,,,0,"percent of total billed charges","88% of total billed charges",7230.5,50,,5784.40,,,0,"percent of total billed charges","50% of total billed charges",2429.45,16.8,,1943.56,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2502.33,17.304,,2001.86,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9110.43,63,,7288.34,,,0,"percent of total billed charges","63% of total billed charges",2212.53,15.3,,1770.02,,,0,"percent of total billed charges","15.3% of total billed charges",2429.45,16.8,,1943.56,,,0,"percent of total billed charges","16.8% of total billed charges",9978.09,69,,,,,0,"fee schedule","69% of total billed charges",14461,100,,11568.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14461,100,,11568.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14461,100,,11568.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8944.13,61.85,,7155.30,,,0,"percent of total billed charges","61.5% of total billed charges",2429.45,16.8,,1943.56,,,0,"percent of total billed charges","16.8% of total billed charges",7230.5,50,,5784.40,,,0,"percent of total billed charges","50% of total billed charges",4656.44,32.2,,3725.15,,,0,"percent of total billed charges","32.2% of total billed charges",4511.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2478.04,17.136,,1982.43,,,0,"percent of total billed charges","17.136% of total billed charges",3158.28,21.84,,2526.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",5451.8,37.7,,4361.44,,,0,"percent of total billed charges","37.7% of total billed charges",5451.8,37.7,,4361.44,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4902.28,33.9,,3921.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",11279.58,78,,9023.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11944.79,82.6,,9555.83,,,0,"percent of total billed charges","82.6% of total billed charges",2429.45,16.8,,1943.56,,,0,"percent of total billed charges","16.8% of total billed charges",7230.5,50,,5784.40,,,0,"percent of total billed charges","50% of total billed charges",11944.79,82.6,,9555.83,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2429.45,16.8,,1943.56,,,0,"percent of total billed charges","16.8% of total billed charges",14461,100,,11568.80,,,0,"percent of total billed charges","100% of total billed charges",2212.53,14461,
"RING PHYSIO CARPENTIER EDWARDS 28MM",ORSUP0064,CDM,278,RC,,,OUTPATIENT,,,14461,9399.65,,12725.68,88,,10180.54,,,0,"percent of total billed charges","88% of total billed charges",7230.5,50,,5784.40,,,0,"percent of total billed charges","50% of total billed charges",2429.45,16.8,,1943.56,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2502.33,17.304,,2001.86,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9110.43,63,,7288.34,,,0,"percent of total billed charges","63% of total billed charges",2212.53,15.3,,1770.02,,,0,"percent of total billed charges","15.3% of total billed charges",2429.45,16.8,,1943.56,,,0,"percent of total billed charges","16.8% of total billed charges",9978.09,69,,,,,0,"fee schedule","69% of total billed charges",14461,100,,11568.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14461,100,,11568.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14461,100,,11568.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8944.13,61.85,,7155.30,,,0,"percent of total billed charges","61.5% of total billed charges",2429.45,16.8,,1943.56,,,0,"percent of total billed charges","16.8% of total billed charges",7230.5,50,,5784.40,,,0,"percent of total billed charges","50% of total billed charges",4656.44,32.2,,3725.15,,,0,"percent of total billed charges","32.2% of total billed charges",4511.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2478.04,17.136,,1982.43,,,0,"percent of total billed charges","17.136% of total billed charges",3158.28,21.84,,2526.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",5451.8,37.7,,4361.44,,,0,"percent of total billed charges","37.7% of total billed charges",5451.8,37.7,,4361.44,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4902.28,33.9,,3921.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",11279.58,78,,9023.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11944.79,82.6,,9555.83,,,0,"percent of total billed charges","82.6% of total billed charges",2429.45,16.8,,1943.56,,,0,"percent of total billed charges","16.8% of total billed charges",7230.5,50,,5784.40,,,0,"percent of total billed charges","50% of total billed charges",11944.79,82.6,,9555.83,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2429.45,16.8,,1943.56,,,0,"percent of total billed charges","16.8% of total billed charges",14461,100,,11568.80,,,0,"percent of total billed charges","100% of total billed charges",2212.53,14461,
"RING PHYSIO CARPENTIER EDWARDS",ORSUP0064,CDM,278,RC,,,OUTPATIENT,,,14461,9399.65,,12725.68,88,,10180.54,,,0,"percent of total billed charges","88% of total billed charges",7230.5,50,,5784.40,,,0,"percent of total billed charges","50% of total billed charges",2429.45,16.8,,1943.56,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2502.33,17.304,,2001.86,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9110.43,63,,7288.34,,,0,"percent of total billed charges","63% of total billed charges",2212.53,15.3,,1770.02,,,0,"percent of total billed charges","15.3% of total billed charges",2429.45,16.8,,1943.56,,,0,"percent of total billed charges","16.8% of total billed charges",9978.09,69,,,,,0,"fee schedule","69% of total billed charges",14461,100,,11568.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14461,100,,11568.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14461,100,,11568.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8944.13,61.85,,7155.30,,,0,"percent of total billed charges","61.5% of total billed charges",2429.45,16.8,,1943.56,,,0,"percent of total billed charges","16.8% of total billed charges",7230.5,50,,5784.40,,,0,"percent of total billed charges","50% of total billed charges",4656.44,32.2,,3725.15,,,0,"percent of total billed charges","32.2% of total billed charges",4511.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2478.04,17.136,,1982.43,,,0,"percent of total billed charges","17.136% of total billed charges",3158.28,21.84,,2526.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",5451.8,37.7,,4361.44,,,0,"percent of total billed charges","37.7% of total billed charges",5451.8,37.7,,4361.44,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4902.28,33.9,,3921.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",11279.58,78,,9023.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11944.79,82.6,,9555.83,,,0,"percent of total billed charges","82.6% of total billed charges",2429.45,16.8,,1943.56,,,0,"percent of total billed charges","16.8% of total billed charges",7230.5,50,,5784.40,,,0,"percent of total billed charges","50% of total billed charges",11944.79,82.6,,9555.83,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2429.45,16.8,,1943.56,,,0,"percent of total billed charges","16.8% of total billed charges",14461,100,,11568.80,,,0,"percent of total billed charges","100% of total billed charges",2212.53,14461,
"RING CONVEX ROUND 12MM  0 DEGREE 495.412",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"RING END TI 2.5DD OD12MM SPNL CNVX RND",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"ROADRUNNER PC WIRE GUIDE 145CM",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"ROADRUNNER UNIGLIDE .035X15CM",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"PISTON .6X1.0X4.5MM CUPPED",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"PISTON .6X.9 X4.5MM CUPPED",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"ROCKER CAST SHOE SMALL",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"ROCKER CAST SHOE MEDIUM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"ROCKER CAST SHOE LARGE",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"ROD CARBON FIBER 8.0MM X 220MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"ROD CARBON FIBER 8.0MM X 200MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"ROD 100MM VENTROFIX",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"ROD 150MM VENTROFIX",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"ROD 50MM VENTROFIX",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"ROD 75MM VENTROFIX",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"ROD 80MM CERVIFIX",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"ROD CARBON FIBER  220MM",ORSUP0056,CDM,278,RC,,,OUTPATIENT,,,12319,8007.35,,10840.72,88,,8672.58,,,0,"percent of total billed charges","88% of total billed charges",6159.5,50,,4927.60,,,0,"percent of total billed charges","50% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2131.68,17.304,,1705.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7760.97,63,,6208.78,,,0,"percent of total billed charges","63% of total billed charges",1884.81,15.3,,1507.85,,,0,"percent of total billed charges","15.3% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",8500.11,69,,,,,0,"fee schedule","69% of total billed charges",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7619.3,61.85,,6095.44,,,0,"percent of total billed charges","61.5% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",6159.5,50,,4927.60,,,0,"percent of total billed charges","50% of total billed charges",3966.72,32.2,,3173.38,,,0,"percent of total billed charges","32.2% of total billed charges",3843.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2110.98,17.136,,1688.78,,,0,"percent of total billed charges","17.136% of total billed charges",2690.47,21.84,,2152.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4644.26,37.7,,3715.41,,,0,"percent of total billed charges","37.7% of total billed charges",4644.26,37.7,,3715.41,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4176.14,33.9,,3340.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",9608.82,78,,7687.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10175.49,82.6,,8140.39,,,0,"percent of total billed charges","82.6% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",6159.5,50,,4927.60,,,0,"percent of total billed charges","50% of total billed charges",10175.49,82.6,,8140.39,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",1884.81,12319,
"ROD CARBON FIBER  240MM",ORSUP0056,CDM,278,RC,,,OUTPATIENT,,,12319,8007.35,,10840.72,88,,8672.58,,,0,"percent of total billed charges","88% of total billed charges",6159.5,50,,4927.60,,,0,"percent of total billed charges","50% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2131.68,17.304,,1705.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7760.97,63,,6208.78,,,0,"percent of total billed charges","63% of total billed charges",1884.81,15.3,,1507.85,,,0,"percent of total billed charges","15.3% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",8500.11,69,,,,,0,"fee schedule","69% of total billed charges",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7619.3,61.85,,6095.44,,,0,"percent of total billed charges","61.5% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",6159.5,50,,4927.60,,,0,"percent of total billed charges","50% of total billed charges",3966.72,32.2,,3173.38,,,0,"percent of total billed charges","32.2% of total billed charges",3843.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2110.98,17.136,,1688.78,,,0,"percent of total billed charges","17.136% of total billed charges",2690.47,21.84,,2152.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4644.26,37.7,,3715.41,,,0,"percent of total billed charges","37.7% of total billed charges",4644.26,37.7,,3715.41,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4176.14,33.9,,3340.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",9608.82,78,,7687.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10175.49,82.6,,8140.39,,,0,"percent of total billed charges","82.6% of total billed charges",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",6159.5,50,,4927.60,,,0,"percent of total billed charges","50% of total billed charges",10175.49,82.6,,8140.39,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2069.59,16.8,,1655.67,,,0,"percent of total billed charges","16.8% of total billed charges",12319,100,,9855.20,,,0,"percent of total billed charges","100% of total billed charges",1884.81,12319,
"ROD CARBON FIBER11.0MM X 300MM",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"ROD CONNECTOR TI PARALLEL OPEN 3.5MM/3.5MM 498.922",ORSUP0021,CDM,278,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",835.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.7% of total billed charges",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",907.84,33.9,,726.27,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"ROD CURVED 3.5MM TI 80MM 498.137",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"ROD EXT FIX CARBN FIBR 8.0X240MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"ROD TRANSCONNECTOR 49-69MM X 6MM PANGEA SPNL LPRO",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"ROD 125 MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"ROD 5 1/2 MM CURVED",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"ROD CURVED 3.5MM TI 40MM 498.136",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"ROD SPNL TI L125MM OD6.0MM HRD",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"ROD SPNL TI L50MM PANGEA PRECONTOURED",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"ROD SPNL TI L60MM PANGEA PRECONTOURED",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"ROD SPNL TI L70MM PANGEA PRECONTOURED",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"ROD SPNL TI L80MM PANGEA PRECONTOURED",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"ROD SPNL TI OD3.5MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"ROD TI TRANSCONNECTOR 60MM FOR 3.5MM 04.614.513",ORSUP0025,CDM,278,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",1169.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.7% of total billed charges",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.91,33.9,,1016.73,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"ROLLS CANDO SADDLE BLUE 31.5IN",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"ROLLER TUBE",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"ROM PLUS RUPTURE MEMBRANE TEST",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"ROM PLUS QUALITY CONTROLS",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"ROSEN WIRE GUIDE .035 X 180CM",ORSUP0002,CDM,278,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.7% of total billed charges",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.43,33.9,,36.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"ROSEN WIRE GUIDE 035 X 260CM",ORSUP0002,CDM,278,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.7% of total billed charges",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.43,33.9,,36.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"ROTALINK ROTABLASTER 2.0MM",ORSUP0028,CDM,278,RC,,,OUTPATIENT,,,4553,2959.45,,4006.64,88,,3205.31,,,0,"percent of total billed charges","88% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",787.85,17.304,,630.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2868.39,63,,2294.71,,,0,"percent of total billed charges","63% of total billed charges",696.61,15.3,,557.29,,,0,"percent of total billed charges","15.3% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",3141.57,69,,,,,0,"fee schedule","69% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2816.03,61.85,,2252.82,,,0,"percent of total billed charges","61.5% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",1466.07,32.2,,1172.86,,,0,"percent of total billed charges","32.2% of total billed charges",1420.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",780.2,17.136,,624.16,,,0,"percent of total billed charges","17.136% of total billed charges",994.38,21.84,,795.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.7% of total billed charges",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1543.47,33.9,,1234.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3551.34,78,,2841.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",696.61,4553,
"ROTALINK ROTABLASTER 1.75MM",ORSUP0030,CDM,278,RC,,,OUTPATIENT,,,5088,3307.2,,4477.44,88,,3581.95,,,0,"percent of total billed charges","88% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",880.43,17.304,,704.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3205.44,63,,2564.35,,,0,"percent of total billed charges","63% of total billed charges",778.46,15.3,,622.77,,,0,"percent of total billed charges","15.3% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",3510.72,69,,,,,0,"fee schedule","69% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3146.93,61.85,,2517.54,,,0,"percent of total billed charges","61.5% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",1638.34,32.2,,1310.67,,,0,"percent of total billed charges","32.2% of total billed charges",1587.46,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",871.88,17.136,,697.50,,,0,"percent of total billed charges","17.136% of total billed charges",1111.22,21.84,,888.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1918.18,37.7,,1534.54,,,0,"percent of total billed charges","37.7% of total billed charges",1918.18,37.7,,1534.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1724.83,33.9,,1379.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3968.64,78,,3174.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",778.46,5088,
"ROTALINK ROTABLASTER 1.5MM",ORSUP0030,CDM,278,RC,,,OUTPATIENT,,,5088,3307.2,,4477.44,88,,3581.95,,,0,"percent of total billed charges","88% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",880.43,17.304,,704.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3205.44,63,,2564.35,,,0,"percent of total billed charges","63% of total billed charges",778.46,15.3,,622.77,,,0,"percent of total billed charges","15.3% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",3510.72,69,,,,,0,"fee schedule","69% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3146.93,61.85,,2517.54,,,0,"percent of total billed charges","61.5% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",1638.34,32.2,,1310.67,,,0,"percent of total billed charges","32.2% of total billed charges",1587.46,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",871.88,17.136,,697.50,,,0,"percent of total billed charges","17.136% of total billed charges",1111.22,21.84,,888.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1918.18,37.7,,1534.54,,,0,"percent of total billed charges","37.7% of total billed charges",1918.18,37.7,,1534.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1724.83,33.9,,1379.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3968.64,78,,3174.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",778.46,5088,
"ROTH NET PEDIATRIC FOREIGN BODY SNARE",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"ROTOLINK PLUS 1.75",ORSUP0036,CDM,278,RC,,,OUTPATIENT,,,6695,4351.75,,5891.6,88,,4713.28,,,0,"percent of total billed charges","88% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1158.5,17.304,,926.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4217.85,63,,3374.28,,,0,"percent of total billed charges","63% of total billed charges",1024.34,15.3,,819.47,,,0,"percent of total billed charges","15.3% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",4619.55,69,,,,,0,"fee schedule","69% of total billed charges",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4140.86,61.85,,3312.69,,,0,"percent of total billed charges","61.5% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",2155.79,32.2,,1724.63,,,0,"percent of total billed charges","32.2% of total billed charges",2088.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1147.26,17.136,,917.81,,,0,"percent of total billed charges","17.136% of total billed charges",1462.19,21.84,,1169.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2524.02,37.7,,2019.22,,,0,"percent of total billed charges","37.7% of total billed charges",2524.02,37.7,,2019.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2269.61,33.9,,1815.69,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5222.1,78,,4177.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5530.07,82.6,,4424.06,,,0,"percent of total billed charges","82.6% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",5530.07,82.6,,4424.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",1024.34,6695,
"ROUND W/ VENTS BLUE .75",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"ROUND W/ VENTS PURPLE .75",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"ROUTER SPRIAL 2.3 MM",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"ROYAL FLUSH HIGH FLOW CATH 6FR X 90CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"RUBBER BANDS STERILE",491128,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"RUBELLA IGG CAL BOX /1 SET",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"RUMI ARCH KOH EFFICIENT 4.0CM",ORSUP0011,CDM,270,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"RUMI ARCH 3.5CM Koh EFFICIENT",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"RUMI ARCH 3.0CM Koh-EFFICIENT",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"RUMI KOH-EFFICIENT  HANDLE 4.0CM",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,824,535.6,,725.12,88,,580.10,,,0,"percent of total billed charges","88% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.58,17.304,,114.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",519.12,63,,415.30,,,0,"percent of total billed charges","63% of total billed charges",126.07,15.3,,100.86,,,0,"percent of total billed charges","15.3% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",568.56,69,,,,,0,"fee schedule","69% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.64,61.85,,407.71,,,0,"percent of total billed charges","61.5% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",265.33,32.2,,212.26,,,0,"percent of total billed charges","32.2% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",141.2,17.136,,112.96,,,0,"percent of total billed charges","17.136% of total billed charges",179.96,21.84,,143.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",310.65,37.7,,248.52,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",642.72,78,,514.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",126.07,824,
"S SYRINGE MODULE",ORSUP0030,CDM,272,RC,,,OUTPATIENT,,,5088,3307.2,,4477.44,88,,3581.95,,,0,"percent of total billed charges","88% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",880.43,17.304,,704.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3205.44,63,,2564.35,,,0,"percent of total billed charges","63% of total billed charges",778.46,15.3,,622.77,,,0,"percent of total billed charges","15.3% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",3510.72,69,,,,,0,"fee schedule","69% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3146.93,61.85,,2517.54,,,0,"percent of total billed charges","61.5% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",1638.34,32.2,,1310.67,,,0,"percent of total billed charges","32.2% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",871.88,17.136,,697.50,,,0,"percent of total billed charges","17.136% of total billed charges",1111.22,21.84,,888.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1918.18,37.7,,1534.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3968.64,78,,3174.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",778.46,5088,
"S.G CAL (HIGH) 10ML BTL",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"S/D BLADE 1.5MM  X/D  58MM  WIDE DIA. WS. 2.0MM/BOS/NEURO/RCT/USR DRIVER",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"S/D HANDLE NEURO BLUE BULB STYLE ONE FLAT SIDE 2.0/2.3/2.7 SYSTEMS",ORSUP0026,CDM,270,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"S7735 AUTOCHECK 5+ LEVEL 1",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SAFESTEP SPONGE 2MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SAFTEY NEEDLE 22GX1.5",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"SAGITTAL SAW BLADE 4125-89-90",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,515,334.75,,453.2,88,,362.56,,,0,"percent of total billed charges","88% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.12,17.304,,71.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",324.45,63,,259.56,,,0,"percent of total billed charges","63% of total billed charges",78.8,15.3,,63.04,,,0,"percent of total billed charges","15.3% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",355.35,69,,,,,0,"fee schedule","69% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",318.53,61.85,,254.82,,,0,"percent of total billed charges","61.5% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",165.83,32.2,,132.66,,,0,"percent of total billed charges","32.2% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.25,17.136,,70.60,,,0,"percent of total billed charges","17.136% of total billed charges",112.48,21.84,,89.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",194.16,37.7,,155.33,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",401.7,78,,321.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",78.8,515,
"SALEM SUMP NASOGASTRIC TUBE 14FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SALINE LOCK ADAPTOR",491133,CDM,270,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"SALINE NORMAL 1000ML .45",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"SANI CLOTH SUPER XL 55% ALCOHOL 8X14 PURPLE TOP",207902,CDM,272,RC,,,OUTPATIENT,,,236,153.4,,207.68,88,,166.14,,,0,"percent of total billed charges","88% of total billed charges",118,50,,94.40,,,0,"percent of total billed charges","50% of total billed charges",39.65,16.8,,31.72,,,0,"percent of total billed charges","16.8% of total billed charges",236,100,,188.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.84,17.304,,32.67,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",148.68,63,,118.94,,,0,"percent of total billed charges","63% of total billed charges",36.11,15.3,,28.89,,,0,"percent of total billed charges","15.3% of total billed charges",39.65,16.8,,31.72,,,0,"percent of total billed charges","16.8% of total billed charges",162.84,69,,,,,0,"fee schedule","69% of total billed charges",236,100,,188.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",236,100,,188.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",236,100,,188.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",145.97,61.85,,116.78,,,0,"percent of total billed charges","61.5% of total billed charges",39.65,16.8,,31.72,,,0,"percent of total billed charges","16.8% of total billed charges",118,50,,94.40,,,0,"percent of total billed charges","50% of total billed charges",75.99,32.2,,60.79,,,0,"percent of total billed charges","32.2% of total billed charges",39.65,16.8,,31.72,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.44,17.136,,32.35,,,0,"percent of total billed charges","17.136% of total billed charges",51.54,21.84,,41.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",88.97,37.7,,71.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",184.08,78,,147.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.94,82.6,,155.95,,,0,"percent of total billed charges","82.6% of total billed charges",39.65,16.8,,31.72,,,0,"percent of total billed charges","16.8% of total billed charges",118,50,,94.40,,,0,"percent of total billed charges","50% of total billed charges",194.94,82.6,,155.95,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.65,16.8,,31.72,,,0,"percent of total billed charges","16.8% of total billed charges",236,100,,188.80,,,0,"percent of total billed charges","100% of total billed charges",36.11,236,
"SANITIZER QC FOAM 6 - 750ML",ORSUP0009,CDM,270,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"SARS-COV-2 REF MATERIAL",ORSUP0026,CDM,272,RC,,,OUTPATIENT,,,3090,2008.5,,2719.2,88,,2175.36,,,0,"percent of total billed charges","88% of total billed charges",1545,50,,1236.00,,,0,"percent of total billed charges","50% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",534.69,17.304,,427.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1946.7,63,,1557.36,,,0,"percent of total billed charges","63% of total billed charges",472.77,15.3,,378.22,,,0,"percent of total billed charges","15.3% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",2132.1,69,,,,,0,"fee schedule","69% of total billed charges",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1911.17,61.85,,1528.94,,,0,"percent of total billed charges","61.5% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",1545,50,,1236.00,,,0,"percent of total billed charges","50% of total billed charges",994.98,32.2,,795.98,,,0,"percent of total billed charges","32.2% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",529.5,17.136,,423.60,,,0,"percent of total billed charges","17.136% of total billed charges",674.86,21.84,,539.89,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1164.93,37.7,,931.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2410.2,78,,1928.16,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2552.34,82.6,,2041.87,,,0,"percent of total billed charges","82.6% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",1545,50,,1236.00,,,0,"percent of total billed charges","50% of total billed charges",2552.34,82.6,,2041.87,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",472.77,3090,
"SARS-COV-2 CARTRIDGES",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"SARSANTGN FIA NAS SW",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"SAW BLADE STRYKER 2108-185",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"SAW BLADE STRYKER 2108-152",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"SAW BLADE RECIPROCATING",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"SAW BLADE MINI K-124",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"SAW BLADE MINI K121",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SAW BLADE MAXI L135",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"SAW BLADE MAXI L122",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"SAW BLADE GIGLI 12IN",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SCALPEL DISPOSABLE STERILE W/",156689,CDM,272,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"SCALPEL DISPOSABLE STERILE WIT",156690,CDM,272,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"SCANNER TEMPORAL TAT-5000 ARTERIAL",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"SCISSOR ROUND TIP ROBOTIC",280485,CDM,272,RC,,,OUTPATIENT,,,9931,6455.15,,8739.28,88,,6991.42,,,0,"percent of total billed charges","88% of total billed charges",4965.5,50,,3972.40,,,0,"percent of total billed charges","50% of total billed charges",1668.41,16.8,,1334.73,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1718.46,17.304,,1374.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6256.53,63,,5005.22,,,0,"percent of total billed charges","63% of total billed charges",1519.44,15.3,,1215.55,,,0,"percent of total billed charges","15.3% of total billed charges",1668.41,16.8,,1334.73,,,0,"percent of total billed charges","16.8% of total billed charges",6852.39,69,,,,,0,"fee schedule","69% of total billed charges",9931,100,,7944.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9931,100,,7944.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9931,100,,7944.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6142.32,61.85,,4913.86,,,0,"percent of total billed charges","61.5% of total billed charges",1668.41,16.8,,1334.73,,,0,"percent of total billed charges","16.8% of total billed charges",4965.5,50,,3972.40,,,0,"percent of total billed charges","50% of total billed charges",3197.78,32.2,,2558.22,,,0,"percent of total billed charges","32.2% of total billed charges",1668.41,16.8,,1334.73,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1701.78,17.136,,1361.42,,,0,"percent of total billed charges","17.136% of total billed charges",2168.93,21.84,,1735.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3743.99,37.7,,2995.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7746.18,78,,6196.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8203.01,82.6,,6562.41,,,0,"percent of total billed charges","82.6% of total billed charges",1668.41,16.8,,1334.73,,,0,"percent of total billed charges","16.8% of total billed charges",4965.5,50,,3972.40,,,0,"percent of total billed charges","50% of total billed charges",8203.01,82.6,,6562.41,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1668.41,16.8,,1334.73,,,0,"percent of total billed charges","16.8% of total billed charges",9931,100,,7944.80,,,0,"percent of total billed charges","100% of total billed charges",1519.44,9931,
"SCISSORS CURVED 5MM DA VINCI",337815,CDM,272,RC,,,OUTPATIENT,,,4030,2619.5,,3546.4,88,,2837.12,,,0,"percent of total billed charges","88% of total billed charges",2015,50,,1612.00,,,0,"percent of total billed charges","50% of total billed charges",677.04,16.8,,541.63,,,0,"percent of total billed charges","16.8% of total billed charges",4030,100,,3224.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",697.35,17.304,,557.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2538.9,63,,2031.12,,,0,"percent of total billed charges","63% of total billed charges",616.59,15.3,,493.27,,,0,"percent of total billed charges","15.3% of total billed charges",677.04,16.8,,541.63,,,0,"percent of total billed charges","16.8% of total billed charges",2780.7,69,,,,,0,"fee schedule","69% of total billed charges",4030,100,,3224.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4030,100,,3224.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4030,100,,3224.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2492.56,61.85,,1994.05,,,0,"percent of total billed charges","61.5% of total billed charges",677.04,16.8,,541.63,,,0,"percent of total billed charges","16.8% of total billed charges",2015,50,,1612.00,,,0,"percent of total billed charges","50% of total billed charges",1297.66,32.2,,1038.13,,,0,"percent of total billed charges","32.2% of total billed charges",677.04,16.8,,541.63,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",690.58,17.136,,552.46,,,0,"percent of total billed charges","17.136% of total billed charges",880.15,21.84,,704.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1519.31,37.7,,1215.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3143.4,78,,2514.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3328.78,82.6,,2663.02,,,0,"percent of total billed charges","82.6% of total billed charges",677.04,16.8,,541.63,,,0,"percent of total billed charges","16.8% of total billed charges",2015,50,,1612.00,,,0,"percent of total billed charges","50% of total billed charges",3328.78,82.6,,2663.02,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",677.04,16.8,,541.63,,,0,"percent of total billed charges","16.8% of total billed charges",4030,100,,3224.00,,,0,"percent of total billed charges","100% of total billed charges",616.59,4030,
"SCISSORS IRIS CARB-EDGE STRAIGHT SHARP",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"SCISSORS MAYO STRIAGHT ROUND BLADE 5-7/8",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"SCLEROSOL INTRAPLEURAL AERSOSOL 4 GM  (10CANS/CS)",ORSUP0014,CDM,270,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"SCOPE DISPOSABLE FLEXIBLE - ASCOPE 3 SLIM",188550,CDM,272,RC,,,OUTPATIENT,,,7995,5196.75,,7035.6,88,,5628.48,,,0,"percent of total billed charges","88% of total billed charges",3997.5,50,,3198.00,,,0,"percent of total billed charges","50% of total billed charges",1343.16,16.8,,1074.53,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1383.45,17.304,,1106.76,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5036.85,63,,4029.48,,,0,"percent of total billed charges","63% of total billed charges",1223.24,15.3,,978.59,,,0,"percent of total billed charges","15.3% of total billed charges",1343.16,16.8,,1074.53,,,0,"percent of total billed charges","16.8% of total billed charges",5516.55,69,,,,,0,"fee schedule","69% of total billed charges",7995,100,,6396.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7995,100,,6396.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7995,100,,6396.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4944.91,61.85,,3955.93,,,0,"percent of total billed charges","61.5% of total billed charges",1343.16,16.8,,1074.53,,,0,"percent of total billed charges","16.8% of total billed charges",3997.5,50,,3198.00,,,0,"percent of total billed charges","50% of total billed charges",2574.39,32.2,,2059.51,,,0,"percent of total billed charges","32.2% of total billed charges",1343.16,16.8,,1074.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1370.02,17.136,,1096.02,,,0,"percent of total billed charges","17.136% of total billed charges",1746.11,21.84,,1396.89,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3014.12,37.7,,2411.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6236.1,78,,4988.88,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6603.87,82.6,,5283.10,,,0,"percent of total billed charges","82.6% of total billed charges",1343.16,16.8,,1074.53,,,0,"percent of total billed charges","16.8% of total billed charges",3997.5,50,,3198.00,,,0,"percent of total billed charges","50% of total billed charges",6603.87,82.6,,5283.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1343.16,16.8,,1074.53,,,0,"percent of total billed charges","16.8% of total billed charges",7995,100,,6396.00,,,0,"percent of total billed charges","100% of total billed charges",1223.24,7995,
"SCOPE FLEXIBLE DISPOSABLE - ASCOPE 3",188551,CDM,272,RC,,,OUTPATIENT,,,2229,1448.85,,1961.52,88,,1569.22,,,0,"percent of total billed charges","88% of total billed charges",1114.5,50,,891.60,,,0,"percent of total billed charges","50% of total billed charges",374.47,16.8,,299.58,,,0,"percent of total billed charges","16.8% of total billed charges",2229,100,,1783.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",385.71,17.304,,308.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1404.27,63,,1123.42,,,0,"percent of total billed charges","63% of total billed charges",341.04,15.3,,272.83,,,0,"percent of total billed charges","15.3% of total billed charges",374.47,16.8,,299.58,,,0,"percent of total billed charges","16.8% of total billed charges",1538.01,69,,,,,0,"fee schedule","69% of total billed charges",2229,100,,1783.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2229,100,,1783.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2229,100,,1783.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1378.64,61.85,,1102.91,,,0,"percent of total billed charges","61.5% of total billed charges",374.47,16.8,,299.58,,,0,"percent of total billed charges","16.8% of total billed charges",1114.5,50,,891.60,,,0,"percent of total billed charges","50% of total billed charges",717.74,32.2,,574.19,,,0,"percent of total billed charges","32.2% of total billed charges",374.47,16.8,,299.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",381.96,17.136,,305.57,,,0,"percent of total billed charges","17.136% of total billed charges",486.81,21.84,,389.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",840.33,37.7,,672.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1738.62,78,,1390.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1841.15,82.6,,1472.92,,,0,"percent of total billed charges","82.6% of total billed charges",374.47,16.8,,299.58,,,0,"percent of total billed charges","16.8% of total billed charges",1114.5,50,,891.60,,,0,"percent of total billed charges","50% of total billed charges",1841.15,82.6,,1472.92,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",374.47,16.8,,299.58,,,0,"percent of total billed charges","16.8% of total billed charges",2229,100,,1783.20,,,0,"percent of total billed charges","100% of total billed charges",341.04,2229,
"SCREW SCHANZ TITANIUM 4.0X3.0  20MM THRD/80MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"SCREW CANN SS 4.0MM 28MM LT",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"SCREW CANN SS 4.0MM 34MM LT",ORSUP0018,CDM,278,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",605.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.7% of total billed charges",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",658.34,33.9,,526.67,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"SCREW CANN SS 4.0MM 46MM LT",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"SCREW CANN SS 4.0MM 50MM LT",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"SCREW CORTICAL 3.5MM 16",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"SCREW CORTICAL 3.5MM 14",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW CORTICAL 3.5MM 12",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"SCREW CORTICAL 3.5MM 10",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"SCREW LOCKING  T7 2.7 X 12MM",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"SCREW CORTEX 2.7MMX22MM",ORSUP0004,CDM,278,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.7% of total billed charges",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.85,33.9,,72.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"SCREW 1.3MM CORTEX SELF TAPPING W/FLUTES 4MM",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SCREW 1.5 CORTEX 6MM",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SCREW 10 X 25               AR-1401",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SCREW 12.0MM (3.5)",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"SCREW 2.3 X 18MM THREADED LOCKING",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SCREW 2.3 X 20MM THREADED LOCKING",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SCREW 2.3 X 22MM THREADED LOCKING",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SCREW 2.3 X 24MM",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SCREW 2.3MM NON-LOCKING DISTAL CO-N2320",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SCREW 2.3MM X 14MM LOCKING DISTAL CO-T2314",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SCREW 2.4 X 10MM LOCKING",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"SCREW 2.4 X 12MM LOCKING",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"SCREW 2.4 X 12MM NON-LOCKING",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"SCREW 2.7 X 14MM NON-LOCKING MFT-011-27-14",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 2.7 X 16MM NON-LOCKING  MFT-011-27-16",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 2.7 X 26MM NON-LOCKING MFT-011-27-26",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 3.5 X 10MM LOCKING MFT-021-35-10",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 3.5 X 12MM LOCKING",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"SCREW 3.5 X 12MM LOCKING MFT-021-35-12",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 3.5 X 14MM LOCKING MFT-021-35-14",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 3.5 X 14MM NON-LOCKING MFT-011-35-14",ORSUP006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"SCREW 3.5 X 16MM LOCKING SCREW MFT-021-35-16",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 3.5 X 16MM NON-LOCKING MFT-011-35-16",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 3.5 X 18MM LOCKING MFT-021-35-18",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 3.5 X 18MM NON-LOCKING MFT-011-35-18",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 3.5 X 20MM LOCKING MFT-021-35-20",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 3.5 X 20MM NON-LOCKING MFT-011-35-20",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 3.5 X 22MM LOCKING MFT-021-35-22",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 3.5 X 24MM NON-LOCKING MFT-011-35-24",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 3.5 X 24MMM LOCKING MFT-021-35-24",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 3.5 X 26MM LOCKING MFT-021-35-26",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 3.5 X 26MM NON-LOCKING MFT-001-35-26",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 3.5 X 28MM LOCKING MFT-021-35-28",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 4.0 X 14MM NON-LOCKING MFT-011-40-14",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 4.0 X 18MM NON-LOCKING MFT-011-40-18",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 4.0MM TI LOCKING W/T25 STARDRIVE 26MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 4.0MM TI LOCKING W/T25 STARDRIVE 28MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 4.0MM TI LOCKING W/T25 STARDRIVE 30MM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SCREW 4.0MM TI LOCKING W/T25 STARDRIVE 34MM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SCREW 4.0MM TI LOCKING W/T25 STARDRIVE 36MM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SCREW 4.0MM TI LOCKING W/T25 STARDRIVE 38MM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SCREW 4.0MM TI LOCKING W/T25 STARDRIVE 40MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 4.0MM TI LOCKING W/T25 STARDRIVE 42MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 4.0MM TI LOCKING W/T25 STARDRIVE 46MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 4.0MM TI LOCKING W/T25 STARDRIVE 48MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 4.0MM TI LOCKING W/T25 STARDRIVE 50MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 4.0MM TI LOCKING W/T25 STARDRIVE 62MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 4.0MM TI LOCKING W/T25 STARDRIVE 70MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 4.0MM TI LOCKING W/T25 STARDRIVE 72MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 5.0MM CANNULATED LOCKING 25MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"SCREW 5.0MM CANNULATED LOCKING 30MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"SCREW 5.0MM TI LOCKING 36MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 5.0MM TI LOCKING 38MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 5.0MM TI LOCKING 40MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 5.0MM TI LOCKING 42MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 5.0MM TI LOCKING 44MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 5.0MM TI LOCKING 48MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 5.0MM TI LOCKING 54MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 5.0MM TI LOCKING 60MM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"SCREW 5.0MM TI LOCKING W/T25 STARDRIVE 28MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 5.0MM TI LOCKING W/T25 STARDRIVE 30MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 5.0MM TI LOCKING W/T25 STARDRIVE 32MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 5.0MM TI LOCKING W/T25 STARDRIVE 34MM",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",605.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.7% of total billed charges",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",658.34,33.9,,526.67,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"SCREW 5.0MM TI LOCKING W/T25 STARDRIVE 36MM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SCREW 5.0MM TI LOCKING W/T25 STARDRIVE 38MM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SCREW 5.0MM TI LOCKING W/T25 STARDRIVE 40MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 5.0MM TI LOCKING W/T25 STARDRIVE 44MM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SCREW 5.0MM TI LOCKING W/T25 STARDRIVE 46MM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SCREW 5.0MM TI LOCKING W/T25 STARDRIVE 48MM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SCREW 5.0MM TI LOCKING W/T25 STARDRIVE 50MM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SCREW 5.0MM TI LOCKING W/T25 STARDRIVE 52MM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SCREW 5.0MM TI LOCKING W/T25 STARDRIVE 56MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 5.0MM TI LOCKING W/T25 STARDRIVE 58MM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SCREW 5.0MM TI LOCKING W/T25 STARDRIVE 66MM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SCREW 5.0MM TI LOCKING W/T25 STARDRIVE 76MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW 7.3MM CANNULATED LOCKING 80MM",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"SCREW ACL 8 X 25 ARTHREX    AR-1381",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SCREW ACUTRAX FUSION 18MM",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"SCREW BIOCOMPOSITE TENODESIS 8X12",ORSUP0019,CDM,278,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",668.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.7% of total billed charges",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",726.14,33.9,,580.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"SCREW BIOTENODESIS PEEK 7MM",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",751.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.7% of total billed charges",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",816.99,33.9,,653.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"SCREW BIOTENODESIS PEEK 8MM",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",751.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.7% of total billed charges",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",816.99,33.9,,653.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"SCREW BIOTENODESIS PEEK 9MM",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",751.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.7% of total billed charges",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",816.99,33.9,,653.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"SCREW BIOTENODESIS ST 8.0X23MM",ORSUP0019,CDM,278,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",668.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.7% of total billed charges",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",726.14,33.9,,580.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"SCREW BN TI L30MM OD5MM NAIL-EX TIB 2 COR LOK STRDR RECESS N",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"SCREW BNE 316L SS L12MM OD2.4MM LCP CORTL/DIST RADL ST T8 ST",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SCREW BNE 316L SS L12MM OD2.4MM LCP DIST RADL ST STRDRV RECE",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"SCREW BNE 316L SS L14MM OD2.7MM LCP CORTL ST T8 STRDRV RECES",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SCREW BNE 316L SS L16MM OD2.4MM LCP DIST RADL ST STRDRV RECE",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"SCREW BNE 316L SS L16MM OD2.7MM LCP CORTL ST T8 STRDRV RECES",ORSUP0003,CDM,278,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.7% of total billed charges",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.14,33.9,,54.51,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"SCREW BNE 316L SS L18MM OD2.4MM LCP DIST RADL ST STRDRV RECE",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"SCREW BNE 316L SS L18MM OD2.7MM LCP CORTL ST T8 STRDRV RECES",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SCREW BNE 316L SS L20MM OD2.4MM LCP DIST RADL ST STRDRV RECE",ORSUP0018,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"SCREW BNE 316L SS L22MM OD2.4MM LCP DIST RADL ST STRDRV RECE",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SCREW BNE 316L SS L24MM OD2.4MM LCP DIST RADL ST STRDRV RECE",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SCREW BNE 316L SS L26MM OD2.4MM LCP DIST RADL ST STRDRV RECE",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SCREW BNE SS L14MM OD2.4MM LCP STRDRV DIST RADL ST RECESS LO",ORSUP0018,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"SCREW BNE TI L14MM OD3.5MM AXON CANC THRD",ORSUP0031,CDM,278,RC,,,OUTPATIENT,,,5356,3481.4,,4713.28,88,,3770.62,,,0,"percent of total billed charges","88% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",926.8,17.304,,741.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3374.28,63,,2699.42,,,0,"percent of total billed charges","63% of total billed charges",819.47,15.3,,655.58,,,0,"percent of total billed charges","15.3% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",3695.64,69,,,,,0,"fee schedule","69% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3312.69,61.85,,2650.15,,,0,"percent of total billed charges","61.5% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",1724.63,32.2,,1379.70,,,0,"percent of total billed charges","32.2% of total billed charges",1671.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",917.8,17.136,,734.24,,,0,"percent of total billed charges","17.136% of total billed charges",1169.75,21.84,,935.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.7% of total billed charges",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1815.68,33.9,,1452.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4177.68,78,,3342.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",819.47,5356,
"SCREW BNE TI L16MM OD3.5MM AXON CANC THRD",ORSUP0031,CDM,278,RC,,,OUTPATIENT,,,5356,3481.4,,4713.28,88,,3770.62,,,0,"percent of total billed charges","88% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",926.8,17.304,,741.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3374.28,63,,2699.42,,,0,"percent of total billed charges","63% of total billed charges",819.47,15.3,,655.58,,,0,"percent of total billed charges","15.3% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",3695.64,69,,,,,0,"fee schedule","69% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3312.69,61.85,,2650.15,,,0,"percent of total billed charges","61.5% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",1724.63,32.2,,1379.70,,,0,"percent of total billed charges","32.2% of total billed charges",1671.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",917.8,17.136,,734.24,,,0,"percent of total billed charges","17.136% of total billed charges",1169.75,21.84,,935.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.7% of total billed charges",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1815.68,33.9,,1452.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4177.68,78,,3342.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",819.47,5356,
"SCREW BNE TI L45MM OD5.2MM CLKX PDCL TP LD DL COR",ORSUP0023,CDM,278,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",1002.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.7% of total billed charges",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1089.55,33.9,,871.64,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"SCREW BONE CANCELLOUS 6.5 X 25MM",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SCREW BONE L65MM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SCREW BONE L70MM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SCREW BONE L75MM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SCREW BONE L85MM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SCREW BONE L90MM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SCREW BONE TITANIUM L60MM NAIL-EX",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"SCREW CANC SS 4.0MM 18MM FT",ORSUP0003,CDM,278,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.7% of total billed charges",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.14,33.9,,54.51,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"SCREW CANCELLOUS POLYAXIAL 3.5MM TI 12MM 04.614.012",ORSUP0028,CDM,278,RC,,,OUTPATIENT,,,4553,2959.45,,4006.64,88,,3205.31,,,0,"percent of total billed charges","88% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",787.85,17.304,,630.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2868.39,63,,2294.71,,,0,"percent of total billed charges","63% of total billed charges",696.61,15.3,,557.29,,,0,"percent of total billed charges","15.3% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",3141.57,69,,,,,0,"fee schedule","69% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2816.03,61.85,,2252.82,,,0,"percent of total billed charges","61.5% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",1466.07,32.2,,1172.86,,,0,"percent of total billed charges","32.2% of total billed charges",1420.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",780.2,17.136,,624.16,,,0,"percent of total billed charges","17.136% of total billed charges",994.38,21.84,,795.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.7% of total billed charges",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1543.47,33.9,,1234.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3551.34,78,,2841.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",696.61,4553,
"SCREW CANCELLOUS POLYAXIAL 3.5MM TI 14MM 04.614.014",ORSUP0028,CDM,278,RC,,,OUTPATIENT,,,4553,2959.45,,4006.64,88,,3205.31,,,0,"percent of total billed charges","88% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",787.85,17.304,,630.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2868.39,63,,2294.71,,,0,"percent of total billed charges","63% of total billed charges",696.61,15.3,,557.29,,,0,"percent of total billed charges","15.3% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",3141.57,69,,,,,0,"fee schedule","69% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2816.03,61.85,,2252.82,,,0,"percent of total billed charges","61.5% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",1466.07,32.2,,1172.86,,,0,"percent of total billed charges","32.2% of total billed charges",1420.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",780.2,17.136,,624.16,,,0,"percent of total billed charges","17.136% of total billed charges",994.38,21.84,,795.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.7% of total billed charges",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1543.47,33.9,,1234.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3551.34,78,,2841.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",696.61,4553,
"SCREW CANCELLOUS POLYAXIAL 3.5MM TI 16MM 04.614.016",ORSUP0033,CDM,278,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",1838.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.7% of total billed charges",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1997.39,33.9,,1597.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"SCREW CANCELLOUS POLYAXIAL 3.5MM TI 24MM 04.614.024",ORSUP0033,CDM,278,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",1838.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.7% of total billed charges",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1997.39,33.9,,1597.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"SCREW CANCELLOUS POLYAXIAL 3.5MM TI 26MM 04.614.026",ORSUP0033,CDM,278,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",1838.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.7% of total billed charges",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1997.39,33.9,,1597.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"SCREW CANCELLOUS POLYAXIAL 3.5MM TI 30MM 04.614.030",ORSUP0036,CDM,278,RC,,,OUTPATIENT,,,6695,4351.75,,5891.6,88,,4713.28,,,0,"percent of total billed charges","88% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1158.5,17.304,,926.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4217.85,63,,3374.28,,,0,"percent of total billed charges","63% of total billed charges",1024.34,15.3,,819.47,,,0,"percent of total billed charges","15.3% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",4619.55,69,,,,,0,"fee schedule","69% of total billed charges",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4140.86,61.85,,3312.69,,,0,"percent of total billed charges","61.5% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",2155.79,32.2,,1724.63,,,0,"percent of total billed charges","32.2% of total billed charges",2088.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1147.26,17.136,,917.81,,,0,"percent of total billed charges","17.136% of total billed charges",1462.19,21.84,,1169.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2524.02,37.7,,2019.22,,,0,"percent of total billed charges","37.7% of total billed charges",2524.02,37.7,,2019.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2269.61,33.9,,1815.69,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5222.1,78,,4177.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5530.07,82.6,,4424.06,,,0,"percent of total billed charges","82.6% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",5530.07,82.6,,4424.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",1024.34,6695,
"SCREW CANCELLOUS POLYAXIAL 4.0MM TI 14MM 04.614.114",ORSUP0033,CDM,278,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",1838.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.7% of total billed charges",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1997.39,33.9,,1597.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"SCREW CANCELLOUS POLYAXIAL 4.0MM TI 16MM 04.614.116",ORSUP0037,CDM,278,RC,,,OUTPATIENT,,,6963,4525.95,,6127.44,88,,4901.95,,,0,"percent of total billed charges","88% of total billed charges",3481.5,50,,2785.20,,,0,"percent of total billed charges","50% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1204.88,17.304,,963.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4386.69,63,,3509.35,,,0,"percent of total billed charges","63% of total billed charges",1065.34,15.3,,852.27,,,0,"percent of total billed charges","15.3% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",4804.47,69,,,,,0,"fee schedule","69% of total billed charges",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4306.62,61.85,,3445.30,,,0,"percent of total billed charges","61.5% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",3481.5,50,,2785.20,,,0,"percent of total billed charges","50% of total billed charges",2242.09,32.2,,1793.67,,,0,"percent of total billed charges","32.2% of total billed charges",2172.46,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1193.18,17.136,,954.54,,,0,"percent of total billed charges","17.136% of total billed charges",1520.72,21.84,,1216.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2625.05,37.7,,2100.04,,,0,"percent of total billed charges","37.7% of total billed charges",2625.05,37.7,,2100.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2360.46,33.9,,1888.37,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5431.14,78,,4344.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5751.44,82.6,,4601.15,,,0,"percent of total billed charges","82.6% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",3481.5,50,,2785.20,,,0,"percent of total billed charges","50% of total billed charges",5751.44,82.6,,4601.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",1065.34,6963,
"SCREW CANCELLOUS POLYAXIAL 4.0MM TI 20MM 04.614.120",ORSUP0027,CDM,278,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",1336.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.7% of total billed charges",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1452.62,33.9,,1162.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"SCREW CANCELLOUS POLYAXIAL 4.0MM TI 22MM 04.614.122",ORSUP0027,CDM,278,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",1336.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.7% of total billed charges",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1452.62,33.9,,1162.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"SCREW CANCELLOUS POLYAXIAL 4.0MM TI 24MM 04.614.124",ORSUP0033,CDM,278,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",1838.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.7% of total billed charges",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1997.39,33.9,,1597.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"SCREW CANCELLOUS POLYAXIAL 4.0MM TI 26MM 04.614.126",ORSUP0037,CDM,278,RC,,,OUTPATIENT,,,6963,4525.95,,6127.44,88,,4901.95,,,0,"percent of total billed charges","88% of total billed charges",3481.5,50,,2785.20,,,0,"percent of total billed charges","50% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1204.88,17.304,,963.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4386.69,63,,3509.35,,,0,"percent of total billed charges","63% of total billed charges",1065.34,15.3,,852.27,,,0,"percent of total billed charges","15.3% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",4804.47,69,,,,,0,"fee schedule","69% of total billed charges",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4306.62,61.85,,3445.30,,,0,"percent of total billed charges","61.5% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",3481.5,50,,2785.20,,,0,"percent of total billed charges","50% of total billed charges",2242.09,32.2,,1793.67,,,0,"percent of total billed charges","32.2% of total billed charges",2172.46,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1193.18,17.136,,954.54,,,0,"percent of total billed charges","17.136% of total billed charges",1520.72,21.84,,1216.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2625.05,37.7,,2100.04,,,0,"percent of total billed charges","37.7% of total billed charges",2625.05,37.7,,2100.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2360.46,33.9,,1888.37,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5431.14,78,,4344.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5751.44,82.6,,4601.15,,,0,"percent of total billed charges","82.6% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",3481.5,50,,2785.20,,,0,"percent of total billed charges","50% of total billed charges",5751.44,82.6,,4601.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",1065.34,6963,
"SCREW CANCELLOUS POLYAXIAL 4.0MM TI 28MM 04.614.128",ORSUP0033,CDM,278,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",1838.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.7% of total billed charges",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1997.39,33.9,,1597.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"SCREW CANCELLOUS POLYAXIAL 4.5MM TI 22MM 04.614.222",ORSUP0027,CDM,278,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",1336.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.7% of total billed charges",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1452.62,33.9,,1162.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"SCREW CANCELLOUS POLYAXIAL 4.5MM TI 24MM 04.614.224",ORSUP0033,CDM,278,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",1838.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.7% of total billed charges",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1997.39,33.9,,1597.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"SCREW CANCELLOUS POLYAXIAL 4.5MM TI 26MM 04.614.226",ORSUP0033,CDM,278,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",1838.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.7% of total billed charges",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1997.39,33.9,,1597.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"SCREW CANCELLOUS POLYAXIAL 4.5MM TI 28MM 04.614.228",ORSUP0038,CDM,278,RC,,,OUTPATIENT,,,7231,4700.15,,6363.28,88,,5090.62,,,0,"percent of total billed charges","88% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1251.25,17.304,,1001.00,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4555.53,63,,3644.42,,,0,"percent of total billed charges","63% of total billed charges",1106.34,15.3,,885.07,,,0,"percent of total billed charges","15.3% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4989.39,69,,,,,0,"fee schedule","69% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4472.37,61.85,,3577.90,,,0,"percent of total billed charges","61.5% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",2328.38,32.2,,1862.70,,,0,"percent of total billed charges","32.2% of total billed charges",2256.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1239.1,17.136,,991.28,,,0,"percent of total billed charges","17.136% of total billed charges",1579.25,21.84,,1263.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.7% of total billed charges",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2451.31,33.9,,1961.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5640.18,78,,4512.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",1106.34,7231,
"SCREW CANN 32MM 6.5 X 100 THREAD",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SCREW CANN 32MM 6.5 X 105 THREAD",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW CANN 32MM 6.5 X 45 THREAD",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW CANN 32MM 6.5 X 50 THREAD",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW CANN 32MM 6.5 X 60 THREAD",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"SCREW CANN 32MM 6.5 X 95 THREAD",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW CANN 45MM 6.5",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW CANN 6.5 X  80 THREAD",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW CANN 6.5 X  85 THREAD",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW CANN 6.5 X  90 THREAD",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW CANN 6.5 X  95 THREAD",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW CANN 6.5 X 100 THREAD",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW CANN 6.5 X 105 THREAD",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW CANN 6.5 X 55 THREAD",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SCREW CANN 6.5 X 65 THREAD",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW CANN 6.5MM X 60 THREAD",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW CANN 70MM 6.5",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW CANN SS 4.0MM 24MM ST",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW CANN SS 4.0MM 26MM ST",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW CANN SS 4.0MM 30MM LT",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW CANN SS 4.0MM 36MM LT",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"SCREW CANN SS 4.0MM 38MM ST",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",751.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.7% of total billed charges",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",816.99,33.9,,653.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"SCREW CANN SS 4.0MM 40MM LT",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"SCREW CANN SS 4.0MM 48MM LT",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",751.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.7% of total billed charges",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",816.99,33.9,,653.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"SCREW CANN SS 7.3MM 16MM THREAD 100MM",ORSUP0023,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW CANN SS 7.3MM 16MM THREAD 45MM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SCREW CANN SS 7.3MM 16MM THREAD 50MM",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW CANN SS 7.3MM 16MM THREAD 75MM",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW CANNULATED 5.0MM LOCKING 45MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW CANNULATED 5.0MM LOCKING 65MM",ORSUP0021,CDM,278,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",835.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.7% of total billed charges",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",907.84,33.9,,726.27,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"SCREW CANNULATED 5.0MM LOCKING 80MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"SCREW CANNULATED ACL INTERFERENCE 9X25MM",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"SCREW CANNULATED CONICAL 5.0X75MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW CANNULATED LOCKING 75MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"SCREW CORTCL CONGRUENT TI 3.5X16MM",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"SCREW CORTEX 1.3MMX10MM ST",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SCREW CORTEX 1.3MMX11MM ST",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SCREW CORTEX 1.3MMX12MM ST",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SCREW CORTEX 1.3MMX13MM ST",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SCREW CORTEX 1.3MMX14MM ST",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SCREW CORTEX 1.3MMX16MM ST",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SCREW CORTEX 1.3MMX18MM ST",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SCREW CORTEX 2.0MMX20MM",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SCREW CORTEX 2.0MMX24MM",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"SCREW CORTEX 2.0MMX32MM",ORSUP0003,CDM,278,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.7% of total billed charges",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.14,33.9,,54.51,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"SCREW CORTEX 2.4 X 12 401.512",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SCREW CORTEX 2.4MMX10MM ST",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SCREW CORTEX 2.4MMX11MM ST",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SCREW CORTEX 2.4MMX13MM ST",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"SCREW CORTEX 2.4MMX14MMST",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SCREW CORTEX 2.4MMX18MM ST",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SCREW CORTEX 2.4MMX20MM ST",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SCREW CORTEX 2.4MMX22MM ST",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SCREW CORTEX 2.4MMX24MM ST",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SCREW CORTEX 2.4MMX26MM ST",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SCREW CORTEX 2.4MMX28MM ST",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"SCREW CORTEX 2.4MMX30MM ST",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SCREW CORTEX 2.4MMX32MMST",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"SCREW CORTEX 2.4MMX6MM ST",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SCREW CORTEX 2.4MMX8MM ST",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SCREW CORTEX 2.7MMX12MM",ORSUP0004,CDM,278,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.7% of total billed charges",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.85,33.9,,72.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"SCREW CORTEX 2.7X14MM",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.7% of total billed charges",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.85,33.9,,72.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"SCREW CORTEX 3.5X16MM  404.816",ORSUP0003,CDM,278,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.7% of total billed charges",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.14,33.9,,54.51,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"SCREW CORTEX 3.5X18MM 404.818",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.7% of total billed charges",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.14,33.9,,54.51,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"SCREW CORTEX POLYAXIAL SHAFT 3.5MM TI 24MM 04.614.324",ORSUP0038,CDM,278,RC,,,OUTPATIENT,,,7231,4700.15,,6363.28,88,,5090.62,,,0,"percent of total billed charges","88% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1251.25,17.304,,1001.00,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4555.53,63,,3644.42,,,0,"percent of total billed charges","63% of total billed charges",1106.34,15.3,,885.07,,,0,"percent of total billed charges","15.3% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4989.39,69,,,,,0,"fee schedule","69% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4472.37,61.85,,3577.90,,,0,"percent of total billed charges","61.5% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",2328.38,32.2,,1862.70,,,0,"percent of total billed charges","32.2% of total billed charges",2256.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1239.1,17.136,,991.28,,,0,"percent of total billed charges","17.136% of total billed charges",1579.25,21.84,,1263.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.7% of total billed charges",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2451.31,33.9,,1961.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5640.18,78,,4512.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",1106.34,7231,
"SCREW CORTEX SELFTAPPING 2.4MM X 16MM",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SCREW CORTEX SS 3.5MM 12MM SELF-TAP",ORSUP0003,CDM,278,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.7% of total billed charges",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.14,33.9,,54.51,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"SCREW CORTEX SS 3.5MM 20MM SELF-TAP",ORSUP0003,CDM,278,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.7% of total billed charges",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.14,33.9,,54.51,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"SCREW CORTEX SS 3.5MM 30MM SELF-TAP",ORSUP0003,CDM,278,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.7% of total billed charges",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.14,33.9,,54.51,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"SCREW CORTEX SS 3.5MM 34MM SELF-TAP",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"SCREW CORTEX SS 3.5MM 40MM SELF-TAP",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"SCREW CORTEX SS 4.5MM 40MM SELF-TAP",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SCREW CORTEX TIN 1.5MMX6MM",ORSUP0004,CDM,278,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.7% of total billed charges",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.85,33.9,,72.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"SCREW CORTEX TIN 1.5MMX7MM",ORSUP0004,CDM,278,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.7% of total billed charges",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.83,33.9,,55.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"SCREW CORTEX TITANIUM 1.5X14MM",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.7% of total billed charges",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.46,33.9,,69.97,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"SCREW CORTEX TITANIUM 1.5X16MM",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SCREW CORTEX TITANIUM 1.5X18MM",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.7% of total billed charges",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.46,33.9,,69.97,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"SCREW CORTEX TITANIUM 1.5X8MM",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,515,334.75,,453.2,88,,362.56,,,0,"percent of total billed charges","88% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.12,17.304,,71.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",324.45,63,,259.56,,,0,"percent of total billed charges","63% of total billed charges",78.8,15.3,,63.04,,,0,"percent of total billed charges","15.3% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",355.35,69,,,,,0,"fee schedule","69% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",318.53,61.85,,254.82,,,0,"percent of total billed charges","61.5% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",165.83,32.2,,132.66,,,0,"percent of total billed charges","32.2% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.25,17.136,,70.60,,,0,"percent of total billed charges","17.136% of total billed charges",112.48,21.84,,89.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.16,37.7,,155.33,,,0,"percent of total billed charges","37.7% of total billed charges",194.16,37.7,,155.33,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",174.59,33.9,,139.67,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",401.7,78,,321.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",78.8,515,
"SCREW CORTEX TITANIUM 2.0X10MM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.94,17.304,,85.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.23,61.85,,305.78,,,0,"percent of total billed charges","61.5% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",199,32.2,,159.20,,,0,"percent of total billed charges","32.2% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.136,,84.72,,,0,"percent of total billed charges","17.136% of total billed charges",134.97,21.84,,107.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.7% of total billed charges",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.5,33.9,,167.60,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,618,
"SCREW CORTEX TITANIUM 2.0X12MM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.94,17.304,,85.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.23,61.85,,305.78,,,0,"percent of total billed charges","61.5% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",199,32.2,,159.20,,,0,"percent of total billed charges","32.2% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.136,,84.72,,,0,"percent of total billed charges","17.136% of total billed charges",134.97,21.84,,107.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.7% of total billed charges",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.5,33.9,,167.60,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,618,
"SCREW CORTEX TITANIUM 2.0X14MM",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"SCREW CORTEX TITANIUM 2.0X18MM",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"SCREW CORTEX TITANIUM 2.7X20MM",ORSUP0004,CDM,278,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.7% of total billed charges",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.85,33.9,,72.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"SCREW CORTEX TITANIUM 2.OX16MM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.94,17.304,,85.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.23,61.85,,305.78,,,0,"percent of total billed charges","61.5% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",199,32.2,,159.20,,,0,"percent of total billed charges","32.2% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.136,,84.72,,,0,"percent of total billed charges","17.136% of total billed charges",134.97,21.84,,107.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.7% of total billed charges",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.5,33.9,,167.60,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,618,
"SCREW CORTEX TITANIUM 400.812",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SCREW CORTEX TITANIUM 400.820",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SCREW CORTEX TITANIUM 400.822",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SCREW CORTEX TITATIUM 1.5X10MM",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.7% of total billed charges",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.46,33.9,,69.97,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"SCREW CORTICAL 3.5 X 10MM",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"SCREW CORTICAL 3.5 X 14MM",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"SCREW CORTICAL 3.5 X 22MM",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"SCREW CORTICAL LOCKING  3.5 X 14MM",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"SCREW CORTICAL LOCKING 3.5 X 16MM",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"SCREW CORTICAL LOCKING 3.5 X 18MM",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"SCREW CORTICAL LOCKING 3.5 X 8MM",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"SCREW EMERGENCY 4MM MATRIXNEURO TI",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"SCREW HEX CORTICAL 3.2 X 14MM",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"SCREW LOCKING 2.7MMX16MM",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"SCREW LOCKING 2.7MMX18MM 202.218",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"SCREW LOCKING 3.5MM SLF-TAP W/STARDRIVE 12MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW LOCKING 3.5MM SLF-TAP W/STARDRIVE 16MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW LOCKING 3.5MM SLF-TAP W/STARDRIVE 18MM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW LOCKING 3.5MM SLF-TAP W/STARDRIVE 22MM",ORSUP0018,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SCREW LOCKING 3.5MM SLF-TAP W/STARDRIVE 28MM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SCREW LOCKING 3.5MM SLF-TAP W/STARDRIVE 30MM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SCREW LOCKING 3.5MM SLF-TAP W/STARDRIVE 32MM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SCREW LOCKING 3.5MM SLF-TAP W/STARDRIVE 36MM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SCREW LOCKING 3.5MM SLF-TAP W/STARDRIVE 38MM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SCREW LOCKING 3.5MM SLF-TAP W/STARDRIVE 40MM",ORSUP0018,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW LOCKING 3.5MM SLF-TAP W/STARDRIVE 45MM",ORSUP0018,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW LOCKING 3.5MM SLF-TAP W/STARDRIVE 50MM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"SCREW LOCKING 3.5MM SLF-TAP W/STARDRIVE 55MM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SCREW LOCKING 3.5MM SLF-TAP W/STARDRIVE 60MM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SCREW LOCKING 5.0MM SLF-TAP W/STAR DRIVE 36MM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SCREW LOCKING 5.0MM X 42MM STARDRIVE",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SCREW LOW PROFILE 400.844",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SCREW MAXTORQUE 4.0 X 20MM, SHORT THREAD MSD-010-40-020S",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SCREW MAXTORQUE 4.0 X 24MM, LONG THREAD MSD-010-40-024L",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"SCREW MAXTORQUE 4.0 X 24MM, SHORT THREAD MSD-010-40-024S",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SCREW MAXTORQUE 4.0 X 26MM, SHORT THREAD MSD-010-40-26S",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SCREW MAXTORQUE 4.0 X 28MM, LONG THREAD MSD-010-40-028L",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SCREW MAXTORQUE 4.0 X 28MM, SHORT THREAD MSD-010-40-28S",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SCREW MAXTORQUE 4.0 X 30MM, LONG THREAD MSD-010-40-030L",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SCREW MAXTORQUE 4.0 X 30MM, SHORT THREAD MSD-010-40-030S",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SCREW MAXTORQUE 4.0 X 32MM, LONG THREAD MSD-010-40-325L",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SCREW MAXTORQUE 4.0 X 35MM, LONG THREAD MSD-010-40-035L",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SCREW MAXTORQUE 4.0 X 37.5MM, LONG THREAD MSD-010-40-375L",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SCREW MAXTORQUE 4.0 X 42,5MM, LONG THREAD MSD-010-40-425L",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SCREW MAXTORQUE 5.5 X 37.5MM, SHORT THREAD MSD-010-55-375S",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW SCHANZ 5.0MM BLUNT TROCAR POINT 170MM",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SCREW SCHANZ 5.0MM SELF-DRILL 80MM THREAD",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW SELF-DRILLING TI MATRIXNEURO 3MM 04.503.103.01",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SCREW SELF-DRILLING TI MATRIXNEURO 4MM 04.503.104.01",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"SCREW SLF-TPNG WITH T25 STARDRIVE RECESS 28MM 5.0MM LOCKING",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW SLF-TPNG WITH T25 STARDRIVE RECESS 32MM 5.0MM LOCKING",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW SLF-TPNG WITH T25 STARDRIVE RECESS 38MM 5.0MM LOCKING",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"SCREW SLF-TPNG WITH T25 STARDRIVE RECESS 40MM 5.0MM LOCKING",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SCREW TI LOW PROFILE NEURO EMERGENCY SELF-TAP 4MM",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SCREWS LOCKING 4 X 25MM",ORSUP0019,CDM,278,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",668.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.7% of total billed charges",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",726.14,33.9,,580.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"SCREW 14MM",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SCREW 16MM",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW 7 MM X 55MM",ORSUP0029,CDM,278,RC,,,OUTPATIENT,,,4820,3133,,4241.6,88,,3393.28,,,0,"percent of total billed charges","88% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",834.05,17.304,,667.24,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3036.6,63,,2429.28,,,0,"percent of total billed charges","63% of total billed charges",737.46,15.3,,589.97,,,0,"percent of total billed charges","15.3% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",3325.8,69,,,,,0,"fee schedule","69% of total billed charges",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2981.17,61.85,,2384.94,,,0,"percent of total billed charges","61.5% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",1552.04,32.2,,1241.63,,,0,"percent of total billed charges","32.2% of total billed charges",1503.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",825.96,17.136,,660.77,,,0,"percent of total billed charges","17.136% of total billed charges",1052.69,21.84,,842.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1817.14,37.7,,1453.71,,,0,"percent of total billed charges","37.7% of total billed charges",1817.14,37.7,,1453.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1633.98,33.9,,1307.18,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3759.6,78,,3007.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3981.32,82.6,,3185.06,,,0,"percent of total billed charges","82.6% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",3981.32,82.6,,3185.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",737.46,4820,
"SCREW 7.5X45MM",ORSUP0035,CDM,278,RC,,,OUTPATIENT,,,6427,4177.55,,5655.76,88,,4524.61,,,0,"percent of total billed charges","88% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1112.13,17.304,,889.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4049.01,63,,3239.21,,,0,"percent of total billed charges","63% of total billed charges",983.33,15.3,,786.66,,,0,"percent of total billed charges","15.3% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4434.63,69,,,,,0,"fee schedule","69% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3975.1,61.85,,3180.08,,,0,"percent of total billed charges","61.5% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",2069.49,32.2,,1655.59,,,0,"percent of total billed charges","32.2% of total billed charges",2005.22,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1101.33,17.136,,881.06,,,0,"percent of total billed charges","17.136% of total billed charges",1403.66,21.84,,1122.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.7% of total billed charges",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2178.75,33.9,,1743.00,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5013.06,78,,4010.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",983.33,6427,
"SCREW 7MM X 45 TITANIUM POLYAXIAL",ORSUP0035,CDM,278,RC,,,OUTPATIENT,,,6427,4177.55,,5655.76,88,,4524.61,,,0,"percent of total billed charges","88% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1112.13,17.304,,889.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4049.01,63,,3239.21,,,0,"percent of total billed charges","63% of total billed charges",983.33,15.3,,786.66,,,0,"percent of total billed charges","15.3% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4434.63,69,,,,,0,"fee schedule","69% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3975.1,61.85,,3180.08,,,0,"percent of total billed charges","61.5% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",2069.49,32.2,,1655.59,,,0,"percent of total billed charges","32.2% of total billed charges",2005.22,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1101.33,17.136,,881.06,,,0,"percent of total billed charges","17.136% of total billed charges",1403.66,21.84,,1122.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.7% of total billed charges",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2178.75,33.9,,1743.00,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5013.06,78,,4010.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",983.33,6427,
"SCREW 7MM X 50 TITANIUM POLYAXIAL",ORSUP0029,CDM,278,RC,,,OUTPATIENT,,,4820,3133,,4241.6,88,,3393.28,,,0,"percent of total billed charges","88% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",834.05,17.304,,667.24,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3036.6,63,,2429.28,,,0,"percent of total billed charges","63% of total billed charges",737.46,15.3,,589.97,,,0,"percent of total billed charges","15.3% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",3325.8,69,,,,,0,"fee schedule","69% of total billed charges",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2981.17,61.85,,2384.94,,,0,"percent of total billed charges","61.5% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",1552.04,32.2,,1241.63,,,0,"percent of total billed charges","32.2% of total billed charges",1503.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",825.96,17.136,,660.77,,,0,"percent of total billed charges","17.136% of total billed charges",1052.69,21.84,,842.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1817.14,37.7,,1453.71,,,0,"percent of total billed charges","37.7% of total billed charges",1817.14,37.7,,1453.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1633.98,33.9,,1307.18,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3759.6,78,,3007.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3981.32,82.6,,3185.06,,,0,"percent of total billed charges","82.6% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",3981.32,82.6,,3185.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",737.46,4820,
"SCREW 8 MM X 50MM",ORSUP0035,CDM,278,RC,,,OUTPATIENT,,,6427,4177.55,,5655.76,88,,4524.61,,,0,"percent of total billed charges","88% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1112.13,17.304,,889.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4049.01,63,,3239.21,,,0,"percent of total billed charges","63% of total billed charges",983.33,15.3,,786.66,,,0,"percent of total billed charges","15.3% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4434.63,69,,,,,0,"fee schedule","69% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3975.1,61.85,,3180.08,,,0,"percent of total billed charges","61.5% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",2069.49,32.2,,1655.59,,,0,"percent of total billed charges","32.2% of total billed charges",2005.22,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1101.33,17.136,,881.06,,,0,"percent of total billed charges","17.136% of total billed charges",1403.66,21.84,,1122.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.7% of total billed charges",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2178.75,33.9,,1743.00,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5013.06,78,,4010.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",983.33,6427,
"SCREW BARIABLE SELF TAP 16MM",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW BONE TI L16MM OD4.5MM VECTRA CERV ST FA SLF RET",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW BONE TI L18MM OD4.5MM VECTRA CERV ST FA SLF RET",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW BONE TI L18MM OD4MM VECTRA CERV ST FA SLF RET",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW BONE TI L40MM OD7MM PANGEA PDCL 2 COR PA NS",ORSUP0033,CDM,278,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",1838.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.7% of total billed charges",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1997.39,33.9,,1597.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"SCREW BONE TI L40MM OD8MM PANGEA PDCL PA PREASSEMBLED",ORSUP0033,CDM,278,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",1838.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.7% of total billed charges",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1997.39,33.9,,1597.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"SCREW BONE TI L45MM OD6MM PANGEA PDCL PA PREASSEMBLED",ORSUP0034,CDM,278,RC,,,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1065.75,17.304,,852.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",942.33,15.3,,753.86,,,0,"percent of total billed charges","15.3% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3809.34,61.85,,3047.47,,,0,"percent of total billed charges","61.5% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1983.2,32.2,,1586.56,,,0,"percent of total billed charges","32.2% of total billed charges",1921.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1055.41,17.136,,844.33,,,0,"percent of total billed charges","17.136% of total billed charges",1345.13,21.84,,1076.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",942.33,6159,
"SCREW BONE TI L45MM OD7MM PANGEA PDCL 2 COR PA NS",ORSUP0033,CDM,278,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",1838.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.7% of total billed charges",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1997.39,33.9,,1597.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"SCREW BONE TI L45MM OD8MM PANGEA PDCL PA",ORSUP0034,CDM,278,RC,,,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1065.75,17.304,,852.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",942.33,15.3,,753.86,,,0,"percent of total billed charges","15.3% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3809.34,61.85,,3047.47,,,0,"percent of total billed charges","61.5% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1983.2,32.2,,1586.56,,,0,"percent of total billed charges","32.2% of total billed charges",1921.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1055.41,17.136,,844.33,,,0,"percent of total billed charges","17.136% of total billed charges",1345.13,21.84,,1076.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",942.33,6159,
"SCREW BONE TI L50MM OD5MM PANGEA PDCL PA PREASSEMBLED",ORSUP0033,CDM,278,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",1838.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.7% of total billed charges",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1997.39,33.9,,1597.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"SCREW BONE TI L50MM OD6MM PANGEA PDCL PA PREASSEMBLED",ORSUP0033,CDM,278,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",1838.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.7% of total billed charges",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1997.39,33.9,,1597.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"SCREW BONE TI L50MM OD7MM PANGEA PDCL 2 COR PA NS",ORSUP0033,CDM,278,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",1838.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.7% of total billed charges",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1997.39,33.9,,1597.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"SCREW BONE TI L50MM OD8MM PANGEA PDCL PA",ORSUP0033,CDM,278,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",1838.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.7% of total billed charges",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1997.39,33.9,,1597.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"SCREW BONE TI L55MM OD7MM PANGEA  PDCL PA PREASSEMBLED",ORSUP0033,CDM,278,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",1838.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.7% of total billed charges",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1997.39,33.9,,1597.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"SCREW BONE TI L55MM OD8MM PANGEA PDCL PA PREASSEMBLED",ORSUP0033,CDM,278,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",1838.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.7% of total billed charges",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1997.39,33.9,,1597.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"SCREW BONE TI L60MM OD7MM PANGEA PDCL PA PREASSEMBLED",ORSUP0033,CDM,278,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",1838.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.7% of total billed charges",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1997.39,33.9,,1597.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"SCREW BONE TI L60MM OD8MM PANGEA PDCL PA PREASSEMBLED",ORSUP0032,CDM,278,RC,,,OUTPATIENT,,,5624,3655.6,,4949.12,88,,3959.30,,,0,"percent of total billed charges","88% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",973.18,17.304,,778.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3543.12,63,,2834.50,,,0,"percent of total billed charges","63% of total billed charges",860.47,15.3,,688.38,,,0,"percent of total billed charges","15.3% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",3880.56,69,,,,,0,"fee schedule","69% of total billed charges",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3478.44,61.85,,2782.75,,,0,"percent of total billed charges","61.5% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",1810.93,32.2,,1448.74,,,0,"percent of total billed charges","32.2% of total billed charges",1754.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",963.73,17.136,,770.98,,,0,"percent of total billed charges","17.136% of total billed charges",1228.28,21.84,,982.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2120.25,37.7,,1696.20,,,0,"percent of total billed charges","37.7% of total billed charges",2120.25,37.7,,1696.20,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1906.54,33.9,,1525.23,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4386.72,78,,3509.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4645.42,82.6,,3716.34,,,0,"percent of total billed charges","82.6% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",4645.42,82.6,,3716.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",860.47,5624,
"SCREW BONE VECTRA TI L 16MM OD4MM ANT CERV SLF RET SLFDRL",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW BONE VECTRA TI L14MM OD4.5MM ANT CERV SLF RE",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"SCREW BONE VECTRA TI L14MM OD4MM ANT CERV SLF RET SLFDRL VA",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW BONE VECTRA TI L16MM OD4.5MM ANT CERV SLF RET SLFDRL VA",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW BONE VECTRA TI L16MM OD4MM ANT CERV SLF RET SLFDRL FA",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW BONE VECTRA TI L18MM OD4.5MM ANT CERV SLF RET SLFDRL VA",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW BONE VECTRA TI L18MM OD4MM ANT CERV SLF RET SLFDRL FA",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW BONE VECTRA TI L18MM OD4MM ANT CERV SLF RET SLFDRL VA",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW SELF-TAPPING 45MM",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW TITANIUM SELF TAP 18MM",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SCREW SYN LOCKING 5.0MM",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SCREW CONEPT 7 X 25",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SCREW CONCEPT 7 X 20",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SCREW 208.900 CANNULATED",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SCREW BIO FEMOR INTER 7X20",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"SCREW CONCEPT 9 X 30",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SCREW CONCEPT 9 X 25",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SCREW CONCEPT 9 X 20",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SCREW CONCEPT 7 X 30",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SCREW BIO TIBIAL 7 X 20",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"SCREW BIO TIBIAL 7 X 25",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SCREW CORTEX 1.3MM X 9MM ST",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SCREW CORTEX 1.3MM X 6MM S-T",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SCREW CORTEX 1.3MM X 7MM S-T",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SCREW COREX 1.0 X 8MM TITANIUM S-T",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"SCREW CANNULATED 4.0 LONG THREAD",ORSUP0021,CDM,278,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",668.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.7% of total billed charges",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",726.14,33.9,,580.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"SCREW CANNULATED 8MM X 20MM",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.94,17.304,,85.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.23,61.85,,305.78,,,0,"percent of total billed charges","61.5% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",199,32.2,,159.20,,,0,"percent of total billed charges","32.2% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.136,,84.72,,,0,"percent of total billed charges","17.136% of total billed charges",134.97,21.84,,107.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.7% of total billed charges",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.5,33.9,,167.60,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,618,
"SCREW CANNULATED FULL THREAD 8 X 25",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,515,334.75,,453.2,88,,362.56,,,0,"percent of total billed charges","88% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.12,17.304,,71.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",324.45,63,,259.56,,,0,"percent of total billed charges","63% of total billed charges",78.8,15.3,,63.04,,,0,"percent of total billed charges","15.3% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",355.35,69,,,,,0,"fee schedule","69% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",318.53,61.85,,254.82,,,0,"percent of total billed charges","61.5% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",165.83,32.2,,132.66,,,0,"percent of total billed charges","32.2% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.25,17.136,,70.60,,,0,"percent of total billed charges","17.136% of total billed charges",112.48,21.84,,89.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.16,37.7,,155.33,,,0,"percent of total billed charges","37.7% of total billed charges",194.16,37.7,,155.33,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",174.59,33.9,,139.67,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",401.7,78,,321.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",78.8,515,
"SCREW CANNULATED FULL THREAD 8 X 30",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,515,334.75,,453.2,88,,362.56,,,0,"percent of total billed charges","88% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.12,17.304,,71.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",324.45,63,,259.56,,,0,"percent of total billed charges","63% of total billed charges",78.8,15.3,,63.04,,,0,"percent of total billed charges","15.3% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",355.35,69,,,,,0,"fee schedule","69% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",318.53,61.85,,254.82,,,0,"percent of total billed charges","61.5% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",165.83,32.2,,132.66,,,0,"percent of total billed charges","32.2% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.25,17.136,,70.60,,,0,"percent of total billed charges","17.136% of total billed charges",112.48,21.84,,89.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.16,37.7,,155.33,,,0,"percent of total billed charges","37.7% of total billed charges",194.16,37.7,,155.33,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",174.59,33.9,,139.67,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",401.7,78,,321.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",78.8,515,
"SCRUB SOLN EXIDINE-4 GAL",185641,CDM,270,RC,,,OUTPATIENT,,,519,337.35,,456.72,88,,365.38,,,0,"percent of total billed charges","88% of total billed charges",259.5,50,,207.60,,,0,"percent of total billed charges","50% of total billed charges",87.19,16.8,,69.75,,,0,"percent of total billed charges","16.8% of total billed charges",519,100,,415.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.81,17.304,,71.85,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.97,63,,261.58,,,0,"percent of total billed charges","63% of total billed charges",79.41,15.3,,63.53,,,0,"percent of total billed charges","15.3% of total billed charges",87.19,16.8,,69.75,,,0,"percent of total billed charges","16.8% of total billed charges",358.11,69,,,,,0,"fee schedule","69% of total billed charges",519,100,,415.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",519,100,,415.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",519,100,,415.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",321,61.85,,256.80,,,0,"percent of total billed charges","61.5% of total billed charges",87.19,16.8,,69.75,,,0,"percent of total billed charges","16.8% of total billed charges",259.5,50,,207.60,,,0,"percent of total billed charges","50% of total billed charges",167.12,32.2,,133.70,,,0,"percent of total billed charges","32.2% of total billed charges",87.19,16.8,,69.75,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.94,17.136,,71.15,,,0,"percent of total billed charges","17.136% of total billed charges",113.35,21.84,,90.68,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",195.66,37.7,,156.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",404.82,78,,323.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",428.69,82.6,,342.95,,,0,"percent of total billed charges","82.6% of total billed charges",87.19,16.8,,69.75,,,0,"percent of total billed charges","16.8% of total billed charges",259.5,50,,207.60,,,0,"percent of total billed charges","50% of total billed charges",428.69,82.6,,342.95,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.19,16.8,,69.75,,,0,"percent of total billed charges","16.8% of total billed charges",519,100,,415.20,,,0,"percent of total billed charges","100% of total billed charges",79.41,519,
"SCRUB SITE IPA DEVICE W/ ISO ALCOHOL BX/100",323429,CDM,272,RC,,,OUTPATIENT,,,207,134.55,,182.16,88,,145.73,,,0,"percent of total billed charges","88% of total billed charges",103.5,50,,82.80,,,0,"percent of total billed charges","50% of total billed charges",34.78,16.8,,27.82,,,0,"percent of total billed charges","16.8% of total billed charges",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.82,17.304,,28.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",130.41,63,,104.33,,,0,"percent of total billed charges","63% of total billed charges",31.67,15.3,,25.34,,,0,"percent of total billed charges","15.3% of total billed charges",34.78,16.8,,27.82,,,0,"percent of total billed charges","16.8% of total billed charges",142.83,69,,,,,0,"fee schedule","69% of total billed charges",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,61.85,,102.42,,,0,"percent of total billed charges","61.5% of total billed charges",34.78,16.8,,27.82,,,0,"percent of total billed charges","16.8% of total billed charges",103.5,50,,82.80,,,0,"percent of total billed charges","50% of total billed charges",66.65,32.2,,53.32,,,0,"percent of total billed charges","32.2% of total billed charges",34.78,16.8,,27.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.47,17.136,,28.38,,,0,"percent of total billed charges","17.136% of total billed charges",45.21,21.84,,36.17,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",78.04,37.7,,62.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",161.46,78,,129.17,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.98,82.6,,136.78,,,0,"percent of total billed charges","82.6% of total billed charges",34.78,16.8,,27.82,,,0,"percent of total billed charges","16.8% of total billed charges",103.5,50,,82.80,,,0,"percent of total billed charges","50% of total billed charges",170.98,82.6,,136.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,16.8,,27.82,,,0,"percent of total billed charges","16.8% of total billed charges",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",31.67,207,
"SCRUB BETASEPT 4% CHG 32OZ",216301,CDM,270,RC,,,OUTPATIENT,,,70,45.5,,61.6,88,,49.28,,,0,"percent of total billed charges","88% of total billed charges",35,50,,28.00,,,0,"percent of total billed charges","50% of total billed charges",11.76,16.8,,9.41,,,0,"percent of total billed charges","16.8% of total billed charges",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.11,17.304,,9.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.1,63,,35.28,,,0,"percent of total billed charges","63% of total billed charges",10.71,15.3,,8.57,,,0,"percent of total billed charges","15.3% of total billed charges",11.76,16.8,,9.41,,,0,"percent of total billed charges","16.8% of total billed charges",48.3,69,,,,,0,"fee schedule","69% of total billed charges",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.3,61.85,,34.64,,,0,"percent of total billed charges","61.5% of total billed charges",11.76,16.8,,9.41,,,0,"percent of total billed charges","16.8% of total billed charges",35,50,,28.00,,,0,"percent of total billed charges","50% of total billed charges",22.54,32.2,,18.03,,,0,"percent of total billed charges","32.2% of total billed charges",11.76,16.8,,9.41,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,17.136,,9.60,,,0,"percent of total billed charges","17.136% of total billed charges",15.29,21.84,,12.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.39,37.7,,21.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",54.6,78,,43.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.82,82.6,,46.26,,,0,"percent of total billed charges","82.6% of total billed charges",11.76,16.8,,9.41,,,0,"percent of total billed charges","16.8% of total billed charges",35,50,,28.00,,,0,"percent of total billed charges","50% of total billed charges",57.82,82.6,,46.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.76,16.8,,9.41,,,0,"percent of total billed charges","16.8% of total billed charges",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",10.71,70,
"SCRUB BRUSH W/IODINE",491162,CDM,270,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"SCRUB BRUSH DRY",491158,CDM,270,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"SCRW 2.3 THREADED 16MM",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SCRW 2.7MM LOCKING SLF-TPNG W/T8 STARDRIVE RECESS 28MM 202.228",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"SCRW 5.0MM CANNULATED LOCKING 85MM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"SCRW BNE L130MM OD7.3MM CNULA FULTHRD",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SEALANT SURGICAL CO-SEAL 4ML",ORSUP0024,CDM,278,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",1086.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.7% of total billed charges",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1180.06,33.9,,944.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"SEALANT FLOSEAL HEMOSTATIC MATRIX 10ML",ORSUP0019,CDM,278,RC,,,OUTPATIENT,,,1648,1071.2,,1450.24,88,,1160.19,,,0,"percent of total billed charges","88% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",285.17,17.304,,228.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1038.24,63,,830.59,,,0,"percent of total billed charges","63% of total billed charges",252.14,15.3,,201.71,,,0,"percent of total billed charges","15.3% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1137.12,69,,,,,0,"fee schedule","69% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.29,61.85,,815.43,,,0,"percent of total billed charges","61.5% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",530.66,32.2,,424.53,,,0,"percent of total billed charges","32.2% of total billed charges",514.18,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",282.4,17.136,,225.92,,,0,"percent of total billed charges","17.136% of total billed charges",359.92,21.84,,287.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",621.3,37.7,,497.04,,,0,"percent of total billed charges","37.7% of total billed charges",621.3,37.7,,497.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",558.67,33.9,,446.94,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1285.44,78,,1028.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1361.25,82.6,,1089.00,,,0,"percent of total billed charges","82.6% of total billed charges",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",824,50,,659.20,,,0,"percent of total billed charges","50% of total billed charges",1361.25,82.6,,1089.00,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.86,16.8,,221.49,,,0,"percent of total billed charges","16.8% of total billed charges",1648,100,,1318.40,,,0,"percent of total billed charges","100% of total billed charges",252.14,1648,
"SEAL ANGIO STS 6FR VIP",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"SEAL SYSTEM HEARTSTRING BX/5",ORSUP0023,CDM,270,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"SEALER CURVED LARGE JAW OPEN",ORSUP0093,CDM,272,RC,,,OUTPATIENT,,,22495,14621.75,,19795.6,88,,15836.48,,,0,"percent of total billed charges","88% of total billed charges",11247.5,50,,8998.00,,,0,"percent of total billed charges","50% of total billed charges",3779.16,16.8,,3023.33,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3892.53,17.304,,3114.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14171.85,63,,11337.48,,,0,"percent of total billed charges","63% of total billed charges",3441.74,15.3,,2753.39,,,0,"percent of total billed charges","15.3% of total billed charges",3779.16,16.8,,3023.33,,,0,"percent of total billed charges","16.8% of total billed charges",15521.55,69,,,,,0,"fee schedule","69% of total billed charges",22495,100,,17996.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22495,100,,17996.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22495,100,,17996.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13913.16,61.85,,11130.53,,,0,"percent of total billed charges","61.5% of total billed charges",3779.16,16.8,,3023.33,,,0,"percent of total billed charges","16.8% of total billed charges",11247.5,50,,8998.00,,,0,"percent of total billed charges","50% of total billed charges",7243.39,32.2,,5794.71,,,0,"percent of total billed charges","32.2% of total billed charges",3779.16,16.8,,3023.33,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3854.74,17.136,,3083.79,,,0,"percent of total billed charges","17.136% of total billed charges",4912.91,21.84,,3930.33,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8480.62,37.7,,6784.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17546.1,78,,14036.88,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",18580.87,82.6,,14864.70,,,0,"percent of total billed charges","82.6% of total billed charges",3779.16,16.8,,3023.33,,,0,"percent of total billed charges","16.8% of total billed charges",11247.5,50,,8998.00,,,0,"percent of total billed charges","50% of total billed charges",18580.87,82.6,,14864.70,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3779.16,16.8,,3023.33,,,0,"percent of total billed charges","16.8% of total billed charges",22495,100,,17996.00,,,0,"percent of total billed charges","100% of total billed charges",3441.74,22495,
"SEALANT EVICEL FIBRIN 5ML (1EA/BX)",ORSUP0025,CDM,272,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"SEALANT TISSEEL FIBRIN 10ML FROZEN",ORSUP0026,CDM,272,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"SEALENT TISSEEL FBRINOGEN 4ML",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SEAL 5MM DISPOSABLE GREEN",270727,CDM,272,RC,,,OUTPATIENT,,,2811,1827.15,,2473.68,88,,1978.94,,,0,"percent of total billed charges","88% of total billed charges",1405.5,50,,1124.40,,,0,"percent of total billed charges","50% of total billed charges",472.25,16.8,,377.80,,,0,"percent of total billed charges","16.8% of total billed charges",2811,100,,2248.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",486.42,17.304,,389.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1770.93,63,,1416.74,,,0,"percent of total billed charges","63% of total billed charges",430.08,15.3,,344.06,,,0,"percent of total billed charges","15.3% of total billed charges",472.25,16.8,,377.80,,,0,"percent of total billed charges","16.8% of total billed charges",1939.59,69,,,,,0,"fee schedule","69% of total billed charges",2811,100,,2248.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2811,100,,2248.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2811,100,,2248.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1738.6,61.85,,1390.88,,,0,"percent of total billed charges","61.5% of total billed charges",472.25,16.8,,377.80,,,0,"percent of total billed charges","16.8% of total billed charges",1405.5,50,,1124.40,,,0,"percent of total billed charges","50% of total billed charges",905.14,32.2,,724.11,,,0,"percent of total billed charges","32.2% of total billed charges",472.25,16.8,,377.80,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",481.69,17.136,,385.35,,,0,"percent of total billed charges","17.136% of total billed charges",613.92,21.84,,491.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1059.75,37.7,,847.80,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2192.58,78,,1754.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2321.89,82.6,,1857.51,,,0,"percent of total billed charges","82.6% of total billed charges",472.25,16.8,,377.80,,,0,"percent of total billed charges","16.8% of total billed charges",1405.5,50,,1124.40,,,0,"percent of total billed charges","50% of total billed charges",2321.89,82.6,,1857.51,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",472.25,16.8,,377.80,,,0,"percent of total billed charges","16.8% of total billed charges",2811,100,,2248.80,,,0,"percent of total billed charges","100% of total billed charges",430.08,2811,
"SEAL CANNULA 8.5 - 13MM",176843,CDM,272,RC,,,OUTPATIENT,,,331,215.15,,291.28,88,,233.02,,,0,"percent of total billed charges","88% of total billed charges",165.5,50,,132.40,,,0,"percent of total billed charges","50% of total billed charges",55.61,16.8,,44.49,,,0,"percent of total billed charges","16.8% of total billed charges",331,100,,264.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.28,17.304,,45.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.53,63,,166.82,,,0,"percent of total billed charges","63% of total billed charges",50.64,15.3,,40.51,,,0,"percent of total billed charges","15.3% of total billed charges",55.61,16.8,,44.49,,,0,"percent of total billed charges","16.8% of total billed charges",228.39,69,,,,,0,"fee schedule","69% of total billed charges",331,100,,264.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331,100,,264.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331,100,,264.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.72,61.85,,163.78,,,0,"percent of total billed charges","61.5% of total billed charges",55.61,16.8,,44.49,,,0,"percent of total billed charges","16.8% of total billed charges",165.5,50,,132.40,,,0,"percent of total billed charges","50% of total billed charges",106.58,32.2,,85.26,,,0,"percent of total billed charges","32.2% of total billed charges",55.61,16.8,,44.49,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.72,17.136,,45.38,,,0,"percent of total billed charges","17.136% of total billed charges",72.29,21.84,,57.83,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",124.79,37.7,,99.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",258.18,78,,206.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",273.41,82.6,,218.73,,,0,"percent of total billed charges","82.6% of total billed charges",55.61,16.8,,44.49,,,0,"percent of total billed charges","16.8% of total billed charges",165.5,50,,132.40,,,0,"percent of total billed charges","50% of total billed charges",273.41,82.6,,218.73,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",55.61,16.8,,44.49,,,0,"percent of total billed charges","16.8% of total billed charges",331,100,,264.80,,,0,"percent of total billed charges","100% of total billed charges",50.64,331,
"SEAL CANNULA 8MM",238235,CDM,272,RC,,,OUTPATIENT,,,124,80.6,,109.12,88,,87.30,,,0,"percent of total billed charges","88% of total billed charges",62,50,,49.60,,,0,"percent of total billed charges","50% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.46,17.304,,17.17,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.12,63,,62.50,,,0,"percent of total billed charges","63% of total billed charges",18.97,15.3,,15.18,,,0,"percent of total billed charges","15.3% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",85.56,69,,,,,0,"fee schedule","69% of total billed charges",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.69,61.85,,61.35,,,0,"percent of total billed charges","61.5% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",62,50,,49.60,,,0,"percent of total billed charges","50% of total billed charges",39.93,32.2,,31.94,,,0,"percent of total billed charges","32.2% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.25,17.136,,17.00,,,0,"percent of total billed charges","17.136% of total billed charges",27.08,21.84,,21.66,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.75,37.7,,37.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",96.72,78,,77.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",102.42,82.6,,81.94,,,0,"percent of total billed charges","82.6% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",62,50,,49.60,,,0,"percent of total billed charges","50% of total billed charges",102.42,82.6,,81.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",18.97,124,
"SEALER AQUAMANTIS BIPOLAR 2.3",ORSUP0025,CDM,272,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"SEALER BIPOLAR 6.0",ORSUP0029,CDM,272,RC,,,OUTPATIENT,,,4820,3133,,4241.6,88,,3393.28,,,0,"percent of total billed charges","88% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",834.05,17.304,,667.24,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3036.6,63,,2429.28,,,0,"percent of total billed charges","63% of total billed charges",737.46,15.3,,589.97,,,0,"percent of total billed charges","15.3% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",3325.8,69,,,,,0,"fee schedule","69% of total billed charges",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2981.17,61.85,,2384.94,,,0,"percent of total billed charges","61.5% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",1552.04,32.2,,1241.63,,,0,"percent of total billed charges","32.2% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",825.96,17.136,,660.77,,,0,"percent of total billed charges","17.136% of total billed charges",1052.69,21.84,,842.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1817.14,37.7,,1453.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3759.6,78,,3007.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3981.32,82.6,,3185.06,,,0,"percent of total billed charges","82.6% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",3981.32,82.6,,3185.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",737.46,4820,
"SEALER ENDOWRIST ONE VESSEL",413063,CDM,272,RC,,,OUTPATIENT,,,18183,11818.95,,16001.04,88,,12800.83,,,0,"percent of total billed charges","88% of total billed charges",9091.5,50,,7273.20,,,0,"percent of total billed charges","50% of total billed charges",3054.74,16.8,,2443.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3146.39,17.304,,2517.11,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11455.29,63,,9164.23,,,0,"percent of total billed charges","63% of total billed charges",2782,15.3,,2225.60,,,0,"percent of total billed charges","15.3% of total billed charges",3054.74,16.8,,2443.79,,,0,"percent of total billed charges","16.8% of total billed charges",12546.27,69,,,,,0,"fee schedule","69% of total billed charges",18183,100,,14546.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18183,100,,14546.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18183,100,,14546.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11246.19,61.85,,8996.95,,,0,"percent of total billed charges","61.5% of total billed charges",3054.74,16.8,,2443.79,,,0,"percent of total billed charges","16.8% of total billed charges",9091.5,50,,7273.20,,,0,"percent of total billed charges","50% of total billed charges",5854.93,32.2,,4683.94,,,0,"percent of total billed charges","32.2% of total billed charges",3054.74,16.8,,2443.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3115.84,17.136,,2492.67,,,0,"percent of total billed charges","17.136% of total billed charges",3971.17,21.84,,3176.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6854.99,37.7,,5483.99,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14182.74,78,,11346.19,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15019.16,82.6,,12015.33,,,0,"percent of total billed charges","82.6% of total billed charges",3054.74,16.8,,2443.79,,,0,"percent of total billed charges","16.8% of total billed charges",9091.5,50,,7273.20,,,0,"percent of total billed charges","50% of total billed charges",15019.16,82.6,,12015.33,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3054.74,16.8,,2443.79,,,0,"percent of total billed charges","16.8% of total billed charges",18183,100,,14546.40,,,0,"percent of total billed charges","100% of total billed charges",2782,18183,
"SEALER TISSUE LAPAROSCOPIC ARTICULATING",ORSUP0034,CDM,272,RC,,,OUTPATIENT,,,4820,3133,,4241.6,88,,3393.28,,,0,"percent of total billed charges","88% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",834.05,17.304,,667.24,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3036.6,63,,2429.28,,,0,"percent of total billed charges","63% of total billed charges",737.46,15.3,,589.97,,,0,"percent of total billed charges","15.3% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",3325.8,69,,,,,0,"fee schedule","69% of total billed charges",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2981.17,61.85,,2384.94,,,0,"percent of total billed charges","61.5% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",1552.04,32.2,,1241.63,,,0,"percent of total billed charges","32.2% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",825.96,17.136,,660.77,,,0,"percent of total billed charges","17.136% of total billed charges",1052.69,21.84,,842.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1817.14,37.7,,1453.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3759.6,78,,3007.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3981.32,82.6,,3185.06,,,0,"percent of total billed charges","82.6% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",3981.32,82.6,,3185.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",737.46,4820,
"SEALER TISSUE ENSEAL G2 35CM CURVED JAW",ORSUP0029,CDM,272,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"SEALER TISSUE ENSEAL G2 45CM CURVED JAW",ORSUP0031,CDM,272,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"SEAL SET SINGLE USE",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"SECONDARY MED SET",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SECURESTRAP 12",ORSUP0024,CDM,272,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"SECURESTRAP 25",ORSUP0024,CDM,278,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",1169.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.7% of total billed charges",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.91,33.9,,1016.73,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"SED-CHEK 2 ESR CONTROL",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SEDIPLAST AUTOZERO ESR SYSTEM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SYRINGE 10CC LL NON SAFETY",180427,CDM,272,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"SYRINGE ONLY LUER LOK 30CC",157837,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"SEE ITEM #288701 KIT INTRODUCER MICROPUNCTURE 5F CATH NDL \\T\\ NIT GW",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"JELLY KY 4OZ FLIP TOP BOTTLE",11913,CDM,270,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"SEE ITEM #147499 VACU TUBE 6ML DRAW 367815",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SUTURE PROLENE 5-0 P3 8698G",491469,CDM,272,RC,,,OUTPATIENT,,,40,26,,35.2,88,,28.16,,,0,"percent of total billed charges","88% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.92,17.304,,5.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.2,63,,20.16,,,0,"percent of total billed charges","63% of total billed charges",6.12,15.3,,4.90,,,0,"percent of total billed charges","15.3% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",27.6,69,,,,,0,"fee schedule","69% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.74,61.85,,19.79,,,0,"percent of total billed charges","61.5% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",12.88,32.2,,10.30,,,0,"percent of total billed charges","32.2% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.85,17.136,,5.48,,,0,"percent of total billed charges","17.136% of total billed charges",8.74,21.84,,6.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.08,37.7,,12.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",31.2,78,,24.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",6.12,40,
"SEE ITEM 74721 JURGEN BALL .045",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SUTURE VICRYL 4-0 J218H",491509,CDM,272,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"SUTURE VICRYL 4-0 J662H",491514,CDM,272,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"SUTURE PROLENE 4-0 8557H",491460,CDM,272,RC,,,OUTPATIENT,,,32,20.8,,28.16,88,,22.53,,,0,"percent of total billed charges","88% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.54,17.304,,4.43,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.16,63,,16.13,,,0,"percent of total billed charges","63% of total billed charges",4.9,15.3,,3.92,,,0,"percent of total billed charges","15.3% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",22.08,69,,,,,0,"fee schedule","69% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.79,61.85,,15.83,,,0,"percent of total billed charges","61.5% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",10.3,32.2,,8.24,,,0,"percent of total billed charges","32.2% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.48,17.136,,4.38,,,0,"percent of total billed charges","17.136% of total billed charges",6.99,21.84,,5.59,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.96,78,,19.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",4.9,32,
"SUTURE ETHILON 4-0 1629H",491407,CDM,272,RC,,,OUTPATIENT,,,587,381.55,,516.56,88,,413.25,,,0,"percent of total billed charges","88% of total billed charges",293.5,50,,234.80,,,0,"percent of total billed charges","50% of total billed charges",98.62,16.8,,78.90,,,0,"percent of total billed charges","16.8% of total billed charges",587,100,,469.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.57,17.304,,81.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",369.81,63,,295.85,,,0,"percent of total billed charges","63% of total billed charges",89.81,15.3,,71.85,,,0,"percent of total billed charges","15.3% of total billed charges",98.62,16.8,,78.90,,,0,"percent of total billed charges","16.8% of total billed charges",405.03,69,,,,,0,"fee schedule","69% of total billed charges",587,100,,469.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",587,100,,469.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",587,100,,469.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.06,61.85,,290.45,,,0,"percent of total billed charges","61.5% of total billed charges",98.62,16.8,,78.90,,,0,"percent of total billed charges","16.8% of total billed charges",293.5,50,,234.80,,,0,"percent of total billed charges","50% of total billed charges",189.01,32.2,,151.21,,,0,"percent of total billed charges","32.2% of total billed charges",98.62,16.8,,78.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",100.59,17.136,,80.47,,,0,"percent of total billed charges","17.136% of total billed charges",128.2,21.84,,102.56,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",221.3,37.7,,177.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",457.86,78,,366.29,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",484.86,82.6,,387.89,,,0,"percent of total billed charges","82.6% of total billed charges",98.62,16.8,,78.90,,,0,"percent of total billed charges","16.8% of total billed charges",293.5,50,,234.80,,,0,"percent of total billed charges","50% of total billed charges",484.86,82.6,,387.89,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.62,16.8,,78.90,,,0,"percent of total billed charges","16.8% of total billed charges",587,100,,469.60,,,0,"percent of total billed charges","100% of total billed charges",89.81,587,
"SUTURE ETHILON 3-0 663H",491406,CDM,272,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.9,61.85,,7.92,,,0,"percent of total billed charges","61.5% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"SUTURE PROLENE 2-0 8411H",491453,CDM,272,RC,,,OUTPATIENT,,,22,14.3,,19.36,88,,15.49,,,0,"percent of total billed charges","88% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.81,17.304,,3.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.86,63,,11.09,,,0,"percent of total billed charges","63% of total billed charges",3.37,15.3,,2.70,,,0,"percent of total billed charges","15.3% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",15.18,69,,,,,0,"fee schedule","69% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.61,61.85,,10.89,,,0,"percent of total billed charges","61.5% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",7.08,32.2,,5.66,,,0,"percent of total billed charges","32.2% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.77,17.136,,3.02,,,0,"percent of total billed charges","17.136% of total billed charges",4.8,21.84,,3.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.29,37.7,,6.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.16,78,,13.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",3.37,22,
"SUTURE CHROMIC GUT 2-0 G123H",491381,CDM,272,RC,,,OUTPATIENT,,,28,18.2,,24.64,88,,19.71,,,0,"percent of total billed charges","88% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.85,17.304,,3.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.64,63,,14.11,,,0,"percent of total billed charges","63% of total billed charges",4.28,15.3,,3.42,,,0,"percent of total billed charges","15.3% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",19.32,69,,,,,0,"fee schedule","69% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.32,61.85,,13.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",9.02,32.2,,7.22,,,0,"percent of total billed charges","32.2% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.8,17.136,,3.84,,,0,"percent of total billed charges","17.136% of total billed charges",6.12,21.84,,4.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.56,37.7,,8.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.84,78,,17.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",4.28,28,
"SEIZSURE BITE STICKS",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SELECTROGEN 0.8% 2 X 10ML",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"SELECTOGEN 3% 2 X 10ML",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SEMITENDINOSUS TENDON <+26CM LENGTH",ORSUP0057,CDM,278,RC,,,OUTPATIENT,,,12587,8181.55,,11076.56,88,,8861.25,,,0,"percent of total billed charges","88% of total billed charges",6293.5,50,,5034.80,,,0,"percent of total billed charges","50% of total billed charges",2114.62,16.8,,1691.70,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2178.05,17.304,,1742.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7929.81,63,,6343.85,,,0,"percent of total billed charges","63% of total billed charges",1925.81,15.3,,1540.65,,,0,"percent of total billed charges","15.3% of total billed charges",2114.62,16.8,,1691.70,,,0,"percent of total billed charges","16.8% of total billed charges",8685.03,69,,,,,0,"fee schedule","69% of total billed charges",12587,100,,10069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12587,100,,10069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12587,100,,10069.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7785.06,61.85,,6228.05,,,0,"percent of total billed charges","61.5% of total billed charges",2114.62,16.8,,1691.70,,,0,"percent of total billed charges","16.8% of total billed charges",6293.5,50,,5034.80,,,0,"percent of total billed charges","50% of total billed charges",4053.01,32.2,,3242.41,,,0,"percent of total billed charges","32.2% of total billed charges",3927.14,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2156.91,17.136,,1725.53,,,0,"percent of total billed charges","17.136% of total billed charges",2749,21.84,,2199.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4745.3,37.7,,3796.24,,,0,"percent of total billed charges","37.7% of total billed charges",4745.3,37.7,,3796.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4266.99,33.9,,3413.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",9817.86,78,,7854.29,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10396.86,82.6,,8317.49,,,0,"percent of total billed charges","82.6% of total billed charges",2114.62,16.8,,1691.70,,,0,"percent of total billed charges","16.8% of total billed charges",6293.5,50,,5034.80,,,0,"percent of total billed charges","50% of total billed charges",10396.86,82.6,,8317.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2114.62,16.8,,1691.70,,,0,"percent of total billed charges","16.8% of total billed charges",12587,100,,10069.60,,,0,"percent of total billed charges","100% of total billed charges",1925.81,12587,
"SENSOR ELIBRA SOFT TISSUE FORCE SENSOR SMALL",ORSUP0022,CDM,270,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"SENSOR FLO-TRAC FOR VIGILEO",ORSUP0021,CDM,270,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"SENSOR SP02 FINGER ADULT DISP",267940,CDM,270,RC,,,OUTPATIENT,,,72,46.8,,63.36,88,,50.69,,,0,"percent of total billed charges","88% of total billed charges",36,50,,28.80,,,0,"percent of total billed charges","50% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.46,17.304,,9.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.36,63,,36.29,,,0,"percent of total billed charges","63% of total billed charges",11.02,15.3,,8.82,,,0,"percent of total billed charges","15.3% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",49.68,69,,,,,0,"fee schedule","69% of total billed charges",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.53,61.85,,35.62,,,0,"percent of total billed charges","61.5% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",36,50,,28.80,,,0,"percent of total billed charges","50% of total billed charges",23.18,32.2,,18.54,,,0,"percent of total billed charges","32.2% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.34,17.136,,9.87,,,0,"percent of total billed charges","17.136% of total billed charges",15.72,21.84,,12.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",27.14,37.7,,21.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",56.16,78,,44.93,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.47,82.6,,47.58,,,0,"percent of total billed charges","82.6% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",36,50,,28.80,,,0,"percent of total billed charges","50% of total billed charges",59.47,82.6,,47.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",11.02,72,
"SENSOR SPO2 FINGER NEONATE/ADULT  DISP",177202,CDM,270,RC,,,OUTPATIENT,,,92,59.8,,80.96,88,,64.77,,,0,"percent of total billed charges","88% of total billed charges",46,50,,36.80,,,0,"percent of total billed charges","50% of total billed charges",15.46,16.8,,12.37,,,0,"percent of total billed charges","16.8% of total billed charges",92,100,,73.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.92,17.304,,12.74,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.96,63,,46.37,,,0,"percent of total billed charges","63% of total billed charges",14.08,15.3,,11.26,,,0,"percent of total billed charges","15.3% of total billed charges",15.46,16.8,,12.37,,,0,"percent of total billed charges","16.8% of total billed charges",63.48,69,,,,,0,"fee schedule","69% of total billed charges",92,100,,73.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92,100,,73.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92,100,,73.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.9,61.85,,45.52,,,0,"percent of total billed charges","61.5% of total billed charges",15.46,16.8,,12.37,,,0,"percent of total billed charges","16.8% of total billed charges",46,50,,36.80,,,0,"percent of total billed charges","50% of total billed charges",29.62,32.2,,23.70,,,0,"percent of total billed charges","32.2% of total billed charges",15.46,16.8,,12.37,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.77,17.136,,12.62,,,0,"percent of total billed charges","17.136% of total billed charges",20.09,21.84,,16.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.68,37.7,,27.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",71.76,78,,57.41,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.99,82.6,,60.79,,,0,"percent of total billed charges","82.6% of total billed charges",15.46,16.8,,12.37,,,0,"percent of total billed charges","16.8% of total billed charges",46,50,,36.80,,,0,"percent of total billed charges","50% of total billed charges",75.99,82.6,,60.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.46,16.8,,12.37,,,0,"percent of total billed charges","16.8% of total billed charges",92,100,,73.60,,,0,"percent of total billed charges","100% of total billed charges",14.08,92,
"SENSOR NITINOL GUIDEWIRE",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"SENSOR COVER",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SENSOR NEONATAL SPO2",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"SENTRINEX PORT DRESSING",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SEPARATOR TISS NON THRD W/ UNIV 12X100MM",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SEPERATOR ACCESS SYSTEM 15 X 100MM",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SEPRAFILM ADHESION BARRIER",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"SERFAS ENERGY 90-S CRUISE",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1030,669.5,,906.4,88,,725.12,,,0,"percent of total billed charges","88% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.23,17.304,,142.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.9,63,,519.12,,,0,"percent of total billed charges","63% of total billed charges",157.59,15.3,,126.07,,,0,"percent of total billed charges","15.3% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",710.7,69,,,,,0,"fee schedule","69% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",637.06,61.85,,509.65,,,0,"percent of total billed charges","61.5% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",331.66,32.2,,265.33,,,0,"percent of total billed charges","32.2% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.5,17.136,,141.20,,,0,"percent of total billed charges","17.136% of total billed charges",224.95,21.84,,179.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",388.31,37.7,,310.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",803.4,78,,642.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",157.59,1030,
"SERFAS ENERGY CONTOUR PROBE",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,927,602.55,,815.76,88,,652.61,,,0,"percent of total billed charges","88% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.41,17.304,,128.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.01,63,,467.21,,,0,"percent of total billed charges","63% of total billed charges",141.83,15.3,,113.46,,,0,"percent of total billed charges","15.3% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",639.63,69,,,,,0,"fee schedule","69% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",573.35,61.85,,458.68,,,0,"percent of total billed charges","61.5% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",298.49,32.2,,238.79,,,0,"percent of total billed charges","32.2% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.85,17.136,,127.08,,,0,"percent of total billed charges","17.136% of total billed charges",202.46,21.84,,161.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",349.48,37.7,,279.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",723.06,78,,578.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",141.83,927,
"SERTERA BREAST BIOPSY DEVICE 14G X 11.5CM",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SERTERA BREAST BIOPSY INTRODUCER 14G",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SERUM ANTI JKB",ORSUP0025,CDM,272,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"SERUM PROTEIN MULTI CAL LVL 1-6",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"SET EXTERNAL DRNAGE VENTRICULA",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SET COLON DECOMPRESSION 14F 175CM 6SP",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"SET PNEUMOTHORAX 10.2FR X 29CM",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SET ANGIOJET SPIROFLEX ULTRA",ORSUP0051,CDM,278,RC,,,OUTPATIENT,,,10712,6962.8,,9426.56,88,,7541.25,,,0,"percent of total billed charges","88% of total billed charges",5356,50,,4284.80,,,0,"percent of total billed charges","50% of total billed charges",1799.62,16.8,,1439.70,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1853.6,17.304,,1482.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6748.56,63,,5398.85,,,0,"percent of total billed charges","63% of total billed charges",1638.94,15.3,,1311.15,,,0,"percent of total billed charges","15.3% of total billed charges",1799.62,16.8,,1439.70,,,0,"percent of total billed charges","16.8% of total billed charges",7391.28,69,,,,,0,"fee schedule","69% of total billed charges",10712,100,,8569.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10712,100,,8569.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10712,100,,8569.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6625.37,61.85,,5300.30,,,0,"percent of total billed charges","61.5% of total billed charges",1799.62,16.8,,1439.70,,,0,"percent of total billed charges","16.8% of total billed charges",5356,50,,4284.80,,,0,"percent of total billed charges","50% of total billed charges",3449.26,32.2,,2759.41,,,0,"percent of total billed charges","32.2% of total billed charges",3342.14,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1835.61,17.136,,1468.49,,,0,"percent of total billed charges","17.136% of total billed charges",2339.5,21.84,,1871.60,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4038.42,37.7,,3230.74,,,0,"percent of total billed charges","37.7% of total billed charges",4038.42,37.7,,3230.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3631.37,33.9,,2905.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",8355.36,78,,6684.29,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8848.11,82.6,,7078.49,,,0,"percent of total billed charges","82.6% of total billed charges",1799.62,16.8,,1439.70,,,0,"percent of total billed charges","16.8% of total billed charges",5356,50,,4284.80,,,0,"percent of total billed charges","50% of total billed charges",8848.11,82.6,,7078.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1799.62,16.8,,1439.70,,,0,"percent of total billed charges","16.8% of total billed charges",10712,100,,8569.60,,,0,"percent of total billed charges","100% of total billed charges",1638.94,10712,
"SET MICRO PUNCTURE 5FR",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"SET MICROPUNCT  5FR",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"SET EZ-IO 45MM NEEDLE \\T\\ STABILIZER",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"SET EXT MICRO VOLUME W/LL ADAPTR  SLIDE CLMP 60",156763,CDM,270,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"SET IV 4 WAY STOPCOCK CLEARLINK",355174,CDM,270,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"SET IV VENTED SOLUTION",82363,CDM,270,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"SET MICRODRIP LS VENTED 2Y'S",185655,CDM,270,RC,,,OUTPATIENT,,,26,16.9,,22.88,88,,18.30,,,0,"percent of total billed charges","88% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.5,17.304,,3.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.38,63,,13.10,,,0,"percent of total billed charges","63% of total billed charges",3.98,15.3,,3.18,,,0,"percent of total billed charges","15.3% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",17.94,69,,,,,0,"fee schedule","69% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.08,61.85,,12.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",8.37,32.2,,6.70,,,0,"percent of total billed charges","32.2% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.46,17.136,,3.57,,,0,"percent of total billed charges","17.136% of total billed charges",5.68,21.84,,4.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.8,37.7,,7.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.28,78,,16.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",3.98,26,
"SET CLEARLINK PRIMARY SET PUMP 2C8537",83497,CDM,270,RC,,,OUTPATIENT,,,26,16.9,,22.88,88,,18.30,,,0,"percent of total billed charges","88% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.5,17.304,,3.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.38,63,,13.10,,,0,"percent of total billed charges","63% of total billed charges",3.98,15.3,,3.18,,,0,"percent of total billed charges","15.3% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",17.94,69,,,,,0,"fee schedule","69% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.08,61.85,,12.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",8.37,32.2,,6.70,,,0,"percent of total billed charges","32.2% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.46,17.136,,3.57,,,0,"percent of total billed charges","17.136% of total billed charges",5.68,21.84,,4.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.8,37.7,,7.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.28,78,,16.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",3.98,26,
"SET CATH EXTENSION STD BORE",204589,CDM,272,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"SET DECANTING 2C4014",10422,CDM,270,RC,,,OUTPATIENT,,,23,14.95,,20.24,88,,16.19,,,0,"percent of total billed charges","88% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.98,17.304,,3.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.49,63,,11.59,,,0,"percent of total billed charges","63% of total billed charges",3.52,15.3,,2.82,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",15.87,69,,,,,0,"fee schedule","69% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.23,61.85,,11.38,,,0,"percent of total billed charges","61.5% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",7.41,32.2,,5.93,,,0,"percent of total billed charges","32.2% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.94,17.136,,3.15,,,0,"percent of total billed charges","17.136% of total billed charges",5.02,21.84,,4.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.94,78,,14.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",3.52,23,
"SET FLUID WARMING W/8' TUBING STRL FOR MDL HL90",149423,CDM,270,RC,,,OUTPATIENT,,,140,91,,123.2,88,,98.56,,,0,"percent of total billed charges","88% of total billed charges",70,50,,56.00,,,0,"percent of total billed charges","50% of total billed charges",23.52,16.8,,18.82,,,0,"percent of total billed charges","16.8% of total billed charges",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.23,17.304,,19.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.2,63,,70.56,,,0,"percent of total billed charges","63% of total billed charges",21.42,15.3,,17.14,,,0,"percent of total billed charges","15.3% of total billed charges",23.52,16.8,,18.82,,,0,"percent of total billed charges","16.8% of total billed charges",96.6,69,,,,,0,"fee schedule","69% of total billed charges",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.59,61.85,,69.27,,,0,"percent of total billed charges","61.5% of total billed charges",23.52,16.8,,18.82,,,0,"percent of total billed charges","16.8% of total billed charges",70,50,,56.00,,,0,"percent of total billed charges","50% of total billed charges",45.08,32.2,,36.06,,,0,"percent of total billed charges","32.2% of total billed charges",23.52,16.8,,18.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.99,17.136,,19.19,,,0,"percent of total billed charges","17.136% of total billed charges",30.58,21.84,,24.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",52.78,37.7,,42.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",109.2,78,,87.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.64,82.6,,92.51,,,0,"percent of total billed charges","82.6% of total billed charges",23.52,16.8,,18.82,,,0,"percent of total billed charges","16.8% of total billed charges",70,50,,56.00,,,0,"percent of total billed charges","50% of total billed charges",115.64,82.6,,92.51,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.52,16.8,,18.82,,,0,"percent of total billed charges","16.8% of total billed charges",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",21.42,140,
"SET ANESTHESIA 72 INCH INFUSOR GREEN",8844,CDM,270,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.9,61.85,,7.92,,,0,"percent of total billed charges","61.5% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"SET EXTENSION CLEARLINK W/CONTROL-A-FLO",141785,CDM,270,RC,,,OUTPATIENT,,,27,17.55,,23.76,88,,19.01,,,0,"percent of total billed charges","88% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.67,17.304,,3.74,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.01,63,,13.61,,,0,"percent of total billed charges","63% of total billed charges",4.13,15.3,,3.30,,,0,"percent of total billed charges","15.3% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",18.63,69,,,,,0,"fee schedule","69% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.7,61.85,,13.36,,,0,"percent of total billed charges","61.5% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",8.69,32.2,,6.95,,,0,"percent of total billed charges","32.2% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.63,17.136,,3.70,,,0,"percent of total billed charges","17.136% of total billed charges",5.9,21.84,,4.72,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.18,37.7,,8.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.06,78,,16.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.3,82.6,,17.84,,,0,"percent of total billed charges","82.6% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",22.3,82.6,,17.84,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",4.13,27,
"SET IV CATH FLO LINK STD BORE CATH EXT W/POS FLUID",355535,CDM,272,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"SET EXT T CONECTOR 2N3339",10046,CDM,270,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"SET EXTENSION #3 W/ .22MIC FILTER",83495,CDM,270,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SET CLAVE LS TWIN SITE EXT 2C8612",185656,CDM,270,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.9,61.85,,7.92,,,0,"percent of total billed charges","61.5% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"SET IV DIAL A FLOW",ORSUP0019,CDM,270,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"SET SOLUTION BASIC W LL",216339,CDM,270,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"SET IV BURETROL INLINE",185659,CDM,270,RC,,,OUTPATIENT,,,22,14.3,,19.36,88,,15.49,,,0,"percent of total billed charges","88% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.81,17.304,,3.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.86,63,,11.09,,,0,"percent of total billed charges","63% of total billed charges",3.37,15.3,,2.70,,,0,"percent of total billed charges","15.3% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",15.18,69,,,,,0,"fee schedule","69% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.61,61.85,,10.89,,,0,"percent of total billed charges","61.5% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",7.08,32.2,,5.66,,,0,"percent of total billed charges","32.2% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.77,17.136,,3.02,,,0,"percent of total billed charges","17.136% of total billed charges",4.8,21.84,,3.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.29,37.7,,6.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.16,78,,13.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",3.37,22,
"SET IV SOLUTION PRIMARY 112IN CLEARLINK",81694,CDM,270,RC,,,OUTPATIENT,,,24,15.6,,21.12,88,,16.90,,,0,"percent of total billed charges","88% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.15,17.304,,3.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.12,63,,12.10,,,0,"percent of total billed charges","63% of total billed charges",3.67,15.3,,2.94,,,0,"percent of total billed charges","15.3% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",16.56,69,,,,,0,"fee schedule","69% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.84,61.85,,11.87,,,0,"percent of total billed charges","61.5% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",7.73,32.2,,6.18,,,0,"percent of total billed charges","32.2% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.11,17.136,,3.29,,,0,"percent of total billed charges","17.136% of total billed charges",5.24,21.84,,4.19,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.05,37.7,,7.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.72,78,,14.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,24,
"SET Y-TYPE BLOOD/SOLUTION 2C8750",83492,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SET CARDIOPLEGIA",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"SET BLOOD WARM LEVEL 1 NORMOTHERMIC",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"SET CYSTOSCOPY",75573,CDM,270,RC,,,OUTPATIENT,,,60,39,,52.8,88,,42.24,,,0,"percent of total billed charges","88% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.38,17.304,,8.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.8,63,,30.24,,,0,"percent of total billed charges","63% of total billed charges",9.18,15.3,,7.34,,,0,"percent of total billed charges","15.3% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",41.4,69,,,,,0,"fee schedule","69% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.11,61.85,,29.69,,,0,"percent of total billed charges","61.5% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",19.32,32.2,,15.46,,,0,"percent of total billed charges","32.2% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.28,17.136,,8.22,,,0,"percent of total billed charges","17.136% of total billed charges",13.1,21.84,,10.48,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,37.7,,18.10,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.8,78,,37.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.56,82.6,,39.65,,,0,"percent of total billed charges","82.6% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",49.56,82.6,,39.65,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",9.18,60,
"SET EXTENSION 71 INCHES LF",283055,CDM,270,RC,,,OUTPATIENT,,,28,18.2,,24.64,88,,19.71,,,0,"percent of total billed charges","88% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.85,17.304,,3.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.64,63,,14.11,,,0,"percent of total billed charges","63% of total billed charges",4.28,15.3,,3.42,,,0,"percent of total billed charges","15.3% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",19.32,69,,,,,0,"fee schedule","69% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.32,61.85,,13.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",9.02,32.2,,7.22,,,0,"percent of total billed charges","32.2% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.8,17.136,,3.84,,,0,"percent of total billed charges","17.136% of total billed charges",6.12,21.84,,4.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.56,37.7,,8.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.84,78,,17.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",4.28,28,
"SET PROCEDURE FOR PROLAPSE AND HEMORRHOIDS 33MM",ORSUP0023,CDM,272,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"SET INFUSION SAFETY POWERLOC 20G X 1 W/Y SITE",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SET TISSEL EZ SPRAY 10/PK",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"SET TISSEEL EZ SPRAY",ORSUP0027,CDM,272,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"SET INFUSION WING W/NDL SHIELD 12IN TB 19G X .88IN",164821,CDM,272,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.95,61.85,,3.96,,,0,"percent of total billed charges","61.5% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"SET GASTROSTOMY FLEXIFLO 50190",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SET THROMBECTOMY AVX",ORSUP0011,CDM,270,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SET CATH CRICOTHYROTOMY E/R",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SET TUR 2 LEAD Y TYPE 2C4041",ORSUP0003,CDM,270,RC,,,OUTPATIENT,,,102,66.3,,89.76,88,,71.81,,,0,"percent of total billed charges","88% of total billed charges",51,50,,40.80,,,0,"percent of total billed charges","50% of total billed charges",17.14,16.8,,13.71,,,0,"percent of total billed charges","16.8% of total billed charges",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.304,,14.12,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.26,63,,51.41,,,0,"percent of total billed charges","63% of total billed charges",15.61,15.3,,12.49,,,0,"percent of total billed charges","15.3% of total billed charges",17.14,16.8,,13.71,,,0,"percent of total billed charges","16.8% of total billed charges",70.38,69,,,,,0,"fee schedule","69% of total billed charges",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.09,61.85,,50.47,,,0,"percent of total billed charges","61.5% of total billed charges",17.14,16.8,,13.71,,,0,"percent of total billed charges","16.8% of total billed charges",51,50,,40.80,,,0,"percent of total billed charges","50% of total billed charges",32.84,32.2,,26.27,,,0,"percent of total billed charges","32.2% of total billed charges",17.14,16.8,,13.71,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.48,17.136,,13.98,,,0,"percent of total billed charges","17.136% of total billed charges",22.28,21.84,,17.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.45,37.7,,30.76,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",79.56,78,,63.65,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.25,82.6,,67.40,,,0,"percent of total billed charges","82.6% of total billed charges",17.14,16.8,,13.71,,,0,"percent of total billed charges","16.8% of total billed charges",51,50,,40.80,,,0,"percent of total billed charges","50% of total billed charges",84.25,82.6,,67.40,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.14,16.8,,13.71,,,0,"percent of total billed charges","16.8% of total billed charges",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",15.61,102,
"SET UP PACK",491170,CDM,270,RC,,,OUTPATIENT,,,28,18.2,,24.64,88,,19.71,,,0,"percent of total billed charges","88% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.85,17.304,,3.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.64,63,,14.11,,,0,"percent of total billed charges","63% of total billed charges",4.28,15.3,,3.42,,,0,"percent of total billed charges","15.3% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",19.32,69,,,,,0,"fee schedule","69% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.32,61.85,,13.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",9.02,32.2,,7.22,,,0,"percent of total billed charges","32.2% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.8,17.136,,3.84,,,0,"percent of total billed charges","17.136% of total billed charges",6.12,21.84,,4.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.56,37.7,,8.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.84,78,,17.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",4.28,28,
"SET BLOOD Y-TYPE TUBING",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SET GRAVITY VENTED/NON VENTED WITH CECK VALVE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SET ADMIN CADD YELLOW STRIPE 123IN",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SET INFUSION GALACTOGRAPHY",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SET IV SOLUTION PRIMARY 117IN",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SET IV SOLUTION GRAVITY 104IN",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SET IV SOLUTION PRIMARY 20 DROP",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SET IV SOLUTION GRAVITY MALE LL",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SET IV SOLUTION GRAVITY BACK CHECK VALVE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SET IV BURETTES DEHP FREE",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SET EXT 0.2 MICRON FILTER",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SET EXT MICROBORE SLIDE CLAMP FIXED MALE LL",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SET EXT STANDARD BORE 2 Y SITES",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SET EXT T CONNECTOR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SET EXT STANDARD BORE 5IN NON DEHP",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SET EXT SPECIALTY LOW PRESSURE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SET IV 4 WAY STOPCOCK  W WHITE TAB",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SET EXTENSION SMALL BORE SLIDE CLAMPSPIN MALE LL",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SET ULTRATHANE NEPHROSTOMY 8.5",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SET TUBING 2 SPIKE GRAVITY",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"SET ADMIN EPIDURAL W/NONVENTED SPIKE TUBING",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"SHAMPOO HAIR CARE READY BATH RINSE-FREE",156826,CDM,272,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"SHAMPOO AND BODY WASH",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SHARPS CONTAINER 2GL RED",491173,CDM,270,RC,,,OUTPATIENT,,,28,18.2,,24.64,88,,19.71,,,0,"percent of total billed charges","88% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.85,17.304,,3.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.64,63,,14.11,,,0,"percent of total billed charges","63% of total billed charges",4.28,15.3,,3.42,,,0,"percent of total billed charges","15.3% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",19.32,69,,,,,0,"fee schedule","69% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.32,61.85,,13.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",9.02,32.2,,7.22,,,0,"percent of total billed charges","32.2% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.8,17.136,,3.84,,,0,"percent of total billed charges","17.136% of total billed charges",6.12,21.84,,4.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.56,37.7,,8.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.84,78,,17.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",4.28,28,
"SHARPS CONTAINER 18 GL",491172,CDM,270,RC,,,OUTPATIENT,,,127,82.55,,111.76,88,,89.41,,,0,"percent of total billed charges","88% of total billed charges",63.5,50,,50.80,,,0,"percent of total billed charges","50% of total billed charges",21.34,16.8,,17.07,,,0,"percent of total billed charges","16.8% of total billed charges",127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.98,17.304,,17.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.01,63,,64.01,,,0,"percent of total billed charges","63% of total billed charges",19.43,15.3,,15.54,,,0,"percent of total billed charges","15.3% of total billed charges",21.34,16.8,,17.07,,,0,"percent of total billed charges","16.8% of total billed charges",87.63,69,,,,,0,"fee schedule","69% of total billed charges",127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.55,61.85,,62.84,,,0,"percent of total billed charges","61.5% of total billed charges",21.34,16.8,,17.07,,,0,"percent of total billed charges","16.8% of total billed charges",63.5,50,,50.80,,,0,"percent of total billed charges","50% of total billed charges",40.89,32.2,,32.71,,,0,"percent of total billed charges","32.2% of total billed charges",21.34,16.8,,17.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.76,17.136,,17.41,,,0,"percent of total billed charges","17.136% of total billed charges",27.74,21.84,,22.19,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47.88,37.7,,38.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",99.06,78,,79.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.9,82.6,,83.92,,,0,"percent of total billed charges","82.6% of total billed charges",21.34,16.8,,17.07,,,0,"percent of total billed charges","16.8% of total billed charges",63.5,50,,50.80,,,0,"percent of total billed charges","50% of total billed charges",104.9,82.6,,83.92,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.34,16.8,,17.07,,,0,"percent of total billed charges","16.8% of total billed charges",127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",19.43,127,
"SHARPS CONTAINER CHEMOTHERAPY YELLOW 9GL",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SHARPS CONTAINER 3 GAL RED",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SHARPS CONTAINER 1 QT",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SHARPS COLLECTOR CHEMOTHERAPY ABSORB PAD 3 GAL",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SHAVER 2344000",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"SHAVER EXCALIBER 4.0 MM",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SHAVER BLADE 3.5 AGGRESS PLUS",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"SHAVER BLADE 4.0 AGGRESS PLUS",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"SHEATH DEFL BI-DIR",ORSUP0027,CDM,278,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",1336.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.7% of total billed charges",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1452.62,33.9,,1162.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"SHEATH INTRO PINNACLE 6FR X 65CM STR",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"SHEATH INTRO 6FR X 45CM PINNACLE DESTINATION",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"SHEATH INTRO HEMOSTASIS CRV 8.5FRX60CM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"SHEATH INTRO TRANSSEPTAL SL1 8.5FRX62CM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"SHEATH ANSEL 6FR 45CM 2RENAL GUIDE",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SHEATH ANSEL 6FR 45CM 1RENAL GUIDE",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SHEATH ANSEL 4FR 45CM",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SHEATH 14FR X 30CM  BEACON TIP",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SHEATH 12FR X 30CM  BEACON TIP",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SHEATH GUIDING RAABE 8FR 70CM",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SHEATH 35CM 7FR",ORSUP0003,CDM,278,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.7% of total billed charges",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.14,33.9,,54.51,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"SHEATH RAABE  6X55",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"SHEATH SHUTTLE 6FR FLEXOR",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SHEATH 18FRX30CMX38 BEACON TIP",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"SHEATH ACC UROPASS 11/13FRX24 CM",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"SHEATH BRAINPATH 13.5X60MM",ORSUP0052,CDM,278,RC,,,OUTPATIENT,,,10980,7137,,9662.4,88,,7729.92,,,0,"percent of total billed charges","88% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1899.98,17.304,,1519.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6917.4,63,,5533.92,,,0,"percent of total billed charges","63% of total billed charges",1679.94,15.3,,1343.95,,,0,"percent of total billed charges","15.3% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",7576.2,69,,,,,0,"fee schedule","69% of total billed charges",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6791.13,61.85,,5432.90,,,0,"percent of total billed charges","61.5% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",3535.56,32.2,,2828.45,,,0,"percent of total billed charges","32.2% of total billed charges",3425.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1881.53,17.136,,1505.22,,,0,"percent of total billed charges","17.136% of total billed charges",2398.03,21.84,,1918.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4139.46,37.7,,3311.57,,,0,"percent of total billed charges","37.7% of total billed charges",4139.46,37.7,,3311.57,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3722.22,33.9,,2977.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",8564.4,78,,6851.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9069.48,82.6,,7255.58,,,0,"percent of total billed charges","82.6% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",9069.48,82.6,,7255.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",1679.94,10980,
"SHEATH ENDOSCRUB STZ 4 MM 30D",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SHEATH ENDOSCRUB STZ 4MM 0 D 19-12000",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SHEATH GUIDING FLEXOR ANSEL 8FR 45CM",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SHEATH INTRO 5FR GLIDESHEATH",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SHEARS HARMONIC FOCUS CVD 9CM",ORSUP0023,CDM,272,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"SHEAR CURVED HARMONIC DAVINCI",173871,CDM,272,RC,,,OUTPATIENT,,,5602,3641.3,,4929.76,88,,3943.81,,,0,"percent of total billed charges","88% of total billed charges",2801,50,,2240.80,,,0,"percent of total billed charges","50% of total billed charges",941.14,16.8,,752.91,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",969.37,17.304,,775.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3529.26,63,,2823.41,,,0,"percent of total billed charges","63% of total billed charges",857.11,15.3,,685.69,,,0,"percent of total billed charges","15.3% of total billed charges",941.14,16.8,,752.91,,,0,"percent of total billed charges","16.8% of total billed charges",3865.38,69,,,,,0,"fee schedule","69% of total billed charges",5602,100,,4481.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5602,100,,4481.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5602,100,,4481.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3464.84,61.85,,2771.87,,,0,"percent of total billed charges","61.5% of total billed charges",941.14,16.8,,752.91,,,0,"percent of total billed charges","16.8% of total billed charges",2801,50,,2240.80,,,0,"percent of total billed charges","50% of total billed charges",1803.84,32.2,,1443.07,,,0,"percent of total billed charges","32.2% of total billed charges",941.14,16.8,,752.91,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",959.96,17.136,,767.97,,,0,"percent of total billed charges","17.136% of total billed charges",1223.48,21.84,,978.78,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2111.95,37.7,,1689.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4369.56,78,,3495.65,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4627.25,82.6,,3701.80,,,0,"percent of total billed charges","82.6% of total billed charges",941.14,16.8,,752.91,,,0,"percent of total billed charges","16.8% of total billed charges",2801,50,,2240.80,,,0,"percent of total billed charges","50% of total billed charges",4627.25,82.6,,3701.80,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",941.14,16.8,,752.91,,,0,"percent of total billed charges","16.8% of total billed charges",5602,100,,4481.60,,,0,"percent of total billed charges","100% of total billed charges",857.11,5602,
"SHEAR HAMONIC ACE CVD",ORSUP0032,CDM,272,RC,,,OUTPATIENT,,,5624,3655.6,,4949.12,88,,3959.30,,,0,"percent of total billed charges","88% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",973.18,17.304,,778.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3543.12,63,,2834.50,,,0,"percent of total billed charges","63% of total billed charges",860.47,15.3,,688.38,,,0,"percent of total billed charges","15.3% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",3880.56,69,,,,,0,"fee schedule","69% of total billed charges",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3478.44,61.85,,2782.75,,,0,"percent of total billed charges","61.5% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",1810.93,32.2,,1448.74,,,0,"percent of total billed charges","32.2% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",963.73,17.136,,770.98,,,0,"percent of total billed charges","17.136% of total billed charges",1228.28,21.84,,982.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2120.25,37.7,,1696.20,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4386.72,78,,3509.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4645.42,82.6,,3716.34,,,0,"percent of total billed charges","82.6% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",4645.42,82.6,,3716.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",860.47,5624,
"SHEAR HARMONIC ACE 5MM 36CM 6/BX",ORSUP0024,CDM,272,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"SHEARS HOT ENDOWRIST DA VINCI",173499,CDM,272,RC,,,OUTPATIENT,,,16298,10593.7,,14342.24,88,,11473.79,,,0,"percent of total billed charges","88% of total billed charges",8149,50,,6519.20,,,0,"percent of total billed charges","50% of total billed charges",2738.06,16.8,,2190.45,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2820.21,17.304,,2256.17,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10267.74,63,,8214.19,,,0,"percent of total billed charges","63% of total billed charges",2493.59,15.3,,1994.87,,,0,"percent of total billed charges","15.3% of total billed charges",2738.06,16.8,,2190.45,,,0,"percent of total billed charges","16.8% of total billed charges",11245.62,69,,,,,0,"fee schedule","69% of total billed charges",16298,100,,13038.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16298,100,,13038.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16298,100,,13038.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10080.31,61.85,,8064.25,,,0,"percent of total billed charges","61.5% of total billed charges",2738.06,16.8,,2190.45,,,0,"percent of total billed charges","16.8% of total billed charges",8149,50,,6519.20,,,0,"percent of total billed charges","50% of total billed charges",5247.96,32.2,,4198.37,,,0,"percent of total billed charges","32.2% of total billed charges",2738.06,16.8,,2190.45,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2792.83,17.136,,2234.26,,,0,"percent of total billed charges","17.136% of total billed charges",3559.48,21.84,,2847.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6144.35,37.7,,4915.48,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12712.44,78,,10169.95,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13462.15,82.6,,10769.72,,,0,"percent of total billed charges","82.6% of total billed charges",2738.06,16.8,,2190.45,,,0,"percent of total billed charges","16.8% of total billed charges",8149,50,,6519.20,,,0,"percent of total billed charges","50% of total billed charges",13462.15,82.6,,10769.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2738.06,16.8,,2190.45,,,0,"percent of total billed charges","16.8% of total billed charges",16298,100,,13038.40,,,0,"percent of total billed charges","100% of total billed charges",2493.59,16298,
"SHEATH HOODLESS OVAL TPR BUR 5.0MM X 13CM",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SHEATH MINI ACCESS 6F",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SHEATH INTRODUCER SHORT 7FR",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SHEATH INTRODUCER SHORT 6F.035",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SHEATH INTRODUCER 6F PERFORMER",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"SHEATH INTRODUCER 5F PERFORMER",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"SHEARS HARMONIC HAR36 LAPAR",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SHEATH INTRO 5FR 504-605X",ORSUP0002,CDM,278,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.7% of total billed charges",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.92,33.9,,27.94,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"SHEATH HF ANSOCH 5FR X 55CM",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,412,267.8,,362.56,88,,290.05,,,0,"percent of total billed charges","88% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.29,17.304,,57.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",259.56,63,,207.65,,,0,"percent of total billed charges","63% of total billed charges",63.04,15.3,,50.43,,,0,"percent of total billed charges","15.3% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",284.28,69,,,,,0,"fee schedule","69% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",254.82,61.85,,203.86,,,0,"percent of total billed charges","61.5% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",132.66,32.2,,106.13,,,0,"percent of total billed charges","32.2% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.6,17.136,,56.48,,,0,"percent of total billed charges","17.136% of total billed charges",89.98,21.84,,71.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",155.32,37.7,,124.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",321.36,78,,257.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",63.04,412,
"SHEATH PRELUDE 6FR X13CM",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"SHEATH BALKIN 6FR X 40CM",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SHEATH CHECK-FLO ANSL1 7FR X 45CM",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SHEATH CHECK-FLO ANSL1 8FR X 55CM",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SHEATH HF 7FR",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"SHEATH ANSEL 8 FR",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"SHEATH INTRODUCER 6 FR",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"SHEET DRAPE 40X58 STERILE",8228,CDM,272,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"SHEET DRAPE 53X77 STERILE",156845,CDM,272,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.9,61.85,,7.92,,,0,"percent of total billed charges","61.5% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"SHEET T LAPAROTOMY STERILE",10273,CDM,272,RC,,,OUTPATIENT,,,80,52,,70.4,88,,56.32,,,0,"percent of total billed charges","88% of total billed charges",40,50,,32.00,,,0,"percent of total billed charges","50% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.84,17.304,,11.07,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.4,63,,40.32,,,0,"percent of total billed charges","63% of total billed charges",12.24,15.3,,9.79,,,0,"percent of total billed charges","15.3% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",55.2,69,,,,,0,"fee schedule","69% of total billed charges",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.48,61.85,,39.58,,,0,"percent of total billed charges","61.5% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",40,50,,32.00,,,0,"percent of total billed charges","50% of total billed charges",25.76,32.2,,20.61,,,0,"percent of total billed charges","32.2% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.71,17.136,,10.97,,,0,"percent of total billed charges","17.136% of total billed charges",17.47,21.84,,13.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.16,37.7,,24.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",62.4,78,,49.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",66.08,82.6,,52.86,,,0,"percent of total billed charges","82.6% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",40,50,,32.00,,,0,"percent of total billed charges","50% of total billed charges",66.08,82.6,,52.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",12.24,80,
"SHEET ORTHO SPLIT STERILE",187599,CDM,272,RC,,,OUTPATIENT,,,79,51.35,,69.52,88,,55.62,,,0,"percent of total billed charges","88% of total billed charges",39.5,50,,31.60,,,0,"percent of total billed charges","50% of total billed charges",13.27,16.8,,10.62,,,0,"percent of total billed charges","16.8% of total billed charges",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.67,17.304,,10.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.77,63,,39.82,,,0,"percent of total billed charges","63% of total billed charges",12.09,15.3,,9.67,,,0,"percent of total billed charges","15.3% of total billed charges",13.27,16.8,,10.62,,,0,"percent of total billed charges","16.8% of total billed charges",54.51,69,,,,,0,"fee schedule","69% of total billed charges",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.86,61.85,,39.09,,,0,"percent of total billed charges","61.5% of total billed charges",13.27,16.8,,10.62,,,0,"percent of total billed charges","16.8% of total billed charges",39.5,50,,31.60,,,0,"percent of total billed charges","50% of total billed charges",25.44,32.2,,20.35,,,0,"percent of total billed charges","32.2% of total billed charges",13.27,16.8,,10.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.54,17.136,,10.83,,,0,"percent of total billed charges","17.136% of total billed charges",17.25,21.84,,13.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.78,37.7,,23.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",61.62,78,,49.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",65.25,82.6,,52.20,,,0,"percent of total billed charges","82.6% of total billed charges",13.27,16.8,,10.62,,,0,"percent of total billed charges","16.8% of total billed charges",39.5,50,,31.60,,,0,"percent of total billed charges","50% of total billed charges",65.25,82.6,,52.20,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.27,16.8,,10.62,,,0,"percent of total billed charges","16.8% of total billed charges",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",12.09,79,
"SHEET ABSORB 3X6",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SHILEY TRACH CUFFLESS PEDIATRIC  3.5MM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"SHILEY TRACH CUFFLESS PEDIATRIC 3.0MM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"SHILEY TRACH TAPERGUARD CUFF LONG 5.5MM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"SHIPPER THERAPAK EXEMPT HUMAN SPECIMEN",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"SHOE COVER IMPERVIOUS NONSKID",227878,CDM,270,RC,,,OUTPATIENT,,,56,36.4,,49.28,88,,39.42,,,0,"percent of total billed charges","88% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.69,17.304,,7.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.28,63,,28.22,,,0,"percent of total billed charges","63% of total billed charges",8.57,15.3,,6.86,,,0,"percent of total billed charges","15.3% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",38.64,69,,,,,0,"fee schedule","69% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.64,61.85,,27.71,,,0,"percent of total billed charges","61.5% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",18.03,32.2,,14.42,,,0,"percent of total billed charges","32.2% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.6,17.136,,7.68,,,0,"percent of total billed charges","17.136% of total billed charges",12.23,21.84,,9.78,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.11,37.7,,16.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.68,78,,34.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",8.57,56,
"SHOE POST-OP VELCRO CLOSURE WOMEN'S SMALL",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SHOE POST-OP VELCRO CLOSURE MEN'S LARGE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SHOE COVERS X-LG X-TRA TRACT",491189,CDM,270,RC,,,OUTPATIENT,,,125,81.25,,110,88,,88.00,,,0,"percent of total billed charges","88% of total billed charges",62.5,50,,50.00,,,0,"percent of total billed charges","50% of total billed charges",21,16.8,,16.80,,,0,"percent of total billed charges","16.8% of total billed charges",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.63,17.304,,17.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.75,63,,63.00,,,0,"percent of total billed charges","63% of total billed charges",19.13,15.3,,15.30,,,0,"percent of total billed charges","15.3% of total billed charges",21,16.8,,16.80,,,0,"percent of total billed charges","16.8% of total billed charges",86.25,69,,,,,0,"fee schedule","69% of total billed charges",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.31,61.85,,61.85,,,0,"percent of total billed charges","61.5% of total billed charges",21,16.8,,16.80,,,0,"percent of total billed charges","16.8% of total billed charges",62.5,50,,50.00,,,0,"percent of total billed charges","50% of total billed charges",40.25,32.2,,32.20,,,0,"percent of total billed charges","32.2% of total billed charges",21,16.8,,16.80,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.42,17.136,,17.14,,,0,"percent of total billed charges","17.136% of total billed charges",27.3,21.84,,21.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47.13,37.7,,37.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",97.5,78,,78.00,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.25,82.6,,82.60,,,0,"percent of total billed charges","82.6% of total billed charges",21,16.8,,16.80,,,0,"percent of total billed charges","16.8% of total billed charges",62.5,50,,50.00,,,0,"percent of total billed charges","50% of total billed charges",103.25,82.6,,82.60,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,16.8,,16.80,,,0,"percent of total billed charges","16.8% of total billed charges",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",19.13,125,
"SHOE COVERS X-TRA TRACTION",491190,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"SHORT GUIDE PIN 2.4MM",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"SHORTSHOT SAEED HEMORROID LIGATOR",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"SHOULDER ARTHROSCOPY",326413,CDM,270,RC,,,OUTPATIENT,,,753,489.45,,662.64,88,,530.11,,,0,"percent of total billed charges","88% of total billed charges",376.5,50,,301.20,,,0,"percent of total billed charges","50% of total billed charges",126.5,16.8,,101.20,,,0,"percent of total billed charges","16.8% of total billed charges",753,100,,602.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",130.3,17.304,,104.24,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",474.39,63,,379.51,,,0,"percent of total billed charges","63% of total billed charges",115.21,15.3,,92.17,,,0,"percent of total billed charges","15.3% of total billed charges",126.5,16.8,,101.20,,,0,"percent of total billed charges","16.8% of total billed charges",519.57,69,,,,,0,"fee schedule","69% of total billed charges",753,100,,602.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",753,100,,602.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",753,100,,602.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",465.73,61.85,,372.58,,,0,"percent of total billed charges","61.5% of total billed charges",126.5,16.8,,101.20,,,0,"percent of total billed charges","16.8% of total billed charges",376.5,50,,301.20,,,0,"percent of total billed charges","50% of total billed charges",242.47,32.2,,193.98,,,0,"percent of total billed charges","32.2% of total billed charges",126.5,16.8,,101.20,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.03,17.136,,103.22,,,0,"percent of total billed charges","17.136% of total billed charges",164.46,21.84,,131.57,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",283.88,37.7,,227.10,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",587.34,78,,469.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",621.98,82.6,,497.58,,,0,"percent of total billed charges","82.6% of total billed charges",126.5,16.8,,101.20,,,0,"percent of total billed charges","16.8% of total billed charges",376.5,50,,301.20,,,0,"percent of total billed charges","50% of total billed charges",621.98,82.6,,497.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.5,16.8,,101.20,,,0,"percent of total billed charges","16.8% of total billed charges",753,100,,602.40,,,0,"percent of total billed charges","100% of total billed charges",115.21,753,
"SHOULDER IMOB X-LG MENS",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SHOULDER IMOB LG MENS",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"SHOULDER POSITIONER ARM CANOE",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SHOULDER IMMOBILIZER XL",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SHUNT 2.5MM FLOCOIL CORONARY",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SHUNT CAROTID 3X4X30",ORSUP0025,CDM,272,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"SHUNT CAROTID 3X5X30",ORSUP0025,CDM,272,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"SHUNT 1.5MM FLOCOIL CORONARY",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SHUNT 20MM TIP",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"SHUNT CAROTID ENDART.3.5X5MM",ORSUP0024,CDM,272,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"SHUNT CAROTID 3X4X10",ORSUP0023,CDM,272,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"SHUNT CAROTID 3.5X5",ORSUP0024,CDM,272,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"SHUNT STRATA II SNAP ASSEMBLY REGULAR",ORSUP0098,CDM,272,RC,,,OUTPATIENT,,,23834,15492.1,,20973.92,88,,16779.14,,,0,"percent of total billed charges","88% of total billed charges",11917,50,,9533.60,,,0,"percent of total billed charges","50% of total billed charges",4004.11,16.8,,3203.29,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4124.24,17.304,,3299.39,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15015.42,63,,12012.34,,,0,"percent of total billed charges","63% of total billed charges",3646.6,15.3,,2917.28,,,0,"percent of total billed charges","15.3% of total billed charges",4004.11,16.8,,3203.29,,,0,"percent of total billed charges","16.8% of total billed charges",16445.46,69,,,,,0,"fee schedule","69% of total billed charges",23834,100,,19067.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23834,100,,19067.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23834,100,,19067.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14741.33,61.85,,11793.06,,,0,"percent of total billed charges","61.5% of total billed charges",4004.11,16.8,,3203.29,,,0,"percent of total billed charges","16.8% of total billed charges",11917,50,,9533.60,,,0,"percent of total billed charges","50% of total billed charges",7674.55,32.2,,6139.64,,,0,"percent of total billed charges","32.2% of total billed charges",4004.11,16.8,,3203.29,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4084.19,17.136,,3267.35,,,0,"percent of total billed charges","17.136% of total billed charges",5205.35,21.84,,4164.28,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8985.42,37.7,,7188.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18590.52,78,,14872.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19686.88,82.6,,15749.50,,,0,"percent of total billed charges","82.6% of total billed charges",4004.11,16.8,,3203.29,,,0,"percent of total billed charges","16.8% of total billed charges",11917,50,,9533.60,,,0,"percent of total billed charges","50% of total billed charges",19686.88,82.6,,15749.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4004.11,16.8,,3203.29,,,0,"percent of total billed charges","16.8% of total billed charges",23834,100,,19067.20,,,0,"percent of total billed charges","100% of total billed charges",3646.6,23834,
"SIGMOIDOSCOPE DISPOSABLE",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SIGMOIDOSCOPE SUCTION",491207,CDM,270,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"SIGNAL REAGENT BOX/2 PACKS",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"SILASTIC SHEETING .030 MATT",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"SILASTIC SHEETING .062 MATT",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"SILASTIC SHEETING DRESSING",ORSUP0013,CDM,270,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SILICONE BITE LINERS",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SILK 2-0 FS (685H)",491209,CDM,270,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"SILK 2-0 STRANDS (A185H)",491210,CDM,270,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"SILK 3-0 STRANDS (A184H)",491211,CDM,270,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"SILK 4-0 STRANDS (A183H)",491212,CDM,270,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"SILK TAPE 1",491213,CDM,270,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"SILK TAPE 2",491214,CDM,270,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"SILK TAPE 3",491215,CDM,270,RC,,,OUTPATIENT,,,28,18.2,,24.64,88,,19.71,,,0,"percent of total billed charges","88% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.85,17.304,,3.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.64,63,,14.11,,,0,"percent of total billed charges","63% of total billed charges",4.28,15.3,,3.42,,,0,"percent of total billed charges","15.3% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",19.32,69,,,,,0,"fee schedule","69% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.32,61.85,,13.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",9.02,32.2,,7.22,,,0,"percent of total billed charges","32.2% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.8,17.136,,3.84,,,0,"percent of total billed charges","17.136% of total billed charges",6.12,21.84,,4.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.56,37.7,,8.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.84,78,,17.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",4.28,28,
"SILVASORB SILVER ANTIMICROBIAL WOUND GEL",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SIMILAC MILK STORAGE BOTTLES W/CAP 4OZ",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SIMPLEX HV W/GENTAMICIN",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"SINGLE-SITE ENERGIZED MARYLAND",ORSUP0039,CDM,272,RC,,,OUTPATIENT,,,7498,4873.7,,6598.24,88,,5278.59,,,0,"percent of total billed charges","88% of total billed charges",3749,50,,2999.20,,,0,"percent of total billed charges","50% of total billed charges",1259.66,16.8,,1007.73,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1297.45,17.304,,1037.96,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4723.74,63,,3778.99,,,0,"percent of total billed charges","63% of total billed charges",1147.19,15.3,,917.75,,,0,"percent of total billed charges","15.3% of total billed charges",1259.66,16.8,,1007.73,,,0,"percent of total billed charges","16.8% of total billed charges",5173.62,69,,,,,0,"fee schedule","69% of total billed charges",7498,100,,5998.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7498,100,,5998.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7498,100,,5998.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4637.51,61.85,,3710.01,,,0,"percent of total billed charges","61.5% of total billed charges",1259.66,16.8,,1007.73,,,0,"percent of total billed charges","16.8% of total billed charges",3749,50,,2999.20,,,0,"percent of total billed charges","50% of total billed charges",2414.36,32.2,,1931.49,,,0,"percent of total billed charges","32.2% of total billed charges",1259.66,16.8,,1007.73,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1284.86,17.136,,1027.89,,,0,"percent of total billed charges","17.136% of total billed charges",1637.56,21.84,,1310.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2826.75,37.7,,2261.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5848.44,78,,4678.75,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6193.35,82.6,,4954.68,,,0,"percent of total billed charges","82.6% of total billed charges",1259.66,16.8,,1007.73,,,0,"percent of total billed charges","16.8% of total billed charges",3749,50,,2999.20,,,0,"percent of total billed charges","50% of total billed charges",6193.35,82.6,,4954.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1259.66,16.8,,1007.73,,,0,"percent of total billed charges","16.8% of total billed charges",7498,100,,5998.40,,,0,"percent of total billed charges","100% of total billed charges",1147.19,7498,
"SINUS ILLUMINATION SYSTEM",ORSUP0016,CDM,270,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SINUS GUIDE CATH M-110",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"SINUS GUIDE CATH S-0 0 DEGREE",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"SINUS GUIDE CATH F-70",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"SINUS DEPLOYMENT GUIDE FRONTAL",ORSUP0015,CDM,270,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SINUS SPACER FRONTAL",ORSUP0016,CDM,270,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SIS SLING",ORSUP0061,CDM,278,RC,,,OUTPATIENT,,,10506,6828.9,,9245.28,88,,7396.22,,,0,"percent of total billed charges","88% of total billed charges",5253,50,,4202.40,,,0,"percent of total billed charges","50% of total billed charges",1765.01,16.8,,1412.01,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1817.96,17.304,,1454.37,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6618.78,63,,5295.02,,,0,"percent of total billed charges","63% of total billed charges",1607.42,15.3,,1285.94,,,0,"percent of total billed charges","15.3% of total billed charges",1765.01,16.8,,1412.01,,,0,"percent of total billed charges","16.8% of total billed charges",7249.14,69,,,,,0,"fee schedule","69% of total billed charges",10506,100,,8404.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10506,100,,8404.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10506,100,,8404.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6497.96,61.85,,5198.37,,,0,"percent of total billed charges","61.5% of total billed charges",1765.01,16.8,,1412.01,,,0,"percent of total billed charges","16.8% of total billed charges",5253,50,,4202.40,,,0,"percent of total billed charges","50% of total billed charges",3382.93,32.2,,2706.34,,,0,"percent of total billed charges","32.2% of total billed charges",3277.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1800.31,17.136,,1440.25,,,0,"percent of total billed charges","17.136% of total billed charges",2294.51,21.84,,1835.61,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3960.76,37.7,,3168.61,,,0,"percent of total billed charges","37.7% of total billed charges",3960.76,37.7,,3168.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3561.53,33.9,,2849.22,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",8194.68,78,,6555.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8677.96,82.6,,6942.37,,,0,"percent of total billed charges","82.6% of total billed charges",1765.01,16.8,,1412.01,,,0,"percent of total billed charges","16.8% of total billed charges",5253,50,,4202.40,,,0,"percent of total billed charges","50% of total billed charges",8677.96,82.6,,6942.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1765.01,16.8,,1412.01,,,0,"percent of total billed charges","16.8% of total billed charges",10506,100,,8404.80,,,0,"percent of total billed charges","100% of total billed charges",1607.42,10506,
"SIZER GAIT LARGE 30-099-03",ORSUP0018,CDM,278,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",605.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.7% of total billed charges",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",658.34,33.9,,526.67,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"SIZER GAIT SMALL 30-099-01",ORSUP0018,CDM,278,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",605.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.7% of total billed charges",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",658.34,33.9,,526.67,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"SKIN AFFIX TISSUE ADHESIVE 0.4ML APPLICATORS",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SKIN MARKING PEN STERILE",491224,CDM,272,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"SKIN PROTECTANT CALMOSEPTINE 3.5GM PK",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SLEEVE FOR BLADELESS TROCAR 11MM X 100MM",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SLEEVE 5MM",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"SLEEVE SCD KNEE MEDIUM",ORSUP0013,CDM,270,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SLEEVE SCD THIGH LENGTH",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SLEEVE ARM SHOULDER SUSPENSION",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SLEEP CANNULAS",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SLIDER SHEET",ORSUP0010,CDM,270,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"SLIDES PLAIN",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SLINGS DISPOSABLE ARJO MEDIUM",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SLINGS DISPOSABLE LARGE",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SLINGS PT LIFT XL DISP FLITES",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SLING ARM X-LRG",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SLING ARM MEDIUM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SLING ARM LARGE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SLING ARM SMALL",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SLING ARM X-LARGE",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SLING S3 LATERAL TRACTION",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SLING DISPOSABLE W/HEAD SUPPORT XLRG",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"SLING DISPOSABLE W/HEAD SUPPORT LRG",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"SLING EZ LIFT SMALL",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"SLING EZ LIFT MEDIUM",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"SLING FLITE XL",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"SLING FLITE MEDIUM",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"SLING FLITE LARGE",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"SLIPPERS DUAL TREAD LARGE BLUE",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"SLIPPER GRIP YELLOW FALL PREVENTION STANDARD",255368,CDM,272,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.95,61.85,,3.96,,,0,"percent of total billed charges","61.5% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"SLIPPER YELLOW LARGE",191408,CDM,272,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"SLIPPER YELLOW XL",312698,CDM,272,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"SLIPPERS DUAL TREAD MEDIUM GREEN",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"SLIPPERS DUAL TREAD XLARGE BEIGE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"SLIPPERS, FALL 2XL",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"SLIPPERS, GRAY 2XL",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"SLIPPERS PATIENT XXXL BARIATRIC GRAY",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SLIPPERS FALL YELLOW 3XL",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SMART NDL 18 GA  2 3/4",ORSUP0035,CDM,272,RC,,,OUTPATIENT,,,6427,4177.55,,5655.76,88,,4524.61,,,0,"percent of total billed charges","88% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1112.13,17.304,,889.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4049.01,63,,3239.21,,,0,"percent of total billed charges","63% of total billed charges",983.33,15.3,,786.66,,,0,"percent of total billed charges","15.3% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4434.63,69,,,,,0,"fee schedule","69% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3975.1,61.85,,3180.08,,,0,"percent of total billed charges","61.5% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",2069.49,32.2,,1655.59,,,0,"percent of total billed charges","32.2% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1101.33,17.136,,881.06,,,0,"percent of total billed charges","17.136% of total billed charges",1403.66,21.84,,1122.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5013.06,78,,4010.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",983.33,6427,
"SMARTPORT CT",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SMITH PROVENT ABG SYRINGE 3ML",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"SMOOTH PEGS LOCKING SZ 16MM",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SMOOTH PEGS LOCKING SZ 18MM",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SMOOTH PEGS LOCKING SZ 20MM",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SMOOTH PEGS LOCKING SZ22",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SNAP COVER BANDED BAG 20 X 20",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SNAPSURE FOLEY CATHETER WITH URINE METER MRI SAFE 16FR",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"SNARE VASC RETRV FILT 6FRX15MMX120CM",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"SNARE ROTATABLE 13MM MICRO OVAL",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"SNARE POLYP JMBO HEX",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"SNARE RETRIEVAL ULTRA CATCH NT",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SNARE RETRIVAL KIT",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SNARE DISPOSABLE",ORSUP0003,CDM,270,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"SNARE RETRIEVAL X-CATCH NT",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"SNARE KIT 4FR 10X120",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,927,602.55,,815.76,88,,652.61,,,0,"percent of total billed charges","88% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.41,17.304,,128.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.01,63,,467.21,,,0,"percent of total billed charges","63% of total billed charges",141.83,15.3,,113.46,,,0,"percent of total billed charges","15.3% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",639.63,69,,,,,0,"fee schedule","69% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",573.35,61.85,,458.68,,,0,"percent of total billed charges","61.5% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",298.49,32.2,,238.79,,,0,"percent of total billed charges","32.2% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.85,17.136,,127.08,,,0,"percent of total billed charges","17.136% of total billed charges",202.46,21.84,,161.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",349.48,37.7,,279.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",723.06,78,,578.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",463.5,50,,370.80,,,0,"percent of total billed charges","50% of total billed charges",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.74,16.8,,124.59,,,0,"percent of total billed charges","16.8% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",141.83,927,
"SOAP CALGON VESTAL LOTION 1 LITER",ORSUP0010,CDM,270,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"SOAP SKIN  SHAMPOO LIQUID CONCENTRATE 4OZ",146385,CDM,272,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"SODA SORB CANISTERS",491238,CDM,270,RC,,,OUTPATIENT,,,224,145.6,,197.12,88,,157.70,,,0,"percent of total billed charges","88% of total billed charges",112,50,,89.60,,,0,"percent of total billed charges","50% of total billed charges",37.63,16.8,,30.10,,,0,"percent of total billed charges","16.8% of total billed charges",224,100,,179.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.76,17.304,,31.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",141.12,63,,112.90,,,0,"percent of total billed charges","63% of total billed charges",34.27,15.3,,27.42,,,0,"percent of total billed charges","15.3% of total billed charges",37.63,16.8,,30.10,,,0,"percent of total billed charges","16.8% of total billed charges",154.56,69,,,,,0,"fee schedule","69% of total billed charges",224,100,,179.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",224,100,,179.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",224,100,,179.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.54,61.85,,110.83,,,0,"percent of total billed charges","61.5% of total billed charges",37.63,16.8,,30.10,,,0,"percent of total billed charges","16.8% of total billed charges",112,50,,89.60,,,0,"percent of total billed charges","50% of total billed charges",72.13,32.2,,57.70,,,0,"percent of total billed charges","32.2% of total billed charges",37.63,16.8,,30.10,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.38,17.136,,30.70,,,0,"percent of total billed charges","17.136% of total billed charges",48.92,21.84,,39.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",84.45,37.7,,67.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",174.72,78,,139.78,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.02,82.6,,148.02,,,0,"percent of total billed charges","82.6% of total billed charges",37.63,16.8,,30.10,,,0,"percent of total billed charges","16.8% of total billed charges",112,50,,89.60,,,0,"percent of total billed charges","50% of total billed charges",185.02,82.6,,148.02,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.63,16.8,,30.10,,,0,"percent of total billed charges","16.8% of total billed charges",224,100,,179.20,,,0,"percent of total billed charges","100% of total billed charges",34.27,224,
"SODA SORB REFILL BAG",491239,CDM,270,RC,,,OUTPATIENT,,,52,33.8,,45.76,88,,36.61,,,0,"percent of total billed charges","88% of total billed charges",26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,17.304,,7.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.76,63,,26.21,,,0,"percent of total billed charges","63% of total billed charges",7.96,15.3,,6.37,,,0,"percent of total billed charges","15.3% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",35.88,69,,,,,0,"fee schedule","69% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.16,61.85,,25.73,,,0,"percent of total billed charges","61.5% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",16.74,32.2,,13.39,,,0,"percent of total billed charges","32.2% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.91,17.136,,7.13,,,0,"percent of total billed charges","17.136% of total billed charges",11.36,21.84,,9.09,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.6,37.7,,15.68,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",40.56,78,,32.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",7.96,52,
"SODIUM HYDROXIDE 4%",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"SODIUM CHLORIDE 0.9%500ML",CATH00008,CDM,272,RC,,,OUTPATIENT,,,400,260,,352,88,,281.60,,,0,"percent of total billed charges","88% of total billed charges",200,50,,160.00,,,0,"percent of total billed charges","50% of total billed charges",67.2,16.8,,53.76,,,0,"percent of total billed charges","16.8% of total billed charges",400,100,,320.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.22,17.304,,55.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",252,63,,201.60,,,0,"percent of total billed charges","63% of total billed charges",61.2,15.3,,48.96,,,0,"percent of total billed charges","15.3% of total billed charges",67.2,16.8,,53.76,,,0,"percent of total billed charges","16.8% of total billed charges",276,69,,,,,0,"fee schedule","69% of total billed charges",400,100,,320.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",400,100,,320.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",400,100,,320.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",247.4,61.85,,197.92,,,0,"percent of total billed charges","61.5% of total billed charges",67.2,16.8,,53.76,,,0,"percent of total billed charges","16.8% of total billed charges",200,50,,160.00,,,0,"percent of total billed charges","50% of total billed charges",128.8,32.2,,103.04,,,0,"percent of total billed charges","32.2% of total billed charges",67.2,16.8,,53.76,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.54,17.136,,54.83,,,0,"percent of total billed charges","17.136% of total billed charges",87.36,21.84,,69.89,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",150.8,37.7,,120.64,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",312,78,,249.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",330.4,82.6,,264.32,,,0,"percent of total billed charges","82.6% of total billed charges",67.2,16.8,,53.76,,,0,"percent of total billed charges","16.8% of total billed charges",200,50,,160.00,,,0,"percent of total billed charges","50% of total billed charges",330.4,82.6,,264.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.2,16.8,,53.76,,,0,"percent of total billed charges","16.8% of total billed charges",400,100,,320.00,,,0,"percent of total billed charges","100% of total billed charges",61.2,400,
"SODIUM /NA+/5 PACK/250 SLDS",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
SODIUM,ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SODIUM HYPOCHLORITE 5% AVAILABLE CHLORINE",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,515,334.75,,453.2,88,,362.56,,,0,"percent of total billed charges","88% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.12,17.304,,71.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",324.45,63,,259.56,,,0,"percent of total billed charges","63% of total billed charges",78.8,15.3,,63.04,,,0,"percent of total billed charges","15.3% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",355.35,69,,,,,0,"fee schedule","69% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",318.53,61.85,,254.82,,,0,"percent of total billed charges","61.5% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",165.83,32.2,,132.66,,,0,"percent of total billed charges","32.2% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.25,17.136,,70.60,,,0,"percent of total billed charges","17.136% of total billed charges",112.48,21.84,,89.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",194.16,37.7,,155.33,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",401.7,78,,321.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",257.5,50,,206.00,,,0,"percent of total billed charges","50% of total billed charges",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.52,16.8,,69.22,,,0,"percent of total billed charges","16.8% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",78.8,515,
"SODIUM HEPARIN VACUTAINER 13X75 4ML",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SOFIA FLU AB TEST KIT",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"SOFIA RSV TEST KIT",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"SOFIA STREP A WVD",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SOFIA2 FLUSRS ANTIGN NS",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"SOFT GUEDEL AIRWAY 70MM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SOFT-VU SO 0 MINI OMNI 5FR X 65CM",ORSUP0004,CDM,278,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.7% of total billed charges",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.83,33.9,,55.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"SOFT-VU HEADHUNTER 4FR X 130CM",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,412,267.8,,362.56,88,,290.05,,,0,"percent of total billed charges","88% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.29,17.304,,57.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",259.56,63,,207.65,,,0,"percent of total billed charges","63% of total billed charges",63.04,15.3,,50.43,,,0,"percent of total billed charges","15.3% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",284.28,69,,,,,0,"fee schedule","69% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",254.82,61.85,,203.86,,,0,"percent of total billed charges","61.5% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",132.66,32.2,,106.13,,,0,"percent of total billed charges","32.2% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.6,17.136,,56.48,,,0,"percent of total billed charges","17.136% of total billed charges",89.98,21.84,,71.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.32,37.7,,124.26,,,0,"percent of total billed charges","37.7% of total billed charges",155.32,37.7,,124.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",139.67,33.9,,111.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",321.36,78,,257.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",206,50,,164.80,,,0,"percent of total billed charges","50% of total billed charges",340.31,82.6,,272.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.22,16.8,,55.38,,,0,"percent of total billed charges","16.8% of total billed charges",412,100,,329.60,,,0,"percent of total billed charges","100% of total billed charges",63.04,412,
"SOHENDRA CATH BILIARY",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SOHENDRA BILIARY DIL CATH",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"SOHENDRA CATH BILARY",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"SOL IRRG H2O 1000ML 2F7114",10394,CDM,258,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SOL IRR NACL 0.9% 1000ML BOTTLE 2F7124",10388,CDM,258,RC,,,OUTPATIENT,,,41,26.65,,36.08,88,,28.86,,,0,"percent of total billed charges","88% of total billed charges",20.5,50,,16.40,,,0,"percent of total billed charges","50% of total billed charges",6.89,16.8,,5.51,,,0,"percent of total billed charges","16.8% of total billed charges",41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.09,17.304,,5.67,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.83,63,,20.66,,,0,"percent of total billed charges","63% of total billed charges",6.27,15.3,,5.02,,,0,"percent of total billed charges","15.3% of total billed charges",6.89,16.8,,5.51,,,0,"percent of total billed charges","16.8% of total billed charges",28.29,69,,,,,0,"fee schedule","69% of total billed charges",41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.36,61.85,,20.29,,,0,"percent of total billed charges","61.5% of total billed charges",6.89,16.8,,5.51,,,0,"percent of total billed charges","16.8% of total billed charges",20.5,50,,16.40,,,0,"percent of total billed charges","50% of total billed charges",13.2,32.2,,10.56,,,0,"percent of total billed charges","32.2% of total billed charges",6.89,16.8,,5.51,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.03,17.136,,5.62,,,0,"percent of total billed charges","17.136% of total billed charges",8.95,21.84,,7.16,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.46,37.7,,12.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",31.98,78,,25.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.87,82.6,,27.10,,,0,"percent of total billed charges","82.6% of total billed charges",6.89,16.8,,5.51,,,0,"percent of total billed charges","16.8% of total billed charges",20.5,50,,16.40,,,0,"percent of total billed charges","50% of total billed charges",33.87,82.6,,27.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.89,16.8,,5.51,,,0,"percent of total billed charges","16.8% of total billed charges",41,100,,32.80,,,0,"percent of total billed charges","100% of total billed charges",6.27,41,
"SOL IRR LACT RING 3000ML BAG 2B7487",10396,CDM,258,RC,,,OUTPATIENT,,,127,82.55,,111.76,88,,89.41,,,0,"percent of total billed charges","88% of total billed charges",63.5,50,,50.80,,,0,"percent of total billed charges","50% of total billed charges",21.34,16.8,,17.07,,,0,"percent of total billed charges","16.8% of total billed charges",127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.98,17.304,,17.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.01,63,,64.01,,,0,"percent of total billed charges","63% of total billed charges",19.43,15.3,,15.54,,,0,"percent of total billed charges","15.3% of total billed charges",21.34,16.8,,17.07,,,0,"percent of total billed charges","16.8% of total billed charges",87.63,69,,,,,0,"fee schedule","69% of total billed charges",127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.55,61.85,,62.84,,,0,"percent of total billed charges","61.5% of total billed charges",21.34,16.8,,17.07,,,0,"percent of total billed charges","16.8% of total billed charges",63.5,50,,50.80,,,0,"percent of total billed charges","50% of total billed charges",40.89,32.2,,32.71,,,0,"percent of total billed charges","32.2% of total billed charges",21.34,16.8,,17.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.76,17.136,,17.41,,,0,"percent of total billed charges","17.136% of total billed charges",27.74,21.84,,22.19,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47.88,37.7,,38.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",99.06,78,,79.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.9,82.6,,83.92,,,0,"percent of total billed charges","82.6% of total billed charges",21.34,16.8,,17.07,,,0,"percent of total billed charges","16.8% of total billed charges",63.5,50,,50.80,,,0,"percent of total billed charges","50% of total billed charges",104.9,82.6,,83.92,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.34,16.8,,17.07,,,0,"percent of total billed charges","16.8% of total billed charges",127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",19.43,127,
"SOL IRR NACL 0.9% 3000ML BAG 2B7127",165076,CDM,258,RC,,,OUTPATIENT,,,122,79.3,,107.36,88,,85.89,,,0,"percent of total billed charges","88% of total billed charges",61,50,,48.80,,,0,"percent of total billed charges","50% of total billed charges",20.5,16.8,,16.40,,,0,"percent of total billed charges","16.8% of total billed charges",122,100,,97.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.11,17.304,,16.89,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.86,63,,61.49,,,0,"percent of total billed charges","63% of total billed charges",18.67,15.3,,14.94,,,0,"percent of total billed charges","15.3% of total billed charges",20.5,16.8,,16.40,,,0,"percent of total billed charges","16.8% of total billed charges",84.18,69,,,,,0,"fee schedule","69% of total billed charges",122,100,,97.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",122,100,,97.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",122,100,,97.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.46,61.85,,60.37,,,0,"percent of total billed charges","61.5% of total billed charges",20.5,16.8,,16.40,,,0,"percent of total billed charges","16.8% of total billed charges",61,50,,48.80,,,0,"percent of total billed charges","50% of total billed charges",39.28,32.2,,31.42,,,0,"percent of total billed charges","32.2% of total billed charges",20.5,16.8,,16.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.91,17.136,,16.73,,,0,"percent of total billed charges","17.136% of total billed charges",26.64,21.84,,21.31,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",45.99,37.7,,36.79,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",95.16,78,,76.13,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",100.77,82.6,,80.62,,,0,"percent of total billed charges","82.6% of total billed charges",20.5,16.8,,16.40,,,0,"percent of total billed charges","16.8% of total billed charges",61,50,,48.80,,,0,"percent of total billed charges","50% of total billed charges",100.77,82.6,,80.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.5,16.8,,16.40,,,0,"percent of total billed charges","16.8% of total billed charges",122,100,,97.60,,,0,"percent of total billed charges","100% of total billed charges",18.67,122,
"SOL IV NACL 0.9% 500ML BAG 2B1323Q",10390,CDM,258,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.9,61.85,,7.92,,,0,"percent of total billed charges","61.5% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"SOL IV NACL 0.9% 1000ML BAG 2B1324X",10391,CDM,258,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.9,61.85,,7.92,,,0,"percent of total billed charges","61.5% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"SOL LACT RING INJ 1000ML 2B2324X",10384,CDM,258,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"SOL NACL 0.9% W/ KCL 40MEQ",75217,CDM,272,RC,,,OUTPATIENT,,,21,13.65,,18.48,88,,14.78,,,0,"percent of total billed charges","88% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.63,17.304,,2.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.23,63,,10.58,,,0,"percent of total billed charges","63% of total billed charges",3.21,15.3,,2.57,,,0,"percent of total billed charges","15.3% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",14.49,69,,,,,0,"fee schedule","69% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.99,61.85,,10.39,,,0,"percent of total billed charges","61.5% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",6.76,32.2,,5.41,,,0,"percent of total billed charges","32.2% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.6,17.136,,2.88,,,0,"percent of total billed charges","17.136% of total billed charges",4.59,21.84,,3.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.92,37.7,,6.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.38,78,,13.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",3.21,21,
"SOL D5 / LACT RINGERS 2B2074",10382,CDM,258,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.37,61.85,,9.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"SOL IV D5W 1000ML",10541,CDM,258,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"SOL D5/.9%NACL INJ 1000ML 2B1064",10545,CDM,258,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"SOL D5W .45NS 500ML 2B1073Q",11151,CDM,272,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.9,61.85,,7.92,,,0,"percent of total billed charges","61.5% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"SOL D5/.45NACL 1000ML 2B1074",10546,CDM,258,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"SOL D-5  2% NACL 500ML 2B1093Q",11174,CDM,272,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.9,61.85,,7.92,,,0,"percent of total billed charges","61.5% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"SOL IV D5/.2NACL 1000ML 2B1094",10547,CDM,272,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"SOL D5NS WITH KCL 40 MEQ",80578,CDM,272,RC,,,OUTPATIENT,,,31,20.15,,27.28,88,,21.82,,,0,"percent of total billed charges","88% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.36,17.304,,4.29,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.53,63,,15.62,,,0,"percent of total billed charges","63% of total billed charges",4.74,15.3,,3.79,,,0,"percent of total billed charges","15.3% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",21.39,69,,,,,0,"fee schedule","69% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.17,61.85,,15.34,,,0,"percent of total billed charges","61.5% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",9.98,32.2,,7.98,,,0,"percent of total billed charges","32.2% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.31,17.136,,4.25,,,0,"percent of total billed charges","17.136% of total billed charges",6.77,21.84,,5.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.69,37.7,,9.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.18,78,,19.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.61,82.6,,20.49,,,0,"percent of total billed charges","82.6% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",25.61,82.6,,20.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",4.74,31,
"SOL KCI 40MEQ D5 AND 45NACL 2B1674",11173,CDM,272,RC,,,OUTPATIENT,,,100,65,,88,88,,70.40,,,0,"percent of total billed charges","88% of total billed charges",50,50,,40.00,,,0,"percent of total billed charges","50% of total billed charges",16.8,16.8,,13.44,,,0,"percent of total billed charges","16.8% of total billed charges",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,17.304,,13.84,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",63,63,,50.40,,,0,"percent of total billed charges","63% of total billed charges",15.3,15.3,,12.24,,,0,"percent of total billed charges","15.3% of total billed charges",16.8,16.8,,13.44,,,0,"percent of total billed charges","16.8% of total billed charges",69,69,,,,,0,"fee schedule","69% of total billed charges",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.85,61.85,,49.48,,,0,"percent of total billed charges","61.5% of total billed charges",16.8,16.8,,13.44,,,0,"percent of total billed charges","16.8% of total billed charges",50,50,,40.00,,,0,"percent of total billed charges","50% of total billed charges",32.2,32.2,,25.76,,,0,"percent of total billed charges","32.2% of total billed charges",16.8,16.8,,13.44,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.14,17.136,,13.71,,,0,"percent of total billed charges","17.136% of total billed charges",21.84,21.84,,17.47,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",78,78,,62.40,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",16.8,16.8,,13.44,,,0,"percent of total billed charges","16.8% of total billed charges",50,50,,40.00,,,0,"percent of total billed charges","50% of total billed charges",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.8,16.8,,13.44,,,0,"percent of total billed charges","16.8% of total billed charges",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",15.3,100,
"SOL KCI 30MEQ D5  45 NACL 2B1664",11172,CDM,272,RC,,,OUTPATIENT,,,31,20.15,,27.28,88,,21.82,,,0,"percent of total billed charges","88% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.36,17.304,,4.29,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.53,63,,15.62,,,0,"percent of total billed charges","63% of total billed charges",4.74,15.3,,3.79,,,0,"percent of total billed charges","15.3% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",21.39,69,,,,,0,"fee schedule","69% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.17,61.85,,15.34,,,0,"percent of total billed charges","61.5% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",9.98,32.2,,7.98,,,0,"percent of total billed charges","32.2% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.31,17.136,,4.25,,,0,"percent of total billed charges","17.136% of total billed charges",6.77,21.84,,5.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.69,37.7,,9.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.18,78,,19.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.61,82.6,,20.49,,,0,"percent of total billed charges","82.6% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",25.61,82.6,,20.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",4.74,31,
"SOL D5W 0.9% NACL W/20MEQ KCL",39181,CDM,272,RC,,,OUTPATIENT,,,26,16.9,,22.88,88,,18.30,,,0,"percent of total billed charges","88% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.5,17.304,,3.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.38,63,,13.10,,,0,"percent of total billed charges","63% of total billed charges",3.98,15.3,,3.18,,,0,"percent of total billed charges","15.3% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",17.94,69,,,,,0,"fee schedule","69% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.08,61.85,,12.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",8.37,32.2,,6.70,,,0,"percent of total billed charges","32.2% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.46,17.136,,3.57,,,0,"percent of total billed charges","17.136% of total billed charges",5.68,21.84,,4.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.8,37.7,,7.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.28,78,,16.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",3.98,26,
"SOL IV D5/.45 NACL W/KCL 20MEQ 2B1654",10548,CDM,258,RC,,,OUTPATIENT,,,22,14.3,,19.36,88,,15.49,,,0,"percent of total billed charges","88% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.81,17.304,,3.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.86,63,,11.09,,,0,"percent of total billed charges","63% of total billed charges",3.37,15.3,,2.70,,,0,"percent of total billed charges","15.3% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",15.18,69,,,,,0,"fee schedule","69% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.61,61.85,,10.89,,,0,"percent of total billed charges","61.5% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",7.08,32.2,,5.66,,,0,"percent of total billed charges","32.2% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.77,17.136,,3.02,,,0,"percent of total billed charges","17.136% of total billed charges",4.8,21.84,,3.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.29,37.7,,6.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.16,78,,13.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",3.37,22,
"SOL 1/2 NS W/20MEQ KCL/1000ML",84944,CDM,272,RC,,,OUTPATIENT,,,74,48.1,,65.12,88,,52.10,,,0,"percent of total billed charges","88% of total billed charges",37,50,,29.60,,,0,"percent of total billed charges","50% of total billed charges",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.8,17.304,,10.24,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.62,63,,37.30,,,0,"percent of total billed charges","63% of total billed charges",11.32,15.3,,9.06,,,0,"percent of total billed charges","15.3% of total billed charges",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",51.06,69,,,,,0,"fee schedule","69% of total billed charges",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.77,61.85,,36.62,,,0,"percent of total billed charges","61.5% of total billed charges",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",37,50,,29.60,,,0,"percent of total billed charges","50% of total billed charges",23.83,32.2,,19.06,,,0,"percent of total billed charges","32.2% of total billed charges",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.68,17.136,,10.14,,,0,"percent of total billed charges","17.136% of total billed charges",16.16,21.84,,12.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",27.9,37.7,,22.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",57.72,78,,46.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.12,82.6,,48.90,,,0,"percent of total billed charges","82.6% of total billed charges",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",37,50,,29.60,,,0,"percent of total billed charges","50% of total billed charges",61.12,82.6,,48.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.43,16.8,,9.94,,,0,"percent of total billed charges","16.8% of total billed charges",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",11.32,74,
"SOL IV D10W 1000ML",10379,CDM,272,RC,,,OUTPATIENT,,,23,14.95,,20.24,88,,16.19,,,0,"percent of total billed charges","88% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.98,17.304,,3.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.49,63,,11.59,,,0,"percent of total billed charges","63% of total billed charges",3.52,15.3,,2.82,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",15.87,69,,,,,0,"fee schedule","69% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.23,61.85,,11.38,,,0,"percent of total billed charges","61.5% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",7.41,32.2,,5.93,,,0,"percent of total billed charges","32.2% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.94,17.136,,3.15,,,0,"percent of total billed charges","17.136% of total billed charges",5.02,21.84,,4.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.94,78,,14.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",3.52,23,
"SOL IV D5/45NACL W/10 MEQ KCL",10378,CDM,272,RC,,,OUTPATIENT,,,32,20.8,,28.16,88,,22.53,,,0,"percent of total billed charges","88% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.54,17.304,,4.43,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.16,63,,16.13,,,0,"percent of total billed charges","63% of total billed charges",4.9,15.3,,3.92,,,0,"percent of total billed charges","15.3% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",22.08,69,,,,,0,"fee schedule","69% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.79,61.85,,15.83,,,0,"percent of total billed charges","61.5% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",10.3,32.2,,8.24,,,0,"percent of total billed charges","32.2% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.48,17.136,,4.38,,,0,"percent of total billed charges","17.136% of total billed charges",6.99,21.84,,5.59,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.96,78,,19.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",4.9,32,
"SOL IV 0.9% NACL MINI- BAG 100ML VIAFLEX LF",10538,CDM,270,RC,,,OUTPATIENT,,,60,39,,52.8,88,,42.24,,,0,"percent of total billed charges","88% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.38,17.304,,8.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.8,63,,30.24,,,0,"percent of total billed charges","63% of total billed charges",9.18,15.3,,7.34,,,0,"percent of total billed charges","15.3% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",41.4,69,,,,,0,"fee schedule","69% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.11,61.85,,29.69,,,0,"percent of total billed charges","61.5% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",19.32,32.2,,15.46,,,0,"percent of total billed charges","32.2% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.28,17.136,,8.22,,,0,"percent of total billed charges","17.136% of total billed charges",13.1,21.84,,10.48,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,37.7,,18.10,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.8,78,,37.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.56,82.6,,39.65,,,0,"percent of total billed charges","82.6% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",49.56,82.6,,39.65,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",9.18,60,
"SOL IV .45% NACL 1000ML 2B1314",10387,CDM,272,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"SOL IV H2O 1000ML 2B0304",10393,CDM,272,RC,,,OUTPATIENT,,,25,16.25,,22,88,,17.60,,,0,"percent of total billed charges","88% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,17.304,,3.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.75,63,,12.60,,,0,"percent of total billed charges","63% of total billed charges",3.83,15.3,,3.06,,,0,"percent of total billed charges","15.3% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",17.25,69,,,,,0,"fee schedule","69% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.46,61.85,,12.37,,,0,"percent of total billed charges","61.5% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",8.05,32.2,,6.44,,,0,"percent of total billed charges","32.2% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.28,17.136,,3.42,,,0,"percent of total billed charges","17.136% of total billed charges",5.46,21.84,,4.37,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.43,37.7,,7.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.5,78,,15.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",3.83,25,
"SOL 3% NS 500ML 2B1353Q",11177,CDM,272,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"SOL INJ 10MEQ POTASSIUM CHLORIDE INJ 10 MEQ",60575,CDM,272,RC,,,OUTPATIENT,,,40,26,,35.2,88,,28.16,,,0,"percent of total billed charges","88% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.92,17.304,,5.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.2,63,,20.16,,,0,"percent of total billed charges","63% of total billed charges",6.12,15.3,,4.90,,,0,"percent of total billed charges","15.3% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",27.6,69,,,,,0,"fee schedule","69% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.74,61.85,,19.79,,,0,"percent of total billed charges","61.5% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",12.88,32.2,,10.30,,,0,"percent of total billed charges","32.2% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.85,17.136,,5.48,,,0,"percent of total billed charges","17.136% of total billed charges",8.74,21.84,,6.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.08,37.7,,12.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",31.2,78,,24.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",6.12,40,
"SOL KCL 20 MEQ ST H20 100ML",74727,CDM,272,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"SOL 9% NACL W/ HEP 1000U 2B0953",7772,CDM,272,RC,,,OUTPATIENT,,,146,94.9,,128.48,88,,102.78,,,0,"percent of total billed charges","88% of total billed charges",73,50,,58.40,,,0,"percent of total billed charges","50% of total billed charges",24.53,16.8,,19.62,,,0,"percent of total billed charges","16.8% of total billed charges",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.26,17.304,,20.21,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.98,63,,73.58,,,0,"percent of total billed charges","63% of total billed charges",22.34,15.3,,17.87,,,0,"percent of total billed charges","15.3% of total billed charges",24.53,16.8,,19.62,,,0,"percent of total billed charges","16.8% of total billed charges",100.74,69,,,,,0,"fee schedule","69% of total billed charges",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.3,61.85,,72.24,,,0,"percent of total billed charges","61.5% of total billed charges",24.53,16.8,,19.62,,,0,"percent of total billed charges","16.8% of total billed charges",73,50,,58.40,,,0,"percent of total billed charges","50% of total billed charges",47.01,32.2,,37.61,,,0,"percent of total billed charges","32.2% of total billed charges",24.53,16.8,,19.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.02,17.136,,20.02,,,0,"percent of total billed charges","17.136% of total billed charges",31.89,21.84,,25.51,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",55.04,37.7,,44.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",113.88,78,,91.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",120.6,82.6,,96.48,,,0,"percent of total billed charges","82.6% of total billed charges",24.53,16.8,,19.62,,,0,"percent of total billed charges","16.8% of total billed charges",73,50,,58.40,,,0,"percent of total billed charges","50% of total billed charges",120.6,82.6,,96.48,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.53,16.8,,19.62,,,0,"percent of total billed charges","16.8% of total billed charges",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",22.34,146,
"SOL SODIUM CITRATE",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SOL.9% NACL WITH KCL 20ME",73031,CDM,258,RC,,,OUTPATIENT,,,23,14.95,,20.24,88,,16.19,,,0,"percent of total billed charges","88% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.98,17.304,,3.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.49,63,,11.59,,,0,"percent of total billed charges","63% of total billed charges",3.52,15.3,,2.82,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",15.87,69,,,,,0,"fee schedule","69% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.23,61.85,,11.38,,,0,"percent of total billed charges","61.5% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",7.41,32.2,,5.93,,,0,"percent of total billed charges","32.2% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.94,17.136,,3.15,,,0,"percent of total billed charges","17.136% of total billed charges",5.02,21.84,,4.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.94,78,,14.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",3.52,23,
"SOLIDIFIER 500C",400784,CDM,270,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"SOLN IRRIG H2O 3000ML STERILE",146429,CDM,258,RC,,,OUTPATIENT,,,121,78.65,,106.48,88,,85.18,,,0,"percent of total billed charges","88% of total billed charges",60.5,50,,48.40,,,0,"percent of total billed charges","50% of total billed charges",20.33,16.8,,16.26,,,0,"percent of total billed charges","16.8% of total billed charges",121,100,,96.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.94,17.304,,16.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.23,63,,60.98,,,0,"percent of total billed charges","63% of total billed charges",18.51,15.3,,14.81,,,0,"percent of total billed charges","15.3% of total billed charges",20.33,16.8,,16.26,,,0,"percent of total billed charges","16.8% of total billed charges",83.49,69,,,,,0,"fee schedule","69% of total billed charges",121,100,,96.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",121,100,,96.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",121,100,,96.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.84,61.85,,59.87,,,0,"percent of total billed charges","61.5% of total billed charges",20.33,16.8,,16.26,,,0,"percent of total billed charges","16.8% of total billed charges",60.5,50,,48.40,,,0,"percent of total billed charges","50% of total billed charges",38.96,32.2,,31.17,,,0,"percent of total billed charges","32.2% of total billed charges",20.33,16.8,,16.26,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.73,17.136,,16.58,,,0,"percent of total billed charges","17.136% of total billed charges",26.43,21.84,,21.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",45.62,37.7,,36.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",94.38,78,,75.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",99.95,82.6,,79.96,,,0,"percent of total billed charges","82.6% of total billed charges",20.33,16.8,,16.26,,,0,"percent of total billed charges","16.8% of total billed charges",60.5,50,,48.40,,,0,"percent of total billed charges","50% of total billed charges",99.95,82.6,,79.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.33,16.8,,16.26,,,0,"percent of total billed charges","16.8% of total billed charges",121,100,,96.80,,,0,"percent of total billed charges","100% of total billed charges",18.51,121,
"SOLN IRRIG SORBITOL 3% 3000ML",41330,CDM,258,RC,,,OUTPATIENT,,,92,59.8,,80.96,88,,64.77,,,0,"percent of total billed charges","88% of total billed charges",46,50,,36.80,,,0,"percent of total billed charges","50% of total billed charges",15.46,16.8,,12.37,,,0,"percent of total billed charges","16.8% of total billed charges",92,100,,73.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.92,17.304,,12.74,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.96,63,,46.37,,,0,"percent of total billed charges","63% of total billed charges",14.08,15.3,,11.26,,,0,"percent of total billed charges","15.3% of total billed charges",15.46,16.8,,12.37,,,0,"percent of total billed charges","16.8% of total billed charges",63.48,69,,,,,0,"fee schedule","69% of total billed charges",92,100,,73.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92,100,,73.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92,100,,73.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.9,61.85,,45.52,,,0,"percent of total billed charges","61.5% of total billed charges",15.46,16.8,,12.37,,,0,"percent of total billed charges","16.8% of total billed charges",46,50,,36.80,,,0,"percent of total billed charges","50% of total billed charges",29.62,32.2,,23.70,,,0,"percent of total billed charges","32.2% of total billed charges",15.46,16.8,,12.37,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.77,17.136,,12.62,,,0,"percent of total billed charges","17.136% of total billed charges",20.09,21.84,,16.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.68,37.7,,27.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",71.76,78,,57.41,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.99,82.6,,60.79,,,0,"percent of total billed charges","82.6% of total billed charges",15.46,16.8,,12.37,,,0,"percent of total billed charges","16.8% of total billed charges",46,50,,36.80,,,0,"percent of total billed charges","50% of total billed charges",75.99,82.6,,60.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.46,16.8,,12.37,,,0,"percent of total billed charges","16.8% of total billed charges",92,100,,73.60,,,0,"percent of total billed charges","100% of total billed charges",14.08,92,
"SOLN  LAC RINGERS 500 ML   2B2323Q",35738,CDM,258,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"SOLN  DEX INJ 5% 50 ML      2B0081",35723,CDM,272,RC,,,OUTPATIENT,,,57,37.05,,50.16,88,,40.13,,,0,"percent of total billed charges","88% of total billed charges",28.5,50,,22.80,,,0,"percent of total billed charges","50% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.86,17.304,,7.89,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.91,63,,28.73,,,0,"percent of total billed charges","63% of total billed charges",8.72,15.3,,6.98,,,0,"percent of total billed charges","15.3% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",39.33,69,,,,,0,"fee schedule","69% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.25,61.85,,28.20,,,0,"percent of total billed charges","61.5% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",28.5,50,,22.80,,,0,"percent of total billed charges","50% of total billed charges",18.35,32.2,,14.68,,,0,"percent of total billed charges","32.2% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.77,17.136,,7.82,,,0,"percent of total billed charges","17.136% of total billed charges",12.45,21.84,,9.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.49,37.7,,17.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",44.46,78,,35.57,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.08,82.6,,37.66,,,0,"percent of total billed charges","82.6% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",28.5,50,,22.80,,,0,"percent of total billed charges","50% of total billed charges",47.08,82.6,,37.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",8.72,57,
"SOLN  DEX INJ 5% 100 ML     2B0082",35724,CDM,272,RC,,,OUTPATIENT,,,57,37.05,,50.16,88,,40.13,,,0,"percent of total billed charges","88% of total billed charges",28.5,50,,22.80,,,0,"percent of total billed charges","50% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.86,17.304,,7.89,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.91,63,,28.73,,,0,"percent of total billed charges","63% of total billed charges",8.72,15.3,,6.98,,,0,"percent of total billed charges","15.3% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",39.33,69,,,,,0,"fee schedule","69% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.25,61.85,,28.20,,,0,"percent of total billed charges","61.5% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",28.5,50,,22.80,,,0,"percent of total billed charges","50% of total billed charges",18.35,32.2,,14.68,,,0,"percent of total billed charges","32.2% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.77,17.136,,7.82,,,0,"percent of total billed charges","17.136% of total billed charges",12.45,21.84,,9.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.49,37.7,,17.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",44.46,78,,35.57,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.08,82.6,,37.66,,,0,"percent of total billed charges","82.6% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",28.5,50,,22.80,,,0,"percent of total billed charges","50% of total billed charges",47.08,82.6,,37.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",8.72,57,
"SOLN D5W WITH KCL 20MEQ 1LTR",73036,CDM,272,RC,,,OUTPATIENT,,,32,20.8,,28.16,88,,22.53,,,0,"percent of total billed charges","88% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.54,17.304,,4.43,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.16,63,,16.13,,,0,"percent of total billed charges","63% of total billed charges",4.9,15.3,,3.92,,,0,"percent of total billed charges","15.3% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",22.08,69,,,,,0,"fee schedule","69% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.79,61.85,,15.83,,,0,"percent of total billed charges","61.5% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",10.3,32.2,,8.24,,,0,"percent of total billed charges","32.2% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.48,17.136,,4.38,,,0,"percent of total billed charges","17.136% of total billed charges",6.99,21.84,,5.59,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.96,78,,19.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",4.9,32,
"SOLN D5W/.2% NACL W/ KCL 20",75218,CDM,272,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"SOLN  0.9% NACL  MINI-BAG 50ML VIAFLEX LF",36128,CDM,270,RC,,,OUTPATIENT,,,125,81.25,,110,88,,88.00,,,0,"percent of total billed charges","88% of total billed charges",62.5,50,,50.00,,,0,"percent of total billed charges","50% of total billed charges",21,16.8,,16.80,,,0,"percent of total billed charges","16.8% of total billed charges",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.63,17.304,,17.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.75,63,,63.00,,,0,"percent of total billed charges","63% of total billed charges",19.13,15.3,,15.30,,,0,"percent of total billed charges","15.3% of total billed charges",21,16.8,,16.80,,,0,"percent of total billed charges","16.8% of total billed charges",86.25,69,,,,,0,"fee schedule","69% of total billed charges",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.31,61.85,,61.85,,,0,"percent of total billed charges","61.5% of total billed charges",21,16.8,,16.80,,,0,"percent of total billed charges","16.8% of total billed charges",62.5,50,,50.00,,,0,"percent of total billed charges","50% of total billed charges",40.25,32.2,,32.20,,,0,"percent of total billed charges","32.2% of total billed charges",21,16.8,,16.80,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.42,17.136,,17.14,,,0,"percent of total billed charges","17.136% of total billed charges",27.3,21.84,,21.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47.13,37.7,,37.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",97.5,78,,78.00,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.25,82.6,,82.60,,,0,"percent of total billed charges","82.6% of total billed charges",21,16.8,,16.80,,,0,"percent of total billed charges","16.8% of total billed charges",62.5,50,,50.00,,,0,"percent of total billed charges","50% of total billed charges",103.25,82.6,,82.60,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,16.8,,16.80,,,0,"percent of total billed charges","16.8% of total billed charges",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",19.13,125,
"SOLN .9% NACL 50ML 4 PK",73035,CDM,272,RC,,,OUTPATIENT,,,57,37.05,,50.16,88,,40.13,,,0,"percent of total billed charges","88% of total billed charges",28.5,50,,22.80,,,0,"percent of total billed charges","50% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.86,17.304,,7.89,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.91,63,,28.73,,,0,"percent of total billed charges","63% of total billed charges",8.72,15.3,,6.98,,,0,"percent of total billed charges","15.3% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",39.33,69,,,,,0,"fee schedule","69% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.25,61.85,,28.20,,,0,"percent of total billed charges","61.5% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",28.5,50,,22.80,,,0,"percent of total billed charges","50% of total billed charges",18.35,32.2,,14.68,,,0,"percent of total billed charges","32.2% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.77,17.136,,7.82,,,0,"percent of total billed charges","17.136% of total billed charges",12.45,21.84,,9.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.49,37.7,,17.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",44.46,78,,35.57,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.08,82.6,,37.66,,,0,"percent of total billed charges","82.6% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",28.5,50,,22.80,,,0,"percent of total billed charges","50% of total billed charges",47.08,82.6,,37.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",8.72,57,
"SOLN  0.9% SOD CHL 250ML   2B1322Q",35735,CDM,258,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"SOLN  BETADINE 1/2 OZ",36364,CDM,270,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"SOLN ANTISEPTIC 4PCT CHOLRHEXIDINE GLUCONATE",268468,CDM,270,RC,,,OUTPATIENT,,,871,566.15,,766.48,88,,613.18,,,0,"percent of total billed charges","88% of total billed charges",435.5,50,,348.40,,,0,"percent of total billed charges","50% of total billed charges",146.33,16.8,,117.06,,,0,"percent of total billed charges","16.8% of total billed charges",871,100,,696.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",150.72,17.304,,120.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",548.73,63,,438.98,,,0,"percent of total billed charges","63% of total billed charges",133.26,15.3,,106.61,,,0,"percent of total billed charges","15.3% of total billed charges",146.33,16.8,,117.06,,,0,"percent of total billed charges","16.8% of total billed charges",600.99,69,,,,,0,"fee schedule","69% of total billed charges",871,100,,696.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",871,100,,696.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",871,100,,696.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",538.71,61.85,,430.97,,,0,"percent of total billed charges","61.5% of total billed charges",146.33,16.8,,117.06,,,0,"percent of total billed charges","16.8% of total billed charges",435.5,50,,348.40,,,0,"percent of total billed charges","50% of total billed charges",280.46,32.2,,224.37,,,0,"percent of total billed charges","32.2% of total billed charges",146.33,16.8,,117.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",149.25,17.136,,119.40,,,0,"percent of total billed charges","17.136% of total billed charges",190.23,21.84,,152.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",328.37,37.7,,262.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",679.38,78,,543.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.45,82.6,,575.56,,,0,"percent of total billed charges","82.6% of total billed charges",146.33,16.8,,117.06,,,0,"percent of total billed charges","16.8% of total billed charges",435.5,50,,348.40,,,0,"percent of total billed charges","50% of total billed charges",719.45,82.6,,575.56,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",146.33,16.8,,117.06,,,0,"percent of total billed charges","16.8% of total billed charges",871,100,,696.80,,,0,"percent of total billed charges","100% of total billed charges",133.26,871,
"SOLUTION PLEGISOL 1000ML",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"SOLUTION IRRIGATION STERILE WATER 1500ML PB",165087,CDM,272,RC,,,OUTPATIENT,,,56,36.4,,49.28,88,,39.42,,,0,"percent of total billed charges","88% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.69,17.304,,7.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.28,63,,28.22,,,0,"percent of total billed charges","63% of total billed charges",8.57,15.3,,6.86,,,0,"percent of total billed charges","15.3% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",38.64,69,,,,,0,"fee schedule","69% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.64,61.85,,27.71,,,0,"percent of total billed charges","61.5% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",18.03,32.2,,14.42,,,0,"percent of total billed charges","32.2% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.6,17.136,,7.68,,,0,"percent of total billed charges","17.136% of total billed charges",12.23,21.84,,9.78,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.11,37.7,,16.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.68,78,,34.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",8.57,56,
"SOLUTION IV DEXTROSE 5% LACT RINGERS INJ 500ML BG",165088,CDM,270,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"SOLUTION IV 0.9% SODIUM CHL 100ML QUAD",35734,CDM,258,RC,,,OUTPATIENT,,,57,37.05,,50.16,88,,40.13,,,0,"percent of total billed charges","88% of total billed charges",28.5,50,,22.80,,,0,"percent of total billed charges","50% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.86,17.304,,7.89,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.91,63,,28.73,,,0,"percent of total billed charges","63% of total billed charges",8.72,15.3,,6.98,,,0,"percent of total billed charges","15.3% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",39.33,69,,,,,0,"fee schedule","69% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.25,61.85,,28.20,,,0,"percent of total billed charges","61.5% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",28.5,50,,22.80,,,0,"percent of total billed charges","50% of total billed charges",18.35,32.2,,14.68,,,0,"percent of total billed charges","32.2% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.77,17.136,,7.82,,,0,"percent of total billed charges","17.136% of total billed charges",12.45,21.84,,9.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.49,37.7,,17.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",44.46,78,,35.57,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.08,82.6,,37.66,,,0,"percent of total billed charges","82.6% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",28.5,50,,22.80,,,0,"percent of total billed charges","50% of total billed charges",47.08,82.6,,37.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",8.72,57,
"SOLUTION SCRUB CARE 2PCT FOAM CHG 30 OZ",176079,CDM,270,RC,,,OUTPATIENT,,,109,70.85,,95.92,88,,76.74,,,0,"percent of total billed charges","88% of total billed charges",54.5,50,,43.60,,,0,"percent of total billed charges","50% of total billed charges",18.31,16.8,,14.65,,,0,"percent of total billed charges","16.8% of total billed charges",109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.86,17.304,,15.09,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.67,63,,54.94,,,0,"percent of total billed charges","63% of total billed charges",16.68,15.3,,13.34,,,0,"percent of total billed charges","15.3% of total billed charges",18.31,16.8,,14.65,,,0,"percent of total billed charges","16.8% of total billed charges",75.21,69,,,,,0,"fee schedule","69% of total billed charges",109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.42,61.85,,53.94,,,0,"percent of total billed charges","61.5% of total billed charges",18.31,16.8,,14.65,,,0,"percent of total billed charges","16.8% of total billed charges",54.5,50,,43.60,,,0,"percent of total billed charges","50% of total billed charges",35.1,32.2,,28.08,,,0,"percent of total billed charges","32.2% of total billed charges",18.31,16.8,,14.65,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.68,17.136,,14.94,,,0,"percent of total billed charges","17.136% of total billed charges",23.81,21.84,,19.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.09,37.7,,32.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",85.02,78,,68.02,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.03,82.6,,72.02,,,0,"percent of total billed charges","82.6% of total billed charges",18.31,16.8,,14.65,,,0,"percent of total billed charges","16.8% of total billed charges",54.5,50,,43.60,,,0,"percent of total billed charges","50% of total billed charges",90.03,82.6,,72.02,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.31,16.8,,14.65,,,0,"percent of total billed charges","16.8% of total billed charges",109,100,,87.20,,,0,"percent of total billed charges","100% of total billed charges",16.68,109,
"SOLUTION ACL TOP RINSE  4L BOTTLE",ORSUP0010,CDM,270,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"SOLUTION BETADINE 4OZ",383653,CDM,270,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"SOLUTION HYPOCHLORITE S5362 100ML",165070,CDM,270,RC,,,OUTPATIENT,,,278,180.7,,244.64,88,,195.71,,,0,"percent of total billed charges","88% of total billed charges",139,50,,111.20,,,0,"percent of total billed charges","50% of total billed charges",46.7,16.8,,37.36,,,0,"percent of total billed charges","16.8% of total billed charges",278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.11,17.304,,38.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",175.14,63,,140.11,,,0,"percent of total billed charges","63% of total billed charges",42.53,15.3,,34.02,,,0,"percent of total billed charges","15.3% of total billed charges",46.7,16.8,,37.36,,,0,"percent of total billed charges","16.8% of total billed charges",191.82,69,,,,,0,"fee schedule","69% of total billed charges",278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",171.94,61.85,,137.55,,,0,"percent of total billed charges","61.5% of total billed charges",46.7,16.8,,37.36,,,0,"percent of total billed charges","16.8% of total billed charges",139,50,,111.20,,,0,"percent of total billed charges","50% of total billed charges",89.52,32.2,,71.62,,,0,"percent of total billed charges","32.2% of total billed charges",46.7,16.8,,37.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.64,17.136,,38.11,,,0,"percent of total billed charges","17.136% of total billed charges",60.72,21.84,,48.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.81,37.7,,83.85,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",216.84,78,,173.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.63,82.6,,183.70,,,0,"percent of total billed charges","82.6% of total billed charges",46.7,16.8,,37.36,,,0,"percent of total billed charges","16.8% of total billed charges",139,50,,111.20,,,0,"percent of total billed charges","50% of total billed charges",229.63,82.6,,183.70,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.7,16.8,,37.36,,,0,"percent of total billed charges","16.8% of total billed charges",278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",42.53,278,
"SOLUTION RAPICIDE",19761,CDM,270,RC,,,OUTPATIENT,,,785,510.25,,690.8,88,,552.64,,,0,"percent of total billed charges","88% of total billed charges",392.5,50,,314.00,,,0,"percent of total billed charges","50% of total billed charges",131.88,16.8,,105.50,,,0,"percent of total billed charges","16.8% of total billed charges",785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",135.84,17.304,,108.67,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.55,63,,395.64,,,0,"percent of total billed charges","63% of total billed charges",120.11,15.3,,96.09,,,0,"percent of total billed charges","15.3% of total billed charges",131.88,16.8,,105.50,,,0,"percent of total billed charges","16.8% of total billed charges",541.65,69,,,,,0,"fee schedule","69% of total billed charges",785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",485.52,61.85,,388.42,,,0,"percent of total billed charges","61.5% of total billed charges",131.88,16.8,,105.50,,,0,"percent of total billed charges","16.8% of total billed charges",392.5,50,,314.00,,,0,"percent of total billed charges","50% of total billed charges",252.77,32.2,,202.22,,,0,"percent of total billed charges","32.2% of total billed charges",131.88,16.8,,105.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.52,17.136,,107.62,,,0,"percent of total billed charges","17.136% of total billed charges",171.44,21.84,,137.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",295.95,37.7,,236.76,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",612.3,78,,489.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.41,82.6,,518.73,,,0,"percent of total billed charges","82.6% of total billed charges",131.88,16.8,,105.50,,,0,"percent of total billed charges","16.8% of total billed charges",392.5,50,,314.00,,,0,"percent of total billed charges","50% of total billed charges",648.41,82.6,,518.73,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",131.88,16.8,,105.50,,,0,"percent of total billed charges","16.8% of total billed charges",785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",120.11,785,
"SOLUTION CALIBRATION VERIFICATION MATERAL 4X2.5ML",ORSUP0011,CDM,270,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SOLUTION STERILE SODIUM CHLORIDE BOTTLE 1000ML",491241,CDM,272,RC,,,OUTPATIENT,,,28,18.2,,24.64,88,,19.71,,,0,"percent of total billed charges","88% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.85,17.304,,3.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.64,63,,14.11,,,0,"percent of total billed charges","63% of total billed charges",4.28,15.3,,3.42,,,0,"percent of total billed charges","15.3% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",19.32,69,,,,,0,"fee schedule","69% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.32,61.85,,13.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",9.02,32.2,,7.22,,,0,"percent of total billed charges","32.2% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.8,17.136,,3.84,,,0,"percent of total billed charges","17.136% of total billed charges",6.12,21.84,,4.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.56,37.7,,8.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.84,78,,17.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",4.28,28,
"SOLUTION STERILE SODIUM CHLORIDE BOTTLE 500ML",491242,CDM,272,RC,,,OUTPATIENT,,,21,13.65,,18.48,88,,14.78,,,0,"percent of total billed charges","88% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.63,17.304,,2.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.23,63,,10.58,,,0,"percent of total billed charges","63% of total billed charges",3.21,15.3,,2.57,,,0,"percent of total billed charges","15.3% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",14.49,69,,,,,0,"fee schedule","69% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.99,61.85,,10.39,,,0,"percent of total billed charges","61.5% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",6.76,32.2,,5.41,,,0,"percent of total billed charges","32.2% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.6,17.136,,2.88,,,0,"percent of total billed charges","17.136% of total billed charges",4.59,21.84,,3.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.92,37.7,,6.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.38,78,,13.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",3.21,21,
"SOLUTION STERILE WATER BOTTLE 1000ML",491243,CDM,272,RC,,,OUTPATIENT,,,23,14.95,,20.24,88,,16.19,,,0,"percent of total billed charges","88% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.98,17.304,,3.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.49,63,,11.59,,,0,"percent of total billed charges","63% of total billed charges",3.52,15.3,,2.82,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",15.87,69,,,,,0,"fee schedule","69% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.23,61.85,,11.38,,,0,"percent of total billed charges","61.5% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",7.41,32.2,,5.93,,,0,"percent of total billed charges","32.2% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.94,17.136,,3.15,,,0,"percent of total billed charges","17.136% of total billed charges",5.02,21.84,,4.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.94,78,,14.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",3.52,23,
"SOLUTION SALINE .9% 50ML",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SOLUTION SALINE .9% 250ML",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SOLUTION SALINE .9% 500ML",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SOLUTION SALINE .9% 1000ML",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SOLUTION LR INJ 500ML",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SOLUTION LR INJ 1000ML",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SOLUTION 5% DEXTROSE INJ 100ML",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SOLUTION 5% DEXTROSE INJ 250ML",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SOLUTION 5% DEXTROSE INJ 500ML",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SOLUTION 5% DEXTROSE INJ 1000ML",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SOLUTION 10 MEQ POTASIUM CHLORIDE 5% DEXT AND 0.45 SODIUM CH",ORSUP0002,CDM,258,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION 10% DEXTROSE INJ 1000ML",ORSUP0002,CDM,258,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION 5% DEXTROSE IN LR INJ 1000ML",ORSUP0002,CDM,258,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION 0.45% SODIUM CHLORIDE INJ 1000ML",ORSUP0002,CDM,258,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION 0.9% SODIUM CHLORIDE IR 1000ML POUR BOTTLE",ORSUP0002,CDM,258,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION STERILE WATER FOR INJ 1000ML",ORSUP0002,CDM,258,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION STERILE WATER FOR IR 1000ML POUR BOTTLE",ORSUP0002,CDM,258,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION 5% DEXTROSE 0.9% SODIUM CHLORIDE INJ 1000ML",ORSUP0002,CDM,258,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION 5% DEXTROSE 0.45% SODIUM CHLORIDE INJ 1000ML",ORSUP0002,CDM,258,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION 5% DEXTROSE 0.225% SODIUM CHLORIDE INJ 1000ML",ORSUP0002,CDM,258,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION 20 MEQ POTASSIUM CHLORIDE IN 5% DEXT 0.45% SODIUM C",ORSUP0002,CDM,258,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION 5% DEXT 0.45% SODIUM CHLORIDE INJ 500ML",ORSUP0002,CDM,258,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION 30 MEQ POTASSIUM CHLORIDE 5% DEXT 0.45% SODIUM CHLO",ORSUP0002,CDM,258,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION 40 MEQ POTASSIUM CHLORIDE 5% DEXT 0.45% SODIUM CHLO",ORSUP0002,CDM,258,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION 5% DEXT 0.225% SODIUM CHLORIDE INJ 500 ML",ORSUP0002,CDM,258,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION 20 MEQ POTASSIUM CHLORIDE IN LR 5% DEXT INJ 1000ML",ORSUP0002,CDM,258,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION 0.9% SODIUM CHLORIDE IR 3000ML",ORSUP0002,CDM,258,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION STERILE WATER IR 1500ML POUR BOTTLE",ORSUP0002,CDM,258,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION 5% DEXT LR INJ 500ML",ORSUP0002,CDM,258,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION 20 MEQ POTASSIUM CHLORIDE 5% DEXT 0.9% SODIUM CHLOR",ORSUP0002,CDM,258,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION SORBITOL-MANNITOL IR 3000ML",ORSUP0002,CDM,258,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SOLUTION 0.9% SODIUM CHLORIDE IR 500ML POUR BOTTLE",ORSUP0002,CDM,258,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION 10 MEQ POTASSIUM CHLORIDE IN WATER INJ 100ML",ORSUP0002,CDM,258,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION 20 MEQ POTASSIUM CHLORIDE 0.9% SODIUM CHLORIDE INJ",ORSUP0002,CDM,258,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION 20 MEQ POTASSIUM CHLORIDE 5% DEXT INJ 1000ML",ORSUP0002,CDM,258,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION 20 MEQ POTASSIUM CHLORIDE IN WATER FOR INJ 100ML",ORSUP0002,CDM,258,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION 40 MEQ POTASSIUM CHLORIDE IN 0.9% SODIUM CHLORIDE I",ORSUP0002,CDM,258,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SOLUTION 20 MEQ POTASSIUM CHLORIDE 5% DEXT 0.22% SODIUM CHLO",ORSUP0002,CDM,258,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION 40 MEQ POTASSIUM CHLORIDE 5% DEXTR 0.9% SODIUM CHLO",ORSUP0002,CDM,258,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION 20 MEQ POTASSIUM CHLORIDE 0.45% SODIUM CHLORIDE INJ",ORSUP0002,CDM,258,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION (7% BSA) BOX/12 BTLS",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION STERILE WATER FOR IR 3000ML",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SOLUTION STERILE WATER FOR IR 500ML POUR BOTTLE",ORSUP0002,CDM,271,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.7% of total billed charges",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.93,33.9,,12.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION 0.9% SODIUM CHLORIDE INJ 100ML",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION 10% DEXTROSE INJ 250ML",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLUTION IRRIGATION SODIUM CHLORIDE BTL 100ML",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SOLYX SKLING",ORSUP0061,CDM,278,RC,,,OUTPATIENT,,,10506,6828.9,,9245.28,88,,7396.22,,,0,"percent of total billed charges","88% of total billed charges",5253,50,,4202.40,,,0,"percent of total billed charges","50% of total billed charges",1765.01,16.8,,1412.01,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1817.96,17.304,,1454.37,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6618.78,63,,5295.02,,,0,"percent of total billed charges","63% of total billed charges",1607.42,15.3,,1285.94,,,0,"percent of total billed charges","15.3% of total billed charges",1765.01,16.8,,1412.01,,,0,"percent of total billed charges","16.8% of total billed charges",7249.14,69,,,,,0,"fee schedule","69% of total billed charges",10506,100,,8404.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10506,100,,8404.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10506,100,,8404.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6497.96,61.85,,5198.37,,,0,"percent of total billed charges","61.5% of total billed charges",1765.01,16.8,,1412.01,,,0,"percent of total billed charges","16.8% of total billed charges",5253,50,,4202.40,,,0,"percent of total billed charges","50% of total billed charges",3382.93,32.2,,2706.34,,,0,"percent of total billed charges","32.2% of total billed charges",3277.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1800.31,17.136,,1440.25,,,0,"percent of total billed charges","17.136% of total billed charges",2294.51,21.84,,1835.61,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3960.76,37.7,,3168.61,,,0,"percent of total billed charges","37.7% of total billed charges",3960.76,37.7,,3168.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3561.53,33.9,,2849.22,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",8194.68,78,,6555.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8677.96,82.6,,6942.37,,,0,"percent of total billed charges","82.6% of total billed charges",1765.01,16.8,,1412.01,,,0,"percent of total billed charges","16.8% of total billed charges",5253,50,,4202.40,,,0,"percent of total billed charges","50% of total billed charges",8677.96,82.6,,6942.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1765.01,16.8,,1412.01,,,0,"percent of total billed charges","16.8% of total billed charges",10506,100,,8404.80,,,0,"percent of total billed charges","100% of total billed charges",1607.42,10506,
SONOCHECK,ORSUP0016,CDM,270,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SONOPLEX II 22G X 50MM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"SONOPLEX II 22G X 80MM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"SONOPLEX II 22G X 100MM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"SONOPLEX II 22G X 150MM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"SOOTHIE PACIFIER",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SORBAVIEW SHIELD FOR PICCS",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SPACER ADV ACF LORDOTIC 5MM",ORSUP0036,CDM,278,RC,,,OUTPATIENT,,,6695,4351.75,,5891.6,88,,4713.28,,,0,"percent of total billed charges","88% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1158.5,17.304,,926.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4217.85,63,,3374.28,,,0,"percent of total billed charges","63% of total billed charges",1024.34,15.3,,819.47,,,0,"percent of total billed charges","15.3% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",4619.55,69,,,,,0,"fee schedule","69% of total billed charges",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4140.86,61.85,,3312.69,,,0,"percent of total billed charges","61.5% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",2155.79,32.2,,1724.63,,,0,"percent of total billed charges","32.2% of total billed charges",2088.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1147.26,17.136,,917.81,,,0,"percent of total billed charges","17.136% of total billed charges",1462.19,21.84,,1169.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2524.02,37.7,,2019.22,,,0,"percent of total billed charges","37.7% of total billed charges",2524.02,37.7,,2019.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2269.61,33.9,,1815.69,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5222.1,78,,4177.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5530.07,82.6,,4424.06,,,0,"percent of total billed charges","82.6% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",5530.07,82.6,,4424.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",1024.34,6695,
"SPACER ADV ACF LORDOTIC 6MM",ORSUP0038,CDM,278,RC,,,OUTPATIENT,,,7231,4700.15,,6363.28,88,,5090.62,,,0,"percent of total billed charges","88% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1251.25,17.304,,1001.00,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4555.53,63,,3644.42,,,0,"percent of total billed charges","63% of total billed charges",1106.34,15.3,,885.07,,,0,"percent of total billed charges","15.3% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4989.39,69,,,,,0,"fee schedule","69% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4472.37,61.85,,3577.90,,,0,"percent of total billed charges","61.5% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",2328.38,32.2,,1862.70,,,0,"percent of total billed charges","32.2% of total billed charges",2256.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1239.1,17.136,,991.28,,,0,"percent of total billed charges","17.136% of total billed charges",1579.25,21.84,,1263.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.7% of total billed charges",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2451.31,33.9,,1961.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5640.18,78,,4512.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",1106.34,7231,
"SPACER ADV ACF LORDOTIC 7MM",ORSUP0037,CDM,278,RC,,,OUTPATIENT,,,6963,4525.95,,6127.44,88,,4901.95,,,0,"percent of total billed charges","88% of total billed charges",3481.5,50,,2785.20,,,0,"percent of total billed charges","50% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1204.88,17.304,,963.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4386.69,63,,3509.35,,,0,"percent of total billed charges","63% of total billed charges",1065.34,15.3,,852.27,,,0,"percent of total billed charges","15.3% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",4804.47,69,,,,,0,"fee schedule","69% of total billed charges",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4306.62,61.85,,3445.30,,,0,"percent of total billed charges","61.5% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",3481.5,50,,2785.20,,,0,"percent of total billed charges","50% of total billed charges",2242.09,32.2,,1793.67,,,0,"percent of total billed charges","32.2% of total billed charges",2172.46,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1193.18,17.136,,954.54,,,0,"percent of total billed charges","17.136% of total billed charges",1520.72,21.84,,1216.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2625.05,37.7,,2100.04,,,0,"percent of total billed charges","37.7% of total billed charges",2625.05,37.7,,2100.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2360.46,33.9,,1888.37,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5431.14,78,,4344.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5751.44,82.6,,4601.15,,,0,"percent of total billed charges","82.6% of total billed charges",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",3481.5,50,,2785.20,,,0,"percent of total billed charges","50% of total billed charges",5751.44,82.6,,4601.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1169.78,16.8,,935.82,,,0,"percent of total billed charges","16.8% of total billed charges",6963,100,,5570.40,,,0,"percent of total billed charges","100% of total billed charges",1065.34,6963,
"SPACER ADV ACF LORDOTIC 8MM",ORSUP0038,CDM,278,RC,,,OUTPATIENT,,,7231,4700.15,,6363.28,88,,5090.62,,,0,"percent of total billed charges","88% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1251.25,17.304,,1001.00,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4555.53,63,,3644.42,,,0,"percent of total billed charges","63% of total billed charges",1106.34,15.3,,885.07,,,0,"percent of total billed charges","15.3% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4989.39,69,,,,,0,"fee schedule","69% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4472.37,61.85,,3577.90,,,0,"percent of total billed charges","61.5% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",2328.38,32.2,,1862.70,,,0,"percent of total billed charges","32.2% of total billed charges",2256.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1239.1,17.136,,991.28,,,0,"percent of total billed charges","17.136% of total billed charges",1579.25,21.84,,1263.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.7% of total billed charges",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2451.31,33.9,,1961.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5640.18,78,,4512.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",1106.34,7231,
"SPACER 9MM LORDOTIC",ORSUP0038,CDM,278,RC,,,OUTPATIENT,,,7231,4700.15,,6363.28,88,,5090.62,,,0,"percent of total billed charges","88% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1251.25,17.304,,1001.00,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4555.53,63,,3644.42,,,0,"percent of total billed charges","63% of total billed charges",1106.34,15.3,,885.07,,,0,"percent of total billed charges","15.3% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4989.39,69,,,,,0,"fee schedule","69% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4472.37,61.85,,3577.90,,,0,"percent of total billed charges","61.5% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",2328.38,32.2,,1862.70,,,0,"percent of total billed charges","32.2% of total billed charges",2256.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1239.1,17.136,,991.28,,,0,"percent of total billed charges","17.136% of total billed charges",1579.25,21.84,,1263.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.7% of total billed charges",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2451.31,33.9,,1961.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5640.18,78,,4512.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",1106.34,7231,
"SPACER TPAL 12MM",ORSUP0114,CDM,278,RC,,,OUTPATIENT,,,28119,18277.35,,24744.72,88,,19795.78,,,0,"percent of total billed charges","88% of total billed charges",14059.5,50,,11247.60,,,0,"percent of total billed charges","50% of total billed charges",4723.99,16.8,,3779.19,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4865.71,17.304,,3892.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17714.97,63,,14171.98,,,0,"percent of total billed charges","63% of total billed charges",4302.21,15.3,,3441.77,,,0,"percent of total billed charges","15.3% of total billed charges",4723.99,16.8,,3779.19,,,0,"percent of total billed charges","16.8% of total billed charges",19402.11,69,,,,,0,"fee schedule","69% of total billed charges",28119,100,,22495.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28119,100,,22495.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28119,100,,22495.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17391.6,61.85,,13913.28,,,0,"percent of total billed charges","61.5% of total billed charges",4723.99,16.8,,3779.19,,,0,"percent of total billed charges","16.8% of total billed charges",14059.5,50,,11247.60,,,0,"percent of total billed charges","50% of total billed charges",9054.32,32.2,,7243.46,,,0,"percent of total billed charges","32.2% of total billed charges",8773.13,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",4818.47,17.136,,3854.78,,,0,"percent of total billed charges","17.136% of total billed charges",6141.19,21.84,,4912.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",10600.86,37.7,,8480.69,,,0,"percent of total billed charges","37.7% of total billed charges",10600.86,37.7,,8480.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",9532.34,33.9,,7625.87,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",21932.82,78,,17546.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23226.29,82.6,,18581.03,,,0,"percent of total billed charges","82.6% of total billed charges",4723.99,16.8,,3779.19,,,0,"percent of total billed charges","16.8% of total billed charges",14059.5,50,,11247.60,,,0,"percent of total billed charges","50% of total billed charges",23226.29,82.6,,18581.03,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4723.99,16.8,,3779.19,,,0,"percent of total billed charges","16.8% of total billed charges",28119,100,,22495.20,,,0,"percent of total billed charges","100% of total billed charges",4302.21,28119,
"SPACER VERTEBRAL 9MM 889.845",ORSUP0052,CDM,278,RC,,,OUTPATIENT,,,10980,7137,,9662.4,88,,7729.92,,,0,"percent of total billed charges","88% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1899.98,17.304,,1519.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6917.4,63,,5533.92,,,0,"percent of total billed charges","63% of total billed charges",1679.94,15.3,,1343.95,,,0,"percent of total billed charges","15.3% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",7576.2,69,,,,,0,"fee schedule","69% of total billed charges",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6791.13,61.85,,5432.90,,,0,"percent of total billed charges","61.5% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",3535.56,32.2,,2828.45,,,0,"percent of total billed charges","32.2% of total billed charges",3425.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1881.53,17.136,,1505.22,,,0,"percent of total billed charges","17.136% of total billed charges",2398.03,21.84,,1918.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4139.46,37.7,,3311.57,,,0,"percent of total billed charges","37.7% of total billed charges",4139.46,37.7,,3311.57,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3722.22,33.9,,2977.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",8564.4,78,,6851.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9069.48,82.6,,7255.58,,,0,"percent of total billed charges","82.6% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",9069.48,82.6,,7255.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",1679.94,10980,
"SPACER VRTBRL 13MM PR",ORSUP0052,CDM,278,RC,,,OUTPATIENT,,,10980,7137,,9662.4,88,,7729.92,,,0,"percent of total billed charges","88% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1899.98,17.304,,1519.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6917.4,63,,5533.92,,,0,"percent of total billed charges","63% of total billed charges",1679.94,15.3,,1343.95,,,0,"percent of total billed charges","15.3% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",7576.2,69,,,,,0,"fee schedule","69% of total billed charges",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6791.13,61.85,,5432.90,,,0,"percent of total billed charges","61.5% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",3535.56,32.2,,2828.45,,,0,"percent of total billed charges","32.2% of total billed charges",3425.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1881.53,17.136,,1505.22,,,0,"percent of total billed charges","17.136% of total billed charges",2398.03,21.84,,1918.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4139.46,37.7,,3311.57,,,0,"percent of total billed charges","37.7% of total billed charges",4139.46,37.7,,3311.57,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3722.22,33.9,,2977.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",8564.4,78,,6851.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9069.48,82.6,,7255.58,,,0,"percent of total billed charges","82.6% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",9069.48,82.6,,7255.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",1679.94,10980,
"SPACR VERT H15MM PR",ORSUP0052,CDM,278,RC,,,OUTPATIENT,,,10980,7137,,9662.4,88,,7729.92,,,0,"percent of total billed charges","88% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1899.98,17.304,,1519.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6917.4,63,,5533.92,,,0,"percent of total billed charges","63% of total billed charges",1679.94,15.3,,1343.95,,,0,"percent of total billed charges","15.3% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",7576.2,69,,,,,0,"fee schedule","69% of total billed charges",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6791.13,61.85,,5432.90,,,0,"percent of total billed charges","61.5% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",3535.56,32.2,,2828.45,,,0,"percent of total billed charges","32.2% of total billed charges",3425.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1881.53,17.136,,1505.22,,,0,"percent of total billed charges","17.136% of total billed charges",2398.03,21.84,,1918.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4139.46,37.7,,3311.57,,,0,"percent of total billed charges","37.7% of total billed charges",4139.46,37.7,,3311.57,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3722.22,33.9,,2977.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",8564.4,78,,6851.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9069.48,82.6,,7255.58,,,0,"percent of total billed charges","82.6% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",9069.48,82.6,,7255.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",1679.94,10980,
"SPEAR  SURGICAL",129486,CDM,270,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"SPECIMEN MEDELA",ORSUP0011,CDM,270,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SPECIMEN CUP URINE 4 OZ STRL",491245,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"SPECIMEN SOCK",491247,CDM,270,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"SPECIMEN QUICK TRAP-NEPTUNE",491246,CDM,270,RC,,,OUTPATIENT,,,972,631.8,,855.36,88,,684.29,,,0,"percent of total billed charges","88% of total billed charges",486,50,,388.80,,,0,"percent of total billed charges","50% of total billed charges",163.3,16.8,,130.64,,,0,"percent of total billed charges","16.8% of total billed charges",972,100,,777.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.19,17.304,,134.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",612.36,63,,489.89,,,0,"percent of total billed charges","63% of total billed charges",148.72,15.3,,118.98,,,0,"percent of total billed charges","15.3% of total billed charges",163.3,16.8,,130.64,,,0,"percent of total billed charges","16.8% of total billed charges",670.68,69,,,,,0,"fee schedule","69% of total billed charges",972,100,,777.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",972,100,,777.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",972,100,,777.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",601.18,61.85,,480.94,,,0,"percent of total billed charges","61.5% of total billed charges",163.3,16.8,,130.64,,,0,"percent of total billed charges","16.8% of total billed charges",486,50,,388.80,,,0,"percent of total billed charges","50% of total billed charges",312.98,32.2,,250.38,,,0,"percent of total billed charges","32.2% of total billed charges",163.3,16.8,,130.64,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.56,17.136,,133.25,,,0,"percent of total billed charges","17.136% of total billed charges",212.28,21.84,,169.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",366.44,37.7,,293.15,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",758.16,78,,606.53,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",802.87,82.6,,642.30,,,0,"percent of total billed charges","82.6% of total billed charges",163.3,16.8,,130.64,,,0,"percent of total billed charges","16.8% of total billed charges",486,50,,388.80,,,0,"percent of total billed charges","50% of total billed charges",802.87,82.6,,642.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",163.3,16.8,,130.64,,,0,"percent of total billed charges","16.8% of total billed charges",972,100,,777.60,,,0,"percent of total billed charges","100% of total billed charges",148.72,972,
"SPECIMAN COLLECTOR ANER",491244,CDM,270,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"SPECIALTY IA 1 6X5ML",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SPECIALTY IA 2 6X5ML",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SPECI-CATH URINE COLEECTION KIT",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SPECI-CATH NEONATAL KIT 5FR 9 IN",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SPECIMEN CONTAINER STERILE 4OZ",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SPECIALIST PLASTER BANDAGE EXTRA FAST SET 5 X 5YD",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SPECIALIST PLASTER BANDAGE EXTRA FAST SET 4 X 5",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SPECIALIST PLASTER BANDAGES EXTRA FAST SET 3 X 3",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SPEEDBRIDGE IMPL SYS W/BIOCOMPOSITE SWIVELOCK",ORSUP0048,CDM,278,RC,,,OUTPATIENT,,,9641,6266.65,,8484.08,88,,6787.26,,,0,"percent of total billed charges","88% of total billed charges",4820.5,50,,3856.40,,,0,"percent of total billed charges","50% of total billed charges",1619.69,16.8,,1295.75,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1668.28,17.304,,1334.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6073.83,63,,4859.06,,,0,"percent of total billed charges","63% of total billed charges",1475.07,15.3,,1180.06,,,0,"percent of total billed charges","15.3% of total billed charges",1619.69,16.8,,1295.75,,,0,"percent of total billed charges","16.8% of total billed charges",6652.29,69,,,,,0,"fee schedule","69% of total billed charges",9641,100,,7712.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9641,100,,7712.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9641,100,,7712.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5962.96,61.85,,4770.37,,,0,"percent of total billed charges","61.5% of total billed charges",1619.69,16.8,,1295.75,,,0,"percent of total billed charges","16.8% of total billed charges",4820.5,50,,3856.40,,,0,"percent of total billed charges","50% of total billed charges",3104.4,32.2,,2483.52,,,0,"percent of total billed charges","32.2% of total billed charges",3007.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1652.08,17.136,,1321.66,,,0,"percent of total billed charges","17.136% of total billed charges",2105.59,21.84,,1684.47,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3634.66,37.7,,2907.73,,,0,"percent of total billed charges","37.7% of total billed charges",3634.66,37.7,,2907.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3268.3,33.9,,2614.64,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7519.98,78,,6015.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7963.47,82.6,,6370.78,,,0,"percent of total billed charges","82.6% of total billed charges",1619.69,16.8,,1295.75,,,0,"percent of total billed charges","16.8% of total billed charges",4820.5,50,,3856.40,,,0,"percent of total billed charges","50% of total billed charges",7963.47,82.6,,6370.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1619.69,16.8,,1295.75,,,0,"percent of total billed charges","16.8% of total billed charges",9641,100,,7712.80,,,0,"percent of total billed charges","100% of total billed charges",1475.07,9641,
"SPEE-D-RING MAMMO SEMI OPAQUE 1/2 ID NO BURNOUT",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SPEEDBRIDGE WITH BIOCOMPOSITE",ORSUP0045,CDM,272,RC,,,OUTPATIENT,,,9105,5918.25,,8012.4,88,,6409.92,,,0,"percent of total billed charges","88% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1575.53,17.304,,1260.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5736.15,63,,4588.92,,,0,"percent of total billed charges","63% of total billed charges",1393.07,15.3,,1114.46,,,0,"percent of total billed charges","15.3% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",6282.45,69,,,,,0,"fee schedule","69% of total billed charges",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5631.44,61.85,,4505.15,,,0,"percent of total billed charges","61.5% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",2931.81,32.2,,2345.45,,,0,"percent of total billed charges","32.2% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1560.23,17.136,,1248.18,,,0,"percent of total billed charges","17.136% of total billed charges",1988.53,21.84,,1590.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3432.59,37.7,,2746.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7101.9,78,,5681.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7520.73,82.6,,6016.58,,,0,"percent of total billed charges","82.6% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",7520.73,82.6,,6016.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",1393.07,9105,
"SPEEDBRIDGE W/ COMPOSITE SWIVELOCK",ORSUP0052,CDM,272,RC,,,OUTPATIENT,,,10980,7137,,9662.4,88,,7729.92,,,0,"percent of total billed charges","88% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1899.98,17.304,,1519.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6917.4,63,,5533.92,,,0,"percent of total billed charges","63% of total billed charges",1679.94,15.3,,1343.95,,,0,"percent of total billed charges","15.3% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",7576.2,69,,,,,0,"fee schedule","69% of total billed charges",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6791.13,61.85,,5432.90,,,0,"percent of total billed charges","61.5% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",3535.56,32.2,,2828.45,,,0,"percent of total billed charges","32.2% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1881.53,17.136,,1505.22,,,0,"percent of total billed charges","17.136% of total billed charges",2398.03,21.84,,1918.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4139.46,37.7,,3311.57,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8564.4,78,,6851.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9069.48,82.6,,7255.58,,,0,"percent of total billed charges","82.6% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",9069.48,82.6,,7255.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",1679.94,10980,
"SPEEDBRIDGE IMPLANT SYSTEM",ORSUP0049,CDM,278,RC,,,OUTPATIENT,,,7828,5088.2,,6888.64,88,,5510.91,,,0,"percent of total billed charges","88% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1354.56,17.304,,1083.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4931.64,63,,3945.31,,,0,"percent of total billed charges","63% of total billed charges",1197.68,15.3,,958.14,,,0,"percent of total billed charges","15.3% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",5401.32,69,,,,,0,"fee schedule","69% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4841.62,61.85,,3873.30,,,0,"percent of total billed charges","61.5% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",2520.62,32.2,,2016.50,,,0,"percent of total billed charges","32.2% of total billed charges",2442.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1341.41,17.136,,1073.13,,,0,"percent of total billed charges","17.136% of total billed charges",1709.64,21.84,,1367.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.7% of total billed charges",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2653.69,33.9,,2122.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6105.84,78,,4884.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",1197.68,7828,
"SPG SUPER FLUFF 6X6.75 LATEX FREE",47750,CDM,270,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"SPHERES REFLECTIVE DISP.",ORSUP0031,CDM,270,RC,,,OUTPATIENT,,,5356,3481.4,,4713.28,88,,3770.62,,,0,"percent of total billed charges","88% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",926.8,17.304,,741.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3374.28,63,,2699.42,,,0,"percent of total billed charges","63% of total billed charges",819.47,15.3,,655.58,,,0,"percent of total billed charges","15.3% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",3695.64,69,,,,,0,"fee schedule","69% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3312.69,61.85,,2650.15,,,0,"percent of total billed charges","61.5% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",1724.63,32.2,,1379.70,,,0,"percent of total billed charges","32.2% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",917.8,17.136,,734.24,,,0,"percent of total billed charges","17.136% of total billed charges",1169.75,21.84,,935.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4177.68,78,,3342.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",819.47,5356,
"SPHINCTEROTOME HYDRATOME  4.4 X 260",ORSUP0019,CDM,278,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",668.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.7% of total billed charges",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",726.14,33.9,,580.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"SPHINCTEROTOME ESCPC L30CM L260CM OD0.25IN JAGTOME/JGWR CAN",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"SPHINCTEROTOME ESCPC L30MM L5MM OD3.9FR",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"SPIDER EMB 30X320 FX DEVICE",ORSUP0038,CDM,278,RC,,,OUTPATIENT,,,7231,4700.15,,6363.28,88,,5090.62,,,0,"percent of total billed charges","88% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1251.25,17.304,,1001.00,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4555.53,63,,3644.42,,,0,"percent of total billed charges","63% of total billed charges",1106.34,15.3,,885.07,,,0,"percent of total billed charges","15.3% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4989.39,69,,,,,0,"fee schedule","69% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4472.37,61.85,,3577.90,,,0,"percent of total billed charges","61.5% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",2328.38,32.2,,1862.70,,,0,"percent of total billed charges","32.2% of total billed charges",2256.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1239.1,17.136,,991.28,,,0,"percent of total billed charges","17.136% of total billed charges",1579.25,21.84,,1263.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.7% of total billed charges",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2451.31,33.9,,1961.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5640.18,78,,4512.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",1106.34,7231,
"SPIDER FX 6MM US DEVICE",ORSUP0031,CDM,278,RC,,,OUTPATIENT,,,5356,3481.4,,4713.28,88,,3770.62,,,0,"percent of total billed charges","88% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",926.8,17.304,,741.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3374.28,63,,2699.42,,,0,"percent of total billed charges","63% of total billed charges",819.47,15.3,,655.58,,,0,"percent of total billed charges","15.3% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",3695.64,69,,,,,0,"fee schedule","69% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3312.69,61.85,,2650.15,,,0,"percent of total billed charges","61.5% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",1724.63,32.2,,1379.70,,,0,"percent of total billed charges","32.2% of total billed charges",1671.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",917.8,17.136,,734.24,,,0,"percent of total billed charges","17.136% of total billed charges",1169.75,21.84,,935.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.7% of total billed charges",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1815.68,33.9,,1452.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4177.68,78,,3342.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",819.47,5356,
"SPIDER PROTECTION DEVICE",ORSUP0038,CDM,278,RC,,,OUTPATIENT,,,7231,4700.15,,6363.28,88,,5090.62,,,0,"percent of total billed charges","88% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1251.25,17.304,,1001.00,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4555.53,63,,3644.42,,,0,"percent of total billed charges","63% of total billed charges",1106.34,15.3,,885.07,,,0,"percent of total billed charges","15.3% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4989.39,69,,,,,0,"fee schedule","69% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4472.37,61.85,,3577.90,,,0,"percent of total billed charges","61.5% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",2328.38,32.2,,1862.70,,,0,"percent of total billed charges","32.2% of total billed charges",2256.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1239.1,17.136,,991.28,,,0,"percent of total billed charges","17.136% of total billed charges",1579.25,21.84,,1263.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.7% of total billed charges",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2451.31,33.9,,1961.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5640.18,78,,4512.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",1106.34,7231,
"SPINAL TI L200MM OD6.0MM THRCLMBR HRD",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"SPINAL FLUID CONTROL LVL 1",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"SPINAL FLUID CONTROL LVL 2",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"SPINNING SPIROS CONNECTOR CLOSED MALE LUER RED CAP",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SPIRAL PDO 14X14CM DBLE ARMED USP 3-0 FS",419628,CDM,272,RC,,,OUTPATIENT,,,175,113.75,,154,88,,123.20,,,0,"percent of total billed charges","88% of total billed charges",87.5,50,,70.00,,,0,"percent of total billed charges","50% of total billed charges",29.4,16.8,,23.52,,,0,"percent of total billed charges","16.8% of total billed charges",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.28,17.304,,24.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.25,63,,88.20,,,0,"percent of total billed charges","63% of total billed charges",26.78,15.3,,21.42,,,0,"percent of total billed charges","15.3% of total billed charges",29.4,16.8,,23.52,,,0,"percent of total billed charges","16.8% of total billed charges",120.75,69,,,,,0,"fee schedule","69% of total billed charges",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",108.24,61.85,,86.59,,,0,"percent of total billed charges","61.5% of total billed charges",29.4,16.8,,23.52,,,0,"percent of total billed charges","16.8% of total billed charges",87.5,50,,70.00,,,0,"percent of total billed charges","50% of total billed charges",56.35,32.2,,45.08,,,0,"percent of total billed charges","32.2% of total billed charges",29.4,16.8,,23.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.99,17.136,,23.99,,,0,"percent of total billed charges","17.136% of total billed charges",38.22,21.84,,30.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",65.98,37.7,,52.78,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",136.5,78,,109.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",144.55,82.6,,115.64,,,0,"percent of total billed charges","82.6% of total billed charges",29.4,16.8,,23.52,,,0,"percent of total billed charges","16.8% of total billed charges",87.5,50,,70.00,,,0,"percent of total billed charges","50% of total billed charges",144.55,82.6,,115.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.4,16.8,,23.52,,,0,"percent of total billed charges","16.8% of total billed charges",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",26.78,175,
"SPIRAL PGA-PCL 30X30CM DBLE ARMED USP 3-0 FS-1",419619,CDM,272,RC,,,OUTPATIENT,,,215,139.75,,189.2,88,,151.36,,,0,"percent of total billed charges","88% of total billed charges",107.5,50,,86.00,,,0,"percent of total billed charges","50% of total billed charges",36.12,16.8,,28.90,,,0,"percent of total billed charges","16.8% of total billed charges",215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.2,17.304,,29.76,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",135.45,63,,108.36,,,0,"percent of total billed charges","63% of total billed charges",32.9,15.3,,26.32,,,0,"percent of total billed charges","15.3% of total billed charges",36.12,16.8,,28.90,,,0,"percent of total billed charges","16.8% of total billed charges",148.35,69,,,,,0,"fee schedule","69% of total billed charges",215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",132.98,61.85,,106.38,,,0,"percent of total billed charges","61.5% of total billed charges",36.12,16.8,,28.90,,,0,"percent of total billed charges","16.8% of total billed charges",107.5,50,,86.00,,,0,"percent of total billed charges","50% of total billed charges",69.23,32.2,,55.38,,,0,"percent of total billed charges","32.2% of total billed charges",36.12,16.8,,28.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.84,17.136,,29.47,,,0,"percent of total billed charges","17.136% of total billed charges",46.96,21.84,,37.57,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",81.06,37.7,,64.85,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",167.7,78,,134.16,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",177.59,82.6,,142.07,,,0,"percent of total billed charges","82.6% of total billed charges",36.12,16.8,,28.90,,,0,"percent of total billed charges","16.8% of total billed charges",107.5,50,,86.00,,,0,"percent of total billed charges","50% of total billed charges",177.59,82.6,,142.07,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.12,16.8,,28.90,,,0,"percent of total billed charges","16.8% of total billed charges",215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",32.9,215,
"SPLASH SHIELD",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SPLASHCAP IRRIGATION SHIELD",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SPLINT FIBERGLASS PADDED 5IN X 20' ROLL CASE",ORSUP0009,CDM,270,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"SPLINT SPECIALIST PLSTR 5IN X 30IN FAST",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SPLINT SPECIALIST PLSTR 4IN X 15IN  FAST",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SPLINT SPECIALIST PLSTR 3IN X 15IN  FAST",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SPLINT FIBERGLASS PADDED 5IN X 15' ROLL CASE",ORSUP0009,CDM,270,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"SPLINT ORTHO GLASS FIBER PRE CUT 4X30",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SPLINT ORTHO GLASS ROLL 2 X15",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SPLINT PRE CUT ORTHO GLASS 4 INCH X 15 INCH",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SPLINT FINGER COT ALUM PADDED 1 1/5 L",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SPLINT DOYLE NASAL         15 24055",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SPLINT OCL 4IN",ORSUP0011,CDM,270,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SPLINT OCL 6IN",ORSUP0013,CDM,270,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SPLINT INTRANASAL POSISEP X",ORSUP0014,CDM,270,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"SPLINT SPECIALIST PLSTR 5IN X 45IN  FAST",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SPLINT 3X35 SCOTCHCAST COMFORT",1374,CDM,270,RC,,,OUTPATIENT,,,30,19.5,,26.4,88,,21.12,,,0,"percent of total billed charges","88% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.19,17.304,,4.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.9,63,,15.12,,,0,"percent of total billed charges","63% of total billed charges",4.59,15.3,,3.67,,,0,"percent of total billed charges","15.3% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",20.7,69,,,,,0,"fee schedule","69% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.56,61.85,,14.85,,,0,"percent of total billed charges","61.5% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",9.66,32.2,,7.73,,,0,"percent of total billed charges","32.2% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.14,17.136,,4.11,,,0,"percent of total billed charges","17.136% of total billed charges",6.55,21.84,,5.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.31,37.7,,9.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.4,78,,18.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",4.59,30,
"SPLINT CONFORMABLE ROLL 5X15FT",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"SPLINT CONFORMABLE 2X10",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SPLINT CONFORMABLE 3X12",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SPLINT CONFORMABLE 3X35",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SPLINT CONFORMABLE 4X30",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SPO2 OXIMETER DISP (SLEEP STUDY)",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"SPONGE TONSIL GAUZE FILLED W/STRING LARGE STERILE",165769,CDM,272,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"SPONGE GAUZE 8X4 X-RAY 10'S",111079,CDM,270,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"SPONGE LAP XRAY 18X18 STERILE",429533,CDM,272,RC,,,OUTPATIENT,,,60,39,,52.8,88,,42.24,,,0,"percent of total billed charges","88% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.38,17.304,,8.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.8,63,,30.24,,,0,"percent of total billed charges","63% of total billed charges",9.18,15.3,,7.34,,,0,"percent of total billed charges","15.3% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",41.4,69,,,,,0,"fee schedule","69% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.11,61.85,,29.69,,,0,"percent of total billed charges","61.5% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",19.32,32.2,,15.46,,,0,"percent of total billed charges","32.2% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.28,17.136,,8.22,,,0,"percent of total billed charges","17.136% of total billed charges",13.1,21.84,,10.48,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,37.7,,18.10,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.8,78,,37.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.56,82.6,,39.65,,,0,"percent of total billed charges","82.6% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",49.56,82.6,,39.65,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",9.18,60,
"ROSEBUDS 1/2IN",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SPONGE 4 X 4 10PLY STERILE",79591,CDM,272,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"SPONGE NEURO PATTIES 1/2X1",75843,CDM,270,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"SPONGE PATTIE 13",91869,CDM,270,RC,,,OUTPATIENT,,,40,26,,35.2,88,,28.16,,,0,"percent of total billed charges","88% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.92,17.304,,5.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.2,63,,20.16,,,0,"percent of total billed charges","63% of total billed charges",6.12,15.3,,4.90,,,0,"percent of total billed charges","15.3% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",27.6,69,,,,,0,"fee schedule","69% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.74,61.85,,19.79,,,0,"percent of total billed charges","61.5% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",12.88,32.2,,10.30,,,0,"percent of total billed charges","32.2% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.85,17.136,,5.48,,,0,"percent of total billed charges","17.136% of total billed charges",8.74,21.84,,6.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.08,37.7,,12.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",31.2,78,,24.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",6.12,40,
"SPONGE PATTIE 11",91868,CDM,270,RC,,,OUTPATIENT,,,65,42.25,,57.2,88,,45.76,,,0,"percent of total billed charges","88% of total billed charges",32.5,50,,26.00,,,0,"percent of total billed charges","50% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.25,17.304,,9.00,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.95,63,,32.76,,,0,"percent of total billed charges","63% of total billed charges",9.95,15.3,,7.96,,,0,"percent of total billed charges","15.3% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",44.85,69,,,,,0,"fee schedule","69% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.2,61.85,,32.16,,,0,"percent of total billed charges","61.5% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",32.5,50,,26.00,,,0,"percent of total billed charges","50% of total billed charges",20.93,32.2,,16.74,,,0,"percent of total billed charges","32.2% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.14,17.136,,8.91,,,0,"percent of total billed charges","17.136% of total billed charges",14.2,21.84,,11.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.51,37.7,,19.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.7,78,,40.56,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",32.5,50,,26.00,,,0,"percent of total billed charges","50% of total billed charges",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",9.95,65,
"SPONGE COVER 4 X 4 N/S         1792",35369,CDM,270,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"SPONGE COVER 4 X 4 STER",36531,CDM,272,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"SPONGE GAUZE 2 X 2 STERILE 21420",96097,CDM,272,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.95,61.85,,3.96,,,0,"percent of total billed charges","61.5% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"SPONGE GZ DRN LF ST 6 PLY 4X4IN",133730,CDM,270,RC,,,OUTPATIENT,,,21,13.65,,18.48,88,,14.78,,,0,"percent of total billed charges","88% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.63,17.304,,2.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.23,63,,10.58,,,0,"percent of total billed charges","63% of total billed charges",3.21,15.3,,2.57,,,0,"percent of total billed charges","15.3% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",14.49,69,,,,,0,"fee schedule","69% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.99,61.85,,10.39,,,0,"percent of total billed charges","61.5% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",6.76,32.2,,5.41,,,0,"percent of total billed charges","32.2% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.6,17.136,,2.88,,,0,"percent of total billed charges","17.136% of total billed charges",4.59,21.84,,3.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.92,37.7,,6.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.38,78,,13.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",3.21,21,
"SPONGE X-RAY DETECT 8X4IN 16PLY 10 S TRAY DBL FILAMENT",328975,CDM,270,RC,,,OUTPATIENT,,,33,21.45,,29.04,88,,23.23,,,0,"percent of total billed charges","88% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,17.304,,4.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.79,63,,16.63,,,0,"percent of total billed charges","63% of total billed charges",5.05,15.3,,4.04,,,0,"percent of total billed charges","15.3% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",22.77,69,,,,,0,"fee schedule","69% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.41,61.85,,16.33,,,0,"percent of total billed charges","61.5% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",10.63,32.2,,8.50,,,0,"percent of total billed charges","32.2% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.65,17.136,,4.52,,,0,"percent of total billed charges","17.136% of total billed charges",7.21,21.84,,5.77,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.44,37.7,,9.95,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25.74,78,,20.59,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",5.05,33,
"SPONGE SURGIFOAM 100 ABS GELATIN 80MM X 125MM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"SPONGE TRACH #8 BIVONA",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SPONGE TONSIL LG/XLG 1 1/4''",491262,CDM,270,RC,,,OUTPATIENT,,,172,111.8,,151.36,88,,121.09,,,0,"percent of total billed charges","88% of total billed charges",86,50,,68.80,,,0,"percent of total billed charges","50% of total billed charges",28.9,16.8,,23.12,,,0,"percent of total billed charges","16.8% of total billed charges",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.76,17.304,,23.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",108.36,63,,86.69,,,0,"percent of total billed charges","63% of total billed charges",26.32,15.3,,21.06,,,0,"percent of total billed charges","15.3% of total billed charges",28.9,16.8,,23.12,,,0,"percent of total billed charges","16.8% of total billed charges",118.68,69,,,,,0,"fee schedule","69% of total billed charges",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.38,61.85,,85.10,,,0,"percent of total billed charges","61.5% of total billed charges",28.9,16.8,,23.12,,,0,"percent of total billed charges","16.8% of total billed charges",86,50,,68.80,,,0,"percent of total billed charges","50% of total billed charges",55.38,32.2,,44.30,,,0,"percent of total billed charges","32.2% of total billed charges",28.9,16.8,,23.12,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.47,17.136,,23.58,,,0,"percent of total billed charges","17.136% of total billed charges",37.56,21.84,,30.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",64.84,37.7,,51.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",134.16,78,,107.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.07,82.6,,113.66,,,0,"percent of total billed charges","82.6% of total billed charges",28.9,16.8,,23.12,,,0,"percent of total billed charges","16.8% of total billed charges",86,50,,68.80,,,0,"percent of total billed charges","50% of total billed charges",142.07,82.6,,113.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.9,16.8,,23.12,,,0,"percent of total billed charges","16.8% of total billed charges",172,100,,137.60,,,0,"percent of total billed charges","100% of total billed charges",26.32,172,
"SPONGE TONSIL SM/MED 7/8''",491263,CDM,270,RC,,,OUTPATIENT,,,33,21.45,,29.04,88,,23.23,,,0,"percent of total billed charges","88% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,17.304,,4.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.79,63,,16.63,,,0,"percent of total billed charges","63% of total billed charges",5.05,15.3,,4.04,,,0,"percent of total billed charges","15.3% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",22.77,69,,,,,0,"fee schedule","69% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.41,61.85,,16.33,,,0,"percent of total billed charges","61.5% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",10.63,32.2,,8.50,,,0,"percent of total billed charges","32.2% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.65,17.136,,4.52,,,0,"percent of total billed charges","17.136% of total billed charges",7.21,21.84,,5.77,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.44,37.7,,9.95,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25.74,78,,20.59,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",5.05,33,
"SPONGE COUNTER BAG",491254,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"SPONGE 4X4 10PK STR RFD XRAY",491251,CDM,270,RC,,,OUTPATIENT,,,44,28.6,,38.72,88,,30.98,,,0,"percent of total billed charges","88% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.61,17.304,,6.09,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.72,63,,22.18,,,0,"percent of total billed charges","63% of total billed charges",6.73,15.3,,5.38,,,0,"percent of total billed charges","15.3% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",30.36,69,,,,,0,"fee schedule","69% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.21,61.85,,21.77,,,0,"percent of total billed charges","61.5% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",14.17,32.2,,11.34,,,0,"percent of total billed charges","32.2% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.54,17.136,,6.03,,,0,"percent of total billed charges","17.136% of total billed charges",9.61,21.84,,7.69,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.59,37.7,,13.27,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.32,78,,27.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",6.73,44,
"SPONGE ROSEBUD DISSECTOR 5-PK",491261,CDM,270,RC,,,OUTPATIENT,,,785,510.25,,690.8,88,,552.64,,,0,"percent of total billed charges","88% of total billed charges",392.5,50,,314.00,,,0,"percent of total billed charges","50% of total billed charges",131.88,16.8,,105.50,,,0,"percent of total billed charges","16.8% of total billed charges",785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",135.84,17.304,,108.67,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.55,63,,395.64,,,0,"percent of total billed charges","63% of total billed charges",120.11,15.3,,96.09,,,0,"percent of total billed charges","15.3% of total billed charges",131.88,16.8,,105.50,,,0,"percent of total billed charges","16.8% of total billed charges",541.65,69,,,,,0,"fee schedule","69% of total billed charges",785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",485.52,61.85,,388.42,,,0,"percent of total billed charges","61.5% of total billed charges",131.88,16.8,,105.50,,,0,"percent of total billed charges","16.8% of total billed charges",392.5,50,,314.00,,,0,"percent of total billed charges","50% of total billed charges",252.77,32.2,,202.22,,,0,"percent of total billed charges","32.2% of total billed charges",131.88,16.8,,105.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.52,17.136,,107.62,,,0,"percent of total billed charges","17.136% of total billed charges",171.44,21.84,,137.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",295.95,37.7,,236.76,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",612.3,78,,489.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.41,82.6,,518.73,,,0,"percent of total billed charges","82.6% of total billed charges",131.88,16.8,,105.50,,,0,"percent of total billed charges","16.8% of total billed charges",392.5,50,,314.00,,,0,"percent of total billed charges","50% of total billed charges",648.41,82.6,,518.73,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",131.88,16.8,,105.50,,,0,"percent of total billed charges","16.8% of total billed charges",785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",120.11,785,
"SPONGE ENT MICRO EYE",491255,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"SPONGE LAP 18 X 18 XRAY RFD",491259,CDM,270,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"SPONGE LAP 18 X 4",491260,CDM,270,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"SPONGE 4X4 4PLY 10PK STERILE",491252,CDM,272,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"SPONGE LAP",491258,CDM,270,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"SPONGE LAP XRAY 4X18 STERILE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SPONGE NEURO X-RAY DETECTABLE STERILE 1/2 X 3 10/PK",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SPONGE NEURO X-RAY DETECTABLE STERILE 1/2 X 1/2 10/PK",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SPONGE NEURO X-RAY DETECTABLE STERILE 1/2 X  1 10/PK",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SPONGE NEURO X-RAY DETECTABLE STERILE 1 X 1 10/PK",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SPONGE NEURO X-RAY DETECTABLE STERILE 1 X 3 10/PK",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SPRAY SKIN CLEANSER REMEDY",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SPUR II PEDIATRIC RESUSCITATOR BAG NEONATEL",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SPY GLASS IRRIGATIN SYSTEM",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"STABILIZING SPACER FOR LEVEL 1 INSERTS, TITANIUM PLATES",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"STAIN TRICHROME BLUE 500ML",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"STAIN WRIGHT 16 OZ",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"STAINLESS STEEL REPROCESSING TRAY 2D CAM",ORSUP0030,CDM,272,RC,,,OUTPATIENT,,,5088,3307.2,,4477.44,88,,3581.95,,,0,"percent of total billed charges","88% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",880.43,17.304,,704.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3205.44,63,,2564.35,,,0,"percent of total billed charges","63% of total billed charges",778.46,15.3,,622.77,,,0,"percent of total billed charges","15.3% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",3510.72,69,,,,,0,"fee schedule","69% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3146.93,61.85,,2517.54,,,0,"percent of total billed charges","61.5% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",1638.34,32.2,,1310.67,,,0,"percent of total billed charges","32.2% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",871.88,17.136,,697.50,,,0,"percent of total billed charges","17.136% of total billed charges",1111.22,21.84,,888.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1918.18,37.7,,1534.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3968.64,78,,3174.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",778.46,5088,
"STANDARD BALLOON G-TUBE 14FR",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"STAPLER SKIN 35W PROXIMATE PLU",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"STAPLER RELOADING UNIT 30MM FOR TL30",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"STAPLER RELOAD 45MM REG EZ45B",ORSUP0035,CDM,272,RC,,,OUTPATIENT,,,6427,4177.55,,5655.76,88,,4524.61,,,0,"percent of total billed charges","88% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1112.13,17.304,,889.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4049.01,63,,3239.21,,,0,"percent of total billed charges","63% of total billed charges",983.33,15.3,,786.66,,,0,"percent of total billed charges","15.3% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4434.63,69,,,,,0,"fee schedule","69% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3975.1,61.85,,3180.08,,,0,"percent of total billed charges","61.5% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",2069.49,32.2,,1655.59,,,0,"percent of total billed charges","32.2% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1101.33,17.136,,881.06,,,0,"percent of total billed charges","17.136% of total billed charges",1403.66,21.84,,1122.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5013.06,78,,4010.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",983.33,6427,
"STAPLER TLV30 LINEAR INTERNAL 30MM VASCULAR RELOADABLE",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"STAPLER TLH30 LINEAR INTERNAL 30MM HEAVY WIRE RELOADABLE",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"STAPLER RELOAD LINEAR PROXIMAT",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"STAPLER TLH60 LINEAR INTERNAL 60MM HEAVY WIRE RELOADABLE",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"STAPLER TL60 LINEAR INTERNAL 60MM RELOADABLE",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"STAPLER TL30 LINEAR INTERNAL 30MM RELOADABLE",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"STAPLER POWER ARTICULATING ECHELON 45",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"STAPLER POWER STD FLEX 60MM-34CM SHAFT",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"STAPLER INT 28CM SHFT PWR ECHLN FLX 45MM",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"STAPLER ILS CURVED CIRCULAR 29MM",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"STAPLER CIRCULAR CURVED 33MM",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"STAPLER CIRCULAR CURVED 29MM 3",ORSUP0028,CDM,272,RC,,,OUTPATIENT,,,4553,2959.45,,4006.64,88,,3205.31,,,0,"percent of total billed charges","88% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",787.85,17.304,,630.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2868.39,63,,2294.71,,,0,"percent of total billed charges","63% of total billed charges",696.61,15.3,,557.29,,,0,"percent of total billed charges","15.3% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",3141.57,69,,,,,0,"fee schedule","69% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2816.03,61.85,,2252.82,,,0,"percent of total billed charges","61.5% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",1466.07,32.2,,1172.86,,,0,"percent of total billed charges","32.2% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",780.2,17.136,,624.16,,,0,"percent of total billed charges","17.136% of total billed charges",994.38,21.84,,795.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1716.48,37.7,,1373.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3551.34,78,,2841.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",2276.5,50,,1821.20,,,0,"percent of total billed charges","50% of total billed charges",3760.78,82.6,,3008.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",764.9,16.8,,611.92,,,0,"percent of total billed charges","16.8% of total billed charges",4553,100,,3642.40,,,0,"percent of total billed charges","100% of total billed charges",696.61,4553,
"STAPLER CIRCULAR CURVED 25MM 3",ORSUP0033,CDM,272,RC,,,OUTPATIENT,,,4532,2945.8,,3988.16,88,,3190.53,,,0,"percent of total billed charges","88% of total billed charges",2266,50,,1812.80,,,0,"percent of total billed charges","50% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",784.22,17.304,,627.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2855.16,63,,2284.13,,,0,"percent of total billed charges","63% of total billed charges",693.4,15.3,,554.72,,,0,"percent of total billed charges","15.3% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",3127.08,69,,,,,0,"fee schedule","69% of total billed charges",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2803.04,61.85,,2242.43,,,0,"percent of total billed charges","61.5% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",2266,50,,1812.80,,,0,"percent of total billed charges","50% of total billed charges",1459.3,32.2,,1167.44,,,0,"percent of total billed charges","32.2% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",776.6,17.136,,621.28,,,0,"percent of total billed charges","17.136% of total billed charges",989.79,21.84,,791.83,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1708.56,37.7,,1366.85,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3534.96,78,,2827.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3743.43,82.6,,2994.74,,,0,"percent of total billed charges","82.6% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",2266,50,,1812.80,,,0,"percent of total billed charges","50% of total billed charges",3743.43,82.6,,2994.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",693.4,4532,
"STAPLER CONTOUR CVD CUTTER GREEN THICK  CS40G",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"STAPLER CONTOUR CVD CUTTER BLUE STANDARD  CS40B",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"STAPLER ARTICULATING LINEAR ACCESS 55 THICK",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"STAPLER ENDO ROTICULATOR 45MM",ORSUP0019,CDM,272,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"STAPLER INTERNAL ARTICULATING 60MM LINEAR CUTTER",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"STAPLER ECHELON VASC POWERED W/TIP 35MM",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2446,1589.9,,2152.48,88,,1721.98,,,0,"percent of total billed charges","88% of total billed charges",1223,50,,978.40,,,0,"percent of total billed charges","50% of total billed charges",410.93,16.8,,328.74,,,0,"percent of total billed charges","16.8% of total billed charges",2446,100,,1956.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",423.26,17.304,,338.61,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540.98,63,,1232.78,,,0,"percent of total billed charges","63% of total billed charges",374.24,15.3,,299.39,,,0,"percent of total billed charges","15.3% of total billed charges",410.93,16.8,,328.74,,,0,"percent of total billed charges","16.8% of total billed charges",1687.74,69,,,,,0,"fee schedule","69% of total billed charges",2446,100,,1956.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2446,100,,1956.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2446,100,,1956.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1512.85,61.85,,1210.28,,,0,"percent of total billed charges","61.5% of total billed charges",410.93,16.8,,328.74,,,0,"percent of total billed charges","16.8% of total billed charges",1223,50,,978.40,,,0,"percent of total billed charges","50% of total billed charges",787.61,32.2,,630.09,,,0,"percent of total billed charges","32.2% of total billed charges",410.93,16.8,,328.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",419.15,17.136,,335.32,,,0,"percent of total billed charges","17.136% of total billed charges",534.21,21.84,,427.37,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",922.14,37.7,,737.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1907.88,78,,1526.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2020.4,82.6,,1616.32,,,0,"percent of total billed charges","82.6% of total billed charges",410.93,16.8,,328.74,,,0,"percent of total billed charges","16.8% of total billed charges",1223,50,,978.40,,,0,"percent of total billed charges","50% of total billed charges",2020.4,82.6,,1616.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",410.93,16.8,,328.74,,,0,"percent of total billed charges","16.8% of total billed charges",2446,100,,1956.80,,,0,"percent of total billed charges","100% of total billed charges",374.24,2446,
"STAPLER FLEX POWERED PLUS STD 340MM",ORSUP0023,CDM,272,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"STAPLER RELOAD ENDOWRIST 45 BLUE",ORSUP0052,CDM,272,RC,,,OUTPATIENT,,,10980,7137,,9662.4,88,,7729.92,,,0,"percent of total billed charges","88% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1899.98,17.304,,1519.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6917.4,63,,5533.92,,,0,"percent of total billed charges","63% of total billed charges",1679.94,15.3,,1343.95,,,0,"percent of total billed charges","15.3% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",7576.2,69,,,,,0,"fee schedule","69% of total billed charges",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6791.13,61.85,,5432.90,,,0,"percent of total billed charges","61.5% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",3535.56,32.2,,2828.45,,,0,"percent of total billed charges","32.2% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1881.53,17.136,,1505.22,,,0,"percent of total billed charges","17.136% of total billed charges",2398.03,21.84,,1918.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4139.46,37.7,,3311.57,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8564.4,78,,6851.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9069.48,82.6,,7255.58,,,0,"percent of total billed charges","82.6% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",9069.48,82.6,,7255.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",1679.94,10980,
"STAPLER ENDOWRIST SHEATH",429590,CDM,272,RC,,,OUTPATIENT,,,1653,1074.45,,1454.64,88,,1163.71,,,0,"percent of total billed charges","88% of total billed charges",826.5,50,,661.20,,,0,"percent of total billed charges","50% of total billed charges",277.7,16.8,,222.16,,,0,"percent of total billed charges","16.8% of total billed charges",1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",286.04,17.304,,228.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1041.39,63,,833.11,,,0,"percent of total billed charges","63% of total billed charges",252.91,15.3,,202.33,,,0,"percent of total billed charges","15.3% of total billed charges",277.7,16.8,,222.16,,,0,"percent of total billed charges","16.8% of total billed charges",1140.57,69,,,,,0,"fee schedule","69% of total billed charges",1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1022.38,61.85,,817.90,,,0,"percent of total billed charges","61.5% of total billed charges",277.7,16.8,,222.16,,,0,"percent of total billed charges","16.8% of total billed charges",826.5,50,,661.20,,,0,"percent of total billed charges","50% of total billed charges",532.27,32.2,,425.82,,,0,"percent of total billed charges","32.2% of total billed charges",277.7,16.8,,222.16,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",283.26,17.136,,226.61,,,0,"percent of total billed charges","17.136% of total billed charges",361.02,21.84,,288.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",623.18,37.7,,498.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1289.34,78,,1031.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1365.38,82.6,,1092.30,,,0,"percent of total billed charges","82.6% of total billed charges",277.7,16.8,,222.16,,,0,"percent of total billed charges","16.8% of total billed charges",826.5,50,,661.20,,,0,"percent of total billed charges","50% of total billed charges",1365.38,82.6,,1092.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",277.7,16.8,,222.16,,,0,"percent of total billed charges","16.8% of total billed charges",1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",252.91,1653,
"STAPLER SKIN INSORB 20",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"STAPLER PURSESTRING 65",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"STAPLER INTRALUMINAR 25MM",ORSUP0015,CDM,270,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"STAPLER LINEAR 55MM STANDARD",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"STAPLER ENDOSCOPIC MULTIFEED",ORSUP0009,CDM,270,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"STAPLER CONTOUR CR40B REGULAR",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"STAPLER CONTOUR CR40G THICK",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"KIT STAPH AUREUS ATTC 43300",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"STAPLER LINEAR PROXIMATE 30",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"STAPH SAPROPHYTICUS ATCC BAA-750",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"STAPH AUREUS CULTI LOOPS BAA-976",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"STAPH AUREUS ATCC CULTI LOOPS BAA-1026",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"STAPH AUREUS ATCC CULTI LOOPS 29213",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"STAPH AUREUS ATCC CULTI LOOPS 33591",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"STAPLER PROXIMATE RELOAD LINEAR 60MM",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"STAPLER SUREFORM 60 SPU",ORSUP0024,CDM,272,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"STAPLER SUREFORM 45 SPU",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"STAPLER CANNULA SEAL 12MM",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1030,669.5,,906.4,88,,725.12,,,0,"percent of total billed charges","88% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.23,17.304,,142.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.9,63,,519.12,,,0,"percent of total billed charges","63% of total billed charges",157.59,15.3,,126.07,,,0,"percent of total billed charges","15.3% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",710.7,69,,,,,0,"fee schedule","69% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",637.06,61.85,,509.65,,,0,"percent of total billed charges","61.5% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",331.66,32.2,,265.33,,,0,"percent of total billed charges","32.2% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.5,17.136,,141.20,,,0,"percent of total billed charges","17.136% of total billed charges",224.95,21.84,,179.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",388.31,37.7,,310.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",803.4,78,,642.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",157.59,1030,
"STAPLER CIRCULAR 25MM",ORSUP0020,CDM,270,RC,,,OUTPATIENT,,,1854,1205.1,,1631.52,88,,1305.22,,,0,"percent of total billed charges","88% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",320.82,17.304,,256.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1168.02,63,,934.42,,,0,"percent of total billed charges","63% of total billed charges",283.66,15.3,,226.93,,,0,"percent of total billed charges","15.3% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1279.26,69,,,,,0,"fee schedule","69% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1146.7,61.85,,917.36,,,0,"percent of total billed charges","61.5% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",596.99,32.2,,477.59,,,0,"percent of total billed charges","32.2% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.7,17.136,,254.16,,,0,"percent of total billed charges","17.136% of total billed charges",404.91,21.84,,323.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",698.96,37.7,,559.17,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1446.12,78,,1156.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1531.4,82.6,,1225.12,,,0,"percent of total billed charges","82.6% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",1531.4,82.6,,1225.12,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",283.66,1854,
"STAPLER CIRCULAR 33MM",ORSUP0020,CDM,270,RC,,,OUTPATIENT,,,1854,1205.1,,1631.52,88,,1305.22,,,0,"percent of total billed charges","88% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",320.82,17.304,,256.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1168.02,63,,934.42,,,0,"percent of total billed charges","63% of total billed charges",283.66,15.3,,226.93,,,0,"percent of total billed charges","15.3% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1279.26,69,,,,,0,"fee schedule","69% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1146.7,61.85,,917.36,,,0,"percent of total billed charges","61.5% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",596.99,32.2,,477.59,,,0,"percent of total billed charges","32.2% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.7,17.136,,254.16,,,0,"percent of total billed charges","17.136% of total billed charges",404.91,21.84,,323.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",698.96,37.7,,559.17,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1446.12,78,,1156.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1531.4,82.6,,1225.12,,,0,"percent of total billed charges","82.6% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",1531.4,82.6,,1225.12,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",283.66,1854,
"STATLOCK IAB",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"STAXX FINGER SPLINT CLEAR #1",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"STAXX FINGER SPLINT CLEAR #2",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"STAXX FINGER SPLINT CLEAR #3",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"STAXX FINGER SPLINT CLEAR #4",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"STAXX FINGER SPLINT CLEAR #5",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"STAXX FINGER SPLINT CLEAR #6",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"STAXX FINGER SPLINT CLEAR #7",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"STAY HOOK BLUNT ELONGATED 12MM",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"STAY 3 FINGER 20MM X 20MM",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"STEAM ARROW",114876,CDM,270,RC,,,OUTPATIENT,,,606,393.9,,533.28,88,,426.62,,,0,"percent of total billed charges","88% of total billed charges",303,50,,242.40,,,0,"percent of total billed charges","50% of total billed charges",101.81,16.8,,81.45,,,0,"percent of total billed charges","16.8% of total billed charges",606,100,,484.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.86,17.304,,83.89,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",381.78,63,,305.42,,,0,"percent of total billed charges","63% of total billed charges",92.72,15.3,,74.18,,,0,"percent of total billed charges","15.3% of total billed charges",101.81,16.8,,81.45,,,0,"percent of total billed charges","16.8% of total billed charges",418.14,69,,,,,0,"fee schedule","69% of total billed charges",606,100,,484.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",606,100,,484.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",606,100,,484.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",374.81,61.85,,299.85,,,0,"percent of total billed charges","61.5% of total billed charges",101.81,16.8,,81.45,,,0,"percent of total billed charges","16.8% of total billed charges",303,50,,242.40,,,0,"percent of total billed charges","50% of total billed charges",195.13,32.2,,156.10,,,0,"percent of total billed charges","32.2% of total billed charges",101.81,16.8,,81.45,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.84,17.136,,83.07,,,0,"percent of total billed charges","17.136% of total billed charges",132.35,21.84,,105.88,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",228.46,37.7,,182.77,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",472.68,78,,378.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",500.56,82.6,,400.45,,,0,"percent of total billed charges","82.6% of total billed charges",101.81,16.8,,81.45,,,0,"percent of total billed charges","16.8% of total billed charges",303,50,,242.40,,,0,"percent of total billed charges","50% of total billed charges",500.56,82.6,,400.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.81,16.8,,81.45,,,0,"percent of total billed charges","16.8% of total billed charges",606,100,,484.80,,,0,"percent of total billed charges","100% of total billed charges",92.72,606,
"STEAM INDICATOR",491278,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"STEAM INDICATOR CARD",491279,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"STEAM TAPE BLUE",491280,CDM,270,RC,,,OUTPATIENT,,,53,34.45,,46.64,88,,37.31,,,0,"percent of total billed charges","88% of total billed charges",26.5,50,,21.20,,,0,"percent of total billed charges","50% of total billed charges",8.9,16.8,,7.12,,,0,"percent of total billed charges","16.8% of total billed charges",53,100,,42.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.17,17.304,,7.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.39,63,,26.71,,,0,"percent of total billed charges","63% of total billed charges",8.11,15.3,,6.49,,,0,"percent of total billed charges","15.3% of total billed charges",8.9,16.8,,7.12,,,0,"percent of total billed charges","16.8% of total billed charges",36.57,69,,,,,0,"fee schedule","69% of total billed charges",53,100,,42.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53,100,,42.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53,100,,42.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.78,61.85,,26.22,,,0,"percent of total billed charges","61.5% of total billed charges",8.9,16.8,,7.12,,,0,"percent of total billed charges","16.8% of total billed charges",26.5,50,,21.20,,,0,"percent of total billed charges","50% of total billed charges",17.07,32.2,,13.66,,,0,"percent of total billed charges","32.2% of total billed charges",8.9,16.8,,7.12,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.08,17.136,,7.26,,,0,"percent of total billed charges","17.136% of total billed charges",11.58,21.84,,9.26,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.98,37.7,,15.98,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.34,78,,33.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.78,82.6,,35.02,,,0,"percent of total billed charges","82.6% of total billed charges",8.9,16.8,,7.12,,,0,"percent of total billed charges","16.8% of total billed charges",26.5,50,,21.20,,,0,"percent of total billed charges","50% of total billed charges",43.78,82.6,,35.02,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.9,16.8,,7.12,,,0,"percent of total billed charges","16.8% of total billed charges",53,100,,42.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,53,
"STEAM AND GAS STERILIZATION ROLL 8X100",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"STEAM/ GAS POUCH SELF SEAL 5.25 X 12",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"STEAM AUTOCLAVE TAPE WH/GR INDICATOR",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"STEINMAN PIN 5/64",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"STEINMAN PIN 3/32",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"STEINMANN PINS 3/16",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"STEINMANN PINS 5/32",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"STENT 2.25 x 12MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0049,CDM,278,RC,,,OUTPATIENT,,,7828,5088.2,,6888.64,88,,5510.91,,,0,"percent of total billed charges","88% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1354.56,17.304,,1083.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4931.64,63,,3945.31,,,0,"percent of total billed charges","63% of total billed charges",1197.68,15.3,,958.14,,,0,"percent of total billed charges","15.3% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",5401.32,69,,,,,0,"fee schedule","69% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4841.62,61.85,,3873.30,,,0,"percent of total billed charges","61.5% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",2520.62,32.2,,2016.50,,,0,"percent of total billed charges","32.2% of total billed charges",2442.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1341.41,17.136,,1073.13,,,0,"percent of total billed charges","17.136% of total billed charges",1709.64,21.84,,1367.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.7% of total billed charges",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2653.69,33.9,,2122.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6105.84,78,,4884.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",1197.68,7828,
"STENT 2.25 x 18MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0049,CDM,278,RC,,,OUTPATIENT,,,7828,5088.2,,6888.64,88,,5510.91,,,0,"percent of total billed charges","88% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1354.56,17.304,,1083.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4931.64,63,,3945.31,,,0,"percent of total billed charges","63% of total billed charges",1197.68,15.3,,958.14,,,0,"percent of total billed charges","15.3% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",5401.32,69,,,,,0,"fee schedule","69% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4841.62,61.85,,3873.30,,,0,"percent of total billed charges","61.5% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",2520.62,32.2,,2016.50,,,0,"percent of total billed charges","32.2% of total billed charges",2442.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1341.41,17.136,,1073.13,,,0,"percent of total billed charges","17.136% of total billed charges",1709.64,21.84,,1367.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.7% of total billed charges",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2653.69,33.9,,2122.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6105.84,78,,4884.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",1197.68,7828,
"STENT 2.25 x 22MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0049,CDM,278,RC,,,OUTPATIENT,,,7828,5088.2,,6888.64,88,,5510.91,,,0,"percent of total billed charges","88% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1354.56,17.304,,1083.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4931.64,63,,3945.31,,,0,"percent of total billed charges","63% of total billed charges",1197.68,15.3,,958.14,,,0,"percent of total billed charges","15.3% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",5401.32,69,,,,,0,"fee schedule","69% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4841.62,61.85,,3873.30,,,0,"percent of total billed charges","61.5% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",2520.62,32.2,,2016.50,,,0,"percent of total billed charges","32.2% of total billed charges",2442.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1341.41,17.136,,1073.13,,,0,"percent of total billed charges","17.136% of total billed charges",1709.64,21.84,,1367.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.7% of total billed charges",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2653.69,33.9,,2122.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6105.84,78,,4884.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",1197.68,7828,
"STENT 2.25 x 26MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0049,CDM,278,RC,,,OUTPATIENT,,,7828,5088.2,,6888.64,88,,5510.91,,,0,"percent of total billed charges","88% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1354.56,17.304,,1083.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4931.64,63,,3945.31,,,0,"percent of total billed charges","63% of total billed charges",1197.68,15.3,,958.14,,,0,"percent of total billed charges","15.3% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",5401.32,69,,,,,0,"fee schedule","69% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4841.62,61.85,,3873.30,,,0,"percent of total billed charges","61.5% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",2520.62,32.2,,2016.50,,,0,"percent of total billed charges","32.2% of total billed charges",2442.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1341.41,17.136,,1073.13,,,0,"percent of total billed charges","17.136% of total billed charges",1709.64,21.84,,1367.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.7% of total billed charges",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2653.69,33.9,,2122.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6105.84,78,,4884.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",1197.68,7828,
"STENT 2.25 x 30MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0049,CDM,278,RC,,,OUTPATIENT,,,7828,5088.2,,6888.64,88,,5510.91,,,0,"percent of total billed charges","88% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1354.56,17.304,,1083.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4931.64,63,,3945.31,,,0,"percent of total billed charges","63% of total billed charges",1197.68,15.3,,958.14,,,0,"percent of total billed charges","15.3% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",5401.32,69,,,,,0,"fee schedule","69% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4841.62,61.85,,3873.30,,,0,"percent of total billed charges","61.5% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",2520.62,32.2,,2016.50,,,0,"percent of total billed charges","32.2% of total billed charges",2442.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1341.41,17.136,,1073.13,,,0,"percent of total billed charges","17.136% of total billed charges",1709.64,21.84,,1367.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.7% of total billed charges",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2653.69,33.9,,2122.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6105.84,78,,4884.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",1197.68,7828,
"STENT 2.50 x 14MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0049,CDM,278,RC,,,OUTPATIENT,,,7828,5088.2,,6888.64,88,,5510.91,,,0,"percent of total billed charges","88% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1354.56,17.304,,1083.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4931.64,63,,3945.31,,,0,"percent of total billed charges","63% of total billed charges",1197.68,15.3,,958.14,,,0,"percent of total billed charges","15.3% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",5401.32,69,,,,,0,"fee schedule","69% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4841.62,61.85,,3873.30,,,0,"percent of total billed charges","61.5% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",2520.62,32.2,,2016.50,,,0,"percent of total billed charges","32.2% of total billed charges",2442.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1341.41,17.136,,1073.13,,,0,"percent of total billed charges","17.136% of total billed charges",1709.64,21.84,,1367.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.7% of total billed charges",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2653.69,33.9,,2122.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6105.84,78,,4884.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",1197.68,7828,
"STENT 2.50 x 18MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0049,CDM,278,RC,,,OUTPATIENT,,,7828,5088.2,,6888.64,88,,5510.91,,,0,"percent of total billed charges","88% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1354.56,17.304,,1083.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4931.64,63,,3945.31,,,0,"percent of total billed charges","63% of total billed charges",1197.68,15.3,,958.14,,,0,"percent of total billed charges","15.3% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",5401.32,69,,,,,0,"fee schedule","69% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4841.62,61.85,,3873.30,,,0,"percent of total billed charges","61.5% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",2520.62,32.2,,2016.50,,,0,"percent of total billed charges","32.2% of total billed charges",2442.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1341.41,17.136,,1073.13,,,0,"percent of total billed charges","17.136% of total billed charges",1709.64,21.84,,1367.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.7% of total billed charges",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2653.69,33.9,,2122.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6105.84,78,,4884.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",1197.68,7828,
"STENT 2.50 x 22MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0049,CDM,278,RC,,,OUTPATIENT,,,7828,5088.2,,6888.64,88,,5510.91,,,0,"percent of total billed charges","88% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1354.56,17.304,,1083.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4931.64,63,,3945.31,,,0,"percent of total billed charges","63% of total billed charges",1197.68,15.3,,958.14,,,0,"percent of total billed charges","15.3% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",5401.32,69,,,,,0,"fee schedule","69% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4841.62,61.85,,3873.30,,,0,"percent of total billed charges","61.5% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",2520.62,32.2,,2016.50,,,0,"percent of total billed charges","32.2% of total billed charges",2442.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1341.41,17.136,,1073.13,,,0,"percent of total billed charges","17.136% of total billed charges",1709.64,21.84,,1367.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.7% of total billed charges",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2653.69,33.9,,2122.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6105.84,78,,4884.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",1197.68,7828,
"STENT 2.50 x 30MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0049,CDM,278,RC,,,OUTPATIENT,,,7828,5088.2,,6888.64,88,,5510.91,,,0,"percent of total billed charges","88% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1354.56,17.304,,1083.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4931.64,63,,3945.31,,,0,"percent of total billed charges","63% of total billed charges",1197.68,15.3,,958.14,,,0,"percent of total billed charges","15.3% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",5401.32,69,,,,,0,"fee schedule","69% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4841.62,61.85,,3873.30,,,0,"percent of total billed charges","61.5% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",2520.62,32.2,,2016.50,,,0,"percent of total billed charges","32.2% of total billed charges",2442.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1341.41,17.136,,1073.13,,,0,"percent of total billed charges","17.136% of total billed charges",1709.64,21.84,,1367.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.7% of total billed charges",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2653.69,33.9,,2122.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6105.84,78,,4884.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",1197.68,7828,
"STENT 2.75 x 12MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0033,CDM,278,RC,,,OUTPATIENT,,,4532,2945.8,,3988.16,88,,3190.53,,,0,"percent of total billed charges","88% of total billed charges",2266,50,,1812.80,,,0,"percent of total billed charges","50% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",784.22,17.304,,627.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2855.16,63,,2284.13,,,0,"percent of total billed charges","63% of total billed charges",693.4,15.3,,554.72,,,0,"percent of total billed charges","15.3% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",3127.08,69,,,,,0,"fee schedule","69% of total billed charges",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2803.04,61.85,,2242.43,,,0,"percent of total billed charges","61.5% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",2266,50,,1812.80,,,0,"percent of total billed charges","50% of total billed charges",1459.3,32.2,,1167.44,,,0,"percent of total billed charges","32.2% of total billed charges",1413.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",776.6,17.136,,621.28,,,0,"percent of total billed charges","17.136% of total billed charges",989.79,21.84,,791.83,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1708.56,37.7,,1366.85,,,0,"percent of total billed charges","37.7% of total billed charges",1708.56,37.7,,1366.85,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1536.35,33.9,,1229.08,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3534.96,78,,2827.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3743.43,82.6,,2994.74,,,0,"percent of total billed charges","82.6% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",2266,50,,1812.80,,,0,"percent of total billed charges","50% of total billed charges",3743.43,82.6,,2994.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",693.4,4532,
"STENT 2.75 x 14MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0033,CDM,278,RC,,,OUTPATIENT,,,4532,2945.8,,3988.16,88,,3190.53,,,0,"percent of total billed charges","88% of total billed charges",2266,50,,1812.80,,,0,"percent of total billed charges","50% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",784.22,17.304,,627.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2855.16,63,,2284.13,,,0,"percent of total billed charges","63% of total billed charges",693.4,15.3,,554.72,,,0,"percent of total billed charges","15.3% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",3127.08,69,,,,,0,"fee schedule","69% of total billed charges",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2803.04,61.85,,2242.43,,,0,"percent of total billed charges","61.5% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",2266,50,,1812.80,,,0,"percent of total billed charges","50% of total billed charges",1459.3,32.2,,1167.44,,,0,"percent of total billed charges","32.2% of total billed charges",1413.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",776.6,17.136,,621.28,,,0,"percent of total billed charges","17.136% of total billed charges",989.79,21.84,,791.83,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1708.56,37.7,,1366.85,,,0,"percent of total billed charges","37.7% of total billed charges",1708.56,37.7,,1366.85,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1536.35,33.9,,1229.08,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3534.96,78,,2827.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3743.43,82.6,,2994.74,,,0,"percent of total billed charges","82.6% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",2266,50,,1812.80,,,0,"percent of total billed charges","50% of total billed charges",3743.43,82.6,,2994.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",693.4,4532,
"STENT 2.75 x 18MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0049,CDM,278,RC,,,OUTPATIENT,,,7828,5088.2,,6888.64,88,,5510.91,,,0,"percent of total billed charges","88% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1354.56,17.304,,1083.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4931.64,63,,3945.31,,,0,"percent of total billed charges","63% of total billed charges",1197.68,15.3,,958.14,,,0,"percent of total billed charges","15.3% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",5401.32,69,,,,,0,"fee schedule","69% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4841.62,61.85,,3873.30,,,0,"percent of total billed charges","61.5% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",2520.62,32.2,,2016.50,,,0,"percent of total billed charges","32.2% of total billed charges",2442.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1341.41,17.136,,1073.13,,,0,"percent of total billed charges","17.136% of total billed charges",1709.64,21.84,,1367.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.7% of total billed charges",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2653.69,33.9,,2122.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6105.84,78,,4884.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",1197.68,7828,
"STENT 2.75 x 22MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0049,CDM,278,RC,,,OUTPATIENT,,,7828,5088.2,,6888.64,88,,5510.91,,,0,"percent of total billed charges","88% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1354.56,17.304,,1083.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4931.64,63,,3945.31,,,0,"percent of total billed charges","63% of total billed charges",1197.68,15.3,,958.14,,,0,"percent of total billed charges","15.3% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",5401.32,69,,,,,0,"fee schedule","69% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4841.62,61.85,,3873.30,,,0,"percent of total billed charges","61.5% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",2520.62,32.2,,2016.50,,,0,"percent of total billed charges","32.2% of total billed charges",2442.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1341.41,17.136,,1073.13,,,0,"percent of total billed charges","17.136% of total billed charges",1709.64,21.84,,1367.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.7% of total billed charges",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2653.69,33.9,,2122.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6105.84,78,,4884.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",1197.68,7828,
"STENT 2.75 x 26MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0049,CDM,278,RC,,,OUTPATIENT,,,7828,5088.2,,6888.64,88,,5510.91,,,0,"percent of total billed charges","88% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1354.56,17.304,,1083.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4931.64,63,,3945.31,,,0,"percent of total billed charges","63% of total billed charges",1197.68,15.3,,958.14,,,0,"percent of total billed charges","15.3% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",5401.32,69,,,,,0,"fee schedule","69% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4841.62,61.85,,3873.30,,,0,"percent of total billed charges","61.5% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",2520.62,32.2,,2016.50,,,0,"percent of total billed charges","32.2% of total billed charges",2442.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1341.41,17.136,,1073.13,,,0,"percent of total billed charges","17.136% of total billed charges",1709.64,21.84,,1367.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.7% of total billed charges",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2653.69,33.9,,2122.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6105.84,78,,4884.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",1197.68,7828,
"STENT 2.75 x 30MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0049,CDM,278,RC,,,OUTPATIENT,,,7828,5088.2,,6888.64,88,,5510.91,,,0,"percent of total billed charges","88% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1354.56,17.304,,1083.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4931.64,63,,3945.31,,,0,"percent of total billed charges","63% of total billed charges",1197.68,15.3,,958.14,,,0,"percent of total billed charges","15.3% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",5401.32,69,,,,,0,"fee schedule","69% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4841.62,61.85,,3873.30,,,0,"percent of total billed charges","61.5% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",2520.62,32.2,,2016.50,,,0,"percent of total billed charges","32.2% of total billed charges",2442.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1341.41,17.136,,1073.13,,,0,"percent of total billed charges","17.136% of total billed charges",1709.64,21.84,,1367.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.7% of total billed charges",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2653.69,33.9,,2122.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6105.84,78,,4884.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",1197.68,7828,
"STENT 3.0 x 15MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0049,CDM,278,RC,,,OUTPATIENT,,,7828,5088.2,,6888.64,88,,5510.91,,,0,"percent of total billed charges","88% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1354.56,17.304,,1083.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4931.64,63,,3945.31,,,0,"percent of total billed charges","63% of total billed charges",1197.68,15.3,,958.14,,,0,"percent of total billed charges","15.3% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",5401.32,69,,,,,0,"fee schedule","69% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4841.62,61.85,,3873.30,,,0,"percent of total billed charges","61.5% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",2520.62,32.2,,2016.50,,,0,"percent of total billed charges","32.2% of total billed charges",2442.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1341.41,17.136,,1073.13,,,0,"percent of total billed charges","17.136% of total billed charges",1709.64,21.84,,1367.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.7% of total billed charges",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2653.69,33.9,,2122.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6105.84,78,,4884.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",1197.68,7828,
"STENT 3.0 x 18MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0049,CDM,278,RC,,,OUTPATIENT,,,7828,5088.2,,6888.64,88,,5510.91,,,0,"percent of total billed charges","88% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1354.56,17.304,,1083.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4931.64,63,,3945.31,,,0,"percent of total billed charges","63% of total billed charges",1197.68,15.3,,958.14,,,0,"percent of total billed charges","15.3% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",5401.32,69,,,,,0,"fee schedule","69% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4841.62,61.85,,3873.30,,,0,"percent of total billed charges","61.5% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",2520.62,32.2,,2016.50,,,0,"percent of total billed charges","32.2% of total billed charges",2442.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1341.41,17.136,,1073.13,,,0,"percent of total billed charges","17.136% of total billed charges",1709.64,21.84,,1367.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.7% of total billed charges",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2653.69,33.9,,2122.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6105.84,78,,4884.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",1197.68,7828,
"STENT 3.0 x 22MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0049,CDM,278,RC,,,OUTPATIENT,,,7828,5088.2,,6888.64,88,,5510.91,,,0,"percent of total billed charges","88% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1354.56,17.304,,1083.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4931.64,63,,3945.31,,,0,"percent of total billed charges","63% of total billed charges",1197.68,15.3,,958.14,,,0,"percent of total billed charges","15.3% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",5401.32,69,,,,,0,"fee schedule","69% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4841.62,61.85,,3873.30,,,0,"percent of total billed charges","61.5% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",2520.62,32.2,,2016.50,,,0,"percent of total billed charges","32.2% of total billed charges",2442.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1341.41,17.136,,1073.13,,,0,"percent of total billed charges","17.136% of total billed charges",1709.64,21.84,,1367.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.7% of total billed charges",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2653.69,33.9,,2122.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6105.84,78,,4884.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",1197.68,7828,
"STENT 3.0 x 30MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0049,CDM,278,RC,,,OUTPATIENT,,,7828,5088.2,,6888.64,88,,5510.91,,,0,"percent of total billed charges","88% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1354.56,17.304,,1083.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4931.64,63,,3945.31,,,0,"percent of total billed charges","63% of total billed charges",1197.68,15.3,,958.14,,,0,"percent of total billed charges","15.3% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",5401.32,69,,,,,0,"fee schedule","69% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4841.62,61.85,,3873.30,,,0,"percent of total billed charges","61.5% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",2520.62,32.2,,2016.50,,,0,"percent of total billed charges","32.2% of total billed charges",2442.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1341.41,17.136,,1073.13,,,0,"percent of total billed charges","17.136% of total billed charges",1709.64,21.84,,1367.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.7% of total billed charges",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2653.69,33.9,,2122.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6105.84,78,,4884.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",1197.68,7828,
"STENT 3.5 x 18MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0039,CDM,278,RC,,,OUTPATIENT,,,5768,3749.2,,5075.84,88,,4060.67,,,0,"percent of total billed charges","88% of total billed charges",2884,50,,2307.20,,,0,"percent of total billed charges","50% of total billed charges",969.02,16.8,,775.22,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",998.09,17.304,,798.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3633.84,63,,2907.07,,,0,"percent of total billed charges","63% of total billed charges",882.5,15.3,,706.00,,,0,"percent of total billed charges","15.3% of total billed charges",969.02,16.8,,775.22,,,0,"percent of total billed charges","16.8% of total billed charges",3979.92,69,,,,,0,"fee schedule","69% of total billed charges",5768,100,,4614.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5768,100,,4614.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5768,100,,4614.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3567.51,61.85,,2854.01,,,0,"percent of total billed charges","61.5% of total billed charges",969.02,16.8,,775.22,,,0,"percent of total billed charges","16.8% of total billed charges",2884,50,,2307.20,,,0,"percent of total billed charges","50% of total billed charges",1857.3,32.2,,1485.84,,,0,"percent of total billed charges","32.2% of total billed charges",1799.62,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",988.4,17.136,,790.72,,,0,"percent of total billed charges","17.136% of total billed charges",1259.73,21.84,,1007.78,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2174.54,37.7,,1739.63,,,0,"percent of total billed charges","37.7% of total billed charges",2174.54,37.7,,1739.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1955.35,33.9,,1564.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4499.04,78,,3599.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4764.37,82.6,,3811.50,,,0,"percent of total billed charges","82.6% of total billed charges",969.02,16.8,,775.22,,,0,"percent of total billed charges","16.8% of total billed charges",2884,50,,2307.20,,,0,"percent of total billed charges","50% of total billed charges",4764.37,82.6,,3811.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",969.02,16.8,,775.22,,,0,"percent of total billed charges","16.8% of total billed charges",5768,100,,4614.40,,,0,"percent of total billed charges","100% of total billed charges",882.5,5768,
"STENT 3.5 x 22MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0049,CDM,278,RC,,,OUTPATIENT,,,7828,5088.2,,6888.64,88,,5510.91,,,0,"percent of total billed charges","88% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1354.56,17.304,,1083.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4931.64,63,,3945.31,,,0,"percent of total billed charges","63% of total billed charges",1197.68,15.3,,958.14,,,0,"percent of total billed charges","15.3% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",5401.32,69,,,,,0,"fee schedule","69% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4841.62,61.85,,3873.30,,,0,"percent of total billed charges","61.5% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",2520.62,32.2,,2016.50,,,0,"percent of total billed charges","32.2% of total billed charges",2442.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1341.41,17.136,,1073.13,,,0,"percent of total billed charges","17.136% of total billed charges",1709.64,21.84,,1367.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.7% of total billed charges",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2653.69,33.9,,2122.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6105.84,78,,4884.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",1197.68,7828,
"STENT 3.5 x 30MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0033,CDM,278,RC,,,OUTPATIENT,,,4532,2945.8,,3988.16,88,,3190.53,,,0,"percent of total billed charges","88% of total billed charges",2266,50,,1812.80,,,0,"percent of total billed charges","50% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",784.22,17.304,,627.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2855.16,63,,2284.13,,,0,"percent of total billed charges","63% of total billed charges",693.4,15.3,,554.72,,,0,"percent of total billed charges","15.3% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",3127.08,69,,,,,0,"fee schedule","69% of total billed charges",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2803.04,61.85,,2242.43,,,0,"percent of total billed charges","61.5% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",2266,50,,1812.80,,,0,"percent of total billed charges","50% of total billed charges",1459.3,32.2,,1167.44,,,0,"percent of total billed charges","32.2% of total billed charges",1413.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",776.6,17.136,,621.28,,,0,"percent of total billed charges","17.136% of total billed charges",989.79,21.84,,791.83,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1708.56,37.7,,1366.85,,,0,"percent of total billed charges","37.7% of total billed charges",1708.56,37.7,,1366.85,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1536.35,33.9,,1229.08,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3534.96,78,,2827.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3743.43,82.6,,2994.74,,,0,"percent of total billed charges","82.6% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",2266,50,,1812.80,,,0,"percent of total billed charges","50% of total billed charges",3743.43,82.6,,2994.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",693.4,4532,
"STENT 4.0 x 18MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0049,CDM,278,RC,,,OUTPATIENT,,,7828,5088.2,,6888.64,88,,5510.91,,,0,"percent of total billed charges","88% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1354.56,17.304,,1083.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4931.64,63,,3945.31,,,0,"percent of total billed charges","63% of total billed charges",1197.68,15.3,,958.14,,,0,"percent of total billed charges","15.3% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",5401.32,69,,,,,0,"fee schedule","69% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4841.62,61.85,,3873.30,,,0,"percent of total billed charges","61.5% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",2520.62,32.2,,2016.50,,,0,"percent of total billed charges","32.2% of total billed charges",2442.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1341.41,17.136,,1073.13,,,0,"percent of total billed charges","17.136% of total billed charges",1709.64,21.84,,1367.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.7% of total billed charges",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2653.69,33.9,,2122.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6105.84,78,,4884.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",1197.68,7828,
"STENT 4.0 x 26MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0033,CDM,278,RC,,,OUTPATIENT,,,4532,2945.8,,3988.16,88,,3190.53,,,0,"percent of total billed charges","88% of total billed charges",2266,50,,1812.80,,,0,"percent of total billed charges","50% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",784.22,17.304,,627.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2855.16,63,,2284.13,,,0,"percent of total billed charges","63% of total billed charges",693.4,15.3,,554.72,,,0,"percent of total billed charges","15.3% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",3127.08,69,,,,,0,"fee schedule","69% of total billed charges",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2803.04,61.85,,2242.43,,,0,"percent of total billed charges","61.5% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",2266,50,,1812.80,,,0,"percent of total billed charges","50% of total billed charges",1459.3,32.2,,1167.44,,,0,"percent of total billed charges","32.2% of total billed charges",1413.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",776.6,17.136,,621.28,,,0,"percent of total billed charges","17.136% of total billed charges",989.79,21.84,,791.83,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1708.56,37.7,,1366.85,,,0,"percent of total billed charges","37.7% of total billed charges",1708.56,37.7,,1366.85,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1536.35,33.9,,1229.08,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3534.96,78,,2827.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3743.43,82.6,,2994.74,,,0,"percent of total billed charges","82.6% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",2266,50,,1812.80,,,0,"percent of total billed charges","50% of total billed charges",3743.43,82.6,,2994.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",693.4,4532,
"STENT RESOLUTE RX  3.5 X 38MM",ORSUP0040,CDM,278,RC,,,OUTPATIENT,,,7766,5047.9,,6834.08,88,,5467.26,,,0,"percent of total billed charges","88% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1343.83,17.304,,1075.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4892.58,63,,3914.06,,,0,"percent of total billed charges","63% of total billed charges",1188.2,15.3,,950.56,,,0,"percent of total billed charges","15.3% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",5358.54,69,,,,,0,"fee schedule","69% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4803.27,61.85,,3842.62,,,0,"percent of total billed charges","61.5% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",2500.65,32.2,,2000.52,,,0,"percent of total billed charges","32.2% of total billed charges",2422.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1330.78,17.136,,1064.62,,,0,"percent of total billed charges","17.136% of total billed charges",1696.09,21.84,,1356.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2927.78,37.7,,2342.22,,,0,"percent of total billed charges","37.7% of total billed charges",2927.78,37.7,,2342.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2632.67,33.9,,2106.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6057.48,78,,4845.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",1188.2,7766,
"STENT VIABAHN W/MARKER 8MM X 15CM",ORSUP0105,CDM,278,RC,,,OUTPATIENT,,,25709,16710.85,,22623.92,88,,18099.14,,,0,"percent of total billed charges","88% of total billed charges",12854.5,50,,10283.60,,,0,"percent of total billed charges","50% of total billed charges",4319.11,16.8,,3455.29,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4448.69,17.304,,3558.95,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",16196.67,63,,12957.34,,,0,"percent of total billed charges","63% of total billed charges",3933.48,15.3,,3146.78,,,0,"percent of total billed charges","15.3% of total billed charges",4319.11,16.8,,3455.29,,,0,"percent of total billed charges","16.8% of total billed charges",17739.21,69,,,,,0,"fee schedule","69% of total billed charges",25709,100,,20567.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25709,100,,20567.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25709,100,,20567.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15901.02,61.85,,12720.82,,,0,"percent of total billed charges","61.5% of total billed charges",4319.11,16.8,,3455.29,,,0,"percent of total billed charges","16.8% of total billed charges",12854.5,50,,10283.60,,,0,"percent of total billed charges","50% of total billed charges",8278.3,32.2,,6622.64,,,0,"percent of total billed charges","32.2% of total billed charges",8021.21,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",4405.49,17.136,,3524.39,,,0,"percent of total billed charges","17.136% of total billed charges",5614.85,21.84,,4491.88,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",9692.29,37.7,,7753.83,,,0,"percent of total billed charges","37.7% of total billed charges",9692.29,37.7,,7753.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",8715.35,33.9,,6972.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",20053.02,78,,16042.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",21235.63,82.6,,16988.50,,,0,"percent of total billed charges","82.6% of total billed charges",4319.11,16.8,,3455.29,,,0,"percent of total billed charges","16.8% of total billed charges",12854.5,50,,10283.60,,,0,"percent of total billed charges","50% of total billed charges",21235.63,82.6,,16988.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4319.11,16.8,,3455.29,,,0,"percent of total billed charges","16.8% of total billed charges",25709,100,,20567.20,,,0,"percent of total billed charges","100% of total billed charges",3933.48,25709,
"STENT URETERAL 6 FR 22CM",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"STENT URETERAL 6FR 24CM",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"STENT URETERAL 6FR 26CM",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.94,17.304,,85.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.23,61.85,,305.78,,,0,"percent of total billed charges","61.5% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",199,32.2,,159.20,,,0,"percent of total billed charges","32.2% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.136,,84.72,,,0,"percent of total billed charges","17.136% of total billed charges",134.97,21.84,,107.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,618,
"STENT URETERAL 6FR 28CM",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"STENT URETERAL 7FR 22CM",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"STENT GUIDE VIPER TRACK TAPE 30CM",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"STENT TRACHEOBRONCIAL COVERED 12 X 20",ORSUP0050,CDM,278,RC,,,OUTPATIENT,,,10444,6788.6,,9190.72,88,,7352.58,,,0,"percent of total billed charges","88% of total billed charges",5222,50,,4177.60,,,0,"percent of total billed charges","50% of total billed charges",1754.59,16.8,,1403.67,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1807.23,17.304,,1445.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6579.72,63,,5263.78,,,0,"percent of total billed charges","63% of total billed charges",1597.93,15.3,,1278.34,,,0,"percent of total billed charges","15.3% of total billed charges",1754.59,16.8,,1403.67,,,0,"percent of total billed charges","16.8% of total billed charges",7206.36,69,,,,,0,"fee schedule","69% of total billed charges",10444,100,,8355.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10444,100,,8355.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10444,100,,8355.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6459.61,61.85,,5167.69,,,0,"percent of total billed charges","61.5% of total billed charges",1754.59,16.8,,1403.67,,,0,"percent of total billed charges","16.8% of total billed charges",5222,50,,4177.60,,,0,"percent of total billed charges","50% of total billed charges",3362.97,32.2,,2690.38,,,0,"percent of total billed charges","32.2% of total billed charges",3258.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1789.68,17.136,,1431.74,,,0,"percent of total billed charges","17.136% of total billed charges",2280.97,21.84,,1824.78,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3937.39,37.7,,3149.91,,,0,"percent of total billed charges","37.7% of total billed charges",3937.39,37.7,,3149.91,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3540.52,33.9,,2832.42,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",8146.32,78,,6517.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8626.74,82.6,,6901.39,,,0,"percent of total billed charges","82.6% of total billed charges",1754.59,16.8,,1403.67,,,0,"percent of total billed charges","16.8% of total billed charges",5222,50,,4177.60,,,0,"percent of total billed charges","50% of total billed charges",8626.74,82.6,,6901.39,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1754.59,16.8,,1403.67,,,0,"percent of total billed charges","16.8% of total billed charges",10444,100,,8355.20,,,0,"percent of total billed charges","100% of total billed charges",1597.93,10444,
"STENT SOF-CURL URETERAL 4.5FR",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"STENT URETERAL SOF-CURL 4.5X26",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"STENT URETERAL SOF-CURL 4.5X28",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"STENT URETERAL SOF-CURL 4.5X22",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"STENT SET KWART 8.2FR 22-32CM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"STENT SET KWART 7FR X 26CM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"STENT GRAFT 8MMX70MM STRAIGHT",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"STENT GRAFT 9FR 7MMX70MM STRT",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"STENT GRAFT 9FR 6MMX70MM STRT",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"STENT GRAFT 9FR 7MMX70MM FLARD",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"STENT GRAFT 6MMX70MM FLARED",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"STENT GRAFT 8MMX70MM FLARED",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"STENT 6FR 28CM DBL PIGTAIL",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"STENT 6FR 26CM DBL PIGTAIL",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"STENT 6FR 24CM DBL PIGTAIL",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"STENT 3.0 x 12MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0039,CDM,278,RC,,,OUTPATIENT,,,5768,3749.2,,5075.84,88,,4060.67,,,0,"percent of total billed charges","88% of total billed charges",2884,50,,2307.20,,,0,"percent of total billed charges","50% of total billed charges",969.02,16.8,,775.22,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",998.09,17.304,,798.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3633.84,63,,2907.07,,,0,"percent of total billed charges","63% of total billed charges",882.5,15.3,,706.00,,,0,"percent of total billed charges","15.3% of total billed charges",969.02,16.8,,775.22,,,0,"percent of total billed charges","16.8% of total billed charges",3979.92,69,,,,,0,"fee schedule","69% of total billed charges",5768,100,,4614.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5768,100,,4614.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5768,100,,4614.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3567.51,61.85,,2854.01,,,0,"percent of total billed charges","61.5% of total billed charges",969.02,16.8,,775.22,,,0,"percent of total billed charges","16.8% of total billed charges",2884,50,,2307.20,,,0,"percent of total billed charges","50% of total billed charges",1857.3,32.2,,1485.84,,,0,"percent of total billed charges","32.2% of total billed charges",1799.62,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",988.4,17.136,,790.72,,,0,"percent of total billed charges","17.136% of total billed charges",1259.73,21.84,,1007.78,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2174.54,37.7,,1739.63,,,0,"percent of total billed charges","37.7% of total billed charges",2174.54,37.7,,1739.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1955.35,33.9,,1564.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4499.04,78,,3599.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4764.37,82.6,,3811.50,,,0,"percent of total billed charges","82.6% of total billed charges",969.02,16.8,,775.22,,,0,"percent of total billed charges","16.8% of total billed charges",2884,50,,2307.20,,,0,"percent of total billed charges","50% of total billed charges",4764.37,82.6,,3811.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",969.02,16.8,,775.22,,,0,"percent of total billed charges","16.8% of total billed charges",5768,100,,4614.40,,,0,"percent of total billed charges","100% of total billed charges",882.5,5768,
"STENT 3.5 x 09MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0033,CDM,278,RC,,,OUTPATIENT,,,4532,2945.8,,3988.16,88,,3190.53,,,0,"percent of total billed charges","88% of total billed charges",2266,50,,1812.80,,,0,"percent of total billed charges","50% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",784.22,17.304,,627.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2855.16,63,,2284.13,,,0,"percent of total billed charges","63% of total billed charges",693.4,15.3,,554.72,,,0,"percent of total billed charges","15.3% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",3127.08,69,,,,,0,"fee schedule","69% of total billed charges",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2803.04,61.85,,2242.43,,,0,"percent of total billed charges","61.5% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",2266,50,,1812.80,,,0,"percent of total billed charges","50% of total billed charges",1459.3,32.2,,1167.44,,,0,"percent of total billed charges","32.2% of total billed charges",1413.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",776.6,17.136,,621.28,,,0,"percent of total billed charges","17.136% of total billed charges",989.79,21.84,,791.83,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1708.56,37.7,,1366.85,,,0,"percent of total billed charges","37.7% of total billed charges",1708.56,37.7,,1366.85,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1536.35,33.9,,1229.08,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3534.96,78,,2827.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3743.43,82.6,,2994.74,,,0,"percent of total billed charges","82.6% of total billed charges",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",2266,50,,1812.80,,,0,"percent of total billed charges","50% of total billed charges",3743.43,82.6,,2994.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",761.38,16.8,,609.10,,,0,"percent of total billed charges","16.8% of total billed charges",4532,100,,3625.60,,,0,"percent of total billed charges","100% of total billed charges",693.4,4532,
"STENT 3.5 x 12MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0049,CDM,278,RC,,,OUTPATIENT,,,7828,5088.2,,6888.64,88,,5510.91,,,0,"percent of total billed charges","88% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1354.56,17.304,,1083.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4931.64,63,,3945.31,,,0,"percent of total billed charges","63% of total billed charges",1197.68,15.3,,958.14,,,0,"percent of total billed charges","15.3% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",5401.32,69,,,,,0,"fee schedule","69% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4841.62,61.85,,3873.30,,,0,"percent of total billed charges","61.5% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",2520.62,32.2,,2016.50,,,0,"percent of total billed charges","32.2% of total billed charges",2442.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1341.41,17.136,,1073.13,,,0,"percent of total billed charges","17.136% of total billed charges",1709.64,21.84,,1367.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.7% of total billed charges",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2653.69,33.9,,2122.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6105.84,78,,4884.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",1197.68,7828,
"STENT 4.0 x 22MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0049,CDM,278,RC,,,OUTPATIENT,,,7828,5088.2,,6888.64,88,,5510.91,,,0,"percent of total billed charges","88% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1354.56,17.304,,1083.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4931.64,63,,3945.31,,,0,"percent of total billed charges","63% of total billed charges",1197.68,15.3,,958.14,,,0,"percent of total billed charges","15.3% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",5401.32,69,,,,,0,"fee schedule","69% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4841.62,61.85,,3873.30,,,0,"percent of total billed charges","61.5% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",2520.62,32.2,,2016.50,,,0,"percent of total billed charges","32.2% of total billed charges",2442.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1341.41,17.136,,1073.13,,,0,"percent of total billed charges","17.136% of total billed charges",1709.64,21.84,,1367.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.7% of total billed charges",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2653.69,33.9,,2122.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6105.84,78,,4884.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",1197.68,7828,
N/A,ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.94,17.304,,85.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.23,61.85,,305.78,,,0,"percent of total billed charges","61.5% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",199,32.2,,159.20,,,0,"percent of total billed charges","32.2% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.136,,84.72,,,0,"percent of total billed charges","17.136% of total billed charges",134.97,21.84,,107.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.7% of total billed charges",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.5,33.9,,167.60,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,618,
"STENT 3.5 x 26MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0049,CDM,278,RC,,,OUTPATIENT,,,7828,5088.2,,6888.64,88,,5510.91,,,0,"percent of total billed charges","88% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1354.56,17.304,,1083.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4931.64,63,,3945.31,,,0,"percent of total billed charges","63% of total billed charges",1197.68,15.3,,958.14,,,0,"percent of total billed charges","15.3% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",5401.32,69,,,,,0,"fee schedule","69% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4841.62,61.85,,3873.30,,,0,"percent of total billed charges","61.5% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",2520.62,32.2,,2016.50,,,0,"percent of total billed charges","32.2% of total billed charges",2442.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1341.41,17.136,,1073.13,,,0,"percent of total billed charges","17.136% of total billed charges",1709.64,21.84,,1367.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.7% of total billed charges",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2653.69,33.9,,2122.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6105.84,78,,4884.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",1197.68,7828,
"STENT 2.50 x 26MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0049,CDM,278,RC,,,OUTPATIENT,,,7828,5088.2,,6888.64,88,,5510.91,,,0,"percent of total billed charges","88% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1354.56,17.304,,1083.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4931.64,63,,3945.31,,,0,"percent of total billed charges","63% of total billed charges",1197.68,15.3,,958.14,,,0,"percent of total billed charges","15.3% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",5401.32,69,,,,,0,"fee schedule","69% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4841.62,61.85,,3873.30,,,0,"percent of total billed charges","61.5% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",2520.62,32.2,,2016.50,,,0,"percent of total billed charges","32.2% of total billed charges",2442.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1341.41,17.136,,1073.13,,,0,"percent of total billed charges","17.136% of total billed charges",1709.64,21.84,,1367.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.7% of total billed charges",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2653.69,33.9,,2122.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6105.84,78,,4884.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",1197.68,7828,
"STENT 3.5 x 15MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0049,CDM,278,RC,,,OUTPATIENT,,,7828,5088.2,,6888.64,88,,5510.91,,,0,"percent of total billed charges","88% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1354.56,17.304,,1083.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4931.64,63,,3945.31,,,0,"percent of total billed charges","63% of total billed charges",1197.68,15.3,,958.14,,,0,"percent of total billed charges","15.3% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",5401.32,69,,,,,0,"fee schedule","69% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4841.62,61.85,,3873.30,,,0,"percent of total billed charges","61.5% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",2520.62,32.2,,2016.50,,,0,"percent of total billed charges","32.2% of total billed charges",2442.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1341.41,17.136,,1073.13,,,0,"percent of total billed charges","17.136% of total billed charges",1709.64,21.84,,1367.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.7% of total billed charges",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2653.69,33.9,,2122.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6105.84,78,,4884.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",1197.68,7828,
"STENT 2.50 x 12MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0049,CDM,278,RC,,,OUTPATIENT,,,7828,5088.2,,6888.64,88,,5510.91,,,0,"percent of total billed charges","88% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1354.56,17.304,,1083.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4931.64,63,,3945.31,,,0,"percent of total billed charges","63% of total billed charges",1197.68,15.3,,958.14,,,0,"percent of total billed charges","15.3% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",5401.32,69,,,,,0,"fee schedule","69% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4841.62,61.85,,3873.30,,,0,"percent of total billed charges","61.5% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",2520.62,32.2,,2016.50,,,0,"percent of total billed charges","32.2% of total billed charges",2442.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1341.41,17.136,,1073.13,,,0,"percent of total billed charges","17.136% of total billed charges",1709.64,21.84,,1367.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.7% of total billed charges",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2653.69,33.9,,2122.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6105.84,78,,4884.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",1197.68,7828,
"STENT ZILVER PTX 6 X 40 X 125CM",ORSUP0038,CDM,278,RC,,,OUTPATIENT,,,7231,4700.15,,6363.28,88,,5090.62,,,0,"percent of total billed charges","88% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1251.25,17.304,,1001.00,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4555.53,63,,3644.42,,,0,"percent of total billed charges","63% of total billed charges",1106.34,15.3,,885.07,,,0,"percent of total billed charges","15.3% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4989.39,69,,,,,0,"fee schedule","69% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4472.37,61.85,,3577.90,,,0,"percent of total billed charges","61.5% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",2328.38,32.2,,1862.70,,,0,"percent of total billed charges","32.2% of total billed charges",2256.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1239.1,17.136,,991.28,,,0,"percent of total billed charges","17.136% of total billed charges",1579.25,21.84,,1263.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.7% of total billed charges",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2451.31,33.9,,1961.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5640.18,78,,4512.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",1106.34,7231,
"STENT ZILVER PTX 7 X 40 X 125CM",ORSUP0056,CDM,278,RC,,,OUTPATIENT,,,9373,6092.45,,8248.24,88,,6598.59,,,0,"percent of total billed charges","88% of total billed charges",4686.5,50,,3749.20,,,0,"percent of total billed charges","50% of total billed charges",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1621.9,17.304,,1297.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5904.99,63,,4723.99,,,0,"percent of total billed charges","63% of total billed charges",1434.07,15.3,,1147.26,,,0,"percent of total billed charges","15.3% of total billed charges",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",6467.37,69,,,,,0,"fee schedule","69% of total billed charges",9373,100,,7498.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9373,100,,7498.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9373,100,,7498.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5797.2,61.85,,4637.76,,,0,"percent of total billed charges","61.5% of total billed charges",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",4686.5,50,,3749.20,,,0,"percent of total billed charges","50% of total billed charges",3018.11,32.2,,2414.49,,,0,"percent of total billed charges","32.2% of total billed charges",2924.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1606.16,17.136,,1284.93,,,0,"percent of total billed charges","17.136% of total billed charges",2047.06,21.84,,1637.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3533.62,37.7,,2826.90,,,0,"percent of total billed charges","37.7% of total billed charges",3533.62,37.7,,2826.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3177.45,33.9,,2541.96,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7310.94,78,,5848.75,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7742.1,82.6,,6193.68,,,0,"percent of total billed charges","82.6% of total billed charges",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",4686.5,50,,3749.20,,,0,"percent of total billed charges","50% of total billed charges",7742.1,82.6,,6193.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",9373,100,,7498.40,,,0,"percent of total billed charges","100% of total billed charges",1434.07,9373,
"STENT ZILVER PTX 8 X 40 X 125CM",ORSUP0038,CDM,278,RC,,,OUTPATIENT,,,7231,4700.15,,6363.28,88,,5090.62,,,0,"percent of total billed charges","88% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1251.25,17.304,,1001.00,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4555.53,63,,3644.42,,,0,"percent of total billed charges","63% of total billed charges",1106.34,15.3,,885.07,,,0,"percent of total billed charges","15.3% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4989.39,69,,,,,0,"fee schedule","69% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4472.37,61.85,,3577.90,,,0,"percent of total billed charges","61.5% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",2328.38,32.2,,1862.70,,,0,"percent of total billed charges","32.2% of total billed charges",2256.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1239.1,17.136,,991.28,,,0,"percent of total billed charges","17.136% of total billed charges",1579.25,21.84,,1263.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.7% of total billed charges",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2451.31,33.9,,1961.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5640.18,78,,4512.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",1106.34,7231,
"STENT ZILVER PTX 7 X 60 X 125CM",ORSUP0056,CDM,278,RC,,,OUTPATIENT,,,9373,6092.45,,8248.24,88,,6598.59,,,0,"percent of total billed charges","88% of total billed charges",4686.5,50,,3749.20,,,0,"percent of total billed charges","50% of total billed charges",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1621.9,17.304,,1297.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5904.99,63,,4723.99,,,0,"percent of total billed charges","63% of total billed charges",1434.07,15.3,,1147.26,,,0,"percent of total billed charges","15.3% of total billed charges",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",6467.37,69,,,,,0,"fee schedule","69% of total billed charges",9373,100,,7498.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9373,100,,7498.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9373,100,,7498.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5797.2,61.85,,4637.76,,,0,"percent of total billed charges","61.5% of total billed charges",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",4686.5,50,,3749.20,,,0,"percent of total billed charges","50% of total billed charges",3018.11,32.2,,2414.49,,,0,"percent of total billed charges","32.2% of total billed charges",2924.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1606.16,17.136,,1284.93,,,0,"percent of total billed charges","17.136% of total billed charges",2047.06,21.84,,1637.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3533.62,37.7,,2826.90,,,0,"percent of total billed charges","37.7% of total billed charges",3533.62,37.7,,2826.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3177.45,33.9,,2541.96,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7310.94,78,,5848.75,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7742.1,82.6,,6193.68,,,0,"percent of total billed charges","82.6% of total billed charges",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",4686.5,50,,3749.20,,,0,"percent of total billed charges","50% of total billed charges",7742.1,82.6,,6193.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",9373,100,,7498.40,,,0,"percent of total billed charges","100% of total billed charges",1434.07,9373,
"STENT ZILVER PTX 6 X 80 X 125CM",ORSUP0047,CDM,278,RC,,,OUTPATIENT,,,7416,4820.4,,6526.08,88,,5220.86,,,0,"percent of total billed charges","88% of total billed charges",3708,50,,2966.40,,,0,"percent of total billed charges","50% of total billed charges",1245.89,16.8,,996.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1283.26,17.304,,1026.61,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4672.08,63,,3737.66,,,0,"percent of total billed charges","63% of total billed charges",1134.65,15.3,,907.72,,,0,"percent of total billed charges","15.3% of total billed charges",1245.89,16.8,,996.71,,,0,"percent of total billed charges","16.8% of total billed charges",5117.04,69,,,,,0,"fee schedule","69% of total billed charges",7416,100,,5932.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7416,100,,5932.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7416,100,,5932.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4586.8,61.85,,3669.44,,,0,"percent of total billed charges","61.5% of total billed charges",1245.89,16.8,,996.71,,,0,"percent of total billed charges","16.8% of total billed charges",3708,50,,2966.40,,,0,"percent of total billed charges","50% of total billed charges",2387.95,32.2,,1910.36,,,0,"percent of total billed charges","32.2% of total billed charges",2313.79,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1270.81,17.136,,1016.65,,,0,"percent of total billed charges","17.136% of total billed charges",1619.65,21.84,,1295.72,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2795.83,37.7,,2236.66,,,0,"percent of total billed charges","37.7% of total billed charges",2795.83,37.7,,2236.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2514.02,33.9,,2011.22,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5784.48,78,,4627.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6125.62,82.6,,4900.50,,,0,"percent of total billed charges","82.6% of total billed charges",1245.89,16.8,,996.71,,,0,"percent of total billed charges","16.8% of total billed charges",3708,50,,2966.40,,,0,"percent of total billed charges","50% of total billed charges",6125.62,82.6,,4900.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1245.89,16.8,,996.71,,,0,"percent of total billed charges","16.8% of total billed charges",7416,100,,5932.80,,,0,"percent of total billed charges","100% of total billed charges",1134.65,7416,
"STENT ZILVER PTX 6 X 100 X 125CM",ORSUP0047,CDM,272,RC,,,OUTPATIENT,,,7416,4820.4,,6526.08,88,,5220.86,,,0,"percent of total billed charges","88% of total billed charges",3708,50,,2966.40,,,0,"percent of total billed charges","50% of total billed charges",1245.89,16.8,,996.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1283.26,17.304,,1026.61,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4672.08,63,,3737.66,,,0,"percent of total billed charges","63% of total billed charges",1134.65,15.3,,907.72,,,0,"percent of total billed charges","15.3% of total billed charges",1245.89,16.8,,996.71,,,0,"percent of total billed charges","16.8% of total billed charges",5117.04,69,,,,,0,"fee schedule","69% of total billed charges",7416,100,,5932.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7416,100,,5932.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7416,100,,5932.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4586.8,61.85,,3669.44,,,0,"percent of total billed charges","61.5% of total billed charges",1245.89,16.8,,996.71,,,0,"percent of total billed charges","16.8% of total billed charges",3708,50,,2966.40,,,0,"percent of total billed charges","50% of total billed charges",2387.95,32.2,,1910.36,,,0,"percent of total billed charges","32.2% of total billed charges",1245.89,16.8,,996.71,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.81,17.136,,1016.65,,,0,"percent of total billed charges","17.136% of total billed charges",1619.65,21.84,,1295.72,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2795.83,37.7,,2236.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5784.48,78,,4627.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6125.62,82.6,,4900.50,,,0,"percent of total billed charges","82.6% of total billed charges",1245.89,16.8,,996.71,,,0,"percent of total billed charges","16.8% of total billed charges",3708,50,,2966.40,,,0,"percent of total billed charges","50% of total billed charges",6125.62,82.6,,4900.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1245.89,16.8,,996.71,,,0,"percent of total billed charges","16.8% of total billed charges",7416,100,,5932.80,,,0,"percent of total billed charges","100% of total billed charges",1134.65,7416,
"STENT ZILVER PTX 7 X 100 X 125CM",ORSUP0053,CDM,278,RC,,,OUTPATIENT,,,9105,5918.25,,8012.4,88,,6409.92,,,0,"percent of total billed charges","88% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1575.53,17.304,,1260.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5736.15,63,,4588.92,,,0,"percent of total billed charges","63% of total billed charges",1393.07,15.3,,1114.46,,,0,"percent of total billed charges","15.3% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",6282.45,69,,,,,0,"fee schedule","69% of total billed charges",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5631.44,61.85,,4505.15,,,0,"percent of total billed charges","61.5% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",2931.81,32.2,,2345.45,,,0,"percent of total billed charges","32.2% of total billed charges",2840.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1560.23,17.136,,1248.18,,,0,"percent of total billed charges","17.136% of total billed charges",1988.53,21.84,,1590.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3432.59,37.7,,2746.07,,,0,"percent of total billed charges","37.7% of total billed charges",3432.59,37.7,,2746.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3086.6,33.9,,2469.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7101.9,78,,5681.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7520.73,82.6,,6016.58,,,0,"percent of total billed charges","82.6% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",7520.73,82.6,,6016.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",1393.07,9105,
"STENT ZILVER PTX 7 X 120 X 125CM",ORSUP0045,CDM,278,RC,,,OUTPATIENT,,,7004,4552.6,,6163.52,88,,4930.82,,,0,"percent of total billed charges","88% of total billed charges",3502,50,,2801.60,,,0,"percent of total billed charges","50% of total billed charges",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1211.97,17.304,,969.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4412.52,63,,3530.02,,,0,"percent of total billed charges","63% of total billed charges",1071.61,15.3,,857.29,,,0,"percent of total billed charges","15.3% of total billed charges",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",4832.76,69,,,,,0,"fee schedule","69% of total billed charges",7004,100,,5603.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7004,100,,5603.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7004,100,,5603.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4331.97,61.85,,3465.58,,,0,"percent of total billed charges","61.5% of total billed charges",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",3502,50,,2801.60,,,0,"percent of total billed charges","50% of total billed charges",2255.29,32.2,,1804.23,,,0,"percent of total billed charges","32.2% of total billed charges",2185.25,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1200.21,17.136,,960.17,,,0,"percent of total billed charges","17.136% of total billed charges",1529.67,21.84,,1223.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2640.51,37.7,,2112.41,,,0,"percent of total billed charges","37.7% of total billed charges",2640.51,37.7,,2112.41,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2374.36,33.9,,1899.49,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5463.12,78,,4370.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5785.3,82.6,,4628.24,,,0,"percent of total billed charges","82.6% of total billed charges",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",3502,50,,2801.60,,,0,"percent of total billed charges","50% of total billed charges",5785.3,82.6,,4628.24,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1176.67,16.8,,941.34,,,0,"percent of total billed charges","16.8% of total billed charges",7004,100,,5603.20,,,0,"percent of total billed charges","100% of total billed charges",1071.61,7004,
"STENT ZILVER PTX 6 X 140 X 125CM",ORSUP0047,CDM,278,RC,,,OUTPATIENT,,,7498,4873.7,,6598.24,88,,5278.59,,,0,"percent of total billed charges","88% of total billed charges",3749,50,,2999.20,,,0,"percent of total billed charges","50% of total billed charges",1259.66,16.8,,1007.73,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1297.45,17.304,,1037.96,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4723.74,63,,3778.99,,,0,"percent of total billed charges","63% of total billed charges",1147.19,15.3,,917.75,,,0,"percent of total billed charges","15.3% of total billed charges",1259.66,16.8,,1007.73,,,0,"percent of total billed charges","16.8% of total billed charges",5173.62,69,,,,,0,"fee schedule","69% of total billed charges",7498,100,,5998.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7498,100,,5998.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7498,100,,5998.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4637.51,61.85,,3710.01,,,0,"percent of total billed charges","61.5% of total billed charges",1259.66,16.8,,1007.73,,,0,"percent of total billed charges","16.8% of total billed charges",3749,50,,2999.20,,,0,"percent of total billed charges","50% of total billed charges",2414.36,32.2,,1931.49,,,0,"percent of total billed charges","32.2% of total billed charges",2339.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1284.86,17.136,,1027.89,,,0,"percent of total billed charges","17.136% of total billed charges",1637.56,21.84,,1310.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2826.75,37.7,,2261.40,,,0,"percent of total billed charges","37.7% of total billed charges",2826.75,37.7,,2261.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2541.82,33.9,,2033.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5848.44,78,,4678.75,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6193.35,82.6,,4954.68,,,0,"percent of total billed charges","82.6% of total billed charges",1259.66,16.8,,1007.73,,,0,"percent of total billed charges","16.8% of total billed charges",3749,50,,2999.20,,,0,"percent of total billed charges","50% of total billed charges",6193.35,82.6,,4954.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1259.66,16.8,,1007.73,,,0,"percent of total billed charges","16.8% of total billed charges",7498,100,,5998.40,,,0,"percent of total billed charges","100% of total billed charges",1147.19,7498,
"STENT ZILVER PTX 7 X 140 X 125CM",ORSUP0039,CDM,278,RC,,,OUTPATIENT,,,7498,4873.7,,6598.24,88,,5278.59,,,0,"percent of total billed charges","88% of total billed charges",3749,50,,2999.20,,,0,"percent of total billed charges","50% of total billed charges",1259.66,16.8,,1007.73,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1297.45,17.304,,1037.96,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4723.74,63,,3778.99,,,0,"percent of total billed charges","63% of total billed charges",1147.19,15.3,,917.75,,,0,"percent of total billed charges","15.3% of total billed charges",1259.66,16.8,,1007.73,,,0,"percent of total billed charges","16.8% of total billed charges",5173.62,69,,,,,0,"fee schedule","69% of total billed charges",7498,100,,5998.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7498,100,,5998.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7498,100,,5998.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4637.51,61.85,,3710.01,,,0,"percent of total billed charges","61.5% of total billed charges",1259.66,16.8,,1007.73,,,0,"percent of total billed charges","16.8% of total billed charges",3749,50,,2999.20,,,0,"percent of total billed charges","50% of total billed charges",2414.36,32.2,,1931.49,,,0,"percent of total billed charges","32.2% of total billed charges",2339.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1284.86,17.136,,1027.89,,,0,"percent of total billed charges","17.136% of total billed charges",1637.56,21.84,,1310.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2826.75,37.7,,2261.40,,,0,"percent of total billed charges","37.7% of total billed charges",2826.75,37.7,,2261.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2541.82,33.9,,2033.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5848.44,78,,4678.75,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6193.35,82.6,,4954.68,,,0,"percent of total billed charges","82.6% of total billed charges",1259.66,16.8,,1007.73,,,0,"percent of total billed charges","16.8% of total billed charges",3749,50,,2999.20,,,0,"percent of total billed charges","50% of total billed charges",6193.35,82.6,,4954.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1259.66,16.8,,1007.73,,,0,"percent of total billed charges","16.8% of total billed charges",7498,100,,5998.40,,,0,"percent of total billed charges","100% of total billed charges",1147.19,7498,
"MALTOPHILIA 5 LOOPS ATCC 17666",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"STENT RESOLUTE ONYX CORONARY",ORSUP0043,CDM,278,RC,,,OUTPATIENT,,,8570,5570.5,,7541.6,88,,6033.28,,,0,"percent of total billed charges","88% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1482.95,17.304,,1186.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5399.1,63,,4319.28,,,0,"percent of total billed charges","63% of total billed charges",1311.21,15.3,,1048.97,,,0,"percent of total billed charges","15.3% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",5913.3,69,,,,,0,"fee schedule","69% of total billed charges",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5300.55,61.85,,4240.44,,,0,"percent of total billed charges","61.5% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",2759.54,32.2,,2207.63,,,0,"percent of total billed charges","32.2% of total billed charges",2673.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1468.56,17.136,,1174.85,,,0,"percent of total billed charges","17.136% of total billed charges",1871.69,21.84,,1497.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3230.89,37.7,,2584.71,,,0,"percent of total billed charges","37.7% of total billed charges",3230.89,37.7,,2584.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2905.23,33.9,,2324.18,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6684.6,78,,5347.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7078.82,82.6,,5663.06,,,0,"percent of total billed charges","82.6% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",7078.82,82.6,,5663.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",1311.21,8570,
"STENT 3.0 X26MM RESOLUTE INTEGRITY RX CORONARY",ORSUP0049,CDM,278,RC,,,OUTPATIENT,,,7828,5088.2,,6888.64,88,,5510.91,,,0,"percent of total billed charges","88% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1354.56,17.304,,1083.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4931.64,63,,3945.31,,,0,"percent of total billed charges","63% of total billed charges",1197.68,15.3,,958.14,,,0,"percent of total billed charges","15.3% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",5401.32,69,,,,,0,"fee schedule","69% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4841.62,61.85,,3873.30,,,0,"percent of total billed charges","61.5% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",2520.62,32.2,,2016.50,,,0,"percent of total billed charges","32.2% of total billed charges",2442.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1341.41,17.136,,1073.13,,,0,"percent of total billed charges","17.136% of total billed charges",1709.64,21.84,,1367.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.7% of total billed charges",2951.16,37.7,,2360.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2653.69,33.9,,2122.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6105.84,78,,4884.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",3914,50,,3131.20,,,0,"percent of total billed charges","50% of total billed charges",6465.93,82.6,,5172.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1315.1,16.8,,1052.08,,,0,"percent of total billed charges","16.8% of total billed charges",7828,100,,6262.40,,,0,"percent of total billed charges","100% of total billed charges",1197.68,7828,
"STENT SOFT URETERAL 5FR X 22CM",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"STENT SOFT URETERAL 5FR X 24CM",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"STENT SOFT URETERAL 5FR X 26CM",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"STERI-STRIP 1/4",86143,CDM,270,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"STERILE #32 RUBBER BANDS",437415,CDM,272,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"STERILIZATION WRAP GEMINI 54X54",415064,CDM,270,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"STERILIUM HAND RUB 1000ML",491304,CDM,270,RC,,,OUTPATIENT,,,454,295.1,,399.52,88,,319.62,,,0,"percent of total billed charges","88% of total billed charges",227,50,,181.60,,,0,"percent of total billed charges","50% of total billed charges",76.27,16.8,,61.02,,,0,"percent of total billed charges","16.8% of total billed charges",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.56,17.304,,62.85,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",286.02,63,,228.82,,,0,"percent of total billed charges","63% of total billed charges",69.46,15.3,,55.57,,,0,"percent of total billed charges","15.3% of total billed charges",76.27,16.8,,61.02,,,0,"percent of total billed charges","16.8% of total billed charges",313.26,69,,,,,0,"fee schedule","69% of total billed charges",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",280.8,61.85,,224.64,,,0,"percent of total billed charges","61.5% of total billed charges",76.27,16.8,,61.02,,,0,"percent of total billed charges","16.8% of total billed charges",227,50,,181.60,,,0,"percent of total billed charges","50% of total billed charges",146.19,32.2,,116.95,,,0,"percent of total billed charges","32.2% of total billed charges",76.27,16.8,,61.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.8,17.136,,62.24,,,0,"percent of total billed charges","17.136% of total billed charges",99.15,21.84,,79.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",171.16,37.7,,136.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",354.12,78,,283.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",375,82.6,,300.00,,,0,"percent of total billed charges","82.6% of total billed charges",76.27,16.8,,61.02,,,0,"percent of total billed charges","16.8% of total billed charges",227,50,,181.60,,,0,"percent of total billed charges","50% of total billed charges",375,82.6,,300.00,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.27,16.8,,61.02,,,0,"percent of total billed charges","16.8% of total billed charges",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",69.46,454,
"STERI DRAPE 2045",491300,CDM,270,RC,,,OUTPATIENT,,,33,21.45,,29.04,88,,23.23,,,0,"percent of total billed charges","88% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,17.304,,4.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.79,63,,16.63,,,0,"percent of total billed charges","63% of total billed charges",5.05,15.3,,4.04,,,0,"percent of total billed charges","15.3% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",22.77,69,,,,,0,"fee schedule","69% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.41,61.85,,16.33,,,0,"percent of total billed charges","61.5% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",10.63,32.2,,8.50,,,0,"percent of total billed charges","32.2% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.65,17.136,,4.52,,,0,"percent of total billed charges","17.136% of total billed charges",7.21,21.84,,5.77,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.44,37.7,,9.95,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25.74,78,,20.59,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",5.05,33,
"STERILIZATION INTEGRATOR",491305,CDM,270,RC,,,OUTPATIENT,,,316,205.4,,278.08,88,,222.46,,,0,"percent of total billed charges","88% of total billed charges",158,50,,126.40,,,0,"percent of total billed charges","50% of total billed charges",53.09,16.8,,42.47,,,0,"percent of total billed charges","16.8% of total billed charges",316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54.68,17.304,,43.74,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",199.08,63,,159.26,,,0,"percent of total billed charges","63% of total billed charges",48.35,15.3,,38.68,,,0,"percent of total billed charges","15.3% of total billed charges",53.09,16.8,,42.47,,,0,"percent of total billed charges","16.8% of total billed charges",218.04,69,,,,,0,"fee schedule","69% of total billed charges",316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",195.45,61.85,,156.36,,,0,"percent of total billed charges","61.5% of total billed charges",53.09,16.8,,42.47,,,0,"percent of total billed charges","16.8% of total billed charges",158,50,,126.40,,,0,"percent of total billed charges","50% of total billed charges",101.75,32.2,,81.40,,,0,"percent of total billed charges","32.2% of total billed charges",53.09,16.8,,42.47,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",54.15,17.136,,43.32,,,0,"percent of total billed charges","17.136% of total billed charges",69.01,21.84,,55.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",119.13,37.7,,95.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",246.48,78,,197.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.02,82.6,,208.82,,,0,"percent of total billed charges","82.6% of total billed charges",53.09,16.8,,42.47,,,0,"percent of total billed charges","16.8% of total billed charges",158,50,,126.40,,,0,"percent of total billed charges","50% of total billed charges",261.02,82.6,,208.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.09,16.8,,42.47,,,0,"percent of total billed charges","16.8% of total billed charges",316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",48.35,316,
"STERILE SLEEVE",491303,CDM,272,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"STERI DRAPE 1071",491299,CDM,270,RC,,,OUTPATIENT,,,32,20.8,,28.16,88,,22.53,,,0,"percent of total billed charges","88% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.54,17.304,,4.43,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.16,63,,16.13,,,0,"percent of total billed charges","63% of total billed charges",4.9,15.3,,3.92,,,0,"percent of total billed charges","15.3% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",22.08,69,,,,,0,"fee schedule","69% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.79,61.85,,15.83,,,0,"percent of total billed charges","61.5% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",10.3,32.2,,8.24,,,0,"percent of total billed charges","32.2% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.48,17.136,,4.38,,,0,"percent of total billed charges","17.136% of total billed charges",6.99,21.84,,5.59,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.96,78,,19.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",4.9,32,
"STERIS NEW AUTOCLAVE PRINTER PAPER",491306,CDM,270,RC,,,OUTPATIENT,,,34,22.1,,29.92,88,,23.94,,,0,"percent of total billed charges","88% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.88,17.304,,4.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.42,63,,17.14,,,0,"percent of total billed charges","63% of total billed charges",5.2,15.3,,4.16,,,0,"percent of total billed charges","15.3% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",23.46,69,,,,,0,"fee schedule","69% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.03,61.85,,16.82,,,0,"percent of total billed charges","61.5% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",10.95,32.2,,8.76,,,0,"percent of total billed charges","32.2% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.83,17.136,,4.66,,,0,"percent of total billed charges","17.136% of total billed charges",7.43,21.84,,5.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.82,37.7,,10.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.52,78,,21.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",5.2,34,
"STERIS OLD AUTOCLAVE PRINTER PAPER",491307,CDM,270,RC,,,OUTPATIENT,,,58,37.7,,51.04,88,,40.83,,,0,"percent of total billed charges","88% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.04,17.304,,8.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.54,63,,29.23,,,0,"percent of total billed charges","63% of total billed charges",8.87,15.3,,7.10,,,0,"percent of total billed charges","15.3% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",40.02,69,,,,,0,"fee schedule","69% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.87,61.85,,28.70,,,0,"percent of total billed charges","61.5% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",18.68,32.2,,14.94,,,0,"percent of total billed charges","32.2% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.94,17.136,,7.95,,,0,"percent of total billed charges","17.136% of total billed charges",12.67,21.84,,10.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.87,37.7,,17.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",45.24,78,,36.19,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",8.87,58,
"STERIS WASHER PRINTER PAPER",491309,CDM,270,RC,,,OUTPATIENT,,,76,49.4,,66.88,88,,53.50,,,0,"percent of total billed charges","88% of total billed charges",38,50,,30.40,,,0,"percent of total billed charges","50% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.15,17.304,,10.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.88,63,,38.30,,,0,"percent of total billed charges","63% of total billed charges",11.63,15.3,,9.30,,,0,"percent of total billed charges","15.3% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",52.44,69,,,,,0,"fee schedule","69% of total billed charges",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.01,61.85,,37.61,,,0,"percent of total billed charges","61.5% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",38,50,,30.40,,,0,"percent of total billed charges","50% of total billed charges",24.47,32.2,,19.58,,,0,"percent of total billed charges","32.2% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.02,17.136,,10.42,,,0,"percent of total billed charges","17.136% of total billed charges",16.6,21.84,,13.28,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.65,37.7,,22.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",59.28,78,,47.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.78,82.6,,50.22,,,0,"percent of total billed charges","82.6% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",38,50,,30.40,,,0,"percent of total billed charges","50% of total billed charges",62.78,82.6,,50.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",11.63,76,
"STERILLIUM RUB 1000ML SURGICAL HAND SPRAY",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"STERILIT DRIP FEED OILER",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"STERILE WATER, INHALATION 1000ML",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,26,16.9,,22.88,88,,18.30,,,0,"percent of total billed charges","88% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.5,17.304,,3.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.38,63,,13.10,,,0,"percent of total billed charges","63% of total billed charges",3.98,15.3,,3.18,,,0,"percent of total billed charges","15.3% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",17.94,69,,,,,0,"fee schedule","69% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.08,61.85,,12.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",8.37,32.2,,6.70,,,0,"percent of total billed charges","32.2% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.46,17.136,,3.57,,,0,"percent of total billed charges","17.136% of total billed charges",5.68,21.84,,4.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.8,37.7,,7.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.28,78,,16.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",3.98,26,
"STERILIZATION RECORD ENVELOPES 9X12",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"STERILE LUBRICATING JELLY",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"STERI-STRIP 1 X 5",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"STETHOSCOPE ESOPHAGEAL 24 FR.",185997,CDM,272,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.9,61.85,,7.92,,,0,"percent of total billed charges","61.5% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"STETHOSCOPE ESOPHAGEAL 18 FR.",185996,CDM,272,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"STETHOSCOPE ESOPHAGEAL W/TEMP SNSR 400 SERIES 12F",157309,CDM,272,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"STICK TIGERWIRE #2",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"STICK BITE",12017,CDM,270,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"STIFF SNARE 15MM",491313,CDM,270,RC,,,OUTPATIENT,,,94,61.1,,82.72,88,,66.18,,,0,"percent of total billed charges","88% of total billed charges",47,50,,37.60,,,0,"percent of total billed charges","50% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.27,17.304,,13.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.22,63,,47.38,,,0,"percent of total billed charges","63% of total billed charges",14.38,15.3,,11.50,,,0,"percent of total billed charges","15.3% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",64.86,69,,,,,0,"fee schedule","69% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.14,61.85,,46.51,,,0,"percent of total billed charges","61.5% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",47,50,,37.60,,,0,"percent of total billed charges","50% of total billed charges",30.27,32.2,,24.22,,,0,"percent of total billed charges","32.2% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.11,17.136,,12.89,,,0,"percent of total billed charges","17.136% of total billed charges",20.53,21.84,,16.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.44,37.7,,28.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",73.32,78,,58.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",47,50,,37.60,,,0,"percent of total billed charges","50% of total billed charges",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",14.38,94,
"STIMULATOR NERVE PRASS STD MONO W/PROTECTED LEAD HANDLE",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"STIRRUP STRAP",491316,CDM,270,RC,,,OUTPATIENT,,,26,16.9,,22.88,88,,18.30,,,0,"percent of total billed charges","88% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.5,17.304,,3.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.38,63,,13.10,,,0,"percent of total billed charges","63% of total billed charges",3.98,15.3,,3.18,,,0,"percent of total billed charges","15.3% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",17.94,69,,,,,0,"fee schedule","69% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.08,61.85,,12.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",8.37,32.2,,6.70,,,0,"percent of total billed charges","32.2% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.46,17.136,,3.57,,,0,"percent of total billed charges","17.136% of total billed charges",5.68,21.84,,4.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.8,37.7,,7.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.28,78,,16.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",3.98,26,
"STOCKING TED KNEE XL REG",36369,CDM,270,RC,,,OUTPATIENT,,,31,20.15,,27.28,88,,21.82,,,0,"percent of total billed charges","88% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.36,17.304,,4.29,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.53,63,,15.62,,,0,"percent of total billed charges","63% of total billed charges",4.74,15.3,,3.79,,,0,"percent of total billed charges","15.3% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",21.39,69,,,,,0,"fee schedule","69% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.17,61.85,,15.34,,,0,"percent of total billed charges","61.5% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",9.98,32.2,,7.98,,,0,"percent of total billed charges","32.2% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.31,17.136,,4.25,,,0,"percent of total billed charges","17.136% of total billed charges",6.77,21.84,,5.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.69,37.7,,9.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.18,78,,19.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.61,82.6,,20.49,,,0,"percent of total billed charges","82.6% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",25.61,82.6,,20.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",4.74,31,
"STOCKING TED XL REG W/BELT",12048,CDM,270,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"STOCKING TED KNEE SM LONG",89481,CDM,270,RC,,,OUTPATIENT,,,31,20.15,,27.28,88,,21.82,,,0,"percent of total billed charges","88% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.36,17.304,,4.29,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.53,63,,15.62,,,0,"percent of total billed charges","63% of total billed charges",4.74,15.3,,3.79,,,0,"percent of total billed charges","15.3% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",21.39,69,,,,,0,"fee schedule","69% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.17,61.85,,15.34,,,0,"percent of total billed charges","61.5% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",9.98,32.2,,7.98,,,0,"percent of total billed charges","32.2% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.31,17.136,,4.25,,,0,"percent of total billed charges","17.136% of total billed charges",6.77,21.84,,5.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.69,37.7,,9.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.18,78,,19.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.61,82.6,,20.49,,,0,"percent of total billed charges","82.6% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",25.61,82.6,,20.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",4.74,31,
"STOCKING TED THIGH MED REG",11862,CDM,270,RC,,,OUTPATIENT,,,443,287.95,,389.84,88,,311.87,,,0,"percent of total billed charges","88% of total billed charges",221.5,50,,177.20,,,0,"percent of total billed charges","50% of total billed charges",74.42,16.8,,59.54,,,0,"percent of total billed charges","16.8% of total billed charges",443,100,,354.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.66,17.304,,61.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",279.09,63,,223.27,,,0,"percent of total billed charges","63% of total billed charges",67.78,15.3,,54.22,,,0,"percent of total billed charges","15.3% of total billed charges",74.42,16.8,,59.54,,,0,"percent of total billed charges","16.8% of total billed charges",305.67,69,,,,,0,"fee schedule","69% of total billed charges",443,100,,354.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",443,100,,354.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",443,100,,354.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",274,61.85,,219.20,,,0,"percent of total billed charges","61.5% of total billed charges",74.42,16.8,,59.54,,,0,"percent of total billed charges","16.8% of total billed charges",221.5,50,,177.20,,,0,"percent of total billed charges","50% of total billed charges",142.65,32.2,,114.12,,,0,"percent of total billed charges","32.2% of total billed charges",74.42,16.8,,59.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.91,17.136,,60.73,,,0,"percent of total billed charges","17.136% of total billed charges",96.75,21.84,,77.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",167.01,37.7,,133.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",345.54,78,,276.43,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.92,82.6,,292.74,,,0,"percent of total billed charges","82.6% of total billed charges",74.42,16.8,,59.54,,,0,"percent of total billed charges","16.8% of total billed charges",221.5,50,,177.20,,,0,"percent of total billed charges","50% of total billed charges",365.92,82.6,,292.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.42,16.8,,59.54,,,0,"percent of total billed charges","16.8% of total billed charges",443,100,,354.40,,,0,"percent of total billed charges","100% of total billed charges",67.78,443,
"STOCKING TED KNEE LG REG",36368,CDM,270,RC,,,OUTPATIENT,,,533,346.45,,469.04,88,,375.23,,,0,"percent of total billed charges","88% of total billed charges",266.5,50,,213.20,,,0,"percent of total billed charges","50% of total billed charges",89.54,16.8,,71.63,,,0,"percent of total billed charges","16.8% of total billed charges",533,100,,426.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.23,17.304,,73.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",335.79,63,,268.63,,,0,"percent of total billed charges","63% of total billed charges",81.55,15.3,,65.24,,,0,"percent of total billed charges","15.3% of total billed charges",89.54,16.8,,71.63,,,0,"percent of total billed charges","16.8% of total billed charges",367.77,69,,,,,0,"fee schedule","69% of total billed charges",533,100,,426.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",533,100,,426.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",533,100,,426.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",329.66,61.85,,263.73,,,0,"percent of total billed charges","61.5% of total billed charges",89.54,16.8,,71.63,,,0,"percent of total billed charges","16.8% of total billed charges",266.5,50,,213.20,,,0,"percent of total billed charges","50% of total billed charges",171.63,32.2,,137.30,,,0,"percent of total billed charges","32.2% of total billed charges",89.54,16.8,,71.63,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.33,17.136,,73.06,,,0,"percent of total billed charges","17.136% of total billed charges",116.41,21.84,,93.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",200.94,37.7,,160.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",415.74,78,,332.59,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",440.26,82.6,,352.21,,,0,"percent of total billed charges","82.6% of total billed charges",89.54,16.8,,71.63,,,0,"percent of total billed charges","16.8% of total billed charges",266.5,50,,213.20,,,0,"percent of total billed charges","50% of total billed charges",440.26,82.6,,352.21,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.54,16.8,,71.63,,,0,"percent of total billed charges","16.8% of total billed charges",533,100,,426.40,,,0,"percent of total billed charges","100% of total billed charges",81.55,533,
"STOCKINETTE TUBULAR 6IN X 25 YD",151801,CDM,270,RC,,,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",47.5,50,,38.00,,,0,"percent of total billed charges","50% of total billed charges",15.96,16.8,,12.77,,,0,"percent of total billed charges","16.8% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.44,17.304,,13.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",15.96,16.8,,12.77,,,0,"percent of total billed charges","16.8% of total billed charges",65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.76,61.85,,47.01,,,0,"percent of total billed charges","61.5% of total billed charges",15.96,16.8,,12.77,,,0,"percent of total billed charges","16.8% of total billed charges",47.5,50,,38.00,,,0,"percent of total billed charges","50% of total billed charges",30.59,32.2,,24.47,,,0,"percent of total billed charges","32.2% of total billed charges",15.96,16.8,,12.77,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.28,17.136,,13.02,,,0,"percent of total billed charges","17.136% of total billed charges",20.75,21.84,,16.60,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",15.96,16.8,,12.77,,,0,"percent of total billed charges","16.8% of total billed charges",47.5,50,,38.00,,,0,"percent of total billed charges","50% of total billed charges",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.96,16.8,,12.77,,,0,"percent of total billed charges","16.8% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,95,
"STOCKINETTE TUBULAR 4IN 25YD",169635,CDM,270,RC,,,OUTPATIENT,,,54,35.1,,47.52,88,,38.02,,,0,"percent of total billed charges","88% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.34,17.304,,7.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.02,63,,27.22,,,0,"percent of total billed charges","63% of total billed charges",8.26,15.3,,6.61,,,0,"percent of total billed charges","15.3% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",37.26,69,,,,,0,"fee schedule","69% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.4,61.85,,26.72,,,0,"percent of total billed charges","61.5% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",17.39,32.2,,13.91,,,0,"percent of total billed charges","32.2% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.25,17.136,,7.40,,,0,"percent of total billed charges","17.136% of total billed charges",11.79,21.84,,9.43,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.36,37.7,,16.29,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",42.12,78,,33.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.6,82.6,,35.68,,,0,"percent of total billed charges","82.6% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",44.6,82.6,,35.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",8.26,54,
"STOCKINETTE IMPERVIOUS LG",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"STOCKINETTE IMPERVIOUS MD 9",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"STOCKINETTE TUBULAR 3IN X 25 YD NON-STER",157328,CDM,270,RC,,,OUTPATIENT,,,49,31.85,,43.12,88,,34.50,,,0,"percent of total billed charges","88% of total billed charges",24.5,50,,19.60,,,0,"percent of total billed charges","50% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.48,17.304,,6.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.87,63,,24.70,,,0,"percent of total billed charges","63% of total billed charges",7.5,15.3,,6.00,,,0,"percent of total billed charges","15.3% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",33.81,69,,,,,0,"fee schedule","69% of total billed charges",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.31,61.85,,24.25,,,0,"percent of total billed charges","61.5% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",24.5,50,,19.60,,,0,"percent of total billed charges","50% of total billed charges",15.78,32.2,,12.62,,,0,"percent of total billed charges","32.2% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.4,17.136,,6.72,,,0,"percent of total billed charges","17.136% of total billed charges",10.7,21.84,,8.56,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.47,37.7,,14.78,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.22,78,,30.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.47,82.6,,32.38,,,0,"percent of total billed charges","82.6% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",24.5,50,,19.60,,,0,"percent of total billed charges","50% of total billed charges",40.47,82.6,,32.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",7.5,49,
"STOCKING TED THIGH LG LONG",165710,CDM,270,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"STOCKINETTE 4 STERILE",104478,CDM,272,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"STOCKINETTE 6 STERILE",104479,CDM,272,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.9,61.85,,7.92,,,0,"percent of total billed charges","61.5% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"STOCKINETTE TUBULAR 2IN X 25YD",12135,CDM,270,RC,,,OUTPATIENT,,,44,28.6,,38.72,88,,30.98,,,0,"percent of total billed charges","88% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.61,17.304,,6.09,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.72,63,,22.18,,,0,"percent of total billed charges","63% of total billed charges",6.73,15.3,,5.38,,,0,"percent of total billed charges","15.3% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",30.36,69,,,,,0,"fee schedule","69% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.21,61.85,,21.77,,,0,"percent of total billed charges","61.5% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",14.17,32.2,,11.34,,,0,"percent of total billed charges","32.2% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.54,17.136,,6.03,,,0,"percent of total billed charges","17.136% of total billed charges",9.61,21.84,,7.69,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.59,37.7,,13.27,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.32,78,,27.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",6.73,44,
"STOCKINETTE TUBULAR 3IN",12136,CDM,270,RC,,,OUTPATIENT,,,52,33.8,,45.76,88,,36.61,,,0,"percent of total billed charges","88% of total billed charges",26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,17.304,,7.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.76,63,,26.21,,,0,"percent of total billed charges","63% of total billed charges",7.96,15.3,,6.37,,,0,"percent of total billed charges","15.3% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",35.88,69,,,,,0,"fee schedule","69% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.16,61.85,,25.73,,,0,"percent of total billed charges","61.5% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",16.74,32.2,,13.39,,,0,"percent of total billed charges","32.2% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.91,17.136,,7.13,,,0,"percent of total billed charges","17.136% of total billed charges",11.36,21.84,,9.09,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.6,37.7,,15.68,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",40.56,78,,32.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",7.96,52,
"STOCKINETTE TUBULAR 4IN",12133,CDM,270,RC,,,OUTPATIENT,,,66,42.9,,58.08,88,,46.46,,,0,"percent of total billed charges","88% of total billed charges",33,50,,26.40,,,0,"percent of total billed charges","50% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.42,17.304,,9.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.58,63,,33.26,,,0,"percent of total billed charges","63% of total billed charges",10.1,15.3,,8.08,,,0,"percent of total billed charges","15.3% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",45.54,69,,,,,0,"fee schedule","69% of total billed charges",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.82,61.85,,32.66,,,0,"percent of total billed charges","61.5% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",33,50,,26.40,,,0,"percent of total billed charges","50% of total billed charges",21.25,32.2,,17.00,,,0,"percent of total billed charges","32.2% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.31,17.136,,9.05,,,0,"percent of total billed charges","17.136% of total billed charges",14.41,21.84,,11.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.88,37.7,,19.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",51.48,78,,41.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",54.52,82.6,,43.62,,,0,"percent of total billed charges","82.6% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",33,50,,26.40,,,0,"percent of total billed charges","50% of total billed charges",54.52,82.6,,43.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",10.1,66,
"STOCKING TED THIGH LG REG",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"STOCK THIGH XL REG",ORSUP0003,CDM,270,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"STOCKINETTE IMPERVIOUS STERILE 12 X 48 (LARGE)",491324,CDM,272,RC,,,OUTPATIENT,,,69,44.85,,60.72,88,,48.58,,,0,"percent of total billed charges","88% of total billed charges",34.5,50,,27.60,,,0,"percent of total billed charges","50% of total billed charges",11.59,16.8,,9.27,,,0,"percent of total billed charges","16.8% of total billed charges",69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.94,17.304,,9.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.47,63,,34.78,,,0,"percent of total billed charges","63% of total billed charges",10.56,15.3,,8.45,,,0,"percent of total billed charges","15.3% of total billed charges",11.59,16.8,,9.27,,,0,"percent of total billed charges","16.8% of total billed charges",47.61,69,,,,,0,"fee schedule","69% of total billed charges",69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.68,61.85,,34.14,,,0,"percent of total billed charges","61.5% of total billed charges",11.59,16.8,,9.27,,,0,"percent of total billed charges","16.8% of total billed charges",34.5,50,,27.60,,,0,"percent of total billed charges","50% of total billed charges",22.22,32.2,,17.78,,,0,"percent of total billed charges","32.2% of total billed charges",11.59,16.8,,9.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.82,17.136,,9.46,,,0,"percent of total billed charges","17.136% of total billed charges",15.07,21.84,,12.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.01,37.7,,20.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",53.82,78,,43.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.99,82.6,,45.59,,,0,"percent of total billed charges","82.6% of total billed charges",11.59,16.8,,9.27,,,0,"percent of total billed charges","16.8% of total billed charges",34.5,50,,27.60,,,0,"percent of total billed charges","50% of total billed charges",56.99,82.6,,45.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.59,16.8,,9.27,,,0,"percent of total billed charges","16.8% of total billed charges",69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",10.56,69,
"STOCKINETTE IMPERVIOUS STERILE 9 X 48 (MEDIUM)",491325,CDM,272,RC,,,OUTPATIENT,,,71,46.15,,62.48,88,,49.98,,,0,"percent of total billed charges","88% of total billed charges",35.5,50,,28.40,,,0,"percent of total billed charges","50% of total billed charges",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.29,17.304,,9.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.73,63,,35.78,,,0,"percent of total billed charges","63% of total billed charges",10.86,15.3,,8.69,,,0,"percent of total billed charges","15.3% of total billed charges",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",48.99,69,,,,,0,"fee schedule","69% of total billed charges",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.91,61.85,,35.13,,,0,"percent of total billed charges","61.5% of total billed charges",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",35.5,50,,28.40,,,0,"percent of total billed charges","50% of total billed charges",22.86,32.2,,18.29,,,0,"percent of total billed charges","32.2% of total billed charges",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.17,17.136,,9.74,,,0,"percent of total billed charges","17.136% of total billed charges",15.51,21.84,,12.41,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.77,37.7,,21.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",55.38,78,,44.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.65,82.6,,46.92,,,0,"percent of total billed charges","82.6% of total billed charges",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",35.5,50,,28.40,,,0,"percent of total billed charges","50% of total billed charges",58.65,82.6,,46.92,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",10.86,71,
"STOCKINETTE TUBULAR 2",491326,CDM,270,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"STOCKINETTE TUBULAR 3",491327,CDM,270,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"STOMA POWDER",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"STONE RETRIEVAL BASKET ZEROTIP",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"STONE EXT HELICAL 2.8FR 4-WIRE",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"STONE EXTRACTOR 4-WIRE",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"STOPCOCK 3WAY LG BORE W/ROTATING MALE LUER LOCK",169671,CDM,270,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"STOPCOCK 3-3 WAY W/MLL",187968,CDM,270,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"STOPCOCK 3-WAY",491331,CDM,270,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"STOPCOCK 4 WAY (BACK UP)",491332,CDM,270,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"STOPCOCK HIGH PRESSURE 1200PSI",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"STRATTICE CONTOUR 2",ORSUP0063,CDM,272,RC,,,OUTPATIENT,,,14193,9225.45,,12489.84,88,,9991.87,,,0,"percent of total billed charges","88% of total billed charges",7096.5,50,,5677.20,,,0,"percent of total billed charges","50% of total billed charges",2384.42,16.8,,1907.54,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2455.96,17.304,,1964.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8941.59,63,,7153.27,,,0,"percent of total billed charges","63% of total billed charges",2171.53,15.3,,1737.22,,,0,"percent of total billed charges","15.3% of total billed charges",2384.42,16.8,,1907.54,,,0,"percent of total billed charges","16.8% of total billed charges",9793.17,69,,,,,0,"fee schedule","69% of total billed charges",14193,100,,11354.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14193,100,,11354.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14193,100,,11354.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8778.37,61.85,,7022.70,,,0,"percent of total billed charges","61.5% of total billed charges",2384.42,16.8,,1907.54,,,0,"percent of total billed charges","16.8% of total billed charges",7096.5,50,,5677.20,,,0,"percent of total billed charges","50% of total billed charges",4570.15,32.2,,3656.12,,,0,"percent of total billed charges","32.2% of total billed charges",2384.42,16.8,,1907.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2432.11,17.136,,1945.69,,,0,"percent of total billed charges","17.136% of total billed charges",3099.75,21.84,,2479.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5350.76,37.7,,4280.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11070.54,78,,8856.43,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11723.42,82.6,,9378.74,,,0,"percent of total billed charges","82.6% of total billed charges",2384.42,16.8,,1907.54,,,0,"percent of total billed charges","16.8% of total billed charges",7096.5,50,,5677.20,,,0,"percent of total billed charges","50% of total billed charges",11723.42,82.6,,9378.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2384.42,16.8,,1907.54,,,0,"percent of total billed charges","16.8% of total billed charges",14193,100,,11354.40,,,0,"percent of total billed charges","100% of total billed charges",2171.53,14193,
"STRAINER CALCULI",148479,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"STRAP TABLE PATIENT RESTRAINT",ORSUP0021,CDM,270,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"STRAP TAMPER RESISTANT SOFTTOUCH INFANT",ORSUP0020,CDM,270,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"STRAIGHT CATH 65CM 451-501V5 CORDIS",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"STRATAFIX 2-0 9",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"STRECK CELL-CHEX BODY FLUID CONTROL",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"STREPTOCOCCUS PYOGENES GROUP A",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"STREPTOCOCCUS PYOGENES ATCC 19615",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"STREPTOCOCCUS PNEUMONIAE ATCC 6305 CULTI LOOPS",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"STREP THERMOPHILUS ATCC CULTI LOOPS 19258",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"STREP GROUP A LATEX",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"STREP PATHODX POSITIVE CTL 3ML",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"STREP PNEUMO SENS (AST-74",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"STRIP  BETA-TCP  50MM X 25MM X 3MM STERILE 07.801.100.99S",ORSUP0022,CDM,278,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",919.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.7% of total billed charges",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",998.69,33.9,,798.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"STRIP INDICATOR CHEMICAL STERRAD",151487,CDM,270,RC,,,OUTPATIENT,,,175,113.75,,154,88,,123.20,,,0,"percent of total billed charges","88% of total billed charges",87.5,50,,70.00,,,0,"percent of total billed charges","50% of total billed charges",29.4,16.8,,23.52,,,0,"percent of total billed charges","16.8% of total billed charges",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.28,17.304,,24.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.25,63,,88.20,,,0,"percent of total billed charges","63% of total billed charges",26.78,15.3,,21.42,,,0,"percent of total billed charges","15.3% of total billed charges",29.4,16.8,,23.52,,,0,"percent of total billed charges","16.8% of total billed charges",120.75,69,,,,,0,"fee schedule","69% of total billed charges",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",108.24,61.85,,86.59,,,0,"percent of total billed charges","61.5% of total billed charges",29.4,16.8,,23.52,,,0,"percent of total billed charges","16.8% of total billed charges",87.5,50,,70.00,,,0,"percent of total billed charges","50% of total billed charges",56.35,32.2,,45.08,,,0,"percent of total billed charges","32.2% of total billed charges",29.4,16.8,,23.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.99,17.136,,23.99,,,0,"percent of total billed charges","17.136% of total billed charges",38.22,21.84,,30.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",65.98,37.7,,52.78,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",136.5,78,,109.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",144.55,82.6,,115.64,,,0,"percent of total billed charges","82.6% of total billed charges",29.4,16.8,,23.52,,,0,"percent of total billed charges","16.8% of total billed charges",87.5,50,,70.00,,,0,"percent of total billed charges","50% of total billed charges",144.55,82.6,,115.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.4,16.8,,23.52,,,0,"percent of total billed charges","16.8% of total billed charges",175,100,,140.00,,,0,"percent of total billed charges","100% of total billed charges",26.78,175,
"STRIP STERI 15 IODOPHOR REIN",187244,CDM,272,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"STRIP PRECISION XCEED PRO G3CH",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"STRIPS RAPIDCIDE TEST",289499,CDM,270,RC,,,OUTPATIENT,,,343,222.95,,301.84,88,,241.47,,,0,"percent of total billed charges","88% of total billed charges",171.5,50,,137.20,,,0,"percent of total billed charges","50% of total billed charges",57.62,16.8,,46.10,,,0,"percent of total billed charges","16.8% of total billed charges",343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.35,17.304,,47.48,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",216.09,63,,172.87,,,0,"percent of total billed charges","63% of total billed charges",52.48,15.3,,41.98,,,0,"percent of total billed charges","15.3% of total billed charges",57.62,16.8,,46.10,,,0,"percent of total billed charges","16.8% of total billed charges",236.67,69,,,,,0,"fee schedule","69% of total billed charges",343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",212.15,61.85,,169.72,,,0,"percent of total billed charges","61.5% of total billed charges",57.62,16.8,,46.10,,,0,"percent of total billed charges","16.8% of total billed charges",171.5,50,,137.20,,,0,"percent of total billed charges","50% of total billed charges",110.45,32.2,,88.36,,,0,"percent of total billed charges","32.2% of total billed charges",57.62,16.8,,46.10,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.78,17.136,,47.02,,,0,"percent of total billed charges","17.136% of total billed charges",74.91,21.84,,59.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",129.31,37.7,,103.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",267.54,78,,214.03,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",283.32,82.6,,226.66,,,0,"percent of total billed charges","82.6% of total billed charges",57.62,16.8,,46.10,,,0,"percent of total billed charges","16.8% of total billed charges",171.5,50,,137.20,,,0,"percent of total billed charges","50% of total billed charges",283.32,82.6,,226.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.62,16.8,,46.10,,,0,"percent of total billed charges","16.8% of total billed charges",343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",52.48,343,
"STRIPS CALIBRATION",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"STRYKER HOOD SWEAT BANDS",491335,CDM,270,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"STRYK SAW BLADE 6125-127-090",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"STRYKER PRINTER PAPER SEPC-110",491337,CDM,270,RC,,,OUTPATIENT,,,1327,862.55,,1167.76,88,,934.21,,,0,"percent of total billed charges","88% of total billed charges",663.5,50,,530.80,,,0,"percent of total billed charges","50% of total billed charges",222.94,16.8,,178.35,,,0,"percent of total billed charges","16.8% of total billed charges",1327,100,,1061.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.62,17.304,,183.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",836.01,63,,668.81,,,0,"percent of total billed charges","63% of total billed charges",203.03,15.3,,162.42,,,0,"percent of total billed charges","15.3% of total billed charges",222.94,16.8,,178.35,,,0,"percent of total billed charges","16.8% of total billed charges",915.63,69,,,,,0,"fee schedule","69% of total billed charges",1327,100,,1061.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1327,100,,1061.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1327,100,,1061.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",820.75,61.85,,656.60,,,0,"percent of total billed charges","61.5% of total billed charges",222.94,16.8,,178.35,,,0,"percent of total billed charges","16.8% of total billed charges",663.5,50,,530.80,,,0,"percent of total billed charges","50% of total billed charges",427.29,32.2,,341.83,,,0,"percent of total billed charges","32.2% of total billed charges",222.94,16.8,,178.35,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.39,17.136,,181.91,,,0,"percent of total billed charges","17.136% of total billed charges",289.82,21.84,,231.86,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",500.28,37.7,,400.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1035.06,78,,828.05,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.1,82.6,,876.88,,,0,"percent of total billed charges","82.6% of total billed charges",222.94,16.8,,178.35,,,0,"percent of total billed charges","16.8% of total billed charges",663.5,50,,530.80,,,0,"percent of total billed charges","50% of total billed charges",1096.1,82.6,,876.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",222.94,16.8,,178.35,,,0,"percent of total billed charges","16.8% of total billed charges",1327,100,,1061.60,,,0,"percent of total billed charges","100% of total billed charges",203.03,1327,
"STRYKER HOOD T-5/FACE SHIELD",491336,CDM,270,RC,,,OUTPATIENT,,,358,232.7,,315.04,88,,252.03,,,0,"percent of total billed charges","88% of total billed charges",179,50,,143.20,,,0,"percent of total billed charges","50% of total billed charges",60.14,16.8,,48.11,,,0,"percent of total billed charges","16.8% of total billed charges",358,100,,286.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.95,17.304,,49.56,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",225.54,63,,180.43,,,0,"percent of total billed charges","63% of total billed charges",54.77,15.3,,43.82,,,0,"percent of total billed charges","15.3% of total billed charges",60.14,16.8,,48.11,,,0,"percent of total billed charges","16.8% of total billed charges",247.02,69,,,,,0,"fee schedule","69% of total billed charges",358,100,,286.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",358,100,,286.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",358,100,,286.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.42,61.85,,177.14,,,0,"percent of total billed charges","61.5% of total billed charges",60.14,16.8,,48.11,,,0,"percent of total billed charges","16.8% of total billed charges",179,50,,143.20,,,0,"percent of total billed charges","50% of total billed charges",115.28,32.2,,92.22,,,0,"percent of total billed charges","32.2% of total billed charges",60.14,16.8,,48.11,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.35,17.136,,49.08,,,0,"percent of total billed charges","17.136% of total billed charges",78.19,21.84,,62.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",134.97,37.7,,107.98,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",279.24,78,,223.39,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.71,82.6,,236.57,,,0,"percent of total billed charges","82.6% of total billed charges",60.14,16.8,,48.11,,,0,"percent of total billed charges","16.8% of total billed charges",179,50,,143.20,,,0,"percent of total billed charges","50% of total billed charges",295.71,82.6,,236.57,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.14,16.8,,48.11,,,0,"percent of total billed charges","16.8% of total billed charges",358,100,,286.40,,,0,"percent of total billed charges","100% of total billed charges",54.77,358,
"STRYKER BONE DRILL",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"STRYKER ENDO AIR+",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2266,1472.9,,1994.08,88,,1595.26,,,0,"percent of total billed charges","88% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",392.11,17.304,,313.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1427.58,63,,1142.06,,,0,"percent of total billed charges","63% of total billed charges",346.7,15.3,,277.36,,,0,"percent of total billed charges","15.3% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1563.54,69,,,,,0,"fee schedule","69% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1401.52,61.85,,1121.22,,,0,"percent of total billed charges","61.5% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",729.65,32.2,,583.72,,,0,"percent of total billed charges","32.2% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",388.3,17.136,,310.64,,,0,"percent of total billed charges","17.136% of total billed charges",494.89,21.84,,395.91,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",854.28,37.7,,683.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1767.48,78,,1413.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1871.72,82.6,,1497.38,,,0,"percent of total billed charges","82.6% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",1871.72,82.6,,1497.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",346.7,2266,
"STYLET INTUBATION 14FR SATIN SLIP",157379,CDM,272,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"STYLET INTUBATING 14FR",322960,CDM,272,RC,,,OUTPATIENT,,,29,18.85,,25.52,88,,20.42,,,0,"percent of total billed charges","88% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.02,17.304,,4.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.27,63,,14.62,,,0,"percent of total billed charges","63% of total billed charges",4.44,15.3,,3.55,,,0,"percent of total billed charges","15.3% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",20.01,69,,,,,0,"fee schedule","69% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.94,61.85,,14.35,,,0,"percent of total billed charges","61.5% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",9.34,32.2,,7.47,,,0,"percent of total billed charges","32.2% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.97,17.136,,3.98,,,0,"percent of total billed charges","17.136% of total billed charges",6.33,21.84,,5.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.93,37.7,,8.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,78,,18.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",4.44,29,
"STYLET TUBE ENDOTRACHEAL 6FR 2.5-4.5 OD",419618,CDM,270,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"STYLET CATH STRAIGHTENING 61CM",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"STYLET 14FR",491338,CDM,270,RC,,,OUTPATIENT,,,22,14.3,,19.36,88,,15.49,,,0,"percent of total billed charges","88% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.81,17.304,,3.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.86,63,,11.09,,,0,"percent of total billed charges","63% of total billed charges",3.37,15.3,,2.70,,,0,"percent of total billed charges","15.3% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",15.18,69,,,,,0,"fee schedule","69% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.61,61.85,,10.89,,,0,"percent of total billed charges","61.5% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",7.08,32.2,,5.66,,,0,"percent of total billed charges","32.2% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.77,17.136,,3.02,,,0,"percent of total billed charges","17.136% of total billed charges",4.8,21.84,,3.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.29,37.7,,6.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.16,78,,13.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",3.37,22,
"SUBSTITUTE BNGF GRFTN + DBM PST SYR 1ML",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"SUCTION POOLE TIP INSTRUMENT",54677,CDM,270,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"SUCTION/IRRIGATOR ESCPC TBG W/TIP DISP",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SUCTION MAT, LOW PROFILE 50 INCH X 34 INCH",422030,CDM,272,RC,,,OUTPATIENT,,,449,291.85,,395.12,88,,316.10,,,0,"percent of total billed charges","88% of total billed charges",224.5,50,,179.60,,,0,"percent of total billed charges","50% of total billed charges",75.43,16.8,,60.34,,,0,"percent of total billed charges","16.8% of total billed charges",449,100,,359.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.69,17.304,,62.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",282.87,63,,226.30,,,0,"percent of total billed charges","63% of total billed charges",68.7,15.3,,54.96,,,0,"percent of total billed charges","15.3% of total billed charges",75.43,16.8,,60.34,,,0,"percent of total billed charges","16.8% of total billed charges",309.81,69,,,,,0,"fee schedule","69% of total billed charges",449,100,,359.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",449,100,,359.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",449,100,,359.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",277.71,61.85,,222.17,,,0,"percent of total billed charges","61.5% of total billed charges",75.43,16.8,,60.34,,,0,"percent of total billed charges","16.8% of total billed charges",224.5,50,,179.60,,,0,"percent of total billed charges","50% of total billed charges",144.58,32.2,,115.66,,,0,"percent of total billed charges","32.2% of total billed charges",75.43,16.8,,60.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.94,17.136,,61.55,,,0,"percent of total billed charges","17.136% of total billed charges",98.06,21.84,,78.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",169.27,37.7,,135.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",350.22,78,,280.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.87,82.6,,296.70,,,0,"percent of total billed charges","82.6% of total billed charges",75.43,16.8,,60.34,,,0,"percent of total billed charges","16.8% of total billed charges",224.5,50,,179.60,,,0,"percent of total billed charges","50% of total billed charges",370.87,82.6,,296.70,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.43,16.8,,60.34,,,0,"percent of total billed charges","16.8% of total billed charges",449,100,,359.20,,,0,"percent of total billed charges","100% of total billed charges",68.7,449,
"SUCTION IRRIGATOR XL",ORSUP0013,CDM,270,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SUCTION IRRIGATOR STRYKER",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SUCTION TIP POOLE",491347,CDM,270,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.95,61.85,,3.96,,,0,"percent of total billed charges","61.5% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"SUCTION CANN 1500CC WALL",491341,CDM,272,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"SUCTION CANISTER 1500ML",491340,CDM,270,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"SUCTION TIP ARGYLE",491346,CDM,270,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"SUCTION TIP YANKAUER",491348,CDM,270,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
SULFOLYSR,ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"SUPER-ATRAU RAPTOR GRASPER",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SUPER-ATRAU GRASPERS FENESTRAT",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SUPERFROST MICROSCOPE SLIDES",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SUPPORTER ADULT LARGER",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SUPPORTER ADULT MEDIUM",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SUPPORTER ATHLETIC MEDIUM",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SUPPORTER ATHLETIC X-LARGE",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SUPPORTER ATHLETIC SMALL",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SUPPLEMENT PROMOTE VANILLA 1500ML BTL READY TO HANG",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SUPPLEMENT PROMOTE VANILLA 1000ML BTL READY TO HANG",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SURESTEP ADD-A-FOLEY KIT",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SURE-VUE COLOR STAPH  300PK",ORSUP0013,CDM,270,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SUREPREP RAPID DRY WAND",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SUREPREP RAPID DRY WIPE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SURGICEL FIBRILLAR ABSORB HEMOSTAT 1 X 2",ORSUP0005,CDM,278,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.7% of total billed charges",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,33.9,,90.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SURGICEL ABSORBABLE HEMOSTAT 2X3",ORSUP0003,CDM,278,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.7% of total billed charges",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.14,33.9,,54.51,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"SURGIFLO WITH THROMBIN",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1030,669.5,,906.4,88,,725.12,,,0,"percent of total billed charges","88% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.23,17.304,,142.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.9,63,,519.12,,,0,"percent of total billed charges","63% of total billed charges",157.59,15.3,,126.07,,,0,"percent of total billed charges","15.3% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",710.7,69,,,,,0,"fee schedule","69% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",637.06,61.85,,509.65,,,0,"percent of total billed charges","61.5% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",331.66,32.2,,265.33,,,0,"percent of total billed charges","32.2% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.5,17.136,,141.20,,,0,"percent of total billed charges","17.136% of total billed charges",224.95,21.84,,179.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",388.31,37.7,,310.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",803.4,78,,642.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",157.59,1030,
"SURGICEL ABSORBABLE HEMOSTAT 4X8",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"SURGICAL PATTIES 1/2'' X 3''",69301,CDM,270,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"SURGI STAIN",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"SURGICEL SNOW ABS 2 X 4",ORSUP0021,CDM,270,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SURGICAL PATTIE 1 X 3",491365,CDM,270,RC,,,OUTPATIENT,,,44,28.6,,38.72,88,,30.98,,,0,"percent of total billed charges","88% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.61,17.304,,6.09,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.72,63,,22.18,,,0,"percent of total billed charges","63% of total billed charges",6.73,15.3,,5.38,,,0,"percent of total billed charges","15.3% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",30.36,69,,,,,0,"fee schedule","69% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.21,61.85,,21.77,,,0,"percent of total billed charges","61.5% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",14.17,32.2,,11.34,,,0,"percent of total billed charges","32.2% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.54,17.136,,6.03,,,0,"percent of total billed charges","17.136% of total billed charges",9.61,21.84,,7.69,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.59,37.7,,13.27,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.32,78,,27.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",6.73,44,
"SURGICAL PATTIES 1/2 X 3",491367,CDM,270,RC,,,OUTPATIENT,,,111,72.15,,97.68,88,,78.14,,,0,"percent of total billed charges","88% of total billed charges",55.5,50,,44.40,,,0,"percent of total billed charges","50% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.21,17.304,,15.37,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.93,63,,55.94,,,0,"percent of total billed charges","63% of total billed charges",16.98,15.3,,13.58,,,0,"percent of total billed charges","15.3% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",76.59,69,,,,,0,"fee schedule","69% of total billed charges",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.65,61.85,,54.92,,,0,"percent of total billed charges","61.5% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",55.5,50,,44.40,,,0,"percent of total billed charges","50% of total billed charges",35.74,32.2,,28.59,,,0,"percent of total billed charges","32.2% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.02,17.136,,15.22,,,0,"percent of total billed charges","17.136% of total billed charges",24.24,21.84,,19.39,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.85,37.7,,33.48,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",86.58,78,,69.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.69,82.6,,73.35,,,0,"percent of total billed charges","82.6% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",55.5,50,,44.40,,,0,"percent of total billed charges","50% of total billed charges",91.69,82.6,,73.35,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",16.98,111,
"SURGICAL PATTIES 1/2 X 2",491366,CDM,270,RC,,,OUTPATIENT,,,111,72.15,,97.68,88,,78.14,,,0,"percent of total billed charges","88% of total billed charges",55.5,50,,44.40,,,0,"percent of total billed charges","50% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.21,17.304,,15.37,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.93,63,,55.94,,,0,"percent of total billed charges","63% of total billed charges",16.98,15.3,,13.58,,,0,"percent of total billed charges","15.3% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",76.59,69,,,,,0,"fee schedule","69% of total billed charges",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.65,61.85,,54.92,,,0,"percent of total billed charges","61.5% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",55.5,50,,44.40,,,0,"percent of total billed charges","50% of total billed charges",35.74,32.2,,28.59,,,0,"percent of total billed charges","32.2% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.02,17.136,,15.22,,,0,"percent of total billed charges","17.136% of total billed charges",24.24,21.84,,19.39,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.85,37.7,,33.48,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",86.58,78,,69.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.69,82.6,,73.35,,,0,"percent of total billed charges","82.6% of total billed charges",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",55.5,50,,44.40,,,0,"percent of total billed charges","50% of total billed charges",91.69,82.6,,73.35,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.65,16.8,,14.92,,,0,"percent of total billed charges","16.8% of total billed charges",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",16.98,111,
"SURGEON CAP BLUE",491356,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"SURGICAL BLADE #10",491357,CDM,272,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"SURGICAL BLADE #11",491358,CDM,272,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"SURGICAL BLADE #15",491359,CDM,272,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"SURGICAL GLOVE POWDER FREE ORTHO SIZE 7.5",491360,CDM,270,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"SURGICAL GLOVE POWDER FREE ORTHO SIZE 8.5",491361,CDM,270,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"SURGICAL MASK GREEN",491362,CDM,270,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"SURGICAL MASK LIGHT  COOL",491363,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"SURGICAL MASK PURPLE",491364,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"SURGICAL SCRUB AVAGARD",491368,CDM,270,RC,,,OUTPATIENT,,,431,280.15,,379.28,88,,303.42,,,0,"percent of total billed charges","88% of total billed charges",215.5,50,,172.40,,,0,"percent of total billed charges","50% of total billed charges",72.41,16.8,,57.93,,,0,"percent of total billed charges","16.8% of total billed charges",431,100,,344.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.58,17.304,,59.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",271.53,63,,217.22,,,0,"percent of total billed charges","63% of total billed charges",65.94,15.3,,52.75,,,0,"percent of total billed charges","15.3% of total billed charges",72.41,16.8,,57.93,,,0,"percent of total billed charges","16.8% of total billed charges",297.39,69,,,,,0,"fee schedule","69% of total billed charges",431,100,,344.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",431,100,,344.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",431,100,,344.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.57,61.85,,213.26,,,0,"percent of total billed charges","61.5% of total billed charges",72.41,16.8,,57.93,,,0,"percent of total billed charges","16.8% of total billed charges",215.5,50,,172.40,,,0,"percent of total billed charges","50% of total billed charges",138.78,32.2,,111.02,,,0,"percent of total billed charges","32.2% of total billed charges",72.41,16.8,,57.93,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",73.86,17.136,,59.09,,,0,"percent of total billed charges","17.136% of total billed charges",94.13,21.84,,75.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",162.49,37.7,,129.99,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",336.18,78,,268.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",356.01,82.6,,284.81,,,0,"percent of total billed charges","82.6% of total billed charges",72.41,16.8,,57.93,,,0,"percent of total billed charges","16.8% of total billed charges",215.5,50,,172.40,,,0,"percent of total billed charges","50% of total billed charges",356.01,82.6,,284.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",72.41,16.8,,57.93,,,0,"percent of total billed charges","16.8% of total billed charges",431,100,,344.80,,,0,"percent of total billed charges","100% of total billed charges",65.94,431,
"SURGICAL SCRUB DIAL SOAP",491369,CDM,270,RC,,,OUTPATIENT,,,666,432.9,,586.08,88,,468.86,,,0,"percent of total billed charges","88% of total billed charges",333,50,,266.40,,,0,"percent of total billed charges","50% of total billed charges",111.89,16.8,,89.51,,,0,"percent of total billed charges","16.8% of total billed charges",666,100,,532.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.24,17.304,,92.19,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",419.58,63,,335.66,,,0,"percent of total billed charges","63% of total billed charges",101.9,15.3,,81.52,,,0,"percent of total billed charges","15.3% of total billed charges",111.89,16.8,,89.51,,,0,"percent of total billed charges","16.8% of total billed charges",459.54,69,,,,,0,"fee schedule","69% of total billed charges",666,100,,532.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",666,100,,532.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",666,100,,532.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",411.92,61.85,,329.54,,,0,"percent of total billed charges","61.5% of total billed charges",111.89,16.8,,89.51,,,0,"percent of total billed charges","16.8% of total billed charges",333,50,,266.40,,,0,"percent of total billed charges","50% of total billed charges",214.45,32.2,,171.56,,,0,"percent of total billed charges","32.2% of total billed charges",111.89,16.8,,89.51,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.13,17.136,,91.30,,,0,"percent of total billed charges","17.136% of total billed charges",145.45,21.84,,116.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",251.08,37.7,,200.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",519.48,78,,415.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.12,82.6,,440.10,,,0,"percent of total billed charges","82.6% of total billed charges",111.89,16.8,,89.51,,,0,"percent of total billed charges","16.8% of total billed charges",333,50,,266.40,,,0,"percent of total billed charges","50% of total billed charges",550.12,82.6,,440.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",111.89,16.8,,89.51,,,0,"percent of total billed charges","16.8% of total billed charges",666,100,,532.80,,,0,"percent of total billed charges","100% of total billed charges",101.9,666,
"SURGICEL 1 X 1",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"SURGICEL 3 X 4",ORSUP0009,CDM,270,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"SURGIFLO 8ML",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SURGIFLO ENDOSCOPIC APPLICATOR",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"SURGICUTT BLEEDING TIME",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SURGICAL TRAY CORNER PROTECTOR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SUT CAPRIO CAPTURING DEVICE",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",751.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.7% of total billed charges",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",816.99,33.9,,653.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"SUT DEVICE CAPIO DISP",ORSUP0018,CDM,278,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",605.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.7% of total billed charges",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",658.34,33.9,,526.67,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"SUT PASSER MEDIUM   9893",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SUT RETRIEVER HEWSON",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"SUT FIBERWIRE 2 T-5 36IN AR-7200",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"SUT VICRYL RAPID 4-0",188339,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SUT CTD VICRYL 3-0",149584,CDM,272,RC,,,OUTPATIENT,,,72,46.8,,63.36,88,,50.69,,,0,"percent of total billed charges","88% of total billed charges",36,50,,28.80,,,0,"percent of total billed charges","50% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.46,17.304,,9.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.36,63,,36.29,,,0,"percent of total billed charges","63% of total billed charges",11.02,15.3,,8.82,,,0,"percent of total billed charges","15.3% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",49.68,69,,,,,0,"fee schedule","69% of total billed charges",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.53,61.85,,35.62,,,0,"percent of total billed charges","61.5% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",36,50,,28.80,,,0,"percent of total billed charges","50% of total billed charges",23.18,32.2,,18.54,,,0,"percent of total billed charges","32.2% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.34,17.136,,9.87,,,0,"percent of total billed charges","17.136% of total billed charges",15.72,21.84,,12.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",27.14,37.7,,21.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",56.16,78,,44.93,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.47,82.6,,47.58,,,0,"percent of total billed charges","82.6% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",36,50,,28.80,,,0,"percent of total billed charges","50% of total billed charges",59.47,82.6,,47.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",11.02,72,
"SUT VCRL 3-0 FS-1 27IN UND  J442H",13697,CDM,272,RC,,,OUTPATIENT,,,21,13.65,,18.48,88,,14.78,,,0,"percent of total billed charges","88% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.63,17.304,,2.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.23,63,,10.58,,,0,"percent of total billed charges","63% of total billed charges",3.21,15.3,,2.57,,,0,"percent of total billed charges","15.3% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",14.49,69,,,,,0,"fee schedule","69% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.99,61.85,,10.39,,,0,"percent of total billed charges","61.5% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",6.76,32.2,,5.41,,,0,"percent of total billed charges","32.2% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.6,17.136,,2.88,,,0,"percent of total billed charges","17.136% of total billed charges",4.59,21.84,,3.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.92,37.7,,6.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.38,78,,13.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",3.21,21,
"SUTURE COATED VICRYL UND BR 3-0 CLOSURE 27 CT-2",70812,CDM,272,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"SUT CTD VICRYL 3-0 UND CR/C",157515,CDM,272,RC,,,OUTPATIENT,,,126,81.9,,110.88,88,,88.70,,,0,"percent of total billed charges","88% of total billed charges",63,50,,50.40,,,0,"percent of total billed charges","50% of total billed charges",21.17,16.8,,16.94,,,0,"percent of total billed charges","16.8% of total billed charges",126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.8,17.304,,17.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.38,63,,63.50,,,0,"percent of total billed charges","63% of total billed charges",19.28,15.3,,15.42,,,0,"percent of total billed charges","15.3% of total billed charges",21.17,16.8,,16.94,,,0,"percent of total billed charges","16.8% of total billed charges",86.94,69,,,,,0,"fee schedule","69% of total billed charges",126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.93,61.85,,62.34,,,0,"percent of total billed charges","61.5% of total billed charges",21.17,16.8,,16.94,,,0,"percent of total billed charges","16.8% of total billed charges",63,50,,50.40,,,0,"percent of total billed charges","50% of total billed charges",40.57,32.2,,32.46,,,0,"percent of total billed charges","32.2% of total billed charges",21.17,16.8,,16.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.59,17.136,,17.27,,,0,"percent of total billed charges","17.136% of total billed charges",27.52,21.84,,22.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47.5,37.7,,38.00,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",98.28,78,,78.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.08,82.6,,83.26,,,0,"percent of total billed charges","82.6% of total billed charges",21.17,16.8,,16.94,,,0,"percent of total billed charges","16.8% of total billed charges",63,50,,50.40,,,0,"percent of total billed charges","50% of total billed charges",104.08,82.6,,83.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.17,16.8,,16.94,,,0,"percent of total billed charges","16.8% of total billed charges",126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",19.28,126,
"SUT VCRL 3-0 SH 27IN UND  J416H",13693,CDM,272,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"SUT VCRL 2-0 UR-5 27IN DYED J375H",91615,CDM,272,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"SUT CTD VICRYL 2-0 VIL BR SH 27",13684,CDM,272,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"SUT CTD VICRYL 1 VIL BR CT-2 27",13680,CDM,272,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"SUT VICRYL PLUS ANTIBACTERIAL CTXB 0",207899,CDM,272,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"SUT VCRL 0 CTX 36IN UND  J978H",13602,CDM,272,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.9,61.85,,7.92,,,0,"percent of total billed charges","61.5% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"SUT TICRON 2-0 SH-2 3385-56",185777,CDM,272,RC,,,OUTPATIENT,,,665,432.25,,585.2,88,,468.16,,,0,"percent of total billed charges","88% of total billed charges",332.5,50,,266.00,,,0,"percent of total billed charges","50% of total billed charges",111.72,16.8,,89.38,,,0,"percent of total billed charges","16.8% of total billed charges",665,100,,532.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.07,17.304,,92.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.95,63,,335.16,,,0,"percent of total billed charges","63% of total billed charges",101.75,15.3,,81.40,,,0,"percent of total billed charges","15.3% of total billed charges",111.72,16.8,,89.38,,,0,"percent of total billed charges","16.8% of total billed charges",458.85,69,,,,,0,"fee schedule","69% of total billed charges",665,100,,532.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",665,100,,532.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",665,100,,532.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",411.3,61.85,,329.04,,,0,"percent of total billed charges","61.5% of total billed charges",111.72,16.8,,89.38,,,0,"percent of total billed charges","16.8% of total billed charges",332.5,50,,266.00,,,0,"percent of total billed charges","50% of total billed charges",214.13,32.2,,171.30,,,0,"percent of total billed charges","32.2% of total billed charges",111.72,16.8,,89.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.95,17.136,,91.16,,,0,"percent of total billed charges","17.136% of total billed charges",145.24,21.84,,116.19,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",250.71,37.7,,200.57,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",518.7,78,,414.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",549.29,82.6,,439.43,,,0,"percent of total billed charges","82.6% of total billed charges",111.72,16.8,,89.38,,,0,"percent of total billed charges","16.8% of total billed charges",332.5,50,,266.00,,,0,"percent of total billed charges","50% of total billed charges",549.29,82.6,,439.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",111.72,16.8,,89.38,,,0,"percent of total billed charges","16.8% of total billed charges",665,100,,532.00,,,0,"percent of total billed charges","100% of total billed charges",101.75,665,
"SUT TICRON 2 GC 3113-81",11430,CDM,272,RC,,,OUTPATIENT,,,45,29.25,,39.6,88,,31.68,,,0,"percent of total billed charges","88% of total billed charges",22.5,50,,18.00,,,0,"percent of total billed charges","50% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.79,17.304,,6.23,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.35,63,,22.68,,,0,"percent of total billed charges","63% of total billed charges",6.89,15.3,,5.51,,,0,"percent of total billed charges","15.3% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",31.05,69,,,,,0,"fee schedule","69% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.83,61.85,,22.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",22.5,50,,18.00,,,0,"percent of total billed charges","50% of total billed charges",14.49,32.2,,11.59,,,0,"percent of total billed charges","32.2% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.71,17.136,,6.17,,,0,"percent of total billed charges","17.136% of total billed charges",9.83,21.84,,7.86,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.97,37.7,,13.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.1,78,,28.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",22.5,50,,18.00,,,0,"percent of total billed charges","50% of total billed charges",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",6.89,45,
"SUT CTD VICRYL 2-0 CR/CT-2 CT-2",11377,CDM,272,RC,,,OUTPATIENT,,,94,61.1,,82.72,88,,66.18,,,0,"percent of total billed charges","88% of total billed charges",47,50,,37.60,,,0,"percent of total billed charges","50% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.27,17.304,,13.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.22,63,,47.38,,,0,"percent of total billed charges","63% of total billed charges",14.38,15.3,,11.50,,,0,"percent of total billed charges","15.3% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",64.86,69,,,,,0,"fee schedule","69% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.14,61.85,,46.51,,,0,"percent of total billed charges","61.5% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",47,50,,37.60,,,0,"percent of total billed charges","50% of total billed charges",30.27,32.2,,24.22,,,0,"percent of total billed charges","32.2% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.11,17.136,,12.89,,,0,"percent of total billed charges","17.136% of total billed charges",20.53,21.84,,16.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.44,37.7,,28.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",73.32,78,,58.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",47,50,,37.60,,,0,"percent of total billed charges","50% of total billed charges",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",14.38,94,
"SUT SILK 4-0 RB-1 C054D",35355,CDM,272,RC,,,OUTPATIENT,,,65,42.25,,57.2,88,,45.76,,,0,"percent of total billed charges","88% of total billed charges",32.5,50,,26.00,,,0,"percent of total billed charges","50% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.25,17.304,,9.00,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.95,63,,32.76,,,0,"percent of total billed charges","63% of total billed charges",9.95,15.3,,7.96,,,0,"percent of total billed charges","15.3% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",44.85,69,,,,,0,"fee schedule","69% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.2,61.85,,32.16,,,0,"percent of total billed charges","61.5% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",32.5,50,,26.00,,,0,"percent of total billed charges","50% of total billed charges",20.93,32.2,,16.74,,,0,"percent of total billed charges","32.2% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.14,17.136,,8.91,,,0,"percent of total billed charges","17.136% of total billed charges",14.2,21.84,,11.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.51,37.7,,19.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.7,78,,40.56,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",32.5,50,,26.00,,,0,"percent of total billed charges","50% of total billed charges",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",9.95,65,
"SUT CAPIO 48IN BX/12 833-124",129719,CDM,272,RC,,,OUTPATIENT,,,288,187.2,,253.44,88,,202.75,,,0,"percent of total billed charges","88% of total billed charges",144,50,,115.20,,,0,"percent of total billed charges","50% of total billed charges",48.38,16.8,,38.70,,,0,"percent of total billed charges","16.8% of total billed charges",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.84,17.304,,39.87,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.44,63,,145.15,,,0,"percent of total billed charges","63% of total billed charges",44.06,15.3,,35.25,,,0,"percent of total billed charges","15.3% of total billed charges",48.38,16.8,,38.70,,,0,"percent of total billed charges","16.8% of total billed charges",198.72,69,,,,,0,"fee schedule","69% of total billed charges",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.13,61.85,,142.50,,,0,"percent of total billed charges","61.5% of total billed charges",48.38,16.8,,38.70,,,0,"percent of total billed charges","16.8% of total billed charges",144,50,,115.20,,,0,"percent of total billed charges","50% of total billed charges",92.74,32.2,,74.19,,,0,"percent of total billed charges","32.2% of total billed charges",48.38,16.8,,38.70,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.35,17.136,,39.48,,,0,"percent of total billed charges","17.136% of total billed charges",62.9,21.84,,50.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",108.58,37.7,,86.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",224.64,78,,179.71,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",237.89,82.6,,190.31,,,0,"percent of total billed charges","82.6% of total billed charges",48.38,16.8,,38.70,,,0,"percent of total billed charges","16.8% of total billed charges",144,50,,115.20,,,0,"percent of total billed charges","50% of total billed charges",237.89,82.6,,190.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.38,16.8,,38.70,,,0,"percent of total billed charges","16.8% of total billed charges",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",44.06,288,
"SUT CAPIO CT BRD POLY N-ABSRB TC O CR 36 IDA",200039,CDM,272,RC,,,OUTPATIENT,,,288,187.2,,253.44,88,,202.75,,,0,"percent of total billed charges","88% of total billed charges",144,50,,115.20,,,0,"percent of total billed charges","50% of total billed charges",48.38,16.8,,38.70,,,0,"percent of total billed charges","16.8% of total billed charges",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.84,17.304,,39.87,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.44,63,,145.15,,,0,"percent of total billed charges","63% of total billed charges",44.06,15.3,,35.25,,,0,"percent of total billed charges","15.3% of total billed charges",48.38,16.8,,38.70,,,0,"percent of total billed charges","16.8% of total billed charges",198.72,69,,,,,0,"fee schedule","69% of total billed charges",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.13,61.85,,142.50,,,0,"percent of total billed charges","61.5% of total billed charges",48.38,16.8,,38.70,,,0,"percent of total billed charges","16.8% of total billed charges",144,50,,115.20,,,0,"percent of total billed charges","50% of total billed charges",92.74,32.2,,74.19,,,0,"percent of total billed charges","32.2% of total billed charges",48.38,16.8,,38.70,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.35,17.136,,39.48,,,0,"percent of total billed charges","17.136% of total billed charges",62.9,21.84,,50.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",108.58,37.7,,86.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",224.64,78,,179.71,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",237.89,82.6,,190.31,,,0,"percent of total billed charges","82.6% of total billed charges",48.38,16.8,,38.70,,,0,"percent of total billed charges","16.8% of total billed charges",144,50,,115.20,,,0,"percent of total billed charges","50% of total billed charges",237.89,82.6,,190.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.38,16.8,,38.70,,,0,"percent of total billed charges","16.8% of total billed charges",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",44.06,288,
"SUT ETHILON BLK MONO 5-0 PS-2 18 INCH 1666G",13635,CDM,272,RC,,,OUTPATIENT,,,248,161.2,,218.24,88,,174.59,,,0,"percent of total billed charges","88% of total billed charges",124,50,,99.20,,,0,"percent of total billed charges","50% of total billed charges",41.66,16.8,,33.33,,,0,"percent of total billed charges","16.8% of total billed charges",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.91,17.304,,34.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.24,63,,124.99,,,0,"percent of total billed charges","63% of total billed charges",37.94,15.3,,30.35,,,0,"percent of total billed charges","15.3% of total billed charges",41.66,16.8,,33.33,,,0,"percent of total billed charges","16.8% of total billed charges",171.12,69,,,,,0,"fee schedule","69% of total billed charges",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",153.39,61.85,,122.71,,,0,"percent of total billed charges","61.5% of total billed charges",41.66,16.8,,33.33,,,0,"percent of total billed charges","16.8% of total billed charges",124,50,,99.20,,,0,"percent of total billed charges","50% of total billed charges",79.86,32.2,,63.89,,,0,"percent of total billed charges","32.2% of total billed charges",41.66,16.8,,33.33,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.5,17.136,,34.00,,,0,"percent of total billed charges","17.136% of total billed charges",54.16,21.84,,43.33,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",93.5,37.7,,74.80,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",193.44,78,,154.75,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.85,82.6,,163.88,,,0,"percent of total billed charges","82.6% of total billed charges",41.66,16.8,,33.33,,,0,"percent of total billed charges","16.8% of total billed charges",124,50,,99.20,,,0,"percent of total billed charges","50% of total billed charges",204.85,82.6,,163.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.66,16.8,,33.33,,,0,"percent of total billed charges","16.8% of total billed charges",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",37.94,248,
"SUT SILK 4-0 K571H",13805,CDM,272,RC,,,OUTPATIENT,,,788,512.2,,693.44,88,,554.75,,,0,"percent of total billed charges","88% of total billed charges",394,50,,315.20,,,0,"percent of total billed charges","50% of total billed charges",132.38,16.8,,105.90,,,0,"percent of total billed charges","16.8% of total billed charges",788,100,,630.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.36,17.304,,109.09,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.44,63,,397.15,,,0,"percent of total billed charges","63% of total billed charges",120.56,15.3,,96.45,,,0,"percent of total billed charges","15.3% of total billed charges",132.38,16.8,,105.90,,,0,"percent of total billed charges","16.8% of total billed charges",543.72,69,,,,,0,"fee schedule","69% of total billed charges",788,100,,630.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",788,100,,630.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",788,100,,630.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",487.38,61.85,,389.90,,,0,"percent of total billed charges","61.5% of total billed charges",132.38,16.8,,105.90,,,0,"percent of total billed charges","16.8% of total billed charges",394,50,,315.20,,,0,"percent of total billed charges","50% of total billed charges",253.74,32.2,,202.99,,,0,"percent of total billed charges","32.2% of total billed charges",132.38,16.8,,105.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",135.03,17.136,,108.02,,,0,"percent of total billed charges","17.136% of total billed charges",172.1,21.84,,137.68,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",297.08,37.7,,237.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",614.64,78,,491.71,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",650.89,82.6,,520.71,,,0,"percent of total billed charges","82.6% of total billed charges",132.38,16.8,,105.90,,,0,"percent of total billed charges","16.8% of total billed charges",394,50,,315.20,,,0,"percent of total billed charges","50% of total billed charges",650.89,82.6,,520.71,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",132.38,16.8,,105.90,,,0,"percent of total billed charges","16.8% of total billed charges",788,100,,630.40,,,0,"percent of total billed charges","100% of total billed charges",120.56,788,
"SUT SLK 3-0 SH 30IN K832H",11373,CDM,272,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"SUT SILK 3-0 CR/RB-1 8-18 BLK BR",83555,CDM,272,RC,,,OUTPATIENT,,,64,41.6,,56.32,88,,45.06,,,0,"percent of total billed charges","88% of total billed charges",32,50,,25.60,,,0,"percent of total billed charges","50% of total billed charges",10.75,16.8,,8.60,,,0,"percent of total billed charges","16.8% of total billed charges",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.07,17.304,,8.86,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.32,63,,32.26,,,0,"percent of total billed charges","63% of total billed charges",9.79,15.3,,7.83,,,0,"percent of total billed charges","15.3% of total billed charges",10.75,16.8,,8.60,,,0,"percent of total billed charges","16.8% of total billed charges",44.16,69,,,,,0,"fee schedule","69% of total billed charges",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.58,61.85,,31.66,,,0,"percent of total billed charges","61.5% of total billed charges",10.75,16.8,,8.60,,,0,"percent of total billed charges","16.8% of total billed charges",32,50,,25.60,,,0,"percent of total billed charges","50% of total billed charges",20.61,32.2,,16.49,,,0,"percent of total billed charges","32.2% of total billed charges",10.75,16.8,,8.60,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.97,17.136,,8.78,,,0,"percent of total billed charges","17.136% of total billed charges",13.98,21.84,,11.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.13,37.7,,19.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",49.92,78,,39.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.86,82.6,,42.29,,,0,"percent of total billed charges","82.6% of total billed charges",10.75,16.8,,8.60,,,0,"percent of total billed charges","16.8% of total billed charges",32,50,,25.60,,,0,"percent of total billed charges","50% of total billed charges",52.86,82.6,,42.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.75,16.8,,8.60,,,0,"percent of total billed charges","16.8% of total billed charges",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",9.79,64,
"SUT SILK 1 K845H",13861,CDM,272,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"SUT SLK 0 MH 30IN K844H",13666,CDM,272,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.95,61.85,,3.96,,,0,"percent of total billed charges","61.5% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"SUT PROLENE 7-0 BV175-7  2-24 INCH",80850,CDM,272,RC,,,OUTPATIENT,,,338,219.7,,297.44,88,,237.95,,,0,"percent of total billed charges","88% of total billed charges",169,50,,135.20,,,0,"percent of total billed charges","50% of total billed charges",56.78,16.8,,45.42,,,0,"percent of total billed charges","16.8% of total billed charges",338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.49,17.304,,46.79,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",212.94,63,,170.35,,,0,"percent of total billed charges","63% of total billed charges",51.71,15.3,,41.37,,,0,"percent of total billed charges","15.3% of total billed charges",56.78,16.8,,45.42,,,0,"percent of total billed charges","16.8% of total billed charges",233.22,69,,,,,0,"fee schedule","69% of total billed charges",338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.05,61.85,,167.24,,,0,"percent of total billed charges","61.5% of total billed charges",56.78,16.8,,45.42,,,0,"percent of total billed charges","16.8% of total billed charges",169,50,,135.20,,,0,"percent of total billed charges","50% of total billed charges",108.84,32.2,,87.07,,,0,"percent of total billed charges","32.2% of total billed charges",56.78,16.8,,45.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.92,17.136,,46.34,,,0,"percent of total billed charges","17.136% of total billed charges",73.82,21.84,,59.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",127.43,37.7,,101.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",263.64,78,,210.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",279.19,82.6,,223.35,,,0,"percent of total billed charges","82.6% of total billed charges",56.78,16.8,,45.42,,,0,"percent of total billed charges","16.8% of total billed charges",169,50,,135.20,,,0,"percent of total billed charges","50% of total billed charges",279.19,82.6,,223.35,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.78,16.8,,45.42,,,0,"percent of total billed charges","16.8% of total billed charges",338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",51.71,338,
"SUT PROLENE EB 175.7",187893,CDM,272,RC,,,OUTPATIENT,,,676,439.4,,594.88,88,,475.90,,,0,"percent of total billed charges","88% of total billed charges",338,50,,270.40,,,0,"percent of total billed charges","50% of total billed charges",113.57,16.8,,90.86,,,0,"percent of total billed charges","16.8% of total billed charges",676,100,,540.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",116.98,17.304,,93.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",425.88,63,,340.70,,,0,"percent of total billed charges","63% of total billed charges",103.43,15.3,,82.74,,,0,"percent of total billed charges","15.3% of total billed charges",113.57,16.8,,90.86,,,0,"percent of total billed charges","16.8% of total billed charges",466.44,69,,,,,0,"fee schedule","69% of total billed charges",676,100,,540.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",676,100,,540.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",676,100,,540.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.11,61.85,,334.49,,,0,"percent of total billed charges","61.5% of total billed charges",113.57,16.8,,90.86,,,0,"percent of total billed charges","16.8% of total billed charges",338,50,,270.40,,,0,"percent of total billed charges","50% of total billed charges",217.67,32.2,,174.14,,,0,"percent of total billed charges","32.2% of total billed charges",113.57,16.8,,90.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.84,17.136,,92.67,,,0,"percent of total billed charges","17.136% of total billed charges",147.64,21.84,,118.11,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",254.85,37.7,,203.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",527.28,78,,421.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",558.38,82.6,,446.70,,,0,"percent of total billed charges","82.6% of total billed charges",113.57,16.8,,90.86,,,0,"percent of total billed charges","16.8% of total billed charges",338,50,,270.40,,,0,"percent of total billed charges","50% of total billed charges",558.38,82.6,,446.70,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.57,16.8,,90.86,,,0,"percent of total billed charges","16.8% of total billed charges",676,100,,540.80,,,0,"percent of total billed charges","100% of total billed charges",103.43,676,
"SUT PROLENE 7-0 BV-1-BV-1",46500,CDM,272,RC,,,OUTPATIENT,,,90,58.5,,79.2,88,,63.36,,,0,"percent of total billed charges","88% of total billed charges",45,50,,36.00,,,0,"percent of total billed charges","50% of total billed charges",15.12,16.8,,12.10,,,0,"percent of total billed charges","16.8% of total billed charges",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.57,17.304,,12.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.7,63,,45.36,,,0,"percent of total billed charges","63% of total billed charges",13.77,15.3,,11.02,,,0,"percent of total billed charges","15.3% of total billed charges",15.12,16.8,,12.10,,,0,"percent of total billed charges","16.8% of total billed charges",62.1,69,,,,,0,"fee schedule","69% of total billed charges",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",55.67,61.85,,44.54,,,0,"percent of total billed charges","61.5% of total billed charges",15.12,16.8,,12.10,,,0,"percent of total billed charges","16.8% of total billed charges",45,50,,36.00,,,0,"percent of total billed charges","50% of total billed charges",28.98,32.2,,23.18,,,0,"percent of total billed charges","32.2% of total billed charges",15.12,16.8,,12.10,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.42,17.136,,12.34,,,0,"percent of total billed charges","17.136% of total billed charges",19.66,21.84,,15.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",33.93,37.7,,27.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",70.2,78,,56.16,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.34,82.6,,59.47,,,0,"percent of total billed charges","82.6% of total billed charges",15.12,16.8,,12.10,,,0,"percent of total billed charges","16.8% of total billed charges",45,50,,36.00,,,0,"percent of total billed charges","50% of total billed charges",74.34,82.6,,59.47,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.12,16.8,,12.10,,,0,"percent of total billed charges","16.8% of total billed charges",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",13.77,90,
"SUT PRLN 5-0 RB-2 8710H",166140,CDM,272,RC,,,OUTPATIENT,,,35,22.75,,30.8,88,,24.64,,,0,"percent of total billed charges","88% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.06,17.304,,4.85,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.05,63,,17.64,,,0,"percent of total billed charges","63% of total billed charges",5.36,15.3,,4.29,,,0,"percent of total billed charges","15.3% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",24.15,69,,,,,0,"fee schedule","69% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.65,61.85,,17.32,,,0,"percent of total billed charges","61.5% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",11.27,32.2,,9.02,,,0,"percent of total billed charges","32.2% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,17.136,,4.80,,,0,"percent of total billed charges","17.136% of total billed charges",7.64,21.84,,6.11,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.2,37.7,,10.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",27.3,78,,21.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.91,82.6,,23.13,,,0,"percent of total billed charges","82.6% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",28.91,82.6,,23.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",5.36,35,
"SUT PROLENE BLU MONO 4-0 36   RB-1",106336,CDM,272,RC,,,OUTPATIENT,,,143,92.95,,125.84,88,,100.67,,,0,"percent of total billed charges","88% of total billed charges",71.5,50,,57.20,,,0,"percent of total billed charges","50% of total billed charges",24.02,16.8,,19.22,,,0,"percent of total billed charges","16.8% of total billed charges",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.74,17.304,,19.79,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.09,63,,72.07,,,0,"percent of total billed charges","63% of total billed charges",21.88,15.3,,17.50,,,0,"percent of total billed charges","15.3% of total billed charges",24.02,16.8,,19.22,,,0,"percent of total billed charges","16.8% of total billed charges",98.67,69,,,,,0,"fee schedule","69% of total billed charges",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.45,61.85,,70.76,,,0,"percent of total billed charges","61.5% of total billed charges",24.02,16.8,,19.22,,,0,"percent of total billed charges","16.8% of total billed charges",71.5,50,,57.20,,,0,"percent of total billed charges","50% of total billed charges",46.05,32.2,,36.84,,,0,"percent of total billed charges","32.2% of total billed charges",24.02,16.8,,19.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.5,17.136,,19.60,,,0,"percent of total billed charges","17.136% of total billed charges",31.23,21.84,,24.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",53.91,37.7,,43.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",111.54,78,,89.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",24.02,16.8,,19.22,,,0,"percent of total billed charges","16.8% of total billed charges",71.5,50,,57.20,,,0,"percent of total billed charges","50% of total billed charges",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.02,16.8,,19.22,,,0,"percent of total billed charges","16.8% of total billed charges",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",21.88,143,
"SUT PROLENE 3-0 FSL BL MONO",157694,CDM,272,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"SUT PROLENE 2-0 FS BL MONO",147002,CDM,272,RC,,,OUTPATIENT,,,207,134.55,,182.16,88,,145.73,,,0,"percent of total billed charges","88% of total billed charges",103.5,50,,82.80,,,0,"percent of total billed charges","50% of total billed charges",34.78,16.8,,27.82,,,0,"percent of total billed charges","16.8% of total billed charges",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.82,17.304,,28.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",130.41,63,,104.33,,,0,"percent of total billed charges","63% of total billed charges",31.67,15.3,,25.34,,,0,"percent of total billed charges","15.3% of total billed charges",34.78,16.8,,27.82,,,0,"percent of total billed charges","16.8% of total billed charges",142.83,69,,,,,0,"fee schedule","69% of total billed charges",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,61.85,,102.42,,,0,"percent of total billed charges","61.5% of total billed charges",34.78,16.8,,27.82,,,0,"percent of total billed charges","16.8% of total billed charges",103.5,50,,82.80,,,0,"percent of total billed charges","50% of total billed charges",66.65,32.2,,53.32,,,0,"percent of total billed charges","32.2% of total billed charges",34.78,16.8,,27.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.47,17.136,,28.38,,,0,"percent of total billed charges","17.136% of total billed charges",45.21,21.84,,36.17,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",78.04,37.7,,62.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",161.46,78,,129.17,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.98,82.6,,136.78,,,0,"percent of total billed charges","82.6% of total billed charges",34.78,16.8,,27.82,,,0,"percent of total billed charges","16.8% of total billed charges",103.5,50,,82.80,,,0,"percent of total billed charges","50% of total billed charges",170.98,82.6,,136.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,16.8,,27.82,,,0,"percent of total billed charges","16.8% of total billed charges",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",31.67,207,
"SUT PROLENE BLU MONO #0 SH 30 INCH       8834H",39815,CDM,272,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.37,61.85,,9.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"SUT ETHILON 4-0 PC5   1894G",82279,CDM,272,RC,,,OUTPATIENT,,,24,15.6,,21.12,88,,16.90,,,0,"percent of total billed charges","88% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.15,17.304,,3.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.12,63,,12.10,,,0,"percent of total billed charges","63% of total billed charges",3.67,15.3,,2.94,,,0,"percent of total billed charges","15.3% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",16.56,69,,,,,0,"fee schedule","69% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.84,61.85,,11.87,,,0,"percent of total billed charges","61.5% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",7.73,32.2,,6.18,,,0,"percent of total billed charges","32.2% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.11,17.136,,3.29,,,0,"percent of total billed charges","17.136% of total billed charges",5.24,21.84,,4.19,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.05,37.7,,7.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.72,78,,14.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,24,
"SUT ETHILON 2-0 BLK MONO FS",149618,CDM,272,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"SUT NYLON 2 460T",186277,CDM,272,RC,,,OUTPATIENT,,,21,13.65,,18.48,88,,14.78,,,0,"percent of total billed charges","88% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.63,17.304,,2.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.23,63,,10.58,,,0,"percent of total billed charges","63% of total billed charges",3.21,15.3,,2.57,,,0,"percent of total billed charges","15.3% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",14.49,69,,,,,0,"fee schedule","69% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.99,61.85,,10.39,,,0,"percent of total billed charges","61.5% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",6.76,32.2,,5.41,,,0,"percent of total billed charges","32.2% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.6,17.136,,2.88,,,0,"percent of total billed charges","17.136% of total billed charges",4.59,21.84,,3.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.92,37.7,,6.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.38,78,,13.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",3.21,21,
"SUT MERSILENE 4-0 P-3 WHT B",146953,CDM,272,RC,,,OUTPATIENT,,,27,17.55,,23.76,88,,19.01,,,0,"percent of total billed charges","88% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.67,17.304,,3.74,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.01,63,,13.61,,,0,"percent of total billed charges","63% of total billed charges",4.13,15.3,,3.30,,,0,"percent of total billed charges","15.3% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",18.63,69,,,,,0,"fee schedule","69% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.7,61.85,,13.36,,,0,"percent of total billed charges","61.5% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",8.69,32.2,,6.95,,,0,"percent of total billed charges","32.2% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.63,17.136,,3.70,,,0,"percent of total billed charges","17.136% of total billed charges",5.9,21.84,,4.72,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.18,37.7,,8.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.06,78,,16.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.3,82.6,,17.84,,,0,"percent of total billed charges","82.6% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",22.3,82.6,,17.84,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",4.13,27,
"SUT ETHBND 2-0 SH-2 30IN W/PLEDGET DBL ARM WHITE PXX80",80846,CDM,272,RC,,,OUTPATIENT,,,439,285.35,,386.32,88,,309.06,,,0,"percent of total billed charges","88% of total billed charges",219.5,50,,175.60,,,0,"percent of total billed charges","50% of total billed charges",73.75,16.8,,59.00,,,0,"percent of total billed charges","16.8% of total billed charges",439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.96,17.304,,60.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.57,63,,221.26,,,0,"percent of total billed charges","63% of total billed charges",67.17,15.3,,53.74,,,0,"percent of total billed charges","15.3% of total billed charges",73.75,16.8,,59.00,,,0,"percent of total billed charges","16.8% of total billed charges",302.91,69,,,,,0,"fee schedule","69% of total billed charges",439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",271.52,61.85,,217.22,,,0,"percent of total billed charges","61.5% of total billed charges",73.75,16.8,,59.00,,,0,"percent of total billed charges","16.8% of total billed charges",219.5,50,,175.60,,,0,"percent of total billed charges","50% of total billed charges",141.36,32.2,,113.09,,,0,"percent of total billed charges","32.2% of total billed charges",73.75,16.8,,59.00,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.23,17.136,,60.18,,,0,"percent of total billed charges","17.136% of total billed charges",95.88,21.84,,76.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",165.5,37.7,,132.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",342.42,78,,273.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",362.61,82.6,,290.09,,,0,"percent of total billed charges","82.6% of total billed charges",73.75,16.8,,59.00,,,0,"percent of total billed charges","16.8% of total billed charges",219.5,50,,175.60,,,0,"percent of total billed charges","50% of total billed charges",362.61,82.6,,290.09,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",73.75,16.8,,59.00,,,0,"percent of total billed charges","16.8% of total billed charges",439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",67.17,439,
"SUT ETHBND 2-0 SH 30IN DBL ARM WHITE PXX76",188085,CDM,272,RC,,,OUTPATIENT,,,438,284.7,,385.44,88,,308.35,,,0,"percent of total billed charges","88% of total billed charges",219,50,,175.20,,,0,"percent of total billed charges","50% of total billed charges",73.58,16.8,,58.86,,,0,"percent of total billed charges","16.8% of total billed charges",438,100,,350.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.79,17.304,,60.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",275.94,63,,220.75,,,0,"percent of total billed charges","63% of total billed charges",67.01,15.3,,53.61,,,0,"percent of total billed charges","15.3% of total billed charges",73.58,16.8,,58.86,,,0,"percent of total billed charges","16.8% of total billed charges",302.22,69,,,,,0,"fee schedule","69% of total billed charges",438,100,,350.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",438,100,,350.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",438,100,,350.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",270.9,61.85,,216.72,,,0,"percent of total billed charges","61.5% of total billed charges",73.58,16.8,,58.86,,,0,"percent of total billed charges","16.8% of total billed charges",219,50,,175.20,,,0,"percent of total billed charges","50% of total billed charges",141.04,32.2,,112.83,,,0,"percent of total billed charges","32.2% of total billed charges",73.58,16.8,,58.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.06,17.136,,60.05,,,0,"percent of total billed charges","17.136% of total billed charges",95.66,21.84,,76.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",165.13,37.7,,132.10,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",341.64,78,,273.31,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",361.79,82.6,,289.43,,,0,"percent of total billed charges","82.6% of total billed charges",73.58,16.8,,58.86,,,0,"percent of total billed charges","16.8% of total billed charges",219,50,,175.20,,,0,"percent of total billed charges","50% of total billed charges",361.79,82.6,,289.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",73.58,16.8,,58.86,,,0,"percent of total billed charges","16.8% of total billed charges",438,100,,350.40,,,0,"percent of total billed charges","100% of total billed charges",67.01,438,
"SUT CHR 4-0 SH 27IN  G121H",18509,CDM,272,RC,,,OUTPATIENT,,,30,19.5,,26.4,88,,21.12,,,0,"percent of total billed charges","88% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.19,17.304,,4.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.9,63,,15.12,,,0,"percent of total billed charges","63% of total billed charges",4.59,15.3,,3.67,,,0,"percent of total billed charges","15.3% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",20.7,69,,,,,0,"fee schedule","69% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.56,61.85,,14.85,,,0,"percent of total billed charges","61.5% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",9.66,32.2,,7.73,,,0,"percent of total billed charges","32.2% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.14,17.136,,4.11,,,0,"percent of total billed charges","17.136% of total billed charges",6.55,21.84,,5.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.31,37.7,,9.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.4,78,,18.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",4.59,30,
"SUT CHR GUT 2-0 STANDARD 54",157442,CDM,272,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"SUT 2-0 TI-CRON CV-316",185776,CDM,272,RC,,,OUTPATIENT,,,83,53.95,,73.04,88,,58.43,,,0,"percent of total billed charges","88% of total billed charges",41.5,50,,33.20,,,0,"percent of total billed charges","50% of total billed charges",13.94,16.8,,11.15,,,0,"percent of total billed charges","16.8% of total billed charges",83,100,,66.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.36,17.304,,11.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.29,63,,41.83,,,0,"percent of total billed charges","63% of total billed charges",12.7,15.3,,10.16,,,0,"percent of total billed charges","15.3% of total billed charges",13.94,16.8,,11.15,,,0,"percent of total billed charges","16.8% of total billed charges",57.27,69,,,,,0,"fee schedule","69% of total billed charges",83,100,,66.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",83,100,,66.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",83,100,,66.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.34,61.85,,41.07,,,0,"percent of total billed charges","61.5% of total billed charges",13.94,16.8,,11.15,,,0,"percent of total billed charges","16.8% of total billed charges",41.5,50,,33.20,,,0,"percent of total billed charges","50% of total billed charges",26.73,32.2,,21.38,,,0,"percent of total billed charges","32.2% of total billed charges",13.94,16.8,,11.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.22,17.136,,11.38,,,0,"percent of total billed charges","17.136% of total billed charges",18.13,21.84,,14.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",31.29,37.7,,25.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",64.74,78,,51.79,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.56,82.6,,54.85,,,0,"percent of total billed charges","82.6% of total billed charges",13.94,16.8,,11.15,,,0,"percent of total billed charges","16.8% of total billed charges",41.5,50,,33.20,,,0,"percent of total billed charges","50% of total billed charges",68.56,82.6,,54.85,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.94,16.8,,11.15,,,0,"percent of total billed charges","16.8% of total billed charges",83,100,,66.40,,,0,"percent of total billed charges","100% of total billed charges",12.7,83,
"SUT 4-0 NYLON PC-1  1854G",14989,CDM,272,RC,,,OUTPATIENT,,,283,183.95,,249.04,88,,199.23,,,0,"percent of total billed charges","88% of total billed charges",141.5,50,,113.20,,,0,"percent of total billed charges","50% of total billed charges",47.54,16.8,,38.03,,,0,"percent of total billed charges","16.8% of total billed charges",283,100,,226.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.97,17.304,,39.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.29,63,,142.63,,,0,"percent of total billed charges","63% of total billed charges",43.3,15.3,,34.64,,,0,"percent of total billed charges","15.3% of total billed charges",47.54,16.8,,38.03,,,0,"percent of total billed charges","16.8% of total billed charges",195.27,69,,,,,0,"fee schedule","69% of total billed charges",283,100,,226.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",283,100,,226.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",283,100,,226.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",175.04,61.85,,140.03,,,0,"percent of total billed charges","61.5% of total billed charges",47.54,16.8,,38.03,,,0,"percent of total billed charges","16.8% of total billed charges",141.5,50,,113.20,,,0,"percent of total billed charges","50% of total billed charges",91.13,32.2,,72.90,,,0,"percent of total billed charges","32.2% of total billed charges",47.54,16.8,,38.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.49,17.136,,38.79,,,0,"percent of total billed charges","17.136% of total billed charges",61.81,21.84,,49.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",106.69,37.7,,85.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",220.74,78,,176.59,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",233.76,82.6,,187.01,,,0,"percent of total billed charges","82.6% of total billed charges",47.54,16.8,,38.03,,,0,"percent of total billed charges","16.8% of total billed charges",141.5,50,,113.20,,,0,"percent of total billed charges","50% of total billed charges",233.76,82.6,,187.01,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.54,16.8,,38.03,,,0,"percent of total billed charges","16.8% of total billed charges",283,100,,226.40,,,0,"percent of total billed charges","100% of total billed charges",43.3,283,
"SUT CHR GUT 2-0 CT-1 36 INC",157440,CDM,272,RC,,,OUTPATIENT,,,31,20.15,,27.28,88,,21.82,,,0,"percent of total billed charges","88% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.36,17.304,,4.29,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.53,63,,15.62,,,0,"percent of total billed charges","63% of total billed charges",4.74,15.3,,3.79,,,0,"percent of total billed charges","15.3% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",21.39,69,,,,,0,"fee schedule","69% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.17,61.85,,15.34,,,0,"percent of total billed charges","61.5% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",9.98,32.2,,7.98,,,0,"percent of total billed charges","32.2% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.31,17.136,,4.25,,,0,"percent of total billed charges","17.136% of total billed charges",6.77,21.84,,5.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.69,37.7,,9.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.18,78,,19.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.61,82.6,,20.49,,,0,"percent of total billed charges","82.6% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",25.61,82.6,,20.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",4.74,31,
"SUT CTD VICRYL 0 VIL BR UR-5",13792,CDM,272,RC,,,OUTPATIENT,,,467,303.55,,410.96,88,,328.77,,,0,"percent of total billed charges","88% of total billed charges",233.5,50,,186.80,,,0,"percent of total billed charges","50% of total billed charges",78.46,16.8,,62.77,,,0,"percent of total billed charges","16.8% of total billed charges",467,100,,373.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.81,17.304,,64.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",294.21,63,,235.37,,,0,"percent of total billed charges","63% of total billed charges",71.45,15.3,,57.16,,,0,"percent of total billed charges","15.3% of total billed charges",78.46,16.8,,62.77,,,0,"percent of total billed charges","16.8% of total billed charges",322.23,69,,,,,0,"fee schedule","69% of total billed charges",467,100,,373.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",467,100,,373.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",467,100,,373.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",288.84,61.85,,231.07,,,0,"percent of total billed charges","61.5% of total billed charges",78.46,16.8,,62.77,,,0,"percent of total billed charges","16.8% of total billed charges",233.5,50,,186.80,,,0,"percent of total billed charges","50% of total billed charges",150.37,32.2,,120.30,,,0,"percent of total billed charges","32.2% of total billed charges",78.46,16.8,,62.77,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.03,17.136,,64.02,,,0,"percent of total billed charges","17.136% of total billed charges",101.99,21.84,,81.59,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.06,37.7,,140.85,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",364.26,78,,291.41,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",385.74,82.6,,308.59,,,0,"percent of total billed charges","82.6% of total billed charges",78.46,16.8,,62.77,,,0,"percent of total billed charges","16.8% of total billed charges",233.5,50,,186.80,,,0,"percent of total billed charges","50% of total billed charges",385.74,82.6,,308.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.46,16.8,,62.77,,,0,"percent of total billed charges","16.8% of total billed charges",467,100,,373.60,,,0,"percent of total billed charges","100% of total billed charges",71.45,467,
"SUT CTD VICRYL 1 UND BR CTX",146847,CDM,272,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"SUT CTD VICRYL 5-0 UND BR R",165962,CDM,272,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"SUT ETHIBOND TIES 4 0      X183H",36923,CDM,272,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"SUT ETHILON 6-0 BLK MONO PS",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SUT INCHSUT 3-0 VICRYL 27 INCH INCH UNDYED RB-1 INCH",202604,CDM,272,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"SUT NYLON 3-0 FS1 18IN",185116,CDM,272,RC,,,OUTPATIENT,,,139,90.35,,122.32,88,,97.86,,,0,"percent of total billed charges","88% of total billed charges",69.5,50,,55.60,,,0,"percent of total billed charges","50% of total billed charges",23.35,16.8,,18.68,,,0,"percent of total billed charges","16.8% of total billed charges",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.05,17.304,,19.24,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.57,63,,70.06,,,0,"percent of total billed charges","63% of total billed charges",21.27,15.3,,17.02,,,0,"percent of total billed charges","15.3% of total billed charges",23.35,16.8,,18.68,,,0,"percent of total billed charges","16.8% of total billed charges",95.91,69,,,,,0,"fee schedule","69% of total billed charges",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.97,61.85,,68.78,,,0,"percent of total billed charges","61.5% of total billed charges",23.35,16.8,,18.68,,,0,"percent of total billed charges","16.8% of total billed charges",69.5,50,,55.60,,,0,"percent of total billed charges","50% of total billed charges",44.76,32.2,,35.81,,,0,"percent of total billed charges","32.2% of total billed charges",23.35,16.8,,18.68,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.82,17.136,,19.06,,,0,"percent of total billed charges","17.136% of total billed charges",30.36,21.84,,24.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",52.4,37.7,,41.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",108.42,78,,86.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,82.6,,91.85,,,0,"percent of total billed charges","82.6% of total billed charges",23.35,16.8,,18.68,,,0,"percent of total billed charges","16.8% of total billed charges",69.5,50,,55.60,,,0,"percent of total billed charges","50% of total billed charges",114.81,82.6,,91.85,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.35,16.8,,18.68,,,0,"percent of total billed charges","16.8% of total billed charges",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",21.27,139,
"SUT PDS II 1 TP-1 96IN LOOP Z880G",166072,CDM,272,RC,,,OUTPATIENT,,,30,19.5,,26.4,88,,21.12,,,0,"percent of total billed charges","88% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.19,17.304,,4.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.9,63,,15.12,,,0,"percent of total billed charges","63% of total billed charges",4.59,15.3,,3.67,,,0,"percent of total billed charges","15.3% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",20.7,69,,,,,0,"fee schedule","69% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.56,61.85,,14.85,,,0,"percent of total billed charges","61.5% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",9.66,32.2,,7.73,,,0,"percent of total billed charges","32.2% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.14,17.136,,4.11,,,0,"percent of total billed charges","17.136% of total billed charges",6.55,21.84,,5.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.31,37.7,,9.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.4,78,,18.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",4.59,30,
"SUT PLAIN 3-0 N862H",13724,CDM,272,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"SUT PRLN 5-0 C-1 36IN DBL ARM 4/PK M8720H",85554,CDM,272,RC,,,OUTPATIENT,,,264,171.6,,232.32,88,,185.86,,,0,"percent of total billed charges","88% of total billed charges",132,50,,105.60,,,0,"percent of total billed charges","50% of total billed charges",44.35,16.8,,35.48,,,0,"percent of total billed charges","16.8% of total billed charges",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.68,17.304,,36.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.32,63,,133.06,,,0,"percent of total billed charges","63% of total billed charges",40.39,15.3,,32.31,,,0,"percent of total billed charges","15.3% of total billed charges",44.35,16.8,,35.48,,,0,"percent of total billed charges","16.8% of total billed charges",182.16,69,,,,,0,"fee schedule","69% of total billed charges",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",163.28,61.85,,130.62,,,0,"percent of total billed charges","61.5% of total billed charges",44.35,16.8,,35.48,,,0,"percent of total billed charges","16.8% of total billed charges",132,50,,105.60,,,0,"percent of total billed charges","50% of total billed charges",85.01,32.2,,68.01,,,0,"percent of total billed charges","32.2% of total billed charges",44.35,16.8,,35.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.24,17.136,,36.19,,,0,"percent of total billed charges","17.136% of total billed charges",57.66,21.84,,46.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",99.53,37.7,,79.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",205.92,78,,164.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",218.06,82.6,,174.45,,,0,"percent of total billed charges","82.6% of total billed charges",44.35,16.8,,35.48,,,0,"percent of total billed charges","16.8% of total billed charges",132,50,,105.60,,,0,"percent of total billed charges","50% of total billed charges",218.06,82.6,,174.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.35,16.8,,35.48,,,0,"percent of total billed charges","16.8% of total billed charges",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",40.39,264,
"SUT PRLN 6-0 BV-1 30IN DBL ARM 8709H",13663,CDM,272,RC,,,OUTPATIENT,,,2955,1920.75,,2600.4,88,,2080.32,,,0,"percent of total billed charges","88% of total billed charges",1477.5,50,,1182.00,,,0,"percent of total billed charges","50% of total billed charges",496.44,16.8,,397.15,,,0,"percent of total billed charges","16.8% of total billed charges",2955,100,,2364.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",511.33,17.304,,409.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1861.65,63,,1489.32,,,0,"percent of total billed charges","63% of total billed charges",452.12,15.3,,361.70,,,0,"percent of total billed charges","15.3% of total billed charges",496.44,16.8,,397.15,,,0,"percent of total billed charges","16.8% of total billed charges",2038.95,69,,,,,0,"fee schedule","69% of total billed charges",2955,100,,2364.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2955,100,,2364.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2955,100,,2364.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1827.67,61.85,,1462.14,,,0,"percent of total billed charges","61.5% of total billed charges",496.44,16.8,,397.15,,,0,"percent of total billed charges","16.8% of total billed charges",1477.5,50,,1182.00,,,0,"percent of total billed charges","50% of total billed charges",951.51,32.2,,761.21,,,0,"percent of total billed charges","32.2% of total billed charges",496.44,16.8,,397.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",506.37,17.136,,405.10,,,0,"percent of total billed charges","17.136% of total billed charges",645.37,21.84,,516.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1114.04,37.7,,891.23,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2304.9,78,,1843.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2440.83,82.6,,1952.66,,,0,"percent of total billed charges","82.6% of total billed charges",496.44,16.8,,397.15,,,0,"percent of total billed charges","16.8% of total billed charges",1477.5,50,,1182.00,,,0,"percent of total billed charges","50% of total billed charges",2440.83,82.6,,1952.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.44,16.8,,397.15,,,0,"percent of total billed charges","16.8% of total billed charges",2955,100,,2364.00,,,0,"percent of total billed charges","100% of total billed charges",452.12,2955,
"SUT PROLENE 4-0 FS-2 BL MON",166132,CDM,272,RC,,,OUTPATIENT,,,23,14.95,,20.24,88,,16.19,,,0,"percent of total billed charges","88% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.98,17.304,,3.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.49,63,,11.59,,,0,"percent of total billed charges","63% of total billed charges",3.52,15.3,,2.82,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",15.87,69,,,,,0,"fee schedule","69% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.23,61.85,,11.38,,,0,"percent of total billed charges","61.5% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",7.41,32.2,,5.93,,,0,"percent of total billed charges","32.2% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.94,17.136,,3.15,,,0,"percent of total billed charges","17.136% of total billed charges",5.02,21.84,,4.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.94,78,,14.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",3.52,23,
"SUT SILK 0 C021D",17171050,CDM,272,RC,,,OUTPATIENT,,,50,32.5,,44,88,,35.20,,,0,"percent of total billed charges","88% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.65,17.304,,6.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.5,63,,25.20,,,0,"percent of total billed charges","63% of total billed charges",7.65,15.3,,6.12,,,0,"percent of total billed charges","15.3% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",34.5,69,,,,,0,"fee schedule","69% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.93,61.85,,24.74,,,0,"percent of total billed charges","61.5% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",16.1,32.2,,12.88,,,0,"percent of total billed charges","32.2% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.57,17.136,,6.86,,,0,"percent of total billed charges","17.136% of total billed charges",10.92,21.84,,8.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39,78,,31.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",7.65,50,
"SUT TI-CRON 3-0 3256-41",17110100,CDM,272,RC,,,OUTPATIENT,,,76,49.4,,66.88,88,,53.50,,,0,"percent of total billed charges","88% of total billed charges",38,50,,30.40,,,0,"percent of total billed charges","50% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.15,17.304,,10.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.88,63,,38.30,,,0,"percent of total billed charges","63% of total billed charges",11.63,15.3,,9.30,,,0,"percent of total billed charges","15.3% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",52.44,69,,,,,0,"fee schedule","69% of total billed charges",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.01,61.85,,37.61,,,0,"percent of total billed charges","61.5% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",38,50,,30.40,,,0,"percent of total billed charges","50% of total billed charges",24.47,32.2,,19.58,,,0,"percent of total billed charges","32.2% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.02,17.136,,10.42,,,0,"percent of total billed charges","17.136% of total billed charges",16.6,21.84,,13.28,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.65,37.7,,22.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",59.28,78,,47.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.78,82.6,,50.22,,,0,"percent of total billed charges","82.6% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",38,50,,30.40,,,0,"percent of total billed charges","50% of total billed charges",62.78,82.6,,50.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",11.63,76,
"SUT TICRON 3-0 CV 3256-41",185764,CDM,272,RC,,,OUTPATIENT,,,130,84.5,,114.4,88,,91.52,,,0,"percent of total billed charges","88% of total billed charges",65,50,,52.00,,,0,"percent of total billed charges","50% of total billed charges",21.84,16.8,,17.47,,,0,"percent of total billed charges","16.8% of total billed charges",130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.5,17.304,,18.00,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.9,63,,65.52,,,0,"percent of total billed charges","63% of total billed charges",19.89,15.3,,15.91,,,0,"percent of total billed charges","15.3% of total billed charges",21.84,16.8,,17.47,,,0,"percent of total billed charges","16.8% of total billed charges",89.7,69,,,,,0,"fee schedule","69% of total billed charges",130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.41,61.85,,64.33,,,0,"percent of total billed charges","61.5% of total billed charges",21.84,16.8,,17.47,,,0,"percent of total billed charges","16.8% of total billed charges",65,50,,52.00,,,0,"percent of total billed charges","50% of total billed charges",41.86,32.2,,33.49,,,0,"percent of total billed charges","32.2% of total billed charges",21.84,16.8,,17.47,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.28,17.136,,17.82,,,0,"percent of total billed charges","17.136% of total billed charges",28.39,21.84,,22.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",49.01,37.7,,39.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.4,78,,81.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",107.38,82.6,,85.90,,,0,"percent of total billed charges","82.6% of total billed charges",21.84,16.8,,17.47,,,0,"percent of total billed charges","16.8% of total billed charges",65,50,,52.00,,,0,"percent of total billed charges","50% of total billed charges",107.38,82.6,,85.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.84,16.8,,17.47,,,0,"percent of total billed charges","16.8% of total billed charges",130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",19.89,130,
"SUT VCRL 0 REEL 54IN UND  J287G",13797,CDM,272,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"SUT VICRYL 0 CT-1",9873,CDM,272,RC,,,OUTPATIENT,,,886,575.9,,779.68,88,,623.74,,,0,"percent of total billed charges","88% of total billed charges",443,50,,354.40,,,0,"percent of total billed charges","50% of total billed charges",148.85,16.8,,119.08,,,0,"percent of total billed charges","16.8% of total billed charges",886,100,,708.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",153.31,17.304,,122.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",558.18,63,,446.54,,,0,"percent of total billed charges","63% of total billed charges",135.56,15.3,,108.45,,,0,"percent of total billed charges","15.3% of total billed charges",148.85,16.8,,119.08,,,0,"percent of total billed charges","16.8% of total billed charges",611.34,69,,,,,0,"fee schedule","69% of total billed charges",886,100,,708.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",886,100,,708.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",886,100,,708.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",547.99,61.85,,438.39,,,0,"percent of total billed charges","61.5% of total billed charges",148.85,16.8,,119.08,,,0,"percent of total billed charges","16.8% of total billed charges",443,50,,354.40,,,0,"percent of total billed charges","50% of total billed charges",285.29,32.2,,228.23,,,0,"percent of total billed charges","32.2% of total billed charges",148.85,16.8,,119.08,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.82,17.136,,121.46,,,0,"percent of total billed charges","17.136% of total billed charges",193.5,21.84,,154.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",334.02,37.7,,267.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",691.08,78,,552.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",731.84,82.6,,585.47,,,0,"percent of total billed charges","82.6% of total billed charges",148.85,16.8,,119.08,,,0,"percent of total billed charges","16.8% of total billed charges",443,50,,354.40,,,0,"percent of total billed charges","50% of total billed charges",731.84,82.6,,585.47,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",148.85,16.8,,119.08,,,0,"percent of total billed charges","16.8% of total billed charges",886,100,,708.80,,,0,"percent of total billed charges","100% of total billed charges",135.56,886,
"SUT VICRYL 2 TP-1 J849G",34315,CDM,272,RC,,,OUTPATIENT,,,69,44.85,,60.72,88,,48.58,,,0,"percent of total billed charges","88% of total billed charges",34.5,50,,27.60,,,0,"percent of total billed charges","50% of total billed charges",11.59,16.8,,9.27,,,0,"percent of total billed charges","16.8% of total billed charges",69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.94,17.304,,9.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.47,63,,34.78,,,0,"percent of total billed charges","63% of total billed charges",10.56,15.3,,8.45,,,0,"percent of total billed charges","15.3% of total billed charges",11.59,16.8,,9.27,,,0,"percent of total billed charges","16.8% of total billed charges",47.61,69,,,,,0,"fee schedule","69% of total billed charges",69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.68,61.85,,34.14,,,0,"percent of total billed charges","61.5% of total billed charges",11.59,16.8,,9.27,,,0,"percent of total billed charges","16.8% of total billed charges",34.5,50,,27.60,,,0,"percent of total billed charges","50% of total billed charges",22.22,32.2,,17.78,,,0,"percent of total billed charges","32.2% of total billed charges",11.59,16.8,,9.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.82,17.136,,9.46,,,0,"percent of total billed charges","17.136% of total billed charges",15.07,21.84,,12.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.01,37.7,,20.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",53.82,78,,43.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.99,82.6,,45.59,,,0,"percent of total billed charges","82.6% of total billed charges",11.59,16.8,,9.27,,,0,"percent of total billed charges","16.8% of total billed charges",34.5,50,,27.60,,,0,"percent of total billed charges","50% of total billed charges",56.99,82.6,,45.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.59,16.8,,9.27,,,0,"percent of total billed charges","16.8% of total billed charges",69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",10.56,69,
"SUT VICRYL 6 0 PC 1",66704,CDM,272,RC,,,OUTPATIENT,,,353,229.45,,310.64,88,,248.51,,,0,"percent of total billed charges","88% of total billed charges",176.5,50,,141.20,,,0,"percent of total billed charges","50% of total billed charges",59.3,16.8,,47.44,,,0,"percent of total billed charges","16.8% of total billed charges",353,100,,282.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.08,17.304,,48.86,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",222.39,63,,177.91,,,0,"percent of total billed charges","63% of total billed charges",54.01,15.3,,43.21,,,0,"percent of total billed charges","15.3% of total billed charges",59.3,16.8,,47.44,,,0,"percent of total billed charges","16.8% of total billed charges",243.57,69,,,,,0,"fee schedule","69% of total billed charges",353,100,,282.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",353,100,,282.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",353,100,,282.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",218.33,61.85,,174.66,,,0,"percent of total billed charges","61.5% of total billed charges",59.3,16.8,,47.44,,,0,"percent of total billed charges","16.8% of total billed charges",176.5,50,,141.20,,,0,"percent of total billed charges","50% of total billed charges",113.67,32.2,,90.94,,,0,"percent of total billed charges","32.2% of total billed charges",59.3,16.8,,47.44,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.49,17.136,,48.39,,,0,"percent of total billed charges","17.136% of total billed charges",77.1,21.84,,61.68,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",133.08,37.7,,106.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",275.34,78,,220.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",291.58,82.6,,233.26,,,0,"percent of total billed charges","82.6% of total billed charges",59.3,16.8,,47.44,,,0,"percent of total billed charges","16.8% of total billed charges",176.5,50,,141.20,,,0,"percent of total billed charges","50% of total billed charges",291.58,82.6,,233.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.3,16.8,,47.44,,,0,"percent of total billed charges","16.8% of total billed charges",353,100,,282.40,,,0,"percent of total billed charges","100% of total billed charges",54.01,353,
"SUT VICRYL PLUS ANTIMICROB VIL BR 0 8-18 CT-1",157779,CDM,272,RC,,,OUTPATIENT,,,107,69.55,,94.16,88,,75.33,,,0,"percent of total billed charges","88% of total billed charges",53.5,50,,42.80,,,0,"percent of total billed charges","50% of total billed charges",17.98,16.8,,14.38,,,0,"percent of total billed charges","16.8% of total billed charges",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.52,17.304,,14.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.41,63,,53.93,,,0,"percent of total billed charges","63% of total billed charges",16.37,15.3,,13.10,,,0,"percent of total billed charges","15.3% of total billed charges",17.98,16.8,,14.38,,,0,"percent of total billed charges","16.8% of total billed charges",73.83,69,,,,,0,"fee schedule","69% of total billed charges",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",66.18,61.85,,52.94,,,0,"percent of total billed charges","61.5% of total billed charges",17.98,16.8,,14.38,,,0,"percent of total billed charges","16.8% of total billed charges",53.5,50,,42.80,,,0,"percent of total billed charges","50% of total billed charges",34.45,32.2,,27.56,,,0,"percent of total billed charges","32.2% of total billed charges",17.98,16.8,,14.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.34,17.136,,14.67,,,0,"percent of total billed charges","17.136% of total billed charges",23.37,21.84,,18.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",40.34,37.7,,32.27,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",83.46,78,,66.77,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.38,82.6,,70.70,,,0,"percent of total billed charges","82.6% of total billed charges",17.98,16.8,,14.38,,,0,"percent of total billed charges","16.8% of total billed charges",53.5,50,,42.80,,,0,"percent of total billed charges","50% of total billed charges",88.38,82.6,,70.70,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.98,16.8,,14.38,,,0,"percent of total billed charges","16.8% of total billed charges",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",16.37,107,
"SUT VCRL + 2-0 CT-1 27IN VCP259H",85395,CDM,272,RC,,,OUTPATIENT,,,409,265.85,,359.92,88,,287.94,,,0,"percent of total billed charges","88% of total billed charges",204.5,50,,163.60,,,0,"percent of total billed charges","50% of total billed charges",68.71,16.8,,54.97,,,0,"percent of total billed charges","16.8% of total billed charges",409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.77,17.304,,56.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",257.67,63,,206.14,,,0,"percent of total billed charges","63% of total billed charges",62.58,15.3,,50.06,,,0,"percent of total billed charges","15.3% of total billed charges",68.71,16.8,,54.97,,,0,"percent of total billed charges","16.8% of total billed charges",282.21,69,,,,,0,"fee schedule","69% of total billed charges",409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.97,61.85,,202.38,,,0,"percent of total billed charges","61.5% of total billed charges",68.71,16.8,,54.97,,,0,"percent of total billed charges","16.8% of total billed charges",204.5,50,,163.60,,,0,"percent of total billed charges","50% of total billed charges",131.7,32.2,,105.36,,,0,"percent of total billed charges","32.2% of total billed charges",68.71,16.8,,54.97,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.09,17.136,,56.07,,,0,"percent of total billed charges","17.136% of total billed charges",89.33,21.84,,71.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",154.19,37.7,,123.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",319.02,78,,255.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.83,82.6,,270.26,,,0,"percent of total billed charges","82.6% of total billed charges",68.71,16.8,,54.97,,,0,"percent of total billed charges","16.8% of total billed charges",204.5,50,,163.60,,,0,"percent of total billed charges","50% of total billed charges",337.83,82.6,,270.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.71,16.8,,54.97,,,0,"percent of total billed charges","16.8% of total billed charges",409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",62.58,409,
"SUT CTD VICRYL 2-0 UND BR C",165905,CDM,272,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"SUT CTD VICRYL 2-0 UND BR S",146858,CDM,272,RC,,,OUTPATIENT,,,50,32.5,,44,88,,35.20,,,0,"percent of total billed charges","88% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.65,17.304,,6.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.5,63,,25.20,,,0,"percent of total billed charges","63% of total billed charges",7.65,15.3,,6.12,,,0,"percent of total billed charges","15.3% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",34.5,69,,,,,0,"fee schedule","69% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.93,61.85,,24.74,,,0,"percent of total billed charges","61.5% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",16.1,32.2,,12.88,,,0,"percent of total billed charges","32.2% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.57,17.136,,6.86,,,0,"percent of total billed charges","17.136% of total billed charges",10.92,21.84,,8.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39,78,,31.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",7.65,50,
"SUT CTD VICRYL 0 UND BR CR/",165879,CDM,272,RC,,,OUTPATIENT,,,77,50.05,,67.76,88,,54.21,,,0,"percent of total billed charges","88% of total billed charges",38.5,50,,30.80,,,0,"percent of total billed charges","50% of total billed charges",12.94,16.8,,10.35,,,0,"percent of total billed charges","16.8% of total billed charges",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.32,17.304,,10.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.51,63,,38.81,,,0,"percent of total billed charges","63% of total billed charges",11.78,15.3,,9.42,,,0,"percent of total billed charges","15.3% of total billed charges",12.94,16.8,,10.35,,,0,"percent of total billed charges","16.8% of total billed charges",53.13,69,,,,,0,"fee schedule","69% of total billed charges",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.62,61.85,,38.10,,,0,"percent of total billed charges","61.5% of total billed charges",12.94,16.8,,10.35,,,0,"percent of total billed charges","16.8% of total billed charges",38.5,50,,30.80,,,0,"percent of total billed charges","50% of total billed charges",24.79,32.2,,19.83,,,0,"percent of total billed charges","32.2% of total billed charges",12.94,16.8,,10.35,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.19,17.136,,10.55,,,0,"percent of total billed charges","17.136% of total billed charges",16.82,21.84,,13.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.03,37.7,,23.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",60.06,78,,48.05,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.6,82.6,,50.88,,,0,"percent of total billed charges","82.6% of total billed charges",12.94,16.8,,10.35,,,0,"percent of total billed charges","16.8% of total billed charges",38.5,50,,30.80,,,0,"percent of total billed charges","50% of total billed charges",63.6,82.6,,50.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.94,16.8,,10.35,,,0,"percent of total billed charges","16.8% of total billed charges",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",11.78,77,
"SUT MONOCRYL 0 CT-1 Y740D",50304,CDM,272,RC,,,OUTPATIENT,,,87,56.55,,76.56,88,,61.25,,,0,"percent of total billed charges","88% of total billed charges",43.5,50,,34.80,,,0,"percent of total billed charges","50% of total billed charges",14.62,16.8,,11.70,,,0,"percent of total billed charges","16.8% of total billed charges",87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.05,17.304,,12.04,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",54.81,63,,43.85,,,0,"percent of total billed charges","63% of total billed charges",13.31,15.3,,10.65,,,0,"percent of total billed charges","15.3% of total billed charges",14.62,16.8,,11.70,,,0,"percent of total billed charges","16.8% of total billed charges",60.03,69,,,,,0,"fee schedule","69% of total billed charges",87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.81,61.85,,43.05,,,0,"percent of total billed charges","61.5% of total billed charges",14.62,16.8,,11.70,,,0,"percent of total billed charges","16.8% of total billed charges",43.5,50,,34.80,,,0,"percent of total billed charges","50% of total billed charges",28.01,32.2,,22.41,,,0,"percent of total billed charges","32.2% of total billed charges",14.62,16.8,,11.70,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.91,17.136,,11.93,,,0,"percent of total billed charges","17.136% of total billed charges",19,21.84,,15.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",32.8,37.7,,26.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",67.86,78,,54.29,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.86,82.6,,57.49,,,0,"percent of total billed charges","82.6% of total billed charges",14.62,16.8,,11.70,,,0,"percent of total billed charges","16.8% of total billed charges",43.5,50,,34.80,,,0,"percent of total billed charges","50% of total billed charges",71.86,82.6,,57.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.62,16.8,,11.70,,,0,"percent of total billed charges","16.8% of total billed charges",87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",13.31,87,
"SUT SILK 3-0 12-18 LABYRINT",147059,CDM,272,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"SUT PRLN 4-0 RB-1 36IN DBL ARM 8557H",166136,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SUT PRLN 3-0 FS-2 18IN 8665G",11365,CDM,272,RC,,,OUTPATIENT,,,23,14.95,,20.24,88,,16.19,,,0,"percent of total billed charges","88% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.98,17.304,,3.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.49,63,,11.59,,,0,"percent of total billed charges","63% of total billed charges",3.52,15.3,,2.82,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",15.87,69,,,,,0,"fee schedule","69% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.23,61.85,,11.38,,,0,"percent of total billed charges","61.5% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",7.41,32.2,,5.93,,,0,"percent of total billed charges","32.2% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.94,17.136,,3.15,,,0,"percent of total billed charges","17.136% of total billed charges",5.02,21.84,,4.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.94,78,,14.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",3.52,23,
"SUT PRLN 2-0 SH 30IN 8833H",11363,CDM,272,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"SUT ETHILON 2-0 1674H",13887,CDM,272,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"SUT MRSLN 5MM BP 12IN RS20",13826,CDM,272,RC,,,OUTPATIENT,,,192,124.8,,168.96,88,,135.17,,,0,"percent of total billed charges","88% of total billed charges",96,50,,76.80,,,0,"percent of total billed charges","50% of total billed charges",32.26,16.8,,25.81,,,0,"percent of total billed charges","16.8% of total billed charges",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.22,17.304,,26.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",120.96,63,,96.77,,,0,"percent of total billed charges","63% of total billed charges",29.38,15.3,,23.50,,,0,"percent of total billed charges","15.3% of total billed charges",32.26,16.8,,25.81,,,0,"percent of total billed charges","16.8% of total billed charges",132.48,69,,,,,0,"fee schedule","69% of total billed charges",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",118.75,61.85,,95.00,,,0,"percent of total billed charges","61.5% of total billed charges",32.26,16.8,,25.81,,,0,"percent of total billed charges","16.8% of total billed charges",96,50,,76.80,,,0,"percent of total billed charges","50% of total billed charges",61.82,32.2,,49.46,,,0,"percent of total billed charges","32.2% of total billed charges",32.26,16.8,,25.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.9,17.136,,26.32,,,0,"percent of total billed charges","17.136% of total billed charges",41.93,21.84,,33.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",72.38,37.7,,57.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",149.76,78,,119.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.59,82.6,,126.87,,,0,"percent of total billed charges","82.6% of total billed charges",32.26,16.8,,25.81,,,0,"percent of total billed charges","16.8% of total billed charges",96,50,,76.80,,,0,"percent of total billed charges","50% of total billed charges",158.59,82.6,,126.87,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.26,16.8,,25.81,,,0,"percent of total billed charges","16.8% of total billed charges",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",29.38,192,
"SUT ETHBND 2-0 SH 30IN DBL ARM WHITE 10X82",184791,CDM,272,RC,,,OUTPATIENT,,,227,147.55,,199.76,88,,159.81,,,0,"percent of total billed charges","88% of total billed charges",113.5,50,,90.80,,,0,"percent of total billed charges","50% of total billed charges",38.14,16.8,,30.51,,,0,"percent of total billed charges","16.8% of total billed charges",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.28,17.304,,31.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",143.01,63,,114.41,,,0,"percent of total billed charges","63% of total billed charges",34.73,15.3,,27.78,,,0,"percent of total billed charges","15.3% of total billed charges",38.14,16.8,,30.51,,,0,"percent of total billed charges","16.8% of total billed charges",156.63,69,,,,,0,"fee schedule","69% of total billed charges",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",140.4,61.85,,112.32,,,0,"percent of total billed charges","61.5% of total billed charges",38.14,16.8,,30.51,,,0,"percent of total billed charges","16.8% of total billed charges",113.5,50,,90.80,,,0,"percent of total billed charges","50% of total billed charges",73.09,32.2,,58.47,,,0,"percent of total billed charges","32.2% of total billed charges",38.14,16.8,,30.51,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.9,17.136,,31.12,,,0,"percent of total billed charges","17.136% of total billed charges",49.58,21.84,,39.66,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",85.58,37.7,,68.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",177.06,78,,141.65,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",187.5,82.6,,150.00,,,0,"percent of total billed charges","82.6% of total billed charges",38.14,16.8,,30.51,,,0,"percent of total billed charges","16.8% of total billed charges",113.5,50,,90.80,,,0,"percent of total billed charges","50% of total billed charges",187.5,82.6,,150.00,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.14,16.8,,30.51,,,0,"percent of total billed charges","16.8% of total billed charges",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",34.73,227,
"SUT CHR GUT 6 0 PS 4 18IN",56944,CDM,272,RC,,,OUTPATIENT,,,39,25.35,,34.32,88,,27.46,,,0,"percent of total billed charges","88% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.75,17.304,,5.40,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.57,63,,19.66,,,0,"percent of total billed charges","63% of total billed charges",5.97,15.3,,4.78,,,0,"percent of total billed charges","15.3% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",26.91,69,,,,,0,"fee schedule","69% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.12,61.85,,19.30,,,0,"percent of total billed charges","61.5% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",12.56,32.2,,10.05,,,0,"percent of total billed charges","32.2% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.68,17.136,,5.34,,,0,"percent of total billed charges","17.136% of total billed charges",8.52,21.84,,6.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.42,78,,24.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",5.97,39,
"SUT 0 27 PDS PLUS VIO MONO CT-1",266013,CDM,272,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"SUT VICRYL 3-0 PS-1",84362,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SUT VICRYL 3-0 SH 27 INCH",237411,CDM,272,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"SUT VICRYL 4-0 J494G",17162330,CDM,272,RC,,,OUTPATIENT,,,29,18.85,,25.52,88,,20.42,,,0,"percent of total billed charges","88% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.02,17.304,,4.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.27,63,,14.62,,,0,"percent of total billed charges","63% of total billed charges",4.44,15.3,,3.55,,,0,"percent of total billed charges","15.3% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",20.01,69,,,,,0,"fee schedule","69% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.94,61.85,,14.35,,,0,"percent of total billed charges","61.5% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",9.34,32.2,,7.47,,,0,"percent of total billed charges","32.2% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.97,17.136,,3.98,,,0,"percent of total billed charges","17.136% of total billed charges",6.33,21.84,,5.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.93,37.7,,8.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,78,,18.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",4.44,29,
"VICRYL 4-0 SH (J415H)",491680,CDM,272,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"ANCHOR BIO-COMPOSITE SWIVELOCK",ORSUP0022,CDM,278,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",919.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.7% of total billed charges",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",998.69,33.9,,798.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"SUTURE ANCHOR 2.4 X 6.5MM",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"SUTURE ANCHOR BIOCOMP SWIVELLOCK C VENTED 4.75 X 19.1MM",ORSUP0021,CDM,278,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",835.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.7% of total billed charges",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",907.84,33.9,,726.27,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"SUTURE ANCHOR SWIVEL LOCK C 5.5X19.1 CLOSED EYELET",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",751.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.7% of total billed charges",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",816.99,33.9,,653.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"SUTURE TI-KNOT QUICK LOAD TK5 DEVICE",ORSUP0031,CDM,272,RC,,,OUTPATIENT,,,5356,3481.4,,4713.28,88,,3770.62,,,0,"percent of total billed charges","88% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",926.8,17.304,,741.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3374.28,63,,2699.42,,,0,"percent of total billed charges","63% of total billed charges",819.47,15.3,,655.58,,,0,"percent of total billed charges","15.3% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",3695.64,69,,,,,0,"fee schedule","69% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3312.69,61.85,,2650.15,,,0,"percent of total billed charges","61.5% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",1724.63,32.2,,1379.70,,,0,"percent of total billed charges","32.2% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",917.8,17.136,,734.24,,,0,"percent of total billed charges","17.136% of total billed charges",1169.75,21.84,,935.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4177.68,78,,3342.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",819.47,5356,
"SUTURE TIE KNOT TITANIUM",ORSUP0026,CDM,272,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"SUTURE LASSO 25 DEGREE",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SUTURE LASSO 25 DEGREE TIGHT LEFT",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SUTURE LASSO CRESCENT",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SUTURE CTD VICRYL 5-0 UND BR P-3",13863,CDM,272,RC,,,OUTPATIENT,,,33,21.45,,29.04,88,,23.23,,,0,"percent of total billed charges","88% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,17.304,,4.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.79,63,,16.63,,,0,"percent of total billed charges","63% of total billed charges",5.05,15.3,,4.04,,,0,"percent of total billed charges","15.3% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",22.77,69,,,,,0,"fee schedule","69% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.41,61.85,,16.33,,,0,"percent of total billed charges","61.5% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",10.63,32.2,,8.50,,,0,"percent of total billed charges","32.2% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.65,17.136,,4.52,,,0,"percent of total billed charges","17.136% of total billed charges",7.21,21.84,,5.77,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.44,37.7,,9.95,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25.74,78,,20.59,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",5.05,33,
"SUTURE VICRYL J284G 4-0 REEL UND",32399,CDM,272,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"SUTURE VICRYL J415H 4-0 SH UNDY",165951,CDM,272,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"SUTURE COATED VICRYL UND BR 4-0 URL. 27 RB-1",39366,CDM,272,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"SUTURE VICRYL J783G 4-0 SH CR/8",80881,CDM,272,RC,,,OUTPATIENT,,,82,53.3,,72.16,88,,57.73,,,0,"percent of total billed charges","88% of total billed charges",41,50,,32.80,,,0,"percent of total billed charges","50% of total billed charges",13.78,16.8,,11.02,,,0,"percent of total billed charges","16.8% of total billed charges",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.19,17.304,,11.35,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.66,63,,41.33,,,0,"percent of total billed charges","63% of total billed charges",12.55,15.3,,10.04,,,0,"percent of total billed charges","15.3% of total billed charges",13.78,16.8,,11.02,,,0,"percent of total billed charges","16.8% of total billed charges",56.58,69,,,,,0,"fee schedule","69% of total billed charges",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.72,61.85,,40.58,,,0,"percent of total billed charges","61.5% of total billed charges",13.78,16.8,,11.02,,,0,"percent of total billed charges","16.8% of total billed charges",41,50,,32.80,,,0,"percent of total billed charges","50% of total billed charges",26.4,32.2,,21.12,,,0,"percent of total billed charges","32.2% of total billed charges",13.78,16.8,,11.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.05,17.136,,11.24,,,0,"percent of total billed charges","17.136% of total billed charges",17.91,21.84,,14.33,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.91,37.7,,24.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",63.96,78,,51.17,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.73,82.6,,54.18,,,0,"percent of total billed charges","82.6% of total billed charges",13.78,16.8,,11.02,,,0,"percent of total billed charges","16.8% of total billed charges",41,50,,32.80,,,0,"percent of total billed charges","50% of total billed charges",67.73,82.6,,54.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.78,16.8,,11.02,,,0,"percent of total billed charges","16.8% of total billed charges",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",12.55,82,
"SUTURE VICRYL J823G 4-0 PC-5 UN",98932,CDM,272,RC,,,OUTPATIENT,,,29,18.85,,25.52,88,,20.42,,,0,"percent of total billed charges","88% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.02,17.304,,4.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.27,63,,14.62,,,0,"percent of total billed charges","63% of total billed charges",4.44,15.3,,3.55,,,0,"percent of total billed charges","15.3% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",20.01,69,,,,,0,"fee schedule","69% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.94,61.85,,14.35,,,0,"percent of total billed charges","61.5% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",9.34,32.2,,7.47,,,0,"percent of total billed charges","32.2% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.97,17.136,,3.98,,,0,"percent of total billed charges","17.136% of total billed charges",6.33,21.84,,5.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.93,37.7,,8.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,78,,18.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",4.44,29,
"SUTURE COATED VICRYL UND BR 4-0 CUT. 27 FS-2",13696,CDM,272,RC,,,OUTPATIENT,,,21,13.65,,18.48,88,,14.78,,,0,"percent of total billed charges","88% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.63,17.304,,2.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.23,63,,10.58,,,0,"percent of total billed charges","63% of total billed charges",3.21,15.3,,2.57,,,0,"percent of total billed charges","15.3% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",14.49,69,,,,,0,"fee schedule","69% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.99,61.85,,10.39,,,0,"percent of total billed charges","61.5% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",6.76,32.2,,5.41,,,0,"percent of total billed charges","32.2% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.6,17.136,,2.88,,,0,"percent of total billed charges","17.136% of total billed charges",4.59,21.84,,3.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.92,37.7,,6.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.38,78,,13.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",3.21,21,
"SUTURE COATED VICRYL UND BR 3-0 CLOSURE 27 CT-1",13690,CDM,272,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"SUTURE VICRYL J824G 3-0 PC-5 UN",80859,CDM,272,RC,,,OUTPATIENT,,,29,18.85,,25.52,88,,20.42,,,0,"percent of total billed charges","88% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.02,17.304,,4.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.27,63,,14.62,,,0,"percent of total billed charges","63% of total billed charges",4.44,15.3,,3.55,,,0,"percent of total billed charges","15.3% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",20.01,69,,,,,0,"fee schedule","69% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.94,61.85,,14.35,,,0,"percent of total billed charges","61.5% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",9.34,32.2,,7.47,,,0,"percent of total billed charges","32.2% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.97,17.136,,3.98,,,0,"percent of total billed charges","17.136% of total billed charges",6.33,21.84,,5.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.93,37.7,,8.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,78,,18.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",4.44,29,
"SUTURE VICRYL J869H 2-0 CP-2 UN",157497,CDM,272,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"SUTURE VICRYL J266H 2-0 CP-1 UD",157499,CDM,272,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"SUTURE VICRYL J259H2-0CT-1UND27IN",165904,CDM,272,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"SUTURE VICRYL J762D 2-0 CP-2 CR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SUTURE VICRYL J261H #1CT-1UND36IN",165893,CDM,272,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"SUTURE COATED VICRYL VIL BR 0 URL. 27 UR-6",32185,CDM,272,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"SUTURE VICRYL J270H #0 CT-2 UD",40253,CDM,272,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"SUTURE VICRYL J727D #0 CT-2 BR",165887,CDM,272,RC,,,OUTPATIENT,,,97,63.05,,85.36,88,,68.29,,,0,"percent of total billed charges","88% of total billed charges",48.5,50,,38.80,,,0,"percent of total billed charges","50% of total billed charges",16.3,16.8,,13.04,,,0,"percent of total billed charges","16.8% of total billed charges",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.78,17.304,,13.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.11,63,,48.89,,,0,"percent of total billed charges","63% of total billed charges",14.84,15.3,,11.87,,,0,"percent of total billed charges","15.3% of total billed charges",16.3,16.8,,13.04,,,0,"percent of total billed charges","16.8% of total billed charges",66.93,69,,,,,0,"fee schedule","69% of total billed charges",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.99,61.85,,47.99,,,0,"percent of total billed charges","61.5% of total billed charges",16.3,16.8,,13.04,,,0,"percent of total billed charges","16.8% of total billed charges",48.5,50,,38.80,,,0,"percent of total billed charges","50% of total billed charges",31.23,32.2,,24.98,,,0,"percent of total billed charges","32.2% of total billed charges",16.3,16.8,,13.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.62,17.136,,13.30,,,0,"percent of total billed charges","17.136% of total billed charges",21.18,21.84,,16.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.57,37.7,,29.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.66,78,,60.53,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.12,82.6,,64.10,,,0,"percent of total billed charges","82.6% of total billed charges",16.3,16.8,,13.04,,,0,"percent of total billed charges","16.8% of total billed charges",48.5,50,,38.80,,,0,"percent of total billed charges","50% of total billed charges",80.12,82.6,,64.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.3,16.8,,13.04,,,0,"percent of total billed charges","16.8% of total billed charges",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",14.84,97,
"SUTURE COAT VICRYL UND BR 0 CLOSURE 27 CT-1",39367,CDM,272,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"SUTURE VICRYL PLUS CTD VCP946H",215819,CDM,272,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"SUTURE COATED VICRYL VIL BR 2-0 18 SH-1",70829,CDM,272,RC,,,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",47.5,50,,38.00,,,0,"percent of total billed charges","50% of total billed charges",15.96,16.8,,12.77,,,0,"percent of total billed charges","16.8% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.44,17.304,,13.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",15.96,16.8,,12.77,,,0,"percent of total billed charges","16.8% of total billed charges",65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.76,61.85,,47.01,,,0,"percent of total billed charges","61.5% of total billed charges",15.96,16.8,,12.77,,,0,"percent of total billed charges","16.8% of total billed charges",47.5,50,,38.00,,,0,"percent of total billed charges","50% of total billed charges",30.59,32.2,,24.47,,,0,"percent of total billed charges","32.2% of total billed charges",15.96,16.8,,12.77,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.28,17.136,,13.02,,,0,"percent of total billed charges","17.136% of total billed charges",20.75,21.84,,16.60,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",15.96,16.8,,12.77,,,0,"percent of total billed charges","16.8% of total billed charges",47.5,50,,38.00,,,0,"percent of total billed charges","50% of total billed charges",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.96,16.8,,12.77,,,0,"percent of total billed charges","16.8% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,95,
"SUTURE PROLENE BL MONO 5-0 PLASTIC 18 P-3 12/BX",13660,CDM,272,RC,,,OUTPATIENT,,,32,20.8,,28.16,88,,22.53,,,0,"percent of total billed charges","88% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.54,17.304,,4.43,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.16,63,,16.13,,,0,"percent of total billed charges","63% of total billed charges",4.9,15.3,,3.92,,,0,"percent of total billed charges","15.3% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",22.08,69,,,,,0,"fee schedule","69% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.79,61.85,,15.83,,,0,"percent of total billed charges","61.5% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",10.3,32.2,,8.24,,,0,"percent of total billed charges","32.2% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.48,17.136,,4.38,,,0,"percent of total billed charges","17.136% of total billed charges",6.99,21.84,,5.59,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.96,78,,19.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",4.9,32,
"SUTURE CHRMIC U203H 4-0 RB-1",169743,CDM,272,RC,,,OUTPATIENT,,,30,19.5,,26.4,88,,21.12,,,0,"percent of total billed charges","88% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.19,17.304,,4.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.9,63,,15.12,,,0,"percent of total billed charges","63% of total billed charges",4.59,15.3,,3.67,,,0,"percent of total billed charges","15.3% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",20.7,69,,,,,0,"fee schedule","69% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.56,61.85,,14.85,,,0,"percent of total billed charges","61.5% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",9.66,32.2,,7.73,,,0,"percent of total billed charges","32.2% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.14,17.136,,4.11,,,0,"percent of total billed charges","17.136% of total billed charges",6.55,21.84,,5.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.31,37.7,,9.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.4,78,,18.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",4.59,30,
"SUTURE CHRMIC 636H 3-0 FS-2 27",13806,CDM,272,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"SUTURE #2 QUILL PDO",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SUTURE 0 CT-1 QUILL",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SUTURE STEEL M655G#7CCS MS/4 18",57299,CDM,272,RC,,,OUTPATIENT,,,94,61.1,,82.72,88,,66.18,,,0,"percent of total billed charges","88% of total billed charges",47,50,,37.60,,,0,"percent of total billed charges","50% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.27,17.304,,13.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.22,63,,47.38,,,0,"percent of total billed charges","63% of total billed charges",14.38,15.3,,11.50,,,0,"percent of total billed charges","15.3% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",64.86,69,,,,,0,"fee schedule","69% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.14,61.85,,46.51,,,0,"percent of total billed charges","61.5% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",47,50,,37.60,,,0,"percent of total billed charges","50% of total billed charges",30.27,32.2,,24.22,,,0,"percent of total billed charges","32.2% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.11,17.136,,12.89,,,0,"percent of total billed charges","17.136% of total billed charges",20.53,21.84,,16.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.44,37.7,,28.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",73.32,78,,58.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",47,50,,37.60,,,0,"percent of total billed charges","50% of total billed charges",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",14.38,94,
"SUTURE STEELM649G #6V-40MP/418",13884,CDM,272,RC,,,OUTPATIENT,,,80,52,,70.4,88,,56.32,,,0,"percent of total billed charges","88% of total billed charges",40,50,,32.00,,,0,"percent of total billed charges","50% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.84,17.304,,11.07,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.4,63,,40.32,,,0,"percent of total billed charges","63% of total billed charges",12.24,15.3,,9.79,,,0,"percent of total billed charges","15.3% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",55.2,69,,,,,0,"fee schedule","69% of total billed charges",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.48,61.85,,39.58,,,0,"percent of total billed charges","61.5% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",40,50,,32.00,,,0,"percent of total billed charges","50% of total billed charges",25.76,32.2,,20.61,,,0,"percent of total billed charges","32.2% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.71,17.136,,10.97,,,0,"percent of total billed charges","17.136% of total billed charges",17.47,21.84,,13.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.16,37.7,,24.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",62.4,78,,49.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",66.08,82.6,,52.86,,,0,"percent of total billed charges","82.6% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",40,50,,32.00,,,0,"percent of total billed charges","50% of total billed charges",66.08,82.6,,52.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",12.24,80,
"SUTURE SILK BLK BR 4-0 CUTICULAR 18 FS-2",13674,CDM,272,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"SUTURE SILK BLK BR 4-0 NEURO 18 TF-4",46115,CDM,272,RC,,,OUTPATIENT,,,23,14.95,,20.24,88,,16.19,,,0,"percent of total billed charges","88% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.98,17.304,,3.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.49,63,,11.59,,,0,"percent of total billed charges","63% of total billed charges",3.52,15.3,,2.82,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",15.87,69,,,,,0,"fee schedule","69% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.23,61.85,,11.38,,,0,"percent of total billed charges","61.5% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",7.41,32.2,,5.93,,,0,"percent of total billed charges","32.2% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.94,17.136,,3.15,,,0,"percent of total billed charges","17.136% of total billed charges",5.02,21.84,,4.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.94,78,,14.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",3.52,23,
"SUTURE SILK BLK BR 3-0 CUTICULAR 18 FS-1",13672,CDM,272,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"SUTURE SILK BLK BR 2-0 G.I.CARDIO 30 SH",11372,CDM,272,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"SUTURE SLK 685H BLK BR2-0FS 18",166182,CDM,272,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"SUTURE SLK A305H 2-0 STRND 30",157729,CDM,272,RC,,,OUTPATIENT,,,24,15.6,,21.12,88,,16.90,,,0,"percent of total billed charges","88% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.15,17.304,,3.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.12,63,,12.10,,,0,"percent of total billed charges","63% of total billed charges",3.67,15.3,,2.94,,,0,"percent of total billed charges","15.3% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",16.56,69,,,,,0,"fee schedule","69% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.84,61.85,,11.87,,,0,"percent of total billed charges","61.5% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",7.73,32.2,,6.18,,,0,"percent of total billed charges","32.2% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.11,17.136,,3.29,,,0,"percent of total billed charges","17.136% of total billed charges",5.24,21.84,,4.19,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.05,37.7,,7.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.72,78,,14.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,24,
"SUTURE SLK A306H #0 STRAND 30IN",147043,CDM,272,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.95,61.85,,3.96,,,0,"percent of total billed charges","61.5% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"SUTURE PRLN M8706 6-0 C-1 M",13881,CDM,272,RC,,,OUTPATIENT,,,263,170.95,,231.44,88,,185.15,,,0,"percent of total billed charges","88% of total billed charges",131.5,50,,105.20,,,0,"percent of total billed charges","50% of total billed charges",44.18,16.8,,35.34,,,0,"percent of total billed charges","16.8% of total billed charges",263,100,,210.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.51,17.304,,36.41,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.69,63,,132.55,,,0,"percent of total billed charges","63% of total billed charges",40.24,15.3,,32.19,,,0,"percent of total billed charges","15.3% of total billed charges",44.18,16.8,,35.34,,,0,"percent of total billed charges","16.8% of total billed charges",181.47,69,,,,,0,"fee schedule","69% of total billed charges",263,100,,210.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",263,100,,210.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",263,100,,210.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.67,61.85,,130.14,,,0,"percent of total billed charges","61.5% of total billed charges",44.18,16.8,,35.34,,,0,"percent of total billed charges","16.8% of total billed charges",131.5,50,,105.20,,,0,"percent of total billed charges","50% of total billed charges",84.69,32.2,,67.75,,,0,"percent of total billed charges","32.2% of total billed charges",44.18,16.8,,35.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.07,17.136,,36.06,,,0,"percent of total billed charges","17.136% of total billed charges",57.44,21.84,,45.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",99.15,37.7,,79.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",205.14,78,,164.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",217.24,82.6,,173.79,,,0,"percent of total billed charges","82.6% of total billed charges",44.18,16.8,,35.34,,,0,"percent of total billed charges","16.8% of total billed charges",131.5,50,,105.20,,,0,"percent of total billed charges","50% of total billed charges",217.24,82.6,,173.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.18,16.8,,35.34,,,0,"percent of total billed charges","16.8% of total billed charges",263,100,,210.40,,,0,"percent of total billed charges","100% of total billed charges",40.24,263,
"SUTURE PRLN 8706H 6-0 C-1 DA",147033,CDM,272,RC,,,OUTPATIENT,,,65,42.25,,57.2,88,,45.76,,,0,"percent of total billed charges","88% of total billed charges",32.5,50,,26.00,,,0,"percent of total billed charges","50% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.25,17.304,,9.00,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.95,63,,32.76,,,0,"percent of total billed charges","63% of total billed charges",9.95,15.3,,7.96,,,0,"percent of total billed charges","15.3% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",44.85,69,,,,,0,"fee schedule","69% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.2,61.85,,32.16,,,0,"percent of total billed charges","61.5% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",32.5,50,,26.00,,,0,"percent of total billed charges","50% of total billed charges",20.93,32.2,,16.74,,,0,"percent of total billed charges","32.2% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.14,17.136,,8.91,,,0,"percent of total billed charges","17.136% of total billed charges",14.2,21.84,,11.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.51,37.7,,19.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.7,78,,40.56,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",32.5,50,,26.00,,,0,"percent of total billed charges","50% of total billed charges",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",9.95,65,
"SUTURE PROLENE BL MONO 6-0 PLASTIC 18 P-3 12/BX",13717,CDM,272,RC,,,OUTPATIENT,,,408,265.2,,359.04,88,,287.23,,,0,"percent of total billed charges","88% of total billed charges",204,50,,163.20,,,0,"percent of total billed charges","50% of total billed charges",68.54,16.8,,54.83,,,0,"percent of total billed charges","16.8% of total billed charges",408,100,,326.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.6,17.304,,56.48,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",257.04,63,,205.63,,,0,"percent of total billed charges","63% of total billed charges",62.42,15.3,,49.94,,,0,"percent of total billed charges","15.3% of total billed charges",68.54,16.8,,54.83,,,0,"percent of total billed charges","16.8% of total billed charges",281.52,69,,,,,0,"fee schedule","69% of total billed charges",408,100,,326.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",408,100,,326.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",408,100,,326.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.35,61.85,,201.88,,,0,"percent of total billed charges","61.5% of total billed charges",68.54,16.8,,54.83,,,0,"percent of total billed charges","16.8% of total billed charges",204,50,,163.20,,,0,"percent of total billed charges","50% of total billed charges",131.38,32.2,,105.10,,,0,"percent of total billed charges","32.2% of total billed charges",68.54,16.8,,54.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.91,17.136,,55.93,,,0,"percent of total billed charges","17.136% of total billed charges",89.11,21.84,,71.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",153.82,37.7,,123.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",318.24,78,,254.59,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.01,82.6,,269.61,,,0,"percent of total billed charges","82.6% of total billed charges",68.54,16.8,,54.83,,,0,"percent of total billed charges","16.8% of total billed charges",204,50,,163.20,,,0,"percent of total billed charges","50% of total billed charges",337.01,82.6,,269.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.54,16.8,,54.83,,,0,"percent of total billed charges","16.8% of total billed charges",408,100,,326.40,,,0,"percent of total billed charges","100% of total billed charges",62.42,408,
"SUTURE PRLN 8556H 5-0 RB-1 36IN",110818,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SUTURE PRLN 8522H 3-0 SH DA36",166128,CDM,272,RC,,,OUTPATIENT,,,35,22.75,,30.8,88,,24.64,,,0,"percent of total billed charges","88% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.06,17.304,,4.85,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.05,63,,17.64,,,0,"percent of total billed charges","63% of total billed charges",5.36,15.3,,4.29,,,0,"percent of total billed charges","15.3% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",24.15,69,,,,,0,"fee schedule","69% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.65,61.85,,17.32,,,0,"percent of total billed charges","61.5% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",11.27,32.2,,9.02,,,0,"percent of total billed charges","32.2% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,17.136,,4.80,,,0,"percent of total billed charges","17.136% of total billed charges",7.64,21.84,,6.11,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.2,37.7,,10.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",27.3,78,,21.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.91,82.6,,23.13,,,0,"percent of total billed charges","82.6% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",28.91,82.6,,23.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",5.36,35,
"SUTURE PROLENE BL MONO 3-0 CARDIO 48 SHSH",13834,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SUTURE PRLN 8558H 3-0 RB-1DA36",166127,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SUTURE PRLN 8824G #1 TP-1 60IN",14652,CDM,272,RC,,,OUTPATIENT,,,26,16.9,,22.88,88,,18.30,,,0,"percent of total billed charges","88% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.5,17.304,,3.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.38,63,,13.10,,,0,"percent of total billed charges","63% of total billed charges",3.98,15.3,,3.18,,,0,"percent of total billed charges","15.3% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",17.94,69,,,,,0,"fee schedule","69% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.08,61.85,,12.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",8.37,32.2,,6.70,,,0,"percent of total billed charges","32.2% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.46,17.136,,3.57,,,0,"percent of total billed charges","17.136% of total billed charges",5.68,21.84,,4.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.8,37.7,,7.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.28,78,,16.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",3.98,26,
"SUTURE PRLN 8435H #1 CT 30IN",11362,CDM,272,RC,,,OUTPATIENT,,,22,14.3,,19.36,88,,15.49,,,0,"percent of total billed charges","88% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.81,17.304,,3.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.86,63,,11.09,,,0,"percent of total billed charges","63% of total billed charges",3.37,15.3,,2.70,,,0,"percent of total billed charges","15.3% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",15.18,69,,,,,0,"fee schedule","69% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.61,61.85,,10.89,,,0,"percent of total billed charges","61.5% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",7.08,32.2,,5.66,,,0,"percent of total billed charges","32.2% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.77,17.136,,3.02,,,0,"percent of total billed charges","17.136% of total billed charges",4.8,21.84,,3.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.29,37.7,,6.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.16,78,,13.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",3.37,22,
"SUTURE PRLN 8424H #0 CT-1 30IN",157679,CDM,272,RC,,,OUTPATIENT,,,22,14.3,,19.36,88,,15.49,,,0,"percent of total billed charges","88% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.81,17.304,,3.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.86,63,,11.09,,,0,"percent of total billed charges","63% of total billed charges",3.37,15.3,,2.70,,,0,"percent of total billed charges","15.3% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",15.18,69,,,,,0,"fee schedule","69% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.61,61.85,,10.89,,,0,"percent of total billed charges","61.5% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",7.08,32.2,,5.66,,,0,"percent of total billed charges","32.2% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.77,17.136,,3.02,,,0,"percent of total billed charges","17.136% of total billed charges",4.8,21.84,,3.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.29,37.7,,6.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.16,78,,13.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",3.37,22,
"SUTURE GUT PL 2-0 STANDARD 54",46178,CDM,272,RC,,,OUTPATIENT,,,21,13.65,,18.48,88,,14.78,,,0,"percent of total billed charges","88% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.63,17.304,,2.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.23,63,,10.58,,,0,"percent of total billed charges","63% of total billed charges",3.21,15.3,,2.57,,,0,"percent of total billed charges","15.3% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",14.49,69,,,,,0,"fee schedule","69% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.99,61.85,,10.39,,,0,"percent of total billed charges","61.5% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",6.76,32.2,,5.41,,,0,"percent of total billed charges","32.2% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.6,17.136,,2.88,,,0,"percent of total billed charges","17.136% of total billed charges",4.59,21.84,,3.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.92,37.7,,6.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.38,78,,13.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",3.21,21,
"SUTURE PDS II 2-0 CT-1 VIL MON",157647,CDM,272,RC,,,OUTPATIENT,,,22,14.3,,19.36,88,,15.49,,,0,"percent of total billed charges","88% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.81,17.304,,3.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.86,63,,11.09,,,0,"percent of total billed charges","63% of total billed charges",3.37,15.3,,2.70,,,0,"percent of total billed charges","15.3% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",15.18,69,,,,,0,"fee schedule","69% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.61,61.85,,10.89,,,0,"percent of total billed charges","61.5% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",7.08,32.2,,5.66,,,0,"percent of total billed charges","32.2% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.77,17.136,,3.02,,,0,"percent of total billed charges","17.136% of total billed charges",4.8,21.84,,3.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.29,37.7,,6.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.16,78,,13.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",3.37,22,
"SUTURE PDSII 0 TP-1 VIL MONO",157643,CDM,272,RC,,,OUTPATIENT,,,34,22.1,,29.92,88,,23.94,,,0,"percent of total billed charges","88% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.88,17.304,,4.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.42,63,,17.14,,,0,"percent of total billed charges","63% of total billed charges",5.2,15.3,,4.16,,,0,"percent of total billed charges","15.3% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",23.46,69,,,,,0,"fee schedule","69% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.03,61.85,,16.82,,,0,"percent of total billed charges","61.5% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",10.95,32.2,,8.76,,,0,"percent of total billed charges","32.2% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.83,17.136,,4.66,,,0,"percent of total billed charges","17.136% of total billed charges",7.43,21.84,,5.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.82,37.7,,10.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.52,78,,21.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",5.2,34,
"SUTURE PDSII 4-0 18 PS-2",13845,CDM,272,RC,,,OUTPATIENT,,,30,19.5,,26.4,88,,21.12,,,0,"percent of total billed charges","88% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.19,17.304,,4.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.9,63,,15.12,,,0,"percent of total billed charges","63% of total billed charges",4.59,15.3,,3.67,,,0,"percent of total billed charges","15.3% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",20.7,69,,,,,0,"fee schedule","69% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.56,61.85,,14.85,,,0,"percent of total billed charges","61.5% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",9.66,32.2,,7.73,,,0,"percent of total billed charges","32.2% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.14,17.136,,4.11,,,0,"percent of total billed charges","17.136% of total billed charges",6.55,21.84,,5.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.31,37.7,,9.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.4,78,,18.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",4.59,30,
"SUTURE PDSII 3-0 SH 27IN",46183,CDM,272,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"SUTURE NYLN 1698G 6-0 P-3 18IN",13636,CDM,272,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.37,61.85,,9.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"SUTURE NYLN 661G 5-0 FS-2",166021,CDM,272,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"SUTURE NYLN 1865G 5-0 PC-3 18IN",166024,CDM,272,RC,,,OUTPATIENT,,,24,15.6,,21.12,88,,16.90,,,0,"percent of total billed charges","88% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.15,17.304,,3.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.12,63,,12.10,,,0,"percent of total billed charges","63% of total billed charges",3.67,15.3,,2.94,,,0,"percent of total billed charges","15.3% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",16.56,69,,,,,0,"fee schedule","69% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.84,61.85,,11.87,,,0,"percent of total billed charges","61.5% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",7.73,32.2,,6.18,,,0,"percent of total billed charges","32.2% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.11,17.136,,3.29,,,0,"percent of total billed charges","17.136% of total billed charges",5.24,21.84,,4.19,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.05,37.7,,7.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.72,78,,14.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,24,
"SUTURE NYLN 1855G 5-0 PC-1 18IN",169832,CDM,272,RC,,,OUTPATIENT,,,24,15.6,,21.12,88,,16.90,,,0,"percent of total billed charges","88% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.15,17.304,,3.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.12,63,,12.10,,,0,"percent of total billed charges","63% of total billed charges",3.67,15.3,,2.94,,,0,"percent of total billed charges","15.3% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",16.56,69,,,,,0,"fee schedule","69% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.84,61.85,,11.87,,,0,"percent of total billed charges","61.5% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",7.73,32.2,,6.18,,,0,"percent of total billed charges","32.2% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.11,17.136,,3.29,,,0,"percent of total billed charges","17.136% of total billed charges",5.24,21.84,,4.19,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.05,37.7,,7.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.72,78,,14.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,24,
"SUTURE NYLN 1667G 4-0 PS-2 18IN",13634,CDM,272,RC,,,OUTPATIENT,,,22,14.3,,19.36,88,,15.49,,,0,"percent of total billed charges","88% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.81,17.304,,3.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.86,63,,11.09,,,0,"percent of total billed charges","63% of total billed charges",3.37,15.3,,2.70,,,0,"percent of total billed charges","15.3% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",15.18,69,,,,,0,"fee schedule","69% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.61,61.85,,10.89,,,0,"percent of total billed charges","61.5% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",7.08,32.2,,5.66,,,0,"percent of total billed charges","32.2% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.77,17.136,,3.02,,,0,"percent of total billed charges","17.136% of total billed charges",4.8,21.84,,3.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.29,37.7,,6.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.16,78,,13.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",3.37,22,
"SUTURE ETHLN 662H MONO 4-0FS-2",13734,CDM,272,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"SUTURE ETHILON BLK MONO 3-0 CUTICULAR 30 FSL",44786,CDM,272,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"SUTURE ETHILON 3-0 18 INCH FS-1 663G",149619,CDM,272,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"SUTURE NRLN  C584D 4-0 TF CR/8",187408,CDM,272,RC,,,OUTPATIENT,,,144,93.6,,126.72,88,,101.38,,,0,"percent of total billed charges","88% of total billed charges",72,50,,57.60,,,0,"percent of total billed charges","50% of total billed charges",24.19,16.8,,19.35,,,0,"percent of total billed charges","16.8% of total billed charges",144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.92,17.304,,19.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.72,63,,72.58,,,0,"percent of total billed charges","63% of total billed charges",22.03,15.3,,17.62,,,0,"percent of total billed charges","15.3% of total billed charges",24.19,16.8,,19.35,,,0,"percent of total billed charges","16.8% of total billed charges",99.36,69,,,,,0,"fee schedule","69% of total billed charges",144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.06,61.85,,71.25,,,0,"percent of total billed charges","61.5% of total billed charges",24.19,16.8,,19.35,,,0,"percent of total billed charges","16.8% of total billed charges",72,50,,57.60,,,0,"percent of total billed charges","50% of total billed charges",46.37,32.2,,37.10,,,0,"percent of total billed charges","32.2% of total billed charges",24.19,16.8,,19.35,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.68,17.136,,19.74,,,0,"percent of total billed charges","17.136% of total billed charges",31.45,21.84,,25.16,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",54.29,37.7,,43.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",112.32,78,,89.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",118.94,82.6,,95.15,,,0,"percent of total billed charges","82.6% of total billed charges",24.19,16.8,,19.35,,,0,"percent of total billed charges","16.8% of total billed charges",72,50,,57.60,,,0,"percent of total billed charges","50% of total billed charges",118.94,82.6,,95.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.19,16.8,,19.35,,,0,"percent of total billed charges","16.8% of total billed charges",144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",22.03,144,
"SUTURE MONO Y822G 5-0 PC-5 UND",188365,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SUTURE MONOCRYL 4-0 PS-2",16867,CDM,272,RC,,,OUTPATIENT,,,33,21.45,,29.04,88,,23.23,,,0,"percent of total billed charges","88% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,17.304,,4.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.79,63,,16.63,,,0,"percent of total billed charges","63% of total billed charges",5.05,15.3,,4.04,,,0,"percent of total billed charges","15.3% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",22.77,69,,,,,0,"fee schedule","69% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.41,61.85,,16.33,,,0,"percent of total billed charges","61.5% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",10.63,32.2,,8.50,,,0,"percent of total billed charges","32.2% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.65,17.136,,4.52,,,0,"percent of total billed charges","17.136% of total billed charges",7.21,21.84,,5.77,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.44,37.7,,9.95,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25.74,78,,20.59,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",5.05,33,
"SUTURE MONOCRYL 4-0 P-3 18''",20880,CDM,272,RC,,,OUTPATIENT,,,35,22.75,,30.8,88,,24.64,,,0,"percent of total billed charges","88% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.06,17.304,,4.85,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.05,63,,17.64,,,0,"percent of total billed charges","63% of total billed charges",5.36,15.3,,4.29,,,0,"percent of total billed charges","15.3% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",24.15,69,,,,,0,"fee schedule","69% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.65,61.85,,17.32,,,0,"percent of total billed charges","61.5% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",11.27,32.2,,9.02,,,0,"percent of total billed charges","32.2% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,17.136,,4.80,,,0,"percent of total billed charges","17.136% of total billed charges",7.64,21.84,,6.11,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.2,37.7,,10.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",27.3,78,,21.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.91,82.6,,23.13,,,0,"percent of total billed charges","82.6% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",28.91,82.6,,23.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",5.36,35,
"SUTURE ETHIBOND 2-0 SH 36IN",188357,CDM,272,RC,,,OUTPATIENT,,,39,25.35,,34.32,88,,27.46,,,0,"percent of total billed charges","88% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.75,17.304,,5.40,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.57,63,,19.66,,,0,"percent of total billed charges","63% of total billed charges",5.97,15.3,,4.78,,,0,"percent of total billed charges","15.3% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",26.91,69,,,,,0,"fee schedule","69% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.12,61.85,,19.30,,,0,"percent of total billed charges","61.5% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",12.56,32.2,,10.05,,,0,"percent of total billed charges","32.2% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.68,17.136,,5.34,,,0,"percent of total billed charges","17.136% of total billed charges",8.52,21.84,,6.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.42,78,,24.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",5.97,39,
"SUTURE ETHBND CX21D #0 CT-1 CR",8190,CDM,272,RC,,,OUTPATIENT,,,82,53.3,,72.16,88,,57.73,,,0,"percent of total billed charges","88% of total billed charges",41,50,,32.80,,,0,"percent of total billed charges","50% of total billed charges",13.78,16.8,,11.02,,,0,"percent of total billed charges","16.8% of total billed charges",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.19,17.304,,11.35,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.66,63,,41.33,,,0,"percent of total billed charges","63% of total billed charges",12.55,15.3,,10.04,,,0,"percent of total billed charges","15.3% of total billed charges",13.78,16.8,,11.02,,,0,"percent of total billed charges","16.8% of total billed charges",56.58,69,,,,,0,"fee schedule","69% of total billed charges",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.72,61.85,,40.58,,,0,"percent of total billed charges","61.5% of total billed charges",13.78,16.8,,11.02,,,0,"percent of total billed charges","16.8% of total billed charges",41,50,,32.80,,,0,"percent of total billed charges","50% of total billed charges",26.4,32.2,,21.12,,,0,"percent of total billed charges","32.2% of total billed charges",13.78,16.8,,11.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.05,17.136,,11.24,,,0,"percent of total billed charges","17.136% of total billed charges",17.91,21.84,,14.33,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.91,37.7,,24.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",63.96,78,,51.17,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.73,82.6,,54.18,,,0,"percent of total billed charges","82.6% of total billed charges",13.78,16.8,,11.02,,,0,"percent of total billed charges","16.8% of total billed charges",41,50,,32.80,,,0,"percent of total billed charges","50% of total billed charges",67.73,82.6,,54.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.78,16.8,,11.02,,,0,"percent of total billed charges","16.8% of total billed charges",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",12.55,82,
"SUTURE VLOC 3-0",326023,CDM,272,RC,,,OUTPATIENT,,,304,197.6,,267.52,88,,214.02,,,0,"percent of total billed charges","88% of total billed charges",152,50,,121.60,,,0,"percent of total billed charges","50% of total billed charges",51.07,16.8,,40.86,,,0,"percent of total billed charges","16.8% of total billed charges",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.6,17.304,,42.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.52,63,,153.22,,,0,"percent of total billed charges","63% of total billed charges",46.51,15.3,,37.21,,,0,"percent of total billed charges","15.3% of total billed charges",51.07,16.8,,40.86,,,0,"percent of total billed charges","16.8% of total billed charges",209.76,69,,,,,0,"fee schedule","69% of total billed charges",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",188.02,61.85,,150.42,,,0,"percent of total billed charges","61.5% of total billed charges",51.07,16.8,,40.86,,,0,"percent of total billed charges","16.8% of total billed charges",152,50,,121.60,,,0,"percent of total billed charges","50% of total billed charges",97.89,32.2,,78.31,,,0,"percent of total billed charges","32.2% of total billed charges",51.07,16.8,,40.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.09,17.136,,41.67,,,0,"percent of total billed charges","17.136% of total billed charges",66.39,21.84,,53.11,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",114.61,37.7,,91.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",237.12,78,,189.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",251.1,82.6,,200.88,,,0,"percent of total billed charges","82.6% of total billed charges",51.07,16.8,,40.86,,,0,"percent of total billed charges","16.8% of total billed charges",152,50,,121.60,,,0,"percent of total billed charges","50% of total billed charges",251.1,82.6,,200.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.07,16.8,,40.86,,,0,"percent of total billed charges","16.8% of total billed charges",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",46.51,304,
"SUTURE CHRMIC 635H 4-0 FS-2 27",146817,CDM,272,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"SUTURE RETENTION BOLSTER SURG LATEX TUBING 2.5",76181,CDM,272,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"SUTURE SILK 1 6-30 LABYRINTH NABSORB",45148,CDM,272,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.95,61.85,,3.96,,,0,"percent of total billed charges","61.5% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"SUTURE  TICRON AORTIC VALVE 2-0",14187,CDM,272,RC,,,OUTPATIENT,,,1346,874.9,,1184.48,88,,947.58,,,0,"percent of total billed charges","88% of total billed charges",673,50,,538.40,,,0,"percent of total billed charges","50% of total billed charges",226.13,16.8,,180.90,,,0,"percent of total billed charges","16.8% of total billed charges",1346,100,,1076.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",232.91,17.304,,186.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",847.98,63,,678.38,,,0,"percent of total billed charges","63% of total billed charges",205.94,15.3,,164.75,,,0,"percent of total billed charges","15.3% of total billed charges",226.13,16.8,,180.90,,,0,"percent of total billed charges","16.8% of total billed charges",928.74,69,,,,,0,"fee schedule","69% of total billed charges",1346,100,,1076.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1346,100,,1076.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1346,100,,1076.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",832.5,61.85,,666.00,,,0,"percent of total billed charges","61.5% of total billed charges",226.13,16.8,,180.90,,,0,"percent of total billed charges","16.8% of total billed charges",673,50,,538.40,,,0,"percent of total billed charges","50% of total billed charges",433.41,32.2,,346.73,,,0,"percent of total billed charges","32.2% of total billed charges",226.13,16.8,,180.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",230.65,17.136,,184.52,,,0,"percent of total billed charges","17.136% of total billed charges",293.97,21.84,,235.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",507.44,37.7,,405.95,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1049.88,78,,839.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1111.8,82.6,,889.44,,,0,"percent of total billed charges","82.6% of total billed charges",226.13,16.8,,180.90,,,0,"percent of total billed charges","16.8% of total billed charges",673,50,,538.40,,,0,"percent of total billed charges","50% of total billed charges",1111.8,82.6,,889.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",226.13,16.8,,180.90,,,0,"percent of total billed charges","16.8% of total billed charges",1346,100,,1076.80,,,0,"percent of total billed charges","100% of total billed charges",205.94,1346,
"SUTURE 0 VICRYL CT-2",259395,CDM,272,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"SUTURE 3-0 VICRYL CT-1",209738,CDM,272,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"SUTURE CHRMIC 904H #0 CTX 36IN",165829,CDM,272,RC,,,OUTPATIENT,,,32,20.8,,28.16,88,,22.53,,,0,"percent of total billed charges","88% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.54,17.304,,4.43,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.16,63,,16.13,,,0,"percent of total billed charges","63% of total billed charges",4.9,15.3,,3.92,,,0,"percent of total billed charges","15.3% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",22.08,69,,,,,0,"fee schedule","69% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.79,61.85,,15.83,,,0,"percent of total billed charges","61.5% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",10.3,32.2,,8.24,,,0,"percent of total billed charges","32.2% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.48,17.136,,4.38,,,0,"percent of total billed charges","17.136% of total billed charges",6.99,21.84,,5.59,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.96,78,,19.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",4.9,32,
"SUTURE CHRMIC 905H #1 CTX 36IN",149534,CDM,272,RC,,,OUTPATIENT,,,32,20.8,,28.16,88,,22.53,,,0,"percent of total billed charges","88% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.54,17.304,,4.43,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.16,63,,16.13,,,0,"percent of total billed charges","63% of total billed charges",4.9,15.3,,3.92,,,0,"percent of total billed charges","15.3% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",22.08,69,,,,,0,"fee schedule","69% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.79,61.85,,15.83,,,0,"percent of total billed charges","61.5% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",10.3,32.2,,8.24,,,0,"percent of total billed charges","32.2% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.48,17.136,,4.38,,,0,"percent of total billed charges","17.136% of total billed charges",6.99,21.84,,5.59,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.96,78,,19.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",4.9,32,
"SUTURE COATED VCRYL VL BR 0 CLS 8-18C/R CTX COMP",44993,CDM,272,RC,,,OUTPATIENT,,,1159,753.35,,1019.92,88,,815.94,,,0,"percent of total billed charges","88% of total billed charges",579.5,50,,463.60,,,0,"percent of total billed charges","50% of total billed charges",194.71,16.8,,155.77,,,0,"percent of total billed charges","16.8% of total billed charges",1159,100,,927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",200.55,17.304,,160.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.17,63,,584.14,,,0,"percent of total billed charges","63% of total billed charges",177.33,15.3,,141.86,,,0,"percent of total billed charges","15.3% of total billed charges",194.71,16.8,,155.77,,,0,"percent of total billed charges","16.8% of total billed charges",799.71,69,,,,,0,"fee schedule","69% of total billed charges",1159,100,,927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1159,100,,927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1159,100,,927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",716.84,61.85,,573.47,,,0,"percent of total billed charges","61.5% of total billed charges",194.71,16.8,,155.77,,,0,"percent of total billed charges","16.8% of total billed charges",579.5,50,,463.60,,,0,"percent of total billed charges","50% of total billed charges",373.2,32.2,,298.56,,,0,"percent of total billed charges","32.2% of total billed charges",194.71,16.8,,155.77,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",198.61,17.136,,158.89,,,0,"percent of total billed charges","17.136% of total billed charges",253.13,21.84,,202.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",436.94,37.7,,349.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",904.02,78,,723.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",957.33,82.6,,765.86,,,0,"percent of total billed charges","82.6% of total billed charges",194.71,16.8,,155.77,,,0,"percent of total billed charges","16.8% of total billed charges",579.5,50,,463.60,,,0,"percent of total billed charges","50% of total billed charges",957.33,82.6,,765.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.71,16.8,,155.77,,,0,"percent of total billed charges","16.8% of total billed charges",1159,100,,927.20,,,0,"percent of total billed charges","100% of total billed charges",177.33,1159,
"SUTURE COATED VICRYL UND BR 2-0 OB-GYN 36 CT-1",165907,CDM,272,RC,,,OUTPATIENT,,,407,264.55,,358.16,88,,286.53,,,0,"percent of total billed charges","88% of total billed charges",203.5,50,,162.80,,,0,"percent of total billed charges","50% of total billed charges",68.38,16.8,,54.70,,,0,"percent of total billed charges","16.8% of total billed charges",407,100,,325.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.43,17.304,,56.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",256.41,63,,205.13,,,0,"percent of total billed charges","63% of total billed charges",62.27,15.3,,49.82,,,0,"percent of total billed charges","15.3% of total billed charges",68.38,16.8,,54.70,,,0,"percent of total billed charges","16.8% of total billed charges",280.83,69,,,,,0,"fee schedule","69% of total billed charges",407,100,,325.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",407,100,,325.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",407,100,,325.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",251.73,61.85,,201.38,,,0,"percent of total billed charges","61.5% of total billed charges",68.38,16.8,,54.70,,,0,"percent of total billed charges","16.8% of total billed charges",203.5,50,,162.80,,,0,"percent of total billed charges","50% of total billed charges",131.05,32.2,,104.84,,,0,"percent of total billed charges","32.2% of total billed charges",68.38,16.8,,54.70,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.74,17.136,,55.79,,,0,"percent of total billed charges","17.136% of total billed charges",88.89,21.84,,71.11,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",153.44,37.7,,122.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",317.46,78,,253.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.18,82.6,,268.94,,,0,"percent of total billed charges","82.6% of total billed charges",68.38,16.8,,54.70,,,0,"percent of total billed charges","16.8% of total billed charges",203.5,50,,162.80,,,0,"percent of total billed charges","50% of total billed charges",336.18,82.6,,268.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.38,16.8,,54.70,,,0,"percent of total billed charges","16.8% of total billed charges",407,100,,325.60,,,0,"percent of total billed charges","100% of total billed charges",62.27,407,
"SUTURE COATED VICRYL UND BR 3-0  RB-1",39901,CDM,272,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"SUTURE COATED VICRYL UND BR 4-0 PLASTIC 27 PS-2",165941,CDM,272,RC,,,OUTPATIENT,,,27,17.55,,23.76,88,,19.01,,,0,"percent of total billed charges","88% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.67,17.304,,3.74,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.01,63,,13.61,,,0,"percent of total billed charges","63% of total billed charges",4.13,15.3,,3.30,,,0,"percent of total billed charges","15.3% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",18.63,69,,,,,0,"fee schedule","69% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.7,61.85,,13.36,,,0,"percent of total billed charges","61.5% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",8.69,32.2,,6.95,,,0,"percent of total billed charges","32.2% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.63,17.136,,3.70,,,0,"percent of total billed charges","17.136% of total billed charges",5.9,21.84,,4.72,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.18,37.7,,8.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.06,78,,16.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.3,82.6,,17.84,,,0,"percent of total billed charges","82.6% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",22.3,82.6,,17.84,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",4.13,27,
"SUTURE ETHILON BLK MONO 4-0 PLASTIC 18 P-3",40223,CDM,272,RC,,,OUTPATIENT,,,31,20.15,,27.28,88,,21.82,,,0,"percent of total billed charges","88% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.36,17.304,,4.29,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.53,63,,15.62,,,0,"percent of total billed charges","63% of total billed charges",4.74,15.3,,3.79,,,0,"percent of total billed charges","15.3% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",21.39,69,,,,,0,"fee schedule","69% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.17,61.85,,15.34,,,0,"percent of total billed charges","61.5% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",9.98,32.2,,7.98,,,0,"percent of total billed charges","32.2% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.31,17.136,,4.25,,,0,"percent of total billed charges","17.136% of total billed charges",6.77,21.84,,5.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.69,37.7,,9.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.18,78,,19.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.61,82.6,,20.49,,,0,"percent of total billed charges","82.6% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",25.61,82.6,,20.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",4.74,31,
"SUTURE ETHILON GRN MONO 5-0 PLASTIC 18 PS-2",14651,CDM,272,RC,,,OUTPATIENT,,,255,165.75,,224.4,88,,179.52,,,0,"percent of total billed charges","88% of total billed charges",127.5,50,,102.00,,,0,"percent of total billed charges","50% of total billed charges",42.84,16.8,,34.27,,,0,"percent of total billed charges","16.8% of total billed charges",255,100,,204.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.13,17.304,,35.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.65,63,,128.52,,,0,"percent of total billed charges","63% of total billed charges",39.02,15.3,,31.22,,,0,"percent of total billed charges","15.3% of total billed charges",42.84,16.8,,34.27,,,0,"percent of total billed charges","16.8% of total billed charges",175.95,69,,,,,0,"fee schedule","69% of total billed charges",255,100,,204.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",255,100,,204.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",255,100,,204.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.72,61.85,,126.18,,,0,"percent of total billed charges","61.5% of total billed charges",42.84,16.8,,34.27,,,0,"percent of total billed charges","16.8% of total billed charges",127.5,50,,102.00,,,0,"percent of total billed charges","50% of total billed charges",82.11,32.2,,65.69,,,0,"percent of total billed charges","32.2% of total billed charges",42.84,16.8,,34.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.7,17.136,,34.96,,,0,"percent of total billed charges","17.136% of total billed charges",55.69,21.84,,44.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",96.14,37.7,,76.91,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",198.9,78,,159.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",210.63,82.6,,168.50,,,0,"percent of total billed charges","82.6% of total billed charges",42.84,16.8,,34.27,,,0,"percent of total billed charges","16.8% of total billed charges",127.5,50,,102.00,,,0,"percent of total billed charges","50% of total billed charges",210.63,82.6,,168.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.84,16.8,,34.27,,,0,"percent of total billed charges","16.8% of total billed charges",255,100,,204.00,,,0,"percent of total billed charges","100% of total billed charges",39.02,255,
"SUTURE GUT CHR 4-0 PLASTIC 18 P-3",35305,CDM,272,RC,,,OUTPATIENT,,,56,36.4,,49.28,88,,39.42,,,0,"percent of total billed charges","88% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.69,17.304,,7.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.28,63,,28.22,,,0,"percent of total billed charges","63% of total billed charges",8.57,15.3,,6.86,,,0,"percent of total billed charges","15.3% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",38.64,69,,,,,0,"fee schedule","69% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.64,61.85,,27.71,,,0,"percent of total billed charges","61.5% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",18.03,32.2,,14.42,,,0,"percent of total billed charges","32.2% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.6,17.136,,7.68,,,0,"percent of total billed charges","17.136% of total billed charges",12.23,21.84,,9.78,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.11,37.7,,16.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.68,78,,34.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",8.57,56,
"SUTURE LASSO 45 DEGREE CV LEFT",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SUTURE MONOCRYL UND MONO 3-0 G.I. 27 SH",76098,CDM,272,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"SUTURE NYLN 1663G 3-0 PS-1 18",146925,CDM,272,RC,,,OUTPATIENT,,,282,183.3,,248.16,88,,198.53,,,0,"percent of total billed charges","88% of total billed charges",141,50,,112.80,,,0,"percent of total billed charges","50% of total billed charges",47.38,16.8,,37.90,,,0,"percent of total billed charges","16.8% of total billed charges",282,100,,225.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.8,17.304,,39.04,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",177.66,63,,142.13,,,0,"percent of total billed charges","63% of total billed charges",43.15,15.3,,34.52,,,0,"percent of total billed charges","15.3% of total billed charges",47.38,16.8,,37.90,,,0,"percent of total billed charges","16.8% of total billed charges",194.58,69,,,,,0,"fee schedule","69% of total billed charges",282,100,,225.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",282,100,,225.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",282,100,,225.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",174.42,61.85,,139.54,,,0,"percent of total billed charges","61.5% of total billed charges",47.38,16.8,,37.90,,,0,"percent of total billed charges","16.8% of total billed charges",141,50,,112.80,,,0,"percent of total billed charges","50% of total billed charges",90.8,32.2,,72.64,,,0,"percent of total billed charges","32.2% of total billed charges",47.38,16.8,,37.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.32,17.136,,38.66,,,0,"percent of total billed charges","17.136% of total billed charges",61.59,21.84,,49.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",106.31,37.7,,85.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",219.96,78,,175.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",232.93,82.6,,186.34,,,0,"percent of total billed charges","82.6% of total billed charges",47.38,16.8,,37.90,,,0,"percent of total billed charges","16.8% of total billed charges",141,50,,112.80,,,0,"percent of total billed charges","50% of total billed charges",232.93,82.6,,186.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.38,16.8,,37.90,,,0,"percent of total billed charges","16.8% of total billed charges",282,100,,225.60,,,0,"percent of total billed charges","100% of total billed charges",43.15,282,
"SUTURE NYLN 1696G 7-0 P-1 18IN",166042,CDM,272,RC,,,OUTPATIENT,,,24,15.6,,21.12,88,,16.90,,,0,"percent of total billed charges","88% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.15,17.304,,3.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.12,63,,12.10,,,0,"percent of total billed charges","63% of total billed charges",3.67,15.3,,2.94,,,0,"percent of total billed charges","15.3% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",16.56,69,,,,,0,"fee schedule","69% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.84,61.85,,11.87,,,0,"percent of total billed charges","61.5% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",7.73,32.2,,6.18,,,0,"percent of total billed charges","32.2% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.11,17.136,,3.29,,,0,"percent of total billed charges","17.136% of total billed charges",5.24,21.84,,4.19,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.05,37.7,,7.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.72,78,,14.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,24,
"SUTURE NYLN 662G FS-2 18IN",149622,CDM,272,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"SUTURE PDS 2-0 CP-2 CR-8",87946,CDM,272,RC,,,OUTPATIENT,,,132,85.8,,116.16,88,,92.93,,,0,"percent of total billed charges","88% of total billed charges",66,50,,52.80,,,0,"percent of total billed charges","50% of total billed charges",22.18,16.8,,17.74,,,0,"percent of total billed charges","16.8% of total billed charges",132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.84,17.304,,18.27,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",83.16,63,,66.53,,,0,"percent of total billed charges","63% of total billed charges",20.2,15.3,,16.16,,,0,"percent of total billed charges","15.3% of total billed charges",22.18,16.8,,17.74,,,0,"percent of total billed charges","16.8% of total billed charges",91.08,69,,,,,0,"fee schedule","69% of total billed charges",132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.64,61.85,,65.31,,,0,"percent of total billed charges","61.5% of total billed charges",22.18,16.8,,17.74,,,0,"percent of total billed charges","16.8% of total billed charges",66,50,,52.80,,,0,"percent of total billed charges","50% of total billed charges",42.5,32.2,,34.00,,,0,"percent of total billed charges","32.2% of total billed charges",22.18,16.8,,17.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.62,17.136,,18.10,,,0,"percent of total billed charges","17.136% of total billed charges",28.83,21.84,,23.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",49.76,37.7,,39.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",102.96,78,,82.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",109.03,82.6,,87.22,,,0,"percent of total billed charges","82.6% of total billed charges",22.18,16.8,,17.74,,,0,"percent of total billed charges","16.8% of total billed charges",66,50,,52.80,,,0,"percent of total billed charges","50% of total billed charges",109.03,82.6,,87.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.18,16.8,,17.74,,,0,"percent of total billed charges","16.8% of total billed charges",132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",20.2,132,
"SUTURE PDS II 3-0 CR/CP-2 VIL MONO",280739,CDM,272,RC,,,OUTPATIENT,,,133,86.45,,117.04,88,,93.63,,,0,"percent of total billed charges","88% of total billed charges",66.5,50,,53.20,,,0,"percent of total billed charges","50% of total billed charges",22.34,16.8,,17.87,,,0,"percent of total billed charges","16.8% of total billed charges",133,100,,106.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.01,17.304,,18.41,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",83.79,63,,67.03,,,0,"percent of total billed charges","63% of total billed charges",20.35,15.3,,16.28,,,0,"percent of total billed charges","15.3% of total billed charges",22.34,16.8,,17.87,,,0,"percent of total billed charges","16.8% of total billed charges",91.77,69,,,,,0,"fee schedule","69% of total billed charges",133,100,,106.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",133,100,,106.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",133,100,,106.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.26,61.85,,65.81,,,0,"percent of total billed charges","61.5% of total billed charges",22.34,16.8,,17.87,,,0,"percent of total billed charges","16.8% of total billed charges",66.5,50,,53.20,,,0,"percent of total billed charges","50% of total billed charges",42.83,32.2,,34.26,,,0,"percent of total billed charges","32.2% of total billed charges",22.34,16.8,,17.87,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.79,17.136,,18.23,,,0,"percent of total billed charges","17.136% of total billed charges",29.05,21.84,,23.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.14,37.7,,40.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",103.74,78,,82.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",109.86,82.6,,87.89,,,0,"percent of total billed charges","82.6% of total billed charges",22.34,16.8,,17.87,,,0,"percent of total billed charges","16.8% of total billed charges",66.5,50,,53.20,,,0,"percent of total billed charges","50% of total billed charges",109.86,82.6,,87.89,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.34,16.8,,17.87,,,0,"percent of total billed charges","16.8% of total billed charges",133,100,,106.40,,,0,"percent of total billed charges","100% of total billed charges",20.35,133,
"SUTURE PDSII #0 CT-2 37IN",146971,CDM,272,RC,,,OUTPATIENT,,,24,15.6,,21.12,88,,16.90,,,0,"percent of total billed charges","88% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.15,17.304,,3.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.12,63,,12.10,,,0,"percent of total billed charges","63% of total billed charges",3.67,15.3,,2.94,,,0,"percent of total billed charges","15.3% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",16.56,69,,,,,0,"fee schedule","69% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.84,61.85,,11.87,,,0,"percent of total billed charges","61.5% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",7.73,32.2,,6.18,,,0,"percent of total billed charges","32.2% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.11,17.136,,3.29,,,0,"percent of total billed charges","17.136% of total billed charges",5.24,21.84,,4.19,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.05,37.7,,7.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.72,78,,14.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,24,
"SUTURE PDSII 0 CT-1 18 V",149651,CDM,272,RC,,,OUTPATIENT,,,122,79.3,,107.36,88,,85.89,,,0,"percent of total billed charges","88% of total billed charges",61,50,,48.80,,,0,"percent of total billed charges","50% of total billed charges",20.5,16.8,,16.40,,,0,"percent of total billed charges","16.8% of total billed charges",122,100,,97.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.11,17.304,,16.89,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.86,63,,61.49,,,0,"percent of total billed charges","63% of total billed charges",18.67,15.3,,14.94,,,0,"percent of total billed charges","15.3% of total billed charges",20.5,16.8,,16.40,,,0,"percent of total billed charges","16.8% of total billed charges",84.18,69,,,,,0,"fee schedule","69% of total billed charges",122,100,,97.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",122,100,,97.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",122,100,,97.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.46,61.85,,60.37,,,0,"percent of total billed charges","61.5% of total billed charges",20.5,16.8,,16.40,,,0,"percent of total billed charges","16.8% of total billed charges",61,50,,48.80,,,0,"percent of total billed charges","50% of total billed charges",39.28,32.2,,31.42,,,0,"percent of total billed charges","32.2% of total billed charges",20.5,16.8,,16.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.91,17.136,,16.73,,,0,"percent of total billed charges","17.136% of total billed charges",26.64,21.84,,21.31,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",45.99,37.7,,36.79,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",95.16,78,,76.13,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",100.77,82.6,,80.62,,,0,"percent of total billed charges","82.6% of total billed charges",20.5,16.8,,16.40,,,0,"percent of total billed charges","16.8% of total billed charges",61,50,,48.80,,,0,"percent of total billed charges","50% of total billed charges",100.77,82.6,,80.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.5,16.8,,16.40,,,0,"percent of total billed charges","16.8% of total billed charges",122,100,,97.60,,,0,"percent of total billed charges","100% of total billed charges",18.67,122,
"SUTURE PRLN 8631G 4-0 PC-5 18IN",187071,CDM,272,RC,,,OUTPATIENT,,,35,22.75,,30.8,88,,24.64,,,0,"percent of total billed charges","88% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.06,17.304,,4.85,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.05,63,,17.64,,,0,"percent of total billed charges","63% of total billed charges",5.36,15.3,,4.29,,,0,"percent of total billed charges","15.3% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",24.15,69,,,,,0,"fee schedule","69% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.65,61.85,,17.32,,,0,"percent of total billed charges","61.5% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",11.27,32.2,,9.02,,,0,"percent of total billed charges","32.2% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,17.136,,4.80,,,0,"percent of total billed charges","17.136% of total billed charges",7.64,21.84,,6.11,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.2,37.7,,10.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",27.3,78,,21.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.91,82.6,,23.13,,,0,"percent of total billed charges","82.6% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",28.91,82.6,,23.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",5.36,35,
"SUTURE PRLN 8635G 5-0 PC-3 18",166143,CDM,272,RC,,,OUTPATIENT,,,33,21.45,,29.04,88,,23.23,,,0,"percent of total billed charges","88% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,17.304,,4.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.79,63,,16.63,,,0,"percent of total billed charges","63% of total billed charges",5.05,15.3,,4.04,,,0,"percent of total billed charges","15.3% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",22.77,69,,,,,0,"fee schedule","69% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.41,61.85,,16.33,,,0,"percent of total billed charges","61.5% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",10.63,32.2,,8.50,,,0,"percent of total billed charges","32.2% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.65,17.136,,4.52,,,0,"percent of total billed charges","17.136% of total billed charges",7.21,21.84,,5.77,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.44,37.7,,9.95,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25.74,78,,20.59,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",5.05,33,
"SUTURE PRLN 9702H 5-0 BV-1",147028,CDM,272,RC,,,OUTPATIENT,,,119,77.35,,104.72,88,,83.78,,,0,"percent of total billed charges","88% of total billed charges",59.5,50,,47.60,,,0,"percent of total billed charges","50% of total billed charges",19.99,16.8,,15.99,,,0,"percent of total billed charges","16.8% of total billed charges",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.59,17.304,,16.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.97,63,,59.98,,,0,"percent of total billed charges","63% of total billed charges",18.21,15.3,,14.57,,,0,"percent of total billed charges","15.3% of total billed charges",19.99,16.8,,15.99,,,0,"percent of total billed charges","16.8% of total billed charges",82.11,69,,,,,0,"fee schedule","69% of total billed charges",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",73.6,61.85,,58.88,,,0,"percent of total billed charges","61.5% of total billed charges",19.99,16.8,,15.99,,,0,"percent of total billed charges","16.8% of total billed charges",59.5,50,,47.60,,,0,"percent of total billed charges","50% of total billed charges",38.32,32.2,,30.66,,,0,"percent of total billed charges","32.2% of total billed charges",19.99,16.8,,15.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.39,17.136,,16.31,,,0,"percent of total billed charges","17.136% of total billed charges",25.99,21.84,,20.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",92.82,78,,74.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",19.99,16.8,,15.99,,,0,"percent of total billed charges","16.8% of total billed charges",59.5,50,,47.60,,,0,"percent of total billed charges","50% of total billed charges",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.99,16.8,,15.99,,,0,"percent of total billed charges","16.8% of total billed charges",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",18.21,119,
"SUTURE PROLENE BL MONO 3-0 CARDIO 30 SH",36465,CDM,272,RC,,,OUTPATIENT,,,25,16.25,,22,88,,17.60,,,0,"percent of total billed charges","88% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,17.304,,3.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.75,63,,12.60,,,0,"percent of total billed charges","63% of total billed charges",3.83,15.3,,3.06,,,0,"percent of total billed charges","15.3% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",17.25,69,,,,,0,"fee schedule","69% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.46,61.85,,12.37,,,0,"percent of total billed charges","61.5% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",8.05,32.2,,6.44,,,0,"percent of total billed charges","32.2% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.28,17.136,,3.42,,,0,"percent of total billed charges","17.136% of total billed charges",5.46,21.84,,4.37,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.43,37.7,,7.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.5,78,,15.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",3.83,25,
"SUTURE STRATAFIX 3.0 RB-1 16CM",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SUTURE STRATAFIX SPIRAL PDO 2XMH",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"SUTURE VIC COAT PLUS BR UND CT1 0 27IN",377694,CDM,272,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"SUTURE VICRYL 2-0",310901,CDM,272,RC,,,OUTPATIENT,,,79,51.35,,69.52,88,,55.62,,,0,"percent of total billed charges","88% of total billed charges",39.5,50,,31.60,,,0,"percent of total billed charges","50% of total billed charges",13.27,16.8,,10.62,,,0,"percent of total billed charges","16.8% of total billed charges",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.67,17.304,,10.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.77,63,,39.82,,,0,"percent of total billed charges","63% of total billed charges",12.09,15.3,,9.67,,,0,"percent of total billed charges","15.3% of total billed charges",13.27,16.8,,10.62,,,0,"percent of total billed charges","16.8% of total billed charges",54.51,69,,,,,0,"fee schedule","69% of total billed charges",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.86,61.85,,39.09,,,0,"percent of total billed charges","61.5% of total billed charges",13.27,16.8,,10.62,,,0,"percent of total billed charges","16.8% of total billed charges",39.5,50,,31.60,,,0,"percent of total billed charges","50% of total billed charges",25.44,32.2,,20.35,,,0,"percent of total billed charges","32.2% of total billed charges",13.27,16.8,,10.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.54,17.136,,10.83,,,0,"percent of total billed charges","17.136% of total billed charges",17.25,21.84,,13.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.78,37.7,,23.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",61.62,78,,49.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",65.25,82.6,,52.20,,,0,"percent of total billed charges","82.6% of total billed charges",13.27,16.8,,10.62,,,0,"percent of total billed charges","16.8% of total billed charges",39.5,50,,31.60,,,0,"percent of total billed charges","50% of total billed charges",65.25,82.6,,52.20,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.27,16.8,,10.62,,,0,"percent of total billed charges","16.8% of total billed charges",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",12.09,79,
"SUTURE VICRYL J946H #0 CT-1 UND",157480,CDM,272,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"SUTURE VICRYL PLUS 0 8-18 IN VIL CR CT-2",262060,CDM,272,RC,,,OUTPATIENT,,,1068,694.2,,939.84,88,,751.87,,,0,"percent of total billed charges","88% of total billed charges",534,50,,427.20,,,0,"percent of total billed charges","50% of total billed charges",179.42,16.8,,143.54,,,0,"percent of total billed charges","16.8% of total billed charges",1068,100,,854.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",184.81,17.304,,147.85,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",672.84,63,,538.27,,,0,"percent of total billed charges","63% of total billed charges",163.4,15.3,,130.72,,,0,"percent of total billed charges","15.3% of total billed charges",179.42,16.8,,143.54,,,0,"percent of total billed charges","16.8% of total billed charges",736.92,69,,,,,0,"fee schedule","69% of total billed charges",1068,100,,854.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1068,100,,854.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1068,100,,854.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",660.56,61.85,,528.45,,,0,"percent of total billed charges","61.5% of total billed charges",179.42,16.8,,143.54,,,0,"percent of total billed charges","16.8% of total billed charges",534,50,,427.20,,,0,"percent of total billed charges","50% of total billed charges",343.9,32.2,,275.12,,,0,"percent of total billed charges","32.2% of total billed charges",179.42,16.8,,143.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.01,17.136,,146.41,,,0,"percent of total billed charges","17.136% of total billed charges",233.25,21.84,,186.60,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",402.64,37.7,,322.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",833.04,78,,666.43,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",882.17,82.6,,705.74,,,0,"percent of total billed charges","82.6% of total billed charges",179.42,16.8,,143.54,,,0,"percent of total billed charges","16.8% of total billed charges",534,50,,427.20,,,0,"percent of total billed charges","50% of total billed charges",882.17,82.6,,705.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.42,16.8,,143.54,,,0,"percent of total billed charges","16.8% of total billed charges",1068,100,,854.40,,,0,"percent of total billed charges","100% of total billed charges",163.4,1068,
"SUTURE VICRYL PLUS ANTIBACTERIAL 0 27IN",248187,CDM,272,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"SUTURE V LOC 90 3/0 VIOLET 6 CV-23",329634,CDM,272,RC,,,OUTPATIENT,,,289,187.85,,254.32,88,,203.46,,,0,"percent of total billed charges","88% of total billed charges",144.5,50,,115.60,,,0,"percent of total billed charges","50% of total billed charges",48.55,16.8,,38.84,,,0,"percent of total billed charges","16.8% of total billed charges",289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.01,17.304,,40.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",182.07,63,,145.66,,,0,"percent of total billed charges","63% of total billed charges",44.22,15.3,,35.38,,,0,"percent of total billed charges","15.3% of total billed charges",48.55,16.8,,38.84,,,0,"percent of total billed charges","16.8% of total billed charges",199.41,69,,,,,0,"fee schedule","69% of total billed charges",289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.75,61.85,,143.00,,,0,"percent of total billed charges","61.5% of total billed charges",48.55,16.8,,38.84,,,0,"percent of total billed charges","16.8% of total billed charges",144.5,50,,115.60,,,0,"percent of total billed charges","50% of total billed charges",93.06,32.2,,74.45,,,0,"percent of total billed charges","32.2% of total billed charges",48.55,16.8,,38.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.52,17.136,,39.62,,,0,"percent of total billed charges","17.136% of total billed charges",63.12,21.84,,50.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",108.95,37.7,,87.16,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",225.42,78,,180.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",238.71,82.6,,190.97,,,0,"percent of total billed charges","82.6% of total billed charges",48.55,16.8,,38.84,,,0,"percent of total billed charges","16.8% of total billed charges",144.5,50,,115.60,,,0,"percent of total billed charges","50% of total billed charges",238.71,82.6,,190.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.55,16.8,,38.84,,,0,"percent of total billed charges","16.8% of total billed charges",289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",44.22,289,
"SUTURE V LOC 90 3-0 UNDYED 6CY-23",329635,CDM,272,RC,,,OUTPATIENT,,,261,169.65,,229.68,88,,183.74,,,0,"percent of total billed charges","88% of total billed charges",130.5,50,,104.40,,,0,"percent of total billed charges","50% of total billed charges",43.85,16.8,,35.08,,,0,"percent of total billed charges","16.8% of total billed charges",261,100,,208.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.16,17.304,,36.13,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",164.43,63,,131.54,,,0,"percent of total billed charges","63% of total billed charges",39.93,15.3,,31.94,,,0,"percent of total billed charges","15.3% of total billed charges",43.85,16.8,,35.08,,,0,"percent of total billed charges","16.8% of total billed charges",180.09,69,,,,,0,"fee schedule","69% of total billed charges",261,100,,208.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",261,100,,208.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",261,100,,208.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",161.43,61.85,,129.14,,,0,"percent of total billed charges","61.5% of total billed charges",43.85,16.8,,35.08,,,0,"percent of total billed charges","16.8% of total billed charges",130.5,50,,104.40,,,0,"percent of total billed charges","50% of total billed charges",84.04,32.2,,67.23,,,0,"percent of total billed charges","32.2% of total billed charges",43.85,16.8,,35.08,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.72,17.136,,35.78,,,0,"percent of total billed charges","17.136% of total billed charges",57,21.84,,45.60,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",98.4,37.7,,78.72,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",203.58,78,,162.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",215.59,82.6,,172.47,,,0,"percent of total billed charges","82.6% of total billed charges",43.85,16.8,,35.08,,,0,"percent of total billed charges","16.8% of total billed charges",130.5,50,,104.40,,,0,"percent of total billed charges","50% of total billed charges",215.59,82.6,,172.47,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.85,16.8,,35.08,,,0,"percent of total billed charges","16.8% of total billed charges",261,100,,208.80,,,0,"percent of total billed charges","100% of total billed charges",39.93,261,
"SUTURE SLK 685G 2-0 FS 18IN",147054,CDM,272,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"SUTURE SILK 0 BLK BR CT-1 30 INCH",32128,CDM,272,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"SUTURE PROLENE BL MONO 5-0 CARDIO 36 C-1C-1",13661,CDM,272,RC,,,OUTPATIENT,,,66,42.9,,58.08,88,,46.46,,,0,"percent of total billed charges","88% of total billed charges",33,50,,26.40,,,0,"percent of total billed charges","50% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.42,17.304,,9.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.58,63,,33.26,,,0,"percent of total billed charges","63% of total billed charges",10.1,15.3,,8.08,,,0,"percent of total billed charges","15.3% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",45.54,69,,,,,0,"fee schedule","69% of total billed charges",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.82,61.85,,32.66,,,0,"percent of total billed charges","61.5% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",33,50,,26.40,,,0,"percent of total billed charges","50% of total billed charges",21.25,32.2,,17.00,,,0,"percent of total billed charges","32.2% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.31,17.136,,9.05,,,0,"percent of total billed charges","17.136% of total billed charges",14.41,21.84,,11.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.88,37.7,,19.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",51.48,78,,41.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",54.52,82.6,,43.62,,,0,"percent of total billed charges","82.6% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",33,50,,26.40,,,0,"percent of total billed charges","50% of total billed charges",54.52,82.6,,43.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",10.1,66,
"SUTURE SLK A183H 4-0 STRND 18",166201,CDM,272,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"SUTURE SILK BLK BR 3-0 G.I.NEURO 8-18 COMPARTMNT",13718,CDM,272,RC,,,OUTPATIENT,,,76,49.4,,66.88,88,,53.50,,,0,"percent of total billed charges","88% of total billed charges",38,50,,30.40,,,0,"percent of total billed charges","50% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.15,17.304,,10.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.88,63,,38.30,,,0,"percent of total billed charges","63% of total billed charges",11.63,15.3,,9.30,,,0,"percent of total billed charges","15.3% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",52.44,69,,,,,0,"fee schedule","69% of total billed charges",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.01,61.85,,37.61,,,0,"percent of total billed charges","61.5% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",38,50,,30.40,,,0,"percent of total billed charges","50% of total billed charges",24.47,32.2,,19.58,,,0,"percent of total billed charges","32.2% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.02,17.136,,10.42,,,0,"percent of total billed charges","17.136% of total billed charges",16.6,21.84,,13.28,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.65,37.7,,22.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",59.28,78,,47.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.78,82.6,,50.22,,,0,"percent of total billed charges","82.6% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",38,50,,30.40,,,0,"percent of total billed charges","50% of total billed charges",62.78,82.6,,50.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",11.63,76,
"SUTURE SILK 2-0 18 INCH BLK BR A185H",20886,CDM,272,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"SUTURE PRLN 8521H 4-0 SH DA 36",166137,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SUTURE PLAIN 1824H 4-0 SC-1 18",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,29,18.85,,25.52,88,,20.42,,,0,"percent of total billed charges","88% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.02,17.304,,4.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.27,63,,14.62,,,0,"percent of total billed charges","63% of total billed charges",4.44,15.3,,3.55,,,0,"percent of total billed charges","15.3% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",20.01,69,,,,,0,"fee schedule","69% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.94,61.85,,14.35,,,0,"percent of total billed charges","61.5% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",9.34,32.2,,7.47,,,0,"percent of total billed charges","32.2% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.97,17.136,,3.98,,,0,"percent of total billed charges","17.136% of total billed charges",6.33,21.84,,5.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.93,37.7,,8.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,78,,18.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",4.44,29,
"SUTURE PLAIN 53T 2-0 XLH",41042,CDM,272,RC,,,OUTPATIENT,,,65,42.25,,57.2,88,,45.76,,,0,"percent of total billed charges","88% of total billed charges",32.5,50,,26.00,,,0,"percent of total billed charges","50% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.25,17.304,,9.00,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.95,63,,32.76,,,0,"percent of total billed charges","63% of total billed charges",9.95,15.3,,7.96,,,0,"percent of total billed charges","15.3% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",44.85,69,,,,,0,"fee schedule","69% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.2,61.85,,32.16,,,0,"percent of total billed charges","61.5% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",32.5,50,,26.00,,,0,"percent of total billed charges","50% of total billed charges",20.93,32.2,,16.74,,,0,"percent of total billed charges","32.2% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.14,17.136,,8.91,,,0,"percent of total billed charges","17.136% of total billed charges",14.2,21.84,,11.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.51,37.7,,19.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.7,78,,40.56,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",32.5,50,,26.00,,,0,"percent of total billed charges","50% of total billed charges",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",9.95,65,
"SUTURE PDSII 4-0 PC-5",70518,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SUTURE PDSII #1 CTX NEEDLE",13847,CDM,272,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"SUTURE PDSII #1 CT-1 27IN",146972,CDM,272,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"SUTURE NYLN 697G 6-0 P-1 18IN",157601,CDM,272,RC,,,OUTPATIENT,,,22,14.3,,19.36,88,,15.49,,,0,"percent of total billed charges","88% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.81,17.304,,3.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.86,63,,11.09,,,0,"percent of total billed charges","63% of total billed charges",3.37,15.3,,2.70,,,0,"percent of total billed charges","15.3% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",15.18,69,,,,,0,"fee schedule","69% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.61,61.85,,10.89,,,0,"percent of total billed charges","61.5% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",7.08,32.2,,5.66,,,0,"percent of total billed charges","32.2% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.77,17.136,,3.02,,,0,"percent of total billed charges","17.136% of total billed charges",4.8,21.84,,3.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.29,37.7,,6.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.16,78,,13.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",3.37,22,
"SUTURE NYLN 698G 5-0 P-3 18IN",157596,CDM,272,RC,,,OUTPATIENT,,,30,19.5,,26.4,88,,21.12,,,0,"percent of total billed charges","88% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.19,17.304,,4.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.9,63,,15.12,,,0,"percent of total billed charges","63% of total billed charges",4.59,15.3,,3.67,,,0,"percent of total billed charges","15.3% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",20.7,69,,,,,0,"fee schedule","69% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.56,61.85,,14.85,,,0,"percent of total billed charges","61.5% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",9.66,32.2,,7.73,,,0,"percent of total billed charges","32.2% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.14,17.136,,4.11,,,0,"percent of total billed charges","17.136% of total billed charges",6.55,21.84,,5.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.31,37.7,,9.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.4,78,,18.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",4.59,30,
"SUTURE ETHILON BLK MONO 4-0 CUTICULAR 30 FSL",169823,CDM,272,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.9,61.85,,7.92,,,0,"percent of total billed charges","61.5% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"SUTURE NYLN 1864G 4-0 PC-3 18IN",39573,CDM,272,RC,,,OUTPATIENT,,,37,24.05,,32.56,88,,26.05,,,0,"percent of total billed charges","88% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.4,17.304,,5.12,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.31,63,,18.65,,,0,"percent of total billed charges","63% of total billed charges",5.66,15.3,,4.53,,,0,"percent of total billed charges","15.3% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",25.53,69,,,,,0,"fee schedule","69% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.88,61.85,,18.30,,,0,"percent of total billed charges","61.5% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",11.91,32.2,,9.53,,,0,"percent of total billed charges","32.2% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.34,17.136,,5.07,,,0,"percent of total billed charges","17.136% of total billed charges",8.08,21.84,,6.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.95,37.7,,11.16,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.86,78,,23.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",5.66,37,
"SUTURE NYLN 1893G 3-0 PC-5",166006,CDM,272,RC,,,OUTPATIENT,,,23,14.95,,20.24,88,,16.19,,,0,"percent of total billed charges","88% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.98,17.304,,3.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.49,63,,11.59,,,0,"percent of total billed charges","63% of total billed charges",3.52,15.3,,2.82,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",15.87,69,,,,,0,"fee schedule","69% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.23,61.85,,11.38,,,0,"percent of total billed charges","61.5% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",7.41,32.2,,5.93,,,0,"percent of total billed charges","32.2% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.94,17.136,,3.15,,,0,"percent of total billed charges","17.136% of total billed charges",5.02,21.84,,4.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.94,78,,14.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",3.52,23,
"SUTURE V-LOC 2-0 180 ABSB WND CLSR DEVICE  GREEN",317787,CDM,272,RC,,,OUTPATIENT,,,304,197.6,,267.52,88,,214.02,,,0,"percent of total billed charges","88% of total billed charges",152,50,,121.60,,,0,"percent of total billed charges","50% of total billed charges",51.07,16.8,,40.86,,,0,"percent of total billed charges","16.8% of total billed charges",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.6,17.304,,42.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.52,63,,153.22,,,0,"percent of total billed charges","63% of total billed charges",46.51,15.3,,37.21,,,0,"percent of total billed charges","15.3% of total billed charges",51.07,16.8,,40.86,,,0,"percent of total billed charges","16.8% of total billed charges",209.76,69,,,,,0,"fee schedule","69% of total billed charges",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",188.02,61.85,,150.42,,,0,"percent of total billed charges","61.5% of total billed charges",51.07,16.8,,40.86,,,0,"percent of total billed charges","16.8% of total billed charges",152,50,,121.60,,,0,"percent of total billed charges","50% of total billed charges",97.89,32.2,,78.31,,,0,"percent of total billed charges","32.2% of total billed charges",51.07,16.8,,40.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.09,17.136,,41.67,,,0,"percent of total billed charges","17.136% of total billed charges",66.39,21.84,,53.11,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",114.61,37.7,,91.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",237.12,78,,189.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",251.1,82.6,,200.88,,,0,"percent of total billed charges","82.6% of total billed charges",51.07,16.8,,40.86,,,0,"percent of total billed charges","16.8% of total billed charges",152,50,,121.60,,,0,"percent of total billed charges","50% of total billed charges",251.1,82.6,,200.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.07,16.8,,40.86,,,0,"percent of total billed charges","16.8% of total billed charges",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",46.51,304,
"SUTURE CHRMIC G122H 3-0 SH 27IN",165873,CDM,272,RC,,,OUTPATIENT,,,29,18.85,,25.52,88,,20.42,,,0,"percent of total billed charges","88% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.02,17.304,,4.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.27,63,,14.62,,,0,"percent of total billed charges","63% of total billed charges",4.44,15.3,,3.55,,,0,"percent of total billed charges","15.3% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",20.01,69,,,,,0,"fee schedule","69% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.94,61.85,,14.35,,,0,"percent of total billed charges","61.5% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",9.34,32.2,,7.47,,,0,"percent of total billed charges","32.2% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.97,17.136,,3.98,,,0,"percent of total billed charges","17.136% of total billed charges",6.33,21.84,,5.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.93,37.7,,8.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,78,,18.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",4.44,29,
"SUTURE CHRMIC 636G 3-0 FS-2",157449,CDM,272,RC,,,OUTPATIENT,,,60,39,,52.8,88,,42.24,,,0,"percent of total billed charges","88% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.38,17.304,,8.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.8,63,,30.24,,,0,"percent of total billed charges","63% of total billed charges",9.18,15.3,,7.34,,,0,"percent of total billed charges","15.3% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",41.4,69,,,,,0,"fee schedule","69% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.11,61.85,,29.69,,,0,"percent of total billed charges","61.5% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",19.32,32.2,,15.46,,,0,"percent of total billed charges","32.2% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.28,17.136,,8.22,,,0,"percent of total billed charges","17.136% of total billed charges",13.1,21.84,,10.48,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,37.7,,18.10,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.8,78,,37.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.56,82.6,,39.65,,,0,"percent of total billed charges","82.6% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",49.56,82.6,,39.65,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",9.18,60,
"SUTURE 2-0 ETHIBOND EXCELL SH-2 30IN",330616,CDM,272,RC,,,OUTPATIENT,,,39,25.35,,34.32,88,,27.46,,,0,"percent of total billed charges","88% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.75,17.304,,5.40,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.57,63,,19.66,,,0,"percent of total billed charges","63% of total billed charges",5.97,15.3,,4.78,,,0,"percent of total billed charges","15.3% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",26.91,69,,,,,0,"fee schedule","69% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.12,61.85,,19.30,,,0,"percent of total billed charges","61.5% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",12.56,32.2,,10.05,,,0,"percent of total billed charges","32.2% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.68,17.136,,5.34,,,0,"percent of total billed charges","17.136% of total billed charges",8.52,21.84,,6.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.42,78,,24.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",5.97,39,
"SUTURE COATED VICRYL UND BR 2-0 G.I. 27 SH",146859,CDM,272,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"SUTURE ETHIBOND XTRA 2-0 SHSH",453272,CDM,272,RC,,,OUTPATIENT,,,43,27.95,,37.84,88,,30.27,,,0,"percent of total billed charges","88% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.44,17.304,,5.95,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.09,63,,21.67,,,0,"percent of total billed charges","63% of total billed charges",6.58,15.3,,5.26,,,0,"percent of total billed charges","15.3% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",29.67,69,,,,,0,"fee schedule","69% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.6,61.85,,21.28,,,0,"percent of total billed charges","61.5% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",13.85,32.2,,11.08,,,0,"percent of total billed charges","32.2% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.37,17.136,,5.90,,,0,"percent of total billed charges","17.136% of total billed charges",9.39,21.84,,7.51,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.21,37.7,,12.97,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",33.54,78,,26.83,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.52,82.6,,28.42,,,0,"percent of total billed charges","82.6% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",35.52,82.6,,28.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",6.58,43,
"SUTURE ETHILON BLK MONO 2-0 CUTICULAR 18 FS",166001,CDM,272,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.9,61.85,,7.92,,,0,"percent of total billed charges","61.5% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"SUTURE FIBERLINK CLS LP ST BL 2-0 12 AR-7235",ORSUP0027,CDM,272,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"SUTURE MONOCRYL PLUS 4-0 PS-1",240961,CDM,272,RC,,,OUTPATIENT,,,38,24.7,,33.44,88,,26.75,,,0,"percent of total billed charges","88% of total billed charges",19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.58,17.304,,5.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.94,63,,19.15,,,0,"percent of total billed charges","63% of total billed charges",5.81,15.3,,4.65,,,0,"percent of total billed charges","15.3% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",26.22,69,,,,,0,"fee schedule","69% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.5,61.85,,18.80,,,0,"percent of total billed charges","61.5% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",12.24,32.2,,9.79,,,0,"percent of total billed charges","32.2% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.51,17.136,,5.21,,,0,"percent of total billed charges","17.136% of total billed charges",8.3,21.84,,6.64,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.33,37.7,,11.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.64,78,,23.71,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",5.81,38,
"SUTURE PDSII 0 CTX VIL MONO",166067,CDM,272,RC,,,OUTPATIENT,,,397,258.05,,349.36,88,,279.49,,,0,"percent of total billed charges","88% of total billed charges",198.5,50,,158.80,,,0,"percent of total billed charges","50% of total billed charges",66.7,16.8,,53.36,,,0,"percent of total billed charges","16.8% of total billed charges",397,100,,317.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.7,17.304,,54.96,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",250.11,63,,200.09,,,0,"percent of total billed charges","63% of total billed charges",60.74,15.3,,48.59,,,0,"percent of total billed charges","15.3% of total billed charges",66.7,16.8,,53.36,,,0,"percent of total billed charges","16.8% of total billed charges",273.93,69,,,,,0,"fee schedule","69% of total billed charges",397,100,,317.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",397,100,,317.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",397,100,,317.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",245.54,61.85,,196.43,,,0,"percent of total billed charges","61.5% of total billed charges",66.7,16.8,,53.36,,,0,"percent of total billed charges","16.8% of total billed charges",198.5,50,,158.80,,,0,"percent of total billed charges","50% of total billed charges",127.83,32.2,,102.26,,,0,"percent of total billed charges","32.2% of total billed charges",66.7,16.8,,53.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.03,17.136,,54.42,,,0,"percent of total billed charges","17.136% of total billed charges",86.7,21.84,,69.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",149.67,37.7,,119.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",309.66,78,,247.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",327.92,82.6,,262.34,,,0,"percent of total billed charges","82.6% of total billed charges",66.7,16.8,,53.36,,,0,"percent of total billed charges","16.8% of total billed charges",198.5,50,,158.80,,,0,"percent of total billed charges","50% of total billed charges",327.92,82.6,,262.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",66.7,16.8,,53.36,,,0,"percent of total billed charges","16.8% of total billed charges",397,100,,317.60,,,0,"percent of total billed charges","100% of total billed charges",60.74,397,
"SUTURE PLN 3-0 FS-1 27IN MFL ABS",412947,CDM,272,RC,,,OUTPATIENT,,,22,14.3,,19.36,88,,15.49,,,0,"percent of total billed charges","88% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.81,17.304,,3.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.86,63,,11.09,,,0,"percent of total billed charges","63% of total billed charges",3.37,15.3,,2.70,,,0,"percent of total billed charges","15.3% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",15.18,69,,,,,0,"fee schedule","69% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.61,61.85,,10.89,,,0,"percent of total billed charges","61.5% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",7.08,32.2,,5.66,,,0,"percent of total billed charges","32.2% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.77,17.136,,3.02,,,0,"percent of total billed charges","17.136% of total billed charges",4.8,21.84,,3.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.29,37.7,,6.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.16,78,,13.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",3.37,22,
"SUTURE STRATAFIX 2.0 SH 14CM",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SUTURE WIRE SPOOL 24G",491519,CDM,270,RC,,,OUTPATIENT,,,970,630.5,,853.6,88,,682.88,,,0,"percent of total billed charges","88% of total billed charges",485,50,,388.00,,,0,"percent of total billed charges","50% of total billed charges",162.96,16.8,,130.37,,,0,"percent of total billed charges","16.8% of total billed charges",970,100,,776.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",167.85,17.304,,134.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",611.1,63,,488.88,,,0,"percent of total billed charges","63% of total billed charges",148.41,15.3,,118.73,,,0,"percent of total billed charges","15.3% of total billed charges",162.96,16.8,,130.37,,,0,"percent of total billed charges","16.8% of total billed charges",669.3,69,,,,,0,"fee schedule","69% of total billed charges",970,100,,776.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",970,100,,776.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",970,100,,776.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",599.95,61.85,,479.96,,,0,"percent of total billed charges","61.5% of total billed charges",162.96,16.8,,130.37,,,0,"percent of total billed charges","16.8% of total billed charges",485,50,,388.00,,,0,"percent of total billed charges","50% of total billed charges",312.34,32.2,,249.87,,,0,"percent of total billed charges","32.2% of total billed charges",162.96,16.8,,130.37,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.22,17.136,,132.98,,,0,"percent of total billed charges","17.136% of total billed charges",211.85,21.84,,169.48,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.69,37.7,,292.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",756.6,78,,605.28,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",801.22,82.6,,640.98,,,0,"percent of total billed charges","82.6% of total billed charges",162.96,16.8,,130.37,,,0,"percent of total billed charges","16.8% of total billed charges",485,50,,388.00,,,0,"percent of total billed charges","50% of total billed charges",801.22,82.6,,640.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.96,16.8,,130.37,,,0,"percent of total billed charges","16.8% of total billed charges",970,100,,776.00,,,0,"percent of total billed charges","100% of total billed charges",148.41,970,
"SUTURE VICRYL 3-0 SH J864D",491506,CDM,272,RC,,,OUTPATIENT,,,98,63.7,,86.24,88,,68.99,,,0,"percent of total billed charges","88% of total billed charges",49,50,,39.20,,,0,"percent of total billed charges","50% of total billed charges",16.46,16.8,,13.17,,,0,"percent of total billed charges","16.8% of total billed charges",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.96,17.304,,13.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.74,63,,49.39,,,0,"percent of total billed charges","63% of total billed charges",14.99,15.3,,11.99,,,0,"percent of total billed charges","15.3% of total billed charges",16.46,16.8,,13.17,,,0,"percent of total billed charges","16.8% of total billed charges",67.62,69,,,,,0,"fee schedule","69% of total billed charges",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.61,61.85,,48.49,,,0,"percent of total billed charges","61.5% of total billed charges",16.46,16.8,,13.17,,,0,"percent of total billed charges","16.8% of total billed charges",49,50,,39.20,,,0,"percent of total billed charges","50% of total billed charges",31.56,32.2,,25.25,,,0,"percent of total billed charges","32.2% of total billed charges",16.46,16.8,,13.17,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.79,17.136,,13.43,,,0,"percent of total billed charges","17.136% of total billed charges",21.4,21.84,,17.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.95,37.7,,29.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",76.44,78,,61.15,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.95,82.6,,64.76,,,0,"percent of total billed charges","82.6% of total billed charges",16.46,16.8,,13.17,,,0,"percent of total billed charges","16.8% of total billed charges",49,50,,39.20,,,0,"percent of total billed charges","50% of total billed charges",80.95,82.6,,64.76,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.46,16.8,,13.17,,,0,"percent of total billed charges","16.8% of total billed charges",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",14.99,98,
"SUTURE VICRYL 2-0 UR-6 J602H",491498,CDM,272,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"SUTURE VICRYL+ 2-0  VCPP42D",491518,CDM,272,RC,,,OUTPATIENT,,,102,66.3,,89.76,88,,71.81,,,0,"percent of total billed charges","88% of total billed charges",51,50,,40.80,,,0,"percent of total billed charges","50% of total billed charges",17.14,16.8,,13.71,,,0,"percent of total billed charges","16.8% of total billed charges",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.304,,14.12,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.26,63,,51.41,,,0,"percent of total billed charges","63% of total billed charges",15.61,15.3,,12.49,,,0,"percent of total billed charges","15.3% of total billed charges",17.14,16.8,,13.71,,,0,"percent of total billed charges","16.8% of total billed charges",70.38,69,,,,,0,"fee schedule","69% of total billed charges",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.09,61.85,,50.47,,,0,"percent of total billed charges","61.5% of total billed charges",17.14,16.8,,13.71,,,0,"percent of total billed charges","16.8% of total billed charges",51,50,,40.80,,,0,"percent of total billed charges","50% of total billed charges",32.84,32.2,,26.27,,,0,"percent of total billed charges","32.2% of total billed charges",17.14,16.8,,13.71,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.48,17.136,,13.98,,,0,"percent of total billed charges","17.136% of total billed charges",22.28,21.84,,17.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.45,37.7,,30.76,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",79.56,78,,63.65,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.25,82.6,,67.40,,,0,"percent of total billed charges","82.6% of total billed charges",17.14,16.8,,13.71,,,0,"percent of total billed charges","16.8% of total billed charges",51,50,,40.80,,,0,"percent of total billed charges","50% of total billed charges",84.25,82.6,,67.40,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.14,16.8,,13.71,,,0,"percent of total billed charges","16.8% of total billed charges",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",15.61,102,
"SUTURE VICRYL 1-0 J650G",491494,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SUTURE PDS II 1-0 CTX Z765D",491439,CDM,272,RC,,,OUTPATIENT,,,167,108.55,,146.96,88,,117.57,,,0,"percent of total billed charges","88% of total billed charges",83.5,50,,66.80,,,0,"percent of total billed charges","50% of total billed charges",28.06,16.8,,22.45,,,0,"percent of total billed charges","16.8% of total billed charges",167,100,,133.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.9,17.304,,23.12,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.21,63,,84.17,,,0,"percent of total billed charges","63% of total billed charges",25.55,15.3,,20.44,,,0,"percent of total billed charges","15.3% of total billed charges",28.06,16.8,,22.45,,,0,"percent of total billed charges","16.8% of total billed charges",115.23,69,,,,,0,"fee schedule","69% of total billed charges",167,100,,133.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",167,100,,133.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",167,100,,133.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.29,61.85,,82.63,,,0,"percent of total billed charges","61.5% of total billed charges",28.06,16.8,,22.45,,,0,"percent of total billed charges","16.8% of total billed charges",83.5,50,,66.80,,,0,"percent of total billed charges","50% of total billed charges",53.77,32.2,,43.02,,,0,"percent of total billed charges","32.2% of total billed charges",28.06,16.8,,22.45,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.62,17.136,,22.90,,,0,"percent of total billed charges","17.136% of total billed charges",36.47,21.84,,29.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",62.96,37.7,,50.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",130.26,78,,104.21,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.94,82.6,,110.35,,,0,"percent of total billed charges","82.6% of total billed charges",28.06,16.8,,22.45,,,0,"percent of total billed charges","16.8% of total billed charges",83.5,50,,66.80,,,0,"percent of total billed charges","50% of total billed charges",137.94,82.6,,110.35,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.06,16.8,,22.45,,,0,"percent of total billed charges","16.8% of total billed charges",167,100,,133.60,,,0,"percent of total billed charges","100% of total billed charges",25.55,167,
"SUTURE ABS VLOC 180 GS-21",491375,CDM,272,RC,,,OUTPATIENT,,,264,171.6,,232.32,88,,185.86,,,0,"percent of total billed charges","88% of total billed charges",132,50,,105.60,,,0,"percent of total billed charges","50% of total billed charges",44.35,16.8,,35.48,,,0,"percent of total billed charges","16.8% of total billed charges",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.68,17.304,,36.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.32,63,,133.06,,,0,"percent of total billed charges","63% of total billed charges",40.39,15.3,,32.31,,,0,"percent of total billed charges","15.3% of total billed charges",44.35,16.8,,35.48,,,0,"percent of total billed charges","16.8% of total billed charges",182.16,69,,,,,0,"fee schedule","69% of total billed charges",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",163.28,61.85,,130.62,,,0,"percent of total billed charges","61.5% of total billed charges",44.35,16.8,,35.48,,,0,"percent of total billed charges","16.8% of total billed charges",132,50,,105.60,,,0,"percent of total billed charges","50% of total billed charges",85.01,32.2,,68.01,,,0,"percent of total billed charges","32.2% of total billed charges",44.35,16.8,,35.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.24,17.136,,36.19,,,0,"percent of total billed charges","17.136% of total billed charges",57.66,21.84,,46.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",99.53,37.7,,79.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",205.92,78,,164.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",218.06,82.6,,174.45,,,0,"percent of total billed charges","82.6% of total billed charges",44.35,16.8,,35.48,,,0,"percent of total billed charges","16.8% of total billed charges",132,50,,105.60,,,0,"percent of total billed charges","50% of total billed charges",218.06,82.6,,174.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.35,16.8,,35.48,,,0,"percent of total billed charges","16.8% of total billed charges",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",40.39,264,
"SUTURE VICRYL 3-0 J423H",491504,CDM,272,RC,,,OUTPATIENT,,,21,13.65,,18.48,88,,14.78,,,0,"percent of total billed charges","88% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.63,17.304,,2.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.23,63,,10.58,,,0,"percent of total billed charges","63% of total billed charges",3.21,15.3,,2.57,,,0,"percent of total billed charges","15.3% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",14.49,69,,,,,0,"fee schedule","69% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.99,61.85,,10.39,,,0,"percent of total billed charges","61.5% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",6.76,32.2,,5.41,,,0,"percent of total billed charges","32.2% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.6,17.136,,2.88,,,0,"percent of total billed charges","17.136% of total billed charges",4.59,21.84,,3.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.92,37.7,,6.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.38,78,,13.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",3.21,21,
"SUTURE ETHI-PACK STEEL  DS22",491412,CDM,272,RC,,,OUTPATIENT,,,64,41.6,,56.32,88,,45.06,,,0,"percent of total billed charges","88% of total billed charges",32,50,,25.60,,,0,"percent of total billed charges","50% of total billed charges",10.75,16.8,,8.60,,,0,"percent of total billed charges","16.8% of total billed charges",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.07,17.304,,8.86,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.32,63,,32.26,,,0,"percent of total billed charges","63% of total billed charges",9.79,15.3,,7.83,,,0,"percent of total billed charges","15.3% of total billed charges",10.75,16.8,,8.60,,,0,"percent of total billed charges","16.8% of total billed charges",44.16,69,,,,,0,"fee schedule","69% of total billed charges",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.58,61.85,,31.66,,,0,"percent of total billed charges","61.5% of total billed charges",10.75,16.8,,8.60,,,0,"percent of total billed charges","16.8% of total billed charges",32,50,,25.60,,,0,"percent of total billed charges","50% of total billed charges",20.61,32.2,,16.49,,,0,"percent of total billed charges","32.2% of total billed charges",10.75,16.8,,8.60,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.97,17.136,,8.78,,,0,"percent of total billed charges","17.136% of total billed charges",13.98,21.84,,11.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.13,37.7,,19.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",49.92,78,,39.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.86,82.6,,42.29,,,0,"percent of total billed charges","82.6% of total billed charges",10.75,16.8,,8.60,,,0,"percent of total billed charges","16.8% of total billed charges",32,50,,25.60,,,0,"percent of total billed charges","50% of total billed charges",52.86,82.6,,42.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.75,16.8,,8.60,,,0,"percent of total billed charges","16.8% of total billed charges",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",9.79,64,
"SUTURE SILK 3-0 PS-2 1679H",491479,CDM,272,RC,,,OUTPATIENT,,,31,20.15,,27.28,88,,21.82,,,0,"percent of total billed charges","88% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.36,17.304,,4.29,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.53,63,,15.62,,,0,"percent of total billed charges","63% of total billed charges",4.74,15.3,,3.79,,,0,"percent of total billed charges","15.3% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",21.39,69,,,,,0,"fee schedule","69% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.17,61.85,,15.34,,,0,"percent of total billed charges","61.5% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",9.98,32.2,,7.98,,,0,"percent of total billed charges","32.2% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.31,17.136,,4.25,,,0,"percent of total billed charges","17.136% of total billed charges",6.77,21.84,,5.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.69,37.7,,9.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.18,78,,19.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.61,82.6,,20.49,,,0,"percent of total billed charges","82.6% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",25.61,82.6,,20.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",4.74,31,
"SUTURE SILK 2-0 BLK 583H",491477,CDM,272,RC,,,OUTPATIENT,,,29,18.85,,25.52,88,,20.42,,,0,"percent of total billed charges","88% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.02,17.304,,4.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.27,63,,14.62,,,0,"percent of total billed charges","63% of total billed charges",4.44,15.3,,3.55,,,0,"percent of total billed charges","15.3% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",20.01,69,,,,,0,"fee schedule","69% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.94,61.85,,14.35,,,0,"percent of total billed charges","61.5% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",9.34,32.2,,7.47,,,0,"percent of total billed charges","32.2% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.97,17.136,,3.98,,,0,"percent of total billed charges","17.136% of total billed charges",6.33,21.84,,5.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.93,37.7,,8.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,78,,18.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",4.44,29,
"SUTURE PDS II 1 CT Z359T",491438,CDM,272,RC,,,OUTPATIENT,,,609,395.85,,535.92,88,,428.74,,,0,"percent of total billed charges","88% of total billed charges",304.5,50,,243.60,,,0,"percent of total billed charges","50% of total billed charges",102.31,16.8,,81.85,,,0,"percent of total billed charges","16.8% of total billed charges",609,100,,487.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.38,17.304,,84.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",383.67,63,,306.94,,,0,"percent of total billed charges","63% of total billed charges",93.18,15.3,,74.54,,,0,"percent of total billed charges","15.3% of total billed charges",102.31,16.8,,81.85,,,0,"percent of total billed charges","16.8% of total billed charges",420.21,69,,,,,0,"fee schedule","69% of total billed charges",609,100,,487.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",609,100,,487.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",609,100,,487.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",376.67,61.85,,301.34,,,0,"percent of total billed charges","61.5% of total billed charges",102.31,16.8,,81.85,,,0,"percent of total billed charges","16.8% of total billed charges",304.5,50,,243.60,,,0,"percent of total billed charges","50% of total billed charges",196.1,32.2,,156.88,,,0,"percent of total billed charges","32.2% of total billed charges",102.31,16.8,,81.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.36,17.136,,83.49,,,0,"percent of total billed charges","17.136% of total billed charges",133.01,21.84,,106.41,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",229.59,37.7,,183.67,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",475.02,78,,380.02,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",503.03,82.6,,402.42,,,0,"percent of total billed charges","82.6% of total billed charges",102.31,16.8,,81.85,,,0,"percent of total billed charges","16.8% of total billed charges",304.5,50,,243.60,,,0,"percent of total billed charges","50% of total billed charges",503.03,82.6,,402.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",102.31,16.8,,81.85,,,0,"percent of total billed charges","16.8% of total billed charges",609,100,,487.20,,,0,"percent of total billed charges","100% of total billed charges",93.18,609,
"SUTURE MAXON 1GR 60 BTP-X-LOOP",491417,CDM,272,RC,,,OUTPATIENT,,,272,176.8,,239.36,88,,191.49,,,0,"percent of total billed charges","88% of total billed charges",136,50,,108.80,,,0,"percent of total billed charges","50% of total billed charges",45.7,16.8,,36.56,,,0,"percent of total billed charges","16.8% of total billed charges",272,100,,217.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.07,17.304,,37.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",171.36,63,,137.09,,,0,"percent of total billed charges","63% of total billed charges",41.62,15.3,,33.30,,,0,"percent of total billed charges","15.3% of total billed charges",45.7,16.8,,36.56,,,0,"percent of total billed charges","16.8% of total billed charges",187.68,69,,,,,0,"fee schedule","69% of total billed charges",272,100,,217.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",272,100,,217.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",272,100,,217.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.23,61.85,,134.58,,,0,"percent of total billed charges","61.5% of total billed charges",45.7,16.8,,36.56,,,0,"percent of total billed charges","16.8% of total billed charges",136,50,,108.80,,,0,"percent of total billed charges","50% of total billed charges",87.58,32.2,,70.06,,,0,"percent of total billed charges","32.2% of total billed charges",45.7,16.8,,36.56,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.61,17.136,,37.29,,,0,"percent of total billed charges","17.136% of total billed charges",59.4,21.84,,47.52,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",102.54,37.7,,82.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",212.16,78,,169.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.67,82.6,,179.74,,,0,"percent of total billed charges","82.6% of total billed charges",45.7,16.8,,36.56,,,0,"percent of total billed charges","16.8% of total billed charges",136,50,,108.80,,,0,"percent of total billed charges","50% of total billed charges",224.67,82.6,,179.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.7,16.8,,36.56,,,0,"percent of total billed charges","16.8% of total billed charges",272,100,,217.60,,,0,"percent of total billed charges","100% of total billed charges",41.62,272,
"SUTURE VICRYL 5-0 PS2 J495G",491517,CDM,272,RC,,,OUTPATIENT,,,33,21.45,,29.04,88,,23.23,,,0,"percent of total billed charges","88% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,17.304,,4.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.79,63,,16.63,,,0,"percent of total billed charges","63% of total billed charges",5.05,15.3,,4.04,,,0,"percent of total billed charges","15.3% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",22.77,69,,,,,0,"fee schedule","69% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.41,61.85,,16.33,,,0,"percent of total billed charges","61.5% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",10.63,32.2,,8.50,,,0,"percent of total billed charges","32.2% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.65,17.136,,4.52,,,0,"percent of total billed charges","17.136% of total billed charges",7.21,21.84,,5.77,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.44,37.7,,9.95,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25.74,78,,20.59,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",5.05,33,
"SUTURE SILK 5-0 P3 640G",491484,CDM,272,RC,,,OUTPATIENT,,,31,20.15,,27.28,88,,21.82,,,0,"percent of total billed charges","88% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.36,17.304,,4.29,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.53,63,,15.62,,,0,"percent of total billed charges","63% of total billed charges",4.74,15.3,,3.79,,,0,"percent of total billed charges","15.3% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",21.39,69,,,,,0,"fee schedule","69% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.17,61.85,,15.34,,,0,"percent of total billed charges","61.5% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",9.98,32.2,,7.98,,,0,"percent of total billed charges","32.2% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.31,17.136,,4.25,,,0,"percent of total billed charges","17.136% of total billed charges",6.77,21.84,,5.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.69,37.7,,9.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.18,78,,19.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.61,82.6,,20.49,,,0,"percent of total billed charges","82.6% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",25.61,82.6,,20.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",4.74,31,
"SUTURE PDS II 5-0 P3 Z493G",491442,CDM,272,RC,,,OUTPATIENT,,,40,26,,35.2,88,,28.16,,,0,"percent of total billed charges","88% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.92,17.304,,5.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.2,63,,20.16,,,0,"percent of total billed charges","63% of total billed charges",6.12,15.3,,4.90,,,0,"percent of total billed charges","15.3% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",27.6,69,,,,,0,"fee schedule","69% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.74,61.85,,19.79,,,0,"percent of total billed charges","61.5% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",12.88,32.2,,10.30,,,0,"percent of total billed charges","32.2% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.85,17.136,,5.48,,,0,"percent of total billed charges","17.136% of total billed charges",8.74,21.84,,6.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.08,37.7,,12.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",31.2,78,,24.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",6.12,40,
"SUTURE ETHILON 5-0 BLK 668G",491410,CDM,272,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.9,61.85,,7.92,,,0,"percent of total billed charges","61.5% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"SUTURE VICRYL 4-0 J496G PS2",491512,CDM,272,RC,,,OUTPATIENT,,,33,21.45,,29.04,88,,23.23,,,0,"percent of total billed charges","88% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,17.304,,4.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.79,63,,16.63,,,0,"percent of total billed charges","63% of total billed charges",5.05,15.3,,4.04,,,0,"percent of total billed charges","15.3% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",22.77,69,,,,,0,"fee schedule","69% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.41,61.85,,16.33,,,0,"percent of total billed charges","61.5% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",10.63,32.2,,8.50,,,0,"percent of total billed charges","32.2% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.65,17.136,,4.52,,,0,"percent of total billed charges","17.136% of total billed charges",7.21,21.84,,5.77,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.44,37.7,,9.95,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25.74,78,,20.59,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",5.05,33,
"SUTURE VICRYL 4-0 J496H PS-2",491513,CDM,272,RC,,,OUTPATIENT,,,40,26,,35.2,88,,28.16,,,0,"percent of total billed charges","88% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.92,17.304,,5.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.2,63,,20.16,,,0,"percent of total billed charges","63% of total billed charges",6.12,15.3,,4.90,,,0,"percent of total billed charges","15.3% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",27.6,69,,,,,0,"fee schedule","69% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.74,61.85,,19.79,,,0,"percent of total billed charges","61.5% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",12.88,32.2,,10.30,,,0,"percent of total billed charges","32.2% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.85,17.136,,5.48,,,0,"percent of total billed charges","17.136% of total billed charges",8.74,21.84,,6.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.08,37.7,,12.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",31.2,78,,24.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",6.12,40,
"SUTURE SILK 4-0 PS2 1677G",491482,CDM,272,RC,,,OUTPATIENT,,,30,19.5,,26.4,88,,21.12,,,0,"percent of total billed charges","88% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.19,17.304,,4.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.9,63,,15.12,,,0,"percent of total billed charges","63% of total billed charges",4.59,15.3,,3.67,,,0,"percent of total billed charges","15.3% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",20.7,69,,,,,0,"fee schedule","69% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.56,61.85,,14.85,,,0,"percent of total billed charges","61.5% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",9.66,32.2,,7.73,,,0,"percent of total billed charges","32.2% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.14,17.136,,4.11,,,0,"percent of total billed charges","17.136% of total billed charges",6.55,21.84,,5.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.31,37.7,,9.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.4,78,,18.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",4.59,30,
"SUTURE MONOCRYL 4-0 Y823G PC-5",491428,CDM,272,RC,,,OUTPATIENT,,,48,31.2,,42.24,88,,33.79,,,0,"percent of total billed charges","88% of total billed charges",24,50,,19.20,,,0,"percent of total billed charges","50% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.31,17.304,,6.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.24,63,,24.19,,,0,"percent of total billed charges","63% of total billed charges",7.34,15.3,,5.87,,,0,"percent of total billed charges","15.3% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",33.12,69,,,,,0,"fee schedule","69% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.69,61.85,,23.75,,,0,"percent of total billed charges","61.5% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",24,50,,19.20,,,0,"percent of total billed charges","50% of total billed charges",15.46,32.2,,12.37,,,0,"percent of total billed charges","32.2% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.23,17.136,,6.58,,,0,"percent of total billed charges","17.136% of total billed charges",10.48,21.84,,8.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.1,37.7,,14.48,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",37.44,78,,29.95,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.65,82.6,,31.72,,,0,"percent of total billed charges","82.6% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",24,50,,19.20,,,0,"percent of total billed charges","50% of total billed charges",39.65,82.6,,31.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",7.34,48,
"SUTURE MONOCRYL 4-0 MCP415H SH",491426,CDM,272,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.37,61.85,,9.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"SUTURE VICRYL 3-0 PS2 J497G",491505,CDM,272,RC,,,OUTPATIENT,,,33,21.45,,29.04,88,,23.23,,,0,"percent of total billed charges","88% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,17.304,,4.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.79,63,,16.63,,,0,"percent of total billed charges","63% of total billed charges",5.05,15.3,,4.04,,,0,"percent of total billed charges","15.3% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",22.77,69,,,,,0,"fee schedule","69% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.41,61.85,,16.33,,,0,"percent of total billed charges","61.5% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",10.63,32.2,,8.50,,,0,"percent of total billed charges","32.2% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.65,17.136,,4.52,,,0,"percent of total billed charges","17.136% of total billed charges",7.21,21.84,,5.77,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.44,37.7,,9.95,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25.74,78,,20.59,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",5.05,33,
"SUTURE VICRYL 3-0 J205G",491500,CDM,272,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"SUTURE VICRYL 3-0 J219H",491501,CDM,272,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.9,61.85,,7.92,,,0,"percent of total billed charges","61.5% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"SUTURE MONOCRYL 3-0 PS2 Y497G",491424,CDM,272,RC,,,OUTPATIENT,,,44,28.6,,38.72,88,,30.98,,,0,"percent of total billed charges","88% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.61,17.304,,6.09,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.72,63,,22.18,,,0,"percent of total billed charges","63% of total billed charges",6.73,15.3,,5.38,,,0,"percent of total billed charges","15.3% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",30.36,69,,,,,0,"fee schedule","69% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.21,61.85,,21.77,,,0,"percent of total billed charges","61.5% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",14.17,32.2,,11.34,,,0,"percent of total billed charges","32.2% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.54,17.136,,6.03,,,0,"percent of total billed charges","17.136% of total billed charges",9.61,21.84,,7.69,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.59,37.7,,13.27,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.32,78,,27.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",6.73,44,
"SUTURE PLAIN GUT 5-0 686G",491450,CDM,272,RC,,,OUTPATIENT,,,58,37.7,,51.04,88,,40.83,,,0,"percent of total billed charges","88% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.04,17.304,,8.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.54,63,,29.23,,,0,"percent of total billed charges","63% of total billed charges",8.87,15.3,,7.10,,,0,"percent of total billed charges","15.3% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",40.02,69,,,,,0,"fee schedule","69% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.87,61.85,,28.70,,,0,"percent of total billed charges","61.5% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",18.68,32.2,,14.94,,,0,"percent of total billed charges","32.2% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.94,17.136,,7.95,,,0,"percent of total billed charges","17.136% of total billed charges",12.67,21.84,,10.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.87,37.7,,17.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",45.24,78,,36.19,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",8.87,58,
"SUTURE SILK 6-0 P3 1639G",491485,CDM,272,RC,,,OUTPATIENT,,,35,22.75,,30.8,88,,24.64,,,0,"percent of total billed charges","88% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.06,17.304,,4.85,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.05,63,,17.64,,,0,"percent of total billed charges","63% of total billed charges",5.36,15.3,,4.29,,,0,"percent of total billed charges","15.3% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",24.15,69,,,,,0,"fee schedule","69% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.65,61.85,,17.32,,,0,"percent of total billed charges","61.5% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",11.27,32.2,,9.02,,,0,"percent of total billed charges","32.2% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,17.136,,4.80,,,0,"percent of total billed charges","17.136% of total billed charges",7.64,21.84,,6.11,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.2,37.7,,10.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",27.3,78,,21.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.91,82.6,,23.13,,,0,"percent of total billed charges","82.6% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",28.91,82.6,,23.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",5.36,35,
"SUTURE PROLENE 6-0 P1 8697G",491472,CDM,272,RC,,,OUTPATIENT,,,43,27.95,,37.84,88,,30.27,,,0,"percent of total billed charges","88% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.44,17.304,,5.95,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.09,63,,21.67,,,0,"percent of total billed charges","63% of total billed charges",6.58,15.3,,5.26,,,0,"percent of total billed charges","15.3% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",29.67,69,,,,,0,"fee schedule","69% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.6,61.85,,21.28,,,0,"percent of total billed charges","61.5% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",13.85,32.2,,11.08,,,0,"percent of total billed charges","32.2% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.37,17.136,,5.90,,,0,"percent of total billed charges","17.136% of total billed charges",9.39,21.84,,7.51,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.21,37.7,,12.97,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",33.54,78,,26.83,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.52,82.6,,28.42,,,0,"percent of total billed charges","82.6% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",35.52,82.6,,28.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",6.58,43,
"SUTURE PROLENE 6-0 VB/C1 8318H",491473,CDM,272,RC,,,OUTPATIENT,,,50,32.5,,44,88,,35.20,,,0,"percent of total billed charges","88% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.65,17.304,,6.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.5,63,,25.20,,,0,"percent of total billed charges","63% of total billed charges",7.65,15.3,,6.12,,,0,"percent of total billed charges","15.3% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",34.5,69,,,,,0,"fee schedule","69% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.93,61.85,,24.74,,,0,"percent of total billed charges","61.5% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",16.1,32.2,,12.88,,,0,"percent of total billed charges","32.2% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.57,17.136,,6.86,,,0,"percent of total billed charges","17.136% of total billed charges",10.92,21.84,,8.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39,78,,31.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",7.65,50,
"SUTURE PROLENE 4-0 PS-2 8682G",491465,CDM,272,RC,,,OUTPATIENT,,,39,25.35,,34.32,88,,27.46,,,0,"percent of total billed charges","88% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.75,17.304,,5.40,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.57,63,,19.66,,,0,"percent of total billed charges","63% of total billed charges",5.97,15.3,,4.78,,,0,"percent of total billed charges","15.3% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",26.91,69,,,,,0,"fee schedule","69% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.12,61.85,,19.30,,,0,"percent of total billed charges","61.5% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",12.56,32.2,,10.05,,,0,"percent of total billed charges","32.2% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.68,17.136,,5.34,,,0,"percent of total billed charges","17.136% of total billed charges",8.52,21.84,,6.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.42,78,,24.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",5.97,39,
"SUTURE PROLENE 4-0 8861H",491462,CDM,272,RC,,,OUTPATIENT,,,53,34.45,,46.64,88,,37.31,,,0,"percent of total billed charges","88% of total billed charges",26.5,50,,21.20,,,0,"percent of total billed charges","50% of total billed charges",8.9,16.8,,7.12,,,0,"percent of total billed charges","16.8% of total billed charges",53,100,,42.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.17,17.304,,7.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.39,63,,26.71,,,0,"percent of total billed charges","63% of total billed charges",8.11,15.3,,6.49,,,0,"percent of total billed charges","15.3% of total billed charges",8.9,16.8,,7.12,,,0,"percent of total billed charges","16.8% of total billed charges",36.57,69,,,,,0,"fee schedule","69% of total billed charges",53,100,,42.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53,100,,42.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53,100,,42.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.78,61.85,,26.22,,,0,"percent of total billed charges","61.5% of total billed charges",8.9,16.8,,7.12,,,0,"percent of total billed charges","16.8% of total billed charges",26.5,50,,21.20,,,0,"percent of total billed charges","50% of total billed charges",17.07,32.2,,13.66,,,0,"percent of total billed charges","32.2% of total billed charges",8.9,16.8,,7.12,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.08,17.136,,7.26,,,0,"percent of total billed charges","17.136% of total billed charges",11.58,21.84,,9.26,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.98,37.7,,15.98,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.34,78,,33.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.78,82.6,,35.02,,,0,"percent of total billed charges","82.6% of total billed charges",8.9,16.8,,7.12,,,0,"percent of total billed charges","16.8% of total billed charges",26.5,50,,21.20,,,0,"percent of total billed charges","50% of total billed charges",43.78,82.6,,35.02,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.9,16.8,,7.12,,,0,"percent of total billed charges","16.8% of total billed charges",53,100,,42.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,53,
"SUTURE PROLENE 4-0 8871H",491463,CDM,272,RC,,,OUTPATIENT,,,26,16.9,,22.88,88,,18.30,,,0,"percent of total billed charges","88% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.5,17.304,,3.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.38,63,,13.10,,,0,"percent of total billed charges","63% of total billed charges",3.98,15.3,,3.18,,,0,"percent of total billed charges","15.3% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",17.94,69,,,,,0,"fee schedule","69% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.08,61.85,,12.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",8.37,32.2,,6.70,,,0,"percent of total billed charges","32.2% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.46,17.136,,3.57,,,0,"percent of total billed charges","17.136% of total billed charges",5.68,21.84,,4.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.8,37.7,,7.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.28,78,,16.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",3.98,26,
"SUTURE PROLENE 3-0 8687H PS2",491458,CDM,272,RC,,,OUTPATIENT,,,39,25.35,,34.32,88,,27.46,,,0,"percent of total billed charges","88% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.75,17.304,,5.40,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.57,63,,19.66,,,0,"percent of total billed charges","63% of total billed charges",5.97,15.3,,4.78,,,0,"percent of total billed charges","15.3% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",26.91,69,,,,,0,"fee schedule","69% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.12,61.85,,19.30,,,0,"percent of total billed charges","61.5% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",12.56,32.2,,10.05,,,0,"percent of total billed charges","32.2% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.68,17.136,,5.34,,,0,"percent of total billed charges","17.136% of total billed charges",8.52,21.84,,6.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.42,78,,24.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",5.97,39,
"SUTURE PROLENE 2-0 FSLX 8689H",491455,CDM,272,RC,,,OUTPATIENT,,,25,16.25,,22,88,,17.60,,,0,"percent of total billed charges","88% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,17.304,,3.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.75,63,,12.60,,,0,"percent of total billed charges","63% of total billed charges",3.83,15.3,,3.06,,,0,"percent of total billed charges","15.3% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",17.25,69,,,,,0,"fee schedule","69% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.46,61.85,,12.37,,,0,"percent of total billed charges","61.5% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",8.05,32.2,,6.44,,,0,"percent of total billed charges","32.2% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.28,17.136,,3.42,,,0,"percent of total billed charges","17.136% of total billed charges",5.46,21.84,,4.37,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.43,37.7,,7.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.5,78,,15.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",3.83,25,
"SUTURE PROLENE 2-0 8423H CT-1",491454,CDM,272,RC,,,OUTPATIENT,,,23,14.95,,20.24,88,,16.19,,,0,"percent of total billed charges","88% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.98,17.304,,3.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.49,63,,11.59,,,0,"percent of total billed charges","63% of total billed charges",3.52,15.3,,2.82,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",15.87,69,,,,,0,"fee schedule","69% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.23,61.85,,11.38,,,0,"percent of total billed charges","61.5% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",7.41,32.2,,5.93,,,0,"percent of total billed charges","32.2% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.94,17.136,,3.15,,,0,"percent of total billed charges","17.136% of total billed charges",5.02,21.84,,4.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.94,78,,14.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",3.52,23,
"SUTURE PROLENE 3-0 8534H",491456,CDM,272,RC,,,OUTPATIENT,,,34,22.1,,29.92,88,,23.94,,,0,"percent of total billed charges","88% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.88,17.304,,4.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.42,63,,17.14,,,0,"percent of total billed charges","63% of total billed charges",5.2,15.3,,4.16,,,0,"percent of total billed charges","15.3% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",23.46,69,,,,,0,"fee schedule","69% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.03,61.85,,16.82,,,0,"percent of total billed charges","61.5% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",10.95,32.2,,8.76,,,0,"percent of total billed charges","32.2% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.83,17.136,,4.66,,,0,"percent of total billed charges","17.136% of total billed charges",7.43,21.84,,5.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.82,37.7,,10.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.52,78,,21.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",5.2,34,
"SUTURE PROLENE 7-0 M8600",491474,CDM,272,RC,,,OUTPATIENT,,,454,295.1,,399.52,88,,319.62,,,0,"percent of total billed charges","88% of total billed charges",227,50,,181.60,,,0,"percent of total billed charges","50% of total billed charges",76.27,16.8,,61.02,,,0,"percent of total billed charges","16.8% of total billed charges",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.56,17.304,,62.85,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",286.02,63,,228.82,,,0,"percent of total billed charges","63% of total billed charges",69.46,15.3,,55.57,,,0,"percent of total billed charges","15.3% of total billed charges",76.27,16.8,,61.02,,,0,"percent of total billed charges","16.8% of total billed charges",313.26,69,,,,,0,"fee schedule","69% of total billed charges",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",280.8,61.85,,224.64,,,0,"percent of total billed charges","61.5% of total billed charges",76.27,16.8,,61.02,,,0,"percent of total billed charges","16.8% of total billed charges",227,50,,181.60,,,0,"percent of total billed charges","50% of total billed charges",146.19,32.2,,116.95,,,0,"percent of total billed charges","32.2% of total billed charges",76.27,16.8,,61.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.8,17.136,,62.24,,,0,"percent of total billed charges","17.136% of total billed charges",99.15,21.84,,79.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",171.16,37.7,,136.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",354.12,78,,283.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",375,82.6,,300.00,,,0,"percent of total billed charges","82.6% of total billed charges",76.27,16.8,,61.02,,,0,"percent of total billed charges","16.8% of total billed charges",227,50,,181.60,,,0,"percent of total billed charges","50% of total billed charges",375,82.6,,300.00,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.27,16.8,,61.02,,,0,"percent of total billed charges","16.8% of total billed charges",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",69.46,454,
"SUTURE PROLENE 6-0 M8610",491471,CDM,272,RC,,,OUTPATIENT,,,445,289.25,,391.6,88,,313.28,,,0,"percent of total billed charges","88% of total billed charges",222.5,50,,178.00,,,0,"percent of total billed charges","50% of total billed charges",74.76,16.8,,59.81,,,0,"percent of total billed charges","16.8% of total billed charges",445,100,,356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77,17.304,,61.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",280.35,63,,224.28,,,0,"percent of total billed charges","63% of total billed charges",68.09,15.3,,54.47,,,0,"percent of total billed charges","15.3% of total billed charges",74.76,16.8,,59.81,,,0,"percent of total billed charges","16.8% of total billed charges",307.05,69,,,,,0,"fee schedule","69% of total billed charges",445,100,,356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",445,100,,356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",445,100,,356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",275.23,61.85,,220.18,,,0,"percent of total billed charges","61.5% of total billed charges",74.76,16.8,,59.81,,,0,"percent of total billed charges","16.8% of total billed charges",222.5,50,,178.00,,,0,"percent of total billed charges","50% of total billed charges",143.29,32.2,,114.63,,,0,"percent of total billed charges","32.2% of total billed charges",74.76,16.8,,59.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.26,17.136,,61.01,,,0,"percent of total billed charges","17.136% of total billed charges",97.19,21.84,,77.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",167.77,37.7,,134.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",347.1,78,,277.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",367.57,82.6,,294.06,,,0,"percent of total billed charges","82.6% of total billed charges",74.76,16.8,,59.81,,,0,"percent of total billed charges","16.8% of total billed charges",222.5,50,,178.00,,,0,"percent of total billed charges","50% of total billed charges",367.57,82.6,,294.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.76,16.8,,59.81,,,0,"percent of total billed charges","16.8% of total billed charges",445,100,,356.00,,,0,"percent of total billed charges","100% of total billed charges",68.09,445,
"SUTURE PROLENE 6-0 8714H",491470,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SUTURE PROLENE 5-0 8713H",491466,CDM,272,RC,,,OUTPATIENT,,,46,29.9,,40.48,88,,32.38,,,0,"percent of total billed charges","88% of total billed charges",23,50,,18.40,,,0,"percent of total billed charges","50% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.96,17.304,,6.37,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.98,63,,23.18,,,0,"percent of total billed charges","63% of total billed charges",7.04,15.3,,5.63,,,0,"percent of total billed charges","15.3% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",31.74,69,,,,,0,"fee schedule","69% of total billed charges",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.45,61.85,,22.76,,,0,"percent of total billed charges","61.5% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",23,50,,18.40,,,0,"percent of total billed charges","50% of total billed charges",14.81,32.2,,11.85,,,0,"percent of total billed charges","32.2% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.88,17.136,,6.30,,,0,"percent of total billed charges","17.136% of total billed charges",10.05,21.84,,8.04,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.34,37.7,,13.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.88,78,,28.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38,82.6,,30.40,,,0,"percent of total billed charges","82.6% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",23,50,,18.40,,,0,"percent of total billed charges","50% of total billed charges",38,82.6,,30.40,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",7.04,46,
"SUTURE PROLENE 5-0 8756H",491467,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SUTURE PROLENE 5-0 8860H",491468,CDM,272,RC,,,OUTPATIENT,,,53,34.45,,46.64,88,,37.31,,,0,"percent of total billed charges","88% of total billed charges",26.5,50,,21.20,,,0,"percent of total billed charges","50% of total billed charges",8.9,16.8,,7.12,,,0,"percent of total billed charges","16.8% of total billed charges",53,100,,42.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.17,17.304,,7.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.39,63,,26.71,,,0,"percent of total billed charges","63% of total billed charges",8.11,15.3,,6.49,,,0,"percent of total billed charges","15.3% of total billed charges",8.9,16.8,,7.12,,,0,"percent of total billed charges","16.8% of total billed charges",36.57,69,,,,,0,"fee schedule","69% of total billed charges",53,100,,42.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53,100,,42.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53,100,,42.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.78,61.85,,26.22,,,0,"percent of total billed charges","61.5% of total billed charges",8.9,16.8,,7.12,,,0,"percent of total billed charges","16.8% of total billed charges",26.5,50,,21.20,,,0,"percent of total billed charges","50% of total billed charges",17.07,32.2,,13.66,,,0,"percent of total billed charges","32.2% of total billed charges",8.9,16.8,,7.12,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.08,17.136,,7.26,,,0,"percent of total billed charges","17.136% of total billed charges",11.58,21.84,,9.26,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.98,37.7,,15.98,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.34,78,,33.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.78,82.6,,35.02,,,0,"percent of total billed charges","82.6% of total billed charges",8.9,16.8,,7.12,,,0,"percent of total billed charges","16.8% of total billed charges",26.5,50,,21.20,,,0,"percent of total billed charges","50% of total billed charges",43.78,82.6,,35.02,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.9,16.8,,7.12,,,0,"percent of total billed charges","16.8% of total billed charges",53,100,,42.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,53,
"SUTURE PROLENE 4-0 8881H",491464,CDM,272,RC,,,OUTPATIENT,,,28,18.2,,24.64,88,,19.71,,,0,"percent of total billed charges","88% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.85,17.304,,3.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.64,63,,14.11,,,0,"percent of total billed charges","63% of total billed charges",4.28,15.3,,3.42,,,0,"percent of total billed charges","15.3% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",19.32,69,,,,,0,"fee schedule","69% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.32,61.85,,13.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",9.02,32.2,,7.22,,,0,"percent of total billed charges","32.2% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.8,17.136,,3.84,,,0,"percent of total billed charges","17.136% of total billed charges",6.12,21.84,,4.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.56,37.7,,8.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.84,78,,17.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",4.28,28,
"SUTURE PROLENE 4-0 8757H",491461,CDM,272,RC,,,OUTPATIENT,,,46,29.9,,40.48,88,,32.38,,,0,"percent of total billed charges","88% of total billed charges",23,50,,18.40,,,0,"percent of total billed charges","50% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.96,17.304,,6.37,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.98,63,,23.18,,,0,"percent of total billed charges","63% of total billed charges",7.04,15.3,,5.63,,,0,"percent of total billed charges","15.3% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",31.74,69,,,,,0,"fee schedule","69% of total billed charges",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.45,61.85,,22.76,,,0,"percent of total billed charges","61.5% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",23,50,,18.40,,,0,"percent of total billed charges","50% of total billed charges",14.81,32.2,,11.85,,,0,"percent of total billed charges","32.2% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.88,17.136,,6.30,,,0,"percent of total billed charges","17.136% of total billed charges",10.05,21.84,,8.04,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.34,37.7,,13.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.88,78,,28.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38,82.6,,30.40,,,0,"percent of total billed charges","82.6% of total billed charges",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",23,50,,18.40,,,0,"percent of total billed charges","50% of total billed charges",38,82.6,,30.40,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.73,16.8,,6.18,,,0,"percent of total billed charges","16.8% of total billed charges",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",7.04,46,
"SUTURE PROLENE 3-0 8862H",491459,CDM,272,RC,,,OUTPATIENT,,,55,35.75,,48.4,88,,38.72,,,0,"percent of total billed charges","88% of total billed charges",27.5,50,,22.00,,,0,"percent of total billed charges","50% of total billed charges",9.24,16.8,,7.39,,,0,"percent of total billed charges","16.8% of total billed charges",55,100,,44.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.52,17.304,,7.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.65,63,,27.72,,,0,"percent of total billed charges","63% of total billed charges",8.42,15.3,,6.74,,,0,"percent of total billed charges","15.3% of total billed charges",9.24,16.8,,7.39,,,0,"percent of total billed charges","16.8% of total billed charges",37.95,69,,,,,0,"fee schedule","69% of total billed charges",55,100,,44.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",55,100,,44.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",55,100,,44.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.02,61.85,,27.22,,,0,"percent of total billed charges","61.5% of total billed charges",9.24,16.8,,7.39,,,0,"percent of total billed charges","16.8% of total billed charges",27.5,50,,22.00,,,0,"percent of total billed charges","50% of total billed charges",17.71,32.2,,14.17,,,0,"percent of total billed charges","32.2% of total billed charges",9.24,16.8,,7.39,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.42,17.136,,7.54,,,0,"percent of total billed charges","17.136% of total billed charges",12.01,21.84,,9.61,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.74,37.7,,16.59,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",42.9,78,,34.32,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.43,82.6,,36.34,,,0,"percent of total billed charges","82.6% of total billed charges",9.24,16.8,,7.39,,,0,"percent of total billed charges","16.8% of total billed charges",27.5,50,,22.00,,,0,"percent of total billed charges","50% of total billed charges",45.43,82.6,,36.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.24,16.8,,7.39,,,0,"percent of total billed charges","16.8% of total billed charges",55,100,,44.00,,,0,"percent of total billed charges","100% of total billed charges",8.42,55,
"SUTURE PLAIN GUT CT-1 842H",491451,CDM,272,RC,,,OUTPATIENT,,,29,18.85,,25.52,88,,20.42,,,0,"percent of total billed charges","88% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.02,17.304,,4.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.27,63,,14.62,,,0,"percent of total billed charges","63% of total billed charges",4.44,15.3,,3.55,,,0,"percent of total billed charges","15.3% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",20.01,69,,,,,0,"fee schedule","69% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.94,61.85,,14.35,,,0,"percent of total billed charges","61.5% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",9.34,32.2,,7.47,,,0,"percent of total billed charges","32.2% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.97,17.136,,3.98,,,0,"percent of total billed charges","17.136% of total billed charges",6.33,21.84,,5.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.93,37.7,,8.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,78,,18.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",4.44,29,
"SUTURE PDS II TP-1 Z880G",491443,CDM,272,RC,,,OUTPATIENT,,,42,27.3,,36.96,88,,29.57,,,0,"percent of total billed charges","88% of total billed charges",21,50,,16.80,,,0,"percent of total billed charges","50% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.27,17.304,,5.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.46,63,,21.17,,,0,"percent of total billed charges","63% of total billed charges",6.43,15.3,,5.14,,,0,"percent of total billed charges","15.3% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",28.98,69,,,,,0,"fee schedule","69% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.98,61.85,,20.78,,,0,"percent of total billed charges","61.5% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",21,50,,16.80,,,0,"percent of total billed charges","50% of total billed charges",13.52,32.2,,10.82,,,0,"percent of total billed charges","32.2% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.2,17.136,,5.76,,,0,"percent of total billed charges","17.136% of total billed charges",9.17,21.84,,7.34,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",32.76,78,,26.21,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",21,50,,16.80,,,0,"percent of total billed charges","50% of total billed charges",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",6.43,42,
"SUTURE PDS II 2-0 FS-1 Z443H",491440,CDM,272,RC,,,OUTPATIENT,,,27,17.55,,23.76,88,,19.01,,,0,"percent of total billed charges","88% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.67,17.304,,3.74,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.01,63,,13.61,,,0,"percent of total billed charges","63% of total billed charges",4.13,15.3,,3.30,,,0,"percent of total billed charges","15.3% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",18.63,69,,,,,0,"fee schedule","69% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.7,61.85,,13.36,,,0,"percent of total billed charges","61.5% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",8.69,32.2,,6.95,,,0,"percent of total billed charges","32.2% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.63,17.136,,3.70,,,0,"percent of total billed charges","17.136% of total billed charges",5.9,21.84,,4.72,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.18,37.7,,8.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.06,78,,16.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.3,82.6,,17.84,,,0,"percent of total billed charges","82.6% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",22.3,82.6,,17.84,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",4.13,27,
"SUTURE PDS II 3-0 FS-2 Z423H",491441,CDM,272,RC,,,OUTPATIENT,,,29,18.85,,25.52,88,,20.42,,,0,"percent of total billed charges","88% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.02,17.304,,4.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.27,63,,14.62,,,0,"percent of total billed charges","63% of total billed charges",4.44,15.3,,3.55,,,0,"percent of total billed charges","15.3% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",20.01,69,,,,,0,"fee schedule","69% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.94,61.85,,14.35,,,0,"percent of total billed charges","61.5% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",9.34,32.2,,7.47,,,0,"percent of total billed charges","32.2% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.97,17.136,,3.98,,,0,"percent of total billed charges","17.136% of total billed charges",6.33,21.84,,5.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.93,37.7,,8.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,78,,18.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",4.44,29,
"SUTURE ENDOLOOP 0-0 PDS EZ10",491394,CDM,272,RC,,,OUTPATIENT,,,138,89.7,,121.44,88,,97.15,,,0,"percent of total billed charges","88% of total billed charges",69,50,,55.20,,,0,"percent of total billed charges","50% of total billed charges",23.18,16.8,,18.54,,,0,"percent of total billed charges","16.8% of total billed charges",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.88,17.304,,19.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.94,63,,69.55,,,0,"percent of total billed charges","63% of total billed charges",21.11,15.3,,16.89,,,0,"percent of total billed charges","15.3% of total billed charges",23.18,16.8,,18.54,,,0,"percent of total billed charges","16.8% of total billed charges",95.22,69,,,,,0,"fee schedule","69% of total billed charges",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.35,61.85,,68.28,,,0,"percent of total billed charges","61.5% of total billed charges",23.18,16.8,,18.54,,,0,"percent of total billed charges","16.8% of total billed charges",69,50,,55.20,,,0,"percent of total billed charges","50% of total billed charges",44.44,32.2,,35.55,,,0,"percent of total billed charges","32.2% of total billed charges",23.18,16.8,,18.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.65,17.136,,18.92,,,0,"percent of total billed charges","17.136% of total billed charges",30.14,21.84,,24.11,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",52.03,37.7,,41.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",107.64,78,,86.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.99,82.6,,91.19,,,0,"percent of total billed charges","82.6% of total billed charges",23.18,16.8,,18.54,,,0,"percent of total billed charges","16.8% of total billed charges",69,50,,55.20,,,0,"percent of total billed charges","50% of total billed charges",113.99,82.6,,91.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.18,16.8,,18.54,,,0,"percent of total billed charges","16.8% of total billed charges",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",21.11,138,
"SUTURE NUROLON 4-0 N104T",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,151,98.15,,132.88,88,,106.30,,,0,"percent of total billed charges","88% of total billed charges",75.5,50,,60.40,,,0,"percent of total billed charges","50% of total billed charges",25.37,16.8,,20.30,,,0,"percent of total billed charges","16.8% of total billed charges",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.13,17.304,,20.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.13,63,,76.10,,,0,"percent of total billed charges","63% of total billed charges",23.1,15.3,,18.48,,,0,"percent of total billed charges","15.3% of total billed charges",25.37,16.8,,20.30,,,0,"percent of total billed charges","16.8% of total billed charges",104.19,69,,,,,0,"fee schedule","69% of total billed charges",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",93.39,61.85,,74.71,,,0,"percent of total billed charges","61.5% of total billed charges",25.37,16.8,,20.30,,,0,"percent of total billed charges","16.8% of total billed charges",75.5,50,,60.40,,,0,"percent of total billed charges","50% of total billed charges",48.62,32.2,,38.90,,,0,"percent of total billed charges","32.2% of total billed charges",25.37,16.8,,20.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.88,17.136,,20.70,,,0,"percent of total billed charges","17.136% of total billed charges",32.98,21.84,,26.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",56.93,37.7,,45.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",117.78,78,,94.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.73,82.6,,99.78,,,0,"percent of total billed charges","82.6% of total billed charges",25.37,16.8,,20.30,,,0,"percent of total billed charges","16.8% of total billed charges",75.5,50,,60.40,,,0,"percent of total billed charges","50% of total billed charges",124.73,82.6,,99.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.37,16.8,,20.30,,,0,"percent of total billed charges","16.8% of total billed charges",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",23.1,151,
"SUTURE MONCRYL 5-0 P-3 Y844G",491420,CDM,272,RC,,,OUTPATIENT,,,48,31.2,,42.24,88,,33.79,,,0,"percent of total billed charges","88% of total billed charges",24,50,,19.20,,,0,"percent of total billed charges","50% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.31,17.304,,6.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.24,63,,24.19,,,0,"percent of total billed charges","63% of total billed charges",7.34,15.3,,5.87,,,0,"percent of total billed charges","15.3% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",33.12,69,,,,,0,"fee schedule","69% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.69,61.85,,23.75,,,0,"percent of total billed charges","61.5% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",24,50,,19.20,,,0,"percent of total billed charges","50% of total billed charges",15.46,32.2,,12.37,,,0,"percent of total billed charges","32.2% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.23,17.136,,6.58,,,0,"percent of total billed charges","17.136% of total billed charges",10.48,21.84,,8.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.1,37.7,,14.48,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",37.44,78,,29.95,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.65,82.6,,31.72,,,0,"percent of total billed charges","82.6% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",24,50,,19.20,,,0,"percent of total billed charges","50% of total billed charges",39.65,82.6,,31.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",7.34,48,
"SUTURE MONOCRYL 4-0 Y426H",491427,CDM,272,RC,,,OUTPATIENT,,,45,29.25,,39.6,88,,31.68,,,0,"percent of total billed charges","88% of total billed charges",22.5,50,,18.00,,,0,"percent of total billed charges","50% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.79,17.304,,6.23,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.35,63,,22.68,,,0,"percent of total billed charges","63% of total billed charges",6.89,15.3,,5.51,,,0,"percent of total billed charges","15.3% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",31.05,69,,,,,0,"fee schedule","69% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.83,61.85,,22.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",22.5,50,,18.00,,,0,"percent of total billed charges","50% of total billed charges",14.49,32.2,,11.59,,,0,"percent of total billed charges","32.2% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.71,17.136,,6.17,,,0,"percent of total billed charges","17.136% of total billed charges",9.83,21.84,,7.86,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.97,37.7,,13.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.1,78,,28.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",22.5,50,,18.00,,,0,"percent of total billed charges","50% of total billed charges",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",6.89,45,
"SUTURE MONOCRYL 0 CT MCP358H",491421,CDM,272,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.9,61.85,,7.92,,,0,"percent of total billed charges","61.5% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"SUTURE MONOCRYL 5-0 P-3 Y493G",491430,CDM,272,RC,,,OUTPATIENT,,,44,28.6,,38.72,88,,30.98,,,0,"percent of total billed charges","88% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.61,17.304,,6.09,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.72,63,,22.18,,,0,"percent of total billed charges","63% of total billed charges",6.73,15.3,,5.38,,,0,"percent of total billed charges","15.3% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",30.36,69,,,,,0,"fee schedule","69% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.21,61.85,,21.77,,,0,"percent of total billed charges","61.5% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",14.17,32.2,,11.34,,,0,"percent of total billed charges","32.2% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.54,17.136,,6.03,,,0,"percent of total billed charges","17.136% of total billed charges",9.61,21.84,,7.69,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.59,37.7,,13.27,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.32,78,,27.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.39,16.8,,5.91,,,0,"percent of total billed charges","16.8% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",6.73,44,
"SUTURE MONOCRYL 3-0 Y944H",491425,CDM,272,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.37,61.85,,9.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"SUTURE MONOCRYL 3-0 CT1 Y3444H",491423,CDM,272,RC,,,OUTPATIENT,,,22,14.3,,19.36,88,,15.49,,,0,"percent of total billed charges","88% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.81,17.304,,3.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.86,63,,11.09,,,0,"percent of total billed charges","63% of total billed charges",3.37,15.3,,2.70,,,0,"percent of total billed charges","15.3% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",15.18,69,,,,,0,"fee schedule","69% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.61,61.85,,10.89,,,0,"percent of total billed charges","61.5% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",7.08,32.2,,5.66,,,0,"percent of total billed charges","32.2% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.77,17.136,,3.02,,,0,"percent of total billed charges","17.136% of total billed charges",4.8,21.84,,3.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.29,37.7,,6.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.16,78,,13.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",3.37,22,
"SUTURE MONOCRYL 2-0 CT Y357H",491422,CDM,272,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"SUTURE MONOCRYL 4-0 Y935H",491429,CDM,272,RC,,,OUTPATIENT,,,63,40.95,,55.44,88,,44.35,,,0,"percent of total billed charges","88% of total billed charges",31.5,50,,25.20,,,0,"percent of total billed charges","50% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.9,17.304,,8.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.69,63,,31.75,,,0,"percent of total billed charges","63% of total billed charges",9.64,15.3,,7.71,,,0,"percent of total billed charges","15.3% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",43.47,69,,,,,0,"fee schedule","69% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.97,61.85,,31.18,,,0,"percent of total billed charges","61.5% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",31.5,50,,25.20,,,0,"percent of total billed charges","50% of total billed charges",20.29,32.2,,16.23,,,0,"percent of total billed charges","32.2% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.8,17.136,,8.64,,,0,"percent of total billed charges","17.136% of total billed charges",13.76,21.84,,11.01,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.75,37.7,,19.00,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",49.14,78,,39.31,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.04,82.6,,41.63,,,0,"percent of total billed charges","82.6% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",31.5,50,,25.20,,,0,"percent of total billed charges","50% of total billed charges",52.04,82.6,,41.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",9.64,63,
"SUTURE MERSILENE 36'' D9212",491418,CDM,272,RC,,,OUTPATIENT,,,574,373.1,,505.12,88,,404.10,,,0,"percent of total billed charges","88% of total billed charges",287,50,,229.60,,,0,"percent of total billed charges","50% of total billed charges",96.43,16.8,,77.14,,,0,"percent of total billed charges","16.8% of total billed charges",574,100,,459.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",99.32,17.304,,79.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",361.62,63,,289.30,,,0,"percent of total billed charges","63% of total billed charges",87.82,15.3,,70.26,,,0,"percent of total billed charges","15.3% of total billed charges",96.43,16.8,,77.14,,,0,"percent of total billed charges","16.8% of total billed charges",396.06,69,,,,,0,"fee schedule","69% of total billed charges",574,100,,459.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",574,100,,459.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",574,100,,459.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",355.02,61.85,,284.02,,,0,"percent of total billed charges","61.5% of total billed charges",96.43,16.8,,77.14,,,0,"percent of total billed charges","16.8% of total billed charges",287,50,,229.60,,,0,"percent of total billed charges","50% of total billed charges",184.83,32.2,,147.86,,,0,"percent of total billed charges","32.2% of total billed charges",96.43,16.8,,77.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.36,17.136,,78.69,,,0,"percent of total billed charges","17.136% of total billed charges",125.36,21.84,,100.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",216.4,37.7,,173.12,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",447.72,78,,358.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",474.12,82.6,,379.30,,,0,"percent of total billed charges","82.6% of total billed charges",96.43,16.8,,77.14,,,0,"percent of total billed charges","16.8% of total billed charges",287,50,,229.60,,,0,"percent of total billed charges","50% of total billed charges",474.12,82.6,,379.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",96.43,16.8,,77.14,,,0,"percent of total billed charges","16.8% of total billed charges",574,100,,459.20,,,0,"percent of total billed charges","100% of total billed charges",87.82,574,
"SUTURE MERSILENE RS22 TAPE",491419,CDM,272,RC,,,OUTPATIENT,,,290,188.5,,255.2,88,,204.16,,,0,"percent of total billed charges","88% of total billed charges",145,50,,116.00,,,0,"percent of total billed charges","50% of total billed charges",48.72,16.8,,38.98,,,0,"percent of total billed charges","16.8% of total billed charges",290,100,,232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.18,17.304,,40.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",182.7,63,,146.16,,,0,"percent of total billed charges","63% of total billed charges",44.37,15.3,,35.50,,,0,"percent of total billed charges","15.3% of total billed charges",48.72,16.8,,38.98,,,0,"percent of total billed charges","16.8% of total billed charges",200.1,69,,,,,0,"fee schedule","69% of total billed charges",290,100,,232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290,100,,232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290,100,,232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.37,61.85,,143.50,,,0,"percent of total billed charges","61.5% of total billed charges",48.72,16.8,,38.98,,,0,"percent of total billed charges","16.8% of total billed charges",145,50,,116.00,,,0,"percent of total billed charges","50% of total billed charges",93.38,32.2,,74.70,,,0,"percent of total billed charges","32.2% of total billed charges",48.72,16.8,,38.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.69,17.136,,39.75,,,0,"percent of total billed charges","17.136% of total billed charges",63.34,21.84,,50.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",109.33,37.7,,87.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",226.2,78,,180.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",239.54,82.6,,191.63,,,0,"percent of total billed charges","82.6% of total billed charges",48.72,16.8,,38.98,,,0,"percent of total billed charges","16.8% of total billed charges",145,50,,116.00,,,0,"percent of total billed charges","50% of total billed charges",239.54,82.6,,191.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.72,16.8,,38.98,,,0,"percent of total billed charges","16.8% of total billed charges",290,100,,232.00,,,0,"percent of total billed charges","100% of total billed charges",44.37,290,
"SUTURE LASSO 90DEG",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"SUTURE RETRIEVER HEWSON",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SUTURE EHTI-PACK DS18 WIRE",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"SUTURE ETHIBOND MX69G 2 V-37",491402,CDM,272,RC,,,OUTPATIENT,,,145,94.25,,127.6,88,,102.08,,,0,"percent of total billed charges","88% of total billed charges",72.5,50,,58.00,,,0,"percent of total billed charges","50% of total billed charges",24.36,16.8,,19.49,,,0,"percent of total billed charges","16.8% of total billed charges",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.09,17.304,,20.07,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.35,63,,73.08,,,0,"percent of total billed charges","63% of total billed charges",22.19,15.3,,17.75,,,0,"percent of total billed charges","15.3% of total billed charges",24.36,16.8,,19.49,,,0,"percent of total billed charges","16.8% of total billed charges",100.05,69,,,,,0,"fee schedule","69% of total billed charges",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.68,61.85,,71.74,,,0,"percent of total billed charges","61.5% of total billed charges",24.36,16.8,,19.49,,,0,"percent of total billed charges","16.8% of total billed charges",72.5,50,,58.00,,,0,"percent of total billed charges","50% of total billed charges",46.69,32.2,,37.35,,,0,"percent of total billed charges","32.2% of total billed charges",24.36,16.8,,19.49,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.85,17.136,,19.88,,,0,"percent of total billed charges","17.136% of total billed charges",31.67,21.84,,25.34,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",54.67,37.7,,43.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",113.1,78,,90.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",119.77,82.6,,95.82,,,0,"percent of total billed charges","82.6% of total billed charges",24.36,16.8,,19.49,,,0,"percent of total billed charges","16.8% of total billed charges",72.5,50,,58.00,,,0,"percent of total billed charges","50% of total billed charges",119.77,82.6,,95.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.36,16.8,,19.49,,,0,"percent of total billed charges","16.8% of total billed charges",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",22.19,145,
"SUTURE ETHIBOND MB47G 5 CCS",491401,CDM,272,RC,,,OUTPATIENT,,,181,117.65,,159.28,88,,127.42,,,0,"percent of total billed charges","88% of total billed charges",90.5,50,,72.40,,,0,"percent of total billed charges","50% of total billed charges",30.41,16.8,,24.33,,,0,"percent of total billed charges","16.8% of total billed charges",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.32,17.304,,25.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.03,63,,91.22,,,0,"percent of total billed charges","63% of total billed charges",27.69,15.3,,22.15,,,0,"percent of total billed charges","15.3% of total billed charges",30.41,16.8,,24.33,,,0,"percent of total billed charges","16.8% of total billed charges",124.89,69,,,,,0,"fee schedule","69% of total billed charges",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",111.95,61.85,,89.56,,,0,"percent of total billed charges","61.5% of total billed charges",30.41,16.8,,24.33,,,0,"percent of total billed charges","16.8% of total billed charges",90.5,50,,72.40,,,0,"percent of total billed charges","50% of total billed charges",58.28,32.2,,46.62,,,0,"percent of total billed charges","32.2% of total billed charges",30.41,16.8,,24.33,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.02,17.136,,24.82,,,0,"percent of total billed charges","17.136% of total billed charges",39.53,21.84,,31.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",68.24,37.7,,54.59,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",141.18,78,,112.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",149.51,82.6,,119.61,,,0,"percent of total billed charges","82.6% of total billed charges",30.41,16.8,,24.33,,,0,"percent of total billed charges","16.8% of total billed charges",90.5,50,,72.40,,,0,"percent of total billed charges","50% of total billed charges",149.51,82.6,,119.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.41,16.8,,24.33,,,0,"percent of total billed charges","16.8% of total billed charges",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",27.69,181,
"SUTURE ETHIBOND O CR/MO CX45D",491403,CDM,272,RC,,,OUTPATIENT,,,115,74.75,,101.2,88,,80.96,,,0,"percent of total billed charges","88% of total billed charges",57.5,50,,46.00,,,0,"percent of total billed charges","50% of total billed charges",19.32,16.8,,15.46,,,0,"percent of total billed charges","16.8% of total billed charges",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.9,17.304,,15.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",72.45,63,,57.96,,,0,"percent of total billed charges","63% of total billed charges",17.6,15.3,,14.08,,,0,"percent of total billed charges","15.3% of total billed charges",19.32,16.8,,15.46,,,0,"percent of total billed charges","16.8% of total billed charges",79.35,69,,,,,0,"fee schedule","69% of total billed charges",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.13,61.85,,56.90,,,0,"percent of total billed charges","61.5% of total billed charges",19.32,16.8,,15.46,,,0,"percent of total billed charges","16.8% of total billed charges",57.5,50,,46.00,,,0,"percent of total billed charges","50% of total billed charges",37.03,32.2,,29.62,,,0,"percent of total billed charges","32.2% of total billed charges",19.32,16.8,,15.46,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.71,17.136,,15.77,,,0,"percent of total billed charges","17.136% of total billed charges",25.12,21.84,,20.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.36,37.7,,34.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",89.7,78,,71.76,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",94.99,82.6,,75.99,,,0,"percent of total billed charges","82.6% of total billed charges",19.32,16.8,,15.46,,,0,"percent of total billed charges","16.8% of total billed charges",57.5,50,,46.00,,,0,"percent of total billed charges","50% of total billed charges",94.99,82.6,,75.99,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.32,16.8,,15.46,,,0,"percent of total billed charges","16.8% of total billed charges",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",17.6,115,
"SUTURE ENDOSTITCH 2-0 VLOC 180",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SUTURE ENDOLOOP 0 VICRYL EJ10G",491393,CDM,272,RC,,,OUTPATIENT,,,77,50.05,,67.76,88,,54.21,,,0,"percent of total billed charges","88% of total billed charges",38.5,50,,30.80,,,0,"percent of total billed charges","50% of total billed charges",12.94,16.8,,10.35,,,0,"percent of total billed charges","16.8% of total billed charges",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.32,17.304,,10.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.51,63,,38.81,,,0,"percent of total billed charges","63% of total billed charges",11.78,15.3,,9.42,,,0,"percent of total billed charges","15.3% of total billed charges",12.94,16.8,,10.35,,,0,"percent of total billed charges","16.8% of total billed charges",53.13,69,,,,,0,"fee schedule","69% of total billed charges",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.62,61.85,,38.10,,,0,"percent of total billed charges","61.5% of total billed charges",12.94,16.8,,10.35,,,0,"percent of total billed charges","16.8% of total billed charges",38.5,50,,30.80,,,0,"percent of total billed charges","50% of total billed charges",24.79,32.2,,19.83,,,0,"percent of total billed charges","32.2% of total billed charges",12.94,16.8,,10.35,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.19,17.136,,10.55,,,0,"percent of total billed charges","17.136% of total billed charges",16.82,21.84,,13.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.03,37.7,,23.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",60.06,78,,48.05,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.6,82.6,,50.88,,,0,"percent of total billed charges","82.6% of total billed charges",12.94,16.8,,10.35,,,0,"percent of total billed charges","16.8% of total billed charges",38.5,50,,30.80,,,0,"percent of total billed charges","50% of total billed charges",63.6,82.6,,50.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.94,16.8,,10.35,,,0,"percent of total billed charges","16.8% of total billed charges",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",11.78,77,
"SUTURE ENDOLOOP 0-PDS II",491395,CDM,272,RC,,,OUTPATIENT,,,355,230.75,,312.4,88,,249.92,,,0,"percent of total billed charges","88% of total billed charges",177.5,50,,142.00,,,0,"percent of total billed charges","50% of total billed charges",59.64,16.8,,47.71,,,0,"percent of total billed charges","16.8% of total billed charges",355,100,,284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.43,17.304,,49.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.65,63,,178.92,,,0,"percent of total billed charges","63% of total billed charges",54.32,15.3,,43.46,,,0,"percent of total billed charges","15.3% of total billed charges",59.64,16.8,,47.71,,,0,"percent of total billed charges","16.8% of total billed charges",244.95,69,,,,,0,"fee schedule","69% of total billed charges",355,100,,284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",355,100,,284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",355,100,,284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",219.57,61.85,,175.66,,,0,"percent of total billed charges","61.5% of total billed charges",59.64,16.8,,47.71,,,0,"percent of total billed charges","16.8% of total billed charges",177.5,50,,142.00,,,0,"percent of total billed charges","50% of total billed charges",114.31,32.2,,91.45,,,0,"percent of total billed charges","32.2% of total billed charges",59.64,16.8,,47.71,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.83,17.136,,48.66,,,0,"percent of total billed charges","17.136% of total billed charges",77.53,21.84,,62.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",133.84,37.7,,107.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",276.9,78,,221.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",293.23,82.6,,234.58,,,0,"percent of total billed charges","82.6% of total billed charges",59.64,16.8,,47.71,,,0,"percent of total billed charges","16.8% of total billed charges",177.5,50,,142.00,,,0,"percent of total billed charges","50% of total billed charges",293.23,82.6,,234.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.64,16.8,,47.71,,,0,"percent of total billed charges","16.8% of total billed charges",355,100,,284.00,,,0,"percent of total billed charges","100% of total billed charges",54.32,355,
"SUTURE ANCHOR CORKSCREW II",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"SUTURE CHROMIC GUT 5-0 1658G",491390,CDM,272,RC,,,OUTPATIENT,,,58,37.7,,51.04,88,,40.83,,,0,"percent of total billed charges","88% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.04,17.304,,8.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.54,63,,29.23,,,0,"percent of total billed charges","63% of total billed charges",8.87,15.3,,7.10,,,0,"percent of total billed charges","15.3% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",40.02,69,,,,,0,"fee schedule","69% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.87,61.85,,28.70,,,0,"percent of total billed charges","61.5% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",18.68,32.2,,14.94,,,0,"percent of total billed charges","32.2% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.94,17.136,,7.95,,,0,"percent of total billed charges","17.136% of total billed charges",12.67,21.84,,10.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.87,37.7,,17.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",45.24,78,,36.19,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",29,50,,23.20,,,0,"percent of total billed charges","50% of total billed charges",47.91,82.6,,38.33,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.74,16.8,,7.79,,,0,"percent of total billed charges","16.8% of total billed charges",58,100,,46.40,,,0,"percent of total billed charges","100% of total billed charges",8.87,58,
"SUTURE CHROMIC GUT 4-0 1637G",491388,CDM,272,RC,,,OUTPATIENT,,,59,38.35,,51.92,88,,41.54,,,0,"percent of total billed charges","88% of total billed charges",29.5,50,,23.60,,,0,"percent of total billed charges","50% of total billed charges",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.21,17.304,,8.17,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.17,63,,29.74,,,0,"percent of total billed charges","63% of total billed charges",9.03,15.3,,7.22,,,0,"percent of total billed charges","15.3% of total billed charges",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",40.71,69,,,,,0,"fee schedule","69% of total billed charges",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.49,61.85,,29.19,,,0,"percent of total billed charges","61.5% of total billed charges",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",29.5,50,,23.60,,,0,"percent of total billed charges","50% of total billed charges",19,32.2,,15.20,,,0,"percent of total billed charges","32.2% of total billed charges",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.11,17.136,,8.09,,,0,"percent of total billed charges","17.136% of total billed charges",12.89,21.84,,10.31,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.24,37.7,,17.79,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.02,78,,36.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.73,82.6,,38.98,,,0,"percent of total billed charges","82.6% of total billed charges",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",29.5,50,,23.60,,,0,"percent of total billed charges","50% of total billed charges",48.73,82.6,,38.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",9.03,59,
"SUTURE CHROMIC GUT 3-0 U204H",491386,CDM,272,RC,,,OUTPATIENT,,,30,19.5,,26.4,88,,21.12,,,0,"percent of total billed charges","88% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.19,17.304,,4.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.9,63,,15.12,,,0,"percent of total billed charges","63% of total billed charges",4.59,15.3,,3.67,,,0,"percent of total billed charges","15.3% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",20.7,69,,,,,0,"fee schedule","69% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.56,61.85,,14.85,,,0,"percent of total billed charges","61.5% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",9.66,32.2,,7.73,,,0,"percent of total billed charges","32.2% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.14,17.136,,4.11,,,0,"percent of total billed charges","17.136% of total billed charges",6.55,21.84,,5.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.31,37.7,,9.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.4,78,,18.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",4.59,30,
"SUTURE CHROMIC GUT 3-0 810H",491385,CDM,272,RC,,,OUTPATIENT,,,29,18.85,,25.52,88,,20.42,,,0,"percent of total billed charges","88% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.02,17.304,,4.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.27,63,,14.62,,,0,"percent of total billed charges","63% of total billed charges",4.44,15.3,,3.55,,,0,"percent of total billed charges","15.3% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",20.01,69,,,,,0,"fee schedule","69% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.94,61.85,,14.35,,,0,"percent of total billed charges","61.5% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",9.34,32.2,,7.47,,,0,"percent of total billed charges","32.2% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.97,17.136,,3.98,,,0,"percent of total billed charges","17.136% of total billed charges",6.33,21.84,,5.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.93,37.7,,8.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,78,,18.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",4.44,29,
"SUTURE CHROMIC GUT 0 884H",491378,CDM,272,RC,,,OUTPATIENT,,,29,18.85,,25.52,88,,20.42,,,0,"percent of total billed charges","88% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.02,17.304,,4.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.27,63,,14.62,,,0,"percent of total billed charges","63% of total billed charges",4.44,15.3,,3.55,,,0,"percent of total billed charges","15.3% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",20.01,69,,,,,0,"fee schedule","69% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.94,61.85,,14.35,,,0,"percent of total billed charges","61.5% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",9.34,32.2,,7.47,,,0,"percent of total billed charges","32.2% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.97,17.136,,3.98,,,0,"percent of total billed charges","17.136% of total billed charges",6.33,21.84,,5.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.93,37.7,,8.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,78,,18.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",4.44,29,
"SUTURE CHROMIC GUT 0-0 47T",491379,CDM,272,RC,,,OUTPATIENT,,,50,32.5,,44,88,,35.20,,,0,"percent of total billed charges","88% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.65,17.304,,6.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.5,63,,25.20,,,0,"percent of total billed charges","63% of total billed charges",7.65,15.3,,6.12,,,0,"percent of total billed charges","15.3% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",34.5,69,,,,,0,"fee schedule","69% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.93,61.85,,24.74,,,0,"percent of total billed charges","61.5% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",16.1,32.2,,12.88,,,0,"percent of total billed charges","32.2% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.57,17.136,,6.86,,,0,"percent of total billed charges","17.136% of total billed charges",10.92,21.84,,8.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39,78,,31.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.4,16.8,,6.72,,,0,"percent of total billed charges","16.8% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",7.65,50,
"SUTURE CHROMIC GUT 1-0 813H",491380,CDM,272,RC,,,OUTPATIENT,,,30,19.5,,26.4,88,,21.12,,,0,"percent of total billed charges","88% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.19,17.304,,4.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.9,63,,15.12,,,0,"percent of total billed charges","63% of total billed charges",4.59,15.3,,3.67,,,0,"percent of total billed charges","15.3% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",20.7,69,,,,,0,"fee schedule","69% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.56,61.85,,14.85,,,0,"percent of total billed charges","61.5% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",9.66,32.2,,7.73,,,0,"percent of total billed charges","32.2% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.14,17.136,,4.11,,,0,"percent of total billed charges","17.136% of total billed charges",6.55,21.84,,5.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.31,37.7,,9.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.4,78,,18.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",4.59,30,
"SUTURE PLAIN 6-0 1916G",491449,CDM,272,RC,,,OUTPATIENT,,,62,40.3,,54.56,88,,43.65,,,0,"percent of total billed charges","88% of total billed charges",31,50,,24.80,,,0,"percent of total billed charges","50% of total billed charges",10.42,16.8,,8.34,,,0,"percent of total billed charges","16.8% of total billed charges",62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.73,17.304,,8.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.06,63,,31.25,,,0,"percent of total billed charges","63% of total billed charges",9.49,15.3,,7.59,,,0,"percent of total billed charges","15.3% of total billed charges",10.42,16.8,,8.34,,,0,"percent of total billed charges","16.8% of total billed charges",42.78,69,,,,,0,"fee schedule","69% of total billed charges",62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.35,61.85,,30.68,,,0,"percent of total billed charges","61.5% of total billed charges",10.42,16.8,,8.34,,,0,"percent of total billed charges","16.8% of total billed charges",31,50,,24.80,,,0,"percent of total billed charges","50% of total billed charges",19.96,32.2,,15.97,,,0,"percent of total billed charges","32.2% of total billed charges",10.42,16.8,,8.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.62,17.136,,8.50,,,0,"percent of total billed charges","17.136% of total billed charges",13.54,21.84,,10.83,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.37,37.7,,18.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",48.36,78,,38.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.21,82.6,,40.97,,,0,"percent of total billed charges","82.6% of total billed charges",10.42,16.8,,8.34,,,0,"percent of total billed charges","16.8% of total billed charges",31,50,,24.80,,,0,"percent of total billed charges","50% of total billed charges",51.21,82.6,,40.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.42,16.8,,8.34,,,0,"percent of total billed charges","16.8% of total billed charges",62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",9.49,62,
"SUTURE PDS 6-0 Z489G",491437,CDM,272,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"SUTURE ETHILON 6-0 697H",491411,CDM,272,RC,,,OUTPATIENT,,,31,20.15,,27.28,88,,21.82,,,0,"percent of total billed charges","88% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.36,17.304,,4.29,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.53,63,,15.62,,,0,"percent of total billed charges","63% of total billed charges",4.74,15.3,,3.79,,,0,"percent of total billed charges","15.3% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",21.39,69,,,,,0,"fee schedule","69% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.17,61.85,,15.34,,,0,"percent of total billed charges","61.5% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",9.98,32.2,,7.98,,,0,"percent of total billed charges","32.2% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.31,17.136,,4.25,,,0,"percent of total billed charges","17.136% of total billed charges",6.77,21.84,,5.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.69,37.7,,9.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.18,78,,19.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.61,82.6,,20.49,,,0,"percent of total billed charges","82.6% of total billed charges",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",15.5,50,,12.40,,,0,"percent of total billed charges","50% of total billed charges",25.61,82.6,,20.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.21,16.8,,4.17,,,0,"percent of total billed charges","16.8% of total billed charges",31,100,,24.80,,,0,"percent of total billed charges","100% of total billed charges",4.74,31,
"SUTURE VICRYL 5-0 J490G",491516,CDM,272,RC,,,OUTPATIENT,,,28,18.2,,24.64,88,,19.71,,,0,"percent of total billed charges","88% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.85,17.304,,3.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.64,63,,14.11,,,0,"percent of total billed charges","63% of total billed charges",4.28,15.3,,3.42,,,0,"percent of total billed charges","15.3% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",19.32,69,,,,,0,"fee schedule","69% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.32,61.85,,13.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",9.02,32.2,,7.22,,,0,"percent of total billed charges","32.2% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.8,17.136,,3.84,,,0,"percent of total billed charges","17.136% of total billed charges",6.12,21.84,,4.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.56,37.7,,8.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.84,78,,17.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",4.28,28,
"SUTURE SURGILENE 5-0 3412-23",491488,CDM,272,RC,,,OUTPATIENT,,,45,29.25,,39.6,88,,31.68,,,0,"percent of total billed charges","88% of total billed charges",22.5,50,,18.00,,,0,"percent of total billed charges","50% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.79,17.304,,6.23,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.35,63,,22.68,,,0,"percent of total billed charges","63% of total billed charges",6.89,15.3,,5.51,,,0,"percent of total billed charges","15.3% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",31.05,69,,,,,0,"fee schedule","69% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.83,61.85,,22.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",22.5,50,,18.00,,,0,"percent of total billed charges","50% of total billed charges",14.49,32.2,,11.59,,,0,"percent of total billed charges","32.2% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.71,17.136,,6.17,,,0,"percent of total billed charges","17.136% of total billed charges",9.83,21.84,,7.86,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.97,37.7,,13.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.1,78,,28.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",22.5,50,,18.00,,,0,"percent of total billed charges","50% of total billed charges",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",6.89,45,
"SUTURE SURGILENE 5-0 3420-23",491489,CDM,272,RC,,,OUTPATIENT,,,22,14.3,,19.36,88,,15.49,,,0,"percent of total billed charges","88% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.81,17.304,,3.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.86,63,,11.09,,,0,"percent of total billed charges","63% of total billed charges",3.37,15.3,,2.70,,,0,"percent of total billed charges","15.3% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",15.18,69,,,,,0,"fee schedule","69% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.61,61.85,,10.89,,,0,"percent of total billed charges","61.5% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",7.08,32.2,,5.66,,,0,"percent of total billed charges","32.2% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.77,17.136,,3.02,,,0,"percent of total billed charges","17.136% of total billed charges",4.8,21.84,,3.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.29,37.7,,6.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.16,78,,13.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",3.37,22,
"SUTURE PLAIN 5-0 1915G",491448,CDM,272,RC,,,OUTPATIENT,,,63,40.95,,55.44,88,,44.35,,,0,"percent of total billed charges","88% of total billed charges",31.5,50,,25.20,,,0,"percent of total billed charges","50% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.9,17.304,,8.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.69,63,,31.75,,,0,"percent of total billed charges","63% of total billed charges",9.64,15.3,,7.71,,,0,"percent of total billed charges","15.3% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",43.47,69,,,,,0,"fee schedule","69% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.97,61.85,,31.18,,,0,"percent of total billed charges","61.5% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",31.5,50,,25.20,,,0,"percent of total billed charges","50% of total billed charges",20.29,32.2,,16.23,,,0,"percent of total billed charges","32.2% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.8,17.136,,8.64,,,0,"percent of total billed charges","17.136% of total billed charges",13.76,21.84,,11.01,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.75,37.7,,19.00,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",49.14,78,,39.31,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.04,82.6,,41.63,,,0,"percent of total billed charges","82.6% of total billed charges",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",31.5,50,,25.20,,,0,"percent of total billed charges","50% of total billed charges",52.04,82.6,,41.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.58,16.8,,8.46,,,0,"percent of total billed charges","16.8% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",9.64,63,
"SUTURE ETHILON 5-0 661H",491408,CDM,272,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.9,61.85,,7.92,,,0,"percent of total billed charges","61.5% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"SUTURE ETHILON 5-0 695G",491409,CDM,272,RC,,,OUTPATIENT,,,33,21.45,,29.04,88,,23.23,,,0,"percent of total billed charges","88% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,17.304,,4.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.79,63,,16.63,,,0,"percent of total billed charges","63% of total billed charges",5.05,15.3,,4.04,,,0,"percent of total billed charges","15.3% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",22.77,69,,,,,0,"fee schedule","69% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.41,61.85,,16.33,,,0,"percent of total billed charges","61.5% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",10.63,32.2,,8.50,,,0,"percent of total billed charges","32.2% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.65,17.136,,4.52,,,0,"percent of total billed charges","17.136% of total billed charges",7.21,21.84,,5.77,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.44,37.7,,9.95,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25.74,78,,20.59,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",5.05,33,
"SUTURE VICRYL 4-0 J441H",491511,CDM,272,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.37,61.85,,9.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"SUTURE VICRYL 4-0 J337H",491510,CDM,272,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"SUTURE STEEL 4-0 539G",491486,CDM,272,RC,,,OUTPATIENT,,,67,43.55,,58.96,88,,47.17,,,0,"percent of total billed charges","88% of total billed charges",33.5,50,,26.80,,,0,"percent of total billed charges","50% of total billed charges",11.26,16.8,,9.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.59,17.304,,9.27,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.21,63,,33.77,,,0,"percent of total billed charges","63% of total billed charges",10.25,15.3,,8.20,,,0,"percent of total billed charges","15.3% of total billed charges",11.26,16.8,,9.01,,,0,"percent of total billed charges","16.8% of total billed charges",46.23,69,,,,,0,"fee schedule","69% of total billed charges",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.44,61.85,,33.15,,,0,"percent of total billed charges","61.5% of total billed charges",11.26,16.8,,9.01,,,0,"percent of total billed charges","16.8% of total billed charges",33.5,50,,26.80,,,0,"percent of total billed charges","50% of total billed charges",21.57,32.2,,17.26,,,0,"percent of total billed charges","32.2% of total billed charges",11.26,16.8,,9.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.48,17.136,,9.18,,,0,"percent of total billed charges","17.136% of total billed charges",14.63,21.84,,11.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25.26,37.7,,20.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",52.26,78,,41.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",55.34,82.6,,44.27,,,0,"percent of total billed charges","82.6% of total billed charges",11.26,16.8,,9.01,,,0,"percent of total billed charges","16.8% of total billed charges",33.5,50,,26.80,,,0,"percent of total billed charges","50% of total billed charges",55.34,82.6,,44.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.26,16.8,,9.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",10.25,67,
"SUTURE SILK 4-0 SA83H",491483,CDM,272,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.37,61.85,,9.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"SUTURE SILK 4-0 C014D",491481,CDM,272,RC,,,OUTPATIENT,,,75,48.75,,66,88,,52.80,,,0,"percent of total billed charges","88% of total billed charges",37.5,50,,30.00,,,0,"percent of total billed charges","50% of total billed charges",12.6,16.8,,10.08,,,0,"percent of total billed charges","16.8% of total billed charges",75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.98,17.304,,10.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.25,63,,37.80,,,0,"percent of total billed charges","63% of total billed charges",11.48,15.3,,9.18,,,0,"percent of total billed charges","15.3% of total billed charges",12.6,16.8,,10.08,,,0,"percent of total billed charges","16.8% of total billed charges",51.75,69,,,,,0,"fee schedule","69% of total billed charges",75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.39,61.85,,37.11,,,0,"percent of total billed charges","61.5% of total billed charges",12.6,16.8,,10.08,,,0,"percent of total billed charges","16.8% of total billed charges",37.5,50,,30.00,,,0,"percent of total billed charges","50% of total billed charges",24.15,32.2,,19.32,,,0,"percent of total billed charges","32.2% of total billed charges",12.6,16.8,,10.08,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.85,17.136,,10.28,,,0,"percent of total billed charges","17.136% of total billed charges",16.38,21.84,,13.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.28,37.7,,22.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.5,78,,46.80,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.95,82.6,,49.56,,,0,"percent of total billed charges","82.6% of total billed charges",12.6,16.8,,10.08,,,0,"percent of total billed charges","16.8% of total billed charges",37.5,50,,30.00,,,0,"percent of total billed charges","50% of total billed charges",61.95,82.6,,49.56,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,16.8,,10.08,,,0,"percent of total billed charges","16.8% of total billed charges",75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",11.48,75,
"SUTURE PLAIN 4-0 1828H",491447,CDM,272,RC,,,OUTPATIENT,,,42,27.3,,36.96,88,,29.57,,,0,"percent of total billed charges","88% of total billed charges",21,50,,16.80,,,0,"percent of total billed charges","50% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.27,17.304,,5.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.46,63,,21.17,,,0,"percent of total billed charges","63% of total billed charges",6.43,15.3,,5.14,,,0,"percent of total billed charges","15.3% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",28.98,69,,,,,0,"fee schedule","69% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.98,61.85,,20.78,,,0,"percent of total billed charges","61.5% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",21,50,,16.80,,,0,"percent of total billed charges","50% of total billed charges",13.52,32.2,,10.82,,,0,"percent of total billed charges","32.2% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.2,17.136,,5.76,,,0,"percent of total billed charges","17.136% of total billed charges",9.17,21.84,,7.34,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",32.76,78,,26.21,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",21,50,,16.80,,,0,"percent of total billed charges","50% of total billed charges",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.06,16.8,,5.65,,,0,"percent of total billed charges","16.8% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",6.43,42,
"SUTURE PDS 4-0 Z494G",491436,CDM,272,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"SUTURE CHROMIC GUT 4-0 1634G",491387,CDM,272,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"SUTURE CHROMIC GUT 4-0 654G",491389,CDM,272,RC,,,OUTPATIENT,,,40,26,,35.2,88,,28.16,,,0,"percent of total billed charges","88% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.92,17.304,,5.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.2,63,,20.16,,,0,"percent of total billed charges","63% of total billed charges",6.12,15.3,,4.90,,,0,"percent of total billed charges","15.3% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",27.6,69,,,,,0,"fee schedule","69% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.74,61.85,,19.79,,,0,"percent of total billed charges","61.5% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",12.88,32.2,,10.30,,,0,"percent of total billed charges","32.2% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.85,17.136,,5.48,,,0,"percent of total billed charges","17.136% of total billed charges",8.74,21.84,,6.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.08,37.7,,12.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",31.2,78,,24.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",6.12,40,
"SUTURE VICRYL 3-0 J285G",491502,CDM,272,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"SUTURE VICRYL 3-0 VR497",491507,CDM,272,RC,,,OUTPATIENT,,,48,31.2,,42.24,88,,33.79,,,0,"percent of total billed charges","88% of total billed charges",24,50,,19.20,,,0,"percent of total billed charges","50% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.31,17.304,,6.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.24,63,,24.19,,,0,"percent of total billed charges","63% of total billed charges",7.34,15.3,,5.87,,,0,"percent of total billed charges","15.3% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",33.12,69,,,,,0,"fee schedule","69% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.69,61.85,,23.75,,,0,"percent of total billed charges","61.5% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",24,50,,19.20,,,0,"percent of total billed charges","50% of total billed charges",15.46,32.2,,12.37,,,0,"percent of total billed charges","32.2% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.23,17.136,,6.58,,,0,"percent of total billed charges","17.136% of total billed charges",10.48,21.84,,8.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.1,37.7,,14.48,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",37.44,78,,29.95,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.65,82.6,,31.72,,,0,"percent of total billed charges","82.6% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",24,50,,19.20,,,0,"percent of total billed charges","50% of total billed charges",39.65,82.6,,31.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",7.34,48,
"SUTURE VICRYL 3-0 VR944",491508,CDM,272,RC,,,OUTPATIENT,,,29,18.85,,25.52,88,,20.42,,,0,"percent of total billed charges","88% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.02,17.304,,4.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.27,63,,14.62,,,0,"percent of total billed charges","63% of total billed charges",4.44,15.3,,3.55,,,0,"percent of total billed charges","15.3% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",20.01,69,,,,,0,"fee schedule","69% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.94,61.85,,14.35,,,0,"percent of total billed charges","61.5% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",9.34,32.2,,7.47,,,0,"percent of total billed charges","32.2% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.97,17.136,,3.98,,,0,"percent of total billed charges","17.136% of total billed charges",6.33,21.84,,5.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.93,37.7,,8.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,78,,18.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",4.44,29,
"SUTURE VICRYL 3-0 J338H",491503,CDM,272,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"SUTURE SURGILENE 3-0 3422-43",491487,CDM,272,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"SUTURE SILK 3-0 SA84H",491480,CDM,272,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.37,61.85,,9.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"SUTURE SILK 3-0 1177-42",491478,CDM,272,RC,,,OUTPATIENT,,,40,26,,35.2,88,,28.16,,,0,"percent of total billed charges","88% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.92,17.304,,5.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.2,63,,20.16,,,0,"percent of total billed charges","63% of total billed charges",6.12,15.3,,4.90,,,0,"percent of total billed charges","15.3% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",27.6,69,,,,,0,"fee schedule","69% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.74,61.85,,19.79,,,0,"percent of total billed charges","61.5% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",12.88,32.2,,10.30,,,0,"percent of total billed charges","32.2% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.85,17.136,,5.48,,,0,"percent of total billed charges","17.136% of total billed charges",8.74,21.84,,6.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.08,37.7,,12.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",31.2,78,,24.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",6.12,40,
"SUTURE PLAIN 3-0 G322H",491446,CDM,272,RC,,,OUTPATIENT,,,29,18.85,,25.52,88,,20.42,,,0,"percent of total billed charges","88% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.02,17.304,,4.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.27,63,,14.62,,,0,"percent of total billed charges","63% of total billed charges",4.44,15.3,,3.55,,,0,"percent of total billed charges","15.3% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",20.01,69,,,,,0,"fee schedule","69% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.94,61.85,,14.35,,,0,"percent of total billed charges","61.5% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",9.34,32.2,,7.47,,,0,"percent of total billed charges","32.2% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.97,17.136,,3.98,,,0,"percent of total billed charges","17.136% of total billed charges",6.33,21.84,,5.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.93,37.7,,8.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,78,,18.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",4.44,29,
"SUTURE PLAIN 3-0 873H",491445,CDM,272,RC,,,OUTPATIENT,,,29,18.85,,25.52,88,,20.42,,,0,"percent of total billed charges","88% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.02,17.304,,4.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.27,63,,14.62,,,0,"percent of total billed charges","63% of total billed charges",4.44,15.3,,3.55,,,0,"percent of total billed charges","15.3% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",20.01,69,,,,,0,"fee schedule","69% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.94,61.85,,14.35,,,0,"percent of total billed charges","61.5% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",9.34,32.2,,7.47,,,0,"percent of total billed charges","32.2% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.97,17.136,,3.98,,,0,"percent of total billed charges","17.136% of total billed charges",6.33,21.84,,5.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.93,37.7,,8.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,78,,18.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",4.44,29,
"SUTURE ETHILON 3-0 1669H",491404,CDM,272,RC,,,OUTPATIENT,,,32,20.8,,28.16,88,,22.53,,,0,"percent of total billed charges","88% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.54,17.304,,4.43,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.16,63,,16.13,,,0,"percent of total billed charges","63% of total billed charges",4.9,15.3,,3.92,,,0,"percent of total billed charges","15.3% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",22.08,69,,,,,0,"fee schedule","69% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.79,61.85,,15.83,,,0,"percent of total billed charges","61.5% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",10.3,32.2,,8.24,,,0,"percent of total billed charges","32.2% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.48,17.136,,4.38,,,0,"percent of total billed charges","17.136% of total billed charges",6.99,21.84,,5.59,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.96,78,,19.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",4.9,32,
"SUTURE ETHILON 3-0 1673H",491405,CDM,272,RC,,,OUTPATIENT,,,49,31.85,,43.12,88,,34.50,,,0,"percent of total billed charges","88% of total billed charges",24.5,50,,19.60,,,0,"percent of total billed charges","50% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.48,17.304,,6.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.87,63,,24.70,,,0,"percent of total billed charges","63% of total billed charges",7.5,15.3,,6.00,,,0,"percent of total billed charges","15.3% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",33.81,69,,,,,0,"fee schedule","69% of total billed charges",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.31,61.85,,24.25,,,0,"percent of total billed charges","61.5% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",24.5,50,,19.60,,,0,"percent of total billed charges","50% of total billed charges",15.78,32.2,,12.62,,,0,"percent of total billed charges","32.2% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.4,17.136,,6.72,,,0,"percent of total billed charges","17.136% of total billed charges",10.7,21.84,,8.56,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.47,37.7,,14.78,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.22,78,,30.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.47,82.6,,32.38,,,0,"percent of total billed charges","82.6% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",24.5,50,,19.60,,,0,"percent of total billed charges","50% of total billed charges",40.47,82.6,,32.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",7.5,49,
"SUTURE DEXON 3-0 9608-41",491391,CDM,272,RC,,,OUTPATIENT,,,29,18.85,,25.52,88,,20.42,,,0,"percent of total billed charges","88% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.02,17.304,,4.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.27,63,,14.62,,,0,"percent of total billed charges","63% of total billed charges",4.44,15.3,,3.55,,,0,"percent of total billed charges","15.3% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",20.01,69,,,,,0,"fee schedule","69% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.94,61.85,,14.35,,,0,"percent of total billed charges","61.5% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",9.34,32.2,,7.47,,,0,"percent of total billed charges","32.2% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.97,17.136,,3.98,,,0,"percent of total billed charges","17.136% of total billed charges",6.33,21.84,,5.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.93,37.7,,8.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,78,,18.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",4.44,29,
"SUTURE CHROMIC GUT 3-0 1638G",491384,CDM,272,RC,,,OUTPATIENT,,,56,36.4,,49.28,88,,39.42,,,0,"percent of total billed charges","88% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.69,17.304,,7.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.28,63,,28.22,,,0,"percent of total billed charges","63% of total billed charges",8.57,15.3,,6.86,,,0,"percent of total billed charges","15.3% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",38.64,69,,,,,0,"fee schedule","69% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.64,61.85,,27.71,,,0,"percent of total billed charges","61.5% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",18.03,32.2,,14.42,,,0,"percent of total billed charges","32.2% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.6,17.136,,7.68,,,0,"percent of total billed charges","17.136% of total billed charges",12.23,21.84,,9.78,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.11,37.7,,16.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.68,78,,34.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",8.57,56,
"SUTURE VICRYL 2-0 J286G",491496,CDM,272,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"SUTURE ENDOSTITCH 2-0",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SUTURE VICRYL 2-0 VR417",491499,CDM,272,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"SUTURE PDS 2-0 Z-997G",491435,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SUTURE PDS 2-0 Z-333H",491434,CDM,272,RC,,,OUTPATIENT,,,32,20.8,,28.16,88,,22.53,,,0,"percent of total billed charges","88% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.54,17.304,,4.43,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.16,63,,16.13,,,0,"percent of total billed charges","63% of total billed charges",4.9,15.3,,3.92,,,0,"percent of total billed charges","15.3% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",22.08,69,,,,,0,"fee schedule","69% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.79,61.85,,15.83,,,0,"percent of total billed charges","61.5% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",10.3,32.2,,8.24,,,0,"percent of total billed charges","32.2% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.48,17.136,,4.38,,,0,"percent of total billed charges","17.136% of total billed charges",6.99,21.84,,5.59,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.96,78,,19.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",4.9,32,
"SUTURE CHROMIC GUT 2-0 N-878H",491382,CDM,272,RC,,,OUTPATIENT,,,34,22.1,,29.92,88,,23.94,,,0,"percent of total billed charges","88% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.88,17.304,,4.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.42,63,,17.14,,,0,"percent of total billed charges","63% of total billed charges",5.2,15.3,,4.16,,,0,"percent of total billed charges","15.3% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",23.46,69,,,,,0,"fee schedule","69% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.03,61.85,,16.82,,,0,"percent of total billed charges","61.5% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",10.95,32.2,,8.76,,,0,"percent of total billed charges","32.2% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.83,17.136,,4.66,,,0,"percent of total billed charges","17.136% of total billed charges",7.43,21.84,,5.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.82,37.7,,10.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.52,78,,21.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",5.2,34,
"SUTURE CHROMIC GUT 2-0 U255H",491383,CDM,272,RC,,,OUTPATIENT,,,35,22.75,,30.8,88,,24.64,,,0,"percent of total billed charges","88% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.06,17.304,,4.85,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.05,63,,17.64,,,0,"percent of total billed charges","63% of total billed charges",5.36,15.3,,4.29,,,0,"percent of total billed charges","15.3% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",24.15,69,,,,,0,"fee schedule","69% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.65,61.85,,17.32,,,0,"percent of total billed charges","61.5% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",11.27,32.2,,9.02,,,0,"percent of total billed charges","32.2% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,17.136,,4.80,,,0,"percent of total billed charges","17.136% of total billed charges",7.64,21.84,,6.11,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.2,37.7,,10.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",27.3,78,,21.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.91,82.6,,23.13,,,0,"percent of total billed charges","82.6% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",28.91,82.6,,23.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",5.36,35,
"SUTURE ETHIBOND 2-0 X-519H",491400,CDM,272,RC,,,OUTPATIENT,,,23,14.95,,20.24,88,,16.19,,,0,"percent of total billed charges","88% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.98,17.304,,3.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.49,63,,11.59,,,0,"percent of total billed charges","63% of total billed charges",3.52,15.3,,2.82,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",15.87,69,,,,,0,"fee schedule","69% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.23,61.85,,11.38,,,0,"percent of total billed charges","61.5% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",7.41,32.2,,5.93,,,0,"percent of total billed charges","32.2% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.94,17.136,,3.15,,,0,"percent of total billed charges","17.136% of total billed charges",5.02,21.84,,4.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.94,78,,14.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",3.52,23,
"SUTURE PDS 1-0 Z-347H",491432,CDM,272,RC,,,OUTPATIENT,,,25,16.25,,22,88,,17.60,,,0,"percent of total billed charges","88% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,17.304,,3.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.75,63,,12.60,,,0,"percent of total billed charges","63% of total billed charges",3.83,15.3,,3.06,,,0,"percent of total billed charges","15.3% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",17.25,69,,,,,0,"fee schedule","69% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.46,61.85,,12.37,,,0,"percent of total billed charges","61.5% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",8.05,32.2,,6.44,,,0,"percent of total billed charges","32.2% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.28,17.136,,3.42,,,0,"percent of total billed charges","17.136% of total billed charges",5.46,21.84,,4.37,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.43,37.7,,7.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.5,78,,15.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",3.83,25,
"SUTURE ETHIBOND 1-0 C-X30G",491399,CDM,272,RC,,,OUTPATIENT,,,97,63.05,,85.36,88,,68.29,,,0,"percent of total billed charges","88% of total billed charges",48.5,50,,38.80,,,0,"percent of total billed charges","50% of total billed charges",16.3,16.8,,13.04,,,0,"percent of total billed charges","16.8% of total billed charges",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.78,17.304,,13.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.11,63,,48.89,,,0,"percent of total billed charges","63% of total billed charges",14.84,15.3,,11.87,,,0,"percent of total billed charges","15.3% of total billed charges",16.3,16.8,,13.04,,,0,"percent of total billed charges","16.8% of total billed charges",66.93,69,,,,,0,"fee schedule","69% of total billed charges",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.99,61.85,,47.99,,,0,"percent of total billed charges","61.5% of total billed charges",16.3,16.8,,13.04,,,0,"percent of total billed charges","16.8% of total billed charges",48.5,50,,38.80,,,0,"percent of total billed charges","50% of total billed charges",31.23,32.2,,24.98,,,0,"percent of total billed charges","32.2% of total billed charges",16.3,16.8,,13.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.62,17.136,,13.30,,,0,"percent of total billed charges","17.136% of total billed charges",21.18,21.84,,16.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.57,37.7,,29.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.66,78,,60.53,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.12,82.6,,64.10,,,0,"percent of total billed charges","82.6% of total billed charges",16.3,16.8,,13.04,,,0,"percent of total billed charges","16.8% of total billed charges",48.5,50,,38.80,,,0,"percent of total billed charges","50% of total billed charges",80.12,82.6,,64.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.3,16.8,,13.04,,,0,"percent of total billed charges","16.8% of total billed charges",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",14.84,97,
"SUTURE VICRYL 1-0 J741D",491495,CDM,272,RC,,,OUTPATIENT,,,101,65.65,,88.88,88,,71.10,,,0,"percent of total billed charges","88% of total billed charges",50.5,50,,40.40,,,0,"percent of total billed charges","50% of total billed charges",16.97,16.8,,13.58,,,0,"percent of total billed charges","16.8% of total billed charges",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.48,17.304,,13.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.63,63,,50.90,,,0,"percent of total billed charges","63% of total billed charges",15.45,15.3,,12.36,,,0,"percent of total billed charges","15.3% of total billed charges",16.97,16.8,,13.58,,,0,"percent of total billed charges","16.8% of total billed charges",69.69,69,,,,,0,"fee schedule","69% of total billed charges",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,61.85,,49.98,,,0,"percent of total billed charges","61.5% of total billed charges",16.97,16.8,,13.58,,,0,"percent of total billed charges","16.8% of total billed charges",50.5,50,,40.40,,,0,"percent of total billed charges","50% of total billed charges",32.52,32.2,,26.02,,,0,"percent of total billed charges","32.2% of total billed charges",16.97,16.8,,13.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.31,17.136,,13.85,,,0,"percent of total billed charges","17.136% of total billed charges",22.06,21.84,,17.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.08,37.7,,30.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",78.78,78,,63.02,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",83.43,82.6,,66.74,,,0,"percent of total billed charges","82.6% of total billed charges",16.97,16.8,,13.58,,,0,"percent of total billed charges","16.8% of total billed charges",50.5,50,,40.40,,,0,"percent of total billed charges","50% of total billed charges",83.43,82.6,,66.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.97,16.8,,13.58,,,0,"percent of total billed charges","16.8% of total billed charges",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",15.45,101,
"SUTURE VICRYL 1-0 J347H CT-1",491493,CDM,272,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"SUTURE PDS 1-0 Z-741D",491433,CDM,272,RC,,,OUTPATIENT,,,166,107.9,,146.08,88,,116.86,,,0,"percent of total billed charges","88% of total billed charges",83,50,,66.40,,,0,"percent of total billed charges","50% of total billed charges",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.72,17.304,,22.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.58,63,,83.66,,,0,"percent of total billed charges","63% of total billed charges",25.4,15.3,,20.32,,,0,"percent of total billed charges","15.3% of total billed charges",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",114.54,69,,,,,0,"fee schedule","69% of total billed charges",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",102.67,61.85,,82.14,,,0,"percent of total billed charges","61.5% of total billed charges",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",83,50,,66.40,,,0,"percent of total billed charges","50% of total billed charges",53.45,32.2,,42.76,,,0,"percent of total billed charges","32.2% of total billed charges",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.45,17.136,,22.76,,,0,"percent of total billed charges","17.136% of total billed charges",36.25,21.84,,29.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",62.58,37.7,,50.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",129.48,78,,103.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.12,82.6,,109.70,,,0,"percent of total billed charges","82.6% of total billed charges",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",83,50,,66.40,,,0,"percent of total billed charges","50% of total billed charges",137.12,82.6,,109.70,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",25.4,166,
"SUTURE VICRYL 0-0 J724D CR CTX",491491,CDM,272,RC,,,OUTPATIENT,,,52,33.8,,45.76,88,,36.61,,,0,"percent of total billed charges","88% of total billed charges",26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,17.304,,7.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.76,63,,26.21,,,0,"percent of total billed charges","63% of total billed charges",7.96,15.3,,6.37,,,0,"percent of total billed charges","15.3% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",35.88,69,,,,,0,"fee schedule","69% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.16,61.85,,25.73,,,0,"percent of total billed charges","61.5% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",16.74,32.2,,13.39,,,0,"percent of total billed charges","32.2% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.91,17.136,,7.13,,,0,"percent of total billed charges","17.136% of total billed charges",11.36,21.84,,9.09,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.6,37.7,,15.68,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",40.56,78,,32.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",7.96,52,
"SUTURE VICRYL 0-0 J334H CT-2",491490,CDM,272,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"SUTURE VICRYL 0-0 J74OD",491492,CDM,272,RC,,,OUTPATIENT,,,97,63.05,,85.36,88,,68.29,,,0,"percent of total billed charges","88% of total billed charges",48.5,50,,38.80,,,0,"percent of total billed charges","50% of total billed charges",16.3,16.8,,13.04,,,0,"percent of total billed charges","16.8% of total billed charges",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.78,17.304,,13.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.11,63,,48.89,,,0,"percent of total billed charges","63% of total billed charges",14.84,15.3,,11.87,,,0,"percent of total billed charges","15.3% of total billed charges",16.3,16.8,,13.04,,,0,"percent of total billed charges","16.8% of total billed charges",66.93,69,,,,,0,"fee schedule","69% of total billed charges",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.99,61.85,,47.99,,,0,"percent of total billed charges","61.5% of total billed charges",16.3,16.8,,13.04,,,0,"percent of total billed charges","16.8% of total billed charges",48.5,50,,38.80,,,0,"percent of total billed charges","50% of total billed charges",31.23,32.2,,24.98,,,0,"percent of total billed charges","32.2% of total billed charges",16.3,16.8,,13.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.62,17.136,,13.30,,,0,"percent of total billed charges","17.136% of total billed charges",21.18,21.84,,16.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.57,37.7,,29.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.66,78,,60.53,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.12,82.6,,64.10,,,0,"percent of total billed charges","82.6% of total billed charges",16.3,16.8,,13.04,,,0,"percent of total billed charges","16.8% of total billed charges",48.5,50,,38.80,,,0,"percent of total billed charges","50% of total billed charges",80.12,82.6,,64.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.3,16.8,,13.04,,,0,"percent of total billed charges","16.8% of total billed charges",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",14.84,97,
"SUTURE SILK 0-0 SA86G",491476,CDM,272,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.37,61.85,,9.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"SUTURE PROLENE 0-0 8418H",491452,CDM,272,RC,,,OUTPATIENT,,,28,18.2,,24.64,88,,19.71,,,0,"percent of total billed charges","88% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.85,17.304,,3.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.64,63,,14.11,,,0,"percent of total billed charges","63% of total billed charges",4.28,15.3,,3.42,,,0,"percent of total billed charges","15.3% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",19.32,69,,,,,0,"fee schedule","69% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.32,61.85,,13.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",9.02,32.2,,7.22,,,0,"percent of total billed charges","32.2% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.8,17.136,,3.84,,,0,"percent of total billed charges","17.136% of total billed charges",6.12,21.84,,4.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.56,37.7,,8.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.84,78,,17.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",4.28,28,
"SUTURE PLAIN 0 L-104G",491444,CDM,272,RC,,,OUTPATIENT,,,32,20.8,,28.16,88,,22.53,,,0,"percent of total billed charges","88% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.54,17.304,,4.43,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.16,63,,16.13,,,0,"percent of total billed charges","63% of total billed charges",4.9,15.3,,3.92,,,0,"percent of total billed charges","15.3% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",22.08,69,,,,,0,"fee schedule","69% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.79,61.85,,15.83,,,0,"percent of total billed charges","61.5% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",10.3,32.2,,8.24,,,0,"percent of total billed charges","32.2% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.48,17.136,,4.38,,,0,"percent of total billed charges","17.136% of total billed charges",6.99,21.84,,5.59,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.96,78,,19.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",4.9,32,
"SUTURE MAXON 0 6319-62",491416,CDM,272,RC,,,OUTPATIENT,,,55,35.75,,48.4,88,,38.72,,,0,"percent of total billed charges","88% of total billed charges",27.5,50,,22.00,,,0,"percent of total billed charges","50% of total billed charges",9.24,16.8,,7.39,,,0,"percent of total billed charges","16.8% of total billed charges",55,100,,44.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.52,17.304,,7.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.65,63,,27.72,,,0,"percent of total billed charges","63% of total billed charges",8.42,15.3,,6.74,,,0,"percent of total billed charges","15.3% of total billed charges",9.24,16.8,,7.39,,,0,"percent of total billed charges","16.8% of total billed charges",37.95,69,,,,,0,"fee schedule","69% of total billed charges",55,100,,44.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",55,100,,44.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",55,100,,44.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.02,61.85,,27.22,,,0,"percent of total billed charges","61.5% of total billed charges",9.24,16.8,,7.39,,,0,"percent of total billed charges","16.8% of total billed charges",27.5,50,,22.00,,,0,"percent of total billed charges","50% of total billed charges",17.71,32.2,,14.17,,,0,"percent of total billed charges","32.2% of total billed charges",9.24,16.8,,7.39,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.42,17.136,,7.54,,,0,"percent of total billed charges","17.136% of total billed charges",12.01,21.84,,9.61,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.74,37.7,,16.59,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",42.9,78,,34.32,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.43,82.6,,36.34,,,0,"percent of total billed charges","82.6% of total billed charges",9.24,16.8,,7.39,,,0,"percent of total billed charges","16.8% of total billed charges",27.5,50,,22.00,,,0,"percent of total billed charges","50% of total billed charges",45.43,82.6,,36.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.24,16.8,,7.39,,,0,"percent of total billed charges","16.8% of total billed charges",55,100,,44.00,,,0,"percent of total billed charges","100% of total billed charges",8.42,55,
"SUTURE ETHIBOND 0 EC11",491398,CDM,272,RC,,,OUTPATIENT,,,1976,1284.4,,1738.88,88,,1391.10,,,0,"percent of total billed charges","88% of total billed charges",988,50,,790.40,,,0,"percent of total billed charges","50% of total billed charges",331.97,16.8,,265.58,,,0,"percent of total billed charges","16.8% of total billed charges",1976,100,,1580.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",341.93,17.304,,273.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1244.88,63,,995.90,,,0,"percent of total billed charges","63% of total billed charges",302.33,15.3,,241.86,,,0,"percent of total billed charges","15.3% of total billed charges",331.97,16.8,,265.58,,,0,"percent of total billed charges","16.8% of total billed charges",1363.44,69,,,,,0,"fee schedule","69% of total billed charges",1976,100,,1580.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1976,100,,1580.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1976,100,,1580.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1222.16,61.85,,977.73,,,0,"percent of total billed charges","61.5% of total billed charges",331.97,16.8,,265.58,,,0,"percent of total billed charges","16.8% of total billed charges",988,50,,790.40,,,0,"percent of total billed charges","50% of total billed charges",636.27,32.2,,509.02,,,0,"percent of total billed charges","32.2% of total billed charges",331.97,16.8,,265.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.61,17.136,,270.89,,,0,"percent of total billed charges","17.136% of total billed charges",431.56,21.84,,345.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",744.95,37.7,,595.96,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1541.28,78,,1233.02,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1632.18,82.6,,1305.74,,,0,"percent of total billed charges","82.6% of total billed charges",331.97,16.8,,265.58,,,0,"percent of total billed charges","16.8% of total billed charges",988,50,,790.40,,,0,"percent of total billed charges","50% of total billed charges",1632.18,82.6,,1305.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.97,16.8,,265.58,,,0,"percent of total billed charges","16.8% of total billed charges",1976,100,,1580.80,,,0,"percent of total billed charges","100% of total billed charges",302.33,1976,
"SUTURE CHROMIC GUT 0 812H",491377,CDM,272,RC,,,OUTPATIENT,,,29,18.85,,25.52,88,,20.42,,,0,"percent of total billed charges","88% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.02,17.304,,4.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.27,63,,14.62,,,0,"percent of total billed charges","63% of total billed charges",4.44,15.3,,3.55,,,0,"percent of total billed charges","15.3% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",20.01,69,,,,,0,"fee schedule","69% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.94,61.85,,14.35,,,0,"percent of total billed charges","61.5% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",9.34,32.2,,7.47,,,0,"percent of total billed charges","32.2% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.97,17.136,,3.98,,,0,"percent of total billed charges","17.136% of total billed charges",6.33,21.84,,5.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.93,37.7,,8.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,78,,18.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",4.44,29,
"ETHILON 5-0 PC-3 (1965G)",490542,CDM,270,RC,,,OUTPATIENT,,,37,24.05,,32.56,88,,26.05,,,0,"percent of total billed charges","88% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.4,17.304,,5.12,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.31,63,,18.65,,,0,"percent of total billed charges","63% of total billed charges",5.66,15.3,,4.53,,,0,"percent of total billed charges","15.3% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",25.53,69,,,,,0,"fee schedule","69% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.88,61.85,,18.30,,,0,"percent of total billed charges","61.5% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",11.91,32.2,,9.53,,,0,"percent of total billed charges","32.2% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.34,17.136,,5.07,,,0,"percent of total billed charges","17.136% of total billed charges",8.08,21.84,,6.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.95,37.7,,11.16,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.86,78,,23.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",5.66,37,
"ETHILON 6-0 PC-1 (1856G)",490545,CDM,270,RC,,,OUTPATIENT,,,38,24.7,,33.44,88,,26.75,,,0,"percent of total billed charges","88% of total billed charges",19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.58,17.304,,5.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.94,63,,19.15,,,0,"percent of total billed charges","63% of total billed charges",5.81,15.3,,4.65,,,0,"percent of total billed charges","15.3% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",26.22,69,,,,,0,"fee schedule","69% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.5,61.85,,18.80,,,0,"percent of total billed charges","61.5% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",12.24,32.2,,9.79,,,0,"percent of total billed charges","32.2% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.51,17.136,,5.21,,,0,"percent of total billed charges","17.136% of total billed charges",8.3,21.84,,6.64,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.33,37.7,,11.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.64,78,,23.71,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",5.81,38,
"ETHILON 8-0 BV130-5 (2808G)",490546,CDM,270,RC,,,OUTPATIENT,,,131,85.15,,115.28,88,,92.22,,,0,"percent of total billed charges","88% of total billed charges",65.5,50,,52.40,,,0,"percent of total billed charges","50% of total billed charges",22.01,16.8,,17.61,,,0,"percent of total billed charges","16.8% of total billed charges",131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.67,17.304,,18.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.53,63,,66.02,,,0,"percent of total billed charges","63% of total billed charges",20.04,15.3,,16.03,,,0,"percent of total billed charges","15.3% of total billed charges",22.01,16.8,,17.61,,,0,"percent of total billed charges","16.8% of total billed charges",90.39,69,,,,,0,"fee schedule","69% of total billed charges",131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.02,61.85,,64.82,,,0,"percent of total billed charges","61.5% of total billed charges",22.01,16.8,,17.61,,,0,"percent of total billed charges","16.8% of total billed charges",65.5,50,,52.40,,,0,"percent of total billed charges","50% of total billed charges",42.18,32.2,,33.74,,,0,"percent of total billed charges","32.2% of total billed charges",22.01,16.8,,17.61,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.45,17.136,,17.96,,,0,"percent of total billed charges","17.136% of total billed charges",28.61,21.84,,22.89,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",49.39,37.7,,39.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",102.18,78,,81.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",108.21,82.6,,86.57,,,0,"percent of total billed charges","82.6% of total billed charges",22.01,16.8,,17.61,,,0,"percent of total billed charges","16.8% of total billed charges",65.5,50,,52.40,,,0,"percent of total billed charges","50% of total billed charges",108.21,82.6,,86.57,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.01,16.8,,17.61,,,0,"percent of total billed charges","16.8% of total billed charges",131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",20.04,131,
"SUTURE VICRYL 2-0 J581G",491497,CDM,272,RC,,,OUTPATIENT,,,33,21.45,,29.04,88,,23.23,,,0,"percent of total billed charges","88% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,17.304,,4.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.79,63,,16.63,,,0,"percent of total billed charges","63% of total billed charges",5.05,15.3,,4.04,,,0,"percent of total billed charges","15.3% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",22.77,69,,,,,0,"fee schedule","69% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.41,61.85,,16.33,,,0,"percent of total billed charges","61.5% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",10.63,32.2,,8.50,,,0,"percent of total billed charges","32.2% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.65,17.136,,4.52,,,0,"percent of total billed charges","17.136% of total billed charges",7.21,21.84,,5.77,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.44,37.7,,9.95,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25.74,78,,20.59,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",5.05,33,
"VICRYL 1 CT-2 (J335H)",491676,CDM,272,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"VICRYL UNDYED 0 CT-2 (J270H)",491686,CDM,272,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"SUTURE LASSO 45 DEGREE CV RT",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"SUTURE PROLENE BLACK CT-2 NEEDLE SIZE 0 8-18",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SUTURE VLOC PBT 0 BLU 9 GS-22",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
N/A,ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"SUTURE VLOC 180 2-0 GR 6 GS-21",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"SUTURE 6-0 18 CTD VIC UND BR PC",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SUTURE STRATAFIX SPIRAL MONOCRYL + 2-0 CT-2",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"SUTURE STRATAFIX SYNNETRIC PDS + SZ0 18IN CTX",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"SUTURE STRATAFIX SPIRAL MONOCRYL PLUS CT-1 2-0 27IN",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"SUTURE VIOLET COATED VICRYL 4-0 P-3",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SUTURE VICRYL SZ 0 D-SPECIAL C-T2 NDL",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SUTURE PROLENE BLUE BV-1 NDL SZ 7-0",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SUTURE V-LOC 180 ABSORBABLE VIOLET SZ 3-0 9IN V-20 NDLE",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"SUTURE V-LOC 180 ABSORBABLE VIOLET SZ 3 6IN V-20 NDLE",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"SUTURE ABSOBABLE CT-2 2-0 VIOLET 26MM CT-2",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SUTURE TAPER POINT REVERSE CUTTING 3-0 CT-1",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SUTURE UNDYED VICRYL O CTX 8-18IN",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SUTURE 4-0 ETHILON 1611G",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"SUTURE 0 PROLENE BLUE 8690H",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SUTURE 0 VICRYL ENDOKNOT D9920",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SUTURE 2-0 STRATAFIX SPIRAL CT-1",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"SUTURE 4-0 STRATAFIX  MONOCRYL PS-2",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"SUTURE CT-1 STRATAFIX PDS PLUS 0",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"SUTURE V-LOC 180 SZ 2 GRN",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"SUTURE V-LOC 90 SZ 2 VIOLET",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"SUTURE V-LOC SZ 2 BLUE NONABSORBABLE",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"SUTURE TRI-CRON WHITE SZ 0 CV-305",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"SUTURE V-LOC PBT NONABSORBABLE BLUE SZ0",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SUTURE ANCHOR PEEK 3MMX12.4MM",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"SUTURE ANCHOR CORKSCREW 4.5X14MM",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"SUTURE PS-3 NONABSORBABLE 1668H",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SUTURE STRATAFIX TAPER POINT SXPP1A435",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"SUTURE TRAY DISPOSABLE",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"SUTURE NONABSORBABLE V-LOC SZ 2 GS-22 NEEDLE",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"SUTURE VLOC ABSORBABLE P-14 SZ 3-0",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"SUTURE VICRYL COATED UNDYED SZ 2/0 54",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SUTURE VICRYL COATED PS-2 SZ 5-0",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SUTURE V-LOV UNDYEDSZ PS-12 SZ 3-0",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"SUTURE REMOVAL TRAY",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SUTURE MONOCRYL PLUS P-3 UNDYED SIZE 4-0 18",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SUTURE 4-0 1 X 27 RB-1 TAPER POINT PDS II",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SUTURE PROLENE 4-0, P-3 NEEDLE  18",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SUTURE PROLENE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SUTURE STRATAFIX PDS VIOLET SZ1 18 CT NEEDLE",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"SUTURE MONOCRYL 3-0 PS-2 12 X 12CM ROYAL BLUE",ORSUP003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"SUTURE MONCRYL UNDYED 14CM X 14CM CP-2 SZ 2-0",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"SUTURE VICRYL PLUS ANTIBACTERIAL SH-1 NEEDLE SIZE 4-27",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"Supplies:SUTURE STRATAFIX PDS VIOLET 3-0 CT-1 12",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,150,97.5,,132,88,,105.60,,,0,"percent of total billed charges","88% of total billed charges",75,50,,60.00,,,0,"percent of total billed charges","50% of total billed charges",25.2,16.8,,20.16,,,0,"percent of total billed charges","16.8% of total billed charges",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.96,17.304,,20.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",94.5,63,,75.60,,,0,"percent of total billed charges","63% of total billed charges",22.95,15.3,,18.36,,,0,"percent of total billed charges","15.3% of total billed charges",25.2,16.8,,20.16,,,0,"percent of total billed charges","16.8% of total billed charges",103.5,69,,,,,0,"fee schedule","69% of total billed charges",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.78,61.85,,74.22,,,0,"percent of total billed charges","61.5% of total billed charges",25.2,16.8,,20.16,,,0,"percent of total billed charges","16.8% of total billed charges",75,50,,60.00,,,0,"percent of total billed charges","50% of total billed charges",48.3,32.2,,38.64,,,0,"percent of total billed charges","32.2% of total billed charges",25.2,16.8,,20.16,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.7,17.136,,20.56,,,0,"percent of total billed charges","17.136% of total billed charges",32.76,21.84,,26.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",117,78,,93.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",25.2,16.8,,20.16,,,0,"percent of total billed charges","16.8% of total billed charges",75,50,,60.00,,,0,"percent of total billed charges","50% of total billed charges",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.2,16.8,,20.16,,,0,"percent of total billed charges","16.8% of total billed charges",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",22.95,150,
"SWABSTICK POVIDONE PREP SWAB",12071,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"SWABSTICK CHLORAPREP TRIPLE APPLICATOR 5.25ML",231194,CDM,270,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"SWAB POVIDONE IODINE 10% PREP .65CC AMPULES",166244,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"SWAB PROCTO 16IN X 1 1/2IN STERILE 2/PK",147097,CDM,272,RC,,,OUTPATIENT,,,37,24.05,,32.56,88,,26.05,,,0,"percent of total billed charges","88% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.4,17.304,,5.12,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.31,63,,18.65,,,0,"percent of total billed charges","63% of total billed charges",5.66,15.3,,4.53,,,0,"percent of total billed charges","15.3% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",25.53,69,,,,,0,"fee schedule","69% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.88,61.85,,18.30,,,0,"percent of total billed charges","61.5% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",11.91,32.2,,9.53,,,0,"percent of total billed charges","32.2% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.34,17.136,,5.07,,,0,"percent of total billed charges","17.136% of total billed charges",8.08,21.84,,6.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.95,37.7,,11.16,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.86,78,,23.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",5.66,37,
"SWABSTICK CHLORASCRUB 1.6ML",176704,CDM,270,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"SWAB BACTI NPG",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SWAG BOGYN RAYON TIP STERILE 8",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SWAN GANZ CCO/SVO2",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SWIVELOCK TENODESIS BIOCOMPOSITE 8MM",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",751.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.7% of total billed charges",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",816.99,33.9,,653.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"SWIVELOCK TENODESIS BIOCOMPOSITE, 8MM",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",751.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.7% of total billed charges",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",816.99,33.9,,653.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"SWIVEL BALLARD SX14F",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"SWIVELOCK 4.75 PEEK W/ FIBERTAPE",ORSUP0052,CDM,272,RC,,,OUTPATIENT,,,10980,7137,,9662.4,88,,7729.92,,,0,"percent of total billed charges","88% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1899.98,17.304,,1519.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6917.4,63,,5533.92,,,0,"percent of total billed charges","63% of total billed charges",1679.94,15.3,,1343.95,,,0,"percent of total billed charges","15.3% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",7576.2,69,,,,,0,"fee schedule","69% of total billed charges",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6791.13,61.85,,5432.90,,,0,"percent of total billed charges","61.5% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",3535.56,32.2,,2828.45,,,0,"percent of total billed charges","32.2% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1881.53,17.136,,1505.22,,,0,"percent of total billed charges","17.136% of total billed charges",2398.03,21.84,,1918.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4139.46,37.7,,3311.57,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8564.4,78,,6851.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9069.48,82.6,,7255.58,,,0,"percent of total billed charges","82.6% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",9069.48,82.6,,7255.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",1679.94,10980,
"SWVLK TENO BIO -COMP 7X19.1MM",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",751.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.7% of total billed charges",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",816.99,33.9,,653.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"SYNDESMOSIS REPAIR IMPLANT KNOTLESS TIGHTROPE ST STEEL",ORSUP0029,CDM,278,RC,,,OUTPATIENT,,,4820,3133,,4241.6,88,,3393.28,,,0,"percent of total billed charges","88% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",834.05,17.304,,667.24,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3036.6,63,,2429.28,,,0,"percent of total billed charges","63% of total billed charges",737.46,15.3,,589.97,,,0,"percent of total billed charges","15.3% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",3325.8,69,,,,,0,"fee schedule","69% of total billed charges",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2981.17,61.85,,2384.94,,,0,"percent of total billed charges","61.5% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",1552.04,32.2,,1241.63,,,0,"percent of total billed charges","32.2% of total billed charges",1503.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",825.96,17.136,,660.77,,,0,"percent of total billed charges","17.136% of total billed charges",1052.69,21.84,,842.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1817.14,37.7,,1453.71,,,0,"percent of total billed charges","37.7% of total billed charges",1817.14,37.7,,1453.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1633.98,33.9,,1307.18,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3759.6,78,,3007.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3981.32,82.6,,3185.06,,,0,"percent of total billed charges","82.6% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",3981.32,82.6,,3185.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",737.46,4820,
"SYNTHETIC CAST PADDING NS 6",491521,CDM,270,RC,,,OUTPATIENT,,,21,13.65,,18.48,88,,14.78,,,0,"percent of total billed charges","88% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.63,17.304,,2.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.23,63,,10.58,,,0,"percent of total billed charges","63% of total billed charges",3.21,15.3,,2.57,,,0,"percent of total billed charges","15.3% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",14.49,69,,,,,0,"fee schedule","69% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.99,61.85,,10.39,,,0,"percent of total billed charges","61.5% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",6.76,32.2,,5.41,,,0,"percent of total billed charges","32.2% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.6,17.136,,2.88,,,0,"percent of total billed charges","17.136% of total billed charges",4.59,21.84,,3.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.92,37.7,,6.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.38,78,,13.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",3.21,21,
"SYRINGE SALINE FLUSH 10ML",310300,CDM,272,RC,,,OUTPATIENT,,,513,333.45,,451.44,88,,361.15,,,0,"percent of total billed charges","88% of total billed charges",256.5,50,,205.20,,,0,"percent of total billed charges","50% of total billed charges",86.18,16.8,,68.94,,,0,"percent of total billed charges","16.8% of total billed charges",513,100,,410.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.77,17.304,,71.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",323.19,63,,258.55,,,0,"percent of total billed charges","63% of total billed charges",78.49,15.3,,62.79,,,0,"percent of total billed charges","15.3% of total billed charges",86.18,16.8,,68.94,,,0,"percent of total billed charges","16.8% of total billed charges",353.97,69,,,,,0,"fee schedule","69% of total billed charges",513,100,,410.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",513,100,,410.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",513,100,,410.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.29,61.85,,253.83,,,0,"percent of total billed charges","61.5% of total billed charges",86.18,16.8,,68.94,,,0,"percent of total billed charges","16.8% of total billed charges",256.5,50,,205.20,,,0,"percent of total billed charges","50% of total billed charges",165.19,32.2,,132.15,,,0,"percent of total billed charges","32.2% of total billed charges",86.18,16.8,,68.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.91,17.136,,70.33,,,0,"percent of total billed charges","17.136% of total billed charges",112.04,21.84,,89.63,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",193.4,37.7,,154.72,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.14,78,,320.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",423.74,82.6,,338.99,,,0,"percent of total billed charges","82.6% of total billed charges",86.18,16.8,,68.94,,,0,"percent of total billed charges","16.8% of total billed charges",256.5,50,,205.20,,,0,"percent of total billed charges","50% of total billed charges",423.74,82.6,,338.99,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.18,16.8,,68.94,,,0,"percent of total billed charges","16.8% of total billed charges",513,100,,410.40,,,0,"percent of total billed charges","100% of total billed charges",78.49,513,
"SYRINGE 1CC LUER TIP W/O NDL",186393,CDM,272,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"SYRINGE TOOMY 60CC",186504,CDM,272,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"SYRINGE 1CC W/SAFETY GLIDE NEEDLE 25G X 5/8IN",166256,CDM,272,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"SYRINGE ONLY SLIP TIP 20CC",147154,CDM,272,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"SYRINGE 10CC LUER SLIP NO NEEDLE",157799,CDM,272,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"SYRINGE LUER LOK 60ML",12349,CDM,272,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"SYRINGE ONLY LUER LOK 20CC",169956,CDM,272,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"SYRINGE 3CC 23X1 SAFETY",10475,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"SYRINGE 3CC W/SAFETY GLIDE NEEDLE 25G X 5/8IN",169938,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"SYRINGE ONLY LUER LOK CONTROL",157840,CDM,272,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"SYRINGE BULB-IRRIGATION",81466,CDM,272,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"SYRINGE EAR/ULCER 2.0 OZ L/F",45199,CDM,272,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"SYRINGE 1CC INSULIN SAFETY GLIDE W/29GX1/2 NDL",147108,CDM,272,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"SYRINGE INSULIN SAFETY 1/2ML 29GA X 1/2 NEEDLE",20384,CDM,272,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"SYRINGE 3CC W/SAFETY GLIDE NEEDLE 22G X 1 1/2IN",147112,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"SYRINGE 1CC TUBERCULIN SAFETY GLIDE 27GX1/2IN NDL",147109,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"SYRINGE CATH 60CC TIP 2 OZ",122872,CDM,272,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"SYRINGE 1CC LL W/O NDL",67357,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"SYRINGE ORAL 10ML. CLEAR",119777,CDM,272,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"SYRINGE 5ML LL SYRINGE ONLY",312502,CDM,272,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"SYRINGE 5CC LL LAB/NUC/PHARM",180426,CDM,272,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"SYRINGE 10ML MEDICAL LUER SLIP LOR",394223,CDM,272,RC,,,OUTPATIENT,,,28,18.2,,24.64,88,,19.71,,,0,"percent of total billed charges","88% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.85,17.304,,3.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.64,63,,14.11,,,0,"percent of total billed charges","63% of total billed charges",4.28,15.3,,3.42,,,0,"percent of total billed charges","15.3% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",19.32,69,,,,,0,"fee schedule","69% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.32,61.85,,13.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",9.02,32.2,,7.22,,,0,"percent of total billed charges","32.2% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.8,17.136,,3.84,,,0,"percent of total billed charges","17.136% of total billed charges",6.12,21.84,,4.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.56,37.7,,8.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.84,78,,17.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",4.28,28,
"SYRINGE EAR/ULCER STRL 2 OZ(41814670)",61304,CDM,272,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"SYRINGE LUER TIP CAP SUB#358381682101",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SYRINGE 10ML SLIP TIP",457924,CDM,272,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"SYRINGE 1ML LUER SLIP",320289,CDM,272,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"SYRINGE 20ML LL NO NDL",409460,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"SYRINGE 20ML LS NO NDL",409463,CDM,272,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"SYRINGE 30ML LL NO NDL",409461,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"SYRINGE 3CC KIT BLOOD GAS 23G",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SYRINGE 10CC L-L NO NDL CS/2",456870,CDM,272,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"SYRINGE ANGIO MANUAL INJ 10ML ROTATING ADPT",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"SYRINGE  TOOMEY 70CC",491526,CDM,272,RC,,,OUTPATIENT,,,27,17.55,,23.76,88,,19.01,,,0,"percent of total billed charges","88% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.67,17.304,,3.74,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.01,63,,13.61,,,0,"percent of total billed charges","63% of total billed charges",4.13,15.3,,3.30,,,0,"percent of total billed charges","15.3% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",18.63,69,,,,,0,"fee schedule","69% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.7,61.85,,13.36,,,0,"percent of total billed charges","61.5% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",8.69,32.2,,6.95,,,0,"percent of total billed charges","32.2% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.63,17.136,,3.70,,,0,"percent of total billed charges","17.136% of total billed charges",5.9,21.84,,4.72,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.18,37.7,,8.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.06,78,,16.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.3,82.6,,17.84,,,0,"percent of total billed charges","82.6% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",22.3,82.6,,17.84,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",4.13,27,
"SYRINGE TOOMEY 60CC",491541,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"SYRINGE 60CC CATH TIP",491533,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"SYRINGE RING PLUNGER 20CC",491539,CDM,272,RC,,,OUTPATIENT,,,54,35.1,,47.52,88,,38.02,,,0,"percent of total billed charges","88% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.34,17.304,,7.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.02,63,,27.22,,,0,"percent of total billed charges","63% of total billed charges",8.26,15.3,,6.61,,,0,"percent of total billed charges","15.3% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",37.26,69,,,,,0,"fee schedule","69% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.4,61.85,,26.72,,,0,"percent of total billed charges","61.5% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",17.39,32.2,,13.91,,,0,"percent of total billed charges","32.2% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.25,17.136,,7.40,,,0,"percent of total billed charges","17.136% of total billed charges",11.79,21.84,,9.43,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.36,37.7,,16.29,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",42.12,78,,33.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.6,82.6,,35.68,,,0,"percent of total billed charges","82.6% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",44.6,82.6,,35.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",8.26,54,
"SYRINGE RING PLUNGER 10CC",491538,CDM,272,RC,,,OUTPATIENT,,,49,31.85,,43.12,88,,34.50,,,0,"percent of total billed charges","88% of total billed charges",24.5,50,,19.60,,,0,"percent of total billed charges","50% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.48,17.304,,6.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.87,63,,24.70,,,0,"percent of total billed charges","63% of total billed charges",7.5,15.3,,6.00,,,0,"percent of total billed charges","15.3% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",33.81,69,,,,,0,"fee schedule","69% of total billed charges",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.31,61.85,,24.25,,,0,"percent of total billed charges","61.5% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",24.5,50,,19.60,,,0,"percent of total billed charges","50% of total billed charges",15.78,32.2,,12.62,,,0,"percent of total billed charges","32.2% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.4,17.136,,6.72,,,0,"percent of total billed charges","17.136% of total billed charges",10.7,21.84,,8.56,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.47,37.7,,14.78,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.22,78,,30.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.47,82.6,,32.38,,,0,"percent of total billed charges","82.6% of total billed charges",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",24.5,50,,19.60,,,0,"percent of total billed charges","50% of total billed charges",40.47,82.6,,32.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.23,16.8,,6.58,,,0,"percent of total billed charges","16.8% of total billed charges",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",7.5,49,
"SYRINGE ASEPTO",491535,CDM,272,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"SYRINGE 10ML",491527,CDM,272,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"SYRINGE 20ML",491529,CDM,272,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"SYRINGE 30ML",491530,CDM,272,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"SYRINGE 3ML",491531,CDM,272,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"SYRINGE 5ML",491532,CDM,272,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"SYRINGE 60ML",491534,CDM,272,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"SYRINGE TB W/O NEEDLE",491540,CDM,272,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"SYRINGE CONTROL 10CC",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SYRINGE 20ML STERILE LUER LOCK",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SYRINGE MONOJECT 1ML LUER LOCK",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SYRINGE MONOJECT 1ML LUER LOCK ORANGE CAP TIP",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SYRINGE SLIP TIP STERILE 1ML",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SYRINGE, PRO-VENT 3ML LITHIUM HEPARIN",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"SYRINGE SURE-SNAP SAFTEY 27G X 1.25",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SYRINGE 30ML SLIP TIP LL",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"SYSTEM BONE MARROW ASPIRATION  W/ 11 GUAGE/15CM NEEDLE",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"SYSTEM CEMENT COMPACT VACUUM MIXING",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SYSTEM CSF DRAINAGE EXTERNAL",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"SYSTEM EMBOSHIELD 7.2MM X 4-7MM",ORSUP0043,CDM,278,RC,,,OUTPATIENT,,,8570,5570.5,,7541.6,88,,6033.28,,,0,"percent of total billed charges","88% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1482.95,17.304,,1186.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5399.1,63,,4319.28,,,0,"percent of total billed charges","63% of total billed charges",1311.21,15.3,,1048.97,,,0,"percent of total billed charges","15.3% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",5913.3,69,,,,,0,"fee schedule","69% of total billed charges",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5300.55,61.85,,4240.44,,,0,"percent of total billed charges","61.5% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",2759.54,32.2,,2207.63,,,0,"percent of total billed charges","32.2% of total billed charges",2673.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1468.56,17.136,,1174.85,,,0,"percent of total billed charges","17.136% of total billed charges",1871.69,21.84,,1497.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3230.89,37.7,,2584.71,,,0,"percent of total billed charges","37.7% of total billed charges",3230.89,37.7,,2584.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2905.23,33.9,,2324.18,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6684.6,78,,5347.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7078.82,82.6,,5663.06,,,0,"percent of total billed charges","82.6% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",7078.82,82.6,,5663.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",1311.21,8570,
"SYSTEM FLTR REMOV RECOV CONE VENA CAVA",ORSUP0031,CDM,278,RC,,,OUTPATIENT,,,5356,3481.4,,4713.28,88,,3770.62,,,0,"percent of total billed charges","88% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",926.8,17.304,,741.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3374.28,63,,2699.42,,,0,"percent of total billed charges","63% of total billed charges",819.47,15.3,,655.58,,,0,"percent of total billed charges","15.3% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",3695.64,69,,,,,0,"fee schedule","69% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3312.69,61.85,,2650.15,,,0,"percent of total billed charges","61.5% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",1724.63,32.2,,1379.70,,,0,"percent of total billed charges","32.2% of total billed charges",1671.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",917.8,17.136,,734.24,,,0,"percent of total billed charges","17.136% of total billed charges",1169.75,21.84,,935.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.7% of total billed charges",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1815.68,33.9,,1452.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4177.68,78,,3342.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",819.47,5356,
"SYSTEM PROLENE 4 MESH HERNIA MEDIUM",ORSUP0018,CDM,278,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",605.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.7% of total billed charges",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",658.34,33.9,,526.67,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"SYSTEM PROLENE POLY LARGE HERNIA",ORSUP0018,CDM,278,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",605.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.7% of total billed charges",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",658.34,33.9,,526.67,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"SYSTEM VERTE-STACK SPINAL  END CAP 6MM X 14MM X 11MM",ORSUP0032,CDM,278,RC,,,OUTPATIENT,,,5624,3655.6,,4949.12,88,,3959.30,,,0,"percent of total billed charges","88% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",973.18,17.304,,778.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3543.12,63,,2834.50,,,0,"percent of total billed charges","63% of total billed charges",860.47,15.3,,688.38,,,0,"percent of total billed charges","15.3% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",3880.56,69,,,,,0,"fee schedule","69% of total billed charges",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3478.44,61.85,,2782.75,,,0,"percent of total billed charges","61.5% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",1810.93,32.2,,1448.74,,,0,"percent of total billed charges","32.2% of total billed charges",1754.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",963.73,17.136,,770.98,,,0,"percent of total billed charges","17.136% of total billed charges",1228.28,21.84,,982.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2120.25,37.7,,1696.20,,,0,"percent of total billed charges","37.7% of total billed charges",2120.25,37.7,,1696.20,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1906.54,33.9,,1525.23,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4386.72,78,,3509.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4645.42,82.6,,3716.34,,,0,"percent of total billed charges","82.6% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",4645.42,82.6,,3716.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",860.47,5624,
"SYSTEM ROTALINK PLUS 1.5",ORSUP0036,CDM,278,RC,,,OUTPATIENT,,,6695,4351.75,,5891.6,88,,4713.28,,,0,"percent of total billed charges","88% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1158.5,17.304,,926.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4217.85,63,,3374.28,,,0,"percent of total billed charges","63% of total billed charges",1024.34,15.3,,819.47,,,0,"percent of total billed charges","15.3% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",4619.55,69,,,,,0,"fee schedule","69% of total billed charges",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4140.86,61.85,,3312.69,,,0,"percent of total billed charges","61.5% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",2155.79,32.2,,1724.63,,,0,"percent of total billed charges","32.2% of total billed charges",2088.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1147.26,17.136,,917.81,,,0,"percent of total billed charges","17.136% of total billed charges",1462.19,21.84,,1169.75,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2524.02,37.7,,2019.22,,,0,"percent of total billed charges","37.7% of total billed charges",2524.02,37.7,,2019.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2269.61,33.9,,1815.69,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5222.1,78,,4177.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5530.07,82.6,,4424.06,,,0,"percent of total billed charges","82.6% of total billed charges",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",3347.5,50,,2678.00,,,0,"percent of total billed charges","50% of total billed charges",5530.07,82.6,,4424.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1124.76,16.8,,899.81,,,0,"percent of total billed charges","16.8% of total billed charges",6695,100,,5356.00,,,0,"percent of total billed charges","100% of total billed charges",1024.34,6695,
"SYSTEM PAIN PUMP SOAKER CATH EXPANSION 5IN",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"SYSTEM HEARTSTRINGS III PROXIMAL  4.3MM",ORSUP0023,CDM,272,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"SYSTEM SPY SCOPE ACCESS AND DELIVERY",ORSUP0029,CDM,272,RC,,,OUTPATIENT,,,4820,3133,,4241.6,88,,3393.28,,,0,"percent of total billed charges","88% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",834.05,17.304,,667.24,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3036.6,63,,2429.28,,,0,"percent of total billed charges","63% of total billed charges",737.46,15.3,,589.97,,,0,"percent of total billed charges","15.3% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",3325.8,69,,,,,0,"fee schedule","69% of total billed charges",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2981.17,61.85,,2384.94,,,0,"percent of total billed charges","61.5% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",1552.04,32.2,,1241.63,,,0,"percent of total billed charges","32.2% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",825.96,17.136,,660.77,,,0,"percent of total billed charges","17.136% of total billed charges",1052.69,21.84,,842.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1817.14,37.7,,1453.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3759.6,78,,3007.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3981.32,82.6,,3185.06,,,0,"percent of total billed charges","82.6% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",3981.32,82.6,,3185.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",737.46,4820,
"SYSTEM 3 DOSE COMPACT MIXING",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"SYSTEM AERO AIRWAY STENT",ORSUP0050,CDM,278,RC,,,OUTPATIENT,,,10444,6788.6,,9190.72,88,,7352.58,,,0,"percent of total billed charges","88% of total billed charges",5222,50,,4177.60,,,0,"percent of total billed charges","50% of total billed charges",1754.59,16.8,,1403.67,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1807.23,17.304,,1445.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6579.72,63,,5263.78,,,0,"percent of total billed charges","63% of total billed charges",1597.93,15.3,,1278.34,,,0,"percent of total billed charges","15.3% of total billed charges",1754.59,16.8,,1403.67,,,0,"percent of total billed charges","16.8% of total billed charges",7206.36,69,,,,,0,"fee schedule","69% of total billed charges",10444,100,,8355.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10444,100,,8355.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10444,100,,8355.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6459.61,61.85,,5167.69,,,0,"percent of total billed charges","61.5% of total billed charges",1754.59,16.8,,1403.67,,,0,"percent of total billed charges","16.8% of total billed charges",5222,50,,4177.60,,,0,"percent of total billed charges","50% of total billed charges",3362.97,32.2,,2690.38,,,0,"percent of total billed charges","32.2% of total billed charges",3258.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1789.68,17.136,,1431.74,,,0,"percent of total billed charges","17.136% of total billed charges",2280.97,21.84,,1824.78,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3937.39,37.7,,3149.91,,,0,"percent of total billed charges","37.7% of total billed charges",3937.39,37.7,,3149.91,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3540.52,33.9,,2832.42,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",8146.32,78,,6517.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8626.74,82.6,,6901.39,,,0,"percent of total billed charges","82.6% of total billed charges",1754.59,16.8,,1403.67,,,0,"percent of total billed charges","16.8% of total billed charges",5222,50,,4177.60,,,0,"percent of total billed charges","50% of total billed charges",8626.74,82.6,,6901.39,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1754.59,16.8,,1403.67,,,0,"percent of total billed charges","16.8% of total billed charges",10444,100,,8355.20,,,0,"percent of total billed charges","100% of total billed charges",1597.93,10444,
"SYSTEM SINUS ILLUMINATION SIS-100A",ORSUP0052,CDM,272,RC,,,OUTPATIENT,,,10980,7137,,9662.4,88,,7729.92,,,0,"percent of total billed charges","88% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1899.98,17.304,,1519.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6917.4,63,,5533.92,,,0,"percent of total billed charges","63% of total billed charges",1679.94,15.3,,1343.95,,,0,"percent of total billed charges","15.3% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",7576.2,69,,,,,0,"fee schedule","69% of total billed charges",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6791.13,61.85,,5432.90,,,0,"percent of total billed charges","61.5% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",3535.56,32.2,,2828.45,,,0,"percent of total billed charges","32.2% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1881.53,17.136,,1505.22,,,0,"percent of total billed charges","17.136% of total billed charges",2398.03,21.84,,1918.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4139.46,37.7,,3311.57,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8564.4,78,,6851.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9069.48,82.6,,7255.58,,,0,"percent of total billed charges","82.6% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",9069.48,82.6,,7255.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",1679.94,10980,
"SYSTEM SINUS ILLUMINATION SIS-100B",ORSUP0025,CDM,272,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"CATH SUPRAPUBIC BALLOON 12FR",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"SYSTEM REPAIR BICEPS DISTAL",ORSUP0018,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"T-PIECE NEONATAL CURCUIT",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"T-TUBE 3 FRENCH",ORSUP0025,CDM,272,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"TACHOSIL FIBRIN SEALANT PATCH",ORSUP0019,CDM,270,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"TACHOSIL PATCH 4.8CM X 4.8CM",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"TACKY MATS BLUE 34X18",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.94,17.304,,85.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.23,61.85,,305.78,,,0,"percent of total billed charges","61.5% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",199,32.2,,159.20,,,0,"percent of total billed charges","32.2% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.136,,84.72,,,0,"percent of total billed charges","17.136% of total billed charges",134.97,21.84,,107.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,618,
"TACTILE BASELINE MONOFILAMENT DISPOSABLE 10G",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"TAG HUGS",ORSUP0013,CDM,270,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"TAGS VENDOR TEAL GREEN",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1030,669.5,,906.4,88,,725.12,,,0,"percent of total billed charges","88% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.23,17.304,,142.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.9,63,,519.12,,,0,"percent of total billed charges","63% of total billed charges",157.59,15.3,,126.07,,,0,"percent of total billed charges","15.3% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",710.7,69,,,,,0,"fee schedule","69% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",637.06,61.85,,509.65,,,0,"percent of total billed charges","61.5% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",331.66,32.2,,265.33,,,0,"percent of total billed charges","32.2% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.5,17.136,,141.20,,,0,"percent of total billed charges","17.136% of total billed charges",224.95,21.84,,179.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",388.31,37.7,,310.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",803.4,78,,642.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",157.59,1030,
"TAMP INFLAT KYPHX EXACT 15X3.0MM",ORSUP0031,CDM,272,RC,,,OUTPATIENT,,,5356,3481.4,,4713.28,88,,3770.62,,,0,"percent of total billed charges","88% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",926.8,17.304,,741.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3374.28,63,,2699.42,,,0,"percent of total billed charges","63% of total billed charges",819.47,15.3,,655.58,,,0,"percent of total billed charges","15.3% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",3695.64,69,,,,,0,"fee schedule","69% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3312.69,61.85,,2650.15,,,0,"percent of total billed charges","61.5% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",1724.63,32.2,,1379.70,,,0,"percent of total billed charges","32.2% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",917.8,17.136,,734.24,,,0,"percent of total billed charges","17.136% of total billed charges",1169.75,21.84,,935.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4177.68,78,,3342.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",819.47,5356,
"TAMPER EVIDENT SEAL",491544,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"TAP CANN 4.0MM 147MM",ORSUP0026,CDM,272,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"TAPE GLOW AND TELL",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"TAPE TRANSPORE 2IN",185034,CDM,270,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"TAPE TRANSPORE 1IN",185033,CDM,270,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"TAPE MICROPORE 2IN",185038,CDM,270,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"TAPE MICROPORE 1/2IN",13922,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"TAPE MICROPORE 1IN",185037,CDM,270,RC,,,OUTPATIENT,,,60,39,,52.8,88,,42.24,,,0,"percent of total billed charges","88% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.38,17.304,,8.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.8,63,,30.24,,,0,"percent of total billed charges","63% of total billed charges",9.18,15.3,,7.34,,,0,"percent of total billed charges","15.3% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",41.4,69,,,,,0,"fee schedule","69% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.11,61.85,,29.69,,,0,"percent of total billed charges","61.5% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",19.32,32.2,,15.46,,,0,"percent of total billed charges","32.2% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.28,17.136,,8.22,,,0,"percent of total billed charges","17.136% of total billed charges",13.1,21.84,,10.48,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,37.7,,18.10,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.8,78,,37.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.56,82.6,,39.65,,,0,"percent of total billed charges","82.6% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",49.56,82.6,,39.65,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",9.18,60,
"TAPE MICROFOAM 3IN",185036,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"TAPE SURGICAL DURAPORE 2 INCH",185040,CDM,270,RC,,,OUTPATIENT,,,93,60.45,,81.84,88,,65.47,,,0,"percent of total billed charges","88% of total billed charges",46.5,50,,37.20,,,0,"percent of total billed charges","50% of total billed charges",15.62,16.8,,12.50,,,0,"percent of total billed charges","16.8% of total billed charges",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.09,17.304,,12.87,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.59,63,,46.87,,,0,"percent of total billed charges","63% of total billed charges",14.23,15.3,,11.38,,,0,"percent of total billed charges","15.3% of total billed charges",15.62,16.8,,12.50,,,0,"percent of total billed charges","16.8% of total billed charges",64.17,69,,,,,0,"fee schedule","69% of total billed charges",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.52,61.85,,46.02,,,0,"percent of total billed charges","61.5% of total billed charges",15.62,16.8,,12.50,,,0,"percent of total billed charges","16.8% of total billed charges",46.5,50,,37.20,,,0,"percent of total billed charges","50% of total billed charges",29.95,32.2,,23.96,,,0,"percent of total billed charges","32.2% of total billed charges",15.62,16.8,,12.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.94,17.136,,12.75,,,0,"percent of total billed charges","17.136% of total billed charges",20.31,21.84,,16.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.06,37.7,,28.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",72.54,78,,58.03,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.82,82.6,,61.46,,,0,"percent of total billed charges","82.6% of total billed charges",15.62,16.8,,12.50,,,0,"percent of total billed charges","16.8% of total billed charges",46.5,50,,37.20,,,0,"percent of total billed charges","50% of total billed charges",76.82,82.6,,61.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.62,16.8,,12.50,,,0,"percent of total billed charges","16.8% of total billed charges",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",14.23,93,
"TAPE ADHESIVE 3IN",185635,CDM,270,RC,,,OUTPATIENT,,,64,41.6,,56.32,88,,45.06,,,0,"percent of total billed charges","88% of total billed charges",32,50,,25.60,,,0,"percent of total billed charges","50% of total billed charges",10.75,16.8,,8.60,,,0,"percent of total billed charges","16.8% of total billed charges",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.07,17.304,,8.86,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.32,63,,32.26,,,0,"percent of total billed charges","63% of total billed charges",9.79,15.3,,7.83,,,0,"percent of total billed charges","15.3% of total billed charges",10.75,16.8,,8.60,,,0,"percent of total billed charges","16.8% of total billed charges",44.16,69,,,,,0,"fee schedule","69% of total billed charges",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.58,61.85,,31.66,,,0,"percent of total billed charges","61.5% of total billed charges",10.75,16.8,,8.60,,,0,"percent of total billed charges","16.8% of total billed charges",32,50,,25.60,,,0,"percent of total billed charges","50% of total billed charges",20.61,32.2,,16.49,,,0,"percent of total billed charges","32.2% of total billed charges",10.75,16.8,,8.60,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.97,17.136,,8.78,,,0,"percent of total billed charges","17.136% of total billed charges",13.98,21.84,,11.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.13,37.7,,19.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",49.92,78,,39.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.86,82.6,,42.29,,,0,"percent of total billed charges","82.6% of total billed charges",10.75,16.8,,8.60,,,0,"percent of total billed charges","16.8% of total billed charges",32,50,,25.60,,,0,"percent of total billed charges","50% of total billed charges",52.86,82.6,,42.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.75,16.8,,8.60,,,0,"percent of total billed charges","16.8% of total billed charges",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",9.79,64,
"TAPE STERRAD SEALSURE",317198,CDM,270,RC,,,OUTPATIENT,,,80,52,,70.4,88,,56.32,,,0,"percent of total billed charges","88% of total billed charges",40,50,,32.00,,,0,"percent of total billed charges","50% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.84,17.304,,11.07,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.4,63,,40.32,,,0,"percent of total billed charges","63% of total billed charges",12.24,15.3,,9.79,,,0,"percent of total billed charges","15.3% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",55.2,69,,,,,0,"fee schedule","69% of total billed charges",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.48,61.85,,39.58,,,0,"percent of total billed charges","61.5% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",40,50,,32.00,,,0,"percent of total billed charges","50% of total billed charges",25.76,32.2,,20.61,,,0,"percent of total billed charges","32.2% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.71,17.136,,10.97,,,0,"percent of total billed charges","17.136% of total billed charges",17.47,21.84,,13.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.16,37.7,,24.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",62.4,78,,49.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",66.08,82.6,,52.86,,,0,"percent of total billed charges","82.6% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",40,50,,32.00,,,0,"percent of total billed charges","50% of total billed charges",66.08,82.6,,52.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",12.24,80,
"TAPE SURGICAL DURAPORE 1 INCH",11490,CDM,270,RC,,,OUTPATIENT,,,93,60.45,,81.84,88,,65.47,,,0,"percent of total billed charges","88% of total billed charges",46.5,50,,37.20,,,0,"percent of total billed charges","50% of total billed charges",15.62,16.8,,12.50,,,0,"percent of total billed charges","16.8% of total billed charges",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.09,17.304,,12.87,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.59,63,,46.87,,,0,"percent of total billed charges","63% of total billed charges",14.23,15.3,,11.38,,,0,"percent of total billed charges","15.3% of total billed charges",15.62,16.8,,12.50,,,0,"percent of total billed charges","16.8% of total billed charges",64.17,69,,,,,0,"fee schedule","69% of total billed charges",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.52,61.85,,46.02,,,0,"percent of total billed charges","61.5% of total billed charges",15.62,16.8,,12.50,,,0,"percent of total billed charges","16.8% of total billed charges",46.5,50,,37.20,,,0,"percent of total billed charges","50% of total billed charges",29.95,32.2,,23.96,,,0,"percent of total billed charges","32.2% of total billed charges",15.62,16.8,,12.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.94,17.136,,12.75,,,0,"percent of total billed charges","17.136% of total billed charges",20.31,21.84,,16.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.06,37.7,,28.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",72.54,78,,58.03,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.82,82.6,,61.46,,,0,"percent of total billed charges","82.6% of total billed charges",15.62,16.8,,12.50,,,0,"percent of total billed charges","16.8% of total billed charges",46.5,50,,37.20,,,0,"percent of total billed charges","50% of total billed charges",76.82,82.6,,61.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.62,16.8,,12.50,,,0,"percent of total billed charges","16.8% of total billed charges",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",14.23,93,
"TAPE TRANSPORE 1/2 INCH",9954,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"TAPE SURG MEDIPORE 2IN X 10YD",166425,CDM,270,RC,,,OUTPATIENT,,,29,18.85,,25.52,88,,20.42,,,0,"percent of total billed charges","88% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.02,17.304,,4.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.27,63,,14.62,,,0,"percent of total billed charges","63% of total billed charges",4.44,15.3,,3.55,,,0,"percent of total billed charges","15.3% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",20.01,69,,,,,0,"fee schedule","69% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.94,61.85,,14.35,,,0,"percent of total billed charges","61.5% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",9.34,32.2,,7.47,,,0,"percent of total billed charges","32.2% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.97,17.136,,3.98,,,0,"percent of total billed charges","17.136% of total billed charges",6.33,21.84,,5.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.93,37.7,,8.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,78,,18.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",14.5,50,,11.60,,,0,"percent of total billed charges","50% of total billed charges",23.95,82.6,,19.16,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",4.44,29,
"TAPE MEDIPORE 1 IN SOFT CLOTH",139642,CDM,270,RC,,,OUTPATIENT,,,32,20.8,,28.16,88,,22.53,,,0,"percent of total billed charges","88% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.54,17.304,,4.43,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.16,63,,16.13,,,0,"percent of total billed charges","63% of total billed charges",4.9,15.3,,3.92,,,0,"percent of total billed charges","15.3% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",22.08,69,,,,,0,"fee schedule","69% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.79,61.85,,15.83,,,0,"percent of total billed charges","61.5% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",10.3,32.2,,8.24,,,0,"percent of total billed charges","32.2% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.48,17.136,,4.38,,,0,"percent of total billed charges","17.136% of total billed charges",6.99,21.84,,5.59,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.96,78,,19.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",4.9,32,
"TAPE SURGICAL DURAPORE 3",166430,CDM,270,RC,,,OUTPATIENT,,,24,15.6,,21.12,88,,16.90,,,0,"percent of total billed charges","88% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.15,17.304,,3.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.12,63,,12.10,,,0,"percent of total billed charges","63% of total billed charges",3.67,15.3,,2.94,,,0,"percent of total billed charges","15.3% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",16.56,69,,,,,0,"fee schedule","69% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.84,61.85,,11.87,,,0,"percent of total billed charges","61.5% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",7.73,32.2,,6.18,,,0,"percent of total billed charges","32.2% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.11,17.136,,3.29,,,0,"percent of total billed charges","17.136% of total billed charges",5.24,21.84,,4.19,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.05,37.7,,7.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.72,78,,14.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,24,
"TAPE BLENDERM 1X5YDS",58965,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"TAPE HEPARIN ANESTHESIA 1/2",446806,CDM,270,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"TAPE HY-TAPE 1/2 LATEX FREE",42089,CDM,270,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"TAPE HY-TAPE 1X5 LATEX FREE",45393,CDM,270,RC,,,OUTPATIENT,,,34,22.1,,29.92,88,,23.94,,,0,"percent of total billed charges","88% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.88,17.304,,4.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.42,63,,17.14,,,0,"percent of total billed charges","63% of total billed charges",5.2,15.3,,4.16,,,0,"percent of total billed charges","15.3% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",23.46,69,,,,,0,"fee schedule","69% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.03,61.85,,16.82,,,0,"percent of total billed charges","61.5% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",10.95,32.2,,8.76,,,0,"percent of total billed charges","32.2% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.83,17.136,,4.66,,,0,"percent of total billed charges","17.136% of total billed charges",7.43,21.84,,5.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.82,37.7,,10.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.52,78,,21.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",5.2,34,
"TAPE MEASURE PAPER 72 IN",310363,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"TAPE COTTON UMBILICAL 1/8 X 30",56930,CDM,272,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"TAPE MICROPORE 3''",491550,CDM,270,RC,,,OUTPATIENT,,,60,39,,52.8,88,,42.24,,,0,"percent of total billed charges","88% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.38,17.304,,8.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.8,63,,30.24,,,0,"percent of total billed charges","63% of total billed charges",9.18,15.3,,7.34,,,0,"percent of total billed charges","15.3% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",41.4,69,,,,,0,"fee schedule","69% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.11,61.85,,29.69,,,0,"percent of total billed charges","61.5% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",19.32,32.2,,15.46,,,0,"percent of total billed charges","32.2% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.28,17.136,,8.22,,,0,"percent of total billed charges","17.136% of total billed charges",13.1,21.84,,10.48,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,37.7,,18.10,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.8,78,,37.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.56,82.6,,39.65,,,0,"percent of total billed charges","82.6% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",49.56,82.6,,39.65,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",9.18,60,
"TAPE MICROFOAM 2''",491549,CDM,270,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.37,61.85,,9.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"TAPE MEDIPORE SOFT CLOTH 4''",491548,CDM,270,RC,,,OUTPATIENT,,,66,42.9,,58.08,88,,46.46,,,0,"percent of total billed charges","88% of total billed charges",33,50,,26.40,,,0,"percent of total billed charges","50% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.42,17.304,,9.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.58,63,,33.26,,,0,"percent of total billed charges","63% of total billed charges",10.1,15.3,,8.08,,,0,"percent of total billed charges","15.3% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",45.54,69,,,,,0,"fee schedule","69% of total billed charges",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.82,61.85,,32.66,,,0,"percent of total billed charges","61.5% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",33,50,,26.40,,,0,"percent of total billed charges","50% of total billed charges",21.25,32.2,,17.00,,,0,"percent of total billed charges","32.2% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.31,17.136,,9.05,,,0,"percent of total billed charges","17.136% of total billed charges",14.41,21.84,,11.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.88,37.7,,19.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",51.48,78,,41.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",54.52,82.6,,43.62,,,0,"percent of total billed charges","82.6% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",33,50,,26.40,,,0,"percent of total billed charges","50% of total billed charges",54.52,82.6,,43.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",10.1,66,
"TAPE MEDIPORE 2'' SKIN SENSITIV",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"TAPE ELASTOCON 3''",491546,CDM,270,RC,,,OUTPATIENT,,,158,102.7,,139.04,88,,111.23,,,0,"percent of total billed charges","88% of total billed charges",79,50,,63.20,,,0,"percent of total billed charges","50% of total billed charges",26.54,16.8,,21.23,,,0,"percent of total billed charges","16.8% of total billed charges",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.34,17.304,,21.87,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",99.54,63,,79.63,,,0,"percent of total billed charges","63% of total billed charges",24.17,15.3,,19.34,,,0,"percent of total billed charges","15.3% of total billed charges",26.54,16.8,,21.23,,,0,"percent of total billed charges","16.8% of total billed charges",109.02,69,,,,,0,"fee schedule","69% of total billed charges",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.72,61.85,,78.18,,,0,"percent of total billed charges","61.5% of total billed charges",26.54,16.8,,21.23,,,0,"percent of total billed charges","16.8% of total billed charges",79,50,,63.20,,,0,"percent of total billed charges","50% of total billed charges",50.88,32.2,,40.70,,,0,"percent of total billed charges","32.2% of total billed charges",26.54,16.8,,21.23,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.07,17.136,,21.66,,,0,"percent of total billed charges","17.136% of total billed charges",34.51,21.84,,27.61,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",59.57,37.7,,47.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",123.24,78,,98.59,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",130.51,82.6,,104.41,,,0,"percent of total billed charges","82.6% of total billed charges",26.54,16.8,,21.23,,,0,"percent of total billed charges","16.8% of total billed charges",79,50,,63.20,,,0,"percent of total billed charges","50% of total billed charges",130.51,82.6,,104.41,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.54,16.8,,21.23,,,0,"percent of total billed charges","16.8% of total billed charges",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",24.17,158,
"TAPE ADHESIVE POUROUS 1''X10YDS",491545,CDM,270,RC,,,OUTPATIENT,,,78,50.7,,68.64,88,,54.91,,,0,"percent of total billed charges","88% of total billed charges",39,50,,31.20,,,0,"percent of total billed charges","50% of total billed charges",13.1,16.8,,10.48,,,0,"percent of total billed charges","16.8% of total billed charges",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.5,17.304,,10.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.14,63,,39.31,,,0,"percent of total billed charges","63% of total billed charges",11.93,15.3,,9.54,,,0,"percent of total billed charges","15.3% of total billed charges",13.1,16.8,,10.48,,,0,"percent of total billed charges","16.8% of total billed charges",53.82,69,,,,,0,"fee schedule","69% of total billed charges",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.24,61.85,,38.59,,,0,"percent of total billed charges","61.5% of total billed charges",13.1,16.8,,10.48,,,0,"percent of total billed charges","16.8% of total billed charges",39,50,,31.20,,,0,"percent of total billed charges","50% of total billed charges",25.12,32.2,,20.10,,,0,"percent of total billed charges","32.2% of total billed charges",13.1,16.8,,10.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.37,17.136,,10.70,,,0,"percent of total billed charges","17.136% of total billed charges",17.04,21.84,,13.63,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.41,37.7,,23.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",60.84,78,,48.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",13.1,16.8,,10.48,,,0,"percent of total billed charges","16.8% of total billed charges",39,50,,31.20,,,0,"percent of total billed charges","50% of total billed charges",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.1,16.8,,10.48,,,0,"percent of total billed charges","16.8% of total billed charges",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",11.93,78,
"TAPE KINESIO CLASSIC BLACK 2IN X 16.4IN BX OF 6",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"TAPE MICROFOAM 1 INCH",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"TAPE STEAM INDICATOR LEAD FREE  GREEN",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"TAPERED W/ VENTS PURPLE 1.5",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"TAPERED W/ VENTS GREEN 2",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"TAXO P 5.0",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"TB AURAMINE RHODAMINE  6/PK",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"FIXATION RING AND CONTACT SOLUTION SET FOR TCPO2/CO2",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"TDM PERF VERIFIER I BX/6 BTLS",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"TDM PERF VERIFIER II BX/6 BTLS",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"TDM PERF VERIFIER III BX/6 BTLS",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"TECHNOWIPES LINT FREE WIPE",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"TED HOSE STOCKING KNEE HIGH REG. MEDIUM",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"TED HOSE STOCKING KNEE HIGH LONG SMALL",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"TED HOSE STOCKING KNEE HIGH LONG MEDIUM",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"TED HOSE STOCKING KNEE HIGH REGULAR 2XL",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"TED HOSE STOCKING KNEE HIGH LONG 2XL",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"TED HOSE STOCKING KNEE HIGH REGULAR 3XL",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"TED HOSE STOCKING KNEE HIGH LONG 3XL",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"TED HOSE STOCKING THIGH HIGH SHORT SMALL",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"TED HOSE STOCKING THIGH HIGH SHORT MED",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"TED HOSE STOCKING THIGH HIGH SHORT LG",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"TED HOSE STOCKING THIGH HIGH REGULAR SMALL",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"TED HOSE STOCKING THIGH HIGH REGULAR MED",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"TED HOSE STOCKING THIGH HIGH REGULAR LG",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"TED HOSE STOCKING THIGH HIGH REGULAR XL",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"TED HOSE STOCKING THIGH HIGH REGULAR X2XL",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"TED HOSE STOCKING THIGH HIGH LONG SMALL",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"TED HOSE STOCKING THIGH HIGH LONG MED",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"TED HOSE STOCKING THIGH HIGH LONG LG",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"TED HOSE STOCKING THIGH HIGH LONG XL",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"TED HOSE STOCKING THIGH HIGH LONG 2XL",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"TED HOSE STOCKING KNEE HIGH LG LONG",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"TED HOSE STOCKING KNEE HIGH XL LONG",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"TEMNO ELITE BIOSPY SYSTEM 18X10",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"TEMNO ELITE BIOSPY SYSTEM 18X15",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"TEMNO ELITE BIOSPY SYSTEM 18X20",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"TEMNO ELITE BIOSPY SYSTEM 20X10",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"TEMNO ELITE BIOSPY SYSTEM 20X15",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"TEMNO ELITE BIOSPY SYSTEM 20X20",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"TEMPERATURE PROBE, RIGHT ANGLE 850",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,721,468.65,,634.48,88,,507.58,,,0,"percent of total billed charges","88% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.76,17.304,,99.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.23,63,,363.38,,,0,"percent of total billed charges","63% of total billed charges",110.31,15.3,,88.25,,,0,"percent of total billed charges","15.3% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",497.49,69,,,,,0,"fee schedule","69% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",445.94,61.85,,356.75,,,0,"percent of total billed charges","61.5% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",232.16,32.2,,185.73,,,0,"percent of total billed charges","32.2% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",123.55,17.136,,98.84,,,0,"percent of total billed charges","17.136% of total billed charges",157.47,21.84,,125.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",271.82,37.7,,217.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",562.38,78,,449.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",595.55,82.6,,476.44,,,0,"percent of total billed charges","82.6% of total billed charges",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",360.5,50,,288.40,,,0,"percent of total billed charges","50% of total billed charges",595.55,82.6,,476.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",121.13,16.8,,96.90,,,0,"percent of total billed charges","16.8% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",110.31,721,
"TEST STRIP CIDEX OPA SOLUTION 60 STRIP/BT",166476,CDM,270,RC,,,OUTPATIENT,,,300,195,,264,88,,211.20,,,0,"percent of total billed charges","88% of total billed charges",150,50,,120.00,,,0,"percent of total billed charges","50% of total billed charges",50.4,16.8,,40.32,,,0,"percent of total billed charges","16.8% of total billed charges",300,100,,240.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,17.304,,41.53,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",189,63,,151.20,,,0,"percent of total billed charges","63% of total billed charges",45.9,15.3,,36.72,,,0,"percent of total billed charges","15.3% of total billed charges",50.4,16.8,,40.32,,,0,"percent of total billed charges","16.8% of total billed charges",207,69,,,,,0,"fee schedule","69% of total billed charges",300,100,,240.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",300,100,,240.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",300,100,,240.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.55,61.85,,148.44,,,0,"percent of total billed charges","61.5% of total billed charges",50.4,16.8,,40.32,,,0,"percent of total billed charges","16.8% of total billed charges",150,50,,120.00,,,0,"percent of total billed charges","50% of total billed charges",96.6,32.2,,77.28,,,0,"percent of total billed charges","32.2% of total billed charges",50.4,16.8,,40.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.41,17.136,,41.13,,,0,"percent of total billed charges","17.136% of total billed charges",65.52,21.84,,52.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",113.1,37.7,,90.48,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",234,78,,187.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",247.8,82.6,,198.24,,,0,"percent of total billed charges","82.6% of total billed charges",50.4,16.8,,40.32,,,0,"percent of total billed charges","16.8% of total billed charges",150,50,,120.00,,,0,"percent of total billed charges","50% of total billed charges",247.8,82.6,,198.24,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.4,16.8,,40.32,,,0,"percent of total billed charges","16.8% of total billed charges",300,100,,240.00,,,0,"percent of total billed charges","100% of total billed charges",45.9,300,
"TEST STRIPS METRICIDE OPA",491559,CDM,270,RC,,,OUTPATIENT,,,410,266.5,,360.8,88,,288.64,,,0,"percent of total billed charges","88% of total billed charges",205,50,,164.00,,,0,"percent of total billed charges","50% of total billed charges",68.88,16.8,,55.10,,,0,"percent of total billed charges","16.8% of total billed charges",410,100,,328.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.95,17.304,,56.76,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.3,63,,206.64,,,0,"percent of total billed charges","63% of total billed charges",62.73,15.3,,50.18,,,0,"percent of total billed charges","15.3% of total billed charges",68.88,16.8,,55.10,,,0,"percent of total billed charges","16.8% of total billed charges",282.9,69,,,,,0,"fee schedule","69% of total billed charges",410,100,,328.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",410,100,,328.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",410,100,,328.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.59,61.85,,202.87,,,0,"percent of total billed charges","61.5% of total billed charges",68.88,16.8,,55.10,,,0,"percent of total billed charges","16.8% of total billed charges",205,50,,164.00,,,0,"percent of total billed charges","50% of total billed charges",132.02,32.2,,105.62,,,0,"percent of total billed charges","32.2% of total billed charges",68.88,16.8,,55.10,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.26,17.136,,56.21,,,0,"percent of total billed charges","17.136% of total billed charges",89.54,21.84,,71.63,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",154.57,37.7,,123.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",319.8,78,,255.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.66,82.6,,270.93,,,0,"percent of total billed charges","82.6% of total billed charges",68.88,16.8,,55.10,,,0,"percent of total billed charges","16.8% of total billed charges",205,50,,164.00,,,0,"percent of total billed charges","50% of total billed charges",338.66,82.6,,270.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.88,16.8,,55.10,,,0,"percent of total billed charges","16.8% of total billed charges",410,100,,328.00,,,0,"percent of total billed charges","100% of total billed charges",62.73,410,
"TEST STREP A QUICKVUE+",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"TESTOSTERONE 100 WELLS",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"TESTOSTERONE CAL BX/1 SET",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"TESTOSTERONE REAGENT KIT2X5",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"TEST TUBES POLYPROPLYENE ALIQUOT",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"THERMOMETER CAPS RESPOSABLE",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"THERMOMETER SKIN STRIP",ORSUP0013,CDM,270,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"THERMO SCIENTIFIC NERL REAG GRADE WATER",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"THERMASPLINT MED NASAL SPLINT",491561,CDM,270,RC,,,OUTPATIENT,,,245,159.25,,215.6,88,,172.48,,,0,"percent of total billed charges","88% of total billed charges",122.5,50,,98.00,,,0,"percent of total billed charges","50% of total billed charges",41.16,16.8,,32.93,,,0,"percent of total billed charges","16.8% of total billed charges",245,100,,196.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.39,17.304,,33.91,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",154.35,63,,123.48,,,0,"percent of total billed charges","63% of total billed charges",37.49,15.3,,29.99,,,0,"percent of total billed charges","15.3% of total billed charges",41.16,16.8,,32.93,,,0,"percent of total billed charges","16.8% of total billed charges",169.05,69,,,,,0,"fee schedule","69% of total billed charges",245,100,,196.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",245,100,,196.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",245,100,,196.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.53,61.85,,121.22,,,0,"percent of total billed charges","61.5% of total billed charges",41.16,16.8,,32.93,,,0,"percent of total billed charges","16.8% of total billed charges",122.5,50,,98.00,,,0,"percent of total billed charges","50% of total billed charges",78.89,32.2,,63.11,,,0,"percent of total billed charges","32.2% of total billed charges",41.16,16.8,,32.93,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.98,17.136,,33.58,,,0,"percent of total billed charges","17.136% of total billed charges",53.51,21.84,,42.81,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",92.37,37.7,,73.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",191.1,78,,152.88,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.37,82.6,,161.90,,,0,"percent of total billed charges","82.6% of total billed charges",41.16,16.8,,32.93,,,0,"percent of total billed charges","16.8% of total billed charges",122.5,50,,98.00,,,0,"percent of total billed charges","50% of total billed charges",202.37,82.6,,161.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.16,16.8,,32.93,,,0,"percent of total billed charges","16.8% of total billed charges",245,100,,196.00,,,0,"percent of total billed charges","100% of total billed charges",37.49,245,
"THERMASPLINT LRG NASAL SPLINT",491560,CDM,270,RC,,,OUTPATIENT,,,240,156,,211.2,88,,168.96,,,0,"percent of total billed charges","88% of total billed charges",120,50,,96.00,,,0,"percent of total billed charges","50% of total billed charges",40.32,16.8,,32.26,,,0,"percent of total billed charges","16.8% of total billed charges",240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.53,17.304,,33.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.2,63,,120.96,,,0,"percent of total billed charges","63% of total billed charges",36.72,15.3,,29.38,,,0,"percent of total billed charges","15.3% of total billed charges",40.32,16.8,,32.26,,,0,"percent of total billed charges","16.8% of total billed charges",165.6,69,,,,,0,"fee schedule","69% of total billed charges",240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",148.44,61.85,,118.75,,,0,"percent of total billed charges","61.5% of total billed charges",40.32,16.8,,32.26,,,0,"percent of total billed charges","16.8% of total billed charges",120,50,,96.00,,,0,"percent of total billed charges","50% of total billed charges",77.28,32.2,,61.82,,,0,"percent of total billed charges","32.2% of total billed charges",40.32,16.8,,32.26,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.13,17.136,,32.90,,,0,"percent of total billed charges","17.136% of total billed charges",52.42,21.84,,41.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",90.48,37.7,,72.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",187.2,78,,149.76,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",198.24,82.6,,158.59,,,0,"percent of total billed charges","82.6% of total billed charges",40.32,16.8,,32.26,,,0,"percent of total billed charges","16.8% of total billed charges",120,50,,96.00,,,0,"percent of total billed charges","50% of total billed charges",198.24,82.6,,158.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.32,16.8,,32.26,,,0,"percent of total billed charges","16.8% of total billed charges",240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",36.72,240,
"THERMOMETER FOREHEAD STRIPS",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"THERMAL PAPER Z-FOLD RED GRID 8.5IN X 11IN",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"THERMAL PRINTER PAPER",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"THERMOMETER DIGITAL DISPOSABLE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"THERMAL PAPER",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"THERMAL PAPER ROLL HEARING TEST MACHINE",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"THIOGLYCOLLATE MEDIUM WITH DEXTROSE HEMIN VITAMIN K",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"THIS LOT READY LABERL GREEN",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"THREADER FG OTW 1.2MMX12MM",ORSUP0032,CDM,278,RC,,,OUTPATIENT,,,5624,3655.6,,4949.12,88,,3959.30,,,0,"percent of total billed charges","88% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",973.18,17.304,,778.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3543.12,63,,2834.50,,,0,"percent of total billed charges","63% of total billed charges",860.47,15.3,,688.38,,,0,"percent of total billed charges","15.3% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",3880.56,69,,,,,0,"fee schedule","69% of total billed charges",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3478.44,61.85,,2782.75,,,0,"percent of total billed charges","61.5% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",1810.93,32.2,,1448.74,,,0,"percent of total billed charges","32.2% of total billed charges",1754.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",963.73,17.136,,770.98,,,0,"percent of total billed charges","17.136% of total billed charges",1228.28,21.84,,982.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2120.25,37.7,,1696.20,,,0,"percent of total billed charges","37.7% of total billed charges",2120.25,37.7,,1696.20,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1906.54,33.9,,1525.23,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4386.72,78,,3509.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4645.42,82.6,,3716.34,,,0,"percent of total billed charges","82.6% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",4645.42,82.6,,3716.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",860.47,5624,
"THROMB SET ANGIOJET 120CM SOLE",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"THUMBS UP GOWN",491563,CDM,270,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"THYROID DRAPE",491564,CDM,270,RC,,,OUTPATIENT,,,90,58.5,,79.2,88,,63.36,,,0,"percent of total billed charges","88% of total billed charges",45,50,,36.00,,,0,"percent of total billed charges","50% of total billed charges",15.12,16.8,,12.10,,,0,"percent of total billed charges","16.8% of total billed charges",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.57,17.304,,12.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.7,63,,45.36,,,0,"percent of total billed charges","63% of total billed charges",13.77,15.3,,11.02,,,0,"percent of total billed charges","15.3% of total billed charges",15.12,16.8,,12.10,,,0,"percent of total billed charges","16.8% of total billed charges",62.1,69,,,,,0,"fee schedule","69% of total billed charges",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",55.67,61.85,,44.54,,,0,"percent of total billed charges","61.5% of total billed charges",15.12,16.8,,12.10,,,0,"percent of total billed charges","16.8% of total billed charges",45,50,,36.00,,,0,"percent of total billed charges","50% of total billed charges",28.98,32.2,,23.18,,,0,"percent of total billed charges","32.2% of total billed charges",15.12,16.8,,12.10,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.42,17.136,,12.34,,,0,"percent of total billed charges","17.136% of total billed charges",19.66,21.84,,15.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",33.93,37.7,,27.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",70.2,78,,56.16,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.34,82.6,,59.47,,,0,"percent of total billed charges","82.6% of total billed charges",15.12,16.8,,12.10,,,0,"percent of total billed charges","16.8% of total billed charges",45,50,,36.00,,,0,"percent of total billed charges","50% of total billed charges",74.34,82.6,,59.47,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.12,16.8,,12.10,,,0,"percent of total billed charges","16.8% of total billed charges",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",13.77,90,
"TI LOCKING SCREW 04.614.508",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"TI WRIST FUSION PLATE",ORSUP0034,CDM,278,RC,,,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1065.75,17.304,,852.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",942.33,15.3,,753.86,,,0,"percent of total billed charges","15.3% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3809.34,61.85,,3047.47,,,0,"percent of total billed charges","61.5% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1983.2,32.2,,1586.56,,,0,"percent of total billed charges","32.2% of total billed charges",1921.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1055.41,17.136,,844.33,,,0,"percent of total billed charges","17.136% of total billed charges",1345.13,21.84,,1076.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",942.33,6159,
N/A,ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"TIGHTROPE ABS BUTTON",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"TIGHTROPE ACL RT AR-1588RT",ORSUP0019,CDM,278,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",668.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.7% of total billed charges",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",726.14,33.9,,580.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"TIGHTROPE BTB",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",751.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.7% of total billed charges",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",816.99,33.9,,653.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"TIGHTROPE BUTTON EXTENDER",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"TIGHTROPE ABS IMPLANT",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"TIGHTROPE ABS IMPLANT OPEN",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"TIP DRILL 2.5MM GUIDEWIRE 200MM L",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"TIP SUCT YANKAUER BULL TIP",76442,CDM,270,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"TIP EAR INFANT 4.5MM RED BROWN",ORSUP0008,CDM,270,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"TIP PIPETTE RACKED FOR ID-MICRO TYPING SYS 4/PK",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"TIP MLA ECON-PAK LARGE",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"TIP CAUTERY HOOK 5MM  DA VINCI (SINGLE USE)",337820,CDM,272,RC,,,OUTPATIENT,,,5581,3627.65,,4911.28,88,,3929.02,,,0,"percent of total billed charges","88% of total billed charges",2790.5,50,,2232.40,,,0,"percent of total billed charges","50% of total billed charges",937.61,16.8,,750.09,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",965.74,17.304,,772.59,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3516.03,63,,2812.82,,,0,"percent of total billed charges","63% of total billed charges",853.89,15.3,,683.11,,,0,"percent of total billed charges","15.3% of total billed charges",937.61,16.8,,750.09,,,0,"percent of total billed charges","16.8% of total billed charges",3850.89,69,,,,,0,"fee schedule","69% of total billed charges",5581,100,,4464.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5581,100,,4464.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5581,100,,4464.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3451.85,61.85,,2761.48,,,0,"percent of total billed charges","61.5% of total billed charges",937.61,16.8,,750.09,,,0,"percent of total billed charges","16.8% of total billed charges",2790.5,50,,2232.40,,,0,"percent of total billed charges","50% of total billed charges",1797.08,32.2,,1437.66,,,0,"percent of total billed charges","32.2% of total billed charges",937.61,16.8,,750.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",956.36,17.136,,765.09,,,0,"percent of total billed charges","17.136% of total billed charges",1218.89,21.84,,975.11,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2104.04,37.7,,1683.23,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4353.18,78,,3482.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4609.91,82.6,,3687.93,,,0,"percent of total billed charges","82.6% of total billed charges",937.61,16.8,,750.09,,,0,"percent of total billed charges","16.8% of total billed charges",2790.5,50,,2232.40,,,0,"percent of total billed charges","50% of total billed charges",4609.91,82.6,,3687.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",937.61,16.8,,750.09,,,0,"percent of total billed charges","16.8% of total billed charges",5581,100,,4464.80,,,0,"percent of total billed charges","100% of total billed charges",853.89,5581,
"TIP COVER ACCESSORY HOT SHEAR DA VINCI",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"TIP RUMI ORANGE 6.7MM X 12CM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"TIP RUMI YELLOW 5.1MM X 3.75CM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"TIP UP FENESTRATED GRASPER",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"TIPS MALLEABLE FOR FLOSEAL",ORSUP0010,CDM,270,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"TISSUE MORCELLATOR",ORSUP0027,CDM,278,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",1336.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.7% of total billed charges",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1452.62,33.9,,1162.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"TISSUE FACIAL",202443,CDM,270,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"TISSUE STABILIZER OCTOPUS 4",ORSUP0031,CDM,272,RC,,,OUTPATIENT,,,5356,3481.4,,4713.28,88,,3770.62,,,0,"percent of total billed charges","88% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",926.8,17.304,,741.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3374.28,63,,2699.42,,,0,"percent of total billed charges","63% of total billed charges",819.47,15.3,,655.58,,,0,"percent of total billed charges","15.3% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",3695.64,69,,,,,0,"fee schedule","69% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3312.69,61.85,,2650.15,,,0,"percent of total billed charges","61.5% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",1724.63,32.2,,1379.70,,,0,"percent of total billed charges","32.2% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",917.8,17.136,,734.24,,,0,"percent of total billed charges","17.136% of total billed charges",1169.75,21.84,,935.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2019.21,37.7,,1615.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4177.68,78,,3342.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",2678,50,,2142.40,,,0,"percent of total billed charges","50% of total billed charges",4424.06,82.6,,3539.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",899.81,16.8,,719.85,,,0,"percent of total billed charges","16.8% of total billed charges",5356,100,,4284.80,,,0,"percent of total billed charges","100% of total billed charges",819.47,5356,
"TISSUE EXPANDER 133MX-11T",ORSUP0013,CDM,270,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"TISSUE TRAP FOR BERKLEY CANNIS",491573,CDM,270,RC,,,OUTPATIENT,,,72,46.8,,63.36,88,,50.69,,,0,"percent of total billed charges","88% of total billed charges",36,50,,28.80,,,0,"percent of total billed charges","50% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.46,17.304,,9.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.36,63,,36.29,,,0,"percent of total billed charges","63% of total billed charges",11.02,15.3,,8.82,,,0,"percent of total billed charges","15.3% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",49.68,69,,,,,0,"fee schedule","69% of total billed charges",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.53,61.85,,35.62,,,0,"percent of total billed charges","61.5% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",36,50,,28.80,,,0,"percent of total billed charges","50% of total billed charges",23.18,32.2,,18.54,,,0,"percent of total billed charges","32.2% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.34,17.136,,9.87,,,0,"percent of total billed charges","17.136% of total billed charges",15.72,21.84,,12.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",27.14,37.7,,21.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",56.16,78,,44.93,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.47,82.6,,47.58,,,0,"percent of total billed charges","82.6% of total billed charges",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",36,50,,28.80,,,0,"percent of total billed charges","50% of total billed charges",59.47,82.6,,47.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.1,16.8,,9.68,,,0,"percent of total billed charges","16.8% of total billed charges",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",11.02,72,
"TISSUE ANCHOR 2.7MM",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"TISSUE ANCHOR 3.5MM",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"TISSEEL PRE-FILLED SYR 2 ML",ORSUP0015,CDM,270,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"TISSUE EXPANDER 133FX-12-T",ORSUP0040,CDM,270,RC,,,OUTPATIENT,,,7766,5047.9,,6834.08,88,,5467.26,,,0,"percent of total billed charges","88% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1343.83,17.304,,1075.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4892.58,63,,3914.06,,,0,"percent of total billed charges","63% of total billed charges",1188.2,15.3,,950.56,,,0,"percent of total billed charges","15.3% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",5358.54,69,,,,,0,"fee schedule","69% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4803.27,61.85,,3842.62,,,0,"percent of total billed charges","61.5% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",2500.65,32.2,,2000.52,,,0,"percent of total billed charges","32.2% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1330.78,17.136,,1064.62,,,0,"percent of total billed charges","17.136% of total billed charges",1696.09,21.84,,1356.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2927.78,37.7,,2342.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6057.48,78,,4845.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",3883,50,,3106.40,,,0,"percent of total billed charges","50% of total billed charges",6414.72,82.6,,5131.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1304.69,16.8,,1043.75,,,0,"percent of total billed charges","16.8% of total billed charges",7766,100,,6212.80,,,0,"percent of total billed charges","100% of total billed charges",1188.2,7766,
"TISSUE TRAP/CANNISTER",491574,CDM,270,RC,,,OUTPATIENT,,,89,57.85,,78.32,88,,62.66,,,0,"percent of total billed charges","88% of total billed charges",44.5,50,,35.60,,,0,"percent of total billed charges","50% of total billed charges",14.95,16.8,,11.96,,,0,"percent of total billed charges","16.8% of total billed charges",89,100,,71.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.4,17.304,,12.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.07,63,,44.86,,,0,"percent of total billed charges","63% of total billed charges",13.62,15.3,,10.90,,,0,"percent of total billed charges","15.3% of total billed charges",14.95,16.8,,11.96,,,0,"percent of total billed charges","16.8% of total billed charges",61.41,69,,,,,0,"fee schedule","69% of total billed charges",89,100,,71.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89,100,,71.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89,100,,71.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",55.05,61.85,,44.04,,,0,"percent of total billed charges","61.5% of total billed charges",14.95,16.8,,11.96,,,0,"percent of total billed charges","16.8% of total billed charges",44.5,50,,35.60,,,0,"percent of total billed charges","50% of total billed charges",28.66,32.2,,22.93,,,0,"percent of total billed charges","32.2% of total billed charges",14.95,16.8,,11.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.25,17.136,,12.20,,,0,"percent of total billed charges","17.136% of total billed charges",19.44,21.84,,15.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",33.55,37.7,,26.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",69.42,78,,55.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",73.51,82.6,,58.81,,,0,"percent of total billed charges","82.6% of total billed charges",14.95,16.8,,11.96,,,0,"percent of total billed charges","16.8% of total billed charges",44.5,50,,35.60,,,0,"percent of total billed charges","50% of total billed charges",73.51,82.6,,58.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.95,16.8,,11.96,,,0,"percent of total billed charges","16.8% of total billed charges",89,100,,71.20,,,0,"percent of total billed charges","100% of total billed charges",13.62,89,
"TISSUE GRAFT ACHILLES TENDON",ORSUP0082,CDM,278,RC,,,OUTPATIENT,,,19282,12533.3,,16968.16,88,,13574.53,,,0,"percent of total billed charges","88% of total billed charges",9641,50,,7712.80,,,0,"percent of total billed charges","50% of total billed charges",3239.38,16.8,,2591.50,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3336.56,17.304,,2669.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12147.66,63,,9718.13,,,0,"percent of total billed charges","63% of total billed charges",2950.15,15.3,,2360.12,,,0,"percent of total billed charges","15.3% of total billed charges",3239.38,16.8,,2591.50,,,0,"percent of total billed charges","16.8% of total billed charges",13304.58,69,,,,,0,"fee schedule","69% of total billed charges",19282,100,,15425.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19282,100,,15425.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19282,100,,15425.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11925.92,61.85,,9540.74,,,0,"percent of total billed charges","61.5% of total billed charges",3239.38,16.8,,2591.50,,,0,"percent of total billed charges","16.8% of total billed charges",9641,50,,7712.80,,,0,"percent of total billed charges","50% of total billed charges",6208.8,32.2,,4967.04,,,0,"percent of total billed charges","32.2% of total billed charges",6015.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3304.16,17.136,,2643.33,,,0,"percent of total billed charges","17.136% of total billed charges",4211.19,21.84,,3368.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",7269.31,37.7,,5815.45,,,0,"percent of total billed charges","37.7% of total billed charges",7269.31,37.7,,5815.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",6536.6,33.9,,5229.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",15039.96,78,,12031.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15926.93,82.6,,12741.54,,,0,"percent of total billed charges","82.6% of total billed charges",3239.38,16.8,,2591.50,,,0,"percent of total billed charges","16.8% of total billed charges",9641,50,,7712.80,,,0,"percent of total billed charges","50% of total billed charges",15926.93,82.6,,12741.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3239.38,16.8,,2591.50,,,0,"percent of total billed charges","16.8% of total billed charges",19282,100,,15425.60,,,0,"percent of total billed charges","100% of total billed charges",2950.15,19282,
"TISSEEL FROZEN 2 ML",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"TISSEEL PRE-FILLED SYR 2ML FROZEN",ORSUP0019,CDM,272,RC,,,OUTPATIENT,,,1030,669.5,,906.4,88,,725.12,,,0,"percent of total billed charges","88% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.23,17.304,,142.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.9,63,,519.12,,,0,"percent of total billed charges","63% of total billed charges",157.59,15.3,,126.07,,,0,"percent of total billed charges","15.3% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",710.7,69,,,,,0,"fee schedule","69% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",637.06,61.85,,509.65,,,0,"percent of total billed charges","61.5% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",331.66,32.2,,265.33,,,0,"percent of total billed charges","32.2% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.5,17.136,,141.20,,,0,"percent of total billed charges","17.136% of total billed charges",224.95,21.84,,179.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",388.31,37.7,,310.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",803.4,78,,642.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",157.59,1030,
"TISSUE GRINDER 15ML DISPOSABLE",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"TONER CARTRIDGE T650",ORSUP0016,CDM,270,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"TONER CARTRIDGE",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"TONER 81A FOR HP LASERJET M604/M605",ORSUP0011,CDM,270,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"TONER CARTRIDGE HP",ORSUP0010,CDM,270,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"TONER CTRG DELL 1720 BK",ORSUP0009,CDM,270,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"TONER FOR HP LASERJET PRO M402N",ORSUP0009,CDM,270,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"TONER HP CF226X BLACK PG YLD 9000",ORSUP0021,CDM,270,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"TONER HP LASER JET PRO 400",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"TONER HP M602",ORSUP0011,CDM,270,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"TONER HP P2035/2055DN 2300",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"TONER MAGENTA FOR HP LASERJET CP2025",ORSUP0009,CDM,270,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"TONER YELLOW FOR HP LASERJET CP2025",ORSUP0009,CDM,270,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"TONSIL WIRE #8",491577,CDM,272,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.95,61.85,,3.96,,,0,"percent of total billed charges","61.5% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"TOOL GENCUT CORING",ORSUP0023,CDM,270,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"TOOL SNAP ASSEMBLY",ORSUP0019,CDM,272,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"TOOTHPASTE .85oz",86938,CDM,272,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"TOOTHPASTE FLUORIDE .85 OZ SPARKLE FRESH",174738,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"TORPEDO SHAVER COOLCUT 4MM",ORSUP0023,CDM,272,RC,,,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",556.15,17.304,,444.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1987.86,61.85,,1590.29,,,0,"percent of total billed charges","61.5% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",1034.91,32.2,,827.93,,,0,"percent of total billed charges","32.2% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.75,17.136,,440.60,,,0,"percent of total billed charges","17.136% of total billed charges",701.94,21.84,,561.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",1607,50,,1285.60,,,0,"percent of total billed charges","50% of total billed charges",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,16.8,,431.96,,,0,"percent of total billed charges","16.8% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,3214,
"REAGENT TOTAL T4",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"TOT B-HCG CAL II BX/3 SET",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"TOT B-HCG II 100 WELLS",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"TOT BILIRUBIN /5 PACK/ 300 SLDS",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"TOTAL HIP",326411,CDM,270,RC,,,OUTPATIENT,,,1129,733.85,,993.52,88,,794.82,,,0,"percent of total billed charges","88% of total billed charges",564.5,50,,451.60,,,0,"percent of total billed charges","50% of total billed charges",189.67,16.8,,151.74,,,0,"percent of total billed charges","16.8% of total billed charges",1129,100,,903.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",195.36,17.304,,156.29,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",711.27,63,,569.02,,,0,"percent of total billed charges","63% of total billed charges",172.74,15.3,,138.19,,,0,"percent of total billed charges","15.3% of total billed charges",189.67,16.8,,151.74,,,0,"percent of total billed charges","16.8% of total billed charges",779.01,69,,,,,0,"fee schedule","69% of total billed charges",1129,100,,903.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1129,100,,903.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1129,100,,903.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",698.29,61.85,,558.63,,,0,"percent of total billed charges","61.5% of total billed charges",189.67,16.8,,151.74,,,0,"percent of total billed charges","16.8% of total billed charges",564.5,50,,451.60,,,0,"percent of total billed charges","50% of total billed charges",363.54,32.2,,290.83,,,0,"percent of total billed charges","32.2% of total billed charges",189.67,16.8,,151.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",193.47,17.136,,154.78,,,0,"percent of total billed charges","17.136% of total billed charges",246.57,21.84,,197.26,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",425.63,37.7,,340.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",880.62,78,,704.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",932.55,82.6,,746.04,,,0,"percent of total billed charges","82.6% of total billed charges",189.67,16.8,,151.74,,,0,"percent of total billed charges","16.8% of total billed charges",564.5,50,,451.60,,,0,"percent of total billed charges","50% of total billed charges",932.55,82.6,,746.04,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",189.67,16.8,,151.74,,,0,"percent of total billed charges","16.8% of total billed charges",1129,100,,903.20,,,0,"percent of total billed charges","100% of total billed charges",172.74,1129,
"TOTAL KNEE",326388,CDM,270,RC,,,OUTPATIENT,,,1082,703.3,,952.16,88,,761.73,,,0,"percent of total billed charges","88% of total billed charges",541,50,,432.80,,,0,"percent of total billed charges","50% of total billed charges",181.78,16.8,,145.42,,,0,"percent of total billed charges","16.8% of total billed charges",1082,100,,865.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",187.23,17.304,,149.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",681.66,63,,545.33,,,0,"percent of total billed charges","63% of total billed charges",165.55,15.3,,132.44,,,0,"percent of total billed charges","15.3% of total billed charges",181.78,16.8,,145.42,,,0,"percent of total billed charges","16.8% of total billed charges",746.58,69,,,,,0,"fee schedule","69% of total billed charges",1082,100,,865.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1082,100,,865.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1082,100,,865.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",669.22,61.85,,535.38,,,0,"percent of total billed charges","61.5% of total billed charges",181.78,16.8,,145.42,,,0,"percent of total billed charges","16.8% of total billed charges",541,50,,432.80,,,0,"percent of total billed charges","50% of total billed charges",348.4,32.2,,278.72,,,0,"percent of total billed charges","32.2% of total billed charges",181.78,16.8,,145.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.41,17.136,,148.33,,,0,"percent of total billed charges","17.136% of total billed charges",236.31,21.84,,189.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",407.91,37.7,,326.33,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",843.96,78,,675.17,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",893.73,82.6,,714.98,,,0,"percent of total billed charges","82.6% of total billed charges",181.78,16.8,,145.42,,,0,"percent of total billed charges","16.8% of total billed charges",541,50,,432.80,,,0,"percent of total billed charges","50% of total billed charges",893.73,82.6,,714.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.78,16.8,,145.42,,,0,"percent of total billed charges","16.8% of total billed charges",1082,100,,865.60,,,0,"percent of total billed charges","100% of total billed charges",165.55,1082,
"TOTAL 5 CALIBRATION VERIFICATION",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"TOTAL KNEE PACK",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,824,535.6,,725.12,88,,580.10,,,0,"percent of total billed charges","88% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.58,17.304,,114.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",519.12,63,,415.30,,,0,"percent of total billed charges","63% of total billed charges",126.07,15.3,,100.86,,,0,"percent of total billed charges","15.3% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",568.56,69,,,,,0,"fee schedule","69% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.64,61.85,,407.71,,,0,"percent of total billed charges","61.5% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",265.33,32.2,,212.26,,,0,"percent of total billed charges","32.2% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",141.2,17.136,,112.96,,,0,"percent of total billed charges","17.136% of total billed charges",179.96,21.84,,143.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",310.65,37.7,,248.52,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",642.72,78,,514.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",126.07,824,
"TOURNI-COT FINGER LARGE",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"TOURNIQUET 18IN DISPOSABLE",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"TOURNIQUET 24IN DISP. REPROCESSED",ORSUP0003,CDM,270,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"TOURNIQUET 30IN DISPOSABLE",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"TOURNIQUET DISPOSABLE 18 INCH",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"TOURNIQUET EXTENSION TUBING",ORSUP0011,CDM,270,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"TOURNIQUET LF 1 X 18 BLUE",ORSUP0003,CDM,270,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"TOURNIQUET 12IN",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"TOURNIQUET 12",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"TOURNIQUET CUFF 9X1.75 DISP",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"TOURNIQUET CUFF 44X4 DISP",ORSUP0004,CDM,270,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"TOURNIQUET CUFF 34X4 DISP",ORSUP0003,CDM,270,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"TOURNIQUET CUFF 30X4 DISP",ORSUP0003,CDM,270,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"TOURNIQUET CUFF 24X5.5 DISP",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"TOURNIQUET CUFF 24X4 DISP",ORSUP0003,CDM,270,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"TOURNIQUET CUFF 18X5.2 DISP",ORSUP0004,CDM,270,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"TOURNIQUET CUFF 12X2 DISP",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"TOURNIQUET CUFF 18X3 DISP",ORSUP0003,CDM,270,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"TOURNIQUET PADDING 4",491587,CDM,270,RC,,,OUTPATIENT,,,94,61.1,,82.72,88,,66.18,,,0,"percent of total billed charges","88% of total billed charges",47,50,,37.60,,,0,"percent of total billed charges","50% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.27,17.304,,13.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.22,63,,47.38,,,0,"percent of total billed charges","63% of total billed charges",14.38,15.3,,11.50,,,0,"percent of total billed charges","15.3% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",64.86,69,,,,,0,"fee schedule","69% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.14,61.85,,46.51,,,0,"percent of total billed charges","61.5% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",47,50,,37.60,,,0,"percent of total billed charges","50% of total billed charges",30.27,32.2,,24.22,,,0,"percent of total billed charges","32.2% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.11,17.136,,12.89,,,0,"percent of total billed charges","17.136% of total billed charges",20.53,21.84,,16.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.44,37.7,,28.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",73.32,78,,58.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",47,50,,37.60,,,0,"percent of total billed charges","50% of total billed charges",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.79,16.8,,12.63,,,0,"percent of total billed charges","16.8% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",14.38,94,
"TOURNIQUET STERILE 18",491588,CDM,272,RC,,,OUTPATIENT,,,3410,2216.5,,3000.8,88,,2400.64,,,0,"percent of total billed charges","88% of total billed charges",1705,50,,1364.00,,,0,"percent of total billed charges","50% of total billed charges",572.88,16.8,,458.30,,,0,"percent of total billed charges","16.8% of total billed charges",3410,100,,2728.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.07,17.304,,472.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2148.3,63,,1718.64,,,0,"percent of total billed charges","63% of total billed charges",521.73,15.3,,417.38,,,0,"percent of total billed charges","15.3% of total billed charges",572.88,16.8,,458.30,,,0,"percent of total billed charges","16.8% of total billed charges",2352.9,69,,,,,0,"fee schedule","69% of total billed charges",3410,100,,2728.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3410,100,,2728.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3410,100,,2728.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2109.09,61.85,,1687.27,,,0,"percent of total billed charges","61.5% of total billed charges",572.88,16.8,,458.30,,,0,"percent of total billed charges","16.8% of total billed charges",1705,50,,1364.00,,,0,"percent of total billed charges","50% of total billed charges",1098.02,32.2,,878.42,,,0,"percent of total billed charges","32.2% of total billed charges",572.88,16.8,,458.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.34,17.136,,467.47,,,0,"percent of total billed charges","17.136% of total billed charges",744.74,21.84,,595.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1285.57,37.7,,1028.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2659.8,78,,2127.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2816.66,82.6,,2253.33,,,0,"percent of total billed charges","82.6% of total billed charges",572.88,16.8,,458.30,,,0,"percent of total billed charges","16.8% of total billed charges",1705,50,,1364.00,,,0,"percent of total billed charges","50% of total billed charges",2816.66,82.6,,2253.33,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",572.88,16.8,,458.30,,,0,"percent of total billed charges","16.8% of total billed charges",3410,100,,2728.00,,,0,"percent of total billed charges","100% of total billed charges",521.73,3410,
"TOURNIQUET STERILE 34",491589,CDM,272,RC,,,OUTPATIENT,,,3410,2216.5,,3000.8,88,,2400.64,,,0,"percent of total billed charges","88% of total billed charges",1705,50,,1364.00,,,0,"percent of total billed charges","50% of total billed charges",572.88,16.8,,458.30,,,0,"percent of total billed charges","16.8% of total billed charges",3410,100,,2728.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.07,17.304,,472.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2148.3,63,,1718.64,,,0,"percent of total billed charges","63% of total billed charges",521.73,15.3,,417.38,,,0,"percent of total billed charges","15.3% of total billed charges",572.88,16.8,,458.30,,,0,"percent of total billed charges","16.8% of total billed charges",2352.9,69,,,,,0,"fee schedule","69% of total billed charges",3410,100,,2728.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3410,100,,2728.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3410,100,,2728.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2109.09,61.85,,1687.27,,,0,"percent of total billed charges","61.5% of total billed charges",572.88,16.8,,458.30,,,0,"percent of total billed charges","16.8% of total billed charges",1705,50,,1364.00,,,0,"percent of total billed charges","50% of total billed charges",1098.02,32.2,,878.42,,,0,"percent of total billed charges","32.2% of total billed charges",572.88,16.8,,458.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.34,17.136,,467.47,,,0,"percent of total billed charges","17.136% of total billed charges",744.74,21.84,,595.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1285.57,37.7,,1028.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2659.8,78,,2127.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2816.66,82.6,,2253.33,,,0,"percent of total billed charges","82.6% of total billed charges",572.88,16.8,,458.30,,,0,"percent of total billed charges","16.8% of total billed charges",1705,50,,1364.00,,,0,"percent of total billed charges","50% of total billed charges",2816.66,82.6,,2253.33,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",572.88,16.8,,458.30,,,0,"percent of total billed charges","16.8% of total billed charges",3410,100,,2728.00,,,0,"percent of total billed charges","100% of total billed charges",521.73,3410,
"TOURNIQUET PNEUM TOURNI-COT XLG BLUE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"TOURNI-COT DIGITAL TOURNIQUESTS",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"TOWEL DISP NON STERILE 27 X 17 IN WHITE",451804,CDM,272,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"TOWEL OR BLUE N/S 16X26 INCH",80187,CDM,270,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"TOWEL OR BLUE ST 8/PK",274814,CDM,270,RC,,,OUTPATIENT,,,30,19.5,,26.4,88,,21.12,,,0,"percent of total billed charges","88% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.19,17.304,,4.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.9,63,,15.12,,,0,"percent of total billed charges","63% of total billed charges",4.59,15.3,,3.67,,,0,"percent of total billed charges","15.3% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",20.7,69,,,,,0,"fee schedule","69% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.56,61.85,,14.85,,,0,"percent of total billed charges","61.5% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",9.66,32.2,,7.73,,,0,"percent of total billed charges","32.2% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.14,17.136,,4.11,,,0,"percent of total billed charges","17.136% of total billed charges",6.55,21.84,,5.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.31,37.7,,9.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.4,78,,18.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",15,50,,12.00,,,0,"percent of total billed charges","50% of total billed charges",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,16.8,,4.03,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",4.59,30,
"TOWEL OR DISP BLUE 4/PK STERILE",327290,CDM,272,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"TOWEL PAPER ABSORBENT STERILE 13X26",107424,CDM,272,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.13,61.85,,8.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",14.87,82.6,,11.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"TOWEL NON STERILE OR DISPOSABLE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"TOWEL CLAMP STERILE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"TR BAND REG COMPRESSION DEVICE",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"TRABEXUS EB 3CC",ORSUP0051,CDM,278,RC,,,OUTPATIENT,,,8240,5356,,7251.2,88,,5800.96,,,0,"percent of total billed charges","88% of total billed charges",4120,50,,3296.00,,,0,"percent of total billed charges","50% of total billed charges",1384.32,16.8,,1107.46,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1425.85,17.304,,1140.68,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5191.2,63,,4152.96,,,0,"percent of total billed charges","63% of total billed charges",1260.72,15.3,,1008.58,,,0,"percent of total billed charges","15.3% of total billed charges",1384.32,16.8,,1107.46,,,0,"percent of total billed charges","16.8% of total billed charges",5685.6,69,,,,,0,"fee schedule","69% of total billed charges",8240,100,,6592.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8240,100,,6592.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8240,100,,6592.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5096.44,61.85,,4077.15,,,0,"percent of total billed charges","61.5% of total billed charges",1384.32,16.8,,1107.46,,,0,"percent of total billed charges","16.8% of total billed charges",4120,50,,3296.00,,,0,"percent of total billed charges","50% of total billed charges",2653.28,32.2,,2122.62,,,0,"percent of total billed charges","32.2% of total billed charges",2570.88,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1412.01,17.136,,1129.61,,,0,"percent of total billed charges","17.136% of total billed charges",1799.62,21.84,,1439.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3106.48,37.7,,2485.18,,,0,"percent of total billed charges","37.7% of total billed charges",3106.48,37.7,,2485.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2793.36,33.9,,2234.69,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427.2,78,,5141.76,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6806.24,82.6,,5444.99,,,0,"percent of total billed charges","82.6% of total billed charges",1384.32,16.8,,1107.46,,,0,"percent of total billed charges","16.8% of total billed charges",4120,50,,3296.00,,,0,"percent of total billed charges","50% of total billed charges",6806.24,82.6,,5444.99,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1384.32,16.8,,1107.46,,,0,"percent of total billed charges","16.8% of total billed charges",8240,100,,6592.00,,,0,"percent of total billed charges","100% of total billed charges",1260.72,8240,
"TRABEXUS ED 5CC",ORSUP0071,CDM,278,RC,,,OUTPATIENT,,,12566,8167.9,,11058.08,88,,8846.46,,,0,"percent of total billed charges","88% of total billed charges",6283,50,,5026.40,,,0,"percent of total billed charges","50% of total billed charges",2111.09,16.8,,1688.87,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2174.42,17.304,,1739.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7916.58,63,,6333.26,,,0,"percent of total billed charges","63% of total billed charges",1922.6,15.3,,1538.08,,,0,"percent of total billed charges","15.3% of total billed charges",2111.09,16.8,,1688.87,,,0,"percent of total billed charges","16.8% of total billed charges",8670.54,69,,,,,0,"fee schedule","69% of total billed charges",12566,100,,10052.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12566,100,,10052.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12566,100,,10052.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7772.07,61.85,,6217.66,,,0,"percent of total billed charges","61.5% of total billed charges",2111.09,16.8,,1688.87,,,0,"percent of total billed charges","16.8% of total billed charges",6283,50,,5026.40,,,0,"percent of total billed charges","50% of total billed charges",4046.25,32.2,,3237.00,,,0,"percent of total billed charges","32.2% of total billed charges",3920.59,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2153.31,17.136,,1722.65,,,0,"percent of total billed charges","17.136% of total billed charges",2744.41,21.84,,2195.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4737.38,37.7,,3789.90,,,0,"percent of total billed charges","37.7% of total billed charges",4737.38,37.7,,3789.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4259.87,33.9,,3407.90,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",9801.48,78,,7841.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10379.52,82.6,,8303.62,,,0,"percent of total billed charges","82.6% of total billed charges",2111.09,16.8,,1688.87,,,0,"percent of total billed charges","16.8% of total billed charges",6283,50,,5026.40,,,0,"percent of total billed charges","50% of total billed charges",10379.52,82.6,,8303.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2111.09,16.8,,1688.87,,,0,"percent of total billed charges","16.8% of total billed charges",12566,100,,10052.80,,,0,"percent of total billed charges","100% of total billed charges",1922.6,12566,
"TRACH TUBE CUFFLESS/FEN SZ 6",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"TRACH TUBE FOME CUFF BIVONA 8",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"TRACH SHILEY ADULT SZ. 10",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"TRACH SHILEY 6.0 CUFFLESS",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"TRADITIONAL MARYLAND DISS. TIP",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"TRANSVAGINAL TAPE ADVANTAGE FIT",ORSUP0043,CDM,278,RC,,,OUTPATIENT,,,8570,5570.5,,7541.6,88,,6033.28,,,0,"percent of total billed charges","88% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1482.95,17.304,,1186.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5399.1,63,,4319.28,,,0,"percent of total billed charges","63% of total billed charges",1311.21,15.3,,1048.97,,,0,"percent of total billed charges","15.3% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",5913.3,69,,,,,0,"fee schedule","69% of total billed charges",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5300.55,61.85,,4240.44,,,0,"percent of total billed charges","61.5% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",2759.54,32.2,,2207.63,,,0,"percent of total billed charges","32.2% of total billed charges",2673.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1468.56,17.136,,1174.85,,,0,"percent of total billed charges","17.136% of total billed charges",1871.69,21.84,,1497.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3230.89,37.7,,2584.71,,,0,"percent of total billed charges","37.7% of total billed charges",3230.89,37.7,,2584.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2905.23,33.9,,2324.18,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6684.6,78,,5347.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7078.82,82.6,,5663.06,,,0,"percent of total billed charges","82.6% of total billed charges",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",4285,50,,3428.00,,,0,"percent of total billed charges","50% of total billed charges",7078.82,82.6,,5663.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1439.76,16.8,,1151.81,,,0,"percent of total billed charges","16.8% of total billed charges",8570,100,,6856.00,,,0,"percent of total billed charges","100% of total billed charges",1311.21,8570,
"TRANFUSION SERVICE RECORD",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"TRANSDUCER PRESSURE DISPOSABLE",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"TRANS RADIAL BAND LGR 29CM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"TRANS RADIAL BAND REG",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"TRANSPORE TAPE 1",491596,CDM,270,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"TRANSPORE TAPE 2",491597,CDM,270,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"TRANSDUCER CMI INTRAN PLUS INTRAUTERINE PRESSURE",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"TRANSPORTATION IDENTIFICATION TAG CLEAN/DIRTY",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"TRANSTIBIAL ACL WITHOUT SAWBLADE",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,824,535.6,,725.12,88,,580.10,,,0,"percent of total billed charges","88% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.58,17.304,,114.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",519.12,63,,415.30,,,0,"percent of total billed charges","63% of total billed charges",126.07,15.3,,100.86,,,0,"percent of total billed charges","15.3% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",568.56,69,,,,,0,"fee schedule","69% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.64,61.85,,407.71,,,0,"percent of total billed charges","61.5% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",265.33,32.2,,212.26,,,0,"percent of total billed charges","32.2% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",141.2,17.136,,112.96,,,0,"percent of total billed charges","17.136% of total billed charges",179.96,21.84,,143.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",310.65,37.7,,248.52,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",642.72,78,,514.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",126.07,824,
"TRAP MUCUS SPECIMEN COLLECTOR   40CC",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"TRAP POLYP",491598,CDM,270,RC,,,OUTPATIENT,,,68,44.2,,59.84,88,,47.87,,,0,"percent of total billed charges","88% of total billed charges",34,50,,27.20,,,0,"percent of total billed charges","50% of total billed charges",11.42,16.8,,9.14,,,0,"percent of total billed charges","16.8% of total billed charges",68,100,,54.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.77,17.304,,9.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.84,63,,34.27,,,0,"percent of total billed charges","63% of total billed charges",10.4,15.3,,8.32,,,0,"percent of total billed charges","15.3% of total billed charges",11.42,16.8,,9.14,,,0,"percent of total billed charges","16.8% of total billed charges",46.92,69,,,,,0,"fee schedule","69% of total billed charges",68,100,,54.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",68,100,,54.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",68,100,,54.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.06,61.85,,33.65,,,0,"percent of total billed charges","61.5% of total billed charges",11.42,16.8,,9.14,,,0,"percent of total billed charges","16.8% of total billed charges",34,50,,27.20,,,0,"percent of total billed charges","50% of total billed charges",21.9,32.2,,17.52,,,0,"percent of total billed charges","32.2% of total billed charges",11.42,16.8,,9.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.65,17.136,,9.32,,,0,"percent of total billed charges","17.136% of total billed charges",14.85,21.84,,11.88,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25.64,37.7,,20.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",53.04,78,,42.43,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.17,82.6,,44.94,,,0,"percent of total billed charges","82.6% of total billed charges",11.42,16.8,,9.14,,,0,"percent of total billed charges","16.8% of total billed charges",34,50,,27.20,,,0,"percent of total billed charges","50% of total billed charges",56.17,82.6,,44.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.42,16.8,,9.14,,,0,"percent of total billed charges","16.8% of total billed charges",68,100,,54.40,,,0,"percent of total billed charges","100% of total billed charges",10.4,68,
"TRAPESE SINGLE CHAMBER POLYP TRAP",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"TRAY CATHETER FOLEY 5CC 16FR",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"TRAY CATH BRD 16FR 2L DRNBG FOLEY STLK SIL STRL LATEX FREE",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"TRAY SURESTEP 16 FR",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"TRAY URINE DRAIN METER 153202",39774,CDM,272,RC,,,OUTPATIENT,,,45,29.25,,39.6,88,,31.68,,,0,"percent of total billed charges","88% of total billed charges",22.5,50,,18.00,,,0,"percent of total billed charges","50% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.79,17.304,,6.23,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.35,63,,22.68,,,0,"percent of total billed charges","63% of total billed charges",6.89,15.3,,5.51,,,0,"percent of total billed charges","15.3% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",31.05,69,,,,,0,"fee schedule","69% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.83,61.85,,22.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",22.5,50,,18.00,,,0,"percent of total billed charges","50% of total billed charges",14.49,32.2,,11.59,,,0,"percent of total billed charges","32.2% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.71,17.136,,6.17,,,0,"percent of total billed charges","17.136% of total billed charges",9.83,21.84,,7.86,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.97,37.7,,13.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.1,78,,28.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",22.5,50,,18.00,,,0,"percent of total billed charges","50% of total billed charges",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,16.8,,6.05,,,0,"percent of total billed charges","16.8% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",6.89,45,
"TRAY CATH HEMODIALYSIS NIAGRA TEMP 24CM STRAIGHT",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"TRAY CATH DIALYSIS TEMP 15CM DUAL CRV (OLD#5696150)",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"TRAY PERIVAC W/DRUGS 8.3F",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"TRAY CHEST TUBE THAL-QUICK 28F",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"TRAY CHEST TUBE 24FR COOK",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"TRAY  CATH SWAN-GANZ VIP 7.5FR",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"TRAY SURG PREP PVP LF 2FO SKN W/SOL",266545,CDM,270,RC,,,OUTPATIENT,,,24,15.6,,21.12,88,,16.90,,,0,"percent of total billed charges","88% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.15,17.304,,3.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.12,63,,12.10,,,0,"percent of total billed charges","63% of total billed charges",3.67,15.3,,2.94,,,0,"percent of total billed charges","15.3% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",16.56,69,,,,,0,"fee schedule","69% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.84,61.85,,11.87,,,0,"percent of total billed charges","61.5% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",7.73,32.2,,6.18,,,0,"percent of total billed charges","32.2% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.11,17.136,,3.29,,,0,"percent of total billed charges","17.136% of total billed charges",5.24,21.84,,4.19,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.05,37.7,,7.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.72,78,,14.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,24,
"TRAY SKIN SCRUB DRY PREP",14121,CDM,270,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"TRAY DRESSING CHANGE",ORSUP0002,CDM,270,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"TRAY BASIC",326408,CDM,270,RC,,,OUTPATIENT,,,313,203.45,,275.44,88,,220.35,,,0,"percent of total billed charges","88% of total billed charges",156.5,50,,125.20,,,0,"percent of total billed charges","50% of total billed charges",52.58,16.8,,42.06,,,0,"percent of total billed charges","16.8% of total billed charges",313,100,,250.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54.16,17.304,,43.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",197.19,63,,157.75,,,0,"percent of total billed charges","63% of total billed charges",47.89,15.3,,38.31,,,0,"percent of total billed charges","15.3% of total billed charges",52.58,16.8,,42.06,,,0,"percent of total billed charges","16.8% of total billed charges",215.97,69,,,,,0,"fee schedule","69% of total billed charges",313,100,,250.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",313,100,,250.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",313,100,,250.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",193.59,61.85,,154.87,,,0,"percent of total billed charges","61.5% of total billed charges",52.58,16.8,,42.06,,,0,"percent of total billed charges","16.8% of total billed charges",156.5,50,,125.20,,,0,"percent of total billed charges","50% of total billed charges",100.79,32.2,,80.63,,,0,"percent of total billed charges","32.2% of total billed charges",52.58,16.8,,42.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.64,17.136,,42.91,,,0,"percent of total billed charges","17.136% of total billed charges",68.36,21.84,,54.69,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",118,37.7,,94.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",244.14,78,,195.31,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.54,82.6,,206.83,,,0,"percent of total billed charges","82.6% of total billed charges",52.58,16.8,,42.06,,,0,"percent of total billed charges","16.8% of total billed charges",156.5,50,,125.20,,,0,"percent of total billed charges","50% of total billed charges",258.54,82.6,,206.83,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.58,16.8,,42.06,,,0,"percent of total billed charges","16.8% of total billed charges",313,100,,250.40,,,0,"percent of total billed charges","100% of total billed charges",47.89,313,
"TRAY C SECTION",182456,CDM,270,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"TRAY ENT",326409,CDM,270,RC,,,OUTPATIENT,,,320,208,,281.6,88,,225.28,,,0,"percent of total billed charges","88% of total billed charges",160,50,,128.00,,,0,"percent of total billed charges","50% of total billed charges",53.76,16.8,,43.01,,,0,"percent of total billed charges","16.8% of total billed charges",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",55.37,17.304,,44.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",201.6,63,,161.28,,,0,"percent of total billed charges","63% of total billed charges",48.96,15.3,,39.17,,,0,"percent of total billed charges","15.3% of total billed charges",53.76,16.8,,43.01,,,0,"percent of total billed charges","16.8% of total billed charges",220.8,69,,,,,0,"fee schedule","69% of total billed charges",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",197.92,61.85,,158.34,,,0,"percent of total billed charges","61.5% of total billed charges",53.76,16.8,,43.01,,,0,"percent of total billed charges","16.8% of total billed charges",160,50,,128.00,,,0,"percent of total billed charges","50% of total billed charges",103.04,32.2,,82.43,,,0,"percent of total billed charges","32.2% of total billed charges",53.76,16.8,,43.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",54.84,17.136,,43.87,,,0,"percent of total billed charges","17.136% of total billed charges",69.89,21.84,,55.91,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.64,37.7,,96.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",249.6,78,,199.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",264.32,82.6,,211.46,,,0,"percent of total billed charges","82.6% of total billed charges",53.76,16.8,,43.01,,,0,"percent of total billed charges","16.8% of total billed charges",160,50,,128.00,,,0,"percent of total billed charges","50% of total billed charges",264.32,82.6,,211.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.76,16.8,,43.01,,,0,"percent of total billed charges","16.8% of total billed charges",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",48.96,320,
"TRAY GENERAL PURPOSE 20/CS",42176,CDM,270,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.9,61.85,,7.92,,,0,"percent of total billed charges","61.5% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"TRAY THORACIC",326395,CDM,270,RC,,,OUTPATIENT,,,1371,891.15,,1206.48,88,,965.18,,,0,"percent of total billed charges","88% of total billed charges",685.5,50,,548.40,,,0,"percent of total billed charges","50% of total billed charges",230.33,16.8,,184.26,,,0,"percent of total billed charges","16.8% of total billed charges",1371,100,,1096.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",237.24,17.304,,189.79,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",863.73,63,,690.98,,,0,"percent of total billed charges","63% of total billed charges",209.76,15.3,,167.81,,,0,"percent of total billed charges","15.3% of total billed charges",230.33,16.8,,184.26,,,0,"percent of total billed charges","16.8% of total billed charges",945.99,69,,,,,0,"fee schedule","69% of total billed charges",1371,100,,1096.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1371,100,,1096.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1371,100,,1096.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",847.96,61.85,,678.37,,,0,"percent of total billed charges","61.5% of total billed charges",230.33,16.8,,184.26,,,0,"percent of total billed charges","16.8% of total billed charges",685.5,50,,548.40,,,0,"percent of total billed charges","50% of total billed charges",441.46,32.2,,353.17,,,0,"percent of total billed charges","32.2% of total billed charges",230.33,16.8,,184.26,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",234.93,17.136,,187.94,,,0,"percent of total billed charges","17.136% of total billed charges",299.43,21.84,,239.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",516.87,37.7,,413.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1069.38,78,,855.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1132.45,82.6,,905.96,,,0,"percent of total billed charges","82.6% of total billed charges",230.33,16.8,,184.26,,,0,"percent of total billed charges","16.8% of total billed charges",685.5,50,,548.40,,,0,"percent of total billed charges","50% of total billed charges",1132.45,82.6,,905.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",230.33,16.8,,184.26,,,0,"percent of total billed charges","16.8% of total billed charges",1371,100,,1096.80,,,0,"percent of total billed charges","100% of total billed charges",209.76,1371,
"TRAY OASIS SCOPE TRANSPORT",420935,CDM,272,RC,,,OUTPATIENT,,,27,17.55,,23.76,88,,19.01,,,0,"percent of total billed charges","88% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.67,17.304,,3.74,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.01,63,,13.61,,,0,"percent of total billed charges","63% of total billed charges",4.13,15.3,,3.30,,,0,"percent of total billed charges","15.3% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",18.63,69,,,,,0,"fee schedule","69% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.7,61.85,,13.36,,,0,"percent of total billed charges","61.5% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",8.69,32.2,,6.95,,,0,"percent of total billed charges","32.2% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.63,17.136,,3.70,,,0,"percent of total billed charges","17.136% of total billed charges",5.9,21.84,,4.72,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.18,37.7,,8.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.06,78,,16.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.3,82.6,,17.84,,,0,"percent of total billed charges","82.6% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",22.3,82.6,,17.84,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",4.13,27,
"TRAY PARACENTESIS/THORCENTESIS",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,328,213.2,,288.64,88,,230.91,,,0,"percent of total billed charges","88% of total billed charges",164,50,,131.20,,,0,"percent of total billed charges","50% of total billed charges",55.1,16.8,,44.08,,,0,"percent of total billed charges","16.8% of total billed charges",328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.76,17.304,,45.41,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.64,63,,165.31,,,0,"percent of total billed charges","63% of total billed charges",50.18,15.3,,40.14,,,0,"percent of total billed charges","15.3% of total billed charges",55.1,16.8,,44.08,,,0,"percent of total billed charges","16.8% of total billed charges",226.32,69,,,,,0,"fee schedule","69% of total billed charges",328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.87,61.85,,162.30,,,0,"percent of total billed charges","61.5% of total billed charges",55.1,16.8,,44.08,,,0,"percent of total billed charges","16.8% of total billed charges",164,50,,131.20,,,0,"percent of total billed charges","50% of total billed charges",105.62,32.2,,84.50,,,0,"percent of total billed charges","32.2% of total billed charges",55.1,16.8,,44.08,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.21,17.136,,44.97,,,0,"percent of total billed charges","17.136% of total billed charges",71.64,21.84,,57.31,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",123.66,37.7,,98.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",255.84,78,,204.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",270.93,82.6,,216.74,,,0,"percent of total billed charges","82.6% of total billed charges",55.1,16.8,,44.08,,,0,"percent of total billed charges","16.8% of total billed charges",164,50,,131.20,,,0,"percent of total billed charges","50% of total billed charges",270.93,82.6,,216.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",55.1,16.8,,44.08,,,0,"percent of total billed charges","16.8% of total billed charges",328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",50.18,328,
"TRAY BONE MARROW BIOPSY AND ASPIRATION",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"TRAY CHOLECYSTECTOMY",258031,CDM,272,RC,,,OUTPATIENT,,,1731,1125.15,,1523.28,88,,1218.62,,,0,"percent of total billed charges","88% of total billed charges",865.5,50,,692.40,,,0,"percent of total billed charges","50% of total billed charges",290.81,16.8,,232.65,,,0,"percent of total billed charges","16.8% of total billed charges",1731,100,,1384.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",299.53,17.304,,239.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1090.53,63,,872.42,,,0,"percent of total billed charges","63% of total billed charges",264.84,15.3,,211.87,,,0,"percent of total billed charges","15.3% of total billed charges",290.81,16.8,,232.65,,,0,"percent of total billed charges","16.8% of total billed charges",1194.39,69,,,,,0,"fee schedule","69% of total billed charges",1731,100,,1384.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1731,100,,1384.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1731,100,,1384.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1070.62,61.85,,856.50,,,0,"percent of total billed charges","61.5% of total billed charges",290.81,16.8,,232.65,,,0,"percent of total billed charges","16.8% of total billed charges",865.5,50,,692.40,,,0,"percent of total billed charges","50% of total billed charges",557.38,32.2,,445.90,,,0,"percent of total billed charges","32.2% of total billed charges",290.81,16.8,,232.65,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",296.62,17.136,,237.30,,,0,"percent of total billed charges","17.136% of total billed charges",378.05,21.84,,302.44,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",652.59,37.7,,522.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1350.18,78,,1080.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1429.81,82.6,,1143.85,,,0,"percent of total billed charges","82.6% of total billed charges",290.81,16.8,,232.65,,,0,"percent of total billed charges","16.8% of total billed charges",865.5,50,,692.40,,,0,"percent of total billed charges","50% of total billed charges",1429.81,82.6,,1143.85,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.81,16.8,,232.65,,,0,"percent of total billed charges","16.8% of total billed charges",1731,100,,1384.80,,,0,"percent of total billed charges","100% of total billed charges",264.84,1731,
"TRAY EXPANDER 15/3",ORSUP0072,CDM,272,RC,,,OUTPATIENT,,,16604,10792.6,,14611.52,88,,11689.22,,,0,"percent of total billed charges","88% of total billed charges",8302,50,,6641.60,,,0,"percent of total billed charges","50% of total billed charges",2789.47,16.8,,2231.58,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2873.16,17.304,,2298.53,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10460.52,63,,8368.42,,,0,"percent of total billed charges","63% of total billed charges",2540.41,15.3,,2032.33,,,0,"percent of total billed charges","15.3% of total billed charges",2789.47,16.8,,2231.58,,,0,"percent of total billed charges","16.8% of total billed charges",11456.76,69,,,,,0,"fee schedule","69% of total billed charges",16604,100,,13283.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16604,100,,13283.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16604,100,,13283.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10269.57,61.85,,8215.66,,,0,"percent of total billed charges","61.5% of total billed charges",2789.47,16.8,,2231.58,,,0,"percent of total billed charges","16.8% of total billed charges",8302,50,,6641.60,,,0,"percent of total billed charges","50% of total billed charges",5346.49,32.2,,4277.19,,,0,"percent of total billed charges","32.2% of total billed charges",2789.47,16.8,,2231.58,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2845.26,17.136,,2276.21,,,0,"percent of total billed charges","17.136% of total billed charges",3626.31,21.84,,2901.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6259.71,37.7,,5007.77,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12951.12,78,,10360.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13714.9,82.6,,10971.92,,,0,"percent of total billed charges","82.6% of total billed charges",2789.47,16.8,,2231.58,,,0,"percent of total billed charges","16.8% of total billed charges",8302,50,,6641.60,,,0,"percent of total billed charges","50% of total billed charges",13714.9,82.6,,10971.92,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2789.47,16.8,,2231.58,,,0,"percent of total billed charges","16.8% of total billed charges",16604,100,,13283.20,,,0,"percent of total billed charges","100% of total billed charges",2540.41,16604,
"TRAY EXPANDER 20/3",ORSUP0074,CDM,272,RC,,,OUTPATIENT,,,17139,11140.35,,15082.32,88,,12065.86,,,0,"percent of total billed charges","88% of total billed charges",8569.5,50,,6855.60,,,0,"percent of total billed charges","50% of total billed charges",2879.35,16.8,,2303.48,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2965.73,17.304,,2372.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10797.57,63,,8638.06,,,0,"percent of total billed charges","63% of total billed charges",2622.27,15.3,,2097.82,,,0,"percent of total billed charges","15.3% of total billed charges",2879.35,16.8,,2303.48,,,0,"percent of total billed charges","16.8% of total billed charges",11825.91,69,,,,,0,"fee schedule","69% of total billed charges",17139,100,,13711.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17139,100,,13711.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17139,100,,13711.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10600.47,61.85,,8480.38,,,0,"percent of total billed charges","61.5% of total billed charges",2879.35,16.8,,2303.48,,,0,"percent of total billed charges","16.8% of total billed charges",8569.5,50,,6855.60,,,0,"percent of total billed charges","50% of total billed charges",5518.76,32.2,,4415.01,,,0,"percent of total billed charges","32.2% of total billed charges",2879.35,16.8,,2303.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2936.94,17.136,,2349.55,,,0,"percent of total billed charges","17.136% of total billed charges",3743.16,21.84,,2994.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6461.4,37.7,,5169.12,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13368.42,78,,10694.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14156.81,82.6,,11325.45,,,0,"percent of total billed charges","82.6% of total billed charges",2879.35,16.8,,2303.48,,,0,"percent of total billed charges","16.8% of total billed charges",8569.5,50,,6855.60,,,0,"percent of total billed charges","50% of total billed charges",14156.81,82.6,,11325.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2879.35,16.8,,2303.48,,,0,"percent of total billed charges","16.8% of total billed charges",17139,100,,13711.20,,,0,"percent of total billed charges","100% of total billed charges",2622.27,17139,
"TRAY KYPHO PAK XPANDER II 15/3 ADD FRACTURE",ORSUP0075,CDM,272,RC,,,OUTPATIENT,,,13390,8703.5,,11783.2,88,,9426.56,,,0,"percent of total billed charges","88% of total billed charges",6695,50,,5356.00,,,0,"percent of total billed charges","50% of total billed charges",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2317.01,17.304,,1853.61,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8435.7,63,,6748.56,,,0,"percent of total billed charges","63% of total billed charges",2048.67,15.3,,1638.94,,,0,"percent of total billed charges","15.3% of total billed charges",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",9239.1,69,,,,,0,"fee schedule","69% of total billed charges",13390,100,,10712.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13390,100,,10712.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13390,100,,10712.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8281.72,61.85,,6625.38,,,0,"percent of total billed charges","61.5% of total billed charges",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",6695,50,,5356.00,,,0,"percent of total billed charges","50% of total billed charges",4311.58,32.2,,3449.26,,,0,"percent of total billed charges","32.2% of total billed charges",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2294.51,17.136,,1835.61,,,0,"percent of total billed charges","17.136% of total billed charges",2924.38,21.84,,2339.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5048.03,37.7,,4038.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10444.2,78,,8355.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11060.14,82.6,,8848.11,,,0,"percent of total billed charges","82.6% of total billed charges",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",6695,50,,5356.00,,,0,"percent of total billed charges","50% of total billed charges",11060.14,82.6,,8848.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2249.52,16.8,,1799.62,,,0,"percent of total billed charges","16.8% of total billed charges",13390,100,,10712.00,,,0,"percent of total billed charges","100% of total billed charges",2048.67,13390,
"TRAY SPINAL",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"TRAY UROLOGIST",ORSUP0010,CDM,270,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"TRAY CATH 16FR W/ DRAIN BAG",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"TRAY CATH 16FR W/URINE METER",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"TRAY LINER",491601,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"TRAY CATH FOLEY 16FR W/TEMP SENSOR",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,17.304,,49.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.28,61.85,,178.62,,,0,"percent of total billed charges","61.5% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",116.24,32.2,,92.99,,,0,"percent of total billed charges","32.2% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.86,17.136,,49.49,,,0,"percent of total billed charges","17.136% of total billed charges",78.84,21.84,,63.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,361,
"TRAY ENDO TRANSPORT",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"TRAY PNEUMOPERICARDIAL",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"TRAY FOLEY CATH SILICONE 1 LAYER W/DRAIN BAG",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"TRAY STANDARD TUBE",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"TRAY LACERATION STERILE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"TRAY URETHRAL CLOSED SYS 14FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"TRAY KYPHON PAK XPANDER II 20/2 KIT",ORSUP0073,CDM,272,RC,,,OUTPATIENT,,,12978,8435.7,,11420.64,88,,9136.51,,,0,"percent of total billed charges","88% of total billed charges",6489,50,,5191.20,,,0,"percent of total billed charges","50% of total billed charges",2180.3,16.8,,1744.24,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2245.71,17.304,,1796.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8176.14,63,,6540.91,,,0,"percent of total billed charges","63% of total billed charges",1985.63,15.3,,1588.50,,,0,"percent of total billed charges","15.3% of total billed charges",2180.3,16.8,,1744.24,,,0,"percent of total billed charges","16.8% of total billed charges",8954.82,69,,,,,0,"fee schedule","69% of total billed charges",12978,100,,10382.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12978,100,,10382.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12978,100,,10382.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8026.89,61.85,,6421.51,,,0,"percent of total billed charges","61.5% of total billed charges",2180.3,16.8,,1744.24,,,0,"percent of total billed charges","16.8% of total billed charges",6489,50,,5191.20,,,0,"percent of total billed charges","50% of total billed charges",4178.92,32.2,,3343.14,,,0,"percent of total billed charges","32.2% of total billed charges",2180.3,16.8,,1744.24,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2223.91,17.136,,1779.13,,,0,"percent of total billed charges","17.136% of total billed charges",2834.4,21.84,,2267.52,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4892.71,37.7,,3914.17,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10122.84,78,,8098.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10719.83,82.6,,8575.86,,,0,"percent of total billed charges","82.6% of total billed charges",2180.3,16.8,,1744.24,,,0,"percent of total billed charges","16.8% of total billed charges",6489,50,,5191.20,,,0,"percent of total billed charges","50% of total billed charges",10719.83,82.6,,8575.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2180.3,16.8,,1744.24,,,0,"percent of total billed charges","16.8% of total billed charges",12978,100,,10382.40,,,0,"percent of total billed charges","100% of total billed charges",1985.63,12978,
"TRIAGE METERPRO CARDIAC PANEL TROPONIN CK-MB",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"TRIAGE METERPRO CARDIAC PANEL TROPONIN",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"TRIGLYCERIDES /5 PACK /300 SLDS",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"TRIPLE TRANSDUCER WITH VAMP PLUS",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"TROCAR NAIL FIX CANNLTED 11MM 130D 40MM LEFT STRL",ORSUP0048,CDM,278,RC,,,OUTPATIENT,,,9909,6440.85,,8719.92,88,,6975.94,,,0,"percent of total billed charges","88% of total billed charges",4954.5,50,,3963.60,,,0,"percent of total billed charges","50% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1714.65,17.304,,1371.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6242.67,63,,4994.14,,,0,"percent of total billed charges","63% of total billed charges",1516.08,15.3,,1212.86,,,0,"percent of total billed charges","15.3% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",6837.21,69,,,,,0,"fee schedule","69% of total billed charges",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6128.72,61.85,,4902.98,,,0,"percent of total billed charges","61.5% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",4954.5,50,,3963.60,,,0,"percent of total billed charges","50% of total billed charges",3190.7,32.2,,2552.56,,,0,"percent of total billed charges","32.2% of total billed charges",3091.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1698.01,17.136,,1358.41,,,0,"percent of total billed charges","17.136% of total billed charges",2164.13,21.84,,1731.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3735.69,37.7,,2988.55,,,0,"percent of total billed charges","37.7% of total billed charges",3735.69,37.7,,2988.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3359.15,33.9,,2687.32,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7729.02,78,,6183.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8184.83,82.6,,6547.86,,,0,"percent of total billed charges","82.6% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",4954.5,50,,3963.60,,,0,"percent of total billed charges","50% of total billed charges",8184.83,82.6,,6547.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",1516.08,9909,
"TROCAR W/SLEEVE BLUNT TIP 12MM X 100MM",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"TROCAR W/SLEEVE BLADELESS 5MM X 100MM",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"TROCAR W/SLEEVE BLADELESS 12MM X 150MM  XLONG",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"TROCAR W/SLEEVE BLADELESS 12MM X 100MM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"TROCAR LAPSCP 100MM X 5MM EPATH EXCEL BLDLS OPTCL SMOOTH SLEEVE",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"TROCAR EXCEL W/BLADE 5MM",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"TROCAR EXCEL W/BLADE 12MM",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"TROCAR LAPAROSCOPIC L100 MM OD11 MM ENDOPATH XCEL BLADELESS",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"TROCAR W/SLEEVE BLADELESS 11MM X 100MM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"TROCAR EXCEL W/BLADE 11MM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"TROCAR  5X100MM Z-THR OPTICAL SEP SYS",ORSUP0026,CDM,272,RC,,,OUTPATIENT,,,3090,2008.5,,2719.2,88,,2175.36,,,0,"percent of total billed charges","88% of total billed charges",1545,50,,1236.00,,,0,"percent of total billed charges","50% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",534.69,17.304,,427.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1946.7,63,,1557.36,,,0,"percent of total billed charges","63% of total billed charges",472.77,15.3,,378.22,,,0,"percent of total billed charges","15.3% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",2132.1,69,,,,,0,"fee schedule","69% of total billed charges",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1911.17,61.85,,1528.94,,,0,"percent of total billed charges","61.5% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",1545,50,,1236.00,,,0,"percent of total billed charges","50% of total billed charges",994.98,32.2,,795.98,,,0,"percent of total billed charges","32.2% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",529.5,17.136,,423.60,,,0,"percent of total billed charges","17.136% of total billed charges",674.86,21.84,,539.89,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1164.93,37.7,,931.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2410.2,78,,1928.16,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2552.34,82.6,,2041.87,,,0,"percent of total billed charges","82.6% of total billed charges",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",1545,50,,1236.00,,,0,"percent of total billed charges","50% of total billed charges",2552.34,82.6,,2041.87,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",519.12,16.8,,415.30,,,0,"percent of total billed charges","16.8% of total billed charges",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",472.77,3090,
"TROCAR ADVANCED FIXATION 12 X 150 MM",331933,CDM,272,RC,,,OUTPATIENT,,,992,644.8,,872.96,88,,698.37,,,0,"percent of total billed charges","88% of total billed charges",496,50,,396.80,,,0,"percent of total billed charges","50% of total billed charges",166.66,16.8,,133.33,,,0,"percent of total billed charges","16.8% of total billed charges",992,100,,793.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",171.66,17.304,,137.33,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",624.96,63,,499.97,,,0,"percent of total billed charges","63% of total billed charges",151.78,15.3,,121.42,,,0,"percent of total billed charges","15.3% of total billed charges",166.66,16.8,,133.33,,,0,"percent of total billed charges","16.8% of total billed charges",684.48,69,,,,,0,"fee schedule","69% of total billed charges",992,100,,793.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",992,100,,793.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",992,100,,793.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",613.55,61.85,,490.84,,,0,"percent of total billed charges","61.5% of total billed charges",166.66,16.8,,133.33,,,0,"percent of total billed charges","16.8% of total billed charges",496,50,,396.80,,,0,"percent of total billed charges","50% of total billed charges",319.42,32.2,,255.54,,,0,"percent of total billed charges","32.2% of total billed charges",166.66,16.8,,133.33,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",169.99,17.136,,135.99,,,0,"percent of total billed charges","17.136% of total billed charges",216.65,21.84,,173.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",373.98,37.7,,299.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",773.76,78,,619.01,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",819.39,82.6,,655.51,,,0,"percent of total billed charges","82.6% of total billed charges",166.66,16.8,,133.33,,,0,"percent of total billed charges","16.8% of total billed charges",496,50,,396.80,,,0,"percent of total billed charges","50% of total billed charges",819.39,82.6,,655.51,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.66,16.8,,133.33,,,0,"percent of total billed charges","16.8% of total billed charges",992,100,,793.60,,,0,"percent of total billed charges","100% of total billed charges",151.78,992,
"TROCAR BLADELESS 15MM",187505,CDM,272,RC,,,OUTPATIENT,,,3224,2095.6,,2837.12,88,,2269.70,,,0,"percent of total billed charges","88% of total billed charges",1612,50,,1289.60,,,0,"percent of total billed charges","50% of total billed charges",541.63,16.8,,433.30,,,0,"percent of total billed charges","16.8% of total billed charges",3224,100,,2579.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",557.88,17.304,,446.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2031.12,63,,1624.90,,,0,"percent of total billed charges","63% of total billed charges",493.27,15.3,,394.62,,,0,"percent of total billed charges","15.3% of total billed charges",541.63,16.8,,433.30,,,0,"percent of total billed charges","16.8% of total billed charges",2224.56,69,,,,,0,"fee schedule","69% of total billed charges",3224,100,,2579.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3224,100,,2579.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3224,100,,2579.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1994.04,61.85,,1595.23,,,0,"percent of total billed charges","61.5% of total billed charges",541.63,16.8,,433.30,,,0,"percent of total billed charges","16.8% of total billed charges",1612,50,,1289.60,,,0,"percent of total billed charges","50% of total billed charges",1038.13,32.2,,830.50,,,0,"percent of total billed charges","32.2% of total billed charges",541.63,16.8,,433.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",552.46,17.136,,441.97,,,0,"percent of total billed charges","17.136% of total billed charges",704.12,21.84,,563.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1215.45,37.7,,972.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2514.72,78,,2011.78,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2663.02,82.6,,2130.42,,,0,"percent of total billed charges","82.6% of total billed charges",541.63,16.8,,433.30,,,0,"percent of total billed charges","16.8% of total billed charges",1612,50,,1289.60,,,0,"percent of total billed charges","50% of total billed charges",2663.02,82.6,,2130.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",541.63,16.8,,433.30,,,0,"percent of total billed charges","16.8% of total billed charges",3224,100,,2579.20,,,0,"percent of total billed charges","100% of total billed charges",493.27,3224,
"TROCAR BLADELESS EXCEL B11LT REPROCESSED",255655R,CDM,272,RC,,,OUTPATIENT,,,276,179.4,,242.88,88,,194.30,,,0,"percent of total billed charges","88% of total billed charges",138,50,,110.40,,,0,"percent of total billed charges","50% of total billed charges",46.37,16.8,,37.10,,,0,"percent of total billed charges","16.8% of total billed charges",276,100,,220.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.76,17.304,,38.21,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.88,63,,139.10,,,0,"percent of total billed charges","63% of total billed charges",42.23,15.3,,33.78,,,0,"percent of total billed charges","15.3% of total billed charges",46.37,16.8,,37.10,,,0,"percent of total billed charges","16.8% of total billed charges",190.44,69,,,,,0,"fee schedule","69% of total billed charges",276,100,,220.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",276,100,,220.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",276,100,,220.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.71,61.85,,136.57,,,0,"percent of total billed charges","61.5% of total billed charges",46.37,16.8,,37.10,,,0,"percent of total billed charges","16.8% of total billed charges",138,50,,110.40,,,0,"percent of total billed charges","50% of total billed charges",88.87,32.2,,71.10,,,0,"percent of total billed charges","32.2% of total billed charges",46.37,16.8,,37.10,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.3,17.136,,37.84,,,0,"percent of total billed charges","17.136% of total billed charges",60.28,21.84,,48.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.05,37.7,,83.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",215.28,78,,172.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.98,82.6,,182.38,,,0,"percent of total billed charges","82.6% of total billed charges",46.37,16.8,,37.10,,,0,"percent of total billed charges","16.8% of total billed charges",138,50,,110.40,,,0,"percent of total billed charges","50% of total billed charges",227.98,82.6,,182.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,16.8,,37.10,,,0,"percent of total billed charges","16.8% of total billed charges",276,100,,220.80,,,0,"percent of total billed charges","100% of total billed charges",42.23,276,
"TROCAR FIOS KII OPTIMA  12X150MM",353966,CDM,272,RC,,,OUTPATIENT,,,579,376.35,,509.52,88,,407.62,,,0,"percent of total billed charges","88% of total billed charges",289.5,50,,231.60,,,0,"percent of total billed charges","50% of total billed charges",97.27,16.8,,77.82,,,0,"percent of total billed charges","16.8% of total billed charges",579,100,,463.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",100.19,17.304,,80.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",364.77,63,,291.82,,,0,"percent of total billed charges","63% of total billed charges",88.59,15.3,,70.87,,,0,"percent of total billed charges","15.3% of total billed charges",97.27,16.8,,77.82,,,0,"percent of total billed charges","16.8% of total billed charges",399.51,69,,,,,0,"fee schedule","69% of total billed charges",579,100,,463.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579,100,,463.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579,100,,463.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",358.11,61.85,,286.49,,,0,"percent of total billed charges","61.5% of total billed charges",97.27,16.8,,77.82,,,0,"percent of total billed charges","16.8% of total billed charges",289.5,50,,231.60,,,0,"percent of total billed charges","50% of total billed charges",186.44,32.2,,149.15,,,0,"percent of total billed charges","32.2% of total billed charges",97.27,16.8,,77.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",99.22,17.136,,79.38,,,0,"percent of total billed charges","17.136% of total billed charges",126.45,21.84,,101.16,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",218.28,37.7,,174.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",451.62,78,,361.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",478.25,82.6,,382.60,,,0,"percent of total billed charges","82.6% of total billed charges",97.27,16.8,,77.82,,,0,"percent of total billed charges","16.8% of total billed charges",289.5,50,,231.60,,,0,"percent of total billed charges","50% of total billed charges",478.25,82.6,,382.60,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.27,16.8,,77.82,,,0,"percent of total billed charges","16.8% of total billed charges",579,100,,463.20,,,0,"percent of total billed charges","100% of total billed charges",88.59,579,
"TROCAR GELPORT BALLOON 12MMX100MM",311644,CDM,272,RC,,,OUTPATIENT,,,240,156,,211.2,88,,168.96,,,0,"percent of total billed charges","88% of total billed charges",120,50,,96.00,,,0,"percent of total billed charges","50% of total billed charges",40.32,16.8,,32.26,,,0,"percent of total billed charges","16.8% of total billed charges",240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.53,17.304,,33.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.2,63,,120.96,,,0,"percent of total billed charges","63% of total billed charges",36.72,15.3,,29.38,,,0,"percent of total billed charges","15.3% of total billed charges",40.32,16.8,,32.26,,,0,"percent of total billed charges","16.8% of total billed charges",165.6,69,,,,,0,"fee schedule","69% of total billed charges",240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",148.44,61.85,,118.75,,,0,"percent of total billed charges","61.5% of total billed charges",40.32,16.8,,32.26,,,0,"percent of total billed charges","16.8% of total billed charges",120,50,,96.00,,,0,"percent of total billed charges","50% of total billed charges",77.28,32.2,,61.82,,,0,"percent of total billed charges","32.2% of total billed charges",40.32,16.8,,32.26,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.13,17.136,,32.90,,,0,"percent of total billed charges","17.136% of total billed charges",52.42,21.84,,41.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",90.48,37.7,,72.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",187.2,78,,149.76,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",198.24,82.6,,158.59,,,0,"percent of total billed charges","82.6% of total billed charges",40.32,16.8,,32.26,,,0,"percent of total billed charges","16.8% of total billed charges",120,50,,96.00,,,0,"percent of total billed charges","50% of total billed charges",198.24,82.6,,158.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.32,16.8,,32.26,,,0,"percent of total billed charges","16.8% of total billed charges",240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",36.72,240,
"TROCAR HASSON 12 X 100MM",189090,CDM,272,RC,,,OUTPATIENT,,,579,376.35,,509.52,88,,407.62,,,0,"percent of total billed charges","88% of total billed charges",289.5,50,,231.60,,,0,"percent of total billed charges","50% of total billed charges",97.27,16.8,,77.82,,,0,"percent of total billed charges","16.8% of total billed charges",579,100,,463.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",100.19,17.304,,80.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",364.77,63,,291.82,,,0,"percent of total billed charges","63% of total billed charges",88.59,15.3,,70.87,,,0,"percent of total billed charges","15.3% of total billed charges",97.27,16.8,,77.82,,,0,"percent of total billed charges","16.8% of total billed charges",399.51,69,,,,,0,"fee schedule","69% of total billed charges",579,100,,463.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579,100,,463.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579,100,,463.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",358.11,61.85,,286.49,,,0,"percent of total billed charges","61.5% of total billed charges",97.27,16.8,,77.82,,,0,"percent of total billed charges","16.8% of total billed charges",289.5,50,,231.60,,,0,"percent of total billed charges","50% of total billed charges",186.44,32.2,,149.15,,,0,"percent of total billed charges","32.2% of total billed charges",97.27,16.8,,77.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",99.22,17.136,,79.38,,,0,"percent of total billed charges","17.136% of total billed charges",126.45,21.84,,101.16,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",218.28,37.7,,174.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",451.62,78,,361.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",478.25,82.6,,382.60,,,0,"percent of total billed charges","82.6% of total billed charges",97.27,16.8,,77.82,,,0,"percent of total billed charges","16.8% of total billed charges",289.5,50,,231.60,,,0,"percent of total billed charges","50% of total billed charges",478.25,82.6,,382.60,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.27,16.8,,77.82,,,0,"percent of total billed charges","16.8% of total billed charges",579,100,,463.20,,,0,"percent of total billed charges","100% of total billed charges",88.59,579,
"TROCAR KII FIOS 1ST ENTRY Z THREAD 12 X 100MM",353967,CDM,272,RC,,,OUTPATIENT,,,3472,2256.8,,3055.36,88,,2444.29,,,0,"percent of total billed charges","88% of total billed charges",1736,50,,1388.80,,,0,"percent of total billed charges","50% of total billed charges",583.3,16.8,,466.64,,,0,"percent of total billed charges","16.8% of total billed charges",3472,100,,2777.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",600.79,17.304,,480.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2187.36,63,,1749.89,,,0,"percent of total billed charges","63% of total billed charges",531.22,15.3,,424.98,,,0,"percent of total billed charges","15.3% of total billed charges",583.3,16.8,,466.64,,,0,"percent of total billed charges","16.8% of total billed charges",2395.68,69,,,,,0,"fee schedule","69% of total billed charges",3472,100,,2777.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3472,100,,2777.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3472,100,,2777.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2147.43,61.85,,1717.94,,,0,"percent of total billed charges","61.5% of total billed charges",583.3,16.8,,466.64,,,0,"percent of total billed charges","16.8% of total billed charges",1736,50,,1388.80,,,0,"percent of total billed charges","50% of total billed charges",1117.98,32.2,,894.38,,,0,"percent of total billed charges","32.2% of total billed charges",583.3,16.8,,466.64,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",594.96,17.136,,475.97,,,0,"percent of total billed charges","17.136% of total billed charges",758.28,21.84,,606.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1308.94,37.7,,1047.15,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2708.16,78,,2166.53,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2867.87,82.6,,2294.30,,,0,"percent of total billed charges","82.6% of total billed charges",583.3,16.8,,466.64,,,0,"percent of total billed charges","16.8% of total billed charges",1736,50,,1388.80,,,0,"percent of total billed charges","50% of total billed charges",2867.87,82.6,,2294.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",583.3,16.8,,466.64,,,0,"percent of total billed charges","16.8% of total billed charges",3472,100,,2777.60,,,0,"percent of total billed charges","100% of total billed charges",531.22,3472,
"TROCAR WITH SLEEVE 12X100MM KII FIOS",291568,CDM,272,RC,,,OUTPATIENT,,,579,376.35,,509.52,88,,407.62,,,0,"percent of total billed charges","88% of total billed charges",289.5,50,,231.60,,,0,"percent of total billed charges","50% of total billed charges",97.27,16.8,,77.82,,,0,"percent of total billed charges","16.8% of total billed charges",579,100,,463.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",100.19,17.304,,80.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",364.77,63,,291.82,,,0,"percent of total billed charges","63% of total billed charges",88.59,15.3,,70.87,,,0,"percent of total billed charges","15.3% of total billed charges",97.27,16.8,,77.82,,,0,"percent of total billed charges","16.8% of total billed charges",399.51,69,,,,,0,"fee schedule","69% of total billed charges",579,100,,463.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579,100,,463.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579,100,,463.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",358.11,61.85,,286.49,,,0,"percent of total billed charges","61.5% of total billed charges",97.27,16.8,,77.82,,,0,"percent of total billed charges","16.8% of total billed charges",289.5,50,,231.60,,,0,"percent of total billed charges","50% of total billed charges",186.44,32.2,,149.15,,,0,"percent of total billed charges","32.2% of total billed charges",97.27,16.8,,77.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",99.22,17.136,,79.38,,,0,"percent of total billed charges","17.136% of total billed charges",126.45,21.84,,101.16,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",218.28,37.7,,174.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",451.62,78,,361.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",478.25,82.6,,382.60,,,0,"percent of total billed charges","82.6% of total billed charges",97.27,16.8,,77.82,,,0,"percent of total billed charges","16.8% of total billed charges",289.5,50,,231.60,,,0,"percent of total billed charges","50% of total billed charges",478.25,82.6,,382.60,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.27,16.8,,77.82,,,0,"percent of total billed charges","16.8% of total billed charges",579,100,,463.20,,,0,"percent of total billed charges","100% of total billed charges",88.59,579,
"TROCAR WITH SLEEVE 5X100MM KII FIOS",291564,CDM,272,RC,,,OUTPATIENT,,,140,91,,123.2,88,,98.56,,,0,"percent of total billed charges","88% of total billed charges",70,50,,56.00,,,0,"percent of total billed charges","50% of total billed charges",23.52,16.8,,18.82,,,0,"percent of total billed charges","16.8% of total billed charges",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.23,17.304,,19.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.2,63,,70.56,,,0,"percent of total billed charges","63% of total billed charges",21.42,15.3,,17.14,,,0,"percent of total billed charges","15.3% of total billed charges",23.52,16.8,,18.82,,,0,"percent of total billed charges","16.8% of total billed charges",96.6,69,,,,,0,"fee schedule","69% of total billed charges",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.59,61.85,,69.27,,,0,"percent of total billed charges","61.5% of total billed charges",23.52,16.8,,18.82,,,0,"percent of total billed charges","16.8% of total billed charges",70,50,,56.00,,,0,"percent of total billed charges","50% of total billed charges",45.08,32.2,,36.06,,,0,"percent of total billed charges","32.2% of total billed charges",23.52,16.8,,18.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.99,17.136,,19.19,,,0,"percent of total billed charges","17.136% of total billed charges",30.58,21.84,,24.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",52.78,37.7,,42.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",109.2,78,,87.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.64,82.6,,92.51,,,0,"percent of total billed charges","82.6% of total billed charges",23.52,16.8,,18.82,,,0,"percent of total billed charges","16.8% of total billed charges",70,50,,56.00,,,0,"percent of total billed charges","50% of total billed charges",115.64,82.6,,92.51,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.52,16.8,,18.82,,,0,"percent of total billed charges","16.8% of total billed charges",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",21.42,140,
"TROCAR XCEL 11MM BLADELESS W/HANDLE",376256,CDM,272,RC,,,OUTPATIENT,,,459,298.35,,403.92,88,,323.14,,,0,"percent of total billed charges","88% of total billed charges",229.5,50,,183.60,,,0,"percent of total billed charges","50% of total billed charges",77.11,16.8,,61.69,,,0,"percent of total billed charges","16.8% of total billed charges",459,100,,367.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.43,17.304,,63.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",289.17,63,,231.34,,,0,"percent of total billed charges","63% of total billed charges",70.23,15.3,,56.18,,,0,"percent of total billed charges","15.3% of total billed charges",77.11,16.8,,61.69,,,0,"percent of total billed charges","16.8% of total billed charges",316.71,69,,,,,0,"fee schedule","69% of total billed charges",459,100,,367.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",459,100,,367.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",459,100,,367.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",283.89,61.85,,227.11,,,0,"percent of total billed charges","61.5% of total billed charges",77.11,16.8,,61.69,,,0,"percent of total billed charges","16.8% of total billed charges",229.5,50,,183.60,,,0,"percent of total billed charges","50% of total billed charges",147.8,32.2,,118.24,,,0,"percent of total billed charges","32.2% of total billed charges",77.11,16.8,,61.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.65,17.136,,62.92,,,0,"percent of total billed charges","17.136% of total billed charges",100.25,21.84,,80.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",173.04,37.7,,138.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",358.02,78,,286.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.13,82.6,,303.30,,,0,"percent of total billed charges","82.6% of total billed charges",77.11,16.8,,61.69,,,0,"percent of total billed charges","16.8% of total billed charges",229.5,50,,183.60,,,0,"percent of total billed charges","50% of total billed charges",379.13,82.6,,303.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.11,16.8,,61.69,,,0,"percent of total billed charges","16.8% of total billed charges",459,100,,367.20,,,0,"percent of total billed charges","100% of total billed charges",70.23,459,
"TROCAR XCEL ENDO REPROCESSED",270875,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"TROCAR ZTHREAD OPTICAL 5X150 MM",419277,CDM,272,RC,,,OUTPATIENT,,,496,322.4,,436.48,88,,349.18,,,0,"percent of total billed charges","88% of total billed charges",248,50,,198.40,,,0,"percent of total billed charges","50% of total billed charges",83.33,16.8,,66.66,,,0,"percent of total billed charges","16.8% of total billed charges",496,100,,396.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.83,17.304,,68.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",312.48,63,,249.98,,,0,"percent of total billed charges","63% of total billed charges",75.89,15.3,,60.71,,,0,"percent of total billed charges","15.3% of total billed charges",83.33,16.8,,66.66,,,0,"percent of total billed charges","16.8% of total billed charges",342.24,69,,,,,0,"fee schedule","69% of total billed charges",496,100,,396.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496,100,,396.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496,100,,396.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",306.78,61.85,,245.42,,,0,"percent of total billed charges","61.5% of total billed charges",83.33,16.8,,66.66,,,0,"percent of total billed charges","16.8% of total billed charges",248,50,,198.40,,,0,"percent of total billed charges","50% of total billed charges",159.71,32.2,,127.77,,,0,"percent of total billed charges","32.2% of total billed charges",83.33,16.8,,66.66,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.99,17.136,,67.99,,,0,"percent of total billed charges","17.136% of total billed charges",108.33,21.84,,86.66,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",186.99,37.7,,149.59,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",386.88,78,,309.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",409.7,82.6,,327.76,,,0,"percent of total billed charges","82.6% of total billed charges",83.33,16.8,,66.66,,,0,"percent of total billed charges","16.8% of total billed charges",248,50,,198.40,,,0,"percent of total billed charges","50% of total billed charges",409.7,82.6,,327.76,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",83.33,16.8,,66.66,,,0,"percent of total billed charges","16.8% of total billed charges",496,100,,396.80,,,0,"percent of total billed charges","100% of total billed charges",75.89,496,
"TROCAR 5MM B5XT BLADELESS",491609,CDM,272,RC,,,OUTPATIENT,,,338,219.7,,297.44,88,,237.95,,,0,"percent of total billed charges","88% of total billed charges",169,50,,135.20,,,0,"percent of total billed charges","50% of total billed charges",56.78,16.8,,45.42,,,0,"percent of total billed charges","16.8% of total billed charges",338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.49,17.304,,46.79,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",212.94,63,,170.35,,,0,"percent of total billed charges","63% of total billed charges",51.71,15.3,,41.37,,,0,"percent of total billed charges","15.3% of total billed charges",56.78,16.8,,45.42,,,0,"percent of total billed charges","16.8% of total billed charges",233.22,69,,,,,0,"fee schedule","69% of total billed charges",338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.05,61.85,,167.24,,,0,"percent of total billed charges","61.5% of total billed charges",56.78,16.8,,45.42,,,0,"percent of total billed charges","16.8% of total billed charges",169,50,,135.20,,,0,"percent of total billed charges","50% of total billed charges",108.84,32.2,,87.07,,,0,"percent of total billed charges","32.2% of total billed charges",56.78,16.8,,45.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.92,17.136,,46.34,,,0,"percent of total billed charges","17.136% of total billed charges",73.82,21.84,,59.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",127.43,37.7,,101.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",263.64,78,,210.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",279.19,82.6,,223.35,,,0,"percent of total billed charges","82.6% of total billed charges",56.78,16.8,,45.42,,,0,"percent of total billed charges","16.8% of total billed charges",169,50,,135.20,,,0,"percent of total billed charges","50% of total billed charges",279.19,82.6,,223.35,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.78,16.8,,45.42,,,0,"percent of total billed charges","16.8% of total billed charges",338,100,,270.40,,,0,"percent of total billed charges","100% of total billed charges",51.71,338,
"TROCAR 5MM 2B5LT BLADELESS",491608,CDM,272,RC,,,OUTPATIENT,,,379,246.35,,333.52,88,,266.82,,,0,"percent of total billed charges","88% of total billed charges",189.5,50,,151.60,,,0,"percent of total billed charges","50% of total billed charges",63.67,16.8,,50.94,,,0,"percent of total billed charges","16.8% of total billed charges",379,100,,303.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",65.58,17.304,,52.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",238.77,63,,191.02,,,0,"percent of total billed charges","63% of total billed charges",57.99,15.3,,46.39,,,0,"percent of total billed charges","15.3% of total billed charges",63.67,16.8,,50.94,,,0,"percent of total billed charges","16.8% of total billed charges",261.51,69,,,,,0,"fee schedule","69% of total billed charges",379,100,,303.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",379,100,,303.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",379,100,,303.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",234.41,61.85,,187.53,,,0,"percent of total billed charges","61.5% of total billed charges",63.67,16.8,,50.94,,,0,"percent of total billed charges","16.8% of total billed charges",189.5,50,,151.60,,,0,"percent of total billed charges","50% of total billed charges",122.04,32.2,,97.63,,,0,"percent of total billed charges","32.2% of total billed charges",63.67,16.8,,50.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.95,17.136,,51.96,,,0,"percent of total billed charges","17.136% of total billed charges",82.77,21.84,,66.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",142.88,37.7,,114.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",295.62,78,,236.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.05,82.6,,250.44,,,0,"percent of total billed charges","82.6% of total billed charges",63.67,16.8,,50.94,,,0,"percent of total billed charges","16.8% of total billed charges",189.5,50,,151.60,,,0,"percent of total billed charges","50% of total billed charges",313.05,82.6,,250.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.67,16.8,,50.94,,,0,"percent of total billed charges","16.8% of total billed charges",379,100,,303.20,,,0,"percent of total billed charges","100% of total billed charges",57.99,379,
"TROCAR 12MM D12XT DILATING TIP",491607,CDM,270,RC,,,OUTPATIENT,,,590,383.5,,519.2,88,,415.36,,,0,"percent of total billed charges","88% of total billed charges",295,50,,236.00,,,0,"percent of total billed charges","50% of total billed charges",99.12,16.8,,79.30,,,0,"percent of total billed charges","16.8% of total billed charges",590,100,,472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",102.09,17.304,,81.67,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",371.7,63,,297.36,,,0,"percent of total billed charges","63% of total billed charges",90.27,15.3,,72.22,,,0,"percent of total billed charges","15.3% of total billed charges",99.12,16.8,,79.30,,,0,"percent of total billed charges","16.8% of total billed charges",407.1,69,,,,,0,"fee schedule","69% of total billed charges",590,100,,472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",590,100,,472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",590,100,,472.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",364.92,61.85,,291.94,,,0,"percent of total billed charges","61.5% of total billed charges",99.12,16.8,,79.30,,,0,"percent of total billed charges","16.8% of total billed charges",295,50,,236.00,,,0,"percent of total billed charges","50% of total billed charges",189.98,32.2,,151.98,,,0,"percent of total billed charges","32.2% of total billed charges",99.12,16.8,,79.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.1,17.136,,80.88,,,0,"percent of total billed charges","17.136% of total billed charges",128.86,21.84,,103.09,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",222.43,37.7,,177.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",460.2,78,,368.16,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",487.34,82.6,,389.87,,,0,"percent of total billed charges","82.6% of total billed charges",99.12,16.8,,79.30,,,0,"percent of total billed charges","16.8% of total billed charges",295,50,,236.00,,,0,"percent of total billed charges","50% of total billed charges",487.34,82.6,,389.87,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",99.12,16.8,,79.30,,,0,"percent of total billed charges","16.8% of total billed charges",590,100,,472.00,,,0,"percent of total billed charges","100% of total billed charges",90.27,590,
"TROCAR 10/12MM H12LP BLUNT TIP",491606,CDM,270,RC,,,OUTPATIENT,,,495,321.75,,435.6,88,,348.48,,,0,"percent of total billed charges","88% of total billed charges",247.5,50,,198.00,,,0,"percent of total billed charges","50% of total billed charges",83.16,16.8,,66.53,,,0,"percent of total billed charges","16.8% of total billed charges",495,100,,396.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.65,17.304,,68.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",311.85,63,,249.48,,,0,"percent of total billed charges","63% of total billed charges",75.74,15.3,,60.59,,,0,"percent of total billed charges","15.3% of total billed charges",83.16,16.8,,66.53,,,0,"percent of total billed charges","16.8% of total billed charges",341.55,69,,,,,0,"fee schedule","69% of total billed charges",495,100,,396.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",495,100,,396.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",495,100,,396.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",306.16,61.85,,244.93,,,0,"percent of total billed charges","61.5% of total billed charges",83.16,16.8,,66.53,,,0,"percent of total billed charges","16.8% of total billed charges",247.5,50,,198.00,,,0,"percent of total billed charges","50% of total billed charges",159.39,32.2,,127.51,,,0,"percent of total billed charges","32.2% of total billed charges",83.16,16.8,,66.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.82,17.136,,67.86,,,0,"percent of total billed charges","17.136% of total billed charges",108.11,21.84,,86.49,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",186.62,37.7,,149.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",386.1,78,,308.88,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.87,82.6,,327.10,,,0,"percent of total billed charges","82.6% of total billed charges",83.16,16.8,,66.53,,,0,"percent of total billed charges","16.8% of total billed charges",247.5,50,,198.00,,,0,"percent of total billed charges","50% of total billed charges",408.87,82.6,,327.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",83.16,16.8,,66.53,,,0,"percent of total billed charges","16.8% of total billed charges",495,100,,396.00,,,0,"percent of total billed charges","100% of total billed charges",75.74,495,
"TROCAR 10/12MM B12LT BLADELESS",491605,CDM,272,RC,,,OUTPATIENT,,,385,250.25,,338.8,88,,271.04,,,0,"percent of total billed charges","88% of total billed charges",192.5,50,,154.00,,,0,"percent of total billed charges","50% of total billed charges",64.68,16.8,,51.74,,,0,"percent of total billed charges","16.8% of total billed charges",385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",66.62,17.304,,53.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",242.55,63,,194.04,,,0,"percent of total billed charges","63% of total billed charges",58.91,15.3,,47.13,,,0,"percent of total billed charges","15.3% of total billed charges",64.68,16.8,,51.74,,,0,"percent of total billed charges","16.8% of total billed charges",265.65,69,,,,,0,"fee schedule","69% of total billed charges",385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",238.12,61.85,,190.50,,,0,"percent of total billed charges","61.5% of total billed charges",64.68,16.8,,51.74,,,0,"percent of total billed charges","16.8% of total billed charges",192.5,50,,154.00,,,0,"percent of total billed charges","50% of total billed charges",123.97,32.2,,99.18,,,0,"percent of total billed charges","32.2% of total billed charges",64.68,16.8,,51.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",65.97,17.136,,52.78,,,0,"percent of total billed charges","17.136% of total billed charges",84.08,21.84,,67.26,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",145.15,37.7,,116.12,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",300.3,78,,240.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",318.01,82.6,,254.41,,,0,"percent of total billed charges","82.6% of total billed charges",64.68,16.8,,51.74,,,0,"percent of total billed charges","16.8% of total billed charges",192.5,50,,154.00,,,0,"percent of total billed charges","50% of total billed charges",318.01,82.6,,254.41,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.68,16.8,,51.74,,,0,"percent of total billed charges","16.8% of total billed charges",385,100,,308.00,,,0,"percent of total billed charges","100% of total billed charges",58.91,385,
"TROCAR KII BLUNT 5X100 C0Q20",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"TROCAR KII BLUNT TIP C0R47 12",491611,CDM,270,RC,,,OUTPATIENT,,,347,225.55,,305.36,88,,244.29,,,0,"percent of total billed charges","88% of total billed charges",173.5,50,,138.80,,,0,"percent of total billed charges","50% of total billed charges",58.3,16.8,,46.64,,,0,"percent of total billed charges","16.8% of total billed charges",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.04,17.304,,48.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",218.61,63,,174.89,,,0,"percent of total billed charges","63% of total billed charges",53.09,15.3,,42.47,,,0,"percent of total billed charges","15.3% of total billed charges",58.3,16.8,,46.64,,,0,"percent of total billed charges","16.8% of total billed charges",239.43,69,,,,,0,"fee schedule","69% of total billed charges",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",214.62,61.85,,171.70,,,0,"percent of total billed charges","61.5% of total billed charges",58.3,16.8,,46.64,,,0,"percent of total billed charges","16.8% of total billed charges",173.5,50,,138.80,,,0,"percent of total billed charges","50% of total billed charges",111.73,32.2,,89.38,,,0,"percent of total billed charges","32.2% of total billed charges",58.3,16.8,,46.64,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.46,17.136,,47.57,,,0,"percent of total billed charges","17.136% of total billed charges",75.78,21.84,,60.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",130.82,37.7,,104.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",270.66,78,,216.53,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",286.62,82.6,,229.30,,,0,"percent of total billed charges","82.6% of total billed charges",58.3,16.8,,46.64,,,0,"percent of total billed charges","16.8% of total billed charges",173.5,50,,138.80,,,0,"percent of total billed charges","50% of total billed charges",286.62,82.6,,229.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.3,16.8,,46.64,,,0,"percent of total billed charges","16.8% of total billed charges",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",53.09,347,
"TROCAR SLEEVE 12MM CB12LT",491612,CDM,270,RC,,,OUTPATIENT,,,293,190.45,,257.84,88,,206.27,,,0,"percent of total billed charges","88% of total billed charges",146.5,50,,117.20,,,0,"percent of total billed charges","50% of total billed charges",49.22,16.8,,39.38,,,0,"percent of total billed charges","16.8% of total billed charges",293,100,,234.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.7,17.304,,40.56,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",184.59,63,,147.67,,,0,"percent of total billed charges","63% of total billed charges",44.83,15.3,,35.86,,,0,"percent of total billed charges","15.3% of total billed charges",49.22,16.8,,39.38,,,0,"percent of total billed charges","16.8% of total billed charges",202.17,69,,,,,0,"fee schedule","69% of total billed charges",293,100,,234.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",293,100,,234.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",293,100,,234.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.22,61.85,,144.98,,,0,"percent of total billed charges","61.5% of total billed charges",49.22,16.8,,39.38,,,0,"percent of total billed charges","16.8% of total billed charges",146.5,50,,117.20,,,0,"percent of total billed charges","50% of total billed charges",94.35,32.2,,75.48,,,0,"percent of total billed charges","32.2% of total billed charges",49.22,16.8,,39.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.21,17.136,,40.17,,,0,"percent of total billed charges","17.136% of total billed charges",63.99,21.84,,51.19,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",110.46,37.7,,88.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",228.54,78,,182.83,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",242.02,82.6,,193.62,,,0,"percent of total billed charges","82.6% of total billed charges",49.22,16.8,,39.38,,,0,"percent of total billed charges","16.8% of total billed charges",146.5,50,,117.20,,,0,"percent of total billed charges","50% of total billed charges",242.02,82.6,,193.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.22,16.8,,39.38,,,0,"percent of total billed charges","16.8% of total billed charges",293,100,,234.40,,,0,"percent of total billed charges","100% of total billed charges",44.83,293,
"TROCAR DILATING 12MM",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"TROCAR SHIELDED BLADE  KII 8X100",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"TROCAR ENDOPATH BLUNT TIP 10 X 100MM",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"TROCAR CLEANER XL 12MM",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"TROPONIN I ES 100 WELLS",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"TROPONIN I ES CAL BX/ 1 SET",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"TRYPTIC SOY BROTH 15% GLYCEROL",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"AGAR SETTLING PLATE TRYPTIC SOY",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"REAGENT TSH 100 WELLS",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"TSH CALIBRATOR",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"TUBE TRACH SZ 8 LOW PRES CUFFED SHILEYDISP CANN",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"TUBE TRACH LOW PRESSURE CUFFED CANNULA 7.0MM SZ 6",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"TUBE ENDO INTRMD HIGH LOW 6.0",166661,CDM,272,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"TUBE LOPRO MURPHY CUFF 4.0",12506,CDM,272,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"TUBE ENDO CUFFED 3.0",11074,CDM,272,RC,,,OUTPATIENT,,,24,15.6,,21.12,88,,16.90,,,0,"percent of total billed charges","88% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.15,17.304,,3.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.12,63,,12.10,,,0,"percent of total billed charges","63% of total billed charges",3.67,15.3,,2.94,,,0,"percent of total billed charges","15.3% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",16.56,69,,,,,0,"fee schedule","69% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.84,61.85,,11.87,,,0,"percent of total billed charges","61.5% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",7.73,32.2,,6.18,,,0,"percent of total billed charges","32.2% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.11,17.136,,3.29,,,0,"percent of total billed charges","17.136% of total billed charges",5.24,21.84,,4.19,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.05,37.7,,7.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.72,78,,14.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,24,
"TUBE NASAL JEJUNAL FEEDING 8FR/240 CM",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"TUBE SALEM SUMP 10F",12441,CDM,272,RC,,,OUTPATIENT,,,43,27.95,,37.84,88,,30.27,,,0,"percent of total billed charges","88% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.44,17.304,,5.95,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.09,63,,21.67,,,0,"percent of total billed charges","63% of total billed charges",6.58,15.3,,5.26,,,0,"percent of total billed charges","15.3% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",29.67,69,,,,,0,"fee schedule","69% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.6,61.85,,21.28,,,0,"percent of total billed charges","61.5% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",13.85,32.2,,11.08,,,0,"percent of total billed charges","32.2% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.37,17.136,,5.90,,,0,"percent of total billed charges","17.136% of total billed charges",9.39,21.84,,7.51,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.21,37.7,,12.97,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",33.54,78,,26.83,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.52,82.6,,28.42,,,0,"percent of total billed charges","82.6% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",21.5,50,,17.20,,,0,"percent of total billed charges","50% of total billed charges",35.52,82.6,,28.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",6.58,43,
"TUBE  TRANSGASTRIC JEJUNAL FEEDING 18FR",ORSUP0018,CDM,272,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"TUBE FEEDING JEJUNAL/GAST POLYURTHN W/STYT 9F 36",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"TUBE FEEDING 3.5FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"TUBE ENDO CUF ORAL/NASAL HI VOL W/CON 9.0MM",148031,CDM,272,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"TUBE ET ORAL RAE CUFFED 7.0",12470,CDM,272,RC,,,OUTPATIENT,,,34,22.1,,29.92,88,,23.94,,,0,"percent of total billed charges","88% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.88,17.304,,4.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.42,63,,17.14,,,0,"percent of total billed charges","63% of total billed charges",5.2,15.3,,4.16,,,0,"percent of total billed charges","15.3% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",23.46,69,,,,,0,"fee schedule","69% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.03,61.85,,16.82,,,0,"percent of total billed charges","61.5% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",10.95,32.2,,8.76,,,0,"percent of total billed charges","32.2% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.83,17.136,,4.66,,,0,"percent of total billed charges","17.136% of total billed charges",7.43,21.84,,5.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.82,37.7,,10.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.52,78,,21.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",5.2,34,
"TUBE ET ORAL RAE CUFFED 6.5",12471,CDM,272,RC,,,OUTPATIENT,,,34,22.1,,29.92,88,,23.94,,,0,"percent of total billed charges","88% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.88,17.304,,4.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.42,63,,17.14,,,0,"percent of total billed charges","63% of total billed charges",5.2,15.3,,4.16,,,0,"percent of total billed charges","15.3% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",23.46,69,,,,,0,"fee schedule","69% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.03,61.85,,16.82,,,0,"percent of total billed charges","61.5% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",10.95,32.2,,8.76,,,0,"percent of total billed charges","32.2% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.83,17.136,,4.66,,,0,"percent of total billed charges","17.136% of total billed charges",7.43,21.84,,5.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.82,37.7,,10.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.52,78,,21.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",5.2,34,
"TUBE ENDO CUF ORAL/NASAL HI VOL W/CON 8.5MM",148030,CDM,272,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"TUBE TRACH ORAL MURPHY EYE CUFFED 6.0MM",12472,CDM,272,RC,,,OUTPATIENT,,,34,22.1,,29.92,88,,23.94,,,0,"percent of total billed charges","88% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.88,17.304,,4.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.42,63,,17.14,,,0,"percent of total billed charges","63% of total billed charges",5.2,15.3,,4.16,,,0,"percent of total billed charges","15.3% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",23.46,69,,,,,0,"fee schedule","69% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.03,61.85,,16.82,,,0,"percent of total billed charges","61.5% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",10.95,32.2,,8.76,,,0,"percent of total billed charges","32.2% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.83,17.136,,4.66,,,0,"percent of total billed charges","17.136% of total billed charges",7.43,21.84,,5.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.82,37.7,,10.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.52,78,,21.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",5.2,34,
"TUBE ENDO EMG 7.0MM",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"TUBE ENDO CUF ORAL/NASAL HI VOL W/CON 7.0MM",158182,CDM,272,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"TUBE INTRMD HIGH LOW ENDO 7.5",148016,CDM,272,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"TUBE ENDO EMG 6.0MM",ORSUP0020,CDM,272,RC,,,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.03,17.304,,333.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.59,61.85,,1192.47,,,0,"percent of total billed charges","61.5% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",776.02,32.2,,620.82,,,0,"percent of total billed charges","32.2% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.98,17.136,,330.38,,,0,"percent of total billed charges","17.136% of total billed charges",526.34,21.84,,421.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",1205,50,,964.00,,,0,"percent of total billed charges","50% of total billed charges",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",404.88,16.8,,323.90,,,0,"percent of total billed charges","16.8% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,2410,
"TUBE ENDO CUF ORAL/NASAL HI VOL W/CON 6.5MM",158181,CDM,272,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"TUBE ENDO CUFFED 5.0MM",11072,CDM,272,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"TUBE ENDO CUFFED 5.5MM",11071,CDM,272,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"TUBE ENDO CUFFED 4.5",11073,CDM,272,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"TUBE ET ORAL RAE CUFFED 4.5",12475,CDM,272,RC,,,OUTPATIENT,,,34,22.1,,29.92,88,,23.94,,,0,"percent of total billed charges","88% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.88,17.304,,4.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.42,63,,17.14,,,0,"percent of total billed charges","63% of total billed charges",5.2,15.3,,4.16,,,0,"percent of total billed charges","15.3% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",23.46,69,,,,,0,"fee schedule","69% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.03,61.85,,16.82,,,0,"percent of total billed charges","61.5% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",10.95,32.2,,8.76,,,0,"percent of total billed charges","32.2% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.83,17.136,,4.66,,,0,"percent of total billed charges","17.136% of total billed charges",7.43,21.84,,5.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.82,37.7,,10.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.52,78,,21.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",5.2,34,
"TUBE ET ORAL RAE CUFFED 7.5",12469,CDM,272,RC,,,OUTPATIENT,,,54,35.1,,47.52,88,,38.02,,,0,"percent of total billed charges","88% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.34,17.304,,7.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.02,63,,27.22,,,0,"percent of total billed charges","63% of total billed charges",8.26,15.3,,6.61,,,0,"percent of total billed charges","15.3% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",37.26,69,,,,,0,"fee schedule","69% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.4,61.85,,26.72,,,0,"percent of total billed charges","61.5% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",17.39,32.2,,13.91,,,0,"percent of total billed charges","32.2% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.25,17.136,,7.40,,,0,"percent of total billed charges","17.136% of total billed charges",11.79,21.84,,9.43,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.36,37.7,,16.29,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",42.12,78,,33.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.6,82.6,,35.68,,,0,"percent of total billed charges","82.6% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",44.6,82.6,,35.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",8.26,54,
"TUBE ENDOBRONCH 37FR RT ANG 126037",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"TUBE ENDOBRONCHIAL LEFT 37FR",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"TUBE BRONCHO CATH 35FR LEFT",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"TUBE TRACH XL PROX CUFFED 6.0",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"TUBE TRACH LOW PRESSURE CUFF CANNULA 9.0MM SZ 10",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"TUBE TRACH LOW PRESS CUFFED REUSABLE CANNULA SZ 6",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"TUBE TRACH LOW PRESS CUFFED REUSABLE CANNULA SZ 8",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"TUBE TRACH LOW PRESS CUFFED REUSALBE CANNULA SZ 4",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"TUBE TRACH LOW PRESS CUFFLESS FEN REUS CANN SZ 4",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"TUBE TRACH NEONATL W/OBTRTR 3.5MMI.D.X5.2MMX32MML",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"TUBE GASTROSTOMY 20FR STRAIGHT REPL",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"TUBE GASTROSTOMY 18FR STRAIGHT REPL",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"TUBE GASTROSTOMY 16FR STRAIGHT REPL",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"TUBE TRACH XL PROX CUFFED 8.0",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"TUBE TRACH XL DISTAL CUFFED 8.0",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"TUBE E.T.5.5 CUFFED",186426,CDM,272,RC,,,OUTPATIENT,,,192,124.8,,168.96,88,,135.17,,,0,"percent of total billed charges","88% of total billed charges",96,50,,76.80,,,0,"percent of total billed charges","50% of total billed charges",32.26,16.8,,25.81,,,0,"percent of total billed charges","16.8% of total billed charges",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.22,17.304,,26.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",120.96,63,,96.77,,,0,"percent of total billed charges","63% of total billed charges",29.38,15.3,,23.50,,,0,"percent of total billed charges","15.3% of total billed charges",32.26,16.8,,25.81,,,0,"percent of total billed charges","16.8% of total billed charges",132.48,69,,,,,0,"fee schedule","69% of total billed charges",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",118.75,61.85,,95.00,,,0,"percent of total billed charges","61.5% of total billed charges",32.26,16.8,,25.81,,,0,"percent of total billed charges","16.8% of total billed charges",96,50,,76.80,,,0,"percent of total billed charges","50% of total billed charges",61.82,32.2,,49.46,,,0,"percent of total billed charges","32.2% of total billed charges",32.26,16.8,,25.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.9,17.136,,26.32,,,0,"percent of total billed charges","17.136% of total billed charges",41.93,21.84,,33.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",72.38,37.7,,57.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",149.76,78,,119.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.59,82.6,,126.87,,,0,"percent of total billed charges","82.6% of total billed charges",32.26,16.8,,25.81,,,0,"percent of total billed charges","16.8% of total billed charges",96,50,,76.80,,,0,"percent of total billed charges","50% of total billed charges",158.59,82.6,,126.87,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.26,16.8,,25.81,,,0,"percent of total billed charges","16.8% of total billed charges",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",29.38,192,
"TUBE FEEDING 5FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"TUBE PEG REPLACEMENT 20FR",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"TUBE E.T.3.5 W/STYLETTE",186868,CDM,272,RC,,,OUTPATIENT,,,35,22.75,,30.8,88,,24.64,,,0,"percent of total billed charges","88% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.06,17.304,,4.85,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.05,63,,17.64,,,0,"percent of total billed charges","63% of total billed charges",5.36,15.3,,4.29,,,0,"percent of total billed charges","15.3% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",24.15,69,,,,,0,"fee schedule","69% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.65,61.85,,17.32,,,0,"percent of total billed charges","61.5% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",11.27,32.2,,9.02,,,0,"percent of total billed charges","32.2% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,17.136,,4.80,,,0,"percent of total billed charges","17.136% of total billed charges",7.64,21.84,,6.11,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.2,37.7,,10.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",27.3,78,,21.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.91,82.6,,23.13,,,0,"percent of total billed charges","82.6% of total billed charges",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",17.5,50,,14.00,,,0,"percent of total billed charges","50% of total billed charges",28.91,82.6,,23.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.88,16.8,,4.70,,,0,"percent of total billed charges","16.8% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",5.36,35,
"TUBE E.T.6.5 CUFFED",186422,CDM,272,RC,,,OUTPATIENT,,,135,87.75,,118.8,88,,95.04,,,0,"percent of total billed charges","88% of total billed charges",67.5,50,,54.00,,,0,"percent of total billed charges","50% of total billed charges",22.68,16.8,,18.14,,,0,"percent of total billed charges","16.8% of total billed charges",135,100,,108.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.36,17.304,,18.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.05,63,,68.04,,,0,"percent of total billed charges","63% of total billed charges",20.66,15.3,,16.53,,,0,"percent of total billed charges","15.3% of total billed charges",22.68,16.8,,18.14,,,0,"percent of total billed charges","16.8% of total billed charges",93.15,69,,,,,0,"fee schedule","69% of total billed charges",135,100,,108.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",135,100,,108.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",135,100,,108.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",83.5,61.85,,66.80,,,0,"percent of total billed charges","61.5% of total billed charges",22.68,16.8,,18.14,,,0,"percent of total billed charges","16.8% of total billed charges",67.5,50,,54.00,,,0,"percent of total billed charges","50% of total billed charges",43.47,32.2,,34.78,,,0,"percent of total billed charges","32.2% of total billed charges",22.68,16.8,,18.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.13,17.136,,18.50,,,0,"percent of total billed charges","17.136% of total billed charges",29.48,21.84,,23.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.9,37.7,,40.72,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",105.3,78,,84.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",111.51,82.6,,89.21,,,0,"percent of total billed charges","82.6% of total billed charges",22.68,16.8,,18.14,,,0,"percent of total billed charges","16.8% of total billed charges",67.5,50,,54.00,,,0,"percent of total billed charges","50% of total billed charges",111.51,82.6,,89.21,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,16.8,,18.14,,,0,"percent of total billed charges","16.8% of total billed charges",135,100,,108.00,,,0,"percent of total billed charges","100% of total billed charges",20.66,135,
"TUBE E.T.7.0 CUFFED",186423,CDM,272,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"TUBE E.T.8.0 CUFFED",186428,CDM,272,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"TUBE ET UNCUFF 4.0",113985,CDM,272,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"TUBE MINNESOTA",ORSUP0026,CDM,272,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"TUBE NIM TRIVANTAGE EMG ENDOTACH 7MM",ORSUP0021,CDM,272,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"TUBE TRACH ADJUSTABLE 6.0MM HYPERFLEX",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"TUBE TRACH ADJUSTABLE 7.0MM HYPERFLEX",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"TUBE TRACH ADJUSTABLE 9.0MM HYPERFLEX",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"TUBE TRACH FOME CUFF 7.0",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"TUBE TRACH LOW PRESSURE CUFFED FENESTRATED SZ 8",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"TUBE VENTILATION SHEELY TYPE ACTIVANT ANTIMICROBIAL 10-26145",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"TUBE SET DUALWAVE OUTFLOW  CS/10",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"TUBE SUCT CONNECT 3/16IN X 20IN STERILE LF",61328,CDM,272,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"TUBE SUCTION CONNECTING NONCONDUCTIVE 1/4INX20FT STERILE",315164,CDM,272,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"TUBE YANKAUER SUCTION (REG) OR",47879,CDM,272,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.95,61.85,,3.96,,,0,"percent of total billed charges","61.5% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"TUBE SET BIPOLAR SCP INTL INTG IRR 1000",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"TUBE VAC +  PST W/HGARD POLYMER G",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"TUBE MICROTAINER GRN LITHM HEP W/MICROGUARD CLSR",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"TUBE SERUM PLSTC RED SILICN CT 6ML 13X100 HEMOGRD",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"TUBE HOLDERS LAB",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"TUBES POLYSTERENE",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"TUBE CONNECTING 6MM X 12",100560,CDM,272,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.95,61.85,,3.96,,,0,"percent of total billed charges","61.5% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"TUBE FLOSTEADY ARTHROSCOPY",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"TUBE NASOPHARYNGEAL AIRWAY 26FR",9976,CDM,272,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"TUBE TRACH ADJUSTABLE 8.0MM HYPERFLEX",ORSUP0018,CDM,272,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"TUBE TRACH SZ 4 CUFFED DISP CANNULA",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"TUBE FEEDING 8FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"TUBE FEEDING W/S/L 10FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"TUBE ET ORAL RAE CUFFED 5.5",12473,CDM,272,RC,,,OUTPATIENT,,,34,22.1,,29.92,88,,23.94,,,0,"percent of total billed charges","88% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.88,17.304,,4.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.42,63,,17.14,,,0,"percent of total billed charges","63% of total billed charges",5.2,15.3,,4.16,,,0,"percent of total billed charges","15.3% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",23.46,69,,,,,0,"fee schedule","69% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.03,61.85,,16.82,,,0,"percent of total billed charges","61.5% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",10.95,32.2,,8.76,,,0,"percent of total billed charges","32.2% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.83,17.136,,4.66,,,0,"percent of total billed charges","17.136% of total billed charges",7.43,21.84,,5.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.82,37.7,,10.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.52,78,,21.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",5.2,34,
"TUBE ET ORAL RAE CUFFED 5.0",12474,CDM,272,RC,,,OUTPATIENT,,,57,37.05,,50.16,88,,40.13,,,0,"percent of total billed charges","88% of total billed charges",28.5,50,,22.80,,,0,"percent of total billed charges","50% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.86,17.304,,7.89,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.91,63,,28.73,,,0,"percent of total billed charges","63% of total billed charges",8.72,15.3,,6.98,,,0,"percent of total billed charges","15.3% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",39.33,69,,,,,0,"fee schedule","69% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.25,61.85,,28.20,,,0,"percent of total billed charges","61.5% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",28.5,50,,22.80,,,0,"percent of total billed charges","50% of total billed charges",18.35,32.2,,14.68,,,0,"percent of total billed charges","32.2% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.77,17.136,,7.82,,,0,"percent of total billed charges","17.136% of total billed charges",12.45,21.84,,9.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.49,37.7,,17.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",44.46,78,,35.57,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.08,82.6,,37.66,,,0,"percent of total billed charges","82.6% of total billed charges",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",28.5,50,,22.80,,,0,"percent of total billed charges","50% of total billed charges",47.08,82.6,,37.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.58,16.8,,7.66,,,0,"percent of total billed charges","16.8% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",8.72,57,
"TUBE TRACH RAE NASAL UNCUFFED 4.0",158301,CDM,272,RC,,,OUTPATIENT,,,22,14.3,,19.36,88,,15.49,,,0,"percent of total billed charges","88% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.81,17.304,,3.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.86,63,,11.09,,,0,"percent of total billed charges","63% of total billed charges",3.37,15.3,,2.70,,,0,"percent of total billed charges","15.3% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",15.18,69,,,,,0,"fee schedule","69% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.61,61.85,,10.89,,,0,"percent of total billed charges","61.5% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",7.08,32.2,,5.66,,,0,"percent of total billed charges","32.2% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.77,17.136,,3.02,,,0,"percent of total billed charges","17.136% of total billed charges",4.8,21.84,,3.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.29,37.7,,6.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.16,78,,13.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",3.37,22,
"TUBE ENDO 'RAE' PED UNCUFFED NASAL 4.5MM",158188,CDM,272,RC,,,OUTPATIENT,,,22,14.3,,19.36,88,,15.49,,,0,"percent of total billed charges","88% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.81,17.304,,3.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.86,63,,11.09,,,0,"percent of total billed charges","63% of total billed charges",3.37,15.3,,2.70,,,0,"percent of total billed charges","15.3% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",15.18,69,,,,,0,"fee schedule","69% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.61,61.85,,10.89,,,0,"percent of total billed charges","61.5% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",7.08,32.2,,5.66,,,0,"percent of total billed charges","32.2% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.77,17.136,,3.02,,,0,"percent of total billed charges","17.136% of total billed charges",4.8,21.84,,3.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.29,37.7,,6.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.16,78,,13.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.7,16.8,,2.96,,,0,"percent of total billed charges","16.8% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",3.37,22,
"TUBE ET ORAL RAE CUFFED 8.0 MURPHY TIP",12468,CDM,272,RC,,,OUTPATIENT,,,34,22.1,,29.92,88,,23.94,,,0,"percent of total billed charges","88% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.88,17.304,,4.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.42,63,,17.14,,,0,"percent of total billed charges","63% of total billed charges",5.2,15.3,,4.16,,,0,"percent of total billed charges","15.3% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",23.46,69,,,,,0,"fee schedule","69% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.03,61.85,,16.82,,,0,"percent of total billed charges","61.5% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",10.95,32.2,,8.76,,,0,"percent of total billed charges","32.2% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.83,17.136,,4.66,,,0,"percent of total billed charges","17.136% of total billed charges",7.43,21.84,,5.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.82,37.7,,10.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.52,78,,21.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",5.2,34,
"TUBE BRONCHO CATH 41FR LEFT",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"TUBE BRONCHO CATH 39FR LEFT",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"TUBE BRONCHO-CATH ENDOBRONCHIAL  LEFT 32 FR",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"TUBE TRACH XL DISTAL CUFFED 6.0",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"TUBE TRACH CUFFLESS SIZE 8",9255,CDM,272,RC,,,OUTPATIENT,,,244,158.6,,214.72,88,,171.78,,,0,"percent of total billed charges","88% of total billed charges",122,50,,97.60,,,0,"percent of total billed charges","50% of total billed charges",40.99,16.8,,32.79,,,0,"percent of total billed charges","16.8% of total billed charges",244,100,,195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.22,17.304,,33.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",153.72,63,,122.98,,,0,"percent of total billed charges","63% of total billed charges",37.33,15.3,,29.86,,,0,"percent of total billed charges","15.3% of total billed charges",40.99,16.8,,32.79,,,0,"percent of total billed charges","16.8% of total billed charges",168.36,69,,,,,0,"fee schedule","69% of total billed charges",244,100,,195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",244,100,,195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",244,100,,195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",150.91,61.85,,120.73,,,0,"percent of total billed charges","61.5% of total billed charges",40.99,16.8,,32.79,,,0,"percent of total billed charges","16.8% of total billed charges",122,50,,97.60,,,0,"percent of total billed charges","50% of total billed charges",78.57,32.2,,62.86,,,0,"percent of total billed charges","32.2% of total billed charges",40.99,16.8,,32.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.81,17.136,,33.45,,,0,"percent of total billed charges","17.136% of total billed charges",53.29,21.84,,42.63,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",91.99,37.7,,73.59,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",190.32,78,,152.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",201.54,82.6,,161.23,,,0,"percent of total billed charges","82.6% of total billed charges",40.99,16.8,,32.79,,,0,"percent of total billed charges","16.8% of total billed charges",122,50,,97.60,,,0,"percent of total billed charges","50% of total billed charges",201.54,82.6,,161.23,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.99,16.8,,32.79,,,0,"percent of total billed charges","16.8% of total billed charges",244,100,,195.20,,,0,"percent of total billed charges","100% of total billed charges",37.33,244,
"TUBE TRACH SZ 8 UNCUFFED DISP CANNULA",98934,CDM,272,RC,,,OUTPATIENT,,,227,147.55,,199.76,88,,159.81,,,0,"percent of total billed charges","88% of total billed charges",113.5,50,,90.80,,,0,"percent of total billed charges","50% of total billed charges",38.14,16.8,,30.51,,,0,"percent of total billed charges","16.8% of total billed charges",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.28,17.304,,31.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",143.01,63,,114.41,,,0,"percent of total billed charges","63% of total billed charges",34.73,15.3,,27.78,,,0,"percent of total billed charges","15.3% of total billed charges",38.14,16.8,,30.51,,,0,"percent of total billed charges","16.8% of total billed charges",156.63,69,,,,,0,"fee schedule","69% of total billed charges",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",140.4,61.85,,112.32,,,0,"percent of total billed charges","61.5% of total billed charges",38.14,16.8,,30.51,,,0,"percent of total billed charges","16.8% of total billed charges",113.5,50,,90.80,,,0,"percent of total billed charges","50% of total billed charges",73.09,32.2,,58.47,,,0,"percent of total billed charges","32.2% of total billed charges",38.14,16.8,,30.51,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.9,17.136,,31.12,,,0,"percent of total billed charges","17.136% of total billed charges",49.58,21.84,,39.66,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",85.58,37.7,,68.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",177.06,78,,141.65,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",187.5,82.6,,150.00,,,0,"percent of total billed charges","82.6% of total billed charges",38.14,16.8,,30.51,,,0,"percent of total billed charges","16.8% of total billed charges",113.5,50,,90.80,,,0,"percent of total billed charges","50% of total billed charges",187.5,82.6,,150.00,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.14,16.8,,30.51,,,0,"percent of total billed charges","16.8% of total billed charges",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",34.73,227,
"TUBE TRACH SZ 6 CUFFLESS SHILEY DISP CANN",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"TUBE TRACH NEO 3.0",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"TUBE E.T.6.0 CUFFED",186421,CDM,272,RC,,,OUTPATIENT,,,135,87.75,,118.8,88,,95.04,,,0,"percent of total billed charges","88% of total billed charges",67.5,50,,54.00,,,0,"percent of total billed charges","50% of total billed charges",22.68,16.8,,18.14,,,0,"percent of total billed charges","16.8% of total billed charges",135,100,,108.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.36,17.304,,18.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.05,63,,68.04,,,0,"percent of total billed charges","63% of total billed charges",20.66,15.3,,16.53,,,0,"percent of total billed charges","15.3% of total billed charges",22.68,16.8,,18.14,,,0,"percent of total billed charges","16.8% of total billed charges",93.15,69,,,,,0,"fee schedule","69% of total billed charges",135,100,,108.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",135,100,,108.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",135,100,,108.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",83.5,61.85,,66.80,,,0,"percent of total billed charges","61.5% of total billed charges",22.68,16.8,,18.14,,,0,"percent of total billed charges","16.8% of total billed charges",67.5,50,,54.00,,,0,"percent of total billed charges","50% of total billed charges",43.47,32.2,,34.78,,,0,"percent of total billed charges","32.2% of total billed charges",22.68,16.8,,18.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.13,17.136,,18.50,,,0,"percent of total billed charges","17.136% of total billed charges",29.48,21.84,,23.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.9,37.7,,40.72,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",105.3,78,,84.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",111.51,82.6,,89.21,,,0,"percent of total billed charges","82.6% of total billed charges",22.68,16.8,,18.14,,,0,"percent of total billed charges","16.8% of total billed charges",67.5,50,,54.00,,,0,"percent of total billed charges","50% of total billed charges",111.51,82.6,,89.21,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,16.8,,18.14,,,0,"percent of total billed charges","16.8% of total billed charges",135,100,,108.00,,,0,"percent of total billed charges","100% of total billed charges",20.66,135,
"TUBE ET 7.5",221213,CDM,272,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.04,61.85,,6.43,,,0,"percent of total billed charges","61.5% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"TUBE CONNECTING 12'",491620,CDM,272,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"FEEDING TUBE 8FR.IN",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"TUBE GAUZE 1",491621,CDM,270,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"TUBE FEEDING ENTUIT 14 FR GASTROSTOMY",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"TUBE FEEDING ENTUIT 16 FR GASTROSTOMY",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"TUBE FEEDING ENTUIT 18 FR GASTROSTOMY",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"TUBE FEEDING ENTUIT 20 FR GASTROSTOMY",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,824,535.6,,725.12,88,,580.10,,,0,"percent of total billed charges","88% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.58,17.304,,114.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",519.12,63,,415.30,,,0,"percent of total billed charges","63% of total billed charges",126.07,15.3,,100.86,,,0,"percent of total billed charges","15.3% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",568.56,69,,,,,0,"fee schedule","69% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.64,61.85,,407.71,,,0,"percent of total billed charges","61.5% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",265.33,32.2,,212.26,,,0,"percent of total billed charges","32.2% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",141.2,17.136,,112.96,,,0,"percent of total billed charges","17.136% of total billed charges",179.96,21.84,,143.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",310.65,37.7,,248.52,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",642.72,78,,514.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",412,50,,329.60,,,0,"percent of total billed charges","50% of total billed charges",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.43,16.8,,110.74,,,0,"percent of total billed charges","16.8% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",126.07,824,
"TUBE FEEDING 10FR SALEM SUMP",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"TUBE FEEDING 12FR SALEM SUMP",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"TUBE SALEM SUMP 8 FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"TUBE VINYL CONNECTING 30CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"TUBE VAC K2EDTA PINK 13 X 100ML",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"TUBE 12 X 75",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"TUBEGAUZE 10X25",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.82,17.304,,21.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.87,61.85,,76.70,,,0,"percent of total billed charges","61.5% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",49.91,32.2,,39.93,,,0,"percent of total billed charges","32.2% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.56,17.136,,21.25,,,0,"percent of total billed charges","17.136% of total billed charges",33.85,21.84,,27.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",77.5,50,,62.00,,,0,"percent of total billed charges","50% of total billed charges",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.04,16.8,,20.83,,,0,"percent of total billed charges","16.8% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,155,
"TUBING SUCTION (STERILE) 6'",81478,CDM,272,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"TUBING CONNECTING 6MM X 10FT",56496,CDM,272,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"TUBING OXYGEN 7 FT VINYL TIP",151702,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"TUBING OXYGEN 7FT",104745,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"TUBING HEATED INSUFLATION",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"TUBING CORRUGATED 6'' 100 FT DISP",274674,CDM,272,RC,,,OUTPATIENT,,,91,59.15,,80.08,88,,64.06,,,0,"percent of total billed charges","88% of total billed charges",45.5,50,,36.40,,,0,"percent of total billed charges","50% of total billed charges",15.29,16.8,,12.23,,,0,"percent of total billed charges","16.8% of total billed charges",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.75,17.304,,12.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.33,63,,45.86,,,0,"percent of total billed charges","63% of total billed charges",13.92,15.3,,11.14,,,0,"percent of total billed charges","15.3% of total billed charges",15.29,16.8,,12.23,,,0,"percent of total billed charges","16.8% of total billed charges",62.79,69,,,,,0,"fee schedule","69% of total billed charges",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,61.85,,45.02,,,0,"percent of total billed charges","61.5% of total billed charges",15.29,16.8,,12.23,,,0,"percent of total billed charges","16.8% of total billed charges",45.5,50,,36.40,,,0,"percent of total billed charges","50% of total billed charges",29.3,32.2,,23.44,,,0,"percent of total billed charges","32.2% of total billed charges",15.29,16.8,,12.23,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.59,17.136,,12.47,,,0,"percent of total billed charges","17.136% of total billed charges",19.87,21.84,,15.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.31,37.7,,27.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",70.98,78,,56.78,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.17,82.6,,60.14,,,0,"percent of total billed charges","82.6% of total billed charges",15.29,16.8,,12.23,,,0,"percent of total billed charges","16.8% of total billed charges",45.5,50,,36.40,,,0,"percent of total billed charges","50% of total billed charges",75.17,82.6,,60.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.29,16.8,,12.23,,,0,"percent of total billed charges","16.8% of total billed charges",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",13.92,91,
"SET SECONDARY UNIVERSAL VENTED",83498,CDM,270,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.95,61.85,,3.96,,,0,"percent of total billed charges","61.5% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"SET IV BURETROL INLINE DEHP FREE",402456,CDM,270,RC,,,OUTPATIENT,,,28,18.2,,24.64,88,,19.71,,,0,"percent of total billed charges","88% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.85,17.304,,3.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.64,63,,14.11,,,0,"percent of total billed charges","63% of total billed charges",4.28,15.3,,3.42,,,0,"percent of total billed charges","15.3% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",19.32,69,,,,,0,"fee schedule","69% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.32,61.85,,13.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",9.02,32.2,,7.22,,,0,"percent of total billed charges","32.2% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.8,17.136,,3.84,,,0,"percent of total billed charges","17.136% of total billed charges",6.12,21.84,,4.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.56,37.7,,8.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.84,78,,17.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",4.28,28,
"TUBING GAS SAMPLE",246634,CDM,270,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.9,61.85,,7.92,,,0,"percent of total billed charges","61.5% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"TUBING  HYDRA IRRIGATION",484762,CDM,272,RC,,,OUTPATIENT,,,124,80.6,,109.12,88,,87.30,,,0,"percent of total billed charges","88% of total billed charges",62,50,,49.60,,,0,"percent of total billed charges","50% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.46,17.304,,17.17,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.12,63,,62.50,,,0,"percent of total billed charges","63% of total billed charges",18.97,15.3,,15.18,,,0,"percent of total billed charges","15.3% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",85.56,69,,,,,0,"fee schedule","69% of total billed charges",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76.69,61.85,,61.35,,,0,"percent of total billed charges","61.5% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",62,50,,49.60,,,0,"percent of total billed charges","50% of total billed charges",39.93,32.2,,31.94,,,0,"percent of total billed charges","32.2% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.25,17.136,,17.00,,,0,"percent of total billed charges","17.136% of total billed charges",27.08,21.84,,21.66,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.75,37.7,,37.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",96.72,78,,77.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",102.42,82.6,,81.94,,,0,"percent of total billed charges","82.6% of total billed charges",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",62,50,,49.60,,,0,"percent of total billed charges","50% of total billed charges",102.42,82.6,,81.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.83,16.8,,16.66,,,0,"percent of total billed charges","16.8% of total billed charges",124,100,,99.20,,,0,"percent of total billed charges","100% of total billed charges",18.97,124,
"TUBING  INTERSEPT 1/4 X 3/32 X 6 FT",272371,CDM,272,RC,,,OUTPATIENT,,,40,26,,35.2,88,,28.16,,,0,"percent of total billed charges","88% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.92,17.304,,5.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.2,63,,20.16,,,0,"percent of total billed charges","63% of total billed charges",6.12,15.3,,4.90,,,0,"percent of total billed charges","15.3% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",27.6,69,,,,,0,"fee schedule","69% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.74,61.85,,19.79,,,0,"percent of total billed charges","61.5% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",12.88,32.2,,10.30,,,0,"percent of total billed charges","32.2% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.85,17.136,,5.48,,,0,"percent of total billed charges","17.136% of total billed charges",8.74,21.84,,6.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.08,37.7,,12.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",31.2,78,,24.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.72,16.8,,5.38,,,0,"percent of total billed charges","16.8% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",6.12,40,
"TUBING 5/16 ID CLEAR 100 RL",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"TUBING INTERSEPT 3/8 X 3/32 X 6 FT",272373,CDM,270,RC,,,OUTPATIENT,,,53,34.45,,46.64,88,,37.31,,,0,"percent of total billed charges","88% of total billed charges",26.5,50,,21.20,,,0,"percent of total billed charges","50% of total billed charges",8.9,16.8,,7.12,,,0,"percent of total billed charges","16.8% of total billed charges",53,100,,42.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.17,17.304,,7.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.39,63,,26.71,,,0,"percent of total billed charges","63% of total billed charges",8.11,15.3,,6.49,,,0,"percent of total billed charges","15.3% of total billed charges",8.9,16.8,,7.12,,,0,"percent of total billed charges","16.8% of total billed charges",36.57,69,,,,,0,"fee schedule","69% of total billed charges",53,100,,42.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53,100,,42.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53,100,,42.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.78,61.85,,26.22,,,0,"percent of total billed charges","61.5% of total billed charges",8.9,16.8,,7.12,,,0,"percent of total billed charges","16.8% of total billed charges",26.5,50,,21.20,,,0,"percent of total billed charges","50% of total billed charges",17.07,32.2,,13.66,,,0,"percent of total billed charges","32.2% of total billed charges",8.9,16.8,,7.12,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.08,17.136,,7.26,,,0,"percent of total billed charges","17.136% of total billed charges",11.58,21.84,,9.26,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.98,37.7,,15.98,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.34,78,,33.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.78,82.6,,35.02,,,0,"percent of total billed charges","82.6% of total billed charges",8.9,16.8,,7.12,,,0,"percent of total billed charges","16.8% of total billed charges",26.5,50,,21.20,,,0,"percent of total billed charges","50% of total billed charges",43.78,82.6,,35.02,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.9,16.8,,7.12,,,0,"percent of total billed charges","16.8% of total billed charges",53,100,,42.40,,,0,"percent of total billed charges","100% of total billed charges",8.11,53,
"TUBING IRRIGATION 7501669",ORSUP0011,CDM,270,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"TUBING PATIENT REDEUCE",ORSUP0024,CDM,270,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"TUBING PUMP REDEUCE",ORSUP0026,CDM,270,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"TUBING DUAL PROBE",ORSUP0019,CDM,272,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"TUBING PNEUMATIC KAIRISON FK888SU",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"TUBING SMARTABLATE PUMP",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"TUBING VACUUM FOR LEEP(OB/GYN)",491641,CDM,270,RC,,,OUTPATIENT,,,128,83.2,,112.64,88,,90.11,,,0,"percent of total billed charges","88% of total billed charges",64,50,,51.20,,,0,"percent of total billed charges","50% of total billed charges",21.5,16.8,,17.20,,,0,"percent of total billed charges","16.8% of total billed charges",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.15,17.304,,17.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.64,63,,64.51,,,0,"percent of total billed charges","63% of total billed charges",19.58,15.3,,15.66,,,0,"percent of total billed charges","15.3% of total billed charges",21.5,16.8,,17.20,,,0,"percent of total billed charges","16.8% of total billed charges",88.32,69,,,,,0,"fee schedule","69% of total billed charges",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.17,61.85,,63.34,,,0,"percent of total billed charges","61.5% of total billed charges",21.5,16.8,,17.20,,,0,"percent of total billed charges","16.8% of total billed charges",64,50,,51.20,,,0,"percent of total billed charges","50% of total billed charges",41.22,32.2,,32.98,,,0,"percent of total billed charges","32.2% of total billed charges",21.5,16.8,,17.20,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.93,17.136,,17.54,,,0,"percent of total billed charges","17.136% of total billed charges",27.96,21.84,,22.37,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",48.26,37.7,,38.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",99.84,78,,79.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.73,82.6,,84.58,,,0,"percent of total billed charges","82.6% of total billed charges",21.5,16.8,,17.20,,,0,"percent of total billed charges","16.8% of total billed charges",64,50,,51.20,,,0,"percent of total billed charges","50% of total billed charges",105.73,82.6,,84.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.5,16.8,,17.20,,,0,"percent of total billed charges","16.8% of total billed charges",128,100,,102.40,,,0,"percent of total billed charges","100% of total billed charges",19.58,128,
"TUBING INFLOW",ORSUP0013,CDM,270,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"TUBING LEG BAG W/CONNECTOR",491634,CDM,270,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"TUBING CROSSFLOW INFLO CASSET",ORSUP0009,CDM,270,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"TUBING 60GTT/ML",491625,CDM,272,RC,,,OUTPATIENT,,,38,24.7,,33.44,88,,26.75,,,0,"percent of total billed charges","88% of total billed charges",19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.58,17.304,,5.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.94,63,,19.15,,,0,"percent of total billed charges","63% of total billed charges",5.81,15.3,,4.65,,,0,"percent of total billed charges","15.3% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",26.22,69,,,,,0,"fee schedule","69% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.5,61.85,,18.80,,,0,"percent of total billed charges","61.5% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",12.24,32.2,,9.79,,,0,"percent of total billed charges","32.2% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.51,17.136,,5.21,,,0,"percent of total billed charges","17.136% of total billed charges",8.3,21.84,,6.64,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.33,37.7,,11.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.64,78,,23.71,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.38,16.8,,5.10,,,0,"percent of total billed charges","16.8% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",5.81,38,
"TUBING ADMINISTRATION SET 15GTT/ML",491626,CDM,272,RC,,,OUTPATIENT,,,25,16.25,,22,88,,17.60,,,0,"percent of total billed charges","88% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,17.304,,3.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.75,63,,12.60,,,0,"percent of total billed charges","63% of total billed charges",3.83,15.3,,3.06,,,0,"percent of total billed charges","15.3% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",17.25,69,,,,,0,"fee schedule","69% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.46,61.85,,12.37,,,0,"percent of total billed charges","61.5% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",8.05,32.2,,6.44,,,0,"percent of total billed charges","32.2% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.28,17.136,,3.42,,,0,"percent of total billed charges","17.136% of total billed charges",5.46,21.84,,4.37,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.43,37.7,,7.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.5,78,,15.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",3.83,25,
"TUBING CYSTO IRRIGATION",491628,CDM,270,RC,,,OUTPATIENT,,,27,17.55,,23.76,88,,19.01,,,0,"percent of total billed charges","88% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.67,17.304,,3.74,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.01,63,,13.61,,,0,"percent of total billed charges","63% of total billed charges",4.13,15.3,,3.30,,,0,"percent of total billed charges","15.3% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",18.63,69,,,,,0,"fee schedule","69% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.7,61.85,,13.36,,,0,"percent of total billed charges","61.5% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",8.69,32.2,,6.95,,,0,"percent of total billed charges","32.2% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.63,17.136,,3.70,,,0,"percent of total billed charges","17.136% of total billed charges",5.9,21.84,,4.72,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.18,37.7,,8.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.06,78,,16.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.3,82.6,,17.84,,,0,"percent of total billed charges","82.6% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",22.3,82.6,,17.84,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",4.13,27,
"TUBING IV BURETROL",491632,CDM,270,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"TUBING IV SECONDARY",491633,CDM,270,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"TUBING MICROBORE 60GTT/ML",491635,CDM,270,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"TUBING OXYGEN 7' EXTENSION",491636,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"TUBING SALINE LOCK EXT 8",491637,CDM,270,RC,,,OUTPATIENT,,,28,18.2,,24.64,88,,19.71,,,0,"percent of total billed charges","88% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.85,17.304,,3.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.64,63,,14.11,,,0,"percent of total billed charges","63% of total billed charges",4.28,15.3,,3.42,,,0,"percent of total billed charges","15.3% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",19.32,69,,,,,0,"fee schedule","69% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.32,61.85,,13.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",9.02,32.2,,7.22,,,0,"percent of total billed charges","32.2% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.8,17.136,,3.84,,,0,"percent of total billed charges","17.136% of total billed charges",6.12,21.84,,4.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.56,37.7,,8.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.84,78,,17.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",4.28,28,
"TUBING SMALL BORE EXT SET 6",491638,CDM,270,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"TUBING SUCTION",491639,CDM,270,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"TUBING MAIN PUMP",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"TUBING CTA CONNECTING",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"TUBING MALE TO MALE 72 IN",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"TUBING CORE IRRIGATION",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"TUBING HIGH PRESSURE NAMIC FLEXCIL 48IN",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"TUBING CONNECTING 7FR-10FR X 30CM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"TUBING PRESSURE MONITORING MALE/FEMALE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"TUBING EPIDURAL ADMIN FILTER 0.2 MICRON FILTER(CURLIN PUMP)",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
N/A,490153,CDM,272,RC,,,OUTPATIENT,,,1494,971.1,,1314.72,88,,1051.78,,,0,"percent of total billed charges","88% of total billed charges",747,50,,597.60,,,0,"percent of total billed charges","50% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.52,17.304,,206.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",941.22,63,,752.98,,,0,"percent of total billed charges","63% of total billed charges",228.58,15.3,,182.86,,,0,"percent of total billed charges","15.3% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",1030.86,69,,,,,0,"fee schedule","69% of total billed charges",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",924.04,61.85,,739.23,,,0,"percent of total billed charges","61.5% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",747,50,,597.60,,,0,"percent of total billed charges","50% of total billed charges",481.07,32.2,,384.86,,,0,"percent of total billed charges","32.2% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",256.01,17.136,,204.81,,,0,"percent of total billed charges","17.136% of total billed charges",326.29,21.84,,261.03,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",563.24,37.7,,450.59,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1165.32,78,,932.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1234.04,82.6,,987.23,,,0,"percent of total billed charges","82.6% of total billed charges",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",747,50,,597.60,,,0,"percent of total billed charges","50% of total billed charges",1234.04,82.6,,987.23,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",250.99,16.8,,200.79,,,0,"percent of total billed charges","16.8% of total billed charges",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",228.58,1494,
"TWIST DRILL 1.1MM X 50MM W/NOTCH 5MM STOP",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"TWIST DRILL 2.30 MM DRILL-2.30",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"TWISTER 25MM",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"TWISTER 13MM",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"TYPESAFE 2.0 SEGMENT PIERCING DEVICE",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2266,1472.9,,1994.08,88,,1595.26,,,0,"percent of total billed charges","88% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",392.11,17.304,,313.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1427.58,63,,1142.06,,,0,"percent of total billed charges","63% of total billed charges",346.7,15.3,,277.36,,,0,"percent of total billed charges","15.3% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1563.54,69,,,,,0,"fee schedule","69% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1401.52,61.85,,1121.22,,,0,"percent of total billed charges","61.5% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",729.65,32.2,,583.72,,,0,"percent of total billed charges","32.2% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",388.3,17.136,,310.64,,,0,"percent of total billed charges","17.136% of total billed charges",494.89,21.84,,395.91,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",854.28,37.7,,683.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1767.48,78,,1413.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1871.72,82.6,,1497.38,,,0,"percent of total billed charges","82.6% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",1871.72,82.6,,1497.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",346.7,2266,
UIBC,ORSUP0026,CDM,272,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"ULTIMATE CHAIR SENSOR",ORSUP0016,CDM,270,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"ULTRACLIP II COIL TISSUE MARKER",ORSUP0019,CDM,278,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",668.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.7% of total billed charges",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",726.14,33.9,,580.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"ULTRASNAP ATP SWABS",ORSUP0016,CDM,270,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"ULTRASLING LRG",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"ULTRASOUND GEL",491644,CDM,270,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.75,61.85,,9.40,,,0,"percent of total billed charges","61.5% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",15.69,82.6,,12.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"ULTRASONIC TESTERS",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"ULTRA-SLIP STYLETS",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"ULTRABRIDGE KIT",ORSUP0054,CDM,272,RC,,,OUTPATIENT,,,8600,5590,,7568,88,,6054.40,,,0,"percent of total billed charges","88% of total billed charges",4300,50,,3440.00,,,0,"percent of total billed charges","50% of total billed charges",1444.8,16.8,,1155.84,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1488.14,17.304,,1190.51,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5418,63,,4334.40,,,0,"percent of total billed charges","63% of total billed charges",1315.8,15.3,,1052.64,,,0,"percent of total billed charges","15.3% of total billed charges",1444.8,16.8,,1155.84,,,0,"percent of total billed charges","16.8% of total billed charges",5934,69,,,,,0,"fee schedule","69% of total billed charges",8600,100,,6880.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8600,100,,6880.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8600,100,,6880.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5319.1,61.85,,4255.28,,,0,"percent of total billed charges","61.5% of total billed charges",1444.8,16.8,,1155.84,,,0,"percent of total billed charges","16.8% of total billed charges",4300,50,,3440.00,,,0,"percent of total billed charges","50% of total billed charges",2769.2,32.2,,2215.36,,,0,"percent of total billed charges","32.2% of total billed charges",1444.8,16.8,,1155.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1473.7,17.136,,1178.96,,,0,"percent of total billed charges","17.136% of total billed charges",1878.24,21.84,,1502.59,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3242.2,37.7,,2593.76,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6708,78,,5366.40,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7103.6,82.6,,5682.88,,,0,"percent of total billed charges","82.6% of total billed charges",1444.8,16.8,,1155.84,,,0,"percent of total billed charges","16.8% of total billed charges",4300,50,,3440.00,,,0,"percent of total billed charges","50% of total billed charges",7103.6,82.6,,5682.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1444.8,16.8,,1155.84,,,0,"percent of total billed charges","16.8% of total billed charges",8600,100,,6880.00,,,0,"percent of total billed charges","100% of total billed charges",1315.8,8600,
"UMBILICAL CORD CLAMP PLASTIC OFF-WHITE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"UMBILICAL VESSEL CATH DUAL LUMEN 3.5FR",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"UNCROSSMATCHED BLOOD LABELS",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"UNDERWEAR PROTECTIVE PULL-UP LARGE",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"UNDER WEAR PULL UP SM",329909,CDM,272,RC,,,OUTPATIENT,,,401,260.65,,352.88,88,,282.30,,,0,"percent of total billed charges","88% of total billed charges",200.5,50,,160.40,,,0,"percent of total billed charges","50% of total billed charges",67.37,16.8,,53.90,,,0,"percent of total billed charges","16.8% of total billed charges",401,100,,320.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.39,17.304,,55.51,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.63,63,,202.10,,,0,"percent of total billed charges","63% of total billed charges",61.35,15.3,,49.08,,,0,"percent of total billed charges","15.3% of total billed charges",67.37,16.8,,53.90,,,0,"percent of total billed charges","16.8% of total billed charges",276.69,69,,,,,0,"fee schedule","69% of total billed charges",401,100,,320.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",401,100,,320.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",401,100,,320.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.02,61.85,,198.42,,,0,"percent of total billed charges","61.5% of total billed charges",67.37,16.8,,53.90,,,0,"percent of total billed charges","16.8% of total billed charges",200.5,50,,160.40,,,0,"percent of total billed charges","50% of total billed charges",129.12,32.2,,103.30,,,0,"percent of total billed charges","32.2% of total billed charges",67.37,16.8,,53.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.72,17.136,,54.98,,,0,"percent of total billed charges","17.136% of total billed charges",87.58,21.84,,70.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.18,37.7,,120.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",312.78,78,,250.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.23,82.6,,264.98,,,0,"percent of total billed charges","82.6% of total billed charges",67.37,16.8,,53.90,,,0,"percent of total billed charges","16.8% of total billed charges",200.5,50,,160.40,,,0,"percent of total billed charges","50% of total billed charges",331.23,82.6,,264.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.37,16.8,,53.90,,,0,"percent of total billed charges","16.8% of total billed charges",401,100,,320.80,,,0,"percent of total billed charges","100% of total billed charges",61.35,401,
"UNDERPAD 20.5X36IN",193403,CDM,272,RC,,,OUTPATIENT,,,24,15.6,,21.12,88,,16.90,,,0,"percent of total billed charges","88% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.15,17.304,,3.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.12,63,,12.10,,,0,"percent of total billed charges","63% of total billed charges",3.67,15.3,,2.94,,,0,"percent of total billed charges","15.3% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",16.56,69,,,,,0,"fee schedule","69% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.84,61.85,,11.87,,,0,"percent of total billed charges","61.5% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",7.73,32.2,,6.18,,,0,"percent of total billed charges","32.2% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.11,17.136,,3.29,,,0,"percent of total billed charges","17.136% of total billed charges",5.24,21.84,,4.19,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.05,37.7,,7.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.72,78,,14.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,24,
"UNDERPAD LARGE 30X30",76648,CDM,272,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"UNDERWEAR PROTECTIVE PULLUP DISPOS MEDIUM",240857,CDM,272,RC,,,OUTPATIENT,,,279,181.35,,245.52,88,,196.42,,,0,"percent of total billed charges","88% of total billed charges",139.5,50,,111.60,,,0,"percent of total billed charges","50% of total billed charges",46.87,16.8,,37.50,,,0,"percent of total billed charges","16.8% of total billed charges",279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.28,17.304,,38.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",175.77,63,,140.62,,,0,"percent of total billed charges","63% of total billed charges",42.69,15.3,,34.15,,,0,"percent of total billed charges","15.3% of total billed charges",46.87,16.8,,37.50,,,0,"percent of total billed charges","16.8% of total billed charges",192.51,69,,,,,0,"fee schedule","69% of total billed charges",279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",172.56,61.85,,138.05,,,0,"percent of total billed charges","61.5% of total billed charges",46.87,16.8,,37.50,,,0,"percent of total billed charges","16.8% of total billed charges",139.5,50,,111.60,,,0,"percent of total billed charges","50% of total billed charges",89.84,32.2,,71.87,,,0,"percent of total billed charges","32.2% of total billed charges",46.87,16.8,,37.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.81,17.136,,38.25,,,0,"percent of total billed charges","17.136% of total billed charges",60.93,21.84,,48.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",105.18,37.7,,84.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",217.62,78,,174.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",230.45,82.6,,184.36,,,0,"percent of total billed charges","82.6% of total billed charges",46.87,16.8,,37.50,,,0,"percent of total billed charges","16.8% of total billed charges",139.5,50,,111.60,,,0,"percent of total billed charges","50% of total billed charges",230.45,82.6,,184.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.87,16.8,,37.50,,,0,"percent of total billed charges","16.8% of total billed charges",279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",42.69,279,
"UNDERGLOVE SZ 9 SURGEON",491645,CDM,270,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,61.85,,3.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",5.78,82.6,,4.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
UNDERPADS,491646,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"UNDERPAD COMFORT GLIDE DRYPAD 36 X 57",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"UNDERPAD 17X24 DISPOSABLE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"UNDERWEAR ATTENDS PULL ON 22-34 SM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"UNDERWEAR ATTENDS PULL ON 34-44 MED",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"UNDERWEAR ATTENDS PULL ON 44-58 LRG",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"UNDERGLOVES GAMMEX PI",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"UNIGLIDE ROADRUNNER .018X320CM",ORSUP0002,CDM,278,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.7% of total billed charges",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.43,33.9,,36.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"UNIT PREVENA PLUS 125 THERAPY",ORSUP0022,CDM,272,RC,,,OUTPATIENT,,,2946,1914.9,,2592.48,88,,2073.98,,,0,"percent of total billed charges","88% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.78,17.304,,407.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1855.98,63,,1484.78,,,0,"percent of total billed charges","63% of total billed charges",450.74,15.3,,360.59,,,0,"percent of total billed charges","15.3% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2032.74,69,,,,,0,"fee schedule","69% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1822.1,61.85,,1457.68,,,0,"percent of total billed charges","61.5% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",948.61,32.2,,758.89,,,0,"percent of total billed charges","32.2% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.83,17.136,,403.86,,,0,"percent of total billed charges","17.136% of total billed charges",643.41,21.84,,514.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1110.64,37.7,,888.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2297.88,78,,1838.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",1473,50,,1178.40,,,0,"percent of total billed charges","50% of total billed charges",2433.4,82.6,,1946.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",494.93,16.8,,395.94,,,0,"percent of total billed charges","16.8% of total billed charges",2946,100,,2356.80,,,0,"percent of total billed charges","100% of total billed charges",450.74,2946,
"UNIVERSAL ECG CLIPS",ORSUP0009,CDM,270,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"UNIVERSAL VIRAL TRANSPORT 1ML",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"UNIVERSAL HOSE RED 60401800100",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"UNIVERSAL HOSE BLUE 60401700100",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"FACIAL WRAP UNIVERSAL",490585,CDM,270,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"UNIV WASH RESERVOIR FILTR",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"UNIVERSAL LIGHT COVER HANDLE COVER PURPLE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"UNIVERSAL NUT NIPPLE ADAPTER",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"UNIVERSAL FLAT SYLE CLIPPER BLADE GREY",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"UNIVERSAL SEAL 5-12MM IS4000",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"UNIVERSAL VENT CIRCUIT NONHEATED NIV",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"UNNA BOOT 4 INCH GELOCAST",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"UPLUG 406",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"UPRO PERF VERIFIER II",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"UPRO PERF VERIFIER I BX / 6BTLS",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"URETERAL CATH 5 FR",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"URETHRAL DILATOR SET 24FR",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1185,770.25,,1042.8,88,,834.24,,,0,"percent of total billed charges","88% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",205.05,17.304,,164.04,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",746.55,63,,597.24,,,0,"percent of total billed charges","63% of total billed charges",181.31,15.3,,145.05,,,0,"percent of total billed charges","15.3% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",817.65,69,,,,,0,"fee schedule","69% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.92,61.85,,586.34,,,0,"percent of total billed charges","61.5% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",381.57,32.2,,305.26,,,0,"percent of total billed charges","32.2% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",203.06,17.136,,162.45,,,0,"percent of total billed charges","17.136% of total billed charges",258.8,21.84,,207.04,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",446.75,37.7,,357.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",924.3,78,,739.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",592.5,50,,474.00,,,0,"percent of total billed charges","50% of total billed charges",978.81,82.6,,783.05,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",199.08,16.8,,159.26,,,0,"percent of total billed charges","16.8% of total billed charges",1185,100,,948.00,,,0,"percent of total billed charges","100% of total billed charges",181.31,1185,
"URIC ACID /5 PACK / 300 SLDS",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"URINE METER",491649,CDM,270,RC,,,OUTPATIENT,,,66,42.9,,58.08,88,,46.46,,,0,"percent of total billed charges","88% of total billed charges",33,50,,26.40,,,0,"percent of total billed charges","50% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.42,17.304,,9.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.58,63,,33.26,,,0,"percent of total billed charges","63% of total billed charges",10.1,15.3,,8.08,,,0,"percent of total billed charges","15.3% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",45.54,69,,,,,0,"fee schedule","69% of total billed charges",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.82,61.85,,32.66,,,0,"percent of total billed charges","61.5% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",33,50,,26.40,,,0,"percent of total billed charges","50% of total billed charges",21.25,32.2,,17.00,,,0,"percent of total billed charges","32.2% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.31,17.136,,9.05,,,0,"percent of total billed charges","17.136% of total billed charges",14.41,21.84,,11.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.88,37.7,,19.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",51.48,78,,41.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",54.52,82.6,,43.62,,,0,"percent of total billed charges","82.6% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",33,50,,26.40,,,0,"percent of total billed charges","50% of total billed charges",54.52,82.6,,43.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",10.1,66,
"URINAL W/ HANDLE",491648,CDM,270,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"URINE MANAGEMENT SYSTEM FEMALE EXTERNAL",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"URINE MANAGEMENT PRIMOFIT EXTERNAL",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"URINE ELEC DILUENT / BOX /12 BTLS",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"URINE PROTEINS / 5 PACK/ 90 SLDS",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"URINE COLLECTION PEDS STERILE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"URINE CAL 6X5ML",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"URINE CREATINE CAL",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"URINE COLLECTION KIT A-CT/NG",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"URISYS CALIBRATIONS STRIPS 50",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"UROPASS SHEATH 12/14FR x 46CM",ORSUP0016,CDM,270,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"UROPASS SHEATH 12/14FR X 54CM",ORSUP0016,CDM,270,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"UROPASS SHEATH 12/14FR X 38CM",ORSUP0016,CDM,270,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"UROPASS SHEATH 12/14FR X 24CM",ORSUP0015,CDM,270,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"UROPASS URETERAL ACCESS SHEATH 11/13FR 54CM",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"UROPASS URETERAL ACCESS SHEATH 11/13FR 46CM",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"URYSIS 1800 PAPER",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"1050 STERI DRAPE",490000,CDM,272,RC,,,OUTPATIENT,,,34,22.1,,29.92,88,,23.94,,,0,"percent of total billed charges","88% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.88,17.304,,4.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.42,63,,17.14,,,0,"percent of total billed charges","63% of total billed charges",5.2,15.3,,4.16,,,0,"percent of total billed charges","15.3% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",23.46,69,,,,,0,"fee schedule","69% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.03,61.85,,16.82,,,0,"percent of total billed charges","61.5% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",10.95,32.2,,8.76,,,0,"percent of total billed charges","32.2% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.83,17.136,,4.66,,,0,"percent of total billed charges","17.136% of total billed charges",7.43,21.84,,5.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.82,37.7,,10.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.52,78,,21.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",5.2,34,
"ADAPTIC NON-ADHERENT GAUZE 3 X 16",490018,CDM,270,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"ADAPTIC NON-ADHERENT GAUZE 3 X 3",490019,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"ADULT LAPAROTOMY DRAPE",490021,CDM,270,RC,,,OUTPATIENT,,,61,39.65,,53.68,88,,42.94,,,0,"percent of total billed charges","88% of total billed charges",30.5,50,,24.40,,,0,"percent of total billed charges","50% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.56,17.304,,8.45,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.43,63,,30.74,,,0,"percent of total billed charges","63% of total billed charges",9.33,15.3,,7.46,,,0,"percent of total billed charges","15.3% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",42.09,69,,,,,0,"fee schedule","69% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.73,61.85,,30.18,,,0,"percent of total billed charges","61.5% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",30.5,50,,24.40,,,0,"percent of total billed charges","50% of total billed charges",19.64,32.2,,15.71,,,0,"percent of total billed charges","32.2% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.45,17.136,,8.36,,,0,"percent of total billed charges","17.136% of total billed charges",13.32,21.84,,10.66,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23,37.7,,18.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47.58,78,,38.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.39,82.6,,40.31,,,0,"percent of total billed charges","82.6% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",30.5,50,,24.40,,,0,"percent of total billed charges","50% of total billed charges",50.39,82.6,,40.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",9.33,61,
"USE ITEM #1008 ARM SLING LARGE",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"USE ITEM #79590 ARM SLING XL",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"COBAN STERILE 4",490357,CDM,272,RC,,,OUTPATIENT,,,39,25.35,,34.32,88,,27.46,,,0,"percent of total billed charges","88% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.75,17.304,,5.40,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.57,63,,19.66,,,0,"percent of total billed charges","63% of total billed charges",5.97,15.3,,4.78,,,0,"percent of total billed charges","15.3% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",26.91,69,,,,,0,"fee schedule","69% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.12,61.85,,19.30,,,0,"percent of total billed charges","61.5% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",12.56,32.2,,10.05,,,0,"percent of total billed charges","32.2% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.68,17.136,,5.34,,,0,"percent of total billed charges","17.136% of total billed charges",8.52,21.84,,6.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.42,78,,24.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.55,16.8,,5.24,,,0,"percent of total billed charges","16.8% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",5.97,39,
"EXTREMITY DRAPE",490548,CDM,270,RC,,,OUTPATIENT,,,64,41.6,,56.32,88,,45.06,,,0,"percent of total billed charges","88% of total billed charges",32,50,,25.60,,,0,"percent of total billed charges","50% of total billed charges",10.75,16.8,,8.60,,,0,"percent of total billed charges","16.8% of total billed charges",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.07,17.304,,8.86,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.32,63,,32.26,,,0,"percent of total billed charges","63% of total billed charges",9.79,15.3,,7.83,,,0,"percent of total billed charges","15.3% of total billed charges",10.75,16.8,,8.60,,,0,"percent of total billed charges","16.8% of total billed charges",44.16,69,,,,,0,"fee schedule","69% of total billed charges",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.58,61.85,,31.66,,,0,"percent of total billed charges","61.5% of total billed charges",10.75,16.8,,8.60,,,0,"percent of total billed charges","16.8% of total billed charges",32,50,,25.60,,,0,"percent of total billed charges","50% of total billed charges",20.61,32.2,,16.49,,,0,"percent of total billed charges","32.2% of total billed charges",10.75,16.8,,8.60,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.97,17.136,,8.78,,,0,"percent of total billed charges","17.136% of total billed charges",13.98,21.84,,11.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.13,37.7,,19.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",49.92,78,,39.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.86,82.6,,42.29,,,0,"percent of total billed charges","82.6% of total billed charges",10.75,16.8,,8.60,,,0,"percent of total billed charges","16.8% of total billed charges",32,50,,25.60,,,0,"percent of total billed charges","50% of total billed charges",52.86,82.6,,42.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.75,16.8,,8.60,,,0,"percent of total billed charges","16.8% of total billed charges",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",9.79,64,
"IOBAN INCISE DRAPE W/POUCH 129 W X 100 L",490763,CDM,270,RC,,,OUTPATIENT,,,266,172.9,,234.08,88,,187.26,,,0,"percent of total billed charges","88% of total billed charges",133,50,,106.40,,,0,"percent of total billed charges","50% of total billed charges",44.69,16.8,,35.75,,,0,"percent of total billed charges","16.8% of total billed charges",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.03,17.304,,36.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",167.58,63,,134.06,,,0,"percent of total billed charges","63% of total billed charges",40.7,15.3,,32.56,,,0,"percent of total billed charges","15.3% of total billed charges",44.69,16.8,,35.75,,,0,"percent of total billed charges","16.8% of total billed charges",183.54,69,,,,,0,"fee schedule","69% of total billed charges",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",164.52,61.85,,131.62,,,0,"percent of total billed charges","61.5% of total billed charges",44.69,16.8,,35.75,,,0,"percent of total billed charges","16.8% of total billed charges",133,50,,106.40,,,0,"percent of total billed charges","50% of total billed charges",85.65,32.2,,68.52,,,0,"percent of total billed charges","32.2% of total billed charges",44.69,16.8,,35.75,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.58,17.136,,36.46,,,0,"percent of total billed charges","17.136% of total billed charges",58.09,21.84,,46.47,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",100.28,37.7,,80.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",207.48,78,,165.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",219.72,82.6,,175.78,,,0,"percent of total billed charges","82.6% of total billed charges",44.69,16.8,,35.75,,,0,"percent of total billed charges","16.8% of total billed charges",133,50,,106.40,,,0,"percent of total billed charges","50% of total billed charges",219.72,82.6,,175.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.69,16.8,,35.75,,,0,"percent of total billed charges","16.8% of total billed charges",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",40.7,266,
"KLING GAUZE STERILE 6",490797,CDM,272,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.09,61.85,,2.47,,,0,"percent of total billed charges","61.5% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",4.13,82.6,,3.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"MAYO STAND COVER",490868,CDM,270,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.37,61.85,,9.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"PEDIATRIC LAPAROTOMY DRAPE",491048,CDM,270,RC,,,OUTPATIENT,,,71,46.15,,62.48,88,,49.98,,,0,"percent of total billed charges","88% of total billed charges",35.5,50,,28.40,,,0,"percent of total billed charges","50% of total billed charges",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.29,17.304,,9.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.73,63,,35.78,,,0,"percent of total billed charges","63% of total billed charges",10.86,15.3,,8.69,,,0,"percent of total billed charges","15.3% of total billed charges",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",48.99,69,,,,,0,"fee schedule","69% of total billed charges",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.91,61.85,,35.13,,,0,"percent of total billed charges","61.5% of total billed charges",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",35.5,50,,28.40,,,0,"percent of total billed charges","50% of total billed charges",22.86,32.2,,18.29,,,0,"percent of total billed charges","32.2% of total billed charges",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.17,17.136,,9.74,,,0,"percent of total billed charges","17.136% of total billed charges",15.51,21.84,,12.41,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.77,37.7,,21.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",55.38,78,,44.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.65,82.6,,46.92,,,0,"percent of total billed charges","82.6% of total billed charges",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",35.5,50,,28.40,,,0,"percent of total billed charges","50% of total billed charges",58.65,82.6,,46.92,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",10.86,71,
"PLASTER SPLINT 3 X 15",491075,CDM,270,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"PLASTER SPLINT 5 X 30",491077,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"SHOULDER ARTHROSCOPY DRAPE",491192,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"STERI STRIP 1",491301,CDM,270,RC,,,OUTPATIENT,,,28,18.2,,24.64,88,,19.71,,,0,"percent of total billed charges","88% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.85,17.304,,3.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.64,63,,14.11,,,0,"percent of total billed charges","63% of total billed charges",4.28,15.3,,3.42,,,0,"percent of total billed charges","15.3% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",19.32,69,,,,,0,"fee schedule","69% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.32,61.85,,13.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",9.02,32.2,,7.22,,,0,"percent of total billed charges","32.2% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.8,17.136,,3.84,,,0,"percent of total billed charges","17.136% of total billed charges",6.12,21.84,,4.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.56,37.7,,8.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.84,78,,17.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",4.28,28,
"STERI STRIP 1/4",491302,CDM,270,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.95,61.85,,3.96,,,0,"percent of total billed charges","61.5% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"STERIS WASHER INDICATOR",491308,CDM,270,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.37,61.85,,9.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"STERRAD CASSETTES",491310,CDM,270,RC,,,OUTPATIENT,,,904,587.6,,795.52,88,,636.42,,,0,"percent of total billed charges","88% of total billed charges",452,50,,361.60,,,0,"percent of total billed charges","50% of total billed charges",151.87,16.8,,121.50,,,0,"percent of total billed charges","16.8% of total billed charges",904,100,,723.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.43,17.304,,125.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",569.52,63,,455.62,,,0,"percent of total billed charges","63% of total billed charges",138.31,15.3,,110.65,,,0,"percent of total billed charges","15.3% of total billed charges",151.87,16.8,,121.50,,,0,"percent of total billed charges","16.8% of total billed charges",623.76,69,,,,,0,"fee schedule","69% of total billed charges",904,100,,723.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",904,100,,723.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",904,100,,723.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",559.12,61.85,,447.30,,,0,"percent of total billed charges","61.5% of total billed charges",151.87,16.8,,121.50,,,0,"percent of total billed charges","16.8% of total billed charges",452,50,,361.60,,,0,"percent of total billed charges","50% of total billed charges",291.09,32.2,,232.87,,,0,"percent of total billed charges","32.2% of total billed charges",151.87,16.8,,121.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",154.91,17.136,,123.93,,,0,"percent of total billed charges","17.136% of total billed charges",197.43,21.84,,157.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",340.81,37.7,,272.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",705.12,78,,564.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",746.7,82.6,,597.36,,,0,"percent of total billed charges","82.6% of total billed charges",151.87,16.8,,121.50,,,0,"percent of total billed charges","16.8% of total billed charges",452,50,,361.60,,,0,"percent of total billed charges","50% of total billed charges",746.7,82.6,,597.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.87,16.8,,121.50,,,0,"percent of total billed charges","16.8% of total billed charges",904,100,,723.20,,,0,"percent of total billed charges","100% of total billed charges",138.31,904,
"STERRAD INDICATOR TAPE",491311,CDM,270,RC,,,OUTPATIENT,,,243,157.95,,213.84,88,,171.07,,,0,"percent of total billed charges","88% of total billed charges",121.5,50,,97.20,,,0,"percent of total billed charges","50% of total billed charges",40.82,16.8,,32.66,,,0,"percent of total billed charges","16.8% of total billed charges",243,100,,194.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.05,17.304,,33.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",153.09,63,,122.47,,,0,"percent of total billed charges","63% of total billed charges",37.18,15.3,,29.74,,,0,"percent of total billed charges","15.3% of total billed charges",40.82,16.8,,32.66,,,0,"percent of total billed charges","16.8% of total billed charges",167.67,69,,,,,0,"fee schedule","69% of total billed charges",243,100,,194.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",243,100,,194.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",243,100,,194.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",150.3,61.85,,120.24,,,0,"percent of total billed charges","61.5% of total billed charges",40.82,16.8,,32.66,,,0,"percent of total billed charges","16.8% of total billed charges",121.5,50,,97.20,,,0,"percent of total billed charges","50% of total billed charges",78.25,32.2,,62.60,,,0,"percent of total billed charges","32.2% of total billed charges",40.82,16.8,,32.66,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.64,17.136,,33.31,,,0,"percent of total billed charges","17.136% of total billed charges",53.07,21.84,,42.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",91.61,37.7,,73.29,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",189.54,78,,151.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",200.72,82.6,,160.58,,,0,"percent of total billed charges","82.6% of total billed charges",40.82,16.8,,32.66,,,0,"percent of total billed charges","16.8% of total billed charges",121.5,50,,97.20,,,0,"percent of total billed charges","50% of total billed charges",200.72,82.6,,160.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.82,16.8,,32.66,,,0,"percent of total billed charges","16.8% of total billed charges",243,100,,194.40,,,0,"percent of total billed charges","100% of total billed charges",37.18,243,
"STERRAD INDICATORS",491312,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"TABLE COVER",491542,CDM,270,RC,,,OUTPATIENT,,,25,16.25,,22,88,,17.60,,,0,"percent of total billed charges","88% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,17.304,,3.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.75,63,,12.60,,,0,"percent of total billed charges","63% of total billed charges",3.83,15.3,,3.06,,,0,"percent of total billed charges","15.3% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",17.25,69,,,,,0,"fee schedule","69% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.46,61.85,,12.37,,,0,"percent of total billed charges","61.5% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",8.05,32.2,,6.44,,,0,"percent of total billed charges","32.2% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.28,17.136,,3.42,,,0,"percent of total billed charges","17.136% of total billed charges",5.46,21.84,,4.37,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.43,37.7,,7.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.5,78,,15.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",3.83,25,
"TUBE GAUZE 5/8",491622,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"UTAHLOOP 20MMX12MM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"UTAHLOOP 15MMX12MM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"UTAHLOOP 10MMX10MM",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"UTERINE MANIPULATOR TIP GREEN",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"UTERINE MANIPULATOR TIP BLUE",ORSUP0007,CDM,270,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"V-AGAR MONOPLATE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"VAC VIA THERAPY SYSTEM",ORSUP0027,CDM,272,RC,,,OUTPATIENT,,,4285,2785.25,,3770.8,88,,3016.64,,,0,"percent of total billed charges","88% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.48,17.304,,593.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2699.55,63,,2159.64,,,0,"percent of total billed charges","63% of total billed charges",655.61,15.3,,524.49,,,0,"percent of total billed charges","15.3% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2956.65,69,,,,,0,"fee schedule","69% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.27,61.85,,2120.22,,,0,"percent of total billed charges","61.5% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",1379.77,32.2,,1103.82,,,0,"percent of total billed charges","32.2% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",734.28,17.136,,587.42,,,0,"percent of total billed charges","17.136% of total billed charges",935.84,21.84,,748.67,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1615.45,37.7,,1292.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3342.3,78,,2673.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",2142.5,50,,1714.00,,,0,"percent of total billed charges","50% of total billed charges",3539.41,82.6,,2831.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",719.88,16.8,,575.90,,,0,"percent of total billed charges","16.8% of total billed charges",4285,100,,3428.00,,,0,"percent of total billed charges","100% of total billed charges",655.61,4285,
"NEEDLE FLEXITIP COLONSCOPE 5MM",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"VACUUM CURETTE 10MM CURVED",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"VACURETTE CVD  8MM      40789 308",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"VACUTAINER BLOOD COLLECTION SET 21G X 0.75 NEEDLE 12 TUBING",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"VACUTAINER VENOUS BLOOD COLLECTION SERUM SEPARATION TUBE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"VACUTAINER BLOOD COLLECTION SET 23G X 0.75 NEEDLE 12 TUBING",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"VACUUM \\T\\ GAS WYE FITTING",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1030,669.5,,906.4,88,,725.12,,,0,"percent of total billed charges","88% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.23,17.304,,142.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.9,63,,519.12,,,0,"percent of total billed charges","63% of total billed charges",157.59,15.3,,126.07,,,0,"percent of total billed charges","15.3% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",710.7,69,,,,,0,"fee schedule","69% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",637.06,61.85,,509.65,,,0,"percent of total billed charges","61.5% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",331.66,32.2,,265.33,,,0,"percent of total billed charges","32.2% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.5,17.136,,141.20,,,0,"percent of total billed charges","17.136% of total billed charges",224.95,21.84,,179.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",388.31,37.7,,310.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",803.4,78,,642.72,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",515,50,,412.00,,,0,"percent of total billed charges","50% of total billed charges",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.04,16.8,,138.43,,,0,"percent of total billed charges","16.8% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",157.59,1030,
"VACUTAINER BLOOD COLLECTION SET WITH LUER ADAPTER 25G X 0.75",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"VACUUM CURETTE 10MM STRAIGHT",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"VACUUM CURETTE 14MM STRAIGHT",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"VACUUM CURETTE 12MM CURVED",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"VAGINAL/CERVICAL RETRACTOR SM",ORSUP0011,CDM,270,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"VAGINAL/CERVICAL RETRACTOR MED",ORSUP0016,CDM,270,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"VAGINAL/CERVICAL RETRACTOR LG",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"VAGINAL PACKING XRAY",491664,CDM,270,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"VAGINAL SPECULUMS LIGHTED MEDIUM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"VAGINAL SPECULUM (CORDED) NONSTERLE MD",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"VAGINAL SPECULUM BUILT IN LIGHT MED",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"ER-SPEC LIGHTED VAGINAL SPECULUM LRG",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"ER-SPEC LIGHTED VAGINAL SPECULUM XLRG",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"VAGINAL SPECULUMS LIGHTED SMALL",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"VALLEYLAB LAPAROSCOPE WIRE L-HOOK ELECTRODE SOLID 45CM",484955,CDM,272,RC,,,OUTPATIENT,,,3853,2504.45,,3390.64,88,,2712.51,,,0,"percent of total billed charges","88% of total billed charges",1926.5,50,,1541.20,,,0,"percent of total billed charges","50% of total billed charges",647.3,16.8,,517.84,,,0,"percent of total billed charges","16.8% of total billed charges",3853,100,,3082.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",666.72,17.304,,533.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2427.39,63,,1941.91,,,0,"percent of total billed charges","63% of total billed charges",589.51,15.3,,471.61,,,0,"percent of total billed charges","15.3% of total billed charges",647.3,16.8,,517.84,,,0,"percent of total billed charges","16.8% of total billed charges",2658.57,69,,,,,0,"fee schedule","69% of total billed charges",3853,100,,3082.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3853,100,,3082.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3853,100,,3082.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2383.08,61.85,,1906.46,,,0,"percent of total billed charges","61.5% of total billed charges",647.3,16.8,,517.84,,,0,"percent of total billed charges","16.8% of total billed charges",1926.5,50,,1541.20,,,0,"percent of total billed charges","50% of total billed charges",1240.67,32.2,,992.54,,,0,"percent of total billed charges","32.2% of total billed charges",647.3,16.8,,517.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",660.25,17.136,,528.20,,,0,"percent of total billed charges","17.136% of total billed charges",841.5,21.84,,673.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1452.58,37.7,,1162.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3005.34,78,,2404.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3182.58,82.6,,2546.06,,,0,"percent of total billed charges","82.6% of total billed charges",647.3,16.8,,517.84,,,0,"percent of total billed charges","16.8% of total billed charges",1926.5,50,,1541.20,,,0,"percent of total billed charges","50% of total billed charges",3182.58,82.6,,2546.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",647.3,16.8,,517.84,,,0,"percent of total billed charges","16.8% of total billed charges",3853,100,,3082.40,,,0,"percent of total billed charges","100% of total billed charges",589.51,3853,
"VALPROIC REAGENT BOX / 300T",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"VALVE AIR SALEM SUMP WITH TUBE 16FR",42447,CDM,272,RC,,,OUTPATIENT,,,33,21.45,,29.04,88,,23.23,,,0,"percent of total billed charges","88% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,17.304,,4.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.79,63,,16.63,,,0,"percent of total billed charges","63% of total billed charges",5.05,15.3,,4.04,,,0,"percent of total billed charges","15.3% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",22.77,69,,,,,0,"fee schedule","69% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.41,61.85,,16.33,,,0,"percent of total billed charges","61.5% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",10.63,32.2,,8.50,,,0,"percent of total billed charges","32.2% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.65,17.136,,4.52,,,0,"percent of total billed charges","17.136% of total billed charges",7.21,21.84,,5.77,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.44,37.7,,9.95,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25.74,78,,20.59,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",5.05,33,
"VALVE PERIMOUNT TFX 27MM",ORSUP0134,CDM,278,RC,,,OUTPATIENT,,,34814,22629.1,,30636.32,88,,24509.06,,,0,"percent of total billed charges","88% of total billed charges",17407,50,,13925.60,,,0,"percent of total billed charges","50% of total billed charges",5848.75,16.8,,4679.00,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6024.21,17.304,,4819.37,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",21932.82,63,,17546.26,,,0,"percent of total billed charges","63% of total billed charges",5326.54,15.3,,4261.23,,,0,"percent of total billed charges","15.3% of total billed charges",5848.75,16.8,,4679.00,,,0,"percent of total billed charges","16.8% of total billed charges",24021.66,69,,,,,0,"fee schedule","69% of total billed charges",34814,100,,27851.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34814,100,,27851.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34814,100,,27851.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21532.46,61.85,,17225.97,,,0,"percent of total billed charges","61.5% of total billed charges",5848.75,16.8,,4679.00,,,0,"percent of total billed charges","16.8% of total billed charges",17407,50,,13925.60,,,0,"percent of total billed charges","50% of total billed charges",11210.11,32.2,,8968.09,,,0,"percent of total billed charges","32.2% of total billed charges",10861.97,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",5965.73,17.136,,4772.58,,,0,"percent of total billed charges","17.136% of total billed charges",7603.38,21.84,,6082.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",13124.88,37.7,,10499.90,,,0,"percent of total billed charges","37.7% of total billed charges",13124.88,37.7,,10499.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",11801.95,33.9,,9441.56,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",27154.92,78,,21723.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28756.36,82.6,,23005.09,,,0,"percent of total billed charges","82.6% of total billed charges",5848.75,16.8,,4679.00,,,0,"percent of total billed charges","16.8% of total billed charges",17407,50,,13925.60,,,0,"percent of total billed charges","50% of total billed charges",28756.36,82.6,,23005.09,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5848.75,16.8,,4679.00,,,0,"percent of total billed charges","16.8% of total billed charges",34814,100,,27851.20,,,0,"percent of total billed charges","100% of total billed charges",4695,34814,
"VALVE PERICARDIAL TISSUE HEART 25MM 3000TFX",ORSUP0134,CDM,278,RC,,,OUTPATIENT,,,34814,22629.1,,30636.32,88,,24509.06,,,0,"percent of total billed charges","88% of total billed charges",17407,50,,13925.60,,,0,"percent of total billed charges","50% of total billed charges",5848.75,16.8,,4679.00,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6024.21,17.304,,4819.37,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",21932.82,63,,17546.26,,,0,"percent of total billed charges","63% of total billed charges",5326.54,15.3,,4261.23,,,0,"percent of total billed charges","15.3% of total billed charges",5848.75,16.8,,4679.00,,,0,"percent of total billed charges","16.8% of total billed charges",24021.66,69,,,,,0,"fee schedule","69% of total billed charges",34814,100,,27851.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34814,100,,27851.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34814,100,,27851.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21532.46,61.85,,17225.97,,,0,"percent of total billed charges","61.5% of total billed charges",5848.75,16.8,,4679.00,,,0,"percent of total billed charges","16.8% of total billed charges",17407,50,,13925.60,,,0,"percent of total billed charges","50% of total billed charges",11210.11,32.2,,8968.09,,,0,"percent of total billed charges","32.2% of total billed charges",10861.97,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",5965.73,17.136,,4772.58,,,0,"percent of total billed charges","17.136% of total billed charges",7603.38,21.84,,6082.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",13124.88,37.7,,10499.90,,,0,"percent of total billed charges","37.7% of total billed charges",13124.88,37.7,,10499.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",11801.95,33.9,,9441.56,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",27154.92,78,,21723.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28756.36,82.6,,23005.09,,,0,"percent of total billed charges","82.6% of total billed charges",5848.75,16.8,,4679.00,,,0,"percent of total billed charges","16.8% of total billed charges",17407,50,,13925.60,,,0,"percent of total billed charges","50% of total billed charges",28756.36,82.6,,23005.09,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5848.75,16.8,,4679.00,,,0,"percent of total billed charges","16.8% of total billed charges",34814,100,,27851.20,,,0,"percent of total billed charges","100% of total billed charges",4695,34814,
"VALVE PERIMOUNT TFX 23MM",ORSUP0134,CDM,278,RC,,,OUTPATIENT,,,34814,22629.1,,30636.32,88,,24509.06,,,0,"percent of total billed charges","88% of total billed charges",17407,50,,13925.60,,,0,"percent of total billed charges","50% of total billed charges",5848.75,16.8,,4679.00,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6024.21,17.304,,4819.37,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",21932.82,63,,17546.26,,,0,"percent of total billed charges","63% of total billed charges",5326.54,15.3,,4261.23,,,0,"percent of total billed charges","15.3% of total billed charges",5848.75,16.8,,4679.00,,,0,"percent of total billed charges","16.8% of total billed charges",24021.66,69,,,,,0,"fee schedule","69% of total billed charges",34814,100,,27851.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34814,100,,27851.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34814,100,,27851.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21532.46,61.85,,17225.97,,,0,"percent of total billed charges","61.5% of total billed charges",5848.75,16.8,,4679.00,,,0,"percent of total billed charges","16.8% of total billed charges",17407,50,,13925.60,,,0,"percent of total billed charges","50% of total billed charges",11210.11,32.2,,8968.09,,,0,"percent of total billed charges","32.2% of total billed charges",10861.97,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",5965.73,17.136,,4772.58,,,0,"percent of total billed charges","17.136% of total billed charges",7603.38,21.84,,6082.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",13124.88,37.7,,10499.90,,,0,"percent of total billed charges","37.7% of total billed charges",13124.88,37.7,,10499.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",11801.95,33.9,,9441.56,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",27154.92,78,,21723.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28756.36,82.6,,23005.09,,,0,"percent of total billed charges","82.6% of total billed charges",5848.75,16.8,,4679.00,,,0,"percent of total billed charges","16.8% of total billed charges",17407,50,,13925.60,,,0,"percent of total billed charges","50% of total billed charges",28756.36,82.6,,23005.09,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5848.75,16.8,,4679.00,,,0,"percent of total billed charges","16.8% of total billed charges",34814,100,,27851.20,,,0,"percent of total billed charges","100% of total billed charges",4695,34814,
"VALVE PERIMOUNT TFX 21MM",ORSUP0134,CDM,278,RC,,,OUTPATIENT,,,34814,22629.1,,30636.32,88,,24509.06,,,0,"percent of total billed charges","88% of total billed charges",17407,50,,13925.60,,,0,"percent of total billed charges","50% of total billed charges",5848.75,16.8,,4679.00,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6024.21,17.304,,4819.37,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",21932.82,63,,17546.26,,,0,"percent of total billed charges","63% of total billed charges",5326.54,15.3,,4261.23,,,0,"percent of total billed charges","15.3% of total billed charges",5848.75,16.8,,4679.00,,,0,"percent of total billed charges","16.8% of total billed charges",24021.66,69,,,,,0,"fee schedule","69% of total billed charges",34814,100,,27851.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34814,100,,27851.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34814,100,,27851.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21532.46,61.85,,17225.97,,,0,"percent of total billed charges","61.5% of total billed charges",5848.75,16.8,,4679.00,,,0,"percent of total billed charges","16.8% of total billed charges",17407,50,,13925.60,,,0,"percent of total billed charges","50% of total billed charges",11210.11,32.2,,8968.09,,,0,"percent of total billed charges","32.2% of total billed charges",10861.97,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",5965.73,17.136,,4772.58,,,0,"percent of total billed charges","17.136% of total billed charges",7603.38,21.84,,6082.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",13124.88,37.7,,10499.90,,,0,"percent of total billed charges","37.7% of total billed charges",13124.88,37.7,,10499.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",11801.95,33.9,,9441.56,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",27154.92,78,,21723.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28756.36,82.6,,23005.09,,,0,"percent of total billed charges","82.6% of total billed charges",5848.75,16.8,,4679.00,,,0,"percent of total billed charges","16.8% of total billed charges",17407,50,,13925.60,,,0,"percent of total billed charges","50% of total billed charges",28756.36,82.6,,23005.09,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5848.75,16.8,,4679.00,,,0,"percent of total billed charges","16.8% of total billed charges",34814,100,,27851.20,,,0,"percent of total billed charges","100% of total billed charges",4695,34814,
"VALVE AORTIC HI PROFILE HEART FLEX CUFF 19MM",ORSUP0100,CDM,278,RC,,,OUTPATIENT,,,24370,15840.5,,21445.6,88,,17156.48,,,0,"percent of total billed charges","88% of total billed charges",12185,50,,9748.00,,,0,"percent of total billed charges","50% of total billed charges",4094.16,16.8,,3275.33,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4216.98,17.304,,3373.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15353.1,63,,12282.48,,,0,"percent of total billed charges","63% of total billed charges",3728.61,15.3,,2982.89,,,0,"percent of total billed charges","15.3% of total billed charges",4094.16,16.8,,3275.33,,,0,"percent of total billed charges","16.8% of total billed charges",16815.3,69,,,,,0,"fee schedule","69% of total billed charges",24370,100,,19496.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24370,100,,19496.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24370,100,,19496.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15072.85,61.85,,12058.28,,,0,"percent of total billed charges","61.5% of total billed charges",4094.16,16.8,,3275.33,,,0,"percent of total billed charges","16.8% of total billed charges",12185,50,,9748.00,,,0,"percent of total billed charges","50% of total billed charges",7847.14,32.2,,6277.71,,,0,"percent of total billed charges","32.2% of total billed charges",7603.44,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",4176.04,17.136,,3340.83,,,0,"percent of total billed charges","17.136% of total billed charges",5322.41,21.84,,4257.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",9187.49,37.7,,7349.99,,,0,"percent of total billed charges","37.7% of total billed charges",9187.49,37.7,,7349.99,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",8261.43,33.9,,6609.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",19008.6,78,,15206.88,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",20129.62,82.6,,16103.70,,,0,"percent of total billed charges","82.6% of total billed charges",4094.16,16.8,,3275.33,,,0,"percent of total billed charges","16.8% of total billed charges",12185,50,,9748.00,,,0,"percent of total billed charges","50% of total billed charges",20129.62,82.6,,16103.70,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4094.16,16.8,,3275.33,,,0,"percent of total billed charges","16.8% of total billed charges",24370,100,,19496.00,,,0,"percent of total billed charges","100% of total billed charges",3728.61,24370,
"VALVE AORTIC HI PROFILE HEART FLEX CUFF 21MM",ORSUP0080,CDM,278,RC,,,OUTPATIENT,,,18746,12184.9,,16496.48,88,,13197.18,,,0,"percent of total billed charges","88% of total billed charges",9373,50,,7498.40,,,0,"percent of total billed charges","50% of total billed charges",3149.33,16.8,,2519.46,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3243.81,17.304,,2595.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11809.98,63,,9447.98,,,0,"percent of total billed charges","63% of total billed charges",2868.14,15.3,,2294.51,,,0,"percent of total billed charges","15.3% of total billed charges",3149.33,16.8,,2519.46,,,0,"percent of total billed charges","16.8% of total billed charges",12934.74,69,,,,,0,"fee schedule","69% of total billed charges",18746,100,,14996.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18746,100,,14996.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18746,100,,14996.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11594.4,61.85,,9275.52,,,0,"percent of total billed charges","61.5% of total billed charges",3149.33,16.8,,2519.46,,,0,"percent of total billed charges","16.8% of total billed charges",9373,50,,7498.40,,,0,"percent of total billed charges","50% of total billed charges",6036.21,32.2,,4828.97,,,0,"percent of total billed charges","32.2% of total billed charges",5848.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3212.31,17.136,,2569.85,,,0,"percent of total billed charges","17.136% of total billed charges",4094.13,21.84,,3275.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",7067.24,37.7,,5653.79,,,0,"percent of total billed charges","37.7% of total billed charges",7067.24,37.7,,5653.79,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",6354.89,33.9,,5083.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",14621.88,78,,11697.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15484.2,82.6,,12387.36,,,0,"percent of total billed charges","82.6% of total billed charges",3149.33,16.8,,2519.46,,,0,"percent of total billed charges","16.8% of total billed charges",9373,50,,7498.40,,,0,"percent of total billed charges","50% of total billed charges",15484.2,82.6,,12387.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3149.33,16.8,,2519.46,,,0,"percent of total billed charges","16.8% of total billed charges",18746,100,,14996.80,,,0,"percent of total billed charges","100% of total billed charges",2868.14,18746,
"VALVE AORTIC HI PROFILE HEART FLEX CUFF 25MM",ORSUP0080,CDM,278,RC,,,OUTPATIENT,,,18746,12184.9,,16496.48,88,,13197.18,,,0,"percent of total billed charges","88% of total billed charges",9373,50,,7498.40,,,0,"percent of total billed charges","50% of total billed charges",3149.33,16.8,,2519.46,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3243.81,17.304,,2595.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11809.98,63,,9447.98,,,0,"percent of total billed charges","63% of total billed charges",2868.14,15.3,,2294.51,,,0,"percent of total billed charges","15.3% of total billed charges",3149.33,16.8,,2519.46,,,0,"percent of total billed charges","16.8% of total billed charges",12934.74,69,,,,,0,"fee schedule","69% of total billed charges",18746,100,,14996.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18746,100,,14996.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18746,100,,14996.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11594.4,61.85,,9275.52,,,0,"percent of total billed charges","61.5% of total billed charges",3149.33,16.8,,2519.46,,,0,"percent of total billed charges","16.8% of total billed charges",9373,50,,7498.40,,,0,"percent of total billed charges","50% of total billed charges",6036.21,32.2,,4828.97,,,0,"percent of total billed charges","32.2% of total billed charges",5848.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3212.31,17.136,,2569.85,,,0,"percent of total billed charges","17.136% of total billed charges",4094.13,21.84,,3275.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",7067.24,37.7,,5653.79,,,0,"percent of total billed charges","37.7% of total billed charges",7067.24,37.7,,5653.79,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",6354.89,33.9,,5083.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",14621.88,78,,11697.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15484.2,82.6,,12387.36,,,0,"percent of total billed charges","82.6% of total billed charges",3149.33,16.8,,2519.46,,,0,"percent of total billed charges","16.8% of total billed charges",9373,50,,7498.40,,,0,"percent of total billed charges","50% of total billed charges",15484.2,82.6,,12387.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3149.33,16.8,,2519.46,,,0,"percent of total billed charges","16.8% of total billed charges",18746,100,,14996.80,,,0,"percent of total billed charges","100% of total billed charges",2868.14,18746,
"VALVE AORTIC HI PROFILE HEART FLEX CUFF 27MM",ORSUP0080,CDM,278,RC,,,OUTPATIENT,,,18746,12184.9,,16496.48,88,,13197.18,,,0,"percent of total billed charges","88% of total billed charges",9373,50,,7498.40,,,0,"percent of total billed charges","50% of total billed charges",3149.33,16.8,,2519.46,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3243.81,17.304,,2595.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11809.98,63,,9447.98,,,0,"percent of total billed charges","63% of total billed charges",2868.14,15.3,,2294.51,,,0,"percent of total billed charges","15.3% of total billed charges",3149.33,16.8,,2519.46,,,0,"percent of total billed charges","16.8% of total billed charges",12934.74,69,,,,,0,"fee schedule","69% of total billed charges",18746,100,,14996.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18746,100,,14996.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18746,100,,14996.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11594.4,61.85,,9275.52,,,0,"percent of total billed charges","61.5% of total billed charges",3149.33,16.8,,2519.46,,,0,"percent of total billed charges","16.8% of total billed charges",9373,50,,7498.40,,,0,"percent of total billed charges","50% of total billed charges",6036.21,32.2,,4828.97,,,0,"percent of total billed charges","32.2% of total billed charges",5848.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3212.31,17.136,,2569.85,,,0,"percent of total billed charges","17.136% of total billed charges",4094.13,21.84,,3275.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",7067.24,37.7,,5653.79,,,0,"percent of total billed charges","37.7% of total billed charges",7067.24,37.7,,5653.79,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",6354.89,33.9,,5083.91,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",14621.88,78,,11697.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",15484.2,82.6,,12387.36,,,0,"percent of total billed charges","82.6% of total billed charges",3149.33,16.8,,2519.46,,,0,"percent of total billed charges","16.8% of total billed charges",9373,50,,7498.40,,,0,"percent of total billed charges","50% of total billed charges",15484.2,82.6,,12387.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3149.33,16.8,,2519.46,,,0,"percent of total billed charges","16.8% of total billed charges",18746,100,,14996.80,,,0,"percent of total billed charges","100% of total billed charges",2868.14,18746,
"VALVE EPIC MITRAL 29MM",ORSUP0094,CDM,278,RC,,,OUTPATIENT,,,22763,14795.95,,20031.44,88,,16025.15,,,0,"percent of total billed charges","88% of total billed charges",11381.5,50,,9105.20,,,0,"percent of total billed charges","50% of total billed charges",3824.18,16.8,,3059.34,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3938.91,17.304,,3151.13,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14340.69,63,,11472.55,,,0,"percent of total billed charges","63% of total billed charges",3482.74,15.3,,2786.19,,,0,"percent of total billed charges","15.3% of total billed charges",3824.18,16.8,,3059.34,,,0,"percent of total billed charges","16.8% of total billed charges",15706.47,69,,,,,0,"fee schedule","69% of total billed charges",22763,100,,18210.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22763,100,,18210.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22763,100,,18210.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14078.92,61.85,,11263.14,,,0,"percent of total billed charges","61.5% of total billed charges",3824.18,16.8,,3059.34,,,0,"percent of total billed charges","16.8% of total billed charges",11381.5,50,,9105.20,,,0,"percent of total billed charges","50% of total billed charges",7329.69,32.2,,5863.75,,,0,"percent of total billed charges","32.2% of total billed charges",7102.06,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3900.67,17.136,,3120.54,,,0,"percent of total billed charges","17.136% of total billed charges",4971.44,21.84,,3977.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",8581.65,37.7,,6865.32,,,0,"percent of total billed charges","37.7% of total billed charges",8581.65,37.7,,6865.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",7716.66,33.9,,6173.33,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",17755.14,78,,14204.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",18802.24,82.6,,15041.79,,,0,"percent of total billed charges","82.6% of total billed charges",3824.18,16.8,,3059.34,,,0,"percent of total billed charges","16.8% of total billed charges",11381.5,50,,9105.20,,,0,"percent of total billed charges","50% of total billed charges",18802.24,82.6,,15041.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3824.18,16.8,,3059.34,,,0,"percent of total billed charges","16.8% of total billed charges",22763,100,,18210.40,,,0,"percent of total billed charges","100% of total billed charges",3482.74,22763,
"VALVE HEART MITRAL 31MM ROTATABLE",ORSUP0083,CDM,278,RC,,,OUTPATIENT,,,19549,12706.85,,17203.12,88,,13762.50,,,0,"percent of total billed charges","88% of total billed charges",9774.5,50,,7819.60,,,0,"percent of total billed charges","50% of total billed charges",3284.23,16.8,,2627.38,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3382.76,17.304,,2706.21,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12315.87,63,,9852.70,,,0,"percent of total billed charges","63% of total billed charges",2991,15.3,,2392.80,,,0,"percent of total billed charges","15.3% of total billed charges",3284.23,16.8,,2627.38,,,0,"percent of total billed charges","16.8% of total billed charges",13488.81,69,,,,,0,"fee schedule","69% of total billed charges",19549,100,,15639.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19549,100,,15639.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19549,100,,15639.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12091.06,61.85,,9672.85,,,0,"percent of total billed charges","61.5% of total billed charges",3284.23,16.8,,2627.38,,,0,"percent of total billed charges","16.8% of total billed charges",9774.5,50,,7819.60,,,0,"percent of total billed charges","50% of total billed charges",6294.78,32.2,,5035.82,,,0,"percent of total billed charges","32.2% of total billed charges",6099.29,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3349.92,17.136,,2679.94,,,0,"percent of total billed charges","17.136% of total billed charges",4269.5,21.84,,3415.60,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",7369.97,37.7,,5895.98,,,0,"percent of total billed charges","37.7% of total billed charges",7369.97,37.7,,5895.98,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",6627.11,33.9,,5301.69,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",15248.22,78,,12198.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16147.47,82.6,,12917.98,,,0,"percent of total billed charges","82.6% of total billed charges",3284.23,16.8,,2627.38,,,0,"percent of total billed charges","16.8% of total billed charges",9774.5,50,,7819.60,,,0,"percent of total billed charges","50% of total billed charges",16147.47,82.6,,12917.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3284.23,16.8,,2627.38,,,0,"percent of total billed charges","16.8% of total billed charges",19549,100,,15639.20,,,0,"percent of total billed charges","100% of total billed charges",2991,19549,
"VALVE MITRAL 27MM MEDTRONICS",ORSUP0093,CDM,278,RC,,,OUTPATIENT,,,22495,14621.75,,19795.6,88,,15836.48,,,0,"percent of total billed charges","88% of total billed charges",11247.5,50,,8998.00,,,0,"percent of total billed charges","50% of total billed charges",3779.16,16.8,,3023.33,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3892.53,17.304,,3114.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14171.85,63,,11337.48,,,0,"percent of total billed charges","63% of total billed charges",3441.74,15.3,,2753.39,,,0,"percent of total billed charges","15.3% of total billed charges",3779.16,16.8,,3023.33,,,0,"percent of total billed charges","16.8% of total billed charges",15521.55,69,,,,,0,"fee schedule","69% of total billed charges",22495,100,,17996.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22495,100,,17996.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22495,100,,17996.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13913.16,61.85,,11130.53,,,0,"percent of total billed charges","61.5% of total billed charges",3779.16,16.8,,3023.33,,,0,"percent of total billed charges","16.8% of total billed charges",11247.5,50,,8998.00,,,0,"percent of total billed charges","50% of total billed charges",7243.39,32.2,,5794.71,,,0,"percent of total billed charges","32.2% of total billed charges",7018.44,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3854.74,17.136,,3083.79,,,0,"percent of total billed charges","17.136% of total billed charges",4912.91,21.84,,3930.33,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",8480.62,37.7,,6784.50,,,0,"percent of total billed charges","37.7% of total billed charges",8480.62,37.7,,6784.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",7625.81,33.9,,6100.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",17546.1,78,,14036.88,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",18580.87,82.6,,14864.70,,,0,"percent of total billed charges","82.6% of total billed charges",3779.16,16.8,,3023.33,,,0,"percent of total billed charges","16.8% of total billed charges",11247.5,50,,8998.00,,,0,"percent of total billed charges","50% of total billed charges",18580.87,82.6,,14864.70,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3779.16,16.8,,3023.33,,,0,"percent of total billed charges","16.8% of total billed charges",22495,100,,17996.00,,,0,"percent of total billed charges","100% of total billed charges",3441.74,22495,
"VALVE TRIFECTA GLIDE  19MM",ORSUP0124,CDM,278,RC,,,OUTPATIENT,,,32136,20888.4,,28279.68,88,,22623.74,,,0,"percent of total billed charges","88% of total billed charges",16068,50,,12854.40,,,0,"percent of total billed charges","50% of total billed charges",5398.85,16.8,,4319.08,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5560.81,17.304,,4448.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20245.68,63,,16196.54,,,0,"percent of total billed charges","63% of total billed charges",4916.81,15.3,,3933.45,,,0,"percent of total billed charges","15.3% of total billed charges",5398.85,16.8,,4319.08,,,0,"percent of total billed charges","16.8% of total billed charges",22173.84,69,,,,,0,"fee schedule","69% of total billed charges",32136,100,,25708.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32136,100,,25708.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32136,100,,25708.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19876.12,61.85,,15900.90,,,0,"percent of total billed charges","61.5% of total billed charges",5398.85,16.8,,4319.08,,,0,"percent of total billed charges","16.8% of total billed charges",16068,50,,12854.40,,,0,"percent of total billed charges","50% of total billed charges",10347.79,32.2,,8278.23,,,0,"percent of total billed charges","32.2% of total billed charges",10026.43,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",5506.82,17.136,,4405.46,,,0,"percent of total billed charges","17.136% of total billed charges",7018.5,21.84,,5614.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",12115.27,37.7,,9692.22,,,0,"percent of total billed charges","37.7% of total billed charges",12115.27,37.7,,9692.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",10894.1,33.9,,8715.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",25066.08,78,,20052.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",26544.34,82.6,,21235.47,,,0,"percent of total billed charges","82.6% of total billed charges",5398.85,16.8,,4319.08,,,0,"percent of total billed charges","16.8% of total billed charges",16068,50,,12854.40,,,0,"percent of total billed charges","50% of total billed charges",26544.34,82.6,,21235.47,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5398.85,16.8,,4319.08,,,0,"percent of total billed charges","16.8% of total billed charges",32136,100,,25708.80,,,0,"percent of total billed charges","100% of total billed charges",4695,32136,
"VALVE TRIFECTA GLIDE  21MM",ORSUP0121,CDM,278,RC,,,OUTPATIENT,,,31333,20366.45,,27573.04,88,,22058.43,,,0,"percent of total billed charges","88% of total billed charges",15666.5,50,,12533.20,,,0,"percent of total billed charges","50% of total billed charges",5263.94,16.8,,4211.15,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5421.86,17.304,,4337.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",19739.79,63,,15791.83,,,0,"percent of total billed charges","63% of total billed charges",4793.95,15.3,,3835.16,,,0,"percent of total billed charges","15.3% of total billed charges",5263.94,16.8,,4211.15,,,0,"percent of total billed charges","16.8% of total billed charges",21619.77,69,,,,,0,"fee schedule","69% of total billed charges",31333,100,,25066.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31333,100,,25066.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31333,100,,25066.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19379.46,61.85,,15503.57,,,0,"percent of total billed charges","61.5% of total billed charges",5263.94,16.8,,4211.15,,,0,"percent of total billed charges","16.8% of total billed charges",15666.5,50,,12533.20,,,0,"percent of total billed charges","50% of total billed charges",10089.23,32.2,,8071.38,,,0,"percent of total billed charges","32.2% of total billed charges",9775.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",5369.22,17.136,,4295.38,,,0,"percent of total billed charges","17.136% of total billed charges",6843.13,21.84,,5474.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",11812.54,37.7,,9450.03,,,0,"percent of total billed charges","37.7% of total billed charges",11812.54,37.7,,9450.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",10621.89,33.9,,8497.51,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",24439.74,78,,19551.79,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",25881.06,82.6,,20704.85,,,0,"percent of total billed charges","82.6% of total billed charges",5263.94,16.8,,4211.15,,,0,"percent of total billed charges","16.8% of total billed charges",15666.5,50,,12533.20,,,0,"percent of total billed charges","50% of total billed charges",25881.06,82.6,,20704.85,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5263.94,16.8,,4211.15,,,0,"percent of total billed charges","16.8% of total billed charges",31333,100,,25066.40,,,0,"percent of total billed charges","100% of total billed charges",4695,31333,
"VALVE TRIFECTA GLIDE  23MM",ORSUP0124,CDM,278,RC,,,OUTPATIENT,,,32136,20888.4,,28279.68,88,,22623.74,,,0,"percent of total billed charges","88% of total billed charges",16068,50,,12854.40,,,0,"percent of total billed charges","50% of total billed charges",5398.85,16.8,,4319.08,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5560.81,17.304,,4448.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20245.68,63,,16196.54,,,0,"percent of total billed charges","63% of total billed charges",4916.81,15.3,,3933.45,,,0,"percent of total billed charges","15.3% of total billed charges",5398.85,16.8,,4319.08,,,0,"percent of total billed charges","16.8% of total billed charges",22173.84,69,,,,,0,"fee schedule","69% of total billed charges",32136,100,,25708.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32136,100,,25708.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32136,100,,25708.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19876.12,61.85,,15900.90,,,0,"percent of total billed charges","61.5% of total billed charges",5398.85,16.8,,4319.08,,,0,"percent of total billed charges","16.8% of total billed charges",16068,50,,12854.40,,,0,"percent of total billed charges","50% of total billed charges",10347.79,32.2,,8278.23,,,0,"percent of total billed charges","32.2% of total billed charges",10026.43,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",5506.82,17.136,,4405.46,,,0,"percent of total billed charges","17.136% of total billed charges",7018.5,21.84,,5614.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",12115.27,37.7,,9692.22,,,0,"percent of total billed charges","37.7% of total billed charges",12115.27,37.7,,9692.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",10894.1,33.9,,8715.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",25066.08,78,,20052.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",26544.34,82.6,,21235.47,,,0,"percent of total billed charges","82.6% of total billed charges",5398.85,16.8,,4319.08,,,0,"percent of total billed charges","16.8% of total billed charges",16068,50,,12854.40,,,0,"percent of total billed charges","50% of total billed charges",26544.34,82.6,,21235.47,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5398.85,16.8,,4319.08,,,0,"percent of total billed charges","16.8% of total billed charges",32136,100,,25708.80,,,0,"percent of total billed charges","100% of total billed charges",4695,32136,
"VALVE TRIFECTA GLIDE  25MM",ORSUP0124,CDM,278,RC,,,OUTPATIENT,,,32136,20888.4,,28279.68,88,,22623.74,,,0,"percent of total billed charges","88% of total billed charges",16068,50,,12854.40,,,0,"percent of total billed charges","50% of total billed charges",5398.85,16.8,,4319.08,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5560.81,17.304,,4448.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20245.68,63,,16196.54,,,0,"percent of total billed charges","63% of total billed charges",4916.81,15.3,,3933.45,,,0,"percent of total billed charges","15.3% of total billed charges",5398.85,16.8,,4319.08,,,0,"percent of total billed charges","16.8% of total billed charges",22173.84,69,,,,,0,"fee schedule","69% of total billed charges",32136,100,,25708.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32136,100,,25708.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32136,100,,25708.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19876.12,61.85,,15900.90,,,0,"percent of total billed charges","61.5% of total billed charges",5398.85,16.8,,4319.08,,,0,"percent of total billed charges","16.8% of total billed charges",16068,50,,12854.40,,,0,"percent of total billed charges","50% of total billed charges",10347.79,32.2,,8278.23,,,0,"percent of total billed charges","32.2% of total billed charges",10026.43,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",5506.82,17.136,,4405.46,,,0,"percent of total billed charges","17.136% of total billed charges",7018.5,21.84,,5614.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",12115.27,37.7,,9692.22,,,0,"percent of total billed charges","37.7% of total billed charges",12115.27,37.7,,9692.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",10894.1,33.9,,8715.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",25066.08,78,,20052.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",26544.34,82.6,,21235.47,,,0,"percent of total billed charges","82.6% of total billed charges",5398.85,16.8,,4319.08,,,0,"percent of total billed charges","16.8% of total billed charges",16068,50,,12854.40,,,0,"percent of total billed charges","50% of total billed charges",26544.34,82.6,,21235.47,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5398.85,16.8,,4319.08,,,0,"percent of total billed charges","16.8% of total billed charges",32136,100,,25708.80,,,0,"percent of total billed charges","100% of total billed charges",4695,32136,
"VALVE SPEAKING LOW PROFILE PURPLE",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"VALVE FIXED PRESSURE 40MM",ORSUP0035,CDM,272,RC,,,OUTPATIENT,,,6427,4177.55,,5655.76,88,,4524.61,,,0,"percent of total billed charges","88% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1112.13,17.304,,889.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4049.01,63,,3239.21,,,0,"percent of total billed charges","63% of total billed charges",983.33,15.3,,786.66,,,0,"percent of total billed charges","15.3% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",4434.63,69,,,,,0,"fee schedule","69% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3975.1,61.85,,3180.08,,,0,"percent of total billed charges","61.5% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",2069.49,32.2,,1655.59,,,0,"percent of total billed charges","32.2% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1101.33,17.136,,881.06,,,0,"percent of total billed charges","17.136% of total billed charges",1403.66,21.84,,1122.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2422.98,37.7,,1938.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5013.06,78,,4010.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",3213.5,50,,2570.80,,,0,"percent of total billed charges","50% of total billed charges",5308.7,82.6,,4246.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1079.74,16.8,,863.79,,,0,"percent of total billed charges","16.8% of total billed charges",6427,100,,5141.60,,,0,"percent of total billed charges","100% of total billed charges",983.33,6427,
"VALVE FIXED PRESSURE 100MM",ORSUP0033,CDM,272,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"VANCOMYCIN REAGENT BOX / 300T",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"VANTEX 7FR 20CM 3L CVC PLUS KIT",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"VAPOR-TRAL(FORMALDEHYDE DOSIMETER)",ORSUP0019,CDM,272,RC,,,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.65,17.304,,296.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1324.83,61.85,,1059.86,,,0,"percent of total billed charges","61.5% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",689.72,32.2,,551.78,,,0,"percent of total billed charges","32.2% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",367.05,17.136,,293.64,,,0,"percent of total billed charges","17.136% of total billed charges",467.81,21.84,,374.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",1071,50,,856.80,,,0,"percent of total billed charges","50% of total billed charges",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.86,16.8,,287.89,,,0,"percent of total billed charges","16.8% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,2142,
"VAPOR ADSORPTION CARTRIDGE",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"VAPR PREMIERE 50 ELECTRODE",ORSUP0018,CDM,272,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"VAPR PREMIERE 90 ELECTRODE",ORSUP0018,CDM,272,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"VARIBAR NECTAR D115",ORSUP0021,CDM,270,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"VARIBAR THIN LIQUID",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"VARITHENA CANNISTER 18 LITER",ORSUP0083,CDM,272,RC,,,OUTPATIENT,,,15038,9774.7,,13233.44,88,,10586.75,,,0,"percent of total billed charges","88% of total billed charges",7519,50,,6015.20,,,0,"percent of total billed charges","50% of total billed charges",2526.38,16.8,,2021.10,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2602.18,17.304,,2081.74,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9473.94,63,,7579.15,,,0,"percent of total billed charges","63% of total billed charges",2300.81,15.3,,1840.65,,,0,"percent of total billed charges","15.3% of total billed charges",2526.38,16.8,,2021.10,,,0,"percent of total billed charges","16.8% of total billed charges",10376.22,69,,,,,0,"fee schedule","69% of total billed charges",15038,100,,12030.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15038,100,,12030.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15038,100,,12030.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9301,61.85,,7440.80,,,0,"percent of total billed charges","61.5% of total billed charges",2526.38,16.8,,2021.10,,,0,"percent of total billed charges","16.8% of total billed charges",7519,50,,6015.20,,,0,"percent of total billed charges","50% of total billed charges",4842.24,32.2,,3873.79,,,0,"percent of total billed charges","32.2% of total billed charges",2526.38,16.8,,2021.10,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2576.91,17.136,,2061.53,,,0,"percent of total billed charges","17.136% of total billed charges",3284.3,21.84,,2627.44,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5669.33,37.7,,4535.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11729.64,78,,9383.71,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12421.39,82.6,,9937.11,,,0,"percent of total billed charges","82.6% of total billed charges",2526.38,16.8,,2021.10,,,0,"percent of total billed charges","16.8% of total billed charges",7519,50,,6015.20,,,0,"percent of total billed charges","50% of total billed charges",12421.39,82.6,,9937.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2526.38,16.8,,2021.10,,,0,"percent of total billed charges","16.8% of total billed charges",15038,100,,12030.40,,,0,"percent of total billed charges","100% of total billed charges",2300.81,15038,
"VARIABLE ANGLE FIZATION SCREW",ORSUP0022,CDM,278,RC,,,OUTPATIENT,,,2266,1472.9,,1994.08,88,,1595.26,,,0,"percent of total billed charges","88% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",392.11,17.304,,313.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1427.58,63,,1142.06,,,0,"percent of total billed charges","63% of total billed charges",346.7,15.3,,277.36,,,0,"percent of total billed charges","15.3% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1563.54,69,,,,,0,"fee schedule","69% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1401.52,61.85,,1121.22,,,0,"percent of total billed charges","61.5% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",729.65,32.2,,583.72,,,0,"percent of total billed charges","32.2% of total billed charges",706.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",388.3,17.136,,310.64,,,0,"percent of total billed charges","17.136% of total billed charges",494.89,21.84,,395.91,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",854.28,37.7,,683.42,,,0,"percent of total billed charges","37.7% of total billed charges",854.28,37.7,,683.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",768.17,33.9,,614.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1767.48,78,,1413.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1871.72,82.6,,1497.38,,,0,"percent of total billed charges","82.6% of total billed charges",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",1133,50,,906.40,,,0,"percent of total billed charges","50% of total billed charges",1871.72,82.6,,1497.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",380.69,16.8,,304.55,,,0,"percent of total billed charges","16.8% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",346.7,2266,
"VASCULAR CLOSURE DEVICE 6FT MANX GNP",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"VASCU-GUARD VG-0209N",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"VASCU-GUARD VG-0108N",ORSUP0015,CDM,278,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",417.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.7% of total billed charges",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.92,33.9,,363.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"VASCULAR GRAFT IMPRA FLEX 8MM X 30",ORSUP0026,CDM,278,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",1253.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.7% of total billed charges",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1361.76,33.9,,1089.41,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"VASCULAR FLORESTER 1.75",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"VASHE WOUND SOLUTION BOTTLE 4oz",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"VASHE WOUND SOLUTION BOTTLE 8.5 FL.OZ",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.82,17.304,,14.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,61.85,,50.97,,,0,"percent of total billed charges","61.5% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",33.17,32.2,,26.54,,,0,"percent of total billed charges","32.2% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.136,,14.12,,,0,"percent of total billed charges","17.136% of total billed charges",22.5,21.84,,18.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",51.5,50,,41.20,,,0,"percent of total billed charges","50% of total billed charges",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.3,16.8,,13.84,,,0,"percent of total billed charges","16.8% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,103,
"VENA CAVA FILTER, JUGULAR",ORSUP0012,CDM,270,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
VENASEAL,ORSUP0046,CDM,272,RC,,,OUTPATIENT,,,9373,6092.45,,8248.24,88,,6598.59,,,0,"percent of total billed charges","88% of total billed charges",4686.5,50,,3749.20,,,0,"percent of total billed charges","50% of total billed charges",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1621.9,17.304,,1297.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5904.99,63,,4723.99,,,0,"percent of total billed charges","63% of total billed charges",1434.07,15.3,,1147.26,,,0,"percent of total billed charges","15.3% of total billed charges",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",6467.37,69,,,,,0,"fee schedule","69% of total billed charges",9373,100,,7498.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9373,100,,7498.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9373,100,,7498.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5797.2,61.85,,4637.76,,,0,"percent of total billed charges","61.5% of total billed charges",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",4686.5,50,,3749.20,,,0,"percent of total billed charges","50% of total billed charges",3018.11,32.2,,2414.49,,,0,"percent of total billed charges","32.2% of total billed charges",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1606.16,17.136,,1284.93,,,0,"percent of total billed charges","17.136% of total billed charges",2047.06,21.84,,1637.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3533.62,37.7,,2826.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7310.94,78,,5848.75,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7742.1,82.6,,6193.68,,,0,"percent of total billed charges","82.6% of total billed charges",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",4686.5,50,,3749.20,,,0,"percent of total billed charges","50% of total billed charges",7742.1,82.6,,6193.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",9373,100,,7498.40,,,0,"percent of total billed charges","100% of total billed charges",1434.07,9373,
"VENCLOSE PACKS W/ SHEATH 7CM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"VENOUS CATH PERIPHERAL 18G X 1.88",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"VENTRALIGHT CIRCLE MESH 8",ORSUP0064,CDM,278,RC,,,OUTPATIENT,,,11124,7230.6,,9789.12,88,,7831.30,,,0,"percent of total billed charges","88% of total billed charges",5562,50,,4449.60,,,0,"percent of total billed charges","50% of total billed charges",1868.83,16.8,,1495.06,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1924.9,17.304,,1539.92,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7008.12,63,,5606.50,,,0,"percent of total billed charges","63% of total billed charges",1701.97,15.3,,1361.58,,,0,"percent of total billed charges","15.3% of total billed charges",1868.83,16.8,,1495.06,,,0,"percent of total billed charges","16.8% of total billed charges",7675.56,69,,,,,0,"fee schedule","69% of total billed charges",11124,100,,8899.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11124,100,,8899.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11124,100,,8899.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6880.19,61.85,,5504.15,,,0,"percent of total billed charges","61.5% of total billed charges",1868.83,16.8,,1495.06,,,0,"percent of total billed charges","16.8% of total billed charges",5562,50,,4449.60,,,0,"percent of total billed charges","50% of total billed charges",3581.93,32.2,,2865.54,,,0,"percent of total billed charges","32.2% of total billed charges",3470.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1906.21,17.136,,1524.97,,,0,"percent of total billed charges","17.136% of total billed charges",2429.48,21.84,,1943.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4193.75,37.7,,3355.00,,,0,"percent of total billed charges","37.7% of total billed charges",4193.75,37.7,,3355.00,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3771.04,33.9,,3016.83,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",8676.72,78,,6941.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9188.42,82.6,,7350.74,,,0,"percent of total billed charges","82.6% of total billed charges",1868.83,16.8,,1495.06,,,0,"percent of total billed charges","16.8% of total billed charges",5562,50,,4449.60,,,0,"percent of total billed charges","50% of total billed charges",9188.42,82.6,,7350.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1868.83,16.8,,1495.06,,,0,"percent of total billed charges","16.8% of total billed charges",11124,100,,8899.20,,,0,"percent of total billed charges","100% of total billed charges",1701.97,11124,
"VENUS CLOSURE FAST 7 X 100 CF7-7-100",ORSUP0033,CDM,272,RC,,,OUTPATIENT,,,5892,3829.8,,5184.96,88,,4147.97,,,0,"percent of total billed charges","88% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1019.55,17.304,,815.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3711.96,63,,2969.57,,,0,"percent of total billed charges","63% of total billed charges",901.48,15.3,,721.18,,,0,"percent of total billed charges","15.3% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",4065.48,69,,,,,0,"fee schedule","69% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3644.2,61.85,,2915.36,,,0,"percent of total billed charges","61.5% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",1897.22,32.2,,1517.78,,,0,"percent of total billed charges","32.2% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1009.65,17.136,,807.72,,,0,"percent of total billed charges","17.136% of total billed charges",1286.81,21.84,,1029.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2221.28,37.7,,1777.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4595.76,78,,3676.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",2946,50,,2356.80,,,0,"percent of total billed charges","50% of total billed charges",4866.79,82.6,,3893.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",989.86,16.8,,791.89,,,0,"percent of total billed charges","16.8% of total billed charges",5892,100,,4713.60,,,0,"percent of total billed charges","100% of total billed charges",901.48,5892,
"VERAFLO CLEANSE CHOICE MEDIUM",ORSUP0025,CDM,270,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"VERF KIT ABL-90/80 COOX VK KIT",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"VERIFICATION THERMOMETER -5C to +20C",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"VERIFICATION THERMOMETER -90C TO +25C",ORSUP0005,CDM,272,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.57,61.85,,127.66,,,0,"percent of total billed charges","61.5% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"VERSETTE FEMALE EXTERNAL CATHETER MESH",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"VERTEBRAL SPACER CR LORDOTIC 10MM 889..926",ORSUP0038,CDM,278,RC,,,OUTPATIENT,,,7231,4700.15,,6363.28,88,,5090.62,,,0,"percent of total billed charges","88% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1251.25,17.304,,1001.00,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4555.53,63,,3644.42,,,0,"percent of total billed charges","63% of total billed charges",1106.34,15.3,,885.07,,,0,"percent of total billed charges","15.3% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4989.39,69,,,,,0,"fee schedule","69% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4472.37,61.85,,3577.90,,,0,"percent of total billed charges","61.5% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",2328.38,32.2,,1862.70,,,0,"percent of total billed charges","32.2% of total billed charges",2256.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1239.1,17.136,,991.28,,,0,"percent of total billed charges","17.136% of total billed charges",1579.25,21.84,,1263.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.7% of total billed charges",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2451.31,33.9,,1961.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5640.18,78,,4512.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",1106.34,7231,
"VERTEBRAL SPACER CR LORDOTIC 7MM 889.923",ORSUP0038,CDM,278,RC,,,OUTPATIENT,,,7231,4700.15,,6363.28,88,,5090.62,,,0,"percent of total billed charges","88% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1251.25,17.304,,1001.00,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4555.53,63,,3644.42,,,0,"percent of total billed charges","63% of total billed charges",1106.34,15.3,,885.07,,,0,"percent of total billed charges","15.3% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4989.39,69,,,,,0,"fee schedule","69% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4472.37,61.85,,3577.90,,,0,"percent of total billed charges","61.5% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",2328.38,32.2,,1862.70,,,0,"percent of total billed charges","32.2% of total billed charges",2256.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1239.1,17.136,,991.28,,,0,"percent of total billed charges","17.136% of total billed charges",1579.25,21.84,,1263.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.7% of total billed charges",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2451.31,33.9,,1961.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5640.18,78,,4512.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",1106.34,7231,
"VERTEBRAL SPACER CR LORDOTIC 8MM 889.924",ORSUP0038,CDM,278,RC,,,OUTPATIENT,,,7231,4700.15,,6363.28,88,,5090.62,,,0,"percent of total billed charges","88% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1251.25,17.304,,1001.00,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4555.53,63,,3644.42,,,0,"percent of total billed charges","63% of total billed charges",1106.34,15.3,,885.07,,,0,"percent of total billed charges","15.3% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",4989.39,69,,,,,0,"fee schedule","69% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4472.37,61.85,,3577.90,,,0,"percent of total billed charges","61.5% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",2328.38,32.2,,1862.70,,,0,"percent of total billed charges","32.2% of total billed charges",2256.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1239.1,17.136,,991.28,,,0,"percent of total billed charges","17.136% of total billed charges",1579.25,21.84,,1263.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.7% of total billed charges",2726.09,37.7,,2180.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2451.31,33.9,,1961.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5640.18,78,,4512.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",3615.5,50,,2892.40,,,0,"percent of total billed charges","50% of total billed charges",5972.81,82.6,,4778.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1214.81,16.8,,971.85,,,0,"percent of total billed charges","16.8% of total billed charges",7231,100,,5784.80,,,0,"percent of total billed charges","100% of total billed charges",1106.34,7231,
"VERTEBRAL SPACERS PR",ORSUP0052,CDM,278,RC,,,OUTPATIENT,,,10980,7137,,9662.4,88,,7729.92,,,0,"percent of total billed charges","88% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1899.98,17.304,,1519.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6917.4,63,,5533.92,,,0,"percent of total billed charges","63% of total billed charges",1679.94,15.3,,1343.95,,,0,"percent of total billed charges","15.3% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",7576.2,69,,,,,0,"fee schedule","69% of total billed charges",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6791.13,61.85,,5432.90,,,0,"percent of total billed charges","61.5% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",3535.56,32.2,,2828.45,,,0,"percent of total billed charges","32.2% of total billed charges",3425.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1881.53,17.136,,1505.22,,,0,"percent of total billed charges","17.136% of total billed charges",2398.03,21.84,,1918.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4139.46,37.7,,3311.57,,,0,"percent of total billed charges","37.7% of total billed charges",4139.46,37.7,,3311.57,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3722.22,33.9,,2977.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",8564.4,78,,6851.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9069.48,82.6,,7255.58,,,0,"percent of total billed charges","82.6% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",9069.48,82.6,,7255.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",1679.94,10980,
"VERTEBROPLASTY 11G 4 FACETTE NEEDLE",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"VERTICAL DRAIN/TUBE ATTACHMENT 5-40 FR",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"VESSEL SEALER EXTEND",ORSUP0026,CDM,272,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"VEST TALL",ORSUP0047,CDM,272,RC,,,OUTPATIENT,,,9641,6266.65,,8484.08,88,,6787.26,,,0,"percent of total billed charges","88% of total billed charges",4820.5,50,,3856.40,,,0,"percent of total billed charges","50% of total billed charges",1619.69,16.8,,1295.75,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1668.28,17.304,,1334.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6073.83,63,,4859.06,,,0,"percent of total billed charges","63% of total billed charges",1475.07,15.3,,1180.06,,,0,"percent of total billed charges","15.3% of total billed charges",1619.69,16.8,,1295.75,,,0,"percent of total billed charges","16.8% of total billed charges",6652.29,69,,,,,0,"fee schedule","69% of total billed charges",9641,100,,7712.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9641,100,,7712.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9641,100,,7712.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5962.96,61.85,,4770.37,,,0,"percent of total billed charges","61.5% of total billed charges",1619.69,16.8,,1295.75,,,0,"percent of total billed charges","16.8% of total billed charges",4820.5,50,,3856.40,,,0,"percent of total billed charges","50% of total billed charges",3104.4,32.2,,2483.52,,,0,"percent of total billed charges","32.2% of total billed charges",1619.69,16.8,,1295.75,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1652.08,17.136,,1321.66,,,0,"percent of total billed charges","17.136% of total billed charges",2105.59,21.84,,1684.47,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3634.66,37.7,,2907.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7519.98,78,,6015.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7963.47,82.6,,6370.78,,,0,"percent of total billed charges","82.6% of total billed charges",1619.69,16.8,,1295.75,,,0,"percent of total billed charges","16.8% of total billed charges",4820.5,50,,3856.40,,,0,"percent of total billed charges","50% of total billed charges",7963.47,82.6,,6370.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1619.69,16.8,,1295.75,,,0,"percent of total billed charges","16.8% of total billed charges",9641,100,,7712.80,,,0,"percent of total billed charges","100% of total billed charges",1475.07,9641,
"VEST SAFETY SMALL",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"VEST SAFETY MEDIUM",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"VEST SAFETY LARGE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"VEST SAFETY X-LARGE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"VIAL ADAPTER PINSYNC VENTED",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"VICRYL 0 CT-1 (J260H)",491674,CDM,272,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"VICRYL 1 CT-1 (J261H)",491675,CDM,272,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"VICRYL 3-0 SH (J784G)",491677,CDM,272,RC,,,OUTPATIENT,,,96,62.4,,84.48,88,,67.58,,,0,"percent of total billed charges","88% of total billed charges",48,50,,38.40,,,0,"percent of total billed charges","50% of total billed charges",16.13,16.8,,12.90,,,0,"percent of total billed charges","16.8% of total billed charges",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.61,17.304,,13.29,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.48,63,,48.38,,,0,"percent of total billed charges","63% of total billed charges",14.69,15.3,,11.75,,,0,"percent of total billed charges","15.3% of total billed charges",16.13,16.8,,12.90,,,0,"percent of total billed charges","16.8% of total billed charges",66.24,69,,,,,0,"fee schedule","69% of total billed charges",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.38,61.85,,47.50,,,0,"percent of total billed charges","61.5% of total billed charges",16.13,16.8,,12.90,,,0,"percent of total billed charges","16.8% of total billed charges",48,50,,38.40,,,0,"percent of total billed charges","50% of total billed charges",30.91,32.2,,24.73,,,0,"percent of total billed charges","32.2% of total billed charges",16.13,16.8,,12.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.45,17.136,,13.16,,,0,"percent of total billed charges","17.136% of total billed charges",20.97,21.84,,16.78,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.19,37.7,,28.95,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",74.88,78,,59.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",16.13,16.8,,12.90,,,0,"percent of total billed charges","16.8% of total billed charges",48,50,,38.40,,,0,"percent of total billed charges","50% of total billed charges",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.13,16.8,,12.90,,,0,"percent of total billed charges","16.8% of total billed charges",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",14.69,96,
"VICRYL 4-0 P-3 (J494G)",491678,CDM,272,RC,,,OUTPATIENT,,,33,21.45,,29.04,88,,23.23,,,0,"percent of total billed charges","88% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,17.304,,4.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.79,63,,16.63,,,0,"percent of total billed charges","63% of total billed charges",5.05,15.3,,4.04,,,0,"percent of total billed charges","15.3% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",22.77,69,,,,,0,"fee schedule","69% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.41,61.85,,16.33,,,0,"percent of total billed charges","61.5% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",10.63,32.2,,8.50,,,0,"percent of total billed charges","32.2% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.65,17.136,,4.52,,,0,"percent of total billed charges","17.136% of total billed charges",7.21,21.84,,5.77,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.44,37.7,,9.95,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25.74,78,,20.59,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",5.05,33,
"VICRYL 4-0 PC-5 (J823G)",491679,CDM,272,RC,,,OUTPATIENT,,,37,24.05,,32.56,88,,26.05,,,0,"percent of total billed charges","88% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.4,17.304,,5.12,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.31,63,,18.65,,,0,"percent of total billed charges","63% of total billed charges",5.66,15.3,,4.53,,,0,"percent of total billed charges","15.3% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",25.53,69,,,,,0,"fee schedule","69% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.88,61.85,,18.30,,,0,"percent of total billed charges","61.5% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",11.91,32.2,,9.53,,,0,"percent of total billed charges","32.2% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.34,17.136,,5.07,,,0,"percent of total billed charges","17.136% of total billed charges",8.08,21.84,,6.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.95,37.7,,11.16,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.86,78,,23.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",5.66,37,
"VICRYL 6-0 P-3 (J492G)",491681,CDM,272,RC,,,OUTPATIENT,,,34,22.1,,29.92,88,,23.94,,,0,"percent of total billed charges","88% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.88,17.304,,4.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.42,63,,17.14,,,0,"percent of total billed charges","63% of total billed charges",5.2,15.3,,4.16,,,0,"percent of total billed charges","15.3% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",23.46,69,,,,,0,"fee schedule","69% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.03,61.85,,16.82,,,0,"percent of total billed charges","61.5% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",10.95,32.2,,8.76,,,0,"percent of total billed charges","32.2% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.83,17.136,,4.66,,,0,"percent of total billed charges","17.136% of total billed charges",7.43,21.84,,5.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.82,37.7,,10.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.52,78,,21.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,16.8,,4.57,,,0,"percent of total billed charges","16.8% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",5.2,34,
"VICRYL PLUS 0 CT-1 (VCP840D)",491682,CDM,272,RC,,,OUTPATIENT,,,105,68.25,,92.4,88,,73.92,,,0,"percent of total billed charges","88% of total billed charges",52.5,50,,42.00,,,0,"percent of total billed charges","50% of total billed charges",17.64,16.8,,14.11,,,0,"percent of total billed charges","16.8% of total billed charges",105,100,,84.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.17,17.304,,14.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",66.15,63,,52.92,,,0,"percent of total billed charges","63% of total billed charges",16.07,15.3,,12.86,,,0,"percent of total billed charges","15.3% of total billed charges",17.64,16.8,,14.11,,,0,"percent of total billed charges","16.8% of total billed charges",72.45,69,,,,,0,"fee schedule","69% of total billed charges",105,100,,84.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",105,100,,84.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",105,100,,84.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.94,61.85,,51.95,,,0,"percent of total billed charges","61.5% of total billed charges",17.64,16.8,,14.11,,,0,"percent of total billed charges","16.8% of total billed charges",52.5,50,,42.00,,,0,"percent of total billed charges","50% of total billed charges",33.81,32.2,,27.05,,,0,"percent of total billed charges","32.2% of total billed charges",17.64,16.8,,14.11,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.99,17.136,,14.39,,,0,"percent of total billed charges","17.136% of total billed charges",22.93,21.84,,18.34,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39.59,37.7,,31.67,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",81.9,78,,65.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.73,82.6,,69.38,,,0,"percent of total billed charges","82.6% of total billed charges",17.64,16.8,,14.11,,,0,"percent of total billed charges","16.8% of total billed charges",52.5,50,,42.00,,,0,"percent of total billed charges","50% of total billed charges",86.73,82.6,,69.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.64,16.8,,14.11,,,0,"percent of total billed charges","16.8% of total billed charges",105,100,,84.00,,,0,"percent of total billed charges","100% of total billed charges",16.07,105,
"VICRYL PLUS 2-0 CT-1 (VCP839D)",491683,CDM,272,RC,,,OUTPATIENT,,,102,66.3,,89.76,88,,71.81,,,0,"percent of total billed charges","88% of total billed charges",51,50,,40.80,,,0,"percent of total billed charges","50% of total billed charges",17.14,16.8,,13.71,,,0,"percent of total billed charges","16.8% of total billed charges",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.65,17.304,,14.12,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.26,63,,51.41,,,0,"percent of total billed charges","63% of total billed charges",15.61,15.3,,12.49,,,0,"percent of total billed charges","15.3% of total billed charges",17.14,16.8,,13.71,,,0,"percent of total billed charges","16.8% of total billed charges",70.38,69,,,,,0,"fee schedule","69% of total billed charges",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.09,61.85,,50.47,,,0,"percent of total billed charges","61.5% of total billed charges",17.14,16.8,,13.71,,,0,"percent of total billed charges","16.8% of total billed charges",51,50,,40.80,,,0,"percent of total billed charges","50% of total billed charges",32.84,32.2,,26.27,,,0,"percent of total billed charges","32.2% of total billed charges",17.14,16.8,,13.71,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.48,17.136,,13.98,,,0,"percent of total billed charges","17.136% of total billed charges",22.28,21.84,,17.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.45,37.7,,30.76,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",79.56,78,,63.65,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.25,82.6,,67.40,,,0,"percent of total billed charges","82.6% of total billed charges",17.14,16.8,,13.71,,,0,"percent of total billed charges","16.8% of total billed charges",51,50,,40.80,,,0,"percent of total billed charges","50% of total billed charges",84.25,82.6,,67.40,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.14,16.8,,13.71,,,0,"percent of total billed charges","16.8% of total billed charges",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",15.61,102,
"VICRYL RAPIDE 2-0 SH (UR417)",491684,CDM,272,RC,,,OUTPATIENT,,,28,18.2,,24.64,88,,19.71,,,0,"percent of total billed charges","88% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.85,17.304,,3.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.64,63,,14.11,,,0,"percent of total billed charges","63% of total billed charges",4.28,15.3,,3.42,,,0,"percent of total billed charges","15.3% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",19.32,69,,,,,0,"fee schedule","69% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.32,61.85,,13.86,,,0,"percent of total billed charges","61.5% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",9.02,32.2,,7.22,,,0,"percent of total billed charges","32.2% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.8,17.136,,3.84,,,0,"percent of total billed charges","17.136% of total billed charges",6.12,21.84,,4.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.56,37.7,,8.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.84,78,,17.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",14,50,,11.20,,,0,"percent of total billed charges","50% of total billed charges",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.7,16.8,,3.76,,,0,"percent of total billed charges","16.8% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",4.28,28,
"VICRYL RAPIDE 4-0 P-3 (UR494)",491685,CDM,272,RC,,,OUTPATIENT,,,48,31.2,,42.24,88,,33.79,,,0,"percent of total billed charges","88% of total billed charges",24,50,,19.20,,,0,"percent of total billed charges","50% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.31,17.304,,6.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.24,63,,24.19,,,0,"percent of total billed charges","63% of total billed charges",7.34,15.3,,5.87,,,0,"percent of total billed charges","15.3% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",33.12,69,,,,,0,"fee schedule","69% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.69,61.85,,23.75,,,0,"percent of total billed charges","61.5% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",24,50,,19.20,,,0,"percent of total billed charges","50% of total billed charges",15.46,32.2,,12.37,,,0,"percent of total billed charges","32.2% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.23,17.136,,6.58,,,0,"percent of total billed charges","17.136% of total billed charges",10.48,21.84,,8.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.1,37.7,,14.48,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",37.44,78,,29.95,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.65,82.6,,31.72,,,0,"percent of total billed charges","82.6% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",24,50,,19.20,,,0,"percent of total billed charges","50% of total billed charges",39.65,82.6,,31.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",7.34,48,
"VIDAS BRAHAMS PCT PROCALCITONIN",ORSUP0002,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"VIPERWIRE ADVANCED PERIPHERAL GUIDE",ORSUP0013,CDM,278,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",334.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.7% of total billed charges",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.07,33.9,,290.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"VIROCLEAR SINGLE LVL",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"VIROTROL SINGLE LVL",ORSUP0015,CDM,272,RC,,,OUTPATIENT,,,1339,870.35,,1178.32,88,,942.66,,,0,"percent of total billed charges","88% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.7,17.304,,185.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",843.57,63,,674.86,,,0,"percent of total billed charges","63% of total billed charges",204.87,15.3,,163.90,,,0,"percent of total billed charges","15.3% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",923.91,69,,,,,0,"fee schedule","69% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.17,61.85,,662.54,,,0,"percent of total billed charges","61.5% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",431.16,32.2,,344.93,,,0,"percent of total billed charges","32.2% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",229.45,17.136,,183.56,,,0,"percent of total billed charges","17.136% of total billed charges",292.44,21.84,,233.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",504.8,37.7,,403.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1044.42,78,,835.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",669.5,50,,535.60,,,0,"percent of total billed charges","50% of total billed charges",1106.01,82.6,,884.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",224.95,16.8,,179.96,,,0,"percent of total billed charges","16.8% of total billed charges",1339,100,,1071.20,,,0,"percent of total billed charges","100% of total billed charges",204.87,1339,
"VIROCLEAR TRCH SINGLE LVL",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"VIROTROL TRCH SINGLE LVL",ORSUP0016,CDM,272,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"VIROTROL HIV-2",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"VISAIRO NIV UNDER NOSE MASK",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"VISAIRO NIV UNDER NOSE MASK SZ B",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"VISAIRO NIV UNDER NOSE MASK SZ C",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"VISITECMINI MINISCUS FLAT BLADE HANDLE 4MM",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"VISTASEAL FIBRIN SEALANT 2ML",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"VISTASEAL FIBRIN SEALANT 4ML",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,1854,1205.1,,1631.52,88,,1305.22,,,0,"percent of total billed charges","88% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",320.82,17.304,,256.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1168.02,63,,934.42,,,0,"percent of total billed charges","63% of total billed charges",283.66,15.3,,226.93,,,0,"percent of total billed charges","15.3% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1279.26,69,,,,,0,"fee schedule","69% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1146.7,61.85,,917.36,,,0,"percent of total billed charges","61.5% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",596.99,32.2,,477.59,,,0,"percent of total billed charges","32.2% of total billed charges",578.45,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",317.7,17.136,,254.16,,,0,"percent of total billed charges","17.136% of total billed charges",404.91,21.84,,323.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",698.96,37.7,,559.17,,,0,"percent of total billed charges","37.7% of total billed charges",698.96,37.7,,559.17,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",628.51,33.9,,502.81,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1446.12,78,,1156.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1531.4,82.6,,1225.12,,,0,"percent of total billed charges","82.6% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",1531.4,82.6,,1225.12,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",283.66,1854,
"VISTASEAL RIDGID LAP DUAL APPLICATOR 35CM",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"VIT D (25 OH) CAL",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.94,17.304,,85.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.23,61.85,,305.78,,,0,"percent of total billed charges","61.5% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",199,32.2,,159.20,,,0,"percent of total billed charges","32.2% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.136,,84.72,,,0,"percent of total billed charges","17.136% of total billed charges",134.97,21.84,,107.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",309,50,,247.20,,,0,"percent of total billed charges","50% of total billed charges",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.82,16.8,,83.06,,,0,"percent of total billed charges","16.8% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,618,
"GRAM NEG SENS (AST-84)",ORSUP0007,CDM,272,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"VITEK 2 AST-N809",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"VITOSS BA 10CC FOAM STRIP",ORSUP0052,CDM,278,RC,,,OUTPATIENT,,,10980,7137,,9662.4,88,,7729.92,,,0,"percent of total billed charges","88% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1899.98,17.304,,1519.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6917.4,63,,5533.92,,,0,"percent of total billed charges","63% of total billed charges",1679.94,15.3,,1343.95,,,0,"percent of total billed charges","15.3% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",7576.2,69,,,,,0,"fee schedule","69% of total billed charges",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6791.13,61.85,,5432.90,,,0,"percent of total billed charges","61.5% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",3535.56,32.2,,2828.45,,,0,"percent of total billed charges","32.2% of total billed charges",3425.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1881.53,17.136,,1505.22,,,0,"percent of total billed charges","17.136% of total billed charges",2398.03,21.84,,1918.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4139.46,37.7,,3311.57,,,0,"percent of total billed charges","37.7% of total billed charges",4139.46,37.7,,3311.57,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3722.22,33.9,,2977.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",8564.4,78,,6851.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9069.48,82.6,,7255.58,,,0,"percent of total billed charges","82.6% of total billed charges",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",5490,50,,4392.00,,,0,"percent of total billed charges","50% of total billed charges",9069.48,82.6,,7255.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1844.64,16.8,,1475.71,,,0,"percent of total billed charges","16.8% of total billed charges",10980,100,,8784.00,,,0,"percent of total billed charges","100% of total billed charges",1679.94,10980,
"VITOSS 2.5CC",ORSUP0024,CDM,278,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",1086.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.7% of total billed charges",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1180.06,33.9,,944.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"VITROSS BONE GRAFT SUBSTITUTE 5CC",ORSUP0034,CDM,278,RC,,,OUTPATIENT,,,4820,3133,,4241.6,88,,3393.28,,,0,"percent of total billed charges","88% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",834.05,17.304,,667.24,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3036.6,63,,2429.28,,,0,"percent of total billed charges","63% of total billed charges",737.46,15.3,,589.97,,,0,"percent of total billed charges","15.3% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",3325.8,69,,,,,0,"fee schedule","69% of total billed charges",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2981.17,61.85,,2384.94,,,0,"percent of total billed charges","61.5% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",1552.04,32.2,,1241.63,,,0,"percent of total billed charges","32.2% of total billed charges",1503.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",825.96,17.136,,660.77,,,0,"percent of total billed charges","17.136% of total billed charges",1052.69,21.84,,842.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1817.14,37.7,,1453.71,,,0,"percent of total billed charges","37.7% of total billed charges",1817.14,37.7,,1453.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1633.98,33.9,,1307.18,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3759.6,78,,3007.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3981.32,82.6,,3185.06,,,0,"percent of total billed charges","82.6% of total billed charges",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",2410,50,,1928.00,,,0,"percent of total billed charges","50% of total billed charges",3981.32,82.6,,3185.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",809.76,16.8,,647.81,,,0,"percent of total billed charges","16.8% of total billed charges",4820,100,,3856.00,,,0,"percent of total billed charges","100% of total billed charges",737.46,4820,
"VIZISHOT 21G",ORSUP0012,CDM,272,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"VOLAR LOCKING DISTAL RADIUS PLATE 9 HOLE",ORSUP0044,CDM,278,RC,,,OUTPATIENT,,,5088,3307.2,,4477.44,88,,3581.95,,,0,"percent of total billed charges","88% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",880.43,17.304,,704.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3205.44,63,,2564.35,,,0,"percent of total billed charges","63% of total billed charges",778.46,15.3,,622.77,,,0,"percent of total billed charges","15.3% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",3510.72,69,,,,,0,"fee schedule","69% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3146.93,61.85,,2517.54,,,0,"percent of total billed charges","61.5% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",1638.34,32.2,,1310.67,,,0,"percent of total billed charges","32.2% of total billed charges",1587.46,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",871.88,17.136,,697.50,,,0,"percent of total billed charges","17.136% of total billed charges",1111.22,21.84,,888.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1918.18,37.7,,1534.54,,,0,"percent of total billed charges","37.7% of total billed charges",1918.18,37.7,,1534.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1724.83,33.9,,1379.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3968.64,78,,3174.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",2544,50,,2035.20,,,0,"percent of total billed charges","50% of total billed charges",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",854.78,16.8,,683.82,,,0,"percent of total billed charges","16.8% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",778.46,5088,
"VOLAR PEG THREADED 18MM TPEG-18",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"VOLAR PEG THREADED 22MM TPEG-22",ORSUP0011,CDM,278,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.7% of total billed charges",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.22,33.9,,217.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"WALKER CAST FOAM SZ MED     01F M",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"WALKER CAST FOAM SZ SM     01F S",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"WALKER CAST FOAM SZ LARGE     01F L",ORSUP0006,CDM,270,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"WALKER BOOT MID-CALF XLARGE",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"WALKER BOOT MID-CALF LARGE",ORSUP0014,CDM,272,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"WALKER BOOT MID-CALF MEDIUM",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"WALKER BOOT MID-CALF SMALL",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"WALKER BOOT MID-CALF XSMALL",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"WASHER MAXTORQUE 4.0 CONTOURED (GOLD) CSS-500-40B",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"WASH REAGENT BOX / 2 BOTTLES",ORSUP0010,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"WATER NERL REAGENT 5 GAL",ORSUP0011,CDM,272,RC,,,OUTPATIENT,,,803,521.95,,706.64,88,,565.31,,,0,"percent of total billed charges","88% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138.95,17.304,,111.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.89,63,,404.71,,,0,"percent of total billed charges","63% of total billed charges",122.86,15.3,,98.29,,,0,"percent of total billed charges","15.3% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",554.07,69,,,,,0,"fee schedule","69% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496.66,61.85,,397.33,,,0,"percent of total billed charges","61.5% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",258.57,32.2,,206.86,,,0,"percent of total billed charges","32.2% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",137.6,17.136,,110.08,,,0,"percent of total billed charges","17.136% of total billed charges",175.38,21.84,,140.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.73,37.7,,242.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",626.34,78,,501.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",401.5,50,,321.20,,,0,"percent of total billed charges","50% of total billed charges",663.28,82.6,,530.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.9,16.8,,107.92,,,0,"percent of total billed charges","16.8% of total billed charges",803,100,,642.40,,,0,"percent of total billed charges","100% of total billed charges",122.86,803,
"WAX MAXX",ORSUP0016,CDM,270,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"WEBRIL STERILE 4IN",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"WEBRIL 4'' NON-STERILE",491688,CDM,272,RC,,,OUTPATIENT,,,625,406.25,,550,88,,440.00,,,0,"percent of total billed charges","88% of total billed charges",312.5,50,,250.00,,,0,"percent of total billed charges","50% of total billed charges",105,16.8,,84.00,,,0,"percent of total billed charges","16.8% of total billed charges",625,100,,500.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",108.15,17.304,,86.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",393.75,63,,315.00,,,0,"percent of total billed charges","63% of total billed charges",95.63,15.3,,76.50,,,0,"percent of total billed charges","15.3% of total billed charges",105,16.8,,84.00,,,0,"percent of total billed charges","16.8% of total billed charges",431.25,69,,,,,0,"fee schedule","69% of total billed charges",625,100,,500.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",625,100,,500.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",625,100,,500.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",386.56,61.85,,309.25,,,0,"percent of total billed charges","61.5% of total billed charges",105,16.8,,84.00,,,0,"percent of total billed charges","16.8% of total billed charges",312.5,50,,250.00,,,0,"percent of total billed charges","50% of total billed charges",201.25,32.2,,161.00,,,0,"percent of total billed charges","32.2% of total billed charges",105,16.8,,84.00,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",107.1,17.136,,85.68,,,0,"percent of total billed charges","17.136% of total billed charges",136.5,21.84,,109.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",235.63,37.7,,188.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",487.5,78,,390.00,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",516.25,82.6,,413.00,,,0,"percent of total billed charges","82.6% of total billed charges",105,16.8,,84.00,,,0,"percent of total billed charges","16.8% of total billed charges",312.5,50,,250.00,,,0,"percent of total billed charges","50% of total billed charges",516.25,82.6,,413.00,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",105,16.8,,84.00,,,0,"percent of total billed charges","16.8% of total billed charges",625,100,,500.00,,,0,"percent of total billed charges","100% of total billed charges",95.63,625,
"WEBRIL NS 3",491689,CDM,270,RC,,,OUTPATIENT,,,10,6.5,,8.8,88,,7.04,,,0,"percent of total billed charges","88% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.73,17.304,,1.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.3,63,,5.04,,,0,"percent of total billed charges","63% of total billed charges",1.53,15.3,,1.22,,,0,"percent of total billed charges","15.3% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",6.9,69,,,,,0,"fee schedule","69% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.19,61.85,,4.95,,,0,"percent of total billed charges","61.5% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",3.22,32.2,,2.58,,,0,"percent of total billed charges","32.2% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.71,17.136,,1.37,,,0,"percent of total billed charges","17.136% of total billed charges",2.18,21.84,,1.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.77,37.7,,3.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.8,78,,6.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",5,50,,4.00,,,0,"percent of total billed charges","50% of total billed charges",8.26,82.6,,6.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.68,16.8,,1.34,,,0,"percent of total billed charges","16.8% of total billed charges",10,100,,8.00,,,0,"percent of total billed charges","100% of total billed charges",1.53,10,
"WEBRIL NS 4",491690,CDM,270,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"WEBRIL NS 6",491691,CDM,270,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.37,61.85,,9.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"WEBRIL STERILE 3",491692,CDM,272,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.42,61.85,,5.94,,,0,"percent of total billed charges","61.5% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",9.91,82.6,,7.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"WEBRIL STERILE 4",491693,CDM,272,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.9,61.85,,7.92,,,0,"percent of total billed charges","61.5% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"WEBRIL STERILE 6",491695,CDM,272,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.37,61.85,,9.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"WECK CLIPS MEDIUM",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"WECK CLIPS LARGE",ORSUP0013,CDM,272,RC,,,OUTPATIENT,,,1071,696.15,,942.48,88,,753.98,,,0,"percent of total billed charges","88% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.33,17.304,,148.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.73,63,,539.78,,,0,"percent of total billed charges","63% of total billed charges",163.86,15.3,,131.09,,,0,"percent of total billed charges","15.3% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",738.99,69,,,,,0,"fee schedule","69% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",662.41,61.85,,529.93,,,0,"percent of total billed charges","61.5% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",344.86,32.2,,275.89,,,0,"percent of total billed charges","32.2% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.53,17.136,,146.82,,,0,"percent of total billed charges","17.136% of total billed charges",233.91,21.84,,187.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.77,37.7,,323.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",835.38,78,,668.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",535.5,50,,428.40,,,0,"percent of total billed charges","50% of total billed charges",884.65,82.6,,707.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.93,16.8,,143.94,,,0,"percent of total billed charges","16.8% of total billed charges",1071,100,,856.80,,,0,"percent of total billed charges","100% of total billed charges",163.86,1071,
"WEDGE ANCHOR 5.0",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"WEDGE ANCHOR 3.0 TITANIUM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"WICK EAR 24MM LONG",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"WIPE DEODORANT TOPICAL SKIN USE",ORSUP0009,CDM,270,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"WIPES PREOP SKIN 2% CHG",384423,CDM,270,RC,,,OUTPATIENT,,,52,33.8,,45.76,88,,36.61,,,0,"percent of total billed charges","88% of total billed charges",26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,17.304,,7.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.76,63,,26.21,,,0,"percent of total billed charges","63% of total billed charges",7.96,15.3,,6.37,,,0,"percent of total billed charges","15.3% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",35.88,69,,,,,0,"fee schedule","69% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.16,61.85,,25.73,,,0,"percent of total billed charges","61.5% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",16.74,32.2,,13.39,,,0,"percent of total billed charges","32.2% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.91,17.136,,7.13,,,0,"percent of total billed charges","17.136% of total billed charges",11.36,21.84,,9.09,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.6,37.7,,15.68,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",40.56,78,,32.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.74,16.8,,6.99,,,0,"percent of total billed charges","16.8% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",7.96,52,
"WIPES SATPAX CLEANROOM",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"WIPE ADHESIVE REMOVE STING FRE",491696,CDM,270,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"WIPE MAMMO",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"WIRE GUIDE 3.2MM X 400MM L",ORSUP0010,CDM,278,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.7% of total billed charges",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.13,33.9,,181.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"WIRE K NON STER  .054X4",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"WIRE KIRSCHNER SINGLE TROCAR .045IN DIA 6IN L N/S",ORSUP0004,CDM,278,RC,,,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.65,17.304,,28.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.3,17.136,,28.24,,,0,"percent of total billed charges","17.136% of total billed charges",44.99,21.84,,35.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.7% of total billed charges",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.83,33.9,,55.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,16.8,,27.69,,,0,"percent of total billed charges","16.8% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,206,
"WIRE KIRSCHNER TROCAR POINT 1.25MM DIA 150MM L",ORSUP0002,CDM,278,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.7% of total billed charges",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.43,33.9,,36.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"WIRE KIRSCHNER TROCAR POINT 1.6MM DIA 150MM L",ORSUP0002,CDM,278,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.7% of total billed charges",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.43,33.9,,36.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"WIRE KIRSCHNER TROCAR POINT 2.5MM DIA 285MM L",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"WIRE SMALL VESSEL V-18 300/8CM TIP .018",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"WIRE CORE 14WR 300 10MM",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"WIRE GUIDE GRAND SLAM .014X300CM",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"WIRE GUIDE AMPLATZ SUPER STIFF 1CM STTP.035 260CM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"WIRE .035 HYDROPHILIC  260 CM",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"WIRE GUIDE ANGIO V-18 .018IN TIP 8CM 200CM L",ORSUP0007,CDM,278,RC,,,OUTPATIENT,,,469,304.85,,412.72,88,,330.18,,,0,"percent of total billed charges","88% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.16,17.304,,64.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.47,63,,236.38,,,0,"percent of total billed charges","63% of total billed charges",71.76,15.3,,57.41,,,0,"percent of total billed charges","15.3% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",323.61,69,,,,,0,"fee schedule","69% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.08,61.85,,232.06,,,0,"percent of total billed charges","61.5% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",151.02,32.2,,120.82,,,0,"percent of total billed charges","32.2% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.37,17.136,,64.30,,,0,"percent of total billed charges","17.136% of total billed charges",102.43,21.84,,81.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.7% of total billed charges",176.81,37.7,,141.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.99,33.9,,127.19,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",365.82,78,,292.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",234.5,50,,187.60,,,0,"percent of total billed charges","50% of total billed charges",387.39,82.6,,309.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.79,16.8,,63.03,,,0,"percent of total billed charges","16.8% of total billed charges",469,100,,375.20,,,0,"percent of total billed charges","100% of total billed charges",71.76,469,
"WIRE CORE .014 190CM 10CM",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"WIRE RUNTHROUGH EXTENSION .014 300CM",ORSUP0009,CDM,278,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.7% of total billed charges",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.42,33.9,,163.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"WIRE GUIDE JAGWIRE .035X260CM",ORSUP0014,CDM,278,RC,,,OUTPATIENT,,,1205,783.25,,1060.4,88,,848.32,,,0,"percent of total billed charges","88% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208.51,17.304,,166.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.15,63,,607.32,,,0,"percent of total billed charges","63% of total billed charges",184.37,15.3,,147.50,,,0,"percent of total billed charges","15.3% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",831.45,69,,,,,0,"fee schedule","69% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",745.29,61.85,,596.23,,,0,"percent of total billed charges","61.5% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",388.01,32.2,,310.41,,,0,"percent of total billed charges","32.2% of total billed charges",375.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.49,17.136,,165.19,,,0,"percent of total billed charges","17.136% of total billed charges",263.17,21.84,,210.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.7% of total billed charges",454.29,37.7,,363.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",408.5,33.9,,326.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",939.9,78,,751.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",602.5,50,,482.00,,,0,"percent of total billed charges","50% of total billed charges",995.33,82.6,,796.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.44,16.8,,161.95,,,0,"percent of total billed charges","16.8% of total billed charges",1205,100,,964.00,,,0,"percent of total billed charges","100% of total billed charges",184.37,1205,
"WIRE ACUITY WHISPER VIEW",ORSUP0021,CDM,278,RC,,,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.4,17.304,,370.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1656.34,61.85,,1325.07,,,0,"percent of total billed charges","61.5% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",862.32,32.2,,689.86,,,0,"percent of total billed charges","32.2% of total billed charges",835.54,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",458.9,17.136,,367.12,,,0,"percent of total billed charges","17.136% of total billed charges",584.88,21.84,,467.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.7% of total billed charges",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",907.84,33.9,,726.27,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",1339,50,,1071.20,,,0,"percent of total billed charges","50% of total billed charges",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.9,16.8,,359.92,,,0,"percent of total billed charges","16.8% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,2678,
"WIRE HYBRID .035",ORSUP0008,CDM,278,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.7% of total billed charges",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.7,33.9,,145.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"WIRE TIGER 180CM",ORSUP0018,CDM,278,RC,,,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.04,17.304,,268.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.13,61.85,,960.90,,,0,"percent of total billed charges","61.5% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",625.32,32.2,,500.26,,,0,"percent of total billed charges","32.2% of total billed charges",605.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",332.78,17.136,,266.22,,,0,"percent of total billed charges","17.136% of total billed charges",424.13,21.84,,339.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.7% of total billed charges",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",658.34,33.9,,526.67,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",971,50,,776.80,,,0,"percent of total billed charges","50% of total billed charges",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.26,16.8,,261.01,,,0,"percent of total billed charges","16.8% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,1942,
"WIRE TIGER 260CM",ORSUP0006,CDM,278,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.7% of total billed charges",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.28,33.9,,109.02,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"WIRE 1.25MM THREADED GUIDE",ORSUP0004,CDM,272,RC,,,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"WIRE SUT PASSING STL 18GA",ORSUP0017,CDM,272,RC,,,OUTPATIENT,,,670,435.5,,589.6,88,,471.68,,,0,"percent of total billed charges","88% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.94,17.304,,92.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.1,63,,337.68,,,0,"percent of total billed charges","63% of total billed charges",102.51,15.3,,82.01,,,0,"percent of total billed charges","15.3% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",462.3,69,,,,,0,"fee schedule","69% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414.4,61.85,,331.52,,,0,"percent of total billed charges","61.5% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",215.74,32.2,,172.59,,,0,"percent of total billed charges","32.2% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.81,17.136,,91.85,,,0,"percent of total billed charges","17.136% of total billed charges",146.33,21.84,,117.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.59,37.7,,202.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",522.6,78,,418.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",335,50,,268.00,,,0,"percent of total billed charges","50% of total billed charges",553.42,82.6,,442.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.56,16.8,,90.05,,,0,"percent of total billed charges","16.8% of total billed charges",670,100,,536.00,,,0,"percent of total billed charges","100% of total billed charges",102.51,670,
"WIRE GUIDE NITINOL .035/150/3",ORSUP0008,CDM,272,RC,,,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.75,17.304,,74.20,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.52,61.85,,265.22,,,0,"percent of total billed charges","61.5% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",172.59,32.2,,138.07,,,0,"percent of total billed charges","32.2% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.85,17.136,,73.48,,,0,"percent of total billed charges","17.136% of total billed charges",117.06,21.84,,93.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",268,50,,214.40,,,0,"percent of total billed charges","50% of total billed charges",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.05,16.8,,72.04,,,0,"percent of total billed charges","16.8% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,536,
"WIRE GUIDE STIFF .035X150 NITI",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"WIRE GUIDE STIFF .025X150 NITI",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,603,391.95,,530.64,88,,424.51,,,0,"percent of total billed charges","88% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.34,17.304,,83.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.89,63,,303.91,,,0,"percent of total billed charges","63% of total billed charges",92.26,15.3,,73.81,,,0,"percent of total billed charges","15.3% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",416.07,69,,,,,0,"fee schedule","69% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.96,61.85,,298.37,,,0,"percent of total billed charges","61.5% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",194.17,32.2,,155.34,,,0,"percent of total billed charges","32.2% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.33,17.136,,82.66,,,0,"percent of total billed charges","17.136% of total billed charges",131.7,21.84,,105.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.33,37.7,,181.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.34,78,,376.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",301.5,50,,241.20,,,0,"percent of total billed charges","50% of total billed charges",498.08,82.6,,398.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.3,16.8,,81.04,,,0,"percent of total billed charges","16.8% of total billed charges",603,100,,482.40,,,0,"percent of total billed charges","100% of total billed charges",92.26,603,
"WIRE GUIDE MOV CORE .035X145",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.56,17.304,,55.65,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",248.64,61.85,,198.91,,,0,"percent of total billed charges","61.5% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",129.44,32.2,,103.55,,,0,"percent of total billed charges","32.2% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.89,17.136,,55.11,,,0,"percent of total billed charges","17.136% of total billed charges",87.8,21.84,,70.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",201,50,,160.80,,,0,"percent of total billed charges","50% of total billed charges",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.54,16.8,,54.03,,,0,"percent of total billed charges","16.8% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,402,
"WIRE SUTURE PASSER",ORSUP0009,CDM,272,RC,,,OUTPATIENT,,,464,301.6,,408.32,88,,326.66,,,0,"percent of total billed charges","88% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.29,17.304,,64.23,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.32,63,,233.86,,,0,"percent of total billed charges","63% of total billed charges",70.99,15.3,,56.79,,,0,"percent of total billed charges","15.3% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",320.16,69,,,,,0,"fee schedule","69% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",286.98,61.85,,229.58,,,0,"percent of total billed charges","61.5% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",149.41,32.2,,119.53,,,0,"percent of total billed charges","32.2% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.51,17.136,,63.61,,,0,"percent of total billed charges","17.136% of total billed charges",101.34,21.84,,81.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",174.93,37.7,,139.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",361.92,78,,289.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",232,50,,185.60,,,0,"percent of total billed charges","50% of total billed charges",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.95,16.8,,62.36,,,0,"percent of total billed charges","16.8% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",70.99,464,
"WIRE FILTER EMBOLICEZ 190X1.25-3.5CM",ORSUP0049,CDM,272,RC,,,OUTPATIENT,,,10176,6614.4,,8954.88,88,,7163.90,,,0,"percent of total billed charges","88% of total billed charges",5088,50,,4070.40,,,0,"percent of total billed charges","50% of total billed charges",1709.57,16.8,,1367.66,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1760.86,17.304,,1408.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6410.88,63,,5128.70,,,0,"percent of total billed charges","63% of total billed charges",1556.93,15.3,,1245.54,,,0,"percent of total billed charges","15.3% of total billed charges",1709.57,16.8,,1367.66,,,0,"percent of total billed charges","16.8% of total billed charges",7021.44,69,,,,,0,"fee schedule","69% of total billed charges",10176,100,,8140.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10176,100,,8140.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10176,100,,8140.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6293.86,61.85,,5035.09,,,0,"percent of total billed charges","61.5% of total billed charges",1709.57,16.8,,1367.66,,,0,"percent of total billed charges","16.8% of total billed charges",5088,50,,4070.40,,,0,"percent of total billed charges","50% of total billed charges",3276.67,32.2,,2621.34,,,0,"percent of total billed charges","32.2% of total billed charges",1709.57,16.8,,1367.66,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1743.76,17.136,,1395.01,,,0,"percent of total billed charges","17.136% of total billed charges",2222.44,21.84,,1777.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3836.35,37.7,,3069.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7937.28,78,,6349.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8405.38,82.6,,6724.30,,,0,"percent of total billed charges","82.6% of total billed charges",1709.57,16.8,,1367.66,,,0,"percent of total billed charges","16.8% of total billed charges",5088,50,,4070.40,,,0,"percent of total billed charges","50% of total billed charges",8405.38,82.6,,6724.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1709.57,16.8,,1367.66,,,0,"percent of total billed charges","16.8% of total billed charges",10176,100,,8140.80,,,0,"percent of total billed charges","100% of total billed charges",1556.93,10176,
"WNAVICROSS 150CM STRAIGHT",ORSUP0016,CDM,278,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",480.48,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.7% of total billed charges",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.06,33.9,,417.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"WOUND CLOSURE DEVICE V LOC 180",366887,CDM,272,RC,,,OUTPATIENT,,,304,197.6,,267.52,88,,214.02,,,0,"percent of total billed charges","88% of total billed charges",152,50,,121.60,,,0,"percent of total billed charges","50% of total billed charges",51.07,16.8,,40.86,,,0,"percent of total billed charges","16.8% of total billed charges",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.6,17.304,,42.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.52,63,,153.22,,,0,"percent of total billed charges","63% of total billed charges",46.51,15.3,,37.21,,,0,"percent of total billed charges","15.3% of total billed charges",51.07,16.8,,40.86,,,0,"percent of total billed charges","16.8% of total billed charges",209.76,69,,,,,0,"fee schedule","69% of total billed charges",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",188.02,61.85,,150.42,,,0,"percent of total billed charges","61.5% of total billed charges",51.07,16.8,,40.86,,,0,"percent of total billed charges","16.8% of total billed charges",152,50,,121.60,,,0,"percent of total billed charges","50% of total billed charges",97.89,32.2,,78.31,,,0,"percent of total billed charges","32.2% of total billed charges",51.07,16.8,,40.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.09,17.136,,41.67,,,0,"percent of total billed charges","17.136% of total billed charges",66.39,21.84,,53.11,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",114.61,37.7,,91.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",237.12,78,,189.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",251.1,82.6,,200.88,,,0,"percent of total billed charges","82.6% of total billed charges",51.07,16.8,,40.86,,,0,"percent of total billed charges","16.8% of total billed charges",152,50,,121.60,,,0,"percent of total billed charges","50% of total billed charges",251.1,82.6,,200.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.07,16.8,,40.86,,,0,"percent of total billed charges","16.8% of total billed charges",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",46.51,304,
"WOUND SUCTION KIT 100ML J-VAC",ORSUP0001,CDM,270,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"WOUND MATRIX RESTRATA 2.5CM X 2.5CM",ORSUP0034,CDM,272,RC,,,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1065.75,17.304,,852.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",942.33,15.3,,753.86,,,0,"percent of total billed charges","15.3% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3809.34,61.85,,3047.47,,,0,"percent of total billed charges","61.5% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1983.2,32.2,,1586.56,,,0,"percent of total billed charges","32.2% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1055.41,17.136,,844.33,,,0,"percent of total billed charges","17.136% of total billed charges",1345.13,21.84,,1076.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",942.33,6159,
"WOUND MATRIX RESTRATA 2.5CM X 5.0CM",ORSUP0048,CDM,272,RC,,,OUTPATIENT,,,9909,6440.85,,8719.92,88,,6975.94,,,0,"percent of total billed charges","88% of total billed charges",4954.5,50,,3963.60,,,0,"percent of total billed charges","50% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1714.65,17.304,,1371.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6242.67,63,,4994.14,,,0,"percent of total billed charges","63% of total billed charges",1516.08,15.3,,1212.86,,,0,"percent of total billed charges","15.3% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",6837.21,69,,,,,0,"fee schedule","69% of total billed charges",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6128.72,61.85,,4902.98,,,0,"percent of total billed charges","61.5% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",4954.5,50,,3963.60,,,0,"percent of total billed charges","50% of total billed charges",3190.7,32.2,,2552.56,,,0,"percent of total billed charges","32.2% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1698.01,17.136,,1358.41,,,0,"percent of total billed charges","17.136% of total billed charges",2164.13,21.84,,1731.30,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3735.69,37.7,,2988.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7729.02,78,,6183.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8184.83,82.6,,6547.86,,,0,"percent of total billed charges","82.6% of total billed charges",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",4954.5,50,,3963.60,,,0,"percent of total billed charges","50% of total billed charges",8184.83,82.6,,6547.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1664.71,16.8,,1331.77,,,0,"percent of total billed charges","16.8% of total billed charges",9909,100,,7927.20,,,0,"percent of total billed charges","100% of total billed charges",1516.08,9909,
"WOUND MATRIX RESTRATA 2.5CM X 7.5CM",ORSUP0062,CDM,272,RC,,,OUTPATIENT,,,13926,9051.9,,12254.88,88,,9803.90,,,0,"percent of total billed charges","88% of total billed charges",6963,50,,5570.40,,,0,"percent of total billed charges","50% of total billed charges",2339.57,16.8,,1871.66,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2409.76,17.304,,1927.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8773.38,63,,7018.70,,,0,"percent of total billed charges","63% of total billed charges",2130.68,15.3,,1704.54,,,0,"percent of total billed charges","15.3% of total billed charges",2339.57,16.8,,1871.66,,,0,"percent of total billed charges","16.8% of total billed charges",9608.94,69,,,,,0,"fee schedule","69% of total billed charges",13926,100,,11140.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13926,100,,11140.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13926,100,,11140.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8613.23,61.85,,6890.58,,,0,"percent of total billed charges","61.5% of total billed charges",2339.57,16.8,,1871.66,,,0,"percent of total billed charges","16.8% of total billed charges",6963,50,,5570.40,,,0,"percent of total billed charges","50% of total billed charges",4484.17,32.2,,3587.34,,,0,"percent of total billed charges","32.2% of total billed charges",2339.57,16.8,,1871.66,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2386.36,17.136,,1909.09,,,0,"percent of total billed charges","17.136% of total billed charges",3041.44,21.84,,2433.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5250.1,37.7,,4200.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10862.28,78,,8689.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11502.88,82.6,,9202.30,,,0,"percent of total billed charges","82.6% of total billed charges",2339.57,16.8,,1871.66,,,0,"percent of total billed charges","16.8% of total billed charges",6963,50,,5570.40,,,0,"percent of total billed charges","50% of total billed charges",11502.88,82.6,,9202.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2339.57,16.8,,1871.66,,,0,"percent of total billed charges","16.8% of total billed charges",13926,100,,11140.80,,,0,"percent of total billed charges","100% of total billed charges",2130.68,13926,
"WOUND MATRIX RESTRATA 5.0CM X 5.0CM",ORSUP0074,CDM,272,RC,,,OUTPATIENT,,,17139,11140.35,,15082.32,88,,12065.86,,,0,"percent of total billed charges","88% of total billed charges",8569.5,50,,6855.60,,,0,"percent of total billed charges","50% of total billed charges",2879.35,16.8,,2303.48,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2965.73,17.304,,2372.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10797.57,63,,8638.06,,,0,"percent of total billed charges","63% of total billed charges",2622.27,15.3,,2097.82,,,0,"percent of total billed charges","15.3% of total billed charges",2879.35,16.8,,2303.48,,,0,"percent of total billed charges","16.8% of total billed charges",11825.91,69,,,,,0,"fee schedule","69% of total billed charges",17139,100,,13711.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17139,100,,13711.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17139,100,,13711.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10600.47,61.85,,8480.38,,,0,"percent of total billed charges","61.5% of total billed charges",2879.35,16.8,,2303.48,,,0,"percent of total billed charges","16.8% of total billed charges",8569.5,50,,6855.60,,,0,"percent of total billed charges","50% of total billed charges",5518.76,32.2,,4415.01,,,0,"percent of total billed charges","32.2% of total billed charges",2879.35,16.8,,2303.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2936.94,17.136,,2349.55,,,0,"percent of total billed charges","17.136% of total billed charges",3743.16,21.84,,2994.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6461.4,37.7,,5169.12,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13368.42,78,,10694.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",14156.81,82.6,,11325.45,,,0,"percent of total billed charges","82.6% of total billed charges",2879.35,16.8,,2303.48,,,0,"percent of total billed charges","16.8% of total billed charges",8569.5,50,,6855.60,,,0,"percent of total billed charges","50% of total billed charges",14156.81,82.6,,11325.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2879.35,16.8,,2303.48,,,0,"percent of total billed charges","16.8% of total billed charges",17139,100,,13711.20,,,0,"percent of total billed charges","100% of total billed charges",2622.27,17139,
"WOUND MATRIX RESTRATA 7.5CM X 7.5CM",ORSUP0087,CDM,272,RC,,,OUTPATIENT,,,20621,13403.65,,18146.48,88,,14517.18,,,0,"percent of total billed charges","88% of total billed charges",10310.5,50,,8248.40,,,0,"percent of total billed charges","50% of total billed charges",3464.33,16.8,,2771.46,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3568.26,17.304,,2854.61,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12991.23,63,,10392.98,,,0,"percent of total billed charges","63% of total billed charges",3155.01,15.3,,2524.01,,,0,"percent of total billed charges","15.3% of total billed charges",3464.33,16.8,,2771.46,,,0,"percent of total billed charges","16.8% of total billed charges",14228.49,69,,,,,0,"fee schedule","69% of total billed charges",20621,100,,16496.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20621,100,,16496.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20621,100,,16496.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12754.09,61.85,,10203.27,,,0,"percent of total billed charges","61.5% of total billed charges",3464.33,16.8,,2771.46,,,0,"percent of total billed charges","16.8% of total billed charges",10310.5,50,,8248.40,,,0,"percent of total billed charges","50% of total billed charges",6639.96,32.2,,5311.97,,,0,"percent of total billed charges","32.2% of total billed charges",3464.33,16.8,,2771.46,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3533.61,17.136,,2826.89,,,0,"percent of total billed charges","17.136% of total billed charges",4503.63,21.84,,3602.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7774.12,37.7,,6219.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16084.38,78,,12867.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17032.95,82.6,,13626.36,,,0,"percent of total billed charges","82.6% of total billed charges",3464.33,16.8,,2771.46,,,0,"percent of total billed charges","16.8% of total billed charges",10310.5,50,,8248.40,,,0,"percent of total billed charges","50% of total billed charges",17032.95,82.6,,13626.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3464.33,16.8,,2771.46,,,0,"percent of total billed charges","16.8% of total billed charges",20621,100,,16496.80,,,0,"percent of total billed charges","100% of total billed charges",3155.01,20621,
"WOUND MATRIX RESTRATA 10.0CM X 12.5CM",ORSUP0115,CDM,272,RC,,,OUTPATIENT,,,28387,18451.55,,24980.56,88,,19984.45,,,0,"percent of total billed charges","88% of total billed charges",14193.5,50,,11354.80,,,0,"percent of total billed charges","50% of total billed charges",4769.02,16.8,,3815.22,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4912.09,17.304,,3929.67,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17883.81,63,,14307.05,,,0,"percent of total billed charges","63% of total billed charges",4343.21,15.3,,3474.57,,,0,"percent of total billed charges","15.3% of total billed charges",4769.02,16.8,,3815.22,,,0,"percent of total billed charges","16.8% of total billed charges",19587.03,69,,,,,0,"fee schedule","69% of total billed charges",28387,100,,22709.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28387,100,,22709.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28387,100,,22709.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17557.36,61.85,,14045.89,,,0,"percent of total billed charges","61.5% of total billed charges",4769.02,16.8,,3815.22,,,0,"percent of total billed charges","16.8% of total billed charges",14193.5,50,,11354.80,,,0,"percent of total billed charges","50% of total billed charges",9140.61,32.2,,7312.49,,,0,"percent of total billed charges","32.2% of total billed charges",4769.02,16.8,,3815.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4864.4,17.136,,3891.52,,,0,"percent of total billed charges","17.136% of total billed charges",6199.72,21.84,,4959.78,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10701.9,37.7,,8561.52,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22141.86,78,,17713.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23447.66,82.6,,18758.13,,,0,"percent of total billed charges","82.6% of total billed charges",4769.02,16.8,,3815.22,,,0,"percent of total billed charges","16.8% of total billed charges",14193.5,50,,11354.80,,,0,"percent of total billed charges","50% of total billed charges",23447.66,82.6,,18758.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4769.02,16.8,,3815.22,,,0,"percent of total billed charges","16.8% of total billed charges",28387,100,,22709.60,,,0,"percent of total billed charges","100% of total billed charges",4343.21,28387,
"WOUND MEASURING STICK",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"WOUND MATRIX 2-LAYER 10X15CM",ORSUP0059,CDM,278,RC,,,OUTPATIENT,,,10094,6561.1,,8882.72,88,,7106.18,,,0,"percent of total billed charges","88% of total billed charges",5047,50,,4037.60,,,0,"percent of total billed charges","50% of total billed charges",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1746.67,17.304,,1397.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6359.22,63,,5087.38,,,0,"percent of total billed charges","63% of total billed charges",1544.38,15.3,,1235.50,,,0,"percent of total billed charges","15.3% of total billed charges",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",6964.86,69,,,,,0,"fee schedule","69% of total billed charges",10094,100,,8075.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10094,100,,8075.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10094,100,,8075.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6243.14,61.85,,4994.51,,,0,"percent of total billed charges","61.5% of total billed charges",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",5047,50,,4037.60,,,0,"percent of total billed charges","50% of total billed charges",3250.27,32.2,,2600.22,,,0,"percent of total billed charges","32.2% of total billed charges",3149.33,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1729.71,17.136,,1383.77,,,0,"percent of total billed charges","17.136% of total billed charges",2204.53,21.84,,1763.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3805.44,37.7,,3044.35,,,0,"percent of total billed charges","37.7% of total billed charges",3805.44,37.7,,3044.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3421.87,33.9,,2737.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7873.32,78,,6298.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",8337.64,82.6,,6670.11,,,0,"percent of total billed charges","82.6% of total billed charges",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",5047,50,,4037.60,,,0,"percent of total billed charges","50% of total billed charges",8337.64,82.6,,6670.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1695.79,16.8,,1356.63,,,0,"percent of total billed charges","16.8% of total billed charges",10094,100,,8075.20,,,0,"percent of total billed charges","100% of total billed charges",1544.38,10094,
"WOUND MATRIX 2-LAYER 7X10CM",ORSUP0040,CDM,278,RC,,,OUTPATIENT,,,5974,3883.1,,5257.12,88,,4205.70,,,0,"percent of total billed charges","88% of total billed charges",2987,50,,2389.60,,,0,"percent of total billed charges","50% of total billed charges",1003.63,16.8,,802.90,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1033.74,17.304,,826.99,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3763.62,63,,3010.90,,,0,"percent of total billed charges","63% of total billed charges",914.02,15.3,,731.22,,,0,"percent of total billed charges","15.3% of total billed charges",1003.63,16.8,,802.90,,,0,"percent of total billed charges","16.8% of total billed charges",4122.06,69,,,,,0,"fee schedule","69% of total billed charges",5974,100,,4779.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5974,100,,4779.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5974,100,,4779.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3694.92,61.85,,2955.94,,,0,"percent of total billed charges","61.5% of total billed charges",1003.63,16.8,,802.90,,,0,"percent of total billed charges","16.8% of total billed charges",2987,50,,2389.60,,,0,"percent of total billed charges","50% of total billed charges",1923.63,32.2,,1538.90,,,0,"percent of total billed charges","32.2% of total billed charges",1863.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1023.7,17.136,,818.96,,,0,"percent of total billed charges","17.136% of total billed charges",1304.72,21.84,,1043.78,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2252.2,37.7,,1801.76,,,0,"percent of total billed charges","37.7% of total billed charges",2252.2,37.7,,1801.76,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2025.19,33.9,,1620.15,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4659.72,78,,3727.78,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4934.52,82.6,,3947.62,,,0,"percent of total billed charges","82.6% of total billed charges",1003.63,16.8,,802.90,,,0,"percent of total billed charges","16.8% of total billed charges",2987,50,,2389.60,,,0,"percent of total billed charges","50% of total billed charges",4934.52,82.6,,3947.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1003.63,16.8,,802.90,,,0,"percent of total billed charges","16.8% of total billed charges",5974,100,,4779.20,,,0,"percent of total billed charges","100% of total billed charges",914.02,5974,
"WRAP ONE-STEP QUICK CHECK 48X48 KC500",419656,CDM,270,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.37,61.85,,9.90,,,0,"percent of total billed charges","61.5% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"WRAP STRL 36X36 KMGRD KC600 QUICK CHECK",414461,CDM,270,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"WRAP ONE-STEP QUICK CHECK 30X30 KC500",419653,CDM,270,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.71,61.85,,2.97,,,0,"percent of total billed charges","61.5% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",4.96,82.6,,3.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"WRAP ONE-STEP QUICK CHECK 24X24 KC200",402886,CDM,270,RC,,,OUTPATIENT,,,256,166.4,,225.28,88,,180.22,,,0,"percent of total billed charges","88% of total billed charges",128,50,,102.40,,,0,"percent of total billed charges","50% of total billed charges",43.01,16.8,,34.41,,,0,"percent of total billed charges","16.8% of total billed charges",256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.3,17.304,,35.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",161.28,63,,129.02,,,0,"percent of total billed charges","63% of total billed charges",39.17,15.3,,31.34,,,0,"percent of total billed charges","15.3% of total billed charges",43.01,16.8,,34.41,,,0,"percent of total billed charges","16.8% of total billed charges",176.64,69,,,,,0,"fee schedule","69% of total billed charges",256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.34,61.85,,126.67,,,0,"percent of total billed charges","61.5% of total billed charges",43.01,16.8,,34.41,,,0,"percent of total billed charges","16.8% of total billed charges",128,50,,102.40,,,0,"percent of total billed charges","50% of total billed charges",82.43,32.2,,65.94,,,0,"percent of total billed charges","32.2% of total billed charges",43.01,16.8,,34.41,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.87,17.136,,35.10,,,0,"percent of total billed charges","17.136% of total billed charges",55.91,21.84,,44.73,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",96.51,37.7,,77.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",199.68,78,,159.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.46,82.6,,169.17,,,0,"percent of total billed charges","82.6% of total billed charges",43.01,16.8,,34.41,,,0,"percent of total billed charges","16.8% of total billed charges",128,50,,102.40,,,0,"percent of total billed charges","50% of total billed charges",211.46,82.6,,169.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.01,16.8,,34.41,,,0,"percent of total billed charges","16.8% of total billed charges",256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",39.17,256,
"WRAP ONE-STEP QUICK CHECK 24X24 KC500",417805,CDM,270,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"WRAP ONE-STEP QUICK CHECK 18X18 KC500",402883,CDM,270,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.86,61.85,,1.49,,,0,"percent of total billed charges","61.5% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",2.48,82.6,,1.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"WRAP KIMGUARD 18 X 18",491705,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"WRAP KIMGUARD 24 X 24",491706,CDM,270,RC,,,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.47,61.85,,1.98,,,0,"percent of total billed charges","61.5% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",1.29,32.2,,1.03,,,0,"percent of total billed charges","32.2% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2,50,,1.60,,,0,"percent of total billed charges","50% of total billed charges",3.3,82.6,,2.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"WRAP KIMGUARD 30 X 30",491707,CDM,270,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"WRAP KIMGUARD 36 X 36",491708,CDM,270,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.95,61.85,,3.96,,,0,"percent of total billed charges","61.5% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"WRAP KIMGUARD 48 X 48",491709,CDM,270,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.9,61.85,,7.92,,,0,"percent of total billed charges","61.5% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"WRIST FIXATOR LOW-PROFILE",ORSUP0016,CDM,270,RC,,,OUTPATIENT,,,1540,1001,,1355.2,88,,1084.16,,,0,"percent of total billed charges","88% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266.48,17.304,,213.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",970.2,63,,776.16,,,0,"percent of total billed charges","63% of total billed charges",235.62,15.3,,188.50,,,0,"percent of total billed charges","15.3% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1062.6,69,,,,,0,"fee schedule","69% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.49,61.85,,761.99,,,0,"percent of total billed charges","61.5% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",495.88,32.2,,396.70,,,0,"percent of total billed charges","32.2% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.89,17.136,,211.11,,,0,"percent of total billed charges","17.136% of total billed charges",336.34,21.84,,269.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.58,37.7,,464.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1201.2,78,,960.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",770,50,,616.00,,,0,"percent of total billed charges","50% of total billed charges",1272.04,82.6,,1017.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",258.72,16.8,,206.98,,,0,"percent of total billed charges","16.8% of total billed charges",1540,100,,1232.00,,,0,"percent of total billed charges","100% of total billed charges",235.62,1540,
"WRIST BAND ALLERGY ALERT",491710,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"WRIST BAND FALL RISK",491711,CDM,270,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.24,61.85,,0.99,,,0,"percent of total billed charges","61.5% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",1.65,82.6,,1.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"WRIST BAND PT IDENTIFICATION",491712,CDM,270,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.62,61.85,,0.50,,,0,"percent of total billed charges","61.5% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.83,82.6,,0.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"WRISTJACK SYSTEM STERILE",ORSUP0046,CDM,272,RC,,,OUTPATIENT,,,9373,6092.45,,8248.24,88,,6598.59,,,0,"percent of total billed charges","88% of total billed charges",4686.5,50,,3749.20,,,0,"percent of total billed charges","50% of total billed charges",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1621.9,17.304,,1297.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5904.99,63,,4723.99,,,0,"percent of total billed charges","63% of total billed charges",1434.07,15.3,,1147.26,,,0,"percent of total billed charges","15.3% of total billed charges",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",6467.37,69,,,,,0,"fee schedule","69% of total billed charges",9373,100,,7498.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9373,100,,7498.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9373,100,,7498.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5797.2,61.85,,4637.76,,,0,"percent of total billed charges","61.5% of total billed charges",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",4686.5,50,,3749.20,,,0,"percent of total billed charges","50% of total billed charges",3018.11,32.2,,2414.49,,,0,"percent of total billed charges","32.2% of total billed charges",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1606.16,17.136,,1284.93,,,0,"percent of total billed charges","17.136% of total billed charges",2047.06,21.84,,1637.65,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3533.62,37.7,,2826.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7310.94,78,,5848.75,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7742.1,82.6,,6193.68,,,0,"percent of total billed charges","82.6% of total billed charges",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",4686.5,50,,3749.20,,,0,"percent of total billed charges","50% of total billed charges",7742.1,82.6,,6193.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1574.66,16.8,,1259.73,,,0,"percent of total billed charges","16.8% of total billed charges",9373,100,,7498.40,,,0,"percent of total billed charges","100% of total billed charges",1434.07,9373,
"XCELA PLUS PORT 5FR",ORSUP0020,CDM,278,RC,,,OUTPATIENT,,,1854,1205.1,,1631.52,88,,1305.22,,,0,"percent of total billed charges","88% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",320.82,17.304,,256.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1168.02,63,,934.42,,,0,"percent of total billed charges","63% of total billed charges",283.66,15.3,,226.93,,,0,"percent of total billed charges","15.3% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1279.26,69,,,,,0,"fee schedule","69% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1146.7,61.85,,917.36,,,0,"percent of total billed charges","61.5% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",596.99,32.2,,477.59,,,0,"percent of total billed charges","32.2% of total billed charges",578.45,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",317.7,17.136,,254.16,,,0,"percent of total billed charges","17.136% of total billed charges",404.91,21.84,,323.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",698.96,37.7,,559.17,,,0,"percent of total billed charges","37.7% of total billed charges",698.96,37.7,,559.17,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",628.51,33.9,,502.81,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1446.12,78,,1156.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1531.4,82.6,,1225.12,,,0,"percent of total billed charges","82.6% of total billed charges",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",927,50,,741.60,,,0,"percent of total billed charges","50% of total billed charges",1531.4,82.6,,1225.12,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",311.47,16.8,,249.18,,,0,"percent of total billed charges","16.8% of total billed charges",1854,100,,1483.20,,,0,"percent of total billed charges","100% of total billed charges",283.66,1854,
"XCISE CORLESS MORCELLATOR",ORSUP0026,CDM,278,RC,,,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.1,17.304,,556.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2484.51,61.85,,1987.61,,,0,"percent of total billed charges","61.5% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",1293.47,32.2,,1034.78,,,0,"percent of total billed charges","32.2% of total billed charges",1253.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",688.35,17.136,,550.68,,,0,"percent of total billed charges","17.136% of total billed charges",877.31,21.84,,701.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.7% of total billed charges",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1361.76,33.9,,1089.41,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",2008.5,50,,1606.80,,,0,"percent of total billed charges","50% of total billed charges",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.86,16.8,,539.89,,,0,"percent of total billed charges","16.8% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,4017,
"XENFORM 4X7 MATRIX",ORSUP0025,CDM,278,RC,,,OUTPATIENT,,,3749,2436.85,,3299.12,88,,2639.30,,,0,"percent of total billed charges","88% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",648.73,17.304,,518.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2361.87,63,,1889.50,,,0,"percent of total billed charges","63% of total billed charges",573.6,15.3,,458.88,,,0,"percent of total billed charges","15.3% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",2586.81,69,,,,,0,"fee schedule","69% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2318.76,61.85,,1855.01,,,0,"percent of total billed charges","61.5% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",1207.18,32.2,,965.74,,,0,"percent of total billed charges","32.2% of total billed charges",1169.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",642.43,17.136,,513.94,,,0,"percent of total billed charges","17.136% of total billed charges",818.78,21.84,,655.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.7% of total billed charges",1413.37,37.7,,1130.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1270.91,33.9,,1016.73,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2924.22,78,,2339.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",1874.5,50,,1499.60,,,0,"percent of total billed charges","50% of total billed charges",3096.67,82.6,,2477.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",629.83,16.8,,503.86,,,0,"percent of total billed charges","16.8% of total billed charges",3749,100,,2999.20,,,0,"percent of total billed charges","100% of total billed charges",573.6,3749,
"XEROFORM 5 X 9",491714,CDM,270,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"AGAR XLD",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"XN CHECK",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,17.304,,27.82,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.32,61.85,,99.46,,,0,"percent of total billed charges","61.5% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",64.72,32.2,,51.78,,,0,"percent of total billed charges","32.2% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.44,17.136,,27.55,,,0,"percent of total billed charges","17.136% of total billed charges",43.9,21.84,,35.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",100.5,50,,80.40,,,0,"percent of total billed charges","50% of total billed charges",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.77,16.8,,27.02,,,0,"percent of total billed charges","16.8% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,201,
"Y SILICONE STENTS 14-10-10 X 110-50-50",ORSUP0032,CDM,278,RC,,,OUTPATIENT,,,5624,3655.6,,4949.12,88,,3959.30,,,0,"percent of total billed charges","88% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",973.18,17.304,,778.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3543.12,63,,2834.50,,,0,"percent of total billed charges","63% of total billed charges",860.47,15.3,,688.38,,,0,"percent of total billed charges","15.3% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",3880.56,69,,,,,0,"fee schedule","69% of total billed charges",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3478.44,61.85,,2782.75,,,0,"percent of total billed charges","61.5% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",1810.93,32.2,,1448.74,,,0,"percent of total billed charges","32.2% of total billed charges",1754.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",963.73,17.136,,770.98,,,0,"percent of total billed charges","17.136% of total billed charges",1228.28,21.84,,982.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2120.25,37.7,,1696.20,,,0,"percent of total billed charges","37.7% of total billed charges",2120.25,37.7,,1696.20,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1906.54,33.9,,1525.23,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4386.72,78,,3509.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4645.42,82.6,,3716.34,,,0,"percent of total billed charges","82.6% of total billed charges",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",2812,50,,2249.60,,,0,"percent of total billed charges","50% of total billed charges",4645.42,82.6,,3716.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",944.83,16.8,,755.86,,,0,"percent of total billed charges","16.8% of total billed charges",5624,100,,4499.20,,,0,"percent of total billed charges","100% of total billed charges",860.47,5624,
"Y SILICONE STENTS 15-12-12 X 110-50-50",ORSUP0034,CDM,278,RC,,,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1065.75,17.304,,852.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",942.33,15.3,,753.86,,,0,"percent of total billed charges","15.3% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3809.34,61.85,,3047.47,,,0,"percent of total billed charges","61.5% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1983.2,32.2,,1586.56,,,0,"percent of total billed charges","32.2% of total billed charges",1921.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1055.41,17.136,,844.33,,,0,"percent of total billed charges","17.136% of total billed charges",1345.13,21.84,,1076.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",942.33,6159,
"Y SILICONE STENTS 16-13-13 X 110-50-50",ORSUP0034,CDM,278,RC,,,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1065.75,17.304,,852.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",942.33,15.3,,753.86,,,0,"percent of total billed charges","15.3% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3809.34,61.85,,3047.47,,,0,"percent of total billed charges","61.5% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1983.2,32.2,,1586.56,,,0,"percent of total billed charges","32.2% of total billed charges",1921.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1055.41,17.136,,844.33,,,0,"percent of total billed charges","17.136% of total billed charges",1345.13,21.84,,1076.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",942.33,6159,
"Y SILICONE STENTS 18-14-14 X 110-50-50",ORSUP0034,CDM,278,RC,,,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1065.75,17.304,,852.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",942.33,15.3,,753.86,,,0,"percent of total billed charges","15.3% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3809.34,61.85,,3047.47,,,0,"percent of total billed charges","61.5% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",1983.2,32.2,,1586.56,,,0,"percent of total billed charges","32.2% of total billed charges",1921.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1055.41,17.136,,844.33,,,0,"percent of total billed charges","17.136% of total billed charges",1345.13,21.84,,1076.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",3079.5,50,,2463.60,,,0,"percent of total billed charges","50% of total billed charges",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1034.71,16.8,,827.77,,,0,"percent of total billed charges","16.8% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",942.33,6159,
"Y-ADAPTOR MORSE OPTION .125",ORSUP0005,CDM,270,RC,,,OUTPATIENT,,,335,217.75,,294.8,88,,235.84,,,0,"percent of total billed charges","88% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.97,17.304,,46.38,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.05,63,,168.84,,,0,"percent of total billed charges","63% of total billed charges",51.26,15.3,,41.01,,,0,"percent of total billed charges","15.3% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",231.15,69,,,,,0,"fee schedule","69% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.2,61.85,,165.76,,,0,"percent of total billed charges","61.5% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",107.87,32.2,,86.30,,,0,"percent of total billed charges","32.2% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.41,17.136,,45.93,,,0,"percent of total billed charges","17.136% of total billed charges",73.16,21.84,,58.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.3,37.7,,101.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",261.3,78,,209.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",167.5,50,,134.00,,,0,"percent of total billed charges","50% of total billed charges",276.71,82.6,,221.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,16.8,,45.02,,,0,"percent of total billed charges","16.8% of total billed charges",335,100,,268.00,,,0,"percent of total billed charges","100% of total billed charges",51.26,335,
"Y-PLATE 2X",ORSUP0012,CDM,278,RC,,,OUTPATIENT,,,937,609.05,,824.56,88,,659.65,,,0,"percent of total billed charges","88% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.14,17.304,,129.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.31,63,,472.25,,,0,"percent of total billed charges","63% of total billed charges",143.36,15.3,,114.69,,,0,"percent of total billed charges","15.3% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",646.53,69,,,,,0,"fee schedule","69% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.53,61.85,,463.62,,,0,"percent of total billed charges","61.5% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",301.71,32.2,,241.37,,,0,"percent of total billed charges","32.2% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.56,17.136,,128.45,,,0,"percent of total billed charges","17.136% of total billed charges",204.64,21.84,,163.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.7% of total billed charges",353.25,37.7,,282.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.64,33.9,,254.11,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",730.86,78,,584.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",468.5,50,,374.80,,,0,"percent of total billed charges","50% of total billed charges",773.96,82.6,,619.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.42,16.8,,125.94,,,0,"percent of total billed charges","16.8% of total billed charges",937,100,,749.60,,,0,"percent of total billed charges","100% of total billed charges",143.36,937,
"Y-PLATE 3 X 8",ORSUP0054,CDM,278,RC,,,OUTPATIENT,,,9105,5918.25,,8012.4,88,,6409.92,,,0,"percent of total billed charges","88% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1575.53,17.304,,1260.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5736.15,63,,4588.92,,,0,"percent of total billed charges","63% of total billed charges",1393.07,15.3,,1114.46,,,0,"percent of total billed charges","15.3% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",6282.45,69,,,,,0,"fee schedule","69% of total billed charges",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5631.44,61.85,,4505.15,,,0,"percent of total billed charges","61.5% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",2931.81,32.2,,2345.45,,,0,"percent of total billed charges","32.2% of total billed charges",2840.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1560.23,17.136,,1248.18,,,0,"percent of total billed charges","17.136% of total billed charges",1988.53,21.84,,1590.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3432.59,37.7,,2746.07,,,0,"percent of total billed charges","37.7% of total billed charges",3432.59,37.7,,2746.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3086.6,33.9,,2469.28,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7101.9,78,,5681.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7520.73,82.6,,6016.58,,,0,"percent of total billed charges","82.6% of total billed charges",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",4552.5,50,,3642.00,,,0,"percent of total billed charges","50% of total billed charges",7520.73,82.6,,6016.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1529.64,16.8,,1223.71,,,0,"percent of total billed charges","16.8% of total billed charges",9105,100,,7284.00,,,0,"percent of total billed charges","100% of total billed charges",1393.07,9105,
"YANKAUER FLEXIBLE",ORSUP0001,CDM,272,RC,,,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.27,61.85,,17.82,,,0,"percent of total billed charges","61.5% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",11.59,32.2,,9.27,,,0,"percent of total billed charges","32.2% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",18,50,,14.40,,,0,"percent of total billed charges","50% of total billed charges",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,36,
"YSC Level 5 Ea Addt'l 15 Min",SUR200051,CDM,360,RC,,,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3367,3367,
"YUEH 5.0 CENTESIS CATH NEEDLE",ORSUP0003,CDM,272,RC,,,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.19,17.304,,18.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.96,17.136,,18.37,,,0,"percent of total billed charges","17.136% of total billed charges",29.27,21.84,,23.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.51,16.8,,18.01,,,0,"percent of total billed charges","16.8% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,134,
"ZEISS MICROSCOPE PROJECTION BULB",491715,CDM,270,RC,,,OUTPATIENT,,,208,135.2,,183.04,88,,146.43,,,0,"percent of total billed charges","88% of total billed charges",104,50,,83.20,,,0,"percent of total billed charges","50% of total billed charges",34.94,16.8,,27.95,,,0,"percent of total billed charges","16.8% of total billed charges",208,100,,166.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.99,17.304,,28.79,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",131.04,63,,104.83,,,0,"percent of total billed charges","63% of total billed charges",31.82,15.3,,25.46,,,0,"percent of total billed charges","15.3% of total billed charges",34.94,16.8,,27.95,,,0,"percent of total billed charges","16.8% of total billed charges",143.52,69,,,,,0,"fee schedule","69% of total billed charges",208,100,,166.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208,100,,166.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",208,100,,166.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.65,61.85,,102.92,,,0,"percent of total billed charges","61.5% of total billed charges",34.94,16.8,,27.95,,,0,"percent of total billed charges","16.8% of total billed charges",104,50,,83.20,,,0,"percent of total billed charges","50% of total billed charges",66.98,32.2,,53.58,,,0,"percent of total billed charges","32.2% of total billed charges",34.94,16.8,,27.95,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.64,17.136,,28.51,,,0,"percent of total billed charges","17.136% of total billed charges",45.43,21.84,,36.34,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",78.42,37.7,,62.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",162.24,78,,129.79,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",171.81,82.6,,137.45,,,0,"percent of total billed charges","82.6% of total billed charges",34.94,16.8,,27.95,,,0,"percent of total billed charges","16.8% of total billed charges",104,50,,83.20,,,0,"percent of total billed charges","50% of total billed charges",171.81,82.6,,137.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.94,16.8,,27.95,,,0,"percent of total billed charges","16.8% of total billed charges",208,100,,166.40,,,0,"percent of total billed charges","100% of total billed charges",31.82,208,
"ZEPTOMETRIX NATROL CT/NG/TV POSITIVE CONTROL",ORSUP0006,CDM,272,RC,,,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.12,61.85,,152.90,,,0,"percent of total billed charges","61.5% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",99.5,32.2,,79.60,,,0,"percent of total billed charges","32.2% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",154.5,50,,123.60,,,0,"percent of total billed charges","50% of total billed charges",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"ZIPTIGHT FIXATION DEVICE , ANKLE",ORSUP0024,CDM,278,RC,,,OUTPATIENT,,,3481,2262.65,,3063.28,88,,2450.62,,,0,"percent of total billed charges","88% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.35,17.304,,481.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2193.03,63,,1754.42,,,0,"percent of total billed charges","63% of total billed charges",532.59,15.3,,426.07,,,0,"percent of total billed charges","15.3% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",2401.89,69,,,,,0,"fee schedule","69% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2153,61.85,,1722.40,,,0,"percent of total billed charges","61.5% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",1120.88,32.2,,896.70,,,0,"percent of total billed charges","32.2% of total billed charges",1086.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",596.5,17.136,,477.20,,,0,"percent of total billed charges","17.136% of total billed charges",760.25,21.84,,608.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.7% of total billed charges",1312.34,37.7,,1049.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1180.06,33.9,,944.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2715.18,78,,2172.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",1740.5,50,,1392.40,,,0,"percent of total billed charges","50% of total billed charges",2875.31,82.6,,2300.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",584.81,16.8,,467.85,,,0,"percent of total billed charges","16.8% of total billed charges",3481,100,,2784.80,,,0,"percent of total billed charges","100% of total billed charges",532.59,3481,
"ZIPWIRE STRAIGHT TIP AND STD SHAFT .035",ORSUP0017,CDM,278,RC,,,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.26,17.304,,241.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.81,61.85,,861.45,,,0,"percent of total billed charges","61.5% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",560.6,32.2,,448.48,,,0,"percent of total billed charges","32.2% of total billed charges",543.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",298.34,17.136,,238.67,,,0,"percent of total billed charges","17.136% of total billed charges",380.23,21.84,,304.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.7% of total billed charges",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.2,33.9,,472.16,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",870.5,50,,696.40,,,0,"percent of total billed charges","50% of total billed charges",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.49,16.8,,233.99,,,0,"percent of total billed charges","16.8% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,1741,
"19101 BREAST BIOPSY OPEN, INCISIONAL",76119101,CDM,761,RC,19101,CPT,OUTPATIENT,,,13402,8711.3,,11793.76,88,,9435.01,,,0,"percent of total billed charges","88% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6803.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",1298.41,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8443.26,63,,6754.61,,,0,"percent of total billed charges","63% of total billed charges",2050.51,15.3,,1640.41,,,0,"percent of total billed charges","15.3% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,9247.38,69,,,,,0,"fee schedule","69% of total billed charges",13402,100,,10721.60,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13402,100,,10721.60,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13402,100,,10721.60,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",12828.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3353.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",933.77,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1285.8,100,,,,,0,"fee schedule",EAPG,1638.77,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5052.55,37.7,,4042.04,,,0,"percent of total billed charges","37.7% of total billed charges",5052.55,37.7,,4042.04,,,0,"percent of total billed charges","37.70% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4543.28,33.9,,3634.62,,,0,"percent of total billed charges","33.9% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10453.56,78,,8362.85,,,0,"percent of total billed charges","78% of total billed charges",3926.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11070.05,82.6,,8856.04,,,0,"percent of total billed charges","82.6% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11070.05,82.6,,8856.04,,,0,"percent of total billed charges","82.6% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,13402,100,,10721.60,,,0,"percent of total billed charges","100% of total billed charges",933.77,13402,
"31500 INTUBATION EMERGENCY AIRWAY",76131500,CDM,761,RC,31500,CPT,OUTPATIENT,,,1677,1090.05,,1475.76,88,,1180.61,,,0,"percent of total billed charges","88% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818.62,100,,,,,0,"fee schedule",EAPG,1677,100,,1341.60,,,0,"percent of total billed charges","100% of total billed charges",435.98,175,,,,,0,"fee schedule","175% of CMS fee schedule",843.18,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056.51,63,,845.21,,,0,"percent of total billed charges","63% of total billed charges",256.58,15.3,,205.26,,,0,"percent of total billed charges","15.3% of total billed charges",818.62,100,,,,,0,"fee schedule",EAPG,1157.13,69,,,,,0,"fee schedule","69% of total billed charges",1677,100,,1341.60,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1677,100,,1341.60,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1677,100,,1341.60,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",859.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818.62,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",606.38,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",834.99,100,,,,,0,"fee schedule",EAPG,1064.21,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",632.23,37.7,,505.78,,,0,"percent of total billed charges","37.7% of total billed charges",632.23,37.7,,505.78,,,0,"percent of total billed charges","37.70% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.5,33.9,,454.80,,,0,"percent of total billed charges","33.9% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1308.06,78,,1046.45,,,0,"percent of total billed charges","78% of total billed charges",251.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1385.2,82.6,,1108.16,,,0,"percent of total billed charges","82.6% of total billed charges",818.62,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1385.2,82.6,,1108.16,,,0,"percent of total billed charges","82.6% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818.62,100,,,,,0,"fee schedule",EAPG,1677,100,,1341.60,,,0,"percent of total billed charges","100% of total billed charges",224.74,1677,
"43202 ESOPHAGOSCOPY FLEX BIOPSYY CHARGE",75043202,CDM,750,RC,43202,CPT,OUTPATIENT,,,6731,4375.15,,5923.28,88,,4738.62,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4240.53,63,,3392.42,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,4644.39,69,,,,,0,"fee schedule","69% of total billed charges",6731,100,,5384.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6731,100,,5384.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6731,100,,5384.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.37,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2537.59,37.7,,2030.07,,,0,"percent of total billed charges","37.7% of total billed charges",2537.59,37.7,,2030.07,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2281.81,33.9,,1825.45,,,0,"percent of total billed charges","33.9% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5250.18,78,,4200.14,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5559.81,82.6,,4447.85,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5559.81,82.6,,4447.85,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,6731,100,,5384.80,,,0,"percent of total billed charges","100% of total billed charges",638.37,6731,
"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH BAND LIGATION OF E",76143205,CDM,750,RC,43205,CPT,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.37,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",638.37,6601.69,
"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH REMOVAL OF FOREIGN",76143215,CDM,750,RC,43215,CPT,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.37,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",638.37,6601.69,
"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH DILATION OF ESOPHAG",76143213,CDM,750,RC,43213,CPT,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.37,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",638.37,6601.69,
"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH INSERTION OF GUIDE",76143226,CDM,750,RC,43226,CPT,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.37,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",638.37,6601.69,
"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH TRANSENDOSCOPIC BAL",76143220,CDM,750,RC,43220,CPT,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.37,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",638.37,6601.69,
"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH CONTROL OF BLEEDIN",76143227,CDM,750,RC,43227,CPT,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.37,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",638.37,6601.69,
"GASTROSCOPY DIAGNOSTIC W/WO BRUSHING SURG",76143235,CDM,750,RC,43235,CPT,OUTPATIENT,,,3068,1994.2,,2699.84,88,,2159.87,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1932.84,63,,1546.27,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,2116.92,69,,,,,0,"fee schedule","69% of total billed charges",3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.37,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1156.64,37.7,,925.31,,,0,"percent of total billed charges","37.7% of total billed charges",1156.64,37.7,,925.31,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1040.05,33.9,,832.04,,,0,"percent of total billed charges","33.9% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2393.04,78,,1914.43,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2534.17,82.6,,2027.34,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2534.17,82.6,,2027.34,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",638.37,3367,
"GASTROSCOPY W/BX",76143239,CDM,750,RC,43239,CPT,OUTPATIENT,,,3068,1994.2,,2699.84,88,,2159.87,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1932.84,63,,1546.27,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,2116.92,69,,,,,0,"fee schedule","69% of total billed charges",3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.37,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1156.64,37.7,,925.31,,,0,"percent of total billed charges","37.7% of total billed charges",1156.64,37.7,,925.31,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1040.05,33.9,,832.04,,,0,"percent of total billed charges","33.9% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2393.04,78,,1914.43,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2534.17,82.6,,2027.34,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2534.17,82.6,,2027.34,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",638.37,3367,
"ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; W/ DIRECTED",76143236,CDM,750,RC,43236,CPT,OUTPATIENT,,,3068,1994.2,,2699.84,88,,2159.87,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1932.84,63,,1546.27,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,2116.92,69,,,,,0,"fee schedule","69% of total billed charges",3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.37,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1156.64,37.7,,925.31,,,0,"percent of total billed charges","37.7% of total billed charges",1156.64,37.7,,925.31,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1040.05,33.9,,832.04,,,0,"percent of total billed charges","33.9% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2393.04,78,,1914.43,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2534.17,82.6,,2027.34,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2534.17,82.6,,2027.34,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",638.37,3367,
"ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH DILATI",76143233,CDM,750,RC,43233,CPT,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.37,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",638.37,6601.69,
"GASTROSCOPY DIAGNOSTIC W/WO BRUSHING SURG SU",76143235,CDM,750,RC,43235,CPT,OUTPATIENT,,,3068,1994.2,,2699.84,88,,2159.87,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1932.84,63,,1546.27,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,2116.92,69,,,,,0,"fee schedule","69% of total billed charges",3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.37,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1156.64,37.7,,925.31,,,0,"percent of total billed charges","37.7% of total billed charges",1156.64,37.7,,925.31,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1040.05,33.9,,832.04,,,0,"percent of total billed charges","33.9% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2393.04,78,,1914.43,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2534.17,82.6,,2027.34,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2534.17,82.6,,2027.34,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",638.37,3367,
"GASTROSCOPY WITH PEG TUBE PLACEMENT SURG",76143246,CDM,750,RC,43246,CPT,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.37,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",638.37,6601.69,
"GASTROSCOPY W REMOVAL FOREIGN BODY SURG",76143247,CDM,750,RC,43247,CPT,OUTPATIENT,,,3068,1994.2,,2699.84,88,,2159.87,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1932.84,63,,1546.27,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,2116.92,69,,,,,0,"fee schedule","69% of total billed charges",3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.37,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1156.64,37.7,,925.31,,,0,"percent of total billed charges","37.7% of total billed charges",1156.64,37.7,,925.31,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1040.05,33.9,,832.04,,,0,"percent of total billed charges","33.9% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2393.04,78,,1914.43,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2534.17,82.6,,2027.34,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2534.17,82.6,,2027.34,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",638.37,3367,
"GASTROSCOPY W DILATION GASTRIC/DUODENUM SURG",76143245,CDM,750,RC,43245,CPT,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.37,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",638.37,6601.69,
"ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSO",76143248,CDM,750,RC,43248,CPT,OUTPATIENT,,,3068,1994.2,,2699.84,88,,2159.87,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1932.84,63,,1546.27,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,2116.92,69,,,,,0,"fee schedule","69% of total billed charges",3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.37,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1156.64,37.7,,925.31,,,0,"percent of total billed charges","37.7% of total billed charges",1156.64,37.7,,925.31,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1040.05,33.9,,832.04,,,0,"percent of total billed charges","33.9% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2393.04,78,,1914.43,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2534.17,82.6,,2027.34,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2534.17,82.6,,2027.34,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",638.37,3367,
"EGD W/DILATION (ANY METHOD) SURG",76143249,CDM,750,RC,43249,CPT,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.37,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",638.37,6601.69,
"ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; W/ BAND LIG",76143244,CDM,750,RC,43244,CPT,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.37,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",638.37,6601.69,
"GASTROSCOPY W/CONTROLL OF BLEED SURG",76143255,CDM,750,RC,43255,CPT,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.37,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",638.37,6601.69,
"Esophagogastroduodenoscopy removal of tumor(s) w/ snare tec",75043251,CDM,750,RC,43251,CPT,OUTPATIENT,,,6156,4001.4,,5417.28,88,,4333.82,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3878.28,63,,3102.62,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,4247.64,69,,,,,0,"fee schedule","69% of total billed charges",6156,100,,4924.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6156,100,,4924.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6156,100,,4924.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.37,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2320.81,37.7,,1856.65,,,0,"percent of total billed charges","37.7% of total billed charges",2320.81,37.7,,1856.65,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2086.88,33.9,,1669.50,,,0,"percent of total billed charges","33.9% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4801.68,78,,3841.34,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5084.86,82.6,,4067.89,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5084.86,82.6,,4067.89,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,6156,100,,4924.80,,,0,"percent of total billed charges","100% of total billed charges",638.37,6601.69,
"ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAP",76143262,CDM,750,RC,43262,CPT,OUTPATIENT,,,11644,7568.6,,10246.72,88,,8197.38,,,0,"percent of total billed charges","88% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2299.5,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6835.86,175,,,,,0,"fee schedule","175% of CMS fee schedule",2368.49,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7335.72,63,,5868.58,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",2299.5,100,,,,,0,"fee schedule",EAPG,8034.36,69,,,,,0,"fee schedule","69% of total billed charges",11644,100,,9315.20,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11644,100,,9315.20,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11644,100,,9315.20,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",12515.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2299.5,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3272.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1703.33,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2345.49,100,,,,,0,"fee schedule",EAPG,2989.36,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4389.79,37.7,,3511.83,,,0,"percent of total billed charges","37.7% of total billed charges",4389.79,37.7,,3511.83,,,0,"percent of total billed charges","37.70% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3947.32,33.9,,3157.86,,,0,"percent of total billed charges","33.9% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9082.32,78,,7265.86,,,0,"percent of total billed charges","78% of total billed charges",3945.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9617.94,82.6,,7694.35,,,0,"percent of total billed charges","82.6% of total billed charges",2299.5,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9617.94,82.6,,7694.35,,,0,"percent of total billed charges","82.6% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2299.5,100,,,,,0,"fee schedule",EAPG,11644,100,,9315.20,,,0,"percent of total billed charges","100% of total billed charges",1703.33,12515.8,
"43264 ERCP; WITH REMVOAL OF CALCULI/DEBRIS FROM BI",76143264,CDM,750,RC,43264,CPT,OUTPATIENT,,,11644,7568.6,,10246.72,88,,8197.38,,,0,"percent of total billed charges","88% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2299.5,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6835.86,175,,,,,0,"fee schedule","175% of CMS fee schedule",2368.49,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7335.72,63,,5868.58,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",2299.5,100,,,,,0,"fee schedule",EAPG,8034.36,69,,,,,0,"fee schedule","69% of total billed charges",11644,100,,9315.20,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11644,100,,9315.20,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11644,100,,9315.20,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",12515.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2299.5,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3272.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1703.33,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2345.49,100,,,,,0,"fee schedule",EAPG,2989.36,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4389.79,37.7,,3511.83,,,0,"percent of total billed charges","37.7% of total billed charges",4389.79,37.7,,3511.83,,,0,"percent of total billed charges","37.70% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3947.32,33.9,,3157.86,,,0,"percent of total billed charges","33.9% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9082.32,78,,7265.86,,,0,"percent of total billed charges","78% of total billed charges",3945.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9617.94,82.6,,7694.35,,,0,"percent of total billed charges","82.6% of total billed charges",2299.5,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9617.94,82.6,,7694.35,,,0,"percent of total billed charges","82.6% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2299.5,100,,,,,0,"fee schedule",EAPG,11644,100,,9315.20,,,0,"percent of total billed charges","100% of total billed charges",1703.33,12515.8,
"(ERCP); with removal of foreign body(s) or stent(s) SURG",76143275,CDM,750,RC,43275,CPT,OUTPATIENT,,,11644,7568.6,,10246.72,88,,8197.38,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2299.5,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",2368.49,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7335.72,63,,5868.58,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",2299.5,100,,,,,0,"fee schedule",EAPG,8034.36,69,,,,,0,"fee schedule","69% of total billed charges",11644,100,,9315.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11644,100,,9315.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11644,100,,9315.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",12515.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2299.5,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3272.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1703.33,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2345.49,100,,,,,0,"fee schedule",EAPG,2989.36,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4389.79,37.7,,3511.83,,,0,"percent of total billed charges","37.7% of total billed charges",4389.79,37.7,,3511.83,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3947.32,33.9,,3157.86,,,0,"percent of total billed charges","33.9% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9082.32,78,,7265.86,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9617.94,82.6,,7694.35,,,0,"percent of total billed charges","82.6% of total billed charges",2299.5,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9617.94,82.6,,7694.35,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2299.5,100,,,,,0,"fee schedule",EAPG,11644,100,,9315.20,,,0,"percent of total billed charges","100% of total billed charges",1703.33,12515.8,
"(ERCP); with placement of endoscopic stent into biliary SUR",76143274,CDM,750,RC,43274,CPT,OUTPATIENT,,,19089,12407.85,,16798.32,88,,13438.66,,,0,"percent of total billed charges","88% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3870.92,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",10172.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",3987.05,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",12026.07,63,,9620.86,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",3870.92,100,,,,,0,"fee schedule",EAPG,13171.41,69,,,,,0,"fee schedule","69% of total billed charges",19089,100,,15271.20,,,0,"percent of total billed charges","100% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19089,100,,15271.20,,,0,"percent of total billed charges","100% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19089,100,,15271.20,,,0,"percent of total billed charges","100% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",20428.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3870.92,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5340.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2867.35,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3948.34,100,,,,,0,"fee schedule",EAPG,5032.19,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7196.55,37.7,,5757.24,,,0,"percent of total billed charges","37.7% of total billed charges",7196.55,37.7,,5757.24,,,0,"percent of total billed charges","37.70% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6471.17,33.9,,5176.94,,,0,"percent of total billed charges","33.9% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14889.42,78,,11911.54,,,0,"percent of total billed charges","78% of total billed charges",5871.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15767.51,82.6,,12614.01,,,0,"percent of total billed charges","82.6% of total billed charges",3870.92,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15767.51,82.6,,12614.01,,,0,"percent of total billed charges","82.6% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3870.92,100,,,,,0,"fee schedule",EAPG,19089,100,,15271.20,,,0,"percent of total billed charges","100% of total billed charges",2867.35,20428.51,
"(ERCP); with trans-endoscopic balloon dilation of SURG",76143277,CDM,750,RC,43277,CPT,OUTPATIENT,,,11644,7568.6,,10246.72,88,,8197.38,,,0,"percent of total billed charges","88% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3870.92,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6835.86,175,,,,,0,"fee schedule","175% of CMS fee schedule",3987.05,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7335.72,63,,5868.58,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",3870.92,100,,,,,0,"fee schedule",EAPG,8034.36,69,,,,,0,"fee schedule","69% of total billed charges",11644,100,,9315.20,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11644,100,,9315.20,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11644,100,,9315.20,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",12515.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3870.92,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3272.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2867.35,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3948.34,100,,,,,0,"fee schedule",EAPG,5032.19,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4389.79,37.7,,3511.83,,,0,"percent of total billed charges","37.7% of total billed charges",4389.79,37.7,,3511.83,,,0,"percent of total billed charges","37.70% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3947.32,33.9,,3157.86,,,0,"percent of total billed charges","33.9% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9082.32,78,,7265.86,,,0,"percent of total billed charges","78% of total billed charges",3945.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9617.94,82.6,,7694.35,,,0,"percent of total billed charges","82.6% of total billed charges",3870.92,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9617.94,82.6,,7694.35,,,0,"percent of total billed charges","82.6% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3870.92,100,,,,,0,"fee schedule",EAPG,11644,100,,9315.20,,,0,"percent of total billed charges","100% of total billed charges",2867.35,12515.8,
"GASTROSCOPY W ABLATION ANY KIND SURG",76143270,CDM,750,RC,43270,CPT,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1867.66,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",1923.69,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",1867.66,100,,,,,0,"fee schedule",EAPG,4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1867.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1383.45,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1905.02,100,,,,,0,"fee schedule",EAPG,2427.97,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1867.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1867.66,100,,,,,0,"fee schedule",EAPG,6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1383.45,6601.69,
"ERCP with removal/exchange of stent(s) of pancreatic duct SU",76143276,CDM,750,RC,43276,CPT,OUTPATIENT,,,19089,12407.85,,16798.32,88,,13438.66,,,0,"percent of total billed charges","88% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3870.92,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",10172.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",3987.05,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",12026.07,63,,9620.86,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",3870.92,100,,,,,0,"fee schedule",EAPG,13171.41,69,,,,,0,"fee schedule","69% of total billed charges",19089,100,,15271.20,,,0,"percent of total billed charges","100% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19089,100,,15271.20,,,0,"percent of total billed charges","100% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19089,100,,15271.20,,,0,"percent of total billed charges","100% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",20428.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3870.92,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5340.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2867.35,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3948.34,100,,,,,0,"fee schedule",EAPG,5032.19,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7196.55,37.7,,5757.24,,,0,"percent of total billed charges","37.7% of total billed charges",7196.55,37.7,,5757.24,,,0,"percent of total billed charges","37.70% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6471.17,33.9,,5176.94,,,0,"percent of total billed charges","33.9% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14889.42,78,,11911.54,,,0,"percent of total billed charges","78% of total billed charges",5871.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15767.51,82.6,,12614.01,,,0,"percent of total billed charges","82.6% of total billed charges",3870.92,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15767.51,82.6,,12614.01,,,0,"percent of total billed charges","82.6% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3870.92,100,,,,,0,"fee schedule",EAPG,19089,100,,15271.20,,,0,"percent of total billed charges","100% of total billed charges",2867.35,20428.51,
"Replacement of gastrostomy tube, percutaneous, includes rem",76143763,CDM,750,RC,43763,CPT,OUTPATIENT,,,1009,655.85,,887.92,88,,710.34,,,0,"percent of total billed charges","88% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,1009,100,,807.20,,,0,"percent of total billed charges","100% of total billed charges",441.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",624,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",635.67,63,,508.54,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,696.21,69,,,,,0,"fee schedule","69% of total billed charges",1009,100,,807.20,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1009,100,,807.20,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1009,100,,807.20,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1081.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",282.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",448.76,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",617.95,100,,,,,0,"fee schedule",EAPG,787.58,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",380.39,37.7,,304.31,,,0,"percent of total billed charges","37.7% of total billed charges",380.39,37.7,,304.31,,,0,"percent of total billed charges","37.70% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.05,33.9,,273.64,,,0,"percent of total billed charges","33.9% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",787.02,78,,629.62,,,0,"percent of total billed charges","78% of total billed charges",254.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",833.43,82.6,,666.74,,,0,"percent of total billed charges","82.6% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",833.43,82.6,,666.74,,,0,"percent of total billed charges","82.6% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,1009,100,,807.20,,,0,"percent of total billed charges","100% of total billed charges",252.08,3367,
"Replace Gastrostomy Tube SURG",76143762,CDM,750,RC,43762,CPT,OUTPATIENT,,,1009,655.85,,887.92,88,,710.34,,,0,"percent of total billed charges","88% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,1009,100,,807.20,,,0,"percent of total billed charges","100% of total billed charges",441.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",624,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",635.67,63,,508.54,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,696.21,69,,,,,0,"fee schedule","69% of total billed charges",1009,100,,807.20,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1009,100,,807.20,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1009,100,,807.20,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1081.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",282.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",448.76,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",617.95,100,,,,,0,"fee schedule",EAPG,787.58,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",380.39,37.7,,304.31,,,0,"percent of total billed charges","37.7% of total billed charges",380.39,37.7,,304.31,,,0,"percent of total billed charges","37.70% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.05,33.9,,273.64,,,0,"percent of total billed charges","33.9% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",787.02,78,,629.62,,,0,"percent of total billed charges","78% of total billed charges",254.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",833.43,82.6,,666.74,,,0,"percent of total billed charges","82.6% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",833.43,82.6,,666.74,,,0,"percent of total billed charges","82.6% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,1009,100,,807.20,,,0,"percent of total billed charges","100% of total billed charges",252.08,3367,
"43830 Gastrostomy, open; without construction of gastric tub",75043830,CDM,750,RC,43830,CPT,OUTPATIENT,,,6838,4444.7,,6017.44,88,,4813.95,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2897.21,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",2984.13,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4307.94,63,,3446.35,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",2897.21,100,,,,,0,"fee schedule",EAPG,4718.22,69,,,,,0,"fee schedule","69% of total billed charges",6838,100,,5470.40,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6838,100,,5470.40,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6838,100,,5470.40,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2897.21,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2146.08,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2955.15,100,,,,,0,"fee schedule",EAPG,3766.37,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2577.93,37.7,,2062.34,,,0,"percent of total billed charges","37.7% of total billed charges",2577.93,37.7,,2062.34,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2318.08,33.9,,1854.46,,,0,"percent of total billed charges","33.9% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5333.64,78,,4266.91,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5648.19,82.6,,4518.55,,,0,"percent of total billed charges","82.6% of total billed charges",2897.21,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5648.19,82.6,,4518.55,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2897.21,100,,,,,0,"fee schedule",EAPG,6838,100,,5470.40,,,0,"percent of total billed charges","100% of total billed charges",1725.93,6838,
"Smll Intestinal Endscpy, Entrscpy Bynd Scnd Port Of Duodenu",76144361,CDM,750,RC,44361,CPT,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.37,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",638.37,6601.69,
"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTI",76144366,CDM,750,RC,44366,CPT,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1867.66,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",1923.69,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",1867.66,100,,,,,0,"fee schedule",EAPG,4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1867.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1383.45,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1905.02,100,,,,,0,"fee schedule",EAPG,2427.97,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1867.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1867.66,100,,,,,0,"fee schedule",EAPG,6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1383.45,6601.69,
"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTIO",76144369,CDM,750,RC,44369,CPT,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.37,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",638.37,6601.69,
"SMALL BOWEL ENDOSCOPY, DIAG NOT INCLUDING",76144360,CDM,750,RC,44360,CPT,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.37,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",638.37,6601.69,
"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTI",76144364,CDM,750,RC,44364,CPT,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1867.66,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",1923.69,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",1867.66,100,,,,,0,"fee schedule",EAPG,4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1867.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1383.45,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1905.02,100,,,,,0,"fee schedule",EAPG,2427.97,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1867.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1867.66,100,,,,,0,"fee schedule",EAPG,6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1383.45,6601.69,
"Small intestinal endoscopy, enteroscopy beyond second portio",76144373,CDM,750,RC,44373,CPT,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.37,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",638.37,6601.69,
"SMALL BOWEL ENDOSCOPY, BEYOND SECOND PORTION W BIOPSY,",76144377,CDM,750,RC,44377,CPT,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.37,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",638.37,6601.69,
"Smll Intstnl Endscpy, Entrscpy Bynd Scnd Portion Of Duodenum",76144378,CDM,750,RC,44378,CPT,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1867.66,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",1923.69,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",1867.66,100,,,,,0,"fee schedule",EAPG,4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1867.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1383.45,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1905.02,100,,,,,0,"fee schedule",EAPG,2427.97,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1867.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1867.66,100,,,,,0,"fee schedule",EAPG,6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1383.45,6601.69,
"Colonoscopy through stoma; with biopsy, single or multiple",44389,CDM,750,RC,44389,CPT,OUTPATIENT,,,4021,2613.65,,3538.48,88,,2830.78,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,4021,100,,3216.80,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2533.23,63,,2026.58,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,2774.49,69,,,,,0,"fee schedule","69% of total billed charges",4021,100,,3216.80,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4021,100,,3216.80,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4021,100,,3216.80,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.91,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1515.92,37.7,,1212.74,,,0,"percent of total billed charges","37.7% of total billed charges",1515.92,37.7,,1212.74,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1363.12,33.9,,1090.50,,,0,"percent of total billed charges","33.9% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3136.38,78,,2509.10,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3321.35,82.6,,2657.08,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3321.35,82.6,,2657.08,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,4021,100,,3216.80,,,0,"percent of total billed charges","100% of total billed charges",647.91,4212.68,
"Ileoscopy, Through Stoma; With Biopsy, Single Or Multiple",76144382,CDM,750,RC,44382,CPT,OUTPATIENT,,,3068,1994.2,,2699.84,88,,2159.87,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1932.84,63,,1546.27,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,2116.92,69,,,,,0,"fee schedule","69% of total billed charges",3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.91,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1156.64,37.7,,925.31,,,0,"percent of total billed charges","37.7% of total billed charges",1156.64,37.7,,925.31,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1040.05,33.9,,832.04,,,0,"percent of total billed charges","33.9% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2393.04,78,,1914.43,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2534.17,82.6,,2027.34,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2534.17,82.6,,2027.34,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",647.91,3367,
"COLONOSCOPY THRU STOMA",76144388,CDM,750,RC,44388,CPT,OUTPATIENT,,,3010,1956.5,,2648.8,88,,2119.04,,,0,"percent of total billed charges","88% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",1631.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1896.3,63,,1517.04,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,2076.9,69,,,,,0,"fee schedule","69% of total billed charges",3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",3224.22,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",842.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.91,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1134.77,37.7,,907.82,,,0,"percent of total billed charges","37.7% of total billed charges",1134.77,37.7,,907.82,,,0,"percent of total billed charges","37.70% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1020.39,33.9,,816.31,,,0,"percent of total billed charges","33.9% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2347.8,78,,1878.24,,,0,"percent of total billed charges","78% of total billed charges",941.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2486.26,82.6,,1989.01,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2486.26,82.6,,1989.01,,,0,"percent of total billed charges","82.6% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",647.91,3367,
"ILEOSCOPY, THROUGH STOMA; WITH TRANSENDOSCOPIC BALLOON DILA",76144381,CDM,750,RC,44381,CPT,OUTPATIENT,,,6159,4003.35,,5419.92,88,,4335.94,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3880.17,63,,3104.14,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,4249.71,69,,,,,0,"fee schedule","69% of total billed charges",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.91,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.7% of total billed charges",2321.94,37.7,,1857.55,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.9,33.9,,1670.32,,,0,"percent of total billed charges","33.9% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4804.02,78,,3843.22,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5087.33,82.6,,4069.86,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,6159,100,,4927.20,,,0,"percent of total billed charges","100% of total billed charges",647.91,6601.69,
"Ileoxopy thru Stoma",76144380,CDM,750,RC,44380,CPT,OUTPATIENT,,,3068,1994.2,,2699.84,88,,2159.87,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1932.84,63,,1546.27,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,2116.92,69,,,,,0,"fee schedule","69% of total billed charges",3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.91,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1156.64,37.7,,925.31,,,0,"percent of total billed charges","37.7% of total billed charges",1156.64,37.7,,925.31,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1040.05,33.9,,832.04,,,0,"percent of total billed charges","33.9% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2393.04,78,,1914.43,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2534.17,82.6,,2027.34,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2534.17,82.6,,2027.34,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",647.91,3367,
"COLONOSCOPY THROUGH STOMA; WITH CONTROL OF BLEEDING, ANY ME",76144391,CDM,750,RC,44391,CPT,OUTPATIENT,,,3933,2556.45,,3461.04,88,,2768.83,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2477.79,63,,1982.23,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,2713.77,69,,,,,0,"fee schedule","69% of total billed charges",3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.91,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1482.74,37.7,,1186.19,,,0,"percent of total billed charges","37.7% of total billed charges",1482.74,37.7,,1186.19,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1333.29,33.9,,1066.63,,,0,"percent of total billed charges","33.9% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3067.74,78,,2454.19,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3248.66,82.6,,2598.93,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3248.66,82.6,,2598.93,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",647.91,4212.68,
"COLONOSCOPY THROUGH STOMA; REMOVAL OF TUMOR/POLYP, SNARE TE",76144394,CDM,750,RC,44394,CPT,OUTPATIENT,,,3933,2556.45,,3461.04,88,,2768.83,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2477.79,63,,1982.23,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,2713.77,69,,,,,0,"fee schedule","69% of total billed charges",3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.91,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1482.74,37.7,,1186.19,,,0,"percent of total billed charges","37.7% of total billed charges",1482.74,37.7,,1186.19,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1333.29,33.9,,1066.63,,,0,"percent of total billed charges","33.9% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3067.74,78,,2454.19,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3248.66,82.6,,2598.93,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3248.66,82.6,,2598.93,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",647.91,4212.68,
"COLONOSCOPY THROUGH STOMA; WITH ABLATION OF TUMOR(S), POLYP",76144401,CDM,750,RC,44401,CPT,OUTPATIENT,,,3933,2556.45,,3461.04,88,,2768.83,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2477.79,63,,1982.23,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,2713.77,69,,,,,0,"fee schedule","69% of total billed charges",3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.91,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1482.74,37.7,,1186.19,,,0,"percent of total billed charges","37.7% of total billed charges",1482.74,37.7,,1186.19,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1333.29,33.9,,1066.63,,,0,"percent of total billed charges","33.9% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3067.74,78,,2454.19,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3248.66,82.6,,2598.93,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3248.66,82.6,,2598.93,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",647.91,4212.68,
"COLONOSCOPY THROUGH STOMA; WITH DIRECTED SUBMUCOSAL INJECTIO",76144404,CDM,750,RC,44404,CPT,OUTPATIENT,,,3933,2556.45,,3461.04,88,,2768.83,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2477.79,63,,1982.23,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,2713.77,69,,,,,0,"fee schedule","69% of total billed charges",3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.91,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1482.74,37.7,,1186.19,,,0,"percent of total billed charges","37.7% of total billed charges",1482.74,37.7,,1186.19,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1333.29,33.9,,1066.63,,,0,"percent of total billed charges","33.9% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3067.74,78,,2454.19,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3248.66,82.6,,2598.93,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3248.66,82.6,,2598.93,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",647.91,4212.68,
"COLONOSCOPY THROUGH STOMA; WITH TRANSENDOSCOPIC BALLOON DIL",76144405,CDM,750,RC,44405,CPT,OUTPATIENT,,,3010,1956.5,,2648.8,88,,2119.04,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1896.3,63,,1517.04,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,2076.9,69,,,,,0,"fee schedule","69% of total billed charges",3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.91,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1134.77,37.7,,907.82,,,0,"percent of total billed charges","37.7% of total billed charges",1134.77,37.7,,907.82,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1020.39,33.9,,816.31,,,0,"percent of total billed charges","33.9% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2347.8,78,,1878.24,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2486.26,82.6,,1989.01,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2486.26,82.6,,1989.01,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",647.91,4212.68,
"FLEX SIG SURG",76145330,CDM,750,RC,45330,CPT,OUTPATIENT,,,3010,1956.5,,2648.8,88,,2119.04,,,0,"percent of total billed charges","88% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",1631.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1896.3,63,,1517.04,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,2076.9,69,,,,,0,"fee schedule","69% of total billed charges",3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",3224.22,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",842.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.91,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1134.77,37.7,,907.82,,,0,"percent of total billed charges","37.7% of total billed charges",1134.77,37.7,,907.82,,,0,"percent of total billed charges","37.70% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1020.39,33.9,,816.31,,,0,"percent of total billed charges","33.9% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2347.8,78,,1878.24,,,0,"percent of total billed charges","78% of total billed charges",941.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2486.26,82.6,,1989.01,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2486.26,82.6,,1989.01,,,0,"percent of total billed charges","82.6% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",647.91,3367,
"FLEX SIG W/BX",76145331,CDM,750,RC,45331,CPT,OUTPATIENT,,,3010,1956.5,,2648.8,88,,2119.04,,,0,"percent of total billed charges","88% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",1631.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1896.3,63,,1517.04,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,2076.9,69,,,,,0,"fee schedule","69% of total billed charges",3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",3224.22,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",842.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.91,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1134.77,37.7,,907.82,,,0,"percent of total billed charges","37.7% of total billed charges",1134.77,37.7,,907.82,,,0,"percent of total billed charges","37.70% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1020.39,33.9,,816.31,,,0,"percent of total billed charges","33.9% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2347.8,78,,1878.24,,,0,"percent of total billed charges","78% of total billed charges",941.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2486.26,82.6,,1989.01,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2486.26,82.6,,1989.01,,,0,"percent of total billed charges","82.6% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",647.91,3367,
"FLEX SIG W/REMOVAL POLYP/SNARE",76145338,CDM,750,RC,45338,CPT,OUTPATIENT,,,3932,2555.8,,3460.16,88,,2768.13,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3932,100,,3145.60,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2477.16,63,,1981.73,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,2713.08,69,,,,,0,"fee schedule","69% of total billed charges",3932,100,,3145.60,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3932,100,,3145.60,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3932,100,,3145.60,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.91,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1482.36,37.7,,1185.89,,,0,"percent of total billed charges","37.7% of total billed charges",1482.36,37.7,,1185.89,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1332.95,33.9,,1066.36,,,0,"percent of total billed charges","33.9% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3066.96,78,,2453.57,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3247.83,82.6,,2598.26,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3247.83,82.6,,2598.26,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3932,100,,3145.60,,,0,"percent of total billed charges","100% of total billed charges",647.91,4212.68,
"IGMOIDOSCOPY, FLEXIBLE",76145335,CDM,750,RC,45335,CPT,OUTPATIENT,,,3010,1956.5,,2648.8,88,,2119.04,,,0,"percent of total billed charges","88% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",1631.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1896.3,63,,1517.04,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,2076.9,69,,,,,0,"fee schedule","69% of total billed charges",3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",3224.22,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",842.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.91,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1134.77,37.7,,907.82,,,0,"percent of total billed charges","37.7% of total billed charges",1134.77,37.7,,907.82,,,0,"percent of total billed charges","37.70% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1020.39,33.9,,816.31,,,0,"percent of total billed charges","33.9% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2347.8,78,,1878.24,,,0,"percent of total billed charges","78% of total billed charges",941.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2486.26,82.6,,1989.01,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2486.26,82.6,,1989.01,,,0,"percent of total billed charges","82.6% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",647.91,3367,
"Sigmoidoscopy,flexible w/ctrl bleeding",76145334,CDM,750,RC,45334,CPT,OUTPATIENT,,,3933,2556.45,,3461.04,88,,2768.83,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2477.79,63,,1982.23,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,2713.77,69,,,,,0,"fee schedule","69% of total billed charges",3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.91,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1482.74,37.7,,1186.19,,,0,"percent of total billed charges","37.7% of total billed charges",1482.74,37.7,,1186.19,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1333.29,33.9,,1066.63,,,0,"percent of total billed charges","33.9% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3067.74,78,,2454.19,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3248.66,82.6,,2598.93,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3248.66,82.6,,2598.93,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",647.91,4212.68,
"SIGMOIDOSCOPY, FLEXIBLE; WITH PLACEMENT OF ENDOSCOPIC STENT",76145347,CDM,761,RC,45347,CPT,OUTPATIENT,,,3933,2556.45,,3461.04,88,,2768.83,,,0,"percent of total billed charges","88% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1843.93,100,,,,,0,"fee schedule",EAPG,3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",10172.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",1899.25,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2477.79,63,,1982.23,,,0,"percent of total billed charges","63% of total billed charges",601.75,15.3,,481.40,,,0,"percent of total billed charges","15.3% of total billed charges",1843.93,100,,,,,0,"fee schedule",EAPG,2713.77,69,,,,,0,"fee schedule","69% of total billed charges",3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",20428.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1843.93,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5340.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1365.87,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1880.81,100,,,,,0,"fee schedule",EAPG,2397.11,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1482.74,37.7,,1186.19,,,0,"percent of total billed charges","37.7% of total billed charges",1482.74,37.7,,1186.19,,,0,"percent of total billed charges","37.70% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1333.29,33.9,,1066.63,,,0,"percent of total billed charges","33.9% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3067.74,78,,2454.19,,,0,"percent of total billed charges","78% of total billed charges",5871.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3248.66,82.6,,2598.93,,,0,"percent of total billed charges","82.6% of total billed charges",1843.93,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3248.66,82.6,,2598.93,,,0,"percent of total billed charges","82.6% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1843.93,100,,,,,0,"fee schedule",EAPG,3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",601.75,20428.51,
"SIGMOIDOSCOPY, FLEXIBLE",76145340,CDM,750,RC,45340,CPT,OUTPATIENT,,,3933,2556.45,,3461.04,88,,2768.83,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2477.79,63,,1982.23,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,2713.77,69,,,,,0,"fee schedule","69% of total billed charges",3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.91,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1482.74,37.7,,1186.19,,,0,"percent of total billed charges","37.7% of total billed charges",1482.74,37.7,,1186.19,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1333.29,33.9,,1066.63,,,0,"percent of total billed charges","33.9% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3067.74,78,,2454.19,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3248.66,82.6,,2598.93,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3248.66,82.6,,2598.93,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",647.91,4212.68,
"Sigmoidoscopy, flexible w/ablation of tumors SURG",76145346,CDM,750,RC,45346,CPT,OUTPATIENT,,,3933,2556.45,,3461.04,88,,2768.83,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2477.79,63,,1982.23,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,2713.77,69,,,,,0,"fee schedule","69% of total billed charges",3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.91,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1482.74,37.7,,1186.19,,,0,"percent of total billed charges","37.7% of total billed charges",1482.74,37.7,,1186.19,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1333.29,33.9,,1066.63,,,0,"percent of total billed charges","33.9% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3067.74,78,,2454.19,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3248.66,82.6,,2598.93,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3248.66,82.6,,2598.93,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3933,100,,3146.40,,,0,"percent of total billed charges","100% of total billed charges",647.91,4212.68,
"DIAGNOSTIC COLONOSCOPY SURG",76145378,CDM,750,RC,45378,CPT,OUTPATIENT,,,3010,1956.5,,2648.8,88,,2119.04,,,0,"percent of total billed charges","88% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",1631.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1896.3,63,,1517.04,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,2076.9,69,,,,,0,"fee schedule","69% of total billed charges",3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",3224.22,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",842.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.91,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1134.77,37.7,,907.82,,,0,"percent of total billed charges","37.7% of total billed charges",1134.77,37.7,,907.82,,,0,"percent of total billed charges","37.70% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1020.39,33.9,,816.31,,,0,"percent of total billed charges","33.9% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2347.8,78,,1878.24,,,0,"percent of total billed charges","78% of total billed charges",941.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2486.26,82.6,,1989.01,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2486.26,82.6,,1989.01,,,0,"percent of total billed charges","82.6% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",647.91,3367,
"COLONOSCOPY W/CONTROL BLEED SURG",76145382,CDM,750,RC,45382,CPT,OUTPATIENT,,,3935,2557.75,,3462.8,88,,2770.24,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3935,100,,3148.00,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2479.05,63,,1983.24,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,2715.15,69,,,,,0,"fee schedule","69% of total billed charges",3935,100,,3148.00,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3935,100,,3148.00,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3935,100,,3148.00,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.91,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1483.5,37.7,,1186.80,,,0,"percent of total billed charges","37.7% of total billed charges",1483.5,37.7,,1186.80,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1333.97,33.9,,1067.18,,,0,"percent of total billed charges","33.9% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3069.3,78,,2455.44,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3250.31,82.6,,2600.25,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3250.31,82.6,,2600.25,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3935,100,,3148.00,,,0,"percent of total billed charges","100% of total billed charges",647.91,4212.68,
"COLONOSCOPY W/POLYPECTOMY SURG",76145385,CDM,750,RC,45385,CPT,OUTPATIENT,,,3935,2557.75,,3462.8,88,,2770.24,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3935,100,,3148.00,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2479.05,63,,1983.24,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,2715.15,69,,,,,0,"fee schedule","69% of total billed charges",3935,100,,3148.00,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3935,100,,3148.00,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3935,100,,3148.00,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.91,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1483.5,37.7,,1186.80,,,0,"percent of total billed charges","37.7% of total billed charges",1483.5,37.7,,1186.80,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1333.97,33.9,,1067.18,,,0,"percent of total billed charges","33.9% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3069.3,78,,2455.44,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3250.31,82.6,,2600.25,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3250.31,82.6,,2600.25,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3935,100,,3148.00,,,0,"percent of total billed charges","100% of total billed charges",647.91,4212.68,
"COLONOSCOPY ABLATION TUMOR POLYP LESION",76145388,CDM,750,RC,45388,CPT,OUTPATIENT,,,3935,2557.75,,3462.8,88,,2770.24,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3935,100,,3148.00,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2479.05,63,,1983.24,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,2715.15,69,,,,,0,"fee schedule","69% of total billed charges",3935,100,,3148.00,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3935,100,,3148.00,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3935,100,,3148.00,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.91,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1483.5,37.7,,1186.80,,,0,"percent of total billed charges","37.7% of total billed charges",1483.5,37.7,,1186.80,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1333.97,33.9,,1067.18,,,0,"percent of total billed charges","33.9% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3069.3,78,,2455.44,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3250.31,82.6,,2600.25,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3250.31,82.6,,2600.25,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3935,100,,3148.00,,,0,"percent of total billed charges","100% of total billed charges",647.91,4212.68,
"COLONOSCOPY SUB INJ SURG",76145381,CDM,750,RC,45381,CPT,OUTPATIENT,,,3935,2557.75,,3462.8,88,,2770.24,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3935,100,,3148.00,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2479.05,63,,1983.24,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,2715.15,69,,,,,0,"fee schedule","69% of total billed charges",3935,100,,3148.00,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3935,100,,3148.00,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3935,100,,3148.00,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.91,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1483.5,37.7,,1186.80,,,0,"percent of total billed charges","37.7% of total billed charges",1483.5,37.7,,1186.80,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1333.97,33.9,,1067.18,,,0,"percent of total billed charges","33.9% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3069.3,78,,2455.44,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3250.31,82.6,,2600.25,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3250.31,82.6,,2600.25,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3935,100,,3148.00,,,0,"percent of total billed charges","100% of total billed charges",647.91,4212.68,
"COLONOSCOPY, FLEXIBLE; WITH TRANSENDOSCOPIC BALLOON DILATIO",76145386,CDM,750,RC,45386,CPT,OUTPATIENT,,,3935,2557.75,,3462.8,88,,2770.24,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3935,100,,3148.00,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2479.05,63,,1983.24,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,2715.15,69,,,,,0,"fee schedule","69% of total billed charges",3935,100,,3148.00,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3935,100,,3148.00,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3935,100,,3148.00,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.91,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1483.5,37.7,,1186.80,,,0,"percent of total billed charges","37.7% of total billed charges",1483.5,37.7,,1186.80,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1333.97,33.9,,1067.18,,,0,"percent of total billed charges","33.9% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3069.3,78,,2455.44,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3250.31,82.6,,2600.25,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3250.31,82.6,,2600.25,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3935,100,,3148.00,,,0,"percent of total billed charges","100% of total billed charges",647.91,4212.68,
"COLONOSCOPY W/BX SURG",76145380,CDM,750,RC,45380,CPT,OUTPATIENT,,,3935,2557.75,,3462.8,88,,2770.24,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3935,100,,3148.00,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2479.05,63,,1983.24,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,2715.15,69,,,,,0,"fee schedule","69% of total billed charges",3935,100,,3148.00,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3935,100,,3148.00,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3935,100,,3148.00,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.91,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1483.5,37.7,,1186.80,,,0,"percent of total billed charges","37.7% of total billed charges",1483.5,37.7,,1186.80,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1333.97,33.9,,1067.18,,,0,"percent of total billed charges","33.9% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3069.3,78,,2455.44,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3250.31,82.6,,2600.25,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3250.31,82.6,,2600.25,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3935,100,,3148.00,,,0,"percent of total billed charges","100% of total billed charges",647.91,4212.68,
"45389 Colonoscopy, flexible; with endoscopic stent placement",75045389,CDM,750,RC,45389,CPT,OUTPATIENT,,,20162,13105.3,,17742.56,88,,14194.05,,,0,"percent of total billed charges","88% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1843.93,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",10172.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",1899.25,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",12702.06,63,,10161.65,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",1843.93,100,,,,,0,"fee schedule",EAPG,13911.78,69,,,,,0,"fee schedule","69% of total billed charges",20162,100,,16129.60,,,0,"percent of total billed charges","100% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",20162,100,,16129.60,,,0,"percent of total billed charges","100% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",20162,100,,16129.60,,,0,"percent of total billed charges","100% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",20428.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1843.93,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5340.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1365.87,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1880.81,100,,,,,0,"fee schedule",EAPG,2397.11,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7601.07,37.7,,6080.86,,,0,"percent of total billed charges","37.7% of total billed charges",7601.07,37.7,,6080.86,,,0,"percent of total billed charges","37.70% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6834.92,33.9,,5467.94,,,0,"percent of total billed charges","33.9% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15726.36,78,,12581.09,,,0,"percent of total billed charges","78% of total billed charges",5871.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16653.81,82.6,,13323.05,,,0,"percent of total billed charges","82.6% of total billed charges",1843.93,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16653.81,82.6,,13323.05,,,0,"percent of total billed charges","82.6% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1843.93,100,,,,,0,"fee schedule",EAPG,20162,100,,16129.60,,,0,"percent of total billed charges","100% of total billed charges",1365.87,20428.51,
"45393 COLONOSCOPY, FLEXIBLE; WITH DECOMPRESSION (FOR PATHOLO",76145393,CDM,761,RC,45393,CPT,OUTPATIENT,,,4379,2846.35,,3853.52,88,,3082.82,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,4379,100,,3503.20,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2758.77,63,,2207.02,,,0,"percent of total billed charges","63% of total billed charges",669.99,15.3,,535.99,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,3021.51,69,,,,,0,"fee schedule","69% of total billed charges",4379,100,,3503.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4379,100,,3503.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4379,100,,3503.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.91,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1650.88,37.7,,1320.70,,,0,"percent of total billed charges","37.7% of total billed charges",1650.88,37.7,,1320.70,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1484.48,33.9,,1187.58,,,0,"percent of total billed charges","33.9% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3415.62,78,,2732.50,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3617.05,82.6,,2893.64,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3617.05,82.6,,2893.64,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,4379,100,,3503.20,,,0,"percent of total billed charges","100% of total billed charges",647.91,4379,
"45390 COLONOSCOPY W/ EMR of POLYP",75045390,CDM,750,RC,45390,CPT,OUTPATIENT,,,9944,6463.6,,8750.72,88,,7000.58,,,0,"percent of total billed charges","88% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1843.93,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5011.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",1899.25,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6264.72,63,,5011.78,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",1843.93,100,,,,,0,"fee schedule",EAPG,6861.36,69,,,,,0,"fee schedule","69% of total billed charges",9944,100,,7955.20,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9944,100,,7955.20,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9944,100,,7955.20,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",9926.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1843.93,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2595.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1365.87,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1880.81,100,,,,,0,"fee schedule",EAPG,2397.11,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3748.89,37.7,,2999.11,,,0,"percent of total billed charges","37.7% of total billed charges",3748.89,37.7,,2999.11,,,0,"percent of total billed charges","37.70% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3371.02,33.9,,2696.82,,,0,"percent of total billed charges","33.9% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7756.32,78,,6205.06,,,0,"percent of total billed charges","78% of total billed charges",2892.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8213.74,82.6,,6570.99,,,0,"percent of total billed charges","82.6% of total billed charges",1843.93,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8213.74,82.6,,6570.99,,,0,"percent of total billed charges","82.6% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1843.93,100,,,,,0,"fee schedule",EAPG,9944,100,,7955.20,,,0,"percent of total billed charges","100% of total billed charges",1365.87,9944,
"45398 Colonoscopy, flexible; with band ligation(s) (eg, hemo",75045398,CDM,750,RC,45398,CPT,OUTPATIENT,,,4021,2613.65,,3538.48,88,,2830.78,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,4021,100,,3216.80,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2533.23,63,,2026.58,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,2774.49,69,,,,,0,"fee schedule","69% of total billed charges",4021,100,,3216.80,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4021,100,,3216.80,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4021,100,,3216.80,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.91,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1515.92,37.7,,1212.74,,,0,"percent of total billed charges","37.7% of total billed charges",1515.92,37.7,,1212.74,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1363.12,33.9,,1090.50,,,0,"percent of total billed charges","33.9% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3136.38,78,,2509.10,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3321.35,82.6,,2657.08,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3321.35,82.6,,2657.08,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,4021,100,,3216.80,,,0,"percent of total billed charges","100% of total billed charges",647.91,4212.68,
"45990 Anorectal exam, surgical, requiring anesthesia (genera",75045990,CDM,750,RC,45990,CPT,OUTPATIENT,,,9885,6425.25,,8698.8,88,,6959.04,,,0,"percent of total billed charges","88% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5011.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",1367,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6227.55,63,,4982.04,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,6820.65,69,,,,,0,"fee schedule","69% of total billed charges",9885,100,,7908.00,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9885,100,,7908.00,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9885,100,,7908.00,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",9926.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2595.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",983.1,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3726.65,37.7,,2981.32,,,0,"percent of total billed charges","37.7% of total billed charges",3726.65,37.7,,2981.32,,,0,"percent of total billed charges","37.70% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3351.02,33.9,,2680.82,,,0,"percent of total billed charges","33.9% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7710.3,78,,6168.24,,,0,"percent of total billed charges","78% of total billed charges",2892.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8165.01,82.6,,6532.01,,,0,"percent of total billed charges","82.6% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8165.01,82.6,,6532.01,,,0,"percent of total billed charges","82.6% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,9885,100,,7908.00,,,0,"percent of total billed charges","100% of total billed charges",983.1,9926.34,
"46999 UNLISTED PROCEDURE ANUS SURG",75046999,CDM,750,RC,46999,CPT,OUTPATIENT,,,3284,2134.6,,2889.92,88,,2311.94,,,0,"percent of total billed charges","88% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,3284,100,,2627.20,,,0,"percent of total billed charges","100% of total billed charges",1631.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",1367,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2068.92,63,,1655.14,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,2265.96,69,,,,,0,"fee schedule","69% of total billed charges",3284,100,,2627.20,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3284,100,,2627.20,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3284,100,,2627.20,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",3224.22,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",842.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",983.1,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1238.07,37.7,,990.46,,,0,"percent of total billed charges","37.7% of total billed charges",1238.07,37.7,,990.46,,,0,"percent of total billed charges","37.70% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1113.28,33.9,,890.62,,,0,"percent of total billed charges","33.9% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2561.52,78,,2049.22,,,0,"percent of total billed charges","78% of total billed charges",941.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2712.58,82.6,,2170.06,,,0,"percent of total billed charges","82.6% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2712.58,82.6,,2170.06,,,0,"percent of total billed charges","82.6% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,3284,100,,2627.20,,,0,"percent of total billed charges","100% of total billed charges",842.93,3367,
"Abdominal Paracentesis Diagnostic/Therapeutic W/Imaging",76149083,CDM,750,RC,49083,CPT,OUTPATIENT,,,3069,1994.85,,2700.72,88,,2160.58,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,3069,100,,2455.20,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",685.84,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1933.47,63,,1546.78,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,2117.61,69,,,,,0,"fee schedule","69% of total billed charges",3069,100,,2455.20,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3069,100,,2455.20,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3069,100,,2455.20,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",493.23,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",679.18,100,,,,,0,"fee schedule",EAPG,865.63,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1157.01,37.7,,925.61,,,0,"percent of total billed charges","37.7% of total billed charges",1157.01,37.7,,925.61,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1040.39,33.9,,832.31,,,0,"percent of total billed charges","33.9% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2393.82,78,,1915.06,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2534.99,82.6,,2027.99,,,0,"percent of total billed charges","82.6% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2534.99,82.6,,2027.99,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,3069,100,,2455.20,,,0,"percent of total billed charges","100% of total billed charges",493.23,3367,
"Peritoneal lavage, including imaging guidance, when performe",76149084,CDM,750,RC,49084,CPT,OUTPATIENT,,,3068,1994.2,,2699.84,88,,2159.87,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",685.84,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1932.84,63,,1546.27,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,2116.92,69,,,,,0,"fee schedule","69% of total billed charges",3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",493.23,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",679.18,100,,,,,0,"fee schedule",EAPG,865.63,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1156.64,37.7,,925.31,,,0,"percent of total billed charges","37.7% of total billed charges",1156.64,37.7,,925.31,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1040.05,33.9,,832.04,,,0,"percent of total billed charges","33.9% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2393.04,78,,1914.43,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2534.17,82.6,,2027.34,,,0,"percent of total billed charges","82.6% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2534.17,82.6,,2027.34,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",493.23,3367,
"ABD PARACENTESIS W/O IMAGING CHARGE",76149082,CDM,750,RC,49082,CPT,OUTPATIENT,,,3068,1994.2,,2699.84,88,,2159.87,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",685.84,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1932.84,63,,1546.27,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,2116.92,69,,,,,0,"fee schedule","69% of total billed charges",3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",493.23,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",679.18,100,,,,,0,"fee schedule",EAPG,865.63,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1156.64,37.7,,925.31,,,0,"percent of total billed charges","37.7% of total billed charges",1156.64,37.7,,925.31,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1040.05,33.9,,832.04,,,0,"percent of total billed charges","33.9% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2393.04,78,,1914.43,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2534.17,82.6,,2027.34,,,0,"percent of total billed charges","82.6% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2534.17,82.6,,2027.34,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,3068,100,,2454.40,,,0,"percent of total billed charges","100% of total billed charges",493.23,3367,
"SPINAL FLUID TAP DIAGNOSTIC",AMB820040,CDM,761,RC,62270,CPT,OUTPATIENT,,,1600,1040,,1408,88,,1126.40,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1600,100,,1280.00,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1008,63,,806.40,,,0,"percent of total billed charges","63% of total billed charges",244.8,15.3,,195.84,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,1104,69,,,,,0,"fee schedule","69% of total billed charges",1600,100,,1280.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1600,100,,1280.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1600,100,,1280.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",570.86,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",603.2,37.7,,482.56,,,0,"percent of total billed charges","37.7% of total billed charges",603.2,37.7,,482.56,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",542.4,33.9,,433.92,,,0,"percent of total billed charges","33.9% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1248,78,,998.40,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1321.6,82.6,,1057.28,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1321.6,82.6,,1057.28,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1600,100,,1280.00,,,0,"percent of total billed charges","100% of total billed charges",244.8,2578.03,
"Injection, anesthetic agent; sciatic nerve",76164445,CDM,761,RC,64445,CPT,OUTPATIENT,,,2060,1339,,1812.8,88,,1450.24,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1297.8,63,,1038.24,,,0,"percent of total billed charges","63% of total billed charges",315.18,15.3,,252.14,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,1421.4,69,,,,,0,"fee schedule","69% of total billed charges",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.52,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",776.62,37.7,,621.30,,,0,"percent of total billed charges","37.7% of total billed charges",776.62,37.7,,621.30,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",698.34,33.9,,558.67,,,0,"percent of total billed charges","33.9% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1606.8,78,,1285.44,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1701.56,82.6,,1361.25,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1701.56,82.6,,1361.25,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,2060,100,,1648.00,,,0,"percent of total billed charges","100% of total billed charges",290.52,2578.03,
"95926 SSEP LOWER LIMBS",36095926,CDM,922,RC,95926,CPT,OUTPATIENT,,,716,465.4,,630.08,88,,504.06,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,716,100,,572.80,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",126.58,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",109.55,15.3,,87.64,,,0,"percent of total billed charges","15.3% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,494.04,69,,,,,0,"fee schedule","69% of total billed charges",716,100,,572.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",716,100,,572.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",716,100,,572.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.03,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.35,100,,,,,0,"fee schedule",EAPG,159.77,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",269.93,37.7,,215.94,,,0,"percent of total billed charges","37.7% of total billed charges",269.93,37.7,,215.94,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",242.72,33.9,,194.18,,,0,"percent of total billed charges","33.9% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",558.48,78,,446.78,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591.42,82.6,,473.14,,,0,"percent of total billed charges","82.6% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591.42,82.6,,473.14,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,716,100,,572.80,,,0,"percent of total billed charges","100% of total billed charges",91.03,1074.33,
"95929 CMEP Lower Limbs",36095929,CDM,920,RC,95929,CPT,OUTPATIENT,,,1293,840.45,,1137.84,88,,910.27,,,0,"percent of total billed charges","88% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,1293,100,,1034.40,,,0,"percent of total billed charges","100% of total billed charges",956.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",126.58,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",197.83,15.3,,158.26,,,0,"percent of total billed charges","15.3% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,892.17,69,,,,,0,"fee schedule","69% of total billed charges",1293,100,,1034.40,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1293,100,,1034.40,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1293,100,,1034.40,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1981.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",518.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.03,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.35,100,,,,,0,"fee schedule",EAPG,159.77,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",487.46,37.7,,389.97,,,0,"percent of total billed charges","37.7% of total billed charges",487.46,37.7,,389.97,,,0,"percent of total billed charges","37.70% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",438.33,33.9,,350.66,,,0,"percent of total billed charges","33.9% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1008.54,78,,806.83,,,0,"percent of total billed charges","78% of total billed charges",552.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1068.02,82.6,,854.42,,,0,"percent of total billed charges","82.6% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1068.02,82.6,,854.42,,,0,"percent of total billed charges","82.6% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,1293,100,,1034.40,,,0,"percent of total billed charges","100% of total billed charges",91.03,1981.61,
"96413 CHEMO ADM IV INF 1HR SGL INIT",AMB820083,CDM,335,RC,96413,CPT,OUTPATIENT,,,1224,795.6,,1077.12,88,,861.70,,,0,"percent of total billed charges","88% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,1224,100,,979.20,,,0,"percent of total billed charges","100% of total billed charges",604.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",281.17,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",771.12,63,,616.90,,,0,"percent of total billed charges","63% of total billed charges",187.27,15.3,,149.82,,,0,"percent of total billed charges","15.3% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,844.56,69,,,,,0,"fee schedule","69% of total billed charges",1224,100,,979.20,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1224,100,,979.20,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1224,100,,979.20,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",1262.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.21,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278.44,100,,,,,0,"fee schedule",EAPG,354.88,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",461.45,37.7,,369.16,,,0,"percent of total billed charges","37.7% of total billed charges",461.45,37.7,,369.16,,,0,"percent of total billed charges","37.70% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",414.94,33.9,,331.95,,,0,"percent of total billed charges","33.9% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",954.72,78,,763.78,,,0,"percent of total billed charges","78% of total billed charges",348.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1011.02,82.6,,808.82,,,0,"percent of total billed charges","82.6% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1011.02,82.6,,808.82,,,0,"percent of total billed charges","82.6% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,1224,100,,979.20,,,0,"percent of total billed charges","100% of total billed charges",187.27,1262.42,
"96415 CHEMO ADM IV INF EA ADDT'L HR",AMB820084,CDM,335,RC,96415,CPT,OUTPATIENT,,,229,148.85,,201.52,88,,161.22,,,0,"percent of total billed charges","88% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,229,100,,183.20,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",475.9,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",144.27,63,,115.42,,,0,"percent of total billed charges","63% of total billed charges",35.04,15.3,,28.03,,,0,"percent of total billed charges","15.3% of total billed charges",462.04,100,,,,,0,"fee schedule",EAPG,158.01,69,,,,,0,"fee schedule","69% of total billed charges",229,100,,183.20,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229,100,,183.20,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229,100,,183.20,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.25,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",471.28,100,,,,,0,"fee schedule",EAPG,600.65,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",86.33,37.7,,69.06,,,0,"percent of total billed charges","37.7% of total billed charges",86.33,37.7,,69.06,,,0,"percent of total billed charges","37.70% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.63,33.9,,62.10,,,0,"percent of total billed charges","33.9% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",178.62,78,,142.90,,,0,"percent of total billed charges","78% of total billed charges",72.56,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.15,82.6,,151.32,,,0,"percent of total billed charges","82.6% of total billed charges",462.04,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.15,82.6,,151.32,,,0,"percent of total billed charges","82.6% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,229,100,,183.20,,,0,"percent of total billed charges","100% of total billed charges",35.04,600.65,
"Moderate Sedation (1st 15) Charge Surg",76199152,CDM,750,RC,99152,CPT,OUTPATIENT,,,493,320.45,,433.84,88,,347.07,,,0,"percent of total billed charges","88% of total billed charges",246.5,50,,197.20,,,0,"percent of total billed charges","50% of total billed charges",21.54,100,,,,,0,"fee schedule",EAPG,493,100,,394.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.18,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",310.59,63,,248.47,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",21.54,100,,,,,0,"fee schedule",EAPG,340.17,69,,,,,0,"fee schedule","69% of total billed charges",493,100,,394.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",493,100,,394.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",493,100,,394.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",304.92,61.85,,243.94,,,0,"percent of total billed charges","61.5% of total billed charges",21.54,100,,,,,0,"fee schedule",EAPG,246.5,50,,197.20,,,0,"percent of total billed charges","50% of total billed charges",158.75,32.2,,127.00,,,0,"percent of total billed charges","32.2% of total billed charges",15.95,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",21.97,100,,,,,0,"fee schedule",EAPG,28,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",185.86,37.7,,148.69,,,0,"percent of total billed charges","37.7% of total billed charges",185.86,37.7,,148.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",167.13,33.9,,133.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",384.54,78,,307.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",407.22,82.6,,325.78,,,0,"percent of total billed charges","82.6% of total billed charges",21.54,100,,,,,0,"fee schedule",EAPG,246.5,50,,197.20,,,0,"percent of total billed charges","50% of total billed charges",407.22,82.6,,325.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.54,100,,,,,0,"fee schedule",EAPG,493,100,,394.40,,,0,"percent of total billed charges","100% of total billed charges",15.95,3367,
"COLONOSCOPY-DX HIGH RISK",750G0105,CDM,750,RC,,,OUTPATIENT,,,3010,1956.5,,2648.8,88,,2119.04,,,0,"percent of total billed charges","88% of total billed charges",1505,50,,1204.00,,,0,"percent of total billed charges","50% of total billed charges",505.68,16.8,,404.54,,,0,"percent of total billed charges","16.8% of total billed charges",3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",520.85,17.304,,416.68,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1896.3,63,,1517.04,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",505.68,16.8,,404.54,,,0,"percent of total billed charges","16.8% of total billed charges",2076.9,69,,,,,0,"fee schedule","69% of total billed charges",3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1861.69,61.85,,1489.35,,,0,"percent of total billed charges","61.5% of total billed charges",505.68,16.8,,404.54,,,0,"percent of total billed charges","16.8% of total billed charges",1505,50,,1204.00,,,0,"percent of total billed charges","50% of total billed charges",969.22,32.2,,775.38,,,0,"percent of total billed charges","32.2% of total billed charges",505.68,16.8,,404.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",515.79,17.136,,412.63,,,0,"percent of total billed charges","17.136% of total billed charges",657.38,21.84,,525.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1134.77,37.7,,907.82,,,0,"percent of total billed charges","37.7% of total billed charges",1134.77,37.7,,907.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1020.39,33.9,,816.31,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2347.8,78,,1878.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2486.26,82.6,,1989.01,,,0,"percent of total billed charges","82.6% of total billed charges",505.68,16.8,,404.54,,,0,"percent of total billed charges","16.8% of total billed charges",1505,50,,1204.00,,,0,"percent of total billed charges","50% of total billed charges",2486.26,82.6,,1989.01,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.68,16.8,,404.54,,,0,"percent of total billed charges","16.8% of total billed charges",3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",505.68,3367,
N/A,750G0121,CDM,750,RC,,,OUTPATIENT,,,3010,1956.5,,2648.8,88,,2119.04,,,0,"percent of total billed charges","88% of total billed charges",1505,50,,1204.00,,,0,"percent of total billed charges","50% of total billed charges",505.68,16.8,,404.54,,,0,"percent of total billed charges","16.8% of total billed charges",3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",520.85,17.304,,416.68,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1896.3,63,,1517.04,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",505.68,16.8,,404.54,,,0,"percent of total billed charges","16.8% of total billed charges",2076.9,69,,,,,0,"fee schedule","69% of total billed charges",3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1861.69,61.85,,1489.35,,,0,"percent of total billed charges","61.5% of total billed charges",505.68,16.8,,404.54,,,0,"percent of total billed charges","16.8% of total billed charges",1505,50,,1204.00,,,0,"percent of total billed charges","50% of total billed charges",969.22,32.2,,775.38,,,0,"percent of total billed charges","32.2% of total billed charges",505.68,16.8,,404.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",515.79,17.136,,412.63,,,0,"percent of total billed charges","17.136% of total billed charges",657.38,21.84,,525.90,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1134.77,37.7,,907.82,,,0,"percent of total billed charges","37.7% of total billed charges",1134.77,37.7,,907.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1020.39,33.9,,816.31,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2347.8,78,,1878.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2486.26,82.6,,1989.01,,,0,"percent of total billed charges","82.6% of total billed charges",505.68,16.8,,404.54,,,0,"percent of total billed charges","16.8% of total billed charges",1505,50,,1204.00,,,0,"percent of total billed charges","50% of total billed charges",2486.26,82.6,,1989.01,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.68,16.8,,404.54,,,0,"percent of total billed charges","16.8% of total billed charges",3010,100,,2408.00,,,0,"percent of total billed charges","100% of total billed charges",505.68,3367,
"MOD SED ENDO/GT SERVICE 5/>YRS CHARGE SURG",750G0500,CDM,750,RC,,,OUTPATIENT,,,493,320.45,,433.84,88,,347.07,,,0,"percent of total billed charges","88% of total billed charges",246.5,50,,197.20,,,0,"percent of total billed charges","50% of total billed charges",82.82,16.8,,66.26,,,0,"percent of total billed charges","16.8% of total billed charges",493,100,,394.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.31,17.304,,68.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",310.59,63,,248.47,,,0,"percent of total billed charges","63% of total billed charges",3367,15.3,,2693.60,,,0,"percent of total billed charges","15.3% of total billed charges",82.82,16.8,,66.26,,,0,"percent of total billed charges","16.8% of total billed charges",340.17,69,,,,,0,"fee schedule","69% of total billed charges",493,100,,394.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",493,100,,394.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",493,100,,394.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",304.92,61.85,,243.94,,,0,"percent of total billed charges","61.5% of total billed charges",82.82,16.8,,66.26,,,0,"percent of total billed charges","16.8% of total billed charges",246.5,50,,197.20,,,0,"percent of total billed charges","50% of total billed charges",158.75,32.2,,127.00,,,0,"percent of total billed charges","32.2% of total billed charges",82.82,16.8,,66.26,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.48,17.136,,67.58,,,0,"percent of total billed charges","17.136% of total billed charges",107.67,21.84,,86.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",185.86,37.7,,148.69,,,0,"percent of total billed charges","37.7% of total billed charges",185.86,37.7,,148.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",167.13,33.9,,133.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",384.54,78,,307.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",407.22,82.6,,325.78,,,0,"percent of total billed charges","82.6% of total billed charges",82.82,16.8,,66.26,,,0,"percent of total billed charges","16.8% of total billed charges",246.5,50,,197.20,,,0,"percent of total billed charges","50% of total billed charges",407.22,82.6,,325.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.82,16.8,,66.26,,,0,"percent of total billed charges","16.8% of total billed charges",493,100,,394.40,,,0,"percent of total billed charges","100% of total billed charges",82.82,3367,
"BLOOD ADMIN",39136430,CDM,391,RC,36430,CPT,OUTPATIENT,,,1828,1188.2,,1608.64,88,,1286.91,,,0,"percent of total billed charges","88% of total billed charges",442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",414.73,100,,,,,0,"fee schedule",EAPG,1828,100,,1462.40,,,0,"percent of total billed charges","100% of total billed charges",774.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",427.18,100,,,,,0,"fee schedule",EAPG,442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1151.64,63,,921.31,,,0,"percent of total billed charges","63% of total billed charges",279.68,15.3,,223.74,,,0,"percent of total billed charges","15.3% of total billed charges",414.73,100,,,,,0,"fee schedule",EAPG,1261.32,69,,,,,0,"fee schedule","69% of total billed charges",1828,100,,1462.40,,,0,"percent of total billed charges","100% of total billed charges",442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1828,100,,1462.40,,,0,"percent of total billed charges","100% of total billed charges",442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1828,100,,1462.40,,,0,"percent of total billed charges","100% of total billed charges",442.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",1613.06,100,,,,,0,"fee schedule","100% of CMS OPPS rate",414.73,100,,,,,0,"fee schedule",EAPG,442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",421.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.21,100,,,,,0,"fee schedule",EAPG,442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",423.03,100,,,,,0,"fee schedule",EAPG,539.16,100,,,,,0,"fee schedule",EAPG,442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",689.16,37.7,,551.33,,,0,"percent of total billed charges","37.7% of total billed charges",689.16,37.7,,551.33,,,0,"percent of total billed charges","37.70% of total billed charges",442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",619.69,33.9,,495.75,,,0,"percent of total billed charges","33.9% of total billed charges",442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1425.84,78,,1140.67,,,0,"percent of total billed charges","78% of total billed charges",447.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1509.93,82.6,,1207.94,,,0,"percent of total billed charges","82.6% of total billed charges",414.73,100,,,,,0,"fee schedule",EAPG,442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1509.93,82.6,,1207.94,,,0,"percent of total billed charges","82.6% of total billed charges",442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",414.73,100,,,,,0,"fee schedule",EAPG,1828,100,,1462.40,,,0,"percent of total billed charges","100% of total billed charges",279.68,1828,
"BLOOD ADMIN",39136430,CDM,391,RC,36430,CPT,OUTPATIENT,,,1828,1188.2,,1608.64,88,,1286.91,,,0,"percent of total billed charges","88% of total billed charges",442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",414.73,100,,,,,0,"fee schedule",EAPG,1828,100,,1462.40,,,0,"percent of total billed charges","100% of total billed charges",774.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",427.18,100,,,,,0,"fee schedule",EAPG,442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1151.64,63,,921.31,,,0,"percent of total billed charges","63% of total billed charges",279.68,15.3,,223.74,,,0,"percent of total billed charges","15.3% of total billed charges",414.73,100,,,,,0,"fee schedule",EAPG,1261.32,69,,,,,0,"fee schedule","69% of total billed charges",1828,100,,1462.40,,,0,"percent of total billed charges","100% of total billed charges",442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1828,100,,1462.40,,,0,"percent of total billed charges","100% of total billed charges",442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1828,100,,1462.40,,,0,"percent of total billed charges","100% of total billed charges",442.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",1613.06,100,,,,,0,"fee schedule","100% of CMS OPPS rate",414.73,100,,,,,0,"fee schedule",EAPG,442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",421.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.21,100,,,,,0,"fee schedule",EAPG,442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",423.03,100,,,,,0,"fee schedule",EAPG,539.16,100,,,,,0,"fee schedule",EAPG,442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",689.16,37.7,,551.33,,,0,"percent of total billed charges","37.7% of total billed charges",689.16,37.7,,551.33,,,0,"percent of total billed charges","37.70% of total billed charges",442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",619.69,33.9,,495.75,,,0,"percent of total billed charges","33.9% of total billed charges",442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1425.84,78,,1140.67,,,0,"percent of total billed charges","78% of total billed charges",447.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1509.93,82.6,,1207.94,,,0,"percent of total billed charges","82.6% of total billed charges",414.73,100,,,,,0,"fee schedule",EAPG,442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1509.93,82.6,,1207.94,,,0,"percent of total billed charges","82.6% of total billed charges",442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",414.73,100,,,,,0,"fee schedule",EAPG,1828,100,,1462.40,,,0,"percent of total billed charges","100% of total billed charges",279.68,1828,
"ABG PUNCTURE",30036600,CDM,300,RC,36600,CPT,OUTPATIENT,,,538,349.7,,473.44,88,,378.75,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,538,100,,430.40,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",54.44,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.94,63,,271.15,,,0,"percent of total billed charges","63% of total billed charges",82.31,15.3,,65.85,,,0,"percent of total billed charges","15.3% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,371.22,69,,,,,0,"fee schedule","69% of total billed charges",538,100,,430.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",538,100,,430.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",538,100,,430.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.15,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",53.92,100,,,,,0,"fee schedule",EAPG,68.72,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.83,37.7,,162.26,,,0,"percent of total billed charges","37.7% of total billed charges",202.83,37.7,,162.26,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",182.38,33.9,,145.90,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",419.64,78,,335.71,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",444.39,82.6,,355.51,,,0,"percent of total billed charges","82.6% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",444.39,82.6,,355.51,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,538,100,,430.40,,,0,"percent of total billed charges","100% of total billed charges",39.15,538,
Electrocardiogram,73093005,CDM,730,RC,93005,CPT,OUTPATIENT,,,509,330.85,,447.92,88,,358.34,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",24.47,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320.67,63,,256.54,,,0,"percent of total billed charges","63% of total billed charges",77.88,15.3,,62.30,,,0,"percent of total billed charges","15.3% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,351.21,69,,,,,0,"fee schedule","69% of total billed charges",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17.6,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.23,100,,,,,0,"fee schedule",EAPG,30.89,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191.89,37.7,,153.51,,,0,"percent of total billed charges","37.7% of total billed charges",191.89,37.7,,153.51,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",172.55,33.9,,138.04,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397.02,78,,317.62,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.43,82.6,,336.34,,,0,"percent of total billed charges","82.6% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.43,82.6,,336.34,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",17.6,509,
"FETAL NON-STRESS TEST",59025,CDM,761,RC,59025,CPT,OUTPATIENT,,,561,364.65,,493.68,88,,394.94,,,0,"percent of total billed charges","88% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",165.98,100,,,,,0,"fee schedule",EAPG,561,100,,448.80,,,0,"percent of total billed charges","100% of total billed charges",355.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",170.96,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",353.43,63,,282.74,,,0,"percent of total billed charges","63% of total billed charges",85.83,15.3,,68.66,,,0,"percent of total billed charges","15.3% of total billed charges",165.98,100,,,,,0,"fee schedule",EAPG,387.09,69,,,,,0,"fee schedule","69% of total billed charges",561,100,,448.80,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561,100,,448.80,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561,100,,448.80,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",691.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",165.98,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.94,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.3,100,,,,,0,"fee schedule",EAPG,215.77,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",211.5,37.7,,169.20,,,0,"percent of total billed charges","37.7% of total billed charges",211.5,37.7,,169.20,,,0,"percent of total billed charges","37.70% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.18,33.9,,152.14,,,0,"percent of total billed charges","33.9% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",437.58,78,,350.06,,,0,"percent of total billed charges","78% of total billed charges",205.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",463.39,82.6,,370.71,,,0,"percent of total billed charges","82.6% of total billed charges",165.98,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",463.39,82.6,,370.71,,,0,"percent of total billed charges","82.6% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",165.98,100,,,,,0,"fee schedule",EAPG,561,100,,448.80,,,0,"percent of total billed charges","100% of total billed charges",85.83,691.92,
"HEARING SCREEN AUDITORY EVOKED",47192258,CDM,471,RC,92558,CPT,OUTPATIENT,,,983,638.95,,865.04,88,,692.03,,,0,"percent of total billed charges","88% of total billed charges",491.5,50,,393.20,,,0,"percent of total billed charges","50% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,983,100,,786.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.11,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",150.4,15.3,,120.32,,,0,"percent of total billed charges","15.3% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,678.27,69,,,,,0,"fee schedule","69% of total billed charges",983,100,,786.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",983,100,,786.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",983,100,,786.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",607.99,61.85,,486.39,,,0,"percent of total billed charges","61.5% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,491.5,50,,393.20,,,0,"percent of total billed charges","50% of total billed charges",316.53,32.2,,253.22,,,0,"percent of total billed charges","32.2% of total billed charges",23.09,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",31.8,100,,,,,0,"fee schedule",EAPG,40.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",370.59,37.7,,296.47,,,0,"percent of total billed charges","37.7% of total billed charges",370.59,37.7,,296.47,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",333.24,33.9,,266.59,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",766.74,78,,613.39,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",811.96,82.6,,649.57,,,0,"percent of total billed charges","82.6% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,491.5,50,,393.20,,,0,"percent of total billed charges","50% of total billed charges",811.96,82.6,,649.57,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.18,100,,,,,0,"fee schedule",EAPG,983,100,,786.40,,,0,"percent of total billed charges","100% of total billed charges",23.09,983,
Phototherapy,MED120045,CDM,290,RC,,,OUTPATIENT,,,683,443.95,,601.04,88,,480.83,,,0,"percent of total billed charges","88% of total billed charges",341.5,50,,273.20,,,0,"percent of total billed charges","50% of total billed charges",114.74,16.8,,91.79,,,0,"percent of total billed charges","16.8% of total billed charges",683,100,,546.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",118.19,17.304,,94.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",430.29,63,,344.23,,,0,"percent of total billed charges","63% of total billed charges",104.5,15.3,,83.60,,,0,"percent of total billed charges","15.3% of total billed charges",114.74,16.8,,91.79,,,0,"percent of total billed charges","16.8% of total billed charges",471.27,69,,,,,0,"fee schedule","69% of total billed charges",683,100,,546.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",683,100,,546.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",683,100,,546.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.44,61.85,,337.95,,,0,"percent of total billed charges","61.5% of total billed charges",114.74,16.8,,91.79,,,0,"percent of total billed charges","16.8% of total billed charges",341.5,50,,273.20,,,0,"percent of total billed charges","50% of total billed charges",219.93,32.2,,175.94,,,0,"percent of total billed charges","32.2% of total billed charges",114.74,16.8,,91.79,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",117.04,17.136,,93.63,,,0,"percent of total billed charges","17.136% of total billed charges",149.17,21.84,,119.34,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",257.49,37.7,,205.99,,,0,"percent of total billed charges","37.7% of total billed charges",257.49,37.7,,205.99,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.54,33.9,,185.23,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",532.74,78,,426.19,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",564.16,82.6,,451.33,,,0,"percent of total billed charges","82.6% of total billed charges",114.74,16.8,,91.79,,,0,"percent of total billed charges","16.8% of total billed charges",341.5,50,,273.20,,,0,"percent of total billed charges","50% of total billed charges",564.16,82.6,,451.33,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.74,16.8,,91.79,,,0,"percent of total billed charges","16.8% of total billed charges",683,100,,546.40,,,0,"percent of total billed charges","100% of total billed charges",104.5,683,
"SMOKE/TOBAC COUNSEL 3-10M",94299406,CDM,942,RC,99406,CPT,OUTPATIENT,,,111,72.15,,97.68,88,,78.14,,,0,"percent of total billed charges","88% of total billed charges",29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",21.69,100,,,,,0,"fee schedule",EAPG,111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",51.21,175,,,,,0,"fee schedule","175% of CMS fee schedule",22.34,100,,,,,0,"fee schedule",EAPG,29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",69.93,63,,55.94,,,0,"percent of total billed charges","63% of total billed charges",16.98,15.3,,13.58,,,0,"percent of total billed charges","15.3% of total billed charges",21.69,100,,,,,0,"fee schedule",EAPG,76.59,69,,,,,0,"fee schedule","69% of total billed charges",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",29.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",21.69,100,,,,,0,"fee schedule",EAPG,29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",27.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22.13,100,,,,,0,"fee schedule",EAPG,28.2,100,,,,,0,"fee schedule",EAPG,29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",41.85,37.7,,33.48,,,0,"percent of total billed charges","37.7% of total billed charges",41.85,37.7,,33.48,,,0,"percent of total billed charges","37.70% of total billed charges",29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",86.58,78,,69.26,,,0,"percent of total billed charges","78% of total billed charges",29.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.69,82.6,,73.35,,,0,"percent of total billed charges","82.6% of total billed charges",21.69,100,,,,,0,"fee schedule","100% of WA fee schedule",29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.69,82.6,,73.35,,,0,"percent of total billed charges","82.6% of total billed charges",29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",21.69,100,,,,,0,"fee schedule",EAPG,111,100,,88.80,,,0,"percent of total billed charges","100% of total billed charges",16.98,111,
"THERAPEUTIC PHLEBOTOMY ONC.",94099195,CDM,940,RC,99195,CPT,OUTPATIENT,,,351,228.15,,308.88,88,,247.10,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,351,100,,280.80,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",54.44,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.13,63,,176.90,,,0,"percent of total billed charges","63% of total billed charges",53.7,15.3,,42.96,,,0,"percent of total billed charges","15.3% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,242.19,69,,,,,0,"fee schedule","69% of total billed charges",351,100,,280.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",351,100,,280.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",351,100,,280.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.15,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",53.92,100,,,,,0,"fee schedule",EAPG,68.72,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.33,37.7,,105.86,,,0,"percent of total billed charges","37.7% of total billed charges",132.33,37.7,,105.86,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.99,33.9,,95.19,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",273.78,78,,219.02,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.93,82.6,,231.94,,,0,"percent of total billed charges","82.6% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.93,82.6,,231.94,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,351,100,,280.80,,,0,"percent of total billed charges","100% of total billed charges",39.15,454.8,
"Continuous Positive Airway Pressure (CPAP)",41094660,CDM,410,RC,94660,CPT,OUTPATIENT,,,544,353.6,,478.72,88,,382.98,,,0,"percent of total billed charges","88% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.78,100,,,,,0,"fee schedule",EAPG,544,100,,435.20,,,0,"percent of total billed charges","100% of total billed charges",380.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",115.13,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.72,63,,274.18,,,0,"percent of total billed charges","63% of total billed charges",83.23,15.3,,66.58,,,0,"percent of total billed charges","15.3% of total billed charges",111.78,100,,,,,0,"fee schedule",EAPG,375.36,69,,,,,0,"fee schedule","69% of total billed charges",544,100,,435.20,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",544,100,,435.20,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",544,100,,435.20,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",763.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.78,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",82.8,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",114.01,100,,,,,0,"fee schedule",EAPG,145.31,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",205.09,37.7,,164.07,,,0,"percent of total billed charges","37.7% of total billed charges",205.09,37.7,,164.07,,,0,"percent of total billed charges","37.70% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",184.42,33.9,,147.54,,,0,"percent of total billed charges","33.9% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",424.32,78,,339.46,,,0,"percent of total billed charges","78% of total billed charges",219.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.34,82.6,,359.47,,,0,"percent of total billed charges","82.6% of total billed charges",111.78,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.34,82.6,,359.47,,,0,"percent of total billed charges","82.6% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.78,100,,,,,0,"fee schedule",EAPG,544,100,,435.20,,,0,"percent of total billed charges","100% of total billed charges",82.8,763.26,
"ID ABSCESS SINGLE OR SIMPLE",76110060,CDM,761,RC,10060,CPT,OUTPATIENT,,,375,243.75,,330,88,,264.00,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,375,100,,300.00,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",236.25,63,,189.00,,,0,"percent of total billed charges","63% of total billed charges",57.38,15.3,,45.90,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,258.75,69,,,,,0,"fee schedule","69% of total billed charges",375,100,,300.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",375,100,,300.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",375,100,,300.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.13,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",141.38,37.7,,113.10,,,0,"percent of total billed charges","37.7% of total billed charges",141.38,37.7,,113.10,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",127.13,33.9,,101.70,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",292.5,78,,234.00,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.75,82.6,,247.80,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.75,82.6,,247.80,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,375,100,,300.00,,,0,"percent of total billed charges","100% of total billed charges",57.38,729.41,
"ID ABSCESS MULTIPLE OR COMPLI",76110061,CDM,761,RC,10061,CPT,OUTPATIENT,,,515,334.75,,453.2,88,,362.56,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",324.45,63,,259.56,,,0,"percent of total billed charges","63% of total billed charges",78.8,15.3,,63.04,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,355.35,69,,,,,0,"fee schedule","69% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.13,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",194.16,37.7,,155.33,,,0,"percent of total billed charges","37.7% of total billed charges",194.16,37.7,,155.33,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",174.59,33.9,,139.67,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.7,78,,321.36,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",78.8,1404.97,
"10160 PUNCT ASP-ABSCSS/EHMA/BULLA/CYST CHARGE",76110160,CDM,761,RC,10160,CPT,OUTPATIENT,,,478,310.7,,420.64,88,,336.51,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",301.14,63,,240.91,,,0,"percent of total billed charges","63% of total billed charges",73.13,15.3,,58.50,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,329.82,69,,,,,0,"fee schedule","69% of total billed charges",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.13,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180.21,37.7,,144.17,,,0,"percent of total billed charges","37.7% of total billed charges",180.21,37.7,,144.17,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",162.04,33.9,,129.63,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",372.84,78,,298.27,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394.83,82.6,,315.86,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394.83,82.6,,315.86,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",73.13,1404.97,
"DEBRID EXT ECZEMAT/INFEC SKIN",76111000,CDM,761,RC,11000,CPT,OUTPATIENT,,,383,248.95,,337.04,88,,269.63,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,383,100,,306.40,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",241.29,63,,193.03,,,0,"percent of total billed charges","63% of total billed charges",58.6,15.3,,46.88,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,264.27,69,,,,,0,"fee schedule","69% of total billed charges",383,100,,306.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",383,100,,306.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",383,100,,306.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",144.39,37.7,,115.51,,,0,"percent of total billed charges","37.7% of total billed charges",144.39,37.7,,115.51,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",129.84,33.9,,103.87,,,0,"percent of total billed charges","33.9% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.74,78,,238.99,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",316.36,82.6,,253.09,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",316.36,82.6,,253.09,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,383,100,,306.40,,,0,"percent of total billed charges","100% of total billed charges",58.6,2129.45,
"DEBRID MUSCLE/FASCIA FIRST 20S",76111043,CDM,761,RC,11043,CPT,OUTPATIENT,,,787,511.55,,692.56,88,,554.05,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,787,100,,629.60,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",495.81,63,,396.65,,,0,"percent of total billed charges","63% of total billed charges",120.41,15.3,,96.33,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,543.03,69,,,,,0,"fee schedule","69% of total billed charges",787,100,,629.60,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",787,100,,629.60,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",787,100,,629.60,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.7,37.7,,237.36,,,0,"percent of total billed charges","37.7% of total billed charges",296.7,37.7,,237.36,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",266.79,33.9,,213.43,,,0,"percent of total billed charges","33.9% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",613.86,78,,491.09,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",650.06,82.6,,520.05,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",650.06,82.6,,520.05,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,787,100,,629.60,,,0,"percent of total billed charges","100% of total billed charges",120.41,2129.45,
"DEBRID SUBQ FIRST 20 SQCM OR <",76111042,CDM,761,RC,11042,CPT,OUTPATIENT,,,316,205.4,,278.08,88,,222.46,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.08,63,,159.26,,,0,"percent of total billed charges","63% of total billed charges",48.35,15.3,,38.68,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,218.04,69,,,,,0,"fee schedule","69% of total billed charges",316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",119.13,37.7,,95.30,,,0,"percent of total billed charges","37.7% of total billed charges",119.13,37.7,,95.30,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.12,33.9,,85.70,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",246.48,78,,197.18,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",261.02,82.6,,208.82,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",261.02,82.6,,208.82,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",48.35,1404.97,
"DEBRID BONE FIRST 20SQ CM OR <",76111044,CDM,761,RC,11044,CPT,OUTPATIENT,,,1162,755.3,,1022.56,88,,818.05,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.83,100,,,,,0,"fee schedule",EAPG,1162,100,,929.60,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",930.95,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",732.06,63,,585.65,,,0,"percent of total billed charges","63% of total billed charges",177.79,15.3,,142.23,,,0,"percent of total billed charges","15.3% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,801.78,69,,,,,0,"fee schedule","69% of total billed charges",1162,100,,929.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1162,100,,929.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1162,100,,929.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.83,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",669.51,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",921.91,100,,,,,0,"fee schedule",EAPG,1174.99,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",438.07,37.7,,350.46,,,0,"percent of total billed charges","37.7% of total billed charges",438.07,37.7,,350.46,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",393.92,33.9,,315.14,,,0,"percent of total billed charges","33.9% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",906.36,78,,725.09,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",959.81,82.6,,767.85,,,0,"percent of total billed charges","82.6% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",959.81,82.6,,767.85,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.83,100,,,,,0,"fee schedule",EAPG,1162,100,,929.60,,,0,"percent of total billed charges","100% of total billed charges",177.79,5715.97,
"DEBRID MUSCLE/FASCIA EA ADD 20",76111046,CDM,761,RC,11046,CPT,OUTPATIENT,,,285,185.25,,250.8,88,,200.64,,,0,"percent of total billed charges","88% of total billed charges",142.5,50,,114.00,,,0,"percent of total billed charges","50% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",930.95,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",179.55,63,,143.64,,,0,"percent of total billed charges","63% of total billed charges",43.61,15.3,,34.89,,,0,"percent of total billed charges","15.3% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,196.65,69,,,,,0,"fee schedule","69% of total billed charges",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.27,61.85,,141.02,,,0,"percent of total billed charges","61.5% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,142.5,50,,114.00,,,0,"percent of total billed charges","50% of total billed charges",91.77,32.2,,73.42,,,0,"percent of total billed charges","32.2% of total billed charges",669.51,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",921.91,100,,,,,0,"fee schedule",EAPG,1174.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",107.45,37.7,,85.96,,,0,"percent of total billed charges","37.7% of total billed charges",107.45,37.7,,85.96,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",96.62,33.9,,77.30,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",222.3,78,,177.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",235.41,82.6,,188.33,,,0,"percent of total billed charges","82.6% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,142.5,50,,114.00,,,0,"percent of total billed charges","50% of total billed charges",235.41,82.6,,188.33,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",903.83,100,,,,,0,"fee schedule",EAPG,285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",43.61,1174.99,
"DEBRID BONE EA ADDL 20 SQ CM",76111047,CDM,761,RC,11047,CPT,OUTPATIENT,,,501,325.65,,440.88,88,,352.70,,,0,"percent of total billed charges","88% of total billed charges",250.5,50,,200.40,,,0,"percent of total billed charges","50% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,501,100,,400.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",930.95,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",315.63,63,,252.50,,,0,"percent of total billed charges","63% of total billed charges",76.65,15.3,,61.32,,,0,"percent of total billed charges","15.3% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,345.69,69,,,,,0,"fee schedule","69% of total billed charges",501,100,,400.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",501,100,,400.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",501,100,,400.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309.87,61.85,,247.90,,,0,"percent of total billed charges","61.5% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,250.5,50,,200.40,,,0,"percent of total billed charges","50% of total billed charges",161.32,32.2,,129.06,,,0,"percent of total billed charges","32.2% of total billed charges",669.51,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",921.91,100,,,,,0,"fee schedule",EAPG,1174.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",188.88,37.7,,151.10,,,0,"percent of total billed charges","37.7% of total billed charges",188.88,37.7,,151.10,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",169.84,33.9,,135.87,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",390.78,78,,312.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",413.83,82.6,,331.06,,,0,"percent of total billed charges","82.6% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,250.5,50,,200.40,,,0,"percent of total billed charges","50% of total billed charges",413.83,82.6,,331.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",903.83,100,,,,,0,"fee schedule",EAPG,501,100,,400.80,,,0,"percent of total billed charges","100% of total billed charges",76.65,1174.99,
"DEBRIDE SUBQ EA ADDL 20 SQ CM",76111045,CDM,761,RC,11045,CPT,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",930.95,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.9,61.85,,7.92,,,0,"percent of total billed charges","61.5% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",669.51,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",921.91,100,,,,,0,"fee schedule",EAPG,1174.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.7% of total billed charges",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.42,33.9,,4.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",903.83,100,,,,,0,"fee schedule",EAPG,16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,1174.99,
"PARING/CUT BENIGN HYPER LES 1",76111055,CDM,761,RC,11055,CPT,OUTPATIENT,,,85,55.25,,74.8,88,,59.84,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",53.55,63,,42.84,,,0,"percent of total billed charges","63% of total billed charges",13.01,15.3,,10.41,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,58.65,69,,,,,0,"fee schedule","69% of total billed charges",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.13,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32.05,37.7,,25.64,,,0,"percent of total billed charges","37.7% of total billed charges",32.05,37.7,,25.64,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",28.82,33.9,,23.06,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.3,78,,53.04,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",70.21,82.6,,56.17,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",70.21,82.6,,56.17,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",13.01,729.42,
"PARING/CUT BENIGN HYPERLES 2-4",76111056,CDM,761,RC,11056,CPT,OUTPATIENT,,,115,74.75,,101.2,88,,80.96,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",72.45,63,,57.96,,,0,"percent of total billed charges","63% of total billed charges",17.6,15.3,,14.08,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,79.35,69,,,,,0,"fee schedule","69% of total billed charges",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.13,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",43.36,37.7,,34.69,,,0,"percent of total billed charges","37.7% of total billed charges",43.36,37.7,,34.69,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.99,33.9,,31.19,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",89.7,78,,71.76,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",94.99,82.6,,75.99,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",94.99,82.6,,75.99,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",17.6,729.42,
"PARING/CUT BENIGN HYPER LES >4",76111057,CDM,761,RC,11057,CPT,OUTPATIENT,,,156,101.4,,137.28,88,,109.82,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",98.28,63,,78.62,,,0,"percent of total billed charges","63% of total billed charges",23.87,15.3,,19.10,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,107.64,69,,,,,0,"fee schedule","69% of total billed charges",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.13,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",58.81,37.7,,47.05,,,0,"percent of total billed charges","37.7% of total billed charges",58.81,37.7,,47.05,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.88,33.9,,42.30,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",121.68,78,,97.34,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",128.86,82.6,,103.09,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",128.86,82.6,,103.09,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",23.87,729.41,
"TRIM NONDYSTROPHIC NAILS ANY #",76111719,CDM,761,RC,11719,CPT,OUTPATIENT,,,74,48.1,,65.12,88,,52.10,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",60.86,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.62,63,,37.30,,,0,"percent of total billed charges","63% of total billed charges",11.32,15.3,,9.06,,,0,"percent of total billed charges","15.3% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,51.06,69,,,,,0,"fee schedule","69% of total billed charges",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",43.77,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60.27,100,,,,,0,"fee schedule",EAPG,76.81,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",27.9,37.7,,22.32,,,0,"percent of total billed charges","37.7% of total billed charges",27.9,37.7,,22.32,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",25.09,33.9,,20.07,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",57.72,78,,46.18,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.12,82.6,,48.90,,,0,"percent of total billed charges","82.6% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.12,82.6,,48.90,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",11.32,226.12,
"DEBRIDE NAIL 1-5",76111720,CDM,761,RC,11720,CPT,OUTPATIENT,,,74,48.1,,65.12,88,,52.10,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",60.86,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.62,63,,37.30,,,0,"percent of total billed charges","63% of total billed charges",11.32,15.3,,9.06,,,0,"percent of total billed charges","15.3% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,51.06,69,,,,,0,"fee schedule","69% of total billed charges",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",43.77,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60.27,100,,,,,0,"fee schedule",EAPG,76.81,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",27.9,37.7,,22.32,,,0,"percent of total billed charges","37.7% of total billed charges",27.9,37.7,,22.32,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",25.09,33.9,,20.07,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",57.72,78,,46.18,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.12,82.6,,48.90,,,0,"percent of total billed charges","82.6% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.12,82.6,,48.90,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",11.32,226.12,
"DEBRIDE NAIL > 5",76111721,CDM,761,RC,11721,CPT,OUTPATIENT,,,126,81.9,,110.88,88,,88.70,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",60.86,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",79.38,63,,63.50,,,0,"percent of total billed charges","63% of total billed charges",19.28,15.3,,15.42,,,0,"percent of total billed charges","15.3% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,86.94,69,,,,,0,"fee schedule","69% of total billed charges",126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",43.77,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60.27,100,,,,,0,"fee schedule",EAPG,76.81,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.5,37.7,,38.00,,,0,"percent of total billed charges","37.7% of total billed charges",47.5,37.7,,38.00,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42.71,33.9,,34.17,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",98.28,78,,78.62,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",104.08,82.6,,83.26,,,0,"percent of total billed charges","82.6% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",104.08,82.6,,83.26,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",19.28,226.12,
"AVULSION OF NAIL PLATE > 1",76111732,CDM,761,RC,11732,CPT,OUTPATIENT,,,91,59.15,,80.08,88,,64.06,,,0,"percent of total billed charges","88% of total billed charges",45.5,50,,36.40,,,0,"percent of total billed charges","50% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.86,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",57.33,63,,45.86,,,0,"percent of total billed charges","63% of total billed charges",13.92,15.3,,11.14,,,0,"percent of total billed charges","15.3% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,62.79,69,,,,,0,"fee schedule","69% of total billed charges",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,61.85,,45.02,,,0,"percent of total billed charges","61.5% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,45.5,50,,36.40,,,0,"percent of total billed charges","50% of total billed charges",29.3,32.2,,23.44,,,0,"percent of total billed charges","32.2% of total billed charges",43.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",60.27,100,,,,,0,"fee schedule",EAPG,76.81,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",34.31,37.7,,27.45,,,0,"percent of total billed charges","37.7% of total billed charges",34.31,37.7,,27.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.85,33.9,,24.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.98,78,,56.78,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.17,82.6,,60.14,,,0,"percent of total billed charges","82.6% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,45.5,50,,36.40,,,0,"percent of total billed charges","50% of total billed charges",75.17,82.6,,60.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.09,100,,,,,0,"fee schedule",EAPG,91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",13.92,91,
"EXCISION OF NAIL PART OR COMP",76111750,CDM,761,RC,11750,CPT,OUTPATIENT,,,1774,1153.1,,1561.12,88,,1248.90,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,1774,100,,1419.20,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1117.62,63,,894.10,,,0,"percent of total billed charges","63% of total billed charges",271.42,15.3,,217.14,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,1224.06,69,,,,,0,"fee schedule","69% of total billed charges",1774,100,,1419.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1774,100,,1419.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1774,100,,1419.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.37,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",668.8,37.7,,535.04,,,0,"percent of total billed charges","37.7% of total billed charges",668.8,37.7,,535.04,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",601.39,33.9,,481.11,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1383.72,78,,1106.98,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1465.32,82.6,,1172.26,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1465.32,82.6,,1172.26,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,1774,100,,1419.20,,,0,"percent of total billed charges","100% of total billed charges",271.42,1774,
"APPLY SKIN SUB LEGS 1ST 25SQCM",76115271,CDM,761,RC,15271,CPT,OUTPATIENT,,,6451,4193.15,,5676.88,88,,4541.50,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1817.34,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4064.13,63,,3251.30,,,0,"percent of total billed charges","63% of total billed charges",987,15.3,,789.60,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,4451.19,69,,,,,0,"fee schedule","69% of total billed charges",6451,100,,5160.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6451,100,,5160.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6451,100,,5160.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1306.97,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2432.03,37.7,,1945.62,,,0,"percent of total billed charges","37.7% of total billed charges",2432.03,37.7,,1945.62,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2186.89,33.9,,1749.51,,,0,"percent of total billed charges","33.9% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5031.78,78,,4025.42,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5328.53,82.6,,4262.82,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5328.53,82.6,,4262.82,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,6451,100,,5160.80,,,0,"percent of total billed charges","100% of total billed charges",987,6968.7,
"APPLY SKIN SUB LEGS ADDL25SQCM",76115272,CDM,761,RC,15272,CPT,OUTPATIENT,,,91,59.15,,80.08,88,,64.06,,,0,"percent of total billed charges","88% of total billed charges",45.5,50,,36.40,,,0,"percent of total billed charges","50% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1817.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",57.33,63,,45.86,,,0,"percent of total billed charges","63% of total billed charges",13.92,15.3,,11.14,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,62.79,69,,,,,0,"fee schedule","69% of total billed charges",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.28,61.85,,45.02,,,0,"percent of total billed charges","61.5% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,45.5,50,,36.40,,,0,"percent of total billed charges","50% of total billed charges",29.3,32.2,,23.44,,,0,"percent of total billed charges","32.2% of total billed charges",1306.97,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",34.31,37.7,,27.45,,,0,"percent of total billed charges","37.7% of total billed charges",34.31,37.7,,27.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.85,33.9,,24.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.98,78,,56.78,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.17,82.6,,60.14,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,45.5,50,,36.40,,,0,"percent of total billed charges","50% of total billed charges",75.17,82.6,,60.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1764.4,100,,,,,0,"fee schedule",EAPG,91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",13.92,2293.73,
"APPLY SKIN SUB LEGS 1ST 100SQC",76115273,CDM,761,RC,15273,CPT,OUTPATIENT,,,12692,8249.8,,11168.96,88,,8935.17,,,0,"percent of total billed charges","88% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6403.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",1817.34,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7995.96,63,,6396.77,,,0,"percent of total billed charges","63% of total billed charges",1941.88,15.3,,1553.50,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,8757.48,69,,,,,0,"fee schedule","69% of total billed charges",12692,100,,10153.60,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",12692,100,,10153.60,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",12692,100,,10153.60,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",14308.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3740.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1306.97,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4784.88,37.7,,3827.90,,,0,"percent of total billed charges","37.7% of total billed charges",4784.88,37.7,,3827.90,,,0,"percent of total billed charges","37.70% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4302.59,33.9,,3442.07,,,0,"percent of total billed charges","33.9% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9899.76,78,,7919.81,,,0,"percent of total billed charges","78% of total billed charges",3695.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10483.59,82.6,,8386.87,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10483.59,82.6,,8386.87,,,0,"percent of total billed charges","82.6% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,12692,100,,10153.60,,,0,"percent of total billed charges","100% of total billed charges",1306.97,14308.84,
"APPLY SKIN SUB LEG EA ADDL 100",76115274,CDM,761,RC,15274,CPT,OUTPATIENT,,,231,150.15,,203.28,88,,162.62,,,0,"percent of total billed charges","88% of total billed charges",115.5,50,,92.40,,,0,"percent of total billed charges","50% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,231,100,,184.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1817.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",145.53,63,,116.42,,,0,"percent of total billed charges","63% of total billed charges",35.34,15.3,,28.27,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,159.39,69,,,,,0,"fee schedule","69% of total billed charges",231,100,,184.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231,100,,184.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231,100,,184.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.87,61.85,,114.30,,,0,"percent of total billed charges","61.5% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,115.5,50,,92.40,,,0,"percent of total billed charges","50% of total billed charges",74.38,32.2,,59.50,,,0,"percent of total billed charges","32.2% of total billed charges",1306.97,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",87.09,37.7,,69.67,,,0,"percent of total billed charges","37.7% of total billed charges",87.09,37.7,,69.67,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.31,33.9,,62.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",180.18,78,,144.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",190.81,82.6,,152.65,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,115.5,50,,92.40,,,0,"percent of total billed charges","50% of total billed charges",190.81,82.6,,152.65,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1764.4,100,,,,,0,"fee schedule",EAPG,231,100,,184.80,,,0,"percent of total billed charges","100% of total billed charges",35.34,2293.73,
"APPLY SKIN SUB FEET 1ST 25SQCM",76115275,CDM,761,RC,15275,CPT,OUTPATIENT,,,491,319.15,,432.08,88,,345.66,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,491,100,,392.80,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1817.34,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.33,63,,247.46,,,0,"percent of total billed charges","63% of total billed charges",75.12,15.3,,60.10,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,338.79,69,,,,,0,"fee schedule","69% of total billed charges",491,100,,392.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",491,100,,392.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",491,100,,392.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1306.97,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",185.11,37.7,,148.09,,,0,"percent of total billed charges","37.7% of total billed charges",185.11,37.7,,148.09,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",166.45,33.9,,133.16,,,0,"percent of total billed charges","33.9% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",382.98,78,,306.38,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",405.57,82.6,,324.46,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",405.57,82.6,,324.46,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,491,100,,392.80,,,0,"percent of total billed charges","100% of total billed charges",75.12,6968.7,
"APPLY SKIN SUB FEET ADDL25SQCM",76115276,CDM,761,RC,15276,CPT,OUTPATIENT,,,130,84.5,,114.4,88,,91.52,,,0,"percent of total billed charges","88% of total billed charges",65,50,,52.00,,,0,"percent of total billed charges","50% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1817.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",81.9,63,,65.52,,,0,"percent of total billed charges","63% of total billed charges",19.89,15.3,,15.91,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,89.7,69,,,,,0,"fee schedule","69% of total billed charges",130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.41,61.85,,64.33,,,0,"percent of total billed charges","61.5% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,65,50,,52.00,,,0,"percent of total billed charges","50% of total billed charges",41.86,32.2,,33.49,,,0,"percent of total billed charges","32.2% of total billed charges",1306.97,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",49.01,37.7,,39.21,,,0,"percent of total billed charges","37.7% of total billed charges",49.01,37.7,,39.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.07,33.9,,35.26,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.4,78,,81.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",107.38,82.6,,85.90,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,65,50,,52.00,,,0,"percent of total billed charges","50% of total billed charges",107.38,82.6,,85.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1764.4,100,,,,,0,"fee schedule",EAPG,130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",19.89,2293.73,
"APPLY SKIN SUB FEET 1ST 100SQC",76115277,CDM,761,RC,15277,CPT,OUTPATIENT,,,6451,4193.15,,5676.88,88,,4541.50,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1817.34,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4064.13,63,,3251.30,,,0,"percent of total billed charges","63% of total billed charges",987,15.3,,789.60,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,4451.19,69,,,,,0,"fee schedule","69% of total billed charges",6451,100,,5160.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6451,100,,5160.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6451,100,,5160.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1306.97,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2432.03,37.7,,1945.62,,,0,"percent of total billed charges","37.7% of total billed charges",2432.03,37.7,,1945.62,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2186.89,33.9,,1749.51,,,0,"percent of total billed charges","33.9% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5031.78,78,,4025.42,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5328.53,82.6,,4262.82,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5328.53,82.6,,4262.82,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,6451,100,,5160.80,,,0,"percent of total billed charges","100% of total billed charges",987,6968.7,
"APPLY SKIN SUB FEET EA ADDL100",76115278,CDM,761,RC,15278,CPT,OUTPATIENT,,,290,188.5,,255.2,88,,204.16,,,0,"percent of total billed charges","88% of total billed charges",145,50,,116.00,,,0,"percent of total billed charges","50% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,290,100,,232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1817.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",182.7,63,,146.16,,,0,"percent of total billed charges","63% of total billed charges",44.37,15.3,,35.50,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,200.1,69,,,,,0,"fee schedule","69% of total billed charges",290,100,,232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290,100,,232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",290,100,,232.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.37,61.85,,143.50,,,0,"percent of total billed charges","61.5% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,145,50,,116.00,,,0,"percent of total billed charges","50% of total billed charges",93.38,32.2,,74.70,,,0,"percent of total billed charges","32.2% of total billed charges",1306.97,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",109.33,37.7,,87.46,,,0,"percent of total billed charges","37.7% of total billed charges",109.33,37.7,,87.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.31,33.9,,78.65,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",226.2,78,,180.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",239.54,82.6,,191.63,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,145,50,,116.00,,,0,"percent of total billed charges","50% of total billed charges",239.54,82.6,,191.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1764.4,100,,,,,0,"fee schedule",EAPG,290,100,,232.00,,,0,"percent of total billed charges","100% of total billed charges",44.37,2293.73,
"DRESS AN/OR DEBMT BURN INI MED",76116025,CDM,761,RC,16025,CPT,OUTPATIENT,,,565,367.25,,497.2,88,,397.76,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,565,100,,452.00,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.95,63,,284.76,,,0,"percent of total billed charges","63% of total billed charges",86.45,15.3,,69.16,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,389.85,69,,,,,0,"fee schedule","69% of total billed charges",565,100,,452.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",565,100,,452.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",565,100,,452.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",213.01,37.7,,170.41,,,0,"percent of total billed charges","37.7% of total billed charges",213.01,37.7,,170.41,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191.54,33.9,,153.23,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",440.7,78,,352.56,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",466.69,82.6,,373.35,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",466.69,82.6,,373.35,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,565,100,,452.00,,,0,"percent of total billed charges","100% of total billed charges",86.45,729.41,
"DRESS AN/OR DEBMT BURN INI SM",76116020,CDM,761,RC,16020,CPT,OUTPATIENT,,,367,238.55,,322.96,88,,258.37,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,367,100,,293.60,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",231.21,63,,184.97,,,0,"percent of total billed charges","63% of total billed charges",56.15,15.3,,44.92,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,253.23,69,,,,,0,"fee schedule","69% of total billed charges",367,100,,293.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367,100,,293.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367,100,,293.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",138.36,37.7,,110.69,,,0,"percent of total billed charges","37.7% of total billed charges",138.36,37.7,,110.69,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.41,33.9,,99.53,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",286.26,78,,229.01,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",303.14,82.6,,242.51,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",303.14,82.6,,242.51,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,367,100,,293.60,,,0,"percent of total billed charges","100% of total billed charges",56.15,729.42,
"DRESS AN/OR DEBMT BURN INI LG",76116030,CDM,761,RC,16030,CPT,OUTPATIENT,,,677,440.05,,595.76,88,,476.61,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,677,100,,541.60,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.51,63,,341.21,,,0,"percent of total billed charges","63% of total billed charges",103.58,15.3,,82.86,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,467.13,69,,,,,0,"fee schedule","69% of total billed charges",677,100,,541.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",677,100,,541.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",677,100,,541.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.23,37.7,,204.18,,,0,"percent of total billed charges","37.7% of total billed charges",255.23,37.7,,204.18,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.5,33.9,,183.60,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",528.06,78,,422.45,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",559.2,82.6,,447.36,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",559.2,82.6,,447.36,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,677,100,,541.60,,,0,"percent of total billed charges","100% of total billed charges",103.58,1404.97,
"CHEM CAUTERIZ GRANU TISSUE",76117250,CDM,761,RC,17250,CPT,OUTPATIENT,,,452,293.8,,397.76,88,,318.21,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,452,100,,361.60,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.76,63,,227.81,,,0,"percent of total billed charges","63% of total billed charges",69.16,15.3,,55.33,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,311.88,69,,,,,0,"fee schedule","69% of total billed charges",452,100,,361.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",452,100,,361.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",452,100,,361.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.13,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",170.4,37.7,,136.32,,,0,"percent of total billed charges","37.7% of total billed charges",170.4,37.7,,136.32,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",153.23,33.9,,122.58,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352.56,78,,282.05,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",373.35,82.6,,298.68,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",373.35,82.6,,298.68,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,452,100,,361.60,,,0,"percent of total billed charges","100% of total billed charges",69.16,729.42,
"BIOPSY BONE EXCISIONAL SUPERFI",76120240,CDM,761,RC,20240,CPT,OUTPATIENT,,,776,504.4,,682.88,88,,546.30,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,776,100,,620.80,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",488.88,63,,391.10,,,0,"percent of total billed charges","63% of total billed charges",118.73,15.3,,94.98,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,535.44,69,,,,,0,"fee schedule","69% of total billed charges",776,100,,620.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",776,100,,620.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",776,100,,620.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1164.3,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",292.55,37.7,,234.04,,,0,"percent of total billed charges","37.7% of total billed charges",292.55,37.7,,234.04,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",263.06,33.9,,210.45,,,0,"percent of total billed charges","33.9% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.28,78,,484.22,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",640.98,82.6,,512.78,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",640.98,82.6,,512.78,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,776,100,,620.80,,,0,"percent of total billed charges","100% of total billed charges",118.73,9628.23,
"APPLY TOTAL CONT LEG CAST LT",76129445LT,CDM,761,RC,29445,CPT,OUTPATIENT,,,531,345.15,,467.28,88,,373.82,,,0,"percent of total billed charges","88% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,531,100,,424.80,,,0,"percent of total billed charges","100% of total billed charges",479.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",174.75,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",334.53,63,,267.62,,,0,"percent of total billed charges","63% of total billed charges",81.24,15.3,,64.99,,,0,"percent of total billed charges","15.3% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,366.39,69,,,,,0,"fee schedule","69% of total billed charges",531,100,,424.80,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",531,100,,424.80,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",531,100,,424.80,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",979.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.68,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.06,100,,,,,0,"fee schedule",EAPG,220.57,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200.19,37.7,,160.15,,,0,"percent of total billed charges","37.7% of total billed charges",200.19,37.7,,160.15,,,0,"percent of total billed charges","37.70% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180.01,33.9,,144.01,,,0,"percent of total billed charges","33.9% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",414.18,78,,331.34,,,0,"percent of total billed charges","78% of total billed charges",276.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",438.61,82.6,,350.89,,,0,"percent of total billed charges","82.6% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",438.61,82.6,,350.89,,,0,"percent of total billed charges","82.6% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,531,100,,424.80,,,0,"percent of total billed charges","100% of total billed charges",81.24,979.75,
"APPLY TOTAL CONT LEG CAST RT",76129445RT,CDM,761,RC,29445,CPT,OUTPATIENT,,,531,345.15,,467.28,88,,373.82,,,0,"percent of total billed charges","88% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,531,100,,424.80,,,0,"percent of total billed charges","100% of total billed charges",479.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",174.75,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",334.53,63,,267.62,,,0,"percent of total billed charges","63% of total billed charges",81.24,15.3,,64.99,,,0,"percent of total billed charges","15.3% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,366.39,69,,,,,0,"fee schedule","69% of total billed charges",531,100,,424.80,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",531,100,,424.80,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",531,100,,424.80,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",979.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.68,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.06,100,,,,,0,"fee schedule",EAPG,220.57,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200.19,37.7,,160.15,,,0,"percent of total billed charges","37.7% of total billed charges",200.19,37.7,,160.15,,,0,"percent of total billed charges","37.70% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180.01,33.9,,144.01,,,0,"percent of total billed charges","33.9% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",414.18,78,,331.34,,,0,"percent of total billed charges","78% of total billed charges",276.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",438.61,82.6,,350.89,,,0,"percent of total billed charges","82.6% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",438.61,82.6,,350.89,,,0,"percent of total billed charges","82.6% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,531,100,,424.80,,,0,"percent of total billed charges","100% of total billed charges",81.24,979.75,
"APPLY MULTI COMP ANKLE/FOOT",76129581,CDM,761,RC,29581,CPT,OUTPATIENT,,,66,42.9,,58.08,88,,46.46,,,0,"percent of total billed charges","88% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",281.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",174.75,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",41.58,63,,33.26,,,0,"percent of total billed charges","63% of total billed charges",10.1,15.3,,8.08,,,0,"percent of total billed charges","15.3% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,45.54,69,,,,,0,"fee schedule","69% of total billed charges",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",573.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",149.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.68,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.06,100,,,,,0,"fee schedule",EAPG,220.57,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.88,37.7,,19.90,,,0,"percent of total billed charges","37.7% of total billed charges",24.88,37.7,,19.90,,,0,"percent of total billed charges","37.70% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22.37,33.9,,17.90,,,0,"percent of total billed charges","33.9% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.48,78,,41.18,,,0,"percent of total billed charges","78% of total billed charges",162.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",54.52,82.6,,43.62,,,0,"percent of total billed charges","82.6% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",54.52,82.6,,43.62,,,0,"percent of total billed charges","82.6% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",10.1,573.54,
"APPLY BILATERAL UNNA BOOT",76129580,CDM,761,RC,29580,CPT,OUTPATIENT,,,180,117,,158.4,88,,126.72,,,0,"percent of total billed charges","88% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",281.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",174.75,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",113.4,63,,90.72,,,0,"percent of total billed charges","63% of total billed charges",27.54,15.3,,22.03,,,0,"percent of total billed charges","15.3% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,124.2,69,,,,,0,"fee schedule","69% of total billed charges",180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",573.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",149.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.68,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.06,100,,,,,0,"fee schedule",EAPG,220.57,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",67.86,37.7,,54.29,,,0,"percent of total billed charges","37.7% of total billed charges",67.86,37.7,,54.29,,,0,"percent of total billed charges","37.70% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.02,33.9,,48.82,,,0,"percent of total billed charges","33.9% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",140.4,78,,112.32,,,0,"percent of total billed charges","78% of total billed charges",162.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.68,82.6,,118.94,,,0,"percent of total billed charges","82.6% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.68,82.6,,118.94,,,0,"percent of total billed charges","82.6% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",27.54,573.54,
"APPLY UNNA BOOT LT",76129580,CDM,761,RC,29580,CPT,OUTPATIENT,,,180,117,,158.4,88,,126.72,,,0,"percent of total billed charges","88% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",281.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",174.75,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",113.4,63,,90.72,,,0,"percent of total billed charges","63% of total billed charges",27.54,15.3,,22.03,,,0,"percent of total billed charges","15.3% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,124.2,69,,,,,0,"fee schedule","69% of total billed charges",180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",573.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",149.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.68,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.06,100,,,,,0,"fee schedule",EAPG,220.57,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",67.86,37.7,,54.29,,,0,"percent of total billed charges","37.7% of total billed charges",67.86,37.7,,54.29,,,0,"percent of total billed charges","37.70% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.02,33.9,,48.82,,,0,"percent of total billed charges","33.9% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",140.4,78,,112.32,,,0,"percent of total billed charges","78% of total billed charges",162.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.68,82.6,,118.94,,,0,"percent of total billed charges","82.6% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.68,82.6,,118.94,,,0,"percent of total billed charges","82.6% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",27.54,573.54,
"APPLY UNNA BOOT RT",76129580,CDM,761,RC,29580,CPT,OUTPATIENT,,,180,117,,158.4,88,,126.72,,,0,"percent of total billed charges","88% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",281.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",174.75,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",113.4,63,,90.72,,,0,"percent of total billed charges","63% of total billed charges",27.54,15.3,,22.03,,,0,"percent of total billed charges","15.3% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,124.2,69,,,,,0,"fee schedule","69% of total billed charges",180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",573.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",149.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.68,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.06,100,,,,,0,"fee schedule",EAPG,220.57,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",67.86,37.7,,54.29,,,0,"percent of total billed charges","37.7% of total billed charges",67.86,37.7,,54.29,,,0,"percent of total billed charges","37.70% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.02,33.9,,48.82,,,0,"percent of total billed charges","33.9% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",140.4,78,,112.32,,,0,"percent of total billed charges","78% of total billed charges",162.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.68,82.6,,118.94,,,0,"percent of total billed charges","82.6% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.68,82.6,,118.94,,,0,"percent of total billed charges","82.6% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",27.54,573.54,
"REM IMPACT CERUMEN REQ IRRIGAT",76169209,CDM,761,RC,69209,CPT,OUTPATIENT,,,65,42.25,,57.2,88,,45.76,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",11.25,17.304,,9.00,,,0,"percent of total billed charges","17.304% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.95,63,,32.76,,,0,"percent of total billed charges","63% of total billed charges",9.95,15.3,,7.96,,,0,"percent of total billed charges","15.3% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",44.85,69,,,,,0,"fee schedule","69% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11.14,17.136,,8.91,,,0,"percent of total billed charges","17.136% of total billed charges",14.2,21.84,,11.36,,,0,"percent of total billed charges","21.84% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.51,37.7,,19.61,,,0,"percent of total billed charges","37.7% of total billed charges",24.51,37.7,,19.61,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22.04,33.9,,17.63,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",50.7,78,,40.56,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",9.95,226.12,
"REM IMPACT CERUMEN REQ INSTRU",76169210,CDM,761,RC,69210,CPT,OUTPATIENT,,,166,107.9,,146.08,88,,116.86,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",28.72,17.304,,22.98,,,0,"percent of total billed charges","17.304% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",104.58,63,,83.66,,,0,"percent of total billed charges","63% of total billed charges",25.4,15.3,,20.32,,,0,"percent of total billed charges","15.3% of total billed charges",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",114.54,69,,,,,0,"fee schedule","69% of total billed charges",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",28.45,17.136,,22.76,,,0,"percent of total billed charges","17.136% of total billed charges",36.25,21.84,,29.00,,,0,"percent of total billed charges","21.84% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",62.58,37.7,,50.06,,,0,"percent of total billed charges","37.7% of total billed charges",62.58,37.7,,50.06,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",56.27,33.9,,45.02,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",129.48,78,,103.58,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",137.12,82.6,,109.70,,,0,"percent of total billed charges","82.6% of total billed charges",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",137.12,82.6,,109.70,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",27.89,16.8,,22.31,,,0,"percent of total billed charges","16.8% of total billed charges",166,100,,132.80,,,0,"percent of total billed charges","100% of total billed charges",25.4,226.12,
"BLOOD GLUCOSE CHECK",30082962,CDM,300,RC,82962,CPT,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",3.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",5.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,3.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",3.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",3.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",3.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.54,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,3.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.28,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,3.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,3.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.7% of total billed charges",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",3.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.93,33.9,,12.74,,,0,"percent of total billed charges","33.9% of total billed charges",3.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",3.31,101,,,,,0,"fee schedule","101% of CMS fee schedule ",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,3.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",3.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,47,
"TCPO/ABI BILAT 1-2 OR UNILAT>3",76193922,CDM,761,RC,93922,CPT,OUTPATIENT,,,711,462.15,,625.68,88,,500.54,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,711,100,,568.80,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",447.93,63,,358.34,,,0,"percent of total billed charges","63% of total billed charges",108.78,15.3,,87.02,,,0,"percent of total billed charges","15.3% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,490.59,69,,,,,0,"fee schedule","69% of total billed charges",711,100,,568.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",711,100,,568.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",711,100,,568.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.81,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",268.05,37.7,,214.44,,,0,"percent of total billed charges","37.7% of total billed charges",268.05,37.7,,214.44,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",241.03,33.9,,192.82,,,0,"percent of total billed charges","33.9% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.58,78,,443.66,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",587.29,82.6,,469.83,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",587.29,82.6,,469.83,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,711,100,,568.80,,,0,"percent of total billed charges","100% of total billed charges",73.81,711,
"TCPO/ABI BILAT >3 OR BILAT SGL",76193923,CDM,921,RC,93923,CPT,OUTPATIENT,,,1024,665.6,,901.12,88,,720.90,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.99,100,,,,,0,"fee schedule",EAPG,1024,100,,819.20,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",155.52,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",645.12,63,,516.10,,,0,"percent of total billed charges","63% of total billed charges",156.67,15.3,,125.34,,,0,"percent of total billed charges","15.3% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,706.56,69,,,,,0,"fee schedule","69% of total billed charges",1024,100,,819.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1024,100,,819.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1024,100,,819.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.99,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.84,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.01,100,,,,,0,"fee schedule",EAPG,196.29,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",386.05,37.7,,308.84,,,0,"percent of total billed charges","37.7% of total billed charges",386.05,37.7,,308.84,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",347.14,33.9,,277.71,,,0,"percent of total billed charges","33.9% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",798.72,78,,638.98,,,0,"percent of total billed charges","78% of total billed charges",160.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",845.82,82.6,,676.66,,,0,"percent of total billed charges","82.6% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",845.82,82.6,,676.66,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.99,100,,,,,0,"fee schedule",EAPG,1024,100,,819.20,,,0,"percent of total billed charges","100% of total billed charges",111.84,1024,
"INJECTION SUBQ/IM WOUND CARE",76196372X,CDM,761,RC,96372,CPT,OUTPATIENT,,,320,208,,281.6,88,,225.28,,,0,"percent of total billed charges","88% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",48.96,15.3,,39.17,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,220.8,69,,,,,0,"fee schedule","69% of total billed charges",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.48,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",120.64,37.7,,96.51,,,0,"percent of total billed charges","37.7% of total billed charges",120.64,37.7,,96.51,,,0,"percent of total billed charges","37.70% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.48,33.9,,86.78,,,0,"percent of total billed charges","33.9% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",249.6,78,,199.68,,,0,"percent of total billed charges","78% of total billed charges",72.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",264.32,82.6,,211.46,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",264.32,82.6,,211.46,,,0,"percent of total billed charges","82.6% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",29.48,320,
"DEBRIDE OPEN WD FIRST 20SQCM",76197597,CDM,761,RC,97597,CPT,OUTPATIENT,,,119,77.35,,104.72,88,,83.78,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.97,63,,59.98,,,0,"percent of total billed charges","63% of total billed charges",18.21,15.3,,14.57,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,82.11,69,,,,,0,"fee schedule","69% of total billed charges",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.7% of total billed charges",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.34,33.9,,32.27,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.82,78,,74.26,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",18.21,729.41,
"DEBRID OPEN WD EA ADDL 20SQ CM",76197598,CDM,761,RC,97598,CPT,OUTPATIENT,,,56,36.4,,49.28,88,,39.42,,,0,"percent of total billed charges","88% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",930.95,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",35.28,63,,28.22,,,0,"percent of total billed charges","63% of total billed charges",8.57,15.3,,6.86,,,0,"percent of total billed charges","15.3% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,38.64,69,,,,,0,"fee schedule","69% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.64,61.85,,27.71,,,0,"percent of total billed charges","61.5% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",18.03,32.2,,14.42,,,0,"percent of total billed charges","32.2% of total billed charges",669.51,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",921.91,100,,,,,0,"fee schedule",EAPG,1174.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",21.11,37.7,,16.89,,,0,"percent of total billed charges","37.7% of total billed charges",21.11,37.7,,16.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.98,33.9,,15.18,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.68,78,,34.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",903.83,100,,,,,0,"fee schedule",EAPG,56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",8.57,1174.99,
"NONSELECTIVE DEBRIDEMENT",76197602,CDM,761,RC,97602,CPT,OUTPATIENT,,,266,172.9,,234.08,88,,187.26,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",167.58,63,,134.06,,,0,"percent of total billed charges","63% of total billed charges",40.7,15.3,,32.56,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,183.54,69,,,,,0,"fee schedule","69% of total billed charges",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.28,37.7,,80.22,,,0,"percent of total billed charges","37.7% of total billed charges",100.28,37.7,,80.22,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",90.17,33.9,,72.14,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",207.48,78,,165.98,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",219.72,82.6,,175.78,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",219.72,82.6,,175.78,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",40.7,729.42,
"NPWT < 50 SQ CM",76197605,CDM,761,RC,97605,CPT,OUTPATIENT,,,591,384.15,,520.08,88,,416.06,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",372.33,63,,297.86,,,0,"percent of total billed charges","63% of total billed charges",90.42,15.3,,72.34,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,407.79,69,,,,,0,"fee schedule","69% of total billed charges",591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",222.81,37.7,,178.25,,,0,"percent of total billed charges","37.7% of total billed charges",222.81,37.7,,178.25,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200.35,33.9,,160.28,,,0,"percent of total billed charges","33.9% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460.98,78,,368.78,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",488.17,82.6,,390.54,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",488.17,82.6,,390.54,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",90.42,729.42,
"NPWT > 50 SQ CM",76197606,CDM,761,RC,97606,CPT,OUTPATIENT,,,591,384.15,,520.08,88,,416.06,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",372.33,63,,297.86,,,0,"percent of total billed charges","63% of total billed charges",90.42,15.3,,72.34,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,407.79,69,,,,,0,"fee schedule","69% of total billed charges",591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",222.81,37.7,,178.25,,,0,"percent of total billed charges","37.7% of total billed charges",222.81,37.7,,178.25,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200.35,33.9,,160.28,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460.98,78,,368.78,,,0,"percent of total billed charges","78% of total billed charges",410.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",488.17,82.6,,390.54,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",488.17,82.6,,390.54,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",90.42,1404.98,
"NPWT < 50 SQ CM DISPOSABLE",76197607,CDM,761,RC,97607,CPT,OUTPATIENT,,,389,252.85,,342.32,88,,273.86,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,389,100,,311.20,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",245.07,63,,196.06,,,0,"percent of total billed charges","63% of total billed charges",59.52,15.3,,47.62,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,268.41,69,,,,,0,"fee schedule","69% of total billed charges",389,100,,311.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",389,100,,311.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",389,100,,311.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",146.65,37.7,,117.32,,,0,"percent of total billed charges","37.7% of total billed charges",146.65,37.7,,117.32,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",131.87,33.9,,105.50,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",303.42,78,,242.74,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",321.31,82.6,,257.05,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",321.31,82.6,,257.05,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,389,100,,311.20,,,0,"percent of total billed charges","100% of total billed charges",59.52,1404.97,
"NPWT > 50 SQ CM DISPOSABLE",76197608,CDM,761,RC,97608,CPT,OUTPATIENT,,,389,252.85,,342.32,88,,273.86,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,389,100,,311.20,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",245.07,63,,196.06,,,0,"percent of total billed charges","63% of total billed charges",59.52,15.3,,47.62,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,268.41,69,,,,,0,"fee schedule","69% of total billed charges",389,100,,311.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",389,100,,311.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",389,100,,311.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.91,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",146.65,37.7,,117.32,,,0,"percent of total billed charges","37.7% of total billed charges",146.65,37.7,,117.32,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",131.87,33.9,,105.50,,,0,"percent of total billed charges","33.9% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",303.42,78,,242.74,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",321.31,82.6,,257.05,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",321.31,82.6,,257.05,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,389,100,,311.20,,,0,"percent of total billed charges","100% of total billed charges",59.52,1404.97,
"EM LEVEL 1",51099201,CDM,510,RC,99211,CPT,OUTPATIENT,,,56,36.4,,49.28,88,,39.42,,,0,"percent of total billed charges","88% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.69,17.304,,7.75,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.28,63,,28.22,,,0,"percent of total billed charges","63% of total billed charges",8.57,15.3,,6.86,,,0,"percent of total billed charges","15.3% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",38.64,69,,,,,0,"fee schedule","69% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.64,61.85,,27.71,,,0,"percent of total billed charges","61.5% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",18.03,32.2,,14.42,,,0,"percent of total billed charges","32.2% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.6,17.136,,7.68,,,0,"percent of total billed charges","17.136% of total billed charges",12.23,21.84,,9.78,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.11,37.7,,16.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.68,78,,34.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.41,16.8,,7.53,,,0,"percent of total billed charges","16.8% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",8.57,56,
"APILGRAF PER 1 SQ CM",636Q4101,CDM,636,RC,,,OUTPATIENT,,,156,101.4,,137.28,88,,109.82,,,0,"percent of total billed charges","88% of total billed charges",78,50,,62.40,,,0,"percent of total billed charges","50% of total billed charges",26.21,16.8,,20.97,,,0,"percent of total billed charges","16.8% of total billed charges",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.99,17.304,,21.59,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.28,63,,78.62,,,0,"percent of total billed charges","63% of total billed charges",23.87,15.3,,19.10,,,0,"percent of total billed charges","15.3% of total billed charges",26.21,16.8,,20.97,,,0,"percent of total billed charges","16.8% of total billed charges",107.64,69,,,,,0,"fee schedule","69% of total billed charges",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",96.49,61.85,,77.19,,,0,"percent of total billed charges","61.5% of total billed charges",26.21,16.8,,20.97,,,0,"percent of total billed charges","16.8% of total billed charges",78,50,,62.40,,,0,"percent of total billed charges","50% of total billed charges",50.23,32.2,,40.18,,,0,"percent of total billed charges","32.2% of total billed charges",26.21,16.8,,20.97,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.73,17.136,,21.38,,,0,"percent of total billed charges","17.136% of total billed charges",34.07,21.84,,27.26,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.81,37.7,,47.05,,,0,"percent of total billed charges","37.7% of total billed charges",58.81,37.7,,47.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.88,33.9,,42.30,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",121.68,78,,97.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.21,16.8,,20.97,,,0,"percent of total billed charges","16.8% of total billed charges",78,50,,62.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.21,16.8,,20.97,,,0,"percent of total billed charges","16.8% of total billed charges",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",23.87,156,
"EPIFIX 18MM DISK",636Q4186,CDM,636,RC,,,OUTPATIENT,,,1151,748.15,,1012.88,88,,810.30,,,0,"percent of total billed charges","88% of total billed charges",575.5,50,,460.40,,,0,"percent of total billed charges","50% of total billed charges",193.37,16.8,,154.70,,,0,"percent of total billed charges","16.8% of total billed charges",1151,100,,920.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",199.17,17.304,,159.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",725.13,63,,580.10,,,0,"percent of total billed charges","63% of total billed charges",176.1,15.3,,140.88,,,0,"percent of total billed charges","15.3% of total billed charges",193.37,16.8,,154.70,,,0,"percent of total billed charges","16.8% of total billed charges",794.19,69,,,,,0,"fee schedule","69% of total billed charges",1151,100,,920.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1151,100,,920.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1151,100,,920.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",711.89,61.85,,569.51,,,0,"percent of total billed charges","61.5% of total billed charges",193.37,16.8,,154.70,,,0,"percent of total billed charges","16.8% of total billed charges",575.5,50,,460.40,,,0,"percent of total billed charges","50% of total billed charges",370.62,32.2,,296.50,,,0,"percent of total billed charges","32.2% of total billed charges",193.37,16.8,,154.70,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",197.24,17.136,,157.79,,,0,"percent of total billed charges","17.136% of total billed charges",251.38,21.84,,201.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",433.93,37.7,,347.14,,,0,"percent of total billed charges","37.7% of total billed charges",433.93,37.7,,347.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",390.19,33.9,,312.15,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",897.78,78,,718.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",193.37,16.8,,154.70,,,0,"percent of total billed charges","16.8% of total billed charges",575.5,50,,460.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",193.37,16.8,,154.70,,,0,"percent of total billed charges","16.8% of total billed charges",1151,100,,920.80,,,0,"percent of total billed charges","100% of total billed charges",176.1,1151,
"EPIFIX 2 MC X 2 CM",636Q4186,CDM,636,RC,,,OUTPATIENT,,,1233,801.45,,1085.04,88,,868.03,,,0,"percent of total billed charges","88% of total billed charges",616.5,50,,493.20,,,0,"percent of total billed charges","50% of total billed charges",207.14,16.8,,165.71,,,0,"percent of total billed charges","16.8% of total billed charges",1233,100,,986.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.36,17.304,,170.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",776.79,63,,621.43,,,0,"percent of total billed charges","63% of total billed charges",188.65,15.3,,150.92,,,0,"percent of total billed charges","15.3% of total billed charges",207.14,16.8,,165.71,,,0,"percent of total billed charges","16.8% of total billed charges",850.77,69,,,,,0,"fee schedule","69% of total billed charges",1233,100,,986.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1233,100,,986.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1233,100,,986.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",762.61,61.85,,610.09,,,0,"percent of total billed charges","61.5% of total billed charges",207.14,16.8,,165.71,,,0,"percent of total billed charges","16.8% of total billed charges",616.5,50,,493.20,,,0,"percent of total billed charges","50% of total billed charges",397.03,32.2,,317.62,,,0,"percent of total billed charges","32.2% of total billed charges",207.14,16.8,,165.71,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.29,17.136,,169.03,,,0,"percent of total billed charges","17.136% of total billed charges",269.29,21.84,,215.43,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",464.84,37.7,,371.87,,,0,"percent of total billed charges","37.7% of total billed charges",464.84,37.7,,371.87,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.99,33.9,,334.39,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",961.74,78,,769.39,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",207.14,16.8,,165.71,,,0,"percent of total billed charges","16.8% of total billed charges",616.5,50,,493.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",207.14,16.8,,165.71,,,0,"percent of total billed charges","16.8% of total billed charges",1233,100,,986.40,,,0,"percent of total billed charges","100% of total billed charges",188.65,1233,
"EPIFIX 2 CM X 3 CM",636Q4186,CDM,636,RC,,,OUTPATIENT,,,507,329.55,,446.16,88,,356.93,,,0,"percent of total billed charges","88% of total billed charges",253.5,50,,202.80,,,0,"percent of total billed charges","50% of total billed charges",85.18,16.8,,68.14,,,0,"percent of total billed charges","16.8% of total billed charges",507,100,,405.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.73,17.304,,70.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",319.41,63,,255.53,,,0,"percent of total billed charges","63% of total billed charges",77.57,15.3,,62.06,,,0,"percent of total billed charges","15.3% of total billed charges",85.18,16.8,,68.14,,,0,"percent of total billed charges","16.8% of total billed charges",349.83,69,,,,,0,"fee schedule","69% of total billed charges",507,100,,405.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",507,100,,405.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",507,100,,405.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.58,61.85,,250.86,,,0,"percent of total billed charges","61.5% of total billed charges",85.18,16.8,,68.14,,,0,"percent of total billed charges","16.8% of total billed charges",253.5,50,,202.80,,,0,"percent of total billed charges","50% of total billed charges",163.25,32.2,,130.60,,,0,"percent of total billed charges","32.2% of total billed charges",85.18,16.8,,68.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",86.88,17.136,,69.50,,,0,"percent of total billed charges","17.136% of total billed charges",110.73,21.84,,88.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.14,37.7,,152.91,,,0,"percent of total billed charges","37.7% of total billed charges",191.14,37.7,,152.91,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",171.87,33.9,,137.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",395.46,78,,316.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",85.18,16.8,,68.14,,,0,"percent of total billed charges","16.8% of total billed charges",253.5,50,,202.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",85.18,16.8,,68.14,,,0,"percent of total billed charges","16.8% of total billed charges",507,100,,405.60,,,0,"percent of total billed charges","100% of total billed charges",77.57,507,
"EPIFIX MESH 3.5 CM X 3.5 CM",636Q4186,CDM,636,RC,,,OUTPATIENT,,,720,468,,633.6,88,,506.88,,,0,"percent of total billed charges","88% of total billed charges",360,50,,288.00,,,0,"percent of total billed charges","50% of total billed charges",120.96,16.8,,96.77,,,0,"percent of total billed charges","16.8% of total billed charges",720,100,,576.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.59,17.304,,99.67,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",453.6,63,,362.88,,,0,"percent of total billed charges","63% of total billed charges",110.16,15.3,,88.13,,,0,"percent of total billed charges","15.3% of total billed charges",120.96,16.8,,96.77,,,0,"percent of total billed charges","16.8% of total billed charges",496.8,69,,,,,0,"fee schedule","69% of total billed charges",720,100,,576.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",720,100,,576.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",720,100,,576.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",445.32,61.85,,356.26,,,0,"percent of total billed charges","61.5% of total billed charges",120.96,16.8,,96.77,,,0,"percent of total billed charges","16.8% of total billed charges",360,50,,288.00,,,0,"percent of total billed charges","50% of total billed charges",231.84,32.2,,185.47,,,0,"percent of total billed charges","32.2% of total billed charges",120.96,16.8,,96.77,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",123.38,17.136,,98.70,,,0,"percent of total billed charges","17.136% of total billed charges",157.25,21.84,,125.80,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",271.44,37.7,,217.15,,,0,"percent of total billed charges","37.7% of total billed charges",271.44,37.7,,217.15,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",244.08,33.9,,195.26,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",561.6,78,,449.28,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.96,16.8,,96.77,,,0,"percent of total billed charges","16.8% of total billed charges",360,50,,288.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",120.96,16.8,,96.77,,,0,"percent of total billed charges","16.8% of total billed charges",720,100,,576.00,,,0,"percent of total billed charges","100% of total billed charges",110.16,720,
"EPIFIX MESH 4CMX4.5CM",636Q4186,CDM,636,RC,,,OUTPATIENT,,,539,350.35,,474.32,88,,379.46,,,0,"percent of total billed charges","88% of total billed charges",269.5,50,,215.60,,,0,"percent of total billed charges","50% of total billed charges",90.55,16.8,,72.44,,,0,"percent of total billed charges","16.8% of total billed charges",539,100,,431.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",93.27,17.304,,74.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",339.57,63,,271.66,,,0,"percent of total billed charges","63% of total billed charges",82.47,15.3,,65.98,,,0,"percent of total billed charges","15.3% of total billed charges",90.55,16.8,,72.44,,,0,"percent of total billed charges","16.8% of total billed charges",371.91,69,,,,,0,"fee schedule","69% of total billed charges",539,100,,431.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",539,100,,431.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",539,100,,431.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",333.37,61.85,,266.70,,,0,"percent of total billed charges","61.5% of total billed charges",90.55,16.8,,72.44,,,0,"percent of total billed charges","16.8% of total billed charges",269.5,50,,215.60,,,0,"percent of total billed charges","50% of total billed charges",173.56,32.2,,138.85,,,0,"percent of total billed charges","32.2% of total billed charges",90.55,16.8,,72.44,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.36,17.136,,73.89,,,0,"percent of total billed charges","17.136% of total billed charges",117.72,21.84,,94.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",203.2,37.7,,162.56,,,0,"percent of total billed charges","37.7% of total billed charges",203.2,37.7,,162.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",182.72,33.9,,146.18,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",420.42,78,,336.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",90.55,16.8,,72.44,,,0,"percent of total billed charges","16.8% of total billed charges",269.5,50,,215.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",90.55,16.8,,72.44,,,0,"percent of total billed charges","16.8% of total billed charges",539,100,,431.20,,,0,"percent of total billed charges","100% of total billed charges",82.47,539,
"Hyperbaric oxygen under pressure, full body chamber, per 30",413G0277,CDM,413,RC,,,OUTPATIENT,,,551,358.15,,484.88,88,,387.90,,,0,"percent of total billed charges","88% of total billed charges",275.5,50,,220.40,,,0,"percent of total billed charges","50% of total billed charges",92.57,16.8,,74.06,,,0,"percent of total billed charges","16.8% of total billed charges",551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95.35,17.304,,76.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",347.13,63,,277.70,,,0,"percent of total billed charges","63% of total billed charges",84.3,15.3,,67.44,,,0,"percent of total billed charges","15.3% of total billed charges",92.57,16.8,,74.06,,,0,"percent of total billed charges","16.8% of total billed charges",380.19,69,,,,,0,"fee schedule","69% of total billed charges",551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",340.79,61.85,,272.63,,,0,"percent of total billed charges","61.5% of total billed charges",92.57,16.8,,74.06,,,0,"percent of total billed charges","16.8% of total billed charges",275.5,50,,220.40,,,0,"percent of total billed charges","50% of total billed charges",177.42,32.2,,141.94,,,0,"percent of total billed charges","32.2% of total billed charges",92.57,16.8,,74.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",94.42,17.136,,75.54,,,0,"percent of total billed charges","17.136% of total billed charges",120.34,21.84,,96.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.73,37.7,,166.18,,,0,"percent of total billed charges","37.7% of total billed charges",207.73,37.7,,166.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",186.79,33.9,,149.43,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",429.78,78,,343.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",455.13,82.6,,364.10,,,0,"percent of total billed charges","82.6% of total billed charges",92.57,16.8,,74.06,,,0,"percent of total billed charges","16.8% of total billed charges",275.5,50,,220.40,,,0,"percent of total billed charges","50% of total billed charges",455.13,82.6,,364.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.57,16.8,,74.06,,,0,"percent of total billed charges","16.8% of total billed charges",551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",84.3,551,
"PURAPLY 2 X 4",636Q4195,CDM,636,RC,,,OUTPATIENT,,,3820,2483,,3361.6,88,,2689.28,,,0,"percent of total billed charges","88% of total billed charges",1910,50,,1528.00,,,0,"percent of total billed charges","50% of total billed charges",641.76,16.8,,513.41,,,0,"percent of total billed charges","16.8% of total billed charges",3820,100,,3056.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",661.01,17.304,,528.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2406.6,63,,1925.28,,,0,"percent of total billed charges","63% of total billed charges",584.46,15.3,,467.57,,,0,"percent of total billed charges","15.3% of total billed charges",641.76,16.8,,513.41,,,0,"percent of total billed charges","16.8% of total billed charges",2635.8,69,,,,,0,"fee schedule","69% of total billed charges",3820,100,,3056.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3820,100,,3056.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3820,100,,3056.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2362.67,61.85,,1890.14,,,0,"percent of total billed charges","61.5% of total billed charges",641.76,16.8,,513.41,,,0,"percent of total billed charges","16.8% of total billed charges",1910,50,,1528.00,,,0,"percent of total billed charges","50% of total billed charges",1230.04,32.2,,984.03,,,0,"percent of total billed charges","32.2% of total billed charges",641.76,16.8,,513.41,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",654.6,17.136,,523.68,,,0,"percent of total billed charges","17.136% of total billed charges",834.29,21.84,,667.43,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1440.14,37.7,,1152.11,,,0,"percent of total billed charges","37.7% of total billed charges",1440.14,37.7,,1152.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1294.98,33.9,,1035.98,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2979.6,78,,2383.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",641.76,16.8,,513.41,,,0,"percent of total billed charges","16.8% of total billed charges",1910,50,,1528.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",641.76,16.8,,513.41,,,0,"percent of total billed charges","16.8% of total billed charges",3820,100,,3056.00,,,0,"percent of total billed charges","100% of total billed charges",584.46,3820,
"PURAPLY 5 X 5",636Q4195,CDM,636,RC,,,OUTPATIENT,,,11937,7759.05,,10504.56,88,,8403.65,,,0,"percent of total billed charges","88% of total billed charges",5968.5,50,,4774.80,,,0,"percent of total billed charges","50% of total billed charges",2005.42,16.8,,1604.34,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2065.58,17.304,,1652.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7520.31,63,,6016.25,,,0,"percent of total billed charges","63% of total billed charges",1826.36,15.3,,1461.09,,,0,"percent of total billed charges","15.3% of total billed charges",2005.42,16.8,,1604.34,,,0,"percent of total billed charges","16.8% of total billed charges",8236.53,69,,,,,0,"fee schedule","69% of total billed charges",11937,100,,9549.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11937,100,,9549.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11937,100,,9549.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7383.03,61.85,,5906.42,,,0,"percent of total billed charges","61.5% of total billed charges",2005.42,16.8,,1604.34,,,0,"percent of total billed charges","16.8% of total billed charges",5968.5,50,,4774.80,,,0,"percent of total billed charges","50% of total billed charges",3843.71,32.2,,3074.97,,,0,"percent of total billed charges","32.2% of total billed charges",2005.42,16.8,,1604.34,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2045.52,17.136,,1636.42,,,0,"percent of total billed charges","17.136% of total billed charges",2607.04,21.84,,2085.63,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4500.25,37.7,,3600.20,,,0,"percent of total billed charges","37.7% of total billed charges",4500.25,37.7,,3600.20,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4046.64,33.9,,3237.31,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",9310.86,78,,7448.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2005.42,16.8,,1604.34,,,0,"percent of total billed charges","16.8% of total billed charges",5968.5,50,,4774.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2005.42,16.8,,1604.34,,,0,"percent of total billed charges","16.8% of total billed charges",11937,100,,9549.60,,,0,"percent of total billed charges","100% of total billed charges",1826.36,11937,
"PURAPLY 6 X 9",636Q4195,CDM,636,RC,,,OUTPATIENT,,,24038,15624.7,,21153.44,88,,16922.75,,,0,"percent of total billed charges","88% of total billed charges",12019,50,,9615.20,,,0,"percent of total billed charges","50% of total billed charges",4038.38,16.8,,3230.70,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4159.54,17.304,,3327.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15143.94,63,,12115.15,,,0,"percent of total billed charges","63% of total billed charges",3677.81,15.3,,2942.25,,,0,"percent of total billed charges","15.3% of total billed charges",4038.38,16.8,,3230.70,,,0,"percent of total billed charges","16.8% of total billed charges",16586.22,69,,,,,0,"fee schedule","69% of total billed charges",24038,100,,19230.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24038,100,,19230.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24038,100,,19230.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14867.5,61.85,,11894.00,,,0,"percent of total billed charges","61.5% of total billed charges",4038.38,16.8,,3230.70,,,0,"percent of total billed charges","16.8% of total billed charges",12019,50,,9615.20,,,0,"percent of total billed charges","50% of total billed charges",7740.24,32.2,,6192.19,,,0,"percent of total billed charges","32.2% of total billed charges",4038.38,16.8,,3230.70,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4119.15,17.136,,3295.32,,,0,"percent of total billed charges","17.136% of total billed charges",5249.9,21.84,,4199.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",9062.33,37.7,,7249.86,,,0,"percent of total billed charges","37.7% of total billed charges",9062.33,37.7,,7249.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",8148.88,33.9,,6519.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",18749.64,78,,14999.71,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4038.38,16.8,,3230.70,,,0,"percent of total billed charges","16.8% of total billed charges",12019,50,,9615.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4038.38,16.8,,3230.70,,,0,"percent of total billed charges","16.8% of total billed charges",24038,100,,19230.40,,,0,"percent of total billed charges","100% of total billed charges",3677.81,24038,
"PURAPLY AM 2 X 2",636Q4196,CDM,636,RC,,,OUTPATIENT,,,2745,1784.25,,2415.6,88,,1932.48,,,0,"percent of total billed charges","88% of total billed charges",1372.5,50,,1098.00,,,0,"percent of total billed charges","50% of total billed charges",461.16,16.8,,368.93,,,0,"percent of total billed charges","16.8% of total billed charges",2745,100,,2196.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",474.99,17.304,,379.99,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1729.35,63,,1383.48,,,0,"percent of total billed charges","63% of total billed charges",419.99,15.3,,335.99,,,0,"percent of total billed charges","15.3% of total billed charges",461.16,16.8,,368.93,,,0,"percent of total billed charges","16.8% of total billed charges",1894.05,69,,,,,0,"fee schedule","69% of total billed charges",2745,100,,2196.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2745,100,,2196.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2745,100,,2196.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1697.78,61.85,,1358.22,,,0,"percent of total billed charges","61.5% of total billed charges",461.16,16.8,,368.93,,,0,"percent of total billed charges","16.8% of total billed charges",1372.5,50,,1098.00,,,0,"percent of total billed charges","50% of total billed charges",883.89,32.2,,707.11,,,0,"percent of total billed charges","32.2% of total billed charges",461.16,16.8,,368.93,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.38,17.136,,376.30,,,0,"percent of total billed charges","17.136% of total billed charges",599.51,21.84,,479.61,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1034.87,37.7,,827.90,,,0,"percent of total billed charges","37.7% of total billed charges",1034.87,37.7,,827.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",930.56,33.9,,744.45,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2141.1,78,,1712.88,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",461.16,16.8,,368.93,,,0,"percent of total billed charges","16.8% of total billed charges",1372.5,50,,1098.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",461.16,16.8,,368.93,,,0,"percent of total billed charges","16.8% of total billed charges",2745,100,,2196.00,,,0,"percent of total billed charges","100% of total billed charges",419.99,2745,
"PURAPLY AM 2 X 4",636Q4196,CDM,636,RC,,,OUTPATIENT,,,4153,2699.45,,3654.64,88,,2923.71,,,0,"percent of total billed charges","88% of total billed charges",2076.5,50,,1661.20,,,0,"percent of total billed charges","50% of total billed charges",697.7,16.8,,558.16,,,0,"percent of total billed charges","16.8% of total billed charges",4153,100,,3322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",718.64,17.304,,574.91,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2616.39,63,,2093.11,,,0,"percent of total billed charges","63% of total billed charges",635.41,15.3,,508.33,,,0,"percent of total billed charges","15.3% of total billed charges",697.7,16.8,,558.16,,,0,"percent of total billed charges","16.8% of total billed charges",2865.57,69,,,,,0,"fee schedule","69% of total billed charges",4153,100,,3322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4153,100,,3322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4153,100,,3322.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2568.63,61.85,,2054.90,,,0,"percent of total billed charges","61.5% of total billed charges",697.7,16.8,,558.16,,,0,"percent of total billed charges","16.8% of total billed charges",2076.5,50,,1661.20,,,0,"percent of total billed charges","50% of total billed charges",1337.27,32.2,,1069.82,,,0,"percent of total billed charges","32.2% of total billed charges",697.7,16.8,,558.16,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",711.66,17.136,,569.33,,,0,"percent of total billed charges","17.136% of total billed charges",907.02,21.84,,725.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1565.68,37.7,,1252.54,,,0,"percent of total billed charges","37.7% of total billed charges",1565.68,37.7,,1252.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1407.87,33.9,,1126.30,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3239.34,78,,2591.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",697.7,16.8,,558.16,,,0,"percent of total billed charges","16.8% of total billed charges",2076.5,50,,1661.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",697.7,16.8,,558.16,,,0,"percent of total billed charges","16.8% of total billed charges",4153,100,,3322.40,,,0,"percent of total billed charges","100% of total billed charges",635.41,4153,
"PURAPLY AM 5 X 5",636Q4196,CDM,636,RC,,,OUTPATIENT,,,12978,8435.7,,11420.64,88,,9136.51,,,0,"percent of total billed charges","88% of total billed charges",6489,50,,5191.20,,,0,"percent of total billed charges","50% of total billed charges",2180.3,16.8,,1744.24,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2245.71,17.304,,1796.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8176.14,63,,6540.91,,,0,"percent of total billed charges","63% of total billed charges",1985.63,15.3,,1588.50,,,0,"percent of total billed charges","15.3% of total billed charges",2180.3,16.8,,1744.24,,,0,"percent of total billed charges","16.8% of total billed charges",8954.82,69,,,,,0,"fee schedule","69% of total billed charges",12978,100,,10382.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12978,100,,10382.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12978,100,,10382.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8026.89,61.85,,6421.51,,,0,"percent of total billed charges","61.5% of total billed charges",2180.3,16.8,,1744.24,,,0,"percent of total billed charges","16.8% of total billed charges",6489,50,,5191.20,,,0,"percent of total billed charges","50% of total billed charges",4178.92,32.2,,3343.14,,,0,"percent of total billed charges","32.2% of total billed charges",2180.3,16.8,,1744.24,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2223.91,17.136,,1779.13,,,0,"percent of total billed charges","17.136% of total billed charges",2834.4,21.84,,2267.52,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4892.71,37.7,,3914.17,,,0,"percent of total billed charges","37.7% of total billed charges",4892.71,37.7,,3914.17,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4399.54,33.9,,3519.63,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",10122.84,78,,8098.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2180.3,16.8,,1744.24,,,0,"percent of total billed charges","16.8% of total billed charges",6489,50,,5191.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2180.3,16.8,,1744.24,,,0,"percent of total billed charges","16.8% of total billed charges",12978,100,,10382.40,,,0,"percent of total billed charges","100% of total billed charges",1985.63,12978,
"PURAPLY AM 6 X 9",636Q4196,CDM,636,RC,,,OUTPATIENT,,,26125,16981.25,,22990,88,,18392.00,,,0,"percent of total billed charges","88% of total billed charges",13062.5,50,,10450.00,,,0,"percent of total billed charges","50% of total billed charges",4389,16.8,,3511.20,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4520.67,17.304,,3616.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",16458.75,63,,13167.00,,,0,"percent of total billed charges","63% of total billed charges",3997.13,15.3,,3197.70,,,0,"percent of total billed charges","15.3% of total billed charges",4389,16.8,,3511.20,,,0,"percent of total billed charges","16.8% of total billed charges",18026.25,69,,,,,0,"fee schedule","69% of total billed charges",26125,100,,20900.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26125,100,,20900.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26125,100,,20900.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16158.31,61.85,,12926.65,,,0,"percent of total billed charges","61.5% of total billed charges",4389,16.8,,3511.20,,,0,"percent of total billed charges","16.8% of total billed charges",13062.5,50,,10450.00,,,0,"percent of total billed charges","50% of total billed charges",8412.25,32.2,,6729.80,,,0,"percent of total billed charges","32.2% of total billed charges",4389,16.8,,3511.20,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4476.78,17.136,,3581.42,,,0,"percent of total billed charges","17.136% of total billed charges",5705.7,21.84,,4564.56,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",9849.13,37.7,,7879.30,,,0,"percent of total billed charges","37.7% of total billed charges",9849.13,37.7,,7879.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",8856.38,33.9,,7085.10,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",20377.5,78,,16302.00,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4389,16.8,,3511.20,,,0,"percent of total billed charges","16.8% of total billed charges",13062.5,50,,10450.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4389,16.8,,3511.20,,,0,"percent of total billed charges","16.8% of total billed charges",26125,100,,20900.00,,,0,"percent of total billed charges","100% of total billed charges",3997.13,26125,
"90378 Immune Globulins, Serum or Recombinant Produ",7906418,CDM,636,RC,90378,CPT,OUTPATIENT,,,1166,757.9,,1026.08,88,,820.86,,,0,"percent of total billed charges","88% of total billed charges",339.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1011.48,100,,,,,0,"fee schedule",EAPG,1166,100,,932.80,,,0,"percent of total billed charges","100% of total billed charges",594.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",1041.83,100,,,,,0,"fee schedule",EAPG,339.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",734.58,63,,587.66,,,0,"percent of total billed charges","63% of total billed charges",178.4,15.3,,142.72,,,0,"percent of total billed charges","15.3% of total billed charges",1011.48,100,,,,,0,"fee schedule",EAPG,804.54,69,,,,,0,"fee schedule","69% of total billed charges",1166,100,,932.80,,,0,"percent of total billed charges","100% of total billed charges",339.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1166,100,,932.80,,,0,"percent of total billed charges","100% of total billed charges",339.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1166,100,,932.80,,,0,"percent of total billed charges","100% of total billed charges",339.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",4535.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1011.48,100,,,,,0,"fee schedule",EAPG,339.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1185.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1113.04,100,,,,,0,"fee schedule",EAPG,339.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1031.71,100,,,,,0,"fee schedule",EAPG,1314.93,100,,,,,0,"fee schedule",EAPG,339.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",439.58,37.7,,351.66,,,0,"percent of total billed charges","37.7% of total billed charges",439.58,37.7,,351.66,,,0,"percent of total billed charges","37.70% of total billed charges",339.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",395.27,33.9,,316.22,,,0,"percent of total billed charges","33.9% of total billed charges",339.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",909.48,78,,727.58,,,0,"percent of total billed charges","78% of total billed charges",343.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1011.48,100,,,,,0,"fee schedule",EAPG,339.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",339.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1011.48,100,,,,,0,"fee schedule",EAPG,1166,100,,932.80,,,0,"percent of total billed charges","100% of total billed charges",178.4,4535.18,
"90471 OP/Immunization administration; 1 vaccine",7904783,CDM,771,RC,90471,CPT,OUTPATIENT,,,45,29.25,,39.6,88,,31.68,,,0,"percent of total billed charges","88% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.67,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",28.35,63,,22.68,,,0,"percent of total billed charges","63% of total billed charges",6.89,15.3,,5.51,,,0,"percent of total billed charges","15.3% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,31.05,69,,,,,0,"fee schedule","69% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.33,100,,,,,0,"fee schedule",EAPG,45.03,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16.97,37.7,,13.58,,,0,"percent of total billed charges","37.7% of total billed charges",16.97,37.7,,13.58,,,0,"percent of total billed charges","37.70% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15.26,33.9,,12.21,,,0,"percent of total billed charges","33.9% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.1,78,,28.08,,,0,"percent of total billed charges","78% of total billed charges",72.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",6.89,251.75,
"90474 Immunization administration by intranasal/or",7904793,CDM,521,RC,90474,CPT,OUTPATIENT,,,21,13.65,,18.48,88,,14.78,,,0,"percent of total billed charges","88% of total billed charges",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.67,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",13.23,63,,10.58,,,0,"percent of total billed charges","63% of total billed charges",3.21,15.3,,2.57,,,0,"percent of total billed charges","15.3% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,14.49,69,,,,,0,"fee schedule","69% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.99,61.85,,10.39,,,0,"percent of total billed charges","61.5% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",6.76,32.2,,5.41,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.33,100,,,,,0,"fee schedule",EAPG,45.03,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.92,37.7,,6.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.38,78,,13.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",34.64,100,,,,,0,"fee schedule","100% of WA fee schedule",10.5,50,,8.40,,,0,"percent of total billed charges","50% of total billed charges",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",195.17,100,,,,,0,"fee schedule",EAPG,21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",3.21,195.17,
"90472 Additional immunization administration",7904794,CDM,521,RC,90472,CPT,OUTPATIENT,,,23,14.95,,20.24,88,,16.19,,,0,"percent of total billed charges","88% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.67,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",14.49,63,,11.59,,,0,"percent of total billed charges","63% of total billed charges",3.52,15.3,,2.82,,,0,"percent of total billed charges","15.3% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,15.87,69,,,,,0,"fee schedule","69% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.23,61.85,,11.38,,,0,"percent of total billed charges","61.5% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",7.41,32.2,,5.93,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.33,100,,,,,0,"fee schedule",EAPG,45.03,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.94,78,,14.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",195.17,100,,,,,0,"fee schedule",EAPG,23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",3.52,195.17,
"90473 Immunization administration by intranasal/or",7904795,CDM,521,RC,90473,CPT,OUTPATIENT,,,71,46.15,,62.48,88,,49.98,,,0,"percent of total billed charges","88% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.67,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",44.73,63,,35.78,,,0,"percent of total billed charges","63% of total billed charges",10.86,15.3,,8.69,,,0,"percent of total billed charges","15.3% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,48.99,69,,,,,0,"fee schedule","69% of total billed charges",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.33,100,,,,,0,"fee schedule",EAPG,45.03,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",26.77,37.7,,21.42,,,0,"percent of total billed charges","37.70% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",55.38,78,,44.30,,,0,"percent of total billed charges","78% of total billed charges",72.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",58.65,82.6,,46.92,,,0,"percent of total billed charges","82.6% of total billed charges",34.64,100,,,,,0,"fee schedule","100% of WA fee schedule",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",58.65,82.6,,46.92,,,0,"percent of total billed charges","82.6% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",195.17,100,,,,,0,"fee schedule",EAPG,71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",10.86,251.75,
"90471 Administration flu vaccine",8195926,CDM,771,RC,90471,CPT,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.67,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.33,100,,,,,0,"fee schedule",EAPG,45.03,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.7% of total billed charges",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15.93,33.9,,12.74,,,0,"percent of total billed charges","33.9% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",72.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,251.75,
"90471 Administration pneumococcal vaccine",9971156,CDM,771,RC,90471,CPT,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.67,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.33,100,,,,,0,"fee schedule",EAPG,45.03,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.7% of total billed charges",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15.93,33.9,,12.74,,,0,"percent of total billed charges","33.9% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",72.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,251.75,
"90471 Administration hepatitis B vaccine",9971168,CDM,771,RC,90471,CPT,OUTPATIENT,,,45,29.25,,39.6,88,,31.68,,,0,"percent of total billed charges","88% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.67,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",28.35,63,,22.68,,,0,"percent of total billed charges","63% of total billed charges",6.89,15.3,,5.51,,,0,"percent of total billed charges","15.3% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,31.05,69,,,,,0,"fee schedule","69% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.33,100,,,,,0,"fee schedule",EAPG,45.03,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16.97,37.7,,13.58,,,0,"percent of total billed charges","37.7% of total billed charges",16.97,37.7,,13.58,,,0,"percent of total billed charges","37.70% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15.26,33.9,,12.21,,,0,"percent of total billed charges","33.9% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.1,78,,28.08,,,0,"percent of total billed charges","78% of total billed charges",72.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",6.89,251.75,
"90632 Hepatitis A vaccine, adult",7904959,CDM,636,RC,90632,CPT,OUTPATIENT,,,71,46.15,,62.48,88,,49.98,,,0,"percent of total billed charges","88% of total billed charges",35.5,50,,28.40,,,0,"percent of total billed charges","50% of total billed charges",24.38,100,,,,,0,"fee schedule",EAPG,71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.11,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",44.73,63,,35.78,,,0,"percent of total billed charges","63% of total billed charges",10.86,15.3,,8.69,,,0,"percent of total billed charges","15.3% of total billed charges",24.38,100,,,,,0,"fee schedule",EAPG,48.99,69,,,,,0,"fee schedule","69% of total billed charges",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.91,61.85,,35.13,,,0,"percent of total billed charges","61.5% of total billed charges",24.38,100,,,,,0,"fee schedule",EAPG,35.5,50,,28.40,,,0,"percent of total billed charges","50% of total billed charges",22.86,32.2,,18.29,,,0,"percent of total billed charges","32.2% of total billed charges",18.06,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",24.87,100,,,,,0,"fee schedule",EAPG,31.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",26.77,37.7,,21.42,,,0,"percent of total billed charges","37.7% of total billed charges",26.77,37.7,,21.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.07,33.9,,19.26,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",55.38,78,,44.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,35.5,50,,28.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",10.86,71,
"90633 Hepatitis A vaccine, pediatric",7904960,CDM,636,RC,90633,CPT,OUTPATIENT,,,37,24.05,,32.56,88,,26.05,,,0,"percent of total billed charges","88% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",24.38,100,,,,,0,"fee schedule",EAPG,37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.11,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",23.31,63,,18.65,,,0,"percent of total billed charges","63% of total billed charges",5.66,15.3,,4.53,,,0,"percent of total billed charges","15.3% of total billed charges",24.38,100,,,,,0,"fee schedule",EAPG,25.53,69,,,,,0,"fee schedule","69% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.88,61.85,,18.30,,,0,"percent of total billed charges","61.5% of total billed charges",24.38,100,,,,,0,"fee schedule",EAPG,18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",11.91,32.2,,9.53,,,0,"percent of total billed charges","32.2% of total billed charges",18.06,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",24.87,100,,,,,0,"fee schedule",EAPG,31.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",13.95,37.7,,11.16,,,0,"percent of total billed charges","37.7% of total billed charges",13.95,37.7,,11.16,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.54,33.9,,10.03,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.86,78,,23.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule","100% of WA fee schedule",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",5.66,37,
"90636 Hepatitis A&B vaccine",7906436,CDM,636,RC,90636,CPT,OUTPATIENT,,,150,97.5,,132,88,,105.60,,,0,"percent of total billed charges","88% of total billed charges",75,50,,60.00,,,0,"percent of total billed charges","50% of total billed charges",98.87,100,,,,,0,"fee schedule",EAPG,150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",94.5,63,,75.60,,,0,"percent of total billed charges","63% of total billed charges",22.95,15.3,,18.36,,,0,"percent of total billed charges","15.3% of total billed charges",98.87,100,,,,,0,"fee schedule",EAPG,103.5,69,,,,,0,"fee schedule","69% of total billed charges",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",92.78,61.85,,74.22,,,0,"percent of total billed charges","61.5% of total billed charges",98.87,100,,,,,0,"fee schedule",EAPG,75,50,,60.00,,,0,"percent of total billed charges","50% of total billed charges",48.3,32.2,,38.64,,,0,"percent of total billed charges","32.2% of total billed charges",73.23,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",100.85,100,,,,,0,"fee schedule",EAPG,128.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.7% of total billed charges",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.85,33.9,,40.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",117,78,,93.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule",EAPG,75,50,,60.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule",EAPG,150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",22.95,150,
"90647 Hemophilus influenza b vaccine (Hib)",7904965,CDM,636,RC,90647,CPT,OUTPATIENT,,,24,15.6,,21.12,88,,16.90,,,0,"percent of total billed charges","88% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",24.38,100,,,,,0,"fee schedule",EAPG,24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.11,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",15.12,63,,12.10,,,0,"percent of total billed charges","63% of total billed charges",3.67,15.3,,2.94,,,0,"percent of total billed charges","15.3% of total billed charges",24.38,100,,,,,0,"fee schedule",EAPG,16.56,69,,,,,0,"fee schedule","69% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.84,61.85,,11.87,,,0,"percent of total billed charges","61.5% of total billed charges",24.38,100,,,,,0,"fee schedule",EAPG,12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",7.73,32.2,,6.18,,,0,"percent of total billed charges","32.2% of total billed charges",18.06,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",24.87,100,,,,,0,"fee schedule",EAPG,31.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",9.05,37.7,,7.24,,,0,"percent of total billed charges","37.7% of total billed charges",9.05,37.7,,7.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.14,33.9,,6.51,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.72,78,,14.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,31.69,
"HAEMOPHILUS B POLYSAC CONJ VAC 10 MCG IJ SOLR",7904967,CDM,636,RC,90648,CPT,OUTPATIENT,,,32,20.8,,28.16,88,,22.53,,,0,"percent of total billed charges","88% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",24.38,100,,,,,0,"fee schedule",EAPG,32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.11,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",20.16,63,,16.13,,,0,"percent of total billed charges","63% of total billed charges",4.9,15.3,,3.92,,,0,"percent of total billed charges","15.3% of total billed charges",24.38,100,,,,,0,"fee schedule",EAPG,22.08,69,,,,,0,"fee schedule","69% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.79,61.85,,15.83,,,0,"percent of total billed charges","61.5% of total billed charges",24.38,100,,,,,0,"fee schedule",EAPG,16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",10.3,32.2,,8.24,,,0,"percent of total billed charges","32.2% of total billed charges",18.06,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",24.87,100,,,,,0,"fee schedule",EAPG,31.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.7% of total billed charges",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.85,33.9,,8.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.96,78,,19.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",4.9,32,
"90651 Human Papilloma virus (HPV) vaccine",7904969,CDM,636,RC,90651,CPT,OUTPATIENT,,,396,257.4,,348.48,88,,278.78,,,0,"percent of total billed charges","88% of total billed charges",198,50,,158.40,,,0,"percent of total billed charges","50% of total billed charges",98.87,100,,,,,0,"fee schedule",EAPG,396,100,,316.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",249.48,63,,199.58,,,0,"percent of total billed charges","63% of total billed charges",60.59,15.3,,48.47,,,0,"percent of total billed charges","15.3% of total billed charges",98.87,100,,,,,0,"fee schedule",EAPG,273.24,69,,,,,0,"fee schedule","69% of total billed charges",396,100,,316.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",396,100,,316.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",396,100,,316.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",244.93,61.85,,195.94,,,0,"percent of total billed charges","61.5% of total billed charges",98.87,100,,,,,0,"fee schedule",EAPG,198,50,,158.40,,,0,"percent of total billed charges","50% of total billed charges",127.51,32.2,,102.01,,,0,"percent of total billed charges","32.2% of total billed charges",73.23,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",100.85,100,,,,,0,"fee schedule",EAPG,128.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",149.29,37.7,,119.43,,,0,"percent of total billed charges","37.7% of total billed charges",149.29,37.7,,119.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.24,33.9,,107.39,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",308.88,78,,247.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule",EAPG,198,50,,158.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule",EAPG,396,100,,316.80,,,0,"percent of total billed charges","100% of total billed charges",60.59,396,
"90655 Influenza virus vaccine, trivalent, 6-35 mon",7949839,CDM,636,RC,90655,CPT,OUTPATIENT,,,22,14.3,,19.36,88,,15.49,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.11,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",13.86,63,,11.09,,,0,"percent of total billed charges","63% of total billed charges",3.37,15.3,,2.70,,,0,"percent of total billed charges","15.3% of total billed charges",24.38,100,,,,,0,"fee schedule",EAPG,15.18,69,,,,,0,"fee schedule","69% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.06,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",24.87,100,,,,,0,"fee schedule",EAPG,31.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",8.29,37.7,,6.63,,,0,"percent of total billed charges","37.7% of total billed charges",8.29,37.7,,6.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.46,33.9,,5.97,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.16,78,,13.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule","100% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",3.37,31.69,
"90658 Influenza virus vaccine, trivalent, split vi",7961406,CDM,636,RC,90658,CPT,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.11,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",24.38,100,,,,,0,"fee schedule",EAPG,13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.06,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",24.87,100,,,,,0,"fee schedule",EAPG,31.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.7% of total billed charges",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.78,33.9,,5.42,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,31.69,
"90675 Rabies vaccine",7906441,CDM,636,RC,90675,CPT,OUTPATIENT,,,285,185.25,,250.8,88,,200.64,,,0,"percent of total billed charges","88% of total billed charges",322.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",98.87,100,,,,,0,"fee schedule",EAPG,285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",564.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",101.83,100,,,,,0,"fee schedule",EAPG,322.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",179.55,63,,143.64,,,0,"percent of total billed charges","63% of total billed charges",43.61,15.3,,34.89,,,0,"percent of total billed charges","15.3% of total billed charges",98.87,100,,,,,0,"fee schedule",EAPG,196.65,69,,,,,0,"fee schedule","69% of total billed charges",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",322.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",322.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",322.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",1249.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",98.87,100,,,,,0,"fee schedule",EAPG,322.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327.52,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.23,100,,,,,0,"fee schedule",EAPG,322.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.85,100,,,,,0,"fee schedule",EAPG,128.53,100,,,,,0,"fee schedule",EAPG,322.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.45,37.7,,85.96,,,0,"percent of total billed charges","37.7% of total billed charges",107.45,37.7,,85.96,,,0,"percent of total billed charges","37.70% of total billed charges",322.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",96.62,33.9,,77.30,,,0,"percent of total billed charges","33.9% of total billed charges",322.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",222.3,78,,177.84,,,0,"percent of total billed charges","78% of total billed charges",325.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule",EAPG,322.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",322.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",98.87,100,,,,,0,"fee schedule",EAPG,285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",43.61,1249.28,
"90677 Pneumococcal conjugate vaccine, 20 valent (P",11152998,CDM,636,RC,90677,CPT,OUTPATIENT,,,817,531.05,,718.96,88,,575.17,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule",EAPG,817,100,,653.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",514.71,63,,411.77,,,0,"percent of total billed charges","63% of total billed charges",125,15.3,,100.00,,,0,"percent of total billed charges","15.3% of total billed charges",98.87,100,,,,,0,"fee schedule",EAPG,563.73,69,,,,,0,"fee schedule","69% of total billed charges",817,100,,653.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",817,100,,653.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",817,100,,653.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",73.23,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",100.85,100,,,,,0,"fee schedule",EAPG,128.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",308.01,37.7,,246.41,,,0,"percent of total billed charges","37.7% of total billed charges",308.01,37.7,,246.41,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",276.96,33.9,,221.57,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",637.26,78,,509.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule",EAPG,817,100,,653.60,,,0,"percent of total billed charges","100% of total billed charges",73.23,817,
"90680 Rotavirus vaccine",7906426,CDM,636,RC,90680,CPT,OUTPATIENT,,,102,66.3,,89.76,88,,71.81,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule",EAPG,102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",64.26,63,,51.41,,,0,"percent of total billed charges","63% of total billed charges",15.61,15.3,,12.49,,,0,"percent of total billed charges","15.3% of total billed charges",98.87,100,,,,,0,"fee schedule",EAPG,70.38,69,,,,,0,"fee schedule","69% of total billed charges",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",73.23,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",100.85,100,,,,,0,"fee schedule",EAPG,128.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",38.45,37.7,,30.76,,,0,"percent of total billed charges","37.7% of total billed charges",38.45,37.7,,30.76,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.58,33.9,,27.66,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.56,78,,63.65,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule","100% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule",EAPG,102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",15.61,128.53,
"90688 Influenza virus vaccine, quadrivalent",7949841,CDM,636,RC,90688,CPT,OUTPATIENT,,,27,17.55,,23.76,88,,19.01,,,0,"percent of total billed charges","88% of total billed charges",20.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.38,100,,,,,0,"fee schedule",EAPG,27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",36.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.11,100,,,,,0,"fee schedule",EAPG,20.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.01,63,,13.61,,,0,"percent of total billed charges","63% of total billed charges",4.13,15.3,,3.30,,,0,"percent of total billed charges","15.3% of total billed charges",24.38,100,,,,,0,"fee schedule",EAPG,18.63,69,,,,,0,"fee schedule","69% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",20.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",20.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",20.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",73.33,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",24.38,100,,,,,0,"fee schedule",EAPG,20.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.88,100,,,,,0,"fee schedule","100% of LI fee schedule",18.06,100,,,,,0,"fee schedule",EAPG,20.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.87,100,,,,,0,"fee schedule",EAPG,31.69,100,,,,,0,"fee schedule",EAPG,20.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.18,37.7,,8.14,,,0,"percent of total billed charges","37.7% of total billed charges",10.18,37.7,,8.14,,,0,"percent of total billed charges","37.70% of total billed charges",20.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.15,33.9,,7.32,,,0,"percent of total billed charges","33.9% of total billed charges",20.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.06,78,,16.85,,,0,"percent of total billed charges","78% of total billed charges",21.09,101,,,,,0,"fee schedule","101% of CMS fee schedule ",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,20.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",20.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.38,100,,,,,0,"fee schedule",EAPG,27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",4.13,73.33,
"90696 Diphtheria, tetanus toxoids, acellular pertu",7904955,CDM,636,RC,90696,CPT,OUTPATIENT,,,100,65,,88,88,,70.40,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.11,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",63,63,,50.40,,,0,"percent of total billed charges","63% of total billed charges",15.3,15.3,,12.24,,,0,"percent of total billed charges","15.3% of total billed charges",24.38,100,,,,,0,"fee schedule",EAPG,69,69,,,,,0,"fee schedule","69% of total billed charges",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.06,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",24.87,100,,,,,0,"fee schedule",EAPG,31.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.7% of total billed charges",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.9,33.9,,27.12,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",78,78,,62.40,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule","100% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",15.3,100,
"90698 DTaP/HIB/IPV vaccine",7904957,CDM,636,RC,90698,CPT,OUTPATIENT,,,102,66.3,,89.76,88,,71.81,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.11,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",64.26,63,,51.41,,,0,"percent of total billed charges","63% of total billed charges",15.61,15.3,,12.49,,,0,"percent of total billed charges","15.3% of total billed charges",24.38,100,,,,,0,"fee schedule",EAPG,70.38,69,,,,,0,"fee schedule","69% of total billed charges",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.06,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",24.87,100,,,,,0,"fee schedule",EAPG,31.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",38.45,37.7,,30.76,,,0,"percent of total billed charges","37.7% of total billed charges",38.45,37.7,,30.76,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.58,33.9,,27.66,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.56,78,,63.65,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule","100% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",15.61,102,
"90691 Typhoid vaccine",7906431,CDM,636,RC,90691,CPT,OUTPATIENT,,,64,41.6,,56.32,88,,45.06,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.11,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",40.32,63,,32.26,,,0,"percent of total billed charges","63% of total billed charges",9.79,15.3,,7.83,,,0,"percent of total billed charges","15.3% of total billed charges",24.38,100,,,,,0,"fee schedule",EAPG,44.16,69,,,,,0,"fee schedule","69% of total billed charges",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.06,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",24.87,100,,,,,0,"fee schedule",EAPG,31.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",24.13,37.7,,19.30,,,0,"percent of total billed charges","37.7% of total billed charges",24.13,37.7,,19.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.7,33.9,,17.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.92,78,,39.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",9.79,64,
"90700 Diphtheria, tetanus toxoids, and acellular p",7904951,CDM,636,RC,90700,CPT,OUTPATIENT,,,35,22.75,,30.8,88,,24.64,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.11,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",22.05,63,,17.64,,,0,"percent of total billed charges","63% of total billed charges",5.36,15.3,,4.29,,,0,"percent of total billed charges","15.3% of total billed charges",24.38,100,,,,,0,"fee schedule",EAPG,24.15,69,,,,,0,"fee schedule","69% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.06,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",24.87,100,,,,,0,"fee schedule",EAPG,31.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",13.2,37.7,,10.56,,,0,"percent of total billed charges","37.7% of total billed charges",13.2,37.7,,10.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.87,33.9,,9.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.3,78,,21.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule","100% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",5.36,35,
"90707 MMR vaccine",7906414,CDM,636,RC,90707,CPT,OUTPATIENT,,,106,68.9,,93.28,88,,74.62,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.11,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",66.78,63,,53.42,,,0,"percent of total billed charges","63% of total billed charges",16.22,15.3,,12.98,,,0,"percent of total billed charges","15.3% of total billed charges",24.38,100,,,,,0,"fee schedule",EAPG,73.14,69,,,,,0,"fee schedule","69% of total billed charges",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.06,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",24.87,100,,,,,0,"fee schedule",EAPG,31.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",39.96,37.7,,31.97,,,0,"percent of total billed charges","37.7% of total billed charges",39.96,37.7,,31.97,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.93,33.9,,28.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.68,78,,66.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",16.22,106,
"90710 MMRV vaccine",7906416,CDM,636,RC,90710,CPT,OUTPATIENT,,,170,110.5,,149.6,88,,119.68,,,0,"percent of total billed charges","88% of total billed charges",132.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.38,100,,,,,0,"fee schedule",EAPG,170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",232.2,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.11,100,,,,,0,"fee schedule",EAPG,132.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.1,63,,85.68,,,0,"percent of total billed charges","63% of total billed charges",26.01,15.3,,20.81,,,0,"percent of total billed charges","15.3% of total billed charges",24.38,100,,,,,0,"fee schedule",EAPG,117.3,69,,,,,0,"fee schedule","69% of total billed charges",170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",132.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",132.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",132.69,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,132.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",18.06,100,,,,,0,"fee schedule",EAPG,132.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.87,100,,,,,0,"fee schedule",EAPG,31.69,100,,,,,0,"fee schedule",EAPG,132.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.09,37.7,,51.27,,,0,"percent of total billed charges","37.7% of total billed charges",64.09,37.7,,51.27,,,0,"percent of total billed charges","37.70% of total billed charges",132.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",57.63,33.9,,46.10,,,0,"percent of total billed charges","33.9% of total billed charges",132.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.6,78,,106.08,,,0,"percent of total billed charges","78% of total billed charges",134.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule","100% of WA fee schedule",132.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",132.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.38,100,,,,,0,"fee schedule",EAPG,170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",18.06,232.2,
"90713 Poliovirus vaccine",7906424,CDM,636,RC,90713,CPT,OUTPATIENT,,,40,26,,35.2,88,,28.16,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.11,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",25.2,63,,20.16,,,0,"percent of total billed charges","63% of total billed charges",6.12,15.3,,4.90,,,0,"percent of total billed charges","15.3% of total billed charges",24.38,100,,,,,0,"fee schedule",EAPG,27.6,69,,,,,0,"fee schedule","69% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.06,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",24.87,100,,,,,0,"fee schedule",EAPG,31.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",15.08,37.7,,12.06,,,0,"percent of total billed charges","37.7% of total billed charges",15.08,37.7,,12.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.56,33.9,,10.85,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.2,78,,24.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",6.12,40,
"90714 Td vaccine",7906428,CDM,636,RC,90714,CPT,OUTPATIENT,,,141,91.65,,124.08,88,,99.26,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,141,100,,112.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.11,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",88.83,63,,71.06,,,0,"percent of total billed charges","63% of total billed charges",21.57,15.3,,17.26,,,0,"percent of total billed charges","15.3% of total billed charges",24.38,100,,,,,0,"fee schedule",EAPG,97.29,69,,,,,0,"fee schedule","69% of total billed charges",141,100,,112.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",141,100,,112.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",141,100,,112.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.06,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",24.87,100,,,,,0,"fee schedule",EAPG,31.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",53.16,37.7,,42.53,,,0,"percent of total billed charges","37.7% of total billed charges",53.16,37.7,,42.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.8,33.9,,38.24,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",109.98,78,,87.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,141,100,,112.80,,,0,"percent of total billed charges","100% of total billed charges",18.06,141,
"90715 Tetanus, diphtheria toxoids and acellular pe",7906429,CDM,636,RC,90715,CPT,OUTPATIENT,,,131,85.15,,115.28,88,,92.22,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.11,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",82.53,63,,66.02,,,0,"percent of total billed charges","63% of total billed charges",20.04,15.3,,16.03,,,0,"percent of total billed charges","15.3% of total billed charges",24.38,100,,,,,0,"fee schedule",EAPG,90.39,69,,,,,0,"fee schedule","69% of total billed charges",131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.06,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",24.87,100,,,,,0,"fee schedule",EAPG,31.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",49.39,37.7,,39.51,,,0,"percent of total billed charges","37.7% of total billed charges",49.39,37.7,,39.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.41,33.9,,35.53,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",102.18,78,,81.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",18.06,131,
"90716 Varicella vaccine",7906432,CDM,636,RC,90716,CPT,OUTPATIENT,,,191,124.15,,168.08,88,,134.46,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule",EAPG,191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",120.33,63,,96.26,,,0,"percent of total billed charges","63% of total billed charges",29.22,15.3,,23.38,,,0,"percent of total billed charges","15.3% of total billed charges",98.87,100,,,,,0,"fee schedule",EAPG,131.79,69,,,,,0,"fee schedule","69% of total billed charges",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",73.23,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",100.85,100,,,,,0,"fee schedule",EAPG,128.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",72.01,37.7,,57.61,,,0,"percent of total billed charges","37.7% of total billed charges",72.01,37.7,,57.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",64.75,33.9,,51.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",148.98,78,,119.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule","100% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule",EAPG,191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",29.22,191,
"90717 Yellow fever vaccine",7906442,CDM,636,RC,90717,CPT,OUTPATIENT,,,125,81.25,,110,88,,88.00,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule",EAPG,125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",78.75,63,,63.00,,,0,"percent of total billed charges","63% of total billed charges",19.13,15.3,,15.30,,,0,"percent of total billed charges","15.3% of total billed charges",98.87,100,,,,,0,"fee schedule",EAPG,86.25,69,,,,,0,"fee schedule","69% of total billed charges",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",73.23,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",100.85,100,,,,,0,"fee schedule",EAPG,128.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",47.13,37.7,,37.70,,,0,"percent of total billed charges","37.7% of total billed charges",47.13,37.7,,37.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.38,33.9,,33.90,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.5,78,,78.00,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule",EAPG,125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",19.13,128.53,
"90723 DTaP/HepB/IPV vaccine",7904953,CDM,636,RC,90723,CPT,OUTPATIENT,,,101,65.65,,88.88,88,,71.10,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.11,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",63.63,63,,50.90,,,0,"percent of total billed charges","63% of total billed charges",15.45,15.3,,12.36,,,0,"percent of total billed charges","15.3% of total billed charges",24.38,100,,,,,0,"fee schedule",EAPG,69.69,69,,,,,0,"fee schedule","69% of total billed charges",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.06,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",24.87,100,,,,,0,"fee schedule",EAPG,31.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",38.08,37.7,,30.46,,,0,"percent of total billed charges","37.7% of total billed charges",38.08,37.7,,30.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.24,33.9,,27.39,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.78,78,,63.02,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule","100% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",15.45,101,
"90734 Meningococcal conjugate vaccine, serogroups",7906412,CDM,636,RC,90734,CPT,OUTPATIENT,,,144,93.6,,126.72,88,,101.38,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule",EAPG,144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",90.72,63,,72.58,,,0,"percent of total billed charges","63% of total billed charges",22.03,15.3,,17.62,,,0,"percent of total billed charges","15.3% of total billed charges",98.87,100,,,,,0,"fee schedule",EAPG,99.36,69,,,,,0,"fee schedule","69% of total billed charges",144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",73.23,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",100.85,100,,,,,0,"fee schedule",EAPG,128.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",54.29,37.7,,43.43,,,0,"percent of total billed charges","37.7% of total billed charges",54.29,37.7,,43.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.82,33.9,,39.06,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.32,78,,89.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule",EAPG,144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",22.03,144,
"90732 Pneumococcal vaccine",7906422,CDM,636,RC,90732,CPT,OUTPATIENT,,,212,137.8,,186.56,88,,149.25,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.11,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",133.56,63,,106.85,,,0,"percent of total billed charges","63% of total billed charges",32.44,15.3,,25.95,,,0,"percent of total billed charges","15.3% of total billed charges",24.38,100,,,,,0,"fee schedule",EAPG,146.28,69,,,,,0,"fee schedule","69% of total billed charges",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.06,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",24.87,100,,,,,0,"fee schedule",EAPG,31.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",79.92,37.7,,63.94,,,0,"percent of total billed charges","37.7% of total billed charges",79.92,37.7,,63.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.87,33.9,,57.50,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.36,78,,132.29,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",18.06,212,
"90736 Zoster vaccine",7906434,CDM,636,RC,90736,CPT,OUTPATIENT,,,293,190.45,,257.84,88,,206.27,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule",EAPG,293,100,,234.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",184.59,63,,147.67,,,0,"percent of total billed charges","63% of total billed charges",44.83,15.3,,35.86,,,0,"percent of total billed charges","15.3% of total billed charges",98.87,100,,,,,0,"fee schedule",EAPG,202.17,69,,,,,0,"fee schedule","69% of total billed charges",293,100,,234.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",293,100,,234.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",293,100,,234.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",73.23,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",100.85,100,,,,,0,"fee schedule",EAPG,128.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",110.46,37.7,,88.37,,,0,"percent of total billed charges","37.7% of total billed charges",110.46,37.7,,88.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",99.33,33.9,,79.46,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",228.54,78,,182.83,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule",EAPG,293,100,,234.40,,,0,"percent of total billed charges","100% of total billed charges",44.83,293,
"90746 Hepatitis B vaccine",7904962,CDM,636,RC,90746,CPT,OUTPATIENT,,,88,57.2,,77.44,88,,61.95,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.11,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",55.44,63,,44.35,,,0,"percent of total billed charges","63% of total billed charges",13.46,15.3,,10.77,,,0,"percent of total billed charges","15.3% of total billed charges",24.38,100,,,,,0,"fee schedule",EAPG,60.72,69,,,,,0,"fee schedule","69% of total billed charges",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.3,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",47.3,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18.06,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",24.87,100,,,,,0,"fee schedule",EAPG,31.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",33.18,37.7,,26.54,,,0,"percent of total billed charges","37.7% of total billed charges",33.18,37.7,,26.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.83,33.9,,23.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.64,78,,54.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",13.46,88,
"90744 Hepatitis B vaccine",7904963,CDM,636,RC,90744,CPT,OUTPATIENT,,,32,20.8,,28.16,88,,22.53,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.11,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",20.16,63,,16.13,,,0,"percent of total billed charges","63% of total billed charges",4.9,15.3,,3.92,,,0,"percent of total billed charges","15.3% of total billed charges",24.38,100,,,,,0,"fee schedule",EAPG,22.08,69,,,,,0,"fee schedule","69% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",17.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18.06,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",24.87,100,,,,,0,"fee schedule",EAPG,31.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.7% of total billed charges",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.85,33.9,,8.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.96,78,,19.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule","100% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.38,100,,,,,0,"fee schedule",EAPG,32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",4.9,32,
"90750 Zoster (Shingrix) vaccine",9386097,CDM,636,RC,90750,CPT,OUTPATIENT,,,306,198.9,,269.28,88,,215.42,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule",EAPG,306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",192.78,63,,154.22,,,0,"percent of total billed charges","63% of total billed charges",46.82,15.3,,37.46,,,0,"percent of total billed charges","15.3% of total billed charges",98.87,100,,,,,0,"fee schedule",EAPG,211.14,69,,,,,0,"fee schedule","69% of total billed charges",306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",73.23,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",100.85,100,,,,,0,"fee schedule",EAPG,128.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",115.36,37.7,,92.29,,,0,"percent of total billed charges","37.7% of total billed charges",115.36,37.7,,92.29,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",103.73,33.9,,82.98,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",238.68,78,,190.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",98.87,100,,,,,0,"fee schedule",EAPG,306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",46.82,306,
"G0008 Administration of influenza virus vaccine",7903301,CDM,771,RC,,,OUTPATIENT,,,27,17.55,,23.76,88,,19.01,,,0,"percent of total billed charges","88% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.67,17.304,,3.74,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.01,63,,13.61,,,0,"percent of total billed charges","63% of total billed charges",4.13,15.3,,3.30,,,0,"percent of total billed charges","15.3% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",18.63,69,,,,,0,"fee schedule","69% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",8.69,32.2,,6.95,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.63,17.136,,3.70,,,0,"percent of total billed charges","17.136% of total billed charges",5.9,21.84,,4.72,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.18,37.7,,8.14,,,0,"percent of total billed charges","37.7% of total billed charges",10.18,37.7,,8.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.15,33.9,,7.32,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.06,78,,16.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.3,82.6,,17.84,,,0,"percent of total billed charges","82.6% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",13.5,50,,10.80,,,0,"percent of total billed charges","50% of total billed charges",22.3,82.6,,17.84,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",4.13,27,
"G0009 Administration of pneumococcal vaccine",7903302,CDM,771,RC,,,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.13,17.304,,6.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.05,17.136,,6.44,,,0,"percent of total billed charges","17.136% of total billed charges",10.26,21.84,,8.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.7% of total billed charges",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.93,33.9,,12.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.9,16.8,,6.32,,,0,"percent of total billed charges","16.8% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"0171T Insertion of posterior spinous process distr",7962393,CDM,521,RC,22867,CPT,OUTPATIENT,,,3942,2562.3,,3468.96,88,,2775.17,,,0,"percent of total billed charges","88% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11832.42,100,,,,,0,"fee schedule",EAPG,3942,100,,3153.60,,,0,"percent of total billed charges","100% of total billed charges",33264.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2483.46,63,,1986.77,,,0,"percent of total billed charges","63% of total billed charges",603.13,15.3,,482.50,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,2719.98,69,,,,,0,"fee schedule","69% of total billed charges",3942,100,,3153.60,,,0,"percent of total billed charges","100% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3942,100,,3153.60,,,0,"percent of total billed charges","100% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3942,100,,3153.60,,,0,"percent of total billed charges","100% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",64464.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11832.42,100,,,,,0,"fee schedule",EAPG,19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16853.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1486.13,37.7,,1188.90,,,0,"percent of total billed charges","37.70% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3074.76,78,,2459.81,,,0,"percent of total billed charges","78% of total billed charges",19198.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3256.09,82.6,,2604.87,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3256.09,82.6,,2604.87,,,0,"percent of total billed charges","82.6% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11992.95,100,,,,,0,"fee schedule",EAPG,3942,100,,3153.60,,,0,"percent of total billed charges","100% of total billed charges",603.13,64464.78,
"0172T Insertion of posterior spinous process distr",7961958,CDM,521,RC,22868,CPT,OUTPATIENT,,,806,523.9,,709.28,88,,567.42,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",11832.42,100,,,,,0,"fee schedule",EAPG,806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12187.4,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",507.78,63,,406.22,,,0,"percent of total billed charges","63% of total billed charges",123.32,15.3,,98.66,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,556.14,69,,,,,0,"fee schedule","69% of total billed charges",806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11832.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",303.86,37.7,,243.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",628.68,78,,502.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",665.76,82.6,,532.61,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",665.76,82.6,,532.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",11992.95,100,,,,,0,"fee schedule",EAPG,806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",123.32,15382.15,
"0201T Percutaneous sacral augmentation (sacroplast",7962201,CDM,521,RC,0201T,CPT,OUTPATIENT,,,1752,1138.8,,1541.76,88,,1233.41,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,1752,100,,1401.60,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1103.76,63,,883.01,,,0,"percent of total billed charges","63% of total billed charges",268.06,15.3,,214.45,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,1208.88,69,,,,,0,"fee schedule","69% of total billed charges",1752,100,,1401.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1752,100,,1401.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1752,100,,1401.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",660.5,37.7,,528.40,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1366.56,78,,1093.25,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1447.15,82.6,,1157.72,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule","100% of WA fee schedule",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1447.15,82.6,,1157.72,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,1752,100,,1401.60,,,0,"percent of total billed charges","100% of total billed charges",268.06,25451.55,
"10021 Fine needle aspiration; without imaging guid",7963421,CDM,521,RC,10021,CPT,OUTPATIENT,,,329,213.85,,289.52,88,,231.62,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.92,100,,,,,0,"fee schedule",EAPG,329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",585.99,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",207.27,63,,165.82,,,0,"percent of total billed charges","63% of total billed charges",50.34,15.3,,40.27,,,0,"percent of total billed charges","15.3% of total billed charges",568.92,100,,,,,0,"fee schedule",EAPG,227.01,69,,,,,0,"fee schedule","69% of total billed charges",329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.92,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",580.3,100,,,,,0,"fee schedule",EAPG,739.6,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",124.03,37.7,,99.22,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.62,78,,205.30,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",271.75,82.6,,217.40,,,0,"percent of total billed charges","82.6% of total billed charges",568.92,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",271.75,82.6,,217.40,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",729.45,100,,,,,0,"fee schedule",EAPG,329,100,,263.20,,,0,"percent of total billed charges","100% of total billed charges",50.34,1404.97,
"10040 EXTRACTION- Acne Surgery Fac",7901104,CDM,521,RC,10040,CPT,OUTPATIENT,,,169,109.85,,148.72,88,,118.98,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",106.47,63,,85.18,,,0,"percent of total billed charges","63% of total billed charges",25.86,15.3,,20.69,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,116.61,69,,,,,0,"fee schedule","69% of total billed charges",169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",63.71,37.7,,50.97,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",131.82,78,,105.46,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",139.59,82.6,,111.67,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",139.59,82.6,,111.67,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",25.86,729.42,
"10060 I & D Abcess Simple/Single Fac",7901105,CDM,521,RC,10060,CPT,OUTPATIENT,,,350,227.5,,308,88,,246.40,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",220.5,63,,176.40,,,0,"percent of total billed charges","63% of total billed charges",53.55,15.3,,42.84,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,241.5,69,,,,,0,"fee schedule","69% of total billed charges",350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",131.95,37.7,,105.56,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",273,78,,218.40,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.1,82.6,,231.28,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.1,82.6,,231.28,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",53.55,729.41,
"10061 I & D Abcess Complicated/Multiple Fac",7901106,CDM,521,RC,10061,CPT,OUTPATIENT,,,547,355.55,,481.36,88,,385.09,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,547,100,,437.60,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",344.61,63,,275.69,,,0,"percent of total billed charges","63% of total billed charges",83.69,15.3,,66.95,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,377.43,69,,,,,0,"fee schedule","69% of total billed charges",547,100,,437.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",547,100,,437.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",547,100,,437.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",206.22,37.7,,164.98,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.66,78,,341.33,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",451.82,82.6,,361.46,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",451.82,82.6,,361.46,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,547,100,,437.60,,,0,"percent of total billed charges","100% of total billed charges",83.69,1404.97,
"10080 I & D of Pilonidal Cyst Simple FAC",7901107,CDM,521,RC,10080,CPT,OUTPATIENT,,,304,197.6,,267.52,88,,214.02,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191.52,63,,153.22,,,0,"percent of total billed charges","63% of total billed charges",46.51,15.3,,37.21,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,209.76,69,,,,,0,"fee schedule","69% of total billed charges",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",114.61,37.7,,91.69,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",237.12,78,,189.70,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",251.1,82.6,,200.88,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",251.1,82.6,,200.88,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",46.51,2526.76,
"10081 I & D Pilondial Cyst Complicated FAC",7901108,CDM,521,RC,10081,CPT,OUTPATIENT,,,630,409.5,,554.4,88,,443.52,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",989.16,100,,,,,0,"fee schedule",EAPG,630,100,,504.00,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",1018.83,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",396.9,63,,317.52,,,0,"percent of total billed charges","63% of total billed charges",96.39,15.3,,77.11,,,0,"percent of total billed charges","15.3% of total billed charges",989.16,100,,,,,0,"fee schedule",EAPG,434.7,69,,,,,0,"fee schedule","69% of total billed charges",630,100,,504.00,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",630,100,,504.00,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",630,100,,504.00,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",989.16,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1008.94,100,,,,,0,"fee schedule",EAPG,1285.91,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",237.51,37.7,,190.01,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",491.4,78,,393.12,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",520.38,82.6,,416.30,,,0,"percent of total billed charges","82.6% of total billed charges",989.16,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",520.38,82.6,,416.30,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1149.69,100,,,,,0,"fee schedule",EAPG,630,100,,504.00,,,0,"percent of total billed charges","100% of total billed charges",96.39,2526.76,
"10120 Incision & Removal Foreign Body Simp FAC",7901109,CDM,521,RC,10120,CPT,OUTPATIENT,,,281,182.65,,247.28,88,,197.82,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,281,100,,224.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.03,63,,141.62,,,0,"percent of total billed charges","63% of total billed charges",42.99,15.3,,34.39,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,193.89,69,,,,,0,"fee schedule","69% of total billed charges",281,100,,224.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",281,100,,224.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",281,100,,224.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",105.94,37.7,,84.75,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",219.18,78,,175.34,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",232.11,82.6,,185.69,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",232.11,82.6,,185.69,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,281,100,,224.80,,,0,"percent of total billed charges","100% of total billed charges",42.99,1404.97,
"10121 Incision & Removal Foreign Body Comp FAC",7901110,CDM,521,RC,10121,CPT,OUTPATIENT,,,489,317.85,,430.32,88,,344.26,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,489,100,,391.20,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1066.24,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",308.07,63,,246.46,,,0,"percent of total billed charges","63% of total billed charges",74.82,15.3,,59.86,,,0,"percent of total billed charges","15.3% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,337.41,69,,,,,0,"fee schedule","69% of total billed charges",489,100,,391.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",489,100,,391.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",489,100,,391.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055.89,100,,,,,0,"fee schedule",EAPG,1345.74,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",184.35,37.7,,147.48,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",381.42,78,,305.14,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",403.91,82.6,,323.13,,,0,"percent of total billed charges","82.6% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",403.91,82.6,,323.13,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1195.71,100,,,,,0,"fee schedule",EAPG,489,100,,391.20,,,0,"percent of total billed charges","100% of total billed charges",74.82,5715.97,
"10140 I & D of Hematoma",7901111,CDM,521,RC,10140,CPT,OUTPATIENT,,,299,194.35,,263.12,88,,210.50,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",989.16,100,,,,,0,"fee schedule",EAPG,299,100,,239.20,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1018.83,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",188.37,63,,150.70,,,0,"percent of total billed charges","63% of total billed charges",45.75,15.3,,36.60,,,0,"percent of total billed charges","15.3% of total billed charges",989.16,100,,,,,0,"fee schedule",EAPG,206.31,69,,,,,0,"fee schedule","69% of total billed charges",299,100,,239.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",299,100,,239.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",299,100,,239.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",989.16,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1008.94,100,,,,,0,"fee schedule",EAPG,1285.91,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",112.72,37.7,,90.18,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",233.22,78,,186.58,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",246.97,82.6,,197.58,,,0,"percent of total billed charges","82.6% of total billed charges",989.16,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",246.97,82.6,,197.58,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1149.69,100,,,,,0,"fee schedule",EAPG,299,100,,239.20,,,0,"percent of total billed charges","100% of total billed charges",45.75,5715.97,
"10160 Skin Puncture Aspirate Abcess",7901112,CDM,521,RC,10160,CPT,OUTPATIENT,,,215,139.75,,189.2,88,,151.36,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",135.45,63,,108.36,,,0,"percent of total billed charges","63% of total billed charges",32.9,15.3,,26.32,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,148.35,69,,,,,0,"fee schedule","69% of total billed charges",215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",81.06,37.7,,64.85,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",167.7,78,,134.16,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.59,82.6,,142.07,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.59,82.6,,142.07,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",32.9,1404.97,
"10180 I & D Postop Wound",7901113,CDM,521,RC,10180,CPT,OUTPATIENT,,,605,393.25,,532.4,88,,425.92,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.83,100,,,,,0,"fee schedule",EAPG,605,100,,484.00,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",930.95,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",381.15,63,,304.92,,,0,"percent of total billed charges","63% of total billed charges",92.57,15.3,,74.06,,,0,"percent of total billed charges","15.3% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,417.45,69,,,,,0,"fee schedule","69% of total billed charges",605,100,,484.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605,100,,484.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605,100,,484.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.83,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",921.91,100,,,,,0,"fee schedule",EAPG,1174.99,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",228.09,37.7,,182.47,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",471.9,78,,377.52,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.73,82.6,,399.78,,,0,"percent of total billed charges","82.6% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.73,82.6,,399.78,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1064.36,100,,,,,0,"fee schedule",EAPG,605,100,,484.00,,,0,"percent of total billed charges","100% of total billed charges",92.57,9628.23,
"11000 Debride SKin Up to 10% Body Surface",7901114,CDM,521,RC,11000,CPT,OUTPATIENT,,,100,65,,88,88,,70.40,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",63,63,,50.40,,,0,"percent of total billed charges","63% of total billed charges",15.3,15.3,,12.24,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,69,69,,,,,0,"fee schedule","69% of total billed charges",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",78,78,,62.40,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.26,100,,,,,0,"fee schedule",EAPG,100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",15.3,2129.45,
"11001 Debride Skin EA Addl 10% of Body",7901115,CDM,521,RC,11001,CPT,OUTPATIENT,,,64,41.6,,56.32,88,,45.06,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.73,100,,,,,0,"fee schedule",EAPG,64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",40.32,63,,32.26,,,0,"percent of total billed charges","63% of total billed charges",9.79,15.3,,7.83,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,44.16,69,,,,,0,"fee schedule","69% of total billed charges",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",338.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.13,37.7,,19.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",49.92,78,,39.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.86,82.6,,42.29,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",52.86,82.6,,42.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",499.26,100,,,,,0,"fee schedule",EAPG,64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",9.79,499.26,
"11006 Debride of soft tissue infect; ext genitalia",7961451,CDM,521,RC,11006,CPT,OUTPATIENT,,,1990,1293.5,,1751.2,88,,1400.96,,,0,"percent of total billed charges","88% of total billed charges",1990,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",903.83,100,,,,,0,"fee schedule",EAPG,1990,100,,1592.00,,,0,"percent of total billed charges","100% of total billed charges",1990,175,,,,,0,"fee schedule","175% of CMS fee schedule",930.95,100,,,,,0,"fee schedule",EAPG,1990,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1253.7,63,,1002.96,,,0,"percent of total billed charges","63% of total billed charges",304.47,15.3,,243.58,,,0,"percent of total billed charges","15.3% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,1373.1,69,,,,,0,"fee schedule","69% of total billed charges",1990,100,,1592.00,,,0,"percent of total billed charges","100% of total billed charges",1990,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1990,100,,1592.00,,,0,"percent of total billed charges","100% of total billed charges",1990,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1990,100,,1592.00,,,0,"percent of total billed charges","100% of total billed charges",1990,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1990,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",903.83,100,,,,,0,"fee schedule",EAPG,1990,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1990,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1990,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",921.91,100,,,,,0,"fee schedule",EAPG,1174.99,100,,,,,0,"fee schedule",EAPG,1990,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",750.23,37.7,,600.18,,,0,"percent of total billed charges","37.70% of total billed charges",1990,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1990,100,,,,,0,"fee schedule","100% of CMS fee schedule",1552.2,78,,1241.76,,,0,"percent of total billed charges","78% of total billed charges",1990,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1643.74,82.6,,1314.99,,,0,"percent of total billed charges","82.6% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,1990,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1643.74,82.6,,1314.99,,,0,"percent of total billed charges","82.6% of total billed charges",1990,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1064.36,100,,,,,0,"fee schedule",EAPG,1990,100,,1592.00,,,0,"percent of total billed charges","100% of total billed charges",304.47,1990,
"11005 Debride of skin, subQ tissue, muscle/fascia",7961724,CDM,521,RC,11005,CPT,OUTPATIENT,,,2197,1428.05,,1933.36,88,,1546.69,,,0,"percent of total billed charges","88% of total billed charges",2197,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",903.83,100,,,,,0,"fee schedule",EAPG,2197,100,,1757.60,,,0,"percent of total billed charges","100% of total billed charges",2197,175,,,,,0,"fee schedule","175% of CMS fee schedule",930.95,100,,,,,0,"fee schedule",EAPG,2197,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1384.11,63,,1107.29,,,0,"percent of total billed charges","63% of total billed charges",336.14,15.3,,268.91,,,0,"percent of total billed charges","15.3% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,1515.93,69,,,,,0,"fee schedule","69% of total billed charges",2197,100,,1757.60,,,0,"percent of total billed charges","100% of total billed charges",2197,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2197,100,,1757.60,,,0,"percent of total billed charges","100% of total billed charges",2197,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2197,100,,1757.60,,,0,"percent of total billed charges","100% of total billed charges",2197,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2197,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",903.83,100,,,,,0,"fee schedule",EAPG,2197,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2197,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2197,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",921.91,100,,,,,0,"fee schedule",EAPG,1174.99,100,,,,,0,"fee schedule",EAPG,2197,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",828.27,37.7,,662.62,,,0,"percent of total billed charges","37.70% of total billed charges",2197,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2197,100,,,,,0,"fee schedule","100% of CMS fee schedule",1713.66,78,,1370.93,,,0,"percent of total billed charges","78% of total billed charges",2197,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1814.72,82.6,,1451.78,,,0,"percent of total billed charges","82.6% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,2197,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1814.72,82.6,,1451.78,,,0,"percent of total billed charges","82.6% of total billed charges",2197,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1064.36,100,,,,,0,"fee schedule",EAPG,2197,100,,1757.60,,,0,"percent of total billed charges","100% of total billed charges",336.14,2197,
"11004 Debride of skin, subQ tissue, muscle and fas",7962278,CDM,521,RC,11004,CPT,OUTPATIENT,,,1646,1069.9,,1448.48,88,,1158.78,,,0,"percent of total billed charges","88% of total billed charges",1646,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",903.83,100,,,,,0,"fee schedule",EAPG,1646,100,,1316.80,,,0,"percent of total billed charges","100% of total billed charges",1646,175,,,,,0,"fee schedule","175% of CMS fee schedule",930.95,100,,,,,0,"fee schedule",EAPG,1646,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1036.98,63,,829.58,,,0,"percent of total billed charges","63% of total billed charges",251.84,15.3,,201.47,,,0,"percent of total billed charges","15.3% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,1135.74,69,,,,,0,"fee schedule","69% of total billed charges",1646,100,,1316.80,,,0,"percent of total billed charges","100% of total billed charges",1646,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1646,100,,1316.80,,,0,"percent of total billed charges","100% of total billed charges",1646,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1646,100,,1316.80,,,0,"percent of total billed charges","100% of total billed charges",1646,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1646,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",903.83,100,,,,,0,"fee schedule",EAPG,1646,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1646,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1646,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",921.91,100,,,,,0,"fee schedule",EAPG,1174.99,100,,,,,0,"fee schedule",EAPG,1646,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",620.54,37.7,,496.43,,,0,"percent of total billed charges","37.70% of total billed charges",1646,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1646,100,,,,,0,"fee schedule","100% of CMS fee schedule",1283.88,78,,1027.10,,,0,"percent of total billed charges","78% of total billed charges",1646,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1359.6,82.6,,1087.68,,,0,"percent of total billed charges","82.6% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,1646,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1359.6,82.6,,1087.68,,,0,"percent of total billed charges","82.6% of total billed charges",1646,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1064.36,100,,,,,0,"fee schedule",EAPG,1646,100,,1316.80,,,0,"percent of total billed charges","100% of total billed charges",251.84,1646,
"11008 Removal of prosthetic material or mesh, abdo",7962867,CDM,521,RC,11008,CPT,OUTPATIENT,,,789,512.85,,694.32,88,,555.46,,,0,"percent of total billed charges","88% of total billed charges",789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",903.83,100,,,,,0,"fee schedule",EAPG,789,100,,631.20,,,0,"percent of total billed charges","100% of total billed charges",789,175,,,,,0,"fee schedule","175% of CMS fee schedule",930.95,100,,,,,0,"fee schedule",EAPG,789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",497.07,63,,397.66,,,0,"percent of total billed charges","63% of total billed charges",120.72,15.3,,96.58,,,0,"percent of total billed charges","15.3% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,544.41,69,,,,,0,"fee schedule","69% of total billed charges",789,100,,631.20,,,0,"percent of total billed charges","100% of total billed charges",789,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",789,100,,631.20,,,0,"percent of total billed charges","100% of total billed charges",789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",789,100,,631.20,,,0,"percent of total billed charges","100% of total billed charges",789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",903.83,100,,,,,0,"fee schedule",EAPG,789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",921.91,100,,,,,0,"fee schedule",EAPG,1174.99,100,,,,,0,"fee schedule",EAPG,789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",297.45,37.7,,237.96,,,0,"percent of total billed charges","37.70% of total billed charges",789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",789,100,,,,,0,"fee schedule","100% of CMS fee schedule",615.42,78,,492.34,,,0,"percent of total billed charges","78% of total billed charges",789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",651.71,82.6,,521.37,,,0,"percent of total billed charges","82.6% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",651.71,82.6,,521.37,,,0,"percent of total billed charges","82.6% of total billed charges",789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1064.36,100,,,,,0,"fee schedule",EAPG,789,100,,631.20,,,0,"percent of total billed charges","100% of total billed charges",120.72,1174.99,
"11010 Debridement Open Fx/Dislocation; Skin and Su",7963271,CDM,521,RC,11010,CPT,OUTPATIENT,,,922,599.3,,811.36,88,,649.09,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,922,100,,737.60,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",580.86,63,,464.69,,,0,"percent of total billed charges","63% of total billed charges",141.07,15.3,,112.86,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,636.18,69,,,,,0,"fee schedule","69% of total billed charges",922,100,,737.60,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",922,100,,737.60,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",922,100,,737.60,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",347.59,37.7,,278.07,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",719.16,78,,575.33,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",761.57,82.6,,609.26,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",761.57,82.6,,609.26,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.26,100,,,,,0,"fee schedule",EAPG,922,100,,737.60,,,0,"percent of total billed charges","100% of total billed charges",141.07,2526.76,
"11011 Debridement Open Fx/Dislocation; to Muscle",7963534,CDM,521,RC,11011,CPT,OUTPATIENT,,,1548,1006.2,,1362.24,88,,1089.79,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,1548,100,,1238.40,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",975.24,63,,780.19,,,0,"percent of total billed charges","63% of total billed charges",236.84,15.3,,189.47,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,1068.12,69,,,,,0,"fee schedule","69% of total billed charges",1548,100,,1238.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1548,100,,1238.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1548,100,,1238.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",583.6,37.7,,466.88,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1207.44,78,,965.95,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1278.65,82.6,,1022.92,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1278.65,82.6,,1022.92,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.26,100,,,,,0,"fee schedule",EAPG,1548,100,,1238.40,,,0,"percent of total billed charges","100% of total billed charges",236.84,2526.76,
"11012 Debridement Open Fx/Dislocation; to Bone",7963575,CDM,521,RC,11012,CPT,OUTPATIENT,,,2256,1466.4,,1985.28,88,,1588.22,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.83,100,,,,,0,"fee schedule",EAPG,2256,100,,1804.80,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",930.95,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1421.28,63,,1137.02,,,0,"percent of total billed charges","63% of total billed charges",345.17,15.3,,276.14,,,0,"percent of total billed charges","15.3% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,1556.64,69,,,,,0,"fee schedule","69% of total billed charges",2256,100,,1804.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2256,100,,1804.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2256,100,,1804.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.83,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",921.91,100,,,,,0,"fee schedule",EAPG,1174.99,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",850.51,37.7,,680.41,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1759.68,78,,1407.74,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.46,82.6,,1490.77,,,0,"percent of total billed charges","82.6% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.46,82.6,,1490.77,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1064.36,100,,,,,0,"fee schedule",EAPG,2256,100,,1804.80,,,0,"percent of total billed charges","100% of total billed charges",345.17,9628.23,
"11042 Debride Skin & Subcutaneous Tissue",7901116,CDM,521,RC,11042,CPT,OUTPATIENT,,,315,204.75,,277.2,88,,221.76,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,315,100,,252.00,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",198.45,63,,158.76,,,0,"percent of total billed charges","63% of total billed charges",48.2,15.3,,38.56,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,217.35,69,,,,,0,"fee schedule","69% of total billed charges",315,100,,252.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",315,100,,252.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",315,100,,252.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",118.76,37.7,,95.01,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",245.7,78,,196.56,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.19,82.6,,208.15,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.19,82.6,,208.15,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.26,100,,,,,0,"fee schedule",EAPG,315,100,,252.00,,,0,"percent of total billed charges","100% of total billed charges",48.2,1404.97,
"11043 Debride Subq Tiss/Musc 1st 20 SQ CM",7901117,CDM,521,RC,11043,CPT,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.26,100,,,,,0,"fee schedule",EAPG,618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,2129.45,
"11044 Debride Bone 1st 20 SQ CM",7901118,CDM,521,RC,11044,CPT,OUTPATIENT,,,862,560.3,,758.56,88,,606.85,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.83,100,,,,,0,"fee schedule",EAPG,862,100,,689.60,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",930.95,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",543.06,63,,434.45,,,0,"percent of total billed charges","63% of total billed charges",131.89,15.3,,105.51,,,0,"percent of total billed charges","15.3% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,594.78,69,,,,,0,"fee schedule","69% of total billed charges",862,100,,689.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",862,100,,689.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",862,100,,689.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.83,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",921.91,100,,,,,0,"fee schedule",EAPG,1174.99,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",324.97,37.7,,259.98,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672.36,78,,537.89,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",712.01,82.6,,569.61,,,0,"percent of total billed charges","82.6% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",712.01,82.6,,569.61,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1064.36,100,,,,,0,"fee schedule",EAPG,862,100,,689.60,,,0,"percent of total billed charges","100% of total billed charges",131.89,5715.97,
"11045 Debride SUBQ Tiss EA Addl 20 SQ CM",7901119,CDM,521,RC,11045,CPT,OUTPATIENT,,,145,94.25,,127.6,88,,102.08,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",903.83,100,,,,,0,"fee schedule",EAPG,145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",930.95,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",91.35,63,,73.08,,,0,"percent of total billed charges","63% of total billed charges",22.19,15.3,,17.75,,,0,"percent of total billed charges","15.3% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,100.05,69,,,,,0,"fee schedule","69% of total billed charges",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",903.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",921.91,100,,,,,0,"fee schedule",EAPG,1174.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",54.67,37.7,,43.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",113.1,78,,90.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",119.77,82.6,,95.82,,,0,"percent of total billed charges","82.6% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",119.77,82.6,,95.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1064.36,100,,,,,0,"fee schedule",EAPG,145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",22.19,1174.99,
"11046 Debridement, muscle and/or fascia; each addi",7903321,CDM,521,RC,11046,CPT,OUTPATIENT,,,256,166.4,,225.28,88,,180.22,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",903.83,100,,,,,0,"fee schedule",EAPG,256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",930.95,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",161.28,63,,129.02,,,0,"percent of total billed charges","63% of total billed charges",39.17,15.3,,31.34,,,0,"percent of total billed charges","15.3% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,176.64,69,,,,,0,"fee schedule","69% of total billed charges",256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",903.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",921.91,100,,,,,0,"fee schedule",EAPG,1174.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",96.51,37.7,,77.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",199.68,78,,159.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.46,82.6,,169.17,,,0,"percent of total billed charges","82.6% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",211.46,82.6,,169.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1064.36,100,,,,,0,"fee schedule",EAPG,256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",39.17,1174.99,
"11047 Debridement, bone; each additional 20 sq cm,",7963094,CDM,521,RC,11047,CPT,OUTPATIENT,,,432,280.8,,380.16,88,,304.13,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",903.83,100,,,,,0,"fee schedule",EAPG,432,100,,345.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",930.95,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",272.16,63,,217.73,,,0,"percent of total billed charges","63% of total billed charges",66.1,15.3,,52.88,,,0,"percent of total billed charges","15.3% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,298.08,69,,,,,0,"fee schedule","69% of total billed charges",432,100,,345.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",432,100,,345.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",432,100,,345.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",903.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",921.91,100,,,,,0,"fee schedule",EAPG,1174.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",162.86,37.7,,130.29,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",336.96,78,,269.57,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",356.83,82.6,,285.46,,,0,"percent of total billed charges","82.6% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",356.83,82.6,,285.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1064.36,100,,,,,0,"fee schedule",EAPG,432,100,,345.60,,,0,"percent of total billed charges","100% of total billed charges",66.1,1174.99,
"11040 debride skin, partial",7963885,CDM,521,RC,11040,CPT,OUTPATIENT,,,76,49.4,,66.88,88,,53.50,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.15,17.304,,10.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.88,63,,38.30,,,0,"percent of total billed charges","63% of total billed charges",11.63,15.3,,9.30,,,0,"percent of total billed charges","15.3% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",52.44,69,,,,,0,"fee schedule","69% of total billed charges",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.02,17.136,,10.42,,,0,"percent of total billed charges","17.136% of total billed charges",16.6,21.84,,13.28,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.65,37.7,,22.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",59.28,78,,47.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.78,82.6,,50.22,,,0,"percent of total billed charges","82.6% of total billed charges",12.77,16.8,,10.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.78,82.6,,50.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",11.63,160.53,
"11055 Paring Skin LSN, Single Lesion",7901120,CDM,521,RC,11055,CPT,OUTPATIENT,,,76,49.4,,66.88,88,,53.50,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.88,63,,38.30,,,0,"percent of total billed charges","63% of total billed charges",11.63,15.3,,9.30,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,52.44,69,,,,,0,"fee schedule","69% of total billed charges",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",28.65,37.7,,22.92,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.28,78,,47.42,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",62.78,82.6,,50.22,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",62.78,82.6,,50.22,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",11.63,729.42,
"11056 Paring Skin Lesion, 2 to 4 Lesions",7901121,CDM,521,RC,11056,CPT,OUTPATIENT,,,82,53.3,,72.16,88,,57.73,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.66,63,,41.33,,,0,"percent of total billed charges","63% of total billed charges",12.55,15.3,,10.04,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,56.58,69,,,,,0,"fee schedule","69% of total billed charges",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",30.91,37.7,,24.73,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",63.96,78,,51.17,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",67.73,82.6,,54.18,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",67.73,82.6,,54.18,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",12.55,729.42,
"11057 Paring Skin LSN, More than 4 lesions",7901122,CDM,521,RC,11057,CPT,OUTPATIENT,,,96,62.4,,84.48,88,,67.58,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60.48,63,,48.38,,,0,"percent of total billed charges","63% of total billed charges",14.69,15.3,,11.75,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,66.24,69,,,,,0,"fee schedule","69% of total billed charges",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",36.19,37.7,,28.95,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.88,78,,59.90,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",14.69,729.41,
"11200 Remove Skin Tags Up to 15 Lesions",7901125,CDM,521,RC,11200,CPT,OUTPATIENT,,,173,112.45,,152.24,88,,121.79,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.99,63,,87.19,,,0,"percent of total billed charges","63% of total billed charges",26.47,15.3,,21.18,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,119.37,69,,,,,0,"fee schedule","69% of total billed charges",173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",65.22,37.7,,52.18,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",134.94,78,,107.95,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",142.9,82.6,,114.32,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule","100% of WA fee schedule",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",142.9,82.6,,114.32,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",26.47,729.42,
"11201 Remove Skin Tags, EA Addtl 10 Lesions",7901126,CDM,521,RC,11201,CPT,OUTPATIENT,,,85,55.25,,74.8,88,,59.84,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",147.32,100,,,,,0,"fee schedule",EAPG,85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.74,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",53.55,63,,42.84,,,0,"percent of total billed charges","63% of total billed charges",13.01,15.3,,10.41,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,58.65,69,,,,,0,"fee schedule","69% of total billed charges",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.57,61.85,,42.06,,,0,"percent of total billed charges","61.5% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",32.05,37.7,,25.64,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",66.3,78,,53.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.21,82.6,,56.17,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule","100% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",70.21,82.6,,56.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",307.85,100,,,,,0,"fee schedule",EAPG,85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",13.01,307.85,
"11300 Shave Skin Lesion Less Than 0.5 CM",7901127,CDM,521,RC,11300,CPT,OUTPATIENT,,,181,117.65,,159.28,88,,127.42,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",114.03,63,,91.22,,,0,"percent of total billed charges","63% of total billed charges",27.69,15.3,,22.15,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,124.89,69,,,,,0,"fee schedule","69% of total billed charges",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",68.24,37.7,,54.59,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",141.18,78,,112.94,,,0,"percent of total billed charges","78% of total billed charges",410.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",149.51,82.6,,119.61,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",149.51,82.6,,119.61,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",27.69,1404.98,
"11301 Shave Skin Lesion 0.6 to 1.0 CM",7901128,CDM,521,RC,11301,CPT,OUTPATIENT,,,228,148.2,,200.64,88,,160.51,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",143.64,63,,114.91,,,0,"percent of total billed charges","63% of total billed charges",34.88,15.3,,27.90,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,157.32,69,,,,,0,"fee schedule","69% of total billed charges",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",85.96,37.7,,68.77,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.84,78,,142.27,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",188.33,82.6,,150.66,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",188.33,82.6,,150.66,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",34.88,729.42,
"11302 Shave SKin Lesion 1.1 to 2.0 CM",7901129,CDM,521,RC,11302,CPT,OUTPATIENT,,,275,178.75,,242,88,,193.60,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,275,100,,220.00,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.25,63,,138.60,,,0,"percent of total billed charges","63% of total billed charges",42.08,15.3,,33.66,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,189.75,69,,,,,0,"fee schedule","69% of total billed charges",275,100,,220.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",275,100,,220.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",275,100,,220.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",103.68,37.7,,82.94,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",214.5,78,,171.60,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",227.15,82.6,,181.72,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",227.15,82.6,,181.72,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,275,100,,220.00,,,0,"percent of total billed charges","100% of total billed charges",42.08,729.42,
"11303 Shave Skin Lesion Over 2.0 CM",7901130,CDM,521,RC,11303,CPT,OUTPATIENT,,,394,256.1,,346.72,88,,277.38,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,394,100,,315.20,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",248.22,63,,198.58,,,0,"percent of total billed charges","63% of total billed charges",60.28,15.3,,48.22,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,271.86,69,,,,,0,"fee schedule","69% of total billed charges",394,100,,315.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394,100,,315.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394,100,,315.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",148.54,37.7,,118.83,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.32,78,,245.86,,,0,"percent of total billed charges","78% of total billed charges",410.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",325.44,82.6,,260.35,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",325.44,82.6,,260.35,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,394,100,,315.20,,,0,"percent of total billed charges","100% of total billed charges",60.28,1404.98,
"11305 Shave Skin Lesion Scap Less Than 5.0 CM",7901131,CDM,521,RC,11305,CPT,OUTPATIENT,,,183,118.95,,161.04,88,,128.83,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,183,100,,146.40,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.29,63,,92.23,,,0,"percent of total billed charges","63% of total billed charges",28,15.3,,22.40,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,126.27,69,,,,,0,"fee schedule","69% of total billed charges",183,100,,146.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",183,100,,146.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",183,100,,146.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",68.99,37.7,,55.19,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",142.74,78,,114.19,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.16,82.6,,120.93,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.16,82.6,,120.93,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,183,100,,146.40,,,0,"percent of total billed charges","100% of total billed charges",28,729.42,
"11306 Shave Skin Lesion Scalp 0.6 to 1.0 CM",7901132,CDM,521,RC,11306,CPT,OUTPATIENT,,,245,159.25,,215.6,88,,172.48,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,245,100,,196.00,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.35,63,,123.48,,,0,"percent of total billed charges","63% of total billed charges",37.49,15.3,,29.99,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,169.05,69,,,,,0,"fee schedule","69% of total billed charges",245,100,,196.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",245,100,,196.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",245,100,,196.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",92.37,37.7,,73.90,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191.1,78,,152.88,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.37,82.6,,161.90,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.37,82.6,,161.90,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,245,100,,196.00,,,0,"percent of total billed charges","100% of total billed charges",37.49,729.42,
"11307 Shave Skin Lesion Scalp 1.1 to 2.0 CM",7901133,CDM,521,RC,11307,CPT,OUTPATIENT,,,298,193.7,,262.24,88,,209.79,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,298,100,,238.40,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",187.74,63,,150.19,,,0,"percent of total billed charges","63% of total billed charges",45.59,15.3,,36.47,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,205.62,69,,,,,0,"fee schedule","69% of total billed charges",298,100,,238.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298,100,,238.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298,100,,238.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",112.35,37.7,,89.88,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",232.44,78,,185.95,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",246.15,82.6,,196.92,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",246.15,82.6,,196.92,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,298,100,,238.40,,,0,"percent of total billed charges","100% of total billed charges",45.59,729.41,
"11308 Shave Skin Lesion Scalp > 2.0 CM",7901134,CDM,521,RC,11308,CPT,OUTPATIENT,,,394,256.1,,346.72,88,,277.38,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,394,100,,315.20,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",248.22,63,,198.58,,,0,"percent of total billed charges","63% of total billed charges",60.28,15.3,,48.22,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,271.86,69,,,,,0,"fee schedule","69% of total billed charges",394,100,,315.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394,100,,315.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394,100,,315.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",148.54,37.7,,118.83,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.32,78,,245.86,,,0,"percent of total billed charges","78% of total billed charges",410.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",325.44,82.6,,260.35,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",325.44,82.6,,260.35,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,394,100,,315.20,,,0,"percent of total billed charges","100% of total billed charges",60.28,1404.98,
"11310 Shave Skin Lesion Face < 0.5 CM",7901135,CDM,521,RC,11310,CPT,OUTPATIENT,,,219,142.35,,192.72,88,,154.18,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",137.97,63,,110.38,,,0,"percent of total billed charges","63% of total billed charges",33.51,15.3,,26.81,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,151.11,69,,,,,0,"fee schedule","69% of total billed charges",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",82.56,37.7,,66.05,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",170.82,78,,136.66,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180.89,82.6,,144.71,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180.89,82.6,,144.71,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",33.51,729.41,
"11311 Shave Skin Lesion Face Under 0.6 to 1.0 CM",7901136,CDM,521,RC,11311,CPT,OUTPATIENT,,,270,175.5,,237.6,88,,190.08,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",170.1,63,,136.08,,,0,"percent of total billed charges","63% of total billed charges",41.31,15.3,,33.05,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,186.3,69,,,,,0,"fee schedule","69% of total billed charges",270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",101.79,37.7,,81.43,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.6,78,,168.48,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",223.02,82.6,,178.42,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",223.02,82.6,,178.42,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",41.31,729.41,
"11312 Shave Skin Lesion Face 1.1 to 2.0 CM",7901137,CDM,521,RC,11312,CPT,OUTPATIENT,,,320,208,,281.6,88,,225.28,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",201.6,63,,161.28,,,0,"percent of total billed charges","63% of total billed charges",48.96,15.3,,39.17,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,220.8,69,,,,,0,"fee schedule","69% of total billed charges",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",120.64,37.7,,96.51,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",249.6,78,,199.68,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",264.32,82.6,,211.46,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",264.32,82.6,,211.46,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",48.96,1404.97,
"11313 Shave Skin Lesion Face Over 2.0 CM",7901138,CDM,521,RC,11313,CPT,OUTPATIENT,,,418,271.7,,367.84,88,,294.27,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",263.34,63,,210.67,,,0,"percent of total billed charges","63% of total billed charges",63.95,15.3,,51.16,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,288.42,69,,,,,0,"fee schedule","69% of total billed charges",418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",157.59,37.7,,126.07,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",326.04,78,,260.83,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.27,82.6,,276.22,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.27,82.6,,276.22,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",63.95,1404.97,
"11400 Exc Benign Lesion < 0.5 CM",7901139,CDM,521,RC,11400,CPT,OUTPATIENT,,,271,176.15,,238.48,88,,190.78,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,271,100,,216.80,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",170.73,63,,136.58,,,0,"percent of total billed charges","63% of total billed charges",41.46,15.3,,33.17,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,186.99,69,,,,,0,"fee schedule","69% of total billed charges",271,100,,216.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",271,100,,216.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",271,100,,216.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",102.17,37.7,,81.74,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",211.38,78,,169.10,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",223.85,82.6,,179.08,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",223.85,82.6,,179.08,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.98,100,,,,,0,"fee schedule",EAPG,271,100,,216.80,,,0,"percent of total billed charges","100% of total billed charges",41.46,2526.76,
"11401 Exc Benign Lesion 0.6 to 1.0 CM",7901140,CDM,521,RC,11401,CPT,OUTPATIENT,,,330,214.5,,290.4,88,,232.32,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,330,100,,264.00,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",207.9,63,,166.32,,,0,"percent of total billed charges","63% of total billed charges",50.49,15.3,,40.39,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,227.7,69,,,,,0,"fee schedule","69% of total billed charges",330,100,,264.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330,100,,264.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330,100,,264.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",124.41,37.7,,99.53,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",257.4,78,,205.92,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.58,82.6,,218.06,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.58,82.6,,218.06,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.98,100,,,,,0,"fee schedule",EAPG,330,100,,264.00,,,0,"percent of total billed charges","100% of total billed charges",50.49,1404.97,
"11402 Exc Benign Lesion 1.1 to 2.0 CM",7901141,CDM,521,RC,11402,CPT,OUTPATIENT,,,408,265.2,,359.04,88,,287.23,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,408,100,,326.40,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",257.04,63,,205.63,,,0,"percent of total billed charges","63% of total billed charges",62.42,15.3,,49.94,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,281.52,69,,,,,0,"fee schedule","69% of total billed charges",408,100,,326.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408,100,,326.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408,100,,326.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",153.82,37.7,,123.06,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",318.24,78,,254.59,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",337.01,82.6,,269.61,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",337.01,82.6,,269.61,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.98,100,,,,,0,"fee schedule",EAPG,408,100,,326.40,,,0,"percent of total billed charges","100% of total billed charges",62.42,2526.76,
"11403 Exc Benign Lesion 2.1 to 3.0 CM",7901142,CDM,521,RC,11403,CPT,OUTPATIENT,,,523,339.95,,460.24,88,,368.19,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,523,100,,418.40,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",329.49,63,,263.59,,,0,"percent of total billed charges","63% of total billed charges",80.02,15.3,,64.02,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,360.87,69,,,,,0,"fee schedule","69% of total billed charges",523,100,,418.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",523,100,,418.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",523,100,,418.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",197.17,37.7,,157.74,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",407.94,78,,326.35,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",432,82.6,,345.60,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",432,82.6,,345.60,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.98,100,,,,,0,"fee schedule",EAPG,523,100,,418.40,,,0,"percent of total billed charges","100% of total billed charges",80.02,2526.76,
"11404 Exc Benign Lesion 3.1 to 4.0 CM",7901143,CDM,521,RC,11404,CPT,OUTPATIENT,,,646,419.9,,568.48,88,,454.78,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,646,100,,516.80,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1066.24,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",406.98,63,,325.58,,,0,"percent of total billed charges","63% of total billed charges",98.84,15.3,,79.07,,,0,"percent of total billed charges","15.3% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,445.74,69,,,,,0,"fee schedule","69% of total billed charges",646,100,,516.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",646,100,,516.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",646,100,,516.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055.89,100,,,,,0,"fee schedule",EAPG,1345.74,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",243.54,37.7,,194.83,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",503.88,78,,403.10,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",533.6,82.6,,426.88,,,0,"percent of total billed charges","82.6% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",533.6,82.6,,426.88,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1195.71,100,,,,,0,"fee schedule",EAPG,646,100,,516.80,,,0,"percent of total billed charges","100% of total billed charges",98.84,5715.97,
"11406 Exc Benign Lesion > 4.0 CM",7901144,CDM,521,RC,11406,CPT,OUTPATIENT,,,922,599.3,,811.36,88,,649.09,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,922,100,,737.60,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1640.79,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",580.86,63,,464.69,,,0,"percent of total billed charges","63% of total billed charges",141.07,15.3,,112.86,,,0,"percent of total billed charges","15.3% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,636.18,69,,,,,0,"fee schedule","69% of total billed charges",922,100,,737.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",922,100,,737.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",922,100,,737.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1624.86,100,,,,,0,"fee schedule",EAPG,2070.9,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",347.59,37.7,,278.07,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",719.16,78,,575.33,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",761.57,82.6,,609.26,,,0,"percent of total billed charges","82.6% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",761.57,82.6,,609.26,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.53,100,,,,,0,"fee schedule",EAPG,922,100,,737.60,,,0,"percent of total billed charges","100% of total billed charges",141.07,5715.97,
"11420 Exc Benign Lesion Scalp to 0.5 CM",7901145,CDM,521,RC,11420,CPT,OUTPATIENT,,,188,122.2,,165.44,88,,132.35,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,188,100,,150.40,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1066.24,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.44,63,,94.75,,,0,"percent of total billed charges","63% of total billed charges",28.76,15.3,,23.01,,,0,"percent of total billed charges","15.3% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,129.72,69,,,,,0,"fee schedule","69% of total billed charges",188,100,,150.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",188,100,,150.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",188,100,,150.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055.89,100,,,,,0,"fee schedule",EAPG,1345.74,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",70.88,37.7,,56.70,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",146.64,78,,117.31,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",155.29,82.6,,124.23,,,0,"percent of total billed charges","82.6% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",155.29,82.6,,124.23,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1195.71,100,,,,,0,"fee schedule",EAPG,188,100,,150.40,,,0,"percent of total billed charges","100% of total billed charges",28.76,5715.97,
"11421 Exc Benign Lesion Scalp 0.6 to 1 CM",7901146,CDM,521,RC,11421,CPT,OUTPATIENT,,,370,240.5,,325.6,88,,260.48,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,370,100,,296.00,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",233.1,63,,186.48,,,0,"percent of total billed charges","63% of total billed charges",56.61,15.3,,45.29,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,255.3,69,,,,,0,"fee schedule","69% of total billed charges",370,100,,296.00,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",370,100,,296.00,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",370,100,,296.00,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",139.49,37.7,,111.59,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",288.6,78,,230.88,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",305.62,82.6,,244.50,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",305.62,82.6,,244.50,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.98,100,,,,,0,"fee schedule",EAPG,370,100,,296.00,,,0,"percent of total billed charges","100% of total billed charges",56.61,2526.76,
"11422 Exec Benign Lesion Scalp 1.1 to 2 CM",7901147,CDM,521,RC,11422,CPT,OUTPATIENT,,,457,297.05,,402.16,88,,321.73,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,457,100,,365.60,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1066.24,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287.91,63,,230.33,,,0,"percent of total billed charges","63% of total billed charges",69.92,15.3,,55.94,,,0,"percent of total billed charges","15.3% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,315.33,69,,,,,0,"fee schedule","69% of total billed charges",457,100,,365.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",457,100,,365.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",457,100,,365.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055.89,100,,,,,0,"fee schedule",EAPG,1345.74,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",172.29,37.7,,137.83,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",356.46,78,,285.17,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",377.48,82.6,,301.98,,,0,"percent of total billed charges","82.6% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",377.48,82.6,,301.98,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1195.71,100,,,,,0,"fee schedule",EAPG,457,100,,365.60,,,0,"percent of total billed charges","100% of total billed charges",69.92,5715.97,
"11423 Exc Benign Lesion Scalp 2.1 to 3 CM",7901148,CDM,521,RC,11423,CPT,OUTPATIENT,,,600,390,,528,88,,422.40,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,600,100,,480.00,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1066.24,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",378,63,,302.40,,,0,"percent of total billed charges","63% of total billed charges",91.8,15.3,,73.44,,,0,"percent of total billed charges","15.3% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,414,69,,,,,0,"fee schedule","69% of total billed charges",600,100,,480.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",600,100,,480.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",600,100,,480.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055.89,100,,,,,0,"fee schedule",EAPG,1345.74,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",226.2,37.7,,180.96,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",468,78,,374.40,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",495.6,82.6,,396.48,,,0,"percent of total billed charges","82.6% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",495.6,82.6,,396.48,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1195.71,100,,,,,0,"fee schedule",EAPG,600,100,,480.00,,,0,"percent of total billed charges","100% of total billed charges",91.8,5715.97,
"11424 Exc Benign Lesion Scalp 3.1 to 4 CM",7901149,CDM,521,RC,11424,CPT,OUTPATIENT,,,734,477.1,,645.92,88,,516.74,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,734,100,,587.20,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1066.24,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.42,63,,369.94,,,0,"percent of total billed charges","63% of total billed charges",112.3,15.3,,89.84,,,0,"percent of total billed charges","15.3% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,506.46,69,,,,,0,"fee schedule","69% of total billed charges",734,100,,587.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",734,100,,587.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",734,100,,587.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055.89,100,,,,,0,"fee schedule",EAPG,1345.74,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",276.72,37.7,,221.38,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",572.52,78,,458.02,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",606.28,82.6,,485.02,,,0,"percent of total billed charges","82.6% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",606.28,82.6,,485.02,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1195.71,100,,,,,0,"fee schedule",EAPG,734,100,,587.20,,,0,"percent of total billed charges","100% of total billed charges",112.3,5715.97,
"11426 Exc Benign Lesion Scalp > 4.0 CM",7901150,CDM,521,RC,11426,CPT,OUTPATIENT,,,1037,674.05,,912.56,88,,730.05,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,1037,100,,829.60,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1640.79,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",653.31,63,,522.65,,,0,"percent of total billed charges","63% of total billed charges",158.66,15.3,,126.93,,,0,"percent of total billed charges","15.3% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,715.53,69,,,,,0,"fee schedule","69% of total billed charges",1037,100,,829.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1037,100,,829.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1037,100,,829.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1624.86,100,,,,,0,"fee schedule",EAPG,2070.9,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",390.95,37.7,,312.76,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",808.86,78,,647.09,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",856.56,82.6,,685.25,,,0,"percent of total billed charges","82.6% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",856.56,82.6,,685.25,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.53,100,,,,,0,"fee schedule",EAPG,1037,100,,829.60,,,0,"percent of total billed charges","100% of total billed charges",158.66,9628.23,
"11440 Exc Benign Lesion Face Under 0.5 CM",7901151,CDM,521,RC,11440,CPT,OUTPATIENT,,,343,222.95,,301.84,88,,241.47,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.09,63,,172.87,,,0,"percent of total billed charges","63% of total billed charges",52.48,15.3,,41.98,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,236.67,69,,,,,0,"fee schedule","69% of total billed charges",343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",129.31,37.7,,103.45,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.54,78,,214.03,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.32,82.6,,226.66,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.32,82.6,,226.66,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.98,100,,,,,0,"fee schedule",EAPG,343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",52.48,2526.76,
"11441 Exc Benign Lesion Face 0.6 to 1.0 CM",7901152,CDM,521,RC,11441,CPT,OUTPATIENT,,,430,279.5,,378.4,88,,302.72,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,430,100,,344.00,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.9,63,,216.72,,,0,"percent of total billed charges","63% of total billed charges",65.79,15.3,,52.63,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,296.7,69,,,,,0,"fee schedule","69% of total billed charges",430,100,,344.00,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",430,100,,344.00,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",430,100,,344.00,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",162.11,37.7,,129.69,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.4,78,,268.32,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.18,82.6,,284.14,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.18,82.6,,284.14,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.98,100,,,,,0,"fee schedule",EAPG,430,100,,344.00,,,0,"percent of total billed charges","100% of total billed charges",65.79,2526.76,
"11442 Exc Benign Lesion Face 1.1 to 2.0 CM",7901153,CDM,521,RC,11442,CPT,OUTPATIENT,,,535,347.75,,470.8,88,,376.64,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",337.05,63,,269.64,,,0,"percent of total billed charges","63% of total billed charges",81.86,15.3,,65.49,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,369.15,69,,,,,0,"fee schedule","69% of total billed charges",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",201.7,37.7,,161.36,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",417.3,78,,333.84,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.91,82.6,,353.53,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.91,82.6,,353.53,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.98,100,,,,,0,"fee schedule",EAPG,535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",81.86,2526.76,
"11443 Exc Benign Lesion Face 2.1 to 3.0 CM",7901154,CDM,521,RC,11443,CPT,OUTPATIENT,,,695,451.75,,611.6,88,,489.28,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,695,100,,556.00,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1066.24,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",437.85,63,,350.28,,,0,"percent of total billed charges","63% of total billed charges",106.34,15.3,,85.07,,,0,"percent of total billed charges","15.3% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,479.55,69,,,,,0,"fee schedule","69% of total billed charges",695,100,,556.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",695,100,,556.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",695,100,,556.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055.89,100,,,,,0,"fee schedule",EAPG,1345.74,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",262.02,37.7,,209.62,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",542.1,78,,433.68,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",574.07,82.6,,459.26,,,0,"percent of total billed charges","82.6% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",574.07,82.6,,459.26,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1195.71,100,,,,,0,"fee schedule",EAPG,695,100,,556.00,,,0,"percent of total billed charges","100% of total billed charges",106.34,5715.97,
"11444 Exc Benign Lesion Face 3.1 to 4.0 CM",7901155,CDM,521,RC,11444,CPT,OUTPATIENT,,,908,590.2,,799.04,88,,639.23,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,908,100,,726.40,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1066.24,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",572.04,63,,457.63,,,0,"percent of total billed charges","63% of total billed charges",138.92,15.3,,111.14,,,0,"percent of total billed charges","15.3% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,626.52,69,,,,,0,"fee schedule","69% of total billed charges",908,100,,726.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",908,100,,726.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",908,100,,726.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055.89,100,,,,,0,"fee schedule",EAPG,1345.74,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",342.32,37.7,,273.86,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",708.24,78,,566.59,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",750.01,82.6,,600.01,,,0,"percent of total billed charges","82.6% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",750.01,82.6,,600.01,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1195.71,100,,,,,0,"fee schedule",EAPG,908,100,,726.40,,,0,"percent of total billed charges","100% of total billed charges",138.92,5715.97,
"11446 Exc Benign Lesion Face Over 4.0 CM",7901156,CDM,521,RC,11446,CPT,OUTPATIENT,,,1129,733.85,,993.52,88,,794.82,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,1129,100,,903.20,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1640.79,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",711.27,63,,569.02,,,0,"percent of total billed charges","63% of total billed charges",172.74,15.3,,138.19,,,0,"percent of total billed charges","15.3% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,779.01,69,,,,,0,"fee schedule","69% of total billed charges",1129,100,,903.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1129,100,,903.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1129,100,,903.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1624.86,100,,,,,0,"fee schedule",EAPG,2070.9,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",425.63,37.7,,340.50,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",880.62,78,,704.50,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",932.55,82.6,,746.04,,,0,"percent of total billed charges","82.6% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",932.55,82.6,,746.04,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.53,100,,,,,0,"fee schedule",EAPG,1129,100,,903.20,,,0,"percent of total billed charges","100% of total billed charges",172.74,9628.23,
"11450 Excision of skin/subcutaneous tissue for hid",7961725,CDM,521,RC,11450,CPT,OUTPATIENT,,,585,380.25,,514.8,88,,411.84,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,585,100,,468.00,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1640.79,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",368.55,63,,294.84,,,0,"percent of total billed charges","63% of total billed charges",89.51,15.3,,71.61,,,0,"percent of total billed charges","15.3% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,403.65,69,,,,,0,"fee schedule","69% of total billed charges",585,100,,468.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",585,100,,468.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",585,100,,468.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1624.86,100,,,,,0,"fee schedule",EAPG,2070.9,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",220.55,37.7,,176.44,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",456.3,78,,365.04,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",483.21,82.6,,386.57,,,0,"percent of total billed charges","82.6% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",483.21,82.6,,386.57,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.53,100,,,,,0,"fee schedule",EAPG,585,100,,468.00,,,0,"percent of total billed charges","100% of total billed charges",89.51,9628.23,
"11451 Excision of skin and subcutaneous tissue for",7961963,CDM,521,RC,11451,CPT,OUTPATIENT,,,903,586.95,,794.64,88,,635.71,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,903,100,,722.40,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1640.79,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.89,63,,455.11,,,0,"percent of total billed charges","63% of total billed charges",138.16,15.3,,110.53,,,0,"percent of total billed charges","15.3% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,623.07,69,,,,,0,"fee schedule","69% of total billed charges",903,100,,722.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903,100,,722.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903,100,,722.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1624.86,100,,,,,0,"fee schedule",EAPG,2070.9,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",340.43,37.7,,272.34,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",704.34,78,,563.47,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",745.88,82.6,,596.70,,,0,"percent of total billed charges","82.6% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",745.88,82.6,,596.70,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.53,100,,,,,0,"fee schedule",EAPG,903,100,,722.40,,,0,"percent of total billed charges","100% of total billed charges",138.16,9628.23,
"11462 Excision of skin/subcutaneous tissue for hid",7961726,CDM,521,RC,11462,CPT,OUTPATIENT,,,690,448.5,,607.2,88,,485.76,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,690,100,,552.00,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1640.79,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",434.7,63,,347.76,,,0,"percent of total billed charges","63% of total billed charges",105.57,15.3,,84.46,,,0,"percent of total billed charges","15.3% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,476.1,69,,,,,0,"fee schedule","69% of total billed charges",690,100,,552.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",690,100,,552.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",690,100,,552.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1624.86,100,,,,,0,"fee schedule",EAPG,2070.9,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",260.13,37.7,,208.10,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",538.2,78,,430.56,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",569.94,82.6,,455.95,,,0,"percent of total billed charges","82.6% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",569.94,82.6,,455.95,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.53,100,,,,,0,"fee schedule",EAPG,690,100,,552.00,,,0,"percent of total billed charges","100% of total billed charges",105.57,9628.23,
"11463 Excision of skin/subcutaneous tissue for hid",7962310,CDM,521,RC,11463,CPT,OUTPATIENT,,,933,606.45,,821.04,88,,656.83,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,933,100,,746.40,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1640.79,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",587.79,63,,470.23,,,0,"percent of total billed charges","63% of total billed charges",142.75,15.3,,114.20,,,0,"percent of total billed charges","15.3% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,643.77,69,,,,,0,"fee schedule","69% of total billed charges",933,100,,746.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",933,100,,746.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",933,100,,746.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1624.86,100,,,,,0,"fee schedule",EAPG,2070.9,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",351.74,37.7,,281.39,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",727.74,78,,582.19,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.66,82.6,,616.53,,,0,"percent of total billed charges","82.6% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.66,82.6,,616.53,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.53,100,,,,,0,"fee schedule",EAPG,933,100,,746.40,,,0,"percent of total billed charges","100% of total billed charges",142.75,9628.23,
"11470 Exc skin/subq tissue for hidradenitis, peria",7961452,CDM,521,RC,11470,CPT,OUTPATIENT,,,955,620.75,,840.4,88,,672.32,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1640.79,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",601.65,63,,481.32,,,0,"percent of total billed charges","63% of total billed charges",146.12,15.3,,116.90,,,0,"percent of total billed charges","15.3% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,658.95,69,,,,,0,"fee schedule","69% of total billed charges",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1624.86,100,,,,,0,"fee schedule",EAPG,2070.9,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",360.04,37.7,,288.03,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",744.9,78,,595.92,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",788.83,82.6,,631.06,,,0,"percent of total billed charges","82.6% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",788.83,82.6,,631.06,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.53,100,,,,,0,"fee schedule",EAPG,955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",146.12,9628.23,
"11600 Exc Malignant Lesion < 0.5 CM",7901157,CDM,521,RC,11600,CPT,OUTPATIENT,,,339,220.35,,298.32,88,,238.66,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",213.57,63,,170.86,,,0,"percent of total billed charges","63% of total billed charges",51.87,15.3,,41.50,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,233.91,69,,,,,0,"fee schedule","69% of total billed charges",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",127.8,37.7,,102.24,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",264.42,78,,211.54,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.01,82.6,,224.01,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.01,82.6,,224.01,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.98,100,,,,,0,"fee schedule",EAPG,339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",51.87,2526.76,
"11601 Exc Malignant Lesion 0.5 to 1.0 CM",7901158,CDM,521,RC,11601,CPT,OUTPATIENT,,,323,209.95,,284.24,88,,227.39,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,323,100,,258.40,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",203.49,63,,162.79,,,0,"percent of total billed charges","63% of total billed charges",49.42,15.3,,39.54,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,222.87,69,,,,,0,"fee schedule","69% of total billed charges",323,100,,258.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",323,100,,258.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",323,100,,258.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",121.77,37.7,,97.42,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",251.94,78,,201.55,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",266.8,82.6,,213.44,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",266.8,82.6,,213.44,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.98,100,,,,,0,"fee schedule",EAPG,323,100,,258.40,,,0,"percent of total billed charges","100% of total billed charges",49.42,2526.76,
"11602 Exc Malignant Lesion 1.1 to 2.0 CM",7901159,CDM,521,RC,11602,CPT,OUTPATIENT,,,488,317.2,,429.44,88,,343.55,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,488,100,,390.40,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.44,63,,245.95,,,0,"percent of total billed charges","63% of total billed charges",74.66,15.3,,59.73,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,336.72,69,,,,,0,"fee schedule","69% of total billed charges",488,100,,390.40,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",488,100,,390.40,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",488,100,,390.40,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",183.98,37.7,,147.18,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",380.64,78,,304.51,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",403.09,82.6,,322.47,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",403.09,82.6,,322.47,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.98,100,,,,,0,"fee schedule",EAPG,488,100,,390.40,,,0,"percent of total billed charges","100% of total billed charges",74.66,1404.97,
"11603 Exc Malignant Lesion 2.1 to 3.0 CM",7901160,CDM,521,RC,11603,CPT,OUTPATIENT,,,584,379.6,,513.92,88,,411.14,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,584,100,,467.20,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.92,63,,294.34,,,0,"percent of total billed charges","63% of total billed charges",89.35,15.3,,71.48,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,402.96,69,,,,,0,"fee schedule","69% of total billed charges",584,100,,467.20,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",584,100,,467.20,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",584,100,,467.20,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",220.17,37.7,,176.14,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",455.52,78,,364.42,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",482.38,82.6,,385.90,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",482.38,82.6,,385.90,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.98,100,,,,,0,"fee schedule",EAPG,584,100,,467.20,,,0,"percent of total billed charges","100% of total billed charges",89.35,2526.76,
"11604 Exc Malignant Lesion 3.1 to 4.0 CM",7901161,CDM,521,RC,11604,CPT,OUTPATIENT,,,698,453.7,,614.24,88,,491.39,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,698,100,,558.40,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",1066.24,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",439.74,63,,351.79,,,0,"percent of total billed charges","63% of total billed charges",106.79,15.3,,85.43,,,0,"percent of total billed charges","15.3% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,481.62,69,,,,,0,"fee schedule","69% of total billed charges",698,100,,558.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",698,100,,558.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",698,100,,558.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055.89,100,,,,,0,"fee schedule",EAPG,1345.74,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",263.15,37.7,,210.52,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",544.44,78,,435.55,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",576.55,82.6,,461.24,,,0,"percent of total billed charges","82.6% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",576.55,82.6,,461.24,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1195.71,100,,,,,0,"fee schedule",EAPG,698,100,,558.40,,,0,"percent of total billed charges","100% of total billed charges",106.79,2526.76,
"11606 Exc Malignant Lesion > 4.0 CM",7901162,CDM,521,RC,11606,CPT,OUTPATIENT,,,957,622.05,,842.16,88,,673.73,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,957,100,,765.60,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1640.79,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",602.91,63,,482.33,,,0,"percent of total billed charges","63% of total billed charges",146.42,15.3,,117.14,,,0,"percent of total billed charges","15.3% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,660.33,69,,,,,0,"fee schedule","69% of total billed charges",957,100,,765.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",957,100,,765.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",957,100,,765.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1624.86,100,,,,,0,"fee schedule",EAPG,2070.9,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",360.79,37.7,,288.63,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",746.46,78,,597.17,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790.48,82.6,,632.38,,,0,"percent of total billed charges","82.6% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790.48,82.6,,632.38,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.53,100,,,,,0,"fee schedule",EAPG,957,100,,765.60,,,0,"percent of total billed charges","100% of total billed charges",146.42,5715.97,
"11620 Exc Malig Lesion Scalp < 0.5 CM",7901163,CDM,521,RC,11620,CPT,OUTPATIENT,,,379,246.35,,333.52,88,,266.82,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,379,100,,303.20,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1066.24,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",238.77,63,,191.02,,,0,"percent of total billed charges","63% of total billed charges",57.99,15.3,,46.39,,,0,"percent of total billed charges","15.3% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,261.51,69,,,,,0,"fee schedule","69% of total billed charges",379,100,,303.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",379,100,,303.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",379,100,,303.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055.89,100,,,,,0,"fee schedule",EAPG,1345.74,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",142.88,37.7,,114.30,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",295.62,78,,236.50,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",313.05,82.6,,250.44,,,0,"percent of total billed charges","82.6% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",313.05,82.6,,250.44,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1195.71,100,,,,,0,"fee schedule",EAPG,379,100,,303.20,,,0,"percent of total billed charges","100% of total billed charges",57.99,5715.97,
"11621 Exc Malig Lesion Scalp 0.6 to 1.0 CM",7901164,CDM,521,RC,11621,CPT,OUTPATIENT,,,481,312.65,,423.28,88,,338.62,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,481,100,,384.80,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",303.03,63,,242.42,,,0,"percent of total billed charges","63% of total billed charges",73.59,15.3,,58.87,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,331.89,69,,,,,0,"fee schedule","69% of total billed charges",481,100,,384.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",481,100,,384.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",481,100,,384.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",181.34,37.7,,145.07,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",375.18,78,,300.14,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397.31,82.6,,317.85,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397.31,82.6,,317.85,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.98,100,,,,,0,"fee schedule",EAPG,481,100,,384.80,,,0,"percent of total billed charges","100% of total billed charges",73.59,2526.76,
"11622 Exc Malig Lesion Scalp 1.1 to 2.0 CM",7901165,CDM,521,RC,11622,CPT,OUTPATIENT,,,570,370.5,,501.6,88,,401.28,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,570,100,,456.00,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",359.1,63,,287.28,,,0,"percent of total billed charges","63% of total billed charges",87.21,15.3,,69.77,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,393.3,69,,,,,0,"fee schedule","69% of total billed charges",570,100,,456.00,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",570,100,,456.00,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",570,100,,456.00,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",214.89,37.7,,171.91,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",444.6,78,,355.68,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",470.82,82.6,,376.66,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",470.82,82.6,,376.66,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.98,100,,,,,0,"fee schedule",EAPG,570,100,,456.00,,,0,"percent of total billed charges","100% of total billed charges",87.21,2526.76,
"11623 Exc Malig Lesion Scalp 2.1 to 3.0 CM",7901166,CDM,521,RC,11623,CPT,OUTPATIENT,,,696,452.4,,612.48,88,,489.98,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,696,100,,556.80,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1066.24,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",438.48,63,,350.78,,,0,"percent of total billed charges","63% of total billed charges",106.49,15.3,,85.19,,,0,"percent of total billed charges","15.3% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,480.24,69,,,,,0,"fee schedule","69% of total billed charges",696,100,,556.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",696,100,,556.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",696,100,,556.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055.89,100,,,,,0,"fee schedule",EAPG,1345.74,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",262.39,37.7,,209.91,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",542.88,78,,434.30,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",574.9,82.6,,459.92,,,0,"percent of total billed charges","82.6% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",574.9,82.6,,459.92,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1195.71,100,,,,,0,"fee schedule",EAPG,696,100,,556.80,,,0,"percent of total billed charges","100% of total billed charges",106.49,5715.97,
"11624 Exc Malig Lesion Scalp 3.1 to 4.0 CM",7901167,CDM,521,RC,11624,CPT,OUTPATIENT,,,799,519.35,,703.12,88,,562.50,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,799,100,,639.20,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1066.24,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",503.37,63,,402.70,,,0,"percent of total billed charges","63% of total billed charges",122.25,15.3,,97.80,,,0,"percent of total billed charges","15.3% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,551.31,69,,,,,0,"fee schedule","69% of total billed charges",799,100,,639.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",799,100,,639.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",799,100,,639.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055.89,100,,,,,0,"fee schedule",EAPG,1345.74,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",301.22,37.7,,240.98,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",623.22,78,,498.58,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",659.97,82.6,,527.98,,,0,"percent of total billed charges","82.6% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",659.97,82.6,,527.98,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1195.71,100,,,,,0,"fee schedule",EAPG,799,100,,639.20,,,0,"percent of total billed charges","100% of total billed charges",122.25,5715.97,
"11626 Exc Malig Lesion Scalp > 4.0 CM",7901168,CDM,521,RC,11626,CPT,OUTPATIENT,,,1136,738.4,,999.68,88,,799.74,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,1136,100,,908.80,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1640.79,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",715.68,63,,572.54,,,0,"percent of total billed charges","63% of total billed charges",173.81,15.3,,139.05,,,0,"percent of total billed charges","15.3% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,783.84,69,,,,,0,"fee schedule","69% of total billed charges",1136,100,,908.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1136,100,,908.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1136,100,,908.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1624.86,100,,,,,0,"fee schedule",EAPG,2070.9,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",428.27,37.7,,342.62,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.08,78,,708.86,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",938.34,82.6,,750.67,,,0,"percent of total billed charges","82.6% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",938.34,82.6,,750.67,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.53,100,,,,,0,"fee schedule",EAPG,1136,100,,908.80,,,0,"percent of total billed charges","100% of total billed charges",173.81,9628.23,
"11640 Exc Malignant Lesion Under 5.0 CM",7901169,CDM,521,RC,11640,CPT,OUTPATIENT,,,476,309.4,,418.88,88,,335.10,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,476,100,,380.80,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",299.88,63,,239.90,,,0,"percent of total billed charges","63% of total billed charges",72.83,15.3,,58.26,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,328.44,69,,,,,0,"fee schedule","69% of total billed charges",476,100,,380.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",476,100,,380.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",476,100,,380.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",179.45,37.7,,143.56,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",371.28,78,,297.02,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",393.18,82.6,,314.54,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",393.18,82.6,,314.54,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.98,100,,,,,0,"fee schedule",EAPG,476,100,,380.80,,,0,"percent of total billed charges","100% of total billed charges",72.83,2526.76,
"11641 Exc Malig Lesion Face 0.6 to 1.0 CM",7901170,CDM,521,RC,11641,CPT,OUTPATIENT,,,604,392.6,,531.52,88,,425.22,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,604,100,,483.20,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",380.52,63,,304.42,,,0,"percent of total billed charges","63% of total billed charges",92.41,15.3,,73.93,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,416.76,69,,,,,0,"fee schedule","69% of total billed charges",604,100,,483.20,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",604,100,,483.20,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",604,100,,483.20,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",227.71,37.7,,182.17,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",471.12,78,,376.90,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",498.9,82.6,,399.12,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",498.9,82.6,,399.12,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.98,100,,,,,0,"fee schedule",EAPG,604,100,,483.20,,,0,"percent of total billed charges","100% of total billed charges",92.41,2526.76,
"11642 Exc Malig Lesion Face 1.1 to 2.0 CM",7901171,CDM,521,RC,11642,CPT,OUTPATIENT,,,703,456.95,,618.64,88,,494.91,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,703,100,,562.40,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",442.89,63,,354.31,,,0,"percent of total billed charges","63% of total billed charges",107.56,15.3,,86.05,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,485.07,69,,,,,0,"fee schedule","69% of total billed charges",703,100,,562.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",703,100,,562.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",703,100,,562.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",265.03,37.7,,212.02,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",548.34,78,,438.67,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",580.68,82.6,,464.54,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",580.68,82.6,,464.54,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.98,100,,,,,0,"fee schedule",EAPG,703,100,,562.40,,,0,"percent of total billed charges","100% of total billed charges",107.56,2526.76,
"11643 Exc Malig Lesion Face 2.1 to 3.0 CM",7901172,CDM,521,RC,11643,CPT,OUTPATIENT,,,838,544.7,,737.44,88,,589.95,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,838,100,,670.40,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1066.24,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",527.94,63,,422.35,,,0,"percent of total billed charges","63% of total billed charges",128.21,15.3,,102.57,,,0,"percent of total billed charges","15.3% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,578.22,69,,,,,0,"fee schedule","69% of total billed charges",838,100,,670.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",838,100,,670.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",838,100,,670.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055.89,100,,,,,0,"fee schedule",EAPG,1345.74,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",315.93,37.7,,252.74,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",653.64,78,,522.91,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",692.19,82.6,,553.75,,,0,"percent of total billed charges","82.6% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",692.19,82.6,,553.75,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1195.71,100,,,,,0,"fee schedule",EAPG,838,100,,670.40,,,0,"percent of total billed charges","100% of total billed charges",128.21,5715.97,
"11644 Exc Malig Lesion Face 3.1 to 4.0 CM",7901173,CDM,521,RC,11644,CPT,OUTPATIENT,,,766,497.9,,674.08,88,,539.26,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,766,100,,612.80,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1066.24,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",482.58,63,,386.06,,,0,"percent of total billed charges","63% of total billed charges",117.2,15.3,,93.76,,,0,"percent of total billed charges","15.3% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,528.54,69,,,,,0,"fee schedule","69% of total billed charges",766,100,,612.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",766,100,,612.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",766,100,,612.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055.89,100,,,,,0,"fee schedule",EAPG,1345.74,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",288.78,37.7,,231.02,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",597.48,78,,477.98,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",632.72,82.6,,506.18,,,0,"percent of total billed charges","82.6% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",632.72,82.6,,506.18,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1195.71,100,,,,,0,"fee schedule",EAPG,766,100,,612.80,,,0,"percent of total billed charges","100% of total billed charges",117.2,5715.97,
"11646 Exc Malig Lesion Face > 4.0 CM",7901174,CDM,521,RC,11646,CPT,OUTPATIENT,,,1111,722.15,,977.68,88,,782.14,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,1111,100,,888.80,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1640.79,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",699.93,63,,559.94,,,0,"percent of total billed charges","63% of total billed charges",169.98,15.3,,135.98,,,0,"percent of total billed charges","15.3% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,766.59,69,,,,,0,"fee schedule","69% of total billed charges",1111,100,,888.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1111,100,,888.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1111,100,,888.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1624.86,100,,,,,0,"fee schedule",EAPG,2070.9,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",418.85,37.7,,335.08,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",866.58,78,,693.26,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",917.69,82.6,,734.15,,,0,"percent of total billed charges","82.6% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",917.69,82.6,,734.15,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.53,100,,,,,0,"fee schedule",EAPG,1111,100,,888.80,,,0,"percent of total billed charges","100% of total billed charges",169.98,9628.23,
"11719 Trimming of Nondystropic Nails",7901175,CDM,521,RC,11719,CPT,OUTPATIENT,,,45,29.25,,39.6,88,,31.68,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",60.86,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",28.35,63,,22.68,,,0,"percent of total billed charges","63% of total billed charges",6.89,15.3,,5.51,,,0,"percent of total billed charges","15.3% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,31.05,69,,,,,0,"fee schedule","69% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60.27,100,,,,,0,"fee schedule",EAPG,76.81,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",16.97,37.7,,13.58,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.1,78,,28.08,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",219.62,100,,,,,0,"fee schedule",EAPG,45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",6.89,226.12,
"11720 Debridement Nail(s) 1 to 5",7901176,CDM,521,RC,11720,CPT,OUTPATIENT,,,62,40.3,,54.56,88,,43.65,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",60.86,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.06,63,,31.25,,,0,"percent of total billed charges","63% of total billed charges",9.49,15.3,,7.59,,,0,"percent of total billed charges","15.3% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,42.78,69,,,,,0,"fee schedule","69% of total billed charges",62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60.27,100,,,,,0,"fee schedule",EAPG,76.81,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",23.37,37.7,,18.70,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",48.36,78,,38.69,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.21,82.6,,40.97,,,0,"percent of total billed charges","82.6% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.21,82.6,,40.97,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",219.62,100,,,,,0,"fee schedule",EAPG,62,100,,49.60,,,0,"percent of total billed charges","100% of total billed charges",9.49,226.12,
"11721 Debridement Nails EA ADDL, 6 or more",7901177,CDM,521,RC,11721,CPT,OUTPATIENT,,,97,63.05,,85.36,88,,68.29,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",60.86,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.11,63,,48.89,,,0,"percent of total billed charges","63% of total billed charges",14.84,15.3,,11.87,,,0,"percent of total billed charges","15.3% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,66.93,69,,,,,0,"fee schedule","69% of total billed charges",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60.27,100,,,,,0,"fee schedule",EAPG,76.81,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",36.57,37.7,,29.26,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75.66,78,,60.53,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.12,82.6,,64.10,,,0,"percent of total billed charges","82.6% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.12,82.6,,64.10,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",219.62,100,,,,,0,"fee schedule",EAPG,97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",14.84,226.12,
"11730 Avulsion Nail Plate Simple Single",7901178,CDM,521,RC,11730,CPT,OUTPATIENT,,,177,115.05,,155.76,88,,124.61,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",60.86,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.51,63,,89.21,,,0,"percent of total billed charges","63% of total billed charges",27.08,15.3,,21.66,,,0,"percent of total billed charges","15.3% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,122.13,69,,,,,0,"fee schedule","69% of total billed charges",177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60.27,100,,,,,0,"fee schedule",EAPG,76.81,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",66.73,37.7,,53.38,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",138.06,78,,110.45,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",146.2,82.6,,116.96,,,0,"percent of total billed charges","82.6% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",146.2,82.6,,116.96,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",219.62,100,,,,,0,"fee schedule",EAPG,177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",27.08,729.42,
"11732 Avulsion Nail Plate Simple EA ADDL",7901179,CDM,521,RC,11732,CPT,OUTPATIENT,,,96,62.4,,84.48,88,,67.58,,,0,"percent of total billed charges","88% of total billed charges",48,50,,38.40,,,0,"percent of total billed charges","50% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.86,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",60.48,63,,48.38,,,0,"percent of total billed charges","63% of total billed charges",14.69,15.3,,11.75,,,0,"percent of total billed charges","15.3% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,66.24,69,,,,,0,"fee schedule","69% of total billed charges",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.38,61.85,,47.50,,,0,"percent of total billed charges","61.5% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",60.27,100,,,,,0,"fee schedule",EAPG,76.81,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.19,37.7,,28.95,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",74.88,78,,59.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,48,50,,38.40,,,0,"percent of total billed charges","50% of total billed charges",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",219.62,100,,,,,0,"fee schedule",EAPG,96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",14.69,219.62,
"11740 Evacuate Subungual Hematoma",7901180,CDM,521,RC,11740,CPT,OUTPATIENT,,,90,58.5,,79.2,88,,63.36,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",60.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",56.7,63,,45.36,,,0,"percent of total billed charges","63% of total billed charges",13.77,15.3,,11.02,,,0,"percent of total billed charges","15.3% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,62.1,69,,,,,0,"fee schedule","69% of total billed charges",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60.27,100,,,,,0,"fee schedule",EAPG,76.81,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",33.93,37.7,,27.14,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",70.2,78,,56.16,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.34,82.6,,59.47,,,0,"percent of total billed charges","82.6% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.34,82.6,,59.47,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",219.62,100,,,,,0,"fee schedule",EAPG,90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",13.77,454.8,
"11750 Exc Nail Matrix Partial or Complete",7901181,CDM,521,RC,11750,CPT,OUTPATIENT,,,535,347.75,,470.8,88,,376.64,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",337.05,63,,269.64,,,0,"percent of total billed charges","63% of total billed charges",81.86,15.3,,65.49,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,369.15,69,,,,,0,"fee schedule","69% of total billed charges",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",201.7,37.7,,161.36,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",417.3,78,,333.84,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.91,82.6,,353.53,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.91,82.6,,353.53,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.98,100,,,,,0,"fee schedule",EAPG,535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",81.86,1404.97,
"11752 Excision of nail and nail matrix, partial/co",7961727,CDM,521,RC,,,OUTPATIENT,,,757,492.05,,666.16,88,,532.93,,,0,"percent of total billed charges","88% of total billed charges",378.5,50,,302.80,,,0,"percent of total billed charges","50% of total billed charges",127.18,16.8,,101.74,,,0,"percent of total billed charges","16.8% of total billed charges",757,100,,605.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",130.99,17.304,,104.79,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",476.91,63,,381.53,,,0,"percent of total billed charges","63% of total billed charges",115.82,15.3,,92.66,,,0,"percent of total billed charges","15.3% of total billed charges",127.18,16.8,,101.74,,,0,"percent of total billed charges","16.8% of total billed charges",522.33,69,,,,,0,"fee schedule","69% of total billed charges",757,100,,605.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",757,100,,605.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",757,100,,605.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",468.2,61.85,,374.56,,,0,"percent of total billed charges","61.5% of total billed charges",127.18,16.8,,101.74,,,0,"percent of total billed charges","16.8% of total billed charges",378.5,50,,302.80,,,0,"percent of total billed charges","50% of total billed charges",243.75,32.2,,195.00,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",129.72,17.136,,103.78,,,0,"percent of total billed charges","17.136% of total billed charges",165.33,21.84,,132.26,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",285.39,37.7,,228.31,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",590.46,78,,472.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",625.28,82.6,,500.22,,,0,"percent of total billed charges","82.6% of total billed charges",127.18,16.8,,101.74,,,0,"percent of total billed charges","16.8% of total billed charges",378.5,50,,302.80,,,0,"percent of total billed charges","50% of total billed charges",625.28,82.6,,500.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",757,100,,605.60,,,0,"percent of total billed charges","100% of total billed charges",115.82,757,
"11760 Repair of Nail Bed",7901183,CDM,521,RC,11760,CPT,OUTPATIENT,,,422,274.3,,371.36,88,,297.09,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",60.86,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.86,63,,212.69,,,0,"percent of total billed charges","63% of total billed charges",64.57,15.3,,51.66,,,0,"percent of total billed charges","15.3% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,291.18,69,,,,,0,"fee schedule","69% of total billed charges",422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60.27,100,,,,,0,"fee schedule",EAPG,76.81,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.09,37.7,,127.27,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",329.16,78,,263.33,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.57,82.6,,278.86,,,0,"percent of total billed charges","82.6% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.57,82.6,,278.86,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",219.62,100,,,,,0,"fee schedule",EAPG,422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",59.09,2129.45,
"11765 Wedge Skin Excision Nail Fold",7901185,CDM,521,RC,11765,CPT,OUTPATIENT,,,191,124.15,,168.08,88,,134.46,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",60.86,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",120.33,63,,96.26,,,0,"percent of total billed charges","63% of total billed charges",29.22,15.3,,23.38,,,0,"percent of total billed charges","15.3% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,131.79,69,,,,,0,"fee schedule","69% of total billed charges",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.09,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60.27,100,,,,,0,"fee schedule",EAPG,76.81,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",72.01,37.7,,57.61,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.98,78,,119.18,,,0,"percent of total billed charges","78% of total billed charges",410.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",157.77,82.6,,126.22,,,0,"percent of total billed charges","82.6% of total billed charges",59.09,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",157.77,82.6,,126.22,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",219.62,100,,,,,0,"fee schedule",EAPG,191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",29.22,1404.98,
"11770 Exc Pilonidal Cyst or Sinus Simple",7901186,CDM,521,RC,11770,CPT,OUTPATIENT,,,814,529.1,,716.32,88,,573.06,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,814,100,,651.20,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1066.24,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.82,63,,410.26,,,0,"percent of total billed charges","63% of total billed charges",124.54,15.3,,99.63,,,0,"percent of total billed charges","15.3% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,561.66,69,,,,,0,"fee schedule","69% of total billed charges",814,100,,651.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",814,100,,651.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",814,100,,651.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055.89,100,,,,,0,"fee schedule",EAPG,1345.74,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",306.88,37.7,,245.50,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",634.92,78,,507.94,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672.36,82.6,,537.89,,,0,"percent of total billed charges","82.6% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672.36,82.6,,537.89,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1195.71,100,,,,,0,"fee schedule",EAPG,814,100,,651.20,,,0,"percent of total billed charges","100% of total billed charges",124.54,9628.23,
"11771 Exc Pilonidal Cyst or Sinus Exten",7901187,CDM,521,RC,11771,CPT,OUTPATIENT,,,1377,895.05,,1211.76,88,,969.41,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,1377,100,,1101.60,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1640.79,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",867.51,63,,694.01,,,0,"percent of total billed charges","63% of total billed charges",210.68,15.3,,168.54,,,0,"percent of total billed charges","15.3% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,950.13,69,,,,,0,"fee schedule","69% of total billed charges",1377,100,,1101.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1377,100,,1101.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1377,100,,1101.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1624.86,100,,,,,0,"fee schedule",EAPG,2070.9,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",519.13,37.7,,415.30,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1074.06,78,,859.25,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1137.4,82.6,,909.92,,,0,"percent of total billed charges","82.6% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1137.4,82.6,,909.92,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.53,100,,,,,0,"fee schedule",EAPG,1377,100,,1101.60,,,0,"percent of total billed charges","100% of total billed charges",210.68,9628.23,
"11772 Exc Pilonidal Cyst or Sinus Compl",7901188,CDM,521,RC,11772,CPT,OUTPATIENT,,,2636,1713.4,,2319.68,88,,1855.74,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,2636,100,,2108.80,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1640.79,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1660.68,63,,1328.54,,,0,"percent of total billed charges","63% of total billed charges",403.31,15.3,,322.65,,,0,"percent of total billed charges","15.3% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,1818.84,69,,,,,0,"fee schedule","69% of total billed charges",2636,100,,2108.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2636,100,,2108.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2636,100,,2108.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1624.86,100,,,,,0,"fee schedule",EAPG,2070.9,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",993.77,37.7,,795.02,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2056.08,78,,1644.86,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2177.34,82.6,,1741.87,,,0,"percent of total billed charges","82.6% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2177.34,82.6,,1741.87,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.53,100,,,,,0,"fee schedule",EAPG,2636,100,,2108.80,,,0,"percent of total billed charges","100% of total billed charges",403.31,9628.23,
"11900 Intralesional Inject, Up to 7 Lesions",7901189,CDM,521,RC,11900,CPT,OUTPATIENT,,,135,87.75,,118.8,88,,95.04,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,135,100,,108.00,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.05,63,,68.04,,,0,"percent of total billed charges","63% of total billed charges",20.66,15.3,,16.53,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,93.15,69,,,,,0,"fee schedule","69% of total billed charges",135,100,,108.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",135,100,,108.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",135,100,,108.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",50.9,37.7,,40.72,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.3,78,,84.24,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.51,82.6,,89.21,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.51,82.6,,89.21,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,135,100,,108.00,,,0,"percent of total billed charges","100% of total billed charges",20.66,729.42,
"11950 Subcutaneous injection of filling material (",7962760,CDM,521,RC,11950,CPT,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule","100% of WA fee schedule",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.98,100,,,,,0,"fee schedule",EAPG,103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,729.41,
"11976 Norplant Removal",7901191,CDM,521,RC,11976,CPT,OUTPATIENT,,,413,268.45,,363.44,88,,290.75,,,0,"percent of total billed charges","88% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,413,100,,330.40,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.19,63,,208.15,,,0,"percent of total billed charges","63% of total billed charges",63.19,15.3,,50.55,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,284.97,69,,,,,0,"fee schedule","69% of total billed charges",413,100,,330.40,,,0,"percent of total billed charges","100% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",413,100,,330.40,,,0,"percent of total billed charges","100% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",413,100,,330.40,,,0,"percent of total billed charges","100% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",155.7,37.7,,124.56,,,0,"percent of total billed charges","37.70% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",322.14,78,,257.71,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",341.14,82.6,,272.91,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",341.14,82.6,,272.91,,,0,"percent of total billed charges","82.6% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.98,100,,,,,0,"fee schedule",EAPG,413,100,,330.40,,,0,"percent of total billed charges","100% of total billed charges",63.19,2526.77,
"11971 Removal of tissue expander(s) without insert",7963064,CDM,521,RC,11971,CPT,OUTPATIENT,,,690,448.5,,607.2,88,,485.76,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,690,100,,552.00,,,0,"percent of total billed charges","100% of total billed charges",5071.88,175,,,,,0,"fee schedule","175% of CMS fee schedule",1298.41,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",434.7,63,,347.76,,,0,"percent of total billed charges","63% of total billed charges",105.57,15.3,,84.46,,,0,"percent of total billed charges","15.3% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,476.1,69,,,,,0,"fee schedule","69% of total billed charges",690,100,,552.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",690,100,,552.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",690,100,,552.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1285.8,100,,,,,0,"fee schedule",EAPG,1638.77,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",260.13,37.7,,208.10,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",538.2,78,,430.56,,,0,"percent of total billed charges","78% of total billed charges",2927.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",569.94,82.6,,455.95,,,0,"percent of total billed charges","82.6% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",569.94,82.6,,455.95,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1421.12,100,,,,,0,"fee schedule",EAPG,690,100,,552.00,,,0,"percent of total billed charges","100% of total billed charges",105.57,9628.24,
"11970 Replacement of tissue expander with permanen",7963238,CDM,521,RC,11970,CPT,OUTPATIENT,,,1327,862.55,,1167.76,88,,934.21,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2917.59,100,,,,,0,"fee schedule",EAPG,1327,100,,1061.60,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",3005.11,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",836.01,63,,668.81,,,0,"percent of total billed charges","63% of total billed charges",203.03,15.3,,162.42,,,0,"percent of total billed charges","15.3% of total billed charges",2917.59,100,,,,,0,"fee schedule",EAPG,915.63,69,,,,,0,"fee schedule","69% of total billed charges",1327,100,,1061.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327,100,,1061.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327,100,,1061.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2917.59,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2975.94,100,,,,,0,"fee schedule",EAPG,3792.86,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",500.28,37.7,,400.22,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.06,78,,828.05,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1096.1,82.6,,876.88,,,0,"percent of total billed charges","82.6% of total billed charges",2917.59,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1096.1,82.6,,876.88,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3078.12,100,,,,,0,"fee schedule",EAPG,1327,100,,1061.60,,,0,"percent of total billed charges","100% of total billed charges",203.03,25451.55,
"11981 Insert Drug Implant Device",7901192,CDM,521,RC,11981,CPT,OUTPATIENT,,,448,291.2,,394.24,88,,315.39,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,448,100,,358.40,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",282.24,63,,225.79,,,0,"percent of total billed charges","63% of total billed charges",68.54,15.3,,54.83,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,309.12,69,,,,,0,"fee schedule","69% of total billed charges",448,100,,358.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",448,100,,358.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",448,100,,358.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",168.9,37.7,,135.12,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",349.44,78,,279.55,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",370.05,82.6,,296.04,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",370.05,82.6,,296.04,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,448,100,,358.40,,,0,"percent of total billed charges","100% of total billed charges",68.54,454.8,
"11982 Remove Drug Implant Device",7901193,CDM,521,RC,11982,CPT,OUTPATIENT,,,493,320.45,,433.84,88,,347.07,,,0,"percent of total billed charges","88% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,493,100,,394.40,,,0,"percent of total billed charges","100% of total billed charges",711.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",310.59,63,,248.47,,,0,"percent of total billed charges","63% of total billed charges",75.43,15.3,,60.34,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,340.17,69,,,,,0,"fee schedule","69% of total billed charges",493,100,,394.40,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",493,100,,394.40,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",493,100,,394.40,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",1097.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",185.86,37.7,,148.69,,,0,"percent of total billed charges","37.70% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",384.54,78,,307.63,,,0,"percent of total billed charges","78% of total billed charges",410.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",407.22,82.6,,325.78,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",407.22,82.6,,325.78,,,0,"percent of total billed charges","82.6% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,493,100,,394.40,,,0,"percent of total billed charges","100% of total billed charges",75.43,1097.77,
"11983 Remove/Insert Drug Implant",7901194,CDM,521,RC,11983,CPT,OUTPATIENT,,,775,503.75,,682,88,,545.60,,,0,"percent of total billed charges","88% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,775,100,,620.00,,,0,"percent of total billed charges","100% of total billed charges",711.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",488.25,63,,390.60,,,0,"percent of total billed charges","63% of total billed charges",118.58,15.3,,94.86,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,534.75,69,,,,,0,"fee schedule","69% of total billed charges",775,100,,620.00,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",775,100,,620.00,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",775,100,,620.00,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",1097.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",292.18,37.7,,233.74,,,0,"percent of total billed charges","37.70% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",604.5,78,,483.60,,,0,"percent of total billed charges","78% of total billed charges",410.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",640.15,82.6,,512.12,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",640.15,82.6,,512.12,,,0,"percent of total billed charges","82.6% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,775,100,,620.00,,,0,"percent of total billed charges","100% of total billed charges",118.58,1097.77,
"11980 Subcutaneous hormone pellet implantation (im",7962140,CDM,521,RC,11980,CPT,OUTPATIENT,,,300,195,,264,88,,211.20,,,0,"percent of total billed charges","88% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,300,100,,240.00,,,0,"percent of total billed charges","100% of total billed charges",711.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189,63,,151.20,,,0,"percent of total billed charges","63% of total billed charges",45.9,15.3,,36.72,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,207,69,,,,,0,"fee schedule","69% of total billed charges",300,100,,240.00,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",300,100,,240.00,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",300,100,,240.00,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",1097.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",113.1,37.7,,90.48,,,0,"percent of total billed charges","37.70% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234,78,,187.20,,,0,"percent of total billed charges","78% of total billed charges",410.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",247.8,82.6,,198.24,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",247.8,82.6,,198.24,,,0,"percent of total billed charges","82.6% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.98,100,,,,,0,"fee schedule",EAPG,300,100,,240.00,,,0,"percent of total billed charges","100% of total billed charges",45.9,1097.77,
"12001 Laceration Repair < 2.5 CM",7901195,CDM,521,RC,12001,CPT,OUTPATIENT,,,164,106.6,,144.32,88,,115.46,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",103.32,63,,82.66,,,0,"percent of total billed charges","63% of total billed charges",25.09,15.3,,20.07,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,113.16,69,,,,,0,"fee schedule","69% of total billed charges",164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",61.83,37.7,,49.46,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",127.92,78,,102.34,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",135.46,82.6,,108.37,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",135.46,82.6,,108.37,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",328.93,100,,,,,0,"fee schedule",EAPG,164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",25.09,729.42,
"12002 Laceration Repair 2.6 to 7.5 CM",7901196,CDM,521,RC,12002,CPT,OUTPATIENT,,,199,129.35,,175.12,88,,140.10,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,199,100,,159.20,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.37,63,,100.30,,,0,"percent of total billed charges","63% of total billed charges",30.45,15.3,,24.36,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,137.31,69,,,,,0,"fee schedule","69% of total billed charges",199,100,,159.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199,100,,159.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199,100,,159.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",75.02,37.7,,60.02,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",155.22,78,,124.18,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",164.37,82.6,,131.50,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",164.37,82.6,,131.50,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",328.93,100,,,,,0,"fee schedule",EAPG,199,100,,159.20,,,0,"percent of total billed charges","100% of total billed charges",30.45,729.42,
"12004 Laceration Repair 7.6 to 12.5 CM",7901197,CDM,521,RC,12004,CPT,OUTPATIENT,,,227,147.55,,199.76,88,,159.81,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",143.01,63,,114.41,,,0,"percent of total billed charges","63% of total billed charges",34.73,15.3,,27.78,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,156.63,69,,,,,0,"fee schedule","69% of total billed charges",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",85.58,37.7,,68.46,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.06,78,,141.65,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",187.5,82.6,,150.00,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",187.5,82.6,,150.00,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",328.93,100,,,,,0,"fee schedule",EAPG,227,100,,181.60,,,0,"percent of total billed charges","100% of total billed charges",34.73,729.42,
"12005 Laceration Repair 12.6 to 20.0 CM",7901198,CDM,521,RC,12005,CPT,OUTPATIENT,,,460,299,,404.8,88,,323.84,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,460,100,,368.00,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.8,63,,231.84,,,0,"percent of total billed charges","63% of total billed charges",70.38,15.3,,56.30,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,317.4,69,,,,,0,"fee schedule","69% of total billed charges",460,100,,368.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460,100,,368.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460,100,,368.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",173.42,37.7,,138.74,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",358.8,78,,287.04,,,0,"percent of total billed charges","78% of total billed charges",410.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",379.96,82.6,,303.97,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",379.96,82.6,,303.97,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",328.93,100,,,,,0,"fee schedule",EAPG,460,100,,368.00,,,0,"percent of total billed charges","100% of total billed charges",70.38,1404.98,
"12006 Laceration repair 20.1 to 30.0 CM",7901199,CDM,521,RC,12006,CPT,OUTPATIENT,,,502,326.3,,441.76,88,,353.41,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",316.26,63,,253.01,,,0,"percent of total billed charges","63% of total billed charges",76.81,15.3,,61.45,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,346.38,69,,,,,0,"fee schedule","69% of total billed charges",502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",189.25,37.7,,151.40,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",391.56,78,,313.25,,,0,"percent of total billed charges","78% of total billed charges",410.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",414.65,82.6,,331.72,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",414.65,82.6,,331.72,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",328.93,100,,,,,0,"fee schedule",EAPG,502,100,,401.60,,,0,"percent of total billed charges","100% of total billed charges",76.81,1404.98,
"12007 Laceration Repair > 30.0 CM",7901200,CDM,521,RC,12007,CPT,OUTPATIENT,,,565,367.25,,497.2,88,,397.76,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,565,100,,452.00,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.95,63,,284.76,,,0,"percent of total billed charges","63% of total billed charges",86.45,15.3,,69.16,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,389.85,69,,,,,0,"fee schedule","69% of total billed charges",565,100,,452.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",565,100,,452.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",565,100,,452.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",213.01,37.7,,170.41,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",440.7,78,,352.56,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",466.69,82.6,,373.35,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",466.69,82.6,,373.35,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",328.93,100,,,,,0,"fee schedule",EAPG,565,100,,452.00,,,0,"percent of total billed charges","100% of total billed charges",86.45,729.41,
"12011 Laceration Repair Face < 2.5 CM",7901201,CDM,521,RC,12011,CPT,OUTPATIENT,,,195,126.75,,171.6,88,,137.28,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,195,100,,156.00,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.85,63,,98.28,,,0,"percent of total billed charges","63% of total billed charges",29.84,15.3,,23.87,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,134.55,69,,,,,0,"fee schedule","69% of total billed charges",195,100,,156.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",195,100,,156.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",195,100,,156.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",73.52,37.7,,58.82,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",152.1,78,,121.68,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",161.07,82.6,,128.86,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",161.07,82.6,,128.86,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",328.93,100,,,,,0,"fee schedule",EAPG,195,100,,156.00,,,0,"percent of total billed charges","100% of total billed charges",29.84,729.42,
"12013 Laceration Repair Face 2.6 to 5.0 CM",7901202,CDM,521,RC,12013,CPT,OUTPATIENT,,,219,142.35,,192.72,88,,154.18,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",137.97,63,,110.38,,,0,"percent of total billed charges","63% of total billed charges",33.51,15.3,,26.81,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,151.11,69,,,,,0,"fee schedule","69% of total billed charges",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",82.56,37.7,,66.05,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",170.82,78,,136.66,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180.89,82.6,,144.71,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180.89,82.6,,144.71,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",328.93,100,,,,,0,"fee schedule",EAPG,219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",33.51,729.42,
"12014 Laceration Repair Face 5.1 to 7.5 CM",7901203,CDM,521,RC,12014,CPT,OUTPATIENT,,,250,162.5,,220,88,,176.00,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,250,100,,200.00,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",157.5,63,,126.00,,,0,"percent of total billed charges","63% of total billed charges",38.25,15.3,,30.60,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,172.5,69,,,,,0,"fee schedule","69% of total billed charges",250,100,,200.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250,100,,200.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250,100,,200.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",94.25,37.7,,75.40,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",195,78,,156.00,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206.5,82.6,,165.20,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206.5,82.6,,165.20,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",328.93,100,,,,,0,"fee schedule",EAPG,250,100,,200.00,,,0,"percent of total billed charges","100% of total billed charges",38.25,729.42,
"12015 Laceration Repair Face 7.6 to 12.5 CM",7901204,CDM,521,RC,12015,CPT,OUTPATIENT,,,531,345.15,,467.28,88,,373.82,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,531,100,,424.80,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",334.53,63,,267.62,,,0,"percent of total billed charges","63% of total billed charges",81.24,15.3,,64.99,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,366.39,69,,,,,0,"fee schedule","69% of total billed charges",531,100,,424.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",531,100,,424.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",531,100,,424.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",200.19,37.7,,160.15,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",414.18,78,,331.34,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",438.61,82.6,,350.89,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",438.61,82.6,,350.89,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",328.93,100,,,,,0,"fee schedule",EAPG,531,100,,424.80,,,0,"percent of total billed charges","100% of total billed charges",81.24,729.42,
"12016 Laceration Repair Face 12.6 to 20.0 CM",7901206,CDM,521,RC,12016,CPT,OUTPATIENT,,,531,345.15,,467.28,88,,373.82,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,531,100,,424.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",334.53,63,,267.62,,,0,"percent of total billed charges","63% of total billed charges",81.24,15.3,,64.99,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,366.39,69,,,,,0,"fee schedule","69% of total billed charges",531,100,,424.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",531,100,,424.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",531,100,,424.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",200.19,37.7,,160.15,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",414.18,78,,331.34,,,0,"percent of total billed charges","78% of total billed charges",410.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",438.61,82.6,,350.89,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",438.61,82.6,,350.89,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",328.93,100,,,,,0,"fee schedule",EAPG,531,100,,424.80,,,0,"percent of total billed charges","100% of total billed charges",81.24,1404.98,
"12017 Laceration Repr Face 20.1 to 30.0 CM",7902022,CDM,521,RC,12017,CPT,OUTPATIENT,,,881,572.65,,775.28,88,,620.22,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,881,100,,704.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",555.03,63,,444.02,,,0,"percent of total billed charges","63% of total billed charges",134.79,15.3,,107.83,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,607.89,69,,,,,0,"fee schedule","69% of total billed charges",881,100,,704.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",881,100,,704.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",881,100,,704.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",332.14,37.7,,265.71,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",687.18,78,,549.74,,,0,"percent of total billed charges","78% of total billed charges",410.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",727.71,82.6,,582.17,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",727.71,82.6,,582.17,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",328.93,100,,,,,0,"fee schedule",EAPG,881,100,,704.80,,,0,"percent of total billed charges","100% of total billed charges",134.79,1404.98,
"12018 Laceration Repair Face > 30.0 CM",7902023,CDM,521,RC,12018,CPT,OUTPATIENT,,,791,514.15,,696.08,88,,556.86,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,791,100,,632.80,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",498.33,63,,398.66,,,0,"percent of total billed charges","63% of total billed charges",121.02,15.3,,96.82,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,545.79,69,,,,,0,"fee schedule","69% of total billed charges",791,100,,632.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",791,100,,632.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",791,100,,632.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",298.21,37.7,,238.57,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.98,78,,493.58,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",653.37,82.6,,522.70,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",653.37,82.6,,522.70,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",328.93,100,,,,,0,"fee schedule",EAPG,791,100,,632.80,,,0,"percent of total billed charges","100% of total billed charges",121.02,791,
"12020 Close Split Wound",7902024,CDM,521,RC,12020,CPT,OUTPATIENT,,,378,245.7,,332.64,88,,266.11,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,378,100,,302.40,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",238.14,63,,190.51,,,0,"percent of total billed charges","63% of total billed charges",57.83,15.3,,46.26,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,260.82,69,,,,,0,"fee schedule","69% of total billed charges",378,100,,302.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",378,100,,302.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",378,100,,302.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",142.51,37.7,,114.01,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.84,78,,235.87,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",312.23,82.6,,249.78,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",312.23,82.6,,249.78,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.26,100,,,,,0,"fee schedule",EAPG,378,100,,302.40,,,0,"percent of total billed charges","100% of total billed charges",57.83,2129.45,
"12021 Close Split Wound W/ Packing",7902025,CDM,521,RC,12021,CPT,OUTPATIENT,,,333,216.45,,293.04,88,,234.43,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,333,100,,266.40,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",209.79,63,,167.83,,,0,"percent of total billed charges","63% of total billed charges",50.95,15.3,,40.76,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,229.77,69,,,,,0,"fee schedule","69% of total billed charges",333,100,,266.40,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",333,100,,266.40,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",333,100,,266.40,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",125.54,37.7,,100.43,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",259.74,78,,207.79,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",275.06,82.6,,220.05,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",275.06,82.6,,220.05,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.26,100,,,,,0,"fee schedule",EAPG,333,100,,266.40,,,0,"percent of total billed charges","100% of total billed charges",50.95,1404.97,
"12031 Layered Wound Repair < 2.5 CM",7902026,CDM,521,RC,12031,CPT,OUTPATIENT,,,687,446.55,,604.56,88,,483.65,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,687,100,,549.60,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",432.81,63,,346.25,,,0,"percent of total billed charges","63% of total billed charges",105.11,15.3,,84.09,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,474.03,69,,,,,0,"fee schedule","69% of total billed charges",687,100,,549.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",687,100,,549.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",687,100,,549.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",259,37.7,,207.20,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",535.86,78,,428.69,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",567.46,82.6,,453.97,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",567.46,82.6,,453.97,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.26,100,,,,,0,"fee schedule",EAPG,687,100,,549.60,,,0,"percent of total billed charges","100% of total billed charges",105.11,1404.97,
"12032 Layered Wound Repair 2.6 to 7.5 CM",7902027,CDM,521,RC,12032,CPT,OUTPATIENT,,,536,348.4,,471.68,88,,377.34,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",337.68,63,,270.14,,,0,"percent of total billed charges","63% of total billed charges",82.01,15.3,,65.61,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,369.84,69,,,,,0,"fee schedule","69% of total billed charges",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",202.07,37.7,,161.66,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.08,78,,334.46,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",442.74,82.6,,354.19,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.26,100,,,,,0,"fee schedule",EAPG,536,100,,428.80,,,0,"percent of total billed charges","100% of total billed charges",82.01,1404.97,
"12034 Layered Wound Repair 7.6 to 12.5 CM",7902028,CDM,521,RC,12034,CPT,OUTPATIENT,,,551,358.15,,484.88,88,,387.90,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",347.13,63,,277.70,,,0,"percent of total billed charges","63% of total billed charges",84.3,15.3,,67.44,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,380.19,69,,,,,0,"fee schedule","69% of total billed charges",551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",207.73,37.7,,166.18,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",429.78,78,,343.82,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",455.13,82.6,,364.10,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",455.13,82.6,,364.10,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.26,100,,,,,0,"fee schedule",EAPG,551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",84.3,1404.97,
"12035 Layered Wound Repair 12.6 to 20.0 CM",7902029,CDM,521,RC,12035,CPT,OUTPATIENT,,,809,525.85,,711.92,88,,569.54,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509.67,63,,407.74,,,0,"percent of total billed charges","63% of total billed charges",123.78,15.3,,99.02,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,558.21,69,,,,,0,"fee schedule","69% of total billed charges",809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",304.99,37.7,,243.99,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",631.02,78,,504.82,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",668.23,82.6,,534.58,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",668.23,82.6,,534.58,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.26,100,,,,,0,"fee schedule",EAPG,809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",123.78,1404.97,
"12036 Layered Wound Repair 20.1 to 30.0 CM",7902030,CDM,521,RC,12036,CPT,OUTPATIENT,,,796,517.4,,700.48,88,,560.38,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,796,100,,636.80,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",501.48,63,,401.18,,,0,"percent of total billed charges","63% of total billed charges",121.79,15.3,,97.43,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,549.24,69,,,,,0,"fee schedule","69% of total billed charges",796,100,,636.80,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",796,100,,636.80,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",796,100,,636.80,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",300.09,37.7,,240.07,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",620.88,78,,496.70,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",657.5,82.6,,526.00,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",657.5,82.6,,526.00,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.26,100,,,,,0,"fee schedule",EAPG,796,100,,636.80,,,0,"percent of total billed charges","100% of total billed charges",121.79,2129.45,
"12037 Layered Wound Repair > 30 CM",7902031,CDM,521,RC,12037,CPT,OUTPATIENT,,,938,609.7,,825.44,88,,660.35,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,938,100,,750.40,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",590.94,63,,472.75,,,0,"percent of total billed charges","63% of total billed charges",143.51,15.3,,114.81,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,647.22,69,,,,,0,"fee schedule","69% of total billed charges",938,100,,750.40,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",938,100,,750.40,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",938,100,,750.40,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",353.63,37.7,,282.90,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",731.64,78,,585.31,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",774.79,82.6,,619.83,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",774.79,82.6,,619.83,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.26,100,,,,,0,"fee schedule",EAPG,938,100,,750.40,,,0,"percent of total billed charges","100% of total billed charges",143.51,6968.7,
"12041 Layer Wound Repair Neck/HF/G < 2.5CM",7902032,CDM,521,RC,12041,CPT,OUTPATIENT,,,427,277.55,,375.76,88,,300.61,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",269.01,63,,215.21,,,0,"percent of total billed charges","63% of total billed charges",65.33,15.3,,52.26,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,294.63,69,,,,,0,"fee schedule","69% of total billed charges",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",160.98,37.7,,128.78,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",333.06,78,,266.45,,,0,"percent of total billed charges","78% of total billed charges",410.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352.7,82.6,,282.16,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352.7,82.6,,282.16,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.26,100,,,,,0,"fee schedule",EAPG,427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",65.33,1404.98,
"12042 Layer Wound Repair Neck/HF/G 2.6 to 7.5 CM",7902033,CDM,521,RC,12042,CPT,OUTPATIENT,,,509,330.85,,447.92,88,,358.34,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320.67,63,,256.54,,,0,"percent of total billed charges","63% of total billed charges",77.88,15.3,,62.30,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,351.21,69,,,,,0,"fee schedule","69% of total billed charges",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",191.89,37.7,,153.51,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397.02,78,,317.62,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.43,82.6,,336.34,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.43,82.6,,336.34,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.26,100,,,,,0,"fee schedule",EAPG,509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",77.88,1404.97,
"12044 Layer Wound Repair Neck/HF/G 7.6 to 12.5 CM",7902034,CDM,521,RC,12044,CPT,OUTPATIENT,,,637,414.05,,560.56,88,,448.45,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,637,100,,509.60,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.31,63,,321.05,,,0,"percent of total billed charges","63% of total billed charges",97.46,15.3,,77.97,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,439.53,69,,,,,0,"fee schedule","69% of total billed charges",637,100,,509.60,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",637,100,,509.60,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",637,100,,509.60,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.15,37.7,,192.12,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",496.86,78,,397.49,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",526.16,82.6,,420.93,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",526.16,82.6,,420.93,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.26,100,,,,,0,"fee schedule",EAPG,637,100,,509.60,,,0,"percent of total billed charges","100% of total billed charges",97.46,2129.45,
"12045 Layer Wound Repair Neck/HF/G 12.6 -to 20.0 C",7902035,CDM,521,RC,12045,CPT,OUTPATIENT,,,621,403.65,,546.48,88,,437.18,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,621,100,,496.80,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",391.23,63,,312.98,,,0,"percent of total billed charges","63% of total billed charges",95.01,15.3,,76.01,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,428.49,69,,,,,0,"fee schedule","69% of total billed charges",621,100,,496.80,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",621,100,,496.80,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",621,100,,496.80,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",234.12,37.7,,187.30,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",484.38,78,,387.50,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.95,82.6,,410.36,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.95,82.6,,410.36,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.26,100,,,,,0,"fee schedule",EAPG,621,100,,496.80,,,0,"percent of total billed charges","100% of total billed charges",95.01,2129.45,
"12046 Layer Wound Repair Neck/HF/G 20.1 to 30.0 CM",7902036,CDM,521,RC,12046,CPT,OUTPATIENT,,,908,590.2,,799.04,88,,639.23,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,908,100,,726.40,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",572.04,63,,457.63,,,0,"percent of total billed charges","63% of total billed charges",138.92,15.3,,111.14,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,626.52,69,,,,,0,"fee schedule","69% of total billed charges",908,100,,726.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",908,100,,726.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",908,100,,726.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",342.32,37.7,,273.86,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",708.24,78,,566.59,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",750.01,82.6,,600.01,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",750.01,82.6,,600.01,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.26,100,,,,,0,"fee schedule",EAPG,908,100,,726.40,,,0,"percent of total billed charges","100% of total billed charges",138.92,2129.45,
"12047 Layer Wound Repair Neck/HF/G > 30 CM",7902037,CDM,521,RC,12047,CPT,OUTPATIENT,,,929,603.85,,817.52,88,,654.02,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,929,100,,743.20,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",585.27,63,,468.22,,,0,"percent of total billed charges","63% of total billed charges",142.14,15.3,,113.71,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,641.01,69,,,,,0,"fee schedule","69% of total billed charges",929,100,,743.20,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",929,100,,743.20,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",929,100,,743.20,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",350.23,37.7,,280.18,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",724.62,78,,579.70,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",767.35,82.6,,613.88,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",767.35,82.6,,613.88,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.26,100,,,,,0,"fee schedule",EAPG,929,100,,743.20,,,0,"percent of total billed charges","100% of total billed charges",142.14,6968.7,
"12052 Layered Wound Rep Face 2.6 to 5.0 CM",7901205,CDM,521,RC,12052,CPT,OUTPATIENT,,,519,337.35,,456.72,88,,365.38,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,519,100,,415.20,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",326.97,63,,261.58,,,0,"percent of total billed charges","63% of total billed charges",79.41,15.3,,63.53,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,358.11,69,,,,,0,"fee schedule","69% of total billed charges",519,100,,415.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",519,100,,415.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",519,100,,415.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",195.66,37.7,,156.53,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",404.82,78,,323.86,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",428.69,82.6,,342.95,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",428.69,82.6,,342.95,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.26,100,,,,,0,"fee schedule",EAPG,519,100,,415.20,,,0,"percent of total billed charges","100% of total billed charges",79.41,1404.97,
"12051 Layered Wound Rep Face < 2.5 CM",7902038,CDM,521,RC,12051,CPT,OUTPATIENT,,,501,325.65,,440.88,88,,352.70,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,501,100,,400.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",315.63,63,,252.50,,,0,"percent of total billed charges","63% of total billed charges",76.65,15.3,,61.32,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,345.69,69,,,,,0,"fee schedule","69% of total billed charges",501,100,,400.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",501,100,,400.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",501,100,,400.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",188.88,37.7,,151.10,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.78,78,,312.62,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",413.83,82.6,,331.06,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",413.83,82.6,,331.06,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.26,100,,,,,0,"fee schedule",EAPG,501,100,,400.80,,,0,"percent of total billed charges","100% of total billed charges",76.65,1404.97,
"12053 Layer Wound Repair Face 5.1 to 7.5 CM",7902039,CDM,521,RC,12053,CPT,OUTPATIENT,,,719,467.35,,632.72,88,,506.18,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,719,100,,575.20,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",452.97,63,,362.38,,,0,"percent of total billed charges","63% of total billed charges",110.01,15.3,,88.01,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,496.11,69,,,,,0,"fee schedule","69% of total billed charges",719,100,,575.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",719,100,,575.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",719,100,,575.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",271.06,37.7,,216.85,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.82,78,,448.66,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.89,82.6,,475.11,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.89,82.6,,475.11,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.26,100,,,,,0,"fee schedule",EAPG,719,100,,575.20,,,0,"percent of total billed charges","100% of total billed charges",110.01,1404.97,
"12054 Layer Wound Repair Face 7.6 to 12.5 CM",7902040,CDM,521,RC,12054,CPT,OUTPATIENT,,,652,423.8,,573.76,88,,459.01,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,652,100,,521.60,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.76,63,,328.61,,,0,"percent of total billed charges","63% of total billed charges",99.76,15.3,,79.81,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,449.88,69,,,,,0,"fee schedule","69% of total billed charges",652,100,,521.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652,100,,521.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652,100,,521.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",245.8,37.7,,196.64,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",508.56,78,,406.85,,,0,"percent of total billed charges","78% of total billed charges",410.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",538.55,82.6,,430.84,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",538.55,82.6,,430.84,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.26,100,,,,,0,"fee schedule",EAPG,652,100,,521.60,,,0,"percent of total billed charges","100% of total billed charges",99.76,1404.98,
"12055 Layer Wound Repair Face 12.6 to 20.0 CM",7902041,CDM,521,RC,12055,CPT,OUTPATIENT,,,657,427.05,,578.16,88,,462.53,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,657,100,,525.60,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",413.91,63,,331.13,,,0,"percent of total billed charges","63% of total billed charges",100.52,15.3,,80.42,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,453.33,69,,,,,0,"fee schedule","69% of total billed charges",657,100,,525.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",657,100,,525.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",657,100,,525.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",247.69,37.7,,198.15,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.46,78,,409.97,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",542.68,82.6,,434.14,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",542.68,82.6,,434.14,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.26,100,,,,,0,"fee schedule",EAPG,657,100,,525.60,,,0,"percent of total billed charges","100% of total billed charges",100.52,1404.97,
"12056 Layer Wound Repair Face 20.1 to 30 CM",7902051,CDM,521,RC,12056,CPT,OUTPATIENT,,,1144,743.6,,1006.72,88,,805.38,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,1144,100,,915.20,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",720.72,63,,576.58,,,0,"percent of total billed charges","63% of total billed charges",175.03,15.3,,140.02,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,789.36,69,,,,,0,"fee schedule","69% of total billed charges",1144,100,,915.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1144,100,,915.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1144,100,,915.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",431.29,37.7,,345.03,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.32,78,,713.86,,,0,"percent of total billed charges","78% of total billed charges",410.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",944.94,82.6,,755.95,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",944.94,82.6,,755.95,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.26,100,,,,,0,"fee schedule",EAPG,1144,100,,915.20,,,0,"percent of total billed charges","100% of total billed charges",175.03,1404.98,
"12057 Repair, intermediate, wounds of face/ears/ey",7961453,CDM,521,RC,12057,CPT,OUTPATIENT,,,1056,686.4,,929.28,88,,743.42,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.28,63,,532.22,,,0,"percent of total billed charges","63% of total billed charges",161.57,15.3,,129.26,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,728.64,69,,,,,0,"fee schedule","69% of total billed charges",1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",398.11,37.7,,318.49,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",823.68,78,,658.94,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",872.26,82.6,,697.81,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",872.26,82.6,,697.81,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.26,100,,,,,0,"fee schedule",EAPG,1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",161.57,1404.97,
"13101 Repair Complex Trunk 2.6 to 7.5 CM",7902052,CDM,521,RC,13101,CPT,OUTPATIENT,,,721,468.65,,634.48,88,,507.58,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",454.23,63,,363.38,,,0,"percent of total billed charges","63% of total billed charges",110.31,15.3,,88.25,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,497.49,69,,,,,0,"fee schedule","69% of total billed charges",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",271.82,37.7,,217.46,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",562.38,78,,449.90,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",595.55,82.6,,476.44,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",595.55,82.6,,476.44,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.98,100,,,,,0,"fee schedule",EAPG,721,100,,576.80,,,0,"percent of total billed charges","100% of total billed charges",110.31,2129.45,
"13102 Repair Complex Trunk EA addl 5 CM",7902053,CDM,521,RC,13102,CPT,OUTPATIENT,,,219,142.35,,192.72,88,,154.18,,,0,"percent of total billed charges","88% of total billed charges",109.5,50,,87.60,,,0,"percent of total billed charges","50% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",413.49,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",137.97,63,,110.38,,,0,"percent of total billed charges","63% of total billed charges",33.51,15.3,,26.81,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,151.11,69,,,,,0,"fee schedule","69% of total billed charges",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",135.45,61.85,,108.36,,,0,"percent of total billed charges","61.5% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",82.56,37.7,,66.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",170.82,78,,136.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",180.89,82.6,,144.71,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,109.5,50,,87.60,,,0,"percent of total billed charges","50% of total billed charges",180.89,82.6,,144.71,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",561.98,100,,,,,0,"fee schedule",EAPG,219,100,,175.20,,,0,"percent of total billed charges","100% of total billed charges",33.51,561.98,
"13100 Repair Complex Trunk 1.1 to 2.5 CM",7903073,CDM,521,RC,13100,CPT,OUTPATIENT,,,530,344.5,,466.4,88,,373.12,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,530,100,,424.00,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",333.9,63,,267.12,,,0,"percent of total billed charges","63% of total billed charges",81.09,15.3,,64.87,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,365.7,69,,,,,0,"fee schedule","69% of total billed charges",530,100,,424.00,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",530,100,,424.00,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",530,100,,424.00,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",199.81,37.7,,159.85,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",413.4,78,,330.72,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",437.78,82.6,,350.22,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",437.78,82.6,,350.22,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.98,100,,,,,0,"fee schedule",EAPG,530,100,,424.00,,,0,"percent of total billed charges","100% of total billed charges",81.09,2129.45,
"13120 Repair Complex Scalp 1.1 to 2.5 CM",7902054,CDM,521,RC,13120,CPT,OUTPATIENT,,,634,412.1,,557.92,88,,446.34,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,634,100,,507.20,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",399.42,63,,319.54,,,0,"percent of total billed charges","63% of total billed charges",97,15.3,,77.60,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,437.46,69,,,,,0,"fee schedule","69% of total billed charges",634,100,,507.20,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",634,100,,507.20,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",634,100,,507.20,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",239.02,37.7,,191.22,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",494.52,78,,395.62,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",523.68,82.6,,418.94,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",523.68,82.6,,418.94,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.98,100,,,,,0,"fee schedule",EAPG,634,100,,507.20,,,0,"percent of total billed charges","100% of total billed charges",97,2129.45,
"13122 Repair Complex Scalp EA ADDL 5 CM",7903055,CDM,521,RC,13122,CPT,OUTPATIENT,,,325,211.25,,286,88,,228.80,,,0,"percent of total billed charges","88% of total billed charges",162.5,50,,130.00,,,0,"percent of total billed charges","50% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,325,100,,260.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",413.49,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",204.75,63,,163.80,,,0,"percent of total billed charges","63% of total billed charges",49.73,15.3,,39.78,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,224.25,69,,,,,0,"fee schedule","69% of total billed charges",325,100,,260.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",325,100,,260.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",325,100,,260.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201.01,61.85,,160.81,,,0,"percent of total billed charges","61.5% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",122.53,37.7,,98.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",253.5,78,,202.80,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",268.45,82.6,,214.76,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,162.5,50,,130.00,,,0,"percent of total billed charges","50% of total billed charges",268.45,82.6,,214.76,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",561.98,100,,,,,0,"fee schedule",EAPG,325,100,,260.00,,,0,"percent of total billed charges","100% of total billed charges",49.73,561.98,
"13121 Repair Complex Scalp 2.6 to 7.5 CM",7903074,CDM,521,RC,13121,CPT,OUTPATIENT,,,867,563.55,,762.96,88,,610.37,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,867,100,,693.60,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",546.21,63,,436.97,,,0,"percent of total billed charges","63% of total billed charges",132.65,15.3,,106.12,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,598.23,69,,,,,0,"fee schedule","69% of total billed charges",867,100,,693.60,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",867,100,,693.60,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",867,100,,693.60,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",326.86,37.7,,261.49,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",676.26,78,,541.01,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",716.14,82.6,,572.91,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",716.14,82.6,,572.91,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.98,100,,,,,0,"fee schedule",EAPG,867,100,,693.60,,,0,"percent of total billed charges","100% of total billed charges",132.65,2129.45,
"13131 Repr Comp Face/NCK/HF/G 1.1 to 2.5 CM",7903075,CDM,521,RC,13131,CPT,OUTPATIENT,,,791,514.15,,696.08,88,,556.86,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,791,100,,632.80,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",498.33,63,,398.66,,,0,"percent of total billed charges","63% of total billed charges",121.02,15.3,,96.82,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,545.79,69,,,,,0,"fee schedule","69% of total billed charges",791,100,,632.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",791,100,,632.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",791,100,,632.80,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",298.21,37.7,,238.57,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.98,78,,493.58,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",653.37,82.6,,522.70,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",653.37,82.6,,522.70,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.98,100,,,,,0,"fee schedule",EAPG,791,100,,632.80,,,0,"percent of total billed charges","100% of total billed charges",121.02,1404.97,
"13132 Repr Comp Face/NCK/HF/G 2.6 to 7.5 CM",7903076,CDM,521,RC,13132,CPT,OUTPATIENT,,,840,546,,739.2,88,,591.36,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,840,100,,672.00,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",529.2,63,,423.36,,,0,"percent of total billed charges","63% of total billed charges",128.52,15.3,,102.82,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,579.6,69,,,,,0,"fee schedule","69% of total billed charges",840,100,,672.00,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",840,100,,672.00,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",840,100,,672.00,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",316.68,37.7,,253.34,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",655.2,78,,524.16,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",693.84,82.6,,555.07,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",693.84,82.6,,555.07,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.98,100,,,,,0,"fee schedule",EAPG,840,100,,672.00,,,0,"percent of total billed charges","100% of total billed charges",128.52,2129.45,
"13133 Repair Comp Face/NCK/HF/G EA ADD 5CM",7903077,CDM,521,RC,13133,CPT,OUTPATIENT,,,518,336.7,,455.84,88,,364.67,,,0,"percent of total billed charges","88% of total billed charges",259,50,,207.20,,,0,"percent of total billed charges","50% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,518,100,,414.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",413.49,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",326.34,63,,261.07,,,0,"percent of total billed charges","63% of total billed charges",79.25,15.3,,63.40,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,357.42,69,,,,,0,"fee schedule","69% of total billed charges",518,100,,414.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",518,100,,414.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",518,100,,414.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",320.38,61.85,,256.30,,,0,"percent of total billed charges","61.5% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",195.29,37.7,,156.23,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",404.04,78,,323.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",427.87,82.6,,342.30,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,259,50,,207.20,,,0,"percent of total billed charges","50% of total billed charges",427.87,82.6,,342.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",561.98,100,,,,,0,"fee schedule",EAPG,518,100,,414.40,,,0,"percent of total billed charges","100% of total billed charges",79.25,561.98,
"13153 Repr Comp Eye/Nose/Ear/LP Ea ADD 5 CM",7903056,CDM,521,RC,13153,CPT,OUTPATIENT,,,554,360.1,,487.52,88,,390.02,,,0,"percent of total billed charges","88% of total billed charges",277,50,,221.60,,,0,"percent of total billed charges","50% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,554,100,,443.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1066.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",349.02,63,,279.22,,,0,"percent of total billed charges","63% of total billed charges",84.76,15.3,,67.81,,,0,"percent of total billed charges","15.3% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,382.26,69,,,,,0,"fee schedule","69% of total billed charges",554,100,,443.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",554,100,,443.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",554,100,,443.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",342.65,61.85,,274.12,,,0,"percent of total billed charges","61.5% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1055.89,100,,,,,0,"fee schedule",EAPG,1345.74,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",208.86,37.7,,167.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",432.12,78,,345.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",457.6,82.6,,366.08,,,0,"percent of total billed charges","82.6% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,277,50,,221.60,,,0,"percent of total billed charges","50% of total billed charges",457.6,82.6,,366.08,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1195.71,100,,,,,0,"fee schedule",EAPG,554,100,,443.20,,,0,"percent of total billed charges","100% of total billed charges",84.76,1345.74,
"13151 Repr Comp Eye/Nose/Ear/Lip 1.1 to 2.5 CM",7903078,CDM,521,RC,13151,CPT,OUTPATIENT,,,928,603.2,,816.64,88,,653.31,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,928,100,,742.40,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",584.64,63,,467.71,,,0,"percent of total billed charges","63% of total billed charges",141.98,15.3,,113.58,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,640.32,69,,,,,0,"fee schedule","69% of total billed charges",928,100,,742.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",928,100,,742.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",928,100,,742.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",349.86,37.7,,279.89,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",723.84,78,,579.07,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",766.53,82.6,,613.22,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",766.53,82.6,,613.22,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.98,100,,,,,0,"fee schedule",EAPG,928,100,,742.40,,,0,"percent of total billed charges","100% of total billed charges",141.98,2129.45,
"13152 Repr Comp Eye/Nose/Ear/Lip 2.6 to 7.5 CM",7903079,CDM,521,RC,13152,CPT,OUTPATIENT,,,1388,902.2,,1221.44,88,,977.15,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,1388,100,,1110.40,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.44,63,,699.55,,,0,"percent of total billed charges","63% of total billed charges",212.36,15.3,,169.89,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,957.72,69,,,,,0,"fee schedule","69% of total billed charges",1388,100,,1110.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1388,100,,1110.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1388,100,,1110.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",523.28,37.7,,418.62,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1082.64,78,,866.11,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1146.49,82.6,,917.19,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1146.49,82.6,,917.19,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.98,100,,,,,0,"fee schedule",EAPG,1388,100,,1110.40,,,0,"percent of total billed charges","100% of total billed charges",212.36,2129.45,
"13150 repair of wound or lesion",7963834,CDM,521,RC,13150,CPT,OUTPATIENT,,,763,495.95,,671.44,88,,537.15,,,0,"percent of total billed charges","88% of total billed charges",381.5,50,,305.20,,,0,"percent of total billed charges","50% of total billed charges",128.18,16.8,,102.54,,,0,"percent of total billed charges","16.8% of total billed charges",763,100,,610.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",132.03,17.304,,105.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",480.69,63,,384.55,,,0,"percent of total billed charges","63% of total billed charges",116.74,15.3,,93.39,,,0,"percent of total billed charges","15.3% of total billed charges",128.18,16.8,,102.54,,,0,"percent of total billed charges","16.8% of total billed charges",526.47,69,,,,,0,"fee schedule","69% of total billed charges",763,100,,610.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",763,100,,610.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",763,100,,610.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",471.92,61.85,,377.54,,,0,"percent of total billed charges","61.5% of total billed charges",128.18,16.8,,102.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",130.75,17.136,,104.60,,,0,"percent of total billed charges","17.136% of total billed charges",166.64,21.84,,133.31,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",287.65,37.7,,230.12,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",595.14,78,,476.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",630.24,82.6,,504.19,,,0,"percent of total billed charges","82.6% of total billed charges",128.18,16.8,,102.54,,,0,"percent of total billed charges","16.8% of total billed charges",381.5,50,,305.20,,,0,"percent of total billed charges","50% of total billed charges",630.24,82.6,,504.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",763,100,,610.40,,,0,"percent of total billed charges","100% of total billed charges",116.74,763,
"13160 Late Closure Wound",7903057,CDM,521,RC,13160,CPT,OUTPATIENT,,,1702,1106.3,,1497.76,88,,1198.21,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.83,100,,,,,0,"fee schedule",EAPG,1702,100,,1361.60,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",930.95,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1072.26,63,,857.81,,,0,"percent of total billed charges","63% of total billed charges",260.41,15.3,,208.33,,,0,"percent of total billed charges","15.3% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,1174.38,69,,,,,0,"fee schedule","69% of total billed charges",1702,100,,1361.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1702,100,,1361.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1702,100,,1361.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.83,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",921.91,100,,,,,0,"fee schedule",EAPG,1174.99,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",641.65,37.7,,513.32,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.56,78,,1062.05,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1405.85,82.6,,1124.68,,,0,"percent of total billed charges","82.6% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1405.85,82.6,,1124.68,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1064.36,100,,,,,0,"fee schedule",EAPG,1702,100,,1361.60,,,0,"percent of total billed charges","100% of total billed charges",260.41,6968.7,
"14000 Adj TIS Trans Trunk < 10 SQ CM",7903058,CDM,521,RC,14000,CPT,OUTPATIENT,,,1809,1175.85,,1591.92,88,,1273.54,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,1809,100,,1447.20,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1817.34,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1139.67,63,,911.74,,,0,"percent of total billed charges","63% of total billed charges",276.78,15.3,,221.42,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1248.21,69,,,,,0,"fee schedule","69% of total billed charges",1809,100,,1447.20,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1809,100,,1447.20,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1809,100,,1447.20,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",681.99,37.7,,545.59,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1411.02,78,,1128.82,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.23,82.6,,1195.38,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.23,82.6,,1195.38,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1924.93,100,,,,,0,"fee schedule",EAPG,1809,100,,1447.20,,,0,"percent of total billed charges","100% of total billed charges",276.78,6968.7,
"14001 Adjacent tissue transfer or rearrangement, t",7962435,CDM,521,RC,14001,CPT,OUTPATIENT,,,1910,1241.5,,1680.8,88,,1344.64,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,1910,100,,1528.00,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1817.34,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1203.3,63,,962.64,,,0,"percent of total billed charges","63% of total billed charges",292.23,15.3,,233.78,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1317.9,69,,,,,0,"fee schedule","69% of total billed charges",1910,100,,1528.00,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1910,100,,1528.00,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1910,100,,1528.00,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",720.07,37.7,,576.06,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1489.8,78,,1191.84,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1577.66,82.6,,1262.13,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1577.66,82.6,,1262.13,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1924.93,100,,,,,0,"fee schedule",EAPG,1910,100,,1528.00,,,0,"percent of total billed charges","100% of total billed charges",292.23,6968.7,
"14021 Adjacent tissue transfer or rearrangement, s",7961569,CDM,521,RC,14021,CPT,OUTPATIENT,,,2105,1368.25,,1852.4,88,,1481.92,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,2105,100,,1684.00,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1817.34,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1326.15,63,,1060.92,,,0,"percent of total billed charges","63% of total billed charges",322.07,15.3,,257.66,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1452.45,69,,,,,0,"fee schedule","69% of total billed charges",2105,100,,1684.00,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2105,100,,1684.00,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2105,100,,1684.00,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",793.59,37.7,,634.87,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1641.9,78,,1313.52,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1738.73,82.6,,1390.98,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1738.73,82.6,,1390.98,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1924.93,100,,,,,0,"fee schedule",EAPG,2105,100,,1684.00,,,0,"percent of total billed charges","100% of total billed charges",322.07,6968.7,
"14020 Adjacent tissue transfer or rearrangement, s",7962279,CDM,521,RC,14020,CPT,OUTPATIENT,,,2086,1355.9,,1835.68,88,,1468.54,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,2086,100,,1668.80,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1817.34,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1314.18,63,,1051.34,,,0,"percent of total billed charges","63% of total billed charges",319.16,15.3,,255.33,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1439.34,69,,,,,0,"fee schedule","69% of total billed charges",2086,100,,1668.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2086,100,,1668.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2086,100,,1668.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",786.42,37.7,,629.14,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1627.08,78,,1301.66,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1723.04,82.6,,1378.43,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1723.04,82.6,,1378.43,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1924.93,100,,,,,0,"fee schedule",EAPG,2086,100,,1668.80,,,0,"percent of total billed charges","100% of total billed charges",319.16,6968.7,
"14040 Adj TIS Trans Forehead < 10 SQ CM",7903059,CDM,521,RC,14040,CPT,OUTPATIENT,,,1859,1208.35,,1635.92,88,,1308.74,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,1859,100,,1487.20,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1817.34,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1171.17,63,,936.94,,,0,"percent of total billed charges","63% of total billed charges",284.43,15.3,,227.54,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1282.71,69,,,,,0,"fee schedule","69% of total billed charges",1859,100,,1487.20,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1859,100,,1487.20,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1859,100,,1487.20,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",700.84,37.7,,560.67,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1450.02,78,,1160.02,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1535.53,82.6,,1228.42,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1535.53,82.6,,1228.42,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1924.93,100,,,,,0,"fee schedule",EAPG,1859,100,,1487.20,,,0,"percent of total billed charges","100% of total billed charges",284.43,6968.7,
"14041 Adjacent tissue transfer; forehead, cheeks,",7961454,CDM,521,RC,14041,CPT,OUTPATIENT,,,2277,1480.05,,2003.76,88,,1603.01,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,2277,100,,1821.60,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1817.34,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1434.51,63,,1147.61,,,0,"percent of total billed charges","63% of total billed charges",348.38,15.3,,278.70,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1571.13,69,,,,,0,"fee schedule","69% of total billed charges",2277,100,,1821.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2277,100,,1821.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2277,100,,1821.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",858.43,37.7,,686.74,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1776.06,78,,1420.85,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1880.8,82.6,,1504.64,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1880.8,82.6,,1504.64,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1924.93,100,,,,,0,"fee schedule",EAPG,2277,100,,1821.60,,,0,"percent of total billed charges","100% of total billed charges",348.38,6968.7,
"14060 Adj TIS Trans Facial < 10 SQ CM",7903060,CDM,521,RC,14060,CPT,OUTPATIENT,,,1979,1286.35,,1741.52,88,,1393.22,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,1979,100,,1583.20,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1817.34,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1246.77,63,,997.42,,,0,"percent of total billed charges","63% of total billed charges",302.79,15.3,,242.23,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1365.51,69,,,,,0,"fee schedule","69% of total billed charges",1979,100,,1583.20,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1979,100,,1583.20,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1979,100,,1583.20,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",746.08,37.7,,596.86,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1543.62,78,,1234.90,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1634.65,82.6,,1307.72,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1634.65,82.6,,1307.72,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1924.93,100,,,,,0,"fee schedule",EAPG,1979,100,,1583.20,,,0,"percent of total billed charges","100% of total billed charges",302.79,6968.7,
"14061 Adj tissue transfer/rearrangement, eyelids/n",7961728,CDM,521,RC,14061,CPT,OUTPATIENT,,,2437,1584.05,,2144.56,88,,1715.65,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,2437,100,,1949.60,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1817.34,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1535.31,63,,1228.25,,,0,"percent of total billed charges","63% of total billed charges",372.86,15.3,,298.29,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1681.53,69,,,,,0,"fee schedule","69% of total billed charges",2437,100,,1949.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2437,100,,1949.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2437,100,,1949.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",918.75,37.7,,735.00,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1900.86,78,,1520.69,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2012.96,82.6,,1610.37,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2012.96,82.6,,1610.37,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1924.93,100,,,,,0,"fee schedule",EAPG,2437,100,,1949.60,,,0,"percent of total billed charges","100% of total billed charges",372.86,6968.7,
"14301 Adjacent tissue transfer or rearrangement, a",7962311,CDM,521,RC,14301,CPT,OUTPATIENT,,,2580,1677,,2270.4,88,,1816.32,,,0,"percent of total billed charges","88% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,2580,100,,2064.00,,,0,"percent of total billed charges","100% of total billed charges",6403.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",1817.34,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1625.4,63,,1300.32,,,0,"percent of total billed charges","63% of total billed charges",394.74,15.3,,315.79,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1780.2,69,,,,,0,"fee schedule","69% of total billed charges",2580,100,,2064.00,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2580,100,,2064.00,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2580,100,,2064.00,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",14308.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3740.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",972.66,37.7,,778.13,,,0,"percent of total billed charges","37.70% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2012.4,78,,1609.92,,,0,"percent of total billed charges","78% of total billed charges",3695.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2131.08,82.6,,1704.86,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2131.08,82.6,,1704.86,,,0,"percent of total billed charges","82.6% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1924.93,100,,,,,0,"fee schedule",EAPG,2580,100,,2064.00,,,0,"percent of total billed charges","100% of total billed charges",394.74,14308.84,
"14350 Filleted finger or toe flap, including prepa",7962868,CDM,521,RC,14350,CPT,OUTPATIENT,,,2086,1355.9,,1835.68,88,,1468.54,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,2086,100,,1668.80,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1817.34,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1314.18,63,,1051.34,,,0,"percent of total billed charges","63% of total billed charges",319.16,15.3,,255.33,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1439.34,69,,,,,0,"fee schedule","69% of total billed charges",2086,100,,1668.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2086,100,,1668.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2086,100,,1668.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",786.42,37.7,,629.14,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1627.08,78,,1301.66,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1723.04,82.6,,1378.43,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1723.04,82.6,,1378.43,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1924.93,100,,,,,0,"fee schedule",EAPG,2086,100,,1668.80,,,0,"percent of total billed charges","100% of total billed charges",319.16,6968.7,
"15002 Wound Prep Trk/Arm/Leg 1st 100 SQ CM",7903061,CDM,521,RC,15002,CPT,OUTPATIENT,,,1099,714.35,,967.12,88,,773.70,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.83,100,,,,,0,"fee schedule",EAPG,1099,100,,879.20,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",930.95,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",692.37,63,,553.90,,,0,"percent of total billed charges","63% of total billed charges",168.15,15.3,,134.52,,,0,"percent of total billed charges","15.3% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,758.31,69,,,,,0,"fee schedule","69% of total billed charges",1099,100,,879.20,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1099,100,,879.20,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1099,100,,879.20,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.83,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",921.91,100,,,,,0,"fee schedule",EAPG,1174.99,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",414.32,37.7,,331.46,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",857.22,78,,685.78,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.77,82.6,,726.22,,,0,"percent of total billed charges","82.6% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.77,82.6,,726.22,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1064.36,100,,,,,0,"fee schedule",EAPG,1099,100,,879.20,,,0,"percent of total billed charges","100% of total billed charges",168.15,6968.7,
"15004 Wound Prep Fac/Nck/HF/G 1st 100 SQ CM",7903062,CDM,521,RC,15004,CPT,OUTPATIENT,,,797,518.05,,701.36,88,,561.09,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.83,100,,,,,0,"fee schedule",EAPG,797,100,,637.60,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",930.95,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",502.11,63,,401.69,,,0,"percent of total billed charges","63% of total billed charges",121.94,15.3,,97.55,,,0,"percent of total billed charges","15.3% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,549.93,69,,,,,0,"fee schedule","69% of total billed charges",797,100,,637.60,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",797,100,,637.60,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",797,100,,637.60,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.83,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",921.91,100,,,,,0,"fee schedule",EAPG,1174.99,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",300.47,37.7,,240.38,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",621.66,78,,497.33,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.32,82.6,,526.66,,,0,"percent of total billed charges","82.6% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.32,82.6,,526.66,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1064.36,100,,,,,0,"fee schedule",EAPG,797,100,,637.60,,,0,"percent of total billed charges","100% of total billed charges",121.94,2129.45,
"15005 Wnd Prep F/N/HF/G Addl CM",8165341,CDM,521,RC,15005,CPT,OUTPATIENT,,,585,380.25,,514.8,88,,411.84,,,0,"percent of total billed charges","88% of total billed charges",292.5,50,,234.00,,,0,"percent of total billed charges","50% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,585,100,,468.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",348.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",368.55,63,,294.84,,,0,"percent of total billed charges","63% of total billed charges",89.51,15.3,,71.61,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,403.65,69,,,,,0,"fee schedule","69% of total billed charges",585,100,,468.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",585,100,,468.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",585,100,,468.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361.82,61.85,,289.46,,,0,"percent of total billed charges","61.5% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",220.55,37.7,,176.44,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",456.3,78,,365.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",483.21,82.6,,386.57,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,292.5,50,,234.00,,,0,"percent of total billed charges","50% of total billed charges",483.21,82.6,,386.57,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",499.26,100,,,,,0,"fee schedule",EAPG,585,100,,468.00,,,0,"percent of total billed charges","100% of total billed charges",89.51,585,
"15050 Pinch graft, single or multiple, to cover sm",7962229,CDM,521,RC,15050,CPT,OUTPATIENT,,,713,463.45,,627.44,88,,501.95,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,713,100,,570.40,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.19,63,,359.35,,,0,"percent of total billed charges","63% of total billed charges",109.09,15.3,,87.27,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,491.97,69,,,,,0,"fee schedule","69% of total billed charges",713,100,,570.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",713,100,,570.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",713,100,,570.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",268.8,37.7,,215.04,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.14,78,,444.91,,,0,"percent of total billed charges","78% of total billed charges",646.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",588.94,82.6,,471.15,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",588.94,82.6,,471.15,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.98,100,,,,,0,"fee schedule",EAPG,713,100,,570.40,,,0,"percent of total billed charges","100% of total billed charges",109.09,2129.45,
"15101 Split-thickness autograft, trunk, arms, legs",7962761,CDM,521,RC,15101,CPT,OUTPATIENT,,,325,211.25,,286,88,,228.80,,,0,"percent of total billed charges","88% of total billed charges",162.5,50,,130.00,,,0,"percent of total billed charges","50% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,325,100,,260.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1817.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",204.75,63,,163.80,,,0,"percent of total billed charges","63% of total billed charges",49.73,15.3,,39.78,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,224.25,69,,,,,0,"fee schedule","69% of total billed charges",325,100,,260.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",325,100,,260.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",325,100,,260.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",201.01,61.85,,160.81,,,0,"percent of total billed charges","61.5% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",122.53,37.7,,98.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",253.5,78,,202.80,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",268.45,82.6,,214.76,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,162.5,50,,130.00,,,0,"percent of total billed charges","50% of total billed charges",268.45,82.6,,214.76,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1924.93,100,,,,,0,"fee schedule",EAPG,325,100,,260.00,,,0,"percent of total billed charges","100% of total billed charges",49.73,2293.73,
"15100 Split-thickness autograft, trunk, arms, legs",7962834,CDM,521,RC,15100,CPT,OUTPATIENT,,,2149,1396.85,,1891.12,88,,1512.90,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,2149,100,,1719.20,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1817.34,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.87,63,,1083.10,,,0,"percent of total billed charges","63% of total billed charges",328.8,15.3,,263.04,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1482.81,69,,,,,0,"fee schedule","69% of total billed charges",2149,100,,1719.20,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2149,100,,1719.20,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2149,100,,1719.20,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",810.17,37.7,,648.14,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1676.22,78,,1340.98,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1775.07,82.6,,1420.06,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1775.07,82.6,,1420.06,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1924.93,100,,,,,0,"fee schedule",EAPG,2149,100,,1719.20,,,0,"percent of total billed charges","100% of total billed charges",328.8,6968.7,
"15120 Split-thickness autograft, first 100 sq cm o",7903309,CDM,521,RC,15120,CPT,OUTPATIENT,,,3385,2200.25,,2978.8,88,,2383.04,,,0,"percent of total billed charges","88% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,3385,100,,2708.00,,,0,"percent of total billed charges","100% of total billed charges",6403.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",1817.34,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2132.55,63,,1706.04,,,0,"percent of total billed charges","63% of total billed charges",517.91,15.3,,414.33,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,2335.65,69,,,,,0,"fee schedule","69% of total billed charges",3385,100,,2708.00,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3385,100,,2708.00,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3385,100,,2708.00,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",14308.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3740.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1276.15,37.7,,1020.92,,,0,"percent of total billed charges","37.70% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2640.3,78,,2112.24,,,0,"percent of total billed charges","78% of total billed charges",3695.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2796.01,82.6,,2236.81,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2796.01,82.6,,2236.81,,,0,"percent of total billed charges","82.6% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1924.93,100,,,,,0,"fee schedule",EAPG,3385,100,,2708.00,,,0,"percent of total billed charges","100% of total billed charges",517.91,14308.84,
"15121 Split-thickness autograft, face/scalp/neck/g",7961796,CDM,521,RC,15121,CPT,OUTPATIENT,,,392,254.8,,344.96,88,,275.97,,,0,"percent of total billed charges","88% of total billed charges",196,50,,156.80,,,0,"percent of total billed charges","50% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,392,100,,313.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1817.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",246.96,63,,197.57,,,0,"percent of total billed charges","63% of total billed charges",59.98,15.3,,47.98,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,270.48,69,,,,,0,"fee schedule","69% of total billed charges",392,100,,313.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",392,100,,313.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",392,100,,313.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",242.45,61.85,,193.96,,,0,"percent of total billed charges","61.5% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",126.22,32.2,,100.98,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",147.78,37.7,,118.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",305.76,78,,244.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",323.79,82.6,,259.03,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,196,50,,156.80,,,0,"percent of total billed charges","50% of total billed charges",323.79,82.6,,259.03,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1924.93,100,,,,,0,"fee schedule",EAPG,392,100,,313.60,,,0,"percent of total billed charges","100% of total billed charges",59.98,2293.73,
"15220 Full thickness graft, free, including direct",7961455,CDM,521,RC,15220,CPT,OUTPATIENT,,,1824,1185.6,,1605.12,88,,1284.10,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,1824,100,,1459.20,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1817.34,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1149.12,63,,919.30,,,0,"percent of total billed charges","63% of total billed charges",279.07,15.3,,223.26,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1258.56,69,,,,,0,"fee schedule","69% of total billed charges",1824,100,,1459.20,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1824,100,,1459.20,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1824,100,,1459.20,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",687.65,37.7,,550.12,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1422.72,78,,1138.18,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1506.62,82.6,,1205.30,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1506.62,82.6,,1205.30,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1924.93,100,,,,,0,"fee schedule",EAPG,1824,100,,1459.20,,,0,"percent of total billed charges","100% of total billed charges",279.07,6968.7,
"15240 Full thickness graft, free; forehead, cheeks",7961797,CDM,521,RC,15240,CPT,OUTPATIENT,,,2679,1741.35,,2357.52,88,,1886.02,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,2679,100,,2143.20,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1817.34,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1687.77,63,,1350.22,,,0,"percent of total billed charges","63% of total billed charges",409.89,15.3,,327.91,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1848.51,69,,,,,0,"fee schedule","69% of total billed charges",2679,100,,2143.20,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2679,100,,2143.20,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2679,100,,2143.20,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1009.98,37.7,,807.98,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2089.62,78,,1671.70,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2212.85,82.6,,1770.28,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2212.85,82.6,,1770.28,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1924.93,100,,,,,0,"fee schedule",EAPG,2679,100,,2143.20,,,0,"percent of total billed charges","100% of total billed charges",409.89,6968.7,
"15260 Full thickness graft, free, direct closure o",7961729,CDM,521,RC,15260,CPT,OUTPATIENT,,,1320,858,,1161.6,88,,929.28,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,1320,100,,1056.00,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1817.34,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",831.6,63,,665.28,,,0,"percent of total billed charges","63% of total billed charges",201.96,15.3,,161.57,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,910.8,69,,,,,0,"fee schedule","69% of total billed charges",1320,100,,1056.00,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1320,100,,1056.00,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1320,100,,1056.00,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",497.64,37.7,,398.11,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1029.6,78,,823.68,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1090.32,82.6,,872.26,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1090.32,82.6,,872.26,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1924.93,100,,,,,0,"fee schedule",EAPG,1320,100,,1056.00,,,0,"percent of total billed charges","100% of total billed charges",201.96,6968.7,
"15274 Application of skin substitute graft to trun",7961964,CDM,521,RC,15274,CPT,OUTPATIENT,,,134,87.1,,117.92,88,,94.34,,,0,"percent of total billed charges","88% of total billed charges",67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1817.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",84.42,63,,67.54,,,0,"percent of total billed charges","63% of total billed charges",20.5,15.3,,16.40,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,92.46,69,,,,,0,"fee schedule","69% of total billed charges",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.88,61.85,,66.30,,,0,"percent of total billed charges","61.5% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",43.15,32.2,,34.52,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.52,37.7,,40.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.52,78,,83.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,67,50,,53.60,,,0,"percent of total billed charges","50% of total billed charges",110.68,82.6,,88.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1924.93,100,,,,,0,"fee schedule",EAPG,134,100,,107.20,,,0,"percent of total billed charges","100% of total billed charges",20.5,2293.73,
"15273 Application of skin substitute graft to trun",7962081,CDM,521,RC,15273,CPT,OUTPATIENT,,,595,386.75,,523.6,88,,418.88,,,0,"percent of total billed charges","88% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,595,100,,476.00,,,0,"percent of total billed charges","100% of total billed charges",6403.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",1817.34,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",374.85,63,,299.88,,,0,"percent of total billed charges","63% of total billed charges",91.04,15.3,,72.83,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,410.55,69,,,,,0,"fee schedule","69% of total billed charges",595,100,,476.00,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",595,100,,476.00,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",595,100,,476.00,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",14308.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3740.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",224.32,37.7,,179.46,,,0,"percent of total billed charges","37.70% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",464.1,78,,371.28,,,0,"percent of total billed charges","78% of total billed charges",3695.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",491.47,82.6,,393.18,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",491.47,82.6,,393.18,,,0,"percent of total billed charges","82.6% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1924.93,100,,,,,0,"fee schedule",EAPG,595,100,,476.00,,,0,"percent of total billed charges","100% of total billed charges",91.04,14308.84,
"15277 Skin Sub Grft F/N/HF/G Child",8165342,CDM,521,RC,15277,CPT,OUTPATIENT,,,1461,949.65,,1285.68,88,,1028.54,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1817.34,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",920.43,63,,736.34,,,0,"percent of total billed charges","63% of total billed charges",223.53,15.3,,178.82,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1008.09,69,,,,,0,"fee schedule","69% of total billed charges",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",550.8,37.7,,440.64,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1139.58,78,,911.66,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1206.79,82.6,,965.43,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1206.79,82.6,,965.43,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1924.93,100,,,,,0,"fee schedule",EAPG,1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",223.53,6968.7,
"15278 Skin Sub Grft F/N/HF/G Child Add",8165575,CDM,521,RC,15278,CPT,OUTPATIENT,,,369,239.85,,324.72,88,,259.78,,,0,"percent of total billed charges","88% of total billed charges",184.5,50,,147.60,,,0,"percent of total billed charges","50% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,369,100,,295.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1817.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",232.47,63,,185.98,,,0,"percent of total billed charges","63% of total billed charges",56.46,15.3,,45.17,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,254.61,69,,,,,0,"fee schedule","69% of total billed charges",369,100,,295.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",369,100,,295.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",369,100,,295.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",228.23,61.85,,182.58,,,0,"percent of total billed charges","61.5% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,184.5,50,,147.60,,,0,"percent of total billed charges","50% of total billed charges",118.82,32.2,,95.06,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",139.11,37.7,,111.29,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",287.82,78,,230.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",304.79,82.6,,243.83,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,184.5,50,,147.60,,,0,"percent of total billed charges","50% of total billed charges",304.79,82.6,,243.83,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1924.93,100,,,,,0,"fee schedule",EAPG,369,100,,295.20,,,0,"percent of total billed charges","100% of total billed charges",56.46,2293.73,
"15738 Muscle, myocutaneous, or fasciocutaneous fla",7963040,CDM,521,RC,15738,CPT,OUTPATIENT,,,3525,2291.25,,3102,88,,2481.60,,,0,"percent of total billed charges","88% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,3525,100,,2820.00,,,0,"percent of total billed charges","100% of total billed charges",6403.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",1817.34,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2220.75,63,,1776.60,,,0,"percent of total billed charges","63% of total billed charges",539.33,15.3,,431.46,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,2432.25,69,,,,,0,"fee schedule","69% of total billed charges",3525,100,,2820.00,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3525,100,,2820.00,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3525,100,,2820.00,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",14308.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3740.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1328.93,37.7,,1063.14,,,0,"percent of total billed charges","37.70% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2749.5,78,,2199.60,,,0,"percent of total billed charges","78% of total billed charges",3695.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2911.65,82.6,,2329.32,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2911.65,82.6,,2329.32,,,0,"percent of total billed charges","82.6% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1924.93,100,,,,,0,"fee schedule",EAPG,3525,100,,2820.00,,,0,"percent of total billed charges","100% of total billed charges",539.33,14308.84,
"15734 Muscle, myocutaneous, or fasciocutaneous fla",7963320,CDM,521,RC,15734,CPT,OUTPATIENT,,,3856,2506.4,,3393.28,88,,2714.62,,,0,"percent of total billed charges","88% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,3856,100,,3084.80,,,0,"percent of total billed charges","100% of total billed charges",6403.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",1817.34,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2429.28,63,,1943.42,,,0,"percent of total billed charges","63% of total billed charges",589.97,15.3,,471.98,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,2660.64,69,,,,,0,"fee schedule","69% of total billed charges",3856,100,,3084.80,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3856,100,,3084.80,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3856,100,,3084.80,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",14308.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3740.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1453.71,37.7,,1162.97,,,0,"percent of total billed charges","37.70% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3007.68,78,,2406.14,,,0,"percent of total billed charges","78% of total billed charges",3695.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3185.06,82.6,,2548.05,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3185.06,82.6,,2548.05,,,0,"percent of total billed charges","82.6% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1924.93,100,,,,,0,"fee schedule",EAPG,3856,100,,3084.80,,,0,"percent of total billed charges","100% of total billed charges",589.97,14308.84,
"15777 Implantation of biologic implant (eg, acellu",7962094,CDM,521,RC,15777,CPT,OUTPATIENT,,,516,335.4,,454.08,88,,363.26,,,0,"percent of total billed charges","88% of total billed charges",258,50,,206.40,,,0,"percent of total billed charges","50% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,516,100,,412.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1817.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",325.08,63,,260.06,,,0,"percent of total billed charges","63% of total billed charges",78.95,15.3,,63.16,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,356.04,69,,,,,0,"fee schedule","69% of total billed charges",516,100,,412.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",516,100,,412.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",516,100,,412.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",319.15,61.85,,255.32,,,0,"percent of total billed charges","61.5% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,258,50,,206.40,,,0,"percent of total billed charges","50% of total billed charges",166.15,32.2,,132.92,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",194.53,37.7,,155.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",402.48,78,,321.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",426.22,82.6,,340.98,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,258,50,,206.40,,,0,"percent of total billed charges","50% of total billed charges",426.22,82.6,,340.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1924.93,100,,,,,0,"fee schedule",EAPG,516,100,,412.80,,,0,"percent of total billed charges","100% of total billed charges",78.95,2293.73,
"15770 Graft; derma-fat-fascia",7963867,CDM,521,RC,15770,CPT,OUTPATIENT,,,2370,1540.5,,2085.6,88,,1668.48,,,0,"percent of total billed charges","88% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,2370,100,,1896.00,,,0,"percent of total billed charges","100% of total billed charges",6403.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",1817.34,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.1,63,,1194.48,,,0,"percent of total billed charges","63% of total billed charges",362.61,15.3,,290.09,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1635.3,69,,,,,0,"fee schedule","69% of total billed charges",2370,100,,1896.00,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2370,100,,1896.00,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2370,100,,1896.00,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",14308.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3740.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",893.49,37.7,,714.79,,,0,"percent of total billed charges","37.70% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1848.6,78,,1478.88,,,0,"percent of total billed charges","78% of total billed charges",3695.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1957.62,82.6,,1566.10,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1957.62,82.6,,1566.10,,,0,"percent of total billed charges","82.6% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1924.93,100,,,,,0,"fee schedule",EAPG,2370,100,,1896.00,,,0,"percent of total billed charges","100% of total billed charges",362.61,14308.84,
"15823 Blepharoplasty, upper eyelid; with excessive",7962869,CDM,521,RC,15823,CPT,OUTPATIENT,,,1327,862.55,,1167.76,88,,934.21,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,1327,100,,1061.60,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1640.79,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",836.01,63,,668.81,,,0,"percent of total billed charges","63% of total billed charges",203.03,15.3,,162.42,,,0,"percent of total billed charges","15.3% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,915.63,69,,,,,0,"fee schedule","69% of total billed charges",1327,100,,1061.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327,100,,1061.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327,100,,1061.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1624.86,100,,,,,0,"fee schedule",EAPG,2070.9,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",500.28,37.7,,400.22,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.06,78,,828.05,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1096.1,82.6,,876.88,,,0,"percent of total billed charges","82.6% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1096.1,82.6,,876.88,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.53,100,,,,,0,"fee schedule",EAPG,1327,100,,1061.60,,,0,"percent of total billed charges","100% of total billed charges",203.03,6968.7,
"15821 Blepharoplasty, lower eyelid; with extensive",7963041,CDM,521,RC,15821,CPT,OUTPATIENT,,,1327,862.55,,1167.76,88,,934.21,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,1327,100,,1061.60,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1640.79,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",836.01,63,,668.81,,,0,"percent of total billed charges","63% of total billed charges",203.03,15.3,,162.42,,,0,"percent of total billed charges","15.3% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,915.63,69,,,,,0,"fee schedule","69% of total billed charges",1327,100,,1061.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327,100,,1061.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327,100,,1061.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1624.86,100,,,,,0,"fee schedule",EAPG,2070.9,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",500.28,37.7,,400.22,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.06,78,,828.05,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1096.1,82.6,,876.88,,,0,"percent of total billed charges","82.6% of total billed charges",1593,100,,,,,0,"fee schedule","100% of WA fee schedule",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1096.1,82.6,,876.88,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.53,100,,,,,0,"fee schedule",EAPG,1327,100,,1061.60,,,0,"percent of total billed charges","100% of total billed charges",203.03,6968.7,
"15822 Blepharoplasty, upper eyelid;",7963744,CDM,521,RC,15822,CPT,OUTPATIENT,,,955,620.75,,840.4,88,,672.32,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1640.79,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",601.65,63,,481.32,,,0,"percent of total billed charges","63% of total billed charges",146.12,15.3,,116.90,,,0,"percent of total billed charges","15.3% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,658.95,69,,,,,0,"fee schedule","69% of total billed charges",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1624.86,100,,,,,0,"fee schedule",EAPG,2070.9,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",360.04,37.7,,288.03,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",744.9,78,,595.92,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",788.83,82.6,,631.06,,,0,"percent of total billed charges","82.6% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",788.83,82.6,,631.06,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.53,100,,,,,0,"fee schedule",EAPG,955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",146.12,6968.7,
"15830 Excision, excessive skin and subcutaneous ti",7961896,CDM,521,RC,15830,CPT,OUTPATIENT,,,2446,1589.9,,2152.48,88,,1721.98,,,0,"percent of total billed charges","88% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,2446,100,,1956.80,,,0,"percent of total billed charges","100% of total billed charges",11639.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",1640.79,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1540.98,63,,1232.78,,,0,"percent of total billed charges","63% of total billed charges",374.24,15.3,,299.39,,,0,"percent of total billed charges","15.3% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,1687.74,69,,,,,0,"fee schedule","69% of total billed charges",2446,100,,1956.80,,,0,"percent of total billed charges","100% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2446,100,,1956.80,,,0,"percent of total billed charges","100% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2446,100,,1956.80,,,0,"percent of total billed charges","100% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",22481.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5877.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1624.86,100,,,,,0,"fee schedule",EAPG,2070.9,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",922.14,37.7,,737.71,,,0,"percent of total billed charges","37.70% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1907.88,78,,1526.30,,,0,"percent of total billed charges","78% of total billed charges",6717.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2020.4,82.6,,1616.32,,,0,"percent of total billed charges","82.6% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2020.4,82.6,,1616.32,,,0,"percent of total billed charges","82.6% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.53,100,,,,,0,"fee schedule",EAPG,2446,100,,1956.80,,,0,"percent of total billed charges","100% of total billed charges",374.24,22481.81,
"15839 Excision, excessive skin and subcutaneous ti",7962436,CDM,521,RC,15839,CPT,OUTPATIENT,,,1655,1075.75,,1456.4,88,,1165.12,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,1655,100,,1324.00,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1640.79,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1042.65,63,,834.12,,,0,"percent of total billed charges","63% of total billed charges",253.22,15.3,,202.58,,,0,"percent of total billed charges","15.3% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,1141.95,69,,,,,0,"fee schedule","69% of total billed charges",1655,100,,1324.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1655,100,,1324.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1655,100,,1324.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1624.86,100,,,,,0,"fee schedule",EAPG,2070.9,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",623.94,37.7,,499.15,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1290.9,78,,1032.72,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1367.03,82.6,,1093.62,,,0,"percent of total billed charges","82.6% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1367.03,82.6,,1093.62,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.53,100,,,,,0,"fee schedule",EAPG,1655,100,,1324.00,,,0,"percent of total billed charges","100% of total billed charges",253.22,9628.23,
"15847 Excision, excessive skin and subcutaneous ti",7962519,CDM,521,RC,15847,CPT,OUTPATIENT,,,573,372.45,,504.24,88,,403.39,,,0,"percent of total billed charges","88% of total billed charges",286.5,50,,229.20,,,0,"percent of total billed charges","50% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,573,100,,458.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1640.79,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",360.99,63,,288.79,,,0,"percent of total billed charges","63% of total billed charges",87.67,15.3,,70.14,,,0,"percent of total billed charges","15.3% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,395.37,69,,,,,0,"fee schedule","69% of total billed charges",573,100,,458.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",573,100,,458.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",573,100,,458.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",354.4,61.85,,283.52,,,0,"percent of total billed charges","61.5% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,286.5,50,,229.20,,,0,"percent of total billed charges","50% of total billed charges",184.51,32.2,,147.61,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1624.86,100,,,,,0,"fee schedule",EAPG,2070.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",216.02,37.7,,172.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",446.94,78,,357.55,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",473.3,82.6,,378.64,,,0,"percent of total billed charges","82.6% of total billed charges",1593,100,,,,,0,"fee schedule","100% of WA fee schedule",286.5,50,,229.20,,,0,"percent of total billed charges","50% of total billed charges",473.3,82.6,,378.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1753.53,100,,,,,0,"fee schedule",EAPG,573,100,,458.40,,,0,"percent of total billed charges","100% of total billed charges",87.67,2070.9,
"15842 Graft for facial nerve paralysis; free muscl",7962572,CDM,521,RC,15842,CPT,OUTPATIENT,,,8348,5426.2,,7346.24,88,,5876.99,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1817.34,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5259.24,63,,4207.39,,,0,"percent of total billed charges","63% of total billed charges",1277.24,15.3,,1021.79,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,5760.12,69,,,,,0,"fee schedule","69% of total billed charges",8348,100,,6678.40,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8348,100,,6678.40,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8348,100,,6678.40,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3147.2,37.7,,2517.76,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6511.44,78,,5209.15,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6895.45,82.6,,5516.36,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6895.45,82.6,,5516.36,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1924.93,100,,,,,0,"fee schedule",EAPG,8348,100,,6678.40,,,0,"percent of total billed charges","100% of total billed charges",1277.24,8348,
"15852 Dressing change (for other than burns) under",7962661,CDM,521,RC,15852,CPT,OUTPATIENT,,,288,187.2,,253.44,88,,202.75,,,0,"percent of total billed charges","88% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",1121.02,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",181.44,63,,145.15,,,0,"percent of total billed charges","63% of total billed charges",44.06,15.3,,35.25,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,198.72,69,,,,,0,"fee schedule","69% of total billed charges",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",2129.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",108.58,37.7,,86.86,,,0,"percent of total billed charges","37.70% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.64,78,,179.71,,,0,"percent of total billed charges","78% of total billed charges",646.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",237.89,82.6,,190.31,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",237.89,82.6,,190.31,,,0,"percent of total billed charges","82.6% of total billed charges",640.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",328.93,100,,,,,0,"fee schedule",EAPG,288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",44.06,2129.45,
"15878 Suction assisted lipectomy; upper extremity",7963517,CDM,521,RC,15878,CPT,OUTPATIENT,,,822,534.3,,723.36,88,,578.69,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,822,100,,657.60,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1640.79,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",517.86,63,,414.29,,,0,"percent of total billed charges","63% of total billed charges",125.77,15.3,,100.62,,,0,"percent of total billed charges","15.3% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,567.18,69,,,,,0,"fee schedule","69% of total billed charges",822,100,,657.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",822,100,,657.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",822,100,,657.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1624.86,100,,,,,0,"fee schedule",EAPG,2070.9,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",309.89,37.7,,247.91,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",641.16,78,,512.93,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",678.97,82.6,,543.18,,,0,"percent of total billed charges","82.6% of total billed charges",1593,100,,,,,0,"fee schedule","100% of WA fee schedule",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",678.97,82.6,,543.18,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.53,100,,,,,0,"fee schedule",EAPG,822,100,,657.60,,,0,"percent of total billed charges","100% of total billed charges",125.77,6968.7,
"15876 Suction assisted lipectomy; head and neck",7963555,CDM,521,RC,15876,CPT,OUTPATIENT,,,478,310.7,,420.64,88,,336.51,,,0,"percent of total billed charges","88% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",6403.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",1640.79,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",301.14,63,,240.91,,,0,"percent of total billed charges","63% of total billed charges",73.13,15.3,,58.50,,,0,"percent of total billed charges","15.3% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,329.82,69,,,,,0,"fee schedule","69% of total billed charges",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",14308.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3740.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1624.86,100,,,,,0,"fee schedule",EAPG,2070.9,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",180.21,37.7,,144.17,,,0,"percent of total billed charges","37.70% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",372.84,78,,298.27,,,0,"percent of total billed charges","78% of total billed charges",3695.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394.83,82.6,,315.86,,,0,"percent of total billed charges","82.6% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394.83,82.6,,315.86,,,0,"percent of total billed charges","82.6% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.53,100,,,,,0,"fee schedule",EAPG,478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",73.13,14308.84,
"15877 Suction assisted lipectomy; trunk",7963701,CDM,521,RC,15877,CPT,OUTPATIENT,,,3178,2065.7,,2796.64,88,,2237.31,,,0,"percent of total billed charges","88% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,3178,100,,2542.40,,,0,"percent of total billed charges","100% of total billed charges",6403.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",1640.79,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2002.14,63,,1601.71,,,0,"percent of total billed charges","63% of total billed charges",486.23,15.3,,388.98,,,0,"percent of total billed charges","15.3% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,2192.82,69,,,,,0,"fee schedule","69% of total billed charges",3178,100,,2542.40,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3178,100,,2542.40,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3178,100,,2542.40,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",14308.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3740.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1624.86,100,,,,,0,"fee schedule",EAPG,2070.9,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1198.11,37.7,,958.49,,,0,"percent of total billed charges","37.70% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2478.84,78,,1983.07,,,0,"percent of total billed charges","78% of total billed charges",3695.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2625.03,82.6,,2100.02,,,0,"percent of total billed charges","82.6% of total billed charges",1593,100,,,,,0,"fee schedule","100% of WA fee schedule",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2625.03,82.6,,2100.02,,,0,"percent of total billed charges","82.6% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.53,100,,,,,0,"fee schedule",EAPG,3178,100,,2542.40,,,0,"percent of total billed charges","100% of total billed charges",486.23,14308.84,
"15937 Excision, sacral pressure ulcer, in preparat",7962134,CDM,521,RC,15937,CPT,OUTPATIENT,,,2255,1465.75,,1984.4,88,,1587.52,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.83,100,,,,,0,"fee schedule",EAPG,2255,100,,1804.00,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",930.95,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1420.65,63,,1136.52,,,0,"percent of total billed charges","63% of total billed charges",345.02,15.3,,276.02,,,0,"percent of total billed charges","15.3% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,1555.95,69,,,,,0,"fee schedule","69% of total billed charges",2255,100,,1804.00,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2255,100,,1804.00,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2255,100,,1804.00,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.83,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",921.91,100,,,,,0,"fee schedule",EAPG,1174.99,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",850.14,37.7,,680.11,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1758.9,78,,1407.12,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1862.63,82.6,,1490.10,,,0,"percent of total billed charges","82.6% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1862.63,82.6,,1490.10,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1064.36,100,,,,,0,"fee schedule",EAPG,2255,100,,1804.00,,,0,"percent of total billed charges","100% of total billed charges",345.02,6968.7,
"15946 Excision, ischial pressure ulcer, with ostec",7961965,CDM,521,RC,15946,CPT,OUTPATIENT,,,3493,2270.45,,3073.84,88,,2459.07,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.83,100,,,,,0,"fee schedule",EAPG,3493,100,,2794.40,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",930.95,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2200.59,63,,1760.47,,,0,"percent of total billed charges","63% of total billed charges",534.43,15.3,,427.54,,,0,"percent of total billed charges","15.3% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,2410.17,69,,,,,0,"fee schedule","69% of total billed charges",3493,100,,2794.40,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3493,100,,2794.40,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3493,100,,2794.40,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.83,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",921.91,100,,,,,0,"fee schedule",EAPG,1174.99,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1316.86,37.7,,1053.49,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2724.54,78,,2179.63,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2885.22,82.6,,2308.18,,,0,"percent of total billed charges","82.6% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2885.22,82.6,,2308.18,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1064.36,100,,,,,0,"fee schedule",EAPG,3493,100,,2794.40,,,0,"percent of total billed charges","100% of total billed charges",534.43,6968.7,
"16000 Local Treatment of Burns",7903067,CDM,521,RC,16000,CPT,OUTPATIENT,,,123,79.95,,108.24,88,,86.59,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.49,63,,61.99,,,0,"percent of total billed charges","63% of total billed charges",18.82,15.3,,15.06,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,84.87,69,,,,,0,"fee schedule","69% of total billed charges",123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",46.37,37.7,,37.10,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",95.94,78,,76.75,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.6,82.6,,81.28,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.6,82.6,,81.28,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",328.93,100,,,,,0,"fee schedule",EAPG,123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",18.82,729.42,
"16025 Burn Treatment Medium",7903068,CDM,521,RC,16025,CPT,OUTPATIENT,,,262,170.3,,230.56,88,,184.45,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",165.06,63,,132.05,,,0,"percent of total billed charges","63% of total billed charges",40.09,15.3,,32.07,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,180.78,69,,,,,0,"fee schedule","69% of total billed charges",262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",98.77,37.7,,79.02,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",204.36,78,,163.49,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.41,82.6,,173.13,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.41,82.6,,173.13,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",328.93,100,,,,,0,"fee schedule",EAPG,262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",40.09,729.41,
"16020 Burn Treatment Small",7903080,CDM,521,RC,16020,CPT,OUTPATIENT,,,150,97.5,,132,88,,105.60,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",94.5,63,,75.60,,,0,"percent of total billed charges","63% of total billed charges",22.95,15.3,,18.36,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,103.5,69,,,,,0,"fee schedule","69% of total billed charges",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",117,78,,93.60,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",328.93,100,,,,,0,"fee schedule",EAPG,150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",22.95,729.42,
"16030 Burn Treatment Large",7903069,CDM,521,RC,16030,CPT,OUTPATIENT,,,462,300.3,,406.56,88,,325.25,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,462,100,,369.60,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",291.06,63,,232.85,,,0,"percent of total billed charges","63% of total billed charges",70.69,15.3,,56.55,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,318.78,69,,,,,0,"fee schedule","69% of total billed charges",462,100,,369.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462,100,,369.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462,100,,369.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",174.17,37.7,,139.34,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",360.36,78,,288.29,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",381.61,82.6,,305.29,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",381.61,82.6,,305.29,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.26,100,,,,,0,"fee schedule",EAPG,462,100,,369.60,,,0,"percent of total billed charges","100% of total billed charges",70.69,1404.97,
"17000 Destruction, premalignant, first lesion; any",7903081,CDM,521,RC,17000,CPT,OUTPATIENT,,,192,124.8,,168.96,88,,135.17,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",120.96,63,,96.77,,,0,"percent of total billed charges","63% of total billed charges",29.38,15.3,,23.50,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,132.48,69,,,,,0,"fee schedule","69% of total billed charges",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",72.38,37.7,,57.90,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",149.76,78,,119.81,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.59,82.6,,126.87,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.59,82.6,,126.87,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,192,100,,153.60,,,0,"percent of total billed charges","100% of total billed charges",29.38,729.42,
"17003 Destruction, premalignant, 2-14 lesions; any",7903082,CDM,521,RC,17003,CPT,OUTPATIENT,,,45,29.25,,39.6,88,,31.68,,,0,"percent of total billed charges","88% of total billed charges",22.5,50,,18.00,,,0,"percent of total billed charges","50% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.74,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",28.35,63,,22.68,,,0,"percent of total billed charges","63% of total billed charges",6.89,15.3,,5.51,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,31.05,69,,,,,0,"fee schedule","69% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.83,61.85,,22.26,,,0,"percent of total billed charges","61.5% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,22.5,50,,18.00,,,0,"percent of total billed charges","50% of total billed charges",14.49,32.2,,11.59,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.97,37.7,,13.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.1,78,,28.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,22.5,50,,18.00,,,0,"percent of total billed charges","50% of total billed charges",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",307.85,100,,,,,0,"fee schedule",EAPG,45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",6.89,307.85,
"17004 Destruction, premalignant, 15 or more lesion",7903083,CDM,521,RC,17004,CPT,OUTPATIENT,,,542,352.3,,476.96,88,,381.57,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,542,100,,433.60,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",341.46,63,,273.17,,,0,"percent of total billed charges","63% of total billed charges",82.93,15.3,,66.34,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,373.98,69,,,,,0,"fee schedule","69% of total billed charges",542,100,,433.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",542,100,,433.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",542,100,,433.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.33,37.7,,163.46,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",422.76,78,,338.21,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",447.69,82.6,,358.15,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",447.69,82.6,,358.15,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,542,100,,433.60,,,0,"percent of total billed charges","100% of total billed charges",82.93,1404.97,
"17106 Destruction of cutaneous vascular proliferat",7961570,CDM,521,RC,17106,CPT,OUTPATIENT,,,703,456.95,,618.64,88,,494.91,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",989.16,100,,,,,0,"fee schedule",EAPG,703,100,,562.40,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",1018.83,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",442.89,63,,354.31,,,0,"percent of total billed charges","63% of total billed charges",107.56,15.3,,86.05,,,0,"percent of total billed charges","15.3% of total billed charges",989.16,100,,,,,0,"fee schedule",EAPG,485.07,69,,,,,0,"fee schedule","69% of total billed charges",703,100,,562.40,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",703,100,,562.40,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",703,100,,562.40,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",989.16,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1008.94,100,,,,,0,"fee schedule",EAPG,1285.91,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",265.03,37.7,,212.02,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",548.34,78,,438.67,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",580.68,82.6,,464.54,,,0,"percent of total billed charges","82.6% of total billed charges",989.16,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",580.68,82.6,,464.54,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1149.69,100,,,,,0,"fee schedule",EAPG,703,100,,562.40,,,0,"percent of total billed charges","100% of total billed charges",107.56,1404.97,
"17110 Destruct Benign Up tp 14 Lesions",7903084,CDM,521,RC,17110,CPT,OUTPATIENT,,,478,310.7,,420.64,88,,336.51,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",301.14,63,,240.91,,,0,"percent of total billed charges","63% of total billed charges",73.13,15.3,,58.50,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,329.82,69,,,,,0,"fee schedule","69% of total billed charges",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",180.21,37.7,,144.17,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",372.84,78,,298.27,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394.83,82.6,,315.86,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394.83,82.6,,315.86,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",73.13,729.42,
"17111 Destruct Benign 15 or more Lesions",7903085,CDM,521,RC,17111,CPT,OUTPATIENT,,,290,188.5,,255.2,88,,204.16,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,290,100,,232.00,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",182.7,63,,146.16,,,0,"percent of total billed charges","63% of total billed charges",44.37,15.3,,35.50,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,200.1,69,,,,,0,"fee schedule","69% of total billed charges",290,100,,232.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290,100,,232.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290,100,,232.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",109.33,37.7,,87.46,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",226.2,78,,180.96,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",239.54,82.6,,191.63,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",239.54,82.6,,191.63,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,290,100,,232.00,,,0,"percent of total billed charges","100% of total billed charges",44.37,729.42,
"17250 Chemical Cautery Tissue",7903086,CDM,521,RC,17250,CPT,OUTPATIENT,,,118,76.7,,103.84,88,,83.07,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,118,100,,94.40,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.34,63,,59.47,,,0,"percent of total billed charges","63% of total billed charges",18.05,15.3,,14.44,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,81.42,69,,,,,0,"fee schedule","69% of total billed charges",118,100,,94.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118,100,,94.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118,100,,94.40,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",44.49,37.7,,35.59,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.04,78,,73.63,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",97.47,82.6,,77.98,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",97.47,82.6,,77.98,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,118,100,,94.40,,,0,"percent of total billed charges","100% of total billed charges",18.05,729.42,
"17260 Dest Malig Les Trunk < 0.5 CM",7903087,CDM,521,RC,17260,CPT,OUTPATIENT,,,260,169,,228.8,88,,183.04,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,260,100,,208.00,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",163.8,63,,131.04,,,0,"percent of total billed charges","63% of total billed charges",39.78,15.3,,31.82,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,179.4,69,,,,,0,"fee schedule","69% of total billed charges",260,100,,208.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260,100,,208.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260,100,,208.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",98.02,37.7,,78.42,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.8,78,,162.24,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",214.76,82.6,,171.81,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",214.76,82.6,,171.81,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,260,100,,208.00,,,0,"percent of total billed charges","100% of total billed charges",39.78,729.42,
"17261 Dest Malig Les Trunk 0.6 to 1.0 CM",7903088,CDM,521,RC,17261,CPT,OUTPATIENT,,,356,231.4,,313.28,88,,250.62,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.28,63,,179.42,,,0,"percent of total billed charges","63% of total billed charges",54.47,15.3,,43.58,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,245.64,69,,,,,0,"fee schedule","69% of total billed charges",356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",134.21,37.7,,107.37,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.68,78,,222.14,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.06,82.6,,235.25,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.06,82.6,,235.25,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",54.47,729.42,
"17262 Dest Malig Les Trunk 1.1 to 2.0 CM",7903089,CDM,521,RC,17262,CPT,OUTPATIENT,,,454,295.1,,399.52,88,,319.62,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",286.02,63,,228.82,,,0,"percent of total billed charges","63% of total billed charges",69.46,15.3,,55.57,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,313.26,69,,,,,0,"fee schedule","69% of total billed charges",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",171.16,37.7,,136.93,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",354.12,78,,283.30,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",375,82.6,,300.00,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",375,82.6,,300.00,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",69.46,729.42,
"17270 Dest Malig Les SCLP/NCK/HF < 0.5 CM",7903090,CDM,521,RC,17270,CPT,OUTPATIENT,,,285,185.25,,250.8,88,,200.64,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",179.55,63,,143.64,,,0,"percent of total billed charges","63% of total billed charges",43.61,15.3,,34.89,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,196.65,69,,,,,0,"fee schedule","69% of total billed charges",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",107.45,37.7,,85.96,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",222.3,78,,177.84,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",235.41,82.6,,188.33,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",235.41,82.6,,188.33,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",43.61,729.41,
"17271 Destruction, malignant lesion, scalp, neck,",7961456,CDM,521,RC,17271,CPT,OUTPATIENT,,,411,267.15,,361.68,88,,289.34,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,411,100,,328.80,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",258.93,63,,207.14,,,0,"percent of total billed charges","63% of total billed charges",62.88,15.3,,50.30,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,283.59,69,,,,,0,"fee schedule","69% of total billed charges",411,100,,328.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",411,100,,328.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",411,100,,328.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",154.95,37.7,,123.96,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320.58,78,,256.46,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",339.49,82.6,,271.59,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",339.49,82.6,,271.59,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,411,100,,328.80,,,0,"percent of total billed charges","100% of total billed charges",62.88,729.41,
"17272 Destruction, malignant lesion, scalp, neck,",7961457,CDM,521,RC,17272,CPT,OUTPATIENT,,,379,246.35,,333.52,88,,266.82,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,379,100,,303.20,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",238.77,63,,191.02,,,0,"percent of total billed charges","63% of total billed charges",57.99,15.3,,46.39,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,261.51,69,,,,,0,"fee schedule","69% of total billed charges",379,100,,303.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",379,100,,303.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",379,100,,303.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",142.88,37.7,,114.30,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",295.62,78,,236.50,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",313.05,82.6,,250.44,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",313.05,82.6,,250.44,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,379,100,,303.20,,,0,"percent of total billed charges","100% of total billed charges",57.99,729.42,
"17274 Destruction, malignant lesion, scalp, neck,",7961458,CDM,521,RC,17274,CPT,OUTPATIENT,,,432,280.8,,380.16,88,,304.13,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,432,100,,345.60,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.16,63,,217.73,,,0,"percent of total billed charges","63% of total billed charges",66.1,15.3,,52.88,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,298.08,69,,,,,0,"fee schedule","69% of total billed charges",432,100,,345.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",432,100,,345.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",432,100,,345.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",162.86,37.7,,130.29,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",336.96,78,,269.57,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",356.83,82.6,,285.46,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",356.83,82.6,,285.46,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,432,100,,345.60,,,0,"percent of total billed charges","100% of total billed charges",66.1,1404.97,
"17280 Destruction, malignant lesion, face, ears, e",7961459,CDM,521,RC,17280,CPT,OUTPATIENT,,,306,198.9,,269.28,88,,215.42,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",192.78,63,,154.22,,,0,"percent of total billed charges","63% of total billed charges",46.82,15.3,,37.46,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,211.14,69,,,,,0,"fee schedule","69% of total billed charges",306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",115.36,37.7,,92.29,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",238.68,78,,190.94,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.76,82.6,,202.21,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.76,82.6,,202.21,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",46.82,729.42,
"17281 Destruction, malignant lesion, face, ears, e",7961850,CDM,521,RC,17281,CPT,OUTPATIENT,,,350,227.5,,308,88,,246.40,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",220.5,63,,176.40,,,0,"percent of total billed charges","63% of total billed charges",53.55,15.3,,42.84,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,241.5,69,,,,,0,"fee schedule","69% of total billed charges",350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",131.95,37.7,,105.56,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",273,78,,218.40,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.1,82.6,,231.28,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.1,82.6,,231.28,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",53.55,1404.97,
"17282 Destruction, malignant lesion, face, ears, e",7961851,CDM,521,RC,17282,CPT,OUTPATIENT,,,434,282.1,,381.92,88,,305.54,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,434,100,,347.20,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",273.42,63,,218.74,,,0,"percent of total billed charges","63% of total billed charges",66.4,15.3,,53.12,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,299.46,69,,,,,0,"fee schedule","69% of total billed charges",434,100,,347.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",434,100,,347.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",434,100,,347.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",163.62,37.7,,130.90,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.52,78,,270.82,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",358.48,82.6,,286.78,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",358.48,82.6,,286.78,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,434,100,,347.20,,,0,"percent of total billed charges","100% of total billed charges",66.4,1404.97,
"17340 Cryotherapy (CO2 slush, liquid N2) for acne",7963518,CDM,521,RC,17340,CPT,OUTPATIENT,,,143,92.95,,125.84,88,,100.67,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",90.09,63,,72.07,,,0,"percent of total billed charges","63% of total billed charges",21.88,15.3,,17.50,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,98.67,69,,,,,0,"fee schedule","69% of total billed charges",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",53.91,37.7,,43.13,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.54,78,,89.23,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",21.88,307.85,
"17360 Chemical exfoliation for acne (eg, acne past",7963297,CDM,521,RC,17360,CPT,OUTPATIENT,,,106,68.9,,93.28,88,,74.62,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.78,63,,53.42,,,0,"percent of total billed charges","63% of total billed charges",16.22,15.3,,12.98,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,73.14,69,,,,,0,"fee schedule","69% of total billed charges",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",39.96,37.7,,31.97,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",82.68,78,,66.14,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",87.56,82.6,,70.05,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule","100% of WA fee schedule",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",87.56,82.6,,70.05,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",16.22,729.42,
"17999 Unlisted procedure, skin, mucous membrane an",7962921,CDM,521,RC,17999,CPT,OUTPATIENT,,,199,129.35,,175.12,88,,140.10,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,199,100,,159.20,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.37,63,,100.30,,,0,"percent of total billed charges","63% of total billed charges",30.45,15.3,,24.36,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,137.31,69,,,,,0,"fee schedule","69% of total billed charges",199,100,,159.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199,100,,159.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199,100,,159.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",75.02,37.7,,60.02,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",155.22,78,,124.18,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",164.37,82.6,,131.50,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",164.37,82.6,,131.50,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,199,100,,159.20,,,0,"percent of total billed charges","100% of total billed charges",30.45,729.42,
"19000 Puncture aspiration of cyst of breast",7903169,CDM,521,RC,19000,CPT,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.92,100,,,,,0,"fee schedule",EAPG,206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",585.99,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",568.92,100,,,,,0,"fee schedule",EAPG,142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.92,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",580.3,100,,,,,0,"fee schedule",EAPG,739.6,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",568.92,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",729.45,100,,,,,0,"fee schedule",EAPG,206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,2526.76,
"19001 Puncture aspiration of cyst of breast; each",7903170,CDM,521,RC,19001,CPT,OUTPATIENT,,,118,76.7,,103.84,88,,83.07,,,0,"percent of total billed charges","88% of total billed charges",59,50,,47.20,,,0,"percent of total billed charges","50% of total billed charges",568.92,100,,,,,0,"fee schedule",EAPG,118,100,,94.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",585.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",74.34,63,,59.47,,,0,"percent of total billed charges","63% of total billed charges",18.05,15.3,,14.44,,,0,"percent of total billed charges","15.3% of total billed charges",568.92,100,,,,,0,"fee schedule",EAPG,81.42,69,,,,,0,"fee schedule","69% of total billed charges",118,100,,94.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",118,100,,94.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",118,100,,94.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",72.98,61.85,,58.38,,,0,"percent of total billed charges","61.5% of total billed charges",568.92,100,,,,,0,"fee schedule",EAPG,59,50,,47.20,,,0,"percent of total billed charges","50% of total billed charges",38,32.2,,30.40,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",580.3,100,,,,,0,"fee schedule",EAPG,739.6,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",44.49,37.7,,35.59,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",92.04,78,,73.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.47,82.6,,77.98,,,0,"percent of total billed charges","82.6% of total billed charges",568.92,100,,,,,0,"fee schedule",EAPG,59,50,,47.20,,,0,"percent of total billed charges","50% of total billed charges",97.47,82.6,,77.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",729.45,100,,,,,0,"fee schedule",EAPG,118,100,,94.40,,,0,"percent of total billed charges","100% of total billed charges",18.05,739.6,
"19020 Mastotomy with exploration or drainage of ab",7963244,CDM,521,RC,19020,CPT,OUTPATIENT,,,797,518.05,,701.36,88,,561.09,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,797,100,,637.60,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1298.41,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",502.11,63,,401.69,,,0,"percent of total billed charges","63% of total billed charges",121.94,15.3,,97.55,,,0,"percent of total billed charges","15.3% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,549.93,69,,,,,0,"fee schedule","69% of total billed charges",797,100,,637.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",797,100,,637.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",797,100,,637.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1285.8,100,,,,,0,"fee schedule",EAPG,1638.77,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",300.47,37.7,,240.38,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",621.66,78,,497.33,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.32,82.6,,526.66,,,0,"percent of total billed charges","82.6% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.32,82.6,,526.66,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1421.12,100,,,,,0,"fee schedule",EAPG,797,100,,637.60,,,0,"percent of total billed charges","100% of total billed charges",121.94,5715.97,
"19084 Biopsy, breast, w/ localization device; each",7961571,CDM,521,RC,19084,CPT,OUTPATIENT,,,239,155.35,,210.32,88,,168.26,,,0,"percent of total billed charges","88% of total billed charges",119.5,50,,95.60,,,0,"percent of total billed charges","50% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1298.41,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",150.57,63,,120.46,,,0,"percent of total billed charges","63% of total billed charges",36.57,15.3,,29.26,,,0,"percent of total billed charges","15.3% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,164.91,69,,,,,0,"fee schedule","69% of total billed charges",239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",147.82,61.85,,118.26,,,0,"percent of total billed charges","61.5% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,119.5,50,,95.60,,,0,"percent of total billed charges","50% of total billed charges",76.96,32.2,,61.57,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1285.8,100,,,,,0,"fee schedule",EAPG,1638.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",90.1,37.7,,72.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",186.42,78,,149.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",197.41,82.6,,157.93,,,0,"percent of total billed charges","82.6% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,119.5,50,,95.60,,,0,"percent of total billed charges","50% of total billed charges",197.41,82.6,,157.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1421.12,100,,,,,0,"fee schedule",EAPG,239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",36.57,1638.77,
"19082 Biopsy, breast, w/ localization device; each",7961658,CDM,521,RC,19082,CPT,OUTPATIENT,,,254,165.1,,223.52,88,,178.82,,,0,"percent of total billed charges","88% of total billed charges",127,50,,101.60,,,0,"percent of total billed charges","50% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1298.41,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",160.02,63,,128.02,,,0,"percent of total billed charges","63% of total billed charges",38.86,15.3,,31.09,,,0,"percent of total billed charges","15.3% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,175.26,69,,,,,0,"fee schedule","69% of total billed charges",254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.1,61.85,,125.68,,,0,"percent of total billed charges","61.5% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,127,50,,101.60,,,0,"percent of total billed charges","50% of total billed charges",81.79,32.2,,65.43,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1285.8,100,,,,,0,"fee schedule",EAPG,1638.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",95.76,37.7,,76.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",198.12,78,,158.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.8,82.6,,167.84,,,0,"percent of total billed charges","82.6% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,127,50,,101.60,,,0,"percent of total billed charges","50% of total billed charges",209.8,82.6,,167.84,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1421.12,100,,,,,0,"fee schedule",EAPG,254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",38.86,1638.77,
"19081 Biopsy, breast, w/ localization device; firs",7962280,CDM,521,RC,19081,CPT,OUTPATIENT,,,524,340.6,,461.12,88,,368.90,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,524,100,,419.20,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1298.41,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.12,63,,264.10,,,0,"percent of total billed charges","63% of total billed charges",80.17,15.3,,64.14,,,0,"percent of total billed charges","15.3% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,361.56,69,,,,,0,"fee schedule","69% of total billed charges",524,100,,419.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",524,100,,419.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",524,100,,419.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1285.8,100,,,,,0,"fee schedule",EAPG,1638.77,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",197.55,37.7,,158.04,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.72,78,,326.98,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",432.82,82.6,,346.26,,,0,"percent of total billed charges","82.6% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",432.82,82.6,,346.26,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1421.12,100,,,,,0,"fee schedule",EAPG,524,100,,419.20,,,0,"percent of total billed charges","100% of total billed charges",80.17,5715.97,
"19083 Biopsy, breast, w/ localization device; firs",7962354,CDM,521,RC,19083,CPT,OUTPATIENT,,,492,319.8,,432.96,88,,346.37,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1298.41,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.96,63,,247.97,,,0,"percent of total billed charges","63% of total billed charges",75.28,15.3,,60.22,,,0,"percent of total billed charges","15.3% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,339.48,69,,,,,0,"fee schedule","69% of total billed charges",492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1285.8,100,,,,,0,"fee schedule",EAPG,1638.77,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",185.48,37.7,,148.38,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",383.76,78,,307.01,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",406.39,82.6,,325.11,,,0,"percent of total billed charges","82.6% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",406.39,82.6,,325.11,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1421.12,100,,,,,0,"fee schedule",EAPG,492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",75.28,5715.97,
"19101 Biopsy of breast; open, incisional",7903175,CDM,521,RC,19101,CPT,OUTPATIENT,,,1162,755.3,,1022.56,88,,818.05,,,0,"percent of total billed charges","88% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,1162,100,,929.60,,,0,"percent of total billed charges","100% of total billed charges",6803.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",1298.41,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",732.06,63,,585.65,,,0,"percent of total billed charges","63% of total billed charges",177.79,15.3,,142.23,,,0,"percent of total billed charges","15.3% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,801.78,69,,,,,0,"fee schedule","69% of total billed charges",1162,100,,929.60,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1162,100,,929.60,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1162,100,,929.60,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",12828.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3353.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1285.8,100,,,,,0,"fee schedule",EAPG,1638.77,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",438.07,37.7,,350.46,,,0,"percent of total billed charges","37.70% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",906.36,78,,725.09,,,0,"percent of total billed charges","78% of total billed charges",3926.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",959.81,82.6,,767.85,,,0,"percent of total billed charges","82.6% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",959.81,82.6,,767.85,,,0,"percent of total billed charges","82.6% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1421.12,100,,,,,0,"fee schedule",EAPG,1162,100,,929.60,,,0,"percent of total billed charges","100% of total billed charges",177.79,12828.41,
"19100 Biopsy of breast; percutaneous, needle core,",7962762,CDM,521,RC,19100,CPT,OUTPATIENT,,,285,185.25,,250.8,88,,200.64,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1298.41,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",179.55,63,,143.64,,,0,"percent of total billed charges","63% of total billed charges",43.61,15.3,,34.89,,,0,"percent of total billed charges","15.3% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,196.65,69,,,,,0,"fee schedule","69% of total billed charges",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1285.8,100,,,,,0,"fee schedule",EAPG,1638.77,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",107.45,37.7,,85.96,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",222.3,78,,177.84,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",235.41,82.6,,188.33,,,0,"percent of total billed charges","82.6% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",235.41,82.6,,188.33,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1421.12,100,,,,,0,"fee schedule",EAPG,285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",43.61,5715.97,
"19120 Excision of cyst, fibroadenoma, or other ben",7961798,CDM,521,RC,19120,CPT,OUTPATIENT,,,1549,1006.85,,1363.12,88,,1090.50,,,0,"percent of total billed charges","88% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,1549,100,,1239.20,,,0,"percent of total billed charges","100% of total billed charges",6803.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",1298.41,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",975.87,63,,780.70,,,0,"percent of total billed charges","63% of total billed charges",237,15.3,,189.60,,,0,"percent of total billed charges","15.3% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,1068.81,69,,,,,0,"fee schedule","69% of total billed charges",1549,100,,1239.20,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1549,100,,1239.20,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1549,100,,1239.20,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",12828.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3353.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1285.8,100,,,,,0,"fee schedule",EAPG,1638.77,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",583.97,37.7,,467.18,,,0,"percent of total billed charges","37.70% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1208.22,78,,966.58,,,0,"percent of total billed charges","78% of total billed charges",3926.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1279.47,82.6,,1023.58,,,0,"percent of total billed charges","82.6% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1279.47,82.6,,1023.58,,,0,"percent of total billed charges","82.6% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1421.12,100,,,,,0,"fee schedule",EAPG,1549,100,,1239.20,,,0,"percent of total billed charges","100% of total billed charges",237,12828.41,
"19126 Exc of breast lesion identified by radiologi",7962312,CDM,521,RC,19126,CPT,OUTPATIENT,,,924,600.6,,813.12,88,,650.50,,,0,"percent of total billed charges","88% of total billed charges",462,50,,369.60,,,0,"percent of total billed charges","50% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,924,100,,739.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1298.41,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",582.12,63,,465.70,,,0,"percent of total billed charges","63% of total billed charges",141.37,15.3,,113.10,,,0,"percent of total billed charges","15.3% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,637.56,69,,,,,0,"fee schedule","69% of total billed charges",924,100,,739.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",924,100,,739.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",924,100,,739.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",571.49,61.85,,457.19,,,0,"percent of total billed charges","61.5% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,462,50,,369.60,,,0,"percent of total billed charges","50% of total billed charges",297.53,32.2,,238.02,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1285.8,100,,,,,0,"fee schedule",EAPG,1638.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",348.35,37.7,,278.68,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",720.72,78,,576.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",763.22,82.6,,610.58,,,0,"percent of total billed charges","82.6% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,462,50,,369.60,,,0,"percent of total billed charges","50% of total billed charges",763.22,82.6,,610.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1421.12,100,,,,,0,"fee schedule",EAPG,924,100,,739.20,,,0,"percent of total billed charges","100% of total billed charges",141.37,1638.77,
"19125 Exc of breast lesion identified by radiologi",7963095,CDM,521,RC,19125,CPT,OUTPATIENT,,,1741,1131.65,,1532.08,88,,1225.66,,,0,"percent of total billed charges","88% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",6803.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",1298.41,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1096.83,63,,877.46,,,0,"percent of total billed charges","63% of total billed charges",266.37,15.3,,213.10,,,0,"percent of total billed charges","15.3% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,1201.29,69,,,,,0,"fee schedule","69% of total billed charges",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",12828.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3353.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1285.8,100,,,,,0,"fee schedule",EAPG,1638.77,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",656.36,37.7,,525.09,,,0,"percent of total billed charges","37.70% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1357.98,78,,1086.38,,,0,"percent of total billed charges","78% of total billed charges",3926.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1438.07,82.6,,1150.46,,,0,"percent of total billed charges","82.6% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1421.12,100,,,,,0,"fee schedule",EAPG,1741,100,,1392.80,,,0,"percent of total billed charges","100% of total billed charges",266.37,12828.41,
"19260 Excision of chest wall tumor including ribs",7963519,CDM,521,RC,,,OUTPATIENT,,,3401,2210.65,,2992.88,88,,2394.30,,,0,"percent of total billed charges","88% of total billed charges",1700.5,50,,1360.40,,,0,"percent of total billed charges","50% of total billed charges",571.37,16.8,,457.10,,,0,"percent of total billed charges","16.8% of total billed charges",3401,100,,2720.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",588.51,17.304,,470.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2142.63,63,,1714.10,,,0,"percent of total billed charges","63% of total billed charges",520.35,15.3,,416.28,,,0,"percent of total billed charges","15.3% of total billed charges",571.37,16.8,,457.10,,,0,"percent of total billed charges","16.8% of total billed charges",2346.69,69,,,,,0,"fee schedule","69% of total billed charges",3401,100,,2720.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3401,100,,2720.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3401,100,,2720.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2103.52,61.85,,1682.82,,,0,"percent of total billed charges","61.5% of total billed charges",571.37,16.8,,457.10,,,0,"percent of total billed charges","16.8% of total billed charges",1700.5,50,,1360.40,,,0,"percent of total billed charges","50% of total billed charges",1095.12,32.2,,876.10,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",582.8,17.136,,466.24,,,0,"percent of total billed charges","17.136% of total billed charges",742.78,21.84,,594.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1282.18,37.7,,1025.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2652.78,78,,2122.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2809.23,82.6,,2247.38,,,0,"percent of total billed charges","82.6% of total billed charges",571.37,16.8,,457.10,,,0,"percent of total billed charges","16.8% of total billed charges",1700.5,50,,1360.40,,,0,"percent of total billed charges","50% of total billed charges",2809.23,82.6,,2247.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",3401,100,,2720.80,,,0,"percent of total billed charges","100% of total billed charges",160.53,3401,
"19271 Exc of chest wall tumor, incl ribs, plastic",7961730,CDM,521,RC,21602,CPT,OUTPATIENT,,,4832,3140.8,,4252.16,88,,3401.73,,,0,"percent of total billed charges","88% of total billed charges",4832,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",4832,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,4832,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3044.16,63,,2435.33,,,0,"percent of total billed charges","63% of total billed charges",739.3,15.3,,591.44,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,3334.08,69,,,,,0,"fee schedule","69% of total billed charges",4832,100,,3865.60,,,0,"percent of total billed charges","100% of total billed charges",4832,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4832,100,,3865.60,,,0,"percent of total billed charges","100% of total billed charges",4832,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4832,100,,3865.60,,,0,"percent of total billed charges","100% of total billed charges",4832,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.92,100,,,,,0,"fee schedule",EAPG,4832,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4832,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",4832,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,4832,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1821.66,37.7,,1457.33,,,0,"percent of total billed charges","37.70% of total billed charges",4832,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4832,100,,,,,0,"fee schedule","100% of CMS fee schedule",3768.96,78,,3015.17,,,0,"percent of total billed charges","78% of total billed charges",4832,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3991.23,82.6,,3192.98,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,4832,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3991.23,82.6,,3192.98,,,0,"percent of total billed charges","82.6% of total billed charges",4832,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,4832,100,,3865.60,,,0,"percent of total billed charges","100% of total billed charges",739.3,25451.55,
"19282 Placement of breast localization device(s) (",7962068,CDM,521,RC,19282,CPT,OUTPATIENT,,,146,94.9,,128.48,88,,102.78,,,0,"percent of total billed charges","88% of total billed charges",73,50,,58.40,,,0,"percent of total billed charges","50% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1298.41,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",91.98,63,,73.58,,,0,"percent of total billed charges","63% of total billed charges",22.34,15.3,,17.87,,,0,"percent of total billed charges","15.3% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,100.74,69,,,,,0,"fee schedule","69% of total billed charges",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.3,61.85,,72.24,,,0,"percent of total billed charges","61.5% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,73,50,,58.40,,,0,"percent of total billed charges","50% of total billed charges",47.01,32.2,,37.61,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1285.8,100,,,,,0,"fee schedule",EAPG,1638.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",55.04,37.7,,44.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",113.88,78,,91.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",120.6,82.6,,96.48,,,0,"percent of total billed charges","82.6% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,73,50,,58.40,,,0,"percent of total billed charges","50% of total billed charges",120.6,82.6,,96.48,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1421.12,100,,,,,0,"fee schedule",EAPG,146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",22.34,1638.77,
"19284 Placement of breast localization device(s) (",7962069,CDM,521,RC,19284,CPT,OUTPATIENT,,,147,95.55,,129.36,88,,103.49,,,0,"percent of total billed charges","88% of total billed charges",73.5,50,,58.80,,,0,"percent of total billed charges","50% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1298.41,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",92.61,63,,74.09,,,0,"percent of total billed charges","63% of total billed charges",22.49,15.3,,17.99,,,0,"percent of total billed charges","15.3% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,101.43,69,,,,,0,"fee schedule","69% of total billed charges",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.92,61.85,,72.74,,,0,"percent of total billed charges","61.5% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,73.5,50,,58.80,,,0,"percent of total billed charges","50% of total billed charges",47.33,32.2,,37.86,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1285.8,100,,,,,0,"fee schedule",EAPG,1638.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",55.42,37.7,,44.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",114.66,78,,91.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",121.42,82.6,,97.14,,,0,"percent of total billed charges","82.6% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,73.5,50,,58.80,,,0,"percent of total billed charges","50% of total billed charges",121.42,82.6,,97.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1421.12,100,,,,,0,"fee schedule",EAPG,147,100,,117.60,,,0,"percent of total billed charges","100% of total billed charges",22.49,1638.77,
"19286 Placement of breast localization device(s) (",7962072,CDM,521,RC,19286,CPT,OUTPATIENT,,,127,82.55,,111.76,88,,89.41,,,0,"percent of total billed charges","88% of total billed charges",63.5,50,,50.80,,,0,"percent of total billed charges","50% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1298.41,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",80.01,63,,64.01,,,0,"percent of total billed charges","63% of total billed charges",19.43,15.3,,15.54,,,0,"percent of total billed charges","15.3% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,87.63,69,,,,,0,"fee schedule","69% of total billed charges",127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.55,61.85,,62.84,,,0,"percent of total billed charges","61.5% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,63.5,50,,50.80,,,0,"percent of total billed charges","50% of total billed charges",40.89,32.2,,32.71,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1285.8,100,,,,,0,"fee schedule",EAPG,1638.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47.88,37.7,,38.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",99.06,78,,79.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.9,82.6,,83.92,,,0,"percent of total billed charges","82.6% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,63.5,50,,50.80,,,0,"percent of total billed charges","50% of total billed charges",104.9,82.6,,83.92,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1421.12,100,,,,,0,"fee schedule",EAPG,127,100,,101.60,,,0,"percent of total billed charges","100% of total billed charges",19.43,1638.77,
"19281 Placement of breast localization device(s) (",7962100,CDM,521,RC,19281,CPT,OUTPATIENT,,,302,196.3,,265.76,88,,212.61,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1298.41,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.26,63,,152.21,,,0,"percent of total billed charges","63% of total billed charges",46.21,15.3,,36.97,,,0,"percent of total billed charges","15.3% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,208.38,69,,,,,0,"fee schedule","69% of total billed charges",302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1285.8,100,,,,,0,"fee schedule",EAPG,1638.77,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",113.85,37.7,,91.08,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",235.56,78,,188.45,,,0,"percent of total billed charges","78% of total billed charges",1670.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",249.45,82.6,,199.56,,,0,"percent of total billed charges","82.6% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",249.45,82.6,,199.56,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1421.12,100,,,,,0,"fee schedule",EAPG,302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",46.21,2893.89,
"19283 Placement of breast localization device(s) (",7962101,CDM,521,RC,19283,CPT,OUTPATIENT,,,306,198.9,,269.28,88,,215.42,,,0,"percent of total billed charges","88% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",1298.41,100,,,,,0,"fee schedule",EAPG,717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",192.78,63,,154.22,,,0,"percent of total billed charges","63% of total billed charges",46.82,15.3,,37.46,,,0,"percent of total billed charges","15.3% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,211.14,69,,,,,0,"fee schedule","69% of total billed charges",306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1285.8,100,,,,,0,"fee schedule",EAPG,1638.77,100,,,,,0,"fee schedule",EAPG,717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",115.36,37.7,,92.29,,,0,"percent of total billed charges","37.70% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",238.68,78,,190.94,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.76,82.6,,202.21,,,0,"percent of total billed charges","82.6% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.76,82.6,,202.21,,,0,"percent of total billed charges","82.6% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1421.12,100,,,,,0,"fee schedule",EAPG,306,100,,244.80,,,0,"percent of total billed charges","100% of total billed charges",46.82,2526.77,
"19285 Placement of breast localization device(s) (",7962102,CDM,521,RC,19285,CPT,OUTPATIENT,,,259,168.35,,227.92,88,,182.34,,,0,"percent of total billed charges","88% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",1298.41,100,,,,,0,"fee schedule",EAPG,717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",163.17,63,,130.54,,,0,"percent of total billed charges","63% of total billed charges",39.63,15.3,,31.70,,,0,"percent of total billed charges","15.3% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,178.71,69,,,,,0,"fee schedule","69% of total billed charges",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1285.8,100,,,,,0,"fee schedule",EAPG,1638.77,100,,,,,0,"fee schedule",EAPG,717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",97.64,37.7,,78.11,,,0,"percent of total billed charges","37.70% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.02,78,,161.62,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",213.93,82.6,,171.14,,,0,"percent of total billed charges","82.6% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",213.93,82.6,,171.14,,,0,"percent of total billed charges","82.6% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1421.12,100,,,,,0,"fee schedule",EAPG,259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",39.63,2526.77,
"19307 Mastectomy, modified radical, including axil",7961460,CDM,521,RC,19307,CPT,OUTPATIENT,,,3241,2106.65,,2852.08,88,,2281.66,,,0,"percent of total billed charges","88% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6136.14,100,,,,,0,"fee schedule",EAPG,3241,100,,2592.80,,,0,"percent of total billed charges","100% of total billed charges",11639.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",6320.22,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2041.83,63,,1633.46,,,0,"percent of total billed charges","63% of total billed charges",495.87,15.3,,396.70,,,0,"percent of total billed charges","15.3% of total billed charges",6136.14,100,,,,,0,"fee schedule",EAPG,2236.29,69,,,,,0,"fee schedule","69% of total billed charges",3241,100,,2592.80,,,0,"percent of total billed charges","100% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3241,100,,2592.80,,,0,"percent of total billed charges","100% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3241,100,,2592.80,,,0,"percent of total billed charges","100% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",22481.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6136.14,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5877.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6258.86,100,,,,,0,"fee schedule",EAPG,7976.98,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1221.86,37.7,,977.49,,,0,"percent of total billed charges","37.70% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2527.98,78,,2022.38,,,0,"percent of total billed charges","78% of total billed charges",6717.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2677.07,82.6,,2141.66,,,0,"percent of total billed charges","82.6% of total billed charges",6136.14,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2677.07,82.6,,2141.66,,,0,"percent of total billed charges","82.6% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6296.67,100,,,,,0,"fee schedule",EAPG,3241,100,,2592.80,,,0,"percent of total billed charges","100% of total billed charges",495.87,22481.81,
"19305 Mastectomy, radical, including pectoral musc",7962862,CDM,521,RC,19305,CPT,OUTPATIENT,,,3288,2137.2,,2893.44,88,,2314.75,,,0,"percent of total billed charges","88% of total billed charges",3288,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6136.14,100,,,,,0,"fee schedule",EAPG,3288,100,,2630.40,,,0,"percent of total billed charges","100% of total billed charges",3288,175,,,,,0,"fee schedule","175% of CMS fee schedule",6320.22,100,,,,,0,"fee schedule",EAPG,3288,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2071.44,63,,1657.15,,,0,"percent of total billed charges","63% of total billed charges",503.06,15.3,,402.45,,,0,"percent of total billed charges","15.3% of total billed charges",6136.14,100,,,,,0,"fee schedule",EAPG,2268.72,69,,,,,0,"fee schedule","69% of total billed charges",3288,100,,2630.40,,,0,"percent of total billed charges","100% of total billed charges",3288,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3288,100,,2630.40,,,0,"percent of total billed charges","100% of total billed charges",3288,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3288,100,,2630.40,,,0,"percent of total billed charges","100% of total billed charges",3288,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3288,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6136.14,100,,,,,0,"fee schedule",EAPG,3288,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3288,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3288,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6258.86,100,,,,,0,"fee schedule",EAPG,7976.98,100,,,,,0,"fee schedule",EAPG,3288,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1239.58,37.7,,991.66,,,0,"percent of total billed charges","37.70% of total billed charges",3288,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3288,100,,,,,0,"fee schedule","100% of CMS fee schedule",2564.64,78,,2051.71,,,0,"percent of total billed charges","78% of total billed charges",3288,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2715.89,82.6,,2172.71,,,0,"percent of total billed charges","82.6% of total billed charges",6136.14,100,,,,,0,"fee schedule","100% of WA fee schedule",3288,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2715.89,82.6,,2172.71,,,0,"percent of total billed charges","82.6% of total billed charges",3288,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6296.67,100,,,,,0,"fee schedule",EAPG,3288,100,,2630.40,,,0,"percent of total billed charges","100% of total billed charges",503.06,7976.98,
"19302 Mastectomy, partial; with axillary lymphaden",7963377,CDM,521,RC,19302,CPT,OUTPATIENT,,,3401,2210.65,,2992.88,88,,2394.30,,,0,"percent of total billed charges","88% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2917.59,100,,,,,0,"fee schedule",EAPG,3401,100,,2720.80,,,0,"percent of total billed charges","100% of total billed charges",11639.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",3005.11,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2142.63,63,,1714.10,,,0,"percent of total billed charges","63% of total billed charges",520.35,15.3,,416.28,,,0,"percent of total billed charges","15.3% of total billed charges",2917.59,100,,,,,0,"fee schedule",EAPG,2346.69,69,,,,,0,"fee schedule","69% of total billed charges",3401,100,,2720.80,,,0,"percent of total billed charges","100% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3401,100,,2720.80,,,0,"percent of total billed charges","100% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3401,100,,2720.80,,,0,"percent of total billed charges","100% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",22481.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2917.59,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5877.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2975.94,100,,,,,0,"fee schedule",EAPG,3792.86,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1282.18,37.7,,1025.74,,,0,"percent of total billed charges","37.70% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2652.78,78,,2122.22,,,0,"percent of total billed charges","78% of total billed charges",6717.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.23,82.6,,2247.38,,,0,"percent of total billed charges","82.6% of total billed charges",2917.59,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.23,82.6,,2247.38,,,0,"percent of total billed charges","82.6% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3078.12,100,,,,,0,"fee schedule",EAPG,3401,100,,2720.80,,,0,"percent of total billed charges","100% of total billed charges",520.35,22481.81,
"19303 Mastectomy, simple, complete",7963773,CDM,521,RC,19303,CPT,OUTPATIENT,,,3140,2041,,2763.2,88,,2210.56,,,0,"percent of total billed charges","88% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2917.59,100,,,,,0,"fee schedule",EAPG,3140,100,,2512.00,,,0,"percent of total billed charges","100% of total billed charges",11639.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",3005.11,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.2,63,,1582.56,,,0,"percent of total billed charges","63% of total billed charges",480.42,15.3,,384.34,,,0,"percent of total billed charges","15.3% of total billed charges",2917.59,100,,,,,0,"fee schedule",EAPG,2166.6,69,,,,,0,"fee schedule","69% of total billed charges",3140,100,,2512.00,,,0,"percent of total billed charges","100% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3140,100,,2512.00,,,0,"percent of total billed charges","100% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3140,100,,2512.00,,,0,"percent of total billed charges","100% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",22481.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2917.59,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5877.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2975.94,100,,,,,0,"fee schedule",EAPG,3792.86,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1183.78,37.7,,947.02,,,0,"percent of total billed charges","37.70% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2449.2,78,,1959.36,,,0,"percent of total billed charges","78% of total billed charges",6717.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2593.64,82.6,,2074.91,,,0,"percent of total billed charges","82.6% of total billed charges",2917.59,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2593.64,82.6,,2074.91,,,0,"percent of total billed charges","82.6% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3078.12,100,,,,,0,"fee schedule",EAPG,3140,100,,2512.00,,,0,"percent of total billed charges","100% of total billed charges",480.42,22481.81,
"19300 Mastectomy for gynecomastia",7963805,CDM,521,RC,19300,CPT,OUTPATIENT,,,622,404.3,,547.36,88,,437.89,,,0,"percent of total billed charges","88% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,622,100,,497.60,,,0,"percent of total billed charges","100% of total billed charges",6803.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",1298.41,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",391.86,63,,313.49,,,0,"percent of total billed charges","63% of total billed charges",95.17,15.3,,76.14,,,0,"percent of total billed charges","15.3% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,429.18,69,,,,,0,"fee schedule","69% of total billed charges",622,100,,497.60,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",622,100,,497.60,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",622,100,,497.60,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",12828.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.59,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3353.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1285.8,100,,,,,0,"fee schedule",EAPG,1638.77,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",234.49,37.7,,187.59,,,0,"percent of total billed charges","37.70% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",485.16,78,,388.13,,,0,"percent of total billed charges","78% of total billed charges",3926.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",513.77,82.6,,411.02,,,0,"percent of total billed charges","82.6% of total billed charges",1260.59,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",513.77,82.6,,411.02,,,0,"percent of total billed charges","82.6% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1421.12,100,,,,,0,"fee schedule",EAPG,622,100,,497.60,,,0,"percent of total billed charges","100% of total billed charges",95.17,12828.41,
"19301 Mastectomy, partial",7963905,CDM,521,RC,19301,CPT,OUTPATIENT,,,1416,920.4,,1246.08,88,,996.86,,,0,"percent of total billed charges","88% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2917.59,100,,,,,0,"fee schedule",EAPG,1416,100,,1132.80,,,0,"percent of total billed charges","100% of total billed charges",6803.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",3005.11,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.08,63,,713.66,,,0,"percent of total billed charges","63% of total billed charges",216.65,15.3,,173.32,,,0,"percent of total billed charges","15.3% of total billed charges",2917.59,100,,,,,0,"fee schedule",EAPG,977.04,69,,,,,0,"fee schedule","69% of total billed charges",1416,100,,1132.80,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1416,100,,1132.80,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1416,100,,1132.80,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",12828.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2917.59,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3353.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2975.94,100,,,,,0,"fee schedule",EAPG,3792.86,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",533.83,37.7,,427.06,,,0,"percent of total billed charges","37.70% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1104.48,78,,883.58,,,0,"percent of total billed charges","78% of total billed charges",3926.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1169.62,82.6,,935.70,,,0,"percent of total billed charges","82.6% of total billed charges",2917.59,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1169.62,82.6,,935.70,,,0,"percent of total billed charges","82.6% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3078.12,100,,,,,0,"fee schedule",EAPG,1416,100,,1132.80,,,0,"percent of total billed charges","100% of total billed charges",216.65,12828.41,
"19318 Reduction mammaplasty",7963888,CDM,521,RC,19318,CPT,OUTPATIENT,,,8482,5513.3,,7464.16,88,,5971.33,,,0,"percent of total billed charges","88% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6136.14,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",11639.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",6320.22,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5343.66,63,,4274.93,,,0,"percent of total billed charges","63% of total billed charges",1297.75,15.3,,1038.20,,,0,"percent of total billed charges","15.3% of total billed charges",6136.14,100,,,,,0,"fee schedule",EAPG,5852.58,69,,,,,0,"fee schedule","69% of total billed charges",8482,100,,6785.60,,,0,"percent of total billed charges","100% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8482,100,,6785.60,,,0,"percent of total billed charges","100% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8482,100,,6785.60,,,0,"percent of total billed charges","100% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",22481.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6136.14,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5877.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6258.86,100,,,,,0,"fee schedule",EAPG,7976.98,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3197.71,37.7,,2558.17,,,0,"percent of total billed charges","37.70% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6615.96,78,,5292.77,,,0,"percent of total billed charges","78% of total billed charges",6717.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7006.13,82.6,,5604.90,,,0,"percent of total billed charges","82.6% of total billed charges",6136.14,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7006.13,82.6,,5604.90,,,0,"percent of total billed charges","82.6% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6296.67,100,,,,,0,"fee schedule",EAPG,8482,100,,6785.60,,,0,"percent of total billed charges","100% of total billed charges",1297.75,22481.81,
"19316 Mastopexy",7963935,CDM,521,RC,19316,CPT,OUTPATIENT,,,1687,1096.55,,1484.56,88,,1187.65,,,0,"percent of total billed charges","88% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2917.59,100,,,,,0,"fee schedule",EAPG,1687,100,,1349.60,,,0,"percent of total billed charges","100% of total billed charges",11639.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",3005.11,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1062.81,63,,850.25,,,0,"percent of total billed charges","63% of total billed charges",258.11,15.3,,206.49,,,0,"percent of total billed charges","15.3% of total billed charges",2917.59,100,,,,,0,"fee schedule",EAPG,1164.03,69,,,,,0,"fee schedule","69% of total billed charges",1687,100,,1349.60,,,0,"percent of total billed charges","100% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1687,100,,1349.60,,,0,"percent of total billed charges","100% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1687,100,,1349.60,,,0,"percent of total billed charges","100% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",22481.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2917.59,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5877.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2975.94,100,,,,,0,"fee schedule",EAPG,3792.86,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",636,37.7,,508.80,,,0,"percent of total billed charges","37.70% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1315.86,78,,1052.69,,,0,"percent of total billed charges","78% of total billed charges",6717.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1393.46,82.6,,1114.77,,,0,"percent of total billed charges","82.6% of total billed charges",2917.59,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1393.46,82.6,,1114.77,,,0,"percent of total billed charges","82.6% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3078.12,100,,,,,0,"fee schedule",EAPG,1687,100,,1349.60,,,0,"percent of total billed charges","100% of total billed charges",258.11,22481.81,
"19325 Mammaplasty, augmentation; with prosthetic i",7963378,CDM,521,RC,19325,CPT,OUTPATIENT,,,1379,896.35,,1213.52,88,,970.82,,,0,"percent of total billed charges","88% of total billed charges",9614.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2917.59,100,,,,,0,"fee schedule",EAPG,1379,100,,1103.20,,,0,"percent of total billed charges","100% of total billed charges",16825.93,175,,,,,0,"fee schedule","175% of CMS fee schedule",3005.11,100,,,,,0,"fee schedule",EAPG,9614.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,63,,695.02,,,0,"percent of total billed charges","63% of total billed charges",210.99,15.3,,168.79,,,0,"percent of total billed charges","15.3% of total billed charges",2917.59,100,,,,,0,"fee schedule",EAPG,951.51,69,,,,,0,"fee schedule","69% of total billed charges",1379,100,,1103.20,,,0,"percent of total billed charges","100% of total billed charges",9614.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1379,100,,1103.20,,,0,"percent of total billed charges","100% of total billed charges",9614.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1379,100,,1103.20,,,0,"percent of total billed charges","100% of total billed charges",9614.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",36237.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2917.59,100,,,,,0,"fee schedule",EAPG,9614.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9473.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",9614.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2975.94,100,,,,,0,"fee schedule",EAPG,3792.86,100,,,,,0,"fee schedule",EAPG,9614.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",519.88,37.7,,415.90,,,0,"percent of total billed charges","37.70% of total billed charges",9614.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",9614.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1075.62,78,,860.50,,,0,"percent of total billed charges","78% of total billed charges",9710.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1139.05,82.6,,911.24,,,0,"percent of total billed charges","82.6% of total billed charges",2917.59,100,,,,,0,"fee schedule",EAPG,9614.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1139.05,82.6,,911.24,,,0,"percent of total billed charges","82.6% of total billed charges",9614.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3078.12,100,,,,,0,"fee schedule",EAPG,1379,100,,1103.20,,,0,"percent of total billed charges","100% of total billed charges",210.99,36237.94,
"19328 Removal of intact mammary implant",7963702,CDM,521,RC,19328,CPT,OUTPATIENT,,,1083,703.95,,953.04,88,,762.43,,,0,"percent of total billed charges","88% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2917.59,100,,,,,0,"fee schedule",EAPG,1083,100,,866.40,,,0,"percent of total billed charges","100% of total billed charges",6803.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",3005.11,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",682.29,63,,545.83,,,0,"percent of total billed charges","63% of total billed charges",165.7,15.3,,132.56,,,0,"percent of total billed charges","15.3% of total billed charges",2917.59,100,,,,,0,"fee schedule",EAPG,747.27,69,,,,,0,"fee schedule","69% of total billed charges",1083,100,,866.40,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1083,100,,866.40,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1083,100,,866.40,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",12828.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2917.59,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3353.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2975.94,100,,,,,0,"fee schedule",EAPG,3792.86,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",408.29,37.7,,326.63,,,0,"percent of total billed charges","37.70% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.74,78,,675.79,,,0,"percent of total billed charges","78% of total billed charges",3926.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",894.56,82.6,,715.65,,,0,"percent of total billed charges","82.6% of total billed charges",2917.59,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",894.56,82.6,,715.65,,,0,"percent of total billed charges","82.6% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3078.12,100,,,,,0,"fee schedule",EAPG,1083,100,,866.40,,,0,"percent of total billed charges","100% of total billed charges",165.7,12828.42,
"19330 Removal of mammary implant material",7963671,CDM,521,RC,19330,CPT,OUTPATIENT,,,1359,883.35,,1195.92,88,,956.74,,,0,"percent of total billed charges","88% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2917.59,100,,,,,0,"fee schedule",EAPG,1359,100,,1087.20,,,0,"percent of total billed charges","100% of total billed charges",6803.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",3005.11,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",856.17,63,,684.94,,,0,"percent of total billed charges","63% of total billed charges",207.93,15.3,,166.34,,,0,"percent of total billed charges","15.3% of total billed charges",2917.59,100,,,,,0,"fee schedule",EAPG,937.71,69,,,,,0,"fee schedule","69% of total billed charges",1359,100,,1087.20,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1359,100,,1087.20,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1359,100,,1087.20,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",12828.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2917.59,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3353.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2975.94,100,,,,,0,"fee schedule",EAPG,3792.86,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",512.34,37.7,,409.87,,,0,"percent of total billed charges","37.70% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1060.02,78,,848.02,,,0,"percent of total billed charges","78% of total billed charges",3926.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1122.53,82.6,,898.02,,,0,"percent of total billed charges","82.6% of total billed charges",2917.59,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1122.53,82.6,,898.02,,,0,"percent of total billed charges","82.6% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3078.12,100,,,,,0,"fee schedule",EAPG,1359,100,,1087.20,,,0,"percent of total billed charges","100% of total billed charges",207.93,12828.42,
"19340 Immediate insertion of breast prosthesis fol",7961572,CDM,521,RC,19340,CPT,OUTPATIENT,,,2196,1427.4,,1932.48,88,,1545.98,,,0,"percent of total billed charges","88% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2917.59,100,,,,,0,"fee schedule",EAPG,2196,100,,1756.80,,,0,"percent of total billed charges","100% of total billed charges",11639.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",3005.11,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1383.48,63,,1106.78,,,0,"percent of total billed charges","63% of total billed charges",335.99,15.3,,268.79,,,0,"percent of total billed charges","15.3% of total billed charges",2917.59,100,,,,,0,"fee schedule",EAPG,1515.24,69,,,,,0,"fee schedule","69% of total billed charges",2196,100,,1756.80,,,0,"percent of total billed charges","100% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2196,100,,1756.80,,,0,"percent of total billed charges","100% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2196,100,,1756.80,,,0,"percent of total billed charges","100% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",22481.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2917.59,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5877.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2975.94,100,,,,,0,"fee schedule",EAPG,3792.86,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",827.89,37.7,,662.31,,,0,"percent of total billed charges","37.70% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1712.88,78,,1370.30,,,0,"percent of total billed charges","78% of total billed charges",6717.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1813.9,82.6,,1451.12,,,0,"percent of total billed charges","82.6% of total billed charges",2917.59,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1813.9,82.6,,1451.12,,,0,"percent of total billed charges","82.6% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3078.12,100,,,,,0,"fee schedule",EAPG,2196,100,,1756.80,,,0,"percent of total billed charges","100% of total billed charges",335.99,22481.81,
"19357 Breast reconstruction, immediate/delayed, w/",7961659,CDM,521,RC,19357,CPT,OUTPATIENT,,,3289,2137.85,,2894.32,88,,2315.46,,,0,"percent of total billed charges","88% of total billed charges",17973.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6136.14,100,,,,,0,"fee schedule",EAPG,3289,100,,2631.20,,,0,"percent of total billed charges","100% of total billed charges",31453.97,175,,,,,0,"fee schedule","175% of CMS fee schedule",6320.22,100,,,,,0,"fee schedule",EAPG,17973.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2072.07,63,,1657.66,,,0,"percent of total billed charges","63% of total billed charges",503.22,15.3,,402.58,,,0,"percent of total billed charges","15.3% of total billed charges",6136.14,100,,,,,0,"fee schedule",EAPG,2269.41,69,,,,,0,"fee schedule","69% of total billed charges",3289,100,,2631.20,,,0,"percent of total billed charges","100% of total billed charges",17973.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3289,100,,2631.20,,,0,"percent of total billed charges","100% of total billed charges",17973.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3289,100,,2631.20,,,0,"percent of total billed charges","100% of total billed charges",17973.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",60648.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6136.14,100,,,,,0,"fee schedule",EAPG,17973.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15855.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",17973.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6258.86,100,,,,,0,"fee schedule",EAPG,7976.98,100,,,,,0,"fee schedule",EAPG,17973.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1239.95,37.7,,991.96,,,0,"percent of total billed charges","37.70% of total billed charges",17973.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",17973.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2565.42,78,,2052.34,,,0,"percent of total billed charges","78% of total billed charges",18153.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2716.71,82.6,,2173.37,,,0,"percent of total billed charges","82.6% of total billed charges",6136.14,100,,,,,0,"fee schedule",EAPG,17973.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2716.71,82.6,,2173.37,,,0,"percent of total billed charges","82.6% of total billed charges",17973.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6296.67,100,,,,,0,"fee schedule",EAPG,3289,100,,2631.20,,,0,"percent of total billed charges","100% of total billed charges",503.22,60648.32,
"19350 Delayed insertion of breast prosthesis follo",7961731,CDM,521,RC,19350,CPT,OUTPATIENT,,,1446,939.9,,1272.48,88,,1017.98,,,0,"percent of total billed charges","88% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2917.59,100,,,,,0,"fee schedule",EAPG,1446,100,,1156.80,,,0,"percent of total billed charges","100% of total billed charges",6803.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",3005.11,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",910.98,63,,728.78,,,0,"percent of total billed charges","63% of total billed charges",221.24,15.3,,176.99,,,0,"percent of total billed charges","15.3% of total billed charges",2917.59,100,,,,,0,"fee schedule",EAPG,997.74,69,,,,,0,"fee schedule","69% of total billed charges",1446,100,,1156.80,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1446,100,,1156.80,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1446,100,,1156.80,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",12828.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2917.59,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3353.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2975.94,100,,,,,0,"fee schedule",EAPG,3792.86,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",545.14,37.7,,436.11,,,0,"percent of total billed charges","37.70% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1127.88,78,,902.30,,,0,"percent of total billed charges","78% of total billed charges",3926.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1194.4,82.6,,955.52,,,0,"percent of total billed charges","82.6% of total billed charges",2917.59,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1194.4,82.6,,955.52,,,0,"percent of total billed charges","82.6% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3078.12,100,,,,,0,"fee schedule",EAPG,1446,100,,1156.80,,,0,"percent of total billed charges","100% of total billed charges",221.24,12828.41,
"19355 Correction of inverted nipples",7963742,CDM,521,RC,19355,CPT,OUTPATIENT,,,1209,785.85,,1063.92,88,,851.14,,,0,"percent of total billed charges","88% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2917.59,100,,,,,0,"fee schedule",EAPG,1209,100,,967.20,,,0,"percent of total billed charges","100% of total billed charges",6803.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",3005.11,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",761.67,63,,609.34,,,0,"percent of total billed charges","63% of total billed charges",184.98,15.3,,147.98,,,0,"percent of total billed charges","15.3% of total billed charges",2917.59,100,,,,,0,"fee schedule",EAPG,834.21,69,,,,,0,"fee schedule","69% of total billed charges",1209,100,,967.20,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1209,100,,967.20,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1209,100,,967.20,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",12828.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2917.59,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3353.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2975.94,100,,,,,0,"fee schedule",EAPG,3792.86,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",455.79,37.7,,364.63,,,0,"percent of total billed charges","37.70% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",943.02,78,,754.42,,,0,"percent of total billed charges","78% of total billed charges",3926.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",998.63,82.6,,798.90,,,0,"percent of total billed charges","82.6% of total billed charges",2917.59,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",998.63,82.6,,798.90,,,0,"percent of total billed charges","82.6% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3078.12,100,,,,,0,"fee schedule",EAPG,1209,100,,967.20,,,0,"percent of total billed charges","100% of total billed charges",184.98,12828.41,
"19361 Breast reconstruction with latissimus dorsi",7962584,CDM,521,RC,19361,CPT,OUTPATIENT,,,3395,2206.75,,2987.6,88,,2390.08,,,0,"percent of total billed charges","88% of total billed charges",3395,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6136.14,100,,,,,0,"fee schedule",EAPG,3395,100,,2716.00,,,0,"percent of total billed charges","100% of total billed charges",3395,175,,,,,0,"fee schedule","175% of CMS fee schedule",6320.22,100,,,,,0,"fee schedule",EAPG,3395,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2138.85,63,,1711.08,,,0,"percent of total billed charges","63% of total billed charges",519.44,15.3,,415.55,,,0,"percent of total billed charges","15.3% of total billed charges",6136.14,100,,,,,0,"fee schedule",EAPG,2342.55,69,,,,,0,"fee schedule","69% of total billed charges",3395,100,,2716.00,,,0,"percent of total billed charges","100% of total billed charges",3395,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3395,100,,2716.00,,,0,"percent of total billed charges","100% of total billed charges",3395,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3395,100,,2716.00,,,0,"percent of total billed charges","100% of total billed charges",3395,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3395,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6136.14,100,,,,,0,"fee schedule",EAPG,3395,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3395,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3395,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6258.86,100,,,,,0,"fee schedule",EAPG,7976.98,100,,,,,0,"fee schedule",EAPG,3395,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1279.92,37.7,,1023.94,,,0,"percent of total billed charges","37.70% of total billed charges",3395,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3395,100,,,,,0,"fee schedule","100% of CMS fee schedule",2648.1,78,,2118.48,,,0,"percent of total billed charges","78% of total billed charges",3395,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2804.27,82.6,,2243.42,,,0,"percent of total billed charges","82.6% of total billed charges",6136.14,100,,,,,0,"fee schedule","100% of WA fee schedule",3395,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2804.27,82.6,,2243.42,,,0,"percent of total billed charges","82.6% of total billed charges",3395,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6296.67,100,,,,,0,"fee schedule",EAPG,3395,100,,2716.00,,,0,"percent of total billed charges","100% of total billed charges",519.44,7976.98,
"19370 Open periprosthetic capsulotomy, breast",7963594,CDM,521,RC,19370,CPT,OUTPATIENT,,,1496,972.4,,1316.48,88,,1053.18,,,0,"percent of total billed charges","88% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2917.59,100,,,,,0,"fee schedule",EAPG,1496,100,,1196.80,,,0,"percent of total billed charges","100% of total billed charges",6803.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",3005.11,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",942.48,63,,753.98,,,0,"percent of total billed charges","63% of total billed charges",228.89,15.3,,183.11,,,0,"percent of total billed charges","15.3% of total billed charges",2917.59,100,,,,,0,"fee schedule",EAPG,1032.24,69,,,,,0,"fee schedule","69% of total billed charges",1496,100,,1196.80,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1496,100,,1196.80,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1496,100,,1196.80,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",12828.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2917.59,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3353.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2975.94,100,,,,,0,"fee schedule",EAPG,3792.86,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",563.99,37.7,,451.19,,,0,"percent of total billed charges","37.70% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1166.88,78,,933.50,,,0,"percent of total billed charges","78% of total billed charges",3926.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1235.7,82.6,,988.56,,,0,"percent of total billed charges","82.6% of total billed charges",2917.59,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1235.7,82.6,,988.56,,,0,"percent of total billed charges","82.6% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3078.12,100,,,,,0,"fee schedule",EAPG,1496,100,,1196.80,,,0,"percent of total billed charges","100% of total billed charges",228.89,12828.41,
"19371 Periprosthetic capsulectomy, breast",7963672,CDM,521,RC,19371,CPT,OUTPATIENT,,,1708,1110.2,,1503.04,88,,1202.43,,,0,"percent of total billed charges","88% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2917.59,100,,,,,0,"fee schedule",EAPG,1708,100,,1366.40,,,0,"percent of total billed charges","100% of total billed charges",6803.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",3005.11,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1076.04,63,,860.83,,,0,"percent of total billed charges","63% of total billed charges",261.32,15.3,,209.06,,,0,"percent of total billed charges","15.3% of total billed charges",2917.59,100,,,,,0,"fee schedule",EAPG,1178.52,69,,,,,0,"fee schedule","69% of total billed charges",1708,100,,1366.40,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1708,100,,1366.40,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1708,100,,1366.40,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",12828.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2917.59,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3353.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2975.94,100,,,,,0,"fee schedule",EAPG,3792.86,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",643.92,37.7,,515.14,,,0,"percent of total billed charges","37.70% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1332.24,78,,1065.79,,,0,"percent of total billed charges","78% of total billed charges",3926.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1410.81,82.6,,1128.65,,,0,"percent of total billed charges","82.6% of total billed charges",2917.59,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1410.81,82.6,,1128.65,,,0,"percent of total billed charges","82.6% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3078.12,100,,,,,0,"fee schedule",EAPG,1708,100,,1366.40,,,0,"percent of total billed charges","100% of total billed charges",261.32,12828.41,
"19380 Revision of reconstructed breast",7963713,CDM,521,RC,19380,CPT,OUTPATIENT,,,1687,1096.55,,1484.56,88,,1187.65,,,0,"percent of total billed charges","88% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2917.59,100,,,,,0,"fee schedule",EAPG,1687,100,,1349.60,,,0,"percent of total billed charges","100% of total billed charges",11639.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",3005.11,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1062.81,63,,850.25,,,0,"percent of total billed charges","63% of total billed charges",258.11,15.3,,206.49,,,0,"percent of total billed charges","15.3% of total billed charges",2917.59,100,,,,,0,"fee schedule",EAPG,1164.03,69,,,,,0,"fee schedule","69% of total billed charges",1687,100,,1349.60,,,0,"percent of total billed charges","100% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1687,100,,1349.60,,,0,"percent of total billed charges","100% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1687,100,,1349.60,,,0,"percent of total billed charges","100% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",22481.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2917.59,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5877.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2975.94,100,,,,,0,"fee schedule",EAPG,3792.86,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",636,37.7,,508.80,,,0,"percent of total billed charges","37.70% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1315.86,78,,1052.69,,,0,"percent of total billed charges","78% of total billed charges",6717.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1393.46,82.6,,1114.77,,,0,"percent of total billed charges","82.6% of total billed charges",2917.59,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1393.46,82.6,,1114.77,,,0,"percent of total billed charges","82.6% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3078.12,100,,,,,0,"fee schedule",EAPG,1687,100,,1349.60,,,0,"percent of total billed charges","100% of total billed charges",258.11,22481.81,
"20102 Exploration of penetrating wound (separate p",7962697,CDM,521,RC,20102,CPT,OUTPATIENT,,,1721,1118.65,,1514.48,88,,1211.58,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.83,100,,,,,0,"fee schedule",EAPG,1721,100,,1376.80,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",930.95,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1084.23,63,,867.38,,,0,"percent of total billed charges","63% of total billed charges",263.31,15.3,,210.65,,,0,"percent of total billed charges","15.3% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,1187.49,69,,,,,0,"fee schedule","69% of total billed charges",1721,100,,1376.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1721,100,,1376.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1721,100,,1376.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.83,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",921.91,100,,,,,0,"fee schedule",EAPG,1174.99,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",648.82,37.7,,519.06,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1342.38,78,,1073.90,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1421.55,82.6,,1137.24,,,0,"percent of total billed charges","82.6% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1421.55,82.6,,1137.24,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1064.36,100,,,,,0,"fee schedule",EAPG,1721,100,,1376.80,,,0,"percent of total billed charges","100% of total billed charges",263.31,6968.7,
"20103 Exploration of penetrating wound (separate p",7962986,CDM,521,RC,20103,CPT,OUTPATIENT,,,1445,939.25,,1271.6,88,,1017.28,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,1445,100,,1156.00,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",910.35,63,,728.28,,,0,"percent of total billed charges","63% of total billed charges",221.09,15.3,,176.87,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,997.05,69,,,,,0,"fee schedule","69% of total billed charges",1445,100,,1156.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1445,100,,1156.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1445,100,,1156.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",544.77,37.7,,435.82,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1127.1,78,,901.68,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.57,82.6,,954.86,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.57,82.6,,954.86,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.26,100,,,,,0,"fee schedule",EAPG,1445,100,,1156.00,,,0,"percent of total billed charges","100% of total billed charges",221.09,2893.89,
"20101 Exploration of penetrating wound (separate p",7963096,CDM,521,RC,20101,CPT,OUTPATIENT,,,2096,1362.4,,1844.48,88,,1475.58,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.83,100,,,,,0,"fee schedule",EAPG,2096,100,,1676.80,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",930.95,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1320.48,63,,1056.38,,,0,"percent of total billed charges","63% of total billed charges",320.69,15.3,,256.55,,,0,"percent of total billed charges","15.3% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,1446.24,69,,,,,0,"fee schedule","69% of total billed charges",2096,100,,1676.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2096,100,,1676.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2096,100,,1676.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.83,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",921.91,100,,,,,0,"fee schedule",EAPG,1174.99,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",790.19,37.7,,632.15,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1634.88,78,,1307.90,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1731.3,82.6,,1385.04,,,0,"percent of total billed charges","82.6% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1731.3,82.6,,1385.04,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1064.36,100,,,,,0,"fee schedule",EAPG,2096,100,,1676.80,,,0,"percent of total billed charges","100% of total billed charges",320.69,6968.7,
"20100 Exploration of penetrating wound (separate p",7963132,CDM,521,RC,20100,CPT,OUTPATIENT,,,1978,1285.7,,1740.64,88,,1392.51,,,0,"percent of total billed charges","88% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.83,100,,,,,0,"fee schedule",EAPG,1978,100,,1582.40,,,0,"percent of total billed charges","100% of total billed charges",982.07,175,,,,,0,"fee schedule","175% of CMS fee schedule",930.95,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1246.14,63,,996.91,,,0,"percent of total billed charges","63% of total billed charges",302.63,15.3,,242.10,,,0,"percent of total billed charges","15.3% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,1364.82,69,,,,,0,"fee schedule","69% of total billed charges",1978,100,,1582.40,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978,100,,1582.40,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978,100,,1582.40,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",1837.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.83,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",480.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",921.91,100,,,,,0,"fee schedule",EAPG,1174.99,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",745.71,37.7,,596.57,,,0,"percent of total billed charges","37.70% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1542.84,78,,1234.27,,,0,"percent of total billed charges","78% of total billed charges",566.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1633.83,82.6,,1307.06,,,0,"percent of total billed charges","82.6% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1633.83,82.6,,1307.06,,,0,"percent of total billed charges","82.6% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1064.36,100,,,,,0,"fee schedule",EAPG,1978,100,,1582.40,,,0,"percent of total billed charges","100% of total billed charges",302.63,1978,
"20206 Biopsy, muscle, percutaneous needle",7963673,CDM,521,RC,20206,CPT,OUTPATIENT,,,378,245.7,,332.64,88,,266.11,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.92,100,,,,,0,"fee schedule",EAPG,378,100,,302.40,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",585.99,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",238.14,63,,190.51,,,0,"percent of total billed charges","63% of total billed charges",57.83,15.3,,46.26,,,0,"percent of total billed charges","15.3% of total billed charges",568.92,100,,,,,0,"fee schedule",EAPG,260.82,69,,,,,0,"fee schedule","69% of total billed charges",378,100,,302.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",378,100,,302.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",378,100,,302.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.92,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",580.3,100,,,,,0,"fee schedule",EAPG,739.6,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",142.51,37.7,,114.01,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.84,78,,235.87,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",312.23,82.6,,249.78,,,0,"percent of total billed charges","82.6% of total billed charges",568.92,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",312.23,82.6,,249.78,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",729.45,100,,,,,0,"fee schedule",EAPG,378,100,,302.40,,,0,"percent of total billed charges","100% of total billed charges",57.83,5715.97,
"20200 Biopsy, muscle; superficial",7963806,CDM,521,RC,20200,CPT,OUTPATIENT,,,482,313.3,,424.16,88,,339.33,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,482,100,,385.60,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",303.66,63,,242.93,,,0,"percent of total billed charges","63% of total billed charges",73.75,15.3,,59.00,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,332.58,69,,,,,0,"fee schedule","69% of total billed charges",482,100,,385.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",482,100,,385.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",482,100,,385.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",181.71,37.7,,145.37,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",375.96,78,,300.77,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",398.13,82.6,,318.50,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",398.13,82.6,,318.50,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,482,100,,385.60,,,0,"percent of total billed charges","100% of total billed charges",73.75,5715.97,
"20205 Biopsy, muscle; deep",7963901,CDM,521,RC,20205,CPT,OUTPATIENT,,,812,527.8,,714.56,88,,571.65,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,812,100,,649.60,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",511.56,63,,409.25,,,0,"percent of total billed charges","63% of total billed charges",124.24,15.3,,99.39,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,560.28,69,,,,,0,"fee schedule","69% of total billed charges",812,100,,649.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",812,100,,649.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",812,100,,649.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",306.12,37.7,,244.90,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",633.36,78,,506.69,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",670.71,82.6,,536.57,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",670.71,82.6,,536.57,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,812,100,,649.60,,,0,"percent of total billed charges","100% of total billed charges",124.24,9628.23,
"20220 Biopsy, bone, trocar, or needle; superficial",7961897,CDM,521,RC,20220,CPT,OUTPATIENT,,,451,293.15,,396.88,88,,317.50,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.92,100,,,,,0,"fee schedule",EAPG,451,100,,360.80,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",585.99,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.13,63,,227.30,,,0,"percent of total billed charges","63% of total billed charges",69,15.3,,55.20,,,0,"percent of total billed charges","15.3% of total billed charges",568.92,100,,,,,0,"fee schedule",EAPG,311.19,69,,,,,0,"fee schedule","69% of total billed charges",451,100,,360.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",451,100,,360.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",451,100,,360.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.92,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",580.3,100,,,,,0,"fee schedule",EAPG,739.6,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",170.03,37.7,,136.02,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",351.78,78,,281.42,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",372.53,82.6,,298.02,,,0,"percent of total billed charges","82.6% of total billed charges",568.92,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",372.53,82.6,,298.02,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",729.45,100,,,,,0,"fee schedule",EAPG,451,100,,360.80,,,0,"percent of total billed charges","100% of total billed charges",69,5715.97,
"20225 Biopsy, bone, trocar, or needle; deep (eg, v",7962956,CDM,521,RC,20225,CPT,OUTPATIENT,,,456,296.4,,401.28,88,,321.02,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,456,100,,364.80,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287.28,63,,229.82,,,0,"percent of total billed charges","63% of total billed charges",69.77,15.3,,55.82,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,314.64,69,,,,,0,"fee schedule","69% of total billed charges",456,100,,364.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",456,100,,364.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",456,100,,364.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",171.91,37.7,,137.53,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.68,78,,284.54,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",376.66,82.6,,301.33,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",376.66,82.6,,301.33,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,456,100,,364.80,,,0,"percent of total billed charges","100% of total billed charges",69.77,5715.97,
"20245 Biopsy, bone, open; deep (eg, humerus, ischi",7963272,CDM,521,RC,20245,CPT,OUTPATIENT,,,1513,983.45,,1331.44,88,,1065.15,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1513,100,,1210.40,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",953.19,63,,762.55,,,0,"percent of total billed charges","63% of total billed charges",231.49,15.3,,185.19,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1043.97,69,,,,,0,"fee schedule","69% of total billed charges",1513,100,,1210.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1513,100,,1210.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1513,100,,1210.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",570.4,37.7,,456.32,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1180.14,78,,944.11,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1249.74,82.6,,999.79,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1249.74,82.6,,999.79,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,1513,100,,1210.40,,,0,"percent of total billed charges","100% of total billed charges",231.49,9628.23,
"20240 Biopsy, bone, open; superficial",7963725,CDM,521,RC,20240,CPT,OUTPATIENT,,,843,547.95,,741.84,88,,593.47,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,843,100,,674.40,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",531.09,63,,424.87,,,0,"percent of total billed charges","63% of total billed charges",128.98,15.3,,103.18,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,581.67,69,,,,,0,"fee schedule","69% of total billed charges",843,100,,674.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",843,100,,674.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",843,100,,674.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",317.81,37.7,,254.25,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",657.54,78,,526.03,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",696.32,82.6,,557.06,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",696.32,82.6,,557.06,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,843,100,,674.40,,,0,"percent of total billed charges","100% of total billed charges",128.98,9628.23,
"20251 Biopsy, vertebral body, open; lumbar or cerv",7963422,CDM,521,RC,20251,CPT,OUTPATIENT,,,2055,1335.75,,1808.4,88,,1446.72,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,2055,100,,1644.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1294.65,63,,1035.72,,,0,"percent of total billed charges","63% of total billed charges",314.42,15.3,,251.54,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,1417.95,69,,,,,0,"fee schedule","69% of total billed charges",2055,100,,1644.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2055,100,,1644.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2055,100,,1644.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",774.74,37.7,,619.79,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1602.9,78,,1282.32,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1697.43,82.6,,1357.94,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1697.43,82.6,,1357.94,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,2055,100,,1644.00,,,0,"percent of total billed charges","100% of total billed charges",314.42,25451.55,
"20250 Biopsy, vertebral body, open; thoracic",7963617,CDM,521,RC,20250,CPT,OUTPATIENT,,,1976,1284.4,,1738.88,88,,1391.10,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,1976,100,,1580.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1244.88,63,,995.90,,,0,"percent of total billed charges","63% of total billed charges",302.33,15.3,,241.86,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,1363.44,69,,,,,0,"fee schedule","69% of total billed charges",1976,100,,1580.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1976,100,,1580.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1976,100,,1580.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",744.95,37.7,,595.96,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1541.28,78,,1233.02,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1632.18,82.6,,1305.74,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1632.18,82.6,,1305.74,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,1976,100,,1580.80,,,0,"percent of total billed charges","100% of total billed charges",302.33,11498.59,
"20500 Injection of sinus tract; therapeutic (separ",7963128,CDM,521,RC,20500,CPT,OUTPATIENT,,,839,545.35,,738.32,88,,590.66,,,0,"percent of total billed charges","88% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,839,100,,671.20,,,0,"percent of total billed charges","100% of total billed charges",2722.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",528.57,63,,422.86,,,0,"percent of total billed charges","63% of total billed charges",128.37,15.3,,102.70,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,578.91,69,,,,,0,"fee schedule","69% of total billed charges",839,100,,671.20,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",839,100,,671.20,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",839,100,,671.20,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",5495.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1436.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",316.3,37.7,,253.04,,,0,"percent of total billed charges","37.70% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",654.42,78,,523.54,,,0,"percent of total billed charges","78% of total billed charges",1571.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",693.01,82.6,,554.41,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",693.01,82.6,,554.41,,,0,"percent of total billed charges","82.6% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.24,100,,,,,0,"fee schedule",EAPG,839,100,,671.20,,,0,"percent of total billed charges","100% of total billed charges",128.37,5495.75,
"20520 Removal of foreign body in muscle or tendon",7903178,CDM,521,RC,20520,CPT,OUTPATIENT,,,365,237.25,,321.2,88,,256.96,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,365,100,,292.00,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.95,63,,183.96,,,0,"percent of total billed charges","63% of total billed charges",55.85,15.3,,44.68,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,251.85,69,,,,,0,"fee schedule","69% of total billed charges",365,100,,292.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",365,100,,292.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",365,100,,292.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",137.61,37.7,,110.09,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.7,78,,227.76,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",301.49,82.6,,241.19,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",301.49,82.6,,241.19,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,365,100,,292.00,,,0,"percent of total billed charges","100% of total billed charges",55.85,5715.97,
"20526 Injection, therapeutic (eg, local anesthetic",7962585,CDM,521,RC,20526,CPT,OUTPATIENT,,,202,131.3,,177.76,88,,142.21,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",223.22,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",127.26,63,,101.81,,,0,"percent of total billed charges","63% of total billed charges",30.91,15.3,,24.73,,,0,"percent of total billed charges","15.3% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,139.38,69,,,,,0,"fee schedule","69% of total billed charges",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.05,100,,,,,0,"fee schedule",EAPG,281.73,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",76.15,37.7,,60.92,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",157.56,78,,126.05,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",166.85,82.6,,133.48,,,0,"percent of total billed charges","82.6% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",166.85,82.6,,133.48,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",377.25,100,,,,,0,"fee schedule",EAPG,202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",30.91,1061,
"20525 Removal of foreign body in muscle or tendon",7962763,CDM,521,RC,20525,CPT,OUTPATIENT,,,1094,711.1,,962.72,88,,770.18,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1094,100,,875.20,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",689.22,63,,551.38,,,0,"percent of total billed charges","63% of total billed charges",167.38,15.3,,133.90,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,754.86,69,,,,,0,"fee schedule","69% of total billed charges",1094,100,,875.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1094,100,,875.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1094,100,,875.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",412.44,37.7,,329.95,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",853.32,78,,682.66,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.64,82.6,,722.91,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.64,82.6,,722.91,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,1094,100,,875.20,,,0,"percent of total billed charges","100% of total billed charges",167.38,9628.23,
"20550 Injection(s); single tendon sheath, or ligam",7962355,CDM,521,RC,20550,CPT,OUTPATIENT,,,174,113.1,,153.12,88,,122.50,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,174,100,,139.20,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",223.22,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.62,63,,87.70,,,0,"percent of total billed charges","63% of total billed charges",26.62,15.3,,21.30,,,0,"percent of total billed charges","15.3% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,120.06,69,,,,,0,"fee schedule","69% of total billed charges",174,100,,139.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",174,100,,139.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",174,100,,139.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.05,100,,,,,0,"fee schedule",EAPG,281.73,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",65.6,37.7,,52.48,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",135.72,78,,108.58,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",143.72,82.6,,114.98,,,0,"percent of total billed charges","82.6% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",143.72,82.6,,114.98,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",377.25,100,,,,,0,"fee schedule",EAPG,174,100,,139.20,,,0,"percent of total billed charges","100% of total billed charges",26.62,1061,
"20553 Injection(s); single or multiple trigger poi",7962798,CDM,521,RC,20553,CPT,OUTPATIENT,,,114,74.1,,100.32,88,,80.26,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,114,100,,91.20,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",223.22,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",71.82,63,,57.46,,,0,"percent of total billed charges","63% of total billed charges",17.44,15.3,,13.95,,,0,"percent of total billed charges","15.3% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,78.66,69,,,,,0,"fee schedule","69% of total billed charges",114,100,,91.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",114,100,,91.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",114,100,,91.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.05,100,,,,,0,"fee schedule",EAPG,281.73,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",42.98,37.7,,34.38,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",88.92,78,,71.14,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",94.16,82.6,,75.33,,,0,"percent of total billed charges","82.6% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",94.16,82.6,,75.33,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",377.25,100,,,,,0,"fee schedule",EAPG,114,100,,91.20,,,0,"percent of total billed charges","100% of total billed charges",17.44,1061,
"20552 Injection(s); single or multiple trigger poi",7962899,CDM,521,RC,20552,CPT,OUTPATIENT,,,99,64.35,,87.12,88,,69.70,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",223.22,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",62.37,63,,49.90,,,0,"percent of total billed charges","63% of total billed charges",15.15,15.3,,12.12,,,0,"percent of total billed charges","15.3% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,68.31,69,,,,,0,"fee schedule","69% of total billed charges",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.05,100,,,,,0,"fee schedule",EAPG,281.73,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",37.32,37.7,,29.86,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.22,78,,61.78,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",377.25,100,,,,,0,"fee schedule",EAPG,99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",15.15,1061,
"20551 Injection(s), single tendon origin/insertion",8531631,CDM,521,RC,20551,CPT,OUTPATIENT,,,185,120.25,,162.8,88,,130.24,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",223.22,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",116.55,63,,93.24,,,0,"percent of total billed charges","63% of total billed charges",28.31,15.3,,22.65,,,0,"percent of total billed charges","15.3% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,127.65,69,,,,,0,"fee schedule","69% of total billed charges",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.05,100,,,,,0,"fee schedule",EAPG,281.73,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",69.75,37.7,,55.80,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",144.3,78,,115.44,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",152.81,82.6,,122.25,,,0,"percent of total billed charges","82.6% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",152.81,82.6,,122.25,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",377.25,100,,,,,0,"fee schedule",EAPG,185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",28.31,1061,
"20600 Arthrocentesis, aspiration and/or injection,",7961461,CDM,521,RC,20600,CPT,OUTPATIENT,,,85,55.25,,74.8,88,,59.84,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",223.22,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",53.55,63,,42.84,,,0,"percent of total billed charges","63% of total billed charges",13.01,15.3,,10.41,,,0,"percent of total billed charges","15.3% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,58.65,69,,,,,0,"fee schedule","69% of total billed charges",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.05,100,,,,,0,"fee schedule",EAPG,281.73,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",32.05,37.7,,25.64,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.3,78,,53.04,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",70.21,82.6,,56.17,,,0,"percent of total billed charges","82.6% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",70.21,82.6,,56.17,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",377.25,100,,,,,0,"fee schedule",EAPG,85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",13.01,1061,
"20606 Arthrocentesis, aspiration and/or injection,",7962076,CDM,521,RC,20606,CPT,OUTPATIENT,,,234,152.1,,205.92,88,,164.74,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.75,100,,,,,0,"fee schedule",EAPG,234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",457.07,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.42,63,,117.94,,,0,"percent of total billed charges","63% of total billed charges",35.8,15.3,,28.64,,,0,"percent of total billed charges","15.3% of total billed charges",443.75,100,,,,,0,"fee schedule",EAPG,161.46,69,,,,,0,"fee schedule","69% of total billed charges",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.75,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",452.63,100,,,,,0,"fee schedule",EAPG,576.88,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",88.22,37.7,,70.58,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",182.52,78,,146.02,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",193.28,82.6,,154.62,,,0,"percent of total billed charges","82.6% of total billed charges",443.75,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",193.28,82.6,,154.62,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",604.28,100,,,,,0,"fee schedule",EAPG,234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",35.8,2578.03,
"20604 Arthrocentesis, aspiration and/or injection,",7962113,CDM,521,RC,20604,CPT,OUTPATIENT,,,211,137.15,,185.68,88,,148.54,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.75,100,,,,,0,"fee schedule",EAPG,211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",457.07,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.93,63,,106.34,,,0,"percent of total billed charges","63% of total billed charges",32.28,15.3,,25.82,,,0,"percent of total billed charges","15.3% of total billed charges",443.75,100,,,,,0,"fee schedule",EAPG,145.59,69,,,,,0,"fee schedule","69% of total billed charges",211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.75,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",452.63,100,,,,,0,"fee schedule",EAPG,576.88,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",79.55,37.7,,63.64,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",164.58,78,,131.66,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",174.29,82.6,,139.43,,,0,"percent of total billed charges","82.6% of total billed charges",443.75,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",174.29,82.6,,139.43,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",604.28,100,,,,,0,"fee schedule",EAPG,211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",32.28,1061,
"20605 Arthrocentesis, aspiration and/or injection,",7962734,CDM,521,RC,20605,CPT,OUTPATIENT,,,89,57.85,,78.32,88,,62.66,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,89,100,,71.20,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",223.22,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",56.07,63,,44.86,,,0,"percent of total billed charges","63% of total billed charges",13.62,15.3,,10.90,,,0,"percent of total billed charges","15.3% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,61.41,69,,,,,0,"fee schedule","69% of total billed charges",89,100,,71.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",89,100,,71.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",89,100,,71.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.05,100,,,,,0,"fee schedule",EAPG,281.73,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",33.55,37.7,,26.84,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",69.42,78,,55.54,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.51,82.6,,58.81,,,0,"percent of total billed charges","82.6% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.51,82.6,,58.81,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",377.25,100,,,,,0,"fee schedule",EAPG,89,100,,71.20,,,0,"percent of total billed charges","100% of total billed charges",13.62,1061,
"20604 Arthrocentesis, asp and/or inj, sm joint/bur",10225159,CDM,521,RC,20604,CPT,OUTPATIENT,,,211,137.15,,185.68,88,,148.54,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.75,100,,,,,0,"fee schedule",EAPG,211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",457.07,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.93,63,,106.34,,,0,"percent of total billed charges","63% of total billed charges",32.28,15.3,,25.82,,,0,"percent of total billed charges","15.3% of total billed charges",443.75,100,,,,,0,"fee schedule",EAPG,145.59,69,,,,,0,"fee schedule","69% of total billed charges",211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.75,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",452.63,100,,,,,0,"fee schedule",EAPG,576.88,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",79.55,37.7,,63.64,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",164.58,78,,131.66,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",174.29,82.6,,139.43,,,0,"percent of total billed charges","82.6% of total billed charges",443.75,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",174.29,82.6,,139.43,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",604.28,100,,,,,0,"fee schedule",EAPG,211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",32.28,1061,
"20606 Arthrocentesis, asp and/or inj, intermed joi",10225170,CDM,521,RC,20606,CPT,OUTPATIENT,,,234,152.1,,205.92,88,,164.74,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.75,100,,,,,0,"fee schedule",EAPG,234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",457.07,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.42,63,,117.94,,,0,"percent of total billed charges","63% of total billed charges",35.8,15.3,,28.64,,,0,"percent of total billed charges","15.3% of total billed charges",443.75,100,,,,,0,"fee schedule",EAPG,161.46,69,,,,,0,"fee schedule","69% of total billed charges",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.75,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",452.63,100,,,,,0,"fee schedule",EAPG,576.88,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",88.22,37.7,,70.58,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",182.52,78,,146.02,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",193.28,82.6,,154.62,,,0,"percent of total billed charges","82.6% of total billed charges",443.75,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",193.28,82.6,,154.62,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",604.28,100,,,,,0,"fee schedule",EAPG,234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",35.8,2578.03,
"20612 Aspiration and/or injection of ganglion cyst",7903131,CDM,521,RC,20612,CPT,OUTPATIENT,,,171,111.15,,150.48,88,,120.38,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,171,100,,136.80,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",223.22,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.73,63,,86.18,,,0,"percent of total billed charges","63% of total billed charges",26.16,15.3,,20.93,,,0,"percent of total billed charges","15.3% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,117.99,69,,,,,0,"fee schedule","69% of total billed charges",171,100,,136.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171,100,,136.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171,100,,136.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.05,100,,,,,0,"fee schedule",EAPG,281.73,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",64.47,37.7,,51.58,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",133.38,78,,106.70,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",141.25,82.6,,113.00,,,0,"percent of total billed charges","82.6% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",141.25,82.6,,113.00,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",377.25,100,,,,,0,"fee schedule",EAPG,171,100,,136.80,,,0,"percent of total billed charges","100% of total billed charges",26.16,1061,
"20610 Arthrocentesis, aspiration and/or injection,",7903381,CDM,521,RC,20610,CPT,OUTPATIENT,,,106,68.9,,93.28,88,,74.62,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",223.22,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.78,63,,53.42,,,0,"percent of total billed charges","63% of total billed charges",16.22,15.3,,12.98,,,0,"percent of total billed charges","15.3% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,73.14,69,,,,,0,"fee schedule","69% of total billed charges",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.05,100,,,,,0,"fee schedule",EAPG,281.73,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",39.96,37.7,,31.97,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",82.68,78,,66.14,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",87.56,82.6,,70.05,,,0,"percent of total billed charges","82.6% of total billed charges",216.72,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",87.56,82.6,,70.05,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",377.25,100,,,,,0,"fee schedule",EAPG,106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",16.22,1061,
"20611 Arthrocentesis, aspiration and/or injection,",7962216,CDM,521,RC,20611,CPT,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.75,100,,,,,0,"fee schedule",EAPG,268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",457.07,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",443.75,100,,,,,0,"fee schedule",EAPG,184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.75,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",452.63,100,,,,,0,"fee schedule",EAPG,576.88,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",443.75,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",604.28,100,,,,,0,"fee schedule",EAPG,268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,1061,
"20615 Aspiration and injection for treatment of bo",7963318,CDM,521,RC,20615,CPT,OUTPATIENT,,,558,362.7,,491.04,88,,392.83,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.75,100,,,,,0,"fee schedule",EAPG,558,100,,446.40,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",457.07,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",351.54,63,,281.23,,,0,"percent of total billed charges","63% of total billed charges",85.37,15.3,,68.30,,,0,"percent of total billed charges","15.3% of total billed charges",443.75,100,,,,,0,"fee schedule",EAPG,385.02,69,,,,,0,"fee schedule","69% of total billed charges",558,100,,446.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",558,100,,446.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",558,100,,446.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.75,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",452.63,100,,,,,0,"fee schedule",EAPG,576.88,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",210.37,37.7,,168.30,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",435.24,78,,348.19,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460.91,82.6,,368.73,,,0,"percent of total billed charges","82.6% of total billed charges",443.75,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460.91,82.6,,368.73,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",604.28,100,,,,,0,"fee schedule",EAPG,558,100,,446.40,,,0,"percent of total billed charges","100% of total billed charges",85.37,2526.76,
"20611 Arthrocentesis, asp and/or inj, major joint/",10225171,CDM,521,RC,20611,CPT,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.75,100,,,,,0,"fee schedule",EAPG,268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",457.07,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",443.75,100,,,,,0,"fee schedule",EAPG,184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.75,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",452.63,100,,,,,0,"fee schedule",EAPG,576.88,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",443.75,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",604.28,100,,,,,0,"fee schedule",EAPG,268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,1061,
"20660 Application of cranial tongs, caliper, or st",7962490,CDM,521,RC,20660,CPT,OUTPATIENT,,,1774,1153.1,,1561.12,88,,1248.90,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2168.78,100,,,,,0,"fee schedule",EAPG,1774,100,,1419.20,,,0,"percent of total billed charges","100% of total billed charges",2868.75,175,,,,,0,"fee schedule","175% of CMS fee schedule",2233.84,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1117.62,63,,894.10,,,0,"percent of total billed charges","63% of total billed charges",271.42,15.3,,217.14,,,0,"percent of total billed charges","15.3% of total billed charges",2168.78,100,,,,,0,"fee schedule",EAPG,1224.06,69,,,,,0,"fee schedule","69% of total billed charges",1774,100,,1419.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1774,100,,1419.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1774,100,,1419.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2168.78,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2212.16,100,,,,,0,"fee schedule",EAPG,2819.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",668.8,37.7,,535.04,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1383.72,78,,1106.98,,,0,"percent of total billed charges","78% of total billed charges",1655.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1465.32,82.6,,1172.26,,,0,"percent of total billed charges","82.6% of total billed charges",2168.78,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1465.32,82.6,,1172.26,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2329.31,100,,,,,0,"fee schedule",EAPG,1774,100,,1419.20,,,0,"percent of total billed charges","100% of total billed charges",271.42,5656.46,
"20665 Removal of tongs or halo applied by another",7963273,CDM,521,RC,20665,CPT,OUTPATIENT,,,416,270.4,,366.08,88,,292.86,,,0,"percent of total billed charges","88% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.4,100,,,,,0,"fee schedule",EAPG,416,100,,332.80,,,0,"percent of total billed charges","100% of total billed charges",711.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",178.61,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",262.08,63,,209.66,,,0,"percent of total billed charges","63% of total billed charges",63.65,15.3,,50.92,,,0,"percent of total billed charges","15.3% of total billed charges",173.4,100,,,,,0,"fee schedule",EAPG,287.04,69,,,,,0,"fee schedule","69% of total billed charges",416,100,,332.80,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",416,100,,332.80,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",416,100,,332.80,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",1097.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.4,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",176.87,100,,,,,0,"fee schedule",EAPG,225.43,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",156.83,37.7,,125.46,,,0,"percent of total billed charges","37.70% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",324.48,78,,259.58,,,0,"percent of total billed charges","78% of total billed charges",410.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",343.62,82.6,,274.90,,,0,"percent of total billed charges","82.6% of total billed charges",173.4,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",343.62,82.6,,274.90,,,0,"percent of total billed charges","82.6% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",333.93,100,,,,,0,"fee schedule",EAPG,416,100,,332.80,,,0,"percent of total billed charges","100% of total billed charges",63.65,1097.77,
"20661 Application of halo, including removal; cran",7963439,CDM,521,RC,20661,CPT,OUTPATIENT,,,1652,1073.8,,1453.76,88,,1163.01,,,0,"percent of total billed charges","88% of total billed charges",1652,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2168.78,100,,,,,0,"fee schedule",EAPG,1652,100,,1321.60,,,0,"percent of total billed charges","100% of total billed charges",1652,175,,,,,0,"fee schedule","175% of CMS fee schedule",2233.84,100,,,,,0,"fee schedule",EAPG,1652,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1040.76,63,,832.61,,,0,"percent of total billed charges","63% of total billed charges",252.76,15.3,,202.21,,,0,"percent of total billed charges","15.3% of total billed charges",2168.78,100,,,,,0,"fee schedule",EAPG,1139.88,69,,,,,0,"fee schedule","69% of total billed charges",1652,100,,1321.60,,,0,"percent of total billed charges","100% of total billed charges",1652,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1652,100,,1321.60,,,0,"percent of total billed charges","100% of total billed charges",1652,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1652,100,,1321.60,,,0,"percent of total billed charges","100% of total billed charges",1652,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2168.78,100,,,,,0,"fee schedule",EAPG,1652,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1652,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2212.16,100,,,,,0,"fee schedule",EAPG,2819.42,100,,,,,0,"fee schedule",EAPG,1652,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",622.8,37.7,,498.24,,,0,"percent of total billed charges","37.70% of total billed charges",1652,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1652,100,,,,,0,"fee schedule","100% of CMS fee schedule",1288.56,78,,1030.85,,,0,"percent of total billed charges","78% of total billed charges",1652,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1364.55,82.6,,1091.64,,,0,"percent of total billed charges","82.6% of total billed charges",2168.78,100,,,,,0,"fee schedule","100% of WA fee schedule",1652,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1364.55,82.6,,1091.64,,,0,"percent of total billed charges","82.6% of total billed charges",1652,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2329.31,100,,,,,0,"fee schedule",EAPG,1652,100,,1321.60,,,0,"percent of total billed charges","100% of total billed charges",252.76,11498.59,
"20670 Removal of implant; superficial (buried wire",7963185,CDM,521,RC,20670,CPT,OUTPATIENT,,,535,347.75,,470.8,88,,376.64,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2168.78,100,,,,,0,"fee schedule",EAPG,535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",2233.84,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",337.05,63,,269.64,,,0,"percent of total billed charges","63% of total billed charges",81.86,15.3,,65.49,,,0,"percent of total billed charges","15.3% of total billed charges",2168.78,100,,,,,0,"fee schedule",EAPG,369.15,69,,,,,0,"fee schedule","69% of total billed charges",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2168.78,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2212.16,100,,,,,0,"fee schedule",EAPG,2819.42,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",201.7,37.7,,161.36,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",417.3,78,,333.84,,,0,"percent of total billed charges","78% of total billed charges",1670.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.91,82.6,,353.53,,,0,"percent of total billed charges","82.6% of total billed charges",2168.78,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.91,82.6,,353.53,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2329.31,100,,,,,0,"fee schedule",EAPG,535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",81.86,5715.98,
"20680 Removal of implant; deep (buried wire, pin,",7962396,CDM,521,RC,20680,CPT,OUTPATIENT,,,1307,849.55,,1150.16,88,,920.13,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2168.78,100,,,,,0,"fee schedule",EAPG,1307,100,,1045.60,,,0,"percent of total billed charges","100% of total billed charges",5071.88,175,,,,,0,"fee schedule","175% of CMS fee schedule",2233.84,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",823.41,63,,658.73,,,0,"percent of total billed charges","63% of total billed charges",199.97,15.3,,159.98,,,0,"percent of total billed charges","15.3% of total billed charges",2168.78,100,,,,,0,"fee schedule",EAPG,901.83,69,,,,,0,"fee schedule","69% of total billed charges",1307,100,,1045.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1307,100,,1045.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1307,100,,1045.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2168.78,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2212.16,100,,,,,0,"fee schedule",EAPG,2819.42,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",492.74,37.7,,394.19,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1019.46,78,,815.57,,,0,"percent of total billed charges","78% of total billed charges",2927.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1079.58,82.6,,863.66,,,0,"percent of total billed charges","82.6% of total billed charges",2168.78,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1079.58,82.6,,863.66,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2329.31,100,,,,,0,"fee schedule",EAPG,1307,100,,1045.60,,,0,"percent of total billed charges","100% of total billed charges",199.97,9628.24,
"20692 Application of a multiplane (pins or wires m",7961660,CDM,521,RC,20692,CPT,OUTPATIENT,,,3274,2128.1,,2881.12,88,,2304.90,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2168.78,100,,,,,0,"fee schedule",EAPG,3274,100,,2619.20,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",2233.84,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2062.62,63,,1650.10,,,0,"percent of total billed charges","63% of total billed charges",500.92,15.3,,400.74,,,0,"percent of total billed charges","15.3% of total billed charges",2168.78,100,,,,,0,"fee schedule",EAPG,2259.06,69,,,,,0,"fee schedule","69% of total billed charges",3274,100,,2619.20,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3274,100,,2619.20,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3274,100,,2619.20,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2168.78,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2212.16,100,,,,,0,"fee schedule",EAPG,2819.42,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1234.3,37.7,,987.44,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2553.72,78,,2042.98,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2704.32,82.6,,2163.46,,,0,"percent of total billed charges","82.6% of total billed charges",2168.78,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2704.32,82.6,,2163.46,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2329.31,100,,,,,0,"fee schedule",EAPG,3274,100,,2619.20,,,0,"percent of total billed charges","100% of total billed charges",500.92,50029.1,
"20690 Application of a uniplane (pins or wires in",7961799,CDM,521,RC,20690,CPT,OUTPATIENT,,,1523,989.95,,1340.24,88,,1072.19,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2168.78,100,,,,,0,"fee schedule",EAPG,1523,100,,1218.40,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",2233.84,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",959.49,63,,767.59,,,0,"percent of total billed charges","63% of total billed charges",233.02,15.3,,186.42,,,0,"percent of total billed charges","15.3% of total billed charges",2168.78,100,,,,,0,"fee schedule",EAPG,1050.87,69,,,,,0,"fee schedule","69% of total billed charges",1523,100,,1218.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1523,100,,1218.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1523,100,,1218.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2168.78,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2212.16,100,,,,,0,"fee schedule",EAPG,2819.42,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",574.17,37.7,,459.34,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1187.94,78,,950.35,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1258,82.6,,1006.40,,,0,"percent of total billed charges","82.6% of total billed charges",2168.78,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1258,82.6,,1006.40,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2329.31,100,,,,,0,"fee schedule",EAPG,1523,100,,1218.40,,,0,"percent of total billed charges","100% of total billed charges",233.02,25451.55,
"20693 Adjustment or revision of external fixation",7962764,CDM,521,RC,20693,CPT,OUTPATIENT,,,1662,1080.3,,1462.56,88,,1170.05,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2168.78,100,,,,,0,"fee schedule",EAPG,1662,100,,1329.60,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",2233.84,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1047.06,63,,837.65,,,0,"percent of total billed charges","63% of total billed charges",254.29,15.3,,203.43,,,0,"percent of total billed charges","15.3% of total billed charges",2168.78,100,,,,,0,"fee schedule",EAPG,1146.78,69,,,,,0,"fee schedule","69% of total billed charges",1662,100,,1329.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1662,100,,1329.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1662,100,,1329.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2168.78,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2212.16,100,,,,,0,"fee schedule",EAPG,2819.42,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",626.57,37.7,,501.26,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1296.36,78,,1037.09,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1372.81,82.6,,1098.25,,,0,"percent of total billed charges","82.6% of total billed charges",2168.78,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1372.81,82.6,,1098.25,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2329.31,100,,,,,0,"fee schedule",EAPG,1662,100,,1329.60,,,0,"percent of total billed charges","100% of total billed charges",254.29,25451.55,
"20694 Removal, under anesthesia, of external fixat",7963274,CDM,521,RC,20694,CPT,OUTPATIENT,,,1274,828.1,,1121.12,88,,896.90,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2168.78,100,,,,,0,"fee schedule",EAPG,1274,100,,1019.20,,,0,"percent of total billed charges","100% of total billed charges",2868.75,175,,,,,0,"fee schedule","175% of CMS fee schedule",2233.84,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",802.62,63,,642.10,,,0,"percent of total billed charges","63% of total billed charges",194.92,15.3,,155.94,,,0,"percent of total billed charges","15.3% of total billed charges",2168.78,100,,,,,0,"fee schedule",EAPG,879.06,69,,,,,0,"fee schedule","69% of total billed charges",1274,100,,1019.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1274,100,,1019.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1274,100,,1019.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2168.78,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2212.16,100,,,,,0,"fee schedule",EAPG,2819.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",480.3,37.7,,384.24,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",993.72,78,,794.98,,,0,"percent of total billed charges","78% of total billed charges",1655.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1052.32,82.6,,841.86,,,0,"percent of total billed charges","82.6% of total billed charges",2168.78,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1052.32,82.6,,841.86,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2329.31,100,,,,,0,"fee schedule",EAPG,1274,100,,1019.20,,,0,"percent of total billed charges","100% of total billed charges",194.92,5656.46,
"20827 Replantation, thumb (includes distal tip to",7962616,CDM,521,RC,20827,CPT,OUTPATIENT,,,8053,5234.45,,7086.64,88,,5669.31,,,0,"percent of total billed charges","88% of total billed charges",8053,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1978.8,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8053,175,,,,,0,"fee schedule","175% of CMS fee schedule",2038.17,100,,,,,0,"fee schedule",EAPG,8053,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5073.39,63,,4058.71,,,0,"percent of total billed charges","63% of total billed charges",1232.11,15.3,,985.69,,,0,"percent of total billed charges","15.3% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,5556.57,69,,,,,0,"fee schedule","69% of total billed charges",8053,100,,6442.40,,,0,"percent of total billed charges","100% of total billed charges",8053,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8053,100,,6442.40,,,0,"percent of total billed charges","100% of total billed charges",8053,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8053,100,,6442.40,,,0,"percent of total billed charges","100% of total billed charges",8053,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,8053,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8053,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",8053,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2018.38,100,,,,,0,"fee schedule",EAPG,2572.45,100,,,,,0,"fee schedule",EAPG,8053,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3035.98,37.7,,2428.78,,,0,"percent of total billed charges","37.70% of total billed charges",8053,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8053,100,,,,,0,"fee schedule","100% of CMS fee schedule",6281.34,78,,5025.07,,,0,"percent of total billed charges","78% of total billed charges",8053,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6651.78,82.6,,5321.42,,,0,"percent of total billed charges","82.6% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,8053,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6651.78,82.6,,5321.42,,,0,"percent of total billed charges","82.6% of total billed charges",8053,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2139.33,100,,,,,0,"fee schedule",EAPG,8053,100,,6442.40,,,0,"percent of total billed charges","100% of total billed charges",1232.11,25451.55,
"20900 Bone graft, any donor area; minor or small (",7962987,CDM,521,RC,20900,CPT,OUTPATIENT,,,1349,876.85,,1187.12,88,,949.70,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,1349,100,,1079.20,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",1817.34,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",849.87,63,,679.90,,,0,"percent of total billed charges","63% of total billed charges",206.4,15.3,,165.12,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,930.81,69,,,,,0,"fee schedule","69% of total billed charges",1349,100,,1079.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1349,100,,1079.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1349,100,,1079.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",508.57,37.7,,406.86,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1052.22,78,,841.78,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1114.27,82.6,,891.42,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1114.27,82.6,,891.42,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1924.93,100,,,,,0,"fee schedule",EAPG,1349,100,,1079.20,,,0,"percent of total billed charges","100% of total billed charges",206.4,25451.55,
"20902 Bone graft, any donor area; major or large",7963535,CDM,521,RC,20902,CPT,OUTPATIENT,,,2026,1316.9,,1782.88,88,,1426.30,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,2026,100,,1620.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",1817.34,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1276.38,63,,1021.10,,,0,"percent of total billed charges","63% of total billed charges",309.98,15.3,,247.98,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1397.94,69,,,,,0,"fee schedule","69% of total billed charges",2026,100,,1620.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2026,100,,1620.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2026,100,,1620.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",763.8,37.7,,611.04,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1580.28,78,,1264.22,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1673.48,82.6,,1338.78,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1673.48,82.6,,1338.78,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1924.93,100,,,,,0,"fee schedule",EAPG,2026,100,,1620.80,,,0,"percent of total billed charges","100% of total billed charges",309.98,25451.55,
"20922 Fascia lata graft; by incision and area expo",7962924,CDM,521,RC,20922,CPT,OUTPATIENT,,,1622,1054.3,,1427.36,88,,1141.89,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,1622,100,,1297.60,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1817.34,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1021.86,63,,817.49,,,0,"percent of total billed charges","63% of total billed charges",248.17,15.3,,198.54,,,0,"percent of total billed charges","15.3% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1119.18,69,,,,,0,"fee schedule","69% of total billed charges",1622,100,,1297.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1622,100,,1297.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1622,100,,1297.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1799.69,100,,,,,0,"fee schedule",EAPG,2293.73,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",611.49,37.7,,489.19,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1265.16,78,,1012.13,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1339.77,82.6,,1071.82,,,0,"percent of total billed charges","82.6% of total billed charges",1764.4,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1339.77,82.6,,1071.82,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1924.93,100,,,,,0,"fee schedule",EAPG,1622,100,,1297.60,,,0,"percent of total billed charges","100% of total billed charges",248.17,6968.7,
"20930 Allograft, morselized, or placement of osteo",7962230,CDM,521,RC,20930,CPT,OUTPATIENT,,,634,412.1,,557.92,88,,446.34,,,0,"percent of total billed charges","88% of total billed charges",317,50,,253.60,,,0,"percent of total billed charges","50% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,634,100,,507.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9513.71,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",399.42,63,,319.54,,,0,"percent of total billed charges","63% of total billed charges",97,15.3,,77.60,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,437.46,69,,,,,0,"fee schedule","69% of total billed charges",634,100,,507.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",634,100,,507.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",634,100,,507.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",392.13,61.85,,313.70,,,0,"percent of total billed charges","61.5% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,317,50,,253.60,,,0,"percent of total billed charges","50% of total billed charges",204.15,32.2,,163.32,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",239.02,37.7,,191.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",494.52,78,,395.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",523.68,82.6,,418.94,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,317,50,,253.60,,,0,"percent of total billed charges","50% of total billed charges",523.68,82.6,,418.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9397.14,100,,,,,0,"fee schedule",EAPG,634,100,,507.20,,,0,"percent of total billed charges","100% of total billed charges",97,12007.59,
"20938 Autograft for spine surgery only; structural",7962765,CDM,521,RC,20938,CPT,OUTPATIENT,,,1252,813.8,,1101.76,88,,881.41,,,0,"percent of total billed charges","88% of total billed charges",626,50,,500.80,,,0,"percent of total billed charges","50% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,1252,100,,1001.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9513.71,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",788.76,63,,631.01,,,0,"percent of total billed charges","63% of total billed charges",191.56,15.3,,153.25,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,863.88,69,,,,,0,"fee schedule","69% of total billed charges",1252,100,,1001.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1252,100,,1001.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1252,100,,1001.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",774.36,61.85,,619.49,,,0,"percent of total billed charges","61.5% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,626,50,,500.80,,,0,"percent of total billed charges","50% of total billed charges",403.14,32.2,,322.51,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",472,37.7,,377.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",976.56,78,,781.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1034.15,82.6,,827.32,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,626,50,,500.80,,,0,"percent of total billed charges","50% of total billed charges",1034.15,82.6,,827.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9397.14,100,,,,,0,"fee schedule",EAPG,1252,100,,1001.60,,,0,"percent of total billed charges","100% of total billed charges",191.56,12007.59,
"20936 Autograft for spine surgery only; local, obt",7962871,CDM,521,RC,20936,CPT,OUTPATIENT,,,873,567.45,,768.24,88,,614.59,,,0,"percent of total billed charges","88% of total billed charges",436.5,50,,349.20,,,0,"percent of total billed charges","50% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,873,100,,698.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9513.71,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",549.99,63,,439.99,,,0,"percent of total billed charges","63% of total billed charges",133.57,15.3,,106.86,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,602.37,69,,,,,0,"fee schedule","69% of total billed charges",873,100,,698.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",873,100,,698.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",873,100,,698.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,61.85,,431.96,,,0,"percent of total billed charges","61.5% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,436.5,50,,349.20,,,0,"percent of total billed charges","50% of total billed charges",281.11,32.2,,224.89,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",329.12,37.7,,263.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",680.94,78,,544.75,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",721.1,82.6,,576.88,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,436.5,50,,349.20,,,0,"percent of total billed charges","50% of total billed charges",721.1,82.6,,576.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9397.14,100,,,,,0,"fee schedule",EAPG,873,100,,698.40,,,0,"percent of total billed charges","100% of total billed charges",133.57,12007.59,
"20931 Allograft, structural, for spine surgery onl",7963478,CDM,521,RC,20931,CPT,OUTPATIENT,,,742,482.3,,652.96,88,,522.37,,,0,"percent of total billed charges","88% of total billed charges",371,50,,296.80,,,0,"percent of total billed charges","50% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,742,100,,593.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9513.71,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",467.46,63,,373.97,,,0,"percent of total billed charges","63% of total billed charges",113.53,15.3,,90.82,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,511.98,69,,,,,0,"fee schedule","69% of total billed charges",742,100,,593.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",742,100,,593.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",742,100,,593.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",458.93,61.85,,367.14,,,0,"percent of total billed charges","61.5% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,371,50,,296.80,,,0,"percent of total billed charges","50% of total billed charges",238.92,32.2,,191.14,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",279.73,37.7,,223.78,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",578.76,78,,463.01,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",612.89,82.6,,490.31,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,371,50,,296.80,,,0,"percent of total billed charges","50% of total billed charges",612.89,82.6,,490.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9397.14,100,,,,,0,"fee schedule",EAPG,742,100,,593.60,,,0,"percent of total billed charges","100% of total billed charges",113.53,12007.59,
"20937 Autograft for spine surgery only; morselized",7963500,CDM,521,RC,20937,CPT,OUTPATIENT,,,535,347.75,,470.8,88,,376.64,,,0,"percent of total billed charges","88% of total billed charges",267.5,50,,214.00,,,0,"percent of total billed charges","50% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9513.71,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",337.05,63,,269.64,,,0,"percent of total billed charges","63% of total billed charges",81.86,15.3,,65.49,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,369.15,69,,,,,0,"fee schedule","69% of total billed charges",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",330.9,61.85,,264.72,,,0,"percent of total billed charges","61.5% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,267.5,50,,214.00,,,0,"percent of total billed charges","50% of total billed charges",172.27,32.2,,137.82,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",201.7,37.7,,161.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",417.3,78,,333.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",441.91,82.6,,353.53,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,267.5,50,,214.00,,,0,"percent of total billed charges","50% of total billed charges",441.91,82.6,,353.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9397.14,100,,,,,0,"fee schedule",EAPG,535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",81.86,12007.59,
"20939 Bone Marrow Aspir Bone Grfg",8165576,CDM,521,RC,20939,CPT,OUTPATIENT,,,441,286.65,,388.08,88,,310.46,,,0,"percent of total billed charges","88% of total billed charges",220.5,50,,176.40,,,0,"percent of total billed charges","50% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9513.71,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",277.83,63,,222.26,,,0,"percent of total billed charges","63% of total billed charges",67.47,15.3,,53.98,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,304.29,69,,,,,0,"fee schedule","69% of total billed charges",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.76,61.85,,218.21,,,0,"percent of total billed charges","61.5% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,220.5,50,,176.40,,,0,"percent of total billed charges","50% of total billed charges",142,32.2,,113.60,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",166.26,37.7,,133.01,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",343.98,78,,275.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",364.27,82.6,,291.42,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule","100% of WA fee schedule",220.5,50,,176.40,,,0,"percent of total billed charges","50% of total billed charges",364.27,82.6,,291.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9397.14,100,,,,,0,"fee schedule",EAPG,441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",67.47,12007.59,
"20950 Monitoring of interstitial fluid pressure in",7962281,CDM,521,RC,20950,CPT,OUTPATIENT,,,428,278.2,,376.64,88,,301.31,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.4,100,,,,,0,"fee schedule",EAPG,428,100,,342.40,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",178.61,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",269.64,63,,215.71,,,0,"percent of total billed charges","63% of total billed charges",65.48,15.3,,52.38,,,0,"percent of total billed charges","15.3% of total billed charges",173.4,100,,,,,0,"fee schedule",EAPG,295.32,69,,,,,0,"fee schedule","69% of total billed charges",428,100,,342.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",428,100,,342.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",428,100,,342.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.4,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",176.87,100,,,,,0,"fee schedule",EAPG,225.43,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",161.36,37.7,,129.09,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",333.84,78,,267.07,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",353.53,82.6,,282.82,,,0,"percent of total billed charges","82.6% of total billed charges",173.4,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",353.53,82.6,,282.82,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",333.93,100,,,,,0,"fee schedule",EAPG,428,100,,342.40,,,0,"percent of total billed charges","100% of total billed charges",65.48,2526.76,
"20956 Bone graft with microvascular anastomosis; i",7963241,CDM,521,RC,20956,CPT,OUTPATIENT,,,8097,5263.05,,7125.36,88,,5700.29,,,0,"percent of total billed charges","88% of total billed charges",8097,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3083.85,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8097,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,8097,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5101.11,63,,4080.89,,,0,"percent of total billed charges","63% of total billed charges",1238.84,15.3,,991.07,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,5586.93,69,,,,,0,"fee schedule","69% of total billed charges",8097,100,,6477.60,,,0,"percent of total billed charges","100% of total billed charges",8097,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8097,100,,6477.60,,,0,"percent of total billed charges","100% of total billed charges",8097,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8097,100,,6477.60,,,0,"percent of total billed charges","100% of total billed charges",8097,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,8097,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8097,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",8097,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,8097,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3052.57,37.7,,2442.06,,,0,"percent of total billed charges","37.70% of total billed charges",8097,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8097,100,,,,,0,"fee schedule","100% of CMS fee schedule",6315.66,78,,5052.53,,,0,"percent of total billed charges","78% of total billed charges",8097,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6688.12,82.6,,5350.50,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule","100% of WA fee schedule",8097,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6688.12,82.6,,5350.50,,,0,"percent of total billed charges","82.6% of total billed charges",8097,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3244.38,100,,,,,0,"fee schedule",EAPG,8097,100,,6477.60,,,0,"percent of total billed charges","100% of total billed charges",1238.84,25451.55,
"20985 Computer-assisted surgical navigational proc",7962111,CDM,521,RC,20985,CPT,OUTPATIENT,,,496,322.4,,436.48,88,,349.18,,,0,"percent of total billed charges","88% of total billed charges",248,50,,198.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",496,100,,396.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",312.48,63,,249.98,,,0,"percent of total billed charges","63% of total billed charges",75.89,15.3,,60.71,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",342.24,69,,,,,0,"fee schedule","69% of total billed charges",496,100,,396.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496,100,,396.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",496,100,,396.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",306.78,61.85,,245.42,,,0,"percent of total billed charges","61.5% of total billed charges",,,,,,,0,other,"not separately reimbursment",248,50,,198.40,,,0,"percent of total billed charges","50% of total billed charges",159.71,32.2,,127.77,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",186.99,37.7,,149.59,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",386.88,78,,309.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",409.7,82.6,,327.76,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",248,50,,198.40,,,0,"percent of total billed charges","50% of total billed charges",409.7,82.6,,327.76,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",496,100,,396.80,,,0,"percent of total billed charges","100% of total billed charges",75.89,496,
"20999 Unlisted procedure, musculoskeletal system,",7963371,CDM,521,RC,20999,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1193.28,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1229.08,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1193.28,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1193.28,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1193.28,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1353.81,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1193.28,1551.26,
"21016 Radical resection of tumor (eg, sarcoma), so",7962164,CDM,521,RC,21016,CPT,OUTPATIENT,,,2940,1911,,2587.2,88,,2069.76,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2940,100,,2352.00,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1852.2,63,,1481.76,,,0,"percent of total billed charges","63% of total billed charges",449.82,15.3,,359.86,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2028.6,69,,,,,0,"fee schedule","69% of total billed charges",2940,100,,2352.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2940,100,,2352.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2940,100,,2352.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1108.38,37.7,,886.70,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2293.2,78,,1834.56,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2428.44,82.6,,1942.75,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2428.44,82.6,,1942.75,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,2940,100,,2352.00,,,0,"percent of total billed charges","100% of total billed charges",449.82,9628.23,
"21015 Radical resection of tumor (eg, sarcoma), so",7962231,CDM,521,RC,21015,CPT,OUTPATIENT,,,1960,1274,,1724.8,88,,1379.84,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1960,100,,1568.00,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1234.8,63,,987.84,,,0,"percent of total billed charges","63% of total billed charges",299.88,15.3,,239.90,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1352.4,69,,,,,0,"fee schedule","69% of total billed charges",1960,100,,1568.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1960,100,,1568.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1960,100,,1568.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",738.92,37.7,,591.14,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1528.8,78,,1223.04,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1618.96,82.6,,1295.17,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1618.96,82.6,,1295.17,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,1960,100,,1568.00,,,0,"percent of total billed charges","100% of total billed charges",299.88,9628.23,
"21012 Excision, tumor, soft tissue of face or scal",7962586,CDM,521,RC,21012,CPT,OUTPATIENT,,,974,633.1,,857.12,88,,685.70,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,974,100,,779.20,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",613.62,63,,490.90,,,0,"percent of total billed charges","63% of total billed charges",149.02,15.3,,119.22,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,672.06,69,,,,,0,"fee schedule","69% of total billed charges",974,100,,779.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",974,100,,779.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",974,100,,779.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",367.2,37.7,,293.76,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.72,78,,607.78,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",804.52,82.6,,643.62,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",804.52,82.6,,643.62,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,974,100,,779.20,,,0,"percent of total billed charges","100% of total billed charges",149.02,5715.97,
"21011 Excision, tumor, soft tissue of face or scal",7962619,CDM,521,RC,21011,CPT,OUTPATIENT,,,753,489.45,,662.64,88,,530.11,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,753,100,,602.40,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",474.39,63,,379.51,,,0,"percent of total billed charges","63% of total billed charges",115.21,15.3,,92.17,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,519.57,69,,,,,0,"fee schedule","69% of total billed charges",753,100,,602.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",753,100,,602.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",753,100,,602.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",283.88,37.7,,227.10,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",587.34,78,,469.87,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",621.98,82.6,,497.58,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",621.98,82.6,,497.58,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,753,100,,602.40,,,0,"percent of total billed charges","100% of total billed charges",115.21,5715.97,
"21014 Excision, tumor, soft tissue of face and sca",7962620,CDM,521,RC,21014,CPT,OUTPATIENT,,,1500,975,,1320,88,,1056.00,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1500,100,,1200.00,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",945,63,,756.00,,,0,"percent of total billed charges","63% of total billed charges",229.5,15.3,,183.60,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1035,69,,,,,0,"fee schedule","69% of total billed charges",1500,100,,1200.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1500,100,,1200.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1500,100,,1200.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",565.5,37.7,,452.40,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1170,78,,936.00,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239,82.6,,991.20,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239,82.6,,991.20,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,1500,100,,1200.00,,,0,"percent of total billed charges","100% of total billed charges",229.5,9628.23,
"21013 Excision, tumor, soft tissue of face and sca",7962662,CDM,521,RC,21013,CPT,OUTPATIENT,,,1162,755.3,,1022.56,88,,818.05,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1162,100,,929.60,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",732.06,63,,585.65,,,0,"percent of total billed charges","63% of total billed charges",177.79,15.3,,142.23,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,801.78,69,,,,,0,"fee schedule","69% of total billed charges",1162,100,,929.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1162,100,,929.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1162,100,,929.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",438.07,37.7,,350.46,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",906.36,78,,725.09,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",959.81,82.6,,767.85,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",959.81,82.6,,767.85,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,1162,100,,929.60,,,0,"percent of total billed charges","100% of total billed charges",177.79,5715.97,
"21029 Removal by contouring of benign tumor of fac",7962587,CDM,521,RC,21029,CPT,OUTPATIENT,,,1653,1074.45,,1454.64,88,,1163.71,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2697.98,100,,,,,0,"fee schedule",EAPG,1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",2778.92,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1041.39,63,,833.11,,,0,"percent of total billed charges","63% of total billed charges",252.91,15.3,,202.33,,,0,"percent of total billed charges","15.3% of total billed charges",2697.98,100,,,,,0,"fee schedule",EAPG,1140.57,69,,,,,0,"fee schedule","69% of total billed charges",1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2697.98,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2751.94,100,,,,,0,"fee schedule",EAPG,3507.38,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",623.18,37.7,,498.54,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1289.34,78,,1031.47,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1365.38,82.6,,1092.30,,,0,"percent of total billed charges","82.6% of total billed charges",2697.98,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1365.38,82.6,,1092.30,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2858.51,100,,,,,0,"fee schedule",EAPG,1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",252.91,11116.67,
"21030 Excision of benign tumor or cyst of maxilla",7962397,CDM,521,RC,21030,CPT,OUTPATIENT,,,1547,1005.55,,1361.36,88,,1089.09,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2697.98,100,,,,,0,"fee schedule",EAPG,1547,100,,1237.60,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",2778.92,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",974.61,63,,779.69,,,0,"percent of total billed charges","63% of total billed charges",236.69,15.3,,189.35,,,0,"percent of total billed charges","15.3% of total billed charges",2697.98,100,,,,,0,"fee schedule",EAPG,1067.43,69,,,,,0,"fee schedule","69% of total billed charges",1547,100,,1237.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1547,100,,1237.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1547,100,,1237.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2697.98,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2751.94,100,,,,,0,"fee schedule",EAPG,3507.38,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",583.22,37.7,,466.58,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1206.66,78,,965.33,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1277.82,82.6,,1022.26,,,0,"percent of total billed charges","82.6% of total billed charges",2697.98,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1277.82,82.6,,1022.26,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2858.51,100,,,,,0,"fee schedule",EAPG,1547,100,,1237.60,,,0,"percent of total billed charges","100% of total billed charges",236.69,20662.24,
"21040 Excision of benign tumor or cyst of mandible",7962544,CDM,521,RC,21040,CPT,OUTPATIENT,,,1200,780,,1056,88,,844.80,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2697.98,100,,,,,0,"fee schedule",EAPG,1200,100,,960.00,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",2778.92,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",756,63,,604.80,,,0,"percent of total billed charges","63% of total billed charges",183.6,15.3,,146.88,,,0,"percent of total billed charges","15.3% of total billed charges",2697.98,100,,,,,0,"fee schedule",EAPG,828,69,,,,,0,"fee schedule","69% of total billed charges",1200,100,,960.00,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1200,100,,960.00,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1200,100,,960.00,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2697.98,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2751.94,100,,,,,0,"fee schedule",EAPG,3507.38,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",452.4,37.7,,361.92,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",936,78,,748.80,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",991.2,82.6,,792.96,,,0,"percent of total billed charges","82.6% of total billed charges",2697.98,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",991.2,82.6,,792.96,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2858.51,100,,,,,0,"fee schedule",EAPG,1200,100,,960.00,,,0,"percent of total billed charges","100% of total billed charges",183.6,11116.67,
"21172 Reconstruction superior-lateral orbital rim",7962119,CDM,521,RC,21172,CPT,OUTPATIENT,,,5660,3679,,4980.8,88,,3984.64,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4013.79,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4134.2,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3565.8,63,,2852.64,,,0,"percent of total billed charges","63% of total billed charges",865.98,15.3,,692.78,,,0,"percent of total billed charges","15.3% of total billed charges",4013.79,100,,,,,0,"fee schedule",EAPG,3905.4,69,,,,,0,"fee schedule","69% of total billed charges",5660,100,,4528.00,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5660,100,,4528.00,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5660,100,,4528.00,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4013.79,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4094.06,100,,,,,0,"fee schedule",EAPG,5217.93,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2133.82,37.7,,1707.06,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4414.8,78,,3531.84,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4675.16,82.6,,3740.13,,,0,"percent of total billed charges","82.6% of total billed charges",4013.79,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4675.16,82.6,,3740.13,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4174.32,100,,,,,0,"fee schedule",EAPG,5660,100,,4528.00,,,0,"percent of total billed charges","100% of total billed charges",865.98,20662.24,
"21256 Reconstruction of orbit with osteotomies (ex",7961966,CDM,521,RC,21256,CPT,OUTPATIENT,,,6892,4479.8,,6064.96,88,,4851.97,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4013.79,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4134.2,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4341.96,63,,3473.57,,,0,"percent of total billed charges","63% of total billed charges",1054.48,15.3,,843.58,,,0,"percent of total billed charges","15.3% of total billed charges",4013.79,100,,,,,0,"fee schedule",EAPG,4755.48,69,,,,,0,"fee schedule","69% of total billed charges",6892,100,,5513.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6892,100,,5513.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6892,100,,5513.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4013.79,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4094.06,100,,,,,0,"fee schedule",EAPG,5217.93,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2598.28,37.7,,2078.62,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5375.76,78,,4300.61,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5692.79,82.6,,4554.23,,,0,"percent of total billed charges","82.6% of total billed charges",4013.79,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5692.79,82.6,,4554.23,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4174.32,100,,,,,0,"fee schedule",EAPG,6892,100,,5513.60,,,0,"percent of total billed charges","100% of total billed charges",1054.48,20662.24,
"21315 Closed treatment of nasal bone fracture; wit",7903189,CDM,521,RC,21315,CPT,OUTPATIENT,,,581,377.65,,511.28,88,,409.02,,,0,"percent of total billed charges","88% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,581,100,,464.80,,,0,"percent of total billed charges","100% of total billed charges",2722.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",366.03,63,,292.82,,,0,"percent of total billed charges","63% of total billed charges",88.89,15.3,,71.11,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,400.89,69,,,,,0,"fee schedule","69% of total billed charges",581,100,,464.80,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",581,100,,464.80,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",581,100,,464.80,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",5495.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1436.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",219.04,37.7,,175.23,,,0,"percent of total billed charges","37.70% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",453.18,78,,362.54,,,0,"percent of total billed charges","78% of total billed charges",1571.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",479.91,82.6,,383.93,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",479.91,82.6,,383.93,,,0,"percent of total billed charges","82.6% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,581,100,,464.80,,,0,"percent of total billed charges","100% of total billed charges",88.89,5495.75,
"21335 Open treatment of nasal fracture; with conco",7962282,CDM,521,RC,21335,CPT,OUTPATIENT,,,1614,1049.1,,1420.32,88,,1136.26,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2697.98,100,,,,,0,"fee schedule",EAPG,1614,100,,1291.20,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",2778.92,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1016.82,63,,813.46,,,0,"percent of total billed charges","63% of total billed charges",246.94,15.3,,197.55,,,0,"percent of total billed charges","15.3% of total billed charges",2697.98,100,,,,,0,"fee schedule",EAPG,1113.66,69,,,,,0,"fee schedule","69% of total billed charges",1614,100,,1291.20,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1614,100,,1291.20,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1614,100,,1291.20,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2697.98,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2751.94,100,,,,,0,"fee schedule",EAPG,3507.38,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",608.48,37.7,,486.78,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1258.92,78,,1007.14,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1333.16,82.6,,1066.53,,,0,"percent of total billed charges","82.6% of total billed charges",2697.98,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1333.16,82.6,,1066.53,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2858.51,100,,,,,0,"fee schedule",EAPG,1614,100,,1291.20,,,0,"percent of total billed charges","100% of total billed charges",246.94,11116.67,
"21337 Closed treatment of nasal septal fracture, w",7962735,CDM,521,RC,21337,CPT,OUTPATIENT,,,582,378.3,,512.16,88,,409.73,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,582,100,,465.60,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",366.66,63,,293.33,,,0,"percent of total billed charges","63% of total billed charges",89.05,15.3,,71.24,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,401.58,69,,,,,0,"fee schedule","69% of total billed charges",582,100,,465.60,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",582,100,,465.60,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",582,100,,465.60,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",219.41,37.7,,175.53,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",453.96,78,,363.17,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",480.73,82.6,,384.58,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",480.73,82.6,,384.58,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,582,100,,465.60,,,0,"percent of total billed charges","100% of total billed charges",89.05,11116.67,
"21344 Open treatment of complicated frontal sinus",7961898,CDM,521,RC,21344,CPT,OUTPATIENT,,,6015,3909.75,,5293.2,88,,4234.56,,,0,"percent of total billed charges","88% of total billed charges",6015,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4013.79,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6015,175,,,,,0,"fee schedule","175% of CMS fee schedule",4134.2,100,,,,,0,"fee schedule",EAPG,6015,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3789.45,63,,3031.56,,,0,"percent of total billed charges","63% of total billed charges",920.3,15.3,,736.24,,,0,"percent of total billed charges","15.3% of total billed charges",4013.79,100,,,,,0,"fee schedule",EAPG,4150.35,69,,,,,0,"fee schedule","69% of total billed charges",6015,100,,4812.00,,,0,"percent of total billed charges","100% of total billed charges",6015,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6015,100,,4812.00,,,0,"percent of total billed charges","100% of total billed charges",6015,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6015,100,,4812.00,,,0,"percent of total billed charges","100% of total billed charges",6015,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4013.79,100,,,,,0,"fee schedule",EAPG,6015,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6015,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4094.06,100,,,,,0,"fee schedule",EAPG,5217.93,100,,,,,0,"fee schedule",EAPG,6015,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2267.66,37.7,,1814.13,,,0,"percent of total billed charges","37.70% of total billed charges",6015,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6015,100,,,,,0,"fee schedule","100% of CMS fee schedule",4691.7,78,,3753.36,,,0,"percent of total billed charges","78% of total billed charges",6015,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4968.39,82.6,,3974.71,,,0,"percent of total billed charges","82.6% of total billed charges",4013.79,100,,,,,0,"fee schedule","100% of WA fee schedule",6015,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4968.39,82.6,,3974.71,,,0,"percent of total billed charges","82.6% of total billed charges",6015,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4174.32,100,,,,,0,"fee schedule",EAPG,6015,100,,4812.00,,,0,"percent of total billed charges","100% of total billed charges",920.3,20662.24,
"21343 Open Tx Depressed Frontal Sinus Fx",7963687,CDM,521,RC,21343,CPT,OUTPATIENT,,,4130,2684.5,,3634.4,88,,2907.52,,,0,"percent of total billed charges","88% of total billed charges",4130,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2697.98,100,,,,,0,"fee schedule",EAPG,4130,100,,3304.00,,,0,"percent of total billed charges","100% of total billed charges",4130,175,,,,,0,"fee schedule","175% of CMS fee schedule",2778.92,100,,,,,0,"fee schedule",EAPG,4130,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2601.9,63,,2081.52,,,0,"percent of total billed charges","63% of total billed charges",631.89,15.3,,505.51,,,0,"percent of total billed charges","15.3% of total billed charges",2697.98,100,,,,,0,"fee schedule",EAPG,2849.7,69,,,,,0,"fee schedule","69% of total billed charges",4130,100,,3304.00,,,0,"percent of total billed charges","100% of total billed charges",4130,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4130,100,,3304.00,,,0,"percent of total billed charges","100% of total billed charges",4130,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4130,100,,3304.00,,,0,"percent of total billed charges","100% of total billed charges",4130,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2697.98,100,,,,,0,"fee schedule",EAPG,4130,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4130,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2751.94,100,,,,,0,"fee schedule",EAPG,3507.38,100,,,,,0,"fee schedule",EAPG,4130,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1557.01,37.7,,1245.61,,,0,"percent of total billed charges","37.70% of total billed charges",4130,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4130,100,,,,,0,"fee schedule","100% of CMS fee schedule",3221.4,78,,2577.12,,,0,"percent of total billed charges","78% of total billed charges",4130,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3411.38,82.6,,2729.10,,,0,"percent of total billed charges","82.6% of total billed charges",2697.98,100,,,,,0,"fee schedule",EAPG,4130,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3411.38,82.6,,2729.10,,,0,"percent of total billed charges","82.6% of total billed charges",4130,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2858.51,100,,,,,0,"fee schedule",EAPG,4130,100,,3304.00,,,0,"percent of total billed charges","100% of total billed charges",631.89,20662.24,
"21365 Open tx of complicated fx of malar/tripod/zy",7961800,CDM,521,RC,21365,CPT,OUTPATIENT,,,1702,1106.3,,1497.76,88,,1198.21,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4013.79,100,,,,,0,"fee schedule",EAPG,1702,100,,1361.60,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4134.2,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1072.26,63,,857.81,,,0,"percent of total billed charges","63% of total billed charges",260.41,15.3,,208.33,,,0,"percent of total billed charges","15.3% of total billed charges",4013.79,100,,,,,0,"fee schedule",EAPG,1174.38,69,,,,,0,"fee schedule","69% of total billed charges",1702,100,,1361.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1702,100,,1361.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1702,100,,1361.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4013.79,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4094.06,100,,,,,0,"fee schedule",EAPG,5217.93,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",641.65,37.7,,513.32,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.56,78,,1062.05,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1405.85,82.6,,1124.68,,,0,"percent of total billed charges","82.6% of total billed charges",4013.79,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1405.85,82.6,,1124.68,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4174.32,100,,,,,0,"fee schedule",EAPG,1702,100,,1361.60,,,0,"percent of total billed charges","100% of total billed charges",260.41,20662.24,
"21360 Open treatment of depressed malar fracture,",7962283,CDM,521,RC,21360,CPT,OUTPATIENT,,,1044,678.6,,918.72,88,,734.98,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2697.98,100,,,,,0,"fee schedule",EAPG,1044,100,,835.20,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",2778.92,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",657.72,63,,526.18,,,0,"percent of total billed charges","63% of total billed charges",159.73,15.3,,127.78,,,0,"percent of total billed charges","15.3% of total billed charges",2697.98,100,,,,,0,"fee schedule",EAPG,720.36,69,,,,,0,"fee schedule","69% of total billed charges",1044,100,,835.20,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1044,100,,835.20,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1044,100,,835.20,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2697.98,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2751.94,100,,,,,0,"fee schedule",EAPG,3507.38,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",393.59,37.7,,314.87,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",814.32,78,,651.46,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",862.34,82.6,,689.87,,,0,"percent of total billed charges","82.6% of total billed charges",2697.98,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",862.34,82.6,,689.87,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2858.51,100,,,,,0,"fee schedule",EAPG,1044,100,,835.20,,,0,"percent of total billed charges","100% of total billed charges",159.73,20662.24,
"21366 Open tx of complicated fx of malar/tripod/zy",7962588,CDM,521,RC,21366,CPT,OUTPATIENT,,,2546,1654.9,,2240.48,88,,1792.38,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4013.79,100,,,,,0,"fee schedule",EAPG,2546,100,,2036.80,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4134.2,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.98,63,,1283.18,,,0,"percent of total billed charges","63% of total billed charges",389.54,15.3,,311.63,,,0,"percent of total billed charges","15.3% of total billed charges",4013.79,100,,,,,0,"fee schedule",EAPG,1756.74,69,,,,,0,"fee schedule","69% of total billed charges",2546,100,,2036.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2546,100,,2036.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2546,100,,2036.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4013.79,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4094.06,100,,,,,0,"fee schedule",EAPG,5217.93,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",959.84,37.7,,767.87,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1985.88,78,,1588.70,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2103,82.6,,1682.40,,,0,"percent of total billed charges","82.6% of total billed charges",4013.79,100,,,,,0,"fee schedule","100% of WA fee schedule",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2103,82.6,,1682.40,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4174.32,100,,,,,0,"fee schedule",EAPG,2546,100,,2036.80,,,0,"percent of total billed charges","100% of total billed charges",389.54,20662.24,
"21395 Open treatment of orbital floor blowout frac",7961967,CDM,521,RC,21395,CPT,OUTPATIENT,,,3951,2568.15,,3476.88,88,,2781.50,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4013.79,100,,,,,0,"fee schedule",EAPG,3951,100,,3160.80,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4134.2,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2489.13,63,,1991.30,,,0,"percent of total billed charges","63% of total billed charges",604.5,15.3,,483.60,,,0,"percent of total billed charges","15.3% of total billed charges",4013.79,100,,,,,0,"fee schedule",EAPG,2726.19,69,,,,,0,"fee schedule","69% of total billed charges",3951,100,,3160.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3951,100,,3160.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3951,100,,3160.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4013.79,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4094.06,100,,,,,0,"fee schedule",EAPG,5217.93,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1489.53,37.7,,1191.62,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3081.78,78,,2465.42,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3263.53,82.6,,2610.82,,,0,"percent of total billed charges","82.6% of total billed charges",4013.79,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3263.53,82.6,,2610.82,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4174.32,100,,,,,0,"fee schedule",EAPG,3951,100,,3160.80,,,0,"percent of total billed charges","100% of total billed charges",604.5,20662.24,
"21390 Open treatment of orbital floor blowout frac",7962313,CDM,521,RC,21390,CPT,OUTPATIENT,,,1751,1138.15,,1540.88,88,,1232.70,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4013.79,100,,,,,0,"fee schedule",EAPG,1751,100,,1400.80,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4134.2,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1103.13,63,,882.50,,,0,"percent of total billed charges","63% of total billed charges",267.9,15.3,,214.32,,,0,"percent of total billed charges","15.3% of total billed charges",4013.79,100,,,,,0,"fee schedule",EAPG,1208.19,69,,,,,0,"fee schedule","69% of total billed charges",1751,100,,1400.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1751,100,,1400.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1751,100,,1400.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4013.79,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4094.06,100,,,,,0,"fee schedule",EAPG,5217.93,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",660.13,37.7,,528.10,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1365.78,78,,1092.62,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1446.33,82.6,,1157.06,,,0,"percent of total billed charges","82.6% of total billed charges",4013.79,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1446.33,82.6,,1157.06,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4174.32,100,,,,,0,"fee schedule",EAPG,1751,100,,1400.80,,,0,"percent of total billed charges","100% of total billed charges",267.9,20662.24,
"21406 Open treatment of fracture of orbit, except",7962872,CDM,521,RC,21406,CPT,OUTPATIENT,,,2383,1548.95,,2097.04,88,,1677.63,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4013.79,100,,,,,0,"fee schedule",EAPG,2383,100,,1906.40,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4134.2,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1501.29,63,,1201.03,,,0,"percent of total billed charges","63% of total billed charges",364.6,15.3,,291.68,,,0,"percent of total billed charges","15.3% of total billed charges",4013.79,100,,,,,0,"fee schedule",EAPG,1644.27,69,,,,,0,"fee schedule","69% of total billed charges",2383,100,,1906.40,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2383,100,,1906.40,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2383,100,,1906.40,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4013.79,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4094.06,100,,,,,0,"fee schedule",EAPG,5217.93,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",898.39,37.7,,718.71,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1858.74,78,,1486.99,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1968.36,82.6,,1574.69,,,0,"percent of total billed charges","82.6% of total billed charges",4013.79,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1968.36,82.6,,1574.69,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4174.32,100,,,,,0,"fee schedule",EAPG,2383,100,,1906.40,,,0,"percent of total billed charges","100% of total billed charges",364.6,20662.24,
"21407 Open treatment of fracture of orbit, except",7962957,CDM,521,RC,21407,CPT,OUTPATIENT,,,1433,931.45,,1261.04,88,,1008.83,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2697.98,100,,,,,0,"fee schedule",EAPG,1433,100,,1146.40,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",2778.92,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",902.79,63,,722.23,,,0,"percent of total billed charges","63% of total billed charges",219.25,15.3,,175.40,,,0,"percent of total billed charges","15.3% of total billed charges",2697.98,100,,,,,0,"fee schedule",EAPG,988.77,69,,,,,0,"fee schedule","69% of total billed charges",1433,100,,1146.40,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1433,100,,1146.40,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1433,100,,1146.40,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2697.98,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2751.94,100,,,,,0,"fee schedule",EAPG,3507.38,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",540.24,37.7,,432.19,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1117.74,78,,894.19,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1183.66,82.6,,946.93,,,0,"percent of total billed charges","82.6% of total billed charges",2697.98,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1183.66,82.6,,946.93,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2858.51,100,,,,,0,"fee schedule",EAPG,1433,100,,1146.40,,,0,"percent of total billed charges","100% of total billed charges",219.25,20662.24,
"21451 Closed treatment of mandibular fracture; wit",7963129,CDM,521,RC,21451,CPT,OUTPATIENT,,,1201,780.65,,1056.88,88,,845.50,,,0,"percent of total billed charges","88% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1201,100,,960.80,,,0,"percent of total billed charges","100% of total billed charges",2722.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",756.63,63,,605.30,,,0,"percent of total billed charges","63% of total billed charges",183.75,15.3,,147.00,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,828.69,69,,,,,0,"fee schedule","69% of total billed charges",1201,100,,960.80,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1201,100,,960.80,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1201,100,,960.80,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",5495.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1436.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",452.78,37.7,,362.22,,,0,"percent of total billed charges","37.70% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",936.78,78,,749.42,,,0,"percent of total billed charges","78% of total billed charges",1571.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",992.03,82.6,,793.62,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",992.03,82.6,,793.62,,,0,"percent of total billed charges","82.6% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,1201,100,,960.80,,,0,"percent of total billed charges","100% of total billed charges",183.75,5495.75,
"21499 Unlisted musculoskeletal procedure, head",7963576,CDM,521,RC,21499,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2697.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2778.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2697.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2697.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2751.94,100,,,,,0,"fee schedule",EAPG,3507.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2697.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2858.51,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2697.98,3507.38,
"21501 Incision and drainage, deep abscess or hemat",7962461,CDM,521,RC,21501,CPT,OUTPATIENT,,,951,618.15,,836.88,88,,669.50,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2020.72,100,,,,,0,"fee schedule",EAPG,951,100,,760.80,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",2081.34,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",599.13,63,,479.30,,,0,"percent of total billed charges","63% of total billed charges",145.5,15.3,,116.40,,,0,"percent of total billed charges","15.3% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,656.19,69,,,,,0,"fee schedule","69% of total billed charges",951,100,,760.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",951,100,,760.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",951,100,,760.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2020.72,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2061.13,100,,,,,0,"fee schedule",EAPG,2626.94,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",358.53,37.7,,286.82,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",741.78,78,,593.42,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",785.53,82.6,,628.42,,,0,"percent of total billed charges","82.6% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",785.53,82.6,,628.42,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2181.25,100,,,,,0,"fee schedule",EAPG,951,100,,760.80,,,0,"percent of total billed charges","100% of total billed charges",145.5,9628.23,
"21550 Biopsy, soft tissue of neck or thorax",7903192,CDM,521,RC,21550,CPT,OUTPATIENT,,,418,271.7,,367.84,88,,294.27,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2020.72,100,,,,,0,"fee schedule",EAPG,418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",2081.34,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",263.34,63,,210.67,,,0,"percent of total billed charges","63% of total billed charges",63.95,15.3,,51.16,,,0,"percent of total billed charges","15.3% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,288.42,69,,,,,0,"fee schedule","69% of total billed charges",418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2020.72,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2061.13,100,,,,,0,"fee schedule",EAPG,2626.94,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",157.59,37.7,,126.07,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",326.04,78,,260.83,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.27,82.6,,276.22,,,0,"percent of total billed charges","82.6% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.27,82.6,,276.22,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2181.25,100,,,,,0,"fee schedule",EAPG,418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",63.95,5715.97,
"21552 Excision, tumor, soft tissue of neck or ante",7962232,CDM,521,RC,21552,CPT,OUTPATIENT,,,1423,924.95,,1252.24,88,,1001.79,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2020.72,100,,,,,0,"fee schedule",EAPG,1423,100,,1138.40,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",2081.34,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",896.49,63,,717.19,,,0,"percent of total billed charges","63% of total billed charges",217.72,15.3,,174.18,,,0,"percent of total billed charges","15.3% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,981.87,69,,,,,0,"fee schedule","69% of total billed charges",1423,100,,1138.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1423,100,,1138.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1423,100,,1138.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2020.72,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2061.13,100,,,,,0,"fee schedule",EAPG,2626.94,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",536.47,37.7,,429.18,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1109.94,78,,887.95,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1175.4,82.6,,940.32,,,0,"percent of total billed charges","82.6% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1175.4,82.6,,940.32,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2181.25,100,,,,,0,"fee schedule",EAPG,1423,100,,1138.40,,,0,"percent of total billed charges","100% of total billed charges",217.72,9628.23,
"21555 Excision, tumor, soft tissue of neck or ante",7962284,CDM,521,RC,21555,CPT,OUTPATIENT,,,865,562.25,,761.2,88,,608.96,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2020.72,100,,,,,0,"fee schedule",EAPG,865,100,,692.00,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",2081.34,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",544.95,63,,435.96,,,0,"percent of total billed charges","63% of total billed charges",132.35,15.3,,105.88,,,0,"percent of total billed charges","15.3% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,596.85,69,,,,,0,"fee schedule","69% of total billed charges",865,100,,692.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",865,100,,692.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",865,100,,692.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2020.72,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2061.13,100,,,,,0,"fee schedule",EAPG,2626.94,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",326.11,37.7,,260.89,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",674.7,78,,539.76,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",714.49,82.6,,571.59,,,0,"percent of total billed charges","82.6% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",714.49,82.6,,571.59,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2181.25,100,,,,,0,"fee schedule",EAPG,865,100,,692.00,,,0,"percent of total billed charges","100% of total billed charges",132.35,5715.97,
"21554 Excision, tumor, soft tissue of neck or ante",7962314,CDM,521,RC,21554,CPT,OUTPATIENT,,,2055,1335.75,,1808.4,88,,1446.72,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2020.72,100,,,,,0,"fee schedule",EAPG,2055,100,,1644.00,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",2081.34,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1294.65,63,,1035.72,,,0,"percent of total billed charges","63% of total billed charges",314.42,15.3,,251.54,,,0,"percent of total billed charges","15.3% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,1417.95,69,,,,,0,"fee schedule","69% of total billed charges",2055,100,,1644.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2055,100,,1644.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2055,100,,1644.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2020.72,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2061.13,100,,,,,0,"fee schedule",EAPG,2626.94,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",774.74,37.7,,619.79,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1602.9,78,,1282.32,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1697.43,82.6,,1357.94,,,0,"percent of total billed charges","82.6% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1697.43,82.6,,1357.94,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2181.25,100,,,,,0,"fee schedule",EAPG,2055,100,,1644.00,,,0,"percent of total billed charges","100% of total billed charges",314.42,9628.23,
"21556 Excision, tumor, soft tissue of neck or ante",7962356,CDM,521,RC,21556,CPT,OUTPATIENT,,,1474,958.1,,1297.12,88,,1037.70,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2020.72,100,,,,,0,"fee schedule",EAPG,1474,100,,1179.20,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",2081.34,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",928.62,63,,742.90,,,0,"percent of total billed charges","63% of total billed charges",225.52,15.3,,180.42,,,0,"percent of total billed charges","15.3% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,1017.06,69,,,,,0,"fee schedule","69% of total billed charges",1474,100,,1179.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1474,100,,1179.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1474,100,,1179.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2020.72,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2061.13,100,,,,,0,"fee schedule",EAPG,2626.94,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",555.7,37.7,,444.56,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1149.72,78,,919.78,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.52,82.6,,974.02,,,0,"percent of total billed charges","82.6% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.52,82.6,,974.02,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2181.25,100,,,,,0,"fee schedule",EAPG,1474,100,,1179.20,,,0,"percent of total billed charges","100% of total billed charges",225.52,9628.23,
"21558 Radical resection of tumor, soft tissue of n",7962357,CDM,521,RC,21558,CPT,OUTPATIENT,,,4514,2934.1,,3972.32,88,,3177.86,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.92,100,,,,,0,"fee schedule",EAPG,4514,100,,3611.20,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2843.82,63,,2275.06,,,0,"percent of total billed charges","63% of total billed charges",690.64,15.3,,552.51,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,3114.66,69,,,,,0,"fee schedule","69% of total billed charges",4514,100,,3611.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4514,100,,3611.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4514,100,,3611.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.92,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1701.78,37.7,,1361.42,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3520.92,78,,2816.74,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3728.56,82.6,,2982.85,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3728.56,82.6,,2982.85,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4844.45,100,,,,,0,"fee schedule",EAPG,4514,100,,3611.20,,,0,"percent of total billed charges","100% of total billed charges",690.64,9628.23,
"21557 Radical resection of tumor, soft tissue of n",7962398,CDM,521,RC,21557,CPT,OUTPATIENT,,,3719,2417.35,,3272.72,88,,2618.18,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2020.72,100,,,,,0,"fee schedule",EAPG,3719,100,,2975.20,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",2081.34,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2342.97,63,,1874.38,,,0,"percent of total billed charges","63% of total billed charges",569.01,15.3,,455.21,,,0,"percent of total billed charges","15.3% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,2566.11,69,,,,,0,"fee schedule","69% of total billed charges",3719,100,,2975.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3719,100,,2975.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3719,100,,2975.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2020.72,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2061.13,100,,,,,0,"fee schedule",EAPG,2626.94,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1402.06,37.7,,1121.65,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2900.82,78,,2320.66,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3071.89,82.6,,2457.51,,,0,"percent of total billed charges","82.6% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3071.89,82.6,,2457.51,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2181.25,100,,,,,0,"fee schedule",EAPG,3719,100,,2975.20,,,0,"percent of total billed charges","100% of total billed charges",569.01,9628.23,
"21602 Excision of chest wall tumor involving rib(s",7962149,CDM,521,RC,21603,CPT,OUTPATIENT,,,5285,3435.25,,4650.8,88,,3720.64,,,0,"percent of total billed charges","88% of total billed charges",5285,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5285,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,5285,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3329.55,63,,2663.64,,,0,"percent of total billed charges","63% of total billed charges",808.61,15.3,,646.89,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,3646.65,69,,,,,0,"fee schedule","69% of total billed charges",5285,100,,4228.00,,,0,"percent of total billed charges","100% of total billed charges",5285,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5285,100,,4228.00,,,0,"percent of total billed charges","100% of total billed charges",5285,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5285,100,,4228.00,,,0,"percent of total billed charges","100% of total billed charges",5285,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.92,100,,,,,0,"fee schedule",EAPG,5285,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5285,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,5285,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1992.45,37.7,,1593.96,,,0,"percent of total billed charges","37.70% of total billed charges",5285,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5285,100,,,,,0,"fee schedule","100% of CMS fee schedule",4122.3,78,,3297.84,,,0,"percent of total billed charges","78% of total billed charges",5285,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4365.41,82.6,,3492.33,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,5285,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4365.41,82.6,,3492.33,,,0,"percent of total billed charges","82.6% of total billed charges",5285,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,5285,100,,4228.00,,,0,"percent of total billed charges","100% of total billed charges",808.61,25451.55,
"21602 - Exc ch wal tum w/o lymphadec",9442480,CDM,521,RC,21602,CPT,OUTPATIENT,,,4832,3140.8,,4252.16,88,,3401.73,,,0,"percent of total billed charges","88% of total billed charges",4832,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",4832,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,4832,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3044.16,63,,2435.33,,,0,"percent of total billed charges","63% of total billed charges",739.3,15.3,,591.44,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,3334.08,69,,,,,0,"fee schedule","69% of total billed charges",4832,100,,3865.60,,,0,"percent of total billed charges","100% of total billed charges",4832,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4832,100,,3865.60,,,0,"percent of total billed charges","100% of total billed charges",4832,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4832,100,,3865.60,,,0,"percent of total billed charges","100% of total billed charges",4832,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.92,100,,,,,0,"fee schedule",EAPG,4832,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4832,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,4832,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1821.66,37.7,,1457.33,,,0,"percent of total billed charges","37.70% of total billed charges",4832,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4832,100,,,,,0,"fee schedule","100% of CMS fee schedule",3768.96,78,,3015.17,,,0,"percent of total billed charges","78% of total billed charges",4832,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3991.23,82.6,,3192.98,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,4832,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3991.23,82.6,,3192.98,,,0,"percent of total billed charges","82.6% of total billed charges",4832,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,4832,100,,3865.60,,,0,"percent of total billed charges","100% of total billed charges",739.3,25451.55,
"21601 Excision of chest wall tumor including rib(s",9476535,CDM,521,RC,21601,CPT,OUTPATIENT,,,3401,2210.65,,2992.88,88,,2394.30,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2020.72,100,,,,,0,"fee schedule",EAPG,3401,100,,2720.80,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",2081.34,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2142.63,63,,1714.10,,,0,"percent of total billed charges","63% of total billed charges",520.35,15.3,,416.28,,,0,"percent of total billed charges","15.3% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,2346.69,69,,,,,0,"fee schedule","69% of total billed charges",3401,100,,2720.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3401,100,,2720.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3401,100,,2720.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2020.72,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2061.13,100,,,,,0,"fee schedule",EAPG,2626.94,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1282.18,37.7,,1025.74,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2652.78,78,,2122.22,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.23,82.6,,2247.38,,,0,"percent of total billed charges","82.6% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.23,82.6,,2247.38,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2181.25,100,,,,,0,"fee schedule",EAPG,3401,100,,2720.80,,,0,"percent of total billed charges","100% of total billed charges",520.35,9628.23,
"21610 Costotransversectomy (separate procedure)",7963556,CDM,521,RC,21610,CPT,OUTPATIENT,,,2967,1928.55,,2610.96,88,,2088.77,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,2967,100,,2373.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1869.21,63,,1495.37,,,0,"percent of total billed charges","63% of total billed charges",453.95,15.3,,363.16,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,2047.23,69,,,,,0,"fee schedule","69% of total billed charges",2967,100,,2373.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2967,100,,2373.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2967,100,,2373.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1118.56,37.7,,894.85,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2314.26,78,,1851.41,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2450.74,82.6,,1960.59,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2450.74,82.6,,1960.59,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,2967,100,,2373.60,,,0,"percent of total billed charges","100% of total billed charges",453.95,11498.59,
"21615 Excision first and/or cervical rib;",7963674,CDM,521,RC,21615,CPT,OUTPATIENT,,,1770,1150.5,,1557.6,88,,1246.08,,,0,"percent of total billed charges","88% of total billed charges",1770,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,1770,100,,1416.00,,,0,"percent of total billed charges","100% of total billed charges",1770,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,1770,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1115.1,63,,892.08,,,0,"percent of total billed charges","63% of total billed charges",270.81,15.3,,216.65,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,1221.3,69,,,,,0,"fee schedule","69% of total billed charges",1770,100,,1416.00,,,0,"percent of total billed charges","100% of total billed charges",1770,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1770,100,,1416.00,,,0,"percent of total billed charges","100% of total billed charges",1770,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1770,100,,1416.00,,,0,"percent of total billed charges","100% of total billed charges",1770,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.92,100,,,,,0,"fee schedule",EAPG,1770,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1770,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,1770,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",667.29,37.7,,533.83,,,0,"percent of total billed charges","37.70% of total billed charges",1770,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1770,100,,,,,0,"fee schedule","100% of CMS fee schedule",1380.6,78,,1104.48,,,0,"percent of total billed charges","78% of total billed charges",1770,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1462.02,82.6,,1169.62,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule","100% of WA fee schedule",1770,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1462.02,82.6,,1169.62,,,0,"percent of total billed charges","82.6% of total billed charges",1770,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,1770,100,,1416.00,,,0,"percent of total billed charges","100% of total billed charges",270.81,25451.55,
"21627 Sternal debridement",7963906,CDM,521,RC,21627,CPT,OUTPATIENT,,,1583,1028.95,,1393.04,88,,1114.43,,,0,"percent of total billed charges","88% of total billed charges",1583,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2020.72,100,,,,,0,"fee schedule",EAPG,1583,100,,1266.40,,,0,"percent of total billed charges","100% of total billed charges",1583,175,,,,,0,"fee schedule","175% of CMS fee schedule",2081.34,100,,,,,0,"fee schedule",EAPG,1583,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",997.29,63,,797.83,,,0,"percent of total billed charges","63% of total billed charges",242.2,15.3,,193.76,,,0,"percent of total billed charges","15.3% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,1092.27,69,,,,,0,"fee schedule","69% of total billed charges",1583,100,,1266.40,,,0,"percent of total billed charges","100% of total billed charges",1583,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1583,100,,1266.40,,,0,"percent of total billed charges","100% of total billed charges",1583,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1583,100,,1266.40,,,0,"percent of total billed charges","100% of total billed charges",1583,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2020.72,100,,,,,0,"fee schedule",EAPG,1583,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1583,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2061.13,100,,,,,0,"fee schedule",EAPG,2626.94,100,,,,,0,"fee schedule",EAPG,1583,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",596.79,37.7,,477.43,,,0,"percent of total billed charges","37.70% of total billed charges",1583,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1583,100,,,,,0,"fee schedule","100% of CMS fee schedule",1234.74,78,,987.79,,,0,"percent of total billed charges","78% of total billed charges",1583,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1307.56,82.6,,1046.05,,,0,"percent of total billed charges","82.6% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,1583,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1307.56,82.6,,1046.05,,,0,"percent of total billed charges","82.6% of total billed charges",1583,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2181.25,100,,,,,0,"fee schedule",EAPG,1583,100,,1266.40,,,0,"percent of total billed charges","100% of total billed charges",242.2,25451.55,
"21700 Division of scalenus anticus; without resect",7963012,CDM,521,RC,21700,CPT,OUTPATIENT,,,1060,689,,932.8,88,,746.24,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,1060,100,,848.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",667.8,63,,534.24,,,0,"percent of total billed charges","63% of total billed charges",162.18,15.3,,129.74,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,731.4,69,,,,,0,"fee schedule","69% of total billed charges",1060,100,,848.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1060,100,,848.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1060,100,,848.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",399.62,37.7,,319.70,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",826.8,78,,661.44,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.56,82.6,,700.45,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.56,82.6,,700.45,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,1060,100,,848.00,,,0,"percent of total billed charges","100% of total billed charges",162.18,25451.55,
"21800 treatment of rib fracture",7963835,CDM,521,RC,21800,CPT,OUTPATIENT,,,264,171.6,,232.32,88,,185.86,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.35,16.8,,35.48,,,0,"percent of total billed charges","16.8% of total billed charges",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.68,17.304,,36.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.32,63,,133.06,,,0,"percent of total billed charges","63% of total billed charges",40.39,15.3,,32.31,,,0,"percent of total billed charges","15.3% of total billed charges",44.35,16.8,,35.48,,,0,"percent of total billed charges","16.8% of total billed charges",182.16,69,,,,,0,"fee schedule","69% of total billed charges",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",44.35,16.8,,35.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",45.24,17.136,,36.19,,,0,"percent of total billed charges","17.136% of total billed charges",57.66,21.84,,46.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",99.53,37.7,,79.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",205.92,78,,164.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",218.06,82.6,,174.45,,,0,"percent of total billed charges","82.6% of total billed charges",44.35,16.8,,35.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",218.06,82.6,,174.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",40.39,264,
"21920 Biopsy, soft tissue of back or flank; superf",7963376,CDM,521,RC,21920,CPT,OUTPATIENT,,,320,208,,281.6,88,,225.28,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",201.6,63,,161.28,,,0,"percent of total billed charges","63% of total billed charges",48.96,15.3,,39.17,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,220.8,69,,,,,0,"fee schedule","69% of total billed charges",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",120.64,37.7,,96.51,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",249.6,78,,199.68,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",264.32,82.6,,211.46,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",264.32,82.6,,211.46,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",48.96,5715.97,
"21925 Biopsy, soft tissue of back or flank; deep",7963536,CDM,521,RC,21925,CPT,OUTPATIENT,,,1176,764.4,,1034.88,88,,827.90,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1176,100,,940.80,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",740.88,63,,592.70,,,0,"percent of total billed charges","63% of total billed charges",179.93,15.3,,143.94,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,811.44,69,,,,,0,"fee schedule","69% of total billed charges",1176,100,,940.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1176,100,,940.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1176,100,,940.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",443.35,37.7,,354.68,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",917.28,78,,733.82,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",971.38,82.6,,777.10,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",971.38,82.6,,777.10,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,1176,100,,940.80,,,0,"percent of total billed charges","100% of total billed charges",179.93,5715.97,
"21933 Excision, tumor, soft tissue of back or flan",7961462,CDM,521,RC,21933,CPT,OUTPATIENT,,,2102,1366.3,,1849.76,88,,1479.81,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2102,100,,1681.60,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1324.26,63,,1059.41,,,0,"percent of total billed charges","63% of total billed charges",321.61,15.3,,257.29,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1450.38,69,,,,,0,"fee schedule","69% of total billed charges",2102,100,,1681.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2102,100,,1681.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2102,100,,1681.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",792.45,37.7,,633.96,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1639.56,78,,1311.65,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1736.25,82.6,,1389.00,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1736.25,82.6,,1389.00,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,2102,100,,1681.60,,,0,"percent of total billed charges","100% of total billed charges",321.61,9628.23,
"21932 Excision, tumor, soft tissue of back or flan",7961573,CDM,521,RC,21932,CPT,OUTPATIENT,,,1883,1223.95,,1657.04,88,,1325.63,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1883,100,,1506.40,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1186.29,63,,949.03,,,0,"percent of total billed charges","63% of total billed charges",288.1,15.3,,230.48,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1299.27,69,,,,,0,"fee schedule","69% of total billed charges",1883,100,,1506.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1883,100,,1506.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1883,100,,1506.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",709.89,37.7,,567.91,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1468.74,78,,1174.99,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1555.36,82.6,,1244.29,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1555.36,82.6,,1244.29,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,1883,100,,1506.40,,,0,"percent of total billed charges","100% of total billed charges",288.1,9628.23,
"21935 Radical resection of tumor (eg, sarcoma), so",7962233,CDM,521,RC,21935,CPT,OUTPATIENT,,,3930,2554.5,,3458.4,88,,2766.72,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,3930,100,,3144.00,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2475.9,63,,1980.72,,,0,"percent of total billed charges","63% of total billed charges",601.29,15.3,,481.03,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2711.7,69,,,,,0,"fee schedule","69% of total billed charges",3930,100,,3144.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3930,100,,3144.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3930,100,,3144.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1481.61,37.7,,1185.29,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3065.4,78,,2452.32,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3246.18,82.6,,2596.94,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3246.18,82.6,,2596.94,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,3930,100,,3144.00,,,0,"percent of total billed charges","100% of total billed charges",601.29,9628.23,
"21931 Excision, tumor, soft tissue of back or flan",7962589,CDM,521,RC,21931,CPT,OUTPATIENT,,,1379,896.35,,1213.52,88,,970.82,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1379,100,,1103.20,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,63,,695.02,,,0,"percent of total billed charges","63% of total billed charges",210.99,15.3,,168.79,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,951.51,69,,,,,0,"fee schedule","69% of total billed charges",1379,100,,1103.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1379,100,,1103.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1379,100,,1103.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",519.88,37.7,,415.90,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1075.62,78,,860.50,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1139.05,82.6,,911.24,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1139.05,82.6,,911.24,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,1379,100,,1103.20,,,0,"percent of total billed charges","100% of total billed charges",210.99,5715.97,
"21930 Excision, tumor, soft tissue of back or flan",7962621,CDM,521,RC,21930,CPT,OUTPATIENT,,,1201,780.65,,1056.88,88,,845.50,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1201,100,,960.80,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",756.63,63,,605.30,,,0,"percent of total billed charges","63% of total billed charges",183.75,15.3,,147.00,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,828.69,69,,,,,0,"fee schedule","69% of total billed charges",1201,100,,960.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1201,100,,960.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1201,100,,960.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",452.78,37.7,,362.22,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",936.78,78,,749.42,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",992.03,82.6,,793.62,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",992.03,82.6,,793.62,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,1201,100,,960.80,,,0,"percent of total billed charges","100% of total billed charges",183.75,5715.97,
"22010 I&D, open, of deep abscess, posterior spine;",7962358,CDM,521,RC,22010,CPT,OUTPATIENT,,,3136,2038.4,,2759.68,88,,2207.74,,,0,"percent of total billed charges","88% of total billed charges",3136,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,3136,100,,2508.80,,,0,"percent of total billed charges","100% of total billed charges",3136,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,3136,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1975.68,63,,1580.54,,,0,"percent of total billed charges","63% of total billed charges",479.81,15.3,,383.85,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,2163.84,69,,,,,0,"fee schedule","69% of total billed charges",3136,100,,2508.80,,,0,"percent of total billed charges","100% of total billed charges",3136,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3136,100,,2508.80,,,0,"percent of total billed charges","100% of total billed charges",3136,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3136,100,,2508.80,,,0,"percent of total billed charges","100% of total billed charges",3136,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9236.61,100,,,,,0,"fee schedule",EAPG,3136,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3136,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,3136,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1182.27,37.7,,945.82,,,0,"percent of total billed charges","37.70% of total billed charges",3136,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3136,100,,,,,0,"fee schedule","100% of CMS fee schedule",2446.08,78,,1956.86,,,0,"percent of total billed charges","78% of total billed charges",3136,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2590.34,82.6,,2072.27,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule","100% of WA fee schedule",3136,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2590.34,82.6,,2072.27,,,0,"percent of total billed charges","82.6% of total billed charges",3136,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9397.14,100,,,,,0,"fee schedule",EAPG,3136,100,,2508.80,,,0,"percent of total billed charges","100% of total billed charges",479.81,25451.55,
"22015 I&D, open, of deep abscess, posterior spine;",7962622,CDM,521,RC,22015,CPT,OUTPATIENT,,,3108,2020.2,,2735.04,88,,2188.03,,,0,"percent of total billed charges","88% of total billed charges",3108,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,3108,100,,2486.40,,,0,"percent of total billed charges","100% of total billed charges",3108,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,3108,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1958.04,63,,1566.43,,,0,"percent of total billed charges","63% of total billed charges",475.52,15.3,,380.42,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,2144.52,69,,,,,0,"fee schedule","69% of total billed charges",3108,100,,2486.40,,,0,"percent of total billed charges","100% of total billed charges",3108,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3108,100,,2486.40,,,0,"percent of total billed charges","100% of total billed charges",3108,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3108,100,,2486.40,,,0,"percent of total billed charges","100% of total billed charges",3108,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9236.61,100,,,,,0,"fee schedule",EAPG,3108,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3108,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,3108,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1171.72,37.7,,937.38,,,0,"percent of total billed charges","37.70% of total billed charges",3108,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3108,100,,,,,0,"fee schedule","100% of CMS fee schedule",2424.24,78,,1939.39,,,0,"percent of total billed charges","78% of total billed charges",3108,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2567.21,82.6,,2053.77,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule","100% of WA fee schedule",3108,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2567.21,82.6,,2053.77,,,0,"percent of total billed charges","82.6% of total billed charges",3108,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9397.14,100,,,,,0,"fee schedule",EAPG,3108,100,,2486.40,,,0,"percent of total billed charges","100% of total billed charges",475.52,25451.55,
"22100 Partial exc posterior vertebral component fo",7961899,CDM,521,RC,22100,CPT,OUTPATIENT,,,2176,1414.4,,1914.88,88,,1531.90,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,2176,100,,1740.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1370.88,63,,1096.70,,,0,"percent of total billed charges","63% of total billed charges",332.93,15.3,,266.34,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,1501.44,69,,,,,0,"fee schedule","69% of total billed charges",2176,100,,1740.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2176,100,,1740.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2176,100,,1740.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",820.35,37.7,,656.28,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1697.28,78,,1357.82,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1797.38,82.6,,1437.90,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1797.38,82.6,,1437.90,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,2176,100,,1740.80,,,0,"percent of total billed charges","100% of total billed charges",332.93,25451.55,
"22101 Partial exc posterior vertebral component fo",7961900,CDM,521,RC,22101,CPT,OUTPATIENT,,,2205,1433.25,,1940.4,88,,1552.32,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,2205,100,,1764.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1389.15,63,,1111.32,,,0,"percent of total billed charges","63% of total billed charges",337.37,15.3,,269.90,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,1521.45,69,,,,,0,"fee schedule","69% of total billed charges",2205,100,,1764.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2205,100,,1764.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2205,100,,1764.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",831.29,37.7,,665.03,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1719.9,78,,1375.92,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.33,82.6,,1457.06,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.33,82.6,,1457.06,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,2205,100,,1764.00,,,0,"percent of total billed charges","100% of total billed charges",337.37,25451.55,
"22103 Partial excision of posterior vertebral comp",7962074,CDM,521,RC,22103,CPT,OUTPATIENT,,,453,294.45,,398.64,88,,318.91,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",4192.88,100,,,,,0,"fee schedule",EAPG,453,100,,362.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4318.67,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",285.39,63,,228.31,,,0,"percent of total billed charges","63% of total billed charges",69.31,15.3,,55.45,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,312.57,69,,,,,0,"fee schedule","69% of total billed charges",453,100,,362.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",453,100,,362.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",453,100,,362.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4192.88,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",170.78,37.7,,136.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.34,78,,282.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",374.18,82.6,,299.34,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",374.18,82.6,,299.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4353.41,100,,,,,0,"fee schedule",EAPG,453,100,,362.40,,,0,"percent of total billed charges","100% of total billed charges",69.31,5450.75,
"22102 Partial exc posterior vertebral component fo",7962234,CDM,521,RC,22102,CPT,OUTPATIENT,,,2172,1411.8,,1911.36,88,,1529.09,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,2172,100,,1737.60,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1368.36,63,,1094.69,,,0,"percent of total billed charges","63% of total billed charges",332.32,15.3,,265.86,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,1498.68,69,,,,,0,"fee schedule","69% of total billed charges",2172,100,,1737.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2172,100,,1737.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2172,100,,1737.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",818.84,37.7,,655.07,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1694.16,78,,1355.33,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1794.07,82.6,,1435.26,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1794.07,82.6,,1435.26,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,2172,100,,1737.60,,,0,"percent of total billed charges","100% of total billed charges",332.32,25451.55,
"22116 Partial exc vertebral body, for intrinsic le",7961661,CDM,521,RC,22116,CPT,OUTPATIENT,,,509,330.85,,447.92,88,,358.34,,,0,"percent of total billed charges","88% of total billed charges",509,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",509,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,509,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",320.67,63,,256.54,,,0,"percent of total billed charges","63% of total billed charges",77.88,15.3,,62.30,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,351.21,69,,,,,0,"fee schedule","69% of total billed charges",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",509,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",509,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",509,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9236.61,100,,,,,0,"fee schedule",EAPG,509,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",509,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,509,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",191.89,37.7,,153.51,,,0,"percent of total billed charges","37.70% of total billed charges",509,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",509,100,,,,,0,"fee schedule","100% of CMS fee schedule",397.02,78,,317.62,,,0,"percent of total billed charges","78% of total billed charges",509,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",420.43,82.6,,336.34,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule","100% of WA fee schedule",509,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",420.43,82.6,,336.34,,,0,"percent of total billed charges","82.6% of total billed charges",509,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9397.14,100,,,,,0,"fee schedule",EAPG,509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",77.88,12007.59,
"22110 Partial exc vertebral body, for intrinsic le",7961801,CDM,521,RC,22110,CPT,OUTPATIENT,,,2789,1812.85,,2454.32,88,,1963.46,,,0,"percent of total billed charges","88% of total billed charges",2789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,2789,100,,2231.20,,,0,"percent of total billed charges","100% of total billed charges",2789,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,2789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1757.07,63,,1405.66,,,0,"percent of total billed charges","63% of total billed charges",426.72,15.3,,341.38,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,1924.41,69,,,,,0,"fee schedule","69% of total billed charges",2789,100,,2231.20,,,0,"percent of total billed charges","100% of total billed charges",2789,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2789,100,,2231.20,,,0,"percent of total billed charges","100% of total billed charges",2789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2789,100,,2231.20,,,0,"percent of total billed charges","100% of total billed charges",2789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9236.61,100,,,,,0,"fee schedule",EAPG,2789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2789,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",2789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,2789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1051.45,37.7,,841.16,,,0,"percent of total billed charges","37.70% of total billed charges",2789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2789,100,,,,,0,"fee schedule","100% of CMS fee schedule",2175.42,78,,1740.34,,,0,"percent of total billed charges","78% of total billed charges",2789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2303.71,82.6,,1842.97,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule","100% of WA fee schedule",2789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2303.71,82.6,,1842.97,,,0,"percent of total billed charges","82.6% of total billed charges",2789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9397.14,100,,,,,0,"fee schedule",EAPG,2789,100,,2231.20,,,0,"percent of total billed charges","100% of total billed charges",426.72,25451.55,
"22112 Partial excision of vertebral body, for intr",7962112,CDM,521,RC,22112,CPT,OUTPATIENT,,,2772,1801.8,,2439.36,88,,1951.49,,,0,"percent of total billed charges","88% of total billed charges",2772,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,2772,100,,2217.60,,,0,"percent of total billed charges","100% of total billed charges",2772,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,2772,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1746.36,63,,1397.09,,,0,"percent of total billed charges","63% of total billed charges",424.12,15.3,,339.30,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,1912.68,69,,,,,0,"fee schedule","69% of total billed charges",2772,100,,2217.60,,,0,"percent of total billed charges","100% of total billed charges",2772,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2772,100,,2217.60,,,0,"percent of total billed charges","100% of total billed charges",2772,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2772,100,,2217.60,,,0,"percent of total billed charges","100% of total billed charges",2772,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9236.61,100,,,,,0,"fee schedule",EAPG,2772,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2772,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",2772,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,2772,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1045.04,37.7,,836.03,,,0,"percent of total billed charges","37.70% of total billed charges",2772,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2772,100,,,,,0,"fee schedule","100% of CMS fee schedule",2162.16,78,,1729.73,,,0,"percent of total billed charges","78% of total billed charges",2772,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2289.67,82.6,,1831.74,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule","100% of WA fee schedule",2772,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2289.67,82.6,,1831.74,,,0,"percent of total billed charges","82.6% of total billed charges",2772,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9397.14,100,,,,,0,"fee schedule",EAPG,2772,100,,2217.60,,,0,"percent of total billed charges","100% of total billed charges",424.12,25451.55,
"22114 Partial excision of vertebral body, for intr",7962115,CDM,521,RC,22114,CPT,OUTPATIENT,,,2804,1822.6,,2467.52,88,,1974.02,,,0,"percent of total billed charges","88% of total billed charges",2804,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,2804,100,,2243.20,,,0,"percent of total billed charges","100% of total billed charges",2804,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,2804,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1766.52,63,,1413.22,,,0,"percent of total billed charges","63% of total billed charges",429.01,15.3,,343.21,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,1934.76,69,,,,,0,"fee schedule","69% of total billed charges",2804,100,,2243.20,,,0,"percent of total billed charges","100% of total billed charges",2804,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2804,100,,2243.20,,,0,"percent of total billed charges","100% of total billed charges",2804,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2804,100,,2243.20,,,0,"percent of total billed charges","100% of total billed charges",2804,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9236.61,100,,,,,0,"fee schedule",EAPG,2804,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2804,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",2804,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,2804,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1057.11,37.7,,845.69,,,0,"percent of total billed charges","37.70% of total billed charges",2804,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2804,100,,,,,0,"fee schedule","100% of CMS fee schedule",2187.12,78,,1749.70,,,0,"percent of total billed charges","78% of total billed charges",2804,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2316.1,82.6,,1852.88,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule","100% of WA fee schedule",2804,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2316.1,82.6,,1852.88,,,0,"percent of total billed charges","82.6% of total billed charges",2804,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9397.14,100,,,,,0,"fee schedule",EAPG,2804,100,,2243.20,,,0,"percent of total billed charges","100% of total billed charges",429.01,25451.55,
"22214 Osteotomy of spine, posterior/posterolateral",7962399,CDM,521,RC,22214,CPT,OUTPATIENT,,,4929,3203.85,,4337.52,88,,3470.02,,,0,"percent of total billed charges","88% of total billed charges",4929,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4192.88,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",4929,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,4929,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3105.27,63,,2484.22,,,0,"percent of total billed charges","63% of total billed charges",754.14,15.3,,603.31,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,3401.01,69,,,,,0,"fee schedule","69% of total billed charges",4929,100,,3943.20,,,0,"percent of total billed charges","100% of total billed charges",4929,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4929,100,,3943.20,,,0,"percent of total billed charges","100% of total billed charges",4929,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4929,100,,3943.20,,,0,"percent of total billed charges","100% of total billed charges",4929,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,4929,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4929,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",4929,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,4929,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1858.23,37.7,,1486.58,,,0,"percent of total billed charges","37.70% of total billed charges",4929,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4929,100,,,,,0,"fee schedule","100% of CMS fee schedule",3844.62,78,,3075.70,,,0,"percent of total billed charges","78% of total billed charges",4929,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4071.35,82.6,,3257.08,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule","100% of WA fee schedule",4929,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4071.35,82.6,,3257.08,,,0,"percent of total billed charges","82.6% of total billed charges",4929,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4353.41,100,,,,,0,"fee schedule",EAPG,4929,100,,3943.20,,,0,"percent of total billed charges","100% of total billed charges",754.14,25451.55,
"22305 Closed tx of vertebral process fracture(s)",7963537,CDM,521,RC,,,OUTPATIENT,,,698,453.7,,614.24,88,,491.39,,,0,"percent of total billed charges","88% of total billed charges",349,50,,279.20,,,0,"percent of total billed charges","50% of total billed charges",117.26,16.8,,93.81,,,0,"percent of total billed charges","16.8% of total billed charges",698,100,,558.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",120.78,17.304,,96.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",439.74,63,,351.79,,,0,"percent of total billed charges","63% of total billed charges",106.79,15.3,,85.43,,,0,"percent of total billed charges","15.3% of total billed charges",117.26,16.8,,93.81,,,0,"percent of total billed charges","16.8% of total billed charges",481.62,69,,,,,0,"fee schedule","69% of total billed charges",698,100,,558.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",698,100,,558.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",698,100,,558.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",117.26,16.8,,93.81,,,0,"percent of total billed charges","16.8% of total billed charges",349,50,,279.20,,,0,"percent of total billed charges","50% of total billed charges",224.76,32.2,,179.81,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",119.61,17.136,,95.69,,,0,"percent of total billed charges","17.136% of total billed charges",152.44,21.84,,121.95,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",263.15,37.7,,210.52,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",544.44,78,,435.55,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",576.55,82.6,,461.24,,,0,"percent of total billed charges","82.6% of total billed charges",117.26,16.8,,93.81,,,0,"percent of total billed charges","16.8% of total billed charges",349,50,,279.20,,,0,"percent of total billed charges","50% of total billed charges",576.55,82.6,,461.24,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",698,100,,558.40,,,0,"percent of total billed charges","100% of total billed charges",106.79,698,
"22310 Closed tx of vertebral body fracture(s), w/o",7961463,CDM,521,RC,22310,CPT,OUTPATIENT,,,1060,689,,932.8,88,,746.24,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1060,100,,848.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",667.8,63,,534.24,,,0,"percent of total billed charges","63% of total billed charges",162.18,15.3,,129.74,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,731.4,69,,,,,0,"fee schedule","69% of total billed charges",1060,100,,848.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1060,100,,848.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1060,100,,848.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",399.62,37.7,,319.70,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",826.8,78,,661.44,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.56,82.6,,700.45,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.56,82.6,,700.45,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,1060,100,,848.00,,,0,"percent of total billed charges","100% of total billed charges",162.18,1060,
"22315 Closed tx of vertebral fx/dislocation(s) req",7962235,CDM,521,RC,22315,CPT,OUTPATIENT,,,2100,1365,,1848,88,,1478.40,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,2100,100,,1680.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1323,63,,1058.40,,,0,"percent of total billed charges","63% of total billed charges",321.3,15.3,,257.04,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1449,69,,,,,0,"fee schedule","69% of total billed charges",2100,100,,1680.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2100,100,,1680.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2100,100,,1680.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",791.7,37.7,,633.36,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1638,78,,1310.40,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1734.6,82.6,,1387.68,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1734.6,82.6,,1387.68,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,2100,100,,1680.00,,,0,"percent of total billed charges","100% of total billed charges",321.3,11498.59,
"22318 Open tx odontoid fx and/or dislocation, ant",7962925,CDM,521,RC,22318,CPT,OUTPATIENT,,,4541,2951.65,,3996.08,88,,3196.86,,,0,"percent of total billed charges","88% of total billed charges",4541,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,4541,100,,3632.80,,,0,"percent of total billed charges","100% of total billed charges",4541,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,4541,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2860.83,63,,2288.66,,,0,"percent of total billed charges","63% of total billed charges",694.77,15.3,,555.82,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,3133.29,69,,,,,0,"fee schedule","69% of total billed charges",4541,100,,3632.80,,,0,"percent of total billed charges","100% of total billed charges",4541,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4541,100,,3632.80,,,0,"percent of total billed charges","100% of total billed charges",4541,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4541,100,,3632.80,,,0,"percent of total billed charges","100% of total billed charges",4541,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9236.61,100,,,,,0,"fee schedule",EAPG,4541,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4541,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",4541,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,4541,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1711.96,37.7,,1369.57,,,0,"percent of total billed charges","37.70% of total billed charges",4541,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4541,100,,,,,0,"fee schedule","100% of CMS fee schedule",3541.98,78,,2833.58,,,0,"percent of total billed charges","78% of total billed charges",4541,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3750.87,82.6,,3000.70,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule","100% of WA fee schedule",4541,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3750.87,82.6,,3000.70,,,0,"percent of total billed charges","82.6% of total billed charges",4541,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9397.14,100,,,,,0,"fee schedule",EAPG,4541,100,,3632.80,,,0,"percent of total billed charges","100% of total billed charges",694.77,50029.1,
"22319 Open Tx Dislocation of Odontoid W Internal F",7962988,CDM,521,RC,22319,CPT,OUTPATIENT,,,5102,3316.3,,4489.76,88,,3591.81,,,0,"percent of total billed charges","88% of total billed charges",5102,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5102,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,5102,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3214.26,63,,2571.41,,,0,"percent of total billed charges","63% of total billed charges",780.61,15.3,,624.49,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,3520.38,69,,,,,0,"fee schedule","69% of total billed charges",5102,100,,4081.60,,,0,"percent of total billed charges","100% of total billed charges",5102,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5102,100,,4081.60,,,0,"percent of total billed charges","100% of total billed charges",5102,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5102,100,,4081.60,,,0,"percent of total billed charges","100% of total billed charges",5102,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9236.61,100,,,,,0,"fee schedule",EAPG,5102,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5102,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",5102,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,5102,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1923.45,37.7,,1538.76,,,0,"percent of total billed charges","37.70% of total billed charges",5102,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5102,100,,,,,0,"fee schedule","100% of CMS fee schedule",3979.56,78,,3183.65,,,0,"percent of total billed charges","78% of total billed charges",5102,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4214.25,82.6,,3371.40,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule","100% of WA fee schedule",5102,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4214.25,82.6,,3371.40,,,0,"percent of total billed charges","82.6% of total billed charges",5102,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9397.14,100,,,,,0,"fee schedule",EAPG,5102,100,,4081.60,,,0,"percent of total billed charges","100% of total billed charges",780.61,50029.1,
"22328 Open tx vertebral fx and/or dislocation, pos",7961732,CDM,521,RC,22328,CPT,OUTPATIENT,,,988,642.2,,869.44,88,,695.55,,,0,"percent of total billed charges","88% of total billed charges",988,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,988,100,,790.40,,,0,"percent of total billed charges","100% of total billed charges",988,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,988,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",622.44,63,,497.95,,,0,"percent of total billed charges","63% of total billed charges",151.16,15.3,,120.93,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,681.72,69,,,,,0,"fee schedule","69% of total billed charges",988,100,,790.40,,,0,"percent of total billed charges","100% of total billed charges",988,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",988,100,,790.40,,,0,"percent of total billed charges","100% of total billed charges",988,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",988,100,,790.40,,,0,"percent of total billed charges","100% of total billed charges",988,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9236.61,100,,,,,0,"fee schedule",EAPG,988,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",318.14,32.2,,254.51,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",988,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,988,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",372.48,37.7,,297.98,,,0,"percent of total billed charges","37.70% of total billed charges",988,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",988,100,,,,,0,"fee schedule","100% of CMS fee schedule",770.64,78,,616.51,,,0,"percent of total billed charges","78% of total billed charges",988,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",816.09,82.6,,652.87,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule","100% of WA fee schedule",988,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",816.09,82.6,,652.87,,,0,"percent of total billed charges","82.6% of total billed charges",988,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9397.14,100,,,,,0,"fee schedule",EAPG,988,100,,790.40,,,0,"percent of total billed charges","100% of total billed charges",151.16,12007.59,
"22326 Open tx vertebral fx and/or dislocation, pos",7962285,CDM,521,RC,22326,CPT,OUTPATIENT,,,4239,2755.35,,3730.32,88,,2984.26,,,0,"percent of total billed charges","88% of total billed charges",4239,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,4239,100,,3391.20,,,0,"percent of total billed charges","100% of total billed charges",4239,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,4239,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2670.57,63,,2136.46,,,0,"percent of total billed charges","63% of total billed charges",648.57,15.3,,518.86,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,2924.91,69,,,,,0,"fee schedule","69% of total billed charges",4239,100,,3391.20,,,0,"percent of total billed charges","100% of total billed charges",4239,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4239,100,,3391.20,,,0,"percent of total billed charges","100% of total billed charges",4239,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4239,100,,3391.20,,,0,"percent of total billed charges","100% of total billed charges",4239,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9236.61,100,,,,,0,"fee schedule",EAPG,4239,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4239,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",4239,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,4239,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1598.1,37.7,,1278.48,,,0,"percent of total billed charges","37.70% of total billed charges",4239,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4239,100,,,,,0,"fee schedule","100% of CMS fee schedule",3306.42,78,,2645.14,,,0,"percent of total billed charges","78% of total billed charges",4239,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3501.41,82.6,,2801.13,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule","100% of WA fee schedule",4239,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3501.41,82.6,,2801.13,,,0,"percent of total billed charges","82.6% of total billed charges",4239,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9397.14,100,,,,,0,"fee schedule",EAPG,4239,100,,3391.20,,,0,"percent of total billed charges","100% of total billed charges",648.57,50029.1,
"22327 Open tx vertebral fx and/or dislocation, pos",7962286,CDM,521,RC,22327,CPT,OUTPATIENT,,,4022,2614.3,,3539.36,88,,2831.49,,,0,"percent of total billed charges","88% of total billed charges",4022,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,4022,100,,3217.60,,,0,"percent of total billed charges","100% of total billed charges",4022,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,4022,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2533.86,63,,2027.09,,,0,"percent of total billed charges","63% of total billed charges",615.37,15.3,,492.30,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,2775.18,69,,,,,0,"fee schedule","69% of total billed charges",4022,100,,3217.60,,,0,"percent of total billed charges","100% of total billed charges",4022,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4022,100,,3217.60,,,0,"percent of total billed charges","100% of total billed charges",4022,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4022,100,,3217.60,,,0,"percent of total billed charges","100% of total billed charges",4022,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9236.61,100,,,,,0,"fee schedule",EAPG,4022,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4022,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",4022,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,4022,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1516.29,37.7,,1213.03,,,0,"percent of total billed charges","37.70% of total billed charges",4022,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4022,100,,,,,0,"fee schedule","100% of CMS fee schedule",3137.16,78,,2509.73,,,0,"percent of total billed charges","78% of total billed charges",4022,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3322.17,82.6,,2657.74,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule","100% of WA fee schedule",4022,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3322.17,82.6,,2657.74,,,0,"percent of total billed charges","82.6% of total billed charges",4022,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9397.14,100,,,,,0,"fee schedule",EAPG,4022,100,,3217.60,,,0,"percent of total billed charges","100% of total billed charges",615.37,50029.1,
"22325 Open tx vertebral fx and/or dislocation, pos",7962359,CDM,521,RC,22325,CPT,OUTPATIENT,,,4526,2941.9,,3982.88,88,,3186.30,,,0,"percent of total billed charges","88% of total billed charges",4526,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,4526,100,,3620.80,,,0,"percent of total billed charges","100% of total billed charges",4526,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,4526,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2851.38,63,,2281.10,,,0,"percent of total billed charges","63% of total billed charges",692.48,15.3,,553.98,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,3122.94,69,,,,,0,"fee schedule","69% of total billed charges",4526,100,,3620.80,,,0,"percent of total billed charges","100% of total billed charges",4526,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4526,100,,3620.80,,,0,"percent of total billed charges","100% of total billed charges",4526,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4526,100,,3620.80,,,0,"percent of total billed charges","100% of total billed charges",4526,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9236.61,100,,,,,0,"fee schedule",EAPG,4526,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4526,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",4526,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,4526,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1706.3,37.7,,1365.04,,,0,"percent of total billed charges","37.70% of total billed charges",4526,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4526,100,,,,,0,"fee schedule","100% of CMS fee schedule",3530.28,78,,2824.22,,,0,"percent of total billed charges","78% of total billed charges",4526,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3738.48,82.6,,2990.78,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule","100% of WA fee schedule",4526,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3738.48,82.6,,2990.78,,,0,"percent of total billed charges","82.6% of total billed charges",4526,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9397.14,100,,,,,0,"fee schedule",EAPG,4526,100,,3620.80,,,0,"percent of total billed charges","100% of total billed charges",692.48,50029.1,
"22505 Manipulation of spine requiring anesthesia,",7963275,CDM,521,RC,22505,CPT,OUTPATIENT,,,493,320.45,,433.84,88,,347.07,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,493,100,,394.40,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",916.1,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",310.59,63,,248.47,,,0,"percent of total billed charges","63% of total billed charges",75.43,15.3,,60.34,,,0,"percent of total billed charges","15.3% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,340.17,69,,,,,0,"fee schedule","69% of total billed charges",493,100,,394.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",493,100,,394.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",493,100,,394.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.21,100,,,,,0,"fee schedule",EAPG,1156.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",185.86,37.7,,148.69,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",384.54,78,,307.63,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",407.22,82.6,,325.78,,,0,"percent of total billed charges","82.6% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",407.22,82.6,,325.78,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1049.95,100,,,,,0,"fee schedule",EAPG,493,100,,394.40,,,0,"percent of total billed charges","100% of total billed charges",75.43,5656.45,
"22520 percut vertebroplasty thor",7963814,CDM,521,RC,22520,CPT,OUTPATIENT,,,1867,1213.55,,1642.96,88,,1314.37,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.66,16.8,,250.93,,,0,"percent of total billed charges","16.8% of total billed charges",1867,100,,1493.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",323.07,17.304,,258.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1176.21,63,,940.97,,,0,"percent of total billed charges","63% of total billed charges",285.65,15.3,,228.52,,,0,"percent of total billed charges","15.3% of total billed charges",313.66,16.8,,250.93,,,0,"percent of total billed charges","16.8% of total billed charges",1288.23,69,,,,,0,"fee schedule","69% of total billed charges",1867,100,,1493.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1867,100,,1493.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1867,100,,1493.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",313.66,16.8,,250.93,,,0,"percent of total billed charges","16.8% of total billed charges",933.5,50,,746.80,,,0,"percent of total billed charges","50% of total billed charges",601.17,32.2,,480.94,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",319.93,17.136,,255.94,,,0,"percent of total billed charges","17.136% of total billed charges",407.75,21.84,,326.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",703.86,37.7,,563.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1456.26,78,,1165.01,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1542.14,82.6,,1233.71,,,0,"percent of total billed charges","82.6% of total billed charges",313.66,16.8,,250.93,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1542.14,82.6,,1233.71,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",1867,100,,1493.60,,,0,"percent of total billed charges","100% of total billed charges",160.53,1867,
"22521 percut vertebroplasty lumb",7963815,CDM,521,RC,22521,CPT,OUTPATIENT,,,1752,1138.8,,1541.76,88,,1233.41,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",294.34,16.8,,235.47,,,0,"percent of total billed charges","16.8% of total billed charges",1752,100,,1401.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",303.17,17.304,,242.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1103.76,63,,883.01,,,0,"percent of total billed charges","63% of total billed charges",268.06,15.3,,214.45,,,0,"percent of total billed charges","15.3% of total billed charges",294.34,16.8,,235.47,,,0,"percent of total billed charges","16.8% of total billed charges",1208.88,69,,,,,0,"fee schedule","69% of total billed charges",1752,100,,1401.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1752,100,,1401.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1752,100,,1401.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",294.34,16.8,,235.47,,,0,"percent of total billed charges","16.8% of total billed charges",876,50,,700.80,,,0,"percent of total billed charges","50% of total billed charges",564.14,32.2,,451.31,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",300.22,17.136,,240.18,,,0,"percent of total billed charges","17.136% of total billed charges",382.64,21.84,,306.11,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",660.5,37.7,,528.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1366.56,78,,1093.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1447.15,82.6,,1157.72,,,0,"percent of total billed charges","82.6% of total billed charges",294.34,16.8,,235.47,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1447.15,82.6,,1157.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",1752,100,,1401.60,,,0,"percent of total billed charges","100% of total billed charges",160.53,1752,
"22522 percut vertebroplasty addl",7963816,CDM,521,RC,22522,CPT,OUTPATIENT,,,612,397.8,,538.56,88,,430.85,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",102.82,16.8,,82.26,,,0,"percent of total billed charges","16.8% of total billed charges",612,100,,489.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",105.9,17.304,,84.72,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",385.56,63,,308.45,,,0,"percent of total billed charges","63% of total billed charges",93.64,15.3,,74.91,,,0,"percent of total billed charges","15.3% of total billed charges",102.82,16.8,,82.26,,,0,"percent of total billed charges","16.8% of total billed charges",422.28,69,,,,,0,"fee schedule","69% of total billed charges",612,100,,489.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",612,100,,489.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",612,100,,489.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",102.82,16.8,,82.26,,,0,"percent of total billed charges","16.8% of total billed charges",306,50,,244.80,,,0,"percent of total billed charges","50% of total billed charges",197.06,32.2,,157.65,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",104.87,17.136,,83.90,,,0,"percent of total billed charges","17.136% of total billed charges",133.66,21.84,,106.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",230.72,37.7,,184.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",477.36,78,,381.89,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.51,82.6,,404.41,,,0,"percent of total billed charges","82.6% of total billed charges",102.82,16.8,,82.26,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",505.51,82.6,,404.41,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",612,100,,489.60,,,0,"percent of total billed charges","100% of total billed charges",93.64,612,
"22524 percut kyphoplasty lumbar",7963836,CDM,521,RC,22524,CPT,OUTPATIENT,,,2890,1878.5,,2543.2,88,,2034.56,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",485.52,16.8,,388.42,,,0,"percent of total billed charges","16.8% of total billed charges",2890,100,,2312.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",500.09,17.304,,400.07,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1820.7,63,,1456.56,,,0,"percent of total billed charges","63% of total billed charges",442.17,15.3,,353.74,,,0,"percent of total billed charges","15.3% of total billed charges",485.52,16.8,,388.42,,,0,"percent of total billed charges","16.8% of total billed charges",1994.1,69,,,,,0,"fee schedule","69% of total billed charges",2890,100,,2312.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2890,100,,2312.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2890,100,,2312.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",485.52,16.8,,388.42,,,0,"percent of total billed charges","16.8% of total billed charges",1445,50,,1156.00,,,0,"percent of total billed charges","50% of total billed charges",930.58,32.2,,744.46,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",495.23,17.136,,396.18,,,0,"percent of total billed charges","17.136% of total billed charges",631.18,21.84,,504.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1089.53,37.7,,871.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2254.2,78,,1803.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2387.14,82.6,,1909.71,,,0,"percent of total billed charges","82.6% of total billed charges",485.52,16.8,,388.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2387.14,82.6,,1909.71,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",2890,100,,2312.00,,,0,"percent of total billed charges","100% of total billed charges",160.53,2890,
"22525 percut kyphoplasty add-on",7963837,CDM,521,RC,22525,CPT,OUTPATIENT,,,915,594.75,,805.2,88,,644.16,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",153.72,16.8,,122.98,,,0,"percent of total billed charges","16.8% of total billed charges",915,100,,732.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.33,17.304,,126.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",576.45,63,,461.16,,,0,"percent of total billed charges","63% of total billed charges",140,15.3,,112.00,,,0,"percent of total billed charges","15.3% of total billed charges",153.72,16.8,,122.98,,,0,"percent of total billed charges","16.8% of total billed charges",631.35,69,,,,,0,"fee schedule","69% of total billed charges",915,100,,732.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",915,100,,732.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",915,100,,732.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",153.72,16.8,,122.98,,,0,"percent of total billed charges","16.8% of total billed charges",457.5,50,,366.00,,,0,"percent of total billed charges","50% of total billed charges",294.63,32.2,,235.70,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.79,17.136,,125.43,,,0,"percent of total billed charges","17.136% of total billed charges",199.84,21.84,,159.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",344.96,37.7,,275.97,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",713.7,78,,570.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",755.79,82.6,,604.63,,,0,"percent of total billed charges","82.6% of total billed charges",153.72,16.8,,122.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",755.79,82.6,,604.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",915,100,,732.00,,,0,"percent of total billed charges","100% of total billed charges",140,915,
"22523 percut kyphoplasty thor",7963861,CDM,521,RC,22523,CPT,OUTPATIENT,,,1887,1226.55,,1660.56,88,,1328.45,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",317.02,16.8,,253.62,,,0,"percent of total billed charges","16.8% of total billed charges",1887,100,,1509.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.53,17.304,,261.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1188.81,63,,951.05,,,0,"percent of total billed charges","63% of total billed charges",288.71,15.3,,230.97,,,0,"percent of total billed charges","15.3% of total billed charges",317.02,16.8,,253.62,,,0,"percent of total billed charges","16.8% of total billed charges",1302.03,69,,,,,0,"fee schedule","69% of total billed charges",1887,100,,1509.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1887,100,,1509.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1887,100,,1509.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",317.02,16.8,,253.62,,,0,"percent of total billed charges","16.8% of total billed charges",943.5,50,,754.80,,,0,"percent of total billed charges","50% of total billed charges",607.61,32.2,,486.09,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",323.36,17.136,,258.69,,,0,"percent of total billed charges","17.136% of total billed charges",412.12,21.84,,329.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",711.4,37.7,,569.12,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1471.86,78,,1177.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1558.66,82.6,,1246.93,,,0,"percent of total billed charges","82.6% of total billed charges",317.02,16.8,,253.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1558.66,82.6,,1246.93,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",1887,100,,1509.60,,,0,"percent of total billed charges","100% of total billed charges",160.53,1887,
"22534 Arthrodesis, lateral extracavitary technique",7962214,CDM,521,RC,22534,CPT,OUTPATIENT,,,1561,1014.65,,1373.68,88,,1098.94,,,0,"percent of total billed charges","88% of total billed charges",1561,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",1561,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,1561,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",983.43,63,,786.74,,,0,"percent of total billed charges","63% of total billed charges",238.83,15.3,,191.06,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,1077.09,69,,,,,0,"fee schedule","69% of total billed charges",1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",1561,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",1561,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",1561,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",11832.42,100,,,,,0,"fee schedule",EAPG,1561,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",502.64,32.2,,402.11,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",1561,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,1561,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",588.5,37.7,,470.80,,,0,"percent of total billed charges","37.70% of total billed charges",1561,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1561,100,,,,,0,"fee schedule","100% of CMS fee schedule",1217.58,78,,974.06,,,0,"percent of total billed charges","78% of total billed charges",1561,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1289.39,82.6,,1031.51,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",1561,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1289.39,82.6,,1031.51,,,0,"percent of total billed charges","82.6% of total billed charges",1561,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",238.83,15382.15,
"22532 Arthrodesis, lateral extracavitary technique",7962222,CDM,521,RC,22532,CPT,OUTPATIENT,,,6183,4018.95,,5441.04,88,,4352.83,,,0,"percent of total billed charges","88% of total billed charges",6183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6183,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,6183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3895.29,63,,3116.23,,,0,"percent of total billed charges","63% of total billed charges",946,15.3,,756.80,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,4266.27,69,,,,,0,"fee schedule","69% of total billed charges",6183,100,,4946.40,,,0,"percent of total billed charges","100% of total billed charges",6183,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6183,100,,4946.40,,,0,"percent of total billed charges","100% of total billed charges",6183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6183,100,,4946.40,,,0,"percent of total billed charges","100% of total billed charges",6183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",64464.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11832.42,100,,,,,0,"fee schedule",EAPG,6183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6183,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",6183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,6183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2330.99,37.7,,1864.79,,,0,"percent of total billed charges","37.70% of total billed charges",6183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6183,100,,,,,0,"fee schedule","100% of CMS fee schedule",4822.74,78,,3858.19,,,0,"percent of total billed charges","78% of total billed charges",6183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5107.16,82.6,,4085.73,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",6183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5107.16,82.6,,4085.73,,,0,"percent of total billed charges","82.6% of total billed charges",6183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,6183,100,,4946.40,,,0,"percent of total billed charges","100% of total billed charges",946,64464.78,
"22533 Arthrodesis, lateral extracavitary technique",7962223,CDM,521,RC,22533,CPT,OUTPATIENT,,,6062,3940.3,,5334.56,88,,4267.65,,,0,"percent of total billed charges","88% of total billed charges",6062,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6062,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,6062,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3819.06,63,,3055.25,,,0,"percent of total billed charges","63% of total billed charges",927.49,15.3,,741.99,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,4182.78,69,,,,,0,"fee schedule","69% of total billed charges",6062,100,,4849.60,,,0,"percent of total billed charges","100% of total billed charges",6062,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6062,100,,4849.60,,,0,"percent of total billed charges","100% of total billed charges",6062,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6062,100,,4849.60,,,0,"percent of total billed charges","100% of total billed charges",6062,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",64464.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11832.42,100,,,,,0,"fee schedule",EAPG,6062,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6062,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",6062,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,6062,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2285.37,37.7,,1828.30,,,0,"percent of total billed charges","37.70% of total billed charges",6062,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6062,100,,,,,0,"fee schedule","100% of CMS fee schedule",4728.36,78,,3782.69,,,0,"percent of total billed charges","78% of total billed charges",6062,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5007.21,82.6,,4005.77,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",6062,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5007.21,82.6,,4005.77,,,0,"percent of total billed charges","82.6% of total billed charges",6062,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,6062,100,,4849.60,,,0,"percent of total billed charges","100% of total billed charges",927.49,64464.78,
"22548 Arthrodesis, anterior transoral/extraoral te",7962958,CDM,521,RC,22548,CPT,OUTPATIENT,,,9232,6000.8,,8124.16,88,,6499.33,,,0,"percent of total billed charges","88% of total billed charges",9232,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9232,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,9232,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5816.16,63,,4652.93,,,0,"percent of total billed charges","63% of total billed charges",1412.5,15.3,,1130.00,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,6370.08,69,,,,,0,"fee schedule","69% of total billed charges",9232,100,,7385.60,,,0,"percent of total billed charges","100% of total billed charges",9232,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9232,100,,7385.60,,,0,"percent of total billed charges","100% of total billed charges",9232,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9232,100,,7385.60,,,0,"percent of total billed charges","100% of total billed charges",9232,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",64464.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11832.42,100,,,,,0,"fee schedule",EAPG,9232,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9232,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",9232,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,9232,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3480.46,37.7,,2784.37,,,0,"percent of total billed charges","37.70% of total billed charges",9232,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9232,100,,,,,0,"fee schedule","100% of CMS fee schedule",7200.96,78,,5760.77,,,0,"percent of total billed charges","78% of total billed charges",9232,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7625.63,82.6,,6100.50,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",9232,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7625.63,82.6,,6100.50,,,0,"percent of total billed charges","82.6% of total billed charges",9232,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,9232,100,,7385.60,,,0,"percent of total billed charges","100% of total billed charges",1412.5,64464.78,
"22554 Arthrodesis, anterior interbody technique; c",7963097,CDM,521,RC,22554,CPT,OUTPATIENT,,,6677,4340.05,,5875.76,88,,4700.61,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9236.61,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4206.51,63,,3365.21,,,0,"percent of total billed charges","63% of total billed charges",1021.58,15.3,,817.26,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,4607.13,69,,,,,0,"fee schedule","69% of total billed charges",6677,100,,5341.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6677,100,,5341.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6677,100,,5341.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9236.61,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2517.23,37.7,,2013.78,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5208.06,78,,4166.45,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5515.2,82.6,,4412.16,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5515.2,82.6,,4412.16,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9397.14,100,,,,,0,"fee schedule",EAPG,6677,100,,5341.60,,,0,"percent of total billed charges","100% of total billed charges",1021.58,50029.1,
"22556 Arthrodesis, anterior interbody technique;",7963321,CDM,521,RC,22556,CPT,OUTPATIENT,,,8599,5589.35,,7567.12,88,,6053.70,,,0,"percent of total billed charges","88% of total billed charges",8599,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8599,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,8599,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5417.37,63,,4333.90,,,0,"percent of total billed charges","63% of total billed charges",1315.65,15.3,,1052.52,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,5933.31,69,,,,,0,"fee schedule","69% of total billed charges",8599,100,,6879.20,,,0,"percent of total billed charges","100% of total billed charges",8599,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8599,100,,6879.20,,,0,"percent of total billed charges","100% of total billed charges",8599,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8599,100,,6879.20,,,0,"percent of total billed charges","100% of total billed charges",8599,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",64464.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11832.42,100,,,,,0,"fee schedule",EAPG,8599,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8599,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",8599,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,8599,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3241.82,37.7,,2593.46,,,0,"percent of total billed charges","37.70% of total billed charges",8599,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8599,100,,,,,0,"fee schedule","100% of CMS fee schedule",6707.22,78,,5365.78,,,0,"percent of total billed charges","78% of total billed charges",8599,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7102.77,82.6,,5682.22,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",8599,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7102.77,82.6,,5682.22,,,0,"percent of total billed charges","82.6% of total billed charges",8599,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,8599,100,,6879.20,,,0,"percent of total billed charges","100% of total billed charges",1315.65,64464.78,
"22558 Arthrodesis, anterior interbody technique; l",7963405,CDM,521,RC,22558,CPT,OUTPATIENT,,,7175,4663.75,,6314,88,,5051.20,,,0,"percent of total billed charges","88% of total billed charges",7175,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7175,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,7175,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4520.25,63,,3616.20,,,0,"percent of total billed charges","63% of total billed charges",1097.78,15.3,,878.22,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,4950.75,69,,,,,0,"fee schedule","69% of total billed charges",7175,100,,5740.00,,,0,"percent of total billed charges","100% of total billed charges",7175,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7175,100,,5740.00,,,0,"percent of total billed charges","100% of total billed charges",7175,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7175,100,,5740.00,,,0,"percent of total billed charges","100% of total billed charges",7175,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",64464.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9236.61,100,,,,,0,"fee schedule",EAPG,7175,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7175,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",7175,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,7175,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2704.98,37.7,,2163.98,,,0,"percent of total billed charges","37.70% of total billed charges",7175,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7175,100,,,,,0,"fee schedule","100% of CMS fee schedule",5596.5,78,,4477.20,,,0,"percent of total billed charges","78% of total billed charges",7175,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5926.55,82.6,,4741.24,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,7175,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5926.55,82.6,,4741.24,,,0,"percent of total billed charges","82.6% of total billed charges",7175,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9397.14,100,,,,,0,"fee schedule",EAPG,7175,100,,5740.00,,,0,"percent of total billed charges","100% of total billed charges",1097.78,64464.78,
"22585 Arthrodesis, anterior interbody technique; e",7962836,CDM,521,RC,22585,CPT,OUTPATIENT,,,1804,1172.6,,1587.52,88,,1270.02,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",9236.61,100,,,,,0,"fee schedule",EAPG,1804,100,,1443.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9513.71,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1136.52,63,,909.22,,,0,"percent of total billed charges","63% of total billed charges",276.01,15.3,,220.81,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,1244.76,69,,,,,0,"fee schedule","69% of total billed charges",1804,100,,1443.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1804,100,,1443.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1804,100,,1443.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9236.61,100,,,,,0,"fee schedule",EAPG,902,50,,721.60,,,0,"percent of total billed charges","50% of total billed charges",580.89,32.2,,464.71,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",680.11,37.7,,544.09,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1407.12,78,,1125.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1490.1,82.6,,1192.08,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1490.1,82.6,,1192.08,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9397.14,100,,,,,0,"fee schedule",EAPG,1804,100,,1443.20,,,0,"percent of total billed charges","100% of total billed charges",276.01,12007.59,
"22590 Arthrodesis, posterior technique, craniocerv",7963065,CDM,521,RC,22590,CPT,OUTPATIENT,,,7745,5034.25,,6815.6,88,,5452.48,,,0,"percent of total billed charges","88% of total billed charges",7745,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7745,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,7745,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4879.35,63,,3903.48,,,0,"percent of total billed charges","63% of total billed charges",1184.99,15.3,,947.99,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,5344.05,69,,,,,0,"fee schedule","69% of total billed charges",7745,100,,6196.00,,,0,"percent of total billed charges","100% of total billed charges",7745,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7745,100,,6196.00,,,0,"percent of total billed charges","100% of total billed charges",7745,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7745,100,,6196.00,,,0,"percent of total billed charges","100% of total billed charges",7745,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",64464.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11832.42,100,,,,,0,"fee schedule",EAPG,7745,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7745,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",7745,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,7745,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2919.87,37.7,,2335.90,,,0,"percent of total billed charges","37.70% of total billed charges",7745,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7745,100,,,,,0,"fee schedule","100% of CMS fee schedule",6041.1,78,,4832.88,,,0,"percent of total billed charges","78% of total billed charges",7745,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6397.37,82.6,,5117.90,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",7745,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6397.37,82.6,,5117.90,,,0,"percent of total billed charges","82.6% of total billed charges",7745,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,7745,100,,6196.00,,,0,"percent of total billed charges","100% of total billed charges",1184.99,64464.78,
"22595 Arthrodesis, posterior technique, atlas-axis",7963322,CDM,521,RC,22595,CPT,OUTPATIENT,,,7377,4795.05,,6491.76,88,,5193.41,,,0,"percent of total billed charges","88% of total billed charges",7377,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7377,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,7377,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4647.51,63,,3718.01,,,0,"percent of total billed charges","63% of total billed charges",1128.68,15.3,,902.94,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,5090.13,69,,,,,0,"fee schedule","69% of total billed charges",7377,100,,5901.60,,,0,"percent of total billed charges","100% of total billed charges",7377,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7377,100,,5901.60,,,0,"percent of total billed charges","100% of total billed charges",7377,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7377,100,,5901.60,,,0,"percent of total billed charges","100% of total billed charges",7377,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",64464.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11832.42,100,,,,,0,"fee schedule",EAPG,7377,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7377,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",7377,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,7377,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2781.13,37.7,,2224.90,,,0,"percent of total billed charges","37.70% of total billed charges",7377,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7377,100,,,,,0,"fee schedule","100% of CMS fee schedule",5754.06,78,,4603.25,,,0,"percent of total billed charges","78% of total billed charges",7377,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6093.4,82.6,,4874.72,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",7377,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6093.4,82.6,,4874.72,,,0,"percent of total billed charges","82.6% of total billed charges",7377,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,7377,100,,5901.60,,,0,"percent of total billed charges","100% of total billed charges",1128.68,64464.78,
"22600 Arthrodesis, posterior or posterolateral tec",7961733,CDM,521,RC,22600,CPT,OUTPATIENT,,,6330,4114.5,,5570.4,88,,4456.32,,,0,"percent of total billed charges","88% of total billed charges",6330,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6330,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,6330,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3987.9,63,,3190.32,,,0,"percent of total billed charges","63% of total billed charges",968.49,15.3,,774.79,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,4367.7,69,,,,,0,"fee schedule","69% of total billed charges",6330,100,,5064.00,,,0,"percent of total billed charges","100% of total billed charges",6330,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6330,100,,5064.00,,,0,"percent of total billed charges","100% of total billed charges",6330,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6330,100,,5064.00,,,0,"percent of total billed charges","100% of total billed charges",6330,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",64464.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9236.61,100,,,,,0,"fee schedule",EAPG,6330,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6330,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",6330,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,6330,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2386.41,37.7,,1909.13,,,0,"percent of total billed charges","37.70% of total billed charges",6330,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6330,100,,,,,0,"fee schedule","100% of CMS fee schedule",4937.4,78,,3949.92,,,0,"percent of total billed charges","78% of total billed charges",6330,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5228.58,82.6,,4182.86,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,6330,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5228.58,82.6,,4182.86,,,0,"percent of total billed charges","82.6% of total billed charges",6330,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9397.14,100,,,,,0,"fee schedule",EAPG,6330,100,,5064.00,,,0,"percent of total billed charges","100% of total billed charges",968.49,64464.78,
"22614 Arthrodesis, posterior or posterolateral tec",7962462,CDM,521,RC,22614,CPT,OUTPATIENT,,,1909,1240.85,,1679.92,88,,1343.94,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",9236.61,100,,,,,0,"fee schedule",EAPG,1909,100,,1527.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9513.71,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1202.67,63,,962.14,,,0,"percent of total billed charges","63% of total billed charges",292.08,15.3,,233.66,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,1317.21,69,,,,,0,"fee schedule","69% of total billed charges",1909,100,,1527.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1909,100,,1527.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1909,100,,1527.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9236.61,100,,,,,0,"fee schedule",EAPG,954.5,50,,763.60,,,0,"percent of total billed charges","50% of total billed charges",614.7,32.2,,491.76,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",719.69,37.7,,575.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1489.02,78,,1191.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1576.83,82.6,,1261.46,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1576.83,82.6,,1261.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9397.14,100,,,,,0,"fee schedule",EAPG,1909,100,,1527.20,,,0,"percent of total billed charges","100% of total billed charges",292.08,12007.59,
"22610 Arthrodesis, posterior or posterolateral tec",7962663,CDM,521,RC,22610,CPT,OUTPATIENT,,,5665,3682.25,,4985.2,88,,3988.16,,,0,"percent of total billed charges","88% of total billed charges",5665,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5665,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,5665,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3568.95,63,,2855.16,,,0,"percent of total billed charges","63% of total billed charges",866.75,15.3,,693.40,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,3908.85,69,,,,,0,"fee schedule","69% of total billed charges",5665,100,,4532.00,,,0,"percent of total billed charges","100% of total billed charges",5665,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5665,100,,4532.00,,,0,"percent of total billed charges","100% of total billed charges",5665,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5665,100,,4532.00,,,0,"percent of total billed charges","100% of total billed charges",5665,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",64464.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11832.42,100,,,,,0,"fee schedule",EAPG,5665,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5665,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",5665,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,5665,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2135.71,37.7,,1708.57,,,0,"percent of total billed charges","37.70% of total billed charges",5665,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5665,100,,,,,0,"fee schedule","100% of CMS fee schedule",4418.7,78,,3534.96,,,0,"percent of total billed charges","78% of total billed charges",5665,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4679.29,82.6,,3743.43,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",5665,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4679.29,82.6,,3743.43,,,0,"percent of total billed charges","82.6% of total billed charges",5665,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,5665,100,,4532.00,,,0,"percent of total billed charges","100% of total billed charges",866.75,64464.78,
"22612 Arthrodesis, posterior or posterolateral tec",7962736,CDM,521,RC,22612,CPT,OUTPATIENT,,,6532,4245.8,,5748.16,88,,4598.53,,,0,"percent of total billed charges","88% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9236.61,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",33264.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4115.16,63,,3292.13,,,0,"percent of total billed charges","63% of total billed charges",999.4,15.3,,799.52,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,4507.08,69,,,,,0,"fee schedule","69% of total billed charges",6532,100,,5225.60,,,0,"percent of total billed charges","100% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6532,100,,5225.60,,,0,"percent of total billed charges","100% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6532,100,,5225.60,,,0,"percent of total billed charges","100% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9236.61,100,,,,,0,"fee schedule",EAPG,19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2462.56,37.7,,1970.05,,,0,"percent of total billed charges","37.70% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5094.96,78,,4075.97,,,0,"percent of total billed charges","78% of total billed charges",19198.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5395.43,82.6,,4316.34,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5395.43,82.6,,4316.34,,,0,"percent of total billed charges","82.6% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9397.14,100,,,,,0,"fee schedule",EAPG,6532,100,,5225.60,,,0,"percent of total billed charges","100% of total billed charges",999.4,50029.1,
"22632 Arthrodesis, posterior interbody technique,",7962766,CDM,521,RC,22632,CPT,OUTPATIENT,,,1626,1056.9,,1430.88,88,,1144.70,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",9236.61,100,,,,,0,"fee schedule",EAPG,1626,100,,1300.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9513.71,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1024.38,63,,819.50,,,0,"percent of total billed charges","63% of total billed charges",248.78,15.3,,199.02,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,1121.94,69,,,,,0,"fee schedule","69% of total billed charges",1626,100,,1300.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1626,100,,1300.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1626,100,,1300.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9236.61,100,,,,,0,"fee schedule",EAPG,813,50,,650.40,,,0,"percent of total billed charges","50% of total billed charges",523.57,32.2,,418.86,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",613,37.7,,490.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1268.28,78,,1014.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1343.08,82.6,,1074.46,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1343.08,82.6,,1074.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9397.14,100,,,,,0,"fee schedule",EAPG,1626,100,,1300.80,,,0,"percent of total billed charges","100% of total billed charges",248.78,12007.59,
"22630 Arthrodesis, posterior interbody technique,",7962837,CDM,521,RC,22630,CPT,OUTPATIENT,,,6450,4192.5,,5676,88,,4540.80,,,0,"percent of total billed charges","88% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9236.61,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",33264.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4063.5,63,,3250.80,,,0,"percent of total billed charges","63% of total billed charges",986.85,15.3,,789.48,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,4450.5,69,,,,,0,"fee schedule","69% of total billed charges",6450,100,,5160.00,,,0,"percent of total billed charges","100% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6450,100,,5160.00,,,0,"percent of total billed charges","100% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6450,100,,5160.00,,,0,"percent of total billed charges","100% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",64464.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9236.61,100,,,,,0,"fee schedule",EAPG,19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16853.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2431.65,37.7,,1945.32,,,0,"percent of total billed charges","37.70% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5031,78,,4024.80,,,0,"percent of total billed charges","78% of total billed charges",19198.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5327.7,82.6,,4262.16,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5327.7,82.6,,4262.16,,,0,"percent of total billed charges","82.6% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9397.14,100,,,,,0,"fee schedule",EAPG,6450,100,,5160.00,,,0,"percent of total billed charges","100% of total billed charges",986.85,64464.78,
"22802 Arthrodesis, posterior, for spinal deformity",7961464,CDM,521,RC,22802,CPT,OUTPATIENT,,,6580,4277,,5790.4,88,,4632.32,,,0,"percent of total billed charges","88% of total billed charges",6580,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6580,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,6580,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4145.4,63,,3316.32,,,0,"percent of total billed charges","63% of total billed charges",1006.74,15.3,,805.39,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,4540.2,69,,,,,0,"fee schedule","69% of total billed charges",6580,100,,5264.00,,,0,"percent of total billed charges","100% of total billed charges",6580,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6580,100,,5264.00,,,0,"percent of total billed charges","100% of total billed charges",6580,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6580,100,,5264.00,,,0,"percent of total billed charges","100% of total billed charges",6580,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",64464.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11832.42,100,,,,,0,"fee schedule",EAPG,6580,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6580,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",6580,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,6580,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2480.66,37.7,,1984.53,,,0,"percent of total billed charges","37.70% of total billed charges",6580,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6580,100,,,,,0,"fee schedule","100% of CMS fee schedule",5132.4,78,,4105.92,,,0,"percent of total billed charges","78% of total billed charges",6580,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5435.08,82.6,,4348.06,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",6580,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5435.08,82.6,,4348.06,,,0,"percent of total billed charges","82.6% of total billed charges",6580,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,6580,100,,5264.00,,,0,"percent of total billed charges","100% of total billed charges",1006.74,64464.78,
"22808 Arthrodesis, anterior, for spinal deformity,",7961662,CDM,521,RC,22808,CPT,OUTPATIENT,,,9421,6123.65,,8290.48,88,,6632.38,,,0,"percent of total billed charges","88% of total billed charges",9421,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9421,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,9421,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5935.23,63,,4748.18,,,0,"percent of total billed charges","63% of total billed charges",1441.41,15.3,,1153.13,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,6500.49,69,,,,,0,"fee schedule","69% of total billed charges",9421,100,,7536.80,,,0,"percent of total billed charges","100% of total billed charges",9421,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9421,100,,7536.80,,,0,"percent of total billed charges","100% of total billed charges",9421,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9421,100,,7536.80,,,0,"percent of total billed charges","100% of total billed charges",9421,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",64464.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11832.42,100,,,,,0,"fee schedule",EAPG,9421,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9421,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",9421,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,9421,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3551.72,37.7,,2841.38,,,0,"percent of total billed charges","37.70% of total billed charges",9421,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9421,100,,,,,0,"fee schedule","100% of CMS fee schedule",7348.38,78,,5878.70,,,0,"percent of total billed charges","78% of total billed charges",9421,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7781.75,82.6,,6225.40,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",9421,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7781.75,82.6,,6225.40,,,0,"percent of total billed charges","82.6% of total billed charges",9421,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,9421,100,,7536.80,,,0,"percent of total billed charges","100% of total billed charges",1441.41,64464.78,
"22810 Arthrodesis, anterior, for spinal deformity,",7961663,CDM,521,RC,22810,CPT,OUTPATIENT,,,10923,7099.95,,9612.24,88,,7689.79,,,0,"percent of total billed charges","88% of total billed charges",10923,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",10923,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,10923,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6881.49,63,,5505.19,,,0,"percent of total billed charges","63% of total billed charges",1671.22,15.3,,1336.98,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,7536.87,69,,,,,0,"fee schedule","69% of total billed charges",10923,100,,8738.40,,,0,"percent of total billed charges","100% of total billed charges",10923,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10923,100,,8738.40,,,0,"percent of total billed charges","100% of total billed charges",10923,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10923,100,,8738.40,,,0,"percent of total billed charges","100% of total billed charges",10923,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",64464.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11832.42,100,,,,,0,"fee schedule",EAPG,10923,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10923,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",10923,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,10923,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4117.97,37.7,,3294.38,,,0,"percent of total billed charges","37.70% of total billed charges",10923,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10923,100,,,,,0,"fee schedule","100% of CMS fee schedule",8519.94,78,,6815.95,,,0,"percent of total billed charges","78% of total billed charges",10923,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9022.4,82.6,,7217.92,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",10923,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9022.4,82.6,,7217.92,,,0,"percent of total billed charges","82.6% of total billed charges",10923,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,10923,100,,8738.40,,,0,"percent of total billed charges","100% of total billed charges",1671.22,64464.78,
"22830 Exploration of spinal fusion",7963774,CDM,521,RC,22830,CPT,OUTPATIENT,,,4790,3113.5,,4215.2,88,,3372.16,,,0,"percent of total billed charges","88% of total billed charges",4790,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4192.88,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",4790,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,4790,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3017.7,63,,2414.16,,,0,"percent of total billed charges","63% of total billed charges",732.87,15.3,,586.30,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,3305.1,69,,,,,0,"fee schedule","69% of total billed charges",4790,100,,3832.00,,,0,"percent of total billed charges","100% of total billed charges",4790,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4790,100,,3832.00,,,0,"percent of total billed charges","100% of total billed charges",4790,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4790,100,,3832.00,,,0,"percent of total billed charges","100% of total billed charges",4790,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,4790,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4790,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",4790,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,4790,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1805.83,37.7,,1444.66,,,0,"percent of total billed charges","37.70% of total billed charges",4790,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4790,100,,,,,0,"fee schedule","100% of CMS fee schedule",3736.2,78,,2988.96,,,0,"percent of total billed charges","78% of total billed charges",4790,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3956.54,82.6,,3165.23,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,4790,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3956.54,82.6,,3165.23,,,0,"percent of total billed charges","82.6% of total billed charges",4790,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4353.41,100,,,,,0,"fee schedule",EAPG,4790,100,,3832.00,,,0,"percent of total billed charges","100% of total billed charges",732.87,50029.1,
"22844 Posterior segmental instrumentation; 13 or m",7962926,CDM,521,RC,22844,CPT,OUTPATIENT,,,5686,3695.9,,5003.68,88,,4002.94,,,0,"percent of total billed charges","88% of total billed charges",5686,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5686,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,5686,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3582.18,63,,2865.74,,,0,"percent of total billed charges","63% of total billed charges",869.96,15.3,,695.97,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,3923.34,69,,,,,0,"fee schedule","69% of total billed charges",5686,100,,4548.80,,,0,"percent of total billed charges","100% of total billed charges",5686,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5686,100,,4548.80,,,0,"percent of total billed charges","100% of total billed charges",5686,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5686,100,,4548.80,,,0,"percent of total billed charges","100% of total billed charges",5686,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9236.61,100,,,,,0,"fee schedule",EAPG,5686,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1830.89,32.2,,1464.71,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",5686,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,5686,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2143.62,37.7,,1714.90,,,0,"percent of total billed charges","37.70% of total billed charges",5686,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5686,100,,,,,0,"fee schedule","100% of CMS fee schedule",4435.08,78,,3548.06,,,0,"percent of total billed charges","78% of total billed charges",5686,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4696.64,82.6,,3757.31,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule","100% of WA fee schedule",5686,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4696.64,82.6,,3757.31,,,0,"percent of total billed charges","82.6% of total billed charges",5686,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9397.14,100,,,,,0,"fee schedule",EAPG,5686,100,,4548.80,,,0,"percent of total billed charges","100% of total billed charges",869.96,12007.59,
"22843 Posterior segmental instrumentation; 7 to 12",7963013,CDM,521,RC,22843,CPT,OUTPATIENT,,,5119,3327.35,,4504.72,88,,3603.78,,,0,"percent of total billed charges","88% of total billed charges",5119,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5119,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,5119,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3224.97,63,,2579.98,,,0,"percent of total billed charges","63% of total billed charges",783.21,15.3,,626.57,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,3532.11,69,,,,,0,"fee schedule","69% of total billed charges",5119,100,,4095.20,,,0,"percent of total billed charges","100% of total billed charges",5119,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5119,100,,4095.20,,,0,"percent of total billed charges","100% of total billed charges",5119,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5119,100,,4095.20,,,0,"percent of total billed charges","100% of total billed charges",5119,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9236.61,100,,,,,0,"fee schedule",EAPG,5119,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1648.32,32.2,,1318.66,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",5119,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,5119,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1929.86,37.7,,1543.89,,,0,"percent of total billed charges","37.70% of total billed charges",5119,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5119,100,,,,,0,"fee schedule","100% of CMS fee schedule",3992.82,78,,3194.26,,,0,"percent of total billed charges","78% of total billed charges",5119,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4228.29,82.6,,3382.63,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule","100% of WA fee schedule",5119,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4228.29,82.6,,3382.63,,,0,"percent of total billed charges","82.6% of total billed charges",5119,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9397.14,100,,,,,0,"fee schedule",EAPG,5119,100,,4095.20,,,0,"percent of total billed charges","100% of total billed charges",783.21,12007.59,
"22842 Posterior segmental instrumentation; 3 to 6",7963042,CDM,521,RC,22842,CPT,OUTPATIENT,,,4676,3039.4,,4114.88,88,,3291.90,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",9236.61,100,,,,,0,"fee schedule",EAPG,4676,100,,3740.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9513.71,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2945.88,63,,2356.70,,,0,"percent of total billed charges","63% of total billed charges",715.43,15.3,,572.34,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,3226.44,69,,,,,0,"fee schedule","69% of total billed charges",4676,100,,3740.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4676,100,,3740.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4676,100,,3740.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9236.61,100,,,,,0,"fee schedule",EAPG,2338,50,,1870.40,,,0,"percent of total billed charges","50% of total billed charges",1505.67,32.2,,1204.54,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1762.85,37.7,,1410.28,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3647.28,78,,2917.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3862.38,82.6,,3089.90,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule","100% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",3862.38,82.6,,3089.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9397.14,100,,,,,0,"fee schedule",EAPG,4676,100,,3740.80,,,0,"percent of total billed charges","100% of total billed charges",715.43,12007.59,
"22841 Internal spinal fixation by wiring of spinou",7963245,CDM,521,RC,22841,CPT,OUTPATIENT,,,1594,1036.1,,1402.72,88,,1122.18,,,0,"percent of total billed charges","88% of total billed charges",1594,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,1594,100,,1275.20,,,0,"percent of total billed charges","100% of total billed charges",1594,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,1594,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1004.22,63,,803.38,,,0,"percent of total billed charges","63% of total billed charges",243.88,15.3,,195.10,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,1099.86,69,,,,,0,"fee schedule","69% of total billed charges",1594,100,,1275.20,,,0,"percent of total billed charges","100% of total billed charges",1594,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1594,100,,1275.20,,,0,"percent of total billed charges","100% of total billed charges",1594,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1594,100,,1275.20,,,0,"percent of total billed charges","100% of total billed charges",1594,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9236.61,100,,,,,0,"fee schedule",EAPG,1594,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",513.27,32.2,,410.62,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",1594,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,1594,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",600.94,37.7,,480.75,,,0,"percent of total billed charges","37.70% of total billed charges",1594,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1594,100,,,,,0,"fee schedule","100% of CMS fee schedule",1243.32,78,,994.66,,,0,"percent of total billed charges","78% of total billed charges",1594,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1316.64,82.6,,1053.31,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule","100% of WA fee schedule",1594,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1316.64,82.6,,1053.31,,,0,"percent of total billed charges","82.6% of total billed charges",1594,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9397.14,100,,,,,0,"fee schedule",EAPG,1594,100,,1275.20,,,0,"percent of total billed charges","100% of total billed charges",243.88,12007.59,
"22845 Anterior instrumentation; 2 to 3 vertebral s",7963351,CDM,521,RC,22845,CPT,OUTPATIENT,,,4915,3194.75,,4325.2,88,,3460.16,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",9236.61,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9513.71,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3096.45,63,,2477.16,,,0,"percent of total billed charges","63% of total billed charges",752,15.3,,601.60,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,3391.35,69,,,,,0,"fee schedule","69% of total billed charges",4915,100,,3932.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4915,100,,3932.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4915,100,,3932.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9236.61,100,,,,,0,"fee schedule",EAPG,2457.5,50,,1966.00,,,0,"percent of total billed charges","50% of total billed charges",1582.63,32.2,,1266.10,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1852.96,37.7,,1482.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3833.7,78,,3066.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4059.79,82.6,,3247.83,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",4059.79,82.6,,3247.83,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9397.14,100,,,,,0,"fee schedule",EAPG,4915,100,,3932.00,,,0,"percent of total billed charges","100% of total billed charges",752,12007.59,
"22846 Anterior instrumentation; 4 to 7 vertebral s",7963352,CDM,521,RC,22846,CPT,OUTPATIENT,,,4482,2913.3,,3944.16,88,,3155.33,,,0,"percent of total billed charges","88% of total billed charges",4482,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4482,100,,3585.60,,,0,"percent of total billed charges","100% of total billed charges",4482,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,4482,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2823.66,63,,2258.93,,,0,"percent of total billed charges","63% of total billed charges",685.75,15.3,,548.60,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,3092.58,69,,,,,0,"fee schedule","69% of total billed charges",4482,100,,3585.60,,,0,"percent of total billed charges","100% of total billed charges",4482,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4482,100,,3585.60,,,0,"percent of total billed charges","100% of total billed charges",4482,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4482,100,,3585.60,,,0,"percent of total billed charges","100% of total billed charges",4482,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",11832.42,100,,,,,0,"fee schedule",EAPG,4482,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1443.2,32.2,,1154.56,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",4482,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,4482,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1689.71,37.7,,1351.77,,,0,"percent of total billed charges","37.70% of total billed charges",4482,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4482,100,,,,,0,"fee schedule","100% of CMS fee schedule",3495.96,78,,2796.77,,,0,"percent of total billed charges","78% of total billed charges",4482,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3702.13,82.6,,2961.70,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,4482,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3702.13,82.6,,2961.70,,,0,"percent of total billed charges","82.6% of total billed charges",4482,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,4482,100,,3585.60,,,0,"percent of total billed charges","100% of total billed charges",685.75,15382.15,
"22840 Posterior non-segmental instrumentation",7963595,CDM,521,RC,22840,CPT,OUTPATIENT,,,3855,2505.75,,3392.4,88,,2713.92,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",11832.42,100,,,,,0,"fee schedule",EAPG,3855,100,,3084.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12187.4,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2428.65,63,,1942.92,,,0,"percent of total billed charges","63% of total billed charges",589.82,15.3,,471.86,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,2659.95,69,,,,,0,"fee schedule","69% of total billed charges",3855,100,,3084.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3855,100,,3084.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3855,100,,3084.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11832.42,100,,,,,0,"fee schedule",EAPG,1927.5,50,,1542.00,,,0,"percent of total billed charges","50% of total billed charges",1241.31,32.2,,993.05,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1453.34,37.7,,1162.67,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3006.9,78,,2405.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3184.23,82.6,,2547.38,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3184.23,82.6,,2547.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",11992.95,100,,,,,0,"fee schedule",EAPG,3855,100,,3084.00,,,0,"percent of total billed charges","100% of total billed charges",589.82,15382.15,
"22849 Reinsertion of spinal fixation device",7963638,CDM,521,RC,22849,CPT,OUTPATIENT,,,6407,4164.55,,5638.16,88,,4510.53,,,0,"percent of total billed charges","88% of total billed charges",6407,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6407,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,6407,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4036.41,63,,3229.13,,,0,"percent of total billed charges","63% of total billed charges",980.27,15.3,,784.22,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,4420.83,69,,,,,0,"fee schedule","69% of total billed charges",6407,100,,5125.60,,,0,"percent of total billed charges","100% of total billed charges",6407,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6407,100,,5125.60,,,0,"percent of total billed charges","100% of total billed charges",6407,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6407,100,,5125.60,,,0,"percent of total billed charges","100% of total billed charges",6407,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",64464.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9236.61,100,,,,,0,"fee schedule",EAPG,6407,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6407,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",6407,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,6407,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2415.44,37.7,,1932.35,,,0,"percent of total billed charges","37.70% of total billed charges",6407,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6407,100,,,,,0,"fee schedule","100% of CMS fee schedule",4997.46,78,,3997.97,,,0,"percent of total billed charges","78% of total billed charges",6407,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5292.18,82.6,,4233.74,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule","100% of WA fee schedule",6407,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5292.18,82.6,,4233.74,,,0,"percent of total billed charges","82.6% of total billed charges",6407,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9397.14,100,,,,,0,"fee schedule",EAPG,6407,100,,5125.60,,,0,"percent of total billed charges","100% of total billed charges",980.27,64464.78,
"22851 Application of intervertebral biomechanical",7961734,CDM,521,RC,,,OUTPATIENT,,,2239,1455.35,,1970.32,88,,1576.26,,,0,"percent of total billed charges","88% of total billed charges",1119.5,50,,895.60,,,0,"percent of total billed charges","50% of total billed charges",376.15,16.8,,300.92,,,0,"percent of total billed charges","16.8% of total billed charges",2239,100,,1791.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",387.44,17.304,,309.95,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1410.57,63,,1128.46,,,0,"percent of total billed charges","63% of total billed charges",342.57,15.3,,274.06,,,0,"percent of total billed charges","15.3% of total billed charges",376.15,16.8,,300.92,,,0,"percent of total billed charges","16.8% of total billed charges",1544.91,69,,,,,0,"fee schedule","69% of total billed charges",2239,100,,1791.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2239,100,,1791.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2239,100,,1791.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",376.15,16.8,,300.92,,,0,"percent of total billed charges","16.8% of total billed charges",1119.5,50,,895.60,,,0,"percent of total billed charges","50% of total billed charges",720.96,32.2,,576.77,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",383.68,17.136,,306.94,,,0,"percent of total billed charges","17.136% of total billed charges",489,21.84,,391.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",844.1,37.7,,675.28,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1746.42,78,,1397.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1849.41,82.6,,1479.53,,,0,"percent of total billed charges","82.6% of total billed charges",376.15,16.8,,300.92,,,0,"percent of total billed charges","16.8% of total billed charges",1119.5,50,,895.60,,,0,"percent of total billed charges","50% of total billed charges",1849.41,82.6,,1479.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",2239,100,,1791.20,,,0,"percent of total billed charges","100% of total billed charges",160.53,2239,
"22850 Removal of posterior nonsegmental instrument",7962799,CDM,521,RC,22850,CPT,OUTPATIENT,,,3787,2461.55,,3332.56,88,,2666.05,,,0,"percent of total billed charges","88% of total billed charges",3787,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4192.88,100,,,,,0,"fee schedule",EAPG,3787,100,,3029.60,,,0,"percent of total billed charges","100% of total billed charges",3787,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,3787,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2385.81,63,,1908.65,,,0,"percent of total billed charges","63% of total billed charges",579.41,15.3,,463.53,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,2613.03,69,,,,,0,"fee schedule","69% of total billed charges",3787,100,,3029.60,,,0,"percent of total billed charges","100% of total billed charges",3787,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3787,100,,3029.60,,,0,"percent of total billed charges","100% of total billed charges",3787,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3787,100,,3029.60,,,0,"percent of total billed charges","100% of total billed charges",3787,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,3787,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3787,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",3787,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,3787,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1427.7,37.7,,1142.16,,,0,"percent of total billed charges","37.70% of total billed charges",3787,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3787,100,,,,,0,"fee schedule","100% of CMS fee schedule",2953.86,78,,2363.09,,,0,"percent of total billed charges","78% of total billed charges",3787,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3128.06,82.6,,2502.45,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,3787,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3128.06,82.6,,2502.45,,,0,"percent of total billed charges","82.6% of total billed charges",3787,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4353.41,100,,,,,0,"fee schedule",EAPG,3787,100,,3029.60,,,0,"percent of total billed charges","100% of total billed charges",579.41,50029.1,
"22857 Total disc arthroplasty, anterior approach;",7962838,CDM,521,RC,22857,CPT,OUTPATIENT,,,21564,14016.6,,18976.32,88,,15181.06,,,0,"percent of total billed charges","88% of total billed charges",21564,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",21564,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,21564,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13585.32,63,,10868.26,,,0,"percent of total billed charges","63% of total billed charges",3299.29,15.3,,2639.43,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,14879.16,69,,,,,0,"fee schedule","69% of total billed charges",21564,100,,17251.20,,,0,"percent of total billed charges","100% of total billed charges",21564,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",21564,100,,17251.20,,,0,"percent of total billed charges","100% of total billed charges",21564,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",21564,100,,17251.20,,,0,"percent of total billed charges","100% of total billed charges",21564,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",64464.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9236.61,100,,,,,0,"fee schedule",EAPG,21564,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",21564,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",21564,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,21564,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8129.63,37.7,,6503.70,,,0,"percent of total billed charges","37.70% of total billed charges",21564,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",21564,100,,,,,0,"fee schedule","100% of CMS fee schedule",16819.92,78,,13455.94,,,0,"percent of total billed charges","78% of total billed charges",21564,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",17811.86,82.6,,14249.49,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule","100% of WA fee schedule",21564,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",17811.86,82.6,,14249.49,,,0,"percent of total billed charges","82.6% of total billed charges",21564,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9397.14,100,,,,,0,"fee schedule",EAPG,21564,100,,17251.20,,,0,"percent of total billed charges","100% of total billed charges",3299.29,64464.78,
"22852 Removal of posterior segmental instrumentati",7963460,CDM,521,RC,22852,CPT,OUTPATIENT,,,3050,1982.5,,2684,88,,2147.20,,,0,"percent of total billed charges","88% of total billed charges",3050,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4192.88,100,,,,,0,"fee schedule",EAPG,3050,100,,2440.00,,,0,"percent of total billed charges","100% of total billed charges",3050,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,3050,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1921.5,63,,1537.20,,,0,"percent of total billed charges","63% of total billed charges",466.65,15.3,,373.32,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,2104.5,69,,,,,0,"fee schedule","69% of total billed charges",3050,100,,2440.00,,,0,"percent of total billed charges","100% of total billed charges",3050,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3050,100,,2440.00,,,0,"percent of total billed charges","100% of total billed charges",3050,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3050,100,,2440.00,,,0,"percent of total billed charges","100% of total billed charges",3050,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,3050,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3050,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",3050,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,3050,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1149.85,37.7,,919.88,,,0,"percent of total billed charges","37.70% of total billed charges",3050,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3050,100,,,,,0,"fee schedule","100% of CMS fee schedule",2379,78,,1903.20,,,0,"percent of total billed charges","78% of total billed charges",3050,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2519.3,82.6,,2015.44,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule","100% of WA fee schedule",3050,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2519.3,82.6,,2015.44,,,0,"percent of total billed charges","82.6% of total billed charges",3050,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4353.41,100,,,,,0,"fee schedule",EAPG,3050,100,,2440.00,,,0,"percent of total billed charges","100% of total billed charges",466.65,50029.1,
"22855 Removal of anterior instrumentation",7963675,CDM,521,RC,22855,CPT,OUTPATIENT,,,4020,2613,,3537.6,88,,2830.08,,,0,"percent of total billed charges","88% of total billed charges",4020,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4192.88,100,,,,,0,"fee schedule",EAPG,4020,100,,3216.00,,,0,"percent of total billed charges","100% of total billed charges",4020,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,4020,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2532.6,63,,2026.08,,,0,"percent of total billed charges","63% of total billed charges",615.06,15.3,,492.05,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,2773.8,69,,,,,0,"fee schedule","69% of total billed charges",4020,100,,3216.00,,,0,"percent of total billed charges","100% of total billed charges",4020,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4020,100,,3216.00,,,0,"percent of total billed charges","100% of total billed charges",4020,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4020,100,,3216.00,,,0,"percent of total billed charges","100% of total billed charges",4020,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,4020,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4020,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",4020,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,4020,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1515.54,37.7,,1212.43,,,0,"percent of total billed charges","37.70% of total billed charges",4020,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4020,100,,,,,0,"fee schedule","100% of CMS fee schedule",3135.6,78,,2508.48,,,0,"percent of total billed charges","78% of total billed charges",4020,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3320.52,82.6,,2656.42,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,4020,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3320.52,82.6,,2656.42,,,0,"percent of total billed charges","82.6% of total billed charges",4020,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4353.41,100,,,,,0,"fee schedule",EAPG,4020,100,,3216.00,,,0,"percent of total billed charges","100% of total billed charges",615.06,50029.1,
"22899 Unlisted procedure, spine",7963843,CDM,521,RC,22899,CPT,OUTPATIENT,,,3942,2562.3,,3468.96,88,,2775.17,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,3942,100,,3153.60,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2483.46,63,,1986.77,,,0,"percent of total billed charges","63% of total billed charges",603.13,15.3,,482.50,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,2719.98,69,,,,,0,"fee schedule","69% of total billed charges",3942,100,,3153.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3942,100,,3153.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3942,100,,3153.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1486.13,37.7,,1188.90,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3074.76,78,,2459.81,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3256.09,82.6,,2604.87,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3256.09,82.6,,2604.87,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,3942,100,,3153.60,,,0,"percent of total billed charges","100% of total billed charges",218.99,5450.75,
"22900 Excision, tumor, soft tissue of abdominal wa",7961465,CDM,521,RC,22900,CPT,OUTPATIENT,,,1626,1056.9,,1430.88,88,,1144.70,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1626,100,,1300.80,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1024.38,63,,819.50,,,0,"percent of total billed charges","63% of total billed charges",248.78,15.3,,199.02,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1121.94,69,,,,,0,"fee schedule","69% of total billed charges",1626,100,,1300.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1626,100,,1300.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1626,100,,1300.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",613,37.7,,490.40,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1268.28,78,,1014.62,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1343.08,82.6,,1074.46,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1343.08,82.6,,1074.46,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,1626,100,,1300.80,,,0,"percent of total billed charges","100% of total billed charges",248.78,9628.23,
"22901 Excision, tumor, soft tissue of abdominal wa",7961968,CDM,521,RC,22901,CPT,OUTPATIENT,,,1910,1241.5,,1680.8,88,,1344.64,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1910,100,,1528.00,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1203.3,63,,962.64,,,0,"percent of total billed charges","63% of total billed charges",292.23,15.3,,233.78,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1317.9,69,,,,,0,"fee schedule","69% of total billed charges",1910,100,,1528.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1910,100,,1528.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1910,100,,1528.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",720.07,37.7,,576.06,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1489.8,78,,1191.84,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1577.66,82.6,,1262.13,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1577.66,82.6,,1262.13,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,1910,100,,1528.00,,,0,"percent of total billed charges","100% of total billed charges",292.23,9628.23,
"22903 Excision, tumor, soft tissue of abdominal wa",7962545,CDM,521,RC,22903,CPT,OUTPATIENT,,,1254,815.1,,1103.52,88,,882.82,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1254,100,,1003.20,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790.02,63,,632.02,,,0,"percent of total billed charges","63% of total billed charges",191.86,15.3,,153.49,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,865.26,69,,,,,0,"fee schedule","69% of total billed charges",1254,100,,1003.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1254,100,,1003.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1254,100,,1003.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",472.76,37.7,,378.21,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",978.12,78,,782.50,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.8,82.6,,828.64,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.8,82.6,,828.64,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,1254,100,,1003.20,,,0,"percent of total billed charges","100% of total billed charges",191.86,9628.23,
"22902 Excision, tumor, soft tissue of abdominal wa",7962590,CDM,521,RC,22902,CPT,OUTPATIENT,,,946,614.9,,832.48,88,,665.98,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,946,100,,756.80,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",595.98,63,,476.78,,,0,"percent of total billed charges","63% of total billed charges",144.74,15.3,,115.79,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,652.74,69,,,,,0,"fee schedule","69% of total billed charges",946,100,,756.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",946,100,,756.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",946,100,,756.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",356.64,37.7,,285.31,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737.88,78,,590.30,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",781.4,82.6,,625.12,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",781.4,82.6,,625.12,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,946,100,,756.80,,,0,"percent of total billed charges","100% of total billed charges",144.74,5715.97,
"23000 Removal of subdeltoid calcareous deposits, o",7963440,CDM,521,RC,23000,CPT,OUTPATIENT,,,1649,1071.85,,1451.12,88,,1160.90,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1649,100,,1319.20,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1038.87,63,,831.10,,,0,"percent of total billed charges","63% of total billed charges",252.3,15.3,,201.84,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1137.81,69,,,,,0,"fee schedule","69% of total billed charges",1649,100,,1319.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1649,100,,1319.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1649,100,,1319.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",621.67,37.7,,497.34,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1286.22,78,,1028.98,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1362.07,82.6,,1089.66,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1362.07,82.6,,1089.66,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,1649,100,,1319.20,,,0,"percent of total billed charges","100% of total billed charges",252.3,9628.23,
"23030 Incision and drainage, shoulder area; deep a",7963043,CDM,521,RC,23030,CPT,OUTPATIENT,,,1016,660.4,,894.08,88,,715.26,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1016,100,,812.80,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",640.08,63,,512.06,,,0,"percent of total billed charges","63% of total billed charges",155.45,15.3,,124.36,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,701.04,69,,,,,0,"fee schedule","69% of total billed charges",1016,100,,812.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1016,100,,812.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1016,100,,812.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",383.03,37.7,,306.42,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",792.48,78,,633.98,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",839.22,82.6,,671.38,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",839.22,82.6,,671.38,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,1016,100,,812.80,,,0,"percent of total billed charges","100% of total billed charges",155.45,9628.23,
"23031 Incision and drainage, shoulder area; infect",7963323,CDM,521,RC,23031,CPT,OUTPATIENT,,,895,581.75,,787.6,88,,630.08,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,895,100,,716.00,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",563.85,63,,451.08,,,0,"percent of total billed charges","63% of total billed charges",136.94,15.3,,109.55,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,617.55,69,,,,,0,"fee schedule","69% of total billed charges",895,100,,716.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",895,100,,716.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",895,100,,716.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",337.42,37.7,,269.94,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",698.1,78,,558.48,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",739.27,82.6,,591.42,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",739.27,82.6,,591.42,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,895,100,,716.00,,,0,"percent of total billed charges","100% of total billed charges",136.94,9628.23,
"23040 Arthrotomy, glenohumeral joint, including ex",7961735,CDM,521,RC,23040,CPT,OUTPATIENT,,,2913,1893.45,,2563.44,88,,2050.75,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,2913,100,,2330.40,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4140.73,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1835.19,63,,1468.15,,,0,"percent of total billed charges","63% of total billed charges",445.69,15.3,,356.55,,,0,"percent of total billed charges","15.3% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,2009.97,69,,,,,0,"fee schedule","69% of total billed charges",2913,100,,2330.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2913,100,,2330.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2913,100,,2330.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.53,100,,,,,0,"fee schedule",EAPG,5226.17,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1098.2,37.7,,878.56,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2272.14,78,,1817.71,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2406.14,82.6,,1924.91,,,0,"percent of total billed charges","82.6% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2406.14,82.6,,1924.91,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4180.66,100,,,,,0,"fee schedule",EAPG,2913,100,,2330.40,,,0,"percent of total billed charges","100% of total billed charges",445.69,11498.59,
"23044 Arthrotomy, acromioclavicular, sternoclavicu",7962315,CDM,521,RC,23044,CPT,OUTPATIENT,,,1936,1258.4,,1703.68,88,,1362.94,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,1936,100,,1548.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4140.73,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1219.68,63,,975.74,,,0,"percent of total billed charges","63% of total billed charges",296.21,15.3,,236.97,,,0,"percent of total billed charges","15.3% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,1335.84,69,,,,,0,"fee schedule","69% of total billed charges",1936,100,,1548.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1936,100,,1548.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1936,100,,1548.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.53,100,,,,,0,"fee schedule",EAPG,5226.17,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",729.87,37.7,,583.90,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1510.08,78,,1208.06,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1599.14,82.6,,1279.31,,,0,"percent of total billed charges","82.6% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1599.14,82.6,,1279.31,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4180.66,100,,,,,0,"fee schedule",EAPG,1936,100,,1548.80,,,0,"percent of total billed charges","100% of total billed charges",296.21,11498.59,
"23065 Biopsy, soft tissue of shoulder area; superf",7963406,CDM,521,RC,23065,CPT,OUTPATIENT,,,557,362.05,,490.16,88,,392.13,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,557,100,,445.60,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350.91,63,,280.73,,,0,"percent of total billed charges","63% of total billed charges",85.22,15.3,,68.18,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,384.33,69,,,,,0,"fee schedule","69% of total billed charges",557,100,,445.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",557,100,,445.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",557,100,,445.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",209.99,37.7,,167.99,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",434.46,78,,347.57,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460.08,82.6,,368.06,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460.08,82.6,,368.06,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,557,100,,445.60,,,0,"percent of total billed charges","100% of total billed charges",85.22,5715.97,
"23066 Biopsy, soft tissue of shoulder area; deep",7963538,CDM,521,RC,23066,CPT,OUTPATIENT,,,1771,1151.15,,1558.48,88,,1246.78,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1771,100,,1416.80,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1115.73,63,,892.58,,,0,"percent of total billed charges","63% of total billed charges",270.96,15.3,,216.77,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1221.99,69,,,,,0,"fee schedule","69% of total billed charges",1771,100,,1416.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1771,100,,1416.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1771,100,,1416.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",667.67,37.7,,534.14,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1381.38,78,,1105.10,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1462.85,82.6,,1170.28,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1462.85,82.6,,1170.28,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,1771,100,,1416.80,,,0,"percent of total billed charges","100% of total billed charges",270.96,9628.23,
"23073 Excision, tumor, soft tissue of shoulder are",7961466,CDM,521,RC,23073,CPT,OUTPATIENT,,,2326,1511.9,,2046.88,88,,1637.50,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2326,100,,1860.80,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1465.38,63,,1172.30,,,0,"percent of total billed charges","63% of total billed charges",355.88,15.3,,284.70,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1604.94,69,,,,,0,"fee schedule","69% of total billed charges",2326,100,,1860.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2326,100,,1860.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2326,100,,1860.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",876.9,37.7,,701.52,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1814.28,78,,1451.42,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1921.28,82.6,,1537.02,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1921.28,82.6,,1537.02,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,2326,100,,1860.80,,,0,"percent of total billed charges","100% of total billed charges",355.88,9628.23,
"23076 Excision, tumor, soft tissue of shoulder are",7961574,CDM,521,RC,23076,CPT,OUTPATIENT,,,1818,1181.7,,1599.84,88,,1279.87,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1818,100,,1454.40,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1145.34,63,,916.27,,,0,"percent of total billed charges","63% of total billed charges",278.15,15.3,,222.52,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1254.42,69,,,,,0,"fee schedule","69% of total billed charges",1818,100,,1454.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1818,100,,1454.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1818,100,,1454.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",685.39,37.7,,548.31,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1418.04,78,,1134.43,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1501.67,82.6,,1201.34,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1501.67,82.6,,1201.34,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,1818,100,,1454.40,,,0,"percent of total billed charges","100% of total billed charges",278.15,9628.23,
"23071 Excision, tumor, soft tissue of shoulder are",7962591,CDM,521,RC,23071,CPT,OUTPATIENT,,,1036,673.4,,911.68,88,,729.34,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1036,100,,828.80,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.68,63,,522.14,,,0,"percent of total billed charges","63% of total billed charges",158.51,15.3,,126.81,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,714.84,69,,,,,0,"fee schedule","69% of total billed charges",1036,100,,828.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1036,100,,828.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1036,100,,828.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",390.57,37.7,,312.46,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",808.08,78,,646.46,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",855.74,82.6,,684.59,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",855.74,82.6,,684.59,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,1036,100,,828.80,,,0,"percent of total billed charges","100% of total billed charges",158.51,5715.97,
"23075 Excision, tumor, soft tissue of shoulder are",7962623,CDM,521,RC,23075,CPT,OUTPATIENT,,,1172,761.8,,1031.36,88,,825.09,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1172,100,,937.60,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",738.36,63,,590.69,,,0,"percent of total billed charges","63% of total billed charges",179.32,15.3,,143.46,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,808.68,69,,,,,0,"fee schedule","69% of total billed charges",1172,100,,937.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1172,100,,937.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1172,100,,937.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",441.84,37.7,,353.47,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",914.16,78,,731.33,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",968.07,82.6,,774.46,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",968.07,82.6,,774.46,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,1172,100,,937.60,,,0,"percent of total billed charges","100% of total billed charges",179.32,5715.97,
"23101 Arthrotomy, acromioclavicular/sternoclavicul",7961664,CDM,521,RC,23101,CPT,OUTPATIENT,,,1466,952.9,,1290.08,88,,1032.06,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,1466,100,,1172.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4140.73,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",923.58,63,,738.86,,,0,"percent of total billed charges","63% of total billed charges",224.3,15.3,,179.44,,,0,"percent of total billed charges","15.3% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,1011.54,69,,,,,0,"fee schedule","69% of total billed charges",1466,100,,1172.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1466,100,,1172.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1466,100,,1172.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.53,100,,,,,0,"fee schedule",EAPG,5226.17,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",552.68,37.7,,442.14,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1143.48,78,,914.78,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1210.92,82.6,,968.74,,,0,"percent of total billed charges","82.6% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1210.92,82.6,,968.74,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4180.66,100,,,,,0,"fee schedule",EAPG,1466,100,,1172.80,,,0,"percent of total billed charges","100% of total billed charges",224.3,11498.59,
"23107 Arthrotomy, glenohumeral joint, w/ joint exp",7961736,CDM,521,RC,23107,CPT,OUTPATIENT,,,2189,1422.85,,1926.32,88,,1541.06,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,2189,100,,1751.20,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4140.73,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1379.07,63,,1103.26,,,0,"percent of total billed charges","63% of total billed charges",334.92,15.3,,267.94,,,0,"percent of total billed charges","15.3% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,1510.41,69,,,,,0,"fee schedule","69% of total billed charges",2189,100,,1751.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2189,100,,1751.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2189,100,,1751.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.53,100,,,,,0,"fee schedule",EAPG,5226.17,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",825.25,37.7,,660.20,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1707.42,78,,1365.94,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1808.11,82.6,,1446.49,,,0,"percent of total billed charges","82.6% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1808.11,82.6,,1446.49,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4180.66,100,,,,,0,"fee schedule",EAPG,2189,100,,1751.20,,,0,"percent of total billed charges","100% of total billed charges",334.92,25451.55,
"23120 Claviculectomy; partialng biopsy and/or exci",7963441,CDM,521,RC,23120,CPT,OUTPATIENT,,,2040,1326,,1795.2,88,,1436.16,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,2040,100,,1632.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4140.73,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1285.2,63,,1028.16,,,0,"percent of total billed charges","63% of total billed charges",312.12,15.3,,249.70,,,0,"percent of total billed charges","15.3% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,1407.6,69,,,,,0,"fee schedule","69% of total billed charges",2040,100,,1632.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2040,100,,1632.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2040,100,,1632.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.53,100,,,,,0,"fee schedule",EAPG,5226.17,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",769.08,37.7,,615.26,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1591.2,78,,1272.96,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1685.04,82.6,,1348.03,,,0,"percent of total billed charges","82.6% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1685.04,82.6,,1348.03,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4180.66,100,,,,,0,"fee schedule",EAPG,2040,100,,1632.00,,,0,"percent of total billed charges","100% of total billed charges",312.12,11498.59,
"23130 Acromioplasty or acromionectomy, partial, wi",7961852,CDM,521,RC,23130,CPT,OUTPATIENT,,,2369,1539.85,,2084.72,88,,1667.78,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,2369,100,,1895.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4140.73,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1492.47,63,,1193.98,,,0,"percent of total billed charges","63% of total billed charges",362.46,15.3,,289.97,,,0,"percent of total billed charges","15.3% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,1634.61,69,,,,,0,"fee schedule","69% of total billed charges",2369,100,,1895.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2369,100,,1895.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2369,100,,1895.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.53,100,,,,,0,"fee schedule",EAPG,5226.17,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",893.11,37.7,,714.49,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1847.82,78,,1478.26,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1956.79,82.6,,1565.43,,,0,"percent of total billed charges","82.6% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1956.79,82.6,,1565.43,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4180.66,100,,,,,0,"fee schedule",EAPG,2369,100,,1895.20,,,0,"percent of total billed charges","100% of total billed charges",362.46,11498.59,
"23140 Excision or curettage of bone cyst or benign",7962664,CDM,521,RC,23140,CPT,OUTPATIENT,,,1898,1233.7,,1670.24,88,,1336.19,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,1898,100,,1518.40,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4140.73,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1195.74,63,,956.59,,,0,"percent of total billed charges","63% of total billed charges",290.39,15.3,,232.31,,,0,"percent of total billed charges","15.3% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,1309.62,69,,,,,0,"fee schedule","69% of total billed charges",1898,100,,1518.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1898,100,,1518.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1898,100,,1518.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.53,100,,,,,0,"fee schedule",EAPG,5226.17,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",715.55,37.7,,572.44,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1480.44,78,,1184.35,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1567.75,82.6,,1254.20,,,0,"percent of total billed charges","82.6% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1567.75,82.6,,1254.20,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4180.66,100,,,,,0,"fee schedule",EAPG,1898,100,,1518.40,,,0,"percent of total billed charges","100% of total billed charges",290.39,11498.59,
"23156 Excision or curettage of bone cyst or benign",7961969,CDM,521,RC,23156,CPT,OUTPATIENT,,,1132,735.8,,996.16,88,,796.93,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,1132,100,,905.60,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4140.73,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",713.16,63,,570.53,,,0,"percent of total billed charges","63% of total billed charges",173.2,15.3,,138.56,,,0,"percent of total billed charges","15.3% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,781.08,69,,,,,0,"fee schedule","69% of total billed charges",1132,100,,905.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1132,100,,905.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1132,100,,905.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.53,100,,,,,0,"fee schedule",EAPG,5226.17,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",426.76,37.7,,341.41,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",882.96,78,,706.37,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",935.03,82.6,,748.02,,,0,"percent of total billed charges","82.6% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",935.03,82.6,,748.02,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4180.66,100,,,,,0,"fee schedule",EAPG,1132,100,,905.60,,,0,"percent of total billed charges","100% of total billed charges",173.2,25451.55,
"23331 remove shoulder foreign body",7963751,CDM,521,RC,23331,CPT,OUTPATIENT,,,2044,1328.6,,1798.72,88,,1438.98,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",343.39,16.8,,274.71,,,0,"percent of total billed charges","16.8% of total billed charges",2044,100,,1635.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",353.69,17.304,,282.95,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1287.72,63,,1030.18,,,0,"percent of total billed charges","63% of total billed charges",312.73,15.3,,250.18,,,0,"percent of total billed charges","15.3% of total billed charges",343.39,16.8,,274.71,,,0,"percent of total billed charges","16.8% of total billed charges",1410.36,69,,,,,0,"fee schedule","69% of total billed charges",2044,100,,1635.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2044,100,,1635.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2044,100,,1635.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1264.21,61.85,,1011.37,,,0,"percent of total billed charges","61.5% of total billed charges",343.39,16.8,,274.71,,,0,"percent of total billed charges","16.8% of total billed charges",1022,50,,817.60,,,0,"percent of total billed charges","50% of total billed charges",658.17,32.2,,526.54,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",350.26,17.136,,280.21,,,0,"percent of total billed charges","17.136% of total billed charges",446.41,21.84,,357.13,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",770.59,37.7,,616.47,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1594.32,78,,1275.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1688.34,82.6,,1350.67,,,0,"percent of total billed charges","82.6% of total billed charges",343.39,16.8,,274.71,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1688.34,82.6,,1350.67,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",2044,100,,1635.20,,,0,"percent of total billed charges","100% of total billed charges",160.53,2044,
"23332 remove shoulder foreign body",7963752,CDM,521,RC,23332,CPT,OUTPATIENT,,,3209,2085.85,,2823.92,88,,2259.14,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.11,16.8,,431.29,,,0,"percent of total billed charges","16.8% of total billed charges",3209,100,,2567.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",555.29,17.304,,444.23,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2021.67,63,,1617.34,,,0,"percent of total billed charges","63% of total billed charges",490.98,15.3,,392.78,,,0,"percent of total billed charges","15.3% of total billed charges",539.11,16.8,,431.29,,,0,"percent of total billed charges","16.8% of total billed charges",2214.21,69,,,,,0,"fee schedule","69% of total billed charges",3209,100,,2567.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3209,100,,2567.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3209,100,,2567.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1984.77,61.85,,1587.82,,,0,"percent of total billed charges","61.5% of total billed charges",539.11,16.8,,431.29,,,0,"percent of total billed charges","16.8% of total billed charges",1604.5,50,,1283.60,,,0,"percent of total billed charges","50% of total billed charges",1033.3,32.2,,826.64,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",549.89,17.136,,439.91,,,0,"percent of total billed charges","17.136% of total billed charges",700.85,21.84,,560.68,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1209.79,37.7,,967.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2503.02,78,,2002.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.63,82.6,,2120.50,,,0,"percent of total billed charges","82.6% of total billed charges",539.11,16.8,,431.29,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2650.63,82.6,,2120.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",3209,100,,2567.20,,,0,"percent of total billed charges","100% of total billed charges",160.53,3209,
"23397 Muscle transfer, any type, shoulder or upper",7963181,CDM,521,RC,23397,CPT,OUTPATIENT,,,3631,2360.15,,3195.28,88,,2556.22,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,3631,100,,2904.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4140.73,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2287.53,63,,1830.02,,,0,"percent of total billed charges","63% of total billed charges",555.54,15.3,,444.43,,,0,"percent of total billed charges","15.3% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,2505.39,69,,,,,0,"fee schedule","69% of total billed charges",3631,100,,2904.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3631,100,,2904.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3631,100,,2904.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.53,100,,,,,0,"fee schedule",EAPG,5226.17,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1368.89,37.7,,1095.11,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2832.18,78,,2265.74,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2999.21,82.6,,2399.37,,,0,"percent of total billed charges","82.6% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2999.21,82.6,,2399.37,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4180.66,100,,,,,0,"fee schedule",EAPG,3631,100,,2904.80,,,0,"percent of total billed charges","100% of total billed charges",555.54,25451.55,
"23405 Tenotomy, shoulder area; single tendon",7963618,CDM,521,RC,23405,CPT,OUTPATIENT,,,1996,1297.4,,1756.48,88,,1405.18,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,1996,100,,1596.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4140.73,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1257.48,63,,1005.98,,,0,"percent of total billed charges","63% of total billed charges",305.39,15.3,,244.31,,,0,"percent of total billed charges","15.3% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,1377.24,69,,,,,0,"fee schedule","69% of total billed charges",1996,100,,1596.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1996,100,,1596.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1996,100,,1596.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.53,100,,,,,0,"fee schedule",EAPG,5226.17,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",752.49,37.7,,601.99,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1556.88,78,,1245.50,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1648.7,82.6,,1318.96,,,0,"percent of total billed charges","82.6% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1648.7,82.6,,1318.96,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4180.66,100,,,,,0,"fee schedule",EAPG,1996,100,,1596.80,,,0,"percent of total billed charges","100% of total billed charges",305.39,25451.55,
"23412 Repair of ruptured musculotendinous cuff (eg",7962698,CDM,521,RC,23412,CPT,OUTPATIENT,,,3151,2048.15,,2772.88,88,,2218.30,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,3151,100,,2520.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4140.73,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1985.13,63,,1588.10,,,0,"percent of total billed charges","63% of total billed charges",482.1,15.3,,385.68,,,0,"percent of total billed charges","15.3% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,2174.19,69,,,,,0,"fee schedule","69% of total billed charges",3151,100,,2520.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3151,100,,2520.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3151,100,,2520.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.53,100,,,,,0,"fee schedule",EAPG,5226.17,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1187.93,37.7,,950.34,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2457.78,78,,1966.22,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2602.73,82.6,,2082.18,,,0,"percent of total billed charges","82.6% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2602.73,82.6,,2082.18,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4180.66,100,,,,,0,"fee schedule",EAPG,3151,100,,2520.80,,,0,"percent of total billed charges","100% of total billed charges",482.1,25451.55,
"23410 Repair of ruptured musculotendinous cuff (eg",7962768,CDM,521,RC,23410,CPT,OUTPATIENT,,,3344,2173.6,,2942.72,88,,2354.18,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,3344,100,,2675.20,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4140.73,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2106.72,63,,1685.38,,,0,"percent of total billed charges","63% of total billed charges",511.63,15.3,,409.30,,,0,"percent of total billed charges","15.3% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,2307.36,69,,,,,0,"fee schedule","69% of total billed charges",3344,100,,2675.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3344,100,,2675.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3344,100,,2675.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.53,100,,,,,0,"fee schedule",EAPG,5226.17,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1260.69,37.7,,1008.55,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2608.32,78,,2086.66,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2762.14,82.6,,2209.71,,,0,"percent of total billed charges","82.6% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2762.14,82.6,,2209.71,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4180.66,100,,,,,0,"fee schedule",EAPG,3344,100,,2675.20,,,0,"percent of total billed charges","100% of total billed charges",511.63,25451.55,
"23415 Coracoacromial ligament release, with or wit",7963044,CDM,521,RC,23415,CPT,OUTPATIENT,,,2208,1435.2,,1943.04,88,,1554.43,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,2208,100,,1766.40,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4140.73,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1391.04,63,,1112.83,,,0,"percent of total billed charges","63% of total billed charges",337.82,15.3,,270.26,,,0,"percent of total billed charges","15.3% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,1523.52,69,,,,,0,"fee schedule","69% of total billed charges",2208,100,,1766.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2208,100,,1766.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2208,100,,1766.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.53,100,,,,,0,"fee schedule",EAPG,5226.17,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",832.42,37.7,,665.94,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1722.24,78,,1377.79,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1823.81,82.6,,1459.05,,,0,"percent of total billed charges","82.6% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1823.81,82.6,,1459.05,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4180.66,100,,,,,0,"fee schedule",EAPG,2208,100,,1766.40,,,0,"percent of total billed charges","100% of total billed charges",337.82,25451.55,
"23420 Reconstruction of complete shoulder (rotator",7961575,CDM,521,RC,23420,CPT,OUTPATIENT,,,4201,2730.65,,3696.88,88,,2957.50,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,4201,100,,3360.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4140.73,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2646.63,63,,2117.30,,,0,"percent of total billed charges","63% of total billed charges",642.75,15.3,,514.20,,,0,"percent of total billed charges","15.3% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,2898.69,69,,,,,0,"fee schedule","69% of total billed charges",4201,100,,3360.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4201,100,,3360.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4201,100,,3360.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.53,100,,,,,0,"fee schedule",EAPG,5226.17,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1583.78,37.7,,1267.02,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3276.78,78,,2621.42,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3470.03,82.6,,2776.02,,,0,"percent of total billed charges","82.6% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3470.03,82.6,,2776.02,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4180.66,100,,,,,0,"fee schedule",EAPG,4201,100,,3360.80,,,0,"percent of total billed charges","100% of total billed charges",642.75,25451.55,
"23430 Tenodesis of long tendon of biceps",7963688,CDM,521,RC,23430,CPT,OUTPATIENT,,,2556,1661.4,,2249.28,88,,1799.42,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,2556,100,,2044.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4140.73,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1610.28,63,,1288.22,,,0,"percent of total billed charges","63% of total billed charges",391.07,15.3,,312.86,,,0,"percent of total billed charges","15.3% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,1763.64,69,,,,,0,"fee schedule","69% of total billed charges",2556,100,,2044.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2556,100,,2044.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2556,100,,2044.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.53,100,,,,,0,"fee schedule",EAPG,5226.17,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",963.61,37.7,,770.89,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1993.68,78,,1594.94,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2111.26,82.6,,1689.01,,,0,"percent of total billed charges","82.6% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2111.26,82.6,,1689.01,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4180.66,100,,,,,0,"fee schedule",EAPG,2556,100,,2044.80,,,0,"percent of total billed charges","100% of total billed charges",391.07,25451.55,
"23440 Resection or transplantation of long tendon",7963298,CDM,521,RC,23440,CPT,OUTPATIENT,,,2253,1464.45,,1982.64,88,,1586.11,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,2253,100,,1802.40,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4140.73,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1419.39,63,,1135.51,,,0,"percent of total billed charges","63% of total billed charges",344.71,15.3,,275.77,,,0,"percent of total billed charges","15.3% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,1554.57,69,,,,,0,"fee schedule","69% of total billed charges",2253,100,,1802.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2253,100,,1802.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2253,100,,1802.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.53,100,,,,,0,"fee schedule",EAPG,5226.17,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",849.38,37.7,,679.50,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1757.34,78,,1405.87,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1860.98,82.6,,1488.78,,,0,"percent of total billed charges","82.6% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1860.98,82.6,,1488.78,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4180.66,100,,,,,0,"fee schedule",EAPG,2253,100,,1802.40,,,0,"percent of total billed charges","100% of total billed charges",344.71,25451.55,
"23450 Capsulorrhaphy, anterior; Putti-Platt proced",7962665,CDM,521,RC,23450,CPT,OUTPATIENT,,,3503,2276.95,,3082.64,88,,2466.11,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,3503,100,,2802.40,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4140.73,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2206.89,63,,1765.51,,,0,"percent of total billed charges","63% of total billed charges",535.96,15.3,,428.77,,,0,"percent of total billed charges","15.3% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,2417.07,69,,,,,0,"fee schedule","69% of total billed charges",3503,100,,2802.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3503,100,,2802.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3503,100,,2802.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.53,100,,,,,0,"fee schedule",EAPG,5226.17,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1320.63,37.7,,1056.50,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2732.34,78,,2185.87,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2893.48,82.6,,2314.78,,,0,"percent of total billed charges","82.6% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2893.48,82.6,,2314.78,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4180.66,100,,,,,0,"fee schedule",EAPG,3503,100,,2802.40,,,0,"percent of total billed charges","100% of total billed charges",535.96,25451.55,
"23455 Capsulorrhaphy, anterior; with labral repair",7962873,CDM,521,RC,23455,CPT,OUTPATIENT,,,4097,2663.05,,3605.36,88,,2884.29,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,4097,100,,3277.60,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4140.73,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2581.11,63,,2064.89,,,0,"percent of total billed charges","63% of total billed charges",626.84,15.3,,501.47,,,0,"percent of total billed charges","15.3% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,2826.93,69,,,,,0,"fee schedule","69% of total billed charges",4097,100,,3277.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4097,100,,3277.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4097,100,,3277.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.53,100,,,,,0,"fee schedule",EAPG,5226.17,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1544.57,37.7,,1235.66,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3195.66,78,,2556.53,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3384.12,82.6,,2707.30,,,0,"percent of total billed charges","82.6% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3384.12,82.6,,2707.30,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4180.66,100,,,,,0,"fee schedule",EAPG,4097,100,,3277.60,,,0,"percent of total billed charges","100% of total billed charges",626.84,25451.55,
"23466 Capsulorrhaphy, glenohumeral joint, any type",7962666,CDM,521,RC,23466,CPT,OUTPATIENT,,,4147,2695.55,,3649.36,88,,2919.49,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,4147,100,,3317.60,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4140.73,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2612.61,63,,2090.09,,,0,"percent of total billed charges","63% of total billed charges",634.49,15.3,,507.59,,,0,"percent of total billed charges","15.3% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,2861.43,69,,,,,0,"fee schedule","69% of total billed charges",4147,100,,3317.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4147,100,,3317.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4147,100,,3317.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.53,100,,,,,0,"fee schedule",EAPG,5226.17,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1563.42,37.7,,1250.74,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3234.66,78,,2587.73,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3425.42,82.6,,2740.34,,,0,"percent of total billed charges","82.6% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3425.42,82.6,,2740.34,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4180.66,100,,,,,0,"fee schedule",EAPG,4147,100,,3317.60,,,0,"percent of total billed charges","100% of total billed charges",634.49,25451.55,
"23462 Capsulorrhaphy, anterior, any type; with cor",7962927,CDM,521,RC,23462,CPT,OUTPATIENT,,,3429,2228.85,,3017.52,88,,2414.02,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,3429,100,,2743.20,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4140.73,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2160.27,63,,1728.22,,,0,"percent of total billed charges","63% of total billed charges",524.64,15.3,,419.71,,,0,"percent of total billed charges","15.3% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,2366.01,69,,,,,0,"fee schedule","69% of total billed charges",3429,100,,2743.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3429,100,,2743.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3429,100,,2743.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.53,100,,,,,0,"fee schedule",EAPG,5226.17,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1292.73,37.7,,1034.18,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2674.62,78,,2139.70,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2832.35,82.6,,2265.88,,,0,"percent of total billed charges","82.6% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2832.35,82.6,,2265.88,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4180.66,100,,,,,0,"fee schedule",EAPG,3429,100,,2743.20,,,0,"percent of total billed charges","100% of total billed charges",524.64,25451.55,
"23460 Capsulorrhaphy, anterior, any type; with bon",7963353,CDM,521,RC,23460,CPT,OUTPATIENT,,,3856,2506.4,,3393.28,88,,2714.62,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,3856,100,,3084.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4140.73,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2429.28,63,,1943.42,,,0,"percent of total billed charges","63% of total billed charges",589.97,15.3,,471.98,,,0,"percent of total billed charges","15.3% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,2660.64,69,,,,,0,"fee schedule","69% of total billed charges",3856,100,,3084.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3856,100,,3084.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3856,100,,3084.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.53,100,,,,,0,"fee schedule",EAPG,5226.17,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1453.71,37.7,,1162.97,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3007.68,78,,2406.14,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3185.06,82.6,,2548.05,,,0,"percent of total billed charges","82.6% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3185.06,82.6,,2548.05,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4180.66,100,,,,,0,"fee schedule",EAPG,3856,100,,3084.80,,,0,"percent of total billed charges","100% of total billed charges",589.97,25451.55,
"23474 Revision of total shoulder arthroplasty, inc",7961737,CDM,521,RC,23474,CPT,OUTPATIENT,,,6967,4528.55,,6130.96,88,,4904.77,,,0,"percent of total billed charges","88% of total billed charges",6967,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8399.65,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6967,175,,,,,0,"fee schedule","175% of CMS fee schedule",8651.64,100,,,,,0,"fee schedule",EAPG,6967,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4389.21,63,,3511.37,,,0,"percent of total billed charges","63% of total billed charges",1065.95,15.3,,852.76,,,0,"percent of total billed charges","15.3% of total billed charges",8399.65,100,,,,,0,"fee schedule",EAPG,4807.23,69,,,,,0,"fee schedule","69% of total billed charges",6967,100,,5573.60,,,0,"percent of total billed charges","100% of total billed charges",6967,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6967,100,,5573.60,,,0,"percent of total billed charges","100% of total billed charges",6967,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6967,100,,5573.60,,,0,"percent of total billed charges","100% of total billed charges",6967,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8399.65,100,,,,,0,"fee schedule",EAPG,6967,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6967,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",6967,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8567.64,100,,,,,0,"fee schedule",EAPG,10919.55,100,,,,,0,"fee schedule",EAPG,6967,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2626.56,37.7,,2101.25,,,0,"percent of total billed charges","37.70% of total billed charges",6967,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6967,100,,,,,0,"fee schedule","100% of CMS fee schedule",5434.26,78,,4347.41,,,0,"percent of total billed charges","78% of total billed charges",6967,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5754.74,82.6,,4603.79,,,0,"percent of total billed charges","82.6% of total billed charges",8399.65,100,,,,,0,"fee schedule","100% of WA fee schedule",6967,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5754.74,82.6,,4603.79,,,0,"percent of total billed charges","82.6% of total billed charges",6967,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8560.18,100,,,,,0,"fee schedule",EAPG,6967,100,,5573.60,,,0,"percent of total billed charges","100% of total billed charges",1065.95,50029.1,
"23473 Revision of total shoulder arthroplasty, inc",7961802,CDM,521,RC,23473,CPT,OUTPATIENT,,,6448,4191.2,,5674.24,88,,4539.39,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8399.65,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",8651.64,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4062.24,63,,3249.79,,,0,"percent of total billed charges","63% of total billed charges",986.54,15.3,,789.23,,,0,"percent of total billed charges","15.3% of total billed charges",8399.65,100,,,,,0,"fee schedule",EAPG,4449.12,69,,,,,0,"fee schedule","69% of total billed charges",6448,100,,5158.40,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6448,100,,5158.40,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6448,100,,5158.40,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8399.65,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8567.64,100,,,,,0,"fee schedule",EAPG,10919.55,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2430.9,37.7,,1944.72,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5029.44,78,,4023.55,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5326.05,82.6,,4260.84,,,0,"percent of total billed charges","82.6% of total billed charges",8399.65,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5326.05,82.6,,4260.84,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8560.18,100,,,,,0,"fee schedule",EAPG,6448,100,,5158.40,,,0,"percent of total billed charges","100% of total billed charges",986.54,50029.1,
"23470 Arthroplasty, glenohumeral joint; hemiarthro",7963379,CDM,521,RC,23470,CPT,OUTPATIENT,,,4131,2685.15,,3635.28,88,,2908.22,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8399.65,100,,,,,0,"fee schedule",EAPG,4131,100,,3304.80,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",8651.64,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2602.53,63,,2082.02,,,0,"percent of total billed charges","63% of total billed charges",632.04,15.3,,505.63,,,0,"percent of total billed charges","15.3% of total billed charges",8399.65,100,,,,,0,"fee schedule",EAPG,2850.39,69,,,,,0,"fee schedule","69% of total billed charges",4131,100,,3304.80,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4131,100,,3304.80,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4131,100,,3304.80,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8399.65,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8567.64,100,,,,,0,"fee schedule",EAPG,10919.55,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1557.39,37.7,,1245.91,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.18,78,,2577.74,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3412.21,82.6,,2729.77,,,0,"percent of total billed charges","82.6% of total billed charges",8399.65,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3412.21,82.6,,2729.77,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8560.18,100,,,,,0,"fee schedule",EAPG,4131,100,,3304.80,,,0,"percent of total billed charges","100% of total billed charges",632.04,50029.1,
"23472 Arthroplasty, glenohumeral joint; total shou",7963423,CDM,521,RC,23472,CPT,OUTPATIENT,,,5790,3763.5,,5095.2,88,,4076.16,,,0,"percent of total billed charges","88% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8399.65,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",33264.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",8651.64,100,,,,,0,"fee schedule",EAPG,19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3647.7,63,,2918.16,,,0,"percent of total billed charges","63% of total billed charges",885.87,15.3,,708.70,,,0,"percent of total billed charges","15.3% of total billed charges",8399.65,100,,,,,0,"fee schedule",EAPG,3995.1,69,,,,,0,"fee schedule","69% of total billed charges",5790,100,,4632.00,,,0,"percent of total billed charges","100% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5790,100,,4632.00,,,0,"percent of total billed charges","100% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5790,100,,4632.00,,,0,"percent of total billed charges","100% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8399.65,100,,,,,0,"fee schedule",EAPG,19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8567.64,100,,,,,0,"fee schedule",EAPG,10919.55,100,,,,,0,"fee schedule",EAPG,19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2182.83,37.7,,1746.26,,,0,"percent of total billed charges","37.70% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4516.2,78,,3612.96,,,0,"percent of total billed charges","78% of total billed charges",19198.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4782.54,82.6,,3826.03,,,0,"percent of total billed charges","82.6% of total billed charges",8399.65,100,,,,,0,"fee schedule",EAPG,19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4782.54,82.6,,3826.03,,,0,"percent of total billed charges","82.6% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8560.18,100,,,,,0,"fee schedule",EAPG,5790,100,,4632.00,,,0,"percent of total billed charges","100% of total billed charges",885.87,50029.1,
"23485 Osteotomy, clavicle, w/wo internal fixation;",7962360,CDM,521,RC,23485,CPT,OUTPATIENT,,,2782,1808.3,,2448.16,88,,1958.53,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8682.91,100,,,,,0,"fee schedule",EAPG,2782,100,,2225.60,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",8943.4,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1752.66,63,,1402.13,,,0,"percent of total billed charges","63% of total billed charges",425.65,15.3,,340.52,,,0,"percent of total billed charges","15.3% of total billed charges",8682.91,100,,,,,0,"fee schedule",EAPG,1919.58,69,,,,,0,"fee schedule","69% of total billed charges",2782,100,,2225.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2782,100,,2225.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2782,100,,2225.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8682.91,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8856.57,100,,,,,0,"fee schedule",EAPG,11287.79,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1048.81,37.7,,839.05,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2169.96,78,,1735.97,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2297.93,82.6,,1838.34,,,0,"percent of total billed charges","82.6% of total billed charges",8682.91,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2297.93,82.6,,1838.34,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8843.44,100,,,,,0,"fee schedule",EAPG,2782,100,,2225.60,,,0,"percent of total billed charges","100% of total billed charges",425.65,50029.1,
"23500 Closed treatment of clavicular fracture; wit",7903132,CDM,521,RC,23500,CPT,OUTPATIENT,,,576,374.4,,506.88,88,,405.50,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,576,100,,460.80,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",362.88,63,,290.30,,,0,"percent of total billed charges","63% of total billed charges",88.13,15.3,,70.50,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,397.44,69,,,,,0,"fee schedule","69% of total billed charges",576,100,,460.80,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",576,100,,460.80,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",576,100,,460.80,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",217.15,37.7,,173.72,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.28,78,,359.42,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",475.78,82.6,,380.62,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",475.78,82.6,,380.62,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,576,100,,460.80,,,0,"percent of total billed charges","100% of total billed charges",88.13,837.64,
"23505 Closed treatment of clavicular fracture; wit",7963165,CDM,521,RC,23505,CPT,OUTPATIENT,,,833,541.45,,733.04,88,,586.43,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,833,100,,666.40,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",524.79,63,,419.83,,,0,"percent of total billed charges","63% of total billed charges",127.45,15.3,,101.96,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,574.77,69,,,,,0,"fee schedule","69% of total billed charges",833,100,,666.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",833,100,,666.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",833,100,,666.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",314.04,37.7,,251.23,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",649.74,78,,519.79,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",688.06,82.6,,550.45,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",688.06,82.6,,550.45,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,833,100,,666.40,,,0,"percent of total billed charges","100% of total billed charges",127.45,5656.45,
"23515 Open treatment of clavicular fracture, inclu",7962437,CDM,521,RC,23515,CPT,OUTPATIENT,,,2347,1525.55,,2065.36,88,,1652.29,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2347,100,,1877.60,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.61,63,,1182.89,,,0,"percent of total billed charges","63% of total billed charges",359.09,15.3,,287.27,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1619.43,69,,,,,0,"fee schedule","69% of total billed charges",2347,100,,1877.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2347,100,,1877.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2347,100,,1877.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",884.82,37.7,,707.86,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1830.66,78,,1464.53,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1938.62,82.6,,1550.90,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1938.62,82.6,,1550.90,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2347,100,,1877.60,,,0,"percent of total billed charges","100% of total billed charges",359.09,25451.55,
"23530 Open treatment of sternoclavicular dislocati",7962922,CDM,521,RC,23530,CPT,OUTPATIENT,,,1866,1212.9,,1642.08,88,,1313.66,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,1866,100,,1492.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1175.58,63,,940.46,,,0,"percent of total billed charges","63% of total billed charges",285.5,15.3,,228.40,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1287.54,69,,,,,0,"fee schedule","69% of total billed charges",1866,100,,1492.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1866,100,,1492.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1866,100,,1492.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",703.48,37.7,,562.78,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1455.48,78,,1164.38,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1541.32,82.6,,1233.06,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1541.32,82.6,,1233.06,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,1866,100,,1492.80,,,0,"percent of total billed charges","100% of total billed charges",285.5,25451.55,
"23552 Open tx acromioclavicular dislocation, acute",7962624,CDM,521,RC,23552,CPT,OUTPATIENT,,,1882,1223.3,,1656.16,88,,1324.93,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,1882,100,,1505.60,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1185.66,63,,948.53,,,0,"percent of total billed charges","63% of total billed charges",287.95,15.3,,230.36,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1298.58,69,,,,,0,"fee schedule","69% of total billed charges",1882,100,,1505.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1882,100,,1505.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1882,100,,1505.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",709.51,37.7,,567.61,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1467.96,78,,1174.37,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1554.53,82.6,,1243.62,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1554.53,82.6,,1243.62,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,1882,100,,1505.60,,,0,"percent of total billed charges","100% of total billed charges",287.95,25451.55,
"23550 Open treatment of acromioclavicular dislocat",7962928,CDM,521,RC,23550,CPT,OUTPATIENT,,,1635,1062.75,,1438.8,88,,1151.04,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,1635,100,,1308.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1030.05,63,,824.04,,,0,"percent of total billed charges","63% of total billed charges",250.16,15.3,,200.13,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1128.15,69,,,,,0,"fee schedule","69% of total billed charges",1635,100,,1308.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1635,100,,1308.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1635,100,,1308.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",616.4,37.7,,493.12,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1275.3,78,,1020.24,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1350.51,82.6,,1080.41,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1350.51,82.6,,1080.41,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,1635,100,,1308.00,,,0,"percent of total billed charges","100% of total billed charges",250.16,25451.55,
"23585 Open treatment of scapular fracture includes",7962520,CDM,521,RC,23585,CPT,OUTPATIENT,,,2878,1870.7,,2532.64,88,,2026.11,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2878,100,,2302.40,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1813.14,63,,1450.51,,,0,"percent of total billed charges","63% of total billed charges",440.33,15.3,,352.26,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1985.82,69,,,,,0,"fee schedule","69% of total billed charges",2878,100,,2302.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2878,100,,2302.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2878,100,,2302.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1085.01,37.7,,868.01,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2244.84,78,,1795.87,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2377.23,82.6,,1901.78,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2377.23,82.6,,1901.78,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2878,100,,2302.40,,,0,"percent of total billed charges","100% of total billed charges",440.33,25451.55,
"23600 Closed treatment of proximal humeral fractur",7903201,CDM,521,RC,23600,CPT,OUTPATIENT,,,927,602.55,,815.76,88,,652.61,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",584.01,63,,467.21,,,0,"percent of total billed charges","63% of total billed charges",141.83,15.3,,113.46,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,639.63,69,,,,,0,"fee schedule","69% of total billed charges",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",349.48,37.7,,279.58,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",723.06,78,,578.45,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",765.7,82.6,,612.56,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,927,100,,741.60,,,0,"percent of total billed charges","100% of total billed charges",141.83,927,
"23605 Closed treatment of proximal humeral fractur",7961901,CDM,521,RC,23605,CPT,OUTPATIENT,,,1407,914.55,,1238.16,88,,990.53,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1407,100,,1125.60,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.41,63,,709.13,,,0,"percent of total billed charges","63% of total billed charges",215.27,15.3,,172.22,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,970.83,69,,,,,0,"fee schedule","69% of total billed charges",1407,100,,1125.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1407,100,,1125.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1407,100,,1125.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",530.44,37.7,,424.35,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1097.46,78,,877.97,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1162.18,82.6,,929.74,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1162.18,82.6,,929.74,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,1407,100,,1125.60,,,0,"percent of total billed charges","100% of total billed charges",215.27,5656.45,
"23616 Open tx proximal humeral fx, incl int fixati",7961803,CDM,521,RC,23616,CPT,OUTPATIENT,,,5855,3805.75,,5152.4,88,,4121.92,,,0,"percent of total billed charges","88% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",33264.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3688.65,63,,2950.92,,,0,"percent of total billed charges","63% of total billed charges",895.82,15.3,,716.66,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,4039.95,69,,,,,0,"fee schedule","69% of total billed charges",5855,100,,4684.00,,,0,"percent of total billed charges","100% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5855,100,,4684.00,,,0,"percent of total billed charges","100% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5855,100,,4684.00,,,0,"percent of total billed charges","100% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",64464.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16853.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2207.34,37.7,,1765.87,,,0,"percent of total billed charges","37.70% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4566.9,78,,3653.52,,,0,"percent of total billed charges","78% of total billed charges",19198.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4836.23,82.6,,3868.98,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4836.23,82.6,,3868.98,,,0,"percent of total billed charges","82.6% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,5855,100,,4684.00,,,0,"percent of total billed charges","100% of total billed charges",895.82,64464.78,
"23615 Open tx proximal humeral fx, incl int fixati",7962546,CDM,521,RC,23615,CPT,OUTPATIENT,,,3326,2161.9,,2926.88,88,,2341.50,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3326,100,,2660.80,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2095.38,63,,1676.30,,,0,"percent of total billed charges","63% of total billed charges",508.88,15.3,,407.10,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,2294.94,69,,,,,0,"fee schedule","69% of total billed charges",3326,100,,2660.80,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3326,100,,2660.80,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3326,100,,2660.80,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1253.9,37.7,,1003.12,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2594.28,78,,2075.42,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2747.28,82.6,,2197.82,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2747.28,82.6,,2197.82,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,3326,100,,2660.80,,,0,"percent of total billed charges","100% of total billed charges",508.88,50029.1,
"23630 Open tx greater humeral tuberosity fracture,",7962165,CDM,521,RC,23630,CPT,OUTPATIENT,,,2436,1583.4,,2143.68,88,,1714.94,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2436,100,,1948.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1534.68,63,,1227.74,,,0,"percent of total billed charges","63% of total billed charges",372.71,15.3,,298.17,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1680.84,69,,,,,0,"fee schedule","69% of total billed charges",2436,100,,1948.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2436,100,,1948.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2436,100,,1948.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",918.37,37.7,,734.70,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1900.08,78,,1520.06,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2012.14,82.6,,1609.71,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2012.14,82.6,,1609.71,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2436,100,,1948.80,,,0,"percent of total billed charges","100% of total billed charges",372.71,25451.55,
"23650 Closed treatment of shoulder dislocation, wi",7903203,CDM,521,RC,23650,CPT,OUTPATIENT,,,662,430.3,,582.56,88,,466.05,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,662,100,,529.60,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",417.06,63,,333.65,,,0,"percent of total billed charges","63% of total billed charges",101.29,15.3,,81.03,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,456.78,69,,,,,0,"fee schedule","69% of total billed charges",662,100,,529.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",662,100,,529.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",662,100,,529.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.57,37.7,,199.66,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",516.36,78,,413.09,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",546.81,82.6,,437.45,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",546.81,82.6,,437.45,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,662,100,,529.60,,,0,"percent of total billed charges","100% of total billed charges",101.29,837.64,
"23655 Closed treatment of shoulder dislocation, wi",7962438,CDM,521,RC,23655,CPT,OUTPATIENT,,,1180,767,,1038.4,88,,830.72,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,1180,100,,944.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",916.1,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",743.4,63,,594.72,,,0,"percent of total billed charges","63% of total billed charges",180.54,15.3,,144.43,,,0,"percent of total billed charges","15.3% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,814.2,69,,,,,0,"fee schedule","69% of total billed charges",1180,100,,944.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1180,100,,944.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1180,100,,944.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.21,100,,,,,0,"fee schedule",EAPG,1156.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",444.86,37.7,,355.89,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",920.4,78,,736.32,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",974.68,82.6,,779.74,,,0,"percent of total billed charges","82.6% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",974.68,82.6,,779.74,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1049.95,100,,,,,0,"fee schedule",EAPG,1180,100,,944.00,,,0,"percent of total billed charges","100% of total billed charges",180.54,5656.45,
"23670 Open treatment of shoulder dislocation, with",7961970,CDM,521,RC,23670,CPT,OUTPATIENT,,,2191,1424.15,,1928.08,88,,1542.46,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2191,100,,1752.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1380.33,63,,1104.26,,,0,"percent of total billed charges","63% of total billed charges",335.22,15.3,,268.18,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1511.79,69,,,,,0,"fee schedule","69% of total billed charges",2191,100,,1752.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2191,100,,1752.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2191,100,,1752.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",826.01,37.7,,660.81,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1708.98,78,,1367.18,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1809.77,82.6,,1447.82,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1809.77,82.6,,1447.82,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2191,100,,1752.80,,,0,"percent of total billed charges","100% of total billed charges",335.22,25451.55,
"23680 Open tx shoulder dislocation, with surgical",7961576,CDM,521,RC,23680,CPT,OUTPATIENT,,,2568,1669.2,,2259.84,88,,1807.87,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2568,100,,2054.40,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1617.84,63,,1294.27,,,0,"percent of total billed charges","63% of total billed charges",392.9,15.3,,314.32,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1771.92,69,,,,,0,"fee schedule","69% of total billed charges",2568,100,,2054.40,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2568,100,,2054.40,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2568,100,,2054.40,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",968.14,37.7,,774.51,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2003.04,78,,1602.43,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2121.17,82.6,,1696.94,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2121.17,82.6,,1696.94,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2568,100,,2054.40,,,0,"percent of total billed charges","100% of total billed charges",392.9,50029.1,
"23700 Manipulation under anesthesia, shoulder join",7961804,CDM,521,RC,23700,CPT,OUTPATIENT,,,756,491.4,,665.28,88,,532.22,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,756,100,,604.80,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",916.1,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",476.28,63,,381.02,,,0,"percent of total billed charges","63% of total billed charges",115.67,15.3,,92.54,,,0,"percent of total billed charges","15.3% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,521.64,69,,,,,0,"fee schedule","69% of total billed charges",756,100,,604.80,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",756,100,,604.80,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",756,100,,604.80,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.21,100,,,,,0,"fee schedule",EAPG,1156.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",285.01,37.7,,228.01,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",589.68,78,,471.74,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",624.46,82.6,,499.57,,,0,"percent of total billed charges","82.6% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",624.46,82.6,,499.57,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1049.95,100,,,,,0,"fee schedule",EAPG,756,100,,604.80,,,0,"percent of total billed charges","100% of total billed charges",115.67,5656.45,
"23929 Unlisted procedure, shoulder",7963775,CDM,521,RC,23929,CPT,OUTPATIENT,,,4048,2631.2,,3562.24,88,,2849.79,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,4048,100,,3238.40,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2550.24,63,,2040.19,,,0,"percent of total billed charges","63% of total billed charges",619.34,15.3,,495.47,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,2793.12,69,,,,,0,"fee schedule","69% of total billed charges",4048,100,,3238.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4048,100,,3238.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4048,100,,3238.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1526.1,37.7,,1220.88,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3157.44,78,,2525.95,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3343.65,82.6,,2674.92,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3343.65,82.6,,2674.92,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,4048,100,,3238.40,,,0,"percent of total billed charges","100% of total billed charges",218.99,4048,
"23930 Incision and drainage, upper arm or elbow ar",7962737,CDM,521,RC,23930,CPT,OUTPATIENT,,,785,510.25,,690.8,88,,552.64,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",494.55,63,,395.64,,,0,"percent of total billed charges","63% of total billed charges",120.11,15.3,,96.09,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,541.65,69,,,,,0,"fee schedule","69% of total billed charges",785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",295.95,37.7,,236.76,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",612.3,78,,489.84,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",648.41,82.6,,518.73,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",648.41,82.6,,518.73,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",120.11,9628.23,
"23935 Incision, deep, with opening of bone cortex,",7963066,CDM,521,RC,23935,CPT,OUTPATIENT,,,1853,1204.45,,1630.64,88,,1304.51,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,1853,100,,1482.40,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",5267.52,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1167.39,63,,933.91,,,0,"percent of total billed charges","63% of total billed charges",283.51,15.3,,226.81,,,0,"percent of total billed charges","15.3% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,1278.57,69,,,,,0,"fee schedule","69% of total billed charges",1853,100,,1482.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1853,100,,1482.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1853,100,,1482.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5216.38,100,,,,,0,"fee schedule",EAPG,6648.32,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",698.58,37.7,,558.86,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1445.34,78,,1156.27,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.58,82.6,,1224.46,,,0,"percent of total billed charges","82.6% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.58,82.6,,1224.46,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5274.62,100,,,,,0,"fee schedule",EAPG,1853,100,,1482.40,,,0,"percent of total billed charges","100% of total billed charges",283.51,11498.59,
"23931 Incision and drainage, upper arm or elbow ar",7963299,CDM,521,RC,23931,CPT,OUTPATIENT,,,555,360.75,,488.4,88,,390.72,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,555,100,,444.00,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",349.65,63,,279.72,,,0,"percent of total billed charges","63% of total billed charges",84.92,15.3,,67.94,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,382.95,69,,,,,0,"fee schedule","69% of total billed charges",555,100,,444.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",555,100,,444.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",555,100,,444.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",209.24,37.7,,167.39,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",432.9,78,,346.32,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",458.43,82.6,,366.74,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",458.43,82.6,,366.74,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,555,100,,444.00,,,0,"percent of total billed charges","100% of total billed charges",84.92,5715.97,
"24006 Arthrotomy of the elbow, with capsular excis",7961886,CDM,521,RC,24006,CPT,OUTPATIENT,,,2899,1884.35,,2551.12,88,,2040.90,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,2899,100,,2319.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1826.37,63,,1461.10,,,0,"percent of total billed charges","63% of total billed charges",443.55,15.3,,354.84,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,2000.31,69,,,,,0,"fee schedule","69% of total billed charges",2899,100,,2319.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2899,100,,2319.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2899,100,,2319.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1092.92,37.7,,874.34,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2261.22,78,,1808.98,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2394.57,82.6,,1915.66,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2394.57,82.6,,1915.66,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,2899,100,,2319.20,,,0,"percent of total billed charges","100% of total billed charges",443.55,11498.59,
"24000 Arthrotomy, elbow, including exploration, dr",7962521,CDM,521,RC,24000,CPT,OUTPATIENT,,,1392,904.8,,1224.96,88,,979.97,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,1392,100,,1113.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",876.96,63,,701.57,,,0,"percent of total billed charges","63% of total billed charges",212.98,15.3,,170.38,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,960.48,69,,,,,0,"fee schedule","69% of total billed charges",1392,100,,1113.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1392,100,,1113.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1392,100,,1113.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",524.78,37.7,,419.82,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1085.76,78,,868.61,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1149.79,82.6,,919.83,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1149.79,82.6,,919.83,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,1392,100,,1113.60,,,0,"percent of total billed charges","100% of total billed charges",212.98,11498.59,
"24066 Biopsy, soft tissue of upper arm or elbow ar",7962400,CDM,521,RC,24066,CPT,OUTPATIENT,,,1198,778.7,,1054.24,88,,843.39,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1198,100,,958.40,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",754.74,63,,603.79,,,0,"percent of total billed charges","63% of total billed charges",183.29,15.3,,146.63,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,826.62,69,,,,,0,"fee schedule","69% of total billed charges",1198,100,,958.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1198,100,,958.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1198,100,,958.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",451.65,37.7,,361.32,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",934.44,78,,747.55,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",989.55,82.6,,791.64,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",989.55,82.6,,791.64,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,1198,100,,958.40,,,0,"percent of total billed charges","100% of total billed charges",183.29,9628.23,
"24065 Biopsy, soft tissue of upper arm or elbow ar",7963133,CDM,521,RC,24065,CPT,OUTPATIENT,,,491,319.15,,432.08,88,,345.66,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,491,100,,392.80,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.33,63,,247.46,,,0,"percent of total billed charges","63% of total billed charges",75.12,15.3,,60.10,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,338.79,69,,,,,0,"fee schedule","69% of total billed charges",491,100,,392.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",491,100,,392.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",491,100,,392.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",185.11,37.7,,148.09,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",382.98,78,,306.38,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",405.57,82.6,,324.46,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",405.57,82.6,,324.46,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,491,100,,392.80,,,0,"percent of total billed charges","100% of total billed charges",75.12,5715.97,
"24071 Excision, tumor, soft tissue of upper arm or",7962236,CDM,521,RC,24071,CPT,OUTPATIENT,,,1157,752.05,,1018.16,88,,814.53,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1157,100,,925.60,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",728.91,63,,583.13,,,0,"percent of total billed charges","63% of total billed charges",177.02,15.3,,141.62,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,798.33,69,,,,,0,"fee schedule","69% of total billed charges",1157,100,,925.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1157,100,,925.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1157,100,,925.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",436.19,37.7,,348.95,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",902.46,78,,721.97,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",955.68,82.6,,764.54,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",955.68,82.6,,764.54,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,1157,100,,925.60,,,0,"percent of total billed charges","100% of total billed charges",177.02,9628.23,
"24075 Excision, tumor, soft tissue of upper arm or",7962287,CDM,521,RC,24075,CPT,OUTPATIENT,,,1094,711.1,,962.72,88,,770.18,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1094,100,,875.20,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",689.22,63,,551.38,,,0,"percent of total billed charges","63% of total billed charges",167.38,15.3,,133.90,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,754.86,69,,,,,0,"fee schedule","69% of total billed charges",1094,100,,875.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1094,100,,875.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1094,100,,875.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",412.44,37.7,,329.95,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",853.32,78,,682.66,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.64,82.6,,722.91,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.64,82.6,,722.91,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,1094,100,,875.20,,,0,"percent of total billed charges","100% of total billed charges",167.38,5715.97,
"24073 Excision, tumor, soft tissue of upper arm or",7962316,CDM,521,RC,24073,CPT,OUTPATIENT,,,2018,1311.7,,1775.84,88,,1420.67,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,2018,100,,1614.40,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1271.34,63,,1017.07,,,0,"percent of total billed charges","63% of total billed charges",308.75,15.3,,247.00,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,1392.42,69,,,,,0,"fee schedule","69% of total billed charges",2018,100,,1614.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2018,100,,1614.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2018,100,,1614.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",760.79,37.7,,608.63,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1574.04,78,,1259.23,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1666.87,82.6,,1333.50,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1666.87,82.6,,1333.50,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,2018,100,,1614.40,,,0,"percent of total billed charges","100% of total billed charges",308.75,9628.23,
"24076 Excision, tumor, soft tissue of upper arm or",7962361,CDM,521,RC,24076,CPT,OUTPATIENT,,,1595,1036.75,,1403.6,88,,1122.88,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1595,100,,1276.00,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1004.85,63,,803.88,,,0,"percent of total billed charges","63% of total billed charges",244.04,15.3,,195.23,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1100.55,69,,,,,0,"fee schedule","69% of total billed charges",1595,100,,1276.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1595,100,,1276.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1595,100,,1276.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",601.32,37.7,,481.06,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1244.1,78,,995.28,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1317.47,82.6,,1053.98,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1317.47,82.6,,1053.98,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,1595,100,,1276.00,,,0,"percent of total billed charges","100% of total billed charges",244.04,9628.23,
"24101 Arthrotomy, elbow; with joint exploration, w",7961577,CDM,521,RC,24101,CPT,OUTPATIENT,,,2637,1714.05,,2320.56,88,,1856.45,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,2637,100,,2109.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1661.31,63,,1329.05,,,0,"percent of total billed charges","63% of total billed charges",403.46,15.3,,322.77,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,1819.53,69,,,,,0,"fee schedule","69% of total billed charges",2637,100,,2109.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2637,100,,2109.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2637,100,,2109.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",994.15,37.7,,795.32,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2056.86,78,,1645.49,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2178.16,82.6,,1742.53,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2178.16,82.6,,1742.53,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,2637,100,,2109.60,,,0,"percent of total billed charges","100% of total billed charges",403.46,11498.59,
"24102 Arthrotomy, elbow; with synovectomy",7963652,CDM,521,RC,24102,CPT,OUTPATIENT,,,3161,2054.65,,2781.68,88,,2225.34,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,3161,100,,2528.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1991.43,63,,1593.14,,,0,"percent of total billed charges","63% of total billed charges",483.63,15.3,,386.90,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,2181.09,69,,,,,0,"fee schedule","69% of total billed charges",3161,100,,2528.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3161,100,,2528.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3161,100,,2528.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1191.7,37.7,,953.36,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2465.58,78,,1972.46,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2610.99,82.6,,2088.79,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2610.99,82.6,,2088.79,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,3161,100,,2528.80,,,0,"percent of total billed charges","100% of total billed charges",483.63,11498.59,
"24105 Excision, olecranon bursa",7963844,CDM,521,RC,24105,CPT,OUTPATIENT,,,1406,913.9,,1237.28,88,,989.82,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,1406,100,,1124.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",885.78,63,,708.62,,,0,"percent of total billed charges","63% of total billed charges",215.12,15.3,,172.10,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,970.14,69,,,,,0,"fee schedule","69% of total billed charges",1406,100,,1124.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1406,100,,1124.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1406,100,,1124.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",530.06,37.7,,424.05,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1096.68,78,,877.34,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1161.36,82.6,,929.09,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1161.36,82.6,,929.09,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,1406,100,,1124.80,,,0,"percent of total billed charges","100% of total billed charges",215.12,11498.59,
"24116 Excision or curettage of bone cyst or benign",7962578,CDM,521,RC,24116,CPT,OUTPATIENT,,,2149,1396.85,,1891.12,88,,1512.90,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,2149,100,,1719.20,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4140.73,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.87,63,,1083.10,,,0,"percent of total billed charges","63% of total billed charges",328.8,15.3,,263.04,,,0,"percent of total billed charges","15.3% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,1482.81,69,,,,,0,"fee schedule","69% of total billed charges",2149,100,,1719.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2149,100,,1719.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2149,100,,1719.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.53,100,,,,,0,"fee schedule",EAPG,5226.17,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",810.17,37.7,,648.14,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1676.22,78,,1340.98,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1775.07,82.6,,1420.06,,,0,"percent of total billed charges","82.6% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1775.07,82.6,,1420.06,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4180.66,100,,,,,0,"fee schedule",EAPG,2149,100,,1719.20,,,0,"percent of total billed charges","100% of total billed charges",328.8,25451.55,
"24110 Excision or curettage of bone cyst or benign",7963098,CDM,521,RC,24110,CPT,OUTPATIENT,,,2274,1478.1,,2001.12,88,,1600.90,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,2274,100,,1819.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4140.73,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1432.62,63,,1146.10,,,0,"percent of total billed charges","63% of total billed charges",347.92,15.3,,278.34,,,0,"percent of total billed charges","15.3% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,1569.06,69,,,,,0,"fee schedule","69% of total billed charges",2274,100,,1819.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2274,100,,1819.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2274,100,,1819.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.53,100,,,,,0,"fee schedule",EAPG,5226.17,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",857.3,37.7,,685.84,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1773.72,78,,1418.98,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1878.32,82.6,,1502.66,,,0,"percent of total billed charges","82.6% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1878.32,82.6,,1502.66,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4180.66,100,,,,,0,"fee schedule",EAPG,2274,100,,1819.20,,,0,"percent of total billed charges","100% of total billed charges",347.92,11498.59,
"24120 Excision or curettage of bone cyst/benign tu",7961665,CDM,521,RC,24120,CPT,OUTPATIENT,,,1841,1196.65,,1620.08,88,,1296.06,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,1841,100,,1472.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1159.83,63,,927.86,,,0,"percent of total billed charges","63% of total billed charges",281.67,15.3,,225.34,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,1270.29,69,,,,,0,"fee schedule","69% of total billed charges",1841,100,,1472.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1841,100,,1472.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1841,100,,1472.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",694.06,37.7,,555.25,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1435.98,78,,1148.78,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1520.67,82.6,,1216.54,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1520.67,82.6,,1216.54,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,1841,100,,1472.80,,,0,"percent of total billed charges","100% of total billed charges",281.67,11498.59,
"24147 Partial excision bone, olecranon process",7963577,CDM,521,RC,24147,CPT,OUTPATIENT,,,2385,1550.25,,2098.8,88,,1679.04,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,2385,100,,1908.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1502.55,63,,1202.04,,,0,"percent of total billed charges","63% of total billed charges",364.91,15.3,,291.93,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,1645.65,69,,,,,0,"fee schedule","69% of total billed charges",2385,100,,1908.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2385,100,,1908.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2385,100,,1908.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",899.15,37.7,,719.32,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1860.3,78,,1488.24,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1970.01,82.6,,1576.01,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1970.01,82.6,,1576.01,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,2385,100,,1908.00,,,0,"percent of total billed charges","100% of total billed charges",364.91,11498.59,
"24164 Excision or curettage of bone cyst or benign",7963099,CDM,521,RC,24164,CPT,OUTPATIENT,,,2036,1323.4,,1791.68,88,,1433.34,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,2036,100,,1628.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1282.68,63,,1026.14,,,0,"percent of total billed charges","63% of total billed charges",311.51,15.3,,249.21,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,1404.84,69,,,,,0,"fee schedule","69% of total billed charges",2036,100,,1628.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2036,100,,1628.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2036,100,,1628.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",767.57,37.7,,614.06,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1588.08,78,,1270.46,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1681.74,82.6,,1345.39,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1681.74,82.6,,1345.39,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,2036,100,,1628.80,,,0,"percent of total billed charges","100% of total billed charges",311.51,11498.59,
"24200 Removal of foreign body, upper arm or elbow",7903205,CDM,521,RC,24200,CPT,OUTPATIENT,,,852,553.8,,749.76,88,,599.81,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,852,100,,681.60,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",536.76,63,,429.41,,,0,"percent of total billed charges","63% of total billed charges",130.36,15.3,,104.29,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,587.88,69,,,,,0,"fee schedule","69% of total billed charges",852,100,,681.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",852,100,,681.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",852,100,,681.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",321.2,37.7,,256.96,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",664.56,78,,531.65,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",703.75,82.6,,563.00,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",703.75,82.6,,563.00,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,852,100,,681.60,,,0,"percent of total billed charges","100% of total billed charges",130.36,5715.97,
"24201 Removal of foreign body, upper arm or elbow",7962317,CDM,521,RC,24201,CPT,OUTPATIENT,,,1685,1095.25,,1482.8,88,,1186.24,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1685,100,,1348.00,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1061.55,63,,849.24,,,0,"percent of total billed charges","63% of total billed charges",257.81,15.3,,206.25,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1162.65,69,,,,,0,"fee schedule","69% of total billed charges",1685,100,,1348.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1685,100,,1348.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1685,100,,1348.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",635.25,37.7,,508.20,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1314.3,78,,1051.44,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1391.81,82.6,,1113.45,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1391.81,82.6,,1113.45,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,1685,100,,1348.00,,,0,"percent of total billed charges","100% of total billed charges",257.81,9628.23,
"24301 Muscle or tendon transfer, any type, upper a",7962166,CDM,521,RC,24301,CPT,OUTPATIENT,,,2837,1844.05,,2496.56,88,,1997.25,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,2837,100,,2269.60,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",5267.52,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1787.31,63,,1429.85,,,0,"percent of total billed charges","63% of total billed charges",434.06,15.3,,347.25,,,0,"percent of total billed charges","15.3% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,1957.53,69,,,,,0,"fee schedule","69% of total billed charges",2837,100,,2269.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2837,100,,2269.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2837,100,,2269.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5216.38,100,,,,,0,"fee schedule",EAPG,6648.32,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1069.55,37.7,,855.64,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2212.86,78,,1770.29,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2343.36,82.6,,1874.69,,,0,"percent of total billed charges","82.6% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2343.36,82.6,,1874.69,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5274.62,100,,,,,0,"fee schedule",EAPG,2837,100,,2269.60,,,0,"percent of total billed charges","100% of total billed charges",434.06,25451.55,
"24300 Manipulation, elbow, under anesthesia",7963639,CDM,521,RC,24300,CPT,OUTPATIENT,,,1274,828.1,,1121.12,88,,896.90,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,1274,100,,1019.20,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",916.1,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",802.62,63,,642.10,,,0,"percent of total billed charges","63% of total billed charges",194.92,15.3,,155.94,,,0,"percent of total billed charges","15.3% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,879.06,69,,,,,0,"fee schedule","69% of total billed charges",1274,100,,1019.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1274,100,,1019.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1274,100,,1019.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.21,100,,,,,0,"fee schedule",EAPG,1156.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",480.3,37.7,,384.24,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",993.72,78,,794.98,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1052.32,82.6,,841.86,,,0,"percent of total billed charges","82.6% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1052.32,82.6,,841.86,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1049.95,100,,,,,0,"fee schedule",EAPG,1274,100,,1019.20,,,0,"percent of total billed charges","100% of total billed charges",194.92,5656.45,
"24310 Tenotomy, open, elbow to shoulder, each tend",7963461,CDM,521,RC,24310,CPT,OUTPATIENT,,,1954,1270.1,,1719.52,88,,1375.62,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,1954,100,,1563.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4140.73,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1231.02,63,,984.82,,,0,"percent of total billed charges","63% of total billed charges",298.96,15.3,,239.17,,,0,"percent of total billed charges","15.3% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,1348.26,69,,,,,0,"fee schedule","69% of total billed charges",1954,100,,1563.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1954,100,,1563.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1954,100,,1563.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.53,100,,,,,0,"fee schedule",EAPG,5226.17,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",736.66,37.7,,589.33,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1524.12,78,,1219.30,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1614,82.6,,1291.20,,,0,"percent of total billed charges","82.6% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1614,82.6,,1291.20,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4180.66,100,,,,,0,"fee schedule",EAPG,1954,100,,1563.20,,,0,"percent of total billed charges","100% of total billed charges",298.96,11498.59,
"24341 Repair, tendon or muscle, upper arm or elbow",7961853,CDM,521,RC,24341,CPT,OUTPATIENT,,,2477,1610.05,,2179.76,88,,1743.81,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,2477,100,,1981.60,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4140.73,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1560.51,63,,1248.41,,,0,"percent of total billed charges","63% of total billed charges",378.98,15.3,,303.18,,,0,"percent of total billed charges","15.3% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,1709.13,69,,,,,0,"fee schedule","69% of total billed charges",2477,100,,1981.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2477,100,,1981.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2477,100,,1981.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.53,100,,,,,0,"fee schedule",EAPG,5226.17,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",933.83,37.7,,747.06,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1932.06,78,,1545.65,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2046,82.6,,1636.80,,,0,"percent of total billed charges","82.6% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2046,82.6,,1636.80,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4180.66,100,,,,,0,"fee schedule",EAPG,2477,100,,1981.60,,,0,"percent of total billed charges","100% of total billed charges",378.98,25451.55,
"24342 Reinsertion of ruptured biceps or triceps te",7962237,CDM,521,RC,24342,CPT,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4140.73,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4100.53,100,,,,,0,"fee schedule",EAPG,5226.17,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",4020.13,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4180.66,100,,,,,0,"fee schedule",EAPG,3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,25451.55,
"24359 Tenotomy, elbow, lateral or medial; debridem",7961902,CDM,521,RC,24359,CPT,OUTPATIENT,,,2165,1407.25,,1905.2,88,,1524.16,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,2165,100,,1732.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1363.95,63,,1091.16,,,0,"percent of total billed charges","63% of total billed charges",331.25,15.3,,265.00,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,1493.85,69,,,,,0,"fee schedule","69% of total billed charges",2165,100,,1732.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2165,100,,1732.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2165,100,,1732.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",816.21,37.7,,652.97,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1688.7,78,,1350.96,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1788.29,82.6,,1430.63,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1788.29,82.6,,1430.63,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,2165,100,,1732.00,,,0,"percent of total billed charges","100% of total billed charges",331.25,11498.59,
"24358 Tenotomy, elbow, lateral or medial; debridem",7962522,CDM,521,RC,24358,CPT,OUTPATIENT,,,1694,1101.1,,1490.72,88,,1192.58,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,1694,100,,1355.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1067.22,63,,853.78,,,0,"percent of total billed charges","63% of total billed charges",259.18,15.3,,207.34,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,1168.86,69,,,,,0,"fee schedule","69% of total billed charges",1694,100,,1355.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1694,100,,1355.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1694,100,,1355.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",638.64,37.7,,510.91,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1321.32,78,,1057.06,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1399.24,82.6,,1119.39,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1399.24,82.6,,1119.39,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,1694,100,,1355.20,,,0,"percent of total billed charges","100% of total billed charges",259.18,11498.59,
"24363 Arthroplasty, elbow; with distal humerus and",7962401,CDM,521,RC,24363,CPT,OUTPATIENT,,,6816,4430.4,,5998.08,88,,4798.46,,,0,"percent of total billed charges","88% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8399.65,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",33264.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",8651.64,100,,,,,0,"fee schedule",EAPG,19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4294.08,63,,3435.26,,,0,"percent of total billed charges","63% of total billed charges",1042.85,15.3,,834.28,,,0,"percent of total billed charges","15.3% of total billed charges",8399.65,100,,,,,0,"fee schedule",EAPG,4703.04,69,,,,,0,"fee schedule","69% of total billed charges",6816,100,,5452.80,,,0,"percent of total billed charges","100% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6816,100,,5452.80,,,0,"percent of total billed charges","100% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6816,100,,5452.80,,,0,"percent of total billed charges","100% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",64464.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8399.65,100,,,,,0,"fee schedule",EAPG,19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16853.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8567.64,100,,,,,0,"fee schedule",EAPG,10919.55,100,,,,,0,"fee schedule",EAPG,19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2569.63,37.7,,2055.70,,,0,"percent of total billed charges","37.70% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5316.48,78,,4253.18,,,0,"percent of total billed charges","78% of total billed charges",19198.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5630.02,82.6,,4504.02,,,0,"percent of total billed charges","82.6% of total billed charges",8399.65,100,,,,,0,"fee schedule",EAPG,19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5630.02,82.6,,4504.02,,,0,"percent of total billed charges","82.6% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8560.18,100,,,,,0,"fee schedule",EAPG,6816,100,,5452.80,,,0,"percent of total billed charges","100% of total billed charges",1042.85,64464.78,
"24361 Arthroplasty, elbow; with distal humeral pro",7962983,CDM,521,RC,24361,CPT,OUTPATIENT,,,3599,2339.35,,3167.12,88,,2533.70,,,0,"percent of total billed charges","88% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8399.65,100,,,,,0,"fee schedule",EAPG,3599,100,,2879.20,,,0,"percent of total billed charges","100% of total billed charges",33264.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",8651.64,100,,,,,0,"fee schedule",EAPG,19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2267.37,63,,1813.90,,,0,"percent of total billed charges","63% of total billed charges",550.65,15.3,,440.52,,,0,"percent of total billed charges","15.3% of total billed charges",8399.65,100,,,,,0,"fee schedule",EAPG,2483.31,69,,,,,0,"fee schedule","69% of total billed charges",3599,100,,2879.20,,,0,"percent of total billed charges","100% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3599,100,,2879.20,,,0,"percent of total billed charges","100% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3599,100,,2879.20,,,0,"percent of total billed charges","100% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",64464.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8399.65,100,,,,,0,"fee schedule",EAPG,19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16853.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8567.64,100,,,,,0,"fee schedule",EAPG,10919.55,100,,,,,0,"fee schedule",EAPG,19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1356.82,37.7,,1085.46,,,0,"percent of total billed charges","37.70% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2807.22,78,,2245.78,,,0,"percent of total billed charges","78% of total billed charges",19198.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2972.77,82.6,,2378.22,,,0,"percent of total billed charges","82.6% of total billed charges",8399.65,100,,,,,0,"fee schedule",EAPG,19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2972.77,82.6,,2378.22,,,0,"percent of total billed charges","82.6% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8560.18,100,,,,,0,"fee schedule",EAPG,3599,100,,2879.20,,,0,"percent of total billed charges","100% of total billed charges",550.65,64464.78,
"24366 Arthroplasty, radial head; with implant",7963596,CDM,521,RC,24366,CPT,OUTPATIENT,,,2924,1900.6,,2573.12,88,,2058.50,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8399.65,100,,,,,0,"fee schedule",EAPG,2924,100,,2339.20,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",8651.64,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1842.12,63,,1473.70,,,0,"percent of total billed charges","63% of total billed charges",447.37,15.3,,357.90,,,0,"percent of total billed charges","15.3% of total billed charges",8399.65,100,,,,,0,"fee schedule",EAPG,2017.56,69,,,,,0,"fee schedule","69% of total billed charges",2924,100,,2339.20,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2924,100,,2339.20,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2924,100,,2339.20,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8399.65,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8567.64,100,,,,,0,"fee schedule",EAPG,10919.55,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1102.35,37.7,,881.88,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2280.72,78,,1824.58,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2415.22,82.6,,1932.18,,,0,"percent of total billed charges","82.6% of total billed charges",8399.65,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2415.22,82.6,,1932.18,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8560.18,100,,,,,0,"fee schedule",EAPG,2924,100,,2339.20,,,0,"percent of total billed charges","100% of total billed charges",447.37,50029.1,
"24365 Arthroplasty, radial head;",7963833,CDM,521,RC,24365,CPT,OUTPATIENT,,,2430,1579.5,,2138.4,88,,1710.72,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8399.65,100,,,,,0,"fee schedule",EAPG,2430,100,,1944.00,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",8651.64,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.9,63,,1224.72,,,0,"percent of total billed charges","63% of total billed charges",371.79,15.3,,297.43,,,0,"percent of total billed charges","15.3% of total billed charges",8399.65,100,,,,,0,"fee schedule",EAPG,1676.7,69,,,,,0,"fee schedule","69% of total billed charges",2430,100,,1944.00,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2430,100,,1944.00,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2430,100,,1944.00,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8399.65,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8567.64,100,,,,,0,"fee schedule",EAPG,10919.55,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",916.11,37.7,,732.89,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1895.4,78,,1516.32,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2007.18,82.6,,1605.74,,,0,"percent of total billed charges","82.6% of total billed charges",8399.65,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2007.18,82.6,,1605.74,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8560.18,100,,,,,0,"fee schedule",EAPG,2430,100,,1944.00,,,0,"percent of total billed charges","100% of total billed charges",371.79,50029.1,
"24430 Repair of nonunion or malunion, humerus; wit",7962402,CDM,521,RC,24430,CPT,OUTPATIENT,,,4163,2705.95,,3663.44,88,,2930.75,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8682.91,100,,,,,0,"fee schedule",EAPG,4163,100,,3330.40,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",8943.4,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2622.69,63,,2098.15,,,0,"percent of total billed charges","63% of total billed charges",636.94,15.3,,509.55,,,0,"percent of total billed charges","15.3% of total billed charges",8682.91,100,,,,,0,"fee schedule",EAPG,2872.47,69,,,,,0,"fee schedule","69% of total billed charges",4163,100,,3330.40,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4163,100,,3330.40,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4163,100,,3330.40,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8682.91,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8856.57,100,,,,,0,"fee schedule",EAPG,11287.79,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1569.45,37.7,,1255.56,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3247.14,78,,2597.71,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3438.64,82.6,,2750.91,,,0,"percent of total billed charges","82.6% of total billed charges",8682.91,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3438.64,82.6,,2750.91,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8843.44,100,,,,,0,"fee schedule",EAPG,4163,100,,3330.40,,,0,"percent of total billed charges","100% of total billed charges",636.94,50029.1,
"24435 Repair of nonunion or malunion, humerus; wit",7962800,CDM,521,RC,24435,CPT,OUTPATIENT,,,3502,2276.3,,3081.76,88,,2465.41,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8682.91,100,,,,,0,"fee schedule",EAPG,3502,100,,2801.60,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",8943.4,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2206.26,63,,1765.01,,,0,"percent of total billed charges","63% of total billed charges",535.81,15.3,,428.65,,,0,"percent of total billed charges","15.3% of total billed charges",8682.91,100,,,,,0,"fee schedule",EAPG,2416.38,69,,,,,0,"fee schedule","69% of total billed charges",3502,100,,2801.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3502,100,,2801.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3502,100,,2801.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8682.91,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8856.57,100,,,,,0,"fee schedule",EAPG,11287.79,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1320.25,37.7,,1056.20,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2731.56,78,,2185.25,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2892.65,82.6,,2314.12,,,0,"percent of total billed charges","82.6% of total billed charges",8682.91,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2892.65,82.6,,2314.12,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8843.44,100,,,,,0,"fee schedule",EAPG,3502,100,,2801.60,,,0,"percent of total billed charges","100% of total billed charges",535.81,50029.1,
"24495 Decompression fasciotomy, forearm, with brac",7962900,CDM,521,RC,24495,CPT,OUTPATIENT,,,2402,1561.3,,2113.76,88,,1691.01,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,2402,100,,1921.60,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",5267.52,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1513.26,63,,1210.61,,,0,"percent of total billed charges","63% of total billed charges",367.51,15.3,,294.01,,,0,"percent of total billed charges","15.3% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,1657.38,69,,,,,0,"fee schedule","69% of total billed charges",2402,100,,1921.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2402,100,,1921.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2402,100,,1921.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5216.38,100,,,,,0,"fee schedule",EAPG,6648.32,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",905.55,37.7,,724.44,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1873.56,78,,1498.85,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1984.05,82.6,,1587.24,,,0,"percent of total billed charges","82.6% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1984.05,82.6,,1587.24,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5274.62,100,,,,,0,"fee schedule",EAPG,2402,100,,1921.60,,,0,"percent of total billed charges","100% of total billed charges",367.51,25451.55,
"24500 Closed treatment of humeral shaft fracture;",7903207,CDM,521,RC,24500,CPT,OUTPATIENT,,,806,523.9,,709.28,88,,567.42,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",507.78,63,,406.22,,,0,"percent of total billed charges","63% of total billed charges",123.32,15.3,,98.66,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,556.14,69,,,,,0,"fee schedule","69% of total billed charges",806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",303.86,37.7,,243.09,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",628.68,78,,502.94,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.76,82.6,,532.61,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.76,82.6,,532.61,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",123.32,837.64,
"24516 Open tx humeral shaft fracture, w/ intramedu",7961467,CDM,521,RC,24516,CPT,OUTPATIENT,,,3153,2049.45,,2774.64,88,,2219.71,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3153,100,,2522.40,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1986.39,63,,1589.11,,,0,"percent of total billed charges","63% of total billed charges",482.41,15.3,,385.93,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,2175.57,69,,,,,0,"fee schedule","69% of total billed charges",3153,100,,2522.40,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3153,100,,2522.40,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3153,100,,2522.40,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1188.68,37.7,,950.94,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2459.34,78,,1967.47,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2604.38,82.6,,2083.50,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2604.38,82.6,,2083.50,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,3153,100,,2522.40,,,0,"percent of total billed charges","100% of total billed charges",482.41,50029.1,
"24515 Open treatment of humeral shaft fracture wit",7962318,CDM,521,RC,24515,CPT,OUTPATIENT,,,2664,1731.6,,2344.32,88,,1875.46,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2664,100,,2131.20,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1678.32,63,,1342.66,,,0,"percent of total billed charges","63% of total billed charges",407.59,15.3,,326.07,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1838.16,69,,,,,0,"fee schedule","69% of total billed charges",2664,100,,2131.20,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2664,100,,2131.20,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2664,100,,2131.20,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1004.33,37.7,,803.46,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2077.92,78,,1662.34,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2200.46,82.6,,1760.37,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2200.46,82.6,,1760.37,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2664,100,,2131.20,,,0,"percent of total billed charges","100% of total billed charges",407.59,50029.1,
"24538 Percutaneous skeletal fixation of supra/tran",7961468,CDM,521,RC,24538,CPT,OUTPATIENT,,,3066,1992.9,,2698.08,88,,2158.46,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3066,100,,2452.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1931.58,63,,1545.26,,,0,"percent of total billed charges","63% of total billed charges",469.1,15.3,,375.28,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,2115.54,69,,,,,0,"fee schedule","69% of total billed charges",3066,100,,2452.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3066,100,,2452.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3066,100,,2452.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1155.88,37.7,,924.70,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2391.48,78,,1913.18,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2532.52,82.6,,2026.02,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2532.52,82.6,,2026.02,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,3066,100,,2452.80,,,0,"percent of total billed charges","100% of total billed charges",469.1,25451.55,
"24530 Closed tx supra/transcondylar humeral fx, w/",7962439,CDM,521,RC,24530,CPT,OUTPATIENT,,,894,581.1,,786.72,88,,629.38,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,894,100,,715.20,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",563.22,63,,450.58,,,0,"percent of total billed charges","63% of total billed charges",136.78,15.3,,109.42,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,616.86,69,,,,,0,"fee schedule","69% of total billed charges",894,100,,715.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",894,100,,715.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",894,100,,715.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",337.04,37.7,,269.63,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",697.32,78,,557.86,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",738.44,82.6,,590.75,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",738.44,82.6,,590.75,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,894,100,,715.20,,,0,"percent of total billed charges","100% of total billed charges",136.78,894,
"24535 Closed tx supra/transcondylar humeral fx, w/",7962463,CDM,521,RC,24535,CPT,OUTPATIENT,,,1953,1269.45,,1718.64,88,,1374.91,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1953,100,,1562.40,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1230.39,63,,984.31,,,0,"percent of total billed charges","63% of total billed charges",298.81,15.3,,239.05,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1347.57,69,,,,,0,"fee schedule","69% of total billed charges",1953,100,,1562.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1953,100,,1562.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1953,100,,1562.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",736.28,37.7,,589.02,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1523.34,78,,1218.67,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1613.18,82.6,,1290.54,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1613.18,82.6,,1290.54,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,1953,100,,1562.40,,,0,"percent of total billed charges","100% of total billed charges",298.81,5656.45,
"24546 Open tx humeral supracondylar/transcondylar",7961469,CDM,521,RC,24546,CPT,OUTPATIENT,,,4642,3017.3,,4084.96,88,,3267.97,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,4642,100,,3713.60,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2924.46,63,,2339.57,,,0,"percent of total billed charges","63% of total billed charges",710.23,15.3,,568.18,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3202.98,69,,,,,0,"fee schedule","69% of total billed charges",4642,100,,3713.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4642,100,,3713.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4642,100,,3713.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",64464.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16853.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1750.03,37.7,,1400.02,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3620.76,78,,2896.61,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3834.29,82.6,,3067.43,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3834.29,82.6,,3067.43,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,4642,100,,3713.60,,,0,"percent of total billed charges","100% of total billed charges",710.23,64464.78,
"24545 Open tx humeral supra/transcondylar fx, incl",7961738,CDM,521,RC,24545,CPT,OUTPATIENT,,,3405,2213.25,,2996.4,88,,2397.12,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3405,100,,2724.00,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2145.15,63,,1716.12,,,0,"percent of total billed charges","63% of total billed charges",520.97,15.3,,416.78,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,2349.45,69,,,,,0,"fee schedule","69% of total billed charges",3405,100,,2724.00,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3405,100,,2724.00,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3405,100,,2724.00,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1283.69,37.7,,1026.95,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2655.9,78,,2124.72,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2812.53,82.6,,2250.02,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2812.53,82.6,,2250.02,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,3405,100,,2724.00,,,0,"percent of total billed charges","100% of total billed charges",520.97,50029.1,
"24566 Percutaneous skeletal fixation of humeral ep",7961971,CDM,521,RC,24566,CPT,OUTPATIENT,,,2046,1329.9,,1800.48,88,,1440.38,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2046,100,,1636.80,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1288.98,63,,1031.18,,,0,"percent of total billed charges","63% of total billed charges",313.04,15.3,,250.43,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1411.74,69,,,,,0,"fee schedule","69% of total billed charges",2046,100,,1636.80,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2046,100,,1636.80,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2046,100,,1636.80,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",771.34,37.7,,617.07,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1595.88,78,,1276.70,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1690,82.6,,1352.00,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1690,82.6,,1352.00,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2046,100,,1636.80,,,0,"percent of total billed charges","100% of total billed charges",313.04,6221.9,
"24576 Closed treatment of humeral condylar fractur",7903209,CDM,521,RC,24576,CPT,OUTPATIENT,,,824,535.6,,725.12,88,,580.10,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",519.12,63,,415.30,,,0,"percent of total billed charges","63% of total billed charges",126.07,15.3,,100.86,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,568.56,69,,,,,0,"fee schedule","69% of total billed charges",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",310.65,37.7,,248.52,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",642.72,78,,514.18,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",680.62,82.6,,544.50,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,824,100,,659.20,,,0,"percent of total billed charges","100% of total billed charges",126.07,837.64,
"24575 Open tx humeral epicondylar fx, medial or la",7962547,CDM,521,RC,24575,CPT,OUTPATIENT,,,2680,1742,,2358.4,88,,1886.72,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2680,100,,2144.00,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1688.4,63,,1350.72,,,0,"percent of total billed charges","63% of total billed charges",410.04,15.3,,328.03,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1849.2,69,,,,,0,"fee schedule","69% of total billed charges",2680,100,,2144.00,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2680,100,,2144.00,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2680,100,,2144.00,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1010.36,37.7,,808.29,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2090.4,78,,1672.32,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2213.68,82.6,,1770.94,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2213.68,82.6,,1770.94,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2680,100,,2144.00,,,0,"percent of total billed charges","100% of total billed charges",410.04,50029.1,
"24579 Open tx humeral condylar fx, medial or later",7962667,CDM,521,RC,24579,CPT,OUTPATIENT,,,2613,1698.45,,2299.44,88,,1839.55,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2613,100,,2090.40,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1646.19,63,,1316.95,,,0,"percent of total billed charges","63% of total billed charges",399.79,15.3,,319.83,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1802.97,69,,,,,0,"fee schedule","69% of total billed charges",2613,100,,2090.40,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2613,100,,2090.40,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2613,100,,2090.40,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",985.1,37.7,,788.08,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2038.14,78,,1630.51,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2158.34,82.6,,1726.67,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2158.34,82.6,,1726.67,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2613,100,,2090.40,,,0,"percent of total billed charges","100% of total billed charges",399.79,50029.1,
"24582 Percutaneous skeletal fixation of humeral co",7961903,CDM,521,RC,24582,CPT,OUTPATIENT,,,1353,879.45,,1190.64,88,,952.51,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,1353,100,,1082.40,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",852.39,63,,681.91,,,0,"percent of total billed charges","63% of total billed charges",207.01,15.3,,165.61,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,933.57,69,,,,,0,"fee schedule","69% of total billed charges",1353,100,,1082.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353,100,,1082.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353,100,,1082.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",510.08,37.7,,408.06,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055.34,78,,844.27,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1117.58,82.6,,894.06,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1117.58,82.6,,894.06,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,1353,100,,1082.40,,,0,"percent of total billed charges","100% of total billed charges",207.01,25451.55,
"24587 Open treatment of periarticular fracture and",7962096,CDM,521,RC,24587,CPT,OUTPATIENT,,,3122,2029.3,,2747.36,88,,2197.89,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3122,100,,2497.60,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1966.86,63,,1573.49,,,0,"percent of total billed charges","63% of total billed charges",477.67,15.3,,382.14,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,2154.18,69,,,,,0,"fee schedule","69% of total billed charges",3122,100,,2497.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3122,100,,2497.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3122,100,,2497.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1176.99,37.7,,941.59,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2435.16,78,,1948.13,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2578.77,82.6,,2063.02,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2578.77,82.6,,2063.02,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,3122,100,,2497.60,,,0,"percent of total billed charges","100% of total billed charges",477.67,50029.1,
"24586 Open treatment of periarticular fracture and",7962738,CDM,521,RC,24586,CPT,OUTPATIENT,,,4052,2633.8,,3565.76,88,,2852.61,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,4052,100,,3241.60,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2552.76,63,,2042.21,,,0,"percent of total billed charges","63% of total billed charges",619.96,15.3,,495.97,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,2795.88,69,,,,,0,"fee schedule","69% of total billed charges",4052,100,,3241.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4052,100,,3241.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4052,100,,3241.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1527.6,37.7,,1222.08,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3160.56,78,,2528.45,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3346.95,82.6,,2677.56,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3346.95,82.6,,2677.56,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,4052,100,,3241.60,,,0,"percent of total billed charges","100% of total billed charges",619.96,50029.1,
"24605 Treatment of closed elbow dislocation; requi",7963134,CDM,521,RC,24605,CPT,OUTPATIENT,,,1245,809.25,,1095.6,88,,876.48,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,1245,100,,996.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",916.1,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",784.35,63,,627.48,,,0,"percent of total billed charges","63% of total billed charges",190.49,15.3,,152.39,,,0,"percent of total billed charges","15.3% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,859.05,69,,,,,0,"fee schedule","69% of total billed charges",1245,100,,996.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1245,100,,996.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1245,100,,996.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.21,100,,,,,0,"fee schedule",EAPG,1156.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",469.37,37.7,,375.50,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",971.1,78,,776.88,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1028.37,82.6,,822.70,,,0,"percent of total billed charges","82.6% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1028.37,82.6,,822.70,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1049.95,100,,,,,0,"fee schedule",EAPG,1245,100,,996.00,,,0,"percent of total billed charges","100% of total billed charges",190.49,5656.45,
"24600 Treatment of closed elbow dislocation; witho",7963186,CDM,521,RC,24600,CPT,OUTPATIENT,,,690,448.5,,607.2,88,,485.76,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,690,100,,552.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",434.7,63,,347.76,,,0,"percent of total billed charges","63% of total billed charges",105.57,15.3,,84.46,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,476.1,69,,,,,0,"fee schedule","69% of total billed charges",690,100,,552.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",690,100,,552.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",690,100,,552.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",260.13,37.7,,208.10,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",538.2,78,,430.56,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",569.94,82.6,,455.95,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",569.94,82.6,,455.95,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,690,100,,552.00,,,0,"percent of total billed charges","100% of total billed charges",105.57,837.64,
"24620 Closed treatment of Monteggia type of fractu",7962238,CDM,521,RC,24620,CPT,OUTPATIENT,,,1716,1115.4,,1510.08,88,,1208.06,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1716,100,,1372.80,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1081.08,63,,864.86,,,0,"percent of total billed charges","63% of total billed charges",262.55,15.3,,210.04,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1184.04,69,,,,,0,"fee schedule","69% of total billed charges",1716,100,,1372.80,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1716,100,,1372.80,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1716,100,,1372.80,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",646.93,37.7,,517.54,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1338.48,78,,1070.78,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1417.42,82.6,,1133.94,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1417.42,82.6,,1133.94,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,1716,100,,1372.80,,,0,"percent of total billed charges","100% of total billed charges",262.55,5656.45,
"24635 Open tx of Monteggia type of fracture disloc",7962239,CDM,521,RC,24635,CPT,OUTPATIENT,,,4071,2646.15,,3582.48,88,,2865.98,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,4071,100,,3256.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2564.73,63,,2051.78,,,0,"percent of total billed charges","63% of total billed charges",622.86,15.3,,498.29,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,2808.99,69,,,,,0,"fee schedule","69% of total billed charges",4071,100,,3256.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4071,100,,3256.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4071,100,,3256.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1534.77,37.7,,1227.82,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3175.38,78,,2540.30,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3362.65,82.6,,2690.12,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3362.65,82.6,,2690.12,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,4071,100,,3256.80,,,0,"percent of total billed charges","100% of total billed charges",622.86,25451.55,
"24640 Closed treatment of radial head subluxation",7961904,CDM,521,RC,24640,CPT,OUTPATIENT,,,288,187.2,,253.44,88,,202.75,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",181.44,63,,145.15,,,0,"percent of total billed charges","63% of total billed charges",44.06,15.3,,35.25,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,198.72,69,,,,,0,"fee schedule","69% of total billed charges",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",108.58,37.7,,86.86,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.64,78,,179.71,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",237.89,82.6,,190.31,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",237.89,82.6,,190.31,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",44.06,837.64,
"24650 Closed treatment of radial head or neck frac",7903210,CDM,521,RC,24650,CPT,OUTPATIENT,,,674,438.1,,593.12,88,,474.50,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,674,100,,539.20,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",424.62,63,,339.70,,,0,"percent of total billed charges","63% of total billed charges",103.12,15.3,,82.50,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,465.06,69,,,,,0,"fee schedule","69% of total billed charges",674,100,,539.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",674,100,,539.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",674,100,,539.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",254.1,37.7,,203.28,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",525.72,78,,420.58,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.72,82.6,,445.38,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.72,82.6,,445.38,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,674,100,,539.20,,,0,"percent of total billed charges","100% of total billed charges",103.12,837.64,
"24655 Closed treatment of radial head or neck frac",7962901,CDM,521,RC,24655,CPT,OUTPATIENT,,,1172,761.8,,1031.36,88,,825.09,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1172,100,,937.60,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",738.36,63,,590.69,,,0,"percent of total billed charges","63% of total billed charges",179.32,15.3,,143.46,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,808.68,69,,,,,0,"fee schedule","69% of total billed charges",1172,100,,937.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1172,100,,937.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1172,100,,937.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",441.84,37.7,,353.47,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",914.16,78,,731.33,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",968.07,82.6,,774.46,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",968.07,82.6,,774.46,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,1172,100,,937.60,,,0,"percent of total billed charges","100% of total billed charges",179.32,5656.45,
"24666 Open tx of radial head/neck fx, w/ int fixat",7961578,CDM,521,RC,24666,CPT,OUTPATIENT,,,2817,1831.05,,2478.96,88,,1983.17,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2817,100,,2253.60,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1774.71,63,,1419.77,,,0,"percent of total billed charges","63% of total billed charges",431,15.3,,344.80,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1943.73,69,,,,,0,"fee schedule","69% of total billed charges",2817,100,,2253.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2817,100,,2253.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2817,100,,2253.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1062.01,37.7,,849.61,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2197.26,78,,1757.81,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2326.84,82.6,,1861.47,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2326.84,82.6,,1861.47,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2817,100,,2253.60,,,0,"percent of total billed charges","100% of total billed charges",431,50029.1,
"24665 Open tx of radial head or neck fracture, inc",7961739,CDM,521,RC,24665,CPT,OUTPATIENT,,,2202,1431.3,,1937.76,88,,1550.21,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2202,100,,1761.60,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1387.26,63,,1109.81,,,0,"percent of total billed charges","63% of total billed charges",336.91,15.3,,269.53,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1519.38,69,,,,,0,"fee schedule","69% of total billed charges",2202,100,,1761.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2202,100,,1761.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2202,100,,1761.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",830.15,37.7,,664.12,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1717.56,78,,1374.05,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1818.85,82.6,,1455.08,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1818.85,82.6,,1455.08,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2202,100,,1761.60,,,0,"percent of total billed charges","100% of total billed charges",336.91,25451.55,
"24670 Closed treatment of ulnar fracture, proximal",7903211,CDM,521,RC,24670,CPT,OUTPATIENT,,,740,481,,651.2,88,,520.96,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,740,100,,592.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",466.2,63,,372.96,,,0,"percent of total billed charges","63% of total billed charges",113.22,15.3,,90.58,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,510.6,69,,,,,0,"fee schedule","69% of total billed charges",740,100,,592.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",740,100,,592.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",740,100,,592.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",278.98,37.7,,223.18,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",577.2,78,,461.76,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",611.24,82.6,,488.99,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",611.24,82.6,,488.99,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,740,100,,592.00,,,0,"percent of total billed charges","100% of total billed charges",113.22,837.64,
"24685 Open treatment of ulnar fracture, proximal e",7961470,CDM,521,RC,24685,CPT,OUTPATIENT,,,2431,1580.15,,2139.28,88,,1711.42,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2431,100,,1944.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1531.53,63,,1225.22,,,0,"percent of total billed charges","63% of total billed charges",371.94,15.3,,297.55,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1677.39,69,,,,,0,"fee schedule","69% of total billed charges",2431,100,,1944.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2431,100,,1944.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2431,100,,1944.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",916.49,37.7,,733.19,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1896.18,78,,1516.94,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2008.01,82.6,,1606.41,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2008.01,82.6,,1606.41,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2431,100,,1944.80,,,0,"percent of total billed charges","100% of total billed charges",371.94,25451.55,
"25000 Incision, extensor tendon sheath, wrist (eg,",7962959,CDM,521,RC,25000,CPT,OUTPATIENT,,,1520,988,,1337.6,88,,1070.08,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,1520,100,,1216.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",957.6,63,,766.08,,,0,"percent of total billed charges","63% of total billed charges",232.56,15.3,,186.05,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,1048.8,69,,,,,0,"fee schedule","69% of total billed charges",1520,100,,1216.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1520,100,,1216.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1520,100,,1216.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",573.04,37.7,,458.43,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1185.6,78,,948.48,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1255.52,82.6,,1004.42,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1255.52,82.6,,1004.42,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,1520,100,,1216.00,,,0,"percent of total billed charges","100% of total billed charges",232.56,5656.45,
"25020 Decompression fasciotomy, forearm/wrist, fle",7961905,CDM,521,RC,25020,CPT,OUTPATIENT,,,2775,1803.75,,2442,88,,1953.60,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,2775,100,,2220.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1748.25,63,,1398.60,,,0,"percent of total billed charges","63% of total billed charges",424.58,15.3,,339.66,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,1914.75,69,,,,,0,"fee schedule","69% of total billed charges",2775,100,,2220.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2775,100,,2220.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2775,100,,2220.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1046.18,37.7,,836.94,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2164.5,78,,1731.60,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2292.15,82.6,,1833.72,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2292.15,82.6,,1833.72,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,2775,100,,2220.00,,,0,"percent of total billed charges","100% of total billed charges",424.58,5656.45,
"25023 Decompression fasciotomy, forearm/wrist, fle",7962167,CDM,521,RC,25023,CPT,OUTPATIENT,,,3216,2090.4,,2830.08,88,,2264.06,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,3216,100,,2572.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2026.08,63,,1620.86,,,0,"percent of total billed charges","63% of total billed charges",492.05,15.3,,393.64,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,2219.04,69,,,,,0,"fee schedule","69% of total billed charges",3216,100,,2572.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3216,100,,2572.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3216,100,,2572.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1212.43,37.7,,969.94,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2508.48,78,,2006.78,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2656.42,82.6,,2125.14,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2656.42,82.6,,2125.14,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,3216,100,,2572.80,,,0,"percent of total billed charges","100% of total billed charges",492.05,11498.59,
"25025 Decompression fasciotomy, forearm and/or wri",7962205,CDM,521,RC,25025,CPT,OUTPATIENT,,,3529,2293.85,,3105.52,88,,2484.42,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,3529,100,,2823.20,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2223.27,63,,1778.62,,,0,"percent of total billed charges","63% of total billed charges",539.94,15.3,,431.95,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,2435.01,69,,,,,0,"fee schedule","69% of total billed charges",3529,100,,2823.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3529,100,,2823.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3529,100,,2823.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1330.43,37.7,,1064.34,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2752.62,78,,2202.10,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2914.95,82.6,,2331.96,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2914.95,82.6,,2331.96,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,3529,100,,2823.20,,,0,"percent of total billed charges","100% of total billed charges",539.94,5656.45,
"25024 Decompression fasciotomy, forearm and/or wri",7962491,CDM,521,RC,25024,CPT,OUTPATIENT,,,2259,1468.35,,1987.92,88,,1590.34,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,2259,100,,1807.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1423.17,63,,1138.54,,,0,"percent of total billed charges","63% of total billed charges",345.63,15.3,,276.50,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,1558.71,69,,,,,0,"fee schedule","69% of total billed charges",2259,100,,1807.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2259,100,,1807.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2259,100,,1807.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",851.64,37.7,,681.31,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1762.02,78,,1409.62,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1865.93,82.6,,1492.74,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1865.93,82.6,,1492.74,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,2259,100,,1807.20,,,0,"percent of total billed charges","100% of total billed charges",345.63,11498.59,
"25028 Incision and drainage, forearm and/or wrist;",7962839,CDM,521,RC,25028,CPT,OUTPATIENT,,,1187,771.55,,1044.56,88,,835.65,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,1187,100,,949.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",747.81,63,,598.25,,,0,"percent of total billed charges","63% of total billed charges",181.61,15.3,,145.29,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,819.03,69,,,,,0,"fee schedule","69% of total billed charges",1187,100,,949.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1187,100,,949.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1187,100,,949.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",447.5,37.7,,358.00,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",925.86,78,,740.69,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",980.46,82.6,,784.37,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",980.46,82.6,,784.37,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,1187,100,,949.60,,,0,"percent of total billed charges","100% of total billed charges",181.61,11498.59,
"25040 Arthrotomy, radiocarpal or midcarpal joint,",7962240,CDM,521,RC,25040,CPT,OUTPATIENT,,,2381,1547.65,,2095.28,88,,1676.22,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,2381,100,,1904.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1500.03,63,,1200.02,,,0,"percent of total billed charges","63% of total billed charges",364.29,15.3,,291.43,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,1642.89,69,,,,,0,"fee schedule","69% of total billed charges",2381,100,,1904.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2381,100,,1904.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2381,100,,1904.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",897.64,37.7,,718.11,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1857.18,78,,1485.74,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1966.71,82.6,,1573.37,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1966.71,82.6,,1573.37,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,2381,100,,1904.80,,,0,"percent of total billed charges","100% of total billed charges",364.29,11498.59,
"25066 Biopsy, soft tissue of forearm and/or wrist;",7962492,CDM,521,RC,25066,CPT,OUTPATIENT,,,785,510.25,,690.8,88,,552.64,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",494.55,63,,395.64,,,0,"percent of total billed charges","63% of total billed charges",120.11,15.3,,96.09,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,541.65,69,,,,,0,"fee schedule","69% of total billed charges",785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",295.95,37.7,,236.76,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",612.3,78,,489.84,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",648.41,82.6,,518.73,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",648.41,82.6,,518.73,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",120.11,9628.23,
"25065 Biopsy, soft tissue of forearm and/or wrist;",7963214,CDM,521,RC,25065,CPT,OUTPATIENT,,,453,294.45,,398.64,88,,318.91,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,453,100,,362.40,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",285.39,63,,228.31,,,0,"percent of total billed charges","63% of total billed charges",69.31,15.3,,55.45,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,312.57,69,,,,,0,"fee schedule","69% of total billed charges",453,100,,362.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",453,100,,362.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",453,100,,362.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",170.78,37.7,,136.62,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",353.34,78,,282.67,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",374.18,82.6,,299.34,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",374.18,82.6,,299.34,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,453,100,,362.40,,,0,"percent of total billed charges","100% of total billed charges",69.31,5715.97,
"25071 Excision, tumor, soft tissue of forearm and/",7961906,CDM,521,RC,25071,CPT,OUTPATIENT,,,1233,801.45,,1085.04,88,,868.03,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,1233,100,,986.40,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",776.79,63,,621.43,,,0,"percent of total billed charges","63% of total billed charges",188.65,15.3,,150.92,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,850.77,69,,,,,0,"fee schedule","69% of total billed charges",1233,100,,986.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1233,100,,986.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1233,100,,986.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",464.84,37.7,,371.87,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",961.74,78,,769.39,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1018.46,82.6,,814.77,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1018.46,82.6,,814.77,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,1233,100,,986.40,,,0,"percent of total billed charges","100% of total billed charges",188.65,5715.97,
"25075 Excision, tumor, soft tissue of forearm and/",7962168,CDM,521,RC,25075,CPT,OUTPATIENT,,,1037,674.05,,912.56,88,,730.05,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,1037,100,,829.60,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",653.31,63,,522.65,,,0,"percent of total billed charges","63% of total billed charges",158.66,15.3,,126.93,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,715.53,69,,,,,0,"fee schedule","69% of total billed charges",1037,100,,829.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1037,100,,829.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1037,100,,829.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",390.95,37.7,,312.76,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",808.86,78,,647.09,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",856.56,82.6,,685.25,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",856.56,82.6,,685.25,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,1037,100,,829.60,,,0,"percent of total billed charges","100% of total billed charges",158.66,5715.97,
"25076 Excision, tumor, soft tissue of forearm and/",7962288,CDM,521,RC,25076,CPT,OUTPATIENT,,,1795,1166.75,,1579.6,88,,1263.68,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,1795,100,,1436.00,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1130.85,63,,904.68,,,0,"percent of total billed charges","63% of total billed charges",274.64,15.3,,219.71,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,1238.55,69,,,,,0,"fee schedule","69% of total billed charges",1795,100,,1436.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1795,100,,1436.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1795,100,,1436.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",676.72,37.7,,541.38,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1400.1,78,,1120.08,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1482.67,82.6,,1186.14,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1482.67,82.6,,1186.14,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,1795,100,,1436.00,,,0,"percent of total billed charges","100% of total billed charges",274.64,5715.97,
"25101 Arthrotomy, wrist joint; with joint explorat",7961805,CDM,521,RC,25101,CPT,OUTPATIENT,,,1177,765.05,,1035.76,88,,828.61,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,1177,100,,941.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",741.51,63,,593.21,,,0,"percent of total billed charges","63% of total billed charges",180.08,15.3,,144.06,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,812.13,69,,,,,0,"fee schedule","69% of total billed charges",1177,100,,941.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1177,100,,941.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1177,100,,941.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",443.73,37.7,,354.98,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",918.06,78,,734.45,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",972.2,82.6,,777.76,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",972.2,82.6,,777.76,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,1177,100,,941.60,,,0,"percent of total billed charges","100% of total billed charges",180.08,11498.59,
"25107 Arthrotomy, distal radioulnar joint includin",7962289,CDM,521,RC,25107,CPT,OUTPATIENT,,,2439,1585.35,,2146.32,88,,1717.06,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,2439,100,,1951.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1536.57,63,,1229.26,,,0,"percent of total billed charges","63% of total billed charges",373.17,15.3,,298.54,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,1682.91,69,,,,,0,"fee schedule","69% of total billed charges",2439,100,,1951.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2439,100,,1951.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2439,100,,1951.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",919.5,37.7,,735.60,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1902.42,78,,1521.94,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.61,82.6,,1611.69,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.61,82.6,,1611.69,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,2439,100,,1951.20,,,0,"percent of total billed charges","100% of total billed charges",373.17,11498.59,
"25109 Excision of tendon, forearm and/or wrist, fl",7962929,CDM,521,RC,25109,CPT,OUTPATIENT,,,1553,1009.45,,1366.64,88,,1093.31,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,1553,100,,1242.40,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",978.39,63,,782.71,,,0,"percent of total billed charges","63% of total billed charges",237.61,15.3,,190.09,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,1071.57,69,,,,,0,"fee schedule","69% of total billed charges",1553,100,,1242.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1553,100,,1242.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1553,100,,1242.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",585.48,37.7,,468.38,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1211.34,78,,969.07,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1282.78,82.6,,1026.22,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1282.78,82.6,,1026.22,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,1553,100,,1242.40,,,0,"percent of total billed charges","100% of total billed charges",237.61,11498.59,
"25105 Arthrotomy, wrist joint; with synovectomy",7963557,CDM,521,RC,25105,CPT,OUTPATIENT,,,1391,904.15,,1224.08,88,,979.26,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,1391,100,,1112.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",876.33,63,,701.06,,,0,"percent of total billed charges","63% of total billed charges",212.82,15.3,,170.26,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,959.79,69,,,,,0,"fee schedule","69% of total billed charges",1391,100,,1112.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1391,100,,1112.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1391,100,,1112.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",524.41,37.7,,419.53,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1084.98,78,,867.98,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1148.97,82.6,,919.18,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1148.97,82.6,,919.18,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,1391,100,,1112.80,,,0,"percent of total billed charges","100% of total billed charges",212.82,11498.59,
"25100 Arthrotomy, wrist joint; with biopsy",7963655,CDM,521,RC,25100,CPT,OUTPATIENT,,,1008,655.2,,887.04,88,,709.63,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,1008,100,,806.40,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",635.04,63,,508.03,,,0,"percent of total billed charges","63% of total billed charges",154.22,15.3,,123.38,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,695.52,69,,,,,0,"fee schedule","69% of total billed charges",1008,100,,806.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1008,100,,806.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1008,100,,806.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",380.02,37.7,,304.02,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.24,78,,628.99,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",832.61,82.6,,666.09,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",832.61,82.6,,666.09,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,1008,100,,806.40,,,0,"percent of total billed charges","100% of total billed charges",154.22,11498.59,
"25116 Radical excision of bursa, synovia of wrist,",7962440,CDM,521,RC,25116,CPT,OUTPATIENT,,,1431,930.15,,1259.28,88,,1007.42,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,1431,100,,1144.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",901.53,63,,721.22,,,0,"percent of total billed charges","63% of total billed charges",218.94,15.3,,175.15,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,987.39,69,,,,,0,"fee schedule","69% of total billed charges",1431,100,,1144.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1431,100,,1144.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1431,100,,1144.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",539.49,37.7,,431.59,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1116.18,78,,892.94,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1182.01,82.6,,945.61,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1182.01,82.6,,945.61,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,1431,100,,1144.80,,,0,"percent of total billed charges","100% of total billed charges",218.94,11498.59,
"25118 Synovectomy, extensor tendon sheath, wrist,",7963014,CDM,521,RC,25118,CPT,OUTPATIENT,,,917,596.05,,806.96,88,,645.57,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,917,100,,733.60,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",577.71,63,,462.17,,,0,"percent of total billed charges","63% of total billed charges",140.3,15.3,,112.24,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,632.73,69,,,,,0,"fee schedule","69% of total billed charges",917,100,,733.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",917,100,,733.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",917,100,,733.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",345.71,37.7,,276.57,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",715.26,78,,572.21,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",757.44,82.6,,605.95,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",757.44,82.6,,605.95,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,917,100,,733.60,,,0,"percent of total billed charges","100% of total billed charges",140.3,5656.45,
"25112 Excision of ganglion, wrist (dorsal or volar",7963215,CDM,521,RC,25112,CPT,OUTPATIENT,,,1487,966.55,,1308.56,88,,1046.85,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1487,100,,1189.60,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",936.81,63,,749.45,,,0,"percent of total billed charges","63% of total billed charges",227.51,15.3,,182.01,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1026.03,69,,,,,0,"fee schedule","69% of total billed charges",1487,100,,1189.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1487,100,,1189.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1487,100,,1189.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",560.6,37.7,,448.48,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1159.86,78,,927.89,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1228.26,82.6,,982.61,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1228.26,82.6,,982.61,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.81,100,,,,,0,"fee schedule",EAPG,1487,100,,1189.60,,,0,"percent of total billed charges","100% of total billed charges",227.51,5656.45,
"25110 Excision, lesion of tendon sheath, forearm a",7963246,CDM,521,RC,25110,CPT,OUTPATIENT,,,985,640.25,,866.8,88,,693.44,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,985,100,,788.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",620.55,63,,496.44,,,0,"percent of total billed charges","63% of total billed charges",150.71,15.3,,120.57,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,679.65,69,,,,,0,"fee schedule","69% of total billed charges",985,100,,788.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",985,100,,788.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",985,100,,788.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",371.35,37.7,,297.08,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",768.3,78,,614.64,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",813.61,82.6,,650.89,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",813.61,82.6,,650.89,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,985,100,,788.00,,,0,"percent of total billed charges","100% of total billed charges",150.71,5656.45,
"25111 Excision of ganglion, wrist (dorsal or volar",7963276,CDM,521,RC,25111,CPT,OUTPATIENT,,,1233,801.45,,1085.04,88,,868.03,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1233,100,,986.40,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",776.79,63,,621.43,,,0,"percent of total billed charges","63% of total billed charges",188.65,15.3,,150.92,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,850.77,69,,,,,0,"fee schedule","69% of total billed charges",1233,100,,986.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1233,100,,986.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1233,100,,986.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",464.84,37.7,,371.87,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",961.74,78,,769.39,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1018.46,82.6,,814.77,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1018.46,82.6,,814.77,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.81,100,,,,,0,"fee schedule",EAPG,1233,100,,986.40,,,0,"percent of total billed charges","100% of total billed charges",188.65,5656.45,
"25135 Excision or curettage of bone cyst or benign",7962403,CDM,521,RC,25135,CPT,OUTPATIENT,,,2218,1441.7,,1951.84,88,,1561.47,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,2218,100,,1774.40,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1397.34,63,,1117.87,,,0,"percent of total billed charges","63% of total billed charges",339.35,15.3,,271.48,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,1530.42,69,,,,,0,"fee schedule","69% of total billed charges",2218,100,,1774.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2218,100,,1774.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2218,100,,1774.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",836.19,37.7,,668.95,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1730.04,78,,1384.03,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1832.07,82.6,,1465.66,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1832.07,82.6,,1465.66,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,2218,100,,1774.40,,,0,"percent of total billed charges","100% of total billed charges",339.35,25451.55,
"25240 Excision distal ulna partial or complete (eg",7962464,CDM,521,RC,25240,CPT,OUTPATIENT,,,1955,1270.75,,1720.4,88,,1376.32,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,1955,100,,1564.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1231.65,63,,985.32,,,0,"percent of total billed charges","63% of total billed charges",299.12,15.3,,239.30,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,1348.95,69,,,,,0,"fee schedule","69% of total billed charges",1955,100,,1564.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955,100,,1564.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955,100,,1564.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",737.04,37.7,,589.63,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1524.9,78,,1219.92,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1614.83,82.6,,1291.86,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1614.83,82.6,,1291.86,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,1955,100,,1564.00,,,0,"percent of total billed charges","100% of total billed charges",299.12,11498.59,
"25248 Exploration with removal of deep foreign bod",7963015,CDM,521,RC,25248,CPT,OUTPATIENT,,,1443,937.95,,1269.84,88,,1015.87,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,1443,100,,1154.40,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",909.09,63,,727.27,,,0,"percent of total billed charges","63% of total billed charges",220.78,15.3,,176.62,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,995.67,69,,,,,0,"fee schedule","69% of total billed charges",1443,100,,1154.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1443,100,,1154.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1443,100,,1154.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",544.01,37.7,,435.21,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1125.54,78,,900.43,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1191.92,82.6,,953.54,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1191.92,82.6,,953.54,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,1443,100,,1154.40,,,0,"percent of total billed charges","100% of total billed charges",220.78,5656.45,
"25259 Manipulation, wrist, under anesthesia",7963614,CDM,521,RC,25259,CPT,OUTPATIENT,,,1216,790.4,,1070.08,88,,856.06,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,1216,100,,972.80,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",916.1,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",766.08,63,,612.86,,,0,"percent of total billed charges","63% of total billed charges",186.05,15.3,,148.84,,,0,"percent of total billed charges","15.3% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,839.04,69,,,,,0,"fee schedule","69% of total billed charges",1216,100,,972.80,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1216,100,,972.80,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1216,100,,972.80,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.21,100,,,,,0,"fee schedule",EAPG,1156.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",458.43,37.7,,366.74,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",948.48,78,,758.78,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1004.42,82.6,,803.54,,,0,"percent of total billed charges","82.6% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1004.42,82.6,,803.54,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1049.95,100,,,,,0,"fee schedule",EAPG,1216,100,,972.80,,,0,"percent of total billed charges","100% of total billed charges",186.05,5656.45,
"25260 Repair, tendon or muscle, flexor, forearm an",7961471,CDM,521,RC,25260,CPT,OUTPATIENT,,,2047,1330.55,,1801.36,88,,1441.09,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,2047,100,,1637.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1289.61,63,,1031.69,,,0,"percent of total billed charges","63% of total billed charges",313.19,15.3,,250.55,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,1412.43,69,,,,,0,"fee schedule","69% of total billed charges",2047,100,,1637.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047,100,,1637.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047,100,,1637.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",771.72,37.7,,617.38,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1596.66,78,,1277.33,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1690.82,82.6,,1352.66,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1690.82,82.6,,1352.66,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,2047,100,,1637.60,,,0,"percent of total billed charges","100% of total billed charges",313.19,11498.59,
"25270 Repair, tendon or muscle, extensor, forearm",7961472,CDM,521,RC,25270,CPT,OUTPATIENT,,,2107,1369.55,,1854.16,88,,1483.33,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,2107,100,,1685.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.41,63,,1061.93,,,0,"percent of total billed charges","63% of total billed charges",322.37,15.3,,257.90,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,1453.83,69,,,,,0,"fee schedule","69% of total billed charges",2107,100,,1685.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2107,100,,1685.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2107,100,,1685.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",794.34,37.7,,635.47,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1643.46,78,,1314.77,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1740.38,82.6,,1392.30,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1740.38,82.6,,1392.30,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,2107,100,,1685.60,,,0,"percent of total billed charges","100% of total billed charges",322.37,11498.59,
"25290 Tenotomy, open, flexor or extensor tendon, f",7962319,CDM,521,RC,25290,CPT,OUTPATIENT,,,2329,1513.85,,2049.52,88,,1639.62,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,2329,100,,1863.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1467.27,63,,1173.82,,,0,"percent of total billed charges","63% of total billed charges",356.34,15.3,,285.07,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,1607.01,69,,,,,0,"fee schedule","69% of total billed charges",2329,100,,1863.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2329,100,,1863.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2329,100,,1863.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",878.03,37.7,,702.42,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1816.62,78,,1453.30,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1923.75,82.6,,1539.00,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1923.75,82.6,,1539.00,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,2329,100,,1863.20,,,0,"percent of total billed charges","100% of total billed charges",356.34,11498.59,
"25295 Tenolysis, flexor or extensor tendon, forear",7962493,CDM,521,RC,25295,CPT,OUTPATIENT,,,2204,1432.6,,1939.52,88,,1551.62,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,2204,100,,1763.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1388.52,63,,1110.82,,,0,"percent of total billed charges","63% of total billed charges",337.21,15.3,,269.77,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,1520.76,69,,,,,0,"fee schedule","69% of total billed charges",2204,100,,1763.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2204,100,,1763.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2204,100,,1763.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",830.91,37.7,,664.73,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1719.12,78,,1375.30,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1820.5,82.6,,1456.40,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1820.5,82.6,,1456.40,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,2204,100,,1763.20,,,0,"percent of total billed charges","100% of total billed charges",337.21,11498.59,
"25301 Tenodesis at wrist; extensors of fingers",7963578,CDM,521,RC,25301,CPT,OUTPATIENT,,,2377,1545.05,,2091.76,88,,1673.41,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,2377,100,,1901.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1497.51,63,,1198.01,,,0,"percent of total billed charges","63% of total billed charges",363.68,15.3,,290.94,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,1640.13,69,,,,,0,"fee schedule","69% of total billed charges",2377,100,,1901.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2377,100,,1901.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2377,100,,1901.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",896.13,37.7,,716.90,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1854.06,78,,1483.25,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1963.4,82.6,,1570.72,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1963.4,82.6,,1570.72,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,2377,100,,1901.60,,,0,"percent of total billed charges","100% of total billed charges",363.68,11498.59,
"25320 Capsulorrhaphy or reconstruction, wrist, ope",7962874,CDM,521,RC,25320,CPT,OUTPATIENT,,,3683,2393.95,,3241.04,88,,2592.83,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,3683,100,,2946.40,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",5267.52,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2320.29,63,,1856.23,,,0,"percent of total billed charges","63% of total billed charges",563.5,15.3,,450.80,,,0,"percent of total billed charges","15.3% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,2541.27,69,,,,,0,"fee schedule","69% of total billed charges",3683,100,,2946.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3683,100,,2946.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3683,100,,2946.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5216.38,100,,,,,0,"fee schedule",EAPG,6648.32,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1388.49,37.7,,1110.79,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2872.74,78,,2298.19,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3042.16,82.6,,2433.73,,,0,"percent of total billed charges","82.6% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3042.16,82.6,,2433.73,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5274.62,100,,,,,0,"fee schedule",EAPG,3683,100,,2946.40,,,0,"percent of total billed charges","100% of total billed charges",563.5,25451.55,
"25350 Osteotomy, radius; distal third",7963726,CDM,521,RC,25350,CPT,OUTPATIENT,,,3075,1998.75,,2706,88,,2164.80,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,3075,100,,2460.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",5267.52,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1937.25,63,,1549.80,,,0,"percent of total billed charges","63% of total billed charges",470.48,15.3,,376.38,,,0,"percent of total billed charges","15.3% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,2121.75,69,,,,,0,"fee schedule","69% of total billed charges",3075,100,,2460.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3075,100,,2460.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3075,100,,2460.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5216.38,100,,,,,0,"fee schedule",EAPG,6648.32,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1159.28,37.7,,927.42,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2398.5,78,,1918.80,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2539.95,82.6,,2031.96,,,0,"percent of total billed charges","82.6% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2539.95,82.6,,2031.96,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5274.62,100,,,,,0,"fee schedule",EAPG,3075,100,,2460.00,,,0,"percent of total billed charges","100% of total billed charges",470.48,25451.55,
"25360 Osteotomy; ulna",7963922,CDM,521,RC,25360,CPT,OUTPATIENT,,,2768,1799.2,,2435.84,88,,1948.67,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,2768,100,,2214.40,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",5267.52,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1743.84,63,,1395.07,,,0,"percent of total billed charges","63% of total billed charges",423.5,15.3,,338.80,,,0,"percent of total billed charges","15.3% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,1909.92,69,,,,,0,"fee schedule","69% of total billed charges",2768,100,,2214.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2768,100,,2214.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2768,100,,2214.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5216.38,100,,,,,0,"fee schedule",EAPG,6648.32,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1043.54,37.7,,834.83,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2159.04,78,,1727.23,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2286.37,82.6,,1829.10,,,0,"percent of total billed charges","82.6% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2286.37,82.6,,1829.10,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5274.62,100,,,,,0,"fee schedule",EAPG,2768,100,,2214.40,,,0,"percent of total billed charges","100% of total billed charges",423.5,25451.55,
"25391 Osteoplasty, radius OR ulna; lengthening wit",7963247,CDM,521,RC,25391,CPT,OUTPATIENT,,,4101,2665.65,,3608.88,88,,2887.10,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,4101,100,,3280.80,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",5267.52,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2583.63,63,,2066.90,,,0,"percent of total billed charges","63% of total billed charges",627.45,15.3,,501.96,,,0,"percent of total billed charges","15.3% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,2829.69,69,,,,,0,"fee schedule","69% of total billed charges",4101,100,,3280.80,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4101,100,,3280.80,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4101,100,,3280.80,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5216.38,100,,,,,0,"fee schedule",EAPG,6648.32,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1546.08,37.7,,1236.86,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3198.78,78,,2559.02,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3387.43,82.6,,2709.94,,,0,"percent of total billed charges","82.6% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3387.43,82.6,,2709.94,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5274.62,100,,,,,0,"fee schedule",EAPG,4101,100,,3280.80,,,0,"percent of total billed charges","100% of total billed charges",627.45,50029.1,
"25390 Osteoplasty, radius OR ulna; shortening",7963597,CDM,521,RC,25390,CPT,OUTPATIENT,,,3677,2390.05,,3235.76,88,,2588.61,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,3677,100,,2941.60,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",5267.52,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2316.51,63,,1853.21,,,0,"percent of total billed charges","63% of total billed charges",562.58,15.3,,450.06,,,0,"percent of total billed charges","15.3% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,2537.13,69,,,,,0,"fee schedule","69% of total billed charges",3677,100,,2941.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3677,100,,2941.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3677,100,,2941.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5216.38,100,,,,,0,"fee schedule",EAPG,6648.32,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1386.23,37.7,,1108.98,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2868.06,78,,2294.45,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3037.2,82.6,,2429.76,,,0,"percent of total billed charges","82.6% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3037.2,82.6,,2429.76,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5274.62,100,,,,,0,"fee schedule",EAPG,3677,100,,2941.60,,,0,"percent of total billed charges","100% of total billed charges",562.58,25451.55,
"25400 Repair of nonunion or malunion, radius OR ul",7961855,CDM,521,RC,25400,CPT,OUTPATIENT,,,3480,2262,,3062.4,88,,2449.92,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,3480,100,,2784.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",5267.52,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2192.4,63,,1753.92,,,0,"percent of total billed charges","63% of total billed charges",532.44,15.3,,425.95,,,0,"percent of total billed charges","15.3% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,2401.2,69,,,,,0,"fee schedule","69% of total billed charges",3480,100,,2784.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3480,100,,2784.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3480,100,,2784.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5216.38,100,,,,,0,"fee schedule",EAPG,6648.32,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1311.96,37.7,,1049.57,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2714.4,78,,2171.52,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2874.48,82.6,,2299.58,,,0,"percent of total billed charges","82.6% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2874.48,82.6,,2299.58,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5274.62,100,,,,,0,"fee schedule",EAPG,3480,100,,2784.00,,,0,"percent of total billed charges","100% of total billed charges",532.44,25451.55,
"25405 Repair of nonunion or malunion, radius OR ul",7961856,CDM,521,RC,25405,CPT,OUTPATIENT,,,4388,2852.2,,3861.44,88,,3089.15,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,4388,100,,3510.40,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",5267.52,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2764.44,63,,2211.55,,,0,"percent of total billed charges","63% of total billed charges",671.36,15.3,,537.09,,,0,"percent of total billed charges","15.3% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,3027.72,69,,,,,0,"fee schedule","69% of total billed charges",4388,100,,3510.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4388,100,,3510.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4388,100,,3510.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5216.38,100,,,,,0,"fee schedule",EAPG,6648.32,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1654.28,37.7,,1323.42,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3422.64,78,,2738.11,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3624.49,82.6,,2899.59,,,0,"percent of total billed charges","82.6% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3624.49,82.6,,2899.59,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5274.62,100,,,,,0,"fee schedule",EAPG,4388,100,,3510.40,,,0,"percent of total billed charges","100% of total billed charges",671.36,25451.55,
"25415 Repair of nonunion or malunion, radius AND u",7961806,CDM,521,RC,25415,CPT,OUTPATIENT,,,4066,2642.9,,3578.08,88,,2862.46,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,4066,100,,3252.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",5267.52,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2561.58,63,,2049.26,,,0,"percent of total billed charges","63% of total billed charges",622.1,15.3,,497.68,,,0,"percent of total billed charges","15.3% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,2805.54,69,,,,,0,"fee schedule","69% of total billed charges",4066,100,,3252.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4066,100,,3252.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4066,100,,3252.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5216.38,100,,,,,0,"fee schedule",EAPG,6648.32,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1532.88,37.7,,1226.30,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3171.48,78,,2537.18,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3358.52,82.6,,2686.82,,,0,"percent of total billed charges","82.6% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3358.52,82.6,,2686.82,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5274.62,100,,,,,0,"fee schedule",EAPG,4066,100,,3252.80,,,0,"percent of total billed charges","100% of total billed charges",622.1,25451.55,
"25420 Repair of nonunion or malunion, radius AND u",7961807,CDM,521,RC,25420,CPT,OUTPATIENT,,,5289,3437.85,,4654.32,88,,3723.46,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",5267.52,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3332.07,63,,2665.66,,,0,"percent of total billed charges","63% of total billed charges",809.22,15.3,,647.38,,,0,"percent of total billed charges","15.3% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,3649.41,69,,,,,0,"fee schedule","69% of total billed charges",5289,100,,4231.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5289,100,,4231.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5289,100,,4231.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5216.38,100,,,,,0,"fee schedule",EAPG,6648.32,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1993.95,37.7,,1595.16,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4125.42,78,,3300.34,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4368.71,82.6,,3494.97,,,0,"percent of total billed charges","82.6% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4368.71,82.6,,3494.97,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5274.62,100,,,,,0,"fee schedule",EAPG,5289,100,,4231.20,,,0,"percent of total billed charges","100% of total billed charges",809.22,25451.55,
"25440 Repair of nonunion, scaphoid carpal bone, w/",7962902,CDM,521,RC,25440,CPT,OUTPATIENT,,,1913,1243.45,,1683.44,88,,1346.75,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,1913,100,,1530.40,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",5267.52,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1205.19,63,,964.15,,,0,"percent of total billed charges","63% of total billed charges",292.69,15.3,,234.15,,,0,"percent of total billed charges","15.3% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,1319.97,69,,,,,0,"fee schedule","69% of total billed charges",1913,100,,1530.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1913,100,,1530.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1913,100,,1530.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5216.38,100,,,,,0,"fee schedule",EAPG,6648.32,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",721.2,37.7,,576.96,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1492.14,78,,1193.71,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1580.14,82.6,,1264.11,,,0,"percent of total billed charges","82.6% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1580.14,82.6,,1264.11,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5274.62,100,,,,,0,"fee schedule",EAPG,1913,100,,1530.40,,,0,"percent of total billed charges","100% of total billed charges",292.69,25451.55,
"25447 Arthroplasty, interposition, intercarpal or",7962930,CDM,521,RC,25447,CPT,OUTPATIENT,,,2410,1566.5,,2120.8,88,,1696.64,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3128.81,100,,,,,0,"fee schedule",EAPG,2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",3222.67,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1518.3,63,,1214.64,,,0,"percent of total billed charges","63% of total billed charges",368.73,15.3,,294.98,,,0,"percent of total billed charges","15.3% of total billed charges",3128.81,100,,,,,0,"fee schedule",EAPG,1662.9,69,,,,,0,"fee schedule","69% of total billed charges",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3128.81,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3191.38,100,,,,,0,"fee schedule",EAPG,4067.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",908.57,37.7,,726.86,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1879.8,78,,1503.84,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",3128.81,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1990.66,82.6,,1592.53,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3289.34,100,,,,,0,"fee schedule",EAPG,2410,100,,1928.00,,,0,"percent of total billed charges","100% of total billed charges",368.73,11498.59,
"25500 Closed treatment of radial shaft fracture; w",7903213,CDM,521,RC,25500,CPT,OUTPATIENT,,,627,407.55,,551.76,88,,441.41,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,627,100,,501.60,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",395.01,63,,316.01,,,0,"percent of total billed charges","63% of total billed charges",95.93,15.3,,76.74,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,432.63,69,,,,,0,"fee schedule","69% of total billed charges",627,100,,501.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",627,100,,501.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",627,100,,501.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",236.38,37.7,,189.10,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",489.06,78,,391.25,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",517.9,82.6,,414.32,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",517.9,82.6,,414.32,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,627,100,,501.60,,,0,"percent of total billed charges","100% of total billed charges",95.93,837.64,
"25505 Closed treatment of radial shaft fracture; w",7963100,CDM,521,RC,25505,CPT,OUTPATIENT,,,1307,849.55,,1150.16,88,,920.13,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1307,100,,1045.60,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",823.41,63,,658.73,,,0,"percent of total billed charges","63% of total billed charges",199.97,15.3,,159.98,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,901.83,69,,,,,0,"fee schedule","69% of total billed charges",1307,100,,1045.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1307,100,,1045.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1307,100,,1045.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",492.74,37.7,,394.19,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1019.46,78,,815.57,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1079.58,82.6,,863.66,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1079.58,82.6,,863.66,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,1307,100,,1045.60,,,0,"percent of total billed charges","100% of total billed charges",199.97,5656.45,
"25515 Open treatment of radial shaft fracture, inc",7962362,CDM,521,RC,25515,CPT,OUTPATIENT,,,2499,1624.35,,2199.12,88,,1759.30,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2499,100,,1999.20,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1574.37,63,,1259.50,,,0,"percent of total billed charges","63% of total billed charges",382.35,15.3,,305.88,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1724.31,69,,,,,0,"fee schedule","69% of total billed charges",2499,100,,1999.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2499,100,,1999.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2499,100,,1999.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",942.12,37.7,,753.70,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1949.22,78,,1559.38,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2064.17,82.6,,1651.34,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2064.17,82.6,,1651.34,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2499,100,,1999.20,,,0,"percent of total billed charges","100% of total billed charges",382.35,25451.55,
"25526 Open tx radial shaft fx, open tx joint dislo",7961579,CDM,521,RC,25526,CPT,OUTPATIENT,,,1495,971.75,,1315.6,88,,1052.48,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,1495,100,,1196.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",941.85,63,,753.48,,,0,"percent of total billed charges","63% of total billed charges",228.74,15.3,,182.99,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1031.55,69,,,,,0,"fee schedule","69% of total billed charges",1495,100,,1196.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1495,100,,1196.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1495,100,,1196.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",563.62,37.7,,450.90,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1166.1,78,,932.88,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1234.87,82.6,,987.90,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1234.87,82.6,,987.90,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,1495,100,,1196.00,,,0,"percent of total billed charges","100% of total billed charges",228.74,25451.55,
"25525 Open tx radial shaft fx and closed tx of joi",7962404,CDM,521,RC,25525,CPT,OUTPATIENT,,,3243,2107.95,,2853.84,88,,2283.07,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3243,100,,2594.40,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2043.09,63,,1634.47,,,0,"percent of total billed charges","63% of total billed charges",496.18,15.3,,396.94,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,2237.67,69,,,,,0,"fee schedule","69% of total billed charges",3243,100,,2594.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3243,100,,2594.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3243,100,,2594.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1222.61,37.7,,978.09,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2529.54,78,,2023.63,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2678.72,82.6,,2142.98,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2678.72,82.6,,2142.98,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,3243,100,,2594.40,,,0,"percent of total billed charges","100% of total billed charges",496.18,25451.55,
"25530 Closed treatment of ulnar shaft fracture; wi",7903214,CDM,521,RC,25530,CPT,OUTPATIENT,,,791,514.15,,696.08,88,,556.86,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,791,100,,632.80,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",498.33,63,,398.66,,,0,"percent of total billed charges","63% of total billed charges",121.02,15.3,,96.82,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,545.79,69,,,,,0,"fee schedule","69% of total billed charges",791,100,,632.80,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",791,100,,632.80,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",791,100,,632.80,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",298.21,37.7,,238.57,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.98,78,,493.58,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",653.37,82.6,,522.70,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",653.37,82.6,,522.70,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,791,100,,632.80,,,0,"percent of total billed charges","100% of total billed charges",121.02,837.64,
"25535 Closed treatment of ulnar shaft fracture; wi",7963135,CDM,521,RC,25535,CPT,OUTPATIENT,,,758,492.7,,667.04,88,,533.63,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,758,100,,606.40,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",477.54,63,,382.03,,,0,"percent of total billed charges","63% of total billed charges",115.97,15.3,,92.78,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,523.02,69,,,,,0,"fee schedule","69% of total billed charges",758,100,,606.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",758,100,,606.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",758,100,,606.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",285.77,37.7,,228.62,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591.24,78,,472.99,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",626.11,82.6,,500.89,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",626.11,82.6,,500.89,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,758,100,,606.40,,,0,"percent of total billed charges","100% of total billed charges",115.97,837.64,
"25545 Open treatment of ulnar shaft fracture, incl",7962405,CDM,521,RC,25545,CPT,OUTPATIENT,,,2282,1483.3,,2008.16,88,,1606.53,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2282,100,,1825.60,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1437.66,63,,1150.13,,,0,"percent of total billed charges","63% of total billed charges",349.15,15.3,,279.32,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1574.58,69,,,,,0,"fee schedule","69% of total billed charges",2282,100,,1825.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2282,100,,1825.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2282,100,,1825.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",860.31,37.7,,688.25,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1779.96,78,,1423.97,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1884.93,82.6,,1507.94,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1884.93,82.6,,1507.94,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2282,100,,1825.60,,,0,"percent of total billed charges","100% of total billed charges",349.15,25451.55,
"25560 Closed treatment of radial and ulnar shaft f",7903215,CDM,521,RC,25560,CPT,OUTPATIENT,,,759,493.35,,667.92,88,,534.34,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,759,100,,607.20,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",478.17,63,,382.54,,,0,"percent of total billed charges","63% of total billed charges",116.13,15.3,,92.90,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,523.71,69,,,,,0,"fee schedule","69% of total billed charges",759,100,,607.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759,100,,607.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759,100,,607.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",286.14,37.7,,228.91,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",592.02,78,,473.62,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",626.93,82.6,,501.54,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",626.93,82.6,,501.54,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,759,100,,607.20,,,0,"percent of total billed charges","100% of total billed charges",116.13,837.64,
"25565 Closed treatment of radial and ulnar shaft f",7903216,CDM,521,RC,25565,CPT,OUTPATIENT,,,1780,1157,,1566.4,88,,1253.12,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1780,100,,1424.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1121.4,63,,897.12,,,0,"percent of total billed charges","63% of total billed charges",272.34,15.3,,217.87,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1228.2,69,,,,,0,"fee schedule","69% of total billed charges",1780,100,,1424.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1780,100,,1424.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1780,100,,1424.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",671.06,37.7,,536.85,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1388.4,78,,1110.72,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1470.28,82.6,,1176.22,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1470.28,82.6,,1176.22,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,1780,100,,1424.00,,,0,"percent of total billed charges","100% of total billed charges",272.34,5656.45,
"25575 Open tx radial AND ulnar shaft fx, with inte",7962548,CDM,521,RC,25575,CPT,OUTPATIENT,,,3185,2070.25,,2802.8,88,,2242.24,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3185,100,,2548.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2006.55,63,,1605.24,,,0,"percent of total billed charges","63% of total billed charges",487.31,15.3,,389.85,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,2197.65,69,,,,,0,"fee schedule","69% of total billed charges",3185,100,,2548.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3185,100,,2548.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3185,100,,2548.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1200.75,37.7,,960.60,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2484.3,78,,1987.44,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2630.81,82.6,,2104.65,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2630.81,82.6,,2104.65,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,3185,100,,2548.00,,,0,"percent of total billed charges","100% of total billed charges",487.31,25451.55,
"25574 Open tx radial AND ulnar shaft fx, with inte",7962592,CDM,521,RC,25574,CPT,OUTPATIENT,,,2541,1651.65,,2236.08,88,,1788.86,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2541,100,,2032.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1600.83,63,,1280.66,,,0,"percent of total billed charges","63% of total billed charges",388.77,15.3,,311.02,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1753.29,69,,,,,0,"fee schedule","69% of total billed charges",2541,100,,2032.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2541,100,,2032.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2541,100,,2032.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",957.96,37.7,,766.37,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1981.98,78,,1585.58,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2098.87,82.6,,1679.10,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2098.87,82.6,,1679.10,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2541,100,,2032.80,,,0,"percent of total billed charges","100% of total billed charges",388.77,25451.55,
"25600 Closed treatment of distal radial fracture;",7903135,CDM,521,RC,25600,CPT,OUTPATIENT,,,777,505.05,,683.76,88,,547.01,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,777,100,,621.60,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",489.51,63,,391.61,,,0,"percent of total billed charges","63% of total billed charges",118.88,15.3,,95.10,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,536.13,69,,,,,0,"fee schedule","69% of total billed charges",777,100,,621.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",777,100,,621.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",777,100,,621.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",292.93,37.7,,234.34,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",606.06,78,,484.85,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",641.8,82.6,,513.44,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",641.8,82.6,,513.44,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,777,100,,621.60,,,0,"percent of total billed charges","100% of total billed charges",118.88,837.64,
"25605 Closed treatment of distal radial fracture;",7903136,CDM,521,RC,25605,CPT,OUTPATIENT,,,1284,834.6,,1129.92,88,,903.94,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1284,100,,1027.20,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",808.92,63,,647.14,,,0,"percent of total billed charges","63% of total billed charges",196.45,15.3,,157.16,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,885.96,69,,,,,0,"fee schedule","69% of total billed charges",1284,100,,1027.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1284,100,,1027.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1284,100,,1027.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",484.07,37.7,,387.26,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1001.52,78,,801.22,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1060.58,82.6,,848.46,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1060.58,82.6,,848.46,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,1284,100,,1027.20,,,0,"percent of total billed charges","100% of total billed charges",196.45,5656.45,
"25608 Open tx distal radial intra-articular fx or",7961473,CDM,521,RC,25608,CPT,OUTPATIENT,,,2760,1794,,2428.8,88,,1943.04,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2760,100,,2208.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1738.8,63,,1391.04,,,0,"percent of total billed charges","63% of total billed charges",422.28,15.3,,337.82,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1904.4,69,,,,,0,"fee schedule","69% of total billed charges",2760,100,,2208.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2760,100,,2208.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2760,100,,2208.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1040.52,37.7,,832.42,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2152.8,78,,1722.24,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2279.76,82.6,,1823.81,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2279.76,82.6,,1823.81,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2760,100,,2208.00,,,0,"percent of total billed charges","100% of total billed charges",422.28,25451.55,
"25609 Open tx distal radial intra-articular fx or",7961808,CDM,521,RC,25609,CPT,OUTPATIENT,,,2118,1376.7,,1863.84,88,,1491.07,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2118,100,,1694.40,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1334.34,63,,1067.47,,,0,"percent of total billed charges","63% of total billed charges",324.05,15.3,,259.24,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1461.42,69,,,,,0,"fee schedule","69% of total billed charges",2118,100,,1694.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2118,100,,1694.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2118,100,,1694.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",798.49,37.7,,638.79,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1652.04,78,,1321.63,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1749.47,82.6,,1399.58,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1749.47,82.6,,1399.58,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2118,100,,1694.40,,,0,"percent of total billed charges","100% of total billed charges",324.05,25451.55,
"25607 Open tx distal radial extra-articular fx or",7961857,CDM,521,RC,25607,CPT,OUTPATIENT,,,2071,1346.15,,1822.48,88,,1457.98,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2071,100,,1656.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1304.73,63,,1043.78,,,0,"percent of total billed charges","63% of total billed charges",316.86,15.3,,253.49,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1428.99,69,,,,,0,"fee schedule","69% of total billed charges",2071,100,,1656.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2071,100,,1656.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2071,100,,1656.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",780.77,37.7,,624.62,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1615.38,78,,1292.30,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1710.65,82.6,,1368.52,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1710.65,82.6,,1368.52,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2071,100,,1656.80,,,0,"percent of total billed charges","100% of total billed charges",316.86,25451.55,
"25606 Percutaneous skeletal fixation of distal rad",7962441,CDM,521,RC,25606,CPT,OUTPATIENT,,,2118,1376.7,,1863.84,88,,1491.07,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2118,100,,1694.40,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1334.34,63,,1067.47,,,0,"percent of total billed charges","63% of total billed charges",324.05,15.3,,259.24,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1461.42,69,,,,,0,"fee schedule","69% of total billed charges",2118,100,,1694.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2118,100,,1694.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2118,100,,1694.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",798.49,37.7,,638.79,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1652.04,78,,1321.63,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1749.47,82.6,,1399.58,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1749.47,82.6,,1399.58,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2118,100,,1694.40,,,0,"percent of total billed charges","100% of total billed charges",324.05,11498.59,
"25622 Closed treatment of carpal scaphoid (navicul",7962523,CDM,521,RC,25622,CPT,OUTPATIENT,,,777,505.05,,683.76,88,,547.01,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,777,100,,621.60,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",489.51,63,,391.61,,,0,"percent of total billed charges","63% of total billed charges",118.88,15.3,,95.10,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,536.13,69,,,,,0,"fee schedule","69% of total billed charges",777,100,,621.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",777,100,,621.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",777,100,,621.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",292.93,37.7,,234.34,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",606.06,78,,484.85,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",641.8,82.6,,513.44,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",641.8,82.6,,513.44,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,777,100,,621.60,,,0,"percent of total billed charges","100% of total billed charges",118.88,837.64,
"25624 Closed treatment of carpal scaphoid (navicul",7962625,CDM,521,RC,25624,CPT,OUTPATIENT,,,1054,685.1,,927.52,88,,742.02,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1054,100,,843.20,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",664.02,63,,531.22,,,0,"percent of total billed charges","63% of total billed charges",161.26,15.3,,129.01,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,727.26,69,,,,,0,"fee schedule","69% of total billed charges",1054,100,,843.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1054,100,,843.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1054,100,,843.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",397.36,37.7,,317.89,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",822.12,78,,657.70,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",870.6,82.6,,696.48,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",870.6,82.6,,696.48,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,1054,100,,843.20,,,0,"percent of total billed charges","100% of total billed charges",161.26,5656.45,
"25628 Open treatment of carpal scaphoid fracture,",7962801,CDM,521,RC,25628,CPT,OUTPATIENT,,,1723,1119.95,,1516.24,88,,1212.99,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,1723,100,,1378.40,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1085.49,63,,868.39,,,0,"percent of total billed charges","63% of total billed charges",263.62,15.3,,210.90,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1188.87,69,,,,,0,"fee schedule","69% of total billed charges",1723,100,,1378.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1723,100,,1378.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1723,100,,1378.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",649.57,37.7,,519.66,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1343.94,78,,1075.15,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1423.2,82.6,,1138.56,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1423.2,82.6,,1138.56,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,1723,100,,1378.40,,,0,"percent of total billed charges","100% of total billed charges",263.62,25451.55,
"25635 Closed treatment of carpal bone fracture; wi",7962802,CDM,521,RC,25635,CPT,OUTPATIENT,,,1015,659.75,,893.2,88,,714.56,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1015,100,,812.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",639.45,63,,511.56,,,0,"percent of total billed charges","63% of total billed charges",155.3,15.3,,124.24,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,700.35,69,,,,,0,"fee schedule","69% of total billed charges",1015,100,,812.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1015,100,,812.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1015,100,,812.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",382.66,37.7,,306.13,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",791.7,78,,633.36,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",838.39,82.6,,670.71,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",838.39,82.6,,670.71,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,1015,100,,812.00,,,0,"percent of total billed charges","100% of total billed charges",155.3,5656.45,
"25630 Closed treatment of carpal bone fracture; wi",7963045,CDM,521,RC,25630,CPT,OUTPATIENT,,,724,470.6,,637.12,88,,509.70,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,724,100,,579.20,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",456.12,63,,364.90,,,0,"percent of total billed charges","63% of total billed charges",110.77,15.3,,88.62,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,499.56,69,,,,,0,"fee schedule","69% of total billed charges",724,100,,579.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",724,100,,579.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",724,100,,579.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",272.95,37.7,,218.36,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",564.72,78,,451.78,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",598.02,82.6,,478.42,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",598.02,82.6,,478.42,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,724,100,,579.20,,,0,"percent of total billed charges","100% of total billed charges",110.77,837.64,
"25645 Open treatment of carpal bone fracture (othe",7961809,CDM,521,RC,25645,CPT,OUTPATIENT,,,2019,1312.35,,1776.72,88,,1421.38,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2019,100,,1615.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1271.97,63,,1017.58,,,0,"percent of total billed charges","63% of total billed charges",308.91,15.3,,247.13,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1393.11,69,,,,,0,"fee schedule","69% of total billed charges",2019,100,,1615.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2019,100,,1615.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2019,100,,1615.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",761.16,37.7,,608.93,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1574.82,78,,1259.86,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1667.69,82.6,,1334.15,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1667.69,82.6,,1334.15,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2019,100,,1615.20,,,0,"percent of total billed charges","100% of total billed charges",308.91,11498.59,
"25651 Percutaneous skeletal fixation of ulnar styl",7963216,CDM,521,RC,25651,CPT,OUTPATIENT,,,1323,859.95,,1164.24,88,,931.39,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,1323,100,,1058.40,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",833.49,63,,666.79,,,0,"percent of total billed charges","63% of total billed charges",202.42,15.3,,161.94,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,912.87,69,,,,,0,"fee schedule","69% of total billed charges",1323,100,,1058.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1323,100,,1058.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1323,100,,1058.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",498.77,37.7,,399.02,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1031.94,78,,825.55,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1092.8,82.6,,874.24,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1092.8,82.6,,874.24,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,1323,100,,1058.40,,,0,"percent of total billed charges","100% of total billed charges",202.42,11498.59,
"25652 Open treatment of ulnar styloid fracture",7963579,CDM,521,RC,25652,CPT,OUTPATIENT,,,1622,1054.3,,1427.36,88,,1141.89,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,1622,100,,1297.60,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1021.86,63,,817.49,,,0,"percent of total billed charges","63% of total billed charges",248.17,15.3,,198.54,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1119.18,69,,,,,0,"fee schedule","69% of total billed charges",1622,100,,1297.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1622,100,,1297.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1622,100,,1297.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",611.49,37.7,,489.19,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1265.16,78,,1012.13,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1339.77,82.6,,1071.82,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1339.77,82.6,,1071.82,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,1622,100,,1297.60,,,0,"percent of total billed charges","100% of total billed charges",248.17,25451.55,
"25670 Open treatment of radiocarpal or intercarpal",7962699,CDM,521,RC,25670,CPT,OUTPATIENT,,,1858,1207.7,,1635.04,88,,1308.03,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,1858,100,,1486.40,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1170.54,63,,936.43,,,0,"percent of total billed charges","63% of total billed charges",284.27,15.3,,227.42,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1282.02,69,,,,,0,"fee schedule","69% of total billed charges",1858,100,,1486.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1858,100,,1486.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1858,100,,1486.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",700.47,37.7,,560.38,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1449.24,78,,1159.39,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1534.71,82.6,,1227.77,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1534.71,82.6,,1227.77,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,1858,100,,1486.40,,,0,"percent of total billed charges","100% of total billed charges",284.27,25451.55,
"25676 Open treatment of distal radioulnar dislocat",7962960,CDM,521,RC,25676,CPT,OUTPATIENT,,,955,620.75,,840.4,88,,672.32,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",601.65,63,,481.32,,,0,"percent of total billed charges","63% of total billed charges",146.12,15.3,,116.90,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,658.95,69,,,,,0,"fee schedule","69% of total billed charges",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",360.04,37.7,,288.03,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",744.9,78,,595.92,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",788.83,82.6,,631.06,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",788.83,82.6,,631.06,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",146.12,25451.55,
"25671 Percutaneous skeletal fixation of distal rad",7962984,CDM,521,RC,25671,CPT,OUTPATIENT,,,970,630.5,,853.6,88,,682.88,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,970,100,,776.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",611.1,63,,488.88,,,0,"percent of total billed charges","63% of total billed charges",148.41,15.3,,118.73,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,669.3,69,,,,,0,"fee schedule","69% of total billed charges",970,100,,776.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",970,100,,776.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",970,100,,776.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",365.69,37.7,,292.55,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",756.6,78,,605.28,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",801.22,82.6,,640.98,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",801.22,82.6,,640.98,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,970,100,,776.00,,,0,"percent of total billed charges","100% of total billed charges",148.41,11498.59,
"25685 Open treatment of trans-scaphoperilunar type",7962875,CDM,521,RC,25685,CPT,OUTPATIENT,,,2266,1472.9,,1994.08,88,,1595.26,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1427.58,63,,1142.06,,,0,"percent of total billed charges","63% of total billed charges",346.7,15.3,,277.36,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1563.54,69,,,,,0,"fee schedule","69% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",854.28,37.7,,683.42,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1767.48,78,,1413.98,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1871.72,82.6,,1497.38,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1871.72,82.6,,1497.38,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",346.7,25451.55,
"25690 Closed treatment of lunate dislocation, with",7963187,CDM,521,RC,25690,CPT,OUTPATIENT,,,1404,912.6,,1235.52,88,,988.42,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1404,100,,1123.20,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",884.52,63,,707.62,,,0,"percent of total billed charges","63% of total billed charges",214.81,15.3,,171.85,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,968.76,69,,,,,0,"fee schedule","69% of total billed charges",1404,100,,1123.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1404,100,,1123.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1404,100,,1123.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",529.31,37.7,,423.45,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1095.12,78,,876.10,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1159.7,82.6,,927.76,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1159.7,82.6,,927.76,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,1404,100,,1123.20,,,0,"percent of total billed charges","100% of total billed charges",214.81,5656.45,
"25800 Arthrodesis, wrist; complete, w/o bone graft",7963501,CDM,521,RC,25800,CPT,OUTPATIENT,,,2071,1346.15,,1822.48,88,,1457.98,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,2071,100,,1656.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",5267.52,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1304.73,63,,1043.78,,,0,"percent of total billed charges","63% of total billed charges",316.86,15.3,,253.49,,,0,"percent of total billed charges","15.3% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,1428.99,69,,,,,0,"fee schedule","69% of total billed charges",2071,100,,1656.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2071,100,,1656.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2071,100,,1656.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5216.38,100,,,,,0,"fee schedule",EAPG,6648.32,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",780.77,37.7,,624.62,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1615.38,78,,1292.30,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1710.65,82.6,,1368.52,,,0,"percent of total billed charges","82.6% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1710.65,82.6,,1368.52,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5274.62,100,,,,,0,"fee schedule",EAPG,2071,100,,1656.80,,,0,"percent of total billed charges","100% of total billed charges",316.86,25451.55,
"25805 Arthrodesis, wrist; with sliding graft",7963619,CDM,521,RC,25805,CPT,OUTPATIENT,,,2393,1555.45,,2105.84,88,,1684.67,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,2393,100,,1914.40,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",5267.52,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1507.59,63,,1206.07,,,0,"percent of total billed charges","63% of total billed charges",366.13,15.3,,292.90,,,0,"percent of total billed charges","15.3% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,1651.17,69,,,,,0,"fee schedule","69% of total billed charges",2393,100,,1914.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2393,100,,1914.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2393,100,,1914.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5216.38,100,,,,,0,"fee schedule",EAPG,6648.32,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",902.16,37.7,,721.73,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1866.54,78,,1493.23,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1976.62,82.6,,1581.30,,,0,"percent of total billed charges","82.6% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1976.62,82.6,,1581.30,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5274.62,100,,,,,0,"fee schedule",EAPG,2393,100,,1914.40,,,0,"percent of total billed charges","100% of total billed charges",366.13,25451.55,
"25810 Arthrodesis, wrist; with iliac or other auto",7962593,CDM,521,RC,25810,CPT,OUTPATIENT,,,3232,2100.8,,2844.16,88,,2275.33,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,3232,100,,2585.60,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",5267.52,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2036.16,63,,1628.93,,,0,"percent of total billed charges","63% of total billed charges",494.5,15.3,,395.60,,,0,"percent of total billed charges","15.3% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,2230.08,69,,,,,0,"fee schedule","69% of total billed charges",3232,100,,2585.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3232,100,,2585.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3232,100,,2585.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5216.38,100,,,,,0,"fee schedule",EAPG,6648.32,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1218.46,37.7,,974.77,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2520.96,78,,2016.77,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2669.63,82.6,,2135.70,,,0,"percent of total billed charges","82.6% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2669.63,82.6,,2135.70,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5274.62,100,,,,,0,"fee schedule",EAPG,3232,100,,2585.60,,,0,"percent of total billed charges","100% of total billed charges",494.5,50029.1,
"25825 Arthrodesis, wrist; with autograft (includes",7963067,CDM,521,RC,25825,CPT,OUTPATIENT,,,3192,2074.8,,2808.96,88,,2247.17,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,3192,100,,2553.60,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",2038.17,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2010.96,63,,1608.77,,,0,"percent of total billed charges","63% of total billed charges",488.38,15.3,,390.70,,,0,"percent of total billed charges","15.3% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,2202.48,69,,,,,0,"fee schedule","69% of total billed charges",3192,100,,2553.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3192,100,,2553.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3192,100,,2553.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2018.38,100,,,,,0,"fee schedule",EAPG,2572.45,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.38,37.7,,962.70,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2489.76,78,,1991.81,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2636.59,82.6,,2109.27,,,0,"percent of total billed charges","82.6% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2636.59,82.6,,2109.27,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2139.33,100,,,,,0,"fee schedule",EAPG,3192,100,,2553.60,,,0,"percent of total billed charges","100% of total billed charges",488.38,25451.55,
"25900 Amputation, forearm, through radius and ulna",7963493,CDM,521,RC,25900,CPT,OUTPATIENT,,,2195,1426.75,,1931.6,88,,1545.28,,,0,"percent of total billed charges","88% of total billed charges",2195,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5114.09,100,,,,,0,"fee schedule",EAPG,2195,100,,1756.00,,,0,"percent of total billed charges","100% of total billed charges",2195,175,,,,,0,"fee schedule","175% of CMS fee schedule",5267.52,100,,,,,0,"fee schedule",EAPG,2195,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1382.85,63,,1106.28,,,0,"percent of total billed charges","63% of total billed charges",335.84,15.3,,268.67,,,0,"percent of total billed charges","15.3% of total billed charges",5114.09,100,,,,,0,"fee schedule",EAPG,1514.55,69,,,,,0,"fee schedule","69% of total billed charges",2195,100,,1756.00,,,0,"percent of total billed charges","100% of total billed charges",2195,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2195,100,,1756.00,,,0,"percent of total billed charges","100% of total billed charges",2195,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2195,100,,1756.00,,,0,"percent of total billed charges","100% of total billed charges",2195,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.09,100,,,,,0,"fee schedule",EAPG,2195,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2195,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",2195,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5216.38,100,,,,,0,"fee schedule",EAPG,6648.32,100,,,,,0,"fee schedule",EAPG,2195,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",827.52,37.7,,662.02,,,0,"percent of total billed charges","37.70% of total billed charges",2195,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2195,100,,,,,0,"fee schedule","100% of CMS fee schedule",1712.1,78,,1369.68,,,0,"percent of total billed charges","78% of total billed charges",2195,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1813.07,82.6,,1450.46,,,0,"percent of total billed charges","82.6% of total billed charges",5114.09,100,,,,,0,"fee schedule","100% of WA fee schedule",2195,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1813.07,82.6,,1450.46,,,0,"percent of total billed charges","82.6% of total billed charges",2195,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5274.62,100,,,,,0,"fee schedule",EAPG,2195,100,,1756.00,,,0,"percent of total billed charges","100% of total billed charges",335.84,50029.1,
"25931 Transmetacarpal amputation; re-amputation",7963569,CDM,521,RC,25931,CPT,OUTPATIENT,,,1448,941.2,,1274.24,88,,1019.39,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,1448,100,,1158.40,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1605.2,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",912.24,63,,729.79,,,0,"percent of total billed charges","63% of total billed charges",221.54,15.3,,177.23,,,0,"percent of total billed charges","15.3% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,999.12,69,,,,,0,"fee schedule","69% of total billed charges",1448,100,,1158.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1448,100,,1158.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1448,100,,1158.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.62,100,,,,,0,"fee schedule",EAPG,2025.98,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",545.9,37.7,,436.72,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1129.44,78,,903.55,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1196.05,82.6,,956.84,,,0,"percent of total billed charges","82.6% of total billed charges",1558.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1196.05,82.6,,956.84,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1718.98,100,,,,,0,"fee schedule",EAPG,1448,100,,1158.40,,,0,"percent of total billed charges","100% of total billed charges",221.54,11498.59,
"26011 Drainage of finger abscess; complicated (eg,",7963354,CDM,521,RC,26011,CPT,OUTPATIENT,,,690,448.5,,607.2,88,,485.76,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",989.16,100,,,,,0,"fee schedule",EAPG,690,100,,552.00,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1018.83,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",434.7,63,,347.76,,,0,"percent of total billed charges","63% of total billed charges",105.57,15.3,,84.46,,,0,"percent of total billed charges","15.3% of total billed charges",989.16,100,,,,,0,"fee schedule",EAPG,476.1,69,,,,,0,"fee schedule","69% of total billed charges",690,100,,552.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",690,100,,552.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",690,100,,552.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",989.16,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1008.94,100,,,,,0,"fee schedule",EAPG,1285.91,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",260.13,37.7,,208.10,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",538.2,78,,430.56,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",569.94,82.6,,455.95,,,0,"percent of total billed charges","82.6% of total billed charges",989.16,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",569.94,82.6,,455.95,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1149.69,100,,,,,0,"fee schedule",EAPG,690,100,,552.00,,,0,"percent of total billed charges","100% of total billed charges",105.57,5715.97,
"26010 Drainage of finger abscess; simple",7963689,CDM,521,RC,26010,CPT,OUTPATIENT,,,475,308.75,,418,88,,334.40,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",151.74,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",299.25,63,,239.40,,,0,"percent of total billed charges","63% of total billed charges",72.68,15.3,,58.14,,,0,"percent of total billed charges","15.3% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,327.75,69,,,,,0,"fee schedule","69% of total billed charges",475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",179.08,37.7,,143.26,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",370.5,78,,296.40,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.35,82.6,,313.88,,,0,"percent of total billed charges","82.6% of total billed charges",147.32,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.35,82.6,,313.88,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.85,100,,,,,0,"fee schedule",EAPG,475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",72.68,729.41,
"26020 Drainage of tendon sheath, digit and/or palm",7963380,CDM,521,RC,26020,CPT,OUTPATIENT,,,1769,1149.85,,1556.72,88,,1245.38,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1769,100,,1415.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1114.47,63,,891.58,,,0,"percent of total billed charges","63% of total billed charges",270.66,15.3,,216.53,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1220.61,69,,,,,0,"fee schedule","69% of total billed charges",1769,100,,1415.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1769,100,,1415.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1769,100,,1415.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",666.91,37.7,,533.53,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1379.82,78,,1103.86,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1461.19,82.6,,1168.95,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1461.19,82.6,,1168.95,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.81,100,,,,,0,"fee schedule",EAPG,1769,100,,1415.20,,,0,"percent of total billed charges","100% of total billed charges",270.66,11498.59,
"26034 Incision, bone cortex, hand or finger (eg, o",7962700,CDM,521,RC,26034,CPT,OUTPATIENT,,,2270,1475.5,,1997.6,88,,1598.08,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,2270,100,,1816.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1430.1,63,,1144.08,,,0,"percent of total billed charges","63% of total billed charges",347.31,15.3,,277.85,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1566.3,69,,,,,0,"fee schedule","69% of total billed charges",2270,100,,1816.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2270,100,,1816.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2270,100,,1816.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",855.79,37.7,,684.63,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1770.6,78,,1416.48,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1875.02,82.6,,1500.02,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1875.02,82.6,,1500.02,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.81,100,,,,,0,"fee schedule",EAPG,2270,100,,1816.00,,,0,"percent of total billed charges","100% of total billed charges",347.31,5656.45,
"26037 Decompressive fasciotomy, hand (excludes 260",7963442,CDM,521,RC,26037,CPT,OUTPATIENT,,,1357,882.05,,1194.16,88,,955.33,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,1357,100,,1085.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2038.17,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",854.91,63,,683.93,,,0,"percent of total billed charges","63% of total billed charges",207.62,15.3,,166.10,,,0,"percent of total billed charges","15.3% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,936.33,69,,,,,0,"fee schedule","69% of total billed charges",1357,100,,1085.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1357,100,,1085.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1357,100,,1085.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2018.38,100,,,,,0,"fee schedule",EAPG,2572.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",511.59,37.7,,409.27,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1058.46,78,,846.77,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1120.88,82.6,,896.70,,,0,"percent of total billed charges","82.6% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1120.88,82.6,,896.70,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2139.33,100,,,,,0,"fee schedule",EAPG,1357,100,,1085.60,,,0,"percent of total billed charges","100% of total billed charges",207.62,11498.59,
"26045 Fasciotomy, palmar (eg, Dupuytren's contract",7963016,CDM,521,RC,26045,CPT,OUTPATIENT,,,2239,1455.35,,1970.32,88,,1576.26,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,2239,100,,1791.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1410.57,63,,1128.46,,,0,"percent of total billed charges","63% of total billed charges",342.57,15.3,,274.06,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1544.91,69,,,,,0,"fee schedule","69% of total billed charges",2239,100,,1791.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2239,100,,1791.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2239,100,,1791.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",844.1,37.7,,675.28,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1746.42,78,,1397.14,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1849.41,82.6,,1479.53,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1849.41,82.6,,1479.53,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.81,100,,,,,0,"fee schedule",EAPG,2239,100,,1791.20,,,0,"percent of total billed charges","100% of total billed charges",342.57,11498.59,
"26055 Tendon sheath incision (eg, for trigger fing",7963443,CDM,521,RC,26055,CPT,OUTPATIENT,,,1639,1065.35,,1442.32,88,,1153.86,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1639,100,,1311.20,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1032.57,63,,826.06,,,0,"percent of total billed charges","63% of total billed charges",250.77,15.3,,200.62,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1130.91,69,,,,,0,"fee schedule","69% of total billed charges",1639,100,,1311.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1639,100,,1311.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1639,100,,1311.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",617.9,37.7,,494.32,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1278.42,78,,1022.74,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.81,82.6,,1083.05,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.81,82.6,,1083.05,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.81,100,,,,,0,"fee schedule",EAPG,1639,100,,1311.20,,,0,"percent of total billed charges","100% of total billed charges",250.77,5656.45,
"26070 Arthrotomy, w/ exploration/drainage/removal",7961740,CDM,521,RC,26070,CPT,OUTPATIENT,,,1067,693.55,,938.96,88,,751.17,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1067,100,,853.60,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672.21,63,,537.77,,,0,"percent of total billed charges","63% of total billed charges",163.25,15.3,,130.60,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,736.23,69,,,,,0,"fee schedule","69% of total billed charges",1067,100,,853.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1067,100,,853.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1067,100,,853.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",402.26,37.7,,321.81,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",832.26,78,,665.81,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",881.34,82.6,,705.07,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",881.34,82.6,,705.07,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.81,100,,,,,0,"fee schedule",EAPG,1067,100,,853.60,,,0,"percent of total billed charges","100% of total billed charges",163.25,5656.45,
"26075 Arthrotomy, w/ exploration/drainage/removal",7961741,CDM,521,RC,26075,CPT,OUTPATIENT,,,1255,815.75,,1104.4,88,,883.52,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1255,100,,1004.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790.65,63,,632.52,,,0,"percent of total billed charges","63% of total billed charges",192.02,15.3,,153.62,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,865.95,69,,,,,0,"fee schedule","69% of total billed charges",1255,100,,1004.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1255,100,,1004.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1255,100,,1004.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",473.14,37.7,,378.51,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",978.9,78,,783.12,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1036.63,82.6,,829.30,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1036.63,82.6,,829.30,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.81,100,,,,,0,"fee schedule",EAPG,1255,100,,1004.00,,,0,"percent of total billed charges","100% of total billed charges",192.02,11498.59,
"26080 Arthrotomy, w/ exploration/drainage/removal",7962169,CDM,521,RC,26080,CPT,OUTPATIENT,,,765,497.25,,673.2,88,,538.56,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,765,100,,612.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",481.95,63,,385.56,,,0,"percent of total billed charges","63% of total billed charges",117.05,15.3,,93.64,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,527.85,69,,,,,0,"fee schedule","69% of total billed charges",765,100,,612.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",765,100,,612.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",765,100,,612.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",288.41,37.7,,230.73,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",596.7,78,,477.36,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",631.89,82.6,,505.51,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",631.89,82.6,,505.51,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.81,100,,,,,0,"fee schedule",EAPG,765,100,,612.00,,,0,"percent of total billed charges","100% of total billed charges",117.05,5656.45,
"26111 Excision, tumor or vascular malformation, so",7961666,CDM,521,RC,26111,CPT,OUTPATIENT,,,1316,855.4,,1158.08,88,,926.46,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1316,100,,1052.80,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",829.08,63,,663.26,,,0,"percent of total billed charges","63% of total billed charges",201.35,15.3,,161.08,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,908.04,69,,,,,0,"fee schedule","69% of total billed charges",1316,100,,1052.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1316,100,,1052.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1316,100,,1052.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",496.13,37.7,,396.90,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1026.48,78,,821.18,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1087.02,82.6,,869.62,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1087.02,82.6,,869.62,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.81,100,,,,,0,"fee schedule",EAPG,1316,100,,1052.80,,,0,"percent of total billed charges","100% of total billed charges",201.35,5715.97,
"26113 Excision, tumor, soft tissue, or vascular ma",7961667,CDM,521,RC,26113,CPT,OUTPATIENT,,,1717,1116.05,,1510.96,88,,1208.77,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1717,100,,1373.60,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1081.71,63,,865.37,,,0,"percent of total billed charges","63% of total billed charges",262.7,15.3,,210.16,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1184.73,69,,,,,0,"fee schedule","69% of total billed charges",1717,100,,1373.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1717,100,,1373.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1717,100,,1373.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",647.31,37.7,,517.85,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1339.26,78,,1071.41,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1418.24,82.6,,1134.59,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1418.24,82.6,,1134.59,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.81,100,,,,,0,"fee schedule",EAPG,1717,100,,1373.60,,,0,"percent of total billed charges","100% of total billed charges",262.7,5715.97,
"26115 Exc, tumor/vascular malformation, soft tissu",7961668,CDM,521,RC,26115,CPT,OUTPATIENT,,,1589,1032.85,,1398.32,88,,1118.66,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1589,100,,1271.20,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1001.07,63,,800.86,,,0,"percent of total billed charges","63% of total billed charges",243.12,15.3,,194.50,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1096.41,69,,,,,0,"fee schedule","69% of total billed charges",1589,100,,1271.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589,100,,1271.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589,100,,1271.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",599.05,37.7,,479.24,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.42,78,,991.54,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1312.51,82.6,,1050.01,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1312.51,82.6,,1050.01,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.81,100,,,,,0,"fee schedule",EAPG,1589,100,,1271.20,,,0,"percent of total billed charges","100% of total billed charges",243.12,5715.97,
"26116 Exc, tumor/soft tissue/vascular malformation",7961810,CDM,521,RC,26116,CPT,OUTPATIENT,,,2191,1424.15,,1928.08,88,,1542.46,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,2191,100,,1752.80,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1380.33,63,,1104.26,,,0,"percent of total billed charges","63% of total billed charges",335.22,15.3,,268.18,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1511.79,69,,,,,0,"fee schedule","69% of total billed charges",2191,100,,1752.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2191,100,,1752.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2191,100,,1752.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",826.01,37.7,,660.81,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1708.98,78,,1367.18,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1809.77,82.6,,1447.82,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1809.77,82.6,,1447.82,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.81,100,,,,,0,"fee schedule",EAPG,2191,100,,1752.80,,,0,"percent of total billed charges","100% of total billed charges",335.22,5715.97,
"26123 Fasciectomy, palm only, w/ or w/o Z-plasty,",7961474,CDM,521,RC,26123,CPT,OUTPATIENT,,,4106,2668.9,,3613.28,88,,2890.62,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,4106,100,,3284.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2038.17,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2586.78,63,,2069.42,,,0,"percent of total billed charges","63% of total billed charges",628.22,15.3,,502.58,,,0,"percent of total billed charges","15.3% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,2833.14,69,,,,,0,"fee schedule","69% of total billed charges",4106,100,,3284.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4106,100,,3284.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4106,100,,3284.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2018.38,100,,,,,0,"fee schedule",EAPG,2572.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1547.96,37.7,,1238.37,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3202.68,78,,2562.14,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3391.56,82.6,,2713.25,,,0,"percent of total billed charges","82.6% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3391.56,82.6,,2713.25,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2139.33,100,,,,,0,"fee schedule",EAPG,4106,100,,3284.80,,,0,"percent of total billed charges","100% of total billed charges",628.22,11498.59,
"26125 Fasciectomy, palm, w/wo Z-plasty, other loca",7961669,CDM,521,RC,26125,CPT,OUTPATIENT,,,1595,1036.75,,1403.6,88,,1122.88,,,0,"percent of total billed charges","88% of total billed charges",797.5,50,,638.00,,,0,"percent of total billed charges","50% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,1595,100,,1276.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2038.17,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1004.85,63,,803.88,,,0,"percent of total billed charges","63% of total billed charges",244.04,15.3,,195.23,,,0,"percent of total billed charges","15.3% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,1100.55,69,,,,,0,"fee schedule","69% of total billed charges",1595,100,,1276.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1595,100,,1276.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1595,100,,1276.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",986.51,61.85,,789.21,,,0,"percent of total billed charges","61.5% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,797.5,50,,638.00,,,0,"percent of total billed charges","50% of total billed charges",513.59,32.2,,410.87,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2018.38,100,,,,,0,"fee schedule",EAPG,2572.45,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",601.32,37.7,,481.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1244.1,78,,995.28,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1317.47,82.6,,1053.98,,,0,"percent of total billed charges","82.6% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,797.5,50,,638.00,,,0,"percent of total billed charges","50% of total billed charges",1317.47,82.6,,1053.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2139.33,100,,,,,0,"fee schedule",EAPG,1595,100,,1276.00,,,0,"percent of total billed charges","100% of total billed charges",244.04,2572.45,
"26121 Fasciectomy, palm only, w/wo Z-plasty, other",7961858,CDM,521,RC,26121,CPT,OUTPATIENT,,,1751,1138.15,,1540.88,88,,1232.70,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,1751,100,,1400.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2038.17,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1103.13,63,,882.50,,,0,"percent of total billed charges","63% of total billed charges",267.9,15.3,,214.32,,,0,"percent of total billed charges","15.3% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,1208.19,69,,,,,0,"fee schedule","69% of total billed charges",1751,100,,1400.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1751,100,,1400.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1751,100,,1400.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2018.38,100,,,,,0,"fee schedule",EAPG,2572.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",660.13,37.7,,528.10,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1365.78,78,,1092.62,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1446.33,82.6,,1157.06,,,0,"percent of total billed charges","82.6% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1446.33,82.6,,1157.06,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2139.33,100,,,,,0,"fee schedule",EAPG,1751,100,,1400.80,,,0,"percent of total billed charges","100% of total billed charges",267.9,11498.59,
"26140 Synovectomy, proximal interphalangeal jnt, i",7961475,CDM,521,RC,26140,CPT,OUTPATIENT,,,765,497.25,,673.2,88,,538.56,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,765,100,,612.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",481.95,63,,385.56,,,0,"percent of total billed charges","63% of total billed charges",117.05,15.3,,93.64,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,527.85,69,,,,,0,"fee schedule","69% of total billed charges",765,100,,612.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",765,100,,612.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",765,100,,612.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",288.41,37.7,,230.73,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",596.7,78,,477.36,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",631.89,82.6,,505.51,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",631.89,82.6,,505.51,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.81,100,,,,,0,"fee schedule",EAPG,765,100,,612.00,,,0,"percent of total billed charges","100% of total billed charges",117.05,5656.45,
"26145 Synovectomy, tendon sheath, radical, flexor",7962363,CDM,521,RC,26145,CPT,OUTPATIENT,,,1234,802.1,,1085.92,88,,868.74,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,1234,100,,987.20,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",2038.17,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",777.42,63,,621.94,,,0,"percent of total billed charges","63% of total billed charges",188.8,15.3,,151.04,,,0,"percent of total billed charges","15.3% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,851.46,69,,,,,0,"fee schedule","69% of total billed charges",1234,100,,987.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1234,100,,987.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1234,100,,987.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2018.38,100,,,,,0,"fee schedule",EAPG,2572.45,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",465.22,37.7,,372.18,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",962.52,78,,770.02,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1019.28,82.6,,815.42,,,0,"percent of total billed charges","82.6% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1019.28,82.6,,815.42,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2139.33,100,,,,,0,"fee schedule",EAPG,1234,100,,987.20,,,0,"percent of total billed charges","100% of total billed charges",188.8,5656.45,
"26160 Excision of lesion of tendon sheath or joint",7962876,CDM,521,RC,26160,CPT,OUTPATIENT,,,1539,1000.35,,1354.32,88,,1083.46,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1539,100,,1231.20,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",969.57,63,,775.66,,,0,"percent of total billed charges","63% of total billed charges",235.47,15.3,,188.38,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1061.91,69,,,,,0,"fee schedule","69% of total billed charges",1539,100,,1231.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1539,100,,1231.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1539,100,,1231.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",580.2,37.7,,464.16,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1200.42,78,,960.34,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1271.21,82.6,,1016.97,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1271.21,82.6,,1016.97,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.81,100,,,,,0,"fee schedule",EAPG,1539,100,,1231.20,,,0,"percent of total billed charges","100% of total billed charges",235.47,5656.45,
"26200 Excision or curettage of bone cyst or benign",7962961,CDM,521,RC,26200,CPT,OUTPATIENT,,,2006,1303.9,,1765.28,88,,1412.22,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,2006,100,,1604.80,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1263.78,63,,1011.02,,,0,"percent of total billed charges","63% of total billed charges",306.92,15.3,,245.54,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1384.14,69,,,,,0,"fee schedule","69% of total billed charges",2006,100,,1604.80,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2006,100,,1604.80,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2006,100,,1604.80,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",756.26,37.7,,605.01,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1564.68,78,,1251.74,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1656.96,82.6,,1325.57,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1656.96,82.6,,1325.57,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.81,100,,,,,0,"fee schedule",EAPG,2006,100,,1604.80,,,0,"percent of total billed charges","100% of total billed charges",306.92,5656.45,
"26235 Partial excision of bone; proximal or middle",7963046,CDM,521,RC,26235,CPT,OUTPATIENT,,,1479,961.35,,1301.52,88,,1041.22,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,1479,100,,1183.20,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",2038.17,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",931.77,63,,745.42,,,0,"percent of total billed charges","63% of total billed charges",226.29,15.3,,181.03,,,0,"percent of total billed charges","15.3% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,1020.51,69,,,,,0,"fee schedule","69% of total billed charges",1479,100,,1183.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1479,100,,1183.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1479,100,,1183.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2018.38,100,,,,,0,"fee schedule",EAPG,2572.45,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",557.58,37.7,,446.06,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1153.62,78,,922.90,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1221.65,82.6,,977.32,,,0,"percent of total billed charges","82.6% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1221.65,82.6,,977.32,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2139.33,100,,,,,0,"fee schedule",EAPG,1479,100,,1183.20,,,0,"percent of total billed charges","100% of total billed charges",226.29,5656.45,
"26236 Partial excision of bone; distal phalanx of",7963381,CDM,521,RC,26236,CPT,OUTPATIENT,,,1040,676,,915.2,88,,732.16,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1040,100,,832.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",655.2,63,,524.16,,,0,"percent of total billed charges","63% of total billed charges",159.12,15.3,,127.30,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,717.6,69,,,,,0,"fee schedule","69% of total billed charges",1040,100,,832.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1040,100,,832.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1040,100,,832.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",392.08,37.7,,313.66,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",811.2,78,,648.96,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.04,82.6,,687.23,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.04,82.6,,687.23,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.81,100,,,,,0,"fee schedule",EAPG,1040,100,,832.00,,,0,"percent of total billed charges","100% of total billed charges",159.12,5656.45,
"26357 Repair flexor tendon, in zone 2 digital flex",7961670,CDM,521,RC,26357,CPT,OUTPATIENT,,,2049,1331.85,,1803.12,88,,1442.50,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,2049,100,,1639.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2038.17,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1290.87,63,,1032.70,,,0,"percent of total billed charges","63% of total billed charges",313.5,15.3,,250.80,,,0,"percent of total billed charges","15.3% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,1413.81,69,,,,,0,"fee schedule","69% of total billed charges",2049,100,,1639.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2049,100,,1639.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2049,100,,1639.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2018.38,100,,,,,0,"fee schedule",EAPG,2572.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",772.47,37.7,,617.98,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1598.22,78,,1278.58,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1692.47,82.6,,1353.98,,,0,"percent of total billed charges","82.6% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1692.47,82.6,,1353.98,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2139.33,100,,,,,0,"fee schedule",EAPG,2049,100,,1639.20,,,0,"percent of total billed charges","100% of total billed charges",313.5,11498.59,
"26350 Repair or advancement, flexor tendon, primar",7961811,CDM,521,RC,26350,CPT,OUTPATIENT,,,3016,1960.4,,2654.08,88,,2123.26,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,3016,100,,2412.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1900.08,63,,1520.06,,,0,"percent of total billed charges","63% of total billed charges",461.45,15.3,,369.16,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,2081.04,69,,,,,0,"fee schedule","69% of total billed charges",3016,100,,2412.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3016,100,,2412.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3016,100,,2412.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1137.03,37.7,,909.62,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2352.48,78,,1881.98,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2491.22,82.6,,1992.98,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2491.22,82.6,,1992.98,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.81,100,,,,,0,"fee schedule",EAPG,3016,100,,2412.80,,,0,"percent of total billed charges","100% of total billed charges",461.45,11498.59,
"26356 Repair/advancement, flexor tendon, primary,",7962769,CDM,521,RC,26356,CPT,OUTPATIENT,,,3878,2520.7,,3412.64,88,,2730.11,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,3878,100,,3102.40,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2038.17,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2443.14,63,,1954.51,,,0,"percent of total billed charges","63% of total billed charges",593.33,15.3,,474.66,,,0,"percent of total billed charges","15.3% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,2675.82,69,,,,,0,"fee schedule","69% of total billed charges",3878,100,,3102.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3878,100,,3102.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3878,100,,3102.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2018.38,100,,,,,0,"fee schedule",EAPG,2572.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1462.01,37.7,,1169.61,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3024.84,78,,2419.87,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3203.23,82.6,,2562.58,,,0,"percent of total billed charges","82.6% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3203.23,82.6,,2562.58,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2139.33,100,,,,,0,"fee schedule",EAPG,3878,100,,3102.40,,,0,"percent of total billed charges","100% of total billed charges",593.33,11498.59,
"26373 Repair profundus tendon, with intact superfi",7961580,CDM,521,RC,26373,CPT,OUTPATIENT,,,1309,850.85,,1151.92,88,,921.54,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,1309,100,,1047.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2038.17,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",824.67,63,,659.74,,,0,"percent of total billed charges","63% of total billed charges",200.28,15.3,,160.22,,,0,"percent of total billed charges","15.3% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,903.21,69,,,,,0,"fee schedule","69% of total billed charges",1309,100,,1047.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1309,100,,1047.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1309,100,,1047.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2018.38,100,,,,,0,"fee schedule",EAPG,2572.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",493.49,37.7,,394.79,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1021.02,78,,816.82,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1081.23,82.6,,864.98,,,0,"percent of total billed charges","82.6% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1081.23,82.6,,864.98,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2139.33,100,,,,,0,"fee schedule",EAPG,1309,100,,1047.20,,,0,"percent of total billed charges","100% of total billed charges",200.28,11498.59,
"26370 Repair profundus tendon, with intact superfi",7962494,CDM,521,RC,26370,CPT,OUTPATIENT,,,1894,1231.1,,1666.72,88,,1333.38,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,1894,100,,1515.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2038.17,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.22,63,,954.58,,,0,"percent of total billed charges","63% of total billed charges",289.78,15.3,,231.82,,,0,"percent of total billed charges","15.3% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,1306.86,69,,,,,0,"fee schedule","69% of total billed charges",1894,100,,1515.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1894,100,,1515.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1894,100,,1515.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2018.38,100,,,,,0,"fee schedule",EAPG,2572.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",714.04,37.7,,571.23,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1477.32,78,,1181.86,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1564.44,82.6,,1251.55,,,0,"percent of total billed charges","82.6% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1564.44,82.6,,1251.55,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2139.33,100,,,,,0,"fee schedule",EAPG,1894,100,,1515.20,,,0,"percent of total billed charges","100% of total billed charges",289.78,11498.59,
"26418 Repair, extensor tendon, finger, primary or",7962241,CDM,521,RC,26418,CPT,OUTPATIENT,,,2374,1543.1,,2089.12,88,,1671.30,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,2374,100,,1899.20,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1495.62,63,,1196.50,,,0,"percent of total billed charges","63% of total billed charges",363.22,15.3,,290.58,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1638.06,69,,,,,0,"fee schedule","69% of total billed charges",2374,100,,1899.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2374,100,,1899.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2374,100,,1899.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",895,37.7,,716.00,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1851.72,78,,1481.38,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1960.92,82.6,,1568.74,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1960.92,82.6,,1568.74,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.81,100,,,,,0,"fee schedule",EAPG,2374,100,,1899.20,,,0,"percent of total billed charges","100% of total billed charges",363.22,5656.45,
"26410 Repair, extensor tendon, hand, primary or se",7962320,CDM,521,RC,26410,CPT,OUTPATIENT,,,2073,1347.45,,1824.24,88,,1459.39,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,2073,100,,1658.40,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1305.99,63,,1044.79,,,0,"percent of total billed charges","63% of total billed charges",317.17,15.3,,253.74,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1430.37,69,,,,,0,"fee schedule","69% of total billed charges",2073,100,,1658.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2073,100,,1658.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2073,100,,1658.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",781.52,37.7,,625.22,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1616.94,78,,1293.55,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1712.3,82.6,,1369.84,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1712.3,82.6,,1369.84,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.81,100,,,,,0,"fee schedule",EAPG,2073,100,,1658.40,,,0,"percent of total billed charges","100% of total billed charges",317.17,5656.45,
"26433 Repair of extensor tendon, distal insertion,",7962465,CDM,521,RC,26433,CPT,OUTPATIENT,,,1330,864.5,,1170.4,88,,936.32,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1330,100,,1064.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",837.9,63,,670.32,,,0,"percent of total billed charges","63% of total billed charges",203.49,15.3,,162.79,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,917.7,69,,,,,0,"fee schedule","69% of total billed charges",1330,100,,1064.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1330,100,,1064.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1330,100,,1064.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",501.41,37.7,,401.13,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1037.4,78,,829.92,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1098.58,82.6,,878.86,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1098.58,82.6,,878.86,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.81,100,,,,,0,"fee schedule",EAPG,1330,100,,1064.00,,,0,"percent of total billed charges","100% of total billed charges",203.49,11498.59,
"26445 Tenolysis, extensor tendon, hand OR finger,",7963248,CDM,521,RC,26445,CPT,OUTPATIENT,,,2003,1301.95,,1762.64,88,,1410.11,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,2003,100,,1602.40,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1261.89,63,,1009.51,,,0,"percent of total billed charges","63% of total billed charges",306.46,15.3,,245.17,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1382.07,69,,,,,0,"fee schedule","69% of total billed charges",2003,100,,1602.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2003,100,,1602.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2003,100,,1602.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",755.13,37.7,,604.10,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1562.34,78,,1249.87,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1654.48,82.6,,1323.58,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1654.48,82.6,,1323.58,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.81,100,,,,,0,"fee schedule",EAPG,2003,100,,1602.40,,,0,"percent of total billed charges","100% of total billed charges",306.46,11498.59,
"26455 Tenotomy, flexor, finger, open, each tendon",7963520,CDM,521,RC,26455,CPT,OUTPATIENT,,,1388,902.2,,1221.44,88,,977.15,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1388,100,,1110.40,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.44,63,,699.55,,,0,"percent of total billed charges","63% of total billed charges",212.36,15.3,,169.89,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,957.72,69,,,,,0,"fee schedule","69% of total billed charges",1388,100,,1110.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1388,100,,1110.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1388,100,,1110.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",523.28,37.7,,418.62,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1082.64,78,,866.11,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1146.49,82.6,,917.19,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1146.49,82.6,,917.19,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.81,100,,,,,0,"fee schedule",EAPG,1388,100,,1110.40,,,0,"percent of total billed charges","100% of total billed charges",212.36,5656.45,
"26460 Tenotomy, extensor, hand or finger, open, ea",7963317,CDM,521,RC,26460,CPT,OUTPATIENT,,,849,551.85,,747.12,88,,597.70,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,849,100,,679.20,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",534.87,63,,427.90,,,0,"percent of total billed charges","63% of total billed charges",129.9,15.3,,103.92,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,585.81,69,,,,,0,"fee schedule","69% of total billed charges",849,100,,679.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",849,100,,679.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",849,100,,679.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.07,37.7,,256.06,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",662.22,78,,529.78,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",701.27,82.6,,561.02,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",701.27,82.6,,561.02,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.81,100,,,,,0,"fee schedule",EAPG,849,100,,679.20,,,0,"percent of total billed charges","100% of total billed charges",129.9,5656.45,
"26476 Lengthening of tendon, extensor, hand or fin",7963124,CDM,521,RC,26476,CPT,OUTPATIENT,,,1370,890.5,,1205.6,88,,964.48,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1370,100,,1096.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",863.1,63,,690.48,,,0,"percent of total billed charges","63% of total billed charges",209.61,15.3,,167.69,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,945.3,69,,,,,0,"fee schedule","69% of total billed charges",1370,100,,1096.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1370,100,,1096.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1370,100,,1096.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",516.49,37.7,,413.19,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1068.6,78,,854.88,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1131.62,82.6,,905.30,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1131.62,82.6,,905.30,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.81,100,,,,,0,"fee schedule",EAPG,1370,100,,1096.00,,,0,"percent of total billed charges","100% of total billed charges",209.61,11498.59,
"26478 Lengthening of tendon, flexor, hand or finge",7963166,CDM,521,RC,26478,CPT,OUTPATIENT,,,1457,947.05,,1282.16,88,,1025.73,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1457,100,,1165.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",917.91,63,,734.33,,,0,"percent of total billed charges","63% of total billed charges",222.92,15.3,,178.34,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1005.33,69,,,,,0,"fee schedule","69% of total billed charges",1457,100,,1165.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1457,100,,1165.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1457,100,,1165.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",549.29,37.7,,439.43,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1136.46,78,,909.17,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1203.48,82.6,,962.78,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1203.48,82.6,,962.78,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.81,100,,,,,0,"fee schedule",EAPG,1457,100,,1165.60,,,0,"percent of total billed charges","100% of total billed charges",222.92,11498.59,
"26480 Transfer or transplant of tendon, carpometac",7962406,CDM,521,RC,26480,CPT,OUTPATIENT,,,3355,2180.75,,2952.4,88,,2361.92,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,3355,100,,2684.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2038.17,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2113.65,63,,1690.92,,,0,"percent of total billed charges","63% of total billed charges",513.32,15.3,,410.66,,,0,"percent of total billed charges","15.3% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,2314.95,69,,,,,0,"fee schedule","69% of total billed charges",3355,100,,2684.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3355,100,,2684.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3355,100,,2684.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2018.38,100,,,,,0,"fee schedule",EAPG,2572.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1264.84,37.7,,1011.87,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2616.9,78,,2093.52,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2771.23,82.6,,2216.98,,,0,"percent of total billed charges","82.6% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2771.23,82.6,,2216.98,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2139.33,100,,,,,0,"fee schedule",EAPG,3355,100,,2684.00,,,0,"percent of total billed charges","100% of total billed charges",513.32,11498.59,
"26485 Transfer or transplant of tendon, palmar; wi",7962466,CDM,521,RC,26485,CPT,OUTPATIENT,,,2324,1510.6,,2045.12,88,,1636.10,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,2324,100,,1859.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2038.17,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1464.12,63,,1171.30,,,0,"percent of total billed charges","63% of total billed charges",355.57,15.3,,284.46,,,0,"percent of total billed charges","15.3% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,1603.56,69,,,,,0,"fee schedule","69% of total billed charges",2324,100,,1859.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2324,100,,1859.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2324,100,,1859.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2018.38,100,,,,,0,"fee schedule",EAPG,2572.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",876.15,37.7,,700.92,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1812.72,78,,1450.18,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1919.62,82.6,,1535.70,,,0,"percent of total billed charges","82.6% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1919.62,82.6,,1535.70,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2139.33,100,,,,,0,"fee schedule",EAPG,2324,100,,1859.20,,,0,"percent of total billed charges","100% of total billed charges",355.57,11498.59,
"26520 Capsulectomy or capsulotomy; metacarpophalan",7962931,CDM,521,RC,26520,CPT,OUTPATIENT,,,2535,1647.75,,2230.8,88,,1784.64,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,2535,100,,2028.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1597.05,63,,1277.64,,,0,"percent of total billed charges","63% of total billed charges",387.86,15.3,,310.29,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1749.15,69,,,,,0,"fee schedule","69% of total billed charges",2535,100,,2028.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2535,100,,2028.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2535,100,,2028.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",955.7,37.7,,764.56,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1977.3,78,,1581.84,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2093.91,82.6,,1675.13,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2093.91,82.6,,1675.13,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.81,100,,,,,0,"fee schedule",EAPG,2535,100,,2028.00,,,0,"percent of total billed charges","100% of total billed charges",387.86,11498.59,
"26535 Arthroplasty, interphalangeal joint; each jo",7963444,CDM,521,RC,26535,CPT,OUTPATIENT,,,1042,677.3,,916.96,88,,733.57,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3128.81,100,,,,,0,"fee schedule",EAPG,1042,100,,833.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",3222.67,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",656.46,63,,525.17,,,0,"percent of total billed charges","63% of total billed charges",159.43,15.3,,127.54,,,0,"percent of total billed charges","15.3% of total billed charges",3128.81,100,,,,,0,"fee schedule",EAPG,718.98,69,,,,,0,"fee schedule","69% of total billed charges",1042,100,,833.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1042,100,,833.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1042,100,,833.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3128.81,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3191.38,100,,,,,0,"fee schedule",EAPG,4067.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",392.83,37.7,,314.26,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",812.76,78,,650.21,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",860.69,82.6,,688.55,,,0,"percent of total billed charges","82.6% of total billed charges",3128.81,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",860.69,82.6,,688.55,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3289.34,100,,,,,0,"fee schedule",EAPG,1042,100,,833.60,,,0,"percent of total billed charges","100% of total billed charges",159.43,11498.59,
"26540 Repair of collateral ligament, metacarpophal",7962626,CDM,521,RC,26540,CPT,OUTPATIENT,,,3544,2303.6,,3118.72,88,,2494.98,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,3544,100,,2835.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2232.72,63,,1786.18,,,0,"percent of total billed charges","63% of total billed charges",542.23,15.3,,433.78,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,2445.36,69,,,,,0,"fee schedule","69% of total billed charges",3544,100,,2835.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3544,100,,2835.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3544,100,,2835.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1336.09,37.7,,1068.87,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2764.32,78,,2211.46,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2927.34,82.6,,2341.87,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2927.34,82.6,,2341.87,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.81,100,,,,,0,"fee schedule",EAPG,3544,100,,2835.20,,,0,"percent of total billed charges","100% of total billed charges",542.23,11498.59,
"26567 Osteotomy; phalanx of finger, each",7963690,CDM,521,RC,26567,CPT,OUTPATIENT,,,2219,1442.35,,1952.72,88,,1562.18,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,2219,100,,1775.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2038.17,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1397.97,63,,1118.38,,,0,"percent of total billed charges","63% of total billed charges",339.51,15.3,,271.61,,,0,"percent of total billed charges","15.3% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,1531.11,69,,,,,0,"fee schedule","69% of total billed charges",2219,100,,1775.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2219,100,,1775.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2219,100,,1775.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2018.38,100,,,,,0,"fee schedule",EAPG,2572.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",836.56,37.7,,669.25,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1730.82,78,,1384.66,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1832.89,82.6,,1466.31,,,0,"percent of total billed charges","82.6% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1832.89,82.6,,1466.31,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2139.33,100,,,,,0,"fee schedule",EAPG,2219,100,,1775.20,,,0,"percent of total billed charges","100% of total billed charges",339.51,11498.59,
"26565 Osteotomy; metacarpal, each",7963807,CDM,521,RC,26565,CPT,OUTPATIENT,,,2900,1885,,2552,88,,2041.60,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,2900,100,,2320.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2038.17,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1827,63,,1461.60,,,0,"percent of total billed charges","63% of total billed charges",443.7,15.3,,354.96,,,0,"percent of total billed charges","15.3% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,2001,69,,,,,0,"fee schedule","69% of total billed charges",2900,100,,2320.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2900,100,,2320.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2900,100,,2320.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2018.38,100,,,,,0,"fee schedule",EAPG,2572.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1093.3,37.7,,874.64,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2262,78,,1809.60,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2395.4,82.6,,1916.32,,,0,"percent of total billed charges","82.6% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2395.4,82.6,,1916.32,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2139.33,100,,,,,0,"fee schedule",EAPG,2900,100,,2320.00,,,0,"percent of total billed charges","100% of total billed charges",443.7,11498.59,
"26600 Closed treatment of metacarpal fracture, sin",7903139,CDM,521,RC,26600,CPT,OUTPATIENT,,,549,356.85,,483.12,88,,386.50,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.87,63,,276.70,,,0,"percent of total billed charges","63% of total billed charges",84,15.3,,67.20,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,378.81,69,,,,,0,"fee schedule","69% of total billed charges",549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",206.97,37.7,,165.58,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",428.22,78,,342.58,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",453.47,82.6,,362.78,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",453.47,82.6,,362.78,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",84,837.64,
"26605 Closed treatment of metacarpal fracture, sin",7903220,CDM,521,RC,26605,CPT,OUTPATIENT,,,825,536.25,,726,88,,580.80,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,825,100,,660.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",519.75,63,,415.80,,,0,"percent of total billed charges","63% of total billed charges",126.23,15.3,,100.98,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,569.25,69,,,,,0,"fee schedule","69% of total billed charges",825,100,,660.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",825,100,,660.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",825,100,,660.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",311.03,37.7,,248.82,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.5,78,,514.80,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",681.45,82.6,,545.16,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",681.45,82.6,,545.16,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,825,100,,660.00,,,0,"percent of total billed charges","100% of total billed charges",126.23,837.64,
"26607 Closed treatment of metacarpal fracture, wit",7961581,CDM,521,RC,26607,CPT,OUTPATIENT,,,1376,894.4,,1210.88,88,,968.70,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1376,100,,1100.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",866.88,63,,693.50,,,0,"percent of total billed charges","63% of total billed charges",210.53,15.3,,168.42,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,949.44,69,,,,,0,"fee schedule","69% of total billed charges",1376,100,,1100.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1376,100,,1100.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1376,100,,1100.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",518.75,37.7,,415.00,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1073.28,78,,858.62,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1136.58,82.6,,909.26,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1136.58,82.6,,909.26,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,1376,100,,1100.80,,,0,"percent of total billed charges","100% of total billed charges",210.53,11498.59,
"26608 Percutaneous skeletal fixation of metacarpal",7962989,CDM,521,RC,26608,CPT,OUTPATIENT,,,1547,1005.55,,1361.36,88,,1089.09,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,1547,100,,1237.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",974.61,63,,779.69,,,0,"percent of total billed charges","63% of total billed charges",236.69,15.3,,189.35,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1067.43,69,,,,,0,"fee schedule","69% of total billed charges",1547,100,,1237.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1547,100,,1237.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1547,100,,1237.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",583.22,37.7,,466.58,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1206.66,78,,965.33,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1277.82,82.6,,1022.26,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1277.82,82.6,,1022.26,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,1547,100,,1237.60,,,0,"percent of total billed charges","100% of total billed charges",236.69,11498.59,
"26615 Open treatment of metacarpal fracture, singl",7962364,CDM,521,RC,26615,CPT,OUTPATIENT,,,1686,1095.9,,1483.68,88,,1186.94,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,1686,100,,1348.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1062.18,63,,849.74,,,0,"percent of total billed charges","63% of total billed charges",257.96,15.3,,206.37,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1163.34,69,,,,,0,"fee schedule","69% of total billed charges",1686,100,,1348.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1686,100,,1348.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1686,100,,1348.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",635.62,37.7,,508.50,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1315.08,78,,1052.06,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1392.64,82.6,,1114.11,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1392.64,82.6,,1114.11,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,1686,100,,1348.80,,,0,"percent of total billed charges","100% of total billed charges",257.96,11498.59,
"26645 Closed treatment of carpometacarpal fracture",7961476,CDM,521,RC,26645,CPT,OUTPATIENT,,,1158,752.7,,1019.04,88,,815.23,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1158,100,,926.40,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",729.54,63,,583.63,,,0,"percent of total billed charges","63% of total billed charges",177.17,15.3,,141.74,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,799.02,69,,,,,0,"fee schedule","69% of total billed charges",1158,100,,926.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1158,100,,926.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1158,100,,926.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",436.57,37.7,,349.26,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.24,78,,722.59,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",956.51,82.6,,765.21,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",956.51,82.6,,765.21,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,1158,100,,926.40,,,0,"percent of total billed charges","100% of total billed charges",177.17,5656.45,
"26641 Closed treatment of carpometacarpal dislocat",7962701,CDM,521,RC,26641,CPT,OUTPATIENT,,,881,572.65,,775.28,88,,620.22,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,881,100,,704.80,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",555.03,63,,444.02,,,0,"percent of total billed charges","63% of total billed charges",134.79,15.3,,107.83,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,607.89,69,,,,,0,"fee schedule","69% of total billed charges",881,100,,704.80,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",881,100,,704.80,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",881,100,,704.80,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",332.14,37.7,,265.71,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",687.18,78,,549.74,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",727.71,82.6,,582.17,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",727.71,82.6,,582.17,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,881,100,,704.80,,,0,"percent of total billed charges","100% of total billed charges",134.79,881,
"26665 Open treatment of carpometacarpal fracture d",7961477,CDM,521,RC,26665,CPT,OUTPATIENT,,,2469,1604.85,,2172.72,88,,1738.18,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2469,100,,1975.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1555.47,63,,1244.38,,,0,"percent of total billed charges","63% of total billed charges",377.76,15.3,,302.21,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1703.61,69,,,,,0,"fee schedule","69% of total billed charges",2469,100,,1975.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2469,100,,1975.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2469,100,,1975.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",930.81,37.7,,744.65,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1925.82,78,,1540.66,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2039.39,82.6,,1631.51,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2039.39,82.6,,1631.51,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2469,100,,1975.20,,,0,"percent of total billed charges","100% of total billed charges",377.76,11498.59,
"26675 Closed treatment of carpometacarpal dislocat",7961478,CDM,521,RC,26675,CPT,OUTPATIENT,,,1441,936.65,,1268.08,88,,1014.46,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,1441,100,,1152.80,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",916.1,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.83,63,,726.26,,,0,"percent of total billed charges","63% of total billed charges",220.47,15.3,,176.38,,,0,"percent of total billed charges","15.3% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,994.29,69,,,,,0,"fee schedule","69% of total billed charges",1441,100,,1152.80,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1441,100,,1152.80,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1441,100,,1152.80,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.21,100,,,,,0,"fee schedule",EAPG,1156.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",543.26,37.7,,434.61,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1123.98,78,,899.18,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1190.27,82.6,,952.22,,,0,"percent of total billed charges","82.6% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1190.27,82.6,,952.22,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1049.95,100,,,,,0,"fee schedule",EAPG,1441,100,,1152.80,,,0,"percent of total billed charges","100% of total billed charges",220.47,5656.45,
"26686 Open treatment of carpometacarpal dislocatio",7962152,CDM,521,RC,26686,CPT,OUTPATIENT,,,950,617.5,,836,88,,668.80,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,950,100,,760.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",598.5,63,,478.80,,,0,"percent of total billed charges","63% of total billed charges",145.35,15.3,,116.28,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,655.5,69,,,,,0,"fee schedule","69% of total billed charges",950,100,,760.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",950,100,,760.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",950,100,,760.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",358.15,37.7,,286.52,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",741,78,,592.80,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",784.7,82.6,,627.76,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",784.7,82.6,,627.76,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,950,100,,760.00,,,0,"percent of total billed charges","100% of total billed charges",145.35,11498.59,
"26685 Open treatment of carpometacarpal dislocatio",7962321,CDM,521,RC,26685,CPT,OUTPATIENT,,,1872,1216.8,,1647.36,88,,1317.89,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,1872,100,,1497.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1179.36,63,,943.49,,,0,"percent of total billed charges","63% of total billed charges",286.42,15.3,,229.14,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1291.68,69,,,,,0,"fee schedule","69% of total billed charges",1872,100,,1497.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1872,100,,1497.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1872,100,,1497.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.74,37.7,,564.59,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1460.16,78,,1168.13,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1546.27,82.6,,1237.02,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1546.27,82.6,,1237.02,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,1872,100,,1497.60,,,0,"percent of total billed charges","100% of total billed charges",286.42,11498.59,
"26700 Closed treatment of metacarpophalangeal disl",7961479,CDM,521,RC,26700,CPT,OUTPATIENT,,,554,360.1,,487.52,88,,390.02,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,554,100,,443.20,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",349.02,63,,279.22,,,0,"percent of total billed charges","63% of total billed charges",84.76,15.3,,67.81,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,382.26,69,,,,,0,"fee schedule","69% of total billed charges",554,100,,443.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554,100,,443.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554,100,,443.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",208.86,37.7,,167.09,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",432.12,78,,345.70,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",457.6,82.6,,366.08,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",457.6,82.6,,366.08,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,554,100,,443.20,,,0,"percent of total billed charges","100% of total billed charges",84.76,837.64,
"26705 Closed treatment of metacarpophalangeal disl",7961480,CDM,521,RC,26705,CPT,OUTPATIENT,,,968,629.2,,851.84,88,,681.47,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,968,100,,774.40,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",916.1,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",609.84,63,,487.87,,,0,"percent of total billed charges","63% of total billed charges",148.1,15.3,,118.48,,,0,"percent of total billed charges","15.3% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,667.92,69,,,,,0,"fee schedule","69% of total billed charges",968,100,,774.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",968,100,,774.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",968,100,,774.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.21,100,,,,,0,"fee schedule",EAPG,1156.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",364.94,37.7,,291.95,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",755.04,78,,604.03,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",799.57,82.6,,639.66,,,0,"percent of total billed charges","82.6% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",799.57,82.6,,639.66,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1049.95,100,,,,,0,"fee schedule",EAPG,968,100,,774.40,,,0,"percent of total billed charges","100% of total billed charges",148.1,5656.45,
"26715 Open treatment of metacarpophalangeal disloc",7962290,CDM,521,RC,26715,CPT,OUTPATIENT,,,1378,895.7,,1212.64,88,,970.11,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,1378,100,,1102.40,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.14,63,,694.51,,,0,"percent of total billed charges","63% of total billed charges",210.83,15.3,,168.66,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,950.82,69,,,,,0,"fee schedule","69% of total billed charges",1378,100,,1102.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1378,100,,1102.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1378,100,,1102.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",519.51,37.7,,415.61,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1074.84,78,,859.87,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1138.23,82.6,,910.58,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1138.23,82.6,,910.58,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,1378,100,,1102.40,,,0,"percent of total billed charges","100% of total billed charges",210.83,11498.59,
"26725 Closed treatment of phalangeal shaft fractur",7961481,CDM,521,RC,26725,CPT,OUTPATIENT,,,702,456.3,,617.76,88,,494.21,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,702,100,,561.60,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",442.26,63,,353.81,,,0,"percent of total billed charges","63% of total billed charges",107.41,15.3,,85.93,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,484.38,69,,,,,0,"fee schedule","69% of total billed charges",702,100,,561.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",702,100,,561.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",702,100,,561.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",264.65,37.7,,211.72,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",547.56,78,,438.05,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579.85,82.6,,463.88,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579.85,82.6,,463.88,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,702,100,,561.60,,,0,"percent of total billed charges","100% of total billed charges",107.41,837.64,
"26727 Percutaneous skeletal fixation unstable phal",7961812,CDM,521,RC,26727,CPT,OUTPATIENT,,,1692,1099.8,,1488.96,88,,1191.17,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,1692,100,,1353.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1065.96,63,,852.77,,,0,"percent of total billed charges","63% of total billed charges",258.88,15.3,,207.10,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1167.48,69,,,,,0,"fee schedule","69% of total billed charges",1692,100,,1353.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1692,100,,1353.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1692,100,,1353.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",637.88,37.7,,510.30,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1319.76,78,,1055.81,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1397.59,82.6,,1118.07,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1397.59,82.6,,1118.07,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,1692,100,,1353.60,,,0,"percent of total billed charges","100% of total billed charges",258.88,11498.59,
"26720 Closed treatment of phalangeal shaft fx, pro",7962170,CDM,521,RC,26720,CPT,OUTPATIENT,,,541,351.65,,476.08,88,,380.86,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,541,100,,432.80,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",340.83,63,,272.66,,,0,"percent of total billed charges","63% of total billed charges",82.77,15.3,,66.22,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,373.29,69,,,,,0,"fee schedule","69% of total billed charges",541,100,,432.80,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",541,100,,432.80,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",541,100,,432.80,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",203.96,37.7,,163.17,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",421.98,78,,337.58,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",446.87,82.6,,357.50,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",446.87,82.6,,357.50,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,541,100,,432.80,,,0,"percent of total billed charges","100% of total billed charges",82.77,837.64,
"26735 Open treatment of phalangeal shaft fx, proxi",7961907,CDM,521,RC,26735,CPT,OUTPATIENT,,,2109,1370.85,,1855.92,88,,1484.74,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2109,100,,1687.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1328.67,63,,1062.94,,,0,"percent of total billed charges","63% of total billed charges",322.68,15.3,,258.14,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1455.21,69,,,,,0,"fee schedule","69% of total billed charges",2109,100,,1687.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2109,100,,1687.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2109,100,,1687.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",795.09,37.7,,636.07,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.02,78,,1316.02,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1742.03,82.6,,1393.62,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1742.03,82.6,,1393.62,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2109,100,,1687.20,,,0,"percent of total billed charges","100% of total billed charges",322.68,11498.59,
"26740 Closed treatment of articular fx,metacarpoph",7961482,CDM,521,RC,26740,CPT,OUTPATIENT,,,579,376.35,,509.52,88,,407.62,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,579,100,,463.20,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",364.77,63,,291.82,,,0,"percent of total billed charges","63% of total billed charges",88.59,15.3,,70.87,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,399.51,69,,,,,0,"fee schedule","69% of total billed charges",579,100,,463.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579,100,,463.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579,100,,463.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",218.28,37.7,,174.62,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",451.62,78,,361.30,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",478.25,82.6,,382.60,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",478.25,82.6,,382.60,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,579,100,,463.20,,,0,"percent of total billed charges","100% of total billed charges",88.59,837.64,
"26742 Closed treatment of articular fx, metacarpop",7961483,CDM,521,RC,26742,CPT,OUTPATIENT,,,1230,799.5,,1082.4,88,,865.92,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1230,100,,984.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",774.9,63,,619.92,,,0,"percent of total billed charges","63% of total billed charges",188.19,15.3,,150.55,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,848.7,69,,,,,0,"fee schedule","69% of total billed charges",1230,100,,984.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1230,100,,984.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1230,100,,984.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",463.71,37.7,,370.97,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",959.4,78,,767.52,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1015.98,82.6,,812.78,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1015.98,82.6,,812.78,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,1230,100,,984.00,,,0,"percent of total billed charges","100% of total billed charges",188.19,5656.45,
"26746 Open treatment of articular fx metacarpophal",7962442,CDM,521,RC,26746,CPT,OUTPATIENT,,,2367,1538.55,,2082.96,88,,1666.37,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2367,100,,1893.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1491.21,63,,1192.97,,,0,"percent of total billed charges","63% of total billed charges",362.15,15.3,,289.72,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1633.23,69,,,,,0,"fee schedule","69% of total billed charges",2367,100,,1893.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2367,100,,1893.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2367,100,,1893.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",892.36,37.7,,713.89,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1846.26,78,,1477.01,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.14,82.6,,1564.11,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.14,82.6,,1564.11,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2367,100,,1893.60,,,0,"percent of total billed charges","100% of total billed charges",362.15,11498.59,
"26755 Closed treatment of distal phalangeal fractu",7961908,CDM,521,RC,26755,CPT,OUTPATIENT,,,551,358.15,,484.88,88,,387.90,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",347.13,63,,277.70,,,0,"percent of total billed charges","63% of total billed charges",84.3,15.3,,67.44,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,380.19,69,,,,,0,"fee schedule","69% of total billed charges",551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",207.73,37.7,,166.18,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",429.78,78,,343.82,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",455.13,82.6,,364.10,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",455.13,82.6,,364.10,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,551,100,,440.80,,,0,"percent of total billed charges","100% of total billed charges",84.3,837.64,
"26756 Percutaneous skeletal fixation of distal pha",7962365,CDM,521,RC,26756,CPT,OUTPATIENT,,,1470,955.5,,1293.6,88,,1034.88,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,1470,100,,1176.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",926.1,63,,740.88,,,0,"percent of total billed charges","63% of total billed charges",224.91,15.3,,179.93,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1014.3,69,,,,,0,"fee schedule","69% of total billed charges",1470,100,,1176.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1470,100,,1176.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1470,100,,1176.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",554.19,37.7,,443.35,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1146.6,78,,917.28,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1214.22,82.6,,971.38,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1214.22,82.6,,971.38,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,1470,100,,1176.00,,,0,"percent of total billed charges","100% of total billed charges",224.91,11498.59,
"26765 Open treatment of distal phalangeal fracture",7961484,CDM,521,RC,26765,CPT,OUTPATIENT,,,1117,726.05,,982.96,88,,786.37,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,1117,100,,893.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",703.71,63,,562.97,,,0,"percent of total billed charges","63% of total billed charges",170.9,15.3,,136.72,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,770.73,69,,,,,0,"fee schedule","69% of total billed charges",1117,100,,893.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1117,100,,893.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1117,100,,893.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",421.11,37.7,,336.89,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",871.26,78,,697.01,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",922.64,82.6,,738.11,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",922.64,82.6,,738.11,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,1117,100,,893.60,,,0,"percent of total billed charges","100% of total billed charges",170.9,11498.59,
"26775 Closed treatment of interphalangeal joint di",7961485,CDM,521,RC,26775,CPT,OUTPATIENT,,,902,586.3,,793.76,88,,635.01,,,0,"percent of total billed charges","88% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,902,100,,721.60,,,0,"percent of total billed charges","100% of total billed charges",479.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",916.1,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.26,63,,454.61,,,0,"percent of total billed charges","63% of total billed charges",138.01,15.3,,110.41,,,0,"percent of total billed charges","15.3% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,622.38,69,,,,,0,"fee schedule","69% of total billed charges",902,100,,721.60,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",902,100,,721.60,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",902,100,,721.60,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",979.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.21,100,,,,,0,"fee schedule",EAPG,1156.25,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",340.05,37.7,,272.04,,,0,"percent of total billed charges","37.70% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",703.56,78,,562.85,,,0,"percent of total billed charges","78% of total billed charges",276.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",745.05,82.6,,596.04,,,0,"percent of total billed charges","82.6% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",745.05,82.6,,596.04,,,0,"percent of total billed charges","82.6% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1049.95,100,,,,,0,"fee schedule",EAPG,902,100,,721.60,,,0,"percent of total billed charges","100% of total billed charges",138.01,1156.25,
"26776 Percutaneous skeletal fixation of interphala",7961486,CDM,521,RC,26776,CPT,OUTPATIENT,,,1409,915.85,,1239.92,88,,991.94,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,1409,100,,1127.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",887.67,63,,710.14,,,0,"percent of total billed charges","63% of total billed charges",215.58,15.3,,172.46,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,972.21,69,,,,,0,"fee schedule","69% of total billed charges",1409,100,,1127.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1409,100,,1127.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1409,100,,1127.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",531.19,37.7,,424.95,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1099.02,78,,879.22,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1163.83,82.6,,931.06,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1163.83,82.6,,931.06,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,1409,100,,1127.20,,,0,"percent of total billed charges","100% of total billed charges",215.58,11498.59,
"26770 Closed treatment of interphalangeal joint di",7961859,CDM,521,RC,26770,CPT,OUTPATIENT,,,422,274.3,,371.36,88,,297.09,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.86,63,,212.69,,,0,"percent of total billed charges","63% of total billed charges",64.57,15.3,,51.66,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,291.18,69,,,,,0,"fee schedule","69% of total billed charges",422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.09,37.7,,127.27,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",329.16,78,,263.33,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.57,82.6,,278.86,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.57,82.6,,278.86,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",64.57,837.64,
"26841 Arthrodesis, carpometacarpal joint, thumb, w",7962549,CDM,521,RC,26841,CPT,OUTPATIENT,,,1818,1181.7,,1599.84,88,,1279.87,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,1818,100,,1454.40,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",2038.17,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1145.34,63,,916.27,,,0,"percent of total billed charges","63% of total billed charges",278.15,15.3,,222.52,,,0,"percent of total billed charges","15.3% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,1254.42,69,,,,,0,"fee schedule","69% of total billed charges",1818,100,,1454.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1818,100,,1454.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1818,100,,1454.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2018.38,100,,,,,0,"fee schedule",EAPG,2572.45,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",685.39,37.7,,548.31,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1418.04,78,,1134.43,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1501.67,82.6,,1201.34,,,0,"percent of total billed charges","82.6% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1501.67,82.6,,1201.34,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2139.33,100,,,,,0,"fee schedule",EAPG,1818,100,,1454.40,,,0,"percent of total billed charges","100% of total billed charges",278.15,25451.55,
"26850 Arthrodesis, metacarpophalangeal joint, with",7962668,CDM,521,RC,26850,CPT,OUTPATIENT,,,2739,1780.35,,2410.32,88,,1928.26,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,2739,100,,2191.20,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",2038.17,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.57,63,,1380.46,,,0,"percent of total billed charges","63% of total billed charges",419.07,15.3,,335.26,,,0,"percent of total billed charges","15.3% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,1889.91,69,,,,,0,"fee schedule","69% of total billed charges",2739,100,,2191.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2739,100,,2191.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2739,100,,2191.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2018.38,100,,,,,0,"fee schedule",EAPG,2572.45,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1032.6,37.7,,826.08,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2136.42,78,,1709.14,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2262.41,82.6,,1809.93,,,0,"percent of total billed charges","82.6% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2262.41,82.6,,1809.93,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2139.33,100,,,,,0,"fee schedule",EAPG,2739,100,,2191.20,,,0,"percent of total billed charges","100% of total billed charges",419.07,25451.55,
"26860 Arthrodesis, interphalangeal joint, with or",7962803,CDM,521,RC,26860,CPT,OUTPATIENT,,,2238,1454.7,,1969.44,88,,1575.55,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,2238,100,,1790.40,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1409.94,63,,1127.95,,,0,"percent of total billed charges","63% of total billed charges",342.41,15.3,,273.93,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,1544.22,69,,,,,0,"fee schedule","69% of total billed charges",2238,100,,1790.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2238,100,,1790.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2238,100,,1790.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",843.73,37.7,,674.98,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1745.64,78,,1396.51,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1848.59,82.6,,1478.87,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1848.59,82.6,,1478.87,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.81,100,,,,,0,"fee schedule",EAPG,2238,100,,1790.40,,,0,"percent of total billed charges","100% of total billed charges",342.41,11498.59,
"26910 Amputation, metacarpal, with finger or thumb",7961743,CDM,521,RC,26910,CPT,OUTPATIENT,,,1544,1003.6,,1358.72,88,,1086.98,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,1544,100,,1235.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2038.17,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",972.72,63,,778.18,,,0,"percent of total billed charges","63% of total billed charges",236.23,15.3,,188.98,,,0,"percent of total billed charges","15.3% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,1065.36,69,,,,,0,"fee schedule","69% of total billed charges",1544,100,,1235.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1544,100,,1235.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1544,100,,1235.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2018.38,100,,,,,0,"fee schedule",EAPG,2572.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",582.09,37.7,,465.67,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1204.32,78,,963.46,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1275.34,82.6,,1020.27,,,0,"percent of total billed charges","82.6% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1275.34,82.6,,1020.27,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2139.33,100,,,,,0,"fee schedule",EAPG,1544,100,,1235.20,,,0,"percent of total billed charges","100% of total billed charges",236.23,11498.59,
"26952 Amputation, finger or thumb, primary or seco",7962171,CDM,521,RC,26952,CPT,OUTPATIENT,,,2411,1567.15,,2121.68,88,,1697.34,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,2411,100,,1928.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2038.17,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1518.93,63,,1215.14,,,0,"percent of total billed charges","63% of total billed charges",368.88,15.3,,295.10,,,0,"percent of total billed charges","15.3% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,1663.59,69,,,,,0,"fee schedule","69% of total billed charges",2411,100,,1928.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2411,100,,1928.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2411,100,,1928.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2018.38,100,,,,,0,"fee schedule",EAPG,2572.45,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",908.95,37.7,,727.16,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1880.58,78,,1504.46,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1991.49,82.6,,1593.19,,,0,"percent of total billed charges","82.6% of total billed charges",1978.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1991.49,82.6,,1593.19,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2139.33,100,,,,,0,"fee schedule",EAPG,2411,100,,1928.80,,,0,"percent of total billed charges","100% of total billed charges",368.88,11498.59,
"26951 Amputation, finger or thumb, primary or seco",7962524,CDM,521,RC,26951,CPT,OUTPATIENT,,,1382,898.3,,1216.16,88,,972.93,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1229.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",870.66,63,,696.53,,,0,"percent of total billed charges","63% of total billed charges",211.45,15.3,,169.16,,,0,"percent of total billed charges","15.3% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,953.58,69,,,,,0,"fee schedule","69% of total billed charges",1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.28,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.14,100,,,,,0,"fee schedule",EAPG,1551.26,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",521.01,37.7,,416.81,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1077.96,78,,862.37,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1141.53,82.6,,913.22,,,0,"percent of total billed charges","82.6% of total billed charges",1193.28,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1141.53,82.6,,913.22,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.81,100,,,,,0,"fee schedule",EAPG,1382,100,,1105.60,,,0,"percent of total billed charges","100% of total billed charges",211.45,11498.59,
"26989 Unlisted procedure, hands or fingers",7963656,CDM,521,RC,26989,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",412.25,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",560.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",400.24,560.77,
"26990 Incision and drainage, pelvis or hip joint a",7962702,CDM,521,RC,26990,CPT,OUTPATIENT,,,2044,1328.6,,1798.72,88,,1438.98,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,2044,100,,1635.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1287.72,63,,1030.18,,,0,"percent of total billed charges","63% of total billed charges",312.73,15.3,,250.18,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,1410.36,69,,,,,0,"fee schedule","69% of total billed charges",2044,100,,1635.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2044,100,,1635.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2044,100,,1635.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",770.59,37.7,,616.47,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1594.32,78,,1275.46,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1688.34,82.6,,1350.67,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1688.34,82.6,,1350.67,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3244.38,100,,,,,0,"fee schedule",EAPG,2044,100,,1635.20,,,0,"percent of total billed charges","100% of total billed charges",312.73,11498.59,
"26991 Incision and drainage, pelvis or hip joint a",7963017,CDM,521,RC,26991,CPT,OUTPATIENT,,,1709,1110.85,,1503.92,88,,1203.14,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1709,100,,1367.20,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1076.67,63,,861.34,,,0,"percent of total billed charges","63% of total billed charges",261.48,15.3,,209.18,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1179.21,69,,,,,0,"fee schedule","69% of total billed charges",1709,100,,1367.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1709,100,,1367.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1709,100,,1367.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",644.29,37.7,,515.43,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1333.02,78,,1066.42,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1411.63,82.6,,1129.30,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1411.63,82.6,,1129.30,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,1709,100,,1367.20,,,0,"percent of total billed charges","100% of total billed charges",261.48,5656.45,
"26992 Incision, bone cortex, pelvis and/or hip joi",7963018,CDM,521,RC,26992,CPT,OUTPATIENT,,,1923,1249.95,,1692.24,88,,1353.79,,,0,"percent of total billed charges","88% of total billed charges",1923,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3083.85,100,,,,,0,"fee schedule",EAPG,1923,100,,1538.40,,,0,"percent of total billed charges","100% of total billed charges",1923,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,1923,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1211.49,63,,969.19,,,0,"percent of total billed charges","63% of total billed charges",294.22,15.3,,235.38,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,1326.87,69,,,,,0,"fee schedule","69% of total billed charges",1923,100,,1538.40,,,0,"percent of total billed charges","100% of total billed charges",1923,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1923,100,,1538.40,,,0,"percent of total billed charges","100% of total billed charges",1923,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1923,100,,1538.40,,,0,"percent of total billed charges","100% of total billed charges",1923,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,1923,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1923,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,1923,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",724.97,37.7,,579.98,,,0,"percent of total billed charges","37.70% of total billed charges",1923,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1923,100,,,,,0,"fee schedule","100% of CMS fee schedule",1499.94,78,,1199.95,,,0,"percent of total billed charges","78% of total billed charges",1923,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1588.4,82.6,,1270.72,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,1923,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1588.4,82.6,,1270.72,,,0,"percent of total billed charges","82.6% of total billed charges",1923,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3244.38,100,,,,,0,"fee schedule",EAPG,1923,100,,1538.40,,,0,"percent of total billed charges","100% of total billed charges",294.22,25451.55,
"27001 Tenotomy, adductor of hip, open",7963727,CDM,521,RC,27001,CPT,OUTPATIENT,,,1048,681.2,,922.24,88,,737.79,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,1048,100,,838.40,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.24,63,,528.19,,,0,"percent of total billed charges","63% of total billed charges",160.34,15.3,,128.27,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,723.12,69,,,,,0,"fee schedule","69% of total billed charges",1048,100,,838.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1048,100,,838.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1048,100,,838.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",395.1,37.7,,316.08,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",817.44,78,,653.95,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",865.65,82.6,,692.52,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",865.65,82.6,,692.52,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3244.38,100,,,,,0,"fee schedule",EAPG,1048,100,,838.40,,,0,"percent of total billed charges","100% of total billed charges",160.34,11498.59,
"27025 Fasciotomy, hip or thigh, any type",7963669,CDM,521,RC,27025,CPT,OUTPATIENT,,,3041,1976.65,,2676.08,88,,2140.86,,,0,"percent of total billed charges","88% of total billed charges",3041,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3083.85,100,,,,,0,"fee schedule",EAPG,3041,100,,2432.80,,,0,"percent of total billed charges","100% of total billed charges",3041,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,3041,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1915.83,63,,1532.66,,,0,"percent of total billed charges","63% of total billed charges",465.27,15.3,,372.22,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,2098.29,69,,,,,0,"fee schedule","69% of total billed charges",3041,100,,2432.80,,,0,"percent of total billed charges","100% of total billed charges",3041,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3041,100,,2432.80,,,0,"percent of total billed charges","100% of total billed charges",3041,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3041,100,,2432.80,,,0,"percent of total billed charges","100% of total billed charges",3041,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,3041,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3041,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,3041,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1146.46,37.7,,917.17,,,0,"percent of total billed charges","37.70% of total billed charges",3041,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3041,100,,,,,0,"fee schedule","100% of CMS fee schedule",2371.98,78,,1897.58,,,0,"percent of total billed charges","78% of total billed charges",3041,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2511.87,82.6,,2009.50,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,3041,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2511.87,82.6,,2009.50,,,0,"percent of total billed charges","82.6% of total billed charges",3041,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3244.38,100,,,,,0,"fee schedule",EAPG,3041,100,,2432.80,,,0,"percent of total billed charges","100% of total billed charges",465.27,25451.55,
"27030 Arthrotomy, hip, with drainage (eg, infectio",7963462,CDM,521,RC,27030,CPT,OUTPATIENT,,,1561,1014.65,,1373.68,88,,1098.94,,,0,"percent of total billed charges","88% of total billed charges",1561,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3083.85,100,,,,,0,"fee schedule",EAPG,1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",1561,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,1561,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",983.43,63,,786.74,,,0,"percent of total billed charges","63% of total billed charges",238.83,15.3,,191.06,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,1077.09,69,,,,,0,"fee schedule","69% of total billed charges",1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",1561,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",1561,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",1561,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,1561,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1561,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,1561,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",588.5,37.7,,470.80,,,0,"percent of total billed charges","37.70% of total billed charges",1561,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1561,100,,,,,0,"fee schedule","100% of CMS fee schedule",1217.58,78,,974.06,,,0,"percent of total billed charges","78% of total billed charges",1561,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1289.39,82.6,,1031.51,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule","100% of WA fee schedule",1561,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1289.39,82.6,,1031.51,,,0,"percent of total billed charges","82.6% of total billed charges",1561,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3244.38,100,,,,,0,"fee schedule",EAPG,1561,100,,1248.80,,,0,"percent of total billed charges","100% of total billed charges",238.83,25451.55,
"27041 Biopsy, soft tissue of pelvis and hip area;",7962550,CDM,521,RC,27041,CPT,OUTPATIENT,,,2916,1895.4,,2566.08,88,,2052.86,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2916,100,,2332.80,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1837.08,63,,1469.66,,,0,"percent of total billed charges","63% of total billed charges",446.15,15.3,,356.92,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2012.04,69,,,,,0,"fee schedule","69% of total billed charges",2916,100,,2332.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2916,100,,2332.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2916,100,,2332.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1099.33,37.7,,879.46,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2274.48,78,,1819.58,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2408.62,82.6,,1926.90,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2408.62,82.6,,1926.90,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,2916,100,,2332.80,,,0,"percent of total billed charges","100% of total billed charges",446.15,5715.97,
"27050 Arthrotomy, with biopsy; sacroiliac joint",7963558,CDM,521,RC,27050,CPT,OUTPATIENT,,,1144,743.6,,1006.72,88,,805.38,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,1144,100,,915.20,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",720.72,63,,576.58,,,0,"percent of total billed charges","63% of total billed charges",175.03,15.3,,140.02,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,789.36,69,,,,,0,"fee schedule","69% of total billed charges",1144,100,,915.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1144,100,,915.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1144,100,,915.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",431.29,37.7,,345.03,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.32,78,,713.86,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",944.94,82.6,,755.95,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",944.94,82.6,,755.95,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3244.38,100,,,,,0,"fee schedule",EAPG,1144,100,,915.20,,,0,"percent of total billed charges","100% of total billed charges",175.03,5656.45,
"27052 Arthrotomy, with biopsy; hip joint",7963691,CDM,521,RC,27052,CPT,OUTPATIENT,,,1890,1228.5,,1663.2,88,,1330.56,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,1890,100,,1512.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1190.7,63,,952.56,,,0,"percent of total billed charges","63% of total billed charges",289.17,15.3,,231.34,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,1304.1,69,,,,,0,"fee schedule","69% of total billed charges",1890,100,,1512.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1890,100,,1512.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1890,100,,1512.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",712.53,37.7,,570.02,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1474.2,78,,1179.36,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561.14,82.6,,1248.91,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561.14,82.6,,1248.91,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3244.38,100,,,,,0,"fee schedule",EAPG,1890,100,,1512.00,,,0,"percent of total billed charges","100% of total billed charges",289.17,5656.45,
"27065 Excision of bone cyst or benign tumor, great",7962495,CDM,521,RC,27065,CPT,OUTPATIENT,,,1685,1095.25,,1482.8,88,,1186.24,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,1685,100,,1348.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1061.55,63,,849.24,,,0,"percent of total billed charges","63% of total billed charges",257.81,15.3,,206.25,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,1162.65,69,,,,,0,"fee schedule","69% of total billed charges",1685,100,,1348.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1685,100,,1348.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1685,100,,1348.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",635.25,37.7,,508.20,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1314.3,78,,1051.44,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1391.81,82.6,,1113.45,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1391.81,82.6,,1113.45,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3244.38,100,,,,,0,"fee schedule",EAPG,1685,100,,1348.00,,,0,"percent of total billed charges","100% of total billed charges",257.81,25451.55,
"27066 Excision of bone cyst or benign tumor, great",7962739,CDM,521,RC,27066,CPT,OUTPATIENT,,,1951,1268.15,,1716.88,88,,1373.50,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,1951,100,,1560.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1229.13,63,,983.30,,,0,"percent of total billed charges","63% of total billed charges",298.5,15.3,,238.80,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,1346.19,69,,,,,0,"fee schedule","69% of total billed charges",1951,100,,1560.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1951,100,,1560.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1951,100,,1560.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",735.53,37.7,,588.42,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1521.78,78,,1217.42,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1611.53,82.6,,1289.22,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1611.53,82.6,,1289.22,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3244.38,100,,,,,0,"fee schedule",EAPG,1951,100,,1560.80,,,0,"percent of total billed charges","100% of total billed charges",298.5,11498.59,
"27062 Excision; trochanteric bursa or calcificatio",7963479,CDM,521,RC,27062,CPT,OUTPATIENT,,,1499,974.35,,1319.12,88,,1055.30,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,1499,100,,1199.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",944.37,63,,755.50,,,0,"percent of total billed charges","63% of total billed charges",229.35,15.3,,183.48,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,1034.31,69,,,,,0,"fee schedule","69% of total billed charges",1499,100,,1199.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1499,100,,1199.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1499,100,,1199.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",565.12,37.7,,452.10,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1169.22,78,,935.38,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1238.17,82.6,,990.54,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1238.17,82.6,,990.54,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3244.38,100,,,,,0,"fee schedule",EAPG,1499,100,,1199.20,,,0,"percent of total billed charges","100% of total billed charges",229.35,11498.59,
"27070 Partial excision, wing of ilium, symphysis p",7961582,CDM,521,RC,27070,CPT,OUTPATIENT,,,2839,1845.35,,2498.32,88,,1998.66,,,0,"percent of total billed charges","88% of total billed charges",2839,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3083.85,100,,,,,0,"fee schedule",EAPG,2839,100,,2271.20,,,0,"percent of total billed charges","100% of total billed charges",2839,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,2839,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1788.57,63,,1430.86,,,0,"percent of total billed charges","63% of total billed charges",434.37,15.3,,347.50,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,1958.91,69,,,,,0,"fee schedule","69% of total billed charges",2839,100,,2271.20,,,0,"percent of total billed charges","100% of total billed charges",2839,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2839,100,,2271.20,,,0,"percent of total billed charges","100% of total billed charges",2839,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2839,100,,2271.20,,,0,"percent of total billed charges","100% of total billed charges",2839,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,2839,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2839,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,2839,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1070.3,37.7,,856.24,,,0,"percent of total billed charges","37.70% of total billed charges",2839,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2839,100,,,,,0,"fee schedule","100% of CMS fee schedule",2214.42,78,,1771.54,,,0,"percent of total billed charges","78% of total billed charges",2839,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2345.01,82.6,,1876.01,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule","100% of WA fee schedule",2839,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2345.01,82.6,,1876.01,,,0,"percent of total billed charges","82.6% of total billed charges",2839,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3244.38,100,,,,,0,"fee schedule",EAPG,2839,100,,2271.20,,,0,"percent of total billed charges","100% of total billed charges",434.37,25451.55,
"27087 Removal of foreign body, pelvis or hip; deep",7962669,CDM,521,RC,27087,CPT,OUTPATIENT,,,1267,823.55,,1114.96,88,,891.97,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,1267,100,,1013.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",798.21,63,,638.57,,,0,"percent of total billed charges","63% of total billed charges",193.85,15.3,,155.08,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,874.23,69,,,,,0,"fee schedule","69% of total billed charges",1267,100,,1013.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1267,100,,1013.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1267,100,,1013.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",477.66,37.7,,382.13,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.26,78,,790.61,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1046.54,82.6,,837.23,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1046.54,82.6,,837.23,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3244.38,100,,,,,0,"fee schedule",EAPG,1267,100,,1013.60,,,0,"percent of total billed charges","100% of total billed charges",193.85,11498.59,
"27086 Removal of foreign body, pelvis or hip; subc",7963136,CDM,521,RC,27086,CPT,OUTPATIENT,,,757,492.05,,666.16,88,,532.93,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,757,100,,605.60,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",476.91,63,,381.53,,,0,"percent of total billed charges","63% of total billed charges",115.82,15.3,,92.66,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,522.33,69,,,,,0,"fee schedule","69% of total billed charges",757,100,,605.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",757,100,,605.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",757,100,,605.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",285.39,37.7,,228.31,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",590.46,78,,472.37,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",625.28,82.6,,500.22,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",625.28,82.6,,500.22,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,757,100,,605.60,,,0,"percent of total billed charges","100% of total billed charges",115.82,9628.23,
"27080 Coccygectomy, primary",7963889,CDM,521,RC,27080,CPT,OUTPATIENT,,,1850,1202.5,,1628,88,,1302.40,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,1850,100,,1480.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1165.5,63,,932.40,,,0,"percent of total billed charges","63% of total billed charges",283.05,15.3,,226.44,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,1276.5,69,,,,,0,"fee schedule","69% of total billed charges",1850,100,,1480.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1850,100,,1480.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1850,100,,1480.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",697.45,37.7,,557.96,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1443,78,,1154.40,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1528.1,82.6,,1222.48,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1528.1,82.6,,1222.48,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3244.38,100,,,,,0,"fee schedule",EAPG,1850,100,,1480.00,,,0,"percent of total billed charges","100% of total billed charges",283.05,11498.59,
"27096 Injection procedure for sacroiliac joint, an",7962443,CDM,521,RC,27096,CPT,OUTPATIENT,,,264,171.6,,232.32,88,,185.86,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",443.75,100,,,,,0,"fee schedule",EAPG,264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",457.07,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",166.32,63,,133.06,,,0,"percent of total billed charges","63% of total billed charges",40.39,15.3,,32.31,,,0,"percent of total billed charges","15.3% of total billed charges",443.75,100,,,,,0,"fee schedule",EAPG,182.16,69,,,,,0,"fee schedule","69% of total billed charges",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",443.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",452.63,100,,,,,0,"fee schedule",EAPG,576.88,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",99.53,37.7,,79.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",205.92,78,,164.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",218.06,82.6,,174.45,,,0,"percent of total billed charges","82.6% of total billed charges",443.75,100,,,,,0,"fee schedule","100% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",218.06,82.6,,174.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",604.28,100,,,,,0,"fee schedule",EAPG,264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",40.39,604.28,
"27091 Removal of hip prosthesis; complicated, incl",7962804,CDM,521,RC,27091,CPT,OUTPATIENT,,,4227,2747.55,,3719.76,88,,2975.81,,,0,"percent of total billed charges","88% of total billed charges",4227,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3083.85,100,,,,,0,"fee schedule",EAPG,4227,100,,3381.60,,,0,"percent of total billed charges","100% of total billed charges",4227,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,4227,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2663.01,63,,2130.41,,,0,"percent of total billed charges","63% of total billed charges",646.73,15.3,,517.38,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,2916.63,69,,,,,0,"fee schedule","69% of total billed charges",4227,100,,3381.60,,,0,"percent of total billed charges","100% of total billed charges",4227,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4227,100,,3381.60,,,0,"percent of total billed charges","100% of total billed charges",4227,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4227,100,,3381.60,,,0,"percent of total billed charges","100% of total billed charges",4227,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,4227,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4227,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,4227,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1593.58,37.7,,1274.86,,,0,"percent of total billed charges","37.70% of total billed charges",4227,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4227,100,,,,,0,"fee schedule","100% of CMS fee schedule",3297.06,78,,2637.65,,,0,"percent of total billed charges","78% of total billed charges",4227,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3491.5,82.6,,2793.20,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule","100% of WA fee schedule",4227,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3491.5,82.6,,2793.20,,,0,"percent of total billed charges","82.6% of total billed charges",4227,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3244.38,100,,,,,0,"fee schedule",EAPG,4227,100,,3381.60,,,0,"percent of total billed charges","100% of total billed charges",646.73,9628.23,
"27090 Removal of hip prosthesis; (separate procedu",7963445,CDM,521,RC,27090,CPT,OUTPATIENT,,,1936,1258.4,,1703.68,88,,1362.94,,,0,"percent of total billed charges","88% of total billed charges",1936,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3083.85,100,,,,,0,"fee schedule",EAPG,1936,100,,1548.80,,,0,"percent of total billed charges","100% of total billed charges",1936,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,1936,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1219.68,63,,975.74,,,0,"percent of total billed charges","63% of total billed charges",296.21,15.3,,236.97,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,1335.84,69,,,,,0,"fee schedule","69% of total billed charges",1936,100,,1548.80,,,0,"percent of total billed charges","100% of total billed charges",1936,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1936,100,,1548.80,,,0,"percent of total billed charges","100% of total billed charges",1936,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1936,100,,1548.80,,,0,"percent of total billed charges","100% of total billed charges",1936,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,1936,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1936,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,1936,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",729.87,37.7,,583.90,,,0,"percent of total billed charges","37.70% of total billed charges",1936,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1936,100,,,,,0,"fee schedule","100% of CMS fee schedule",1510.08,78,,1208.06,,,0,"percent of total billed charges","78% of total billed charges",1936,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1599.14,82.6,,1279.31,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule","100% of WA fee schedule",1936,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1599.14,82.6,,1279.31,,,0,"percent of total billed charges","82.6% of total billed charges",1936,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3244.38,100,,,,,0,"fee schedule",EAPG,1936,100,,1548.80,,,0,"percent of total billed charges","100% of total billed charges",296.21,9628.23,
"27125 Hemiarthroplasty, hip, partial (eg, femoral",7962407,CDM,521,RC,27125,CPT,OUTPATIENT,,,3566,2317.9,,3138.08,88,,2510.46,,,0,"percent of total billed charges","88% of total billed charges",3566,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3128.81,100,,,,,0,"fee schedule",EAPG,3566,100,,2852.80,,,0,"percent of total billed charges","100% of total billed charges",3566,175,,,,,0,"fee schedule","175% of CMS fee schedule",3222.67,100,,,,,0,"fee schedule",EAPG,3566,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2246.58,63,,1797.26,,,0,"percent of total billed charges","63% of total billed charges",545.6,15.3,,436.48,,,0,"percent of total billed charges","15.3% of total billed charges",3128.81,100,,,,,0,"fee schedule",EAPG,2460.54,69,,,,,0,"fee schedule","69% of total billed charges",3566,100,,2852.80,,,0,"percent of total billed charges","100% of total billed charges",3566,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3566,100,,2852.80,,,0,"percent of total billed charges","100% of total billed charges",3566,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3566,100,,2852.80,,,0,"percent of total billed charges","100% of total billed charges",3566,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3128.81,100,,,,,0,"fee schedule",EAPG,3566,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3566,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3191.38,100,,,,,0,"fee schedule",EAPG,4067.45,100,,,,,0,"fee schedule",EAPG,3566,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1344.38,37.7,,1075.50,,,0,"percent of total billed charges","37.70% of total billed charges",3566,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3566,100,,,,,0,"fee schedule","100% of CMS fee schedule",2781.48,78,,2225.18,,,0,"percent of total billed charges","78% of total billed charges",3566,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2945.52,82.6,,2356.42,,,0,"percent of total billed charges","82.6% of total billed charges",3128.81,100,,,,,0,"fee schedule","100% of WA fee schedule",3566,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2945.52,82.6,,2356.42,,,0,"percent of total billed charges","82.6% of total billed charges",3566,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3289.34,100,,,,,0,"fee schedule",EAPG,3566,100,,2852.80,,,0,"percent of total billed charges","100% of total billed charges",545.6,50029.1,
"27122 Acetabuloplasty; resection, femoral head (eg",7962877,CDM,521,RC,27122,CPT,OUTPATIENT,,,4363,2835.95,,3839.44,88,,3071.55,,,0,"percent of total billed charges","88% of total billed charges",4363,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3083.85,100,,,,,0,"fee schedule",EAPG,4363,100,,3490.40,,,0,"percent of total billed charges","100% of total billed charges",4363,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,4363,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2748.69,63,,2198.95,,,0,"percent of total billed charges","63% of total billed charges",667.54,15.3,,534.03,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,3010.47,69,,,,,0,"fee schedule","69% of total billed charges",4363,100,,3490.40,,,0,"percent of total billed charges","100% of total billed charges",4363,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4363,100,,3490.40,,,0,"percent of total billed charges","100% of total billed charges",4363,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4363,100,,3490.40,,,0,"percent of total billed charges","100% of total billed charges",4363,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,4363,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4363,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,4363,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1644.85,37.7,,1315.88,,,0,"percent of total billed charges","37.70% of total billed charges",4363,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4363,100,,,,,0,"fee schedule","100% of CMS fee schedule",3403.14,78,,2722.51,,,0,"percent of total billed charges","78% of total billed charges",4363,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3603.84,82.6,,2883.07,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule","100% of WA fee schedule",4363,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3603.84,82.6,,2883.07,,,0,"percent of total billed charges","82.6% of total billed charges",4363,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3244.38,100,,,,,0,"fee schedule",EAPG,4363,100,,3490.40,,,0,"percent of total billed charges","100% of total billed charges",667.54,50029.1,
"27134 Revision of total hip arthroplasty; both com",7961744,CDM,521,RC,27134,CPT,OUTPATIENT,,,6589,4282.85,,5798.32,88,,4638.66,,,0,"percent of total billed charges","88% of total billed charges",6589,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8399.65,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6589,175,,,,,0,"fee schedule","175% of CMS fee schedule",8651.64,100,,,,,0,"fee schedule",EAPG,6589,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4151.07,63,,3320.86,,,0,"percent of total billed charges","63% of total billed charges",1008.12,15.3,,806.50,,,0,"percent of total billed charges","15.3% of total billed charges",8399.65,100,,,,,0,"fee schedule",EAPG,4546.41,69,,,,,0,"fee schedule","69% of total billed charges",6589,100,,5271.20,,,0,"percent of total billed charges","100% of total billed charges",6589,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6589,100,,5271.20,,,0,"percent of total billed charges","100% of total billed charges",6589,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6589,100,,5271.20,,,0,"percent of total billed charges","100% of total billed charges",6589,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8399.65,100,,,,,0,"fee schedule",EAPG,6589,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6589,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8567.64,100,,,,,0,"fee schedule",EAPG,10919.55,100,,,,,0,"fee schedule",EAPG,6589,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2484.05,37.7,,1987.24,,,0,"percent of total billed charges","37.70% of total billed charges",6589,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6589,100,,,,,0,"fee schedule","100% of CMS fee schedule",5139.42,78,,4111.54,,,0,"percent of total billed charges","78% of total billed charges",6589,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5442.51,82.6,,4354.01,,,0,"percent of total billed charges","82.6% of total billed charges",8399.65,100,,,,,0,"fee schedule","100% of WA fee schedule",6589,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5442.51,82.6,,4354.01,,,0,"percent of total billed charges","82.6% of total billed charges",6589,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8560.18,100,,,,,0,"fee schedule",EAPG,6589,100,,5271.20,,,0,"percent of total billed charges","100% of total billed charges",1008.12,50029.1,
"27138 Revision of total hip arthroplasty; femoral",7962291,CDM,521,RC,27138,CPT,OUTPATIENT,,,4850,3152.5,,4268,88,,3414.40,,,0,"percent of total billed charges","88% of total billed charges",4850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8399.65,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",4850,175,,,,,0,"fee schedule","175% of CMS fee schedule",8651.64,100,,,,,0,"fee schedule",EAPG,4850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3055.5,63,,2444.40,,,0,"percent of total billed charges","63% of total billed charges",742.05,15.3,,593.64,,,0,"percent of total billed charges","15.3% of total billed charges",8399.65,100,,,,,0,"fee schedule",EAPG,3346.5,69,,,,,0,"fee schedule","69% of total billed charges",4850,100,,3880.00,,,0,"percent of total billed charges","100% of total billed charges",4850,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4850,100,,3880.00,,,0,"percent of total billed charges","100% of total billed charges",4850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4850,100,,3880.00,,,0,"percent of total billed charges","100% of total billed charges",4850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8399.65,100,,,,,0,"fee schedule",EAPG,4850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8567.64,100,,,,,0,"fee schedule",EAPG,10919.55,100,,,,,0,"fee schedule",EAPG,4850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1828.45,37.7,,1462.76,,,0,"percent of total billed charges","37.70% of total billed charges",4850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4850,100,,,,,0,"fee schedule","100% of CMS fee schedule",3783,78,,3026.40,,,0,"percent of total billed charges","78% of total billed charges",4850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4006.1,82.6,,3204.88,,,0,"percent of total billed charges","82.6% of total billed charges",8399.65,100,,,,,0,"fee schedule","100% of WA fee schedule",4850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4006.1,82.6,,3204.88,,,0,"percent of total billed charges","82.6% of total billed charges",4850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8560.18,100,,,,,0,"fee schedule",EAPG,4850,100,,3880.00,,,0,"percent of total billed charges","100% of total billed charges",742.05,50029.1,
"27130 Arthroplasty, acetabular and proximal femora",7962878,CDM,521,RC,27130,CPT,OUTPATIENT,,,6991,4544.15,,6152.08,88,,4921.66,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8399.65,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",8651.64,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4404.33,63,,3523.46,,,0,"percent of total billed charges","63% of total billed charges",1069.62,15.3,,855.70,,,0,"percent of total billed charges","15.3% of total billed charges",8399.65,100,,,,,0,"fee schedule",EAPG,4823.79,69,,,,,0,"fee schedule","69% of total billed charges",6991,100,,5592.80,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6991,100,,5592.80,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6991,100,,5592.80,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8399.65,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8567.64,100,,,,,0,"fee schedule",EAPG,10919.55,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2635.61,37.7,,2108.49,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5452.98,78,,4362.38,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5774.57,82.6,,4619.66,,,0,"percent of total billed charges","82.6% of total billed charges",8399.65,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5774.57,82.6,,4619.66,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"case rate","pays based on per visit rate",6991,100,,5592.80,,,0,"percent of total billed charges","100% of total billed charges",160.53,50029.1,
"27137 Revision of total hip arthroplasty; acetabul",7963068,CDM,521,RC,27137,CPT,OUTPATIENT,,,4540,2951,,3995.2,88,,3196.16,,,0,"percent of total billed charges","88% of total billed charges",4540,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8399.65,100,,,,,0,"fee schedule",EAPG,4540,100,,3632.00,,,0,"percent of total billed charges","100% of total billed charges",4540,175,,,,,0,"fee schedule","175% of CMS fee schedule",8651.64,100,,,,,0,"fee schedule",EAPG,4540,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2860.2,63,,2288.16,,,0,"percent of total billed charges","63% of total billed charges",694.62,15.3,,555.70,,,0,"percent of total billed charges","15.3% of total billed charges",8399.65,100,,,,,0,"fee schedule",EAPG,3132.6,69,,,,,0,"fee schedule","69% of total billed charges",4540,100,,3632.00,,,0,"percent of total billed charges","100% of total billed charges",4540,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4540,100,,3632.00,,,0,"percent of total billed charges","100% of total billed charges",4540,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4540,100,,3632.00,,,0,"percent of total billed charges","100% of total billed charges",4540,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8399.65,100,,,,,0,"fee schedule",EAPG,4540,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4540,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8567.64,100,,,,,0,"fee schedule",EAPG,10919.55,100,,,,,0,"fee schedule",EAPG,4540,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1711.58,37.7,,1369.26,,,0,"percent of total billed charges","37.70% of total billed charges",4540,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4540,100,,,,,0,"fee schedule","100% of CMS fee schedule",3541.2,78,,2832.96,,,0,"percent of total billed charges","78% of total billed charges",4540,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3750.04,82.6,,3000.03,,,0,"percent of total billed charges","82.6% of total billed charges",8399.65,100,,,,,0,"fee schedule","100% of WA fee schedule",4540,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3750.04,82.6,,3000.03,,,0,"percent of total billed charges","82.6% of total billed charges",4540,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8560.18,100,,,,,0,"fee schedule",EAPG,4540,100,,3632.00,,,0,"percent of total billed charges","100% of total billed charges",694.62,50029.1,
"27132 Conversion of previous hip surgery to total",7963101,CDM,521,RC,27132,CPT,OUTPATIENT,,,5625,3656.25,,4950,88,,3960.00,,,0,"percent of total billed charges","88% of total billed charges",5625,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8399.65,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5625,175,,,,,0,"fee schedule","175% of CMS fee schedule",8651.64,100,,,,,0,"fee schedule",EAPG,5625,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3543.75,63,,2835.00,,,0,"percent of total billed charges","63% of total billed charges",860.63,15.3,,688.50,,,0,"percent of total billed charges","15.3% of total billed charges",8399.65,100,,,,,0,"fee schedule",EAPG,3881.25,69,,,,,0,"fee schedule","69% of total billed charges",5625,100,,4500.00,,,0,"percent of total billed charges","100% of total billed charges",5625,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5625,100,,4500.00,,,0,"percent of total billed charges","100% of total billed charges",5625,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5625,100,,4500.00,,,0,"percent of total billed charges","100% of total billed charges",5625,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8399.65,100,,,,,0,"fee schedule",EAPG,5625,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5625,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8567.64,100,,,,,0,"fee schedule",EAPG,10919.55,100,,,,,0,"fee schedule",EAPG,5625,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2120.63,37.7,,1696.50,,,0,"percent of total billed charges","37.70% of total billed charges",5625,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5625,100,,,,,0,"fee schedule","100% of CMS fee schedule",4387.5,78,,3510.00,,,0,"percent of total billed charges","78% of total billed charges",5625,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4646.25,82.6,,3717.00,,,0,"percent of total billed charges","82.6% of total billed charges",8399.65,100,,,,,0,"fee schedule","100% of WA fee schedule",5625,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4646.25,82.6,,3717.00,,,0,"percent of total billed charges","82.6% of total billed charges",5625,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8560.18,100,,,,,0,"fee schedule",EAPG,5625,100,,4500.00,,,0,"percent of total billed charges","100% of total billed charges",860.63,50029.1,
"27226 Open treatment of posterior or anterior acet",7961909,CDM,521,RC,27226,CPT,OUTPATIENT,,,3792,2464.8,,3336.96,88,,2669.57,,,0,"percent of total billed charges","88% of total billed charges",3792,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4786.08,100,,,,,0,"fee schedule",EAPG,3792,100,,3033.60,,,0,"percent of total billed charges","100% of total billed charges",3792,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,3792,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2388.96,63,,1911.17,,,0,"percent of total billed charges","63% of total billed charges",580.18,15.3,,464.14,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,2616.48,69,,,,,0,"fee schedule","69% of total billed charges",3792,100,,3033.60,,,0,"percent of total billed charges","100% of total billed charges",3792,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3792,100,,3033.60,,,0,"percent of total billed charges","100% of total billed charges",3792,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3792,100,,3033.60,,,0,"percent of total billed charges","100% of total billed charges",3792,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3792,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3792,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,3792,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1429.58,37.7,,1143.66,,,0,"percent of total billed charges","37.70% of total billed charges",3792,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3792,100,,,,,0,"fee schedule","100% of CMS fee schedule",2957.76,78,,2366.21,,,0,"percent of total billed charges","78% of total billed charges",3792,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3132.19,82.6,,2505.75,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule","100% of WA fee schedule",3792,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3132.19,82.6,,2505.75,,,0,"percent of total billed charges","82.6% of total billed charges",3792,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4946.61,100,,,,,0,"fee schedule",EAPG,3792,100,,3033.60,,,0,"percent of total billed charges","100% of total billed charges",580.18,25451.55,
"27238 Closed treatment of intertrochanteric or sub",7961745,CDM,521,RC,27238,CPT,OUTPATIENT,,,1261,819.65,,1109.68,88,,887.74,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1261,100,,1008.80,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",794.43,63,,635.54,,,0,"percent of total billed charges","63% of total billed charges",192.93,15.3,,154.34,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,870.09,69,,,,,0,"fee schedule","69% of total billed charges",1261,100,,1008.80,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1261,100,,1008.80,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1261,100,,1008.80,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",475.4,37.7,,380.32,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",983.58,78,,786.86,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1041.59,82.6,,833.27,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1041.59,82.6,,833.27,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,1261,100,,1008.80,,,0,"percent of total billed charges","100% of total billed charges",192.93,5656.45,
"27236 Open treatment of femoral fracture, proximal",7962703,CDM,521,RC,27236,CPT,OUTPATIENT,,,4659,3028.35,,4099.92,88,,3279.94,,,0,"percent of total billed charges","88% of total billed charges",4659,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4786.08,100,,,,,0,"fee schedule",EAPG,4659,100,,3727.20,,,0,"percent of total billed charges","100% of total billed charges",4659,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,4659,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2935.17,63,,2348.14,,,0,"percent of total billed charges","63% of total billed charges",712.83,15.3,,570.26,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3214.71,69,,,,,0,"fee schedule","69% of total billed charges",4659,100,,3727.20,,,0,"percent of total billed charges","100% of total billed charges",4659,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4659,100,,3727.20,,,0,"percent of total billed charges","100% of total billed charges",4659,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4659,100,,3727.20,,,0,"percent of total billed charges","100% of total billed charges",4659,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,4659,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4659,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,4659,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1756.44,37.7,,1405.15,,,0,"percent of total billed charges","37.70% of total billed charges",4659,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4659,100,,,,,0,"fee schedule","100% of CMS fee schedule",3634.02,78,,2907.22,,,0,"percent of total billed charges","78% of total billed charges",4659,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3848.33,82.6,,3078.66,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule","100% of WA fee schedule",4659,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3848.33,82.6,,3078.66,,,0,"percent of total billed charges","82.6% of total billed charges",4659,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4946.61,100,,,,,0,"fee schedule",EAPG,4659,100,,3727.20,,,0,"percent of total billed charges","100% of total billed charges",712.83,25451.55,
"27235 Percutaneous skeletal fixation of femoral fr",7962805,CDM,521,RC,27235,CPT,OUTPATIENT,,,3905,2538.25,,3436.4,88,,2749.12,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3905,100,,3124.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2460.15,63,,1968.12,,,0,"percent of total billed charges","63% of total billed charges",597.47,15.3,,477.98,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,2694.45,69,,,,,0,"fee schedule","69% of total billed charges",3905,100,,3124.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3905,100,,3124.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3905,100,,3124.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1472.19,37.7,,1177.75,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3045.9,78,,2436.72,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3225.53,82.6,,2580.42,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3225.53,82.6,,2580.42,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,3905,100,,3124.00,,,0,"percent of total billed charges","100% of total billed charges",597.47,25451.55,
"27244 Treatment of intertrochanteric or subtrochan",7961487,CDM,521,RC,27244,CPT,OUTPATIENT,,,4529,2943.85,,3985.52,88,,3188.42,,,0,"percent of total billed charges","88% of total billed charges",4529,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3083.85,100,,,,,0,"fee schedule",EAPG,4529,100,,3623.20,,,0,"percent of total billed charges","100% of total billed charges",4529,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,4529,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2853.27,63,,2282.62,,,0,"percent of total billed charges","63% of total billed charges",692.94,15.3,,554.35,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,3125.01,69,,,,,0,"fee schedule","69% of total billed charges",4529,100,,3623.20,,,0,"percent of total billed charges","100% of total billed charges",4529,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4529,100,,3623.20,,,0,"percent of total billed charges","100% of total billed charges",4529,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4529,100,,3623.20,,,0,"percent of total billed charges","100% of total billed charges",4529,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,4529,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4529,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,4529,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1707.43,37.7,,1365.94,,,0,"percent of total billed charges","37.70% of total billed charges",4529,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4529,100,,,,,0,"fee schedule","100% of CMS fee schedule",3532.62,78,,2826.10,,,0,"percent of total billed charges","78% of total billed charges",4529,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3740.95,82.6,,2992.76,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule","100% of WA fee schedule",4529,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3740.95,82.6,,2992.76,,,0,"percent of total billed charges","82.6% of total billed charges",4529,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3244.38,100,,,,,0,"fee schedule",EAPG,4529,100,,3623.20,,,0,"percent of total billed charges","100% of total billed charges",692.94,25451.55,
"27245 Treatment of intertrochanteric or subtrochan",7961671,CDM,521,RC,27245,CPT,OUTPATIENT,,,5198,3378.7,,4574.24,88,,3659.39,,,0,"percent of total billed charges","88% of total billed charges",5198,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3083.85,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5198,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,5198,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3274.74,63,,2619.79,,,0,"percent of total billed charges","63% of total billed charges",795.29,15.3,,636.23,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,3586.62,69,,,,,0,"fee schedule","69% of total billed charges",5198,100,,4158.40,,,0,"percent of total billed charges","100% of total billed charges",5198,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5198,100,,4158.40,,,0,"percent of total billed charges","100% of total billed charges",5198,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5198,100,,4158.40,,,0,"percent of total billed charges","100% of total billed charges",5198,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,5198,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5198,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,5198,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1959.65,37.7,,1567.72,,,0,"percent of total billed charges","37.70% of total billed charges",5198,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5198,100,,,,,0,"fee schedule","100% of CMS fee schedule",4054.44,78,,3243.55,,,0,"percent of total billed charges","78% of total billed charges",5198,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4293.55,82.6,,3434.84,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule","100% of WA fee schedule",5198,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4293.55,82.6,,3434.84,,,0,"percent of total billed charges","82.6% of total billed charges",5198,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3244.38,100,,,,,0,"fee schedule",EAPG,5198,100,,4158.40,,,0,"percent of total billed charges","100% of total billed charges",795.29,25451.55,
"27248 Open treatment of greater trochanteric fract",7961746,CDM,521,RC,27248,CPT,OUTPATIENT,,,2066,1342.9,,1818.08,88,,1454.46,,,0,"percent of total billed charges","88% of total billed charges",2066,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4786.08,100,,,,,0,"fee schedule",EAPG,2066,100,,1652.80,,,0,"percent of total billed charges","100% of total billed charges",2066,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,2066,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1301.58,63,,1041.26,,,0,"percent of total billed charges","63% of total billed charges",316.1,15.3,,252.88,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1425.54,69,,,,,0,"fee schedule","69% of total billed charges",2066,100,,1652.80,,,0,"percent of total billed charges","100% of total billed charges",2066,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2066,100,,1652.80,,,0,"percent of total billed charges","100% of total billed charges",2066,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2066,100,,1652.80,,,0,"percent of total billed charges","100% of total billed charges",2066,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2066,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2066,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,2066,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",778.88,37.7,,623.10,,,0,"percent of total billed charges","37.70% of total billed charges",2066,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2066,100,,,,,0,"fee schedule","100% of CMS fee schedule",1611.48,78,,1289.18,,,0,"percent of total billed charges","78% of total billed charges",2066,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1706.52,82.6,,1365.22,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule","100% of WA fee schedule",2066,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1706.52,82.6,,1365.22,,,0,"percent of total billed charges","82.6% of total billed charges",2066,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4946.61,100,,,,,0,"fee schedule",EAPG,2066,100,,1652.80,,,0,"percent of total billed charges","100% of total billed charges",316.1,25451.55,
"27257 Treatment of spontaneous hip dislocation; wi",7962444,CDM,521,RC,27257,CPT,OUTPATIENT,,,1102,716.3,,969.76,88,,775.81,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,1102,100,,881.60,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",916.1,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.26,63,,555.41,,,0,"percent of total billed charges","63% of total billed charges",168.61,15.3,,134.89,,,0,"percent of total billed charges","15.3% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,760.38,69,,,,,0,"fee schedule","69% of total billed charges",1102,100,,881.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1102,100,,881.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1102,100,,881.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.21,100,,,,,0,"fee schedule",EAPG,1156.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",415.45,37.7,,332.36,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.56,78,,687.65,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",910.25,82.6,,728.20,,,0,"percent of total billed charges","82.6% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",910.25,82.6,,728.20,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1049.95,100,,,,,0,"fee schedule",EAPG,1102,100,,881.60,,,0,"percent of total billed charges","100% of total billed charges",168.61,5656.45,
"27252 Closed treatment of hip dislocation, traumat",7962879,CDM,521,RC,27252,CPT,OUTPATIENT,,,1825,1186.25,,1606,88,,1284.80,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,1825,100,,1460.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",916.1,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1149.75,63,,919.80,,,0,"percent of total billed charges","63% of total billed charges",279.23,15.3,,223.38,,,0,"percent of total billed charges","15.3% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,1259.25,69,,,,,0,"fee schedule","69% of total billed charges",1825,100,,1460.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1825,100,,1460.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1825,100,,1460.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.21,100,,,,,0,"fee schedule",EAPG,1156.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",688.03,37.7,,550.42,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1423.5,78,,1138.80,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1507.45,82.6,,1205.96,,,0,"percent of total billed charges","82.6% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1507.45,82.6,,1205.96,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1049.95,100,,,,,0,"fee schedule",EAPG,1825,100,,1460.00,,,0,"percent of total billed charges","100% of total billed charges",279.23,5656.45,
"27266 Closed treatment of post hip arthroplasty di",7962366,CDM,521,RC,27266,CPT,OUTPATIENT,,,1424,925.6,,1253.12,88,,1002.50,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,1424,100,,1139.20,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",916.1,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",897.12,63,,717.70,,,0,"percent of total billed charges","63% of total billed charges",217.87,15.3,,174.30,,,0,"percent of total billed charges","15.3% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,982.56,69,,,,,0,"fee schedule","69% of total billed charges",1424,100,,1139.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1424,100,,1139.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1424,100,,1139.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.21,100,,,,,0,"fee schedule",EAPG,1156.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",536.85,37.7,,429.48,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1110.72,78,,888.58,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1176.22,82.6,,940.98,,,0,"percent of total billed charges","82.6% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1176.22,82.6,,940.98,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1049.95,100,,,,,0,"fee schedule",EAPG,1424,100,,1139.20,,,0,"percent of total billed charges","100% of total billed charges",217.87,5656.45,
"27265 Closed treatment of post hip arthroplasty di",7962704,CDM,521,RC,27265,CPT,OUTPATIENT,,,935,607.75,,822.8,88,,658.24,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,935,100,,748.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",589.05,63,,471.24,,,0,"percent of total billed charges","63% of total billed charges",143.06,15.3,,114.45,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,645.15,69,,,,,0,"fee schedule","69% of total billed charges",935,100,,748.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",935,100,,748.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",935,100,,748.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",352.5,37.7,,282.00,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",729.3,78,,583.44,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",772.31,82.6,,617.85,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",772.31,82.6,,617.85,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,935,100,,748.00,,,0,"percent of total billed charges","100% of total billed charges",143.06,935,
"27299 Unlisted procedure, pelvis or hip joint",7963598,CDM,521,RC,27299,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",412.25,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",560.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",400.24,560.77,
"27306 Tenotomy, percutaneous, adductor or hamstrin",7962394,CDM,521,RC,27306,CPT,OUTPATIENT,,,1251,813.15,,1100.88,88,,880.70,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,1251,100,,1000.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",788.13,63,,630.50,,,0,"percent of total billed charges","63% of total billed charges",191.4,15.3,,153.12,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,863.19,69,,,,,0,"fee schedule","69% of total billed charges",1251,100,,1000.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1251,100,,1000.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1251,100,,1000.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",471.63,37.7,,377.30,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",975.78,78,,780.62,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033.33,82.6,,826.66,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033.33,82.6,,826.66,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3244.38,100,,,,,0,"fee schedule",EAPG,1251,100,,1000.80,,,0,"percent of total billed charges","100% of total billed charges",191.4,11498.59,
"27301 Incision and drainage, deep abscess, bursa,",7962551,CDM,521,RC,27301,CPT,OUTPATIENT,,,963,625.95,,847.44,88,,677.95,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,963,100,,770.40,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",606.69,63,,485.35,,,0,"percent of total billed charges","63% of total billed charges",147.34,15.3,,117.87,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,664.47,69,,,,,0,"fee schedule","69% of total billed charges",963,100,,770.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",963,100,,770.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",963,100,,770.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",363.05,37.7,,290.44,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",751.14,78,,600.91,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",795.44,82.6,,636.35,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",795.44,82.6,,636.35,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,963,100,,770.40,,,0,"percent of total billed charges","100% of total billed charges",147.34,9628.23,
"27305 Fasciotomy, iliotibial (tenotomy), open",7963599,CDM,521,RC,27305,CPT,OUTPATIENT,,,1396,907.4,,1228.48,88,,982.78,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,1396,100,,1116.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.48,63,,703.58,,,0,"percent of total billed charges","63% of total billed charges",213.59,15.3,,170.87,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,963.24,69,,,,,0,"fee schedule","69% of total billed charges",1396,100,,1116.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1396,100,,1116.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1396,100,,1116.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",526.29,37.7,,421.03,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1088.88,78,,871.10,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1153.1,82.6,,922.48,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1153.1,82.6,,922.48,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3244.38,100,,,,,0,"fee schedule",EAPG,1396,100,,1116.80,,,0,"percent of total billed charges","100% of total billed charges",213.59,11498.59,
"27310 Arthrotomy, knee, with exploration, drainage",7961910,CDM,521,RC,27310,CPT,OUTPATIENT,,,1897,1233.05,,1669.36,88,,1335.49,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,1897,100,,1517.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2893.79,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1195.11,63,,956.09,,,0,"percent of total billed charges","63% of total billed charges",290.24,15.3,,232.19,,,0,"percent of total billed charges","15.3% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,1308.93,69,,,,,0,"fee schedule","69% of total billed charges",1897,100,,1517.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1897,100,,1517.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1897,100,,1517.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2865.69,100,,,,,0,"fee schedule",EAPG,3652.35,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",715.17,37.7,,572.14,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1479.66,78,,1183.73,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1566.92,82.6,,1253.54,,,0,"percent of total billed charges","82.6% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1566.92,82.6,,1253.54,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2970.03,100,,,,,0,"fee schedule",EAPG,1897,100,,1517.60,,,0,"percent of total billed charges","100% of total billed charges",290.24,11498.59,
"27327 Excision, tumor, soft tissue of thigh or kne",7962467,CDM,521,RC,27327,CPT,OUTPATIENT,,,734,477.1,,645.92,88,,516.74,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,734,100,,587.20,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.42,63,,369.94,,,0,"percent of total billed charges","63% of total billed charges",112.3,15.3,,89.84,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,506.46,69,,,,,0,"fee schedule","69% of total billed charges",734,100,,587.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",734,100,,587.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",734,100,,587.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",276.72,37.7,,221.38,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",572.52,78,,458.02,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",606.28,82.6,,485.02,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",606.28,82.6,,485.02,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,734,100,,587.20,,,0,"percent of total billed charges","100% of total billed charges",112.3,5715.97,
"27328 Excision, tumor, soft tissue of thigh or kne",7962525,CDM,521,RC,27328,CPT,OUTPATIENT,,,1421,923.65,,1250.48,88,,1000.38,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1421,100,,1136.80,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",895.23,63,,716.18,,,0,"percent of total billed charges","63% of total billed charges",217.41,15.3,,173.93,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,980.49,69,,,,,0,"fee schedule","69% of total billed charges",1421,100,,1136.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1421,100,,1136.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1421,100,,1136.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",535.72,37.7,,428.58,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1108.38,78,,886.70,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1173.75,82.6,,939.00,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1173.75,82.6,,939.00,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,1421,100,,1136.80,,,0,"percent of total billed charges","100% of total billed charges",217.41,9628.23,
"27326 Neurectomy, popliteal (gastrocnemius)",7963615,CDM,521,RC,27326,CPT,OUTPATIENT,,,1531,995.15,,1347.28,88,,1077.82,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,1531,100,,1224.80,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",2893.79,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",964.53,63,,771.62,,,0,"percent of total billed charges","63% of total billed charges",234.24,15.3,,187.39,,,0,"percent of total billed charges","15.3% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,1056.39,69,,,,,0,"fee schedule","69% of total billed charges",1531,100,,1224.80,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1531,100,,1224.80,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1531,100,,1224.80,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2865.69,100,,,,,0,"fee schedule",EAPG,3652.35,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",577.19,37.7,,461.75,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1194.18,78,,955.34,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1264.61,82.6,,1011.69,,,0,"percent of total billed charges","82.6% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1264.61,82.6,,1011.69,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2970.03,100,,,,,0,"fee schedule",EAPG,1531,100,,1224.80,,,0,"percent of total billed charges","100% of total billed charges",234.24,7127.26,
"27331 Arthrotomy, knee; including joint exploratio",7961672,CDM,521,RC,27331,CPT,OUTPATIENT,,,1694,1101.1,,1490.72,88,,1192.58,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,1694,100,,1355.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2893.79,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1067.22,63,,853.78,,,0,"percent of total billed charges","63% of total billed charges",259.18,15.3,,207.34,,,0,"percent of total billed charges","15.3% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,1168.86,69,,,,,0,"fee schedule","69% of total billed charges",1694,100,,1355.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1694,100,,1355.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1694,100,,1355.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2865.69,100,,,,,0,"fee schedule",EAPG,3652.35,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",638.64,37.7,,510.91,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1321.32,78,,1057.06,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1399.24,82.6,,1119.39,,,0,"percent of total billed charges","82.6% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1399.24,82.6,,1119.39,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2970.03,100,,,,,0,"fee schedule",EAPG,1694,100,,1355.20,,,0,"percent of total billed charges","100% of total billed charges",259.18,11498.59,
"27337 Excision, tumor, soft tissue of thigh or kne",7962445,CDM,521,RC,27337,CPT,OUTPATIENT,,,922,599.3,,811.36,88,,649.09,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,922,100,,737.60,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",580.86,63,,464.69,,,0,"percent of total billed charges","63% of total billed charges",141.07,15.3,,112.86,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,636.18,69,,,,,0,"fee schedule","69% of total billed charges",922,100,,737.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",922,100,,737.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",922,100,,737.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",347.59,37.7,,278.07,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",719.16,78,,575.33,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",761.57,82.6,,609.26,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",761.57,82.6,,609.26,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,922,100,,737.60,,,0,"percent of total billed charges","100% of total billed charges",141.07,9628.23,
"27339 Excision, tumor, soft tissue of thigh or kne",7962496,CDM,521,RC,27339,CPT,OUTPATIENT,,,1789,1162.85,,1574.32,88,,1259.46,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1789,100,,1431.20,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1127.07,63,,901.66,,,0,"percent of total billed charges","63% of total billed charges",273.72,15.3,,218.98,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1234.41,69,,,,,0,"fee schedule","69% of total billed charges",1789,100,,1431.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1789,100,,1431.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1789,100,,1431.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",674.45,37.7,,539.56,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1395.42,78,,1116.34,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1477.71,82.6,,1182.17,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1477.71,82.6,,1182.17,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,1789,100,,1431.20,,,0,"percent of total billed charges","100% of total billed charges",273.72,9628.23,
"27334 Arthrotomy, with synovectomy, knee; anterior",7963188,CDM,521,RC,27334,CPT,OUTPATIENT,,,2514,1634.1,,2212.32,88,,1769.86,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,2514,100,,2011.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2893.79,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1583.82,63,,1267.06,,,0,"percent of total billed charges","63% of total billed charges",384.64,15.3,,307.71,,,0,"percent of total billed charges","15.3% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,1734.66,69,,,,,0,"fee schedule","69% of total billed charges",2514,100,,2011.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2514,100,,2011.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2514,100,,2011.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2865.69,100,,,,,0,"fee schedule",EAPG,3652.35,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",947.78,37.7,,758.22,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1960.92,78,,1568.74,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2076.56,82.6,,1661.25,,,0,"percent of total billed charges","82.6% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2076.56,82.6,,1661.25,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2970.03,100,,,,,0,"fee schedule",EAPG,2514,100,,2011.20,,,0,"percent of total billed charges","100% of total billed charges",384.64,11498.59,
"27347 Excision of lesion of meniscus or capsule (e",7962880,CDM,521,RC,27347,CPT,OUTPATIENT,,,1134,737.1,,997.92,88,,798.34,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,1134,100,,907.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2893.79,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",714.42,63,,571.54,,,0,"percent of total billed charges","63% of total billed charges",173.5,15.3,,138.80,,,0,"percent of total billed charges","15.3% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,782.46,69,,,,,0,"fee schedule","69% of total billed charges",1134,100,,907.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1134,100,,907.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1134,100,,907.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2865.69,100,,,,,0,"fee schedule",EAPG,3652.35,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",427.52,37.7,,342.02,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",884.52,78,,707.62,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",936.68,82.6,,749.34,,,0,"percent of total billed charges","82.6% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",936.68,82.6,,749.34,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2970.03,100,,,,,0,"fee schedule",EAPG,1134,100,,907.20,,,0,"percent of total billed charges","100% of total billed charges",173.5,11498.59,
"27340 Excision, prepatellar bursa",7963808,CDM,521,RC,27340,CPT,OUTPATIENT,,,1019,662.35,,896.72,88,,717.38,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,1019,100,,815.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2893.79,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",641.97,63,,513.58,,,0,"percent of total billed charges","63% of total billed charges",155.91,15.3,,124.73,,,0,"percent of total billed charges","15.3% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,703.11,69,,,,,0,"fee schedule","69% of total billed charges",1019,100,,815.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1019,100,,815.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1019,100,,815.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2865.69,100,,,,,0,"fee schedule",EAPG,3652.35,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",384.16,37.7,,307.33,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",794.82,78,,635.86,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",841.69,82.6,,673.35,,,0,"percent of total billed charges","82.6% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",841.69,82.6,,673.35,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2970.03,100,,,,,0,"fee schedule",EAPG,1019,100,,815.20,,,0,"percent of total billed charges","100% of total billed charges",155.91,11498.59,
"27358 Excision or curettage of bone cyst or benign",7962367,CDM,521,RC,27358,CPT,OUTPATIENT,,,963,625.95,,847.44,88,,677.95,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",3083.85,100,,,,,0,"fee schedule",EAPG,963,100,,770.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3176.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",606.69,63,,485.35,,,0,"percent of total billed charges","63% of total billed charges",147.34,15.3,,117.87,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,664.47,69,,,,,0,"fee schedule","69% of total billed charges",963,100,,770.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",963,100,,770.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",963,100,,770.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3083.85,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",363.05,37.7,,290.44,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",751.14,78,,600.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",795.44,82.6,,636.35,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",795.44,82.6,,636.35,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3244.38,100,,,,,0,"fee schedule",EAPG,963,100,,770.40,,,0,"percent of total billed charges","100% of total billed charges",147.34,4009.01,
"27355 Excision or curettage of bone cyst or benign",7963102,CDM,521,RC,27355,CPT,OUTPATIENT,,,1815,1179.75,,1597.2,88,,1277.76,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,1815,100,,1452.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1143.45,63,,914.76,,,0,"percent of total billed charges","63% of total billed charges",277.7,15.3,,222.16,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,1252.35,69,,,,,0,"fee schedule","69% of total billed charges",1815,100,,1452.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1815,100,,1452.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1815,100,,1452.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",684.26,37.7,,547.41,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1415.7,78,,1132.56,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1499.19,82.6,,1199.35,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1499.19,82.6,,1199.35,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3244.38,100,,,,,0,"fee schedule",EAPG,1815,100,,1452.00,,,0,"percent of total billed charges","100% of total billed charges",277.7,11498.59,
"27350 Patellectomy or hemipatellectomy",7963714,CDM,521,RC,27350,CPT,OUTPATIENT,,,1704,1107.6,,1499.52,88,,1199.62,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,1704,100,,1363.20,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",2893.79,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1073.52,63,,858.82,,,0,"percent of total billed charges","63% of total billed charges",260.71,15.3,,208.57,,,0,"percent of total billed charges","15.3% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,1175.76,69,,,,,0,"fee schedule","69% of total billed charges",1704,100,,1363.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1704,100,,1363.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1704,100,,1363.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2865.69,100,,,,,0,"fee schedule",EAPG,3652.35,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",642.41,37.7,,513.93,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1329.12,78,,1063.30,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1407.5,82.6,,1126.00,,,0,"percent of total billed charges","82.6% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1407.5,82.6,,1126.00,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2970.03,100,,,,,0,"fee schedule",EAPG,1704,100,,1363.20,,,0,"percent of total billed charges","100% of total billed charges",260.71,25451.55,
"27360 Partial excision bone, femur, proximal tibia",7963167,CDM,521,RC,27360,CPT,OUTPATIENT,,,2265,1472.25,,1993.2,88,,1594.56,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,2265,100,,1812.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2893.79,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1426.95,63,,1141.56,,,0,"percent of total billed charges","63% of total billed charges",346.55,15.3,,277.24,,,0,"percent of total billed charges","15.3% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,1562.85,69,,,,,0,"fee schedule","69% of total billed charges",2265,100,,1812.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2265,100,,1812.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2265,100,,1812.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2865.69,100,,,,,0,"fee schedule",EAPG,3652.35,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",853.91,37.7,,683.13,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1766.7,78,,1413.36,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1870.89,82.6,,1496.71,,,0,"percent of total billed charges","82.6% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1870.89,82.6,,1496.71,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2970.03,100,,,,,0,"fee schedule",EAPG,2265,100,,1812.00,,,0,"percent of total billed charges","100% of total billed charges",346.55,11498.59,
"27372 Removal of foreign body, deep, thigh region",7963217,CDM,521,RC,27372,CPT,OUTPATIENT,,,1089,707.85,,958.32,88,,766.66,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1089,100,,871.20,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.07,63,,548.86,,,0,"percent of total billed charges","63% of total billed charges",166.62,15.3,,133.30,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,751.41,69,,,,,0,"fee schedule","69% of total billed charges",1089,100,,871.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1089,100,,871.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1089,100,,871.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",410.55,37.7,,328.44,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",849.42,78,,679.54,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",899.51,82.6,,719.61,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",899.51,82.6,,719.61,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,1089,100,,871.20,,,0,"percent of total billed charges","100% of total billed charges",166.62,9628.23,
"27381 Suture of infrapatellar tendon; secondary re",7961747,CDM,521,RC,27381,CPT,OUTPATIENT,,,2196,1427.4,,1932.48,88,,1545.98,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,2196,100,,1756.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",6479.35,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1383.48,63,,1106.78,,,0,"percent of total billed charges","63% of total billed charges",335.99,15.3,,268.79,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,1515.24,69,,,,,0,"fee schedule","69% of total billed charges",2196,100,,1756.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2196,100,,1756.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2196,100,,1756.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",827.89,37.7,,662.31,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1712.88,78,,1370.30,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1813.9,82.6,,1451.12,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1813.9,82.6,,1451.12,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6451.16,100,,,,,0,"fee schedule",EAPG,2196,100,,1756.80,,,0,"percent of total billed charges","100% of total billed charges",335.99,25451.55,
"27386 Suture of quadriceps or hamstring muscle rup",7962670,CDM,521,RC,27386,CPT,OUTPATIENT,,,2422,1574.3,,2131.36,88,,1705.09,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,2422,100,,1937.60,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1525.86,63,,1220.69,,,0,"percent of total billed charges","63% of total billed charges",370.57,15.3,,296.46,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,1671.18,69,,,,,0,"fee schedule","69% of total billed charges",2422,100,,1937.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2422,100,,1937.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2422,100,,1937.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",913.09,37.7,,730.47,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1889.16,78,,1511.33,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2000.57,82.6,,1600.46,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2000.57,82.6,,1600.46,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3244.38,100,,,,,0,"fee schedule",EAPG,2422,100,,1937.60,,,0,"percent of total billed charges","100% of total billed charges",370.57,25451.55,
"27385 Suture of quadriceps or hamstring muscle rup",7963189,CDM,521,RC,27385,CPT,OUTPATIENT,,,1681,1092.65,,1479.28,88,,1183.42,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,1681,100,,1344.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1059.03,63,,847.22,,,0,"percent of total billed charges","63% of total billed charges",257.19,15.3,,205.75,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,1159.89,69,,,,,0,"fee schedule","69% of total billed charges",1681,100,,1344.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1681,100,,1344.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1681,100,,1344.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",633.74,37.7,,506.99,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1311.18,78,,1048.94,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1388.51,82.6,,1110.81,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1388.51,82.6,,1110.81,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3244.38,100,,,,,0,"fee schedule",EAPG,1681,100,,1344.80,,,0,"percent of total billed charges","100% of total billed charges",257.19,25451.55,
"27380 Suture of infrapatellar tendon; primary",7963600,CDM,521,RC,27380,CPT,OUTPATIENT,,,1685,1095.25,,1482.8,88,,1186.24,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,1685,100,,1348.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",2893.79,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1061.55,63,,849.24,,,0,"percent of total billed charges","63% of total billed charges",257.81,15.3,,206.25,,,0,"percent of total billed charges","15.3% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,1162.65,69,,,,,0,"fee schedule","69% of total billed charges",1685,100,,1348.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1685,100,,1348.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1685,100,,1348.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2865.69,100,,,,,0,"fee schedule",EAPG,3652.35,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",635.25,37.7,,508.20,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1314.3,78,,1051.44,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1391.81,82.6,,1113.45,,,0,"percent of total billed charges","82.6% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1391.81,82.6,,1113.45,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2970.03,100,,,,,0,"fee schedule",EAPG,1685,100,,1348.00,,,0,"percent of total billed charges","100% of total billed charges",257.81,25451.55,
"27390 Tenotomy, open, hamstring, knee to hip; sing",7963268,CDM,521,RC,27390,CPT,OUTPATIENT,,,1383,898.95,,1217.04,88,,973.63,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,1383,100,,1106.40,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",871.29,63,,697.03,,,0,"percent of total billed charges","63% of total billed charges",211.6,15.3,,169.28,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,954.27,69,,,,,0,"fee schedule","69% of total billed charges",1383,100,,1106.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1383,100,,1106.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1383,100,,1106.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",521.39,37.7,,417.11,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1078.74,78,,862.99,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1142.36,82.6,,913.89,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1142.36,82.6,,913.89,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3244.38,100,,,,,0,"fee schedule",EAPG,1383,100,,1106.40,,,0,"percent of total billed charges","100% of total billed charges",211.6,11498.59,
"27409 Repair, primary, torn ligament and/or capsul",7962242,CDM,521,RC,27409,CPT,OUTPATIENT,,,2808,1825.2,,2471.04,88,,1976.83,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,2808,100,,2246.40,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",6479.35,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1769.04,63,,1415.23,,,0,"percent of total billed charges","63% of total billed charges",429.62,15.3,,343.70,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,1937.52,69,,,,,0,"fee schedule","69% of total billed charges",2808,100,,2246.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2808,100,,2246.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2808,100,,2246.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1058.62,37.7,,846.90,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2190.24,78,,1752.19,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2319.41,82.6,,1855.53,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2319.41,82.6,,1855.53,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6451.16,100,,,,,0,"fee schedule",EAPG,2808,100,,2246.40,,,0,"percent of total billed charges","100% of total billed charges",429.62,25451.55,
"27405 Repair, primary, torn ligament and/or capsul",7963019,CDM,521,RC,27405,CPT,OUTPATIENT,,,2431,1580.15,,2139.28,88,,1711.42,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,2431,100,,1944.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",6479.35,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1531.53,63,,1225.22,,,0,"percent of total billed charges","63% of total billed charges",371.94,15.3,,297.55,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,1677.39,69,,,,,0,"fee schedule","69% of total billed charges",2431,100,,1944.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2431,100,,1944.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2431,100,,1944.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",916.49,37.7,,733.19,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1896.18,78,,1516.94,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2008.01,82.6,,1606.41,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2008.01,82.6,,1606.41,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6451.16,100,,,,,0,"fee schedule",EAPG,2431,100,,1944.80,,,0,"percent of total billed charges","100% of total billed charges",371.94,25451.55,
"27418 Anterior tibial tubercleplasty (eg, Maquet t",7963168,CDM,521,RC,27418,CPT,OUTPATIENT,,,1995,1296.75,,1755.6,88,,1404.48,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,1995,100,,1596.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",6479.35,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1256.85,63,,1005.48,,,0,"percent of total billed charges","63% of total billed charges",305.24,15.3,,244.19,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,1376.55,69,,,,,0,"fee schedule","69% of total billed charges",1995,100,,1596.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1995,100,,1596.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1995,100,,1596.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",752.12,37.7,,601.70,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1556.1,78,,1244.88,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1647.87,82.6,,1318.30,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1647.87,82.6,,1318.30,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6451.16,100,,,,,0,"fee schedule",EAPG,1995,100,,1596.00,,,0,"percent of total billed charges","100% of total billed charges",305.24,25451.55,
"27415 Osteochondral allograft, knee, open",7963653,CDM,521,RC,27415,CPT,OUTPATIENT,,,4016,2610.4,,3534.08,88,,2827.26,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5038.03,100,,,,,0,"fee schedule",EAPG,4016,100,,3212.80,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",5189.17,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2530.08,63,,2024.06,,,0,"percent of total billed charges","63% of total billed charges",614.45,15.3,,491.56,,,0,"percent of total billed charges","15.3% of total billed charges",5038.03,100,,,,,0,"fee schedule",EAPG,2771.04,69,,,,,0,"fee schedule","69% of total billed charges",4016,100,,3212.80,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4016,100,,3212.80,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4016,100,,3212.80,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5038.03,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5138.79,100,,,,,0,"fee schedule",EAPG,6549.44,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1514.03,37.7,,1211.22,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3132.48,78,,2505.98,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3317.22,82.6,,2653.78,,,0,"percent of total billed charges","82.6% of total billed charges",5038.03,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3317.22,82.6,,2653.78,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5198.56,100,,,,,0,"fee schedule",EAPG,4016,100,,3212.80,,,0,"percent of total billed charges","100% of total billed charges",614.45,50029.1,
"27429 Ligamentous reconstruction (augmentation), k",7961789,CDM,521,RC,27429,CPT,OUTPATIENT,,,3649,2371.85,,3211.12,88,,2568.90,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,3649,100,,2919.20,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",6479.35,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2298.87,63,,1839.10,,,0,"percent of total billed charges","63% of total billed charges",558.3,15.3,,446.64,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,2517.81,69,,,,,0,"fee schedule","69% of total billed charges",3649,100,,2919.20,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3649,100,,2919.20,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3649,100,,2919.20,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1375.67,37.7,,1100.54,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2846.22,78,,2276.98,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3014.07,82.6,,2411.26,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3014.07,82.6,,2411.26,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6451.16,100,,,,,0,"fee schedule",EAPG,3649,100,,2919.20,,,0,"percent of total billed charges","100% of total billed charges",558.3,50029.1,
"27422 Reconstruction of dislocating patella; with",7961813,CDM,521,RC,27422,CPT,OUTPATIENT,,,2435,1582.75,,2142.8,88,,1714.24,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,2435,100,,1948.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",6479.35,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1534.05,63,,1227.24,,,0,"percent of total billed charges","63% of total billed charges",372.56,15.3,,298.05,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,1680.15,69,,,,,0,"fee schedule","69% of total billed charges",2435,100,,1948.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2435,100,,1948.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2435,100,,1948.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",918,37.7,,734.40,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1899.3,78,,1519.44,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2011.31,82.6,,1609.05,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2011.31,82.6,,1609.05,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6451.16,100,,,,,0,"fee schedule",EAPG,2435,100,,1948.00,,,0,"percent of total billed charges","100% of total billed charges",372.56,25451.55,
"27428 Ligamentous reconstruction (augmentation), k",7962770,CDM,521,RC,27428,CPT,OUTPATIENT,,,3733,2426.45,,3285.04,88,,2628.03,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,3733,100,,2986.40,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",6479.35,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2351.79,63,,1881.43,,,0,"percent of total billed charges","63% of total billed charges",571.15,15.3,,456.92,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,2575.77,69,,,,,0,"fee schedule","69% of total billed charges",3733,100,,2986.40,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3733,100,,2986.40,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3733,100,,2986.40,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1407.34,37.7,,1125.87,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2911.74,78,,2329.39,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.46,82.6,,2466.77,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.46,82.6,,2466.77,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6451.16,100,,,,,0,"fee schedule",EAPG,3733,100,,2986.40,,,0,"percent of total billed charges","100% of total billed charges",571.15,50029.1,
"27420 Reconstruction of dislocating patella; (eg,",7962932,CDM,521,RC,27420,CPT,OUTPATIENT,,,2261,1469.65,,1989.68,88,,1591.74,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,2261,100,,1808.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",6479.35,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1424.43,63,,1139.54,,,0,"percent of total billed charges","63% of total billed charges",345.93,15.3,,276.74,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,1560.09,69,,,,,0,"fee schedule","69% of total billed charges",2261,100,,1808.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2261,100,,1808.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2261,100,,1808.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",852.4,37.7,,681.92,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1763.58,78,,1410.86,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1867.59,82.6,,1494.07,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1867.59,82.6,,1494.07,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6451.16,100,,,,,0,"fee schedule",EAPG,2261,100,,1808.80,,,0,"percent of total billed charges","100% of total billed charges",345.93,25451.55,
"27427 Ligamentous reconstruction (augmentation), k",7962990,CDM,521,RC,27427,CPT,OUTPATIENT,,,2619,1702.35,,2304.72,88,,1843.78,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,2619,100,,2095.20,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",6479.35,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1649.97,63,,1319.98,,,0,"percent of total billed charges","63% of total billed charges",400.71,15.3,,320.57,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,1807.11,69,,,,,0,"fee schedule","69% of total billed charges",2619,100,,2095.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2619,100,,2095.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2619,100,,2095.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",987.36,37.7,,789.89,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2042.82,78,,1634.26,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2163.29,82.6,,1730.63,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2163.29,82.6,,1730.63,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6451.16,100,,,,,0,"fee schedule",EAPG,2619,100,,2095.20,,,0,"percent of total billed charges","100% of total billed charges",400.71,25451.55,
"27425 Lateral retinacular release, open",7963703,CDM,521,RC,27425,CPT,OUTPATIENT,,,1069,694.85,,940.72,88,,752.58,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,1069,100,,855.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2893.79,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.47,63,,538.78,,,0,"percent of total billed charges","63% of total billed charges",163.56,15.3,,130.85,,,0,"percent of total billed charges","15.3% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,737.61,69,,,,,0,"fee schedule","69% of total billed charges",1069,100,,855.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1069,100,,855.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1069,100,,855.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2865.69,100,,,,,0,"fee schedule",EAPG,3652.35,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",403.01,37.7,,322.41,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",833.82,78,,667.06,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",882.99,82.6,,706.39,,,0,"percent of total billed charges","82.6% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",882.99,82.6,,706.39,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2970.03,100,,,,,0,"fee schedule",EAPG,1069,100,,855.20,,,0,"percent of total billed charges","100% of total billed charges",163.56,11498.59,
"27430 Quadricepsplasty (eg, Bennett or Thompson ty",7963446,CDM,521,RC,27430,CPT,OUTPATIENT,,,1934,1257.1,,1701.92,88,,1361.54,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,1934,100,,1547.20,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1218.42,63,,974.74,,,0,"percent of total billed charges","63% of total billed charges",295.9,15.3,,236.72,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,1334.46,69,,,,,0,"fee schedule","69% of total billed charges",1934,100,,1547.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1934,100,,1547.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1934,100,,1547.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",729.12,37.7,,583.30,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1508.52,78,,1206.82,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1597.48,82.6,,1277.98,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1597.48,82.6,,1277.98,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3244.38,100,,,,,0,"fee schedule",EAPG,1934,100,,1547.20,,,0,"percent of total billed charges","100% of total billed charges",295.9,25451.55,
"27435 Capsulotomy, posterior capsular release, kne",7963494,CDM,521,RC,27435,CPT,OUTPATIENT,,,1963,1275.95,,1727.44,88,,1381.95,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,1963,100,,1570.40,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2893.79,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1236.69,63,,989.35,,,0,"percent of total billed charges","63% of total billed charges",300.34,15.3,,240.27,,,0,"percent of total billed charges","15.3% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,1354.47,69,,,,,0,"fee schedule","69% of total billed charges",1963,100,,1570.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1963,100,,1570.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1963,100,,1570.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2865.69,100,,,,,0,"fee schedule",EAPG,3652.35,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",740.05,37.7,,592.04,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1531.14,78,,1224.91,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1621.44,82.6,,1297.15,,,0,"percent of total billed charges","82.6% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1621.44,82.6,,1297.15,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2970.03,100,,,,,0,"fee schedule",EAPG,1963,100,,1570.40,,,0,"percent of total billed charges","100% of total billed charges",300.34,11498.59,
"27438 Arthroplasty, patella; with prosthesis",7963620,CDM,521,RC,27438,CPT,OUTPATIENT,,,2251,1463.15,,1980.88,88,,1584.70,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8399.65,100,,,,,0,"fee schedule",EAPG,2251,100,,1800.80,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",8651.64,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1418.13,63,,1134.50,,,0,"percent of total billed charges","63% of total billed charges",344.4,15.3,,275.52,,,0,"percent of total billed charges","15.3% of total billed charges",8399.65,100,,,,,0,"fee schedule",EAPG,1553.19,69,,,,,0,"fee schedule","69% of total billed charges",2251,100,,1800.80,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2251,100,,1800.80,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2251,100,,1800.80,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8399.65,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8567.64,100,,,,,0,"fee schedule",EAPG,10919.55,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",848.63,37.7,,678.90,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1755.78,78,,1404.62,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1859.33,82.6,,1487.46,,,0,"percent of total billed charges","82.6% of total billed charges",8399.65,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1859.33,82.6,,1487.46,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8560.18,100,,,,,0,"fee schedule",EAPG,2251,100,,1800.80,,,0,"percent of total billed charges","100% of total billed charges",344.4,50029.1,
"27447 Arthroplasty, knee, condyle and plateau; med",7962740,CDM,521,RC,27447,CPT,OUTPATIENT,,,5062,3290.3,,4454.56,88,,3563.65,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8399.65,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",8651.64,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3189.06,63,,2551.25,,,0,"percent of total billed charges","63% of total billed charges",774.49,15.3,,619.59,,,0,"percent of total billed charges","15.3% of total billed charges",8399.65,100,,,,,0,"fee schedule",EAPG,3492.78,69,,,,,0,"fee schedule","69% of total billed charges",5062,100,,4049.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5062,100,,4049.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5062,100,,4049.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8399.65,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8567.64,100,,,,,0,"fee schedule",EAPG,10919.55,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1908.37,37.7,,1526.70,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3948.36,78,,3158.69,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4181.21,82.6,,3344.97,,,0,"percent of total billed charges","82.6% of total billed charges",8399.65,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4181.21,82.6,,3344.97,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8560.18,100,,,,,0,"fee schedule",EAPG,5062,100,,4049.60,,,0,"percent of total billed charges","100% of total billed charges",774.49,50029.1,
"27446 Arthroplasty, knee, condyle and plateau; med",7962806,CDM,521,RC,27446,CPT,OUTPATIENT,,,3860,2509,,3396.8,88,,2717.44,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8399.65,100,,,,,0,"fee schedule",EAPG,3860,100,,3088.00,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",8651.64,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2431.8,63,,1945.44,,,0,"percent of total billed charges","63% of total billed charges",590.58,15.3,,472.46,,,0,"percent of total billed charges","15.3% of total billed charges",8399.65,100,,,,,0,"fee schedule",EAPG,2663.4,69,,,,,0,"fee schedule","69% of total billed charges",3860,100,,3088.00,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3860,100,,3088.00,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3860,100,,3088.00,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8399.65,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8567.64,100,,,,,0,"fee schedule",EAPG,10919.55,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1455.22,37.7,,1164.18,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3010.8,78,,2408.64,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3188.36,82.6,,2550.69,,,0,"percent of total billed charges","82.6% of total billed charges",8399.65,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3188.36,82.6,,2550.69,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8560.18,100,,,,,0,"fee schedule",EAPG,3860,100,,3088.00,,,0,"percent of total billed charges","100% of total billed charges",590.58,50029.1,
"27442 Arthroplasty, femoral condyles or tibial pla",7963169,CDM,521,RC,27442,CPT,OUTPATIENT,,,2703,1756.95,,2378.64,88,,1902.91,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8399.65,100,,,,,0,"fee schedule",EAPG,2703,100,,2162.40,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",8651.64,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1702.89,63,,1362.31,,,0,"percent of total billed charges","63% of total billed charges",413.56,15.3,,330.85,,,0,"percent of total billed charges","15.3% of total billed charges",8399.65,100,,,,,0,"fee schedule",EAPG,1865.07,69,,,,,0,"fee schedule","69% of total billed charges",2703,100,,2162.40,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2703,100,,2162.40,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2703,100,,2162.40,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8399.65,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8567.64,100,,,,,0,"fee schedule",EAPG,10919.55,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1019.03,37.7,,815.22,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2108.34,78,,1686.67,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2232.68,82.6,,1786.14,,,0,"percent of total billed charges","82.6% of total billed charges",8399.65,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2232.68,82.6,,1786.14,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8560.18,100,,,,,0,"fee schedule",EAPG,2703,100,,2162.40,,,0,"percent of total billed charges","100% of total billed charges",413.56,50029.1,
"27455 Osteotomy, proximal tibia, including fibular",7961583,CDM,521,RC,27455,CPT,OUTPATIENT,,,2786,1810.9,,2451.68,88,,1961.34,,,0,"percent of total billed charges","88% of total billed charges",2786,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6290.63,100,,,,,0,"fee schedule",EAPG,2786,100,,2228.80,,,0,"percent of total billed charges","100% of total billed charges",2786,175,,,,,0,"fee schedule","175% of CMS fee schedule",6479.35,100,,,,,0,"fee schedule",EAPG,2786,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1755.18,63,,1404.14,,,0,"percent of total billed charges","63% of total billed charges",426.26,15.3,,341.01,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,1922.34,69,,,,,0,"fee schedule","69% of total billed charges",2786,100,,2228.80,,,0,"percent of total billed charges","100% of total billed charges",2786,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2786,100,,2228.80,,,0,"percent of total billed charges","100% of total billed charges",2786,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2786,100,,2228.80,,,0,"percent of total billed charges","100% of total billed charges",2786,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,2786,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2786,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",2786,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,2786,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1050.32,37.7,,840.26,,,0,"percent of total billed charges","37.70% of total billed charges",2786,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2786,100,,,,,0,"fee schedule","100% of CMS fee schedule",2173.08,78,,1738.46,,,0,"percent of total billed charges","78% of total billed charges",2786,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2301.24,82.6,,1840.99,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,2786,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2301.24,82.6,,1840.99,,,0,"percent of total billed charges","82.6% of total billed charges",2786,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6451.16,100,,,,,0,"fee schedule",EAPG,2786,100,,2228.80,,,0,"percent of total billed charges","100% of total billed charges",426.26,25451.55,
"27472 Repair, nonunion or malunion, femur, distal",7961673,CDM,521,RC,27472,CPT,OUTPATIENT,,,3995,2596.75,,3515.6,88,,2812.48,,,0,"percent of total billed charges","88% of total billed charges",3995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3083.85,100,,,,,0,"fee schedule",EAPG,3995,100,,3196.00,,,0,"percent of total billed charges","100% of total billed charges",3995,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,3995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2516.85,63,,2013.48,,,0,"percent of total billed charges","63% of total billed charges",611.24,15.3,,488.99,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,2756.55,69,,,,,0,"fee schedule","69% of total billed charges",3995,100,,3196.00,,,0,"percent of total billed charges","100% of total billed charges",3995,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3995,100,,3196.00,,,0,"percent of total billed charges","100% of total billed charges",3995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3995,100,,3196.00,,,0,"percent of total billed charges","100% of total billed charges",3995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,3995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3995,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",3995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,3995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1506.12,37.7,,1204.90,,,0,"percent of total billed charges","37.70% of total billed charges",3995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3995,100,,,,,0,"fee schedule","100% of CMS fee schedule",3116.1,78,,2492.88,,,0,"percent of total billed charges","78% of total billed charges",3995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3299.87,82.6,,2639.90,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule","100% of WA fee schedule",3995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3299.87,82.6,,2639.90,,,0,"percent of total billed charges","82.6% of total billed charges",3995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3244.38,100,,,,,0,"fee schedule",EAPG,3995,100,,3196.00,,,0,"percent of total billed charges","100% of total billed charges",611.24,25451.55,
"27470 Repair, nonunion or malunion, femur, distal",7962627,CDM,521,RC,27470,CPT,OUTPATIENT,,,3085,2005.25,,2714.8,88,,2171.84,,,0,"percent of total billed charges","88% of total billed charges",3085,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3083.85,100,,,,,0,"fee schedule",EAPG,3085,100,,2468.00,,,0,"percent of total billed charges","100% of total billed charges",3085,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,3085,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1943.55,63,,1554.84,,,0,"percent of total billed charges","63% of total billed charges",472.01,15.3,,377.61,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,2128.65,69,,,,,0,"fee schedule","69% of total billed charges",3085,100,,2468.00,,,0,"percent of total billed charges","100% of total billed charges",3085,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3085,100,,2468.00,,,0,"percent of total billed charges","100% of total billed charges",3085,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3085,100,,2468.00,,,0,"percent of total billed charges","100% of total billed charges",3085,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,3085,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3085,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",3085,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,3085,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1163.05,37.7,,930.44,,,0,"percent of total billed charges","37.70% of total billed charges",3085,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3085,100,,,,,0,"fee schedule","100% of CMS fee schedule",2406.3,78,,1925.04,,,0,"percent of total billed charges","78% of total billed charges",3085,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2548.21,82.6,,2038.57,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule","100% of WA fee schedule",3085,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2548.21,82.6,,2038.57,,,0,"percent of total billed charges","82.6% of total billed charges",3085,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3244.38,100,,,,,0,"fee schedule",EAPG,3085,100,,2468.00,,,0,"percent of total billed charges","100% of total billed charges",472.01,25451.55,
"27488 Removal of prosthesis, including total knee",7962468,CDM,521,RC,27488,CPT,OUTPATIENT,,,2909,1890.85,,2559.92,88,,2047.94,,,0,"percent of total billed charges","88% of total billed charges",2909,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6290.63,100,,,,,0,"fee schedule",EAPG,2909,100,,2327.20,,,0,"percent of total billed charges","100% of total billed charges",2909,175,,,,,0,"fee schedule","175% of CMS fee schedule",6479.35,100,,,,,0,"fee schedule",EAPG,2909,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1832.67,63,,1466.14,,,0,"percent of total billed charges","63% of total billed charges",445.08,15.3,,356.06,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,2007.21,69,,,,,0,"fee schedule","69% of total billed charges",2909,100,,2327.20,,,0,"percent of total billed charges","100% of total billed charges",2909,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2909,100,,2327.20,,,0,"percent of total billed charges","100% of total billed charges",2909,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2909,100,,2327.20,,,0,"percent of total billed charges","100% of total billed charges",2909,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,2909,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2909,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",2909,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,2909,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1096.69,37.7,,877.35,,,0,"percent of total billed charges","37.70% of total billed charges",2909,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2909,100,,,,,0,"fee schedule","100% of CMS fee schedule",2269.02,78,,1815.22,,,0,"percent of total billed charges","78% of total billed charges",2909,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2402.83,82.6,,1922.26,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule","100% of WA fee schedule",2909,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2402.83,82.6,,1922.26,,,0,"percent of total billed charges","82.6% of total billed charges",2909,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6451.16,100,,,,,0,"fee schedule",EAPG,2909,100,,2327.20,,,0,"percent of total billed charges","100% of total billed charges",445.08,25451.55,
"27486 Revision of total knee arthroplasty, with or",7962628,CDM,521,RC,27486,CPT,OUTPATIENT,,,4312,2802.8,,3794.56,88,,3035.65,,,0,"percent of total billed charges","88% of total billed charges",4312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8399.65,100,,,,,0,"fee schedule",EAPG,4312,100,,3449.60,,,0,"percent of total billed charges","100% of total billed charges",4312,175,,,,,0,"fee schedule","175% of CMS fee schedule",8651.64,100,,,,,0,"fee schedule",EAPG,4312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2716.56,63,,2173.25,,,0,"percent of total billed charges","63% of total billed charges",659.74,15.3,,527.79,,,0,"percent of total billed charges","15.3% of total billed charges",8399.65,100,,,,,0,"fee schedule",EAPG,2975.28,69,,,,,0,"fee schedule","69% of total billed charges",4312,100,,3449.60,,,0,"percent of total billed charges","100% of total billed charges",4312,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4312,100,,3449.60,,,0,"percent of total billed charges","100% of total billed charges",4312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4312,100,,3449.60,,,0,"percent of total billed charges","100% of total billed charges",4312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8399.65,100,,,,,0,"fee schedule",EAPG,4312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4312,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",4312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8567.64,100,,,,,0,"fee schedule",EAPG,10919.55,100,,,,,0,"fee schedule",EAPG,4312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1625.62,37.7,,1300.50,,,0,"percent of total billed charges","37.70% of total billed charges",4312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4312,100,,,,,0,"fee schedule","100% of CMS fee schedule",3363.36,78,,2690.69,,,0,"percent of total billed charges","78% of total billed charges",4312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3561.71,82.6,,2849.37,,,0,"percent of total billed charges","82.6% of total billed charges",8399.65,100,,,,,0,"fee schedule","100% of WA fee schedule",4312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3561.71,82.6,,2849.37,,,0,"percent of total billed charges","82.6% of total billed charges",4312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8560.18,100,,,,,0,"fee schedule",EAPG,4312,100,,3449.60,,,0,"percent of total billed charges","100% of total billed charges",659.74,50029.1,
"27487 Revision of total knee arthroplasty; femoral",7962741,CDM,521,RC,27487,CPT,OUTPATIENT,,,5908,3840.2,,5199.04,88,,4159.23,,,0,"percent of total billed charges","88% of total billed charges",5908,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8399.65,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5908,175,,,,,0,"fee schedule","175% of CMS fee schedule",8651.64,100,,,,,0,"fee schedule",EAPG,5908,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3722.04,63,,2977.63,,,0,"percent of total billed charges","63% of total billed charges",903.92,15.3,,723.14,,,0,"percent of total billed charges","15.3% of total billed charges",8399.65,100,,,,,0,"fee schedule",EAPG,4076.52,69,,,,,0,"fee schedule","69% of total billed charges",5908,100,,4726.40,,,0,"percent of total billed charges","100% of total billed charges",5908,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5908,100,,4726.40,,,0,"percent of total billed charges","100% of total billed charges",5908,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5908,100,,4726.40,,,0,"percent of total billed charges","100% of total billed charges",5908,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8399.65,100,,,,,0,"fee schedule",EAPG,5908,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5908,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",5908,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8567.64,100,,,,,0,"fee schedule",EAPG,10919.55,100,,,,,0,"fee schedule",EAPG,5908,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2227.32,37.7,,1781.86,,,0,"percent of total billed charges","37.70% of total billed charges",5908,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5908,100,,,,,0,"fee schedule","100% of CMS fee schedule",4608.24,78,,3686.59,,,0,"percent of total billed charges","78% of total billed charges",5908,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4880.01,82.6,,3904.01,,,0,"percent of total billed charges","82.6% of total billed charges",8399.65,100,,,,,0,"fee schedule","100% of WA fee schedule",5908,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4880.01,82.6,,3904.01,,,0,"percent of total billed charges","82.6% of total billed charges",5908,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8560.18,100,,,,,0,"fee schedule",EAPG,5908,100,,4726.40,,,0,"percent of total billed charges","100% of total billed charges",903.92,50029.1,
"27496 Decompression fasciotomy, thigh and/or knee,",7961674,CDM,521,RC,27496,CPT,OUTPATIENT,,,1555,1010.75,,1368.4,88,,1094.72,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,1555,100,,1244.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",979.65,63,,783.72,,,0,"percent of total billed charges","63% of total billed charges",237.92,15.3,,190.34,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,1072.95,69,,,,,0,"fee schedule","69% of total billed charges",1555,100,,1244.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1555,100,,1244.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1555,100,,1244.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",586.24,37.7,,468.99,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1212.9,78,,970.32,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1284.43,82.6,,1027.54,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1284.43,82.6,,1027.54,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3244.38,100,,,,,0,"fee schedule",EAPG,1555,100,,1244.00,,,0,"percent of total billed charges","100% of total billed charges",237.92,11498.59,
"27508 Closed treatment of femoral fracture, distal",7961584,CDM,521,RC,27508,CPT,OUTPATIENT,,,1258,817.7,,1107.04,88,,885.63,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1258,100,,1006.40,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",792.54,63,,634.03,,,0,"percent of total billed charges","63% of total billed charges",192.47,15.3,,153.98,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,868.02,69,,,,,0,"fee schedule","69% of total billed charges",1258,100,,1006.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1258,100,,1006.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1258,100,,1006.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",474.27,37.7,,379.42,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",981.24,78,,784.99,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1039.11,82.6,,831.29,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1039.11,82.6,,831.29,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,1258,100,,1006.40,,,0,"percent of total billed charges","100% of total billed charges",192.47,1258,
"27509 Percutaneous skeletal fixation of femoral fr",7961860,CDM,521,RC,27509,CPT,OUTPATIENT,,,2212,1437.8,,1946.56,88,,1557.25,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2212,100,,1769.60,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1393.56,63,,1114.85,,,0,"percent of total billed charges","63% of total billed charges",338.44,15.3,,270.75,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1526.28,69,,,,,0,"fee schedule","69% of total billed charges",2212,100,,1769.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2212,100,,1769.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2212,100,,1769.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",833.92,37.7,,667.14,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.36,78,,1380.29,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1827.11,82.6,,1461.69,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1827.11,82.6,,1461.69,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2212,100,,1769.60,,,0,"percent of total billed charges","100% of total billed charges",338.44,25451.55,
"27507 Open treatment of femoral shaft fracture wit",7962322,CDM,521,RC,27507,CPT,OUTPATIENT,,,4175,2713.75,,3674,88,,2939.20,,,0,"percent of total billed charges","88% of total billed charges",4175,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4786.08,100,,,,,0,"fee schedule",EAPG,4175,100,,3340.00,,,0,"percent of total billed charges","100% of total billed charges",4175,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,4175,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2630.25,63,,2104.20,,,0,"percent of total billed charges","63% of total billed charges",638.78,15.3,,511.02,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,2880.75,69,,,,,0,"fee schedule","69% of total billed charges",4175,100,,3340.00,,,0,"percent of total billed charges","100% of total billed charges",4175,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4175,100,,3340.00,,,0,"percent of total billed charges","100% of total billed charges",4175,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4175,100,,3340.00,,,0,"percent of total billed charges","100% of total billed charges",4175,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,4175,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4175,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",4175,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,4175,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1573.98,37.7,,1259.18,,,0,"percent of total billed charges","37.70% of total billed charges",4175,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4175,100,,,,,0,"fee schedule","100% of CMS fee schedule",3256.5,78,,2605.20,,,0,"percent of total billed charges","78% of total billed charges",4175,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3448.55,82.6,,2758.84,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule","100% of WA fee schedule",4175,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3448.55,82.6,,2758.84,,,0,"percent of total billed charges","82.6% of total billed charges",4175,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4946.61,100,,,,,0,"fee schedule",EAPG,4175,100,,3340.00,,,0,"percent of total billed charges","100% of total billed charges",638.78,25451.55,
"27506 Open treatment of femoral shaft fracture, wi",7962408,CDM,521,RC,27506,CPT,OUTPATIENT,,,5621,3653.65,,4946.48,88,,3957.18,,,0,"percent of total billed charges","88% of total billed charges",5621,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3083.85,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5621,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,5621,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3541.23,63,,2832.98,,,0,"percent of total billed charges","63% of total billed charges",860.01,15.3,,688.01,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,3878.49,69,,,,,0,"fee schedule","69% of total billed charges",5621,100,,4496.80,,,0,"percent of total billed charges","100% of total billed charges",5621,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5621,100,,4496.80,,,0,"percent of total billed charges","100% of total billed charges",5621,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5621,100,,4496.80,,,0,"percent of total billed charges","100% of total billed charges",5621,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,5621,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5621,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",5621,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,5621,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2119.12,37.7,,1695.30,,,0,"percent of total billed charges","37.70% of total billed charges",5621,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5621,100,,,,,0,"fee schedule","100% of CMS fee schedule",4384.38,78,,3507.50,,,0,"percent of total billed charges","78% of total billed charges",5621,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4642.95,82.6,,3714.36,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule","100% of WA fee schedule",5621,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4642.95,82.6,,3714.36,,,0,"percent of total billed charges","82.6% of total billed charges",5621,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3244.38,100,,,,,0,"fee schedule",EAPG,5621,100,,4496.80,,,0,"percent of total billed charges","100% of total billed charges",860.01,25451.55,
"27502 Closed treatment of femoral shaft fracture,",7963069,CDM,521,RC,27502,CPT,OUTPATIENT,,,2579,1676.35,,2269.52,88,,1815.62,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,2579,100,,2063.20,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1624.77,63,,1299.82,,,0,"percent of total billed charges","63% of total billed charges",394.59,15.3,,315.67,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1779.51,69,,,,,0,"fee schedule","69% of total billed charges",2579,100,,2063.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2579,100,,2063.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2579,100,,2063.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",972.28,37.7,,777.82,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2011.62,78,,1609.30,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2130.25,82.6,,1704.20,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2130.25,82.6,,1704.20,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,2579,100,,2063.20,,,0,"percent of total billed charges","100% of total billed charges",394.59,5656.45,
"27513 Open treatment of femoral supracondylar or t",7961488,CDM,521,RC,27513,CPT,OUTPATIENT,,,4660,3029,,4100.8,88,,3280.64,,,0,"percent of total billed charges","88% of total billed charges",4660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4786.08,100,,,,,0,"fee schedule",EAPG,4660,100,,3728.00,,,0,"percent of total billed charges","100% of total billed charges",4660,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,4660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2935.8,63,,2348.64,,,0,"percent of total billed charges","63% of total billed charges",712.98,15.3,,570.38,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3215.4,69,,,,,0,"fee schedule","69% of total billed charges",4660,100,,3728.00,,,0,"percent of total billed charges","100% of total billed charges",4660,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4660,100,,3728.00,,,0,"percent of total billed charges","100% of total billed charges",4660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4660,100,,3728.00,,,0,"percent of total billed charges","100% of total billed charges",4660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,4660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4660,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",4660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,4660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1756.82,37.7,,1405.46,,,0,"percent of total billed charges","37.70% of total billed charges",4660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4660,100,,,,,0,"fee schedule","100% of CMS fee schedule",3634.8,78,,2907.84,,,0,"percent of total billed charges","78% of total billed charges",4660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3849.16,82.6,,3079.33,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule","100% of WA fee schedule",4660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3849.16,82.6,,3079.33,,,0,"percent of total billed charges","82.6% of total billed charges",4660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4946.61,100,,,,,0,"fee schedule",EAPG,4660,100,,3728.00,,,0,"percent of total billed charges","100% of total billed charges",712.98,25451.55,
"27511 Open treatment of femoral supracondylar or t",7961585,CDM,521,RC,27511,CPT,OUTPATIENT,,,3963,2575.95,,3487.44,88,,2789.95,,,0,"percent of total billed charges","88% of total billed charges",3963,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4786.08,100,,,,,0,"fee schedule",EAPG,3963,100,,3170.40,,,0,"percent of total billed charges","100% of total billed charges",3963,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,3963,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2496.69,63,,1997.35,,,0,"percent of total billed charges","63% of total billed charges",606.34,15.3,,485.07,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,2734.47,69,,,,,0,"fee schedule","69% of total billed charges",3963,100,,3170.40,,,0,"percent of total billed charges","100% of total billed charges",3963,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3963,100,,3170.40,,,0,"percent of total billed charges","100% of total billed charges",3963,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3963,100,,3170.40,,,0,"percent of total billed charges","100% of total billed charges",3963,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3963,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3963,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",3963,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,3963,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1494.05,37.7,,1195.24,,,0,"percent of total billed charges","37.70% of total billed charges",3963,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3963,100,,,,,0,"fee schedule","100% of CMS fee schedule",3091.14,78,,2472.91,,,0,"percent of total billed charges","78% of total billed charges",3963,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3273.44,82.6,,2618.75,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule","100% of WA fee schedule",3963,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3273.44,82.6,,2618.75,,,0,"percent of total billed charges","82.6% of total billed charges",3963,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4946.61,100,,,,,0,"fee schedule",EAPG,3963,100,,3170.40,,,0,"percent of total billed charges","100% of total billed charges",606.34,25451.55,
"27517 Closed treatment of distal femoral epiphysea",7962629,CDM,521,RC,27517,CPT,OUTPATIENT,,,2242,1457.3,,1972.96,88,,1578.37,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,2242,100,,1793.60,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1412.46,63,,1129.97,,,0,"percent of total billed charges","63% of total billed charges",343.03,15.3,,274.42,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1546.98,69,,,,,0,"fee schedule","69% of total billed charges",2242,100,,1793.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2242,100,,1793.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2242,100,,1793.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",845.23,37.7,,676.18,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1748.76,78,,1399.01,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1851.89,82.6,,1481.51,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1851.89,82.6,,1481.51,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,2242,100,,1793.60,,,0,"percent of total billed charges","100% of total billed charges",343.03,5656.45,
"27514 Open treatment of femoral fracture, distal e",7962705,CDM,521,RC,27514,CPT,OUTPATIENT,,,4408,2865.2,,3879.04,88,,3103.23,,,0,"percent of total billed charges","88% of total billed charges",4408,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4786.08,100,,,,,0,"fee schedule",EAPG,4408,100,,3526.40,,,0,"percent of total billed charges","100% of total billed charges",4408,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,4408,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2777.04,63,,2221.63,,,0,"percent of total billed charges","63% of total billed charges",674.42,15.3,,539.54,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3041.52,69,,,,,0,"fee schedule","69% of total billed charges",4408,100,,3526.40,,,0,"percent of total billed charges","100% of total billed charges",4408,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4408,100,,3526.40,,,0,"percent of total billed charges","100% of total billed charges",4408,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4408,100,,3526.40,,,0,"percent of total billed charges","100% of total billed charges",4408,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,4408,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4408,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",4408,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,4408,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1661.82,37.7,,1329.46,,,0,"percent of total billed charges","37.70% of total billed charges",4408,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4408,100,,,,,0,"fee schedule","100% of CMS fee schedule",3438.24,78,,2750.59,,,0,"percent of total billed charges","78% of total billed charges",4408,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3641.01,82.6,,2912.81,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule","100% of WA fee schedule",4408,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3641.01,82.6,,2912.81,,,0,"percent of total billed charges","82.6% of total billed charges",4408,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4946.61,100,,,,,0,"fee schedule",EAPG,4408,100,,3526.40,,,0,"percent of total billed charges","100% of total billed charges",674.42,25451.55,
"27524 Open treatment of patellar fracture, with in",7962497,CDM,521,RC,27524,CPT,OUTPATIENT,,,3214,2089.1,,2828.32,88,,2262.66,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2024.82,63,,1619.86,,,0,"percent of total billed charges","63% of total billed charges",491.74,15.3,,393.39,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,2217.66,69,,,,,0,"fee schedule","69% of total billed charges",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1211.68,37.7,,969.34,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2506.92,78,,2005.54,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2654.76,82.6,,2123.81,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,3214,100,,2571.20,,,0,"percent of total billed charges","100% of total billed charges",491.74,25451.55,
"27536 Open treatment of tibial fracture, proximal;",7961814,CDM,521,RC,27536,CPT,OUTPATIENT,,,3843,2497.95,,3381.84,88,,2705.47,,,0,"percent of total billed charges","88% of total billed charges",3843,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4786.08,100,,,,,0,"fee schedule",EAPG,3843,100,,3074.40,,,0,"percent of total billed charges","100% of total billed charges",3843,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,3843,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2421.09,63,,1936.87,,,0,"percent of total billed charges","63% of total billed charges",587.98,15.3,,470.38,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,2651.67,69,,,,,0,"fee schedule","69% of total billed charges",3843,100,,3074.40,,,0,"percent of total billed charges","100% of total billed charges",3843,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3843,100,,3074.40,,,0,"percent of total billed charges","100% of total billed charges",3843,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3843,100,,3074.40,,,0,"percent of total billed charges","100% of total billed charges",3843,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3843,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3843,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",3843,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,3843,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1448.81,37.7,,1159.05,,,0,"percent of total billed charges","37.70% of total billed charges",3843,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3843,100,,,,,0,"fee schedule","100% of CMS fee schedule",2997.54,78,,2398.03,,,0,"percent of total billed charges","78% of total billed charges",3843,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3174.32,82.6,,2539.46,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3843,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3174.32,82.6,,2539.46,,,0,"percent of total billed charges","82.6% of total billed charges",3843,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4946.61,100,,,,,0,"fee schedule",EAPG,3843,100,,3074.40,,,0,"percent of total billed charges","100% of total billed charges",587.98,25451.55,
"27535 Open treatment of tibial fracture, proximal;",7962323,CDM,521,RC,27535,CPT,OUTPATIENT,,,3756,2441.4,,3305.28,88,,2644.22,,,0,"percent of total billed charges","88% of total billed charges",3756,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4786.08,100,,,,,0,"fee schedule",EAPG,3756,100,,3004.80,,,0,"percent of total billed charges","100% of total billed charges",3756,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,3756,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2366.28,63,,1893.02,,,0,"percent of total billed charges","63% of total billed charges",574.67,15.3,,459.74,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,2591.64,69,,,,,0,"fee schedule","69% of total billed charges",3756,100,,3004.80,,,0,"percent of total billed charges","100% of total billed charges",3756,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3756,100,,3004.80,,,0,"percent of total billed charges","100% of total billed charges",3756,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3756,100,,3004.80,,,0,"percent of total billed charges","100% of total billed charges",3756,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3756,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3756,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",3756,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,3756,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1416.01,37.7,,1132.81,,,0,"percent of total billed charges","37.70% of total billed charges",3756,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3756,100,,,,,0,"fee schedule","100% of CMS fee schedule",2929.68,78,,2343.74,,,0,"percent of total billed charges","78% of total billed charges",3756,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3102.46,82.6,,2481.97,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule","100% of WA fee schedule",3756,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3102.46,82.6,,2481.97,,,0,"percent of total billed charges","82.6% of total billed charges",3756,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4946.61,100,,,,,0,"fee schedule",EAPG,3756,100,,3004.80,,,0,"percent of total billed charges","100% of total billed charges",574.67,25451.55,
"27530 Closed treatment of tibial fracture, proxima",7962552,CDM,521,RC,27530,CPT,OUTPATIENT,,,1044,678.6,,918.72,88,,734.98,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1044,100,,835.20,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",657.72,63,,526.18,,,0,"percent of total billed charges","63% of total billed charges",159.73,15.3,,127.78,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,720.36,69,,,,,0,"fee schedule","69% of total billed charges",1044,100,,835.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1044,100,,835.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1044,100,,835.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",393.59,37.7,,314.87,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",814.32,78,,651.46,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",862.34,82.6,,689.87,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",862.34,82.6,,689.87,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,1044,100,,835.20,,,0,"percent of total billed charges","100% of total billed charges",159.73,1044,
"27540 Open treatment of intercondylar spine and/or",7962594,CDM,521,RC,27540,CPT,OUTPATIENT,,,3413,2218.45,,3003.44,88,,2402.75,,,0,"percent of total billed charges","88% of total billed charges",3413,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4786.08,100,,,,,0,"fee schedule",EAPG,3413,100,,2730.40,,,0,"percent of total billed charges","100% of total billed charges",3413,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,3413,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2150.19,63,,1720.15,,,0,"percent of total billed charges","63% of total billed charges",522.19,15.3,,417.75,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,2354.97,69,,,,,0,"fee schedule","69% of total billed charges",3413,100,,2730.40,,,0,"percent of total billed charges","100% of total billed charges",3413,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3413,100,,2730.40,,,0,"percent of total billed charges","100% of total billed charges",3413,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3413,100,,2730.40,,,0,"percent of total billed charges","100% of total billed charges",3413,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3413,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3413,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",3413,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,3413,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1286.7,37.7,,1029.36,,,0,"percent of total billed charges","37.70% of total billed charges",3413,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3413,100,,,,,0,"fee schedule","100% of CMS fee schedule",2662.14,78,,2129.71,,,0,"percent of total billed charges","78% of total billed charges",3413,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2819.14,82.6,,2255.31,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule","100% of WA fee schedule",3413,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2819.14,82.6,,2255.31,,,0,"percent of total billed charges","82.6% of total billed charges",3413,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4946.61,100,,,,,0,"fee schedule",EAPG,3413,100,,2730.40,,,0,"percent of total billed charges","100% of total billed charges",522.19,25451.55,
"27558 Open treatment of knee dislocation, includes",7961972,CDM,521,RC,27558,CPT,OUTPATIENT,,,4162,2705.3,,3662.56,88,,2930.05,,,0,"percent of total billed charges","88% of total billed charges",4162,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6290.63,100,,,,,0,"fee schedule",EAPG,4162,100,,3329.60,,,0,"percent of total billed charges","100% of total billed charges",4162,175,,,,,0,"fee schedule","175% of CMS fee schedule",6479.35,100,,,,,0,"fee schedule",EAPG,4162,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2622.06,63,,2097.65,,,0,"percent of total billed charges","63% of total billed charges",636.79,15.3,,509.43,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,2871.78,69,,,,,0,"fee schedule","69% of total billed charges",4162,100,,3329.60,,,0,"percent of total billed charges","100% of total billed charges",4162,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4162,100,,3329.60,,,0,"percent of total billed charges","100% of total billed charges",4162,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4162,100,,3329.60,,,0,"percent of total billed charges","100% of total billed charges",4162,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,4162,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4162,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",4162,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,4162,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1569.07,37.7,,1255.26,,,0,"percent of total billed charges","37.70% of total billed charges",4162,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4162,100,,,,,0,"fee schedule","100% of CMS fee schedule",3246.36,78,,2597.09,,,0,"percent of total billed charges","78% of total billed charges",4162,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3437.81,82.6,,2750.25,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule","100% of WA fee schedule",4162,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3437.81,82.6,,2750.25,,,0,"percent of total billed charges","82.6% of total billed charges",4162,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6451.16,100,,,,,0,"fee schedule",EAPG,4162,100,,3329.60,,,0,"percent of total billed charges","100% of total billed charges",636.79,25451.55,
"27552 Closed treatment of knee dislocation; requir",7963170,CDM,521,RC,27552,CPT,OUTPATIENT,,,1499,974.35,,1319.12,88,,1055.30,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,1499,100,,1199.20,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",916.1,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",944.37,63,,755.50,,,0,"percent of total billed charges","63% of total billed charges",229.35,15.3,,183.48,,,0,"percent of total billed charges","15.3% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,1034.31,69,,,,,0,"fee schedule","69% of total billed charges",1499,100,,1199.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1499,100,,1199.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1499,100,,1199.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.21,100,,,,,0,"fee schedule",EAPG,1156.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",565.12,37.7,,452.10,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1169.22,78,,935.38,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1238.17,82.6,,990.54,,,0,"percent of total billed charges","82.6% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1238.17,82.6,,990.54,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1049.95,100,,,,,0,"fee schedule",EAPG,1499,100,,1199.20,,,0,"percent of total billed charges","100% of total billed charges",229.35,5656.45,
"27560 Closed treatment of patellar dislocation; wi",7963103,CDM,521,RC,27560,CPT,OUTPATIENT,,,849,551.85,,747.12,88,,597.70,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,849,100,,679.20,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",534.87,63,,427.90,,,0,"percent of total billed charges","63% of total billed charges",129.9,15.3,,103.92,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,585.81,69,,,,,0,"fee schedule","69% of total billed charges",849,100,,679.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",849,100,,679.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",849,100,,679.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.07,37.7,,256.06,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",662.22,78,,529.78,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",701.27,82.6,,561.02,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",701.27,82.6,,561.02,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,849,100,,679.20,,,0,"percent of total billed charges","100% of total billed charges",129.9,849,
"27570 Manipulation of knee joint under general ane",7963355,CDM,521,RC,27570,CPT,OUTPATIENT,,,783,508.95,,689.04,88,,551.23,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,783,100,,626.40,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",916.1,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",493.29,63,,394.63,,,0,"percent of total billed charges","63% of total billed charges",119.8,15.3,,95.84,,,0,"percent of total billed charges","15.3% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,540.27,69,,,,,0,"fee schedule","69% of total billed charges",783,100,,626.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",783,100,,626.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",783,100,,626.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.21,100,,,,,0,"fee schedule",EAPG,1156.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",295.19,37.7,,236.15,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",610.74,78,,488.59,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",646.76,82.6,,517.41,,,0,"percent of total billed charges","82.6% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",646.76,82.6,,517.41,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1049.95,100,,,,,0,"fee schedule",EAPG,783,100,,626.40,,,0,"percent of total billed charges","100% of total billed charges",119.8,5656.45,
"27580 Arthrodesis, knee, any technique",7963721,CDM,521,RC,27580,CPT,OUTPATIENT,,,2617,1701.05,,2302.96,88,,1842.37,,,0,"percent of total billed charges","88% of total billed charges",2617,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6290.63,100,,,,,0,"fee schedule",EAPG,2617,100,,2093.60,,,0,"percent of total billed charges","100% of total billed charges",2617,175,,,,,0,"fee schedule","175% of CMS fee schedule",6479.35,100,,,,,0,"fee schedule",EAPG,2617,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1648.71,63,,1318.97,,,0,"percent of total billed charges","63% of total billed charges",400.4,15.3,,320.32,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,1805.73,69,,,,,0,"fee schedule","69% of total billed charges",2617,100,,2093.60,,,0,"percent of total billed charges","100% of total billed charges",2617,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2617,100,,2093.60,,,0,"percent of total billed charges","100% of total billed charges",2617,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2617,100,,2093.60,,,0,"percent of total billed charges","100% of total billed charges",2617,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,2617,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2617,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",2617,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,2617,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",986.61,37.7,,789.29,,,0,"percent of total billed charges","37.70% of total billed charges",2617,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2617,100,,,,,0,"fee schedule","100% of CMS fee schedule",2041.26,78,,1633.01,,,0,"percent of total billed charges","78% of total billed charges",2617,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2161.64,82.6,,1729.31,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule","100% of WA fee schedule",2617,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2161.64,82.6,,1729.31,,,0,"percent of total billed charges","82.6% of total billed charges",2617,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6451.16,100,,,,,0,"fee schedule",EAPG,2617,100,,2093.60,,,0,"percent of total billed charges","100% of total billed charges",400.4,50029.1,
"27594 Amputation, thigh, through femur, any level;",7962498,CDM,521,RC,27594,CPT,OUTPATIENT,,,1412,917.8,,1242.56,88,,994.05,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,1412,100,,1129.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.56,63,,711.65,,,0,"percent of total billed charges","63% of total billed charges",216.04,15.3,,172.83,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,974.28,69,,,,,0,"fee schedule","69% of total billed charges",1412,100,,1129.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1412,100,,1129.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1412,100,,1129.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",532.32,37.7,,425.86,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.36,78,,881.09,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1166.31,82.6,,933.05,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1166.31,82.6,,933.05,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3244.38,100,,,,,0,"fee schedule",EAPG,1412,100,,1129.60,,,0,"percent of total billed charges","100% of total billed charges",216.04,11498.59,
"27596 Amputation, thigh, through femur, any level;",7963171,CDM,521,RC,27596,CPT,OUTPATIENT,,,1943,1262.95,,1709.84,88,,1367.87,,,0,"percent of total billed charges","88% of total billed charges",1943,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3083.85,100,,,,,0,"fee schedule",EAPG,1943,100,,1554.40,,,0,"percent of total billed charges","100% of total billed charges",1943,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,1943,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1224.09,63,,979.27,,,0,"percent of total billed charges","63% of total billed charges",297.28,15.3,,237.82,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,1340.67,69,,,,,0,"fee schedule","69% of total billed charges",1943,100,,1554.40,,,0,"percent of total billed charges","100% of total billed charges",1943,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1943,100,,1554.40,,,0,"percent of total billed charges","100% of total billed charges",1943,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1943,100,,1554.40,,,0,"percent of total billed charges","100% of total billed charges",1943,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,1943,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1943,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",1943,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,1943,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",732.51,37.7,,586.01,,,0,"percent of total billed charges","37.70% of total billed charges",1943,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1943,100,,,,,0,"fee schedule","100% of CMS fee schedule",1515.54,78,,1212.43,,,0,"percent of total billed charges","78% of total billed charges",1943,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1604.92,82.6,,1283.94,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule","100% of WA fee schedule",1943,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1604.92,82.6,,1283.94,,,0,"percent of total billed charges","82.6% of total billed charges",1943,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3244.38,100,,,,,0,"fee schedule",EAPG,1943,100,,1554.40,,,0,"percent of total billed charges","100% of total billed charges",297.28,25451.55,
"27590 Amputation, thigh, through femur, any level;",7963502,CDM,521,RC,27590,CPT,OUTPATIENT,,,2877,1870.05,,2531.76,88,,2025.41,,,0,"percent of total billed charges","88% of total billed charges",2877,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3083.85,100,,,,,0,"fee schedule",EAPG,2877,100,,2301.60,,,0,"percent of total billed charges","100% of total billed charges",2877,175,,,,,0,"fee schedule","175% of CMS fee schedule",3176.37,100,,,,,0,"fee schedule",EAPG,2877,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1812.51,63,,1450.01,,,0,"percent of total billed charges","63% of total billed charges",440.18,15.3,,352.14,,,0,"percent of total billed charges","15.3% of total billed charges",3083.85,100,,,,,0,"fee schedule",EAPG,1985.13,69,,,,,0,"fee schedule","69% of total billed charges",2877,100,,2301.60,,,0,"percent of total billed charges","100% of total billed charges",2877,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2877,100,,2301.60,,,0,"percent of total billed charges","100% of total billed charges",2877,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2877,100,,2301.60,,,0,"percent of total billed charges","100% of total billed charges",2877,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",64464.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.85,100,,,,,0,"fee schedule",EAPG,2877,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2877,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",2877,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3145.53,100,,,,,0,"fee schedule",EAPG,4009.01,100,,,,,0,"fee schedule",EAPG,2877,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1084.63,37.7,,867.70,,,0,"percent of total billed charges","37.70% of total billed charges",2877,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2877,100,,,,,0,"fee schedule","100% of CMS fee schedule",2244.06,78,,1795.25,,,0,"percent of total billed charges","78% of total billed charges",2877,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2376.4,82.6,,1901.12,,,0,"percent of total billed charges","82.6% of total billed charges",3083.85,100,,,,,0,"fee schedule","100% of WA fee schedule",2877,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2376.4,82.6,,1901.12,,,0,"percent of total billed charges","82.6% of total billed charges",2877,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3244.38,100,,,,,0,"fee schedule",EAPG,2877,100,,2301.60,,,0,"percent of total billed charges","100% of total billed charges",440.18,64464.78,
"27599 Unlisted procedure, femur or knee",7963704,CDM,521,RC,27599,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",412.25,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",560.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",400.24,560.77,
"27598 Disarticulation at knee",7963868,CDM,521,RC,27598,CPT,OUTPATIENT,,,2857,1857.05,,2514.16,88,,2011.33,,,0,"percent of total billed charges","88% of total billed charges",2857,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6290.63,100,,,,,0,"fee schedule",EAPG,2857,100,,2285.60,,,0,"percent of total billed charges","100% of total billed charges",2857,175,,,,,0,"fee schedule","175% of CMS fee schedule",6479.35,100,,,,,0,"fee schedule",EAPG,2857,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1799.91,63,,1439.93,,,0,"percent of total billed charges","63% of total billed charges",437.12,15.3,,349.70,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,1971.33,69,,,,,0,"fee schedule","69% of total billed charges",2857,100,,2285.60,,,0,"percent of total billed charges","100% of total billed charges",2857,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2857,100,,2285.60,,,0,"percent of total billed charges","100% of total billed charges",2857,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2857,100,,2285.60,,,0,"percent of total billed charges","100% of total billed charges",2857,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,2857,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2857,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,2857,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1077.09,37.7,,861.67,,,0,"percent of total billed charges","37.70% of total billed charges",2857,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2857,100,,,,,0,"fee schedule","100% of CMS fee schedule",2228.46,78,,1782.77,,,0,"percent of total billed charges","78% of total billed charges",2857,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2359.88,82.6,,1887.90,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule","100% of WA fee schedule",2857,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2359.88,82.6,,1887.90,,,0,"percent of total billed charges","82.6% of total billed charges",2857,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6451.16,100,,,,,0,"fee schedule",EAPG,2857,100,,2285.60,,,0,"percent of total billed charges","100% of total billed charges",437.12,50029.1,
"27602 Decompression fasciotomy, leg; anterior and/",7962324,CDM,521,RC,27602,CPT,OUTPATIENT,,,1889,1227.85,,1662.32,88,,1329.86,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,1889,100,,1511.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2893.79,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1190.07,63,,952.06,,,0,"percent of total billed charges","63% of total billed charges",289.02,15.3,,231.22,,,0,"percent of total billed charges","15.3% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,1303.41,69,,,,,0,"fee schedule","69% of total billed charges",1889,100,,1511.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1889,100,,1511.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1889,100,,1511.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2865.69,100,,,,,0,"fee schedule",EAPG,3652.35,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",712.15,37.7,,569.72,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1473.42,78,,1178.74,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1560.31,82.6,,1248.25,,,0,"percent of total billed charges","82.6% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1560.31,82.6,,1248.25,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2970.03,100,,,,,0,"fee schedule",EAPG,1889,100,,1511.20,,,0,"percent of total billed charges","100% of total billed charges",289.02,11498.59,
"27600 Decompression fasciotomy, leg; anterior and/",7962742,CDM,521,RC,27600,CPT,OUTPATIENT,,,1534,997.1,,1349.92,88,,1079.94,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,1534,100,,1227.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2893.79,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",966.42,63,,773.14,,,0,"percent of total billed charges","63% of total billed charges",234.7,15.3,,187.76,,,0,"percent of total billed charges","15.3% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,1058.46,69,,,,,0,"fee schedule","69% of total billed charges",1534,100,,1227.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1534,100,,1227.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1534,100,,1227.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2865.69,100,,,,,0,"fee schedule",EAPG,3652.35,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",578.32,37.7,,462.66,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1196.52,78,,957.22,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1267.08,82.6,,1013.66,,,0,"percent of total billed charges","82.6% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1267.08,82.6,,1013.66,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2970.03,100,,,,,0,"fee schedule",EAPG,1534,100,,1227.20,,,0,"percent of total billed charges","100% of total billed charges",234.7,11498.59,
"27603 Incision and drainage, leg or ankle; deep ab",7963070,CDM,521,RC,27603,CPT,OUTPATIENT,,,943,612.95,,829.84,88,,663.87,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,943,100,,754.40,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",594.09,63,,475.27,,,0,"percent of total billed charges","63% of total billed charges",144.28,15.3,,115.42,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,650.67,69,,,,,0,"fee schedule","69% of total billed charges",943,100,,754.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",943,100,,754.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",943,100,,754.40,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",355.51,37.7,,284.41,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.54,78,,588.43,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",778.92,82.6,,623.14,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",778.92,82.6,,623.14,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,943,100,,754.40,,,0,"percent of total billed charges","100% of total billed charges",144.28,9628.23,
"27601 Decompression fasciotomy, leg; posterior com",7963104,CDM,521,RC,27601,CPT,OUTPATIENT,,,1492,969.8,,1312.96,88,,1050.37,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,1492,100,,1193.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2893.79,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",939.96,63,,751.97,,,0,"percent of total billed charges","63% of total billed charges",228.28,15.3,,182.62,,,0,"percent of total billed charges","15.3% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,1029.48,69,,,,,0,"fee schedule","69% of total billed charges",1492,100,,1193.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1492,100,,1193.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1492,100,,1193.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2865.69,100,,,,,0,"fee schedule",EAPG,3652.35,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",562.48,37.7,,449.98,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1163.76,78,,931.01,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1232.39,82.6,,985.91,,,0,"percent of total billed charges","82.6% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1232.39,82.6,,985.91,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2970.03,100,,,,,0,"fee schedule",EAPG,1492,100,,1193.60,,,0,"percent of total billed charges","100% of total billed charges",228.28,11498.59,
"27607 Incision (eg, osteomyelitis or bone abscess)",7963172,CDM,521,RC,27607,CPT,OUTPATIENT,,,1963,1275.95,,1727.44,88,,1381.95,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,1963,100,,1570.40,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2893.79,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1236.69,63,,989.35,,,0,"percent of total billed charges","63% of total billed charges",300.34,15.3,,240.27,,,0,"percent of total billed charges","15.3% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,1354.47,69,,,,,0,"fee schedule","69% of total billed charges",1963,100,,1570.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1963,100,,1570.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1963,100,,1570.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2865.69,100,,,,,0,"fee schedule",EAPG,3652.35,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",740.05,37.7,,592.04,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1531.14,78,,1224.91,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1621.44,82.6,,1297.15,,,0,"percent of total billed charges","82.6% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1621.44,82.6,,1297.15,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2970.03,100,,,,,0,"fee schedule",EAPG,1963,100,,1570.40,,,0,"percent of total billed charges","100% of total billed charges",300.34,11498.59,
"27612 Arthrotomy, posterior capsular release, ankl",7961815,CDM,521,RC,27612,CPT,OUTPATIENT,,,2114,1374.1,,1860.32,88,,1488.26,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,2114,100,,1691.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2893.79,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1331.82,63,,1065.46,,,0,"percent of total billed charges","63% of total billed charges",323.44,15.3,,258.75,,,0,"percent of total billed charges","15.3% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,1458.66,69,,,,,0,"fee schedule","69% of total billed charges",2114,100,,1691.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2114,100,,1691.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2114,100,,1691.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2865.69,100,,,,,0,"fee schedule",EAPG,3652.35,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",796.98,37.7,,637.58,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1648.92,78,,1319.14,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1746.16,82.6,,1396.93,,,0,"percent of total billed charges","82.6% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1746.16,82.6,,1396.93,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2970.03,100,,,,,0,"fee schedule",EAPG,2114,100,,1691.20,,,0,"percent of total billed charges","100% of total billed charges",323.44,11498.59,
"27618 Excision, tumor, soft tissue of leg or ankle",7962499,CDM,521,RC,27618,CPT,OUTPATIENT,,,1137,739.05,,1000.56,88,,800.45,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1137,100,,909.60,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",716.31,63,,573.05,,,0,"percent of total billed charges","63% of total billed charges",173.96,15.3,,139.17,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,784.53,69,,,,,0,"fee schedule","69% of total billed charges",1137,100,,909.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1137,100,,909.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1137,100,,909.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",428.65,37.7,,342.92,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.86,78,,709.49,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",939.16,82.6,,751.33,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",939.16,82.6,,751.33,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,1137,100,,909.60,,,0,"percent of total billed charges","100% of total billed charges",173.96,5715.97,
"27610 Arthrotomy, ankle, including exploration, dr",7962526,CDM,521,RC,27610,CPT,OUTPATIENT,,,2190,1423.5,,1927.2,88,,1541.76,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,2190,100,,1752.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2893.79,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1379.7,63,,1103.76,,,0,"percent of total billed charges","63% of total billed charges",335.07,15.3,,268.06,,,0,"percent of total billed charges","15.3% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,1511.1,69,,,,,0,"fee schedule","69% of total billed charges",2190,100,,1752.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2190,100,,1752.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2190,100,,1752.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2865.69,100,,,,,0,"fee schedule",EAPG,3652.35,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",825.63,37.7,,660.50,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1708.2,78,,1366.56,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1808.94,82.6,,1447.15,,,0,"percent of total billed charges","82.6% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1808.94,82.6,,1447.15,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2970.03,100,,,,,0,"fee schedule",EAPG,2190,100,,1752.00,,,0,"percent of total billed charges","100% of total billed charges",335.07,11498.59,
"27619 Excision, tumor, soft tissue of leg or ankle",7962553,CDM,521,RC,27619,CPT,OUTPATIENT,,,1817,1181.05,,1598.96,88,,1279.17,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1817,100,,1453.60,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1144.71,63,,915.77,,,0,"percent of total billed charges","63% of total billed charges",278,15.3,,222.40,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1253.73,69,,,,,0,"fee schedule","69% of total billed charges",1817,100,,1453.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1817,100,,1453.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1817,100,,1453.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",685.01,37.7,,548.01,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1417.26,78,,1133.81,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1500.84,82.6,,1200.67,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1500.84,82.6,,1200.67,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,1817,100,,1453.60,,,0,"percent of total billed charges","100% of total billed charges",278,9628.23,
"27614 Biopsy, soft tissue of leg or ankle area; de",7962595,CDM,521,RC,27614,CPT,OUTPATIENT,,,1060,689,,932.8,88,,746.24,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1060,100,,848.00,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",667.8,63,,534.24,,,0,"percent of total billed charges","63% of total billed charges",162.18,15.3,,129.74,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,731.4,69,,,,,0,"fee schedule","69% of total billed charges",1060,100,,848.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1060,100,,848.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1060,100,,848.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",399.62,37.7,,319.70,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",826.8,78,,661.44,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.56,82.6,,700.45,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.56,82.6,,700.45,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,1060,100,,848.00,,,0,"percent of total billed charges","100% of total billed charges",162.18,9628.23,
"27630 Excision of lesion of tendon sheath or capsu",7962172,CDM,521,RC,27630,CPT,OUTPATIENT,,,1341,871.65,,1180.08,88,,944.06,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,1341,100,,1072.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2893.79,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.83,63,,675.86,,,0,"percent of total billed charges","63% of total billed charges",205.17,15.3,,164.14,,,0,"percent of total billed charges","15.3% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,925.29,69,,,,,0,"fee schedule","69% of total billed charges",1341,100,,1072.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1341,100,,1072.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1341,100,,1072.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2865.69,100,,,,,0,"fee schedule",EAPG,3652.35,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",505.56,37.7,,404.45,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.98,78,,836.78,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1107.67,82.6,,886.14,,,0,"percent of total billed charges","82.6% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1107.67,82.6,,886.14,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2970.03,100,,,,,0,"fee schedule",EAPG,1341,100,,1072.80,,,0,"percent of total billed charges","100% of total billed charges",205.17,11498.59,
"27634 Excision, tumor, soft tissue of leg or ankle",7962527,CDM,521,RC,27634,CPT,OUTPATIENT,,,1707,1109.55,,1502.16,88,,1201.73,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,1707,100,,1365.60,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",2893.79,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1075.41,63,,860.33,,,0,"percent of total billed charges","63% of total billed charges",261.17,15.3,,208.94,,,0,"percent of total billed charges","15.3% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,1177.83,69,,,,,0,"fee schedule","69% of total billed charges",1707,100,,1365.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1707,100,,1365.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1707,100,,1365.60,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2865.69,100,,,,,0,"fee schedule",EAPG,3652.35,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",643.54,37.7,,514.83,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1331.46,78,,1065.17,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1409.98,82.6,,1127.98,,,0,"percent of total billed charges","82.6% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1409.98,82.6,,1127.98,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2970.03,100,,,,,0,"fee schedule",EAPG,1707,100,,1365.60,,,0,"percent of total billed charges","100% of total billed charges",261.17,9628.23,
"27635 Excision or curettage of bone cyst or benign",7962881,CDM,521,RC,27635,CPT,OUTPATIENT,,,2377,1545.05,,2091.76,88,,1673.41,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,2377,100,,1901.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2893.79,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1497.51,63,,1198.01,,,0,"percent of total billed charges","63% of total billed charges",363.68,15.3,,290.94,,,0,"percent of total billed charges","15.3% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,1640.13,69,,,,,0,"fee schedule","69% of total billed charges",2377,100,,1901.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2377,100,,1901.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2377,100,,1901.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2865.69,100,,,,,0,"fee schedule",EAPG,3652.35,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",896.13,37.7,,716.90,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1854.06,78,,1483.25,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1963.4,82.6,,1570.72,,,0,"percent of total billed charges","82.6% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1963.4,82.6,,1570.72,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2970.03,100,,,,,0,"fee schedule",EAPG,2377,100,,1901.60,,,0,"percent of total billed charges","100% of total billed charges",363.68,11498.59,
"27647 Radical resection of tumor; talus or calcane",7963463,CDM,521,RC,27647,CPT,OUTPATIENT,,,2514,1634.1,,2212.32,88,,1769.86,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,2514,100,,2011.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",6479.35,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1583.82,63,,1267.06,,,0,"percent of total billed charges","63% of total billed charges",384.64,15.3,,307.71,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,1734.66,69,,,,,0,"fee schedule","69% of total billed charges",2514,100,,2011.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2514,100,,2011.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2514,100,,2011.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",947.78,37.7,,758.22,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1960.92,78,,1568.74,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2076.56,82.6,,1661.25,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2076.56,82.6,,1661.25,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6451.16,100,,,,,0,"fee schedule",EAPG,2514,100,,2011.20,,,0,"percent of total billed charges","100% of total billed charges",384.64,11498.59,
"27641 Partial excision, bone; fibula",7963733,CDM,521,RC,27641,CPT,OUTPATIENT,,,1933,1256.45,,1701.04,88,,1360.83,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,1933,100,,1546.40,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2893.79,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.79,63,,974.23,,,0,"percent of total billed charges","63% of total billed charges",295.75,15.3,,236.60,,,0,"percent of total billed charges","15.3% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,1333.77,69,,,,,0,"fee schedule","69% of total billed charges",1933,100,,1546.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1933,100,,1546.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1933,100,,1546.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2865.69,100,,,,,0,"fee schedule",EAPG,3652.35,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",728.74,37.7,,582.99,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1507.74,78,,1206.19,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1596.66,82.6,,1277.33,,,0,"percent of total billed charges","82.6% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1596.66,82.6,,1277.33,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2970.03,100,,,,,0,"fee schedule",EAPG,1933,100,,1546.40,,,0,"percent of total billed charges","100% of total billed charges",295.75,11498.59,
"27640 Partial excision, bone; tibia",7963745,CDM,521,RC,27640,CPT,OUTPATIENT,,,3085,2005.25,,2714.8,88,,2171.84,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,3085,100,,2468.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",6479.35,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.55,63,,1554.84,,,0,"percent of total billed charges","63% of total billed charges",472.01,15.3,,377.61,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,2128.65,69,,,,,0,"fee schedule","69% of total billed charges",3085,100,,2468.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3085,100,,2468.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3085,100,,2468.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1163.05,37.7,,930.44,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2406.3,78,,1925.04,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2548.21,82.6,,2038.57,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2548.21,82.6,,2038.57,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6451.16,100,,,,,0,"fee schedule",EAPG,3085,100,,2468.00,,,0,"percent of total billed charges","100% of total billed charges",472.01,11498.59,
"27659 Repair, flexor tendon, leg; secondary, with",7962723,CDM,521,RC,27659,CPT,OUTPATIENT,,,2167,1408.55,,1906.96,88,,1525.57,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,2167,100,,1733.60,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",6479.35,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1365.21,63,,1092.17,,,0,"percent of total billed charges","63% of total billed charges",331.55,15.3,,265.24,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,1495.23,69,,,,,0,"fee schedule","69% of total billed charges",2167,100,,1733.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2167,100,,1733.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2167,100,,1733.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",816.96,37.7,,653.57,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1690.26,78,,1352.21,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1789.94,82.6,,1431.95,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1789.94,82.6,,1431.95,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6451.16,100,,,,,0,"fee schedule",EAPG,2167,100,,1733.60,,,0,"percent of total billed charges","100% of total billed charges",331.55,25451.55,
"27650 Repair, primary, open or percutaneous, ruptu",7962991,CDM,521,RC,27650,CPT,OUTPATIENT,,,2692,1749.8,,2368.96,88,,1895.17,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,2692,100,,2153.60,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",2893.79,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1695.96,63,,1356.77,,,0,"percent of total billed charges","63% of total billed charges",411.88,15.3,,329.50,,,0,"percent of total billed charges","15.3% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,1857.48,69,,,,,0,"fee schedule","69% of total billed charges",2692,100,,2153.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2692,100,,2153.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2692,100,,2153.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2865.69,100,,,,,0,"fee schedule",EAPG,3652.35,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1014.88,37.7,,811.90,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2099.76,78,,1679.81,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2223.59,82.6,,1778.87,,,0,"percent of total billed charges","82.6% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2223.59,82.6,,1778.87,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2970.03,100,,,,,0,"fee schedule",EAPG,2692,100,,2153.60,,,0,"percent of total billed charges","100% of total billed charges",411.88,25451.55,
"27658 Repair, flexor tendon, leg; primary, without",7963020,CDM,521,RC,27658,CPT,OUTPATIENT,,,1602,1041.3,,1409.76,88,,1127.81,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,1602,100,,1281.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2893.79,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1009.26,63,,807.41,,,0,"percent of total billed charges","63% of total billed charges",245.11,15.3,,196.09,,,0,"percent of total billed charges","15.3% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,1105.38,69,,,,,0,"fee schedule","69% of total billed charges",1602,100,,1281.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1602,100,,1281.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1602,100,,1281.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2865.69,100,,,,,0,"fee schedule",EAPG,3652.35,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",603.95,37.7,,483.16,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1249.56,78,,999.65,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1323.25,82.6,,1058.60,,,0,"percent of total billed charges","82.6% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1323.25,82.6,,1058.60,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2970.03,100,,,,,0,"fee schedule",EAPG,1602,100,,1281.60,,,0,"percent of total billed charges","100% of total billed charges",245.11,11498.59,
"27654 Repair, secondary, Achilles tendon, with or",7963190,CDM,521,RC,27654,CPT,OUTPATIENT,,,3249,2111.85,,2859.12,88,,2287.30,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,3249,100,,2599.20,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",6479.35,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2046.87,63,,1637.50,,,0,"percent of total billed charges","63% of total billed charges",497.1,15.3,,397.68,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,2241.81,69,,,,,0,"fee schedule","69% of total billed charges",3249,100,,2599.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3249,100,,2599.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3249,100,,2599.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1224.87,37.7,,979.90,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2534.22,78,,2027.38,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2683.67,82.6,,2146.94,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2683.67,82.6,,2146.94,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6451.16,100,,,,,0,"fee schedule",EAPG,3249,100,,2599.20,,,0,"percent of total billed charges","100% of total billed charges",497.1,25451.55,
"27665 Repair, extensor tendon, leg; secondary, wit",7962630,CDM,521,RC,27665,CPT,OUTPATIENT,,,1417,921.05,,1246.96,88,,997.57,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,1417,100,,1133.60,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",6479.35,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.71,63,,714.17,,,0,"percent of total billed charges","63% of total billed charges",216.8,15.3,,173.44,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,977.73,69,,,,,0,"fee schedule","69% of total billed charges",1417,100,,1133.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1417,100,,1133.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1417,100,,1133.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",534.21,37.7,,427.37,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1105.26,78,,884.21,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1170.44,82.6,,936.35,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1170.44,82.6,,936.35,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6451.16,100,,,,,0,"fee schedule",EAPG,1417,100,,1133.60,,,0,"percent of total billed charges","100% of total billed charges",216.8,25451.55,
"27664 Repair, extensor tendon, leg; primary, witho",7962962,CDM,521,RC,27664,CPT,OUTPATIENT,,,1519,987.35,,1336.72,88,,1069.38,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,1519,100,,1215.20,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",2893.79,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",956.97,63,,765.58,,,0,"percent of total billed charges","63% of total billed charges",232.41,15.3,,185.93,,,0,"percent of total billed charges","15.3% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,1048.11,69,,,,,0,"fee schedule","69% of total billed charges",1519,100,,1215.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1519,100,,1215.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1519,100,,1215.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2865.69,100,,,,,0,"fee schedule",EAPG,3652.35,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",572.66,37.7,,458.13,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1184.82,78,,947.86,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1254.69,82.6,,1003.75,,,0,"percent of total billed charges","82.6% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1254.69,82.6,,1003.75,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2970.03,100,,,,,0,"fee schedule",EAPG,1519,100,,1215.20,,,0,"percent of total billed charges","100% of total billed charges",232.41,25451.55,
"27676 Repair, dislocating peroneal tendons; with f",7963105,CDM,521,RC,27676,CPT,OUTPATIENT,,,2226,1446.9,,1958.88,88,,1567.10,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,2226,100,,1780.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",6479.35,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1402.38,63,,1121.90,,,0,"percent of total billed charges","63% of total billed charges",340.58,15.3,,272.46,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,1535.94,69,,,,,0,"fee schedule","69% of total billed charges",2226,100,,1780.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2226,100,,1780.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2226,100,,1780.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",839.2,37.7,,671.36,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1736.28,78,,1389.02,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1838.68,82.6,,1470.94,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1838.68,82.6,,1470.94,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6451.16,100,,,,,0,"fee schedule",EAPG,2226,100,,1780.80,,,0,"percent of total billed charges","100% of total billed charges",340.58,25451.55,
"27686 Lengthening or shortening of tendon, leg or",7962159,CDM,521,RC,27686,CPT,OUTPATIENT,,,2100,1365,,1848,88,,1478.40,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,2100,100,,1680.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2893.79,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1323,63,,1058.40,,,0,"percent of total billed charges","63% of total billed charges",321.3,15.3,,257.04,,,0,"percent of total billed charges","15.3% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,1449,69,,,,,0,"fee schedule","69% of total billed charges",2100,100,,1680.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2100,100,,1680.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2100,100,,1680.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2865.69,100,,,,,0,"fee schedule",EAPG,3652.35,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",791.7,37.7,,633.36,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1638,78,,1310.40,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1734.6,82.6,,1387.68,,,0,"percent of total billed charges","82.6% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1734.6,82.6,,1387.68,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2970.03,100,,,,,0,"fee schedule",EAPG,2100,100,,1680.00,,,0,"percent of total billed charges","100% of total billed charges",321.3,11498.59,
"27685 Lengthening or shortening of tendon, leg or",7962292,CDM,521,RC,27685,CPT,OUTPATIENT,,,1929,1253.85,,1697.52,88,,1358.02,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,1929,100,,1543.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2893.79,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1215.27,63,,972.22,,,0,"percent of total billed charges","63% of total billed charges",295.14,15.3,,236.11,,,0,"percent of total billed charges","15.3% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,1331.01,69,,,,,0,"fee schedule","69% of total billed charges",1929,100,,1543.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1929,100,,1543.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1929,100,,1543.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2865.69,100,,,,,0,"fee schedule",EAPG,3652.35,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",727.23,37.7,,581.78,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1504.62,78,,1203.70,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593.35,82.6,,1274.68,,,0,"percent of total billed charges","82.6% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593.35,82.6,,1274.68,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2970.03,100,,,,,0,"fee schedule",EAPG,1929,100,,1543.20,,,0,"percent of total billed charges","100% of total billed charges",295.14,11498.59,
"27687 Gastrocnemius recession (eg, Strayer procedu",7963447,CDM,521,RC,27687,CPT,OUTPATIENT,,,1772,1151.8,,1559.36,88,,1247.49,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,1772,100,,1417.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2893.79,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1116.36,63,,893.09,,,0,"percent of total billed charges","63% of total billed charges",271.12,15.3,,216.90,,,0,"percent of total billed charges","15.3% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,1222.68,69,,,,,0,"fee schedule","69% of total billed charges",1772,100,,1417.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1772,100,,1417.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1772,100,,1417.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2865.69,100,,,,,0,"fee schedule",EAPG,3652.35,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",668.04,37.7,,534.43,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1382.16,78,,1105.73,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1463.67,82.6,,1170.94,,,0,"percent of total billed charges","82.6% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1463.67,82.6,,1170.94,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2970.03,100,,,,,0,"fee schedule",EAPG,1772,100,,1417.60,,,0,"percent of total billed charges","100% of total billed charges",271.12,11498.59,
"27698 Repair, secondary, disrupted ligament, ankle",7962293,CDM,521,RC,27698,CPT,OUTPATIENT,,,3237,2104.05,,2848.56,88,,2278.85,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,3237,100,,2589.60,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",6479.35,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2039.31,63,,1631.45,,,0,"percent of total billed charges","63% of total billed charges",495.26,15.3,,396.21,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,2233.53,69,,,,,0,"fee schedule","69% of total billed charges",3237,100,,2589.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3237,100,,2589.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3237,100,,2589.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1220.35,37.7,,976.28,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2524.86,78,,2019.89,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2673.76,82.6,,2139.01,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2673.76,82.6,,2139.01,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6451.16,100,,,,,0,"fee schedule",EAPG,3237,100,,2589.60,,,0,"percent of total billed charges","100% of total billed charges",495.26,25451.55,
"27692 Transfer or transplant of single tendon; eac",7963021,CDM,521,RC,27692,CPT,OUTPATIENT,,,460,299,,404.8,88,,323.84,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",6290.63,100,,,,,0,"fee schedule",EAPG,460,100,,368.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6479.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",289.8,63,,231.84,,,0,"percent of total billed charges","63% of total billed charges",70.38,15.3,,56.30,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,317.4,69,,,,,0,"fee schedule","69% of total billed charges",460,100,,368.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",460,100,,368.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",460,100,,368.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",284.51,61.85,,227.61,,,0,"percent of total billed charges","61.5% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",173.42,37.7,,138.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",358.8,78,,287.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.96,82.6,,303.97,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",379.96,82.6,,303.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",6451.16,100,,,,,0,"fee schedule",EAPG,460,100,,368.00,,,0,"percent of total billed charges","100% of total billed charges",70.38,8177.82,
"27695 Repair, primary, disrupted ligament, ankle;",7963277,CDM,521,RC,27695,CPT,OUTPATIENT,,,2212,1437.8,,1946.56,88,,1557.25,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,2212,100,,1769.60,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",6479.35,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1393.56,63,,1114.85,,,0,"percent of total billed charges","63% of total billed charges",338.44,15.3,,270.75,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,1526.28,69,,,,,0,"fee schedule","69% of total billed charges",2212,100,,1769.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2212,100,,1769.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2212,100,,1769.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",833.92,37.7,,667.14,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.36,78,,1380.29,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1827.11,82.6,,1461.69,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1827.11,82.6,,1461.69,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6451.16,100,,,,,0,"fee schedule",EAPG,2212,100,,1769.60,,,0,"percent of total billed charges","100% of total billed charges",338.44,25451.55,
"27690 Transfer or transplant of single tendon; sup",7963324,CDM,521,RC,27690,CPT,OUTPATIENT,,,2127,1382.55,,1871.76,88,,1497.41,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,2127,100,,1701.60,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",6479.35,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1340.01,63,,1072.01,,,0,"percent of total billed charges","63% of total billed charges",325.43,15.3,,260.34,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,1467.63,69,,,,,0,"fee schedule","69% of total billed charges",2127,100,,1701.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2127,100,,1701.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2127,100,,1701.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",801.88,37.7,,641.50,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1659.06,78,,1327.25,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1756.9,82.6,,1405.52,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1756.9,82.6,,1405.52,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6451.16,100,,,,,0,"fee schedule",EAPG,2127,100,,1701.60,,,0,"percent of total billed charges","100% of total billed charges",325.43,25451.55,
"27691 Transfer or transplant of single tendon; dee",7963480,CDM,521,RC,27691,CPT,OUTPATIENT,,,2666,1732.9,,2346.08,88,,1876.86,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,2666,100,,2132.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",6479.35,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1679.58,63,,1343.66,,,0,"percent of total billed charges","63% of total billed charges",407.9,15.3,,326.32,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,1839.54,69,,,,,0,"fee schedule","69% of total billed charges",2666,100,,2132.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2666,100,,2132.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2666,100,,2132.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1005.08,37.7,,804.06,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2079.48,78,,1663.58,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2202.12,82.6,,1761.70,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2202.12,82.6,,1761.70,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6451.16,100,,,,,0,"fee schedule",EAPG,2666,100,,2132.80,,,0,"percent of total billed charges","100% of total billed charges",407.9,25451.55,
"27704 Removal of ankle implant",7963842,CDM,521,RC,27704,CPT,OUTPATIENT,,,1273,827.45,,1120.24,88,,896.19,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,1273,100,,1018.40,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2893.79,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",801.99,63,,641.59,,,0,"percent of total billed charges","63% of total billed charges",194.77,15.3,,155.82,,,0,"percent of total billed charges","15.3% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,878.37,69,,,,,0,"fee schedule","69% of total billed charges",1273,100,,1018.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1273,100,,1018.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1273,100,,1018.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2865.69,100,,,,,0,"fee schedule",EAPG,3652.35,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",479.92,37.7,,383.94,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",992.94,78,,794.35,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1051.5,82.6,,841.20,,,0,"percent of total billed charges","82.6% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1051.5,82.6,,841.20,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2970.03,100,,,,,0,"fee schedule",EAPG,1273,100,,1018.40,,,0,"percent of total billed charges","100% of total billed charges",194.77,11498.59,
"27707 Osteotomy; fibula",7963915,CDM,521,RC,27707,CPT,OUTPATIENT,,,1619,1052.35,,1424.72,88,,1139.78,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,1619,100,,1295.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",6479.35,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1019.97,63,,815.98,,,0,"percent of total billed charges","63% of total billed charges",247.71,15.3,,198.17,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,1117.11,69,,,,,0,"fee schedule","69% of total billed charges",1619,100,,1295.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1619,100,,1295.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1619,100,,1295.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",610.36,37.7,,488.29,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1262.82,78,,1010.26,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1337.29,82.6,,1069.83,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1337.29,82.6,,1069.83,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6451.16,100,,,,,0,"fee schedule",EAPG,1619,100,,1295.20,,,0,"percent of total billed charges","100% of total billed charges",247.71,11498.59,
"27705 Osteotomy; tibia",7963918,CDM,521,RC,27705,CPT,OUTPATIENT,,,3368,2189.2,,2963.84,88,,2371.07,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,3368,100,,2694.40,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",6479.35,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2121.84,63,,1697.47,,,0,"percent of total billed charges","63% of total billed charges",515.3,15.3,,412.24,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,2323.92,69,,,,,0,"fee schedule","69% of total billed charges",3368,100,,2694.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3368,100,,2694.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3368,100,,2694.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1269.74,37.7,,1015.79,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2627.04,78,,2101.63,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2781.97,82.6,,2225.58,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2781.97,82.6,,2225.58,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6451.16,100,,,,,0,"fee schedule",EAPG,3368,100,,2694.40,,,0,"percent of total billed charges","100% of total billed charges",515.3,25451.55,
"27720 Repair of nonunion or malunion, tibia; witho",7962446,CDM,521,RC,27720,CPT,OUTPATIENT,,,3573,2322.45,,3144.24,88,,2515.39,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3573,100,,2858.40,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2250.99,63,,1800.79,,,0,"percent of total billed charges","63% of total billed charges",546.67,15.3,,437.34,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,2465.37,69,,,,,0,"fee schedule","69% of total billed charges",3573,100,,2858.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3573,100,,2858.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3573,100,,2858.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1347.02,37.7,,1077.62,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.94,78,,2229.55,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2951.3,82.6,,2361.04,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2951.3,82.6,,2361.04,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,3573,100,,2858.40,,,0,"percent of total billed charges","100% of total billed charges",546.67,25451.55,
"27724 Repair of nonunion or malunion, tibia; with",7962882,CDM,521,RC,27724,CPT,OUTPATIENT,,,5223,3394.95,,4596.24,88,,3676.99,,,0,"percent of total billed charges","88% of total billed charges",5223,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4786.08,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5223,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,5223,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3290.49,63,,2632.39,,,0,"percent of total billed charges","63% of total billed charges",799.12,15.3,,639.30,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3603.87,69,,,,,0,"fee schedule","69% of total billed charges",5223,100,,4178.40,,,0,"percent of total billed charges","100% of total billed charges",5223,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5223,100,,4178.40,,,0,"percent of total billed charges","100% of total billed charges",5223,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5223,100,,4178.40,,,0,"percent of total billed charges","100% of total billed charges",5223,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,5223,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5223,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,5223,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1969.07,37.7,,1575.26,,,0,"percent of total billed charges","37.70% of total billed charges",5223,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5223,100,,,,,0,"fee schedule","100% of CMS fee schedule",4073.94,78,,3259.15,,,0,"percent of total billed charges","78% of total billed charges",5223,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4314.2,82.6,,3451.36,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,5223,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4314.2,82.6,,3451.36,,,0,"percent of total billed charges","82.6% of total billed charges",5223,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4946.61,100,,,,,0,"fee schedule",EAPG,5223,100,,4178.40,,,0,"percent of total billed charges","100% of total billed charges",799.12,25451.55,
"27726 Repair of fibula nonunion and/or malunion wi",7962992,CDM,521,RC,27726,CPT,OUTPATIENT,,,3064,1991.6,,2696.32,88,,2157.06,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3064,100,,2451.20,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1930.32,63,,1544.26,,,0,"percent of total billed charges","63% of total billed charges",468.79,15.3,,375.03,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,2114.16,69,,,,,0,"fee schedule","69% of total billed charges",3064,100,,2451.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3064,100,,2451.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3064,100,,2451.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1155.13,37.7,,924.10,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2389.92,78,,1911.94,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2530.86,82.6,,2024.69,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2530.86,82.6,,2024.69,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,3064,100,,2451.20,,,0,"percent of total billed charges","100% of total billed charges",468.79,25451.55,
"27758 Open treatment of tibial shaft fracture, wit",7962325,CDM,521,RC,27758,CPT,OUTPATIENT,,,4021,2613.65,,3538.48,88,,2830.78,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,4021,100,,3216.80,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2533.23,63,,2026.58,,,0,"percent of total billed charges","63% of total billed charges",615.21,15.3,,492.17,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,2774.49,69,,,,,0,"fee schedule","69% of total billed charges",4021,100,,3216.80,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4021,100,,3216.80,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4021,100,,3216.80,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1515.92,37.7,,1212.74,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3136.38,78,,2509.10,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3321.35,82.6,,2657.08,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3321.35,82.6,,2657.08,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,4021,100,,3216.80,,,0,"percent of total billed charges","100% of total billed charges",615.21,50029.1,
"27752 Closed treatment of tibial shaft fracture; w",7963106,CDM,521,RC,27752,CPT,OUTPATIENT,,,1703,1106.95,,1498.64,88,,1198.91,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1703,100,,1362.40,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1072.89,63,,858.31,,,0,"percent of total billed charges","63% of total billed charges",260.56,15.3,,208.45,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1175.07,69,,,,,0,"fee schedule","69% of total billed charges",1703,100,,1362.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1703,100,,1362.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1703,100,,1362.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",642.03,37.7,,513.62,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1328.34,78,,1062.67,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1406.68,82.6,,1125.34,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1406.68,82.6,,1125.34,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,1703,100,,1362.40,,,0,"percent of total billed charges","100% of total billed charges",260.56,5656.45,
"27759 Treatment of tibial shaft fracture by intram",7963107,CDM,521,RC,27759,CPT,OUTPATIENT,,,3557,2312.05,,3130.16,88,,2504.13,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3557,100,,2845.60,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2240.91,63,,1792.73,,,0,"percent of total billed charges","63% of total billed charges",544.22,15.3,,435.38,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,2454.33,69,,,,,0,"fee schedule","69% of total billed charges",3557,100,,2845.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3557,100,,2845.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3557,100,,2845.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1340.99,37.7,,1072.79,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2774.46,78,,2219.57,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2938.08,82.6,,2350.46,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2938.08,82.6,,2350.46,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,3557,100,,2845.60,,,0,"percent of total billed charges","100% of total billed charges",544.22,50029.1,
"27760 Closed treatment of medial malleolus fractur",7903239,CDM,521,RC,27760,CPT,OUTPATIENT,,,851,553.15,,748.88,88,,599.10,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,851,100,,680.80,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",536.13,63,,428.90,,,0,"percent of total billed charges","63% of total billed charges",130.2,15.3,,104.16,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,587.19,69,,,,,0,"fee schedule","69% of total billed charges",851,100,,680.80,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",851,100,,680.80,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",851,100,,680.80,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.83,37.7,,256.66,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",663.78,78,,531.02,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",702.93,82.6,,562.34,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",702.93,82.6,,562.34,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,851,100,,680.80,,,0,"percent of total billed charges","100% of total billed charges",130.2,851,
"27769 Open treatment of posterior malleolus fractu",7961816,CDM,521,RC,27769,CPT,OUTPATIENT,,,1761,1144.65,,1549.68,88,,1239.74,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,1761,100,,1408.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1109.43,63,,887.54,,,0,"percent of total billed charges","63% of total billed charges",269.43,15.3,,215.54,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1215.09,69,,,,,0,"fee schedule","69% of total billed charges",1761,100,,1408.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1761,100,,1408.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1761,100,,1408.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",663.9,37.7,,531.12,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1373.58,78,,1098.86,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1454.59,82.6,,1163.67,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1454.59,82.6,,1163.67,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,1761,100,,1408.80,,,0,"percent of total billed charges","100% of total billed charges",269.43,25451.55,
"27766 Open treatment of medial malleolus fracture,",7962173,CDM,521,RC,27766,CPT,OUTPATIENT,,,2565,1667.25,,2257.2,88,,1805.76,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2565,100,,2052.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1615.95,63,,1292.76,,,0,"percent of total billed charges","63% of total billed charges",392.45,15.3,,313.96,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1769.85,69,,,,,0,"fee schedule","69% of total billed charges",2565,100,,2052.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2565,100,,2052.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2565,100,,2052.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",967.01,37.7,,773.61,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2000.7,78,,1600.56,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2118.69,82.6,,1694.95,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2118.69,82.6,,1694.95,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2565,100,,2052.00,,,0,"percent of total billed charges","100% of total billed charges",392.45,25451.55,
"27768 Closed treatment of posterior malleolus frac",7962918,CDM,521,RC,27768,CPT,OUTPATIENT,,,674,438.1,,593.12,88,,474.50,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,674,100,,539.20,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",424.62,63,,339.70,,,0,"percent of total billed charges","63% of total billed charges",103.12,15.3,,82.50,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,465.06,69,,,,,0,"fee schedule","69% of total billed charges",674,100,,539.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",674,100,,539.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",674,100,,539.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",254.1,37.7,,203.28,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",525.72,78,,420.58,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.72,82.6,,445.38,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.72,82.6,,445.38,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,674,100,,539.20,,,0,"percent of total billed charges","100% of total billed charges",103.12,5656.45,
"27762 Closed treatment of medial malleolus fractur",7962993,CDM,521,RC,27762,CPT,OUTPATIENT,,,1252,813.8,,1101.76,88,,881.41,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1252,100,,1001.60,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",788.76,63,,631.01,,,0,"percent of total billed charges","63% of total billed charges",191.56,15.3,,153.25,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,863.88,69,,,,,0,"fee schedule","69% of total billed charges",1252,100,,1001.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1252,100,,1001.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1252,100,,1001.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",472,37.7,,377.60,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",976.56,78,,781.25,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1034.15,82.6,,827.32,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1034.15,82.6,,827.32,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,1252,100,,1001.60,,,0,"percent of total billed charges","100% of total billed charges",191.56,5656.45,
"27786 Closed treatment of distal fibular fracture",7962294,CDM,521,RC,27786,CPT,OUTPATIENT,,,839,545.35,,738.32,88,,590.66,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,839,100,,671.20,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",528.57,63,,422.86,,,0,"percent of total billed charges","63% of total billed charges",128.37,15.3,,102.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,578.91,69,,,,,0,"fee schedule","69% of total billed charges",839,100,,671.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",839,100,,671.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",839,100,,671.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",316.3,37.7,,253.04,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",654.42,78,,523.54,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",693.01,82.6,,554.41,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",693.01,82.6,,554.41,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,839,100,,671.20,,,0,"percent of total billed charges","100% of total billed charges",128.37,839,
"27788 Closed treatment of distal fibular fracture",7962409,CDM,521,RC,27788,CPT,OUTPATIENT,,,1092,709.8,,960.96,88,,768.77,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1092,100,,873.60,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",687.96,63,,550.37,,,0,"percent of total billed charges","63% of total billed charges",167.08,15.3,,133.66,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,753.48,69,,,,,0,"fee schedule","69% of total billed charges",1092,100,,873.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1092,100,,873.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1092,100,,873.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",411.68,37.7,,329.34,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",851.76,78,,681.41,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",901.99,82.6,,721.59,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",901.99,82.6,,721.59,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,1092,100,,873.60,,,0,"percent of total billed charges","100% of total billed charges",167.08,1092,
"27784 Open treatment of proximal fibula or shaft f",7962500,CDM,521,RC,27784,CPT,OUTPATIENT,,,2329,1513.85,,2049.52,88,,1639.62,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2329,100,,1863.20,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1467.27,63,,1173.82,,,0,"percent of total billed charges","63% of total billed charges",356.34,15.3,,285.07,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1607.01,69,,,,,0,"fee schedule","69% of total billed charges",2329,100,,1863.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2329,100,,1863.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2329,100,,1863.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",878.03,37.7,,702.42,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1816.62,78,,1453.30,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1923.75,82.6,,1539.00,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1923.75,82.6,,1539.00,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2329,100,,1863.20,,,0,"percent of total billed charges","100% of total billed charges",356.34,25451.55,
"27792 Open treatment of distal fibular fracture, i",7962295,CDM,521,RC,27792,CPT,OUTPATIENT,,,2389,1552.85,,2102.32,88,,1681.86,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2389,100,,1911.20,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1505.07,63,,1204.06,,,0,"percent of total billed charges","63% of total billed charges",365.52,15.3,,292.42,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1648.41,69,,,,,0,"fee schedule","69% of total billed charges",2389,100,,1911.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2389,100,,1911.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2389,100,,1911.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",900.65,37.7,,720.52,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.42,78,,1490.74,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1973.31,82.6,,1578.65,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1973.31,82.6,,1578.65,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2389,100,,1911.20,,,0,"percent of total billed charges","100% of total billed charges",365.52,25451.55,
"27814 Open treatment of bimalleolar ankle fracture",7961911,CDM,521,RC,27814,CPT,OUTPATIENT,,,3189,2072.85,,2806.32,88,,2245.06,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3189,100,,2551.20,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2009.07,63,,1607.26,,,0,"percent of total billed charges","63% of total billed charges",487.92,15.3,,390.34,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,2200.41,69,,,,,0,"fee schedule","69% of total billed charges",3189,100,,2551.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3189,100,,2551.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3189,100,,2551.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1202.25,37.7,,961.80,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2487.42,78,,1989.94,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2634.11,82.6,,2107.29,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2634.11,82.6,,2107.29,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,3189,100,,2551.20,,,0,"percent of total billed charges","100% of total billed charges",487.92,25451.55,
"27816 Closed treatment of trimalleolar ankle fract",7962840,CDM,521,RC,27816,CPT,OUTPATIENT,,,973,632.45,,856.24,88,,684.99,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,973,100,,778.40,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",612.99,63,,490.39,,,0,"percent of total billed charges","63% of total billed charges",148.87,15.3,,119.10,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,671.37,69,,,,,0,"fee schedule","69% of total billed charges",973,100,,778.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",973,100,,778.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",973,100,,778.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",366.82,37.7,,293.46,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",758.94,78,,607.15,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",803.7,82.6,,642.96,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",803.7,82.6,,642.96,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,973,100,,778.40,,,0,"percent of total billed charges","100% of total billed charges",148.87,973,
"27818 Closed treatment of trimalleolar ankle fract",7962933,CDM,521,RC,27818,CPT,OUTPATIENT,,,1629,1058.85,,1433.52,88,,1146.82,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1629,100,,1303.20,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1026.27,63,,821.02,,,0,"percent of total billed charges","63% of total billed charges",249.24,15.3,,199.39,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1124.01,69,,,,,0,"fee schedule","69% of total billed charges",1629,100,,1303.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1629,100,,1303.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1629,100,,1303.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",614.13,37.7,,491.30,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1270.62,78,,1016.50,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1345.55,82.6,,1076.44,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1345.55,82.6,,1076.44,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,1629,100,,1303.20,,,0,"percent of total billed charges","100% of total billed charges",249.24,5656.45,
"27810 Closed treatment of bimalleolar ankle fractu",7962963,CDM,521,RC,27810,CPT,OUTPATIENT,,,1535,997.75,,1350.8,88,,1080.64,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1535,100,,1228.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.05,63,,773.64,,,0,"percent of total billed charges","63% of total billed charges",234.86,15.3,,187.89,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1059.15,69,,,,,0,"fee schedule","69% of total billed charges",1535,100,,1228.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1535,100,,1228.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1535,100,,1228.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",578.7,37.7,,462.96,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1197.3,78,,957.84,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1267.91,82.6,,1014.33,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1267.91,82.6,,1014.33,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,1535,100,,1228.00,,,0,"percent of total billed charges","100% of total billed charges",234.86,5656.45,
"27825 Closed tx of fx of articular distal tibia, w",7961586,CDM,521,RC,27825,CPT,OUTPATIENT,,,1910,1241.5,,1680.8,88,,1344.64,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1910,100,,1528.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1203.3,63,,962.64,,,0,"percent of total billed charges","63% of total billed charges",292.23,15.3,,233.78,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1317.9,69,,,,,0,"fee schedule","69% of total billed charges",1910,100,,1528.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1910,100,,1528.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1910,100,,1528.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",720.07,37.7,,576.06,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1489.8,78,,1191.84,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1577.66,82.6,,1262.13,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1577.66,82.6,,1262.13,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,1910,100,,1528.00,,,0,"percent of total billed charges","100% of total billed charges",292.23,5656.45,
"27826 Open tx of fx of articular distal tibia, w/",7961587,CDM,521,RC,27826,CPT,OUTPATIENT,,,2595,1686.75,,2283.6,88,,1826.88,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2595,100,,2076.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1634.85,63,,1307.88,,,0,"percent of total billed charges","63% of total billed charges",397.04,15.3,,317.63,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1790.55,69,,,,,0,"fee schedule","69% of total billed charges",2595,100,,2076.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2595,100,,2076.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2595,100,,2076.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",978.32,37.7,,782.66,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2024.1,78,,1619.28,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2143.47,82.6,,1714.78,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2143.47,82.6,,1714.78,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2595,100,,2076.00,,,0,"percent of total billed charges","100% of total billed charges",397.04,25451.55,
"27828 Open tx of fx of articular distal tibia, w/",7961588,CDM,521,RC,27828,CPT,OUTPATIENT,,,4530,2944.5,,3986.4,88,,3189.12,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,4530,100,,3624.00,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2853.9,63,,2283.12,,,0,"percent of total billed charges","63% of total billed charges",693.09,15.3,,554.47,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3125.7,69,,,,,0,"fee schedule","69% of total billed charges",4530,100,,3624.00,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4530,100,,3624.00,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4530,100,,3624.00,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1707.81,37.7,,1366.25,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3533.4,78,,2826.72,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3741.78,82.6,,2993.42,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3741.78,82.6,,2993.42,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,4530,100,,3624.00,,,0,"percent of total billed charges","100% of total billed charges",693.09,50029.1,
"27827 Open tx of fx of articular distal tibia, w/",7961675,CDM,521,RC,27827,CPT,OUTPATIENT,,,4533,2946.45,,3989.04,88,,3191.23,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,4533,100,,3626.40,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2855.79,63,,2284.63,,,0,"percent of total billed charges","63% of total billed charges",693.55,15.3,,554.84,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3127.77,69,,,,,0,"fee schedule","69% of total billed charges",4533,100,,3626.40,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4533,100,,3626.40,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4533,100,,3626.40,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1708.94,37.7,,1367.15,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3535.74,78,,2828.59,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3744.26,82.6,,2995.41,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3744.26,82.6,,2995.41,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,4533,100,,3626.40,,,0,"percent of total billed charges","100% of total billed charges",693.55,50029.1,
"27829 Open tx of distal tibiofibular joint disrupt",7961748,CDM,521,RC,27829,CPT,OUTPATIENT,,,2413,1568.45,,2123.44,88,,1698.75,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2413,100,,1930.40,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1520.19,63,,1216.15,,,0,"percent of total billed charges","63% of total billed charges",369.19,15.3,,295.35,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1664.97,69,,,,,0,"fee schedule","69% of total billed charges",2413,100,,1930.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2413,100,,1930.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2413,100,,1930.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",909.7,37.7,,727.76,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1882.14,78,,1505.71,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1993.14,82.6,,1594.51,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1993.14,82.6,,1594.51,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2413,100,,1930.40,,,0,"percent of total billed charges","100% of total billed charges",369.19,25451.55,
"27824 Closed treatment of fracture of articular di",7961861,CDM,521,RC,27824,CPT,OUTPATIENT,,,1079,701.35,,949.52,88,,759.62,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1079,100,,863.20,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",679.77,63,,543.82,,,0,"percent of total billed charges","63% of total billed charges",165.09,15.3,,132.07,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,744.51,69,,,,,0,"fee schedule","69% of total billed charges",1079,100,,863.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1079,100,,863.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1079,100,,863.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.78,37.7,,325.42,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",841.62,78,,673.30,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891.25,82.6,,713.00,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891.25,82.6,,713.00,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,1079,100,,863.20,,,0,"percent of total billed charges","100% of total billed charges",165.09,1079,
"27822 Open treatment of trimalleolar ankle fractur",7962469,CDM,521,RC,27822,CPT,OUTPATIENT,,,3307,2149.55,,2910.16,88,,2328.13,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3307,100,,2645.60,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2083.41,63,,1666.73,,,0,"percent of total billed charges","63% of total billed charges",505.97,15.3,,404.78,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,2281.83,69,,,,,0,"fee schedule","69% of total billed charges",3307,100,,2645.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3307,100,,2645.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3307,100,,2645.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1246.74,37.7,,997.39,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2579.46,78,,2063.57,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2731.58,82.6,,2185.26,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2731.58,82.6,,2185.26,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,3307,100,,2645.60,,,0,"percent of total billed charges","100% of total billed charges",505.97,25451.55,
"27823 Open treatment of trimalleolar ankle fractur",7962554,CDM,521,RC,27823,CPT,OUTPATIENT,,,2395,1556.75,,2107.6,88,,1686.08,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2395,100,,1916.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1508.85,63,,1207.08,,,0,"percent of total billed charges","63% of total billed charges",366.44,15.3,,293.15,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1652.55,69,,,,,0,"fee schedule","69% of total billed charges",2395,100,,1916.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2395,100,,1916.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2395,100,,1916.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",902.92,37.7,,722.34,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1868.1,78,,1494.48,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.27,82.6,,1582.62,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1978.27,82.6,,1582.62,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2395,100,,1916.00,,,0,"percent of total billed charges","100% of total billed charges",366.44,25451.55,
"27848 Open tx of ankle dislocation, w/wo percutane",7961489,CDM,521,RC,27848,CPT,OUTPATIENT,,,2384,1549.6,,2097.92,88,,1678.34,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2384,100,,1907.20,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1501.92,63,,1201.54,,,0,"percent of total billed charges","63% of total billed charges",364.75,15.3,,291.80,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1644.96,69,,,,,0,"fee schedule","69% of total billed charges",2384,100,,1907.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2384,100,,1907.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2384,100,,1907.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",898.77,37.7,,719.02,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1859.52,78,,1487.62,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1969.18,82.6,,1575.34,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1969.18,82.6,,1575.34,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2384,100,,1907.20,,,0,"percent of total billed charges","100% of total billed charges",364.75,25451.55,
"27846 Open tx of ankle dislocation, w/wo percutane",7961589,CDM,521,RC,27846,CPT,OUTPATIENT,,,2140,1391,,1883.2,88,,1506.56,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2140,100,,1712.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1348.2,63,,1078.56,,,0,"percent of total billed charges","63% of total billed charges",327.42,15.3,,261.94,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1476.6,69,,,,,0,"fee schedule","69% of total billed charges",2140,100,,1712.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2140,100,,1712.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2140,100,,1712.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",806.78,37.7,,645.42,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1669.2,78,,1335.36,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1767.64,82.6,,1414.11,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1767.64,82.6,,1414.11,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2140,100,,1712.00,,,0,"percent of total billed charges","100% of total billed charges",327.42,25451.55,
"27842 Closed tx of ankle dislocation; requiring an",7961862,CDM,521,RC,27842,CPT,OUTPATIENT,,,1445,939.25,,1271.6,88,,1017.28,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,1445,100,,1156.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",916.1,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",910.35,63,,728.28,,,0,"percent of total billed charges","63% of total billed charges",221.09,15.3,,176.87,,,0,"percent of total billed charges","15.3% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,997.05,69,,,,,0,"fee schedule","69% of total billed charges",1445,100,,1156.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1445,100,,1156.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1445,100,,1156.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.21,100,,,,,0,"fee schedule",EAPG,1156.25,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",544.77,37.7,,435.82,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1127.1,78,,901.68,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.57,82.6,,954.86,,,0,"percent of total billed charges","82.6% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.57,82.6,,954.86,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1049.95,100,,,,,0,"fee schedule",EAPG,1445,100,,1156.00,,,0,"percent of total billed charges","100% of total billed charges",221.09,5656.45,
"27840 Closed treatment of ankle dislocation; witho",7963191,CDM,521,RC,27840,CPT,OUTPATIENT,,,1273,827.45,,1120.24,88,,896.19,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1273,100,,1018.40,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",801.99,63,,641.59,,,0,"percent of total billed charges","63% of total billed charges",194.77,15.3,,155.82,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,878.37,69,,,,,0,"fee schedule","69% of total billed charges",1273,100,,1018.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1273,100,,1018.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1273,100,,1018.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",479.92,37.7,,383.94,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",992.94,78,,794.35,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1051.5,82.6,,841.20,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1051.5,82.6,,841.20,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,1273,100,,1018.40,,,0,"percent of total billed charges","100% of total billed charges",194.77,1273,
"27871 Arthrodesis, tibiofibular joint, proximal or",7963356,CDM,521,RC,27871,CPT,OUTPATIENT,,,3222,2094.3,,2835.36,88,,2268.29,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,3222,100,,2577.60,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",6479.35,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2029.86,63,,1623.89,,,0,"percent of total billed charges","63% of total billed charges",492.97,15.3,,394.38,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,2223.18,69,,,,,0,"fee schedule","69% of total billed charges",3222,100,,2577.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222,100,,2577.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222,100,,2577.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1214.69,37.7,,971.75,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2513.16,78,,2010.53,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2661.37,82.6,,2129.10,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2661.37,82.6,,2129.10,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6451.16,100,,,,,0,"fee schedule",EAPG,3222,100,,2577.60,,,0,"percent of total billed charges","100% of total billed charges",492.97,50029.1,
"27870 Arthrodesis, ankle, open",7963858,CDM,521,RC,27870,CPT,OUTPATIENT,,,4075,2648.75,,3586,88,,2868.80,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,4075,100,,3260.00,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",6479.35,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2567.25,63,,2053.80,,,0,"percent of total billed charges","63% of total billed charges",623.48,15.3,,498.78,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,2811.75,69,,,,,0,"fee schedule","69% of total billed charges",4075,100,,3260.00,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4075,100,,3260.00,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4075,100,,3260.00,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1536.28,37.7,,1229.02,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3178.5,78,,2542.80,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3365.95,82.6,,2692.76,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3365.95,82.6,,2692.76,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6451.16,100,,,,,0,"fee schedule",EAPG,4075,100,,3260.00,,,0,"percent of total billed charges","100% of total billed charges",623.48,50029.1,
"27888 Amputation, ankle, through malleoli of tibia",7961490,CDM,521,RC,27888,CPT,OUTPATIENT,,,2001,1300.65,,1760.88,88,,1408.70,,,0,"percent of total billed charges","88% of total billed charges",2001,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6290.63,100,,,,,0,"fee schedule",EAPG,2001,100,,1600.80,,,0,"percent of total billed charges","100% of total billed charges",2001,175,,,,,0,"fee schedule","175% of CMS fee schedule",6479.35,100,,,,,0,"fee schedule",EAPG,2001,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1260.63,63,,1008.50,,,0,"percent of total billed charges","63% of total billed charges",306.15,15.3,,244.92,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,1380.69,69,,,,,0,"fee schedule","69% of total billed charges",2001,100,,1600.80,,,0,"percent of total billed charges","100% of total billed charges",2001,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2001,100,,1600.80,,,0,"percent of total billed charges","100% of total billed charges",2001,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2001,100,,1600.80,,,0,"percent of total billed charges","100% of total billed charges",2001,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,2001,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2001,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,2001,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",754.38,37.7,,603.50,,,0,"percent of total billed charges","37.70% of total billed charges",2001,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2001,100,,,,,0,"fee schedule","100% of CMS fee schedule",1560.78,78,,1248.62,,,0,"percent of total billed charges","78% of total billed charges",2001,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1652.83,82.6,,1322.26,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule","100% of WA fee schedule",2001,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1652.83,82.6,,1322.26,,,0,"percent of total billed charges","82.6% of total billed charges",2001,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6451.16,100,,,,,0,"fee schedule",EAPG,2001,100,,1600.80,,,0,"percent of total billed charges","100% of total billed charges",306.15,50029.1,
"27884 Amputation, leg, through tibia and fibula; s",7962555,CDM,521,RC,27884,CPT,OUTPATIENT,,,1604,1042.6,,1411.52,88,,1129.22,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,1604,100,,1283.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2893.79,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1010.52,63,,808.42,,,0,"percent of total billed charges","63% of total billed charges",245.41,15.3,,196.33,,,0,"percent of total billed charges","15.3% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,1106.76,69,,,,,0,"fee schedule","69% of total billed charges",1604,100,,1283.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1604,100,,1283.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1604,100,,1283.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2865.69,100,,,,,0,"fee schedule",EAPG,3652.35,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",604.71,37.7,,483.77,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1251.12,78,,1000.90,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1324.9,82.6,,1059.92,,,0,"percent of total billed charges","82.6% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1324.9,82.6,,1059.92,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2970.03,100,,,,,0,"fee schedule",EAPG,1604,100,,1283.20,,,0,"percent of total billed charges","100% of total billed charges",245.41,11498.59,
"27882 Amputation, leg, through tibia and fibula; o",7962830,CDM,521,RC,27882,CPT,OUTPATIENT,,,1809,1175.85,,1591.92,88,,1273.54,,,0,"percent of total billed charges","88% of total billed charges",1809,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6290.63,100,,,,,0,"fee schedule",EAPG,1809,100,,1447.20,,,0,"percent of total billed charges","100% of total billed charges",1809,175,,,,,0,"fee schedule","175% of CMS fee schedule",6479.35,100,,,,,0,"fee schedule",EAPG,1809,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1139.67,63,,911.74,,,0,"percent of total billed charges","63% of total billed charges",276.78,15.3,,221.42,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,1248.21,69,,,,,0,"fee schedule","69% of total billed charges",1809,100,,1447.20,,,0,"percent of total billed charges","100% of total billed charges",1809,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1809,100,,1447.20,,,0,"percent of total billed charges","100% of total billed charges",1809,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1809,100,,1447.20,,,0,"percent of total billed charges","100% of total billed charges",1809,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,1809,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1809,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,1809,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",681.99,37.7,,545.59,,,0,"percent of total billed charges","37.70% of total billed charges",1809,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1809,100,,,,,0,"fee schedule","100% of CMS fee schedule",1411.02,78,,1128.82,,,0,"percent of total billed charges","78% of total billed charges",1809,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1494.23,82.6,,1195.38,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule","100% of WA fee schedule",1809,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1494.23,82.6,,1195.38,,,0,"percent of total billed charges","82.6% of total billed charges",1809,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6451.16,100,,,,,0,"fee schedule",EAPG,1809,100,,1447.20,,,0,"percent of total billed charges","100% of total billed charges",276.78,25451.55,
"27886 Amputation, leg, through tibia and fibula; r",7963220,CDM,521,RC,27886,CPT,OUTPATIENT,,,2407,1564.55,,2118.16,88,,1694.53,,,0,"percent of total billed charges","88% of total billed charges",2407,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2809.5,100,,,,,0,"fee schedule",EAPG,2407,100,,1925.60,,,0,"percent of total billed charges","100% of total billed charges",2407,175,,,,,0,"fee schedule","175% of CMS fee schedule",2893.79,100,,,,,0,"fee schedule",EAPG,2407,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1516.41,63,,1213.13,,,0,"percent of total billed charges","63% of total billed charges",368.27,15.3,,294.62,,,0,"percent of total billed charges","15.3% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,1660.83,69,,,,,0,"fee schedule","69% of total billed charges",2407,100,,1925.60,,,0,"percent of total billed charges","100% of total billed charges",2407,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2407,100,,1925.60,,,0,"percent of total billed charges","100% of total billed charges",2407,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2407,100,,1925.60,,,0,"percent of total billed charges","100% of total billed charges",2407,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,2407,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2407,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2865.69,100,,,,,0,"fee schedule",EAPG,3652.35,100,,,,,0,"fee schedule",EAPG,2407,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",907.44,37.7,,725.95,,,0,"percent of total billed charges","37.70% of total billed charges",2407,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2407,100,,,,,0,"fee schedule","100% of CMS fee schedule",1877.46,78,,1501.97,,,0,"percent of total billed charges","78% of total billed charges",2407,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1988.18,82.6,,1590.54,,,0,"percent of total billed charges","82.6% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,2407,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1988.18,82.6,,1590.54,,,0,"percent of total billed charges","82.6% of total billed charges",2407,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2970.03,100,,,,,0,"fee schedule",EAPG,2407,100,,1925.60,,,0,"percent of total billed charges","100% of total billed charges",368.27,25451.55,
"27880 Amputation, leg, through tibia and fibula;",7963539,CDM,521,RC,27880,CPT,OUTPATIENT,,,2868,1864.2,,2523.84,88,,2019.07,,,0,"percent of total billed charges","88% of total billed charges",2868,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6290.63,100,,,,,0,"fee schedule",EAPG,2868,100,,2294.40,,,0,"percent of total billed charges","100% of total billed charges",2868,175,,,,,0,"fee schedule","175% of CMS fee schedule",6479.35,100,,,,,0,"fee schedule",EAPG,2868,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1806.84,63,,1445.47,,,0,"percent of total billed charges","63% of total billed charges",438.8,15.3,,351.04,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,1978.92,69,,,,,0,"fee schedule","69% of total billed charges",2868,100,,2294.40,,,0,"percent of total billed charges","100% of total billed charges",2868,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2868,100,,2294.40,,,0,"percent of total billed charges","100% of total billed charges",2868,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2868,100,,2294.40,,,0,"percent of total billed charges","100% of total billed charges",2868,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",64464.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,2868,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2868,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,2868,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1081.24,37.7,,864.99,,,0,"percent of total billed charges","37.70% of total billed charges",2868,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2868,100,,,,,0,"fee schedule","100% of CMS fee schedule",2237.04,78,,1789.63,,,0,"percent of total billed charges","78% of total billed charges",2868,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2368.97,82.6,,1895.18,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule","100% of WA fee schedule",2868,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2368.97,82.6,,1895.18,,,0,"percent of total billed charges","82.6% of total billed charges",2868,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6451.16,100,,,,,0,"fee schedule",EAPG,2868,100,,2294.40,,,0,"percent of total billed charges","100% of total billed charges",438.8,64464.78,
"27889 Ankle disarticulation",7963895,CDM,521,RC,27889,CPT,OUTPATIENT,,,1924,1250.6,,1693.12,88,,1354.50,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,1924,100,,1539.20,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",6479.35,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1212.12,63,,969.70,,,0,"percent of total billed charges","63% of total billed charges",294.37,15.3,,235.50,,,0,"percent of total billed charges","15.3% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,1327.56,69,,,,,0,"fee schedule","69% of total billed charges",1924,100,,1539.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1924,100,,1539.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1924,100,,1539.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6416.44,100,,,,,0,"fee schedule",EAPG,8177.82,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",725.35,37.7,,580.28,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1500.72,78,,1200.58,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.22,82.6,,1271.38,,,0,"percent of total billed charges","82.6% of total billed charges",6290.63,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.22,82.6,,1271.38,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6451.16,100,,,,,0,"fee schedule",EAPG,1924,100,,1539.20,,,0,"percent of total billed charges","100% of total billed charges",294.37,25451.55,
"27899 Unlisted procedure, leg or ankle",7963715,CDM,521,RC,27899,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",412.25,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.24,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",560.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",400.24,560.77,
"28002 Incision and drainage below fascia, w/wo ten",7961590,CDM,521,RC,28002,CPT,OUTPATIENT,,,1075,698.75,,946,88,,756.80,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1075,100,,860.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",677.25,63,,541.80,,,0,"percent of total billed charges","63% of total billed charges",164.48,15.3,,131.58,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,741.75,69,,,,,0,"fee schedule","69% of total billed charges",1075,100,,860.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1075,100,,860.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1075,100,,860.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",405.28,37.7,,324.22,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",838.5,78,,670.80,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",887.95,82.6,,710.36,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",887.95,82.6,,710.36,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1075,100,,860.00,,,0,"percent of total billed charges","100% of total billed charges",164.48,5656.45,
"28003 Incision and drainage below fascia, w/wo ten",7961912,CDM,521,RC,28003,CPT,OUTPATIENT,,,1853,1204.45,,1630.64,88,,1304.51,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1853,100,,1482.40,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1167.39,63,,933.91,,,0,"percent of total billed charges","63% of total billed charges",283.51,15.3,,226.81,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1278.57,69,,,,,0,"fee schedule","69% of total billed charges",1853,100,,1482.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1853,100,,1482.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1853,100,,1482.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",698.58,37.7,,558.86,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1445.34,78,,1156.27,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.58,82.6,,1224.46,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.58,82.6,,1224.46,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,1853,100,,1482.40,,,0,"percent of total billed charges","100% of total billed charges",283.51,11498.59,
"28005 Incision, bone cortex (eg, osteomyelitis or",7963022,CDM,521,RC,28005,CPT,OUTPATIENT,,,1779,1156.35,,1565.52,88,,1252.42,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,1779,100,,1423.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4853.4,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1120.77,63,,896.62,,,0,"percent of total billed charges","63% of total billed charges",272.19,15.3,,217.75,,,0,"percent of total billed charges","15.3% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,1227.51,69,,,,,0,"fee schedule","69% of total billed charges",1779,100,,1423.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1779,100,,1423.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1779,100,,1423.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4806.28,100,,,,,0,"fee schedule",EAPG,6125.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",670.68,37.7,,536.54,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1387.62,78,,1110.10,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1469.45,82.6,,1175.56,,,0,"percent of total billed charges","82.6% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1469.45,82.6,,1175.56,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4872.57,100,,,,,0,"fee schedule",EAPG,1779,100,,1423.20,,,0,"percent of total billed charges","100% of total billed charges",272.19,11498.59,
"28008 Fasciotomy, foot and/or toe",7963809,CDM,521,RC,28008,CPT,OUTPATIENT,,,1329,863.85,,1169.52,88,,935.62,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1329,100,,1063.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",837.27,63,,669.82,,,0,"percent of total billed charges","63% of total billed charges",203.34,15.3,,162.67,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,917.01,69,,,,,0,"fee schedule","69% of total billed charges",1329,100,,1063.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1329,100,,1063.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1329,100,,1063.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",501.03,37.7,,400.82,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1036.62,78,,829.30,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1097.75,82.6,,878.20,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1097.75,82.6,,878.20,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1329,100,,1063.20,,,0,"percent of total billed charges","100% of total billed charges",203.34,11498.59,
"28022 Arthrotomy, incld exploration, drainage, or",7961491,CDM,521,RC,28022,CPT,OUTPATIENT,,,696,452.4,,612.48,88,,489.98,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,696,100,,556.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",438.48,63,,350.78,,,0,"percent of total billed charges","63% of total billed charges",106.49,15.3,,85.19,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,480.24,69,,,,,0,"fee schedule","69% of total billed charges",696,100,,556.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",696,100,,556.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",696,100,,556.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",262.39,37.7,,209.91,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",542.88,78,,434.30,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",574.9,82.6,,459.92,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",574.9,82.6,,459.92,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,696,100,,556.80,,,0,"percent of total billed charges","100% of total billed charges",106.49,11498.59,
"28024 Exploration of toe joint",8165577,CDM,521,RC,28024,CPT,OUTPATIENT,,,2000,1300,,1760,88,,1408.00,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,2000,100,,1600.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260,63,,1008.00,,,0,"percent of total billed charges","63% of total billed charges",306,15.3,,244.80,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,1380,69,,,,,0,"fee schedule","69% of total billed charges",2000,100,,1600.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2000,100,,1600.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2000,100,,1600.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",754,37.7,,603.20,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1560,78,,1248.00,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1652,82.6,,1321.60,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1652,82.6,,1321.60,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,2000,100,,1600.00,,,0,"percent of total billed charges","100% of total billed charges",306,5656.45,
"28039 Excision, tumor, soft tissue of foot or toe,",7962596,CDM,521,RC,28039,CPT,OUTPATIENT,,,541,351.65,,476.08,88,,380.86,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,541,100,,432.80,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",340.83,63,,272.66,,,0,"percent of total billed charges","63% of total billed charges",82.77,15.3,,66.22,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,373.29,69,,,,,0,"fee schedule","69% of total billed charges",541,100,,432.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",541,100,,432.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",541,100,,432.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",203.96,37.7,,163.17,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",421.98,78,,337.58,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",446.87,82.6,,357.50,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",446.87,82.6,,357.50,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,541,100,,432.80,,,0,"percent of total billed charges","100% of total billed charges",82.77,9628.23,
"28035 Release, tarsal tunnel (posterior tibial ner",7963071,CDM,521,RC,28035,CPT,OUTPATIENT,,,1279,831.35,,1125.52,88,,900.42,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",2893.79,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",805.77,63,,644.62,,,0,"percent of total billed charges","63% of total billed charges",195.69,15.3,,156.55,,,0,"percent of total billed charges","15.3% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,882.51,69,,,,,0,"fee schedule","69% of total billed charges",1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.5,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2865.69,100,,,,,0,"fee schedule",EAPG,3652.35,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",482.18,37.7,,385.74,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",997.62,78,,798.10,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056.45,82.6,,845.16,,,0,"percent of total billed charges","82.6% of total billed charges",2809.5,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1056.45,82.6,,845.16,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2970.03,100,,,,,0,"fee schedule",EAPG,1279,100,,1023.20,,,0,"percent of total billed charges","100% of total billed charges",195.69,7127.26,
"28045 Excision, tumor, soft tissue of foot or toe,",7961591,CDM,521,RC,28045,CPT,OUTPATIENT,,,1199,779.35,,1055.12,88,,844.10,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1199,100,,959.20,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",755.37,63,,604.30,,,0,"percent of total billed charges","63% of total billed charges",183.45,15.3,,146.76,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,827.31,69,,,,,0,"fee schedule","69% of total billed charges",1199,100,,959.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1199,100,,959.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1199,100,,959.20,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",452.02,37.7,,361.62,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",935.22,78,,748.18,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",990.37,82.6,,792.30,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",990.37,82.6,,792.30,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1199,100,,959.20,,,0,"percent of total billed charges","100% of total billed charges",183.45,9628.23,
"28043 Excision, tumor, soft tissue of foot or toe,",7962631,CDM,521,RC,28043,CPT,OUTPATIENT,,,956,621.4,,841.28,88,,673.02,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,956,100,,764.80,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",602.28,63,,481.82,,,0,"percent of total billed charges","63% of total billed charges",146.27,15.3,,117.02,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,659.64,69,,,,,0,"fee schedule","69% of total billed charges",956,100,,764.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",956,100,,764.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",956,100,,764.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",360.41,37.7,,288.33,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",745.68,78,,596.54,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",789.66,82.6,,631.73,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",789.66,82.6,,631.73,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,956,100,,764.80,,,0,"percent of total billed charges","100% of total billed charges",146.27,5715.97,
"28060 Fasciectomy, plantar fascia; partial (separa",7963192,CDM,521,RC,28060,CPT,OUTPATIENT,,,1246,809.9,,1096.48,88,,877.18,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1246,100,,996.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",784.98,63,,627.98,,,0,"percent of total billed charges","63% of total billed charges",190.64,15.3,,152.51,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,859.74,69,,,,,0,"fee schedule","69% of total billed charges",1246,100,,996.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1246,100,,996.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1246,100,,996.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",469.74,37.7,,375.79,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",971.88,78,,777.50,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1029.2,82.6,,823.36,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1029.2,82.6,,823.36,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1246,100,,996.80,,,0,"percent of total billed charges","100% of total billed charges",190.64,11498.59,
"28080 Excision, interdigital (Morton) neuroma, sin",7963300,CDM,521,RC,28080,CPT,OUTPATIENT,,,1422,924.3,,1251.36,88,,1001.09,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1422,100,,1137.60,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",895.86,63,,716.69,,,0,"percent of total billed charges","63% of total billed charges",217.57,15.3,,174.06,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,981.18,69,,,,,0,"fee schedule","69% of total billed charges",1422,100,,1137.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1422,100,,1137.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1422,100,,1137.60,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",536.09,37.7,,428.87,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1109.16,78,,887.33,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1174.57,82.6,,939.66,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1174.57,82.6,,939.66,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1422,100,,1137.60,,,0,"percent of total billed charges","100% of total billed charges",217.57,5656.45,
"28088 Synovectomy, tendon sheath, foot; extensor",7963540,CDM,521,RC,28088,CPT,OUTPATIENT,,,1372,891.8,,1207.36,88,,965.89,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1372,100,,1097.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",864.36,63,,691.49,,,0,"percent of total billed charges","63% of total billed charges",209.92,15.3,,167.94,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,946.68,69,,,,,0,"fee schedule","69% of total billed charges",1372,100,,1097.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1372,100,,1097.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1372,100,,1097.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",517.24,37.7,,413.79,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1070.16,78,,856.13,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1133.27,82.6,,906.62,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1133.27,82.6,,906.62,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1372,100,,1097.60,,,0,"percent of total billed charges","100% of total billed charges",209.92,11498.59,
"28092 Excision of lesion, tendon, tendon sheath, (",7903307,CDM,521,RC,28092,CPT,OUTPATIENT,,,593,385.45,,521.84,88,,417.47,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,593,100,,474.40,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",373.59,63,,298.87,,,0,"percent of total billed charges","63% of total billed charges",90.73,15.3,,72.58,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,409.17,69,,,,,0,"fee schedule","69% of total billed charges",593,100,,474.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593,100,,474.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593,100,,474.40,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",223.56,37.7,,178.85,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.54,78,,370.03,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",489.82,82.6,,391.86,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",489.82,82.6,,391.86,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,593,100,,474.40,,,0,"percent of total billed charges","100% of total billed charges",90.73,5656.45,
"28090 Excision of lesion, tendon, tendon sheath, o",7962368,CDM,521,RC,28090,CPT,OUTPATIENT,,,1514,984.1,,1332.32,88,,1065.86,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1514,100,,1211.20,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",953.82,63,,763.06,,,0,"percent of total billed charges","63% of total billed charges",231.64,15.3,,185.31,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,1044.66,69,,,,,0,"fee schedule","69% of total billed charges",1514,100,,1211.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1514,100,,1211.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1514,100,,1211.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",570.78,37.7,,456.62,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1180.92,78,,944.74,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1250.56,82.6,,1000.45,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1250.56,82.6,,1000.45,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1514,100,,1211.20,,,0,"percent of total billed charges","100% of total billed charges",231.64,5656.45,
"28104 Excision or curettage of bone cyst or benign",7961592,CDM,521,RC,28104,CPT,OUTPATIENT,,,1649,1071.85,,1451.12,88,,1160.90,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1649,100,,1319.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1038.87,63,,831.10,,,0,"percent of total billed charges","63% of total billed charges",252.3,15.3,,201.84,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,1137.81,69,,,,,0,"fee schedule","69% of total billed charges",1649,100,,1319.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1649,100,,1319.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1649,100,,1319.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",621.67,37.7,,497.34,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1286.22,78,,1028.98,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1362.07,82.6,,1089.66,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1362.07,82.6,,1089.66,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1649,100,,1319.20,,,0,"percent of total billed charges","100% of total billed charges",252.3,11498.59,
"28103 Excision or curettage of bone cyst or benign",7962268,CDM,521,RC,28103,CPT,OUTPATIENT,,,671,436.15,,590.48,88,,472.38,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4853.4,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",422.73,63,,338.18,,,0,"percent of total billed charges","63% of total billed charges",102.66,15.3,,82.13,,,0,"percent of total billed charges","15.3% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,462.99,69,,,,,0,"fee schedule","69% of total billed charges",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4806.28,100,,,,,0,"fee schedule",EAPG,6125.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",252.97,37.7,,202.38,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",523.38,78,,418.70,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.25,82.6,,443.40,,,0,"percent of total billed charges","82.6% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.25,82.6,,443.40,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4872.57,100,,,,,0,"fee schedule",EAPG,671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",102.66,25451.55,
"28100 Excision or curettage of bone cyst or benign",7962771,CDM,521,RC,28100,CPT,OUTPATIENT,,,2266,1472.9,,1994.08,88,,1595.26,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4853.4,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1427.58,63,,1142.06,,,0,"percent of total billed charges","63% of total billed charges",346.7,15.3,,277.36,,,0,"percent of total billed charges","15.3% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,1563.54,69,,,,,0,"fee schedule","69% of total billed charges",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4806.28,100,,,,,0,"fee schedule",EAPG,6125.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",854.28,37.7,,683.42,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1767.48,78,,1413.98,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1871.72,82.6,,1497.38,,,0,"percent of total billed charges","82.6% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1871.72,82.6,,1497.38,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4872.57,100,,,,,0,"fee schedule",EAPG,2266,100,,1812.80,,,0,"percent of total billed charges","100% of total billed charges",346.7,11498.59,
"28108 Excision or curettage of bone cyst or benign",7962841,CDM,521,RC,28108,CPT,OUTPATIENT,,,1284,834.6,,1129.92,88,,903.94,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1284,100,,1027.20,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",808.92,63,,647.14,,,0,"percent of total billed charges","63% of total billed charges",196.45,15.3,,157.16,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,885.96,69,,,,,0,"fee schedule","69% of total billed charges",1284,100,,1027.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1284,100,,1027.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1284,100,,1027.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",484.07,37.7,,387.26,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1001.52,78,,801.22,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1060.58,82.6,,848.46,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1060.58,82.6,,848.46,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1284,100,,1027.20,,,0,"percent of total billed charges","100% of total billed charges",196.45,5656.45,
"28112 Ostectomy, complete excision; other metatars",7962556,CDM,521,RC,28112,CPT,OUTPATIENT,,,1591,1034.15,,1400.08,88,,1120.06,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1591,100,,1272.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1002.33,63,,801.86,,,0,"percent of total billed charges","63% of total billed charges",243.42,15.3,,194.74,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,1097.79,69,,,,,0,"fee schedule","69% of total billed charges",1591,100,,1272.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1591,100,,1272.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1591,100,,1272.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",599.81,37.7,,479.85,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1240.98,78,,992.78,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1314.17,82.6,,1051.34,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1314.17,82.6,,1051.34,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1591,100,,1272.80,,,0,"percent of total billed charges","100% of total billed charges",243.42,11498.59,
"28119 Ostectomy, calcaneus; for spur, with or with",7962772,CDM,521,RC,28119,CPT,OUTPATIENT,,,1846,1199.9,,1624.48,88,,1299.58,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1846,100,,1476.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1162.98,63,,930.38,,,0,"percent of total billed charges","63% of total billed charges",282.44,15.3,,225.95,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,1273.74,69,,,,,0,"fee schedule","69% of total billed charges",1846,100,,1476.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1846,100,,1476.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1846,100,,1476.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",695.94,37.7,,556.75,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1439.88,78,,1151.90,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1524.8,82.6,,1219.84,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1524.8,82.6,,1219.84,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1846,100,,1476.80,,,0,"percent of total billed charges","100% of total billed charges",282.44,11498.59,
"28111 Ostectomy, complete excision; first metatars",7963357,CDM,521,RC,28111,CPT,OUTPATIENT,,,1604,1042.6,,1411.52,88,,1129.22,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1604,100,,1283.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1010.52,63,,808.42,,,0,"percent of total billed charges","63% of total billed charges",245.41,15.3,,196.33,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,1106.76,69,,,,,0,"fee schedule","69% of total billed charges",1604,100,,1283.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1604,100,,1283.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1604,100,,1283.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",604.71,37.7,,483.77,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1251.12,78,,1000.90,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1324.9,82.6,,1059.92,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1324.9,82.6,,1059.92,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1604,100,,1283.20,,,0,"percent of total billed charges","100% of total billed charges",245.41,11498.59,
"28113 Ostectomy, complete excision; fifth metatars",7963358,CDM,521,RC,28113,CPT,OUTPATIENT,,,1597,1038.05,,1405.36,88,,1124.29,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1597,100,,1277.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1006.11,63,,804.89,,,0,"percent of total billed charges","63% of total billed charges",244.34,15.3,,195.47,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,1101.93,69,,,,,0,"fee schedule","69% of total billed charges",1597,100,,1277.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1597,100,,1277.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1597,100,,1277.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",602.07,37.7,,481.66,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1245.66,78,,996.53,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1319.12,82.6,,1055.30,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1319.12,82.6,,1055.30,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1597,100,,1277.60,,,0,"percent of total billed charges","100% of total billed charges",244.34,11498.59,
"28122 Partial excision of bone; tarsal or metatars",7962528,CDM,521,RC,28122,CPT,OUTPATIENT,,,1782,1158.3,,1568.16,88,,1254.53,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,1782,100,,1425.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4853.4,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1122.66,63,,898.13,,,0,"percent of total billed charges","63% of total billed charges",272.65,15.3,,218.12,,,0,"percent of total billed charges","15.3% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,1229.58,69,,,,,0,"fee schedule","69% of total billed charges",1782,100,,1425.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1782,100,,1425.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1782,100,,1425.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4806.28,100,,,,,0,"fee schedule",EAPG,6125.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",671.81,37.7,,537.45,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1389.96,78,,1111.97,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1471.93,82.6,,1177.54,,,0,"percent of total billed charges","82.6% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1471.93,82.6,,1177.54,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4872.57,100,,,,,0,"fee schedule",EAPG,1782,100,,1425.60,,,0,"percent of total billed charges","100% of total billed charges",272.65,11498.59,
"28120 Partial excision of bone; talus or calcaneus",7963503,CDM,521,RC,28120,CPT,OUTPATIENT,,,2121,1378.65,,1866.48,88,,1493.18,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,2121,100,,1696.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1336.23,63,,1068.98,,,0,"percent of total billed charges","63% of total billed charges",324.51,15.3,,259.61,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,1463.49,69,,,,,0,"fee schedule","69% of total billed charges",2121,100,,1696.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2121,100,,1696.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2121,100,,1696.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",799.62,37.7,,639.70,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1654.38,78,,1323.50,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1751.95,82.6,,1401.56,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1751.95,82.6,,1401.56,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,2121,100,,1696.80,,,0,"percent of total billed charges","100% of total billed charges",324.51,11498.59,
"28124 Partial excision of bone, phalanx of toe",7963580,CDM,521,RC,28124,CPT,OUTPATIENT,,,1226,796.9,,1078.88,88,,863.10,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1226,100,,980.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",772.38,63,,617.90,,,0,"percent of total billed charges","63% of total billed charges",187.58,15.3,,150.06,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,845.94,69,,,,,0,"fee schedule","69% of total billed charges",1226,100,,980.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1226,100,,980.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1226,100,,980.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",462.2,37.7,,369.76,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",956.28,78,,765.02,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1012.68,82.6,,810.14,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1012.68,82.6,,810.14,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1226,100,,980.80,,,0,"percent of total billed charges","100% of total billed charges",187.58,11498.59,
"28140 Metatarsectomy",7963924,CDM,521,RC,28140,CPT,OUTPATIENT,,,1797,1168.05,,1581.36,88,,1265.09,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1797,100,,1437.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1132.11,63,,905.69,,,0,"percent of total billed charges","63% of total billed charges",274.94,15.3,,219.95,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,1239.93,69,,,,,0,"fee schedule","69% of total billed charges",1797,100,,1437.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1797,100,,1437.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1797,100,,1437.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",677.47,37.7,,541.98,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1401.66,78,,1121.33,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1484.32,82.6,,1187.46,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1484.32,82.6,,1187.46,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1797,100,,1437.60,,,0,"percent of total billed charges","100% of total billed charges",274.94,11498.59,
"28153 Resection, condyle(s), distal end of phalanx",7963278,CDM,521,RC,28153,CPT,OUTPATIENT,,,1229,798.85,,1081.52,88,,865.22,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1229,100,,983.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",774.27,63,,619.42,,,0,"percent of total billed charges","63% of total billed charges",188.04,15.3,,150.43,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,848.01,69,,,,,0,"fee schedule","69% of total billed charges",1229,100,,983.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1229,100,,983.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1229,100,,983.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",463.33,37.7,,370.66,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",958.62,78,,766.90,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1015.15,82.6,,812.12,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1015.15,82.6,,812.12,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1229,100,,983.20,,,0,"percent of total billed charges","100% of total billed charges",188.04,11498.59,
"28150 Phalangectomy, toe, each toe",7963776,CDM,521,RC,28150,CPT,OUTPATIENT,,,836,543.4,,735.68,88,,588.54,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,836,100,,668.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",526.68,63,,421.34,,,0,"percent of total billed charges","63% of total billed charges",127.91,15.3,,102.33,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,576.84,69,,,,,0,"fee schedule","69% of total billed charges",836,100,,668.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",836,100,,668.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",836,100,,668.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",315.17,37.7,,252.14,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652.08,78,,521.66,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",690.54,82.6,,552.43,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",690.54,82.6,,552.43,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,836,100,,668.80,,,0,"percent of total billed charges","100% of total billed charges",127.91,11498.59,
"28160 Hemiphalangectomy or interphalangeal joint e",7962174,CDM,521,RC,28160,CPT,OUTPATIENT,,,1398,908.7,,1230.24,88,,984.19,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1398,100,,1118.40,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",880.74,63,,704.59,,,0,"percent of total billed charges","63% of total billed charges",213.89,15.3,,171.11,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,964.62,69,,,,,0,"fee schedule","69% of total billed charges",1398,100,,1118.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1398,100,,1118.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1398,100,,1118.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",527.05,37.7,,421.64,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1090.44,78,,872.35,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1154.75,82.6,,923.80,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1154.75,82.6,,923.80,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1398,100,,1118.40,,,0,"percent of total billed charges","100% of total billed charges",213.89,11498.59,
"28190 Removal of foreign body, foot; subcutaneous",7903144,CDM,521,RC,28190,CPT,OUTPATIENT,,,467,303.55,,410.96,88,,328.77,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,467,100,,373.60,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.21,63,,235.37,,,0,"percent of total billed charges","63% of total billed charges",71.45,15.3,,57.16,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,322.23,69,,,,,0,"fee schedule","69% of total billed charges",467,100,,373.60,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",467,100,,373.60,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",467,100,,373.60,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",176.06,37.7,,140.85,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",364.26,78,,291.41,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",385.74,82.6,,308.59,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",385.74,82.6,,308.59,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.98,100,,,,,0,"fee schedule",EAPG,467,100,,373.60,,,0,"percent of total billed charges","100% of total billed charges",71.45,2526.76,
"28192 Removal of foreign body, foot; deep",7903246,CDM,521,RC,28192,CPT,OUTPATIENT,,,812,527.8,,714.56,88,,571.65,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,812,100,,649.60,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1618.96,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",511.56,63,,409.25,,,0,"percent of total billed charges","63% of total billed charges",124.24,15.3,,99.39,,,0,"percent of total billed charges","15.3% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,560.28,69,,,,,0,"fee schedule","69% of total billed charges",812,100,,649.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",812,100,,649.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",812,100,,649.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.25,100,,,,,0,"fee schedule",EAPG,2043.35,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",306.12,37.7,,244.90,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",633.36,78,,506.69,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",670.71,82.6,,536.57,,,0,"percent of total billed charges","82.6% of total billed charges",1571.81,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",670.71,82.6,,536.57,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,812,100,,649.60,,,0,"percent of total billed charges","100% of total billed charges",124.24,5715.97,
"28193 Removal of foreign body, foot; complicated",7903247,CDM,521,RC,28193,CPT,OUTPATIENT,,,1285,835.25,,1130.8,88,,904.64,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1285,100,,1028.00,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",809.55,63,,647.64,,,0,"percent of total billed charges","63% of total billed charges",196.61,15.3,,157.29,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,886.65,69,,,,,0,"fee schedule","69% of total billed charges",1285,100,,1028.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1285,100,,1028.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1285,100,,1028.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",484.45,37.7,,387.56,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1002.3,78,,801.84,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1061.41,82.6,,849.13,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1061.41,82.6,,849.13,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1285,100,,1028.00,,,0,"percent of total billed charges","100% of total billed charges",196.61,5715.97,
"28208 Repair, tendon, extensor, foot; primary or s",7962964,CDM,521,RC,28208,CPT,OUTPATIENT,,,1183,768.95,,1041.04,88,,832.83,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1183,100,,946.40,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",745.29,63,,596.23,,,0,"percent of total billed charges","63% of total billed charges",181,15.3,,144.80,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,816.27,69,,,,,0,"fee schedule","69% of total billed charges",1183,100,,946.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1183,100,,946.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1183,100,,946.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",445.99,37.7,,356.79,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",922.74,78,,738.19,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",977.16,82.6,,781.73,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",977.16,82.6,,781.73,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1183,100,,946.40,,,0,"percent of total billed charges","100% of total billed charges",181,11498.59,
"28225 Tenolysis, extensor, foot; single tendon",7963591,CDM,521,RC,28225,CPT,OUTPATIENT,,,1168,759.2,,1027.84,88,,822.27,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1168,100,,934.40,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.84,63,,588.67,,,0,"percent of total billed charges","63% of total billed charges",178.7,15.3,,142.96,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,805.92,69,,,,,0,"fee schedule","69% of total billed charges",1168,100,,934.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1168,100,,934.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1168,100,,934.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",440.34,37.7,,352.27,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",911.04,78,,728.83,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",964.77,82.6,,771.82,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",964.77,82.6,,771.82,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1168,100,,934.40,,,0,"percent of total billed charges","100% of total billed charges",178.7,11498.59,
"28220 Tenolysis, flexor, foot; single tendon",7963621,CDM,521,RC,28220,CPT,OUTPATIENT,,,1189,772.85,,1046.32,88,,837.06,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1189,100,,951.20,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",749.07,63,,599.26,,,0,"percent of total billed charges","63% of total billed charges",181.92,15.3,,145.54,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,820.41,69,,,,,0,"fee schedule","69% of total billed charges",1189,100,,951.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1189,100,,951.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1189,100,,951.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",448.25,37.7,,358.60,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",927.42,78,,741.94,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",982.11,82.6,,785.69,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",982.11,82.6,,785.69,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1189,100,,951.20,,,0,"percent of total billed charges","100% of total billed charges",181.92,5656.45,
"28238 Reconstruction, posterior tibial tendon with",7961913,CDM,521,RC,28238,CPT,OUTPATIENT,,,2300,1495,,2024,88,,1619.20,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,2300,100,,1840.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4853.4,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1449,63,,1159.20,,,0,"percent of total billed charges","63% of total billed charges",351.9,15.3,,281.52,,,0,"percent of total billed charges","15.3% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,1587,69,,,,,0,"fee schedule","69% of total billed charges",2300,100,,1840.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2300,100,,1840.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2300,100,,1840.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4806.28,100,,,,,0,"fee schedule",EAPG,6125.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",867.1,37.7,,693.68,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1794,78,,1435.20,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1899.8,82.6,,1519.84,,,0,"percent of total billed charges","82.6% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1899.8,82.6,,1519.84,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4872.57,100,,,,,0,"fee schedule",EAPG,2300,100,,1840.00,,,0,"percent of total billed charges","100% of total billed charges",351.9,25451.55,
"28250 Division of plantar fascia and muscle (eg, S",7962326,CDM,521,RC,28250,CPT,OUTPATIENT,,,1616,1050.4,,1422.08,88,,1137.66,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1616,100,,1292.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1018.08,63,,814.46,,,0,"percent of total billed charges","63% of total billed charges",247.25,15.3,,197.80,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,1115.04,69,,,,,0,"fee schedule","69% of total billed charges",1616,100,,1292.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1616,100,,1292.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1616,100,,1292.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",609.23,37.7,,487.38,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.48,78,,1008.38,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1334.82,82.6,,1067.86,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1334.82,82.6,,1067.86,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1616,100,,1292.80,,,0,"percent of total billed charges","100% of total billed charges",247.25,11498.59,
"28272 Capsulotomy; interphalangeal joint, each joi",7962919,CDM,521,RC,28272,CPT,OUTPATIENT,,,759,493.35,,667.92,88,,534.34,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,759,100,,607.20,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",478.17,63,,382.54,,,0,"percent of total billed charges","63% of total billed charges",116.13,15.3,,92.90,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,523.71,69,,,,,0,"fee schedule","69% of total billed charges",759,100,,607.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759,100,,607.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759,100,,607.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",286.14,37.7,,228.91,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",592.02,78,,473.62,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",626.93,82.6,,501.54,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",626.93,82.6,,501.54,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,759,100,,607.20,,,0,"percent of total billed charges","100% of total billed charges",116.13,5656.45,
"28286 Correction, cock-up fifth toe, with plastic",7961973,CDM,521,RC,28286,CPT,OUTPATIENT,,,1350,877.5,,1188,88,,950.40,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1350,100,,1080.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",850.5,63,,680.40,,,0,"percent of total billed charges","63% of total billed charges",206.55,15.3,,165.24,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,931.5,69,,,,,0,"fee schedule","69% of total billed charges",1350,100,,1080.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1350,100,,1080.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1350,100,,1080.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",508.95,37.7,,407.16,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1053,78,,842.40,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1115.1,82.6,,892.08,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1115.1,82.6,,892.08,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1350,100,,1080.00,,,0,"percent of total billed charges","100% of total billed charges",206.55,11498.59,
"28288 Ostectomy, partial, exostectomy or condylect",7962243,CDM,521,RC,28288,CPT,OUTPATIENT,,,1516,985.4,,1334.08,88,,1067.26,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1516,100,,1212.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",955.08,63,,764.06,,,0,"percent of total billed charges","63% of total billed charges",231.95,15.3,,185.56,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,1046.04,69,,,,,0,"fee schedule","69% of total billed charges",1516,100,,1212.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1516,100,,1212.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1516,100,,1212.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",571.53,37.7,,457.22,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1182.48,78,,945.98,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1252.22,82.6,,1001.78,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1252.22,82.6,,1001.78,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1516,100,,1212.80,,,0,"percent of total billed charges","100% of total billed charges",231.95,11498.59,
"28289 Hallux rigidus correction w/ cheilectomy, de",7962244,CDM,521,RC,28289,CPT,OUTPATIENT,,,1949,1266.85,,1715.12,88,,1372.10,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,1949,100,,1559.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4853.4,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1227.87,63,,982.30,,,0,"percent of total billed charges","63% of total billed charges",298.2,15.3,,238.56,,,0,"percent of total billed charges","15.3% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,1344.81,69,,,,,0,"fee schedule","69% of total billed charges",1949,100,,1559.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1949,100,,1559.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1949,100,,1559.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4806.28,100,,,,,0,"fee schedule",EAPG,6125.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",734.77,37.7,,587.82,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1520.22,78,,1216.18,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1609.87,82.6,,1287.90,,,0,"percent of total billed charges","82.6% of total billed charges",4712.04,100,,,,,0,"fee schedule","100% of WA fee schedule",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1609.87,82.6,,1287.90,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4872.57,100,,,,,0,"fee schedule",EAPG,1949,100,,1559.20,,,0,"percent of total billed charges","100% of total billed charges",298.2,11498.59,
"28285 Correction, hammertoe (eg, interphalangeal f",7962410,CDM,521,RC,28285,CPT,OUTPATIENT,,,1461,949.65,,1285.68,88,,1028.54,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",920.43,63,,736.34,,,0,"percent of total billed charges","63% of total billed charges",223.53,15.3,,178.82,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,1008.09,69,,,,,0,"fee schedule","69% of total billed charges",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",550.8,37.7,,440.64,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1139.58,78,,911.66,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1206.79,82.6,,965.43,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule","100% of WA fee schedule",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1206.79,82.6,,965.43,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",223.53,11498.59,
"28296 Correction, hallux valgus (bunion), with or",7961593,CDM,521,RC,28296,CPT,OUTPATIENT,,,3002,1951.3,,2641.76,88,,2113.41,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,3002,100,,2401.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4853.4,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1891.26,63,,1513.01,,,0,"percent of total billed charges","63% of total billed charges",459.31,15.3,,367.45,,,0,"percent of total billed charges","15.3% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,2071.38,69,,,,,0,"fee schedule","69% of total billed charges",3002,100,,2401.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3002,100,,2401.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3002,100,,2401.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4806.28,100,,,,,0,"fee schedule",EAPG,6125.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1131.75,37.7,,905.40,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2341.56,78,,1873.25,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2479.65,82.6,,1983.72,,,0,"percent of total billed charges","82.6% of total billed charges",4712.04,100,,,,,0,"fee schedule","100% of WA fee schedule",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2479.65,82.6,,1983.72,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4872.57,100,,,,,0,"fee schedule",EAPG,3002,100,,2401.60,,,0,"percent of total billed charges","100% of total billed charges",459.31,11498.59,
"28294 Correction, hallux valgus (bunion), with or",7961722,CDM,521,RC,28899,CPT,OUTPATIENT,,,2375,1543.75,,2090,88,,1672.00,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,2375,100,,1900.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1496.25,63,,1197.00,,,0,"percent of total billed charges","63% of total billed charges",363.38,15.3,,290.70,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,1638.75,69,,,,,0,"fee schedule","69% of total billed charges",2375,100,,1900.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2375,100,,1900.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2375,100,,1900.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",895.38,37.7,,716.30,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1852.5,78,,1482.00,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1961.75,82.6,,1569.40,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1961.75,82.6,,1569.40,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,2375,100,,1900.00,,,0,"percent of total billed charges","100% of total billed charges",218.99,2375,
"28297 Correction, hallux valgus (bunion), with or",7961817,CDM,521,RC,28297,CPT,OUTPATIENT,,,2767,1798.55,,2434.96,88,,1947.97,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,2767,100,,2213.60,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4853.4,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1743.21,63,,1394.57,,,0,"percent of total billed charges","63% of total billed charges",423.35,15.3,,338.68,,,0,"percent of total billed charges","15.3% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,1909.23,69,,,,,0,"fee schedule","69% of total billed charges",2767,100,,2213.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2767,100,,2213.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2767,100,,2213.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4806.28,100,,,,,0,"fee schedule",EAPG,6125.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1043.16,37.7,,834.53,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2158.26,78,,1726.61,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2285.54,82.6,,1828.43,,,0,"percent of total billed charges","82.6% of total billed charges",4712.04,100,,,,,0,"fee schedule","100% of WA fee schedule",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2285.54,82.6,,1828.43,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4872.57,100,,,,,0,"fee schedule",EAPG,2767,100,,2213.60,,,0,"percent of total billed charges","100% of total billed charges",423.35,25451.55,
"28292 Correction, hallux valgus (bunion), w/ or w/",7961863,CDM,521,RC,28292,CPT,OUTPATIENT,,,2264,1471.6,,1992.32,88,,1593.86,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,2264,100,,1811.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4853.4,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1426.32,63,,1141.06,,,0,"percent of total billed charges","63% of total billed charges",346.39,15.3,,277.11,,,0,"percent of total billed charges","15.3% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,1562.16,69,,,,,0,"fee schedule","69% of total billed charges",2264,100,,1811.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2264,100,,1811.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2264,100,,1811.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4806.28,100,,,,,0,"fee schedule",EAPG,6125.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",853.53,37.7,,682.82,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1765.92,78,,1412.74,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1870.06,82.6,,1496.05,,,0,"percent of total billed charges","82.6% of total billed charges",4712.04,100,,,,,0,"fee schedule","100% of WA fee schedule",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1870.06,82.6,,1496.05,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4872.57,100,,,,,0,"fee schedule",EAPG,2264,100,,1811.20,,,0,"percent of total billed charges","100% of total billed charges",346.39,11498.59,
"28298 Correction, hallux valgus (bunion), with or",7961914,CDM,521,RC,28298,CPT,OUTPATIENT,,,2219,1442.35,,1952.72,88,,1562.18,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,2219,100,,1775.20,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4853.4,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1397.97,63,,1118.38,,,0,"percent of total billed charges","63% of total billed charges",339.51,15.3,,271.61,,,0,"percent of total billed charges","15.3% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,1531.11,69,,,,,0,"fee schedule","69% of total billed charges",2219,100,,1775.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2219,100,,1775.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2219,100,,1775.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4806.28,100,,,,,0,"fee schedule",EAPG,6125.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",836.56,37.7,,669.25,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1730.82,78,,1384.66,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1832.89,82.6,,1466.31,,,0,"percent of total billed charges","82.6% of total billed charges",4712.04,100,,,,,0,"fee schedule","100% of WA fee schedule",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1832.89,82.6,,1466.31,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4872.57,100,,,,,0,"fee schedule",EAPG,2219,100,,1775.20,,,0,"percent of total billed charges","100% of total billed charges",339.51,25451.55,
"28299 Correction, hallux valgus (bunion), with or",7962175,CDM,521,RC,28299,CPT,OUTPATIENT,,,2809,1825.85,,2471.92,88,,1977.54,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,2809,100,,2247.20,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4853.4,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1769.67,63,,1415.74,,,0,"percent of total billed charges","63% of total billed charges",429.78,15.3,,343.82,,,0,"percent of total billed charges","15.3% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,1938.21,69,,,,,0,"fee schedule","69% of total billed charges",2809,100,,2247.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809,100,,2247.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809,100,,2247.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4806.28,100,,,,,0,"fee schedule",EAPG,6125.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1058.99,37.7,,847.19,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2191.02,78,,1752.82,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2320.23,82.6,,1856.18,,,0,"percent of total billed charges","82.6% of total billed charges",4712.04,100,,,,,0,"fee schedule","100% of WA fee schedule",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2320.23,82.6,,1856.18,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4872.57,100,,,,,0,"fee schedule",EAPG,2809,100,,2247.20,,,0,"percent of total billed charges","100% of total billed charges",429.78,25451.55,
"28293 Correction, hallux valgus (bunion), w/wo ses",7962202,CDM,521,RC,28291,CPT,OUTPATIENT,,,2644,1718.6,,2326.72,88,,1861.38,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,2644,100,,2115.20,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4853.4,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1665.72,63,,1332.58,,,0,"percent of total billed charges","63% of total billed charges",404.53,15.3,,323.62,,,0,"percent of total billed charges","15.3% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,1824.36,69,,,,,0,"fee schedule","69% of total billed charges",2644,100,,2115.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2644,100,,2115.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2644,100,,2115.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4806.28,100,,,,,0,"fee schedule",EAPG,6125.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",996.79,37.7,,797.43,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2062.32,78,,1649.86,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2183.94,82.6,,1747.15,,,0,"percent of total billed charges","82.6% of total billed charges",4712.04,100,,,,,0,"fee schedule","100% of WA fee schedule",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2183.94,82.6,,1747.15,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4872.57,100,,,,,0,"fee schedule",EAPG,2644,100,,2115.20,,,0,"percent of total billed charges","100% of total billed charges",404.53,25451.55,
"28290 Correction, hallux valgus (bunion), with or",7962203,CDM,521,RC,28292,CPT,OUTPATIENT,,,1865,1212.25,,1641.2,88,,1312.96,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,1865,100,,1492.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4853.4,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1174.95,63,,939.96,,,0,"percent of total billed charges","63% of total billed charges",285.35,15.3,,228.28,,,0,"percent of total billed charges","15.3% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,1286.85,69,,,,,0,"fee schedule","69% of total billed charges",1865,100,,1492.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1865,100,,1492.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1865,100,,1492.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4806.28,100,,,,,0,"fee schedule",EAPG,6125.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",703.11,37.7,,562.49,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1454.7,78,,1163.76,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1540.49,82.6,,1232.39,,,0,"percent of total billed charges","82.6% of total billed charges",4712.04,100,,,,,0,"fee schedule","100% of WA fee schedule",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1540.49,82.6,,1232.39,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4872.57,100,,,,,0,"fee schedule",EAPG,1865,100,,1492.00,,,0,"percent of total billed charges","100% of total billed charges",285.35,11498.59,
"28300 Osteotomy; calcaneus (eg, Dwyer or Chambers",7961492,CDM,521,RC,28300,CPT,OUTPATIENT,,,2633,1711.45,,2317.04,88,,1853.63,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,2633,100,,2106.40,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4853.4,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1658.79,63,,1327.03,,,0,"percent of total billed charges","63% of total billed charges",402.85,15.3,,322.28,,,0,"percent of total billed charges","15.3% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,1816.77,69,,,,,0,"fee schedule","69% of total billed charges",2633,100,,2106.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2633,100,,2106.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2633,100,,2106.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4806.28,100,,,,,0,"fee schedule",EAPG,6125.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",992.64,37.7,,794.11,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2053.74,78,,1642.99,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2174.86,82.6,,1739.89,,,0,"percent of total billed charges","82.6% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2174.86,82.6,,1739.89,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4872.57,100,,,,,0,"fee schedule",EAPG,2633,100,,2106.40,,,0,"percent of total billed charges","100% of total billed charges",402.85,25451.55,
"28308 Osteotomy, w/wo length, short, angular corre",7961493,CDM,521,RC,28308,CPT,OUTPATIENT,,,2740,1781,,2411.2,88,,1928.96,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,2740,100,,2192.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1726.2,63,,1380.96,,,0,"percent of total billed charges","63% of total billed charges",419.22,15.3,,335.38,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,1890.6,69,,,,,0,"fee schedule","69% of total billed charges",2740,100,,2192.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2740,100,,2192.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2740,100,,2192.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1032.98,37.7,,826.38,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2137.2,78,,1709.76,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2263.24,82.6,,1810.59,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2263.24,82.6,,1810.59,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,2740,100,,2192.00,,,0,"percent of total billed charges","100% of total billed charges",419.22,11498.59,
"28305 Osteotomy, tarsal bones, other than calcaneu",7962136,CDM,521,RC,28305,CPT,OUTPATIENT,,,2740,1781,,2411.2,88,,1928.96,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,2740,100,,2192.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4853.4,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1726.2,63,,1380.96,,,0,"percent of total billed charges","63% of total billed charges",419.22,15.3,,335.38,,,0,"percent of total billed charges","15.3% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,1890.6,69,,,,,0,"fee schedule","69% of total billed charges",2740,100,,2192.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2740,100,,2192.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2740,100,,2192.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4806.28,100,,,,,0,"fee schedule",EAPG,6125.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1032.98,37.7,,826.38,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2137.2,78,,1709.76,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2263.24,82.6,,1810.59,,,0,"percent of total billed charges","82.6% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2263.24,82.6,,1810.59,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4872.57,100,,,,,0,"fee schedule",EAPG,2740,100,,2192.00,,,0,"percent of total billed charges","100% of total billed charges",419.22,25451.55,
"28302 Osteotomy; talus",7963920,CDM,521,RC,28302,CPT,OUTPATIENT,,,2482,1613.3,,2184.16,88,,1747.33,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,2482,100,,1985.60,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4853.4,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1563.66,63,,1250.93,,,0,"percent of total billed charges","63% of total billed charges",379.75,15.3,,303.80,,,0,"percent of total billed charges","15.3% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,1712.58,69,,,,,0,"fee schedule","69% of total billed charges",2482,100,,1985.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2482,100,,1985.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2482,100,,1985.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4806.28,100,,,,,0,"fee schedule",EAPG,6125.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",935.71,37.7,,748.57,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1935.96,78,,1548.77,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2050.13,82.6,,1640.10,,,0,"percent of total billed charges","82.6% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2050.13,82.6,,1640.10,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4872.57,100,,,,,0,"fee schedule",EAPG,2482,100,,1985.60,,,0,"percent of total billed charges","100% of total billed charges",379.75,25451.55,
"28310 Osteotomy, shortening, angular or rotational",7962327,CDM,521,RC,28310,CPT,OUTPATIENT,,,1307,849.55,,1150.16,88,,920.13,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1307,100,,1045.60,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",823.41,63,,658.73,,,0,"percent of total billed charges","63% of total billed charges",199.97,15.3,,159.98,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,901.83,69,,,,,0,"fee schedule","69% of total billed charges",1307,100,,1045.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1307,100,,1045.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1307,100,,1045.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",492.74,37.7,,394.19,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1019.46,78,,815.57,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1079.58,82.6,,863.66,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1079.58,82.6,,863.66,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1307,100,,1045.60,,,0,"percent of total billed charges","100% of total billed charges",199.97,25451.55,
"28313 Reconstruction, angular deformity of toe, so",7962842,CDM,521,RC,28313,CPT,OUTPATIENT,,,1335,867.75,,1174.8,88,,939.84,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1335,100,,1068.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",841.05,63,,672.84,,,0,"percent of total billed charges","63% of total billed charges",204.26,15.3,,163.41,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,921.15,69,,,,,0,"fee schedule","69% of total billed charges",1335,100,,1068.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1335,100,,1068.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1335,100,,1068.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",503.3,37.7,,402.64,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1041.3,78,,833.04,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1102.71,82.6,,882.17,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1102.71,82.6,,882.17,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1335,100,,1068.00,,,0,"percent of total billed charges","100% of total billed charges",204.26,11498.59,
"28315 Sesamoidectomy, first toe",7963845,CDM,521,RC,28315,CPT,OUTPATIENT,,,1444,938.6,,1270.72,88,,1016.58,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1444,100,,1155.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",909.72,63,,727.78,,,0,"percent of total billed charges","63% of total billed charges",220.93,15.3,,176.74,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,996.36,69,,,,,0,"fee schedule","69% of total billed charges",1444,100,,1155.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1444,100,,1155.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1444,100,,1155.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",544.39,37.7,,435.51,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1126.32,78,,901.06,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1192.74,82.6,,954.19,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1192.74,82.6,,954.19,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1444,100,,1155.20,,,0,"percent of total billed charges","100% of total billed charges",220.93,11498.59,
"28344 Reconstruction, toe(s); polydactyly",7963676,CDM,521,RC,28344,CPT,OUTPATIENT,,,1046,679.9,,920.48,88,,736.38,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1046,100,,836.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.98,63,,527.18,,,0,"percent of total billed charges","63% of total billed charges",160.04,15.3,,128.03,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,721.74,69,,,,,0,"fee schedule","69% of total billed charges",1046,100,,836.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1046,100,,836.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1046,100,,836.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",394.34,37.7,,315.47,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",815.88,78,,652.70,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",864,82.6,,691.20,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",864,82.6,,691.20,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1046,100,,836.80,,,0,"percent of total billed charges","100% of total billed charges",160.04,11498.59,
"28406 Percutaneous skeletal fixation of calcaneal",7962773,CDM,521,RC,28406,CPT,OUTPATIENT,,,1276,829.4,,1122.88,88,,898.30,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,1276,100,,1020.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",803.88,63,,643.10,,,0,"percent of total billed charges","63% of total billed charges",195.23,15.3,,156.18,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,880.44,69,,,,,0,"fee schedule","69% of total billed charges",1276,100,,1020.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1276,100,,1020.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1276,100,,1020.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",481.05,37.7,,384.84,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",995.28,78,,796.22,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1053.98,82.6,,843.18,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1053.98,82.6,,843.18,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,1276,100,,1020.80,,,0,"percent of total billed charges","100% of total billed charges",195.23,25451.55,
"28415 Open treatment of calcaneal fracture, includ",7962447,CDM,521,RC,28415,CPT,OUTPATIENT,,,4156,2701.4,,3657.28,88,,2925.82,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,4156,100,,3324.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2618.28,63,,2094.62,,,0,"percent of total billed charges","63% of total billed charges",635.87,15.3,,508.70,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,2867.64,69,,,,,0,"fee schedule","69% of total billed charges",4156,100,,3324.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4156,100,,3324.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4156,100,,3324.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1566.81,37.7,,1253.45,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3241.68,78,,2593.34,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3432.86,82.6,,2746.29,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3432.86,82.6,,2746.29,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,4156,100,,3324.80,,,0,"percent of total billed charges","100% of total billed charges",635.87,25451.55,
"28420 Open tx of calcaneal fx, internal fixation;",7961749,CDM,521,RC,28420,CPT,OUTPATIENT,,,4364,2836.6,,3840.32,88,,3072.26,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,4364,100,,3491.20,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2749.32,63,,2199.46,,,0,"percent of total billed charges","63% of total billed charges",667.69,15.3,,534.15,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3011.16,69,,,,,0,"fee schedule","69% of total billed charges",4364,100,,3491.20,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4364,100,,3491.20,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4364,100,,3491.20,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1645.23,37.7,,1316.18,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3403.92,78,,2723.14,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3604.66,82.6,,2883.73,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3604.66,82.6,,2883.73,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,4364,100,,3491.20,,,0,"percent of total billed charges","100% of total billed charges",667.69,50029.1,
"28430 Closed treatment of talus fracture; without",7903250,CDM,521,RC,28430,CPT,OUTPATIENT,,,737,479.05,,648.56,88,,518.85,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",464.31,63,,371.45,,,0,"percent of total billed charges","63% of total billed charges",112.76,15.3,,90.21,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,508.53,69,,,,,0,"fee schedule","69% of total billed charges",737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",277.85,37.7,,222.28,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",574.86,78,,459.89,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",608.76,82.6,,487.01,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",608.76,82.6,,487.01,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,737,100,,589.60,,,0,"percent of total billed charges","100% of total billed charges",112.76,837.64,
"28465 Open treatment of tarsal bone fracture, incl",7961915,CDM,521,RC,28465,CPT,OUTPATIENT,,,2197,1428.05,,1933.36,88,,1546.69,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2197,100,,1757.60,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1384.11,63,,1107.29,,,0,"percent of total billed charges","63% of total billed charges",336.14,15.3,,268.91,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1515.93,69,,,,,0,"fee schedule","69% of total billed charges",2197,100,,1757.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2197,100,,1757.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2197,100,,1757.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",828.27,37.7,,662.62,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1713.66,78,,1370.93,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1814.72,82.6,,1451.78,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1814.72,82.6,,1451.78,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2197,100,,1757.60,,,0,"percent of total billed charges","100% of total billed charges",336.14,25451.55,
"28470 Closed treatment of metatarsal fracture; wit",7903253,CDM,521,RC,28470,CPT,OUTPATIENT,,,597,388.05,,525.36,88,,420.29,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,597,100,,477.60,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",376.11,63,,300.89,,,0,"percent of total billed charges","63% of total billed charges",91.34,15.3,,73.07,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,411.93,69,,,,,0,"fee schedule","69% of total billed charges",597,100,,477.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",597,100,,477.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",597,100,,477.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",225.07,37.7,,180.06,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465.66,78,,372.53,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",493.12,82.6,,394.50,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",493.12,82.6,,394.50,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,597,100,,477.60,,,0,"percent of total billed charges","100% of total billed charges",91.34,837.64,
"28476 Percutaneous skeletal fixation of metatarsal",7962529,CDM,521,RC,28476,CPT,OUTPATIENT,,,879,571.35,,773.52,88,,618.82,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,879,100,,703.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",553.77,63,,443.02,,,0,"percent of total billed charges","63% of total billed charges",134.49,15.3,,107.59,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,606.51,69,,,,,0,"fee schedule","69% of total billed charges",879,100,,703.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879,100,,703.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879,100,,703.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",331.38,37.7,,265.10,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",685.62,78,,548.50,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.05,82.6,,580.84,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.05,82.6,,580.84,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,879,100,,703.20,,,0,"percent of total billed charges","100% of total billed charges",134.49,11498.59,
"28475 Closed treatment of metatarsal fracture; wit",7962994,CDM,521,RC,28475,CPT,OUTPATIENT,,,861,559.65,,757.68,88,,606.14,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,861,100,,688.80,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",542.43,63,,433.94,,,0,"percent of total billed charges","63% of total billed charges",131.73,15.3,,105.38,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,594.09,69,,,,,0,"fee schedule","69% of total billed charges",861,100,,688.80,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861,100,,688.80,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861,100,,688.80,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",324.6,37.7,,259.68,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671.58,78,,537.26,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",711.19,82.6,,568.95,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",711.19,82.6,,568.95,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,861,100,,688.80,,,0,"percent of total billed charges","100% of total billed charges",131.73,861,
"28485 Open treatment of metatarsal fracture, inclu",7962176,CDM,521,RC,28485,CPT,OUTPATIENT,,,1994,1296.1,,1754.72,88,,1403.78,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,1994,100,,1595.20,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1256.22,63,,1004.98,,,0,"percent of total billed charges","63% of total billed charges",305.08,15.3,,244.06,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1375.86,69,,,,,0,"fee schedule","69% of total billed charges",1994,100,,1595.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1994,100,,1595.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1994,100,,1595.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",751.74,37.7,,601.39,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1555.32,78,,1244.26,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1647.04,82.6,,1317.63,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1647.04,82.6,,1317.63,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,1994,100,,1595.20,,,0,"percent of total billed charges","100% of total billed charges",305.08,25451.55,
"28490 Closed treatment of fracture great toe, phal",7962411,CDM,521,RC,28490,CPT,OUTPATIENT,,,400,260,,352,88,,281.60,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,400,100,,320.00,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252,63,,201.60,,,0,"percent of total billed charges","63% of total billed charges",61.2,15.3,,48.96,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,276,69,,,,,0,"fee schedule","69% of total billed charges",400,100,,320.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400,100,,320.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400,100,,320.00,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",150.8,37.7,,120.64,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",312,78,,249.60,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.4,82.6,,264.32,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.4,82.6,,264.32,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,400,100,,320.00,,,0,"percent of total billed charges","100% of total billed charges",61.2,837.64,
"28496 Treat Big toe Fracture",8165578,CDM,521,RC,28496,CPT,OUTPATIENT,,,1604,1042.6,,1411.52,88,,1129.22,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,1604,100,,1283.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1010.52,63,,808.42,,,0,"percent of total billed charges","63% of total billed charges",245.41,15.3,,196.33,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1106.76,69,,,,,0,"fee schedule","69% of total billed charges",1604,100,,1283.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1604,100,,1283.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1604,100,,1283.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",604.71,37.7,,483.77,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1251.12,78,,1000.90,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1324.9,82.6,,1059.92,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1324.9,82.6,,1059.92,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,1604,100,,1283.20,,,0,"percent of total billed charges","100% of total billed charges",245.41,11498.59,
"28505 Open tx of fx, great toe, phalanx or phalang",7961818,CDM,521,RC,28505,CPT,OUTPATIENT,,,1426,926.9,,1254.88,88,,1003.90,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,1426,100,,1140.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",898.38,63,,718.70,,,0,"percent of total billed charges","63% of total billed charges",218.18,15.3,,174.54,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,983.94,69,,,,,0,"fee schedule","69% of total billed charges",1426,100,,1140.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1426,100,,1140.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1426,100,,1140.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",537.6,37.7,,430.08,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1112.28,78,,889.82,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1177.88,82.6,,942.30,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1177.88,82.6,,942.30,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,1426,100,,1140.80,,,0,"percent of total billed charges","100% of total billed charges",218.18,11498.59,
"28510 Closed treatment of fracture, phalanx or pha",7961494,CDM,521,RC,28510,CPT,OUTPATIENT,,,324,210.6,,285.12,88,,228.10,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,324,100,,259.20,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",204.12,63,,163.30,,,0,"percent of total billed charges","63% of total billed charges",49.57,15.3,,39.66,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,223.56,69,,,,,0,"fee schedule","69% of total billed charges",324,100,,259.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",324,100,,259.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",324,100,,259.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",122.15,37.7,,97.72,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.72,78,,202.18,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.62,82.6,,214.10,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.62,82.6,,214.10,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,324,100,,259.20,,,0,"percent of total billed charges","100% of total billed charges",49.57,837.64,
"28515 Closed treatment of fracture, phalanx or pha",7961495,CDM,521,RC,28515,CPT,OUTPATIENT,,,489,317.85,,430.32,88,,344.26,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,489,100,,391.20,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",308.07,63,,246.46,,,0,"percent of total billed charges","63% of total billed charges",74.82,15.3,,59.86,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,337.41,69,,,,,0,"fee schedule","69% of total billed charges",489,100,,391.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",489,100,,391.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",489,100,,391.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",184.35,37.7,,147.48,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",381.42,78,,305.14,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",403.91,82.6,,323.13,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",403.91,82.6,,323.13,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,489,100,,391.20,,,0,"percent of total billed charges","100% of total billed charges",74.82,837.64,
"28525 Open tx of fx, phalanx or phalanges, other t",7963023,CDM,521,RC,28525,CPT,OUTPATIENT,,,1457,947.05,,1282.16,88,,1025.73,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,1457,100,,1165.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",917.91,63,,734.33,,,0,"percent of total billed charges","63% of total billed charges",222.92,15.3,,178.34,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1005.33,69,,,,,0,"fee schedule","69% of total billed charges",1457,100,,1165.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1457,100,,1165.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1457,100,,1165.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",549.29,37.7,,439.43,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1136.46,78,,909.17,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1203.48,82.6,,962.78,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1203.48,82.6,,962.78,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,1457,100,,1165.60,,,0,"percent of total billed charges","100% of total billed charges",222.92,11498.59,
"28575 Closed treatment of talotarsal joint disloca",7962807,CDM,521,RC,28575,CPT,OUTPATIENT,,,1098,713.7,,966.24,88,,772.99,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,1098,100,,878.40,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",916.1,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",691.74,63,,553.39,,,0,"percent of total billed charges","63% of total billed charges",167.99,15.3,,134.39,,,0,"percent of total billed charges","15.3% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,757.62,69,,,,,0,"fee schedule","69% of total billed charges",1098,100,,878.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1098,100,,878.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1098,100,,878.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",889.42,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.21,100,,,,,0,"fee schedule",EAPG,1156.25,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",413.95,37.7,,331.16,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",856.44,78,,685.15,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",906.95,82.6,,725.56,,,0,"percent of total billed charges","82.6% of total billed charges",889.42,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",906.95,82.6,,725.56,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1049.95,100,,,,,0,"fee schedule",EAPG,1098,100,,878.40,,,0,"percent of total billed charges","100% of total billed charges",167.99,11498.59,
"28606 Percutaneous skeletal fixation of tarsometat",7962245,CDM,521,RC,28606,CPT,OUTPATIENT,,,1795,1166.75,,1579.6,88,,1263.68,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,1795,100,,1436.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1130.85,63,,904.68,,,0,"percent of total billed charges","63% of total billed charges",274.64,15.3,,219.71,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1238.55,69,,,,,0,"fee schedule","69% of total billed charges",1795,100,,1436.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1795,100,,1436.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1795,100,,1436.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",676.72,37.7,,541.38,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1400.1,78,,1120.08,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1482.67,82.6,,1186.14,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1482.67,82.6,,1186.14,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,1795,100,,1436.00,,,0,"percent of total billed charges","100% of total billed charges",274.64,11498.59,
"28615 Open tx of tarsometatarsal joint dislocation",7961916,CDM,521,RC,28615,CPT,OUTPATIENT,,,2417,1571.05,,2126.96,88,,1701.57,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,2417,100,,1933.60,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1522.71,63,,1218.17,,,0,"percent of total billed charges","63% of total billed charges",369.8,15.3,,295.84,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1667.73,69,,,,,0,"fee schedule","69% of total billed charges",2417,100,,1933.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2417,100,,1933.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2417,100,,1933.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",911.21,37.7,,728.97,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1885.26,78,,1508.21,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1996.44,82.6,,1597.15,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1996.44,82.6,,1597.15,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,2417,100,,1933.60,,,0,"percent of total billed charges","100% of total billed charges",369.8,25451.55,
"28645 Open tx of metatarsophalangeal joint disloca",7961676,CDM,521,RC,28645,CPT,OUTPATIENT,,,1581,1027.65,,1391.28,88,,1113.02,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,1581,100,,1264.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",996.03,63,,796.82,,,0,"percent of total billed charges","63% of total billed charges",241.89,15.3,,193.51,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,1090.89,69,,,,,0,"fee schedule","69% of total billed charges",1581,100,,1264.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1581,100,,1264.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1581,100,,1264.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",596.04,37.7,,476.83,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1233.18,78,,986.54,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1305.91,82.6,,1044.73,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1305.91,82.6,,1044.73,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,1581,100,,1264.80,,,0,"percent of total billed charges","100% of total billed charges",241.89,11498.59,
"28666 Percutaneous skeletal fixation of interphala",7962246,CDM,521,RC,28666,CPT,OUTPATIENT,,,487,316.55,,428.56,88,,342.85,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,487,100,,389.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4929.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",306.81,63,,245.45,,,0,"percent of total billed charges","63% of total billed charges",74.51,15.3,,59.61,,,0,"percent of total billed charges","15.3% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,336.03,69,,,,,0,"fee schedule","69% of total billed charges",487,100,,389.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",487,100,,389.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",487,100,,389.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4881.8,100,,,,,0,"fee schedule",EAPG,6221.9,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",183.6,37.7,,146.88,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",379.86,78,,303.89,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.26,82.6,,321.81,,,0,"percent of total billed charges","82.6% of total billed charges",4786.08,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.26,82.6,,321.81,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4946.61,100,,,,,0,"fee schedule",EAPG,487,100,,389.60,,,0,"percent of total billed charges","100% of total billed charges",74.51,11498.59,
"28705 Arthrodesis; pantalar",7963890,CDM,521,RC,28705,CPT,OUTPATIENT,,,3054,1985.1,,2687.52,88,,2150.02,,,0,"percent of total billed charges","88% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,3054,100,,2443.20,,,0,"percent of total billed charges","100% of total billed charges",33264.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",4853.4,100,,,,,0,"fee schedule",EAPG,19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1924.02,63,,1539.22,,,0,"percent of total billed charges","63% of total billed charges",467.26,15.3,,373.81,,,0,"percent of total billed charges","15.3% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,2107.26,69,,,,,0,"fee schedule","69% of total billed charges",3054,100,,2443.20,,,0,"percent of total billed charges","100% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3054,100,,2443.20,,,0,"percent of total billed charges","100% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3054,100,,2443.20,,,0,"percent of total billed charges","100% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS fee schedule",64464.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16853.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4806.28,100,,,,,0,"fee schedule",EAPG,6125.66,100,,,,,0,"fee schedule",EAPG,19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1151.36,37.7,,921.09,,,0,"percent of total billed charges","37.70% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2382.12,78,,1905.70,,,0,"percent of total billed charges","78% of total billed charges",19198.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2522.6,82.6,,2018.08,,,0,"percent of total billed charges","82.6% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2522.6,82.6,,2018.08,,,0,"percent of total billed charges","82.6% of total billed charges",19008.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4872.57,100,,,,,0,"fee schedule",EAPG,3054,100,,2443.20,,,0,"percent of total billed charges","100% of total billed charges",467.26,64464.78,
"28715 Arthrodesis; triple",7963907,CDM,521,RC,28715,CPT,OUTPATIENT,,,4667,3033.55,,4106.96,88,,3285.57,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,4667,100,,3733.60,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",4853.4,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2940.21,63,,2352.17,,,0,"percent of total billed charges","63% of total billed charges",714.05,15.3,,571.24,,,0,"percent of total billed charges","15.3% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,3220.23,69,,,,,0,"fee schedule","69% of total billed charges",4667,100,,3733.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4667,100,,3733.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4667,100,,3733.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4806.28,100,,,,,0,"fee schedule",EAPG,6125.66,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1759.46,37.7,,1407.57,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3640.26,78,,2912.21,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3854.94,82.6,,3083.95,,,0,"percent of total billed charges","82.6% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3854.94,82.6,,3083.95,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4872.57,100,,,,,0,"fee schedule",EAPG,4667,100,,3733.60,,,0,"percent of total billed charges","100% of total billed charges",714.05,50029.1,
"28725 Arthrodesis; subtalar",7963891,CDM,521,RC,28725,CPT,OUTPATIENT,,,3207,2084.55,,2822.16,88,,2257.73,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,3207,100,,2565.60,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",4853.4,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2020.41,63,,1616.33,,,0,"percent of total billed charges","63% of total billed charges",490.67,15.3,,392.54,,,0,"percent of total billed charges","15.3% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,2212.83,69,,,,,0,"fee schedule","69% of total billed charges",3207,100,,2565.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3207,100,,2565.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3207,100,,2565.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4806.28,100,,,,,0,"fee schedule",EAPG,6125.66,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1209.04,37.7,,967.23,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2501.46,78,,2001.17,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2648.98,82.6,,2119.18,,,0,"percent of total billed charges","82.6% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2648.98,82.6,,2119.18,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4872.57,100,,,,,0,"fee schedule",EAPG,3207,100,,2565.60,,,0,"percent of total billed charges","100% of total billed charges",490.67,50029.1,
"28730 Arthrodesis, midtarsal or tarsometatarsal, m",7962934,CDM,521,RC,28730,CPT,OUTPATIENT,,,3095,2011.75,,2723.6,88,,2178.88,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,3095,100,,2476.00,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",4853.4,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1949.85,63,,1559.88,,,0,"percent of total billed charges","63% of total billed charges",473.54,15.3,,378.83,,,0,"percent of total billed charges","15.3% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,2135.55,69,,,,,0,"fee schedule","69% of total billed charges",3095,100,,2476.00,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3095,100,,2476.00,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3095,100,,2476.00,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4806.28,100,,,,,0,"fee schedule",EAPG,6125.66,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1166.82,37.7,,933.46,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2414.1,78,,1931.28,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2556.47,82.6,,2045.18,,,0,"percent of total billed charges","82.6% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2556.47,82.6,,2045.18,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4872.57,100,,,,,0,"fee schedule",EAPG,3095,100,,2476.00,,,0,"percent of total billed charges","100% of total billed charges",473.54,50029.1,
"28740 Arthrodesis, midtarsal or tarsometatarsal, s",7963249,CDM,521,RC,28740,CPT,OUTPATIENT,,,2396,1557.4,,2108.48,88,,1686.78,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,2396,100,,1916.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4853.4,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1509.48,63,,1207.58,,,0,"percent of total billed charges","63% of total billed charges",366.59,15.3,,293.27,,,0,"percent of total billed charges","15.3% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,1653.24,69,,,,,0,"fee schedule","69% of total billed charges",2396,100,,1916.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2396,100,,1916.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2396,100,,1916.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4806.28,100,,,,,0,"fee schedule",EAPG,6125.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",903.29,37.7,,722.63,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1868.88,78,,1495.10,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1979.1,82.6,,1583.28,,,0,"percent of total billed charges","82.6% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1979.1,82.6,,1583.28,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4872.57,100,,,,,0,"fee schedule",EAPG,2396,100,,1916.80,,,0,"percent of total billed charges","100% of total billed charges",366.59,25451.55,
"28750 Arthrodesis, great toe; metatarsophalangeal",7963407,CDM,521,RC,28750,CPT,OUTPATIENT,,,2548,1656.2,,2242.24,88,,1793.79,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,2548,100,,2038.40,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4853.4,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1605.24,63,,1284.19,,,0,"percent of total billed charges","63% of total billed charges",389.84,15.3,,311.87,,,0,"percent of total billed charges","15.3% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,1758.12,69,,,,,0,"fee schedule","69% of total billed charges",2548,100,,2038.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2548,100,,2038.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2548,100,,2038.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4806.28,100,,,,,0,"fee schedule",EAPG,6125.66,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",960.6,37.7,,768.48,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1987.44,78,,1589.95,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.65,82.6,,1683.72,,,0,"percent of total billed charges","82.6% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.65,82.6,,1683.72,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4872.57,100,,,,,0,"fee schedule",EAPG,2548,100,,2038.40,,,0,"percent of total billed charges","100% of total billed charges",389.84,25451.55,
"28755 Arthrodesis, great toe; interphalangeal join",7963481,CDM,521,RC,28755,CPT,OUTPATIENT,,,1501,975.65,,1320.88,88,,1056.70,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1501,100,,1200.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",945.63,63,,756.50,,,0,"percent of total billed charges","63% of total billed charges",229.65,15.3,,183.72,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,1035.69,69,,,,,0,"fee schedule","69% of total billed charges",1501,100,,1200.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1501,100,,1200.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1501,100,,1200.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",565.88,37.7,,452.70,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1170.78,78,,936.62,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.83,82.6,,991.86,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.83,82.6,,991.86,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1501,100,,1200.80,,,0,"percent of total billed charges","100% of total billed charges",229.65,25451.55,
"28800 Amputation, foot; midtarsal (eg, Chopart typ",7963221,CDM,521,RC,28800,CPT,OUTPATIENT,,,2389,1552.85,,2102.32,88,,1681.86,,,0,"percent of total billed charges","88% of total billed charges",2389,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4712.04,100,,,,,0,"fee schedule",EAPG,2389,100,,1911.20,,,0,"percent of total billed charges","100% of total billed charges",2389,175,,,,,0,"fee schedule","175% of CMS fee schedule",4853.4,100,,,,,0,"fee schedule",EAPG,2389,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1505.07,63,,1204.06,,,0,"percent of total billed charges","63% of total billed charges",365.52,15.3,,292.42,,,0,"percent of total billed charges","15.3% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,1648.41,69,,,,,0,"fee schedule","69% of total billed charges",2389,100,,1911.20,,,0,"percent of total billed charges","100% of total billed charges",2389,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2389,100,,1911.20,,,0,"percent of total billed charges","100% of total billed charges",2389,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2389,100,,1911.20,,,0,"percent of total billed charges","100% of total billed charges",2389,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,2389,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2389,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4806.28,100,,,,,0,"fee schedule",EAPG,6125.66,100,,,,,0,"fee schedule",EAPG,2389,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",900.65,37.7,,720.52,,,0,"percent of total billed charges","37.70% of total billed charges",2389,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2389,100,,,,,0,"fee schedule","100% of CMS fee schedule",1863.42,78,,1490.74,,,0,"percent of total billed charges","78% of total billed charges",2389,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1973.31,82.6,,1578.65,,,0,"percent of total billed charges","82.6% of total billed charges",4712.04,100,,,,,0,"fee schedule","100% of WA fee schedule",2389,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1973.31,82.6,,1578.65,,,0,"percent of total billed charges","82.6% of total billed charges",2389,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4872.57,100,,,,,0,"fee schedule",EAPG,2389,100,,1911.20,,,0,"percent of total billed charges","100% of total billed charges",365.52,11498.59,
"28805 Amputation, foot; transmetatarsal",7963705,CDM,521,RC,28805,CPT,OUTPATIENT,,,2425,1576.25,,2134,88,,1707.20,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,2425,100,,1940.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4853.4,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1527.75,63,,1222.20,,,0,"percent of total billed charges","63% of total billed charges",371.03,15.3,,296.82,,,0,"percent of total billed charges","15.3% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,1673.25,69,,,,,0,"fee schedule","69% of total billed charges",2425,100,,1940.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2425,100,,1940.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2425,100,,1940.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4806.28,100,,,,,0,"fee schedule",EAPG,6125.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",914.23,37.7,,731.38,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1891.5,78,,1513.20,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2003.05,82.6,,1602.44,,,0,"percent of total billed charges","82.6% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2003.05,82.6,,1602.44,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4872.57,100,,,,,0,"fee schedule",EAPG,2425,100,,1940.00,,,0,"percent of total billed charges","100% of total billed charges",371.03,11498.59,
"28810 Amputation, metatarsal, with toe, single",7963581,CDM,521,RC,28810,CPT,OUTPATIENT,,,1640,1066,,1443.2,88,,1154.56,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,1640,100,,1312.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",4853.4,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033.2,63,,826.56,,,0,"percent of total billed charges","63% of total billed charges",250.92,15.3,,200.74,,,0,"percent of total billed charges","15.3% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,1131.6,69,,,,,0,"fee schedule","69% of total billed charges",1640,100,,1312.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1640,100,,1312.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1640,100,,1312.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4712.04,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4806.28,100,,,,,0,"fee schedule",EAPG,6125.66,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",618.28,37.7,,494.62,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1279.2,78,,1023.36,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1354.64,82.6,,1083.71,,,0,"percent of total billed charges","82.6% of total billed charges",4712.04,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1354.64,82.6,,1083.71,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4872.57,100,,,,,0,"fee schedule",EAPG,1640,100,,1312.00,,,0,"percent of total billed charges","100% of total billed charges",250.92,11498.59,
"28820 Amputation, toe; metatarsophalangeal joint",7963541,CDM,521,RC,28820,CPT,OUTPATIENT,,,1416,920.4,,1246.08,88,,996.86,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1416,100,,1132.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.08,63,,713.66,,,0,"percent of total billed charges","63% of total billed charges",216.65,15.3,,173.32,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,977.04,69,,,,,0,"fee schedule","69% of total billed charges",1416,100,,1132.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1416,100,,1132.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1416,100,,1132.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",533.83,37.7,,427.06,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1104.48,78,,883.58,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1169.62,82.6,,935.70,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1169.62,82.6,,935.70,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1416,100,,1132.80,,,0,"percent of total billed charges","100% of total billed charges",216.65,11498.59,
"28825 Amputation, toe; interphalangeal joint",7963622,CDM,521,RC,28825,CPT,OUTPATIENT,,,1332,865.8,,1172.16,88,,937.73,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1332,100,,1065.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",839.16,63,,671.33,,,0,"percent of total billed charges","63% of total billed charges",203.8,15.3,,163.04,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,919.08,69,,,,,0,"fee schedule","69% of total billed charges",1332,100,,1065.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1332,100,,1065.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1332,100,,1065.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",502.16,37.7,,401.73,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1038.96,78,,831.17,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1100.23,82.6,,880.18,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1100.23,82.6,,880.18,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1332,100,,1065.60,,,0,"percent of total billed charges","100% of total billed charges",203.8,11498.59,
"29065 Application, cast; shoulder to hand (long ar",7903259,CDM,521,RC,29065,CPT,OUTPATIENT,,,248,161.2,,218.24,88,,174.59,,,0,"percent of total billed charges","88% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",479.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",174.75,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",156.24,63,,124.99,,,0,"percent of total billed charges","63% of total billed charges",37.94,15.3,,30.35,,,0,"percent of total billed charges","15.3% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,171.12,69,,,,,0,"fee schedule","69% of total billed charges",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",979.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.06,100,,,,,0,"fee schedule",EAPG,220.57,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",93.5,37.7,,74.80,,,0,"percent of total billed charges","37.70% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",193.44,78,,154.75,,,0,"percent of total billed charges","78% of total billed charges",276.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",204.85,82.6,,163.88,,,0,"percent of total billed charges","82.6% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",204.85,82.6,,163.88,,,0,"percent of total billed charges","82.6% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.19,100,,,,,0,"fee schedule",EAPG,248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",37.94,979.75,
"29075 Application, cast; elbow to finger (short ar",7903146,CDM,521,RC,29075,CPT,OUTPATIENT,,,211,137.15,,185.68,88,,148.54,,,0,"percent of total billed charges","88% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",479.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",174.75,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.93,63,,106.34,,,0,"percent of total billed charges","63% of total billed charges",32.28,15.3,,25.82,,,0,"percent of total billed charges","15.3% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,145.59,69,,,,,0,"fee schedule","69% of total billed charges",211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",979.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.06,100,,,,,0,"fee schedule",EAPG,220.57,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",79.55,37.7,,63.64,,,0,"percent of total billed charges","37.70% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",164.58,78,,131.66,,,0,"percent of total billed charges","78% of total billed charges",276.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",174.29,82.6,,139.43,,,0,"percent of total billed charges","82.6% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",174.29,82.6,,139.43,,,0,"percent of total billed charges","82.6% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.19,100,,,,,0,"fee schedule",EAPG,211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",32.28,979.75,
"29085 Application, cast; hand and lower forearm (g",7963325,CDM,521,RC,29085,CPT,OUTPATIENT,,,208,135.2,,183.04,88,,146.43,,,0,"percent of total billed charges","88% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,208,100,,166.40,,,0,"percent of total billed charges","100% of total billed charges",281.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",174.75,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",131.04,63,,104.83,,,0,"percent of total billed charges","63% of total billed charges",31.82,15.3,,25.46,,,0,"percent of total billed charges","15.3% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,143.52,69,,,,,0,"fee schedule","69% of total billed charges",208,100,,166.40,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",208,100,,166.40,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",208,100,,166.40,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",573.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",149.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.06,100,,,,,0,"fee schedule",EAPG,220.57,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",78.42,37.7,,62.74,,,0,"percent of total billed charges","37.70% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",162.24,78,,129.79,,,0,"percent of total billed charges","78% of total billed charges",162.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.81,82.6,,137.45,,,0,"percent of total billed charges","82.6% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.81,82.6,,137.45,,,0,"percent of total billed charges","82.6% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.19,100,,,,,0,"fee schedule",EAPG,208,100,,166.40,,,0,"percent of total billed charges","100% of total billed charges",31.82,573.54,
"29125 Application of short arm splint (forearm to",7903149,CDM,521,RC,29125,CPT,OUTPATIENT,,,119,77.35,,104.72,88,,83.78,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.34,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.97,63,,59.98,,,0,"percent of total billed charges","63% of total billed charges",18.21,15.3,,14.57,,,0,"percent of total billed charges","15.3% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,82.11,69,,,,,0,"fee schedule","69% of total billed charges",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.94,100,,,,,0,"fee schedule",EAPG,50.91,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.82,78,,74.26,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.69,100,,,,,0,"fee schedule",EAPG,119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",18.21,454.8,
"29130 Application of finger splint static",7903150,CDM,521,RC,29130,CPT,OUTPATIENT,,,73,47.45,,64.24,88,,51.39,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.34,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",45.99,63,,36.79,,,0,"percent of total billed charges","63% of total billed charges",11.17,15.3,,8.94,,,0,"percent of total billed charges","15.3% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,50.37,69,,,,,0,"fee schedule","69% of total billed charges",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.94,100,,,,,0,"fee schedule",EAPG,50.91,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",27.52,37.7,,22.02,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",56.94,78,,45.55,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.69,100,,,,,0,"fee schedule",EAPG,73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",11.17,454.8,
"29131 Application of finger splint; dynamic",7963640,CDM,521,RC,29131,CPT,OUTPATIENT,,,74,48.1,,65.12,88,,52.10,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.34,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.62,63,,37.30,,,0,"percent of total billed charges","63% of total billed charges",11.32,15.3,,9.06,,,0,"percent of total billed charges","15.3% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,51.06,69,,,,,0,"fee schedule","69% of total billed charges",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.94,100,,,,,0,"fee schedule",EAPG,50.91,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",27.9,37.7,,22.32,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",57.72,78,,46.18,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.12,82.6,,48.90,,,0,"percent of total billed charges","82.6% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.12,82.6,,48.90,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.69,100,,,,,0,"fee schedule",EAPG,74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",11.32,226.12,
"29240 Strapping, shoulder",7963908,CDM,521,RC,29240,CPT,OUTPATIENT,,,102,66.3,,89.76,88,,71.81,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.34,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.26,63,,51.41,,,0,"percent of total billed charges","63% of total billed charges",15.61,15.3,,12.49,,,0,"percent of total billed charges","15.3% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,70.38,69,,,,,0,"fee schedule","69% of total billed charges",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.94,100,,,,,0,"fee schedule",EAPG,50.91,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.45,37.7,,30.76,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",79.56,78,,63.65,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",84.25,82.6,,67.40,,,0,"percent of total billed charges","82.6% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",84.25,82.6,,67.40,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.69,100,,,,,0,"fee schedule",EAPG,102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",15.61,454.8,
"29260 Strapping; elbow or wrist",7963849,CDM,521,RC,29260,CPT,OUTPATIENT,,,92,59.8,,80.96,88,,64.77,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,92,100,,73.60,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.34,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",57.96,63,,46.37,,,0,"percent of total billed charges","63% of total billed charges",14.08,15.3,,11.26,,,0,"percent of total billed charges","15.3% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,63.48,69,,,,,0,"fee schedule","69% of total billed charges",92,100,,73.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92,100,,73.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92,100,,73.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.94,100,,,,,0,"fee schedule",EAPG,50.91,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",34.68,37.7,,27.74,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",71.76,78,,57.41,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75.99,82.6,,60.79,,,0,"percent of total billed charges","82.6% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75.99,82.6,,60.79,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.69,100,,,,,0,"fee schedule",EAPG,92,100,,73.60,,,0,"percent of total billed charges","100% of total billed charges",14.08,226.12,
"29280 Strapping; hand or finger",7963831,CDM,521,RC,29280,CPT,OUTPATIENT,,,85,55.25,,74.8,88,,59.84,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.34,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",53.55,63,,42.84,,,0,"percent of total billed charges","63% of total billed charges",13.01,15.3,,10.41,,,0,"percent of total billed charges","15.3% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,58.65,69,,,,,0,"fee schedule","69% of total billed charges",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.94,100,,,,,0,"fee schedule",EAPG,50.91,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",32.05,37.7,,25.64,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.3,78,,53.04,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",70.21,82.6,,56.17,,,0,"percent of total billed charges","82.6% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",70.21,82.6,,56.17,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.69,100,,,,,0,"fee schedule",EAPG,85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",13.01,226.12,
"29305 Application of Hip Cast",8165579,CDM,521,RC,29305,CPT,OUTPATIENT,,,1039,675.35,,914.32,88,,731.46,,,0,"percent of total billed charges","88% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,1039,100,,831.20,,,0,"percent of total billed charges","100% of total billed charges",479.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",174.75,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",654.57,63,,523.66,,,0,"percent of total billed charges","63% of total billed charges",158.97,15.3,,127.18,,,0,"percent of total billed charges","15.3% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,716.91,69,,,,,0,"fee schedule","69% of total billed charges",1039,100,,831.20,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1039,100,,831.20,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1039,100,,831.20,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",979.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.06,100,,,,,0,"fee schedule",EAPG,220.57,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",391.7,37.7,,313.36,,,0,"percent of total billed charges","37.70% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",810.42,78,,648.34,,,0,"percent of total billed charges","78% of total billed charges",276.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.21,82.6,,686.57,,,0,"percent of total billed charges","82.6% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.21,82.6,,686.57,,,0,"percent of total billed charges","82.6% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.19,100,,,,,0,"fee schedule",EAPG,1039,100,,831.20,,,0,"percent of total billed charges","100% of total billed charges",158.97,1039,
"29325 Application of hip spica cast; 1 and one-hal",7962995,CDM,521,RC,29325,CPT,OUTPATIENT,,,804,522.6,,707.52,88,,566.02,,,0,"percent of total billed charges","88% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,804,100,,643.20,,,0,"percent of total billed charges","100% of total billed charges",479.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",174.75,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",506.52,63,,405.22,,,0,"percent of total billed charges","63% of total billed charges",123.01,15.3,,98.41,,,0,"percent of total billed charges","15.3% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,554.76,69,,,,,0,"fee schedule","69% of total billed charges",804,100,,643.20,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",804,100,,643.20,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",804,100,,643.20,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",979.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.06,100,,,,,0,"fee schedule",EAPG,220.57,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",303.11,37.7,,242.49,,,0,"percent of total billed charges","37.70% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",627.12,78,,501.70,,,0,"percent of total billed charges","78% of total billed charges",276.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",664.1,82.6,,531.28,,,0,"percent of total billed charges","82.6% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",664.1,82.6,,531.28,,,0,"percent of total billed charges","82.6% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.19,100,,,,,0,"fee schedule",EAPG,804,100,,643.20,,,0,"percent of total billed charges","100% of total billed charges",123.01,979.75,
"29345 Application of long leg cast (thigh to toes)",7963482,CDM,521,RC,29345,CPT,OUTPATIENT,,,319,207.35,,280.72,88,,224.58,,,0,"percent of total billed charges","88% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,319,100,,255.20,,,0,"percent of total billed charges","100% of total billed charges",479.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",174.75,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200.97,63,,160.78,,,0,"percent of total billed charges","63% of total billed charges",48.81,15.3,,39.05,,,0,"percent of total billed charges","15.3% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,220.11,69,,,,,0,"fee schedule","69% of total billed charges",319,100,,255.20,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",319,100,,255.20,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",319,100,,255.20,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",979.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.06,100,,,,,0,"fee schedule",EAPG,220.57,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",120.26,37.7,,96.21,,,0,"percent of total billed charges","37.70% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",248.82,78,,199.06,,,0,"percent of total billed charges","78% of total billed charges",276.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",263.49,82.6,,210.79,,,0,"percent of total billed charges","82.6% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",263.49,82.6,,210.79,,,0,"percent of total billed charges","82.6% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.19,100,,,,,0,"fee schedule",EAPG,319,100,,255.20,,,0,"percent of total billed charges","100% of total billed charges",48.81,979.75,
"29365 Application of cylinder cast (thigh to ankle",7903263,CDM,521,RC,29365,CPT,OUTPATIENT,,,352,228.8,,309.76,88,,247.81,,,0,"percent of total billed charges","88% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,352,100,,281.60,,,0,"percent of total billed charges","100% of total billed charges",479.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",174.75,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.76,63,,177.41,,,0,"percent of total billed charges","63% of total billed charges",53.86,15.3,,43.09,,,0,"percent of total billed charges","15.3% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,242.88,69,,,,,0,"fee schedule","69% of total billed charges",352,100,,281.60,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352,100,,281.60,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352,100,,281.60,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",979.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.06,100,,,,,0,"fee schedule",EAPG,220.57,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",132.7,37.7,,106.16,,,0,"percent of total billed charges","37.70% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",274.56,78,,219.65,,,0,"percent of total billed charges","78% of total billed charges",276.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.75,82.6,,232.60,,,0,"percent of total billed charges","82.6% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.75,82.6,,232.60,,,0,"percent of total billed charges","82.6% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.19,100,,,,,0,"fee schedule",EAPG,352,100,,281.60,,,0,"percent of total billed charges","100% of total billed charges",53.86,979.75,
"29405 Application of short leg cast (below knee to",7963359,CDM,521,RC,29405,CPT,OUTPATIENT,,,236,153.4,,207.68,88,,166.14,,,0,"percent of total billed charges","88% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,236,100,,188.80,,,0,"percent of total billed charges","100% of total billed charges",479.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",174.75,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.68,63,,118.94,,,0,"percent of total billed charges","63% of total billed charges",36.11,15.3,,28.89,,,0,"percent of total billed charges","15.3% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,162.84,69,,,,,0,"fee schedule","69% of total billed charges",236,100,,188.80,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",236,100,,188.80,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",236,100,,188.80,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",979.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.06,100,,,,,0,"fee schedule",EAPG,220.57,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",88.97,37.7,,71.18,,,0,"percent of total billed charges","37.70% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",184.08,78,,147.26,,,0,"percent of total billed charges","78% of total billed charges",276.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",194.94,82.6,,155.95,,,0,"percent of total billed charges","82.6% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",194.94,82.6,,155.95,,,0,"percent of total billed charges","82.6% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.19,100,,,,,0,"fee schedule",EAPG,236,100,,188.80,,,0,"percent of total billed charges","100% of total billed charges",36.11,979.75,
"29450 Application of clubfoot cast with molding or",7962597,CDM,521,RC,29450,CPT,OUTPATIENT,,,207,134.55,,182.16,88,,145.73,,,0,"percent of total billed charges","88% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",281.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",174.75,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",130.41,63,,104.33,,,0,"percent of total billed charges","63% of total billed charges",31.67,15.3,,25.34,,,0,"percent of total billed charges","15.3% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,142.83,69,,,,,0,"fee schedule","69% of total billed charges",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",573.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",149.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.06,100,,,,,0,"fee schedule",EAPG,220.57,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",78.04,37.7,,62.43,,,0,"percent of total billed charges","37.70% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",161.46,78,,129.17,,,0,"percent of total billed charges","78% of total billed charges",162.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",170.98,82.6,,136.78,,,0,"percent of total billed charges","82.6% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",170.98,82.6,,136.78,,,0,"percent of total billed charges","82.6% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.19,100,,,,,0,"fee schedule",EAPG,207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",31.67,573.54,
"29505 Application of long leg splint (thigh to ank",7903267,CDM,521,RC,29505,CPT,OUTPATIENT,,,155,100.75,,136.4,88,,109.12,,,0,"percent of total billed charges","88% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",281.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.34,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",97.65,63,,78.12,,,0,"percent of total billed charges","63% of total billed charges",23.72,15.3,,18.98,,,0,"percent of total billed charges","15.3% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,106.95,69,,,,,0,"fee schedule","69% of total billed charges",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",573.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",149.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.94,100,,,,,0,"fee schedule",EAPG,50.91,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",58.44,37.7,,46.75,,,0,"percent of total billed charges","37.70% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",120.9,78,,96.72,,,0,"percent of total billed charges","78% of total billed charges",162.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",128.03,82.6,,102.42,,,0,"percent of total billed charges","82.6% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.69,100,,,,,0,"fee schedule",EAPG,155,100,,124.00,,,0,"percent of total billed charges","100% of total billed charges",23.72,573.54,
"29515 Application of short leg splint (calf to foo",7903152,CDM,521,RC,29515,CPT,OUTPATIENT,,,133,86.45,,117.04,88,,93.63,,,0,"percent of total billed charges","88% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,133,100,,106.40,,,0,"percent of total billed charges","100% of total billed charges",281.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.34,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",83.79,63,,67.03,,,0,"percent of total billed charges","63% of total billed charges",20.35,15.3,,16.28,,,0,"percent of total billed charges","15.3% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,91.77,69,,,,,0,"fee schedule","69% of total billed charges",133,100,,106.40,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",133,100,,106.40,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",133,100,,106.40,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",573.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",149.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.94,100,,,,,0,"fee schedule",EAPG,50.91,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",50.14,37.7,,40.11,,,0,"percent of total billed charges","37.70% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",103.74,78,,82.99,,,0,"percent of total billed charges","78% of total billed charges",162.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.86,82.6,,87.89,,,0,"percent of total billed charges","82.6% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.86,82.6,,87.89,,,0,"percent of total billed charges","82.6% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.69,100,,,,,0,"fee schedule",EAPG,133,100,,106.40,,,0,"percent of total billed charges","100% of total billed charges",20.35,573.54,
"29540 Strapping; ankle and/or foot",7903153,CDM,521,RC,29540,CPT,OUTPATIENT,,,70,45.5,,61.6,88,,49.28,,,0,"percent of total billed charges","88% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",281.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.34,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",44.1,63,,35.28,,,0,"percent of total billed charges","63% of total billed charges",10.71,15.3,,8.57,,,0,"percent of total billed charges","15.3% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,48.3,69,,,,,0,"fee schedule","69% of total billed charges",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",573.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",149.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.94,100,,,,,0,"fee schedule",EAPG,50.91,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",26.39,37.7,,21.11,,,0,"percent of total billed charges","37.70% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",54.6,78,,43.68,,,0,"percent of total billed charges","78% of total billed charges",162.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",57.82,82.6,,46.26,,,0,"percent of total billed charges","82.6% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",57.82,82.6,,46.26,,,0,"percent of total billed charges","82.6% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.69,100,,,,,0,"fee schedule",EAPG,70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",10.71,573.54,
"29550 Strapping; toes",7903154,CDM,521,RC,29550,CPT,OUTPATIENT,,,80,52,,70.4,88,,56.32,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.34,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",50.4,63,,40.32,,,0,"percent of total billed charges","63% of total billed charges",12.24,15.3,,9.79,,,0,"percent of total billed charges","15.3% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,55.2,69,,,,,0,"fee schedule","69% of total billed charges",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.94,100,,,,,0,"fee schedule",EAPG,50.91,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",30.16,37.7,,24.13,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",62.4,78,,49.92,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.08,82.6,,52.86,,,0,"percent of total billed charges","82.6% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.08,82.6,,52.86,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.69,100,,,,,0,"fee schedule",EAPG,80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",12.24,226.12,
"29580 Strapping; Unna boot",7903155,CDM,521,RC,29580,CPT,OUTPATIENT,,,115,74.75,,101.2,88,,80.96,,,0,"percent of total billed charges","88% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",281.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",174.75,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",72.45,63,,57.96,,,0,"percent of total billed charges","63% of total billed charges",17.6,15.3,,14.08,,,0,"percent of total billed charges","15.3% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,79.35,69,,,,,0,"fee schedule","69% of total billed charges",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",573.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",149.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.06,100,,,,,0,"fee schedule",EAPG,220.57,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",43.36,37.7,,34.69,,,0,"percent of total billed charges","37.70% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",89.7,78,,71.76,,,0,"percent of total billed charges","78% of total billed charges",162.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",94.99,82.6,,75.99,,,0,"percent of total billed charges","82.6% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",94.99,82.6,,75.99,,,0,"percent of total billed charges","82.6% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.19,100,,,,,0,"fee schedule",EAPG,115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",17.6,573.54,
"29581 Application Multilayer Compression System; B",7963301,CDM,521,RC,29581,CPT,OUTPATIENT,,,104,67.6,,91.52,88,,73.22,,,0,"percent of total billed charges","88% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",281.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",174.75,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.52,63,,52.42,,,0,"percent of total billed charges","63% of total billed charges",15.91,15.3,,12.73,,,0,"percent of total billed charges","15.3% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,71.76,69,,,,,0,"fee schedule","69% of total billed charges",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",573.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",149.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.06,100,,,,,0,"fee schedule",EAPG,220.57,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",39.21,37.7,,31.37,,,0,"percent of total billed charges","37.70% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",81.12,78,,64.90,,,0,"percent of total billed charges","78% of total billed charges",162.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.9,82.6,,68.72,,,0,"percent of total billed charges","82.6% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.9,82.6,,68.72,,,0,"percent of total billed charges","82.6% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.19,100,,,,,0,"fee schedule",EAPG,104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",15.91,573.54,
"29700 Removal or bivalving; gauntlet, boot or body",7903270,CDM,521,RC,29700,CPT,OUTPATIENT,,,104,67.6,,91.52,88,,73.22,,,0,"percent of total billed charges","88% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",479.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",174.75,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.52,63,,52.42,,,0,"percent of total billed charges","63% of total billed charges",15.91,15.3,,12.73,,,0,"percent of total billed charges","15.3% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,71.76,69,,,,,0,"fee schedule","69% of total billed charges",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",979.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.06,100,,,,,0,"fee schedule",EAPG,220.57,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",39.21,37.7,,31.37,,,0,"percent of total billed charges","37.70% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",81.12,78,,64.90,,,0,"percent of total billed charges","78% of total billed charges",276.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.9,82.6,,68.72,,,0,"percent of total billed charges","82.6% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.9,82.6,,68.72,,,0,"percent of total billed charges","82.6% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.19,100,,,,,0,"fee schedule",EAPG,104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",15.91,979.75,
"29805 Arthroscopy, shoulder, diagnostic, with or w",7962177,CDM,521,RC,29805,CPT,OUTPATIENT,,,997,648.05,,877.36,88,,701.89,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,997,100,,797.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2074.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",628.11,63,,502.49,,,0,"percent of total billed charges","63% of total billed charges",152.54,15.3,,122.03,,,0,"percent of total billed charges","15.3% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,687.93,69,,,,,0,"fee schedule","69% of total billed charges",997,100,,797.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",997,100,,797.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",997,100,,797.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054.4,100,,,,,0,"fee schedule",EAPG,2618.36,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",375.87,37.7,,300.70,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",777.66,78,,622.13,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",823.52,82.6,,658.82,,,0,"percent of total billed charges","82.6% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",823.52,82.6,,658.82,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2174.65,100,,,,,0,"fee schedule",EAPG,997,100,,797.60,,,0,"percent of total billed charges","100% of total billed charges",152.54,11498.59,
"29807 Arthroscopy, shoulder, surgical; repair of S",7963279,CDM,521,RC,29807,CPT,OUTPATIENT,,,2793,1815.45,,2457.84,88,,1966.27,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5038.03,100,,,,,0,"fee schedule",EAPG,2793,100,,2234.40,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",5189.17,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1759.59,63,,1407.67,,,0,"percent of total billed charges","63% of total billed charges",427.33,15.3,,341.86,,,0,"percent of total billed charges","15.3% of total billed charges",5038.03,100,,,,,0,"fee schedule",EAPG,1927.17,69,,,,,0,"fee schedule","69% of total billed charges",2793,100,,2234.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2793,100,,2234.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2793,100,,2234.40,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5038.03,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5138.79,100,,,,,0,"fee schedule",EAPG,6549.44,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1052.96,37.7,,842.37,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2178.54,78,,1742.83,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2307.02,82.6,,1845.62,,,0,"percent of total billed charges","82.6% of total billed charges",5038.03,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2307.02,82.6,,1845.62,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5198.56,100,,,,,0,"fee schedule",EAPG,2793,100,,2234.40,,,0,"percent of total billed charges","100% of total billed charges",427.33,25451.55,
"29806 Arthroscopy, shoulder, surgical; capsulorrha",7963448,CDM,521,RC,29806,CPT,OUTPATIENT,,,3016,1960.4,,2654.08,88,,2123.26,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5038.03,100,,,,,0,"fee schedule",EAPG,3016,100,,2412.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",5189.17,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1900.08,63,,1520.06,,,0,"percent of total billed charges","63% of total billed charges",461.45,15.3,,369.16,,,0,"percent of total billed charges","15.3% of total billed charges",5038.03,100,,,,,0,"fee schedule",EAPG,2081.04,69,,,,,0,"fee schedule","69% of total billed charges",3016,100,,2412.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3016,100,,2412.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3016,100,,2412.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5038.03,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5138.79,100,,,,,0,"fee schedule",EAPG,6549.44,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1137.03,37.7,,909.62,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2352.48,78,,1881.98,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2491.22,82.6,,1992.98,,,0,"percent of total billed charges","82.6% of total billed charges",5038.03,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2491.22,82.6,,1992.98,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5198.56,100,,,,,0,"fee schedule",EAPG,3016,100,,2412.80,,,0,"percent of total billed charges","100% of total billed charges",461.45,25451.55,
"29819 Arthroscopy, shoulder, surgical; with remova",7962632,CDM,521,RC,29819,CPT,OUTPATIENT,,,2270,1475.5,,1997.6,88,,1598.08,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,2270,100,,1816.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2074.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1430.1,63,,1144.08,,,0,"percent of total billed charges","63% of total billed charges",347.31,15.3,,277.85,,,0,"percent of total billed charges","15.3% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,1566.3,69,,,,,0,"fee schedule","69% of total billed charges",2270,100,,1816.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2270,100,,1816.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2270,100,,1816.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054.4,100,,,,,0,"fee schedule",EAPG,2618.36,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",855.79,37.7,,684.63,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1770.6,78,,1416.48,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1875.02,82.6,,1500.02,,,0,"percent of total billed charges","82.6% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1875.02,82.6,,1500.02,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2174.65,100,,,,,0,"fee schedule",EAPG,2270,100,,1816.00,,,0,"percent of total billed charges","100% of total billed charges",347.31,11498.59,
"29824 Arthroscopy, shoulder, surgical; distal clav",7961864,CDM,521,RC,29824,CPT,OUTPATIENT,,,1586,1030.9,,1395.68,88,,1116.54,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,1586,100,,1268.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2074.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",999.18,63,,799.34,,,0,"percent of total billed charges","63% of total billed charges",242.66,15.3,,194.13,,,0,"percent of total billed charges","15.3% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,1094.34,69,,,,,0,"fee schedule","69% of total billed charges",1586,100,,1268.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1586,100,,1268.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1586,100,,1268.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054.4,100,,,,,0,"fee schedule",EAPG,2618.36,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",597.92,37.7,,478.34,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1237.08,78,,989.66,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1310.04,82.6,,1048.03,,,0,"percent of total billed charges","82.6% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1310.04,82.6,,1048.03,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2174.65,100,,,,,0,"fee schedule",EAPG,1586,100,,1268.80,,,0,"percent of total billed charges","100% of total billed charges",242.66,11498.59,
"29825 Arthroscopy, shoulder, surgical; with lysis",7962178,CDM,521,RC,29825,CPT,OUTPATIENT,,,2368,1539.2,,2083.84,88,,1667.07,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,2368,100,,1894.40,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2074.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1491.84,63,,1193.47,,,0,"percent of total billed charges","63% of total billed charges",362.3,15.3,,289.84,,,0,"percent of total billed charges","15.3% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,1633.92,69,,,,,0,"fee schedule","69% of total billed charges",2368,100,,1894.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2368,100,,1894.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2368,100,,1894.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054.4,100,,,,,0,"fee schedule",EAPG,2618.36,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",892.74,37.7,,714.19,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1847.04,78,,1477.63,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.97,82.6,,1564.78,,,0,"percent of total billed charges","82.6% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.97,82.6,,1564.78,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2174.65,100,,,,,0,"fee schedule",EAPG,2368,100,,1894.40,,,0,"percent of total billed charges","100% of total billed charges",362.3,11498.59,
"29823 Arthroscopy, shoulder, surgical; debridement",7963250,CDM,521,RC,29823,CPT,OUTPATIENT,,,1451,943.15,,1276.88,88,,1021.50,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,1451,100,,1160.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2074.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",914.13,63,,731.30,,,0,"percent of total billed charges","63% of total billed charges",222,15.3,,177.60,,,0,"percent of total billed charges","15.3% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,1001.19,69,,,,,0,"fee schedule","69% of total billed charges",1451,100,,1160.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1451,100,,1160.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1451,100,,1160.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054.4,100,,,,,0,"fee schedule",EAPG,2618.36,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",547.03,37.7,,437.62,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1131.78,78,,905.42,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1198.53,82.6,,958.82,,,0,"percent of total billed charges","82.6% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1198.53,82.6,,958.82,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2174.65,100,,,,,0,"fee schedule",EAPG,1451,100,,1160.80,,,0,"percent of total billed charges","100% of total billed charges",222,11498.59,
"29820 Arthroscopy, shoulder, surgical; synovectomy",7963302,CDM,521,RC,29820,CPT,OUTPATIENT,,,2029,1318.85,,1785.52,88,,1428.42,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,2029,100,,1623.20,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",2074.54,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1278.27,63,,1022.62,,,0,"percent of total billed charges","63% of total billed charges",310.44,15.3,,248.35,,,0,"percent of total billed charges","15.3% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,1400.01,69,,,,,0,"fee schedule","69% of total billed charges",2029,100,,1623.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2029,100,,1623.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2029,100,,1623.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054.4,100,,,,,0,"fee schedule",EAPG,2618.36,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",764.93,37.7,,611.94,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1582.62,78,,1266.10,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1675.95,82.6,,1340.76,,,0,"percent of total billed charges","82.6% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1675.95,82.6,,1340.76,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2174.65,100,,,,,0,"fee schedule",EAPG,2029,100,,1623.20,,,0,"percent of total billed charges","100% of total billed charges",310.44,25451.55,
"29822 Arthroscopy, shoulder, surgical; debridement",7963303,CDM,521,RC,29822,CPT,OUTPATIENT,,,2270,1475.5,,1997.6,88,,1598.08,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,2270,100,,1816.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2074.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1430.1,63,,1144.08,,,0,"percent of total billed charges","63% of total billed charges",347.31,15.3,,277.85,,,0,"percent of total billed charges","15.3% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,1566.3,69,,,,,0,"fee schedule","69% of total billed charges",2270,100,,1816.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2270,100,,1816.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2270,100,,1816.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054.4,100,,,,,0,"fee schedule",EAPG,2618.36,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",855.79,37.7,,684.63,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1770.6,78,,1416.48,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1875.02,82.6,,1500.02,,,0,"percent of total billed charges","82.6% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1875.02,82.6,,1500.02,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2174.65,100,,,,,0,"fee schedule",EAPG,2270,100,,1816.00,,,0,"percent of total billed charges","100% of total billed charges",347.31,11498.59,
"29828 Arthroscopy, shoulder, surgical; biceps teno",7963408,CDM,521,RC,29828,CPT,OUTPATIENT,,,3069,1994.85,,2700.72,88,,2160.58,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5038.03,100,,,,,0,"fee schedule",EAPG,3069,100,,2455.20,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",5189.17,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1933.47,63,,1546.78,,,0,"percent of total billed charges","63% of total billed charges",469.56,15.3,,375.65,,,0,"percent of total billed charges","15.3% of total billed charges",5038.03,100,,,,,0,"fee schedule",EAPG,2117.61,69,,,,,0,"fee schedule","69% of total billed charges",3069,100,,2455.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3069,100,,2455.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3069,100,,2455.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5038.03,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5138.79,100,,,,,0,"fee schedule",EAPG,6549.44,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1157.01,37.7,,925.61,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2393.82,78,,1915.06,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2534.99,82.6,,2027.99,,,0,"percent of total billed charges","82.6% of total billed charges",5038.03,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2534.99,82.6,,2027.99,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5198.56,100,,,,,0,"fee schedule",EAPG,3069,100,,2455.20,,,0,"percent of total billed charges","100% of total billed charges",469.56,25451.55,
"29848 Endoscopy, wrist, surgical, with release of",7962808,CDM,521,RC,29848,CPT,OUTPATIENT,,,1454,945.1,,1279.52,88,,1023.62,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,1454,100,,1163.20,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",2074.54,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",916.02,63,,732.82,,,0,"percent of total billed charges","63% of total billed charges",222.46,15.3,,177.97,,,0,"percent of total billed charges","15.3% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,1003.26,69,,,,,0,"fee schedule","69% of total billed charges",1454,100,,1163.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1454,100,,1163.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1454,100,,1163.20,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054.4,100,,,,,0,"fee schedule",EAPG,2618.36,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",548.16,37.7,,438.53,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1134.12,78,,907.30,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1201,82.6,,960.80,,,0,"percent of total billed charges","82.6% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1201,82.6,,960.80,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2174.65,100,,,,,0,"fee schedule",EAPG,1454,100,,1163.20,,,0,"percent of total billed charges","100% of total billed charges",222.46,5656.45,
"29851 Arthroscopically aided tx of intercondylar/t",7961594,CDM,521,RC,29851,CPT,OUTPATIENT,,,2850,1852.5,,2508,88,,2006.40,,,0,"percent of total billed charges","88% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,2850,100,,2280.00,,,0,"percent of total billed charges","100% of total billed charges",2868.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",2074.54,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1795.5,63,,1436.40,,,0,"percent of total billed charges","63% of total billed charges",436.05,15.3,,348.84,,,0,"percent of total billed charges","15.3% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,1966.5,69,,,,,0,"fee schedule","69% of total billed charges",2850,100,,2280.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2850,100,,2280.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2850,100,,2280.00,,,0,"percent of total billed charges","100% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",5656.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1478.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054.4,100,,,,,0,"fee schedule",EAPG,2618.36,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1074.45,37.7,,859.56,,,0,"percent of total billed charges","37.70% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2223,78,,1778.40,,,0,"percent of total billed charges","78% of total billed charges",1655.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2354.1,82.6,,1883.28,,,0,"percent of total billed charges","82.6% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2354.1,82.6,,1883.28,,,0,"percent of total billed charges","82.6% of total billed charges",1639.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2174.65,100,,,,,0,"fee schedule",EAPG,2850,100,,2280.00,,,0,"percent of total billed charges","100% of total billed charges",436.05,5656.45,
"29862 Arthroscopy, hip, surgical; with debridement",7962122,CDM,521,RC,29862,CPT,OUTPATIENT,,,2110,1371.5,,1856.8,88,,1485.44,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5038.03,100,,,,,0,"fee schedule",EAPG,2110,100,,1688.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",5189.17,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1329.3,63,,1063.44,,,0,"percent of total billed charges","63% of total billed charges",322.83,15.3,,258.26,,,0,"percent of total billed charges","15.3% of total billed charges",5038.03,100,,,,,0,"fee schedule",EAPG,1455.9,69,,,,,0,"fee schedule","69% of total billed charges",2110,100,,1688.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2110,100,,1688.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2110,100,,1688.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5038.03,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5138.79,100,,,,,0,"fee schedule",EAPG,6549.44,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",795.47,37.7,,636.38,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.8,78,,1316.64,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1742.86,82.6,,1394.29,,,0,"percent of total billed charges","82.6% of total billed charges",5038.03,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1742.86,82.6,,1394.29,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5198.56,100,,,,,0,"fee schedule",EAPG,2110,100,,1688.00,,,0,"percent of total billed charges","100% of total billed charges",322.83,25451.55,
"29866 Arthroscopy, knee, surgical; osteochondral a",7962135,CDM,521,RC,29866,CPT,OUTPATIENT,,,2699,1754.35,,2375.12,88,,1900.10,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5038.03,100,,,,,0,"fee schedule",EAPG,2699,100,,2159.20,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",5189.17,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1700.37,63,,1360.30,,,0,"percent of total billed charges","63% of total billed charges",412.95,15.3,,330.36,,,0,"percent of total billed charges","15.3% of total billed charges",5038.03,100,,,,,0,"fee schedule",EAPG,1862.31,69,,,,,0,"fee schedule","69% of total billed charges",2699,100,,2159.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2699,100,,2159.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2699,100,,2159.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5038.03,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5138.79,100,,,,,0,"fee schedule",EAPG,6549.44,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1017.52,37.7,,814.02,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2105.22,78,,1684.18,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2229.37,82.6,,1783.50,,,0,"percent of total billed charges","82.6% of total billed charges",5038.03,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2229.37,82.6,,1783.50,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5198.56,100,,,,,0,"fee schedule",EAPG,2699,100,,2159.20,,,0,"percent of total billed charges","100% of total billed charges",412.95,25451.55,
"29879 Arthroscopy, knee, surgical; abrasion arthro",7961917,CDM,521,RC,29879,CPT,OUTPATIENT,,,2772,1801.8,,2439.36,88,,1951.49,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,2772,100,,2217.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2074.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1746.36,63,,1397.09,,,0,"percent of total billed charges","63% of total billed charges",424.12,15.3,,339.30,,,0,"percent of total billed charges","15.3% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,1912.68,69,,,,,0,"fee schedule","69% of total billed charges",2772,100,,2217.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2772,100,,2217.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2772,100,,2217.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054.4,100,,,,,0,"fee schedule",EAPG,2618.36,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1045.04,37.7,,836.03,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2162.16,78,,1729.73,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2289.67,82.6,,1831.74,,,0,"percent of total billed charges","82.6% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2289.67,82.6,,1831.74,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2174.65,100,,,,,0,"fee schedule",EAPG,2772,100,,2217.60,,,0,"percent of total billed charges","100% of total billed charges",424.12,11498.59,
"29877 Arthroscopy, knee, surgical; debridement/sha",7962179,CDM,521,RC,29877,CPT,OUTPATIENT,,,2490,1618.5,,2191.2,88,,1752.96,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,2490,100,,1992.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2074.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1568.7,63,,1254.96,,,0,"percent of total billed charges","63% of total billed charges",380.97,15.3,,304.78,,,0,"percent of total billed charges","15.3% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,1718.1,69,,,,,0,"fee schedule","69% of total billed charges",2490,100,,1992.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2490,100,,1992.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2490,100,,1992.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054.4,100,,,,,0,"fee schedule",EAPG,2618.36,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",938.73,37.7,,750.98,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1942.2,78,,1553.76,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2056.74,82.6,,1645.39,,,0,"percent of total billed charges","82.6% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2056.74,82.6,,1645.39,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2174.65,100,,,,,0,"fee schedule",EAPG,2490,100,,1992.00,,,0,"percent of total billed charges","100% of total billed charges",380.97,11498.59,
"29870 Arthroscopy, knee, diagnostic, with or witho",7962369,CDM,521,RC,29870,CPT,OUTPATIENT,,,1137,739.05,,1000.56,88,,800.45,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,1137,100,,909.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2074.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",716.31,63,,573.05,,,0,"percent of total billed charges","63% of total billed charges",173.96,15.3,,139.17,,,0,"percent of total billed charges","15.3% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,784.53,69,,,,,0,"fee schedule","69% of total billed charges",1137,100,,909.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1137,100,,909.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1137,100,,909.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054.4,100,,,,,0,"fee schedule",EAPG,2618.36,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",428.65,37.7,,342.92,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.86,78,,709.49,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",939.16,82.6,,751.33,,,0,"percent of total billed charges","82.6% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",939.16,82.6,,751.33,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2174.65,100,,,,,0,"fee schedule",EAPG,1137,100,,909.60,,,0,"percent of total billed charges","100% of total billed charges",173.96,11498.59,
"29875 Arthroscopy, knee, surgical; synovectomy, li",7962470,CDM,521,RC,29875,CPT,OUTPATIENT,,,2270,1475.5,,1997.6,88,,1598.08,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,2270,100,,1816.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2074.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1430.1,63,,1144.08,,,0,"percent of total billed charges","63% of total billed charges",347.31,15.3,,277.85,,,0,"percent of total billed charges","15.3% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,1566.3,69,,,,,0,"fee schedule","69% of total billed charges",2270,100,,1816.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2270,100,,1816.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2270,100,,1816.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054.4,100,,,,,0,"fee schedule",EAPG,2618.36,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",855.79,37.7,,684.63,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1770.6,78,,1416.48,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1875.02,82.6,,1500.02,,,0,"percent of total billed charges","82.6% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1875.02,82.6,,1500.02,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2174.65,100,,,,,0,"fee schedule",EAPG,2270,100,,1816.00,,,0,"percent of total billed charges","100% of total billed charges",347.31,11498.59,
"29876 Arthroscopy, knee, surgical; synovectomy, ma",7962774,CDM,521,RC,29876,CPT,OUTPATIENT,,,2767,1798.55,,2434.96,88,,1947.97,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,2767,100,,2213.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2074.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1743.21,63,,1394.57,,,0,"percent of total billed charges","63% of total billed charges",423.35,15.3,,338.68,,,0,"percent of total billed charges","15.3% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,1909.23,69,,,,,0,"fee schedule","69% of total billed charges",2767,100,,2213.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2767,100,,2213.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2767,100,,2213.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054.4,100,,,,,0,"fee schedule",EAPG,2618.36,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1043.16,37.7,,834.53,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2158.26,78,,1726.61,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2285.54,82.6,,1828.43,,,0,"percent of total billed charges","82.6% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2285.54,82.6,,1828.43,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2174.65,100,,,,,0,"fee schedule",EAPG,2767,100,,2213.60,,,0,"percent of total billed charges","100% of total billed charges",423.35,11498.59,
"29874 Arthroscopy, knee, surgical; for removal of",7962809,CDM,521,RC,29874,CPT,OUTPATIENT,,,2069,1344.85,,1820.72,88,,1456.58,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,2069,100,,1655.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2074.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1303.47,63,,1042.78,,,0,"percent of total billed charges","63% of total billed charges",316.56,15.3,,253.25,,,0,"percent of total billed charges","15.3% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,1427.61,69,,,,,0,"fee schedule","69% of total billed charges",2069,100,,1655.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2069,100,,1655.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2069,100,,1655.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054.4,100,,,,,0,"fee schedule",EAPG,2618.36,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",780.01,37.7,,624.01,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1613.82,78,,1291.06,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1708.99,82.6,,1367.19,,,0,"percent of total billed charges","82.6% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1708.99,82.6,,1367.19,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2174.65,100,,,,,0,"fee schedule",EAPG,2069,100,,1655.20,,,0,"percent of total billed charges","100% of total billed charges",316.56,11498.59,
"29871 Arthroscopy, knee, surgical; for infection,",7963024,CDM,521,RC,29871,CPT,OUTPATIENT,,,1654,1075.1,,1455.52,88,,1164.42,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,1654,100,,1323.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2074.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1042.02,63,,833.62,,,0,"percent of total billed charges","63% of total billed charges",253.06,15.3,,202.45,,,0,"percent of total billed charges","15.3% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,1141.26,69,,,,,0,"fee schedule","69% of total billed charges",1654,100,,1323.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1654,100,,1323.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1654,100,,1323.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054.4,100,,,,,0,"fee schedule",EAPG,2618.36,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",623.56,37.7,,498.85,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1290.12,78,,1032.10,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1366.2,82.6,,1092.96,,,0,"percent of total billed charges","82.6% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1366.2,82.6,,1092.96,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2174.65,100,,,,,0,"fee schedule",EAPG,1654,100,,1323.20,,,0,"percent of total billed charges","100% of total billed charges",253.06,11498.59,
"29873 Arthroscopy, knee, surgical; with lateral re",7963409,CDM,521,RC,29873,CPT,OUTPATIENT,,,1372,891.8,,1207.36,88,,965.89,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,1372,100,,1097.60,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2074.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",864.36,63,,691.49,,,0,"percent of total billed charges","63% of total billed charges",209.92,15.3,,167.94,,,0,"percent of total billed charges","15.3% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,946.68,69,,,,,0,"fee schedule","69% of total billed charges",1372,100,,1097.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1372,100,,1097.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1372,100,,1097.60,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054.4,100,,,,,0,"fee schedule",EAPG,2618.36,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",517.24,37.7,,413.79,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1070.16,78,,856.13,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1133.27,82.6,,906.62,,,0,"percent of total billed charges","82.6% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1133.27,82.6,,906.62,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2174.65,100,,,,,0,"fee schedule",EAPG,1372,100,,1097.60,,,0,"percent of total billed charges","100% of total billed charges",209.92,11498.59,
"29880 Arthroscopy, knee, surgical; with meniscecto",7961750,CDM,521,RC,29880,CPT,OUTPATIENT,,,2506,1628.9,,2205.28,88,,1764.22,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,2506,100,,2004.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2074.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1578.78,63,,1263.02,,,0,"percent of total billed charges","63% of total billed charges",383.42,15.3,,306.74,,,0,"percent of total billed charges","15.3% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,1729.14,69,,,,,0,"fee schedule","69% of total billed charges",2506,100,,2004.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2506,100,,2004.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2506,100,,2004.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054.4,100,,,,,0,"fee schedule",EAPG,2618.36,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",944.76,37.7,,755.81,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1954.68,78,,1563.74,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2069.96,82.6,,1655.97,,,0,"percent of total billed charges","82.6% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2069.96,82.6,,1655.97,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2174.65,100,,,,,0,"fee schedule",EAPG,2506,100,,2004.80,,,0,"percent of total billed charges","100% of total billed charges",383.42,11498.59,
"29881 Arthroscopy, knee, surgical; with meniscecto",7961819,CDM,521,RC,29881,CPT,OUTPATIENT,,,2608,1695.2,,2295.04,88,,1836.03,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,2608,100,,2086.40,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2074.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1643.04,63,,1314.43,,,0,"percent of total billed charges","63% of total billed charges",399.02,15.3,,319.22,,,0,"percent of total billed charges","15.3% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,1799.52,69,,,,,0,"fee schedule","69% of total billed charges",2608,100,,2086.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2608,100,,2086.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2608,100,,2086.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054.4,100,,,,,0,"fee schedule",EAPG,2618.36,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",983.22,37.7,,786.58,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2034.24,78,,1627.39,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2154.21,82.6,,1723.37,,,0,"percent of total billed charges","82.6% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2154.21,82.6,,1723.37,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2174.65,100,,,,,0,"fee schedule",EAPG,2608,100,,2086.40,,,0,"percent of total billed charges","100% of total billed charges",399.02,11498.59,
"29889 Arthroscopically aided posterior cruciate li",7961918,CDM,521,RC,29889,CPT,OUTPATIENT,,,4207,2734.55,,3702.16,88,,2961.73,,,0,"percent of total billed charges","88% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5038.03,100,,,,,0,"fee schedule",EAPG,4207,100,,3365.60,,,0,"percent of total billed charges","100% of total billed charges",23491.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",5189.17,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2650.41,63,,2120.33,,,0,"percent of total billed charges","63% of total billed charges",643.67,15.3,,514.94,,,0,"percent of total billed charges","15.3% of total billed charges",5038.03,100,,,,,0,"fee schedule",EAPG,2902.83,69,,,,,0,"fee schedule","69% of total billed charges",4207,100,,3365.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4207,100,,3365.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4207,100,,3365.60,,,0,"percent of total billed charges","100% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",50029.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5038.03,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13079.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5138.79,100,,,,,0,"fee schedule",EAPG,6549.44,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1586.04,37.7,,1268.83,,,0,"percent of total billed charges","37.70% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3281.46,78,,2625.17,,,0,"percent of total billed charges","78% of total billed charges",13558.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3474.98,82.6,,2779.98,,,0,"percent of total billed charges","82.6% of total billed charges",5038.03,100,,,,,0,"fee schedule",EAPG,13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3474.98,82.6,,2779.98,,,0,"percent of total billed charges","82.6% of total billed charges",13423.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5198.56,100,,,,,0,"fee schedule",EAPG,4207,100,,3365.60,,,0,"percent of total billed charges","100% of total billed charges",643.67,50029.1,
"29888 Arthroscopically aided anterior cruciate lig",7962180,CDM,521,RC,29888,CPT,OUTPATIENT,,,4776,3104.4,,4202.88,88,,3362.30,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5038.03,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",5189.17,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3008.88,63,,2407.10,,,0,"percent of total billed charges","63% of total billed charges",730.73,15.3,,584.58,,,0,"percent of total billed charges","15.3% of total billed charges",5038.03,100,,,,,0,"fee schedule",EAPG,3295.44,69,,,,,0,"fee schedule","69% of total billed charges",4776,100,,3820.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4776,100,,3820.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4776,100,,3820.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5038.03,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5138.79,100,,,,,0,"fee schedule",EAPG,6549.44,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1800.55,37.7,,1440.44,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3725.28,78,,2980.22,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3944.98,82.6,,3155.98,,,0,"percent of total billed charges","82.6% of total billed charges",5038.03,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3944.98,82.6,,3155.98,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5198.56,100,,,,,0,"fee schedule",EAPG,4776,100,,3820.80,,,0,"percent of total billed charges","100% of total billed charges",730.73,25451.55,
"29884 Arthroscopy, knee, surgical; with lysis of a",7962412,CDM,521,RC,29884,CPT,OUTPATIENT,,,2091,1359.15,,1840.08,88,,1472.06,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,2091,100,,1672.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2074.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1317.33,63,,1053.86,,,0,"percent of total billed charges","63% of total billed charges",319.92,15.3,,255.94,,,0,"percent of total billed charges","15.3% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,1442.79,69,,,,,0,"fee schedule","69% of total billed charges",2091,100,,1672.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2091,100,,1672.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2091,100,,1672.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054.4,100,,,,,0,"fee schedule",EAPG,2618.36,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",788.31,37.7,,630.65,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1630.98,78,,1304.78,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1727.17,82.6,,1381.74,,,0,"percent of total billed charges","82.6% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1727.17,82.6,,1381.74,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2174.65,100,,,,,0,"fee schedule",EAPG,2091,100,,1672.80,,,0,"percent of total billed charges","100% of total billed charges",319.92,11498.59,
"29883 Arthroscopy, knee, surgical; with meniscus r",7962810,CDM,521,RC,29883,CPT,OUTPATIENT,,,3354,2180.1,,2951.52,88,,2361.22,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,3354,100,,2683.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2074.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2113.02,63,,1690.42,,,0,"percent of total billed charges","63% of total billed charges",513.16,15.3,,410.53,,,0,"percent of total billed charges","15.3% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,2314.26,69,,,,,0,"fee schedule","69% of total billed charges",3354,100,,2683.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3354,100,,2683.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3354,100,,2683.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054.4,100,,,,,0,"fee schedule",EAPG,2618.36,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1264.46,37.7,,1011.57,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2616.12,78,,2092.90,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2770.4,82.6,,2216.32,,,0,"percent of total billed charges","82.6% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2770.4,82.6,,2216.32,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2174.65,100,,,,,0,"fee schedule",EAPG,3354,100,,2683.20,,,0,"percent of total billed charges","100% of total billed charges",513.16,11498.59,
"29882 Arthroscopy, knee, surgical; with meniscus r",7962843,CDM,521,RC,29882,CPT,OUTPATIENT,,,2678,1740.7,,2356.64,88,,1885.31,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2074.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1687.14,63,,1349.71,,,0,"percent of total billed charges","63% of total billed charges",409.73,15.3,,327.78,,,0,"percent of total billed charges","15.3% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,1847.82,69,,,,,0,"fee schedule","69% of total billed charges",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054.4,100,,,,,0,"fee schedule",EAPG,2618.36,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1009.61,37.7,,807.69,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2088.84,78,,1671.07,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2212.03,82.6,,1769.62,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2174.65,100,,,,,0,"fee schedule",EAPG,2678,100,,2142.40,,,0,"percent of total billed charges","100% of total billed charges",409.73,11498.59,
"29898 Arthroscopy, ankle (tibiotalar and fibulotal",7961919,CDM,521,RC,29898,CPT,OUTPATIENT,,,2376,1544.4,,2090.88,88,,1672.70,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,2376,100,,1900.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2074.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1496.88,63,,1197.50,,,0,"percent of total billed charges","63% of total billed charges",363.53,15.3,,290.82,,,0,"percent of total billed charges","15.3% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,1639.44,69,,,,,0,"fee schedule","69% of total billed charges",2376,100,,1900.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2376,100,,1900.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2376,100,,1900.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054.4,100,,,,,0,"fee schedule",EAPG,2618.36,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",895.75,37.7,,716.60,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1853.28,78,,1482.62,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1962.58,82.6,,1570.06,,,0,"percent of total billed charges","82.6% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1962.58,82.6,,1570.06,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2174.65,100,,,,,0,"fee schedule",EAPG,2376,100,,1900.80,,,0,"percent of total billed charges","100% of total billed charges",363.53,11498.59,
"29895 Arthroscopy, ankle (tibiotalar and fibulotal",7962247,CDM,521,RC,29895,CPT,OUTPATIENT,,,1506,978.9,,1325.28,88,,1060.22,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,1506,100,,1204.80,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2074.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",948.78,63,,759.02,,,0,"percent of total billed charges","63% of total billed charges",230.42,15.3,,184.34,,,0,"percent of total billed charges","15.3% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,1039.14,69,,,,,0,"fee schedule","69% of total billed charges",1506,100,,1204.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1506,100,,1204.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1506,100,,1204.80,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054.4,100,,,,,0,"fee schedule",EAPG,2618.36,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",567.76,37.7,,454.21,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1174.68,78,,939.74,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1243.96,82.6,,995.17,,,0,"percent of total billed charges","82.6% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1243.96,82.6,,995.17,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2174.65,100,,,,,0,"fee schedule",EAPG,1506,100,,1204.80,,,0,"percent of total billed charges","100% of total billed charges",230.42,11498.59,
"29897 Arthroscopy, ankle (tibiotalar and fibulotal",7962248,CDM,521,RC,29897,CPT,OUTPATIENT,,,2145,1394.25,,1887.6,88,,1510.08,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,2145,100,,1716.00,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2074.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1351.35,63,,1081.08,,,0,"percent of total billed charges","63% of total billed charges",328.19,15.3,,262.55,,,0,"percent of total billed charges","15.3% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,1480.05,69,,,,,0,"fee schedule","69% of total billed charges",2145,100,,1716.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2145,100,,1716.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2145,100,,1716.00,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054.4,100,,,,,0,"fee schedule",EAPG,2618.36,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",808.67,37.7,,646.94,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1673.1,78,,1338.48,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1771.77,82.6,,1417.42,,,0,"percent of total billed charges","82.6% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1771.77,82.6,,1417.42,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2174.65,100,,,,,0,"fee schedule",EAPG,2145,100,,1716.00,,,0,"percent of total billed charges","100% of total billed charges",328.19,11498.59,
"29999 Unlisted procedure, arthroscopy",7963728,CDM,521,RC,29999,CPT,OUTPATIENT,,,1698,1103.7,,1494.24,88,,1195.39,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,1698,100,,1358.40,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",2074.54,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1069.74,63,,855.79,,,0,"percent of total billed charges","63% of total billed charges",259.79,15.3,,207.83,,,0,"percent of total billed charges","15.3% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,1171.62,69,,,,,0,"fee schedule","69% of total billed charges",1698,100,,1358.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1698,100,,1358.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1698,100,,1358.40,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2014.12,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054.4,100,,,,,0,"fee schedule",EAPG,2618.36,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.15,37.7,,512.12,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1324.44,78,,1059.55,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1402.55,82.6,,1122.04,,,0,"percent of total billed charges","82.6% of total billed charges",2014.12,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1402.55,82.6,,1122.04,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2174.65,100,,,,,0,"fee schedule",EAPG,1698,100,,1358.40,,,0,"percent of total billed charges","100% of total billed charges",218.99,2618.36,
"30000 Drainage abscess or hematoma, nasal, interna",7963280,CDM,521,RC,30000,CPT,OUTPATIENT,,,346,224.9,,304.48,88,,243.58,,,0,"percent of total billed charges","88% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,346,100,,276.80,,,0,"percent of total billed charges","100% of total billed charges",435.98,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",217.98,63,,174.38,,,0,"percent of total billed charges","63% of total billed charges",52.94,15.3,,42.35,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,238.74,69,,,,,0,"fee schedule","69% of total billed charges",346,100,,276.80,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",346,100,,276.80,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",346,100,,276.80,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",859.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.44,37.7,,104.35,,,0,"percent of total billed charges","37.70% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",269.88,78,,215.90,,,0,"percent of total billed charges","78% of total billed charges",251.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",285.8,82.6,,228.64,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",285.8,82.6,,228.64,,,0,"percent of total billed charges","82.6% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.63,100,,,,,0,"fee schedule",EAPG,346,100,,276.80,,,0,"percent of total billed charges","100% of total billed charges",52.94,859.63,
"30110 Excision, nasal polyp(s), simple",7903273,CDM,521,RC,30110,CPT,OUTPATIENT,,,468,304.2,,411.84,88,,329.47,,,0,"percent of total billed charges","88% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,468,100,,374.40,,,0,"percent of total billed charges","100% of total billed charges",2722.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.84,63,,235.87,,,0,"percent of total billed charges","63% of total billed charges",71.6,15.3,,57.28,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,322.92,69,,,,,0,"fee schedule","69% of total billed charges",468,100,,374.40,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",468,100,,374.40,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",468,100,,374.40,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",5495.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1436.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",176.44,37.7,,141.15,,,0,"percent of total billed charges","37.70% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",365.04,78,,292.03,,,0,"percent of total billed charges","78% of total billed charges",1571.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",386.57,82.6,,309.26,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",386.57,82.6,,309.26,,,0,"percent of total billed charges","82.6% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.24,100,,,,,0,"fee schedule",EAPG,468,100,,374.40,,,0,"percent of total billed charges","100% of total billed charges",71.6,5495.75,
"30118 Excision or destruction (eg, laser), intrana",7961595,CDM,521,RC,30118,CPT,OUTPATIENT,,,1930,1254.5,,1698.4,88,,1358.72,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620.58,100,,,,,0,"fee schedule",EAPG,1930,100,,1544.00,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",2699.2,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1215.9,63,,972.72,,,0,"percent of total billed charges","63% of total billed charges",295.29,15.3,,236.23,,,0,"percent of total billed charges","15.3% of total billed charges",2620.58,100,,,,,0,"fee schedule",EAPG,1331.7,69,,,,,0,"fee schedule","69% of total billed charges",1930,100,,1544.00,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1930,100,,1544.00,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1930,100,,1544.00,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620.58,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2672.99,100,,,,,0,"fee schedule",EAPG,3406.75,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",727.61,37.7,,582.09,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1505.4,78,,1204.32,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1594.18,82.6,,1275.34,,,0,"percent of total billed charges","82.6% of total billed charges",2620.58,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1594.18,82.6,,1275.34,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2781.11,100,,,,,0,"fee schedule",EAPG,1930,100,,1544.00,,,0,"percent of total billed charges","100% of total billed charges",295.29,11116.67,
"30117 Excision or destruction (eg, laser), intrana",7962706,CDM,521,RC,30117,CPT,OUTPATIENT,,,2310,1501.5,,2032.8,88,,1626.24,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620.58,100,,,,,0,"fee schedule",EAPG,2310,100,,1848.00,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",2699.2,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1455.3,63,,1164.24,,,0,"percent of total billed charges","63% of total billed charges",353.43,15.3,,282.74,,,0,"percent of total billed charges","15.3% of total billed charges",2620.58,100,,,,,0,"fee schedule",EAPG,1593.9,69,,,,,0,"fee schedule","69% of total billed charges",2310,100,,1848.00,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2310,100,,1848.00,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2310,100,,1848.00,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620.58,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2672.99,100,,,,,0,"fee schedule",EAPG,3406.75,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",870.87,37.7,,696.70,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1801.8,78,,1441.44,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1908.06,82.6,,1526.45,,,0,"percent of total billed charges","82.6% of total billed charges",2620.58,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1908.06,82.6,,1526.45,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2781.11,100,,,,,0,"fee schedule",EAPG,2310,100,,1848.00,,,0,"percent of total billed charges","100% of total billed charges",353.43,11116.67,
"30115 Excision, nasal polyp(s), extensive",7963677,CDM,521,RC,30115,CPT,OUTPATIENT,,,932,605.8,,820.16,88,,656.13,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,932,100,,745.60,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",587.16,63,,469.73,,,0,"percent of total billed charges","63% of total billed charges",142.6,15.3,,114.08,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,643.08,69,,,,,0,"fee schedule","69% of total billed charges",932,100,,745.60,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",932,100,,745.60,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",932,100,,745.60,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",351.36,37.7,,281.09,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.96,78,,581.57,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",769.83,82.6,,615.86,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",769.83,82.6,,615.86,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.24,100,,,,,0,"fee schedule",EAPG,932,100,,745.60,,,0,"percent of total billed charges","100% of total billed charges",142.6,11116.67,
"30130 Excision inferior turbinate, partial or comp",7963108,CDM,521,RC,30130,CPT,OUTPATIENT,,,764,496.6,,672.32,88,,537.86,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2697.98,100,,,,,0,"fee schedule",EAPG,764,100,,611.20,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",2778.92,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",481.32,63,,385.06,,,0,"percent of total billed charges","63% of total billed charges",116.89,15.3,,93.51,,,0,"percent of total billed charges","15.3% of total billed charges",2697.98,100,,,,,0,"fee schedule",EAPG,527.16,69,,,,,0,"fee schedule","69% of total billed charges",764,100,,611.20,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",764,100,,611.20,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",764,100,,611.20,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2697.98,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2751.94,100,,,,,0,"fee schedule",EAPG,3507.38,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",288.03,37.7,,230.42,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",595.92,78,,476.74,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",631.06,82.6,,504.85,,,0,"percent of total billed charges","82.6% of total billed charges",2697.98,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",631.06,82.6,,504.85,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2858.51,100,,,,,0,"fee schedule",EAPG,764,100,,611.20,,,0,"percent of total billed charges","100% of total billed charges",116.89,11116.67,
"30140 Submucous resection inferior turbinate, part",7962775,CDM,521,RC,30140,CPT,OUTPATIENT,,,833,541.45,,733.04,88,,586.43,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2697.98,100,,,,,0,"fee schedule",EAPG,833,100,,666.40,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",2778.92,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",524.79,63,,419.83,,,0,"percent of total billed charges","63% of total billed charges",127.45,15.3,,101.96,,,0,"percent of total billed charges","15.3% of total billed charges",2697.98,100,,,,,0,"fee schedule",EAPG,574.77,69,,,,,0,"fee schedule","69% of total billed charges",833,100,,666.40,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",833,100,,666.40,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",833,100,,666.40,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2697.98,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2751.94,100,,,,,0,"fee schedule",EAPG,3507.38,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",314.04,37.7,,251.23,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",649.74,78,,519.79,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",688.06,82.6,,550.45,,,0,"percent of total billed charges","82.6% of total billed charges",2697.98,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",688.06,82.6,,550.45,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2858.51,100,,,,,0,"fee schedule",EAPG,833,100,,666.40,,,0,"percent of total billed charges","100% of total billed charges",127.45,11116.67,
"30200 Injection into turbinate(s), therapeutic",7903276,CDM,521,RC,30200,CPT,OUTPATIENT,,,273,177.45,,240.24,88,,192.19,,,0,"percent of total billed charges","88% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,273,100,,218.40,,,0,"percent of total billed charges","100% of total billed charges",982.07,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.99,63,,137.59,,,0,"percent of total billed charges","63% of total billed charges",41.77,15.3,,33.42,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,188.37,69,,,,,0,"fee schedule","69% of total billed charges",273,100,,218.40,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",273,100,,218.40,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",273,100,,218.40,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",1837.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",480.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",102.92,37.7,,82.34,,,0,"percent of total billed charges","37.70% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",212.94,78,,170.35,,,0,"percent of total billed charges","78% of total billed charges",566.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",225.5,82.6,,180.40,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",225.5,82.6,,180.40,,,0,"percent of total billed charges","82.6% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.63,100,,,,,0,"fee schedule",EAPG,273,100,,218.40,,,0,"percent of total billed charges","100% of total billed charges",41.77,1837.71,
"30300 Removal foreign body, intranasal; office typ",7903157,CDM,521,RC,30300,CPT,OUTPATIENT,,,356,231.4,,313.28,88,,250.62,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.28,63,,179.42,,,0,"percent of total billed charges","63% of total billed charges",54.47,15.3,,43.58,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,245.64,69,,,,,0,"fee schedule","69% of total billed charges",356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",134.21,37.7,,107.37,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.68,78,,222.14,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.06,82.6,,235.25,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.06,82.6,,235.25,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.63,100,,,,,0,"fee schedule",EAPG,356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",54.47,454.8,
"30400 Rhinoplasty, primary; lateral and alar carti",7962501,CDM,521,RC,30400,CPT,OUTPATIENT,,,2201,1430.65,,1936.88,88,,1549.50,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2697.98,100,,,,,0,"fee schedule",EAPG,2201,100,,1760.80,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",2778.92,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1386.63,63,,1109.30,,,0,"percent of total billed charges","63% of total billed charges",336.75,15.3,,269.40,,,0,"percent of total billed charges","15.3% of total billed charges",2697.98,100,,,,,0,"fee schedule",EAPG,1518.69,69,,,,,0,"fee schedule","69% of total billed charges",2201,100,,1760.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2201,100,,1760.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2201,100,,1760.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2697.98,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2751.94,100,,,,,0,"fee schedule",EAPG,3507.38,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",829.78,37.7,,663.82,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1716.78,78,,1373.42,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1818.03,82.6,,1454.42,,,0,"percent of total billed charges","82.6% of total billed charges",2697.98,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1818.03,82.6,,1454.42,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2858.51,100,,,,,0,"fee schedule",EAPG,2201,100,,1760.80,,,0,"percent of total billed charges","100% of total billed charges",336.75,20662.24,
"30410 Rhinoplasty, primary; complete, external par",7963464,CDM,521,RC,30410,CPT,OUTPATIENT,,,3227,2097.55,,2839.76,88,,2271.81,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4013.79,100,,,,,0,"fee schedule",EAPG,3227,100,,2581.60,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4134.2,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2033.01,63,,1626.41,,,0,"percent of total billed charges","63% of total billed charges",493.73,15.3,,394.98,,,0,"percent of total billed charges","15.3% of total billed charges",4013.79,100,,,,,0,"fee schedule",EAPG,2226.63,69,,,,,0,"fee schedule","69% of total billed charges",3227,100,,2581.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3227,100,,2581.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3227,100,,2581.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4013.79,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4094.06,100,,,,,0,"fee schedule",EAPG,5217.93,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1216.58,37.7,,973.26,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.06,78,,2013.65,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2665.5,82.6,,2132.40,,,0,"percent of total billed charges","82.6% of total billed charges",4013.79,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2665.5,82.6,,2132.40,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4174.32,100,,,,,0,"fee schedule",EAPG,3227,100,,2581.60,,,0,"percent of total billed charges","100% of total billed charges",493.73,20662.24,
"30420 Rhinoplasty, primary; including major septal",7963360,CDM,521,RC,30420,CPT,OUTPATIENT,,,2907,1889.55,,2558.16,88,,2046.53,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4013.79,100,,,,,0,"fee schedule",EAPG,2907,100,,2325.60,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4134.2,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1831.41,63,,1465.13,,,0,"percent of total billed charges","63% of total billed charges",444.77,15.3,,355.82,,,0,"percent of total billed charges","15.3% of total billed charges",4013.79,100,,,,,0,"fee schedule",EAPG,2005.83,69,,,,,0,"fee schedule","69% of total billed charges",2907,100,,2325.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2907,100,,2325.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2907,100,,2325.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4013.79,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4094.06,100,,,,,0,"fee schedule",EAPG,5217.93,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1095.94,37.7,,876.75,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2267.46,78,,1813.97,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2401.18,82.6,,1920.94,,,0,"percent of total billed charges","82.6% of total billed charges",4013.79,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2401.18,82.6,,1920.94,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4174.32,100,,,,,0,"fee schedule",EAPG,2907,100,,2325.60,,,0,"percent of total billed charges","100% of total billed charges",444.77,20662.24,
"30450 Rhinoplasty, secondary; major revision (nasa",7962776,CDM,521,RC,30450,CPT,OUTPATIENT,,,3179,2066.35,,2797.52,88,,2238.02,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4013.79,100,,,,,0,"fee schedule",EAPG,3179,100,,2543.20,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4134.2,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2002.77,63,,1602.22,,,0,"percent of total billed charges","63% of total billed charges",486.39,15.3,,389.11,,,0,"percent of total billed charges","15.3% of total billed charges",4013.79,100,,,,,0,"fee schedule",EAPG,2193.51,69,,,,,0,"fee schedule","69% of total billed charges",3179,100,,2543.20,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3179,100,,2543.20,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3179,100,,2543.20,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4013.79,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4094.06,100,,,,,0,"fee schedule",EAPG,5217.93,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1198.48,37.7,,958.78,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2479.62,78,,1983.70,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2625.85,82.6,,2100.68,,,0,"percent of total billed charges","82.6% of total billed charges",4013.79,100,,,,,0,"fee schedule","100% of WA fee schedule",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2625.85,82.6,,2100.68,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4174.32,100,,,,,0,"fee schedule",EAPG,3179,100,,2543.20,,,0,"percent of total billed charges","100% of total billed charges",486.39,20662.24,
"30462 Rhinoplasty, nasal deformity secondary to co",7961596,CDM,521,RC,30462,CPT,OUTPATIENT,,,2996,1947.4,,2636.48,88,,2109.18,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4013.79,100,,,,,0,"fee schedule",EAPG,2996,100,,2396.80,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4134.2,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1887.48,63,,1509.98,,,0,"percent of total billed charges","63% of total billed charges",458.39,15.3,,366.71,,,0,"percent of total billed charges","15.3% of total billed charges",4013.79,100,,,,,0,"fee schedule",EAPG,2067.24,69,,,,,0,"fee schedule","69% of total billed charges",2996,100,,2396.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2996,100,,2396.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2996,100,,2396.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4013.79,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4094.06,100,,,,,0,"fee schedule",EAPG,5217.93,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1129.49,37.7,,903.59,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2336.88,78,,1869.50,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2474.7,82.6,,1979.76,,,0,"percent of total billed charges","82.6% of total billed charges",4013.79,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2474.7,82.6,,1979.76,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4174.32,100,,,,,0,"fee schedule",EAPG,2996,100,,2396.80,,,0,"percent of total billed charges","100% of total billed charges",458.39,20662.24,
"30460 Rhinoplasty for nasal deformity secondary to",7961974,CDM,521,RC,30460,CPT,OUTPATIENT,,,1736,1128.4,,1527.68,88,,1222.14,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4013.79,100,,,,,0,"fee schedule",EAPG,1736,100,,1388.80,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4134.2,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1093.68,63,,874.94,,,0,"percent of total billed charges","63% of total billed charges",265.61,15.3,,212.49,,,0,"percent of total billed charges","15.3% of total billed charges",4013.79,100,,,,,0,"fee schedule",EAPG,1197.84,69,,,,,0,"fee schedule","69% of total billed charges",1736,100,,1388.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1736,100,,1388.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1736,100,,1388.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4013.79,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4094.06,100,,,,,0,"fee schedule",EAPG,5217.93,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",654.47,37.7,,523.58,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1354.08,78,,1083.26,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1433.94,82.6,,1147.15,,,0,"percent of total billed charges","82.6% of total billed charges",4013.79,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1433.94,82.6,,1147.15,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4174.32,100,,,,,0,"fee schedule",EAPG,1736,100,,1388.80,,,0,"percent of total billed charges","100% of total billed charges",265.61,20662.24,
"30465 Repair of nasal vestibular stenosis",7963678,CDM,521,RC,30465,CPT,OUTPATIENT,,,2149,1396.85,,1891.12,88,,1512.90,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620.58,100,,,,,0,"fee schedule",EAPG,2149,100,,1719.20,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",2699.2,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.87,63,,1083.10,,,0,"percent of total billed charges","63% of total billed charges",328.8,15.3,,263.04,,,0,"percent of total billed charges","15.3% of total billed charges",2620.58,100,,,,,0,"fee schedule",EAPG,1482.81,69,,,,,0,"fee schedule","69% of total billed charges",2149,100,,1719.20,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2149,100,,1719.20,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2149,100,,1719.20,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620.58,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2672.99,100,,,,,0,"fee schedule",EAPG,3406.75,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",810.17,37.7,,648.14,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1676.22,78,,1340.98,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1775.07,82.6,,1420.06,,,0,"percent of total billed charges","82.6% of total billed charges",2620.58,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1775.07,82.6,,1420.06,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2781.11,100,,,,,0,"fee schedule",EAPG,2149,100,,1719.20,,,0,"percent of total billed charges","100% of total billed charges",328.8,20662.24,
"30520 Septoplasty or submucous resection, w/ or w/",7961677,CDM,521,RC,30520,CPT,OUTPATIENT,,,1336,868.4,,1175.68,88,,940.54,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2697.98,100,,,,,0,"fee schedule",EAPG,1336,100,,1068.80,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",2778.92,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",841.68,63,,673.34,,,0,"percent of total billed charges","63% of total billed charges",204.41,15.3,,163.53,,,0,"percent of total billed charges","15.3% of total billed charges",2697.98,100,,,,,0,"fee schedule",EAPG,921.84,69,,,,,0,"fee schedule","69% of total billed charges",1336,100,,1068.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1336,100,,1068.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1336,100,,1068.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2697.98,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2751.94,100,,,,,0,"fee schedule",EAPG,3507.38,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",503.67,37.7,,402.94,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1042.08,78,,833.66,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1103.54,82.6,,882.83,,,0,"percent of total billed charges","82.6% of total billed charges",2697.98,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1103.54,82.6,,882.83,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2858.51,100,,,,,0,"fee schedule",EAPG,1336,100,,1068.80,,,0,"percent of total billed charges","100% of total billed charges",204.41,11116.67,
"30801 Ablation, soft tissue of inferior turbinates",7961497,CDM,521,RC,30801,CPT,OUTPATIENT,,,476,309.4,,418.88,88,,335.10,,,0,"percent of total billed charges","88% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,476,100,,380.80,,,0,"percent of total billed charges","100% of total billed charges",2722.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",299.88,63,,239.90,,,0,"percent of total billed charges","63% of total billed charges",72.83,15.3,,58.26,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,328.44,69,,,,,0,"fee schedule","69% of total billed charges",476,100,,380.80,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",476,100,,380.80,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",476,100,,380.80,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",5495.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1436.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",179.45,37.7,,143.56,,,0,"percent of total billed charges","37.70% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",371.28,78,,297.02,,,0,"percent of total billed charges","78% of total billed charges",1571.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",393.18,82.6,,314.54,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",393.18,82.6,,314.54,,,0,"percent of total billed charges","82.6% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.24,100,,,,,0,"fee schedule",EAPG,476,100,,380.80,,,0,"percent of total billed charges","100% of total billed charges",72.83,5495.75,
"30802 Ablation, soft tissue of inferior turbinates",7961597,CDM,521,RC,30802,CPT,OUTPATIENT,,,616,400.4,,542.08,88,,433.66,,,0,"percent of total billed charges","88% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2697.98,100,,,,,0,"fee schedule",EAPG,616,100,,492.80,,,0,"percent of total billed charges","100% of total billed charges",2722.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",2778.92,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",388.08,63,,310.46,,,0,"percent of total billed charges","63% of total billed charges",94.25,15.3,,75.40,,,0,"percent of total billed charges","15.3% of total billed charges",2697.98,100,,,,,0,"fee schedule",EAPG,425.04,69,,,,,0,"fee schedule","69% of total billed charges",616,100,,492.80,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616,100,,492.80,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616,100,,492.80,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",5495.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2697.98,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1436.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2751.94,100,,,,,0,"fee schedule",EAPG,3507.38,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",232.23,37.7,,185.78,,,0,"percent of total billed charges","37.70% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",480.48,78,,384.38,,,0,"percent of total billed charges","78% of total billed charges",1571.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",508.82,82.6,,407.06,,,0,"percent of total billed charges","82.6% of total billed charges",2697.98,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",508.82,82.6,,407.06,,,0,"percent of total billed charges","82.6% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2858.51,100,,,,,0,"fee schedule",EAPG,616,100,,492.80,,,0,"percent of total billed charges","100% of total billed charges",94.25,5495.75,
"30903 Control nasal hemorrhage, anterior, complex",7961865,CDM,521,RC,30903,CPT,OUTPATIENT,,,356,231.4,,313.28,88,,250.62,,,0,"percent of total billed charges","88% of total billed charges",130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.28,63,,179.42,,,0,"percent of total billed charges","63% of total billed charges",54.47,15.3,,43.58,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,245.64,69,,,,,0,"fee schedule","69% of total billed charges",356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",130.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",134.21,37.7,,107.37,,,0,"percent of total billed charges","37.70% of total billed charges",130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.68,78,,222.14,,,0,"percent of total billed charges","78% of total billed charges",131.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.06,82.6,,235.25,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.06,82.6,,235.25,,,0,"percent of total billed charges","82.6% of total billed charges",130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.63,100,,,,,0,"fee schedule",EAPG,356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",54.47,454.79,
"30901 Control nasal hemorrhage, anterior, simple (",7962249,CDM,521,RC,30901,CPT,OUTPATIENT,,,240,156,,211.2,88,,168.96,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.2,63,,120.96,,,0,"percent of total billed charges","63% of total billed charges",36.72,15.3,,29.38,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,165.6,69,,,,,0,"fee schedule","69% of total billed charges",240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",90.48,37.7,,72.38,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",187.2,78,,149.76,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",198.24,82.6,,158.59,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",198.24,82.6,,158.59,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.63,100,,,,,0,"fee schedule",EAPG,240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",36.72,454.8,
"30930 Fracture nasal inferior turbinate(s), therap",7963410,CDM,521,RC,30930,CPT,OUTPATIENT,,,276,179.4,,242.88,88,,194.30,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2697.98,100,,,,,0,"fee schedule",EAPG,276,100,,220.80,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",2778.92,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.88,63,,139.10,,,0,"percent of total billed charges","63% of total billed charges",42.23,15.3,,33.78,,,0,"percent of total billed charges","15.3% of total billed charges",2697.98,100,,,,,0,"fee schedule",EAPG,190.44,69,,,,,0,"fee schedule","69% of total billed charges",276,100,,220.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",276,100,,220.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",276,100,,220.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2697.98,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2751.94,100,,,,,0,"fee schedule",EAPG,3507.38,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",104.05,37.7,,83.24,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",215.28,78,,172.22,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",227.98,82.6,,182.38,,,0,"percent of total billed charges","82.6% of total billed charges",2697.98,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",227.98,82.6,,182.38,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2858.51,100,,,,,0,"fee schedule",EAPG,276,100,,220.80,,,0,"percent of total billed charges","100% of total billed charges",42.23,11116.67,
"30999 Unlisted procedure, nose",7963859,CDM,521,RC,30999,CPT,OUTPATIENT,,,478,310.7,,420.64,88,,336.51,,,0,"percent of total billed charges","88% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",435.98,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",301.14,63,,240.91,,,0,"percent of total billed charges","63% of total billed charges",73.13,15.3,,58.50,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,329.82,69,,,,,0,"fee schedule","69% of total billed charges",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",859.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",180.21,37.7,,144.17,,,0,"percent of total billed charges","37.70% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",372.84,78,,298.27,,,0,"percent of total billed charges","78% of total billed charges",251.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394.83,82.6,,315.86,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394.83,82.6,,315.86,,,0,"percent of total billed charges","82.6% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.24,100,,,,,0,"fee schedule",EAPG,478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",73.13,1076.02,
"31000 Lavage by cannulation; maxillary sinus (antr",7962671,CDM,521,RC,31000,CPT,OUTPATIENT,,,340,221,,299.2,88,,239.36,,,0,"percent of total billed charges","88% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",435.98,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",214.2,63,,171.36,,,0,"percent of total billed charges","63% of total billed charges",52.02,15.3,,41.62,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,234.6,69,,,,,0,"fee schedule","69% of total billed charges",340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",859.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",128.18,37.7,,102.54,,,0,"percent of total billed charges","37.70% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.2,78,,212.16,,,0,"percent of total billed charges","78% of total billed charges",251.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.84,82.6,,224.67,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.84,82.6,,224.67,,,0,"percent of total billed charges","82.6% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.24,100,,,,,0,"fee schedule",EAPG,340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",52.02,1076.02,
"31032 Sinusotomy, maxillary (antrotomy); radical w",7962530,CDM,521,RC,31032,CPT,OUTPATIENT,,,1221,793.65,,1074.48,88,,859.58,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3143.02,100,,,,,0,"fee schedule",EAPG,1221,100,,976.80,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",3237.31,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",769.23,63,,615.38,,,0,"percent of total billed charges","63% of total billed charges",186.81,15.3,,149.45,,,0,"percent of total billed charges","15.3% of total billed charges",3143.02,100,,,,,0,"fee schedule",EAPG,842.49,69,,,,,0,"fee schedule","69% of total billed charges",1221,100,,976.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1221,100,,976.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1221,100,,976.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3143.02,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3205.88,100,,,,,0,"fee schedule",EAPG,4085.92,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",460.32,37.7,,368.26,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",952.38,78,,761.90,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1008.55,82.6,,806.84,,,0,"percent of total billed charges","82.6% of total billed charges",3143.02,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1008.55,82.6,,806.84,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3303.55,100,,,,,0,"fee schedule",EAPG,1221,100,,976.80,,,0,"percent of total billed charges","100% of total billed charges",186.81,20662.24,
"31070 Sinusotomy frontal; external, simple",7963657,CDM,521,RC,31070,CPT,OUTPATIENT,,,846,549.9,,744.48,88,,595.58,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3143.02,100,,,,,0,"fee schedule",EAPG,846,100,,676.80,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",3237.31,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",532.98,63,,426.38,,,0,"percent of total billed charges","63% of total billed charges",129.44,15.3,,103.55,,,0,"percent of total billed charges","15.3% of total billed charges",3143.02,100,,,,,0,"fee schedule",EAPG,583.74,69,,,,,0,"fee schedule","69% of total billed charges",846,100,,676.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",846,100,,676.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",846,100,,676.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3143.02,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3205.88,100,,,,,0,"fee schedule",EAPG,4085.92,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",318.94,37.7,,255.15,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",659.88,78,,527.90,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",698.8,82.6,,559.04,,,0,"percent of total billed charges","82.6% of total billed charges",3143.02,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",698.8,82.6,,559.04,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3303.55,100,,,,,0,"fee schedule",EAPG,846,100,,676.80,,,0,"percent of total billed charges","100% of total billed charges",129.44,20662.24,
"31238 Nasal/sinus endoscopy, surgical",7904570,CDM,521,RC,31238,CPT,OUTPATIENT,,,427,277.55,,375.76,88,,300.61,,,0,"percent of total billed charges","88% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.64,100,,,,,0,"fee schedule",EAPG,427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",3029.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",1806.25,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",269.01,63,,215.21,,,0,"percent of total billed charges","63% of total billed charges",65.33,15.3,,52.26,,,0,"percent of total billed charges","15.3% of total billed charges",1753.64,100,,,,,0,"fee schedule",EAPG,294.63,69,,,,,0,"fee schedule","69% of total billed charges",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",6079.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.64,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1788.71,100,,,,,0,"fee schedule",EAPG,2279.73,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",160.98,37.7,,128.78,,,0,"percent of total billed charges","37.70% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",333.06,78,,266.45,,,0,"percent of total billed charges","78% of total billed charges",1748.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352.7,82.6,,282.16,,,0,"percent of total billed charges","82.6% of total billed charges",1753.64,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352.7,82.6,,282.16,,,0,"percent of total billed charges","82.6% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1914.17,100,,,,,0,"fee schedule",EAPG,427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",65.33,6079.13,
"31231 Nasal endoscopy, diagnostic, unilateral or b",7963326,CDM,521,RC,31231,CPT,OUTPATIENT,,,406,263.9,,357.28,88,,285.82,,,0,"percent of total billed charges","88% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,406,100,,324.80,,,0,"percent of total billed charges","100% of total billed charges",353.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.78,63,,204.62,,,0,"percent of total billed charges","63% of total billed charges",62.12,15.3,,49.70,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,280.14,69,,,,,0,"fee schedule","69% of total billed charges",406,100,,324.80,,,0,"percent of total billed charges","100% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",406,100,,324.80,,,0,"percent of total billed charges","100% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",406,100,,324.80,,,0,"percent of total billed charges","100% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",667.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",174.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",153.06,37.7,,122.45,,,0,"percent of total billed charges","37.70% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",316.68,78,,253.34,,,0,"percent of total billed charges","78% of total billed charges",204.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.36,82.6,,268.29,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.36,82.6,,268.29,,,0,"percent of total billed charges","82.6% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.63,100,,,,,0,"fee schedule",EAPG,406,100,,324.80,,,0,"percent of total billed charges","100% of total billed charges",62.12,667.83,
"31240 Nasal/sinus endoscopy, surgical",7904571,CDM,521,RC,31240,CPT,OUTPATIENT,,,403,261.95,,354.64,88,,283.71,,,0,"percent of total billed charges","88% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",684.89,100,,,,,0,"fee schedule",EAPG,403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",3029.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",705.44,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",253.89,63,,203.11,,,0,"percent of total billed charges","63% of total billed charges",61.66,15.3,,49.33,,,0,"percent of total billed charges","15.3% of total billed charges",684.89,100,,,,,0,"fee schedule",EAPG,278.07,69,,,,,0,"fee schedule","69% of total billed charges",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",6079.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",684.89,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",698.59,100,,,,,0,"fee schedule",EAPG,890.36,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.70% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",314.34,78,,251.47,,,0,"percent of total billed charges","78% of total billed charges",1748.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",684.89,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",845.42,100,,,,,0,"fee schedule",EAPG,403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",61.66,6079.13,
"31255 Nasal/sinus endoscopy, surgical; with ethmoi",7962370,CDM,521,RC,31255,CPT,OUTPATIENT,,,924,600.6,,813.12,88,,650.50,,,0,"percent of total billed charges","88% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4116.84,100,,,,,0,"fee schedule",EAPG,924,100,,739.20,,,0,"percent of total billed charges","100% of total billed charges",12216.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",4240.34,100,,,,,0,"fee schedule",EAPG,6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",582.12,63,,465.70,,,0,"percent of total billed charges","63% of total billed charges",141.37,15.3,,113.10,,,0,"percent of total billed charges","15.3% of total billed charges",4116.84,100,,,,,0,"fee schedule",EAPG,637.56,69,,,,,0,"fee schedule","69% of total billed charges",924,100,,739.20,,,0,"percent of total billed charges","100% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",924,100,,739.20,,,0,"percent of total billed charges","100% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",924,100,,739.20,,,0,"percent of total billed charges","100% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",23655.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4116.84,100,,,,,0,"fee schedule",EAPG,6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6184.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4199.17,100,,,,,0,"fee schedule",EAPG,5351.89,100,,,,,0,"fee schedule",EAPG,6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",348.35,37.7,,278.68,,,0,"percent of total billed charges","37.70% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",720.72,78,,576.58,,,0,"percent of total billed charges","78% of total billed charges",7050.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",763.22,82.6,,610.58,,,0,"percent of total billed charges","82.6% of total billed charges",4116.84,100,,,,,0,"fee schedule",EAPG,6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",763.22,82.6,,610.58,,,0,"percent of total billed charges","82.6% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4277.37,100,,,,,0,"fee schedule",EAPG,924,100,,739.20,,,0,"percent of total billed charges","100% of total billed charges",141.37,23655.14,
"31254 Nasal/sinus endoscopy, surgical; with ethmoi",7962777,CDM,521,RC,31254,CPT,OUTPATIENT,,,628,408.2,,552.64,88,,442.11,,,0,"percent of total billed charges","88% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620.58,100,,,,,0,"fee schedule",EAPG,628,100,,502.40,,,0,"percent of total billed charges","100% of total billed charges",12216.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",2699.2,100,,,,,0,"fee schedule",EAPG,6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",395.64,63,,316.51,,,0,"percent of total billed charges","63% of total billed charges",96.08,15.3,,76.86,,,0,"percent of total billed charges","15.3% of total billed charges",2620.58,100,,,,,0,"fee schedule",EAPG,433.32,69,,,,,0,"fee schedule","69% of total billed charges",628,100,,502.40,,,0,"percent of total billed charges","100% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",628,100,,502.40,,,0,"percent of total billed charges","100% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",628,100,,502.40,,,0,"percent of total billed charges","100% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",23655.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620.58,100,,,,,0,"fee schedule",EAPG,6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6184.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2672.99,100,,,,,0,"fee schedule",EAPG,3406.75,100,,,,,0,"fee schedule",EAPG,6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",236.76,37.7,,189.41,,,0,"percent of total billed charges","37.70% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",489.84,78,,391.87,,,0,"percent of total billed charges","78% of total billed charges",7050.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",518.73,82.6,,414.98,,,0,"percent of total billed charges","82.6% of total billed charges",2620.58,100,,,,,0,"fee schedule",EAPG,6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",518.73,82.6,,414.98,,,0,"percent of total billed charges","82.6% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2781.11,100,,,,,0,"fee schedule",EAPG,628,100,,502.40,,,0,"percent of total billed charges","100% of total billed charges",96.08,23655.14,
"31256 Nasal/sinus endoscopy, surgical, with maxill",7963173,CDM,521,RC,31256,CPT,OUTPATIENT,,,454,295.1,,399.52,88,,319.62,,,0,"percent of total billed charges","88% of total billed charges",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620.58,100,,,,,0,"fee schedule",EAPG,454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",6684.28,175,,,,,0,"fee schedule","175% of CMS fee schedule",2699.2,100,,,,,0,"fee schedule",EAPG,3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",286.02,63,,228.82,,,0,"percent of total billed charges","63% of total billed charges",69.46,15.3,,55.57,,,0,"percent of total billed charges","15.3% of total billed charges",2620.58,100,,,,,0,"fee schedule",EAPG,313.26,69,,,,,0,"fee schedule","69% of total billed charges",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",3819.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",12585.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620.58,100,,,,,0,"fee schedule",EAPG,3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3290.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2672.99,100,,,,,0,"fee schedule",EAPG,3406.75,100,,,,,0,"fee schedule",EAPG,3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",171.16,37.7,,136.93,,,0,"percent of total billed charges","37.70% of total billed charges",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",354.12,78,,283.30,,,0,"percent of total billed charges","78% of total billed charges",3857.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",375,82.6,,300.00,,,0,"percent of total billed charges","82.6% of total billed charges",2620.58,100,,,,,0,"fee schedule",EAPG,3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",375,82.6,,300.00,,,0,"percent of total billed charges","82.6% of total billed charges",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2781.11,100,,,,,0,"fee schedule",EAPG,454,100,,363.20,,,0,"percent of total billed charges","100% of total billed charges",69.46,12585.79,
"31267 Nasal/sinus endoscopy, surgical, w/ maxillar",7961866,CDM,521,RC,31267,CPT,OUTPATIENT,,,732,475.8,,644.16,88,,515.33,,,0,"percent of total billed charges","88% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",684.89,100,,,,,0,"fee schedule",EAPG,732,100,,585.60,,,0,"percent of total billed charges","100% of total billed charges",12216.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",705.44,100,,,,,0,"fee schedule",EAPG,6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",461.16,63,,368.93,,,0,"percent of total billed charges","63% of total billed charges",112,15.3,,89.60,,,0,"percent of total billed charges","15.3% of total billed charges",684.89,100,,,,,0,"fee schedule",EAPG,505.08,69,,,,,0,"fee schedule","69% of total billed charges",732,100,,585.60,,,0,"percent of total billed charges","100% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",732,100,,585.60,,,0,"percent of total billed charges","100% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",732,100,,585.60,,,0,"percent of total billed charges","100% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",23655.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",684.89,100,,,,,0,"fee schedule",EAPG,6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6184.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",698.59,100,,,,,0,"fee schedule",EAPG,890.36,100,,,,,0,"fee schedule",EAPG,6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",275.96,37.7,,220.77,,,0,"percent of total billed charges","37.70% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",570.96,78,,456.77,,,0,"percent of total billed charges","78% of total billed charges",7050.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",604.63,82.6,,483.70,,,0,"percent of total billed charges","82.6% of total billed charges",684.89,100,,,,,0,"fee schedule",EAPG,6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",604.63,82.6,,483.70,,,0,"percent of total billed charges","82.6% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",845.42,100,,,,,0,"fee schedule",EAPG,732,100,,585.60,,,0,"percent of total billed charges","100% of total billed charges",112,23655.14,
"31276 Nasal/sinus endoscopy, surgical with frontal",7963048,CDM,521,RC,31276,CPT,OUTPATIENT,,,1747,1135.55,,1537.36,88,,1229.89,,,0,"percent of total billed charges","88% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",684.89,100,,,,,0,"fee schedule",EAPG,1747,100,,1397.60,,,0,"percent of total billed charges","100% of total billed charges",12216.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",705.44,100,,,,,0,"fee schedule",EAPG,6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1100.61,63,,880.49,,,0,"percent of total billed charges","63% of total billed charges",267.29,15.3,,213.83,,,0,"percent of total billed charges","15.3% of total billed charges",684.89,100,,,,,0,"fee schedule",EAPG,1205.43,69,,,,,0,"fee schedule","69% of total billed charges",1747,100,,1397.60,,,0,"percent of total billed charges","100% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1747,100,,1397.60,,,0,"percent of total billed charges","100% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1747,100,,1397.60,,,0,"percent of total billed charges","100% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",23655.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",684.89,100,,,,,0,"fee schedule",EAPG,6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6184.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",698.59,100,,,,,0,"fee schedule",EAPG,890.36,100,,,,,0,"fee schedule",EAPG,6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",658.62,37.7,,526.90,,,0,"percent of total billed charges","37.70% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1362.66,78,,1090.13,,,0,"percent of total billed charges","78% of total billed charges",7050.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1443.02,82.6,,1154.42,,,0,"percent of total billed charges","82.6% of total billed charges",684.89,100,,,,,0,"fee schedule",EAPG,6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1443.02,82.6,,1154.42,,,0,"percent of total billed charges","82.6% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",845.42,100,,,,,0,"fee schedule",EAPG,1747,100,,1397.60,,,0,"percent of total billed charges","100% of total billed charges",267.29,23655.14,
"31288 Nasal/sinus endoscopy, surgical, w/ sphenoid",7961678,CDM,521,RC,31288,CPT,OUTPATIENT,,,2244,1458.6,,1974.72,88,,1579.78,,,0,"percent of total billed charges","88% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",684.89,100,,,,,0,"fee schedule",EAPG,2244,100,,1795.20,,,0,"percent of total billed charges","100% of total billed charges",12216.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",705.44,100,,,,,0,"fee schedule",EAPG,6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1413.72,63,,1130.98,,,0,"percent of total billed charges","63% of total billed charges",343.33,15.3,,274.66,,,0,"percent of total billed charges","15.3% of total billed charges",684.89,100,,,,,0,"fee schedule",EAPG,1548.36,69,,,,,0,"fee schedule","69% of total billed charges",2244,100,,1795.20,,,0,"percent of total billed charges","100% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2244,100,,1795.20,,,0,"percent of total billed charges","100% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2244,100,,1795.20,,,0,"percent of total billed charges","100% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",23655.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",684.89,100,,,,,0,"fee schedule",EAPG,6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6184.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",698.59,100,,,,,0,"fee schedule",EAPG,890.36,100,,,,,0,"fee schedule",EAPG,6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",845.99,37.7,,676.79,,,0,"percent of total billed charges","37.70% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1750.32,78,,1400.26,,,0,"percent of total billed charges","78% of total billed charges",7050.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1853.54,82.6,,1482.83,,,0,"percent of total billed charges","82.6% of total billed charges",684.89,100,,,,,0,"fee schedule",EAPG,6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1853.54,82.6,,1482.83,,,0,"percent of total billed charges","82.6% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",845.42,100,,,,,0,"fee schedule",EAPG,2244,100,,1795.20,,,0,"percent of total billed charges","100% of total billed charges",343.33,23655.14,
"31287 Nasal/sinus endoscopy, surgical, with spheno",7963361,CDM,521,RC,31287,CPT,OUTPATIENT,,,535,347.75,,470.8,88,,376.64,,,0,"percent of total billed charges","88% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",684.89,100,,,,,0,"fee schedule",EAPG,535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",12216.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",705.44,100,,,,,0,"fee schedule",EAPG,6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",337.05,63,,269.64,,,0,"percent of total billed charges","63% of total billed charges",81.86,15.3,,65.49,,,0,"percent of total billed charges","15.3% of total billed charges",684.89,100,,,,,0,"fee schedule",EAPG,369.15,69,,,,,0,"fee schedule","69% of total billed charges",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS fee schedule",23655.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",684.89,100,,,,,0,"fee schedule",EAPG,6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6184.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",698.59,100,,,,,0,"fee schedule",EAPG,890.36,100,,,,,0,"fee schedule",EAPG,6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",201.7,37.7,,161.36,,,0,"percent of total billed charges","37.70% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",417.3,78,,333.84,,,0,"percent of total billed charges","78% of total billed charges",7050.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.91,82.6,,353.53,,,0,"percent of total billed charges","82.6% of total billed charges",684.89,100,,,,,0,"fee schedule",EAPG,6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.91,82.6,,353.53,,,0,"percent of total billed charges","82.6% of total billed charges",6980.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",845.42,100,,,,,0,"fee schedule",EAPG,535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",81.86,23655.14,
"31299 Unlisted procedure, accessory sinuses",7963641,CDM,521,RC,31299,CPT,OUTPATIENT,,,1580,1027,,1390.4,88,,1112.32,,,0,"percent of total billed charges","88% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,1580,100,,1264.00,,,0,"percent of total billed charges","100% of total billed charges",435.98,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",995.4,63,,796.32,,,0,"percent of total billed charges","63% of total billed charges",241.74,15.3,,193.39,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,1090.2,69,,,,,0,"fee schedule","69% of total billed charges",1580,100,,1264.00,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1580,100,,1264.00,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1580,100,,1264.00,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",859.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",595.66,37.7,,476.53,,,0,"percent of total billed charges","37.70% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1232.4,78,,985.92,,,0,"percent of total billed charges","78% of total billed charges",251.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1305.08,82.6,,1044.06,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1305.08,82.6,,1044.06,,,0,"percent of total billed charges","82.6% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.24,100,,,,,0,"fee schedule",EAPG,1580,100,,1264.00,,,0,"percent of total billed charges","100% of total billed charges",224.74,1580,
"31300 Laryngotomy (thyrotomy, laryngofissure); wit",7961867,CDM,521,RC,31300,CPT,OUTPATIENT,,,2812,1827.8,,2474.56,88,,1979.65,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620.58,100,,,,,0,"fee schedule",EAPG,2812,100,,2249.60,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",2699.2,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1771.56,63,,1417.25,,,0,"percent of total billed charges","63% of total billed charges",430.24,15.3,,344.19,,,0,"percent of total billed charges","15.3% of total billed charges",2620.58,100,,,,,0,"fee schedule",EAPG,1940.28,69,,,,,0,"fee schedule","69% of total billed charges",2812,100,,2249.60,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2812,100,,2249.60,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2812,100,,2249.60,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620.58,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2672.99,100,,,,,0,"fee schedule",EAPG,3406.75,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1060.12,37.7,,848.10,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.36,78,,1754.69,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2322.71,82.6,,1858.17,,,0,"percent of total billed charges","82.6% of total billed charges",2620.58,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2322.71,82.6,,1858.17,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2781.11,100,,,,,0,"fee schedule",EAPG,2812,100,,2249.60,,,0,"percent of total billed charges","100% of total billed charges",430.24,11116.67,
"31500 Introduction procedures on the larynx",7904575,CDM,521,RC,31500,CPT,OUTPATIENT,,,432,280.8,,380.16,88,,304.13,,,0,"percent of total billed charges","88% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818.62,100,,,,,0,"fee schedule",EAPG,432,100,,345.60,,,0,"percent of total billed charges","100% of total billed charges",435.98,175,,,,,0,"fee schedule","175% of CMS fee schedule",843.18,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.16,63,,217.73,,,0,"percent of total billed charges","63% of total billed charges",66.1,15.3,,52.88,,,0,"percent of total billed charges","15.3% of total billed charges",818.62,100,,,,,0,"fee schedule",EAPG,298.08,69,,,,,0,"fee schedule","69% of total billed charges",432,100,,345.60,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",432,100,,345.60,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",432,100,,345.60,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",859.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818.62,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",834.99,100,,,,,0,"fee schedule",EAPG,1064.21,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",162.86,37.7,,130.29,,,0,"percent of total billed charges","37.70% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",336.96,78,,269.57,,,0,"percent of total billed charges","78% of total billed charges",251.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",356.83,82.6,,285.46,,,0,"percent of total billed charges","82.6% of total billed charges",818.62,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",356.83,82.6,,285.46,,,0,"percent of total billed charges","82.6% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",979.15,100,,,,,0,"fee schedule",EAPG,432,100,,345.60,,,0,"percent of total billed charges","100% of total billed charges",66.1,1064.21,
"31505 Laryngoscopy, indirect",7904576,CDM,521,RC,31505,CPT,OUTPATIENT,,,200,130,,176,88,,140.80,,,0,"percent of total billed charges","88% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",353.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",126,63,,100.80,,,0,"percent of total billed charges","63% of total billed charges",30.6,15.3,,24.48,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,138,69,,,,,0,"fee schedule","69% of total billed charges",200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",667.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",174.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",75.4,37.7,,60.32,,,0,"percent of total billed charges","37.70% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",156,78,,124.80,,,0,"percent of total billed charges","78% of total billed charges",204.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",165.2,82.6,,132.16,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",165.2,82.6,,132.16,,,0,"percent of total billed charges","82.6% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.63,100,,,,,0,"fee schedule",EAPG,200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",30.6,667.83,
"31515 Laryngoscopy direct, with or without tracheo",7962965,CDM,521,RC,31515,CPT,OUTPATIENT,,,572,371.8,,503.36,88,,402.69,,,0,"percent of total billed charges","88% of total billed charges",416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",684.89,100,,,,,0,"fee schedule",EAPG,572,100,,457.60,,,0,"percent of total billed charges","100% of total billed charges",728.82,175,,,,,0,"fee schedule","175% of CMS fee schedule",705.44,100,,,,,0,"fee schedule",EAPG,416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",360.36,63,,288.29,,,0,"percent of total billed charges","63% of total billed charges",87.52,15.3,,70.02,,,0,"percent of total billed charges","15.3% of total billed charges",684.89,100,,,,,0,"fee schedule",EAPG,394.68,69,,,,,0,"fee schedule","69% of total billed charges",572,100,,457.60,,,0,"percent of total billed charges","100% of total billed charges",416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",572,100,,457.60,,,0,"percent of total billed charges","100% of total billed charges",416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",572,100,,457.60,,,0,"percent of total billed charges","100% of total billed charges",416.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",1529.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",684.89,100,,,,,0,"fee schedule",EAPG,416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",399.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",698.59,100,,,,,0,"fee schedule",EAPG,890.36,100,,,,,0,"fee schedule",EAPG,416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",215.64,37.7,,172.51,,,0,"percent of total billed charges","37.70% of total billed charges",416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",446.16,78,,356.93,,,0,"percent of total billed charges","78% of total billed charges",420.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",472.47,82.6,,377.98,,,0,"percent of total billed charges","82.6% of total billed charges",684.89,100,,,,,0,"fee schedule",EAPG,416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",472.47,82.6,,377.98,,,0,"percent of total billed charges","82.6% of total billed charges",416.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",845.42,100,,,,,0,"fee schedule",EAPG,572,100,,457.60,,,0,"percent of total billed charges","100% of total billed charges",87.52,1529.58,
"31526 Laryngoscopy direct, w/ or w/o tracheoscopy;",7961598,CDM,521,RC,31526,CPT,OUTPATIENT,,,350,227.5,,308,88,,246.40,,,0,"percent of total billed charges","88% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",684.89,100,,,,,0,"fee schedule",EAPG,350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",3029.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",705.44,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",220.5,63,,176.40,,,0,"percent of total billed charges","63% of total billed charges",53.55,15.3,,42.84,,,0,"percent of total billed charges","15.3% of total billed charges",684.89,100,,,,,0,"fee schedule",EAPG,241.5,69,,,,,0,"fee schedule","69% of total billed charges",350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",6079.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",684.89,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",698.59,100,,,,,0,"fee schedule",EAPG,890.36,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",131.95,37.7,,105.56,,,0,"percent of total billed charges","37.70% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",273,78,,218.40,,,0,"percent of total billed charges","78% of total billed charges",1748.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.1,82.6,,231.28,,,0,"percent of total billed charges","82.6% of total billed charges",684.89,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.1,82.6,,231.28,,,0,"percent of total billed charges","82.6% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",845.42,100,,,,,0,"fee schedule",EAPG,350,100,,280.00,,,0,"percent of total billed charges","100% of total billed charges",53.55,6079.13,
"31525 Laryngoscopy direct, with or without tracheo",7962557,CDM,521,RC,31525,CPT,OUTPATIENT,,,319,207.35,,280.72,88,,224.58,,,0,"percent of total billed charges","88% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",684.89,100,,,,,0,"fee schedule",EAPG,319,100,,255.20,,,0,"percent of total billed charges","100% of total billed charges",3029.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",705.44,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200.97,63,,160.78,,,0,"percent of total billed charges","63% of total billed charges",48.81,15.3,,39.05,,,0,"percent of total billed charges","15.3% of total billed charges",684.89,100,,,,,0,"fee schedule",EAPG,220.11,69,,,,,0,"fee schedule","69% of total billed charges",319,100,,255.20,,,0,"percent of total billed charges","100% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",319,100,,255.20,,,0,"percent of total billed charges","100% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",319,100,,255.20,,,0,"percent of total billed charges","100% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",6079.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",684.89,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",698.59,100,,,,,0,"fee schedule",EAPG,890.36,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",120.26,37.7,,96.21,,,0,"percent of total billed charges","37.70% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",248.82,78,,199.06,,,0,"percent of total billed charges","78% of total billed charges",1748.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",263.49,82.6,,210.79,,,0,"percent of total billed charges","82.6% of total billed charges",684.89,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",263.49,82.6,,210.79,,,0,"percent of total billed charges","82.6% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",845.42,100,,,,,0,"fee schedule",EAPG,319,100,,255.20,,,0,"percent of total billed charges","100% of total billed charges",48.81,6079.13,
"31536 Laryngoscopy, direct, operative, with biopsy",7962328,CDM,521,RC,31536,CPT,OUTPATIENT,,,440,286,,387.2,88,,309.76,,,0,"percent of total billed charges","88% of total billed charges",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.64,100,,,,,0,"fee schedule",EAPG,440,100,,352.00,,,0,"percent of total billed charges","100% of total billed charges",6684.28,175,,,,,0,"fee schedule","175% of CMS fee schedule",1806.25,100,,,,,0,"fee schedule",EAPG,3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.2,63,,221.76,,,0,"percent of total billed charges","63% of total billed charges",67.32,15.3,,53.86,,,0,"percent of total billed charges","15.3% of total billed charges",1753.64,100,,,,,0,"fee schedule",EAPG,303.6,69,,,,,0,"fee schedule","69% of total billed charges",440,100,,352.00,,,0,"percent of total billed charges","100% of total billed charges",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",440,100,,352.00,,,0,"percent of total billed charges","100% of total billed charges",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",440,100,,352.00,,,0,"percent of total billed charges","100% of total billed charges",3819.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",12585.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.64,100,,,,,0,"fee schedule",EAPG,3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3290.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1788.71,100,,,,,0,"fee schedule",EAPG,2279.73,100,,,,,0,"fee schedule",EAPG,3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",165.88,37.7,,132.70,,,0,"percent of total billed charges","37.70% of total billed charges",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",343.2,78,,274.56,,,0,"percent of total billed charges","78% of total billed charges",3857.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",363.44,82.6,,290.75,,,0,"percent of total billed charges","82.6% of total billed charges",1753.64,100,,,,,0,"fee schedule",EAPG,3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",363.44,82.6,,290.75,,,0,"percent of total billed charges","82.6% of total billed charges",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1914.17,100,,,,,0,"fee schedule",EAPG,440,100,,352.00,,,0,"percent of total billed charges","100% of total billed charges",67.32,12585.79,
"31535 Laryngoscopy, direct, operative, with biopsy",7963504,CDM,521,RC,31535,CPT,OUTPATIENT,,,437,284.05,,384.56,88,,307.65,,,0,"percent of total billed charges","88% of total billed charges",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.64,100,,,,,0,"fee schedule",EAPG,437,100,,349.60,,,0,"percent of total billed charges","100% of total billed charges",6684.28,175,,,,,0,"fee schedule","175% of CMS fee schedule",1806.25,100,,,,,0,"fee schedule",EAPG,3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",275.31,63,,220.25,,,0,"percent of total billed charges","63% of total billed charges",66.86,15.3,,53.49,,,0,"percent of total billed charges","15.3% of total billed charges",1753.64,100,,,,,0,"fee schedule",EAPG,301.53,69,,,,,0,"fee schedule","69% of total billed charges",437,100,,349.60,,,0,"percent of total billed charges","100% of total billed charges",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",437,100,,349.60,,,0,"percent of total billed charges","100% of total billed charges",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",437,100,,349.60,,,0,"percent of total billed charges","100% of total billed charges",3819.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",12585.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.64,100,,,,,0,"fee schedule",EAPG,3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3290.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1788.71,100,,,,,0,"fee schedule",EAPG,2279.73,100,,,,,0,"fee schedule",EAPG,3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",164.75,37.7,,131.80,,,0,"percent of total billed charges","37.70% of total billed charges",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",340.86,78,,272.69,,,0,"percent of total billed charges","78% of total billed charges",3857.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",360.96,82.6,,288.77,,,0,"percent of total billed charges","82.6% of total billed charges",1753.64,100,,,,,0,"fee schedule",EAPG,3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",360.96,82.6,,288.77,,,0,"percent of total billed charges","82.6% of total billed charges",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1914.17,100,,,,,0,"fee schedule",EAPG,437,100,,349.60,,,0,"percent of total billed charges","100% of total billed charges",66.86,12585.79,
"31540 Laryngoscopy, direct, operative, w/ excision",7961679,CDM,521,RC,31540,CPT,OUTPATIENT,,,561,364.65,,493.68,88,,394.94,,,0,"percent of total billed charges","88% of total billed charges",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.64,100,,,,,0,"fee schedule",EAPG,561,100,,448.80,,,0,"percent of total billed charges","100% of total billed charges",6684.28,175,,,,,0,"fee schedule","175% of CMS fee schedule",1806.25,100,,,,,0,"fee schedule",EAPG,3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",353.43,63,,282.74,,,0,"percent of total billed charges","63% of total billed charges",85.83,15.3,,68.66,,,0,"percent of total billed charges","15.3% of total billed charges",1753.64,100,,,,,0,"fee schedule",EAPG,387.09,69,,,,,0,"fee schedule","69% of total billed charges",561,100,,448.80,,,0,"percent of total billed charges","100% of total billed charges",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561,100,,448.80,,,0,"percent of total billed charges","100% of total billed charges",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561,100,,448.80,,,0,"percent of total billed charges","100% of total billed charges",3819.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",12585.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.64,100,,,,,0,"fee schedule",EAPG,3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3290.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1788.71,100,,,,,0,"fee schedule",EAPG,2279.73,100,,,,,0,"fee schedule",EAPG,3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",211.5,37.7,,169.20,,,0,"percent of total billed charges","37.70% of total billed charges",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",437.58,78,,350.06,,,0,"percent of total billed charges","78% of total billed charges",3857.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",463.39,82.6,,370.71,,,0,"percent of total billed charges","82.6% of total billed charges",1753.64,100,,,,,0,"fee schedule",EAPG,3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",463.39,82.6,,370.71,,,0,"percent of total billed charges","82.6% of total billed charges",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1914.17,100,,,,,0,"fee schedule",EAPG,561,100,,448.80,,,0,"percent of total billed charges","100% of total billed charges",85.83,12585.79,
"31541 Laryngoscopy, direct, operative w/ excision",7961820,CDM,521,RC,31541,CPT,OUTPATIENT,,,612,397.8,,538.56,88,,430.85,,,0,"percent of total billed charges","88% of total billed charges",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.64,100,,,,,0,"fee schedule",EAPG,612,100,,489.60,,,0,"percent of total billed charges","100% of total billed charges",6684.28,175,,,,,0,"fee schedule","175% of CMS fee schedule",1806.25,100,,,,,0,"fee schedule",EAPG,3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",385.56,63,,308.45,,,0,"percent of total billed charges","63% of total billed charges",93.64,15.3,,74.91,,,0,"percent of total billed charges","15.3% of total billed charges",1753.64,100,,,,,0,"fee schedule",EAPG,422.28,69,,,,,0,"fee schedule","69% of total billed charges",612,100,,489.60,,,0,"percent of total billed charges","100% of total billed charges",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",612,100,,489.60,,,0,"percent of total billed charges","100% of total billed charges",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",612,100,,489.60,,,0,"percent of total billed charges","100% of total billed charges",3819.59,100,,,,,0,"fee schedule","100% of CMS fee schedule",12585.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.64,100,,,,,0,"fee schedule",EAPG,3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3290.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1788.71,100,,,,,0,"fee schedule",EAPG,2279.73,100,,,,,0,"fee schedule",EAPG,3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",230.72,37.7,,184.58,,,0,"percent of total billed charges","37.70% of total billed charges",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",477.36,78,,381.89,,,0,"percent of total billed charges","78% of total billed charges",3857.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",505.51,82.6,,404.41,,,0,"percent of total billed charges","82.6% of total billed charges",1753.64,100,,,,,0,"fee schedule",EAPG,3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",505.51,82.6,,404.41,,,0,"percent of total billed charges","82.6% of total billed charges",3819.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1914.17,100,,,,,0,"fee schedule",EAPG,612,100,,489.60,,,0,"percent of total billed charges","100% of total billed charges",93.64,12585.79,
"31575 Laryngoscopy, flexible fiberoptic",7904577,CDM,521,RC,31575,CPT,OUTPATIENT,,,252,163.8,,221.76,88,,177.41,,,0,"percent of total billed charges","88% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,252,100,,201.60,,,0,"percent of total billed charges","100% of total billed charges",353.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.76,63,,127.01,,,0,"percent of total billed charges","63% of total billed charges",38.56,15.3,,30.85,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,173.88,69,,,,,0,"fee schedule","69% of total billed charges",252,100,,201.60,,,0,"percent of total billed charges","100% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252,100,,201.60,,,0,"percent of total billed charges","100% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252,100,,201.60,,,0,"percent of total billed charges","100% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",667.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",174.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",95,37.7,,76.00,,,0,"percent of total billed charges","37.70% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",196.56,78,,157.25,,,0,"percent of total billed charges","78% of total billed charges",204.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",208.15,82.6,,166.52,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",208.15,82.6,,166.52,,,0,"percent of total billed charges","82.6% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.63,100,,,,,0,"fee schedule",EAPG,252,100,,201.60,,,0,"percent of total billed charges","100% of total billed charges",38.56,667.83,
"31605 Tracheostomy, emergency procedure; cricothyr",7963183,CDM,521,RC,31605,CPT,OUTPATIENT,,,973,632.45,,856.24,88,,684.99,,,0,"percent of total billed charges","88% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1856.3,100,,,,,0,"fee schedule",EAPG,973,100,,778.40,,,0,"percent of total billed charges","100% of total billed charges",435.98,175,,,,,0,"fee schedule","175% of CMS fee schedule",1911.99,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",612.99,63,,490.39,,,0,"percent of total billed charges","63% of total billed charges",148.87,15.3,,119.10,,,0,"percent of total billed charges","15.3% of total billed charges",1856.3,100,,,,,0,"fee schedule",EAPG,671.37,69,,,,,0,"fee schedule","69% of total billed charges",973,100,,778.40,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",973,100,,778.40,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",973,100,,778.40,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",859.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1856.3,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1893.42,100,,,,,0,"fee schedule",EAPG,2413.19,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",366.82,37.7,,293.46,,,0,"percent of total billed charges","37.70% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",758.94,78,,607.15,,,0,"percent of total billed charges","78% of total billed charges",251.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",803.7,82.6,,642.96,,,0,"percent of total billed charges","82.6% of total billed charges",1856.3,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",803.7,82.6,,642.96,,,0,"percent of total billed charges","82.6% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2016.83,100,,,,,0,"fee schedule",EAPG,973,100,,778.40,,,0,"percent of total billed charges","100% of total billed charges",148.87,2413.19,
"31603 Tracheostomy, emergency procedure; transtrac",7963424,CDM,521,RC,31603,CPT,OUTPATIENT,,,1520,988,,1337.6,88,,1070.08,,,0,"percent of total billed charges","88% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1856.3,100,,,,,0,"fee schedule",EAPG,1520,100,,1216.00,,,0,"percent of total billed charges","100% of total billed charges",2722.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",1911.99,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",957.6,63,,766.08,,,0,"percent of total billed charges","63% of total billed charges",232.56,15.3,,186.05,,,0,"percent of total billed charges","15.3% of total billed charges",1856.3,100,,,,,0,"fee schedule",EAPG,1048.8,69,,,,,0,"fee schedule","69% of total billed charges",1520,100,,1216.00,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1520,100,,1216.00,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1520,100,,1216.00,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",5495.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1856.3,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1436.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1893.42,100,,,,,0,"fee schedule",EAPG,2413.19,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",573.04,37.7,,458.43,,,0,"percent of total billed charges","37.70% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1185.6,78,,948.48,,,0,"percent of total billed charges","78% of total billed charges",1571.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1255.52,82.6,,1004.42,,,0,"percent of total billed charges","82.6% of total billed charges",1856.3,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1255.52,82.6,,1004.42,,,0,"percent of total billed charges","82.6% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2016.83,100,,,,,0,"fee schedule",EAPG,1520,100,,1216.00,,,0,"percent of total billed charges","100% of total billed charges",232.56,5495.75,
"31600 Tracheostomy, planned (separate procedure)",7963542,CDM,521,RC,31600,CPT,OUTPATIENT,,,1470,955.5,,1293.6,88,,1034.88,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1856.3,100,,,,,0,"fee schedule",EAPG,1470,100,,1176.00,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",1911.99,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",926.1,63,,740.88,,,0,"percent of total billed charges","63% of total billed charges",224.91,15.3,,179.93,,,0,"percent of total billed charges","15.3% of total billed charges",1856.3,100,,,,,0,"fee schedule",EAPG,1014.3,69,,,,,0,"fee schedule","69% of total billed charges",1470,100,,1176.00,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1470,100,,1176.00,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1470,100,,1176.00,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1856.3,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1893.42,100,,,,,0,"fee schedule",EAPG,2413.19,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",554.19,37.7,,443.35,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1146.6,78,,917.28,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1214.22,82.6,,971.38,,,0,"percent of total billed charges","82.6% of total billed charges",1856.3,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1214.22,82.6,,971.38,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2016.83,100,,,,,0,"fee schedule",EAPG,1470,100,,1176.00,,,0,"percent of total billed charges","100% of total billed charges",224.91,11116.67,
"31622 Bronchoscopy, rigid or flexible, including f",7961599,CDM,521,RC,31622,CPT,OUTPATIENT,,,1011,657.15,,889.68,88,,711.74,,,0,"percent of total billed charges","88% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1479.3,100,,,,,0,"fee schedule",EAPG,1011,100,,808.80,,,0,"percent of total billed charges","100% of total billed charges",3029.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",1523.68,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",636.93,63,,509.54,,,0,"percent of total billed charges","63% of total billed charges",154.68,15.3,,123.74,,,0,"percent of total billed charges","15.3% of total billed charges",1479.3,100,,,,,0,"fee schedule",EAPG,697.59,69,,,,,0,"fee schedule","69% of total billed charges",1011,100,,808.80,,,0,"percent of total billed charges","100% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1011,100,,808.80,,,0,"percent of total billed charges","100% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1011,100,,808.80,,,0,"percent of total billed charges","100% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",6079.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1479.3,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1508.89,100,,,,,0,"fee schedule",EAPG,1923.09,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",381.15,37.7,,304.92,,,0,"percent of total billed charges","37.70% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",788.58,78,,630.86,,,0,"percent of total billed charges","78% of total billed charges",1748.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",835.09,82.6,,668.07,,,0,"percent of total billed charges","82.6% of total billed charges",1479.3,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",835.09,82.6,,668.07,,,0,"percent of total billed charges","82.6% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1639.83,100,,,,,0,"fee schedule",EAPG,1011,100,,808.80,,,0,"percent of total billed charges","100% of total billed charges",154.68,6079.13,
"31720 Catheter aspiration (separate procedure); na",7963281,CDM,521,RC,31720,CPT,OUTPATIENT,,,505,328.25,,444.4,88,,355.52,,,0,"percent of total billed charges","88% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,505,100,,404.00,,,0,"percent of total billed charges","100% of total billed charges",380.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",48.3,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",318.15,63,,254.52,,,0,"percent of total billed charges","63% of total billed charges",77.27,15.3,,61.82,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,348.45,69,,,,,0,"fee schedule","69% of total billed charges",505,100,,404.00,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",505,100,,404.00,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",505,100,,404.00,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",763.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",190.39,37.7,,152.31,,,0,"percent of total billed charges","37.70% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",393.9,78,,315.12,,,0,"percent of total billed charges","78% of total billed charges",219.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",417.13,82.6,,333.70,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",417.13,82.6,,333.70,,,0,"percent of total billed charges","82.6% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",207.42,100,,,,,0,"fee schedule",EAPG,505,100,,404.00,,,0,"percent of total billed charges","100% of total billed charges",46.89,763.26,
"31750 Tracheoplasty; cervical",7963869,CDM,521,RC,31750,CPT,OUTPATIENT,,,4336,2818.4,,3815.68,88,,3052.54,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1856.3,100,,,,,0,"fee schedule",EAPG,4336,100,,3468.80,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1911.99,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2731.68,63,,2185.34,,,0,"percent of total billed charges","63% of total billed charges",663.41,15.3,,530.73,,,0,"percent of total billed charges","15.3% of total billed charges",1856.3,100,,,,,0,"fee schedule",EAPG,2991.84,69,,,,,0,"fee schedule","69% of total billed charges",4336,100,,3468.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4336,100,,3468.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4336,100,,3468.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1856.3,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1893.42,100,,,,,0,"fee schedule",EAPG,2413.19,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1634.67,37.7,,1307.74,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3382.08,78,,2705.66,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3581.54,82.6,,2865.23,,,0,"percent of total billed charges","82.6% of total billed charges",1856.3,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3581.54,82.6,,2865.23,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2016.83,100,,,,,0,"fee schedule",EAPG,4336,100,,3468.80,,,0,"percent of total billed charges","100% of total billed charges",663.41,20662.24,
"31800 Suture of tracheal wound or injury; cervical",7963476,CDM,521,RC,31800,CPT,OUTPATIENT,,,2176,1414.4,,1914.88,88,,1531.90,,,0,"percent of total billed charges","88% of total billed charges",2176,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1856.3,100,,,,,0,"fee schedule",EAPG,2176,100,,1740.80,,,0,"percent of total billed charges","100% of total billed charges",2176,175,,,,,0,"fee schedule","175% of CMS fee schedule",1911.99,100,,,,,0,"fee schedule",EAPG,2176,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1370.88,63,,1096.70,,,0,"percent of total billed charges","63% of total billed charges",332.93,15.3,,266.34,,,0,"percent of total billed charges","15.3% of total billed charges",1856.3,100,,,,,0,"fee schedule",EAPG,1501.44,69,,,,,0,"fee schedule","69% of total billed charges",2176,100,,1740.80,,,0,"percent of total billed charges","100% of total billed charges",2176,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2176,100,,1740.80,,,0,"percent of total billed charges","100% of total billed charges",2176,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2176,100,,1740.80,,,0,"percent of total billed charges","100% of total billed charges",2176,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2176,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1856.3,100,,,,,0,"fee schedule",EAPG,2176,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2176,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2176,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1893.42,100,,,,,0,"fee schedule",EAPG,2413.19,100,,,,,0,"fee schedule",EAPG,2176,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",820.35,37.7,,656.28,,,0,"percent of total billed charges","37.70% of total billed charges",2176,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2176,100,,,,,0,"fee schedule","100% of CMS fee schedule",1697.28,78,,1357.82,,,0,"percent of total billed charges","78% of total billed charges",2176,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1797.38,82.6,,1437.90,,,0,"percent of total billed charges","82.6% of total billed charges",1856.3,100,,,,,0,"fee schedule","100% of WA fee schedule",2176,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1797.38,82.6,,1437.90,,,0,"percent of total billed charges","82.6% of total billed charges",2176,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2016.83,100,,,,,0,"fee schedule",EAPG,2176,100,,1740.80,,,0,"percent of total billed charges","100% of total billed charges",332.93,2413.19,
"32035 Thoracostomy; with rib resection for empyema",7963505,CDM,521,RC,32035,CPT,OUTPATIENT,,,3138,2039.7,,2761.44,88,,2209.15,,,0,"percent of total billed charges","88% of total billed charges",3138,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,3138,100,,2510.40,,,0,"percent of total billed charges","100% of total billed charges",3138,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,3138,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1976.94,63,,1581.55,,,0,"percent of total billed charges","63% of total billed charges",480.11,15.3,,384.09,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,2165.22,69,,,,,0,"fee schedule","69% of total billed charges",3138,100,,2510.40,,,0,"percent of total billed charges","100% of total billed charges",3138,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3138,100,,2510.40,,,0,"percent of total billed charges","100% of total billed charges",3138,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3138,100,,2510.40,,,0,"percent of total billed charges","100% of total billed charges",3138,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3138,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,3138,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3138,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3138,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,3138,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1183.03,37.7,,946.42,,,0,"percent of total billed charges","37.70% of total billed charges",3138,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3138,100,,,,,0,"fee schedule","100% of CMS fee schedule",2447.64,78,,1958.11,,,0,"percent of total billed charges","78% of total billed charges",3138,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2591.99,82.6,,2073.59,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule","100% of WA fee schedule",3138,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2591.99,82.6,,2073.59,,,0,"percent of total billed charges","82.6% of total billed charges",3138,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,3138,100,,2510.40,,,0,"percent of total billed charges","100% of total billed charges",480.11,6089.09,
"32096 Thoracotomy, with diagnostic biopsy(ies) of",7962158,CDM,521,RC,32096,CPT,OUTPATIENT,,,2128,1383.2,,1872.64,88,,1498.11,,,0,"percent of total billed charges","88% of total billed charges",2128,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2020.72,100,,,,,0,"fee schedule",EAPG,2128,100,,1702.40,,,0,"percent of total billed charges","100% of total billed charges",2128,175,,,,,0,"fee schedule","175% of CMS fee schedule",2081.34,100,,,,,0,"fee schedule",EAPG,2128,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1340.64,63,,1072.51,,,0,"percent of total billed charges","63% of total billed charges",325.58,15.3,,260.46,,,0,"percent of total billed charges","15.3% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,1468.32,69,,,,,0,"fee schedule","69% of total billed charges",2128,100,,1702.40,,,0,"percent of total billed charges","100% of total billed charges",2128,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2128,100,,1702.40,,,0,"percent of total billed charges","100% of total billed charges",2128,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2128,100,,1702.40,,,0,"percent of total billed charges","100% of total billed charges",2128,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2128,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2020.72,100,,,,,0,"fee schedule",EAPG,2128,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2128,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2128,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2061.13,100,,,,,0,"fee schedule",EAPG,2626.94,100,,,,,0,"fee schedule",EAPG,2128,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",802.26,37.7,,641.81,,,0,"percent of total billed charges","37.70% of total billed charges",2128,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2128,100,,,,,0,"fee schedule","100% of CMS fee schedule",1659.84,78,,1327.87,,,0,"percent of total billed charges","78% of total billed charges",2128,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1757.73,82.6,,1406.18,,,0,"percent of total billed charges","82.6% of total billed charges",2020.72,100,,,,,0,"fee schedule","100% of WA fee schedule",2128,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1757.73,82.6,,1406.18,,,0,"percent of total billed charges","82.6% of total billed charges",2128,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2181.25,100,,,,,0,"fee schedule",EAPG,2128,100,,1702.40,,,0,"percent of total billed charges","100% of total billed charges",325.58,2626.94,
"32097 Thoracotomy, with diagnostic biopsy(ies) of",7962413,CDM,521,RC,32097,CPT,OUTPATIENT,,,2128,1383.2,,1872.64,88,,1498.11,,,0,"percent of total billed charges","88% of total billed charges",2128,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,2128,100,,1702.40,,,0,"percent of total billed charges","100% of total billed charges",2128,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,2128,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1340.64,63,,1072.51,,,0,"percent of total billed charges","63% of total billed charges",325.58,15.3,,260.46,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,1468.32,69,,,,,0,"fee schedule","69% of total billed charges",2128,100,,1702.40,,,0,"percent of total billed charges","100% of total billed charges",2128,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2128,100,,1702.40,,,0,"percent of total billed charges","100% of total billed charges",2128,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2128,100,,1702.40,,,0,"percent of total billed charges","100% of total billed charges",2128,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2128,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,2128,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2128,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2128,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,2128,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",802.26,37.7,,641.81,,,0,"percent of total billed charges","37.70% of total billed charges",2128,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2128,100,,,,,0,"fee schedule","100% of CMS fee schedule",1659.84,78,,1327.87,,,0,"percent of total billed charges","78% of total billed charges",2128,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1757.73,82.6,,1406.18,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule","100% of WA fee schedule",2128,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1757.73,82.6,,1406.18,,,0,"percent of total billed charges","82.6% of total billed charges",2128,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,2128,100,,1702.40,,,0,"percent of total billed charges","100% of total billed charges",325.58,6089.09,
"32098 Thoracotomy, with biopsy(ies) of pleura",7963601,CDM,521,RC,32098,CPT,OUTPATIENT,,,2000,1300,,1760,88,,1408.00,,,0,"percent of total billed charges","88% of total billed charges",2000,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,2000,100,,1600.00,,,0,"percent of total billed charges","100% of total billed charges",2000,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,2000,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1260,63,,1008.00,,,0,"percent of total billed charges","63% of total billed charges",306,15.3,,244.80,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,1380,69,,,,,0,"fee schedule","69% of total billed charges",2000,100,,1600.00,,,0,"percent of total billed charges","100% of total billed charges",2000,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2000,100,,1600.00,,,0,"percent of total billed charges","100% of total billed charges",2000,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2000,100,,1600.00,,,0,"percent of total billed charges","100% of total billed charges",2000,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2000,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,2000,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2000,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2000,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,2000,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",754,37.7,,603.20,,,0,"percent of total billed charges","37.70% of total billed charges",2000,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2000,100,,,,,0,"fee schedule","100% of CMS fee schedule",1560,78,,1248.00,,,0,"percent of total billed charges","78% of total billed charges",2000,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1652,82.6,,1321.60,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule","100% of WA fee schedule",2000,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1652,82.6,,1321.60,,,0,"percent of total billed charges","82.6% of total billed charges",2000,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,2000,100,,1600.00,,,0,"percent of total billed charges","100% of total billed charges",306,6089.09,
"32100 Thoracotomy; with exploration",7963746,CDM,521,RC,32100,CPT,OUTPATIENT,,,4862,3160.3,,4278.56,88,,3422.85,,,0,"percent of total billed charges","88% of total billed charges",4862,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",4862,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,4862,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3063.06,63,,2450.45,,,0,"percent of total billed charges","63% of total billed charges",743.89,15.3,,595.11,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,3354.78,69,,,,,0,"fee schedule","69% of total billed charges",4862,100,,3889.60,,,0,"percent of total billed charges","100% of total billed charges",4862,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4862,100,,3889.60,,,0,"percent of total billed charges","100% of total billed charges",4862,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4862,100,,3889.60,,,0,"percent of total billed charges","100% of total billed charges",4862,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4862,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,4862,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4862,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4862,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,4862,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1832.97,37.7,,1466.38,,,0,"percent of total billed charges","37.70% of total billed charges",4862,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4862,100,,,,,0,"fee schedule","100% of CMS fee schedule",3792.36,78,,3033.89,,,0,"percent of total billed charges","78% of total billed charges",4862,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4016.01,82.6,,3212.81,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule","100% of WA fee schedule",4862,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4016.01,82.6,,3212.81,,,0,"percent of total billed charges","82.6% of total billed charges",4862,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,4862,100,,3889.60,,,0,"percent of total billed charges","100% of total billed charges",743.89,6089.09,
"32110 Thoracotomy; with control of traumatic hemor",7962598,CDM,521,RC,32110,CPT,OUTPATIENT,,,4262,2770.3,,3750.56,88,,3000.45,,,0,"percent of total billed charges","88% of total billed charges",4262,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,4262,100,,3409.60,,,0,"percent of total billed charges","100% of total billed charges",4262,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,4262,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2685.06,63,,2148.05,,,0,"percent of total billed charges","63% of total billed charges",652.09,15.3,,521.67,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,2940.78,69,,,,,0,"fee schedule","69% of total billed charges",4262,100,,3409.60,,,0,"percent of total billed charges","100% of total billed charges",4262,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4262,100,,3409.60,,,0,"percent of total billed charges","100% of total billed charges",4262,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4262,100,,3409.60,,,0,"percent of total billed charges","100% of total billed charges",4262,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4262,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,4262,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4262,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4262,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,4262,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1606.77,37.7,,1285.42,,,0,"percent of total billed charges","37.70% of total billed charges",4262,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4262,100,,,,,0,"fee schedule","100% of CMS fee schedule",3324.36,78,,2659.49,,,0,"percent of total billed charges","78% of total billed charges",4262,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3520.41,82.6,,2816.33,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule","100% of WA fee schedule",4262,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3520.41,82.6,,2816.33,,,0,"percent of total billed charges","82.6% of total billed charges",4262,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,4262,100,,3409.60,,,0,"percent of total billed charges","100% of total billed charges",652.09,6089.09,
"32141 Thoracotomy; with resection-plication of bul",7961499,CDM,521,RC,32141,CPT,OUTPATIENT,,,5336,3468.4,,4695.68,88,,3756.54,,,0,"percent of total billed charges","88% of total billed charges",5336,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5336,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,5336,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3361.68,63,,2689.34,,,0,"percent of total billed charges","63% of total billed charges",816.41,15.3,,653.13,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,3681.84,69,,,,,0,"fee schedule","69% of total billed charges",5336,100,,4268.80,,,0,"percent of total billed charges","100% of total billed charges",5336,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5336,100,,4268.80,,,0,"percent of total billed charges","100% of total billed charges",5336,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5336,100,,4268.80,,,0,"percent of total billed charges","100% of total billed charges",5336,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5336,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,5336,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5336,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5336,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,5336,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2011.67,37.7,,1609.34,,,0,"percent of total billed charges","37.70% of total billed charges",5336,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5336,100,,,,,0,"fee schedule","100% of CMS fee schedule",4162.08,78,,3329.66,,,0,"percent of total billed charges","78% of total billed charges",5336,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4407.54,82.6,,3526.03,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule","100% of WA fee schedule",5336,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4407.54,82.6,,3526.03,,,0,"percent of total billed charges","82.6% of total billed charges",5336,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,5336,100,,4268.80,,,0,"percent of total billed charges","100% of total billed charges",816.41,6089.09,
"32140 Thoracotomy; with cyst(s) removal, includes",7962599,CDM,521,RC,32140,CPT,OUTPATIENT,,,2883,1873.95,,2537.04,88,,2029.63,,,0,"percent of total billed charges","88% of total billed charges",2883,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2020.72,100,,,,,0,"fee schedule",EAPG,2883,100,,2306.40,,,0,"percent of total billed charges","100% of total billed charges",2883,175,,,,,0,"fee schedule","175% of CMS fee schedule",2081.34,100,,,,,0,"fee schedule",EAPG,2883,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1816.29,63,,1453.03,,,0,"percent of total billed charges","63% of total billed charges",441.1,15.3,,352.88,,,0,"percent of total billed charges","15.3% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,1989.27,69,,,,,0,"fee schedule","69% of total billed charges",2883,100,,2306.40,,,0,"percent of total billed charges","100% of total billed charges",2883,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2883,100,,2306.40,,,0,"percent of total billed charges","100% of total billed charges",2883,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2883,100,,2306.40,,,0,"percent of total billed charges","100% of total billed charges",2883,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2883,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2020.72,100,,,,,0,"fee schedule",EAPG,2883,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2883,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2883,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2061.13,100,,,,,0,"fee schedule",EAPG,2626.94,100,,,,,0,"fee schedule",EAPG,2883,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1086.89,37.7,,869.51,,,0,"percent of total billed charges","37.70% of total billed charges",2883,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2883,100,,,,,0,"fee schedule","100% of CMS fee schedule",2248.74,78,,1798.99,,,0,"percent of total billed charges","78% of total billed charges",2883,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2381.36,82.6,,1905.09,,,0,"percent of total billed charges","82.6% of total billed charges",2020.72,100,,,,,0,"fee schedule","100% of WA fee schedule",2883,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2381.36,82.6,,1905.09,,,0,"percent of total billed charges","82.6% of total billed charges",2883,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2181.25,100,,,,,0,"fee schedule",EAPG,2883,100,,2306.40,,,0,"percent of total billed charges","100% of total billed charges",441.1,2883,
"32160 Thoracotomy; with cardiac massage",7963706,CDM,521,RC,32160,CPT,OUTPATIENT,,,2309,1500.85,,2031.92,88,,1625.54,,,0,"percent of total billed charges","88% of total billed charges",2309,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,2309,100,,1847.20,,,0,"percent of total billed charges","100% of total billed charges",2309,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,2309,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1454.67,63,,1163.74,,,0,"percent of total billed charges","63% of total billed charges",353.28,15.3,,282.62,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,1593.21,69,,,,,0,"fee schedule","69% of total billed charges",2309,100,,1847.20,,,0,"percent of total billed charges","100% of total billed charges",2309,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2309,100,,1847.20,,,0,"percent of total billed charges","100% of total billed charges",2309,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2309,100,,1847.20,,,0,"percent of total billed charges","100% of total billed charges",2309,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2309,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,2309,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2309,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2309,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,2309,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",870.49,37.7,,696.39,,,0,"percent of total billed charges","37.70% of total billed charges",2309,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2309,100,,,,,0,"fee schedule","100% of CMS fee schedule",1801.02,78,,1440.82,,,0,"percent of total billed charges","78% of total billed charges",2309,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1907.23,82.6,,1525.78,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule","100% of WA fee schedule",2309,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1907.23,82.6,,1525.78,,,0,"percent of total billed charges","82.6% of total billed charges",2309,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,2309,100,,1847.20,,,0,"percent of total billed charges","100% of total billed charges",353.28,6089.09,
"32200 Pneumonostomy, with open drainage of abscess",7963345,CDM,521,RC,32200,CPT,OUTPATIENT,,,5511,3582.15,,4849.68,88,,3879.74,,,0,"percent of total billed charges","88% of total billed charges",5511,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5511,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,5511,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3471.93,63,,2777.54,,,0,"percent of total billed charges","63% of total billed charges",843.18,15.3,,674.54,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,3802.59,69,,,,,0,"fee schedule","69% of total billed charges",5511,100,,4408.80,,,0,"percent of total billed charges","100% of total billed charges",5511,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5511,100,,4408.80,,,0,"percent of total billed charges","100% of total billed charges",5511,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5511,100,,4408.80,,,0,"percent of total billed charges","100% of total billed charges",5511,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5511,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,5511,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5511,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5511,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,5511,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2077.65,37.7,,1662.12,,,0,"percent of total billed charges","37.70% of total billed charges",5511,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5511,100,,,,,0,"fee schedule","100% of CMS fee schedule",4298.58,78,,3438.86,,,0,"percent of total billed charges","78% of total billed charges",5511,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4552.09,82.6,,3641.67,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule","100% of WA fee schedule",5511,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4552.09,82.6,,3641.67,,,0,"percent of total billed charges","82.6% of total billed charges",5511,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,5511,100,,4408.80,,,0,"percent of total billed charges","100% of total billed charges",843.18,6089.09,
"32225 Decortication, pulmonary (separate procedure",7963242,CDM,521,RC,32225,CPT,OUTPATIENT,,,3960,2574,,3484.8,88,,2787.84,,,0,"percent of total billed charges","88% of total billed charges",3960,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2020.72,100,,,,,0,"fee schedule",EAPG,3960,100,,3168.00,,,0,"percent of total billed charges","100% of total billed charges",3960,175,,,,,0,"fee schedule","175% of CMS fee schedule",2081.34,100,,,,,0,"fee schedule",EAPG,3960,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2494.8,63,,1995.84,,,0,"percent of total billed charges","63% of total billed charges",605.88,15.3,,484.70,,,0,"percent of total billed charges","15.3% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,2732.4,69,,,,,0,"fee schedule","69% of total billed charges",3960,100,,3168.00,,,0,"percent of total billed charges","100% of total billed charges",3960,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3960,100,,3168.00,,,0,"percent of total billed charges","100% of total billed charges",3960,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3960,100,,3168.00,,,0,"percent of total billed charges","100% of total billed charges",3960,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3960,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2020.72,100,,,,,0,"fee schedule",EAPG,3960,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3960,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3960,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2061.13,100,,,,,0,"fee schedule",EAPG,2626.94,100,,,,,0,"fee schedule",EAPG,3960,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1492.92,37.7,,1194.34,,,0,"percent of total billed charges","37.70% of total billed charges",3960,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3960,100,,,,,0,"fee schedule","100% of CMS fee schedule",3088.8,78,,2471.04,,,0,"percent of total billed charges","78% of total billed charges",3960,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3270.96,82.6,,2616.77,,,0,"percent of total billed charges","82.6% of total billed charges",2020.72,100,,,,,0,"fee schedule","100% of WA fee schedule",3960,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3270.96,82.6,,2616.77,,,0,"percent of total billed charges","82.6% of total billed charges",3960,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2181.25,100,,,,,0,"fee schedule",EAPG,3960,100,,3168.00,,,0,"percent of total billed charges","100% of total billed charges",605.88,3960,
"32220 Decortication, pulmonary (separate procedure",7963327,CDM,521,RC,32220,CPT,OUTPATIENT,,,6602,4291.3,,5809.76,88,,4647.81,,,0,"percent of total billed charges","88% of total billed charges",6602,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6602,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,6602,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4159.26,63,,3327.41,,,0,"percent of total billed charges","63% of total billed charges",1010.11,15.3,,808.09,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,4555.38,69,,,,,0,"fee schedule","69% of total billed charges",6602,100,,5281.60,,,0,"percent of total billed charges","100% of total billed charges",6602,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6602,100,,5281.60,,,0,"percent of total billed charges","100% of total billed charges",6602,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6602,100,,5281.60,,,0,"percent of total billed charges","100% of total billed charges",6602,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6602,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,6602,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6602,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6602,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,6602,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2488.95,37.7,,1991.16,,,0,"percent of total billed charges","37.70% of total billed charges",6602,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6602,100,,,,,0,"fee schedule","100% of CMS fee schedule",5149.56,78,,4119.65,,,0,"percent of total billed charges","78% of total billed charges",6602,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5453.25,82.6,,4362.60,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule","100% of WA fee schedule",6602,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5453.25,82.6,,4362.60,,,0,"percent of total billed charges","82.6% of total billed charges",6602,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,6602,100,,5281.60,,,0,"percent of total billed charges","100% of total billed charges",1010.11,6602,
"32310 Pleurectomy, parietal (separate procedure)",7963550,CDM,521,RC,32310,CPT,OUTPATIENT,,,4484,2914.6,,3945.92,88,,3156.74,,,0,"percent of total billed charges","88% of total billed charges",4484,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2020.72,100,,,,,0,"fee schedule",EAPG,4484,100,,3587.20,,,0,"percent of total billed charges","100% of total billed charges",4484,175,,,,,0,"fee schedule","175% of CMS fee schedule",2081.34,100,,,,,0,"fee schedule",EAPG,4484,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2824.92,63,,2259.94,,,0,"percent of total billed charges","63% of total billed charges",686.05,15.3,,548.84,,,0,"percent of total billed charges","15.3% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,3093.96,69,,,,,0,"fee schedule","69% of total billed charges",4484,100,,3587.20,,,0,"percent of total billed charges","100% of total billed charges",4484,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4484,100,,3587.20,,,0,"percent of total billed charges","100% of total billed charges",4484,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4484,100,,3587.20,,,0,"percent of total billed charges","100% of total billed charges",4484,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4484,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2020.72,100,,,,,0,"fee schedule",EAPG,4484,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4484,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4484,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2061.13,100,,,,,0,"fee schedule",EAPG,2626.94,100,,,,,0,"fee schedule",EAPG,4484,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1690.47,37.7,,1352.38,,,0,"percent of total billed charges","37.70% of total billed charges",4484,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4484,100,,,,,0,"fee schedule","100% of CMS fee schedule",3497.52,78,,2798.02,,,0,"percent of total billed charges","78% of total billed charges",4484,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3703.78,82.6,,2963.02,,,0,"percent of total billed charges","82.6% of total billed charges",2020.72,100,,,,,0,"fee schedule","100% of WA fee schedule",4484,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3703.78,82.6,,2963.02,,,0,"percent of total billed charges","82.6% of total billed charges",4484,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2181.25,100,,,,,0,"fee schedule",EAPG,4484,100,,3587.20,,,0,"percent of total billed charges","100% of total billed charges",686.05,4484,
"32320 Decortication and parietal pleurectomy",7963623,CDM,521,RC,32320,CPT,OUTPATIENT,,,6965,4527.25,,6129.2,88,,4903.36,,,0,"percent of total billed charges","88% of total billed charges",6965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6965,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,6965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4387.95,63,,3510.36,,,0,"percent of total billed charges","63% of total billed charges",1065.65,15.3,,852.52,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,4805.85,69,,,,,0,"fee schedule","69% of total billed charges",6965,100,,5572.00,,,0,"percent of total billed charges","100% of total billed charges",6965,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6965,100,,5572.00,,,0,"percent of total billed charges","100% of total billed charges",6965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6965,100,,5572.00,,,0,"percent of total billed charges","100% of total billed charges",6965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,6965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,6965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2625.81,37.7,,2100.65,,,0,"percent of total billed charges","37.70% of total billed charges",6965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6965,100,,,,,0,"fee schedule","100% of CMS fee schedule",5432.7,78,,4346.16,,,0,"percent of total billed charges","78% of total billed charges",6965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5753.09,82.6,,4602.47,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule","100% of WA fee schedule",6965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5753.09,82.6,,4602.47,,,0,"percent of total billed charges","82.6% of total billed charges",6965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,6965,100,,5572.00,,,0,"percent of total billed charges","100% of total billed charges",1065.65,6965,
"32440 Removal of lung, pneumonectomy",7963734,CDM,521,RC,32440,CPT,OUTPATIENT,,,4699,3054.35,,4135.12,88,,3308.10,,,0,"percent of total billed charges","88% of total billed charges",4699,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",4699,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,4699,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2960.37,63,,2368.30,,,0,"percent of total billed charges","63% of total billed charges",718.95,15.3,,575.16,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,3242.31,69,,,,,0,"fee schedule","69% of total billed charges",4699,100,,3759.20,,,0,"percent of total billed charges","100% of total billed charges",4699,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4699,100,,3759.20,,,0,"percent of total billed charges","100% of total billed charges",4699,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4699,100,,3759.20,,,0,"percent of total billed charges","100% of total billed charges",4699,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4699,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,4699,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4699,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4699,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,4699,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1771.52,37.7,,1417.22,,,0,"percent of total billed charges","37.70% of total billed charges",4699,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4699,100,,,,,0,"fee schedule","100% of CMS fee schedule",3665.22,78,,2932.18,,,0,"percent of total billed charges","78% of total billed charges",4699,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3881.37,82.6,,3105.10,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule","100% of WA fee schedule",4699,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3881.37,82.6,,3105.10,,,0,"percent of total billed charges","82.6% of total billed charges",4699,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,4699,100,,3759.20,,,0,"percent of total billed charges","100% of total billed charges",718.95,6089.09,
"32484 Removal of lung, other than pneumonectomy; s",7962707,CDM,521,RC,32484,CPT,OUTPATIENT,,,7240,4706,,6371.2,88,,5096.96,,,0,"percent of total billed charges","88% of total billed charges",7240,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7240,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,7240,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4561.2,63,,3648.96,,,0,"percent of total billed charges","63% of total billed charges",1107.72,15.3,,886.18,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,4995.6,69,,,,,0,"fee schedule","69% of total billed charges",7240,100,,5792.00,,,0,"percent of total billed charges","100% of total billed charges",7240,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7240,100,,5792.00,,,0,"percent of total billed charges","100% of total billed charges",7240,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7240,100,,5792.00,,,0,"percent of total billed charges","100% of total billed charges",7240,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7240,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,7240,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7240,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7240,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,7240,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2729.48,37.7,,2183.58,,,0,"percent of total billed charges","37.70% of total billed charges",7240,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7240,100,,,,,0,"fee schedule","100% of CMS fee schedule",5647.2,78,,4517.76,,,0,"percent of total billed charges","78% of total billed charges",7240,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5980.24,82.6,,4784.19,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule","100% of WA fee schedule",7240,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5980.24,82.6,,4784.19,,,0,"percent of total billed charges","82.6% of total billed charges",7240,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,7240,100,,5792.00,,,0,"percent of total billed charges","100% of total billed charges",1107.72,7240,
"32480 Removal of lung, other than pneumonectomy; s",7962935,CDM,521,RC,32480,CPT,OUTPATIENT,,,7172,4661.8,,6311.36,88,,5049.09,,,0,"percent of total billed charges","88% of total billed charges",7172,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7172,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,7172,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4518.36,63,,3614.69,,,0,"percent of total billed charges","63% of total billed charges",1097.32,15.3,,877.86,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,4948.68,69,,,,,0,"fee schedule","69% of total billed charges",7172,100,,5737.60,,,0,"percent of total billed charges","100% of total billed charges",7172,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7172,100,,5737.60,,,0,"percent of total billed charges","100% of total billed charges",7172,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7172,100,,5737.60,,,0,"percent of total billed charges","100% of total billed charges",7172,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7172,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,7172,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7172,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7172,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,7172,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2703.84,37.7,,2163.07,,,0,"percent of total billed charges","37.70% of total billed charges",7172,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7172,100,,,,,0,"fee schedule","100% of CMS fee schedule",5594.16,78,,4475.33,,,0,"percent of total billed charges","78% of total billed charges",7172,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5924.07,82.6,,4739.26,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule","100% of WA fee schedule",7172,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5924.07,82.6,,4739.26,,,0,"percent of total billed charges","82.6% of total billed charges",7172,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,7172,100,,5737.60,,,0,"percent of total billed charges","100% of total billed charges",1097.32,7172,
"32482 Removal of lung, other than pneumonectomy; 2",7962996,CDM,521,RC,32482,CPT,OUTPATIENT,,,5778,3755.7,,5084.64,88,,4067.71,,,0,"percent of total billed charges","88% of total billed charges",5778,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5778,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,5778,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3640.14,63,,2912.11,,,0,"percent of total billed charges","63% of total billed charges",884.03,15.3,,707.22,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,3986.82,69,,,,,0,"fee schedule","69% of total billed charges",5778,100,,4622.40,,,0,"percent of total billed charges","100% of total billed charges",5778,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5778,100,,4622.40,,,0,"percent of total billed charges","100% of total billed charges",5778,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5778,100,,4622.40,,,0,"percent of total billed charges","100% of total billed charges",5778,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5778,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,5778,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5778,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5778,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,5778,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2178.31,37.7,,1742.65,,,0,"percent of total billed charges","37.70% of total billed charges",5778,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5778,100,,,,,0,"fee schedule","100% of CMS fee schedule",4506.84,78,,3605.47,,,0,"percent of total billed charges","78% of total billed charges",5778,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4772.63,82.6,,3818.10,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule","100% of WA fee schedule",5778,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4772.63,82.6,,3818.10,,,0,"percent of total billed charges","82.6% of total billed charges",5778,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,5778,100,,4622.40,,,0,"percent of total billed charges","100% of total billed charges",884.03,6089.09,
"32488 Removal of lung, completion pneumonectomy",7963559,CDM,521,RC,32488,CPT,OUTPATIENT,,,10440,6786,,9187.2,88,,7349.76,,,0,"percent of total billed charges","88% of total billed charges",10440,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",10440,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,10440,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6577.2,63,,5261.76,,,0,"percent of total billed charges","63% of total billed charges",1597.32,15.3,,1277.86,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,7203.6,69,,,,,0,"fee schedule","69% of total billed charges",10440,100,,8352.00,,,0,"percent of total billed charges","100% of total billed charges",10440,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10440,100,,8352.00,,,0,"percent of total billed charges","100% of total billed charges",10440,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10440,100,,8352.00,,,0,"percent of total billed charges","100% of total billed charges",10440,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10440,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,10440,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10440,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10440,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,10440,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3935.88,37.7,,3148.70,,,0,"percent of total billed charges","37.70% of total billed charges",10440,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10440,100,,,,,0,"fee schedule","100% of CMS fee schedule",8143.2,78,,6514.56,,,0,"percent of total billed charges","78% of total billed charges",10440,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8623.44,82.6,,6898.75,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule","100% of WA fee schedule",10440,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8623.44,82.6,,6898.75,,,0,"percent of total billed charges","82.6% of total billed charges",10440,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,10440,100,,8352.00,,,0,"percent of total billed charges","100% of total billed charges",1597.32,10440,
"32491 Removal of lung, other than pneumonectomy; w",7962070,CDM,521,RC,32491,CPT,OUTPATIENT,,,4307,2799.55,,3790.16,88,,3032.13,,,0,"percent of total billed charges","88% of total billed charges",4307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,4307,100,,3445.60,,,0,"percent of total billed charges","100% of total billed charges",4307,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,4307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2713.41,63,,2170.73,,,0,"percent of total billed charges","63% of total billed charges",658.97,15.3,,527.18,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,2971.83,69,,,,,0,"fee schedule","69% of total billed charges",4307,100,,3445.60,,,0,"percent of total billed charges","100% of total billed charges",4307,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4307,100,,3445.60,,,0,"percent of total billed charges","100% of total billed charges",4307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4307,100,,3445.60,,,0,"percent of total billed charges","100% of total billed charges",4307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,4307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,4307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1623.74,37.7,,1298.99,,,0,"percent of total billed charges","37.70% of total billed charges",4307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4307,100,,,,,0,"fee schedule","100% of CMS fee schedule",3359.46,78,,2687.57,,,0,"percent of total billed charges","78% of total billed charges",4307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3557.58,82.6,,2846.06,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule","100% of WA fee schedule",4307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3557.58,82.6,,2846.06,,,0,"percent of total billed charges","82.6% of total billed charges",4307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,4307,100,,3445.60,,,0,"percent of total billed charges","100% of total billed charges",658.97,6089.09,
"32507 Thoracotomy; with diagnostic wedge resection",7961975,CDM,521,RC,32507,CPT,OUTPATIENT,,,414,269.1,,364.32,88,,291.46,,,0,"percent of total billed charges","88% of total billed charges",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,414,100,,331.20,,,0,"percent of total billed charges","100% of total billed charges",414,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",260.82,63,,208.66,,,0,"percent of total billed charges","63% of total billed charges",63.34,15.3,,50.67,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,285.66,69,,,,,0,"fee schedule","69% of total billed charges",414,100,,331.20,,,0,"percent of total billed charges","100% of total billed charges",414,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",414,100,,331.20,,,0,"percent of total billed charges","100% of total billed charges",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",414,100,,331.20,,,0,"percent of total billed charges","100% of total billed charges",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",156.08,37.7,,124.86,,,0,"percent of total billed charges","37.70% of total billed charges",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",414,100,,,,,0,"fee schedule","100% of CMS fee schedule",322.92,78,,258.34,,,0,"percent of total billed charges","78% of total billed charges",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",341.96,82.6,,273.57,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule","100% of WA fee schedule",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",341.96,82.6,,273.57,,,0,"percent of total billed charges","82.6% of total billed charges",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,414,100,,331.20,,,0,"percent of total billed charges","100% of total billed charges",63.34,6089.09,
"32506 Thoracotomy; with therapeutic wedge resectio",7962296,CDM,521,RC,32506,CPT,OUTPATIENT,,,414,269.1,,364.32,88,,291.46,,,0,"percent of total billed charges","88% of total billed charges",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,414,100,,331.20,,,0,"percent of total billed charges","100% of total billed charges",414,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",260.82,63,,208.66,,,0,"percent of total billed charges","63% of total billed charges",63.34,15.3,,50.67,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,285.66,69,,,,,0,"fee schedule","69% of total billed charges",414,100,,331.20,,,0,"percent of total billed charges","100% of total billed charges",414,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",414,100,,331.20,,,0,"percent of total billed charges","100% of total billed charges",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",414,100,,331.20,,,0,"percent of total billed charges","100% of total billed charges",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",156.08,37.7,,124.86,,,0,"percent of total billed charges","37.70% of total billed charges",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",414,100,,,,,0,"fee schedule","100% of CMS fee schedule",322.92,78,,258.34,,,0,"percent of total billed charges","78% of total billed charges",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",341.96,82.6,,273.57,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule","100% of WA fee schedule",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",341.96,82.6,,273.57,,,0,"percent of total billed charges","82.6% of total billed charges",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,414,100,,331.20,,,0,"percent of total billed charges","100% of total billed charges",63.34,6089.09,
"32505 Thoracotomy; with therapeutic wedge resectio",7962708,CDM,521,RC,32505,CPT,OUTPATIENT,,,2452,1593.8,,2157.76,88,,1726.21,,,0,"percent of total billed charges","88% of total billed charges",2452,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,2452,100,,1961.60,,,0,"percent of total billed charges","100% of total billed charges",2452,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,2452,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1544.76,63,,1235.81,,,0,"percent of total billed charges","63% of total billed charges",375.16,15.3,,300.13,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,1691.88,69,,,,,0,"fee schedule","69% of total billed charges",2452,100,,1961.60,,,0,"percent of total billed charges","100% of total billed charges",2452,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2452,100,,1961.60,,,0,"percent of total billed charges","100% of total billed charges",2452,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2452,100,,1961.60,,,0,"percent of total billed charges","100% of total billed charges",2452,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2452,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,2452,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2452,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2452,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,2452,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",924.4,37.7,,739.52,,,0,"percent of total billed charges","37.70% of total billed charges",2452,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2452,100,,,,,0,"fee schedule","100% of CMS fee schedule",1912.56,78,,1530.05,,,0,"percent of total billed charges","78% of total billed charges",2452,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2025.35,82.6,,1620.28,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule","100% of WA fee schedule",2452,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2025.35,82.6,,1620.28,,,0,"percent of total billed charges","82.6% of total billed charges",2452,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,2452,100,,1961.60,,,0,"percent of total billed charges","100% of total billed charges",375.16,6089.09,
"32540 Extrapleural enucleation of empyema (empyeme",7963382,CDM,521,RC,32540,CPT,OUTPATIENT,,,6356,4131.4,,5593.28,88,,4474.62,,,0,"percent of total billed charges","88% of total billed charges",6356,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6356,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,6356,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4004.28,63,,3203.42,,,0,"percent of total billed charges","63% of total billed charges",972.47,15.3,,777.98,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,4385.64,69,,,,,0,"fee schedule","69% of total billed charges",6356,100,,5084.80,,,0,"percent of total billed charges","100% of total billed charges",6356,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6356,100,,5084.80,,,0,"percent of total billed charges","100% of total billed charges",6356,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6356,100,,5084.80,,,0,"percent of total billed charges","100% of total billed charges",6356,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6356,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,6356,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6356,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6356,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,6356,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2396.21,37.7,,1916.97,,,0,"percent of total billed charges","37.70% of total billed charges",6356,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6356,100,,,,,0,"fee schedule","100% of CMS fee schedule",4957.68,78,,3966.14,,,0,"percent of total billed charges","78% of total billed charges",6356,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5250.06,82.6,,4200.05,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule","100% of WA fee schedule",6356,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5250.06,82.6,,4200.05,,,0,"percent of total billed charges","82.6% of total billed charges",6356,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,6356,100,,5084.80,,,0,"percent of total billed charges","100% of total billed charges",972.47,6356,
"32554 Thoracentesis, needle or catheter, aspiratio",7961680,CDM,521,RC,32554,CPT,OUTPATIENT,,,262,170.3,,230.56,88,,184.45,,,0,"percent of total billed charges","88% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",1121.3,175,,,,,0,"fee schedule","175% of CMS fee schedule",884,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",165.06,63,,132.05,,,0,"percent of total billed charges","63% of total billed charges",40.09,15.3,,32.07,,,0,"percent of total billed charges","15.3% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,180.78,69,,,,,0,"fee schedule","69% of total billed charges",262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",2200.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",575.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.42,100,,,,,0,"fee schedule",EAPG,1115.74,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",98.77,37.7,,79.02,,,0,"percent of total billed charges","37.70% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",204.36,78,,163.49,,,0,"percent of total billed charges","78% of total billed charges",647.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.41,82.6,,173.13,,,0,"percent of total billed charges","82.6% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.41,82.6,,173.13,,,0,"percent of total billed charges","82.6% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1018.79,100,,,,,0,"fee schedule",EAPG,262,100,,209.60,,,0,"percent of total billed charges","100% of total billed charges",40.09,2200.34,
"32557 Pleural drainage, percutaneous, with inserti",7961681,CDM,521,RC,32557,CPT,OUTPATIENT,,,479,311.35,,421.52,88,,337.22,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,479,100,,383.20,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",884,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",301.77,63,,241.42,,,0,"percent of total billed charges","63% of total billed charges",73.29,15.3,,58.63,,,0,"percent of total billed charges","15.3% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,330.51,69,,,,,0,"fee schedule","69% of total billed charges",479,100,,383.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",479,100,,383.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",479,100,,383.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.42,100,,,,,0,"fee schedule",EAPG,1115.74,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",180.58,37.7,,144.46,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",373.62,78,,298.90,,,0,"percent of total billed charges","78% of total billed charges",1649.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",395.65,82.6,,316.52,,,0,"percent of total billed charges","82.6% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",395.65,82.6,,316.52,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1018.79,100,,,,,0,"fee schedule",EAPG,479,100,,383.20,,,0,"percent of total billed charges","100% of total billed charges",73.29,5712.48,
"32555 Thoracentesis, needle or catheter, aspiratio",7961976,CDM,521,RC,32555,CPT,OUTPATIENT,,,327,212.55,,287.76,88,,230.21,,,0,"percent of total billed charges","88% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",1121.3,175,,,,,0,"fee schedule","175% of CMS fee schedule",884,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206.01,63,,164.81,,,0,"percent of total billed charges","63% of total billed charges",50.03,15.3,,40.02,,,0,"percent of total billed charges","15.3% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,225.63,69,,,,,0,"fee schedule","69% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",2200.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",575.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.42,100,,,,,0,"fee schedule",EAPG,1115.74,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.70% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.06,78,,204.05,,,0,"percent of total billed charges","78% of total billed charges",647.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1018.79,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",50.03,2200.34,
"32556 Pleural drainage, percutaneous, with inserti",7961977,CDM,521,RC,32556,CPT,OUTPATIENT,,,357,232.05,,314.16,88,,251.33,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,357,100,,285.60,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",884,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.91,63,,179.93,,,0,"percent of total billed charges","63% of total billed charges",54.62,15.3,,43.70,,,0,"percent of total billed charges","15.3% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,246.33,69,,,,,0,"fee schedule","69% of total billed charges",357,100,,285.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",357,100,,285.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",357,100,,285.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.42,100,,,,,0,"fee schedule",EAPG,1115.74,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",134.59,37.7,,107.67,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278.46,78,,222.77,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.88,82.6,,235.90,,,0,"percent of total billed charges","82.6% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.88,82.6,,235.90,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1018.79,100,,,,,0,"fee schedule",EAPG,357,100,,285.60,,,0,"percent of total billed charges","100% of total billed charges",54.62,6601.69,
"32551 Tube thoracostomy, includes connection to dr",7962502,CDM,521,RC,32551,CPT,OUTPATIENT,,,918,596.7,,807.84,88,,646.27,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,918,100,,734.40,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",884,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",578.34,63,,462.67,,,0,"percent of total billed charges","63% of total billed charges",140.45,15.3,,112.36,,,0,"percent of total billed charges","15.3% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,633.42,69,,,,,0,"fee schedule","69% of total billed charges",918,100,,734.40,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",918,100,,734.40,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",918,100,,734.40,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.42,100,,,,,0,"fee schedule",EAPG,1115.74,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",346.09,37.7,,276.87,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",716.04,78,,572.83,,,0,"percent of total billed charges","78% of total billed charges",1649.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",758.27,82.6,,606.62,,,0,"percent of total billed charges","82.6% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",758.27,82.6,,606.62,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1018.79,100,,,,,0,"fee schedule",EAPG,918,100,,734.40,,,0,"percent of total billed charges","100% of total billed charges",140.45,5712.48,
"32550 Insertion of indwelling tunneled pleural cat",7963137,CDM,521,RC,32550,CPT,OUTPATIENT,,,652,423.8,,573.76,88,,459.01,,,0,"percent of total billed charges","88% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,652,100,,521.60,,,0,"percent of total billed charges","100% of total billed charges",6175.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",884,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.76,63,,328.61,,,0,"percent of total billed charges","63% of total billed charges",99.76,15.3,,79.81,,,0,"percent of total billed charges","15.3% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,449.88,69,,,,,0,"fee schedule","69% of total billed charges",652,100,,521.60,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652,100,,521.60,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",652,100,,521.60,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.42,100,,,,,0,"fee schedule",EAPG,1115.74,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",245.8,37.7,,196.64,,,0,"percent of total billed charges","37.70% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",508.56,78,,406.85,,,0,"percent of total billed charges","78% of total billed charges",3564.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",538.55,82.6,,430.84,,,0,"percent of total billed charges","82.6% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",538.55,82.6,,430.84,,,0,"percent of total billed charges","82.6% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1018.79,100,,,,,0,"fee schedule",EAPG,652,100,,521.60,,,0,"percent of total billed charges","100% of total billed charges",99.76,12932.7,
"32560 Instillation, via chest tube/catheter, agent",7961978,CDM,521,RC,32560,CPT,OUTPATIENT,,,647,420.55,,569.36,88,,455.49,,,0,"percent of total billed charges","88% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,647,100,,517.60,,,0,"percent of total billed charges","100% of total billed charges",1121.3,175,,,,,0,"fee schedule","175% of CMS fee schedule",884,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",407.61,63,,326.09,,,0,"percent of total billed charges","63% of total billed charges",98.99,15.3,,79.19,,,0,"percent of total billed charges","15.3% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,446.43,69,,,,,0,"fee schedule","69% of total billed charges",647,100,,517.60,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647,100,,517.60,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647,100,,517.60,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",2200.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",575.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.42,100,,,,,0,"fee schedule",EAPG,1115.74,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",243.92,37.7,,195.14,,,0,"percent of total billed charges","37.70% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",504.66,78,,403.73,,,0,"percent of total billed charges","78% of total billed charges",647.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",534.42,82.6,,427.54,,,0,"percent of total billed charges","82.6% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",534.42,82.6,,427.54,,,0,"percent of total billed charges","82.6% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1018.79,100,,,,,0,"fee schedule",EAPG,647,100,,517.60,,,0,"percent of total billed charges","100% of total billed charges",98.99,2200.34,
"32601 Thoracoscopy, diagnostic; lungs, pericardial",7961500,CDM,521,RC,32601,CPT,OUTPATIENT,,,1672,1086.8,,1471.36,88,,1177.09,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.92,100,,,,,0,"fee schedule",EAPG,1672,100,,1337.60,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1053.36,63,,842.69,,,0,"percent of total billed charges","63% of total billed charges",255.82,15.3,,204.66,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,1153.68,69,,,,,0,"fee schedule","69% of total billed charges",1672,100,,1337.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1672,100,,1337.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1672,100,,1337.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.92,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",630.34,37.7,,504.27,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1304.16,78,,1043.33,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1381.07,82.6,,1104.86,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1381.07,82.6,,1104.86,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4844.45,100,,,,,0,"fee schedule",EAPG,1672,100,,1337.60,,,0,"percent of total billed charges","100% of total billed charges",255.82,20558.19,
"32607 Thoracoscopy; with diagnostic biopsy(ies) of",7961979,CDM,521,RC,32607,CPT,OUTPATIENT,,,816,530.4,,718.08,88,,574.46,,,0,"percent of total billed charges","88% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.92,100,,,,,0,"fee schedule",EAPG,816,100,,652.80,,,0,"percent of total billed charges","100% of total billed charges",18373.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",514.08,63,,411.26,,,0,"percent of total billed charges","63% of total billed charges",124.85,15.3,,99.88,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,563.04,69,,,,,0,"fee schedule","69% of total billed charges",816,100,,652.80,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",816,100,,652.80,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",816,100,,652.80,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.92,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",307.63,37.7,,246.10,,,0,"percent of total billed charges","37.70% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",636.48,78,,509.18,,,0,"percent of total billed charges","78% of total billed charges",10604.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",674.02,82.6,,539.22,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",674.02,82.6,,539.22,,,0,"percent of total billed charges","82.6% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4844.45,100,,,,,0,"fee schedule",EAPG,816,100,,652.80,,,0,"percent of total billed charges","100% of total billed charges",124.85,20558.19,
"32608 Thoracoscopy; with diagnostic biopsy(ies) of",7961980,CDM,521,RC,32608,CPT,OUTPATIENT,,,1001,650.65,,880.88,88,,704.70,,,0,"percent of total billed charges","88% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.92,100,,,,,0,"fee schedule",EAPG,1001,100,,800.80,,,0,"percent of total billed charges","100% of total billed charges",18373.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",630.63,63,,504.50,,,0,"percent of total billed charges","63% of total billed charges",153.15,15.3,,122.52,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,690.69,69,,,,,0,"fee schedule","69% of total billed charges",1001,100,,800.80,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1001,100,,800.80,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1001,100,,800.80,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.92,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",377.38,37.7,,301.90,,,0,"percent of total billed charges","37.70% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",780.78,78,,624.62,,,0,"percent of total billed charges","78% of total billed charges",10604.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",826.83,82.6,,661.46,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",826.83,82.6,,661.46,,,0,"percent of total billed charges","82.6% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4844.45,100,,,,,0,"fee schedule",EAPG,1001,100,,800.80,,,0,"percent of total billed charges","100% of total billed charges",153.15,20558.19,
"32606 Thoracoscopy, diagnostic (separate procedure",7962558,CDM,521,RC,32606,CPT,OUTPATIENT,,,2225,1446.25,,1958,88,,1566.40,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.92,100,,,,,0,"fee schedule",EAPG,2225,100,,1780.00,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1401.75,63,,1121.40,,,0,"percent of total billed charges","63% of total billed charges",340.43,15.3,,272.34,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,1535.25,69,,,,,0,"fee schedule","69% of total billed charges",2225,100,,1780.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2225,100,,1780.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2225,100,,1780.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.92,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",838.83,37.7,,671.06,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1735.5,78,,1388.40,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1837.85,82.6,,1470.28,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1837.85,82.6,,1470.28,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4844.45,100,,,,,0,"fee schedule",EAPG,2225,100,,1780.00,,,0,"percent of total billed charges","100% of total billed charges",340.43,20558.19,
"32604 Thoracoscopy, diagnostic (separate procedure",7962654,CDM,521,RC,32604,CPT,OUTPATIENT,,,2310,1501.5,,2032.8,88,,1626.24,,,0,"percent of total billed charges","88% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2020.72,100,,,,,0,"fee schedule",EAPG,2310,100,,1848.00,,,0,"percent of total billed charges","100% of total billed charges",18373.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",2081.34,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1455.3,63,,1164.24,,,0,"percent of total billed charges","63% of total billed charges",353.43,15.3,,282.74,,,0,"percent of total billed charges","15.3% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,1593.9,69,,,,,0,"fee schedule","69% of total billed charges",2310,100,,1848.00,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2310,100,,1848.00,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2310,100,,1848.00,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2020.72,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2061.13,100,,,,,0,"fee schedule",EAPG,2626.94,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",870.87,37.7,,696.70,,,0,"percent of total billed charges","37.70% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1801.8,78,,1441.44,,,0,"percent of total billed charges","78% of total billed charges",10604.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1908.06,82.6,,1526.45,,,0,"percent of total billed charges","82.6% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1908.06,82.6,,1526.45,,,0,"percent of total billed charges","82.6% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2181.25,100,,,,,0,"fee schedule",EAPG,2310,100,,1848.00,,,0,"percent of total billed charges","100% of total billed charges",353.43,20558.19,
"32609 Thoracoscopy; with biopsy(ies) of pleura",7963582,CDM,521,RC,32609,CPT,OUTPATIENT,,,694,451.1,,610.72,88,,488.58,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2020.72,100,,,,,0,"fee schedule",EAPG,694,100,,555.20,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",2081.34,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",437.22,63,,349.78,,,0,"percent of total billed charges","63% of total billed charges",106.18,15.3,,84.94,,,0,"percent of total billed charges","15.3% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,478.86,69,,,,,0,"fee schedule","69% of total billed charges",694,100,,555.20,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694,100,,555.20,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694,100,,555.20,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2020.72,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2061.13,100,,,,,0,"fee schedule",EAPG,2626.94,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",261.64,37.7,,209.31,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",541.32,78,,433.06,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",573.24,82.6,,458.59,,,0,"percent of total billed charges","82.6% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",573.24,82.6,,458.59,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2181.25,100,,,,,0,"fee schedule",EAPG,694,100,,555.20,,,0,"percent of total billed charges","100% of total billed charges",106.18,20558.19,
"32655 Thoracoscopy, surgical; with resection-plica",7961501,CDM,521,RC,32655,CPT,OUTPATIENT,,,5092,3309.8,,4480.96,88,,3584.77,,,0,"percent of total billed charges","88% of total billed charges",5092,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5092,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,5092,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3207.96,63,,2566.37,,,0,"percent of total billed charges","63% of total billed charges",779.08,15.3,,623.26,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,3513.48,69,,,,,0,"fee schedule","69% of total billed charges",5092,100,,4073.60,,,0,"percent of total billed charges","100% of total billed charges",5092,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5092,100,,4073.60,,,0,"percent of total billed charges","100% of total billed charges",5092,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5092,100,,4073.60,,,0,"percent of total billed charges","100% of total billed charges",5092,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5092,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,5092,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5092,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5092,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,5092,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1919.68,37.7,,1535.74,,,0,"percent of total billed charges","37.70% of total billed charges",5092,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5092,100,,,,,0,"fee schedule","100% of CMS fee schedule",3971.76,78,,3177.41,,,0,"percent of total billed charges","78% of total billed charges",5092,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4205.99,82.6,,3364.79,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,5092,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4205.99,82.6,,3364.79,,,0,"percent of total billed charges","82.6% of total billed charges",5092,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,5092,100,,4073.60,,,0,"percent of total billed charges","100% of total billed charges",779.08,6089.09,
"32652 Thoracoscopy, surgical; with total pulmonary",7962161,CDM,521,RC,32652,CPT,OUTPATIENT,,,6521,4238.65,,5738.48,88,,4590.78,,,0,"percent of total billed charges","88% of total billed charges",6521,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6521,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,6521,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4108.23,63,,3286.58,,,0,"percent of total billed charges","63% of total billed charges",997.71,15.3,,798.17,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,4499.49,69,,,,,0,"fee schedule","69% of total billed charges",6521,100,,5216.80,,,0,"percent of total billed charges","100% of total billed charges",6521,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6521,100,,5216.80,,,0,"percent of total billed charges","100% of total billed charges",6521,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6521,100,,5216.80,,,0,"percent of total billed charges","100% of total billed charges",6521,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6521,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,6521,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6521,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6521,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,6521,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2458.42,37.7,,1966.74,,,0,"percent of total billed charges","37.70% of total billed charges",6521,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6521,100,,,,,0,"fee schedule","100% of CMS fee schedule",5086.38,78,,4069.10,,,0,"percent of total billed charges","78% of total billed charges",6521,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5386.35,82.6,,4309.08,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule","100% of WA fee schedule",6521,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5386.35,82.6,,4309.08,,,0,"percent of total billed charges","82.6% of total billed charges",6521,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,6521,100,,5216.80,,,0,"percent of total billed charges","100% of total billed charges",997.71,6521,
"32653 Thoracoscopy, surgical; with removal of intr",7962388,CDM,521,RC,32653,CPT,OUTPATIENT,,,5179,3366.35,,4557.52,88,,3646.02,,,0,"percent of total billed charges","88% of total billed charges",5179,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2020.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5179,175,,,,,0,"fee schedule","175% of CMS fee schedule",2081.34,100,,,,,0,"fee schedule",EAPG,5179,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3262.77,63,,2610.22,,,0,"percent of total billed charges","63% of total billed charges",792.39,15.3,,633.91,,,0,"percent of total billed charges","15.3% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,3573.51,69,,,,,0,"fee schedule","69% of total billed charges",5179,100,,4143.20,,,0,"percent of total billed charges","100% of total billed charges",5179,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5179,100,,4143.20,,,0,"percent of total billed charges","100% of total billed charges",5179,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5179,100,,4143.20,,,0,"percent of total billed charges","100% of total billed charges",5179,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5179,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2020.72,100,,,,,0,"fee schedule",EAPG,5179,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5179,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5179,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2061.13,100,,,,,0,"fee schedule",EAPG,2626.94,100,,,,,0,"fee schedule",EAPG,5179,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1952.48,37.7,,1561.98,,,0,"percent of total billed charges","37.70% of total billed charges",5179,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5179,100,,,,,0,"fee schedule","100% of CMS fee schedule",4039.62,78,,3231.70,,,0,"percent of total billed charges","78% of total billed charges",5179,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4277.85,82.6,,3422.28,,,0,"percent of total billed charges","82.6% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,5179,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4277.85,82.6,,3422.28,,,0,"percent of total billed charges","82.6% of total billed charges",5179,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2181.25,100,,,,,0,"fee schedule",EAPG,5179,100,,4143.20,,,0,"percent of total billed charges","100% of total billed charges",792.39,5179,
"32658 Thoracoscopy, surgical; with removal of clot",7962458,CDM,521,RC,32658,CPT,OUTPATIENT,,,3613,2348.45,,3179.44,88,,2543.55,,,0,"percent of total billed charges","88% of total billed charges",3613,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,3613,100,,2890.40,,,0,"percent of total billed charges","100% of total billed charges",3613,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,3613,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2276.19,63,,1820.95,,,0,"percent of total billed charges","63% of total billed charges",552.79,15.3,,442.23,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,2492.97,69,,,,,0,"fee schedule","69% of total billed charges",3613,100,,2890.40,,,0,"percent of total billed charges","100% of total billed charges",3613,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3613,100,,2890.40,,,0,"percent of total billed charges","100% of total billed charges",3613,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3613,100,,2890.40,,,0,"percent of total billed charges","100% of total billed charges",3613,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3613,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,3613,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3613,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3613,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,3613,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1362.1,37.7,,1089.68,,,0,"percent of total billed charges","37.70% of total billed charges",3613,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3613,100,,,,,0,"fee schedule","100% of CMS fee schedule",2818.14,78,,2254.51,,,0,"percent of total billed charges","78% of total billed charges",3613,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2984.34,82.6,,2387.47,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,3613,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2984.34,82.6,,2387.47,,,0,"percent of total billed charges","82.6% of total billed charges",3613,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,3613,100,,2890.40,,,0,"percent of total billed charges","100% of total billed charges",552.79,6089.09,
"32650 Thoracoscopy, surgical; with pleurodesis (eg",7962844,CDM,521,RC,32650,CPT,OUTPATIENT,,,3856,2506.4,,3393.28,88,,2714.62,,,0,"percent of total billed charges","88% of total billed charges",3856,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,3856,100,,3084.80,,,0,"percent of total billed charges","100% of total billed charges",3856,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,3856,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2429.28,63,,1943.42,,,0,"percent of total billed charges","63% of total billed charges",589.97,15.3,,471.98,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,2660.64,69,,,,,0,"fee schedule","69% of total billed charges",3856,100,,3084.80,,,0,"percent of total billed charges","100% of total billed charges",3856,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3856,100,,3084.80,,,0,"percent of total billed charges","100% of total billed charges",3856,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3856,100,,3084.80,,,0,"percent of total billed charges","100% of total billed charges",3856,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3856,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,3856,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3856,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3856,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,3856,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1453.71,37.7,,1162.97,,,0,"percent of total billed charges","37.70% of total billed charges",3856,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3856,100,,,,,0,"fee schedule","100% of CMS fee schedule",3007.68,78,,2406.14,,,0,"percent of total billed charges","78% of total billed charges",3856,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3185.06,82.6,,2548.05,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,3856,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3185.06,82.6,,2548.05,,,0,"percent of total billed charges","82.6% of total billed charges",3856,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,3856,100,,3084.80,,,0,"percent of total billed charges","100% of total billed charges",589.97,6089.09,
"32651 Thoracoscopy, surgical; with partial pulmona",7963062,CDM,521,RC,32651,CPT,OUTPATIENT,,,4683,3043.95,,4121.04,88,,3296.83,,,0,"percent of total billed charges","88% of total billed charges",4683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,4683,100,,3746.40,,,0,"percent of total billed charges","100% of total billed charges",4683,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,4683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2950.29,63,,2360.23,,,0,"percent of total billed charges","63% of total billed charges",716.5,15.3,,573.20,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,3231.27,69,,,,,0,"fee schedule","69% of total billed charges",4683,100,,3746.40,,,0,"percent of total billed charges","100% of total billed charges",4683,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683,100,,3746.40,,,0,"percent of total billed charges","100% of total billed charges",4683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683,100,,3746.40,,,0,"percent of total billed charges","100% of total billed charges",4683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,4683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,4683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1765.49,37.7,,1412.39,,,0,"percent of total billed charges","37.70% of total billed charges",4683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4683,100,,,,,0,"fee schedule","100% of CMS fee schedule",3652.74,78,,2922.19,,,0,"percent of total billed charges","78% of total billed charges",4683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3868.16,82.6,,3094.53,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,4683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3868.16,82.6,,3094.53,,,0,"percent of total billed charges","82.6% of total billed charges",4683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,4683,100,,3746.40,,,0,"percent of total billed charges","100% of total billed charges",716.5,6089.09,
"32654 Thoracoscopy, surgical; with control of trau",7963063,CDM,521,RC,32654,CPT,OUTPATIENT,,,5209,3385.85,,4583.92,88,,3667.14,,,0,"percent of total billed charges","88% of total billed charges",5209,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5209,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,5209,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3281.67,63,,2625.34,,,0,"percent of total billed charges","63% of total billed charges",796.98,15.3,,637.58,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,3594.21,69,,,,,0,"fee schedule","69% of total billed charges",5209,100,,4167.20,,,0,"percent of total billed charges","100% of total billed charges",5209,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5209,100,,4167.20,,,0,"percent of total billed charges","100% of total billed charges",5209,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5209,100,,4167.20,,,0,"percent of total billed charges","100% of total billed charges",5209,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5209,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,5209,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5209,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5209,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,5209,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1963.79,37.7,,1571.03,,,0,"percent of total billed charges","37.70% of total billed charges",5209,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5209,100,,,,,0,"fee schedule","100% of CMS fee schedule",4063.02,78,,3250.42,,,0,"percent of total billed charges","78% of total billed charges",5209,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4302.63,82.6,,3442.10,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,5209,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4302.63,82.6,,3442.10,,,0,"percent of total billed charges","82.6% of total billed charges",5209,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,5209,100,,4167.20,,,0,"percent of total billed charges","100% of total billed charges",796.98,6089.09,
"32659 Thoracoscopy, surgical; with creation of win",7963138,CDM,521,RC,32659,CPT,OUTPATIENT,,,4890,3178.5,,4303.2,88,,3442.56,,,0,"percent of total billed charges","88% of total billed charges",4890,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",4890,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,4890,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3080.7,63,,2464.56,,,0,"percent of total billed charges","63% of total billed charges",748.17,15.3,,598.54,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,3374.1,69,,,,,0,"fee schedule","69% of total billed charges",4890,100,,3912.00,,,0,"percent of total billed charges","100% of total billed charges",4890,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4890,100,,3912.00,,,0,"percent of total billed charges","100% of total billed charges",4890,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4890,100,,3912.00,,,0,"percent of total billed charges","100% of total billed charges",4890,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4890,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,4890,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4890,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4890,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,4890,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1843.53,37.7,,1474.82,,,0,"percent of total billed charges","37.70% of total billed charges",4890,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4890,100,,,,,0,"fee schedule","100% of CMS fee schedule",3814.2,78,,3051.36,,,0,"percent of total billed charges","78% of total billed charges",4890,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4039.14,82.6,,3231.31,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,4890,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4039.14,82.6,,3231.31,,,0,"percent of total billed charges","82.6% of total billed charges",4890,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,4890,100,,3912.00,,,0,"percent of total billed charges","100% of total billed charges",748.17,6089.09,
"32656 Thoracoscopy, surgical; with parietal pleure",7963304,CDM,521,RC,32656,CPT,OUTPATIENT,,,6146,3994.9,,5408.48,88,,4326.78,,,0,"percent of total billed charges","88% of total billed charges",6146,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2020.72,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6146,175,,,,,0,"fee schedule","175% of CMS fee schedule",2081.34,100,,,,,0,"fee schedule",EAPG,6146,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3871.98,63,,3097.58,,,0,"percent of total billed charges","63% of total billed charges",940.34,15.3,,752.27,,,0,"percent of total billed charges","15.3% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,4240.74,69,,,,,0,"fee schedule","69% of total billed charges",6146,100,,4916.80,,,0,"percent of total billed charges","100% of total billed charges",6146,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6146,100,,4916.80,,,0,"percent of total billed charges","100% of total billed charges",6146,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6146,100,,4916.80,,,0,"percent of total billed charges","100% of total billed charges",6146,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6146,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2020.72,100,,,,,0,"fee schedule",EAPG,6146,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6146,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6146,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2061.13,100,,,,,0,"fee schedule",EAPG,2626.94,100,,,,,0,"fee schedule",EAPG,6146,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2317.04,37.7,,1853.63,,,0,"percent of total billed charges","37.70% of total billed charges",6146,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6146,100,,,,,0,"fee schedule","100% of CMS fee schedule",4793.88,78,,3835.10,,,0,"percent of total billed charges","78% of total billed charges",6146,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5076.6,82.6,,4061.28,,,0,"percent of total billed charges","82.6% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,6146,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5076.6,82.6,,4061.28,,,0,"percent of total billed charges","82.6% of total billed charges",6146,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2181.25,100,,,,,0,"fee schedule",EAPG,6146,100,,4916.80,,,0,"percent of total billed charges","100% of total billed charges",940.34,6146,
"32668 Thoracoscopy, surgical; with diagnostic wedg",7962114,CDM,521,RC,32668,CPT,OUTPATIENT,,,417,271.05,,366.96,88,,293.57,,,0,"percent of total billed charges","88% of total billed charges",417,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,417,100,,333.60,,,0,"percent of total billed charges","100% of total billed charges",417,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,417,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",262.71,63,,210.17,,,0,"percent of total billed charges","63% of total billed charges",63.8,15.3,,51.04,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,287.73,69,,,,,0,"fee schedule","69% of total billed charges",417,100,,333.60,,,0,"percent of total billed charges","100% of total billed charges",417,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",417,100,,333.60,,,0,"percent of total billed charges","100% of total billed charges",417,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",417,100,,333.60,,,0,"percent of total billed charges","100% of total billed charges",417,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",417,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,417,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",417,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",417,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,417,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",157.21,37.7,,125.77,,,0,"percent of total billed charges","37.70% of total billed charges",417,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",417,100,,,,,0,"fee schedule","100% of CMS fee schedule",325.26,78,,260.21,,,0,"percent of total billed charges","78% of total billed charges",417,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",344.44,82.6,,275.55,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule","100% of WA fee schedule",417,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",344.44,82.6,,275.55,,,0,"percent of total billed charges","82.6% of total billed charges",417,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,417,100,,333.60,,,0,"percent of total billed charges","100% of total billed charges",63.8,6089.09,
"32667 Thoracoscopy, surgical; with therapeutic wed",7962181,CDM,521,RC,32667,CPT,OUTPATIENT,,,414,269.1,,364.32,88,,291.46,,,0,"percent of total billed charges","88% of total billed charges",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,414,100,,331.20,,,0,"percent of total billed charges","100% of total billed charges",414,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",260.82,63,,208.66,,,0,"percent of total billed charges","63% of total billed charges",63.34,15.3,,50.67,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,285.66,69,,,,,0,"fee schedule","69% of total billed charges",414,100,,331.20,,,0,"percent of total billed charges","100% of total billed charges",414,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",414,100,,331.20,,,0,"percent of total billed charges","100% of total billed charges",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",414,100,,331.20,,,0,"percent of total billed charges","100% of total billed charges",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",156.08,37.7,,124.86,,,0,"percent of total billed charges","37.70% of total billed charges",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",414,100,,,,,0,"fee schedule","100% of CMS fee schedule",322.92,78,,258.34,,,0,"percent of total billed charges","78% of total billed charges",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",341.96,82.6,,273.57,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule","100% of WA fee schedule",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",341.96,82.6,,273.57,,,0,"percent of total billed charges","82.6% of total billed charges",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,414,100,,331.20,,,0,"percent of total billed charges","100% of total billed charges",63.34,6089.09,
"32669 Thoracoscopy, surgical; with removal of a si",7962573,CDM,521,RC,32669,CPT,OUTPATIENT,,,3536,2298.4,,3111.68,88,,2489.34,,,0,"percent of total billed charges","88% of total billed charges",3536,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,3536,100,,2828.80,,,0,"percent of total billed charges","100% of total billed charges",3536,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,3536,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2227.68,63,,1782.14,,,0,"percent of total billed charges","63% of total billed charges",541.01,15.3,,432.81,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,2439.84,69,,,,,0,"fee schedule","69% of total billed charges",3536,100,,2828.80,,,0,"percent of total billed charges","100% of total billed charges",3536,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3536,100,,2828.80,,,0,"percent of total billed charges","100% of total billed charges",3536,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3536,100,,2828.80,,,0,"percent of total billed charges","100% of total billed charges",3536,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3536,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,3536,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3536,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3536,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,3536,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1333.07,37.7,,1066.46,,,0,"percent of total billed charges","37.70% of total billed charges",3536,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3536,100,,,,,0,"fee schedule","100% of CMS fee schedule",2758.08,78,,2206.46,,,0,"percent of total billed charges","78% of total billed charges",3536,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2920.74,82.6,,2336.59,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule","100% of WA fee schedule",3536,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2920.74,82.6,,2336.59,,,0,"percent of total billed charges","82.6% of total billed charges",3536,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,3536,100,,2828.80,,,0,"percent of total billed charges","100% of total billed charges",541.01,6089.09,
"32666 Thoracoscopy, surgical; with therapeutic wed",7962600,CDM,521,RC,32666,CPT,OUTPATIENT,,,2296,1492.4,,2020.48,88,,1616.38,,,0,"percent of total billed charges","88% of total billed charges",2296,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,2296,100,,1836.80,,,0,"percent of total billed charges","100% of total billed charges",2296,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,2296,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1446.48,63,,1157.18,,,0,"percent of total billed charges","63% of total billed charges",351.29,15.3,,281.03,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,1584.24,69,,,,,0,"fee schedule","69% of total billed charges",2296,100,,1836.80,,,0,"percent of total billed charges","100% of total billed charges",2296,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2296,100,,1836.80,,,0,"percent of total billed charges","100% of total billed charges",2296,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2296,100,,1836.80,,,0,"percent of total billed charges","100% of total billed charges",2296,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2296,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,2296,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2296,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2296,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,2296,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",865.59,37.7,,692.47,,,0,"percent of total billed charges","37.70% of total billed charges",2296,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2296,100,,,,,0,"fee schedule","100% of CMS fee schedule",1790.88,78,,1432.70,,,0,"percent of total billed charges","78% of total billed charges",2296,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1896.5,82.6,,1517.20,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule","100% of WA fee schedule",2296,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1896.5,82.6,,1517.20,,,0,"percent of total billed charges","82.6% of total billed charges",2296,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,2296,100,,1836.80,,,0,"percent of total billed charges","100% of total billed charges",351.29,6089.09,
"32662 Thoracoscopy, surgical; with excision of med",7962658,CDM,521,RC,32662,CPT,OUTPATIENT,,,5703,3706.95,,5018.64,88,,4014.91,,,0,"percent of total billed charges","88% of total billed charges",5703,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5703,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,5703,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3592.89,63,,2874.31,,,0,"percent of total billed charges","63% of total billed charges",872.56,15.3,,698.05,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,3935.07,69,,,,,0,"fee schedule","69% of total billed charges",5703,100,,4562.40,,,0,"percent of total billed charges","100% of total billed charges",5703,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5703,100,,4562.40,,,0,"percent of total billed charges","100% of total billed charges",5703,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5703,100,,4562.40,,,0,"percent of total billed charges","100% of total billed charges",5703,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5703,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,5703,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5703,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5703,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,5703,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2150.03,37.7,,1720.02,,,0,"percent of total billed charges","37.70% of total billed charges",5703,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5703,100,,,,,0,"fee schedule","100% of CMS fee schedule",4448.34,78,,3558.67,,,0,"percent of total billed charges","78% of total billed charges",5703,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4710.68,82.6,,3768.54,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,5703,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4710.68,82.6,,3768.54,,,0,"percent of total billed charges","82.6% of total billed charges",5703,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,5703,100,,4562.40,,,0,"percent of total billed charges","100% of total billed charges",872.56,6089.09,
"32661 Thoracoscopy, surgical; with excision of per",7962724,CDM,521,RC,32661,CPT,OUTPATIENT,,,4022,2614.3,,3539.36,88,,2831.49,,,0,"percent of total billed charges","88% of total billed charges",4022,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,4022,100,,3217.60,,,0,"percent of total billed charges","100% of total billed charges",4022,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,4022,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2533.86,63,,2027.09,,,0,"percent of total billed charges","63% of total billed charges",615.37,15.3,,492.30,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,2775.18,69,,,,,0,"fee schedule","69% of total billed charges",4022,100,,3217.60,,,0,"percent of total billed charges","100% of total billed charges",4022,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4022,100,,3217.60,,,0,"percent of total billed charges","100% of total billed charges",4022,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4022,100,,3217.60,,,0,"percent of total billed charges","100% of total billed charges",4022,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4022,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,4022,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4022,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4022,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,4022,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1516.29,37.7,,1213.03,,,0,"percent of total billed charges","37.70% of total billed charges",4022,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4022,100,,,,,0,"fee schedule","100% of CMS fee schedule",3137.16,78,,2509.73,,,0,"percent of total billed charges","78% of total billed charges",4022,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3322.17,82.6,,2657.74,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,4022,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3322.17,82.6,,2657.74,,,0,"percent of total billed charges","82.6% of total billed charges",4022,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,4022,100,,3217.60,,,0,"percent of total billed charges","100% of total billed charges",615.37,6089.09,
"32663 Thoracoscopy, surgical; with lobectomy (sing",7963328,CDM,521,RC,32663,CPT,OUTPATIENT,,,7166,4657.9,,6306.08,88,,5044.86,,,0,"percent of total billed charges","88% of total billed charges",7166,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7166,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,7166,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4514.58,63,,3611.66,,,0,"percent of total billed charges","63% of total billed charges",1096.4,15.3,,877.12,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,4944.54,69,,,,,0,"fee schedule","69% of total billed charges",7166,100,,5732.80,,,0,"percent of total billed charges","100% of total billed charges",7166,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7166,100,,5732.80,,,0,"percent of total billed charges","100% of total billed charges",7166,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7166,100,,5732.80,,,0,"percent of total billed charges","100% of total billed charges",7166,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7166,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,7166,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7166,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7166,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,7166,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2701.58,37.7,,2161.26,,,0,"percent of total billed charges","37.70% of total billed charges",7166,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7166,100,,,,,0,"fee schedule","100% of CMS fee schedule",5589.48,78,,4471.58,,,0,"percent of total billed charges","78% of total billed charges",7166,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5919.12,82.6,,4735.30,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule","100% of WA fee schedule",7166,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5919.12,82.6,,4735.30,,,0,"percent of total billed charges","82.6% of total billed charges",7166,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,7166,100,,5732.80,,,0,"percent of total billed charges","100% of total billed charges",1096.4,7166,
"32664 Thoracoscopy, surgical; with thoracic sympat",7963362,CDM,521,RC,32664,CPT,OUTPATIENT,,,3833,2491.45,,3373.04,88,,2698.43,,,0,"percent of total billed charges","88% of total billed charges",3833,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,3833,100,,3066.40,,,0,"percent of total billed charges","100% of total billed charges",3833,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,3833,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2414.79,63,,1931.83,,,0,"percent of total billed charges","63% of total billed charges",586.45,15.3,,469.16,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,2644.77,69,,,,,0,"fee schedule","69% of total billed charges",3833,100,,3066.40,,,0,"percent of total billed charges","100% of total billed charges",3833,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3833,100,,3066.40,,,0,"percent of total billed charges","100% of total billed charges",3833,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3833,100,,3066.40,,,0,"percent of total billed charges","100% of total billed charges",3833,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3833,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,3833,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3833,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3833,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,3833,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1445.04,37.7,,1156.03,,,0,"percent of total billed charges","37.70% of total billed charges",3833,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3833,100,,,,,0,"fee schedule","100% of CMS fee schedule",2989.74,78,,2391.79,,,0,"percent of total billed charges","78% of total billed charges",3833,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3166.06,82.6,,2532.85,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,3833,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3166.06,82.6,,2532.85,,,0,"percent of total billed charges","82.6% of total billed charges",3833,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,3833,100,,3066.40,,,0,"percent of total billed charges","100% of total billed charges",586.45,6089.09,
"32674 Thoracoscopy, surgical; with mediastinal and",7962845,CDM,521,RC,32674,CPT,OUTPATIENT,,,568,369.2,,499.84,88,,399.87,,,0,"percent of total billed charges","88% of total billed charges",568,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",568,100,,454.40,,,0,"percent of total billed charges","100% of total billed charges",568,175,,,,,0,"fee schedule","175% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",568,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",357.84,63,,286.27,,,0,"percent of total billed charges","63% of total billed charges",86.9,15.3,,69.52,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",391.92,69,,,,,0,"fee schedule","69% of total billed charges",568,100,,454.40,,,0,"percent of total billed charges","100% of total billed charges",568,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",568,100,,454.40,,,0,"percent of total billed charges","100% of total billed charges",568,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",568,100,,454.40,,,0,"percent of total billed charges","100% of total billed charges",568,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",568,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",568,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",568,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",568,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",568,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",214.14,37.7,,171.31,,,0,"percent of total billed charges","37.70% of total billed charges",568,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",568,100,,,,,0,"fee schedule","100% of CMS fee schedule",443.04,78,,354.43,,,0,"percent of total billed charges","78% of total billed charges",568,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",469.17,82.6,,375.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",568,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",469.17,82.6,,375.34,,,0,"percent of total billed charges","82.6% of total billed charges",568,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",160.53,100,,,,,0,"case rate","pays based on per visit rate",568,100,,454.40,,,0,"percent of total billed charges","100% of total billed charges",86.9,568,
"32999 Unlisted procedure, lungs and pleura",7963637,CDM,521,RC,32999,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",858.26,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",884,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",858.26,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",858.26,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",875.42,100,,,,,0,"fee schedule",EAPG,1115.74,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",858.26,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1018.79,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",858.26,1115.74,
"33010 Pericardiocentesis; initial",7963810,CDM,521,RC,33016,CPT,OUTPATIENT,,,347,225.55,,305.36,88,,244.29,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",884,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.61,63,,174.89,,,0,"percent of total billed charges","63% of total billed charges",53.09,15.3,,42.47,,,0,"percent of total billed charges","15.3% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,239.43,69,,,,,0,"fee schedule","69% of total billed charges",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.42,100,,,,,0,"fee schedule",EAPG,1115.74,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.82,37.7,,104.66,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.66,78,,216.53,,,0,"percent of total billed charges","78% of total billed charges",1649.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",286.62,82.6,,229.30,,,0,"percent of total billed charges","82.6% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",286.62,82.6,,229.30,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1018.79,100,,,,,0,"fee schedule",EAPG,347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",53.09,5712.48,
"33017 Peri drain w/indwelling cath insert, percuta",7963887,CDM,521,RC,33017,CPT,OUTPATIENT,,,1153,749.45,,1014.64,88,,811.71,,,0,"percent of total billed charges","88% of total billed charges",1153,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",858.26,100,,,,,0,"fee schedule",EAPG,1153,100,,922.40,,,0,"percent of total billed charges","100% of total billed charges",1153,175,,,,,0,"fee schedule","175% of CMS fee schedule",884,100,,,,,0,"fee schedule",EAPG,1153,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",726.39,63,,581.11,,,0,"percent of total billed charges","63% of total billed charges",176.41,15.3,,141.13,,,0,"percent of total billed charges","15.3% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,795.57,69,,,,,0,"fee schedule","69% of total billed charges",1153,100,,922.40,,,0,"percent of total billed charges","100% of total billed charges",1153,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1153,100,,922.40,,,0,"percent of total billed charges","100% of total billed charges",1153,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1153,100,,922.40,,,0,"percent of total billed charges","100% of total billed charges",1153,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1153,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",858.26,100,,,,,0,"fee schedule",EAPG,1153,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1153,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1153,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",875.42,100,,,,,0,"fee schedule",EAPG,1115.74,100,,,,,0,"fee schedule",EAPG,1153,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",434.68,37.7,,347.74,,,0,"percent of total billed charges","37.70% of total billed charges",1153,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1153,100,,,,,0,"fee schedule","100% of CMS fee schedule",899.34,78,,719.47,,,0,"percent of total billed charges","78% of total billed charges",1153,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",952.38,82.6,,761.90,,,0,"percent of total billed charges","82.6% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,1153,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",952.38,82.6,,761.90,,,0,"percent of total billed charges","82.6% of total billed charges",1153,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1018.79,100,,,,,0,"fee schedule",EAPG,1153,100,,922.40,,,0,"percent of total billed charges","100% of total billed charges",176.41,1153,
"33016 - Pericardiocentesis w/imaging",9442492,CDM,521,RC,33016,CPT,OUTPATIENT,,,347,225.55,,305.36,88,,244.29,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",884,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.61,63,,174.89,,,0,"percent of total billed charges","63% of total billed charges",53.09,15.3,,42.47,,,0,"percent of total billed charges","15.3% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,239.43,69,,,,,0,"fee schedule","69% of total billed charges",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.26,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.42,100,,,,,0,"fee schedule",EAPG,1115.74,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.82,37.7,,104.66,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.66,78,,216.53,,,0,"percent of total billed charges","78% of total billed charges",1649.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",286.62,82.6,,229.30,,,0,"percent of total billed charges","82.6% of total billed charges",858.26,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",286.62,82.6,,229.30,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1018.79,100,,,,,0,"fee schedule",EAPG,347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",53.09,5712.48,
"33020 Pericardiotomy for removal of clot or foreig",7962831,CDM,521,RC,33020,CPT,OUTPATIENT,,,2569,1669.85,,2260.72,88,,1808.58,,,0,"percent of total billed charges","88% of total billed charges",2569,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,2569,100,,2055.20,,,0,"percent of total billed charges","100% of total billed charges",2569,175,,,,,0,"fee schedule","175% of CMS fee schedule",11434.32,100,,,,,0,"fee schedule",EAPG,2569,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1618.47,63,,1294.78,,,0,"percent of total billed charges","63% of total billed charges",393.06,15.3,,314.45,,,0,"percent of total billed charges","15.3% of total billed charges",11101.28,100,,,,,0,"fee schedule",EAPG,1772.61,69,,,,,0,"fee schedule","69% of total billed charges",2569,100,,2055.20,,,0,"percent of total billed charges","100% of total billed charges",2569,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2569,100,,2055.20,,,0,"percent of total billed charges","100% of total billed charges",2569,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2569,100,,2055.20,,,0,"percent of total billed charges","100% of total billed charges",2569,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2569,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,2569,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2569,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2569,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11323.31,100,,,,,0,"fee schedule",EAPG,14431.67,100,,,,,0,"fee schedule",EAPG,2569,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",968.51,37.7,,774.81,,,0,"percent of total billed charges","37.70% of total billed charges",2569,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2569,100,,,,,0,"fee schedule","100% of CMS fee schedule",2003.82,78,,1603.06,,,0,"percent of total billed charges","78% of total billed charges",2569,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2121.99,82.6,,1697.59,,,0,"percent of total billed charges","82.6% of total billed charges",11101.28,100,,,,,0,"fee schedule","100% of WA fee schedule",2569,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2121.99,82.6,,1697.59,,,0,"percent of total billed charges","82.6% of total billed charges",2569,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11261.81,100,,,,,0,"fee schedule",EAPG,2569,100,,2055.20,,,0,"percent of total billed charges","100% of total billed charges",393.06,14431.67,
"33025 Creation of pericardial window or partial re",7962997,CDM,521,RC,33025,CPT,OUTPATIENT,,,2898,1883.7,,2550.24,88,,2040.19,,,0,"percent of total billed charges","88% of total billed charges",2898,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,2898,100,,2318.40,,,0,"percent of total billed charges","100% of total billed charges",2898,175,,,,,0,"fee schedule","175% of CMS fee schedule",11434.32,100,,,,,0,"fee schedule",EAPG,2898,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1825.74,63,,1460.59,,,0,"percent of total billed charges","63% of total billed charges",443.39,15.3,,354.71,,,0,"percent of total billed charges","15.3% of total billed charges",11101.28,100,,,,,0,"fee schedule",EAPG,1999.62,69,,,,,0,"fee schedule","69% of total billed charges",2898,100,,2318.40,,,0,"percent of total billed charges","100% of total billed charges",2898,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2898,100,,2318.40,,,0,"percent of total billed charges","100% of total billed charges",2898,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2898,100,,2318.40,,,0,"percent of total billed charges","100% of total billed charges",2898,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2898,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,2898,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2898,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2898,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11323.31,100,,,,,0,"fee schedule",EAPG,14431.67,100,,,,,0,"fee schedule",EAPG,2898,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1092.55,37.7,,874.04,,,0,"percent of total billed charges","37.70% of total billed charges",2898,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2898,100,,,,,0,"fee schedule","100% of CMS fee schedule",2260.44,78,,1808.35,,,0,"percent of total billed charges","78% of total billed charges",2898,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2393.75,82.6,,1915.00,,,0,"percent of total billed charges","82.6% of total billed charges",11101.28,100,,,,,0,"fee schedule","100% of WA fee schedule",2898,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2393.75,82.6,,1915.00,,,0,"percent of total billed charges","82.6% of total billed charges",2898,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11261.81,100,,,,,0,"fee schedule",EAPG,2898,100,,2318.40,,,0,"percent of total billed charges","100% of total billed charges",443.39,14431.67,
"33120 Excision of intracardiac tumor, resection wi",7962846,CDM,521,RC,33120,CPT,OUTPATIENT,,,6122,3979.3,,5387.36,88,,4309.89,,,0,"percent of total billed charges","88% of total billed charges",6122,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6122,175,,,,,0,"fee schedule","175% of CMS fee schedule",11434.32,100,,,,,0,"fee schedule",EAPG,6122,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3856.86,63,,3085.49,,,0,"percent of total billed charges","63% of total billed charges",936.67,15.3,,749.34,,,0,"percent of total billed charges","15.3% of total billed charges",11101.28,100,,,,,0,"fee schedule",EAPG,4224.18,69,,,,,0,"fee schedule","69% of total billed charges",6122,100,,4897.60,,,0,"percent of total billed charges","100% of total billed charges",6122,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6122,100,,4897.60,,,0,"percent of total billed charges","100% of total billed charges",6122,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6122,100,,4897.60,,,0,"percent of total billed charges","100% of total billed charges",6122,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6122,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,6122,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6122,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6122,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11323.31,100,,,,,0,"fee schedule",EAPG,14431.67,100,,,,,0,"fee schedule",EAPG,6122,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2307.99,37.7,,1846.39,,,0,"percent of total billed charges","37.70% of total billed charges",6122,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6122,100,,,,,0,"fee schedule","100% of CMS fee schedule",4775.16,78,,3820.13,,,0,"percent of total billed charges","78% of total billed charges",6122,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5056.77,82.6,,4045.42,,,0,"percent of total billed charges","82.6% of total billed charges",11101.28,100,,,,,0,"fee schedule","100% of WA fee schedule",6122,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5056.77,82.6,,4045.42,,,0,"percent of total billed charges","82.6% of total billed charges",6122,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11261.81,100,,,,,0,"fee schedule",EAPG,6122,100,,4897.60,,,0,"percent of total billed charges","100% of total billed charges",936.67,14431.67,
"33140 Transmyocardial laser revascularization, by",7962559,CDM,521,RC,33140,CPT,OUTPATIENT,,,4621,3003.65,,4066.48,88,,3253.18,,,0,"percent of total billed charges","88% of total billed charges",4621,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,4621,100,,3696.80,,,0,"percent of total billed charges","100% of total billed charges",4621,175,,,,,0,"fee schedule","175% of CMS fee schedule",11434.32,100,,,,,0,"fee schedule",EAPG,4621,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2911.23,63,,2328.98,,,0,"percent of total billed charges","63% of total billed charges",707.01,15.3,,565.61,,,0,"percent of total billed charges","15.3% of total billed charges",11101.28,100,,,,,0,"fee schedule",EAPG,3188.49,69,,,,,0,"fee schedule","69% of total billed charges",4621,100,,3696.80,,,0,"percent of total billed charges","100% of total billed charges",4621,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4621,100,,3696.80,,,0,"percent of total billed charges","100% of total billed charges",4621,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4621,100,,3696.80,,,0,"percent of total billed charges","100% of total billed charges",4621,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4621,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,4621,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4621,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4621,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11323.31,100,,,,,0,"fee schedule",EAPG,14431.67,100,,,,,0,"fee schedule",EAPG,4621,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1742.12,37.7,,1393.70,,,0,"percent of total billed charges","37.70% of total billed charges",4621,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4621,100,,,,,0,"fee schedule","100% of CMS fee schedule",3604.38,78,,2883.50,,,0,"percent of total billed charges","78% of total billed charges",4621,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3816.95,82.6,,3053.56,,,0,"percent of total billed charges","82.6% of total billed charges",11101.28,100,,,,,0,"fee schedule","100% of WA fee schedule",4621,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3816.95,82.6,,3053.56,,,0,"percent of total billed charges","82.6% of total billed charges",4621,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11261.81,100,,,,,0,"fee schedule",EAPG,4621,100,,3696.80,,,0,"percent of total billed charges","100% of total billed charges",707.01,14431.67,
"33203 Insertion of epicardial electrode(s); endosc",7961600,CDM,521,RC,33203,CPT,OUTPATIENT,,,2461,1599.65,,2165.68,88,,1732.54,,,0,"percent of total billed charges","88% of total billed charges",2461,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7477.38,100,,,,,0,"fee schedule",EAPG,2461,100,,1968.80,,,0,"percent of total billed charges","100% of total billed charges",2461,175,,,,,0,"fee schedule","175% of CMS fee schedule",7701.7,100,,,,,0,"fee schedule",EAPG,2461,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1550.43,63,,1240.34,,,0,"percent of total billed charges","63% of total billed charges",376.53,15.3,,301.22,,,0,"percent of total billed charges","15.3% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,1698.09,69,,,,,0,"fee schedule","69% of total billed charges",2461,100,,1968.80,,,0,"percent of total billed charges","100% of total billed charges",2461,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2461,100,,1968.80,,,0,"percent of total billed charges","100% of total billed charges",2461,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2461,100,,1968.80,,,0,"percent of total billed charges","100% of total billed charges",2461,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2461,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7477.38,100,,,,,0,"fee schedule",EAPG,2461,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2461,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2461,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7626.93,100,,,,,0,"fee schedule",EAPG,9720.59,100,,,,,0,"fee schedule",EAPG,2461,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",927.8,37.7,,742.24,,,0,"percent of total billed charges","37.70% of total billed charges",2461,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2461,100,,,,,0,"fee schedule","100% of CMS fee schedule",1919.58,78,,1535.66,,,0,"percent of total billed charges","78% of total billed charges",2461,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2032.79,82.6,,1626.23,,,0,"percent of total billed charges","82.6% of total billed charges",7477.38,100,,,,,0,"fee schedule","100% of WA fee schedule",2461,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2032.79,82.6,,1626.23,,,0,"percent of total billed charges","82.6% of total billed charges",2461,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7637.91,100,,,,,0,"fee schedule",EAPG,2461,100,,1968.80,,,0,"percent of total billed charges","100% of total billed charges",376.53,9720.59,
"33206 Insertion of new or replacement of permanent",7961682,CDM,521,RC,33206,CPT,OUTPATIENT,,,1852,1203.8,,1629.76,88,,1303.81,,,0,"percent of total billed charges","88% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,1852,100,,1481.60,,,0,"percent of total billed charges","100% of total billed charges",19060,175,,,,,0,"fee schedule","175% of CMS fee schedule",7701.7,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1166.76,63,,933.41,,,0,"percent of total billed charges","63% of total billed charges",283.36,15.3,,226.69,,,0,"percent of total billed charges","15.3% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,1277.88,69,,,,,0,"fee schedule","69% of total billed charges",1852,100,,1481.60,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1852,100,,1481.60,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1852,100,,1481.60,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",42250.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11045.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7626.93,100,,,,,0,"fee schedule",EAPG,9720.59,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",698.2,37.7,,558.56,,,0,"percent of total billed charges","37.70% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1444.56,78,,1155.65,,,0,"percent of total billed charges","78% of total billed charges",11000.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1529.75,82.6,,1223.80,,,0,"percent of total billed charges","82.6% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1529.75,82.6,,1223.80,,,0,"percent of total billed charges","82.6% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7637.91,100,,,,,0,"fee schedule",EAPG,1852,100,,1481.60,,,0,"percent of total billed charges","100% of total billed charges",283.36,42250.94,
"33207 Insertion of new/replacement of permanent pa",7961683,CDM,521,RC,33207,CPT,OUTPATIENT,,,1955,1270.75,,1720.4,88,,1376.32,,,0,"percent of total billed charges","88% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,1955,100,,1564.00,,,0,"percent of total billed charges","100% of total billed charges",19060,175,,,,,0,"fee schedule","175% of CMS fee schedule",7701.7,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1231.65,63,,985.32,,,0,"percent of total billed charges","63% of total billed charges",299.12,15.3,,239.30,,,0,"percent of total billed charges","15.3% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,1348.95,69,,,,,0,"fee schedule","69% of total billed charges",1955,100,,1564.00,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955,100,,1564.00,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955,100,,1564.00,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",42250.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11045.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7626.93,100,,,,,0,"fee schedule",EAPG,9720.59,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",737.04,37.7,,589.63,,,0,"percent of total billed charges","37.70% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1524.9,78,,1219.92,,,0,"percent of total billed charges","78% of total billed charges",11000.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1614.83,82.6,,1291.86,,,0,"percent of total billed charges","82.6% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1614.83,82.6,,1291.86,,,0,"percent of total billed charges","82.6% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7637.91,100,,,,,0,"fee schedule",EAPG,1955,100,,1564.00,,,0,"percent of total billed charges","100% of total billed charges",299.12,42250.94,
"33202 Insertion of epicardial electrode(s); open i",7962147,CDM,521,RC,33202,CPT,OUTPATIENT,,,2203,1431.95,,1938.64,88,,1550.91,,,0,"percent of total billed charges","88% of total billed charges",2203,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,2203,100,,1762.40,,,0,"percent of total billed charges","100% of total billed charges",2203,175,,,,,0,"fee schedule","175% of CMS fee schedule",11434.32,100,,,,,0,"fee schedule",EAPG,2203,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1387.89,63,,1110.31,,,0,"percent of total billed charges","63% of total billed charges",337.06,15.3,,269.65,,,0,"percent of total billed charges","15.3% of total billed charges",11101.28,100,,,,,0,"fee schedule",EAPG,1520.07,69,,,,,0,"fee schedule","69% of total billed charges",2203,100,,1762.40,,,0,"percent of total billed charges","100% of total billed charges",2203,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2203,100,,1762.40,,,0,"percent of total billed charges","100% of total billed charges",2203,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2203,100,,1762.40,,,0,"percent of total billed charges","100% of total billed charges",2203,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2203,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,2203,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2203,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2203,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11323.31,100,,,,,0,"fee schedule",EAPG,14431.67,100,,,,,0,"fee schedule",EAPG,2203,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",830.53,37.7,,664.42,,,0,"percent of total billed charges","37.70% of total billed charges",2203,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2203,100,,,,,0,"fee schedule","100% of CMS fee schedule",1718.34,78,,1374.67,,,0,"percent of total billed charges","78% of total billed charges",2203,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1819.68,82.6,,1455.74,,,0,"percent of total billed charges","82.6% of total billed charges",11101.28,100,,,,,0,"fee schedule","100% of WA fee schedule",2203,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1819.68,82.6,,1455.74,,,0,"percent of total billed charges","82.6% of total billed charges",2203,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11261.81,100,,,,,0,"fee schedule",EAPG,2203,100,,1762.40,,,0,"percent of total billed charges","100% of total billed charges",337.06,14431.67,
"33208 Insert permanent pacemaker w/ transvenous el",7962531,CDM,521,RC,33208,CPT,OUTPATIENT,,,2286,1485.9,,2011.68,88,,1609.34,,,0,"percent of total billed charges","88% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,2286,100,,1828.80,,,0,"percent of total billed charges","100% of total billed charges",19060,175,,,,,0,"fee schedule","175% of CMS fee schedule",7701.7,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1440.18,63,,1152.14,,,0,"percent of total billed charges","63% of total billed charges",349.76,15.3,,279.81,,,0,"percent of total billed charges","15.3% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,1577.34,69,,,,,0,"fee schedule","69% of total billed charges",2286,100,,1828.80,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2286,100,,1828.80,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2286,100,,1828.80,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",42250.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11045.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7626.93,100,,,,,0,"fee schedule",EAPG,9720.59,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",861.82,37.7,,689.46,,,0,"percent of total billed charges","37.70% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1783.08,78,,1426.46,,,0,"percent of total billed charges","78% of total billed charges",11000.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1888.24,82.6,,1510.59,,,0,"percent of total billed charges","82.6% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1888.24,82.6,,1510.59,,,0,"percent of total billed charges","82.6% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7637.91,100,,,,,0,"fee schedule",EAPG,2286,100,,1828.80,,,0,"percent of total billed charges","100% of total billed charges",349.76,42250.94,
"33210 Insert/replace of temporary transvenous sing",7961502,CDM,521,RC,33210,CPT,OUTPATIENT,,,698,453.7,,614.24,88,,491.39,,,0,"percent of total billed charges","88% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,698,100,,558.40,,,0,"percent of total billed charges","100% of total billed charges",15164.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",1576.9,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",439.74,63,,351.79,,,0,"percent of total billed charges","63% of total billed charges",106.79,15.3,,85.43,,,0,"percent of total billed charges","15.3% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,481.62,69,,,,,0,"fee schedule","69% of total billed charges",698,100,,558.40,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",698,100,,558.40,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",698,100,,558.40,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",33120.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8658.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561.59,100,,,,,0,"fee schedule",EAPG,1990.26,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",263.15,37.7,,210.52,,,0,"percent of total billed charges","37.70% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",544.44,78,,435.55,,,0,"percent of total billed charges","78% of total billed charges",8751.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",576.55,82.6,,461.24,,,0,"percent of total billed charges","82.6% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",576.55,82.6,,461.24,,,0,"percent of total billed charges","82.6% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1691.5,100,,,,,0,"fee schedule",EAPG,698,100,,558.40,,,0,"percent of total billed charges","100% of total billed charges",106.79,33120.11,
"33216 Insertion of a single transvenous electrode,",7961601,CDM,521,RC,33216,CPT,OUTPATIENT,,,1229,798.85,,1081.52,88,,865.22,,,0,"percent of total billed charges","88% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,1229,100,,983.20,,,0,"percent of total billed charges","100% of total billed charges",15164.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",1576.9,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",774.27,63,,619.42,,,0,"percent of total billed charges","63% of total billed charges",188.04,15.3,,150.43,,,0,"percent of total billed charges","15.3% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,848.01,69,,,,,0,"fee schedule","69% of total billed charges",1229,100,,983.20,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1229,100,,983.20,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1229,100,,983.20,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",33120.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8658.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561.59,100,,,,,0,"fee schedule",EAPG,1990.26,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",463.33,37.7,,370.66,,,0,"percent of total billed charges","37.70% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",958.62,78,,766.90,,,0,"percent of total billed charges","78% of total billed charges",8751.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1015.15,82.6,,812.12,,,0,"percent of total billed charges","82.6% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1015.15,82.6,,812.12,,,0,"percent of total billed charges","82.6% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1691.5,100,,,,,0,"fee schedule",EAPG,1229,100,,983.20,,,0,"percent of total billed charges","100% of total billed charges",188.04,33120.11,
"33215 Repositioning of previously implanted transv",7961920,CDM,521,RC,33215,CPT,OUTPATIENT,,,798,518.7,,702.24,88,,561.79,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,798,100,,638.40,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",1576.9,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",502.74,63,,402.19,,,0,"percent of total billed charges","63% of total billed charges",122.09,15.3,,97.67,,,0,"percent of total billed charges","15.3% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,550.62,69,,,,,0,"fee schedule","69% of total billed charges",798,100,,638.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",798,100,,638.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",798,100,,638.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561.59,100,,,,,0,"fee schedule",EAPG,1990.26,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",300.85,37.7,,240.68,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",622.44,78,,497.95,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",659.15,82.6,,527.32,,,0,"percent of total billed charges","82.6% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",659.15,82.6,,527.32,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1691.5,100,,,,,0,"fee schedule",EAPG,798,100,,638.40,,,0,"percent of total billed charges","100% of total billed charges",122.09,11625.57,
"33218 Repair of single transvenous electrode, perm",7961951,CDM,521,RC,33218,CPT,OUTPATIENT,,,1072,696.8,,943.36,88,,754.69,,,0,"percent of total billed charges","88% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,1072,100,,857.60,,,0,"percent of total billed charges","100% of total billed charges",7009.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",1576.9,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",675.36,63,,540.29,,,0,"percent of total billed charges","63% of total billed charges",164.02,15.3,,131.22,,,0,"percent of total billed charges","15.3% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,739.68,69,,,,,0,"fee schedule","69% of total billed charges",1072,100,,857.60,,,0,"percent of total billed charges","100% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1072,100,,857.60,,,0,"percent of total billed charges","100% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1072,100,,857.60,,,0,"percent of total billed charges","100% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",13976.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3654.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561.59,100,,,,,0,"fee schedule",EAPG,1990.26,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",404.14,37.7,,323.31,,,0,"percent of total billed charges","37.70% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",836.16,78,,668.93,,,0,"percent of total billed charges","78% of total billed charges",4045.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",885.47,82.6,,708.38,,,0,"percent of total billed charges","82.6% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",885.47,82.6,,708.38,,,0,"percent of total billed charges","82.6% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1691.5,100,,,,,0,"fee schedule",EAPG,1072,100,,857.60,,,0,"percent of total billed charges","100% of total billed charges",164.02,13976.6,
"33217 Insertion of 2 transvenous electrodes, perma",7962182,CDM,521,RC,33217,CPT,OUTPATIENT,,,1222,794.3,,1075.36,88,,860.29,,,0,"percent of total billed charges","88% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,1222,100,,977.60,,,0,"percent of total billed charges","100% of total billed charges",15164.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",1576.9,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",769.86,63,,615.89,,,0,"percent of total billed charges","63% of total billed charges",186.97,15.3,,149.58,,,0,"percent of total billed charges","15.3% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,843.18,69,,,,,0,"fee schedule","69% of total billed charges",1222,100,,977.60,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1222,100,,977.60,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1222,100,,977.60,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",33120.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8658.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561.59,100,,,,,0,"fee schedule",EAPG,1990.26,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",460.69,37.7,,368.55,,,0,"percent of total billed charges","37.70% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",953.16,78,,762.53,,,0,"percent of total billed charges","78% of total billed charges",8751.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1009.37,82.6,,807.50,,,0,"percent of total billed charges","82.6% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1009.37,82.6,,807.50,,,0,"percent of total billed charges","82.6% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1691.5,100,,,,,0,"fee schedule",EAPG,1222,100,,977.60,,,0,"percent of total billed charges","100% of total billed charges",186.97,33120.11,
"33211 Insertion or replacement of temporary transv",7962471,CDM,521,RC,33211,CPT,OUTPATIENT,,,545,354.25,,479.6,88,,383.68,,,0,"percent of total billed charges","88% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,545,100,,436.00,,,0,"percent of total billed charges","100% of total billed charges",15164.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",1576.9,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",343.35,63,,274.68,,,0,"percent of total billed charges","63% of total billed charges",83.39,15.3,,66.71,,,0,"percent of total billed charges","15.3% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,376.05,69,,,,,0,"fee schedule","69% of total billed charges",545,100,,436.00,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",545,100,,436.00,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",545,100,,436.00,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",33120.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8658.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561.59,100,,,,,0,"fee schedule",EAPG,1990.26,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",205.47,37.7,,164.38,,,0,"percent of total billed charges","37.70% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",425.1,78,,340.08,,,0,"percent of total billed charges","78% of total billed charges",8751.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",450.17,82.6,,360.14,,,0,"percent of total billed charges","82.6% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",450.17,82.6,,360.14,,,0,"percent of total billed charges","82.6% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1691.5,100,,,,,0,"fee schedule",EAPG,545,100,,436.00,,,0,"percent of total billed charges","100% of total billed charges",83.39,33120.11,
"33212 Insertion of pacemaker pulse generator only;",7962811,CDM,521,RC,33212,CPT,OUTPATIENT,,,1143,742.95,,1005.84,88,,804.67,,,0,"percent of total billed charges","88% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,1143,100,,914.40,,,0,"percent of total billed charges","100% of total billed charges",15164.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",7701.7,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",720.09,63,,576.07,,,0,"percent of total billed charges","63% of total billed charges",174.88,15.3,,139.90,,,0,"percent of total billed charges","15.3% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,788.67,69,,,,,0,"fee schedule","69% of total billed charges",1143,100,,914.40,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1143,100,,914.40,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1143,100,,914.40,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",33120.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8658.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7626.93,100,,,,,0,"fee schedule",EAPG,9720.59,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",430.91,37.7,,344.73,,,0,"percent of total billed charges","37.70% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891.54,78,,713.23,,,0,"percent of total billed charges","78% of total billed charges",8751.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",944.12,82.6,,755.30,,,0,"percent of total billed charges","82.6% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",944.12,82.6,,755.30,,,0,"percent of total billed charges","82.6% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7637.91,100,,,,,0,"fee schedule",EAPG,1143,100,,914.40,,,0,"percent of total billed charges","100% of total billed charges",174.88,33120.11,
"33213 Insertion of pacemaker pulse generator only;",7962847,CDM,521,RC,33213,CPT,OUTPATIENT,,,1213,788.45,,1067.44,88,,853.95,,,0,"percent of total billed charges","88% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,1213,100,,970.40,,,0,"percent of total billed charges","100% of total billed charges",19060,175,,,,,0,"fee schedule","175% of CMS fee schedule",7701.7,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",764.19,63,,611.35,,,0,"percent of total billed charges","63% of total billed charges",185.59,15.3,,148.47,,,0,"percent of total billed charges","15.3% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,836.97,69,,,,,0,"fee schedule","69% of total billed charges",1213,100,,970.40,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1213,100,,970.40,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1213,100,,970.40,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",42250.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11045.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7626.93,100,,,,,0,"fee schedule",EAPG,9720.59,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",457.3,37.7,,365.84,,,0,"percent of total billed charges","37.70% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",946.14,78,,756.91,,,0,"percent of total billed charges","78% of total billed charges",11000.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1001.94,82.6,,801.55,,,0,"percent of total billed charges","82.6% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1001.94,82.6,,801.55,,,0,"percent of total billed charges","82.6% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7637.91,100,,,,,0,"fee schedule",EAPG,1213,100,,970.40,,,0,"percent of total billed charges","100% of total billed charges",185.59,42250.94,
"33214 Upgrade of Implanted Pacemaker System Single",7963194,CDM,521,RC,33214,CPT,OUTPATIENT,,,1485,965.25,,1306.8,88,,1045.44,,,0,"percent of total billed charges","88% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,1485,100,,1188.00,,,0,"percent of total billed charges","100% of total billed charges",19060,175,,,,,0,"fee schedule","175% of CMS fee schedule",7701.7,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",935.55,63,,748.44,,,0,"percent of total billed charges","63% of total billed charges",227.21,15.3,,181.77,,,0,"percent of total billed charges","15.3% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,1024.65,69,,,,,0,"fee schedule","69% of total billed charges",1485,100,,1188.00,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1485,100,,1188.00,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1485,100,,1188.00,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",42250.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11045.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7626.93,100,,,,,0,"fee schedule",EAPG,9720.59,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",559.85,37.7,,447.88,,,0,"percent of total billed charges","37.70% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1158.3,78,,926.64,,,0,"percent of total billed charges","78% of total billed charges",11000.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1226.61,82.6,,981.29,,,0,"percent of total billed charges","82.6% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1226.61,82.6,,981.29,,,0,"percent of total billed charges","82.6% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7637.91,100,,,,,0,"fee schedule",EAPG,1485,100,,1188.00,,,0,"percent of total billed charges","100% of total billed charges",227.21,42250.94,
"33225 Insertion,pacing electrode, lft ventricular,",7961503,CDM,521,RC,33225,CPT,OUTPATIENT,,,1109,720.85,,975.92,88,,780.74,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",7477.38,100,,,,,0,"fee schedule",EAPG,1109,100,,887.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7701.7,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",698.67,63,,558.94,,,0,"percent of total billed charges","63% of total billed charges",169.68,15.3,,135.74,,,0,"percent of total billed charges","15.3% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,765.21,69,,,,,0,"fee schedule","69% of total billed charges",1109,100,,887.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1109,100,,887.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1109,100,,887.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7477.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7626.93,100,,,,,0,"fee schedule",EAPG,9720.59,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",418.09,37.7,,334.47,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",865.02,78,,692.02,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",916.03,82.6,,732.82,,,0,"percent of total billed charges","82.6% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",916.03,82.6,,732.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7637.91,100,,,,,0,"fee schedule",EAPG,1109,100,,887.20,,,0,"percent of total billed charges","100% of total billed charges",169.68,9720.59,
"33220 Repair of 2 transvenous electrodes for perma",7962199,CDM,521,RC,33220,CPT,OUTPATIENT,,,1444,938.6,,1270.72,88,,1016.58,,,0,"percent of total billed charges","88% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,1444,100,,1155.20,,,0,"percent of total billed charges","100% of total billed charges",7009.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",1576.9,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",909.72,63,,727.78,,,0,"percent of total billed charges","63% of total billed charges",220.93,15.3,,176.74,,,0,"percent of total billed charges","15.3% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,996.36,69,,,,,0,"fee schedule","69% of total billed charges",1444,100,,1155.20,,,0,"percent of total billed charges","100% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1444,100,,1155.20,,,0,"percent of total billed charges","100% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1444,100,,1155.20,,,0,"percent of total billed charges","100% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",13976.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3654.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561.59,100,,,,,0,"fee schedule",EAPG,1990.26,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",544.39,37.7,,435.51,,,0,"percent of total billed charges","37.70% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1126.32,78,,901.06,,,0,"percent of total billed charges","78% of total billed charges",4045.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1192.74,82.6,,954.19,,,0,"percent of total billed charges","82.6% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1192.74,82.6,,954.19,,,0,"percent of total billed charges","82.6% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1691.5,100,,,,,0,"fee schedule",EAPG,1444,100,,1155.20,,,0,"percent of total billed charges","100% of total billed charges",220.93,13976.6,
"33224 Insertion of pacing electrode, left ventricu",7962448,CDM,521,RC,33224,CPT,OUTPATIENT,,,1280,832,,1126.4,88,,901.12,,,0,"percent of total billed charges","88% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,1280,100,,1024.00,,,0,"percent of total billed charges","100% of total billed charges",19060,175,,,,,0,"fee schedule","175% of CMS fee schedule",7701.7,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",806.4,63,,645.12,,,0,"percent of total billed charges","63% of total billed charges",195.84,15.3,,156.67,,,0,"percent of total billed charges","15.3% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,883.2,69,,,,,0,"fee schedule","69% of total billed charges",1280,100,,1024.00,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1280,100,,1024.00,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1280,100,,1024.00,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",42250.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11045.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7626.93,100,,,,,0,"fee schedule",EAPG,9720.59,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",482.56,37.7,,386.05,,,0,"percent of total billed charges","37.70% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",998.4,78,,798.72,,,0,"percent of total billed charges","78% of total billed charges",11000.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1057.28,82.6,,845.82,,,0,"percent of total billed charges","82.6% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1057.28,82.6,,845.82,,,0,"percent of total billed charges","82.6% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7637.91,100,,,,,0,"fee schedule",EAPG,1280,100,,1024.00,,,0,"percent of total billed charges","100% of total billed charges",195.84,42250.94,
"33221 Insertion of pacemaker pulse generator only;",7962659,CDM,521,RC,33221,CPT,OUTPATIENT,,,1181,767.65,,1039.28,88,,831.42,,,0,"percent of total billed charges","88% of total billed charges",19874.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,1181,100,,944.80,,,0,"percent of total billed charges","100% of total billed charges",34779.85,175,,,,,0,"fee schedule","175% of CMS fee schedule",7701.7,100,,,,,0,"fee schedule",EAPG,19874.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",744.03,63,,595.22,,,0,"percent of total billed charges","63% of total billed charges",180.69,15.3,,144.55,,,0,"percent of total billed charges","15.3% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,814.89,69,,,,,0,"fee schedule","69% of total billed charges",1181,100,,944.80,,,0,"percent of total billed charges","100% of total billed charges",19874.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1181,100,,944.80,,,0,"percent of total billed charges","100% of total billed charges",19874.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1181,100,,944.80,,,0,"percent of total billed charges","100% of total billed charges",19874.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",75608.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,19874.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",19767,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",19874.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7626.93,100,,,,,0,"fee schedule",EAPG,9720.59,100,,,,,0,"fee schedule",EAPG,19874.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",445.24,37.7,,356.19,,,0,"percent of total billed charges","37.70% of total billed charges",19874.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",19874.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",921.18,78,,736.94,,,0,"percent of total billed charges","78% of total billed charges",20072.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",975.51,82.6,,780.41,,,0,"percent of total billed charges","82.6% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,19874.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",975.51,82.6,,780.41,,,0,"percent of total billed charges","82.6% of total billed charges",19874.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7637.91,100,,,,,0,"fee schedule",EAPG,1181,100,,944.80,,,0,"percent of total billed charges","100% of total billed charges",180.69,75608.83,
"33227 Removal of pacemaker w/ replacement of pulse",7962672,CDM,521,RC,33227,CPT,OUTPATIENT,,,870,565.5,,765.6,88,,612.48,,,0,"percent of total billed charges","88% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,870,100,,696.00,,,0,"percent of total billed charges","100% of total billed charges",15164.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",7701.7,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",548.1,63,,438.48,,,0,"percent of total billed charges","63% of total billed charges",133.11,15.3,,106.49,,,0,"percent of total billed charges","15.3% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,600.3,69,,,,,0,"fee schedule","69% of total billed charges",870,100,,696.00,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",870,100,,696.00,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",870,100,,696.00,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",33120.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8658.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7626.93,100,,,,,0,"fee schedule",EAPG,9720.59,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",327.99,37.7,,262.39,,,0,"percent of total billed charges","37.70% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",678.6,78,,542.88,,,0,"percent of total billed charges","78% of total billed charges",8751.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",718.62,82.6,,574.90,,,0,"percent of total billed charges","82.6% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",718.62,82.6,,574.90,,,0,"percent of total billed charges","82.6% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7637.91,100,,,,,0,"fee schedule",EAPG,870,100,,696.00,,,0,"percent of total billed charges","100% of total billed charges",133.11,33120.11,
"33228 Removal of pacemaker w/ replacement of pulse",7962743,CDM,521,RC,33228,CPT,OUTPATIENT,,,907,589.55,,798.16,88,,638.53,,,0,"percent of total billed charges","88% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,907,100,,725.60,,,0,"percent of total billed charges","100% of total billed charges",19060,175,,,,,0,"fee schedule","175% of CMS fee schedule",7701.7,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",571.41,63,,457.13,,,0,"percent of total billed charges","63% of total billed charges",138.77,15.3,,111.02,,,0,"percent of total billed charges","15.3% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,625.83,69,,,,,0,"fee schedule","69% of total billed charges",907,100,,725.60,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907,100,,725.60,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907,100,,725.60,,,0,"percent of total billed charges","100% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",42250.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11045.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7626.93,100,,,,,0,"fee schedule",EAPG,9720.59,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",341.94,37.7,,273.55,,,0,"percent of total billed charges","37.70% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",707.46,78,,565.97,,,0,"percent of total billed charges","78% of total billed charges",11000.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",749.18,82.6,,599.34,,,0,"percent of total billed charges","82.6% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",749.18,82.6,,599.34,,,0,"percent of total billed charges","82.6% of total billed charges",10891.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7637.91,100,,,,,0,"fee schedule",EAPG,907,100,,725.60,,,0,"percent of total billed charges","100% of total billed charges",138.77,42250.94,
"33226 Repositioning of previously implanted cardia",7963139,CDM,521,RC,33226,CPT,OUTPATIENT,,,1186,770.9,,1043.68,88,,834.94,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6298.95,100,,,,,0,"fee schedule",EAPG,1186,100,,948.80,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",6487.92,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",747.18,63,,597.74,,,0,"percent of total billed charges","63% of total billed charges",181.46,15.3,,145.17,,,0,"percent of total billed charges","15.3% of total billed charges",6298.95,100,,,,,0,"fee schedule",EAPG,818.34,69,,,,,0,"fee schedule","69% of total billed charges",1186,100,,948.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1186,100,,948.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1186,100,,948.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6298.95,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6424.93,100,,,,,0,"fee schedule",EAPG,8188.64,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",447.12,37.7,,357.70,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",925.08,78,,740.06,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",979.64,82.6,,783.71,,,0,"percent of total billed charges","82.6% of total billed charges",6298.95,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",979.64,82.6,,783.71,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6459.48,100,,,,,0,"fee schedule",EAPG,1186,100,,948.80,,,0,"percent of total billed charges","100% of total billed charges",181.46,11625.57,
"33223 Relocation of skin pocket for implantable de",7963251,CDM,521,RC,33223,CPT,OUTPATIENT,,,1301,845.65,,1144.88,88,,915.90,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,1301,100,,1040.80,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1576.9,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",819.63,63,,655.70,,,0,"percent of total billed charges","63% of total billed charges",199.05,15.3,,159.24,,,0,"percent of total billed charges","15.3% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,897.69,69,,,,,0,"fee schedule","69% of total billed charges",1301,100,,1040.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1301,100,,1040.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1301,100,,1040.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561.59,100,,,,,0,"fee schedule",EAPG,1990.26,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",490.48,37.7,,392.38,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1014.78,78,,811.82,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1074.63,82.6,,859.70,,,0,"percent of total billed charges","82.6% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1074.63,82.6,,859.70,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1691.5,100,,,,,0,"fee schedule",EAPG,1301,100,,1040.80,,,0,"percent of total billed charges","100% of total billed charges",199.05,6968.7,
"33222 Relocation of skin pocket for pacemaker",7963602,CDM,521,RC,33222,CPT,OUTPATIENT,,,1017,661.05,,894.96,88,,715.97,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,1017,100,,813.60,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1576.9,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",640.71,63,,512.57,,,0,"percent of total billed charges","63% of total billed charges",155.6,15.3,,124.48,,,0,"percent of total billed charges","15.3% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,701.73,69,,,,,0,"fee schedule","69% of total billed charges",1017,100,,813.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1017,100,,813.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1017,100,,813.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561.59,100,,,,,0,"fee schedule",EAPG,1990.26,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",383.41,37.7,,306.73,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",793.26,78,,634.61,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",840.04,82.6,,672.03,,,0,"percent of total billed charges","82.6% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",840.04,82.6,,672.03,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1691.5,100,,,,,0,"fee schedule",EAPG,1017,100,,813.60,,,0,"percent of total billed charges","100% of total billed charges",155.6,6968.7,
"33231 Insertion of implantable defibrillator pulse",7961887,CDM,521,RC,33231,CPT,OUTPATIENT,,,1525,991.25,,1342,88,,1073.60,,,0,"percent of total billed charges","88% of total billed charges",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22419.38,100,,,,,0,"fee schedule",EAPG,1525,100,,1220.00,,,0,"percent of total billed charges","100% of total billed charges",58722.76,175,,,,,0,"fee schedule","175% of CMS fee schedule",23091.96,100,,,,,0,"fee schedule",EAPG,33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",960.75,63,,768.60,,,0,"percent of total billed charges","63% of total billed charges",233.33,15.3,,186.66,,,0,"percent of total billed charges","15.3% of total billed charges",22419.38,100,,,,,0,"fee schedule",EAPG,1052.25,69,,,,,0,"fee schedule","69% of total billed charges",1525,100,,1220.00,,,0,"percent of total billed charges","100% of total billed charges",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1525,100,,1220.00,,,0,"percent of total billed charges","100% of total billed charges",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1525,100,,1220.00,,,0,"percent of total billed charges","100% of total billed charges",33555.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",133409.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22419.38,100,,,,,0,"fee schedule",EAPG,33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34878.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22867.76,100,,,,,0,"fee schedule",EAPG,29145.19,100,,,,,0,"fee schedule",EAPG,33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",574.93,37.7,,459.94,,,0,"percent of total billed charges","37.70% of total billed charges",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1189.5,78,,951.60,,,0,"percent of total billed charges","78% of total billed charges",33891.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1259.65,82.6,,1007.72,,,0,"percent of total billed charges","82.6% of total billed charges",22419.38,100,,,,,0,"fee schedule",EAPG,33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1259.65,82.6,,1007.72,,,0,"percent of total billed charges","82.6% of total billed charges",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22579.91,100,,,,,0,"fee schedule",EAPG,1525,100,,1220.00,,,0,"percent of total billed charges","100% of total billed charges",233.33,133409.05,
"33237 Removal of permanent epicardial pacemaker an",7961888,CDM,521,RC,33237,CPT,OUTPATIENT,,,2789,1812.85,,2454.32,88,,1963.46,,,0,"percent of total billed charges","88% of total billed charges",2789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,2789,100,,2231.20,,,0,"percent of total billed charges","100% of total billed charges",2789,175,,,,,0,"fee schedule","175% of CMS fee schedule",11434.32,100,,,,,0,"fee schedule",EAPG,2789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1757.07,63,,1405.66,,,0,"percent of total billed charges","63% of total billed charges",426.72,15.3,,341.38,,,0,"percent of total billed charges","15.3% of total billed charges",11101.28,100,,,,,0,"fee schedule",EAPG,1924.41,69,,,,,0,"fee schedule","69% of total billed charges",2789,100,,2231.20,,,0,"percent of total billed charges","100% of total billed charges",2789,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2789,100,,2231.20,,,0,"percent of total billed charges","100% of total billed charges",2789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2789,100,,2231.20,,,0,"percent of total billed charges","100% of total billed charges",2789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,2789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11323.31,100,,,,,0,"fee schedule",EAPG,14431.67,100,,,,,0,"fee schedule",EAPG,2789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1051.45,37.7,,841.16,,,0,"percent of total billed charges","37.70% of total billed charges",2789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2789,100,,,,,0,"fee schedule","100% of CMS fee schedule",2175.42,78,,1740.34,,,0,"percent of total billed charges","78% of total billed charges",2789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2303.71,82.6,,1842.97,,,0,"percent of total billed charges","82.6% of total billed charges",11101.28,100,,,,,0,"fee schedule","100% of WA fee schedule",2789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2303.71,82.6,,1842.97,,,0,"percent of total billed charges","82.6% of total billed charges",2789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11261.81,100,,,,,0,"fee schedule",EAPG,2789,100,,2231.20,,,0,"percent of total billed charges","100% of total billed charges",426.72,14431.67,
"33234 Removal of transvenous pacemaker electrode(s",7961921,CDM,521,RC,33234,CPT,OUTPATIENT,,,1266,822.9,,1114.08,88,,891.26,,,0,"percent of total billed charges","88% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,1266,100,,1012.80,,,0,"percent of total billed charges","100% of total billed charges",7009.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",1576.9,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",797.58,63,,638.06,,,0,"percent of total billed charges","63% of total billed charges",193.7,15.3,,154.96,,,0,"percent of total billed charges","15.3% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,873.54,69,,,,,0,"fee schedule","69% of total billed charges",1266,100,,1012.80,,,0,"percent of total billed charges","100% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1266,100,,1012.80,,,0,"percent of total billed charges","100% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1266,100,,1012.80,,,0,"percent of total billed charges","100% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",13976.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3654.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561.59,100,,,,,0,"fee schedule",EAPG,1990.26,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",477.28,37.7,,381.82,,,0,"percent of total billed charges","37.70% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",987.48,78,,789.98,,,0,"percent of total billed charges","78% of total billed charges",4045.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.72,82.6,,836.58,,,0,"percent of total billed charges","82.6% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.72,82.6,,836.58,,,0,"percent of total billed charges","82.6% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1691.5,100,,,,,0,"fee schedule",EAPG,1266,100,,1012.80,,,0,"percent of total billed charges","100% of total billed charges",193.7,13976.61,
"33236 Removal of permanent epicardial pacemaker an",7962137,CDM,521,RC,33236,CPT,OUTPATIENT,,,2437,1584.05,,2144.56,88,,1715.65,,,0,"percent of total billed charges","88% of total billed charges",2437,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,2437,100,,1949.60,,,0,"percent of total billed charges","100% of total billed charges",2437,175,,,,,0,"fee schedule","175% of CMS fee schedule",11434.32,100,,,,,0,"fee schedule",EAPG,2437,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1535.31,63,,1228.25,,,0,"percent of total billed charges","63% of total billed charges",372.86,15.3,,298.29,,,0,"percent of total billed charges","15.3% of total billed charges",11101.28,100,,,,,0,"fee schedule",EAPG,1681.53,69,,,,,0,"fee schedule","69% of total billed charges",2437,100,,1949.60,,,0,"percent of total billed charges","100% of total billed charges",2437,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2437,100,,1949.60,,,0,"percent of total billed charges","100% of total billed charges",2437,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2437,100,,1949.60,,,0,"percent of total billed charges","100% of total billed charges",2437,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2437,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,2437,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2437,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2437,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11323.31,100,,,,,0,"fee schedule",EAPG,14431.67,100,,,,,0,"fee schedule",EAPG,2437,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",918.75,37.7,,735.00,,,0,"percent of total billed charges","37.70% of total billed charges",2437,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2437,100,,,,,0,"fee schedule","100% of CMS fee schedule",1900.86,78,,1520.69,,,0,"percent of total billed charges","78% of total billed charges",2437,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2012.96,82.6,,1610.37,,,0,"percent of total billed charges","82.6% of total billed charges",11101.28,100,,,,,0,"fee schedule","100% of WA fee schedule",2437,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2012.96,82.6,,1610.37,,,0,"percent of total billed charges","82.6% of total billed charges",2437,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11261.81,100,,,,,0,"fee schedule",EAPG,2437,100,,1949.60,,,0,"percent of total billed charges","100% of total billed charges",372.86,14431.67,
"33230 Insertion of implantable defibrillator pulse",7962308,CDM,521,RC,33230,CPT,OUTPATIENT,,,1471,956.15,,1294.48,88,,1035.58,,,0,"percent of total billed charges","88% of total billed charges",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22419.38,100,,,,,0,"fee schedule",EAPG,1471,100,,1176.80,,,0,"percent of total billed charges","100% of total billed charges",42073.46,175,,,,,0,"fee schedule","175% of CMS fee schedule",23091.96,100,,,,,0,"fee schedule",EAPG,24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",926.73,63,,741.38,,,0,"percent of total billed charges","63% of total billed charges",225.06,15.3,,180.05,,,0,"percent of total billed charges","15.3% of total billed charges",22419.38,100,,,,,0,"fee schedule",EAPG,1014.99,69,,,,,0,"fee schedule","69% of total billed charges",1471,100,,1176.80,,,0,"percent of total billed charges","100% of total billed charges",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1471,100,,1176.80,,,0,"percent of total billed charges","100% of total billed charges",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1471,100,,1176.80,,,0,"percent of total billed charges","100% of total billed charges",24041.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",93601.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22419.38,100,,,,,0,"fee schedule",EAPG,24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24470.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22867.76,100,,,,,0,"fee schedule",EAPG,29145.19,100,,,,,0,"fee schedule",EAPG,24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",554.57,37.7,,443.66,,,0,"percent of total billed charges","37.70% of total billed charges",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1147.38,78,,917.90,,,0,"percent of total billed charges","78% of total billed charges",24282.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1215.05,82.6,,972.04,,,0,"percent of total billed charges","82.6% of total billed charges",22419.38,100,,,,,0,"fee schedule",EAPG,24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1215.05,82.6,,972.04,,,0,"percent of total billed charges","82.6% of total billed charges",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22579.91,100,,,,,0,"fee schedule",EAPG,1471,100,,1176.80,,,0,"percent of total billed charges","100% of total billed charges",225.06,93601.39,
"33235 Removal of transvenous pacemaker electrode(s",7963025,CDM,521,RC,33235,CPT,OUTPATIENT,,,1530,994.5,,1346.4,88,,1077.12,,,0,"percent of total billed charges","88% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,1530,100,,1224.00,,,0,"percent of total billed charges","100% of total billed charges",7009.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",1576.9,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",963.9,63,,771.12,,,0,"percent of total billed charges","63% of total billed charges",234.09,15.3,,187.27,,,0,"percent of total billed charges","15.3% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,1055.7,69,,,,,0,"fee schedule","69% of total billed charges",1530,100,,1224.00,,,0,"percent of total billed charges","100% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530,100,,1224.00,,,0,"percent of total billed charges","100% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530,100,,1224.00,,,0,"percent of total billed charges","100% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",13976.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3654.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561.59,100,,,,,0,"fee schedule",EAPG,1990.26,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",576.81,37.7,,461.45,,,0,"percent of total billed charges","37.70% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.4,78,,954.72,,,0,"percent of total billed charges","78% of total billed charges",4045.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1263.78,82.6,,1011.02,,,0,"percent of total billed charges","82.6% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1263.78,82.6,,1011.02,,,0,"percent of total billed charges","82.6% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1691.5,100,,,,,0,"fee schedule",EAPG,1530,100,,1224.00,,,0,"percent of total billed charges","100% of total billed charges",234.09,13976.61,
"33238 Removal of permanent transvenous electrode(s",7963125,CDM,521,RC,33238,CPT,OUTPATIENT,,,2957,1922.05,,2602.16,88,,2081.73,,,0,"percent of total billed charges","88% of total billed charges",2957,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,2957,100,,2365.60,,,0,"percent of total billed charges","100% of total billed charges",2957,175,,,,,0,"fee schedule","175% of CMS fee schedule",11434.32,100,,,,,0,"fee schedule",EAPG,2957,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1862.91,63,,1490.33,,,0,"percent of total billed charges","63% of total billed charges",452.42,15.3,,361.94,,,0,"percent of total billed charges","15.3% of total billed charges",11101.28,100,,,,,0,"fee schedule",EAPG,2040.33,69,,,,,0,"fee schedule","69% of total billed charges",2957,100,,2365.60,,,0,"percent of total billed charges","100% of total billed charges",2957,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2957,100,,2365.60,,,0,"percent of total billed charges","100% of total billed charges",2957,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2957,100,,2365.60,,,0,"percent of total billed charges","100% of total billed charges",2957,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2957,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,2957,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2957,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2957,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11323.31,100,,,,,0,"fee schedule",EAPG,14431.67,100,,,,,0,"fee schedule",EAPG,2957,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1114.79,37.7,,891.83,,,0,"percent of total billed charges","37.70% of total billed charges",2957,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2957,100,,,,,0,"fee schedule","100% of CMS fee schedule",2306.46,78,,1845.17,,,0,"percent of total billed charges","78% of total billed charges",2957,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2442.48,82.6,,1953.98,,,0,"percent of total billed charges","82.6% of total billed charges",11101.28,100,,,,,0,"fee schedule","100% of WA fee schedule",2957,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2442.48,82.6,,1953.98,,,0,"percent of total billed charges","82.6% of total billed charges",2957,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11261.81,100,,,,,0,"fee schedule",EAPG,2957,100,,2365.60,,,0,"percent of total billed charges","100% of total billed charges",452.42,14431.67,
"33244 Removal of single/dual chamber implantable d",7961602,CDM,521,RC,33244,CPT,OUTPATIENT,,,2315,1504.75,,2037.2,88,,1629.76,,,0,"percent of total billed charges","88% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,2315,100,,1852.00,,,0,"percent of total billed charges","100% of total billed charges",7009.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",1576.9,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1458.45,63,,1166.76,,,0,"percent of total billed charges","63% of total billed charges",354.2,15.3,,283.36,,,0,"percent of total billed charges","15.3% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,1597.35,69,,,,,0,"fee schedule","69% of total billed charges",2315,100,,1852.00,,,0,"percent of total billed charges","100% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2315,100,,1852.00,,,0,"percent of total billed charges","100% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2315,100,,1852.00,,,0,"percent of total billed charges","100% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",13976.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3654.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561.59,100,,,,,0,"fee schedule",EAPG,1990.26,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",872.76,37.7,,698.21,,,0,"percent of total billed charges","37.70% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1805.7,78,,1444.56,,,0,"percent of total billed charges","78% of total billed charges",4045.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1912.19,82.6,,1529.75,,,0,"percent of total billed charges","82.6% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1912.19,82.6,,1529.75,,,0,"percent of total billed charges","82.6% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1691.5,100,,,,,0,"fee schedule",EAPG,2315,100,,1852.00,,,0,"percent of total billed charges","100% of total billed charges",354.2,13976.61,
"33249 Insertion/replacement of implantable defibri",7961684,CDM,521,RC,33249,CPT,OUTPATIENT,,,3175,2063.75,,2794,88,,2235.20,,,0,"percent of total billed charges","88% of total billed charges",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22419.38,100,,,,,0,"fee schedule",EAPG,3175,100,,2540.00,,,0,"percent of total billed charges","100% of total billed charges",58722.76,175,,,,,0,"fee schedule","175% of CMS fee schedule",23091.96,100,,,,,0,"fee schedule",EAPG,33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2000.25,63,,1600.20,,,0,"percent of total billed charges","63% of total billed charges",485.78,15.3,,388.62,,,0,"percent of total billed charges","15.3% of total billed charges",22419.38,100,,,,,0,"fee schedule",EAPG,2190.75,69,,,,,0,"fee schedule","69% of total billed charges",3175,100,,2540.00,,,0,"percent of total billed charges","100% of total billed charges",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3175,100,,2540.00,,,0,"percent of total billed charges","100% of total billed charges",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3175,100,,2540.00,,,0,"percent of total billed charges","100% of total billed charges",33555.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",133409.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22419.38,100,,,,,0,"fee schedule",EAPG,33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34878.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22867.76,100,,,,,0,"fee schedule",EAPG,29145.19,100,,,,,0,"fee schedule",EAPG,33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1196.98,37.7,,957.58,,,0,"percent of total billed charges","37.70% of total billed charges",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2476.5,78,,1981.20,,,0,"percent of total billed charges","78% of total billed charges",33891.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2622.55,82.6,,2098.04,,,0,"percent of total billed charges","82.6% of total billed charges",22419.38,100,,,,,0,"fee schedule",EAPG,33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2622.55,82.6,,2098.04,,,0,"percent of total billed charges","82.6% of total billed charges",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22579.91,100,,,,,0,"fee schedule",EAPG,3175,100,,2540.00,,,0,"percent of total billed charges","100% of total billed charges",485.78,133409.05,
"33243 Removal of single or dual chamber implantabl",7961952,CDM,521,RC,33243,CPT,OUTPATIENT,,,4282,2783.3,,3768.16,88,,3014.53,,,0,"percent of total billed charges","88% of total billed charges",4282,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,4282,100,,3425.60,,,0,"percent of total billed charges","100% of total billed charges",4282,175,,,,,0,"fee schedule","175% of CMS fee schedule",11434.32,100,,,,,0,"fee schedule",EAPG,4282,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2697.66,63,,2158.13,,,0,"percent of total billed charges","63% of total billed charges",655.15,15.3,,524.12,,,0,"percent of total billed charges","15.3% of total billed charges",11101.28,100,,,,,0,"fee schedule",EAPG,2954.58,69,,,,,0,"fee schedule","69% of total billed charges",4282,100,,3425.60,,,0,"percent of total billed charges","100% of total billed charges",4282,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4282,100,,3425.60,,,0,"percent of total billed charges","100% of total billed charges",4282,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4282,100,,3425.60,,,0,"percent of total billed charges","100% of total billed charges",4282,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4282,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,4282,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4282,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4282,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11323.31,100,,,,,0,"fee schedule",EAPG,14431.67,100,,,,,0,"fee schedule",EAPG,4282,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1614.31,37.7,,1291.45,,,0,"percent of total billed charges","37.70% of total billed charges",4282,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4282,100,,,,,0,"fee schedule","100% of CMS fee schedule",3339.96,78,,2671.97,,,0,"percent of total billed charges","78% of total billed charges",4282,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3536.93,82.6,,2829.54,,,0,"percent of total billed charges","82.6% of total billed charges",11101.28,100,,,,,0,"fee schedule","100% of WA fee schedule",4282,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3536.93,82.6,,2829.54,,,0,"percent of total billed charges","82.6% of total billed charges",4282,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11261.81,100,,,,,0,"fee schedule",EAPG,4282,100,,3425.60,,,0,"percent of total billed charges","100% of total billed charges",655.15,14431.67,
"33240 Insertion of implantable defibrillator pulse",7962250,CDM,521,RC,33240,CPT,OUTPATIENT,,,1420,923,,1249.6,88,,999.68,,,0,"percent of total billed charges","88% of total billed charges",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22419.38,100,,,,,0,"fee schedule",EAPG,1420,100,,1136.00,,,0,"percent of total billed charges","100% of total billed charges",42073.46,175,,,,,0,"fee schedule","175% of CMS fee schedule",23091.96,100,,,,,0,"fee schedule",EAPG,24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",894.6,63,,715.68,,,0,"percent of total billed charges","63% of total billed charges",217.26,15.3,,173.81,,,0,"percent of total billed charges","15.3% of total billed charges",22419.38,100,,,,,0,"fee schedule",EAPG,979.8,69,,,,,0,"fee schedule","69% of total billed charges",1420,100,,1136.00,,,0,"percent of total billed charges","100% of total billed charges",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1420,100,,1136.00,,,0,"percent of total billed charges","100% of total billed charges",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1420,100,,1136.00,,,0,"percent of total billed charges","100% of total billed charges",24041.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",93601.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22419.38,100,,,,,0,"fee schedule",EAPG,24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24470.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22867.76,100,,,,,0,"fee schedule",EAPG,29145.19,100,,,,,0,"fee schedule",EAPG,24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",535.34,37.7,,428.27,,,0,"percent of total billed charges","37.70% of total billed charges",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1107.6,78,,886.08,,,0,"percent of total billed charges","78% of total billed charges",24282.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1172.92,82.6,,938.34,,,0,"percent of total billed charges","82.6% of total billed charges",22419.38,100,,,,,0,"fee schedule",EAPG,24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1172.92,82.6,,938.34,,,0,"percent of total billed charges","82.6% of total billed charges",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22579.91,100,,,,,0,"fee schedule",EAPG,1420,100,,1136.00,,,0,"percent of total billed charges","100% of total billed charges",217.26,93601.39,
"33241 Removal of implantable defibrillator pulse g",7963195,CDM,521,RC,33241,CPT,OUTPATIENT,,,716,465.4,,630.08,88,,504.06,,,0,"percent of total billed charges","88% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6298.95,100,,,,,0,"fee schedule",EAPG,716,100,,572.80,,,0,"percent of total billed charges","100% of total billed charges",7009.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",6487.92,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",451.08,63,,360.86,,,0,"percent of total billed charges","63% of total billed charges",109.55,15.3,,87.64,,,0,"percent of total billed charges","15.3% of total billed charges",6298.95,100,,,,,0,"fee schedule",EAPG,494.04,69,,,,,0,"fee schedule","69% of total billed charges",716,100,,572.80,,,0,"percent of total billed charges","100% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",716,100,,572.80,,,0,"percent of total billed charges","100% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",716,100,,572.80,,,0,"percent of total billed charges","100% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",13976.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6298.95,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3654.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6424.93,100,,,,,0,"fee schedule",EAPG,8188.64,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",269.93,37.7,,215.94,,,0,"percent of total billed charges","37.70% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",558.48,78,,446.78,,,0,"percent of total billed charges","78% of total billed charges",4045.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591.42,82.6,,473.14,,,0,"percent of total billed charges","82.6% of total billed charges",6298.95,100,,,,,0,"fee schedule",EAPG,4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591.42,82.6,,473.14,,,0,"percent of total billed charges","82.6% of total billed charges",4005.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6459.48,100,,,,,0,"fee schedule",EAPG,716,100,,572.80,,,0,"percent of total billed charges","100% of total billed charges",109.55,13976.61,
"33250 Operative ablation of supraventricular arrhy",7961981,CDM,521,RC,33250,CPT,OUTPATIENT,,,4476,2909.4,,3938.88,88,,3151.10,,,0,"percent of total billed charges","88% of total billed charges",4476,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,4476,100,,3580.80,,,0,"percent of total billed charges","100% of total billed charges",4476,175,,,,,0,"fee schedule","175% of CMS fee schedule",11434.32,100,,,,,0,"fee schedule",EAPG,4476,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2819.88,63,,2255.90,,,0,"percent of total billed charges","63% of total billed charges",684.83,15.3,,547.86,,,0,"percent of total billed charges","15.3% of total billed charges",11101.28,100,,,,,0,"fee schedule",EAPG,3088.44,69,,,,,0,"fee schedule","69% of total billed charges",4476,100,,3580.80,,,0,"percent of total billed charges","100% of total billed charges",4476,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4476,100,,3580.80,,,0,"percent of total billed charges","100% of total billed charges",4476,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4476,100,,3580.80,,,0,"percent of total billed charges","100% of total billed charges",4476,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4476,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,4476,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4476,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4476,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11323.31,100,,,,,0,"fee schedule",EAPG,14431.67,100,,,,,0,"fee schedule",EAPG,4476,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1687.45,37.7,,1349.96,,,0,"percent of total billed charges","37.70% of total billed charges",4476,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4476,100,,,,,0,"fee schedule","100% of CMS fee schedule",3491.28,78,,2793.02,,,0,"percent of total billed charges","78% of total billed charges",4476,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3697.18,82.6,,2957.74,,,0,"percent of total billed charges","82.6% of total billed charges",11101.28,100,,,,,0,"fee schedule","100% of WA fee schedule",4476,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3697.18,82.6,,2957.74,,,0,"percent of total billed charges","82.6% of total billed charges",4476,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11261.81,100,,,,,0,"fee schedule",EAPG,4476,100,,3580.80,,,0,"percent of total billed charges","100% of total billed charges",684.83,14431.67,
"33251 Operative ablation of supraventricular arrhy",7962084,CDM,521,RC,33251,CPT,OUTPATIENT,,,4802,3121.3,,4225.76,88,,3380.61,,,0,"percent of total billed charges","88% of total billed charges",4802,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",4802,175,,,,,0,"fee schedule","175% of CMS fee schedule",11434.32,100,,,,,0,"fee schedule",EAPG,4802,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3025.26,63,,2420.21,,,0,"percent of total billed charges","63% of total billed charges",734.71,15.3,,587.77,,,0,"percent of total billed charges","15.3% of total billed charges",11101.28,100,,,,,0,"fee schedule",EAPG,3313.38,69,,,,,0,"fee schedule","69% of total billed charges",4802,100,,3841.60,,,0,"percent of total billed charges","100% of total billed charges",4802,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4802,100,,3841.60,,,0,"percent of total billed charges","100% of total billed charges",4802,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4802,100,,3841.60,,,0,"percent of total billed charges","100% of total billed charges",4802,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4802,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,4802,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4802,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4802,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11323.31,100,,,,,0,"fee schedule",EAPG,14431.67,100,,,,,0,"fee schedule",EAPG,4802,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1810.35,37.7,,1448.28,,,0,"percent of total billed charges","37.70% of total billed charges",4802,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4802,100,,,,,0,"fee schedule","100% of CMS fee schedule",3745.56,78,,2996.45,,,0,"percent of total billed charges","78% of total billed charges",4802,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3966.45,82.6,,3173.16,,,0,"percent of total billed charges","82.6% of total billed charges",11101.28,100,,,,,0,"fee schedule","100% of WA fee schedule",4802,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3966.45,82.6,,3173.16,,,0,"percent of total billed charges","82.6% of total billed charges",4802,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11261.81,100,,,,,0,"fee schedule",EAPG,4802,100,,3841.60,,,0,"percent of total billed charges","100% of total billed charges",734.71,14431.67,
"33264 Removal of implantable defibrillator pulse g",7961868,CDM,521,RC,33264,CPT,OUTPATIENT,,,1308,850.2,,1151.04,88,,920.83,,,0,"percent of total billed charges","88% of total billed charges",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22419.38,100,,,,,0,"fee schedule",EAPG,1308,100,,1046.40,,,0,"percent of total billed charges","100% of total billed charges",58722.76,175,,,,,0,"fee schedule","175% of CMS fee schedule",23091.96,100,,,,,0,"fee schedule",EAPG,33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",824.04,63,,659.23,,,0,"percent of total billed charges","63% of total billed charges",200.12,15.3,,160.10,,,0,"percent of total billed charges","15.3% of total billed charges",22419.38,100,,,,,0,"fee schedule",EAPG,902.52,69,,,,,0,"fee schedule","69% of total billed charges",1308,100,,1046.40,,,0,"percent of total billed charges","100% of total billed charges",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1308,100,,1046.40,,,0,"percent of total billed charges","100% of total billed charges",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1308,100,,1046.40,,,0,"percent of total billed charges","100% of total billed charges",33555.87,100,,,,,0,"fee schedule","100% of CMS fee schedule",133409.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22419.38,100,,,,,0,"fee schedule",EAPG,33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34878.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22867.76,100,,,,,0,"fee schedule",EAPG,29145.19,100,,,,,0,"fee schedule",EAPG,33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",493.12,37.7,,394.50,,,0,"percent of total billed charges","37.70% of total billed charges",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1020.24,78,,816.19,,,0,"percent of total billed charges","78% of total billed charges",33891.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1080.41,82.6,,864.33,,,0,"percent of total billed charges","82.6% of total billed charges",22419.38,100,,,,,0,"fee schedule",EAPG,33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1080.41,82.6,,864.33,,,0,"percent of total billed charges","82.6% of total billed charges",33555.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22579.91,100,,,,,0,"fee schedule",EAPG,1308,100,,1046.40,,,0,"percent of total billed charges","100% of total billed charges",200.12,133409.05,
"33262 Removal of implantable defibrillator pulse g",7962126,CDM,521,RC,33262,CPT,OUTPATIENT,,,1211,787.15,,1065.68,88,,852.54,,,0,"percent of total billed charges","88% of total billed charges",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22419.38,100,,,,,0,"fee schedule",EAPG,1211,100,,968.80,,,0,"percent of total billed charges","100% of total billed charges",42073.46,175,,,,,0,"fee schedule","175% of CMS fee schedule",23091.96,100,,,,,0,"fee schedule",EAPG,24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",762.93,63,,610.34,,,0,"percent of total billed charges","63% of total billed charges",185.28,15.3,,148.22,,,0,"percent of total billed charges","15.3% of total billed charges",22419.38,100,,,,,0,"fee schedule",EAPG,835.59,69,,,,,0,"fee schedule","69% of total billed charges",1211,100,,968.80,,,0,"percent of total billed charges","100% of total billed charges",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1211,100,,968.80,,,0,"percent of total billed charges","100% of total billed charges",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1211,100,,968.80,,,0,"percent of total billed charges","100% of total billed charges",24041.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",93601.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22419.38,100,,,,,0,"fee schedule",EAPG,24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24470.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22867.76,100,,,,,0,"fee schedule",EAPG,29145.19,100,,,,,0,"fee schedule",EAPG,24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",456.55,37.7,,365.24,,,0,"percent of total billed charges","37.70% of total billed charges",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",944.58,78,,755.66,,,0,"percent of total billed charges","78% of total billed charges",24282.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1000.29,82.6,,800.23,,,0,"percent of total billed charges","82.6% of total billed charges",22419.38,100,,,,,0,"fee schedule",EAPG,24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1000.29,82.6,,800.23,,,0,"percent of total billed charges","82.6% of total billed charges",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22579.91,100,,,,,0,"fee schedule",EAPG,1211,100,,968.80,,,0,"percent of total billed charges","100% of total billed charges",185.28,93601.39,
"33263 Removal of implantable defibrillator pulse g",7962127,CDM,521,RC,33263,CPT,OUTPATIENT,,,1261,819.65,,1109.68,88,,887.74,,,0,"percent of total billed charges","88% of total billed charges",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22419.38,100,,,,,0,"fee schedule",EAPG,1261,100,,1008.80,,,0,"percent of total billed charges","100% of total billed charges",42073.46,175,,,,,0,"fee schedule","175% of CMS fee schedule",23091.96,100,,,,,0,"fee schedule",EAPG,24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",794.43,63,,635.54,,,0,"percent of total billed charges","63% of total billed charges",192.93,15.3,,154.34,,,0,"percent of total billed charges","15.3% of total billed charges",22419.38,100,,,,,0,"fee schedule",EAPG,870.09,69,,,,,0,"fee schedule","69% of total billed charges",1261,100,,1008.80,,,0,"percent of total billed charges","100% of total billed charges",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1261,100,,1008.80,,,0,"percent of total billed charges","100% of total billed charges",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1261,100,,1008.80,,,0,"percent of total billed charges","100% of total billed charges",24041.98,100,,,,,0,"fee schedule","100% of CMS fee schedule",93601.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22419.38,100,,,,,0,"fee schedule",EAPG,24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24470.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22867.76,100,,,,,0,"fee schedule",EAPG,29145.19,100,,,,,0,"fee schedule",EAPG,24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",475.4,37.7,,380.32,,,0,"percent of total billed charges","37.70% of total billed charges",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",983.58,78,,786.86,,,0,"percent of total billed charges","78% of total billed charges",24282.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1041.59,82.6,,833.27,,,0,"percent of total billed charges","82.6% of total billed charges",22419.38,100,,,,,0,"fee schedule",EAPG,24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1041.59,82.6,,833.27,,,0,"percent of total billed charges","82.6% of total billed charges",24041.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22579.91,100,,,,,0,"fee schedule",EAPG,1261,100,,1008.80,,,0,"percent of total billed charges","100% of total billed charges",192.93,93601.39,
"33284 Removal of an implantable, patient-activated",7962903,CDM,521,RC,33286,CPT,OUTPATIENT,,,634,412.1,,557.92,88,,446.34,,,0,"percent of total billed charges","88% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,634,100,,507.20,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",1576.9,100,,,,,0,"fee schedule",EAPG,717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",399.42,63,,319.54,,,0,"percent of total billed charges","63% of total billed charges",97,15.3,,77.60,,,0,"percent of total billed charges","15.3% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,437.46,69,,,,,0,"fee schedule","69% of total billed charges",634,100,,507.20,,,0,"percent of total billed charges","100% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",634,100,,507.20,,,0,"percent of total billed charges","100% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",634,100,,507.20,,,0,"percent of total billed charges","100% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530.97,100,,,,,0,"fee schedule",EAPG,717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1561.59,100,,,,,0,"fee schedule",EAPG,1990.26,100,,,,,0,"fee schedule",EAPG,717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",239.02,37.7,,191.22,,,0,"percent of total billed charges","37.70% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",494.52,78,,395.62,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",523.68,82.6,,418.94,,,0,"percent of total billed charges","82.6% of total billed charges",1530.97,100,,,,,0,"fee schedule",EAPG,717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",523.68,82.6,,418.94,,,0,"percent of total billed charges","82.6% of total billed charges",717.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1691.5,100,,,,,0,"fee schedule",EAPG,634,100,,507.20,,,0,"percent of total billed charges","100% of total billed charges",97,2526.77,
"33282 Implantation of patient-activated cardiac ev",7963222,CDM,521,RC,33285,CPT,OUTPATIENT,,,898,583.7,,790.24,88,,632.19,,,0,"percent of total billed charges","88% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,898,100,,718.40,,,0,"percent of total billed charges","100% of total billed charges",15164.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",7701.7,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",565.74,63,,452.59,,,0,"percent of total billed charges","63% of total billed charges",137.39,15.3,,109.91,,,0,"percent of total billed charges","15.3% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,619.62,69,,,,,0,"fee schedule","69% of total billed charges",898,100,,718.40,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",898,100,,718.40,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",898,100,,718.40,,,0,"percent of total billed charges","100% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",33120.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7477.38,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8658.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7626.93,100,,,,,0,"fee schedule",EAPG,9720.59,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",338.55,37.7,,270.84,,,0,"percent of total billed charges","37.70% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",700.44,78,,560.35,,,0,"percent of total billed charges","78% of total billed charges",8751.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",741.75,82.6,,593.40,,,0,"percent of total billed charges","82.6% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",741.75,82.6,,593.40,,,0,"percent of total billed charges","82.6% of total billed charges",8665.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7637.91,100,,,,,0,"fee schedule",EAPG,898,100,,718.40,,,0,"percent of total billed charges","100% of total billed charges",137.39,33120.11,
"33300 Repair of cardiac wound; without bypass",7963603,CDM,521,RC,33300,CPT,OUTPATIENT,,,5840,3796,,5139.2,88,,4111.36,,,0,"percent of total billed charges","88% of total billed charges",5840,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5840,175,,,,,0,"fee schedule","175% of CMS fee schedule",11434.32,100,,,,,0,"fee schedule",EAPG,5840,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3679.2,63,,2943.36,,,0,"percent of total billed charges","63% of total billed charges",893.52,15.3,,714.82,,,0,"percent of total billed charges","15.3% of total billed charges",11101.28,100,,,,,0,"fee schedule",EAPG,4029.6,69,,,,,0,"fee schedule","69% of total billed charges",5840,100,,4672.00,,,0,"percent of total billed charges","100% of total billed charges",5840,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5840,100,,4672.00,,,0,"percent of total billed charges","100% of total billed charges",5840,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5840,100,,4672.00,,,0,"percent of total billed charges","100% of total billed charges",5840,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5840,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,5840,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5840,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5840,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11323.31,100,,,,,0,"fee schedule",EAPG,14431.67,100,,,,,0,"fee schedule",EAPG,5840,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2201.68,37.7,,1761.34,,,0,"percent of total billed charges","37.70% of total billed charges",5840,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5840,100,,,,,0,"fee schedule","100% of CMS fee schedule",4555.2,78,,3644.16,,,0,"percent of total billed charges","78% of total billed charges",5840,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4823.84,82.6,,3859.07,,,0,"percent of total billed charges","82.6% of total billed charges",11101.28,100,,,,,0,"fee schedule","100% of WA fee schedule",5840,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4823.84,82.6,,3859.07,,,0,"percent of total billed charges","82.6% of total billed charges",5840,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11261.81,100,,,,,0,"fee schedule",EAPG,5840,100,,4672.00,,,0,"percent of total billed charges","100% of total billed charges",893.52,14431.67,
"33320 Suture repair of aorta or great vessels; wit",7962485,CDM,521,RC,33320,CPT,OUTPATIENT,,,3250,2112.5,,2860,88,,2288.00,,,0,"percent of total billed charges","88% of total billed charges",3250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,3250,100,,2600.00,,,0,"percent of total billed charges","100% of total billed charges",3250,175,,,,,0,"fee schedule","175% of CMS fee schedule",10944.37,100,,,,,0,"fee schedule",EAPG,3250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2047.5,63,,1638.00,,,0,"percent of total billed charges","63% of total billed charges",497.25,15.3,,397.80,,,0,"percent of total billed charges","15.3% of total billed charges",10625.6,100,,,,,0,"fee schedule",EAPG,2242.5,69,,,,,0,"fee schedule","69% of total billed charges",3250,100,,2600.00,,,0,"percent of total billed charges","100% of total billed charges",3250,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3250,100,,2600.00,,,0,"percent of total billed charges","100% of total billed charges",3250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3250,100,,2600.00,,,0,"percent of total billed charges","100% of total billed charges",3250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,3250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10838.11,100,,,,,0,"fee schedule",EAPG,13813.28,100,,,,,0,"fee schedule",EAPG,3250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1225.25,37.7,,980.20,,,0,"percent of total billed charges","37.70% of total billed charges",3250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3250,100,,,,,0,"fee schedule","100% of CMS fee schedule",2535,78,,2028.00,,,0,"percent of total billed charges","78% of total billed charges",3250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2684.5,82.6,,2147.60,,,0,"percent of total billed charges","82.6% of total billed charges",10625.6,100,,,,,0,"fee schedule","100% of WA fee schedule",3250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2684.5,82.6,,2147.60,,,0,"percent of total billed charges","82.6% of total billed charges",3250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10786.13,100,,,,,0,"fee schedule",EAPG,3250,100,,2600.00,,,0,"percent of total billed charges","100% of total billed charges",497.25,13813.28,
"33406 Replacement, aortic valve, open, with cardio",7961982,CDM,521,RC,33406,CPT,OUTPATIENT,,,9258,6017.7,,8147.04,88,,6517.63,,,0,"percent of total billed charges","88% of total billed charges",9258,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9258,175,,,,,0,"fee schedule","175% of CMS fee schedule",11434.32,100,,,,,0,"fee schedule",EAPG,9258,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5832.54,63,,4666.03,,,0,"percent of total billed charges","63% of total billed charges",1416.47,15.3,,1133.18,,,0,"percent of total billed charges","15.3% of total billed charges",11101.28,100,,,,,0,"fee schedule",EAPG,6388.02,69,,,,,0,"fee schedule","69% of total billed charges",9258,100,,7406.40,,,0,"percent of total billed charges","100% of total billed charges",9258,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9258,100,,7406.40,,,0,"percent of total billed charges","100% of total billed charges",9258,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9258,100,,7406.40,,,0,"percent of total billed charges","100% of total billed charges",9258,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9258,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,9258,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9258,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9258,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11323.31,100,,,,,0,"fee schedule",EAPG,14431.67,100,,,,,0,"fee schedule",EAPG,9258,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3490.27,37.7,,2792.22,,,0,"percent of total billed charges","37.70% of total billed charges",9258,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9258,100,,,,,0,"fee schedule","100% of CMS fee schedule",7221.24,78,,5776.99,,,0,"percent of total billed charges","78% of total billed charges",9258,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7647.11,82.6,,6117.69,,,0,"percent of total billed charges","82.6% of total billed charges",11101.28,100,,,,,0,"fee schedule","100% of WA fee schedule",9258,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7647.11,82.6,,6117.69,,,0,"percent of total billed charges","82.6% of total billed charges",9258,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11261.81,100,,,,,0,"fee schedule",EAPG,9258,100,,7406.40,,,0,"percent of total billed charges","100% of total billed charges",1416.47,14431.67,
"33405 Replacement, aortic valve, w/ cardiopulmonar",7962709,CDM,521,RC,33405,CPT,OUTPATIENT,,,7532,4895.8,,6628.16,88,,5302.53,,,0,"percent of total billed charges","88% of total billed charges",7532,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7532,175,,,,,0,"fee schedule","175% of CMS fee schedule",11434.32,100,,,,,0,"fee schedule",EAPG,7532,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4745.16,63,,3796.13,,,0,"percent of total billed charges","63% of total billed charges",1152.4,15.3,,921.92,,,0,"percent of total billed charges","15.3% of total billed charges",11101.28,100,,,,,0,"fee schedule",EAPG,5197.08,69,,,,,0,"fee schedule","69% of total billed charges",7532,100,,6025.60,,,0,"percent of total billed charges","100% of total billed charges",7532,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7532,100,,6025.60,,,0,"percent of total billed charges","100% of total billed charges",7532,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7532,100,,6025.60,,,0,"percent of total billed charges","100% of total billed charges",7532,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7532,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,7532,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7532,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7532,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11323.31,100,,,,,0,"fee schedule",EAPG,14431.67,100,,,,,0,"fee schedule",EAPG,7532,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2839.56,37.7,,2271.65,,,0,"percent of total billed charges","37.70% of total billed charges",7532,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7532,100,,,,,0,"fee schedule","100% of CMS fee schedule",5874.96,78,,4699.97,,,0,"percent of total billed charges","78% of total billed charges",7532,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6221.43,82.6,,4977.14,,,0,"percent of total billed charges","82.6% of total billed charges",11101.28,100,,,,,0,"fee schedule","100% of WA fee schedule",7532,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6221.43,82.6,,4977.14,,,0,"percent of total billed charges","82.6% of total billed charges",7532,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11261.81,100,,,,,0,"fee schedule",EAPG,7532,100,,6025.60,,,0,"percent of total billed charges","100% of total billed charges",1152.4,14431.67,
"33410 Replacement, aortic valve, open, with cardio",7961983,CDM,521,RC,33410,CPT,OUTPATIENT,,,6551,4258.15,,5764.88,88,,4611.90,,,0,"percent of total billed charges","88% of total billed charges",6551,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6551,175,,,,,0,"fee schedule","175% of CMS fee schedule",11434.32,100,,,,,0,"fee schedule",EAPG,6551,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4127.13,63,,3301.70,,,0,"percent of total billed charges","63% of total billed charges",1002.3,15.3,,801.84,,,0,"percent of total billed charges","15.3% of total billed charges",11101.28,100,,,,,0,"fee schedule",EAPG,4520.19,69,,,,,0,"fee schedule","69% of total billed charges",6551,100,,5240.80,,,0,"percent of total billed charges","100% of total billed charges",6551,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6551,100,,5240.80,,,0,"percent of total billed charges","100% of total billed charges",6551,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6551,100,,5240.80,,,0,"percent of total billed charges","100% of total billed charges",6551,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6551,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,6551,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6551,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6551,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11323.31,100,,,,,0,"fee schedule",EAPG,14431.67,100,,,,,0,"fee schedule",EAPG,6551,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2469.73,37.7,,1975.78,,,0,"percent of total billed charges","37.70% of total billed charges",6551,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6551,100,,,,,0,"fee schedule","100% of CMS fee schedule",5109.78,78,,4087.82,,,0,"percent of total billed charges","78% of total billed charges",6551,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5411.13,82.6,,4328.90,,,0,"percent of total billed charges","82.6% of total billed charges",11101.28,100,,,,,0,"fee schedule","100% of WA fee schedule",6551,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5411.13,82.6,,4328.90,,,0,"percent of total billed charges","82.6% of total billed charges",6551,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11261.81,100,,,,,0,"fee schedule",EAPG,6551,100,,5240.80,,,0,"percent of total billed charges","100% of total billed charges",1002.3,14431.67,
"33416 Ventriculomyotomy (-myectomy) for idiopathic",7961984,CDM,521,RC,33416,CPT,OUTPATIENT,,,6215,4039.75,,5469.2,88,,4375.36,,,0,"percent of total billed charges","88% of total billed charges",6215,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6215,175,,,,,0,"fee schedule","175% of CMS fee schedule",11434.32,100,,,,,0,"fee schedule",EAPG,6215,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3915.45,63,,3132.36,,,0,"percent of total billed charges","63% of total billed charges",950.9,15.3,,760.72,,,0,"percent of total billed charges","15.3% of total billed charges",11101.28,100,,,,,0,"fee schedule",EAPG,4288.35,69,,,,,0,"fee schedule","69% of total billed charges",6215,100,,4972.00,,,0,"percent of total billed charges","100% of total billed charges",6215,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6215,100,,4972.00,,,0,"percent of total billed charges","100% of total billed charges",6215,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6215,100,,4972.00,,,0,"percent of total billed charges","100% of total billed charges",6215,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6215,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,6215,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6215,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6215,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11323.31,100,,,,,0,"fee schedule",EAPG,14431.67,100,,,,,0,"fee schedule",EAPG,6215,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2343.06,37.7,,1874.45,,,0,"percent of total billed charges","37.70% of total billed charges",6215,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6215,100,,,,,0,"fee schedule","100% of CMS fee schedule",4847.7,78,,3878.16,,,0,"percent of total billed charges","78% of total billed charges",6215,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5133.59,82.6,,4106.87,,,0,"percent of total billed charges","82.6% of total billed charges",11101.28,100,,,,,0,"fee schedule","100% of WA fee schedule",6215,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5133.59,82.6,,4106.87,,,0,"percent of total billed charges","82.6% of total billed charges",6215,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11261.81,100,,,,,0,"fee schedule",EAPG,6215,100,,4972.00,,,0,"percent of total billed charges","100% of total billed charges",950.9,14431.67,
"33413 Replacement, aortic valve; by translocation",7962125,CDM,521,RC,33413,CPT,OUTPATIENT,,,10395,6756.75,,9147.6,88,,7318.08,,,0,"percent of total billed charges","88% of total billed charges",10395,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",10395,175,,,,,0,"fee schedule","175% of CMS fee schedule",11434.32,100,,,,,0,"fee schedule",EAPG,10395,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6548.85,63,,5239.08,,,0,"percent of total billed charges","63% of total billed charges",1590.44,15.3,,1272.35,,,0,"percent of total billed charges","15.3% of total billed charges",11101.28,100,,,,,0,"fee schedule",EAPG,7172.55,69,,,,,0,"fee schedule","69% of total billed charges",10395,100,,8316.00,,,0,"percent of total billed charges","100% of total billed charges",10395,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10395,100,,8316.00,,,0,"percent of total billed charges","100% of total billed charges",10395,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10395,100,,8316.00,,,0,"percent of total billed charges","100% of total billed charges",10395,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10395,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,10395,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10395,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10395,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11323.31,100,,,,,0,"fee schedule",EAPG,14431.67,100,,,,,0,"fee schedule",EAPG,10395,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3918.92,37.7,,3135.14,,,0,"percent of total billed charges","37.70% of total billed charges",10395,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10395,100,,,,,0,"fee schedule","100% of CMS fee schedule",8108.1,78,,6486.48,,,0,"percent of total billed charges","78% of total billed charges",10395,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8586.27,82.6,,6869.02,,,0,"percent of total billed charges","82.6% of total billed charges",11101.28,100,,,,,0,"fee schedule","100% of WA fee schedule",10395,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8586.27,82.6,,6869.02,,,0,"percent of total billed charges","82.6% of total billed charges",10395,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11261.81,100,,,,,0,"fee schedule",EAPG,10395,100,,8316.00,,,0,"percent of total billed charges","100% of total billed charges",1590.44,14431.67,
"33411 Replacement, aortic valve; with aortic annul",7962516,CDM,521,RC,33411,CPT,OUTPATIENT,,,9098,5913.7,,8006.24,88,,6404.99,,,0,"percent of total billed charges","88% of total billed charges",9098,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9098,175,,,,,0,"fee schedule","175% of CMS fee schedule",11434.32,100,,,,,0,"fee schedule",EAPG,9098,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5731.74,63,,4585.39,,,0,"percent of total billed charges","63% of total billed charges",1391.99,15.3,,1113.59,,,0,"percent of total billed charges","15.3% of total billed charges",11101.28,100,,,,,0,"fee schedule",EAPG,6277.62,69,,,,,0,"fee schedule","69% of total billed charges",9098,100,,7278.40,,,0,"percent of total billed charges","100% of total billed charges",9098,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9098,100,,7278.40,,,0,"percent of total billed charges","100% of total billed charges",9098,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9098,100,,7278.40,,,0,"percent of total billed charges","100% of total billed charges",9098,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9098,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,9098,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9098,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9098,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11323.31,100,,,,,0,"fee schedule",EAPG,14431.67,100,,,,,0,"fee schedule",EAPG,9098,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3429.95,37.7,,2743.96,,,0,"percent of total billed charges","37.70% of total billed charges",9098,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9098,100,,,,,0,"fee schedule","100% of CMS fee schedule",7096.44,78,,5677.15,,,0,"percent of total billed charges","78% of total billed charges",9098,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7514.95,82.6,,6011.96,,,0,"percent of total billed charges","82.6% of total billed charges",11101.28,100,,,,,0,"fee schedule","100% of WA fee schedule",9098,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7514.95,82.6,,6011.96,,,0,"percent of total billed charges","82.6% of total billed charges",9098,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11261.81,100,,,,,0,"fee schedule",EAPG,9098,100,,7278.40,,,0,"percent of total billed charges","100% of total billed charges",1391.99,14431.67,
"33427 Valvuloplasty, mitral valve, w/ cardiopulmon",7961869,CDM,521,RC,33427,CPT,OUTPATIENT,,,8303,5396.95,,7306.64,88,,5845.31,,,0,"percent of total billed charges","88% of total billed charges",8303,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8303,175,,,,,0,"fee schedule","175% of CMS fee schedule",11434.32,100,,,,,0,"fee schedule",EAPG,8303,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5230.89,63,,4184.71,,,0,"percent of total billed charges","63% of total billed charges",1270.36,15.3,,1016.29,,,0,"percent of total billed charges","15.3% of total billed charges",11101.28,100,,,,,0,"fee schedule",EAPG,5729.07,69,,,,,0,"fee schedule","69% of total billed charges",8303,100,,6642.40,,,0,"percent of total billed charges","100% of total billed charges",8303,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8303,100,,6642.40,,,0,"percent of total billed charges","100% of total billed charges",8303,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8303,100,,6642.40,,,0,"percent of total billed charges","100% of total billed charges",8303,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8303,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,8303,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8303,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8303,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11323.31,100,,,,,0,"fee schedule",EAPG,14431.67,100,,,,,0,"fee schedule",EAPG,8303,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3130.23,37.7,,2504.18,,,0,"percent of total billed charges","37.70% of total billed charges",8303,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8303,100,,,,,0,"fee schedule","100% of CMS fee schedule",6476.34,78,,5181.07,,,0,"percent of total billed charges","78% of total billed charges",8303,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6858.28,82.6,,5486.62,,,0,"percent of total billed charges","82.6% of total billed charges",11101.28,100,,,,,0,"fee schedule","100% of WA fee schedule",8303,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6858.28,82.6,,5486.62,,,0,"percent of total billed charges","82.6% of total billed charges",8303,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11261.81,100,,,,,0,"fee schedule",EAPG,8303,100,,6642.40,,,0,"percent of total billed charges","100% of total billed charges",1270.36,14431.67,
"33426 Valvuloplasty, mitral valve, with cardiopulm",7962532,CDM,521,RC,33426,CPT,OUTPATIENT,,,7575,4923.75,,6666,88,,5332.80,,,0,"percent of total billed charges","88% of total billed charges",7575,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7575,175,,,,,0,"fee schedule","175% of CMS fee schedule",11434.32,100,,,,,0,"fee schedule",EAPG,7575,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4772.25,63,,3817.80,,,0,"percent of total billed charges","63% of total billed charges",1158.98,15.3,,927.18,,,0,"percent of total billed charges","15.3% of total billed charges",11101.28,100,,,,,0,"fee schedule",EAPG,5226.75,69,,,,,0,"fee schedule","69% of total billed charges",7575,100,,6060.00,,,0,"percent of total billed charges","100% of total billed charges",7575,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7575,100,,6060.00,,,0,"percent of total billed charges","100% of total billed charges",7575,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7575,100,,6060.00,,,0,"percent of total billed charges","100% of total billed charges",7575,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7575,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,7575,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7575,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7575,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11323.31,100,,,,,0,"fee schedule",EAPG,14431.67,100,,,,,0,"fee schedule",EAPG,7575,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2855.78,37.7,,2284.62,,,0,"percent of total billed charges","37.70% of total billed charges",7575,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7575,100,,,,,0,"fee schedule","100% of CMS fee schedule",5908.5,78,,4726.80,,,0,"percent of total billed charges","78% of total billed charges",7575,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6256.95,82.6,,5005.56,,,0,"percent of total billed charges","82.6% of total billed charges",11101.28,100,,,,,0,"fee schedule","100% of WA fee schedule",7575,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6256.95,82.6,,5005.56,,,0,"percent of total billed charges","82.6% of total billed charges",7575,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11261.81,100,,,,,0,"fee schedule",EAPG,7575,100,,6060.00,,,0,"percent of total billed charges","100% of total billed charges",1158.98,14431.67,
"33422 Valvotomy, mitral valve; open heart, with ca",7963011,CDM,521,RC,33422,CPT,OUTPATIENT,,,4870,3165.5,,4285.6,88,,3428.48,,,0,"percent of total billed charges","88% of total billed charges",4870,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",4870,175,,,,,0,"fee schedule","175% of CMS fee schedule",11434.32,100,,,,,0,"fee schedule",EAPG,4870,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3068.1,63,,2454.48,,,0,"percent of total billed charges","63% of total billed charges",745.11,15.3,,596.09,,,0,"percent of total billed charges","15.3% of total billed charges",11101.28,100,,,,,0,"fee schedule",EAPG,3360.3,69,,,,,0,"fee schedule","69% of total billed charges",4870,100,,3896.00,,,0,"percent of total billed charges","100% of total billed charges",4870,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4870,100,,3896.00,,,0,"percent of total billed charges","100% of total billed charges",4870,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4870,100,,3896.00,,,0,"percent of total billed charges","100% of total billed charges",4870,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4870,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,4870,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4870,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4870,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11323.31,100,,,,,0,"fee schedule",EAPG,14431.67,100,,,,,0,"fee schedule",EAPG,4870,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1835.99,37.7,,1468.79,,,0,"percent of total billed charges","37.70% of total billed charges",4870,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4870,100,,,,,0,"fee schedule","100% of CMS fee schedule",3798.6,78,,3038.88,,,0,"percent of total billed charges","78% of total billed charges",4870,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4022.62,82.6,,3218.10,,,0,"percent of total billed charges","82.6% of total billed charges",11101.28,100,,,,,0,"fee schedule","100% of WA fee schedule",4870,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4022.62,82.6,,3218.10,,,0,"percent of total billed charges","82.6% of total billed charges",4870,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11261.81,100,,,,,0,"fee schedule",EAPG,4870,100,,3896.00,,,0,"percent of total billed charges","100% of total billed charges",745.11,14431.67,
"33430 Replacement, mitral valve, with cardiopulmon",7963282,CDM,521,RC,33430,CPT,OUTPATIENT,,,7726,5021.9,,6798.88,88,,5439.10,,,0,"percent of total billed charges","88% of total billed charges",7726,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7726,175,,,,,0,"fee schedule","175% of CMS fee schedule",11434.32,100,,,,,0,"fee schedule",EAPG,7726,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4867.38,63,,3893.90,,,0,"percent of total billed charges","63% of total billed charges",1182.08,15.3,,945.66,,,0,"percent of total billed charges","15.3% of total billed charges",11101.28,100,,,,,0,"fee schedule",EAPG,5330.94,69,,,,,0,"fee schedule","69% of total billed charges",7726,100,,6180.80,,,0,"percent of total billed charges","100% of total billed charges",7726,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7726,100,,6180.80,,,0,"percent of total billed charges","100% of total billed charges",7726,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7726,100,,6180.80,,,0,"percent of total billed charges","100% of total billed charges",7726,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7726,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,7726,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7726,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7726,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11323.31,100,,,,,0,"fee schedule",EAPG,14431.67,100,,,,,0,"fee schedule",EAPG,7726,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2912.7,37.7,,2330.16,,,0,"percent of total billed charges","37.70% of total billed charges",7726,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7726,100,,,,,0,"fee schedule","100% of CMS fee schedule",6026.28,78,,4821.02,,,0,"percent of total billed charges","78% of total billed charges",7726,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6381.68,82.6,,5105.34,,,0,"percent of total billed charges","82.6% of total billed charges",11101.28,100,,,,,0,"fee schedule","100% of WA fee schedule",7726,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6381.68,82.6,,5105.34,,,0,"percent of total billed charges","82.6% of total billed charges",7726,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11261.81,100,,,,,0,"fee schedule",EAPG,7726,100,,6180.80,,,0,"percent of total billed charges","100% of total billed charges",1182.08,14431.67,
"33465 Replacement, tricuspid valve, with cardiopul",7963196,CDM,521,RC,33465,CPT,OUTPATIENT,,,8234,5352.1,,7245.92,88,,5796.74,,,0,"percent of total billed charges","88% of total billed charges",8234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8234,175,,,,,0,"fee schedule","175% of CMS fee schedule",11434.32,100,,,,,0,"fee schedule",EAPG,8234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5187.42,63,,4149.94,,,0,"percent of total billed charges","63% of total billed charges",1259.8,15.3,,1007.84,,,0,"percent of total billed charges","15.3% of total billed charges",11101.28,100,,,,,0,"fee schedule",EAPG,5681.46,69,,,,,0,"fee schedule","69% of total billed charges",8234,100,,6587.20,,,0,"percent of total billed charges","100% of total billed charges",8234,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8234,100,,6587.20,,,0,"percent of total billed charges","100% of total billed charges",8234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8234,100,,6587.20,,,0,"percent of total billed charges","100% of total billed charges",8234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,8234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11323.31,100,,,,,0,"fee schedule",EAPG,14431.67,100,,,,,0,"fee schedule",EAPG,8234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3104.22,37.7,,2483.38,,,0,"percent of total billed charges","37.70% of total billed charges",8234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8234,100,,,,,0,"fee schedule","100% of CMS fee schedule",6422.52,78,,5138.02,,,0,"percent of total billed charges","78% of total billed charges",8234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6801.28,82.6,,5441.02,,,0,"percent of total billed charges","82.6% of total billed charges",11101.28,100,,,,,0,"fee schedule","100% of WA fee schedule",8234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6801.28,82.6,,5441.02,,,0,"percent of total billed charges","82.6% of total billed charges",8234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11261.81,100,,,,,0,"fee schedule",EAPG,8234,100,,6587.20,,,0,"percent of total billed charges","100% of total billed charges",1259.8,14431.67,
"33460 Valvectomy, tricuspid valve, with cardiopulm",7963239,CDM,521,RC,33460,CPT,OUTPATIENT,,,7131,4635.15,,6275.28,88,,5020.22,,,0,"percent of total billed charges","88% of total billed charges",7131,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7131,175,,,,,0,"fee schedule","175% of CMS fee schedule",11434.32,100,,,,,0,"fee schedule",EAPG,7131,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4492.53,63,,3594.02,,,0,"percent of total billed charges","63% of total billed charges",1091.04,15.3,,872.83,,,0,"percent of total billed charges","15.3% of total billed charges",11101.28,100,,,,,0,"fee schedule",EAPG,4920.39,69,,,,,0,"fee schedule","69% of total billed charges",7131,100,,5704.80,,,0,"percent of total billed charges","100% of total billed charges",7131,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7131,100,,5704.80,,,0,"percent of total billed charges","100% of total billed charges",7131,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7131,100,,5704.80,,,0,"percent of total billed charges","100% of total billed charges",7131,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7131,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,7131,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7131,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7131,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11323.31,100,,,,,0,"fee schedule",EAPG,14431.67,100,,,,,0,"fee schedule",EAPG,7131,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2688.39,37.7,,2150.71,,,0,"percent of total billed charges","37.70% of total billed charges",7131,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7131,100,,,,,0,"fee schedule","100% of CMS fee schedule",5562.18,78,,4449.74,,,0,"percent of total billed charges","78% of total billed charges",7131,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5890.21,82.6,,4712.17,,,0,"percent of total billed charges","82.6% of total billed charges",11101.28,100,,,,,0,"fee schedule","100% of WA fee schedule",7131,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5890.21,82.6,,4712.17,,,0,"percent of total billed charges","82.6% of total billed charges",7131,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11261.81,100,,,,,0,"fee schedule",EAPG,7131,100,,5704.80,,,0,"percent of total billed charges","100% of total billed charges",1091.04,14431.67,
"33463 Valvuloplasty, tricuspid valve; without ring",7963243,CDM,521,RC,33463,CPT,OUTPATIENT,,,5635,3662.75,,4958.8,88,,3967.04,,,0,"percent of total billed charges","88% of total billed charges",5635,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5635,175,,,,,0,"fee schedule","175% of CMS fee schedule",11434.32,100,,,,,0,"fee schedule",EAPG,5635,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3550.05,63,,2840.04,,,0,"percent of total billed charges","63% of total billed charges",862.16,15.3,,689.73,,,0,"percent of total billed charges","15.3% of total billed charges",11101.28,100,,,,,0,"fee schedule",EAPG,3888.15,69,,,,,0,"fee schedule","69% of total billed charges",5635,100,,4508.00,,,0,"percent of total billed charges","100% of total billed charges",5635,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5635,100,,4508.00,,,0,"percent of total billed charges","100% of total billed charges",5635,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5635,100,,4508.00,,,0,"percent of total billed charges","100% of total billed charges",5635,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5635,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,5635,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5635,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5635,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11323.31,100,,,,,0,"fee schedule",EAPG,14431.67,100,,,,,0,"fee schedule",EAPG,5635,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2124.4,37.7,,1699.52,,,0,"percent of total billed charges","37.70% of total billed charges",5635,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5635,100,,,,,0,"fee schedule","100% of CMS fee schedule",4395.3,78,,3516.24,,,0,"percent of total billed charges","78% of total billed charges",5635,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4654.51,82.6,,3723.61,,,0,"percent of total billed charges","82.6% of total billed charges",11101.28,100,,,,,0,"fee schedule","100% of WA fee schedule",5635,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4654.51,82.6,,3723.61,,,0,"percent of total billed charges","82.6% of total billed charges",5635,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11261.81,100,,,,,0,"fee schedule",EAPG,5635,100,,4508.00,,,0,"percent of total billed charges","100% of total billed charges",862.16,14431.67,
"33464 Valvuloplasty, tricuspid valve; with ring in",7963363,CDM,521,RC,33464,CPT,OUTPATIENT,,,6279,4081.35,,5525.52,88,,4420.42,,,0,"percent of total billed charges","88% of total billed charges",6279,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6279,175,,,,,0,"fee schedule","175% of CMS fee schedule",11434.32,100,,,,,0,"fee schedule",EAPG,6279,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3955.77,63,,3164.62,,,0,"percent of total billed charges","63% of total billed charges",960.69,15.3,,768.55,,,0,"percent of total billed charges","15.3% of total billed charges",11101.28,100,,,,,0,"fee schedule",EAPG,4332.51,69,,,,,0,"fee schedule","69% of total billed charges",6279,100,,5023.20,,,0,"percent of total billed charges","100% of total billed charges",6279,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6279,100,,5023.20,,,0,"percent of total billed charges","100% of total billed charges",6279,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6279,100,,5023.20,,,0,"percent of total billed charges","100% of total billed charges",6279,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6279,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,6279,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6279,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6279,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11323.31,100,,,,,0,"fee schedule",EAPG,14431.67,100,,,,,0,"fee schedule",EAPG,6279,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2367.18,37.7,,1893.74,,,0,"percent of total billed charges","37.70% of total billed charges",6279,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6279,100,,,,,0,"fee schedule","100% of CMS fee schedule",4897.62,78,,3918.10,,,0,"percent of total billed charges","78% of total billed charges",6279,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5186.45,82.6,,4149.16,,,0,"percent of total billed charges","82.6% of total billed charges",11101.28,100,,,,,0,"fee schedule","100% of WA fee schedule",6279,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5186.45,82.6,,4149.16,,,0,"percent of total billed charges","82.6% of total billed charges",6279,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11261.81,100,,,,,0,"fee schedule",EAPG,6279,100,,5023.20,,,0,"percent of total billed charges","100% of total billed charges",960.69,14431.67,
"33508 Endoscopy, surgical, incld video-assisted ha",7961685,CDM,521,RC,33508,CPT,OUTPATIENT,,,56,36.4,,49.28,88,,39.42,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",19454.33,100,,,,,0,"fee schedule",EAPG,56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20037.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",35.28,63,,28.22,,,0,"percent of total billed charges","63% of total billed charges",8.57,15.3,,6.86,,,0,"percent of total billed charges","15.3% of total billed charges",19454.33,100,,,,,0,"fee schedule",EAPG,38.64,69,,,,,0,"fee schedule","69% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19454.33,100,,,,,0,"fee schedule",EAPG,28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",18.03,32.2,,14.42,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19843.41,100,,,,,0,"fee schedule",EAPG,25290.63,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.11,37.7,,16.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.68,78,,34.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",19454.33,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",19614.86,100,,,,,0,"fee schedule",EAPG,56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",8.57,25290.63,
"33517 Coronary artery bypass, using venous graft(s",7962251,CDM,521,RC,33517,CPT,OUTPATIENT,,,6789,4412.85,,5974.32,88,,4779.46,,,0,"percent of total billed charges","88% of total billed charges",6789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6789,175,,,,,0,"fee schedule","175% of CMS fee schedule",20037.96,100,,,,,0,"fee schedule",EAPG,6789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4277.07,63,,3421.66,,,0,"percent of total billed charges","63% of total billed charges",1038.72,15.3,,830.98,,,0,"percent of total billed charges","15.3% of total billed charges",19454.33,100,,,,,0,"fee schedule",EAPG,4684.41,69,,,,,0,"fee schedule","69% of total billed charges",6789,100,,5431.20,,,0,"percent of total billed charges","100% of total billed charges",6789,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6789,100,,5431.20,,,0,"percent of total billed charges","100% of total billed charges",6789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6789,100,,5431.20,,,0,"percent of total billed charges","100% of total billed charges",6789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,6789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19843.41,100,,,,,0,"fee schedule",EAPG,25290.63,100,,,,,0,"fee schedule",EAPG,6789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2559.45,37.7,,2047.56,,,0,"percent of total billed charges","37.70% of total billed charges",6789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6789,100,,,,,0,"fee schedule","100% of CMS fee schedule",5295.42,78,,4236.34,,,0,"percent of total billed charges","78% of total billed charges",6789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5607.71,82.6,,4486.17,,,0,"percent of total billed charges","82.6% of total billed charges",19454.33,100,,,,,0,"fee schedule","100% of WA fee schedule",6789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5607.71,82.6,,4486.17,,,0,"percent of total billed charges","82.6% of total billed charges",6789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19614.86,100,,,,,0,"fee schedule",EAPG,6789,100,,5431.20,,,0,"percent of total billed charges","100% of total billed charges",1038.72,25290.63,
"33518 Coronary artery bypass, using venous graft(s",7962329,CDM,521,RC,33518,CPT,OUTPATIENT,,,1141,741.65,,1004.08,88,,803.26,,,0,"percent of total billed charges","88% of total billed charges",1141,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,1141,100,,912.80,,,0,"percent of total billed charges","100% of total billed charges",1141,175,,,,,0,"fee schedule","175% of CMS fee schedule",20037.96,100,,,,,0,"fee schedule",EAPG,1141,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",718.83,63,,575.06,,,0,"percent of total billed charges","63% of total billed charges",174.57,15.3,,139.66,,,0,"percent of total billed charges","15.3% of total billed charges",19454.33,100,,,,,0,"fee schedule",EAPG,787.29,69,,,,,0,"fee schedule","69% of total billed charges",1141,100,,912.80,,,0,"percent of total billed charges","100% of total billed charges",1141,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1141,100,,912.80,,,0,"percent of total billed charges","100% of total billed charges",1141,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1141,100,,912.80,,,0,"percent of total billed charges","100% of total billed charges",1141,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1141,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,1141,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1141,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1141,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19843.41,100,,,,,0,"fee schedule",EAPG,25290.63,100,,,,,0,"fee schedule",EAPG,1141,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",430.16,37.7,,344.13,,,0,"percent of total billed charges","37.70% of total billed charges",1141,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1141,100,,,,,0,"fee schedule","100% of CMS fee schedule",889.98,78,,711.98,,,0,"percent of total billed charges","78% of total billed charges",1141,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",942.47,82.6,,753.98,,,0,"percent of total billed charges","82.6% of total billed charges",19454.33,100,,,,,0,"fee schedule","100% of WA fee schedule",1141,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",942.47,82.6,,753.98,,,0,"percent of total billed charges","82.6% of total billed charges",1141,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19614.86,100,,,,,0,"fee schedule",EAPG,1141,100,,912.80,,,0,"percent of total billed charges","100% of total billed charges",174.57,25290.63,
"33519 Coronary artery bypass, using venous graft(s",7962330,CDM,521,RC,33519,CPT,OUTPATIENT,,,1607,1044.55,,1414.16,88,,1131.33,,,0,"percent of total billed charges","88% of total billed charges",1607,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,1607,100,,1285.60,,,0,"percent of total billed charges","100% of total billed charges",1607,175,,,,,0,"fee schedule","175% of CMS fee schedule",20037.96,100,,,,,0,"fee schedule",EAPG,1607,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1012.41,63,,809.93,,,0,"percent of total billed charges","63% of total billed charges",245.87,15.3,,196.70,,,0,"percent of total billed charges","15.3% of total billed charges",19454.33,100,,,,,0,"fee schedule",EAPG,1108.83,69,,,,,0,"fee schedule","69% of total billed charges",1607,100,,1285.60,,,0,"percent of total billed charges","100% of total billed charges",1607,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1607,100,,1285.60,,,0,"percent of total billed charges","100% of total billed charges",1607,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1607,100,,1285.60,,,0,"percent of total billed charges","100% of total billed charges",1607,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1607,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,1607,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1607,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1607,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19843.41,100,,,,,0,"fee schedule",EAPG,25290.63,100,,,,,0,"fee schedule",EAPG,1607,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",605.84,37.7,,484.67,,,0,"percent of total billed charges","37.70% of total billed charges",1607,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1607,100,,,,,0,"fee schedule","100% of CMS fee schedule",1253.46,78,,1002.77,,,0,"percent of total billed charges","78% of total billed charges",1607,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1327.38,82.6,,1061.90,,,0,"percent of total billed charges","82.6% of total billed charges",19454.33,100,,,,,0,"fee schedule","100% of WA fee schedule",1607,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1327.38,82.6,,1061.90,,,0,"percent of total billed charges","82.6% of total billed charges",1607,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19614.86,100,,,,,0,"fee schedule",EAPG,1607,100,,1285.60,,,0,"percent of total billed charges","100% of total billed charges",245.87,25290.63,
"33510 Coronary artery bypass, vein only; single co",7963026,CDM,521,RC,33510,CPT,OUTPATIENT,,,5397,3508.05,,4749.36,88,,3799.49,,,0,"percent of total billed charges","88% of total billed charges",5397,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5397,175,,,,,0,"fee schedule","175% of CMS fee schedule",20037.96,100,,,,,0,"fee schedule",EAPG,5397,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3400.11,63,,2720.09,,,0,"percent of total billed charges","63% of total billed charges",825.74,15.3,,660.59,,,0,"percent of total billed charges","15.3% of total billed charges",19454.33,100,,,,,0,"fee schedule",EAPG,3723.93,69,,,,,0,"fee schedule","69% of total billed charges",5397,100,,4317.60,,,0,"percent of total billed charges","100% of total billed charges",5397,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5397,100,,4317.60,,,0,"percent of total billed charges","100% of total billed charges",5397,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5397,100,,4317.60,,,0,"percent of total billed charges","100% of total billed charges",5397,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5397,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,5397,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5397,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5397,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19843.41,100,,,,,0,"fee schedule",EAPG,25290.63,100,,,,,0,"fee schedule",EAPG,5397,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2034.67,37.7,,1627.74,,,0,"percent of total billed charges","37.70% of total billed charges",5397,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5397,100,,,,,0,"fee schedule","100% of CMS fee schedule",4209.66,78,,3367.73,,,0,"percent of total billed charges","78% of total billed charges",5397,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4457.92,82.6,,3566.34,,,0,"percent of total billed charges","82.6% of total billed charges",19454.33,100,,,,,0,"fee schedule","100% of WA fee schedule",5397,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4457.92,82.6,,3566.34,,,0,"percent of total billed charges","82.6% of total billed charges",5397,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19614.86,100,,,,,0,"fee schedule",EAPG,5397,100,,4317.60,,,0,"percent of total billed charges","100% of total billed charges",825.74,25290.63,
"33511 Coronary artery bypass, vein only; 2 coronar",7963140,CDM,521,RC,33511,CPT,OUTPATIENT,,,5947,3865.55,,5233.36,88,,4186.69,,,0,"percent of total billed charges","88% of total billed charges",5947,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5947,175,,,,,0,"fee schedule","175% of CMS fee schedule",20037.96,100,,,,,0,"fee schedule",EAPG,5947,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3746.61,63,,2997.29,,,0,"percent of total billed charges","63% of total billed charges",909.89,15.3,,727.91,,,0,"percent of total billed charges","15.3% of total billed charges",19454.33,100,,,,,0,"fee schedule",EAPG,4103.43,69,,,,,0,"fee schedule","69% of total billed charges",5947,100,,4757.60,,,0,"percent of total billed charges","100% of total billed charges",5947,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5947,100,,4757.60,,,0,"percent of total billed charges","100% of total billed charges",5947,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5947,100,,4757.60,,,0,"percent of total billed charges","100% of total billed charges",5947,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5947,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,5947,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5947,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5947,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19843.41,100,,,,,0,"fee schedule",EAPG,25290.63,100,,,,,0,"fee schedule",EAPG,5947,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2242.02,37.7,,1793.62,,,0,"percent of total billed charges","37.70% of total billed charges",5947,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5947,100,,,,,0,"fee schedule","100% of CMS fee schedule",4638.66,78,,3710.93,,,0,"percent of total billed charges","78% of total billed charges",5947,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4912.22,82.6,,3929.78,,,0,"percent of total billed charges","82.6% of total billed charges",19454.33,100,,,,,0,"fee schedule","100% of WA fee schedule",5947,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4912.22,82.6,,3929.78,,,0,"percent of total billed charges","82.6% of total billed charges",5947,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19614.86,100,,,,,0,"fee schedule",EAPG,5947,100,,4757.60,,,0,"percent of total billed charges","100% of total billed charges",909.89,25290.63,
"33512 Coronary artery bypass, vein only; 3 coronar",7963141,CDM,521,RC,33512,CPT,OUTPATIENT,,,6600,4290,,5808,88,,4646.40,,,0,"percent of total billed charges","88% of total billed charges",6600,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6600,175,,,,,0,"fee schedule","175% of CMS fee schedule",20037.96,100,,,,,0,"fee schedule",EAPG,6600,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4158,63,,3326.40,,,0,"percent of total billed charges","63% of total billed charges",1009.8,15.3,,807.84,,,0,"percent of total billed charges","15.3% of total billed charges",19454.33,100,,,,,0,"fee schedule",EAPG,4554,69,,,,,0,"fee schedule","69% of total billed charges",6600,100,,5280.00,,,0,"percent of total billed charges","100% of total billed charges",6600,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6600,100,,5280.00,,,0,"percent of total billed charges","100% of total billed charges",6600,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6600,100,,5280.00,,,0,"percent of total billed charges","100% of total billed charges",6600,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6600,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,6600,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6600,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6600,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19843.41,100,,,,,0,"fee schedule",EAPG,25290.63,100,,,,,0,"fee schedule",EAPG,6600,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2488.2,37.7,,1990.56,,,0,"percent of total billed charges","37.70% of total billed charges",6600,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6600,100,,,,,0,"fee schedule","100% of CMS fee schedule",5148,78,,4118.40,,,0,"percent of total billed charges","78% of total billed charges",6600,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5451.6,82.6,,4361.28,,,0,"percent of total billed charges","82.6% of total billed charges",19454.33,100,,,,,0,"fee schedule","100% of WA fee schedule",6600,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5451.6,82.6,,4361.28,,,0,"percent of total billed charges","82.6% of total billed charges",6600,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19614.86,100,,,,,0,"fee schedule",EAPG,6600,100,,5280.00,,,0,"percent of total billed charges","100% of total billed charges",1009.8,25290.63,
"33513 Coronary artery bypass, vein only; 4 coronar",7963142,CDM,521,RC,33513,CPT,OUTPATIENT,,,7240,4706,,6371.2,88,,5096.96,,,0,"percent of total billed charges","88% of total billed charges",7240,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7240,175,,,,,0,"fee schedule","175% of CMS fee schedule",20037.96,100,,,,,0,"fee schedule",EAPG,7240,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4561.2,63,,3648.96,,,0,"percent of total billed charges","63% of total billed charges",1107.72,15.3,,886.18,,,0,"percent of total billed charges","15.3% of total billed charges",19454.33,100,,,,,0,"fee schedule",EAPG,4995.6,69,,,,,0,"fee schedule","69% of total billed charges",7240,100,,5792.00,,,0,"percent of total billed charges","100% of total billed charges",7240,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7240,100,,5792.00,,,0,"percent of total billed charges","100% of total billed charges",7240,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7240,100,,5792.00,,,0,"percent of total billed charges","100% of total billed charges",7240,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7240,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,7240,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7240,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7240,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19843.41,100,,,,,0,"fee schedule",EAPG,25290.63,100,,,,,0,"fee schedule",EAPG,7240,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2729.48,37.7,,2183.58,,,0,"percent of total billed charges","37.70% of total billed charges",7240,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7240,100,,,,,0,"fee schedule","100% of CMS fee schedule",5647.2,78,,4517.76,,,0,"percent of total billed charges","78% of total billed charges",7240,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5980.24,82.6,,4784.19,,,0,"percent of total billed charges","82.6% of total billed charges",19454.33,100,,,,,0,"fee schedule","100% of WA fee schedule",7240,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5980.24,82.6,,4784.19,,,0,"percent of total billed charges","82.6% of total billed charges",7240,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19614.86,100,,,,,0,"fee schedule",EAPG,7240,100,,5792.00,,,0,"percent of total billed charges","100% of total billed charges",1107.72,25290.63,
"33514 Coronary artery bypass, vein only; 5 coronar",7963143,CDM,521,RC,33514,CPT,OUTPATIENT,,,7644,4968.6,,6726.72,88,,5381.38,,,0,"percent of total billed charges","88% of total billed charges",7644,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7644,175,,,,,0,"fee schedule","175% of CMS fee schedule",20037.96,100,,,,,0,"fee schedule",EAPG,7644,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4815.72,63,,3852.58,,,0,"percent of total billed charges","63% of total billed charges",1169.53,15.3,,935.62,,,0,"percent of total billed charges","15.3% of total billed charges",19454.33,100,,,,,0,"fee schedule",EAPG,5274.36,69,,,,,0,"fee schedule","69% of total billed charges",7644,100,,6115.20,,,0,"percent of total billed charges","100% of total billed charges",7644,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7644,100,,6115.20,,,0,"percent of total billed charges","100% of total billed charges",7644,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7644,100,,6115.20,,,0,"percent of total billed charges","100% of total billed charges",7644,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7644,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,7644,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7644,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7644,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19843.41,100,,,,,0,"fee schedule",EAPG,25290.63,100,,,,,0,"fee schedule",EAPG,7644,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2881.79,37.7,,2305.43,,,0,"percent of total billed charges","37.70% of total billed charges",7644,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7644,100,,,,,0,"fee schedule","100% of CMS fee schedule",5962.32,78,,4769.86,,,0,"percent of total billed charges","78% of total billed charges",7644,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6313.94,82.6,,5051.15,,,0,"percent of total billed charges","82.6% of total billed charges",19454.33,100,,,,,0,"fee schedule","100% of WA fee schedule",7644,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6313.94,82.6,,5051.15,,,0,"percent of total billed charges","82.6% of total billed charges",7644,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19614.86,100,,,,,0,"fee schedule",EAPG,7644,100,,6115.20,,,0,"percent of total billed charges","100% of total billed charges",1169.53,25290.63,
"33523 Coronary artery bypass, using venous graft(s",7961686,CDM,521,RC,33523,CPT,OUTPATIENT,,,3250,2112.5,,2860,88,,2288.00,,,0,"percent of total billed charges","88% of total billed charges",3250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,3250,100,,2600.00,,,0,"percent of total billed charges","100% of total billed charges",3250,175,,,,,0,"fee schedule","175% of CMS fee schedule",20037.96,100,,,,,0,"fee schedule",EAPG,3250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2047.5,63,,1638.00,,,0,"percent of total billed charges","63% of total billed charges",497.25,15.3,,397.80,,,0,"percent of total billed charges","15.3% of total billed charges",19454.33,100,,,,,0,"fee schedule",EAPG,2242.5,69,,,,,0,"fee schedule","69% of total billed charges",3250,100,,2600.00,,,0,"percent of total billed charges","100% of total billed charges",3250,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3250,100,,2600.00,,,0,"percent of total billed charges","100% of total billed charges",3250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3250,100,,2600.00,,,0,"percent of total billed charges","100% of total billed charges",3250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,3250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19843.41,100,,,,,0,"fee schedule",EAPG,25290.63,100,,,,,0,"fee schedule",EAPG,3250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1225.25,37.7,,980.20,,,0,"percent of total billed charges","37.70% of total billed charges",3250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3250,100,,,,,0,"fee schedule","100% of CMS fee schedule",2535,78,,2028.00,,,0,"percent of total billed charges","78% of total billed charges",3250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2684.5,82.6,,2147.60,,,0,"percent of total billed charges","82.6% of total billed charges",19454.33,100,,,,,0,"fee schedule","100% of WA fee schedule",3250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2684.5,82.6,,2147.60,,,0,"percent of total billed charges","82.6% of total billed charges",3250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19614.86,100,,,,,0,"fee schedule",EAPG,3250,100,,2600.00,,,0,"percent of total billed charges","100% of total billed charges",497.25,25290.63,
"33521 Coronary artery bypass, using venous graft(s",7962331,CDM,521,RC,33521,CPT,OUTPATIENT,,,2101,1365.65,,1848.88,88,,1479.10,,,0,"percent of total billed charges","88% of total billed charges",2101,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,2101,100,,1680.80,,,0,"percent of total billed charges","100% of total billed charges",2101,175,,,,,0,"fee schedule","175% of CMS fee schedule",20037.96,100,,,,,0,"fee schedule",EAPG,2101,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1323.63,63,,1058.90,,,0,"percent of total billed charges","63% of total billed charges",321.45,15.3,,257.16,,,0,"percent of total billed charges","15.3% of total billed charges",19454.33,100,,,,,0,"fee schedule",EAPG,1449.69,69,,,,,0,"fee schedule","69% of total billed charges",2101,100,,1680.80,,,0,"percent of total billed charges","100% of total billed charges",2101,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2101,100,,1680.80,,,0,"percent of total billed charges","100% of total billed charges",2101,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2101,100,,1680.80,,,0,"percent of total billed charges","100% of total billed charges",2101,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2101,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,2101,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2101,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2101,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19843.41,100,,,,,0,"fee schedule",EAPG,25290.63,100,,,,,0,"fee schedule",EAPG,2101,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",792.08,37.7,,633.66,,,0,"percent of total billed charges","37.70% of total billed charges",2101,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2101,100,,,,,0,"fee schedule","100% of CMS fee schedule",1638.78,78,,1311.02,,,0,"percent of total billed charges","78% of total billed charges",2101,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1735.43,82.6,,1388.34,,,0,"percent of total billed charges","82.6% of total billed charges",19454.33,100,,,,,0,"fee schedule","100% of WA fee schedule",2101,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1735.43,82.6,,1388.34,,,0,"percent of total billed charges","82.6% of total billed charges",2101,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19614.86,100,,,,,0,"fee schedule",EAPG,2101,100,,1680.80,,,0,"percent of total billed charges","100% of total billed charges",321.45,25290.63,
"33522 Coronary artery bypass, using venous graft(s",7962332,CDM,521,RC,33522,CPT,OUTPATIENT,,,2669,1734.85,,2348.72,88,,1878.98,,,0,"percent of total billed charges","88% of total billed charges",2669,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,2669,100,,2135.20,,,0,"percent of total billed charges","100% of total billed charges",2669,175,,,,,0,"fee schedule","175% of CMS fee schedule",20037.96,100,,,,,0,"fee schedule",EAPG,2669,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1681.47,63,,1345.18,,,0,"percent of total billed charges","63% of total billed charges",408.36,15.3,,326.69,,,0,"percent of total billed charges","15.3% of total billed charges",19454.33,100,,,,,0,"fee schedule",EAPG,1841.61,69,,,,,0,"fee schedule","69% of total billed charges",2669,100,,2135.20,,,0,"percent of total billed charges","100% of total billed charges",2669,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2669,100,,2135.20,,,0,"percent of total billed charges","100% of total billed charges",2669,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2669,100,,2135.20,,,0,"percent of total billed charges","100% of total billed charges",2669,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2669,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,2669,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2669,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2669,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19843.41,100,,,,,0,"fee schedule",EAPG,25290.63,100,,,,,0,"fee schedule",EAPG,2669,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1006.21,37.7,,804.97,,,0,"percent of total billed charges","37.70% of total billed charges",2669,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2669,100,,,,,0,"fee schedule","100% of CMS fee schedule",2081.82,78,,1665.46,,,0,"percent of total billed charges","78% of total billed charges",2669,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2204.59,82.6,,1763.67,,,0,"percent of total billed charges","82.6% of total billed charges",19454.33,100,,,,,0,"fee schedule","100% of WA fee schedule",2669,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2204.59,82.6,,1763.67,,,0,"percent of total billed charges","82.6% of total billed charges",2669,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19614.86,100,,,,,0,"fee schedule",EAPG,2669,100,,2135.20,,,0,"percent of total billed charges","100% of total billed charges",408.36,25290.63,
"33530 Reoperation, coronary artery bypass/valve pr",7962252,CDM,521,RC,33530,CPT,OUTPATIENT,,,1410,916.5,,1240.8,88,,992.64,,,0,"percent of total billed charges","88% of total billed charges",1410,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,1410,100,,1128.00,,,0,"percent of total billed charges","100% of total billed charges",1410,175,,,,,0,"fee schedule","175% of CMS fee schedule",20037.96,100,,,,,0,"fee schedule",EAPG,1410,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",888.3,63,,710.64,,,0,"percent of total billed charges","63% of total billed charges",215.73,15.3,,172.58,,,0,"percent of total billed charges","15.3% of total billed charges",19454.33,100,,,,,0,"fee schedule",EAPG,972.9,69,,,,,0,"fee schedule","69% of total billed charges",1410,100,,1128.00,,,0,"percent of total billed charges","100% of total billed charges",1410,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1410,100,,1128.00,,,0,"percent of total billed charges","100% of total billed charges",1410,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1410,100,,1128.00,,,0,"percent of total billed charges","100% of total billed charges",1410,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1410,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,1410,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1410,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1410,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19843.41,100,,,,,0,"fee schedule",EAPG,25290.63,100,,,,,0,"fee schedule",EAPG,1410,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",531.57,37.7,,425.26,,,0,"percent of total billed charges","37.70% of total billed charges",1410,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1410,100,,,,,0,"fee schedule","100% of CMS fee schedule",1099.8,78,,879.84,,,0,"percent of total billed charges","78% of total billed charges",1410,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1164.66,82.6,,931.73,,,0,"percent of total billed charges","82.6% of total billed charges",19454.33,100,,,,,0,"fee schedule","100% of WA fee schedule",1410,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1164.66,82.6,,931.73,,,0,"percent of total billed charges","82.6% of total billed charges",1410,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19614.86,100,,,,,0,"fee schedule",EAPG,1410,100,,1128.00,,,0,"percent of total billed charges","100% of total billed charges",215.73,25290.63,
"33534 Coronary artery bypass, using arterial graft",7962633,CDM,521,RC,33534,CPT,OUTPATIENT,,,6962,4525.3,,6126.56,88,,4901.25,,,0,"percent of total billed charges","88% of total billed charges",6962,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6962,175,,,,,0,"fee schedule","175% of CMS fee schedule",20037.96,100,,,,,0,"fee schedule",EAPG,6962,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4386.06,63,,3508.85,,,0,"percent of total billed charges","63% of total billed charges",1065.19,15.3,,852.15,,,0,"percent of total billed charges","15.3% of total billed charges",19454.33,100,,,,,0,"fee schedule",EAPG,4803.78,69,,,,,0,"fee schedule","69% of total billed charges",6962,100,,5569.60,,,0,"percent of total billed charges","100% of total billed charges",6962,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6962,100,,5569.60,,,0,"percent of total billed charges","100% of total billed charges",6962,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6962,100,,5569.60,,,0,"percent of total billed charges","100% of total billed charges",6962,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6962,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,6962,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6962,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6962,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19843.41,100,,,,,0,"fee schedule",EAPG,25290.63,100,,,,,0,"fee schedule",EAPG,6962,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2624.67,37.7,,2099.74,,,0,"percent of total billed charges","37.70% of total billed charges",6962,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6962,100,,,,,0,"fee schedule","100% of CMS fee schedule",5430.36,78,,4344.29,,,0,"percent of total billed charges","78% of total billed charges",6962,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5750.61,82.6,,4600.49,,,0,"percent of total billed charges","82.6% of total billed charges",19454.33,100,,,,,0,"fee schedule","100% of WA fee schedule",6962,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5750.61,82.6,,4600.49,,,0,"percent of total billed charges","82.6% of total billed charges",6962,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19614.86,100,,,,,0,"fee schedule",EAPG,6962,100,,5569.60,,,0,"percent of total billed charges","100% of total billed charges",1065.19,25290.63,
"33535 Coronary artery bypass, using arterial graft",7962634,CDM,521,RC,33535,CPT,OUTPATIENT,,,6775,4403.75,,5962,88,,4769.60,,,0,"percent of total billed charges","88% of total billed charges",6775,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6775,175,,,,,0,"fee schedule","175% of CMS fee schedule",20037.96,100,,,,,0,"fee schedule",EAPG,6775,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4268.25,63,,3414.60,,,0,"percent of total billed charges","63% of total billed charges",1036.58,15.3,,829.26,,,0,"percent of total billed charges","15.3% of total billed charges",19454.33,100,,,,,0,"fee schedule",EAPG,4674.75,69,,,,,0,"fee schedule","69% of total billed charges",6775,100,,5420.00,,,0,"percent of total billed charges","100% of total billed charges",6775,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6775,100,,5420.00,,,0,"percent of total billed charges","100% of total billed charges",6775,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6775,100,,5420.00,,,0,"percent of total billed charges","100% of total billed charges",6775,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6775,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,6775,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6775,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6775,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19843.41,100,,,,,0,"fee schedule",EAPG,25290.63,100,,,,,0,"fee schedule",EAPG,6775,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2554.18,37.7,,2043.34,,,0,"percent of total billed charges","37.70% of total billed charges",6775,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6775,100,,,,,0,"fee schedule","100% of CMS fee schedule",5284.5,78,,4227.60,,,0,"percent of total billed charges","78% of total billed charges",6775,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5596.15,82.6,,4476.92,,,0,"percent of total billed charges","82.6% of total billed charges",19454.33,100,,,,,0,"fee schedule","100% of WA fee schedule",6775,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5596.15,82.6,,4476.92,,,0,"percent of total billed charges","82.6% of total billed charges",6775,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19614.86,100,,,,,0,"fee schedule",EAPG,6775,100,,5420.00,,,0,"percent of total billed charges","100% of total billed charges",1036.58,25290.63,
"33533 Coronary artery bypass, using arterial graft",7962812,CDM,521,RC,33533,CPT,OUTPATIENT,,,6297,4093.05,,5541.36,88,,4433.09,,,0,"percent of total billed charges","88% of total billed charges",6297,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6297,175,,,,,0,"fee schedule","175% of CMS fee schedule",20037.96,100,,,,,0,"fee schedule",EAPG,6297,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3967.11,63,,3173.69,,,0,"percent of total billed charges","63% of total billed charges",963.44,15.3,,770.75,,,0,"percent of total billed charges","15.3% of total billed charges",19454.33,100,,,,,0,"fee schedule",EAPG,4344.93,69,,,,,0,"fee schedule","69% of total billed charges",6297,100,,5037.60,,,0,"percent of total billed charges","100% of total billed charges",6297,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6297,100,,5037.60,,,0,"percent of total billed charges","100% of total billed charges",6297,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6297,100,,5037.60,,,0,"percent of total billed charges","100% of total billed charges",6297,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6297,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,6297,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6297,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6297,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19843.41,100,,,,,0,"fee schedule",EAPG,25290.63,100,,,,,0,"fee schedule",EAPG,6297,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2373.97,37.7,,1899.18,,,0,"percent of total billed charges","37.70% of total billed charges",6297,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6297,100,,,,,0,"fee schedule","100% of CMS fee schedule",4911.66,78,,3929.33,,,0,"percent of total billed charges","78% of total billed charges",6297,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5201.32,82.6,,4161.06,,,0,"percent of total billed charges","82.6% of total billed charges",19454.33,100,,,,,0,"fee schedule","100% of WA fee schedule",6297,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5201.32,82.6,,4161.06,,,0,"percent of total billed charges","82.6% of total billed charges",6297,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19614.86,100,,,,,0,"fee schedule",EAPG,6297,100,,5037.60,,,0,"percent of total billed charges","100% of total billed charges",963.44,25290.63,
"33572 Coronary endarterectomy, open, any method, o",7962673,CDM,521,RC,33572,CPT,OUTPATIENT,,,1040,676,,915.2,88,,732.16,,,0,"percent of total billed charges","88% of total billed charges",1040,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,1040,100,,832.00,,,0,"percent of total billed charges","100% of total billed charges",1040,175,,,,,0,"fee schedule","175% of CMS fee schedule",20037.96,100,,,,,0,"fee schedule",EAPG,1040,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",655.2,63,,524.16,,,0,"percent of total billed charges","63% of total billed charges",159.12,15.3,,127.30,,,0,"percent of total billed charges","15.3% of total billed charges",19454.33,100,,,,,0,"fee schedule",EAPG,717.6,69,,,,,0,"fee schedule","69% of total billed charges",1040,100,,832.00,,,0,"percent of total billed charges","100% of total billed charges",1040,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1040,100,,832.00,,,0,"percent of total billed charges","100% of total billed charges",1040,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1040,100,,832.00,,,0,"percent of total billed charges","100% of total billed charges",1040,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1040,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,1040,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1040,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1040,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19843.41,100,,,,,0,"fee schedule",EAPG,25290.63,100,,,,,0,"fee schedule",EAPG,1040,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",392.08,37.7,,313.66,,,0,"percent of total billed charges","37.70% of total billed charges",1040,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1040,100,,,,,0,"fee schedule","100% of CMS fee schedule",811.2,78,,648.96,,,0,"percent of total billed charges","78% of total billed charges",1040,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",859.04,82.6,,687.23,,,0,"percent of total billed charges","82.6% of total billed charges",19454.33,100,,,,,0,"fee schedule","100% of WA fee schedule",1040,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",859.04,82.6,,687.23,,,0,"percent of total billed charges","82.6% of total billed charges",1040,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19614.86,100,,,,,0,"fee schedule",EAPG,1040,100,,832.00,,,0,"percent of total billed charges","100% of total billed charges",159.12,25290.63,
"33641 Repair atrial septal defect, secundum, with",7961870,CDM,521,RC,33641,CPT,OUTPATIENT,,,5057,3287.05,,4450.16,88,,3560.13,,,0,"percent of total billed charges","88% of total billed charges",5057,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5057,175,,,,,0,"fee schedule","175% of CMS fee schedule",11434.32,100,,,,,0,"fee schedule",EAPG,5057,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3185.91,63,,2548.73,,,0,"percent of total billed charges","63% of total billed charges",773.72,15.3,,618.98,,,0,"percent of total billed charges","15.3% of total billed charges",11101.28,100,,,,,0,"fee schedule",EAPG,3489.33,69,,,,,0,"fee schedule","69% of total billed charges",5057,100,,4045.60,,,0,"percent of total billed charges","100% of total billed charges",5057,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5057,100,,4045.60,,,0,"percent of total billed charges","100% of total billed charges",5057,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5057,100,,4045.60,,,0,"percent of total billed charges","100% of total billed charges",5057,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5057,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,5057,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5057,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5057,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11323.31,100,,,,,0,"fee schedule",EAPG,14431.67,100,,,,,0,"fee schedule",EAPG,5057,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1906.49,37.7,,1525.19,,,0,"percent of total billed charges","37.70% of total billed charges",5057,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5057,100,,,,,0,"fee schedule","100% of CMS fee schedule",3944.46,78,,3155.57,,,0,"percent of total billed charges","78% of total billed charges",5057,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4177.08,82.6,,3341.66,,,0,"percent of total billed charges","82.6% of total billed charges",11101.28,100,,,,,0,"fee schedule","100% of WA fee schedule",5057,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4177.08,82.6,,3341.66,,,0,"percent of total billed charges","82.6% of total billed charges",5057,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11261.81,100,,,,,0,"fee schedule",EAPG,5057,100,,4045.60,,,0,"percent of total billed charges","100% of total billed charges",773.72,14431.67,
"33645 Direct or patch closure, sinus venosus, with",7961985,CDM,521,RC,33645,CPT,OUTPATIENT,,,5048,3281.2,,4442.24,88,,3553.79,,,0,"percent of total billed charges","88% of total billed charges",5048,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5048,175,,,,,0,"fee schedule","175% of CMS fee schedule",11434.32,100,,,,,0,"fee schedule",EAPG,5048,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3180.24,63,,2544.19,,,0,"percent of total billed charges","63% of total billed charges",772.34,15.3,,617.87,,,0,"percent of total billed charges","15.3% of total billed charges",11101.28,100,,,,,0,"fee schedule",EAPG,3483.12,69,,,,,0,"fee schedule","69% of total billed charges",5048,100,,4038.40,,,0,"percent of total billed charges","100% of total billed charges",5048,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5048,100,,4038.40,,,0,"percent of total billed charges","100% of total billed charges",5048,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5048,100,,4038.40,,,0,"percent of total billed charges","100% of total billed charges",5048,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5048,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,5048,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5048,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5048,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11323.31,100,,,,,0,"fee schedule",EAPG,14431.67,100,,,,,0,"fee schedule",EAPG,5048,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1903.1,37.7,,1522.48,,,0,"percent of total billed charges","37.70% of total billed charges",5048,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5048,100,,,,,0,"fee schedule","100% of CMS fee schedule",3937.44,78,,3149.95,,,0,"percent of total billed charges","78% of total billed charges",5048,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4169.65,82.6,,3335.72,,,0,"percent of total billed charges","82.6% of total billed charges",11101.28,100,,,,,0,"fee schedule","100% of WA fee schedule",5048,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4169.65,82.6,,3335.72,,,0,"percent of total billed charges","82.6% of total billed charges",5048,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11261.81,100,,,,,0,"fee schedule",EAPG,5048,100,,4038.40,,,0,"percent of total billed charges","100% of total billed charges",772.34,14431.67,
"33647 Repair of atrial septal defect and ventricul",7961986,CDM,521,RC,33647,CPT,OUTPATIENT,,,5598,3638.7,,4926.24,88,,3940.99,,,0,"percent of total billed charges","88% of total billed charges",5598,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5598,175,,,,,0,"fee schedule","175% of CMS fee schedule",11434.32,100,,,,,0,"fee schedule",EAPG,5598,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3526.74,63,,2821.39,,,0,"percent of total billed charges","63% of total billed charges",856.49,15.3,,685.19,,,0,"percent of total billed charges","15.3% of total billed charges",11101.28,100,,,,,0,"fee schedule",EAPG,3862.62,69,,,,,0,"fee schedule","69% of total billed charges",5598,100,,4478.40,,,0,"percent of total billed charges","100% of total billed charges",5598,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5598,100,,4478.40,,,0,"percent of total billed charges","100% of total billed charges",5598,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5598,100,,4478.40,,,0,"percent of total billed charges","100% of total billed charges",5598,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5598,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11101.28,100,,,,,0,"fee schedule",EAPG,5598,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5598,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5598,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11323.31,100,,,,,0,"fee schedule",EAPG,14431.67,100,,,,,0,"fee schedule",EAPG,5598,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2110.45,37.7,,1688.36,,,0,"percent of total billed charges","37.70% of total billed charges",5598,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5598,100,,,,,0,"fee schedule","100% of CMS fee schedule",4366.44,78,,3493.15,,,0,"percent of total billed charges","78% of total billed charges",5598,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4623.95,82.6,,3699.16,,,0,"percent of total billed charges","82.6% of total billed charges",11101.28,100,,,,,0,"fee schedule","100% of WA fee schedule",5598,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4623.95,82.6,,3699.16,,,0,"percent of total billed charges","82.6% of total billed charges",5598,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11261.81,100,,,,,0,"fee schedule",EAPG,5598,100,,4478.40,,,0,"percent of total billed charges","100% of total billed charges",856.49,14431.67,
"33858 Ascending aorta graft, w/cardiopulmonary byp",7961603,CDM,521,RC,33858,CPT,OUTPATIENT,,,7170,4660.5,,6309.6,88,,5047.68,,,0,"percent of total billed charges","88% of total billed charges",7170,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7170,175,,,,,0,"fee schedule","175% of CMS fee schedule",10944.37,100,,,,,0,"fee schedule",EAPG,7170,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4517.1,63,,3613.68,,,0,"percent of total billed charges","63% of total billed charges",1097.01,15.3,,877.61,,,0,"percent of total billed charges","15.3% of total billed charges",10625.6,100,,,,,0,"fee schedule",EAPG,4947.3,69,,,,,0,"fee schedule","69% of total billed charges",7170,100,,5736.00,,,0,"percent of total billed charges","100% of total billed charges",7170,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7170,100,,5736.00,,,0,"percent of total billed charges","100% of total billed charges",7170,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7170,100,,5736.00,,,0,"percent of total billed charges","100% of total billed charges",7170,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7170,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,7170,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7170,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7170,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10838.11,100,,,,,0,"fee schedule",EAPG,13813.28,100,,,,,0,"fee schedule",EAPG,7170,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2703.09,37.7,,2162.47,,,0,"percent of total billed charges","37.70% of total billed charges",7170,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7170,100,,,,,0,"fee schedule","100% of CMS fee schedule",5592.6,78,,4474.08,,,0,"percent of total billed charges","78% of total billed charges",7170,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5922.42,82.6,,4737.94,,,0,"percent of total billed charges","82.6% of total billed charges",10625.6,100,,,,,0,"fee schedule","100% of WA fee schedule",7170,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5922.42,82.6,,4737.94,,,0,"percent of total billed charges","82.6% of total billed charges",7170,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10786.13,100,,,,,0,"fee schedule",EAPG,7170,100,,5736.00,,,0,"percent of total billed charges","100% of total billed charges",1097.01,13813.28,
"33864 Ascending aorta graft, with cardiopulmonary",7961987,CDM,521,RC,33864,CPT,OUTPATIENT,,,10140,6591,,8923.2,88,,7138.56,,,0,"percent of total billed charges","88% of total billed charges",10140,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",10140,175,,,,,0,"fee schedule","175% of CMS fee schedule",10944.37,100,,,,,0,"fee schedule",EAPG,10140,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6388.2,63,,5110.56,,,0,"percent of total billed charges","63% of total billed charges",1551.42,15.3,,1241.14,,,0,"percent of total billed charges","15.3% of total billed charges",10625.6,100,,,,,0,"fee schedule",EAPG,6996.6,69,,,,,0,"fee schedule","69% of total billed charges",10140,100,,8112.00,,,0,"percent of total billed charges","100% of total billed charges",10140,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10140,100,,8112.00,,,0,"percent of total billed charges","100% of total billed charges",10140,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10140,100,,8112.00,,,0,"percent of total billed charges","100% of total billed charges",10140,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10140,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,10140,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10140,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10140,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10838.11,100,,,,,0,"fee schedule",EAPG,13813.28,100,,,,,0,"fee schedule",EAPG,10140,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3822.78,37.7,,3058.22,,,0,"percent of total billed charges","37.70% of total billed charges",10140,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10140,100,,,,,0,"fee schedule","100% of CMS fee schedule",7909.2,78,,6327.36,,,0,"percent of total billed charges","78% of total billed charges",10140,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8375.64,82.6,,6700.51,,,0,"percent of total billed charges","82.6% of total billed charges",10625.6,100,,,,,0,"fee schedule","100% of WA fee schedule",10140,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8375.64,82.6,,6700.51,,,0,"percent of total billed charges","82.6% of total billed charges",10140,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10786.13,100,,,,,0,"fee schedule",EAPG,10140,100,,8112.00,,,0,"percent of total billed charges","100% of total billed charges",1551.42,13813.28,
"33863 Ascending aorta graft, w/ bypass, with aorti",7963049,CDM,521,RC,33863,CPT,OUTPATIENT,,,8480,5512,,7462.4,88,,5969.92,,,0,"percent of total billed charges","88% of total billed charges",8480,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8480,175,,,,,0,"fee schedule","175% of CMS fee schedule",10944.37,100,,,,,0,"fee schedule",EAPG,8480,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5342.4,63,,4273.92,,,0,"percent of total billed charges","63% of total billed charges",1297.44,15.3,,1037.95,,,0,"percent of total billed charges","15.3% of total billed charges",10625.6,100,,,,,0,"fee schedule",EAPG,5851.2,69,,,,,0,"fee schedule","69% of total billed charges",8480,100,,6784.00,,,0,"percent of total billed charges","100% of total billed charges",8480,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8480,100,,6784.00,,,0,"percent of total billed charges","100% of total billed charges",8480,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8480,100,,6784.00,,,0,"percent of total billed charges","100% of total billed charges",8480,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8480,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,8480,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8480,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8480,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10838.11,100,,,,,0,"fee schedule",EAPG,13813.28,100,,,,,0,"fee schedule",EAPG,8480,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3196.96,37.7,,2557.57,,,0,"percent of total billed charges","37.70% of total billed charges",8480,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8480,100,,,,,0,"fee schedule","100% of CMS fee schedule",6614.4,78,,5291.52,,,0,"percent of total billed charges","78% of total billed charges",8480,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7004.48,82.6,,5603.58,,,0,"percent of total billed charges","82.6% of total billed charges",10625.6,100,,,,,0,"fee schedule","100% of WA fee schedule",8480,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7004.48,82.6,,5603.58,,,0,"percent of total billed charges","82.6% of total billed charges",8480,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10786.13,100,,,,,0,"fee schedule",EAPG,8480,100,,6784.00,,,0,"percent of total billed charges","100% of total billed charges",1297.44,13813.28,
"33877 Repair of thoracoabdominal aortic aneurysm w",7961988,CDM,521,RC,33877,CPT,OUTPATIENT,,,10984,7139.6,,9665.92,88,,7732.74,,,0,"percent of total billed charges","88% of total billed charges",10984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",10984,175,,,,,0,"fee schedule","175% of CMS fee schedule",10944.37,100,,,,,0,"fee schedule",EAPG,10984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6919.92,63,,5535.94,,,0,"percent of total billed charges","63% of total billed charges",1680.55,15.3,,1344.44,,,0,"percent of total billed charges","15.3% of total billed charges",10625.6,100,,,,,0,"fee schedule",EAPG,7578.96,69,,,,,0,"fee schedule","69% of total billed charges",10984,100,,8787.20,,,0,"percent of total billed charges","100% of total billed charges",10984,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10984,100,,8787.20,,,0,"percent of total billed charges","100% of total billed charges",10984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10984,100,,8787.20,,,0,"percent of total billed charges","100% of total billed charges",10984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,10984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10838.11,100,,,,,0,"fee schedule",EAPG,13813.28,100,,,,,0,"fee schedule",EAPG,10984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4140.97,37.7,,3312.78,,,0,"percent of total billed charges","37.70% of total billed charges",10984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10984,100,,,,,0,"fee schedule","100% of CMS fee schedule",8567.52,78,,6854.02,,,0,"percent of total billed charges","78% of total billed charges",10984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9072.78,82.6,,7258.22,,,0,"percent of total billed charges","82.6% of total billed charges",10625.6,100,,,,,0,"fee schedule","100% of WA fee schedule",10984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9072.78,82.6,,7258.22,,,0,"percent of total billed charges","82.6% of total billed charges",10984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10786.13,100,,,,,0,"fee schedule",EAPG,10984,100,,8787.20,,,0,"percent of total billed charges","100% of total billed charges",1680.55,13813.28,
"33875 Descending thoracic aorta graft, with or wit",7963252,CDM,521,RC,33875,CPT,OUTPATIENT,,,6862,4460.3,,6038.56,88,,4830.85,,,0,"percent of total billed charges","88% of total billed charges",6862,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6862,175,,,,,0,"fee schedule","175% of CMS fee schedule",10944.37,100,,,,,0,"fee schedule",EAPG,6862,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4323.06,63,,3458.45,,,0,"percent of total billed charges","63% of total billed charges",1049.89,15.3,,839.91,,,0,"percent of total billed charges","15.3% of total billed charges",10625.6,100,,,,,0,"fee schedule",EAPG,4734.78,69,,,,,0,"fee schedule","69% of total billed charges",6862,100,,5489.60,,,0,"percent of total billed charges","100% of total billed charges",6862,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6862,100,,5489.60,,,0,"percent of total billed charges","100% of total billed charges",6862,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6862,100,,5489.60,,,0,"percent of total billed charges","100% of total billed charges",6862,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6862,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,6862,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6862,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6862,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10838.11,100,,,,,0,"fee schedule",EAPG,13813.28,100,,,,,0,"fee schedule",EAPG,6862,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2586.97,37.7,,2069.58,,,0,"percent of total billed charges","37.70% of total billed charges",6862,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6862,100,,,,,0,"fee schedule","100% of CMS fee schedule",5352.36,78,,4281.89,,,0,"percent of total billed charges","78% of total billed charges",6862,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5668.01,82.6,,4534.41,,,0,"percent of total billed charges","82.6% of total billed charges",10625.6,100,,,,,0,"fee schedule","100% of WA fee schedule",6862,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5668.01,82.6,,4534.41,,,0,"percent of total billed charges","82.6% of total billed charges",6862,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10786.13,100,,,,,0,"fee schedule",EAPG,6862,100,,5489.60,,,0,"percent of total billed charges","100% of total billed charges",1049.89,13813.28,
"33871 Transverse aortic arch graft, with cardiopul",7963397,CDM,521,RC,33871,CPT,OUTPATIENT,,,7929,5153.85,,6977.52,88,,5582.02,,,0,"percent of total billed charges","88% of total billed charges",7929,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7929,175,,,,,0,"fee schedule","175% of CMS fee schedule",10944.37,100,,,,,0,"fee schedule",EAPG,7929,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4995.27,63,,3996.22,,,0,"percent of total billed charges","63% of total billed charges",1213.14,15.3,,970.51,,,0,"percent of total billed charges","15.3% of total billed charges",10625.6,100,,,,,0,"fee schedule",EAPG,5471.01,69,,,,,0,"fee schedule","69% of total billed charges",7929,100,,6343.20,,,0,"percent of total billed charges","100% of total billed charges",7929,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7929,100,,6343.20,,,0,"percent of total billed charges","100% of total billed charges",7929,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7929,100,,6343.20,,,0,"percent of total billed charges","100% of total billed charges",7929,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7929,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,7929,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7929,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7929,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10838.11,100,,,,,0,"fee schedule",EAPG,13813.28,100,,,,,0,"fee schedule",EAPG,7929,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2989.23,37.7,,2391.38,,,0,"percent of total billed charges","37.70% of total billed charges",7929,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7929,100,,,,,0,"fee schedule","100% of CMS fee schedule",6184.62,78,,4947.70,,,0,"percent of total billed charges","78% of total billed charges",7929,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6549.35,82.6,,5239.48,,,0,"percent of total billed charges","82.6% of total billed charges",10625.6,100,,,,,0,"fee schedule","100% of WA fee schedule",7929,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6549.35,82.6,,5239.48,,,0,"percent of total billed charges","82.6% of total billed charges",7929,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10786.13,100,,,,,0,"fee schedule",EAPG,7929,100,,6343.20,,,0,"percent of total billed charges","100% of total billed charges",1213.14,13813.28,
"33967 Insertion of intra-aortic balloon assist dev",7963072,CDM,521,RC,33967,CPT,OUTPATIENT,,,845,549.25,,743.6,88,,594.88,,,0,"percent of total billed charges","88% of total billed charges",845,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7477.38,100,,,,,0,"fee schedule",EAPG,845,100,,676.00,,,0,"percent of total billed charges","100% of total billed charges",845,175,,,,,0,"fee schedule","175% of CMS fee schedule",7701.7,100,,,,,0,"fee schedule",EAPG,845,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",532.35,63,,425.88,,,0,"percent of total billed charges","63% of total billed charges",129.29,15.3,,103.43,,,0,"percent of total billed charges","15.3% of total billed charges",7477.38,100,,,,,0,"fee schedule",EAPG,583.05,69,,,,,0,"fee schedule","69% of total billed charges",845,100,,676.00,,,0,"percent of total billed charges","100% of total billed charges",845,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",845,100,,676.00,,,0,"percent of total billed charges","100% of total billed charges",845,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",845,100,,676.00,,,0,"percent of total billed charges","100% of total billed charges",845,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",845,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7477.38,100,,,,,0,"fee schedule",EAPG,845,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",845,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",845,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7626.93,100,,,,,0,"fee schedule",EAPG,9720.59,100,,,,,0,"fee schedule",EAPG,845,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",318.57,37.7,,254.86,,,0,"percent of total billed charges","37.70% of total billed charges",845,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",845,100,,,,,0,"fee schedule","100% of CMS fee schedule",659.1,78,,527.28,,,0,"percent of total billed charges","78% of total billed charges",845,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",697.97,82.6,,558.38,,,0,"percent of total billed charges","82.6% of total billed charges",7477.38,100,,,,,0,"fee schedule","100% of WA fee schedule",845,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",697.97,82.6,,558.38,,,0,"percent of total billed charges","82.6% of total billed charges",845,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7637.91,100,,,,,0,"fee schedule",EAPG,845,100,,676.00,,,0,"percent of total billed charges","100% of total billed charges",129.29,9720.59,
"33968 Removal of intra-aortic balloon assist devic",7963144,CDM,521,RC,33968,CPT,OUTPATIENT,,,99,64.35,,87.12,88,,69.70,,,0,"percent of total billed charges","88% of total billed charges",99,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6298.95,100,,,,,0,"fee schedule",EAPG,99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",99,175,,,,,0,"fee schedule","175% of CMS fee schedule",6487.92,100,,,,,0,"fee schedule",EAPG,99,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",62.37,63,,49.90,,,0,"percent of total billed charges","63% of total billed charges",15.15,15.3,,12.12,,,0,"percent of total billed charges","15.3% of total billed charges",6298.95,100,,,,,0,"fee schedule",EAPG,68.31,69,,,,,0,"fee schedule","69% of total billed charges",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",99,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",99,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",99,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",99,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6298.95,100,,,,,0,"fee schedule",EAPG,99,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",99,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",99,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6424.93,100,,,,,0,"fee schedule",EAPG,8188.64,100,,,,,0,"fee schedule",EAPG,99,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",37.32,37.7,,29.86,,,0,"percent of total billed charges","37.70% of total billed charges",99,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",99,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.22,78,,61.78,,,0,"percent of total billed charges","78% of total billed charges",99,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",6298.95,100,,,,,0,"fee schedule","100% of WA fee schedule",99,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",99,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6459.48,100,,,,,0,"fee schedule",EAPG,99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",15.15,8188.64,
"33970 Insertion of intra-aortic balloon assist dev",7961871,CDM,521,RC,33970,CPT,OUTPATIENT,,,1062,690.3,,934.56,88,,747.65,,,0,"percent of total billed charges","88% of total billed charges",1062,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,1062,100,,849.60,,,0,"percent of total billed charges","100% of total billed charges",1062,175,,,,,0,"fee schedule","175% of CMS fee schedule",10944.37,100,,,,,0,"fee schedule",EAPG,1062,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",669.06,63,,535.25,,,0,"percent of total billed charges","63% of total billed charges",162.49,15.3,,129.99,,,0,"percent of total billed charges","15.3% of total billed charges",10625.6,100,,,,,0,"fee schedule",EAPG,732.78,69,,,,,0,"fee schedule","69% of total billed charges",1062,100,,849.60,,,0,"percent of total billed charges","100% of total billed charges",1062,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1062,100,,849.60,,,0,"percent of total billed charges","100% of total billed charges",1062,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1062,100,,849.60,,,0,"percent of total billed charges","100% of total billed charges",1062,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1062,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,1062,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1062,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1062,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10838.11,100,,,,,0,"fee schedule",EAPG,13813.28,100,,,,,0,"fee schedule",EAPG,1062,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",400.37,37.7,,320.30,,,0,"percent of total billed charges","37.70% of total billed charges",1062,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1062,100,,,,,0,"fee schedule","100% of CMS fee schedule",828.36,78,,662.69,,,0,"percent of total billed charges","78% of total billed charges",1062,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",877.21,82.6,,701.77,,,0,"percent of total billed charges","82.6% of total billed charges",10625.6,100,,,,,0,"fee schedule","100% of WA fee schedule",1062,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",877.21,82.6,,701.77,,,0,"percent of total billed charges","82.6% of total billed charges",1062,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10786.13,100,,,,,0,"fee schedule",EAPG,1062,100,,849.60,,,0,"percent of total billed charges","100% of total billed charges",162.49,13813.28,
"33993 Repositioning of percutaneous ventricular as",7961989,CDM,521,RC,33993,CPT,OUTPATIENT,,,543,352.95,,477.84,88,,382.27,,,0,"percent of total billed charges","88% of total billed charges",543,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6298.95,100,,,,,0,"fee schedule",EAPG,543,100,,434.40,,,0,"percent of total billed charges","100% of total billed charges",543,175,,,,,0,"fee schedule","175% of CMS fee schedule",6487.92,100,,,,,0,"fee schedule",EAPG,543,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",342.09,63,,273.67,,,0,"percent of total billed charges","63% of total billed charges",83.08,15.3,,66.46,,,0,"percent of total billed charges","15.3% of total billed charges",6298.95,100,,,,,0,"fee schedule",EAPG,374.67,69,,,,,0,"fee schedule","69% of total billed charges",543,100,,434.40,,,0,"percent of total billed charges","100% of total billed charges",543,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",543,100,,434.40,,,0,"percent of total billed charges","100% of total billed charges",543,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",543,100,,434.40,,,0,"percent of total billed charges","100% of total billed charges",543,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",543,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6298.95,100,,,,,0,"fee schedule",EAPG,543,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",543,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",543,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6424.93,100,,,,,0,"fee schedule",EAPG,8188.64,100,,,,,0,"fee schedule",EAPG,543,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",204.71,37.7,,163.77,,,0,"percent of total billed charges","37.70% of total billed charges",543,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",543,100,,,,,0,"fee schedule","100% of CMS fee schedule",423.54,78,,338.83,,,0,"percent of total billed charges","78% of total billed charges",543,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",448.52,82.6,,358.82,,,0,"percent of total billed charges","82.6% of total billed charges",6298.95,100,,,,,0,"fee schedule",EAPG,543,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",448.52,82.6,,358.82,,,0,"percent of total billed charges","82.6% of total billed charges",543,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6459.48,100,,,,,0,"fee schedule",EAPG,543,100,,434.40,,,0,"percent of total billed charges","100% of total billed charges",83.08,8188.64,
"33991 Insertion of ventricular assist device, perc",7962097,CDM,521,RC,33991,CPT,OUTPATIENT,,,1893,1230.45,,1665.84,88,,1332.67,,,0,"percent of total billed charges","88% of total billed charges",1893,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",318.02,16.8,,254.42,,,0,"percent of total billed charges","16.8% of total billed charges",1893,100,,1514.40,,,0,"percent of total billed charges","100% of total billed charges",1893,175,,,,,0,"fee schedule","175% of CMS fee schedule",327.56,17.304,,262.05,,,0,"percent of total billed charges","17.304% of total billed charges",1893,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1192.59,63,,954.07,,,0,"percent of total billed charges","63% of total billed charges",289.63,15.3,,231.70,,,0,"percent of total billed charges","15.3% of total billed charges",318.02,16.8,,254.42,,,0,"percent of total billed charges","16.8% of total billed charges",1306.17,69,,,,,0,"fee schedule","69% of total billed charges",1893,100,,1514.40,,,0,"percent of total billed charges","100% of total billed charges",1893,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1893,100,,1514.40,,,0,"percent of total billed charges","100% of total billed charges",1893,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1893,100,,1514.40,,,0,"percent of total billed charges","100% of total billed charges",1893,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1893,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",318.02,16.8,,254.42,,,0,"percent of total billed charges","16.8% of total billed charges",1893,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1893,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1893,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",324.38,17.136,,259.50,,,0,"percent of total billed charges","17.136% of total billed charges",413.43,21.84,,330.74,,,0,"percent of total billed charges","21.84% of total billed charges",1893,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",713.66,37.7,,570.93,,,0,"percent of total billed charges","37.70% of total billed charges",1893,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1893,100,,,,,0,"fee schedule","100% of CMS fee schedule",1476.54,78,,1181.23,,,0,"percent of total billed charges","78% of total billed charges",1893,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1563.62,82.6,,1250.90,,,0,"percent of total billed charges","82.6% of total billed charges",318.02,16.8,,254.42,,,0,"percent of total billed charges","16.8% of total billed charges",1893,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1563.62,82.6,,1250.90,,,0,"percent of total billed charges","82.6% of total billed charges",1893,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",160.53,100,,,,,0,"case rate","pays based on per visit rate",1893,100,,1514.40,,,0,"percent of total billed charges","100% of total billed charges",160.53,1893,
"33992 Removal of percutaneous ventricular assist d",7962160,CDM,521,RC,33992,CPT,OUTPATIENT,,,618,401.7,,543.84,88,,435.07,,,0,"percent of total billed charges","88% of total billed charges",618,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6298.95,100,,,,,0,"fee schedule",EAPG,618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",618,175,,,,,0,"fee schedule","175% of CMS fee schedule",6487.92,100,,,,,0,"fee schedule",EAPG,618,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",389.34,63,,311.47,,,0,"percent of total billed charges","63% of total billed charges",94.55,15.3,,75.64,,,0,"percent of total billed charges","15.3% of total billed charges",6298.95,100,,,,,0,"fee schedule",EAPG,426.42,69,,,,,0,"fee schedule","69% of total billed charges",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",618,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",618,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",618,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",618,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6298.95,100,,,,,0,"fee schedule",EAPG,618,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",618,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",618,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6424.93,100,,,,,0,"fee schedule",EAPG,8188.64,100,,,,,0,"fee schedule",EAPG,618,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",232.99,37.7,,186.39,,,0,"percent of total billed charges","37.70% of total billed charges",618,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",618,100,,,,,0,"fee schedule","100% of CMS fee schedule",482.04,78,,385.63,,,0,"percent of total billed charges","78% of total billed charges",618,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",6298.95,100,,,,,0,"fee schedule",EAPG,618,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",510.47,82.6,,408.38,,,0,"percent of total billed charges","82.6% of total billed charges",618,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6459.48,100,,,,,0,"fee schedule",EAPG,618,100,,494.40,,,0,"percent of total billed charges","100% of total billed charges",94.55,8188.64,
"33990 Insertion of ventricular assist device, perc",7962560,CDM,521,RC,33990,CPT,OUTPATIENT,,,1300,845,,1144,88,,915.20,,,0,"percent of total billed charges","88% of total billed charges",1300,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",218.4,16.8,,174.72,,,0,"percent of total billed charges","16.8% of total billed charges",1300,100,,1040.00,,,0,"percent of total billed charges","100% of total billed charges",1300,175,,,,,0,"fee schedule","175% of CMS fee schedule",224.95,17.304,,179.96,,,0,"percent of total billed charges","17.304% of total billed charges",1300,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",819,63,,655.20,,,0,"percent of total billed charges","63% of total billed charges",198.9,15.3,,159.12,,,0,"percent of total billed charges","15.3% of total billed charges",218.4,16.8,,174.72,,,0,"percent of total billed charges","16.8% of total billed charges",897,69,,,,,0,"fee schedule","69% of total billed charges",1300,100,,1040.00,,,0,"percent of total billed charges","100% of total billed charges",1300,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1300,100,,1040.00,,,0,"percent of total billed charges","100% of total billed charges",1300,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1300,100,,1040.00,,,0,"percent of total billed charges","100% of total billed charges",1300,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1300,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",218.4,16.8,,174.72,,,0,"percent of total billed charges","16.8% of total billed charges",1300,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1300,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1300,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",222.77,17.136,,178.22,,,0,"percent of total billed charges","17.136% of total billed charges",283.92,21.84,,227.14,,,0,"percent of total billed charges","21.84% of total billed charges",1300,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",490.1,37.7,,392.08,,,0,"percent of total billed charges","37.70% of total billed charges",1300,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1300,100,,,,,0,"fee schedule","100% of CMS fee schedule",1014,78,,811.20,,,0,"percent of total billed charges","78% of total billed charges",1300,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1073.8,82.6,,859.04,,,0,"percent of total billed charges","82.6% of total billed charges",218.4,16.8,,174.72,,,0,"percent of total billed charges","16.8% of total billed charges",1300,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1073.8,82.6,,859.04,,,0,"percent of total billed charges","82.6% of total billed charges",1300,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",160.53,100,,,,,0,"case rate","pays based on per visit rate",1300,100,,1040.00,,,0,"percent of total billed charges","100% of total billed charges",160.53,1300,
"34101 Embolectomy/thrombectomy, w/ or w/o cath; ax",7961504,CDM,521,RC,34101,CPT,OUTPATIENT,,,1800,1170,,1584,88,,1267.20,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3301.11,100,,,,,0,"fee schedule",EAPG,1800,100,,1440.00,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3400.14,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1134,63,,907.20,,,0,"percent of total billed charges","63% of total billed charges",275.4,15.3,,220.32,,,0,"percent of total billed charges","15.3% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,1242,69,,,,,0,"fee schedule","69% of total billed charges",1800,100,,1440.00,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1800,100,,1440.00,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1800,100,,1440.00,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3301.11,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3367.13,100,,,,,0,"fee schedule",EAPG,4291.45,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",678.6,37.7,,542.88,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1404,78,,1123.20,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1486.8,82.6,,1189.44,,,0,"percent of total billed charges","82.6% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1486.8,82.6,,1189.44,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3461.64,100,,,,,0,"fee schedule",EAPG,1800,100,,1440.00,,,0,"percent of total billed charges","100% of total billed charges",275.4,19379.77,
"34111 Embolectomy or thrombectomy, w/ or w/o cath;",7962333,CDM,521,RC,34111,CPT,OUTPATIENT,,,1907,1239.55,,1678.16,88,,1342.53,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3301.11,100,,,,,0,"fee schedule",EAPG,1907,100,,1525.60,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3400.14,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1201.41,63,,961.13,,,0,"percent of total billed charges","63% of total billed charges",291.77,15.3,,233.42,,,0,"percent of total billed charges","15.3% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,1315.83,69,,,,,0,"fee schedule","69% of total billed charges",1907,100,,1525.60,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1907,100,,1525.60,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1907,100,,1525.60,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3301.11,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3367.13,100,,,,,0,"fee schedule",EAPG,4291.45,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",718.94,37.7,,575.15,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1487.46,78,,1189.97,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1575.18,82.6,,1260.14,,,0,"percent of total billed charges","82.6% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1575.18,82.6,,1260.14,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3461.64,100,,,,,0,"fee schedule",EAPG,1907,100,,1525.60,,,0,"percent of total billed charges","100% of total billed charges",291.77,19379.77,
"34151 Embolectomy or thrombectomy, with or without",7962133,CDM,521,RC,34151,CPT,OUTPATIENT,,,4349,2826.85,,3827.12,88,,3061.70,,,0,"percent of total billed charges","88% of total billed charges",4349,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4349,100,,3479.20,,,0,"percent of total billed charges","100% of total billed charges",4349,175,,,,,0,"fee schedule","175% of CMS fee schedule",10944.37,100,,,,,0,"fee schedule",EAPG,4349,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2739.87,63,,2191.90,,,0,"percent of total billed charges","63% of total billed charges",665.4,15.3,,532.32,,,0,"percent of total billed charges","15.3% of total billed charges",10625.6,100,,,,,0,"fee schedule",EAPG,3000.81,69,,,,,0,"fee schedule","69% of total billed charges",4349,100,,3479.20,,,0,"percent of total billed charges","100% of total billed charges",4349,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4349,100,,3479.20,,,0,"percent of total billed charges","100% of total billed charges",4349,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4349,100,,3479.20,,,0,"percent of total billed charges","100% of total billed charges",4349,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4349,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4349,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4349,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4349,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10838.11,100,,,,,0,"fee schedule",EAPG,13813.28,100,,,,,0,"fee schedule",EAPG,4349,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1639.57,37.7,,1311.66,,,0,"percent of total billed charges","37.70% of total billed charges",4349,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4349,100,,,,,0,"fee schedule","100% of CMS fee schedule",3392.22,78,,2713.78,,,0,"percent of total billed charges","78% of total billed charges",4349,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3592.27,82.6,,2873.82,,,0,"percent of total billed charges","82.6% of total billed charges",10625.6,100,,,,,0,"fee schedule","100% of WA fee schedule",4349,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3592.27,82.6,,2873.82,,,0,"percent of total billed charges","82.6% of total billed charges",4349,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10786.13,100,,,,,0,"fee schedule",EAPG,4349,100,,3479.20,,,0,"percent of total billed charges","100% of total billed charges",665.4,13813.28,
"34201 Embolectomy/thrombectomy, w/ or w/o cath; fe",7961604,CDM,521,RC,34201,CPT,OUTPATIENT,,,3058,1987.7,,2691.04,88,,2152.83,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3301.11,100,,,,,0,"fee schedule",EAPG,3058,100,,2446.40,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3400.14,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1926.54,63,,1541.23,,,0,"percent of total billed charges","63% of total billed charges",467.87,15.3,,374.30,,,0,"percent of total billed charges","15.3% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,2110.02,69,,,,,0,"fee schedule","69% of total billed charges",3058,100,,2446.40,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3058,100,,2446.40,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3058,100,,2446.40,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3301.11,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3367.13,100,,,,,0,"fee schedule",EAPG,4291.45,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1152.87,37.7,,922.30,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2385.24,78,,1908.19,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2525.91,82.6,,2020.73,,,0,"percent of total billed charges","82.6% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2525.91,82.6,,2020.73,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3461.64,100,,,,,0,"fee schedule",EAPG,3058,100,,2446.40,,,0,"percent of total billed charges","100% of total billed charges",467.87,19379.77,
"34203 Embolectomy/thrombectomy, w/ or w/o cath; po",7961821,CDM,521,RC,34203,CPT,OUTPATIENT,,,2840,1846,,2499.2,88,,1999.36,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3301.11,100,,,,,0,"fee schedule",EAPG,2840,100,,2272.00,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3400.14,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1789.2,63,,1431.36,,,0,"percent of total billed charges","63% of total billed charges",434.52,15.3,,347.62,,,0,"percent of total billed charges","15.3% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,1959.6,69,,,,,0,"fee schedule","69% of total billed charges",2840,100,,2272.00,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2840,100,,2272.00,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2840,100,,2272.00,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3301.11,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3367.13,100,,,,,0,"fee schedule",EAPG,4291.45,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1070.68,37.7,,856.54,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2215.2,78,,1772.16,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2345.84,82.6,,1876.67,,,0,"percent of total billed charges","82.6% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2345.84,82.6,,1876.67,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3461.64,100,,,,,0,"fee schedule",EAPG,2840,100,,2272.00,,,0,"percent of total billed charges","100% of total billed charges",434.52,19379.77,
"34421 Thrombectomy, direct or with catheter; vena",7961505,CDM,521,RC,34421,CPT,OUTPATIENT,,,2475,1608.75,,2178,88,,1742.40,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3301.11,100,,,,,0,"fee schedule",EAPG,2475,100,,1980.00,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",3400.14,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1559.25,63,,1247.40,,,0,"percent of total billed charges","63% of total billed charges",378.68,15.3,,302.94,,,0,"percent of total billed charges","15.3% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,1707.75,69,,,,,0,"fee schedule","69% of total billed charges",2475,100,,1980.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2475,100,,1980.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2475,100,,1980.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3301.11,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3367.13,100,,,,,0,"fee schedule",EAPG,4291.45,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",933.08,37.7,,746.46,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1930.5,78,,1544.40,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2044.35,82.6,,1635.48,,,0,"percent of total billed charges","82.6% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2044.35,82.6,,1635.48,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3461.64,100,,,,,0,"fee schedule",EAPG,2475,100,,1980.00,,,0,"percent of total billed charges","100% of total billed charges",378.68,11625.57,
"34471 Thrombectomy, direct or with catheter; subcl",7962695,CDM,521,RC,34471,CPT,OUTPATIENT,,,3079,2001.35,,2709.52,88,,2167.62,,,0,"percent of total billed charges","88% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3301.11,100,,,,,0,"fee schedule",EAPG,3079,100,,2463.20,,,0,"percent of total billed charges","100% of total billed charges",1121.3,175,,,,,0,"fee schedule","175% of CMS fee schedule",3400.14,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1939.77,63,,1551.82,,,0,"percent of total billed charges","63% of total billed charges",471.09,15.3,,376.87,,,0,"percent of total billed charges","15.3% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,2124.51,69,,,,,0,"fee schedule","69% of total billed charges",3079,100,,2463.20,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3079,100,,2463.20,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3079,100,,2463.20,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",2200.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3301.11,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",575.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3367.13,100,,,,,0,"fee schedule",EAPG,4291.45,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1160.78,37.7,,928.62,,,0,"percent of total billed charges","37.70% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2401.62,78,,1921.30,,,0,"percent of total billed charges","78% of total billed charges",647.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2543.25,82.6,,2034.60,,,0,"percent of total billed charges","82.6% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2543.25,82.6,,2034.60,,,0,"percent of total billed charges","82.6% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3461.64,100,,,,,0,"fee schedule",EAPG,3079,100,,2463.20,,,0,"percent of total billed charges","100% of total billed charges",471.09,4291.45,
"34802 Endovascular repair of infrarenal abdominal",7961687,CDM,521,RC,,,OUTPATIENT,,,3511,2282.15,,3089.68,88,,2471.74,,,0,"percent of total billed charges","88% of total billed charges",1755.5,50,,1404.40,,,0,"percent of total billed charges","50% of total billed charges",589.85,16.8,,471.88,,,0,"percent of total billed charges","16.8% of total billed charges",3511,100,,2808.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",607.54,17.304,,486.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2211.93,63,,1769.54,,,0,"percent of total billed charges","63% of total billed charges",537.18,15.3,,429.74,,,0,"percent of total billed charges","15.3% of total billed charges",589.85,16.8,,471.88,,,0,"percent of total billed charges","16.8% of total billed charges",2422.59,69,,,,,0,"fee schedule","69% of total billed charges",3511,100,,2808.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3511,100,,2808.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3511,100,,2808.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2171.55,61.85,,1737.24,,,0,"percent of total billed charges","61.5% of total billed charges",589.85,16.8,,471.88,,,0,"percent of total billed charges","16.8% of total billed charges",1755.5,50,,1404.40,,,0,"percent of total billed charges","50% of total billed charges",1130.54,32.2,,904.43,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",601.64,17.136,,481.31,,,0,"percent of total billed charges","17.136% of total billed charges",766.8,21.84,,613.44,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1323.65,37.7,,1058.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2738.58,78,,2190.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2900.09,82.6,,2320.07,,,0,"percent of total billed charges","82.6% of total billed charges",589.85,16.8,,471.88,,,0,"percent of total billed charges","16.8% of total billed charges",1755.5,50,,1404.40,,,0,"percent of total billed charges","50% of total billed charges",2900.09,82.6,,2320.07,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",3511,100,,2808.80,,,0,"percent of total billed charges","100% of total billed charges",160.53,3511,
"34803 Endovascular repair of infrarenal abdominal",7961990,CDM,521,RC,,,OUTPATIENT,,,4128,2683.2,,3632.64,88,,2906.11,,,0,"percent of total billed charges","88% of total billed charges",2064,50,,1651.20,,,0,"percent of total billed charges","50% of total billed charges",693.5,16.8,,554.80,,,0,"percent of total billed charges","16.8% of total billed charges",4128,100,,3302.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",714.31,17.304,,571.45,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2600.64,63,,2080.51,,,0,"percent of total billed charges","63% of total billed charges",631.58,15.3,,505.26,,,0,"percent of total billed charges","15.3% of total billed charges",693.5,16.8,,554.80,,,0,"percent of total billed charges","16.8% of total billed charges",2848.32,69,,,,,0,"fee schedule","69% of total billed charges",4128,100,,3302.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4128,100,,3302.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4128,100,,3302.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2553.17,61.85,,2042.54,,,0,"percent of total billed charges","61.5% of total billed charges",693.5,16.8,,554.80,,,0,"percent of total billed charges","16.8% of total billed charges",2064,50,,1651.20,,,0,"percent of total billed charges","50% of total billed charges",1329.22,32.2,,1063.38,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",707.37,17.136,,565.90,,,0,"percent of total billed charges","17.136% of total billed charges",901.56,21.84,,721.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1556.26,37.7,,1245.01,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3219.84,78,,2575.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3409.73,82.6,,2727.78,,,0,"percent of total billed charges","82.6% of total billed charges",693.5,16.8,,554.80,,,0,"percent of total billed charges","16.8% of total billed charges",2064,50,,1651.20,,,0,"percent of total billed charges","50% of total billed charges",3409.73,82.6,,2727.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",4128,100,,3302.40,,,0,"percent of total billed charges","100% of total billed charges",160.53,4128,
"34805 Endovascular repair of infrarenal abdominal",7962130,CDM,521,RC,,,OUTPATIENT,,,3230,2099.5,,2842.4,88,,2273.92,,,0,"percent of total billed charges","88% of total billed charges",1615,50,,1292.00,,,0,"percent of total billed charges","50% of total billed charges",542.64,16.8,,434.11,,,0,"percent of total billed charges","16.8% of total billed charges",3230,100,,2584.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",558.92,17.304,,447.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2034.9,63,,1627.92,,,0,"percent of total billed charges","63% of total billed charges",494.19,15.3,,395.35,,,0,"percent of total billed charges","15.3% of total billed charges",542.64,16.8,,434.11,,,0,"percent of total billed charges","16.8% of total billed charges",2228.7,69,,,,,0,"fee schedule","69% of total billed charges",3230,100,,2584.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3230,100,,2584.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3230,100,,2584.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1997.76,61.85,,1598.21,,,0,"percent of total billed charges","61.5% of total billed charges",542.64,16.8,,434.11,,,0,"percent of total billed charges","16.8% of total billed charges",1615,50,,1292.00,,,0,"percent of total billed charges","50% of total billed charges",1040.06,32.2,,832.05,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",553.49,17.136,,442.79,,,0,"percent of total billed charges","17.136% of total billed charges",705.43,21.84,,564.34,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1217.71,37.7,,974.17,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2519.4,78,,2015.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2667.98,82.6,,2134.38,,,0,"percent of total billed charges","82.6% of total billed charges",542.64,16.8,,434.11,,,0,"percent of total billed charges","16.8% of total billed charges",1615,50,,1292.00,,,0,"percent of total billed charges","50% of total billed charges",2667.98,82.6,,2134.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",3230,100,,2584.00,,,0,"percent of total billed charges","100% of total billed charges",160.53,3230,
"34800 Endovascular repair of infrarenal abdominal",7962414,CDM,521,RC,,,OUTPATIENT,,,3402,2211.3,,2993.76,88,,2395.01,,,0,"percent of total billed charges","88% of total billed charges",1701,50,,1360.80,,,0,"percent of total billed charges","50% of total billed charges",571.54,16.8,,457.23,,,0,"percent of total billed charges","16.8% of total billed charges",3402,100,,2721.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",588.68,17.304,,470.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2143.26,63,,1714.61,,,0,"percent of total billed charges","63% of total billed charges",520.51,15.3,,416.41,,,0,"percent of total billed charges","15.3% of total billed charges",571.54,16.8,,457.23,,,0,"percent of total billed charges","16.8% of total billed charges",2347.38,69,,,,,0,"fee schedule","69% of total billed charges",3402,100,,2721.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3402,100,,2721.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3402,100,,2721.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2104.14,61.85,,1683.31,,,0,"percent of total billed charges","61.5% of total billed charges",571.54,16.8,,457.23,,,0,"percent of total billed charges","16.8% of total billed charges",1701,50,,1360.80,,,0,"percent of total billed charges","50% of total billed charges",1095.44,32.2,,876.35,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",582.97,17.136,,466.38,,,0,"percent of total billed charges","17.136% of total billed charges",743,21.84,,594.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1282.55,37.7,,1026.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2653.56,78,,2122.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2810.05,82.6,,2248.04,,,0,"percent of total billed charges","82.6% of total billed charges",571.54,16.8,,457.23,,,0,"percent of total billed charges","16.8% of total billed charges",1701,50,,1360.80,,,0,"percent of total billed charges","50% of total billed charges",2810.05,82.6,,2248.04,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",3402,100,,2721.60,,,0,"percent of total billed charges","100% of total billed charges",160.53,3402,
"34808 Endovascular placement of iliac artery occlu",7963253,CDM,521,RC,34808,CPT,OUTPATIENT,,,651,423.15,,572.88,88,,458.30,,,0,"percent of total billed charges","88% of total billed charges",651,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",16110.1,100,,,,,0,"fee schedule",EAPG,651,100,,520.80,,,0,"percent of total billed charges","100% of total billed charges",651,175,,,,,0,"fee schedule","175% of CMS fee schedule",16593.41,100,,,,,0,"fee schedule",EAPG,651,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",410.13,63,,328.10,,,0,"percent of total billed charges","63% of total billed charges",99.6,15.3,,79.68,,,0,"percent of total billed charges","15.3% of total billed charges",16110.1,100,,,,,0,"fee schedule",EAPG,449.19,69,,,,,0,"fee schedule","69% of total billed charges",651,100,,520.80,,,0,"percent of total billed charges","100% of total billed charges",651,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",651,100,,520.80,,,0,"percent of total billed charges","100% of total billed charges",651,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",651,100,,520.80,,,0,"percent of total billed charges","100% of total billed charges",651,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",651,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",16110.1,100,,,,,0,"fee schedule",EAPG,651,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",651,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",651,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",16432.31,100,,,,,0,"fee schedule",EAPG,20943.14,100,,,,,0,"fee schedule",EAPG,651,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",245.43,37.7,,196.34,,,0,"percent of total billed charges","37.70% of total billed charges",651,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",651,100,,,,,0,"fee schedule","100% of CMS fee schedule",507.78,78,,406.22,,,0,"percent of total billed charges","78% of total billed charges",651,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",537.73,82.6,,430.18,,,0,"percent of total billed charges","82.6% of total billed charges",16110.1,100,,,,,0,"fee schedule","100% of WA fee schedule",651,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",537.73,82.6,,430.18,,,0,"percent of total billed charges","82.6% of total billed charges",651,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",16270.63,100,,,,,0,"fee schedule",EAPG,651,100,,520.80,,,0,"percent of total billed charges","100% of total billed charges",99.6,20943.14,
"34812 Open femoral artery exposure for delivery of",7961751,CDM,521,RC,34812,CPT,OUTPATIENT,,,965,627.25,,849.2,88,,679.36,,,0,"percent of total billed charges","88% of total billed charges",965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3301.11,100,,,,,0,"fee schedule",EAPG,965,100,,772.00,,,0,"percent of total billed charges","100% of total billed charges",965,175,,,,,0,"fee schedule","175% of CMS fee schedule",3400.14,100,,,,,0,"fee schedule",EAPG,965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",607.95,63,,486.36,,,0,"percent of total billed charges","63% of total billed charges",147.65,15.3,,118.12,,,0,"percent of total billed charges","15.3% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,665.85,69,,,,,0,"fee schedule","69% of total billed charges",965,100,,772.00,,,0,"percent of total billed charges","100% of total billed charges",965,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",965,100,,772.00,,,0,"percent of total billed charges","100% of total billed charges",965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",965,100,,772.00,,,0,"percent of total billed charges","100% of total billed charges",965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3301.11,100,,,,,0,"fee schedule",EAPG,965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3367.13,100,,,,,0,"fee schedule",EAPG,4291.45,100,,,,,0,"fee schedule",EAPG,965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",363.81,37.7,,291.05,,,0,"percent of total billed charges","37.70% of total billed charges",965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",965,100,,,,,0,"fee schedule","100% of CMS fee schedule",752.7,78,,602.16,,,0,"percent of total billed charges","78% of total billed charges",965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",797.09,82.6,,637.67,,,0,"percent of total billed charges","82.6% of total billed charges",3301.11,100,,,,,0,"fee schedule","100% of WA fee schedule",965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",797.09,82.6,,637.67,,,0,"percent of total billed charges","82.6% of total billed charges",965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3461.64,100,,,,,0,"fee schedule",EAPG,965,100,,772.00,,,0,"percent of total billed charges","100% of total billed charges",147.65,4291.45,
"34826 Placement of proximal or distal extension pr",7962601,CDM,521,RC,,,OUTPATIENT,,,602,391.3,,529.76,88,,423.81,,,0,"percent of total billed charges","88% of total billed charges",301,50,,240.80,,,0,"percent of total billed charges","50% of total billed charges",101.14,16.8,,80.91,,,0,"percent of total billed charges","16.8% of total billed charges",602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.17,17.304,,83.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.26,63,,303.41,,,0,"percent of total billed charges","63% of total billed charges",92.11,15.3,,73.69,,,0,"percent of total billed charges","15.3% of total billed charges",101.14,16.8,,80.91,,,0,"percent of total billed charges","16.8% of total billed charges",415.38,69,,,,,0,"fee schedule","69% of total billed charges",602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",372.34,61.85,,297.87,,,0,"percent of total billed charges","61.5% of total billed charges",101.14,16.8,,80.91,,,0,"percent of total billed charges","16.8% of total billed charges",301,50,,240.80,,,0,"percent of total billed charges","50% of total billed charges",193.84,32.2,,155.07,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",103.16,17.136,,82.53,,,0,"percent of total billed charges","17.136% of total billed charges",131.48,21.84,,105.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",226.95,37.7,,181.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",469.56,78,,375.65,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",497.25,82.6,,397.80,,,0,"percent of total billed charges","82.6% of total billed charges",101.14,16.8,,80.91,,,0,"percent of total billed charges","16.8% of total billed charges",301,50,,240.80,,,0,"percent of total billed charges","50% of total billed charges",497.25,82.6,,397.80,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",92.11,602,
"34825 Placement of proximal or distal extension pr",7962883,CDM,521,RC,,,OUTPATIENT,,,1650,1072.5,,1452,88,,1161.60,,,0,"percent of total billed charges","88% of total billed charges",825,50,,660.00,,,0,"percent of total billed charges","50% of total billed charges",277.2,16.8,,221.76,,,0,"percent of total billed charges","16.8% of total billed charges",1650,100,,1320.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",285.52,17.304,,228.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1039.5,63,,831.60,,,0,"percent of total billed charges","63% of total billed charges",252.45,15.3,,201.96,,,0,"percent of total billed charges","15.3% of total billed charges",277.2,16.8,,221.76,,,0,"percent of total billed charges","16.8% of total billed charges",1138.5,69,,,,,0,"fee schedule","69% of total billed charges",1650,100,,1320.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1650,100,,1320.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1650,100,,1320.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1020.53,61.85,,816.42,,,0,"percent of total billed charges","61.5% of total billed charges",277.2,16.8,,221.76,,,0,"percent of total billed charges","16.8% of total billed charges",825,50,,660.00,,,0,"percent of total billed charges","50% of total billed charges",531.3,32.2,,425.04,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",282.74,17.136,,226.19,,,0,"percent of total billed charges","17.136% of total billed charges",360.36,21.84,,288.29,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",622.05,37.7,,497.64,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1287,78,,1029.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1362.9,82.6,,1090.32,,,0,"percent of total billed charges","82.6% of total billed charges",277.2,16.8,,221.76,,,0,"percent of total billed charges","16.8% of total billed charges",825,50,,660.00,,,0,"percent of total billed charges","50% of total billed charges",1362.9,82.6,,1090.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",1650,100,,1320.00,,,0,"percent of total billed charges","100% of total billed charges",160.53,1650,
"34833 Open iliac artery exposure with creation of",7962103,CDM,521,RC,34833,CPT,OUTPATIENT,,,1868,1214.2,,1643.84,88,,1315.07,,,0,"percent of total billed charges","88% of total billed charges",1868,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1868,100,,1494.40,,,0,"percent of total billed charges","100% of total billed charges",1868,175,,,,,0,"fee schedule","175% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",1868,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1176.84,63,,941.47,,,0,"percent of total billed charges","63% of total billed charges",285.8,15.3,,228.64,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",1288.92,69,,,,,0,"fee schedule","69% of total billed charges",1868,100,,1494.40,,,0,"percent of total billed charges","100% of total billed charges",1868,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1868,100,,1494.40,,,0,"percent of total billed charges","100% of total billed charges",1868,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1868,100,,1494.40,,,0,"percent of total billed charges","100% of total billed charges",1868,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1868,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1868,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1868,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1868,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1868,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",704.24,37.7,,563.39,,,0,"percent of total billed charges","37.70% of total billed charges",1868,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1868,100,,,,,0,"fee schedule","100% of CMS fee schedule",1457.04,78,,1165.63,,,0,"percent of total billed charges","78% of total billed charges",1868,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1542.97,82.6,,1234.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1868,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1542.97,82.6,,1234.38,,,0,"percent of total billed charges","82.6% of total billed charges",1868,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",160.53,100,,,,,0,"case rate","pays based on per visit rate",1868,100,,1494.40,,,0,"percent of total billed charges","100% of total billed charges",160.53,1868,
"34900 Endovascular repair of iliac artery using il",7962744,CDM,521,RC,,,OUTPATIENT,,,3027,1967.55,,2663.76,88,,2131.01,,,0,"percent of total billed charges","88% of total billed charges",1513.5,50,,1210.80,,,0,"percent of total billed charges","50% of total billed charges",508.54,16.8,,406.83,,,0,"percent of total billed charges","16.8% of total billed charges",3027,100,,2421.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",523.79,17.304,,419.03,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1907.01,63,,1525.61,,,0,"percent of total billed charges","63% of total billed charges",463.13,15.3,,370.50,,,0,"percent of total billed charges","15.3% of total billed charges",508.54,16.8,,406.83,,,0,"percent of total billed charges","16.8% of total billed charges",2088.63,69,,,,,0,"fee schedule","69% of total billed charges",3027,100,,2421.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3027,100,,2421.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3027,100,,2421.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1872.2,61.85,,1497.76,,,0,"percent of total billed charges","61.5% of total billed charges",508.54,16.8,,406.83,,,0,"percent of total billed charges","16.8% of total billed charges",1513.5,50,,1210.80,,,0,"percent of total billed charges","50% of total billed charges",974.69,32.2,,779.75,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",518.71,17.136,,414.97,,,0,"percent of total billed charges","17.136% of total billed charges",661.1,21.84,,528.88,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1141.18,37.7,,912.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2361.06,78,,1888.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2500.3,82.6,,2000.24,,,0,"percent of total billed charges","82.6% of total billed charges",508.54,16.8,,406.83,,,0,"percent of total billed charges","16.8% of total billed charges",1513.5,50,,1210.80,,,0,"percent of total billed charges","50% of total billed charges",2500.3,82.6,,2000.24,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",3027,100,,2421.60,,,0,"percent of total billed charges","100% of total billed charges",160.53,3027,
"35011 Direct repair of aneurysm, pseudoaneurysm, o",7961752,CDM,521,RC,35011,CPT,OUTPATIENT,,,2633,1711.45,,2317.04,88,,1853.63,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3301.11,100,,,,,0,"fee schedule",EAPG,2633,100,,2106.40,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3400.14,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1658.79,63,,1327.03,,,0,"percent of total billed charges","63% of total billed charges",402.85,15.3,,322.28,,,0,"percent of total billed charges","15.3% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,1816.77,69,,,,,0,"fee schedule","69% of total billed charges",2633,100,,2106.40,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2633,100,,2106.40,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2633,100,,2106.40,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3301.11,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3367.13,100,,,,,0,"fee schedule",EAPG,4291.45,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",992.64,37.7,,794.11,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2053.74,78,,1642.99,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2174.86,82.6,,1739.89,,,0,"percent of total billed charges","82.6% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2174.86,82.6,,1739.89,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3461.64,100,,,,,0,"fee schedule",EAPG,2633,100,,2106.40,,,0,"percent of total billed charges","100% of total billed charges",402.85,19379.77,
"35045 Direct repair of aneurysm, pseudoaneurysm, o",7961688,CDM,521,RC,35045,CPT,OUTPATIENT,,,2908,1890.2,,2559.04,88,,2047.23,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3301.11,100,,,,,0,"fee schedule",EAPG,2908,100,,2326.40,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3400.14,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1832.04,63,,1465.63,,,0,"percent of total billed charges","63% of total billed charges",444.92,15.3,,355.94,,,0,"percent of total billed charges","15.3% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,2006.52,69,,,,,0,"fee schedule","69% of total billed charges",2908,100,,2326.40,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2908,100,,2326.40,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2908,100,,2326.40,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3301.11,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3367.13,100,,,,,0,"fee schedule",EAPG,4291.45,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1096.32,37.7,,877.06,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2268.24,78,,1814.59,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2402.01,82.6,,1921.61,,,0,"percent of total billed charges","82.6% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2402.01,82.6,,1921.61,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3461.64,100,,,,,0,"fee schedule",EAPG,2908,100,,2326.40,,,0,"percent of total billed charges","100% of total billed charges",444.92,19379.77,
"35081 Direct repair of aneurysm, pseudoaneurysm, o",7961753,CDM,521,RC,35081,CPT,OUTPATIENT,,,4968,3229.2,,4371.84,88,,3497.47,,,0,"percent of total billed charges","88% of total billed charges",4968,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",4968,175,,,,,0,"fee schedule","175% of CMS fee schedule",10944.37,100,,,,,0,"fee schedule",EAPG,4968,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3129.84,63,,2503.87,,,0,"percent of total billed charges","63% of total billed charges",760.1,15.3,,608.08,,,0,"percent of total billed charges","15.3% of total billed charges",10625.6,100,,,,,0,"fee schedule",EAPG,3427.92,69,,,,,0,"fee schedule","69% of total billed charges",4968,100,,3974.40,,,0,"percent of total billed charges","100% of total billed charges",4968,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4968,100,,3974.40,,,0,"percent of total billed charges","100% of total billed charges",4968,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4968,100,,3974.40,,,0,"percent of total billed charges","100% of total billed charges",4968,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4968,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4968,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4968,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4968,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10838.11,100,,,,,0,"fee schedule",EAPG,13813.28,100,,,,,0,"fee schedule",EAPG,4968,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1872.94,37.7,,1498.35,,,0,"percent of total billed charges","37.70% of total billed charges",4968,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4968,100,,,,,0,"fee schedule","100% of CMS fee schedule",3875.04,78,,3100.03,,,0,"percent of total billed charges","78% of total billed charges",4968,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4103.57,82.6,,3282.86,,,0,"percent of total billed charges","82.6% of total billed charges",10625.6,100,,,,,0,"fee schedule","100% of WA fee schedule",4968,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4103.57,82.6,,3282.86,,,0,"percent of total billed charges","82.6% of total billed charges",4968,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10786.13,100,,,,,0,"fee schedule",EAPG,4968,100,,3974.40,,,0,"percent of total billed charges","100% of total billed charges",760.1,13813.28,
"35082 Direct repair of ruptured aneurysm, pseudo,",7962183,CDM,521,RC,35082,CPT,OUTPATIENT,,,5795,3766.75,,5099.6,88,,4079.68,,,0,"percent of total billed charges","88% of total billed charges",5795,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5795,175,,,,,0,"fee schedule","175% of CMS fee schedule",10944.37,100,,,,,0,"fee schedule",EAPG,5795,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3650.85,63,,2920.68,,,0,"percent of total billed charges","63% of total billed charges",886.64,15.3,,709.31,,,0,"percent of total billed charges","15.3% of total billed charges",10625.6,100,,,,,0,"fee schedule",EAPG,3998.55,69,,,,,0,"fee schedule","69% of total billed charges",5795,100,,4636.00,,,0,"percent of total billed charges","100% of total billed charges",5795,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5795,100,,4636.00,,,0,"percent of total billed charges","100% of total billed charges",5795,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5795,100,,4636.00,,,0,"percent of total billed charges","100% of total billed charges",5795,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5795,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,5795,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5795,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5795,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10838.11,100,,,,,0,"fee schedule",EAPG,13813.28,100,,,,,0,"fee schedule",EAPG,5795,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2184.72,37.7,,1747.78,,,0,"percent of total billed charges","37.70% of total billed charges",5795,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5795,100,,,,,0,"fee schedule","100% of CMS fee schedule",4520.1,78,,3616.08,,,0,"percent of total billed charges","78% of total billed charges",5795,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4786.67,82.6,,3829.34,,,0,"percent of total billed charges","82.6% of total billed charges",10625.6,100,,,,,0,"fee schedule","100% of WA fee schedule",5795,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4786.67,82.6,,3829.34,,,0,"percent of total billed charges","82.6% of total billed charges",5795,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10786.13,100,,,,,0,"fee schedule",EAPG,5795,100,,4636.00,,,0,"percent of total billed charges","100% of total billed charges",886.64,13813.28,
"35102 Direct repair of aneurysm, pseudo, or excisi",7961506,CDM,521,RC,35102,CPT,OUTPATIENT,,,5668,3684.2,,4987.84,88,,3990.27,,,0,"percent of total billed charges","88% of total billed charges",5668,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5668,175,,,,,0,"fee schedule","175% of CMS fee schedule",10944.37,100,,,,,0,"fee schedule",EAPG,5668,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3570.84,63,,2856.67,,,0,"percent of total billed charges","63% of total billed charges",867.2,15.3,,693.76,,,0,"percent of total billed charges","15.3% of total billed charges",10625.6,100,,,,,0,"fee schedule",EAPG,3910.92,69,,,,,0,"fee schedule","69% of total billed charges",5668,100,,4534.40,,,0,"percent of total billed charges","100% of total billed charges",5668,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5668,100,,4534.40,,,0,"percent of total billed charges","100% of total billed charges",5668,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5668,100,,4534.40,,,0,"percent of total billed charges","100% of total billed charges",5668,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5668,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,5668,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5668,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5668,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10838.11,100,,,,,0,"fee schedule",EAPG,13813.28,100,,,,,0,"fee schedule",EAPG,5668,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2136.84,37.7,,1709.47,,,0,"percent of total billed charges","37.70% of total billed charges",5668,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5668,100,,,,,0,"fee schedule","100% of CMS fee schedule",4421.04,78,,3536.83,,,0,"percent of total billed charges","78% of total billed charges",5668,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4681.77,82.6,,3745.42,,,0,"percent of total billed charges","82.6% of total billed charges",10625.6,100,,,,,0,"fee schedule","100% of WA fee schedule",5668,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4681.77,82.6,,3745.42,,,0,"percent of total billed charges","82.6% of total billed charges",5668,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10786.13,100,,,,,0,"fee schedule",EAPG,5668,100,,4534.40,,,0,"percent of total billed charges","100% of total billed charges",867.2,13813.28,
"35103 Direct repair of ruptured aneurysm; abdomina",7962904,CDM,521,RC,35103,CPT,OUTPATIENT,,,6078,3950.7,,5348.64,88,,4278.91,,,0,"percent of total billed charges","88% of total billed charges",6078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6078,175,,,,,0,"fee schedule","175% of CMS fee schedule",10944.37,100,,,,,0,"fee schedule",EAPG,6078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3829.14,63,,3063.31,,,0,"percent of total billed charges","63% of total billed charges",929.93,15.3,,743.94,,,0,"percent of total billed charges","15.3% of total billed charges",10625.6,100,,,,,0,"fee schedule",EAPG,4193.82,69,,,,,0,"fee schedule","69% of total billed charges",6078,100,,4862.40,,,0,"percent of total billed charges","100% of total billed charges",6078,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6078,100,,4862.40,,,0,"percent of total billed charges","100% of total billed charges",6078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6078,100,,4862.40,,,0,"percent of total billed charges","100% of total billed charges",6078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,6078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10838.11,100,,,,,0,"fee schedule",EAPG,13813.28,100,,,,,0,"fee schedule",EAPG,6078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2291.41,37.7,,1833.13,,,0,"percent of total billed charges","37.70% of total billed charges",6078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6078,100,,,,,0,"fee schedule","100% of CMS fee schedule",4740.84,78,,3792.67,,,0,"percent of total billed charges","78% of total billed charges",6078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5020.43,82.6,,4016.34,,,0,"percent of total billed charges","82.6% of total billed charges",10625.6,100,,,,,0,"fee schedule","100% of WA fee schedule",6078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5020.43,82.6,,4016.34,,,0,"percent of total billed charges","82.6% of total billed charges",6078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10786.13,100,,,,,0,"fee schedule",EAPG,6078,100,,4862.40,,,0,"percent of total billed charges","100% of total billed charges",929.93,13813.28,
"35121 Direct repair of aneurysm; hepatic/celiac/re",7962966,CDM,521,RC,35121,CPT,OUTPATIENT,,,5367,3488.55,,4722.96,88,,3778.37,,,0,"percent of total billed charges","88% of total billed charges",5367,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5367,175,,,,,0,"fee schedule","175% of CMS fee schedule",10944.37,100,,,,,0,"fee schedule",EAPG,5367,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3381.21,63,,2704.97,,,0,"percent of total billed charges","63% of total billed charges",821.15,15.3,,656.92,,,0,"percent of total billed charges","15.3% of total billed charges",10625.6,100,,,,,0,"fee schedule",EAPG,3703.23,69,,,,,0,"fee schedule","69% of total billed charges",5367,100,,4293.60,,,0,"percent of total billed charges","100% of total billed charges",5367,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5367,100,,4293.60,,,0,"percent of total billed charges","100% of total billed charges",5367,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5367,100,,4293.60,,,0,"percent of total billed charges","100% of total billed charges",5367,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5367,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,5367,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5367,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5367,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10838.11,100,,,,,0,"fee schedule",EAPG,13813.28,100,,,,,0,"fee schedule",EAPG,5367,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2023.36,37.7,,1618.69,,,0,"percent of total billed charges","37.70% of total billed charges",5367,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5367,100,,,,,0,"fee schedule","100% of CMS fee schedule",4186.26,78,,3349.01,,,0,"percent of total billed charges","78% of total billed charges",5367,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4433.14,82.6,,3546.51,,,0,"percent of total billed charges","82.6% of total billed charges",10625.6,100,,,,,0,"fee schedule","100% of WA fee schedule",5367,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4433.14,82.6,,3546.51,,,0,"percent of total billed charges","82.6% of total billed charges",5367,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10786.13,100,,,,,0,"fee schedule",EAPG,5367,100,,4293.60,,,0,"percent of total billed charges","100% of total billed charges",821.15,13813.28,
"35131 Direct repair of aneurysm, pseudoaneurysm, o",7962297,CDM,521,RC,35131,CPT,OUTPATIENT,,,4054,2635.1,,3567.52,88,,2854.02,,,0,"percent of total billed charges","88% of total billed charges",4054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4054,100,,3243.20,,,0,"percent of total billed charges","100% of total billed charges",4054,175,,,,,0,"fee schedule","175% of CMS fee schedule",10944.37,100,,,,,0,"fee schedule",EAPG,4054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2554.02,63,,2043.22,,,0,"percent of total billed charges","63% of total billed charges",620.26,15.3,,496.21,,,0,"percent of total billed charges","15.3% of total billed charges",10625.6,100,,,,,0,"fee schedule",EAPG,2797.26,69,,,,,0,"fee schedule","69% of total billed charges",4054,100,,3243.20,,,0,"percent of total billed charges","100% of total billed charges",4054,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4054,100,,3243.20,,,0,"percent of total billed charges","100% of total billed charges",4054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4054,100,,3243.20,,,0,"percent of total billed charges","100% of total billed charges",4054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10838.11,100,,,,,0,"fee schedule",EAPG,13813.28,100,,,,,0,"fee schedule",EAPG,4054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1528.36,37.7,,1222.69,,,0,"percent of total billed charges","37.70% of total billed charges",4054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4054,100,,,,,0,"fee schedule","100% of CMS fee schedule",3162.12,78,,2529.70,,,0,"percent of total billed charges","78% of total billed charges",4054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3348.6,82.6,,2678.88,,,0,"percent of total billed charges","82.6% of total billed charges",10625.6,100,,,,,0,"fee schedule","100% of WA fee schedule",4054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3348.6,82.6,,2678.88,,,0,"percent of total billed charges","82.6% of total billed charges",4054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10786.13,100,,,,,0,"fee schedule",EAPG,4054,100,,3243.20,,,0,"percent of total billed charges","100% of total billed charges",620.26,13813.28,
"35141 Direct repair of aneurysm, pseudoaneurysm, o",7961507,CDM,521,RC,35141,CPT,OUTPATIENT,,,1414,919.1,,1244.32,88,,995.46,,,0,"percent of total billed charges","88% of total billed charges",1414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3301.11,100,,,,,0,"fee schedule",EAPG,1414,100,,1131.20,,,0,"percent of total billed charges","100% of total billed charges",1414,175,,,,,0,"fee schedule","175% of CMS fee schedule",3400.14,100,,,,,0,"fee schedule",EAPG,1414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",890.82,63,,712.66,,,0,"percent of total billed charges","63% of total billed charges",216.34,15.3,,173.07,,,0,"percent of total billed charges","15.3% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,975.66,69,,,,,0,"fee schedule","69% of total billed charges",1414,100,,1131.20,,,0,"percent of total billed charges","100% of total billed charges",1414,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1414,100,,1131.20,,,0,"percent of total billed charges","100% of total billed charges",1414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1414,100,,1131.20,,,0,"percent of total billed charges","100% of total billed charges",1414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3301.11,100,,,,,0,"fee schedule",EAPG,1414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3367.13,100,,,,,0,"fee schedule",EAPG,4291.45,100,,,,,0,"fee schedule",EAPG,1414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",533.08,37.7,,426.46,,,0,"percent of total billed charges","37.70% of total billed charges",1414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1414,100,,,,,0,"fee schedule","100% of CMS fee schedule",1102.92,78,,882.34,,,0,"percent of total billed charges","78% of total billed charges",1414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1167.96,82.6,,934.37,,,0,"percent of total billed charges","82.6% of total billed charges",3301.11,100,,,,,0,"fee schedule","100% of WA fee schedule",1414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1167.96,82.6,,934.37,,,0,"percent of total billed charges","82.6% of total billed charges",1414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3461.64,100,,,,,0,"fee schedule",EAPG,1414,100,,1131.20,,,0,"percent of total billed charges","100% of total billed charges",216.34,4291.45,
"35151 Direct repair of aneurysm, pseudoaneurysm, o",7961872,CDM,521,RC,35151,CPT,OUTPATIENT,,,3472,2256.8,,3055.36,88,,2444.29,,,0,"percent of total billed charges","88% of total billed charges",3472,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3301.11,100,,,,,0,"fee schedule",EAPG,3472,100,,2777.60,,,0,"percent of total billed charges","100% of total billed charges",3472,175,,,,,0,"fee schedule","175% of CMS fee schedule",3400.14,100,,,,,0,"fee schedule",EAPG,3472,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2187.36,63,,1749.89,,,0,"percent of total billed charges","63% of total billed charges",531.22,15.3,,424.98,,,0,"percent of total billed charges","15.3% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,2395.68,69,,,,,0,"fee schedule","69% of total billed charges",3472,100,,2777.60,,,0,"percent of total billed charges","100% of total billed charges",3472,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3472,100,,2777.60,,,0,"percent of total billed charges","100% of total billed charges",3472,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3472,100,,2777.60,,,0,"percent of total billed charges","100% of total billed charges",3472,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3472,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3301.11,100,,,,,0,"fee schedule",EAPG,3472,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3472,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3472,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3367.13,100,,,,,0,"fee schedule",EAPG,4291.45,100,,,,,0,"fee schedule",EAPG,3472,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1308.94,37.7,,1047.15,,,0,"percent of total billed charges","37.70% of total billed charges",3472,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3472,100,,,,,0,"fee schedule","100% of CMS fee schedule",2708.16,78,,2166.53,,,0,"percent of total billed charges","78% of total billed charges",3472,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2867.87,82.6,,2294.30,,,0,"percent of total billed charges","82.6% of total billed charges",3301.11,100,,,,,0,"fee schedule","100% of WA fee schedule",3472,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2867.87,82.6,,2294.30,,,0,"percent of total billed charges","82.6% of total billed charges",3472,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3461.64,100,,,,,0,"fee schedule",EAPG,3472,100,,2777.60,,,0,"percent of total billed charges","100% of total billed charges",531.22,4291.45,
"35190 Repair, acquired or traumatic arteriovenous",7962998,CDM,521,RC,35190,CPT,OUTPATIENT,,,2745,1784.25,,2415.6,88,,1932.48,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.89,100,,,,,0,"fee schedule",EAPG,2745,100,,2196.00,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",2014.57,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1729.35,63,,1383.48,,,0,"percent of total billed charges","63% of total billed charges",419.99,15.3,,335.99,,,0,"percent of total billed charges","15.3% of total billed charges",1955.89,100,,,,,0,"fee schedule",EAPG,1894.05,69,,,,,0,"fee schedule","69% of total billed charges",2745,100,,2196.00,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2745,100,,2196.00,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2745,100,,2196.00,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.89,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1995.01,100,,,,,0,"fee schedule",EAPG,2542.66,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1034.87,37.7,,827.90,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2141.1,78,,1712.88,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2267.37,82.6,,1813.90,,,0,"percent of total billed charges","82.6% of total billed charges",1955.89,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2267.37,82.6,,1813.90,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2116.42,100,,,,,0,"fee schedule",EAPG,2745,100,,2196.00,,,0,"percent of total billed charges","100% of total billed charges",419.99,19379.77,
"35206 Repair blood vessel, direct; upper extremity",7963506,CDM,521,RC,35206,CPT,OUTPATIENT,,,3587,2331.55,,3156.56,88,,2525.25,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.89,100,,,,,0,"fee schedule",EAPG,3587,100,,2869.60,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",2014.57,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2259.81,63,,1807.85,,,0,"percent of total billed charges","63% of total billed charges",548.81,15.3,,439.05,,,0,"percent of total billed charges","15.3% of total billed charges",1955.89,100,,,,,0,"fee schedule",EAPG,2475.03,69,,,,,0,"fee schedule","69% of total billed charges",3587,100,,2869.60,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3587,100,,2869.60,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3587,100,,2869.60,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.89,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1995.01,100,,,,,0,"fee schedule",EAPG,2542.66,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1352.3,37.7,,1081.84,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2797.86,78,,2238.29,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2962.86,82.6,,2370.29,,,0,"percent of total billed charges","82.6% of total billed charges",1955.89,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2962.86,82.6,,2370.29,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2116.42,100,,,,,0,"fee schedule",EAPG,3587,100,,2869.60,,,0,"percent of total billed charges","100% of total billed charges",548.81,11625.57,
"35201 Repair blood vessel, direct; neck",7963707,CDM,521,RC,35201,CPT,OUTPATIENT,,,2747,1785.55,,2417.36,88,,1933.89,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.89,100,,,,,0,"fee schedule",EAPG,2747,100,,2197.60,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",2014.57,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1730.61,63,,1384.49,,,0,"percent of total billed charges","63% of total billed charges",420.29,15.3,,336.23,,,0,"percent of total billed charges","15.3% of total billed charges",1955.89,100,,,,,0,"fee schedule",EAPG,1895.43,69,,,,,0,"fee schedule","69% of total billed charges",2747,100,,2197.60,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2747,100,,2197.60,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2747,100,,2197.60,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.89,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1995.01,100,,,,,0,"fee schedule",EAPG,2542.66,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1035.62,37.7,,828.50,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2142.66,78,,1714.13,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2269.02,82.6,,1815.22,,,0,"percent of total billed charges","82.6% of total billed charges",1955.89,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2269.02,82.6,,1815.22,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2116.42,100,,,,,0,"fee schedule",EAPG,2747,100,,2197.60,,,0,"percent of total billed charges","100% of total billed charges",420.29,19379.77,
"35221 Repair blood vessel, direct; intra-abdominal",7963507,CDM,521,RC,35221,CPT,OUTPATIENT,,,4252,2763.8,,3741.76,88,,2993.41,,,0,"percent of total billed charges","88% of total billed charges",4252,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4252,100,,3401.60,,,0,"percent of total billed charges","100% of total billed charges",4252,175,,,,,0,"fee schedule","175% of CMS fee schedule",10944.37,100,,,,,0,"fee schedule",EAPG,4252,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2678.76,63,,2143.01,,,0,"percent of total billed charges","63% of total billed charges",650.56,15.3,,520.45,,,0,"percent of total billed charges","15.3% of total billed charges",10625.6,100,,,,,0,"fee schedule",EAPG,2933.88,69,,,,,0,"fee schedule","69% of total billed charges",4252,100,,3401.60,,,0,"percent of total billed charges","100% of total billed charges",4252,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4252,100,,3401.60,,,0,"percent of total billed charges","100% of total billed charges",4252,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4252,100,,3401.60,,,0,"percent of total billed charges","100% of total billed charges",4252,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4252,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4252,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4252,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4252,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10838.11,100,,,,,0,"fee schedule",EAPG,13813.28,100,,,,,0,"fee schedule",EAPG,4252,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1603,37.7,,1282.40,,,0,"percent of total billed charges","37.70% of total billed charges",4252,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4252,100,,,,,0,"fee schedule","100% of CMS fee schedule",3316.56,78,,2653.25,,,0,"percent of total billed charges","78% of total billed charges",4252,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3512.15,82.6,,2809.72,,,0,"percent of total billed charges","82.6% of total billed charges",10625.6,100,,,,,0,"fee schedule","100% of WA fee schedule",4252,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3512.15,82.6,,2809.72,,,0,"percent of total billed charges","82.6% of total billed charges",4252,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10786.13,100,,,,,0,"fee schedule",EAPG,4252,100,,3401.60,,,0,"percent of total billed charges","100% of total billed charges",650.56,13813.28,
"35226 Repair blood vessel, direct; lower extremity",7963508,CDM,521,RC,35226,CPT,OUTPATIENT,,,2471,1606.15,,2174.48,88,,1739.58,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.89,100,,,,,0,"fee schedule",EAPG,2471,100,,1976.80,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",2014.57,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1556.73,63,,1245.38,,,0,"percent of total billed charges","63% of total billed charges",378.06,15.3,,302.45,,,0,"percent of total billed charges","15.3% of total billed charges",1955.89,100,,,,,0,"fee schedule",EAPG,1704.99,69,,,,,0,"fee schedule","69% of total billed charges",2471,100,,1976.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2471,100,,1976.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2471,100,,1976.80,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.89,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1995.01,100,,,,,0,"fee schedule",EAPG,2542.66,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",931.57,37.7,,745.26,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1927.38,78,,1541.90,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2041.05,82.6,,1632.84,,,0,"percent of total billed charges","82.6% of total billed charges",1955.89,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2041.05,82.6,,1632.84,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2116.42,100,,,,,0,"fee schedule",EAPG,2471,100,,1976.80,,,0,"percent of total billed charges","100% of total billed charges",378.06,2542.66,
"35236 Repair blood vessel with vein graft; upper e",7963329,CDM,521,RC,35236,CPT,OUTPATIENT,,,3105,2018.25,,2732.4,88,,2185.92,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.89,100,,,,,0,"fee schedule",EAPG,3105,100,,2484.00,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",2014.57,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1956.15,63,,1564.92,,,0,"percent of total billed charges","63% of total billed charges",475.07,15.3,,380.06,,,0,"percent of total billed charges","15.3% of total billed charges",1955.89,100,,,,,0,"fee schedule",EAPG,2142.45,69,,,,,0,"fee schedule","69% of total billed charges",3105,100,,2484.00,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3105,100,,2484.00,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3105,100,,2484.00,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.89,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1995.01,100,,,,,0,"fee schedule",EAPG,2542.66,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1170.59,37.7,,936.47,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2421.9,78,,1937.52,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2564.73,82.6,,2051.78,,,0,"percent of total billed charges","82.6% of total billed charges",1955.89,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2564.73,82.6,,2051.78,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2116.42,100,,,,,0,"fee schedule",EAPG,3105,100,,2484.00,,,0,"percent of total billed charges","100% of total billed charges",475.07,19379.77,
"35231 Repair blood vessel with vein graft; neck",7963570,CDM,521,RC,35231,CPT,OUTPATIENT,,,3555,2310.75,,3128.4,88,,2502.72,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.89,100,,,,,0,"fee schedule",EAPG,3555,100,,2844.00,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",2014.57,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2239.65,63,,1791.72,,,0,"percent of total billed charges","63% of total billed charges",543.92,15.3,,435.14,,,0,"percent of total billed charges","15.3% of total billed charges",1955.89,100,,,,,0,"fee schedule",EAPG,2452.95,69,,,,,0,"fee schedule","69% of total billed charges",3555,100,,2844.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3555,100,,2844.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3555,100,,2844.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.89,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1995.01,100,,,,,0,"fee schedule",EAPG,2542.66,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1340.24,37.7,,1072.19,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2772.9,78,,2218.32,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2936.43,82.6,,2349.14,,,0,"percent of total billed charges","82.6% of total billed charges",1955.89,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2936.43,82.6,,2349.14,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2116.42,100,,,,,0,"fee schedule",EAPG,3555,100,,2844.00,,,0,"percent of total billed charges","100% of total billed charges",543.92,11625.57,
"35241 Repair blood vessel with vein graft; intrath",7963037,CDM,521,RC,35241,CPT,OUTPATIENT,,,4198,2728.7,,3694.24,88,,2955.39,,,0,"percent of total billed charges","88% of total billed charges",4198,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4198,100,,3358.40,,,0,"percent of total billed charges","100% of total billed charges",4198,175,,,,,0,"fee schedule","175% of CMS fee schedule",10944.37,100,,,,,0,"fee schedule",EAPG,4198,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2644.74,63,,2115.79,,,0,"percent of total billed charges","63% of total billed charges",642.29,15.3,,513.83,,,0,"percent of total billed charges","15.3% of total billed charges",10625.6,100,,,,,0,"fee schedule",EAPG,2896.62,69,,,,,0,"fee schedule","69% of total billed charges",4198,100,,3358.40,,,0,"percent of total billed charges","100% of total billed charges",4198,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4198,100,,3358.40,,,0,"percent of total billed charges","100% of total billed charges",4198,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4198,100,,3358.40,,,0,"percent of total billed charges","100% of total billed charges",4198,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4198,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4198,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4198,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4198,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10838.11,100,,,,,0,"fee schedule",EAPG,13813.28,100,,,,,0,"fee schedule",EAPG,4198,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1582.65,37.7,,1266.12,,,0,"percent of total billed charges","37.70% of total billed charges",4198,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4198,100,,,,,0,"fee schedule","100% of CMS fee schedule",3274.44,78,,2619.55,,,0,"percent of total billed charges","78% of total billed charges",4198,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3467.55,82.6,,2774.04,,,0,"percent of total billed charges","82.6% of total billed charges",10625.6,100,,,,,0,"fee schedule","100% of WA fee schedule",4198,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3467.55,82.6,,2774.04,,,0,"percent of total billed charges","82.6% of total billed charges",4198,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10786.13,100,,,,,0,"fee schedule",EAPG,4198,100,,3358.40,,,0,"percent of total billed charges","100% of total billed charges",642.29,13813.28,
"35256 Repair blood vessel with vein graft; lower e",7963330,CDM,521,RC,35256,CPT,OUTPATIENT,,,3144,2043.6,,2766.72,88,,2213.38,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3301.11,100,,,,,0,"fee schedule",EAPG,3144,100,,2515.20,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3400.14,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1980.72,63,,1584.58,,,0,"percent of total billed charges","63% of total billed charges",481.03,15.3,,384.82,,,0,"percent of total billed charges","15.3% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,2169.36,69,,,,,0,"fee schedule","69% of total billed charges",3144,100,,2515.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3144,100,,2515.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3144,100,,2515.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3301.11,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3367.13,100,,,,,0,"fee schedule",EAPG,4291.45,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1185.29,37.7,,948.23,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2452.32,78,,1961.86,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2596.94,82.6,,2077.55,,,0,"percent of total billed charges","82.6% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2596.94,82.6,,2077.55,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3461.64,100,,,,,0,"fee schedule",EAPG,3144,100,,2515.20,,,0,"percent of total billed charges","100% of total billed charges",481.03,19379.77,
"35266 Repair blood vessel with graft other than ve",7962985,CDM,521,RC,35266,CPT,OUTPATIENT,,,2804,1822.6,,2467.52,88,,1974.02,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.89,100,,,,,0,"fee schedule",EAPG,2804,100,,2243.20,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",2014.57,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1766.52,63,,1413.22,,,0,"percent of total billed charges","63% of total billed charges",429.01,15.3,,343.21,,,0,"percent of total billed charges","15.3% of total billed charges",1955.89,100,,,,,0,"fee schedule",EAPG,1934.76,69,,,,,0,"fee schedule","69% of total billed charges",2804,100,,2243.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2804,100,,2243.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2804,100,,2243.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.89,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1995.01,100,,,,,0,"fee schedule",EAPG,2542.66,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1057.11,37.7,,845.69,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2187.12,78,,1749.70,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2316.1,82.6,,1852.88,,,0,"percent of total billed charges","82.6% of total billed charges",1955.89,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2316.1,82.6,,1852.88,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2116.42,100,,,,,0,"fee schedule",EAPG,2804,100,,2243.20,,,0,"percent of total billed charges","100% of total billed charges",429.01,19379.77,
"35281 Repair blood vessel with graft other than ve",7963027,CDM,521,RC,35281,CPT,OUTPATIENT,,,5078,3300.7,,4468.64,88,,3574.91,,,0,"percent of total billed charges","88% of total billed charges",5078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5078,175,,,,,0,"fee schedule","175% of CMS fee schedule",10944.37,100,,,,,0,"fee schedule",EAPG,5078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3199.14,63,,2559.31,,,0,"percent of total billed charges","63% of total billed charges",776.93,15.3,,621.54,,,0,"percent of total billed charges","15.3% of total billed charges",10625.6,100,,,,,0,"fee schedule",EAPG,3503.82,69,,,,,0,"fee schedule","69% of total billed charges",5078,100,,4062.40,,,0,"percent of total billed charges","100% of total billed charges",5078,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5078,100,,4062.40,,,0,"percent of total billed charges","100% of total billed charges",5078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5078,100,,4062.40,,,0,"percent of total billed charges","100% of total billed charges",5078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,5078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10838.11,100,,,,,0,"fee schedule",EAPG,13813.28,100,,,,,0,"fee schedule",EAPG,5078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1914.41,37.7,,1531.53,,,0,"percent of total billed charges","37.70% of total billed charges",5078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5078,100,,,,,0,"fee schedule","100% of CMS fee schedule",3960.84,78,,3168.67,,,0,"percent of total billed charges","78% of total billed charges",5078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4194.43,82.6,,3355.54,,,0,"percent of total billed charges","82.6% of total billed charges",10625.6,100,,,,,0,"fee schedule","100% of WA fee schedule",5078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4194.43,82.6,,3355.54,,,0,"percent of total billed charges","82.6% of total billed charges",5078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10786.13,100,,,,,0,"fee schedule",EAPG,5078,100,,4062.40,,,0,"percent of total billed charges","100% of total billed charges",776.93,13813.28,
"35286 Repair blood vessel with graft other than ve",7963028,CDM,521,RC,35286,CPT,OUTPATIENT,,,2771,1801.15,,2438.48,88,,1950.78,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4439.75,100,,,,,0,"fee schedule",EAPG,2771,100,,2216.80,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",4572.94,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1745.73,63,,1396.58,,,0,"percent of total billed charges","63% of total billed charges",423.96,15.3,,339.17,,,0,"percent of total billed charges","15.3% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,1911.99,69,,,,,0,"fee schedule","69% of total billed charges",2771,100,,2216.80,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2771,100,,2216.80,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2771,100,,2216.80,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4439.75,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4528.55,100,,,,,0,"fee schedule",EAPG,5771.68,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1044.67,37.7,,835.74,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2161.38,78,,1729.10,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2288.85,82.6,,1831.08,,,0,"percent of total billed charges","82.6% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2288.85,82.6,,1831.08,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4600.28,100,,,,,0,"fee schedule",EAPG,2771,100,,2216.80,,,0,"percent of total billed charges","100% of total billed charges",423.96,19379.77,
"35304 Thromboendarterectomy, including patch graft",7961991,CDM,521,RC,35304,CPT,OUTPATIENT,,,4078,2650.7,,3588.64,88,,2870.91,,,0,"percent of total billed charges","88% of total billed charges",4078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3301.11,100,,,,,0,"fee schedule",EAPG,4078,100,,3262.40,,,0,"percent of total billed charges","100% of total billed charges",4078,175,,,,,0,"fee schedule","175% of CMS fee schedule",3400.14,100,,,,,0,"fee schedule",EAPG,4078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2569.14,63,,2055.31,,,0,"percent of total billed charges","63% of total billed charges",623.93,15.3,,499.14,,,0,"percent of total billed charges","15.3% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,2813.82,69,,,,,0,"fee schedule","69% of total billed charges",4078,100,,3262.40,,,0,"percent of total billed charges","100% of total billed charges",4078,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4078,100,,3262.40,,,0,"percent of total billed charges","100% of total billed charges",4078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4078,100,,3262.40,,,0,"percent of total billed charges","100% of total billed charges",4078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3301.11,100,,,,,0,"fee schedule",EAPG,4078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3367.13,100,,,,,0,"fee schedule",EAPG,4291.45,100,,,,,0,"fee schedule",EAPG,4078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1537.41,37.7,,1229.93,,,0,"percent of total billed charges","37.70% of total billed charges",4078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4078,100,,,,,0,"fee schedule","100% of CMS fee schedule",3180.84,78,,2544.67,,,0,"percent of total billed charges","78% of total billed charges",4078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3368.43,82.6,,2694.74,,,0,"percent of total billed charges","82.6% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,4078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3368.43,82.6,,2694.74,,,0,"percent of total billed charges","82.6% of total billed charges",4078,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3461.64,100,,,,,0,"fee schedule",EAPG,4078,100,,3262.40,,,0,"percent of total billed charges","100% of total billed charges",623.93,4291.45,
"35305 Thromboendarterectomy, including patch graft",7962155,CDM,521,RC,35305,CPT,OUTPATIENT,,,3925,2551.25,,3454,88,,2763.20,,,0,"percent of total billed charges","88% of total billed charges",3925,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3301.11,100,,,,,0,"fee schedule",EAPG,3925,100,,3140.00,,,0,"percent of total billed charges","100% of total billed charges",3925,175,,,,,0,"fee schedule","175% of CMS fee schedule",3400.14,100,,,,,0,"fee schedule",EAPG,3925,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2472.75,63,,1978.20,,,0,"percent of total billed charges","63% of total billed charges",600.53,15.3,,480.42,,,0,"percent of total billed charges","15.3% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,2708.25,69,,,,,0,"fee schedule","69% of total billed charges",3925,100,,3140.00,,,0,"percent of total billed charges","100% of total billed charges",3925,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3925,100,,3140.00,,,0,"percent of total billed charges","100% of total billed charges",3925,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3925,100,,3140.00,,,0,"percent of total billed charges","100% of total billed charges",3925,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3925,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3301.11,100,,,,,0,"fee schedule",EAPG,3925,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3925,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3925,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3367.13,100,,,,,0,"fee schedule",EAPG,4291.45,100,,,,,0,"fee schedule",EAPG,3925,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1479.73,37.7,,1183.78,,,0,"percent of total billed charges","37.70% of total billed charges",3925,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3925,100,,,,,0,"fee schedule","100% of CMS fee schedule",3061.5,78,,2449.20,,,0,"percent of total billed charges","78% of total billed charges",3925,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3242.05,82.6,,2593.64,,,0,"percent of total billed charges","82.6% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,3925,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3242.05,82.6,,2593.64,,,0,"percent of total billed charges","82.6% of total billed charges",3925,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3461.64,100,,,,,0,"fee schedule",EAPG,3925,100,,3140.00,,,0,"percent of total billed charges","100% of total billed charges",600.53,4291.45,
"35306 Thromboendarterectomy, including patch graft",7962217,CDM,521,RC,35306,CPT,OUTPATIENT,,,1411,917.15,,1241.68,88,,993.34,,,0,"percent of total billed charges","88% of total billed charges",1411,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3301.11,100,,,,,0,"fee schedule",EAPG,1411,100,,1128.80,,,0,"percent of total billed charges","100% of total billed charges",1411,175,,,,,0,"fee schedule","175% of CMS fee schedule",3400.14,100,,,,,0,"fee schedule",EAPG,1411,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",888.93,63,,711.14,,,0,"percent of total billed charges","63% of total billed charges",215.88,15.3,,172.70,,,0,"percent of total billed charges","15.3% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,973.59,69,,,,,0,"fee schedule","69% of total billed charges",1411,100,,1128.80,,,0,"percent of total billed charges","100% of total billed charges",1411,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1411,100,,1128.80,,,0,"percent of total billed charges","100% of total billed charges",1411,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1411,100,,1128.80,,,0,"percent of total billed charges","100% of total billed charges",1411,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1411,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3301.11,100,,,,,0,"fee schedule",EAPG,1411,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1411,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1411,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3367.13,100,,,,,0,"fee schedule",EAPG,4291.45,100,,,,,0,"fee schedule",EAPG,1411,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",531.95,37.7,,425.56,,,0,"percent of total billed charges","37.70% of total billed charges",1411,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1411,100,,,,,0,"fee schedule","100% of CMS fee schedule",1100.58,78,,880.46,,,0,"percent of total billed charges","78% of total billed charges",1411,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1165.49,82.6,,932.39,,,0,"percent of total billed charges","82.6% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,1411,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1165.49,82.6,,932.39,,,0,"percent of total billed charges","82.6% of total billed charges",1411,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3461.64,100,,,,,0,"fee schedule",EAPG,1411,100,,1128.80,,,0,"percent of total billed charges","100% of total billed charges",215.88,4291.45,
"35303 Thromboendarterectomy, including patch graft",7962602,CDM,521,RC,35303,CPT,OUTPATIENT,,,3925,2551.25,,3454,88,,2763.20,,,0,"percent of total billed charges","88% of total billed charges",3925,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3301.11,100,,,,,0,"fee schedule",EAPG,3925,100,,3140.00,,,0,"percent of total billed charges","100% of total billed charges",3925,175,,,,,0,"fee schedule","175% of CMS fee schedule",3400.14,100,,,,,0,"fee schedule",EAPG,3925,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2472.75,63,,1978.20,,,0,"percent of total billed charges","63% of total billed charges",600.53,15.3,,480.42,,,0,"percent of total billed charges","15.3% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,2708.25,69,,,,,0,"fee schedule","69% of total billed charges",3925,100,,3140.00,,,0,"percent of total billed charges","100% of total billed charges",3925,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3925,100,,3140.00,,,0,"percent of total billed charges","100% of total billed charges",3925,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3925,100,,3140.00,,,0,"percent of total billed charges","100% of total billed charges",3925,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3925,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3301.11,100,,,,,0,"fee schedule",EAPG,3925,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3925,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3925,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3367.13,100,,,,,0,"fee schedule",EAPG,4291.45,100,,,,,0,"fee schedule",EAPG,3925,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1479.73,37.7,,1183.78,,,0,"percent of total billed charges","37.70% of total billed charges",3925,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3925,100,,,,,0,"fee schedule","100% of CMS fee schedule",3061.5,78,,2449.20,,,0,"percent of total billed charges","78% of total billed charges",3925,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3242.05,82.6,,2593.64,,,0,"percent of total billed charges","82.6% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,3925,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3242.05,82.6,,2593.64,,,0,"percent of total billed charges","82.6% of total billed charges",3925,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3461.64,100,,,,,0,"fee schedule",EAPG,3925,100,,3140.00,,,0,"percent of total billed charges","100% of total billed charges",600.53,4291.45,
"35301 Thromboendarterectomy; carotid, vertebral, s",7962778,CDM,521,RC,35301,CPT,OUTPATIENT,,,4859,3158.35,,4275.92,88,,3420.74,,,0,"percent of total billed charges","88% of total billed charges",4859,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4315.84,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",4859,175,,,,,0,"fee schedule","175% of CMS fee schedule",4445.32,100,,,,,0,"fee schedule",EAPG,4859,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3061.17,63,,2448.94,,,0,"percent of total billed charges","63% of total billed charges",743.43,15.3,,594.74,,,0,"percent of total billed charges","15.3% of total billed charges",4315.84,100,,,,,0,"fee schedule",EAPG,3352.71,69,,,,,0,"fee schedule","69% of total billed charges",4859,100,,3887.20,,,0,"percent of total billed charges","100% of total billed charges",4859,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4859,100,,3887.20,,,0,"percent of total billed charges","100% of total billed charges",4859,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4859,100,,3887.20,,,0,"percent of total billed charges","100% of total billed charges",4859,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4859,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4315.84,100,,,,,0,"fee schedule",EAPG,4859,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4859,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4859,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4402.16,100,,,,,0,"fee schedule",EAPG,5610.6,100,,,,,0,"fee schedule",EAPG,4859,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1831.84,37.7,,1465.47,,,0,"percent of total billed charges","37.70% of total billed charges",4859,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4859,100,,,,,0,"fee schedule","100% of CMS fee schedule",3790.02,78,,3032.02,,,0,"percent of total billed charges","78% of total billed charges",4859,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4013.53,82.6,,3210.82,,,0,"percent of total billed charges","82.6% of total billed charges",4315.84,100,,,,,0,"fee schedule","100% of WA fee schedule",4859,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4013.53,82.6,,3210.82,,,0,"percent of total billed charges","82.6% of total billed charges",4859,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4476.37,100,,,,,0,"fee schedule",EAPG,4859,100,,3887.20,,,0,"percent of total billed charges","100% of total billed charges",743.43,5610.6,
"35302 Thromboendarterectomy; superficial femoral a",7963411,CDM,521,RC,35302,CPT,OUTPATIENT,,,3227,2097.55,,2839.76,88,,2271.81,,,0,"percent of total billed charges","88% of total billed charges",3227,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3301.11,100,,,,,0,"fee schedule",EAPG,3227,100,,2581.60,,,0,"percent of total billed charges","100% of total billed charges",3227,175,,,,,0,"fee schedule","175% of CMS fee schedule",3400.14,100,,,,,0,"fee schedule",EAPG,3227,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2033.01,63,,1626.41,,,0,"percent of total billed charges","63% of total billed charges",493.73,15.3,,394.98,,,0,"percent of total billed charges","15.3% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,2226.63,69,,,,,0,"fee schedule","69% of total billed charges",3227,100,,2581.60,,,0,"percent of total billed charges","100% of total billed charges",3227,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3227,100,,2581.60,,,0,"percent of total billed charges","100% of total billed charges",3227,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3227,100,,2581.60,,,0,"percent of total billed charges","100% of total billed charges",3227,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3227,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3301.11,100,,,,,0,"fee schedule",EAPG,3227,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3227,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3227,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3367.13,100,,,,,0,"fee schedule",EAPG,4291.45,100,,,,,0,"fee schedule",EAPG,3227,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1216.58,37.7,,973.26,,,0,"percent of total billed charges","37.70% of total billed charges",3227,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3227,100,,,,,0,"fee schedule","100% of CMS fee schedule",2517.06,78,,2013.65,,,0,"percent of total billed charges","78% of total billed charges",3227,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2665.5,82.6,,2132.40,,,0,"percent of total billed charges","82.6% of total billed charges",3301.11,100,,,,,0,"fee schedule","100% of WA fee schedule",3227,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2665.5,82.6,,2132.40,,,0,"percent of total billed charges","82.6% of total billed charges",3227,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3461.64,100,,,,,0,"fee schedule",EAPG,3227,100,,2581.60,,,0,"percent of total billed charges","100% of total billed charges",493.73,4291.45,
"35321 Thromboendarterectomy, including patch graft",7962574,CDM,521,RC,35321,CPT,OUTPATIENT,,,2555,1660.75,,2248.4,88,,1798.72,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3301.11,100,,,,,0,"fee schedule",EAPG,2555,100,,2044.00,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3400.14,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1609.65,63,,1287.72,,,0,"percent of total billed charges","63% of total billed charges",390.92,15.3,,312.74,,,0,"percent of total billed charges","15.3% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,1762.95,69,,,,,0,"fee schedule","69% of total billed charges",2555,100,,2044.00,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2555,100,,2044.00,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2555,100,,2044.00,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3301.11,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3367.13,100,,,,,0,"fee schedule",EAPG,4291.45,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",963.24,37.7,,770.59,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1992.9,78,,1594.32,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2110.43,82.6,,1688.34,,,0,"percent of total billed charges","82.6% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2110.43,82.6,,1688.34,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3461.64,100,,,,,0,"fee schedule",EAPG,2555,100,,2044.00,,,0,"percent of total billed charges","100% of total billed charges",390.92,19379.77,
"35341 Thromboendarterectomy, including patch graft",7961953,CDM,521,RC,35341,CPT,OUTPATIENT,,,4320,2808,,3801.6,88,,3041.28,,,0,"percent of total billed charges","88% of total billed charges",4320,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4320,100,,3456.00,,,0,"percent of total billed charges","100% of total billed charges",4320,175,,,,,0,"fee schedule","175% of CMS fee schedule",10944.37,100,,,,,0,"fee schedule",EAPG,4320,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2721.6,63,,2177.28,,,0,"percent of total billed charges","63% of total billed charges",660.96,15.3,,528.77,,,0,"percent of total billed charges","15.3% of total billed charges",10625.6,100,,,,,0,"fee schedule",EAPG,2980.8,69,,,,,0,"fee schedule","69% of total billed charges",4320,100,,3456.00,,,0,"percent of total billed charges","100% of total billed charges",4320,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4320,100,,3456.00,,,0,"percent of total billed charges","100% of total billed charges",4320,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4320,100,,3456.00,,,0,"percent of total billed charges","100% of total billed charges",4320,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4320,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4320,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4320,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4320,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10838.11,100,,,,,0,"fee schedule",EAPG,13813.28,100,,,,,0,"fee schedule",EAPG,4320,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1628.64,37.7,,1302.91,,,0,"percent of total billed charges","37.70% of total billed charges",4320,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4320,100,,,,,0,"fee schedule","100% of CMS fee schedule",3369.6,78,,2695.68,,,0,"percent of total billed charges","78% of total billed charges",4320,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3568.32,82.6,,2854.66,,,0,"percent of total billed charges","82.6% of total billed charges",10625.6,100,,,,,0,"fee schedule","100% of WA fee schedule",4320,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3568.32,82.6,,2854.66,,,0,"percent of total billed charges","82.6% of total billed charges",4320,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10786.13,100,,,,,0,"fee schedule",EAPG,4320,100,,3456.00,,,0,"percent of total billed charges","100% of total billed charges",660.96,13813.28,
"35355 Thromboendarterectomy, including patch graft",7962779,CDM,521,RC,35355,CPT,OUTPATIENT,,,2962,1925.3,,2606.56,88,,2085.25,,,0,"percent of total billed charges","88% of total billed charges",2962,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3301.11,100,,,,,0,"fee schedule",EAPG,2962,100,,2369.60,,,0,"percent of total billed charges","100% of total billed charges",2962,175,,,,,0,"fee schedule","175% of CMS fee schedule",3400.14,100,,,,,0,"fee schedule",EAPG,2962,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1866.06,63,,1492.85,,,0,"percent of total billed charges","63% of total billed charges",453.19,15.3,,362.55,,,0,"percent of total billed charges","15.3% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,2043.78,69,,,,,0,"fee schedule","69% of total billed charges",2962,100,,2369.60,,,0,"percent of total billed charges","100% of total billed charges",2962,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2962,100,,2369.60,,,0,"percent of total billed charges","100% of total billed charges",2962,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2962,100,,2369.60,,,0,"percent of total billed charges","100% of total billed charges",2962,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2962,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3301.11,100,,,,,0,"fee schedule",EAPG,2962,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2962,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2962,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3367.13,100,,,,,0,"fee schedule",EAPG,4291.45,100,,,,,0,"fee schedule",EAPG,2962,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1116.67,37.7,,893.34,,,0,"percent of total billed charges","37.70% of total billed charges",2962,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2962,100,,,,,0,"fee schedule","100% of CMS fee schedule",2310.36,78,,1848.29,,,0,"percent of total billed charges","78% of total billed charges",2962,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2446.61,82.6,,1957.29,,,0,"percent of total billed charges","82.6% of total billed charges",3301.11,100,,,,,0,"fee schedule","100% of WA fee schedule",2962,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2446.61,82.6,,1957.29,,,0,"percent of total billed charges","82.6% of total billed charges",2962,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3461.64,100,,,,,0,"fee schedule",EAPG,2962,100,,2369.60,,,0,"percent of total billed charges","100% of total billed charges",453.19,4291.45,
"35351 Thromboendarterectomy, including patch graft",7962967,CDM,521,RC,35351,CPT,OUTPATIENT,,,3736,2428.4,,3287.68,88,,2630.14,,,0,"percent of total billed charges","88% of total billed charges",3736,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,3736,100,,2988.80,,,0,"percent of total billed charges","100% of total billed charges",3736,175,,,,,0,"fee schedule","175% of CMS fee schedule",10944.37,100,,,,,0,"fee schedule",EAPG,3736,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2353.68,63,,1882.94,,,0,"percent of total billed charges","63% of total billed charges",571.61,15.3,,457.29,,,0,"percent of total billed charges","15.3% of total billed charges",10625.6,100,,,,,0,"fee schedule",EAPG,2577.84,69,,,,,0,"fee schedule","69% of total billed charges",3736,100,,2988.80,,,0,"percent of total billed charges","100% of total billed charges",3736,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3736,100,,2988.80,,,0,"percent of total billed charges","100% of total billed charges",3736,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3736,100,,2988.80,,,0,"percent of total billed charges","100% of total billed charges",3736,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3736,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,3736,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3736,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3736,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10838.11,100,,,,,0,"fee schedule",EAPG,13813.28,100,,,,,0,"fee schedule",EAPG,3736,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1408.47,37.7,,1126.78,,,0,"percent of total billed charges","37.70% of total billed charges",3736,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3736,100,,,,,0,"fee schedule","100% of CMS fee schedule",2914.08,78,,2331.26,,,0,"percent of total billed charges","78% of total billed charges",3736,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3085.94,82.6,,2468.75,,,0,"percent of total billed charges","82.6% of total billed charges",10625.6,100,,,,,0,"fee schedule","100% of WA fee schedule",3736,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3085.94,82.6,,2468.75,,,0,"percent of total billed charges","82.6% of total billed charges",3736,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10786.13,100,,,,,0,"fee schedule",EAPG,3736,100,,2988.80,,,0,"percent of total billed charges","100% of total billed charges",571.61,13813.28,
"35361 Thromboendarterectomy, including patch graft",7962511,CDM,521,RC,35361,CPT,OUTPATIENT,,,4905,3188.25,,4316.4,88,,3453.12,,,0,"percent of total billed charges","88% of total billed charges",4905,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",4905,175,,,,,0,"fee schedule","175% of CMS fee schedule",10944.37,100,,,,,0,"fee schedule",EAPG,4905,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3090.15,63,,2472.12,,,0,"percent of total billed charges","63% of total billed charges",750.47,15.3,,600.38,,,0,"percent of total billed charges","15.3% of total billed charges",10625.6,100,,,,,0,"fee schedule",EAPG,3384.45,69,,,,,0,"fee schedule","69% of total billed charges",4905,100,,3924.00,,,0,"percent of total billed charges","100% of total billed charges",4905,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4905,100,,3924.00,,,0,"percent of total billed charges","100% of total billed charges",4905,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4905,100,,3924.00,,,0,"percent of total billed charges","100% of total billed charges",4905,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4905,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4905,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4905,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4905,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10838.11,100,,,,,0,"fee schedule",EAPG,13813.28,100,,,,,0,"fee schedule",EAPG,4905,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1849.19,37.7,,1479.35,,,0,"percent of total billed charges","37.70% of total billed charges",4905,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4905,100,,,,,0,"fee schedule","100% of CMS fee schedule",3825.9,78,,3060.72,,,0,"percent of total billed charges","78% of total billed charges",4905,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4051.53,82.6,,3241.22,,,0,"percent of total billed charges","82.6% of total billed charges",10625.6,100,,,,,0,"fee schedule","100% of WA fee schedule",4905,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4051.53,82.6,,3241.22,,,0,"percent of total billed charges","82.6% of total billed charges",4905,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10786.13,100,,,,,0,"fee schedule",EAPG,4905,100,,3924.00,,,0,"percent of total billed charges","100% of total billed charges",750.47,13813.28,
"35372 Thromboendarterectomy, including patch graft",7962371,CDM,521,RC,35372,CPT,OUTPATIENT,,,2812,1827.8,,2474.56,88,,1979.65,,,0,"percent of total billed charges","88% of total billed charges",2812,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3301.11,100,,,,,0,"fee schedule",EAPG,2812,100,,2249.60,,,0,"percent of total billed charges","100% of total billed charges",2812,175,,,,,0,"fee schedule","175% of CMS fee schedule",3400.14,100,,,,,0,"fee schedule",EAPG,2812,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1771.56,63,,1417.25,,,0,"percent of total billed charges","63% of total billed charges",430.24,15.3,,344.19,,,0,"percent of total billed charges","15.3% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,1940.28,69,,,,,0,"fee schedule","69% of total billed charges",2812,100,,2249.60,,,0,"percent of total billed charges","100% of total billed charges",2812,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2812,100,,2249.60,,,0,"percent of total billed charges","100% of total billed charges",2812,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2812,100,,2249.60,,,0,"percent of total billed charges","100% of total billed charges",2812,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3301.11,100,,,,,0,"fee schedule",EAPG,2812,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2812,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",2812,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3367.13,100,,,,,0,"fee schedule",EAPG,4291.45,100,,,,,0,"fee schedule",EAPG,2812,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1060.12,37.7,,848.10,,,0,"percent of total billed charges","37.70% of total billed charges",2812,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2812,100,,,,,0,"fee schedule","100% of CMS fee schedule",2193.36,78,,1754.69,,,0,"percent of total billed charges","78% of total billed charges",2812,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2322.71,82.6,,1858.17,,,0,"percent of total billed charges","82.6% of total billed charges",3301.11,100,,,,,0,"fee schedule","100% of WA fee schedule",2812,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2322.71,82.6,,1858.17,,,0,"percent of total billed charges","82.6% of total billed charges",2812,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3461.64,100,,,,,0,"fee schedule",EAPG,2812,100,,2249.60,,,0,"percent of total billed charges","100% of total billed charges",430.24,19379.77,
"35371 Thromboendarterectomy, including patch graft",7962674,CDM,521,RC,35371,CPT,OUTPATIENT,,,2350,1527.5,,2068,88,,1654.40,,,0,"percent of total billed charges","88% of total billed charges",2350,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3301.11,100,,,,,0,"fee schedule",EAPG,2350,100,,1880.00,,,0,"percent of total billed charges","100% of total billed charges",2350,175,,,,,0,"fee schedule","175% of CMS fee schedule",3400.14,100,,,,,0,"fee schedule",EAPG,2350,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1480.5,63,,1184.40,,,0,"percent of total billed charges","63% of total billed charges",359.55,15.3,,287.64,,,0,"percent of total billed charges","15.3% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,1621.5,69,,,,,0,"fee schedule","69% of total billed charges",2350,100,,1880.00,,,0,"percent of total billed charges","100% of total billed charges",2350,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2350,100,,1880.00,,,0,"percent of total billed charges","100% of total billed charges",2350,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2350,100,,1880.00,,,0,"percent of total billed charges","100% of total billed charges",2350,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2350,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3301.11,100,,,,,0,"fee schedule",EAPG,2350,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2350,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2350,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3367.13,100,,,,,0,"fee schedule",EAPG,4291.45,100,,,,,0,"fee schedule",EAPG,2350,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",885.95,37.7,,708.76,,,0,"percent of total billed charges","37.70% of total billed charges",2350,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2350,100,,,,,0,"fee schedule","100% of CMS fee schedule",1833,78,,1466.40,,,0,"percent of total billed charges","78% of total billed charges",2350,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1941.1,82.6,,1552.88,,,0,"percent of total billed charges","82.6% of total billed charges",3301.11,100,,,,,0,"fee schedule","100% of WA fee schedule",2350,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1941.1,82.6,,1552.88,,,0,"percent of total billed charges","82.6% of total billed charges",2350,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3461.64,100,,,,,0,"fee schedule",EAPG,2350,100,,1880.00,,,0,"percent of total billed charges","100% of total billed charges",359.55,4291.45,
"35460 Transluminal balloon angioplasty, open; veno",7963474,CDM,521,RC,,,OUTPATIENT,,,920,598,,809.6,88,,647.68,,,0,"percent of total billed charges","88% of total billed charges",460,50,,368.00,,,0,"percent of total billed charges","50% of total billed charges",154.56,16.8,,123.65,,,0,"percent of total billed charges","16.8% of total billed charges",920,100,,736.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.2,17.304,,127.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",579.6,63,,463.68,,,0,"percent of total billed charges","63% of total billed charges",140.76,15.3,,112.61,,,0,"percent of total billed charges","15.3% of total billed charges",154.56,16.8,,123.65,,,0,"percent of total billed charges","16.8% of total billed charges",634.8,69,,,,,0,"fee schedule","69% of total billed charges",920,100,,736.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",920,100,,736.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",920,100,,736.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",569.02,61.85,,455.22,,,0,"percent of total billed charges","61.5% of total billed charges",154.56,16.8,,123.65,,,0,"percent of total billed charges","16.8% of total billed charges",460,50,,368.00,,,0,"percent of total billed charges","50% of total billed charges",296.24,32.2,,236.99,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",157.65,17.136,,126.12,,,0,"percent of total billed charges","17.136% of total billed charges",200.93,21.84,,160.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",346.84,37.7,,277.47,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",717.6,78,,574.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",759.92,82.6,,607.94,,,0,"percent of total billed charges","82.6% of total billed charges",154.56,16.8,,123.65,,,0,"percent of total billed charges","16.8% of total billed charges",460,50,,368.00,,,0,"percent of total billed charges","50% of total billed charges",759.92,82.6,,607.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",920,100,,736.00,,,0,"percent of total billed charges","100% of total billed charges",140.76,920,
"35475 Transluminal balloon angioplasty, percutaneo",7961556,CDM,521,RC,,,OUTPATIENT,,,973,632.45,,856.24,88,,684.99,,,0,"percent of total billed charges","88% of total billed charges",486.5,50,,389.20,,,0,"percent of total billed charges","50% of total billed charges",163.46,16.8,,130.77,,,0,"percent of total billed charges","16.8% of total billed charges",973,100,,778.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.37,17.304,,134.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",612.99,63,,490.39,,,0,"percent of total billed charges","63% of total billed charges",148.87,15.3,,119.10,,,0,"percent of total billed charges","15.3% of total billed charges",163.46,16.8,,130.77,,,0,"percent of total billed charges","16.8% of total billed charges",671.37,69,,,,,0,"fee schedule","69% of total billed charges",973,100,,778.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",973,100,,778.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",973,100,,778.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",601.8,61.85,,481.44,,,0,"percent of total billed charges","61.5% of total billed charges",163.46,16.8,,130.77,,,0,"percent of total billed charges","16.8% of total billed charges",486.5,50,,389.20,,,0,"percent of total billed charges","50% of total billed charges",313.31,32.2,,250.65,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",166.73,17.136,,133.38,,,0,"percent of total billed charges","17.136% of total billed charges",212.5,21.84,,170.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",366.82,37.7,,293.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",758.94,78,,607.15,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",803.7,82.6,,642.96,,,0,"percent of total billed charges","82.6% of total billed charges",163.46,16.8,,130.77,,,0,"percent of total billed charges","16.8% of total billed charges",486.5,50,,389.20,,,0,"percent of total billed charges","50% of total billed charges",803.7,82.6,,642.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",973,100,,778.40,,,0,"percent of total billed charges","100% of total billed charges",148.87,973,
"35471 Transluminal balloon angioplasty, percutaneo",7962733,CDM,521,RC,,,OUTPATIENT,,,1636,1063.4,,1439.68,88,,1151.74,,,0,"percent of total billed charges","88% of total billed charges",818,50,,654.40,,,0,"percent of total billed charges","50% of total billed charges",274.85,16.8,,219.88,,,0,"percent of total billed charges","16.8% of total billed charges",1636,100,,1308.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",283.09,17.304,,226.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030.68,63,,824.54,,,0,"percent of total billed charges","63% of total billed charges",250.31,15.3,,200.25,,,0,"percent of total billed charges","15.3% of total billed charges",274.85,16.8,,219.88,,,0,"percent of total billed charges","16.8% of total billed charges",1128.84,69,,,,,0,"fee schedule","69% of total billed charges",1636,100,,1308.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1636,100,,1308.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1636,100,,1308.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1011.87,61.85,,809.50,,,0,"percent of total billed charges","61.5% of total billed charges",274.85,16.8,,219.88,,,0,"percent of total billed charges","16.8% of total billed charges",818,50,,654.40,,,0,"percent of total billed charges","50% of total billed charges",526.79,32.2,,421.43,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",280.34,17.136,,224.27,,,0,"percent of total billed charges","17.136% of total billed charges",357.3,21.84,,285.84,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",616.77,37.7,,493.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1276.08,78,,1020.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1351.34,82.6,,1081.07,,,0,"percent of total billed charges","82.6% of total billed charges",274.85,16.8,,219.88,,,0,"percent of total billed charges","16.8% of total billed charges",818,50,,654.40,,,0,"percent of total billed charges","50% of total billed charges",1351.34,82.6,,1081.07,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",1636,100,,1308.80,,,0,"percent of total billed charges","100% of total billed charges",160.53,1636,
"35476 Transluminal balloon angioplasty, percutaneo",7963267,CDM,521,RC,,,OUTPATIENT,,,809,525.85,,711.92,88,,569.54,,,0,"percent of total billed charges","88% of total billed charges",404.5,50,,323.60,,,0,"percent of total billed charges","50% of total billed charges",135.91,16.8,,108.73,,,0,"percent of total billed charges","16.8% of total billed charges",809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",139.99,17.304,,111.99,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",509.67,63,,407.74,,,0,"percent of total billed charges","63% of total billed charges",123.78,15.3,,99.02,,,0,"percent of total billed charges","15.3% of total billed charges",135.91,16.8,,108.73,,,0,"percent of total billed charges","16.8% of total billed charges",558.21,69,,,,,0,"fee schedule","69% of total billed charges",809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",500.37,61.85,,400.30,,,0,"percent of total billed charges","61.5% of total billed charges",135.91,16.8,,108.73,,,0,"percent of total billed charges","16.8% of total billed charges",404.5,50,,323.60,,,0,"percent of total billed charges","50% of total billed charges",260.5,32.2,,208.40,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",138.63,17.136,,110.90,,,0,"percent of total billed charges","17.136% of total billed charges",176.69,21.84,,141.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",304.99,37.7,,243.99,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",631.02,78,,504.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",668.23,82.6,,534.58,,,0,"percent of total billed charges","82.6% of total billed charges",135.91,16.8,,108.73,,,0,"percent of total billed charges","16.8% of total billed charges",404.5,50,,323.60,,,0,"percent of total billed charges","50% of total billed charges",668.23,82.6,,534.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",123.78,809,
"35472 Transluminal balloon angioplasty, percutaneo",7963294,CDM,521,RC,,,OUTPATIENT,,,991,644.15,,872.08,88,,697.66,,,0,"percent of total billed charges","88% of total billed charges",495.5,50,,396.40,,,0,"percent of total billed charges","50% of total billed charges",166.49,16.8,,133.19,,,0,"percent of total billed charges","16.8% of total billed charges",991,100,,792.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",171.48,17.304,,137.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",624.33,63,,499.46,,,0,"percent of total billed charges","63% of total billed charges",151.62,15.3,,121.30,,,0,"percent of total billed charges","15.3% of total billed charges",166.49,16.8,,133.19,,,0,"percent of total billed charges","16.8% of total billed charges",683.79,69,,,,,0,"fee schedule","69% of total billed charges",991,100,,792.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",991,100,,792.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",991,100,,792.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",612.93,61.85,,490.34,,,0,"percent of total billed charges","61.5% of total billed charges",166.49,16.8,,133.19,,,0,"percent of total billed charges","16.8% of total billed charges",495.5,50,,396.40,,,0,"percent of total billed charges","50% of total billed charges",319.1,32.2,,255.28,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",169.82,17.136,,135.86,,,0,"percent of total billed charges","17.136% of total billed charges",216.43,21.84,,173.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",373.61,37.7,,298.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",772.98,78,,618.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",818.57,82.6,,654.86,,,0,"percent of total billed charges","82.6% of total billed charges",166.49,16.8,,133.19,,,0,"percent of total billed charges","16.8% of total billed charges",495.5,50,,396.40,,,0,"percent of total billed charges","50% of total billed charges",818.57,82.6,,654.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",991,100,,792.80,,,0,"percent of total billed charges","100% of total billed charges",151.62,991,
"35500 Harvest of upper extremity vein, 1 segment,",7962104,CDM,521,RC,35500,CPT,OUTPATIENT,,,1248,811.2,,1098.24,88,,878.59,,,0,"percent of total billed charges","88% of total billed charges",624,50,,499.20,,,0,"percent of total billed charges","50% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,1248,100,,998.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4572.94,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",786.24,63,,628.99,,,0,"percent of total billed charges","63% of total billed charges",190.94,15.3,,152.75,,,0,"percent of total billed charges","15.3% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,861.12,69,,,,,0,"fee schedule","69% of total billed charges",1248,100,,998.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1248,100,,998.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1248,100,,998.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",771.89,61.85,,617.51,,,0,"percent of total billed charges","61.5% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,624,50,,499.20,,,0,"percent of total billed charges","50% of total billed charges",401.86,32.2,,321.49,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4528.55,100,,,,,0,"fee schedule",EAPG,5771.68,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.5,37.7,,376.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",973.44,78,,778.75,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1030.85,82.6,,824.68,,,0,"percent of total billed charges","82.6% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,624,50,,499.20,,,0,"percent of total billed charges","50% of total billed charges",1030.85,82.6,,824.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4600.28,100,,,,,0,"fee schedule",EAPG,1248,100,,998.40,,,0,"percent of total billed charges","100% of total billed charges",190.94,5771.68,
"35506 Bypass graft, with vein; carotid-subclavian",7962968,CDM,521,RC,35506,CPT,OUTPATIENT,,,3636,2363.4,,3199.68,88,,2559.74,,,0,"percent of total billed charges","88% of total billed charges",3636,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4315.84,100,,,,,0,"fee schedule",EAPG,3636,100,,2908.80,,,0,"percent of total billed charges","100% of total billed charges",3636,175,,,,,0,"fee schedule","175% of CMS fee schedule",4445.32,100,,,,,0,"fee schedule",EAPG,3636,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2290.68,63,,1832.54,,,0,"percent of total billed charges","63% of total billed charges",556.31,15.3,,445.05,,,0,"percent of total billed charges","15.3% of total billed charges",4315.84,100,,,,,0,"fee schedule",EAPG,2508.84,69,,,,,0,"fee schedule","69% of total billed charges",3636,100,,2908.80,,,0,"percent of total billed charges","100% of total billed charges",3636,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3636,100,,2908.80,,,0,"percent of total billed charges","100% of total billed charges",3636,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3636,100,,2908.80,,,0,"percent of total billed charges","100% of total billed charges",3636,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3636,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4315.84,100,,,,,0,"fee schedule",EAPG,3636,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3636,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3636,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4402.16,100,,,,,0,"fee schedule",EAPG,5610.6,100,,,,,0,"fee schedule",EAPG,3636,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1370.77,37.7,,1096.62,,,0,"percent of total billed charges","37.70% of total billed charges",3636,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3636,100,,,,,0,"fee schedule","100% of CMS fee schedule",2836.08,78,,2268.86,,,0,"percent of total billed charges","78% of total billed charges",3636,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3003.34,82.6,,2402.67,,,0,"percent of total billed charges","82.6% of total billed charges",4315.84,100,,,,,0,"fee schedule","100% of WA fee schedule",3636,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3003.34,82.6,,2402.67,,,0,"percent of total billed charges","82.6% of total billed charges",3636,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4476.37,100,,,,,0,"fee schedule",EAPG,3636,100,,2908.80,,,0,"percent of total billed charges","100% of total billed charges",556.31,5610.6,
"35523 Bypass graft, with vein; brachial-ulnar or -",7963398,CDM,521,RC,35523,CPT,OUTPATIENT,,,6211,4037.15,,5465.68,88,,4372.54,,,0,"percent of total billed charges","88% of total billed charges",6211,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4439.75,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6211,175,,,,,0,"fee schedule","175% of CMS fee schedule",4572.94,100,,,,,0,"fee schedule",EAPG,6211,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3912.93,63,,3130.34,,,0,"percent of total billed charges","63% of total billed charges",950.28,15.3,,760.22,,,0,"percent of total billed charges","15.3% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,4285.59,69,,,,,0,"fee schedule","69% of total billed charges",6211,100,,4968.80,,,0,"percent of total billed charges","100% of total billed charges",6211,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6211,100,,4968.80,,,0,"percent of total billed charges","100% of total billed charges",6211,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6211,100,,4968.80,,,0,"percent of total billed charges","100% of total billed charges",6211,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6211,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4439.75,100,,,,,0,"fee schedule",EAPG,6211,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6211,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6211,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4528.55,100,,,,,0,"fee schedule",EAPG,5771.68,100,,,,,0,"fee schedule",EAPG,6211,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2341.55,37.7,,1873.24,,,0,"percent of total billed charges","37.70% of total billed charges",6211,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6211,100,,,,,0,"fee schedule","100% of CMS fee schedule",4844.58,78,,3875.66,,,0,"percent of total billed charges","78% of total billed charges",6211,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5130.29,82.6,,4104.23,,,0,"percent of total billed charges","82.6% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,6211,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5130.29,82.6,,4104.23,,,0,"percent of total billed charges","82.6% of total billed charges",6211,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4600.28,100,,,,,0,"fee schedule",EAPG,6211,100,,4968.80,,,0,"percent of total billed charges","100% of total billed charges",950.28,6211,
"35522 Bypass graft, with vein; axillary-brachial",7963543,CDM,521,RC,35522,CPT,OUTPATIENT,,,5709,3710.85,,5023.92,88,,4019.14,,,0,"percent of total billed charges","88% of total billed charges",5709,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4439.75,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5709,175,,,,,0,"fee schedule","175% of CMS fee schedule",4572.94,100,,,,,0,"fee schedule",EAPG,5709,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3596.67,63,,2877.34,,,0,"percent of total billed charges","63% of total billed charges",873.48,15.3,,698.78,,,0,"percent of total billed charges","15.3% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,3939.21,69,,,,,0,"fee schedule","69% of total billed charges",5709,100,,4567.20,,,0,"percent of total billed charges","100% of total billed charges",5709,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5709,100,,4567.20,,,0,"percent of total billed charges","100% of total billed charges",5709,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5709,100,,4567.20,,,0,"percent of total billed charges","100% of total billed charges",5709,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5709,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4439.75,100,,,,,0,"fee schedule",EAPG,5709,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5709,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5709,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4528.55,100,,,,,0,"fee schedule",EAPG,5771.68,100,,,,,0,"fee schedule",EAPG,5709,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2152.29,37.7,,1721.83,,,0,"percent of total billed charges","37.70% of total billed charges",5709,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5709,100,,,,,0,"fee schedule","100% of CMS fee schedule",4453.02,78,,3562.42,,,0,"percent of total billed charges","78% of total billed charges",5709,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4715.63,82.6,,3772.50,,,0,"percent of total billed charges","82.6% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,5709,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4715.63,82.6,,3772.50,,,0,"percent of total billed charges","82.6% of total billed charges",5709,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4600.28,100,,,,,0,"fee schedule",EAPG,5709,100,,4567.20,,,0,"percent of total billed charges","100% of total billed charges",873.48,5771.68,
"35525 Bypass graft, with vein; brachial-brachial",7963544,CDM,521,RC,35525,CPT,OUTPATIENT,,,3105,2018.25,,2732.4,88,,2185.92,,,0,"percent of total billed charges","88% of total billed charges",3105,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4439.75,100,,,,,0,"fee schedule",EAPG,3105,100,,2484.00,,,0,"percent of total billed charges","100% of total billed charges",3105,175,,,,,0,"fee schedule","175% of CMS fee schedule",4572.94,100,,,,,0,"fee schedule",EAPG,3105,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1956.15,63,,1564.92,,,0,"percent of total billed charges","63% of total billed charges",475.07,15.3,,380.06,,,0,"percent of total billed charges","15.3% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,2142.45,69,,,,,0,"fee schedule","69% of total billed charges",3105,100,,2484.00,,,0,"percent of total billed charges","100% of total billed charges",3105,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3105,100,,2484.00,,,0,"percent of total billed charges","100% of total billed charges",3105,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3105,100,,2484.00,,,0,"percent of total billed charges","100% of total billed charges",3105,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3105,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4439.75,100,,,,,0,"fee schedule",EAPG,3105,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3105,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3105,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4528.55,100,,,,,0,"fee schedule",EAPG,5771.68,100,,,,,0,"fee schedule",EAPG,3105,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1170.59,37.7,,936.47,,,0,"percent of total billed charges","37.70% of total billed charges",3105,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3105,100,,,,,0,"fee schedule","100% of CMS fee schedule",2421.9,78,,1937.52,,,0,"percent of total billed charges","78% of total billed charges",3105,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2564.73,82.6,,2051.78,,,0,"percent of total billed charges","82.6% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,3105,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2564.73,82.6,,2051.78,,,0,"percent of total billed charges","82.6% of total billed charges",3105,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4600.28,100,,,,,0,"fee schedule",EAPG,3105,100,,2484.00,,,0,"percent of total billed charges","100% of total billed charges",475.07,5771.68,
"35531 Bypass graft, with vein; aortoceliac or aort",7963213,CDM,521,RC,35531,CPT,OUTPATIENT,,,8725,5671.25,,7678,88,,6142.40,,,0,"percent of total billed charges","88% of total billed charges",8725,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8725,175,,,,,0,"fee schedule","175% of CMS fee schedule",10944.37,100,,,,,0,"fee schedule",EAPG,8725,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5496.75,63,,4397.40,,,0,"percent of total billed charges","63% of total billed charges",1334.93,15.3,,1067.94,,,0,"percent of total billed charges","15.3% of total billed charges",10625.6,100,,,,,0,"fee schedule",EAPG,6020.25,69,,,,,0,"fee schedule","69% of total billed charges",8725,100,,6980.00,,,0,"percent of total billed charges","100% of total billed charges",8725,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8725,100,,6980.00,,,0,"percent of total billed charges","100% of total billed charges",8725,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8725,100,,6980.00,,,0,"percent of total billed charges","100% of total billed charges",8725,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8725,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,8725,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8725,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8725,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10838.11,100,,,,,0,"fee schedule",EAPG,13813.28,100,,,,,0,"fee schedule",EAPG,8725,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3289.33,37.7,,2631.46,,,0,"percent of total billed charges","37.70% of total billed charges",8725,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8725,100,,,,,0,"fee schedule","100% of CMS fee schedule",6805.5,78,,5444.40,,,0,"percent of total billed charges","78% of total billed charges",8725,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7206.85,82.6,,5765.48,,,0,"percent of total billed charges","82.6% of total billed charges",10625.6,100,,,,,0,"fee schedule","100% of WA fee schedule",8725,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7206.85,82.6,,5765.48,,,0,"percent of total billed charges","82.6% of total billed charges",8725,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10786.13,100,,,,,0,"fee schedule",EAPG,8725,100,,6980.00,,,0,"percent of total billed charges","100% of total billed charges",1334.93,13813.28,
"35556 Bypass graft, with vein; femoral-popliteal",7963545,CDM,521,RC,35556,CPT,OUTPATIENT,,,6050,3932.5,,5324,88,,4259.20,,,0,"percent of total billed charges","88% of total billed charges",6050,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4439.75,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6050,175,,,,,0,"fee schedule","175% of CMS fee schedule",4572.94,100,,,,,0,"fee schedule",EAPG,6050,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3811.5,63,,3049.20,,,0,"percent of total billed charges","63% of total billed charges",925.65,15.3,,740.52,,,0,"percent of total billed charges","15.3% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,4174.5,69,,,,,0,"fee schedule","69% of total billed charges",6050,100,,4840.00,,,0,"percent of total billed charges","100% of total billed charges",6050,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6050,100,,4840.00,,,0,"percent of total billed charges","100% of total billed charges",6050,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6050,100,,4840.00,,,0,"percent of total billed charges","100% of total billed charges",6050,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6050,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4439.75,100,,,,,0,"fee schedule",EAPG,6050,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6050,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6050,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4528.55,100,,,,,0,"fee schedule",EAPG,5771.68,100,,,,,0,"fee schedule",EAPG,6050,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2280.85,37.7,,1824.68,,,0,"percent of total billed charges","37.70% of total billed charges",6050,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6050,100,,,,,0,"fee schedule","100% of CMS fee schedule",4719,78,,3775.20,,,0,"percent of total billed charges","78% of total billed charges",6050,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4997.3,82.6,,3997.84,,,0,"percent of total billed charges","82.6% of total billed charges",4439.75,100,,,,,0,"fee schedule","100% of WA fee schedule",6050,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4997.3,82.6,,3997.84,,,0,"percent of total billed charges","82.6% of total billed charges",6050,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4600.28,100,,,,,0,"fee schedule",EAPG,6050,100,,4840.00,,,0,"percent of total billed charges","100% of total billed charges",925.65,6050,
"35558 Bypass graft, with vein; femoral-femoral",7963583,CDM,521,RC,35558,CPT,OUTPATIENT,,,5289,3437.85,,4654.32,88,,3723.46,,,0,"percent of total billed charges","88% of total billed charges",5289,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4439.75,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5289,175,,,,,0,"fee schedule","175% of CMS fee schedule",4572.94,100,,,,,0,"fee schedule",EAPG,5289,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3332.07,63,,2665.66,,,0,"percent of total billed charges","63% of total billed charges",809.22,15.3,,647.38,,,0,"percent of total billed charges","15.3% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,3649.41,69,,,,,0,"fee schedule","69% of total billed charges",5289,100,,4231.20,,,0,"percent of total billed charges","100% of total billed charges",5289,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5289,100,,4231.20,,,0,"percent of total billed charges","100% of total billed charges",5289,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5289,100,,4231.20,,,0,"percent of total billed charges","100% of total billed charges",5289,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5289,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4439.75,100,,,,,0,"fee schedule",EAPG,5289,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5289,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5289,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4528.55,100,,,,,0,"fee schedule",EAPG,5771.68,100,,,,,0,"fee schedule",EAPG,5289,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1993.95,37.7,,1595.16,,,0,"percent of total billed charges","37.70% of total billed charges",5289,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5289,100,,,,,0,"fee schedule","100% of CMS fee schedule",4125.42,78,,3300.34,,,0,"percent of total billed charges","78% of total billed charges",5289,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4368.71,82.6,,3494.97,,,0,"percent of total billed charges","82.6% of total billed charges",4439.75,100,,,,,0,"fee schedule","100% of WA fee schedule",5289,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4368.71,82.6,,3494.97,,,0,"percent of total billed charges","82.6% of total billed charges",5289,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4600.28,100,,,,,0,"fee schedule",EAPG,5289,100,,4231.20,,,0,"percent of total billed charges","100% of total billed charges",809.22,5771.68,
"35566 Bypass graft, with vein; femoral-anterior ti",7962372,CDM,521,RC,35566,CPT,OUTPATIENT,,,6846,4449.9,,6024.48,88,,4819.58,,,0,"percent of total billed charges","88% of total billed charges",6846,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4439.75,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6846,175,,,,,0,"fee schedule","175% of CMS fee schedule",4572.94,100,,,,,0,"fee schedule",EAPG,6846,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4312.98,63,,3450.38,,,0,"percent of total billed charges","63% of total billed charges",1047.44,15.3,,837.95,,,0,"percent of total billed charges","15.3% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,4723.74,69,,,,,0,"fee schedule","69% of total billed charges",6846,100,,5476.80,,,0,"percent of total billed charges","100% of total billed charges",6846,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6846,100,,5476.80,,,0,"percent of total billed charges","100% of total billed charges",6846,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6846,100,,5476.80,,,0,"percent of total billed charges","100% of total billed charges",6846,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6846,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4439.75,100,,,,,0,"fee schedule",EAPG,6846,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6846,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6846,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4528.55,100,,,,,0,"fee schedule",EAPG,5771.68,100,,,,,0,"fee schedule",EAPG,6846,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2580.94,37.7,,2064.75,,,0,"percent of total billed charges","37.70% of total billed charges",6846,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6846,100,,,,,0,"fee schedule","100% of CMS fee schedule",5339.88,78,,4271.90,,,0,"percent of total billed charges","78% of total billed charges",6846,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5654.8,82.6,,4523.84,,,0,"percent of total billed charges","82.6% of total billed charges",4439.75,100,,,,,0,"fee schedule","100% of WA fee schedule",6846,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5654.8,82.6,,4523.84,,,0,"percent of total billed charges","82.6% of total billed charges",6846,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4600.28,100,,,,,0,"fee schedule",EAPG,6846,100,,5476.80,,,0,"percent of total billed charges","100% of total billed charges",1047.44,6846,
"35565 Bypass graft, with vein; iliofemoral",7963658,CDM,521,RC,35565,CPT,OUTPATIENT,,,3917,2546.05,,3446.96,88,,2757.57,,,0,"percent of total billed charges","88% of total billed charges",3917,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,3917,100,,3133.60,,,0,"percent of total billed charges","100% of total billed charges",3917,175,,,,,0,"fee schedule","175% of CMS fee schedule",10944.37,100,,,,,0,"fee schedule",EAPG,3917,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2467.71,63,,1974.17,,,0,"percent of total billed charges","63% of total billed charges",599.3,15.3,,479.44,,,0,"percent of total billed charges","15.3% of total billed charges",10625.6,100,,,,,0,"fee schedule",EAPG,2702.73,69,,,,,0,"fee schedule","69% of total billed charges",3917,100,,3133.60,,,0,"percent of total billed charges","100% of total billed charges",3917,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3917,100,,3133.60,,,0,"percent of total billed charges","100% of total billed charges",3917,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3917,100,,3133.60,,,0,"percent of total billed charges","100% of total billed charges",3917,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3917,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,3917,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3917,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3917,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10838.11,100,,,,,0,"fee schedule",EAPG,13813.28,100,,,,,0,"fee schedule",EAPG,3917,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1476.71,37.7,,1181.37,,,0,"percent of total billed charges","37.70% of total billed charges",3917,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3917,100,,,,,0,"fee schedule","100% of CMS fee schedule",3055.26,78,,2444.21,,,0,"percent of total billed charges","78% of total billed charges",3917,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3235.44,82.6,,2588.35,,,0,"percent of total billed charges","82.6% of total billed charges",10625.6,100,,,,,0,"fee schedule","100% of WA fee schedule",3917,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3235.44,82.6,,2588.35,,,0,"percent of total billed charges","82.6% of total billed charges",3917,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10786.13,100,,,,,0,"fee schedule",EAPG,3917,100,,3133.60,,,0,"percent of total billed charges","100% of total billed charges",599.3,13813.28,
"35570 Bypass graft, with vein; tibial-tibial, pero",7961954,CDM,521,RC,35570,CPT,OUTPATIENT,,,6652,4323.8,,5853.76,88,,4683.01,,,0,"percent of total billed charges","88% of total billed charges",6652,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4439.75,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6652,175,,,,,0,"fee schedule","175% of CMS fee schedule",4572.94,100,,,,,0,"fee schedule",EAPG,6652,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4190.76,63,,3352.61,,,0,"percent of total billed charges","63% of total billed charges",1017.76,15.3,,814.21,,,0,"percent of total billed charges","15.3% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,4589.88,69,,,,,0,"fee schedule","69% of total billed charges",6652,100,,5321.60,,,0,"percent of total billed charges","100% of total billed charges",6652,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6652,100,,5321.60,,,0,"percent of total billed charges","100% of total billed charges",6652,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6652,100,,5321.60,,,0,"percent of total billed charges","100% of total billed charges",6652,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6652,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4439.75,100,,,,,0,"fee schedule",EAPG,6652,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6652,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6652,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4528.55,100,,,,,0,"fee schedule",EAPG,5771.68,100,,,,,0,"fee schedule",EAPG,6652,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2507.8,37.7,,2006.24,,,0,"percent of total billed charges","37.70% of total billed charges",6652,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6652,100,,,,,0,"fee schedule","100% of CMS fee schedule",5188.56,78,,4150.85,,,0,"percent of total billed charges","78% of total billed charges",6652,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5494.55,82.6,,4395.64,,,0,"percent of total billed charges","82.6% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,6652,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5494.55,82.6,,4395.64,,,0,"percent of total billed charges","82.6% of total billed charges",6652,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4600.28,100,,,,,0,"fee schedule",EAPG,6652,100,,5321.60,,,0,"percent of total billed charges","100% of total billed charges",1017.76,6652,
"35571 Bypass graft, with vein; popliteal-tibial, -",7962373,CDM,521,RC,35571,CPT,OUTPATIENT,,,6457,4197.05,,5682.16,88,,4545.73,,,0,"percent of total billed charges","88% of total billed charges",6457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4439.75,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6457,175,,,,,0,"fee schedule","175% of CMS fee schedule",4572.94,100,,,,,0,"fee schedule",EAPG,6457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4067.91,63,,3254.33,,,0,"percent of total billed charges","63% of total billed charges",987.92,15.3,,790.34,,,0,"percent of total billed charges","15.3% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,4455.33,69,,,,,0,"fee schedule","69% of total billed charges",6457,100,,5165.60,,,0,"percent of total billed charges","100% of total billed charges",6457,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6457,100,,5165.60,,,0,"percent of total billed charges","100% of total billed charges",6457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6457,100,,5165.60,,,0,"percent of total billed charges","100% of total billed charges",6457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4439.75,100,,,,,0,"fee schedule",EAPG,6457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4528.55,100,,,,,0,"fee schedule",EAPG,5771.68,100,,,,,0,"fee schedule",EAPG,6457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2434.29,37.7,,1947.43,,,0,"percent of total billed charges","37.70% of total billed charges",6457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6457,100,,,,,0,"fee schedule","100% of CMS fee schedule",5036.46,78,,4029.17,,,0,"percent of total billed charges","78% of total billed charges",6457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5333.48,82.6,,4266.78,,,0,"percent of total billed charges","82.6% of total billed charges",4439.75,100,,,,,0,"fee schedule","100% of WA fee schedule",6457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5333.48,82.6,,4266.78,,,0,"percent of total billed charges","82.6% of total billed charges",6457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4600.28,100,,,,,0,"fee schedule",EAPG,6457,100,,5165.60,,,0,"percent of total billed charges","100% of total billed charges",987.92,6457,
"35600 Harvest of upper extremity artery, 1 segment",7962415,CDM,521,RC,35600,CPT,OUTPATIENT,,,850,552.5,,748,88,,598.40,,,0,"percent of total billed charges","88% of total billed charges",850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,850,100,,680.00,,,0,"percent of total billed charges","100% of total billed charges",850,175,,,,,0,"fee schedule","175% of CMS fee schedule",20037.96,100,,,,,0,"fee schedule",EAPG,850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",535.5,63,,428.40,,,0,"percent of total billed charges","63% of total billed charges",130.05,15.3,,104.04,,,0,"percent of total billed charges","15.3% of total billed charges",19454.33,100,,,,,0,"fee schedule",EAPG,586.5,69,,,,,0,"fee schedule","69% of total billed charges",850,100,,680.00,,,0,"percent of total billed charges","100% of total billed charges",850,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",850,100,,680.00,,,0,"percent of total billed charges","100% of total billed charges",850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",850,100,,680.00,,,0,"percent of total billed charges","100% of total billed charges",850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19454.33,100,,,,,0,"fee schedule",EAPG,850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19843.41,100,,,,,0,"fee schedule",EAPG,25290.63,100,,,,,0,"fee schedule",EAPG,850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",320.45,37.7,,256.36,,,0,"percent of total billed charges","37.70% of total billed charges",850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",850,100,,,,,0,"fee schedule","100% of CMS fee schedule",663,78,,530.40,,,0,"percent of total billed charges","78% of total billed charges",850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",702.1,82.6,,561.68,,,0,"percent of total billed charges","82.6% of total billed charges",19454.33,100,,,,,0,"fee schedule","100% of WA fee schedule",850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",702.1,82.6,,561.68,,,0,"percent of total billed charges","82.6% of total billed charges",850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19614.86,100,,,,,0,"fee schedule",EAPG,850,100,,680.00,,,0,"percent of total billed charges","100% of total billed charges",130.05,25290.63,
"35606 Bypass graft, with other than vein; carotid-",7963283,CDM,521,RC,35606,CPT,OUTPATIENT,,,5528,3593.2,,4864.64,88,,3891.71,,,0,"percent of total billed charges","88% of total billed charges",5528,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4315.84,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5528,175,,,,,0,"fee schedule","175% of CMS fee schedule",4445.32,100,,,,,0,"fee schedule",EAPG,5528,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3482.64,63,,2786.11,,,0,"percent of total billed charges","63% of total billed charges",845.78,15.3,,676.62,,,0,"percent of total billed charges","15.3% of total billed charges",4315.84,100,,,,,0,"fee schedule",EAPG,3814.32,69,,,,,0,"fee schedule","69% of total billed charges",5528,100,,4422.40,,,0,"percent of total billed charges","100% of total billed charges",5528,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5528,100,,4422.40,,,0,"percent of total billed charges","100% of total billed charges",5528,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5528,100,,4422.40,,,0,"percent of total billed charges","100% of total billed charges",5528,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5528,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4315.84,100,,,,,0,"fee schedule",EAPG,5528,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5528,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5528,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4402.16,100,,,,,0,"fee schedule",EAPG,5610.6,100,,,,,0,"fee schedule",EAPG,5528,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2084.06,37.7,,1667.25,,,0,"percent of total billed charges","37.70% of total billed charges",5528,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5528,100,,,,,0,"fee schedule","100% of CMS fee schedule",4311.84,78,,3449.47,,,0,"percent of total billed charges","78% of total billed charges",5528,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4566.13,82.6,,3652.90,,,0,"percent of total billed charges","82.6% of total billed charges",4315.84,100,,,,,0,"fee schedule","100% of WA fee schedule",5528,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4566.13,82.6,,3652.90,,,0,"percent of total billed charges","82.6% of total billed charges",5528,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4476.37,100,,,,,0,"fee schedule",EAPG,5528,100,,4422.40,,,0,"percent of total billed charges","100% of total billed charges",845.78,5610.6,
"35631 Bypass graft, with other than vein; aortocel",7962613,CDM,521,RC,35631,CPT,OUTPATIENT,,,6819,4432.35,,6000.72,88,,4800.58,,,0,"percent of total billed charges","88% of total billed charges",6819,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6819,175,,,,,0,"fee schedule","175% of CMS fee schedule",10944.37,100,,,,,0,"fee schedule",EAPG,6819,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4295.97,63,,3436.78,,,0,"percent of total billed charges","63% of total billed charges",1043.31,15.3,,834.65,,,0,"percent of total billed charges","15.3% of total billed charges",10625.6,100,,,,,0,"fee schedule",EAPG,4705.11,69,,,,,0,"fee schedule","69% of total billed charges",6819,100,,5455.20,,,0,"percent of total billed charges","100% of total billed charges",6819,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6819,100,,5455.20,,,0,"percent of total billed charges","100% of total billed charges",6819,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6819,100,,5455.20,,,0,"percent of total billed charges","100% of total billed charges",6819,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6819,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,6819,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6819,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6819,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10838.11,100,,,,,0,"fee schedule",EAPG,13813.28,100,,,,,0,"fee schedule",EAPG,6819,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2570.76,37.7,,2056.61,,,0,"percent of total billed charges","37.70% of total billed charges",6819,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6819,100,,,,,0,"fee schedule","100% of CMS fee schedule",5318.82,78,,4255.06,,,0,"percent of total billed charges","78% of total billed charges",6819,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5632.49,82.6,,4505.99,,,0,"percent of total billed charges","82.6% of total billed charges",10625.6,100,,,,,0,"fee schedule","100% of WA fee schedule",6819,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5632.49,82.6,,4505.99,,,0,"percent of total billed charges","82.6% of total billed charges",6819,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10786.13,100,,,,,0,"fee schedule",EAPG,6819,100,,5455.20,,,0,"percent of total billed charges","100% of total billed charges",1043.31,13813.28,
"35637 Bypass graft, with other than vein; aortoili",7963465,CDM,521,RC,35637,CPT,OUTPATIENT,,,5149,3346.85,,4531.12,88,,3624.90,,,0,"percent of total billed charges","88% of total billed charges",5149,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5149,175,,,,,0,"fee schedule","175% of CMS fee schedule",10944.37,100,,,,,0,"fee schedule",EAPG,5149,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3243.87,63,,2595.10,,,0,"percent of total billed charges","63% of total billed charges",787.8,15.3,,630.24,,,0,"percent of total billed charges","15.3% of total billed charges",10625.6,100,,,,,0,"fee schedule",EAPG,3552.81,69,,,,,0,"fee schedule","69% of total billed charges",5149,100,,4119.20,,,0,"percent of total billed charges","100% of total billed charges",5149,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5149,100,,4119.20,,,0,"percent of total billed charges","100% of total billed charges",5149,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5149,100,,4119.20,,,0,"percent of total billed charges","100% of total billed charges",5149,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5149,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,5149,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5149,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5149,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10838.11,100,,,,,0,"fee schedule",EAPG,13813.28,100,,,,,0,"fee schedule",EAPG,5149,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1941.17,37.7,,1552.94,,,0,"percent of total billed charges","37.70% of total billed charges",5149,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5149,100,,,,,0,"fee schedule","100% of CMS fee schedule",4016.22,78,,3212.98,,,0,"percent of total billed charges","78% of total billed charges",5149,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4253.07,82.6,,3402.46,,,0,"percent of total billed charges","82.6% of total billed charges",10625.6,100,,,,,0,"fee schedule","100% of WA fee schedule",5149,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4253.07,82.6,,3402.46,,,0,"percent of total billed charges","82.6% of total billed charges",5149,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10786.13,100,,,,,0,"fee schedule",EAPG,5149,100,,4119.20,,,0,"percent of total billed charges","100% of total billed charges",787.8,13813.28,
"35634 Bypass graft, with other than vein; iliorena",7963495,CDM,521,RC,35634,CPT,OUTPATIENT,,,5980,3887,,5262.4,88,,4209.92,,,0,"percent of total billed charges","88% of total billed charges",5980,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5980,175,,,,,0,"fee schedule","175% of CMS fee schedule",10944.37,100,,,,,0,"fee schedule",EAPG,5980,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3767.4,63,,3013.92,,,0,"percent of total billed charges","63% of total billed charges",914.94,15.3,,731.95,,,0,"percent of total billed charges","15.3% of total billed charges",10625.6,100,,,,,0,"fee schedule",EAPG,4126.2,69,,,,,0,"fee schedule","69% of total billed charges",5980,100,,4784.00,,,0,"percent of total billed charges","100% of total billed charges",5980,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5980,100,,4784.00,,,0,"percent of total billed charges","100% of total billed charges",5980,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5980,100,,4784.00,,,0,"percent of total billed charges","100% of total billed charges",5980,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5980,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,5980,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5980,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5980,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10838.11,100,,,,,0,"fee schedule",EAPG,13813.28,100,,,,,0,"fee schedule",EAPG,5980,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2254.46,37.7,,1803.57,,,0,"percent of total billed charges","37.70% of total billed charges",5980,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5980,100,,,,,0,"fee schedule","100% of CMS fee schedule",4664.4,78,,3731.52,,,0,"percent of total billed charges","78% of total billed charges",5980,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4939.48,82.6,,3951.58,,,0,"percent of total billed charges","82.6% of total billed charges",10625.6,100,,,,,0,"fee schedule","100% of WA fee schedule",5980,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4939.48,82.6,,3951.58,,,0,"percent of total billed charges","82.6% of total billed charges",5980,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10786.13,100,,,,,0,"fee schedule",EAPG,5980,100,,4784.00,,,0,"percent of total billed charges","100% of total billed charges",914.94,13813.28,
"35646 Bypass graft, with other than vein; aortobif",7963383,CDM,521,RC,35646,CPT,OUTPATIENT,,,7753,5039.45,,6822.64,88,,5458.11,,,0,"percent of total billed charges","88% of total billed charges",7753,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7753,175,,,,,0,"fee schedule","175% of CMS fee schedule",10944.37,100,,,,,0,"fee schedule",EAPG,7753,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4884.39,63,,3907.51,,,0,"percent of total billed charges","63% of total billed charges",1186.21,15.3,,948.97,,,0,"percent of total billed charges","15.3% of total billed charges",10625.6,100,,,,,0,"fee schedule",EAPG,5349.57,69,,,,,0,"fee schedule","69% of total billed charges",7753,100,,6202.40,,,0,"percent of total billed charges","100% of total billed charges",7753,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7753,100,,6202.40,,,0,"percent of total billed charges","100% of total billed charges",7753,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7753,100,,6202.40,,,0,"percent of total billed charges","100% of total billed charges",7753,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7753,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,7753,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7753,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7753,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10838.11,100,,,,,0,"fee schedule",EAPG,13813.28,100,,,,,0,"fee schedule",EAPG,7753,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2922.88,37.7,,2338.30,,,0,"percent of total billed charges","37.70% of total billed charges",7753,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7753,100,,,,,0,"fee schedule","100% of CMS fee schedule",6047.34,78,,4837.87,,,0,"percent of total billed charges","78% of total billed charges",7753,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6403.98,82.6,,5123.18,,,0,"percent of total billed charges","82.6% of total billed charges",10625.6,100,,,,,0,"fee schedule","100% of WA fee schedule",7753,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6403.98,82.6,,5123.18,,,0,"percent of total billed charges","82.6% of total billed charges",7753,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10786.13,100,,,,,0,"fee schedule",EAPG,7753,100,,6202.40,,,0,"percent of total billed charges","100% of total billed charges",1186.21,13813.28,
"35647 Bypass graft, with other than vein; aortofem",7963425,CDM,521,RC,35647,CPT,OUTPATIENT,,,6850,4452.5,,6028,88,,4822.40,,,0,"percent of total billed charges","88% of total billed charges",6850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4439.75,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6850,175,,,,,0,"fee schedule","175% of CMS fee schedule",4572.94,100,,,,,0,"fee schedule",EAPG,6850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4315.5,63,,3452.40,,,0,"percent of total billed charges","63% of total billed charges",1048.05,15.3,,838.44,,,0,"percent of total billed charges","15.3% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,4726.5,69,,,,,0,"fee schedule","69% of total billed charges",6850,100,,5480.00,,,0,"percent of total billed charges","100% of total billed charges",6850,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6850,100,,5480.00,,,0,"percent of total billed charges","100% of total billed charges",6850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6850,100,,5480.00,,,0,"percent of total billed charges","100% of total billed charges",6850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4439.75,100,,,,,0,"fee schedule",EAPG,6850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4528.55,100,,,,,0,"fee schedule",EAPG,5771.68,100,,,,,0,"fee schedule",EAPG,6850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2582.45,37.7,,2065.96,,,0,"percent of total billed charges","37.70% of total billed charges",6850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6850,100,,,,,0,"fee schedule","100% of CMS fee schedule",5343,78,,4274.40,,,0,"percent of total billed charges","78% of total billed charges",6850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5658.1,82.6,,4526.48,,,0,"percent of total billed charges","82.6% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,6850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5658.1,82.6,,4526.48,,,0,"percent of total billed charges","82.6% of total billed charges",6850,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4600.28,100,,,,,0,"fee schedule",EAPG,6850,100,,5480.00,,,0,"percent of total billed charges","100% of total billed charges",1048.05,6850,
"35654 Bypass graft, with other than vein; axillary",7963109,CDM,521,RC,35654,CPT,OUTPATIENT,,,6190,4023.5,,5447.2,88,,4357.76,,,0,"percent of total billed charges","88% of total billed charges",6190,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6190,175,,,,,0,"fee schedule","175% of CMS fee schedule",10944.37,100,,,,,0,"fee schedule",EAPG,6190,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3899.7,63,,3119.76,,,0,"percent of total billed charges","63% of total billed charges",947.07,15.3,,757.66,,,0,"percent of total billed charges","15.3% of total billed charges",10625.6,100,,,,,0,"fee schedule",EAPG,4271.1,69,,,,,0,"fee schedule","69% of total billed charges",6190,100,,4952.00,,,0,"percent of total billed charges","100% of total billed charges",6190,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6190,100,,4952.00,,,0,"percent of total billed charges","100% of total billed charges",6190,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6190,100,,4952.00,,,0,"percent of total billed charges","100% of total billed charges",6190,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6190,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,6190,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6190,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6190,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10838.11,100,,,,,0,"fee schedule",EAPG,13813.28,100,,,,,0,"fee schedule",EAPG,6190,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2333.63,37.7,,1866.90,,,0,"percent of total billed charges","37.70% of total billed charges",6190,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6190,100,,,,,0,"fee schedule","100% of CMS fee schedule",4828.2,78,,3862.56,,,0,"percent of total billed charges","78% of total billed charges",6190,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5112.94,82.6,,4090.35,,,0,"percent of total billed charges","82.6% of total billed charges",10625.6,100,,,,,0,"fee schedule","100% of WA fee schedule",6190,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5112.94,82.6,,4090.35,,,0,"percent of total billed charges","82.6% of total billed charges",6190,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10786.13,100,,,,,0,"fee schedule",EAPG,6190,100,,4952.00,,,0,"percent of total billed charges","100% of total billed charges",947.07,13813.28,
"35650 Bypass graft, with other than vein; axillary",7963305,CDM,521,RC,35650,CPT,OUTPATIENT,,,5013,3258.45,,4411.44,88,,3529.15,,,0,"percent of total billed charges","88% of total billed charges",5013,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4439.75,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5013,175,,,,,0,"fee schedule","175% of CMS fee schedule",4572.94,100,,,,,0,"fee schedule",EAPG,5013,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3158.19,63,,2526.55,,,0,"percent of total billed charges","63% of total billed charges",766.99,15.3,,613.59,,,0,"percent of total billed charges","15.3% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,3458.97,69,,,,,0,"fee schedule","69% of total billed charges",5013,100,,4010.40,,,0,"percent of total billed charges","100% of total billed charges",5013,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5013,100,,4010.40,,,0,"percent of total billed charges","100% of total billed charges",5013,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5013,100,,4010.40,,,0,"percent of total billed charges","100% of total billed charges",5013,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5013,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4439.75,100,,,,,0,"fee schedule",EAPG,5013,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5013,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5013,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4528.55,100,,,,,0,"fee schedule",EAPG,5771.68,100,,,,,0,"fee schedule",EAPG,5013,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1889.9,37.7,,1511.92,,,0,"percent of total billed charges","37.70% of total billed charges",5013,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5013,100,,,,,0,"fee schedule","100% of CMS fee schedule",3910.14,78,,3128.11,,,0,"percent of total billed charges","78% of total billed charges",5013,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4140.74,82.6,,3312.59,,,0,"percent of total billed charges","82.6% of total billed charges",4439.75,100,,,,,0,"fee schedule","100% of WA fee schedule",5013,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4140.74,82.6,,3312.59,,,0,"percent of total billed charges","82.6% of total billed charges",5013,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4600.28,100,,,,,0,"fee schedule",EAPG,5013,100,,4010.40,,,0,"percent of total billed charges","100% of total billed charges",766.99,5771.68,
"35656 Bypass graft, with other than vein; femoral-",7963306,CDM,521,RC,35656,CPT,OUTPATIENT,,,5491,3569.15,,4832.08,88,,3865.66,,,0,"percent of total billed charges","88% of total billed charges",5491,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4439.75,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5491,175,,,,,0,"fee schedule","175% of CMS fee schedule",4572.94,100,,,,,0,"fee schedule",EAPG,5491,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3459.33,63,,2767.46,,,0,"percent of total billed charges","63% of total billed charges",840.12,15.3,,672.10,,,0,"percent of total billed charges","15.3% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,3788.79,69,,,,,0,"fee schedule","69% of total billed charges",5491,100,,4392.80,,,0,"percent of total billed charges","100% of total billed charges",5491,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5491,100,,4392.80,,,0,"percent of total billed charges","100% of total billed charges",5491,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5491,100,,4392.80,,,0,"percent of total billed charges","100% of total billed charges",5491,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5491,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4439.75,100,,,,,0,"fee schedule",EAPG,5491,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5491,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5491,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4528.55,100,,,,,0,"fee schedule",EAPG,5771.68,100,,,,,0,"fee schedule",EAPG,5491,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2070.11,37.7,,1656.09,,,0,"percent of total billed charges","37.70% of total billed charges",5491,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5491,100,,,,,0,"fee schedule","100% of CMS fee schedule",4282.98,78,,3426.38,,,0,"percent of total billed charges","78% of total billed charges",5491,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4535.57,82.6,,3628.46,,,0,"percent of total billed charges","82.6% of total billed charges",4439.75,100,,,,,0,"fee schedule","100% of WA fee schedule",5491,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4535.57,82.6,,3628.46,,,0,"percent of total billed charges","82.6% of total billed charges",5491,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4600.28,100,,,,,0,"fee schedule",EAPG,5491,100,,4392.80,,,0,"percent of total billed charges","100% of total billed charges",840.12,5771.68,
"35666 Bypass graft, other than vein; femoral-anter",7961689,CDM,521,RC,35666,CPT,OUTPATIENT,,,6126,3981.9,,5390.88,88,,4312.70,,,0,"percent of total billed charges","88% of total billed charges",6126,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4439.75,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6126,175,,,,,0,"fee schedule","175% of CMS fee schedule",4572.94,100,,,,,0,"fee schedule",EAPG,6126,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3859.38,63,,3087.50,,,0,"percent of total billed charges","63% of total billed charges",937.28,15.3,,749.82,,,0,"percent of total billed charges","15.3% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,4226.94,69,,,,,0,"fee schedule","69% of total billed charges",6126,100,,4900.80,,,0,"percent of total billed charges","100% of total billed charges",6126,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6126,100,,4900.80,,,0,"percent of total billed charges","100% of total billed charges",6126,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6126,100,,4900.80,,,0,"percent of total billed charges","100% of total billed charges",6126,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6126,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4439.75,100,,,,,0,"fee schedule",EAPG,6126,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6126,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6126,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4528.55,100,,,,,0,"fee schedule",EAPG,5771.68,100,,,,,0,"fee schedule",EAPG,6126,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2309.5,37.7,,1847.60,,,0,"percent of total billed charges","37.70% of total billed charges",6126,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6126,100,,,,,0,"fee schedule","100% of CMS fee schedule",4778.28,78,,3822.62,,,0,"percent of total billed charges","78% of total billed charges",6126,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5060.08,82.6,,4048.06,,,0,"percent of total billed charges","82.6% of total billed charges",4439.75,100,,,,,0,"fee schedule","100% of WA fee schedule",6126,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5060.08,82.6,,4048.06,,,0,"percent of total billed charges","82.6% of total billed charges",6126,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4600.28,100,,,,,0,"fee schedule",EAPG,6126,100,,4900.80,,,0,"percent of total billed charges","100% of total billed charges",937.28,6126,
"35661 Bypass graft, with other than vein; femoral-",7963364,CDM,521,RC,35661,CPT,OUTPATIENT,,,4864,3161.6,,4280.32,88,,3424.26,,,0,"percent of total billed charges","88% of total billed charges",4864,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4439.75,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",4864,175,,,,,0,"fee schedule","175% of CMS fee schedule",4572.94,100,,,,,0,"fee schedule",EAPG,4864,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3064.32,63,,2451.46,,,0,"percent of total billed charges","63% of total billed charges",744.19,15.3,,595.35,,,0,"percent of total billed charges","15.3% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,3356.16,69,,,,,0,"fee schedule","69% of total billed charges",4864,100,,3891.20,,,0,"percent of total billed charges","100% of total billed charges",4864,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4864,100,,3891.20,,,0,"percent of total billed charges","100% of total billed charges",4864,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4864,100,,3891.20,,,0,"percent of total billed charges","100% of total billed charges",4864,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4864,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4439.75,100,,,,,0,"fee schedule",EAPG,4864,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4864,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4864,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4528.55,100,,,,,0,"fee schedule",EAPG,5771.68,100,,,,,0,"fee schedule",EAPG,4864,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1833.73,37.7,,1466.98,,,0,"percent of total billed charges","37.70% of total billed charges",4864,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4864,100,,,,,0,"fee schedule","100% of CMS fee schedule",3793.92,78,,3035.14,,,0,"percent of total billed charges","78% of total billed charges",4864,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4017.66,82.6,,3214.13,,,0,"percent of total billed charges","82.6% of total billed charges",4439.75,100,,,,,0,"fee schedule","100% of WA fee schedule",4864,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4017.66,82.6,,3214.13,,,0,"percent of total billed charges","82.6% of total billed charges",4864,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4600.28,100,,,,,0,"fee schedule",EAPG,4864,100,,3891.20,,,0,"percent of total billed charges","100% of total billed charges",744.19,5771.68,
"35665 Bypass graft, with other than vein; iliofemo",7963449,CDM,521,RC,35665,CPT,OUTPATIENT,,,5638,3664.7,,4961.44,88,,3969.15,,,0,"percent of total billed charges","88% of total billed charges",5638,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4439.75,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5638,175,,,,,0,"fee schedule","175% of CMS fee schedule",4572.94,100,,,,,0,"fee schedule",EAPG,5638,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3551.94,63,,2841.55,,,0,"percent of total billed charges","63% of total billed charges",862.61,15.3,,690.09,,,0,"percent of total billed charges","15.3% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,3890.22,69,,,,,0,"fee schedule","69% of total billed charges",5638,100,,4510.40,,,0,"percent of total billed charges","100% of total billed charges",5638,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5638,100,,4510.40,,,0,"percent of total billed charges","100% of total billed charges",5638,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5638,100,,4510.40,,,0,"percent of total billed charges","100% of total billed charges",5638,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5638,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4439.75,100,,,,,0,"fee schedule",EAPG,5638,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5638,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5638,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4528.55,100,,,,,0,"fee schedule",EAPG,5771.68,100,,,,,0,"fee schedule",EAPG,5638,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2125.53,37.7,,1700.42,,,0,"percent of total billed charges","37.70% of total billed charges",5638,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5638,100,,,,,0,"fee schedule","100% of CMS fee schedule",4397.64,78,,3518.11,,,0,"percent of total billed charges","78% of total billed charges",5638,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4656.99,82.6,,3725.59,,,0,"percent of total billed charges","82.6% of total billed charges",4439.75,100,,,,,0,"fee schedule","100% of WA fee schedule",5638,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4656.99,82.6,,3725.59,,,0,"percent of total billed charges","82.6% of total billed charges",5638,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4600.28,100,,,,,0,"fee schedule",EAPG,5638,100,,4510.40,,,0,"percent of total billed charges","100% of total billed charges",862.61,5771.68,
"35685 Placement of vein patch or cuff at distal an",7961992,CDM,521,RC,35685,CPT,OUTPATIENT,,,582,378.3,,512.16,88,,409.73,,,0,"percent of total billed charges","88% of total billed charges",291,50,,232.80,,,0,"percent of total billed charges","50% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,582,100,,465.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4572.94,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",366.66,63,,293.33,,,0,"percent of total billed charges","63% of total billed charges",89.05,15.3,,71.24,,,0,"percent of total billed charges","15.3% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,401.58,69,,,,,0,"fee schedule","69% of total billed charges",582,100,,465.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",582,100,,465.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",582,100,,465.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.97,61.85,,287.98,,,0,"percent of total billed charges","61.5% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,291,50,,232.80,,,0,"percent of total billed charges","50% of total billed charges",187.4,32.2,,149.92,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4528.55,100,,,,,0,"fee schedule",EAPG,5771.68,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",219.41,37.7,,175.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",453.96,78,,363.17,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",480.73,82.6,,384.58,,,0,"percent of total billed charges","82.6% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,291,50,,232.80,,,0,"percent of total billed charges","50% of total billed charges",480.73,82.6,,384.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4600.28,100,,,,,0,"fee schedule",EAPG,582,100,,465.60,,,0,"percent of total billed charges","100% of total billed charges",89.05,5771.68,
"35683 Bypass graft; autogenous composite, 3 or mor",7962184,CDM,521,RC,35683,CPT,OUTPATIENT,,,1830,1189.5,,1610.4,88,,1288.32,,,0,"percent of total billed charges","88% of total billed charges",1830,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4439.75,100,,,,,0,"fee schedule",EAPG,1830,100,,1464.00,,,0,"percent of total billed charges","100% of total billed charges",1830,175,,,,,0,"fee schedule","175% of CMS fee schedule",4572.94,100,,,,,0,"fee schedule",EAPG,1830,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1152.9,63,,922.32,,,0,"percent of total billed charges","63% of total billed charges",279.99,15.3,,223.99,,,0,"percent of total billed charges","15.3% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,1262.7,69,,,,,0,"fee schedule","69% of total billed charges",1830,100,,1464.00,,,0,"percent of total billed charges","100% of total billed charges",1830,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1830,100,,1464.00,,,0,"percent of total billed charges","100% of total billed charges",1830,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1830,100,,1464.00,,,0,"percent of total billed charges","100% of total billed charges",1830,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1830,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4439.75,100,,,,,0,"fee schedule",EAPG,1830,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1830,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1830,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4528.55,100,,,,,0,"fee schedule",EAPG,5771.68,100,,,,,0,"fee schedule",EAPG,1830,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",689.91,37.7,,551.93,,,0,"percent of total billed charges","37.70% of total billed charges",1830,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1830,100,,,,,0,"fee schedule","100% of CMS fee schedule",1427.4,78,,1141.92,,,0,"percent of total billed charges","78% of total billed charges",1830,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1511.58,82.6,,1209.26,,,0,"percent of total billed charges","82.6% of total billed charges",4439.75,100,,,,,0,"fee schedule","100% of WA fee schedule",1830,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1511.58,82.6,,1209.26,,,0,"percent of total billed charges","82.6% of total billed charges",1830,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4600.28,100,,,,,0,"fee schedule",EAPG,1830,100,,1464.00,,,0,"percent of total billed charges","100% of total billed charges",279.99,5771.68,
"35682 Bypass graft; autogenous composite, 2 segmen",7962745,CDM,521,RC,35682,CPT,OUTPATIENT,,,1847,1200.55,,1625.36,88,,1300.29,,,0,"percent of total billed charges","88% of total billed charges",1847,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4439.75,100,,,,,0,"fee schedule",EAPG,1847,100,,1477.60,,,0,"percent of total billed charges","100% of total billed charges",1847,175,,,,,0,"fee schedule","175% of CMS fee schedule",4572.94,100,,,,,0,"fee schedule",EAPG,1847,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1163.61,63,,930.89,,,0,"percent of total billed charges","63% of total billed charges",282.59,15.3,,226.07,,,0,"percent of total billed charges","15.3% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,1274.43,69,,,,,0,"fee schedule","69% of total billed charges",1847,100,,1477.60,,,0,"percent of total billed charges","100% of total billed charges",1847,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1847,100,,1477.60,,,0,"percent of total billed charges","100% of total billed charges",1847,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1847,100,,1477.60,,,0,"percent of total billed charges","100% of total billed charges",1847,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1847,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4439.75,100,,,,,0,"fee schedule",EAPG,1847,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1847,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1847,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4528.55,100,,,,,0,"fee schedule",EAPG,5771.68,100,,,,,0,"fee schedule",EAPG,1847,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",696.32,37.7,,557.06,,,0,"percent of total billed charges","37.70% of total billed charges",1847,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1847,100,,,,,0,"fee schedule","100% of CMS fee schedule",1440.66,78,,1152.53,,,0,"percent of total billed charges","78% of total billed charges",1847,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1525.62,82.6,,1220.50,,,0,"percent of total billed charges","82.6% of total billed charges",4439.75,100,,,,,0,"fee schedule","100% of WA fee schedule",1847,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1525.62,82.6,,1220.50,,,0,"percent of total billed charges","82.6% of total billed charges",1847,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4600.28,100,,,,,0,"fee schedule",EAPG,1847,100,,1477.60,,,0,"percent of total billed charges","100% of total billed charges",282.59,5771.68,
"35697 Reimplantation, visceral artery to infrarena",7962603,CDM,521,RC,35697,CPT,OUTPATIENT,,,667,433.55,,586.96,88,,469.57,,,0,"percent of total billed charges","88% of total billed charges",667,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3301.11,100,,,,,0,"fee schedule",EAPG,667,100,,533.60,,,0,"percent of total billed charges","100% of total billed charges",667,175,,,,,0,"fee schedule","175% of CMS fee schedule",3400.14,100,,,,,0,"fee schedule",EAPG,667,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",420.21,63,,336.17,,,0,"percent of total billed charges","63% of total billed charges",102.05,15.3,,81.64,,,0,"percent of total billed charges","15.3% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,460.23,69,,,,,0,"fee schedule","69% of total billed charges",667,100,,533.60,,,0,"percent of total billed charges","100% of total billed charges",667,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",667,100,,533.60,,,0,"percent of total billed charges","100% of total billed charges",667,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",667,100,,533.60,,,0,"percent of total billed charges","100% of total billed charges",667,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",667,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3301.11,100,,,,,0,"fee schedule",EAPG,667,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",667,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",667,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3367.13,100,,,,,0,"fee schedule",EAPG,4291.45,100,,,,,0,"fee schedule",EAPG,667,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",251.46,37.7,,201.17,,,0,"percent of total billed charges","37.70% of total billed charges",667,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",667,100,,,,,0,"fee schedule","100% of CMS fee schedule",520.26,78,,416.21,,,0,"percent of total billed charges","78% of total billed charges",667,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",550.94,82.6,,440.75,,,0,"percent of total billed charges","82.6% of total billed charges",3301.11,100,,,,,0,"fee schedule","100% of WA fee schedule",667,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",550.94,82.6,,440.75,,,0,"percent of total billed charges","82.6% of total billed charges",667,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3461.64,100,,,,,0,"fee schedule",EAPG,667,100,,533.60,,,0,"percent of total billed charges","100% of total billed charges",102.05,4291.45,
"35700 Reoperation, distal vessels, more than 1 mon",7962780,CDM,521,RC,35700,CPT,OUTPATIENT,,,876,569.4,,770.88,88,,616.70,,,0,"percent of total billed charges","88% of total billed charges",876,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3301.11,100,,,,,0,"fee schedule",EAPG,876,100,,700.80,,,0,"percent of total billed charges","100% of total billed charges",876,175,,,,,0,"fee schedule","175% of CMS fee schedule",3400.14,100,,,,,0,"fee schedule",EAPG,876,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",551.88,63,,441.50,,,0,"percent of total billed charges","63% of total billed charges",134.03,15.3,,107.22,,,0,"percent of total billed charges","15.3% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,604.44,69,,,,,0,"fee schedule","69% of total billed charges",876,100,,700.80,,,0,"percent of total billed charges","100% of total billed charges",876,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",876,100,,700.80,,,0,"percent of total billed charges","100% of total billed charges",876,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",876,100,,700.80,,,0,"percent of total billed charges","100% of total billed charges",876,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",876,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3301.11,100,,,,,0,"fee schedule",EAPG,876,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",876,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",876,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3367.13,100,,,,,0,"fee schedule",EAPG,4291.45,100,,,,,0,"fee schedule",EAPG,876,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",330.25,37.7,,264.20,,,0,"percent of total billed charges","37.70% of total billed charges",876,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",876,100,,,,,0,"fee schedule","100% of CMS fee schedule",683.28,78,,546.62,,,0,"percent of total billed charges","78% of total billed charges",876,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",723.58,82.6,,578.86,,,0,"percent of total billed charges","82.6% of total billed charges",3301.11,100,,,,,0,"fee schedule","100% of WA fee schedule",876,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",723.58,82.6,,578.86,,,0,"percent of total billed charges","82.6% of total billed charges",876,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3461.64,100,,,,,0,"fee schedule",EAPG,876,100,,700.80,,,0,"percent of total billed charges","100% of total billed charges",134.03,4291.45,
"35701 Exploration, with or without lysis of artery",7963110,CDM,521,RC,35701,CPT,OUTPATIENT,,,2279,1481.35,,2005.52,88,,1604.42,,,0,"percent of total billed charges","88% of total billed charges",2279,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4315.84,100,,,,,0,"fee schedule",EAPG,2279,100,,1823.20,,,0,"percent of total billed charges","100% of total billed charges",2279,175,,,,,0,"fee schedule","175% of CMS fee schedule",4445.32,100,,,,,0,"fee schedule",EAPG,2279,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1435.77,63,,1148.62,,,0,"percent of total billed charges","63% of total billed charges",348.69,15.3,,278.95,,,0,"percent of total billed charges","15.3% of total billed charges",4315.84,100,,,,,0,"fee schedule",EAPG,1572.51,69,,,,,0,"fee schedule","69% of total billed charges",2279,100,,1823.20,,,0,"percent of total billed charges","100% of total billed charges",2279,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2279,100,,1823.20,,,0,"percent of total billed charges","100% of total billed charges",2279,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2279,100,,1823.20,,,0,"percent of total billed charges","100% of total billed charges",2279,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2279,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4315.84,100,,,,,0,"fee schedule",EAPG,2279,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2279,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2279,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4402.16,100,,,,,0,"fee schedule",EAPG,5610.6,100,,,,,0,"fee schedule",EAPG,2279,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",859.18,37.7,,687.34,,,0,"percent of total billed charges","37.70% of total billed charges",2279,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2279,100,,,,,0,"fee schedule","100% of CMS fee schedule",1777.62,78,,1422.10,,,0,"percent of total billed charges","78% of total billed charges",2279,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1882.45,82.6,,1505.96,,,0,"percent of total billed charges","82.6% of total billed charges",4315.84,100,,,,,0,"fee schedule",EAPG,2279,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1882.45,82.6,,1505.96,,,0,"percent of total billed charges","82.6% of total billed charges",2279,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4476.37,100,,,,,0,"fee schedule",EAPG,2279,100,,1823.20,,,0,"percent of total billed charges","100% of total billed charges",348.69,5610.6,
"35702 Exploration w/o surgical repair, artery; upp",7963111,CDM,521,RC,35702,CPT,OUTPATIENT,,,2013,1308.45,,1771.44,88,,1417.15,,,0,"percent of total billed charges","88% of total billed charges",2013,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3301.11,100,,,,,0,"fee schedule",EAPG,2013,100,,1610.40,,,0,"percent of total billed charges","100% of total billed charges",2013,175,,,,,0,"fee schedule","175% of CMS fee schedule",3400.14,100,,,,,0,"fee schedule",EAPG,2013,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1268.19,63,,1014.55,,,0,"percent of total billed charges","63% of total billed charges",307.99,15.3,,246.39,,,0,"percent of total billed charges","15.3% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,1388.97,69,,,,,0,"fee schedule","69% of total billed charges",2013,100,,1610.40,,,0,"percent of total billed charges","100% of total billed charges",2013,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2013,100,,1610.40,,,0,"percent of total billed charges","100% of total billed charges",2013,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2013,100,,1610.40,,,0,"percent of total billed charges","100% of total billed charges",2013,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2013,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3301.11,100,,,,,0,"fee schedule",EAPG,2013,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2013,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2013,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3367.13,100,,,,,0,"fee schedule",EAPG,4291.45,100,,,,,0,"fee schedule",EAPG,2013,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",758.9,37.7,,607.12,,,0,"percent of total billed charges","37.70% of total billed charges",2013,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2013,100,,,,,0,"fee schedule","100% of CMS fee schedule",1570.14,78,,1256.11,,,0,"percent of total billed charges","78% of total billed charges",2013,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1662.74,82.6,,1330.19,,,0,"percent of total billed charges","82.6% of total billed charges",3301.11,100,,,,,0,"fee schedule","100% of WA fee schedule",2013,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1662.74,82.6,,1330.19,,,0,"percent of total billed charges","82.6% of total billed charges",2013,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3461.64,100,,,,,0,"fee schedule",EAPG,2013,100,,1610.40,,,0,"percent of total billed charges","100% of total billed charges",307.99,4291.45,
"35761 Exploration, with or without lysis of artery",7903316,CDM,521,RC,35703,CPT,OUTPATIENT,,,1673,1087.45,,1472.24,88,,1177.79,,,0,"percent of total billed charges","88% of total billed charges",1673,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3301.11,100,,,,,0,"fee schedule",EAPG,1673,100,,1338.40,,,0,"percent of total billed charges","100% of total billed charges",1673,175,,,,,0,"fee schedule","175% of CMS fee schedule",3400.14,100,,,,,0,"fee schedule",EAPG,1673,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1053.99,63,,843.19,,,0,"percent of total billed charges","63% of total billed charges",255.97,15.3,,204.78,,,0,"percent of total billed charges","15.3% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,1154.37,69,,,,,0,"fee schedule","69% of total billed charges",1673,100,,1338.40,,,0,"percent of total billed charges","100% of total billed charges",1673,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1673,100,,1338.40,,,0,"percent of total billed charges","100% of total billed charges",1673,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1673,100,,1338.40,,,0,"percent of total billed charges","100% of total billed charges",1673,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1673,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3301.11,100,,,,,0,"fee schedule",EAPG,1673,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1673,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1673,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3367.13,100,,,,,0,"fee schedule",EAPG,4291.45,100,,,,,0,"fee schedule",EAPG,1673,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",630.72,37.7,,504.58,,,0,"percent of total billed charges","37.70% of total billed charges",1673,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1673,100,,,,,0,"fee schedule","100% of CMS fee schedule",1304.94,78,,1043.95,,,0,"percent of total billed charges","78% of total billed charges",1673,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1381.9,82.6,,1105.52,,,0,"percent of total billed charges","82.6% of total billed charges",3301.11,100,,,,,0,"fee schedule","100% of WA fee schedule",1673,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1381.9,82.6,,1105.52,,,0,"percent of total billed charges","82.6% of total billed charges",1673,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3461.64,100,,,,,0,"fee schedule",EAPG,1673,100,,1338.40,,,0,"percent of total billed charges","100% of total billed charges",255.97,4291.45,
"35800 Exploration for postoperative hemorrhage, th",7962781,CDM,521,RC,35800,CPT,OUTPATIENT,,,1989,1292.85,,1750.32,88,,1400.26,,,0,"percent of total billed charges","88% of total billed charges",1989,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3301.11,100,,,,,0,"fee schedule",EAPG,1989,100,,1591.20,,,0,"percent of total billed charges","100% of total billed charges",1989,175,,,,,0,"fee schedule","175% of CMS fee schedule",3400.14,100,,,,,0,"fee schedule",EAPG,1989,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1253.07,63,,1002.46,,,0,"percent of total billed charges","63% of total billed charges",304.32,15.3,,243.46,,,0,"percent of total billed charges","15.3% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,1372.41,69,,,,,0,"fee schedule","69% of total billed charges",1989,100,,1591.20,,,0,"percent of total billed charges","100% of total billed charges",1989,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1989,100,,1591.20,,,0,"percent of total billed charges","100% of total billed charges",1989,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1989,100,,1591.20,,,0,"percent of total billed charges","100% of total billed charges",1989,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3301.11,100,,,,,0,"fee schedule",EAPG,1989,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1989,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",1989,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3367.13,100,,,,,0,"fee schedule",EAPG,4291.45,100,,,,,0,"fee schedule",EAPG,1989,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",749.85,37.7,,599.88,,,0,"percent of total billed charges","37.70% of total billed charges",1989,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1989,100,,,,,0,"fee schedule","100% of CMS fee schedule",1551.42,78,,1241.14,,,0,"percent of total billed charges","78% of total billed charges",1989,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1642.91,82.6,,1314.33,,,0,"percent of total billed charges","82.6% of total billed charges",3301.11,100,,,,,0,"fee schedule","100% of WA fee schedule",1989,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1642.91,82.6,,1314.33,,,0,"percent of total billed charges","82.6% of total billed charges",1989,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3461.64,100,,,,,0,"fee schedule",EAPG,1989,100,,1591.20,,,0,"percent of total billed charges","100% of total billed charges",304.32,19379.77,
"35840 Exploration for postoperative hemorrhage, th",7962675,CDM,521,RC,35840,CPT,OUTPATIENT,,,2779,1806.35,,2445.52,88,,1956.42,,,0,"percent of total billed charges","88% of total billed charges",2779,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",16110.1,100,,,,,0,"fee schedule",EAPG,2779,100,,2223.20,,,0,"percent of total billed charges","100% of total billed charges",2779,175,,,,,0,"fee schedule","175% of CMS fee schedule",16593.41,100,,,,,0,"fee schedule",EAPG,2779,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1750.77,63,,1400.62,,,0,"percent of total billed charges","63% of total billed charges",425.19,15.3,,340.15,,,0,"percent of total billed charges","15.3% of total billed charges",16110.1,100,,,,,0,"fee schedule",EAPG,1917.51,69,,,,,0,"fee schedule","69% of total billed charges",2779,100,,2223.20,,,0,"percent of total billed charges","100% of total billed charges",2779,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2779,100,,2223.20,,,0,"percent of total billed charges","100% of total billed charges",2779,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2779,100,,2223.20,,,0,"percent of total billed charges","100% of total billed charges",2779,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2779,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",16110.1,100,,,,,0,"fee schedule",EAPG,2779,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2779,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2779,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",16432.31,100,,,,,0,"fee schedule",EAPG,20943.14,100,,,,,0,"fee schedule",EAPG,2779,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1047.68,37.7,,838.14,,,0,"percent of total billed charges","37.70% of total billed charges",2779,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2779,100,,,,,0,"fee schedule","100% of CMS fee schedule",2167.62,78,,1734.10,,,0,"percent of total billed charges","78% of total billed charges",2779,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2295.45,82.6,,1836.36,,,0,"percent of total billed charges","82.6% of total billed charges",16110.1,100,,,,,0,"fee schedule","100% of WA fee schedule",2779,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2295.45,82.6,,1836.36,,,0,"percent of total billed charges","82.6% of total billed charges",2779,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",16270.63,100,,,,,0,"fee schedule",EAPG,2779,100,,2223.20,,,0,"percent of total billed charges","100% of total billed charges",425.19,20943.14,
"35860 Exploration for postoperative hemorrhage, th",7962604,CDM,521,RC,35860,CPT,OUTPATIENT,,,2160,1404,,1900.8,88,,1520.64,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3301.11,100,,,,,0,"fee schedule",EAPG,2160,100,,1728.00,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",3400.14,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1360.8,63,,1088.64,,,0,"percent of total billed charges","63% of total billed charges",330.48,15.3,,264.38,,,0,"percent of total billed charges","15.3% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,1490.4,69,,,,,0,"fee schedule","69% of total billed charges",2160,100,,1728.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2160,100,,1728.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2160,100,,1728.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3301.11,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3367.13,100,,,,,0,"fee schedule",EAPG,4291.45,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",814.32,37.7,,651.46,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1684.8,78,,1347.84,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1784.16,82.6,,1427.33,,,0,"percent of total billed charges","82.6% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1784.16,82.6,,1427.33,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3461.64,100,,,,,0,"fee schedule",EAPG,2160,100,,1728.00,,,0,"percent of total billed charges","100% of total billed charges",330.48,11625.57,
"35879 Revision, lower extremity arterial bypass, w",7961508,CDM,521,RC,35879,CPT,OUTPATIENT,,,3924,2550.6,,3453.12,88,,2762.50,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4439.75,100,,,,,0,"fee schedule",EAPG,3924,100,,3139.20,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",4572.94,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2472.12,63,,1977.70,,,0,"percent of total billed charges","63% of total billed charges",600.37,15.3,,480.30,,,0,"percent of total billed charges","15.3% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,2707.56,69,,,,,0,"fee schedule","69% of total billed charges",3924,100,,3139.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3924,100,,3139.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3924,100,,3139.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4439.75,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4528.55,100,,,,,0,"fee schedule",EAPG,5771.68,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1479.35,37.7,,1183.48,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3060.72,78,,2448.58,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3241.22,82.6,,2592.98,,,0,"percent of total billed charges","82.6% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3241.22,82.6,,2592.98,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4600.28,100,,,,,0,"fee schedule",EAPG,3924,100,,3139.20,,,0,"percent of total billed charges","100% of total billed charges",600.37,19379.77,
"35876 Thrombectomy of arterial or venous graft; wi",7962374,CDM,521,RC,35876,CPT,OUTPATIENT,,,3947,2565.55,,3473.36,88,,2778.69,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3301.11,100,,,,,0,"fee schedule",EAPG,3947,100,,3157.60,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3400.14,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2486.61,63,,1989.29,,,0,"percent of total billed charges","63% of total billed charges",603.89,15.3,,483.11,,,0,"percent of total billed charges","15.3% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,2723.43,69,,,,,0,"fee schedule","69% of total billed charges",3947,100,,3157.60,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3947,100,,3157.60,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3947,100,,3157.60,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3301.11,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3367.13,100,,,,,0,"fee schedule",EAPG,4291.45,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1488.02,37.7,,1190.42,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3078.66,78,,2462.93,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3260.22,82.6,,2608.18,,,0,"percent of total billed charges","82.6% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3260.22,82.6,,2608.18,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3461.64,100,,,,,0,"fee schedule",EAPG,3947,100,,3157.60,,,0,"percent of total billed charges","100% of total billed charges",603.89,19379.77,
"35875 Thrombectomy of arterial or venous graft",7963584,CDM,521,RC,35875,CPT,OUTPATIENT,,,2949,1916.85,,2595.12,88,,2076.10,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3301.11,100,,,,,0,"fee schedule",EAPG,2949,100,,2359.20,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3400.14,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1857.87,63,,1486.30,,,0,"percent of total billed charges","63% of total billed charges",451.2,15.3,,360.96,,,0,"percent of total billed charges","15.3% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,2034.81,69,,,,,0,"fee schedule","69% of total billed charges",2949,100,,2359.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2949,100,,2359.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2949,100,,2359.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3301.11,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3367.13,100,,,,,0,"fee schedule",EAPG,4291.45,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1111.77,37.7,,889.42,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2300.22,78,,1840.18,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2435.87,82.6,,1948.70,,,0,"percent of total billed charges","82.6% of total billed charges",3301.11,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2435.87,82.6,,1948.70,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3461.64,100,,,,,0,"fee schedule",EAPG,2949,100,,2359.20,,,0,"percent of total billed charges","100% of total billed charges",451.2,19379.77,
"35883 Revision, femoral anastomosis of bypass graf",7961690,CDM,521,RC,35883,CPT,OUTPATIENT,,,5464,3551.6,,4808.32,88,,3846.66,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4439.75,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",4572.94,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3442.32,63,,2753.86,,,0,"percent of total billed charges","63% of total billed charges",835.99,15.3,,668.79,,,0,"percent of total billed charges","15.3% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,3770.16,69,,,,,0,"fee schedule","69% of total billed charges",5464,100,,4371.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5464,100,,4371.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5464,100,,4371.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4439.75,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4528.55,100,,,,,0,"fee schedule",EAPG,5771.68,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2059.93,37.7,,1647.94,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4261.92,78,,3409.54,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4513.26,82.6,,3610.61,,,0,"percent of total billed charges","82.6% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4513.26,82.6,,3610.61,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4600.28,100,,,,,0,"fee schedule",EAPG,5464,100,,4371.20,,,0,"percent of total billed charges","100% of total billed charges",835.99,19379.77,
"35881 Revision, lower extremity arterial bypass, w",7961822,CDM,521,RC,35881,CPT,OUTPATIENT,,,4624,3005.6,,4069.12,88,,3255.30,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4439.75,100,,,,,0,"fee schedule",EAPG,4624,100,,3699.20,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",4572.94,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2913.12,63,,2330.50,,,0,"percent of total billed charges","63% of total billed charges",707.47,15.3,,565.98,,,0,"percent of total billed charges","15.3% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,3190.56,69,,,,,0,"fee schedule","69% of total billed charges",4624,100,,3699.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4624,100,,3699.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4624,100,,3699.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4439.75,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4528.55,100,,,,,0,"fee schedule",EAPG,5771.68,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1743.25,37.7,,1394.60,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3606.72,78,,2885.38,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3819.42,82.6,,3055.54,,,0,"percent of total billed charges","82.6% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3819.42,82.6,,3055.54,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4600.28,100,,,,,0,"fee schedule",EAPG,4624,100,,3699.20,,,0,"percent of total billed charges","100% of total billed charges",707.47,19379.77,
"35884 Revision, femoral anastomosis of synthetic a",7962226,CDM,521,RC,35884,CPT,OUTPATIENT,,,5603,3641.95,,4930.64,88,,3944.51,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4439.75,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",4572.94,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3529.89,63,,2823.91,,,0,"percent of total billed charges","63% of total billed charges",857.26,15.3,,685.81,,,0,"percent of total billed charges","15.3% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,3866.07,69,,,,,0,"fee schedule","69% of total billed charges",5603,100,,4482.40,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5603,100,,4482.40,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5603,100,,4482.40,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4439.75,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4528.55,100,,,,,0,"fee schedule",EAPG,5771.68,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2112.33,37.7,,1689.86,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4370.34,78,,3496.27,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4628.08,82.6,,3702.46,,,0,"percent of total billed charges","82.6% of total billed charges",4439.75,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4628.08,82.6,,3702.46,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4600.28,100,,,,,0,"fee schedule",EAPG,5603,100,,4482.40,,,0,"percent of total billed charges","100% of total billed charges",857.26,19379.77,
"35903 Excision of infected graft; extremity",7963642,CDM,521,RC,35903,CPT,OUTPATIENT,,,2851,1853.15,,2508.88,88,,2007.10,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.89,100,,,,,0,"fee schedule",EAPG,2851,100,,2280.80,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",2014.57,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1796.13,63,,1436.90,,,0,"percent of total billed charges","63% of total billed charges",436.2,15.3,,348.96,,,0,"percent of total billed charges","15.3% of total billed charges",1955.89,100,,,,,0,"fee schedule",EAPG,1967.19,69,,,,,0,"fee schedule","69% of total billed charges",2851,100,,2280.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2851,100,,2280.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2851,100,,2280.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.89,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1995.01,100,,,,,0,"fee schedule",EAPG,2542.66,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1074.83,37.7,,859.86,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2223.78,78,,1779.02,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2354.93,82.6,,1883.94,,,0,"percent of total billed charges","82.6% of total billed charges",1955.89,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2354.93,82.6,,1883.94,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2116.42,100,,,,,0,"fee schedule",EAPG,2851,100,,2280.80,,,0,"percent of total billed charges","100% of total billed charges",436.2,11625.57,
"35907 Excision of infected graft; abdomen",7963654,CDM,521,RC,35907,CPT,OUTPATIENT,,,8368,5439.2,,7363.84,88,,5891.07,,,0,"percent of total billed charges","88% of total billed charges",8368,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8368,175,,,,,0,"fee schedule","175% of CMS fee schedule",10944.37,100,,,,,0,"fee schedule",EAPG,8368,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5271.84,63,,4217.47,,,0,"percent of total billed charges","63% of total billed charges",1280.3,15.3,,1024.24,,,0,"percent of total billed charges","15.3% of total billed charges",10625.6,100,,,,,0,"fee schedule",EAPG,5773.92,69,,,,,0,"fee schedule","69% of total billed charges",8368,100,,6694.40,,,0,"percent of total billed charges","100% of total billed charges",8368,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8368,100,,6694.40,,,0,"percent of total billed charges","100% of total billed charges",8368,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8368,100,,6694.40,,,0,"percent of total billed charges","100% of total billed charges",8368,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8368,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,8368,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8368,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8368,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10838.11,100,,,,,0,"fee schedule",EAPG,13813.28,100,,,,,0,"fee schedule",EAPG,8368,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3154.74,37.7,,2523.79,,,0,"percent of total billed charges","37.70% of total billed charges",8368,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8368,100,,,,,0,"fee schedule","100% of CMS fee schedule",6527.04,78,,5221.63,,,0,"percent of total billed charges","78% of total billed charges",8368,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6911.97,82.6,,5529.58,,,0,"percent of total billed charges","82.6% of total billed charges",10625.6,100,,,,,0,"fee schedule","100% of WA fee schedule",8368,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6911.97,82.6,,5529.58,,,0,"percent of total billed charges","82.6% of total billed charges",8368,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10786.13,100,,,,,0,"fee schedule",EAPG,8368,100,,6694.40,,,0,"percent of total billed charges","100% of total billed charges",1280.3,13813.28,
"35905 Excision of infected graft; thorax",7963698,CDM,521,RC,35905,CPT,OUTPATIENT,,,7361,4784.65,,6477.68,88,,5182.14,,,0,"percent of total billed charges","88% of total billed charges",7361,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7361,175,,,,,0,"fee schedule","175% of CMS fee schedule",10944.37,100,,,,,0,"fee schedule",EAPG,7361,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4637.43,63,,3709.94,,,0,"percent of total billed charges","63% of total billed charges",1126.23,15.3,,900.98,,,0,"percent of total billed charges","15.3% of total billed charges",10625.6,100,,,,,0,"fee schedule",EAPG,5079.09,69,,,,,0,"fee schedule","69% of total billed charges",7361,100,,5888.80,,,0,"percent of total billed charges","100% of total billed charges",7361,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7361,100,,5888.80,,,0,"percent of total billed charges","100% of total billed charges",7361,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7361,100,,5888.80,,,0,"percent of total billed charges","100% of total billed charges",7361,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7361,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,7361,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7361,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7361,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10838.11,100,,,,,0,"fee schedule",EAPG,13813.28,100,,,,,0,"fee schedule",EAPG,7361,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2775.1,37.7,,2220.08,,,0,"percent of total billed charges","37.70% of total billed charges",7361,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7361,100,,,,,0,"fee schedule","100% of CMS fee schedule",5741.58,78,,4593.26,,,0,"percent of total billed charges","78% of total billed charges",7361,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6080.19,82.6,,4864.15,,,0,"percent of total billed charges","82.6% of total billed charges",10625.6,100,,,,,0,"fee schedule","100% of WA fee schedule",7361,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6080.19,82.6,,4864.15,,,0,"percent of total billed charges","82.6% of total billed charges",7361,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10786.13,100,,,,,0,"fee schedule",EAPG,7361,100,,5888.80,,,0,"percent of total billed charges","100% of total billed charges",1126.23,13813.28,
"36000 Introduction of needle or intracatheter, vei",7903305,CDM,521,RC,36000,CPT,OUTPATIENT,,,101,65.65,,88.88,88,,71.10,,,0,"percent of total billed charges","88% of total billed charges",50.5,50,,40.40,,,0,"percent of total billed charges","50% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54.44,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",63.63,63,,50.90,,,0,"percent of total billed charges","63% of total billed charges",15.45,15.3,,12.36,,,0,"percent of total billed charges","15.3% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,69.69,69,,,,,0,"fee schedule","69% of total billed charges",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,61.85,,49.98,,,0,"percent of total billed charges","61.5% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,50.5,50,,40.40,,,0,"percent of total billed charges","50% of total billed charges",32.52,32.2,,26.02,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",53.92,100,,,,,0,"fee schedule",EAPG,68.72,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.08,37.7,,30.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",78.78,78,,63.02,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",83.43,82.6,,66.74,,,0,"percent of total billed charges","82.6% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,50.5,50,,40.40,,,0,"percent of total billed charges","50% of total billed charges",83.43,82.6,,66.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.39,100,,,,,0,"fee schedule",EAPG,101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",15.45,213.39,
"36002 Injection procedures (eg, thrombin) for perc",7961842,CDM,521,RC,36002,CPT,OUTPATIENT,,,475,308.75,,418,88,,334.40,,,0,"percent of total billed charges","88% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.06,100,,,,,0,"fee schedule",EAPG,475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",1121.3,175,,,,,0,"fee schedule","175% of CMS fee schedule",781.83,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",299.25,63,,239.40,,,0,"percent of total billed charges","63% of total billed charges",72.68,15.3,,58.14,,,0,"percent of total billed charges","15.3% of total billed charges",759.06,100,,,,,0,"fee schedule",EAPG,327.75,69,,,,,0,"fee schedule","69% of total billed charges",475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",2200.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.06,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",575.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",774.24,100,,,,,0,"fee schedule",EAPG,986.78,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",179.08,37.7,,143.26,,,0,"percent of total billed charges","37.70% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",370.5,78,,296.40,,,0,"percent of total billed charges","78% of total billed charges",647.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.35,82.6,,313.88,,,0,"percent of total billed charges","82.6% of total billed charges",759.06,100,,,,,0,"fee schedule",EAPG,640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.35,82.6,,313.88,,,0,"percent of total billed charges","82.6% of total billed charges",640.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",919.59,100,,,,,0,"fee schedule",EAPG,475,100,,380.00,,,0,"percent of total billed charges","100% of total billed charges",72.68,2200.34,
"36005 Injection procedure for extremity venography",7963509,CDM,521,RC,36005,CPT,OUTPATIENT,,,487,316.55,,428.56,88,,342.85,,,0,"percent of total billed charges","88% of total billed charges",243.5,50,,194.80,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,487,100,,389.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",306.81,63,,245.45,,,0,"percent of total billed charges","63% of total billed charges",74.51,15.3,,59.61,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,336.03,69,,,,,0,"fee schedule","69% of total billed charges",487,100,,389.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",487,100,,389.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",487,100,,389.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.21,61.85,,240.97,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,243.5,50,,194.80,,,0,"percent of total billed charges","50% of total billed charges",156.81,32.2,,125.45,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",183.6,37.7,,146.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",379.86,78,,303.89,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",402.26,82.6,,321.81,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,243.5,50,,194.80,,,0,"percent of total billed charges","50% of total billed charges",402.26,82.6,,321.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",733.1,100,,,,,0,"fee schedule",EAPG,487,100,,389.60,,,0,"percent of total billed charges","100% of total billed charges",74.51,744.35,
"36011 Selective catheter placement, venous system;",7961509,CDM,521,RC,36011,CPT,OUTPATIENT,,,1469,954.85,,1292.72,88,,1034.18,,,0,"percent of total billed charges","88% of total billed charges",734.5,50,,587.60,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,1469,100,,1175.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",925.47,63,,740.38,,,0,"percent of total billed charges","63% of total billed charges",224.76,15.3,,179.81,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,1013.61,69,,,,,0,"fee schedule","69% of total billed charges",1469,100,,1175.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1469,100,,1175.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1469,100,,1175.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",908.58,61.85,,726.86,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,734.5,50,,587.60,,,0,"percent of total billed charges","50% of total billed charges",473.02,32.2,,378.42,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",553.81,37.7,,443.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1145.82,78,,916.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1213.39,82.6,,970.71,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,734.5,50,,587.60,,,0,"percent of total billed charges","50% of total billed charges",1213.39,82.6,,970.71,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",733.1,100,,,,,0,"fee schedule",EAPG,1469,100,,1175.20,,,0,"percent of total billed charges","100% of total billed charges",224.76,1469,
"36012 Selective catheter placement, venous system;",7962132,CDM,521,RC,36012,CPT,OUTPATIENT,,,1173,762.45,,1032.24,88,,825.79,,,0,"percent of total billed charges","88% of total billed charges",586.5,50,,469.20,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,1173,100,,938.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",738.99,63,,591.19,,,0,"percent of total billed charges","63% of total billed charges",179.47,15.3,,143.58,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,809.37,69,,,,,0,"fee schedule","69% of total billed charges",1173,100,,938.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1173,100,,938.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1173,100,,938.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",725.5,61.85,,580.40,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,586.5,50,,469.20,,,0,"percent of total billed charges","50% of total billed charges",377.71,32.2,,302.17,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",442.22,37.7,,353.78,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",914.94,78,,731.95,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",968.9,82.6,,775.12,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,586.5,50,,469.20,,,0,"percent of total billed charges","50% of total billed charges",968.9,82.6,,775.12,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",733.1,100,,,,,0,"fee schedule",EAPG,1173,100,,938.40,,,0,"percent of total billed charges","100% of total billed charges",179.47,1173,
"36015 Selective catheter placement, segmental or s",7962696,CDM,521,RC,36015,CPT,OUTPATIENT,,,476,309.4,,418.88,88,,335.10,,,0,"percent of total billed charges","88% of total billed charges",238,50,,190.40,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,476,100,,380.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",299.88,63,,239.90,,,0,"percent of total billed charges","63% of total billed charges",72.83,15.3,,58.26,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,328.44,69,,,,,0,"fee schedule","69% of total billed charges",476,100,,380.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",476,100,,380.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",476,100,,380.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",294.41,61.85,,235.53,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,238,50,,190.40,,,0,"percent of total billed charges","50% of total billed charges",153.27,32.2,,122.62,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",179.45,37.7,,143.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",371.28,78,,297.02,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",393.18,82.6,,314.54,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,238,50,,190.40,,,0,"percent of total billed charges","50% of total billed charges",393.18,82.6,,314.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",733.1,100,,,,,0,"fee schedule",EAPG,476,100,,380.80,,,0,"percent of total billed charges","100% of total billed charges",72.83,744.35,
"36014 Selective catheter placement, left or right",7963126,CDM,521,RC,36014,CPT,OUTPATIENT,,,426,276.9,,374.88,88,,299.90,,,0,"percent of total billed charges","88% of total billed charges",213,50,,170.40,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",268.38,63,,214.70,,,0,"percent of total billed charges","63% of total billed charges",65.18,15.3,,52.14,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,293.94,69,,,,,0,"fee schedule","69% of total billed charges",426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",263.48,61.85,,210.78,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,213,50,,170.40,,,0,"percent of total billed charges","50% of total billed charges",137.17,32.2,,109.74,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.6,37.7,,128.48,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",332.28,78,,265.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",351.88,82.6,,281.50,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,213,50,,170.40,,,0,"percent of total billed charges","50% of total billed charges",351.88,82.6,,281.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",733.1,100,,,,,0,"fee schedule",EAPG,426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",65.18,744.35,
"36010 Introduction of catheter, superior or inferi",7963223,CDM,521,RC,36010,CPT,OUTPATIENT,,,506,328.9,,445.28,88,,356.22,,,0,"percent of total billed charges","88% of total billed charges",253,50,,202.40,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",318.78,63,,255.02,,,0,"percent of total billed charges","63% of total billed charges",77.42,15.3,,61.94,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,349.14,69,,,,,0,"fee schedule","69% of total billed charges",506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",312.96,61.85,,250.37,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,253,50,,202.40,,,0,"percent of total billed charges","50% of total billed charges",162.93,32.2,,130.34,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",190.76,37.7,,152.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",394.68,78,,315.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.96,82.6,,334.37,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,253,50,,202.40,,,0,"percent of total billed charges","50% of total billed charges",417.96,82.6,,334.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",733.1,100,,,,,0,"fee schedule",EAPG,506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",77.42,744.35,
"36100 Introduction of needle or intracatheter, car",7962884,CDM,521,RC,36100,CPT,OUTPATIENT,,,656,426.4,,577.28,88,,461.82,,,0,"percent of total billed charges","88% of total billed charges",328,50,,262.40,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,656,100,,524.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",413.28,63,,330.62,,,0,"percent of total billed charges","63% of total billed charges",100.37,15.3,,80.30,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,452.64,69,,,,,0,"fee schedule","69% of total billed charges",656,100,,524.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",656,100,,524.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",656,100,,524.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",405.74,61.85,,324.59,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,328,50,,262.40,,,0,"percent of total billed charges","50% of total billed charges",211.23,32.2,,168.98,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",247.31,37.7,,197.85,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",511.68,78,,409.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",541.86,82.6,,433.49,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,328,50,,262.40,,,0,"percent of total billed charges","50% of total billed charges",541.86,82.6,,433.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",733.1,100,,,,,0,"fee schedule",EAPG,656,100,,524.80,,,0,"percent of total billed charges","100% of total billed charges",100.37,744.35,
"36120 Introduction of needle or intracatheter; ret",7962905,CDM,521,RC,,,OUTPATIENT,,,289,187.85,,254.32,88,,203.46,,,0,"percent of total billed charges","88% of total billed charges",144.5,50,,115.60,,,0,"percent of total billed charges","50% of total billed charges",48.55,16.8,,38.84,,,0,"percent of total billed charges","16.8% of total billed charges",289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.01,17.304,,40.01,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",182.07,63,,145.66,,,0,"percent of total billed charges","63% of total billed charges",44.22,15.3,,35.38,,,0,"percent of total billed charges","15.3% of total billed charges",48.55,16.8,,38.84,,,0,"percent of total billed charges","16.8% of total billed charges",199.41,69,,,,,0,"fee schedule","69% of total billed charges",289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.75,61.85,,143.00,,,0,"percent of total billed charges","61.5% of total billed charges",48.55,16.8,,38.84,,,0,"percent of total billed charges","16.8% of total billed charges",144.5,50,,115.60,,,0,"percent of total billed charges","50% of total billed charges",93.06,32.2,,74.45,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",49.52,17.136,,39.62,,,0,"percent of total billed charges","17.136% of total billed charges",63.12,21.84,,50.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",108.95,37.7,,87.16,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",225.42,78,,180.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",238.71,82.6,,190.97,,,0,"percent of total billed charges","82.6% of total billed charges",48.55,16.8,,38.84,,,0,"percent of total billed charges","16.8% of total billed charges",144.5,50,,115.60,,,0,"percent of total billed charges","50% of total billed charges",238.71,82.6,,190.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",289,100,,231.20,,,0,"percent of total billed charges","100% of total billed charges",44.22,289,
"36147 Intro of needle and/or catheter, arterioveno",7961849,CDM,521,RC,,,OUTPATIENT,,,1419,922.35,,1248.72,88,,998.98,,,0,"percent of total billed charges","88% of total billed charges",709.5,50,,567.60,,,0,"percent of total billed charges","50% of total billed charges",238.39,16.8,,190.71,,,0,"percent of total billed charges","16.8% of total billed charges",1419,100,,1135.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",245.54,17.304,,196.43,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",893.97,63,,715.18,,,0,"percent of total billed charges","63% of total billed charges",217.11,15.3,,173.69,,,0,"percent of total billed charges","15.3% of total billed charges",238.39,16.8,,190.71,,,0,"percent of total billed charges","16.8% of total billed charges",979.11,69,,,,,0,"fee schedule","69% of total billed charges",1419,100,,1135.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1419,100,,1135.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1419,100,,1135.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",877.65,61.85,,702.12,,,0,"percent of total billed charges","61.5% of total billed charges",238.39,16.8,,190.71,,,0,"percent of total billed charges","16.8% of total billed charges",709.5,50,,567.60,,,0,"percent of total billed charges","50% of total billed charges",456.92,32.2,,365.54,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",243.16,17.136,,194.53,,,0,"percent of total billed charges","17.136% of total billed charges",309.91,21.84,,247.93,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",534.96,37.7,,427.97,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1106.82,78,,885.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1172.09,82.6,,937.67,,,0,"percent of total billed charges","82.6% of total billed charges",238.39,16.8,,190.71,,,0,"percent of total billed charges","16.8% of total billed charges",709.5,50,,567.60,,,0,"percent of total billed charges","50% of total billed charges",1172.09,82.6,,937.67,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",1419,100,,1135.20,,,0,"percent of total billed charges","100% of total billed charges",160.53,1419,
"36140 Introduction of needle or intracatheter; ext",7963197,CDM,521,RC,36140,CPT,OUTPATIENT,,,735,477.75,,646.8,88,,517.44,,,0,"percent of total billed charges","88% of total billed charges",367.5,50,,294.00,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,735,100,,588.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",463.05,63,,370.44,,,0,"percent of total billed charges","63% of total billed charges",112.46,15.3,,89.97,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,507.15,69,,,,,0,"fee schedule","69% of total billed charges",735,100,,588.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",735,100,,588.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",735,100,,588.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.6,61.85,,363.68,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,367.5,50,,294.00,,,0,"percent of total billed charges","50% of total billed charges",236.67,32.2,,189.34,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",277.1,37.7,,221.68,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",573.3,78,,458.64,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",607.11,82.6,,485.69,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,367.5,50,,294.00,,,0,"percent of total billed charges","50% of total billed charges",607.11,82.6,,485.69,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",733.1,100,,,,,0,"fee schedule",EAPG,735,100,,588.00,,,0,"percent of total billed charges","100% of total billed charges",112.46,744.35,
"36148 access av dial grft for proc",7963768,CDM,521,RC,,,OUTPATIENT,,,448,291.2,,394.24,88,,315.39,,,0,"percent of total billed charges","88% of total billed charges",224,50,,179.20,,,0,"percent of total billed charges","50% of total billed charges",75.26,16.8,,60.21,,,0,"percent of total billed charges","16.8% of total billed charges",448,100,,358.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.52,17.304,,62.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",282.24,63,,225.79,,,0,"percent of total billed charges","63% of total billed charges",68.54,15.3,,54.83,,,0,"percent of total billed charges","15.3% of total billed charges",75.26,16.8,,60.21,,,0,"percent of total billed charges","16.8% of total billed charges",309.12,69,,,,,0,"fee schedule","69% of total billed charges",448,100,,358.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",448,100,,358.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",448,100,,358.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",277.09,61.85,,221.67,,,0,"percent of total billed charges","61.5% of total billed charges",75.26,16.8,,60.21,,,0,"percent of total billed charges","16.8% of total billed charges",224,50,,179.20,,,0,"percent of total billed charges","50% of total billed charges",144.26,32.2,,115.41,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",76.77,17.136,,61.42,,,0,"percent of total billed charges","17.136% of total billed charges",97.84,21.84,,78.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",168.9,37.7,,135.12,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",349.44,78,,279.55,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.05,82.6,,296.04,,,0,"percent of total billed charges","82.6% of total billed charges",75.26,16.8,,60.21,,,0,"percent of total billed charges","16.8% of total billed charges",224,50,,179.20,,,0,"percent of total billed charges","50% of total billed charges",370.05,82.6,,296.04,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",448,100,,358.40,,,0,"percent of total billed charges","100% of total billed charges",68.54,448,
"36200 Introduction of catheter, aorta",7963729,CDM,521,RC,36200,CPT,OUTPATIENT,,,974,633.1,,857.12,88,,685.70,,,0,"percent of total billed charges","88% of total billed charges",487,50,,389.60,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,974,100,,779.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",613.62,63,,490.90,,,0,"percent of total billed charges","63% of total billed charges",149.02,15.3,,119.22,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,672.06,69,,,,,0,"fee schedule","69% of total billed charges",974,100,,779.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",974,100,,779.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",974,100,,779.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.42,61.85,,481.94,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,487,50,,389.60,,,0,"percent of total billed charges","50% of total billed charges",313.63,32.2,,250.90,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",367.2,37.7,,293.76,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",759.72,78,,607.78,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",804.52,82.6,,643.62,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,487,50,,389.60,,,0,"percent of total billed charges","50% of total billed charges",804.52,82.6,,643.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",733.1,100,,,,,0,"fee schedule",EAPG,974,100,,779.20,,,0,"percent of total billed charges","100% of total billed charges",149.02,974,
"36218 Selective catheter placement, arterial syste",7961605,CDM,521,RC,36218,CPT,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.41,61.85,,101.93,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",66.33,32.2,,53.06,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,103,50,,82.40,,,0,"percent of total billed charges","50% of total billed charges",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",733.1,100,,,,,0,"fee schedule",EAPG,206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,744.35,
"36216 Selective cath plcmnt, arterial system; init",7961691,CDM,521,RC,36216,CPT,OUTPATIENT,,,1067,693.55,,938.96,88,,751.17,,,0,"percent of total billed charges","88% of total billed charges",533.5,50,,426.80,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,1067,100,,853.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",672.21,63,,537.77,,,0,"percent of total billed charges","63% of total billed charges",163.25,15.3,,130.60,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,736.23,69,,,,,0,"fee schedule","69% of total billed charges",1067,100,,853.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1067,100,,853.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1067,100,,853.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",659.94,61.85,,527.95,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,533.5,50,,426.80,,,0,"percent of total billed charges","50% of total billed charges",343.57,32.2,,274.86,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",402.26,37.7,,321.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",832.26,78,,665.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",881.34,82.6,,705.07,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,533.5,50,,426.80,,,0,"percent of total billed charges","50% of total billed charges",881.34,82.6,,705.07,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",733.1,100,,,,,0,"fee schedule",EAPG,1067,100,,853.60,,,0,"percent of total billed charges","100% of total billed charges",163.25,1067,
"36215 Selective cath plcmnt, arterial system; each",7961754,CDM,521,RC,36215,CPT,OUTPATIENT,,,949,616.85,,835.12,88,,668.10,,,0,"percent of total billed charges","88% of total billed charges",474.5,50,,379.60,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,949,100,,759.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",597.87,63,,478.30,,,0,"percent of total billed charges","63% of total billed charges",145.2,15.3,,116.16,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,654.81,69,,,,,0,"fee schedule","69% of total billed charges",949,100,,759.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",949,100,,759.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",949,100,,759.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",586.96,61.85,,469.57,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,474.5,50,,379.60,,,0,"percent of total billed charges","50% of total billed charges",305.58,32.2,,244.46,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",357.77,37.7,,286.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",740.22,78,,592.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",783.87,82.6,,627.10,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,474.5,50,,379.60,,,0,"percent of total billed charges","50% of total billed charges",783.87,82.6,,627.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",733.1,100,,,,,0,"fee schedule",EAPG,949,100,,759.20,,,0,"percent of total billed charges","100% of total billed charges",145.2,949,
"36217 Selective cath plcmnt, arterial system; init",7961755,CDM,521,RC,36217,CPT,OUTPATIENT,,,1288,837.2,,1133.44,88,,906.75,,,0,"percent of total billed charges","88% of total billed charges",644,50,,515.20,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,1288,100,,1030.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",811.44,63,,649.15,,,0,"percent of total billed charges","63% of total billed charges",197.06,15.3,,157.65,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,888.72,69,,,,,0,"fee schedule","69% of total billed charges",1288,100,,1030.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1288,100,,1030.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1288,100,,1030.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",796.63,61.85,,637.30,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,644,50,,515.20,,,0,"percent of total billed charges","50% of total billed charges",414.74,32.2,,331.79,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",485.58,37.7,,388.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1004.64,78,,803.71,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1063.89,82.6,,851.11,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,644,50,,515.20,,,0,"percent of total billed charges","50% of total billed charges",1063.89,82.6,,851.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",733.1,100,,,,,0,"fee schedule",EAPG,1288,100,,1030.40,,,0,"percent of total billed charges","100% of total billed charges",197.06,1288,
"36222 Selective catheter placement, common carotid",7961756,CDM,521,RC,36222,CPT,OUTPATIENT,,,1135,737.75,,998.8,88,,799.04,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,1135,100,,908.00,,,0,"percent of total billed charges","100% of total billed charges",5689.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",3820.51,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",715.05,63,,572.04,,,0,"percent of total billed charges","63% of total billed charges",173.66,15.3,,138.93,,,0,"percent of total billed charges","15.3% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,783.15,69,,,,,0,"fee schedule","69% of total billed charges",1135,100,,908.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1135,100,,908.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1135,100,,908.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3783.42,100,,,,,0,"fee schedule",EAPG,4822.01,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",427.9,37.7,,342.32,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",885.3,78,,708.24,,,0,"percent of total billed charges","78% of total billed charges",3283.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",937.51,82.6,,750.01,,,0,"percent of total billed charges","82.6% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",937.51,82.6,,750.01,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3869.76,100,,,,,0,"fee schedule",EAPG,1135,100,,908.00,,,0,"percent of total billed charges","100% of total billed charges",173.66,11625.58,
"36223 Selective catheter placement, common carotid",7961757,CDM,521,RC,36223,CPT,OUTPATIENT,,,1227,797.55,,1079.76,88,,863.81,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,1227,100,,981.60,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3820.51,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",773.01,63,,618.41,,,0,"percent of total billed charges","63% of total billed charges",187.73,15.3,,150.18,,,0,"percent of total billed charges","15.3% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,846.63,69,,,,,0,"fee schedule","69% of total billed charges",1227,100,,981.60,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1227,100,,981.60,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1227,100,,981.60,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3783.42,100,,,,,0,"fee schedule",EAPG,4822.01,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",462.58,37.7,,370.06,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",957.06,78,,765.65,,,0,"percent of total billed charges","78% of total billed charges",5661.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.5,82.6,,810.80,,,0,"percent of total billed charges","82.6% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.5,82.6,,810.80,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3869.76,100,,,,,0,"fee schedule",EAPG,1227,100,,981.60,,,0,"percent of total billed charges","100% of total billed charges",187.73,19379.78,
"36225 Selective catheter placement, subclavian or",7961758,CDM,521,RC,36225,CPT,OUTPATIENT,,,1223,794.95,,1076.24,88,,860.99,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,1223,100,,978.40,,,0,"percent of total billed charges","100% of total billed charges",5689.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",3820.51,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.49,63,,616.39,,,0,"percent of total billed charges","63% of total billed charges",187.12,15.3,,149.70,,,0,"percent of total billed charges","15.3% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,843.87,69,,,,,0,"fee schedule","69% of total billed charges",1223,100,,978.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1223,100,,978.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1223,100,,978.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3783.42,100,,,,,0,"fee schedule",EAPG,4822.01,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",461.07,37.7,,368.86,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",953.94,78,,763.15,,,0,"percent of total billed charges","78% of total billed charges",3283.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1010.2,82.6,,808.16,,,0,"percent of total billed charges","82.6% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1010.2,82.6,,808.16,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3869.76,100,,,,,0,"fee schedule",EAPG,1223,100,,978.40,,,0,"percent of total billed charges","100% of total billed charges",187.12,11625.58,
"36221 Non-selective catheter placement, thoracic a",7961873,CDM,521,RC,36221,CPT,OUTPATIENT,,,839,545.35,,738.32,88,,590.66,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,839,100,,671.20,,,0,"percent of total billed charges","100% of total billed charges",5689.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",3820.51,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",528.57,63,,422.86,,,0,"percent of total billed charges","63% of total billed charges",128.37,15.3,,102.70,,,0,"percent of total billed charges","15.3% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,578.91,69,,,,,0,"fee schedule","69% of total billed charges",839,100,,671.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",839,100,,671.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",839,100,,671.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3783.42,100,,,,,0,"fee schedule",EAPG,4822.01,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",316.3,37.7,,253.04,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",654.42,78,,523.54,,,0,"percent of total billed charges","78% of total billed charges",3283.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",693.01,82.6,,554.41,,,0,"percent of total billed charges","82.6% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",693.01,82.6,,554.41,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3869.76,100,,,,,0,"fee schedule",EAPG,839,100,,671.20,,,0,"percent of total billed charges","100% of total billed charges",128.37,11625.58,
"36228 Selective catheter placement, each intracran",7961993,CDM,521,RC,36228,CPT,OUTPATIENT,,,862,560.3,,758.56,88,,606.85,,,0,"percent of total billed charges","88% of total billed charges",431,50,,344.80,,,0,"percent of total billed charges","50% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,862,100,,689.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3820.51,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",543.06,63,,434.45,,,0,"percent of total billed charges","63% of total billed charges",131.89,15.3,,105.51,,,0,"percent of total billed charges","15.3% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,594.78,69,,,,,0,"fee schedule","69% of total billed charges",862,100,,689.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",862,100,,689.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",862,100,,689.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",533.15,61.85,,426.52,,,0,"percent of total billed charges","61.5% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,431,50,,344.80,,,0,"percent of total billed charges","50% of total billed charges",277.56,32.2,,222.05,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3783.42,100,,,,,0,"fee schedule",EAPG,4822.01,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",324.97,37.7,,259.98,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",672.36,78,,537.89,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",712.01,82.6,,569.61,,,0,"percent of total billed charges","82.6% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,431,50,,344.80,,,0,"percent of total billed charges","50% of total billed charges",712.01,82.6,,569.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3869.76,100,,,,,0,"fee schedule",EAPG,862,100,,689.60,,,0,"percent of total billed charges","100% of total billed charges",131.89,4822.01,
"36227 Selective catheter placement, external carot",7962062,CDM,521,RC,36227,CPT,OUTPATIENT,,,423,274.95,,372.24,88,,297.79,,,0,"percent of total billed charges","88% of total billed charges",211.5,50,,169.20,,,0,"percent of total billed charges","50% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,423,100,,338.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3820.51,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",266.49,63,,213.19,,,0,"percent of total billed charges","63% of total billed charges",64.72,15.3,,51.78,,,0,"percent of total billed charges","15.3% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,291.87,69,,,,,0,"fee schedule","69% of total billed charges",423,100,,338.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",423,100,,338.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",423,100,,338.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",261.63,61.85,,209.30,,,0,"percent of total billed charges","61.5% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,211.5,50,,169.20,,,0,"percent of total billed charges","50% of total billed charges",136.21,32.2,,108.97,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3783.42,100,,,,,0,"fee schedule",EAPG,4822.01,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",159.47,37.7,,127.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",329.94,78,,263.95,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",349.4,82.6,,279.52,,,0,"percent of total billed charges","82.6% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,211.5,50,,169.20,,,0,"percent of total billed charges","50% of total billed charges",349.4,82.6,,279.52,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3869.76,100,,,,,0,"fee schedule",EAPG,423,100,,338.40,,,0,"percent of total billed charges","100% of total billed charges",64.72,4822.01,
"36226 Selective catheter placement, vertebral arte",7962066,CDM,521,RC,36226,CPT,OUTPATIENT,,,1338,869.7,,1177.44,88,,941.95,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,1338,100,,1070.40,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3820.51,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",842.94,63,,674.35,,,0,"percent of total billed charges","63% of total billed charges",204.71,15.3,,163.77,,,0,"percent of total billed charges","15.3% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,923.22,69,,,,,0,"fee schedule","69% of total billed charges",1338,100,,1070.40,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1338,100,,1070.40,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1338,100,,1070.40,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3783.42,100,,,,,0,"fee schedule",EAPG,4822.01,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",504.43,37.7,,403.54,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1043.64,78,,834.91,,,0,"percent of total billed charges","78% of total billed charges",5661.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1105.19,82.6,,884.15,,,0,"percent of total billed charges","82.6% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1105.19,82.6,,884.15,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3869.76,100,,,,,0,"fee schedule",EAPG,1338,100,,1070.40,,,0,"percent of total billed charges","100% of total billed charges",204.71,19379.78,
"36224 Selective catheter placement, internal carot",7962375,CDM,521,RC,36224,CPT,OUTPATIENT,,,1336,868.4,,1175.68,88,,940.54,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,1336,100,,1068.80,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3820.51,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",841.68,63,,673.34,,,0,"percent of total billed charges","63% of total billed charges",204.41,15.3,,163.53,,,0,"percent of total billed charges","15.3% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,921.84,69,,,,,0,"fee schedule","69% of total billed charges",1336,100,,1068.80,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1336,100,,1068.80,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1336,100,,1068.80,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3783.42,100,,,,,0,"fee schedule",EAPG,4822.01,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",503.67,37.7,,402.94,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1042.08,78,,833.66,,,0,"percent of total billed charges","78% of total billed charges",5661.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1103.54,82.6,,882.83,,,0,"percent of total billed charges","82.6% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1103.54,82.6,,882.83,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3869.76,100,,,,,0,"fee schedule",EAPG,1336,100,,1068.80,,,0,"percent of total billed charges","100% of total billed charges",204.41,19379.78,
"36246 Selective catheter placement, arterial syste",7961510,CDM,521,RC,36246,CPT,OUTPATIENT,,,769,499.85,,676.72,88,,541.38,,,0,"percent of total billed charges","88% of total billed charges",384.5,50,,307.60,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,769,100,,615.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",484.47,63,,387.58,,,0,"percent of total billed charges","63% of total billed charges",117.66,15.3,,94.13,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,530.61,69,,,,,0,"fee schedule","69% of total billed charges",769,100,,615.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",769,100,,615.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",769,100,,615.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",475.63,61.85,,380.50,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,384.5,50,,307.60,,,0,"percent of total billed charges","50% of total billed charges",247.62,32.2,,198.10,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",289.91,37.7,,231.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",599.82,78,,479.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",635.19,82.6,,508.15,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,384.5,50,,307.60,,,0,"percent of total billed charges","50% of total billed charges",635.19,82.6,,508.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",733.1,100,,,,,0,"fee schedule",EAPG,769,100,,615.20,,,0,"percent of total billed charges","100% of total billed charges",117.66,769,
"36247 Selective catheter placement, arterial syste",7961692,CDM,521,RC,36247,CPT,OUTPATIENT,,,916,595.4,,806.08,88,,644.86,,,0,"percent of total billed charges","88% of total billed charges",458,50,,366.40,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,916,100,,732.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",577.08,63,,461.66,,,0,"percent of total billed charges","63% of total billed charges",140.15,15.3,,112.12,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,632.04,69,,,,,0,"fee schedule","69% of total billed charges",916,100,,732.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",916,100,,732.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",916,100,,732.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",566.55,61.85,,453.24,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,458,50,,366.40,,,0,"percent of total billed charges","50% of total billed charges",294.95,32.2,,235.96,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",345.33,37.7,,276.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",714.48,78,,571.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",756.62,82.6,,605.30,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,458,50,,366.40,,,0,"percent of total billed charges","50% of total billed charges",756.62,82.6,,605.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",733.1,100,,,,,0,"fee schedule",EAPG,916,100,,732.80,,,0,"percent of total billed charges","100% of total billed charges",140.15,916,
"36248 Selective catheter placement, arterial syste",7961759,CDM,521,RC,36248,CPT,OUTPATIENT,,,145,94.25,,127.6,88,,102.08,,,0,"percent of total billed charges","88% of total billed charges",72.5,50,,58.00,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",91.35,63,,73.08,,,0,"percent of total billed charges","63% of total billed charges",22.19,15.3,,17.75,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,100.05,69,,,,,0,"fee schedule","69% of total billed charges",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.68,61.85,,71.74,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,72.5,50,,58.00,,,0,"percent of total billed charges","50% of total billed charges",46.69,32.2,,37.35,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",54.67,37.7,,43.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",113.1,78,,90.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",119.77,82.6,,95.82,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,72.5,50,,58.00,,,0,"percent of total billed charges","50% of total billed charges",119.77,82.6,,95.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",733.1,100,,,,,0,"fee schedule",EAPG,145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",22.19,744.35,
"36245 Selective catheter placement, arterial syste",7961823,CDM,521,RC,36245,CPT,OUTPATIENT,,,728,473.2,,640.64,88,,512.51,,,0,"percent of total billed charges","88% of total billed charges",364,50,,291.20,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,728,100,,582.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",458.64,63,,366.91,,,0,"percent of total billed charges","63% of total billed charges",111.38,15.3,,89.10,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,502.32,69,,,,,0,"fee schedule","69% of total billed charges",728,100,,582.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",728,100,,582.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",728,100,,582.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",450.27,61.85,,360.22,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,364,50,,291.20,,,0,"percent of total billed charges","50% of total billed charges",234.42,32.2,,187.54,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",274.46,37.7,,219.57,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",567.84,78,,454.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",601.33,82.6,,481.06,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,364,50,,291.20,,,0,"percent of total billed charges","50% of total billed charges",601.33,82.6,,481.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",733.1,100,,,,,0,"fee schedule",EAPG,728,100,,582.40,,,0,"percent of total billed charges","100% of total billed charges",111.38,744.35,
"36252 Selective catheter placement (first-order),",7961760,CDM,521,RC,36252,CPT,OUTPATIENT,,,1264,821.6,,1112.32,88,,889.86,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,1264,100,,1011.20,,,0,"percent of total billed charges","100% of total billed charges",5689.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",3820.51,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",796.32,63,,637.06,,,0,"percent of total billed charges","63% of total billed charges",193.39,15.3,,154.71,,,0,"percent of total billed charges","15.3% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,872.16,69,,,,,0,"fee schedule","69% of total billed charges",1264,100,,1011.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1264,100,,1011.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1264,100,,1011.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3783.42,100,,,,,0,"fee schedule",EAPG,4822.01,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",476.53,37.7,,381.22,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",985.92,78,,788.74,,,0,"percent of total billed charges","78% of total billed charges",3283.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1044.06,82.6,,835.25,,,0,"percent of total billed charges","82.6% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1044.06,82.6,,835.25,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3869.76,100,,,,,0,"fee schedule",EAPG,1264,100,,1011.20,,,0,"percent of total billed charges","100% of total billed charges",193.39,11625.58,
"36251 Selective cath plcmt, main renal artery, flu",7962376,CDM,521,RC,36251,CPT,OUTPATIENT,,,971,631.15,,854.48,88,,683.58,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,971,100,,776.80,,,0,"percent of total billed charges","100% of total billed charges",5689.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",3820.51,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",611.73,63,,489.38,,,0,"percent of total billed charges","63% of total billed charges",148.56,15.3,,118.85,,,0,"percent of total billed charges","15.3% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,669.99,69,,,,,0,"fee schedule","69% of total billed charges",971,100,,776.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",971,100,,776.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",971,100,,776.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3709.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3783.42,100,,,,,0,"fee schedule",EAPG,4822.01,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",366.07,37.7,,292.86,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",757.38,78,,605.90,,,0,"percent of total billed charges","78% of total billed charges",3283.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",802.05,82.6,,641.64,,,0,"percent of total billed charges","82.6% of total billed charges",3709.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",802.05,82.6,,641.64,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3869.76,100,,,,,0,"fee schedule",EAPG,971,100,,776.80,,,0,"percent of total billed charges","100% of total billed charges",148.56,11625.58,
"36400 Venipuncture, younger than age 3 years, nece",7962085,CDM,521,RC,36400,CPT,OUTPATIENT,,,82,53.3,,72.16,88,,57.73,,,0,"percent of total billed charges","88% of total billed charges",41,50,,32.80,,,0,"percent of total billed charges","50% of total billed charges",2.1,100,,,,,0,"fee schedule",EAPG,82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.16,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.55,15.3,,10.04,,,0,"percent of total billed charges","15.3% of total billed charges",2.1,100,,,,,0,"fee schedule",EAPG,56.58,69,,,,,0,"fee schedule","69% of total billed charges",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.72,61.85,,40.58,,,0,"percent of total billed charges","61.5% of total billed charges",2.1,100,,,,,0,"fee schedule",EAPG,41,50,,32.80,,,0,"percent of total billed charges","50% of total billed charges",26.4,32.2,,21.12,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.14,100,,,,,0,"fee schedule",EAPG,2.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.91,37.7,,24.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",63.96,78,,51.17,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.73,82.6,,54.18,,,0,"percent of total billed charges","82.6% of total billed charges",2.1,100,,,,,0,"fee schedule",EAPG,41,50,,32.80,,,0,"percent of total billed charges","50% of total billed charges",67.73,82.6,,54.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.63,100,,,,,0,"fee schedule",EAPG,82,100,,65.60,,,0,"percent of total billed charges","100% of total billed charges",2.1,162.63,
"36406 Venipuncture, younger than age 3 years, nece",7962093,CDM,521,RC,36406,CPT,OUTPATIENT,,,50,32.5,,44,88,,35.20,,,0,"percent of total billed charges","88% of total billed charges",25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",2.1,100,,,,,0,"fee schedule",EAPG,50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.16,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.65,15.3,,6.12,,,0,"percent of total billed charges","15.3% of total billed charges",2.1,100,,,,,0,"fee schedule",EAPG,34.5,69,,,,,0,"fee schedule","69% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.93,61.85,,24.74,,,0,"percent of total billed charges","61.5% of total billed charges",2.1,100,,,,,0,"fee schedule",EAPG,25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",16.1,32.2,,12.88,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.14,100,,,,,0,"fee schedule",EAPG,2.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39,78,,31.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",2.1,100,,,,,0,"fee schedule",EAPG,25,50,,20.00,,,0,"percent of total billed charges","50% of total billed charges",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.63,100,,,,,0,"fee schedule",EAPG,50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",2.1,162.63,
"36410 Venipuncture, age 3+ by a physician, for dia",7962746,CDM,521,RC,36410,CPT,OUTPATIENT,,,52,33.8,,45.76,88,,36.61,,,0,"percent of total billed charges","88% of total billed charges",26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54.44,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.96,15.3,,6.37,,,0,"percent of total billed charges","15.3% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,35.88,69,,,,,0,"fee schedule","69% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.16,61.85,,25.73,,,0,"percent of total billed charges","61.5% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",16.74,32.2,,13.39,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",53.92,100,,,,,0,"fee schedule",EAPG,68.72,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.6,37.7,,15.68,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",40.56,78,,32.45,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,26,50,,20.80,,,0,"percent of total billed charges","50% of total billed charges",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.39,100,,,,,0,"fee schedule",EAPG,52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",7.96,213.39,
"36416 Collection of capillary blood specimen",7963624,CDM,521,RC,36416,CPT,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.1,100,,,,,0,"fee schedule",EAPG,15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.16,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.1,100,,,,,0,"fee schedule",EAPG,10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.28,61.85,,7.42,,,0,"percent of total billed charges","61.5% of total billed charges",2.1,100,,,,,0,"fee schedule",EAPG,7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.14,100,,,,,0,"fee schedule",EAPG,2.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",2.1,100,,,,,0,"fee schedule",EAPG,7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.63,100,,,,,0,"fee schedule",EAPG,15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.1,162.63,
"36425 Venipuncture, cutdown; age 1 or over",7963659,CDM,521,RC,36425,CPT,OUTPATIENT,,,116,75.4,,102.08,88,,81.66,,,0,"percent of total billed charges","88% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",711.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",54.44,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.08,63,,58.46,,,0,"percent of total billed charges","63% of total billed charges",17.75,15.3,,14.20,,,0,"percent of total billed charges","15.3% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,80.04,69,,,,,0,"fee schedule","69% of total billed charges",116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",1097.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",53.92,100,,,,,0,"fee schedule",EAPG,68.72,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",43.73,37.7,,34.98,,,0,"percent of total billed charges","37.70% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",90.48,78,,72.38,,,0,"percent of total billed charges","78% of total billed charges",410.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",95.82,82.6,,76.66,,,0,"percent of total billed charges","82.6% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",95.82,82.6,,76.66,,,0,"percent of total billed charges","82.6% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",213.39,100,,,,,0,"fee schedule",EAPG,116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",17.75,1097.77,
"36468 Sclerotherapy of telangiectasia and/or incom",7904580,CDM,521,RC,36468,CPT,OUTPATIENT,,,259,168.35,,227.92,88,,182.34,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510,100,,,,,0,"fee schedule",EAPG,259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",525.3,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",163.17,63,,130.54,,,0,"percent of total billed charges","63% of total billed charges",39.63,15.3,,31.70,,,0,"percent of total billed charges","15.3% of total billed charges",510,100,,,,,0,"fee schedule",EAPG,178.71,69,,,,,0,"fee schedule","69% of total billed charges",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",520.2,100,,,,,0,"fee schedule",EAPG,663,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",97.64,37.7,,78.11,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.02,78,,161.62,,,0,"percent of total billed charges","78% of total billed charges",410.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",213.93,82.6,,171.14,,,0,"percent of total billed charges","82.6% of total billed charges",510,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",213.93,82.6,,171.14,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",670.53,100,,,,,0,"fee schedule",EAPG,259,100,,207.20,,,0,"percent of total billed charges","100% of total billed charges",39.63,1404.98,
"36476 Endovenous ablation therapy of vein, extremi",7961922,CDM,521,RC,36476,CPT,OUTPATIENT,,,1189,772.85,,1046.32,88,,837.06,,,0,"percent of total billed charges","88% of total billed charges",594.5,50,,475.60,,,0,"percent of total billed charges","50% of total billed charges",2302.53,100,,,,,0,"fee schedule",EAPG,1189,100,,951.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2371.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",749.07,63,,599.26,,,0,"percent of total billed charges","63% of total billed charges",181.92,15.3,,145.54,,,0,"percent of total billed charges","15.3% of total billed charges",2302.53,100,,,,,0,"fee schedule",EAPG,820.41,69,,,,,0,"fee schedule","69% of total billed charges",1189,100,,951.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1189,100,,951.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1189,100,,951.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",735.4,61.85,,588.32,,,0,"percent of total billed charges","61.5% of total billed charges",2302.53,100,,,,,0,"fee schedule",EAPG,594.5,50,,475.60,,,0,"percent of total billed charges","50% of total billed charges",382.86,32.2,,306.29,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2348.58,100,,,,,0,"fee schedule",EAPG,2993.29,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",448.25,37.7,,358.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",927.42,78,,741.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",982.11,82.6,,785.69,,,0,"percent of total billed charges","82.6% of total billed charges",2302.53,100,,,,,0,"fee schedule",EAPG,594.5,50,,475.60,,,0,"percent of total billed charges","50% of total billed charges",982.11,82.6,,785.69,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2463.06,100,,,,,0,"fee schedule",EAPG,1189,100,,951.20,,,0,"percent of total billed charges","100% of total billed charges",181.92,2993.29,
"36478 Endovenous ablation therapy of incompetent v",7961994,CDM,521,RC,36478,CPT,OUTPATIENT,,,4260,2769,,3748.8,88,,2999.04,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2302.53,100,,,,,0,"fee schedule",EAPG,4260,100,,3408.00,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",2371.61,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2683.8,63,,2147.04,,,0,"percent of total billed charges","63% of total billed charges",651.78,15.3,,521.42,,,0,"percent of total billed charges","15.3% of total billed charges",2302.53,100,,,,,0,"fee schedule",EAPG,2939.4,69,,,,,0,"fee schedule","69% of total billed charges",4260,100,,3408.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4260,100,,3408.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4260,100,,3408.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2302.53,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2348.58,100,,,,,0,"fee schedule",EAPG,2993.29,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1606.02,37.7,,1284.82,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3322.8,78,,2658.24,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3518.76,82.6,,2815.01,,,0,"percent of total billed charges","82.6% of total billed charges",2302.53,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3518.76,82.6,,2815.01,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2463.06,100,,,,,0,"fee schedule",EAPG,4260,100,,3408.00,,,0,"percent of total billed charges","100% of total billed charges",651.78,11625.57,
"36479 Endovenous ablation therapy of incompetent v",7961995,CDM,521,RC,36479,CPT,OUTPATIENT,,,1237,804.05,,1088.56,88,,870.85,,,0,"percent of total billed charges","88% of total billed charges",618.5,50,,494.80,,,0,"percent of total billed charges","50% of total billed charges",2302.53,100,,,,,0,"fee schedule",EAPG,1237,100,,989.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2371.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",779.31,63,,623.45,,,0,"percent of total billed charges","63% of total billed charges",189.26,15.3,,151.41,,,0,"percent of total billed charges","15.3% of total billed charges",2302.53,100,,,,,0,"fee schedule",EAPG,853.53,69,,,,,0,"fee schedule","69% of total billed charges",1237,100,,989.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1237,100,,989.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1237,100,,989.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",765.08,61.85,,612.06,,,0,"percent of total billed charges","61.5% of total billed charges",2302.53,100,,,,,0,"fee schedule",EAPG,618.5,50,,494.80,,,0,"percent of total billed charges","50% of total billed charges",398.31,32.2,,318.65,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2348.58,100,,,,,0,"fee schedule",EAPG,2993.29,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",466.35,37.7,,373.08,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",964.86,78,,771.89,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1021.76,82.6,,817.41,,,0,"percent of total billed charges","82.6% of total billed charges",2302.53,100,,,,,0,"fee schedule",EAPG,618.5,50,,494.80,,,0,"percent of total billed charges","50% of total billed charges",1021.76,82.6,,817.41,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2463.06,100,,,,,0,"fee schedule",EAPG,1237,100,,989.60,,,0,"percent of total billed charges","100% of total billed charges",189.26,2993.29,
"36471 Injection of sclerosing solution; multiple v",7963174,CDM,521,RC,36471,CPT,OUTPATIENT,,,522,339.3,,459.36,88,,367.49,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510,100,,,,,0,"fee schedule",EAPG,522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",525.3,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",328.86,63,,263.09,,,0,"percent of total billed charges","63% of total billed charges",79.87,15.3,,63.90,,,0,"percent of total billed charges","15.3% of total billed charges",510,100,,,,,0,"fee schedule",EAPG,360.18,69,,,,,0,"fee schedule","69% of total billed charges",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",520.2,100,,,,,0,"fee schedule",EAPG,663,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",196.79,37.7,,157.43,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",407.16,78,,325.73,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",431.17,82.6,,344.94,,,0,"percent of total billed charges","82.6% of total billed charges",510,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",431.17,82.6,,344.94,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",670.53,100,,,,,0,"fee schedule",EAPG,522,100,,417.60,,,0,"percent of total billed charges","100% of total billed charges",79.87,1404.97,
"36470 Injection of sclerosing solution; single vei",7963483,CDM,521,RC,36470,CPT,OUTPATIENT,,,447,290.55,,393.36,88,,314.69,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510,100,,,,,0,"fee schedule",EAPG,447,100,,357.60,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",525.3,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",281.61,63,,225.29,,,0,"percent of total billed charges","63% of total billed charges",68.39,15.3,,54.71,,,0,"percent of total billed charges","15.3% of total billed charges",510,100,,,,,0,"fee schedule",EAPG,308.43,69,,,,,0,"fee schedule","69% of total billed charges",447,100,,357.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",447,100,,357.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",447,100,,357.60,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",520.2,100,,,,,0,"fee schedule",EAPG,663,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",168.52,37.7,,134.82,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.66,78,,278.93,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",369.22,82.6,,295.38,,,0,"percent of total billed charges","82.6% of total billed charges",510,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",369.22,82.6,,295.38,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",670.53,100,,,,,0,"fee schedule",EAPG,447,100,,357.60,,,0,"percent of total billed charges","100% of total billed charges",68.39,1404.97,
"36482 Endoven therm chem ad 1st vein",8165580,CDM,521,RC,36482,CPT,OUTPATIENT,,,387,251.55,,340.56,88,,272.45,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2302.53,100,,,,,0,"fee schedule",EAPG,387,100,,309.60,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",2371.61,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",243.81,63,,195.05,,,0,"percent of total billed charges","63% of total billed charges",59.21,15.3,,47.37,,,0,"percent of total billed charges","15.3% of total billed charges",2302.53,100,,,,,0,"fee schedule",EAPG,267.03,69,,,,,0,"fee schedule","69% of total billed charges",387,100,,309.60,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",387,100,,309.60,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",387,100,,309.60,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2302.53,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2348.58,100,,,,,0,"fee schedule",EAPG,2993.29,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",145.9,37.7,,116.72,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",301.86,78,,241.49,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",319.66,82.6,,255.73,,,0,"percent of total billed charges","82.6% of total billed charges",2302.53,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",319.66,82.6,,255.73,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2463.06,100,,,,,0,"fee schedule",EAPG,387,100,,309.60,,,0,"percent of total billed charges","100% of total billed charges",59.21,19379.77,
"36483 Endoven therm chem ad sub vein",8165581,CDM,521,RC,36483,CPT,OUTPATIENT,,,931,605.15,,819.28,88,,655.42,,,0,"percent of total billed charges","88% of total billed charges",465.5,50,,372.40,,,0,"percent of total billed charges","50% of total billed charges",2302.53,100,,,,,0,"fee schedule",EAPG,931,100,,744.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2371.61,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",586.53,63,,469.22,,,0,"percent of total billed charges","63% of total billed charges",142.44,15.3,,113.95,,,0,"percent of total billed charges","15.3% of total billed charges",2302.53,100,,,,,0,"fee schedule",EAPG,642.39,69,,,,,0,"fee schedule","69% of total billed charges",931,100,,744.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",931,100,,744.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",931,100,,744.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",575.82,61.85,,460.66,,,0,"percent of total billed charges","61.5% of total billed charges",2302.53,100,,,,,0,"fee schedule",EAPG,465.5,50,,372.40,,,0,"percent of total billed charges","50% of total billed charges",299.78,32.2,,239.82,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2348.58,100,,,,,0,"fee schedule",EAPG,2993.29,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",350.99,37.7,,280.79,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",726.18,78,,580.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",769.01,82.6,,615.21,,,0,"percent of total billed charges","82.6% of total billed charges",2302.53,100,,,,,0,"fee schedule",EAPG,465.5,50,,372.40,,,0,"percent of total billed charges","50% of total billed charges",769.01,82.6,,615.21,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2463.06,100,,,,,0,"fee schedule",EAPG,931,100,,744.80,,,0,"percent of total billed charges","100% of total billed charges",142.44,2993.29,
"36510 Catheterization of umbilical vein for diagno",7962906,CDM,521,RC,36510,CPT,OUTPATIENT,,,286,185.9,,251.68,88,,201.34,,,0,"percent of total billed charges","88% of total billed charges",143,50,,114.40,,,0,"percent of total billed charges","50% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,286,100,,228.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54.44,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",180.18,63,,144.14,,,0,"percent of total billed charges","63% of total billed charges",43.76,15.3,,35.01,,,0,"percent of total billed charges","15.3% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,197.34,69,,,,,0,"fee schedule","69% of total billed charges",286,100,,228.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",286,100,,228.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",286,100,,228.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.89,61.85,,141.51,,,0,"percent of total billed charges","61.5% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,143,50,,114.40,,,0,"percent of total billed charges","50% of total billed charges",92.09,32.2,,73.67,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",53.92,100,,,,,0,"fee schedule",EAPG,68.72,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",107.82,37.7,,86.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",223.08,78,,178.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",236.24,82.6,,188.99,,,0,"percent of total billed charges","82.6% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,143,50,,114.40,,,0,"percent of total billed charges","50% of total billed charges",236.24,82.6,,188.99,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.39,100,,,,,0,"fee schedule",EAPG,286,100,,228.80,,,0,"percent of total billed charges","100% of total billed charges",43.76,286,
"36558 Insertion of tunneled centrally inserted cen",7961761,CDM,521,RC,36558,CPT,OUTPATIENT,,,1144,743.6,,1006.72,88,,805.38,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1979.08,100,,,,,0,"fee schedule",EAPG,1144,100,,915.20,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",2038.45,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",720.72,63,,576.58,,,0,"percent of total billed charges","63% of total billed charges",175.03,15.3,,140.02,,,0,"percent of total billed charges","15.3% of total billed charges",1979.08,100,,,,,0,"fee schedule",EAPG,789.36,69,,,,,0,"fee schedule","69% of total billed charges",1144,100,,915.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1144,100,,915.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1144,100,,915.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1979.08,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2018.66,100,,,,,0,"fee schedule",EAPG,2572.8,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",431.29,37.7,,345.03,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.32,78,,713.86,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",944.94,82.6,,755.95,,,0,"percent of total billed charges","82.6% of total billed charges",1979.08,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",944.94,82.6,,755.95,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2139.61,100,,,,,0,"fee schedule",EAPG,1144,100,,915.20,,,0,"percent of total billed charges","100% of total billed charges",175.03,11625.57,
"36556 Insertion of non-tunneled central venous cat",7962782,CDM,521,RC,36556,CPT,OUTPATIENT,,,549,356.85,,483.12,88,,386.50,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",1043.63,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.87,63,,276.70,,,0,"percent of total billed charges","63% of total billed charges",84,15.3,,67.20,,,0,"percent of total billed charges","15.3% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,378.81,69,,,,,0,"fee schedule","69% of total billed charges",549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033.49,100,,,,,0,"fee schedule",EAPG,1317.2,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",206.97,37.7,,165.58,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",428.22,78,,342.58,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",453.47,82.6,,362.78,,,0,"percent of total billed charges","82.6% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",453.47,82.6,,362.78,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1173.76,100,,,,,0,"fee schedule",EAPG,549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",84,11625.57,
"36561 Insertion of tunneled centrally inserted cen",7961874,CDM,521,RC,36561,CPT,OUTPATIENT,,,1346,874.9,,1184.48,88,,947.58,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1979.08,100,,,,,0,"fee schedule",EAPG,1346,100,,1076.80,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",2038.45,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",847.98,63,,678.38,,,0,"percent of total billed charges","63% of total billed charges",205.94,15.3,,164.75,,,0,"percent of total billed charges","15.3% of total billed charges",1979.08,100,,,,,0,"fee schedule",EAPG,928.74,69,,,,,0,"fee schedule","69% of total billed charges",1346,100,,1076.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1346,100,,1076.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1346,100,,1076.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1979.08,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2018.66,100,,,,,0,"fee schedule",EAPG,2572.8,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",507.44,37.7,,405.95,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1049.88,78,,839.90,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1111.8,82.6,,889.44,,,0,"percent of total billed charges","82.6% of total billed charges",1979.08,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1111.8,82.6,,889.44,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2139.61,100,,,,,0,"fee schedule",EAPG,1346,100,,1076.80,,,0,"percent of total billed charges","100% of total billed charges",205.94,11625.57,
"36569 Insertion of PICC, without subcutaneous port",7962676,CDM,521,RC,36569,CPT,OUTPATIENT,,,516,335.4,,454.08,88,,363.26,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,516,100,,412.80,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",1043.63,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",325.08,63,,260.06,,,0,"percent of total billed charges","63% of total billed charges",78.95,15.3,,63.16,,,0,"percent of total billed charges","15.3% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,356.04,69,,,,,0,"fee schedule","69% of total billed charges",516,100,,412.80,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",516,100,,412.80,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",516,100,,412.80,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033.49,100,,,,,0,"fee schedule",EAPG,1317.2,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",194.53,37.7,,155.62,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.48,78,,321.98,,,0,"percent of total billed charges","78% of total billed charges",1649.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.22,82.6,,340.98,,,0,"percent of total billed charges","82.6% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.22,82.6,,340.98,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1173.76,100,,,,,0,"fee schedule",EAPG,516,100,,412.80,,,0,"percent of total billed charges","100% of total billed charges",78.95,5712.48,
"36571 Insertion of peripherally inserted central v",7961996,CDM,521,RC,36571,CPT,OUTPATIENT,,,1240,806,,1091.2,88,,872.96,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,1240,100,,992.00,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",1043.63,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",781.2,63,,624.96,,,0,"percent of total billed charges","63% of total billed charges",189.72,15.3,,151.78,,,0,"percent of total billed charges","15.3% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,855.6,69,,,,,0,"fee schedule","69% of total billed charges",1240,100,,992.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1240,100,,992.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1240,100,,992.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033.49,100,,,,,0,"fee schedule",EAPG,1317.2,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",467.48,37.7,,373.98,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",967.2,78,,773.76,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1024.24,82.6,,819.39,,,0,"percent of total billed charges","82.6% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1024.24,82.6,,819.39,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1173.76,100,,,,,0,"fee schedule",EAPG,1240,100,,992.00,,,0,"percent of total billed charges","100% of total billed charges",189.72,11625.57,
"36589 Removal of central venous access device",7904581,CDM,521,RC,36589,CPT,OUTPATIENT,,,356,231.4,,313.28,88,,250.62,,,0,"percent of total billed charges","88% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",1121.3,175,,,,,0,"fee schedule","175% of CMS fee schedule",678.35,100,,,,,0,"fee schedule",EAPG,640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.28,63,,179.42,,,0,"percent of total billed charges","63% of total billed charges",54.47,15.3,,43.58,,,0,"percent of total billed charges","15.3% of total billed charges",658.59,100,,,,,0,"fee schedule",EAPG,245.64,69,,,,,0,"fee schedule","69% of total billed charges",356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",2200.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",575.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671.77,100,,,,,0,"fee schedule",EAPG,856.17,100,,,,,0,"fee schedule",EAPG,640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",134.21,37.7,,107.37,,,0,"percent of total billed charges","37.70% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.68,78,,222.14,,,0,"percent of total billed charges","78% of total billed charges",647.15,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.06,82.6,,235.25,,,0,"percent of total billed charges","82.6% of total billed charges",658.59,100,,,,,0,"fee schedule",EAPG,640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.06,82.6,,235.25,,,0,"percent of total billed charges","82.6% of total billed charges",640.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",819.12,100,,,,,0,"fee schedule",EAPG,356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",54.47,2200.34,
"36581 Replacement, tunneled centrally inserted cen",7961693,CDM,521,RC,36581,CPT,OUTPATIENT,,,2957,1922.05,,2602.16,88,,2081.73,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1979.08,100,,,,,0,"fee schedule",EAPG,2957,100,,2365.60,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",2038.45,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1862.91,63,,1490.33,,,0,"percent of total billed charges","63% of total billed charges",452.42,15.3,,361.94,,,0,"percent of total billed charges","15.3% of total billed charges",1979.08,100,,,,,0,"fee schedule",EAPG,2040.33,69,,,,,0,"fee schedule","69% of total billed charges",2957,100,,2365.60,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2957,100,,2365.60,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2957,100,,2365.60,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1979.08,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2018.66,100,,,,,0,"fee schedule",EAPG,2572.8,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1114.79,37.7,,891.83,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2306.46,78,,1845.17,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2442.48,82.6,,1953.98,,,0,"percent of total billed charges","82.6% of total billed charges",1979.08,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2442.48,82.6,,1953.98,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2139.61,100,,,,,0,"fee schedule",EAPG,2957,100,,2365.60,,,0,"percent of total billed charges","100% of total billed charges",452.42,11625.57,
"36585 Replacement, complete, of a peripherally ins",7961997,CDM,521,RC,36585,CPT,OUTPATIENT,,,1027,667.55,,903.76,88,,723.01,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,1027,100,,821.60,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",1043.63,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.01,63,,517.61,,,0,"percent of total billed charges","63% of total billed charges",157.13,15.3,,125.70,,,0,"percent of total billed charges","15.3% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,708.63,69,,,,,0,"fee schedule","69% of total billed charges",1027,100,,821.60,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1027,100,,821.60,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1027,100,,821.60,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033.49,100,,,,,0,"fee schedule",EAPG,1317.2,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",387.18,37.7,,309.74,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",801.06,78,,640.85,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",848.3,82.6,,678.64,,,0,"percent of total billed charges","82.6% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",848.3,82.6,,678.64,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1173.76,100,,,,,0,"fee schedule",EAPG,1027,100,,821.60,,,0,"percent of total billed charges","100% of total billed charges",157.13,11625.57,
"36580 Replacement, complete, of a non-tunneled cen",7962117,CDM,521,RC,36580,CPT,OUTPATIENT,,,251,163.15,,220.88,88,,176.70,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,251,100,,200.80,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",1043.63,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.13,63,,126.50,,,0,"percent of total billed charges","63% of total billed charges",38.4,15.3,,30.72,,,0,"percent of total billed charges","15.3% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,173.19,69,,,,,0,"fee schedule","69% of total billed charges",251,100,,200.80,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",251,100,,200.80,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",251,100,,200.80,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033.49,100,,,,,0,"fee schedule",EAPG,1317.2,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",94.63,37.7,,75.70,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",195.78,78,,156.62,,,0,"percent of total billed charges","78% of total billed charges",1649.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",207.33,82.6,,165.86,,,0,"percent of total billed charges","82.6% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",207.33,82.6,,165.86,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1173.76,100,,,,,0,"fee schedule",EAPG,251,100,,200.80,,,0,"percent of total billed charges","100% of total billed charges",38.4,5712.48,
"36582 Replacement, complete, of a tunneled central",7962334,CDM,521,RC,36582,CPT,OUTPATIENT,,,1763,1145.95,,1551.44,88,,1241.15,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1979.08,100,,,,,0,"fee schedule",EAPG,1763,100,,1410.40,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",2038.45,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1110.69,63,,888.55,,,0,"percent of total billed charges","63% of total billed charges",269.74,15.3,,215.79,,,0,"percent of total billed charges","15.3% of total billed charges",1979.08,100,,,,,0,"fee schedule",EAPG,1216.47,69,,,,,0,"fee schedule","69% of total billed charges",1763,100,,1410.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1763,100,,1410.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1763,100,,1410.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1979.08,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2018.66,100,,,,,0,"fee schedule",EAPG,2572.8,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",664.65,37.7,,531.72,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1375.14,78,,1100.11,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1456.24,82.6,,1164.99,,,0,"percent of total billed charges","82.6% of total billed charges",1979.08,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1456.24,82.6,,1164.99,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2139.61,100,,,,,0,"fee schedule",EAPG,1763,100,,1410.40,,,0,"percent of total billed charges","100% of total billed charges",269.74,11625.57,
"36590 Removal of central venous access device",7904582,CDM,521,RC,36590,CPT,OUTPATIENT,,,764,496.6,,672.32,88,,537.86,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,764,100,,611.20,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",678.35,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",481.32,63,,385.06,,,0,"percent of total billed charges","63% of total billed charges",116.89,15.3,,93.51,,,0,"percent of total billed charges","15.3% of total billed charges",658.59,100,,,,,0,"fee schedule",EAPG,527.16,69,,,,,0,"fee schedule","69% of total billed charges",764,100,,611.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",764,100,,611.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",764,100,,611.20,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671.77,100,,,,,0,"fee schedule",EAPG,856.17,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",288.03,37.7,,230.42,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",595.92,78,,476.74,,,0,"percent of total billed charges","78% of total billed charges",1649.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",631.06,82.6,,504.85,,,0,"percent of total billed charges","82.6% of total billed charges",658.59,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",631.06,82.6,,504.85,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",819.12,100,,,,,0,"fee schedule",EAPG,764,100,,611.20,,,0,"percent of total billed charges","100% of total billed charges",116.89,5712.48,
"36598 Contrast injection(s) for radiologic evaluat",7962121,CDM,521,RC,36598,CPT,OUTPATIENT,,,377,245.05,,331.76,88,,265.41,,,0,"percent of total billed charges","88% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.87,100,,,,,0,"fee schedule",EAPG,377,100,,301.60,,,0,"percent of total billed charges","100% of total billed charges",382.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",281.05,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",237.51,63,,190.01,,,0,"percent of total billed charges","63% of total billed charges",57.68,15.3,,46.14,,,0,"percent of total billed charges","15.3% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,260.13,69,,,,,0,"fee schedule","69% of total billed charges",377,100,,301.60,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",377,100,,301.60,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",377,100,,301.60,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",826.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.87,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278.32,100,,,,,0,"fee schedule",EAPG,354.73,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",142.13,37.7,,113.70,,,0,"percent of total billed charges","37.70% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.06,78,,235.25,,,0,"percent of total billed charges","78% of total billed charges",220.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",311.4,82.6,,249.12,,,0,"percent of total billed charges","82.6% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",311.4,82.6,,249.12,,,0,"percent of total billed charges","82.6% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",433.4,100,,,,,0,"fee schedule",EAPG,377,100,,301.60,,,0,"percent of total billed charges","100% of total billed charges",57.68,826.71,
"36597 Repositioning of previously placed central v",7962253,CDM,521,RC,36597,CPT,OUTPATIENT,,,278,180.7,,244.64,88,,195.71,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",678.35,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",175.14,63,,140.11,,,0,"percent of total billed charges","63% of total billed charges",42.53,15.3,,34.02,,,0,"percent of total billed charges","15.3% of total billed charges",658.59,100,,,,,0,"fee schedule",EAPG,191.82,69,,,,,0,"fee schedule","69% of total billed charges",278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.59,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671.77,100,,,,,0,"fee schedule",EAPG,856.17,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",104.81,37.7,,83.85,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.84,78,,173.47,,,0,"percent of total billed charges","78% of total billed charges",1649.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.63,82.6,,183.70,,,0,"percent of total billed charges","82.6% of total billed charges",658.59,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.63,82.6,,183.70,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",819.12,100,,,,,0,"fee schedule",EAPG,278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",42.53,5712.48,
"36593 Declotting by thrombolytic agent of implante",7962472,CDM,521,RC,36593,CPT,OUTPATIENT,,,142,92.3,,124.96,88,,99.97,,,0,"percent of total billed charges","88% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",604.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",281.17,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",89.46,63,,71.57,,,0,"percent of total billed charges","63% of total billed charges",21.73,15.3,,17.38,,,0,"percent of total billed charges","15.3% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,97.98,69,,,,,0,"fee schedule","69% of total billed charges",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",1262.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278.44,100,,,,,0,"fee schedule",EAPG,354.88,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",53.53,37.7,,42.82,,,0,"percent of total billed charges","37.70% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.76,78,,88.61,,,0,"percent of total billed charges","78% of total billed charges",348.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",117.29,82.6,,93.83,,,0,"percent of total billed charges","82.6% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",117.29,82.6,,93.83,,,0,"percent of total billed charges","82.6% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",433.51,100,,,,,0,"fee schedule",EAPG,142,100,,113.60,,,0,"percent of total billed charges","100% of total billed charges",21.73,1262.42,
"36592 Collect spec central/peripheral cath",8092753,CDM,521,RC,36592,CPT,OUTPATIENT,,,264,171.6,,232.32,88,,185.86,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",54.44,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",40.39,15.3,,32.31,,,0,"percent of total billed charges","15.3% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,182.16,69,,,,,0,"fee schedule","69% of total billed charges",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",53.92,100,,,,,0,"fee schedule",EAPG,68.72,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",99.53,37.7,,79.62,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",205.92,78,,164.74,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.06,82.6,,174.45,,,0,"percent of total billed charges","82.6% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.06,82.6,,174.45,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",213.39,100,,,,,0,"fee schedule",EAPG,264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",40.39,454.8,
"36620 Arterial catheterization/cannulation for sam",7961824,CDM,521,RC,36620,CPT,OUTPATIENT,,,328,213.2,,288.64,88,,230.91,,,0,"percent of total billed charges","88% of total billed charges",164,50,,131.20,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.64,63,,165.31,,,0,"percent of total billed charges","63% of total billed charges",50.18,15.3,,40.14,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,226.32,69,,,,,0,"fee schedule","69% of total billed charges",328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.87,61.85,,162.30,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,164,50,,131.20,,,0,"percent of total billed charges","50% of total billed charges",105.62,32.2,,84.50,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",123.66,37.7,,98.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",255.84,78,,204.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",270.93,82.6,,216.74,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,164,50,,131.20,,,0,"percent of total billed charges","50% of total billed charges",270.93,82.6,,216.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",733.1,100,,,,,0,"fee schedule",EAPG,328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",50.18,744.35,
"36625 Arterial catheterization or cannulation for",7961923,CDM,521,RC,36625,CPT,OUTPATIENT,,,416,270.4,,366.08,88,,292.86,,,0,"percent of total billed charges","88% of total billed charges",208,50,,166.40,,,0,"percent of total billed charges","50% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,416,100,,332.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",589.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",262.08,63,,209.66,,,0,"percent of total billed charges","63% of total billed charges",63.65,15.3,,50.92,,,0,"percent of total billed charges","15.3% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,287.04,69,,,,,0,"fee schedule","69% of total billed charges",416,100,,332.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",416,100,,332.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",416,100,,332.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",257.3,61.85,,205.84,,,0,"percent of total billed charges","61.5% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,208,50,,166.40,,,0,"percent of total billed charges","50% of total billed charges",133.95,32.2,,107.16,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",584.03,100,,,,,0,"fee schedule",EAPG,744.35,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.83,37.7,,125.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",324.48,78,,259.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",343.62,82.6,,274.90,,,0,"percent of total billed charges","82.6% of total billed charges",572.57,100,,,,,0,"fee schedule",EAPG,208,50,,166.40,,,0,"percent of total billed charges","50% of total billed charges",343.62,82.6,,274.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",733.1,100,,,,,0,"fee schedule",EAPG,416,100,,332.80,,,0,"percent of total billed charges","100% of total billed charges",63.65,744.35,
"36660 Catheterization, umbilical artery, newborn,",7962885,CDM,521,RC,36660,CPT,OUTPATIENT,,,413,268.45,,363.44,88,,290.75,,,0,"percent of total billed charges","88% of total billed charges",413,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",52.86,100,,,,,0,"fee schedule",EAPG,413,100,,330.40,,,0,"percent of total billed charges","100% of total billed charges",413,175,,,,,0,"fee schedule","175% of CMS fee schedule",54.44,100,,,,,0,"fee schedule",EAPG,413,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",260.19,63,,208.15,,,0,"percent of total billed charges","63% of total billed charges",63.19,15.3,,50.55,,,0,"percent of total billed charges","15.3% of total billed charges",52.86,100,,,,,0,"fee schedule",EAPG,284.97,69,,,,,0,"fee schedule","69% of total billed charges",413,100,,330.40,,,0,"percent of total billed charges","100% of total billed charges",413,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",413,100,,330.40,,,0,"percent of total billed charges","100% of total billed charges",413,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",413,100,,330.40,,,0,"percent of total billed charges","100% of total billed charges",413,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",413,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",52.86,100,,,,,0,"fee schedule",EAPG,413,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",413,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",413,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",53.92,100,,,,,0,"fee schedule",EAPG,68.72,100,,,,,0,"fee schedule",EAPG,413,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",155.7,37.7,,124.56,,,0,"percent of total billed charges","37.70% of total billed charges",413,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",413,100,,,,,0,"fee schedule","100% of CMS fee schedule",322.14,78,,257.71,,,0,"percent of total billed charges","78% of total billed charges",413,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",341.14,82.6,,272.91,,,0,"percent of total billed charges","82.6% of total billed charges",52.86,100,,,,,0,"fee schedule","100% of WA fee schedule",413,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",341.14,82.6,,272.91,,,0,"percent of total billed charges","82.6% of total billed charges",413,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",213.39,100,,,,,0,"fee schedule",EAPG,413,100,,330.40,,,0,"percent of total billed charges","100% of total billed charges",52.86,413,
"36800 Insertion of cannula for hemodialysis, other",7962937,CDM,521,RC,36800,CPT,OUTPATIENT,,,514,334.1,,452.32,88,,361.86,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1979.08,100,,,,,0,"fee schedule",EAPG,514,100,,411.20,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",2038.45,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",323.82,63,,259.06,,,0,"percent of total billed charges","63% of total billed charges",78.64,15.3,,62.91,,,0,"percent of total billed charges","15.3% of total billed charges",1979.08,100,,,,,0,"fee schedule",EAPG,354.66,69,,,,,0,"fee schedule","69% of total billed charges",514,100,,411.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",514,100,,411.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",514,100,,411.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1979.08,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2018.66,100,,,,,0,"fee schedule",EAPG,2572.8,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",193.78,37.7,,155.02,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.92,78,,320.74,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",424.56,82.6,,339.65,,,0,"percent of total billed charges","82.6% of total billed charges",1979.08,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",424.56,82.6,,339.65,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2139.61,100,,,,,0,"fee schedule",EAPG,514,100,,411.20,,,0,"percent of total billed charges","100% of total billed charges",78.64,19379.77,
"36815 Insertion of cannula for hemodialysis, other",7961998,CDM,521,RC,36815,CPT,OUTPATIENT,,,549,356.85,,483.12,88,,386.50,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1979.08,100,,,,,0,"fee schedule",EAPG,549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",2038.45,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.87,63,,276.70,,,0,"percent of total billed charges","63% of total billed charges",84,15.3,,67.20,,,0,"percent of total billed charges","15.3% of total billed charges",1979.08,100,,,,,0,"fee schedule",EAPG,378.81,69,,,,,0,"fee schedule","69% of total billed charges",549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1979.08,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2018.66,100,,,,,0,"fee schedule",EAPG,2572.8,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",206.97,37.7,,165.58,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",428.22,78,,342.58,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",453.47,82.6,,362.78,,,0,"percent of total billed charges","82.6% of total billed charges",1979.08,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",453.47,82.6,,362.78,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2139.61,100,,,,,0,"fee schedule",EAPG,549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",84,19379.77,
"36818 Arteriovenous anastomosis, open; by upper ar",7962725,CDM,521,RC,36818,CPT,OUTPATIENT,,,2215,1439.75,,1949.2,88,,1559.36,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3178.59,100,,,,,0,"fee schedule",EAPG,2215,100,,1772.00,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3273.95,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1395.45,63,,1116.36,,,0,"percent of total billed charges","63% of total billed charges",338.9,15.3,,271.12,,,0,"percent of total billed charges","15.3% of total billed charges",3178.59,100,,,,,0,"fee schedule",EAPG,1528.35,69,,,,,0,"fee schedule","69% of total billed charges",2215,100,,1772.00,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2215,100,,1772.00,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2215,100,,1772.00,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3178.59,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3242.16,100,,,,,0,"fee schedule",EAPG,4132.17,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",835.06,37.7,,668.05,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1727.7,78,,1382.16,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1829.59,82.6,,1463.67,,,0,"percent of total billed charges","82.6% of total billed charges",3178.59,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1829.59,82.6,,1463.67,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3339.12,100,,,,,0,"fee schedule",EAPG,2215,100,,1772.00,,,0,"percent of total billed charges","100% of total billed charges",338.9,19379.77,
"36819 Arteriovenous anastomosis, open; by upper ar",7962747,CDM,521,RC,36819,CPT,OUTPATIENT,,,2502,1626.3,,2201.76,88,,1761.41,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3178.59,100,,,,,0,"fee schedule",EAPG,2502,100,,2001.60,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3273.95,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1576.26,63,,1261.01,,,0,"percent of total billed charges","63% of total billed charges",382.81,15.3,,306.25,,,0,"percent of total billed charges","15.3% of total billed charges",3178.59,100,,,,,0,"fee schedule",EAPG,1726.38,69,,,,,0,"fee schedule","69% of total billed charges",2502,100,,2001.60,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2502,100,,2001.60,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2502,100,,2001.60,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3178.59,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3242.16,100,,,,,0,"fee schedule",EAPG,4132.17,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",943.25,37.7,,754.60,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1951.56,78,,1561.25,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2066.65,82.6,,1653.32,,,0,"percent of total billed charges","82.6% of total billed charges",3178.59,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2066.65,82.6,,1653.32,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3339.12,100,,,,,0,"fee schedule",EAPG,2502,100,,2001.60,,,0,"percent of total billed charges","100% of total billed charges",382.81,19379.77,
"36825 Creation of arteriovenous fistula by non-dir",7961762,CDM,521,RC,36825,CPT,OUTPATIENT,,,2701,1755.65,,2376.88,88,,1901.50,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3178.59,100,,,,,0,"fee schedule",EAPG,2701,100,,2160.80,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3273.95,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1701.63,63,,1361.30,,,0,"percent of total billed charges","63% of total billed charges",413.25,15.3,,330.60,,,0,"percent of total billed charges","15.3% of total billed charges",3178.59,100,,,,,0,"fee schedule",EAPG,1863.69,69,,,,,0,"fee schedule","69% of total billed charges",2701,100,,2160.80,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2701,100,,2160.80,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2701,100,,2160.80,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3178.59,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3242.16,100,,,,,0,"fee schedule",EAPG,4132.17,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1018.28,37.7,,814.62,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2106.78,78,,1685.42,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2231.03,82.6,,1784.82,,,0,"percent of total billed charges","82.6% of total billed charges",3178.59,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2231.03,82.6,,1784.82,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3339.12,100,,,,,0,"fee schedule",EAPG,2701,100,,2160.80,,,0,"percent of total billed charges","100% of total billed charges",413.25,19379.77,
"36820 Arteriovenous anastomosis, open; by forearm",7963059,CDM,521,RC,36820,CPT,OUTPATIENT,,,2346,1524.9,,2064.48,88,,1651.58,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3178.59,100,,,,,0,"fee schedule",EAPG,2346,100,,1876.80,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3273.95,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1477.98,63,,1182.38,,,0,"percent of total billed charges","63% of total billed charges",358.94,15.3,,287.15,,,0,"percent of total billed charges","15.3% of total billed charges",3178.59,100,,,,,0,"fee schedule",EAPG,1618.74,69,,,,,0,"fee schedule","69% of total billed charges",2346,100,,1876.80,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2346,100,,1876.80,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2346,100,,1876.80,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3178.59,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3242.16,100,,,,,0,"fee schedule",EAPG,4132.17,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",884.44,37.7,,707.55,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1829.88,78,,1463.90,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1937.8,82.6,,1550.24,,,0,"percent of total billed charges","82.6% of total billed charges",3178.59,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1937.8,82.6,,1550.24,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3339.12,100,,,,,0,"fee schedule",EAPG,2346,100,,1876.80,,,0,"percent of total billed charges","100% of total billed charges",358.94,19379.77,
"36821 Arteriovenous anastomosis, open; direct, any",7963412,CDM,521,RC,36821,CPT,OUTPATIENT,,,2001,1300.65,,1760.88,88,,1408.70,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3178.59,100,,,,,0,"fee schedule",EAPG,2001,100,,1600.80,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",3273.95,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260.63,63,,1008.50,,,0,"percent of total billed charges","63% of total billed charges",306.15,15.3,,244.92,,,0,"percent of total billed charges","15.3% of total billed charges",3178.59,100,,,,,0,"fee schedule",EAPG,1380.69,69,,,,,0,"fee schedule","69% of total billed charges",2001,100,,1600.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2001,100,,1600.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2001,100,,1600.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3178.59,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3242.16,100,,,,,0,"fee schedule",EAPG,4132.17,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",754.38,37.7,,603.50,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1560.78,78,,1248.62,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1652.83,82.6,,1322.26,,,0,"percent of total billed charges","82.6% of total billed charges",3178.59,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1652.83,82.6,,1322.26,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3339.12,100,,,,,0,"fee schedule",EAPG,2001,100,,1600.80,,,0,"percent of total billed charges","100% of total billed charges",306.15,11625.57,
"36830 Creation of arteriovenous fistula; non-direc",7961694,CDM,521,RC,36830,CPT,OUTPATIENT,,,2620,1703,,2305.6,88,,1844.48,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3178.59,100,,,,,0,"fee schedule",EAPG,2620,100,,2096.00,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3273.95,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1650.6,63,,1320.48,,,0,"percent of total billed charges","63% of total billed charges",400.86,15.3,,320.69,,,0,"percent of total billed charges","15.3% of total billed charges",3178.59,100,,,,,0,"fee schedule",EAPG,1807.8,69,,,,,0,"fee schedule","69% of total billed charges",2620,100,,2096.00,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620,100,,2096.00,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620,100,,2096.00,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3178.59,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3242.16,100,,,,,0,"fee schedule",EAPG,4132.17,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",987.74,37.7,,790.19,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2043.6,78,,1634.88,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2164.12,82.6,,1731.30,,,0,"percent of total billed charges","82.6% of total billed charges",3178.59,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2164.12,82.6,,1731.30,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3339.12,100,,,,,0,"fee schedule",EAPG,2620,100,,2096.00,,,0,"percent of total billed charges","100% of total billed charges",400.86,19379.77,
"36838 Distal revascularization and interval ligati",7961825,CDM,521,RC,36838,CPT,OUTPATIENT,,,3703,2406.95,,3258.64,88,,2606.91,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3178.59,100,,,,,0,"fee schedule",EAPG,3703,100,,2962.40,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3273.95,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2332.89,63,,1866.31,,,0,"percent of total billed charges","63% of total billed charges",566.56,15.3,,453.25,,,0,"percent of total billed charges","15.3% of total billed charges",3178.59,100,,,,,0,"fee schedule",EAPG,2555.07,69,,,,,0,"fee schedule","69% of total billed charges",3703,100,,2962.40,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3703,100,,2962.40,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3703,100,,2962.40,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3178.59,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3242.16,100,,,,,0,"fee schedule",EAPG,4132.17,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1396.03,37.7,,1116.82,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2888.34,78,,2310.67,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3058.68,82.6,,2446.94,,,0,"percent of total billed charges","82.6% of total billed charges",3178.59,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3058.68,82.6,,2446.94,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3339.12,100,,,,,0,"fee schedule",EAPG,3703,100,,2962.40,,,0,"percent of total billed charges","100% of total billed charges",566.56,19379.77,
"36833 Revision, open, arteriovenous fistula; with",7962635,CDM,521,RC,36833,CPT,OUTPATIENT,,,2246,1459.9,,1976.48,88,,1581.18,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3178.59,100,,,,,0,"fee schedule",EAPG,2246,100,,1796.80,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3273.95,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1414.98,63,,1131.98,,,0,"percent of total billed charges","63% of total billed charges",343.64,15.3,,274.91,,,0,"percent of total billed charges","15.3% of total billed charges",3178.59,100,,,,,0,"fee schedule",EAPG,1549.74,69,,,,,0,"fee schedule","69% of total billed charges",2246,100,,1796.80,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2246,100,,1796.80,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2246,100,,1796.80,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3178.59,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3242.16,100,,,,,0,"fee schedule",EAPG,4132.17,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",846.74,37.7,,677.39,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1751.88,78,,1401.50,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1855.2,82.6,,1484.16,,,0,"percent of total billed charges","82.6% of total billed charges",3178.59,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1855.2,82.6,,1484.16,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3339.12,100,,,,,0,"fee schedule",EAPG,2246,100,,1796.80,,,0,"percent of total billed charges","100% of total billed charges",343.64,19379.77,
"36832 Revision, open, arteriovenous fistula; w/o t",7962677,CDM,521,RC,36832,CPT,OUTPATIENT,,,2241,1456.65,,1972.08,88,,1577.66,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3178.59,100,,,,,0,"fee schedule",EAPG,2241,100,,1792.80,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3273.95,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1411.83,63,,1129.46,,,0,"percent of total billed charges","63% of total billed charges",342.87,15.3,,274.30,,,0,"percent of total billed charges","15.3% of total billed charges",3178.59,100,,,,,0,"fee schedule",EAPG,1546.29,69,,,,,0,"fee schedule","69% of total billed charges",2241,100,,1792.80,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2241,100,,1792.80,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2241,100,,1792.80,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3178.59,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3242.16,100,,,,,0,"fee schedule",EAPG,4132.17,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",844.86,37.7,,675.89,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1747.98,78,,1398.38,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1851.07,82.6,,1480.86,,,0,"percent of total billed charges","82.6% of total billed charges",3178.59,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1851.07,82.6,,1480.86,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3339.12,100,,,,,0,"fee schedule",EAPG,2241,100,,1792.80,,,0,"percent of total billed charges","100% of total billed charges",342.87,19379.77,
"36831 Thrombectomy, open, arteriovenous fistula w/",7962710,CDM,521,RC,36831,CPT,OUTPATIENT,,,1679,1091.35,,1477.52,88,,1182.02,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3178.59,100,,,,,0,"fee schedule",EAPG,1679,100,,1343.20,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3273.95,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1057.77,63,,846.22,,,0,"percent of total billed charges","63% of total billed charges",256.89,15.3,,205.51,,,0,"percent of total billed charges","15.3% of total billed charges",3178.59,100,,,,,0,"fee schedule",EAPG,1158.51,69,,,,,0,"fee schedule","69% of total billed charges",1679,100,,1343.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1679,100,,1343.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1679,100,,1343.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3178.59,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3242.16,100,,,,,0,"fee schedule",EAPG,4132.17,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",632.98,37.7,,506.38,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1309.62,78,,1047.70,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1386.85,82.6,,1109.48,,,0,"percent of total billed charges","82.6% of total billed charges",3178.59,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1386.85,82.6,,1109.48,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3339.12,100,,,,,0,"fee schedule",EAPG,1679,100,,1343.20,,,0,"percent of total billed charges","100% of total billed charges",256.89,19379.77,
"36861 External cannula declotting (separate proced",7962790,CDM,521,RC,36861,CPT,OUTPATIENT,,,768,499.2,,675.84,88,,540.67,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,768,100,,614.40,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3318.68,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",483.84,63,,387.07,,,0,"percent of total billed charges","63% of total billed charges",117.5,15.3,,94.00,,,0,"percent of total billed charges","15.3% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,529.92,69,,,,,0,"fee schedule","69% of total billed charges",768,100,,614.40,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",768,100,,614.40,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",768,100,,614.40,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.46,100,,,,,0,"fee schedule",EAPG,4188.63,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",289.54,37.7,,231.63,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",599.04,78,,479.23,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",634.37,82.6,,507.50,,,0,"percent of total billed charges","82.6% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",634.37,82.6,,507.50,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3382.55,100,,,,,0,"fee schedule",EAPG,768,100,,614.40,,,0,"percent of total billed charges","100% of total billed charges",117.5,19379.77,
"36870 percut thrombect av fistula",7963797,CDM,521,RC,,,OUTPATIENT,,,7625,4956.25,,6710,88,,5368.00,,,0,"percent of total billed charges","88% of total billed charges",3812.5,50,,3050.00,,,0,"percent of total billed charges","50% of total billed charges",1281,16.8,,1024.80,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1319.43,17.304,,1055.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4803.75,63,,3843.00,,,0,"percent of total billed charges","63% of total billed charges",1166.63,15.3,,933.30,,,0,"percent of total billed charges","15.3% of total billed charges",1281,16.8,,1024.80,,,0,"percent of total billed charges","16.8% of total billed charges",5261.25,69,,,,,0,"fee schedule","69% of total billed charges",7625,100,,6100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7625,100,,6100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7625,100,,6100.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4716.06,61.85,,3772.85,,,0,"percent of total billed charges","61.5% of total billed charges",1281,16.8,,1024.80,,,0,"percent of total billed charges","16.8% of total billed charges",3812.5,50,,3050.00,,,0,"percent of total billed charges","50% of total billed charges",2455.25,32.2,,1964.20,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1306.62,17.136,,1045.30,,,0,"percent of total billed charges","17.136% of total billed charges",1665.3,21.84,,1332.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2874.63,37.7,,2299.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5947.5,78,,4758.00,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6298.25,82.6,,5038.60,,,0,"percent of total billed charges","82.6% of total billed charges",1281,16.8,,1024.80,,,0,"percent of total billed charges","16.8% of total billed charges",3812.5,50,,3050.00,,,0,"percent of total billed charges","50% of total billed charges",6298.25,82.6,,5038.60,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",7625,100,,6100.00,,,0,"percent of total billed charges","100% of total billed charges",160.53,7625,
"36902 Introduction of needle(s) and/or catheter(s)",7961511,CDM,521,RC,36902,CPT,OUTPATIENT,,,636,413.4,,559.68,88,,447.74,,,0,"percent of total billed charges","88% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,636,100,,508.80,,,0,"percent of total billed charges","100% of total billed charges",10202.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",3318.68,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.68,63,,320.54,,,0,"percent of total billed charges","63% of total billed charges",97.31,15.3,,77.85,,,0,"percent of total billed charges","15.3% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,438.84,69,,,,,0,"fee schedule","69% of total billed charges",636,100,,508.80,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",636,100,,508.80,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",636,100,,508.80,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",20137.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5264.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.46,100,,,,,0,"fee schedule",EAPG,4188.63,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",239.77,37.7,,191.82,,,0,"percent of total billed charges","37.70% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",496.08,78,,396.86,,,0,"percent of total billed charges","78% of total billed charges",5888.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",525.34,82.6,,420.27,,,0,"percent of total billed charges","82.6% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",525.34,82.6,,420.27,,,0,"percent of total billed charges","82.6% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3382.55,100,,,,,0,"fee schedule",EAPG,636,100,,508.80,,,0,"percent of total billed charges","100% of total billed charges",97.31,20137.31,
"36907  Transluminal balloon angioplasty, central d",7961512,CDM,521,RC,36907,CPT,OUTPATIENT,,,366,237.9,,322.08,88,,257.66,,,0,"percent of total billed charges","88% of total billed charges",183,50,,146.40,,,0,"percent of total billed charges","50% of total billed charges",5310.28,100,,,,,0,"fee schedule",EAPG,366,100,,292.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5469.59,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",230.58,63,,184.46,,,0,"percent of total billed charges","63% of total billed charges",56,15.3,,44.80,,,0,"percent of total billed charges","15.3% of total billed charges",5310.28,100,,,,,0,"fee schedule",EAPG,252.54,69,,,,,0,"fee schedule","69% of total billed charges",366,100,,292.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",366,100,,292.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",366,100,,292.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",226.37,61.85,,181.10,,,0,"percent of total billed charges","61.5% of total billed charges",5310.28,100,,,,,0,"fee schedule",EAPG,183,50,,146.40,,,0,"percent of total billed charges","50% of total billed charges",117.85,32.2,,94.28,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5416.49,100,,,,,0,"fee schedule",EAPG,6903.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",137.98,37.7,,110.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",285.48,78,,228.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.32,82.6,,241.86,,,0,"percent of total billed charges","82.6% of total billed charges",5310.28,100,,,,,0,"fee schedule","100% of WA fee schedule",183,50,,146.40,,,0,"percent of total billed charges","50% of total billed charges",302.32,82.6,,241.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5470.81,100,,,,,0,"fee schedule",EAPG,366,100,,292.80,,,0,"percent of total billed charges","100% of total billed charges",56,6903.37,
"36908 Transcatheter placement of intravascular ste",7961513,CDM,521,RC,36908,CPT,OUTPATIENT,,,548,356.2,,482.24,88,,385.79,,,0,"percent of total billed charges","88% of total billed charges",274,50,,219.20,,,0,"percent of total billed charges","50% of total billed charges",5310.28,100,,,,,0,"fee schedule",EAPG,548,100,,438.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5469.59,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",345.24,63,,276.19,,,0,"percent of total billed charges","63% of total billed charges",83.84,15.3,,67.07,,,0,"percent of total billed charges","15.3% of total billed charges",5310.28,100,,,,,0,"fee schedule",EAPG,378.12,69,,,,,0,"fee schedule","69% of total billed charges",548,100,,438.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",548,100,,438.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",548,100,,438.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.94,61.85,,271.15,,,0,"percent of total billed charges","61.5% of total billed charges",5310.28,100,,,,,0,"fee schedule",EAPG,274,50,,219.20,,,0,"percent of total billed charges","50% of total billed charges",176.46,32.2,,141.17,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5416.49,100,,,,,0,"fee schedule",EAPG,6903.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",206.6,37.7,,165.28,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",427.44,78,,341.95,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",452.65,82.6,,362.12,,,0,"percent of total billed charges","82.6% of total billed charges",5310.28,100,,,,,0,"fee schedule","100% of WA fee schedule",274,50,,219.20,,,0,"percent of total billed charges","50% of total billed charges",452.65,82.6,,362.12,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5470.81,100,,,,,0,"fee schedule",EAPG,548,100,,438.40,,,0,"percent of total billed charges","100% of total billed charges",83.84,6903.37,
"36903  Introduction of needle(s) and/or catheter(s",7961606,CDM,521,RC,36903,CPT,OUTPATIENT,,,869,564.85,,764.72,88,,611.78,,,0,"percent of total billed charges","88% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,869,100,,695.20,,,0,"percent of total billed charges","100% of total billed charges",19636.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",10180.16,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",547.47,63,,437.98,,,0,"percent of total billed charges","63% of total billed charges",132.96,15.3,,106.37,,,0,"percent of total billed charges","15.3% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,599.61,69,,,,,0,"fee schedule","69% of total billed charges",869,100,,695.20,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",869,100,,695.20,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",869,100,,695.20,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",40799.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10666.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10081.33,100,,,,,0,"fee schedule",EAPG,12848.75,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",327.61,37.7,,262.09,,,0,"percent of total billed charges","37.70% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",677.82,78,,542.26,,,0,"percent of total billed charges","78% of total billed charges",11332.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",717.79,82.6,,574.23,,,0,"percent of total billed charges","82.6% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",717.79,82.6,,574.23,,,0,"percent of total billed charges","82.6% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10044.18,100,,,,,0,"fee schedule",EAPG,869,100,,695.20,,,0,"percent of total billed charges","100% of total billed charges",132.96,40799.76,
"36904 Percutaneous transluminal mechanical thrombe",7962059,CDM,521,RC,36904,CPT,OUTPATIENT,,,1001,650.65,,880.88,88,,704.70,,,0,"percent of total billed charges","88% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,1001,100,,800.80,,,0,"percent of total billed charges","100% of total billed charges",10202.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",3318.68,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",630.63,63,,504.50,,,0,"percent of total billed charges","63% of total billed charges",153.15,15.3,,122.52,,,0,"percent of total billed charges","15.3% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,690.69,69,,,,,0,"fee schedule","69% of total billed charges",1001,100,,800.80,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1001,100,,800.80,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1001,100,,800.80,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",20137.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5264.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.46,100,,,,,0,"fee schedule",EAPG,4188.63,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",377.38,37.7,,301.90,,,0,"percent of total billed charges","37.70% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",780.78,78,,624.62,,,0,"percent of total billed charges","78% of total billed charges",5888.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",826.83,82.6,,661.46,,,0,"percent of total billed charges","82.6% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",826.83,82.6,,661.46,,,0,"percent of total billed charges","82.6% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3382.55,100,,,,,0,"fee schedule",EAPG,1001,100,,800.80,,,0,"percent of total billed charges","100% of total billed charges",153.15,20137.31,
"36905 Percutaneous transluminal mechanical thrombe",7962060,CDM,521,RC,36905,CPT,OUTPATIENT,,,1257,817.05,,1106.16,88,,884.93,,,0,"percent of total billed charges","88% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5310.28,100,,,,,0,"fee schedule",EAPG,1257,100,,1005.60,,,0,"percent of total billed charges","100% of total billed charges",19636.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",5469.59,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",791.91,63,,633.53,,,0,"percent of total billed charges","63% of total billed charges",192.32,15.3,,153.86,,,0,"percent of total billed charges","15.3% of total billed charges",5310.28,100,,,,,0,"fee schedule",EAPG,867.33,69,,,,,0,"fee schedule","69% of total billed charges",1257,100,,1005.60,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1257,100,,1005.60,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1257,100,,1005.60,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",40799.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5310.28,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10666.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5416.49,100,,,,,0,"fee schedule",EAPG,6903.37,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",473.89,37.7,,379.11,,,0,"percent of total billed charges","37.70% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",980.46,78,,784.37,,,0,"percent of total billed charges","78% of total billed charges",11332.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1038.28,82.6,,830.62,,,0,"percent of total billed charges","82.6% of total billed charges",5310.28,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1038.28,82.6,,830.62,,,0,"percent of total billed charges","82.6% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5470.81,100,,,,,0,"fee schedule",EAPG,1257,100,,1005.60,,,0,"percent of total billed charges","100% of total billed charges",192.32,40799.76,
"36906 Percutaneous transluminal mechanical thrombe",7962061,CDM,521,RC,36906,CPT,OUTPATIENT,,,1466,952.9,,1290.08,88,,1032.06,,,0,"percent of total billed charges","88% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,1466,100,,1172.80,,,0,"percent of total billed charges","100% of total billed charges",31299.05,175,,,,,0,"fee schedule","175% of CMS fee schedule",10180.16,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",923.58,63,,738.86,,,0,"percent of total billed charges","63% of total billed charges",224.3,15.3,,179.44,,,0,"percent of total billed charges","15.3% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,1011.54,69,,,,,0,"fee schedule","69% of total billed charges",1466,100,,1172.80,,,0,"percent of total billed charges","100% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1466,100,,1172.80,,,0,"percent of total billed charges","100% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1466,100,,1172.80,,,0,"percent of total billed charges","100% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",65260.52,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17061.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10081.33,100,,,,,0,"fee schedule",EAPG,12848.75,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",552.68,37.7,,442.14,,,0,"percent of total billed charges","37.70% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1143.48,78,,914.78,,,0,"percent of total billed charges","78% of total billed charges",18064.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1210.92,82.6,,968.74,,,0,"percent of total billed charges","82.6% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1210.92,82.6,,968.74,,,0,"percent of total billed charges","82.6% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10044.18,100,,,,,0,"fee schedule",EAPG,1466,100,,1172.80,,,0,"percent of total billed charges","100% of total billed charges",224.3,65260.52,
"36909 Dialysis circuit permanent vascular emboliza",7962204,CDM,521,RC,36909,CPT,OUTPATIENT,,,521,338.65,,458.48,88,,366.78,,,0,"percent of total billed charges","88% of total billed charges",260.5,50,,208.40,,,0,"percent of total billed charges","50% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,521,100,,416.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10180.16,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",328.23,63,,262.58,,,0,"percent of total billed charges","63% of total billed charges",79.71,15.3,,63.77,,,0,"percent of total billed charges","15.3% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,359.49,69,,,,,0,"fee schedule","69% of total billed charges",521,100,,416.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",521,100,,416.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",521,100,,416.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",322.24,61.85,,257.79,,,0,"percent of total billed charges","61.5% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,260.5,50,,208.40,,,0,"percent of total billed charges","50% of total billed charges",167.76,32.2,,134.21,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10081.33,100,,,,,0,"fee schedule",EAPG,12848.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",196.42,37.7,,157.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",406.38,78,,325.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",430.35,82.6,,344.28,,,0,"percent of total billed charges","82.6% of total billed charges",9883.65,100,,,,,0,"fee schedule","100% of WA fee schedule",260.5,50,,208.40,,,0,"percent of total billed charges","50% of total billed charges",430.35,82.6,,344.28,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10044.18,100,,,,,0,"fee schedule",EAPG,521,100,,416.80,,,0,"percent of total billed charges","100% of total billed charges",79.71,12848.75,
"36901 Introduction of needle(s) and/or catheter(s)",7963050,CDM,521,RC,36901,CPT,OUTPATIENT,,,426,276.9,,374.88,88,,299.90,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",1694.66,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",268.38,63,,214.70,,,0,"percent of total billed charges","63% of total billed charges",65.18,15.3,,52.14,,,0,"percent of total billed charges","15.3% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,293.94,69,,,,,0,"fee schedule","69% of total billed charges",426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.3,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1678.2,100,,,,,0,"fee schedule",EAPG,2138.89,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",160.6,37.7,,128.48,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",332.28,78,,265.82,,,0,"percent of total billed charges","78% of total billed charges",1649.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",351.88,82.6,,281.50,,,0,"percent of total billed charges","82.6% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",351.88,82.6,,281.50,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1805.83,100,,,,,0,"fee schedule",EAPG,426,100,,340.80,,,0,"percent of total billed charges","100% of total billed charges",65.18,5712.48,
"37187 Percutaneous transluminal mechanical thrombe",7961514,CDM,521,RC,37187,CPT,OUTPATIENT,,,1286,835.9,,1131.68,88,,905.34,,,0,"percent of total billed charges","88% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,1286,100,,1028.80,,,0,"percent of total billed charges","100% of total billed charges",19636.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",3318.68,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",810.18,63,,648.14,,,0,"percent of total billed charges","63% of total billed charges",196.76,15.3,,157.41,,,0,"percent of total billed charges","15.3% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,887.34,69,,,,,0,"fee schedule","69% of total billed charges",1286,100,,1028.80,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1286,100,,1028.80,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1286,100,,1028.80,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",40799.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10666.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.46,100,,,,,0,"fee schedule",EAPG,4188.63,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",484.82,37.7,,387.86,,,0,"percent of total billed charges","37.70% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1003.08,78,,802.46,,,0,"percent of total billed charges","78% of total billed charges",11332.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1062.24,82.6,,849.79,,,0,"percent of total billed charges","82.6% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1062.24,82.6,,849.79,,,0,"percent of total billed charges","82.6% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3382.55,100,,,,,0,"fee schedule",EAPG,1286,100,,1028.80,,,0,"percent of total billed charges","100% of total billed charges",196.76,40799.76,
"37185 Primary percutaneous transluminal mechanical",7961826,CDM,521,RC,37185,CPT,OUTPATIENT,,,2772,1801.8,,2439.36,88,,1951.49,,,0,"percent of total billed charges","88% of total billed charges",1386,50,,1108.80,,,0,"percent of total billed charges","50% of total billed charges",5310.28,100,,,,,0,"fee schedule",EAPG,2772,100,,2217.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5469.59,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1746.36,63,,1397.09,,,0,"percent of total billed charges","63% of total billed charges",424.12,15.3,,339.30,,,0,"percent of total billed charges","15.3% of total billed charges",5310.28,100,,,,,0,"fee schedule",EAPG,1912.68,69,,,,,0,"fee schedule","69% of total billed charges",2772,100,,2217.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2772,100,,2217.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2772,100,,2217.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1714.48,61.85,,1371.58,,,0,"percent of total billed charges","61.5% of total billed charges",5310.28,100,,,,,0,"fee schedule",EAPG,1386,50,,1108.80,,,0,"percent of total billed charges","50% of total billed charges",892.58,32.2,,714.06,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5416.49,100,,,,,0,"fee schedule",EAPG,6903.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1045.04,37.7,,836.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2162.16,78,,1729.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2289.67,82.6,,1831.74,,,0,"percent of total billed charges","82.6% of total billed charges",5310.28,100,,,,,0,"fee schedule",EAPG,1386,50,,1108.80,,,0,"percent of total billed charges","50% of total billed charges",2289.67,82.6,,1831.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5470.81,100,,,,,0,"fee schedule",EAPG,2772,100,,2217.60,,,0,"percent of total billed charges","100% of total billed charges",424.12,6903.37,
"37184 Primary percutaneous transluminal mechanical",7962711,CDM,521,RC,37184,CPT,OUTPATIENT,,,8478,5510.7,,7460.64,88,,5968.51,,,0,"percent of total billed charges","88% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5310.28,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",31299.05,175,,,,,0,"fee schedule","175% of CMS fee schedule",5469.59,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5341.14,63,,4272.91,,,0,"percent of total billed charges","63% of total billed charges",1297.13,15.3,,1037.70,,,0,"percent of total billed charges","15.3% of total billed charges",5310.28,100,,,,,0,"fee schedule",EAPG,5849.82,69,,,,,0,"fee schedule","69% of total billed charges",8478,100,,6782.40,,,0,"percent of total billed charges","100% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8478,100,,6782.40,,,0,"percent of total billed charges","100% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8478,100,,6782.40,,,0,"percent of total billed charges","100% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",40799.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5310.28,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10666.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5416.49,100,,,,,0,"fee schedule",EAPG,6903.37,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3196.21,37.7,,2556.97,,,0,"percent of total billed charges","37.70% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6612.84,78,,5290.27,,,0,"percent of total billed charges","78% of total billed charges",18064.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7002.83,82.6,,5602.26,,,0,"percent of total billed charges","82.6% of total billed charges",5310.28,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7002.83,82.6,,5602.26,,,0,"percent of total billed charges","82.6% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5470.81,100,,,,,0,"fee schedule",EAPG,8478,100,,6782.40,,,0,"percent of total billed charges","100% of total billed charges",1297.13,40799.76,
"37186 Secondary percutaneous transluminal thrombec",7963426,CDM,521,RC,37186,CPT,OUTPATIENT,,,671,436.15,,590.48,88,,472.38,,,0,"percent of total billed charges","88% of total billed charges",335.5,50,,268.40,,,0,"percent of total billed charges","50% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10180.16,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",422.73,63,,338.18,,,0,"percent of total billed charges","63% of total billed charges",102.66,15.3,,82.13,,,0,"percent of total billed charges","15.3% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,462.99,69,,,,,0,"fee schedule","69% of total billed charges",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",415.01,61.85,,332.01,,,0,"percent of total billed charges","61.5% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,335.5,50,,268.40,,,0,"percent of total billed charges","50% of total billed charges",216.06,32.2,,172.85,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10081.33,100,,,,,0,"fee schedule",EAPG,12848.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",252.97,37.7,,202.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",523.38,78,,418.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",554.25,82.6,,443.40,,,0,"percent of total billed charges","82.6% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,335.5,50,,268.40,,,0,"percent of total billed charges","50% of total billed charges",554.25,82.6,,443.40,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10044.18,100,,,,,0,"fee schedule",EAPG,671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",102.66,12848.75,
"37193  Description- Retrieval (removal) of intrava",7961515,CDM,521,RC,37193,CPT,OUTPATIENT,,,1523,989.95,,1340.24,88,,1072.19,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,1523,100,,1218.40,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",3318.68,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",959.49,63,,767.59,,,0,"percent of total billed charges","63% of total billed charges",233.02,15.3,,186.42,,,0,"percent of total billed charges","15.3% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,1050.87,69,,,,,0,"fee schedule","69% of total billed charges",1523,100,,1218.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1523,100,,1218.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1523,100,,1218.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.46,100,,,,,0,"fee schedule",EAPG,4188.63,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",574.17,37.7,,459.34,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1187.94,78,,950.35,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1258,82.6,,1006.40,,,0,"percent of total billed charges","82.6% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1258,82.6,,1006.40,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3382.55,100,,,,,0,"fee schedule",EAPG,1523,100,,1218.40,,,0,"percent of total billed charges","100% of total billed charges",233.02,11625.57,
"37192 Repositioning of intravascular vena cava fil",7961999,CDM,521,RC,37192,CPT,OUTPATIENT,,,1523,989.95,,1340.24,88,,1072.19,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,1523,100,,1218.40,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",3318.68,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",959.49,63,,767.59,,,0,"percent of total billed charges","63% of total billed charges",233.02,15.3,,186.42,,,0,"percent of total billed charges","15.3% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,1050.87,69,,,,,0,"fee schedule","69% of total billed charges",1523,100,,1218.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1523,100,,1218.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1523,100,,1218.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.46,100,,,,,0,"fee schedule",EAPG,4188.63,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",574.17,37.7,,459.34,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1187.94,78,,950.35,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1258,82.6,,1006.40,,,0,"percent of total billed charges","82.6% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1258,82.6,,1006.40,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3382.55,100,,,,,0,"fee schedule",EAPG,1523,100,,1218.40,,,0,"percent of total billed charges","100% of total billed charges",233.02,11625.57,
"37197 Transcatheter retrieval, percutaneous, of in",7962071,CDM,521,RC,37197,CPT,OUTPATIENT,,,989,642.85,,870.32,88,,696.26,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,989,100,,791.20,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",3318.68,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",623.07,63,,498.46,,,0,"percent of total billed charges","63% of total billed charges",151.32,15.3,,121.06,,,0,"percent of total billed charges","15.3% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,682.41,69,,,,,0,"fee schedule","69% of total billed charges",989,100,,791.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",989,100,,791.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",989,100,,791.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.46,100,,,,,0,"fee schedule",EAPG,4188.63,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",372.85,37.7,,298.28,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",771.42,78,,617.14,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",816.91,82.6,,653.53,,,0,"percent of total billed charges","82.6% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",816.91,82.6,,653.53,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3382.55,100,,,,,0,"fee schedule",EAPG,989,100,,791.20,,,0,"percent of total billed charges","100% of total billed charges",151.32,11625.57,
"37191 Insertion of intravascular vena cava filter,",7962938,CDM,521,RC,37191,CPT,OUTPATIENT,,,1020,663,,897.6,88,,718.08,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,1020,100,,816.00,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3318.68,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",642.6,63,,514.08,,,0,"percent of total billed charges","63% of total billed charges",156.06,15.3,,124.85,,,0,"percent of total billed charges","15.3% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,703.8,69,,,,,0,"fee schedule","69% of total billed charges",1020,100,,816.00,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1020,100,,816.00,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1020,100,,816.00,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.46,100,,,,,0,"fee schedule",EAPG,4188.63,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",384.54,37.7,,307.63,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",795.6,78,,636.48,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",842.52,82.6,,674.02,,,0,"percent of total billed charges","82.6% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",842.52,82.6,,674.02,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3382.55,100,,,,,0,"fee schedule",EAPG,1020,100,,816.00,,,0,"percent of total billed charges","100% of total billed charges",156.06,19379.77,
"37201 transcatheter therapy infuse",7963753,CDM,521,RC,37201,CPT,OUTPATIENT,,,889,577.85,,782.32,88,,625.86,,,0,"percent of total billed charges","88% of total billed charges",444.5,50,,355.60,,,0,"percent of total billed charges","50% of total billed charges",149.35,16.8,,119.48,,,0,"percent of total billed charges","16.8% of total billed charges",889,100,,711.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",153.83,17.304,,123.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",560.07,63,,448.06,,,0,"percent of total billed charges","63% of total billed charges",136.02,15.3,,108.82,,,0,"percent of total billed charges","15.3% of total billed charges",149.35,16.8,,119.48,,,0,"percent of total billed charges","16.8% of total billed charges",613.41,69,,,,,0,"fee schedule","69% of total billed charges",889,100,,711.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",889,100,,711.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",889,100,,711.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",549.85,61.85,,439.88,,,0,"percent of total billed charges","61.5% of total billed charges",149.35,16.8,,119.48,,,0,"percent of total billed charges","16.8% of total billed charges",444.5,50,,355.60,,,0,"percent of total billed charges","50% of total billed charges",286.26,32.2,,229.01,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",152.34,17.136,,121.87,,,0,"percent of total billed charges","17.136% of total billed charges",194.16,21.84,,155.33,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",335.15,37.7,,268.12,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",693.42,78,,554.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",734.31,82.6,,587.45,,,0,"percent of total billed charges","82.6% of total billed charges",149.35,16.8,,119.48,,,0,"percent of total billed charges","16.8% of total billed charges",444.5,50,,355.60,,,0,"percent of total billed charges","50% of total billed charges",734.31,82.6,,587.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",889,100,,711.20,,,0,"percent of total billed charges","100% of total billed charges",136.02,889,
"37202 transcatheter therapy infuse",7963754,CDM,521,RC,37202,CPT,OUTPATIENT,,,950,617.5,,836,88,,668.80,,,0,"percent of total billed charges","88% of total billed charges",475,50,,380.00,,,0,"percent of total billed charges","50% of total billed charges",159.6,16.8,,127.68,,,0,"percent of total billed charges","16.8% of total billed charges",950,100,,760.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",164.39,17.304,,131.51,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",598.5,63,,478.80,,,0,"percent of total billed charges","63% of total billed charges",145.35,15.3,,116.28,,,0,"percent of total billed charges","15.3% of total billed charges",159.6,16.8,,127.68,,,0,"percent of total billed charges","16.8% of total billed charges",655.5,69,,,,,0,"fee schedule","69% of total billed charges",950,100,,760.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",950,100,,760.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",950,100,,760.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",587.58,61.85,,470.06,,,0,"percent of total billed charges","61.5% of total billed charges",159.6,16.8,,127.68,,,0,"percent of total billed charges","16.8% of total billed charges",475,50,,380.00,,,0,"percent of total billed charges","50% of total billed charges",305.9,32.2,,244.72,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",162.79,17.136,,130.23,,,0,"percent of total billed charges","17.136% of total billed charges",207.48,21.84,,165.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",358.15,37.7,,286.52,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",741,78,,592.80,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",784.7,82.6,,627.76,,,0,"percent of total billed charges","82.6% of total billed charges",159.6,16.8,,127.68,,,0,"percent of total billed charges","16.8% of total billed charges",475,50,,380.00,,,0,"percent of total billed charges","50% of total billed charges",784.7,82.6,,627.76,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",950,100,,760.00,,,0,"percent of total billed charges","100% of total billed charges",145.35,950,
"37206 transcath iv stent/perc addl",7963755,CDM,521,RC,37206,CPT,OUTPATIENT,,,736,478.4,,647.68,88,,518.14,,,0,"percent of total billed charges","88% of total billed charges",368,50,,294.40,,,0,"percent of total billed charges","50% of total billed charges",123.65,16.8,,98.92,,,0,"percent of total billed charges","16.8% of total billed charges",736,100,,588.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.36,17.304,,101.89,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.68,63,,370.94,,,0,"percent of total billed charges","63% of total billed charges",112.61,15.3,,90.09,,,0,"percent of total billed charges","15.3% of total billed charges",123.65,16.8,,98.92,,,0,"percent of total billed charges","16.8% of total billed charges",507.84,69,,,,,0,"fee schedule","69% of total billed charges",736,100,,588.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",736,100,,588.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",736,100,,588.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",455.22,61.85,,364.18,,,0,"percent of total billed charges","61.5% of total billed charges",123.65,16.8,,98.92,,,0,"percent of total billed charges","16.8% of total billed charges",368,50,,294.40,,,0,"percent of total billed charges","50% of total billed charges",236.99,32.2,,189.59,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.12,17.136,,100.90,,,0,"percent of total billed charges","17.136% of total billed charges",160.74,21.84,,128.59,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",277.47,37.7,,221.98,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",574.08,78,,459.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",607.94,82.6,,486.35,,,0,"percent of total billed charges","82.6% of total billed charges",123.65,16.8,,98.92,,,0,"percent of total billed charges","16.8% of total billed charges",368,50,,294.40,,,0,"percent of total billed charges","50% of total billed charges",607.94,82.6,,486.35,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",736,100,,588.80,,,0,"percent of total billed charges","100% of total billed charges",112.61,736,
"37208 transcath iv stent/open addl",7963756,CDM,521,RC,37208,CPT,OUTPATIENT,,,933,606.45,,821.04,88,,656.83,,,0,"percent of total billed charges","88% of total billed charges",466.5,50,,373.20,,,0,"percent of total billed charges","50% of total billed charges",156.74,16.8,,125.39,,,0,"percent of total billed charges","16.8% of total billed charges",933,100,,746.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",161.45,17.304,,129.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",587.79,63,,470.23,,,0,"percent of total billed charges","63% of total billed charges",142.75,15.3,,114.20,,,0,"percent of total billed charges","15.3% of total billed charges",156.74,16.8,,125.39,,,0,"percent of total billed charges","16.8% of total billed charges",643.77,69,,,,,0,"fee schedule","69% of total billed charges",933,100,,746.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",933,100,,746.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",933,100,,746.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",577.06,61.85,,461.65,,,0,"percent of total billed charges","61.5% of total billed charges",156.74,16.8,,125.39,,,0,"percent of total billed charges","16.8% of total billed charges",466.5,50,,373.20,,,0,"percent of total billed charges","50% of total billed charges",300.43,32.2,,240.34,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",159.88,17.136,,127.90,,,0,"percent of total billed charges","17.136% of total billed charges",203.77,21.84,,163.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",351.74,37.7,,281.39,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",727.74,78,,582.19,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",770.66,82.6,,616.53,,,0,"percent of total billed charges","82.6% of total billed charges",156.74,16.8,,125.39,,,0,"percent of total billed charges","16.8% of total billed charges",466.5,50,,373.20,,,0,"percent of total billed charges","50% of total billed charges",770.66,82.6,,616.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",933,100,,746.40,,,0,"percent of total billed charges","100% of total billed charges",142.75,933,
"37205 transcath iv stent, percut",7963818,CDM,521,RC,37205,CPT,OUTPATIENT,,,6522,4239.3,,5739.36,88,,4591.49,,,0,"percent of total billed charges","88% of total billed charges",3261,50,,2608.80,,,0,"percent of total billed charges","50% of total billed charges",1095.7,16.8,,876.56,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1128.57,17.304,,902.86,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4108.86,63,,3287.09,,,0,"percent of total billed charges","63% of total billed charges",997.87,15.3,,798.30,,,0,"percent of total billed charges","15.3% of total billed charges",1095.7,16.8,,876.56,,,0,"percent of total billed charges","16.8% of total billed charges",4500.18,69,,,,,0,"fee schedule","69% of total billed charges",6522,100,,5217.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6522,100,,5217.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6522,100,,5217.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4033.86,61.85,,3227.09,,,0,"percent of total billed charges","61.5% of total billed charges",1095.7,16.8,,876.56,,,0,"percent of total billed charges","16.8% of total billed charges",3261,50,,2608.80,,,0,"percent of total billed charges","50% of total billed charges",2100.08,32.2,,1680.06,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1117.61,17.136,,894.09,,,0,"percent of total billed charges","17.136% of total billed charges",1424.4,21.84,,1139.52,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2458.79,37.7,,1967.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5087.16,78,,4069.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5387.17,82.6,,4309.74,,,0,"percent of total billed charges","82.6% of total billed charges",1095.7,16.8,,876.56,,,0,"percent of total billed charges","16.8% of total billed charges",3261,50,,2608.80,,,0,"percent of total billed charges","50% of total billed charges",5387.17,82.6,,4309.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",6522,100,,5217.60,,,0,"percent of total billed charges","100% of total billed charges",160.53,6522,
"37207 transcath iv stent, open",7963851,CDM,521,RC,37207,CPT,OUTPATIENT,,,1907,1239.55,,1678.16,88,,1342.53,,,0,"percent of total billed charges","88% of total billed charges",953.5,50,,762.80,,,0,"percent of total billed charges","50% of total billed charges",320.38,16.8,,256.30,,,0,"percent of total billed charges","16.8% of total billed charges",1907,100,,1525.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",329.99,17.304,,263.99,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1201.41,63,,961.13,,,0,"percent of total billed charges","63% of total billed charges",291.77,15.3,,233.42,,,0,"percent of total billed charges","15.3% of total billed charges",320.38,16.8,,256.30,,,0,"percent of total billed charges","16.8% of total billed charges",1315.83,69,,,,,0,"fee schedule","69% of total billed charges",1907,100,,1525.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1907,100,,1525.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1907,100,,1525.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1179.48,61.85,,943.58,,,0,"percent of total billed charges","61.5% of total billed charges",320.38,16.8,,256.30,,,0,"percent of total billed charges","16.8% of total billed charges",953.5,50,,762.80,,,0,"percent of total billed charges","50% of total billed charges",614.05,32.2,,491.24,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",326.78,17.136,,261.42,,,0,"percent of total billed charges","17.136% of total billed charges",416.49,21.84,,333.19,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",718.94,37.7,,575.15,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1487.46,78,,1189.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1575.18,82.6,,1260.14,,,0,"percent of total billed charges","82.6% of total billed charges",320.38,16.8,,256.30,,,0,"percent of total billed charges","16.8% of total billed charges",953.5,50,,762.80,,,0,"percent of total billed charges","50% of total billed charges",1575.18,82.6,,1260.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",1907,100,,1525.60,,,0,"percent of total billed charges","100% of total billed charges",160.53,1907,
"37204 transcatheter occlusion",7963862,CDM,521,RC,37204,CPT,OUTPATIENT,,,3580,2327,,3150.4,88,,2520.32,,,0,"percent of total billed charges","88% of total billed charges",1790,50,,1432.00,,,0,"percent of total billed charges","50% of total billed charges",601.44,16.8,,481.15,,,0,"percent of total billed charges","16.8% of total billed charges",3580,100,,2864.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",619.48,17.304,,495.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2255.4,63,,1804.32,,,0,"percent of total billed charges","63% of total billed charges",547.74,15.3,,438.19,,,0,"percent of total billed charges","15.3% of total billed charges",601.44,16.8,,481.15,,,0,"percent of total billed charges","16.8% of total billed charges",2470.2,69,,,,,0,"fee schedule","69% of total billed charges",3580,100,,2864.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3580,100,,2864.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3580,100,,2864.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2214.23,61.85,,1771.38,,,0,"percent of total billed charges","61.5% of total billed charges",601.44,16.8,,481.15,,,0,"percent of total billed charges","16.8% of total billed charges",1790,50,,1432.00,,,0,"percent of total billed charges","50% of total billed charges",1152.76,32.2,,922.21,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",613.47,17.136,,490.78,,,0,"percent of total billed charges","17.136% of total billed charges",781.87,21.84,,625.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1349.66,37.7,,1079.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2792.4,78,,2233.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2957.08,82.6,,2365.66,,,0,"percent of total billed charges","82.6% of total billed charges",601.44,16.8,,481.15,,,0,"percent of total billed charges","16.8% of total billed charges",1790,50,,1432.00,,,0,"percent of total billed charges","50% of total billed charges",2957.08,82.6,,2365.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",3580,100,,2864.00,,,0,"percent of total billed charges","100% of total billed charges",160.53,3580,
"37213 Transcatheter therapy, arterial/venous infus",7961607,CDM,521,RC,37213,CPT,OUTPATIENT,,,808,525.2,,711.04,88,,568.83,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,808,100,,646.40,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",3318.68,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509.04,63,,407.23,,,0,"percent of total billed charges","63% of total billed charges",123.62,15.3,,98.90,,,0,"percent of total billed charges","15.3% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,557.52,69,,,,,0,"fee schedule","69% of total billed charges",808,100,,646.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",808,100,,646.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",808,100,,646.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.46,100,,,,,0,"fee schedule",EAPG,4188.63,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",304.62,37.7,,243.70,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",630.24,78,,504.19,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",667.41,82.6,,533.93,,,0,"percent of total billed charges","82.6% of total billed charges",3222.02,100,,,,,0,"fee schedule","100% of WA fee schedule",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",667.41,82.6,,533.93,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3382.55,100,,,,,0,"fee schedule",EAPG,808,100,,646.40,,,0,"percent of total billed charges","100% of total billed charges",123.62,11625.57,
"37214 Transcatheter therapy, cessation of thrombol",7961608,CDM,521,RC,37214,CPT,OUTPATIENT,,,474,308.1,,417.12,88,,333.70,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,474,100,,379.20,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",3318.68,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.62,63,,238.90,,,0,"percent of total billed charges","63% of total billed charges",72.52,15.3,,58.02,,,0,"percent of total billed charges","15.3% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,327.06,69,,,,,0,"fee schedule","69% of total billed charges",474,100,,379.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",474,100,,379.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",474,100,,379.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.46,100,,,,,0,"fee schedule",EAPG,4188.63,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",178.7,37.7,,142.96,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",369.72,78,,295.78,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",391.52,82.6,,313.22,,,0,"percent of total billed charges","82.6% of total billed charges",3222.02,100,,,,,0,"fee schedule","100% of WA fee schedule",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",391.52,82.6,,313.22,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3382.55,100,,,,,0,"fee schedule",EAPG,474,100,,379.20,,,0,"percent of total billed charges","100% of total billed charges",72.52,11625.57,
"37211 Transcatheter therapy, arterial infusion for",7961695,CDM,521,RC,37211,CPT,OUTPATIENT,,,1309,850.85,,1151.92,88,,921.54,,,0,"percent of total billed charges","88% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,1309,100,,1047.20,,,0,"percent of total billed charges","100% of total billed charges",9808.84,175,,,,,0,"fee schedule","175% of CMS fee schedule",3318.68,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",824.67,63,,659.74,,,0,"percent of total billed charges","63% of total billed charges",200.28,15.3,,160.22,,,0,"percent of total billed charges","15.3% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,903.21,69,,,,,0,"fee schedule","69% of total billed charges",1309,100,,1047.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1309,100,,1047.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1309,100,,1047.20,,,0,"percent of total billed charges","100% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS fee schedule",19379.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5066.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.46,100,,,,,0,"fee schedule",EAPG,4188.63,100,,,,,0,"fee schedule",EAPG,5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",493.49,37.7,,394.79,,,0,"percent of total billed charges","37.70% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1021.02,78,,816.82,,,0,"percent of total billed charges","78% of total billed charges",5661.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1081.23,82.6,,864.98,,,0,"percent of total billed charges","82.6% of total billed charges",3222.02,100,,,,,0,"fee schedule","100% of WA fee schedule",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1081.23,82.6,,864.98,,,0,"percent of total billed charges","82.6% of total billed charges",5605.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3382.55,100,,,,,0,"fee schedule",EAPG,1309,100,,1047.20,,,0,"percent of total billed charges","100% of total billed charges",200.28,19379.77,
"37212 Transcatheter therapy, venous infusion for t",7961763,CDM,521,RC,37212,CPT,OUTPATIENT,,,1156,751.4,,1017.28,88,,813.82,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,1156,100,,924.80,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",3318.68,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",728.28,63,,582.62,,,0,"percent of total billed charges","63% of total billed charges",176.87,15.3,,141.50,,,0,"percent of total billed charges","15.3% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,797.64,69,,,,,0,"fee schedule","69% of total billed charges",1156,100,,924.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1156,100,,924.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1156,100,,924.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.46,100,,,,,0,"fee schedule",EAPG,4188.63,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",435.81,37.7,,348.65,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",901.68,78,,721.34,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",954.86,82.6,,763.89,,,0,"percent of total billed charges","82.6% of total billed charges",3222.02,100,,,,,0,"fee schedule","100% of WA fee schedule",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",954.86,82.6,,763.89,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3382.55,100,,,,,0,"fee schedule",EAPG,1156,100,,924.80,,,0,"percent of total billed charges","100% of total billed charges",176.87,11625.57,
"37217 Transcatheter placement of intravascular ste",7962254,CDM,521,RC,37217,CPT,OUTPATIENT,,,3188,2072.2,,2805.44,88,,2244.35,,,0,"percent of total billed charges","88% of total billed charges",3188,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10125.25,100,,,,,0,"fee schedule",EAPG,3188,100,,2550.40,,,0,"percent of total billed charges","100% of total billed charges",3188,175,,,,,0,"fee schedule","175% of CMS fee schedule",10429,100,,,,,0,"fee schedule",EAPG,3188,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2008.44,63,,1606.75,,,0,"percent of total billed charges","63% of total billed charges",487.76,15.3,,390.21,,,0,"percent of total billed charges","15.3% of total billed charges",10125.25,100,,,,,0,"fee schedule",EAPG,2199.72,69,,,,,0,"fee schedule","69% of total billed charges",3188,100,,2550.40,,,0,"percent of total billed charges","100% of total billed charges",3188,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3188,100,,2550.40,,,0,"percent of total billed charges","100% of total billed charges",3188,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3188,100,,2550.40,,,0,"percent of total billed charges","100% of total billed charges",3188,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3188,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10125.25,100,,,,,0,"fee schedule",EAPG,3188,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3188,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3188,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10327.75,100,,,,,0,"fee schedule",EAPG,13162.82,100,,,,,0,"fee schedule",EAPG,3188,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1201.88,37.7,,961.50,,,0,"percent of total billed charges","37.70% of total billed charges",3188,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3188,100,,,,,0,"fee schedule","100% of CMS fee schedule",2486.64,78,,1989.31,,,0,"percent of total billed charges","78% of total billed charges",3188,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2633.29,82.6,,2106.63,,,0,"percent of total billed charges","82.6% of total billed charges",10125.25,100,,,,,0,"fee schedule","100% of WA fee schedule",3188,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2633.29,82.6,,2106.63,,,0,"percent of total billed charges","82.6% of total billed charges",3188,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10285.78,100,,,,,0,"fee schedule",EAPG,3188,100,,2550.40,,,0,"percent of total billed charges","100% of total billed charges",487.76,13162.82,
"37216 Transcatheter placement of intravascular ste",7962335,CDM,521,RC,37216,CPT,OUTPATIENT,,,3919,2547.35,,3448.72,88,,2758.98,,,0,"percent of total billed charges","88% of total billed charges",1959.5,50,,1567.60,,,0,"percent of total billed charges","50% of total billed charges",10125.25,100,,,,,0,"fee schedule",EAPG,3919,100,,3135.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10429,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2468.97,63,,1975.18,,,0,"percent of total billed charges","63% of total billed charges",599.61,15.3,,479.69,,,0,"percent of total billed charges","15.3% of total billed charges",10125.25,100,,,,,0,"fee schedule",EAPG,2704.11,69,,,,,0,"fee schedule","69% of total billed charges",3919,100,,3135.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3919,100,,3135.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3919,100,,3135.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2423.9,61.85,,1939.12,,,0,"percent of total billed charges","61.5% of total billed charges",10125.25,100,,,,,0,"fee schedule",EAPG,1959.5,50,,1567.60,,,0,"percent of total billed charges","50% of total billed charges",1261.92,32.2,,1009.54,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10327.75,100,,,,,0,"fee schedule",EAPG,13162.82,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1477.46,37.7,,1181.97,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3056.82,78,,2445.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3237.09,82.6,,2589.67,,,0,"percent of total billed charges","82.6% of total billed charges",10125.25,100,,,,,0,"fee schedule","100% of WA fee schedule",1959.5,50,,1567.60,,,0,"percent of total billed charges","50% of total billed charges",3237.09,82.6,,2589.67,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10285.78,100,,,,,0,"fee schedule",EAPG,3919,100,,3135.20,,,0,"percent of total billed charges","100% of total billed charges",599.61,13162.82,
"37215 Transcatheter placement of intravascular ste",7962449,CDM,521,RC,37215,CPT,OUTPATIENT,,,2937,1909.05,,2584.56,88,,2067.65,,,0,"percent of total billed charges","88% of total billed charges",2937,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10125.25,100,,,,,0,"fee schedule",EAPG,2937,100,,2349.60,,,0,"percent of total billed charges","100% of total billed charges",2937,175,,,,,0,"fee schedule","175% of CMS fee schedule",10429,100,,,,,0,"fee schedule",EAPG,2937,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1850.31,63,,1480.25,,,0,"percent of total billed charges","63% of total billed charges",449.36,15.3,,359.49,,,0,"percent of total billed charges","15.3% of total billed charges",10125.25,100,,,,,0,"fee schedule",EAPG,2026.53,69,,,,,0,"fee schedule","69% of total billed charges",2937,100,,2349.60,,,0,"percent of total billed charges","100% of total billed charges",2937,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2937,100,,2349.60,,,0,"percent of total billed charges","100% of total billed charges",2937,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2937,100,,2349.60,,,0,"percent of total billed charges","100% of total billed charges",2937,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2937,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10125.25,100,,,,,0,"fee schedule",EAPG,2937,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2937,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2937,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10327.75,100,,,,,0,"fee schedule",EAPG,13162.82,100,,,,,0,"fee schedule",EAPG,2937,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1107.25,37.7,,885.80,,,0,"percent of total billed charges","37.70% of total billed charges",2937,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2937,100,,,,,0,"fee schedule","100% of CMS fee schedule",2290.86,78,,1832.69,,,0,"percent of total billed charges","78% of total billed charges",2937,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2425.96,82.6,,1940.77,,,0,"percent of total billed charges","82.6% of total billed charges",10125.25,100,,,,,0,"fee schedule","100% of WA fee schedule",2937,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2425.96,82.6,,1940.77,,,0,"percent of total billed charges","82.6% of total billed charges",2937,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10285.78,100,,,,,0,"fee schedule",EAPG,2937,100,,2349.60,,,0,"percent of total billed charges","100% of total billed charges",449.36,13162.82,
"37233 Revascularization, open/percut, tibial/peron",7961696,CDM,521,RC,37233,CPT,OUTPATIENT,,,1084,704.6,,953.92,88,,763.14,,,0,"percent of total billed charges","88% of total billed charges",542,50,,433.60,,,0,"percent of total billed charges","50% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,1084,100,,867.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10180.16,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",682.92,63,,546.34,,,0,"percent of total billed charges","63% of total billed charges",165.85,15.3,,132.68,,,0,"percent of total billed charges","15.3% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,747.96,69,,,,,0,"fee schedule","69% of total billed charges",1084,100,,867.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1084,100,,867.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1084,100,,867.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",670.45,61.85,,536.36,,,0,"percent of total billed charges","61.5% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,542,50,,433.60,,,0,"percent of total billed charges","50% of total billed charges",349.05,32.2,,279.24,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10081.33,100,,,,,0,"fee schedule",EAPG,12848.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",408.67,37.7,,326.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",845.52,78,,676.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",895.38,82.6,,716.30,,,0,"percent of total billed charges","82.6% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,542,50,,433.60,,,0,"percent of total billed charges","50% of total billed charges",895.38,82.6,,716.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10044.18,100,,,,,0,"fee schedule",EAPG,1084,100,,867.20,,,0,"percent of total billed charges","100% of total billed charges",165.85,12848.75,
"37238 Transcatheter plcmnt of intravascular stent,",7961697,CDM,521,RC,37238,CPT,OUTPATIENT,,,952,618.8,,837.76,88,,670.21,,,0,"percent of total billed charges","88% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,952,100,,761.60,,,0,"percent of total billed charges","100% of total billed charges",19636.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",10180.16,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",599.76,63,,479.81,,,0,"percent of total billed charges","63% of total billed charges",145.66,15.3,,116.53,,,0,"percent of total billed charges","15.3% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,656.88,69,,,,,0,"fee schedule","69% of total billed charges",952,100,,761.60,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",952,100,,761.60,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",952,100,,761.60,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",40799.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10666.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10081.33,100,,,,,0,"fee schedule",EAPG,12848.75,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",358.9,37.7,,287.12,,,0,"percent of total billed charges","37.70% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",742.56,78,,594.05,,,0,"percent of total billed charges","78% of total billed charges",11332.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.35,82.6,,629.08,,,0,"percent of total billed charges","82.6% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.35,82.6,,629.08,,,0,"percent of total billed charges","82.6% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10044.18,100,,,,,0,"fee schedule",EAPG,952,100,,761.60,,,0,"percent of total billed charges","100% of total billed charges",145.66,40799.76,
"37239 Transcath plcmnt of intravascular stent, w/",7961765,CDM,521,RC,37239,CPT,OUTPATIENT,,,441,286.65,,388.08,88,,310.46,,,0,"percent of total billed charges","88% of total billed charges",220.5,50,,176.40,,,0,"percent of total billed charges","50% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10180.16,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",277.83,63,,222.26,,,0,"percent of total billed charges","63% of total billed charges",67.47,15.3,,53.98,,,0,"percent of total billed charges","15.3% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,304.29,69,,,,,0,"fee schedule","69% of total billed charges",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.76,61.85,,218.21,,,0,"percent of total billed charges","61.5% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,220.5,50,,176.40,,,0,"percent of total billed charges","50% of total billed charges",142,32.2,,113.60,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10081.33,100,,,,,0,"fee schedule",EAPG,12848.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",166.26,37.7,,133.01,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",343.98,78,,275.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",364.27,82.6,,291.42,,,0,"percent of total billed charges","82.6% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,220.5,50,,176.40,,,0,"percent of total billed charges","50% of total billed charges",364.27,82.6,,291.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10044.18,100,,,,,0,"fee schedule",EAPG,441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",67.47,12848.75,
"37236 Transcatheter placement of an intravascular",7961925,CDM,521,RC,37236,CPT,OUTPATIENT,,,1358,882.7,,1195.04,88,,956.03,,,0,"percent of total billed charges","88% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",19636.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",10180.16,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",855.54,63,,684.43,,,0,"percent of total billed charges","63% of total billed charges",207.77,15.3,,166.22,,,0,"percent of total billed charges","15.3% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,937.02,69,,,,,0,"fee schedule","69% of total billed charges",1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",40799.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10666.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10081.33,100,,,,,0,"fee schedule",EAPG,12848.75,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",511.97,37.7,,409.58,,,0,"percent of total billed charges","37.70% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1059.24,78,,847.39,,,0,"percent of total billed charges","78% of total billed charges",11332.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1121.71,82.6,,897.37,,,0,"percent of total billed charges","82.6% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1121.71,82.6,,897.37,,,0,"percent of total billed charges","82.6% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10044.18,100,,,,,0,"fee schedule",EAPG,1358,100,,1086.40,,,0,"percent of total billed charges","100% of total billed charges",207.77,40799.76,
"37237 Transcatheter placement of an intravascular",7962185,CDM,521,RC,37237,CPT,OUTPATIENT,,,633,411.45,,557.04,88,,445.63,,,0,"percent of total billed charges","88% of total billed charges",316.5,50,,253.20,,,0,"percent of total billed charges","50% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,633,100,,506.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10180.16,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",398.79,63,,319.03,,,0,"percent of total billed charges","63% of total billed charges",96.85,15.3,,77.48,,,0,"percent of total billed charges","15.3% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,436.77,69,,,,,0,"fee schedule","69% of total billed charges",633,100,,506.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",633,100,,506.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",633,100,,506.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",391.51,61.85,,313.21,,,0,"percent of total billed charges","61.5% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,316.5,50,,253.20,,,0,"percent of total billed charges","50% of total billed charges",203.83,32.2,,163.06,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10081.33,100,,,,,0,"fee schedule",EAPG,12848.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",238.64,37.7,,190.91,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",493.74,78,,394.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",522.86,82.6,,418.29,,,0,"percent of total billed charges","82.6% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,316.5,50,,253.20,,,0,"percent of total billed charges","50% of total billed charges",522.86,82.6,,418.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",10044.18,100,,,,,0,"fee schedule",EAPG,633,100,,506.40,,,0,"percent of total billed charges","100% of total billed charges",96.85,12848.75,
"37244 Vascular embolization/occlusion; for arteria",7961612,CDM,521,RC,37244,CPT,OUTPATIENT,,,2012,1307.8,,1770.56,88,,1416.45,,,0,"percent of total billed charges","88% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,2012,100,,1609.60,,,0,"percent of total billed charges","100% of total billed charges",19636.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",10180.16,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1267.56,63,,1014.05,,,0,"percent of total billed charges","63% of total billed charges",307.84,15.3,,246.27,,,0,"percent of total billed charges","15.3% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,1388.28,69,,,,,0,"fee schedule","69% of total billed charges",2012,100,,1609.60,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2012,100,,1609.60,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2012,100,,1609.60,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",40799.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10666.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10081.33,100,,,,,0,"fee schedule",EAPG,12848.75,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",758.52,37.7,,606.82,,,0,"percent of total billed charges","37.70% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1569.36,78,,1255.49,,,0,"percent of total billed charges","78% of total billed charges",11332.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1661.91,82.6,,1329.53,,,0,"percent of total billed charges","82.6% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1661.91,82.6,,1329.53,,,0,"percent of total billed charges","82.6% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10044.18,100,,,,,0,"fee schedule",EAPG,2012,100,,1609.60,,,0,"percent of total billed charges","100% of total billed charges",307.84,40799.76,
"37247 Transluminal balloon angioplasty (except low",7961961,CDM,521,RC,37247,CPT,OUTPATIENT,,,517,336.05,,454.96,88,,363.97,,,0,"percent of total billed charges","88% of total billed charges",258.5,50,,206.80,,,0,"percent of total billed charges","50% of total billed charges",5310.28,100,,,,,0,"fee schedule",EAPG,517,100,,413.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5469.59,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",325.71,63,,260.57,,,0,"percent of total billed charges","63% of total billed charges",79.1,15.3,,63.28,,,0,"percent of total billed charges","15.3% of total billed charges",5310.28,100,,,,,0,"fee schedule",EAPG,356.73,69,,,,,0,"fee schedule","69% of total billed charges",517,100,,413.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",517,100,,413.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",517,100,,413.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",319.76,61.85,,255.81,,,0,"percent of total billed charges","61.5% of total billed charges",5310.28,100,,,,,0,"fee schedule",EAPG,258.5,50,,206.80,,,0,"percent of total billed charges","50% of total billed charges",166.47,32.2,,133.18,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5416.49,100,,,,,0,"fee schedule",EAPG,6903.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",194.91,37.7,,155.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",403.26,78,,322.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",427.04,82.6,,341.63,,,0,"percent of total billed charges","82.6% of total billed charges",5310.28,100,,,,,0,"fee schedule","100% of WA fee schedule",258.5,50,,206.80,,,0,"percent of total billed charges","50% of total billed charges",427.04,82.6,,341.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5470.81,100,,,,,0,"fee schedule",EAPG,517,100,,413.60,,,0,"percent of total billed charges","100% of total billed charges",79.1,6903.37,
"37249 Transluminal balloon angioplasty (except dia",7961962,CDM,521,RC,37249,CPT,OUTPATIENT,,,440,286,,387.2,88,,309.76,,,0,"percent of total billed charges","88% of total billed charges",220,50,,176.00,,,0,"percent of total billed charges","50% of total billed charges",5310.28,100,,,,,0,"fee schedule",EAPG,440,100,,352.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5469.59,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",277.2,63,,221.76,,,0,"percent of total billed charges","63% of total billed charges",67.32,15.3,,53.86,,,0,"percent of total billed charges","15.3% of total billed charges",5310.28,100,,,,,0,"fee schedule",EAPG,303.6,69,,,,,0,"fee schedule","69% of total billed charges",440,100,,352.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",440,100,,352.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",440,100,,352.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.14,61.85,,217.71,,,0,"percent of total billed charges","61.5% of total billed charges",5310.28,100,,,,,0,"fee schedule",EAPG,220,50,,176.00,,,0,"percent of total billed charges","50% of total billed charges",141.68,32.2,,113.34,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5416.49,100,,,,,0,"fee schedule",EAPG,6903.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",165.88,37.7,,132.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",343.2,78,,274.56,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",363.44,82.6,,290.75,,,0,"percent of total billed charges","82.6% of total billed charges",5310.28,100,,,,,0,"fee schedule","100% of WA fee schedule",220,50,,176.00,,,0,"percent of total billed charges","50% of total billed charges",363.44,82.6,,290.75,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5470.81,100,,,,,0,"fee schedule",EAPG,440,100,,352.00,,,0,"percent of total billed charges","100% of total billed charges",67.32,6903.37,
"37248 Transluminal balloon angioplasty (except dia",7962075,CDM,521,RC,37248,CPT,OUTPATIENT,,,896,582.4,,788.48,88,,630.78,,,0,"percent of total billed charges","88% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,896,100,,716.80,,,0,"percent of total billed charges","100% of total billed charges",10202.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",3318.68,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",564.48,63,,451.58,,,0,"percent of total billed charges","63% of total billed charges",137.09,15.3,,109.67,,,0,"percent of total billed charges","15.3% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,618.24,69,,,,,0,"fee schedule","69% of total billed charges",896,100,,716.80,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",896,100,,716.80,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",896,100,,716.80,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",20137.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5264.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.46,100,,,,,0,"fee schedule",EAPG,4188.63,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",337.79,37.7,,270.23,,,0,"percent of total billed charges","37.70% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",698.88,78,,559.10,,,0,"percent of total billed charges","78% of total billed charges",5888.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",740.1,82.6,,592.08,,,0,"percent of total billed charges","82.6% of total billed charges",3222.02,100,,,,,0,"fee schedule","100% of WA fee schedule",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",740.1,82.6,,592.08,,,0,"percent of total billed charges","82.6% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3382.55,100,,,,,0,"fee schedule",EAPG,896,100,,716.80,,,0,"percent of total billed charges","100% of total billed charges",137.09,20137.31,
"37243 Vascular embolization/occlusion; for tumors,",7962678,CDM,521,RC,37243,CPT,OUTPATIENT,,,1725,1121.25,,1518,88,,1214.40,,,0,"percent of total billed charges","88% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,1725,100,,1380.00,,,0,"percent of total billed charges","100% of total billed charges",19636.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",10180.16,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1086.75,63,,869.40,,,0,"percent of total billed charges","63% of total billed charges",263.93,15.3,,211.14,,,0,"percent of total billed charges","15.3% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,1190.25,69,,,,,0,"fee schedule","69% of total billed charges",1725,100,,1380.00,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725,100,,1380.00,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725,100,,1380.00,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",40799.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10666.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10081.33,100,,,,,0,"fee schedule",EAPG,12848.75,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",650.33,37.7,,520.26,,,0,"percent of total billed charges","37.70% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1345.5,78,,1076.40,,,0,"percent of total billed charges","78% of total billed charges",11332.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1424.85,82.6,,1139.88,,,0,"percent of total billed charges","82.6% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1424.85,82.6,,1139.88,,,0,"percent of total billed charges","82.6% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10044.18,100,,,,,0,"fee schedule",EAPG,1725,100,,1380.00,,,0,"percent of total billed charges","100% of total billed charges",263.93,40799.76,
"37242 Vascular embolization/occlusion; arterial, o",7962813,CDM,521,RC,37242,CPT,OUTPATIENT,,,1481,962.65,,1303.28,88,,1042.62,,,0,"percent of total billed charges","88% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,1481,100,,1184.80,,,0,"percent of total billed charges","100% of total billed charges",31299.05,175,,,,,0,"fee schedule","175% of CMS fee schedule",10180.16,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",933.03,63,,746.42,,,0,"percent of total billed charges","63% of total billed charges",226.59,15.3,,181.27,,,0,"percent of total billed charges","15.3% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,1021.89,69,,,,,0,"fee schedule","69% of total billed charges",1481,100,,1184.80,,,0,"percent of total billed charges","100% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1481,100,,1184.80,,,0,"percent of total billed charges","100% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1481,100,,1184.80,,,0,"percent of total billed charges","100% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",40799.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10666.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10081.33,100,,,,,0,"fee schedule",EAPG,12848.75,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",558.34,37.7,,446.67,,,0,"percent of total billed charges","37.70% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1155.18,78,,924.14,,,0,"percent of total billed charges","78% of total billed charges",18064.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1223.31,82.6,,978.65,,,0,"percent of total billed charges","82.6% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1223.31,82.6,,978.65,,,0,"percent of total billed charges","82.6% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10044.18,100,,,,,0,"fee schedule",EAPG,1481,100,,1184.80,,,0,"percent of total billed charges","100% of total billed charges",226.59,40799.76,
"37246 Transluminal balloon angioplasty (except low",7962886,CDM,521,RC,37246,CPT,OUTPATIENT,,,1041,676.65,,916.08,88,,732.86,,,0,"percent of total billed charges","88% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,1041,100,,832.80,,,0,"percent of total billed charges","100% of total billed charges",10202.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",3318.68,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",655.83,63,,524.66,,,0,"percent of total billed charges","63% of total billed charges",159.27,15.3,,127.42,,,0,"percent of total billed charges","15.3% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,718.29,69,,,,,0,"fee schedule","69% of total billed charges",1041,100,,832.80,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1041,100,,832.80,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1041,100,,832.80,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",20137.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3222.02,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5264.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3286.46,100,,,,,0,"fee schedule",EAPG,4188.63,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",392.46,37.7,,313.97,,,0,"percent of total billed charges","37.70% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",811.98,78,,649.58,,,0,"percent of total billed charges","78% of total billed charges",5888.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,82.6,,687.90,,,0,"percent of total billed charges","82.6% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,82.6,,687.90,,,0,"percent of total billed charges","82.6% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3382.55,100,,,,,0,"fee schedule",EAPG,1041,100,,832.80,,,0,"percent of total billed charges","100% of total billed charges",159.27,20137.31,
"37241 Vascular embolization/occlusion; venous, oth",7963051,CDM,521,RC,37241,CPT,OUTPATIENT,,,1324,860.6,,1165.12,88,,932.10,,,0,"percent of total billed charges","88% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,1324,100,,1059.20,,,0,"percent of total billed charges","100% of total billed charges",19636.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",10180.16,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",834.12,63,,667.30,,,0,"percent of total billed charges","63% of total billed charges",202.57,15.3,,162.06,,,0,"percent of total billed charges","15.3% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,913.56,69,,,,,0,"fee schedule","69% of total billed charges",1324,100,,1059.20,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1324,100,,1059.20,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1324,100,,1059.20,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",40799.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9883.65,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10666.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10081.33,100,,,,,0,"fee schedule",EAPG,12848.75,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",499.15,37.7,,399.32,,,0,"percent of total billed charges","37.70% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1032.72,78,,826.18,,,0,"percent of total billed charges","78% of total billed charges",11332.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1093.62,82.6,,874.90,,,0,"percent of total billed charges","82.6% of total billed charges",9883.65,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1093.62,82.6,,874.90,,,0,"percent of total billed charges","82.6% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10044.18,100,,,,,0,"fee schedule",EAPG,1324,100,,1059.20,,,0,"percent of total billed charges","100% of total billed charges",202.57,40799.76,
"37253 Intravascular ultrasound (noncoronary vessel",7962000,CDM,521,RC,37253,CPT,OUTPATIENT,,,198,128.7,,174.24,88,,139.39,,,0,"percent of total billed charges","88% of total billed charges",99,50,,79.20,,,0,"percent of total billed charges","50% of total billed charges",33.26,16.8,,26.61,,,0,"percent of total billed charges","16.8% of total billed charges",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.26,17.304,,27.41,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.74,63,,99.79,,,0,"percent of total billed charges","63% of total billed charges",30.29,15.3,,24.23,,,0,"percent of total billed charges","15.3% of total billed charges",33.26,16.8,,26.61,,,0,"percent of total billed charges","16.8% of total billed charges",136.62,69,,,,,0,"fee schedule","69% of total billed charges",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",122.46,61.85,,97.97,,,0,"percent of total billed charges","61.5% of total billed charges",33.26,16.8,,26.61,,,0,"percent of total billed charges","16.8% of total billed charges",99,50,,79.20,,,0,"percent of total billed charges","50% of total billed charges",63.76,32.2,,51.01,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",33.93,17.136,,27.14,,,0,"percent of total billed charges","17.136% of total billed charges",43.24,21.84,,34.59,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",74.65,37.7,,59.72,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",154.44,78,,123.55,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",163.55,82.6,,130.84,,,0,"percent of total billed charges","82.6% of total billed charges",33.26,16.8,,26.61,,,0,"percent of total billed charges","16.8% of total billed charges",99,50,,79.20,,,0,"percent of total billed charges","50% of total billed charges",163.55,82.6,,130.84,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",30.29,198,
"37252 Intravascular ultrasound (noncoronary vessel",7962064,CDM,521,RC,37252,CPT,OUTPATIENT,,,247,160.55,,217.36,88,,173.89,,,0,"percent of total billed charges","88% of total billed charges",123.5,50,,98.80,,,0,"percent of total billed charges","50% of total billed charges",41.5,16.8,,33.20,,,0,"percent of total billed charges","16.8% of total billed charges",247,100,,197.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.74,17.304,,34.19,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.61,63,,124.49,,,0,"percent of total billed charges","63% of total billed charges",37.79,15.3,,30.23,,,0,"percent of total billed charges","15.3% of total billed charges",41.5,16.8,,33.20,,,0,"percent of total billed charges","16.8% of total billed charges",170.43,69,,,,,0,"fee schedule","69% of total billed charges",247,100,,197.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",247,100,,197.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",247,100,,197.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",152.77,61.85,,122.22,,,0,"percent of total billed charges","61.5% of total billed charges",41.5,16.8,,33.20,,,0,"percent of total billed charges","16.8% of total billed charges",123.5,50,,98.80,,,0,"percent of total billed charges","50% of total billed charges",79.53,32.2,,63.62,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",42.33,17.136,,33.86,,,0,"percent of total billed charges","17.136% of total billed charges",53.94,21.84,,43.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",93.12,37.7,,74.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",192.66,78,,154.13,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",204.02,82.6,,163.22,,,0,"percent of total billed charges","82.6% of total billed charges",41.5,16.8,,33.20,,,0,"percent of total billed charges","16.8% of total billed charges",123.5,50,,98.80,,,0,"percent of total billed charges","50% of total billed charges",204.02,82.6,,163.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",247,100,,197.60,,,0,"percent of total billed charges","100% of total billed charges",37.79,247,
"37251 iv us each add vessel add-on",7963757,CDM,521,RC,37251,CPT,OUTPATIENT,,,285,185.25,,250.8,88,,200.64,,,0,"percent of total billed charges","88% of total billed charges",142.5,50,,114.00,,,0,"percent of total billed charges","50% of total billed charges",47.88,16.8,,38.30,,,0,"percent of total billed charges","16.8% of total billed charges",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.32,17.304,,39.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",179.55,63,,143.64,,,0,"percent of total billed charges","63% of total billed charges",43.61,15.3,,34.89,,,0,"percent of total billed charges","15.3% of total billed charges",47.88,16.8,,38.30,,,0,"percent of total billed charges","16.8% of total billed charges",196.65,69,,,,,0,"fee schedule","69% of total billed charges",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.27,61.85,,141.02,,,0,"percent of total billed charges","61.5% of total billed charges",47.88,16.8,,38.30,,,0,"percent of total billed charges","16.8% of total billed charges",142.5,50,,114.00,,,0,"percent of total billed charges","50% of total billed charges",91.77,32.2,,73.42,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",48.84,17.136,,39.07,,,0,"percent of total billed charges","17.136% of total billed charges",62.24,21.84,,49.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",107.45,37.7,,85.96,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",222.3,78,,177.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",235.41,82.6,,188.33,,,0,"percent of total billed charges","82.6% of total billed charges",47.88,16.8,,38.30,,,0,"percent of total billed charges","16.8% of total billed charges",142.5,50,,114.00,,,0,"percent of total billed charges","50% of total billed charges",235.41,82.6,,188.33,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",285,100,,228.00,,,0,"percent of total billed charges","100% of total billed charges",43.61,285,
"37250 iv us first vessel add-on",7963838,CDM,521,RC,37250,CPT,OUTPATIENT,,,377,245.05,,331.76,88,,265.41,,,0,"percent of total billed charges","88% of total billed charges",188.5,50,,150.80,,,0,"percent of total billed charges","50% of total billed charges",63.34,16.8,,50.67,,,0,"percent of total billed charges","16.8% of total billed charges",377,100,,301.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",65.24,17.304,,52.19,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",237.51,63,,190.01,,,0,"percent of total billed charges","63% of total billed charges",57.68,15.3,,46.14,,,0,"percent of total billed charges","15.3% of total billed charges",63.34,16.8,,50.67,,,0,"percent of total billed charges","16.8% of total billed charges",260.13,69,,,,,0,"fee schedule","69% of total billed charges",377,100,,301.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",377,100,,301.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",377,100,,301.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",233.17,61.85,,186.54,,,0,"percent of total billed charges","61.5% of total billed charges",63.34,16.8,,50.67,,,0,"percent of total billed charges","16.8% of total billed charges",188.5,50,,150.80,,,0,"percent of total billed charges","50% of total billed charges",121.39,32.2,,97.11,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",64.6,17.136,,51.68,,,0,"percent of total billed charges","17.136% of total billed charges",82.34,21.84,,65.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",142.13,37.7,,113.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",294.06,78,,235.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",311.4,82.6,,249.12,,,0,"percent of total billed charges","82.6% of total billed charges",63.34,16.8,,50.67,,,0,"percent of total billed charges","16.8% of total billed charges",188.5,50,,150.80,,,0,"percent of total billed charges","50% of total billed charges",311.4,82.6,,249.12,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",377,100,,301.60,,,0,"percent of total billed charges","100% of total billed charges",57.68,377,
"37606 Ligation; internal or common carotid artery,",7962001,CDM,521,RC,37606,CPT,OUTPATIENT,,,1681,1092.65,,1479.28,88,,1183.42,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4315.84,100,,,,,0,"fee schedule",EAPG,1681,100,,1344.80,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",4445.32,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1059.03,63,,847.22,,,0,"percent of total billed charges","63% of total billed charges",257.19,15.3,,205.75,,,0,"percent of total billed charges","15.3% of total billed charges",4315.84,100,,,,,0,"fee schedule",EAPG,1159.89,69,,,,,0,"fee schedule","69% of total billed charges",1681,100,,1344.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1681,100,,1344.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1681,100,,1344.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4315.84,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4402.16,100,,,,,0,"fee schedule",EAPG,5610.6,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",633.74,37.7,,506.99,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1311.18,78,,1048.94,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1388.51,82.6,,1110.81,,,0,"percent of total billed charges","82.6% of total billed charges",4315.84,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1388.51,82.6,,1110.81,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4476.37,100,,,,,0,"fee schedule",EAPG,1681,100,,1344.80,,,0,"percent of total billed charges","100% of total billed charges",257.19,11625.57,
"37607 Ligation or banding of angioaccess arteriove",7963224,CDM,521,RC,37607,CPT,OUTPATIENT,,,1379,896.35,,1213.52,88,,970.82,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.89,100,,,,,0,"fee schedule",EAPG,1379,100,,1103.20,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",2014.57,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",868.77,63,,695.02,,,0,"percent of total billed charges","63% of total billed charges",210.99,15.3,,168.79,,,0,"percent of total billed charges","15.3% of total billed charges",1955.89,100,,,,,0,"fee schedule",EAPG,951.51,69,,,,,0,"fee schedule","69% of total billed charges",1379,100,,1103.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1379,100,,1103.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1379,100,,1103.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.89,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1995.01,100,,,,,0,"fee schedule",EAPG,2542.66,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",519.88,37.7,,415.90,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1075.62,78,,860.50,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1139.05,82.6,,911.24,,,0,"percent of total billed charges","82.6% of total billed charges",1955.89,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1139.05,82.6,,911.24,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2116.42,100,,,,,0,"fee schedule",EAPG,1379,100,,1103.20,,,0,"percent of total billed charges","100% of total billed charges",210.99,11625.57,
"37605 Ligation; internal or common carotid artery",7963497,CDM,521,RC,37605,CPT,OUTPATIENT,,,2350,1527.5,,2068,88,,1654.40,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4315.84,100,,,,,0,"fee schedule",EAPG,2350,100,,1880.00,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",4445.32,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1480.5,63,,1184.40,,,0,"percent of total billed charges","63% of total billed charges",359.55,15.3,,287.64,,,0,"percent of total billed charges","15.3% of total billed charges",4315.84,100,,,,,0,"fee schedule",EAPG,1621.5,69,,,,,0,"fee schedule","69% of total billed charges",2350,100,,1880.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2350,100,,1880.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2350,100,,1880.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4315.84,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4402.16,100,,,,,0,"fee schedule",EAPG,5610.6,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",885.95,37.7,,708.76,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1833,78,,1466.40,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1941.1,82.6,,1552.88,,,0,"percent of total billed charges","82.6% of total billed charges",4315.84,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1941.1,82.6,,1552.88,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4476.37,100,,,,,0,"fee schedule",EAPG,2350,100,,1880.00,,,0,"percent of total billed charges","100% of total billed charges",359.55,11625.57,
"37609 Ligation or biopsy, temporal artery",7963679,CDM,521,RC,37609,CPT,OUTPATIENT,,,781,507.65,,687.28,88,,549.82,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.89,100,,,,,0,"fee schedule",EAPG,781,100,,624.80,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",2014.57,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",492.03,63,,393.62,,,0,"percent of total billed charges","63% of total billed charges",119.49,15.3,,95.59,,,0,"percent of total billed charges","15.3% of total billed charges",1955.89,100,,,,,0,"fee schedule",EAPG,538.89,69,,,,,0,"fee schedule","69% of total billed charges",781,100,,624.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",781,100,,624.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",781,100,,624.80,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.89,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1995.01,100,,,,,0,"fee schedule",EAPG,2542.66,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",294.44,37.7,,235.55,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",609.18,78,,487.34,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",645.11,82.6,,516.09,,,0,"percent of total billed charges","82.6% of total billed charges",1955.89,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",645.11,82.6,,516.09,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2116.42,100,,,,,0,"fee schedule",EAPG,781,100,,624.80,,,0,"percent of total billed charges","100% of total billed charges",119.49,5715.97,
"37600 Ligation; external carotid artery",7963708,CDM,521,RC,37600,CPT,OUTPATIENT,,,2098,1363.7,,1846.24,88,,1476.99,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4315.84,100,,,,,0,"fee schedule",EAPG,2098,100,,1678.40,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",4445.32,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1321.74,63,,1057.39,,,0,"percent of total billed charges","63% of total billed charges",320.99,15.3,,256.79,,,0,"percent of total billed charges","15.3% of total billed charges",4315.84,100,,,,,0,"fee schedule",EAPG,1447.62,69,,,,,0,"fee schedule","69% of total billed charges",2098,100,,1678.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2098,100,,1678.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2098,100,,1678.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4315.84,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4402.16,100,,,,,0,"fee schedule",EAPG,5610.6,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",790.95,37.7,,632.76,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1636.44,78,,1309.15,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.95,82.6,,1386.36,,,0,"percent of total billed charges","82.6% of total billed charges",4315.84,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.95,82.6,,1386.36,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4476.37,100,,,,,0,"fee schedule",EAPG,2098,100,,1678.40,,,0,"percent of total billed charges","100% of total billed charges",320.99,11625.57,
"37618 Ligation, major artery (eg, post-traumatic,",7963029,CDM,521,RC,37618,CPT,OUTPATIENT,,,1494,971.1,,1314.72,88,,1051.78,,,0,"percent of total billed charges","88% of total billed charges",1494,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1955.89,100,,,,,0,"fee schedule",EAPG,1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",1494,175,,,,,0,"fee schedule","175% of CMS fee schedule",2014.57,100,,,,,0,"fee schedule",EAPG,1494,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",941.22,63,,752.98,,,0,"percent of total billed charges","63% of total billed charges",228.58,15.3,,182.86,,,0,"percent of total billed charges","15.3% of total billed charges",1955.89,100,,,,,0,"fee schedule",EAPG,1030.86,69,,,,,0,"fee schedule","69% of total billed charges",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",1494,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",1494,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",1494,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1494,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1955.89,100,,,,,0,"fee schedule",EAPG,1494,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1494,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1494,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1995.01,100,,,,,0,"fee schedule",EAPG,2542.66,100,,,,,0,"fee schedule",EAPG,1494,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",563.24,37.7,,450.59,,,0,"percent of total billed charges","37.70% of total billed charges",1494,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1494,100,,,,,0,"fee schedule","100% of CMS fee schedule",1165.32,78,,932.26,,,0,"percent of total billed charges","78% of total billed charges",1494,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1234.04,82.6,,987.23,,,0,"percent of total billed charges","82.6% of total billed charges",1955.89,100,,,,,0,"fee schedule",EAPG,1494,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1234.04,82.6,,987.23,,,0,"percent of total billed charges","82.6% of total billed charges",1494,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2116.42,100,,,,,0,"fee schedule",EAPG,1494,100,,1195.20,,,0,"percent of total billed charges","100% of total billed charges",228.58,2542.66,
"37617 Ligation, major artery (eg, post-traumatic,",7963073,CDM,521,RC,37617,CPT,OUTPATIENT,,,3900,2535,,3432,88,,2745.60,,,0,"percent of total billed charges","88% of total billed charges",3900,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10625.6,100,,,,,0,"fee schedule",EAPG,3900,100,,3120.00,,,0,"percent of total billed charges","100% of total billed charges",3900,175,,,,,0,"fee schedule","175% of CMS fee schedule",10944.37,100,,,,,0,"fee schedule",EAPG,3900,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2457,63,,1965.60,,,0,"percent of total billed charges","63% of total billed charges",596.7,15.3,,477.36,,,0,"percent of total billed charges","15.3% of total billed charges",10625.6,100,,,,,0,"fee schedule",EAPG,2691,69,,,,,0,"fee schedule","69% of total billed charges",3900,100,,3120.00,,,0,"percent of total billed charges","100% of total billed charges",3900,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3900,100,,3120.00,,,0,"percent of total billed charges","100% of total billed charges",3900,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3900,100,,3120.00,,,0,"percent of total billed charges","100% of total billed charges",3900,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10625.6,100,,,,,0,"fee schedule",EAPG,3900,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3900,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",3900,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10838.11,100,,,,,0,"fee schedule",EAPG,13813.28,100,,,,,0,"fee schedule",EAPG,3900,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1470.3,37.7,,1176.24,,,0,"percent of total billed charges","37.70% of total billed charges",3900,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3900,100,,,,,0,"fee schedule","100% of CMS fee schedule",3042,78,,2433.60,,,0,"percent of total billed charges","78% of total billed charges",3900,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3221.4,82.6,,2577.12,,,0,"percent of total billed charges","82.6% of total billed charges",10625.6,100,,,,,0,"fee schedule","100% of WA fee schedule",3900,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3221.4,82.6,,2577.12,,,0,"percent of total billed charges","82.6% of total billed charges",3900,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10786.13,100,,,,,0,"fee schedule",EAPG,3900,100,,3120.00,,,0,"percent of total billed charges","100% of total billed charges",596.7,13813.28,
"37700 Ligation and division of long saphenous vein",7961517,CDM,521,RC,37700,CPT,OUTPATIENT,,,1166,757.9,,1026.08,88,,820.86,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2302.53,100,,,,,0,"fee schedule",EAPG,1166,100,,932.80,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",2371.61,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",734.58,63,,587.66,,,0,"percent of total billed charges","63% of total billed charges",178.4,15.3,,142.72,,,0,"percent of total billed charges","15.3% of total billed charges",2302.53,100,,,,,0,"fee schedule",EAPG,804.54,69,,,,,0,"fee schedule","69% of total billed charges",1166,100,,932.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1166,100,,932.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1166,100,,932.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2302.53,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2348.58,100,,,,,0,"fee schedule",EAPG,2993.29,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",439.58,37.7,,351.66,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",909.48,78,,727.58,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",963.12,82.6,,770.50,,,0,"percent of total billed charges","82.6% of total billed charges",2302.53,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",963.12,82.6,,770.50,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2463.06,100,,,,,0,"fee schedule",EAPG,1166,100,,932.80,,,0,"percent of total billed charges","100% of total billed charges",178.4,11625.57,
"37722 Ligation, division, and stripping, long saph",7962339,CDM,521,RC,37722,CPT,OUTPATIENT,,,1703,1106.95,,1498.64,88,,1198.91,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2302.53,100,,,,,0,"fee schedule",EAPG,1703,100,,1362.40,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",2371.61,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1072.89,63,,858.31,,,0,"percent of total billed charges","63% of total billed charges",260.56,15.3,,208.45,,,0,"percent of total billed charges","15.3% of total billed charges",2302.53,100,,,,,0,"fee schedule",EAPG,1175.07,69,,,,,0,"fee schedule","69% of total billed charges",1703,100,,1362.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1703,100,,1362.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1703,100,,1362.40,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2302.53,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2348.58,100,,,,,0,"fee schedule",EAPG,2993.29,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",642.03,37.7,,513.62,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1328.34,78,,1062.67,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1406.68,82.6,,1125.34,,,0,"percent of total billed charges","82.6% of total billed charges",2302.53,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1406.68,82.6,,1125.34,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2463.06,100,,,,,0,"fee schedule",EAPG,1703,100,,1362.40,,,0,"percent of total billed charges","100% of total billed charges",260.56,11625.57,
"37761 Ligation of perforator vein(s), subfascial,",7962206,CDM,521,RC,37761,CPT,OUTPATIENT,,,1872,1216.8,,1647.36,88,,1317.89,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2302.53,100,,,,,0,"fee schedule",EAPG,1872,100,,1497.60,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",2371.61,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1179.36,63,,943.49,,,0,"percent of total billed charges","63% of total billed charges",286.42,15.3,,229.14,,,0,"percent of total billed charges","15.3% of total billed charges",2302.53,100,,,,,0,"fee schedule",EAPG,1291.68,69,,,,,0,"fee schedule","69% of total billed charges",1872,100,,1497.60,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1872,100,,1497.60,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1872,100,,1497.60,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2302.53,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2348.58,100,,,,,0,"fee schedule",EAPG,2993.29,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.74,37.7,,564.59,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1460.16,78,,1168.13,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1546.27,82.6,,1237.02,,,0,"percent of total billed charges","82.6% of total billed charges",2302.53,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1546.27,82.6,,1237.02,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2463.06,100,,,,,0,"fee schedule",EAPG,1872,100,,1497.60,,,0,"percent of total billed charges","100% of total billed charges",286.42,11625.57,
"37760 Ligation of perforator veins, subfascial, ra",7962377,CDM,521,RC,37760,CPT,OUTPATIENT,,,2669,1734.85,,2348.72,88,,1878.98,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2302.53,100,,,,,0,"fee schedule",EAPG,2669,100,,2135.20,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",2371.61,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1681.47,63,,1345.18,,,0,"percent of total billed charges","63% of total billed charges",408.36,15.3,,326.69,,,0,"percent of total billed charges","15.3% of total billed charges",2302.53,100,,,,,0,"fee schedule",EAPG,1841.61,69,,,,,0,"fee schedule","69% of total billed charges",2669,100,,2135.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2669,100,,2135.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2669,100,,2135.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2302.53,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2348.58,100,,,,,0,"fee schedule",EAPG,2993.29,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1006.21,37.7,,804.97,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2081.82,78,,1665.46,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2204.59,82.6,,1763.67,,,0,"percent of total billed charges","82.6% of total billed charges",2302.53,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2204.59,82.6,,1763.67,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2463.06,100,,,,,0,"fee schedule",EAPG,2669,100,,2135.20,,,0,"percent of total billed charges","100% of total billed charges",408.36,11625.57,
"37766 Stab phlebectomy of varicose veins, 1 extrem",7962783,CDM,521,RC,37766,CPT,OUTPATIENT,,,1670,1085.5,,1469.6,88,,1175.68,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2302.53,100,,,,,0,"fee schedule",EAPG,1670,100,,1336.00,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",2371.61,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1052.1,63,,841.68,,,0,"percent of total billed charges","63% of total billed charges",255.51,15.3,,204.41,,,0,"percent of total billed charges","15.3% of total billed charges",2302.53,100,,,,,0,"fee schedule",EAPG,1152.3,69,,,,,0,"fee schedule","69% of total billed charges",1670,100,,1336.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1670,100,,1336.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1670,100,,1336.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2302.53,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2348.58,100,,,,,0,"fee schedule",EAPG,2993.29,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",629.59,37.7,,503.67,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1302.6,78,,1042.08,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1379.42,82.6,,1103.54,,,0,"percent of total billed charges","82.6% of total billed charges",2302.53,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1379.42,82.6,,1103.54,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2463.06,100,,,,,0,"fee schedule",EAPG,1670,100,,1336.00,,,0,"percent of total billed charges","100% of total billed charges",255.51,11625.57,
"37765 Stab phlebectomy of varicose veins, 1 extrem",7962848,CDM,521,RC,37765,CPT,OUTPATIENT,,,1306,848.9,,1149.28,88,,919.42,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2302.53,100,,,,,0,"fee schedule",EAPG,1306,100,,1044.80,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",2371.61,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",822.78,63,,658.22,,,0,"percent of total billed charges","63% of total billed charges",199.82,15.3,,159.86,,,0,"percent of total billed charges","15.3% of total billed charges",2302.53,100,,,,,0,"fee schedule",EAPG,901.14,69,,,,,0,"fee schedule","69% of total billed charges",1306,100,,1044.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1306,100,,1044.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1306,100,,1044.80,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2302.53,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2348.58,100,,,,,0,"fee schedule",EAPG,2993.29,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",492.36,37.7,,393.89,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1018.68,78,,814.94,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1078.76,82.6,,863.01,,,0,"percent of total billed charges","82.6% of total billed charges",2302.53,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1078.76,82.6,,863.01,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2463.06,100,,,,,0,"fee schedule",EAPG,1306,100,,1044.80,,,0,"percent of total billed charges","100% of total billed charges",199.82,11625.57,
"37780 Ligation and division of short saphenous vei",7962679,CDM,521,RC,37780,CPT,OUTPATIENT,,,949,616.85,,835.12,88,,668.10,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2302.53,100,,,,,0,"fee schedule",EAPG,949,100,,759.20,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",2371.61,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",597.87,63,,478.30,,,0,"percent of total billed charges","63% of total billed charges",145.2,15.3,,116.16,,,0,"percent of total billed charges","15.3% of total billed charges",2302.53,100,,,,,0,"fee schedule",EAPG,654.81,69,,,,,0,"fee schedule","69% of total billed charges",949,100,,759.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",949,100,,759.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",949,100,,759.20,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2302.53,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2348.58,100,,,,,0,"fee schedule",EAPG,2993.29,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",357.77,37.7,,286.22,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",740.22,78,,592.18,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",783.87,82.6,,627.10,,,0,"percent of total billed charges","82.6% of total billed charges",2302.53,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",783.87,82.6,,627.10,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2463.06,100,,,,,0,"fee schedule",EAPG,949,100,,759.20,,,0,"percent of total billed charges","100% of total billed charges",145.2,11625.57,
"37785 Ligation, division, and/or excision of varic",7962814,CDM,521,RC,37785,CPT,OUTPATIENT,,,932,605.8,,820.16,88,,656.13,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2302.53,100,,,,,0,"fee schedule",EAPG,932,100,,745.60,,,0,"percent of total billed charges","100% of total billed charges",5689.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",2371.61,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",587.16,63,,469.73,,,0,"percent of total billed charges","63% of total billed charges",142.6,15.3,,114.08,,,0,"percent of total billed charges","15.3% of total billed charges",2302.53,100,,,,,0,"fee schedule",EAPG,643.08,69,,,,,0,"fee schedule","69% of total billed charges",932,100,,745.60,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",932,100,,745.60,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",932,100,,745.60,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2302.53,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2348.58,100,,,,,0,"fee schedule",EAPG,2993.29,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",351.36,37.7,,281.09,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.96,78,,581.57,,,0,"percent of total billed charges","78% of total billed charges",3283.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",769.83,82.6,,615.86,,,0,"percent of total billed charges","82.6% of total billed charges",2302.53,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",769.83,82.6,,615.86,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2463.06,100,,,,,0,"fee schedule",EAPG,932,100,,745.60,,,0,"percent of total billed charges","100% of total billed charges",142.6,11625.57,
"37799 Unlisted procedure, vascular surgery",7963660,CDM,521,RC,37799,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1955.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2014.57,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1955.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1955.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1995.01,100,,,,,0,"fee schedule",EAPG,2542.66,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1955.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2116.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1955.89,2542.66,
"38101 Splenectomy; partial (separate procedure)",7963560,CDM,521,RC,38101,CPT,OUTPATIENT,,,3344,2173.6,,2942.72,88,,2354.18,,,0,"percent of total billed charges","88% of total billed charges",3344,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3355.36,100,,,,,0,"fee schedule",EAPG,3344,100,,2675.20,,,0,"percent of total billed charges","100% of total billed charges",3344,175,,,,,0,"fee schedule","175% of CMS fee schedule",3456.02,100,,,,,0,"fee schedule",EAPG,3344,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2106.72,63,,1685.38,,,0,"percent of total billed charges","63% of total billed charges",511.63,15.3,,409.30,,,0,"percent of total billed charges","15.3% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,2307.36,69,,,,,0,"fee schedule","69% of total billed charges",3344,100,,2675.20,,,0,"percent of total billed charges","100% of total billed charges",3344,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3344,100,,2675.20,,,0,"percent of total billed charges","100% of total billed charges",3344,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3344,100,,2675.20,,,0,"percent of total billed charges","100% of total billed charges",3344,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3344,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3355.36,100,,,,,0,"fee schedule",EAPG,3344,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3344,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3344,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3422.47,100,,,,,0,"fee schedule",EAPG,4361.97,100,,,,,0,"fee schedule",EAPG,3344,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1260.69,37.7,,1008.55,,,0,"percent of total billed charges","37.70% of total billed charges",3344,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3344,100,,,,,0,"fee schedule","100% of CMS fee schedule",2608.32,78,,2086.66,,,0,"percent of total billed charges","78% of total billed charges",3344,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2762.14,82.6,,2209.71,,,0,"percent of total billed charges","82.6% of total billed charges",3355.36,100,,,,,0,"fee schedule","100% of WA fee schedule",3344,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2762.14,82.6,,2209.71,,,0,"percent of total billed charges","82.6% of total billed charges",3344,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3515.89,100,,,,,0,"fee schedule",EAPG,3344,100,,2675.20,,,0,"percent of total billed charges","100% of total billed charges",511.63,4361.97,
"38100 Splenectomy; total (separate procedure)",7963604,CDM,521,RC,38100,CPT,OUTPATIENT,,,5088,3307.2,,4477.44,88,,3581.95,,,0,"percent of total billed charges","88% of total billed charges",5088,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3355.36,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5088,175,,,,,0,"fee schedule","175% of CMS fee schedule",3456.02,100,,,,,0,"fee schedule",EAPG,5088,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3205.44,63,,2564.35,,,0,"percent of total billed charges","63% of total billed charges",778.46,15.3,,622.77,,,0,"percent of total billed charges","15.3% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,3510.72,69,,,,,0,"fee schedule","69% of total billed charges",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",5088,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",5088,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",5088,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5088,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3355.36,100,,,,,0,"fee schedule",EAPG,5088,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5088,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5088,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3422.47,100,,,,,0,"fee schedule",EAPG,4361.97,100,,,,,0,"fee schedule",EAPG,5088,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1918.18,37.7,,1534.54,,,0,"percent of total billed charges","37.70% of total billed charges",5088,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5088,100,,,,,0,"fee schedule","100% of CMS fee schedule",3968.64,78,,3174.91,,,0,"percent of total billed charges","78% of total billed charges",5088,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",3355.36,100,,,,,0,"fee schedule","100% of WA fee schedule",5088,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4202.69,82.6,,3362.15,,,0,"percent of total billed charges","82.6% of total billed charges",5088,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3515.89,100,,,,,0,"fee schedule",EAPG,5088,100,,4070.40,,,0,"percent of total billed charges","100% of total billed charges",778.46,5088,
"38115 Repair of ruptured spleen (splenorrhaphy) wi",7962561,CDM,521,RC,38115,CPT,OUTPATIENT,,,5184,3369.6,,4561.92,88,,3649.54,,,0,"percent of total billed charges","88% of total billed charges",5184,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3355.36,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5184,175,,,,,0,"fee schedule","175% of CMS fee schedule",3456.02,100,,,,,0,"fee schedule",EAPG,5184,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3265.92,63,,2612.74,,,0,"percent of total billed charges","63% of total billed charges",793.15,15.3,,634.52,,,0,"percent of total billed charges","15.3% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,3576.96,69,,,,,0,"fee schedule","69% of total billed charges",5184,100,,4147.20,,,0,"percent of total billed charges","100% of total billed charges",5184,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5184,100,,4147.20,,,0,"percent of total billed charges","100% of total billed charges",5184,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5184,100,,4147.20,,,0,"percent of total billed charges","100% of total billed charges",5184,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5184,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3355.36,100,,,,,0,"fee schedule",EAPG,5184,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5184,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5184,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3422.47,100,,,,,0,"fee schedule",EAPG,4361.97,100,,,,,0,"fee schedule",EAPG,5184,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1954.37,37.7,,1563.50,,,0,"percent of total billed charges","37.70% of total billed charges",5184,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5184,100,,,,,0,"fee schedule","100% of CMS fee schedule",4043.52,78,,3234.82,,,0,"percent of total billed charges","78% of total billed charges",5184,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4281.98,82.6,,3425.58,,,0,"percent of total billed charges","82.6% of total billed charges",3355.36,100,,,,,0,"fee schedule","100% of WA fee schedule",5184,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4281.98,82.6,,3425.58,,,0,"percent of total billed charges","82.6% of total billed charges",5184,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3515.89,100,,,,,0,"fee schedule",EAPG,5184,100,,4147.20,,,0,"percent of total billed charges","100% of total billed charges",793.15,5184,
"38120 Laparoscopy, surgical, splenectomy",7963692,CDM,521,RC,38120,CPT,OUTPATIENT,,,3034,1972.1,,2669.92,88,,2135.94,,,0,"percent of total billed charges","88% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3355.36,100,,,,,0,"fee schedule",EAPG,3034,100,,2427.20,,,0,"percent of total billed charges","100% of total billed charges",18373.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",3456.02,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1911.42,63,,1529.14,,,0,"percent of total billed charges","63% of total billed charges",464.2,15.3,,371.36,,,0,"percent of total billed charges","15.3% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,2093.46,69,,,,,0,"fee schedule","69% of total billed charges",3034,100,,2427.20,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3034,100,,2427.20,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3034,100,,2427.20,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",36187.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3355.36,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9460.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3422.47,100,,,,,0,"fee schedule",EAPG,4361.97,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1143.82,37.7,,915.06,,,0,"percent of total billed charges","37.70% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2366.52,78,,1893.22,,,0,"percent of total billed charges","78% of total billed charges",10604.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2506.08,82.6,,2004.86,,,0,"percent of total billed charges","82.6% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2506.08,82.6,,2004.86,,,0,"percent of total billed charges","82.6% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3515.89,100,,,,,0,"fee schedule",EAPG,3034,100,,2427.20,,,0,"percent of total billed charges","100% of total billed charges",464.2,36187.64,
"38221  Bone marrow; biopsy, needle or trocar",7963625,CDM,521,RC,38221,CPT,OUTPATIENT,,,674,438.1,,593.12,88,,474.50,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1070.37,100,,,,,0,"fee schedule",EAPG,674,100,,539.20,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1102.48,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",424.62,63,,339.70,,,0,"percent of total billed charges","63% of total billed charges",103.12,15.3,,82.50,,,0,"percent of total billed charges","15.3% of total billed charges",1070.37,100,,,,,0,"fee schedule",EAPG,465.06,69,,,,,0,"fee schedule","69% of total billed charges",674,100,,539.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",674,100,,539.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",674,100,,539.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1070.37,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1091.78,100,,,,,0,"fee schedule",EAPG,1391.48,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",254.1,37.7,,203.28,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",525.72,78,,420.58,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.72,82.6,,445.38,,,0,"percent of total billed charges","82.6% of total billed charges",1070.37,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.72,82.6,,445.38,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1230.9,100,,,,,0,"fee schedule",EAPG,674,100,,539.20,,,0,"percent of total billed charges","100% of total billed charges",103.12,5715.97,
"38220 Bone marrow; aspiration only",7963777,CDM,521,RC,38220,CPT,OUTPATIENT,,,240,156,,211.2,88,,168.96,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1070.37,100,,,,,0,"fee schedule",EAPG,240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1102.48,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.2,63,,120.96,,,0,"percent of total billed charges","63% of total billed charges",36.72,15.3,,29.38,,,0,"percent of total billed charges","15.3% of total billed charges",1070.37,100,,,,,0,"fee schedule",EAPG,165.6,69,,,,,0,"fee schedule","69% of total billed charges",240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1070.37,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1091.78,100,,,,,0,"fee schedule",EAPG,1391.48,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",90.48,37.7,,72.38,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",187.2,78,,149.76,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",198.24,82.6,,158.59,,,0,"percent of total billed charges","82.6% of total billed charges",1070.37,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",198.24,82.6,,158.59,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1230.9,100,,,,,0,"fee schedule",EAPG,240,100,,192.00,,,0,"percent of total billed charges","100% of total billed charges",36.72,5715.97,
"38505 Biopsy or excision of lymph node(s); by need",7961518,CDM,521,RC,38505,CPT,OUTPATIENT,,,578,375.7,,508.64,88,,406.91,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,578,100,,462.40,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1066.24,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",364.14,63,,291.31,,,0,"percent of total billed charges","63% of total billed charges",88.43,15.3,,70.74,,,0,"percent of total billed charges","15.3% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,398.82,69,,,,,0,"fee schedule","69% of total billed charges",578,100,,462.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",578,100,,462.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",578,100,,462.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055.89,100,,,,,0,"fee schedule",EAPG,1345.74,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",217.91,37.7,,174.33,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",450.84,78,,360.67,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",477.43,82.6,,381.94,,,0,"percent of total billed charges","82.6% of total billed charges",1035.18,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",477.43,82.6,,381.94,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1195.71,100,,,,,0,"fee schedule",EAPG,578,100,,462.40,,,0,"percent of total billed charges","100% of total billed charges",88.43,5715.97,
"38500  Biopsy or excision of lymph node(s); open,",7963254,CDM,521,RC,38500,CPT,OUTPATIENT,,,1090,708.5,,959.2,88,,767.36,,,0,"percent of total billed charges","88% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2604.24,100,,,,,0,"fee schedule",EAPG,1090,100,,872.00,,,0,"percent of total billed charges","100% of total billed charges",6803.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",2682.36,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.7,63,,549.36,,,0,"percent of total billed charges","63% of total billed charges",166.77,15.3,,133.42,,,0,"percent of total billed charges","15.3% of total billed charges",2604.24,100,,,,,0,"fee schedule",EAPG,752.1,69,,,,,0,"fee schedule","69% of total billed charges",1090,100,,872.00,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1090,100,,872.00,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1090,100,,872.00,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",12828.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2604.24,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3353.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2656.32,100,,,,,0,"fee schedule",EAPG,3385.51,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",410.93,37.7,,328.74,,,0,"percent of total billed charges","37.70% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",850.2,78,,680.16,,,0,"percent of total billed charges","78% of total billed charges",3926.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",900.34,82.6,,720.27,,,0,"percent of total billed charges","82.6% of total billed charges",2604.24,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",900.34,82.6,,720.27,,,0,"percent of total billed charges","82.6% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2764.77,100,,,,,0,"fee schedule",EAPG,1090,100,,872.00,,,0,"percent of total billed charges","100% of total billed charges",166.77,12828.41,
"38510 Biopsy or excision of lymph node(s); open, d",7962999,CDM,521,RC,38510,CPT,OUTPATIENT,,,1618,1051.7,,1423.84,88,,1139.07,,,0,"percent of total billed charges","88% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2604.24,100,,,,,0,"fee schedule",EAPG,1618,100,,1294.40,,,0,"percent of total billed charges","100% of total billed charges",6803.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",2682.36,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1019.34,63,,815.47,,,0,"percent of total billed charges","63% of total billed charges",247.55,15.3,,198.04,,,0,"percent of total billed charges","15.3% of total billed charges",2604.24,100,,,,,0,"fee schedule",EAPG,1116.42,69,,,,,0,"fee schedule","69% of total billed charges",1618,100,,1294.40,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1618,100,,1294.40,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1618,100,,1294.40,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",12828.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2604.24,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3353.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2656.32,100,,,,,0,"fee schedule",EAPG,3385.51,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",609.99,37.7,,487.99,,,0,"percent of total billed charges","37.70% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1262.04,78,,1009.63,,,0,"percent of total billed charges","78% of total billed charges",3926.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1336.47,82.6,,1069.18,,,0,"percent of total billed charges","82.6% of total billed charges",2604.24,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1336.47,82.6,,1069.18,,,0,"percent of total billed charges","82.6% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2764.77,100,,,,,0,"fee schedule",EAPG,1618,100,,1294.40,,,0,"percent of total billed charges","100% of total billed charges",247.55,12828.41,
"38520 Biopsy or excision of lymph node(s); open, d",7961519,CDM,521,RC,38520,CPT,OUTPATIENT,,,1373,892.45,,1208.24,88,,966.59,,,0,"percent of total billed charges","88% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2604.24,100,,,,,0,"fee schedule",EAPG,1373,100,,1098.40,,,0,"percent of total billed charges","100% of total billed charges",6803.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",2682.36,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",864.99,63,,691.99,,,0,"percent of total billed charges","63% of total billed charges",210.07,15.3,,168.06,,,0,"percent of total billed charges","15.3% of total billed charges",2604.24,100,,,,,0,"fee schedule",EAPG,947.37,69,,,,,0,"fee schedule","69% of total billed charges",1373,100,,1098.40,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1373,100,,1098.40,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1373,100,,1098.40,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",12828.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2604.24,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3353.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2656.32,100,,,,,0,"fee schedule",EAPG,3385.51,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",517.62,37.7,,414.10,,,0,"percent of total billed charges","37.70% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1070.94,78,,856.75,,,0,"percent of total billed charges","78% of total billed charges",3926.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1134.1,82.6,,907.28,,,0,"percent of total billed charges","82.6% of total billed charges",2604.24,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1134.1,82.6,,907.28,,,0,"percent of total billed charges","82.6% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2764.77,100,,,,,0,"fee schedule",EAPG,1373,100,,1098.40,,,0,"percent of total billed charges","100% of total billed charges",210.07,12828.41,
"38525 Biopsy or excision of lymph node(s); open, d",7963000,CDM,521,RC,38525,CPT,OUTPATIENT,,,1086,705.9,,955.68,88,,764.54,,,0,"percent of total billed charges","88% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2604.24,100,,,,,0,"fee schedule",EAPG,1086,100,,868.80,,,0,"percent of total billed charges","100% of total billed charges",6803.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",2682.36,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",684.18,63,,547.34,,,0,"percent of total billed charges","63% of total billed charges",166.16,15.3,,132.93,,,0,"percent of total billed charges","15.3% of total billed charges",2604.24,100,,,,,0,"fee schedule",EAPG,749.34,69,,,,,0,"fee schedule","69% of total billed charges",1086,100,,868.80,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1086,100,,868.80,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1086,100,,868.80,,,0,"percent of total billed charges","100% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",12828.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2604.24,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3353.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2656.32,100,,,,,0,"fee schedule",EAPG,3385.51,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",409.42,37.7,,327.54,,,0,"percent of total billed charges","37.70% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",847.08,78,,677.66,,,0,"percent of total billed charges","78% of total billed charges",3926.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",897.04,82.6,,717.63,,,0,"percent of total billed charges","82.6% of total billed charges",2604.24,100,,,,,0,"fee schedule",EAPG,3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",897.04,82.6,,717.63,,,0,"percent of total billed charges","82.6% of total billed charges",3887.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2764.77,100,,,,,0,"fee schedule",EAPG,1086,100,,868.80,,,0,"percent of total billed charges","100% of total billed charges",166.16,12828.41,
"38542 Dissection, deep jugular node(s)",7963716,CDM,521,RC,38542,CPT,OUTPATIENT,,,1512,982.8,,1330.56,88,,1064.45,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2604.24,100,,,,,0,"fee schedule",EAPG,1512,100,,1209.60,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",2682.36,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",952.56,63,,762.05,,,0,"percent of total billed charges","63% of total billed charges",231.34,15.3,,185.07,,,0,"percent of total billed charges","15.3% of total billed charges",2604.24,100,,,,,0,"fee schedule",EAPG,1043.28,69,,,,,0,"fee schedule","69% of total billed charges",1512,100,,1209.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1512,100,,1209.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1512,100,,1209.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2604.24,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2656.32,100,,,,,0,"fee schedule",EAPG,3385.51,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",570.02,37.7,,456.02,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1179.36,78,,943.49,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1248.91,82.6,,999.13,,,0,"percent of total billed charges","82.6% of total billed charges",2604.24,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1248.91,82.6,,999.13,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2764.77,100,,,,,0,"fee schedule",EAPG,1512,100,,1209.60,,,0,"percent of total billed charges","100% of total billed charges",231.34,20558.19,
"38570 Laparoscopy, surgical; with retroperitoneal",7961712,CDM,521,RC,38570,CPT,OUTPATIENT,,,1462,950.3,,1286.56,88,,1029.25,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3355.36,100,,,,,0,"fee schedule",EAPG,1462,100,,1169.60,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",3456.02,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",921.06,63,,736.85,,,0,"percent of total billed charges","63% of total billed charges",223.69,15.3,,178.95,,,0,"percent of total billed charges","15.3% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,1008.78,69,,,,,0,"fee schedule","69% of total billed charges",1462,100,,1169.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1462,100,,1169.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1462,100,,1169.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3355.36,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3422.47,100,,,,,0,"fee schedule",EAPG,4361.97,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",551.17,37.7,,440.94,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1140.36,78,,912.29,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1207.61,82.6,,966.09,,,0,"percent of total billed charges","82.6% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1207.61,82.6,,966.09,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3515.89,100,,,,,0,"fee schedule",EAPG,1462,100,,1169.60,,,0,"percent of total billed charges","100% of total billed charges",223.69,20558.19,
"38724 Cervical lymphadenectomy (modified radical n",7963145,CDM,521,RC,38724,CPT,OUTPATIENT,,,3237,2104.05,,2848.56,88,,2278.85,,,0,"percent of total billed charges","88% of total billed charges",3237,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2604.24,100,,,,,0,"fee schedule",EAPG,3237,100,,2589.60,,,0,"percent of total billed charges","100% of total billed charges",3237,175,,,,,0,"fee schedule","175% of CMS fee schedule",2682.36,100,,,,,0,"fee schedule",EAPG,3237,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2039.31,63,,1631.45,,,0,"percent of total billed charges","63% of total billed charges",495.26,15.3,,396.21,,,0,"percent of total billed charges","15.3% of total billed charges",2604.24,100,,,,,0,"fee schedule",EAPG,2233.53,69,,,,,0,"fee schedule","69% of total billed charges",3237,100,,2589.60,,,0,"percent of total billed charges","100% of total billed charges",3237,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3237,100,,2589.60,,,0,"percent of total billed charges","100% of total billed charges",3237,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3237,100,,2589.60,,,0,"percent of total billed charges","100% of total billed charges",3237,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3237,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2604.24,100,,,,,0,"fee schedule",EAPG,3237,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3237,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3237,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2656.32,100,,,,,0,"fee schedule",EAPG,3385.51,100,,,,,0,"fee schedule",EAPG,3237,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1220.35,37.7,,976.28,,,0,"percent of total billed charges","37.70% of total billed charges",3237,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3237,100,,,,,0,"fee schedule","100% of CMS fee schedule",2524.86,78,,2019.89,,,0,"percent of total billed charges","78% of total billed charges",3237,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2673.76,82.6,,2139.01,,,0,"percent of total billed charges","82.6% of total billed charges",2604.24,100,,,,,0,"fee schedule","100% of WA fee schedule",3237,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2673.76,82.6,,2139.01,,,0,"percent of total billed charges","82.6% of total billed charges",3237,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2764.77,100,,,,,0,"fee schedule",EAPG,3237,100,,2589.60,,,0,"percent of total billed charges","100% of total billed charges",495.26,3385.51,
"38720 Cervical lymphadenectomy (complete)",7963680,CDM,521,RC,38720,CPT,OUTPATIENT,,,3003,1951.95,,2642.64,88,,2114.11,,,0,"percent of total billed charges","88% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2604.24,100,,,,,0,"fee schedule",EAPG,3003,100,,2402.40,,,0,"percent of total billed charges","100% of total billed charges",11639.72,175,,,,,0,"fee schedule","175% of CMS fee schedule",2682.36,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1891.89,63,,1513.51,,,0,"percent of total billed charges","63% of total billed charges",459.46,15.3,,367.57,,,0,"percent of total billed charges","15.3% of total billed charges",2604.24,100,,,,,0,"fee schedule",EAPG,2072.07,69,,,,,0,"fee schedule","69% of total billed charges",3003,100,,2402.40,,,0,"percent of total billed charges","100% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3003,100,,2402.40,,,0,"percent of total billed charges","100% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3003,100,,2402.40,,,0,"percent of total billed charges","100% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",36237.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2604.24,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9473.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2656.32,100,,,,,0,"fee schedule",EAPG,3385.51,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1132.13,37.7,,905.70,,,0,"percent of total billed charges","37.70% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2342.34,78,,1873.87,,,0,"percent of total billed charges","78% of total billed charges",6717.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2480.48,82.6,,1984.38,,,0,"percent of total billed charges","82.6% of total billed charges",2604.24,100,,,,,0,"fee schedule",EAPG,6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2480.48,82.6,,1984.38,,,0,"percent of total billed charges","82.6% of total billed charges",6651.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2764.77,100,,,,,0,"fee schedule",EAPG,3003,100,,2402.40,,,0,"percent of total billed charges","100% of total billed charges",459.46,36237.94,
"38746 Thoracic lymphadenectomy by thoracotomy, med",7962450,CDM,521,RC,38746,CPT,OUTPATIENT,,,1142,742.3,,1004.96,88,,803.97,,,0,"percent of total billed charges","88% of total billed charges",1142,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",191.86,16.8,,153.49,,,0,"percent of total billed charges","16.8% of total billed charges",1142,100,,913.60,,,0,"percent of total billed charges","100% of total billed charges",1142,175,,,,,0,"fee schedule","175% of CMS fee schedule",197.61,17.304,,158.09,,,0,"percent of total billed charges","17.304% of total billed charges",1142,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",719.46,63,,575.57,,,0,"percent of total billed charges","63% of total billed charges",174.73,15.3,,139.78,,,0,"percent of total billed charges","15.3% of total billed charges",191.86,16.8,,153.49,,,0,"percent of total billed charges","16.8% of total billed charges",787.98,69,,,,,0,"fee schedule","69% of total billed charges",1142,100,,913.60,,,0,"percent of total billed charges","100% of total billed charges",1142,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1142,100,,913.60,,,0,"percent of total billed charges","100% of total billed charges",1142,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1142,100,,913.60,,,0,"percent of total billed charges","100% of total billed charges",1142,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1142,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",191.86,16.8,,153.49,,,0,"percent of total billed charges","16.8% of total billed charges",1142,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1142,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1142,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",195.69,17.136,,156.55,,,0,"percent of total billed charges","17.136% of total billed charges",249.41,21.84,,199.53,,,0,"percent of total billed charges","21.84% of total billed charges",1142,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",430.53,37.7,,344.42,,,0,"percent of total billed charges","37.70% of total billed charges",1142,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1142,100,,,,,0,"fee schedule","100% of CMS fee schedule",890.76,78,,712.61,,,0,"percent of total billed charges","78% of total billed charges",1142,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",943.29,82.6,,754.63,,,0,"percent of total billed charges","82.6% of total billed charges",191.86,16.8,,153.49,,,0,"percent of total billed charges","16.8% of total billed charges",1142,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",943.29,82.6,,754.63,,,0,"percent of total billed charges","82.6% of total billed charges",1142,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",160.53,100,,,,,0,"case rate","pays based on per visit rate",1142,100,,913.60,,,0,"percent of total billed charges","100% of total billed charges",160.53,1142,
"38740 Axillary lymphadenectomy; superficial",7963643,CDM,521,RC,38740,CPT,OUTPATIENT,,,2028,1318.2,,1784.64,88,,1427.71,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,2028,100,,1622.40,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",1640.79,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1277.64,63,,1022.11,,,0,"percent of total billed charges","63% of total billed charges",310.28,15.3,,248.22,,,0,"percent of total billed charges","15.3% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,1399.32,69,,,,,0,"fee schedule","69% of total billed charges",2028,100,,1622.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2028,100,,1622.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2028,100,,1622.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1624.86,100,,,,,0,"fee schedule",EAPG,2070.9,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",764.56,37.7,,611.65,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1581.84,78,,1265.47,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1675.13,82.6,,1340.10,,,0,"percent of total billed charges","82.6% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1675.13,82.6,,1340.10,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.53,100,,,,,0,"fee schedule",EAPG,2028,100,,1622.40,,,0,"percent of total billed charges","100% of total billed charges",310.28,20558.19,
"38745 Axillary lymphadenectomy; complete",7963693,CDM,521,RC,38745,CPT,OUTPATIENT,,,4471,2906.15,,3934.48,88,,3147.58,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,4471,100,,3576.80,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",1640.79,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2816.73,63,,2253.38,,,0,"percent of total billed charges","63% of total billed charges",684.06,15.3,,547.25,,,0,"percent of total billed charges","15.3% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,3084.99,69,,,,,0,"fee schedule","69% of total billed charges",4471,100,,3576.80,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4471,100,,3576.80,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4471,100,,3576.80,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1593,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1624.86,100,,,,,0,"fee schedule",EAPG,2070.9,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1685.57,37.7,,1348.46,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3487.38,78,,2789.90,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3693.05,82.6,,2954.44,,,0,"percent of total billed charges","82.6% of total billed charges",1593,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3693.05,82.6,,2954.44,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.53,100,,,,,0,"fee schedule",EAPG,4471,100,,3576.80,,,0,"percent of total billed charges","100% of total billed charges",684.06,20558.19,
"38792 Injection procedure; radioactive tracer for",7962636,CDM,521,RC,38792,CPT,OUTPATIENT,,,287,186.55,,252.56,88,,202.05,,,0,"percent of total billed charges","88% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",736.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",356.1,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180.81,63,,144.65,,,0,"percent of total billed charges","63% of total billed charges",43.91,15.3,,35.13,,,0,"percent of total billed charges","15.3% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,198.03,69,,,,,0,"fee schedule","69% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1532.06,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352.65,100,,,,,0,"fee schedule",EAPG,449.45,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.70% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",223.86,78,,179.09,,,0,"percent of total billed charges","78% of total billed charges",424.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",345.73,100,,,,,0,"fee schedule",EAPG,420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",420.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",506.26,100,,,,,0,"fee schedule",EAPG,287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",43.91,1532.06,
"38900 Intraoperative identification (eg, mapping)",7962087,CDM,521,RC,38900,CPT,OUTPATIENT,,,389,252.85,,342.32,88,,273.86,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",272.87,100,,,,,0,"fee schedule",EAPG,389,100,,311.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.05,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",245.07,63,,196.06,,,0,"percent of total billed charges","63% of total billed charges",59.52,15.3,,47.62,,,0,"percent of total billed charges","15.3% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,268.41,69,,,,,0,"fee schedule","69% of total billed charges",389,100,,311.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",389,100,,311.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",389,100,,311.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",272.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",278.32,100,,,,,0,"fee schedule",EAPG,354.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",146.65,37.7,,117.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",303.42,78,,242.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",321.31,82.6,,257.05,,,0,"percent of total billed charges","82.6% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",321.31,82.6,,257.05,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",433.4,100,,,,,0,"fee schedule",EAPG,389,100,,311.20,,,0,"percent of total billed charges","100% of total billed charges",59.52,433.4,
"38999 Unlisted procedure, hemic or lymphatic syste",7963484,CDM,521,RC,38999,CPT,OUTPATIENT,,,1232,800.8,,1084.16,88,,867.33,,,0,"percent of total billed charges","88% of total billed charges",442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2604.24,100,,,,,0,"fee schedule",EAPG,1232,100,,985.60,,,0,"percent of total billed charges","100% of total billed charges",774.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",2682.36,100,,,,,0,"fee schedule",EAPG,442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",776.16,63,,620.93,,,0,"percent of total billed charges","63% of total billed charges",188.5,15.3,,150.80,,,0,"percent of total billed charges","15.3% of total billed charges",2604.24,100,,,,,0,"fee schedule",EAPG,850.08,69,,,,,0,"fee schedule","69% of total billed charges",1232,100,,985.60,,,0,"percent of total billed charges","100% of total billed charges",442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1232,100,,985.60,,,0,"percent of total billed charges","100% of total billed charges",442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1232,100,,985.60,,,0,"percent of total billed charges","100% of total billed charges",442.76,100,,,,,0,"fee schedule","100% of CMS fee schedule",1613.06,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2604.24,100,,,,,0,"fee schedule",EAPG,442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",421.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2656.32,100,,,,,0,"fee schedule",EAPG,3385.51,100,,,,,0,"fee schedule",EAPG,442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",464.46,37.7,,371.57,,,0,"percent of total billed charges","37.70% of total billed charges",442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",960.96,78,,768.77,,,0,"percent of total billed charges","78% of total billed charges",447.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1017.63,82.6,,814.10,,,0,"percent of total billed charges","82.6% of total billed charges",2604.24,100,,,,,0,"fee schedule",EAPG,442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1017.63,82.6,,814.10,,,0,"percent of total billed charges","82.6% of total billed charges",442.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2764.77,100,,,,,0,"fee schedule",EAPG,1232,100,,985.60,,,0,"percent of total billed charges","100% of total billed charges",188.5,3385.51,
"39000 Mediastinotomy w/ exploration, drainage, rem",7961520,CDM,521,RC,39000,CPT,OUTPATIENT,,,384,249.6,,337.92,88,,270.34,,,0,"percent of total billed charges","88% of total billed charges",384,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2020.72,100,,,,,0,"fee schedule",EAPG,384,100,,307.20,,,0,"percent of total billed charges","100% of total billed charges",384,175,,,,,0,"fee schedule","175% of CMS fee schedule",2081.34,100,,,,,0,"fee schedule",EAPG,384,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",241.92,63,,193.54,,,0,"percent of total billed charges","63% of total billed charges",58.75,15.3,,47.00,,,0,"percent of total billed charges","15.3% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,264.96,69,,,,,0,"fee schedule","69% of total billed charges",384,100,,307.20,,,0,"percent of total billed charges","100% of total billed charges",384,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",384,100,,307.20,,,0,"percent of total billed charges","100% of total billed charges",384,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",384,100,,307.20,,,0,"percent of total billed charges","100% of total billed charges",384,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",384,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2020.72,100,,,,,0,"fee schedule",EAPG,384,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",384,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",384,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2061.13,100,,,,,0,"fee schedule",EAPG,2626.94,100,,,,,0,"fee schedule",EAPG,384,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",144.77,37.7,,115.82,,,0,"percent of total billed charges","37.70% of total billed charges",384,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",384,100,,,,,0,"fee schedule","100% of CMS fee schedule",299.52,78,,239.62,,,0,"percent of total billed charges","78% of total billed charges",384,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",317.18,82.6,,253.74,,,0,"percent of total billed charges","82.6% of total billed charges",2020.72,100,,,,,0,"fee schedule",EAPG,384,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",317.18,82.6,,253.74,,,0,"percent of total billed charges","82.6% of total billed charges",384,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2181.25,100,,,,,0,"fee schedule",EAPG,384,100,,307.20,,,0,"percent of total billed charges","100% of total billed charges",58.75,2626.94,
"39010 Mediastinotomy w/ exploration, drainage, rem",7961613,CDM,521,RC,39010,CPT,OUTPATIENT,,,3376,2194.4,,2970.88,88,,2376.70,,,0,"percent of total billed charges","88% of total billed charges",3376,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,3376,100,,2700.80,,,0,"percent of total billed charges","100% of total billed charges",3376,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,3376,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2126.88,63,,1701.50,,,0,"percent of total billed charges","63% of total billed charges",516.53,15.3,,413.22,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,2329.44,69,,,,,0,"fee schedule","69% of total billed charges",3376,100,,2700.80,,,0,"percent of total billed charges","100% of total billed charges",3376,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3376,100,,2700.80,,,0,"percent of total billed charges","100% of total billed charges",3376,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3376,100,,2700.80,,,0,"percent of total billed charges","100% of total billed charges",3376,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3376,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,3376,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3376,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3376,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,3376,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1272.75,37.7,,1018.20,,,0,"percent of total billed charges","37.70% of total billed charges",3376,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3376,100,,,,,0,"fee schedule","100% of CMS fee schedule",2633.28,78,,2106.62,,,0,"percent of total billed charges","78% of total billed charges",3376,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2788.58,82.6,,2230.86,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,3376,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2788.58,82.6,,2230.86,,,0,"percent of total billed charges","82.6% of total billed charges",3376,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,3376,100,,2700.80,,,0,"percent of total billed charges","100% of total billed charges",516.53,6089.09,
"39220 Resection of mediastinal tumor",7963736,CDM,521,RC,39220,CPT,OUTPATIENT,,,5433,3531.45,,4781.04,88,,3824.83,,,0,"percent of total billed charges","88% of total billed charges",5433,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5433,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,5433,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3422.79,63,,2738.23,,,0,"percent of total billed charges","63% of total billed charges",831.25,15.3,,665.00,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,3748.77,69,,,,,0,"fee schedule","69% of total billed charges",5433,100,,4346.40,,,0,"percent of total billed charges","100% of total billed charges",5433,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5433,100,,4346.40,,,0,"percent of total billed charges","100% of total billed charges",5433,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5433,100,,4346.40,,,0,"percent of total billed charges","100% of total billed charges",5433,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5433,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,5433,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5433,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5433,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,5433,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2048.24,37.7,,1638.59,,,0,"percent of total billed charges","37.70% of total billed charges",5433,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5433,100,,,,,0,"fee schedule","100% of CMS fee schedule",4237.74,78,,3390.19,,,0,"percent of total billed charges","78% of total billed charges",5433,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4487.66,82.6,,3590.13,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule","100% of WA fee schedule",5433,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4487.66,82.6,,3590.13,,,0,"percent of total billed charges","82.6% of total billed charges",5433,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,5433,100,,4346.40,,,0,"percent of total billed charges","100% of total billed charges",831.25,6089.09,
"39400 mediastinoscopy incl biopsy",7963784,CDM,521,RC,39400,CPT,OUTPATIENT,,,1911,1242.15,,1681.68,88,,1345.34,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",321.05,16.8,,256.84,,,0,"percent of total billed charges","16.8% of total billed charges",1911,100,,1528.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",330.68,17.304,,264.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1203.93,63,,963.14,,,0,"percent of total billed charges","63% of total billed charges",292.38,15.3,,233.90,,,0,"percent of total billed charges","15.3% of total billed charges",321.05,16.8,,256.84,,,0,"percent of total billed charges","16.8% of total billed charges",1318.59,69,,,,,0,"fee schedule","69% of total billed charges",1911,100,,1528.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1911,100,,1528.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1911,100,,1528.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",321.05,16.8,,256.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",327.47,17.136,,261.98,,,0,"percent of total billed charges","17.136% of total billed charges",417.36,21.84,,333.89,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",720.45,37.7,,576.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1490.58,78,,1192.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1578.49,82.6,,1262.79,,,0,"percent of total billed charges","82.6% of total billed charges",321.05,16.8,,256.84,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1578.49,82.6,,1262.79,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",1911,100,,1528.80,,,0,"percent of total billed charges","100% of total billed charges",160.53,1911,
"39501 Repair, laceration of diaphragm, any approac",7963485,CDM,521,RC,39501,CPT,OUTPATIENT,,,2464,1601.6,,2168.32,88,,1734.66,,,0,"percent of total billed charges","88% of total billed charges",2464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6261.42,100,,,,,0,"fee schedule",EAPG,2464,100,,1971.20,,,0,"percent of total billed charges","100% of total billed charges",2464,175,,,,,0,"fee schedule","175% of CMS fee schedule",6449.26,100,,,,,0,"fee schedule",EAPG,2464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1552.32,63,,1241.86,,,0,"percent of total billed charges","63% of total billed charges",376.99,15.3,,301.59,,,0,"percent of total billed charges","15.3% of total billed charges",6261.42,100,,,,,0,"fee schedule",EAPG,1700.16,69,,,,,0,"fee schedule","69% of total billed charges",2464,100,,1971.20,,,0,"percent of total billed charges","100% of total billed charges",2464,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2464,100,,1971.20,,,0,"percent of total billed charges","100% of total billed charges",2464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2464,100,,1971.20,,,0,"percent of total billed charges","100% of total billed charges",2464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6261.42,100,,,,,0,"fee schedule",EAPG,2464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6386.65,100,,,,,0,"fee schedule",EAPG,8139.85,100,,,,,0,"fee schedule",EAPG,2464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",928.93,37.7,,743.14,,,0,"percent of total billed charges","37.70% of total billed charges",2464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2464,100,,,,,0,"fee schedule","100% of CMS fee schedule",1921.92,78,,1537.54,,,0,"percent of total billed charges","78% of total billed charges",2464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2035.26,82.6,,1628.21,,,0,"percent of total billed charges","82.6% of total billed charges",6261.42,100,,,,,0,"fee schedule","100% of WA fee schedule",2464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2035.26,82.6,,1628.21,,,0,"percent of total billed charges","82.6% of total billed charges",2464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6421.95,100,,,,,0,"fee schedule",EAPG,2464,100,,1971.20,,,0,"percent of total billed charges","100% of total billed charges",376.99,8139.85,
"39541 Repair, diaphragmatic hernia (other than neo",7962815,CDM,521,RC,39541,CPT,OUTPATIENT,,,2723,1769.95,,2396.24,88,,1916.99,,,0,"percent of total billed charges","88% of total billed charges",2723,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6261.42,100,,,,,0,"fee schedule",EAPG,2723,100,,2178.40,,,0,"percent of total billed charges","100% of total billed charges",2723,175,,,,,0,"fee schedule","175% of CMS fee schedule",6449.26,100,,,,,0,"fee schedule",EAPG,2723,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1715.49,63,,1372.39,,,0,"percent of total billed charges","63% of total billed charges",416.62,15.3,,333.30,,,0,"percent of total billed charges","15.3% of total billed charges",6261.42,100,,,,,0,"fee schedule",EAPG,1878.87,69,,,,,0,"fee schedule","69% of total billed charges",2723,100,,2178.40,,,0,"percent of total billed charges","100% of total billed charges",2723,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2723,100,,2178.40,,,0,"percent of total billed charges","100% of total billed charges",2723,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2723,100,,2178.40,,,0,"percent of total billed charges","100% of total billed charges",2723,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2723,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6261.42,100,,,,,0,"fee schedule",EAPG,2723,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2723,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2723,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6386.65,100,,,,,0,"fee schedule",EAPG,8139.85,100,,,,,0,"fee schedule",EAPG,2723,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1026.57,37.7,,821.26,,,0,"percent of total billed charges","37.70% of total billed charges",2723,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2723,100,,,,,0,"fee schedule","100% of CMS fee schedule",2123.94,78,,1699.15,,,0,"percent of total billed charges","78% of total billed charges",2723,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2249.2,82.6,,1799.36,,,0,"percent of total billed charges","82.6% of total billed charges",6261.42,100,,,,,0,"fee schedule","100% of WA fee schedule",2723,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2249.2,82.6,,1799.36,,,0,"percent of total billed charges","82.6% of total billed charges",2723,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6421.95,100,,,,,0,"fee schedule",EAPG,2723,100,,2178.40,,,0,"percent of total billed charges","100% of total billed charges",416.62,8139.85,
"39561 Resection, diaphragm; with complex repair (e",7962002,CDM,521,RC,39561,CPT,OUTPATIENT,,,3607,2344.55,,3174.16,88,,2539.33,,,0,"percent of total billed charges","88% of total billed charges",3607,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6261.42,100,,,,,0,"fee schedule",EAPG,3607,100,,2885.60,,,0,"percent of total billed charges","100% of total billed charges",3607,175,,,,,0,"fee schedule","175% of CMS fee schedule",6449.26,100,,,,,0,"fee schedule",EAPG,3607,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2272.41,63,,1817.93,,,0,"percent of total billed charges","63% of total billed charges",551.87,15.3,,441.50,,,0,"percent of total billed charges","15.3% of total billed charges",6261.42,100,,,,,0,"fee schedule",EAPG,2488.83,69,,,,,0,"fee schedule","69% of total billed charges",3607,100,,2885.60,,,0,"percent of total billed charges","100% of total billed charges",3607,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3607,100,,2885.60,,,0,"percent of total billed charges","100% of total billed charges",3607,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3607,100,,2885.60,,,0,"percent of total billed charges","100% of total billed charges",3607,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3607,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6261.42,100,,,,,0,"fee schedule",EAPG,3607,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3607,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3607,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6386.65,100,,,,,0,"fee schedule",EAPG,8139.85,100,,,,,0,"fee schedule",EAPG,3607,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1359.84,37.7,,1087.87,,,0,"percent of total billed charges","37.70% of total billed charges",3607,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3607,100,,,,,0,"fee schedule","100% of CMS fee schedule",2813.46,78,,2250.77,,,0,"percent of total billed charges","78% of total billed charges",3607,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2979.38,82.6,,2383.50,,,0,"percent of total billed charges","82.6% of total billed charges",6261.42,100,,,,,0,"fee schedule","100% of WA fee schedule",3607,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2979.38,82.6,,2383.50,,,0,"percent of total billed charges","82.6% of total billed charges",3607,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6421.95,100,,,,,0,"fee schedule",EAPG,3607,100,,2885.60,,,0,"percent of total billed charges","100% of total billed charges",551.87,8139.85,
"39560 Resection, diaphragm; w/ simple repair (eg,",7963030,CDM,521,RC,39560,CPT,OUTPATIENT,,,2312,1502.8,,2034.56,88,,1627.65,,,0,"percent of total billed charges","88% of total billed charges",2312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6261.42,100,,,,,0,"fee schedule",EAPG,2312,100,,1849.60,,,0,"percent of total billed charges","100% of total billed charges",2312,175,,,,,0,"fee schedule","175% of CMS fee schedule",6449.26,100,,,,,0,"fee schedule",EAPG,2312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1456.56,63,,1165.25,,,0,"percent of total billed charges","63% of total billed charges",353.74,15.3,,282.99,,,0,"percent of total billed charges","15.3% of total billed charges",6261.42,100,,,,,0,"fee schedule",EAPG,1595.28,69,,,,,0,"fee schedule","69% of total billed charges",2312,100,,1849.60,,,0,"percent of total billed charges","100% of total billed charges",2312,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2312,100,,1849.60,,,0,"percent of total billed charges","100% of total billed charges",2312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2312,100,,1849.60,,,0,"percent of total billed charges","100% of total billed charges",2312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6261.42,100,,,,,0,"fee schedule",EAPG,2312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6386.65,100,,,,,0,"fee schedule",EAPG,8139.85,100,,,,,0,"fee schedule",EAPG,2312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",871.62,37.7,,697.30,,,0,"percent of total billed charges","37.70% of total billed charges",2312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2312,100,,,,,0,"fee schedule","100% of CMS fee schedule",1803.36,78,,1442.69,,,0,"percent of total billed charges","78% of total billed charges",2312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1909.71,82.6,,1527.77,,,0,"percent of total billed charges","82.6% of total billed charges",6261.42,100,,,,,0,"fee schedule","100% of WA fee schedule",2312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1909.71,82.6,,1527.77,,,0,"percent of total billed charges","82.6% of total billed charges",2312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6421.95,100,,,,,0,"fee schedule",EAPG,2312,100,,1849.60,,,0,"percent of total billed charges","100% of total billed charges",353.74,8139.85,
"40490 Excision procedures on the lips",7904583,CDM,521,RC,40490,CPT,OUTPATIENT,,,320,208,,281.6,88,,225.28,,,0,"percent of total billed charges","88% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",435.98,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",201.6,63,,161.28,,,0,"percent of total billed charges","63% of total billed charges",48.96,15.3,,39.17,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,220.8,69,,,,,0,"fee schedule","69% of total billed charges",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",859.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",120.64,37.7,,96.51,,,0,"percent of total billed charges","37.70% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",249.6,78,,199.68,,,0,"percent of total billed charges","78% of total billed charges",251.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",264.32,82.6,,211.46,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",264.32,82.6,,211.46,,,0,"percent of total billed charges","82.6% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.63,100,,,,,0,"fee schedule",EAPG,320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",48.96,859.63,
"40500 Excision procedure of the lips",7904584,CDM,521,RC,40500,CPT,OUTPATIENT,,,785,510.25,,690.8,88,,552.64,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",494.55,63,,395.64,,,0,"percent of total billed charges","63% of total billed charges",120.11,15.3,,96.09,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,541.65,69,,,,,0,"fee schedule","69% of total billed charges",785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",295.95,37.7,,236.76,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",612.3,78,,489.84,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",648.41,82.6,,518.73,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",648.41,82.6,,518.73,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.24,100,,,,,0,"fee schedule",EAPG,785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",120.11,11116.67,
"40520 Partial excision of lip",7904586,CDM,521,RC,40520,CPT,OUTPATIENT,,,1216,790.4,,1070.08,88,,856.06,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,1216,100,,972.80,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",766.08,63,,612.86,,,0,"percent of total billed charges","63% of total billed charges",186.05,15.3,,148.84,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,839.04,69,,,,,0,"fee schedule","69% of total billed charges",1216,100,,972.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1216,100,,972.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1216,100,,972.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",458.43,37.7,,366.74,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",948.48,78,,758.78,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1004.42,82.6,,803.54,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1004.42,82.6,,803.54,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.24,100,,,,,0,"fee schedule",EAPG,1216,100,,972.80,,,0,"percent of total billed charges","100% of total billed charges",186.05,11116.67,
"40527 Excision of lip; full thickness, reconstruct",7962340,CDM,521,RC,40527,CPT,OUTPATIENT,,,1372,891.8,,1207.36,88,,965.89,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3143.02,100,,,,,0,"fee schedule",EAPG,1372,100,,1097.60,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",3237.31,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",864.36,63,,691.49,,,0,"percent of total billed charges","63% of total billed charges",209.92,15.3,,167.94,,,0,"percent of total billed charges","15.3% of total billed charges",3143.02,100,,,,,0,"fee schedule",EAPG,946.68,69,,,,,0,"fee schedule","69% of total billed charges",1372,100,,1097.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1372,100,,1097.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1372,100,,1097.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3143.02,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3205.88,100,,,,,0,"fee schedule",EAPG,4085.92,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",517.24,37.7,,413.79,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1070.16,78,,856.13,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1133.27,82.6,,906.62,,,0,"percent of total billed charges","82.6% of total billed charges",3143.02,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1133.27,82.6,,906.62,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3303.55,100,,,,,0,"fee schedule",EAPG,1372,100,,1097.60,,,0,"percent of total billed charges","100% of total billed charges",209.92,20662.24,
"40654 Repair lip, full thickness; over one-half ve",7962849,CDM,521,RC,40654,CPT,OUTPATIENT,,,1197,778.05,,1053.36,88,,842.69,,,0,"percent of total billed charges","88% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,1197,100,,957.60,,,0,"percent of total billed charges","100% of total billed charges",2722.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",754.11,63,,603.29,,,0,"percent of total billed charges","63% of total billed charges",183.14,15.3,,146.51,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,825.93,69,,,,,0,"fee schedule","69% of total billed charges",1197,100,,957.60,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1197,100,,957.60,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1197,100,,957.60,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",5495.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1436.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",451.27,37.7,,361.02,,,0,"percent of total billed charges","37.70% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",933.66,78,,746.93,,,0,"percent of total billed charges","78% of total billed charges",1571.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.72,82.6,,790.98,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.72,82.6,,790.98,,,0,"percent of total billed charges","82.6% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.24,100,,,,,0,"fee schedule",EAPG,1197,100,,957.60,,,0,"percent of total billed charges","100% of total billed charges",183.14,5495.75,
"40700 Plastic repair of cleft lip/nasal deformity;",7962299,CDM,521,RC,40700,CPT,OUTPATIENT,,,2228,1448.2,,1960.64,88,,1568.51,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2365,100,,,,,0,"fee schedule",EAPG,2228,100,,1782.40,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",2435.95,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1403.64,63,,1122.91,,,0,"percent of total billed charges","63% of total billed charges",340.88,15.3,,272.70,,,0,"percent of total billed charges","15.3% of total billed charges",2365,100,,,,,0,"fee schedule",EAPG,1537.32,69,,,,,0,"fee schedule","69% of total billed charges",2228,100,,1782.40,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2228,100,,1782.40,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2228,100,,1782.40,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2365,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2412.3,100,,,,,0,"fee schedule",EAPG,3074.51,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",839.96,37.7,,671.97,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1737.84,78,,1390.27,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1840.33,82.6,,1472.26,,,0,"percent of total billed charges","82.6% of total billed charges",2365,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1840.33,82.6,,1472.26,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2525.53,100,,,,,0,"fee schedule",EAPG,2228,100,,1782.40,,,0,"percent of total billed charges","100% of total billed charges",340.88,20662.24,
"40720 Plastic repair of cleft lip/nasal deformity;",7961614,CDM,521,RC,40720,CPT,OUTPATIENT,,,2196,1427.4,,1932.48,88,,1545.98,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2365,100,,,,,0,"fee schedule",EAPG,2196,100,,1756.80,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",2435.95,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1383.48,63,,1106.78,,,0,"percent of total billed charges","63% of total billed charges",335.99,15.3,,268.79,,,0,"percent of total billed charges","15.3% of total billed charges",2365,100,,,,,0,"fee schedule",EAPG,1515.24,69,,,,,0,"fee schedule","69% of total billed charges",2196,100,,1756.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2196,100,,1756.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2196,100,,1756.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2365,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2412.3,100,,,,,0,"fee schedule",EAPG,3074.51,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",827.89,37.7,,662.31,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1712.88,78,,1370.30,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1813.9,82.6,,1451.12,,,0,"percent of total billed charges","82.6% of total billed charges",2365,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1813.9,82.6,,1451.12,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2525.53,100,,,,,0,"fee schedule",EAPG,2196,100,,1756.80,,,0,"percent of total billed charges","100% of total billed charges",335.99,11116.67,
"40800 Drainage of abscess, cyst, hematoma, vestibu",7904587,CDM,521,RC,40800,CPT,OUTPATIENT,,,304,197.6,,267.52,88,,214.02,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",1784.31,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191.52,63,,153.22,,,0,"percent of total billed charges","63% of total billed charges",46.51,15.3,,37.21,,,0,"percent of total billed charges","15.3% of total billed charges",1732.34,100,,,,,0,"fee schedule",EAPG,209.76,69,,,,,0,"fee schedule","69% of total billed charges",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1766.99,100,,,,,0,"fee schedule",EAPG,2252.04,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",114.61,37.7,,91.69,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",237.12,78,,189.70,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",251.1,82.6,,200.88,,,0,"percent of total billed charges","82.6% of total billed charges",1732.34,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",251.1,82.6,,200.88,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1892.87,100,,,,,0,"fee schedule",EAPG,304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",46.51,2526.76,
"40804 Remove foreign body mouth; simple",7904588,CDM,521,RC,40804,CPT,OUTPATIENT,,,341,221.65,,300.08,88,,240.06,,,0,"percent of total billed charges","88% of total billed charges",924.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,341,100,,272.80,,,0,"percent of total billed charges","100% of total billed charges",1618.01,175,,,,,0,"fee schedule","175% of CMS fee schedule",1784.31,100,,,,,0,"fee schedule",EAPG,924.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",214.83,63,,171.86,,,0,"percent of total billed charges","63% of total billed charges",52.17,15.3,,41.74,,,0,"percent of total billed charges","15.3% of total billed charges",1732.34,100,,,,,0,"fee schedule",EAPG,235.29,69,,,,,0,"fee schedule","69% of total billed charges",341,100,,272.80,,,0,"percent of total billed charges","100% of total billed charges",924.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",341,100,,272.80,,,0,"percent of total billed charges","100% of total billed charges",924.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",341,100,,272.80,,,0,"percent of total billed charges","100% of total billed charges",924.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,924.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",924.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1766.99,100,,,,,0,"fee schedule",EAPG,2252.04,100,,,,,0,"fee schedule",EAPG,924.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",128.56,37.7,,102.85,,,0,"percent of total billed charges","37.70% of total billed charges",924.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",924.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.98,78,,212.78,,,0,"percent of total billed charges","78% of total billed charges",933.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",281.67,82.6,,225.34,,,0,"percent of total billed charges","82.6% of total billed charges",1732.34,100,,,,,0,"fee schedule",EAPG,924.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",281.67,82.6,,225.34,,,0,"percent of total billed charges","82.6% of total billed charges",924.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1892.87,100,,,,,0,"fee schedule",EAPG,341,100,,272.80,,,0,"percent of total billed charges","100% of total billed charges",52.17,3289.02,
"40808 Excision and destruction procedures on the v",7904589,CDM,521,RC,40808,CPT,OUTPATIENT,,,430,279.5,,378.4,88,,302.72,,,0,"percent of total billed charges","88% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,430,100,,344.00,,,0,"percent of total billed charges","100% of total billed charges",982.07,175,,,,,0,"fee schedule","175% of CMS fee schedule",1784.31,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.9,63,,216.72,,,0,"percent of total billed charges","63% of total billed charges",65.79,15.3,,52.63,,,0,"percent of total billed charges","15.3% of total billed charges",1732.34,100,,,,,0,"fee schedule",EAPG,296.7,69,,,,,0,"fee schedule","69% of total billed charges",430,100,,344.00,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",430,100,,344.00,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",430,100,,344.00,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",1837.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",480.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1766.99,100,,,,,0,"fee schedule",EAPG,2252.04,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",162.11,37.7,,129.69,,,0,"percent of total billed charges","37.70% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.4,78,,268.32,,,0,"percent of total billed charges","78% of total billed charges",566.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.18,82.6,,284.14,,,0,"percent of total billed charges","82.6% of total billed charges",1732.34,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.18,82.6,,284.14,,,0,"percent of total billed charges","82.6% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1892.87,100,,,,,0,"fee schedule",EAPG,430,100,,344.00,,,0,"percent of total billed charges","100% of total billed charges",65.79,2252.04,
"40806 Incision of labial frenum (frenotomy)",7963644,CDM,521,RC,40806,CPT,OUTPATIENT,,,73,47.45,,64.24,88,,51.39,,,0,"percent of total billed charges","88% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",982.07,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",45.99,63,,36.79,,,0,"percent of total billed charges","63% of total billed charges",11.17,15.3,,8.94,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,50.37,69,,,,,0,"fee schedule","69% of total billed charges",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",1837.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",480.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",27.52,37.7,,22.02,,,0,"percent of total billed charges","37.70% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",56.94,78,,45.55,,,0,"percent of total billed charges","78% of total billed charges",566.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.24,100,,,,,0,"fee schedule",EAPG,73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",11.17,1837.71,
"40810 Excision of lesion of mucosa and submucosa,",7904590,CDM,521,RC,40810,CPT,OUTPATIENT,,,403,261.95,,354.64,88,,283.71,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2545.79,100,,,,,0,"fee schedule",EAPG,403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",2622.17,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",253.89,63,,203.11,,,0,"percent of total billed charges","63% of total billed charges",61.66,15.3,,49.33,,,0,"percent of total billed charges","15.3% of total billed charges",2545.79,100,,,,,0,"fee schedule",EAPG,278.07,69,,,,,0,"fee schedule","69% of total billed charges",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2545.79,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2596.71,100,,,,,0,"fee schedule",EAPG,3309.53,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",151.93,37.7,,121.54,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",314.34,78,,251.47,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",2545.79,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",332.88,82.6,,266.30,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2706.32,100,,,,,0,"fee schedule",EAPG,403,100,,322.40,,,0,"percent of total billed charges","100% of total billed charges",61.66,11116.67,
"40812 Excision of lesion of mucosa and submucosa,",7904591,CDM,521,RC,40812,CPT,OUTPATIENT,,,519,337.35,,456.72,88,,365.38,,,0,"percent of total billed charges","88% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2545.79,100,,,,,0,"fee schedule",EAPG,519,100,,415.20,,,0,"percent of total billed charges","100% of total billed charges",2722.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",2622.17,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",326.97,63,,261.58,,,0,"percent of total billed charges","63% of total billed charges",79.41,15.3,,63.53,,,0,"percent of total billed charges","15.3% of total billed charges",2545.79,100,,,,,0,"fee schedule",EAPG,358.11,69,,,,,0,"fee schedule","69% of total billed charges",519,100,,415.20,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",519,100,,415.20,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",519,100,,415.20,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",5495.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2545.79,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1436.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2596.71,100,,,,,0,"fee schedule",EAPG,3309.53,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",195.66,37.7,,156.53,,,0,"percent of total billed charges","37.70% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",404.82,78,,323.86,,,0,"percent of total billed charges","78% of total billed charges",1571.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",428.69,82.6,,342.95,,,0,"percent of total billed charges","82.6% of total billed charges",2545.79,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",428.69,82.6,,342.95,,,0,"percent of total billed charges","82.6% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2706.32,100,,,,,0,"fee schedule",EAPG,519,100,,415.20,,,0,"percent of total billed charges","100% of total billed charges",79.41,5495.75,
"41000 Intraoral I&D of abscess, cyst, or hematoma",7962473,CDM,521,RC,41000,CPT,OUTPATIENT,,,339,220.35,,298.32,88,,238.66,,,0,"percent of total billed charges","88% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",982.07,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",213.57,63,,170.86,,,0,"percent of total billed charges","63% of total billed charges",51.87,15.3,,41.50,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,233.91,69,,,,,0,"fee schedule","69% of total billed charges",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",1837.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",480.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",127.8,37.7,,102.24,,,0,"percent of total billed charges","37.70% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",264.42,78,,211.54,,,0,"percent of total billed charges","78% of total billed charges",566.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.01,82.6,,224.01,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.01,82.6,,224.01,,,0,"percent of total billed charges","82.6% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.24,100,,,,,0,"fee schedule",EAPG,339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",51.87,1837.71,
"41010 Incision procedures on the tongue and floor",7904594,CDM,521,RC,41010,CPT,OUTPATIENT,,,356,231.4,,313.28,88,,250.62,,,0,"percent of total billed charges","88% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",2722.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.28,63,,179.42,,,0,"percent of total billed charges","63% of total billed charges",54.47,15.3,,43.58,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,245.64,69,,,,,0,"fee schedule","69% of total billed charges",356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",5495.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1436.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",134.21,37.7,,107.37,,,0,"percent of total billed charges","37.70% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.68,78,,222.14,,,0,"percent of total billed charges","78% of total billed charges",1571.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.06,82.6,,235.25,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.06,82.6,,235.25,,,0,"percent of total billed charges","82.6% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.24,100,,,,,0,"fee schedule",EAPG,356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",54.47,5495.75,
"41100 Biopsy of tongue",7904595,CDM,521,RC,41100,CPT,OUTPATIENT,,,359,233.35,,315.92,88,,252.74,,,0,"percent of total billed charges","88% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,359,100,,287.20,,,0,"percent of total billed charges","100% of total billed charges",982.07,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",226.17,63,,180.94,,,0,"percent of total billed charges","63% of total billed charges",54.93,15.3,,43.94,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,247.71,69,,,,,0,"fee schedule","69% of total billed charges",359,100,,287.20,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",359,100,,287.20,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",359,100,,287.20,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",1837.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",480.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",135.34,37.7,,108.27,,,0,"percent of total billed charges","37.70% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.02,78,,224.02,,,0,"percent of total billed charges","78% of total billed charges",566.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.53,82.6,,237.22,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.53,82.6,,237.22,,,0,"percent of total billed charges","82.6% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.63,100,,,,,0,"fee schedule",EAPG,359,100,,287.20,,,0,"percent of total billed charges","100% of total billed charges",54.93,1837.71,
"41113 Excision of lesion of tongue with closure",7904599,CDM,521,RC,41113,CPT,OUTPATIENT,,,547,355.55,,481.36,88,,385.09,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,547,100,,437.60,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",344.61,63,,275.69,,,0,"percent of total billed charges","63% of total billed charges",83.69,15.3,,66.95,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,377.43,69,,,,,0,"fee schedule","69% of total billed charges",547,100,,437.60,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",547,100,,437.60,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",547,100,,437.60,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",206.22,37.7,,164.98,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.66,78,,341.33,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",451.82,82.6,,361.46,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",451.82,82.6,,361.46,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.24,100,,,,,0,"fee schedule",EAPG,547,100,,437.60,,,0,"percent of total billed charges","100% of total billed charges",83.69,11116.67,
"41112 Excision of lesion of tongue with closure; a",7963052,CDM,521,RC,41112,CPT,OUTPATIENT,,,632,410.8,,556.16,88,,444.93,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,632,100,,505.60,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",398.16,63,,318.53,,,0,"percent of total billed charges","63% of total billed charges",96.7,15.3,,77.36,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,436.08,69,,,,,0,"fee schedule","69% of total billed charges",632,100,,505.60,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",632,100,,505.60,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",632,100,,505.60,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",238.26,37.7,,190.61,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",492.96,78,,394.37,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",522.03,82.6,,417.62,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",522.03,82.6,,417.62,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.24,100,,,,,0,"fee schedule",EAPG,632,100,,505.60,,,0,"percent of total billed charges","100% of total billed charges",96.7,11116.67,
"41115 Excision of lingual frenum (frenectomy)",7963605,CDM,521,RC,41115,CPT,OUTPATIENT,,,327,212.55,,287.76,88,,230.21,,,0,"percent of total billed charges","88% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",2722.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206.01,63,,164.81,,,0,"percent of total billed charges","63% of total billed charges",50.03,15.3,,40.02,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,225.63,69,,,,,0,"fee schedule","69% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",5495.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1436.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.70% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.06,78,,204.05,,,0,"percent of total billed charges","78% of total billed charges",1571.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.24,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",50.03,5495.75,
"41120 Glossectomy; less than one-half tongue",7963626,CDM,521,RC,41120,CPT,OUTPATIENT,,,2393,1555.45,,2105.84,88,,1684.67,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3143.02,100,,,,,0,"fee schedule",EAPG,2393,100,,1914.40,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",3237.31,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1507.59,63,,1206.07,,,0,"percent of total billed charges","63% of total billed charges",366.13,15.3,,292.90,,,0,"percent of total billed charges","15.3% of total billed charges",3143.02,100,,,,,0,"fee schedule",EAPG,1651.17,69,,,,,0,"fee schedule","69% of total billed charges",2393,100,,1914.40,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2393,100,,1914.40,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2393,100,,1914.40,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3143.02,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3205.88,100,,,,,0,"fee schedule",EAPG,4085.92,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",902.16,37.7,,721.73,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1866.54,78,,1493.23,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1976.62,82.6,,1581.30,,,0,"percent of total billed charges","82.6% of total billed charges",3143.02,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1976.62,82.6,,1581.30,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3303.55,100,,,,,0,"fee schedule",EAPG,2393,100,,1914.40,,,0,"percent of total billed charges","100% of total billed charges",366.13,20662.24,
"41250 Repair of laceration 2.5 cm or less; floor o",7961926,CDM,521,RC,41250,CPT,OUTPATIENT,,,436,283.4,,383.68,88,,306.94,,,0,"percent of total billed charges","88% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,436,100,,348.80,,,0,"percent of total billed charges","100% of total billed charges",711.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",274.68,63,,219.74,,,0,"percent of total billed charges","63% of total billed charges",66.71,15.3,,53.37,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,300.84,69,,,,,0,"fee schedule","69% of total billed charges",436,100,,348.80,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",436,100,,348.80,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",436,100,,348.80,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",1097.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",164.37,37.7,,131.50,,,0,"percent of total billed charges","37.70% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",340.08,78,,272.06,,,0,"percent of total billed charges","78% of total billed charges",410.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",360.14,82.6,,288.11,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",360.14,82.6,,288.11,,,0,"percent of total billed charges","82.6% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.63,100,,,,,0,"fee schedule",EAPG,436,100,,348.80,,,0,"percent of total billed charges","100% of total billed charges",66.71,1097.77,
"41827 Excision of lesion or tumor, dentoalveolar s",7962680,CDM,521,RC,41827,CPT,OUTPATIENT,,,678,440.7,,596.64,88,,477.31,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3557.96,100,,,,,0,"fee schedule",EAPG,678,100,,542.40,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",3664.7,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",427.14,63,,341.71,,,0,"percent of total billed charges","63% of total billed charges",103.73,15.3,,82.98,,,0,"percent of total billed charges","15.3% of total billed charges",3557.96,100,,,,,0,"fee schedule",EAPG,467.82,69,,,,,0,"fee schedule","69% of total billed charges",678,100,,542.40,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",678,100,,542.40,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",678,100,,542.40,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3557.96,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3629.12,100,,,,,0,"fee schedule",EAPG,4625.35,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",255.61,37.7,,204.49,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",528.84,78,,423.07,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.03,82.6,,448.02,,,0,"percent of total billed charges","82.6% of total billed charges",3557.96,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.03,82.6,,448.02,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3718.49,100,,,,,0,"fee schedule",EAPG,678,100,,542.40,,,0,"percent of total billed charges","100% of total billed charges",103.73,20662.24,
"41899 Other procedures on the dentoalveolar struct",7904603,CDM,521,RC,41899,CPT,OUTPATIENT,,,185,120.25,,162.8,88,,130.24,,,0,"percent of total billed charges","88% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",435.98,175,,,,,0,"fee schedule","175% of CMS fee schedule",1784.31,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",116.55,63,,93.24,,,0,"percent of total billed charges","63% of total billed charges",28.31,15.3,,22.65,,,0,"percent of total billed charges","15.3% of total billed charges",1732.34,100,,,,,0,"fee schedule",EAPG,127.65,69,,,,,0,"fee schedule","69% of total billed charges",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",859.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1732.34,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1766.99,100,,,,,0,"fee schedule",EAPG,2252.04,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",69.75,37.7,,55.80,,,0,"percent of total billed charges","37.70% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",144.3,78,,115.44,,,0,"percent of total billed charges","78% of total billed charges",251.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",152.81,82.6,,122.25,,,0,"percent of total billed charges","82.6% of total billed charges",1732.34,100,,,,,0,"fee schedule","100% of WA fee schedule",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",152.81,82.6,,122.25,,,0,"percent of total billed charges","82.6% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1892.87,100,,,,,0,"fee schedule",EAPG,185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",28.31,2252.04,
"42104 Excision, lesion of palate, uvula",7904605,CDM,521,RC,42104,CPT,OUTPATIENT,,,400,260,,352,88,,281.60,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620.58,100,,,,,0,"fee schedule",EAPG,400,100,,320.00,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",2699.2,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252,63,,201.60,,,0,"percent of total billed charges","63% of total billed charges",61.2,15.3,,48.96,,,0,"percent of total billed charges","15.3% of total billed charges",2620.58,100,,,,,0,"fee schedule",EAPG,276,69,,,,,0,"fee schedule","69% of total billed charges",400,100,,320.00,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400,100,,320.00,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400,100,,320.00,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620.58,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2672.99,100,,,,,0,"fee schedule",EAPG,3406.75,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",150.8,37.7,,120.64,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",312,78,,249.60,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.4,82.6,,264.32,,,0,"percent of total billed charges","82.6% of total billed charges",2620.58,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.4,82.6,,264.32,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2781.11,100,,,,,0,"fee schedule",EAPG,400,100,,320.00,,,0,"percent of total billed charges","100% of total billed charges",61.2,11116.67,
"42140 Excision and destruction procedures on the p",7904607,CDM,521,RC,42140,CPT,OUTPATIENT,,,651,423.15,,572.88,88,,458.30,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620.58,100,,,,,0,"fee schedule",EAPG,651,100,,520.80,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",2699.2,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",410.13,63,,328.10,,,0,"percent of total billed charges","63% of total billed charges",99.6,15.3,,79.68,,,0,"percent of total billed charges","15.3% of total billed charges",2620.58,100,,,,,0,"fee schedule",EAPG,449.19,69,,,,,0,"fee schedule","69% of total billed charges",651,100,,520.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",651,100,,520.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",651,100,,520.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620.58,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2672.99,100,,,,,0,"fee schedule",EAPG,3406.75,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",245.43,37.7,,196.34,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",507.78,78,,406.22,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",537.73,82.6,,430.18,,,0,"percent of total billed charges","82.6% of total billed charges",2620.58,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",537.73,82.6,,430.18,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2781.11,100,,,,,0,"fee schedule",EAPG,651,100,,520.80,,,0,"percent of total billed charges","100% of total billed charges",99.6,11116.67,
"42145 Palatopharyngoplasty (eg, uvulopalatopharyng",7962712,CDM,521,RC,42145,CPT,OUTPATIENT,,,1577,1025.05,,1387.76,88,,1110.21,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2365,100,,,,,0,"fee schedule",EAPG,1577,100,,1261.60,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",2435.95,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",993.51,63,,794.81,,,0,"percent of total billed charges","63% of total billed charges",241.28,15.3,,193.02,,,0,"percent of total billed charges","15.3% of total billed charges",2365,100,,,,,0,"fee schedule",EAPG,1088.13,69,,,,,0,"fee schedule","69% of total billed charges",1577,100,,1261.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1577,100,,1261.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1577,100,,1261.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2365,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2412.3,100,,,,,0,"fee schedule",EAPG,3074.51,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",594.53,37.7,,475.62,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1230.06,78,,984.05,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1302.6,82.6,,1042.08,,,0,"percent of total billed charges","82.6% of total billed charges",2365,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1302.6,82.6,,1042.08,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2525.53,100,,,,,0,"fee schedule",EAPG,1577,100,,1261.60,,,0,"percent of total billed charges","100% of total billed charges",241.28,20662.24,
"42305 Drainage of abscess; parotid, complicated",7963532,CDM,521,RC,42305,CPT,OUTPATIENT,,,1083,703.95,,953.04,88,,762.43,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620.58,100,,,,,0,"fee schedule",EAPG,1083,100,,866.40,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",2699.2,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",682.29,63,,545.83,,,0,"percent of total billed charges","63% of total billed charges",165.7,15.3,,132.56,,,0,"percent of total billed charges","15.3% of total billed charges",2620.58,100,,,,,0,"fee schedule",EAPG,747.27,69,,,,,0,"fee schedule","69% of total billed charges",1083,100,,866.40,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1083,100,,866.40,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1083,100,,866.40,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620.58,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2672.99,100,,,,,0,"fee schedule",EAPG,3406.75,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",408.29,37.7,,326.63,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.74,78,,675.79,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",894.56,82.6,,715.65,,,0,"percent of total billed charges","82.6% of total billed charges",2620.58,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",894.56,82.6,,715.65,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2781.11,100,,,,,0,"fee schedule",EAPG,1083,100,,866.40,,,0,"percent of total billed charges","100% of total billed charges",165.7,11116.67,
"42330 Sialolithotomy",7904610,CDM,521,RC,42330,CPT,OUTPATIENT,,,591,384.15,,520.08,88,,416.06,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2545.79,100,,,,,0,"fee schedule",EAPG,591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",2622.17,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",372.33,63,,297.86,,,0,"percent of total billed charges","63% of total billed charges",90.42,15.3,,72.34,,,0,"percent of total billed charges","15.3% of total billed charges",2545.79,100,,,,,0,"fee schedule",EAPG,407.79,69,,,,,0,"fee schedule","69% of total billed charges",591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2545.79,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2596.71,100,,,,,0,"fee schedule",EAPG,3309.53,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",222.81,37.7,,178.25,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460.98,78,,368.78,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",488.17,82.6,,390.54,,,0,"percent of total billed charges","82.6% of total billed charges",2545.79,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",488.17,82.6,,390.54,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2706.32,100,,,,,0,"fee schedule",EAPG,591,100,,472.80,,,0,"percent of total billed charges","100% of total billed charges",90.42,11116.67,
"42408 Excision of sublingual salivary cyst (ranula",7963486,CDM,521,RC,42408,CPT,OUTPATIENT,,,986,640.9,,867.68,88,,694.14,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2545.79,100,,,,,0,"fee schedule",EAPG,986,100,,788.80,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",2622.17,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",621.18,63,,496.94,,,0,"percent of total billed charges","63% of total billed charges",150.86,15.3,,120.69,,,0,"percent of total billed charges","15.3% of total billed charges",2545.79,100,,,,,0,"fee schedule",EAPG,680.34,69,,,,,0,"fee schedule","69% of total billed charges",986,100,,788.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",986,100,,788.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",986,100,,788.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2545.79,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2596.71,100,,,,,0,"fee schedule",EAPG,3309.53,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",371.72,37.7,,297.38,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",769.08,78,,615.26,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",814.44,82.6,,651.55,,,0,"percent of total billed charges","82.6% of total billed charges",2545.79,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",814.44,82.6,,651.55,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2706.32,100,,,,,0,"fee schedule",EAPG,986,100,,788.80,,,0,"percent of total billed charges","100% of total billed charges",150.86,11116.67,
"42415 Excision of parotid tumor/gland; lateral lob",7961615,CDM,521,RC,42415,CPT,OUTPATIENT,,,2526,1641.9,,2222.88,88,,1778.30,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4116.84,100,,,,,0,"fee schedule",EAPG,2526,100,,2020.80,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4240.34,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1591.38,63,,1273.10,,,0,"percent of total billed charges","63% of total billed charges",386.48,15.3,,309.18,,,0,"percent of total billed charges","15.3% of total billed charges",4116.84,100,,,,,0,"fee schedule",EAPG,1742.94,69,,,,,0,"fee schedule","69% of total billed charges",2526,100,,2020.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2526,100,,2020.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2526,100,,2020.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4116.84,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4199.17,100,,,,,0,"fee schedule",EAPG,5351.89,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",952.3,37.7,,761.84,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1970.28,78,,1576.22,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2086.48,82.6,,1669.18,,,0,"percent of total billed charges","82.6% of total billed charges",4116.84,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2086.48,82.6,,1669.18,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4277.37,100,,,,,0,"fee schedule",EAPG,2526,100,,2020.80,,,0,"percent of total billed charges","100% of total billed charges",386.48,20662.24,
"42410 Excision of parotid tumor/gland; lateral lob",7962784,CDM,521,RC,42410,CPT,OUTPATIENT,,,1404,912.6,,1235.52,88,,988.42,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3143.02,100,,,,,0,"fee schedule",EAPG,1404,100,,1123.20,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",3237.31,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",884.52,63,,707.62,,,0,"percent of total billed charges","63% of total billed charges",214.81,15.3,,171.85,,,0,"percent of total billed charges","15.3% of total billed charges",3143.02,100,,,,,0,"fee schedule",EAPG,968.76,69,,,,,0,"fee schedule","69% of total billed charges",1404,100,,1123.20,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1404,100,,1123.20,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1404,100,,1123.20,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3143.02,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3205.88,100,,,,,0,"fee schedule",EAPG,4085.92,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",529.31,37.7,,423.45,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1095.12,78,,876.10,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1159.7,82.6,,927.76,,,0,"percent of total billed charges","82.6% of total billed charges",3143.02,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1159.7,82.6,,927.76,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3303.55,100,,,,,0,"fee schedule",EAPG,1404,100,,1123.20,,,0,"percent of total billed charges","100% of total billed charges",214.81,20662.24,
"42420 Excision of parotid tumor/gland; total, with",7961927,CDM,521,RC,42420,CPT,OUTPATIENT,,,2894,1881.1,,2546.72,88,,2037.38,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4116.84,100,,,,,0,"fee schedule",EAPG,2894,100,,2315.20,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4240.34,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1823.22,63,,1458.58,,,0,"percent of total billed charges","63% of total billed charges",442.78,15.3,,354.22,,,0,"percent of total billed charges","15.3% of total billed charges",4116.84,100,,,,,0,"fee schedule",EAPG,1996.86,69,,,,,0,"fee schedule","69% of total billed charges",2894,100,,2315.20,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2894,100,,2315.20,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2894,100,,2315.20,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4116.84,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4199.17,100,,,,,0,"fee schedule",EAPG,5351.89,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1091.04,37.7,,872.83,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2257.32,78,,1805.86,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2390.44,82.6,,1912.35,,,0,"percent of total billed charges","82.6% of total billed charges",4116.84,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2390.44,82.6,,1912.35,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4277.37,100,,,,,0,"fee schedule",EAPG,2894,100,,2315.20,,,0,"percent of total billed charges","100% of total billed charges",442.78,20662.24,
"42440 Excision of submandibular (submaxillary) gla",7963466,CDM,521,RC,42440,CPT,OUTPATIENT,,,942,612.3,,828.96,88,,663.17,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3143.02,100,,,,,0,"fee schedule",EAPG,942,100,,753.60,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",3237.31,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.46,63,,474.77,,,0,"percent of total billed charges","63% of total billed charges",144.13,15.3,,115.30,,,0,"percent of total billed charges","15.3% of total billed charges",3143.02,100,,,,,0,"fee schedule",EAPG,649.98,69,,,,,0,"fee schedule","69% of total billed charges",942,100,,753.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",942,100,,753.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",942,100,,753.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3143.02,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3205.88,100,,,,,0,"fee schedule",EAPG,4085.92,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",355.13,37.7,,284.10,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",734.76,78,,587.81,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",778.09,82.6,,622.47,,,0,"percent of total billed charges","82.6% of total billed charges",3143.02,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",778.09,82.6,,622.47,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3303.55,100,,,,,0,"fee schedule",EAPG,942,100,,753.60,,,0,"percent of total billed charges","100% of total billed charges",144.13,20662.24,
"42450 Excision of sublingual gland",7963778,CDM,521,RC,42450,CPT,OUTPATIENT,,,989,642.85,,870.32,88,,696.26,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3143.02,100,,,,,0,"fee schedule",EAPG,989,100,,791.20,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",3237.31,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",623.07,63,,498.46,,,0,"percent of total billed charges","63% of total billed charges",151.32,15.3,,121.06,,,0,"percent of total billed charges","15.3% of total billed charges",3143.02,100,,,,,0,"fee schedule",EAPG,682.41,69,,,,,0,"fee schedule","69% of total billed charges",989,100,,791.20,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",989,100,,791.20,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",989,100,,791.20,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3143.02,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3205.88,100,,,,,0,"fee schedule",EAPG,4085.92,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",372.85,37.7,,298.28,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",771.42,78,,617.14,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",816.91,82.6,,653.53,,,0,"percent of total billed charges","82.6% of total billed charges",3143.02,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",816.91,82.6,,653.53,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3303.55,100,,,,,0,"fee schedule",EAPG,989,100,,791.20,,,0,"percent of total billed charges","100% of total billed charges",151.32,20662.24,
"42700 Incision and drainage abscess, peritonsillar",7904612,CDM,521,RC,42700,CPT,OUTPATIENT,,,416,270.4,,366.08,88,,292.86,,,0,"percent of total billed charges","88% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,416,100,,332.80,,,0,"percent of total billed charges","100% of total billed charges",435.98,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",262.08,63,,209.66,,,0,"percent of total billed charges","63% of total billed charges",63.65,15.3,,50.92,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,287.04,69,,,,,0,"fee schedule","69% of total billed charges",416,100,,332.80,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",416,100,,332.80,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",416,100,,332.80,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",859.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",156.83,37.7,,125.46,,,0,"percent of total billed charges","37.70% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",324.48,78,,259.58,,,0,"percent of total billed charges","78% of total billed charges",251.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",343.62,82.6,,274.90,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",343.62,82.6,,274.90,,,0,"percent of total billed charges","82.6% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.63,100,,,,,0,"fee schedule",EAPG,416,100,,332.80,,,0,"percent of total billed charges","100% of total billed charges",63.65,859.63,
"42800 Biopsy",7904613,CDM,521,RC,42800,CPT,OUTPATIENT,,,343,222.95,,301.84,88,,241.47,,,0,"percent of total billed charges","88% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",2722.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.09,63,,172.87,,,0,"percent of total billed charges","63% of total billed charges",52.48,15.3,,41.98,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,236.67,69,,,,,0,"fee schedule","69% of total billed charges",343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",5495.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1436.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",129.31,37.7,,103.45,,,0,"percent of total billed charges","37.70% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.54,78,,214.03,,,0,"percent of total billed charges","78% of total billed charges",1571.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.32,82.6,,226.66,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.32,82.6,,226.66,,,0,"percent of total billed charges","82.6% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.24,100,,,,,0,"fee schedule",EAPG,343,100,,274.40,,,0,"percent of total billed charges","100% of total billed charges",52.48,5495.75,
"42815 Excision branchial cleft cyst/vestige/fistul",7962186,CDM,521,RC,42815,CPT,OUTPATIENT,,,1108,720.2,,975.04,88,,780.03,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3143.02,100,,,,,0,"fee schedule",EAPG,1108,100,,886.40,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",3237.31,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",698.04,63,,558.43,,,0,"percent of total billed charges","63% of total billed charges",169.52,15.3,,135.62,,,0,"percent of total billed charges","15.3% of total billed charges",3143.02,100,,,,,0,"fee schedule",EAPG,764.52,69,,,,,0,"fee schedule","69% of total billed charges",1108,100,,886.40,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1108,100,,886.40,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1108,100,,886.40,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3143.02,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3205.88,100,,,,,0,"fee schedule",EAPG,4085.92,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",417.72,37.7,,334.18,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",864.24,78,,691.39,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",915.21,82.6,,732.17,,,0,"percent of total billed charges","82.6% of total billed charges",3143.02,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",915.21,82.6,,732.17,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3303.55,100,,,,,0,"fee schedule",EAPG,1108,100,,886.40,,,0,"percent of total billed charges","100% of total billed charges",169.52,20662.24,
"42825 Tonsillectomy, primary or secondary; younger",7963225,CDM,521,RC,42825,CPT,OUTPATIENT,,,588,382.2,,517.44,88,,413.95,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1800.05,100,,,,,0,"fee schedule",EAPG,588,100,,470.40,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1854.05,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",370.44,63,,296.35,,,0,"percent of total billed charges","63% of total billed charges",89.96,15.3,,71.97,,,0,"percent of total billed charges","15.3% of total billed charges",1800.05,100,,,,,0,"fee schedule",EAPG,405.72,69,,,,,0,"fee schedule","69% of total billed charges",588,100,,470.40,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",588,100,,470.40,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",588,100,,470.40,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1800.05,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1836.05,100,,,,,0,"fee schedule",EAPG,2340.06,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",221.68,37.7,,177.34,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",458.64,78,,366.91,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",485.69,82.6,,388.55,,,0,"percent of total billed charges","82.6% of total billed charges",1800.05,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",485.69,82.6,,388.55,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1960.58,100,,,,,0,"fee schedule",EAPG,588,100,,470.40,,,0,"percent of total billed charges","100% of total billed charges",89.96,20662.24,
"42820 Tonsillectomy and adenoidectomy; younger tha",7963331,CDM,521,RC,42820,CPT,OUTPATIENT,,,657,427.05,,578.16,88,,462.53,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1800.05,100,,,,,0,"fee schedule",EAPG,657,100,,525.60,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1854.05,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",413.91,63,,331.13,,,0,"percent of total billed charges","63% of total billed charges",100.52,15.3,,80.42,,,0,"percent of total billed charges","15.3% of total billed charges",1800.05,100,,,,,0,"fee schedule",EAPG,453.33,69,,,,,0,"fee schedule","69% of total billed charges",657,100,,525.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",657,100,,525.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",657,100,,525.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1800.05,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1836.05,100,,,,,0,"fee schedule",EAPG,2340.06,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",247.69,37.7,,198.15,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.46,78,,409.97,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",542.68,82.6,,434.14,,,0,"percent of total billed charges","82.6% of total billed charges",1800.05,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",542.68,82.6,,434.14,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1960.58,100,,,,,0,"fee schedule",EAPG,657,100,,525.60,,,0,"percent of total billed charges","100% of total billed charges",100.52,20662.24,
"42826 Tonsillectomy, primary or secondary; age 12",7963365,CDM,521,RC,42826,CPT,OUTPATIENT,,,567,368.55,,498.96,88,,399.17,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1800.05,100,,,,,0,"fee schedule",EAPG,567,100,,453.60,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",1854.05,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",357.21,63,,285.77,,,0,"percent of total billed charges","63% of total billed charges",86.75,15.3,,69.40,,,0,"percent of total billed charges","15.3% of total billed charges",1800.05,100,,,,,0,"fee schedule",EAPG,391.23,69,,,,,0,"fee schedule","69% of total billed charges",567,100,,453.60,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",567,100,,453.60,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",567,100,,453.60,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1800.05,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1836.05,100,,,,,0,"fee schedule",EAPG,2340.06,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",213.76,37.7,,171.01,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",442.26,78,,353.81,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",468.34,82.6,,374.67,,,0,"percent of total billed charges","82.6% of total billed charges",1800.05,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",468.34,82.6,,374.67,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1960.58,100,,,,,0,"fee schedule",EAPG,567,100,,453.60,,,0,"percent of total billed charges","100% of total billed charges",86.75,11116.67,
"42821 Tonsillectomy and adenoidectomy; age 12 or o",7963450,CDM,521,RC,42821,CPT,OUTPATIENT,,,683,443.95,,601.04,88,,480.83,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1800.05,100,,,,,0,"fee schedule",EAPG,683,100,,546.40,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",1854.05,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",430.29,63,,344.23,,,0,"percent of total billed charges","63% of total billed charges",104.5,15.3,,83.60,,,0,"percent of total billed charges","15.3% of total billed charges",1800.05,100,,,,,0,"fee schedule",EAPG,471.27,69,,,,,0,"fee schedule","69% of total billed charges",683,100,,546.40,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",683,100,,546.40,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",683,100,,546.40,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1800.05,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1836.05,100,,,,,0,"fee schedule",EAPG,2340.06,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",257.49,37.7,,205.99,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",532.74,78,,426.19,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",564.16,82.6,,451.33,,,0,"percent of total billed charges","82.6% of total billed charges",1800.05,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",564.16,82.6,,451.33,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1960.58,100,,,,,0,"fee schedule",EAPG,683,100,,546.40,,,0,"percent of total billed charges","100% of total billed charges",104.5,11116.67,
"42830 Adenoidectomy, primary; younger than age 12",7963522,CDM,521,RC,42830,CPT,OUTPATIENT,,,464,301.6,,408.32,88,,326.66,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1800.05,100,,,,,0,"fee schedule",EAPG,464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",1854.05,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",292.32,63,,233.86,,,0,"percent of total billed charges","63% of total billed charges",70.99,15.3,,56.79,,,0,"percent of total billed charges","15.3% of total billed charges",1800.05,100,,,,,0,"fee schedule",EAPG,320.16,69,,,,,0,"fee schedule","69% of total billed charges",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1800.05,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1836.05,100,,,,,0,"fee schedule",EAPG,2340.06,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",174.93,37.7,,139.94,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",361.92,78,,289.54,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",1800.05,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",383.26,82.6,,306.61,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1960.58,100,,,,,0,"fee schedule",EAPG,464,100,,371.20,,,0,"percent of total billed charges","100% of total billed charges",70.99,11116.67,
"42831 Adenoidectomy, primary; age 12 or over",7963627,CDM,521,RC,42831,CPT,OUTPATIENT,,,576,374.4,,506.88,88,,405.50,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1800.05,100,,,,,0,"fee schedule",EAPG,576,100,,460.80,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",1854.05,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",362.88,63,,290.30,,,0,"percent of total billed charges","63% of total billed charges",88.13,15.3,,70.50,,,0,"percent of total billed charges","15.3% of total billed charges",1800.05,100,,,,,0,"fee schedule",EAPG,397.44,69,,,,,0,"fee schedule","69% of total billed charges",576,100,,460.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",576,100,,460.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",576,100,,460.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1800.05,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1836.05,100,,,,,0,"fee schedule",EAPG,2340.06,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",217.15,37.7,,173.72,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.28,78,,359.42,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",475.78,82.6,,380.62,,,0,"percent of total billed charges","82.6% of total billed charges",1800.05,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",475.78,82.6,,380.62,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1960.58,100,,,,,0,"fee schedule",EAPG,576,100,,460.80,,,0,"percent of total billed charges","100% of total billed charges",88.13,11116.67,
"42842 Radical resection of tonsil/pillars/trigone;",7963112,CDM,521,RC,42842,CPT,OUTPATIENT,,,2187,1421.55,,1924.56,88,,1539.65,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1800.05,100,,,,,0,"fee schedule",EAPG,2187,100,,1749.60,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1854.05,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1377.81,63,,1102.25,,,0,"percent of total billed charges","63% of total billed charges",334.61,15.3,,267.69,,,0,"percent of total billed charges","15.3% of total billed charges",1800.05,100,,,,,0,"fee schedule",EAPG,1509.03,69,,,,,0,"fee schedule","69% of total billed charges",2187,100,,1749.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2187,100,,1749.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2187,100,,1749.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1800.05,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1836.05,100,,,,,0,"fee schedule",EAPG,2340.06,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",824.5,37.7,,659.60,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1705.86,78,,1364.69,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1806.46,82.6,,1445.17,,,0,"percent of total billed charges","82.6% of total billed charges",1800.05,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1806.46,82.6,,1445.17,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1960.58,100,,,,,0,"fee schedule",EAPG,2187,100,,1749.60,,,0,"percent of total billed charges","100% of total billed charges",334.61,20662.24,
"42860 Excision and Destruction procedures on the p",7904617,CDM,521,RC,42860,CPT,OUTPATIENT,,,483,313.95,,425.04,88,,340.03,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1800.05,100,,,,,0,"fee schedule",EAPG,483,100,,386.40,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",1854.05,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",304.29,63,,243.43,,,0,"percent of total billed charges","63% of total billed charges",73.9,15.3,,59.12,,,0,"percent of total billed charges","15.3% of total billed charges",1800.05,100,,,,,0,"fee schedule",EAPG,333.27,69,,,,,0,"fee schedule","69% of total billed charges",483,100,,386.40,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",483,100,,386.40,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",483,100,,386.40,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1800.05,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1836.05,100,,,,,0,"fee schedule",EAPG,2340.06,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",182.09,37.7,,145.67,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",376.74,78,,301.39,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",398.96,82.6,,319.17,,,0,"percent of total billed charges","82.6% of total billed charges",1800.05,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",398.96,82.6,,319.17,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1960.58,100,,,,,0,"fee schedule",EAPG,483,100,,386.40,,,0,"percent of total billed charges","100% of total billed charges",73.9,11116.67,
"42950 Pharyngoplasty",7963925,CDM,521,RC,42950,CPT,OUTPATIENT,,,1739,1130.35,,1530.32,88,,1224.26,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3143.02,100,,,,,0,"fee schedule",EAPG,1739,100,,1391.20,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",3237.31,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1095.57,63,,876.46,,,0,"percent of total billed charges","63% of total billed charges",266.07,15.3,,212.86,,,0,"percent of total billed charges","15.3% of total billed charges",3143.02,100,,,,,0,"fee schedule",EAPG,1199.91,69,,,,,0,"fee schedule","69% of total billed charges",1739,100,,1391.20,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1739,100,,1391.20,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1739,100,,1391.20,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3143.02,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3205.88,100,,,,,0,"fee schedule",EAPG,4085.92,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",655.6,37.7,,524.48,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1356.42,78,,1085.14,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1436.41,82.6,,1149.13,,,0,"percent of total billed charges","82.6% of total billed charges",3143.02,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1436.41,82.6,,1149.13,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3303.55,100,,,,,0,"fee schedule",EAPG,1739,100,,1391.20,,,0,"percent of total billed charges","100% of total billed charges",266.07,20662.24,
"42962 Control oropharyngeal hemorrhage, primary or",7961698,CDM,521,RC,42962,CPT,OUTPATIENT,,,1169,759.85,,1028.72,88,,822.98,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,1169,100,,935.20,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",736.47,63,,589.18,,,0,"percent of total billed charges","63% of total billed charges",178.86,15.3,,143.09,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,806.61,69,,,,,0,"fee schedule","69% of total billed charges",1169,100,,935.20,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1169,100,,935.20,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1169,100,,935.20,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",440.71,37.7,,352.57,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",911.82,78,,729.46,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",965.59,82.6,,772.47,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",965.59,82.6,,772.47,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.24,100,,,,,0,"fee schedule",EAPG,1169,100,,935.20,,,0,"percent of total billed charges","100% of total billed charges",178.86,11116.67,
"43020 Esophagotomy, cervical approach, with remova",7963074,CDM,521,RC,43020,CPT,OUTPATIENT,,,1471,956.15,,1294.48,88,,1035.58,,,0,"percent of total billed charges","88% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,1471,100,,1176.80,,,0,"percent of total billed charges","100% of total billed charges",2722.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",926.73,63,,741.38,,,0,"percent of total billed charges","63% of total billed charges",225.06,15.3,,180.05,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,1014.99,69,,,,,0,"fee schedule","69% of total billed charges",1471,100,,1176.80,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1471,100,,1176.80,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1471,100,,1176.80,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",5495.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1436.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",554.57,37.7,,443.66,,,0,"percent of total billed charges","37.70% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1147.38,78,,917.90,,,0,"percent of total billed charges","78% of total billed charges",1571.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1215.05,82.6,,972.04,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1215.05,82.6,,972.04,,,0,"percent of total billed charges","82.6% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.24,100,,,,,0,"fee schedule",EAPG,1471,100,,1176.80,,,0,"percent of total billed charges","100% of total billed charges",225.06,5495.75,
"43030 Cricopharyngeal myotomy",7963870,CDM,521,RC,43030,CPT,OUTPATIENT,,,1545,1004.25,,1359.6,88,,1087.68,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3143.02,100,,,,,0,"fee schedule",EAPG,1545,100,,1236.00,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",3237.31,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",973.35,63,,778.68,,,0,"percent of total billed charges","63% of total billed charges",236.39,15.3,,189.11,,,0,"percent of total billed charges","15.3% of total billed charges",3143.02,100,,,,,0,"fee schedule",EAPG,1066.05,69,,,,,0,"fee schedule","69% of total billed charges",1545,100,,1236.00,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1545,100,,1236.00,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1545,100,,1236.00,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3143.02,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3205.88,100,,,,,0,"fee schedule",EAPG,4085.92,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",582.47,37.7,,465.98,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1205.1,78,,964.08,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1276.17,82.6,,1020.94,,,0,"percent of total billed charges","82.6% of total billed charges",3143.02,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1276.17,82.6,,1020.94,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3303.55,100,,,,,0,"fee schedule",EAPG,1545,100,,1236.00,,,0,"percent of total billed charges","100% of total billed charges",236.39,20662.24,
"43045 Esophagotomy, thoracic approach, with remova",7963039,CDM,521,RC,43045,CPT,OUTPATIENT,,,3789,2462.85,,3334.32,88,,2667.46,,,0,"percent of total billed charges","88% of total billed charges",3789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,3789,100,,3031.20,,,0,"percent of total billed charges","100% of total billed charges",3789,175,,,,,0,"fee schedule","175% of CMS fee schedule",4824.43,100,,,,,0,"fee schedule",EAPG,3789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2387.07,63,,1909.66,,,0,"percent of total billed charges","63% of total billed charges",579.72,15.3,,463.78,,,0,"percent of total billed charges","15.3% of total billed charges",4683.92,100,,,,,0,"fee schedule",EAPG,2614.41,69,,,,,0,"fee schedule","69% of total billed charges",3789,100,,3031.20,,,0,"percent of total billed charges","100% of total billed charges",3789,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3789,100,,3031.20,,,0,"percent of total billed charges","100% of total billed charges",3789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3789,100,,3031.20,,,0,"percent of total billed charges","100% of total billed charges",3789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4683.92,100,,,,,0,"fee schedule",EAPG,3789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4777.6,100,,,,,0,"fee schedule",EAPG,6089.09,100,,,,,0,"fee schedule",EAPG,3789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1428.45,37.7,,1142.76,,,0,"percent of total billed charges","37.70% of total billed charges",3789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3789,100,,,,,0,"fee schedule","100% of CMS fee schedule",2955.42,78,,2364.34,,,0,"percent of total billed charges","78% of total billed charges",3789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3129.71,82.6,,2503.77,,,0,"percent of total billed charges","82.6% of total billed charges",4683.92,100,,,,,0,"fee schedule","100% of WA fee schedule",3789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3129.71,82.6,,2503.77,,,0,"percent of total billed charges","82.6% of total billed charges",3789,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4844.45,100,,,,,0,"fee schedule",EAPG,3789,100,,3031.20,,,0,"percent of total billed charges","100% of total billed charges",579.72,6089.09,
"43108 Total or near total esophagectomy, without t",7962003,CDM,521,RC,43108,CPT,OUTPATIENT,,,13478,8760.7,,11860.64,88,,9488.51,,,0,"percent of total billed charges","88% of total billed charges",13478,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",13478,175,,,,,0,"fee schedule","175% of CMS fee schedule",3783.52,100,,,,,0,"fee schedule",EAPG,13478,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8491.14,63,,6792.91,,,0,"percent of total billed charges","63% of total billed charges",2062.13,15.3,,1649.70,,,0,"percent of total billed charges","15.3% of total billed charges",3673.32,100,,,,,0,"fee schedule",EAPG,9299.82,69,,,,,0,"fee schedule","69% of total billed charges",13478,100,,10782.40,,,0,"percent of total billed charges","100% of total billed charges",13478,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13478,100,,10782.40,,,0,"percent of total billed charges","100% of total billed charges",13478,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13478,100,,10782.40,,,0,"percent of total billed charges","100% of total billed charges",13478,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13478,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,13478,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13478,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",13478,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3746.79,100,,,,,0,"fee schedule",EAPG,4775.32,100,,,,,0,"fee schedule",EAPG,13478,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5081.21,37.7,,4064.97,,,0,"percent of total billed charges","37.70% of total billed charges",13478,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",13478,100,,,,,0,"fee schedule","100% of CMS fee schedule",10512.84,78,,8410.27,,,0,"percent of total billed charges","78% of total billed charges",13478,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11132.83,82.6,,8906.26,,,0,"percent of total billed charges","82.6% of total billed charges",3673.32,100,,,,,0,"fee schedule","100% of WA fee schedule",13478,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11132.83,82.6,,8906.26,,,0,"percent of total billed charges","82.6% of total billed charges",13478,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3833.85,100,,,,,0,"fee schedule",EAPG,13478,100,,10782.40,,,0,"percent of total billed charges","100% of total billed charges",2062.13,13478,
"43101 Excision of lesion, esophagus, with primary",7962352,CDM,521,RC,43101,CPT,OUTPATIENT,,,2931,1905.15,,2579.28,88,,2063.42,,,0,"percent of total billed charges","88% of total billed charges",2931,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2897.21,100,,,,,0,"fee schedule",EAPG,2931,100,,2344.80,,,0,"percent of total billed charges","100% of total billed charges",2931,175,,,,,0,"fee schedule","175% of CMS fee schedule",2984.13,100,,,,,0,"fee schedule",EAPG,2931,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1846.53,63,,1477.22,,,0,"percent of total billed charges","63% of total billed charges",448.44,15.3,,358.75,,,0,"percent of total billed charges","15.3% of total billed charges",2897.21,100,,,,,0,"fee schedule",EAPG,2022.39,69,,,,,0,"fee schedule","69% of total billed charges",2931,100,,2344.80,,,0,"percent of total billed charges","100% of total billed charges",2931,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2931,100,,2344.80,,,0,"percent of total billed charges","100% of total billed charges",2931,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2931,100,,2344.80,,,0,"percent of total billed charges","100% of total billed charges",2931,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2931,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2897.21,100,,,,,0,"fee schedule",EAPG,2931,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2931,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2931,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2955.15,100,,,,,0,"fee schedule",EAPG,3766.37,100,,,,,0,"fee schedule",EAPG,2931,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1104.99,37.7,,883.99,,,0,"percent of total billed charges","37.70% of total billed charges",2931,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2931,100,,,,,0,"fee schedule","100% of CMS fee schedule",2286.18,78,,1828.94,,,0,"percent of total billed charges","78% of total billed charges",2931,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2421.01,82.6,,1936.81,,,0,"percent of total billed charges","82.6% of total billed charges",2897.21,100,,,,,0,"fee schedule","100% of WA fee schedule",2931,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2421.01,82.6,,1936.81,,,0,"percent of total billed charges","82.6% of total billed charges",2931,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3057.74,100,,,,,0,"fee schedule",EAPG,2931,100,,2344.80,,,0,"percent of total billed charges","100% of total billed charges",448.44,3766.37,
"43100 Excision of lesion, esophagus, with primary",7962850,CDM,521,RC,43100,CPT,OUTPATIENT,,,1874,1218.1,,1649.12,88,,1319.30,,,0,"percent of total billed charges","88% of total billed charges",1874,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2897.21,100,,,,,0,"fee schedule",EAPG,1874,100,,1499.20,,,0,"percent of total billed charges","100% of total billed charges",1874,175,,,,,0,"fee schedule","175% of CMS fee schedule",2984.13,100,,,,,0,"fee schedule",EAPG,1874,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1180.62,63,,944.50,,,0,"percent of total billed charges","63% of total billed charges",286.72,15.3,,229.38,,,0,"percent of total billed charges","15.3% of total billed charges",2897.21,100,,,,,0,"fee schedule",EAPG,1293.06,69,,,,,0,"fee schedule","69% of total billed charges",1874,100,,1499.20,,,0,"percent of total billed charges","100% of total billed charges",1874,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1874,100,,1499.20,,,0,"percent of total billed charges","100% of total billed charges",1874,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1874,100,,1499.20,,,0,"percent of total billed charges","100% of total billed charges",1874,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1874,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2897.21,100,,,,,0,"fee schedule",EAPG,1874,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1874,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1874,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2955.15,100,,,,,0,"fee schedule",EAPG,3766.37,100,,,,,0,"fee schedule",EAPG,1874,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",706.5,37.7,,565.20,,,0,"percent of total billed charges","37.70% of total billed charges",1874,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1874,100,,,,,0,"fee schedule","100% of CMS fee schedule",1461.72,78,,1169.38,,,0,"percent of total billed charges","78% of total billed charges",1874,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1547.92,82.6,,1238.34,,,0,"percent of total billed charges","82.6% of total billed charges",2897.21,100,,,,,0,"fee schedule",EAPG,1874,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1547.92,82.6,,1238.34,,,0,"percent of total billed charges","82.6% of total billed charges",1874,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3057.74,100,,,,,0,"fee schedule",EAPG,1874,100,,1499.20,,,0,"percent of total billed charges","100% of total billed charges",286.72,3766.37,
"43107 Total esophagectomy, without thoracotomy; tr",7963307,CDM,521,RC,43107,CPT,OUTPATIENT,,,7378,4795.7,,6492.64,88,,5194.11,,,0,"percent of total billed charges","88% of total billed charges",7378,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7378,175,,,,,0,"fee schedule","175% of CMS fee schedule",3783.52,100,,,,,0,"fee schedule",EAPG,7378,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4648.14,63,,3718.51,,,0,"percent of total billed charges","63% of total billed charges",1128.83,15.3,,903.06,,,0,"percent of total billed charges","15.3% of total billed charges",3673.32,100,,,,,0,"fee schedule",EAPG,5090.82,69,,,,,0,"fee schedule","69% of total billed charges",7378,100,,5902.40,,,0,"percent of total billed charges","100% of total billed charges",7378,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7378,100,,5902.40,,,0,"percent of total billed charges","100% of total billed charges",7378,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7378,100,,5902.40,,,0,"percent of total billed charges","100% of total billed charges",7378,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7378,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,7378,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7378,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7378,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3746.79,100,,,,,0,"fee schedule",EAPG,4775.32,100,,,,,0,"fee schedule",EAPG,7378,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2781.51,37.7,,2225.21,,,0,"percent of total billed charges","37.70% of total billed charges",7378,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7378,100,,,,,0,"fee schedule","100% of CMS fee schedule",5754.84,78,,4603.87,,,0,"percent of total billed charges","78% of total billed charges",7378,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6094.23,82.6,,4875.38,,,0,"percent of total billed charges","82.6% of total billed charges",3673.32,100,,,,,0,"fee schedule","100% of WA fee schedule",7378,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6094.23,82.6,,4875.38,,,0,"percent of total billed charges","82.6% of total billed charges",7378,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3833.85,100,,,,,0,"fee schedule",EAPG,7378,100,,5902.40,,,0,"percent of total billed charges","100% of total billed charges",1128.83,7378,
"43118 Partial esophagectomy, distal two-thirds, wi",7962004,CDM,521,RC,43118,CPT,OUTPATIENT,,,10460,6799,,9204.8,88,,7363.84,,,0,"percent of total billed charges","88% of total billed charges",10460,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",10460,175,,,,,0,"fee schedule","175% of CMS fee schedule",3783.52,100,,,,,0,"fee schedule",EAPG,10460,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6589.8,63,,5271.84,,,0,"percent of total billed charges","63% of total billed charges",1600.38,15.3,,1280.30,,,0,"percent of total billed charges","15.3% of total billed charges",3673.32,100,,,,,0,"fee schedule",EAPG,7217.4,69,,,,,0,"fee schedule","69% of total billed charges",10460,100,,8368.00,,,0,"percent of total billed charges","100% of total billed charges",10460,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10460,100,,8368.00,,,0,"percent of total billed charges","100% of total billed charges",10460,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10460,100,,8368.00,,,0,"percent of total billed charges","100% of total billed charges",10460,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10460,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,10460,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10460,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10460,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3746.79,100,,,,,0,"fee schedule",EAPG,4775.32,100,,,,,0,"fee schedule",EAPG,10460,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3943.42,37.7,,3154.74,,,0,"percent of total billed charges","37.70% of total billed charges",10460,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10460,100,,,,,0,"fee schedule","100% of CMS fee schedule",8158.8,78,,6527.04,,,0,"percent of total billed charges","78% of total billed charges",10460,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8639.96,82.6,,6911.97,,,0,"percent of total billed charges","82.6% of total billed charges",3673.32,100,,,,,0,"fee schedule","100% of WA fee schedule",10460,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8639.96,82.6,,6911.97,,,0,"percent of total billed charges","82.6% of total billed charges",10460,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3833.85,100,,,,,0,"fee schedule",EAPG,10460,100,,8368.00,,,0,"percent of total billed charges","100% of total billed charges",1600.38,10460,
"43113 Total or near total esophagectomy, with thor",7962090,CDM,521,RC,43113,CPT,OUTPATIENT,,,13183,8568.95,,11601.04,88,,9280.83,,,0,"percent of total billed charges","88% of total billed charges",13183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",13183,175,,,,,0,"fee schedule","175% of CMS fee schedule",3783.52,100,,,,,0,"fee schedule",EAPG,13183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8305.29,63,,6644.23,,,0,"percent of total billed charges","63% of total billed charges",2017,15.3,,1613.60,,,0,"percent of total billed charges","15.3% of total billed charges",3673.32,100,,,,,0,"fee schedule",EAPG,9096.27,69,,,,,0,"fee schedule","69% of total billed charges",13183,100,,10546.40,,,0,"percent of total billed charges","100% of total billed charges",13183,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13183,100,,10546.40,,,0,"percent of total billed charges","100% of total billed charges",13183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13183,100,,10546.40,,,0,"percent of total billed charges","100% of total billed charges",13183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,13183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",13183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3746.79,100,,,,,0,"fee schedule",EAPG,4775.32,100,,,,,0,"fee schedule",EAPG,13183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4969.99,37.7,,3975.99,,,0,"percent of total billed charges","37.70% of total billed charges",13183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",13183,100,,,,,0,"fee schedule","100% of CMS fee schedule",10282.74,78,,8226.19,,,0,"percent of total billed charges","78% of total billed charges",13183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10889.16,82.6,,8711.33,,,0,"percent of total billed charges","82.6% of total billed charges",3673.32,100,,,,,0,"fee schedule","100% of WA fee schedule",13183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10889.16,82.6,,8711.33,,,0,"percent of total billed charges","82.6% of total billed charges",13183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3833.85,100,,,,,0,"fee schedule",EAPG,13183,100,,10546.40,,,0,"percent of total billed charges","100% of total billed charges",2017,13183,
"43116 Partial esophagectomy, cervical, with free i",7962116,CDM,521,RC,43116,CPT,OUTPATIENT,,,15526,10091.9,,13662.88,88,,10930.30,,,0,"percent of total billed charges","88% of total billed charges",15526,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",15526,175,,,,,0,"fee schedule","175% of CMS fee schedule",3783.52,100,,,,,0,"fee schedule",EAPG,15526,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9781.38,63,,7825.10,,,0,"percent of total billed charges","63% of total billed charges",2375.48,15.3,,1900.38,,,0,"percent of total billed charges","15.3% of total billed charges",3673.32,100,,,,,0,"fee schedule",EAPG,10712.94,69,,,,,0,"fee schedule","69% of total billed charges",15526,100,,12420.80,,,0,"percent of total billed charges","100% of total billed charges",15526,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",15526,100,,12420.80,,,0,"percent of total billed charges","100% of total billed charges",15526,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",15526,100,,12420.80,,,0,"percent of total billed charges","100% of total billed charges",15526,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",15526,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,15526,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",15526,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",15526,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3746.79,100,,,,,0,"fee schedule",EAPG,4775.32,100,,,,,0,"fee schedule",EAPG,15526,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5853.3,37.7,,4682.64,,,0,"percent of total billed charges","37.70% of total billed charges",15526,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",15526,100,,,,,0,"fee schedule","100% of CMS fee schedule",12110.28,78,,9688.22,,,0,"percent of total billed charges","78% of total billed charges",15526,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12824.48,82.6,,10259.58,,,0,"percent of total billed charges","82.6% of total billed charges",3673.32,100,,,,,0,"fee schedule","100% of WA fee schedule",15526,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12824.48,82.6,,10259.58,,,0,"percent of total billed charges","82.6% of total billed charges",15526,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3833.85,100,,,,,0,"fee schedule",EAPG,15526,100,,12420.80,,,0,"percent of total billed charges","100% of total billed charges",2375.48,15526,
"43117 Partial esophagectomy, distal two-thirds, wi",7962816,CDM,521,RC,43117,CPT,OUTPATIENT,,,7151,4648.15,,6292.88,88,,5034.30,,,0,"percent of total billed charges","88% of total billed charges",7151,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7151,175,,,,,0,"fee schedule","175% of CMS fee schedule",3783.52,100,,,,,0,"fee schedule",EAPG,7151,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4505.13,63,,3604.10,,,0,"percent of total billed charges","63% of total billed charges",1094.1,15.3,,875.28,,,0,"percent of total billed charges","15.3% of total billed charges",3673.32,100,,,,,0,"fee schedule",EAPG,4934.19,69,,,,,0,"fee schedule","69% of total billed charges",7151,100,,5720.80,,,0,"percent of total billed charges","100% of total billed charges",7151,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7151,100,,5720.80,,,0,"percent of total billed charges","100% of total billed charges",7151,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7151,100,,5720.80,,,0,"percent of total billed charges","100% of total billed charges",7151,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7151,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,7151,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7151,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7151,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3746.79,100,,,,,0,"fee schedule",EAPG,4775.32,100,,,,,0,"fee schedule",EAPG,7151,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2695.93,37.7,,2156.74,,,0,"percent of total billed charges","37.70% of total billed charges",7151,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7151,100,,,,,0,"fee schedule","100% of CMS fee schedule",5577.78,78,,4462.22,,,0,"percent of total billed charges","78% of total billed charges",7151,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5906.73,82.6,,4725.38,,,0,"percent of total billed charges","82.6% of total billed charges",3673.32,100,,,,,0,"fee schedule","100% of WA fee schedule",7151,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5906.73,82.6,,4725.38,,,0,"percent of total billed charges","82.6% of total billed charges",7151,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3833.85,100,,,,,0,"fee schedule",EAPG,7151,100,,5720.80,,,0,"percent of total billed charges","100% of total billed charges",1094.1,7151,
"43112 Total esophagectomy; with or without pylorop",7963413,CDM,521,RC,43112,CPT,OUTPATIENT,,,7793,5065.45,,6857.84,88,,5486.27,,,0,"percent of total billed charges","88% of total billed charges",7793,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7793,175,,,,,0,"fee schedule","175% of CMS fee schedule",3783.52,100,,,,,0,"fee schedule",EAPG,7793,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4909.59,63,,3927.67,,,0,"percent of total billed charges","63% of total billed charges",1192.33,15.3,,953.86,,,0,"percent of total billed charges","15.3% of total billed charges",3673.32,100,,,,,0,"fee schedule",EAPG,5377.17,69,,,,,0,"fee schedule","69% of total billed charges",7793,100,,6234.40,,,0,"percent of total billed charges","100% of total billed charges",7793,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7793,100,,6234.40,,,0,"percent of total billed charges","100% of total billed charges",7793,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7793,100,,6234.40,,,0,"percent of total billed charges","100% of total billed charges",7793,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7793,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,7793,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7793,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7793,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3746.79,100,,,,,0,"fee schedule",EAPG,4775.32,100,,,,,0,"fee schedule",EAPG,7793,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2937.96,37.7,,2350.37,,,0,"percent of total billed charges","37.70% of total billed charges",7793,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7793,100,,,,,0,"fee schedule","100% of CMS fee schedule",6078.54,78,,4862.83,,,0,"percent of total billed charges","78% of total billed charges",7793,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6437.02,82.6,,5149.62,,,0,"percent of total billed charges","82.6% of total billed charges",3673.32,100,,,,,0,"fee schedule","100% of WA fee schedule",7793,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6437.02,82.6,,5149.62,,,0,"percent of total billed charges","82.6% of total billed charges",7793,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3833.85,100,,,,,0,"fee schedule",EAPG,7793,100,,6234.40,,,0,"percent of total billed charges","100% of total billed charges",1192.33,7793,
"43124 Total or partial esophagectomy, without reco",7962005,CDM,521,RC,43124,CPT,OUTPATIENT,,,11074,7198.1,,9745.12,88,,7796.10,,,0,"percent of total billed charges","88% of total billed charges",11074,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",11074,175,,,,,0,"fee schedule","175% of CMS fee schedule",3783.52,100,,,,,0,"fee schedule",EAPG,11074,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6976.62,63,,5581.30,,,0,"percent of total billed charges","63% of total billed charges",1694.32,15.3,,1355.46,,,0,"percent of total billed charges","15.3% of total billed charges",3673.32,100,,,,,0,"fee schedule",EAPG,7641.06,69,,,,,0,"fee schedule","69% of total billed charges",11074,100,,8859.20,,,0,"percent of total billed charges","100% of total billed charges",11074,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11074,100,,8859.20,,,0,"percent of total billed charges","100% of total billed charges",11074,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11074,100,,8859.20,,,0,"percent of total billed charges","100% of total billed charges",11074,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11074,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,11074,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11074,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",11074,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3746.79,100,,,,,0,"fee schedule",EAPG,4775.32,100,,,,,0,"fee schedule",EAPG,11074,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4174.9,37.7,,3339.92,,,0,"percent of total billed charges","37.70% of total billed charges",11074,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",11074,100,,,,,0,"fee schedule","100% of CMS fee schedule",8637.72,78,,6910.18,,,0,"percent of total billed charges","78% of total billed charges",11074,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9147.12,82.6,,7317.70,,,0,"percent of total billed charges","82.6% of total billed charges",3673.32,100,,,,,0,"fee schedule","100% of WA fee schedule",11074,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9147.12,82.6,,7317.70,,,0,"percent of total billed charges","82.6% of total billed charges",11074,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3833.85,100,,,,,0,"fee schedule",EAPG,11074,100,,8859.20,,,0,"percent of total billed charges","100% of total billed charges",1694.32,11074,
"43123 Partial esophagectomy, thoracoabdominal or a",7962073,CDM,521,RC,43123,CPT,OUTPATIENT,,,13664,8881.6,,12024.32,88,,9619.46,,,0,"percent of total billed charges","88% of total billed charges",13664,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",13664,175,,,,,0,"fee schedule","175% of CMS fee schedule",3783.52,100,,,,,0,"fee schedule",EAPG,13664,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8608.32,63,,6886.66,,,0,"percent of total billed charges","63% of total billed charges",2090.59,15.3,,1672.47,,,0,"percent of total billed charges","15.3% of total billed charges",3673.32,100,,,,,0,"fee schedule",EAPG,9428.16,69,,,,,0,"fee schedule","69% of total billed charges",13664,100,,10931.20,,,0,"percent of total billed charges","100% of total billed charges",13664,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13664,100,,10931.20,,,0,"percent of total billed charges","100% of total billed charges",13664,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13664,100,,10931.20,,,0,"percent of total billed charges","100% of total billed charges",13664,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13664,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,13664,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13664,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",13664,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3746.79,100,,,,,0,"fee schedule",EAPG,4775.32,100,,,,,0,"fee schedule",EAPG,13664,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5151.33,37.7,,4121.06,,,0,"percent of total billed charges","37.70% of total billed charges",13664,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",13664,100,,,,,0,"fee schedule","100% of CMS fee schedule",10657.92,78,,8526.34,,,0,"percent of total billed charges","78% of total billed charges",13664,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11286.46,82.6,,9029.17,,,0,"percent of total billed charges","82.6% of total billed charges",3673.32,100,,,,,0,"fee schedule","100% of WA fee schedule",13664,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11286.46,82.6,,9029.17,,,0,"percent of total billed charges","82.6% of total billed charges",13664,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3833.85,100,,,,,0,"fee schedule",EAPG,13664,100,,10931.20,,,0,"percent of total billed charges","100% of total billed charges",2090.59,13664,
"43121 Partial esophagectomy, distal two-thirds, wi",7962098,CDM,521,RC,43121,CPT,OUTPATIENT,,,8312,5402.8,,7314.56,88,,5851.65,,,0,"percent of total billed charges","88% of total billed charges",8312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8312,175,,,,,0,"fee schedule","175% of CMS fee schedule",3783.52,100,,,,,0,"fee schedule",EAPG,8312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5236.56,63,,4189.25,,,0,"percent of total billed charges","63% of total billed charges",1271.74,15.3,,1017.39,,,0,"percent of total billed charges","15.3% of total billed charges",3673.32,100,,,,,0,"fee schedule",EAPG,5735.28,69,,,,,0,"fee schedule","69% of total billed charges",8312,100,,6649.60,,,0,"percent of total billed charges","100% of total billed charges",8312,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8312,100,,6649.60,,,0,"percent of total billed charges","100% of total billed charges",8312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8312,100,,6649.60,,,0,"percent of total billed charges","100% of total billed charges",8312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,8312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3746.79,100,,,,,0,"fee schedule",EAPG,4775.32,100,,,,,0,"fee schedule",EAPG,8312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3133.62,37.7,,2506.90,,,0,"percent of total billed charges","37.70% of total billed charges",8312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8312,100,,,,,0,"fee schedule","100% of CMS fee schedule",6483.36,78,,5186.69,,,0,"percent of total billed charges","78% of total billed charges",8312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6865.71,82.6,,5492.57,,,0,"percent of total billed charges","82.6% of total billed charges",3673.32,100,,,,,0,"fee schedule","100% of WA fee schedule",8312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6865.71,82.6,,5492.57,,,0,"percent of total billed charges","82.6% of total billed charges",8312,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3833.85,100,,,,,0,"fee schedule",EAPG,8312,100,,6649.60,,,0,"percent of total billed charges","100% of total billed charges",1271.74,8312,
"43122 Partial esophagectomy, thoracoabdominal or a",7962107,CDM,521,RC,43122,CPT,OUTPATIENT,,,7424,4825.6,,6533.12,88,,5226.50,,,0,"percent of total billed charges","88% of total billed charges",7424,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7424,175,,,,,0,"fee schedule","175% of CMS fee schedule",3783.52,100,,,,,0,"fee schedule",EAPG,7424,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4677.12,63,,3741.70,,,0,"percent of total billed charges","63% of total billed charges",1135.87,15.3,,908.70,,,0,"percent of total billed charges","15.3% of total billed charges",3673.32,100,,,,,0,"fee schedule",EAPG,5122.56,69,,,,,0,"fee schedule","69% of total billed charges",7424,100,,5939.20,,,0,"percent of total billed charges","100% of total billed charges",7424,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7424,100,,5939.20,,,0,"percent of total billed charges","100% of total billed charges",7424,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7424,100,,5939.20,,,0,"percent of total billed charges","100% of total billed charges",7424,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7424,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,7424,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7424,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7424,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3746.79,100,,,,,0,"fee schedule",EAPG,4775.32,100,,,,,0,"fee schedule",EAPG,7424,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2798.85,37.7,,2239.08,,,0,"percent of total billed charges","37.70% of total billed charges",7424,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7424,100,,,,,0,"fee schedule","100% of CMS fee schedule",5790.72,78,,4632.58,,,0,"percent of total billed charges","78% of total billed charges",7424,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6132.22,82.6,,4905.78,,,0,"percent of total billed charges","82.6% of total billed charges",3673.32,100,,,,,0,"fee schedule","100% of WA fee schedule",7424,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6132.22,82.6,,4905.78,,,0,"percent of total billed charges","82.6% of total billed charges",7424,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3833.85,100,,,,,0,"fee schedule",EAPG,7424,100,,5939.20,,,0,"percent of total billed charges","100% of total billed charges",1135.87,7424,
"43130 Diverticulectomy of hypopharynx or esophagus",7961928,CDM,521,RC,43130,CPT,OUTPATIENT,,,2339,1520.35,,2058.32,88,,1646.66,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3673.32,100,,,,,0,"fee schedule",EAPG,2339,100,,1871.20,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",3783.52,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1473.57,63,,1178.86,,,0,"percent of total billed charges","63% of total billed charges",357.87,15.3,,286.30,,,0,"percent of total billed charges","15.3% of total billed charges",3673.32,100,,,,,0,"fee schedule",EAPG,1613.91,69,,,,,0,"fee schedule","69% of total billed charges",2339,100,,1871.20,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2339,100,,1871.20,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2339,100,,1871.20,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3673.32,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3746.79,100,,,,,0,"fee schedule",EAPG,4775.32,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",881.8,37.7,,705.44,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1824.42,78,,1459.54,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1932.01,82.6,,1545.61,,,0,"percent of total billed charges","82.6% of total billed charges",3673.32,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1932.01,82.6,,1545.61,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3833.85,100,,,,,0,"fee schedule",EAPG,2339,100,,1871.20,,,0,"percent of total billed charges","100% of total billed charges",357.87,20662.24,
"43193 Esophagoscopy, rigid, transoral; with biopsy",7963001,CDM,521,RC,43193,CPT,OUTPATIENT,,,377,245.05,,331.76,88,,265.41,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1867.66,100,,,,,0,"fee schedule",EAPG,377,100,,301.60,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",1923.69,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",237.51,63,,190.01,,,0,"percent of total billed charges","63% of total billed charges",57.68,15.3,,46.14,,,0,"percent of total billed charges","15.3% of total billed charges",1867.66,100,,,,,0,"fee schedule",EAPG,260.13,69,,,,,0,"fee schedule","69% of total billed charges",377,100,,301.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",377,100,,301.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",377,100,,301.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1867.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1905.02,100,,,,,0,"fee schedule",EAPG,2427.97,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",142.13,37.7,,113.70,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.06,78,,235.25,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",311.4,82.6,,249.12,,,0,"percent of total billed charges","82.6% of total billed charges",1867.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",311.4,82.6,,249.12,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2028.19,100,,,,,0,"fee schedule",EAPG,377,100,,301.60,,,0,"percent of total billed charges","100% of total billed charges",57.68,6601.69,
"43191 Esophagoscopy, rigid, transoral; diagnostic",7963523,CDM,521,RC,43191,CPT,OUTPATIENT,,,333,216.45,,293.04,88,,234.43,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1867.66,100,,,,,0,"fee schedule",EAPG,333,100,,266.40,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",1923.69,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",209.79,63,,167.83,,,0,"percent of total billed charges","63% of total billed charges",50.95,15.3,,40.76,,,0,"percent of total billed charges","15.3% of total billed charges",1867.66,100,,,,,0,"fee schedule",EAPG,229.77,69,,,,,0,"fee schedule","69% of total billed charges",333,100,,266.40,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",333,100,,266.40,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",333,100,,266.40,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1867.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1905.02,100,,,,,0,"fee schedule",EAPG,2427.97,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",125.54,37.7,,100.43,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",259.74,78,,207.79,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",275.06,82.6,,220.05,,,0,"percent of total billed charges","82.6% of total billed charges",1867.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",275.06,82.6,,220.05,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2028.19,100,,,,,0,"fee schedule",EAPG,333,100,,266.40,,,0,"percent of total billed charges","100% of total billed charges",50.95,6601.69,
"43201 Esophagoscopy, flexible, transoral; with dir",7961929,CDM,521,RC,43201,CPT,OUTPATIENT,,,820,533,,721.6,88,,577.28,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,820,100,,656.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",516.6,63,,413.28,,,0,"percent of total billed charges","63% of total billed charges",125.46,15.3,,100.37,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,565.8,69,,,,,0,"fee schedule","69% of total billed charges",820,100,,656.00,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",820,100,,656.00,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",820,100,,656.00,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",309.14,37.7,,247.31,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",639.6,78,,511.68,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",677.32,82.6,,541.86,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",677.32,82.6,,541.86,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,820,100,,656.00,,,0,"percent of total billed charges","100% of total billed charges",125.46,6601.69,
"43204 Esophagoscopy, flexible, transoral; with inj",7962417,CDM,521,RC,43204,CPT,OUTPATIENT,,,431,280.15,,379.28,88,,303.42,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,431,100,,344.80,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",271.53,63,,217.22,,,0,"percent of total billed charges","63% of total billed charges",65.94,15.3,,52.75,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,297.39,69,,,,,0,"fee schedule","69% of total billed charges",431,100,,344.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",431,100,,344.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",431,100,,344.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",162.49,37.7,,129.99,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",336.18,78,,268.94,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",356.01,82.6,,284.81,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",356.01,82.6,,284.81,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,431,100,,344.80,,,0,"percent of total billed charges","100% of total billed charges",65.94,6601.69,
"43205 Esophagoscopy, flexible, transoral; with ban",7962614,CDM,521,RC,43205,CPT,OUTPATIENT,,,447,290.55,,393.36,88,,314.69,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,447,100,,357.60,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",281.61,63,,225.29,,,0,"percent of total billed charges","63% of total billed charges",68.39,15.3,,54.71,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,308.43,69,,,,,0,"fee schedule","69% of total billed charges",447,100,,357.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",447,100,,357.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",447,100,,357.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",168.52,37.7,,134.82,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.66,78,,278.93,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",369.22,82.6,,295.38,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",369.22,82.6,,295.38,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,447,100,,357.60,,,0,"percent of total billed charges","100% of total billed charges",68.39,6601.69,
"43202 Esophagoscopy, flexible, transoral; with bio",7962907,CDM,521,RC,43202,CPT,OUTPATIENT,,,1079,701.35,,949.52,88,,759.62,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1079,100,,863.20,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",679.77,63,,543.82,,,0,"percent of total billed charges","63% of total billed charges",165.09,15.3,,132.07,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,744.51,69,,,,,0,"fee schedule","69% of total billed charges",1079,100,,863.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1079,100,,863.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1079,100,,863.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.78,37.7,,325.42,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",841.62,78,,673.30,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891.25,82.6,,713.00,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",891.25,82.6,,713.00,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,1079,100,,863.20,,,0,"percent of total billed charges","100% of total billed charges",165.09,6601.69,
"43206 Esophagoscopy, flexible, transoral; with opt",7963038,CDM,521,RC,43206,CPT,OUTPATIENT,,,986,640.9,,867.68,88,,694.14,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1867.66,100,,,,,0,"fee schedule",EAPG,986,100,,788.80,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",1923.69,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",621.18,63,,496.94,,,0,"percent of total billed charges","63% of total billed charges",150.86,15.3,,120.69,,,0,"percent of total billed charges","15.3% of total billed charges",1867.66,100,,,,,0,"fee schedule",EAPG,680.34,69,,,,,0,"fee schedule","69% of total billed charges",986,100,,788.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",986,100,,788.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",986,100,,788.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1867.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1905.02,100,,,,,0,"fee schedule",EAPG,2427.97,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",371.72,37.7,,297.38,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",769.08,78,,615.26,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",814.44,82.6,,651.55,,,0,"percent of total billed charges","82.6% of total billed charges",1867.66,100,,,,,0,"fee schedule","100% of WA fee schedule",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",814.44,82.6,,651.55,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2028.19,100,,,,,0,"fee schedule",EAPG,986,100,,788.80,,,0,"percent of total billed charges","100% of total billed charges",150.86,6601.69,
"43200 Esophagoscopy, flexible, transoral; diagnost",7963467,CDM,521,RC,43200,CPT,OUTPATIENT,,,806,523.9,,709.28,88,,567.42,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",507.78,63,,406.22,,,0,"percent of total billed charges","63% of total billed charges",123.32,15.3,,98.66,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,556.14,69,,,,,0,"fee schedule","69% of total billed charges",806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",303.86,37.7,,243.09,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",628.68,78,,502.94,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.76,82.6,,532.61,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.76,82.6,,532.61,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,806,100,,644.80,,,0,"percent of total billed charges","100% of total billed charges",123.32,3289.02,
"43213 Esophagoscopy, flexible, transoral; dilation",7961699,CDM,521,RC,43213,CPT,OUTPATIENT,,,3683,2393.95,,3241.04,88,,2592.83,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,3683,100,,2946.40,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2320.29,63,,1856.23,,,0,"percent of total billed charges","63% of total billed charges",563.5,15.3,,450.80,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,2541.27,69,,,,,0,"fee schedule","69% of total billed charges",3683,100,,2946.40,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3683,100,,2946.40,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3683,100,,2946.40,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1388.49,37.7,,1110.79,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2872.74,78,,2298.19,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3042.16,82.6,,2433.73,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3042.16,82.6,,2433.73,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,3683,100,,2946.40,,,0,"percent of total billed charges","100% of total billed charges",563.5,6601.69,
"43214 Esophagoscopy, flexible, transoral; with dil",7961829,CDM,521,RC,43214,CPT,OUTPATIENT,,,582,378.3,,512.16,88,,409.73,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1867.66,100,,,,,0,"fee schedule",EAPG,582,100,,465.60,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",1923.69,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",366.66,63,,293.33,,,0,"percent of total billed charges","63% of total billed charges",89.05,15.3,,71.24,,,0,"percent of total billed charges","15.3% of total billed charges",1867.66,100,,,,,0,"fee schedule",EAPG,401.58,69,,,,,0,"fee schedule","69% of total billed charges",582,100,,465.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",582,100,,465.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",582,100,,465.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1867.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1905.02,100,,,,,0,"fee schedule",EAPG,2427.97,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",219.41,37.7,,175.53,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",453.96,78,,363.17,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",480.73,82.6,,384.58,,,0,"percent of total billed charges","82.6% of total billed charges",1867.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",480.73,82.6,,384.58,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2028.19,100,,,,,0,"fee schedule",EAPG,582,100,,465.60,,,0,"percent of total billed charges","100% of total billed charges",89.05,6601.69,
"43216 Esophagoscopy, flexible, transoral; with rem",7962142,CDM,521,RC,43216,CPT,OUTPATIENT,,,1250,812.5,,1100,88,,880.00,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1250,100,,1000.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",787.5,63,,630.00,,,0,"percent of total billed charges","63% of total billed charges",191.25,15.3,,153.00,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,862.5,69,,,,,0,"fee schedule","69% of total billed charges",1250,100,,1000.00,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1250,100,,1000.00,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1250,100,,1000.00,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",471.25,37.7,,377.00,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",975,78,,780.00,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1032.5,82.6,,826.00,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1032.5,82.6,,826.00,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,1250,100,,1000.00,,,0,"percent of total billed charges","100% of total billed charges",191.25,6601.69,
"43212 Esophagoscopy, flexible, transoral; with pla",7962219,CDM,521,RC,43212,CPT,OUTPATIENT,,,568,369.2,,499.84,88,,399.87,,,0,"percent of total billed charges","88% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3312.37,100,,,,,0,"fee schedule",EAPG,568,100,,454.40,,,0,"percent of total billed charges","100% of total billed charges",10172.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",3411.74,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",357.84,63,,286.27,,,0,"percent of total billed charges","63% of total billed charges",86.9,15.3,,69.52,,,0,"percent of total billed charges","15.3% of total billed charges",3312.37,100,,,,,0,"fee schedule",EAPG,391.92,69,,,,,0,"fee schedule","69% of total billed charges",568,100,,454.40,,,0,"percent of total billed charges","100% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568,100,,454.40,,,0,"percent of total billed charges","100% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568,100,,454.40,,,0,"percent of total billed charges","100% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",20428.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3312.37,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5340.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3378.62,100,,,,,0,"fee schedule",EAPG,4306.08,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",214.14,37.7,,171.31,,,0,"percent of total billed charges","37.70% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.04,78,,354.43,,,0,"percent of total billed charges","78% of total billed charges",5871.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",469.17,82.6,,375.34,,,0,"percent of total billed charges","82.6% of total billed charges",3312.37,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",469.17,82.6,,375.34,,,0,"percent of total billed charges","82.6% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3472.9,100,,,,,0,"fee schedule",EAPG,568,100,,454.40,,,0,"percent of total billed charges","100% of total billed charges",86.9,20428.51,
"43211 Esophagoscopy, flexible, transoral; with end",7962863,CDM,521,RC,43211,CPT,OUTPATIENT,,,724,470.6,,637.12,88,,509.70,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,724,100,,579.20,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",456.12,63,,364.90,,,0,"percent of total billed charges","63% of total billed charges",110.77,15.3,,88.62,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,499.56,69,,,,,0,"fee schedule","69% of total billed charges",724,100,,579.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",724,100,,579.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",724,100,,579.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",272.95,37.7,,218.36,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",564.72,78,,451.78,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",598.02,82.6,,478.42,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",598.02,82.6,,478.42,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,724,100,,579.20,,,0,"percent of total billed charges","100% of total billed charges",110.77,6601.69,
"43217 Esophagoscopy, flexible, transoral; with rem",7962908,CDM,521,RC,43217,CPT,OUTPATIENT,,,1332,865.8,,1172.16,88,,937.73,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1332,100,,1065.60,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",839.16,63,,671.33,,,0,"percent of total billed charges","63% of total billed charges",203.8,15.3,,163.04,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,919.08,69,,,,,0,"fee schedule","69% of total billed charges",1332,100,,1065.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1332,100,,1065.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1332,100,,1065.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",502.16,37.7,,401.73,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1038.96,78,,831.17,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1100.23,82.6,,880.18,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1100.23,82.6,,880.18,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,1332,100,,1065.60,,,0,"percent of total billed charges","100% of total billed charges",203.8,6601.69,
"43215 Esophagoscopy, flexible, transoral; with rem",7963002,CDM,521,RC,43215,CPT,OUTPATIENT,,,1209,785.85,,1063.92,88,,851.14,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1209,100,,967.20,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",761.67,63,,609.34,,,0,"percent of total billed charges","63% of total billed charges",184.98,15.3,,147.98,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,834.21,69,,,,,0,"fee schedule","69% of total billed charges",1209,100,,967.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1209,100,,967.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1209,100,,967.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",455.79,37.7,,364.63,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",943.02,78,,754.42,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",998.63,82.6,,798.90,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",998.63,82.6,,798.90,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,1209,100,,967.20,,,0,"percent of total billed charges","100% of total billed charges",184.98,6601.69,
"43226 Esophagoscopy, flexible, transoral; insertio",7962341,CDM,521,RC,43226,CPT,OUTPATIENT,,,1136,738.4,,999.68,88,,799.74,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1136,100,,908.80,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",715.68,63,,572.54,,,0,"percent of total billed charges","63% of total billed charges",173.81,15.3,,139.05,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,783.84,69,,,,,0,"fee schedule","69% of total billed charges",1136,100,,908.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1136,100,,908.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1136,100,,908.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",428.27,37.7,,342.62,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886.08,78,,708.86,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",938.34,82.6,,750.67,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",938.34,82.6,,750.67,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,1136,100,,908.80,,,0,"percent of total billed charges","100% of total billed charges",173.81,6601.69,
"43220 Esophagoscopy, flexible, transoral; with tra",7962713,CDM,521,RC,43220,CPT,OUTPATIENT,,,3014,1959.1,,2652.32,88,,2121.86,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,3014,100,,2411.20,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1898.82,63,,1519.06,,,0,"percent of total billed charges","63% of total billed charges",461.14,15.3,,368.91,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,2079.66,69,,,,,0,"fee schedule","69% of total billed charges",3014,100,,2411.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3014,100,,2411.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3014,100,,2411.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1136.28,37.7,,909.02,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2350.92,78,,1880.74,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2489.56,82.6,,1991.65,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2489.56,82.6,,1991.65,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,3014,100,,2411.20,,,0,"percent of total billed charges","100% of total billed charges",461.14,6601.69,
"43227 Esophagoscopy, flexible, transoral; with con",7962748,CDM,521,RC,43227,CPT,OUTPATIENT,,,1174,763.1,,1033.12,88,,826.50,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1174,100,,939.20,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",739.62,63,,591.70,,,0,"percent of total billed charges","63% of total billed charges",179.62,15.3,,143.70,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,810.06,69,,,,,0,"fee schedule","69% of total billed charges",1174,100,,939.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1174,100,,939.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1174,100,,939.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",442.6,37.7,,354.08,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",915.72,78,,732.58,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",969.72,82.6,,775.78,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",969.72,82.6,,775.78,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,1174,100,,939.20,,,0,"percent of total billed charges","100% of total billed charges",179.62,6601.69,
"43229 Esophagoscopy, flexible, transoral; w/ ablat",7962851,CDM,521,RC,43229,CPT,OUTPATIENT,,,2166,1407.9,,1906.08,88,,1524.86,,,0,"percent of total billed charges","88% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1867.66,100,,,,,0,"fee schedule",EAPG,2166,100,,1732.80,,,0,"percent of total billed charges","100% of total billed charges",6835.86,175,,,,,0,"fee schedule","175% of CMS fee schedule",1923.69,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1364.58,63,,1091.66,,,0,"percent of total billed charges","63% of total billed charges",331.4,15.3,,265.12,,,0,"percent of total billed charges","15.3% of total billed charges",1867.66,100,,,,,0,"fee schedule",EAPG,1494.54,69,,,,,0,"fee schedule","69% of total billed charges",2166,100,,1732.80,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2166,100,,1732.80,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2166,100,,1732.80,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",12515.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1867.66,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3272.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1905.02,100,,,,,0,"fee schedule",EAPG,2427.97,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",816.58,37.7,,653.26,,,0,"percent of total billed charges","37.70% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1689.48,78,,1351.58,,,0,"percent of total billed charges","78% of total billed charges",3945.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1789.12,82.6,,1431.30,,,0,"percent of total billed charges","82.6% of total billed charges",1867.66,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1789.12,82.6,,1431.30,,,0,"percent of total billed charges","82.6% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2028.19,100,,,,,0,"fee schedule",EAPG,2166,100,,1732.80,,,0,"percent of total billed charges","100% of total billed charges",331.4,12515.8,
"43235 Esophagogastroduodenoscopy, flexible, transo",7961521,CDM,521,RC,43235,CPT,OUTPATIENT,,,390,253.5,,343.2,88,,274.56,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,390,100,,312.00,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",245.7,63,,196.56,,,0,"percent of total billed charges","63% of total billed charges",59.67,15.3,,47.74,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,269.1,69,,,,,0,"fee schedule","69% of total billed charges",390,100,,312.00,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390,100,,312.00,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390,100,,312.00,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",147.03,37.7,,117.62,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",304.2,78,,243.36,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",322.14,82.6,,257.71,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",322.14,82.6,,257.71,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,390,100,,312.00,,,0,"percent of total billed charges","100% of total billed charges",59.67,3289.02,
"43236 Esophagogastroduodenoscopy, flexible,transor",7961522,CDM,521,RC,43236,CPT,OUTPATIENT,,,439,285.35,,386.32,88,,309.06,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",276.57,63,,221.26,,,0,"percent of total billed charges","63% of total billed charges",67.17,15.3,,53.74,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,302.91,69,,,,,0,"fee schedule","69% of total billed charges",439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",165.5,37.7,,132.40,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.42,78,,273.94,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",362.61,82.6,,290.09,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",362.61,82.6,,290.09,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,439,100,,351.20,,,0,"percent of total billed charges","100% of total billed charges",67.17,3289.02,
"43233 Esophagogastroduodenoscopy, flexible, transo",7961930,CDM,521,RC,43233,CPT,OUTPATIENT,,,690,448.5,,607.2,88,,485.76,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,690,100,,552.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",434.7,63,,347.76,,,0,"percent of total billed charges","63% of total billed charges",105.57,15.3,,84.46,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,476.1,69,,,,,0,"fee schedule","69% of total billed charges",690,100,,552.00,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",690,100,,552.00,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",690,100,,552.00,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",260.13,37.7,,208.10,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",538.2,78,,430.56,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",569.94,82.6,,455.95,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",569.94,82.6,,455.95,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,690,100,,552.00,,,0,"percent of total billed charges","100% of total billed charges",105.57,6601.69,
"43238 Esophagogastroduodenoscopy, flexible, transo",7962006,CDM,521,RC,43238,CPT,OUTPATIENT,,,702,456.3,,617.76,88,,494.21,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,702,100,,561.60,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",442.26,63,,353.81,,,0,"percent of total billed charges","63% of total billed charges",107.41,15.3,,85.93,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,484.38,69,,,,,0,"fee schedule","69% of total billed charges",702,100,,561.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",702,100,,561.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",702,100,,561.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",264.65,37.7,,211.72,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",547.56,78,,438.05,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579.85,82.6,,463.88,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579.85,82.6,,463.88,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,702,100,,561.60,,,0,"percent of total billed charges","100% of total billed charges",107.41,6601.69,
"43237 Esophagogastroduodenoscopy, flexible, transo",7962105,CDM,521,RC,43237,CPT,OUTPATIENT,,,616,400.4,,542.08,88,,433.66,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,616,100,,492.80,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",388.08,63,,310.46,,,0,"percent of total billed charges","63% of total billed charges",94.25,15.3,,75.40,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,425.04,69,,,,,0,"fee schedule","69% of total billed charges",616,100,,492.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616,100,,492.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616,100,,492.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",232.23,37.7,,185.78,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",480.48,78,,384.38,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",508.82,82.6,,407.06,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",508.82,82.6,,407.06,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,616,100,,492.80,,,0,"percent of total billed charges","100% of total billed charges",94.25,6601.69,
"43232 Esophagoscopy, flexible, transoral; with tra",7962224,CDM,521,RC,43232,CPT,OUTPATIENT,,,605,393.25,,532.4,88,,425.92,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,605,100,,484.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",381.15,63,,304.92,,,0,"percent of total billed charges","63% of total billed charges",92.57,15.3,,74.06,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,417.45,69,,,,,0,"fee schedule","69% of total billed charges",605,100,,484.00,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605,100,,484.00,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605,100,,484.00,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",228.09,37.7,,182.47,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",471.9,78,,377.52,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.73,82.6,,399.78,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.73,82.6,,399.78,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,605,100,,484.00,,,0,"percent of total billed charges","100% of total billed charges",92.57,6601.69,
"43239 Esophagogastroduodenoscopy, flexible, transo",7962474,CDM,521,RC,43239,CPT,OUTPATIENT,,,1194,776.1,,1050.72,88,,840.58,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1194,100,,955.20,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",752.22,63,,601.78,,,0,"percent of total billed charges","63% of total billed charges",182.68,15.3,,146.14,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,823.86,69,,,,,0,"fee schedule","69% of total billed charges",1194,100,,955.20,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1194,100,,955.20,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1194,100,,955.20,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",450.14,37.7,,360.11,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",931.32,78,,745.06,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",986.24,82.6,,788.99,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",986.24,82.6,,788.99,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,1194,100,,955.20,,,0,"percent of total billed charges","100% of total billed charges",182.68,3289.02,
"43231 Esophagoscopy, flexible, transoral; with end",7962692,CDM,521,RC,43231,CPT,OUTPATIENT,,,509,330.85,,447.92,88,,358.34,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320.67,63,,256.54,,,0,"percent of total billed charges","63% of total billed charges",77.88,15.3,,62.30,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,351.21,69,,,,,0,"fee schedule","69% of total billed charges",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",191.89,37.7,,153.51,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397.02,78,,317.62,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.43,82.6,,336.34,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.43,82.6,,336.34,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",77.88,6601.69,
"43241 Esophagogastroduodenoscopy, flexible, transo",7961523,CDM,521,RC,43241,CPT,OUTPATIENT,,,451,293.15,,396.88,88,,317.50,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,451,100,,360.80,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.13,63,,227.30,,,0,"percent of total billed charges","63% of total billed charges",69,15.3,,55.20,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,311.19,69,,,,,0,"fee schedule","69% of total billed charges",451,100,,360.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",451,100,,360.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",451,100,,360.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",170.03,37.7,,136.02,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",351.78,78,,281.42,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",372.53,82.6,,298.02,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",372.53,82.6,,298.02,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,451,100,,360.80,,,0,"percent of total billed charges","100% of total billed charges",69,6601.69,
"43245 Esophagogastroduodenoscopy, flexible, transo",7961524,CDM,521,RC,43245,CPT,OUTPATIENT,,,1836,1193.4,,1615.68,88,,1292.54,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1836,100,,1468.80,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1156.68,63,,925.34,,,0,"percent of total billed charges","63% of total billed charges",280.91,15.3,,224.73,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1266.84,69,,,,,0,"fee schedule","69% of total billed charges",1836,100,,1468.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1836,100,,1468.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1836,100,,1468.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",692.17,37.7,,553.74,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1432.08,78,,1145.66,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1516.54,82.6,,1213.23,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1516.54,82.6,,1213.23,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,1836,100,,1468.80,,,0,"percent of total billed charges","100% of total billed charges",280.91,6601.69,
"43246 Esophagogastroduodenoscopy, flxble, transora",7961525,CDM,521,RC,43246,CPT,OUTPATIENT,,,627,407.55,,551.76,88,,441.41,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,627,100,,501.60,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",395.01,63,,316.01,,,0,"percent of total billed charges","63% of total billed charges",95.93,15.3,,76.74,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,432.63,69,,,,,0,"fee schedule","69% of total billed charges",627,100,,501.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",627,100,,501.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",627,100,,501.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",236.38,37.7,,189.10,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",489.06,78,,391.25,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",517.9,82.6,,414.32,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",517.9,82.6,,414.32,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,627,100,,501.60,,,0,"percent of total billed charges","100% of total billed charges",95.93,6601.69,
"43243 Esophagogastroduodenoscopy, flexible, transo",7961616,CDM,521,RC,43243,CPT,OUTPATIENT,,,742,482.3,,652.96,88,,522.37,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,742,100,,593.60,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",467.46,63,,373.97,,,0,"percent of total billed charges","63% of total billed charges",113.53,15.3,,90.82,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,511.98,69,,,,,0,"fee schedule","69% of total billed charges",742,100,,593.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",742,100,,593.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",742,100,,593.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",279.73,37.7,,223.78,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",578.76,78,,463.01,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",612.89,82.6,,490.31,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",612.89,82.6,,490.31,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,742,100,,593.60,,,0,"percent of total billed charges","100% of total billed charges",113.53,6601.69,
"43248 Esophagogastroduodenoscopy, flexible, transo",7961766,CDM,521,RC,43248,CPT,OUTPATIENT,,,1226,796.9,,1078.88,88,,863.10,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1226,100,,980.80,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",772.38,63,,617.90,,,0,"percent of total billed charges","63% of total billed charges",187.58,15.3,,150.06,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,845.94,69,,,,,0,"fee schedule","69% of total billed charges",1226,100,,980.80,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1226,100,,980.80,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1226,100,,980.80,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",462.2,37.7,,369.76,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",956.28,78,,765.02,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1012.68,82.6,,810.14,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1012.68,82.6,,810.14,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,1226,100,,980.80,,,0,"percent of total billed charges","100% of total billed charges",187.58,3289.02,
"43244 Esophagogastroduodenoscopy, flexible, transo",7961830,CDM,521,RC,43244,CPT,OUTPATIENT,,,769,499.85,,676.72,88,,541.38,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,769,100,,615.20,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",484.47,63,,387.58,,,0,"percent of total billed charges","63% of total billed charges",117.66,15.3,,94.13,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,530.61,69,,,,,0,"fee schedule","69% of total billed charges",769,100,,615.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",769,100,,615.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",769,100,,615.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",289.91,37.7,,231.93,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",599.82,78,,479.86,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",635.19,82.6,,508.15,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",635.19,82.6,,508.15,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,769,100,,615.20,,,0,"percent of total billed charges","100% of total billed charges",117.66,6601.69,
"43242 Esophagogastroduodenoscopy, flexible, transo",7962007,CDM,521,RC,43242,CPT,OUTPATIENT,,,800,520,,704,88,,563.20,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,800,100,,640.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",504,63,,403.20,,,0,"percent of total billed charges","63% of total billed charges",122.4,15.3,,97.92,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,552,69,,,,,0,"fee schedule","69% of total billed charges",800,100,,640.00,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",800,100,,640.00,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",800,100,,640.00,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",301.6,37.7,,241.28,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",624,78,,499.20,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.8,82.6,,528.64,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.8,82.6,,528.64,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,800,100,,640.00,,,0,"percent of total billed charges","100% of total billed charges",122.4,6601.69,
"43240 Esophagogastroduodenoscopy, flexible, transo",7962077,CDM,521,RC,43240,CPT,OUTPATIENT,,,1222,794.3,,1075.36,88,,860.29,,,0,"percent of total billed charges","88% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3312.37,100,,,,,0,"fee schedule",EAPG,1222,100,,977.60,,,0,"percent of total billed charges","100% of total billed charges",10172.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",3411.74,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",769.86,63,,615.89,,,0,"percent of total billed charges","63% of total billed charges",186.97,15.3,,149.58,,,0,"percent of total billed charges","15.3% of total billed charges",3312.37,100,,,,,0,"fee schedule",EAPG,843.18,69,,,,,0,"fee schedule","69% of total billed charges",1222,100,,977.60,,,0,"percent of total billed charges","100% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1222,100,,977.60,,,0,"percent of total billed charges","100% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1222,100,,977.60,,,0,"percent of total billed charges","100% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",12515.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3312.37,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3272.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3378.62,100,,,,,0,"fee schedule",EAPG,4306.08,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",460.69,37.7,,368.55,,,0,"percent of total billed charges","37.70% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",953.16,78,,762.53,,,0,"percent of total billed charges","78% of total billed charges",5871.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1009.37,82.6,,807.50,,,0,"percent of total billed charges","82.6% of total billed charges",3312.37,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1009.37,82.6,,807.50,,,0,"percent of total billed charges","82.6% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3472.9,100,,,,,0,"fee schedule",EAPG,1222,100,,977.60,,,0,"percent of total billed charges","100% of total billed charges",186.97,12515.8,
"43247 Esophagogastroduodenoscopy, flexible, transo",7962563,CDM,521,RC,43247,CPT,OUTPATIENT,,,1207,784.55,,1062.16,88,,849.73,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1207,100,,965.60,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",760.41,63,,608.33,,,0,"percent of total billed charges","63% of total billed charges",184.67,15.3,,147.74,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,832.83,69,,,,,0,"fee schedule","69% of total billed charges",1207,100,,965.60,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1207,100,,965.60,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1207,100,,965.60,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",455.04,37.7,,364.03,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",941.46,78,,753.17,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",996.98,82.6,,797.58,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",996.98,82.6,,797.58,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,1207,100,,965.60,,,0,"percent of total billed charges","100% of total billed charges",184.67,3289.02,
"43249 Esophagogastroduodenoscop <30 mm diameter, b",7962749,CDM,521,RC,43249,CPT,OUTPATIENT,,,3147,2045.55,,2769.36,88,,2215.49,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,3147,100,,2517.60,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.61,63,,1586.09,,,0,"percent of total billed charges","63% of total billed charges",481.49,15.3,,385.19,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,2171.43,69,,,,,0,"fee schedule","69% of total billed charges",3147,100,,2517.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3147,100,,2517.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3147,100,,2517.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1186.42,37.7,,949.14,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2454.66,78,,1963.73,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2599.42,82.6,,2079.54,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2599.42,82.6,,2079.54,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,3147,100,,2517.60,,,0,"percent of total billed charges","100% of total billed charges",481.49,6601.69,
"43250 EGD flexible, transoral; with removal of tum",7961831,CDM,521,RC,43250,CPT,OUTPATIENT,,,521,338.65,,458.48,88,,366.78,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,521,100,,416.80,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",328.23,63,,262.58,,,0,"percent of total billed charges","63% of total billed charges",79.71,15.3,,63.77,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,359.49,69,,,,,0,"fee schedule","69% of total billed charges",521,100,,416.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",521,100,,416.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",521,100,,416.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",196.42,37.7,,157.14,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",406.38,78,,325.10,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",430.35,82.6,,344.28,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",430.35,82.6,,344.28,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,521,100,,416.80,,,0,"percent of total billed charges","100% of total billed charges",79.71,6601.69,
"43253 Esophagogastroduodenoscopy, flexible, transo",7962063,CDM,521,RC,43253,CPT,OUTPATIENT,,,809,525.85,,711.92,88,,569.54,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509.67,63,,407.74,,,0,"percent of total billed charges","63% of total billed charges",123.78,15.3,,99.02,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,558.21,69,,,,,0,"fee schedule","69% of total billed charges",809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",304.99,37.7,,243.99,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",631.02,78,,504.82,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",668.23,82.6,,534.58,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",668.23,82.6,,534.58,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",123.78,6601.69,
"43259 Esophagogastroduodenoscopy, flexible, transo",7962067,CDM,521,RC,43259,CPT,OUTPATIENT,,,697,453.05,,613.36,88,,490.69,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,697,100,,557.60,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",439.11,63,,351.29,,,0,"percent of total billed charges","63% of total billed charges",106.64,15.3,,85.31,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,480.93,69,,,,,0,"fee schedule","69% of total billed charges",697,100,,557.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",697,100,,557.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",697,100,,557.60,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",262.77,37.7,,210.22,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",543.66,78,,434.93,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",575.72,82.6,,460.58,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",575.72,82.6,,460.58,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,697,100,,557.60,,,0,"percent of total billed charges","100% of total billed charges",106.64,6601.69,
"43255 Esophagogastroduodenoscopy, flexible, transo",7962300,CDM,521,RC,43255,CPT,OUTPATIENT,,,621,403.65,,546.48,88,,437.18,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,621,100,,496.80,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",391.23,63,,312.98,,,0,"percent of total billed charges","63% of total billed charges",95.01,15.3,,76.01,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,428.49,69,,,,,0,"fee schedule","69% of total billed charges",621,100,,496.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",621,100,,496.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",621,100,,496.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",234.12,37.7,,187.30,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",484.38,78,,387.50,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.95,82.6,,410.36,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.95,82.6,,410.36,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,621,100,,496.80,,,0,"percent of total billed charges","100% of total billed charges",95.01,6601.69,
"43254 Esophagogastroduodenoscopy, flexible, transo",7962432,CDM,521,RC,43254,CPT,OUTPATIENT,,,826,536.9,,726.88,88,,581.50,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1867.66,100,,,,,0,"fee schedule",EAPG,826,100,,660.80,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",1923.69,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",520.38,63,,416.30,,,0,"percent of total billed charges","63% of total billed charges",126.38,15.3,,101.10,,,0,"percent of total billed charges","15.3% of total billed charges",1867.66,100,,,,,0,"fee schedule",EAPG,569.94,69,,,,,0,"fee schedule","69% of total billed charges",826,100,,660.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",826,100,,660.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",826,100,,660.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1867.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1905.02,100,,,,,0,"fee schedule",EAPG,2427.97,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",311.4,37.7,,249.12,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",644.28,78,,515.42,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",682.28,82.6,,545.82,,,0,"percent of total billed charges","82.6% of total billed charges",1867.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",682.28,82.6,,545.82,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2028.19,100,,,,,0,"fee schedule",EAPG,826,100,,660.80,,,0,"percent of total billed charges","100% of total billed charges",126.38,6601.69,
"43257 EGD w/ delivery of thermal energy to the mus",7962564,CDM,521,RC,43257,CPT,OUTPATIENT,,,711,462.15,,625.68,88,,500.54,,,0,"percent of total billed charges","88% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1867.66,100,,,,,0,"fee schedule",EAPG,711,100,,568.80,,,0,"percent of total billed charges","100% of total billed charges",6835.86,175,,,,,0,"fee schedule","175% of CMS fee schedule",1923.69,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",447.93,63,,358.34,,,0,"percent of total billed charges","63% of total billed charges",108.78,15.3,,87.02,,,0,"percent of total billed charges","15.3% of total billed charges",1867.66,100,,,,,0,"fee schedule",EAPG,490.59,69,,,,,0,"fee schedule","69% of total billed charges",711,100,,568.80,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",711,100,,568.80,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",711,100,,568.80,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",12515.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1867.66,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3272.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1905.02,100,,,,,0,"fee schedule",EAPG,2427.97,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",268.05,37.7,,214.44,,,0,"percent of total billed charges","37.70% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.58,78,,443.66,,,0,"percent of total billed charges","78% of total billed charges",3945.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",587.29,82.6,,469.83,,,0,"percent of total billed charges","82.6% of total billed charges",1867.66,100,,,,,0,"fee schedule","100% of WA fee schedule",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",587.29,82.6,,469.83,,,0,"percent of total billed charges","82.6% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2028.19,100,,,,,0,"fee schedule",EAPG,711,100,,568.80,,,0,"percent of total billed charges","100% of total billed charges",108.78,12515.8,
"43252 Esophagogastroduodenoscopy, flexible, transo",7962615,CDM,521,RC,43252,CPT,OUTPATIENT,,,521,338.65,,458.48,88,,366.78,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3312.37,100,,,,,0,"fee schedule",EAPG,521,100,,416.80,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",3411.74,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",328.23,63,,262.58,,,0,"percent of total billed charges","63% of total billed charges",79.71,15.3,,63.77,,,0,"percent of total billed charges","15.3% of total billed charges",3312.37,100,,,,,0,"fee schedule",EAPG,359.49,69,,,,,0,"fee schedule","69% of total billed charges",521,100,,416.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",521,100,,416.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",521,100,,416.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",12515.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3312.37,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3272.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3378.62,100,,,,,0,"fee schedule",EAPG,4306.08,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",196.42,37.7,,157.14,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",406.38,78,,325.10,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",430.35,82.6,,344.28,,,0,"percent of total billed charges","82.6% of total billed charges",3312.37,100,,,,,0,"fee schedule","100% of WA fee schedule",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",430.35,82.6,,344.28,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3472.9,100,,,,,0,"fee schedule",EAPG,521,100,,416.80,,,0,"percent of total billed charges","100% of total billed charges",79.71,12515.8,
"43251 Esophagogastroduodenoscopy removal of tumor(",7962969,CDM,521,RC,43251,CPT,OUTPATIENT,,,604,392.6,,531.52,88,,425.22,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,604,100,,483.20,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",380.52,63,,304.42,,,0,"percent of total billed charges","63% of total billed charges",92.41,15.3,,73.93,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,416.76,69,,,,,0,"fee schedule","69% of total billed charges",604,100,,483.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",604,100,,483.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",604,100,,483.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",227.71,37.7,,182.17,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",471.12,78,,376.90,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",498.9,82.6,,399.12,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",498.9,82.6,,399.12,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,604,100,,483.20,,,0,"percent of total billed charges","100% of total billed charges",92.41,6601.69,
"43265 ERCP; with destruction of calculi, any metho",7961617,CDM,521,RC,43265,CPT,OUTPATIENT,,,1315,854.75,,1157.2,88,,925.76,,,0,"percent of total billed charges","88% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3870.92,100,,,,,0,"fee schedule",EAPG,1315,100,,1052.00,,,0,"percent of total billed charges","100% of total billed charges",10172.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",3987.05,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",828.45,63,,662.76,,,0,"percent of total billed charges","63% of total billed charges",201.2,15.3,,160.96,,,0,"percent of total billed charges","15.3% of total billed charges",3870.92,100,,,,,0,"fee schedule",EAPG,907.35,69,,,,,0,"fee schedule","69% of total billed charges",1315,100,,1052.00,,,0,"percent of total billed charges","100% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1315,100,,1052.00,,,0,"percent of total billed charges","100% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1315,100,,1052.00,,,0,"percent of total billed charges","100% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",20428.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3870.92,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5340.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3948.34,100,,,,,0,"fee schedule",EAPG,5032.19,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",495.76,37.7,,396.61,,,0,"percent of total billed charges","37.70% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1025.7,78,,820.56,,,0,"percent of total billed charges","78% of total billed charges",5871.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1086.19,82.6,,868.95,,,0,"percent of total billed charges","82.6% of total billed charges",3870.92,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1086.19,82.6,,868.95,,,0,"percent of total billed charges","82.6% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4031.45,100,,,,,0,"fee schedule",EAPG,1315,100,,1052.00,,,0,"percent of total billed charges","100% of total billed charges",201.2,20428.51,
"43260 ERCP; diagnostic, including collection of sp",7961700,CDM,521,RC,43260,CPT,OUTPATIENT,,,986,640.9,,867.68,88,,694.14,,,0,"percent of total billed charges","88% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2299.5,100,,,,,0,"fee schedule",EAPG,986,100,,788.80,,,0,"percent of total billed charges","100% of total billed charges",6835.86,175,,,,,0,"fee schedule","175% of CMS fee schedule",2368.49,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",621.18,63,,496.94,,,0,"percent of total billed charges","63% of total billed charges",150.86,15.3,,120.69,,,0,"percent of total billed charges","15.3% of total billed charges",2299.5,100,,,,,0,"fee schedule",EAPG,680.34,69,,,,,0,"fee schedule","69% of total billed charges",986,100,,788.80,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",986,100,,788.80,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",986,100,,788.80,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",12515.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2299.5,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3272.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2345.49,100,,,,,0,"fee schedule",EAPG,2989.36,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",371.72,37.7,,297.38,,,0,"percent of total billed charges","37.70% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",769.08,78,,615.26,,,0,"percent of total billed charges","78% of total billed charges",3945.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",814.44,82.6,,651.55,,,0,"percent of total billed charges","82.6% of total billed charges",2299.5,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",814.44,82.6,,651.55,,,0,"percent of total billed charges","82.6% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2460.03,100,,,,,0,"fee schedule",EAPG,986,100,,788.80,,,0,"percent of total billed charges","100% of total billed charges",150.86,12515.8,
"43263 Endoscopic retrograde cholangiopancreatograp",7962156,CDM,521,RC,43263,CPT,OUTPATIENT,,,1091,709.15,,960.08,88,,768.06,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2299.5,100,,,,,0,"fee schedule",EAPG,1091,100,,872.80,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",2368.49,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",687.33,63,,549.86,,,0,"percent of total billed charges","63% of total billed charges",166.92,15.3,,133.54,,,0,"percent of total billed charges","15.3% of total billed charges",2299.5,100,,,,,0,"fee schedule",EAPG,752.79,69,,,,,0,"fee schedule","69% of total billed charges",1091,100,,872.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1091,100,,872.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1091,100,,872.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",12515.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2299.5,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3272.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2345.49,100,,,,,0,"fee schedule",EAPG,2989.36,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",411.31,37.7,,329.05,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",850.98,78,,680.78,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",901.17,82.6,,720.94,,,0,"percent of total billed charges","82.6% of total billed charges",2299.5,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",901.17,82.6,,720.94,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2460.03,100,,,,,0,"fee schedule",EAPG,1091,100,,872.80,,,0,"percent of total billed charges","100% of total billed charges",166.92,12515.8,
"43266 Esophagogastroduodenoscopy, flexible, transo",7962378,CDM,521,RC,43266,CPT,OUTPATIENT,,,693,450.45,,609.84,88,,487.87,,,0,"percent of total billed charges","88% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3312.37,100,,,,,0,"fee schedule",EAPG,693,100,,554.40,,,0,"percent of total billed charges","100% of total billed charges",10172.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",3411.74,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",436.59,63,,349.27,,,0,"percent of total billed charges","63% of total billed charges",106.03,15.3,,84.82,,,0,"percent of total billed charges","15.3% of total billed charges",3312.37,100,,,,,0,"fee schedule",EAPG,478.17,69,,,,,0,"fee schedule","69% of total billed charges",693,100,,554.40,,,0,"percent of total billed charges","100% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",693,100,,554.40,,,0,"percent of total billed charges","100% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",693,100,,554.40,,,0,"percent of total billed charges","100% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",20428.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3312.37,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5340.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3378.62,100,,,,,0,"fee schedule",EAPG,4306.08,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",261.26,37.7,,209.01,,,0,"percent of total billed charges","37.70% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",540.54,78,,432.43,,,0,"percent of total billed charges","78% of total billed charges",5871.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",572.42,82.6,,457.94,,,0,"percent of total billed charges","82.6% of total billed charges",3312.37,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",572.42,82.6,,457.94,,,0,"percent of total billed charges","82.6% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3472.9,100,,,,,0,"fee schedule",EAPG,693,100,,554.40,,,0,"percent of total billed charges","100% of total billed charges",106.03,20428.51,
"43264 ERCP; with removal of calculi/debris from bi",7962887,CDM,521,RC,43264,CPT,OUTPATIENT,,,1109,720.85,,975.92,88,,780.74,,,0,"percent of total billed charges","88% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2299.5,100,,,,,0,"fee schedule",EAPG,1109,100,,887.20,,,0,"percent of total billed charges","100% of total billed charges",6835.86,175,,,,,0,"fee schedule","175% of CMS fee schedule",2368.49,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",698.67,63,,558.94,,,0,"percent of total billed charges","63% of total billed charges",169.68,15.3,,135.74,,,0,"percent of total billed charges","15.3% of total billed charges",2299.5,100,,,,,0,"fee schedule",EAPG,765.21,69,,,,,0,"fee schedule","69% of total billed charges",1109,100,,887.20,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1109,100,,887.20,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1109,100,,887.20,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",12515.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2299.5,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3272.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2345.49,100,,,,,0,"fee schedule",EAPG,2989.36,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",418.09,37.7,,334.47,,,0,"percent of total billed charges","37.70% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",865.02,78,,692.02,,,0,"percent of total billed charges","78% of total billed charges",3945.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",916.03,82.6,,732.82,,,0,"percent of total billed charges","82.6% of total billed charges",2299.5,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",916.03,82.6,,732.82,,,0,"percent of total billed charges","82.6% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2460.03,100,,,,,0,"fee schedule",EAPG,1109,100,,887.20,,,0,"percent of total billed charges","100% of total billed charges",169.68,12515.8,
"43261 ERCP; with biopsy, single or multiple",7963645,CDM,521,RC,43261,CPT,OUTPATIENT,,,1032,670.8,,908.16,88,,726.53,,,0,"percent of total billed charges","88% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2299.5,100,,,,,0,"fee schedule",EAPG,1032,100,,825.60,,,0,"percent of total billed charges","100% of total billed charges",6835.86,175,,,,,0,"fee schedule","175% of CMS fee schedule",2368.49,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",650.16,63,,520.13,,,0,"percent of total billed charges","63% of total billed charges",157.9,15.3,,126.32,,,0,"percent of total billed charges","15.3% of total billed charges",2299.5,100,,,,,0,"fee schedule",EAPG,712.08,69,,,,,0,"fee schedule","69% of total billed charges",1032,100,,825.60,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1032,100,,825.60,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1032,100,,825.60,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",12515.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2299.5,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3272.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2345.49,100,,,,,0,"fee schedule",EAPG,2989.36,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",389.06,37.7,,311.25,,,0,"percent of total billed charges","37.70% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",804.96,78,,643.97,,,0,"percent of total billed charges","78% of total billed charges",3945.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",852.43,82.6,,681.94,,,0,"percent of total billed charges","82.6% of total billed charges",2299.5,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",852.43,82.6,,681.94,,,0,"percent of total billed charges","82.6% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2460.03,100,,,,,0,"fee schedule",EAPG,1032,100,,825.60,,,0,"percent of total billed charges","100% of total billed charges",157.9,12515.8,
"43262 ERCP; with sphincterotomy/papillotomy",7963646,CDM,521,RC,43262,CPT,OUTPATIENT,,,1089,707.85,,958.32,88,,766.66,,,0,"percent of total billed charges","88% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2299.5,100,,,,,0,"fee schedule",EAPG,1089,100,,871.20,,,0,"percent of total billed charges","100% of total billed charges",6835.86,175,,,,,0,"fee schedule","175% of CMS fee schedule",2368.49,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.07,63,,548.86,,,0,"percent of total billed charges","63% of total billed charges",166.62,15.3,,133.30,,,0,"percent of total billed charges","15.3% of total billed charges",2299.5,100,,,,,0,"fee schedule",EAPG,751.41,69,,,,,0,"fee schedule","69% of total billed charges",1089,100,,871.20,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1089,100,,871.20,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1089,100,,871.20,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",12515.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2299.5,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3272.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2345.49,100,,,,,0,"fee schedule",EAPG,2989.36,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",410.55,37.7,,328.44,,,0,"percent of total billed charges","37.70% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",849.42,78,,679.54,,,0,"percent of total billed charges","78% of total billed charges",3945.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",899.51,82.6,,719.61,,,0,"percent of total billed charges","82.6% of total billed charges",2299.5,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",899.51,82.6,,719.61,,,0,"percent of total billed charges","82.6% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2460.03,100,,,,,0,"fee schedule",EAPG,1089,100,,871.20,,,0,"percent of total billed charges","100% of total billed charges",166.62,12515.8,
"43270 ERCP; with destruction of calculi, any metho",7961618,CDM,521,RC,43270,CPT,OUTPATIENT,,,715,464.75,,629.2,88,,503.36,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1867.66,100,,,,,0,"fee schedule",EAPG,715,100,,572.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",1923.69,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",450.45,63,,360.36,,,0,"percent of total billed charges","63% of total billed charges",109.4,15.3,,87.52,,,0,"percent of total billed charges","15.3% of total billed charges",1867.66,100,,,,,0,"fee schedule",EAPG,493.35,69,,,,,0,"fee schedule","69% of total billed charges",715,100,,572.00,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",715,100,,572.00,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",715,100,,572.00,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1867.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1905.02,100,,,,,0,"fee schedule",EAPG,2427.97,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",269.56,37.7,,215.65,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",557.7,78,,446.16,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",590.59,82.6,,472.47,,,0,"percent of total billed charges","82.6% of total billed charges",1867.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",590.59,82.6,,472.47,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2028.19,100,,,,,0,"fee schedule",EAPG,715,100,,572.00,,,0,"percent of total billed charges","100% of total billed charges",109.4,6601.69,
"43276 Endoscopic retrograde cholangiopancreatograp",7962008,CDM,521,RC,43276,CPT,OUTPATIENT,,,1461,949.65,,1285.68,88,,1028.54,,,0,"percent of total billed charges","88% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3870.92,100,,,,,0,"fee schedule",EAPG,1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",10172.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",3987.05,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",920.43,63,,736.34,,,0,"percent of total billed charges","63% of total billed charges",223.53,15.3,,178.82,,,0,"percent of total billed charges","15.3% of total billed charges",3870.92,100,,,,,0,"fee schedule",EAPG,1008.09,69,,,,,0,"fee schedule","69% of total billed charges",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",20428.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3870.92,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5340.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3948.34,100,,,,,0,"fee schedule",EAPG,5032.19,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",550.8,37.7,,440.64,,,0,"percent of total billed charges","37.70% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1139.58,78,,911.66,,,0,"percent of total billed charges","78% of total billed charges",5871.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1206.79,82.6,,965.43,,,0,"percent of total billed charges","82.6% of total billed charges",3870.92,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1206.79,82.6,,965.43,,,0,"percent of total billed charges","82.6% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4031.45,100,,,,,0,"fee schedule",EAPG,1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",223.53,20428.51,
"43274 Endoscopic retrograde cholangiopancreatograp",7962065,CDM,521,RC,43274,CPT,OUTPATIENT,,,1404,912.6,,1235.52,88,,988.42,,,0,"percent of total billed charges","88% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3870.92,100,,,,,0,"fee schedule",EAPG,1404,100,,1123.20,,,0,"percent of total billed charges","100% of total billed charges",10172.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",3987.05,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",884.52,63,,707.62,,,0,"percent of total billed charges","63% of total billed charges",214.81,15.3,,171.85,,,0,"percent of total billed charges","15.3% of total billed charges",3870.92,100,,,,,0,"fee schedule",EAPG,968.76,69,,,,,0,"fee schedule","69% of total billed charges",1404,100,,1123.20,,,0,"percent of total billed charges","100% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1404,100,,1123.20,,,0,"percent of total billed charges","100% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1404,100,,1123.20,,,0,"percent of total billed charges","100% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS fee schedule",20428.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3870.92,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5340.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3948.34,100,,,,,0,"fee schedule",EAPG,5032.19,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",529.31,37.7,,423.45,,,0,"percent of total billed charges","37.70% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1095.12,78,,876.10,,,0,"percent of total billed charges","78% of total billed charges",5871.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1159.7,82.6,,927.76,,,0,"percent of total billed charges","82.6% of total billed charges",3870.92,100,,,,,0,"fee schedule",EAPG,5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1159.7,82.6,,927.76,,,0,"percent of total billed charges","82.6% of total billed charges",5813.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4031.45,100,,,,,0,"fee schedule",EAPG,1404,100,,1123.20,,,0,"percent of total billed charges","100% of total billed charges",214.81,20428.51,
"43277 Endoscopic retrograde cholangiopancreatograp",7962078,CDM,521,RC,43277,CPT,OUTPATIENT,,,1152,748.8,,1013.76,88,,811.01,,,0,"percent of total billed charges","88% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3870.92,100,,,,,0,"fee schedule",EAPG,1152,100,,921.60,,,0,"percent of total billed charges","100% of total billed charges",6835.86,175,,,,,0,"fee schedule","175% of CMS fee schedule",3987.05,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",725.76,63,,580.61,,,0,"percent of total billed charges","63% of total billed charges",176.26,15.3,,141.01,,,0,"percent of total billed charges","15.3% of total billed charges",3870.92,100,,,,,0,"fee schedule",EAPG,794.88,69,,,,,0,"fee schedule","69% of total billed charges",1152,100,,921.60,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1152,100,,921.60,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1152,100,,921.60,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",12515.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3870.92,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3272.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3948.34,100,,,,,0,"fee schedule",EAPG,5032.19,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",434.3,37.7,,347.44,,,0,"percent of total billed charges","37.70% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",898.56,78,,718.85,,,0,"percent of total billed charges","78% of total billed charges",3945.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",951.55,82.6,,761.24,,,0,"percent of total billed charges","82.6% of total billed charges",3870.92,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",951.55,82.6,,761.24,,,0,"percent of total billed charges","82.6% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4031.45,100,,,,,0,"fee schedule",EAPG,1152,100,,921.60,,,0,"percent of total billed charges","100% of total billed charges",176.26,12515.8,
"43278 Endoscopic retrograde cholangiopancreatograp",7962088,CDM,521,RC,43278,CPT,OUTPATIENT,,,1314,854.1,,1156.32,88,,925.06,,,0,"percent of total billed charges","88% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3870.92,100,,,,,0,"fee schedule",EAPG,1314,100,,1051.20,,,0,"percent of total billed charges","100% of total billed charges",6835.86,175,,,,,0,"fee schedule","175% of CMS fee schedule",3987.05,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.82,63,,662.26,,,0,"percent of total billed charges","63% of total billed charges",201.04,15.3,,160.83,,,0,"percent of total billed charges","15.3% of total billed charges",3870.92,100,,,,,0,"fee schedule",EAPG,906.66,69,,,,,0,"fee schedule","69% of total billed charges",1314,100,,1051.20,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1314,100,,1051.20,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1314,100,,1051.20,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",12515.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3870.92,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3272.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3948.34,100,,,,,0,"fee schedule",EAPG,5032.19,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",495.38,37.7,,396.30,,,0,"percent of total billed charges","37.70% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1024.92,78,,819.94,,,0,"percent of total billed charges","78% of total billed charges",3945.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1085.36,82.6,,868.29,,,0,"percent of total billed charges","82.6% of total billed charges",3870.92,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1085.36,82.6,,868.29,,,0,"percent of total billed charges","82.6% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4031.45,100,,,,,0,"fee schedule",EAPG,1314,100,,1051.20,,,0,"percent of total billed charges","100% of total billed charges",201.04,12515.8,
"43275 Endoscopic retrograde cholangiopancreatograp",7962129,CDM,521,RC,43275,CPT,OUTPATIENT,,,1145,744.25,,1007.6,88,,806.08,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2299.5,100,,,,,0,"fee schedule",EAPG,1145,100,,916.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",2368.49,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",721.35,63,,577.08,,,0,"percent of total billed charges","63% of total billed charges",175.19,15.3,,140.15,,,0,"percent of total billed charges","15.3% of total billed charges",2299.5,100,,,,,0,"fee schedule",EAPG,790.05,69,,,,,0,"fee schedule","69% of total billed charges",1145,100,,916.00,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1145,100,,916.00,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1145,100,,916.00,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",12515.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2299.5,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3272.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2345.49,100,,,,,0,"fee schedule",EAPG,2989.36,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",431.67,37.7,,345.34,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",893.1,78,,714.48,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",945.77,82.6,,756.62,,,0,"percent of total billed charges","82.6% of total billed charges",2299.5,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",945.77,82.6,,756.62,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2460.03,100,,,,,0,"fee schedule",EAPG,1145,100,,916.00,,,0,"percent of total billed charges","100% of total billed charges",175.19,12515.8,
"43273 Endoscopic cannulation of papilla with direc",7962218,CDM,521,RC,43273,CPT,OUTPATIENT,,,358,232.7,,315.04,88,,252.03,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",3870.92,100,,,,,0,"fee schedule",EAPG,358,100,,286.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3987.05,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",225.54,63,,180.43,,,0,"percent of total billed charges","63% of total billed charges",54.77,15.3,,43.82,,,0,"percent of total billed charges","15.3% of total billed charges",3870.92,100,,,,,0,"fee schedule",EAPG,247.02,69,,,,,0,"fee schedule","69% of total billed charges",358,100,,286.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",358,100,,286.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",358,100,,286.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.42,61.85,,177.14,,,0,"percent of total billed charges","61.5% of total billed charges",3870.92,100,,,,,0,"fee schedule",EAPG,179,50,,143.20,,,0,"percent of total billed charges","50% of total billed charges",115.28,32.2,,92.22,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3948.34,100,,,,,0,"fee schedule",EAPG,5032.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",134.97,37.7,,107.98,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",279.24,78,,223.39,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.71,82.6,,236.57,,,0,"percent of total billed charges","82.6% of total billed charges",3870.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",295.71,82.6,,236.57,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4031.45,100,,,,,0,"fee schedule",EAPG,358,100,,286.40,,,0,"percent of total billed charges","100% of total billed charges",54.77,5032.19,
"43279 Laparoscopy, surgical, esophagomyotomy (Hell",7962269,CDM,521,RC,43279,CPT,OUTPATIENT,,,3650,2372.5,,3212,88,,2569.60,,,0,"percent of total billed charges","88% of total billed charges",3650,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4719.78,100,,,,,0,"fee schedule",EAPG,3650,100,,2920.00,,,0,"percent of total billed charges","100% of total billed charges",3650,175,,,,,0,"fee schedule","175% of CMS fee schedule",4861.37,100,,,,,0,"fee schedule",EAPG,3650,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2299.5,63,,1839.60,,,0,"percent of total billed charges","63% of total billed charges",558.45,15.3,,446.76,,,0,"percent of total billed charges","15.3% of total billed charges",4719.78,100,,,,,0,"fee schedule",EAPG,2518.5,69,,,,,0,"fee schedule","69% of total billed charges",3650,100,,2920.00,,,0,"percent of total billed charges","100% of total billed charges",3650,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3650,100,,2920.00,,,0,"percent of total billed charges","100% of total billed charges",3650,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3650,100,,2920.00,,,0,"percent of total billed charges","100% of total billed charges",3650,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3650,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4719.78,100,,,,,0,"fee schedule",EAPG,3650,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3650,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3650,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4814.17,100,,,,,0,"fee schedule",EAPG,6135.71,100,,,,,0,"fee schedule",EAPG,3650,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1376.05,37.7,,1100.84,,,0,"percent of total billed charges","37.70% of total billed charges",3650,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3650,100,,,,,0,"fee schedule","100% of CMS fee schedule",2847,78,,2277.60,,,0,"percent of total billed charges","78% of total billed charges",3650,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3014.9,82.6,,2411.92,,,0,"percent of total billed charges","82.6% of total billed charges",4719.78,100,,,,,0,"fee schedule",EAPG,3650,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3014.9,82.6,,2411.92,,,0,"percent of total billed charges","82.6% of total billed charges",3650,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4880.31,100,,,,,0,"fee schedule",EAPG,3650,100,,2920.00,,,0,"percent of total billed charges","100% of total billed charges",558.45,6135.71,
"43280 Laparoscopy, surgical, esophagogastric fundo",7962418,CDM,521,RC,43280,CPT,OUTPATIENT,,,4411,2867.15,,3881.68,88,,3105.34,,,0,"percent of total billed charges","88% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4719.78,100,,,,,0,"fee schedule",EAPG,4411,100,,3528.80,,,0,"percent of total billed charges","100% of total billed charges",18373.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",4861.37,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2778.93,63,,2223.14,,,0,"percent of total billed charges","63% of total billed charges",674.88,15.3,,539.90,,,0,"percent of total billed charges","15.3% of total billed charges",4719.78,100,,,,,0,"fee schedule",EAPG,3043.59,69,,,,,0,"fee schedule","69% of total billed charges",4411,100,,3528.80,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4411,100,,3528.80,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4411,100,,3528.80,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",36187.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4719.78,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9460.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4814.17,100,,,,,0,"fee schedule",EAPG,6135.71,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1662.95,37.7,,1330.36,,,0,"percent of total billed charges","37.70% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3440.58,78,,2752.46,,,0,"percent of total billed charges","78% of total billed charges",10604.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3643.49,82.6,,2914.79,,,0,"percent of total billed charges","82.6% of total billed charges",4719.78,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3643.49,82.6,,2914.79,,,0,"percent of total billed charges","82.6% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4880.31,100,,,,,0,"fee schedule",EAPG,4411,100,,3528.80,,,0,"percent of total billed charges","100% of total billed charges",674.88,36187.64,
"43282 Laparoscopy, surgical, repair of paraesophag",7963284,CDM,521,RC,43282,CPT,OUTPATIENT,,,4635,3012.75,,4078.8,88,,3263.04,,,0,"percent of total billed charges","88% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6261.42,100,,,,,0,"fee schedule",EAPG,4635,100,,3708.00,,,0,"percent of total billed charges","100% of total billed charges",18373.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",6449.26,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2920.05,63,,2336.04,,,0,"percent of total billed charges","63% of total billed charges",709.16,15.3,,567.33,,,0,"percent of total billed charges","15.3% of total billed charges",6261.42,100,,,,,0,"fee schedule",EAPG,3198.15,69,,,,,0,"fee schedule","69% of total billed charges",4635,100,,3708.00,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4635,100,,3708.00,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4635,100,,3708.00,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",36187.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6261.42,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9460.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6386.65,100,,,,,0,"fee schedule",EAPG,8139.85,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1747.4,37.7,,1397.92,,,0,"percent of total billed charges","37.70% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3615.3,78,,2892.24,,,0,"percent of total billed charges","78% of total billed charges",10604.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3828.51,82.6,,3062.81,,,0,"percent of total billed charges","82.6% of total billed charges",6261.42,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3828.51,82.6,,3062.81,,,0,"percent of total billed charges","82.6% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6421.95,100,,,,,0,"fee schedule",EAPG,4635,100,,3708.00,,,0,"percent of total billed charges","100% of total billed charges",709.16,36187.64,
"43325 Esophagogastric fundoplasty, with fundic pat",7962832,CDM,521,RC,43325,CPT,OUTPATIENT,,,902,586.3,,793.76,88,,635.01,,,0,"percent of total billed charges","88% of total billed charges",902,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4719.78,100,,,,,0,"fee schedule",EAPG,902,100,,721.60,,,0,"percent of total billed charges","100% of total billed charges",902,175,,,,,0,"fee schedule","175% of CMS fee schedule",4861.37,100,,,,,0,"fee schedule",EAPG,902,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",568.26,63,,454.61,,,0,"percent of total billed charges","63% of total billed charges",138.01,15.3,,110.41,,,0,"percent of total billed charges","15.3% of total billed charges",4719.78,100,,,,,0,"fee schedule",EAPG,622.38,69,,,,,0,"fee schedule","69% of total billed charges",902,100,,721.60,,,0,"percent of total billed charges","100% of total billed charges",902,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",902,100,,721.60,,,0,"percent of total billed charges","100% of total billed charges",902,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",902,100,,721.60,,,0,"percent of total billed charges","100% of total billed charges",902,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",902,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4719.78,100,,,,,0,"fee schedule",EAPG,902,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",902,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",902,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4814.17,100,,,,,0,"fee schedule",EAPG,6135.71,100,,,,,0,"fee schedule",EAPG,902,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",340.05,37.7,,272.04,,,0,"percent of total billed charges","37.70% of total billed charges",902,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",902,100,,,,,0,"fee schedule","100% of CMS fee schedule",703.56,78,,562.85,,,0,"percent of total billed charges","78% of total billed charges",902,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",745.05,82.6,,596.04,,,0,"percent of total billed charges","82.6% of total billed charges",4719.78,100,,,,,0,"fee schedule","100% of WA fee schedule",902,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",745.05,82.6,,596.04,,,0,"percent of total billed charges","82.6% of total billed charges",902,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4880.31,100,,,,,0,"fee schedule",EAPG,902,100,,721.60,,,0,"percent of total billed charges","100% of total billed charges",138.01,6135.71,
"43328 Esophagogastric fundoplasty partial or compl",7963127,CDM,521,RC,43328,CPT,OUTPATIENT,,,4055,2635.75,,3568.4,88,,2854.72,,,0,"percent of total billed charges","88% of total billed charges",4055,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4719.78,100,,,,,0,"fee schedule",EAPG,4055,100,,3244.00,,,0,"percent of total billed charges","100% of total billed charges",4055,175,,,,,0,"fee schedule","175% of CMS fee schedule",4861.37,100,,,,,0,"fee schedule",EAPG,4055,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2554.65,63,,2043.72,,,0,"percent of total billed charges","63% of total billed charges",620.42,15.3,,496.34,,,0,"percent of total billed charges","15.3% of total billed charges",4719.78,100,,,,,0,"fee schedule",EAPG,2797.95,69,,,,,0,"fee schedule","69% of total billed charges",4055,100,,3244.00,,,0,"percent of total billed charges","100% of total billed charges",4055,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4055,100,,3244.00,,,0,"percent of total billed charges","100% of total billed charges",4055,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4055,100,,3244.00,,,0,"percent of total billed charges","100% of total billed charges",4055,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4055,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4719.78,100,,,,,0,"fee schedule",EAPG,4055,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4055,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4055,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4814.17,100,,,,,0,"fee schedule",EAPG,6135.71,100,,,,,0,"fee schedule",EAPG,4055,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1528.74,37.7,,1222.99,,,0,"percent of total billed charges","37.70% of total billed charges",4055,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4055,100,,,,,0,"fee schedule","100% of CMS fee schedule",3162.9,78,,2530.32,,,0,"percent of total billed charges","78% of total billed charges",4055,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3349.43,82.6,,2679.54,,,0,"percent of total billed charges","82.6% of total billed charges",4719.78,100,,,,,0,"fee schedule","100% of WA fee schedule",4055,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3349.43,82.6,,2679.54,,,0,"percent of total billed charges","82.6% of total billed charges",4055,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4880.31,100,,,,,0,"fee schedule",EAPG,4055,100,,3244.00,,,0,"percent of total billed charges","100% of total billed charges",620.42,6135.71,
"43327 Esophagogastric fundoplasty partial or compl",7963146,CDM,521,RC,43327,CPT,OUTPATIENT,,,2771,1801.15,,2438.48,88,,1950.78,,,0,"percent of total billed charges","88% of total billed charges",2771,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4719.78,100,,,,,0,"fee schedule",EAPG,2771,100,,2216.80,,,0,"percent of total billed charges","100% of total billed charges",2771,175,,,,,0,"fee schedule","175% of CMS fee schedule",4861.37,100,,,,,0,"fee schedule",EAPG,2771,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1745.73,63,,1396.58,,,0,"percent of total billed charges","63% of total billed charges",423.96,15.3,,339.17,,,0,"percent of total billed charges","15.3% of total billed charges",4719.78,100,,,,,0,"fee schedule",EAPG,1911.99,69,,,,,0,"fee schedule","69% of total billed charges",2771,100,,2216.80,,,0,"percent of total billed charges","100% of total billed charges",2771,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2771,100,,2216.80,,,0,"percent of total billed charges","100% of total billed charges",2771,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2771,100,,2216.80,,,0,"percent of total billed charges","100% of total billed charges",2771,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2771,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4719.78,100,,,,,0,"fee schedule",EAPG,2771,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2771,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2771,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4814.17,100,,,,,0,"fee schedule",EAPG,6135.71,100,,,,,0,"fee schedule",EAPG,2771,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1044.67,37.7,,835.74,,,0,"percent of total billed charges","37.70% of total billed charges",2771,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2771,100,,,,,0,"fee schedule","100% of CMS fee schedule",2161.38,78,,1729.10,,,0,"percent of total billed charges","78% of total billed charges",2771,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2288.85,82.6,,1831.08,,,0,"percent of total billed charges","82.6% of total billed charges",4719.78,100,,,,,0,"fee schedule","100% of WA fee schedule",2771,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2288.85,82.6,,1831.08,,,0,"percent of total billed charges","82.6% of total billed charges",2771,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4880.31,100,,,,,0,"fee schedule",EAPG,2771,100,,2216.80,,,0,"percent of total billed charges","100% of total billed charges",423.96,6135.71,
"43335 Repair, paraesophageal hiatal hernia (incl f",7961619,CDM,521,RC,43335,CPT,OUTPATIENT,,,4646,3019.9,,4088.48,88,,3270.78,,,0,"percent of total billed charges","88% of total billed charges",4646,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6261.42,100,,,,,0,"fee schedule",EAPG,4646,100,,3716.80,,,0,"percent of total billed charges","100% of total billed charges",4646,175,,,,,0,"fee schedule","175% of CMS fee schedule",6449.26,100,,,,,0,"fee schedule",EAPG,4646,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2926.98,63,,2341.58,,,0,"percent of total billed charges","63% of total billed charges",710.84,15.3,,568.67,,,0,"percent of total billed charges","15.3% of total billed charges",6261.42,100,,,,,0,"fee schedule",EAPG,3205.74,69,,,,,0,"fee schedule","69% of total billed charges",4646,100,,3716.80,,,0,"percent of total billed charges","100% of total billed charges",4646,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4646,100,,3716.80,,,0,"percent of total billed charges","100% of total billed charges",4646,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4646,100,,3716.80,,,0,"percent of total billed charges","100% of total billed charges",4646,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4646,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6261.42,100,,,,,0,"fee schedule",EAPG,4646,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4646,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4646,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6386.65,100,,,,,0,"fee schedule",EAPG,8139.85,100,,,,,0,"fee schedule",EAPG,4646,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1751.54,37.7,,1401.23,,,0,"percent of total billed charges","37.70% of total billed charges",4646,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4646,100,,,,,0,"fee schedule","100% of CMS fee schedule",3623.88,78,,2899.10,,,0,"percent of total billed charges","78% of total billed charges",4646,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3837.6,82.6,,3070.08,,,0,"percent of total billed charges","82.6% of total billed charges",6261.42,100,,,,,0,"fee schedule",EAPG,4646,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3837.6,82.6,,3070.08,,,0,"percent of total billed charges","82.6% of total billed charges",4646,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6421.95,100,,,,,0,"fee schedule",EAPG,4646,100,,3716.80,,,0,"percent of total billed charges","100% of total billed charges",710.84,8139.85,
"43332 Repair, paraesophageal hiatal hernia, via la",7962852,CDM,521,RC,43332,CPT,OUTPATIENT,,,3944,2563.6,,3470.72,88,,2776.58,,,0,"percent of total billed charges","88% of total billed charges",3944,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6261.42,100,,,,,0,"fee schedule",EAPG,3944,100,,3155.20,,,0,"percent of total billed charges","100% of total billed charges",3944,175,,,,,0,"fee schedule","175% of CMS fee schedule",6449.26,100,,,,,0,"fee schedule",EAPG,3944,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2484.72,63,,1987.78,,,0,"percent of total billed charges","63% of total billed charges",603.43,15.3,,482.74,,,0,"percent of total billed charges","15.3% of total billed charges",6261.42,100,,,,,0,"fee schedule",EAPG,2721.36,69,,,,,0,"fee schedule","69% of total billed charges",3944,100,,3155.20,,,0,"percent of total billed charges","100% of total billed charges",3944,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3944,100,,3155.20,,,0,"percent of total billed charges","100% of total billed charges",3944,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3944,100,,3155.20,,,0,"percent of total billed charges","100% of total billed charges",3944,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3944,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6261.42,100,,,,,0,"fee schedule",EAPG,3944,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3944,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3944,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6386.65,100,,,,,0,"fee schedule",EAPG,8139.85,100,,,,,0,"fee schedule",EAPG,3944,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1486.89,37.7,,1189.51,,,0,"percent of total billed charges","37.70% of total billed charges",3944,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3944,100,,,,,0,"fee schedule","100% of CMS fee schedule",3076.32,78,,2461.06,,,0,"percent of total billed charges","78% of total billed charges",3944,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3257.74,82.6,,2606.19,,,0,"percent of total billed charges","82.6% of total billed charges",6261.42,100,,,,,0,"fee schedule",EAPG,3944,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3257.74,82.6,,2606.19,,,0,"percent of total billed charges","82.6% of total billed charges",3944,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6421.95,100,,,,,0,"fee schedule",EAPG,3944,100,,3155.20,,,0,"percent of total billed charges","100% of total billed charges",603.43,8139.85,
"43331 Esophagomyotomy (Heller type); thoracic appr",7963427,CDM,521,RC,43331,CPT,OUTPATIENT,,,3904,2537.6,,3435.52,88,,2748.42,,,0,"percent of total billed charges","88% of total billed charges",3904,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4719.78,100,,,,,0,"fee schedule",EAPG,3904,100,,3123.20,,,0,"percent of total billed charges","100% of total billed charges",3904,175,,,,,0,"fee schedule","175% of CMS fee schedule",4861.37,100,,,,,0,"fee schedule",EAPG,3904,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2459.52,63,,1967.62,,,0,"percent of total billed charges","63% of total billed charges",597.31,15.3,,477.85,,,0,"percent of total billed charges","15.3% of total billed charges",4719.78,100,,,,,0,"fee schedule",EAPG,2693.76,69,,,,,0,"fee schedule","69% of total billed charges",3904,100,,3123.20,,,0,"percent of total billed charges","100% of total billed charges",3904,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3904,100,,3123.20,,,0,"percent of total billed charges","100% of total billed charges",3904,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3904,100,,3123.20,,,0,"percent of total billed charges","100% of total billed charges",3904,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3904,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4719.78,100,,,,,0,"fee schedule",EAPG,3904,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3904,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3904,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4814.17,100,,,,,0,"fee schedule",EAPG,6135.71,100,,,,,0,"fee schedule",EAPG,3904,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1471.81,37.7,,1177.45,,,0,"percent of total billed charges","37.70% of total billed charges",3904,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3904,100,,,,,0,"fee schedule","100% of CMS fee schedule",3045.12,78,,2436.10,,,0,"percent of total billed charges","78% of total billed charges",3904,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3224.7,82.6,,2579.76,,,0,"percent of total billed charges","82.6% of total billed charges",4719.78,100,,,,,0,"fee schedule","100% of WA fee schedule",3904,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3224.7,82.6,,2579.76,,,0,"percent of total billed charges","82.6% of total billed charges",3904,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4880.31,100,,,,,0,"fee schedule",EAPG,3904,100,,3123.20,,,0,"percent of total billed charges","100% of total billed charges",597.31,6135.71,
"43450 Dilation of esophagus, by unguided sound or",7962565,CDM,521,RC,43450,CPT,OUTPATIENT,,,251,163.15,,220.88,88,,176.70,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,251,100,,200.80,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",624,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.13,63,,126.50,,,0,"percent of total billed charges","63% of total billed charges",38.4,15.3,,30.72,,,0,"percent of total billed charges","15.3% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,173.19,69,,,,,0,"fee schedule","69% of total billed charges",251,100,,200.80,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",251,100,,200.80,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",251,100,,200.80,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",617.95,100,,,,,0,"fee schedule",EAPG,787.58,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",94.63,37.7,,75.70,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",195.78,78,,156.62,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",207.33,82.6,,165.86,,,0,"percent of total billed charges","82.6% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",207.33,82.6,,165.86,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",766.36,100,,,,,0,"fee schedule",EAPG,251,100,,200.80,,,0,"percent of total billed charges","100% of total billed charges",38.4,3289.02,
"43500 Gastrotomy; with exploration or foreign body",7963332,CDM,521,RC,43500,CPT,OUTPATIENT,,,2234,1452.1,,1965.92,88,,1572.74,,,0,"percent of total billed charges","88% of total billed charges",2234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2897.21,100,,,,,0,"fee schedule",EAPG,2234,100,,1787.20,,,0,"percent of total billed charges","100% of total billed charges",2234,175,,,,,0,"fee schedule","175% of CMS fee schedule",2984.13,100,,,,,0,"fee schedule",EAPG,2234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1407.42,63,,1125.94,,,0,"percent of total billed charges","63% of total billed charges",341.8,15.3,,273.44,,,0,"percent of total billed charges","15.3% of total billed charges",2897.21,100,,,,,0,"fee schedule",EAPG,1541.46,69,,,,,0,"fee schedule","69% of total billed charges",2234,100,,1787.20,,,0,"percent of total billed charges","100% of total billed charges",2234,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2234,100,,1787.20,,,0,"percent of total billed charges","100% of total billed charges",2234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2234,100,,1787.20,,,0,"percent of total billed charges","100% of total billed charges",2234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2897.21,100,,,,,0,"fee schedule",EAPG,2234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2955.15,100,,,,,0,"fee schedule",EAPG,3766.37,100,,,,,0,"fee schedule",EAPG,2234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",842.22,37.7,,673.78,,,0,"percent of total billed charges","37.70% of total billed charges",2234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2234,100,,,,,0,"fee schedule","100% of CMS fee schedule",1742.52,78,,1394.02,,,0,"percent of total billed charges","78% of total billed charges",2234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1845.28,82.6,,1476.22,,,0,"percent of total billed charges","82.6% of total billed charges",2897.21,100,,,,,0,"fee schedule",EAPG,2234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1845.28,82.6,,1476.22,,,0,"percent of total billed charges","82.6% of total billed charges",2234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3057.74,100,,,,,0,"fee schedule",EAPG,2234,100,,1787.20,,,0,"percent of total billed charges","100% of total billed charges",341.8,3766.37,
"43501 Gastrotomy; with suture repair of bleeding u",7963428,CDM,521,RC,43501,CPT,OUTPATIENT,,,4275,2778.75,,3762,88,,3009.60,,,0,"percent of total billed charges","88% of total billed charges",4275,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,4275,100,,3420.00,,,0,"percent of total billed charges","100% of total billed charges",4275,175,,,,,0,"fee schedule","175% of CMS fee schedule",3783.52,100,,,,,0,"fee schedule",EAPG,4275,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2693.25,63,,2154.60,,,0,"percent of total billed charges","63% of total billed charges",654.08,15.3,,523.26,,,0,"percent of total billed charges","15.3% of total billed charges",3673.32,100,,,,,0,"fee schedule",EAPG,2949.75,69,,,,,0,"fee schedule","69% of total billed charges",4275,100,,3420.00,,,0,"percent of total billed charges","100% of total billed charges",4275,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4275,100,,3420.00,,,0,"percent of total billed charges","100% of total billed charges",4275,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4275,100,,3420.00,,,0,"percent of total billed charges","100% of total billed charges",4275,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4275,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,4275,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4275,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4275,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3746.79,100,,,,,0,"fee schedule",EAPG,4775.32,100,,,,,0,"fee schedule",EAPG,4275,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1611.68,37.7,,1289.34,,,0,"percent of total billed charges","37.70% of total billed charges",4275,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4275,100,,,,,0,"fee schedule","100% of CMS fee schedule",3334.5,78,,2667.60,,,0,"percent of total billed charges","78% of total billed charges",4275,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3531.15,82.6,,2824.92,,,0,"percent of total billed charges","82.6% of total billed charges",3673.32,100,,,,,0,"fee schedule","100% of WA fee schedule",4275,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3531.15,82.6,,2824.92,,,0,"percent of total billed charges","82.6% of total billed charges",4275,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3833.85,100,,,,,0,"fee schedule",EAPG,4275,100,,3420.00,,,0,"percent of total billed charges","100% of total billed charges",654.08,4775.32,
"43634 Gastrectomy, partial, distal; with formation",7962951,CDM,521,RC,43634,CPT,OUTPATIENT,,,6103,3966.95,,5370.64,88,,4296.51,,,0,"percent of total billed charges","88% of total billed charges",6103,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6103,175,,,,,0,"fee schedule","175% of CMS fee schedule",3783.52,100,,,,,0,"fee schedule",EAPG,6103,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3844.89,63,,3075.91,,,0,"percent of total billed charges","63% of total billed charges",933.76,15.3,,747.01,,,0,"percent of total billed charges","15.3% of total billed charges",3673.32,100,,,,,0,"fee schedule",EAPG,4211.07,69,,,,,0,"fee schedule","69% of total billed charges",6103,100,,4882.40,,,0,"percent of total billed charges","100% of total billed charges",6103,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6103,100,,4882.40,,,0,"percent of total billed charges","100% of total billed charges",6103,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6103,100,,4882.40,,,0,"percent of total billed charges","100% of total billed charges",6103,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6103,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,6103,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6103,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6103,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3746.79,100,,,,,0,"fee schedule",EAPG,4775.32,100,,,,,0,"fee schedule",EAPG,6103,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2300.83,37.7,,1840.66,,,0,"percent of total billed charges","37.70% of total billed charges",6103,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6103,100,,,,,0,"fee schedule","100% of CMS fee schedule",4760.34,78,,3808.27,,,0,"percent of total billed charges","78% of total billed charges",6103,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5041.08,82.6,,4032.86,,,0,"percent of total billed charges","82.6% of total billed charges",3673.32,100,,,,,0,"fee schedule","100% of WA fee schedule",6103,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5041.08,82.6,,4032.86,,,0,"percent of total billed charges","82.6% of total billed charges",6103,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3833.85,100,,,,,0,"fee schedule",EAPG,6103,100,,4882.40,,,0,"percent of total billed charges","100% of total billed charges",933.76,6103,
"43633 Gastrectomy, partial, distal; with Roux-en-Y",7963147,CDM,521,RC,43633,CPT,OUTPATIENT,,,5516,3585.4,,4854.08,88,,3883.26,,,0,"percent of total billed charges","88% of total billed charges",5516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5516,175,,,,,0,"fee schedule","175% of CMS fee schedule",3783.52,100,,,,,0,"fee schedule",EAPG,5516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3475.08,63,,2780.06,,,0,"percent of total billed charges","63% of total billed charges",843.95,15.3,,675.16,,,0,"percent of total billed charges","15.3% of total billed charges",3673.32,100,,,,,0,"fee schedule",EAPG,3806.04,69,,,,,0,"fee schedule","69% of total billed charges",5516,100,,4412.80,,,0,"percent of total billed charges","100% of total billed charges",5516,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5516,100,,4412.80,,,0,"percent of total billed charges","100% of total billed charges",5516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5516,100,,4412.80,,,0,"percent of total billed charges","100% of total billed charges",5516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,5516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3746.79,100,,,,,0,"fee schedule",EAPG,4775.32,100,,,,,0,"fee schedule",EAPG,5516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2079.53,37.7,,1663.62,,,0,"percent of total billed charges","37.70% of total billed charges",5516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5516,100,,,,,0,"fee schedule","100% of CMS fee schedule",4302.48,78,,3441.98,,,0,"percent of total billed charges","78% of total billed charges",5516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4556.22,82.6,,3644.98,,,0,"percent of total billed charges","82.6% of total billed charges",3673.32,100,,,,,0,"fee schedule","100% of WA fee schedule",5516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4556.22,82.6,,3644.98,,,0,"percent of total billed charges","82.6% of total billed charges",5516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3833.85,100,,,,,0,"fee schedule",EAPG,5516,100,,4412.80,,,0,"percent of total billed charges","100% of total billed charges",843.95,5516,
"43631 Gastrectomy, partial, distal; with gastroduo",7963308,CDM,521,RC,43631,CPT,OUTPATIENT,,,4173,2712.45,,3672.24,88,,2937.79,,,0,"percent of total billed charges","88% of total billed charges",4173,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,4173,100,,3338.40,,,0,"percent of total billed charges","100% of total billed charges",4173,175,,,,,0,"fee schedule","175% of CMS fee schedule",3783.52,100,,,,,0,"fee schedule",EAPG,4173,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2628.99,63,,2103.19,,,0,"percent of total billed charges","63% of total billed charges",638.47,15.3,,510.78,,,0,"percent of total billed charges","15.3% of total billed charges",3673.32,100,,,,,0,"fee schedule",EAPG,2879.37,69,,,,,0,"fee schedule","69% of total billed charges",4173,100,,3338.40,,,0,"percent of total billed charges","100% of total billed charges",4173,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4173,100,,3338.40,,,0,"percent of total billed charges","100% of total billed charges",4173,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4173,100,,3338.40,,,0,"percent of total billed charges","100% of total billed charges",4173,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4173,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,4173,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4173,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4173,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3746.79,100,,,,,0,"fee schedule",EAPG,4775.32,100,,,,,0,"fee schedule",EAPG,4173,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1573.22,37.7,,1258.58,,,0,"percent of total billed charges","37.70% of total billed charges",4173,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4173,100,,,,,0,"fee schedule","100% of CMS fee schedule",3254.94,78,,2603.95,,,0,"percent of total billed charges","78% of total billed charges",4173,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3446.9,82.6,,2757.52,,,0,"percent of total billed charges","82.6% of total billed charges",3673.32,100,,,,,0,"fee schedule","100% of WA fee schedule",4173,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3446.9,82.6,,2757.52,,,0,"percent of total billed charges","82.6% of total billed charges",4173,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3833.85,100,,,,,0,"fee schedule",EAPG,4173,100,,3338.40,,,0,"percent of total billed charges","100% of total billed charges",638.47,4775.32,
"43632 Gastrectomy, partial, distal; with gastrojej",7963333,CDM,521,RC,43632,CPT,OUTPATIENT,,,5836,3793.4,,5135.68,88,,4108.54,,,0,"percent of total billed charges","88% of total billed charges",5836,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5836,175,,,,,0,"fee schedule","175% of CMS fee schedule",3783.52,100,,,,,0,"fee schedule",EAPG,5836,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3676.68,63,,2941.34,,,0,"percent of total billed charges","63% of total billed charges",892.91,15.3,,714.33,,,0,"percent of total billed charges","15.3% of total billed charges",3673.32,100,,,,,0,"fee schedule",EAPG,4026.84,69,,,,,0,"fee schedule","69% of total billed charges",5836,100,,4668.80,,,0,"percent of total billed charges","100% of total billed charges",5836,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5836,100,,4668.80,,,0,"percent of total billed charges","100% of total billed charges",5836,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5836,100,,4668.80,,,0,"percent of total billed charges","100% of total billed charges",5836,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5836,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,5836,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5836,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5836,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3746.79,100,,,,,0,"fee schedule",EAPG,4775.32,100,,,,,0,"fee schedule",EAPG,5836,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2200.17,37.7,,1760.14,,,0,"percent of total billed charges","37.70% of total billed charges",5836,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5836,100,,,,,0,"fee schedule","100% of CMS fee schedule",4552.08,78,,3641.66,,,0,"percent of total billed charges","78% of total billed charges",5836,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4820.54,82.6,,3856.43,,,0,"percent of total billed charges","82.6% of total billed charges",3673.32,100,,,,,0,"fee schedule","100% of WA fee schedule",5836,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4820.54,82.6,,3856.43,,,0,"percent of total billed charges","82.6% of total billed charges",5836,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3833.85,100,,,,,0,"fee schedule",EAPG,5836,100,,4668.80,,,0,"percent of total billed charges","100% of total billed charges",892.91,5836,
"43640 Vagotomy including pyloroplasty, with or wit",7962419,CDM,521,RC,43640,CPT,OUTPATIENT,,,2284,1484.6,,2009.92,88,,1607.94,,,0,"percent of total billed charges","88% of total billed charges",2284,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2897.21,100,,,,,0,"fee schedule",EAPG,2284,100,,1827.20,,,0,"percent of total billed charges","100% of total billed charges",2284,175,,,,,0,"fee schedule","175% of CMS fee schedule",2984.13,100,,,,,0,"fee schedule",EAPG,2284,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1438.92,63,,1151.14,,,0,"percent of total billed charges","63% of total billed charges",349.45,15.3,,279.56,,,0,"percent of total billed charges","15.3% of total billed charges",2897.21,100,,,,,0,"fee schedule",EAPG,1575.96,69,,,,,0,"fee schedule","69% of total billed charges",2284,100,,1827.20,,,0,"percent of total billed charges","100% of total billed charges",2284,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2284,100,,1827.20,,,0,"percent of total billed charges","100% of total billed charges",2284,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2284,100,,1827.20,,,0,"percent of total billed charges","100% of total billed charges",2284,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2284,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2897.21,100,,,,,0,"fee schedule",EAPG,2284,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2284,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2284,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2955.15,100,,,,,0,"fee schedule",EAPG,3766.37,100,,,,,0,"fee schedule",EAPG,2284,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",861.07,37.7,,688.86,,,0,"percent of total billed charges","37.70% of total billed charges",2284,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2284,100,,,,,0,"fee schedule","100% of CMS fee schedule",1781.52,78,,1425.22,,,0,"percent of total billed charges","78% of total billed charges",2284,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1886.58,82.6,,1509.26,,,0,"percent of total billed charges","82.6% of total billed charges",2897.21,100,,,,,0,"fee schedule","100% of WA fee schedule",2284,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1886.58,82.6,,1509.26,,,0,"percent of total billed charges","82.6% of total billed charges",2284,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3057.74,100,,,,,0,"fee schedule",EAPG,2284,100,,1827.20,,,0,"percent of total billed charges","100% of total billed charges",349.45,3766.37,
"43659 Unlisted laparoscopy procedure, stomach",7963606,CDM,521,RC,43659,CPT,OUTPATIENT,,,3707,2409.55,,3262.16,88,,2609.73,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2897.21,100,,,,,0,"fee schedule",EAPG,3707,100,,2965.60,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",2984.13,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2335.41,63,,1868.33,,,0,"percent of total billed charges","63% of total billed charges",567.17,15.3,,453.74,,,0,"percent of total billed charges","15.3% of total billed charges",2897.21,100,,,,,0,"fee schedule",EAPG,2557.83,69,,,,,0,"fee schedule","69% of total billed charges",3707,100,,2965.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3707,100,,2965.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3707,100,,2965.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2897.21,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2955.15,100,,,,,0,"fee schedule",EAPG,3766.37,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1397.54,37.7,,1118.03,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2891.46,78,,2313.17,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3061.98,82.6,,2449.58,,,0,"percent of total billed charges","82.6% of total billed charges",2897.21,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3061.98,82.6,,2449.58,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3057.74,100,,,,,0,"fee schedule",EAPG,3707,100,,2965.60,,,0,"percent of total billed charges","100% of total billed charges",567.17,20558.19,
"43752 Naso- or oro-gastric tube placement, requiri",7961832,CDM,521,RC,43752,CPT,OUTPATIENT,,,143,92.95,,125.84,88,,100.67,,,0,"percent of total billed charges","88% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",711.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",624,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",90.09,63,,72.07,,,0,"percent of total billed charges","63% of total billed charges",21.88,15.3,,17.50,,,0,"percent of total billed charges","15.3% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,98.67,69,,,,,0,"fee schedule","69% of total billed charges",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",1097.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",617.95,100,,,,,0,"fee schedule",EAPG,787.58,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",53.91,37.7,,43.13,,,0,"percent of total billed charges","37.70% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.54,78,,89.23,,,0,"percent of total billed charges","78% of total billed charges",410.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",766.36,100,,,,,0,"fee schedule",EAPG,143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",21.88,1097.77,
"43761 Repositioning of a naso- or oro-gastric feed",7962162,CDM,521,RC,43761,CPT,OUTPATIENT,,,529,343.85,,465.52,88,,372.42,,,0,"percent of total billed charges","88% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,529,100,,423.20,,,0,"percent of total billed charges","100% of total billed charges",441.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",624,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",333.27,63,,266.62,,,0,"percent of total billed charges","63% of total billed charges",80.94,15.3,,64.75,,,0,"percent of total billed charges","15.3% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,365.01,69,,,,,0,"fee schedule","69% of total billed charges",529,100,,423.20,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",529,100,,423.20,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",529,100,,423.20,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1081.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",282.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",617.95,100,,,,,0,"fee schedule",EAPG,787.58,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",199.43,37.7,,159.54,,,0,"percent of total billed charges","37.70% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.62,78,,330.10,,,0,"percent of total billed charges","78% of total billed charges",254.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",436.95,82.6,,349.56,,,0,"percent of total billed charges","82.6% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",436.95,82.6,,349.56,,,0,"percent of total billed charges","82.6% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",766.36,100,,,,,0,"fee schedule",EAPG,529,100,,423.20,,,0,"percent of total billed charges","100% of total billed charges",80.94,1081.19,
"43774 Laparoscopy, gastric restrictive procedure;",7961526,CDM,521,RC,43774,CPT,OUTPATIENT,,,1870,1215.5,,1645.6,88,,1316.48,,,0,"percent of total billed charges","88% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4719.78,100,,,,,0,"fee schedule",EAPG,1870,100,,1496.00,,,0,"percent of total billed charges","100% of total billed charges",6835.86,175,,,,,0,"fee schedule","175% of CMS fee schedule",4861.37,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1178.1,63,,942.48,,,0,"percent of total billed charges","63% of total billed charges",286.11,15.3,,228.89,,,0,"percent of total billed charges","15.3% of total billed charges",4719.78,100,,,,,0,"fee schedule",EAPG,1290.3,69,,,,,0,"fee schedule","69% of total billed charges",1870,100,,1496.00,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1870,100,,1496.00,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1870,100,,1496.00,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",12515.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4719.78,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3272.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4814.17,100,,,,,0,"fee schedule",EAPG,6135.71,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",704.99,37.7,,563.99,,,0,"percent of total billed charges","37.70% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1458.6,78,,1166.88,,,0,"percent of total billed charges","78% of total billed charges",3945.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1544.62,82.6,,1235.70,,,0,"percent of total billed charges","82.6% of total billed charges",4719.78,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1544.62,82.6,,1235.70,,,0,"percent of total billed charges","82.6% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4880.31,100,,,,,0,"fee schedule",EAPG,1870,100,,1496.00,,,0,"percent of total billed charges","100% of total billed charges",286.11,12515.8,
"43775 Laparoscopy, gastric restrictive procedure;",7961620,CDM,521,RC,43775,CPT,OUTPATIENT,,,3299,2144.35,,2903.12,88,,2322.50,,,0,"percent of total billed charges","88% of total billed charges",3299,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2897.21,100,,,,,0,"fee schedule",EAPG,3299,100,,2639.20,,,0,"percent of total billed charges","100% of total billed charges",3299,175,,,,,0,"fee schedule","175% of CMS fee schedule",2984.13,100,,,,,0,"fee schedule",EAPG,3299,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2078.37,63,,1662.70,,,0,"percent of total billed charges","63% of total billed charges",504.75,15.3,,403.80,,,0,"percent of total billed charges","15.3% of total billed charges",2897.21,100,,,,,0,"fee schedule",EAPG,2276.31,69,,,,,0,"fee schedule","69% of total billed charges",3299,100,,2639.20,,,0,"percent of total billed charges","100% of total billed charges",3299,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3299,100,,2639.20,,,0,"percent of total billed charges","100% of total billed charges",3299,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3299,100,,2639.20,,,0,"percent of total billed charges","100% of total billed charges",3299,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3299,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2897.21,100,,,,,0,"fee schedule",EAPG,3299,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3299,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3299,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2955.15,100,,,,,0,"fee schedule",EAPG,3766.37,100,,,,,0,"fee schedule",EAPG,3299,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1243.72,37.7,,994.98,,,0,"percent of total billed charges","37.70% of total billed charges",3299,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3299,100,,,,,0,"fee schedule","100% of CMS fee schedule",2573.22,78,,2058.58,,,0,"percent of total billed charges","78% of total billed charges",3299,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2724.97,82.6,,2179.98,,,0,"percent of total billed charges","82.6% of total billed charges",2897.21,100,,,,,0,"fee schedule","100% of WA fee schedule",3299,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2724.97,82.6,,2179.98,,,0,"percent of total billed charges","82.6% of total billed charges",3299,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3057.74,100,,,,,0,"fee schedule",EAPG,3299,100,,2639.20,,,0,"percent of total billed charges","100% of total billed charges",504.75,3766.37,
"43820 Gastrojejunostomy; without vagotomy",7963681,CDM,521,RC,43820,CPT,OUTPATIENT,,,3643,2367.95,,3205.84,88,,2564.67,,,0,"percent of total billed charges","88% of total billed charges",3643,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,3643,100,,2914.40,,,0,"percent of total billed charges","100% of total billed charges",3643,175,,,,,0,"fee schedule","175% of CMS fee schedule",3783.52,100,,,,,0,"fee schedule",EAPG,3643,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2295.09,63,,1836.07,,,0,"percent of total billed charges","63% of total billed charges",557.38,15.3,,445.90,,,0,"percent of total billed charges","15.3% of total billed charges",3673.32,100,,,,,0,"fee schedule",EAPG,2513.67,69,,,,,0,"fee schedule","69% of total billed charges",3643,100,,2914.40,,,0,"percent of total billed charges","100% of total billed charges",3643,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3643,100,,2914.40,,,0,"percent of total billed charges","100% of total billed charges",3643,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3643,100,,2914.40,,,0,"percent of total billed charges","100% of total billed charges",3643,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3643,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,3643,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3643,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3643,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3746.79,100,,,,,0,"fee schedule",EAPG,4775.32,100,,,,,0,"fee schedule",EAPG,3643,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1373.41,37.7,,1098.73,,,0,"percent of total billed charges","37.70% of total billed charges",3643,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3643,100,,,,,0,"fee schedule","100% of CMS fee schedule",2841.54,78,,2273.23,,,0,"percent of total billed charges","78% of total billed charges",3643,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3009.12,82.6,,2407.30,,,0,"percent of total billed charges","82.6% of total billed charges",3673.32,100,,,,,0,"fee schedule","100% of WA fee schedule",3643,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3009.12,82.6,,2407.30,,,0,"percent of total billed charges","82.6% of total billed charges",3643,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3833.85,100,,,,,0,"fee schedule",EAPG,3643,100,,2914.40,,,0,"percent of total billed charges","100% of total billed charges",557.38,4775.32,
"43830 Gastrostomy, open; without construction of g",7962533,CDM,521,RC,43830,CPT,OUTPATIENT,,,1965,1277.25,,1729.2,88,,1383.36,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2897.21,100,,,,,0,"fee schedule",EAPG,1965,100,,1572.00,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",2984.13,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1237.95,63,,990.36,,,0,"percent of total billed charges","63% of total billed charges",300.65,15.3,,240.52,,,0,"percent of total billed charges","15.3% of total billed charges",2897.21,100,,,,,0,"fee schedule",EAPG,1355.85,69,,,,,0,"fee schedule","69% of total billed charges",1965,100,,1572.00,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1965,100,,1572.00,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1965,100,,1572.00,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2897.21,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2955.15,100,,,,,0,"fee schedule",EAPG,3766.37,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",740.81,37.7,,592.65,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1532.7,78,,1226.16,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1623.09,82.6,,1298.47,,,0,"percent of total billed charges","82.6% of total billed charges",2897.21,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1623.09,82.6,,1298.47,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3057.74,100,,,,,0,"fee schedule",EAPG,1965,100,,1572.00,,,0,"percent of total billed charges","100% of total billed charges",300.65,6601.69,
"43840 Gastrorrhaphy, suture of perforated duodenal",7962503,CDM,521,RC,43840,CPT,OUTPATIENT,,,3939,2560.35,,3466.32,88,,2773.06,,,0,"percent of total billed charges","88% of total billed charges",3939,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3673.32,100,,,,,0,"fee schedule",EAPG,3939,100,,3151.20,,,0,"percent of total billed charges","100% of total billed charges",3939,175,,,,,0,"fee schedule","175% of CMS fee schedule",3783.52,100,,,,,0,"fee schedule",EAPG,3939,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2481.57,63,,1985.26,,,0,"percent of total billed charges","63% of total billed charges",602.67,15.3,,482.14,,,0,"percent of total billed charges","15.3% of total billed charges",3673.32,100,,,,,0,"fee schedule",EAPG,2717.91,69,,,,,0,"fee schedule","69% of total billed charges",3939,100,,3151.20,,,0,"percent of total billed charges","100% of total billed charges",3939,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3939,100,,3151.20,,,0,"percent of total billed charges","100% of total billed charges",3939,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3939,100,,3151.20,,,0,"percent of total billed charges","100% of total billed charges",3939,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",20428.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3673.32,100,,,,,0,"fee schedule",EAPG,3939,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3939,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",3939,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3746.79,100,,,,,0,"fee schedule",EAPG,4775.32,100,,,,,0,"fee schedule",EAPG,3939,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1485,37.7,,1188.00,,,0,"percent of total billed charges","37.70% of total billed charges",3939,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3939,100,,,,,0,"fee schedule","100% of CMS fee schedule",3072.42,78,,2457.94,,,0,"percent of total billed charges","78% of total billed charges",3939,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3253.61,82.6,,2602.89,,,0,"percent of total billed charges","82.6% of total billed charges",3673.32,100,,,,,0,"fee schedule","100% of WA fee schedule",3939,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3253.61,82.6,,2602.89,,,0,"percent of total billed charges","82.6% of total billed charges",3939,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3833.85,100,,,,,0,"fee schedule",EAPG,3939,100,,3151.20,,,0,"percent of total billed charges","100% of total billed charges",602.67,20428.51,
"43870 Closure of gastrostomy, surgical",7963717,CDM,521,RC,43870,CPT,OUTPATIENT,,,2053,1334.45,,1806.64,88,,1445.31,,,0,"percent of total billed charges","88% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2897.21,100,,,,,0,"fee schedule",EAPG,2053,100,,1642.40,,,0,"percent of total billed charges","100% of total billed charges",6835.86,175,,,,,0,"fee schedule","175% of CMS fee schedule",2984.13,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1293.39,63,,1034.71,,,0,"percent of total billed charges","63% of total billed charges",314.11,15.3,,251.29,,,0,"percent of total billed charges","15.3% of total billed charges",2897.21,100,,,,,0,"fee schedule",EAPG,1416.57,69,,,,,0,"fee schedule","69% of total billed charges",2053,100,,1642.40,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2053,100,,1642.40,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2053,100,,1642.40,,,0,"percent of total billed charges","100% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",12515.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2897.21,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3272.1,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2955.15,100,,,,,0,"fee schedule",EAPG,3766.37,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",773.98,37.7,,619.18,,,0,"percent of total billed charges","37.70% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1601.34,78,,1281.07,,,0,"percent of total billed charges","78% of total billed charges",3945.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1695.78,82.6,,1356.62,,,0,"percent of total billed charges","82.6% of total billed charges",2897.21,100,,,,,0,"fee schedule",EAPG,3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1695.78,82.6,,1356.62,,,0,"percent of total billed charges","82.6% of total billed charges",3906.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3057.74,100,,,,,0,"fee schedule",EAPG,2053,100,,1642.40,,,0,"percent of total billed charges","100% of total billed charges",314.11,12515.8,
"43999 Unlisted procedure, stomach",7963811,CDM,521,RC,43999,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2897.21,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2984.13,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2897.21,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2897.21,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2955.15,100,,,,,0,"fee schedule",EAPG,3766.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2897.21,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3057.74,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2897.21,3766.37,
"44005 Enterolysis (freeing of intestinal adhesion)",7962970,CDM,521,RC,44005,CPT,OUTPATIENT,,,3384,2199.6,,2977.92,88,,2382.34,,,0,"percent of total billed charges","88% of total billed charges",3384,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,3384,100,,2707.20,,,0,"percent of total billed charges","100% of total billed charges",3384,175,,,,,0,"fee schedule","175% of CMS fee schedule",4682.92,100,,,,,0,"fee schedule",EAPG,3384,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2131.92,63,,1705.54,,,0,"percent of total billed charges","63% of total billed charges",517.75,15.3,,414.20,,,0,"percent of total billed charges","15.3% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,2334.96,69,,,,,0,"fee schedule","69% of total billed charges",3384,100,,2707.20,,,0,"percent of total billed charges","100% of total billed charges",3384,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3384,100,,2707.20,,,0,"percent of total billed charges","100% of total billed charges",3384,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3384,100,,2707.20,,,0,"percent of total billed charges","100% of total billed charges",3384,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3384,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,3384,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3384,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3384,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4637.46,100,,,,,0,"fee schedule",EAPG,5910.49,100,,,,,0,"fee schedule",EAPG,3384,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1275.77,37.7,,1020.62,,,0,"percent of total billed charges","37.70% of total billed charges",3384,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3384,100,,,,,0,"fee schedule","100% of CMS fee schedule",2639.52,78,,2111.62,,,0,"percent of total billed charges","78% of total billed charges",3384,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2795.18,82.6,,2236.14,,,0,"percent of total billed charges","82.6% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,3384,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2795.18,82.6,,2236.14,,,0,"percent of total billed charges","82.6% of total billed charges",3384,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4707.06,100,,,,,0,"fee schedule",EAPG,3384,100,,2707.20,,,0,"percent of total billed charges","100% of total billed charges",517.75,5910.49,
"44015 Tube or needle catheter jejunostomy for ente",7961931,CDM,521,RC,44015,CPT,OUTPATIENT,,,414,269.1,,364.32,88,,291.46,,,0,"percent of total billed charges","88% of total billed charges",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,414,100,,331.20,,,0,"percent of total billed charges","100% of total billed charges",414,175,,,,,0,"fee schedule","175% of CMS fee schedule",4682.92,100,,,,,0,"fee schedule",EAPG,414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",260.82,63,,208.66,,,0,"percent of total billed charges","63% of total billed charges",63.34,15.3,,50.67,,,0,"percent of total billed charges","15.3% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,285.66,69,,,,,0,"fee schedule","69% of total billed charges",414,100,,331.20,,,0,"percent of total billed charges","100% of total billed charges",414,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",414,100,,331.20,,,0,"percent of total billed charges","100% of total billed charges",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",414,100,,331.20,,,0,"percent of total billed charges","100% of total billed charges",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4637.46,100,,,,,0,"fee schedule",EAPG,5910.49,100,,,,,0,"fee schedule",EAPG,414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",156.08,37.7,,124.86,,,0,"percent of total billed charges","37.70% of total billed charges",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",414,100,,,,,0,"fee schedule","100% of CMS fee schedule",322.92,78,,258.34,,,0,"percent of total billed charges","78% of total billed charges",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",341.96,82.6,,273.57,,,0,"percent of total billed charges","82.6% of total billed charges",4546.53,100,,,,,0,"fee schedule","100% of WA fee schedule",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",341.96,82.6,,273.57,,,0,"percent of total billed charges","82.6% of total billed charges",414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4707.06,100,,,,,0,"fee schedule",EAPG,414,100,,331.20,,,0,"percent of total billed charges","100% of total billed charges",63.34,5910.49,
"44010 Duodenotomy, for exploration, biopsy(s), or",7963003,CDM,521,RC,44010,CPT,OUTPATIENT,,,2515,1634.75,,2213.2,88,,1770.56,,,0,"percent of total billed charges","88% of total billed charges",2515,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,2515,100,,2012.00,,,0,"percent of total billed charges","100% of total billed charges",2515,175,,,,,0,"fee schedule","175% of CMS fee schedule",1854.23,100,,,,,0,"fee schedule",EAPG,2515,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1584.45,63,,1267.56,,,0,"percent of total billed charges","63% of total billed charges",384.8,15.3,,307.84,,,0,"percent of total billed charges","15.3% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,1735.35,69,,,,,0,"fee schedule","69% of total billed charges",2515,100,,2012.00,,,0,"percent of total billed charges","100% of total billed charges",2515,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2515,100,,2012.00,,,0,"percent of total billed charges","100% of total billed charges",2515,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2515,100,,2012.00,,,0,"percent of total billed charges","100% of total billed charges",2515,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2515,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,2515,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2515,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2515,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1836.23,100,,,,,0,"fee schedule",EAPG,2340.29,100,,,,,0,"fee schedule",EAPG,2515,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",948.16,37.7,,758.53,,,0,"percent of total billed charges","37.70% of total billed charges",2515,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2515,100,,,,,0,"fee schedule","100% of CMS fee schedule",1961.7,78,,1569.36,,,0,"percent of total billed charges","78% of total billed charges",2515,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2077.39,82.6,,1661.91,,,0,"percent of total billed charges","82.6% of total billed charges",1800.23,100,,,,,0,"fee schedule","100% of WA fee schedule",2515,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2077.39,82.6,,1661.91,,,0,"percent of total billed charges","82.6% of total billed charges",2515,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1960.76,100,,,,,0,"fee schedule",EAPG,2515,100,,2012.00,,,0,"percent of total billed charges","100% of total billed charges",384.8,2515,
"44020 Enterotomy, small intestine, other than duod",7961621,CDM,521,RC,44020,CPT,OUTPATIENT,,,2828,1838.2,,2488.64,88,,1990.91,,,0,"percent of total billed charges","88% of total billed charges",2828,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,2828,100,,2262.40,,,0,"percent of total billed charges","100% of total billed charges",2828,175,,,,,0,"fee schedule","175% of CMS fee schedule",4682.92,100,,,,,0,"fee schedule",EAPG,2828,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1781.64,63,,1425.31,,,0,"percent of total billed charges","63% of total billed charges",432.68,15.3,,346.14,,,0,"percent of total billed charges","15.3% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,1951.32,69,,,,,0,"fee schedule","69% of total billed charges",2828,100,,2262.40,,,0,"percent of total billed charges","100% of total billed charges",2828,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2828,100,,2262.40,,,0,"percent of total billed charges","100% of total billed charges",2828,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2828,100,,2262.40,,,0,"percent of total billed charges","100% of total billed charges",2828,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2828,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,2828,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2828,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2828,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4637.46,100,,,,,0,"fee schedule",EAPG,5910.49,100,,,,,0,"fee schedule",EAPG,2828,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1066.16,37.7,,852.93,,,0,"percent of total billed charges","37.70% of total billed charges",2828,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2828,100,,,,,0,"fee schedule","100% of CMS fee schedule",2205.84,78,,1764.67,,,0,"percent of total billed charges","78% of total billed charges",2828,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2335.93,82.6,,1868.74,,,0,"percent of total billed charges","82.6% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,2828,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2335.93,82.6,,1868.74,,,0,"percent of total billed charges","82.6% of total billed charges",2828,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4707.06,100,,,,,0,"fee schedule",EAPG,2828,100,,2262.40,,,0,"percent of total billed charges","100% of total billed charges",432.68,5910.49,
"44025 Colotomy, for exploration, biopsy(s), or for",7963075,CDM,521,RC,44025,CPT,OUTPATIENT,,,2855,1855.75,,2512.4,88,,2009.92,,,0,"percent of total billed charges","88% of total billed charges",2855,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,2855,100,,2284.00,,,0,"percent of total billed charges","100% of total billed charges",2855,175,,,,,0,"fee schedule","175% of CMS fee schedule",1854.23,100,,,,,0,"fee schedule",EAPG,2855,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1798.65,63,,1438.92,,,0,"percent of total billed charges","63% of total billed charges",436.82,15.3,,349.46,,,0,"percent of total billed charges","15.3% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,1969.95,69,,,,,0,"fee schedule","69% of total billed charges",2855,100,,2284.00,,,0,"percent of total billed charges","100% of total billed charges",2855,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2855,100,,2284.00,,,0,"percent of total billed charges","100% of total billed charges",2855,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2855,100,,2284.00,,,0,"percent of total billed charges","100% of total billed charges",2855,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2855,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,2855,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2855,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2855,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1836.23,100,,,,,0,"fee schedule",EAPG,2340.29,100,,,,,0,"fee schedule",EAPG,2855,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1076.34,37.7,,861.07,,,0,"percent of total billed charges","37.70% of total billed charges",2855,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2855,100,,,,,0,"fee schedule","100% of CMS fee schedule",2226.9,78,,1781.52,,,0,"percent of total billed charges","78% of total billed charges",2855,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2358.23,82.6,,1886.58,,,0,"percent of total billed charges","82.6% of total billed charges",1800.23,100,,,,,0,"fee schedule","100% of WA fee schedule",2855,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2358.23,82.6,,1886.58,,,0,"percent of total billed charges","82.6% of total billed charges",2855,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1960.76,100,,,,,0,"fee schedule",EAPG,2855,100,,2284.00,,,0,"percent of total billed charges","100% of total billed charges",436.82,2855,
"44050 Reduction of volvulus, intussusception, inte",7962817,CDM,521,RC,44050,CPT,OUTPATIENT,,,3220,2093,,2833.6,88,,2266.88,,,0,"percent of total billed charges","88% of total billed charges",3220,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,3220,100,,2576.00,,,0,"percent of total billed charges","100% of total billed charges",3220,175,,,,,0,"fee schedule","175% of CMS fee schedule",4682.92,100,,,,,0,"fee schedule",EAPG,3220,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2028.6,63,,1622.88,,,0,"percent of total billed charges","63% of total billed charges",492.66,15.3,,394.13,,,0,"percent of total billed charges","15.3% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,2221.8,69,,,,,0,"fee schedule","69% of total billed charges",3220,100,,2576.00,,,0,"percent of total billed charges","100% of total billed charges",3220,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3220,100,,2576.00,,,0,"percent of total billed charges","100% of total billed charges",3220,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3220,100,,2576.00,,,0,"percent of total billed charges","100% of total billed charges",3220,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3220,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,3220,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3220,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3220,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4637.46,100,,,,,0,"fee schedule",EAPG,5910.49,100,,,,,0,"fee schedule",EAPG,3220,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1213.94,37.7,,971.15,,,0,"percent of total billed charges","37.70% of total billed charges",3220,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3220,100,,,,,0,"fee schedule","100% of CMS fee schedule",2511.6,78,,2009.28,,,0,"percent of total billed charges","78% of total billed charges",3220,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2659.72,82.6,,2127.78,,,0,"percent of total billed charges","82.6% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,3220,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2659.72,82.6,,2127.78,,,0,"percent of total billed charges","82.6% of total billed charges",3220,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4707.06,100,,,,,0,"fee schedule",EAPG,3220,100,,2576.00,,,0,"percent of total billed charges","100% of total billed charges",492.66,5910.49,
"44121 Enterectomy, resection of small intestine; e",7962342,CDM,521,RC,44121,CPT,OUTPATIENT,,,697,453.05,,613.36,88,,490.69,,,0,"percent of total billed charges","88% of total billed charges",697,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,697,100,,557.60,,,0,"percent of total billed charges","100% of total billed charges",697,175,,,,,0,"fee schedule","175% of CMS fee schedule",4682.92,100,,,,,0,"fee schedule",EAPG,697,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",439.11,63,,351.29,,,0,"percent of total billed charges","63% of total billed charges",106.64,15.3,,85.31,,,0,"percent of total billed charges","15.3% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,480.93,69,,,,,0,"fee schedule","69% of total billed charges",697,100,,557.60,,,0,"percent of total billed charges","100% of total billed charges",697,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",697,100,,557.60,,,0,"percent of total billed charges","100% of total billed charges",697,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",697,100,,557.60,,,0,"percent of total billed charges","100% of total billed charges",697,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",697,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,697,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",697,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",697,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4637.46,100,,,,,0,"fee schedule",EAPG,5910.49,100,,,,,0,"fee schedule",EAPG,697,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",262.77,37.7,,210.22,,,0,"percent of total billed charges","37.70% of total billed charges",697,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",697,100,,,,,0,"fee schedule","100% of CMS fee schedule",543.66,78,,434.93,,,0,"percent of total billed charges","78% of total billed charges",697,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",575.72,82.6,,460.58,,,0,"percent of total billed charges","82.6% of total billed charges",4546.53,100,,,,,0,"fee schedule","100% of WA fee schedule",697,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",575.72,82.6,,460.58,,,0,"percent of total billed charges","82.6% of total billed charges",697,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4707.06,100,,,,,0,"fee schedule",EAPG,697,100,,557.60,,,0,"percent of total billed charges","100% of total billed charges",106.64,5910.49,
"44120 Enterectomy, resection of small intestine; s",7962637,CDM,521,RC,44120,CPT,OUTPATIENT,,,4005,2603.25,,3524.4,88,,2819.52,,,0,"percent of total billed charges","88% of total billed charges",4005,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,4005,100,,3204.00,,,0,"percent of total billed charges","100% of total billed charges",4005,175,,,,,0,"fee schedule","175% of CMS fee schedule",4682.92,100,,,,,0,"fee schedule",EAPG,4005,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2523.15,63,,2018.52,,,0,"percent of total billed charges","63% of total billed charges",612.77,15.3,,490.22,,,0,"percent of total billed charges","15.3% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,2763.45,69,,,,,0,"fee schedule","69% of total billed charges",4005,100,,3204.00,,,0,"percent of total billed charges","100% of total billed charges",4005,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4005,100,,3204.00,,,0,"percent of total billed charges","100% of total billed charges",4005,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4005,100,,3204.00,,,0,"percent of total billed charges","100% of total billed charges",4005,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4005,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,4005,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4005,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4005,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4637.46,100,,,,,0,"fee schedule",EAPG,5910.49,100,,,,,0,"fee schedule",EAPG,4005,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1509.89,37.7,,1207.91,,,0,"percent of total billed charges","37.70% of total billed charges",4005,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4005,100,,,,,0,"fee schedule","100% of CMS fee schedule",3123.9,78,,2499.12,,,0,"percent of total billed charges","78% of total billed charges",4005,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3308.13,82.6,,2646.50,,,0,"percent of total billed charges","82.6% of total billed charges",4546.53,100,,,,,0,"fee schedule","100% of WA fee schedule",4005,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3308.13,82.6,,2646.50,,,0,"percent of total billed charges","82.6% of total billed charges",4005,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4707.06,100,,,,,0,"fee schedule",EAPG,4005,100,,3204.00,,,0,"percent of total billed charges","100% of total billed charges",612.77,5910.49,
"44139 Mobilization (take-down) of splenic flexure",7961767,CDM,521,RC,44139,CPT,OUTPATIENT,,,564,366.6,,496.32,88,,397.06,,,0,"percent of total billed charges","88% of total billed charges",564,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",564,175,,,,,0,"fee schedule","175% of CMS fee schedule",4682.92,100,,,,,0,"fee schedule",EAPG,564,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",355.32,63,,284.26,,,0,"percent of total billed charges","63% of total billed charges",86.29,15.3,,69.03,,,0,"percent of total billed charges","15.3% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,389.16,69,,,,,0,"fee schedule","69% of total billed charges",564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",564,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",564,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",564,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",564,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,564,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",564,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",564,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4637.46,100,,,,,0,"fee schedule",EAPG,5910.49,100,,,,,0,"fee schedule",EAPG,564,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",212.63,37.7,,170.10,,,0,"percent of total billed charges","37.70% of total billed charges",564,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",564,100,,,,,0,"fee schedule","100% of CMS fee schedule",439.92,78,,351.94,,,0,"percent of total billed charges","78% of total billed charges",564,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",465.86,82.6,,372.69,,,0,"percent of total billed charges","82.6% of total billed charges",4546.53,100,,,,,0,"fee schedule","100% of WA fee schedule",564,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",465.86,82.6,,372.69,,,0,"percent of total billed charges","82.6% of total billed charges",564,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4707.06,100,,,,,0,"fee schedule",EAPG,564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",86.29,5910.49,
"44130 Enteroenterostomy, anastomosis of intestine,",7962420,CDM,521,RC,44130,CPT,OUTPATIENT,,,3790,2463.5,,3335.2,88,,2668.16,,,0,"percent of total billed charges","88% of total billed charges",3790,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,3790,100,,3032.00,,,0,"percent of total billed charges","100% of total billed charges",3790,175,,,,,0,"fee schedule","175% of CMS fee schedule",1854.23,100,,,,,0,"fee schedule",EAPG,3790,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2387.7,63,,1910.16,,,0,"percent of total billed charges","63% of total billed charges",579.87,15.3,,463.90,,,0,"percent of total billed charges","15.3% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,2615.1,69,,,,,0,"fee schedule","69% of total billed charges",3790,100,,3032.00,,,0,"percent of total billed charges","100% of total billed charges",3790,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3790,100,,3032.00,,,0,"percent of total billed charges","100% of total billed charges",3790,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3790,100,,3032.00,,,0,"percent of total billed charges","100% of total billed charges",3790,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3790,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,3790,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3790,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3790,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1836.23,100,,,,,0,"fee schedule",EAPG,2340.29,100,,,,,0,"fee schedule",EAPG,3790,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1428.83,37.7,,1143.06,,,0,"percent of total billed charges","37.70% of total billed charges",3790,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3790,100,,,,,0,"fee schedule","100% of CMS fee schedule",2956.2,78,,2364.96,,,0,"percent of total billed charges","78% of total billed charges",3790,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3130.54,82.6,,2504.43,,,0,"percent of total billed charges","82.6% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,3790,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3130.54,82.6,,2504.43,,,0,"percent of total billed charges","82.6% of total billed charges",3790,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1960.76,100,,,,,0,"fee schedule",EAPG,3790,100,,3032.00,,,0,"percent of total billed charges","100% of total billed charges",579.87,3790,
"44143 Colectomy, partial; with end colostomy and c",7961528,CDM,521,RC,44143,CPT,OUTPATIENT,,,4660,3029,,4100.8,88,,3280.64,,,0,"percent of total billed charges","88% of total billed charges",4660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,4660,100,,3728.00,,,0,"percent of total billed charges","100% of total billed charges",4660,175,,,,,0,"fee schedule","175% of CMS fee schedule",4682.92,100,,,,,0,"fee schedule",EAPG,4660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2935.8,63,,2348.64,,,0,"percent of total billed charges","63% of total billed charges",712.98,15.3,,570.38,,,0,"percent of total billed charges","15.3% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,3215.4,69,,,,,0,"fee schedule","69% of total billed charges",4660,100,,3728.00,,,0,"percent of total billed charges","100% of total billed charges",4660,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4660,100,,3728.00,,,0,"percent of total billed charges","100% of total billed charges",4660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4660,100,,3728.00,,,0,"percent of total billed charges","100% of total billed charges",4660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,4660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4637.46,100,,,,,0,"fee schedule",EAPG,5910.49,100,,,,,0,"fee schedule",EAPG,4660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1756.82,37.7,,1405.46,,,0,"percent of total billed charges","37.70% of total billed charges",4660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4660,100,,,,,0,"fee schedule","100% of CMS fee schedule",3634.8,78,,2907.84,,,0,"percent of total billed charges","78% of total billed charges",4660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3849.16,82.6,,3079.33,,,0,"percent of total billed charges","82.6% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,4660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3849.16,82.6,,3079.33,,,0,"percent of total billed charges","82.6% of total billed charges",4660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4707.06,100,,,,,0,"fee schedule",EAPG,4660,100,,3728.00,,,0,"percent of total billed charges","100% of total billed charges",712.98,5910.49,
"44144 Colectomy, partial; with resection, with col",7961768,CDM,521,RC,44144,CPT,OUTPATIENT,,,3886,2525.9,,3419.68,88,,2735.74,,,0,"percent of total billed charges","88% of total billed charges",3886,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,3886,100,,3108.80,,,0,"percent of total billed charges","100% of total billed charges",3886,175,,,,,0,"fee schedule","175% of CMS fee schedule",1854.23,100,,,,,0,"fee schedule",EAPG,3886,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2448.18,63,,1958.54,,,0,"percent of total billed charges","63% of total billed charges",594.56,15.3,,475.65,,,0,"percent of total billed charges","15.3% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,2681.34,69,,,,,0,"fee schedule","69% of total billed charges",3886,100,,3108.80,,,0,"percent of total billed charges","100% of total billed charges",3886,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3886,100,,3108.80,,,0,"percent of total billed charges","100% of total billed charges",3886,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3886,100,,3108.80,,,0,"percent of total billed charges","100% of total billed charges",3886,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3886,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,3886,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3886,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3886,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1836.23,100,,,,,0,"fee schedule",EAPG,2340.29,100,,,,,0,"fee schedule",EAPG,3886,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1465.02,37.7,,1172.02,,,0,"percent of total billed charges","37.70% of total billed charges",3886,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3886,100,,,,,0,"fee schedule","100% of CMS fee schedule",3031.08,78,,2424.86,,,0,"percent of total billed charges","78% of total billed charges",3886,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3209.84,82.6,,2567.87,,,0,"percent of total billed charges","82.6% of total billed charges",1800.23,100,,,,,0,"fee schedule","100% of WA fee schedule",3886,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3209.84,82.6,,2567.87,,,0,"percent of total billed charges","82.6% of total billed charges",3886,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1960.76,100,,,,,0,"fee schedule",EAPG,3886,100,,3108.80,,,0,"percent of total billed charges","100% of total billed charges",594.56,3886,
"44145 Colectomy, partial; with coloproctostomy (lo",7962971,CDM,521,RC,44145,CPT,OUTPATIENT,,,5473,3557.45,,4816.24,88,,3852.99,,,0,"percent of total billed charges","88% of total billed charges",5473,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5473,175,,,,,0,"fee schedule","175% of CMS fee schedule",4682.92,100,,,,,0,"fee schedule",EAPG,5473,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3447.99,63,,2758.39,,,0,"percent of total billed charges","63% of total billed charges",837.37,15.3,,669.90,,,0,"percent of total billed charges","15.3% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,3776.37,69,,,,,0,"fee schedule","69% of total billed charges",5473,100,,4378.40,,,0,"percent of total billed charges","100% of total billed charges",5473,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5473,100,,4378.40,,,0,"percent of total billed charges","100% of total billed charges",5473,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5473,100,,4378.40,,,0,"percent of total billed charges","100% of total billed charges",5473,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5473,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,5473,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5473,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5473,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4637.46,100,,,,,0,"fee schedule",EAPG,5910.49,100,,,,,0,"fee schedule",EAPG,5473,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2063.32,37.7,,1650.66,,,0,"percent of total billed charges","37.70% of total billed charges",5473,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5473,100,,,,,0,"fee schedule","100% of CMS fee schedule",4268.94,78,,3415.15,,,0,"percent of total billed charges","78% of total billed charges",5473,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4520.7,82.6,,3616.56,,,0,"percent of total billed charges","82.6% of total billed charges",4546.53,100,,,,,0,"fee schedule","100% of WA fee schedule",5473,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4520.7,82.6,,3616.56,,,0,"percent of total billed charges","82.6% of total billed charges",5473,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4707.06,100,,,,,0,"fee schedule",EAPG,5473,100,,4378.40,,,0,"percent of total billed charges","100% of total billed charges",837.37,5910.49,
"44141 Colectomy, partial; with skin level cecostom",7963175,CDM,521,RC,44141,CPT,OUTPATIENT,,,5189,3372.85,,4566.32,88,,3653.06,,,0,"percent of total billed charges","88% of total billed charges",5189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5189,175,,,,,0,"fee schedule","175% of CMS fee schedule",4682.92,100,,,,,0,"fee schedule",EAPG,5189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3269.07,63,,2615.26,,,0,"percent of total billed charges","63% of total billed charges",793.92,15.3,,635.14,,,0,"percent of total billed charges","15.3% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,3580.41,69,,,,,0,"fee schedule","69% of total billed charges",5189,100,,4151.20,,,0,"percent of total billed charges","100% of total billed charges",5189,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5189,100,,4151.20,,,0,"percent of total billed charges","100% of total billed charges",5189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5189,100,,4151.20,,,0,"percent of total billed charges","100% of total billed charges",5189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,5189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4637.46,100,,,,,0,"fee schedule",EAPG,5910.49,100,,,,,0,"fee schedule",EAPG,5189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1956.25,37.7,,1565.00,,,0,"percent of total billed charges","37.70% of total billed charges",5189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5189,100,,,,,0,"fee schedule","100% of CMS fee schedule",4047.42,78,,3237.94,,,0,"percent of total billed charges","78% of total billed charges",5189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4286.11,82.6,,3428.89,,,0,"percent of total billed charges","82.6% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,5189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4286.11,82.6,,3428.89,,,0,"percent of total billed charges","82.6% of total billed charges",5189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4707.06,100,,,,,0,"fee schedule",EAPG,5189,100,,4151.20,,,0,"percent of total billed charges","100% of total billed charges",793.92,5910.49,
"44140 Colectomy, partial; with anastomosis",7963661,CDM,521,RC,44140,CPT,OUTPATIENT,,,4509,2930.85,,3967.92,88,,3174.34,,,0,"percent of total billed charges","88% of total billed charges",4509,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,4509,100,,3607.20,,,0,"percent of total billed charges","100% of total billed charges",4509,175,,,,,0,"fee schedule","175% of CMS fee schedule",1854.23,100,,,,,0,"fee schedule",EAPG,4509,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2840.67,63,,2272.54,,,0,"percent of total billed charges","63% of total billed charges",689.88,15.3,,551.90,,,0,"percent of total billed charges","15.3% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,3111.21,69,,,,,0,"fee schedule","69% of total billed charges",4509,100,,3607.20,,,0,"percent of total billed charges","100% of total billed charges",4509,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4509,100,,3607.20,,,0,"percent of total billed charges","100% of total billed charges",4509,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4509,100,,3607.20,,,0,"percent of total billed charges","100% of total billed charges",4509,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4509,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,4509,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4509,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4509,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1836.23,100,,,,,0,"fee schedule",EAPG,2340.29,100,,,,,0,"fee schedule",EAPG,4509,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1699.89,37.7,,1359.91,,,0,"percent of total billed charges","37.70% of total billed charges",4509,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4509,100,,,,,0,"fee schedule","100% of CMS fee schedule",3517.02,78,,2813.62,,,0,"percent of total billed charges","78% of total billed charges",4509,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3724.43,82.6,,2979.54,,,0,"percent of total billed charges","82.6% of total billed charges",1800.23,100,,,,,0,"fee schedule","100% of WA fee schedule",4509,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3724.43,82.6,,2979.54,,,0,"percent of total billed charges","82.6% of total billed charges",4509,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1960.76,100,,,,,0,"fee schedule",EAPG,4509,100,,3607.20,,,0,"percent of total billed charges","100% of total billed charges",689.88,4509,
"44150 Colectomy, total, abdominal, without proctec",7962379,CDM,521,RC,44150,CPT,OUTPATIENT,,,5429,3528.85,,4777.52,88,,3822.02,,,0,"percent of total billed charges","88% of total billed charges",5429,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5429,175,,,,,0,"fee schedule","175% of CMS fee schedule",4682.92,100,,,,,0,"fee schedule",EAPG,5429,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3420.27,63,,2736.22,,,0,"percent of total billed charges","63% of total billed charges",830.64,15.3,,664.51,,,0,"percent of total billed charges","15.3% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,3746.01,69,,,,,0,"fee schedule","69% of total billed charges",5429,100,,4343.20,,,0,"percent of total billed charges","100% of total billed charges",5429,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5429,100,,4343.20,,,0,"percent of total billed charges","100% of total billed charges",5429,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5429,100,,4343.20,,,0,"percent of total billed charges","100% of total billed charges",5429,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5429,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,5429,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5429,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5429,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4637.46,100,,,,,0,"fee schedule",EAPG,5910.49,100,,,,,0,"fee schedule",EAPG,5429,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2046.73,37.7,,1637.38,,,0,"percent of total billed charges","37.70% of total billed charges",5429,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5429,100,,,,,0,"fee schedule","100% of CMS fee schedule",4234.62,78,,3387.70,,,0,"percent of total billed charges","78% of total billed charges",5429,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4484.35,82.6,,3587.48,,,0,"percent of total billed charges","82.6% of total billed charges",4546.53,100,,,,,0,"fee schedule","100% of WA fee schedule",5429,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4484.35,82.6,,3587.48,,,0,"percent of total billed charges","82.6% of total billed charges",5429,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4707.06,100,,,,,0,"fee schedule",EAPG,5429,100,,4343.20,,,0,"percent of total billed charges","100% of total billed charges",830.64,5910.49,
"44160 Colectomy, partial, with removal of terminal",7962853,CDM,521,RC,44160,CPT,OUTPATIENT,,,3587,2331.55,,3156.56,88,,2525.25,,,0,"percent of total billed charges","88% of total billed charges",3587,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,3587,100,,2869.60,,,0,"percent of total billed charges","100% of total billed charges",3587,175,,,,,0,"fee schedule","175% of CMS fee schedule",1854.23,100,,,,,0,"fee schedule",EAPG,3587,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2259.81,63,,1807.85,,,0,"percent of total billed charges","63% of total billed charges",548.81,15.3,,439.05,,,0,"percent of total billed charges","15.3% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,2475.03,69,,,,,0,"fee schedule","69% of total billed charges",3587,100,,2869.60,,,0,"percent of total billed charges","100% of total billed charges",3587,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3587,100,,2869.60,,,0,"percent of total billed charges","100% of total billed charges",3587,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3587,100,,2869.60,,,0,"percent of total billed charges","100% of total billed charges",3587,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3587,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,3587,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3587,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3587,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1836.23,100,,,,,0,"fee schedule",EAPG,2340.29,100,,,,,0,"fee schedule",EAPG,3587,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1352.3,37.7,,1081.84,,,0,"percent of total billed charges","37.70% of total billed charges",3587,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3587,100,,,,,0,"fee schedule","100% of CMS fee schedule",2797.86,78,,2238.29,,,0,"percent of total billed charges","78% of total billed charges",3587,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2962.86,82.6,,2370.29,,,0,"percent of total billed charges","82.6% of total billed charges",1800.23,100,,,,,0,"fee schedule","100% of WA fee schedule",3587,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2962.86,82.6,,2370.29,,,0,"percent of total billed charges","82.6% of total billed charges",3587,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1960.76,100,,,,,0,"fee schedule",EAPG,3587,100,,2869.60,,,0,"percent of total billed charges","100% of total billed charges",548.81,3587,
"44180 Laparoscopy, surgical, enterolysis (freeing",7961932,CDM,521,RC,44180,CPT,OUTPATIENT,,,1755,1140.75,,1544.4,88,,1235.52,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4546.53,100,,,,,0,"fee schedule",EAPG,1755,100,,1404.00,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",4682.92,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1105.65,63,,884.52,,,0,"percent of total billed charges","63% of total billed charges",268.52,15.3,,214.82,,,0,"percent of total billed charges","15.3% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,1210.95,69,,,,,0,"fee schedule","69% of total billed charges",1755,100,,1404.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1755,100,,1404.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1755,100,,1404.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4546.53,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4637.46,100,,,,,0,"fee schedule",EAPG,5910.49,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",661.64,37.7,,529.31,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1368.9,78,,1095.12,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1449.63,82.6,,1159.70,,,0,"percent of total billed charges","82.6% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1449.63,82.6,,1159.70,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4707.06,100,,,,,0,"fee schedule",EAPG,1755,100,,1404.00,,,0,"percent of total billed charges","100% of total billed charges",268.52,20558.19,
"44186 Laparoscopy, surgical; jejunostomy (eg, for",7962864,CDM,521,RC,44186,CPT,OUTPATIENT,,,1235,802.75,,1086.8,88,,869.44,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4546.53,100,,,,,0,"fee schedule",EAPG,1235,100,,988.00,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",4682.92,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",778.05,63,,622.44,,,0,"percent of total billed charges","63% of total billed charges",188.96,15.3,,151.17,,,0,"percent of total billed charges","15.3% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,852.15,69,,,,,0,"fee schedule","69% of total billed charges",1235,100,,988.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1235,100,,988.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1235,100,,988.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4546.53,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4637.46,100,,,,,0,"fee schedule",EAPG,5910.49,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",465.6,37.7,,372.48,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",963.3,78,,770.64,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1020.11,82.6,,816.09,,,0,"percent of total billed charges","82.6% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1020.11,82.6,,816.09,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4707.06,100,,,,,0,"fee schedule",EAPG,1235,100,,988.00,,,0,"percent of total billed charges","100% of total billed charges",188.96,20558.19,
"44187 Laparoscopy, surgical; ileostomy or jejunost",7963161,CDM,521,RC,44187,CPT,OUTPATIENT,,,2045,1329.25,,1799.6,88,,1439.68,,,0,"percent of total billed charges","88% of total billed charges",2045,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,2045,100,,1636.00,,,0,"percent of total billed charges","100% of total billed charges",2045,175,,,,,0,"fee schedule","175% of CMS fee schedule",1854.23,100,,,,,0,"fee schedule",EAPG,2045,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1288.35,63,,1030.68,,,0,"percent of total billed charges","63% of total billed charges",312.89,15.3,,250.31,,,0,"percent of total billed charges","15.3% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,1411.05,69,,,,,0,"fee schedule","69% of total billed charges",2045,100,,1636.00,,,0,"percent of total billed charges","100% of total billed charges",2045,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2045,100,,1636.00,,,0,"percent of total billed charges","100% of total billed charges",2045,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2045,100,,1636.00,,,0,"percent of total billed charges","100% of total billed charges",2045,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2045,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,2045,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2045,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2045,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1836.23,100,,,,,0,"fee schedule",EAPG,2340.29,100,,,,,0,"fee schedule",EAPG,2045,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",770.97,37.7,,616.78,,,0,"percent of total billed charges","37.70% of total billed charges",2045,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2045,100,,,,,0,"fee schedule","100% of CMS fee schedule",1595.1,78,,1276.08,,,0,"percent of total billed charges","78% of total billed charges",2045,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1689.17,82.6,,1351.34,,,0,"percent of total billed charges","82.6% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,2045,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1689.17,82.6,,1351.34,,,0,"percent of total billed charges","82.6% of total billed charges",2045,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1960.76,100,,,,,0,"fee schedule",EAPG,2045,100,,1636.00,,,0,"percent of total billed charges","100% of total billed charges",312.89,2340.29,
"44188 Laparoscopy, surgical, colostomy or skin lev",7963226,CDM,521,RC,44188,CPT,OUTPATIENT,,,3568,2319.2,,3139.84,88,,2511.87,,,0,"percent of total billed charges","88% of total billed charges",3568,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,3568,100,,2854.40,,,0,"percent of total billed charges","100% of total billed charges",3568,175,,,,,0,"fee schedule","175% of CMS fee schedule",4682.92,100,,,,,0,"fee schedule",EAPG,3568,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2247.84,63,,1798.27,,,0,"percent of total billed charges","63% of total billed charges",545.9,15.3,,436.72,,,0,"percent of total billed charges","15.3% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,2461.92,69,,,,,0,"fee schedule","69% of total billed charges",3568,100,,2854.40,,,0,"percent of total billed charges","100% of total billed charges",3568,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3568,100,,2854.40,,,0,"percent of total billed charges","100% of total billed charges",3568,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3568,100,,2854.40,,,0,"percent of total billed charges","100% of total billed charges",3568,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3568,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,3568,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3568,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3568,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4637.46,100,,,,,0,"fee schedule",EAPG,5910.49,100,,,,,0,"fee schedule",EAPG,3568,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1345.14,37.7,,1076.11,,,0,"percent of total billed charges","37.70% of total billed charges",3568,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3568,100,,,,,0,"fee schedule","100% of CMS fee schedule",2783.04,78,,2226.43,,,0,"percent of total billed charges","78% of total billed charges",3568,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2947.17,82.6,,2357.74,,,0,"percent of total billed charges","82.6% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,3568,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2947.17,82.6,,2357.74,,,0,"percent of total billed charges","82.6% of total billed charges",3568,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4707.06,100,,,,,0,"fee schedule",EAPG,3568,100,,2854.40,,,0,"percent of total billed charges","100% of total billed charges",545.9,5910.49,
"44202 Laparoscopy, surgical; enterectomy, resectio",7961529,CDM,521,RC,44202,CPT,OUTPATIENT,,,4003,2601.95,,3522.64,88,,2818.11,,,0,"percent of total billed charges","88% of total billed charges",4003,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,4003,100,,3202.40,,,0,"percent of total billed charges","100% of total billed charges",4003,175,,,,,0,"fee schedule","175% of CMS fee schedule",4682.92,100,,,,,0,"fee schedule",EAPG,4003,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2521.89,63,,2017.51,,,0,"percent of total billed charges","63% of total billed charges",612.46,15.3,,489.97,,,0,"percent of total billed charges","15.3% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,2762.07,69,,,,,0,"fee schedule","69% of total billed charges",4003,100,,3202.40,,,0,"percent of total billed charges","100% of total billed charges",4003,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4003,100,,3202.40,,,0,"percent of total billed charges","100% of total billed charges",4003,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4003,100,,3202.40,,,0,"percent of total billed charges","100% of total billed charges",4003,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4003,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,4003,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4003,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4003,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4637.46,100,,,,,0,"fee schedule",EAPG,5910.49,100,,,,,0,"fee schedule",EAPG,4003,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1509.13,37.7,,1207.30,,,0,"percent of total billed charges","37.70% of total billed charges",4003,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4003,100,,,,,0,"fee schedule","100% of CMS fee schedule",3122.34,78,,2497.87,,,0,"percent of total billed charges","78% of total billed charges",4003,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3306.48,82.6,,2645.18,,,0,"percent of total billed charges","82.6% of total billed charges",4546.53,100,,,,,0,"fee schedule","100% of WA fee schedule",4003,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3306.48,82.6,,2645.18,,,0,"percent of total billed charges","82.6% of total billed charges",4003,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4707.06,100,,,,,0,"fee schedule",EAPG,4003,100,,3202.40,,,0,"percent of total billed charges","100% of total billed charges",612.46,5910.49,
"44205 Laparoscopy, surgical; colectomy, partial, w",7961701,CDM,521,RC,44205,CPT,OUTPATIENT,,,3886,2525.9,,3419.68,88,,2735.74,,,0,"percent of total billed charges","88% of total billed charges",3886,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,3886,100,,3108.80,,,0,"percent of total billed charges","100% of total billed charges",3886,175,,,,,0,"fee schedule","175% of CMS fee schedule",1854.23,100,,,,,0,"fee schedule",EAPG,3886,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2448.18,63,,1958.54,,,0,"percent of total billed charges","63% of total billed charges",594.56,15.3,,475.65,,,0,"percent of total billed charges","15.3% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,2681.34,69,,,,,0,"fee schedule","69% of total billed charges",3886,100,,3108.80,,,0,"percent of total billed charges","100% of total billed charges",3886,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3886,100,,3108.80,,,0,"percent of total billed charges","100% of total billed charges",3886,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3886,100,,3108.80,,,0,"percent of total billed charges","100% of total billed charges",3886,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3886,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,3886,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3886,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3886,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1836.23,100,,,,,0,"fee schedule",EAPG,2340.29,100,,,,,0,"fee schedule",EAPG,3886,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1465.02,37.7,,1172.02,,,0,"percent of total billed charges","37.70% of total billed charges",3886,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3886,100,,,,,0,"fee schedule","100% of CMS fee schedule",3031.08,78,,2424.86,,,0,"percent of total billed charges","78% of total billed charges",3886,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3209.84,82.6,,2567.87,,,0,"percent of total billed charges","82.6% of total billed charges",1800.23,100,,,,,0,"fee schedule","100% of WA fee schedule",3886,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3209.84,82.6,,2567.87,,,0,"percent of total billed charges","82.6% of total billed charges",3886,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1960.76,100,,,,,0,"fee schedule",EAPG,3886,100,,3108.80,,,0,"percent of total billed charges","100% of total billed charges",594.56,3886,
"44206 Laparoscopy, surgical; colectomy, partial, w",7961769,CDM,521,RC,44206,CPT,OUTPATIENT,,,5183,3368.95,,4561.04,88,,3648.83,,,0,"percent of total billed charges","88% of total billed charges",5183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5183,175,,,,,0,"fee schedule","175% of CMS fee schedule",4682.92,100,,,,,0,"fee schedule",EAPG,5183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3265.29,63,,2612.23,,,0,"percent of total billed charges","63% of total billed charges",793,15.3,,634.40,,,0,"percent of total billed charges","15.3% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,3576.27,69,,,,,0,"fee schedule","69% of total billed charges",5183,100,,4146.40,,,0,"percent of total billed charges","100% of total billed charges",5183,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5183,100,,4146.40,,,0,"percent of total billed charges","100% of total billed charges",5183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5183,100,,4146.40,,,0,"percent of total billed charges","100% of total billed charges",5183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,5183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4637.46,100,,,,,0,"fee schedule",EAPG,5910.49,100,,,,,0,"fee schedule",EAPG,5183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1953.99,37.7,,1563.19,,,0,"percent of total billed charges","37.70% of total billed charges",5183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5183,100,,,,,0,"fee schedule","100% of CMS fee schedule",4042.74,78,,3234.19,,,0,"percent of total billed charges","78% of total billed charges",5183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4281.16,82.6,,3424.93,,,0,"percent of total billed charges","82.6% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,5183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4281.16,82.6,,3424.93,,,0,"percent of total billed charges","82.6% of total billed charges",5183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4707.06,100,,,,,0,"fee schedule",EAPG,5183,100,,4146.40,,,0,"percent of total billed charges","100% of total billed charges",793,5910.49,
"44207 Laparoscopy, surgical; colectomy, partial, w",7962451,CDM,521,RC,44207,CPT,OUTPATIENT,,,5004,3252.6,,4403.52,88,,3522.82,,,0,"percent of total billed charges","88% of total billed charges",5004,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5004,175,,,,,0,"fee schedule","175% of CMS fee schedule",4682.92,100,,,,,0,"fee schedule",EAPG,5004,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3152.52,63,,2522.02,,,0,"percent of total billed charges","63% of total billed charges",765.61,15.3,,612.49,,,0,"percent of total billed charges","15.3% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,3452.76,69,,,,,0,"fee schedule","69% of total billed charges",5004,100,,4003.20,,,0,"percent of total billed charges","100% of total billed charges",5004,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5004,100,,4003.20,,,0,"percent of total billed charges","100% of total billed charges",5004,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5004,100,,4003.20,,,0,"percent of total billed charges","100% of total billed charges",5004,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5004,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,5004,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5004,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5004,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4637.46,100,,,,,0,"fee schedule",EAPG,5910.49,100,,,,,0,"fee schedule",EAPG,5004,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1886.51,37.7,,1509.21,,,0,"percent of total billed charges","37.70% of total billed charges",5004,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5004,100,,,,,0,"fee schedule","100% of CMS fee schedule",3903.12,78,,3122.50,,,0,"percent of total billed charges","78% of total billed charges",5004,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4133.3,82.6,,3306.64,,,0,"percent of total billed charges","82.6% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,5004,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4133.3,82.6,,3306.64,,,0,"percent of total billed charges","82.6% of total billed charges",5004,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4707.06,100,,,,,0,"fee schedule",EAPG,5004,100,,4003.20,,,0,"percent of total billed charges","100% of total billed charges",765.61,5910.49,
"44203 Laparoscopy, surgical; ea addtl small intest",7962714,CDM,521,RC,44203,CPT,OUTPATIENT,,,697,453.05,,613.36,88,,490.69,,,0,"percent of total billed charges","88% of total billed charges",697,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,697,100,,557.60,,,0,"percent of total billed charges","100% of total billed charges",697,175,,,,,0,"fee schedule","175% of CMS fee schedule",4682.92,100,,,,,0,"fee schedule",EAPG,697,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",439.11,63,,351.29,,,0,"percent of total billed charges","63% of total billed charges",106.64,15.3,,85.31,,,0,"percent of total billed charges","15.3% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,480.93,69,,,,,0,"fee schedule","69% of total billed charges",697,100,,557.60,,,0,"percent of total billed charges","100% of total billed charges",697,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",697,100,,557.60,,,0,"percent of total billed charges","100% of total billed charges",697,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",697,100,,557.60,,,0,"percent of total billed charges","100% of total billed charges",697,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",697,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,697,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",697,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",697,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4637.46,100,,,,,0,"fee schedule",EAPG,5910.49,100,,,,,0,"fee schedule",EAPG,697,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",262.77,37.7,,210.22,,,0,"percent of total billed charges","37.70% of total billed charges",697,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",697,100,,,,,0,"fee schedule","100% of CMS fee schedule",543.66,78,,434.93,,,0,"percent of total billed charges","78% of total billed charges",697,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",575.72,82.6,,460.58,,,0,"percent of total billed charges","82.6% of total billed charges",4546.53,100,,,,,0,"fee schedule","100% of WA fee schedule",697,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",575.72,82.6,,460.58,,,0,"percent of total billed charges","82.6% of total billed charges",697,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4707.06,100,,,,,0,"fee schedule",EAPG,697,100,,557.60,,,0,"percent of total billed charges","100% of total billed charges",106.64,5910.49,
"44204 Laparoscopy, surgical; colectomy, partial, w",7963148,CDM,521,RC,44204,CPT,OUTPATIENT,,,4431,2880.15,,3899.28,88,,3119.42,,,0,"percent of total billed charges","88% of total billed charges",4431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,4431,100,,3544.80,,,0,"percent of total billed charges","100% of total billed charges",4431,175,,,,,0,"fee schedule","175% of CMS fee schedule",4682.92,100,,,,,0,"fee schedule",EAPG,4431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2791.53,63,,2233.22,,,0,"percent of total billed charges","63% of total billed charges",677.94,15.3,,542.35,,,0,"percent of total billed charges","15.3% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,3057.39,69,,,,,0,"fee schedule","69% of total billed charges",4431,100,,3544.80,,,0,"percent of total billed charges","100% of total billed charges",4431,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4431,100,,3544.80,,,0,"percent of total billed charges","100% of total billed charges",4431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4431,100,,3544.80,,,0,"percent of total billed charges","100% of total billed charges",4431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,4431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4637.46,100,,,,,0,"fee schedule",EAPG,5910.49,100,,,,,0,"fee schedule",EAPG,4431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1670.49,37.7,,1336.39,,,0,"percent of total billed charges","37.70% of total billed charges",4431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4431,100,,,,,0,"fee schedule","100% of CMS fee schedule",3456.18,78,,2764.94,,,0,"percent of total billed charges","78% of total billed charges",4431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3660.01,82.6,,2928.01,,,0,"percent of total billed charges","82.6% of total billed charges",4546.53,100,,,,,0,"fee schedule","100% of WA fee schedule",4431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3660.01,82.6,,2928.01,,,0,"percent of total billed charges","82.6% of total billed charges",4431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4707.06,100,,,,,0,"fee schedule",EAPG,4431,100,,3544.80,,,0,"percent of total billed charges","100% of total billed charges",677.94,5910.49,
"44213 Laparoscopy, surgical, mobilization (take-do",7961530,CDM,521,RC,44213,CPT,OUTPATIENT,,,541,351.65,,476.08,88,,380.86,,,0,"percent of total billed charges","88% of total billed charges",541,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,541,100,,432.80,,,0,"percent of total billed charges","100% of total billed charges",541,175,,,,,0,"fee schedule","175% of CMS fee schedule",4682.92,100,,,,,0,"fee schedule",EAPG,541,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",340.83,63,,272.66,,,0,"percent of total billed charges","63% of total billed charges",82.77,15.3,,66.22,,,0,"percent of total billed charges","15.3% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,373.29,69,,,,,0,"fee schedule","69% of total billed charges",541,100,,432.80,,,0,"percent of total billed charges","100% of total billed charges",541,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",541,100,,432.80,,,0,"percent of total billed charges","100% of total billed charges",541,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",541,100,,432.80,,,0,"percent of total billed charges","100% of total billed charges",541,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",541,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,541,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",541,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",541,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4637.46,100,,,,,0,"fee schedule",EAPG,5910.49,100,,,,,0,"fee schedule",EAPG,541,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",203.96,37.7,,163.17,,,0,"percent of total billed charges","37.70% of total billed charges",541,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",541,100,,,,,0,"fee schedule","100% of CMS fee schedule",421.98,78,,337.58,,,0,"percent of total billed charges","78% of total billed charges",541,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",446.87,82.6,,357.50,,,0,"percent of total billed charges","82.6% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,541,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",446.87,82.6,,357.50,,,0,"percent of total billed charges","82.6% of total billed charges",541,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4707.06,100,,,,,0,"fee schedule",EAPG,541,100,,432.80,,,0,"percent of total billed charges","100% of total billed charges",82.77,5910.49,
"44227 Laparoscopy, surgical, closure of enterostom",7962009,CDM,521,RC,44227,CPT,OUTPATIENT,,,4826,3136.9,,4246.88,88,,3397.50,,,0,"percent of total billed charges","88% of total billed charges",4826,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",4826,175,,,,,0,"fee schedule","175% of CMS fee schedule",4682.92,100,,,,,0,"fee schedule",EAPG,4826,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3040.38,63,,2432.30,,,0,"percent of total billed charges","63% of total billed charges",738.38,15.3,,590.70,,,0,"percent of total billed charges","15.3% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,3329.94,69,,,,,0,"fee schedule","69% of total billed charges",4826,100,,3860.80,,,0,"percent of total billed charges","100% of total billed charges",4826,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4826,100,,3860.80,,,0,"percent of total billed charges","100% of total billed charges",4826,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4826,100,,3860.80,,,0,"percent of total billed charges","100% of total billed charges",4826,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4826,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,4826,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4826,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4826,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4637.46,100,,,,,0,"fee schedule",EAPG,5910.49,100,,,,,0,"fee schedule",EAPG,4826,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1819.4,37.7,,1455.52,,,0,"percent of total billed charges","37.70% of total billed charges",4826,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4826,100,,,,,0,"fee schedule","100% of CMS fee schedule",3764.28,78,,3011.42,,,0,"percent of total billed charges","78% of total billed charges",4826,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3986.28,82.6,,3189.02,,,0,"percent of total billed charges","82.6% of total billed charges",4546.53,100,,,,,0,"fee schedule","100% of WA fee schedule",4826,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3986.28,82.6,,3189.02,,,0,"percent of total billed charges","82.6% of total billed charges",4826,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4707.06,100,,,,,0,"fee schedule",EAPG,4826,100,,3860.80,,,0,"percent of total billed charges","100% of total billed charges",738.38,5910.49,
"44238 Unlisted laparoscopy procedure, intestine (e",7963198,CDM,521,RC,44238,CPT,OUTPATIENT,,,1206,783.9,,1061.28,88,,849.02,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1800.23,100,,,,,0,"fee schedule",EAPG,1206,100,,964.80,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",1854.23,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.78,63,,607.82,,,0,"percent of total billed charges","63% of total billed charges",184.52,15.3,,147.62,,,0,"percent of total billed charges","15.3% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,832.14,69,,,,,0,"fee schedule","69% of total billed charges",1206,100,,964.80,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1206,100,,964.80,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1206,100,,964.80,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1800.23,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1836.23,100,,,,,0,"fee schedule",EAPG,2340.29,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",454.66,37.7,,363.73,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",940.68,78,,752.54,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",996.16,82.6,,796.93,,,0,"percent of total billed charges","82.6% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",996.16,82.6,,796.93,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1960.76,100,,,,,0,"fee schedule",EAPG,1206,100,,964.80,,,0,"percent of total billed charges","100% of total billed charges",184.52,20558.19,
"44300 Placement, enterostomy or cecostomy, tube op",7962421,CDM,521,RC,44300,CPT,OUTPATIENT,,,2366,1537.9,,2082.08,88,,1665.66,,,0,"percent of total billed charges","88% of total billed charges",2366,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,2366,100,,1892.80,,,0,"percent of total billed charges","100% of total billed charges",2366,175,,,,,0,"fee schedule","175% of CMS fee schedule",1854.23,100,,,,,0,"fee schedule",EAPG,2366,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1490.58,63,,1192.46,,,0,"percent of total billed charges","63% of total billed charges",362,15.3,,289.60,,,0,"percent of total billed charges","15.3% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,1632.54,69,,,,,0,"fee schedule","69% of total billed charges",2366,100,,1892.80,,,0,"percent of total billed charges","100% of total billed charges",2366,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2366,100,,1892.80,,,0,"percent of total billed charges","100% of total billed charges",2366,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2366,100,,1892.80,,,0,"percent of total billed charges","100% of total billed charges",2366,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1800.23,100,,,,,0,"fee schedule",EAPG,2366,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2366,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1836.23,100,,,,,0,"fee schedule",EAPG,2340.29,100,,,,,0,"fee schedule",EAPG,2366,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",891.98,37.7,,713.58,,,0,"percent of total billed charges","37.70% of total billed charges",2366,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2366,100,,,,,0,"fee schedule","100% of CMS fee schedule",1845.48,78,,1476.38,,,0,"percent of total billed charges","78% of total billed charges",2366,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1954.32,82.6,,1563.46,,,0,"percent of total billed charges","82.6% of total billed charges",1800.23,100,,,,,0,"fee schedule","100% of WA fee schedule",2366,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1954.32,82.6,,1563.46,,,0,"percent of total billed charges","82.6% of total billed charges",2366,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1960.76,100,,,,,0,"fee schedule",EAPG,2366,100,,1892.80,,,0,"percent of total billed charges","100% of total billed charges",362,6601.69,
"44312 Revision of ileostomy; simple (release of su",7962434,CDM,521,RC,44312,CPT,OUTPATIENT,,,1717,1116.05,,1510.96,88,,1208.77,,,0,"percent of total billed charges","88% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1800.23,100,,,,,0,"fee schedule",EAPG,1717,100,,1373.60,,,0,"percent of total billed charges","100% of total billed charges",6403.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",1854.23,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1081.71,63,,865.37,,,0,"percent of total billed charges","63% of total billed charges",262.7,15.3,,210.16,,,0,"percent of total billed charges","15.3% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,1184.73,69,,,,,0,"fee schedule","69% of total billed charges",1717,100,,1373.60,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1717,100,,1373.60,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1717,100,,1373.60,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",14308.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1800.23,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3740.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1836.23,100,,,,,0,"fee schedule",EAPG,2340.29,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",647.31,37.7,,517.85,,,0,"percent of total billed charges","37.70% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1339.26,78,,1071.41,,,0,"percent of total billed charges","78% of total billed charges",3695.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1418.24,82.6,,1134.59,,,0,"percent of total billed charges","82.6% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1418.24,82.6,,1134.59,,,0,"percent of total billed charges","82.6% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1960.76,100,,,,,0,"fee schedule",EAPG,1717,100,,1373.60,,,0,"percent of total billed charges","100% of total billed charges",262.7,14308.84,
"44314 Revision of ileostomy; complicated (reconstr",7963113,CDM,521,RC,44314,CPT,OUTPATIENT,,,2930,1904.5,,2578.4,88,,2062.72,,,0,"percent of total billed charges","88% of total billed charges",2930,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,2930,100,,2344.00,,,0,"percent of total billed charges","100% of total billed charges",2930,175,,,,,0,"fee schedule","175% of CMS fee schedule",1854.23,100,,,,,0,"fee schedule",EAPG,2930,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1845.9,63,,1476.72,,,0,"percent of total billed charges","63% of total billed charges",448.29,15.3,,358.63,,,0,"percent of total billed charges","15.3% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,2021.7,69,,,,,0,"fee schedule","69% of total billed charges",2930,100,,2344.00,,,0,"percent of total billed charges","100% of total billed charges",2930,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2930,100,,2344.00,,,0,"percent of total billed charges","100% of total billed charges",2930,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2930,100,,2344.00,,,0,"percent of total billed charges","100% of total billed charges",2930,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",14308.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1800.23,100,,,,,0,"fee schedule",EAPG,2930,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3740.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2930,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1836.23,100,,,,,0,"fee schedule",EAPG,2340.29,100,,,,,0,"fee schedule",EAPG,2930,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1104.61,37.7,,883.69,,,0,"percent of total billed charges","37.70% of total billed charges",2930,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2930,100,,,,,0,"fee schedule","100% of CMS fee schedule",2285.4,78,,1828.32,,,0,"percent of total billed charges","78% of total billed charges",2930,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2420.18,82.6,,1936.14,,,0,"percent of total billed charges","82.6% of total billed charges",1800.23,100,,,,,0,"fee schedule","100% of WA fee schedule",2930,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2420.18,82.6,,1936.14,,,0,"percent of total billed charges","82.6% of total billed charges",2930,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1960.76,100,,,,,0,"fee schedule",EAPG,2930,100,,2344.00,,,0,"percent of total billed charges","100% of total billed charges",448.29,14308.84,
"44320 Colostomy or skin level cecostomy;",7963694,CDM,521,RC,44320,CPT,OUTPATIENT,,,3058,1987.7,,2691.04,88,,2152.83,,,0,"percent of total billed charges","88% of total billed charges",3058,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,3058,100,,2446.40,,,0,"percent of total billed charges","100% of total billed charges",3058,175,,,,,0,"fee schedule","175% of CMS fee schedule",4682.92,100,,,,,0,"fee schedule",EAPG,3058,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1926.54,63,,1541.23,,,0,"percent of total billed charges","63% of total billed charges",467.87,15.3,,374.30,,,0,"percent of total billed charges","15.3% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,2110.02,69,,,,,0,"fee schedule","69% of total billed charges",3058,100,,2446.40,,,0,"percent of total billed charges","100% of total billed charges",3058,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3058,100,,2446.40,,,0,"percent of total billed charges","100% of total billed charges",3058,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3058,100,,2446.40,,,0,"percent of total billed charges","100% of total billed charges",3058,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3058,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,3058,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3058,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3058,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4637.46,100,,,,,0,"fee schedule",EAPG,5910.49,100,,,,,0,"fee schedule",EAPG,3058,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1152.87,37.7,,922.30,,,0,"percent of total billed charges","37.70% of total billed charges",3058,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3058,100,,,,,0,"fee schedule","100% of CMS fee schedule",2385.24,78,,1908.19,,,0,"percent of total billed charges","78% of total billed charges",3058,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2525.91,82.6,,2020.73,,,0,"percent of total billed charges","82.6% of total billed charges",4546.53,100,,,,,0,"fee schedule","100% of WA fee schedule",3058,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2525.91,82.6,,2020.73,,,0,"percent of total billed charges","82.6% of total billed charges",3058,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4707.06,100,,,,,0,"fee schedule",EAPG,3058,100,,2446.40,,,0,"percent of total billed charges","100% of total billed charges",467.87,5910.49,
"44345 Revision of colostomy; complicated (reconstr",7963114,CDM,521,RC,44345,CPT,OUTPATIENT,,,2996,1947.4,,2636.48,88,,2109.18,,,0,"percent of total billed charges","88% of total billed charges",2996,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,2996,100,,2396.80,,,0,"percent of total billed charges","100% of total billed charges",2996,175,,,,,0,"fee schedule","175% of CMS fee schedule",1854.23,100,,,,,0,"fee schedule",EAPG,2996,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1887.48,63,,1509.98,,,0,"percent of total billed charges","63% of total billed charges",458.39,15.3,,366.71,,,0,"percent of total billed charges","15.3% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,2067.24,69,,,,,0,"fee schedule","69% of total billed charges",2996,100,,2396.80,,,0,"percent of total billed charges","100% of total billed charges",2996,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2996,100,,2396.80,,,0,"percent of total billed charges","100% of total billed charges",2996,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2996,100,,2396.80,,,0,"percent of total billed charges","100% of total billed charges",2996,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1800.23,100,,,,,0,"fee schedule",EAPG,2996,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2996,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1836.23,100,,,,,0,"fee schedule",EAPG,2340.29,100,,,,,0,"fee schedule",EAPG,2996,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1129.49,37.7,,903.59,,,0,"percent of total billed charges","37.70% of total billed charges",2996,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2996,100,,,,,0,"fee schedule","100% of CMS fee schedule",2336.88,78,,1869.50,,,0,"percent of total billed charges","78% of total billed charges",2996,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2474.7,82.6,,1979.76,,,0,"percent of total billed charges","82.6% of total billed charges",1800.23,100,,,,,0,"fee schedule","100% of WA fee schedule",2996,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2474.7,82.6,,1979.76,,,0,"percent of total billed charges","82.6% of total billed charges",2996,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1960.76,100,,,,,0,"fee schedule",EAPG,2996,100,,2396.80,,,0,"percent of total billed charges","100% of total billed charges",458.39,12932.7,
"44340 Revision of colostomy; simple (release of su",7963149,CDM,521,RC,44340,CPT,OUTPATIENT,,,1787,1161.55,,1572.56,88,,1258.05,,,0,"percent of total billed charges","88% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1800.23,100,,,,,0,"fee schedule",EAPG,1787,100,,1429.60,,,0,"percent of total billed charges","100% of total billed charges",6403.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",1854.23,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1125.81,63,,900.65,,,0,"percent of total billed charges","63% of total billed charges",273.41,15.3,,218.73,,,0,"percent of total billed charges","15.3% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,1233.03,69,,,,,0,"fee schedule","69% of total billed charges",1787,100,,1429.60,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1787,100,,1429.60,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1787,100,,1429.60,,,0,"percent of total billed charges","100% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",14308.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1800.23,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3740.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1836.23,100,,,,,0,"fee schedule",EAPG,2340.29,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",673.7,37.7,,538.96,,,0,"percent of total billed charges","37.70% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1393.86,78,,1115.09,,,0,"percent of total billed charges","78% of total billed charges",3695.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1476.06,82.6,,1180.85,,,0,"percent of total billed charges","82.6% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1476.06,82.6,,1180.85,,,0,"percent of total billed charges","82.6% of total billed charges",3659.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1960.76,100,,,,,0,"fee schedule",EAPG,1787,100,,1429.60,,,0,"percent of total billed charges","100% of total billed charges",273.41,14308.84,
"44346 Revision of colostomy; with repair of paraco",7963176,CDM,521,RC,44346,CPT,OUTPATIENT,,,3368,2189.2,,2963.84,88,,2371.07,,,0,"percent of total billed charges","88% of total billed charges",3368,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,3368,100,,2694.40,,,0,"percent of total billed charges","100% of total billed charges",3368,175,,,,,0,"fee schedule","175% of CMS fee schedule",4682.92,100,,,,,0,"fee schedule",EAPG,3368,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2121.84,63,,1697.47,,,0,"percent of total billed charges","63% of total billed charges",515.3,15.3,,412.24,,,0,"percent of total billed charges","15.3% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,2323.92,69,,,,,0,"fee schedule","69% of total billed charges",3368,100,,2694.40,,,0,"percent of total billed charges","100% of total billed charges",3368,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3368,100,,2694.40,,,0,"percent of total billed charges","100% of total billed charges",3368,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3368,100,,2694.40,,,0,"percent of total billed charges","100% of total billed charges",3368,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4546.53,100,,,,,0,"fee schedule",EAPG,3368,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3368,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4637.46,100,,,,,0,"fee schedule",EAPG,5910.49,100,,,,,0,"fee schedule",EAPG,3368,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1269.74,37.7,,1015.79,,,0,"percent of total billed charges","37.70% of total billed charges",3368,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3368,100,,,,,0,"fee schedule","100% of CMS fee schedule",2627.04,78,,2101.63,,,0,"percent of total billed charges","78% of total billed charges",3368,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2781.97,82.6,,2225.58,,,0,"percent of total billed charges","82.6% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,3368,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2781.97,82.6,,2225.58,,,0,"percent of total billed charges","82.6% of total billed charges",3368,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4707.06,100,,,,,0,"fee schedule",EAPG,3368,100,,2694.40,,,0,"percent of total billed charges","100% of total billed charges",515.3,12932.7,
"44373 Small intestinal endoscopy, enteroscopy beyo",7962092,CDM,521,RC,44373,CPT,OUTPATIENT,,,1119,727.35,,984.72,88,,787.78,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1119,100,,895.20,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",887.66,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",704.97,63,,563.98,,,0,"percent of total billed charges","63% of total billed charges",171.21,15.3,,136.97,,,0,"percent of total billed charges","15.3% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,772.11,69,,,,,0,"fee schedule","69% of total billed charges",1119,100,,895.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1119,100,,895.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1119,100,,895.20,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879.04,100,,,,,0,"fee schedule",EAPG,1120.34,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",421.86,37.7,,337.49,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",872.82,78,,698.26,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",924.29,82.6,,739.43,,,0,"percent of total billed charges","82.6% of total billed charges",861.8,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",924.29,82.6,,739.43,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1022.33,100,,,,,0,"fee schedule",EAPG,1119,100,,895.20,,,0,"percent of total billed charges","100% of total billed charges",171.21,6601.69,
"44388 Colonoscopy through stoma; diagnostic, w/ or",7961531,CDM,521,RC,44388,CPT,OUTPATIENT,,,1005,653.25,,884.4,88,,707.52,,,0,"percent of total billed charges","88% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1005,100,,804.00,,,0,"percent of total billed charges","100% of total billed charges",1631.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",633.15,63,,506.52,,,0,"percent of total billed charges","63% of total billed charges",153.77,15.3,,123.02,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,693.45,69,,,,,0,"fee schedule","69% of total billed charges",1005,100,,804.00,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1005,100,,804.00,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1005,100,,804.00,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",3224.22,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",842.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",378.89,37.7,,303.11,,,0,"percent of total billed charges","37.70% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",783.9,78,,627.12,,,0,"percent of total billed charges","78% of total billed charges",941.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",830.13,82.6,,664.10,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",830.13,82.6,,664.10,,,0,"percent of total billed charges","82.6% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.21,100,,,,,0,"fee schedule",EAPG,1005,100,,804.00,,,0,"percent of total billed charges","100% of total billed charges",153.77,3224.22,
"44389 Colonoscopy through stoma; with biopsy, sing",7963177,CDM,521,RC,44389,CPT,OUTPATIENT,,,663,430.95,,583.44,88,,466.75,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,663,100,,530.40,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",417.69,63,,334.15,,,0,"percent of total billed charges","63% of total billed charges",101.44,15.3,,81.15,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,457.47,69,,,,,0,"fee schedule","69% of total billed charges",663,100,,530.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",663,100,,530.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",663,100,,530.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.95,37.7,,199.96,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",517.14,78,,413.71,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",547.64,82.6,,438.11,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",547.64,82.6,,438.11,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.21,100,,,,,0,"fee schedule",EAPG,663,100,,530.40,,,0,"percent of total billed charges","100% of total billed charges",101.44,4212.68,
"44394 Colonoscopy through stoma; removal of tumor/",7962939,CDM,521,RC,44394,CPT,OUTPATIENT,,,499,324.35,,439.12,88,,351.30,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,499,100,,399.20,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",314.37,63,,251.50,,,0,"percent of total billed charges","63% of total billed charges",76.35,15.3,,61.08,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,344.31,69,,,,,0,"fee schedule","69% of total billed charges",499,100,,399.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499,100,,399.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499,100,,399.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",188.12,37.7,,150.50,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",389.22,78,,311.38,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.17,82.6,,329.74,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.17,82.6,,329.74,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.21,100,,,,,0,"fee schedule",EAPG,499,100,,399.20,,,0,"percent of total billed charges","100% of total billed charges",76.35,4212.68,
"44392 Colonoscopy w/rem Polyp hot bx",8165582,CDM,521,RC,44392,CPT,OUTPATIENT,,,2676,1739.4,,2354.88,88,,1883.90,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,2676,100,,2140.80,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1685.88,63,,1348.70,,,0,"percent of total billed charges","63% of total billed charges",409.43,15.3,,327.54,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1846.44,69,,,,,0,"fee schedule","69% of total billed charges",2676,100,,2140.80,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2676,100,,2140.80,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2676,100,,2140.80,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1008.85,37.7,,807.08,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.28,78,,1669.82,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2210.38,82.6,,1768.30,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2210.38,82.6,,1768.30,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.21,100,,,,,0,"fee schedule",EAPG,2676,100,,2140.80,,,0,"percent of total billed charges","100% of total billed charges",409.43,4212.68,
"44602 Suture of small intestine (enterorrhaphy); s",7961622,CDM,521,RC,44602,CPT,OUTPATIENT,,,2900,1885,,2552,88,,2041.60,,,0,"percent of total billed charges","88% of total billed charges",2900,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,2900,100,,2320.00,,,0,"percent of total billed charges","100% of total billed charges",2900,175,,,,,0,"fee schedule","175% of CMS fee schedule",4682.92,100,,,,,0,"fee schedule",EAPG,2900,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1827,63,,1461.60,,,0,"percent of total billed charges","63% of total billed charges",443.7,15.3,,354.96,,,0,"percent of total billed charges","15.3% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,2001,69,,,,,0,"fee schedule","69% of total billed charges",2900,100,,2320.00,,,0,"percent of total billed charges","100% of total billed charges",2900,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2900,100,,2320.00,,,0,"percent of total billed charges","100% of total billed charges",2900,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2900,100,,2320.00,,,0,"percent of total billed charges","100% of total billed charges",2900,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12515.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4546.53,100,,,,,0,"fee schedule",EAPG,2900,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2900,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4637.46,100,,,,,0,"fee schedule",EAPG,5910.49,100,,,,,0,"fee schedule",EAPG,2900,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1093.3,37.7,,874.64,,,0,"percent of total billed charges","37.70% of total billed charges",2900,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2900,100,,,,,0,"fee schedule","100% of CMS fee schedule",2262,78,,1809.60,,,0,"percent of total billed charges","78% of total billed charges",2900,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2395.4,82.6,,1916.32,,,0,"percent of total billed charges","82.6% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,2900,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2395.4,82.6,,1916.32,,,0,"percent of total billed charges","82.6% of total billed charges",2900,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4707.06,100,,,,,0,"fee schedule",EAPG,2900,100,,2320.00,,,0,"percent of total billed charges","100% of total billed charges",443.7,12515.8,
"44604 Suture of large intestine (colorrhaphy); sin",7962187,CDM,521,RC,44604,CPT,OUTPATIENT,,,3258,2117.7,,2867.04,88,,2293.63,,,0,"percent of total billed charges","88% of total billed charges",3258,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,3258,100,,2606.40,,,0,"percent of total billed charges","100% of total billed charges",3258,175,,,,,0,"fee schedule","175% of CMS fee schedule",4682.92,100,,,,,0,"fee schedule",EAPG,3258,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2052.54,63,,1642.03,,,0,"percent of total billed charges","63% of total billed charges",498.47,15.3,,398.78,,,0,"percent of total billed charges","15.3% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,2248.02,69,,,,,0,"fee schedule","69% of total billed charges",3258,100,,2606.40,,,0,"percent of total billed charges","100% of total billed charges",3258,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3258,100,,2606.40,,,0,"percent of total billed charges","100% of total billed charges",3258,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3258,100,,2606.40,,,0,"percent of total billed charges","100% of total billed charges",3258,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3258,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,3258,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3258,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3258,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4637.46,100,,,,,0,"fee schedule",EAPG,5910.49,100,,,,,0,"fee schedule",EAPG,3258,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1228.27,37.7,,982.62,,,0,"percent of total billed charges","37.70% of total billed charges",3258,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3258,100,,,,,0,"fee schedule","100% of CMS fee schedule",2541.24,78,,2032.99,,,0,"percent of total billed charges","78% of total billed charges",3258,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2691.11,82.6,,2152.89,,,0,"percent of total billed charges","82.6% of total billed charges",4546.53,100,,,,,0,"fee schedule","100% of WA fee schedule",3258,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2691.11,82.6,,2152.89,,,0,"percent of total billed charges","82.6% of total billed charges",3258,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4707.06,100,,,,,0,"fee schedule",EAPG,3258,100,,2606.40,,,0,"percent of total billed charges","100% of total billed charges",498.47,5910.49,
"44626 Closure of enterostomy, lg/small intestine;",7962301,CDM,521,RC,44626,CPT,OUTPATIENT,,,4636,3013.4,,4079.68,88,,3263.74,,,0,"percent of total billed charges","88% of total billed charges",4636,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,4636,100,,3708.80,,,0,"percent of total billed charges","100% of total billed charges",4636,175,,,,,0,"fee schedule","175% of CMS fee schedule",4682.92,100,,,,,0,"fee schedule",EAPG,4636,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2920.68,63,,2336.54,,,0,"percent of total billed charges","63% of total billed charges",709.31,15.3,,567.45,,,0,"percent of total billed charges","15.3% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,3198.84,69,,,,,0,"fee schedule","69% of total billed charges",4636,100,,3708.80,,,0,"percent of total billed charges","100% of total billed charges",4636,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4636,100,,3708.80,,,0,"percent of total billed charges","100% of total billed charges",4636,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4636,100,,3708.80,,,0,"percent of total billed charges","100% of total billed charges",4636,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4636,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,4636,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4636,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4636,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4637.46,100,,,,,0,"fee schedule",EAPG,5910.49,100,,,,,0,"fee schedule",EAPG,4636,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1747.77,37.7,,1398.22,,,0,"percent of total billed charges","37.70% of total billed charges",4636,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4636,100,,,,,0,"fee schedule","100% of CMS fee schedule",3616.08,78,,2892.86,,,0,"percent of total billed charges","78% of total billed charges",4636,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3829.34,82.6,,3063.47,,,0,"percent of total billed charges","82.6% of total billed charges",4546.53,100,,,,,0,"fee schedule","100% of WA fee schedule",4636,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3829.34,82.6,,3063.47,,,0,"percent of total billed charges","82.6% of total billed charges",4636,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4707.06,100,,,,,0,"fee schedule",EAPG,4636,100,,3708.80,,,0,"percent of total billed charges","100% of total billed charges",709.31,5910.49,
"44625 Closure of enterostomy, lg/small intestine;",7962681,CDM,521,RC,44625,CPT,OUTPATIENT,,,2963,1925.95,,2607.44,88,,2085.95,,,0,"percent of total billed charges","88% of total billed charges",2963,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,2963,100,,2370.40,,,0,"percent of total billed charges","100% of total billed charges",2963,175,,,,,0,"fee schedule","175% of CMS fee schedule",1854.23,100,,,,,0,"fee schedule",EAPG,2963,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1866.69,63,,1493.35,,,0,"percent of total billed charges","63% of total billed charges",453.34,15.3,,362.67,,,0,"percent of total billed charges","15.3% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,2044.47,69,,,,,0,"fee schedule","69% of total billed charges",2963,100,,2370.40,,,0,"percent of total billed charges","100% of total billed charges",2963,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2963,100,,2370.40,,,0,"percent of total billed charges","100% of total billed charges",2963,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2963,100,,2370.40,,,0,"percent of total billed charges","100% of total billed charges",2963,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2963,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,2963,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2963,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2963,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1836.23,100,,,,,0,"fee schedule",EAPG,2340.29,100,,,,,0,"fee schedule",EAPG,2963,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1117.05,37.7,,893.64,,,0,"percent of total billed charges","37.70% of total billed charges",2963,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2963,100,,,,,0,"fee schedule","100% of CMS fee schedule",2311.14,78,,1848.91,,,0,"percent of total billed charges","78% of total billed charges",2963,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2447.44,82.6,,1957.95,,,0,"percent of total billed charges","82.6% of total billed charges",1800.23,100,,,,,0,"fee schedule","100% of WA fee schedule",2963,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2447.44,82.6,,1957.95,,,0,"percent of total billed charges","82.6% of total billed charges",2963,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1960.76,100,,,,,0,"fee schedule",EAPG,2963,100,,2370.40,,,0,"percent of total billed charges","100% of total billed charges",453.34,2963,
"44620 Closure of enterostomy, large or small intes",7963429,CDM,521,RC,44620,CPT,OUTPATIENT,,,2519,1637.35,,2216.72,88,,1773.38,,,0,"percent of total billed charges","88% of total billed charges",2519,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,2519,100,,2015.20,,,0,"percent of total billed charges","100% of total billed charges",2519,175,,,,,0,"fee schedule","175% of CMS fee schedule",1854.23,100,,,,,0,"fee schedule",EAPG,2519,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1586.97,63,,1269.58,,,0,"percent of total billed charges","63% of total billed charges",385.41,15.3,,308.33,,,0,"percent of total billed charges","15.3% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,1738.11,69,,,,,0,"fee schedule","69% of total billed charges",2519,100,,2015.20,,,0,"percent of total billed charges","100% of total billed charges",2519,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2519,100,,2015.20,,,0,"percent of total billed charges","100% of total billed charges",2519,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2519,100,,2015.20,,,0,"percent of total billed charges","100% of total billed charges",2519,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2519,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,2519,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2519,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2519,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1836.23,100,,,,,0,"fee schedule",EAPG,2340.29,100,,,,,0,"fee schedule",EAPG,2519,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",949.66,37.7,,759.73,,,0,"percent of total billed charges","37.70% of total billed charges",2519,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2519,100,,,,,0,"fee schedule","100% of CMS fee schedule",1964.82,78,,1571.86,,,0,"percent of total billed charges","78% of total billed charges",2519,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2080.69,82.6,,1664.55,,,0,"percent of total billed charges","82.6% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,2519,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2080.69,82.6,,1664.55,,,0,"percent of total billed charges","82.6% of total billed charges",2519,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1960.76,100,,,,,0,"fee schedule",EAPG,2519,100,,2015.20,,,0,"percent of total billed charges","100% of total billed charges",385.41,2519,
"44640 Closure of intestinal cutaneous fistula",7963607,CDM,521,RC,44640,CPT,OUTPATIENT,,,3148,2046.2,,2770.24,88,,2216.19,,,0,"percent of total billed charges","88% of total billed charges",3148,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,3148,100,,2518.40,,,0,"percent of total billed charges","100% of total billed charges",3148,175,,,,,0,"fee schedule","175% of CMS fee schedule",4682.92,100,,,,,0,"fee schedule",EAPG,3148,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1983.24,63,,1586.59,,,0,"percent of total billed charges","63% of total billed charges",481.64,15.3,,385.31,,,0,"percent of total billed charges","15.3% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,2172.12,69,,,,,0,"fee schedule","69% of total billed charges",3148,100,,2518.40,,,0,"percent of total billed charges","100% of total billed charges",3148,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3148,100,,2518.40,,,0,"percent of total billed charges","100% of total billed charges",3148,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3148,100,,2518.40,,,0,"percent of total billed charges","100% of total billed charges",3148,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3148,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,3148,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3148,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3148,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4637.46,100,,,,,0,"fee schedule",EAPG,5910.49,100,,,,,0,"fee schedule",EAPG,3148,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1186.8,37.7,,949.44,,,0,"percent of total billed charges","37.70% of total billed charges",3148,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3148,100,,,,,0,"fee schedule","100% of CMS fee schedule",2455.44,78,,1964.35,,,0,"percent of total billed charges","78% of total billed charges",3148,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2600.25,82.6,,2080.20,,,0,"percent of total billed charges","82.6% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,3148,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2600.25,82.6,,2080.20,,,0,"percent of total billed charges","82.6% of total billed charges",3148,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4707.06,100,,,,,0,"fee schedule",EAPG,3148,100,,2518.40,,,0,"percent of total billed charges","100% of total billed charges",481.64,5910.49,
"44650 Closure of enteroenteric or enterocolic fist",7963451,CDM,521,RC,44650,CPT,OUTPATIENT,,,4113,2673.45,,3619.44,88,,2895.55,,,0,"percent of total billed charges","88% of total billed charges",4113,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,4113,100,,3290.40,,,0,"percent of total billed charges","100% of total billed charges",4113,175,,,,,0,"fee schedule","175% of CMS fee schedule",1854.23,100,,,,,0,"fee schedule",EAPG,4113,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2591.19,63,,2072.95,,,0,"percent of total billed charges","63% of total billed charges",629.29,15.3,,503.43,,,0,"percent of total billed charges","15.3% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,2837.97,69,,,,,0,"fee schedule","69% of total billed charges",4113,100,,3290.40,,,0,"percent of total billed charges","100% of total billed charges",4113,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4113,100,,3290.40,,,0,"percent of total billed charges","100% of total billed charges",4113,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4113,100,,3290.40,,,0,"percent of total billed charges","100% of total billed charges",4113,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4113,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,4113,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4113,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4113,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1836.23,100,,,,,0,"fee schedule",EAPG,2340.29,100,,,,,0,"fee schedule",EAPG,4113,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1550.6,37.7,,1240.48,,,0,"percent of total billed charges","37.70% of total billed charges",4113,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4113,100,,,,,0,"fee schedule","100% of CMS fee schedule",3208.14,78,,2566.51,,,0,"percent of total billed charges","78% of total billed charges",4113,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3397.34,82.6,,2717.87,,,0,"percent of total billed charges","82.6% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,4113,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3397.34,82.6,,2717.87,,,0,"percent of total billed charges","82.6% of total billed charges",4113,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1960.76,100,,,,,0,"fee schedule",EAPG,4113,100,,3290.40,,,0,"percent of total billed charges","100% of total billed charges",629.29,4113,
"44660 Closure of enterovesical fistula; without in",7962715,CDM,521,RC,44660,CPT,OUTPATIENT,,,3825,2486.25,,3366,88,,2692.80,,,0,"percent of total billed charges","88% of total billed charges",3825,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,3825,100,,3060.00,,,0,"percent of total billed charges","100% of total billed charges",3825,175,,,,,0,"fee schedule","175% of CMS fee schedule",1854.23,100,,,,,0,"fee schedule",EAPG,3825,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2409.75,63,,1927.80,,,0,"percent of total billed charges","63% of total billed charges",585.23,15.3,,468.18,,,0,"percent of total billed charges","15.3% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,2639.25,69,,,,,0,"fee schedule","69% of total billed charges",3825,100,,3060.00,,,0,"percent of total billed charges","100% of total billed charges",3825,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3825,100,,3060.00,,,0,"percent of total billed charges","100% of total billed charges",3825,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3825,100,,3060.00,,,0,"percent of total billed charges","100% of total billed charges",3825,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3825,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,3825,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3825,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3825,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1836.23,100,,,,,0,"fee schedule",EAPG,2340.29,100,,,,,0,"fee schedule",EAPG,3825,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1442.03,37.7,,1153.62,,,0,"percent of total billed charges","37.70% of total billed charges",3825,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3825,100,,,,,0,"fee schedule","100% of CMS fee schedule",2983.5,78,,2386.80,,,0,"percent of total billed charges","78% of total billed charges",3825,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3159.45,82.6,,2527.56,,,0,"percent of total billed charges","82.6% of total billed charges",1800.23,100,,,,,0,"fee schedule","100% of WA fee schedule",3825,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3159.45,82.6,,2527.56,,,0,"percent of total billed charges","82.6% of total billed charges",3825,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1960.76,100,,,,,0,"fee schedule",EAPG,3825,100,,3060.00,,,0,"percent of total billed charges","100% of total billed charges",585.23,3825,
"44661 Closure of enterovesical fistula; with intes",7962716,CDM,521,RC,44661,CPT,OUTPATIENT,,,4546,2954.9,,4000.48,88,,3200.38,,,0,"percent of total billed charges","88% of total billed charges",4546,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,4546,100,,3636.80,,,0,"percent of total billed charges","100% of total billed charges",4546,175,,,,,0,"fee schedule","175% of CMS fee schedule",1854.23,100,,,,,0,"fee schedule",EAPG,4546,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2863.98,63,,2291.18,,,0,"percent of total billed charges","63% of total billed charges",695.54,15.3,,556.43,,,0,"percent of total billed charges","15.3% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,3136.74,69,,,,,0,"fee schedule","69% of total billed charges",4546,100,,3636.80,,,0,"percent of total billed charges","100% of total billed charges",4546,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546,100,,3636.80,,,0,"percent of total billed charges","100% of total billed charges",4546,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546,100,,3636.80,,,0,"percent of total billed charges","100% of total billed charges",4546,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,4546,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4546,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1836.23,100,,,,,0,"fee schedule",EAPG,2340.29,100,,,,,0,"fee schedule",EAPG,4546,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1713.84,37.7,,1371.07,,,0,"percent of total billed charges","37.70% of total billed charges",4546,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4546,100,,,,,0,"fee schedule","100% of CMS fee schedule",3545.88,78,,2836.70,,,0,"percent of total billed charges","78% of total billed charges",4546,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3755,82.6,,3004.00,,,0,"percent of total billed charges","82.6% of total billed charges",1800.23,100,,,,,0,"fee schedule","100% of WA fee schedule",4546,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3755,82.6,,3004.00,,,0,"percent of total billed charges","82.6% of total billed charges",4546,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1960.76,100,,,,,0,"fee schedule",EAPG,4546,100,,3636.80,,,0,"percent of total billed charges","100% of total billed charges",695.54,4546,
"44799 Unlisted procedure, small intestine",7963682,CDM,521,RC,44799,CPT,OUTPATIENT,,,3819,2482.35,,3360.72,88,,2688.58,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1800.23,100,,,,,0,"fee schedule",EAPG,3819,100,,3055.20,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",1854.23,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2405.97,63,,1924.78,,,0,"percent of total billed charges","63% of total billed charges",584.31,15.3,,467.45,,,0,"percent of total billed charges","15.3% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,2635.11,69,,,,,0,"fee schedule","69% of total billed charges",3819,100,,3055.20,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3819,100,,3055.20,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3819,100,,3055.20,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1800.23,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1836.23,100,,,,,0,"fee schedule",EAPG,2340.29,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1439.76,37.7,,1151.81,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2978.82,78,,2383.06,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3154.49,82.6,,2523.59,,,0,"percent of total billed charges","82.6% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3154.49,82.6,,2523.59,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1960.76,100,,,,,0,"fee schedule",EAPG,3819,100,,3055.20,,,0,"percent of total billed charges","100% of total billed charges",584.31,3819,
"44800 Excision of Meckel's diverticulum (diverticu",7962534,CDM,521,RC,44800,CPT,OUTPATIENT,,,3199,2079.35,,2815.12,88,,2252.10,,,0,"percent of total billed charges","88% of total billed charges",3199,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,3199,100,,2559.20,,,0,"percent of total billed charges","100% of total billed charges",3199,175,,,,,0,"fee schedule","175% of CMS fee schedule",1854.23,100,,,,,0,"fee schedule",EAPG,3199,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2015.37,63,,1612.30,,,0,"percent of total billed charges","63% of total billed charges",489.45,15.3,,391.56,,,0,"percent of total billed charges","15.3% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,2207.31,69,,,,,0,"fee schedule","69% of total billed charges",3199,100,,2559.20,,,0,"percent of total billed charges","100% of total billed charges",3199,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3199,100,,2559.20,,,0,"percent of total billed charges","100% of total billed charges",3199,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3199,100,,2559.20,,,0,"percent of total billed charges","100% of total billed charges",3199,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3199,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,3199,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3199,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3199,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1836.23,100,,,,,0,"fee schedule",EAPG,2340.29,100,,,,,0,"fee schedule",EAPG,3199,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1206.02,37.7,,964.82,,,0,"percent of total billed charges","37.70% of total billed charges",3199,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3199,100,,,,,0,"fee schedule","100% of CMS fee schedule",2495.22,78,,1996.18,,,0,"percent of total billed charges","78% of total billed charges",3199,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2642.37,82.6,,2113.90,,,0,"percent of total billed charges","82.6% of total billed charges",1800.23,100,,,,,0,"fee schedule","100% of WA fee schedule",3199,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2642.37,82.6,,2113.90,,,0,"percent of total billed charges","82.6% of total billed charges",3199,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1960.76,100,,,,,0,"fee schedule",EAPG,3199,100,,2559.20,,,0,"percent of total billed charges","100% of total billed charges",489.45,3199,
"44820 Excision of lesion of mesentery (separate pr",7963334,CDM,521,RC,44820,CPT,OUTPATIENT,,,2431,1580.15,,2139.28,88,,1711.42,,,0,"percent of total billed charges","88% of total billed charges",2431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,2431,100,,1944.80,,,0,"percent of total billed charges","100% of total billed charges",2431,175,,,,,0,"fee schedule","175% of CMS fee schedule",1854.23,100,,,,,0,"fee schedule",EAPG,2431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1531.53,63,,1225.22,,,0,"percent of total billed charges","63% of total billed charges",371.94,15.3,,297.55,,,0,"percent of total billed charges","15.3% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,1677.39,69,,,,,0,"fee schedule","69% of total billed charges",2431,100,,1944.80,,,0,"percent of total billed charges","100% of total billed charges",2431,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2431,100,,1944.80,,,0,"percent of total billed charges","100% of total billed charges",2431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2431,100,,1944.80,,,0,"percent of total billed charges","100% of total billed charges",2431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,2431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1836.23,100,,,,,0,"fee schedule",EAPG,2340.29,100,,,,,0,"fee schedule",EAPG,2431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",916.49,37.7,,733.19,,,0,"percent of total billed charges","37.70% of total billed charges",2431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2431,100,,,,,0,"fee schedule","100% of CMS fee schedule",1896.18,78,,1516.94,,,0,"percent of total billed charges","78% of total billed charges",2431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2008.01,82.6,,1606.41,,,0,"percent of total billed charges","82.6% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,2431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2008.01,82.6,,1606.41,,,0,"percent of total billed charges","82.6% of total billed charges",2431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1960.76,100,,,,,0,"fee schedule",EAPG,2431,100,,1944.80,,,0,"percent of total billed charges","100% of total billed charges",371.94,2431,
"44850 Suture of mesentery (separate procedure)",7963585,CDM,521,RC,44850,CPT,OUTPATIENT,,,2166,1407.9,,1906.08,88,,1524.86,,,0,"percent of total billed charges","88% of total billed charges",2166,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,2166,100,,1732.80,,,0,"percent of total billed charges","100% of total billed charges",2166,175,,,,,0,"fee schedule","175% of CMS fee schedule",1854.23,100,,,,,0,"fee schedule",EAPG,2166,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1364.58,63,,1091.66,,,0,"percent of total billed charges","63% of total billed charges",331.4,15.3,,265.12,,,0,"percent of total billed charges","15.3% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,1494.54,69,,,,,0,"fee schedule","69% of total billed charges",2166,100,,1732.80,,,0,"percent of total billed charges","100% of total billed charges",2166,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2166,100,,1732.80,,,0,"percent of total billed charges","100% of total billed charges",2166,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2166,100,,1732.80,,,0,"percent of total billed charges","100% of total billed charges",2166,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2166,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,2166,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2166,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2166,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1836.23,100,,,,,0,"fee schedule",EAPG,2340.29,100,,,,,0,"fee schedule",EAPG,2166,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",816.58,37.7,,653.26,,,0,"percent of total billed charges","37.70% of total billed charges",2166,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2166,100,,,,,0,"fee schedule","100% of CMS fee schedule",1689.48,78,,1351.58,,,0,"percent of total billed charges","78% of total billed charges",2166,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1789.12,82.6,,1431.30,,,0,"percent of total billed charges","82.6% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,2166,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1789.12,82.6,,1431.30,,,0,"percent of total billed charges","82.6% of total billed charges",2166,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1960.76,100,,,,,0,"fee schedule",EAPG,2166,100,,1732.80,,,0,"percent of total billed charges","100% of total billed charges",331.4,2340.29,
"44900 Incision and drainage of appendiceal abscess",7963384,CDM,521,RC,44900,CPT,OUTPATIENT,,,2233,1451.45,,1965.04,88,,1572.03,,,0,"percent of total billed charges","88% of total billed charges",2233,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,2233,100,,1786.40,,,0,"percent of total billed charges","100% of total billed charges",2233,175,,,,,0,"fee schedule","175% of CMS fee schedule",1854.23,100,,,,,0,"fee schedule",EAPG,2233,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1406.79,63,,1125.43,,,0,"percent of total billed charges","63% of total billed charges",341.65,15.3,,273.32,,,0,"percent of total billed charges","15.3% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,1540.77,69,,,,,0,"fee schedule","69% of total billed charges",2233,100,,1786.40,,,0,"percent of total billed charges","100% of total billed charges",2233,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2233,100,,1786.40,,,0,"percent of total billed charges","100% of total billed charges",2233,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2233,100,,1786.40,,,0,"percent of total billed charges","100% of total billed charges",2233,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2233,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1800.23,100,,,,,0,"fee schedule",EAPG,2233,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2233,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2233,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1836.23,100,,,,,0,"fee schedule",EAPG,2340.29,100,,,,,0,"fee schedule",EAPG,2233,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",841.84,37.7,,673.47,,,0,"percent of total billed charges","37.70% of total billed charges",2233,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2233,100,,,,,0,"fee schedule","100% of CMS fee schedule",1741.74,78,,1393.39,,,0,"percent of total billed charges","78% of total billed charges",2233,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1844.46,82.6,,1475.57,,,0,"percent of total billed charges","82.6% of total billed charges",1800.23,100,,,,,0,"fee schedule",EAPG,2233,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1844.46,82.6,,1475.57,,,0,"percent of total billed charges","82.6% of total billed charges",2233,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1960.76,100,,,,,0,"fee schedule",EAPG,2233,100,,1786.40,,,0,"percent of total billed charges","100% of total billed charges",341.65,2340.29,
"44955 Appendectomy; when done for indicated purpos",7962535,CDM,521,RC,44955,CPT,OUTPATIENT,,,688,447.2,,605.44,88,,484.35,,,0,"percent of total billed charges","88% of total billed charges",344,50,,275.20,,,0,"percent of total billed charges","50% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,688,100,,550.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3456.02,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",433.44,63,,346.75,,,0,"percent of total billed charges","63% of total billed charges",105.26,15.3,,84.21,,,0,"percent of total billed charges","15.3% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,474.72,69,,,,,0,"fee schedule","69% of total billed charges",688,100,,550.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",688,100,,550.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",688,100,,550.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3355.36,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3422.47,100,,,,,0,"fee schedule",EAPG,4361.97,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",259.38,37.7,,207.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",536.64,78,,429.31,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",568.29,82.6,,454.63,,,0,"percent of total billed charges","82.6% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,344,50,,275.20,,,0,"percent of total billed charges","50% of total billed charges",568.29,82.6,,454.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3515.89,100,,,,,0,"fee schedule",EAPG,688,100,,550.40,,,0,"percent of total billed charges","100% of total billed charges",105.26,4361.97,
"44950 Appendectomy",7963932,CDM,521,RC,44950,CPT,OUTPATIENT,,,2165,1407.25,,1905.2,88,,1524.16,,,0,"percent of total billed charges","88% of total billed charges",7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4546.53,100,,,,,0,"fee schedule",EAPG,2165,100,,1732.00,,,0,"percent of total billed charges","100% of total billed charges",13504.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",4682.92,100,,,,,0,"fee schedule",EAPG,7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1363.95,63,,1091.16,,,0,"percent of total billed charges","63% of total billed charges",331.25,15.3,,265.00,,,0,"percent of total billed charges","15.3% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,1493.85,69,,,,,0,"fee schedule","69% of total billed charges",2165,100,,1732.00,,,0,"percent of total billed charges","100% of total billed charges",7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2165,100,,1732.00,,,0,"percent of total billed charges","100% of total billed charges",7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2165,100,,1732.00,,,0,"percent of total billed charges","100% of total billed charges",7716.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4546.53,100,,,,,0,"fee schedule",EAPG,7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4637.46,100,,,,,0,"fee schedule",EAPG,5910.49,100,,,,,0,"fee schedule",EAPG,7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",816.21,37.7,,652.97,,,0,"percent of total billed charges","37.70% of total billed charges",7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1688.7,78,,1350.96,,,0,"percent of total billed charges","78% of total billed charges",7793.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1788.29,82.6,,1430.63,,,0,"percent of total billed charges","82.6% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1788.29,82.6,,1430.63,,,0,"percent of total billed charges","82.6% of total billed charges",7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4707.06,100,,,,,0,"fee schedule",EAPG,2165,100,,1732.00,,,0,"percent of total billed charges","100% of total billed charges",331.25,13504.04,
"44960 Appendectomy; for ruptured appendix with abs",7962638,CDM,521,RC,44960,CPT,OUTPATIENT,,,2602,1691.3,,2289.76,88,,1831.81,,,0,"percent of total billed charges","88% of total billed charges",2602,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,2602,100,,2081.60,,,0,"percent of total billed charges","100% of total billed charges",2602,175,,,,,0,"fee schedule","175% of CMS fee schedule",4682.92,100,,,,,0,"fee schedule",EAPG,2602,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1639.26,63,,1311.41,,,0,"percent of total billed charges","63% of total billed charges",398.11,15.3,,318.49,,,0,"percent of total billed charges","15.3% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,1795.38,69,,,,,0,"fee schedule","69% of total billed charges",2602,100,,2081.60,,,0,"percent of total billed charges","100% of total billed charges",2602,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2602,100,,2081.60,,,0,"percent of total billed charges","100% of total billed charges",2602,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2602,100,,2081.60,,,0,"percent of total billed charges","100% of total billed charges",2602,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2602,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4546.53,100,,,,,0,"fee schedule",EAPG,2602,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2602,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2602,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4637.46,100,,,,,0,"fee schedule",EAPG,5910.49,100,,,,,0,"fee schedule",EAPG,2602,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",980.95,37.7,,784.76,,,0,"percent of total billed charges","37.70% of total billed charges",2602,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2602,100,,,,,0,"fee schedule","100% of CMS fee schedule",2029.56,78,,1623.65,,,0,"percent of total billed charges","78% of total billed charges",2602,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2149.25,82.6,,1719.40,,,0,"percent of total billed charges","82.6% of total billed charges",4546.53,100,,,,,0,"fee schedule","100% of WA fee schedule",2602,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2149.25,82.6,,1719.40,,,0,"percent of total billed charges","82.6% of total billed charges",2602,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4707.06,100,,,,,0,"fee schedule",EAPG,2602,100,,2081.60,,,0,"percent of total billed charges","100% of total billed charges",398.11,5910.49,
"44970 Laparoscopy, surgical, appendectomy",7963683,CDM,521,RC,44970,CPT,OUTPATIENT,,,1845,1199.25,,1623.6,88,,1298.88,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4546.53,100,,,,,0,"fee schedule",EAPG,1845,100,,1476.00,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",4682.92,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1162.35,63,,929.88,,,0,"percent of total billed charges","63% of total billed charges",282.29,15.3,,225.83,,,0,"percent of total billed charges","15.3% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,1273.05,69,,,,,0,"fee schedule","69% of total billed charges",1845,100,,1476.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1845,100,,1476.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1845,100,,1476.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4546.53,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4637.46,100,,,,,0,"fee schedule",EAPG,5910.49,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",695.57,37.7,,556.46,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1439.1,78,,1151.28,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1523.97,82.6,,1219.18,,,0,"percent of total billed charges","82.6% of total billed charges",4546.53,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1523.97,82.6,,1219.18,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4707.06,100,,,,,0,"fee schedule",EAPG,1845,100,,1476.00,,,0,"percent of total billed charges","100% of total billed charges",282.29,20558.19,
"45005 Incision and drainage of submucosal abscess,",7963372,CDM,521,RC,45005,CPT,OUTPATIENT,,,698,453.7,,614.24,88,,491.39,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,698,100,,558.40,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",1367,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",439.74,63,,351.79,,,0,"percent of total billed charges","63% of total billed charges",106.79,15.3,,85.43,,,0,"percent of total billed charges","15.3% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,481.62,69,,,,,0,"fee schedule","69% of total billed charges",698,100,,558.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",698,100,,558.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",698,100,,558.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",263.15,37.7,,210.52,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",544.44,78,,435.55,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",576.55,82.6,,461.24,,,0,"percent of total billed charges","82.6% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",576.55,82.6,,461.24,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1487.72,100,,,,,0,"fee schedule",EAPG,698,100,,558.40,,,0,"percent of total billed charges","100% of total billed charges",106.79,4212.68,
"45000 Transrectal drainage of pelvic abscess",7963628,CDM,521,RC,45000,CPT,OUTPATIENT,,,1249,811.85,,1099.12,88,,879.30,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2024.32,100,,,,,0,"fee schedule",EAPG,1249,100,,999.20,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",2085.05,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.87,63,,629.50,,,0,"percent of total billed charges","63% of total billed charges",191.1,15.3,,152.88,,,0,"percent of total billed charges","15.3% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,861.81,69,,,,,0,"fee schedule","69% of total billed charges",1249,100,,999.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1249,100,,999.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1249,100,,999.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2024.32,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2064.8,100,,,,,0,"fee schedule",EAPG,2631.61,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",470.87,37.7,,376.70,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",974.22,78,,779.38,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1031.67,82.6,,825.34,,,0,"percent of total billed charges","82.6% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1031.67,82.6,,825.34,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2184.85,100,,,,,0,"fee schedule",EAPG,1249,100,,999.20,,,0,"percent of total billed charges","100% of total billed charges",191.1,4212.68,
"45020 Incision and drainage of deep supralevator,",7962504,CDM,521,RC,45020,CPT,OUTPATIENT,,,1162,755.3,,1022.56,88,,818.05,,,0,"percent of total billed charges","88% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2024.32,100,,,,,0,"fee schedule",EAPG,1162,100,,929.60,,,0,"percent of total billed charges","100% of total billed charges",5011.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",2085.05,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",732.06,63,,585.65,,,0,"percent of total billed charges","63% of total billed charges",177.79,15.3,,142.23,,,0,"percent of total billed charges","15.3% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,801.78,69,,,,,0,"fee schedule","69% of total billed charges",1162,100,,929.60,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1162,100,,929.60,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1162,100,,929.60,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",9926.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2024.32,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2595.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2064.8,100,,,,,0,"fee schedule",EAPG,2631.61,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",438.07,37.7,,350.46,,,0,"percent of total billed charges","37.70% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",906.36,78,,725.09,,,0,"percent of total billed charges","78% of total billed charges",2892.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",959.81,82.6,,767.85,,,0,"percent of total billed charges","82.6% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",959.81,82.6,,767.85,,,0,"percent of total billed charges","82.6% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2184.85,100,,,,,0,"fee schedule",EAPG,1162,100,,929.60,,,0,"percent of total billed charges","100% of total billed charges",177.79,9926.34,
"45100 Biopsy of anorectal wall, anal approach (eg,",7962940,CDM,521,RC,45100,CPT,OUTPATIENT,,,880,572,,774.4,88,,619.52,,,0,"percent of total billed charges","88% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",5011.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",1367,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.4,63,,443.52,,,0,"percent of total billed charges","63% of total billed charges",134.64,15.3,,107.71,,,0,"percent of total billed charges","15.3% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,607.2,69,,,,,0,"fee schedule","69% of total billed charges",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",9926.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2595.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",331.76,37.7,,265.41,,,0,"percent of total billed charges","37.70% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.4,78,,549.12,,,0,"percent of total billed charges","78% of total billed charges",2892.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.88,82.6,,581.50,,,0,"percent of total billed charges","82.6% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.88,82.6,,581.50,,,0,"percent of total billed charges","82.6% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1487.72,100,,,,,0,"fee schedule",EAPG,880,100,,704.00,,,0,"percent of total billed charges","100% of total billed charges",134.64,9926.34,
"45112 Proctectomy, combined abdominoperineal, pull",7961843,CDM,521,RC,45112,CPT,OUTPATIENT,,,5496,3572.4,,4836.48,88,,3869.18,,,0,"percent of total billed charges","88% of total billed charges",5496,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2024.32,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5496,175,,,,,0,"fee schedule","175% of CMS fee schedule",2085.05,100,,,,,0,"fee schedule",EAPG,5496,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3462.48,63,,2769.98,,,0,"percent of total billed charges","63% of total billed charges",840.89,15.3,,672.71,,,0,"percent of total billed charges","15.3% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,3792.24,69,,,,,0,"fee schedule","69% of total billed charges",5496,100,,4396.80,,,0,"percent of total billed charges","100% of total billed charges",5496,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5496,100,,4396.80,,,0,"percent of total billed charges","100% of total billed charges",5496,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5496,100,,4396.80,,,0,"percent of total billed charges","100% of total billed charges",5496,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5496,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2024.32,100,,,,,0,"fee schedule",EAPG,5496,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5496,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5496,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2064.8,100,,,,,0,"fee schedule",EAPG,2631.61,100,,,,,0,"fee schedule",EAPG,5496,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2071.99,37.7,,1657.59,,,0,"percent of total billed charges","37.70% of total billed charges",5496,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5496,100,,,,,0,"fee schedule","100% of CMS fee schedule",4286.88,78,,3429.50,,,0,"percent of total billed charges","78% of total billed charges",5496,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4539.7,82.6,,3631.76,,,0,"percent of total billed charges","82.6% of total billed charges",2024.32,100,,,,,0,"fee schedule","100% of WA fee schedule",5496,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4539.7,82.6,,3631.76,,,0,"percent of total billed charges","82.6% of total billed charges",5496,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2184.85,100,,,,,0,"fee schedule",EAPG,5496,100,,4396.80,,,0,"percent of total billed charges","100% of total billed charges",840.89,5496,
"45110 Proctectomy; complete, combined abdominoperi",7963004,CDM,521,RC,45110,CPT,OUTPATIENT,,,5294,3441.1,,4658.72,88,,3726.98,,,0,"percent of total billed charges","88% of total billed charges",5294,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2024.32,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5294,175,,,,,0,"fee schedule","175% of CMS fee schedule",2085.05,100,,,,,0,"fee schedule",EAPG,5294,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3335.22,63,,2668.18,,,0,"percent of total billed charges","63% of total billed charges",809.98,15.3,,647.98,,,0,"percent of total billed charges","15.3% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,3652.86,69,,,,,0,"fee schedule","69% of total billed charges",5294,100,,4235.20,,,0,"percent of total billed charges","100% of total billed charges",5294,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5294,100,,4235.20,,,0,"percent of total billed charges","100% of total billed charges",5294,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5294,100,,4235.20,,,0,"percent of total billed charges","100% of total billed charges",5294,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5294,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2024.32,100,,,,,0,"fee schedule",EAPG,5294,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5294,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5294,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2064.8,100,,,,,0,"fee schedule",EAPG,2631.61,100,,,,,0,"fee schedule",EAPG,5294,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1995.84,37.7,,1596.67,,,0,"percent of total billed charges","37.70% of total billed charges",5294,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5294,100,,,,,0,"fee schedule","100% of CMS fee schedule",4129.32,78,,3303.46,,,0,"percent of total billed charges","78% of total billed charges",5294,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4372.84,82.6,,3498.27,,,0,"percent of total billed charges","82.6% of total billed charges",2024.32,100,,,,,0,"fee schedule","100% of WA fee schedule",5294,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4372.84,82.6,,3498.27,,,0,"percent of total billed charges","82.6% of total billed charges",5294,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2184.85,100,,,,,0,"fee schedule",EAPG,5294,100,,4235.20,,,0,"percent of total billed charges","100% of total billed charges",809.98,5294,
"45171 Excision of rectal tumor, transanal approach",7962536,CDM,521,RC,45171,CPT,OUTPATIENT,,,1661,1079.65,,1461.68,88,,1169.34,,,0,"percent of total billed charges","88% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2024.32,100,,,,,0,"fee schedule",EAPG,1661,100,,1328.80,,,0,"percent of total billed charges","100% of total billed charges",5011.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",2085.05,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1046.43,63,,837.14,,,0,"percent of total billed charges","63% of total billed charges",254.13,15.3,,203.30,,,0,"percent of total billed charges","15.3% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,1146.09,69,,,,,0,"fee schedule","69% of total billed charges",1661,100,,1328.80,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1661,100,,1328.80,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1661,100,,1328.80,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",9926.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2024.32,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2595.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2064.8,100,,,,,0,"fee schedule",EAPG,2631.61,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",626.2,37.7,,500.96,,,0,"percent of total billed charges","37.70% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1295.58,78,,1036.46,,,0,"percent of total billed charges","78% of total billed charges",2892.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1371.99,82.6,,1097.59,,,0,"percent of total billed charges","82.6% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1371.99,82.6,,1097.59,,,0,"percent of total billed charges","82.6% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2184.85,100,,,,,0,"fee schedule",EAPG,1661,100,,1328.80,,,0,"percent of total billed charges","100% of total billed charges",254.13,9926.34,
"45305 Proctosigmoidoscopy, rigid",7904620,CDM,521,RC,45305,CPT,OUTPATIENT,,,318,206.7,,279.84,88,,223.87,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,318,100,,254.40,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200.34,63,,160.27,,,0,"percent of total billed charges","63% of total billed charges",48.65,15.3,,38.92,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,219.42,69,,,,,0,"fee schedule","69% of total billed charges",318,100,,254.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",318,100,,254.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",318,100,,254.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",119.89,37.7,,95.91,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",248.04,78,,198.43,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",262.67,82.6,,210.14,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",262.67,82.6,,210.14,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.21,100,,,,,0,"fee schedule",EAPG,318,100,,254.40,,,0,"percent of total billed charges","100% of total billed charges",48.65,4212.68,
"45309 Proctosigmoidoscopy, rigid; with removal of",7961770,CDM,521,RC,45309,CPT,OUTPATIENT,,,544,353.6,,478.72,88,,382.98,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,544,100,,435.20,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.72,63,,274.18,,,0,"percent of total billed charges","63% of total billed charges",83.23,15.3,,66.58,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,375.36,69,,,,,0,"fee schedule","69% of total billed charges",544,100,,435.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",544,100,,435.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",544,100,,435.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",205.09,37.7,,164.07,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",424.32,78,,339.46,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.34,82.6,,359.47,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.34,82.6,,359.47,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.21,100,,,,,0,"fee schedule",EAPG,544,100,,435.20,,,0,"percent of total billed charges","100% of total billed charges",83.23,4212.68,
"45300 Proctosigmoidoscopy, rigid; diagnostic, w/ o",7962380,CDM,521,RC,45300,CPT,OUTPATIENT,,,237,154.05,,208.56,88,,166.85,,,0,"percent of total billed charges","88% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,237,100,,189.60,,,0,"percent of total billed charges","100% of total billed charges",1631.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",149.31,63,,119.45,,,0,"percent of total billed charges","63% of total billed charges",36.26,15.3,,29.01,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,163.53,69,,,,,0,"fee schedule","69% of total billed charges",237,100,,189.60,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",237,100,,189.60,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",237,100,,189.60,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",3224.22,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",842.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",89.35,37.7,,71.48,,,0,"percent of total billed charges","37.70% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",184.86,78,,147.89,,,0,"percent of total billed charges","78% of total billed charges",941.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",195.76,82.6,,156.61,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",195.76,82.6,,156.61,,,0,"percent of total billed charges","82.6% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.21,100,,,,,0,"fee schedule",EAPG,237,100,,189.60,,,0,"percent of total billed charges","100% of total billed charges",36.26,3224.22,
"45303 Proctosigmoidoscopy, rigid; with dilation (e",7962579,CDM,521,RC,45303,CPT,OUTPATIENT,,,220,143,,193.6,88,,154.88,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1843.93,100,,,,,0,"fee schedule",EAPG,220,100,,176.00,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",1899.25,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",138.6,63,,110.88,,,0,"percent of total billed charges","63% of total billed charges",33.66,15.3,,26.93,,,0,"percent of total billed charges","15.3% of total billed charges",1843.93,100,,,,,0,"fee schedule",EAPG,151.8,69,,,,,0,"fee schedule","69% of total billed charges",220,100,,176.00,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",220,100,,176.00,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",220,100,,176.00,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1843.93,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1880.81,100,,,,,0,"fee schedule",EAPG,2397.11,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",82.94,37.7,,66.35,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.6,78,,137.28,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",181.72,82.6,,145.38,,,0,"percent of total billed charges","82.6% of total billed charges",1843.93,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",181.72,82.6,,145.38,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2004.46,100,,,,,0,"fee schedule",EAPG,220,100,,176.00,,,0,"percent of total billed charges","100% of total billed charges",33.66,4212.68,
"45307 Proctosigmoidoscopy, rigid; with removal of",7963227,CDM,521,RC,45307,CPT,OUTPATIENT,,,177,115.05,,155.76,88,,124.61,,,0,"percent of total billed charges","88% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",5011.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.51,63,,89.21,,,0,"percent of total billed charges","63% of total billed charges",27.08,15.3,,21.66,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,122.13,69,,,,,0,"fee schedule","69% of total billed charges",177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",9926.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2595.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",66.73,37.7,,53.38,,,0,"percent of total billed charges","37.70% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",138.06,78,,110.45,,,0,"percent of total billed charges","78% of total billed charges",2892.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",146.2,82.6,,116.96,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",146.2,82.6,,116.96,,,0,"percent of total billed charges","82.6% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.21,100,,,,,0,"fee schedule",EAPG,177,100,,141.60,,,0,"percent of total billed charges","100% of total billed charges",27.08,9926.34,
"45315 Proctosigmoidoscopy, rigid; with removal of",7961532,CDM,521,RC,45315,CPT,OUTPATIENT,,,672,436.8,,591.36,88,,473.09,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",423.36,63,,338.69,,,0,"percent of total billed charges","63% of total billed charges",102.82,15.3,,82.26,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,463.68,69,,,,,0,"fee schedule","69% of total billed charges",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",253.34,37.7,,202.67,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",524.16,78,,419.33,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",555.07,82.6,,444.06,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",555.07,82.6,,444.06,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.21,100,,,,,0,"fee schedule",EAPG,672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",102.82,4212.68,
"45320 Proctosigmoidoscopy, rigid; with ablation of",7962717,CDM,521,RC,45320,CPT,OUTPATIENT,,,462,300.3,,406.56,88,,325.25,,,0,"percent of total billed charges","88% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1843.93,100,,,,,0,"fee schedule",EAPG,462,100,,369.60,,,0,"percent of total billed charges","100% of total billed charges",5011.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",1899.25,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",291.06,63,,232.85,,,0,"percent of total billed charges","63% of total billed charges",70.69,15.3,,56.55,,,0,"percent of total billed charges","15.3% of total billed charges",1843.93,100,,,,,0,"fee schedule",EAPG,318.78,69,,,,,0,"fee schedule","69% of total billed charges",462,100,,369.60,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462,100,,369.60,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462,100,,369.60,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",9926.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1843.93,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2595.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1880.81,100,,,,,0,"fee schedule",EAPG,2397.11,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",174.17,37.7,,139.34,,,0,"percent of total billed charges","37.70% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",360.36,78,,288.29,,,0,"percent of total billed charges","78% of total billed charges",2892.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",381.61,82.6,,305.29,,,0,"percent of total billed charges","82.6% of total billed charges",1843.93,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",381.61,82.6,,305.29,,,0,"percent of total billed charges","82.6% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2004.46,100,,,,,0,"fee schedule",EAPG,462,100,,369.60,,,0,"percent of total billed charges","100% of total billed charges",70.69,9926.34,
"45330 Sigmoidoscopy, flexible",7904621,CDM,521,RC,45330,CPT,OUTPATIENT,,,325,211.25,,286,88,,228.80,,,0,"percent of total billed charges","88% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,325,100,,260.00,,,0,"percent of total billed charges","100% of total billed charges",1631.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",204.75,63,,163.80,,,0,"percent of total billed charges","63% of total billed charges",49.73,15.3,,39.78,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,224.25,69,,,,,0,"fee schedule","69% of total billed charges",325,100,,260.00,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",325,100,,260.00,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",325,100,,260.00,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",3224.22,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",842.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",122.53,37.7,,98.02,,,0,"percent of total billed charges","37.70% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",253.5,78,,202.80,,,0,"percent of total billed charges","78% of total billed charges",941.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",268.45,82.6,,214.76,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",268.45,82.6,,214.76,,,0,"percent of total billed charges","82.6% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.21,100,,,,,0,"fee schedule",EAPG,325,100,,260.00,,,0,"percent of total billed charges","100% of total billed charges",49.73,3224.22,
"45333 Sigmoidoscopy, flexible; w/ removal of tumor",7961771,CDM,521,RC,45333,CPT,OUTPATIENT,,,660,429,,580.8,88,,464.64,,,0,"percent of total billed charges","88% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,660,100,,528.00,,,0,"percent of total billed charges","100% of total billed charges",1631.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",415.8,63,,332.64,,,0,"percent of total billed charges","63% of total billed charges",100.98,15.3,,80.78,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,455.4,69,,,,,0,"fee schedule","69% of total billed charges",660,100,,528.00,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660,100,,528.00,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660,100,,528.00,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",3224.22,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",842.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",248.82,37.7,,199.06,,,0,"percent of total billed charges","37.70% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",514.8,78,,411.84,,,0,"percent of total billed charges","78% of total billed charges",941.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",545.16,82.6,,436.13,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",545.16,82.6,,436.13,,,0,"percent of total billed charges","82.6% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.21,100,,,,,0,"fee schedule",EAPG,660,100,,528.00,,,0,"percent of total billed charges","100% of total billed charges",100.98,3224.22,
"45331 Sigmoidoscopy, flexible; with biopsy, single",7963228,CDM,521,RC,45331,CPT,OUTPATIENT,,,446,289.9,,392.48,88,,313.98,,,0,"percent of total billed charges","88% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,446,100,,356.80,,,0,"percent of total billed charges","100% of total billed charges",1631.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.98,63,,224.78,,,0,"percent of total billed charges","63% of total billed charges",68.24,15.3,,54.59,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,307.74,69,,,,,0,"fee schedule","69% of total billed charges",446,100,,356.80,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",446,100,,356.80,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",446,100,,356.80,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",3224.22,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",842.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",168.14,37.7,,134.51,,,0,"percent of total billed charges","37.70% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",347.88,78,,278.30,,,0,"percent of total billed charges","78% of total billed charges",941.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",368.4,82.6,,294.72,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",368.4,82.6,,294.72,,,0,"percent of total billed charges","82.6% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.21,100,,,,,0,"fee schedule",EAPG,446,100,,356.80,,,0,"percent of total billed charges","100% of total billed charges",68.24,3224.22,
"45355 surgical colonoscopy",7963896,CDM,521,RC,45355,CPT,OUTPATIENT,,,722,469.3,,635.36,88,,508.29,,,0,"percent of total billed charges","88% of total billed charges",361,50,,288.80,,,0,"percent of total billed charges","50% of total billed charges",121.3,16.8,,97.04,,,0,"percent of total billed charges","16.8% of total billed charges",722,100,,577.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",124.93,17.304,,99.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",454.86,63,,363.89,,,0,"percent of total billed charges","63% of total billed charges",110.47,15.3,,88.38,,,0,"percent of total billed charges","15.3% of total billed charges",121.3,16.8,,97.04,,,0,"percent of total billed charges","16.8% of total billed charges",498.18,69,,,,,0,"fee schedule","69% of total billed charges",722,100,,577.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",722,100,,577.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",722,100,,577.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",121.3,16.8,,97.04,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",123.72,17.136,,98.98,,,0,"percent of total billed charges","17.136% of total billed charges",157.68,21.84,,126.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",272.19,37.7,,217.75,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",563.16,78,,450.53,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",596.37,82.6,,477.10,,,0,"percent of total billed charges","82.6% of total billed charges",121.3,16.8,,97.04,,,0,"percent of total billed charges","16.8% of total billed charges",361,50,,288.80,,,0,"percent of total billed charges","50% of total billed charges",596.37,82.6,,477.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",722,100,,577.60,,,0,"percent of total billed charges","100% of total billed charges",110.47,722,
"45378 Colonoscopy, flexible diagnostic, including",7961623,CDM,521,RC,45378,CPT,OUTPATIENT,,,1099,714.35,,967.12,88,,773.70,,,0,"percent of total billed charges","88% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1099,100,,879.20,,,0,"percent of total billed charges","100% of total billed charges",1631.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",692.37,63,,553.90,,,0,"percent of total billed charges","63% of total billed charges",168.15,15.3,,134.52,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,758.31,69,,,,,0,"fee schedule","69% of total billed charges",1099,100,,879.20,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1099,100,,879.20,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1099,100,,879.20,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",3224.22,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",842.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",414.32,37.7,,331.46,,,0,"percent of total billed charges","37.70% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",857.22,78,,685.78,,,0,"percent of total billed charges","78% of total billed charges",941.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.77,82.6,,726.22,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.77,82.6,,726.22,,,0,"percent of total billed charges","82.6% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.21,100,,,,,0,"fee schedule",EAPG,1099,100,,879.20,,,0,"percent of total billed charges","100% of total billed charges",168.15,3224.22,
"45379 Colonoscopy, flexible; with removal of forei",7963285,CDM,521,RC,45379,CPT,OUTPATIENT,,,997,648.05,,877.36,88,,701.89,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,997,100,,797.60,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",628.11,63,,502.49,,,0,"percent of total billed charges","63% of total billed charges",152.54,15.3,,122.03,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,687.93,69,,,,,0,"fee schedule","69% of total billed charges",997,100,,797.60,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",997,100,,797.60,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",997,100,,797.60,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",375.87,37.7,,300.70,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",777.66,78,,622.13,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",823.52,82.6,,658.82,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",823.52,82.6,,658.82,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.21,100,,,,,0,"fee schedule",EAPG,997,100,,797.60,,,0,"percent of total billed charges","100% of total billed charges",152.54,4212.68,
"45384 Colonoscopy, flexible; w/ removal of tumor(s",7961534,CDM,521,RC,45384,CPT,OUTPATIENT,,,776,504.4,,682.88,88,,546.30,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,776,100,,620.80,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",488.88,63,,391.10,,,0,"percent of total billed charges","63% of total billed charges",118.73,15.3,,94.98,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,535.44,69,,,,,0,"fee schedule","69% of total billed charges",776,100,,620.80,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",776,100,,620.80,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",776,100,,620.80,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",292.55,37.7,,234.04,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.28,78,,484.22,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",640.98,82.6,,512.78,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",640.98,82.6,,512.78,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.21,100,,,,,0,"fee schedule",EAPG,776,100,,620.80,,,0,"percent of total billed charges","100% of total billed charges",118.73,4212.68,
"45385 Colonoscopy, flexible; with removal of tumor",7961535,CDM,521,RC,45385,CPT,OUTPATIENT,,,879,571.35,,773.52,88,,618.82,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,879,100,,703.20,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",553.77,63,,443.02,,,0,"percent of total billed charges","63% of total billed charges",134.49,15.3,,107.59,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,606.51,69,,,,,0,"fee schedule","69% of total billed charges",879,100,,703.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879,100,,703.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",879,100,,703.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",331.38,37.7,,265.10,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",685.62,78,,548.50,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.05,82.6,,580.84,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",726.05,82.6,,580.84,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.21,100,,,,,0,"fee schedule",EAPG,879,100,,703.20,,,0,"percent of total billed charges","100% of total billed charges",134.49,4212.68,
"45388 Colonoscopy, flexible; with ablation of tumo",7962537,CDM,521,RC,45388,CPT,OUTPATIENT,,,816,530.4,,718.08,88,,574.46,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,816,100,,652.80,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",514.08,63,,411.26,,,0,"percent of total billed charges","63% of total billed charges",124.85,15.3,,99.88,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,563.04,69,,,,,0,"fee schedule","69% of total billed charges",816,100,,652.80,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",816,100,,652.80,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",816,100,,652.80,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",307.63,37.7,,246.10,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",636.48,78,,509.18,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",674.02,82.6,,539.22,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",674.02,82.6,,539.22,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.21,100,,,,,0,"fee schedule",EAPG,816,100,,652.80,,,0,"percent of total billed charges","100% of total billed charges",124.85,4212.68,
"45381 Colonoscopy, flexible; with directed submuco",7962639,CDM,521,RC,45381,CPT,OUTPATIENT,,,1067,693.55,,938.96,88,,751.17,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1067,100,,853.60,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672.21,63,,537.77,,,0,"percent of total billed charges","63% of total billed charges",163.25,15.3,,130.60,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,736.23,69,,,,,0,"fee schedule","69% of total billed charges",1067,100,,853.60,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1067,100,,853.60,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1067,100,,853.60,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",402.26,37.7,,321.81,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",832.26,78,,665.81,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",881.34,82.6,,705.07,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",881.34,82.6,,705.07,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.21,100,,,,,0,"fee schedule",EAPG,1067,100,,853.60,,,0,"percent of total billed charges","100% of total billed charges",163.25,4212.68,
"45386 Colonoscopy, flexible; with transendoscopic",7963115,CDM,521,RC,45386,CPT,OUTPATIENT,,,761,494.65,,669.68,88,,535.74,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,761,100,,608.80,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",479.43,63,,383.54,,,0,"percent of total billed charges","63% of total billed charges",116.43,15.3,,93.14,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,525.09,69,,,,,0,"fee schedule","69% of total billed charges",761,100,,608.80,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",761,100,,608.80,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",761,100,,608.80,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",286.9,37.7,,229.52,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.58,78,,474.86,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",628.59,82.6,,502.87,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",628.59,82.6,,502.87,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.21,100,,,,,0,"fee schedule",EAPG,761,100,,608.80,,,0,"percent of total billed charges","100% of total billed charges",116.43,4212.68,
"45382 DWM Colonoscopy, flexible; with control",7963150,CDM,521,RC,45382,CPT,OUTPATIENT,,,942,612.3,,828.96,88,,663.17,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,942,100,,753.60,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.46,63,,474.77,,,0,"percent of total billed charges","63% of total billed charges",144.13,15.3,,115.30,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,649.98,69,,,,,0,"fee schedule","69% of total billed charges",942,100,,753.60,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",942,100,,753.60,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",942,100,,753.60,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",355.13,37.7,,284.10,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",734.76,78,,587.81,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",778.09,82.6,,622.47,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",778.09,82.6,,622.47,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.21,100,,,,,0,"fee schedule",EAPG,942,100,,753.60,,,0,"percent of total billed charges","100% of total billed charges",144.13,4212.68,
"45380 Colonoscopy, flexible with biopsy, single o",7963286,CDM,521,RC,45380,CPT,OUTPATIENT,,,1216,790.4,,1070.08,88,,856.06,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1216,100,,972.80,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",766.08,63,,612.86,,,0,"percent of total billed charges","63% of total billed charges",186.05,15.3,,148.84,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,839.04,69,,,,,0,"fee schedule","69% of total billed charges",1216,100,,972.80,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1216,100,,972.80,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1216,100,,972.80,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",458.43,37.7,,366.74,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",948.48,78,,758.78,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1004.42,82.6,,803.54,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1004.42,82.6,,803.54,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.21,100,,,,,0,"fee schedule",EAPG,1216,100,,972.80,,,0,"percent of total billed charges","100% of total billed charges",186.05,4212.68,
"45383 lesion removal colonoscopy",7963819,CDM,521,RC,45383,CPT,OUTPATIENT,,,1792,1164.8,,1576.96,88,,1261.57,,,0,"percent of total billed charges","88% of total billed charges",896,50,,716.80,,,0,"percent of total billed charges","50% of total billed charges",301.06,16.8,,240.85,,,0,"percent of total billed charges","16.8% of total billed charges",1792,100,,1433.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",310.09,17.304,,248.07,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1128.96,63,,903.17,,,0,"percent of total billed charges","63% of total billed charges",274.18,15.3,,219.34,,,0,"percent of total billed charges","15.3% of total billed charges",301.06,16.8,,240.85,,,0,"percent of total billed charges","16.8% of total billed charges",1236.48,69,,,,,0,"fee schedule","69% of total billed charges",1792,100,,1433.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1792,100,,1433.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1792,100,,1433.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",301.06,16.8,,240.85,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",307.08,17.136,,245.66,,,0,"percent of total billed charges","17.136% of total billed charges",391.37,21.84,,313.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",675.58,37.7,,540.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1397.76,78,,1118.21,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1480.19,82.6,,1184.15,,,0,"percent of total billed charges","82.6% of total billed charges",301.06,16.8,,240.85,,,0,"percent of total billed charges","16.8% of total billed charges",896,50,,716.80,,,0,"percent of total billed charges","50% of total billed charges",1480.19,82.6,,1184.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",1792,100,,1433.60,,,0,"percent of total billed charges","100% of total billed charges",160.53,1792,
"45387 colonoscopy w/stent",7963904,CDM,521,RC,45387,CPT,OUTPATIENT,,,1068,694.2,,939.84,88,,751.87,,,0,"percent of total billed charges","88% of total billed charges",534,50,,427.20,,,0,"percent of total billed charges","50% of total billed charges",179.42,16.8,,143.54,,,0,"percent of total billed charges","16.8% of total billed charges",1068,100,,854.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",184.81,17.304,,147.85,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",672.84,63,,538.27,,,0,"percent of total billed charges","63% of total billed charges",163.4,15.3,,130.72,,,0,"percent of total billed charges","15.3% of total billed charges",179.42,16.8,,143.54,,,0,"percent of total billed charges","16.8% of total billed charges",736.92,69,,,,,0,"fee schedule","69% of total billed charges",1068,100,,854.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1068,100,,854.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1068,100,,854.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",179.42,16.8,,143.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",183.01,17.136,,146.41,,,0,"percent of total billed charges","17.136% of total billed charges",233.25,21.84,,186.60,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",402.64,37.7,,322.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",833.04,78,,666.43,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",882.17,82.6,,705.74,,,0,"percent of total billed charges","82.6% of total billed charges",179.42,16.8,,143.54,,,0,"percent of total billed charges","16.8% of total billed charges",534,50,,427.20,,,0,"percent of total billed charges","50% of total billed charges",882.17,82.6,,705.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",1068,100,,854.40,,,0,"percent of total billed charges","100% of total billed charges",160.53,1068,
"45395 Laparoscopy, surgical; proctectomy, complete",7962010,CDM,521,RC,45395,CPT,OUTPATIENT,,,3734,2427.1,,3285.92,88,,2628.74,,,0,"percent of total billed charges","88% of total billed charges",3734,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2024.32,100,,,,,0,"fee schedule",EAPG,3734,100,,2987.20,,,0,"percent of total billed charges","100% of total billed charges",3734,175,,,,,0,"fee schedule","175% of CMS fee schedule",2085.05,100,,,,,0,"fee schedule",EAPG,3734,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2352.42,63,,1881.94,,,0,"percent of total billed charges","63% of total billed charges",571.3,15.3,,457.04,,,0,"percent of total billed charges","15.3% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,2576.46,69,,,,,0,"fee schedule","69% of total billed charges",3734,100,,2987.20,,,0,"percent of total billed charges","100% of total billed charges",3734,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3734,100,,2987.20,,,0,"percent of total billed charges","100% of total billed charges",3734,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3734,100,,2987.20,,,0,"percent of total billed charges","100% of total billed charges",3734,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3734,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2024.32,100,,,,,0,"fee schedule",EAPG,3734,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3734,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3734,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2064.8,100,,,,,0,"fee schedule",EAPG,2631.61,100,,,,,0,"fee schedule",EAPG,3734,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1407.72,37.7,,1126.18,,,0,"percent of total billed charges","37.70% of total billed charges",3734,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3734,100,,,,,0,"fee schedule","100% of CMS fee schedule",2912.52,78,,2330.02,,,0,"percent of total billed charges","78% of total billed charges",3734,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3084.28,82.6,,2467.42,,,0,"percent of total billed charges","82.6% of total billed charges",2024.32,100,,,,,0,"fee schedule","100% of WA fee schedule",3734,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3084.28,82.6,,2467.42,,,0,"percent of total billed charges","82.6% of total billed charges",3734,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2184.85,100,,,,,0,"fee schedule",EAPG,3734,100,,2987.20,,,0,"percent of total billed charges","100% of total billed charges",571.3,3734,
"45393 Colonoscopy, flexible; with decompression (f",7962109,CDM,521,RC,45393,CPT,OUTPATIENT,,,759,493.35,,667.92,88,,534.34,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,759,100,,607.20,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",478.17,63,,382.54,,,0,"percent of total billed charges","63% of total billed charges",116.13,15.3,,92.90,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,523.71,69,,,,,0,"fee schedule","69% of total billed charges",759,100,,607.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759,100,,607.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759,100,,607.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",286.14,37.7,,228.91,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",592.02,78,,473.62,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",626.93,82.6,,501.54,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",626.93,82.6,,501.54,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.21,100,,,,,0,"fee schedule",EAPG,759,100,,607.20,,,0,"percent of total billed charges","100% of total billed charges",116.13,4212.68,
"45399 Unlisted procedure, colon",7963846,CDM,521,RC,45399,CPT,OUTPATIENT,,,3090,2008.5,,2719.2,88,,2175.36,,,0,"percent of total billed charges","88% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",1631.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1946.7,63,,1557.36,,,0,"percent of total billed charges","63% of total billed charges",472.77,15.3,,378.22,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,2132.1,69,,,,,0,"fee schedule","69% of total billed charges",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",3224.22,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",842.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1164.93,37.7,,931.94,,,0,"percent of total billed charges","37.70% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2410.2,78,,1928.16,,,0,"percent of total billed charges","78% of total billed charges",941.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2552.34,82.6,,2041.87,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2552.34,82.6,,2041.87,,,0,"percent of total billed charges","82.6% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.21,100,,,,,0,"fee schedule",EAPG,3090,100,,2472.00,,,0,"percent of total billed charges","100% of total billed charges",472.77,3224.22,
"45400 Laparoscopy, surgical; proctopexy (for prola",7963401,CDM,521,RC,45400,CPT,OUTPATIENT,,,2183,1418.95,,1921.04,88,,1536.83,,,0,"percent of total billed charges","88% of total billed charges",2183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2024.32,100,,,,,0,"fee schedule",EAPG,2183,100,,1746.40,,,0,"percent of total billed charges","100% of total billed charges",2183,175,,,,,0,"fee schedule","175% of CMS fee schedule",2085.05,100,,,,,0,"fee schedule",EAPG,2183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1375.29,63,,1100.23,,,0,"percent of total billed charges","63% of total billed charges",334,15.3,,267.20,,,0,"percent of total billed charges","15.3% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,1506.27,69,,,,,0,"fee schedule","69% of total billed charges",2183,100,,1746.40,,,0,"percent of total billed charges","100% of total billed charges",2183,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2183,100,,1746.40,,,0,"percent of total billed charges","100% of total billed charges",2183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2183,100,,1746.40,,,0,"percent of total billed charges","100% of total billed charges",2183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2024.32,100,,,,,0,"fee schedule",EAPG,2183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2064.8,100,,,,,0,"fee schedule",EAPG,2631.61,100,,,,,0,"fee schedule",EAPG,2183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",822.99,37.7,,658.39,,,0,"percent of total billed charges","37.70% of total billed charges",2183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2183,100,,,,,0,"fee schedule","100% of CMS fee schedule",1702.74,78,,1362.19,,,0,"percent of total billed charges","78% of total billed charges",2183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1803.16,82.6,,1442.53,,,0,"percent of total billed charges","82.6% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,2183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1803.16,82.6,,1442.53,,,0,"percent of total billed charges","82.6% of total billed charges",2183,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2184.85,100,,,,,0,"fee schedule",EAPG,2183,100,,1746.40,,,0,"percent of total billed charges","100% of total billed charges",334,2631.61,
"45562 Exploration, repair, and presacral drainage",7963053,CDM,521,RC,45562,CPT,OUTPATIENT,,,3298,2143.7,,2902.24,88,,2321.79,,,0,"percent of total billed charges","88% of total billed charges",3298,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2024.32,100,,,,,0,"fee schedule",EAPG,3298,100,,2638.40,,,0,"percent of total billed charges","100% of total billed charges",3298,175,,,,,0,"fee schedule","175% of CMS fee schedule",2085.05,100,,,,,0,"fee schedule",EAPG,3298,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2077.74,63,,1662.19,,,0,"percent of total billed charges","63% of total billed charges",504.59,15.3,,403.67,,,0,"percent of total billed charges","15.3% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,2275.62,69,,,,,0,"fee schedule","69% of total billed charges",3298,100,,2638.40,,,0,"percent of total billed charges","100% of total billed charges",3298,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3298,100,,2638.40,,,0,"percent of total billed charges","100% of total billed charges",3298,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3298,100,,2638.40,,,0,"percent of total billed charges","100% of total billed charges",3298,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3298,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2024.32,100,,,,,0,"fee schedule",EAPG,3298,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3298,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3298,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2064.8,100,,,,,0,"fee schedule",EAPG,2631.61,100,,,,,0,"fee schedule",EAPG,3298,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1243.35,37.7,,994.68,,,0,"percent of total billed charges","37.70% of total billed charges",3298,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3298,100,,,,,0,"fee schedule","100% of CMS fee schedule",2572.44,78,,2057.95,,,0,"percent of total billed charges","78% of total billed charges",3298,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2724.15,82.6,,2179.32,,,0,"percent of total billed charges","82.6% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,3298,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2724.15,82.6,,2179.32,,,0,"percent of total billed charges","82.6% of total billed charges",3298,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2184.85,100,,,,,0,"fee schedule",EAPG,3298,100,,2638.40,,,0,"percent of total billed charges","100% of total billed charges",504.59,3298,
"45560 Repair of rectocele (separate procedure)",7963586,CDM,521,RC,45560,CPT,OUTPATIENT,,,1507,979.55,,1326.16,88,,1060.93,,,0,"percent of total billed charges","88% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2024.32,100,,,,,0,"fee schedule",EAPG,1507,100,,1205.60,,,0,"percent of total billed charges","100% of total billed charges",5011.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",2085.05,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",949.41,63,,759.53,,,0,"percent of total billed charges","63% of total billed charges",230.57,15.3,,184.46,,,0,"percent of total billed charges","15.3% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,1039.83,69,,,,,0,"fee schedule","69% of total billed charges",1507,100,,1205.60,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1507,100,,1205.60,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1507,100,,1205.60,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",9926.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2024.32,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2595.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2064.8,100,,,,,0,"fee schedule",EAPG,2631.61,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",568.14,37.7,,454.51,,,0,"percent of total billed charges","37.70% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1175.46,78,,940.37,,,0,"percent of total billed charges","78% of total billed charges",2892.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1244.78,82.6,,995.82,,,0,"percent of total billed charges","82.6% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1244.78,82.6,,995.82,,,0,"percent of total billed charges","82.6% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2184.85,100,,,,,0,"fee schedule",EAPG,1507,100,,1205.60,,,0,"percent of total billed charges","100% of total billed charges",230.57,9926.34,
"45905 Dilation of anal sphincter (separate procedu",7962452,CDM,521,RC,45905,CPT,OUTPATIENT,,,379,246.35,,333.52,88,,266.82,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,379,100,,303.20,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",1367,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",238.77,63,,191.02,,,0,"percent of total billed charges","63% of total billed charges",57.99,15.3,,46.39,,,0,"percent of total billed charges","15.3% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,261.51,69,,,,,0,"fee schedule","69% of total billed charges",379,100,,303.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",379,100,,303.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",379,100,,303.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",142.88,37.7,,114.30,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",295.62,78,,236.50,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",313.05,82.6,,250.44,,,0,"percent of total billed charges","82.6% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",313.05,82.6,,250.44,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1487.72,100,,,,,0,"fee schedule",EAPG,379,100,,303.20,,,0,"percent of total billed charges","100% of total billed charges",57.99,4212.68,
"45915 Removal of fecal impaction or foreign body (",7962475,CDM,521,RC,45915,CPT,OUTPATIENT,,,665,432.25,,585.2,88,,468.16,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,665,100,,532.00,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",1367,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.95,63,,335.16,,,0,"percent of total billed charges","63% of total billed charges",101.75,15.3,,81.40,,,0,"percent of total billed charges","15.3% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,458.85,69,,,,,0,"fee schedule","69% of total billed charges",665,100,,532.00,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665,100,,532.00,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665,100,,532.00,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",250.71,37.7,,200.57,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",518.7,78,,414.96,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",549.29,82.6,,439.43,,,0,"percent of total billed charges","82.6% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",549.29,82.6,,439.43,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1487.72,100,,,,,0,"fee schedule",EAPG,665,100,,532.00,,,0,"percent of total billed charges","100% of total billed charges",101.75,4212.68,
"45990 Anorectal exam, surgical, requiring anesthes",7961875,CDM,521,RC,45990,CPT,OUTPATIENT,,,365,237.25,,321.2,88,,256.96,,,0,"percent of total billed charges","88% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,365,100,,292.00,,,0,"percent of total billed charges","100% of total billed charges",5011.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",1367,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.95,63,,183.96,,,0,"percent of total billed charges","63% of total billed charges",55.85,15.3,,44.68,,,0,"percent of total billed charges","15.3% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,251.85,69,,,,,0,"fee schedule","69% of total billed charges",365,100,,292.00,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",365,100,,292.00,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",365,100,,292.00,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",9926.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2595.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",137.61,37.7,,110.09,,,0,"percent of total billed charges","37.70% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.7,78,,227.76,,,0,"percent of total billed charges","78% of total billed charges",2892.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",301.49,82.6,,241.19,,,0,"percent of total billed charges","82.6% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",301.49,82.6,,241.19,,,0,"percent of total billed charges","82.6% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1487.72,100,,,,,0,"fee schedule",EAPG,365,100,,292.00,,,0,"percent of total billed charges","100% of total billed charges",55.85,9926.34,
"46030 Removal of anal seton, other marker",7963684,CDM,521,RC,46030,CPT,OUTPATIENT,,,422,274.3,,371.36,88,,297.09,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",1367,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.86,63,,212.69,,,0,"percent of total billed charges","63% of total billed charges",64.57,15.3,,51.66,,,0,"percent of total billed charges","15.3% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,291.18,69,,,,,0,"fee schedule","69% of total billed charges",422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.09,37.7,,127.27,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",329.16,78,,263.33,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.57,82.6,,278.86,,,0,"percent of total billed charges","82.6% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.57,82.6,,278.86,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1487.72,100,,,,,0,"fee schedule",EAPG,422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",64.57,4212.68,
"46040 Incision procedures on the anus",7904622,CDM,521,RC,46040,CPT,OUTPATIENT,,,969,629.85,,852.72,88,,682.18,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,969,100,,775.20,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",1367,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",610.47,63,,488.38,,,0,"percent of total billed charges","63% of total billed charges",148.26,15.3,,118.61,,,0,"percent of total billed charges","15.3% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,668.61,69,,,,,0,"fee schedule","69% of total billed charges",969,100,,775.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",969,100,,775.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",969,100,,775.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",365.31,37.7,,292.25,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",755.82,78,,604.66,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",800.39,82.6,,640.31,,,0,"percent of total billed charges","82.6% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",800.39,82.6,,640.31,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1487.72,100,,,,,0,"fee schedule",EAPG,969,100,,775.20,,,0,"percent of total billed charges","100% of total billed charges",148.26,4212.68,
"46045 I&D of intramural, intramuscular, or submuco",7962343,CDM,521,RC,46045,CPT,OUTPATIENT,,,1581,1027.65,,1391.28,88,,1113.02,,,0,"percent of total billed charges","88% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2024.32,100,,,,,0,"fee schedule",EAPG,1581,100,,1264.80,,,0,"percent of total billed charges","100% of total billed charges",5011.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",2085.05,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",996.03,63,,796.82,,,0,"percent of total billed charges","63% of total billed charges",241.89,15.3,,193.51,,,0,"percent of total billed charges","15.3% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,1090.89,69,,,,,0,"fee schedule","69% of total billed charges",1581,100,,1264.80,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1581,100,,1264.80,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1581,100,,1264.80,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",9926.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2024.32,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2595.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2064.8,100,,,,,0,"fee schedule",EAPG,2631.61,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",596.04,37.7,,476.83,,,0,"percent of total billed charges","37.70% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1233.18,78,,986.54,,,0,"percent of total billed charges","78% of total billed charges",2892.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1305.91,82.6,,1044.73,,,0,"percent of total billed charges","82.6% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1305.91,82.6,,1044.73,,,0,"percent of total billed charges","82.6% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2184.85,100,,,,,0,"fee schedule",EAPG,1581,100,,1264.80,,,0,"percent of total billed charges","100% of total billed charges",241.89,9926.34,
"46050 Incision procedures on the anus",7904623,CDM,521,RC,46050,CPT,OUTPATIENT,,,344,223.6,,302.72,88,,242.18,,,0,"percent of total billed charges","88% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",1631.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",1367,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,63,,173.38,,,0,"percent of total billed charges","63% of total billed charges",52.63,15.3,,42.10,,,0,"percent of total billed charges","15.3% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,237.36,69,,,,,0,"fee schedule","69% of total billed charges",344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",3224.22,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",842.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",129.69,37.7,,103.75,,,0,"percent of total billed charges","37.70% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",268.32,78,,214.66,,,0,"percent of total billed charges","78% of total billed charges",941.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.14,82.6,,227.31,,,0,"percent of total billed charges","82.6% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.14,82.6,,227.31,,,0,"percent of total billed charges","82.6% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1487.72,100,,,,,0,"fee schedule",EAPG,344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",52.63,3224.22,
"46060 I&D of ischiorectal or intramural abscess, w",7961933,CDM,521,RC,46060,CPT,OUTPATIENT,,,2006,1303.9,,1765.28,88,,1412.22,,,0,"percent of total billed charges","88% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2024.32,100,,,,,0,"fee schedule",EAPG,2006,100,,1604.80,,,0,"percent of total billed charges","100% of total billed charges",5011.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",2085.05,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1263.78,63,,1011.02,,,0,"percent of total billed charges","63% of total billed charges",306.92,15.3,,245.54,,,0,"percent of total billed charges","15.3% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,1384.14,69,,,,,0,"fee schedule","69% of total billed charges",2006,100,,1604.80,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2006,100,,1604.80,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2006,100,,1604.80,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",9926.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2024.32,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2595.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2064.8,100,,,,,0,"fee schedule",EAPG,2631.61,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",756.26,37.7,,605.01,,,0,"percent of total billed charges","37.70% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1564.68,78,,1251.74,,,0,"percent of total billed charges","78% of total billed charges",2892.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1656.96,82.6,,1325.57,,,0,"percent of total billed charges","82.6% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1656.96,82.6,,1325.57,,,0,"percent of total billed charges","82.6% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2184.85,100,,,,,0,"fee schedule",EAPG,2006,100,,1604.80,,,0,"percent of total billed charges","100% of total billed charges",306.92,9926.34,
"46083 Incision procedures on the anus",7904624,CDM,521,RC,46083,CPT,OUTPATIENT,,,322,209.3,,283.36,88,,226.69,,,0,"percent of total billed charges","88% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,322,100,,257.60,,,0,"percent of total billed charges","100% of total billed charges",441.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",1367,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.86,63,,162.29,,,0,"percent of total billed charges","63% of total billed charges",49.27,15.3,,39.42,,,0,"percent of total billed charges","15.3% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,222.18,69,,,,,0,"fee schedule","69% of total billed charges",322,100,,257.60,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",322,100,,257.60,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",322,100,,257.60,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1081.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",282.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",121.39,37.7,,97.11,,,0,"percent of total billed charges","37.70% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",251.16,78,,200.93,,,0,"percent of total billed charges","78% of total billed charges",254.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.97,82.6,,212.78,,,0,"percent of total billed charges","82.6% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.97,82.6,,212.78,,,0,"percent of total billed charges","82.6% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1487.72,100,,,,,0,"fee schedule",EAPG,322,100,,257.60,,,0,"percent of total billed charges","100% of total billed charges",49.27,1725.34,
"46200 Fissurectomy, including sphincterotomy, when",7963287,CDM,521,RC,46200,CPT,OUTPATIENT,,,1294,841.1,,1138.72,88,,910.98,,,0,"percent of total billed charges","88% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,1294,100,,1035.20,,,0,"percent of total billed charges","100% of total billed charges",5011.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",1367,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",815.22,63,,652.18,,,0,"percent of total billed charges","63% of total billed charges",197.98,15.3,,158.38,,,0,"percent of total billed charges","15.3% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,892.86,69,,,,,0,"fee schedule","69% of total billed charges",1294,100,,1035.20,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1294,100,,1035.20,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1294,100,,1035.20,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",9926.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2595.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",487.84,37.7,,390.27,,,0,"percent of total billed charges","37.70% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1009.32,78,,807.46,,,0,"percent of total billed charges","78% of total billed charges",2892.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1068.84,82.6,,855.07,,,0,"percent of total billed charges","82.6% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1068.84,82.6,,855.07,,,0,"percent of total billed charges","82.6% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1487.72,100,,,,,0,"fee schedule",EAPG,1294,100,,1035.20,,,0,"percent of total billed charges","100% of total billed charges",197.98,9926.34,
"46220 Excision procedures on the anus",7904625,CDM,521,RC,46220,CPT,OUTPATIENT,,,370,240.5,,325.6,88,,260.48,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,370,100,,296.00,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",1367,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",233.1,63,,186.48,,,0,"percent of total billed charges","63% of total billed charges",56.61,15.3,,45.29,,,0,"percent of total billed charges","15.3% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,255.3,69,,,,,0,"fee schedule","69% of total billed charges",370,100,,296.00,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",370,100,,296.00,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",370,100,,296.00,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",139.49,37.7,,111.59,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",288.6,78,,230.88,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",305.62,82.6,,244.50,,,0,"percent of total billed charges","82.6% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",305.62,82.6,,244.50,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1487.72,100,,,,,0,"fee schedule",EAPG,370,100,,296.00,,,0,"percent of total billed charges","100% of total billed charges",56.61,4212.68,
"46221 Excision procedures on the anus",7904626,CDM,521,RC,46221,CPT,OUTPATIENT,,,357,232.05,,314.16,88,,251.33,,,0,"percent of total billed charges","88% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,357,100,,285.60,,,0,"percent of total billed charges","100% of total billed charges",1631.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",1367,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.91,63,,179.93,,,0,"percent of total billed charges","63% of total billed charges",54.62,15.3,,43.70,,,0,"percent of total billed charges","15.3% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,246.33,69,,,,,0,"fee schedule","69% of total billed charges",357,100,,285.60,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",357,100,,285.60,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",357,100,,285.60,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",3224.22,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",842.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",134.59,37.7,,107.67,,,0,"percent of total billed charges","37.70% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278.46,78,,222.77,,,0,"percent of total billed charges","78% of total billed charges",941.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.88,82.6,,235.90,,,0,"percent of total billed charges","82.6% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.88,82.6,,235.90,,,0,"percent of total billed charges","82.6% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1487.72,100,,,,,0,"fee schedule",EAPG,357,100,,285.60,,,0,"percent of total billed charges","100% of total billed charges",54.62,3224.22,
"46230 Excision procedures on the anus",7904627,CDM,521,RC,46230,CPT,OUTPATIENT,,,468,304.2,,411.84,88,,329.47,,,0,"percent of total billed charges","88% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,468,100,,374.40,,,0,"percent of total billed charges","100% of total billed charges",5011.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",1367,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.84,63,,235.87,,,0,"percent of total billed charges","63% of total billed charges",71.6,15.3,,57.28,,,0,"percent of total billed charges","15.3% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,322.92,69,,,,,0,"fee schedule","69% of total billed charges",468,100,,374.40,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",468,100,,374.40,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",468,100,,374.40,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",9926.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2595.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",176.44,37.7,,141.15,,,0,"percent of total billed charges","37.70% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",365.04,78,,292.03,,,0,"percent of total billed charges","78% of total billed charges",2892.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",386.57,82.6,,309.26,,,0,"percent of total billed charges","82.6% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",386.57,82.6,,309.26,,,0,"percent of total billed charges","82.6% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1487.72,100,,,,,0,"fee schedule",EAPG,468,100,,374.40,,,0,"percent of total billed charges","100% of total billed charges",71.6,9926.34,
"46255 Hemorrhoidectomy, internal and external, sin",7963116,CDM,521,RC,46255,CPT,OUTPATIENT,,,1158,752.7,,1019.04,88,,815.23,,,0,"percent of total billed charges","88% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2024.32,100,,,,,0,"fee schedule",EAPG,1158,100,,926.40,,,0,"percent of total billed charges","100% of total billed charges",5011.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",2085.05,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",729.54,63,,583.63,,,0,"percent of total billed charges","63% of total billed charges",177.17,15.3,,141.74,,,0,"percent of total billed charges","15.3% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,799.02,69,,,,,0,"fee schedule","69% of total billed charges",1158,100,,926.40,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1158,100,,926.40,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1158,100,,926.40,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",9926.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2024.32,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2595.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2064.8,100,,,,,0,"fee schedule",EAPG,2631.61,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",436.57,37.7,,349.26,,,0,"percent of total billed charges","37.70% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.24,78,,722.59,,,0,"percent of total billed charges","78% of total billed charges",2892.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",956.51,82.6,,765.21,,,0,"percent of total billed charges","82.6% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",956.51,82.6,,765.21,,,0,"percent of total billed charges","82.6% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2184.85,100,,,,,0,"fee schedule",EAPG,1158,100,,926.40,,,0,"percent of total billed charges","100% of total billed charges",177.17,9926.34,
"46250 Hemorrhoidectomy, external, 2 or more column",7963335,CDM,521,RC,46250,CPT,OUTPATIENT,,,1997,1298.05,,1757.36,88,,1405.89,,,0,"percent of total billed charges","88% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2024.32,100,,,,,0,"fee schedule",EAPG,1997,100,,1597.60,,,0,"percent of total billed charges","100% of total billed charges",5011.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",2085.05,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1258.11,63,,1006.49,,,0,"percent of total billed charges","63% of total billed charges",305.54,15.3,,244.43,,,0,"percent of total billed charges","15.3% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,1377.93,69,,,,,0,"fee schedule","69% of total billed charges",1997,100,,1597.60,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1997,100,,1597.60,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1997,100,,1597.60,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",9926.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2024.32,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2595.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2064.8,100,,,,,0,"fee schedule",EAPG,2631.61,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",752.87,37.7,,602.30,,,0,"percent of total billed charges","37.70% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1557.66,78,,1246.13,,,0,"percent of total billed charges","78% of total billed charges",2892.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1649.52,82.6,,1319.62,,,0,"percent of total billed charges","82.6% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1649.52,82.6,,1319.62,,,0,"percent of total billed charges","82.6% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2184.85,100,,,,,0,"fee schedule",EAPG,1997,100,,1597.60,,,0,"percent of total billed charges","100% of total billed charges",305.54,9926.34,
"46261 Hemorrhoidectomy, internal and external, 2 o",7962344,CDM,521,RC,46261,CPT,OUTPATIENT,,,2485,1615.25,,2186.8,88,,1749.44,,,0,"percent of total billed charges","88% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2024.32,100,,,,,0,"fee schedule",EAPG,2485,100,,1988.00,,,0,"percent of total billed charges","100% of total billed charges",5011.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",2085.05,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1565.55,63,,1252.44,,,0,"percent of total billed charges","63% of total billed charges",380.21,15.3,,304.17,,,0,"percent of total billed charges","15.3% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,1714.65,69,,,,,0,"fee schedule","69% of total billed charges",2485,100,,1988.00,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2485,100,,1988.00,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2485,100,,1988.00,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",9926.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2024.32,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2595.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2064.8,100,,,,,0,"fee schedule",EAPG,2631.61,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",936.85,37.7,,749.48,,,0,"percent of total billed charges","37.70% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1938.3,78,,1550.64,,,0,"percent of total billed charges","78% of total billed charges",2892.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2052.61,82.6,,1642.09,,,0,"percent of total billed charges","82.6% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2052.61,82.6,,1642.09,,,0,"percent of total billed charges","82.6% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2184.85,100,,,,,0,"fee schedule",EAPG,2485,100,,1988.00,,,0,"percent of total billed charges","100% of total billed charges",380.21,9926.34,
"46260 Hemorrhoidectomy, internal and external, 2 o",7962972,CDM,521,RC,46260,CPT,OUTPATIENT,,,2237,1454.05,,1968.56,88,,1574.85,,,0,"percent of total billed charges","88% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2024.32,100,,,,,0,"fee schedule",EAPG,2237,100,,1789.60,,,0,"percent of total billed charges","100% of total billed charges",5011.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",2085.05,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1409.31,63,,1127.45,,,0,"percent of total billed charges","63% of total billed charges",342.26,15.3,,273.81,,,0,"percent of total billed charges","15.3% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,1543.53,69,,,,,0,"fee schedule","69% of total billed charges",2237,100,,1789.60,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2237,100,,1789.60,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2237,100,,1789.60,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",9926.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2024.32,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2595.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2064.8,100,,,,,0,"fee schedule",EAPG,2631.61,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",843.35,37.7,,674.68,,,0,"percent of total billed charges","37.70% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1744.86,78,,1395.89,,,0,"percent of total billed charges","78% of total billed charges",2892.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1847.76,82.6,,1478.21,,,0,"percent of total billed charges","82.6% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1847.76,82.6,,1478.21,,,0,"percent of total billed charges","82.6% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2184.85,100,,,,,0,"fee schedule",EAPG,2237,100,,1789.60,,,0,"percent of total billed charges","100% of total billed charges",342.26,9926.34,
"46270 Surgical treatment of anal fistula (fistulec",7962640,CDM,521,RC,46270,CPT,OUTPATIENT,,,1144,743.6,,1006.72,88,,805.38,,,0,"percent of total billed charges","88% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2024.32,100,,,,,0,"fee schedule",EAPG,1144,100,,915.20,,,0,"percent of total billed charges","100% of total billed charges",5011.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",2085.05,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",720.72,63,,576.58,,,0,"percent of total billed charges","63% of total billed charges",175.03,15.3,,140.02,,,0,"percent of total billed charges","15.3% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,789.36,69,,,,,0,"fee schedule","69% of total billed charges",1144,100,,915.20,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1144,100,,915.20,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1144,100,,915.20,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",9926.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2024.32,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2595.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2064.8,100,,,,,0,"fee schedule",EAPG,2631.61,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",431.29,37.7,,345.03,,,0,"percent of total billed charges","37.70% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.32,78,,713.86,,,0,"percent of total billed charges","78% of total billed charges",2892.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",944.94,82.6,,755.95,,,0,"percent of total billed charges","82.6% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",944.94,82.6,,755.95,,,0,"percent of total billed charges","82.6% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2184.85,100,,,,,0,"fee schedule",EAPG,1144,100,,915.20,,,0,"percent of total billed charges","100% of total billed charges",175.03,9926.34,
"46280 Surgical treatment of anal fistula; transsph",7961536,CDM,521,RC,46280,CPT,OUTPATIENT,,,1429,928.85,,1257.52,88,,1006.02,,,0,"percent of total billed charges","88% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2024.32,100,,,,,0,"fee schedule",EAPG,1429,100,,1143.20,,,0,"percent of total billed charges","100% of total billed charges",5011.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",2085.05,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",900.27,63,,720.22,,,0,"percent of total billed charges","63% of total billed charges",218.64,15.3,,174.91,,,0,"percent of total billed charges","15.3% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,986.01,69,,,,,0,"fee schedule","69% of total billed charges",1429,100,,1143.20,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1429,100,,1143.20,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1429,100,,1143.20,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",9926.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2024.32,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2595.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2064.8,100,,,,,0,"fee schedule",EAPG,2631.61,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",538.73,37.7,,430.98,,,0,"percent of total billed charges","37.70% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1114.62,78,,891.70,,,0,"percent of total billed charges","78% of total billed charges",2892.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1180.35,82.6,,944.28,,,0,"percent of total billed charges","82.6% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1180.35,82.6,,944.28,,,0,"percent of total billed charges","82.6% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2184.85,100,,,,,0,"fee schedule",EAPG,1429,100,,1143.20,,,0,"percent of total billed charges","100% of total billed charges",218.64,9926.34,
"46320 Excision procedures on the anus",7904628,CDM,521,RC,46320,CPT,OUTPATIENT,,,543,352.95,,477.84,88,,382.27,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,543,100,,434.40,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",1367,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.09,63,,273.67,,,0,"percent of total billed charges","63% of total billed charges",83.08,15.3,,66.46,,,0,"percent of total billed charges","15.3% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,374.67,69,,,,,0,"fee schedule","69% of total billed charges",543,100,,434.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",543,100,,434.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",543,100,,434.40,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.71,37.7,,163.77,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",423.54,78,,338.83,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",448.52,82.6,,358.82,,,0,"percent of total billed charges","82.6% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",448.52,82.6,,358.82,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1487.72,100,,,,,0,"fee schedule",EAPG,543,100,,434.40,,,0,"percent of total billed charges","100% of total billed charges",83.08,4212.68,
"46500 Injection of sclerosing solution, hemorrhoid",7963459,CDM,521,RC,46500,CPT,OUTPATIENT,,,291,189.15,,256.08,88,,204.86,,,0,"percent of total billed charges","88% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,291,100,,232.80,,,0,"percent of total billed charges","100% of total billed charges",1631.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",1367,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",183.33,63,,146.66,,,0,"percent of total billed charges","63% of total billed charges",44.52,15.3,,35.62,,,0,"percent of total billed charges","15.3% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,200.79,69,,,,,0,"fee schedule","69% of total billed charges",291,100,,232.80,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",291,100,,232.80,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",291,100,,232.80,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",3224.22,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",842.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",109.71,37.7,,87.77,,,0,"percent of total billed charges","37.70% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",226.98,78,,181.58,,,0,"percent of total billed charges","78% of total billed charges",941.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",240.37,82.6,,192.30,,,0,"percent of total billed charges","82.6% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",240.37,82.6,,192.30,,,0,"percent of total billed charges","82.6% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1487.72,100,,,,,0,"fee schedule",EAPG,291,100,,232.80,,,0,"percent of total billed charges","100% of total billed charges",44.52,3224.22,
"46600 Anoscopy",7904629,CDM,521,RC,46600,CPT,OUTPATIENT,,,146,94.9,,128.48,88,,102.78,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",624,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.98,63,,73.58,,,0,"percent of total billed charges","63% of total billed charges",22.34,15.3,,17.87,,,0,"percent of total billed charges","15.3% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,100.74,69,,,,,0,"fee schedule","69% of total billed charges",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",617.95,100,,,,,0,"fee schedule",EAPG,787.58,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",55.04,37.7,,44.03,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",113.88,78,,91.10,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",120.6,82.6,,96.48,,,0,"percent of total billed charges","82.6% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",120.6,82.6,,96.48,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",766.36,100,,,,,0,"fee schedule",EAPG,146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",22.34,787.58,
"46606 Anoscopy",7904630,CDM,521,RC,46606,CPT,OUTPATIENT,,,489,317.85,,430.32,88,,344.26,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,489,100,,391.20,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",308.07,63,,246.46,,,0,"percent of total billed charges","63% of total billed charges",74.82,15.3,,59.86,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,337.41,69,,,,,0,"fee schedule","69% of total billed charges",489,100,,391.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",489,100,,391.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",489,100,,391.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",184.35,37.7,,147.48,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",381.42,78,,305.14,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",403.91,82.6,,323.13,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",403.91,82.6,,323.13,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.21,100,,,,,0,"fee schedule",EAPG,489,100,,391.20,,,0,"percent of total billed charges","100% of total billed charges",74.82,4212.68,
"46601 Anoscopy; diagnostic, with high-resolution m",7962079,CDM,521,RC,46601,CPT,OUTPATIENT,,,212,137.8,,186.56,88,,149.25,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",624,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",133.56,63,,106.85,,,0,"percent of total billed charges","63% of total billed charges",32.44,15.3,,25.95,,,0,"percent of total billed charges","15.3% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,146.28,69,,,,,0,"fee schedule","69% of total billed charges",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",617.95,100,,,,,0,"fee schedule",EAPG,787.58,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",79.92,37.7,,63.94,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",165.36,78,,132.29,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",175.11,82.6,,140.09,,,0,"percent of total billed charges","82.6% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",175.11,82.6,,140.09,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",766.36,100,,,,,0,"fee schedule",EAPG,212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",32.44,787.58,
"46604 Anoscopy; with dilation (eg, balloon, guide",7963199,CDM,521,RC,46604,CPT,OUTPATIENT,,,214,139.1,,188.32,88,,150.66,,,0,"percent of total billed charges","88% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,214,100,,171.20,,,0,"percent of total billed charges","100% of total billed charges",2106.33,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",134.82,63,,107.86,,,0,"percent of total billed charges","63% of total billed charges",32.74,15.3,,26.19,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,147.66,69,,,,,0,"fee schedule","69% of total billed charges",214,100,,171.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",214,100,,171.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",214,100,,171.20,,,0,"percent of total billed charges","100% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",4212.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",80.68,37.7,,64.54,,,0,"percent of total billed charges","37.70% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",166.92,78,,133.54,,,0,"percent of total billed charges","78% of total billed charges",1215.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",176.76,82.6,,141.41,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",176.76,82.6,,141.41,,,0,"percent of total billed charges","82.6% of total billed charges",1203.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.21,100,,,,,0,"fee schedule",EAPG,214,100,,171.20,,,0,"percent of total billed charges","100% of total billed charges",32.74,4212.68,
"46608 Anoscopy; with removal of foreign body",7963629,CDM,521,RC,46608,CPT,OUTPATIENT,,,394,256.1,,346.72,88,,277.38,,,0,"percent of total billed charges","88% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,394,100,,315.20,,,0,"percent of total billed charges","100% of total billed charges",1631.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",900.92,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",248.22,63,,198.58,,,0,"percent of total billed charges","63% of total billed charges",60.28,15.3,,48.22,,,0,"percent of total billed charges","15.3% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,271.86,69,,,,,0,"fee schedule","69% of total billed charges",394,100,,315.20,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394,100,,315.20,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394,100,,315.20,,,0,"percent of total billed charges","100% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",3224.22,100,,,,,0,"fee schedule","100% of CMS OPPS rate",874.68,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",842.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.17,100,,,,,0,"fee schedule",EAPG,1137.08,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",148.54,37.7,,118.83,,,0,"percent of total billed charges","37.70% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.32,78,,245.86,,,0,"percent of total billed charges","78% of total billed charges",941.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",325.44,82.6,,260.35,,,0,"percent of total billed charges","82.6% of total billed charges",874.68,100,,,,,0,"fee schedule",EAPG,932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",325.44,82.6,,260.35,,,0,"percent of total billed charges","82.6% of total billed charges",932.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1035.21,100,,,,,0,"fee schedule",EAPG,394,100,,315.20,,,0,"percent of total billed charges","100% of total billed charges",60.28,3224.22,
"46610 Anoscopy; w/ removal of single tumor, polyp,",7961537,CDM,521,RC,46610,CPT,OUTPATIENT,,,427,277.55,,375.76,88,,300.61,,,0,"percent of total billed charges","88% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1843.93,100,,,,,0,"fee schedule",EAPG,427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",5011.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",1899.25,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",269.01,63,,215.21,,,0,"percent of total billed charges","63% of total billed charges",65.33,15.3,,52.26,,,0,"percent of total billed charges","15.3% of total billed charges",1843.93,100,,,,,0,"fee schedule",EAPG,294.63,69,,,,,0,"fee schedule","69% of total billed charges",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",9926.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1843.93,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2595.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1880.81,100,,,,,0,"fee schedule",EAPG,2397.11,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",160.98,37.7,,128.78,,,0,"percent of total billed charges","37.70% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",333.06,78,,266.45,,,0,"percent of total billed charges","78% of total billed charges",2892.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352.7,82.6,,282.16,,,0,"percent of total billed charges","82.6% of total billed charges",1843.93,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352.7,82.6,,282.16,,,0,"percent of total billed charges","82.6% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2004.46,100,,,,,0,"fee schedule",EAPG,427,100,,341.60,,,0,"percent of total billed charges","100% of total billed charges",65.33,9926.34,
"46750 Sphincteroplasty, anal, for incontinence or",7963151,CDM,521,RC,46750,CPT,OUTPATIENT,,,1655,1075.75,,1456.4,88,,1165.12,,,0,"percent of total billed charges","88% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2024.32,100,,,,,0,"fee schedule",EAPG,1655,100,,1324.00,,,0,"percent of total billed charges","100% of total billed charges",5011.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",2085.05,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1042.65,63,,834.12,,,0,"percent of total billed charges","63% of total billed charges",253.22,15.3,,202.58,,,0,"percent of total billed charges","15.3% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,1141.95,69,,,,,0,"fee schedule","69% of total billed charges",1655,100,,1324.00,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1655,100,,1324.00,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1655,100,,1324.00,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",9926.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2024.32,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2595.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2064.8,100,,,,,0,"fee schedule",EAPG,2631.61,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",623.94,37.7,,499.15,,,0,"percent of total billed charges","37.70% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1290.9,78,,1032.72,,,0,"percent of total billed charges","78% of total billed charges",2892.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1367.03,82.6,,1093.62,,,0,"percent of total billed charges","82.6% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1367.03,82.6,,1093.62,,,0,"percent of total billed charges","82.6% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2184.85,100,,,,,0,"fee schedule",EAPG,1655,100,,1324.00,,,0,"percent of total billed charges","100% of total billed charges",253.22,9926.34,
"46900 Destruction of lesion(s), anus (eg, condylom",7904640,CDM,521,RC,46900,CPT,OUTPATIENT,,,363,235.95,,319.44,88,,255.55,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,363,100,,290.40,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",1367,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",228.69,63,,182.95,,,0,"percent of total billed charges","63% of total billed charges",55.54,15.3,,44.43,,,0,"percent of total billed charges","15.3% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,250.47,69,,,,,0,"fee schedule","69% of total billed charges",363,100,,290.40,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",363,100,,290.40,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",363,100,,290.40,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",136.85,37.7,,109.48,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.14,78,,226.51,,,0,"percent of total billed charges","78% of total billed charges",410.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",299.84,82.6,,239.87,,,0,"percent of total billed charges","82.6% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",299.84,82.6,,239.87,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1487.72,100,,,,,0,"fee schedule",EAPG,363,100,,290.40,,,0,"percent of total billed charges","100% of total billed charges",55.54,1725.34,
"46910 Destruction of lesion(s), anus, simple; elec",7963178,CDM,521,RC,46910,CPT,OUTPATIENT,,,402,261.3,,353.76,88,,283.01,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1367,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",253.26,63,,202.61,,,0,"percent of total billed charges","63% of total billed charges",61.51,15.3,,49.21,,,0,"percent of total billed charges","15.3% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,277.38,69,,,,,0,"fee schedule","69% of total billed charges",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",151.55,37.7,,121.24,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",313.56,78,,250.85,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",332.05,82.6,,265.64,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1487.72,100,,,,,0,"fee schedule",EAPG,402,100,,321.60,,,0,"percent of total billed charges","100% of total billed charges",61.51,6968.7,
"46916 Destruction of lesion(s), anus, simple; cryo",7963366,CDM,521,RC,46916,CPT,OUTPATIENT,,,344,223.6,,302.72,88,,242.18,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",1367,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,63,,173.38,,,0,"percent of total billed charges","63% of total billed charges",52.63,15.3,,42.10,,,0,"percent of total billed charges","15.3% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,237.36,69,,,,,0,"fee schedule","69% of total billed charges",344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",129.69,37.7,,103.75,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",268.32,78,,214.66,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.14,82.6,,227.31,,,0,"percent of total billed charges","82.6% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.14,82.6,,227.31,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1487.72,100,,,,,0,"fee schedule",EAPG,344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",52.63,1725.34,
"46922 Surgical excision, destruction of lesion (s)",7963385,CDM,521,RC,46922,CPT,OUTPATIENT,,,572,371.8,,503.36,88,,402.69,,,0,"percent of total billed charges","88% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,572,100,,457.60,,,0,"percent of total billed charges","100% of total billed charges",5011.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",1367,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",360.36,63,,288.29,,,0,"percent of total billed charges","63% of total billed charges",87.52,15.3,,70.02,,,0,"percent of total billed charges","15.3% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,394.68,69,,,,,0,"fee schedule","69% of total billed charges",572,100,,457.60,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",572,100,,457.60,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",572,100,,457.60,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",9926.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2595.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",215.64,37.7,,172.51,,,0,"percent of total billed charges","37.70% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",446.16,78,,356.93,,,0,"percent of total billed charges","78% of total billed charges",2892.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",472.47,82.6,,377.98,,,0,"percent of total billed charges","82.6% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",472.47,82.6,,377.98,,,0,"percent of total billed charges","82.6% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1487.72,100,,,,,0,"fee schedule",EAPG,572,100,,457.60,,,0,"percent of total billed charges","100% of total billed charges",87.52,9926.34,
"46924 Destruction of lesion(s), anus, extensive",7963562,CDM,521,RC,46924,CPT,OUTPATIENT,,,1055,685.75,,928.4,88,,742.72,,,0,"percent of total billed charges","88% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,1055,100,,844.00,,,0,"percent of total billed charges","100% of total billed charges",5011.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",1367,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",664.65,63,,531.72,,,0,"percent of total billed charges","63% of total billed charges",161.42,15.3,,129.14,,,0,"percent of total billed charges","15.3% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,727.95,69,,,,,0,"fee schedule","69% of total billed charges",1055,100,,844.00,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055,100,,844.00,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055,100,,844.00,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",9926.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2595.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",397.74,37.7,,318.19,,,0,"percent of total billed charges","37.70% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",822.9,78,,658.32,,,0,"percent of total billed charges","78% of total billed charges",2892.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",871.43,82.6,,697.14,,,0,"percent of total billed charges","82.6% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",871.43,82.6,,697.14,,,0,"percent of total billed charges","82.6% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1487.72,100,,,,,0,"fee schedule",EAPG,1055,100,,844.00,,,0,"percent of total billed charges","100% of total billed charges",161.42,9926.34,
"46946 Hemorrhoidectomy, internal, by ligation othe",7962157,CDM,521,RC,46946,CPT,OUTPATIENT,,,659,428.35,,579.92,88,,463.94,,,0,"percent of total billed charges","88% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,659,100,,527.20,,,0,"percent of total billed charges","100% of total billed charges",5011.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",1367,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",415.17,63,,332.14,,,0,"percent of total billed charges","63% of total billed charges",100.83,15.3,,80.66,,,0,"percent of total billed charges","15.3% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,454.71,69,,,,,0,"fee schedule","69% of total billed charges",659,100,,527.20,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",659,100,,527.20,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",659,100,,527.20,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",9926.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2595.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",248.44,37.7,,198.75,,,0,"percent of total billed charges","37.70% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",514.02,78,,411.22,,,0,"percent of total billed charges","78% of total billed charges",2892.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",544.33,82.6,,435.46,,,0,"percent of total billed charges","82.6% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",544.33,82.6,,435.46,,,0,"percent of total billed charges","82.6% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1487.72,100,,,,,0,"fee schedule",EAPG,659,100,,527.20,,,0,"percent of total billed charges","100% of total billed charges",100.83,9926.34,
"46945 Hemorrhoidectomy, SINGLE internal, by ligati",7962818,CDM,521,RC,46945,CPT,OUTPATIENT,,,659,428.35,,579.92,88,,463.94,,,0,"percent of total billed charges","88% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,659,100,,527.20,,,0,"percent of total billed charges","100% of total billed charges",5011.71,175,,,,,0,"fee schedule","175% of CMS fee schedule",1367,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",415.17,63,,332.14,,,0,"percent of total billed charges","63% of total billed charges",100.83,15.3,,80.66,,,0,"percent of total billed charges","15.3% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,454.71,69,,,,,0,"fee schedule","69% of total billed charges",659,100,,527.20,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",659,100,,527.20,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",659,100,,527.20,,,0,"percent of total billed charges","100% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",9926.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2595.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",248.44,37.7,,198.75,,,0,"percent of total billed charges","37.70% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",514.02,78,,411.22,,,0,"percent of total billed charges","78% of total billed charges",2892.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",544.33,82.6,,435.46,,,0,"percent of total billed charges","82.6% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",544.33,82.6,,435.46,,,0,"percent of total billed charges","82.6% of total billed charges",2863.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1487.72,100,,,,,0,"fee schedule",EAPG,659,100,,527.20,,,0,"percent of total billed charges","100% of total billed charges",100.83,9926.34,
"47001 Biopsy of liver, needle; when done for indic",7961876,CDM,521,RC,47001,CPT,OUTPATIENT,,,453,294.45,,398.64,88,,318.91,,,0,"percent of total billed charges","88% of total billed charges",226.5,50,,181.20,,,0,"percent of total billed charges","50% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,453,100,,362.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",685.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",285.39,63,,228.31,,,0,"percent of total billed charges","63% of total billed charges",69.31,15.3,,55.45,,,0,"percent of total billed charges","15.3% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,312.57,69,,,,,0,"fee schedule","69% of total billed charges",453,100,,362.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",453,100,,362.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",453,100,,362.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",665.87,100,,,,,0,"fee schedule",EAPG,226.5,50,,181.20,,,0,"percent of total billed charges","50% of total billed charges",145.87,32.2,,116.70,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",679.18,100,,,,,0,"fee schedule",EAPG,865.63,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",170.78,37.7,,136.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",353.34,78,,282.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",374.18,82.6,,299.34,,,0,"percent of total billed charges","82.6% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,226.5,50,,181.20,,,0,"percent of total billed charges","50% of total billed charges",374.18,82.6,,299.34,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",826.4,100,,,,,0,"fee schedule",EAPG,453,100,,362.40,,,0,"percent of total billed charges","100% of total billed charges",69.31,865.63,
"47100 Biopsy of liver, wedge",7963882,CDM,521,RC,47100,CPT,OUTPATIENT,,,2156,1401.4,,1897.28,88,,1517.82,,,0,"percent of total billed charges","88% of total billed charges",2156,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5749.65,100,,,,,0,"fee schedule",EAPG,2156,100,,1724.80,,,0,"percent of total billed charges","100% of total billed charges",2156,175,,,,,0,"fee schedule","175% of CMS fee schedule",5922.14,100,,,,,0,"fee schedule",EAPG,2156,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1358.28,63,,1086.62,,,0,"percent of total billed charges","63% of total billed charges",329.87,15.3,,263.90,,,0,"percent of total billed charges","15.3% of total billed charges",5749.65,100,,,,,0,"fee schedule",EAPG,1487.64,69,,,,,0,"fee schedule","69% of total billed charges",2156,100,,1724.80,,,0,"percent of total billed charges","100% of total billed charges",2156,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2156,100,,1724.80,,,0,"percent of total billed charges","100% of total billed charges",2156,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2156,100,,1724.80,,,0,"percent of total billed charges","100% of total billed charges",2156,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2156,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5749.65,100,,,,,0,"fee schedule",EAPG,2156,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2156,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2156,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5864.64,100,,,,,0,"fee schedule",EAPG,7474.55,100,,,,,0,"fee schedule",EAPG,2156,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",812.81,37.7,,650.25,,,0,"percent of total billed charges","37.70% of total billed charges",2156,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2156,100,,,,,0,"fee schedule","100% of CMS fee schedule",1681.68,78,,1345.34,,,0,"percent of total billed charges","78% of total billed charges",2156,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1780.86,82.6,,1424.69,,,0,"percent of total billed charges","82.6% of total billed charges",5749.65,100,,,,,0,"fee schedule","100% of WA fee schedule",2156,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1780.86,82.6,,1424.69,,,0,"percent of total billed charges","82.6% of total billed charges",2156,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5910.18,100,,,,,0,"fee schedule",EAPG,2156,100,,1724.80,,,0,"percent of total billed charges","100% of total billed charges",329.87,7474.55,
"47350 Management of liver hemorrhage; simple sutur",7962819,CDM,521,RC,47350,CPT,OUTPATIENT,,,3949,2566.85,,3475.12,88,,2780.10,,,0,"percent of total billed charges","88% of total billed charges",3949,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2269.56,100,,,,,0,"fee schedule",EAPG,3949,100,,3159.20,,,0,"percent of total billed charges","100% of total billed charges",3949,175,,,,,0,"fee schedule","175% of CMS fee schedule",2337.65,100,,,,,0,"fee schedule",EAPG,3949,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2487.87,63,,1990.30,,,0,"percent of total billed charges","63% of total billed charges",604.2,15.3,,483.36,,,0,"percent of total billed charges","15.3% of total billed charges",2269.56,100,,,,,0,"fee schedule",EAPG,2724.81,69,,,,,0,"fee schedule","69% of total billed charges",3949,100,,3159.20,,,0,"percent of total billed charges","100% of total billed charges",3949,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3949,100,,3159.20,,,0,"percent of total billed charges","100% of total billed charges",3949,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3949,100,,3159.20,,,0,"percent of total billed charges","100% of total billed charges",3949,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3949,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2269.56,100,,,,,0,"fee schedule",EAPG,3949,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3949,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3949,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2314.95,100,,,,,0,"fee schedule",EAPG,2950.43,100,,,,,0,"fee schedule",EAPG,3949,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1488.77,37.7,,1191.02,,,0,"percent of total billed charges","37.70% of total billed charges",3949,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3949,100,,,,,0,"fee schedule","100% of CMS fee schedule",3080.22,78,,2464.18,,,0,"percent of total billed charges","78% of total billed charges",3949,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3261.87,82.6,,2609.50,,,0,"percent of total billed charges","82.6% of total billed charges",2269.56,100,,,,,0,"fee schedule","100% of WA fee schedule",3949,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3261.87,82.6,,2609.50,,,0,"percent of total billed charges","82.6% of total billed charges",3949,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2430.09,100,,,,,0,"fee schedule",EAPG,3949,100,,3159.20,,,0,"percent of total billed charges","100% of total billed charges",604.2,3949,
"47361 Explore hepatic wound, extensive debridement",7961833,CDM,521,RC,47361,CPT,OUTPATIENT,,,8848,5751.2,,7786.24,88,,6228.99,,,0,"percent of total billed charges","88% of total billed charges",8848,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5749.65,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8848,175,,,,,0,"fee schedule","175% of CMS fee schedule",5922.14,100,,,,,0,"fee schedule",EAPG,8848,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5574.24,63,,4459.39,,,0,"percent of total billed charges","63% of total billed charges",1353.74,15.3,,1082.99,,,0,"percent of total billed charges","15.3% of total billed charges",5749.65,100,,,,,0,"fee schedule",EAPG,6105.12,69,,,,,0,"fee schedule","69% of total billed charges",8848,100,,7078.40,,,0,"percent of total billed charges","100% of total billed charges",8848,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8848,100,,7078.40,,,0,"percent of total billed charges","100% of total billed charges",8848,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8848,100,,7078.40,,,0,"percent of total billed charges","100% of total billed charges",8848,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8848,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5749.65,100,,,,,0,"fee schedule",EAPG,8848,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8848,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8848,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5864.64,100,,,,,0,"fee schedule",EAPG,7474.55,100,,,,,0,"fee schedule",EAPG,8848,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3335.7,37.7,,2668.56,,,0,"percent of total billed charges","37.70% of total billed charges",8848,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8848,100,,,,,0,"fee schedule","100% of CMS fee schedule",6901.44,78,,5521.15,,,0,"percent of total billed charges","78% of total billed charges",8848,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7308.45,82.6,,5846.76,,,0,"percent of total billed charges","82.6% of total billed charges",5749.65,100,,,,,0,"fee schedule","100% of WA fee schedule",8848,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7308.45,82.6,,5846.76,,,0,"percent of total billed charges","82.6% of total billed charges",8848,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5910.18,100,,,,,0,"fee schedule",EAPG,8848,100,,7078.40,,,0,"percent of total billed charges","100% of total billed charges",1353.74,8848,
"47360 Management of liver hemorrhage; complex, w/",7962682,CDM,521,RC,47360,CPT,OUTPATIENT,,,5360,3484,,4716.8,88,,3773.44,,,0,"percent of total billed charges","88% of total billed charges",5360,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2269.56,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5360,175,,,,,0,"fee schedule","175% of CMS fee schedule",2337.65,100,,,,,0,"fee schedule",EAPG,5360,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3376.8,63,,2701.44,,,0,"percent of total billed charges","63% of total billed charges",820.08,15.3,,656.06,,,0,"percent of total billed charges","15.3% of total billed charges",2269.56,100,,,,,0,"fee schedule",EAPG,3698.4,69,,,,,0,"fee schedule","69% of total billed charges",5360,100,,4288.00,,,0,"percent of total billed charges","100% of total billed charges",5360,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5360,100,,4288.00,,,0,"percent of total billed charges","100% of total billed charges",5360,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5360,100,,4288.00,,,0,"percent of total billed charges","100% of total billed charges",5360,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5360,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2269.56,100,,,,,0,"fee schedule",EAPG,5360,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5360,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5360,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2314.95,100,,,,,0,"fee schedule",EAPG,2950.43,100,,,,,0,"fee schedule",EAPG,5360,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2020.72,37.7,,1616.58,,,0,"percent of total billed charges","37.70% of total billed charges",5360,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5360,100,,,,,0,"fee schedule","100% of CMS fee schedule",4180.8,78,,3344.64,,,0,"percent of total billed charges","78% of total billed charges",5360,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4427.36,82.6,,3541.89,,,0,"percent of total billed charges","82.6% of total billed charges",2269.56,100,,,,,0,"fee schedule","100% of WA fee schedule",5360,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4427.36,82.6,,3541.89,,,0,"percent of total billed charges","82.6% of total billed charges",5360,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2430.09,100,,,,,0,"fee schedule",EAPG,5360,100,,4288.00,,,0,"percent of total billed charges","100% of total billed charges",820.08,5360,
"47379 Unlisted laparoscopic procedure, liver",7963630,CDM,521,RC,47379,CPT,OUTPATIENT,,,3545,2304.25,,3119.6,88,,2495.68,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2269.56,100,,,,,0,"fee schedule",EAPG,3545,100,,2836.00,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",2337.65,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2233.35,63,,1786.68,,,0,"percent of total billed charges","63% of total billed charges",542.39,15.3,,433.91,,,0,"percent of total billed charges","15.3% of total billed charges",2269.56,100,,,,,0,"fee schedule",EAPG,2446.05,69,,,,,0,"fee schedule","69% of total billed charges",3545,100,,2836.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3545,100,,2836.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3545,100,,2836.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2269.56,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2314.95,100,,,,,0,"fee schedule",EAPG,2950.43,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1336.47,37.7,,1069.18,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2765.1,78,,2212.08,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2928.17,82.6,,2342.54,,,0,"percent of total billed charges","82.6% of total billed charges",2269.56,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2928.17,82.6,,2342.54,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2430.09,100,,,,,0,"fee schedule",EAPG,3545,100,,2836.00,,,0,"percent of total billed charges","100% of total billed charges",542.39,20558.19,
"47564 Laparoscopy, surgical; cholecystectomy with",7962820,CDM,521,RC,47564,CPT,OUTPATIENT,,,4252,2763.8,,3741.76,88,,2993.41,,,0,"percent of total billed charges","88% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3107.46,100,,,,,0,"fee schedule",EAPG,4252,100,,3401.60,,,0,"percent of total billed charges","100% of total billed charges",18373.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",3200.69,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2678.76,63,,2143.01,,,0,"percent of total billed charges","63% of total billed charges",650.56,15.3,,520.45,,,0,"percent of total billed charges","15.3% of total billed charges",3107.46,100,,,,,0,"fee schedule",EAPG,2933.88,69,,,,,0,"fee schedule","69% of total billed charges",4252,100,,3401.60,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4252,100,,3401.60,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4252,100,,3401.60,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3107.46,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3169.61,100,,,,,0,"fee schedule",EAPG,4039.7,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1603,37.7,,1282.40,,,0,"percent of total billed charges","37.70% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3316.56,78,,2653.25,,,0,"percent of total billed charges","78% of total billed charges",10604.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3512.15,82.6,,2809.72,,,0,"percent of total billed charges","82.6% of total billed charges",3107.46,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3512.15,82.6,,2809.72,,,0,"percent of total billed charges","82.6% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3267.99,100,,,,,0,"fee schedule",EAPG,4252,100,,3401.60,,,0,"percent of total billed charges","100% of total billed charges",650.56,20558.19,
"47563 Lap, cholecystectomy w/ cholangiography",7963608,CDM,521,RC,47563,CPT,OUTPATIENT,,,3792,2464.8,,3336.96,88,,2669.57,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3107.46,100,,,,,0,"fee schedule",EAPG,3792,100,,3033.60,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",3200.69,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2388.96,63,,1911.17,,,0,"percent of total billed charges","63% of total billed charges",580.18,15.3,,464.14,,,0,"percent of total billed charges","15.3% of total billed charges",3107.46,100,,,,,0,"fee schedule",EAPG,2616.48,69,,,,,0,"fee schedule","69% of total billed charges",3792,100,,3033.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3792,100,,3033.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3792,100,,3033.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3107.46,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3169.61,100,,,,,0,"fee schedule",EAPG,4039.7,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1429.58,37.7,,1143.66,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2957.76,78,,2366.21,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3132.19,82.6,,2505.75,,,0,"percent of total billed charges","82.6% of total billed charges",3107.46,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3132.19,82.6,,2505.75,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3267.99,100,,,,,0,"fee schedule",EAPG,3792,100,,3033.60,,,0,"percent of total billed charges","100% of total billed charges",580.18,20558.19,
"47562 Laparoscopy, surgical; cholecystectomy",7963631,CDM,521,RC,47562,CPT,OUTPATIENT,,,3608,2345.2,,3175.04,88,,2540.03,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3107.46,100,,,,,0,"fee schedule",EAPG,3608,100,,2886.40,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",3200.69,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2273.04,63,,1818.43,,,0,"percent of total billed charges","63% of total billed charges",552.02,15.3,,441.62,,,0,"percent of total billed charges","15.3% of total billed charges",3107.46,100,,,,,0,"fee schedule",EAPG,2489.52,69,,,,,0,"fee schedule","69% of total billed charges",3608,100,,2886.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3608,100,,2886.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3608,100,,2886.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3107.46,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3169.61,100,,,,,0,"fee schedule",EAPG,4039.7,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1360.22,37.7,,1088.18,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2814.24,78,,2251.39,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2980.21,82.6,,2384.17,,,0,"percent of total billed charges","82.6% of total billed charges",3107.46,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2980.21,82.6,,2384.17,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3267.99,100,,,,,0,"fee schedule",EAPG,3608,100,,2886.40,,,0,"percent of total billed charges","100% of total billed charges",552.02,20558.19,
"47605 Cholecystectomy; with cholangiography",7963647,CDM,521,RC,47605,CPT,OUTPATIENT,,,3337,2169.05,,2936.56,88,,2349.25,,,0,"percent of total billed charges","88% of total billed charges",3337,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5749.65,100,,,,,0,"fee schedule",EAPG,3337,100,,2669.60,,,0,"percent of total billed charges","100% of total billed charges",3337,175,,,,,0,"fee schedule","175% of CMS fee schedule",5922.14,100,,,,,0,"fee schedule",EAPG,3337,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2102.31,63,,1681.85,,,0,"percent of total billed charges","63% of total billed charges",510.56,15.3,,408.45,,,0,"percent of total billed charges","15.3% of total billed charges",5749.65,100,,,,,0,"fee schedule",EAPG,2302.53,69,,,,,0,"fee schedule","69% of total billed charges",3337,100,,2669.60,,,0,"percent of total billed charges","100% of total billed charges",3337,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3337,100,,2669.60,,,0,"percent of total billed charges","100% of total billed charges",3337,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3337,100,,2669.60,,,0,"percent of total billed charges","100% of total billed charges",3337,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3337,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5749.65,100,,,,,0,"fee schedule",EAPG,3337,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3337,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3337,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5864.64,100,,,,,0,"fee schedule",EAPG,7474.55,100,,,,,0,"fee schedule",EAPG,3337,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1258.05,37.7,,1006.44,,,0,"percent of total billed charges","37.70% of total billed charges",3337,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3337,100,,,,,0,"fee schedule","100% of CMS fee schedule",2602.86,78,,2082.29,,,0,"percent of total billed charges","78% of total billed charges",3337,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2756.36,82.6,,2205.09,,,0,"percent of total billed charges","82.6% of total billed charges",5749.65,100,,,,,0,"fee schedule","100% of WA fee schedule",3337,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2756.36,82.6,,2205.09,,,0,"percent of total billed charges","82.6% of total billed charges",3337,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5910.18,100,,,,,0,"fee schedule",EAPG,3337,100,,2669.60,,,0,"percent of total billed charges","100% of total billed charges",510.56,7474.55,
"47600 Cholecystectomy;",7963919,CDM,521,RC,47600,CPT,OUTPATIENT,,,3163,2055.95,,2783.44,88,,2226.75,,,0,"percent of total billed charges","88% of total billed charges",3163,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5749.65,100,,,,,0,"fee schedule",EAPG,3163,100,,2530.40,,,0,"percent of total billed charges","100% of total billed charges",3163,175,,,,,0,"fee schedule","175% of CMS fee schedule",5922.14,100,,,,,0,"fee schedule",EAPG,3163,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1992.69,63,,1594.15,,,0,"percent of total billed charges","63% of total billed charges",483.94,15.3,,387.15,,,0,"percent of total billed charges","15.3% of total billed charges",5749.65,100,,,,,0,"fee schedule",EAPG,2182.47,69,,,,,0,"fee schedule","69% of total billed charges",3163,100,,2530.40,,,0,"percent of total billed charges","100% of total billed charges",3163,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3163,100,,2530.40,,,0,"percent of total billed charges","100% of total billed charges",3163,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3163,100,,2530.40,,,0,"percent of total billed charges","100% of total billed charges",3163,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3163,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5749.65,100,,,,,0,"fee schedule",EAPG,3163,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3163,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3163,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5864.64,100,,,,,0,"fee schedule",EAPG,7474.55,100,,,,,0,"fee schedule",EAPG,3163,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1192.45,37.7,,953.96,,,0,"percent of total billed charges","37.70% of total billed charges",3163,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3163,100,,,,,0,"fee schedule","100% of CMS fee schedule",2467.14,78,,1973.71,,,0,"percent of total billed charges","78% of total billed charges",3163,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2612.64,82.6,,2090.11,,,0,"percent of total billed charges","82.6% of total billed charges",5749.65,100,,,,,0,"fee schedule","100% of WA fee schedule",3163,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2612.64,82.6,,2090.11,,,0,"percent of total billed charges","82.6% of total billed charges",3163,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5910.18,100,,,,,0,"fee schedule",EAPG,3163,100,,2530.40,,,0,"percent of total billed charges","100% of total billed charges",483.94,7474.55,
"47610 Cholecystectomy with exploration of common d",7963430,CDM,521,RC,47610,CPT,OUTPATIENT,,,3966,2577.9,,3490.08,88,,2792.06,,,0,"percent of total billed charges","88% of total billed charges",3966,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5749.65,100,,,,,0,"fee schedule",EAPG,3966,100,,3172.80,,,0,"percent of total billed charges","100% of total billed charges",3966,175,,,,,0,"fee schedule","175% of CMS fee schedule",5922.14,100,,,,,0,"fee schedule",EAPG,3966,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2498.58,63,,1998.86,,,0,"percent of total billed charges","63% of total billed charges",606.8,15.3,,485.44,,,0,"percent of total billed charges","15.3% of total billed charges",5749.65,100,,,,,0,"fee schedule",EAPG,2736.54,69,,,,,0,"fee schedule","69% of total billed charges",3966,100,,3172.80,,,0,"percent of total billed charges","100% of total billed charges",3966,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3966,100,,3172.80,,,0,"percent of total billed charges","100% of total billed charges",3966,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3966,100,,3172.80,,,0,"percent of total billed charges","100% of total billed charges",3966,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3966,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5749.65,100,,,,,0,"fee schedule",EAPG,3966,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3966,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3966,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5864.64,100,,,,,0,"fee schedule",EAPG,7474.55,100,,,,,0,"fee schedule",EAPG,3966,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1495.18,37.7,,1196.14,,,0,"percent of total billed charges","37.70% of total billed charges",3966,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3966,100,,,,,0,"fee schedule","100% of CMS fee schedule",3093.48,78,,2474.78,,,0,"percent of total billed charges","78% of total billed charges",3966,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3275.92,82.6,,2620.74,,,0,"percent of total billed charges","82.6% of total billed charges",5749.65,100,,,,,0,"fee schedule","100% of WA fee schedule",3966,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3275.92,82.6,,2620.74,,,0,"percent of total billed charges","82.6% of total billed charges",3966,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5910.18,100,,,,,0,"fee schedule",EAPG,3966,100,,3172.80,,,0,"percent of total billed charges","100% of total billed charges",606.8,7474.55,
"48105 Resection or debridement of pancreas and per",7962011,CDM,521,RC,48105,CPT,OUTPATIENT,,,8184,5319.6,,7201.92,88,,5761.54,,,0,"percent of total billed charges","88% of total billed charges",8184,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5749.65,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8184,175,,,,,0,"fee schedule","175% of CMS fee schedule",5922.14,100,,,,,0,"fee schedule",EAPG,8184,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5155.92,63,,4124.74,,,0,"percent of total billed charges","63% of total billed charges",1252.15,15.3,,1001.72,,,0,"percent of total billed charges","15.3% of total billed charges",5749.65,100,,,,,0,"fee schedule",EAPG,5646.96,69,,,,,0,"fee schedule","69% of total billed charges",8184,100,,6547.20,,,0,"percent of total billed charges","100% of total billed charges",8184,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8184,100,,6547.20,,,0,"percent of total billed charges","100% of total billed charges",8184,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8184,100,,6547.20,,,0,"percent of total billed charges","100% of total billed charges",8184,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8184,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5749.65,100,,,,,0,"fee schedule",EAPG,8184,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8184,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8184,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5864.64,100,,,,,0,"fee schedule",EAPG,7474.55,100,,,,,0,"fee schedule",EAPG,8184,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3085.37,37.7,,2468.30,,,0,"percent of total billed charges","37.70% of total billed charges",8184,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8184,100,,,,,0,"fee schedule","100% of CMS fee schedule",6383.52,78,,5106.82,,,0,"percent of total billed charges","78% of total billed charges",8184,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6759.98,82.6,,5407.98,,,0,"percent of total billed charges","82.6% of total billed charges",5749.65,100,,,,,0,"fee schedule","100% of WA fee schedule",8184,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6759.98,82.6,,5407.98,,,0,"percent of total billed charges","82.6% of total billed charges",8184,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5910.18,100,,,,,0,"fee schedule",EAPG,8184,100,,6547.20,,,0,"percent of total billed charges","100% of total billed charges",1252.15,8184,
"48100 Biopsy of pancreas, open (eg, fine needle as",7962188,CDM,521,RC,48100,CPT,OUTPATIENT,,,2556,1661.4,,2249.28,88,,1799.42,,,0,"percent of total billed charges","88% of total billed charges",2556,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5749.65,100,,,,,0,"fee schedule",EAPG,2556,100,,2044.80,,,0,"percent of total billed charges","100% of total billed charges",2556,175,,,,,0,"fee schedule","175% of CMS fee schedule",5922.14,100,,,,,0,"fee schedule",EAPG,2556,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1610.28,63,,1288.22,,,0,"percent of total billed charges","63% of total billed charges",391.07,15.3,,312.86,,,0,"percent of total billed charges","15.3% of total billed charges",5749.65,100,,,,,0,"fee schedule",EAPG,1763.64,69,,,,,0,"fee schedule","69% of total billed charges",2556,100,,2044.80,,,0,"percent of total billed charges","100% of total billed charges",2556,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2556,100,,2044.80,,,0,"percent of total billed charges","100% of total billed charges",2556,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2556,100,,2044.80,,,0,"percent of total billed charges","100% of total billed charges",2556,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2556,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5749.65,100,,,,,0,"fee schedule",EAPG,2556,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2556,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2556,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5864.64,100,,,,,0,"fee schedule",EAPG,7474.55,100,,,,,0,"fee schedule",EAPG,2556,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",963.61,37.7,,770.89,,,0,"percent of total billed charges","37.70% of total billed charges",2556,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2556,100,,,,,0,"fee schedule","100% of CMS fee schedule",1993.68,78,,1594.94,,,0,"percent of total billed charges","78% of total billed charges",2556,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2111.26,82.6,,1689.01,,,0,"percent of total billed charges","82.6% of total billed charges",5749.65,100,,,,,0,"fee schedule","100% of WA fee schedule",2556,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2111.26,82.6,,1689.01,,,0,"percent of total billed charges","82.6% of total billed charges",2556,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5910.18,100,,,,,0,"fee schedule",EAPG,2556,100,,2044.80,,,0,"percent of total billed charges","100% of total billed charges",391.07,7474.55,
"48102 Biopsy of pancreas, percutaneous needle",7963574,CDM,521,RC,48102,CPT,OUTPATIENT,,,724,470.6,,637.12,88,,509.70,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,724,100,,579.20,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",685.84,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",456.12,63,,364.90,,,0,"percent of total billed charges","63% of total billed charges",110.77,15.3,,88.62,,,0,"percent of total billed charges","15.3% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,499.56,69,,,,,0,"fee schedule","69% of total billed charges",724,100,,579.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",724,100,,579.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",724,100,,579.20,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",679.18,100,,,,,0,"fee schedule",EAPG,865.63,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",272.95,37.7,,218.36,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",564.72,78,,451.78,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",598.02,82.6,,478.42,,,0,"percent of total billed charges","82.6% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",598.02,82.6,,478.42,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",826.4,100,,,,,0,"fee schedule",EAPG,724,100,,579.20,,,0,"percent of total billed charges","100% of total billed charges",110.77,5715.97,
"48120 Excision of lesion of pancreas (eg, cyst, ad",7963386,CDM,521,RC,48120,CPT,OUTPATIENT,,,3189,2072.85,,2806.32,88,,2245.06,,,0,"percent of total billed charges","88% of total billed charges",3189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5749.65,100,,,,,0,"fee schedule",EAPG,3189,100,,2551.20,,,0,"percent of total billed charges","100% of total billed charges",3189,175,,,,,0,"fee schedule","175% of CMS fee schedule",5922.14,100,,,,,0,"fee schedule",EAPG,3189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2009.07,63,,1607.26,,,0,"percent of total billed charges","63% of total billed charges",487.92,15.3,,390.34,,,0,"percent of total billed charges","15.3% of total billed charges",5749.65,100,,,,,0,"fee schedule",EAPG,2200.41,69,,,,,0,"fee schedule","69% of total billed charges",3189,100,,2551.20,,,0,"percent of total billed charges","100% of total billed charges",3189,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3189,100,,2551.20,,,0,"percent of total billed charges","100% of total billed charges",3189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3189,100,,2551.20,,,0,"percent of total billed charges","100% of total billed charges",3189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5749.65,100,,,,,0,"fee schedule",EAPG,3189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5864.64,100,,,,,0,"fee schedule",EAPG,7474.55,100,,,,,0,"fee schedule",EAPG,3189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1202.25,37.7,,961.80,,,0,"percent of total billed charges","37.70% of total billed charges",3189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3189,100,,,,,0,"fee schedule","100% of CMS fee schedule",2487.42,78,,1989.94,,,0,"percent of total billed charges","78% of total billed charges",3189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2634.11,82.6,,2107.29,,,0,"percent of total billed charges","82.6% of total billed charges",5749.65,100,,,,,0,"fee schedule","100% of WA fee schedule",3189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2634.11,82.6,,2107.29,,,0,"percent of total billed charges","82.6% of total billed charges",3189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5910.18,100,,,,,0,"fee schedule",EAPG,3189,100,,2551.20,,,0,"percent of total billed charges","100% of total billed charges",487.92,7474.55,
"48140 Pancreatectomy, distal subtotal, with or wit",7961702,CDM,521,RC,48140,CPT,OUTPATIENT,,,4492,2919.8,,3952.96,88,,3162.37,,,0,"percent of total billed charges","88% of total billed charges",4492,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5749.65,100,,,,,0,"fee schedule",EAPG,4492,100,,3593.60,,,0,"percent of total billed charges","100% of total billed charges",4492,175,,,,,0,"fee schedule","175% of CMS fee schedule",5922.14,100,,,,,0,"fee schedule",EAPG,4492,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2829.96,63,,2263.97,,,0,"percent of total billed charges","63% of total billed charges",687.28,15.3,,549.82,,,0,"percent of total billed charges","15.3% of total billed charges",5749.65,100,,,,,0,"fee schedule",EAPG,3099.48,69,,,,,0,"fee schedule","69% of total billed charges",4492,100,,3593.60,,,0,"percent of total billed charges","100% of total billed charges",4492,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4492,100,,3593.60,,,0,"percent of total billed charges","100% of total billed charges",4492,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4492,100,,3593.60,,,0,"percent of total billed charges","100% of total billed charges",4492,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4492,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5749.65,100,,,,,0,"fee schedule",EAPG,4492,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4492,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4492,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5864.64,100,,,,,0,"fee schedule",EAPG,7474.55,100,,,,,0,"fee schedule",EAPG,4492,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1693.48,37.7,,1354.78,,,0,"percent of total billed charges","37.70% of total billed charges",4492,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4492,100,,,,,0,"fee schedule","100% of CMS fee schedule",3503.76,78,,2803.01,,,0,"percent of total billed charges","78% of total billed charges",4492,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3710.39,82.6,,2968.31,,,0,"percent of total billed charges","82.6% of total billed charges",5749.65,100,,,,,0,"fee schedule",EAPG,4492,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3710.39,82.6,,2968.31,,,0,"percent of total billed charges","82.6% of total billed charges",4492,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5910.18,100,,,,,0,"fee schedule",EAPG,4492,100,,3593.60,,,0,"percent of total billed charges","100% of total billed charges",687.28,7474.55,
"48150 Pancreatectomy, proximal, partial gastrectom",7962821,CDM,521,RC,48150,CPT,OUTPATIENT,,,7984,5189.6,,7025.92,88,,5620.74,,,0,"percent of total billed charges","88% of total billed charges",7984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5749.65,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7984,175,,,,,0,"fee schedule","175% of CMS fee schedule",5922.14,100,,,,,0,"fee schedule",EAPG,7984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5029.92,63,,4023.94,,,0,"percent of total billed charges","63% of total billed charges",1221.55,15.3,,977.24,,,0,"percent of total billed charges","15.3% of total billed charges",5749.65,100,,,,,0,"fee schedule",EAPG,5508.96,69,,,,,0,"fee schedule","69% of total billed charges",7984,100,,6387.20,,,0,"percent of total billed charges","100% of total billed charges",7984,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7984,100,,6387.20,,,0,"percent of total billed charges","100% of total billed charges",7984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7984,100,,6387.20,,,0,"percent of total billed charges","100% of total billed charges",7984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5749.65,100,,,,,0,"fee schedule",EAPG,7984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5864.64,100,,,,,0,"fee schedule",EAPG,7474.55,100,,,,,0,"fee schedule",EAPG,7984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3009.97,37.7,,2407.98,,,0,"percent of total billed charges","37.70% of total billed charges",7984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7984,100,,,,,0,"fee schedule","100% of CMS fee schedule",6227.52,78,,4982.02,,,0,"percent of total billed charges","78% of total billed charges",7984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6594.78,82.6,,5275.82,,,0,"percent of total billed charges","82.6% of total billed charges",5749.65,100,,,,,0,"fee schedule","100% of WA fee schedule",7984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6594.78,82.6,,5275.82,,,0,"percent of total billed charges","82.6% of total billed charges",7984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5910.18,100,,,,,0,"fee schedule",EAPG,7984,100,,6387.20,,,0,"percent of total billed charges","100% of total billed charges",1221.55,7984,
"49000 Exploratory laparotomy, exploratory celiotom",7961703,CDM,521,RC,49000,CPT,OUTPATIENT,,,2532,1645.8,,2228.16,88,,1782.53,,,0,"percent of total billed charges","88% of total billed charges",2532,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3355.36,100,,,,,0,"fee schedule",EAPG,2532,100,,2025.60,,,0,"percent of total billed charges","100% of total billed charges",2532,175,,,,,0,"fee schedule","175% of CMS fee schedule",3456.02,100,,,,,0,"fee schedule",EAPG,2532,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1595.16,63,,1276.13,,,0,"percent of total billed charges","63% of total billed charges",387.4,15.3,,309.92,,,0,"percent of total billed charges","15.3% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,1747.08,69,,,,,0,"fee schedule","69% of total billed charges",2532,100,,2025.60,,,0,"percent of total billed charges","100% of total billed charges",2532,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2532,100,,2025.60,,,0,"percent of total billed charges","100% of total billed charges",2532,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2532,100,,2025.60,,,0,"percent of total billed charges","100% of total billed charges",2532,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2532,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3355.36,100,,,,,0,"fee schedule",EAPG,2532,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2532,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2532,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3422.47,100,,,,,0,"fee schedule",EAPG,4361.97,100,,,,,0,"fee schedule",EAPG,2532,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",954.56,37.7,,763.65,,,0,"percent of total billed charges","37.70% of total billed charges",2532,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2532,100,,,,,0,"fee schedule","100% of CMS fee schedule",1974.96,78,,1579.97,,,0,"percent of total billed charges","78% of total billed charges",2532,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2091.43,82.6,,1673.14,,,0,"percent of total billed charges","82.6% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,2532,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2091.43,82.6,,1673.14,,,0,"percent of total billed charges","82.6% of total billed charges",2532,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3515.89,100,,,,,0,"fee schedule",EAPG,2532,100,,2025.60,,,0,"percent of total billed charges","100% of total billed charges",387.4,4361.97,
"49002 Reopening of recent laparotomy",7963737,CDM,521,RC,49002,CPT,OUTPATIENT,,,2304,1497.6,,2027.52,88,,1622.02,,,0,"percent of total billed charges","88% of total billed charges",2304,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3355.36,100,,,,,0,"fee schedule",EAPG,2304,100,,1843.20,,,0,"percent of total billed charges","100% of total billed charges",2304,175,,,,,0,"fee schedule","175% of CMS fee schedule",3456.02,100,,,,,0,"fee schedule",EAPG,2304,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1451.52,63,,1161.22,,,0,"percent of total billed charges","63% of total billed charges",352.51,15.3,,282.01,,,0,"percent of total billed charges","15.3% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,1589.76,69,,,,,0,"fee schedule","69% of total billed charges",2304,100,,1843.20,,,0,"percent of total billed charges","100% of total billed charges",2304,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2304,100,,1843.20,,,0,"percent of total billed charges","100% of total billed charges",2304,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2304,100,,1843.20,,,0,"percent of total billed charges","100% of total billed charges",2304,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2304,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3355.36,100,,,,,0,"fee schedule",EAPG,2304,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2304,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2304,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3422.47,100,,,,,0,"fee schedule",EAPG,4361.97,100,,,,,0,"fee schedule",EAPG,2304,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",868.61,37.7,,694.89,,,0,"percent of total billed charges","37.70% of total billed charges",2304,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2304,100,,,,,0,"fee schedule","100% of CMS fee schedule",1797.12,78,,1437.70,,,0,"percent of total billed charges","78% of total billed charges",2304,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1903.1,82.6,,1522.48,,,0,"percent of total billed charges","82.6% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,2304,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1903.1,82.6,,1522.48,,,0,"percent of total billed charges","82.6% of total billed charges",2304,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3515.89,100,,,,,0,"fee schedule",EAPG,2304,100,,1843.20,,,0,"percent of total billed charges","100% of total billed charges",352.51,4361.97,
"49010 Exploration, retroperitoneal area with or wi",7962476,CDM,521,RC,49010,CPT,OUTPATIENT,,,2608,1695.2,,2295.04,88,,1836.03,,,0,"percent of total billed charges","88% of total billed charges",2608,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3355.36,100,,,,,0,"fee schedule",EAPG,2608,100,,2086.40,,,0,"percent of total billed charges","100% of total billed charges",2608,175,,,,,0,"fee schedule","175% of CMS fee schedule",3456.02,100,,,,,0,"fee schedule",EAPG,2608,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1643.04,63,,1314.43,,,0,"percent of total billed charges","63% of total billed charges",399.02,15.3,,319.22,,,0,"percent of total billed charges","15.3% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,1799.52,69,,,,,0,"fee schedule","69% of total billed charges",2608,100,,2086.40,,,0,"percent of total billed charges","100% of total billed charges",2608,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2608,100,,2086.40,,,0,"percent of total billed charges","100% of total billed charges",2608,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2608,100,,2086.40,,,0,"percent of total billed charges","100% of total billed charges",2608,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3355.36,100,,,,,0,"fee schedule",EAPG,2608,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2608,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",2608,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3422.47,100,,,,,0,"fee schedule",EAPG,4361.97,100,,,,,0,"fee schedule",EAPG,2608,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",983.22,37.7,,786.58,,,0,"percent of total billed charges","37.70% of total billed charges",2608,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2608,100,,,,,0,"fee schedule","100% of CMS fee schedule",2034.24,78,,1627.39,,,0,"percent of total billed charges","78% of total billed charges",2608,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2154.21,82.6,,1723.37,,,0,"percent of total billed charges","82.6% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,2608,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2154.21,82.6,,1723.37,,,0,"percent of total billed charges","82.6% of total billed charges",2608,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3515.89,100,,,,,0,"fee schedule",EAPG,2608,100,,2086.40,,,0,"percent of total billed charges","100% of total billed charges",399.02,12932.7,
"49020 Drainage of peritoneal abscess or localized",7961538,CDM,521,RC,49020,CPT,OUTPATIENT,,,2457,1597.05,,2162.16,88,,1729.73,,,0,"percent of total billed charges","88% of total billed charges",2457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3355.36,100,,,,,0,"fee schedule",EAPG,2457,100,,1965.60,,,0,"percent of total billed charges","100% of total billed charges",2457,175,,,,,0,"fee schedule","175% of CMS fee schedule",3456.02,100,,,,,0,"fee schedule",EAPG,2457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1547.91,63,,1238.33,,,0,"percent of total billed charges","63% of total billed charges",375.92,15.3,,300.74,,,0,"percent of total billed charges","15.3% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,1695.33,69,,,,,0,"fee schedule","69% of total billed charges",2457,100,,1965.60,,,0,"percent of total billed charges","100% of total billed charges",2457,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2457,100,,1965.60,,,0,"percent of total billed charges","100% of total billed charges",2457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2457,100,,1965.60,,,0,"percent of total billed charges","100% of total billed charges",2457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3355.36,100,,,,,0,"fee schedule",EAPG,2457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3422.47,100,,,,,0,"fee schedule",EAPG,4361.97,100,,,,,0,"fee schedule",EAPG,2457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",926.29,37.7,,741.03,,,0,"percent of total billed charges","37.70% of total billed charges",2457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2457,100,,,,,0,"fee schedule","100% of CMS fee schedule",1916.46,78,,1533.17,,,0,"percent of total billed charges","78% of total billed charges",2457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2029.48,82.6,,1623.58,,,0,"percent of total billed charges","82.6% of total billed charges",3355.36,100,,,,,0,"fee schedule","100% of WA fee schedule",2457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2029.48,82.6,,1623.58,,,0,"percent of total billed charges","82.6% of total billed charges",2457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3515.89,100,,,,,0,"fee schedule",EAPG,2457,100,,1965.60,,,0,"percent of total billed charges","100% of total billed charges",375.92,4361.97,
"49040 Drainage of subdiaphragmatic or subphrenic a",7963230,CDM,521,RC,49040,CPT,OUTPATIENT,,,2150,1397.5,,1892,88,,1513.60,,,0,"percent of total billed charges","88% of total billed charges",2150,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6261.42,100,,,,,0,"fee schedule",EAPG,2150,100,,1720.00,,,0,"percent of total billed charges","100% of total billed charges",2150,175,,,,,0,"fee schedule","175% of CMS fee schedule",6449.26,100,,,,,0,"fee schedule",EAPG,2150,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1354.5,63,,1083.60,,,0,"percent of total billed charges","63% of total billed charges",328.95,15.3,,263.16,,,0,"percent of total billed charges","15.3% of total billed charges",6261.42,100,,,,,0,"fee schedule",EAPG,1483.5,69,,,,,0,"fee schedule","69% of total billed charges",2150,100,,1720.00,,,0,"percent of total billed charges","100% of total billed charges",2150,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2150,100,,1720.00,,,0,"percent of total billed charges","100% of total billed charges",2150,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2150,100,,1720.00,,,0,"percent of total billed charges","100% of total billed charges",2150,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2150,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6261.42,100,,,,,0,"fee schedule",EAPG,2150,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2150,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2150,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6386.65,100,,,,,0,"fee schedule",EAPG,8139.85,100,,,,,0,"fee schedule",EAPG,2150,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",810.55,37.7,,648.44,,,0,"percent of total billed charges","37.70% of total billed charges",2150,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2150,100,,,,,0,"fee schedule","100% of CMS fee schedule",1677,78,,1341.60,,,0,"percent of total billed charges","78% of total billed charges",2150,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1775.9,82.6,,1420.72,,,0,"percent of total billed charges","82.6% of total billed charges",6261.42,100,,,,,0,"fee schedule","100% of WA fee schedule",2150,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1775.9,82.6,,1420.72,,,0,"percent of total billed charges","82.6% of total billed charges",2150,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6421.95,100,,,,,0,"fee schedule",EAPG,2150,100,,1720.00,,,0,"percent of total billed charges","100% of total billed charges",328.95,8139.85,
"49060 Drainage of retroperitoneal abscess, open",7963563,CDM,521,RC,49060,CPT,OUTPATIENT,,,2230,1449.5,,1962.4,88,,1569.92,,,0,"percent of total billed charges","88% of total billed charges",2230,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3355.36,100,,,,,0,"fee schedule",EAPG,2230,100,,1784.00,,,0,"percent of total billed charges","100% of total billed charges",2230,175,,,,,0,"fee schedule","175% of CMS fee schedule",3456.02,100,,,,,0,"fee schedule",EAPG,2230,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1404.9,63,,1123.92,,,0,"percent of total billed charges","63% of total billed charges",341.19,15.3,,272.95,,,0,"percent of total billed charges","15.3% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,1538.7,69,,,,,0,"fee schedule","69% of total billed charges",2230,100,,1784.00,,,0,"percent of total billed charges","100% of total billed charges",2230,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2230,100,,1784.00,,,0,"percent of total billed charges","100% of total billed charges",2230,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2230,100,,1784.00,,,0,"percent of total billed charges","100% of total billed charges",2230,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2230,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3355.36,100,,,,,0,"fee schedule",EAPG,2230,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2230,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2230,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3422.47,100,,,,,0,"fee schedule",EAPG,4361.97,100,,,,,0,"fee schedule",EAPG,2230,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",840.71,37.7,,672.57,,,0,"percent of total billed charges","37.70% of total billed charges",2230,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2230,100,,,,,0,"fee schedule","100% of CMS fee schedule",1739.4,78,,1391.52,,,0,"percent of total billed charges","78% of total billed charges",2230,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1841.98,82.6,,1473.58,,,0,"percent of total billed charges","82.6% of total billed charges",3355.36,100,,,,,0,"fee schedule","100% of WA fee schedule",2230,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1841.98,82.6,,1473.58,,,0,"percent of total billed charges","82.6% of total billed charges",2230,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3515.89,100,,,,,0,"fee schedule",EAPG,2230,100,,1784.00,,,0,"percent of total billed charges","100% of total billed charges",341.19,4361.97,
"49084 Peritoneal lavage, including imaging guidanc",7963077,CDM,521,RC,49084,CPT,OUTPATIENT,,,96,62.4,,84.48,88,,67.58,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",685.84,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60.48,63,,48.38,,,0,"percent of total billed charges","63% of total billed charges",14.69,15.3,,11.75,,,0,"percent of total billed charges","15.3% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,66.24,69,,,,,0,"fee schedule","69% of total billed charges",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",679.18,100,,,,,0,"fee schedule",EAPG,865.63,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",36.19,37.7,,28.95,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.88,78,,59.90,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",826.4,100,,,,,0,"fee schedule",EAPG,96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",14.69,3289.02,
"49081 Paracentesis w/Imaging",8169532,CDM,521,RC,49081,CPT,OUTPATIENT,,,476,309.4,,418.88,88,,335.10,,,0,"percent of total billed charges","88% of total billed charges",238,50,,190.40,,,0,"percent of total billed charges","50% of total billed charges",79.97,16.8,,63.98,,,0,"percent of total billed charges","16.8% of total billed charges",476,100,,380.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",82.37,17.304,,65.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",299.88,63,,239.90,,,0,"percent of total billed charges","63% of total billed charges",72.83,15.3,,58.26,,,0,"percent of total billed charges","15.3% of total billed charges",79.97,16.8,,63.98,,,0,"percent of total billed charges","16.8% of total billed charges",328.44,69,,,,,0,"fee schedule","69% of total billed charges",476,100,,380.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",476,100,,380.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",476,100,,380.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",79.97,16.8,,63.98,,,0,"percent of total billed charges","16.8% of total billed charges",238,50,,190.40,,,0,"percent of total billed charges","50% of total billed charges",153.27,32.2,,122.62,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",81.57,17.136,,65.26,,,0,"percent of total billed charges","17.136% of total billed charges",103.96,21.84,,83.17,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",179.45,37.7,,143.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",371.28,78,,297.02,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",393.18,82.6,,314.54,,,0,"percent of total billed charges","82.6% of total billed charges",79.97,16.8,,63.98,,,0,"percent of total billed charges","16.8% of total billed charges",238,50,,190.40,,,0,"percent of total billed charges","50% of total billed charges",393.18,82.6,,314.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",476,100,,380.80,,,0,"percent of total billed charges","100% of total billed charges",72.83,476,
"49215 Excision of presacral or sacrococcygeal tumo",7963487,CDM,521,RC,49215,CPT,OUTPATIENT,,,4882,3173.3,,4296.16,88,,3436.93,,,0,"percent of total billed charges","88% of total billed charges",4882,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2024.32,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",4882,175,,,,,0,"fee schedule","175% of CMS fee schedule",2085.05,100,,,,,0,"fee schedule",EAPG,4882,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3075.66,63,,2460.53,,,0,"percent of total billed charges","63% of total billed charges",746.95,15.3,,597.56,,,0,"percent of total billed charges","15.3% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,3368.58,69,,,,,0,"fee schedule","69% of total billed charges",4882,100,,3905.60,,,0,"percent of total billed charges","100% of total billed charges",4882,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4882,100,,3905.60,,,0,"percent of total billed charges","100% of total billed charges",4882,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4882,100,,3905.60,,,0,"percent of total billed charges","100% of total billed charges",4882,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4882,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2024.32,100,,,,,0,"fee schedule",EAPG,4882,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4882,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4882,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2064.8,100,,,,,0,"fee schedule",EAPG,2631.61,100,,,,,0,"fee schedule",EAPG,4882,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1840.51,37.7,,1472.41,,,0,"percent of total billed charges","37.70% of total billed charges",4882,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4882,100,,,,,0,"fee schedule","100% of CMS fee schedule",3807.96,78,,3046.37,,,0,"percent of total billed charges","78% of total billed charges",4882,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4032.53,82.6,,3226.02,,,0,"percent of total billed charges","82.6% of total billed charges",2024.32,100,,,,,0,"fee schedule",EAPG,4882,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4032.53,82.6,,3226.02,,,0,"percent of total billed charges","82.6% of total billed charges",4882,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2184.85,100,,,,,0,"fee schedule",EAPG,4882,100,,3905.60,,,0,"percent of total billed charges","100% of total billed charges",746.95,4882,
"49250 Umbilectomy, omphalectomy, excision of umbil",7962854,CDM,521,RC,49250,CPT,OUTPATIENT,,,1782,1158.3,,1568.16,88,,1254.53,,,0,"percent of total billed charges","88% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,1782,100,,1425.60,,,0,"percent of total billed charges","100% of total billed charges",6175.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",3250.43,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1122.66,63,,898.13,,,0,"percent of total billed charges","63% of total billed charges",272.65,15.3,,218.12,,,0,"percent of total billed charges","15.3% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,1229.58,69,,,,,0,"fee schedule","69% of total billed charges",1782,100,,1425.60,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1782,100,,1425.60,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1782,100,,1425.60,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3218.87,100,,,,,0,"fee schedule",EAPG,4102.48,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",671.81,37.7,,537.45,,,0,"percent of total billed charges","37.70% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1389.96,78,,1111.97,,,0,"percent of total billed charges","78% of total billed charges",3564.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1471.93,82.6,,1177.54,,,0,"percent of total billed charges","82.6% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1471.93,82.6,,1177.54,,,0,"percent of total billed charges","82.6% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3316.28,100,,,,,0,"fee schedule",EAPG,1782,100,,1425.60,,,0,"percent of total billed charges","100% of total billed charges",272.65,12932.7,
"49255 Omentectomy, epiploectomy, resection of omen",7962888,CDM,521,RC,49255,CPT,OUTPATIENT,,,1730,1124.5,,1522.4,88,,1217.92,,,0,"percent of total billed charges","88% of total billed charges",1730,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3355.36,100,,,,,0,"fee schedule",EAPG,1730,100,,1384.00,,,0,"percent of total billed charges","100% of total billed charges",1730,175,,,,,0,"fee schedule","175% of CMS fee schedule",3456.02,100,,,,,0,"fee schedule",EAPG,1730,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1089.9,63,,871.92,,,0,"percent of total billed charges","63% of total billed charges",264.69,15.3,,211.75,,,0,"percent of total billed charges","15.3% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,1193.7,69,,,,,0,"fee schedule","69% of total billed charges",1730,100,,1384.00,,,0,"percent of total billed charges","100% of total billed charges",1730,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1730,100,,1384.00,,,0,"percent of total billed charges","100% of total billed charges",1730,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1730,100,,1384.00,,,0,"percent of total billed charges","100% of total billed charges",1730,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3355.36,100,,,,,0,"fee schedule",EAPG,1730,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1730,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",1730,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3422.47,100,,,,,0,"fee schedule",EAPG,4361.97,100,,,,,0,"fee schedule",EAPG,1730,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",652.21,37.7,,521.77,,,0,"percent of total billed charges","37.70% of total billed charges",1730,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1730,100,,,,,0,"fee schedule","100% of CMS fee schedule",1349.4,78,,1079.52,,,0,"percent of total billed charges","78% of total billed charges",1730,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1428.98,82.6,,1143.18,,,0,"percent of total billed charges","82.6% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,1730,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1428.98,82.6,,1143.18,,,0,"percent of total billed charges","82.6% of total billed charges",1730,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3515.89,100,,,,,0,"fee schedule",EAPG,1730,100,,1384.00,,,0,"percent of total billed charges","100% of total billed charges",264.69,12932.7,
"49320 Laparoscopy, abdomen, peritoneum, and omentu",7961624,CDM,521,RC,49320,CPT,OUTPATIENT,,,1556,1011.4,,1369.28,88,,1095.42,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3355.36,100,,,,,0,"fee schedule",EAPG,1556,100,,1244.80,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",3456.02,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",980.28,63,,784.22,,,0,"percent of total billed charges","63% of total billed charges",238.07,15.3,,190.46,,,0,"percent of total billed charges","15.3% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,1073.64,69,,,,,0,"fee schedule","69% of total billed charges",1556,100,,1244.80,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1556,100,,1244.80,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1556,100,,1244.80,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3355.36,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3422.47,100,,,,,0,"fee schedule",EAPG,4361.97,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",586.61,37.7,,469.29,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1213.68,78,,970.94,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1285.26,82.6,,1028.21,,,0,"percent of total billed charges","82.6% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1285.26,82.6,,1028.21,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3515.89,100,,,,,0,"fee schedule",EAPG,1556,100,,1244.80,,,0,"percent of total billed charges","100% of total billed charges",238.07,20558.19,
"49322 Laparoscopy, surgical; with aspiration of ca",7961625,CDM,521,RC,49322,CPT,OUTPATIENT,,,998,648.7,,878.24,88,,702.59,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3355.36,100,,,,,0,"fee schedule",EAPG,998,100,,798.40,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",3456.02,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",628.74,63,,502.99,,,0,"percent of total billed charges","63% of total billed charges",152.69,15.3,,122.15,,,0,"percent of total billed charges","15.3% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,688.62,69,,,,,0,"fee schedule","69% of total billed charges",998,100,,798.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",998,100,,798.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",998,100,,798.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3355.36,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3422.47,100,,,,,0,"fee schedule",EAPG,4361.97,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",376.25,37.7,,301.00,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",778.44,78,,622.75,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",824.35,82.6,,659.48,,,0,"percent of total billed charges","82.6% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",824.35,82.6,,659.48,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3515.89,100,,,,,0,"fee schedule",EAPG,998,100,,798.40,,,0,"percent of total billed charges","100% of total billed charges",152.69,20558.19,
"49324 Laparoscopy, surgical; with insertion of tun",7962683,CDM,521,RC,49324,CPT,OUTPATIENT,,,1148,746.2,,1010.24,88,,808.19,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3355.36,100,,,,,0,"fee schedule",EAPG,1148,100,,918.40,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",3456.02,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",723.24,63,,578.59,,,0,"percent of total billed charges","63% of total billed charges",175.64,15.3,,140.51,,,0,"percent of total billed charges","15.3% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,792.12,69,,,,,0,"fee schedule","69% of total billed charges",1148,100,,918.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1148,100,,918.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1148,100,,918.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3355.36,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3422.47,100,,,,,0,"fee schedule",EAPG,4361.97,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",432.8,37.7,,346.24,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",895.44,78,,716.35,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",948.25,82.6,,758.60,,,0,"percent of total billed charges","82.6% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",948.25,82.6,,758.60,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3515.89,100,,,,,0,"fee schedule",EAPG,1148,100,,918.40,,,0,"percent of total billed charges","100% of total billed charges",175.64,20558.19,
"49329 Unlisted laparoscopy procedure, abdomen, per",7963031,CDM,521,RC,49329,CPT,OUTPATIENT,,,1011,657.15,,889.68,88,,711.74,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3355.36,100,,,,,0,"fee schedule",EAPG,1011,100,,808.80,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",3456.02,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",636.93,63,,509.54,,,0,"percent of total billed charges","63% of total billed charges",154.68,15.3,,123.74,,,0,"percent of total billed charges","15.3% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,697.59,69,,,,,0,"fee schedule","69% of total billed charges",1011,100,,808.80,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1011,100,,808.80,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1011,100,,808.80,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3355.36,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3422.47,100,,,,,0,"fee schedule",EAPG,4361.97,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",381.15,37.7,,304.92,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",788.58,78,,630.86,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",835.09,82.6,,668.07,,,0,"percent of total billed charges","82.6% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",835.09,82.6,,668.07,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3515.89,100,,,,,0,"fee schedule",EAPG,1011,100,,808.80,,,0,"percent of total billed charges","100% of total billed charges",154.68,20558.19,
"49321 Laparoscopy, surgical; with biopsy (single o",7963255,CDM,521,RC,49321,CPT,OUTPATIENT,,,983,638.95,,865.04,88,,692.03,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3355.36,100,,,,,0,"fee schedule",EAPG,983,100,,786.40,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",3456.02,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",619.29,63,,495.43,,,0,"percent of total billed charges","63% of total billed charges",150.4,15.3,,120.32,,,0,"percent of total billed charges","15.3% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,678.27,69,,,,,0,"fee schedule","69% of total billed charges",983,100,,786.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",983,100,,786.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",983,100,,786.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3355.36,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3422.47,100,,,,,0,"fee schedule",EAPG,4361.97,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",370.59,37.7,,296.47,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",766.74,78,,613.39,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",811.96,82.6,,649.57,,,0,"percent of total billed charges","82.6% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",811.96,82.6,,649.57,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3515.89,100,,,,,0,"fee schedule",EAPG,983,100,,786.40,,,0,"percent of total billed charges","100% of total billed charges",150.4,20558.19,
"49402 Removal of peritoneal foreign body from peri",7963200,CDM,521,RC,49402,CPT,OUTPATIENT,,,2130,1384.5,,1874.4,88,,1499.52,,,0,"percent of total billed charges","88% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3355.36,100,,,,,0,"fee schedule",EAPG,2130,100,,1704.00,,,0,"percent of total billed charges","100% of total billed charges",6175.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",3456.02,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1341.9,63,,1073.52,,,0,"percent of total billed charges","63% of total billed charges",325.89,15.3,,260.71,,,0,"percent of total billed charges","15.3% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,1469.7,69,,,,,0,"fee schedule","69% of total billed charges",2130,100,,1704.00,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2130,100,,1704.00,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2130,100,,1704.00,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3355.36,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3422.47,100,,,,,0,"fee schedule",EAPG,4361.97,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",803.01,37.7,,642.41,,,0,"percent of total billed charges","37.70% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1661.4,78,,1329.12,,,0,"percent of total billed charges","78% of total billed charges",3564.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1759.38,82.6,,1407.50,,,0,"percent of total billed charges","82.6% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1759.38,82.6,,1407.50,,,0,"percent of total billed charges","82.6% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3515.89,100,,,,,0,"fee schedule",EAPG,2130,100,,1704.00,,,0,"percent of total billed charges","100% of total billed charges",325.89,12932.7,
"49421 Insertion of tunneled intraperitoneal cathet",7962973,CDM,521,RC,49421,CPT,OUTPATIENT,,,1124,730.6,,989.12,88,,791.30,,,0,"percent of total billed charges","88% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3355.36,100,,,,,0,"fee schedule",EAPG,1124,100,,899.20,,,0,"percent of total billed charges","100% of total billed charges",6175.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",3456.02,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",708.12,63,,566.50,,,0,"percent of total billed charges","63% of total billed charges",171.97,15.3,,137.58,,,0,"percent of total billed charges","15.3% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,775.56,69,,,,,0,"fee schedule","69% of total billed charges",1124,100,,899.20,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1124,100,,899.20,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1124,100,,899.20,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3355.36,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3422.47,100,,,,,0,"fee schedule",EAPG,4361.97,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",423.75,37.7,,339.00,,,0,"percent of total billed charges","37.70% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",876.72,78,,701.38,,,0,"percent of total billed charges","78% of total billed charges",3564.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",928.42,82.6,,742.74,,,0,"percent of total billed charges","82.6% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",928.42,82.6,,742.74,,,0,"percent of total billed charges","82.6% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3515.89,100,,,,,0,"fee schedule",EAPG,1124,100,,899.20,,,0,"percent of total billed charges","100% of total billed charges",171.97,12932.7,
"49422 Removal of tunneled intraperitoneal catheter",7963510,CDM,521,RC,49422,CPT,OUTPATIENT,,,1110,721.5,,976.8,88,,781.44,,,0,"percent of total billed charges","88% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,1110,100,,888.00,,,0,"percent of total billed charges","100% of total billed charges",5689.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",685.84,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",699.3,63,,559.44,,,0,"percent of total billed charges","63% of total billed charges",169.83,15.3,,135.86,,,0,"percent of total billed charges","15.3% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,765.9,69,,,,,0,"fee schedule","69% of total billed charges",1110,100,,888.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1110,100,,888.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1110,100,,888.00,,,0,"percent of total billed charges","100% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",11625.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3039.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",679.18,100,,,,,0,"fee schedule",EAPG,865.63,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",418.47,37.7,,334.78,,,0,"percent of total billed charges","37.70% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",865.8,78,,692.64,,,0,"percent of total billed charges","78% of total billed charges",3283.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",916.86,82.6,,733.49,,,0,"percent of total billed charges","82.6% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",916.86,82.6,,733.49,,,0,"percent of total billed charges","82.6% of total billed charges",3251.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",826.4,100,,,,,0,"fee schedule",EAPG,1110,100,,888.00,,,0,"percent of total billed charges","100% of total billed charges",169.83,11625.58,
"49425 Insertion of peritoneal-venous shunt",7963662,CDM,521,RC,49425,CPT,OUTPATIENT,,,2683,1743.95,,2361.04,88,,1888.83,,,0,"percent of total billed charges","88% of total billed charges",2683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3355.36,100,,,,,0,"fee schedule",EAPG,2683,100,,2146.40,,,0,"percent of total billed charges","100% of total billed charges",2683,175,,,,,0,"fee schedule","175% of CMS fee schedule",3456.02,100,,,,,0,"fee schedule",EAPG,2683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1690.29,63,,1352.23,,,0,"percent of total billed charges","63% of total billed charges",410.5,15.3,,328.40,,,0,"percent of total billed charges","15.3% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,1851.27,69,,,,,0,"fee schedule","69% of total billed charges",2683,100,,2146.40,,,0,"percent of total billed charges","100% of total billed charges",2683,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2683,100,,2146.40,,,0,"percent of total billed charges","100% of total billed charges",2683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2683,100,,2146.40,,,0,"percent of total billed charges","100% of total billed charges",2683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3355.36,100,,,,,0,"fee schedule",EAPG,2683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3422.47,100,,,,,0,"fee schedule",EAPG,4361.97,100,,,,,0,"fee schedule",EAPG,2683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1011.49,37.7,,809.19,,,0,"percent of total billed charges","37.70% of total billed charges",2683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2683,100,,,,,0,"fee schedule","100% of CMS fee schedule",2092.74,78,,1674.19,,,0,"percent of total billed charges","78% of total billed charges",2683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2216.16,82.6,,1772.93,,,0,"percent of total billed charges","82.6% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,2683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2216.16,82.6,,1772.93,,,0,"percent of total billed charges","82.6% of total billed charges",2683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3515.89,100,,,,,0,"fee schedule",EAPG,2683,100,,2146.40,,,0,"percent of total billed charges","100% of total billed charges",410.5,4361.97,
"49440 Insertion of gastrostomy tube, percutaneous",7963524,CDM,521,RC,49440,CPT,OUTPATIENT,,,2271,1476.15,,1998.48,88,,1598.78,,,0,"percent of total billed charges","88% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,2271,100,,1816.80,,,0,"percent of total billed charges","100% of total billed charges",3396.4,175,,,,,0,"fee schedule","175% of CMS fee schedule",624,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1430.73,63,,1144.58,,,0,"percent of total billed charges","63% of total billed charges",347.46,15.3,,277.97,,,0,"percent of total billed charges","15.3% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,1566.99,69,,,,,0,"fee schedule","69% of total billed charges",2271,100,,1816.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2271,100,,1816.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2271,100,,1816.80,,,0,"percent of total billed charges","100% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS fee schedule",6601.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1725.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",617.95,100,,,,,0,"fee schedule",EAPG,787.58,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",856.17,37.7,,684.94,,,0,"percent of total billed charges","37.70% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1771.38,78,,1417.10,,,0,"percent of total billed charges","78% of total billed charges",1960.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1875.85,82.6,,1500.68,,,0,"percent of total billed charges","82.6% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1875.85,82.6,,1500.68,,,0,"percent of total billed charges","82.6% of total billed charges",1940.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",766.36,100,,,,,0,"fee schedule",EAPG,2271,100,,1816.80,,,0,"percent of total billed charges","100% of total billed charges",347.46,6601.69,
"49451 Replace duoden or jejuno tube, percu, under",7961539,CDM,521,RC,49451,CPT,OUTPATIENT,,,2194,1426.1,,1930.72,88,,1544.58,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,2194,100,,1755.20,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",624,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1382.22,63,,1105.78,,,0,"percent of total billed charges","63% of total billed charges",335.68,15.3,,268.54,,,0,"percent of total billed charges","15.3% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,1513.86,69,,,,,0,"fee schedule","69% of total billed charges",2194,100,,1755.20,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2194,100,,1755.20,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2194,100,,1755.20,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",617.95,100,,,,,0,"fee schedule",EAPG,787.58,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",827.14,37.7,,661.71,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1711.32,78,,1369.06,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1812.24,82.6,,1449.79,,,0,"percent of total billed charges","82.6% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1812.24,82.6,,1449.79,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",766.36,100,,,,,0,"fee schedule",EAPG,2194,100,,1755.20,,,0,"percent of total billed charges","100% of total billed charges",335.68,3289.02,
"49452 Replacement of gastro-jejunostomy tube, perc",7962012,CDM,521,RC,49452,CPT,OUTPATIENT,,,2703,1756.95,,2378.64,88,,1902.91,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,2703,100,,2162.40,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",624,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1702.89,63,,1362.31,,,0,"percent of total billed charges","63% of total billed charges",413.56,15.3,,330.85,,,0,"percent of total billed charges","15.3% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,1865.07,69,,,,,0,"fee schedule","69% of total billed charges",2703,100,,2162.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2703,100,,2162.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2703,100,,2162.40,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",617.95,100,,,,,0,"fee schedule",EAPG,787.58,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1019.03,37.7,,815.22,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2108.34,78,,1686.67,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2232.68,82.6,,1786.14,,,0,"percent of total billed charges","82.6% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2232.68,82.6,,1786.14,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",766.36,100,,,,,0,"fee schedule",EAPG,2703,100,,2162.40,,,0,"percent of total billed charges","100% of total billed charges",413.56,3289.02,
"49450 Replacement of gastrostomy or cecostomy (or",7962095,CDM,521,RC,49450,CPT,OUTPATIENT,,,2004,1302.6,,1763.52,88,,1410.82,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,2004,100,,1603.20,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",624,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1262.52,63,,1010.02,,,0,"percent of total billed charges","63% of total billed charges",306.61,15.3,,245.29,,,0,"percent of total billed charges","15.3% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,1382.76,69,,,,,0,"fee schedule","69% of total billed charges",2004,100,,1603.20,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2004,100,,1603.20,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2004,100,,1603.20,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",617.95,100,,,,,0,"fee schedule",EAPG,787.58,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",755.51,37.7,,604.41,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1563.12,78,,1250.50,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1655.3,82.6,,1324.24,,,0,"percent of total billed charges","82.6% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1655.3,82.6,,1324.24,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",766.36,100,,,,,0,"fee schedule",EAPG,2004,100,,1603.20,,,0,"percent of total billed charges","100% of total billed charges",306.61,3289.02,
"49460 Mechanical removal of obstructive material f",7962013,CDM,521,RC,49460,CPT,OUTPATIENT,,,2217,1441.05,,1950.96,88,,1560.77,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,2217,100,,1773.60,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",624,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1396.71,63,,1117.37,,,0,"percent of total billed charges","63% of total billed charges",339.2,15.3,,271.36,,,0,"percent of total billed charges","15.3% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,1529.73,69,,,,,0,"fee schedule","69% of total billed charges",2217,100,,1773.60,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2217,100,,1773.60,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2217,100,,1773.60,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",605.83,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",617.95,100,,,,,0,"fee schedule",EAPG,787.58,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",835.81,37.7,,668.65,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1729.26,78,,1383.41,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1831.24,82.6,,1464.99,,,0,"percent of total billed charges","82.6% of total billed charges",605.83,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1831.24,82.6,,1464.99,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",766.36,100,,,,,0,"fee schedule",EAPG,2217,100,,1773.60,,,0,"percent of total billed charges","100% of total billed charges",339.2,3289.02,
"49465 Contrast injection(s) for radiological evalu",7962014,CDM,521,RC,49465,CPT,OUTPATIENT,,,504,327.6,,443.52,88,,354.82,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,504,100,,403.20,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",317.52,63,,254.02,,,0,"percent of total billed charges","63% of total billed charges",77.11,15.3,,61.69,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,347.76,69,,,,,0,"fee schedule","69% of total billed charges",504,100,,403.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",504,100,,403.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",504,100,,403.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",190.01,37.7,,152.01,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",393.12,78,,314.50,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",416.3,82.6,,333.04,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",416.3,82.6,,333.04,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",269.29,100,,,,,0,"fee schedule",EAPG,504,100,,403.20,,,0,"percent of total billed charges","100% of total billed charges",77.11,934.91,
"49496 Repair, initial inguinal hernia, infant youn",7961705,CDM,521,RC,49496,CPT,OUTPATIENT,,,2082,1353.3,,1832.16,88,,1465.73,,,0,"percent of total billed charges","88% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,2082,100,,1665.60,,,0,"percent of total billed charges","100% of total billed charges",6175.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",3250.43,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1311.66,63,,1049.33,,,0,"percent of total billed charges","63% of total billed charges",318.55,15.3,,254.84,,,0,"percent of total billed charges","15.3% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,1436.58,69,,,,,0,"fee schedule","69% of total billed charges",2082,100,,1665.60,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2082,100,,1665.60,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2082,100,,1665.60,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3218.87,100,,,,,0,"fee schedule",EAPG,4102.48,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",784.91,37.7,,627.93,,,0,"percent of total billed charges","37.70% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1623.96,78,,1299.17,,,0,"percent of total billed charges","78% of total billed charges",3564.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1719.73,82.6,,1375.78,,,0,"percent of total billed charges","82.6% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1719.73,82.6,,1375.78,,,0,"percent of total billed charges","82.6% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3316.28,100,,,,,0,"fee schedule",EAPG,2082,100,,1665.60,,,0,"percent of total billed charges","100% of total billed charges",318.55,12932.7,
"49491 Repair, initial inguinal hernia, preterm inf",7962015,CDM,521,RC,49491,CPT,OUTPATIENT,,,2545,1654.25,,2239.6,88,,1791.68,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,2545,100,,2036.00,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",3250.43,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.35,63,,1282.68,,,0,"percent of total billed charges","63% of total billed charges",389.39,15.3,,311.51,,,0,"percent of total billed charges","15.3% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,1756.05,69,,,,,0,"fee schedule","69% of total billed charges",2545,100,,2036.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2545,100,,2036.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2545,100,,2036.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3218.87,100,,,,,0,"fee schedule",EAPG,4102.48,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",959.47,37.7,,767.58,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1985.1,78,,1588.08,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2102.17,82.6,,1681.74,,,0,"percent of total billed charges","82.6% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2102.17,82.6,,1681.74,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3316.28,100,,,,,0,"fee schedule",EAPG,2545,100,,2036.00,,,0,"percent of total billed charges","100% of total billed charges",389.39,20558.18,
"49492 Repair, initial inguinal hernia, preterm inf",7962080,CDM,521,RC,49492,CPT,OUTPATIENT,,,3185,2070.25,,2802.8,88,,2242.24,,,0,"percent of total billed charges","88% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,3185,100,,2548.00,,,0,"percent of total billed charges","100% of total billed charges",6175.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",3250.43,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2006.55,63,,1605.24,,,0,"percent of total billed charges","63% of total billed charges",487.31,15.3,,389.85,,,0,"percent of total billed charges","15.3% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,2197.65,69,,,,,0,"fee schedule","69% of total billed charges",3185,100,,2548.00,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3185,100,,2548.00,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3185,100,,2548.00,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3218.87,100,,,,,0,"fee schedule",EAPG,4102.48,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1200.75,37.7,,960.60,,,0,"percent of total billed charges","37.70% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2484.3,78,,1987.44,,,0,"percent of total billed charges","78% of total billed charges",3564.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2630.81,82.6,,2104.65,,,0,"percent of total billed charges","82.6% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2630.81,82.6,,2104.65,,,0,"percent of total billed charges","82.6% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3316.28,100,,,,,0,"fee schedule",EAPG,3185,100,,2548.00,,,0,"percent of total billed charges","100% of total billed charges",487.31,12932.7,
"49495 Repair, initial inguinal hernia, infant youn",7962605,CDM,521,RC,49495,CPT,OUTPATIENT,,,1913,1243.45,,1683.44,88,,1346.75,,,0,"percent of total billed charges","88% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,1913,100,,1530.40,,,0,"percent of total billed charges","100% of total billed charges",6175.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",3250.43,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1205.19,63,,964.15,,,0,"percent of total billed charges","63% of total billed charges",292.69,15.3,,234.15,,,0,"percent of total billed charges","15.3% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,1319.97,69,,,,,0,"fee schedule","69% of total billed charges",1913,100,,1530.40,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1913,100,,1530.40,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1913,100,,1530.40,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3218.87,100,,,,,0,"fee schedule",EAPG,4102.48,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",721.2,37.7,,576.96,,,0,"percent of total billed charges","37.70% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1492.14,78,,1193.71,,,0,"percent of total billed charges","78% of total billed charges",3564.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1580.14,82.6,,1264.11,,,0,"percent of total billed charges","82.6% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1580.14,82.6,,1264.11,,,0,"percent of total billed charges","82.6% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3316.28,100,,,,,0,"fee schedule",EAPG,1913,100,,1530.40,,,0,"percent of total billed charges","100% of total billed charges",292.69,12932.7,
"49501 Repair initial inguinal hernia, age 6 months",7962189,CDM,521,RC,49501,CPT,OUTPATIENT,,,2038,1324.7,,1793.44,88,,1434.75,,,0,"percent of total billed charges","88% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,2038,100,,1630.40,,,0,"percent of total billed charges","100% of total billed charges",6175.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",3250.43,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1283.94,63,,1027.15,,,0,"percent of total billed charges","63% of total billed charges",311.81,15.3,,249.45,,,0,"percent of total billed charges","15.3% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,1406.22,69,,,,,0,"fee schedule","69% of total billed charges",2038,100,,1630.40,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2038,100,,1630.40,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2038,100,,1630.40,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3218.87,100,,,,,0,"fee schedule",EAPG,4102.48,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",768.33,37.7,,614.66,,,0,"percent of total billed charges","37.70% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.64,78,,1271.71,,,0,"percent of total billed charges","78% of total billed charges",3564.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1683.39,82.6,,1346.71,,,0,"percent of total billed charges","82.6% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1683.39,82.6,,1346.71,,,0,"percent of total billed charges","82.6% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3316.28,100,,,,,0,"fee schedule",EAPG,2038,100,,1630.40,,,0,"percent of total billed charges","100% of total billed charges",311.81,12932.7,
"49507 Repair initial inguinal hernia, age 5 years",7962422,CDM,521,RC,49507,CPT,OUTPATIENT,,,2069,1344.85,,1820.72,88,,1456.58,,,0,"percent of total billed charges","88% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,2069,100,,1655.20,,,0,"percent of total billed charges","100% of total billed charges",6175.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",3250.43,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1303.47,63,,1042.78,,,0,"percent of total billed charges","63% of total billed charges",316.56,15.3,,253.25,,,0,"percent of total billed charges","15.3% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,1427.61,69,,,,,0,"fee schedule","69% of total billed charges",2069,100,,1655.20,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2069,100,,1655.20,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2069,100,,1655.20,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3218.87,100,,,,,0,"fee schedule",EAPG,4102.48,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",780.01,37.7,,624.01,,,0,"percent of total billed charges","37.70% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1613.82,78,,1291.06,,,0,"percent of total billed charges","78% of total billed charges",3564.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1708.99,82.6,,1367.19,,,0,"percent of total billed charges","82.6% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1708.99,82.6,,1367.19,,,0,"percent of total billed charges","82.6% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3316.28,100,,,,,0,"fee schedule",EAPG,2069,100,,1655.20,,,0,"percent of total billed charges","100% of total billed charges",316.56,12932.7,
"49500 Repair initial inguinal hernia, age 6 months",7962889,CDM,521,RC,49500,CPT,OUTPATIENT,,,1747,1135.55,,1537.36,88,,1229.89,,,0,"percent of total billed charges","88% of total billed charges",7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,1747,100,,1397.60,,,0,"percent of total billed charges","100% of total billed charges",13504.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",3250.43,100,,,,,0,"fee schedule",EAPG,7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1100.61,63,,880.49,,,0,"percent of total billed charges","63% of total billed charges",267.29,15.3,,213.83,,,0,"percent of total billed charges","15.3% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,1205.43,69,,,,,0,"fee schedule","69% of total billed charges",1747,100,,1397.60,,,0,"percent of total billed charges","100% of total billed charges",7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1747,100,,1397.60,,,0,"percent of total billed charges","100% of total billed charges",7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1747,100,,1397.60,,,0,"percent of total billed charges","100% of total billed charges",7716.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3218.87,100,,,,,0,"fee schedule",EAPG,4102.48,100,,,,,0,"fee schedule",EAPG,7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",658.62,37.7,,526.90,,,0,"percent of total billed charges","37.70% of total billed charges",7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1362.66,78,,1090.13,,,0,"percent of total billed charges","78% of total billed charges",7793.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1443.02,82.6,,1154.42,,,0,"percent of total billed charges","82.6% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1443.02,82.6,,1154.42,,,0,"percent of total billed charges","82.6% of total billed charges",7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3316.28,100,,,,,0,"fee schedule",EAPG,1747,100,,1397.60,,,0,"percent of total billed charges","100% of total billed charges",267.29,13504.04,
"49505 Repair initial inguinal hernia, age 5 years",7963032,CDM,521,RC,49505,CPT,OUTPATIENT,,,1773,1152.45,,1560.24,88,,1248.19,,,0,"percent of total billed charges","88% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,1773,100,,1418.40,,,0,"percent of total billed charges","100% of total billed charges",6175.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",3250.43,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1116.99,63,,893.59,,,0,"percent of total billed charges","63% of total billed charges",271.27,15.3,,217.02,,,0,"percent of total billed charges","15.3% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,1223.37,69,,,,,0,"fee schedule","69% of total billed charges",1773,100,,1418.40,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1773,100,,1418.40,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1773,100,,1418.40,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3218.87,100,,,,,0,"fee schedule",EAPG,4102.48,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",668.42,37.7,,534.74,,,0,"percent of total billed charges","37.70% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1382.94,78,,1106.35,,,0,"percent of total billed charges","78% of total billed charges",3564.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1464.5,82.6,,1171.60,,,0,"percent of total billed charges","82.6% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1464.5,82.6,,1171.60,,,0,"percent of total billed charges","82.6% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3316.28,100,,,,,0,"fee schedule",EAPG,1773,100,,1418.40,,,0,"percent of total billed charges","100% of total billed charges",271.27,12932.7,
"49521 Repair recurrent inguinal hernia, any age; i",7962785,CDM,521,RC,49521,CPT,OUTPATIENT,,,2209,1435.85,,1943.92,88,,1555.14,,,0,"percent of total billed charges","88% of total billed charges",7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,2209,100,,1767.20,,,0,"percent of total billed charges","100% of total billed charges",13504.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",3250.43,100,,,,,0,"fee schedule",EAPG,7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1391.67,63,,1113.34,,,0,"percent of total billed charges","63% of total billed charges",337.98,15.3,,270.38,,,0,"percent of total billed charges","15.3% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,1524.21,69,,,,,0,"fee schedule","69% of total billed charges",2209,100,,1767.20,,,0,"percent of total billed charges","100% of total billed charges",7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2209,100,,1767.20,,,0,"percent of total billed charges","100% of total billed charges",7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2209,100,,1767.20,,,0,"percent of total billed charges","100% of total billed charges",7716.6,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3218.87,100,,,,,0,"fee schedule",EAPG,4102.48,100,,,,,0,"fee schedule",EAPG,7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",832.79,37.7,,666.23,,,0,"percent of total billed charges","37.70% of total billed charges",7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1723.02,78,,1378.42,,,0,"percent of total billed charges","78% of total billed charges",7793.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1824.63,82.6,,1459.70,,,0,"percent of total billed charges","82.6% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1824.63,82.6,,1459.70,,,0,"percent of total billed charges","82.6% of total billed charges",7716.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3316.28,100,,,,,0,"fee schedule",EAPG,2209,100,,1767.20,,,0,"percent of total billed charges","100% of total billed charges",337.98,13504.04,
"49520 Repair recurrent inguinal hernia, any age; r",7963336,CDM,521,RC,49520,CPT,OUTPATIENT,,,2058,1337.7,,1811.04,88,,1448.83,,,0,"percent of total billed charges","88% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,2058,100,,1646.40,,,0,"percent of total billed charges","100% of total billed charges",6175.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",3250.43,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1296.54,63,,1037.23,,,0,"percent of total billed charges","63% of total billed charges",314.87,15.3,,251.90,,,0,"percent of total billed charges","15.3% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,1420.02,69,,,,,0,"fee schedule","69% of total billed charges",2058,100,,1646.40,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2058,100,,1646.40,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2058,100,,1646.40,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3218.87,100,,,,,0,"fee schedule",EAPG,4102.48,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",775.87,37.7,,620.70,,,0,"percent of total billed charges","37.70% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1605.24,78,,1284.19,,,0,"percent of total billed charges","78% of total billed charges",3564.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1699.91,82.6,,1359.93,,,0,"percent of total billed charges","82.6% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1699.91,82.6,,1359.93,,,0,"percent of total billed charges","82.6% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3316.28,100,,,,,0,"fee schedule",EAPG,2058,100,,1646.40,,,0,"percent of total billed charges","100% of total billed charges",314.87,12932.7,
"49525 Repair inguinal hernia, sliding, any age",7963587,CDM,521,RC,49525,CPT,OUTPATIENT,,,1961,1274.65,,1725.68,88,,1380.54,,,0,"percent of total billed charges","88% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,1961,100,,1568.80,,,0,"percent of total billed charges","100% of total billed charges",6175.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",3250.43,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1235.43,63,,988.34,,,0,"percent of total billed charges","63% of total billed charges",300.03,15.3,,240.02,,,0,"percent of total billed charges","15.3% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,1353.09,69,,,,,0,"fee schedule","69% of total billed charges",1961,100,,1568.80,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1961,100,,1568.80,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1961,100,,1568.80,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3218.87,100,,,,,0,"fee schedule",EAPG,4102.48,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",739.3,37.7,,591.44,,,0,"percent of total billed charges","37.70% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1529.58,78,,1223.66,,,0,"percent of total billed charges","78% of total billed charges",3564.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1619.79,82.6,,1295.83,,,0,"percent of total billed charges","82.6% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1619.79,82.6,,1295.83,,,0,"percent of total billed charges","82.6% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3316.28,100,,,,,0,"fee schedule",EAPG,1961,100,,1568.80,,,0,"percent of total billed charges","100% of total billed charges",300.03,12932.7,
"49540 Repair lumbar hernia",7963902,CDM,521,RC,49540,CPT,OUTPATIENT,,,2365,1537.25,,2081.2,88,,1664.96,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4031.42,100,,,,,0,"fee schedule",EAPG,2365,100,,1892.00,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",4152.36,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1489.95,63,,1191.96,,,0,"percent of total billed charges","63% of total billed charges",361.85,15.3,,289.48,,,0,"percent of total billed charges","15.3% of total billed charges",4031.42,100,,,,,0,"fee schedule",EAPG,1631.85,69,,,,,0,"fee schedule","69% of total billed charges",2365,100,,1892.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2365,100,,1892.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2365,100,,1892.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4031.42,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4112.05,100,,,,,0,"fee schedule",EAPG,5240.85,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",891.61,37.7,,713.29,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1844.7,78,,1475.76,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1953.49,82.6,,1562.79,,,0,"percent of total billed charges","82.6% of total billed charges",4031.42,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1953.49,82.6,,1562.79,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4191.95,100,,,,,0,"fee schedule",EAPG,2365,100,,1892.00,,,0,"percent of total billed charges","100% of total billed charges",361.85,20558.19,
"49553 Repair initial femoral hernia, any age; inca",7962890,CDM,521,RC,49553,CPT,OUTPATIENT,,,1933,1256.45,,1701.04,88,,1360.83,,,0,"percent of total billed charges","88% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,1933,100,,1546.40,,,0,"percent of total billed charges","100% of total billed charges",6175.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",3250.43,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1217.79,63,,974.23,,,0,"percent of total billed charges","63% of total billed charges",295.75,15.3,,236.60,,,0,"percent of total billed charges","15.3% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,1333.77,69,,,,,0,"fee schedule","69% of total billed charges",1933,100,,1546.40,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1933,100,,1546.40,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1933,100,,1546.40,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3218.87,100,,,,,0,"fee schedule",EAPG,4102.48,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",728.74,37.7,,582.99,,,0,"percent of total billed charges","37.70% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1507.74,78,,1206.19,,,0,"percent of total billed charges","78% of total billed charges",3564.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1596.66,82.6,,1277.33,,,0,"percent of total billed charges","82.6% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1596.66,82.6,,1277.33,,,0,"percent of total billed charges","82.6% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3316.28,100,,,,,0,"fee schedule",EAPG,1933,100,,1546.40,,,0,"percent of total billed charges","100% of total billed charges",295.75,12932.7,
"49557 Repair recurrent femoral hernia; incarcerate",7963078,CDM,521,RC,49557,CPT,OUTPATIENT,,,2517,1636.05,,2214.96,88,,1771.97,,,0,"percent of total billed charges","88% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,2517,100,,2013.60,,,0,"percent of total billed charges","100% of total billed charges",6175.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",3250.43,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1585.71,63,,1268.57,,,0,"percent of total billed charges","63% of total billed charges",385.1,15.3,,308.08,,,0,"percent of total billed charges","15.3% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,1736.73,69,,,,,0,"fee schedule","69% of total billed charges",2517,100,,2013.60,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517,100,,2013.60,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517,100,,2013.60,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3218.87,100,,,,,0,"fee schedule",EAPG,4102.48,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",948.91,37.7,,759.13,,,0,"percent of total billed charges","37.70% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1963.26,78,,1570.61,,,0,"percent of total billed charges","78% of total billed charges",3564.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2079.04,82.6,,1663.23,,,0,"percent of total billed charges","82.6% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2079.04,82.6,,1663.23,,,0,"percent of total billed charges","82.6% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3316.28,100,,,,,0,"fee schedule",EAPG,2517,100,,2013.60,,,0,"percent of total billed charges","100% of total billed charges",385.1,12932.7,
"49550 Repair initial femoral hernia, any age; redu",7963414,CDM,521,RC,49550,CPT,OUTPATIENT,,,1785,1160.25,,1570.8,88,,1256.64,,,0,"percent of total billed charges","88% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,1785,100,,1428.00,,,0,"percent of total billed charges","100% of total billed charges",6175.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",3250.43,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1124.55,63,,899.64,,,0,"percent of total billed charges","63% of total billed charges",273.11,15.3,,218.49,,,0,"percent of total billed charges","15.3% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,1231.65,69,,,,,0,"fee schedule","69% of total billed charges",1785,100,,1428.00,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1785,100,,1428.00,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1785,100,,1428.00,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3218.87,100,,,,,0,"fee schedule",EAPG,4102.48,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",672.95,37.7,,538.36,,,0,"percent of total billed charges","37.70% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1392.3,78,,1113.84,,,0,"percent of total billed charges","78% of total billed charges",3564.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1474.41,82.6,,1179.53,,,0,"percent of total billed charges","82.6% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1474.41,82.6,,1179.53,,,0,"percent of total billed charges","82.6% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3316.28,100,,,,,0,"fee schedule",EAPG,1785,100,,1428.00,,,0,"percent of total billed charges","100% of total billed charges",273.11,12932.7,
"49555 Repair recurrent femoral hernia; reducible",7963547,CDM,521,RC,49555,CPT,OUTPATIENT,,,2078,1350.7,,1828.64,88,,1462.91,,,0,"percent of total billed charges","88% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,2078,100,,1662.40,,,0,"percent of total billed charges","100% of total billed charges",6175.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",3250.43,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1309.14,63,,1047.31,,,0,"percent of total billed charges","63% of total billed charges",317.93,15.3,,254.34,,,0,"percent of total billed charges","15.3% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,1433.82,69,,,,,0,"fee schedule","69% of total billed charges",2078,100,,1662.40,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2078,100,,1662.40,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2078,100,,1662.40,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3218.87,100,,,,,0,"fee schedule",EAPG,4102.48,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",783.41,37.7,,626.73,,,0,"percent of total billed charges","37.70% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1620.84,78,,1296.67,,,0,"percent of total billed charges","78% of total billed charges",3564.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1716.43,82.6,,1373.14,,,0,"percent of total billed charges","82.6% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1716.43,82.6,,1373.14,,,0,"percent of total billed charges","82.6% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3316.28,100,,,,,0,"fee schedule",EAPG,2078,100,,1662.40,,,0,"percent of total billed charges","100% of total billed charges",317.93,12932.7,
"49568 Implantation of mesh or other prosthesis for",7962302,CDM,521,RC,,,OUTPATIENT,,,842,547.3,,740.96,88,,592.77,,,0,"percent of total billed charges","88% of total billed charges",421,50,,336.80,,,0,"percent of total billed charges","50% of total billed charges",141.46,16.8,,113.17,,,0,"percent of total billed charges","16.8% of total billed charges",842,100,,673.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",145.7,17.304,,116.56,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",530.46,63,,424.37,,,0,"percent of total billed charges","63% of total billed charges",128.83,15.3,,103.06,,,0,"percent of total billed charges","15.3% of total billed charges",141.46,16.8,,113.17,,,0,"percent of total billed charges","16.8% of total billed charges",580.98,69,,,,,0,"fee schedule","69% of total billed charges",842,100,,673.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",842,100,,673.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",842,100,,673.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",520.78,61.85,,416.62,,,0,"percent of total billed charges","61.5% of total billed charges",141.46,16.8,,113.17,,,0,"percent of total billed charges","16.8% of total billed charges",421,50,,336.80,,,0,"percent of total billed charges","50% of total billed charges",271.12,32.2,,216.90,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",144.29,17.136,,115.43,,,0,"percent of total billed charges","17.136% of total billed charges",183.89,21.84,,147.11,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",317.43,37.7,,253.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",656.76,78,,525.41,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",695.49,82.6,,556.39,,,0,"percent of total billed charges","82.6% of total billed charges",141.46,16.8,,113.17,,,0,"percent of total billed charges","16.8% of total billed charges",421,50,,336.80,,,0,"percent of total billed charges","50% of total billed charges",695.49,82.6,,556.39,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",842,100,,673.60,,,0,"percent of total billed charges","100% of total billed charges",128.83,842,
"49561 Repair initial incisional or ventral hernia",7962750,CDM,521,RC,,,OUTPATIENT,,,2528,1643.2,,2224.64,88,,1779.71,,,0,"percent of total billed charges","88% of total billed charges",1264,50,,1011.20,,,0,"percent of total billed charges","50% of total billed charges",424.7,16.8,,339.76,,,0,"percent of total billed charges","16.8% of total billed charges",2528,100,,2022.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",437.45,17.304,,349.96,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1592.64,63,,1274.11,,,0,"percent of total billed charges","63% of total billed charges",386.78,15.3,,309.42,,,0,"percent of total billed charges","15.3% of total billed charges",424.7,16.8,,339.76,,,0,"percent of total billed charges","16.8% of total billed charges",1744.32,69,,,,,0,"fee schedule","69% of total billed charges",2528,100,,2022.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2528,100,,2022.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2528,100,,2022.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1563.57,61.85,,1250.86,,,0,"percent of total billed charges","61.5% of total billed charges",424.7,16.8,,339.76,,,0,"percent of total billed charges","16.8% of total billed charges",1264,50,,1011.20,,,0,"percent of total billed charges","50% of total billed charges",814.02,32.2,,651.22,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",433.2,17.136,,346.56,,,0,"percent of total billed charges","17.136% of total billed charges",552.12,21.84,,441.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",953.06,37.7,,762.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1971.84,78,,1577.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2088.13,82.6,,1670.50,,,0,"percent of total billed charges","82.6% of total billed charges",424.7,16.8,,339.76,,,0,"percent of total billed charges","16.8% of total billed charges",1264,50,,1011.20,,,0,"percent of total billed charges","50% of total billed charges",2088.13,82.6,,1670.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",2528,100,,2022.40,,,0,"percent of total billed charges","100% of total billed charges",160.53,2528,
"49565 Repair recurrent incisional or ventral herni",7963231,CDM,521,RC,,,OUTPATIENT,,,2450,1592.5,,2156,88,,1724.80,,,0,"percent of total billed charges","88% of total billed charges",1225,50,,980.00,,,0,"percent of total billed charges","50% of total billed charges",411.6,16.8,,329.28,,,0,"percent of total billed charges","16.8% of total billed charges",2450,100,,1960.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",423.95,17.304,,339.16,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1543.5,63,,1234.80,,,0,"percent of total billed charges","63% of total billed charges",374.85,15.3,,299.88,,,0,"percent of total billed charges","15.3% of total billed charges",411.6,16.8,,329.28,,,0,"percent of total billed charges","16.8% of total billed charges",1690.5,69,,,,,0,"fee schedule","69% of total billed charges",2450,100,,1960.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2450,100,,1960.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2450,100,,1960.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1515.33,61.85,,1212.26,,,0,"percent of total billed charges","61.5% of total billed charges",411.6,16.8,,329.28,,,0,"percent of total billed charges","16.8% of total billed charges",1225,50,,980.00,,,0,"percent of total billed charges","50% of total billed charges",788.9,32.2,,631.12,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",419.83,17.136,,335.86,,,0,"percent of total billed charges","17.136% of total billed charges",535.08,21.84,,428.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",923.65,37.7,,738.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1911,78,,1528.80,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2023.7,82.6,,1618.96,,,0,"percent of total billed charges","82.6% of total billed charges",411.6,16.8,,329.28,,,0,"percent of total billed charges","16.8% of total billed charges",1225,50,,980.00,,,0,"percent of total billed charges","50% of total billed charges",2023.7,82.6,,1618.96,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",2450,100,,1960.00,,,0,"percent of total billed charges","100% of total billed charges",160.53,2450,
"49560 Repair initial incisional or ventral hernia;",7963288,CDM,521,RC,,,OUTPATIENT,,,2222,1444.3,,1955.36,88,,1564.29,,,0,"percent of total billed charges","88% of total billed charges",1111,50,,888.80,,,0,"percent of total billed charges","50% of total billed charges",373.3,16.8,,298.64,,,0,"percent of total billed charges","16.8% of total billed charges",2222,100,,1777.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",384.49,17.304,,307.59,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1399.86,63,,1119.89,,,0,"percent of total billed charges","63% of total billed charges",339.97,15.3,,271.98,,,0,"percent of total billed charges","15.3% of total billed charges",373.3,16.8,,298.64,,,0,"percent of total billed charges","16.8% of total billed charges",1533.18,69,,,,,0,"fee schedule","69% of total billed charges",2222,100,,1777.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2222,100,,1777.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2222,100,,1777.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1374.31,61.85,,1099.45,,,0,"percent of total billed charges","61.5% of total billed charges",373.3,16.8,,298.64,,,0,"percent of total billed charges","16.8% of total billed charges",1111,50,,888.80,,,0,"percent of total billed charges","50% of total billed charges",715.48,32.2,,572.38,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",380.76,17.136,,304.61,,,0,"percent of total billed charges","17.136% of total billed charges",485.28,21.84,,388.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",837.69,37.7,,670.15,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1733.16,78,,1386.53,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1835.37,82.6,,1468.30,,,0,"percent of total billed charges","82.6% of total billed charges",373.3,16.8,,298.64,,,0,"percent of total billed charges","16.8% of total billed charges",1111,50,,888.80,,,0,"percent of total billed charges","50% of total billed charges",1835.37,82.6,,1468.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",2222,100,,1777.60,,,0,"percent of total billed charges","100% of total billed charges",160.53,2222,
"49570 Repair epigastric hernia (eg, preperitoneal",7962477,CDM,521,RC,,,OUTPATIENT,,,1355,880.75,,1192.4,88,,953.92,,,0,"percent of total billed charges","88% of total billed charges",677.5,50,,542.00,,,0,"percent of total billed charges","50% of total billed charges",227.64,16.8,,182.11,,,0,"percent of total billed charges","16.8% of total billed charges",1355,100,,1084.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",234.47,17.304,,187.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",853.65,63,,682.92,,,0,"percent of total billed charges","63% of total billed charges",207.32,15.3,,165.86,,,0,"percent of total billed charges","15.3% of total billed charges",227.64,16.8,,182.11,,,0,"percent of total billed charges","16.8% of total billed charges",934.95,69,,,,,0,"fee schedule","69% of total billed charges",1355,100,,1084.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1355,100,,1084.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1355,100,,1084.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",838.07,61.85,,670.46,,,0,"percent of total billed charges","61.5% of total billed charges",227.64,16.8,,182.11,,,0,"percent of total billed charges","16.8% of total billed charges",677.5,50,,542.00,,,0,"percent of total billed charges","50% of total billed charges",436.31,32.2,,349.05,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",232.19,17.136,,185.75,,,0,"percent of total billed charges","17.136% of total billed charges",295.93,21.84,,236.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",510.84,37.7,,408.67,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1056.9,78,,845.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1119.23,82.6,,895.38,,,0,"percent of total billed charges","82.6% of total billed charges",227.64,16.8,,182.11,,,0,"percent of total billed charges","16.8% of total billed charges",677.5,50,,542.00,,,0,"percent of total billed charges","50% of total billed charges",1119.23,82.6,,895.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",1355,100,,1084.00,,,0,"percent of total billed charges","100% of total billed charges",160.53,1355,
"49582 Repair umbilical hernia, younger than age 5",7962505,CDM,521,RC,,,OUTPATIENT,,,1590,1033.5,,1399.2,88,,1119.36,,,0,"percent of total billed charges","88% of total billed charges",795,50,,636.00,,,0,"percent of total billed charges","50% of total billed charges",267.12,16.8,,213.70,,,0,"percent of total billed charges","16.8% of total billed charges",1590,100,,1272.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",275.13,17.304,,220.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1001.7,63,,801.36,,,0,"percent of total billed charges","63% of total billed charges",243.27,15.3,,194.62,,,0,"percent of total billed charges","15.3% of total billed charges",267.12,16.8,,213.70,,,0,"percent of total billed charges","16.8% of total billed charges",1097.1,69,,,,,0,"fee schedule","69% of total billed charges",1590,100,,1272.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1590,100,,1272.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1590,100,,1272.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",983.42,61.85,,786.74,,,0,"percent of total billed charges","61.5% of total billed charges",267.12,16.8,,213.70,,,0,"percent of total billed charges","16.8% of total billed charges",795,50,,636.00,,,0,"percent of total billed charges","50% of total billed charges",511.98,32.2,,409.58,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",272.46,17.136,,217.97,,,0,"percent of total billed charges","17.136% of total billed charges",347.26,21.84,,277.81,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",599.43,37.7,,479.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1240.2,78,,992.16,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1313.34,82.6,,1050.67,,,0,"percent of total billed charges","82.6% of total billed charges",267.12,16.8,,213.70,,,0,"percent of total billed charges","16.8% of total billed charges",795,50,,636.00,,,0,"percent of total billed charges","50% of total billed charges",1313.34,82.6,,1050.67,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",1590,100,,1272.00,,,0,"percent of total billed charges","100% of total billed charges",160.53,1590,
"49587 Repair umbilical hernia, age 5 years or olde",7962642,CDM,521,RC,,,OUTPATIENT,,,1819,1182.35,,1600.72,88,,1280.58,,,0,"percent of total billed charges","88% of total billed charges",909.5,50,,727.60,,,0,"percent of total billed charges","50% of total billed charges",305.59,16.8,,244.47,,,0,"percent of total billed charges","16.8% of total billed charges",1819,100,,1455.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",314.76,17.304,,251.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1145.97,63,,916.78,,,0,"percent of total billed charges","63% of total billed charges",278.31,15.3,,222.65,,,0,"percent of total billed charges","15.3% of total billed charges",305.59,16.8,,244.47,,,0,"percent of total billed charges","16.8% of total billed charges",1255.11,69,,,,,0,"fee schedule","69% of total billed charges",1819,100,,1455.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1819,100,,1455.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1819,100,,1455.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1125.05,61.85,,900.04,,,0,"percent of total billed charges","61.5% of total billed charges",305.59,16.8,,244.47,,,0,"percent of total billed charges","16.8% of total billed charges",909.5,50,,727.60,,,0,"percent of total billed charges","50% of total billed charges",585.72,32.2,,468.58,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",311.7,17.136,,249.36,,,0,"percent of total billed charges","17.136% of total billed charges",397.27,21.84,,317.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",685.76,37.7,,548.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1418.82,78,,1135.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1502.49,82.6,,1201.99,,,0,"percent of total billed charges","82.6% of total billed charges",305.59,16.8,,244.47,,,0,"percent of total billed charges","16.8% of total billed charges",909.5,50,,727.60,,,0,"percent of total billed charges","50% of total billed charges",1502.49,82.6,,1201.99,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",1819,100,,1455.20,,,0,"percent of total billed charges","100% of total billed charges",160.53,1819,
"49580 Repair umbilical hernia, younger than age 5",7963117,CDM,521,RC,,,OUTPATIENT,,,1402,911.3,,1233.76,88,,987.01,,,0,"percent of total billed charges","88% of total billed charges",701,50,,560.80,,,0,"percent of total billed charges","50% of total billed charges",235.54,16.8,,188.43,,,0,"percent of total billed charges","16.8% of total billed charges",1402,100,,1121.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",242.6,17.304,,194.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",883.26,63,,706.61,,,0,"percent of total billed charges","63% of total billed charges",214.51,15.3,,171.61,,,0,"percent of total billed charges","15.3% of total billed charges",235.54,16.8,,188.43,,,0,"percent of total billed charges","16.8% of total billed charges",967.38,69,,,,,0,"fee schedule","69% of total billed charges",1402,100,,1121.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1402,100,,1121.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1402,100,,1121.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",867.14,61.85,,693.71,,,0,"percent of total billed charges","61.5% of total billed charges",235.54,16.8,,188.43,,,0,"percent of total billed charges","16.8% of total billed charges",701,50,,560.80,,,0,"percent of total billed charges","50% of total billed charges",451.44,32.2,,361.15,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",240.25,17.136,,192.20,,,0,"percent of total billed charges","17.136% of total billed charges",306.2,21.84,,244.96,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",528.55,37.7,,422.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1093.56,78,,874.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1158.05,82.6,,926.44,,,0,"percent of total billed charges","82.6% of total billed charges",235.54,16.8,,188.43,,,0,"percent of total billed charges","16.8% of total billed charges",701,50,,560.80,,,0,"percent of total billed charges","50% of total billed charges",1158.05,82.6,,926.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",1402,100,,1121.60,,,0,"percent of total billed charges","100% of total billed charges",160.53,1402,
"49590 Repair spigelian hernia",7963871,CDM,521,RC,,,OUTPATIENT,,,1969,1279.85,,1732.72,88,,1386.18,,,0,"percent of total billed charges","88% of total billed charges",984.5,50,,787.60,,,0,"percent of total billed charges","50% of total billed charges",330.79,16.8,,264.63,,,0,"percent of total billed charges","16.8% of total billed charges",1969,100,,1575.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",340.72,17.304,,272.58,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1240.47,63,,992.38,,,0,"percent of total billed charges","63% of total billed charges",301.26,15.3,,241.01,,,0,"percent of total billed charges","15.3% of total billed charges",330.79,16.8,,264.63,,,0,"percent of total billed charges","16.8% of total billed charges",1358.61,69,,,,,0,"fee schedule","69% of total billed charges",1969,100,,1575.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1969,100,,1575.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1969,100,,1575.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1217.83,61.85,,974.26,,,0,"percent of total billed charges","61.5% of total billed charges",330.79,16.8,,264.63,,,0,"percent of total billed charges","16.8% of total billed charges",984.5,50,,787.60,,,0,"percent of total billed charges","50% of total billed charges",634.02,32.2,,507.22,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",337.41,17.136,,269.93,,,0,"percent of total billed charges","17.136% of total billed charges",430.03,21.84,,344.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",742.31,37.7,,593.85,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1535.82,78,,1228.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1626.39,82.6,,1301.11,,,0,"percent of total billed charges","82.6% of total billed charges",330.79,16.8,,264.63,,,0,"percent of total billed charges","16.8% of total billed charges",984.5,50,,787.60,,,0,"percent of total billed charges","50% of total billed charges",1626.39,82.6,,1301.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",1969,100,,1575.20,,,0,"percent of total billed charges","100% of total billed charges",160.53,1969,
"49600 Repair of small omphalocele, with primary cl",7963415,CDM,521,RC,49600,CPT,OUTPATIENT,,,2571,1671.15,,2262.48,88,,1809.98,,,0,"percent of total billed charges","88% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4031.42,100,,,,,0,"fee schedule",EAPG,2571,100,,2056.80,,,0,"percent of total billed charges","100% of total billed charges",6175.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",4152.36,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1619.73,63,,1295.78,,,0,"percent of total billed charges","63% of total billed charges",393.36,15.3,,314.69,,,0,"percent of total billed charges","15.3% of total billed charges",4031.42,100,,,,,0,"fee schedule",EAPG,1773.99,69,,,,,0,"fee schedule","69% of total billed charges",2571,100,,2056.80,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2571,100,,2056.80,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2571,100,,2056.80,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4031.42,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4112.05,100,,,,,0,"fee schedule",EAPG,5240.85,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",969.27,37.7,,775.42,,,0,"percent of total billed charges","37.70% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2005.38,78,,1604.30,,,0,"percent of total billed charges","78% of total billed charges",3564.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2123.65,82.6,,1698.92,,,0,"percent of total billed charges","82.6% of total billed charges",4031.42,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2123.65,82.6,,1698.92,,,0,"percent of total billed charges","82.6% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4191.95,100,,,,,0,"fee schedule",EAPG,2571,100,,2056.80,,,0,"percent of total billed charges","100% of total billed charges",393.36,12932.7,
"49652 Laparoscopy, surgical, repair, ventral, umbi",7961626,CDM,521,RC,,,OUTPATIENT,,,1921,1248.65,,1690.48,88,,1352.38,,,0,"percent of total billed charges","88% of total billed charges",960.5,50,,768.40,,,0,"percent of total billed charges","50% of total billed charges",322.73,16.8,,258.18,,,0,"percent of total billed charges","16.8% of total billed charges",1921,100,,1536.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",332.41,17.304,,265.93,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1210.23,63,,968.18,,,0,"percent of total billed charges","63% of total billed charges",293.91,15.3,,235.13,,,0,"percent of total billed charges","15.3% of total billed charges",322.73,16.8,,258.18,,,0,"percent of total billed charges","16.8% of total billed charges",1325.49,69,,,,,0,"fee schedule","69% of total billed charges",1921,100,,1536.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1921,100,,1536.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1921,100,,1536.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1188.14,61.85,,950.51,,,0,"percent of total billed charges","61.5% of total billed charges",322.73,16.8,,258.18,,,0,"percent of total billed charges","16.8% of total billed charges",960.5,50,,768.40,,,0,"percent of total billed charges","50% of total billed charges",618.56,32.2,,494.85,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",329.18,17.136,,263.34,,,0,"percent of total billed charges","17.136% of total billed charges",419.55,21.84,,335.64,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",724.22,37.7,,579.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1498.38,78,,1198.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1586.75,82.6,,1269.40,,,0,"percent of total billed charges","82.6% of total billed charges",322.73,16.8,,258.18,,,0,"percent of total billed charges","16.8% of total billed charges",960.5,50,,768.40,,,0,"percent of total billed charges","50% of total billed charges",1586.75,82.6,,1269.40,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",1921,100,,1536.80,,,0,"percent of total billed charges","100% of total billed charges",160.53,1921,
"49653 Laparoscopy, surgical, repair, vent/umbil/sp",7961772,CDM,521,RC,,,OUTPATIENT,,,2534,1647.1,,2229.92,88,,1783.94,,,0,"percent of total billed charges","88% of total billed charges",1267,50,,1013.60,,,0,"percent of total billed charges","50% of total billed charges",425.71,16.8,,340.57,,,0,"percent of total billed charges","16.8% of total billed charges",2534,100,,2027.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",438.48,17.304,,350.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1596.42,63,,1277.14,,,0,"percent of total billed charges","63% of total billed charges",387.7,15.3,,310.16,,,0,"percent of total billed charges","15.3% of total billed charges",425.71,16.8,,340.57,,,0,"percent of total billed charges","16.8% of total billed charges",1748.46,69,,,,,0,"fee schedule","69% of total billed charges",2534,100,,2027.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2534,100,,2027.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2534,100,,2027.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1567.28,61.85,,1253.82,,,0,"percent of total billed charges","61.5% of total billed charges",425.71,16.8,,340.57,,,0,"percent of total billed charges","16.8% of total billed charges",1267,50,,1013.60,,,0,"percent of total billed charges","50% of total billed charges",815.95,32.2,,652.76,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",434.23,17.136,,347.38,,,0,"percent of total billed charges","17.136% of total billed charges",553.43,21.84,,442.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",955.32,37.7,,764.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1976.52,78,,1581.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2093.08,82.6,,1674.46,,,0,"percent of total billed charges","82.6% of total billed charges",425.71,16.8,,340.57,,,0,"percent of total billed charges","16.8% of total billed charges",1267,50,,1013.60,,,0,"percent of total billed charges","50% of total billed charges",2093.08,82.6,,1674.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",2534,100,,2027.20,,,0,"percent of total billed charges","100% of total billed charges",160.53,2534,
"49659 Unlisted laparoscopy procedure, hernioplasty",7962786,CDM,521,RC,49659,CPT,OUTPATIENT,,,1108,720.2,,975.04,88,,780.03,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4031.42,100,,,,,0,"fee schedule",EAPG,1108,100,,886.40,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",4152.36,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",698.04,63,,558.43,,,0,"percent of total billed charges","63% of total billed charges",169.52,15.3,,135.62,,,0,"percent of total billed charges","15.3% of total billed charges",4031.42,100,,,,,0,"fee schedule",EAPG,764.52,69,,,,,0,"fee schedule","69% of total billed charges",1108,100,,886.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1108,100,,886.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1108,100,,886.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4031.42,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4112.05,100,,,,,0,"fee schedule",EAPG,5240.85,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",417.72,37.7,,334.18,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",864.24,78,,691.39,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",915.21,82.6,,732.17,,,0,"percent of total billed charges","82.6% of total billed charges",4031.42,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",915.21,82.6,,732.17,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4191.95,100,,,,,0,"fee schedule",EAPG,1108,100,,886.40,,,0,"percent of total billed charges","100% of total billed charges",169.52,20558.19,
"49656 Laparoscopy, surgical, repair, recurrent inc",7962822,CDM,521,RC,,,OUTPATIENT,,,2502,1626.3,,2201.76,88,,1761.41,,,0,"percent of total billed charges","88% of total billed charges",1251,50,,1000.80,,,0,"percent of total billed charges","50% of total billed charges",420.34,16.8,,336.27,,,0,"percent of total billed charges","16.8% of total billed charges",2502,100,,2001.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",432.95,17.304,,346.36,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1576.26,63,,1261.01,,,0,"percent of total billed charges","63% of total billed charges",382.81,15.3,,306.25,,,0,"percent of total billed charges","15.3% of total billed charges",420.34,16.8,,336.27,,,0,"percent of total billed charges","16.8% of total billed charges",1726.38,69,,,,,0,"fee schedule","69% of total billed charges",2502,100,,2001.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2502,100,,2001.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2502,100,,2001.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1547.49,61.85,,1237.99,,,0,"percent of total billed charges","61.5% of total billed charges",420.34,16.8,,336.27,,,0,"percent of total billed charges","16.8% of total billed charges",1251,50,,1000.80,,,0,"percent of total billed charges","50% of total billed charges",805.64,32.2,,644.51,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",428.74,17.136,,342.99,,,0,"percent of total billed charges","17.136% of total billed charges",546.44,21.84,,437.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",943.25,37.7,,754.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1951.56,78,,1561.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2066.65,82.6,,1653.32,,,0,"percent of total billed charges","82.6% of total billed charges",420.34,16.8,,336.27,,,0,"percent of total billed charges","16.8% of total billed charges",1251,50,,1000.80,,,0,"percent of total billed charges","50% of total billed charges",2066.65,82.6,,1653.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",2502,100,,2001.60,,,0,"percent of total billed charges","100% of total billed charges",160.53,2502,
"49654 Laparoscopy, surgical, repair, incisional he",7963118,CDM,521,RC,,,OUTPATIENT,,,2304,1497.6,,2027.52,88,,1622.02,,,0,"percent of total billed charges","88% of total billed charges",1152,50,,921.60,,,0,"percent of total billed charges","50% of total billed charges",387.07,16.8,,309.66,,,0,"percent of total billed charges","16.8% of total billed charges",2304,100,,1843.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",398.68,17.304,,318.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1451.52,63,,1161.22,,,0,"percent of total billed charges","63% of total billed charges",352.51,15.3,,282.01,,,0,"percent of total billed charges","15.3% of total billed charges",387.07,16.8,,309.66,,,0,"percent of total billed charges","16.8% of total billed charges",1589.76,69,,,,,0,"fee schedule","69% of total billed charges",2304,100,,1843.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2304,100,,1843.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2304,100,,1843.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1425.02,61.85,,1140.02,,,0,"percent of total billed charges","61.5% of total billed charges",387.07,16.8,,309.66,,,0,"percent of total billed charges","16.8% of total billed charges",1152,50,,921.60,,,0,"percent of total billed charges","50% of total billed charges",741.89,32.2,,593.51,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",394.81,17.136,,315.85,,,0,"percent of total billed charges","17.136% of total billed charges",503.19,21.84,,402.55,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",868.61,37.7,,694.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1797.12,78,,1437.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1903.1,82.6,,1522.48,,,0,"percent of total billed charges","82.6% of total billed charges",387.07,16.8,,309.66,,,0,"percent of total billed charges","16.8% of total billed charges",1152,50,,921.60,,,0,"percent of total billed charges","50% of total billed charges",1903.1,82.6,,1522.48,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",2304,100,,1843.20,,,0,"percent of total billed charges","100% of total billed charges",160.53,2304,
"49651 Laparoscopy, surgical; repair recurrent ingu",7963256,CDM,521,RC,49651,CPT,OUTPATIENT,,,1607,1044.55,,1414.16,88,,1131.33,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,1607,100,,1285.60,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",3250.43,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1012.41,63,,809.93,,,0,"percent of total billed charges","63% of total billed charges",245.87,15.3,,196.70,,,0,"percent of total billed charges","15.3% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,1108.83,69,,,,,0,"fee schedule","69% of total billed charges",1607,100,,1285.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1607,100,,1285.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1607,100,,1285.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3218.87,100,,,,,0,"fee schedule",EAPG,4102.48,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",605.84,37.7,,484.67,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1253.46,78,,1002.77,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.38,82.6,,1061.90,,,0,"percent of total billed charges","82.6% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.38,82.6,,1061.90,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3316.28,100,,,,,0,"fee schedule",EAPG,1607,100,,1285.60,,,0,"percent of total billed charges","100% of total billed charges",245.87,20558.19,
"49650 Laparoscopy, surgical repair initial inguin",7963309,CDM,521,RC,49650,CPT,OUTPATIENT,,,1255,815.75,,1104.4,88,,883.52,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,1255,100,,1004.00,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",3250.43,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790.65,63,,632.52,,,0,"percent of total billed charges","63% of total billed charges",192.02,15.3,,153.62,,,0,"percent of total billed charges","15.3% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,865.95,69,,,,,0,"fee schedule","69% of total billed charges",1255,100,,1004.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1255,100,,1004.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1255,100,,1004.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3155.75,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3218.87,100,,,,,0,"fee schedule",EAPG,4102.48,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",473.14,37.7,,378.51,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",978.9,78,,783.12,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1036.63,82.6,,829.30,,,0,"percent of total billed charges","82.6% of total billed charges",3155.75,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1036.63,82.6,,829.30,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3316.28,100,,,,,0,"fee schedule",EAPG,1255,100,,1004.00,,,0,"percent of total billed charges","100% of total billed charges",192.02,20558.19,
"49900 Suture, secondary, of abdominal wall for evi",7962909,CDM,521,RC,49900,CPT,OUTPATIENT,,,2359,1533.35,,2075.92,88,,1660.74,,,0,"percent of total billed charges","88% of total billed charges",2359,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3355.36,100,,,,,0,"fee schedule",EAPG,2359,100,,1887.20,,,0,"percent of total billed charges","100% of total billed charges",2359,175,,,,,0,"fee schedule","175% of CMS fee schedule",3456.02,100,,,,,0,"fee schedule",EAPG,2359,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1486.17,63,,1188.94,,,0,"percent of total billed charges","63% of total billed charges",360.93,15.3,,288.74,,,0,"percent of total billed charges","15.3% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,1627.71,69,,,,,0,"fee schedule","69% of total billed charges",2359,100,,1887.20,,,0,"percent of total billed charges","100% of total billed charges",2359,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2359,100,,1887.20,,,0,"percent of total billed charges","100% of total billed charges",2359,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2359,100,,1887.20,,,0,"percent of total billed charges","100% of total billed charges",2359,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2359,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3355.36,100,,,,,0,"fee schedule",EAPG,2359,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2359,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2359,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3422.47,100,,,,,0,"fee schedule",EAPG,4361.97,100,,,,,0,"fee schedule",EAPG,2359,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",889.34,37.7,,711.47,,,0,"percent of total billed charges","37.70% of total billed charges",2359,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2359,100,,,,,0,"fee schedule","100% of CMS fee schedule",1840.02,78,,1472.02,,,0,"percent of total billed charges","78% of total billed charges",2359,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1948.53,82.6,,1558.82,,,0,"percent of total billed charges","82.6% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,2359,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1948.53,82.6,,1558.82,,,0,"percent of total billed charges","82.6% of total billed charges",2359,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3515.89,100,,,,,0,"fee schedule",EAPG,2359,100,,1887.20,,,0,"percent of total billed charges","100% of total billed charges",360.93,4361.97,
"49905 Omental flap, intra-abdominal",7963747,CDM,521,RC,49905,CPT,OUTPATIENT,,,1001,650.65,,880.88,88,,704.70,,,0,"percent of total billed charges","88% of total billed charges",1001,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3355.36,100,,,,,0,"fee schedule",EAPG,1001,100,,800.80,,,0,"percent of total billed charges","100% of total billed charges",1001,175,,,,,0,"fee schedule","175% of CMS fee schedule",3456.02,100,,,,,0,"fee schedule",EAPG,1001,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",630.63,63,,504.50,,,0,"percent of total billed charges","63% of total billed charges",153.15,15.3,,122.52,,,0,"percent of total billed charges","15.3% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,690.69,69,,,,,0,"fee schedule","69% of total billed charges",1001,100,,800.80,,,0,"percent of total billed charges","100% of total billed charges",1001,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1001,100,,800.80,,,0,"percent of total billed charges","100% of total billed charges",1001,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1001,100,,800.80,,,0,"percent of total billed charges","100% of total billed charges",1001,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1001,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3355.36,100,,,,,0,"fee schedule",EAPG,1001,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1001,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1001,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3422.47,100,,,,,0,"fee schedule",EAPG,4361.97,100,,,,,0,"fee schedule",EAPG,1001,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",377.38,37.7,,301.90,,,0,"percent of total billed charges","37.70% of total billed charges",1001,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1001,100,,,,,0,"fee schedule","100% of CMS fee schedule",780.78,78,,624.62,,,0,"percent of total billed charges","78% of total billed charges",1001,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",826.83,82.6,,661.46,,,0,"percent of total billed charges","82.6% of total billed charges",3355.36,100,,,,,0,"fee schedule","100% of WA fee schedule",1001,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",826.83,82.6,,661.46,,,0,"percent of total billed charges","82.6% of total billed charges",1001,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3515.89,100,,,,,0,"fee schedule",EAPG,1001,100,,800.80,,,0,"percent of total billed charges","100% of total billed charges",153.15,4361.97,
"49999 Unlisted procedure, abdomen, peritoneum and",7963367,CDM,521,RC,49999,CPT,OUTPATIENT,,,2209,1435.85,,1943.92,88,,1555.14,,,0,"percent of total billed charges","88% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,2209,100,,1767.20,,,0,"percent of total billed charges","100% of total billed charges",1618,175,,,,,0,"fee schedule","175% of CMS fee schedule",685.84,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1391.67,63,,1113.34,,,0,"percent of total billed charges","63% of total billed charges",337.98,15.3,,270.38,,,0,"percent of total billed charges","15.3% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,1524.21,69,,,,,0,"fee schedule","69% of total billed charges",2209,100,,1767.20,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2209,100,,1767.20,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2209,100,,1767.20,,,0,"percent of total billed charges","100% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",3289.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",665.87,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",679.18,100,,,,,0,"fee schedule",EAPG,865.63,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",832.79,37.7,,666.23,,,0,"percent of total billed charges","37.70% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1723.02,78,,1378.42,,,0,"percent of total billed charges","78% of total billed charges",933.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1824.63,82.6,,1459.70,,,0,"percent of total billed charges","82.6% of total billed charges",665.87,100,,,,,0,"fee schedule",EAPG,924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1824.63,82.6,,1459.70,,,0,"percent of total billed charges","82.6% of total billed charges",924.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",826.4,100,,,,,0,"fee schedule",EAPG,2209,100,,1767.20,,,0,"percent of total billed charges","100% of total billed charges",337.98,3289.02,
"50200 Renal Biopsy Percutaneous",8165584,CDM,521,RC,50200,CPT,OUTPATIENT,,,3343,2172.95,,2941.84,88,,2353.47,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1359.89,100,,,,,0,"fee schedule",EAPG,3343,100,,2674.40,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",1400.69,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2106.09,63,,1684.87,,,0,"percent of total billed charges","63% of total billed charges",511.48,15.3,,409.18,,,0,"percent of total billed charges","15.3% of total billed charges",1359.89,100,,,,,0,"fee schedule",EAPG,2306.67,69,,,,,0,"fee schedule","69% of total billed charges",3343,100,,2674.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3343,100,,2674.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3343,100,,2674.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1359.89,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1387.09,100,,,,,0,"fee schedule",EAPG,1767.86,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1260.31,37.7,,1008.25,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2607.54,78,,2086.03,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2761.32,82.6,,2209.06,,,0,"percent of total billed charges","82.6% of total billed charges",1359.89,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2761.32,82.6,,2209.06,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1520.42,100,,,,,0,"fee schedule",EAPG,3343,100,,2674.40,,,0,"percent of total billed charges","100% of total billed charges",511.48,5715.97,
"50220 Nephrectomy, including partial ureterectomy,",7962257,CDM,521,RC,50220,CPT,OUTPATIENT,,,3026,1966.9,,2662.88,88,,2130.30,,,0,"percent of total billed charges","88% of total billed charges",3026,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6248.26,100,,,,,0,"fee schedule",EAPG,3026,100,,2420.80,,,0,"percent of total billed charges","100% of total billed charges",3026,175,,,,,0,"fee schedule","175% of CMS fee schedule",6435.7,100,,,,,0,"fee schedule",EAPG,3026,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1906.38,63,,1525.10,,,0,"percent of total billed charges","63% of total billed charges",462.98,15.3,,370.38,,,0,"percent of total billed charges","15.3% of total billed charges",6248.26,100,,,,,0,"fee schedule",EAPG,2087.94,69,,,,,0,"fee schedule","69% of total billed charges",3026,100,,2420.80,,,0,"percent of total billed charges","100% of total billed charges",3026,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3026,100,,2420.80,,,0,"percent of total billed charges","100% of total billed charges",3026,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3026,100,,2420.80,,,0,"percent of total billed charges","100% of total billed charges",3026,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3026,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6248.26,100,,,,,0,"fee schedule",EAPG,3026,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3026,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3026,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6373.22,100,,,,,0,"fee schedule",EAPG,8122.73,100,,,,,0,"fee schedule",EAPG,3026,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1140.8,37.7,,912.64,,,0,"percent of total billed charges","37.70% of total billed charges",3026,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3026,100,,,,,0,"fee schedule","100% of CMS fee schedule",2360.28,78,,1888.22,,,0,"percent of total billed charges","78% of total billed charges",3026,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2499.48,82.6,,1999.58,,,0,"percent of total billed charges","82.6% of total billed charges",6248.26,100,,,,,0,"fee schedule","100% of WA fee schedule",3026,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2499.48,82.6,,1999.58,,,0,"percent of total billed charges","82.6% of total billed charges",3026,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6408.79,100,,,,,0,"fee schedule",EAPG,3026,100,,2420.80,,,0,"percent of total billed charges","100% of total billed charges",462.98,8122.73,
"50543 Laparoscopy, surgical; partial nephrectomy",7963551,CDM,521,RC,50543,CPT,OUTPATIENT,,,4783,3108.95,,4209.04,88,,3367.23,,,0,"percent of total billed charges","88% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6248.26,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",18373.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",6435.7,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3013.29,63,,2410.63,,,0,"percent of total billed charges","63% of total billed charges",731.8,15.3,,585.44,,,0,"percent of total billed charges","15.3% of total billed charges",6248.26,100,,,,,0,"fee schedule",EAPG,3300.27,69,,,,,0,"fee schedule","69% of total billed charges",4783,100,,3826.40,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4783,100,,3826.40,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4783,100,,3826.40,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",36187.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6248.26,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9460.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6373.22,100,,,,,0,"fee schedule",EAPG,8122.73,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1803.19,37.7,,1442.55,,,0,"percent of total billed charges","37.70% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3730.74,78,,2984.59,,,0,"percent of total billed charges","78% of total billed charges",10604.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3950.76,82.6,,3160.61,,,0,"percent of total billed charges","82.6% of total billed charges",6248.26,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3950.76,82.6,,3160.61,,,0,"percent of total billed charges","82.6% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6408.79,100,,,,,0,"fee schedule",EAPG,4783,100,,3826.40,,,0,"percent of total billed charges","100% of total billed charges",731.8,36187.64,
"50690 Injection procedure for visualization of ile",7962478,CDM,521,RC,50690,CPT,OUTPATIENT,,,210,136.5,,184.8,88,,147.84,,,0,"percent of total billed charges","88% of total billed charges",105,50,,84.00,,,0,"percent of total billed charges","50% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.05,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",132.3,63,,105.84,,,0,"percent of total billed charges","63% of total billed charges",32.13,15.3,,25.70,,,0,"percent of total billed charges","15.3% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,144.9,69,,,,,0,"fee schedule","69% of total billed charges",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.89,61.85,,103.91,,,0,"percent of total billed charges","61.5% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,105,50,,84.00,,,0,"percent of total billed charges","50% of total billed charges",67.62,32.2,,54.10,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",278.32,100,,,,,0,"fee schedule",EAPG,354.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",79.17,37.7,,63.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",163.8,78,,131.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",173.46,82.6,,138.77,,,0,"percent of total billed charges","82.6% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,105,50,,84.00,,,0,"percent of total billed charges","50% of total billed charges",173.46,82.6,,138.77,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",433.4,100,,,,,0,"fee schedule",EAPG,210,100,,168.00,,,0,"percent of total billed charges","100% of total billed charges",32.13,433.4,
"50820 Ureteroileal conduit (ileal bladder), includ",7961877,CDM,521,RC,50820,CPT,OUTPATIENT,,,2679,1741.35,,2357.52,88,,1886.02,,,0,"percent of total billed charges","88% of total billed charges",2679,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3724.71,100,,,,,0,"fee schedule",EAPG,2679,100,,2143.20,,,0,"percent of total billed charges","100% of total billed charges",2679,175,,,,,0,"fee schedule","175% of CMS fee schedule",3836.45,100,,,,,0,"fee schedule",EAPG,2679,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1687.77,63,,1350.22,,,0,"percent of total billed charges","63% of total billed charges",409.89,15.3,,327.91,,,0,"percent of total billed charges","15.3% of total billed charges",3724.71,100,,,,,0,"fee schedule",EAPG,1848.51,69,,,,,0,"fee schedule","69% of total billed charges",2679,100,,2143.20,,,0,"percent of total billed charges","100% of total billed charges",2679,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2679,100,,2143.20,,,0,"percent of total billed charges","100% of total billed charges",2679,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2679,100,,2143.20,,,0,"percent of total billed charges","100% of total billed charges",2679,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2679,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3724.71,100,,,,,0,"fee schedule",EAPG,2679,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2679,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2679,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3799.2,100,,,,,0,"fee schedule",EAPG,4842.12,100,,,,,0,"fee schedule",EAPG,2679,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1009.98,37.7,,807.98,,,0,"percent of total billed charges","37.70% of total billed charges",2679,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2679,100,,,,,0,"fee schedule","100% of CMS fee schedule",2089.62,78,,1671.70,,,0,"percent of total billed charges","78% of total billed charges",2679,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2212.85,82.6,,1770.28,,,0,"percent of total billed charges","82.6% of total billed charges",3724.71,100,,,,,0,"fee schedule","100% of WA fee schedule",2679,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2212.85,82.6,,1770.28,,,0,"percent of total billed charges","82.6% of total billed charges",2679,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3885.24,100,,,,,0,"fee schedule",EAPG,2679,100,,2143.20,,,0,"percent of total billed charges","100% of total billed charges",409.89,4842.12,
"51045 Cystotomy, with insertion of ureteral cathet",7962606,CDM,521,RC,51045,CPT,OUTPATIENT,,,1144,743.6,,1006.72,88,,805.38,,,0,"percent of total billed charges","88% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1405.94,100,,,,,0,"fee schedule",EAPG,1144,100,,915.20,,,0,"percent of total billed charges","100% of total billed charges",3635.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",1448.12,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",720.72,63,,576.58,,,0,"percent of total billed charges","63% of total billed charges",175.03,15.3,,140.02,,,0,"percent of total billed charges","15.3% of total billed charges",1405.94,100,,,,,0,"fee schedule",EAPG,789.36,69,,,,,0,"fee schedule","69% of total billed charges",1144,100,,915.20,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1144,100,,915.20,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1144,100,,915.20,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",7284.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1405.94,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1904.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1434.06,100,,,,,0,"fee schedule",EAPG,1827.72,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",431.29,37.7,,345.03,,,0,"percent of total billed charges","37.70% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892.32,78,,713.86,,,0,"percent of total billed charges","78% of total billed charges",2098.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",944.94,82.6,,755.95,,,0,"percent of total billed charges","82.6% of total billed charges",1405.94,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",944.94,82.6,,755.95,,,0,"percent of total billed charges","82.6% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1566.47,100,,,,,0,"fee schedule",EAPG,1144,100,,915.20,,,0,"percent of total billed charges","100% of total billed charges",175.03,7284.07,
"51102 Aspiration of bladder",7904643,CDM,521,RC,51102,CPT,OUTPATIENT,,,547,355.55,,481.36,88,,385.09,,,0,"percent of total billed charges","88% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1405.94,100,,,,,0,"fee schedule",EAPG,547,100,,437.60,,,0,"percent of total billed charges","100% of total billed charges",3635.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",1448.12,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",344.61,63,,275.69,,,0,"percent of total billed charges","63% of total billed charges",83.69,15.3,,66.95,,,0,"percent of total billed charges","15.3% of total billed charges",1405.94,100,,,,,0,"fee schedule",EAPG,377.43,69,,,,,0,"fee schedule","69% of total billed charges",547,100,,437.60,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",547,100,,437.60,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",547,100,,437.60,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",7284.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1405.94,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1904.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1434.06,100,,,,,0,"fee schedule",EAPG,1827.72,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",206.22,37.7,,164.98,,,0,"percent of total billed charges","37.70% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.66,78,,341.33,,,0,"percent of total billed charges","78% of total billed charges",2098.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",451.82,82.6,,361.46,,,0,"percent of total billed charges","82.6% of total billed charges",1405.94,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",451.82,82.6,,361.46,,,0,"percent of total billed charges","82.6% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1566.47,100,,,,,0,"fee schedule",EAPG,547,100,,437.60,,,0,"percent of total billed charges","100% of total billed charges",83.69,7284.07,
"51700 Introduction procedures on the bladder",7904644,CDM,521,RC,51700,CPT,OUTPATIENT,,,256,166.4,,225.28,88,,180.22,,,0,"percent of total billed charges","88% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",441.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",66.85,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",161.28,63,,129.02,,,0,"percent of total billed charges","63% of total billed charges",39.17,15.3,,31.34,,,0,"percent of total billed charges","15.3% of total billed charges",64.9,100,,,,,0,"fee schedule",EAPG,176.64,69,,,,,0,"fee schedule","69% of total billed charges",256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1081.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",282.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.2,100,,,,,0,"fee schedule",EAPG,84.37,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",96.51,37.7,,77.21,,,0,"percent of total billed charges","37.70% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.68,78,,159.74,,,0,"percent of total billed charges","78% of total billed charges",254.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",211.46,82.6,,169.17,,,0,"percent of total billed charges","82.6% of total billed charges",64.9,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",211.46,82.6,,169.17,,,0,"percent of total billed charges","82.6% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",225.43,100,,,,,0,"fee schedule",EAPG,256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",39.17,1081.19,
"51701 Introduction procedures on the bladder",7904645,CDM,521,RC,51701,CPT,OUTPATIENT,,,179,116.35,,157.52,88,,126.02,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,179,100,,143.20,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",66.85,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",112.77,63,,90.22,,,0,"percent of total billed charges","63% of total billed charges",27.39,15.3,,21.91,,,0,"percent of total billed charges","15.3% of total billed charges",64.9,100,,,,,0,"fee schedule",EAPG,123.51,69,,,,,0,"fee schedule","69% of total billed charges",179,100,,143.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",179,100,,143.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",179,100,,143.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.2,100,,,,,0,"fee schedule",EAPG,84.37,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",67.48,37.7,,53.98,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",139.62,78,,111.70,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.85,82.6,,118.28,,,0,"percent of total billed charges","82.6% of total billed charges",64.9,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.85,82.6,,118.28,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",225.43,100,,,,,0,"fee schedule",EAPG,179,100,,143.20,,,0,"percent of total billed charges","100% of total billed charges",27.39,454.8,
"51702 Insertion of temporary indwelling bladder ca",7904646,CDM,521,RC,51702,CPT,OUTPATIENT,,,254,165.1,,223.52,88,,178.82,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",66.85,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.02,63,,128.02,,,0,"percent of total billed charges","63% of total billed charges",38.86,15.3,,31.09,,,0,"percent of total billed charges","15.3% of total billed charges",64.9,100,,,,,0,"fee schedule",EAPG,175.26,69,,,,,0,"fee schedule","69% of total billed charges",254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.2,100,,,,,0,"fee schedule",EAPG,84.37,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",95.76,37.7,,76.61,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",198.12,78,,158.50,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",209.8,82.6,,167.84,,,0,"percent of total billed charges","82.6% of total billed charges",64.9,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",209.8,82.6,,167.84,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",225.43,100,,,,,0,"fee schedule",EAPG,254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",38.86,454.8,
"51703 Insertion of temporary indwelling bladder ca",7904647,CDM,521,RC,51703,CPT,OUTPATIENT,,,378,245.7,,332.64,88,,266.11,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,378,100,,302.40,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",66.85,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",238.14,63,,190.51,,,0,"percent of total billed charges","63% of total billed charges",57.83,15.3,,46.26,,,0,"percent of total billed charges","15.3% of total billed charges",64.9,100,,,,,0,"fee schedule",EAPG,260.82,69,,,,,0,"fee schedule","69% of total billed charges",378,100,,302.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",378,100,,302.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",378,100,,302.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.2,100,,,,,0,"fee schedule",EAPG,84.37,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",142.51,37.7,,114.01,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.84,78,,235.87,,,0,"percent of total billed charges","78% of total billed charges",160.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",312.23,82.6,,249.78,,,0,"percent of total billed charges","82.6% of total billed charges",64.9,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",312.23,82.6,,249.78,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",225.43,100,,,,,0,"fee schedule",EAPG,378,100,,302.40,,,0,"percent of total billed charges","100% of total billed charges",57.83,566.91,
"51725 Simple cystometrogram (CMG) (eg, spinal mano",7963387,CDM,521,RC,51725,CPT,OUTPATIENT,,,440,286,,387.2,88,,309.76,,,0,"percent of total billed charges","88% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.36,100,,,,,0,"fee schedule",EAPG,440,100,,352.00,,,0,"percent of total billed charges","100% of total billed charges",441.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",352.63,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.2,63,,221.76,,,0,"percent of total billed charges","63% of total billed charges",67.32,15.3,,53.86,,,0,"percent of total billed charges","15.3% of total billed charges",342.36,100,,,,,0,"fee schedule",EAPG,303.6,69,,,,,0,"fee schedule","69% of total billed charges",440,100,,352.00,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",440,100,,352.00,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",440,100,,352.00,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1081.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.36,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",282.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",349.21,100,,,,,0,"fee schedule",EAPG,445.07,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",165.88,37.7,,132.70,,,0,"percent of total billed charges","37.70% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",343.2,78,,274.56,,,0,"percent of total billed charges","78% of total billed charges",254.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",363.44,82.6,,290.75,,,0,"percent of total billed charges","82.6% of total billed charges",342.36,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",363.44,82.6,,290.75,,,0,"percent of total billed charges","82.6% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",502.89,100,,,,,0,"fee schedule",EAPG,440,100,,352.00,,,0,"percent of total billed charges","100% of total billed charges",67.32,1081.19,
"51798 Urodynamic procedures on the bladder",7904657,CDM,521,RC,51798,CPT,OUTPATIENT,,,40,26,,35.2,88,,28.16,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",66.85,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",25.2,63,,20.16,,,0,"percent of total billed charges","63% of total billed charges",6.12,15.3,,4.90,,,0,"percent of total billed charges","15.3% of total billed charges",64.9,100,,,,,0,"fee schedule",EAPG,27.6,69,,,,,0,"fee schedule","69% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.9,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.2,100,,,,,0,"fee schedule",EAPG,84.37,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",15.08,37.7,,12.06,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.2,78,,24.96,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",64.9,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",225.43,100,,,,,0,"fee schedule",EAPG,40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",6.12,226.12,
"51840 Anterior vesicourethropexy, or urethropexy (",7961878,CDM,521,RC,51840,CPT,OUTPATIENT,,,3000,1950,,2640,88,,2112.00,,,0,"percent of total billed charges","88% of total billed charges",3000,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3724.71,100,,,,,0,"fee schedule",EAPG,3000,100,,2400.00,,,0,"percent of total billed charges","100% of total billed charges",3000,175,,,,,0,"fee schedule","175% of CMS fee schedule",3836.45,100,,,,,0,"fee schedule",EAPG,3000,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1890,63,,1512.00,,,0,"percent of total billed charges","63% of total billed charges",459,15.3,,367.20,,,0,"percent of total billed charges","15.3% of total billed charges",3724.71,100,,,,,0,"fee schedule",EAPG,2070,69,,,,,0,"fee schedule","69% of total billed charges",3000,100,,2400.00,,,0,"percent of total billed charges","100% of total billed charges",3000,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3000,100,,2400.00,,,0,"percent of total billed charges","100% of total billed charges",3000,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3000,100,,2400.00,,,0,"percent of total billed charges","100% of total billed charges",3000,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",17913.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3724.71,100,,,,,0,"fee schedule",EAPG,3000,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3000,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",3000,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3799.2,100,,,,,0,"fee schedule",EAPG,4842.12,100,,,,,0,"fee schedule",EAPG,3000,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1131,37.7,,904.80,,,0,"percent of total billed charges","37.70% of total billed charges",3000,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3000,100,,,,,0,"fee schedule","100% of CMS fee schedule",2340,78,,1872.00,,,0,"percent of total billed charges","78% of total billed charges",3000,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2478,82.6,,1982.40,,,0,"percent of total billed charges","82.6% of total billed charges",3724.71,100,,,,,0,"fee schedule",EAPG,3000,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2478,82.6,,1982.40,,,0,"percent of total billed charges","82.6% of total billed charges",3000,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3885.24,100,,,,,0,"fee schedule",EAPG,3000,100,,2400.00,,,0,"percent of total billed charges","100% of total billed charges",459,17913.89,
"51865 Cystorrhaphy, suture of bladder wound, injur",7962855,CDM,521,RC,51865,CPT,OUTPATIENT,,,2555,1660.75,,2248.4,88,,1798.72,,,0,"percent of total billed charges","88% of total billed charges",2555,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3724.71,100,,,,,0,"fee schedule",EAPG,2555,100,,2044.00,,,0,"percent of total billed charges","100% of total billed charges",2555,175,,,,,0,"fee schedule","175% of CMS fee schedule",3836.45,100,,,,,0,"fee schedule",EAPG,2555,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1609.65,63,,1287.72,,,0,"percent of total billed charges","63% of total billed charges",390.92,15.3,,312.74,,,0,"percent of total billed charges","15.3% of total billed charges",3724.71,100,,,,,0,"fee schedule",EAPG,1762.95,69,,,,,0,"fee schedule","69% of total billed charges",2555,100,,2044.00,,,0,"percent of total billed charges","100% of total billed charges",2555,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2555,100,,2044.00,,,0,"percent of total billed charges","100% of total billed charges",2555,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2555,100,,2044.00,,,0,"percent of total billed charges","100% of total billed charges",2555,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2555,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3724.71,100,,,,,0,"fee schedule",EAPG,2555,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2555,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2555,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3799.2,100,,,,,0,"fee schedule",EAPG,4842.12,100,,,,,0,"fee schedule",EAPG,2555,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",963.24,37.7,,770.59,,,0,"percent of total billed charges","37.70% of total billed charges",2555,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2555,100,,,,,0,"fee schedule","100% of CMS fee schedule",1992.9,78,,1594.32,,,0,"percent of total billed charges","78% of total billed charges",2555,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2110.43,82.6,,1688.34,,,0,"percent of total billed charges","82.6% of total billed charges",3724.71,100,,,,,0,"fee schedule","100% of WA fee schedule",2555,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2110.43,82.6,,1688.34,,,0,"percent of total billed charges","82.6% of total billed charges",2555,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3885.24,100,,,,,0,"fee schedule",EAPG,2555,100,,2044.00,,,0,"percent of total billed charges","100% of total billed charges",390.92,4842.12,
"51860 Cystorrhaphy, suture of bladder wound, injur",7963005,CDM,521,RC,51860,CPT,OUTPATIENT,,,1135,737.75,,998.8,88,,799.04,,,0,"percent of total billed charges","88% of total billed charges",9396.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3724.71,100,,,,,0,"fee schedule",EAPG,1135,100,,908.00,,,0,"percent of total billed charges","100% of total billed charges",16443.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",3836.45,100,,,,,0,"fee schedule",EAPG,9396.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",715.05,63,,572.04,,,0,"percent of total billed charges","63% of total billed charges",173.66,15.3,,138.93,,,0,"percent of total billed charges","15.3% of total billed charges",3724.71,100,,,,,0,"fee schedule",EAPG,783.15,69,,,,,0,"fee schedule","69% of total billed charges",1135,100,,908.00,,,0,"percent of total billed charges","100% of total billed charges",9396.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1135,100,,908.00,,,0,"percent of total billed charges","100% of total billed charges",9396.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1135,100,,908.00,,,0,"percent of total billed charges","100% of total billed charges",9396.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",17931.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3724.71,100,,,,,0,"fee schedule",EAPG,9396.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4687.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",9396.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3799.2,100,,,,,0,"fee schedule",EAPG,4842.12,100,,,,,0,"fee schedule",EAPG,9396.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",427.9,37.7,,342.32,,,0,"percent of total billed charges","37.70% of total billed charges",9396.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",9396.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",885.3,78,,708.24,,,0,"percent of total billed charges","78% of total billed charges",9490.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",937.51,82.6,,750.01,,,0,"percent of total billed charges","82.6% of total billed charges",3724.71,100,,,,,0,"fee schedule",EAPG,9396.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",937.51,82.6,,750.01,,,0,"percent of total billed charges","82.6% of total billed charges",9396.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3885.24,100,,,,,0,"fee schedule",EAPG,1135,100,,908.00,,,0,"percent of total billed charges","100% of total billed charges",173.66,17931.6,
"51992 Laparoscopy, surgical; sling operation for s",7961955,CDM,521,RC,51992,CPT,OUTPATIENT,,,1846,1199.9,,1624.48,88,,1299.58,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2646.75,100,,,,,0,"fee schedule",EAPG,1846,100,,1476.80,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",2726.15,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1162.98,63,,930.38,,,0,"percent of total billed charges","63% of total billed charges",282.44,15.3,,225.95,,,0,"percent of total billed charges","15.3% of total billed charges",2646.75,100,,,,,0,"fee schedule",EAPG,1273.74,69,,,,,0,"fee schedule","69% of total billed charges",1846,100,,1476.80,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1846,100,,1476.80,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1846,100,,1476.80,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2646.75,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2699.68,100,,,,,0,"fee schedule",EAPG,3440.77,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",695.94,37.7,,556.75,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1439.88,78,,1151.90,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1524.8,82.6,,1219.84,,,0,"percent of total billed charges","82.6% of total billed charges",2646.75,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1524.8,82.6,,1219.84,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2807.28,100,,,,,0,"fee schedule",EAPG,1846,100,,1476.80,,,0,"percent of total billed charges","100% of total billed charges",282.44,20558.19,
"52000 Endoscopy-Cystoscopy, urethroscopy, cystoure",7904658,CDM,521,RC,52000,CPT,OUTPATIENT,,,529,343.85,,465.52,88,,372.42,,,0,"percent of total billed charges","88% of total billed charges",696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1405.94,100,,,,,0,"fee schedule",EAPG,529,100,,423.20,,,0,"percent of total billed charges","100% of total billed charges",1219.29,175,,,,,0,"fee schedule","175% of CMS fee schedule",1448.12,100,,,,,0,"fee schedule",EAPG,696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",333.27,63,,266.62,,,0,"percent of total billed charges","63% of total billed charges",80.94,15.3,,64.75,,,0,"percent of total billed charges","15.3% of total billed charges",1405.94,100,,,,,0,"fee schedule",EAPG,365.01,69,,,,,0,"fee schedule","69% of total billed charges",529,100,,423.20,,,0,"percent of total billed charges","100% of total billed charges",696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",529,100,,423.20,,,0,"percent of total billed charges","100% of total billed charges",696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",529,100,,423.20,,,0,"percent of total billed charges","100% of total billed charges",696.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",2335.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1405.94,100,,,,,0,"fee schedule",EAPG,696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",610.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1434.06,100,,,,,0,"fee schedule",EAPG,1827.72,100,,,,,0,"fee schedule",EAPG,696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",199.43,37.7,,159.54,,,0,"percent of total billed charges","37.70% of total billed charges",696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.62,78,,330.10,,,0,"percent of total billed charges","78% of total billed charges",703.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",436.95,82.6,,349.56,,,0,"percent of total billed charges","82.6% of total billed charges",1405.94,100,,,,,0,"fee schedule",EAPG,696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",436.95,82.6,,349.56,,,0,"percent of total billed charges","82.6% of total billed charges",696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1566.47,100,,,,,0,"fee schedule",EAPG,529,100,,423.20,,,0,"percent of total billed charges","100% of total billed charges",80.94,2335.01,
"52204 Cystourethroscopy w/biopsy",8165585,CDM,521,RC,52204,CPT,OUTPATIENT,,,2407,1564.55,,2118.16,88,,1694.53,,,0,"percent of total billed charges","88% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1405.94,100,,,,,0,"fee schedule",EAPG,2407,100,,1925.60,,,0,"percent of total billed charges","100% of total billed charges",3635.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",1448.12,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1516.41,63,,1213.13,,,0,"percent of total billed charges","63% of total billed charges",368.27,15.3,,294.62,,,0,"percent of total billed charges","15.3% of total billed charges",1405.94,100,,,,,0,"fee schedule",EAPG,1660.83,69,,,,,0,"fee schedule","69% of total billed charges",2407,100,,1925.60,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2407,100,,1925.60,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2407,100,,1925.60,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",7284.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1405.94,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1904.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1434.06,100,,,,,0,"fee schedule",EAPG,1827.72,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",907.44,37.7,,725.95,,,0,"percent of total billed charges","37.70% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1877.46,78,,1501.97,,,0,"percent of total billed charges","78% of total billed charges",2098.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1988.18,82.6,,1590.54,,,0,"percent of total billed charges","82.6% of total billed charges",1405.94,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1988.18,82.6,,1590.54,,,0,"percent of total billed charges","82.6% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1566.47,100,,,,,0,"fee schedule",EAPG,2407,100,,1925.60,,,0,"percent of total billed charges","100% of total billed charges",368.27,7284.07,
"52214  Cystourethroscopy w/ Fluguratio",8165587,CDM,521,RC,52214,CPT,OUTPATIENT,,,4428,2878.2,,3896.64,88,,3117.31,,,0,"percent of total billed charges","88% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1405.94,100,,,,,0,"fee schedule",EAPG,4428,100,,3542.40,,,0,"percent of total billed charges","100% of total billed charges",6222.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",1448.12,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2789.64,63,,2231.71,,,0,"percent of total billed charges","63% of total billed charges",677.48,15.3,,541.98,,,0,"percent of total billed charges","15.3% of total billed charges",1405.94,100,,,,,0,"fee schedule",EAPG,3055.32,69,,,,,0,"fee schedule","69% of total billed charges",4428,100,,3542.40,,,0,"percent of total billed charges","100% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4428,100,,3542.40,,,0,"percent of total billed charges","100% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4428,100,,3542.40,,,0,"percent of total billed charges","100% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",12497.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1405.94,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3267.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1434.06,100,,,,,0,"fee schedule",EAPG,1827.72,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1669.36,37.7,,1335.49,,,0,"percent of total billed charges","37.70% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3453.84,78,,2763.07,,,0,"percent of total billed charges","78% of total billed charges",3591.3,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3657.53,82.6,,2926.02,,,0,"percent of total billed charges","82.6% of total billed charges",1405.94,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3657.53,82.6,,2926.02,,,0,"percent of total billed charges","82.6% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1566.47,100,,,,,0,"fee schedule",EAPG,4428,100,,3542.40,,,0,"percent of total billed charges","100% of total billed charges",677.48,12497.73,
"52235 Cysto W/fulgurat med bladtumor",8165589,CDM,521,RC,52235,CPT,OUTPATIENT,,,1941,1261.65,,1708.08,88,,1366.46,,,0,"percent of total billed charges","88% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1405.94,100,,,,,0,"fee schedule",EAPG,1941,100,,1552.80,,,0,"percent of total billed charges","100% of total billed charges",6222.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",1448.12,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1222.83,63,,978.26,,,0,"percent of total billed charges","63% of total billed charges",296.97,15.3,,237.58,,,0,"percent of total billed charges","15.3% of total billed charges",1405.94,100,,,,,0,"fee schedule",EAPG,1339.29,69,,,,,0,"fee schedule","69% of total billed charges",1941,100,,1552.80,,,0,"percent of total billed charges","100% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1941,100,,1552.80,,,0,"percent of total billed charges","100% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1941,100,,1552.80,,,0,"percent of total billed charges","100% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",12497.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1405.94,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3267.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1434.06,100,,,,,0,"fee schedule",EAPG,1827.72,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",731.76,37.7,,585.41,,,0,"percent of total billed charges","37.70% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1513.98,78,,1211.18,,,0,"percent of total billed charges","78% of total billed charges",3591.3,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.27,82.6,,1282.62,,,0,"percent of total billed charges","82.6% of total billed charges",1405.94,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1603.27,82.6,,1282.62,,,0,"percent of total billed charges","82.6% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1566.47,100,,,,,0,"fee schedule",EAPG,1941,100,,1552.80,,,0,"percent of total billed charges","100% of total billed charges",296.97,12497.73,
"52281 Cysto w/dilate urethral",8165591,CDM,521,RC,52281,CPT,OUTPATIENT,,,1914,1244.1,,1684.32,88,,1347.46,,,0,"percent of total billed charges","88% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1405.94,100,,,,,0,"fee schedule",EAPG,1914,100,,1531.20,,,0,"percent of total billed charges","100% of total billed charges",3635.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",1448.12,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1205.82,63,,964.66,,,0,"percent of total billed charges","63% of total billed charges",292.84,15.3,,234.27,,,0,"percent of total billed charges","15.3% of total billed charges",1405.94,100,,,,,0,"fee schedule",EAPG,1320.66,69,,,,,0,"fee schedule","69% of total billed charges",1914,100,,1531.20,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1914,100,,1531.20,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1914,100,,1531.20,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",7284.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1405.94,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1904.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1434.06,100,,,,,0,"fee schedule",EAPG,1827.72,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",721.58,37.7,,577.26,,,0,"percent of total billed charges","37.70% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1492.92,78,,1194.34,,,0,"percent of total billed charges","78% of total billed charges",2098.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1580.96,82.6,,1264.77,,,0,"percent of total billed charges","82.6% of total billed charges",1405.94,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1580.96,82.6,,1264.77,,,0,"percent of total billed charges","82.6% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1566.47,100,,,,,0,"fee schedule",EAPG,1914,100,,1531.20,,,0,"percent of total billed charges","100% of total billed charges",292.84,7284.07,
"52356 Lithotripsy w/insert stent",8165592,CDM,521,RC,52356,CPT,OUTPATIENT,,,2657,1727.05,,2338.16,88,,1870.53,,,0,"percent of total billed charges","88% of total billed charges",5277.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3724.71,100,,,,,0,"fee schedule",EAPG,2657,100,,2125.60,,,0,"percent of total billed charges","100% of total billed charges",9235.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",3836.45,100,,,,,0,"fee schedule",EAPG,5277.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1673.91,63,,1339.13,,,0,"percent of total billed charges","63% of total billed charges",406.52,15.3,,325.22,,,0,"percent of total billed charges","15.3% of total billed charges",3724.71,100,,,,,0,"fee schedule",EAPG,1833.33,69,,,,,0,"fee schedule","69% of total billed charges",2657,100,,2125.60,,,0,"percent of total billed charges","100% of total billed charges",5277.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2657,100,,2125.60,,,0,"percent of total billed charges","100% of total billed charges",5277.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2657,100,,2125.60,,,0,"percent of total billed charges","100% of total billed charges",5277.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",17931.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3724.71,100,,,,,0,"fee schedule",EAPG,5277.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4687.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5277.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3799.2,100,,,,,0,"fee schedule",EAPG,4842.12,100,,,,,0,"fee schedule",EAPG,5277.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1001.69,37.7,,801.35,,,0,"percent of total billed charges","37.70% of total billed charges",5277.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5277.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2072.46,78,,1657.97,,,0,"percent of total billed charges","78% of total billed charges",5330.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2194.68,82.6,,1755.74,,,0,"percent of total billed charges","82.6% of total billed charges",3724.71,100,,,,,0,"fee schedule",EAPG,5277.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2194.68,82.6,,1755.74,,,0,"percent of total billed charges","82.6% of total billed charges",5277.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3885.24,100,,,,,0,"fee schedule",EAPG,2657,100,,2125.60,,,0,"percent of total billed charges","100% of total billed charges",406.52,17931.6,
"53000 Urethrotomy or urethrostomy, external (separ",7962566,CDM,521,RC,53000,CPT,OUTPATIENT,,,809,525.85,,711.92,88,,569.54,,,0,"percent of total billed charges","88% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2646.75,100,,,,,0,"fee schedule",EAPG,809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",3635.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",2726.15,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509.67,63,,407.74,,,0,"percent of total billed charges","63% of total billed charges",123.78,15.3,,99.02,,,0,"percent of total billed charges","15.3% of total billed charges",2646.75,100,,,,,0,"fee schedule",EAPG,558.21,69,,,,,0,"fee schedule","69% of total billed charges",809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",7284.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2646.75,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1904.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2699.68,100,,,,,0,"fee schedule",EAPG,3440.77,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",304.99,37.7,,243.99,,,0,"percent of total billed charges","37.70% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",631.02,78,,504.82,,,0,"percent of total billed charges","78% of total billed charges",2098.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",668.23,82.6,,534.58,,,0,"percent of total billed charges","82.6% of total billed charges",2646.75,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",668.23,82.6,,534.58,,,0,"percent of total billed charges","82.6% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2807.28,100,,,,,0,"fee schedule",EAPG,809,100,,647.20,,,0,"percent of total billed charges","100% of total billed charges",123.78,7284.07,
"53270 Excision or fulguration; Skene's glands",7963611,CDM,521,RC,53270,CPT,OUTPATIENT,,,506,328.9,,445.28,88,,356.22,,,0,"percent of total billed charges","88% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2646.75,100,,,,,0,"fee schedule",EAPG,506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",6222.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",2726.15,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",318.78,63,,255.02,,,0,"percent of total billed charges","63% of total billed charges",77.42,15.3,,61.94,,,0,"percent of total billed charges","15.3% of total billed charges",2646.75,100,,,,,0,"fee schedule",EAPG,349.14,69,,,,,0,"fee schedule","69% of total billed charges",506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",12497.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2646.75,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3267.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2699.68,100,,,,,0,"fee schedule",EAPG,3440.77,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",190.76,37.7,,152.61,,,0,"percent of total billed charges","37.70% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394.68,78,,315.74,,,0,"percent of total billed charges","78% of total billed charges",3591.3,100,,,,,0,"fee schedule","100% of CMS OPPS rate",417.96,82.6,,334.37,,,0,"percent of total billed charges","82.6% of total billed charges",2646.75,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",417.96,82.6,,334.37,,,0,"percent of total billed charges","82.6% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2807.28,100,,,,,0,"fee schedule",EAPG,506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",77.42,12497.73,
"53855 Insertion of a temporary prostatic urethral",7962395,CDM,521,RC,53855,CPT,OUTPATIENT,,,185,120.25,,162.8,88,,130.24,,,0,"percent of total billed charges","88% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2646.75,100,,,,,0,"fee schedule",EAPG,185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",3635.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",2726.15,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",116.55,63,,93.24,,,0,"percent of total billed charges","63% of total billed charges",28.31,15.3,,22.65,,,0,"percent of total billed charges","15.3% of total billed charges",2646.75,100,,,,,0,"fee schedule",EAPG,127.65,69,,,,,0,"fee schedule","69% of total billed charges",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",7284.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2646.75,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1904.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2699.68,100,,,,,0,"fee schedule",EAPG,3440.77,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",69.75,37.7,,55.80,,,0,"percent of total billed charges","37.70% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",144.3,78,,115.44,,,0,"percent of total billed charges","78% of total billed charges",2098.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",152.81,82.6,,122.25,,,0,"percent of total billed charges","82.6% of total billed charges",2646.75,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",152.81,82.6,,122.25,,,0,"percent of total billed charges","82.6% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2807.28,100,,,,,0,"fee schedule",EAPG,185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",28.31,7284.07,
"54055 Destruction of lesion(s), penis (eg, condylo",7904694,CDM,521,RC,54055,CPT,OUTPATIENT,,,352,228.8,,309.76,88,,247.81,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1768.95,100,,,,,0,"fee schedule",EAPG,352,100,,281.60,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1822.02,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",221.76,63,,177.41,,,0,"percent of total billed charges","63% of total billed charges",53.86,15.3,,43.09,,,0,"percent of total billed charges","15.3% of total billed charges",1768.95,100,,,,,0,"fee schedule",EAPG,242.88,69,,,,,0,"fee schedule","69% of total billed charges",352,100,,281.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352,100,,281.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352,100,,281.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1768.95,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1804.33,100,,,,,0,"fee schedule",EAPG,2299.64,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",132.7,37.7,,106.16,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",274.56,78,,219.65,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.75,82.6,,232.60,,,0,"percent of total billed charges","82.6% of total billed charges",1768.95,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.75,82.6,,232.60,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1929.48,100,,,,,0,"fee schedule",EAPG,352,100,,281.60,,,0,"percent of total billed charges","100% of total billed charges",53.86,6968.7,
"54056 Destruction of lesion(s), penis (eg, condylo",7904695,CDM,521,RC,54056,CPT,OUTPATIENT,,,255,165.75,,224.4,88,,179.52,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.36,100,,,,,0,"fee schedule",EAPG,255,100,,204.00,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",352.63,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.65,63,,128.52,,,0,"percent of total billed charges","63% of total billed charges",39.02,15.3,,31.22,,,0,"percent of total billed charges","15.3% of total billed charges",342.36,100,,,,,0,"fee schedule",EAPG,175.95,69,,,,,0,"fee schedule","69% of total billed charges",255,100,,204.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255,100,,204.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255,100,,204.00,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.36,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",349.21,100,,,,,0,"fee schedule",EAPG,445.07,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",96.14,37.7,,76.91,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",198.9,78,,159.12,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.63,82.6,,168.50,,,0,"percent of total billed charges","82.6% of total billed charges",342.36,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.63,82.6,,168.50,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",502.89,100,,,,,0,"fee schedule",EAPG,255,100,,204.00,,,0,"percent of total billed charges","100% of total billed charges",39.02,729.42,
"54050 Destruction of lesion(s), penis, simple; che",7963388,CDM,521,RC,54050,CPT,OUTPATIENT,,,233,151.45,,205.04,88,,164.03,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.36,100,,,,,0,"fee schedule",EAPG,233,100,,186.40,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",352.63,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",146.79,63,,117.43,,,0,"percent of total billed charges","63% of total billed charges",35.65,15.3,,28.52,,,0,"percent of total billed charges","15.3% of total billed charges",342.36,100,,,,,0,"fee schedule",EAPG,160.77,69,,,,,0,"fee schedule","69% of total billed charges",233,100,,186.40,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",233,100,,186.40,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",233,100,,186.40,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.36,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",349.21,100,,,,,0,"fee schedule",EAPG,445.07,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",87.84,37.7,,70.27,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",181.74,78,,145.39,,,0,"percent of total billed charges","78% of total billed charges",410.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",192.46,82.6,,153.97,,,0,"percent of total billed charges","82.6% of total billed charges",342.36,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",192.46,82.6,,153.97,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",502.89,100,,,,,0,"fee schedule",EAPG,233,100,,186.40,,,0,"percent of total billed charges","100% of total billed charges",35.65,1404.98,
"54060 Destruction of lesion(s), penis, simple; sur",7963179,CDM,521,RC,54060,CPT,OUTPATIENT,,,538,349.7,,473.44,88,,378.75,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1768.95,100,,,,,0,"fee schedule",EAPG,538,100,,430.40,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1822.02,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.94,63,,271.15,,,0,"percent of total billed charges","63% of total billed charges",82.31,15.3,,65.85,,,0,"percent of total billed charges","15.3% of total billed charges",1768.95,100,,,,,0,"fee schedule",EAPG,371.22,69,,,,,0,"fee schedule","69% of total billed charges",538,100,,430.40,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",538,100,,430.40,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",538,100,,430.40,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1768.95,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1804.33,100,,,,,0,"fee schedule",EAPG,2299.64,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",202.83,37.7,,162.26,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",419.64,78,,335.71,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",444.39,82.6,,355.51,,,0,"percent of total billed charges","82.6% of total billed charges",1768.95,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",444.39,82.6,,355.51,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1929.48,100,,,,,0,"fee schedule",EAPG,538,100,,430.40,,,0,"percent of total billed charges","100% of total billed charges",82.31,6968.7,
"54065 Destruction of lesion(s), penis, extensive;",7963257,CDM,521,RC,54065,CPT,OUTPATIENT,,,786,510.9,,691.68,88,,553.34,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1768.95,100,,,,,0,"fee schedule",EAPG,786,100,,628.80,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1822.02,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",495.18,63,,396.14,,,0,"percent of total billed charges","63% of total billed charges",120.26,15.3,,96.21,,,0,"percent of total billed charges","15.3% of total billed charges",1768.95,100,,,,,0,"fee schedule",EAPG,542.34,69,,,,,0,"fee schedule","69% of total billed charges",786,100,,628.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786,100,,628.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786,100,,628.80,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1768.95,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1804.33,100,,,,,0,"fee schedule",EAPG,2299.64,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",296.32,37.7,,237.06,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",613.08,78,,490.46,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",649.24,82.6,,519.39,,,0,"percent of total billed charges","82.6% of total billed charges",1768.95,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",649.24,82.6,,519.39,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1929.48,100,,,,,0,"fee schedule",EAPG,786,100,,628.80,,,0,"percent of total billed charges","100% of total billed charges",120.26,6968.7,
"54150 Excision procedures on the penis",7904696,CDM,521,RC,54150,CPT,OUTPATIENT,,,342,222.3,,300.96,88,,240.77,,,0,"percent of total billed charges","88% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1768.95,100,,,,,0,"fee schedule",EAPG,342,100,,273.60,,,0,"percent of total billed charges","100% of total billed charges",3635.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",1822.02,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",215.46,63,,172.37,,,0,"percent of total billed charges","63% of total billed charges",52.33,15.3,,41.86,,,0,"percent of total billed charges","15.3% of total billed charges",1768.95,100,,,,,0,"fee schedule",EAPG,235.98,69,,,,,0,"fee schedule","69% of total billed charges",342,100,,273.60,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342,100,,273.60,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342,100,,273.60,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",7284.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1768.95,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1904.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1804.33,100,,,,,0,"fee schedule",EAPG,2299.64,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",128.93,37.7,,103.14,,,0,"percent of total billed charges","37.70% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",266.76,78,,213.41,,,0,"percent of total billed charges","78% of total billed charges",2098.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",282.49,82.6,,225.99,,,0,"percent of total billed charges","82.6% of total billed charges",1768.95,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",282.49,82.6,,225.99,,,0,"percent of total billed charges","82.6% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1929.48,100,,,,,0,"fee schedule",EAPG,342,100,,273.60,,,0,"percent of total billed charges","100% of total billed charges",52.33,7284.07,
"54160 Circumcision, surgical excision other than c",7962207,CDM,521,RC,54160,CPT,OUTPATIENT,,,428,278.2,,376.64,88,,301.31,,,0,"percent of total billed charges","88% of total billed charges",696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1768.95,100,,,,,0,"fee schedule",EAPG,428,100,,342.40,,,0,"percent of total billed charges","100% of total billed charges",1219.29,175,,,,,0,"fee schedule","175% of CMS fee schedule",1822.02,100,,,,,0,"fee schedule",EAPG,696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",269.64,63,,215.71,,,0,"percent of total billed charges","63% of total billed charges",65.48,15.3,,52.38,,,0,"percent of total billed charges","15.3% of total billed charges",1768.95,100,,,,,0,"fee schedule",EAPG,295.32,69,,,,,0,"fee schedule","69% of total billed charges",428,100,,342.40,,,0,"percent of total billed charges","100% of total billed charges",696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",428,100,,342.40,,,0,"percent of total billed charges","100% of total billed charges",696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",428,100,,342.40,,,0,"percent of total billed charges","100% of total billed charges",696.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",2335.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1768.95,100,,,,,0,"fee schedule",EAPG,696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",610.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1804.33,100,,,,,0,"fee schedule",EAPG,2299.64,100,,,,,0,"fee schedule",EAPG,696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",161.36,37.7,,129.09,,,0,"percent of total billed charges","37.70% of total billed charges",696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",333.84,78,,267.07,,,0,"percent of total billed charges","78% of total billed charges",703.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",353.53,82.6,,282.82,,,0,"percent of total billed charges","82.6% of total billed charges",1768.95,100,,,,,0,"fee schedule",EAPG,696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",353.53,82.6,,282.82,,,0,"percent of total billed charges","82.6% of total billed charges",696.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1929.48,100,,,,,0,"fee schedule",EAPG,428,100,,342.40,,,0,"percent of total billed charges","100% of total billed charges",65.48,2335.01,
"54162 Lysis or excision of penile post-circumcisio",7963258,CDM,521,RC,54162,CPT,OUTPATIENT,,,620,403,,545.6,88,,436.48,,,0,"percent of total billed charges","88% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1768.95,100,,,,,0,"fee schedule",EAPG,620,100,,496.00,,,0,"percent of total billed charges","100% of total billed charges",3635.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",1822.02,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390.6,63,,312.48,,,0,"percent of total billed charges","63% of total billed charges",94.86,15.3,,75.89,,,0,"percent of total billed charges","15.3% of total billed charges",1768.95,100,,,,,0,"fee schedule",EAPG,427.8,69,,,,,0,"fee schedule","69% of total billed charges",620,100,,496.00,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",620,100,,496.00,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",620,100,,496.00,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",7284.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1768.95,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1904.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1804.33,100,,,,,0,"fee schedule",EAPG,2299.64,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",233.74,37.7,,186.99,,,0,"percent of total billed charges","37.70% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",483.6,78,,386.88,,,0,"percent of total billed charges","78% of total billed charges",2098.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.12,82.6,,409.70,,,0,"percent of total billed charges","82.6% of total billed charges",1768.95,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.12,82.6,,409.70,,,0,"percent of total billed charges","82.6% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1929.48,100,,,,,0,"fee schedule",EAPG,620,100,,496.00,,,0,"percent of total billed charges","100% of total billed charges",94.86,7284.07,
"54163 Repair incomplete circumcision",7963738,CDM,521,RC,54163,CPT,OUTPATIENT,,,785,510.25,,690.8,88,,552.64,,,0,"percent of total billed charges","88% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1768.95,100,,,,,0,"fee schedule",EAPG,785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",3635.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",1822.02,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",494.55,63,,395.64,,,0,"percent of total billed charges","63% of total billed charges",120.11,15.3,,96.09,,,0,"percent of total billed charges","15.3% of total billed charges",1768.95,100,,,,,0,"fee schedule",EAPG,541.65,69,,,,,0,"fee schedule","69% of total billed charges",785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",7284.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1768.95,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1904.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1804.33,100,,,,,0,"fee schedule",EAPG,2299.64,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",295.95,37.7,,236.76,,,0,"percent of total billed charges","37.70% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",612.3,78,,489.84,,,0,"percent of total billed charges","78% of total billed charges",2098.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",648.41,82.6,,518.73,,,0,"percent of total billed charges","82.6% of total billed charges",1768.95,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",648.41,82.6,,518.73,,,0,"percent of total billed charges","82.6% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1929.48,100,,,,,0,"fee schedule",EAPG,785,100,,628.00,,,0,"percent of total billed charges","100% of total billed charges",120.11,7284.07,
"54161 Circumcision >28 days of age",8165593,CDM,521,RC,54161,CPT,OUTPATIENT,,,1139,740.35,,1002.32,88,,801.86,,,0,"percent of total billed charges","88% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1768.95,100,,,,,0,"fee schedule",EAPG,1139,100,,911.20,,,0,"percent of total billed charges","100% of total billed charges",3635.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",1822.02,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",717.57,63,,574.06,,,0,"percent of total billed charges","63% of total billed charges",174.27,15.3,,139.42,,,0,"percent of total billed charges","15.3% of total billed charges",1768.95,100,,,,,0,"fee schedule",EAPG,785.91,69,,,,,0,"fee schedule","69% of total billed charges",1139,100,,911.20,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1139,100,,911.20,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1139,100,,911.20,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",7284.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1768.95,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1904.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1804.33,100,,,,,0,"fee schedule",EAPG,2299.64,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",429.4,37.7,,343.52,,,0,"percent of total billed charges","37.70% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",888.42,78,,710.74,,,0,"percent of total billed charges","78% of total billed charges",2098.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",940.81,82.6,,752.65,,,0,"percent of total billed charges","82.6% of total billed charges",1768.95,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",940.81,82.6,,752.65,,,0,"percent of total billed charges","82.6% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1929.48,100,,,,,0,"fee schedule",EAPG,1139,100,,911.20,,,0,"percent of total billed charges","100% of total billed charges",174.27,7284.07,
"54450 Foreskin manipulation including lysis of pre",7962643,CDM,521,RC,54450,CPT,OUTPATIENT,,,202,131.3,,177.76,88,,142.21,,,0,"percent of total billed charges","88% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.36,100,,,,,0,"fee schedule",EAPG,202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",441.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",352.63,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",127.26,63,,101.81,,,0,"percent of total billed charges","63% of total billed charges",30.91,15.3,,24.73,,,0,"percent of total billed charges","15.3% of total billed charges",342.36,100,,,,,0,"fee schedule",EAPG,139.38,69,,,,,0,"fee schedule","69% of total billed charges",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1081.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.36,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",282.66,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",349.21,100,,,,,0,"fee schedule",EAPG,445.07,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",76.15,37.7,,60.92,,,0,"percent of total billed charges","37.70% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",157.56,78,,126.05,,,0,"percent of total billed charges","78% of total billed charges",254.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",166.85,82.6,,133.48,,,0,"percent of total billed charges","82.6% of total billed charges",342.36,100,,,,,0,"fee schedule",EAPG,252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",166.85,82.6,,133.48,,,0,"percent of total billed charges","82.6% of total billed charges",252.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",502.89,100,,,,,0,"fee schedule",EAPG,202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",30.91,1081.19,
"54530 Orchiectomy, radical, for tumor; inguinal ap",7963389,CDM,521,RC,54530,CPT,OUTPATIENT,,,2273,1477.45,,2000.24,88,,1600.19,,,0,"percent of total billed charges","88% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1768.95,100,,,,,0,"fee schedule",EAPG,2273,100,,1818.40,,,0,"percent of total billed charges","100% of total billed charges",6175.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",1822.02,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1431.99,63,,1145.59,,,0,"percent of total billed charges","63% of total billed charges",347.77,15.3,,278.22,,,0,"percent of total billed charges","15.3% of total billed charges",1768.95,100,,,,,0,"fee schedule",EAPG,1568.37,69,,,,,0,"fee schedule","69% of total billed charges",2273,100,,1818.40,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2273,100,,1818.40,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2273,100,,1818.40,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1768.95,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1804.33,100,,,,,0,"fee schedule",EAPG,2299.64,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",856.92,37.7,,685.54,,,0,"percent of total billed charges","37.70% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1772.94,78,,1418.35,,,0,"percent of total billed charges","78% of total billed charges",3564.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1877.5,82.6,,1502.00,,,0,"percent of total billed charges","82.6% of total billed charges",1768.95,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1877.5,82.6,,1502.00,,,0,"percent of total billed charges","82.6% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1929.48,100,,,,,0,"fee schedule",EAPG,2273,100,,1818.40,,,0,"percent of total billed charges","100% of total billed charges",347.77,12932.7,
"54640 Orchiopexy, inguinal approach, with or witho",7963119,CDM,521,RC,54640,CPT,OUTPATIENT,,,1421,923.65,,1250.48,88,,1000.38,,,0,"percent of total billed charges","88% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1855.02,100,,,,,0,"fee schedule",EAPG,1421,100,,1136.80,,,0,"percent of total billed charges","100% of total billed charges",6175.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",1910.67,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",895.23,63,,716.18,,,0,"percent of total billed charges","63% of total billed charges",217.41,15.3,,173.93,,,0,"percent of total billed charges","15.3% of total billed charges",1855.02,100,,,,,0,"fee schedule",EAPG,980.49,69,,,,,0,"fee schedule","69% of total billed charges",1421,100,,1136.80,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1421,100,,1136.80,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1421,100,,1136.80,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1855.02,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1892.12,100,,,,,0,"fee schedule",EAPG,2411.53,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",535.72,37.7,,428.58,,,0,"percent of total billed charges","37.70% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1108.38,78,,886.70,,,0,"percent of total billed charges","78% of total billed charges",3564.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1173.75,82.6,,939.00,,,0,"percent of total billed charges","82.6% of total billed charges",1855.02,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1173.75,82.6,,939.00,,,0,"percent of total billed charges","82.6% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2015.55,100,,,,,0,"fee schedule",EAPG,1421,100,,1136.80,,,0,"percent of total billed charges","100% of total billed charges",217.41,12932.7,
"54700 Incision procedures on the epididymis",7904699,CDM,521,RC,54700,CPT,OUTPATIENT,,,713,463.45,,627.44,88,,501.95,,,0,"percent of total billed charges","88% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1855.02,100,,,,,0,"fee schedule",EAPG,713,100,,570.40,,,0,"percent of total billed charges","100% of total billed charges",3635.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",1910.67,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.19,63,,359.35,,,0,"percent of total billed charges","63% of total billed charges",109.09,15.3,,87.27,,,0,"percent of total billed charges","15.3% of total billed charges",1855.02,100,,,,,0,"fee schedule",EAPG,491.97,69,,,,,0,"fee schedule","69% of total billed charges",713,100,,570.40,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",713,100,,570.40,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",713,100,,570.40,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",7284.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1855.02,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1904.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1892.12,100,,,,,0,"fee schedule",EAPG,2411.53,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",268.8,37.7,,215.04,,,0,"percent of total billed charges","37.70% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",556.14,78,,444.91,,,0,"percent of total billed charges","78% of total billed charges",2098.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",588.94,82.6,,471.15,,,0,"percent of total billed charges","82.6% of total billed charges",1855.02,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",588.94,82.6,,471.15,,,0,"percent of total billed charges","82.6% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2015.55,100,,,,,0,"fee schedule",EAPG,713,100,,570.40,,,0,"percent of total billed charges","100% of total billed charges",109.09,7284.07,
"55040 Excision of hydrocele; unilateral",7963709,CDM,521,RC,55040,CPT,OUTPATIENT,,,904,587.6,,795.52,88,,636.42,,,0,"percent of total billed charges","88% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1768.95,100,,,,,0,"fee schedule",EAPG,904,100,,723.20,,,0,"percent of total billed charges","100% of total billed charges",6175.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",1822.02,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",569.52,63,,455.62,,,0,"percent of total billed charges","63% of total billed charges",138.31,15.3,,110.65,,,0,"percent of total billed charges","15.3% of total billed charges",1768.95,100,,,,,0,"fee schedule",EAPG,623.76,69,,,,,0,"fee schedule","69% of total billed charges",904,100,,723.20,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",904,100,,723.20,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",904,100,,723.20,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1768.95,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1804.33,100,,,,,0,"fee schedule",EAPG,2299.64,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",340.81,37.7,,272.65,,,0,"percent of total billed charges","37.70% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",705.12,78,,564.10,,,0,"percent of total billed charges","78% of total billed charges",3564.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",746.7,82.6,,597.36,,,0,"percent of total billed charges","82.6% of total billed charges",1768.95,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",746.7,82.6,,597.36,,,0,"percent of total billed charges","82.6% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1929.48,100,,,,,0,"fee schedule",EAPG,904,100,,723.20,,,0,"percent of total billed charges","100% of total billed charges",138.31,12932.7,
"55060 Repair of tunica vaginalis hydrocele (Bottle",7963390,CDM,521,RC,55060,CPT,OUTPATIENT,,,1110,721.5,,976.8,88,,781.44,,,0,"percent of total billed charges","88% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1855.02,100,,,,,0,"fee schedule",EAPG,1110,100,,888.00,,,0,"percent of total billed charges","100% of total billed charges",6222.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",1910.67,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",699.3,63,,559.44,,,0,"percent of total billed charges","63% of total billed charges",169.83,15.3,,135.86,,,0,"percent of total billed charges","15.3% of total billed charges",1855.02,100,,,,,0,"fee schedule",EAPG,765.9,69,,,,,0,"fee schedule","69% of total billed charges",1110,100,,888.00,,,0,"percent of total billed charges","100% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1110,100,,888.00,,,0,"percent of total billed charges","100% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1110,100,,888.00,,,0,"percent of total billed charges","100% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",12497.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1855.02,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3267.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1892.12,100,,,,,0,"fee schedule",EAPG,2411.53,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",418.47,37.7,,334.78,,,0,"percent of total billed charges","37.70% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",865.8,78,,692.64,,,0,"percent of total billed charges","78% of total billed charges",3591.3,100,,,,,0,"fee schedule","100% of CMS OPPS rate",916.86,82.6,,733.49,,,0,"percent of total billed charges","82.6% of total billed charges",1855.02,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",916.86,82.6,,733.49,,,0,"percent of total billed charges","82.6% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2015.55,100,,,,,0,"fee schedule",EAPG,1110,100,,888.00,,,0,"percent of total billed charges","100% of total billed charges",169.83,12497.73,
"55250 Vasectomy",7904716,CDM,521,RC,55250,CPT,OUTPATIENT,,,904,587.6,,795.52,88,,636.42,,,0,"percent of total billed charges","88% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1855.02,100,,,,,0,"fee schedule",EAPG,904,100,,723.20,,,0,"percent of total billed charges","100% of total billed charges",3635.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",1910.67,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",569.52,63,,455.62,,,0,"percent of total billed charges","63% of total billed charges",138.31,15.3,,110.65,,,0,"percent of total billed charges","15.3% of total billed charges",1855.02,100,,,,,0,"fee schedule",EAPG,623.76,69,,,,,0,"fee schedule","69% of total billed charges",904,100,,723.20,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",904,100,,723.20,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",904,100,,723.20,,,0,"percent of total billed charges","100% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",7284.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1855.02,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1904.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1892.12,100,,,,,0,"fee schedule",EAPG,2411.53,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",340.81,37.7,,272.65,,,0,"percent of total billed charges","37.70% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",705.12,78,,564.10,,,0,"percent of total billed charges","78% of total billed charges",2098.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",746.7,82.6,,597.36,,,0,"percent of total billed charges","82.6% of total billed charges",1855.02,100,,,,,0,"fee schedule",EAPG,2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",746.7,82.6,,597.36,,,0,"percent of total billed charges","82.6% of total billed charges",2077.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2015.55,100,,,,,0,"fee schedule",EAPG,904,100,,723.20,,,0,"percent of total billed charges","100% of total billed charges",138.31,7284.07,
"55520 Excision of lesion of spermatic cord (separa",7963201,CDM,521,RC,55520,CPT,OUTPATIENT,,,1292,839.8,,1136.96,88,,909.57,,,0,"percent of total billed charges","88% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1855.02,100,,,,,0,"fee schedule",EAPG,1292,100,,1033.60,,,0,"percent of total billed charges","100% of total billed charges",6222.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",1910.67,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",813.96,63,,651.17,,,0,"percent of total billed charges","63% of total billed charges",197.68,15.3,,158.14,,,0,"percent of total billed charges","15.3% of total billed charges",1855.02,100,,,,,0,"fee schedule",EAPG,891.48,69,,,,,0,"fee schedule","69% of total billed charges",1292,100,,1033.60,,,0,"percent of total billed charges","100% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1292,100,,1033.60,,,0,"percent of total billed charges","100% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1292,100,,1033.60,,,0,"percent of total billed charges","100% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",12497.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1855.02,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3267.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1892.12,100,,,,,0,"fee schedule",EAPG,2411.53,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",487.08,37.7,,389.66,,,0,"percent of total billed charges","37.70% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1007.76,78,,806.21,,,0,"percent of total billed charges","78% of total billed charges",3591.3,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1067.19,82.6,,853.75,,,0,"percent of total billed charges","82.6% of total billed charges",1855.02,100,,,,,0,"fee schedule",EAPG,3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1067.19,82.6,,853.75,,,0,"percent of total billed charges","82.6% of total billed charges",3555.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2015.55,100,,,,,0,"fee schedule",EAPG,1292,100,,1033.60,,,0,"percent of total billed charges","100% of total billed charges",197.68,12497.73,
"55540 Excision of varicocele or ligation of sperma",7961956,CDM,521,RC,55540,CPT,OUTPATIENT,,,1461,949.65,,1285.68,88,,1028.54,,,0,"percent of total billed charges","88% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1768.95,100,,,,,0,"fee schedule",EAPG,1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",6175.27,175,,,,,0,"fee schedule","175% of CMS fee schedule",1822.02,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",920.43,63,,736.34,,,0,"percent of total billed charges","63% of total billed charges",223.53,15.3,,178.82,,,0,"percent of total billed charges","15.3% of total billed charges",1768.95,100,,,,,0,"fee schedule",EAPG,1008.09,69,,,,,0,"fee schedule","69% of total billed charges",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",12932.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1768.95,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1804.33,100,,,,,0,"fee schedule",EAPG,2299.64,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",550.8,37.7,,440.64,,,0,"percent of total billed charges","37.70% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1139.58,78,,911.66,,,0,"percent of total billed charges","78% of total billed charges",3564.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1206.79,82.6,,965.43,,,0,"percent of total billed charges","82.6% of total billed charges",1768.95,100,,,,,0,"fee schedule",EAPG,3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1206.79,82.6,,965.43,,,0,"percent of total billed charges","82.6% of total billed charges",3528.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1929.48,100,,,,,0,"fee schedule",EAPG,1461,100,,1168.80,,,0,"percent of total billed charges","100% of total billed charges",223.53,12932.7,
"55845 Prostatectomy, retropubic radical, with or w",7962258,CDM,521,RC,55845,CPT,OUTPATIENT,,,7469,4854.85,,6572.72,88,,5258.18,,,0,"percent of total billed charges","88% of total billed charges",7469,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3867.92,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7469,175,,,,,0,"fee schedule","175% of CMS fee schedule",3983.95,100,,,,,0,"fee schedule",EAPG,7469,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4705.47,63,,3764.38,,,0,"percent of total billed charges","63% of total billed charges",1142.76,15.3,,914.21,,,0,"percent of total billed charges","15.3% of total billed charges",3867.92,100,,,,,0,"fee schedule",EAPG,5153.61,69,,,,,0,"fee schedule","69% of total billed charges",7469,100,,5975.20,,,0,"percent of total billed charges","100% of total billed charges",7469,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7469,100,,5975.20,,,0,"percent of total billed charges","100% of total billed charges",7469,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7469,100,,5975.20,,,0,"percent of total billed charges","100% of total billed charges",7469,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7469,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3867.92,100,,,,,0,"fee schedule",EAPG,7469,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7469,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7469,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3945.27,100,,,,,0,"fee schedule",EAPG,5028.29,100,,,,,0,"fee schedule",EAPG,7469,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2815.81,37.7,,2252.65,,,0,"percent of total billed charges","37.70% of total billed charges",7469,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7469,100,,,,,0,"fee schedule","100% of CMS fee schedule",5825.82,78,,4660.66,,,0,"percent of total billed charges","78% of total billed charges",7469,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6169.39,82.6,,4935.51,,,0,"percent of total billed charges","82.6% of total billed charges",3867.92,100,,,,,0,"fee schedule","100% of WA fee schedule",7469,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6169.39,82.6,,4935.51,,,0,"percent of total billed charges","82.6% of total billed charges",7469,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4028.45,100,,,,,0,"fee schedule",EAPG,7469,100,,5975.20,,,0,"percent of total billed charges","100% of total billed charges",1142.76,7469,
"55866 Laparaoscopy, surgical prostatectomy, retro",7962190,CDM,521,RC,55866,CPT,OUTPATIENT,,,1250,812.5,,1100,88,,880.00,,,0,"percent of total billed charges","88% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3867.92,100,,,,,0,"fee schedule",EAPG,1250,100,,1000.00,,,0,"percent of total billed charges","100% of total billed charges",18373.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",3983.95,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",787.5,63,,630.00,,,0,"percent of total billed charges","63% of total billed charges",191.25,15.3,,153.00,,,0,"percent of total billed charges","15.3% of total billed charges",3867.92,100,,,,,0,"fee schedule",EAPG,862.5,69,,,,,0,"fee schedule","69% of total billed charges",1250,100,,1000.00,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1250,100,,1000.00,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1250,100,,1000.00,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",36187.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3867.92,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9460.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3945.27,100,,,,,0,"fee schedule",EAPG,5028.29,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",471.25,37.7,,377.00,,,0,"percent of total billed charges","37.70% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",975,78,,780.00,,,0,"percent of total billed charges","78% of total billed charges",10604.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1032.5,82.6,,826.00,,,0,"percent of total billed charges","82.6% of total billed charges",3867.92,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1032.5,82.6,,826.00,,,0,"percent of total billed charges","82.6% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4028.45,100,,,,,0,"fee schedule",EAPG,1250,100,,1000.00,,,0,"percent of total billed charges","100% of total billed charges",191.25,36187.64,
"56405 Incision procedures on the vulva, perineum a",7904700,CDM,521,RC,56405,CPT,OUTPATIENT,,,401,260.65,,352.88,88,,282.30,,,0,"percent of total billed charges","88% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.73,100,,,,,0,"fee schedule",EAPG,401,100,,320.80,,,0,"percent of total billed charges","100% of total billed charges",572.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",183.06,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.63,63,,202.10,,,0,"percent of total billed charges","63% of total billed charges",61.35,15.3,,49.08,,,0,"percent of total billed charges","15.3% of total billed charges",177.73,100,,,,,0,"fee schedule",EAPG,276.69,69,,,,,0,"fee schedule","69% of total billed charges",401,100,,320.80,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401,100,,320.80,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401,100,,320.80,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",1143.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.73,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",181.28,100,,,,,0,"fee schedule",EAPG,231.05,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",151.18,37.7,,120.94,,,0,"percent of total billed charges","37.70% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",312.78,78,,250.22,,,0,"percent of total billed charges","78% of total billed charges",330.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",331.23,82.6,,264.98,,,0,"percent of total billed charges","82.6% of total billed charges",177.73,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",331.23,82.6,,264.98,,,0,"percent of total billed charges","82.6% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.26,100,,,,,0,"fee schedule",EAPG,401,100,,320.80,,,0,"percent of total billed charges","100% of total billed charges",61.35,1143.51,
"56420 Incision procedures on the vulva, perineum a",7904701,CDM,521,RC,56420,CPT,OUTPATIENT,,,372,241.8,,327.36,88,,261.89,,,0,"percent of total billed charges","88% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.73,100,,,,,0,"fee schedule",EAPG,372,100,,297.60,,,0,"percent of total billed charges","100% of total billed charges",355.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",183.06,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.36,63,,187.49,,,0,"percent of total billed charges","63% of total billed charges",56.92,15.3,,45.54,,,0,"percent of total billed charges","15.3% of total billed charges",177.73,100,,,,,0,"fee schedule",EAPG,256.68,69,,,,,0,"fee schedule","69% of total billed charges",372,100,,297.60,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",372,100,,297.60,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",372,100,,297.60,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",691.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.73,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",181.28,100,,,,,0,"fee schedule",EAPG,231.05,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",140.24,37.7,,112.19,,,0,"percent of total billed charges","37.70% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.16,78,,232.13,,,0,"percent of total billed charges","78% of total billed charges",205.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.27,82.6,,245.82,,,0,"percent of total billed charges","82.6% of total billed charges",177.73,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307.27,82.6,,245.82,,,0,"percent of total billed charges","82.6% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.26,100,,,,,0,"fee schedule",EAPG,372,100,,297.60,,,0,"percent of total billed charges","100% of total billed charges",56.92,691.92,
"56440 Marsupialization of Bartholin's gland cyst",7963548,CDM,521,RC,56440,CPT,OUTPATIENT,,,637,414.05,,560.56,88,,448.45,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.23,100,,,,,0,"fee schedule",EAPG,637,100,,509.60,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",2259.02,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.31,63,,321.05,,,0,"percent of total billed charges","63% of total billed charges",97.46,15.3,,77.97,,,0,"percent of total billed charges","15.3% of total billed charges",2193.23,100,,,,,0,"fee schedule",EAPG,439.53,69,,,,,0,"fee schedule","69% of total billed charges",637,100,,509.60,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",637,100,,509.60,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",637,100,,509.60,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.23,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2237.09,100,,,,,0,"fee schedule",EAPG,2851.2,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.15,37.7,,192.12,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",496.86,78,,397.49,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",526.16,82.6,,420.93,,,0,"percent of total billed charges","82.6% of total billed charges",2193.23,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",526.16,82.6,,420.93,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2353.76,100,,,,,0,"fee schedule",EAPG,637,100,,509.60,,,0,"percent of total billed charges","100% of total billed charges",97.46,10656.86,
"56441 Lysis of labial adhesions",7963847,CDM,521,RC,56441,CPT,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.23,100,,,,,0,"fee schedule",EAPG,361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",2259.02,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",2193.23,100,,,,,0,"fee schedule",EAPG,249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.23,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2237.09,100,,,,,0,"fee schedule",EAPG,2851.2,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",2193.23,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2353.76,100,,,,,0,"fee schedule",EAPG,361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,10656.86,
"56501 Destruction of lesion(s), vulva",7904702,CDM,521,RC,56501,CPT,OUTPATIENT,,,307,199.55,,270.16,88,,216.13,,,0,"percent of total billed charges","88% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.23,100,,,,,0,"fee schedule",EAPG,307,100,,245.60,,,0,"percent of total billed charges","100% of total billed charges",3255.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",2259.02,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",193.41,63,,154.73,,,0,"percent of total billed charges","63% of total billed charges",46.97,15.3,,37.58,,,0,"percent of total billed charges","15.3% of total billed charges",2193.23,100,,,,,0,"fee schedule",EAPG,211.83,69,,,,,0,"fee schedule","69% of total billed charges",307,100,,245.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307,100,,245.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",307,100,,245.60,,,0,"percent of total billed charges","100% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS fee schedule",6968.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.23,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1821.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2237.09,100,,,,,0,"fee schedule",EAPG,2851.2,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",115.74,37.7,,92.59,,,0,"percent of total billed charges","37.70% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",239.46,78,,191.57,,,0,"percent of total billed charges","78% of total billed charges",1878.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",253.58,82.6,,202.86,,,0,"percent of total billed charges","82.6% of total billed charges",2193.23,100,,,,,0,"fee schedule",EAPG,1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",253.58,82.6,,202.86,,,0,"percent of total billed charges","82.6% of total billed charges",1860.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2353.76,100,,,,,0,"fee schedule",EAPG,307,100,,245.60,,,0,"percent of total billed charges","100% of total billed charges",46.97,6968.7,
"56605 Biopsy of vulva or perineum (separate proced",7904703,CDM,521,RC,56605,CPT,OUTPATIENT,,,316,205.4,,278.08,88,,222.46,,,0,"percent of total billed charges","88% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.4,100,,,,,0,"fee schedule",EAPG,316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",1434.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",424.77,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.08,63,,159.26,,,0,"percent of total billed charges","63% of total billed charges",48.35,15.3,,38.68,,,0,"percent of total billed charges","15.3% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,218.04,69,,,,,0,"fee schedule","69% of total billed charges",316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",2573.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.4,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.64,100,,,,,0,"fee schedule",EAPG,536.12,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",119.13,37.7,,95.30,,,0,"percent of total billed charges","37.70% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",246.48,78,,197.18,,,0,"percent of total billed charges","78% of total billed charges",828.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",261.02,82.6,,208.82,,,0,"percent of total billed charges","82.6% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",261.02,82.6,,208.82,,,0,"percent of total billed charges","82.6% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",572.93,100,,,,,0,"fee schedule",EAPG,316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",48.35,2573.24,
"56606 Biopsy of vulva or perineum",7904720,CDM,521,RC,56606,CPT,OUTPATIENT,,,94,61.1,,82.72,88,,66.18,,,0,"percent of total billed charges","88% of total billed charges",47,50,,37.60,,,0,"percent of total billed charges","50% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",424.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",59.22,63,,47.38,,,0,"percent of total billed charges","63% of total billed charges",14.38,15.3,,11.50,,,0,"percent of total billed charges","15.3% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,64.86,69,,,,,0,"fee schedule","69% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.14,61.85,,46.51,,,0,"percent of total billed charges","61.5% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,47,50,,37.60,,,0,"percent of total billed charges","50% of total billed charges",30.27,32.2,,24.22,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",420.64,100,,,,,0,"fee schedule",EAPG,536.12,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.44,37.7,,28.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",73.32,78,,58.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,47,50,,37.60,,,0,"percent of total billed charges","50% of total billed charges",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",572.93,100,,,,,0,"fee schedule",EAPG,94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",14.38,572.93,
"56620 Vulvectomy simple; partial",7963832,CDM,521,RC,56620,CPT,OUTPATIENT,,,2889,1877.85,,2542.32,88,,2033.86,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.23,100,,,,,0,"fee schedule",EAPG,2889,100,,2311.20,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",2259.02,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1820.07,63,,1456.06,,,0,"percent of total billed charges","63% of total billed charges",442.02,15.3,,353.62,,,0,"percent of total billed charges","15.3% of total billed charges",2193.23,100,,,,,0,"fee schedule",EAPG,1993.41,69,,,,,0,"fee schedule","69% of total billed charges",2889,100,,2311.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2889,100,,2311.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2889,100,,2311.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.23,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2237.09,100,,,,,0,"fee schedule",EAPG,2851.2,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1089.15,37.7,,871.32,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2253.42,78,,1802.74,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2386.31,82.6,,1909.05,,,0,"percent of total billed charges","82.6% of total billed charges",2193.23,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2386.31,82.6,,1909.05,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2353.76,100,,,,,0,"fee schedule",EAPG,2889,100,,2311.20,,,0,"percent of total billed charges","100% of total billed charges",442.02,10656.86,
"56700 Partial hymenectomy or revision of hymenal r",7963452,CDM,521,RC,56700,CPT,OUTPATIENT,,,424,275.6,,373.12,88,,298.50,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.23,100,,,,,0,"fee schedule",EAPG,424,100,,339.20,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",2259.02,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.12,63,,213.70,,,0,"percent of total billed charges","63% of total billed charges",64.87,15.3,,51.90,,,0,"percent of total billed charges","15.3% of total billed charges",2193.23,100,,,,,0,"fee schedule",EAPG,292.56,69,,,,,0,"fee schedule","69% of total billed charges",424,100,,339.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",424,100,,339.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",424,100,,339.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.23,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2237.09,100,,,,,0,"fee schedule",EAPG,2851.2,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.85,37.7,,127.88,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.72,78,,264.58,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350.22,82.6,,280.18,,,0,"percent of total billed charges","82.6% of total billed charges",2193.23,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350.22,82.6,,280.18,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2353.76,100,,,,,0,"fee schedule",EAPG,424,100,,339.20,,,0,"percent of total billed charges","100% of total billed charges",64.87,10656.86,
"56740 Excision of Bartholin's gland or cyst",7903312,CDM,521,RC,56740,CPT,OUTPATIENT,,,744,483.6,,654.72,88,,523.78,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.23,100,,,,,0,"fee schedule",EAPG,744,100,,595.20,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",2259.02,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",468.72,63,,374.98,,,0,"percent of total billed charges","63% of total billed charges",113.83,15.3,,91.06,,,0,"percent of total billed charges","15.3% of total billed charges",2193.23,100,,,,,0,"fee schedule",EAPG,513.36,69,,,,,0,"fee schedule","69% of total billed charges",744,100,,595.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",744,100,,595.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",744,100,,595.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.23,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2237.09,100,,,,,0,"fee schedule",EAPG,2851.2,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",280.49,37.7,,224.39,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",580.32,78,,464.26,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",614.54,82.6,,491.63,,,0,"percent of total billed charges","82.6% of total billed charges",2193.23,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",614.54,82.6,,491.63,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2353.76,100,,,,,0,"fee schedule",EAPG,744,100,,595.20,,,0,"percent of total billed charges","100% of total billed charges",113.83,10656.86,
"56810 Perineoplasty, repair of perineum, nonobstet",7963416,CDM,521,RC,56810,CPT,OUTPATIENT,,,562,365.3,,494.56,88,,395.65,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.23,100,,,,,0,"fee schedule",EAPG,562,100,,449.60,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",2259.02,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",354.06,63,,283.25,,,0,"percent of total billed charges","63% of total billed charges",85.99,15.3,,68.79,,,0,"percent of total billed charges","15.3% of total billed charges",2193.23,100,,,,,0,"fee schedule",EAPG,387.78,69,,,,,0,"fee schedule","69% of total billed charges",562,100,,449.60,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",562,100,,449.60,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",562,100,,449.60,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.23,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2237.09,100,,,,,0,"fee schedule",EAPG,2851.2,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",211.87,37.7,,169.50,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",438.36,78,,350.69,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",464.21,82.6,,371.37,,,0,"percent of total billed charges","82.6% of total billed charges",2193.23,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",464.21,82.6,,371.37,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2353.76,100,,,,,0,"fee schedule",EAPG,562,100,,449.60,,,0,"percent of total billed charges","100% of total billed charges",85.99,10656.86,
"56820 Colposcopy of the vulva",7904721,CDM,521,RC,56820,CPT,OUTPATIENT,,,384,249.6,,337.92,88,,270.34,,,0,"percent of total billed charges","88% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.73,100,,,,,0,"fee schedule",EAPG,384,100,,307.20,,,0,"percent of total billed charges","100% of total billed charges",355.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",183.06,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",241.92,63,,193.54,,,0,"percent of total billed charges","63% of total billed charges",58.75,15.3,,47.00,,,0,"percent of total billed charges","15.3% of total billed charges",177.73,100,,,,,0,"fee schedule",EAPG,264.96,69,,,,,0,"fee schedule","69% of total billed charges",384,100,,307.20,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",384,100,,307.20,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",384,100,,307.20,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",691.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.73,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",181.28,100,,,,,0,"fee schedule",EAPG,231.05,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",144.77,37.7,,115.82,,,0,"percent of total billed charges","37.70% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",299.52,78,,239.62,,,0,"percent of total billed charges","78% of total billed charges",205.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",317.18,82.6,,253.74,,,0,"percent of total billed charges","82.6% of total billed charges",177.73,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",317.18,82.6,,253.74,,,0,"percent of total billed charges","82.6% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.26,100,,,,,0,"fee schedule",EAPG,384,100,,307.20,,,0,"percent of total billed charges","100% of total billed charges",58.75,691.92,
"57022 Incision and drainage of vaginal hematoma; o",7962974,CDM,521,RC,57022,CPT,OUTPATIENT,,,546,354.9,,480.48,88,,384.38,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1708.92,100,,,,,0,"fee schedule",EAPG,546,100,,436.80,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",1760.19,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",343.98,63,,275.18,,,0,"percent of total billed charges","63% of total billed charges",83.54,15.3,,66.83,,,0,"percent of total billed charges","15.3% of total billed charges",1708.92,100,,,,,0,"fee schedule",EAPG,376.74,69,,,,,0,"fee schedule","69% of total billed charges",546,100,,436.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",546,100,,436.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",546,100,,436.80,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1708.92,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1743.1,100,,,,,0,"fee schedule",EAPG,2221.6,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",205.84,37.7,,164.67,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",425.88,78,,340.70,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",451,82.6,,360.80,,,0,"percent of total billed charges","82.6% of total billed charges",1708.92,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",451,82.6,,360.80,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1869.45,100,,,,,0,"fee schedule",EAPG,546,100,,436.80,,,0,"percent of total billed charges","100% of total billed charges",83.54,9628.23,
"57020 Colpocentesis",7963933,CDM,521,RC,57020,CPT,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.4,100,,,,,0,"fee schedule",EAPG,361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",8878.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",424.77,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",17913.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.4,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.64,100,,,,,0,"fee schedule",EAPG,536.12,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",5123.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",572.93,100,,,,,0,"fee schedule",EAPG,361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,17913.89,
"57061 Destruction of vaginal lesion(s)",7904704,CDM,521,RC,57061,CPT,OUTPATIENT,,,393,255.45,,345.84,88,,276.67,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.23,100,,,,,0,"fee schedule",EAPG,393,100,,314.40,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",2259.02,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",247.59,63,,198.07,,,0,"percent of total billed charges","63% of total billed charges",60.13,15.3,,48.10,,,0,"percent of total billed charges","15.3% of total billed charges",2193.23,100,,,,,0,"fee schedule",EAPG,271.17,69,,,,,0,"fee schedule","69% of total billed charges",393,100,,314.40,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",393,100,,314.40,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",393,100,,314.40,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.23,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2237.09,100,,,,,0,"fee schedule",EAPG,2851.2,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",148.16,37.7,,118.53,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",306.54,78,,245.23,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",324.62,82.6,,259.70,,,0,"percent of total billed charges","82.6% of total billed charges",2193.23,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",324.62,82.6,,259.70,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2353.76,100,,,,,0,"fee schedule",EAPG,393,100,,314.40,,,0,"percent of total billed charges","100% of total billed charges",60.13,10656.86,
"57065 Destruction of vaginal lesion(s); extensive",7963525,CDM,521,RC,57065,CPT,OUTPATIENT,,,755,490.75,,664.4,88,,531.52,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.23,100,,,,,0,"fee schedule",EAPG,755,100,,604.00,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",2259.02,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",475.65,63,,380.52,,,0,"percent of total billed charges","63% of total billed charges",115.52,15.3,,92.42,,,0,"percent of total billed charges","15.3% of total billed charges",2193.23,100,,,,,0,"fee schedule",EAPG,520.95,69,,,,,0,"fee schedule","69% of total billed charges",755,100,,604.00,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",755,100,,604.00,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",755,100,,604.00,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.23,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2237.09,100,,,,,0,"fee schedule",EAPG,2851.2,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",284.64,37.7,,227.71,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",588.9,78,,471.12,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",623.63,82.6,,498.90,,,0,"percent of total billed charges","82.6% of total billed charges",2193.23,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",623.63,82.6,,498.90,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2353.76,100,,,,,0,"fee schedule",EAPG,755,100,,604.00,,,0,"percent of total billed charges","100% of total billed charges",115.52,10656.86,
"57100 Biopsy vaginal mucosa",7904722,CDM,521,RC,57100,CPT,OUTPATIENT,,,331,215.15,,291.28,88,,233.02,,,0,"percent of total billed charges","88% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.4,100,,,,,0,"fee schedule",EAPG,331,100,,264.80,,,0,"percent of total billed charges","100% of total billed charges",1434.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",424.77,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",208.53,63,,166.82,,,0,"percent of total billed charges","63% of total billed charges",50.64,15.3,,40.51,,,0,"percent of total billed charges","15.3% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,228.39,69,,,,,0,"fee schedule","69% of total billed charges",331,100,,264.80,,,0,"percent of total billed charges","100% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",331,100,,264.80,,,0,"percent of total billed charges","100% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",331,100,,264.80,,,0,"percent of total billed charges","100% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",2573.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.4,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.64,100,,,,,0,"fee schedule",EAPG,536.12,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",124.79,37.7,,99.83,,,0,"percent of total billed charges","37.70% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",258.18,78,,206.54,,,0,"percent of total billed charges","78% of total billed charges",828.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",273.41,82.6,,218.73,,,0,"percent of total billed charges","82.6% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",273.41,82.6,,218.73,,,0,"percent of total billed charges","82.6% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",572.93,100,,,,,0,"fee schedule",EAPG,331,100,,264.80,,,0,"percent of total billed charges","100% of total billed charges",50.64,2573.24,
"57105 Biopsy of vaginal mucosa; extensive, requiri",7962787,CDM,521,RC,57105,CPT,OUTPATIENT,,,675,438.75,,594,88,,475.20,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.23,100,,,,,0,"fee schedule",EAPG,675,100,,540.00,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",2259.02,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",425.25,63,,340.20,,,0,"percent of total billed charges","63% of total billed charges",103.28,15.3,,82.62,,,0,"percent of total billed charges","15.3% of total billed charges",2193.23,100,,,,,0,"fee schedule",EAPG,465.75,69,,,,,0,"fee schedule","69% of total billed charges",675,100,,540.00,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",675,100,,540.00,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",675,100,,540.00,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.23,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2237.09,100,,,,,0,"fee schedule",EAPG,2851.2,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",254.48,37.7,,203.58,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",526.5,78,,421.20,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",557.55,82.6,,446.04,,,0,"percent of total billed charges","82.6% of total billed charges",2193.23,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",557.55,82.6,,446.04,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2353.76,100,,,,,0,"fee schedule",EAPG,675,100,,540.00,,,0,"percent of total billed charges","100% of total billed charges",103.28,10656.86,
"57135 Excise vaginal cyst of tumor",7904723,CDM,521,RC,57135,CPT,OUTPATIENT,,,909,590.85,,799.92,88,,639.94,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.23,100,,,,,0,"fee schedule",EAPG,909,100,,727.20,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",2259.02,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",572.67,63,,458.14,,,0,"percent of total billed charges","63% of total billed charges",139.08,15.3,,111.26,,,0,"percent of total billed charges","15.3% of total billed charges",2193.23,100,,,,,0,"fee schedule",EAPG,627.21,69,,,,,0,"fee schedule","69% of total billed charges",909,100,,727.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",909,100,,727.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",909,100,,727.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.23,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2237.09,100,,,,,0,"fee schedule",EAPG,2851.2,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",342.69,37.7,,274.15,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",709.02,78,,567.22,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",750.83,82.6,,600.66,,,0,"percent of total billed charges","82.6% of total billed charges",2193.23,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",750.83,82.6,,600.66,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2353.76,100,,,,,0,"fee schedule",EAPG,909,100,,727.20,,,0,"percent of total billed charges","100% of total billed charges",139.08,10656.86,
"57150 Irrigation of vagina and/or application of m",7962016,CDM,521,RC,57150,CPT,OUTPATIENT,,,110,71.5,,96.8,88,,77.44,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.73,100,,,,,0,"fee schedule",EAPG,110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",183.06,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",69.3,63,,55.44,,,0,"percent of total billed charges","63% of total billed charges",16.83,15.3,,13.46,,,0,"percent of total billed charges","15.3% of total billed charges",177.73,100,,,,,0,"fee schedule",EAPG,75.9,69,,,,,0,"fee schedule","69% of total billed charges",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.73,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",181.28,100,,,,,0,"fee schedule",EAPG,231.05,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",41.47,37.7,,33.18,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.8,78,,68.64,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",90.86,82.6,,72.69,,,0,"percent of total billed charges","82.6% of total billed charges",177.73,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",90.86,82.6,,72.69,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.26,100,,,,,0,"fee schedule",EAPG,110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",16.83,338.26,
"57160 Introduction procedures on the vagina",7904705,CDM,521,RC,57160,CPT,OUTPATIENT,,,164,106.6,,144.32,88,,115.46,,,0,"percent of total billed charges","88% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.73,100,,,,,0,"fee schedule",EAPG,164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",355.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",183.06,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",103.32,63,,82.66,,,0,"percent of total billed charges","63% of total billed charges",25.09,15.3,,20.07,,,0,"percent of total billed charges","15.3% of total billed charges",177.73,100,,,,,0,"fee schedule",EAPG,113.16,69,,,,,0,"fee schedule","69% of total billed charges",164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",691.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.73,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",181.28,100,,,,,0,"fee schedule",EAPG,231.05,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",61.83,37.7,,49.46,,,0,"percent of total billed charges","37.70% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",127.92,78,,102.34,,,0,"percent of total billed charges","78% of total billed charges",205.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",135.46,82.6,,108.37,,,0,"percent of total billed charges","82.6% of total billed charges",177.73,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",135.46,82.6,,108.37,,,0,"percent of total billed charges","82.6% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.26,100,,,,,0,"fee schedule",EAPG,164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",25.09,691.92,
"57170 Diaphragm fitting",7904724,CDM,521,RC,57170,CPT,OUTPATIENT,,,164,106.6,,144.32,88,,115.46,,,0,"percent of total billed charges","88% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.73,100,,,,,0,"fee schedule",EAPG,164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",355.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",183.06,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",103.32,63,,82.66,,,0,"percent of total billed charges","63% of total billed charges",25.09,15.3,,20.07,,,0,"percent of total billed charges","15.3% of total billed charges",177.73,100,,,,,0,"fee schedule",EAPG,113.16,69,,,,,0,"fee schedule","69% of total billed charges",164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",691.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.73,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",181.28,100,,,,,0,"fee schedule",EAPG,231.05,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",61.83,37.7,,49.46,,,0,"percent of total billed charges","37.70% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",127.92,78,,102.34,,,0,"percent of total billed charges","78% of total billed charges",205.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",135.46,82.6,,108.37,,,0,"percent of total billed charges","82.6% of total billed charges",177.73,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",135.46,82.6,,108.37,,,0,"percent of total billed charges","82.6% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.26,100,,,,,0,"fee schedule",EAPG,164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",25.09,691.92,
"57180 Introduction of any hemostatic agent or pack",7962017,CDM,521,RC,57180,CPT,OUTPATIENT,,,339,220.35,,298.32,88,,238.66,,,0,"percent of total billed charges","88% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.4,100,,,,,0,"fee schedule",EAPG,339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",355.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",424.77,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",213.57,63,,170.86,,,0,"percent of total billed charges","63% of total billed charges",51.87,15.3,,41.50,,,0,"percent of total billed charges","15.3% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,233.91,69,,,,,0,"fee schedule","69% of total billed charges",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",691.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.4,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.64,100,,,,,0,"fee schedule",EAPG,536.12,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",127.8,37.7,,102.24,,,0,"percent of total billed charges","37.70% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",264.42,78,,211.54,,,0,"percent of total billed charges","78% of total billed charges",205.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.01,82.6,,224.01,,,0,"percent of total billed charges","82.6% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.01,82.6,,224.01,,,0,"percent of total billed charges","82.6% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",572.93,100,,,,,0,"fee schedule",EAPG,339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",51.87,691.92,
"57200 Colporrhaphy, suture of injury of vagina (no",7963202,CDM,521,RC,57200,CPT,OUTPATIENT,,,886,575.9,,779.68,88,,623.74,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.23,100,,,,,0,"fee schedule",EAPG,886,100,,708.80,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",2259.02,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",558.18,63,,446.54,,,0,"percent of total billed charges","63% of total billed charges",135.56,15.3,,108.45,,,0,"percent of total billed charges","15.3% of total billed charges",2193.23,100,,,,,0,"fee schedule",EAPG,611.34,69,,,,,0,"fee schedule","69% of total billed charges",886,100,,708.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886,100,,708.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",886,100,,708.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.23,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2237.09,100,,,,,0,"fee schedule",EAPG,2851.2,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",334.02,37.7,,267.22,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",691.08,78,,552.86,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",731.84,82.6,,585.47,,,0,"percent of total billed charges","82.6% of total billed charges",2193.23,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",731.84,82.6,,585.47,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2353.76,100,,,,,0,"fee schedule",EAPG,886,100,,708.80,,,0,"percent of total billed charges","100% of total billed charges",135.56,10656.86,
"57210 Colpoperineorrhaphy, suture of injury of vag",7962479,CDM,521,RC,57210,CPT,OUTPATIENT,,,1084,704.6,,953.92,88,,763.14,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.23,100,,,,,0,"fee schedule",EAPG,1084,100,,867.20,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",2259.02,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",682.92,63,,546.34,,,0,"percent of total billed charges","63% of total billed charges",165.85,15.3,,132.68,,,0,"percent of total billed charges","15.3% of total billed charges",2193.23,100,,,,,0,"fee schedule",EAPG,747.96,69,,,,,0,"fee schedule","69% of total billed charges",1084,100,,867.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1084,100,,867.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1084,100,,867.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.23,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2237.09,100,,,,,0,"fee schedule",EAPG,2851.2,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",408.67,37.7,,326.94,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",845.52,78,,676.42,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",895.38,82.6,,716.30,,,0,"percent of total billed charges","82.6% of total billed charges",2193.23,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",895.38,82.6,,716.30,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2353.76,100,,,,,0,"fee schedule",EAPG,1084,100,,867.20,,,0,"percent of total billed charges","100% of total billed charges",165.85,10656.86,
"57220 Plastic operation on urethral sphincter, vag",7961957,CDM,521,RC,57220,CPT,OUTPATIENT,,,671,436.15,,590.48,88,,472.38,,,0,"percent of total billed charges","88% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2646.75,100,,,,,0,"fee schedule",EAPG,671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",8878.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",2726.15,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",422.73,63,,338.18,,,0,"percent of total billed charges","63% of total billed charges",102.66,15.3,,82.13,,,0,"percent of total billed charges","15.3% of total billed charges",2646.75,100,,,,,0,"fee schedule",EAPG,462.99,69,,,,,0,"fee schedule","69% of total billed charges",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",17913.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2646.75,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2699.68,100,,,,,0,"fee schedule",EAPG,3440.77,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",252.97,37.7,,202.38,,,0,"percent of total billed charges","37.70% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",523.38,78,,418.70,,,0,"percent of total billed charges","78% of total billed charges",5123.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.25,82.6,,443.40,,,0,"percent of total billed charges","82.6% of total billed charges",2646.75,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.25,82.6,,443.40,,,0,"percent of total billed charges","82.6% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2807.28,100,,,,,0,"fee schedule",EAPG,671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",102.66,17913.89,
"57240 Anterior colporrhaphy, repair of cystocele w",7962480,CDM,521,RC,57240,CPT,OUTPATIENT,,,1972,1281.8,,1735.36,88,,1388.29,,,0,"percent of total billed charges","88% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2646.75,100,,,,,0,"fee schedule",EAPG,1972,100,,1577.60,,,0,"percent of total billed charges","100% of total billed charges",8878.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",2726.15,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1242.36,63,,993.89,,,0,"percent of total billed charges","63% of total billed charges",301.72,15.3,,241.38,,,0,"percent of total billed charges","15.3% of total billed charges",2646.75,100,,,,,0,"fee schedule",EAPG,1360.68,69,,,,,0,"fee schedule","69% of total billed charges",1972,100,,1577.60,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1972,100,,1577.60,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1972,100,,1577.60,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",17913.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2646.75,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2699.68,100,,,,,0,"fee schedule",EAPG,3440.77,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",743.44,37.7,,594.75,,,0,"percent of total billed charges","37.70% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1538.16,78,,1230.53,,,0,"percent of total billed charges","78% of total billed charges",5123.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1628.87,82.6,,1303.10,,,0,"percent of total billed charges","82.6% of total billed charges",2646.75,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1628.87,82.6,,1303.10,,,0,"percent of total billed charges","82.6% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2807.28,100,,,,,0,"fee schedule",EAPG,1972,100,,1577.60,,,0,"percent of total billed charges","100% of total billed charges",301.72,17913.89,
"57250 Posterior colporrhaphy, repair of rectocele",7962684,CDM,521,RC,57250,CPT,OUTPATIENT,,,2000,1300,,1760,88,,1408.00,,,0,"percent of total billed charges","88% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,2000,100,,1600.00,,,0,"percent of total billed charges","100% of total billed charges",8878.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",1367,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1260,63,,1008.00,,,0,"percent of total billed charges","63% of total billed charges",306,15.3,,244.80,,,0,"percent of total billed charges","15.3% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,1380,69,,,,,0,"fee schedule","69% of total billed charges",2000,100,,1600.00,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2000,100,,1600.00,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2000,100,,1600.00,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",17913.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",754,37.7,,603.20,,,0,"percent of total billed charges","37.70% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1560,78,,1248.00,,,0,"percent of total billed charges","78% of total billed charges",5123.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1652,82.6,,1321.60,,,0,"percent of total billed charges","82.6% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1652,82.6,,1321.60,,,0,"percent of total billed charges","82.6% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1487.72,100,,,,,0,"fee schedule",EAPG,2000,100,,1600.00,,,0,"percent of total billed charges","100% of total billed charges",306,17913.89,
"57267 Insertion of mesh/prosthesis, repair of pelv",7962259,CDM,521,RC,57267,CPT,OUTPATIENT,,,756,491.4,,665.28,88,,532.22,,,0,"percent of total billed charges","88% of total billed charges",378,50,,302.40,,,0,"percent of total billed charges","50% of total billed charges",4817.89,100,,,,,0,"fee schedule",EAPG,756,100,,604.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4962.43,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",476.28,63,,381.02,,,0,"percent of total billed charges","63% of total billed charges",115.67,15.3,,92.54,,,0,"percent of total billed charges","15.3% of total billed charges",4817.89,100,,,,,0,"fee schedule",EAPG,521.64,69,,,,,0,"fee schedule","69% of total billed charges",756,100,,604.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",756,100,,604.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",756,100,,604.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",467.59,61.85,,374.07,,,0,"percent of total billed charges","61.5% of total billed charges",4817.89,100,,,,,0,"fee schedule",EAPG,378,50,,302.40,,,0,"percent of total billed charges","50% of total billed charges",243.43,32.2,,194.74,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4914.25,100,,,,,0,"fee schedule",EAPG,6263.26,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",285.01,37.7,,228.01,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",589.68,78,,471.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",624.46,82.6,,499.57,,,0,"percent of total billed charges","82.6% of total billed charges",4817.89,100,,,,,0,"fee schedule",EAPG,378,50,,302.40,,,0,"percent of total billed charges","50% of total billed charges",624.46,82.6,,499.57,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4978.42,100,,,,,0,"fee schedule",EAPG,756,100,,604.80,,,0,"percent of total billed charges","100% of total billed charges",115.67,6263.26,
"57265 Combined anteroposterior colporrhaphy; with",7963079,CDM,521,RC,57265,CPT,OUTPATIENT,,,2697,1753.05,,2373.36,88,,1898.69,,,0,"percent of total billed charges","88% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,2697,100,,2157.60,,,0,"percent of total billed charges","100% of total billed charges",8878.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",1367,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1699.11,63,,1359.29,,,0,"percent of total billed charges","63% of total billed charges",412.64,15.3,,330.11,,,0,"percent of total billed charges","15.3% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,1860.93,69,,,,,0,"fee schedule","69% of total billed charges",2697,100,,2157.60,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2697,100,,2157.60,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2697,100,,2157.60,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",17913.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1016.77,37.7,,813.42,,,0,"percent of total billed charges","37.70% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2103.66,78,,1682.93,,,0,"percent of total billed charges","78% of total billed charges",5123.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2227.72,82.6,,1782.18,,,0,"percent of total billed charges","82.6% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2227.72,82.6,,1782.18,,,0,"percent of total billed charges","82.6% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1487.72,100,,,,,0,"fee schedule",EAPG,2697,100,,2157.60,,,0,"percent of total billed charges","100% of total billed charges",412.64,17913.89,
"57268 Repair of enterocele, vaginal approach (sepa",7963152,CDM,521,RC,57268,CPT,OUTPATIENT,,,1426,926.9,,1254.88,88,,1003.90,,,0,"percent of total billed charges","88% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,1426,100,,1140.80,,,0,"percent of total billed charges","100% of total billed charges",8878.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",1367,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",898.38,63,,718.70,,,0,"percent of total billed charges","63% of total billed charges",218.18,15.3,,174.54,,,0,"percent of total billed charges","15.3% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,983.94,69,,,,,0,"fee schedule","69% of total billed charges",1426,100,,1140.80,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1426,100,,1140.80,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1426,100,,1140.80,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",17913.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1327.19,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",537.6,37.7,,430.08,,,0,"percent of total billed charges","37.70% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1112.28,78,,889.82,,,0,"percent of total billed charges","78% of total billed charges",5123.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1177.88,82.6,,942.30,,,0,"percent of total billed charges","82.6% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1177.88,82.6,,942.30,,,0,"percent of total billed charges","82.6% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1487.72,100,,,,,0,"fee schedule",EAPG,1426,100,,1140.80,,,0,"percent of total billed charges","100% of total billed charges",218.18,17913.89,
"57260 Combined anteroposterior colporrhaphy",7963649,CDM,521,RC,57260,CPT,OUTPATIENT,,,2464,1601.6,,2168.32,88,,1734.66,,,0,"percent of total billed charges","88% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2646.75,100,,,,,0,"fee schedule",EAPG,2464,100,,1971.20,,,0,"percent of total billed charges","100% of total billed charges",8878.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",2726.15,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1552.32,63,,1241.86,,,0,"percent of total billed charges","63% of total billed charges",376.99,15.3,,301.59,,,0,"percent of total billed charges","15.3% of total billed charges",2646.75,100,,,,,0,"fee schedule",EAPG,1700.16,69,,,,,0,"fee schedule","69% of total billed charges",2464,100,,1971.20,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2464,100,,1971.20,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2464,100,,1971.20,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",17913.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2646.75,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2699.68,100,,,,,0,"fee schedule",EAPG,3440.77,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",928.93,37.7,,743.14,,,0,"percent of total billed charges","37.70% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1921.92,78,,1537.54,,,0,"percent of total billed charges","78% of total billed charges",5123.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2035.26,82.6,,1628.21,,,0,"percent of total billed charges","82.6% of total billed charges",2646.75,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2035.26,82.6,,1628.21,,,0,"percent of total billed charges","82.6% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2807.28,100,,,,,0,"fee schedule",EAPG,2464,100,,1971.20,,,0,"percent of total billed charges","100% of total billed charges",376.99,17913.89,
"57270 Repair of enterocele, abdominal approach (se",7963080,CDM,521,RC,57270,CPT,OUTPATIENT,,,2821,1833.65,,2482.48,88,,1985.98,,,0,"percent of total billed charges","88% of total billed charges",2821,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1327.19,100,,,,,0,"fee schedule",EAPG,2821,100,,2256.80,,,0,"percent of total billed charges","100% of total billed charges",2821,175,,,,,0,"fee schedule","175% of CMS fee schedule",1367,100,,,,,0,"fee schedule",EAPG,2821,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1777.23,63,,1421.78,,,0,"percent of total billed charges","63% of total billed charges",431.61,15.3,,345.29,,,0,"percent of total billed charges","15.3% of total billed charges",1327.19,100,,,,,0,"fee schedule",EAPG,1946.49,69,,,,,0,"fee schedule","69% of total billed charges",2821,100,,2256.80,,,0,"percent of total billed charges","100% of total billed charges",2821,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2821,100,,2256.80,,,0,"percent of total billed charges","100% of total billed charges",2821,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2821,100,,2256.80,,,0,"percent of total billed charges","100% of total billed charges",2821,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2821,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1327.19,100,,,,,0,"fee schedule",EAPG,2821,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2821,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2821,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1353.73,100,,,,,0,"fee schedule",EAPG,1725.34,100,,,,,0,"fee schedule",EAPG,2821,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1063.52,37.7,,850.82,,,0,"percent of total billed charges","37.70% of total billed charges",2821,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2821,100,,,,,0,"fee schedule","100% of CMS fee schedule",2200.38,78,,1760.30,,,0,"percent of total billed charges","78% of total billed charges",2821,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2330.15,82.6,,1864.12,,,0,"percent of total billed charges","82.6% of total billed charges",1327.19,100,,,,,0,"fee schedule","100% of WA fee schedule",2821,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2330.15,82.6,,1864.12,,,0,"percent of total billed charges","82.6% of total billed charges",2821,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1487.72,100,,,,,0,"fee schedule",EAPG,2821,100,,2256.80,,,0,"percent of total billed charges","100% of total billed charges",431.61,2821,
"57284 Paravaginal defect repair (including repair",7962163,CDM,521,RC,57284,CPT,OUTPATIENT,,,3825,2486.25,,3366,88,,2692.80,,,0,"percent of total billed charges","88% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5162.77,100,,,,,0,"fee schedule",EAPG,3825,100,,3060.00,,,0,"percent of total billed charges","100% of total billed charges",8878.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",5317.65,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2409.75,63,,1927.80,,,0,"percent of total billed charges","63% of total billed charges",585.23,15.3,,468.18,,,0,"percent of total billed charges","15.3% of total billed charges",5162.77,100,,,,,0,"fee schedule",EAPG,2639.25,69,,,,,0,"fee schedule","69% of total billed charges",3825,100,,3060.00,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3825,100,,3060.00,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3825,100,,3060.00,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",17913.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5162.77,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5266.02,100,,,,,0,"fee schedule",EAPG,6711.6,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1442.03,37.7,,1153.62,,,0,"percent of total billed charges","37.70% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2983.5,78,,2386.80,,,0,"percent of total billed charges","78% of total billed charges",5123.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3159.45,82.6,,2527.56,,,0,"percent of total billed charges","82.6% of total billed charges",5162.77,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3159.45,82.6,,2527.56,,,0,"percent of total billed charges","82.6% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5323.3,100,,,,,0,"fee schedule",EAPG,3825,100,,3060.00,,,0,"percent of total billed charges","100% of total billed charges",585.23,17913.89,
"57283 Colpopexy, vaginal; intra-peritoneal approac",7962506,CDM,521,RC,57283,CPT,OUTPATIENT,,,1683,1093.95,,1481.04,88,,1184.83,,,0,"percent of total billed charges","88% of total billed charges",7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.23,100,,,,,0,"fee schedule",EAPG,1683,100,,1346.40,,,0,"percent of total billed charges","100% of total billed charges",13487.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",2259.02,100,,,,,0,"fee schedule",EAPG,7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1060.29,63,,848.23,,,0,"percent of total billed charges","63% of total billed charges",257.5,15.3,,206.00,,,0,"percent of total billed charges","15.3% of total billed charges",2193.23,100,,,,,0,"fee schedule",EAPG,1161.27,69,,,,,0,"fee schedule","69% of total billed charges",1683,100,,1346.40,,,0,"percent of total billed charges","100% of total billed charges",7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1683,100,,1346.40,,,0,"percent of total billed charges","100% of total billed charges",7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1683,100,,1346.40,,,0,"percent of total billed charges","100% of total billed charges",7707.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",27602.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.23,100,,,,,0,"fee schedule",EAPG,7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7216.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2237.09,100,,,,,0,"fee schedule",EAPG,2851.2,100,,,,,0,"fee schedule",EAPG,7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",634.49,37.7,,507.59,,,0,"percent of total billed charges","37.70% of total billed charges",7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1312.74,78,,1050.19,,,0,"percent of total billed charges","78% of total billed charges",7784.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1390.16,82.6,,1112.13,,,0,"percent of total billed charges","82.6% of total billed charges",2193.23,100,,,,,0,"fee schedule",EAPG,7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1390.16,82.6,,1112.13,,,0,"percent of total billed charges","82.6% of total billed charges",7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2353.76,100,,,,,0,"fee schedule",EAPG,1683,100,,1346.40,,,0,"percent of total billed charges","100% of total billed charges",257.5,27602.09,
"57282 Colpopexy, vaginal; extra-peritoneal approac",7962644,CDM,521,RC,57282,CPT,OUTPATIENT,,,864,561.6,,760.32,88,,608.26,,,0,"percent of total billed charges","88% of total billed charges",7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.23,100,,,,,0,"fee schedule",EAPG,864,100,,691.20,,,0,"percent of total billed charges","100% of total billed charges",13487.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",2259.02,100,,,,,0,"fee schedule",EAPG,7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",544.32,63,,435.46,,,0,"percent of total billed charges","63% of total billed charges",132.19,15.3,,105.75,,,0,"percent of total billed charges","15.3% of total billed charges",2193.23,100,,,,,0,"fee schedule",EAPG,596.16,69,,,,,0,"fee schedule","69% of total billed charges",864,100,,691.20,,,0,"percent of total billed charges","100% of total billed charges",7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",864,100,,691.20,,,0,"percent of total billed charges","100% of total billed charges",7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",864,100,,691.20,,,0,"percent of total billed charges","100% of total billed charges",7707.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",27602.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.23,100,,,,,0,"fee schedule",EAPG,7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7216.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2237.09,100,,,,,0,"fee schedule",EAPG,2851.2,100,,,,,0,"fee schedule",EAPG,7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",325.73,37.7,,260.58,,,0,"percent of total billed charges","37.70% of total billed charges",7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.92,78,,539.14,,,0,"percent of total billed charges","78% of total billed charges",7784.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",713.66,82.6,,570.93,,,0,"percent of total billed charges","82.6% of total billed charges",2193.23,100,,,,,0,"fee schedule",EAPG,7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",713.66,82.6,,570.93,,,0,"percent of total billed charges","82.6% of total billed charges",7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2353.76,100,,,,,0,"fee schedule",EAPG,864,100,,691.20,,,0,"percent of total billed charges","100% of total billed charges",132.19,27602.09,
"57288 Sling operation for stress incontinence (eg,",7962975,CDM,521,RC,57288,CPT,OUTPATIENT,,,3613,2348.45,,3179.44,88,,2543.55,,,0,"percent of total billed charges","88% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2646.75,100,,,,,0,"fee schedule",EAPG,3613,100,,2890.40,,,0,"percent of total billed charges","100% of total billed charges",8878.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",2726.15,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2276.19,63,,1820.95,,,0,"percent of total billed charges","63% of total billed charges",552.79,15.3,,442.23,,,0,"percent of total billed charges","15.3% of total billed charges",2646.75,100,,,,,0,"fee schedule",EAPG,2492.97,69,,,,,0,"fee schedule","69% of total billed charges",3613,100,,2890.40,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3613,100,,2890.40,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3613,100,,2890.40,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",17913.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2646.75,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2699.68,100,,,,,0,"fee schedule",EAPG,3440.77,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1362.1,37.7,,1089.68,,,0,"percent of total billed charges","37.70% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2818.14,78,,2254.51,,,0,"percent of total billed charges","78% of total billed charges",5123.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2984.34,82.6,,2387.47,,,0,"percent of total billed charges","82.6% of total billed charges",2646.75,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2984.34,82.6,,2387.47,,,0,"percent of total billed charges","82.6% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2807.28,100,,,,,0,"fee schedule",EAPG,3613,100,,2890.40,,,0,"percent of total billed charges","100% of total billed charges",552.79,17913.89,
"57289 Pereyra procedure, including anterior colpor",7963347,CDM,521,RC,57289,CPT,OUTPATIENT,,,2361,1534.65,,2077.68,88,,1662.14,,,0,"percent of total billed charges","88% of total billed charges",7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2646.75,100,,,,,0,"fee schedule",EAPG,2361,100,,1888.80,,,0,"percent of total billed charges","100% of total billed charges",13487.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",2726.15,100,,,,,0,"fee schedule",EAPG,7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1487.43,63,,1189.94,,,0,"percent of total billed charges","63% of total billed charges",361.23,15.3,,288.98,,,0,"percent of total billed charges","15.3% of total billed charges",2646.75,100,,,,,0,"fee schedule",EAPG,1629.09,69,,,,,0,"fee schedule","69% of total billed charges",2361,100,,1888.80,,,0,"percent of total billed charges","100% of total billed charges",7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2361,100,,1888.80,,,0,"percent of total billed charges","100% of total billed charges",7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2361,100,,1888.80,,,0,"percent of total billed charges","100% of total billed charges",7707.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",27602.09,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2646.75,100,,,,,0,"fee schedule",EAPG,7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7216.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2699.68,100,,,,,0,"fee schedule",EAPG,3440.77,100,,,,,0,"fee schedule",EAPG,7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",890.1,37.7,,712.08,,,0,"percent of total billed charges","37.70% of total billed charges",7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1841.58,78,,1473.26,,,0,"percent of total billed charges","78% of total billed charges",7784.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1950.19,82.6,,1560.15,,,0,"percent of total billed charges","82.6% of total billed charges",2646.75,100,,,,,0,"fee schedule",EAPG,7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1950.19,82.6,,1560.15,,,0,"percent of total billed charges","82.6% of total billed charges",7707.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2807.28,100,,,,,0,"fee schedule",EAPG,2361,100,,1888.80,,,0,"percent of total billed charges","100% of total billed charges",361.23,27602.09,
"57280 Colpopexy, abdominal approach",7963748,CDM,521,RC,57280,CPT,OUTPATIENT,,,3758,2442.7,,3307.04,88,,2645.63,,,0,"percent of total billed charges","88% of total billed charges",3758,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5162.77,100,,,,,0,"fee schedule",EAPG,3758,100,,3006.40,,,0,"percent of total billed charges","100% of total billed charges",3758,175,,,,,0,"fee schedule","175% of CMS fee schedule",5317.65,100,,,,,0,"fee schedule",EAPG,3758,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2367.54,63,,1894.03,,,0,"percent of total billed charges","63% of total billed charges",574.97,15.3,,459.98,,,0,"percent of total billed charges","15.3% of total billed charges",5162.77,100,,,,,0,"fee schedule",EAPG,2593.02,69,,,,,0,"fee schedule","69% of total billed charges",3758,100,,3006.40,,,0,"percent of total billed charges","100% of total billed charges",3758,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3758,100,,3006.40,,,0,"percent of total billed charges","100% of total billed charges",3758,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3758,100,,3006.40,,,0,"percent of total billed charges","100% of total billed charges",3758,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3758,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5162.77,100,,,,,0,"fee schedule",EAPG,3758,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3758,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3758,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5266.02,100,,,,,0,"fee schedule",EAPG,6711.6,100,,,,,0,"fee schedule",EAPG,3758,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1416.77,37.7,,1133.42,,,0,"percent of total billed charges","37.70% of total billed charges",3758,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3758,100,,,,,0,"fee schedule","100% of CMS fee schedule",2931.24,78,,2344.99,,,0,"percent of total billed charges","78% of total billed charges",3758,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3104.11,82.6,,2483.29,,,0,"percent of total billed charges","82.6% of total billed charges",5162.77,100,,,,,0,"fee schedule","100% of WA fee schedule",3758,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3104.11,82.6,,2483.29,,,0,"percent of total billed charges","82.6% of total billed charges",3758,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5323.3,100,,,,,0,"fee schedule",EAPG,3758,100,,3006.40,,,0,"percent of total billed charges","100% of total billed charges",574.97,6711.6,
"57320 Closure of vesicovaginal fistula; vaginal ap",7963391,CDM,521,RC,57320,CPT,OUTPATIENT,,,1272,826.8,,1119.36,88,,895.49,,,0,"percent of total billed charges","88% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5162.77,100,,,,,0,"fee schedule",EAPG,1272,100,,1017.60,,,0,"percent of total billed charges","100% of total billed charges",8878.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",5317.65,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",801.36,63,,641.09,,,0,"percent of total billed charges","63% of total billed charges",194.62,15.3,,155.70,,,0,"percent of total billed charges","15.3% of total billed charges",5162.77,100,,,,,0,"fee schedule",EAPG,877.68,69,,,,,0,"fee schedule","69% of total billed charges",1272,100,,1017.60,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1272,100,,1017.60,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1272,100,,1017.60,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",17913.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5162.77,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5266.02,100,,,,,0,"fee schedule",EAPG,6711.6,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",479.54,37.7,,383.63,,,0,"percent of total billed charges","37.70% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",992.16,78,,793.73,,,0,"percent of total billed charges","78% of total billed charges",5123.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1050.67,82.6,,840.54,,,0,"percent of total billed charges","82.6% of total billed charges",5162.77,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1050.67,82.6,,840.54,,,0,"percent of total billed charges","82.6% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5323.3,100,,,,,0,"fee schedule",EAPG,1272,100,,1017.60,,,0,"percent of total billed charges","100% of total billed charges",194.62,17913.89,
"57415 Removal of impacted vaginal foreign body und",7962607,CDM,521,RC,57415,CPT,OUTPATIENT,,,294,191.1,,258.72,88,,206.98,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.23,100,,,,,0,"fee schedule",EAPG,294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",2259.02,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",185.22,63,,148.18,,,0,"percent of total billed charges","63% of total billed charges",44.98,15.3,,35.98,,,0,"percent of total billed charges","15.3% of total billed charges",2193.23,100,,,,,0,"fee schedule",EAPG,202.86,69,,,,,0,"fee schedule","69% of total billed charges",294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2193.23,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2237.09,100,,,,,0,"fee schedule",EAPG,2851.2,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",110.84,37.7,,88.67,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.32,78,,183.46,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",242.84,82.6,,194.27,,,0,"percent of total billed charges","82.6% of total billed charges",2193.23,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",242.84,82.6,,194.27,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2353.76,100,,,,,0,"fee schedule",EAPG,294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",44.98,10656.86,
"57410 Pelvic examination under anesthesia (other t",7963289,CDM,521,RC,57410,CPT,OUTPATIENT,,,421,273.65,,370.48,88,,296.38,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.73,100,,,,,0,"fee schedule",EAPG,421,100,,336.80,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",183.06,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.23,63,,212.18,,,0,"percent of total billed charges","63% of total billed charges",64.41,15.3,,51.53,,,0,"percent of total billed charges","15.3% of total billed charges",177.73,100,,,,,0,"fee schedule",EAPG,290.49,69,,,,,0,"fee schedule","69% of total billed charges",421,100,,336.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",421,100,,336.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",421,100,,336.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.73,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",181.28,100,,,,,0,"fee schedule",EAPG,231.05,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",158.72,37.7,,126.98,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",328.38,78,,262.70,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",347.75,82.6,,278.20,,,0,"percent of total billed charges","82.6% of total billed charges",177.73,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",347.75,82.6,,278.20,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.26,100,,,,,0,"fee schedule",EAPG,421,100,,336.80,,,0,"percent of total billed charges","100% of total billed charges",64.41,10656.86,
"57420 Colposcopy of the entire vagina",7904725,CDM,521,RC,57420,CPT,OUTPATIENT,,,344,223.6,,302.72,88,,242.18,,,0,"percent of total billed charges","88% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.4,100,,,,,0,"fee schedule",EAPG,344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",572.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",424.77,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,63,,173.38,,,0,"percent of total billed charges","63% of total billed charges",52.63,15.3,,42.10,,,0,"percent of total billed charges","15.3% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,237.36,69,,,,,0,"fee schedule","69% of total billed charges",344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",1143.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.4,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.64,100,,,,,0,"fee schedule",EAPG,536.12,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",129.69,37.7,,103.75,,,0,"percent of total billed charges","37.70% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",268.32,78,,214.66,,,0,"percent of total billed charges","78% of total billed charges",330.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.14,82.6,,227.31,,,0,"percent of total billed charges","82.6% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.14,82.6,,227.31,,,0,"percent of total billed charges","82.6% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",572.93,100,,,,,0,"fee schedule",EAPG,344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",52.63,1143.51,
"57421 Colposcopy of vagina w/ biopsy",7904726,CDM,521,RC,57421,CPT,OUTPATIENT,,,460,299,,404.8,88,,323.84,,,0,"percent of total billed charges","88% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.4,100,,,,,0,"fee schedule",EAPG,460,100,,368.00,,,0,"percent of total billed charges","100% of total billed charges",1434.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",424.77,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.8,63,,231.84,,,0,"percent of total billed charges","63% of total billed charges",70.38,15.3,,56.30,,,0,"percent of total billed charges","15.3% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,317.4,69,,,,,0,"fee schedule","69% of total billed charges",460,100,,368.00,,,0,"percent of total billed charges","100% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460,100,,368.00,,,0,"percent of total billed charges","100% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460,100,,368.00,,,0,"percent of total billed charges","100% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",2573.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.4,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.64,100,,,,,0,"fee schedule",EAPG,536.12,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",173.42,37.7,,138.74,,,0,"percent of total billed charges","37.70% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",358.8,78,,287.04,,,0,"percent of total billed charges","78% of total billed charges",828.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",379.96,82.6,,303.97,,,0,"percent of total billed charges","82.6% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",379.96,82.6,,303.97,,,0,"percent of total billed charges","82.6% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",572.93,100,,,,,0,"fee schedule",EAPG,460,100,,368.00,,,0,"percent of total billed charges","100% of total billed charges",70.38,2573.24,
"57423 Paravaginal defect repair (including repair",7961557,CDM,521,RC,57423,CPT,OUTPATIENT,,,2711,1762.15,,2385.68,88,,1908.54,,,0,"percent of total billed charges","88% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5162.77,100,,,,,0,"fee schedule",EAPG,2711,100,,2168.80,,,0,"percent of total billed charges","100% of total billed charges",18373.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",5317.65,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1707.93,63,,1366.34,,,0,"percent of total billed charges","63% of total billed charges",414.78,15.3,,331.82,,,0,"percent of total billed charges","15.3% of total billed charges",5162.77,100,,,,,0,"fee schedule",EAPG,1870.59,69,,,,,0,"fee schedule","69% of total billed charges",2711,100,,2168.80,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2711,100,,2168.80,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2711,100,,2168.80,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",36187.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5162.77,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9460.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5266.02,100,,,,,0,"fee schedule",EAPG,6711.6,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1022.05,37.7,,817.64,,,0,"percent of total billed charges","37.70% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2114.58,78,,1691.66,,,0,"percent of total billed charges","78% of total billed charges",10604.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2239.29,82.6,,1791.43,,,0,"percent of total billed charges","82.6% of total billed charges",5162.77,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2239.29,82.6,,1791.43,,,0,"percent of total billed charges","82.6% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5323.3,100,,,,,0,"fee schedule",EAPG,2711,100,,2168.80,,,0,"percent of total billed charges","100% of total billed charges",414.78,36187.64,
"57425 Laparoscopy, surgical, colpopexy (suspension",7963081,CDM,521,RC,57425,CPT,OUTPATIENT,,,2864,1861.6,,2520.32,88,,2016.26,,,0,"percent of total billed charges","88% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5162.77,100,,,,,0,"fee schedule",EAPG,2864,100,,2291.20,,,0,"percent of total billed charges","100% of total billed charges",18373.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",5317.65,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1804.32,63,,1443.46,,,0,"percent of total billed charges","63% of total billed charges",438.19,15.3,,350.55,,,0,"percent of total billed charges","15.3% of total billed charges",5162.77,100,,,,,0,"fee schedule",EAPG,1976.16,69,,,,,0,"fee schedule","69% of total billed charges",2864,100,,2291.20,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2864,100,,2291.20,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2864,100,,2291.20,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",36187.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5162.77,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9460.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5266.02,100,,,,,0,"fee schedule",EAPG,6711.6,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1079.73,37.7,,863.78,,,0,"percent of total billed charges","37.70% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2233.92,78,,1787.14,,,0,"percent of total billed charges","78% of total billed charges",10604.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2365.66,82.6,,1892.53,,,0,"percent of total billed charges","82.6% of total billed charges",5162.77,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2365.66,82.6,,1892.53,,,0,"percent of total billed charges","82.6% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5323.3,100,,,,,0,"fee schedule",EAPG,2864,100,,2291.20,,,0,"percent of total billed charges","100% of total billed charges",438.19,36187.64,
"57452 Colposcopy of cervix",7904727,CDM,521,RC,57452,CPT,OUTPATIENT,,,365,237.25,,321.2,88,,256.96,,,0,"percent of total billed charges","88% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.4,100,,,,,0,"fee schedule",EAPG,365,100,,292.00,,,0,"percent of total billed charges","100% of total billed charges",355.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",424.77,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.95,63,,183.96,,,0,"percent of total billed charges","63% of total billed charges",55.85,15.3,,44.68,,,0,"percent of total billed charges","15.3% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,251.85,69,,,,,0,"fee schedule","69% of total billed charges",365,100,,292.00,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",365,100,,292.00,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",365,100,,292.00,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",691.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.4,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.64,100,,,,,0,"fee schedule",EAPG,536.12,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",137.61,37.7,,110.09,,,0,"percent of total billed charges","37.70% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.7,78,,227.76,,,0,"percent of total billed charges","78% of total billed charges",205.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",301.49,82.6,,241.19,,,0,"percent of total billed charges","82.6% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",301.49,82.6,,241.19,,,0,"percent of total billed charges","82.6% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",572.93,100,,,,,0,"fee schedule",EAPG,365,100,,292.00,,,0,"percent of total billed charges","100% of total billed charges",55.85,691.92,
"57454 Colposcopy of the cervix w/biopsy and ECC",7904728,CDM,521,RC,57454,CPT,OUTPATIENT,,,531,345.15,,467.28,88,,373.82,,,0,"percent of total billed charges","88% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.4,100,,,,,0,"fee schedule",EAPG,531,100,,424.80,,,0,"percent of total billed charges","100% of total billed charges",572.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",424.77,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",334.53,63,,267.62,,,0,"percent of total billed charges","63% of total billed charges",81.24,15.3,,64.99,,,0,"percent of total billed charges","15.3% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,366.39,69,,,,,0,"fee schedule","69% of total billed charges",531,100,,424.80,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",531,100,,424.80,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",531,100,,424.80,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",1143.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.4,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.64,100,,,,,0,"fee schedule",EAPG,536.12,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",200.19,37.7,,160.15,,,0,"percent of total billed charges","37.70% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",414.18,78,,331.34,,,0,"percent of total billed charges","78% of total billed charges",330.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",438.61,82.6,,350.89,,,0,"percent of total billed charges","82.6% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",438.61,82.6,,350.89,,,0,"percent of total billed charges","82.6% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",572.93,100,,,,,0,"fee schedule",EAPG,531,100,,424.80,,,0,"percent of total billed charges","100% of total billed charges",81.24,1143.51,
"57455 Colposcopy of cervix w/ biopsy",7904729,CDM,521,RC,57455,CPT,OUTPATIENT,,,322,209.3,,283.36,88,,226.69,,,0,"percent of total billed charges","88% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.4,100,,,,,0,"fee schedule",EAPG,322,100,,257.60,,,0,"percent of total billed charges","100% of total billed charges",572.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",424.77,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.86,63,,162.29,,,0,"percent of total billed charges","63% of total billed charges",49.27,15.3,,39.42,,,0,"percent of total billed charges","15.3% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,222.18,69,,,,,0,"fee schedule","69% of total billed charges",322,100,,257.60,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",322,100,,257.60,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",322,100,,257.60,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",1143.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.4,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.64,100,,,,,0,"fee schedule",EAPG,536.12,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",121.39,37.7,,97.11,,,0,"percent of total billed charges","37.70% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",251.16,78,,200.93,,,0,"percent of total billed charges","78% of total billed charges",330.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.97,82.6,,212.78,,,0,"percent of total billed charges","82.6% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.97,82.6,,212.78,,,0,"percent of total billed charges","82.6% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",572.93,100,,,,,0,"fee schedule",EAPG,322,100,,257.60,,,0,"percent of total billed charges","100% of total billed charges",49.27,1143.51,
"57456 Colposcopy of the cervix including upper/adj",7904730,CDM,521,RC,57456,CPT,OUTPATIENT,,,272,176.8,,239.36,88,,191.49,,,0,"percent of total billed charges","88% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.4,100,,,,,0,"fee schedule",EAPG,272,100,,217.60,,,0,"percent of total billed charges","100% of total billed charges",572.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",424.77,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.36,63,,137.09,,,0,"percent of total billed charges","63% of total billed charges",41.62,15.3,,33.30,,,0,"percent of total billed charges","15.3% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,187.68,69,,,,,0,"fee schedule","69% of total billed charges",272,100,,217.60,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272,100,,217.60,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272,100,,217.60,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",1143.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.4,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.64,100,,,,,0,"fee schedule",EAPG,536.12,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",102.54,37.7,,82.03,,,0,"percent of total billed charges","37.70% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",212.16,78,,169.73,,,0,"percent of total billed charges","78% of total billed charges",330.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.67,82.6,,179.74,,,0,"percent of total billed charges","82.6% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.67,82.6,,179.74,,,0,"percent of total billed charges","82.6% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",572.93,100,,,,,0,"fee schedule",EAPG,272,100,,217.60,,,0,"percent of total billed charges","100% of total billed charges",41.62,1143.51,
"57461 Colposcopy of the cervix including upper/adj",7904731,CDM,521,RC,57461,CPT,OUTPATIENT,,,814,529.1,,716.32,88,,573.06,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,814,100,,651.20,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",2108.45,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.82,63,,410.26,,,0,"percent of total billed charges","63% of total billed charges",124.54,15.3,,99.63,,,0,"percent of total billed charges","15.3% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,561.66,69,,,,,0,"fee schedule","69% of total billed charges",814,100,,651.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",814,100,,651.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",814,100,,651.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.98,100,,,,,0,"fee schedule",EAPG,2661.15,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",306.88,37.7,,245.50,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",634.92,78,,507.94,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672.36,82.6,,537.89,,,0,"percent of total billed charges","82.6% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672.36,82.6,,537.89,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2207.57,100,,,,,0,"fee schedule",EAPG,814,100,,651.20,,,0,"percent of total billed charges","100% of total billed charges",124.54,10656.86,
"57460 Colposcopy of the cervix incl. upper vagina;",7961936,CDM,521,RC,57460,CPT,OUTPATIENT,,,1257,817.05,,1106.16,88,,884.93,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,1257,100,,1005.60,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",2108.45,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",791.91,63,,633.53,,,0,"percent of total billed charges","63% of total billed charges",192.32,15.3,,153.86,,,0,"percent of total billed charges","15.3% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,867.33,69,,,,,0,"fee schedule","69% of total billed charges",1257,100,,1005.60,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1257,100,,1005.60,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1257,100,,1005.60,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.98,100,,,,,0,"fee schedule",EAPG,2661.15,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",473.89,37.7,,379.11,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",980.46,78,,784.37,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1038.28,82.6,,830.62,,,0,"percent of total billed charges","82.6% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1038.28,82.6,,830.62,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2207.57,100,,,,,0,"fee schedule",EAPG,1257,100,,1005.60,,,0,"percent of total billed charges","100% of total billed charges",192.32,10656.86,
"57500 Excision procedures on the cervix uteri",7904706,CDM,521,RC,57500,CPT,OUTPATIENT,,,290,188.5,,255.2,88,,204.16,,,0,"percent of total billed charges","88% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.4,100,,,,,0,"fee schedule",EAPG,290,100,,232.00,,,0,"percent of total billed charges","100% of total billed charges",1434.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",424.77,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",182.7,63,,146.16,,,0,"percent of total billed charges","63% of total billed charges",44.37,15.3,,35.50,,,0,"percent of total billed charges","15.3% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,200.1,69,,,,,0,"fee schedule","69% of total billed charges",290,100,,232.00,,,0,"percent of total billed charges","100% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290,100,,232.00,,,0,"percent of total billed charges","100% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290,100,,232.00,,,0,"percent of total billed charges","100% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",2573.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.4,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.64,100,,,,,0,"fee schedule",EAPG,536.12,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",109.33,37.7,,87.46,,,0,"percent of total billed charges","37.70% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",226.2,78,,180.96,,,0,"percent of total billed charges","78% of total billed charges",828.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",239.54,82.6,,191.63,,,0,"percent of total billed charges","82.6% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",239.54,82.6,,191.63,,,0,"percent of total billed charges","82.6% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",572.93,100,,,,,0,"fee schedule",EAPG,290,100,,232.00,,,0,"percent of total billed charges","100% of total billed charges",44.37,2573.24,
"57505 Endocervical curettage",7904732,CDM,521,RC,57505,CPT,OUTPATIENT,,,302,196.3,,265.76,88,,212.61,,,0,"percent of total billed charges","88% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.4,100,,,,,0,"fee schedule",EAPG,302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",1434.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",424.77,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.26,63,,152.21,,,0,"percent of total billed charges","63% of total billed charges",46.21,15.3,,36.97,,,0,"percent of total billed charges","15.3% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,208.38,69,,,,,0,"fee schedule","69% of total billed charges",302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",2573.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.4,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.64,100,,,,,0,"fee schedule",EAPG,536.12,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",113.85,37.7,,91.08,,,0,"percent of total billed charges","37.70% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",235.56,78,,188.45,,,0,"percent of total billed charges","78% of total billed charges",828.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",249.45,82.6,,199.56,,,0,"percent of total billed charges","82.6% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",249.45,82.6,,199.56,,,0,"percent of total billed charges","82.6% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",572.93,100,,,,,0,"fee schedule",EAPG,302,100,,241.60,,,0,"percent of total billed charges","100% of total billed charges",46.21,2573.24,
"57511 Cautery of cervix",7904733,CDM,521,RC,57511,CPT,OUTPATIENT,,,392,254.8,,344.96,88,,275.97,,,0,"percent of total billed charges","88% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.4,100,,,,,0,"fee schedule",EAPG,392,100,,313.60,,,0,"percent of total billed charges","100% of total billed charges",572.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",424.77,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",246.96,63,,197.57,,,0,"percent of total billed charges","63% of total billed charges",59.98,15.3,,47.98,,,0,"percent of total billed charges","15.3% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,270.48,69,,,,,0,"fee schedule","69% of total billed charges",392,100,,313.60,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392,100,,313.60,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392,100,,313.60,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",1143.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.4,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.64,100,,,,,0,"fee schedule",EAPG,536.12,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",147.78,37.7,,118.22,,,0,"percent of total billed charges","37.70% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",305.76,78,,244.61,,,0,"percent of total billed charges","78% of total billed charges",330.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",323.79,82.6,,259.03,,,0,"percent of total billed charges","82.6% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",323.79,82.6,,259.03,,,0,"percent of total billed charges","82.6% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",572.93,100,,,,,0,"fee schedule",EAPG,392,100,,313.60,,,0,"percent of total billed charges","100% of total billed charges",59.98,1143.51,
"57510 Cautery of cervix; electro or thermal",7963650,CDM,521,RC,57510,CPT,OUTPATIENT,,,345,224.25,,303.6,88,,242.88,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,345,100,,276.00,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",2108.45,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",217.35,63,,173.88,,,0,"percent of total billed charges","63% of total billed charges",52.79,15.3,,42.23,,,0,"percent of total billed charges","15.3% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,238.05,69,,,,,0,"fee schedule","69% of total billed charges",345,100,,276.00,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345,100,,276.00,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345,100,,276.00,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.98,100,,,,,0,"fee schedule",EAPG,2661.15,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.07,37.7,,104.06,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",269.1,78,,215.28,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.97,82.6,,227.98,,,0,"percent of total billed charges","82.6% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.97,82.6,,227.98,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2207.57,100,,,,,0,"fee schedule",EAPG,345,100,,276.00,,,0,"percent of total billed charges","100% of total billed charges",52.79,10656.86,
"57522 Conization of cervix; loop electrode excisio",7963488,CDM,521,RC,57522,CPT,OUTPATIENT,,,1400,910,,1232,88,,985.60,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,1400,100,,1120.00,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",2108.45,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",882,63,,705.60,,,0,"percent of total billed charges","63% of total billed charges",214.2,15.3,,171.36,,,0,"percent of total billed charges","15.3% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,966,69,,,,,0,"fee schedule","69% of total billed charges",1400,100,,1120.00,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1400,100,,1120.00,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1400,100,,1120.00,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.98,100,,,,,0,"fee schedule",EAPG,2661.15,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",527.8,37.7,,422.24,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1092,78,,873.60,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1156.4,82.6,,925.12,,,0,"percent of total billed charges","82.6% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1156.4,82.6,,925.12,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2207.57,100,,,,,0,"fee schedule",EAPG,1400,100,,1120.00,,,0,"percent of total billed charges","100% of total billed charges",214.2,10656.86,
"57520 Conization of cervix; cold knife or laser",7963564,CDM,521,RC,57520,CPT,OUTPATIENT,,,1618,1051.7,,1423.84,88,,1139.07,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,1618,100,,1294.40,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",2108.45,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1019.34,63,,815.47,,,0,"percent of total billed charges","63% of total billed charges",247.55,15.3,,198.04,,,0,"percent of total billed charges","15.3% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,1116.42,69,,,,,0,"fee schedule","69% of total billed charges",1618,100,,1294.40,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1618,100,,1294.40,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1618,100,,1294.40,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.98,100,,,,,0,"fee schedule",EAPG,2661.15,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",609.99,37.7,,487.99,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1262.04,78,,1009.63,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1336.47,82.6,,1069.18,,,0,"percent of total billed charges","82.6% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1336.47,82.6,,1069.18,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2207.57,100,,,,,0,"fee schedule",EAPG,1618,100,,1294.40,,,0,"percent of total billed charges","100% of total billed charges",247.55,10656.86,
"57555 Excision of cervical stump, vaginal approach",7962381,CDM,521,RC,57555,CPT,OUTPATIENT,,,1278,830.7,,1124.64,88,,899.71,,,0,"percent of total billed charges","88% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,1278,100,,1022.40,,,0,"percent of total billed charges","100% of total billed charges",8878.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",2108.45,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",805.14,63,,644.11,,,0,"percent of total billed charges","63% of total billed charges",195.53,15.3,,156.42,,,0,"percent of total billed charges","15.3% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,881.82,69,,,,,0,"fee schedule","69% of total billed charges",1278,100,,1022.40,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1278,100,,1022.40,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1278,100,,1022.40,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",17913.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.98,100,,,,,0,"fee schedule",EAPG,2661.15,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",481.81,37.7,,385.45,,,0,"percent of total billed charges","37.70% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",996.84,78,,797.47,,,0,"percent of total billed charges","78% of total billed charges",5123.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055.63,82.6,,844.50,,,0,"percent of total billed charges","82.6% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1055.63,82.6,,844.50,,,0,"percent of total billed charges","82.6% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2207.57,100,,,,,0,"fee schedule",EAPG,1278,100,,1022.40,,,0,"percent of total billed charges","100% of total billed charges",195.53,17913.89,
"57558 Dilation and curettage of cervical stump",7963553,CDM,521,RC,57558,CPT,OUTPATIENT,,,316,205.4,,278.08,88,,222.46,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",2108.45,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.08,63,,159.26,,,0,"percent of total billed charges","63% of total billed charges",48.35,15.3,,38.68,,,0,"percent of total billed charges","15.3% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,218.04,69,,,,,0,"fee schedule","69% of total billed charges",316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.98,100,,,,,0,"fee schedule",EAPG,2661.15,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",119.13,37.7,,95.30,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",246.48,78,,197.18,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",261.02,82.6,,208.82,,,0,"percent of total billed charges","82.6% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",261.02,82.6,,208.82,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2207.57,100,,,,,0,"fee schedule",EAPG,316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",48.35,10656.86,
"57800 Dilation cervial canal instrumental",7904734,CDM,521,RC,57800,CPT,OUTPATIENT,,,135,87.75,,118.8,88,,95.04,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,135,100,,108.00,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",2108.45,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.05,63,,68.04,,,0,"percent of total billed charges","63% of total billed charges",20.66,15.3,,16.53,,,0,"percent of total billed charges","15.3% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,93.15,69,,,,,0,"fee schedule","69% of total billed charges",135,100,,108.00,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",135,100,,108.00,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",135,100,,108.00,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.98,100,,,,,0,"fee schedule",EAPG,2661.15,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",50.9,37.7,,40.72,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.3,78,,84.24,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.51,82.6,,89.21,,,0,"percent of total billed charges","82.6% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.51,82.6,,89.21,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2207.57,100,,,,,0,"fee schedule",EAPG,135,100,,108.00,,,0,"percent of total billed charges","100% of total billed charges",20.66,10656.86,
"58100 Endometrial sampling (biopsy) with or withou",7904707,CDM,521,RC,58100,CPT,OUTPATIENT,,,325,211.25,,286,88,,228.80,,,0,"percent of total billed charges","88% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.4,100,,,,,0,"fee schedule",EAPG,325,100,,260.00,,,0,"percent of total billed charges","100% of total billed charges",355.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",424.77,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",204.75,63,,163.80,,,0,"percent of total billed charges","63% of total billed charges",49.73,15.3,,39.78,,,0,"percent of total billed charges","15.3% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,224.25,69,,,,,0,"fee schedule","69% of total billed charges",325,100,,260.00,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",325,100,,260.00,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",325,100,,260.00,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",691.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",412.4,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.64,100,,,,,0,"fee schedule",EAPG,536.12,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",122.53,37.7,,98.02,,,0,"percent of total billed charges","37.70% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",253.5,78,,202.80,,,0,"percent of total billed charges","78% of total billed charges",205.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",268.45,82.6,,214.76,,,0,"percent of total billed charges","82.6% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",268.45,82.6,,214.76,,,0,"percent of total billed charges","82.6% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",572.93,100,,,,,0,"fee schedule",EAPG,325,100,,260.00,,,0,"percent of total billed charges","100% of total billed charges",49.73,691.92,
"58110 Excision procedures on the corpus uteri",7904735,CDM,521,RC,58110,CPT,OUTPATIENT,,,119,77.35,,104.72,88,,83.78,,,0,"percent of total billed charges","88% of total billed charges",59.5,50,,47.60,,,0,"percent of total billed charges","50% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",424.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",74.97,63,,59.98,,,0,"percent of total billed charges","63% of total billed charges",18.21,15.3,,14.57,,,0,"percent of total billed charges","15.3% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,82.11,69,,,,,0,"fee schedule","69% of total billed charges",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",73.6,61.85,,58.88,,,0,"percent of total billed charges","61.5% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,59.5,50,,47.60,,,0,"percent of total billed charges","50% of total billed charges",38.32,32.2,,30.66,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",420.64,100,,,,,0,"fee schedule",EAPG,536.12,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",92.82,78,,74.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",412.4,100,,,,,0,"fee schedule",EAPG,59.5,50,,47.60,,,0,"percent of total billed charges","50% of total billed charges",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",572.93,100,,,,,0,"fee schedule",EAPG,119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",18.21,572.93,
"58120 Dilation and curettage, diagnostic and/or th",7962823,CDM,521,RC,58120,CPT,OUTPATIENT,,,1246,809.9,,1096.48,88,,877.18,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,1246,100,,996.80,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",2108.45,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",784.98,63,,627.98,,,0,"percent of total billed charges","63% of total billed charges",190.64,15.3,,152.51,,,0,"percent of total billed charges","15.3% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,859.74,69,,,,,0,"fee schedule","69% of total billed charges",1246,100,,996.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1246,100,,996.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1246,100,,996.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.98,100,,,,,0,"fee schedule",EAPG,2661.15,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",469.74,37.7,,375.79,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",971.88,78,,777.50,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1029.2,82.6,,823.36,,,0,"percent of total billed charges","82.6% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1029.2,82.6,,823.36,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2207.57,100,,,,,0,"fee schedule",EAPG,1246,100,,996.80,,,0,"percent of total billed charges","100% of total billed charges",190.64,10656.86,
"58140 Myomectomy, excision, 1-4 intramural myoma(s",7961834,CDM,521,RC,58140,CPT,OUTPATIENT,,,4193,2725.45,,3689.84,88,,2951.87,,,0,"percent of total billed charges","88% of total billed charges",4193,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5380.85,100,,,,,0,"fee schedule",EAPG,4193,100,,3354.40,,,0,"percent of total billed charges","100% of total billed charges",4193,175,,,,,0,"fee schedule","175% of CMS fee schedule",5542.28,100,,,,,0,"fee schedule",EAPG,4193,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2641.59,63,,2113.27,,,0,"percent of total billed charges","63% of total billed charges",641.53,15.3,,513.22,,,0,"percent of total billed charges","15.3% of total billed charges",5380.85,100,,,,,0,"fee schedule",EAPG,2893.17,69,,,,,0,"fee schedule","69% of total billed charges",4193,100,,3354.40,,,0,"percent of total billed charges","100% of total billed charges",4193,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4193,100,,3354.40,,,0,"percent of total billed charges","100% of total billed charges",4193,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4193,100,,3354.40,,,0,"percent of total billed charges","100% of total billed charges",4193,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4193,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5380.85,100,,,,,0,"fee schedule",EAPG,4193,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4193,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4193,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5488.47,100,,,,,0,"fee schedule",EAPG,6995.11,100,,,,,0,"fee schedule",EAPG,4193,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1580.76,37.7,,1264.61,,,0,"percent of total billed charges","37.70% of total billed charges",4193,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4193,100,,,,,0,"fee schedule","100% of CMS fee schedule",3270.54,78,,2616.43,,,0,"percent of total billed charges","78% of total billed charges",4193,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3463.42,82.6,,2770.74,,,0,"percent of total billed charges","82.6% of total billed charges",5380.85,100,,,,,0,"fee schedule","100% of WA fee schedule",4193,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3463.42,82.6,,2770.74,,,0,"percent of total billed charges","82.6% of total billed charges",4193,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5541.38,100,,,,,0,"fee schedule",EAPG,4193,100,,3354.40,,,0,"percent of total billed charges","100% of total billed charges",641.53,6995.11,
"58145 Myomectomy, excision of fibroid tumor(s) of",7962423,CDM,521,RC,58145,CPT,OUTPATIENT,,,830,539.5,,730.4,88,,584.32,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3729.36,100,,,,,0,"fee schedule",EAPG,830,100,,664.00,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",3841.24,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",522.9,63,,418.32,,,0,"percent of total billed charges","63% of total billed charges",126.99,15.3,,101.59,,,0,"percent of total billed charges","15.3% of total billed charges",3729.36,100,,,,,0,"fee schedule",EAPG,572.7,69,,,,,0,"fee schedule","69% of total billed charges",830,100,,664.00,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",830,100,,664.00,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",830,100,,664.00,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3729.36,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3803.95,100,,,,,0,"fee schedule",EAPG,4848.17,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",312.91,37.7,,250.33,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.4,78,,517.92,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",685.58,82.6,,548.46,,,0,"percent of total billed charges","82.6% of total billed charges",3729.36,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",685.58,82.6,,548.46,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3889.89,100,,,,,0,"fee schedule",EAPG,830,100,,664.00,,,0,"percent of total billed charges","100% of total billed charges",126.99,10656.86,
"58150 Total abdominal hysterectomy, with or w/o re",7961627,CDM,521,RC,58150,CPT,OUTPATIENT,,,4949,3216.85,,4355.12,88,,3484.10,,,0,"percent of total billed charges","88% of total billed charges",4949,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5380.85,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",4949,175,,,,,0,"fee schedule","175% of CMS fee schedule",5542.28,100,,,,,0,"fee schedule",EAPG,4949,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3117.87,63,,2494.30,,,0,"percent of total billed charges","63% of total billed charges",757.2,15.3,,605.76,,,0,"percent of total billed charges","15.3% of total billed charges",5380.85,100,,,,,0,"fee schedule",EAPG,3414.81,69,,,,,0,"fee schedule","69% of total billed charges",4949,100,,3959.20,,,0,"percent of total billed charges","100% of total billed charges",4949,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4949,100,,3959.20,,,0,"percent of total billed charges","100% of total billed charges",4949,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4949,100,,3959.20,,,0,"percent of total billed charges","100% of total billed charges",4949,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4949,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5380.85,100,,,,,0,"fee schedule",EAPG,4949,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4949,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4949,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5488.47,100,,,,,0,"fee schedule",EAPG,6995.11,100,,,,,0,"fee schedule",EAPG,4949,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1865.77,37.7,,1492.62,,,0,"percent of total billed charges","37.70% of total billed charges",4949,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4949,100,,,,,0,"fee schedule","100% of CMS fee schedule",3860.22,78,,3088.18,,,0,"percent of total billed charges","78% of total billed charges",4949,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4087.87,82.6,,3270.30,,,0,"percent of total billed charges","82.6% of total billed charges",5380.85,100,,,,,0,"fee schedule","100% of WA fee schedule",4949,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4087.87,82.6,,3270.30,,,0,"percent of total billed charges","82.6% of total billed charges",4949,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5541.38,100,,,,,0,"fee schedule",EAPG,4949,100,,3959.20,,,0,"percent of total billed charges","100% of total billed charges",757.2,6995.11,
"58152 Total abdominal hysterectomy (corpus and cer",7962567,CDM,521,RC,58152,CPT,OUTPATIENT,,,5321,3458.65,,4682.48,88,,3745.98,,,0,"percent of total billed charges","88% of total billed charges",5321,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5380.85,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5321,175,,,,,0,"fee schedule","175% of CMS fee schedule",5542.28,100,,,,,0,"fee schedule",EAPG,5321,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3352.23,63,,2681.78,,,0,"percent of total billed charges","63% of total billed charges",814.11,15.3,,651.29,,,0,"percent of total billed charges","15.3% of total billed charges",5380.85,100,,,,,0,"fee schedule",EAPG,3671.49,69,,,,,0,"fee schedule","69% of total billed charges",5321,100,,4256.80,,,0,"percent of total billed charges","100% of total billed charges",5321,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5321,100,,4256.80,,,0,"percent of total billed charges","100% of total billed charges",5321,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5321,100,,4256.80,,,0,"percent of total billed charges","100% of total billed charges",5321,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5321,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5380.85,100,,,,,0,"fee schedule",EAPG,5321,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5321,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5321,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5488.47,100,,,,,0,"fee schedule",EAPG,6995.11,100,,,,,0,"fee schedule",EAPG,5321,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2006.02,37.7,,1604.82,,,0,"percent of total billed charges","37.70% of total billed charges",5321,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5321,100,,,,,0,"fee schedule","100% of CMS fee schedule",4150.38,78,,3320.30,,,0,"percent of total billed charges","78% of total billed charges",5321,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4395.15,82.6,,3516.12,,,0,"percent of total billed charges","82.6% of total billed charges",5380.85,100,,,,,0,"fee schedule","100% of WA fee schedule",5321,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4395.15,82.6,,3516.12,,,0,"percent of total billed charges","82.6% of total billed charges",5321,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5541.38,100,,,,,0,"fee schedule",EAPG,5321,100,,4256.80,,,0,"percent of total billed charges","100% of total billed charges",814.11,6995.11,
"58180 Supracervical abdominal hysterectomy",7963663,CDM,521,RC,58180,CPT,OUTPATIENT,,,2390,1553.5,,2103.2,88,,1682.56,,,0,"percent of total billed charges","88% of total billed charges",2390,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3729.36,100,,,,,0,"fee schedule",EAPG,2390,100,,1912.00,,,0,"percent of total billed charges","100% of total billed charges",2390,175,,,,,0,"fee schedule","175% of CMS fee schedule",3841.24,100,,,,,0,"fee schedule",EAPG,2390,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1505.7,63,,1204.56,,,0,"percent of total billed charges","63% of total billed charges",365.67,15.3,,292.54,,,0,"percent of total billed charges","15.3% of total billed charges",3729.36,100,,,,,0,"fee schedule",EAPG,1649.1,69,,,,,0,"fee schedule","69% of total billed charges",2390,100,,1912.00,,,0,"percent of total billed charges","100% of total billed charges",2390,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2390,100,,1912.00,,,0,"percent of total billed charges","100% of total billed charges",2390,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2390,100,,1912.00,,,0,"percent of total billed charges","100% of total billed charges",2390,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2390,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3729.36,100,,,,,0,"fee schedule",EAPG,2390,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2390,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2390,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3803.95,100,,,,,0,"fee schedule",EAPG,4848.17,100,,,,,0,"fee schedule",EAPG,2390,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",901.03,37.7,,720.82,,,0,"percent of total billed charges","37.70% of total billed charges",2390,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2390,100,,,,,0,"fee schedule","100% of CMS fee schedule",1864.2,78,,1491.36,,,0,"percent of total billed charges","78% of total billed charges",2390,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1974.14,82.6,,1579.31,,,0,"percent of total billed charges","82.6% of total billed charges",3729.36,100,,,,,0,"fee schedule","100% of WA fee schedule",2390,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1974.14,82.6,,1579.31,,,0,"percent of total billed charges","82.6% of total billed charges",2390,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3889.89,100,,,,,0,"fee schedule",EAPG,2390,100,,1912.00,,,0,"percent of total billed charges","100% of total billed charges",365.67,4848.17,
"58262 Vaginal hysterectomy, for uterus 250 g or le",7961937,CDM,521,RC,58262,CPT,OUTPATIENT,,,677,440.05,,595.76,88,,476.61,,,0,"percent of total billed charges","88% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3729.36,100,,,,,0,"fee schedule",EAPG,677,100,,541.60,,,0,"percent of total billed charges","100% of total billed charges",8878.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",3841.24,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.51,63,,341.21,,,0,"percent of total billed charges","63% of total billed charges",103.58,15.3,,82.86,,,0,"percent of total billed charges","15.3% of total billed charges",3729.36,100,,,,,0,"fee schedule",EAPG,467.13,69,,,,,0,"fee schedule","69% of total billed charges",677,100,,541.60,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",677,100,,541.60,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",677,100,,541.60,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",17913.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3729.36,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3803.95,100,,,,,0,"fee schedule",EAPG,4848.17,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",255.23,37.7,,204.18,,,0,"percent of total billed charges","37.70% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",528.06,78,,422.45,,,0,"percent of total billed charges","78% of total billed charges",5123.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",559.2,82.6,,447.36,,,0,"percent of total billed charges","82.6% of total billed charges",3729.36,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",559.2,82.6,,447.36,,,0,"percent of total billed charges","82.6% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3889.89,100,,,,,0,"fee schedule",EAPG,677,100,,541.60,,,0,"percent of total billed charges","100% of total billed charges",103.58,17913.89,
"58260 Vaginal hysterectomy, for uterus 250 g or le",7963468,CDM,521,RC,58260,CPT,OUTPATIENT,,,2085,1355.25,,1834.8,88,,1467.84,,,0,"percent of total billed charges","88% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3729.36,100,,,,,0,"fee schedule",EAPG,2085,100,,1668.00,,,0,"percent of total billed charges","100% of total billed charges",8878.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",3841.24,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1313.55,63,,1050.84,,,0,"percent of total billed charges","63% of total billed charges",319.01,15.3,,255.21,,,0,"percent of total billed charges","15.3% of total billed charges",3729.36,100,,,,,0,"fee schedule",EAPG,1438.65,69,,,,,0,"fee schedule","69% of total billed charges",2085,100,,1668.00,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2085,100,,1668.00,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2085,100,,1668.00,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",17913.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3729.36,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3803.95,100,,,,,0,"fee schedule",EAPG,4848.17,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",786.05,37.7,,628.84,,,0,"percent of total billed charges","37.70% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1626.3,78,,1301.04,,,0,"percent of total billed charges","78% of total billed charges",5123.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1722.21,82.6,,1377.77,,,0,"percent of total billed charges","82.6% of total billed charges",3729.36,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1722.21,82.6,,1377.77,,,0,"percent of total billed charges","82.6% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3889.89,100,,,,,0,"fee schedule",EAPG,2085,100,,1668.00,,,0,"percent of total billed charges","100% of total billed charges",319.01,17913.89,
"58270 Vaginal hysterectomy, for uterus 250 g or le",7962718,CDM,521,RC,58270,CPT,OUTPATIENT,,,4660,3029,,4100.8,88,,3280.64,,,0,"percent of total billed charges","88% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3729.36,100,,,,,0,"fee schedule",EAPG,4660,100,,3728.00,,,0,"percent of total billed charges","100% of total billed charges",8878.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",3841.24,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2935.8,63,,2348.64,,,0,"percent of total billed charges","63% of total billed charges",712.98,15.3,,570.38,,,0,"percent of total billed charges","15.3% of total billed charges",3729.36,100,,,,,0,"fee schedule",EAPG,3215.4,69,,,,,0,"fee schedule","69% of total billed charges",4660,100,,3728.00,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4660,100,,3728.00,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4660,100,,3728.00,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",17913.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3729.36,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3803.95,100,,,,,0,"fee schedule",EAPG,4848.17,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1756.82,37.7,,1405.46,,,0,"percent of total billed charges","37.70% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3634.8,78,,2907.84,,,0,"percent of total billed charges","78% of total billed charges",5123.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3849.16,82.6,,3079.33,,,0,"percent of total billed charges","82.6% of total billed charges",3729.36,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3849.16,82.6,,3079.33,,,0,"percent of total billed charges","82.6% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3889.89,100,,,,,0,"fee schedule",EAPG,4660,100,,3728.00,,,0,"percent of total billed charges","100% of total billed charges",712.98,17913.89,
"58300 Introduction procedures on the corpus uteri",7904708,CDM,521,RC,58300,CPT,OUTPATIENT,,,315,204.75,,277.2,88,,221.76,,,0,"percent of total billed charges","88% of total billed charges",157.5,50,,126.00,,,0,"percent of total billed charges","50% of total billed charges",177.73,100,,,,,0,"fee schedule",EAPG,315,100,,252.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.06,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",198.45,63,,158.76,,,0,"percent of total billed charges","63% of total billed charges",48.2,15.3,,38.56,,,0,"percent of total billed charges","15.3% of total billed charges",177.73,100,,,,,0,"fee schedule",EAPG,217.35,69,,,,,0,"fee schedule","69% of total billed charges",315,100,,252.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",315,100,,252.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",315,100,,252.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.83,61.85,,155.86,,,0,"percent of total billed charges","61.5% of total billed charges",177.73,100,,,,,0,"fee schedule",EAPG,157.5,50,,126.00,,,0,"percent of total billed charges","50% of total billed charges",101.43,32.2,,81.14,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",181.28,100,,,,,0,"fee schedule",EAPG,231.05,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",118.76,37.7,,95.01,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",245.7,78,,196.56,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",260.19,82.6,,208.15,,,0,"percent of total billed charges","82.6% of total billed charges",177.73,100,,,,,0,"fee schedule",EAPG,157.5,50,,126.00,,,0,"percent of total billed charges","50% of total billed charges",260.19,82.6,,208.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",338.26,100,,,,,0,"fee schedule",EAPG,315,100,,252.00,,,0,"percent of total billed charges","100% of total billed charges",48.2,338.26,
"58301 Introduction procedures on the corpus uteri",7904709,CDM,521,RC,58301,CPT,OUTPATIENT,,,203,131.95,,178.64,88,,142.91,,,0,"percent of total billed charges","88% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.73,100,,,,,0,"fee schedule",EAPG,203,100,,162.40,,,0,"percent of total billed charges","100% of total billed charges",572.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",183.06,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",127.89,63,,102.31,,,0,"percent of total billed charges","63% of total billed charges",31.06,15.3,,24.85,,,0,"percent of total billed charges","15.3% of total billed charges",177.73,100,,,,,0,"fee schedule",EAPG,140.07,69,,,,,0,"fee schedule","69% of total billed charges",203,100,,162.40,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",203,100,,162.40,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",203,100,,162.40,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",1143.52,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.73,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",181.28,100,,,,,0,"fee schedule",EAPG,231.05,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",76.53,37.7,,61.22,,,0,"percent of total billed charges","37.70% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158.34,78,,126.67,,,0,"percent of total billed charges","78% of total billed charges",330.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",167.68,82.6,,134.14,,,0,"percent of total billed charges","82.6% of total billed charges",177.73,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",167.68,82.6,,134.14,,,0,"percent of total billed charges","82.6% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.26,100,,,,,0,"fee schedule",EAPG,203,100,,162.40,,,0,"percent of total billed charges","100% of total billed charges",31.06,1143.52,
"58340 Catheterization and introduction of saline o",7962608,CDM,521,RC,58340,CPT,OUTPATIENT,,,416,270.4,,366.08,88,,292.86,,,0,"percent of total billed charges","88% of total billed charges",208,50,,166.40,,,0,"percent of total billed charges","50% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,416,100,,332.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.05,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",262.08,63,,209.66,,,0,"percent of total billed charges","63% of total billed charges",63.65,15.3,,50.92,,,0,"percent of total billed charges","15.3% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,287.04,69,,,,,0,"fee schedule","69% of total billed charges",416,100,,332.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",416,100,,332.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",416,100,,332.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",257.3,61.85,,205.84,,,0,"percent of total billed charges","61.5% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,208,50,,166.40,,,0,"percent of total billed charges","50% of total billed charges",133.95,32.2,,107.16,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",278.32,100,,,,,0,"fee schedule",EAPG,354.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.83,37.7,,125.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",324.48,78,,259.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",343.62,82.6,,274.90,,,0,"percent of total billed charges","82.6% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,208,50,,166.40,,,0,"percent of total billed charges","50% of total billed charges",343.62,82.6,,274.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",433.4,100,,,,,0,"fee schedule",EAPG,416,100,,332.80,,,0,"percent of total billed charges","100% of total billed charges",63.65,433.4,
"58350 Chromotubation of oviduct, including materia",7963469,CDM,521,RC,58350,CPT,OUTPATIENT,,,243,157.95,,213.84,88,,171.07,,,0,"percent of total billed charges","88% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,243,100,,194.40,,,0,"percent of total billed charges","100% of total billed charges",8878.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",2108.45,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",153.09,63,,122.47,,,0,"percent of total billed charges","63% of total billed charges",37.18,15.3,,29.74,,,0,"percent of total billed charges","15.3% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,167.67,69,,,,,0,"fee schedule","69% of total billed charges",243,100,,194.40,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",243,100,,194.40,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",243,100,,194.40,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",17913.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.98,100,,,,,0,"fee schedule",EAPG,2661.15,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",91.61,37.7,,73.29,,,0,"percent of total billed charges","37.70% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.54,78,,151.63,,,0,"percent of total billed charges","78% of total billed charges",5123.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200.72,82.6,,160.58,,,0,"percent of total billed charges","82.6% of total billed charges",2047.04,100,,,,,0,"fee schedule","100% of WA fee schedule",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200.72,82.6,,160.58,,,0,"percent of total billed charges","82.6% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2207.57,100,,,,,0,"fee schedule",EAPG,243,100,,194.40,,,0,"percent of total billed charges","100% of total billed charges",37.18,17913.89,
"58400 Uterine suspension",7963913,CDM,521,RC,58400,CPT,OUTPATIENT,,,955,620.75,,840.4,88,,672.32,,,0,"percent of total billed charges","88% of total billed charges",955,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2047.04,100,,,,,0,"fee schedule",EAPG,955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",955,175,,,,,0,"fee schedule","175% of CMS fee schedule",2108.45,100,,,,,0,"fee schedule",EAPG,955,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",601.65,63,,481.32,,,0,"percent of total billed charges","63% of total billed charges",146.12,15.3,,116.90,,,0,"percent of total billed charges","15.3% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,658.95,69,,,,,0,"fee schedule","69% of total billed charges",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",955,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",955,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",955,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",955,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2047.04,100,,,,,0,"fee schedule",EAPG,955,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",955,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",955,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2087.98,100,,,,,0,"fee schedule",EAPG,2661.15,100,,,,,0,"fee schedule",EAPG,955,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",360.04,37.7,,288.03,,,0,"percent of total billed charges","37.70% of total billed charges",955,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",955,100,,,,,0,"fee schedule","100% of CMS fee schedule",744.9,78,,595.92,,,0,"percent of total billed charges","78% of total billed charges",955,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",788.83,82.6,,631.06,,,0,"percent of total billed charges","82.6% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,955,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",788.83,82.6,,631.06,,,0,"percent of total billed charges","82.6% of total billed charges",955,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2207.57,100,,,,,0,"fee schedule",EAPG,955,100,,764.00,,,0,"percent of total billed charges","100% of total billed charges",146.12,2661.15,
"58541 Laparoscopy, surgical, supracervical hystere",7962609,CDM,521,RC,58541,CPT,OUTPATIENT,,,2151,1398.15,,1892.88,88,,1514.30,,,0,"percent of total billed charges","88% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5380.85,100,,,,,0,"fee schedule",EAPG,2151,100,,1720.80,,,0,"percent of total billed charges","100% of total billed charges",18373.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",5542.28,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1355.13,63,,1084.10,,,0,"percent of total billed charges","63% of total billed charges",329.1,15.3,,263.28,,,0,"percent of total billed charges","15.3% of total billed charges",5380.85,100,,,,,0,"fee schedule",EAPG,1484.19,69,,,,,0,"fee schedule","69% of total billed charges",2151,100,,1720.80,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2151,100,,1720.80,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2151,100,,1720.80,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5380.85,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5488.47,100,,,,,0,"fee schedule",EAPG,6995.11,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",810.93,37.7,,648.74,,,0,"percent of total billed charges","37.70% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1677.78,78,,1342.22,,,0,"percent of total billed charges","78% of total billed charges",10604.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1776.73,82.6,,1421.38,,,0,"percent of total billed charges","82.6% of total billed charges",5380.85,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1776.73,82.6,,1421.38,,,0,"percent of total billed charges","82.6% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5541.38,100,,,,,0,"fee schedule",EAPG,2151,100,,1720.80,,,0,"percent of total billed charges","100% of total billed charges",329.1,20558.19,
"58542 Lap. Supracervical hysterectomy 250g or less",7962941,CDM,521,RC,58542,CPT,OUTPATIENT,,,2188,1422.2,,1925.44,88,,1540.35,,,0,"percent of total billed charges","88% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5380.85,100,,,,,0,"fee schedule",EAPG,2188,100,,1750.40,,,0,"percent of total billed charges","100% of total billed charges",18373.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",5542.28,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1378.44,63,,1102.75,,,0,"percent of total billed charges","63% of total billed charges",334.76,15.3,,267.81,,,0,"percent of total billed charges","15.3% of total billed charges",5380.85,100,,,,,0,"fee schedule",EAPG,1509.72,69,,,,,0,"fee schedule","69% of total billed charges",2188,100,,1750.40,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2188,100,,1750.40,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2188,100,,1750.40,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",36187.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5380.85,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9460.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5488.47,100,,,,,0,"fee schedule",EAPG,6995.11,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",824.88,37.7,,659.90,,,0,"percent of total billed charges","37.70% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1706.64,78,,1365.31,,,0,"percent of total billed charges","78% of total billed charges",10604.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1807.29,82.6,,1445.83,,,0,"percent of total billed charges","82.6% of total billed charges",5380.85,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1807.29,82.6,,1445.83,,,0,"percent of total billed charges","82.6% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5541.38,100,,,,,0,"fee schedule",EAPG,2188,100,,1750.40,,,0,"percent of total billed charges","100% of total billed charges",334.76,36187.64,
"58558 Hysteroscopy, surgical; w/ biopsy of endomet",7962260,CDM,521,RC,58558,CPT,OUTPATIENT,,,788,512.2,,693.44,88,,554.75,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,788,100,,630.40,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",2108.45,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",496.44,63,,397.15,,,0,"percent of total billed charges","63% of total billed charges",120.56,15.3,,96.45,,,0,"percent of total billed charges","15.3% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,543.72,69,,,,,0,"fee schedule","69% of total billed charges",788,100,,630.40,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",788,100,,630.40,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",788,100,,630.40,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.98,100,,,,,0,"fee schedule",EAPG,2661.15,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",297.08,37.7,,237.66,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",614.64,78,,491.71,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",650.89,82.6,,520.71,,,0,"percent of total billed charges","82.6% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",650.89,82.6,,520.71,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2207.57,100,,,,,0,"fee schedule",EAPG,788,100,,630.40,,,0,"percent of total billed charges","100% of total billed charges",120.56,10656.86,
"58553 Laparoscopy, surgical, with vaginal hysterec",7962481,CDM,521,RC,58553,CPT,OUTPATIENT,,,3357,2182.05,,2954.16,88,,2363.33,,,0,"percent of total billed charges","88% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5380.85,100,,,,,0,"fee schedule",EAPG,3357,100,,2685.60,,,0,"percent of total billed charges","100% of total billed charges",18373.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",5542.28,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2114.91,63,,1691.93,,,0,"percent of total billed charges","63% of total billed charges",513.62,15.3,,410.90,,,0,"percent of total billed charges","15.3% of total billed charges",5380.85,100,,,,,0,"fee schedule",EAPG,2316.33,69,,,,,0,"fee schedule","69% of total billed charges",3357,100,,2685.60,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3357,100,,2685.60,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3357,100,,2685.60,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",36187.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5380.85,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9460.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5488.47,100,,,,,0,"fee schedule",EAPG,6995.11,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1265.59,37.7,,1012.47,,,0,"percent of total billed charges","37.70% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2618.46,78,,2094.77,,,0,"percent of total billed charges","78% of total billed charges",10604.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2772.88,82.6,,2218.30,,,0,"percent of total billed charges","82.6% of total billed charges",5380.85,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2772.88,82.6,,2218.30,,,0,"percent of total billed charges","82.6% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5541.38,100,,,,,0,"fee schedule",EAPG,3357,100,,2685.60,,,0,"percent of total billed charges","100% of total billed charges",513.62,36187.64,
"58554 Laparoscopy, surgical, with vaginal hysterec",7962507,CDM,521,RC,58554,CPT,OUTPATIENT,,,3899,2534.35,,3431.12,88,,2744.90,,,0,"percent of total billed charges","88% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5380.85,100,,,,,0,"fee schedule",EAPG,3899,100,,3119.20,,,0,"percent of total billed charges","100% of total billed charges",18373.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",5542.28,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2456.37,63,,1965.10,,,0,"percent of total billed charges","63% of total billed charges",596.55,15.3,,477.24,,,0,"percent of total billed charges","15.3% of total billed charges",5380.85,100,,,,,0,"fee schedule",EAPG,2690.31,69,,,,,0,"fee schedule","69% of total billed charges",3899,100,,3119.20,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3899,100,,3119.20,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3899,100,,3119.20,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",36187.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5380.85,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9460.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5488.47,100,,,,,0,"fee schedule",EAPG,6995.11,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1469.92,37.7,,1175.94,,,0,"percent of total billed charges","37.70% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3041.22,78,,2432.98,,,0,"percent of total billed charges","78% of total billed charges",10604.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3220.57,82.6,,2576.46,,,0,"percent of total billed charges","82.6% of total billed charges",5380.85,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3220.57,82.6,,2576.46,,,0,"percent of total billed charges","82.6% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5541.38,100,,,,,0,"fee schedule",EAPG,3899,100,,3119.20,,,0,"percent of total billed charges","100% of total billed charges",596.55,36187.64,
"58550 Laparoscopy, surgical, with vaginal hysterec",7962645,CDM,521,RC,58550,CPT,OUTPATIENT,,,2612,1697.8,,2298.56,88,,1838.85,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5380.85,100,,,,,0,"fee schedule",EAPG,2612,100,,2089.60,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",5542.28,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1645.56,63,,1316.45,,,0,"percent of total billed charges","63% of total billed charges",399.64,15.3,,319.71,,,0,"percent of total billed charges","15.3% of total billed charges",5380.85,100,,,,,0,"fee schedule",EAPG,1802.28,69,,,,,0,"fee schedule","69% of total billed charges",2612,100,,2089.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2612,100,,2089.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2612,100,,2089.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5380.85,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5488.47,100,,,,,0,"fee schedule",EAPG,6995.11,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",984.72,37.7,,787.78,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2037.36,78,,1629.89,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2157.51,82.6,,1726.01,,,0,"percent of total billed charges","82.6% of total billed charges",5380.85,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2157.51,82.6,,1726.01,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5541.38,100,,,,,0,"fee schedule",EAPG,2612,100,,2089.60,,,0,"percent of total billed charges","100% of total billed charges",399.64,20558.19,
"58552 Laparoscopy, surgical, with vaginal hysterec",7962685,CDM,521,RC,58552,CPT,OUTPATIENT,,,2903,1886.95,,2554.64,88,,2043.71,,,0,"percent of total billed charges","88% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5380.85,100,,,,,0,"fee schedule",EAPG,2903,100,,2322.40,,,0,"percent of total billed charges","100% of total billed charges",18373.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",5542.28,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1828.89,63,,1463.11,,,0,"percent of total billed charges","63% of total billed charges",444.16,15.3,,355.33,,,0,"percent of total billed charges","15.3% of total billed charges",5380.85,100,,,,,0,"fee schedule",EAPG,2003.07,69,,,,,0,"fee schedule","69% of total billed charges",2903,100,,2322.40,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2903,100,,2322.40,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2903,100,,2322.40,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",36187.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5380.85,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9460.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5488.47,100,,,,,0,"fee schedule",EAPG,6995.11,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1094.43,37.7,,875.54,,,0,"percent of total billed charges","37.70% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2264.34,78,,1811.47,,,0,"percent of total billed charges","78% of total billed charges",10604.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2397.88,82.6,,1918.30,,,0,"percent of total billed charges","82.6% of total billed charges",5380.85,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2397.88,82.6,,1918.30,,,0,"percent of total billed charges","82.6% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5541.38,100,,,,,0,"fee schedule",EAPG,2903,100,,2322.40,,,0,"percent of total billed charges","100% of total billed charges",444.16,36187.64,
"58559 Hysteroscopy, surgical; with lysis of intrau",7962719,CDM,521,RC,58559,CPT,OUTPATIENT,,,1012,657.8,,890.56,88,,712.45,,,0,"percent of total billed charges","88% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,1012,100,,809.60,,,0,"percent of total billed charges","100% of total billed charges",8878.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",2108.45,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",637.56,63,,510.05,,,0,"percent of total billed charges","63% of total billed charges",154.84,15.3,,123.87,,,0,"percent of total billed charges","15.3% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,698.28,69,,,,,0,"fee schedule","69% of total billed charges",1012,100,,809.60,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1012,100,,809.60,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1012,100,,809.60,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",17913.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.98,100,,,,,0,"fee schedule",EAPG,2661.15,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",381.52,37.7,,305.22,,,0,"percent of total billed charges","37.70% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",789.36,78,,631.49,,,0,"percent of total billed charges","78% of total billed charges",5123.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",835.91,82.6,,668.73,,,0,"percent of total billed charges","82.6% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",835.91,82.6,,668.73,,,0,"percent of total billed charges","82.6% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2207.57,100,,,,,0,"fee schedule",EAPG,1012,100,,809.60,,,0,"percent of total billed charges","100% of total billed charges",154.84,17913.89,
"58555 Hysteroscopy, diagnostic (separate procedure",7963489,CDM,521,RC,58555,CPT,OUTPATIENT,,,1223,794.95,,1076.24,88,,860.99,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,1223,100,,978.40,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",2108.45,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.49,63,,616.39,,,0,"percent of total billed charges","63% of total billed charges",187.12,15.3,,149.70,,,0,"percent of total billed charges","15.3% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,843.87,69,,,,,0,"fee schedule","69% of total billed charges",1223,100,,978.40,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1223,100,,978.40,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1223,100,,978.40,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.98,100,,,,,0,"fee schedule",EAPG,2661.15,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",461.07,37.7,,368.86,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",953.94,78,,763.15,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1010.2,82.6,,808.16,,,0,"percent of total billed charges","82.6% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1010.2,82.6,,808.16,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2207.57,100,,,,,0,"fee schedule",EAPG,1223,100,,978.40,,,0,"percent of total billed charges","100% of total billed charges",187.12,10656.86,
"58560 Hysteroscopy, surgical; with division or res",7962261,CDM,521,RC,58560,CPT,OUTPATIENT,,,1146,744.9,,1008.48,88,,806.78,,,0,"percent of total billed charges","88% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,1146,100,,916.80,,,0,"percent of total billed charges","100% of total billed charges",8878.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",2108.45,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",721.98,63,,577.58,,,0,"percent of total billed charges","63% of total billed charges",175.34,15.3,,140.27,,,0,"percent of total billed charges","15.3% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,790.74,69,,,,,0,"fee schedule","69% of total billed charges",1146,100,,916.80,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1146,100,,916.80,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1146,100,,916.80,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",17913.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.98,100,,,,,0,"fee schedule",EAPG,2661.15,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",432.04,37.7,,345.63,,,0,"percent of total billed charges","37.70% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",893.88,78,,715.10,,,0,"percent of total billed charges","78% of total billed charges",5123.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",946.6,82.6,,757.28,,,0,"percent of total billed charges","82.6% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",946.6,82.6,,757.28,,,0,"percent of total billed charges","82.6% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2207.57,100,,,,,0,"fee schedule",EAPG,1146,100,,916.80,,,0,"percent of total billed charges","100% of total billed charges",175.34,17913.89,
"58565 Hysteroscopy, surgical; w/ bilateral fallopi",7963033,CDM,521,RC,58565,CPT,OUTPATIENT,,,1283,833.95,,1129.04,88,,903.23,,,0,"percent of total billed charges","88% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3806.28,100,,,,,0,"fee schedule",EAPG,1283,100,,1026.40,,,0,"percent of total billed charges","100% of total billed charges",8878.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",3920.47,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",808.29,63,,646.63,,,0,"percent of total billed charges","63% of total billed charges",196.3,15.3,,157.04,,,0,"percent of total billed charges","15.3% of total billed charges",3806.28,100,,,,,0,"fee schedule",EAPG,885.27,69,,,,,0,"fee schedule","69% of total billed charges",1283,100,,1026.40,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1283,100,,1026.40,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1283,100,,1026.40,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",17913.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3806.28,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3882.4,100,,,,,0,"fee schedule",EAPG,4948.16,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",483.69,37.7,,386.95,,,0,"percent of total billed charges","37.70% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1000.74,78,,800.59,,,0,"percent of total billed charges","78% of total billed charges",5123.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1059.76,82.6,,847.81,,,0,"percent of total billed charges","82.6% of total billed charges",3806.28,100,,,,,0,"fee schedule","100% of WA fee schedule",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1059.76,82.6,,847.81,,,0,"percent of total billed charges","82.6% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3966.81,100,,,,,0,"fee schedule",EAPG,1283,100,,1026.40,,,0,"percent of total billed charges","100% of total billed charges",196.3,17913.89,
"58562 Hysteroscopy, surgical; with removal of impa",7963082,CDM,521,RC,58562,CPT,OUTPATIENT,,,857,557.05,,754.16,88,,603.33,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,857,100,,685.60,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",2108.45,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",539.91,63,,431.93,,,0,"percent of total billed charges","63% of total billed charges",131.12,15.3,,104.90,,,0,"percent of total billed charges","15.3% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,591.33,69,,,,,0,"fee schedule","69% of total billed charges",857,100,,685.60,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",857,100,,685.60,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",857,100,,685.60,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.98,100,,,,,0,"fee schedule",EAPG,2661.15,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",323.09,37.7,,258.47,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",668.46,78,,534.77,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",707.88,82.6,,566.30,,,0,"percent of total billed charges","82.6% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",707.88,82.6,,566.30,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2207.57,100,,,,,0,"fee schedule",EAPG,857,100,,685.60,,,0,"percent of total billed charges","100% of total billed charges",131.12,10656.86,
"58561 Hysteroscopy, surgical; with removal of leio",7963368,CDM,521,RC,58561,CPT,OUTPATIENT,,,1630,1059.5,,1434.4,88,,1147.52,,,0,"percent of total billed charges","88% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3729.36,100,,,,,0,"fee schedule",EAPG,1630,100,,1304.00,,,0,"percent of total billed charges","100% of total billed charges",8878.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",3841.24,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1026.9,63,,821.52,,,0,"percent of total billed charges","63% of total billed charges",249.39,15.3,,199.51,,,0,"percent of total billed charges","15.3% of total billed charges",3729.36,100,,,,,0,"fee schedule",EAPG,1124.7,69,,,,,0,"fee schedule","69% of total billed charges",1630,100,,1304.00,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1630,100,,1304.00,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1630,100,,1304.00,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",17913.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3729.36,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3803.95,100,,,,,0,"fee schedule",EAPG,4848.17,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",614.51,37.7,,491.61,,,0,"percent of total billed charges","37.70% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1271.4,78,,1017.12,,,0,"percent of total billed charges","78% of total billed charges",5123.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1346.38,82.6,,1077.10,,,0,"percent of total billed charges","82.6% of total billed charges",3729.36,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1346.38,82.6,,1077.10,,,0,"percent of total billed charges","82.6% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3889.89,100,,,,,0,"fee schedule",EAPG,1630,100,,1304.00,,,0,"percent of total billed charges","100% of total billed charges",249.39,17913.89,
"58563 Hysteroscopy, surgical; with endometrial abl",7963417,CDM,521,RC,58563,CPT,OUTPATIENT,,,1014,659.1,,892.32,88,,713.86,,,0,"percent of total billed charges","88% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,1014,100,,811.20,,,0,"percent of total billed charges","100% of total billed charges",8878.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",2108.45,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.82,63,,511.06,,,0,"percent of total billed charges","63% of total billed charges",155.14,15.3,,124.11,,,0,"percent of total billed charges","15.3% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,699.66,69,,,,,0,"fee schedule","69% of total billed charges",1014,100,,811.20,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1014,100,,811.20,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1014,100,,811.20,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",17913.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.98,100,,,,,0,"fee schedule",EAPG,2661.15,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",382.28,37.7,,305.82,,,0,"percent of total billed charges","37.70% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790.92,78,,632.74,,,0,"percent of total billed charges","78% of total billed charges",5123.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",837.56,82.6,,670.05,,,0,"percent of total billed charges","82.6% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",837.56,82.6,,670.05,,,0,"percent of total billed charges","82.6% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2207.57,100,,,,,0,"fee schedule",EAPG,1014,100,,811.20,,,0,"percent of total billed charges","100% of total billed charges",155.14,17913.89,
"58571 Laparoscopy, surgical, w/ total hysterectomy",7961540,CDM,521,RC,58571,CPT,OUTPATIENT,,,3078,2000.7,,2708.64,88,,2166.91,,,0,"percent of total billed charges","88% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5380.85,100,,,,,0,"fee schedule",EAPG,3078,100,,2462.40,,,0,"percent of total billed charges","100% of total billed charges",18373.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",5542.28,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1939.14,63,,1551.31,,,0,"percent of total billed charges","63% of total billed charges",470.93,15.3,,376.74,,,0,"percent of total billed charges","15.3% of total billed charges",5380.85,100,,,,,0,"fee schedule",EAPG,2123.82,69,,,,,0,"fee schedule","69% of total billed charges",3078,100,,2462.40,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3078,100,,2462.40,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3078,100,,2462.40,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",36187.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5380.85,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9460.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5488.47,100,,,,,0,"fee schedule",EAPG,6995.11,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1160.41,37.7,,928.33,,,0,"percent of total billed charges","37.70% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2400.84,78,,1920.67,,,0,"percent of total billed charges","78% of total billed charges",10604.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2542.43,82.6,,2033.94,,,0,"percent of total billed charges","82.6% of total billed charges",5380.85,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2542.43,82.6,,2033.94,,,0,"percent of total billed charges","82.6% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5541.38,100,,,,,0,"fee schedule",EAPG,3078,100,,2462.40,,,0,"percent of total billed charges","100% of total billed charges",470.93,36187.64,
"58573 Laparoscopy, surgical, w/ total hysterectomy",7961541,CDM,521,RC,58573,CPT,OUTPATIENT,,,3945,2564.25,,3471.6,88,,2777.28,,,0,"percent of total billed charges","88% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5380.85,100,,,,,0,"fee schedule",EAPG,3945,100,,3156.00,,,0,"percent of total billed charges","100% of total billed charges",18373.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",5542.28,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2485.35,63,,1988.28,,,0,"percent of total billed charges","63% of total billed charges",603.59,15.3,,482.87,,,0,"percent of total billed charges","15.3% of total billed charges",5380.85,100,,,,,0,"fee schedule",EAPG,2722.05,69,,,,,0,"fee schedule","69% of total billed charges",3945,100,,3156.00,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3945,100,,3156.00,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3945,100,,3156.00,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",36187.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5380.85,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9460.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5488.47,100,,,,,0,"fee schedule",EAPG,6995.11,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1487.27,37.7,,1189.82,,,0,"percent of total billed charges","37.70% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3077.1,78,,2461.68,,,0,"percent of total billed charges","78% of total billed charges",10604.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3258.57,82.6,,2606.86,,,0,"percent of total billed charges","82.6% of total billed charges",5380.85,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3258.57,82.6,,2606.86,,,0,"percent of total billed charges","82.6% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5541.38,100,,,,,0,"fee schedule",EAPG,3945,100,,3156.00,,,0,"percent of total billed charges","100% of total billed charges",603.59,36187.64,
"58572 Laparoscopy, surgical, with total hysterecto",7962540,CDM,521,RC,58572,CPT,OUTPATIENT,,,3425,2226.25,,3014,88,,2411.20,,,0,"percent of total billed charges","88% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5380.85,100,,,,,0,"fee schedule",EAPG,3425,100,,2740.00,,,0,"percent of total billed charges","100% of total billed charges",18373.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",5542.28,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2157.75,63,,1726.20,,,0,"percent of total billed charges","63% of total billed charges",524.03,15.3,,419.22,,,0,"percent of total billed charges","15.3% of total billed charges",5380.85,100,,,,,0,"fee schedule",EAPG,2363.25,69,,,,,0,"fee schedule","69% of total billed charges",3425,100,,2740.00,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3425,100,,2740.00,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3425,100,,2740.00,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",36187.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5380.85,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9460.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5488.47,100,,,,,0,"fee schedule",EAPG,6995.11,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1291.23,37.7,,1032.98,,,0,"percent of total billed charges","37.70% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2671.5,78,,2137.20,,,0,"percent of total billed charges","78% of total billed charges",10604.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2829.05,82.6,,2263.24,,,0,"percent of total billed charges","82.6% of total billed charges",5380.85,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2829.05,82.6,,2263.24,,,0,"percent of total billed charges","82.6% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5541.38,100,,,,,0,"fee schedule",EAPG,3425,100,,2740.00,,,0,"percent of total billed charges","100% of total billed charges",524.03,36187.64,
"58570 Laparoscopy, surgical, with total hysterecto",7962720,CDM,521,RC,58570,CPT,OUTPATIENT,,,2749,1786.85,,2419.12,88,,1935.30,,,0,"percent of total billed charges","88% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5380.85,100,,,,,0,"fee schedule",EAPG,2749,100,,2199.20,,,0,"percent of total billed charges","100% of total billed charges",18373.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",5542.28,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1731.87,63,,1385.50,,,0,"percent of total billed charges","63% of total billed charges",420.6,15.3,,336.48,,,0,"percent of total billed charges","15.3% of total billed charges",5380.85,100,,,,,0,"fee schedule",EAPG,1896.81,69,,,,,0,"fee schedule","69% of total billed charges",2749,100,,2199.20,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2749,100,,2199.20,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2749,100,,2199.20,,,0,"percent of total billed charges","100% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",36187.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5380.85,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9460.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5488.47,100,,,,,0,"fee schedule",EAPG,6995.11,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1036.37,37.7,,829.10,,,0,"percent of total billed charges","37.70% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2144.22,78,,1715.38,,,0,"percent of total billed charges","78% of total billed charges",10604.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2270.67,82.6,,1816.54,,,0,"percent of total billed charges","82.6% of total billed charges",5380.85,100,,,,,0,"fee schedule",EAPG,10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2270.67,82.6,,1816.54,,,0,"percent of total billed charges","82.6% of total billed charges",10499.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5541.38,100,,,,,0,"fee schedule",EAPG,2749,100,,2199.20,,,0,"percent of total billed charges","100% of total billed charges",420.6,36187.64,
"58578 Unlisted laparoscopy procedure, uterus",7963636,CDM,521,RC,58578,CPT,OUTPATIENT,,,2749,1786.85,,2419.12,88,,1935.30,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,2749,100,,2199.20,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",2108.45,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1731.87,63,,1385.50,,,0,"percent of total billed charges","63% of total billed charges",420.6,15.3,,336.48,,,0,"percent of total billed charges","15.3% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,1896.81,69,,,,,0,"fee schedule","69% of total billed charges",2749,100,,2199.20,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2749,100,,2199.20,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2749,100,,2199.20,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.98,100,,,,,0,"fee schedule",EAPG,2661.15,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1036.37,37.7,,829.10,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2144.22,78,,1715.38,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2270.67,82.6,,1816.54,,,0,"percent of total billed charges","82.6% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2270.67,82.6,,1816.54,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2207.57,100,,,,,0,"fee schedule",EAPG,2749,100,,2199.20,,,0,"percent of total billed charges","100% of total billed charges",420.6,20558.19,
"58600 Ligation/transection of fallopian tube(s), a",7962191,CDM,521,RC,58600,CPT,OUTPATIENT,,,1823,1184.95,,1604.24,88,,1283.39,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,1823,100,,1458.40,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",2108.45,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1148.49,63,,918.79,,,0,"percent of total billed charges","63% of total billed charges",278.92,15.3,,223.14,,,0,"percent of total billed charges","15.3% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,1257.87,69,,,,,0,"fee schedule","69% of total billed charges",1823,100,,1458.40,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1823,100,,1458.40,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1823,100,,1458.40,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.98,100,,,,,0,"fee schedule",EAPG,2661.15,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",687.27,37.7,,549.82,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1421.94,78,,1137.55,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1505.8,82.6,,1204.64,,,0,"percent of total billed charges","82.6% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1505.8,82.6,,1204.64,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2207.57,100,,,,,0,"fee schedule",EAPG,1823,100,,1458.40,,,0,"percent of total billed charges","100% of total billed charges",278.92,10656.86,
"58605 Ligation or transection of fallopian tube(s)",7962192,CDM,521,RC,58605,CPT,OUTPATIENT,,,1450,942.5,,1276,88,,1020.80,,,0,"percent of total billed charges","88% of total billed charges",1450,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1708.92,100,,,,,0,"fee schedule",EAPG,1450,100,,1160.00,,,0,"percent of total billed charges","100% of total billed charges",1450,175,,,,,0,"fee schedule","175% of CMS fee schedule",1760.19,100,,,,,0,"fee schedule",EAPG,1450,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",913.5,63,,730.80,,,0,"percent of total billed charges","63% of total billed charges",221.85,15.3,,177.48,,,0,"percent of total billed charges","15.3% of total billed charges",1708.92,100,,,,,0,"fee schedule",EAPG,1000.5,69,,,,,0,"fee schedule","69% of total billed charges",1450,100,,1160.00,,,0,"percent of total billed charges","100% of total billed charges",1450,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1450,100,,1160.00,,,0,"percent of total billed charges","100% of total billed charges",1450,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1450,100,,1160.00,,,0,"percent of total billed charges","100% of total billed charges",1450,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1450,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1708.92,100,,,,,0,"fee schedule",EAPG,1450,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1450,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1450,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1743.1,100,,,,,0,"fee schedule",EAPG,2221.6,100,,,,,0,"fee schedule",EAPG,1450,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",546.65,37.7,,437.32,,,0,"percent of total billed charges","37.70% of total billed charges",1450,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1450,100,,,,,0,"fee schedule","100% of CMS fee schedule",1131,78,,904.80,,,0,"percent of total billed charges","78% of total billed charges",1450,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1197.7,82.6,,958.16,,,0,"percent of total billed charges","82.6% of total billed charges",1708.92,100,,,,,0,"fee schedule","100% of WA fee schedule",1450,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1197.7,82.6,,958.16,,,0,"percent of total billed charges","82.6% of total billed charges",1450,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1869.45,100,,,,,0,"fee schedule",EAPG,1450,100,,1160.00,,,0,"percent of total billed charges","100% of total billed charges",221.85,2221.6,
"58611 Ligation/transection of fallopian tube(s); c",7962193,CDM,521,RC,58611,CPT,OUTPATIENT,,,861,559.65,,757.68,88,,606.14,,,0,"percent of total billed charges","88% of total billed charges",861,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1708.92,100,,,,,0,"fee schedule",EAPG,861,100,,688.80,,,0,"percent of total billed charges","100% of total billed charges",861,175,,,,,0,"fee schedule","175% of CMS fee schedule",1760.19,100,,,,,0,"fee schedule",EAPG,861,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",542.43,63,,433.94,,,0,"percent of total billed charges","63% of total billed charges",131.73,15.3,,105.38,,,0,"percent of total billed charges","15.3% of total billed charges",1708.92,100,,,,,0,"fee schedule",EAPG,594.09,69,,,,,0,"fee schedule","69% of total billed charges",861,100,,688.80,,,0,"percent of total billed charges","100% of total billed charges",861,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",861,100,,688.80,,,0,"percent of total billed charges","100% of total billed charges",861,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",861,100,,688.80,,,0,"percent of total billed charges","100% of total billed charges",861,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",861,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1708.92,100,,,,,0,"fee schedule",EAPG,861,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",861,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",861,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1743.1,100,,,,,0,"fee schedule",EAPG,2221.6,100,,,,,0,"fee schedule",EAPG,861,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",324.6,37.7,,259.68,,,0,"percent of total billed charges","37.70% of total billed charges",861,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",861,100,,,,,0,"fee schedule","100% of CMS fee schedule",671.58,78,,537.26,,,0,"percent of total billed charges","78% of total billed charges",861,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",711.19,82.6,,568.95,,,0,"percent of total billed charges","82.6% of total billed charges",1708.92,100,,,,,0,"fee schedule","100% of WA fee schedule",861,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",711.19,82.6,,568.95,,,0,"percent of total billed charges","82.6% of total billed charges",861,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1869.45,100,,,,,0,"fee schedule",EAPG,861,100,,688.80,,,0,"percent of total billed charges","100% of total billed charges",131.73,2221.6,
"58615 Occlusion of fallopian tube(s) by device, va",7962751,CDM,521,RC,58615,CPT,OUTPATIENT,,,1403,911.95,,1234.64,88,,987.71,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,1403,100,,1122.40,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",2108.45,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",883.89,63,,707.11,,,0,"percent of total billed charges","63% of total billed charges",214.66,15.3,,171.73,,,0,"percent of total billed charges","15.3% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,968.07,69,,,,,0,"fee schedule","69% of total billed charges",1403,100,,1122.40,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1403,100,,1122.40,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1403,100,,1122.40,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.98,100,,,,,0,"fee schedule",EAPG,2661.15,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",528.93,37.7,,423.14,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1094.34,78,,875.47,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1158.88,82.6,,927.10,,,0,"percent of total billed charges","82.6% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1158.88,82.6,,927.10,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2207.57,100,,,,,0,"fee schedule",EAPG,1403,100,,1122.40,,,0,"percent of total billed charges","100% of total billed charges",214.66,10656.86,
"58662 Laparoscopy, surgical; w/ fulguration or exc",7961938,CDM,521,RC,58662,CPT,OUTPATIENT,,,2085,1355.25,,1834.8,88,,1467.84,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3806.28,100,,,,,0,"fee schedule",EAPG,2085,100,,1668.00,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",3920.47,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1313.55,63,,1050.84,,,0,"percent of total billed charges","63% of total billed charges",319.01,15.3,,255.21,,,0,"percent of total billed charges","15.3% of total billed charges",3806.28,100,,,,,0,"fee schedule",EAPG,1438.65,69,,,,,0,"fee schedule","69% of total billed charges",2085,100,,1668.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2085,100,,1668.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2085,100,,1668.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3806.28,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3882.4,100,,,,,0,"fee schedule",EAPG,4948.16,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",786.05,37.7,,628.84,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1626.3,78,,1301.04,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1722.21,82.6,,1377.77,,,0,"percent of total billed charges","82.6% of total billed charges",3806.28,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1722.21,82.6,,1377.77,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3966.81,100,,,,,0,"fee schedule",EAPG,2085,100,,1668.00,,,0,"percent of total billed charges","100% of total billed charges",319.01,20558.19,
"58660 Laparoscopy, surgical; with lysis of adhesio",7962646,CDM,521,RC,58660,CPT,OUTPATIENT,,,2470,1605.5,,2173.6,88,,1738.88,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3806.28,100,,,,,0,"fee schedule",EAPG,2470,100,,1976.00,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",3920.47,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1556.1,63,,1244.88,,,0,"percent of total billed charges","63% of total billed charges",377.91,15.3,,302.33,,,0,"percent of total billed charges","15.3% of total billed charges",3806.28,100,,,,,0,"fee schedule",EAPG,1704.3,69,,,,,0,"fee schedule","69% of total billed charges",2470,100,,1976.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2470,100,,1976.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2470,100,,1976.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3806.28,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3882.4,100,,,,,0,"fee schedule",EAPG,4948.16,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",931.19,37.7,,744.95,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1926.6,78,,1541.28,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2040.22,82.6,,1632.18,,,0,"percent of total billed charges","82.6% of total billed charges",3806.28,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2040.22,82.6,,1632.18,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3966.81,100,,,,,0,"fee schedule",EAPG,2470,100,,1976.00,,,0,"percent of total billed charges","100% of total billed charges",377.91,20558.19,
"58661 Laparoscopy, surgical; with removal of adnex",7963203,CDM,521,RC,58661,CPT,OUTPATIENT,,,1899,1234.35,,1671.12,88,,1336.90,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3806.28,100,,,,,0,"fee schedule",EAPG,1899,100,,1519.20,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",3920.47,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1196.37,63,,957.10,,,0,"percent of total billed charges","63% of total billed charges",290.55,15.3,,232.44,,,0,"percent of total billed charges","15.3% of total billed charges",3806.28,100,,,,,0,"fee schedule",EAPG,1310.31,69,,,,,0,"fee schedule","69% of total billed charges",1899,100,,1519.20,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1899,100,,1519.20,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1899,100,,1519.20,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3806.28,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3882.4,100,,,,,0,"fee schedule",EAPG,4948.16,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",715.92,37.7,,572.74,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1481.22,78,,1184.98,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1568.57,82.6,,1254.86,,,0,"percent of total billed charges","82.6% of total billed charges",3806.28,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1568.57,82.6,,1254.86,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3966.81,100,,,,,0,"fee schedule",EAPG,1899,100,,1519.20,,,0,"percent of total billed charges","100% of total billed charges",290.55,20558.19,
"58671 Laparoscopy, surgical; with occlusion of ovi",7961706,CDM,521,RC,58671,CPT,OUTPATIENT,,,892,579.8,,784.96,88,,627.97,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3806.28,100,,,,,0,"fee schedule",EAPG,892,100,,713.60,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",3920.47,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.96,63,,449.57,,,0,"percent of total billed charges","63% of total billed charges",136.48,15.3,,109.18,,,0,"percent of total billed charges","15.3% of total billed charges",3806.28,100,,,,,0,"fee schedule",EAPG,615.48,69,,,,,0,"fee schedule","69% of total billed charges",892,100,,713.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892,100,,713.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",892,100,,713.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3806.28,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3882.4,100,,,,,0,"fee schedule",EAPG,4948.16,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",336.28,37.7,,269.02,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",695.76,78,,556.61,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",736.79,82.6,,589.43,,,0,"percent of total billed charges","82.6% of total billed charges",3806.28,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",736.79,82.6,,589.43,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3966.81,100,,,,,0,"fee schedule",EAPG,892,100,,713.60,,,0,"percent of total billed charges","100% of total billed charges",136.48,20558.19,
"58670 Laparoscopy, surgical; with fulguration of o",7962568,CDM,521,RC,58670,CPT,OUTPATIENT,,,1881,1222.65,,1655.28,88,,1324.22,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3806.28,100,,,,,0,"fee schedule",EAPG,1881,100,,1504.80,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",3920.47,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1185.03,63,,948.02,,,0,"percent of total billed charges","63% of total billed charges",287.79,15.3,,230.23,,,0,"percent of total billed charges","15.3% of total billed charges",3806.28,100,,,,,0,"fee schedule",EAPG,1297.89,69,,,,,0,"fee schedule","69% of total billed charges",1881,100,,1504.80,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1881,100,,1504.80,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1881,100,,1504.80,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3806.28,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3882.4,100,,,,,0,"fee schedule",EAPG,4948.16,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",709.14,37.7,,567.31,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1467.18,78,,1173.74,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1553.71,82.6,,1242.97,,,0,"percent of total billed charges","82.6% of total billed charges",3806.28,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1553.71,82.6,,1242.97,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3966.81,100,,,,,0,"fee schedule",EAPG,1881,100,,1504.80,,,0,"percent of total billed charges","100% of total billed charges",287.79,20558.19,
"58700 Salpingectomy, complete or partial, unilater",7963153,CDM,521,RC,58700,CPT,OUTPATIENT,,,2234,1452.1,,1965.92,88,,1572.74,,,0,"percent of total billed charges","88% of total billed charges",2234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3806.28,100,,,,,0,"fee schedule",EAPG,2234,100,,1787.20,,,0,"percent of total billed charges","100% of total billed charges",2234,175,,,,,0,"fee schedule","175% of CMS fee schedule",3920.47,100,,,,,0,"fee schedule",EAPG,2234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1407.42,63,,1125.94,,,0,"percent of total billed charges","63% of total billed charges",341.8,15.3,,273.44,,,0,"percent of total billed charges","15.3% of total billed charges",3806.28,100,,,,,0,"fee schedule",EAPG,1541.46,69,,,,,0,"fee schedule","69% of total billed charges",2234,100,,1787.20,,,0,"percent of total billed charges","100% of total billed charges",2234,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2234,100,,1787.20,,,0,"percent of total billed charges","100% of total billed charges",2234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2234,100,,1787.20,,,0,"percent of total billed charges","100% of total billed charges",2234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3806.28,100,,,,,0,"fee schedule",EAPG,2234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3882.4,100,,,,,0,"fee schedule",EAPG,4948.16,100,,,,,0,"fee schedule",EAPG,2234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",842.22,37.7,,673.78,,,0,"percent of total billed charges","37.70% of total billed charges",2234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2234,100,,,,,0,"fee schedule","100% of CMS fee schedule",1742.52,78,,1394.02,,,0,"percent of total billed charges","78% of total billed charges",2234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1845.28,82.6,,1476.22,,,0,"percent of total billed charges","82.6% of total billed charges",3806.28,100,,,,,0,"fee schedule","100% of WA fee schedule",2234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1845.28,82.6,,1476.22,,,0,"percent of total billed charges","82.6% of total billed charges",2234,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3966.81,100,,,,,0,"fee schedule",EAPG,2234,100,,1787.20,,,0,"percent of total billed charges","100% of total billed charges",341.8,4948.16,
"58720 Salpingo-oophorectomy, complete or partial,",7962910,CDM,521,RC,58720,CPT,OUTPATIENT,,,2142,1392.3,,1884.96,88,,1507.97,,,0,"percent of total billed charges","88% of total billed charges",2142,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3806.28,100,,,,,0,"fee schedule",EAPG,2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",2142,175,,,,,0,"fee schedule","175% of CMS fee schedule",3920.47,100,,,,,0,"fee schedule",EAPG,2142,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1349.46,63,,1079.57,,,0,"percent of total billed charges","63% of total billed charges",327.73,15.3,,262.18,,,0,"percent of total billed charges","15.3% of total billed charges",3806.28,100,,,,,0,"fee schedule",EAPG,1477.98,69,,,,,0,"fee schedule","69% of total billed charges",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",2142,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",2142,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",2142,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2142,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3806.28,100,,,,,0,"fee schedule",EAPG,2142,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2142,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2142,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3882.4,100,,,,,0,"fee schedule",EAPG,4948.16,100,,,,,0,"fee schedule",EAPG,2142,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",807.53,37.7,,646.02,,,0,"percent of total billed charges","37.70% of total billed charges",2142,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2142,100,,,,,0,"fee schedule","100% of CMS fee schedule",1670.76,78,,1336.61,,,0,"percent of total billed charges","78% of total billed charges",2142,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",3806.28,100,,,,,0,"fee schedule","100% of WA fee schedule",2142,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1769.29,82.6,,1415.43,,,0,"percent of total billed charges","82.6% of total billed charges",2142,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3966.81,100,,,,,0,"fee schedule",EAPG,2142,100,,1713.60,,,0,"percent of total billed charges","100% of total billed charges",327.73,4948.16,
"58740 Lysis of adhesions (salpingolysis, ovariolys",7963453,CDM,521,RC,58740,CPT,OUTPATIENT,,,1997,1298.05,,1757.36,88,,1405.89,,,0,"percent of total billed charges","88% of total billed charges",1997,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3806.28,100,,,,,0,"fee schedule",EAPG,1997,100,,1597.60,,,0,"percent of total billed charges","100% of total billed charges",1997,175,,,,,0,"fee schedule","175% of CMS fee schedule",3920.47,100,,,,,0,"fee schedule",EAPG,1997,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1258.11,63,,1006.49,,,0,"percent of total billed charges","63% of total billed charges",305.54,15.3,,244.43,,,0,"percent of total billed charges","15.3% of total billed charges",3806.28,100,,,,,0,"fee schedule",EAPG,1377.93,69,,,,,0,"fee schedule","69% of total billed charges",1997,100,,1597.60,,,0,"percent of total billed charges","100% of total billed charges",1997,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1997,100,,1597.60,,,0,"percent of total billed charges","100% of total billed charges",1997,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1997,100,,1597.60,,,0,"percent of total billed charges","100% of total billed charges",1997,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1997,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3806.28,100,,,,,0,"fee schedule",EAPG,1997,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1997,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1997,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3882.4,100,,,,,0,"fee schedule",EAPG,4948.16,100,,,,,0,"fee schedule",EAPG,1997,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",752.87,37.7,,602.30,,,0,"percent of total billed charges","37.70% of total billed charges",1997,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1997,100,,,,,0,"fee schedule","100% of CMS fee schedule",1557.66,78,,1246.13,,,0,"percent of total billed charges","78% of total billed charges",1997,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1649.52,82.6,,1319.62,,,0,"percent of total billed charges","82.6% of total billed charges",3806.28,100,,,,,0,"fee schedule",EAPG,1997,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1649.52,82.6,,1319.62,,,0,"percent of total billed charges","82.6% of total billed charges",1997,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3966.81,100,,,,,0,"fee schedule",EAPG,1997,100,,1597.60,,,0,"percent of total billed charges","100% of total billed charges",305.54,4948.16,
"58900 Biopsy of ovary, unilateral or bilateral (se",7963083,CDM,521,RC,58900,CPT,OUTPATIENT,,,2031,1320.15,,1787.28,88,,1429.82,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,2031,100,,1624.80,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",2108.45,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1279.53,63,,1023.62,,,0,"percent of total billed charges","63% of total billed charges",310.74,15.3,,248.59,,,0,"percent of total billed charges","15.3% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,1401.39,69,,,,,0,"fee schedule","69% of total billed charges",2031,100,,1624.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2031,100,,1624.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2031,100,,1624.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.04,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2087.98,100,,,,,0,"fee schedule",EAPG,2661.15,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",765.69,37.7,,612.55,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1584.18,78,,1267.34,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1677.61,82.6,,1342.09,,,0,"percent of total billed charges","82.6% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1677.61,82.6,,1342.09,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2207.57,100,,,,,0,"fee schedule",EAPG,2031,100,,1624.80,,,0,"percent of total billed charges","100% of total billed charges",310.74,10656.86,
"58925 Ovarian cystectomy, unilateral or bilateral",7963526,CDM,521,RC,58925,CPT,OUTPATIENT,,,2658,1727.7,,2339.04,88,,1871.23,,,0,"percent of total billed charges","88% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3806.28,100,,,,,0,"fee schedule",EAPG,2658,100,,2126.40,,,0,"percent of total billed charges","100% of total billed charges",8878.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",3920.47,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1674.54,63,,1339.63,,,0,"percent of total billed charges","63% of total billed charges",406.67,15.3,,325.34,,,0,"percent of total billed charges","15.3% of total billed charges",3806.28,100,,,,,0,"fee schedule",EAPG,1834.02,69,,,,,0,"fee schedule","69% of total billed charges",2658,100,,2126.40,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2658,100,,2126.40,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2658,100,,2126.40,,,0,"percent of total billed charges","100% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",17913.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3806.28,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4683.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3882.4,100,,,,,0,"fee schedule",EAPG,4948.16,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1002.07,37.7,,801.66,,,0,"percent of total billed charges","37.70% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2073.24,78,,1658.59,,,0,"percent of total billed charges","78% of total billed charges",5123.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2195.51,82.6,,1756.41,,,0,"percent of total billed charges","82.6% of total billed charges",3806.28,100,,,,,0,"fee schedule",EAPG,5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2195.51,82.6,,1756.41,,,0,"percent of total billed charges","82.6% of total billed charges",5073.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3966.81,100,,,,,0,"fee schedule",EAPG,2658,100,,2126.40,,,0,"percent of total billed charges","100% of total billed charges",406.67,17913.89,
"58940 Oophorectomy, partial or total, unilateral o",7963233,CDM,521,RC,58940,CPT,OUTPATIENT,,,2414,1569.1,,2124.32,88,,1699.46,,,0,"percent of total billed charges","88% of total billed charges",2414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2047.04,100,,,,,0,"fee schedule",EAPG,2414,100,,1931.20,,,0,"percent of total billed charges","100% of total billed charges",2414,175,,,,,0,"fee schedule","175% of CMS fee schedule",2108.45,100,,,,,0,"fee schedule",EAPG,2414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1520.82,63,,1216.66,,,0,"percent of total billed charges","63% of total billed charges",369.34,15.3,,295.47,,,0,"percent of total billed charges","15.3% of total billed charges",2047.04,100,,,,,0,"fee schedule",EAPG,1665.66,69,,,,,0,"fee schedule","69% of total billed charges",2414,100,,1931.20,,,0,"percent of total billed charges","100% of total billed charges",2414,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2414,100,,1931.20,,,0,"percent of total billed charges","100% of total billed charges",2414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2414,100,,1931.20,,,0,"percent of total billed charges","100% of total billed charges",2414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2047.04,100,,,,,0,"fee schedule",EAPG,2414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2087.98,100,,,,,0,"fee schedule",EAPG,2661.15,100,,,,,0,"fee schedule",EAPG,2414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",910.08,37.7,,728.06,,,0,"percent of total billed charges","37.70% of total billed charges",2414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2414,100,,,,,0,"fee schedule","100% of CMS fee schedule",1882.92,78,,1506.34,,,0,"percent of total billed charges","78% of total billed charges",2414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1993.96,82.6,,1595.17,,,0,"percent of total billed charges","82.6% of total billed charges",2047.04,100,,,,,0,"fee schedule","100% of WA fee schedule",2414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1993.96,82.6,,1595.17,,,0,"percent of total billed charges","82.6% of total billed charges",2414,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2207.57,100,,,,,0,"fee schedule",EAPG,2414,100,,1931.20,,,0,"percent of total billed charges","100% of total billed charges",369.34,2661.15,
"58943 Oophorectomy, partial or total, unilateral o",7963259,CDM,521,RC,58943,CPT,OUTPATIENT,,,2797,1818.05,,2461.36,88,,1969.09,,,0,"percent of total billed charges","88% of total billed charges",2797,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3806.28,100,,,,,0,"fee schedule",EAPG,2797,100,,2237.60,,,0,"percent of total billed charges","100% of total billed charges",2797,175,,,,,0,"fee schedule","175% of CMS fee schedule",3920.47,100,,,,,0,"fee schedule",EAPG,2797,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1762.11,63,,1409.69,,,0,"percent of total billed charges","63% of total billed charges",427.94,15.3,,342.35,,,0,"percent of total billed charges","15.3% of total billed charges",3806.28,100,,,,,0,"fee schedule",EAPG,1929.93,69,,,,,0,"fee schedule","69% of total billed charges",2797,100,,2237.60,,,0,"percent of total billed charges","100% of total billed charges",2797,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2797,100,,2237.60,,,0,"percent of total billed charges","100% of total billed charges",2797,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2797,100,,2237.60,,,0,"percent of total billed charges","100% of total billed charges",2797,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2797,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3806.28,100,,,,,0,"fee schedule",EAPG,2797,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2797,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2797,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3882.4,100,,,,,0,"fee schedule",EAPG,4948.16,100,,,,,0,"fee schedule",EAPG,2797,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1054.47,37.7,,843.58,,,0,"percent of total billed charges","37.70% of total billed charges",2797,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2797,100,,,,,0,"fee schedule","100% of CMS fee schedule",2181.66,78,,1745.33,,,0,"percent of total billed charges","78% of total billed charges",2797,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2310.32,82.6,,1848.26,,,0,"percent of total billed charges","82.6% of total billed charges",3806.28,100,,,,,0,"fee schedule","100% of WA fee schedule",2797,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2310.32,82.6,,1848.26,,,0,"percent of total billed charges","82.6% of total billed charges",2797,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3966.81,100,,,,,0,"fee schedule",EAPG,2797,100,,2237.60,,,0,"percent of total billed charges","100% of total billed charges",427.94,4948.16,
"58960 Laparotomy, for staging or restaging of ovar",7961939,CDM,521,RC,58960,CPT,OUTPATIENT,,,2295,1491.75,,2019.6,88,,1615.68,,,0,"percent of total billed charges","88% of total billed charges",2295,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3806.28,100,,,,,0,"fee schedule",EAPG,2295,100,,1836.00,,,0,"percent of total billed charges","100% of total billed charges",2295,175,,,,,0,"fee schedule","175% of CMS fee schedule",3920.47,100,,,,,0,"fee schedule",EAPG,2295,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1445.85,63,,1156.68,,,0,"percent of total billed charges","63% of total billed charges",351.14,15.3,,280.91,,,0,"percent of total billed charges","15.3% of total billed charges",3806.28,100,,,,,0,"fee schedule",EAPG,1583.55,69,,,,,0,"fee schedule","69% of total billed charges",2295,100,,1836.00,,,0,"percent of total billed charges","100% of total billed charges",2295,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2295,100,,1836.00,,,0,"percent of total billed charges","100% of total billed charges",2295,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2295,100,,1836.00,,,0,"percent of total billed charges","100% of total billed charges",2295,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2295,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3806.28,100,,,,,0,"fee schedule",EAPG,2295,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2295,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2295,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3882.4,100,,,,,0,"fee schedule",EAPG,4948.16,100,,,,,0,"fee schedule",EAPG,2295,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",865.22,37.7,,692.18,,,0,"percent of total billed charges","37.70% of total billed charges",2295,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2295,100,,,,,0,"fee schedule","100% of CMS fee schedule",1790.1,78,,1432.08,,,0,"percent of total billed charges","78% of total billed charges",2295,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1895.67,82.6,,1516.54,,,0,"percent of total billed charges","82.6% of total billed charges",3806.28,100,,,,,0,"fee schedule",EAPG,2295,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1895.67,82.6,,1516.54,,,0,"percent of total billed charges","82.6% of total billed charges",2295,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3966.81,100,,,,,0,"fee schedule",EAPG,2295,100,,1836.00,,,0,"percent of total billed charges","100% of total billed charges",351.14,4948.16,
"59001 Amniocentesis; therapeutic amniotic fluid re",7962353,CDM,521,RC,59001,CPT,OUTPATIENT,,,398,258.7,,350.24,88,,280.19,,,0,"percent of total billed charges","88% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",586.37,100,,,,,0,"fee schedule",EAPG,398,100,,318.40,,,0,"percent of total billed charges","100% of total billed charges",572.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",603.96,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.74,63,,200.59,,,0,"percent of total billed charges","63% of total billed charges",60.89,15.3,,48.71,,,0,"percent of total billed charges","15.3% of total billed charges",586.37,100,,,,,0,"fee schedule",EAPG,274.62,69,,,,,0,"fee schedule","69% of total billed charges",398,100,,318.40,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",398,100,,318.40,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",398,100,,318.40,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",1143.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",586.37,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",598.1,100,,,,,0,"fee schedule",EAPG,762.28,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",150.05,37.7,,120.04,,,0,"percent of total billed charges","37.70% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",310.44,78,,248.35,,,0,"percent of total billed charges","78% of total billed charges",330.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",328.75,82.6,,263.00,,,0,"percent of total billed charges","82.6% of total billed charges",586.37,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",328.75,82.6,,263.00,,,0,"percent of total billed charges","82.6% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",746.9,100,,,,,0,"fee schedule",EAPG,398,100,,318.40,,,0,"percent of total billed charges","100% of total billed charges",60.89,1143.51,
"59000 Amniocentesis; diagnostic",7963848,CDM,521,RC,59000,CPT,OUTPATIENT,,,564,366.6,,496.32,88,,397.06,,,0,"percent of total billed charges","88% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",586.37,100,,,,,0,"fee schedule",EAPG,564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",1434.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",603.96,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.32,63,,284.26,,,0,"percent of total billed charges","63% of total billed charges",86.29,15.3,,69.03,,,0,"percent of total billed charges","15.3% of total billed charges",586.37,100,,,,,0,"fee schedule",EAPG,389.16,69,,,,,0,"fee schedule","69% of total billed charges",564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",2573.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",586.37,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",598.1,100,,,,,0,"fee schedule",EAPG,762.28,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",212.63,37.7,,170.10,,,0,"percent of total billed charges","37.70% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",439.92,78,,351.94,,,0,"percent of total billed charges","78% of total billed charges",828.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465.86,82.6,,372.69,,,0,"percent of total billed charges","82.6% of total billed charges",586.37,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465.86,82.6,,372.69,,,0,"percent of total billed charges","82.6% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",746.9,100,,,,,0,"fee schedule",EAPG,564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",86.29,2573.24,
"59012 Cordocentesis (intrauterine), any method",7963592,CDM,521,RC,59012,CPT,OUTPATIENT,,,811,527.15,,713.68,88,,570.94,,,0,"percent of total billed charges","88% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",586.37,100,,,,,0,"fee schedule",EAPG,811,100,,648.80,,,0,"percent of total billed charges","100% of total billed charges",572.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",603.96,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510.93,63,,408.74,,,0,"percent of total billed charges","63% of total billed charges",124.08,15.3,,99.26,,,0,"percent of total billed charges","15.3% of total billed charges",586.37,100,,,,,0,"fee schedule",EAPG,559.59,69,,,,,0,"fee schedule","69% of total billed charges",811,100,,648.80,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",811,100,,648.80,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",811,100,,648.80,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",1143.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",586.37,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",598.1,100,,,,,0,"fee schedule",EAPG,762.28,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",305.75,37.7,,244.60,,,0,"percent of total billed charges","37.70% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",632.58,78,,506.06,,,0,"percent of total billed charges","78% of total billed charges",330.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",669.89,82.6,,535.91,,,0,"percent of total billed charges","82.6% of total billed charges",586.37,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",669.89,82.6,,535.91,,,0,"percent of total billed charges","82.6% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",746.9,100,,,,,0,"fee schedule",EAPG,811,100,,648.80,,,0,"percent of total billed charges","100% of total billed charges",124.08,1143.51,
"59015 Chorionic villus sampling, any method",7963616,CDM,521,RC,59015,CPT,OUTPATIENT,,,719,467.35,,632.72,88,,506.18,,,0,"percent of total billed charges","88% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",586.37,100,,,,,0,"fee schedule",EAPG,719,100,,575.20,,,0,"percent of total billed charges","100% of total billed charges",1434.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",603.96,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",452.97,63,,362.38,,,0,"percent of total billed charges","63% of total billed charges",110.01,15.3,,88.01,,,0,"percent of total billed charges","15.3% of total billed charges",586.37,100,,,,,0,"fee schedule",EAPG,496.11,69,,,,,0,"fee schedule","69% of total billed charges",719,100,,575.20,,,0,"percent of total billed charges","100% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",719,100,,575.20,,,0,"percent of total billed charges","100% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",719,100,,575.20,,,0,"percent of total billed charges","100% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS fee schedule",2573.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",586.37,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",598.1,100,,,,,0,"fee schedule",EAPG,762.28,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",271.06,37.7,,216.85,,,0,"percent of total billed charges","37.70% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.82,78,,448.66,,,0,"percent of total billed charges","78% of total billed charges",828.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.89,82.6,,475.11,,,0,"percent of total billed charges","82.6% of total billed charges",586.37,100,,,,,0,"fee schedule",EAPG,819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.89,82.6,,475.11,,,0,"percent of total billed charges","82.6% of total billed charges",819.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",746.9,100,,,,,0,"fee schedule",EAPG,719,100,,575.20,,,0,"percent of total billed charges","100% of total billed charges",110.01,2573.24,
"59020 Fetal contraction stress test",7963749,CDM,521,RC,59020,CPT,OUTPATIENT,,,216,140.4,,190.08,88,,152.06,,,0,"percent of total billed charges","88% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",165.98,100,,,,,0,"fee schedule",EAPG,216,100,,172.80,,,0,"percent of total billed charges","100% of total billed charges",355.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",170.96,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",136.08,63,,108.86,,,0,"percent of total billed charges","63% of total billed charges",33.05,15.3,,26.44,,,0,"percent of total billed charges","15.3% of total billed charges",165.98,100,,,,,0,"fee schedule",EAPG,149.04,69,,,,,0,"fee schedule","69% of total billed charges",216,100,,172.80,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216,100,,172.80,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216,100,,172.80,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",691.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",165.98,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.3,100,,,,,0,"fee schedule",EAPG,215.77,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",81.43,37.7,,65.14,,,0,"percent of total billed charges","37.70% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.48,78,,134.78,,,0,"percent of total billed charges","78% of total billed charges",205.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",178.42,82.6,,142.74,,,0,"percent of total billed charges","82.6% of total billed charges",165.98,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",178.42,82.6,,142.74,,,0,"percent of total billed charges","82.6% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",326.51,100,,,,,0,"fee schedule",EAPG,216,100,,172.80,,,0,"percent of total billed charges","100% of total billed charges",33.05,691.92,
"59025 Fetal non-stress test",7963812,CDM,521,RC,59025,CPT,OUTPATIENT,,,201,130.65,,176.88,88,,141.50,,,0,"percent of total billed charges","88% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",165.98,100,,,,,0,"fee schedule",EAPG,201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",355.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",170.96,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",126.63,63,,101.30,,,0,"percent of total billed charges","63% of total billed charges",30.75,15.3,,24.60,,,0,"percent of total billed charges","15.3% of total billed charges",165.98,100,,,,,0,"fee schedule",EAPG,138.69,69,,,,,0,"fee schedule","69% of total billed charges",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",691.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",165.98,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.3,100,,,,,0,"fee schedule",EAPG,215.77,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",75.78,37.7,,60.62,,,0,"percent of total billed charges","37.70% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",156.78,78,,125.42,,,0,"percent of total billed charges","78% of total billed charges",205.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",165.98,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",166.03,82.6,,132.82,,,0,"percent of total billed charges","82.6% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",326.51,100,,,,,0,"fee schedule",EAPG,201,100,,160.80,,,0,"percent of total billed charges","100% of total billed charges",30.75,691.92,
"59050 Fetal monitoring during labor by consulting",7961628,CDM,521,RC,59050,CPT,OUTPATIENT,,,214,139.1,,188.32,88,,150.66,,,0,"percent of total billed charges","88% of total billed charges",107,50,,85.60,,,0,"percent of total billed charges","50% of total billed charges",165.98,100,,,,,0,"fee schedule",EAPG,214,100,,171.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",134.82,63,,107.86,,,0,"percent of total billed charges","63% of total billed charges",32.74,15.3,,26.19,,,0,"percent of total billed charges","15.3% of total billed charges",165.98,100,,,,,0,"fee schedule",EAPG,147.66,69,,,,,0,"fee schedule","69% of total billed charges",214,100,,171.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",214,100,,171.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",214,100,,171.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",132.36,61.85,,105.89,,,0,"percent of total billed charges","61.5% of total billed charges",165.98,100,,,,,0,"fee schedule",EAPG,107,50,,85.60,,,0,"percent of total billed charges","50% of total billed charges",68.91,32.2,,55.13,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",169.3,100,,,,,0,"fee schedule",EAPG,215.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.68,37.7,,64.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",166.92,78,,133.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.76,82.6,,141.41,,,0,"percent of total billed charges","82.6% of total billed charges",165.98,100,,,,,0,"fee schedule",EAPG,107,50,,85.60,,,0,"percent of total billed charges","50% of total billed charges",176.76,82.6,,141.41,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",326.51,100,,,,,0,"fee schedule",EAPG,214,100,,171.20,,,0,"percent of total billed charges","100% of total billed charges",32.74,326.51,
"59120 Surgical treatment of ectopic pregnancy; req",7962345,CDM,521,RC,59120,CPT,OUTPATIENT,,,2004,1302.6,,1763.52,88,,1410.82,,,0,"percent of total billed charges","88% of total billed charges",2004,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3339.65,100,,,,,0,"fee schedule",EAPG,2004,100,,1603.20,,,0,"percent of total billed charges","100% of total billed charges",2004,175,,,,,0,"fee schedule","175% of CMS fee schedule",3439.84,100,,,,,0,"fee schedule",EAPG,2004,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1262.52,63,,1010.02,,,0,"percent of total billed charges","63% of total billed charges",306.61,15.3,,245.29,,,0,"percent of total billed charges","15.3% of total billed charges",3339.65,100,,,,,0,"fee schedule",EAPG,1382.76,69,,,,,0,"fee schedule","69% of total billed charges",2004,100,,1603.20,,,0,"percent of total billed charges","100% of total billed charges",2004,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2004,100,,1603.20,,,0,"percent of total billed charges","100% of total billed charges",2004,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2004,100,,1603.20,,,0,"percent of total billed charges","100% of total billed charges",2004,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2004,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3339.65,100,,,,,0,"fee schedule",EAPG,2004,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2004,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2004,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3406.45,100,,,,,0,"fee schedule",EAPG,4341.55,100,,,,,0,"fee schedule",EAPG,2004,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",755.51,37.7,,604.41,,,0,"percent of total billed charges","37.70% of total billed charges",2004,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2004,100,,,,,0,"fee schedule","100% of CMS fee schedule",1563.12,78,,1250.50,,,0,"percent of total billed charges","78% of total billed charges",2004,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1655.3,82.6,,1324.24,,,0,"percent of total billed charges","82.6% of total billed charges",3339.65,100,,,,,0,"fee schedule",EAPG,2004,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1655.3,82.6,,1324.24,,,0,"percent of total billed charges","82.6% of total billed charges",2004,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3500.18,100,,,,,0,"fee schedule",EAPG,2004,100,,1603.20,,,0,"percent of total billed charges","100% of total billed charges",306.61,4341.55,
"59151 Laparoscopic treatment of ectopic pregnancy;",7962382,CDM,521,RC,59151,CPT,OUTPATIENT,,,3557,2312.05,,3130.16,88,,2504.13,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3339.65,100,,,,,0,"fee schedule",EAPG,3557,100,,2845.60,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",3439.84,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2240.91,63,,1792.73,,,0,"percent of total billed charges","63% of total billed charges",544.22,15.3,,435.38,,,0,"percent of total billed charges","15.3% of total billed charges",3339.65,100,,,,,0,"fee schedule",EAPG,2454.33,69,,,,,0,"fee schedule","69% of total billed charges",3557,100,,2845.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3557,100,,2845.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3557,100,,2845.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3339.65,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3406.45,100,,,,,0,"fee schedule",EAPG,4341.55,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1340.99,37.7,,1072.79,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2774.46,78,,2219.57,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2938.08,82.6,,2350.46,,,0,"percent of total billed charges","82.6% of total billed charges",3339.65,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2938.08,82.6,,2350.46,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3500.18,100,,,,,0,"fee schedule",EAPG,3557,100,,2845.60,,,0,"percent of total billed charges","100% of total billed charges",544.22,20558.19,
"59150 Laparoscopic treatment of ectopic pregnancy;",7962424,CDM,521,RC,59150,CPT,OUTPATIENT,,,3433,2231.45,,3021.04,88,,2416.83,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3339.65,100,,,,,0,"fee schedule",EAPG,3433,100,,2746.40,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",3439.84,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2162.79,63,,1730.23,,,0,"percent of total billed charges","63% of total billed charges",525.25,15.3,,420.20,,,0,"percent of total billed charges","15.3% of total billed charges",3339.65,100,,,,,0,"fee schedule",EAPG,2368.77,69,,,,,0,"fee schedule","69% of total billed charges",3433,100,,2746.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3433,100,,2746.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3433,100,,2746.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3339.65,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3406.45,100,,,,,0,"fee schedule",EAPG,4341.55,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1294.24,37.7,,1035.39,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2677.74,78,,2142.19,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2835.66,82.6,,2268.53,,,0,"percent of total billed charges","82.6% of total billed charges",3339.65,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2835.66,82.6,,2268.53,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3500.18,100,,,,,0,"fee schedule",EAPG,3433,100,,2746.40,,,0,"percent of total billed charges","100% of total billed charges",525.25,20558.19,
"59160 Curettage, postpartum",7963892,CDM,521,RC,59160,CPT,OUTPATIENT,,,1139,740.35,,1002.32,88,,801.86,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1708.92,100,,,,,0,"fee schedule",EAPG,1139,100,,911.20,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",1760.19,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",717.57,63,,574.06,,,0,"percent of total billed charges","63% of total billed charges",174.27,15.3,,139.42,,,0,"percent of total billed charges","15.3% of total billed charges",1708.92,100,,,,,0,"fee schedule",EAPG,785.91,69,,,,,0,"fee schedule","69% of total billed charges",1139,100,,911.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1139,100,,911.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1139,100,,911.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1708.92,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1743.1,100,,,,,0,"fee schedule",EAPG,2221.6,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",429.4,37.7,,343.52,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",888.42,78,,710.74,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",940.81,82.6,,752.65,,,0,"percent of total billed charges","82.6% of total billed charges",1708.92,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",940.81,82.6,,752.65,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1869.45,100,,,,,0,"fee schedule",EAPG,1139,100,,911.20,,,0,"percent of total billed charges","100% of total billed charges",174.27,10656.86,
"59200 Insertion of cervical dilator (eg, laminaria",7963120,CDM,521,RC,59200,CPT,OUTPATIENT,,,290,188.5,,255.2,88,,204.16,,,0,"percent of total billed charges","88% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",586.37,100,,,,,0,"fee schedule",EAPG,290,100,,232.00,,,0,"percent of total billed charges","100% of total billed charges",572.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",603.96,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",182.7,63,,146.16,,,0,"percent of total billed charges","63% of total billed charges",44.37,15.3,,35.50,,,0,"percent of total billed charges","15.3% of total billed charges",586.37,100,,,,,0,"fee schedule",EAPG,200.1,69,,,,,0,"fee schedule","69% of total billed charges",290,100,,232.00,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290,100,,232.00,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290,100,,232.00,,,0,"percent of total billed charges","100% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS fee schedule",1143.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",586.37,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",598.1,100,,,,,0,"fee schedule",EAPG,762.28,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",109.33,37.7,,87.46,,,0,"percent of total billed charges","37.70% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",226.2,78,,180.96,,,0,"percent of total billed charges","78% of total billed charges",330.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",239.54,82.6,,191.63,,,0,"percent of total billed charges","82.6% of total billed charges",586.37,100,,,,,0,"fee schedule",EAPG,327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",239.54,82.6,,191.63,,,0,"percent of total billed charges","82.6% of total billed charges",327.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",746.9,100,,,,,0,"fee schedule",EAPG,290,100,,232.00,,,0,"percent of total billed charges","100% of total billed charges",44.37,1143.51,
"59300 Episiotomy or vaginal repair, by other than",7963310,CDM,521,RC,59300,CPT,OUTPATIENT,,,615,399.75,,541.2,88,,432.96,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1708.92,100,,,,,0,"fee schedule",EAPG,615,100,,492.00,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",1760.19,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",387.45,63,,309.96,,,0,"percent of total billed charges","63% of total billed charges",94.1,15.3,,75.28,,,0,"percent of total billed charges","15.3% of total billed charges",1708.92,100,,,,,0,"fee schedule",EAPG,424.35,69,,,,,0,"fee schedule","69% of total billed charges",615,100,,492.00,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",615,100,,492.00,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",615,100,,492.00,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1708.92,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1743.1,100,,,,,0,"fee schedule",EAPG,2221.6,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",231.86,37.7,,185.49,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",479.7,78,,383.76,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",507.99,82.6,,406.39,,,0,"percent of total billed charges","82.6% of total billed charges",1708.92,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",507.99,82.6,,406.39,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1869.45,100,,,,,0,"fee schedule",EAPG,615,100,,492.00,,,0,"percent of total billed charges","100% of total billed charges",94.1,10656.86,
"59320 Cerclage of cervix, during pregnancy; vagina",7963490,CDM,521,RC,59320,CPT,OUTPATIENT,,,1446,939.9,,1272.48,88,,1017.98,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1708.92,100,,,,,0,"fee schedule",EAPG,1446,100,,1156.80,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",1760.19,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",910.98,63,,728.78,,,0,"percent of total billed charges","63% of total billed charges",221.24,15.3,,176.99,,,0,"percent of total billed charges","15.3% of total billed charges",1708.92,100,,,,,0,"fee schedule",EAPG,997.74,69,,,,,0,"fee schedule","69% of total billed charges",1446,100,,1156.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1446,100,,1156.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1446,100,,1156.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1708.92,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1743.1,100,,,,,0,"fee schedule",EAPG,2221.6,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",545.14,37.7,,436.11,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1127.88,78,,902.30,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1194.4,82.6,,955.52,,,0,"percent of total billed charges","82.6% of total billed charges",1708.92,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1194.4,82.6,,955.52,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1869.45,100,,,,,0,"fee schedule",EAPG,1446,100,,1156.80,,,0,"percent of total billed charges","100% of total billed charges",221.24,10656.86,
"59350 Hysterorrhaphy of ruptured uterus",7963710,CDM,521,RC,59350,CPT,OUTPATIENT,,,1571,1021.15,,1382.48,88,,1105.98,,,0,"percent of total billed charges","88% of total billed charges",1571,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1708.92,100,,,,,0,"fee schedule",EAPG,1571,100,,1256.80,,,0,"percent of total billed charges","100% of total billed charges",1571,175,,,,,0,"fee schedule","175% of CMS fee schedule",1760.19,100,,,,,0,"fee schedule",EAPG,1571,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",989.73,63,,791.78,,,0,"percent of total billed charges","63% of total billed charges",240.36,15.3,,192.29,,,0,"percent of total billed charges","15.3% of total billed charges",1708.92,100,,,,,0,"fee schedule",EAPG,1083.99,69,,,,,0,"fee schedule","69% of total billed charges",1571,100,,1256.80,,,0,"percent of total billed charges","100% of total billed charges",1571,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1571,100,,1256.80,,,0,"percent of total billed charges","100% of total billed charges",1571,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1571,100,,1256.80,,,0,"percent of total billed charges","100% of total billed charges",1571,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1571,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1708.92,100,,,,,0,"fee schedule",EAPG,1571,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1571,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1571,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1743.1,100,,,,,0,"fee schedule",EAPG,2221.6,100,,,,,0,"fee schedule",EAPG,1571,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",592.27,37.7,,473.82,,,0,"percent of total billed charges","37.70% of total billed charges",1571,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1571,100,,,,,0,"fee schedule","100% of CMS fee schedule",1225.38,78,,980.30,,,0,"percent of total billed charges","78% of total billed charges",1571,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1297.65,82.6,,1038.12,,,0,"percent of total billed charges","82.6% of total billed charges",1708.92,100,,,,,0,"fee schedule","100% of WA fee schedule",1571,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1297.65,82.6,,1038.12,,,0,"percent of total billed charges","82.6% of total billed charges",1571,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1869.45,100,,,,,0,"fee schedule",EAPG,1571,100,,1256.80,,,0,"percent of total billed charges","100% of total billed charges",240.36,2221.6,
"59400 Routine obstetric care including antepartum",7962383,CDM,521,RC,59400,CPT,OUTPATIENT,,,4420,2873,,3889.6,88,,3111.68,,,0,"percent of total billed charges","88% of total billed charges",2210,50,,1768.00,,,0,"percent of total billed charges","50% of total billed charges",1955.83,100,,,,,0,"fee schedule",EAPG,4420,100,,3536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2014.51,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2784.6,63,,2227.68,,,0,"percent of total billed charges","63% of total billed charges",676.26,15.3,,541.01,,,0,"percent of total billed charges","15.3% of total billed charges",1955.83,100,,,,,0,"fee schedule",EAPG,3049.8,69,,,,,0,"fee schedule","69% of total billed charges",4420,100,,3536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4420,100,,3536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4420,100,,3536.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2733.77,61.85,,2187.02,,,0,"percent of total billed charges","61.5% of total billed charges",1955.83,100,,,,,0,"fee schedule",EAPG,2210,50,,1768.00,,,0,"percent of total billed charges","50% of total billed charges",1423.24,32.2,,1138.59,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1994.95,100,,,,,0,"fee schedule",EAPG,2542.58,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1666.34,37.7,,1333.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3447.6,78,,2758.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3650.92,82.6,,2920.74,,,0,"percent of total billed charges","82.6% of total billed charges",1955.83,100,,,,,0,"fee schedule","100% of WA fee schedule",2210,50,,1768.00,,,0,"percent of total billed charges","50% of total billed charges",3650.92,82.6,,2920.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2116.36,100,,,,,0,"fee schedule",EAPG,4420,100,,3536.00,,,0,"percent of total billed charges","100% of total billed charges",676.26,4420,
"59409 Vaginal delivery only, with or without episi",7963006,CDM,521,RC,59409,CPT,OUTPATIENT,,,2601,1690.65,,2288.88,88,,1831.10,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.83,100,,,,,0,"fee schedule",EAPG,2601,100,,2080.80,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",2014.51,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1638.63,63,,1310.90,,,0,"percent of total billed charges","63% of total billed charges",397.95,15.3,,318.36,,,0,"percent of total billed charges","15.3% of total billed charges",1955.83,100,,,,,0,"fee schedule",EAPG,1794.69,69,,,,,0,"fee schedule","69% of total billed charges",2601,100,,2080.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2601,100,,2080.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2601,100,,2080.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.83,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1994.95,100,,,,,0,"fee schedule",EAPG,2542.58,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",980.58,37.7,,784.46,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2028.78,78,,1623.02,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2148.43,82.6,,1718.74,,,0,"percent of total billed charges","82.6% of total billed charges",1955.83,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2148.43,82.6,,1718.74,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2116.36,100,,,,,0,"fee schedule",EAPG,2601,100,,2080.80,,,0,"percent of total billed charges","100% of total billed charges",397.95,10656.86,
"59412 External cephalic version, with or without t",7963337,CDM,521,RC,59412,CPT,OUTPATIENT,,,696,452.4,,612.48,88,,489.98,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",586.37,100,,,,,0,"fee schedule",EAPG,696,100,,556.80,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",603.96,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",438.48,63,,350.78,,,0,"percent of total billed charges","63% of total billed charges",106.49,15.3,,85.19,,,0,"percent of total billed charges","15.3% of total billed charges",586.37,100,,,,,0,"fee schedule",EAPG,480.24,69,,,,,0,"fee schedule","69% of total billed charges",696,100,,556.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",696,100,,556.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",696,100,,556.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",586.37,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",598.1,100,,,,,0,"fee schedule",EAPG,762.28,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",262.39,37.7,,209.91,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",542.88,78,,434.30,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",574.9,82.6,,459.92,,,0,"percent of total billed charges","82.6% of total billed charges",586.37,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",574.9,82.6,,459.92,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",746.9,100,,,,,0,"fee schedule",EAPG,696,100,,556.80,,,0,"percent of total billed charges","100% of total billed charges",106.49,10656.86,
"59410 Vaginal delivery only; including postpartum",7963431,CDM,521,RC,59410,CPT,OUTPATIENT,,,2986,1940.9,,2627.68,88,,2102.14,,,0,"percent of total billed charges","88% of total billed charges",1493,50,,1194.40,,,0,"percent of total billed charges","50% of total billed charges",1955.83,100,,,,,0,"fee schedule",EAPG,2986,100,,2388.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2014.51,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1881.18,63,,1504.94,,,0,"percent of total billed charges","63% of total billed charges",456.86,15.3,,365.49,,,0,"percent of total billed charges","15.3% of total billed charges",1955.83,100,,,,,0,"fee schedule",EAPG,2060.34,69,,,,,0,"fee schedule","69% of total billed charges",2986,100,,2388.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2986,100,,2388.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2986,100,,2388.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1846.84,61.85,,1477.47,,,0,"percent of total billed charges","61.5% of total billed charges",1955.83,100,,,,,0,"fee schedule",EAPG,1493,50,,1194.40,,,0,"percent of total billed charges","50% of total billed charges",961.49,32.2,,769.19,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1994.95,100,,,,,0,"fee schedule",EAPG,2542.58,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1125.72,37.7,,900.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2329.08,78,,1863.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2466.44,82.6,,1973.15,,,0,"percent of total billed charges","82.6% of total billed charges",1955.83,100,,,,,0,"fee schedule","100% of WA fee schedule",1493,50,,1194.40,,,0,"percent of total billed charges","50% of total billed charges",2466.44,82.6,,1973.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2116.36,100,,,,,0,"fee schedule",EAPG,2986,100,,2388.80,,,0,"percent of total billed charges","100% of total billed charges",456.86,2986,
"59414 Delivery of placenta (separate procedure)",7963565,CDM,521,RC,59414,CPT,OUTPATIENT,,,634,412.1,,557.92,88,,446.34,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1708.92,100,,,,,0,"fee schedule",EAPG,634,100,,507.20,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",1760.19,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",399.42,63,,319.54,,,0,"percent of total billed charges","63% of total billed charges",97,15.3,,77.60,,,0,"percent of total billed charges","15.3% of total billed charges",1708.92,100,,,,,0,"fee schedule",EAPG,437.46,69,,,,,0,"fee schedule","69% of total billed charges",634,100,,507.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",634,100,,507.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",634,100,,507.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1708.92,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1743.1,100,,,,,0,"fee schedule",EAPG,2221.6,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",239.02,37.7,,191.22,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",494.52,78,,395.62,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",523.68,82.6,,418.94,,,0,"percent of total billed charges","82.6% of total billed charges",1708.92,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",523.68,82.6,,418.94,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1869.45,100,,,,,0,"fee schedule",EAPG,634,100,,507.20,,,0,"percent of total billed charges","100% of total billed charges",97,10656.86,
"59425 Antepartum care only 4-6 visits",7904737,CDM,521,RC,59425,CPT,OUTPATIENT,,,1340,871,,1179.2,88,,943.36,,,0,"percent of total billed charges","88% of total billed charges",670,50,,536.00,,,0,"percent of total billed charges","50% of total billed charges",222.02,100,,,,,0,"fee schedule",EAPG,1340,100,,1072.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",228.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",844.2,63,,675.36,,,0,"percent of total billed charges","63% of total billed charges",205.02,15.3,,164.02,,,0,"percent of total billed charges","15.3% of total billed charges",222.02,100,,,,,0,"fee schedule",EAPG,924.6,69,,,,,0,"fee schedule","69% of total billed charges",1340,100,,1072.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1340,100,,1072.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1340,100,,1072.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",828.79,61.85,,663.03,,,0,"percent of total billed charges","61.5% of total billed charges",222.02,100,,,,,0,"fee schedule",EAPG,670,50,,536.00,,,0,"percent of total billed charges","50% of total billed charges",431.48,32.2,,345.18,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",226.47,100,,,,,0,"fee schedule",EAPG,288.63,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",505.18,37.7,,404.14,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1045.2,78,,836.16,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.84,82.6,,885.47,,,0,"percent of total billed charges","82.6% of total billed charges",222.02,100,,,,,0,"fee schedule","100% of WA fee schedule",670,50,,536.00,,,0,"percent of total billed charges","50% of total billed charges",1106.84,82.6,,885.47,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.55,100,,,,,0,"fee schedule",EAPG,1340,100,,1072.00,,,0,"percent of total billed charges","100% of total billed charges",205.02,1340,
"59426 Antepartum care only 7 more visits",7904738,CDM,521,RC,59426,CPT,OUTPATIENT,,,2397,1558.05,,2109.36,88,,1687.49,,,0,"percent of total billed charges","88% of total billed charges",1198.5,50,,958.80,,,0,"percent of total billed charges","50% of total billed charges",222.02,100,,,,,0,"fee schedule",EAPG,2397,100,,1917.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",228.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1510.11,63,,1208.09,,,0,"percent of total billed charges","63% of total billed charges",366.74,15.3,,293.39,,,0,"percent of total billed charges","15.3% of total billed charges",222.02,100,,,,,0,"fee schedule",EAPG,1653.93,69,,,,,0,"fee schedule","69% of total billed charges",2397,100,,1917.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2397,100,,1917.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2397,100,,1917.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1482.54,61.85,,1186.03,,,0,"percent of total billed charges","61.5% of total billed charges",222.02,100,,,,,0,"fee schedule",EAPG,1198.5,50,,958.80,,,0,"percent of total billed charges","50% of total billed charges",771.83,32.2,,617.46,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",226.47,100,,,,,0,"fee schedule",EAPG,288.63,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",903.67,37.7,,722.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1869.66,78,,1495.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1979.92,82.6,,1583.94,,,0,"percent of total billed charges","82.6% of total billed charges",222.02,100,,,,,0,"fee schedule","100% of WA fee schedule",1198.5,50,,958.80,,,0,"percent of total billed charges","50% of total billed charges",1979.92,82.6,,1583.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.55,100,,,,,0,"fee schedule",EAPG,2397,100,,1917.60,,,0,"percent of total billed charges","100% of total billed charges",222.02,2397,
"59430 Postpartum care",7904739,CDM,521,RC,59430,CPT,OUTPATIENT,,,523,339.95,,460.24,88,,368.19,,,0,"percent of total billed charges","88% of total billed charges",261.5,50,,209.20,,,0,"percent of total billed charges","50% of total billed charges",222.02,100,,,,,0,"fee schedule",EAPG,523,100,,418.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",228.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",329.49,63,,263.59,,,0,"percent of total billed charges","63% of total billed charges",80.02,15.3,,64.02,,,0,"percent of total billed charges","15.3% of total billed charges",222.02,100,,,,,0,"fee schedule",EAPG,360.87,69,,,,,0,"fee schedule","69% of total billed charges",523,100,,418.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",523,100,,418.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",523,100,,418.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",323.48,61.85,,258.78,,,0,"percent of total billed charges","61.5% of total billed charges",222.02,100,,,,,0,"fee schedule",EAPG,261.5,50,,209.20,,,0,"percent of total billed charges","50% of total billed charges",168.41,32.2,,134.73,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",226.47,100,,,,,0,"fee schedule",EAPG,288.63,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",197.17,37.7,,157.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",407.94,78,,326.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",432,82.6,,345.60,,,0,"percent of total billed charges","82.6% of total billed charges",222.02,100,,,,,0,"fee schedule","100% of WA fee schedule",261.5,50,,209.20,,,0,"percent of total billed charges","50% of total billed charges",432,82.6,,345.60,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",382.55,100,,,,,0,"fee schedule",EAPG,523,100,,418.40,,,0,"percent of total billed charges","100% of total billed charges",80.02,523,
"59510 Routine obstetric care including antepartum",7961940,CDM,521,RC,59510,CPT,OUTPATIENT,,,4628,3008.2,,4072.64,88,,3258.11,,,0,"percent of total billed charges","88% of total billed charges",2314,50,,1851.20,,,0,"percent of total billed charges","50% of total billed charges",2349.1,100,,,,,0,"fee schedule",EAPG,4628,100,,3702.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2419.57,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2915.64,63,,2332.51,,,0,"percent of total billed charges","63% of total billed charges",708.08,15.3,,566.46,,,0,"percent of total billed charges","15.3% of total billed charges",2349.1,100,,,,,0,"fee schedule",EAPG,3193.32,69,,,,,0,"fee schedule","69% of total billed charges",4628,100,,3702.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4628,100,,3702.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4628,100,,3702.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2862.42,61.85,,2289.94,,,0,"percent of total billed charges","61.5% of total billed charges",2349.1,100,,,,,0,"fee schedule",EAPG,2314,50,,1851.20,,,0,"percent of total billed charges","50% of total billed charges",1490.22,32.2,,1192.18,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2396.08,100,,,,,0,"fee schedule",EAPG,3053.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1744.76,37.7,,1395.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3609.84,78,,2887.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3822.73,82.6,,3058.18,,,0,"percent of total billed charges","82.6% of total billed charges",2349.1,100,,,,,0,"fee schedule","100% of WA fee schedule",2314,50,,1851.20,,,0,"percent of total billed charges","50% of total billed charges",3822.73,82.6,,3058.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2509.63,100,,,,,0,"fee schedule",EAPG,4628,100,,3702.40,,,0,"percent of total billed charges","100% of total billed charges",708.08,4628,
"59515 Cesarean delivery only; including postpartum",7963418,CDM,521,RC,59515,CPT,OUTPATIENT,,,3645,2369.25,,3207.6,88,,2566.08,,,0,"percent of total billed charges","88% of total billed charges",1822.5,50,,1458.00,,,0,"percent of total billed charges","50% of total billed charges",2349.1,100,,,,,0,"fee schedule",EAPG,3645,100,,2916.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2419.57,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2296.35,63,,1837.08,,,0,"percent of total billed charges","63% of total billed charges",557.69,15.3,,446.15,,,0,"percent of total billed charges","15.3% of total billed charges",2349.1,100,,,,,0,"fee schedule",EAPG,2515.05,69,,,,,0,"fee schedule","69% of total billed charges",3645,100,,2916.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3645,100,,2916.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3645,100,,2916.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2254.43,61.85,,1803.54,,,0,"percent of total billed charges","61.5% of total billed charges",2349.1,100,,,,,0,"fee schedule",EAPG,1822.5,50,,1458.00,,,0,"percent of total billed charges","50% of total billed charges",1173.69,32.2,,938.95,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2396.08,100,,,,,0,"fee schedule",EAPG,3053.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1374.17,37.7,,1099.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2843.1,78,,2274.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3010.77,82.6,,2408.62,,,0,"percent of total billed charges","82.6% of total billed charges",2349.1,100,,,,,0,"fee schedule","100% of WA fee schedule",1822.5,50,,1458.00,,,0,"percent of total billed charges","50% of total billed charges",3010.77,82.6,,2408.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2509.63,100,,,,,0,"fee schedule",EAPG,3645,100,,2916.00,,,0,"percent of total billed charges","100% of total billed charges",557.69,3645,
"59525 Subtotal/total hysterectomy after cesarean d",7963369,CDM,521,RC,59525,CPT,OUTPATIENT,,,2376,1544.4,,2090.88,88,,1672.70,,,0,"percent of total billed charges","88% of total billed charges",2376,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3729.36,100,,,,,0,"fee schedule",EAPG,2376,100,,1900.80,,,0,"percent of total billed charges","100% of total billed charges",2376,175,,,,,0,"fee schedule","175% of CMS fee schedule",3841.24,100,,,,,0,"fee schedule",EAPG,2376,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1496.88,63,,1197.50,,,0,"percent of total billed charges","63% of total billed charges",363.53,15.3,,290.82,,,0,"percent of total billed charges","15.3% of total billed charges",3729.36,100,,,,,0,"fee schedule",EAPG,1639.44,69,,,,,0,"fee schedule","69% of total billed charges",2376,100,,1900.80,,,0,"percent of total billed charges","100% of total billed charges",2376,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2376,100,,1900.80,,,0,"percent of total billed charges","100% of total billed charges",2376,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2376,100,,1900.80,,,0,"percent of total billed charges","100% of total billed charges",2376,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2376,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3729.36,100,,,,,0,"fee schedule",EAPG,2376,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2376,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2376,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3803.95,100,,,,,0,"fee schedule",EAPG,4848.17,100,,,,,0,"fee schedule",EAPG,2376,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",895.75,37.7,,716.60,,,0,"percent of total billed charges","37.70% of total billed charges",2376,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2376,100,,,,,0,"fee schedule","100% of CMS fee schedule",1853.28,78,,1482.62,,,0,"percent of total billed charges","78% of total billed charges",2376,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1962.58,82.6,,1570.06,,,0,"percent of total billed charges","82.6% of total billed charges",3729.36,100,,,,,0,"fee schedule","100% of WA fee schedule",2376,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1962.58,82.6,,1570.06,,,0,"percent of total billed charges","82.6% of total billed charges",2376,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3889.89,100,,,,,0,"fee schedule",EAPG,2376,100,,1900.80,,,0,"percent of total billed charges","100% of total billed charges",363.53,4848.17,
"59614 Vaginal delivery only, vbac (with or w/o epi",7961542,CDM,521,RC,59614,CPT,OUTPATIENT,,,3538,2299.7,,3113.44,88,,2490.75,,,0,"percent of total billed charges","88% of total billed charges",1769,50,,1415.20,,,0,"percent of total billed charges","50% of total billed charges",1955.83,100,,,,,0,"fee schedule",EAPG,3538,100,,2830.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2014.51,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2228.94,63,,1783.15,,,0,"percent of total billed charges","63% of total billed charges",541.31,15.3,,433.05,,,0,"percent of total billed charges","15.3% of total billed charges",1955.83,100,,,,,0,"fee schedule",EAPG,2441.22,69,,,,,0,"fee schedule","69% of total billed charges",3538,100,,2830.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3538,100,,2830.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3538,100,,2830.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2188.25,61.85,,1750.60,,,0,"percent of total billed charges","61.5% of total billed charges",1955.83,100,,,,,0,"fee schedule",EAPG,1769,50,,1415.20,,,0,"percent of total billed charges","50% of total billed charges",1139.24,32.2,,911.39,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1994.95,100,,,,,0,"fee schedule",EAPG,2542.58,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1333.83,37.7,,1067.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2759.64,78,,2207.71,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2922.39,82.6,,2337.91,,,0,"percent of total billed charges","82.6% of total billed charges",1955.83,100,,,,,0,"fee schedule","100% of WA fee schedule",1769,50,,1415.20,,,0,"percent of total billed charges","50% of total billed charges",2922.39,82.6,,2337.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2116.36,100,,,,,0,"fee schedule",EAPG,3538,100,,2830.40,,,0,"percent of total billed charges","100% of total billed charges",541.31,3538,
"59618 Assisted C-section w/ ante and postpartum ca",7961543,CDM,521,RC,59618,CPT,OUTPATIENT,,,5541,3601.65,,4876.08,88,,3900.86,,,0,"percent of total billed charges","88% of total billed charges",2770.5,50,,2216.40,,,0,"percent of total billed charges","50% of total billed charges",2349.1,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2419.57,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",3490.83,63,,2792.66,,,0,"percent of total billed charges","63% of total billed charges",847.77,15.3,,678.22,,,0,"percent of total billed charges","15.3% of total billed charges",2349.1,100,,,,,0,"fee schedule",EAPG,3823.29,69,,,,,0,"fee schedule","69% of total billed charges",5541,100,,4432.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5541,100,,4432.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5541,100,,4432.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3427.11,61.85,,2741.69,,,0,"percent of total billed charges","61.5% of total billed charges",2349.1,100,,,,,0,"fee schedule",EAPG,2770.5,50,,2216.40,,,0,"percent of total billed charges","50% of total billed charges",1784.2,32.2,,1427.36,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2396.08,100,,,,,0,"fee schedule",EAPG,3053.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2088.96,37.7,,1671.17,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4321.98,78,,3457.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4576.87,82.6,,3661.50,,,0,"percent of total billed charges","82.6% of total billed charges",2349.1,100,,,,,0,"fee schedule","100% of WA fee schedule",2770.5,50,,2216.40,,,0,"percent of total billed charges","50% of total billed charges",4576.87,82.6,,3661.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2509.63,100,,,,,0,"fee schedule",EAPG,5541,100,,4432.80,,,0,"percent of total billed charges","100% of total billed charges",847.77,5541,
"59612 Vaginal delivery only, vbac (with or w/o epi",7962911,CDM,521,RC,59612,CPT,OUTPATIENT,,,3261,2119.65,,2869.68,88,,2295.74,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.83,100,,,,,0,"fee schedule",EAPG,3261,100,,2608.80,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",2014.51,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054.43,63,,1643.54,,,0,"percent of total billed charges","63% of total billed charges",498.93,15.3,,399.14,,,0,"percent of total billed charges","15.3% of total billed charges",1955.83,100,,,,,0,"fee schedule",EAPG,2250.09,69,,,,,0,"fee schedule","69% of total billed charges",3261,100,,2608.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3261,100,,2608.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3261,100,,2608.80,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.83,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1994.95,100,,,,,0,"fee schedule",EAPG,2542.58,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1229.4,37.7,,983.52,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2543.58,78,,2034.86,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2693.59,82.6,,2154.87,,,0,"percent of total billed charges","82.6% of total billed charges",1955.83,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2693.59,82.6,,2154.87,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2116.36,100,,,,,0,"fee schedule",EAPG,3261,100,,2608.80,,,0,"percent of total billed charges","100% of total billed charges",498.93,10656.86,
"59620 Cesarean delivery only, following attempted",7961544,CDM,521,RC,59620,CPT,OUTPATIENT,,,3549,2306.85,,3123.12,88,,2498.50,,,0,"percent of total billed charges","88% of total billed charges",3549,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2349.1,100,,,,,0,"fee schedule",EAPG,3549,100,,2839.20,,,0,"percent of total billed charges","100% of total billed charges",3549,175,,,,,0,"fee schedule","175% of CMS fee schedule",2419.57,100,,,,,0,"fee schedule",EAPG,3549,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2235.87,63,,1788.70,,,0,"percent of total billed charges","63% of total billed charges",543,15.3,,434.40,,,0,"percent of total billed charges","15.3% of total billed charges",2349.1,100,,,,,0,"fee schedule",EAPG,2448.81,69,,,,,0,"fee schedule","69% of total billed charges",3549,100,,2839.20,,,0,"percent of total billed charges","100% of total billed charges",3549,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3549,100,,2839.20,,,0,"percent of total billed charges","100% of total billed charges",3549,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3549,100,,2839.20,,,0,"percent of total billed charges","100% of total billed charges",3549,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3549,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2349.1,100,,,,,0,"fee schedule",EAPG,3549,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3549,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3549,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2396.08,100,,,,,0,"fee schedule",EAPG,3053.83,100,,,,,0,"fee schedule",EAPG,3549,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1337.97,37.7,,1070.38,,,0,"percent of total billed charges","37.70% of total billed charges",3549,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3549,100,,,,,0,"fee schedule","100% of CMS fee schedule",2768.22,78,,2214.58,,,0,"percent of total billed charges","78% of total billed charges",3549,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2931.47,82.6,,2345.18,,,0,"percent of total billed charges","82.6% of total billed charges",2349.1,100,,,,,0,"fee schedule","100% of WA fee schedule",3549,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2931.47,82.6,,2345.18,,,0,"percent of total billed charges","82.6% of total billed charges",3549,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2509.63,100,,,,,0,"fee schedule",EAPG,3549,100,,2839.20,,,0,"percent of total billed charges","100% of total billed charges",543,3549,
"59622 Cesarean delivery only, vbac; including post",7963260,CDM,521,RC,59622,CPT,OUTPATIENT,,,3958,2572.7,,3483.04,88,,2786.43,,,0,"percent of total billed charges","88% of total billed charges",1979,50,,1583.20,,,0,"percent of total billed charges","50% of total billed charges",2349.1,100,,,,,0,"fee schedule",EAPG,3958,100,,3166.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2419.57,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",2493.54,63,,1994.83,,,0,"percent of total billed charges","63% of total billed charges",605.57,15.3,,484.46,,,0,"percent of total billed charges","15.3% of total billed charges",2349.1,100,,,,,0,"fee schedule",EAPG,2731.02,69,,,,,0,"fee schedule","69% of total billed charges",3958,100,,3166.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3958,100,,3166.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3958,100,,3166.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2448.02,61.85,,1958.42,,,0,"percent of total billed charges","61.5% of total billed charges",2349.1,100,,,,,0,"fee schedule",EAPG,1979,50,,1583.20,,,0,"percent of total billed charges","50% of total billed charges",1274.48,32.2,,1019.58,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2396.08,100,,,,,0,"fee schedule",EAPG,3053.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1492.17,37.7,,1193.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3087.24,78,,2469.79,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",3269.31,82.6,,2615.45,,,0,"percent of total billed charges","82.6% of total billed charges",2349.1,100,,,,,0,"fee schedule","100% of WA fee schedule",1979,50,,1583.20,,,0,"percent of total billed charges","50% of total billed charges",3269.31,82.6,,2615.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2509.63,100,,,,,0,"fee schedule",EAPG,3958,100,,3166.40,,,0,"percent of total billed charges","100% of total billed charges",605.57,3958,
"59812 Treatment of incomplete abortion, any trimes",7962856,CDM,521,RC,59812,CPT,OUTPATIENT,,,810,526.5,,712.8,88,,570.24,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1591.42,100,,,,,0,"fee schedule",EAPG,810,100,,648.00,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",1639.16,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510.3,63,,408.24,,,0,"percent of total billed charges","63% of total billed charges",123.93,15.3,,99.14,,,0,"percent of total billed charges","15.3% of total billed charges",1591.42,100,,,,,0,"fee schedule",EAPG,558.9,69,,,,,0,"fee schedule","69% of total billed charges",810,100,,648.00,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",810,100,,648.00,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",810,100,,648.00,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1591.42,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1623.25,100,,,,,0,"fee schedule",EAPG,2068.84,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",305.37,37.7,,244.30,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",631.8,78,,505.44,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",669.06,82.6,,535.25,,,0,"percent of total billed charges","82.6% of total billed charges",1591.42,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",669.06,82.6,,535.25,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1751.95,100,,,,,0,"fee schedule",EAPG,810,100,,648.00,,,0,"percent of total billed charges","100% of total billed charges",123.93,10656.86,
"59821 Treatment of missed abortion, completed surg",7962891,CDM,521,RC,59821,CPT,OUTPATIENT,,,552,358.8,,485.76,88,,388.61,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1591.42,100,,,,,0,"fee schedule",EAPG,552,100,,441.60,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",1639.16,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",347.76,63,,278.21,,,0,"percent of total billed charges","63% of total billed charges",84.46,15.3,,67.57,,,0,"percent of total billed charges","15.3% of total billed charges",1591.42,100,,,,,0,"fee schedule",EAPG,380.88,69,,,,,0,"fee schedule","69% of total billed charges",552,100,,441.60,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",552,100,,441.60,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",552,100,,441.60,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1591.42,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1623.25,100,,,,,0,"fee schedule",EAPG,2068.84,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",208.1,37.7,,166.48,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",430.56,78,,344.45,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",455.95,82.6,,364.76,,,0,"percent of total billed charges","82.6% of total billed charges",1591.42,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",455.95,82.6,,364.76,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1751.95,100,,,,,0,"fee schedule",EAPG,552,100,,441.60,,,0,"percent of total billed charges","100% of total billed charges",84.46,10656.86,
"59820 Treatment of missed abortion, completed surg",7962912,CDM,521,RC,59820,CPT,OUTPATIENT,,,1365,887.25,,1201.2,88,,960.96,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1591.42,100,,,,,0,"fee schedule",EAPG,1365,100,,1092.00,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",1639.16,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.95,63,,687.96,,,0,"percent of total billed charges","63% of total billed charges",208.85,15.3,,167.08,,,0,"percent of total billed charges","15.3% of total billed charges",1591.42,100,,,,,0,"fee schedule",EAPG,941.85,69,,,,,0,"fee schedule","69% of total billed charges",1365,100,,1092.00,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1365,100,,1092.00,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1365,100,,1092.00,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1591.42,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1623.25,100,,,,,0,"fee schedule",EAPG,2068.84,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",514.61,37.7,,411.69,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1064.7,78,,851.76,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1127.49,82.6,,901.99,,,0,"percent of total billed charges","82.6% of total billed charges",1591.42,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1127.49,82.6,,901.99,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1751.95,100,,,,,0,"fee schedule",EAPG,1365,100,,1092.00,,,0,"percent of total billed charges","100% of total billed charges",208.85,10656.86,
"59830 Treatment of septic abortion, completed surg",7963392,CDM,521,RC,59830,CPT,OUTPATIENT,,,1611,1047.15,,1417.68,88,,1134.14,,,0,"percent of total billed charges","88% of total billed charges",1611,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1591.42,100,,,,,0,"fee schedule",EAPG,1611,100,,1288.80,,,0,"percent of total billed charges","100% of total billed charges",1611,175,,,,,0,"fee schedule","175% of CMS fee schedule",1639.16,100,,,,,0,"fee schedule",EAPG,1611,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1014.93,63,,811.94,,,0,"percent of total billed charges","63% of total billed charges",246.48,15.3,,197.18,,,0,"percent of total billed charges","15.3% of total billed charges",1591.42,100,,,,,0,"fee schedule",EAPG,1111.59,69,,,,,0,"fee schedule","69% of total billed charges",1611,100,,1288.80,,,0,"percent of total billed charges","100% of total billed charges",1611,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1611,100,,1288.80,,,0,"percent of total billed charges","100% of total billed charges",1611,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1611,100,,1288.80,,,0,"percent of total billed charges","100% of total billed charges",1611,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1611,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1591.42,100,,,,,0,"fee schedule",EAPG,1611,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1611,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1611,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1623.25,100,,,,,0,"fee schedule",EAPG,2068.84,100,,,,,0,"fee schedule",EAPG,1611,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",607.35,37.7,,485.88,,,0,"percent of total billed charges","37.70% of total billed charges",1611,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1611,100,,,,,0,"fee schedule","100% of CMS fee schedule",1256.58,78,,1005.26,,,0,"percent of total billed charges","78% of total billed charges",1611,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1330.69,82.6,,1064.55,,,0,"percent of total billed charges","82.6% of total billed charges",1591.42,100,,,,,0,"fee schedule",EAPG,1611,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1330.69,82.6,,1064.55,,,0,"percent of total billed charges","82.6% of total billed charges",1611,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1751.95,100,,,,,0,"fee schedule",EAPG,1611,100,,1288.80,,,0,"percent of total billed charges","100% of total billed charges",246.48,2068.84,
"59840 Induced abortion, by dilation and curettage",7963527,CDM,521,RC,59840,CPT,OUTPATIENT,,,549,356.85,,483.12,88,,386.50,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1591.42,100,,,,,0,"fee schedule",EAPG,549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",1639.16,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.87,63,,276.70,,,0,"percent of total billed charges","63% of total billed charges",84,15.3,,67.20,,,0,"percent of total billed charges","15.3% of total billed charges",1591.42,100,,,,,0,"fee schedule",EAPG,378.81,69,,,,,0,"fee schedule","69% of total billed charges",549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1591.42,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1623.25,100,,,,,0,"fee schedule",EAPG,2068.84,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",206.97,37.7,,165.58,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",428.22,78,,342.58,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",453.47,82.6,,362.78,,,0,"percent of total billed charges","82.6% of total billed charges",1591.42,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",453.47,82.6,,362.78,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1751.95,100,,,,,0,"fee schedule",EAPG,549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",84,10656.86,
"59855 Induced abortion, by vaginal suppositories w",7962610,CDM,521,RC,59855,CPT,OUTPATIENT,,,1887,1226.55,,1660.56,88,,1328.45,,,0,"percent of total billed charges","88% of total billed charges",1887,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1591.42,100,,,,,0,"fee schedule",EAPG,1887,100,,1509.60,,,0,"percent of total billed charges","100% of total billed charges",1887,175,,,,,0,"fee schedule","175% of CMS fee schedule",1639.16,100,,,,,0,"fee schedule",EAPG,1887,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1188.81,63,,951.05,,,0,"percent of total billed charges","63% of total billed charges",288.71,15.3,,230.97,,,0,"percent of total billed charges","15.3% of total billed charges",1591.42,100,,,,,0,"fee schedule",EAPG,1302.03,69,,,,,0,"fee schedule","69% of total billed charges",1887,100,,1509.60,,,0,"percent of total billed charges","100% of total billed charges",1887,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1887,100,,1509.60,,,0,"percent of total billed charges","100% of total billed charges",1887,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1887,100,,1509.60,,,0,"percent of total billed charges","100% of total billed charges",1887,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1887,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1591.42,100,,,,,0,"fee schedule",EAPG,1887,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1887,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1887,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1623.25,100,,,,,0,"fee schedule",EAPG,2068.84,100,,,,,0,"fee schedule",EAPG,1887,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",711.4,37.7,,569.12,,,0,"percent of total billed charges","37.70% of total billed charges",1887,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1887,100,,,,,0,"fee schedule","100% of CMS fee schedule",1471.86,78,,1177.49,,,0,"percent of total billed charges","78% of total billed charges",1887,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1558.66,82.6,,1246.93,,,0,"percent of total billed charges","82.6% of total billed charges",1591.42,100,,,,,0,"fee schedule","100% of WA fee schedule",1887,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1558.66,82.6,,1246.93,,,0,"percent of total billed charges","82.6% of total billed charges",1887,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1751.95,100,,,,,0,"fee schedule",EAPG,1887,100,,1509.60,,,0,"percent of total billed charges","100% of total billed charges",288.71,2068.84,
"59870 Uterine evacuation and curettage for hydatid",7963290,CDM,521,RC,59870,CPT,OUTPATIENT,,,1599,1039.35,,1407.12,88,,1125.70,,,0,"percent of total billed charges","88% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3339.65,100,,,,,0,"fee schedule",EAPG,1599,100,,1279.20,,,0,"percent of total billed charges","100% of total billed charges",5580.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",3439.84,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1007.37,63,,805.90,,,0,"percent of total billed charges","63% of total billed charges",244.65,15.3,,195.72,,,0,"percent of total billed charges","15.3% of total billed charges",3339.65,100,,,,,0,"fee schedule",EAPG,1103.31,69,,,,,0,"fee schedule","69% of total billed charges",1599,100,,1279.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1599,100,,1279.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1599,100,,1279.20,,,0,"percent of total billed charges","100% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",10656.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3339.65,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2786.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3406.45,100,,,,,0,"fee schedule",EAPG,4341.55,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",602.82,37.7,,482.26,,,0,"percent of total billed charges","37.70% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1247.22,78,,997.78,,,0,"percent of total billed charges","78% of total billed charges",3220.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1320.77,82.6,,1056.62,,,0,"percent of total billed charges","82.6% of total billed charges",3339.65,100,,,,,0,"fee schedule",EAPG,3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1320.77,82.6,,1056.62,,,0,"percent of total billed charges","82.6% of total billed charges",3188.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3500.18,100,,,,,0,"fee schedule",EAPG,1599,100,,1279.20,,,0,"percent of total billed charges","100% of total billed charges",244.65,10656.86,
"59899 Unlisted procedure, maternity care and deliv",7963454,CDM,521,RC,59899,CPT,OUTPATIENT,,,212,137.8,,186.56,88,,149.25,,,0,"percent of total billed charges","88% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",586.37,100,,,,,0,"fee schedule",EAPG,212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",355.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",603.96,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",133.56,63,,106.85,,,0,"percent of total billed charges","63% of total billed charges",32.44,15.3,,25.95,,,0,"percent of total billed charges","15.3% of total billed charges",586.37,100,,,,,0,"fee schedule",EAPG,146.28,69,,,,,0,"fee schedule","69% of total billed charges",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS fee schedule",691.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",586.37,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",598.1,100,,,,,0,"fee schedule",EAPG,762.28,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",79.92,37.7,,63.94,,,0,"percent of total billed charges","37.70% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",165.36,78,,132.29,,,0,"percent of total billed charges","78% of total billed charges",205.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",175.11,82.6,,140.09,,,0,"percent of total billed charges","82.6% of total billed charges",586.37,100,,,,,0,"fee schedule",EAPG,203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",175.11,82.6,,140.09,,,0,"percent of total billed charges","82.6% of total billed charges",203.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",746.9,100,,,,,0,"fee schedule",EAPG,212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",32.44,762.28,
"60100 Biopsy thyroid, percutaneous core needle",7963588,CDM,521,RC,60100,CPT,OUTPATIENT,,,347,225.55,,305.36,88,,244.29,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.92,100,,,,,0,"fee schedule",EAPG,347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",585.99,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.61,63,,174.89,,,0,"percent of total billed charges","63% of total billed charges",53.09,15.3,,42.47,,,0,"percent of total billed charges","15.3% of total billed charges",568.92,100,,,,,0,"fee schedule",EAPG,239.43,69,,,,,0,"fee schedule","69% of total billed charges",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.92,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",580.3,100,,,,,0,"fee schedule",EAPG,739.6,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.82,37.7,,104.66,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.66,78,,216.53,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",286.62,82.6,,229.30,,,0,"percent of total billed charges","82.6% of total billed charges",568.92,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",286.62,82.6,,229.30,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",729.45,100,,,,,0,"fee schedule",EAPG,347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",53.09,2526.76,
"60210 Partial thyroid lobectomy, unilateral; with",7962892,CDM,521,RC,60210,CPT,OUTPATIENT,,,2433,1581.45,,2141.04,88,,1712.83,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3807.24,100,,,,,0,"fee schedule",EAPG,2433,100,,1946.40,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",3921.46,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1532.79,63,,1226.23,,,0,"percent of total billed charges","63% of total billed charges",372.25,15.3,,297.80,,,0,"percent of total billed charges","15.3% of total billed charges",3807.24,100,,,,,0,"fee schedule",EAPG,1678.77,69,,,,,0,"fee schedule","69% of total billed charges",2433,100,,1946.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2433,100,,1946.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2433,100,,1946.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3807.24,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3883.38,100,,,,,0,"fee schedule",EAPG,4949.41,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",917.24,37.7,,733.79,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1897.74,78,,1518.19,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2009.66,82.6,,1607.73,,,0,"percent of total billed charges","82.6% of total billed charges",3807.24,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2009.66,82.6,,1607.73,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3967.77,100,,,,,0,"fee schedule",EAPG,2433,100,,1946.40,,,0,"percent of total billed charges","100% of total billed charges",372.25,20558.19,
"60225 Total thyroid lobectomy, unilateral; w/ cont",7961773,CDM,521,RC,60225,CPT,OUTPATIENT,,,1983,1288.95,,1745.04,88,,1396.03,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3807.24,100,,,,,0,"fee schedule",EAPG,1983,100,,1586.40,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",3921.46,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1249.29,63,,999.43,,,0,"percent of total billed charges","63% of total billed charges",303.4,15.3,,242.72,,,0,"percent of total billed charges","15.3% of total billed charges",3807.24,100,,,,,0,"fee schedule",EAPG,1368.27,69,,,,,0,"fee schedule","69% of total billed charges",1983,100,,1586.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1983,100,,1586.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1983,100,,1586.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3807.24,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3883.38,100,,,,,0,"fee schedule",EAPG,4949.41,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",747.59,37.7,,598.07,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1546.74,78,,1237.39,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1637.96,82.6,,1310.37,,,0,"percent of total billed charges","82.6% of total billed charges",3807.24,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1637.96,82.6,,1310.37,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3967.77,100,,,,,0,"fee schedule",EAPG,1983,100,,1586.40,,,0,"percent of total billed charges","100% of total billed charges",303.4,20558.19,
"60220 Total thyroid lobectomy, unilateral; with or",7962942,CDM,521,RC,60220,CPT,OUTPATIENT,,,2642,1717.3,,2324.96,88,,1859.97,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3807.24,100,,,,,0,"fee schedule",EAPG,2642,100,,2113.60,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",3921.46,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1664.46,63,,1331.57,,,0,"percent of total billed charges","63% of total billed charges",404.23,15.3,,323.38,,,0,"percent of total billed charges","15.3% of total billed charges",3807.24,100,,,,,0,"fee schedule",EAPG,1822.98,69,,,,,0,"fee schedule","69% of total billed charges",2642,100,,2113.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2642,100,,2113.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2642,100,,2113.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3807.24,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3883.38,100,,,,,0,"fee schedule",EAPG,4949.41,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",996.03,37.7,,796.82,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2060.76,78,,1648.61,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2182.29,82.6,,1745.83,,,0,"percent of total billed charges","82.6% of total billed charges",3807.24,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2182.29,82.6,,1745.83,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3967.77,100,,,,,0,"fee schedule",EAPG,2642,100,,2113.60,,,0,"percent of total billed charges","100% of total billed charges",404.23,20558.19,
"60240 Thyroidectomy, total or complete",7963718,CDM,521,RC,60240,CPT,OUTPATIENT,,,2625,1706.25,,2310,88,,1848.00,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3807.24,100,,,,,0,"fee schedule",EAPG,2625,100,,2100.00,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",3921.46,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1653.75,63,,1323.00,,,0,"percent of total billed charges","63% of total billed charges",401.63,15.3,,321.30,,,0,"percent of total billed charges","15.3% of total billed charges",3807.24,100,,,,,0,"fee schedule",EAPG,1811.25,69,,,,,0,"fee schedule","69% of total billed charges",2625,100,,2100.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2625,100,,2100.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2625,100,,2100.00,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3807.24,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3883.38,100,,,,,0,"fee schedule",EAPG,4949.41,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",989.63,37.7,,791.70,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2047.5,78,,1638.00,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2168.25,82.6,,1734.60,,,0,"percent of total billed charges","82.6% of total billed charges",3807.24,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2168.25,82.6,,1734.60,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3967.77,100,,,,,0,"fee schedule",EAPG,2625,100,,2100.00,,,0,"percent of total billed charges","100% of total billed charges",401.63,20558.19,
"60270 Thyroidectomy, including substernal thyroid;",7962346,CDM,521,RC,60270,CPT,OUTPATIENT,,,2913,1893.45,,2563.44,88,,2050.75,,,0,"percent of total billed charges","88% of total billed charges",2913,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3807.24,100,,,,,0,"fee schedule",EAPG,2913,100,,2330.40,,,0,"percent of total billed charges","100% of total billed charges",2913,175,,,,,0,"fee schedule","175% of CMS fee schedule",3921.46,100,,,,,0,"fee schedule",EAPG,2913,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1835.19,63,,1468.15,,,0,"percent of total billed charges","63% of total billed charges",445.69,15.3,,356.55,,,0,"percent of total billed charges","15.3% of total billed charges",3807.24,100,,,,,0,"fee schedule",EAPG,2009.97,69,,,,,0,"fee schedule","69% of total billed charges",2913,100,,2330.40,,,0,"percent of total billed charges","100% of total billed charges",2913,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2913,100,,2330.40,,,0,"percent of total billed charges","100% of total billed charges",2913,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2913,100,,2330.40,,,0,"percent of total billed charges","100% of total billed charges",2913,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2913,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3807.24,100,,,,,0,"fee schedule",EAPG,2913,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2913,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2913,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3883.38,100,,,,,0,"fee schedule",EAPG,4949.41,100,,,,,0,"fee schedule",EAPG,2913,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1098.2,37.7,,878.56,,,0,"percent of total billed charges","37.70% of total billed charges",2913,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2913,100,,,,,0,"fee schedule","100% of CMS fee schedule",2272.14,78,,1817.71,,,0,"percent of total billed charges","78% of total billed charges",2913,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2406.14,82.6,,1924.91,,,0,"percent of total billed charges","82.6% of total billed charges",3807.24,100,,,,,0,"fee schedule","100% of WA fee schedule",2913,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2406.14,82.6,,1924.91,,,0,"percent of total billed charges","82.6% of total billed charges",2913,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3967.77,100,,,,,0,"fee schedule",EAPG,2913,100,,2330.40,,,0,"percent of total billed charges","100% of total billed charges",445.69,4949.41,
"60271 Thyroidectomy, including substernal thyroid;",7963054,CDM,521,RC,60271,CPT,OUTPATIENT,,,3537,2299.05,,3112.56,88,,2490.05,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3807.24,100,,,,,0,"fee schedule",EAPG,3537,100,,2829.60,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",3921.46,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2228.31,63,,1782.65,,,0,"percent of total billed charges","63% of total billed charges",541.16,15.3,,432.93,,,0,"percent of total billed charges","15.3% of total billed charges",3807.24,100,,,,,0,"fee schedule",EAPG,2440.53,69,,,,,0,"fee schedule","69% of total billed charges",3537,100,,2829.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3537,100,,2829.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3537,100,,2829.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3807.24,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3883.38,100,,,,,0,"fee schedule",EAPG,4949.41,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1333.45,37.7,,1066.76,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2758.86,78,,2207.09,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2921.56,82.6,,2337.25,,,0,"percent of total billed charges","82.6% of total billed charges",3807.24,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2921.56,82.6,,2337.25,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3967.77,100,,,,,0,"fee schedule",EAPG,3537,100,,2829.60,,,0,"percent of total billed charges","100% of total billed charges",541.16,20662.24,
"60281 Excision of thyroglossal duct cyst or sinus;",7963291,CDM,521,RC,60281,CPT,OUTPATIENT,,,903,586.95,,794.64,88,,635.71,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3807.24,100,,,,,0,"fee schedule",EAPG,903,100,,722.40,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",3921.46,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.89,63,,455.11,,,0,"percent of total billed charges","63% of total billed charges",138.16,15.3,,110.53,,,0,"percent of total billed charges","15.3% of total billed charges",3807.24,100,,,,,0,"fee schedule",EAPG,623.07,69,,,,,0,"fee schedule","69% of total billed charges",903,100,,722.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903,100,,722.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903,100,,722.40,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3807.24,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3883.38,100,,,,,0,"fee schedule",EAPG,4949.41,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",340.43,37.7,,272.34,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",704.34,78,,563.47,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",745.88,82.6,,596.70,,,0,"percent of total billed charges","82.6% of total billed charges",3807.24,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",745.88,82.6,,596.70,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3967.77,100,,,,,0,"fee schedule",EAPG,903,100,,722.40,,,0,"percent of total billed charges","100% of total billed charges",138.16,20558.19,
"60280 Excision of thyroglossal duct cyst or sinus;",7963512,CDM,521,RC,60280,CPT,OUTPATIENT,,,982,638.3,,864.16,88,,691.33,,,0,"percent of total billed charges","88% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3807.24,100,,,,,0,"fee schedule",EAPG,982,100,,785.60,,,0,"percent of total billed charges","100% of total billed charges",10299.04,175,,,,,0,"fee schedule","175% of CMS fee schedule",3921.46,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",618.66,63,,494.93,,,0,"percent of total billed charges","63% of total billed charges",150.25,15.3,,120.20,,,0,"percent of total billed charges","15.3% of total billed charges",3807.24,100,,,,,0,"fee schedule",EAPG,677.58,69,,,,,0,"fee schedule","69% of total billed charges",982,100,,785.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",982,100,,785.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",982,100,,785.60,,,0,"percent of total billed charges","100% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",20558.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3807.24,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5374.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3883.38,100,,,,,0,"fee schedule",EAPG,4949.41,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",370.21,37.7,,296.17,,,0,"percent of total billed charges","37.70% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",765.96,78,,612.77,,,0,"percent of total billed charges","78% of total billed charges",5944.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",811.13,82.6,,648.90,,,0,"percent of total billed charges","82.6% of total billed charges",3807.24,100,,,,,0,"fee schedule",EAPG,5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",811.13,82.6,,648.90,,,0,"percent of total billed charges","82.6% of total billed charges",5885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3967.77,100,,,,,0,"fee schedule",EAPG,982,100,,785.60,,,0,"percent of total billed charges","100% of total billed charges",150.25,20558.19,
"60300 Aspiration and/or injection, thyroid cyst",7963566,CDM,521,RC,60300,CPT,OUTPATIENT,,,243,157.95,,213.84,88,,171.07,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.92,100,,,,,0,"fee schedule",EAPG,243,100,,194.40,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",585.99,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",153.09,63,,122.47,,,0,"percent of total billed charges","63% of total billed charges",37.18,15.3,,29.74,,,0,"percent of total billed charges","15.3% of total billed charges",568.92,100,,,,,0,"fee schedule",EAPG,167.67,69,,,,,0,"fee schedule","69% of total billed charges",243,100,,194.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",243,100,,194.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",243,100,,194.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",568.92,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",580.3,100,,,,,0,"fee schedule",EAPG,739.6,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",91.61,37.7,,73.29,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.54,78,,151.63,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200.72,82.6,,160.58,,,0,"percent of total billed charges","82.6% of total billed charges",568.92,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200.72,82.6,,160.58,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",729.45,100,,,,,0,"fee schedule",EAPG,243,100,,194.40,,,0,"percent of total billed charges","100% of total billed charges",37.18,2526.76,
"60502 Parathyroidectomy or exploration of parathyr",7962943,CDM,521,RC,60502,CPT,OUTPATIENT,,,2735,1777.75,,2406.8,88,,1925.44,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3807.24,100,,,,,0,"fee schedule",EAPG,2735,100,,2188.00,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",3921.46,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1723.05,63,,1378.44,,,0,"percent of total billed charges","63% of total billed charges",418.46,15.3,,334.77,,,0,"percent of total billed charges","15.3% of total billed charges",3807.24,100,,,,,0,"fee schedule",EAPG,1887.15,69,,,,,0,"fee schedule","69% of total billed charges",2735,100,,2188.00,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2735,100,,2188.00,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2735,100,,2188.00,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3807.24,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3883.38,100,,,,,0,"fee schedule",EAPG,4949.41,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1031.1,37.7,,824.88,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2133.3,78,,1706.64,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2259.11,82.6,,1807.29,,,0,"percent of total billed charges","82.6% of total billed charges",3807.24,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2259.11,82.6,,1807.29,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3967.77,100,,,,,0,"fee schedule",EAPG,2735,100,,2188.00,,,0,"percent of total billed charges","100% of total billed charges",418.46,20662.24,
"60512 Parathyroid autotransplantation (List separa",7961774,CDM,521,RC,60512,CPT,OUTPATIENT,,,516,335.4,,454.08,88,,363.26,,,0,"percent of total billed charges","88% of total billed charges",258,50,,206.40,,,0,"percent of total billed charges","50% of total billed charges",3807.24,100,,,,,0,"fee schedule",EAPG,516,100,,412.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3921.46,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",325.08,63,,260.06,,,0,"percent of total billed charges","63% of total billed charges",78.95,15.3,,63.16,,,0,"percent of total billed charges","15.3% of total billed charges",3807.24,100,,,,,0,"fee schedule",EAPG,356.04,69,,,,,0,"fee schedule","69% of total billed charges",516,100,,412.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",516,100,,412.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",516,100,,412.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",319.15,61.85,,255.32,,,0,"percent of total billed charges","61.5% of total billed charges",3807.24,100,,,,,0,"fee schedule",EAPG,258,50,,206.40,,,0,"percent of total billed charges","50% of total billed charges",166.15,32.2,,132.92,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3883.38,100,,,,,0,"fee schedule",EAPG,4949.41,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",194.53,37.7,,155.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",402.48,78,,321.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",426.22,82.6,,340.98,,,0,"percent of total billed charges","82.6% of total billed charges",3807.24,100,,,,,0,"fee schedule",EAPG,258,50,,206.40,,,0,"percent of total billed charges","50% of total billed charges",426.22,82.6,,340.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",3967.77,100,,,,,0,"fee schedule",EAPG,516,100,,412.80,,,0,"percent of total billed charges","100% of total billed charges",78.95,4949.41,
"60650 Laparoscopy, surgical, w/ adrenalectomy, w/",7961775,CDM,521,RC,60650,CPT,OUTPATIENT,,,1221,793.65,,1074.48,88,,859.58,,,0,"percent of total billed charges","88% of total billed charges",1221,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3355.36,100,,,,,0,"fee schedule",EAPG,1221,100,,976.80,,,0,"percent of total billed charges","100% of total billed charges",1221,175,,,,,0,"fee schedule","175% of CMS fee schedule",3456.02,100,,,,,0,"fee schedule",EAPG,1221,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",769.23,63,,615.38,,,0,"percent of total billed charges","63% of total billed charges",186.81,15.3,,149.45,,,0,"percent of total billed charges","15.3% of total billed charges",3355.36,100,,,,,0,"fee schedule",EAPG,842.49,69,,,,,0,"fee schedule","69% of total billed charges",1221,100,,976.80,,,0,"percent of total billed charges","100% of total billed charges",1221,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1221,100,,976.80,,,0,"percent of total billed charges","100% of total billed charges",1221,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1221,100,,976.80,,,0,"percent of total billed charges","100% of total billed charges",1221,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1221,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3355.36,100,,,,,0,"fee schedule",EAPG,1221,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1221,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1221,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3422.47,100,,,,,0,"fee schedule",EAPG,4361.97,100,,,,,0,"fee schedule",EAPG,1221,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",460.32,37.7,,368.26,,,0,"percent of total billed charges","37.70% of total billed charges",1221,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1221,100,,,,,0,"fee schedule","100% of CMS fee schedule",952.38,78,,761.90,,,0,"percent of total billed charges","78% of total billed charges",1221,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1008.55,82.6,,806.84,,,0,"percent of total billed charges","82.6% of total billed charges",3355.36,100,,,,,0,"fee schedule","100% of WA fee schedule",1221,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1008.55,82.6,,806.84,,,0,"percent of total billed charges","82.6% of total billed charges",1221,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3515.89,100,,,,,0,"fee schedule",EAPG,1221,100,,976.80,,,0,"percent of total billed charges","100% of total billed charges",186.81,4361.97,
"61001 Subdural tap through fontanelle, or suture,",7962018,CDM,521,RC,61001,CPT,OUTPATIENT,,,397,258.05,,349.36,88,,279.49,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,397,100,,317.60,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.11,63,,200.09,,,0,"percent of total billed charges","63% of total billed charges",60.74,15.3,,48.59,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,273.93,69,,,,,0,"fee schedule","69% of total billed charges",397,100,,317.60,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397,100,,317.60,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397,100,,317.60,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",149.67,37.7,,119.74,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.66,78,,247.73,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327.92,82.6,,262.34,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327.92,82.6,,262.34,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",552.74,100,,,,,0,"fee schedule",EAPG,397,100,,317.60,,,0,"percent of total billed charges","100% of total billed charges",60.74,2578.03,
"61000 Subdural tap through fontanelle, or suture,",7962275,CDM,521,RC,61000,CPT,OUTPATIENT,,,602,391.3,,529.76,88,,423.81,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",379.26,63,,303.41,,,0,"percent of total billed charges","63% of total billed charges",92.11,15.3,,73.69,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,415.38,69,,,,,0,"fee schedule","69% of total billed charges",602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",226.95,37.7,,181.56,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",469.56,78,,375.65,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.25,82.6,,397.80,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.25,82.6,,397.80,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",552.74,100,,,,,0,"fee schedule",EAPG,602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",92.11,2578.03,
"61026 Ventricular puncture through previous burr h",7962019,CDM,521,RC,61026,CPT,OUTPATIENT,,,666,432.9,,586.08,88,,468.86,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,666,100,,532.80,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",1076.46,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",419.58,63,,335.66,,,0,"percent of total billed charges","63% of total billed charges",101.9,15.3,,81.52,,,0,"percent of total billed charges","15.3% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,459.54,69,,,,,0,"fee schedule","69% of total billed charges",666,100,,532.80,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",666,100,,532.80,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",666,100,,532.80,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1066.01,100,,,,,0,"fee schedule",EAPG,1358.64,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",251.08,37.7,,200.86,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",519.48,78,,415.58,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",550.12,82.6,,440.10,,,0,"percent of total billed charges","82.6% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",550.12,82.6,,440.10,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1205.64,100,,,,,0,"fee schedule",EAPG,666,100,,532.80,,,0,"percent of total billed charges","100% of total billed charges",101.9,2578.03,
"61020 Ventricular puncture through previous burr h",7962128,CDM,521,RC,61020,CPT,OUTPATIENT,,,515,334.75,,453.2,88,,362.56,,,0,"percent of total billed charges","88% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",1626.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",1076.46,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",324.45,63,,259.56,,,0,"percent of total billed charges","63% of total billed charges",78.8,15.3,,63.04,,,0,"percent of total billed charges","15.3% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,355.35,69,,,,,0,"fee schedule","69% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3341.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1066.01,100,,,,,0,"fee schedule",EAPG,1358.64,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",194.16,37.7,,155.33,,,0,"percent of total billed charges","37.70% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.7,78,,321.36,,,0,"percent of total billed charges","78% of total billed charges",938.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1205.64,100,,,,,0,"fee schedule",EAPG,515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",78.8,3341.26,
"61050 Cisternal or lateral cervical (C1-C2) punctu",7962020,CDM,521,RC,61050,CPT,OUTPATIENT,,,602,391.3,,529.76,88,,423.81,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",379.26,63,,303.41,,,0,"percent of total billed charges","63% of total billed charges",92.11,15.3,,73.69,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,415.38,69,,,,,0,"fee schedule","69% of total billed charges",602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",226.95,37.7,,181.56,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",469.56,78,,375.65,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.25,82.6,,397.80,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",497.25,82.6,,397.80,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",552.74,100,,,,,0,"fee schedule",EAPG,602,100,,481.60,,,0,"percent of total billed charges","100% of total billed charges",92.11,1061,
"61055 Cisternal or lateral cervical (C1-C2) punctu",7962225,CDM,521,RC,61055,CPT,OUTPATIENT,,,706,458.9,,621.28,88,,497.02,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,706,100,,564.80,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",444.78,63,,355.82,,,0,"percent of total billed charges","63% of total billed charges",108.02,15.3,,86.42,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,487.14,69,,,,,0,"fee schedule","69% of total billed charges",706,100,,564.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",706,100,,564.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",706,100,,564.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",266.16,37.7,,212.93,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",550.68,78,,440.54,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",583.16,82.6,,466.53,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",583.16,82.6,,466.53,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",552.74,100,,,,,0,"fee schedule",EAPG,706,100,,564.80,,,0,"percent of total billed charges","100% of total billed charges",108.02,1061,
"61070 Puncture of shunt tubing or reservoir for as",7962647,CDM,521,RC,61070,CPT,OUTPATIENT,,,423,274.95,,372.24,88,,297.79,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,423,100,,338.40,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",266.49,63,,213.19,,,0,"percent of total billed charges","63% of total billed charges",64.72,15.3,,51.78,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,291.87,69,,,,,0,"fee schedule","69% of total billed charges",423,100,,338.40,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",423,100,,338.40,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",423,100,,338.40,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.47,37.7,,127.58,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",329.94,78,,263.95,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",349.4,82.6,,279.52,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",349.4,82.6,,279.52,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",552.74,100,,,,,0,"fee schedule",EAPG,423,100,,338.40,,,0,"percent of total billed charges","100% of total billed charges",64.72,2578.03,
"61107 Twist drill hole(s) for subdural, intracereb",7962021,CDM,521,RC,61107,CPT,OUTPATIENT,,,2713,1763.45,,2387.44,88,,1909.95,,,0,"percent of total billed charges","88% of total billed charges",2713,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,2713,100,,2170.40,,,0,"percent of total billed charges","100% of total billed charges",2713,175,,,,,0,"fee schedule","175% of CMS fee schedule",5945.4,100,,,,,0,"fee schedule",EAPG,2713,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1709.19,63,,1367.35,,,0,"percent of total billed charges","63% of total billed charges",415.09,15.3,,332.07,,,0,"percent of total billed charges","15.3% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,1871.97,69,,,,,0,"fee schedule","69% of total billed charges",2713,100,,2170.40,,,0,"percent of total billed charges","100% of total billed charges",2713,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2713,100,,2170.40,,,0,"percent of total billed charges","100% of total billed charges",2713,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2713,100,,2170.40,,,0,"percent of total billed charges","100% of total billed charges",2713,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2713,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,2713,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2713,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2713,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5887.68,100,,,,,0,"fee schedule",EAPG,7503.9,100,,,,,0,"fee schedule",EAPG,2713,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1022.8,37.7,,818.24,,,0,"percent of total billed charges","37.70% of total billed charges",2713,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2713,100,,,,,0,"fee schedule","100% of CMS fee schedule",2116.14,78,,1692.91,,,0,"percent of total billed charges","78% of total billed charges",2713,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2240.94,82.6,,1792.75,,,0,"percent of total billed charges","82.6% of total billed charges",5772.23,100,,,,,0,"fee schedule","100% of WA fee schedule",2713,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2240.94,82.6,,1792.75,,,0,"percent of total billed charges","82.6% of total billed charges",2713,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5932.76,100,,,,,0,"fee schedule",EAPG,2713,100,,2170.40,,,0,"percent of total billed charges","100% of total billed charges",415.09,7503.9,
"61108 Twist drill hole(s) for subdural, intracereb",7962131,CDM,521,RC,61108,CPT,OUTPATIENT,,,4406,2863.9,,3877.28,88,,3101.82,,,0,"percent of total billed charges","88% of total billed charges",4406,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,4406,100,,3524.80,,,0,"percent of total billed charges","100% of total billed charges",4406,175,,,,,0,"fee schedule","175% of CMS fee schedule",5945.4,100,,,,,0,"fee schedule",EAPG,4406,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2775.78,63,,2220.62,,,0,"percent of total billed charges","63% of total billed charges",674.12,15.3,,539.30,,,0,"percent of total billed charges","15.3% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,3040.14,69,,,,,0,"fee schedule","69% of total billed charges",4406,100,,3524.80,,,0,"percent of total billed charges","100% of total billed charges",4406,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4406,100,,3524.80,,,0,"percent of total billed charges","100% of total billed charges",4406,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4406,100,,3524.80,,,0,"percent of total billed charges","100% of total billed charges",4406,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4406,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,4406,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4406,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4406,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5887.68,100,,,,,0,"fee schedule",EAPG,7503.9,100,,,,,0,"fee schedule",EAPG,4406,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1661.06,37.7,,1328.85,,,0,"percent of total billed charges","37.70% of total billed charges",4406,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4406,100,,,,,0,"fee schedule","100% of CMS fee schedule",3436.68,78,,2749.34,,,0,"percent of total billed charges","78% of total billed charges",4406,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3639.36,82.6,,2911.49,,,0,"percent of total billed charges","82.6% of total billed charges",5772.23,100,,,,,0,"fee schedule","100% of WA fee schedule",4406,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3639.36,82.6,,2911.49,,,0,"percent of total billed charges","82.6% of total billed charges",4406,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5932.76,100,,,,,0,"fee schedule",EAPG,4406,100,,3524.80,,,0,"percent of total billed charges","100% of total billed charges",674.12,7503.9,
"61105 Twist drill hole for subdural or ventricular",7963269,CDM,521,RC,61105,CPT,OUTPATIENT,,,2307,1499.55,,2030.16,88,,1624.13,,,0,"percent of total billed charges","88% of total billed charges",2307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,2307,100,,1845.60,,,0,"percent of total billed charges","100% of total billed charges",2307,175,,,,,0,"fee schedule","175% of CMS fee schedule",5945.4,100,,,,,0,"fee schedule",EAPG,2307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1453.41,63,,1162.73,,,0,"percent of total billed charges","63% of total billed charges",352.97,15.3,,282.38,,,0,"percent of total billed charges","15.3% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,1591.83,69,,,,,0,"fee schedule","69% of total billed charges",2307,100,,1845.60,,,0,"percent of total billed charges","100% of total billed charges",2307,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2307,100,,1845.60,,,0,"percent of total billed charges","100% of total billed charges",2307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2307,100,,1845.60,,,0,"percent of total billed charges","100% of total billed charges",2307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,2307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5887.68,100,,,,,0,"fee schedule",EAPG,7503.9,100,,,,,0,"fee schedule",EAPG,2307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",869.74,37.7,,695.79,,,0,"percent of total billed charges","37.70% of total billed charges",2307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2307,100,,,,,0,"fee schedule","100% of CMS fee schedule",1799.46,78,,1439.57,,,0,"percent of total billed charges","78% of total billed charges",2307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1905.58,82.6,,1524.46,,,0,"percent of total billed charges","82.6% of total billed charges",5772.23,100,,,,,0,"fee schedule","100% of WA fee schedule",2307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1905.58,82.6,,1524.46,,,0,"percent of total billed charges","82.6% of total billed charges",2307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5932.76,100,,,,,0,"fee schedule",EAPG,2307,100,,1845.60,,,0,"percent of total billed charges","100% of total billed charges",352.97,7503.9,
"61120 Burr hole(s) for ventricular puncture (inclu",7962143,CDM,521,RC,61120,CPT,OUTPATIENT,,,3178,2065.7,,2796.64,88,,2237.31,,,0,"percent of total billed charges","88% of total billed charges",3178,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,3178,100,,2542.40,,,0,"percent of total billed charges","100% of total billed charges",3178,175,,,,,0,"fee schedule","175% of CMS fee schedule",5945.4,100,,,,,0,"fee schedule",EAPG,3178,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2002.14,63,,1601.71,,,0,"percent of total billed charges","63% of total billed charges",486.23,15.3,,388.98,,,0,"percent of total billed charges","15.3% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,2192.82,69,,,,,0,"fee schedule","69% of total billed charges",3178,100,,2542.40,,,0,"percent of total billed charges","100% of total billed charges",3178,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3178,100,,2542.40,,,0,"percent of total billed charges","100% of total billed charges",3178,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3178,100,,2542.40,,,0,"percent of total billed charges","100% of total billed charges",3178,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3178,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,3178,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3178,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3178,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5887.68,100,,,,,0,"fee schedule",EAPG,7503.9,100,,,,,0,"fee schedule",EAPG,3178,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1198.11,37.7,,958.49,,,0,"percent of total billed charges","37.70% of total billed charges",3178,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3178,100,,,,,0,"fee schedule","100% of CMS fee schedule",2478.84,78,,1983.07,,,0,"percent of total billed charges","78% of total billed charges",3178,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2625.03,82.6,,2100.02,,,0,"percent of total billed charges","82.6% of total billed charges",5772.23,100,,,,,0,"fee schedule","100% of WA fee schedule",3178,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2625.03,82.6,,2100.02,,,0,"percent of total billed charges","82.6% of total billed charges",3178,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5932.76,100,,,,,0,"fee schedule",EAPG,3178,100,,2542.40,,,0,"percent of total billed charges","100% of total billed charges",486.23,7503.9,
"61140 Burr hole(s) or trephine; with biopsy of bra",7962796,CDM,521,RC,61140,CPT,OUTPATIENT,,,6355,4130.75,,5592.4,88,,4473.92,,,0,"percent of total billed charges","88% of total billed charges",6355,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6355,175,,,,,0,"fee schedule","175% of CMS fee schedule",5945.4,100,,,,,0,"fee schedule",EAPG,6355,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4003.65,63,,3202.92,,,0,"percent of total billed charges","63% of total billed charges",972.32,15.3,,777.86,,,0,"percent of total billed charges","15.3% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,4384.95,69,,,,,0,"fee schedule","69% of total billed charges",6355,100,,5084.00,,,0,"percent of total billed charges","100% of total billed charges",6355,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6355,100,,5084.00,,,0,"percent of total billed charges","100% of total billed charges",6355,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6355,100,,5084.00,,,0,"percent of total billed charges","100% of total billed charges",6355,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6355,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,6355,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6355,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6355,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5887.68,100,,,,,0,"fee schedule",EAPG,7503.9,100,,,,,0,"fee schedule",EAPG,6355,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2395.84,37.7,,1916.67,,,0,"percent of total billed charges","37.70% of total billed charges",6355,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6355,100,,,,,0,"fee schedule","100% of CMS fee schedule",4956.9,78,,3965.52,,,0,"percent of total billed charges","78% of total billed charges",6355,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5249.23,82.6,,4199.38,,,0,"percent of total billed charges","82.6% of total billed charges",5772.23,100,,,,,0,"fee schedule","100% of WA fee schedule",6355,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5249.23,82.6,,4199.38,,,0,"percent of total billed charges","82.6% of total billed charges",6355,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5932.76,100,,,,,0,"fee schedule",EAPG,6355,100,,5084.00,,,0,"percent of total billed charges","100% of total billed charges",972.32,7503.9,
"61151 Burr hole(s) or trephine; with subsequent ta",7962022,CDM,521,RC,61151,CPT,OUTPATIENT,,,836,543.4,,735.68,88,,588.54,,,0,"percent of total billed charges","88% of total billed charges",836,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,836,100,,668.80,,,0,"percent of total billed charges","100% of total billed charges",836,175,,,,,0,"fee schedule","175% of CMS fee schedule",5945.4,100,,,,,0,"fee schedule",EAPG,836,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",526.68,63,,421.34,,,0,"percent of total billed charges","63% of total billed charges",127.91,15.3,,102.33,,,0,"percent of total billed charges","15.3% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,576.84,69,,,,,0,"fee schedule","69% of total billed charges",836,100,,668.80,,,0,"percent of total billed charges","100% of total billed charges",836,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",836,100,,668.80,,,0,"percent of total billed charges","100% of total billed charges",836,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",836,100,,668.80,,,0,"percent of total billed charges","100% of total billed charges",836,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",836,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,836,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",836,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",836,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5887.68,100,,,,,0,"fee schedule",EAPG,7503.9,100,,,,,0,"fee schedule",EAPG,836,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",315.17,37.7,,252.14,,,0,"percent of total billed charges","37.70% of total billed charges",836,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",836,100,,,,,0,"fee schedule","100% of CMS fee schedule",652.08,78,,521.66,,,0,"percent of total billed charges","78% of total billed charges",836,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",690.54,82.6,,552.43,,,0,"percent of total billed charges","82.6% of total billed charges",5772.23,100,,,,,0,"fee schedule","100% of WA fee schedule",836,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",690.54,82.6,,552.43,,,0,"percent of total billed charges","82.6% of total billed charges",836,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5932.76,100,,,,,0,"fee schedule",EAPG,836,100,,668.80,,,0,"percent of total billed charges","100% of total billed charges",127.91,7503.9,
"61154 Burr hole(s) with evacuation and/or drainage",7962486,CDM,521,RC,61154,CPT,OUTPATIENT,,,5658,3677.7,,4979.04,88,,3983.23,,,0,"percent of total billed charges","88% of total billed charges",5658,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5658,175,,,,,0,"fee schedule","175% of CMS fee schedule",5945.4,100,,,,,0,"fee schedule",EAPG,5658,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3564.54,63,,2851.63,,,0,"percent of total billed charges","63% of total billed charges",865.67,15.3,,692.54,,,0,"percent of total billed charges","15.3% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,3904.02,69,,,,,0,"fee schedule","69% of total billed charges",5658,100,,4526.40,,,0,"percent of total billed charges","100% of total billed charges",5658,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5658,100,,4526.40,,,0,"percent of total billed charges","100% of total billed charges",5658,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5658,100,,4526.40,,,0,"percent of total billed charges","100% of total billed charges",5658,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5658,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,5658,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5658,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5658,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5887.68,100,,,,,0,"fee schedule",EAPG,7503.9,100,,,,,0,"fee schedule",EAPG,5658,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2133.07,37.7,,1706.46,,,0,"percent of total billed charges","37.70% of total billed charges",5658,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5658,100,,,,,0,"fee schedule","100% of CMS fee schedule",4413.24,78,,3530.59,,,0,"percent of total billed charges","78% of total billed charges",5658,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4673.51,82.6,,3738.81,,,0,"percent of total billed charges","82.6% of total billed charges",5772.23,100,,,,,0,"fee schedule","100% of WA fee schedule",5658,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4673.51,82.6,,3738.81,,,0,"percent of total billed charges","82.6% of total billed charges",5658,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5932.76,100,,,,,0,"fee schedule",EAPG,5658,100,,4526.40,,,0,"percent of total billed charges","100% of total billed charges",865.67,7503.9,
"61150 Burr hole(s) or trephine; with drainage of b",7962952,CDM,521,RC,61150,CPT,OUTPATIENT,,,6341,4121.65,,5580.08,88,,4464.06,,,0,"percent of total billed charges","88% of total billed charges",6341,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6341,175,,,,,0,"fee schedule","175% of CMS fee schedule",5945.4,100,,,,,0,"fee schedule",EAPG,6341,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3994.83,63,,3195.86,,,0,"percent of total billed charges","63% of total billed charges",970.17,15.3,,776.14,,,0,"percent of total billed charges","15.3% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,4375.29,69,,,,,0,"fee schedule","69% of total billed charges",6341,100,,5072.80,,,0,"percent of total billed charges","100% of total billed charges",6341,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6341,100,,5072.80,,,0,"percent of total billed charges","100% of total billed charges",6341,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6341,100,,5072.80,,,0,"percent of total billed charges","100% of total billed charges",6341,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6341,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,6341,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6341,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6341,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5887.68,100,,,,,0,"fee schedule",EAPG,7503.9,100,,,,,0,"fee schedule",EAPG,6341,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2390.56,37.7,,1912.45,,,0,"percent of total billed charges","37.70% of total billed charges",6341,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6341,100,,,,,0,"fee schedule","100% of CMS fee schedule",4945.98,78,,3956.78,,,0,"percent of total billed charges","78% of total billed charges",6341,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5237.67,82.6,,4190.14,,,0,"percent of total billed charges","82.6% of total billed charges",5772.23,100,,,,,0,"fee schedule","100% of WA fee schedule",6341,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5237.67,82.6,,4190.14,,,0,"percent of total billed charges","82.6% of total billed charges",6341,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5932.76,100,,,,,0,"fee schedule",EAPG,6341,100,,5072.80,,,0,"percent of total billed charges","100% of total billed charges",970.17,7503.9,
"61156 Burr hole(s); with aspiration of hematoma or",7962953,CDM,521,RC,61156,CPT,OUTPATIENT,,,6683,4343.95,,5881.04,88,,4704.83,,,0,"percent of total billed charges","88% of total billed charges",6683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6683,175,,,,,0,"fee schedule","175% of CMS fee schedule",5945.4,100,,,,,0,"fee schedule",EAPG,6683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4210.29,63,,3368.23,,,0,"percent of total billed charges","63% of total billed charges",1022.5,15.3,,818.00,,,0,"percent of total billed charges","15.3% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,4611.27,69,,,,,0,"fee schedule","69% of total billed charges",6683,100,,5346.40,,,0,"percent of total billed charges","100% of total billed charges",6683,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6683,100,,5346.40,,,0,"percent of total billed charges","100% of total billed charges",6683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6683,100,,5346.40,,,0,"percent of total billed charges","100% of total billed charges",6683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,6683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5887.68,100,,,,,0,"fee schedule",EAPG,7503.9,100,,,,,0,"fee schedule",EAPG,6683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2519.49,37.7,,2015.59,,,0,"percent of total billed charges","37.70% of total billed charges",6683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6683,100,,,,,0,"fee schedule","100% of CMS fee schedule",5212.74,78,,4170.19,,,0,"percent of total billed charges","78% of total billed charges",6683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5520.16,82.6,,4416.13,,,0,"percent of total billed charges","82.6% of total billed charges",5772.23,100,,,,,0,"fee schedule","100% of WA fee schedule",6683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5520.16,82.6,,4416.13,,,0,"percent of total billed charges","82.6% of total billed charges",6683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5932.76,100,,,,,0,"fee schedule",EAPG,6683,100,,5346.40,,,0,"percent of total billed charges","100% of total billed charges",1022.5,7503.9,
"61210 Burr hole(s); for implanting ventricular cat",7962023,CDM,521,RC,61210,CPT,OUTPATIENT,,,2657,1727.05,,2338.16,88,,1870.53,,,0,"percent of total billed charges","88% of total billed charges",2657,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,2657,100,,2125.60,,,0,"percent of total billed charges","100% of total billed charges",2657,175,,,,,0,"fee schedule","175% of CMS fee schedule",5945.4,100,,,,,0,"fee schedule",EAPG,2657,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1673.91,63,,1339.13,,,0,"percent of total billed charges","63% of total billed charges",406.52,15.3,,325.22,,,0,"percent of total billed charges","15.3% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,1833.33,69,,,,,0,"fee schedule","69% of total billed charges",2657,100,,2125.60,,,0,"percent of total billed charges","100% of total billed charges",2657,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2657,100,,2125.60,,,0,"percent of total billed charges","100% of total billed charges",2657,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2657,100,,2125.60,,,0,"percent of total billed charges","100% of total billed charges",2657,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2657,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,2657,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2657,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2657,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5887.68,100,,,,,0,"fee schedule",EAPG,7503.9,100,,,,,0,"fee schedule",EAPG,2657,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1001.69,37.7,,801.35,,,0,"percent of total billed charges","37.70% of total billed charges",2657,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2657,100,,,,,0,"fee schedule","100% of CMS fee schedule",2072.46,78,,1657.97,,,0,"percent of total billed charges","78% of total billed charges",2657,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2194.68,82.6,,1755.74,,,0,"percent of total billed charges","82.6% of total billed charges",5772.23,100,,,,,0,"fee schedule","100% of WA fee schedule",2657,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2194.68,82.6,,1755.74,,,0,"percent of total billed charges","82.6% of total billed charges",2657,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5932.76,100,,,,,0,"fee schedule",EAPG,2657,100,,2125.60,,,0,"percent of total billed charges","100% of total billed charges",406.52,7503.9,
"61215 Insertion of subcutaneous reservoir, pump or",7962145,CDM,521,RC,61215,CPT,OUTPATIENT,,,2251,1463.15,,1980.88,88,,1584.70,,,0,"percent of total billed charges","88% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,2251,100,,1800.80,,,0,"percent of total billed charges","100% of total billed charges",11890.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1418.13,63,,1134.50,,,0,"percent of total billed charges","63% of total billed charges",344.4,15.3,,275.52,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,1553.19,69,,,,,0,"fee schedule","69% of total billed charges",2251,100,,1800.80,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2251,100,,1800.80,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2251,100,,1800.80,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",23157.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6054.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",848.63,37.7,,678.90,,,0,"percent of total billed charges","37.70% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1755.78,78,,1404.62,,,0,"percent of total billed charges","78% of total billed charges",6862.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1859.33,82.6,,1487.46,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1859.33,82.6,,1487.46,,,0,"percent of total billed charges","82.6% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,2251,100,,1800.80,,,0,"percent of total billed charges","100% of total billed charges",344.4,23157.6,
"61250 Burr hole(s) or trephine, supratentorial, ex",7962350,CDM,521,RC,61250,CPT,OUTPATIENT,,,3773,2452.45,,3320.24,88,,2656.19,,,0,"percent of total billed charges","88% of total billed charges",3773,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,3773,100,,3018.40,,,0,"percent of total billed charges","100% of total billed charges",3773,175,,,,,0,"fee schedule","175% of CMS fee schedule",5945.4,100,,,,,0,"fee schedule",EAPG,3773,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2376.99,63,,1901.59,,,0,"percent of total billed charges","63% of total billed charges",577.27,15.3,,461.82,,,0,"percent of total billed charges","15.3% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,2603.37,69,,,,,0,"fee schedule","69% of total billed charges",3773,100,,3018.40,,,0,"percent of total billed charges","100% of total billed charges",3773,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3773,100,,3018.40,,,0,"percent of total billed charges","100% of total billed charges",3773,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3773,100,,3018.40,,,0,"percent of total billed charges","100% of total billed charges",3773,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3773,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,3773,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3773,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3773,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5887.68,100,,,,,0,"fee schedule",EAPG,7503.9,100,,,,,0,"fee schedule",EAPG,3773,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1422.42,37.7,,1137.94,,,0,"percent of total billed charges","37.70% of total billed charges",3773,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3773,100,,,,,0,"fee schedule","100% of CMS fee schedule",2942.94,78,,2354.35,,,0,"percent of total billed charges","78% of total billed charges",3773,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3116.5,82.6,,2493.20,,,0,"percent of total billed charges","82.6% of total billed charges",5772.23,100,,,,,0,"fee schedule","100% of WA fee schedule",3773,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3116.5,82.6,,2493.20,,,0,"percent of total billed charges","82.6% of total billed charges",3773,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5932.76,100,,,,,0,"fee schedule",EAPG,3773,100,,3018.40,,,0,"percent of total billed charges","100% of total billed charges",577.27,7503.9,
"61253 Burr hole(s) or trephine, infratentorial, un",7962923,CDM,521,RC,61253,CPT,OUTPATIENT,,,5086,3305.9,,4475.68,88,,3580.54,,,0,"percent of total billed charges","88% of total billed charges",5086,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5086,175,,,,,0,"fee schedule","175% of CMS fee schedule",5945.4,100,,,,,0,"fee schedule",EAPG,5086,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3204.18,63,,2563.34,,,0,"percent of total billed charges","63% of total billed charges",778.16,15.3,,622.53,,,0,"percent of total billed charges","15.3% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,3509.34,69,,,,,0,"fee schedule","69% of total billed charges",5086,100,,4068.80,,,0,"percent of total billed charges","100% of total billed charges",5086,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5086,100,,4068.80,,,0,"percent of total billed charges","100% of total billed charges",5086,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5086,100,,4068.80,,,0,"percent of total billed charges","100% of total billed charges",5086,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5086,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,5086,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5086,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5086,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5887.68,100,,,,,0,"fee schedule",EAPG,7503.9,100,,,,,0,"fee schedule",EAPG,5086,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1917.42,37.7,,1533.94,,,0,"percent of total billed charges","37.70% of total billed charges",5086,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5086,100,,,,,0,"fee schedule","100% of CMS fee schedule",3967.08,78,,3173.66,,,0,"percent of total billed charges","78% of total billed charges",5086,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4201.04,82.6,,3360.83,,,0,"percent of total billed charges","82.6% of total billed charges",5772.23,100,,,,,0,"fee schedule","100% of WA fee schedule",5086,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4201.04,82.6,,3360.83,,,0,"percent of total billed charges","82.6% of total billed charges",5086,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5932.76,100,,,,,0,"fee schedule",EAPG,5086,100,,4068.80,,,0,"percent of total billed charges","100% of total billed charges",778.16,7503.9,
"61305 Craniectomy or craniotomy, exploratory; infr",7962758,CDM,521,RC,61305,CPT,OUTPATIENT,,,8812,5727.8,,7754.56,88,,6203.65,,,0,"percent of total billed charges","88% of total billed charges",8812,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8812,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,8812,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5551.56,63,,4441.25,,,0,"percent of total billed charges","63% of total billed charges",1348.24,15.3,,1078.59,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,6080.28,69,,,,,0,"fee schedule","69% of total billed charges",8812,100,,7049.60,,,0,"percent of total billed charges","100% of total billed charges",8812,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8812,100,,7049.60,,,0,"percent of total billed charges","100% of total billed charges",8812,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8812,100,,7049.60,,,0,"percent of total billed charges","100% of total billed charges",8812,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8812,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,8812,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8812,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8812,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,8812,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3322.12,37.7,,2657.70,,,0,"percent of total billed charges","37.70% of total billed charges",8812,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8812,100,,,,,0,"fee schedule","100% of CMS fee schedule",6873.36,78,,5498.69,,,0,"percent of total billed charges","78% of total billed charges",8812,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7278.71,82.6,,5822.97,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",8812,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7278.71,82.6,,5822.97,,,0,"percent of total billed charges","82.6% of total billed charges",8812,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,8812,100,,7049.60,,,0,"percent of total billed charges","100% of total billed charges",1348.24,8812,
"61304 Craniectomy or craniotomy, exploratory; supr",7963295,CDM,521,RC,61304,CPT,OUTPATIENT,,,7309,4750.85,,6431.92,88,,5145.54,,,0,"percent of total billed charges","88% of total billed charges",7309,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7309,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,7309,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4604.67,63,,3683.74,,,0,"percent of total billed charges","63% of total billed charges",1118.28,15.3,,894.62,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,5043.21,69,,,,,0,"fee schedule","69% of total billed charges",7309,100,,5847.20,,,0,"percent of total billed charges","100% of total billed charges",7309,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7309,100,,5847.20,,,0,"percent of total billed charges","100% of total billed charges",7309,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7309,100,,5847.20,,,0,"percent of total billed charges","100% of total billed charges",7309,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7309,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,7309,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7309,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7309,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,7309,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2755.49,37.7,,2204.39,,,0,"percent of total billed charges","37.70% of total billed charges",7309,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7309,100,,,,,0,"fee schedule","100% of CMS fee schedule",5701.02,78,,4560.82,,,0,"percent of total billed charges","78% of total billed charges",7309,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6037.23,82.6,,4829.78,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",7309,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6037.23,82.6,,4829.78,,,0,"percent of total billed charges","82.6% of total billed charges",7309,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,7309,100,,5847.20,,,0,"percent of total billed charges","100% of total billed charges",1118.28,7309,
"61314 Craniectomy or craniotomy for evacuation of",7961713,CDM,521,RC,61314,CPT,OUTPATIENT,,,7684,4994.6,,6761.92,88,,5409.54,,,0,"percent of total billed charges","88% of total billed charges",7684,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7684,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,7684,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4840.92,63,,3872.74,,,0,"percent of total billed charges","63% of total billed charges",1175.65,15.3,,940.52,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,5301.96,69,,,,,0,"fee schedule","69% of total billed charges",7684,100,,6147.20,,,0,"percent of total billed charges","100% of total billed charges",7684,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7684,100,,6147.20,,,0,"percent of total billed charges","100% of total billed charges",7684,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7684,100,,6147.20,,,0,"percent of total billed charges","100% of total billed charges",7684,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7684,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,7684,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7684,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7684,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,7684,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2896.87,37.7,,2317.50,,,0,"percent of total billed charges","37.70% of total billed charges",7684,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7684,100,,,,,0,"fee schedule","100% of CMS fee schedule",5993.52,78,,4794.82,,,0,"percent of total billed charges","78% of total billed charges",7684,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6346.98,82.6,,5077.58,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",7684,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6346.98,82.6,,5077.58,,,0,"percent of total billed charges","82.6% of total billed charges",7684,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,7684,100,,6147.20,,,0,"percent of total billed charges","100% of total billed charges",1175.65,7684,
"61312 Craniectomy or craniotomy for evacuation of",7962024,CDM,521,RC,61312,CPT,OUTPATIENT,,,7992,5194.8,,7032.96,88,,5626.37,,,0,"percent of total billed charges","88% of total billed charges",7992,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7992,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,7992,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5034.96,63,,4027.97,,,0,"percent of total billed charges","63% of total billed charges",1222.78,15.3,,978.22,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,5514.48,69,,,,,0,"fee schedule","69% of total billed charges",7992,100,,6393.60,,,0,"percent of total billed charges","100% of total billed charges",7992,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7992,100,,6393.60,,,0,"percent of total billed charges","100% of total billed charges",7992,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7992,100,,6393.60,,,0,"percent of total billed charges","100% of total billed charges",7992,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7992,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,7992,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7992,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7992,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,7992,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3012.98,37.7,,2410.38,,,0,"percent of total billed charges","37.70% of total billed charges",7992,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7992,100,,,,,0,"fee schedule","100% of CMS fee schedule",6233.76,78,,4987.01,,,0,"percent of total billed charges","78% of total billed charges",7992,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6601.39,82.6,,5281.11,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",7992,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6601.39,82.6,,5281.11,,,0,"percent of total billed charges","82.6% of total billed charges",7992,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,7992,100,,6393.60,,,0,"percent of total billed charges","100% of total billed charges",1222.78,7992,
"61316 Incision and subcutaneous placement of crani",7962025,CDM,521,RC,61316,CPT,OUTPATIENT,,,506,328.9,,445.28,88,,356.22,,,0,"percent of total billed charges","88% of total billed charges",506,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",506,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,506,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",318.78,63,,255.02,,,0,"percent of total billed charges","63% of total billed charges",77.42,15.3,,61.94,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,349.14,69,,,,,0,"fee schedule","69% of total billed charges",506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",506,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",506,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",506,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",506,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,506,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",506,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",506,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,506,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",190.76,37.7,,152.61,,,0,"percent of total billed charges","37.70% of total billed charges",506,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",506,100,,,,,0,"fee schedule","100% of CMS fee schedule",394.68,78,,315.74,,,0,"percent of total billed charges","78% of total billed charges",506,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",417.96,82.6,,334.37,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",506,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",417.96,82.6,,334.37,,,0,"percent of total billed charges","82.6% of total billed charges",506,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",77.42,4512.18,
"61315 Craniectomy or craniotomy for evacuation of",7962208,CDM,521,RC,61315,CPT,OUTPATIENT,,,9219,5992.35,,8112.72,88,,6490.18,,,0,"percent of total billed charges","88% of total billed charges",9219,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9219,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,9219,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5807.97,63,,4646.38,,,0,"percent of total billed charges","63% of total billed charges",1410.51,15.3,,1128.41,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,6361.11,69,,,,,0,"fee schedule","69% of total billed charges",9219,100,,7375.20,,,0,"percent of total billed charges","100% of total billed charges",9219,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9219,100,,7375.20,,,0,"percent of total billed charges","100% of total billed charges",9219,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9219,100,,7375.20,,,0,"percent of total billed charges","100% of total billed charges",9219,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9219,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,9219,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9219,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9219,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,9219,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3475.56,37.7,,2780.45,,,0,"percent of total billed charges","37.70% of total billed charges",9219,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9219,100,,,,,0,"fee schedule","100% of CMS fee schedule",7190.82,78,,5752.66,,,0,"percent of total billed charges","78% of total billed charges",9219,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7614.89,82.6,,6091.91,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",9219,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7614.89,82.6,,6091.91,,,0,"percent of total billed charges","82.6% of total billed charges",9219,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,9219,100,,7375.20,,,0,"percent of total billed charges","100% of total billed charges",1410.51,9219,
"61313 Craniectomy or craniotomy for evacuation of",7962389,CDM,521,RC,61313,CPT,OUTPATIENT,,,8243,5357.95,,7253.84,88,,5803.07,,,0,"percent of total billed charges","88% of total billed charges",8243,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8243,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,8243,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5193.09,63,,4154.47,,,0,"percent of total billed charges","63% of total billed charges",1261.18,15.3,,1008.94,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,5687.67,69,,,,,0,"fee schedule","69% of total billed charges",8243,100,,6594.40,,,0,"percent of total billed charges","100% of total billed charges",8243,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8243,100,,6594.40,,,0,"percent of total billed charges","100% of total billed charges",8243,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8243,100,,6594.40,,,0,"percent of total billed charges","100% of total billed charges",8243,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8243,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,8243,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8243,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8243,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,8243,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3107.61,37.7,,2486.09,,,0,"percent of total billed charges","37.70% of total billed charges",8243,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8243,100,,,,,0,"fee schedule","100% of CMS fee schedule",6429.54,78,,5143.63,,,0,"percent of total billed charges","78% of total billed charges",8243,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6808.72,82.6,,5446.98,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",8243,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6808.72,82.6,,5446.98,,,0,"percent of total billed charges","82.6% of total billed charges",8243,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,8243,100,,6594.40,,,0,"percent of total billed charges","100% of total billed charges",1261.18,8243,
"61323 Craniectomy or craniotomy, decompressive, wi",7962086,CDM,521,RC,61323,CPT,OUTPATIENT,,,11921,7748.65,,10490.48,88,,8392.38,,,0,"percent of total billed charges","88% of total billed charges",11921,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",11921,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,11921,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7510.23,63,,6008.18,,,0,"percent of total billed charges","63% of total billed charges",1823.91,15.3,,1459.13,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,8225.49,69,,,,,0,"fee schedule","69% of total billed charges",11921,100,,9536.80,,,0,"percent of total billed charges","100% of total billed charges",11921,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11921,100,,9536.80,,,0,"percent of total billed charges","100% of total billed charges",11921,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11921,100,,9536.80,,,0,"percent of total billed charges","100% of total billed charges",11921,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11921,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,11921,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11921,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",11921,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,11921,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4494.22,37.7,,3595.38,,,0,"percent of total billed charges","37.70% of total billed charges",11921,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",11921,100,,,,,0,"fee schedule","100% of CMS fee schedule",9298.38,78,,7438.70,,,0,"percent of total billed charges","78% of total billed charges",11921,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9846.75,82.6,,7877.40,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",11921,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9846.75,82.6,,7877.40,,,0,"percent of total billed charges","82.6% of total billed charges",11921,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,11921,100,,9536.80,,,0,"percent of total billed charges","100% of total billed charges",1823.91,11921,
"61320 Craniectomy or craniotomy, drainage of intra",7962580,CDM,521,RC,61320,CPT,OUTPATIENT,,,8516,5535.4,,7494.08,88,,5995.26,,,0,"percent of total billed charges","88% of total billed charges",8516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8516,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,8516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5365.08,63,,4292.06,,,0,"percent of total billed charges","63% of total billed charges",1302.95,15.3,,1042.36,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,5876.04,69,,,,,0,"fee schedule","69% of total billed charges",8516,100,,6812.80,,,0,"percent of total billed charges","100% of total billed charges",8516,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8516,100,,6812.80,,,0,"percent of total billed charges","100% of total billed charges",8516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8516,100,,6812.80,,,0,"percent of total billed charges","100% of total billed charges",8516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,8516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,8516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3210.53,37.7,,2568.42,,,0,"percent of total billed charges","37.70% of total billed charges",8516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8516,100,,,,,0,"fee schedule","100% of CMS fee schedule",6642.48,78,,5313.98,,,0,"percent of total billed charges","78% of total billed charges",8516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7034.22,82.6,,5627.38,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",8516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7034.22,82.6,,5627.38,,,0,"percent of total billed charges","82.6% of total billed charges",8516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,8516,100,,6812.80,,,0,"percent of total billed charges","100% of total billed charges",1302.95,8516,
"61321 Craniectomy or craniotomy, drainage of intra",7962581,CDM,521,RC,61321,CPT,OUTPATIENT,,,9189,5972.85,,8086.32,88,,6469.06,,,0,"percent of total billed charges","88% of total billed charges",9189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9189,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,9189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5789.07,63,,4631.26,,,0,"percent of total billed charges","63% of total billed charges",1405.92,15.3,,1124.74,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,6340.41,69,,,,,0,"fee schedule","69% of total billed charges",9189,100,,7351.20,,,0,"percent of total billed charges","100% of total billed charges",9189,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9189,100,,7351.20,,,0,"percent of total billed charges","100% of total billed charges",9189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9189,100,,7351.20,,,0,"percent of total billed charges","100% of total billed charges",9189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,9189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,9189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3464.25,37.7,,2771.40,,,0,"percent of total billed charges","37.70% of total billed charges",9189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9189,100,,,,,0,"fee schedule","100% of CMS fee schedule",7167.42,78,,5733.94,,,0,"percent of total billed charges","78% of total billed charges",9189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7590.11,82.6,,6072.09,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",9189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7590.11,82.6,,6072.09,,,0,"percent of total billed charges","82.6% of total billed charges",9189,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,9189,100,,7351.20,,,0,"percent of total billed charges","100% of total billed charges",1405.92,9189,
"61333 Exploration of orbit (transcranial approach)",7962893,CDM,521,RC,61333,CPT,OUTPATIENT,,,8447,5490.55,,7433.36,88,,5946.69,,,0,"percent of total billed charges","88% of total billed charges",8447,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8447,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,8447,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5321.61,63,,4257.29,,,0,"percent of total billed charges","63% of total billed charges",1292.39,15.3,,1033.91,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,5828.43,69,,,,,0,"fee schedule","69% of total billed charges",8447,100,,6757.60,,,0,"percent of total billed charges","100% of total billed charges",8447,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8447,100,,6757.60,,,0,"percent of total billed charges","100% of total billed charges",8447,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8447,100,,6757.60,,,0,"percent of total billed charges","100% of total billed charges",8447,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8447,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,8447,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8447,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8447,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,8447,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3184.52,37.7,,2547.62,,,0,"percent of total billed charges","37.70% of total billed charges",8447,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8447,100,,,,,0,"fee schedule","100% of CMS fee schedule",6588.66,78,,5270.93,,,0,"percent of total billed charges","78% of total billed charges",8447,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6977.22,82.6,,5581.78,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",8447,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6977.22,82.6,,5581.78,,,0,"percent of total billed charges","82.6% of total billed charges",8447,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,8447,100,,6757.60,,,0,"percent of total billed charges","100% of total billed charges",1292.39,8447,
"61330 Decompression of orbit only, transcranial ap",7963348,CDM,521,RC,61330,CPT,OUTPATIENT,,,8516,5535.4,,7494.08,88,,5995.26,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5365.08,63,,4292.06,,,0,"percent of total billed charges","63% of total billed charges",1302.95,15.3,,1042.36,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,5876.04,69,,,,,0,"fee schedule","69% of total billed charges",8516,100,,6812.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8516,100,,6812.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8516,100,,6812.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3470.9,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3210.53,37.7,,2568.42,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6642.48,78,,5313.98,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7034.22,82.6,,5627.38,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7034.22,82.6,,5627.38,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3631.43,100,,,,,0,"fee schedule",EAPG,8516,100,,6812.80,,,0,"percent of total billed charges","100% of total billed charges",1302.95,11116.67,
"61334 explore orbit/remove object",7963785,CDM,521,RC,61334,CPT,OUTPATIENT,,,5948,3866.2,,5234.24,88,,4187.39,,,0,"percent of total billed charges","88% of total billed charges",2974,50,,2379.20,,,0,"percent of total billed charges","50% of total billed charges",999.26,16.8,,799.41,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1029.24,17.304,,823.39,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3747.24,63,,2997.79,,,0,"percent of total billed charges","63% of total billed charges",910.04,15.3,,728.03,,,0,"percent of total billed charges","15.3% of total billed charges",999.26,16.8,,799.41,,,0,"percent of total billed charges","16.8% of total billed charges",4104.12,69,,,,,0,"fee schedule","69% of total billed charges",5948,100,,4758.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5948,100,,4758.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5948,100,,4758.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3678.84,61.85,,2943.07,,,0,"percent of total billed charges","61.5% of total billed charges",999.26,16.8,,799.41,,,0,"percent of total billed charges","16.8% of total billed charges",2974,50,,2379.20,,,0,"percent of total billed charges","50% of total billed charges",1915.26,32.2,,1532.21,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1019.25,17.136,,815.40,,,0,"percent of total billed charges","17.136% of total billed charges",1299.04,21.84,,1039.23,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2242.4,37.7,,1793.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4639.44,78,,3711.55,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",4913.05,82.6,,3930.44,,,0,"percent of total billed charges","82.6% of total billed charges",999.26,16.8,,799.41,,,0,"percent of total billed charges","16.8% of total billed charges",2974,50,,2379.20,,,0,"percent of total billed charges","50% of total billed charges",4913.05,82.6,,3930.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",5948,100,,4758.40,,,0,"percent of total billed charges","100% of total billed charges",160.53,5948,
"61343 Craniectomy, suboccipital w cervical laminec",7961629,CDM,521,RC,61343,CPT,OUTPATIENT,,,10675,6938.75,,9394,88,,7515.20,,,0,"percent of total billed charges","88% of total billed charges",10675,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",10675,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,10675,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6725.25,63,,5380.20,,,0,"percent of total billed charges","63% of total billed charges",1633.28,15.3,,1306.62,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,7365.75,69,,,,,0,"fee schedule","69% of total billed charges",10675,100,,8540.00,,,0,"percent of total billed charges","100% of total billed charges",10675,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10675,100,,8540.00,,,0,"percent of total billed charges","100% of total billed charges",10675,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10675,100,,8540.00,,,0,"percent of total billed charges","100% of total billed charges",10675,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10675,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,10675,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10675,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10675,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,10675,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4024.48,37.7,,3219.58,,,0,"percent of total billed charges","37.70% of total billed charges",10675,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10675,100,,,,,0,"fee schedule","100% of CMS fee schedule",8326.5,78,,6661.20,,,0,"percent of total billed charges","78% of total billed charges",10675,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8817.55,82.6,,7054.04,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",10675,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8817.55,82.6,,7054.04,,,0,"percent of total billed charges","82.6% of total billed charges",10675,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,10675,100,,8540.00,,,0,"percent of total billed charges","100% of total billed charges",1633.28,10675,
"61340 Subtemporal cranial decompression (pseudotum",7962487,CDM,521,RC,61340,CPT,OUTPATIENT,,,5433,3531.45,,4781.04,88,,3824.83,,,0,"percent of total billed charges","88% of total billed charges",5433,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5433,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,5433,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3422.79,63,,2738.23,,,0,"percent of total billed charges","63% of total billed charges",831.25,15.3,,665.00,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,3748.77,69,,,,,0,"fee schedule","69% of total billed charges",5433,100,,4346.40,,,0,"percent of total billed charges","100% of total billed charges",5433,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5433,100,,4346.40,,,0,"percent of total billed charges","100% of total billed charges",5433,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5433,100,,4346.40,,,0,"percent of total billed charges","100% of total billed charges",5433,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5433,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,5433,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5433,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5433,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,5433,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2048.24,37.7,,1638.59,,,0,"percent of total billed charges","37.70% of total billed charges",5433,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5433,100,,,,,0,"fee schedule","100% of CMS fee schedule",4237.74,78,,3390.19,,,0,"percent of total billed charges","78% of total billed charges",5433,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4487.66,82.6,,3590.13,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",5433,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4487.66,82.6,,3590.13,,,0,"percent of total billed charges","82.6% of total billed charges",5433,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,5433,100,,4346.40,,,0,"percent of total billed charges","100% of total billed charges",831.25,5433,
"61345 Other cranial decompression, posterior fossa",7963515,CDM,521,RC,61345,CPT,OUTPATIENT,,,5594,3636.1,,4922.72,88,,3938.18,,,0,"percent of total billed charges","88% of total billed charges",5594,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5594,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,5594,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3524.22,63,,2819.38,,,0,"percent of total billed charges","63% of total billed charges",855.88,15.3,,684.70,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,3859.86,69,,,,,0,"fee schedule","69% of total billed charges",5594,100,,4475.20,,,0,"percent of total billed charges","100% of total billed charges",5594,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5594,100,,4475.20,,,0,"percent of total billed charges","100% of total billed charges",5594,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5594,100,,4475.20,,,0,"percent of total billed charges","100% of total billed charges",5594,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5594,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,5594,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5594,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5594,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,5594,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2108.94,37.7,,1687.15,,,0,"percent of total billed charges","37.70% of total billed charges",5594,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5594,100,,,,,0,"fee schedule","100% of CMS fee schedule",4363.32,78,,3490.66,,,0,"percent of total billed charges","78% of total billed charges",5594,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4620.64,82.6,,3696.51,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",5594,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4620.64,82.6,,3696.51,,,0,"percent of total billed charges","82.6% of total billed charges",5594,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,5594,100,,4475.20,,,0,"percent of total billed charges","100% of total billed charges",855.88,5594,
"61440 incise skull for surgery",7963852,CDM,521,RC,61440,CPT,OUTPATIENT,,,6548,4256.2,,5762.24,88,,4609.79,,,0,"percent of total billed charges","88% of total billed charges",3274,50,,2619.20,,,0,"percent of total billed charges","50% of total billed charges",1100.06,16.8,,880.05,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1133.07,17.304,,906.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4125.24,63,,3300.19,,,0,"percent of total billed charges","63% of total billed charges",1001.84,15.3,,801.47,,,0,"percent of total billed charges","15.3% of total billed charges",1100.06,16.8,,880.05,,,0,"percent of total billed charges","16.8% of total billed charges",4518.12,69,,,,,0,"fee schedule","69% of total billed charges",6548,100,,5238.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6548,100,,5238.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6548,100,,5238.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4049.94,61.85,,3239.95,,,0,"percent of total billed charges","61.5% of total billed charges",1100.06,16.8,,880.05,,,0,"percent of total billed charges","16.8% of total billed charges",3274,50,,2619.20,,,0,"percent of total billed charges","50% of total billed charges",2108.46,32.2,,1686.77,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1122.07,17.136,,897.66,,,0,"percent of total billed charges","17.136% of total billed charges",1430.08,21.84,,1144.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2468.6,37.7,,1974.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5107.44,78,,4085.95,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",5408.65,82.6,,4326.92,,,0,"percent of total billed charges","82.6% of total billed charges",1100.06,16.8,,880.05,,,0,"percent of total billed charges","16.8% of total billed charges",3274,50,,2619.20,,,0,"percent of total billed charges","50% of total billed charges",5408.65,82.6,,4326.92,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",6548,100,,5238.40,,,0,"percent of total billed charges","100% of total billed charges",160.53,6548,
"61450 Craniectomy, subtemporal, for section, compr",7962026,CDM,521,RC,61450,CPT,OUTPATIENT,,,8475,5508.75,,7458,88,,5966.40,,,0,"percent of total billed charges","88% of total billed charges",8475,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8475,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,8475,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5339.25,63,,4271.40,,,0,"percent of total billed charges","63% of total billed charges",1296.68,15.3,,1037.34,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,5847.75,69,,,,,0,"fee schedule","69% of total billed charges",8475,100,,6780.00,,,0,"percent of total billed charges","100% of total billed charges",8475,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8475,100,,6780.00,,,0,"percent of total billed charges","100% of total billed charges",8475,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8475,100,,6780.00,,,0,"percent of total billed charges","100% of total billed charges",8475,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8475,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,8475,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8475,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8475,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,8475,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3195.08,37.7,,2556.06,,,0,"percent of total billed charges","37.70% of total billed charges",8475,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8475,100,,,,,0,"fee schedule","100% of CMS fee schedule",6610.5,78,,5288.40,,,0,"percent of total billed charges","78% of total billed charges",8475,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7000.35,82.6,,5600.28,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",8475,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7000.35,82.6,,5600.28,,,0,"percent of total billed charges","82.6% of total billed charges",8475,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,8475,100,,6780.00,,,0,"percent of total billed charges","100% of total billed charges",1296.68,8475,
"61458 Craniectomy, suboccipital; for exploration o",7962517,CDM,521,RC,61458,CPT,OUTPATIENT,,,8982,5838.3,,7904.16,88,,6323.33,,,0,"percent of total billed charges","88% of total billed charges",8982,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8982,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,8982,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5658.66,63,,4526.93,,,0,"percent of total billed charges","63% of total billed charges",1374.25,15.3,,1099.40,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,6197.58,69,,,,,0,"fee schedule","69% of total billed charges",8982,100,,7185.60,,,0,"percent of total billed charges","100% of total billed charges",8982,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8982,100,,7185.60,,,0,"percent of total billed charges","100% of total billed charges",8982,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8982,100,,7185.60,,,0,"percent of total billed charges","100% of total billed charges",8982,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8982,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,8982,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8982,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8982,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,8982,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3386.21,37.7,,2708.97,,,0,"percent of total billed charges","37.70% of total billed charges",8982,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8982,100,,,,,0,"fee schedule","100% of CMS fee schedule",7005.96,78,,5604.77,,,0,"percent of total billed charges","78% of total billed charges",8982,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7419.13,82.6,,5935.30,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",8982,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7419.13,82.6,,5935.30,,,0,"percent of total billed charges","82.6% of total billed charges",8982,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,8982,100,,7185.60,,,0,"percent of total billed charges","100% of total billed charges",1374.25,8982,
"61460 Craniectomy, suboccipital; for section of 1",7962948,CDM,521,RC,61460,CPT,OUTPATIENT,,,9315,6054.75,,8197.2,88,,6557.76,,,0,"percent of total billed charges","88% of total billed charges",9315,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9315,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,9315,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5868.45,63,,4694.76,,,0,"percent of total billed charges","63% of total billed charges",1425.2,15.3,,1140.16,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,6427.35,69,,,,,0,"fee schedule","69% of total billed charges",9315,100,,7452.00,,,0,"percent of total billed charges","100% of total billed charges",9315,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9315,100,,7452.00,,,0,"percent of total billed charges","100% of total billed charges",9315,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9315,100,,7452.00,,,0,"percent of total billed charges","100% of total billed charges",9315,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9315,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,9315,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9315,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9315,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,9315,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3511.76,37.7,,2809.41,,,0,"percent of total billed charges","37.70% of total billed charges",9315,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9315,100,,,,,0,"fee schedule","100% of CMS fee schedule",7265.7,78,,5812.56,,,0,"percent of total billed charges","78% of total billed charges",9315,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7694.19,82.6,,6155.35,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",9315,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7694.19,82.6,,6155.35,,,0,"percent of total billed charges","82.6% of total billed charges",9315,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,9315,100,,7452.00,,,0,"percent of total billed charges","100% of total billed charges",1425.2,9315,
"61500 Craniectomy; with excision of tumor or other",7962976,CDM,521,RC,61500,CPT,OUTPATIENT,,,5965,3877.25,,5249.2,88,,4199.36,,,0,"percent of total billed charges","88% of total billed charges",5965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5965,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,5965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3757.95,63,,3006.36,,,0,"percent of total billed charges","63% of total billed charges",912.65,15.3,,730.12,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,4115.85,69,,,,,0,"fee schedule","69% of total billed charges",5965,100,,4772.00,,,0,"percent of total billed charges","100% of total billed charges",5965,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5965,100,,4772.00,,,0,"percent of total billed charges","100% of total billed charges",5965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5965,100,,4772.00,,,0,"percent of total billed charges","100% of total billed charges",5965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,5965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,5965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2248.81,37.7,,1799.05,,,0,"percent of total billed charges","37.70% of total billed charges",5965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5965,100,,,,,0,"fee schedule","100% of CMS fee schedule",4652.7,78,,3722.16,,,0,"percent of total billed charges","78% of total billed charges",5965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4927.09,82.6,,3941.67,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",5965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4927.09,82.6,,3941.67,,,0,"percent of total billed charges","82.6% of total billed charges",5965,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,5965,100,,4772.00,,,0,"percent of total billed charges","100% of total billed charges",912.65,5965,
"61501 Craniectomy; for osteomyelitis",7963723,CDM,521,RC,61501,CPT,OUTPATIENT,,,4973,3232.45,,4376.24,88,,3500.99,,,0,"percent of total billed charges","88% of total billed charges",4973,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",4973,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,4973,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3132.99,63,,2506.39,,,0,"percent of total billed charges","63% of total billed charges",760.87,15.3,,608.70,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,3431.37,69,,,,,0,"fee schedule","69% of total billed charges",4973,100,,3978.40,,,0,"percent of total billed charges","100% of total billed charges",4973,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4973,100,,3978.40,,,0,"percent of total billed charges","100% of total billed charges",4973,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4973,100,,3978.40,,,0,"percent of total billed charges","100% of total billed charges",4973,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4973,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4973,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4973,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4973,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,4973,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1874.82,37.7,,1499.86,,,0,"percent of total billed charges","37.70% of total billed charges",4973,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4973,100,,,,,0,"fee schedule","100% of CMS fee schedule",3878.94,78,,3103.15,,,0,"percent of total billed charges","78% of total billed charges",4973,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4107.7,82.6,,3286.16,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",4973,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4107.7,82.6,,3286.16,,,0,"percent of total billed charges","82.6% of total billed charges",4973,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,4973,100,,3978.40,,,0,"percent of total billed charges","100% of total billed charges",760.87,4973,
"61512 Craniectomy, trephination, bone flap craniot",7962027,CDM,521,RC,61512,CPT,OUTPATIENT,,,10461,6799.65,,9205.68,88,,7364.54,,,0,"percent of total billed charges","88% of total billed charges",10461,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",10461,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,10461,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6590.43,63,,5272.34,,,0,"percent of total billed charges","63% of total billed charges",1600.53,15.3,,1280.42,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,7218.09,69,,,,,0,"fee schedule","69% of total billed charges",10461,100,,8368.80,,,0,"percent of total billed charges","100% of total billed charges",10461,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10461,100,,8368.80,,,0,"percent of total billed charges","100% of total billed charges",10461,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10461,100,,8368.80,,,0,"percent of total billed charges","100% of total billed charges",10461,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10461,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,10461,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10461,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10461,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,10461,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3943.8,37.7,,3155.04,,,0,"percent of total billed charges","37.70% of total billed charges",10461,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10461,100,,,,,0,"fee schedule","100% of CMS fee schedule",8159.58,78,,6527.66,,,0,"percent of total billed charges","78% of total billed charges",10461,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8640.79,82.6,,6912.63,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",10461,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8640.79,82.6,,6912.63,,,0,"percent of total billed charges","82.6% of total billed charges",10461,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,10461,100,,8368.80,,,0,"percent of total billed charges","100% of total billed charges",1600.53,10461,
"61514 Craniectomy, trephination, bone flap craniot",7962028,CDM,521,RC,61514,CPT,OUTPATIENT,,,8379,5446.35,,7373.52,88,,5898.82,,,0,"percent of total billed charges","88% of total billed charges",8379,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8379,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,8379,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5278.77,63,,4223.02,,,0,"percent of total billed charges","63% of total billed charges",1281.99,15.3,,1025.59,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,5781.51,69,,,,,0,"fee schedule","69% of total billed charges",8379,100,,6703.20,,,0,"percent of total billed charges","100% of total billed charges",8379,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8379,100,,6703.20,,,0,"percent of total billed charges","100% of total billed charges",8379,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8379,100,,6703.20,,,0,"percent of total billed charges","100% of total billed charges",8379,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8379,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,8379,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8379,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8379,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,8379,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3158.88,37.7,,2527.10,,,0,"percent of total billed charges","37.70% of total billed charges",8379,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8379,100,,,,,0,"fee schedule","100% of CMS fee schedule",6535.62,78,,5228.50,,,0,"percent of total billed charges","78% of total billed charges",8379,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6921.05,82.6,,5536.84,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",8379,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6921.05,82.6,,5536.84,,,0,"percent of total billed charges","82.6% of total billed charges",8379,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,8379,100,,6703.20,,,0,"percent of total billed charges","100% of total billed charges",1281.99,8379,
"61516 Craniectomy, trephination, bone flap craniot",7962029,CDM,521,RC,61516,CPT,OUTPATIENT,,,8190,5323.5,,7207.2,88,,5765.76,,,0,"percent of total billed charges","88% of total billed charges",8190,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8190,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,8190,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5159.7,63,,4127.76,,,0,"percent of total billed charges","63% of total billed charges",1253.07,15.3,,1002.46,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,5651.1,69,,,,,0,"fee schedule","69% of total billed charges",8190,100,,6552.00,,,0,"percent of total billed charges","100% of total billed charges",8190,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8190,100,,6552.00,,,0,"percent of total billed charges","100% of total billed charges",8190,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8190,100,,6552.00,,,0,"percent of total billed charges","100% of total billed charges",8190,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8190,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,8190,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8190,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8190,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,8190,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3087.63,37.7,,2470.10,,,0,"percent of total billed charges","37.70% of total billed charges",8190,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8190,100,,,,,0,"fee schedule","100% of CMS fee schedule",6388.2,78,,5110.56,,,0,"percent of total billed charges","78% of total billed charges",8190,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6764.94,82.6,,5411.95,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",8190,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6764.94,82.6,,5411.95,,,0,"percent of total billed charges","82.6% of total billed charges",8190,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,8190,100,,6552.00,,,0,"percent of total billed charges","100% of total billed charges",1253.07,8190,
"61518 Craniectomy for excision of brain tumor, inf",7962106,CDM,521,RC,61518,CPT,OUTPATIENT,,,10753,6989.45,,9462.64,88,,7570.11,,,0,"percent of total billed charges","88% of total billed charges",10753,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",10753,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,10753,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6774.39,63,,5419.51,,,0,"percent of total billed charges","63% of total billed charges",1645.21,15.3,,1316.17,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,7419.57,69,,,,,0,"fee schedule","69% of total billed charges",10753,100,,8602.40,,,0,"percent of total billed charges","100% of total billed charges",10753,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10753,100,,8602.40,,,0,"percent of total billed charges","100% of total billed charges",10753,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10753,100,,8602.40,,,0,"percent of total billed charges","100% of total billed charges",10753,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10753,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,10753,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10753,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10753,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,10753,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4053.88,37.7,,3243.10,,,0,"percent of total billed charges","37.70% of total billed charges",10753,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10753,100,,,,,0,"fee schedule","100% of CMS fee schedule",8387.34,78,,6709.87,,,0,"percent of total billed charges","78% of total billed charges",10753,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8881.98,82.6,,7105.58,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",10753,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8881.98,82.6,,7105.58,,,0,"percent of total billed charges","82.6% of total billed charges",10753,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,10753,100,,8602.40,,,0,"percent of total billed charges","100% of total billed charges",1645.21,10753,
"61517 Implantation of brain intracavitary chemothe",7962138,CDM,521,RC,61517,CPT,OUTPATIENT,,,515,334.75,,453.2,88,,362.56,,,0,"percent of total billed charges","88% of total billed charges",515,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",515,175,,,,,0,"fee schedule","175% of CMS fee schedule",5945.4,100,,,,,0,"fee schedule",EAPG,515,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",324.45,63,,259.56,,,0,"percent of total billed charges","63% of total billed charges",78.8,15.3,,63.04,,,0,"percent of total billed charges","15.3% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,355.35,69,,,,,0,"fee schedule","69% of total billed charges",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",515,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",515,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",515,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",515,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,515,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",515,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",515,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5887.68,100,,,,,0,"fee schedule",EAPG,7503.9,100,,,,,0,"fee schedule",EAPG,515,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",194.16,37.7,,155.33,,,0,"percent of total billed charges","37.70% of total billed charges",515,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",515,100,,,,,0,"fee schedule","100% of CMS fee schedule",401.7,78,,321.36,,,0,"percent of total billed charges","78% of total billed charges",515,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",5772.23,100,,,,,0,"fee schedule","100% of WA fee schedule",515,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",425.39,82.6,,340.31,,,0,"percent of total billed charges","82.6% of total billed charges",515,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5932.76,100,,,,,0,"fee schedule",EAPG,515,100,,412.00,,,0,"percent of total billed charges","100% of total billed charges",78.8,7503.9,
"61510 Craniectomy, trephination, bone flap craniot",7962144,CDM,521,RC,61510,CPT,OUTPATIENT,,,9572,6221.8,,8423.36,88,,6738.69,,,0,"percent of total billed charges","88% of total billed charges",9572,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9572,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,9572,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6030.36,63,,4824.29,,,0,"percent of total billed charges","63% of total billed charges",1464.52,15.3,,1171.62,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,6604.68,69,,,,,0,"fee schedule","69% of total billed charges",9572,100,,7657.60,,,0,"percent of total billed charges","100% of total billed charges",9572,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9572,100,,7657.60,,,0,"percent of total billed charges","100% of total billed charges",9572,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9572,100,,7657.60,,,0,"percent of total billed charges","100% of total billed charges",9572,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9572,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,9572,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9572,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9572,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,9572,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3608.64,37.7,,2886.91,,,0,"percent of total billed charges","37.70% of total billed charges",9572,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9572,100,,,,,0,"fee schedule","100% of CMS fee schedule",7466.16,78,,5972.93,,,0,"percent of total billed charges","78% of total billed charges",9572,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7906.47,82.6,,6325.18,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",9572,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7906.47,82.6,,6325.18,,,0,"percent of total billed charges","82.6% of total billed charges",9572,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,9572,100,,7657.60,,,0,"percent of total billed charges","100% of total billed charges",1464.52,9572,
"61519 Craniectomy for excision of brain tumor, inf",7962270,CDM,521,RC,61519,CPT,OUTPATIENT,,,13492,8769.8,,11872.96,88,,9498.37,,,0,"percent of total billed charges","88% of total billed charges",13492,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",13492,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,13492,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8499.96,63,,6799.97,,,0,"percent of total billed charges","63% of total billed charges",2064.28,15.3,,1651.42,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,9309.48,69,,,,,0,"fee schedule","69% of total billed charges",13492,100,,10793.60,,,0,"percent of total billed charges","100% of total billed charges",13492,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13492,100,,10793.60,,,0,"percent of total billed charges","100% of total billed charges",13492,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13492,100,,10793.60,,,0,"percent of total billed charges","100% of total billed charges",13492,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13492,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,13492,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13492,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",13492,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,13492,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5086.48,37.7,,4069.18,,,0,"percent of total billed charges","37.70% of total billed charges",13492,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",13492,100,,,,,0,"fee schedule","100% of CMS fee schedule",10523.76,78,,8419.01,,,0,"percent of total billed charges","78% of total billed charges",13492,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11144.39,82.6,,8915.51,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",13492,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11144.39,82.6,,8915.51,,,0,"percent of total billed charges","82.6% of total billed charges",13492,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,13492,100,,10793.60,,,0,"percent of total billed charges","100% of total billed charges",2064.28,13492,
"61520 Craniectomy for excision of brain tumor, inf",7962030,CDM,521,RC,61520,CPT,OUTPATIENT,,,14496,9422.4,,12756.48,88,,10205.18,,,0,"percent of total billed charges","88% of total billed charges",14496,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",14496,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,14496,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9132.48,63,,7305.98,,,0,"percent of total billed charges","63% of total billed charges",2217.89,15.3,,1774.31,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,10002.24,69,,,,,0,"fee schedule","69% of total billed charges",14496,100,,11596.80,,,0,"percent of total billed charges","100% of total billed charges",14496,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",14496,100,,11596.80,,,0,"percent of total billed charges","100% of total billed charges",14496,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",14496,100,,11596.80,,,0,"percent of total billed charges","100% of total billed charges",14496,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",14496,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,14496,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",14496,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",14496,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,14496,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5464.99,37.7,,4371.99,,,0,"percent of total billed charges","37.70% of total billed charges",14496,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",14496,100,,,,,0,"fee schedule","100% of CMS fee schedule",11306.88,78,,9045.50,,,0,"percent of total billed charges","78% of total billed charges",14496,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11973.7,82.6,,9578.96,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",14496,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11973.7,82.6,,9578.96,,,0,"percent of total billed charges","82.6% of total billed charges",14496,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,14496,100,,11596.80,,,0,"percent of total billed charges","100% of total billed charges",2217.89,14496,
"61526 Craniectomy, bone flap craniotomy, transtemp",7962031,CDM,521,RC,61526,CPT,OUTPATIENT,,,10172,6611.8,,8951.36,88,,7161.09,,,0,"percent of total billed charges","88% of total billed charges",10172,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",10172,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,10172,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6408.36,63,,5126.69,,,0,"percent of total billed charges","63% of total billed charges",1556.32,15.3,,1245.06,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,7018.68,69,,,,,0,"fee schedule","69% of total billed charges",10172,100,,8137.60,,,0,"percent of total billed charges","100% of total billed charges",10172,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10172,100,,8137.60,,,0,"percent of total billed charges","100% of total billed charges",10172,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10172,100,,8137.60,,,0,"percent of total billed charges","100% of total billed charges",10172,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10172,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,10172,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10172,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10172,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,10172,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3834.84,37.7,,3067.87,,,0,"percent of total billed charges","37.70% of total billed charges",10172,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10172,100,,,,,0,"fee schedule","100% of CMS fee schedule",7934.16,78,,6347.33,,,0,"percent of total billed charges","78% of total billed charges",10172,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8402.07,82.6,,6721.66,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",10172,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8402.07,82.6,,6721.66,,,0,"percent of total billed charges","82.6% of total billed charges",10172,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,10172,100,,8137.60,,,0,"percent of total billed charges","100% of total billed charges",1556.32,10172,
"61521 Craniectomy for excision of brain tumor, inf",7962150,CDM,521,RC,61521,CPT,OUTPATIENT,,,12830,8339.5,,11290.4,88,,9032.32,,,0,"percent of total billed charges","88% of total billed charges",12830,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12830,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,12830,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8082.9,63,,6466.32,,,0,"percent of total billed charges","63% of total billed charges",1962.99,15.3,,1570.39,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,8852.7,69,,,,,0,"fee schedule","69% of total billed charges",12830,100,,10264.00,,,0,"percent of total billed charges","100% of total billed charges",12830,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12830,100,,10264.00,,,0,"percent of total billed charges","100% of total billed charges",12830,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12830,100,,10264.00,,,0,"percent of total billed charges","100% of total billed charges",12830,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12830,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,12830,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12830,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",12830,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,12830,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4836.91,37.7,,3869.53,,,0,"percent of total billed charges","37.70% of total billed charges",12830,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",12830,100,,,,,0,"fee schedule","100% of CMS fee schedule",10007.4,78,,8005.92,,,0,"percent of total billed charges","78% of total billed charges",12830,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10597.58,82.6,,8478.06,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",12830,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10597.58,82.6,,8478.06,,,0,"percent of total billed charges","82.6% of total billed charges",12830,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,12830,100,,10264.00,,,0,"percent of total billed charges","100% of total billed charges",1962.99,12830,
"61524 Craniectomy, infratentorial or posterior fos",7962351,CDM,521,RC,61524,CPT,OUTPATIENT,,,9054,5885.1,,7967.52,88,,6374.02,,,0,"percent of total billed charges","88% of total billed charges",9054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9054,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,9054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5704.02,63,,4563.22,,,0,"percent of total billed charges","63% of total billed charges",1385.26,15.3,,1108.21,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,6247.26,69,,,,,0,"fee schedule","69% of total billed charges",9054,100,,7243.20,,,0,"percent of total billed charges","100% of total billed charges",9054,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9054,100,,7243.20,,,0,"percent of total billed charges","100% of total billed charges",9054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9054,100,,7243.20,,,0,"percent of total billed charges","100% of total billed charges",9054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,9054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,9054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3413.36,37.7,,2730.69,,,0,"percent of total billed charges","37.70% of total billed charges",9054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9054,100,,,,,0,"fee schedule","100% of CMS fee schedule",7062.12,78,,5649.70,,,0,"percent of total billed charges","78% of total billed charges",9054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7478.6,82.6,,5982.88,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",9054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7478.6,82.6,,5982.88,,,0,"percent of total billed charges","82.6% of total billed charges",9054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,9054,100,,7243.20,,,0,"percent of total billed charges","100% of total billed charges",1385.26,9054,
"61522 Craniectomy, infratentorial or posterior fos",7962575,CDM,521,RC,61522,CPT,OUTPATIENT,,,9546,6204.9,,8400.48,88,,6720.38,,,0,"percent of total billed charges","88% of total billed charges",9546,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9546,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,9546,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6013.98,63,,4811.18,,,0,"percent of total billed charges","63% of total billed charges",1460.54,15.3,,1168.43,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,6586.74,69,,,,,0,"fee schedule","69% of total billed charges",9546,100,,7636.80,,,0,"percent of total billed charges","100% of total billed charges",9546,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9546,100,,7636.80,,,0,"percent of total billed charges","100% of total billed charges",9546,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9546,100,,7636.80,,,0,"percent of total billed charges","100% of total billed charges",9546,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9546,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,9546,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9546,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9546,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,9546,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3598.84,37.7,,2879.07,,,0,"percent of total billed charges","37.70% of total billed charges",9546,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9546,100,,,,,0,"fee schedule","100% of CMS fee schedule",7445.88,78,,5956.70,,,0,"percent of total billed charges","78% of total billed charges",9546,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7885,82.6,,6308.00,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",9546,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7885,82.6,,6308.00,,,0,"percent of total billed charges","82.6% of total billed charges",9546,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,9546,100,,7636.80,,,0,"percent of total billed charges","100% of total billed charges",1460.54,9546,
"61530 Craniectomy, bone flap craniotomy, transtemp",7962099,CDM,521,RC,61530,CPT,OUTPATIENT,,,12355,8030.75,,10872.4,88,,8697.92,,,0,"percent of total billed charges","88% of total billed charges",12355,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12355,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,12355,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7783.65,63,,6226.92,,,0,"percent of total billed charges","63% of total billed charges",1890.32,15.3,,1512.26,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,8524.95,69,,,,,0,"fee schedule","69% of total billed charges",12355,100,,9884.00,,,0,"percent of total billed charges","100% of total billed charges",12355,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12355,100,,9884.00,,,0,"percent of total billed charges","100% of total billed charges",12355,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12355,100,,9884.00,,,0,"percent of total billed charges","100% of total billed charges",12355,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12355,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,12355,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12355,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",12355,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,12355,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4657.84,37.7,,3726.27,,,0,"percent of total billed charges","37.70% of total billed charges",12355,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",12355,100,,,,,0,"fee schedule","100% of CMS fee schedule",9636.9,78,,7709.52,,,0,"percent of total billed charges","78% of total billed charges",12355,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10205.23,82.6,,8164.18,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",12355,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10205.23,82.6,,8164.18,,,0,"percent of total billed charges","82.6% of total billed charges",12355,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,12355,100,,9884.00,,,0,"percent of total billed charges","100% of total billed charges",1890.32,12355,
"61539 Craniotomy with elevation of bone flap; for",7962124,CDM,521,RC,61539,CPT,OUTPATIENT,,,10563,6865.95,,9295.44,88,,7436.35,,,0,"percent of total billed charges","88% of total billed charges",10563,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",10563,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,10563,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6654.69,63,,5323.75,,,0,"percent of total billed charges","63% of total billed charges",1616.14,15.3,,1292.91,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,7288.47,69,,,,,0,"fee schedule","69% of total billed charges",10563,100,,8450.40,,,0,"percent of total billed charges","100% of total billed charges",10563,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10563,100,,8450.40,,,0,"percent of total billed charges","100% of total billed charges",10563,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10563,100,,8450.40,,,0,"percent of total billed charges","100% of total billed charges",10563,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10563,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,10563,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10563,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10563,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,10563,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3982.25,37.7,,3185.80,,,0,"percent of total billed charges","37.70% of total billed charges",10563,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10563,100,,,,,0,"fee schedule","100% of CMS fee schedule",8239.14,78,,6591.31,,,0,"percent of total billed charges","78% of total billed charges",10563,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8725.04,82.6,,6980.03,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",10563,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8725.04,82.6,,6980.03,,,0,"percent of total billed charges","82.6% of total billed charges",10563,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,10563,100,,8450.40,,,0,"percent of total billed charges","100% of total billed charges",1616.14,10563,
"61537 Craniotomy with elevation of bone flap; for",7962141,CDM,521,RC,61537,CPT,OUTPATIENT,,,9311,6052.15,,8193.68,88,,6554.94,,,0,"percent of total billed charges","88% of total billed charges",9311,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9311,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,9311,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5865.93,63,,4692.74,,,0,"percent of total billed charges","63% of total billed charges",1424.58,15.3,,1139.66,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,6424.59,69,,,,,0,"fee schedule","69% of total billed charges",9311,100,,7448.80,,,0,"percent of total billed charges","100% of total billed charges",9311,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9311,100,,7448.80,,,0,"percent of total billed charges","100% of total billed charges",9311,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9311,100,,7448.80,,,0,"percent of total billed charges","100% of total billed charges",9311,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9311,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,9311,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9311,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9311,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,9311,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3510.25,37.7,,2808.20,,,0,"percent of total billed charges","37.70% of total billed charges",9311,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9311,100,,,,,0,"fee schedule","100% of CMS fee schedule",7262.58,78,,5810.06,,,0,"percent of total billed charges","78% of total billed charges",9311,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7690.89,82.6,,6152.71,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",9311,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7690.89,82.6,,6152.71,,,0,"percent of total billed charges","82.6% of total billed charges",9311,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,9311,100,,7448.80,,,0,"percent of total billed charges","100% of total billed charges",1424.58,9311,
"61538 Craniotomy with elevation of bone flap; for",7962146,CDM,521,RC,61538,CPT,OUTPATIENT,,,8879,5771.35,,7813.52,88,,6250.82,,,0,"percent of total billed charges","88% of total billed charges",8879,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8879,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,8879,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5593.77,63,,4475.02,,,0,"percent of total billed charges","63% of total billed charges",1358.49,15.3,,1086.79,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,6126.51,69,,,,,0,"fee schedule","69% of total billed charges",8879,100,,7103.20,,,0,"percent of total billed charges","100% of total billed charges",8879,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8879,100,,7103.20,,,0,"percent of total billed charges","100% of total billed charges",8879,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8879,100,,7103.20,,,0,"percent of total billed charges","100% of total billed charges",8879,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8879,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,8879,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8879,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8879,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,8879,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3347.38,37.7,,2677.90,,,0,"percent of total billed charges","37.70% of total billed charges",8879,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8879,100,,,,,0,"fee schedule","100% of CMS fee schedule",6925.62,78,,5540.50,,,0,"percent of total billed charges","78% of total billed charges",8879,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7334.05,82.6,,5867.24,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",8879,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7334.05,82.6,,5867.24,,,0,"percent of total billed charges","82.6% of total billed charges",8879,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,8879,100,,7103.20,,,0,"percent of total billed charges","100% of total billed charges",1358.49,8879,
"61548 Hypophysectomy or excision of pituitary tumo",7962032,CDM,521,RC,61548,CPT,OUTPATIENT,,,9311,6052.15,,8193.68,88,,6554.94,,,0,"percent of total billed charges","88% of total billed charges",9311,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4013.79,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9311,175,,,,,0,"fee schedule","175% of CMS fee schedule",4134.2,100,,,,,0,"fee schedule",EAPG,9311,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5865.93,63,,4692.74,,,0,"percent of total billed charges","63% of total billed charges",1424.58,15.3,,1139.66,,,0,"percent of total billed charges","15.3% of total billed charges",4013.79,100,,,,,0,"fee schedule",EAPG,6424.59,69,,,,,0,"fee schedule","69% of total billed charges",9311,100,,7448.80,,,0,"percent of total billed charges","100% of total billed charges",9311,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9311,100,,7448.80,,,0,"percent of total billed charges","100% of total billed charges",9311,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9311,100,,7448.80,,,0,"percent of total billed charges","100% of total billed charges",9311,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9311,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4013.79,100,,,,,0,"fee schedule",EAPG,9311,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9311,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9311,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4094.06,100,,,,,0,"fee schedule",EAPG,5217.93,100,,,,,0,"fee schedule",EAPG,9311,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3510.25,37.7,,2808.20,,,0,"percent of total billed charges","37.70% of total billed charges",9311,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9311,100,,,,,0,"fee schedule","100% of CMS fee schedule",7262.58,78,,5810.06,,,0,"percent of total billed charges","78% of total billed charges",9311,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7690.89,82.6,,6152.71,,,0,"percent of total billed charges","82.6% of total billed charges",4013.79,100,,,,,0,"fee schedule","100% of WA fee schedule",9311,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7690.89,82.6,,6152.71,,,0,"percent of total billed charges","82.6% of total billed charges",9311,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4174.32,100,,,,,0,"fee schedule",EAPG,9311,100,,7448.80,,,0,"percent of total billed charges","100% of total billed charges",1424.58,9311,
"61544 Craniotomy with elevation of bone flap; for",7962209,CDM,521,RC,61544,CPT,OUTPATIENT,,,8267,5373.55,,7274.96,88,,5819.97,,,0,"percent of total billed charges","88% of total billed charges",8267,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8267,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,8267,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5208.21,63,,4166.57,,,0,"percent of total billed charges","63% of total billed charges",1264.85,15.3,,1011.88,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,5704.23,69,,,,,0,"fee schedule","69% of total billed charges",8267,100,,6613.60,,,0,"percent of total billed charges","100% of total billed charges",8267,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8267,100,,6613.60,,,0,"percent of total billed charges","100% of total billed charges",8267,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8267,100,,6613.60,,,0,"percent of total billed charges","100% of total billed charges",8267,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8267,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,8267,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8267,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8267,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,8267,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3116.66,37.7,,2493.33,,,0,"percent of total billed charges","37.70% of total billed charges",8267,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8267,100,,,,,0,"fee schedule","100% of CMS fee schedule",6448.26,78,,5158.61,,,0,"percent of total billed charges","78% of total billed charges",8267,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6828.54,82.6,,5462.83,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",8267,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6828.54,82.6,,5462.83,,,0,"percent of total billed charges","82.6% of total billed charges",8267,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,8267,100,,6613.60,,,0,"percent of total billed charges","100% of total billed charges",1264.85,8267,
"61546 Craniotomy for hypophysectomy or excision of",7962390,CDM,521,RC,61546,CPT,OUTPATIENT,,,10249,6661.85,,9019.12,88,,7215.30,,,0,"percent of total billed charges","88% of total billed charges",10249,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",10249,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,10249,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6456.87,63,,5165.50,,,0,"percent of total billed charges","63% of total billed charges",1568.1,15.3,,1254.48,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,7071.81,69,,,,,0,"fee schedule","69% of total billed charges",10249,100,,8199.20,,,0,"percent of total billed charges","100% of total billed charges",10249,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10249,100,,8199.20,,,0,"percent of total billed charges","100% of total billed charges",10249,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10249,100,,8199.20,,,0,"percent of total billed charges","100% of total billed charges",10249,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10249,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,10249,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10249,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10249,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,10249,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3863.87,37.7,,3091.10,,,0,"percent of total billed charges","37.70% of total billed charges",10249,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10249,100,,,,,0,"fee schedule","100% of CMS fee schedule",7994.22,78,,6395.38,,,0,"percent of total billed charges","78% of total billed charges",10249,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8465.67,82.6,,6772.54,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",10249,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8465.67,82.6,,6772.54,,,0,"percent of total billed charges","82.6% of total billed charges",10249,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,10249,100,,8199.20,,,0,"percent of total billed charges","100% of total billed charges",1568.1,10249,
"61545 Craniotomy with elevation of bone flap; for",7962660,CDM,521,RC,61545,CPT,OUTPATIENT,,,13996,9097.4,,12316.48,88,,9853.18,,,0,"percent of total billed charges","88% of total billed charges",13996,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",13996,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,13996,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8817.48,63,,7053.98,,,0,"percent of total billed charges","63% of total billed charges",2141.39,15.3,,1713.11,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,9657.24,69,,,,,0,"fee schedule","69% of total billed charges",13996,100,,11196.80,,,0,"percent of total billed charges","100% of total billed charges",13996,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13996,100,,11196.80,,,0,"percent of total billed charges","100% of total billed charges",13996,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13996,100,,11196.80,,,0,"percent of total billed charges","100% of total billed charges",13996,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13996,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,13996,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13996,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",13996,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,13996,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5276.49,37.7,,4221.19,,,0,"percent of total billed charges","37.70% of total billed charges",13996,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",13996,100,,,,,0,"fee schedule","100% of CMS fee schedule",10916.88,78,,8733.50,,,0,"percent of total billed charges","78% of total billed charges",13996,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11560.7,82.6,,9248.56,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",13996,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11560.7,82.6,,9248.56,,,0,"percent of total billed charges","82.6% of total billed charges",13996,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,13996,100,,11196.80,,,0,"percent of total billed charges","100% of total billed charges",2141.39,13996,
"61556 Craniotomy for craniosynostosis; frontal or",7963060,CDM,521,RC,61556,CPT,OUTPATIENT,,,7746,5034.9,,6816.48,88,,5453.18,,,0,"percent of total billed charges","88% of total billed charges",7746,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7746,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,7746,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4879.98,63,,3903.98,,,0,"percent of total billed charges","63% of total billed charges",1185.14,15.3,,948.11,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,5344.74,69,,,,,0,"fee schedule","69% of total billed charges",7746,100,,6196.80,,,0,"percent of total billed charges","100% of total billed charges",7746,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7746,100,,6196.80,,,0,"percent of total billed charges","100% of total billed charges",7746,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7746,100,,6196.80,,,0,"percent of total billed charges","100% of total billed charges",7746,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7746,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,7746,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7746,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7746,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,7746,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2920.24,37.7,,2336.19,,,0,"percent of total billed charges","37.70% of total billed charges",7746,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7746,100,,,,,0,"fee schedule","100% of CMS fee schedule",6041.88,78,,4833.50,,,0,"percent of total billed charges","78% of total billed charges",7746,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6398.2,82.6,,5118.56,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",7746,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6398.2,82.6,,5118.56,,,0,"percent of total billed charges","82.6% of total billed charges",7746,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,7746,100,,6196.80,,,0,"percent of total billed charges","100% of total billed charges",1185.14,7746,
"61552 Craniectomy for craniosynostosis; multiple c",7963182,CDM,521,RC,61552,CPT,OUTPATIENT,,,5438,3534.7,,4785.44,88,,3828.35,,,0,"percent of total billed charges","88% of total billed charges",5438,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5438,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,5438,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3425.94,63,,2740.75,,,0,"percent of total billed charges","63% of total billed charges",832.01,15.3,,665.61,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,3752.22,69,,,,,0,"fee schedule","69% of total billed charges",5438,100,,4350.40,,,0,"percent of total billed charges","100% of total billed charges",5438,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5438,100,,4350.40,,,0,"percent of total billed charges","100% of total billed charges",5438,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5438,100,,4350.40,,,0,"percent of total billed charges","100% of total billed charges",5438,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5438,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,5438,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5438,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5438,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,5438,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2050.13,37.7,,1640.10,,,0,"percent of total billed charges","37.70% of total billed charges",5438,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5438,100,,,,,0,"fee schedule","100% of CMS fee schedule",4241.64,78,,3393.31,,,0,"percent of total billed charges","78% of total billed charges",5438,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4491.79,82.6,,3593.43,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",5438,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4491.79,82.6,,3593.43,,,0,"percent of total billed charges","82.6% of total billed charges",5438,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,5438,100,,4350.40,,,0,"percent of total billed charges","100% of total billed charges",832.01,5438,
"61550 Craniectomy for craniosynostosis; single cra",7963266,CDM,521,RC,61550,CPT,OUTPATIENT,,,4201,2730.65,,3696.88,88,,2957.50,,,0,"percent of total billed charges","88% of total billed charges",4201,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4201,100,,3360.80,,,0,"percent of total billed charges","100% of total billed charges",4201,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,4201,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2646.63,63,,2117.30,,,0,"percent of total billed charges","63% of total billed charges",642.75,15.3,,514.20,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,2898.69,69,,,,,0,"fee schedule","69% of total billed charges",4201,100,,3360.80,,,0,"percent of total billed charges","100% of total billed charges",4201,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4201,100,,3360.80,,,0,"percent of total billed charges","100% of total billed charges",4201,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4201,100,,3360.80,,,0,"percent of total billed charges","100% of total billed charges",4201,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4201,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4201,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4201,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4201,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,4201,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1583.78,37.7,,1267.02,,,0,"percent of total billed charges","37.70% of total billed charges",4201,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4201,100,,,,,0,"fee schedule","100% of CMS fee schedule",3276.78,78,,2621.42,,,0,"percent of total billed charges","78% of total billed charges",4201,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.03,82.6,,2776.02,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",4201,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.03,82.6,,2776.02,,,0,"percent of total billed charges","82.6% of total billed charges",4201,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,4201,100,,3360.80,,,0,"percent of total billed charges","100% of total billed charges",642.75,4512.18,
"61563 Excision, intra and extracranial, benign tum",7961630,CDM,521,RC,61563,CPT,OUTPATIENT,,,8672,5636.8,,7631.36,88,,6105.09,,,0,"percent of total billed charges","88% of total billed charges",8672,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8672,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,8672,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5463.36,63,,4370.69,,,0,"percent of total billed charges","63% of total billed charges",1326.82,15.3,,1061.46,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,5983.68,69,,,,,0,"fee schedule","69% of total billed charges",8672,100,,6937.60,,,0,"percent of total billed charges","100% of total billed charges",8672,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8672,100,,6937.60,,,0,"percent of total billed charges","100% of total billed charges",8672,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8672,100,,6937.60,,,0,"percent of total billed charges","100% of total billed charges",8672,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8672,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,8672,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8672,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8672,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,8672,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3269.34,37.7,,2615.47,,,0,"percent of total billed charges","37.70% of total billed charges",8672,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8672,100,,,,,0,"fee schedule","100% of CMS fee schedule",6764.16,78,,5411.33,,,0,"percent of total billed charges","78% of total billed charges",8672,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7163.07,82.6,,5730.46,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",8672,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7163.07,82.6,,5730.46,,,0,"percent of total billed charges","82.6% of total billed charges",8672,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,8672,100,,6937.60,,,0,"percent of total billed charges","100% of total billed charges",1326.82,8672,
"61575 Transoral approach to skull base, brain stem",7962139,CDM,521,RC,61575,CPT,OUTPATIENT,,,8401,5460.65,,7392.88,88,,5914.30,,,0,"percent of total billed charges","88% of total billed charges",8401,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4013.79,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8401,175,,,,,0,"fee schedule","175% of CMS fee schedule",4134.2,100,,,,,0,"fee schedule",EAPG,8401,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5292.63,63,,4234.10,,,0,"percent of total billed charges","63% of total billed charges",1285.35,15.3,,1028.28,,,0,"percent of total billed charges","15.3% of total billed charges",4013.79,100,,,,,0,"fee schedule",EAPG,5796.69,69,,,,,0,"fee schedule","69% of total billed charges",8401,100,,6720.80,,,0,"percent of total billed charges","100% of total billed charges",8401,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8401,100,,6720.80,,,0,"percent of total billed charges","100% of total billed charges",8401,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8401,100,,6720.80,,,0,"percent of total billed charges","100% of total billed charges",8401,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8401,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4013.79,100,,,,,0,"fee schedule",EAPG,8401,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8401,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8401,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4094.06,100,,,,,0,"fee schedule",EAPG,5217.93,100,,,,,0,"fee schedule",EAPG,8401,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3167.18,37.7,,2533.74,,,0,"percent of total billed charges","37.70% of total billed charges",8401,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8401,100,,,,,0,"fee schedule","100% of CMS fee schedule",6552.78,78,,5242.22,,,0,"percent of total billed charges","78% of total billed charges",8401,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6939.23,82.6,,5551.38,,,0,"percent of total billed charges","82.6% of total billed charges",4013.79,100,,,,,0,"fee schedule","100% of WA fee schedule",8401,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6939.23,82.6,,5551.38,,,0,"percent of total billed charges","82.6% of total billed charges",8401,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4174.32,100,,,,,0,"fee schedule",EAPG,8401,100,,6720.80,,,0,"percent of total billed charges","100% of total billed charges",1285.35,8401,
"61571 Craniectomy or craniotomy; with treatment of",7962791,CDM,521,RC,61571,CPT,OUTPATIENT,,,8740,5681,,7691.2,88,,6152.96,,,0,"percent of total billed charges","88% of total billed charges",8740,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8740,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,8740,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5506.2,63,,4404.96,,,0,"percent of total billed charges","63% of total billed charges",1337.22,15.3,,1069.78,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,6030.6,69,,,,,0,"fee schedule","69% of total billed charges",8740,100,,6992.00,,,0,"percent of total billed charges","100% of total billed charges",8740,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8740,100,,6992.00,,,0,"percent of total billed charges","100% of total billed charges",8740,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8740,100,,6992.00,,,0,"percent of total billed charges","100% of total billed charges",8740,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8740,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,8740,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8740,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8740,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,8740,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3294.98,37.7,,2635.98,,,0,"percent of total billed charges","37.70% of total billed charges",8740,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8740,100,,,,,0,"fee schedule","100% of CMS fee schedule",6817.2,78,,5453.76,,,0,"percent of total billed charges","78% of total billed charges",8740,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7219.24,82.6,,5775.39,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",8740,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7219.24,82.6,,5775.39,,,0,"percent of total billed charges","82.6% of total billed charges",8740,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,8740,100,,6992.00,,,0,"percent of total billed charges","100% of total billed charges",1337.22,8740,
"61570 Craniectomy or craniotomy; with excision of",7962866,CDM,521,RC,61570,CPT,OUTPATIENT,,,8047,5230.55,,7081.36,88,,5665.09,,,0,"percent of total billed charges","88% of total billed charges",8047,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8047,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,8047,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5069.61,63,,4055.69,,,0,"percent of total billed charges","63% of total billed charges",1231.19,15.3,,984.95,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,5552.43,69,,,,,0,"fee schedule","69% of total billed charges",8047,100,,6437.60,,,0,"percent of total billed charges","100% of total billed charges",8047,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8047,100,,6437.60,,,0,"percent of total billed charges","100% of total billed charges",8047,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8047,100,,6437.60,,,0,"percent of total billed charges","100% of total billed charges",8047,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8047,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,8047,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8047,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8047,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,8047,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3033.72,37.7,,2426.98,,,0,"percent of total billed charges","37.70% of total billed charges",8047,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8047,100,,,,,0,"fee schedule","100% of CMS fee schedule",6276.66,78,,5021.33,,,0,"percent of total billed charges","78% of total billed charges",8047,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6646.82,82.6,,5317.46,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",8047,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6646.82,82.6,,5317.46,,,0,"percent of total billed charges","82.6% of total billed charges",8047,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,8047,100,,6437.60,,,0,"percent of total billed charges","100% of total billed charges",1231.19,8047,
"61581 Craniofacial approach to anterior cranial fo",7962033,CDM,521,RC,61581,CPT,OUTPATIENT,,,11054,7185.1,,9727.52,88,,7782.02,,,0,"percent of total billed charges","88% of total billed charges",11054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4013.79,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",11054,175,,,,,0,"fee schedule","175% of CMS fee schedule",4134.2,100,,,,,0,"fee schedule",EAPG,11054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6964.02,63,,5571.22,,,0,"percent of total billed charges","63% of total billed charges",1691.26,15.3,,1353.01,,,0,"percent of total billed charges","15.3% of total billed charges",4013.79,100,,,,,0,"fee schedule",EAPG,7627.26,69,,,,,0,"fee schedule","69% of total billed charges",11054,100,,8843.20,,,0,"percent of total billed charges","100% of total billed charges",11054,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11054,100,,8843.20,,,0,"percent of total billed charges","100% of total billed charges",11054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11054,100,,8843.20,,,0,"percent of total billed charges","100% of total billed charges",11054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4013.79,100,,,,,0,"fee schedule",EAPG,11054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",11054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4094.06,100,,,,,0,"fee schedule",EAPG,5217.93,100,,,,,0,"fee schedule",EAPG,11054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4167.36,37.7,,3333.89,,,0,"percent of total billed charges","37.70% of total billed charges",11054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",11054,100,,,,,0,"fee schedule","100% of CMS fee schedule",8622.12,78,,6897.70,,,0,"percent of total billed charges","78% of total billed charges",11054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9130.6,82.6,,7304.48,,,0,"percent of total billed charges","82.6% of total billed charges",4013.79,100,,,,,0,"fee schedule","100% of WA fee schedule",11054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9130.6,82.6,,7304.48,,,0,"percent of total billed charges","82.6% of total billed charges",11054,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4174.32,100,,,,,0,"fee schedule",EAPG,11054,100,,8843.20,,,0,"percent of total billed charges","100% of total billed charges",1691.26,11054,
"61583 Craniofacial approach to anterior cranial fo",7962083,CDM,521,RC,61583,CPT,OUTPATIENT,,,10342,6722.3,,9100.96,88,,7280.77,,,0,"percent of total billed charges","88% of total billed charges",10342,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4013.79,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",10342,175,,,,,0,"fee schedule","175% of CMS fee schedule",4134.2,100,,,,,0,"fee schedule",EAPG,10342,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6515.46,63,,5212.37,,,0,"percent of total billed charges","63% of total billed charges",1582.33,15.3,,1265.86,,,0,"percent of total billed charges","15.3% of total billed charges",4013.79,100,,,,,0,"fee schedule",EAPG,7135.98,69,,,,,0,"fee schedule","69% of total billed charges",10342,100,,8273.60,,,0,"percent of total billed charges","100% of total billed charges",10342,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10342,100,,8273.60,,,0,"percent of total billed charges","100% of total billed charges",10342,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10342,100,,8273.60,,,0,"percent of total billed charges","100% of total billed charges",10342,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10342,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4013.79,100,,,,,0,"fee schedule",EAPG,10342,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10342,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10342,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4094.06,100,,,,,0,"fee schedule",EAPG,5217.93,100,,,,,0,"fee schedule",EAPG,10342,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3898.93,37.7,,3119.14,,,0,"percent of total billed charges","37.70% of total billed charges",10342,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10342,100,,,,,0,"fee schedule","100% of CMS fee schedule",8066.76,78,,6453.41,,,0,"percent of total billed charges","78% of total billed charges",10342,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8542.49,82.6,,6833.99,,,0,"percent of total billed charges","82.6% of total billed charges",4013.79,100,,,,,0,"fee schedule","100% of WA fee schedule",10342,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8542.49,82.6,,6833.99,,,0,"percent of total billed charges","82.6% of total billed charges",10342,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4174.32,100,,,,,0,"fee schedule",EAPG,10342,100,,8273.60,,,0,"percent of total billed charges","100% of total billed charges",1582.33,10342,
"61582 Craniofacial approach to anterior cranial fo",7962089,CDM,521,RC,61582,CPT,OUTPATIENT,,,10457,6797.05,,9202.16,88,,7361.73,,,0,"percent of total billed charges","88% of total billed charges",10457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4013.79,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",10457,175,,,,,0,"fee schedule","175% of CMS fee schedule",4134.2,100,,,,,0,"fee schedule",EAPG,10457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6587.91,63,,5270.33,,,0,"percent of total billed charges","63% of total billed charges",1599.92,15.3,,1279.94,,,0,"percent of total billed charges","15.3% of total billed charges",4013.79,100,,,,,0,"fee schedule",EAPG,7215.33,69,,,,,0,"fee schedule","69% of total billed charges",10457,100,,8365.60,,,0,"percent of total billed charges","100% of total billed charges",10457,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10457,100,,8365.60,,,0,"percent of total billed charges","100% of total billed charges",10457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10457,100,,8365.60,,,0,"percent of total billed charges","100% of total billed charges",10457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4013.79,100,,,,,0,"fee schedule",EAPG,10457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4094.06,100,,,,,0,"fee schedule",EAPG,5217.93,100,,,,,0,"fee schedule",EAPG,10457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3942.29,37.7,,3153.83,,,0,"percent of total billed charges","37.70% of total billed charges",10457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10457,100,,,,,0,"fee schedule","100% of CMS fee schedule",8156.46,78,,6525.17,,,0,"percent of total billed charges","78% of total billed charges",10457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8637.48,82.6,,6909.98,,,0,"percent of total billed charges","82.6% of total billed charges",4013.79,100,,,,,0,"fee schedule","100% of WA fee schedule",10457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8637.48,82.6,,6909.98,,,0,"percent of total billed charges","82.6% of total billed charges",10457,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4174.32,100,,,,,0,"fee schedule",EAPG,10457,100,,8365.60,,,0,"percent of total billed charges","100% of total billed charges",1599.92,10457,
"61584 Orbitocranial approach to anterior cranial f",7962091,CDM,521,RC,61584,CPT,OUTPATIENT,,,7098,4613.7,,6246.24,88,,4996.99,,,0,"percent of total billed charges","88% of total billed charges",7098,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4013.79,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7098,175,,,,,0,"fee schedule","175% of CMS fee schedule",4134.2,100,,,,,0,"fee schedule",EAPG,7098,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4471.74,63,,3577.39,,,0,"percent of total billed charges","63% of total billed charges",1085.99,15.3,,868.79,,,0,"percent of total billed charges","15.3% of total billed charges",4013.79,100,,,,,0,"fee schedule",EAPG,4897.62,69,,,,,0,"fee schedule","69% of total billed charges",7098,100,,5678.40,,,0,"percent of total billed charges","100% of total billed charges",7098,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7098,100,,5678.40,,,0,"percent of total billed charges","100% of total billed charges",7098,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7098,100,,5678.40,,,0,"percent of total billed charges","100% of total billed charges",7098,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7098,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4013.79,100,,,,,0,"fee schedule",EAPG,7098,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7098,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7098,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4094.06,100,,,,,0,"fee schedule",EAPG,5217.93,100,,,,,0,"fee schedule",EAPG,7098,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2675.95,37.7,,2140.76,,,0,"percent of total billed charges","37.70% of total billed charges",7098,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7098,100,,,,,0,"fee schedule","100% of CMS fee schedule",5536.44,78,,4429.15,,,0,"percent of total billed charges","78% of total billed charges",7098,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5862.95,82.6,,4690.36,,,0,"percent of total billed charges","82.6% of total billed charges",4013.79,100,,,,,0,"fee schedule","100% of WA fee schedule",7098,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5862.95,82.6,,4690.36,,,0,"percent of total billed charges","82.6% of total billed charges",7098,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4174.32,100,,,,,0,"fee schedule",EAPG,7098,100,,5678.40,,,0,"percent of total billed charges","100% of total billed charges",1085.99,7098,
"61586 Bicoronal, transzygomatic and/or LeFort I os",7962123,CDM,521,RC,61586,CPT,OUTPATIENT,,,7213,4688.45,,6347.44,88,,5077.95,,,0,"percent of total billed charges","88% of total billed charges",7213,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4013.79,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7213,175,,,,,0,"fee schedule","175% of CMS fee schedule",4134.2,100,,,,,0,"fee schedule",EAPG,7213,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4544.19,63,,3635.35,,,0,"percent of total billed charges","63% of total billed charges",1103.59,15.3,,882.87,,,0,"percent of total billed charges","15.3% of total billed charges",4013.79,100,,,,,0,"fee schedule",EAPG,4976.97,69,,,,,0,"fee schedule","69% of total billed charges",7213,100,,5770.40,,,0,"percent of total billed charges","100% of total billed charges",7213,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7213,100,,5770.40,,,0,"percent of total billed charges","100% of total billed charges",7213,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7213,100,,5770.40,,,0,"percent of total billed charges","100% of total billed charges",7213,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7213,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4013.79,100,,,,,0,"fee schedule",EAPG,7213,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7213,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7213,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4094.06,100,,,,,0,"fee schedule",EAPG,5217.93,100,,,,,0,"fee schedule",EAPG,7213,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2719.3,37.7,,2175.44,,,0,"percent of total billed charges","37.70% of total billed charges",7213,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7213,100,,,,,0,"fee schedule","100% of CMS fee schedule",5626.14,78,,4500.91,,,0,"percent of total billed charges","78% of total billed charges",7213,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5957.94,82.6,,4766.35,,,0,"percent of total billed charges","82.6% of total billed charges",4013.79,100,,,,,0,"fee schedule","100% of WA fee schedule",7213,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5957.94,82.6,,4766.35,,,0,"percent of total billed charges","82.6% of total billed charges",7213,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4174.32,100,,,,,0,"fee schedule",EAPG,7213,100,,5770.40,,,0,"percent of total billed charges","100% of total billed charges",1103.59,7213,
"61591 Infratemporal post-auricular approach to mid",7962034,CDM,521,RC,61591,CPT,OUTPATIENT,,,13503,8776.95,,11882.64,88,,9506.11,,,0,"percent of total billed charges","88% of total billed charges",13503,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4013.79,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",13503,175,,,,,0,"fee schedule","175% of CMS fee schedule",4134.2,100,,,,,0,"fee schedule",EAPG,13503,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8506.89,63,,6805.51,,,0,"percent of total billed charges","63% of total billed charges",2065.96,15.3,,1652.77,,,0,"percent of total billed charges","15.3% of total billed charges",4013.79,100,,,,,0,"fee schedule",EAPG,9317.07,69,,,,,0,"fee schedule","69% of total billed charges",13503,100,,10802.40,,,0,"percent of total billed charges","100% of total billed charges",13503,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13503,100,,10802.40,,,0,"percent of total billed charges","100% of total billed charges",13503,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13503,100,,10802.40,,,0,"percent of total billed charges","100% of total billed charges",13503,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13503,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4013.79,100,,,,,0,"fee schedule",EAPG,13503,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13503,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",13503,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4094.06,100,,,,,0,"fee schedule",EAPG,5217.93,100,,,,,0,"fee schedule",EAPG,13503,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5090.63,37.7,,4072.50,,,0,"percent of total billed charges","37.70% of total billed charges",13503,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",13503,100,,,,,0,"fee schedule","100% of CMS fee schedule",10532.34,78,,8425.87,,,0,"percent of total billed charges","78% of total billed charges",13503,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11153.48,82.6,,8922.78,,,0,"percent of total billed charges","82.6% of total billed charges",4013.79,100,,,,,0,"fee schedule","100% of WA fee schedule",13503,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11153.48,82.6,,8922.78,,,0,"percent of total billed charges","82.6% of total billed charges",13503,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4174.32,100,,,,,0,"fee schedule",EAPG,13503,100,,10802.40,,,0,"percent of total billed charges","100% of total billed charges",2065.96,13503,
"61592 Orbitocranial zygomatic approach to middle c",7962215,CDM,521,RC,61592,CPT,OUTPATIENT,,,9472,6156.8,,8335.36,88,,6668.29,,,0,"percent of total billed charges","88% of total billed charges",9472,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4013.79,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9472,175,,,,,0,"fee schedule","175% of CMS fee schedule",4134.2,100,,,,,0,"fee schedule",EAPG,9472,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5967.36,63,,4773.89,,,0,"percent of total billed charges","63% of total billed charges",1449.22,15.3,,1159.38,,,0,"percent of total billed charges","15.3% of total billed charges",4013.79,100,,,,,0,"fee schedule",EAPG,6535.68,69,,,,,0,"fee schedule","69% of total billed charges",9472,100,,7577.60,,,0,"percent of total billed charges","100% of total billed charges",9472,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9472,100,,7577.60,,,0,"percent of total billed charges","100% of total billed charges",9472,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9472,100,,7577.60,,,0,"percent of total billed charges","100% of total billed charges",9472,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9472,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4013.79,100,,,,,0,"fee schedule",EAPG,9472,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9472,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9472,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4094.06,100,,,,,0,"fee schedule",EAPG,5217.93,100,,,,,0,"fee schedule",EAPG,9472,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3570.94,37.7,,2856.75,,,0,"percent of total billed charges","37.70% of total billed charges",9472,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9472,100,,,,,0,"fee schedule","100% of CMS fee schedule",7388.16,78,,5910.53,,,0,"percent of total billed charges","78% of total billed charges",9472,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7823.87,82.6,,6259.10,,,0,"percent of total billed charges","82.6% of total billed charges",4013.79,100,,,,,0,"fee schedule","100% of WA fee schedule",9472,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7823.87,82.6,,6259.10,,,0,"percent of total billed charges","82.6% of total billed charges",9472,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4174.32,100,,,,,0,"fee schedule",EAPG,9472,100,,7577.60,,,0,"percent of total billed charges","100% of total billed charges",1449.22,9472,
"61601 Resection or excision of neoplastic, vascula",7962035,CDM,521,RC,61601,CPT,OUTPATIENT,,,10002,6501.3,,8801.76,88,,7041.41,,,0,"percent of total billed charges","88% of total billed charges",10002,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",10002,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,10002,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6301.26,63,,5041.01,,,0,"percent of total billed charges","63% of total billed charges",1530.31,15.3,,1224.25,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,6901.38,69,,,,,0,"fee schedule","69% of total billed charges",10002,100,,8001.60,,,0,"percent of total billed charges","100% of total billed charges",10002,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10002,100,,8001.60,,,0,"percent of total billed charges","100% of total billed charges",10002,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10002,100,,8001.60,,,0,"percent of total billed charges","100% of total billed charges",10002,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10002,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,10002,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10002,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10002,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,10002,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3770.75,37.7,,3016.60,,,0,"percent of total billed charges","37.70% of total billed charges",10002,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10002,100,,,,,0,"fee schedule","100% of CMS fee schedule",7801.56,78,,6241.25,,,0,"percent of total billed charges","78% of total billed charges",10002,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8261.65,82.6,,6609.32,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",10002,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8261.65,82.6,,6609.32,,,0,"percent of total billed charges","82.6% of total billed charges",10002,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,10002,100,,8001.60,,,0,"percent of total billed charges","100% of total billed charges",1530.31,10002,
"61606 Resection or excision of neoplastic, vascula",7962036,CDM,521,RC,61606,CPT,OUTPATIENT,,,11984,7789.6,,10545.92,88,,8436.74,,,0,"percent of total billed charges","88% of total billed charges",11984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",11984,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,11984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7549.92,63,,6039.94,,,0,"percent of total billed charges","63% of total billed charges",1833.55,15.3,,1466.84,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,8268.96,69,,,,,0,"fee schedule","69% of total billed charges",11984,100,,9587.20,,,0,"percent of total billed charges","100% of total billed charges",11984,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11984,100,,9587.20,,,0,"percent of total billed charges","100% of total billed charges",11984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11984,100,,9587.20,,,0,"percent of total billed charges","100% of total billed charges",11984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,11984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",11984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,11984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4517.97,37.7,,3614.38,,,0,"percent of total billed charges","37.70% of total billed charges",11984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",11984,100,,,,,0,"fee schedule","100% of CMS fee schedule",9347.52,78,,7478.02,,,0,"percent of total billed charges","78% of total billed charges",11984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9898.78,82.6,,7919.02,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",11984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9898.78,82.6,,7919.02,,,0,"percent of total billed charges","82.6% of total billed charges",11984,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,11984,100,,9587.20,,,0,"percent of total billed charges","100% of total billed charges",1833.55,11984,
"61608 Resection or excision of neoplastic, vascula",7962082,CDM,521,RC,61608,CPT,OUTPATIENT,,,13065,8492.25,,11497.2,88,,9197.76,,,0,"percent of total billed charges","88% of total billed charges",13065,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",13065,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,13065,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8230.95,63,,6584.76,,,0,"percent of total billed charges","63% of total billed charges",1998.95,15.3,,1599.16,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,9014.85,69,,,,,0,"fee schedule","69% of total billed charges",13065,100,,10452.00,,,0,"percent of total billed charges","100% of total billed charges",13065,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13065,100,,10452.00,,,0,"percent of total billed charges","100% of total billed charges",13065,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13065,100,,10452.00,,,0,"percent of total billed charges","100% of total billed charges",13065,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13065,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,13065,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13065,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",13065,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,13065,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4925.51,37.7,,3940.41,,,0,"percent of total billed charges","37.70% of total billed charges",13065,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",13065,100,,,,,0,"fee schedule","100% of CMS fee schedule",10190.7,78,,8152.56,,,0,"percent of total billed charges","78% of total billed charges",13065,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10791.69,82.6,,8633.35,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",13065,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10791.69,82.6,,8633.35,,,0,"percent of total billed charges","82.6% of total billed charges",13065,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,13065,100,,10452.00,,,0,"percent of total billed charges","100% of total billed charges",1998.95,13065,
"61607 Resection or excision of neoplastic, vascula",7962120,CDM,521,RC,61607,CPT,OUTPATIENT,,,12225,7946.25,,10758,88,,8606.40,,,0,"percent of total billed charges","88% of total billed charges",12225,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12225,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,12225,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7701.75,63,,6161.40,,,0,"percent of total billed charges","63% of total billed charges",1870.43,15.3,,1496.34,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,8435.25,69,,,,,0,"fee schedule","69% of total billed charges",12225,100,,9780.00,,,0,"percent of total billed charges","100% of total billed charges",12225,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12225,100,,9780.00,,,0,"percent of total billed charges","100% of total billed charges",12225,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12225,100,,9780.00,,,0,"percent of total billed charges","100% of total billed charges",12225,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12225,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,12225,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12225,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",12225,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,12225,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4608.83,37.7,,3687.06,,,0,"percent of total billed charges","37.70% of total billed charges",12225,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",12225,100,,,,,0,"fee schedule","100% of CMS fee schedule",9535.5,78,,7628.40,,,0,"percent of total billed charges","78% of total billed charges",12225,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10097.85,82.6,,8078.28,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",12225,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10097.85,82.6,,8078.28,,,0,"percent of total billed charges","82.6% of total billed charges",12225,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,12225,100,,9780.00,,,0,"percent of total billed charges","100% of total billed charges",1870.43,12225,
"61618 Secondary repair of dura for cerebrospinal f",7962752,CDM,521,RC,61618,CPT,OUTPATIENT,,,5658,3677.7,,4979.04,88,,3983.23,,,0,"percent of total billed charges","88% of total billed charges",5658,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5658,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,5658,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3564.54,63,,2851.63,,,0,"percent of total billed charges","63% of total billed charges",865.67,15.3,,692.54,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,3904.02,69,,,,,0,"fee schedule","69% of total billed charges",5658,100,,4526.40,,,0,"percent of total billed charges","100% of total billed charges",5658,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5658,100,,4526.40,,,0,"percent of total billed charges","100% of total billed charges",5658,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5658,100,,4526.40,,,0,"percent of total billed charges","100% of total billed charges",5658,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5658,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,5658,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5658,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5658,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,5658,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2133.07,37.7,,1706.46,,,0,"percent of total billed charges","37.70% of total billed charges",5658,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5658,100,,,,,0,"fee schedule","100% of CMS fee schedule",4413.24,78,,3530.59,,,0,"percent of total billed charges","78% of total billed charges",5658,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4673.51,82.6,,3738.81,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",5658,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4673.51,82.6,,3738.81,,,0,"percent of total billed charges","82.6% of total billed charges",5658,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,5658,100,,4526.40,,,0,"percent of total billed charges","100% of total billed charges",865.67,5658,
"61624 Transcatheter permanent occlusion/embolizati",7962425,CDM,521,RC,61624,CPT,OUTPATIENT,,,6284,4084.6,,5529.92,88,,4423.94,,,0,"percent of total billed charges","88% of total billed charges",6284,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10125.25,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6284,175,,,,,0,"fee schedule","175% of CMS fee schedule",10429,100,,,,,0,"fee schedule",EAPG,6284,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3958.92,63,,3167.14,,,0,"percent of total billed charges","63% of total billed charges",961.45,15.3,,769.16,,,0,"percent of total billed charges","15.3% of total billed charges",10125.25,100,,,,,0,"fee schedule",EAPG,4335.96,69,,,,,0,"fee schedule","69% of total billed charges",6284,100,,5027.20,,,0,"percent of total billed charges","100% of total billed charges",6284,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6284,100,,5027.20,,,0,"percent of total billed charges","100% of total billed charges",6284,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6284,100,,5027.20,,,0,"percent of total billed charges","100% of total billed charges",6284,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",65260.52,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10125.25,100,,,,,0,"fee schedule",EAPG,6284,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6284,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",6284,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10327.75,100,,,,,0,"fee schedule",EAPG,13162.82,100,,,,,0,"fee schedule",EAPG,6284,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2369.07,37.7,,1895.26,,,0,"percent of total billed charges","37.70% of total billed charges",6284,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6284,100,,,,,0,"fee schedule","100% of CMS fee schedule",4901.52,78,,3921.22,,,0,"percent of total billed charges","78% of total billed charges",6284,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5190.58,82.6,,4152.46,,,0,"percent of total billed charges","82.6% of total billed charges",10125.25,100,,,,,0,"fee schedule","100% of WA fee schedule",6284,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5190.58,82.6,,4152.46,,,0,"percent of total billed charges","82.6% of total billed charges",6284,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10285.78,100,,,,,0,"fee schedule",EAPG,6284,100,,5027.20,,,0,"percent of total billed charges","100% of total billed charges",961.45,65260.52,
"61635 Transcatheter placement of intravascular ste",7962037,CDM,521,RC,61635,CPT,OUTPATIENT,,,9249,6011.85,,8139.12,88,,6511.30,,,0,"percent of total billed charges","88% of total billed charges",9249,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10125.25,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9249,175,,,,,0,"fee schedule","175% of CMS fee schedule",10429,100,,,,,0,"fee schedule",EAPG,9249,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5826.87,63,,4661.50,,,0,"percent of total billed charges","63% of total billed charges",1415.1,15.3,,1132.08,,,0,"percent of total billed charges","15.3% of total billed charges",10125.25,100,,,,,0,"fee schedule",EAPG,6381.81,69,,,,,0,"fee schedule","69% of total billed charges",9249,100,,7399.20,,,0,"percent of total billed charges","100% of total billed charges",9249,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9249,100,,7399.20,,,0,"percent of total billed charges","100% of total billed charges",9249,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9249,100,,7399.20,,,0,"percent of total billed charges","100% of total billed charges",9249,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9249,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10125.25,100,,,,,0,"fee schedule",EAPG,9249,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9249,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9249,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10327.75,100,,,,,0,"fee schedule",EAPG,13162.82,100,,,,,0,"fee schedule",EAPG,9249,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3486.87,37.7,,2789.50,,,0,"percent of total billed charges","37.70% of total billed charges",9249,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9249,100,,,,,0,"fee schedule","100% of CMS fee schedule",7214.22,78,,5771.38,,,0,"percent of total billed charges","78% of total billed charges",9249,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7639.67,82.6,,6111.74,,,0,"percent of total billed charges","82.6% of total billed charges",10125.25,100,,,,,0,"fee schedule","100% of WA fee schedule",9249,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7639.67,82.6,,6111.74,,,0,"percent of total billed charges","82.6% of total billed charges",9249,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10285.78,100,,,,,0,"fee schedule",EAPG,9249,100,,7399.20,,,0,"percent of total billed charges","100% of total billed charges",1415.1,13162.82,
"61686 Surgery of intracranial arteriovenous malfor",7962582,CDM,521,RC,61686,CPT,OUTPATIENT,,,19638,12764.7,,17281.44,88,,13825.15,,,0,"percent of total billed charges","88% of total billed charges",19638,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4315.84,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",19638,175,,,,,0,"fee schedule","175% of CMS fee schedule",4445.32,100,,,,,0,"fee schedule",EAPG,19638,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12371.94,63,,9897.55,,,0,"percent of total billed charges","63% of total billed charges",3004.61,15.3,,2403.69,,,0,"percent of total billed charges","15.3% of total billed charges",4315.84,100,,,,,0,"fee schedule",EAPG,13550.22,69,,,,,0,"fee schedule","69% of total billed charges",19638,100,,15710.40,,,0,"percent of total billed charges","100% of total billed charges",19638,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19638,100,,15710.40,,,0,"percent of total billed charges","100% of total billed charges",19638,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19638,100,,15710.40,,,0,"percent of total billed charges","100% of total billed charges",19638,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19638,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4315.84,100,,,,,0,"fee schedule",EAPG,19638,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",19638,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",19638,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4402.16,100,,,,,0,"fee schedule",EAPG,5610.6,100,,,,,0,"fee schedule",EAPG,19638,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7403.53,37.7,,5922.82,,,0,"percent of total billed charges","37.70% of total billed charges",19638,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",19638,100,,,,,0,"fee schedule","100% of CMS fee schedule",15317.64,78,,12254.11,,,0,"percent of total billed charges","78% of total billed charges",19638,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",16220.99,82.6,,12976.79,,,0,"percent of total billed charges","82.6% of total billed charges",4315.84,100,,,,,0,"fee schedule","100% of WA fee schedule",19638,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",16220.99,82.6,,12976.79,,,0,"percent of total billed charges","82.6% of total billed charges",19638,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4476.37,100,,,,,0,"fee schedule",EAPG,19638,100,,15710.40,,,0,"percent of total billed charges","100% of total billed charges",3004.61,19638,
"61680 Surgery of intracranial arteriovenous malfor",7962617,CDM,521,RC,61680,CPT,OUTPATIENT,,,7655,4975.75,,6736.4,88,,5389.12,,,0,"percent of total billed charges","88% of total billed charges",7655,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4315.84,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7655,175,,,,,0,"fee schedule","175% of CMS fee schedule",4445.32,100,,,,,0,"fee schedule",EAPG,7655,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4822.65,63,,3858.12,,,0,"percent of total billed charges","63% of total billed charges",1171.22,15.3,,936.98,,,0,"percent of total billed charges","15.3% of total billed charges",4315.84,100,,,,,0,"fee schedule",EAPG,5281.95,69,,,,,0,"fee schedule","69% of total billed charges",7655,100,,6124.00,,,0,"percent of total billed charges","100% of total billed charges",7655,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7655,100,,6124.00,,,0,"percent of total billed charges","100% of total billed charges",7655,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7655,100,,6124.00,,,0,"percent of total billed charges","100% of total billed charges",7655,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7655,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4315.84,100,,,,,0,"fee schedule",EAPG,7655,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7655,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7655,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4402.16,100,,,,,0,"fee schedule",EAPG,5610.6,100,,,,,0,"fee schedule",EAPG,7655,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2885.94,37.7,,2308.75,,,0,"percent of total billed charges","37.70% of total billed charges",7655,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7655,100,,,,,0,"fee schedule","100% of CMS fee schedule",5970.9,78,,4776.72,,,0,"percent of total billed charges","78% of total billed charges",7655,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6323.03,82.6,,5058.42,,,0,"percent of total billed charges","82.6% of total billed charges",4315.84,100,,,,,0,"fee schedule","100% of WA fee schedule",7655,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6323.03,82.6,,5058.42,,,0,"percent of total billed charges","82.6% of total billed charges",7655,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4476.37,100,,,,,0,"fee schedule",EAPG,7655,100,,6124.00,,,0,"percent of total billed charges","100% of total billed charges",1171.22,7655,
"61684 Surgery of intracranial arteriovenous malfor",7962618,CDM,521,RC,61684,CPT,OUTPATIENT,,,15608,10145.2,,13735.04,88,,10988.03,,,0,"percent of total billed charges","88% of total billed charges",15608,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4315.84,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",15608,175,,,,,0,"fee schedule","175% of CMS fee schedule",4445.32,100,,,,,0,"fee schedule",EAPG,15608,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9833.04,63,,7866.43,,,0,"percent of total billed charges","63% of total billed charges",2388.02,15.3,,1910.42,,,0,"percent of total billed charges","15.3% of total billed charges",4315.84,100,,,,,0,"fee schedule",EAPG,10769.52,69,,,,,0,"fee schedule","69% of total billed charges",15608,100,,12486.40,,,0,"percent of total billed charges","100% of total billed charges",15608,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",15608,100,,12486.40,,,0,"percent of total billed charges","100% of total billed charges",15608,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",15608,100,,12486.40,,,0,"percent of total billed charges","100% of total billed charges",15608,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",15608,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4315.84,100,,,,,0,"fee schedule",EAPG,15608,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",15608,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",15608,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4402.16,100,,,,,0,"fee schedule",EAPG,5610.6,100,,,,,0,"fee schedule",EAPG,15608,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5884.22,37.7,,4707.38,,,0,"percent of total billed charges","37.70% of total billed charges",15608,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",15608,100,,,,,0,"fee schedule","100% of CMS fee schedule",12174.24,78,,9739.39,,,0,"percent of total billed charges","78% of total billed charges",15608,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12892.21,82.6,,10313.77,,,0,"percent of total billed charges","82.6% of total billed charges",4315.84,100,,,,,0,"fee schedule","100% of WA fee schedule",15608,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12892.21,82.6,,10313.77,,,0,"percent of total billed charges","82.6% of total billed charges",15608,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4476.37,100,,,,,0,"fee schedule",EAPG,15608,100,,12486.40,,,0,"percent of total billed charges","100% of total billed charges",2388.02,15608,
"61682 Surgery of intracranial arteriovenous malfor",7962655,CDM,521,RC,61682,CPT,OUTPATIENT,,,15823,10284.95,,13924.24,88,,11139.39,,,0,"percent of total billed charges","88% of total billed charges",15823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4315.84,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",15823,175,,,,,0,"fee schedule","175% of CMS fee schedule",4445.32,100,,,,,0,"fee schedule",EAPG,15823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9968.49,63,,7974.79,,,0,"percent of total billed charges","63% of total billed charges",2420.92,15.3,,1936.74,,,0,"percent of total billed charges","15.3% of total billed charges",4315.84,100,,,,,0,"fee schedule",EAPG,10917.87,69,,,,,0,"fee schedule","69% of total billed charges",15823,100,,12658.40,,,0,"percent of total billed charges","100% of total billed charges",15823,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",15823,100,,12658.40,,,0,"percent of total billed charges","100% of total billed charges",15823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",15823,100,,12658.40,,,0,"percent of total billed charges","100% of total billed charges",15823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",15823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4315.84,100,,,,,0,"fee schedule",EAPG,15823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",15823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",15823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4402.16,100,,,,,0,"fee schedule",EAPG,5610.6,100,,,,,0,"fee schedule",EAPG,15823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5965.27,37.7,,4772.22,,,0,"percent of total billed charges","37.70% of total billed charges",15823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",15823,100,,,,,0,"fee schedule","100% of CMS fee schedule",12341.94,78,,9873.55,,,0,"percent of total billed charges","78% of total billed charges",15823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13069.8,82.6,,10455.84,,,0,"percent of total billed charges","82.6% of total billed charges",4315.84,100,,,,,0,"fee schedule","100% of WA fee schedule",15823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13069.8,82.6,,10455.84,,,0,"percent of total billed charges","82.6% of total billed charges",15823,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4476.37,100,,,,,0,"fee schedule",EAPG,15823,100,,12658.40,,,0,"percent of total billed charges","100% of total billed charges",2420.92,15823,
"61698 Surgery of complex intracranial aneurysm, in",7962038,CDM,521,RC,61698,CPT,OUTPATIENT,,,22976,14934.4,,20218.88,88,,16175.10,,,0,"percent of total billed charges","88% of total billed charges",22976,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4315.84,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",22976,175,,,,,0,"fee schedule","175% of CMS fee schedule",4445.32,100,,,,,0,"fee schedule",EAPG,22976,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",14474.88,63,,11579.90,,,0,"percent of total billed charges","63% of total billed charges",3515.33,15.3,,2812.26,,,0,"percent of total billed charges","15.3% of total billed charges",4315.84,100,,,,,0,"fee schedule",EAPG,15853.44,69,,,,,0,"fee schedule","69% of total billed charges",22976,100,,18380.80,,,0,"percent of total billed charges","100% of total billed charges",22976,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",22976,100,,18380.80,,,0,"percent of total billed charges","100% of total billed charges",22976,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",22976,100,,18380.80,,,0,"percent of total billed charges","100% of total billed charges",22976,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",22976,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4315.84,100,,,,,0,"fee schedule",EAPG,22976,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",22976,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",22976,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4402.16,100,,,,,0,"fee schedule",EAPG,5610.6,100,,,,,0,"fee schedule",EAPG,22976,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8661.95,37.7,,6929.56,,,0,"percent of total billed charges","37.70% of total billed charges",22976,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",22976,100,,,,,0,"fee schedule","100% of CMS fee schedule",17921.28,78,,14337.02,,,0,"percent of total billed charges","78% of total billed charges",22976,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",18978.18,82.6,,15182.54,,,0,"percent of total billed charges","82.6% of total billed charges",4315.84,100,,,,,0,"fee schedule","100% of WA fee schedule",22976,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",18978.18,82.6,,15182.54,,,0,"percent of total billed charges","82.6% of total billed charges",22976,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4476.37,100,,,,,0,"fee schedule",EAPG,22976,100,,18380.80,,,0,"percent of total billed charges","100% of total billed charges",3515.33,22976,
"61697 Surgery of complex intracranial aneurysm, in",7962276,CDM,521,RC,61697,CPT,OUTPATIENT,,,12931,8405.15,,11379.28,88,,9103.42,,,0,"percent of total billed charges","88% of total billed charges",12931,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4315.84,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12931,175,,,,,0,"fee schedule","175% of CMS fee schedule",4445.32,100,,,,,0,"fee schedule",EAPG,12931,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8146.53,63,,6517.22,,,0,"percent of total billed charges","63% of total billed charges",1978.44,15.3,,1582.75,,,0,"percent of total billed charges","15.3% of total billed charges",4315.84,100,,,,,0,"fee schedule",EAPG,8922.39,69,,,,,0,"fee schedule","69% of total billed charges",12931,100,,10344.80,,,0,"percent of total billed charges","100% of total billed charges",12931,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12931,100,,10344.80,,,0,"percent of total billed charges","100% of total billed charges",12931,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12931,100,,10344.80,,,0,"percent of total billed charges","100% of total billed charges",12931,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12931,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4315.84,100,,,,,0,"fee schedule",EAPG,12931,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12931,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",12931,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4402.16,100,,,,,0,"fee schedule",EAPG,5610.6,100,,,,,0,"fee schedule",EAPG,12931,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4874.99,37.7,,3899.99,,,0,"percent of total billed charges","37.70% of total billed charges",12931,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",12931,100,,,,,0,"fee schedule","100% of CMS fee schedule",10086.18,78,,8068.94,,,0,"percent of total billed charges","78% of total billed charges",12931,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10681.01,82.6,,8544.81,,,0,"percent of total billed charges","82.6% of total billed charges",4315.84,100,,,,,0,"fee schedule","100% of WA fee schedule",12931,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10681.01,82.6,,8544.81,,,0,"percent of total billed charges","82.6% of total billed charges",12931,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4476.37,100,,,,,0,"fee schedule",EAPG,12931,100,,10344.80,,,0,"percent of total billed charges","100% of total billed charges",1978.44,12931,
"61702 Surgery of simple intracranial aneurysm, int",7962039,CDM,521,RC,61702,CPT,OUTPATIENT,,,17464,11351.6,,15368.32,88,,12294.66,,,0,"percent of total billed charges","88% of total billed charges",17464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4315.84,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",17464,175,,,,,0,"fee schedule","175% of CMS fee schedule",4445.32,100,,,,,0,"fee schedule",EAPG,17464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11002.32,63,,8801.86,,,0,"percent of total billed charges","63% of total billed charges",2671.99,15.3,,2137.59,,,0,"percent of total billed charges","15.3% of total billed charges",4315.84,100,,,,,0,"fee schedule",EAPG,12050.16,69,,,,,0,"fee schedule","69% of total billed charges",17464,100,,13971.20,,,0,"percent of total billed charges","100% of total billed charges",17464,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",17464,100,,13971.20,,,0,"percent of total billed charges","100% of total billed charges",17464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",17464,100,,13971.20,,,0,"percent of total billed charges","100% of total billed charges",17464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",17464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4315.84,100,,,,,0,"fee schedule",EAPG,17464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",17464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",17464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4402.16,100,,,,,0,"fee schedule",EAPG,5610.6,100,,,,,0,"fee schedule",EAPG,17464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6583.93,37.7,,5267.14,,,0,"percent of total billed charges","37.70% of total billed charges",17464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",17464,100,,,,,0,"fee schedule","100% of CMS fee schedule",13621.92,78,,10897.54,,,0,"percent of total billed charges","78% of total billed charges",17464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",14425.26,82.6,,11540.21,,,0,"percent of total billed charges","82.6% of total billed charges",4315.84,100,,,,,0,"fee schedule","100% of WA fee schedule",17464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",14425.26,82.6,,11540.21,,,0,"percent of total billed charges","82.6% of total billed charges",17464,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4476.37,100,,,,,0,"fee schedule",EAPG,17464,100,,13971.20,,,0,"percent of total billed charges","100% of total billed charges",2671.99,17464,
"61705 Surgery of aneurysm, vascular malformation o",7962040,CDM,521,RC,61705,CPT,OUTPATIENT,,,8687,5646.55,,7644.56,88,,6115.65,,,0,"percent of total billed charges","88% of total billed charges",8687,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4315.84,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8687,175,,,,,0,"fee schedule","175% of CMS fee schedule",4445.32,100,,,,,0,"fee schedule",EAPG,8687,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5472.81,63,,4378.25,,,0,"percent of total billed charges","63% of total billed charges",1329.11,15.3,,1063.29,,,0,"percent of total billed charges","15.3% of total billed charges",4315.84,100,,,,,0,"fee schedule",EAPG,5994.03,69,,,,,0,"fee schedule","69% of total billed charges",8687,100,,6949.60,,,0,"percent of total billed charges","100% of total billed charges",8687,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8687,100,,6949.60,,,0,"percent of total billed charges","100% of total billed charges",8687,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8687,100,,6949.60,,,0,"percent of total billed charges","100% of total billed charges",8687,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8687,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4315.84,100,,,,,0,"fee schedule",EAPG,8687,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8687,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8687,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4402.16,100,,,,,0,"fee schedule",EAPG,5610.6,100,,,,,0,"fee schedule",EAPG,8687,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3275,37.7,,2620.00,,,0,"percent of total billed charges","37.70% of total billed charges",8687,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8687,100,,,,,0,"fee schedule","100% of CMS fee schedule",6775.86,78,,5420.69,,,0,"percent of total billed charges","78% of total billed charges",8687,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7175.46,82.6,,5740.37,,,0,"percent of total billed charges","82.6% of total billed charges",4315.84,100,,,,,0,"fee schedule","100% of WA fee schedule",8687,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7175.46,82.6,,5740.37,,,0,"percent of total billed charges","82.6% of total billed charges",8687,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4476.37,100,,,,,0,"fee schedule",EAPG,8687,100,,6949.60,,,0,"percent of total billed charges","100% of total billed charges",1329.11,8687,
"61700 Surgery of simple intracranial aneurysm, int",7962391,CDM,521,RC,61700,CPT,OUTPATIENT,,,12979,8436.35,,11421.52,88,,9137.22,,,0,"percent of total billed charges","88% of total billed charges",12979,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4315.84,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12979,175,,,,,0,"fee schedule","175% of CMS fee schedule",4445.32,100,,,,,0,"fee schedule",EAPG,12979,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8176.77,63,,6541.42,,,0,"percent of total billed charges","63% of total billed charges",1985.79,15.3,,1588.63,,,0,"percent of total billed charges","15.3% of total billed charges",4315.84,100,,,,,0,"fee schedule",EAPG,8955.51,69,,,,,0,"fee schedule","69% of total billed charges",12979,100,,10383.20,,,0,"percent of total billed charges","100% of total billed charges",12979,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12979,100,,10383.20,,,0,"percent of total billed charges","100% of total billed charges",12979,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12979,100,,10383.20,,,0,"percent of total billed charges","100% of total billed charges",12979,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12979,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4315.84,100,,,,,0,"fee schedule",EAPG,12979,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12979,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",12979,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4402.16,100,,,,,0,"fee schedule",EAPG,5610.6,100,,,,,0,"fee schedule",EAPG,12979,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4893.08,37.7,,3914.46,,,0,"percent of total billed charges","37.70% of total billed charges",12979,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",12979,100,,,,,0,"fee schedule","100% of CMS fee schedule",10123.62,78,,8098.90,,,0,"percent of total billed charges","78% of total billed charges",12979,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10720.65,82.6,,8576.52,,,0,"percent of total billed charges","82.6% of total billed charges",4315.84,100,,,,,0,"fee schedule","100% of WA fee schedule",12979,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10720.65,82.6,,8576.52,,,0,"percent of total billed charges","82.6% of total billed charges",12979,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4476.37,100,,,,,0,"fee schedule",EAPG,12979,100,,10383.20,,,0,"percent of total billed charges","100% of total billed charges",1985.79,12979,
"61750 Stereotactic biopsy, aspiration, or excision",7961558,CDM,521,RC,61750,CPT,OUTPATIENT,,,8092,5259.8,,7120.96,88,,5696.77,,,0,"percent of total billed charges","88% of total billed charges",8092,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8092,175,,,,,0,"fee schedule","175% of CMS fee schedule",5945.4,100,,,,,0,"fee schedule",EAPG,8092,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5097.96,63,,4078.37,,,0,"percent of total billed charges","63% of total billed charges",1238.08,15.3,,990.46,,,0,"percent of total billed charges","15.3% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,5583.48,69,,,,,0,"fee schedule","69% of total billed charges",8092,100,,6473.60,,,0,"percent of total billed charges","100% of total billed charges",8092,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8092,100,,6473.60,,,0,"percent of total billed charges","100% of total billed charges",8092,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8092,100,,6473.60,,,0,"percent of total billed charges","100% of total billed charges",8092,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8092,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,8092,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8092,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8092,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5887.68,100,,,,,0,"fee schedule",EAPG,7503.9,100,,,,,0,"fee schedule",EAPG,8092,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3050.68,37.7,,2440.54,,,0,"percent of total billed charges","37.70% of total billed charges",8092,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8092,100,,,,,0,"fee schedule","100% of CMS fee schedule",6311.76,78,,5049.41,,,0,"percent of total billed charges","78% of total billed charges",8092,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6683.99,82.6,,5347.19,,,0,"percent of total billed charges","82.6% of total billed charges",5772.23,100,,,,,0,"fee schedule","100% of WA fee schedule",8092,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6683.99,82.6,,5347.19,,,0,"percent of total billed charges","82.6% of total billed charges",8092,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5932.76,100,,,,,0,"fee schedule",EAPG,8092,100,,6473.60,,,0,"percent of total billed charges","100% of total billed charges",1238.08,8092,
"61751 Stereotactic biopsy, aspiration, or excision",7962110,CDM,521,RC,61751,CPT,OUTPATIENT,,,8586,5580.9,,7555.68,88,,6044.54,,,0,"percent of total billed charges","88% of total billed charges",8586,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8586,175,,,,,0,"fee schedule","175% of CMS fee schedule",5945.4,100,,,,,0,"fee schedule",EAPG,8586,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5409.18,63,,4327.34,,,0,"percent of total billed charges","63% of total billed charges",1313.66,15.3,,1050.93,,,0,"percent of total billed charges","15.3% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,5924.34,69,,,,,0,"fee schedule","69% of total billed charges",8586,100,,6868.80,,,0,"percent of total billed charges","100% of total billed charges",8586,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8586,100,,6868.80,,,0,"percent of total billed charges","100% of total billed charges",8586,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8586,100,,6868.80,,,0,"percent of total billed charges","100% of total billed charges",8586,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8586,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,8586,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8586,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8586,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5887.68,100,,,,,0,"fee schedule",EAPG,7503.9,100,,,,,0,"fee schedule",EAPG,8586,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3236.92,37.7,,2589.54,,,0,"percent of total billed charges","37.70% of total billed charges",8586,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8586,100,,,,,0,"fee schedule","100% of CMS fee schedule",6697.08,78,,5357.66,,,0,"percent of total billed charges","78% of total billed charges",8586,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7092.04,82.6,,5673.63,,,0,"percent of total billed charges","82.6% of total billed charges",5772.23,100,,,,,0,"fee schedule","100% of WA fee schedule",8586,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7092.04,82.6,,5673.63,,,0,"percent of total billed charges","82.6% of total billed charges",8586,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5932.76,100,,,,,0,"fee schedule",EAPG,8586,100,,6868.80,,,0,"percent of total billed charges","100% of total billed charges",1313.66,8586,
"61850 Twist drill or burr hole(s) for implantation",7962277,CDM,521,RC,61850,CPT,OUTPATIENT,,,5046,3279.9,,4440.48,88,,3552.38,,,0,"percent of total billed charges","88% of total billed charges",5046,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",18609.86,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5046,175,,,,,0,"fee schedule","175% of CMS fee schedule",19168.16,100,,,,,0,"fee schedule",EAPG,5046,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3178.98,63,,2543.18,,,0,"percent of total billed charges","63% of total billed charges",772.04,15.3,,617.63,,,0,"percent of total billed charges","15.3% of total billed charges",18609.86,100,,,,,0,"fee schedule",EAPG,3481.74,69,,,,,0,"fee schedule","69% of total billed charges",5046,100,,4036.80,,,0,"percent of total billed charges","100% of total billed charges",5046,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5046,100,,4036.80,,,0,"percent of total billed charges","100% of total billed charges",5046,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5046,100,,4036.80,,,0,"percent of total billed charges","100% of total billed charges",5046,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5046,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",18609.86,100,,,,,0,"fee schedule",EAPG,5046,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5046,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5046,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",18982.06,100,,,,,0,"fee schedule",EAPG,24192.82,100,,,,,0,"fee schedule",EAPG,5046,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1902.34,37.7,,1521.87,,,0,"percent of total billed charges","37.70% of total billed charges",5046,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5046,100,,,,,0,"fee schedule","100% of CMS fee schedule",3935.88,78,,3148.70,,,0,"percent of total billed charges","78% of total billed charges",5046,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4168,82.6,,3334.40,,,0,"percent of total billed charges","82.6% of total billed charges",18609.86,100,,,,,0,"fee schedule",EAPG,5046,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4168,82.6,,3334.40,,,0,"percent of total billed charges","82.6% of total billed charges",5046,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",18770.39,100,,,,,0,"fee schedule",EAPG,5046,100,,4036.80,,,0,"percent of total billed charges","100% of total billed charges",772.04,24192.82,
"61860 Craniectomy or craniotomy for implantation o",7962041,CDM,521,RC,61860,CPT,OUTPATIENT,,,8211,5337.15,,7225.68,88,,5780.54,,,0,"percent of total billed charges","88% of total billed charges",8211,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",18609.86,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8211,175,,,,,0,"fee schedule","175% of CMS fee schedule",19168.16,100,,,,,0,"fee schedule",EAPG,8211,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5172.93,63,,4138.34,,,0,"percent of total billed charges","63% of total billed charges",1256.28,15.3,,1005.02,,,0,"percent of total billed charges","15.3% of total billed charges",18609.86,100,,,,,0,"fee schedule",EAPG,5665.59,69,,,,,0,"fee schedule","69% of total billed charges",8211,100,,6568.80,,,0,"percent of total billed charges","100% of total billed charges",8211,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8211,100,,6568.80,,,0,"percent of total billed charges","100% of total billed charges",8211,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8211,100,,6568.80,,,0,"percent of total billed charges","100% of total billed charges",8211,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8211,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",18609.86,100,,,,,0,"fee schedule",EAPG,8211,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8211,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8211,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",18982.06,100,,,,,0,"fee schedule",EAPG,24192.82,100,,,,,0,"fee schedule",EAPG,8211,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3095.55,37.7,,2476.44,,,0,"percent of total billed charges","37.70% of total billed charges",8211,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8211,100,,,,,0,"fee schedule","100% of CMS fee schedule",6404.58,78,,5123.66,,,0,"percent of total billed charges","78% of total billed charges",8211,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6782.29,82.6,,5425.83,,,0,"percent of total billed charges","82.6% of total billed charges",18609.86,100,,,,,0,"fee schedule","100% of WA fee schedule",8211,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6782.29,82.6,,5425.83,,,0,"percent of total billed charges","82.6% of total billed charges",8211,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",18770.39,100,,,,,0,"fee schedule",EAPG,8211,100,,6568.80,,,0,"percent of total billed charges","100% of total billed charges",1256.28,24192.82,
"61863 Twist drill, burr hole, craniotomy, or crani",7962042,CDM,521,RC,61863,CPT,OUTPATIENT,,,7846,5099.9,,6904.48,88,,5523.58,,,0,"percent of total billed charges","88% of total billed charges",7846,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",18609.86,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7846,175,,,,,0,"fee schedule","175% of CMS fee schedule",19168.16,100,,,,,0,"fee schedule",EAPG,7846,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4942.98,63,,3954.38,,,0,"percent of total billed charges","63% of total billed charges",1200.44,15.3,,960.35,,,0,"percent of total billed charges","15.3% of total billed charges",18609.86,100,,,,,0,"fee schedule",EAPG,5413.74,69,,,,,0,"fee schedule","69% of total billed charges",7846,100,,6276.80,,,0,"percent of total billed charges","100% of total billed charges",7846,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7846,100,,6276.80,,,0,"percent of total billed charges","100% of total billed charges",7846,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7846,100,,6276.80,,,0,"percent of total billed charges","100% of total billed charges",7846,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7846,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",18609.86,100,,,,,0,"fee schedule",EAPG,7846,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7846,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7846,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",18982.06,100,,,,,0,"fee schedule",EAPG,24192.82,100,,,,,0,"fee schedule",EAPG,7846,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2957.94,37.7,,2366.35,,,0,"percent of total billed charges","37.70% of total billed charges",7846,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7846,100,,,,,0,"fee schedule","100% of CMS fee schedule",6119.88,78,,4895.90,,,0,"percent of total billed charges","78% of total billed charges",7846,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6480.8,82.6,,5184.64,,,0,"percent of total billed charges","82.6% of total billed charges",18609.86,100,,,,,0,"fee schedule","100% of WA fee schedule",7846,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6480.8,82.6,,5184.64,,,0,"percent of total billed charges","82.6% of total billed charges",7846,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",18770.39,100,,,,,0,"fee schedule",EAPG,7846,100,,6276.80,,,0,"percent of total billed charges","100% of total billed charges",1200.44,24192.82,
"61885 Insertion/replacement of cranial neurostimul",7961545,CDM,521,RC,61885,CPT,OUTPATIENT,,,2417,1571.05,,2126.96,88,,1701.57,,,0,"percent of total billed charges","88% of total billed charges",22312.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18609.86,100,,,,,0,"fee schedule",EAPG,2417,100,,1933.60,,,0,"percent of total billed charges","100% of total billed charges",39046.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",19168.16,100,,,,,0,"fee schedule",EAPG,22312.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1522.71,63,,1218.17,,,0,"percent of total billed charges","63% of total billed charges",369.8,15.3,,295.84,,,0,"percent of total billed charges","15.3% of total billed charges",18609.86,100,,,,,0,"fee schedule",EAPG,1667.73,69,,,,,0,"fee schedule","69% of total billed charges",2417,100,,1933.60,,,0,"percent of total billed charges","100% of total billed charges",22312.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2417,100,,1933.60,,,0,"percent of total billed charges","100% of total billed charges",22312.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2417,100,,1933.60,,,0,"percent of total billed charges","100% of total billed charges",22312.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",83199.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18609.86,100,,,,,0,"fee schedule",EAPG,22312.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",21751.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",22312.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18982.06,100,,,,,0,"fee schedule",EAPG,24192.82,100,,,,,0,"fee schedule",EAPG,22312.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",911.21,37.7,,728.97,,,0,"percent of total billed charges","37.70% of total billed charges",22312.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",22312.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1885.26,78,,1508.21,,,0,"percent of total billed charges","78% of total billed charges",22535.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1996.44,82.6,,1597.15,,,0,"percent of total billed charges","82.6% of total billed charges",18609.86,100,,,,,0,"fee schedule",EAPG,22312.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1996.44,82.6,,1597.15,,,0,"percent of total billed charges","82.6% of total billed charges",22312.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18770.39,100,,,,,0,"fee schedule",EAPG,2417,100,,1933.60,,,0,"percent of total billed charges","100% of total billed charges",369.8,83199.76,
"61886 Insert or replace cranial neurostimulator pu",7963034,CDM,521,RC,61886,CPT,OUTPATIENT,,,3091,2009.15,,2720.08,88,,2176.06,,,0,"percent of total billed charges","88% of total billed charges",31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18609.86,100,,,,,0,"fee schedule",EAPG,3091,100,,2472.80,,,0,"percent of total billed charges","100% of total billed charges",55426.2,175,,,,,0,"fee schedule","175% of CMS fee schedule",19168.16,100,,,,,0,"fee schedule",EAPG,31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1947.33,63,,1557.86,,,0,"percent of total billed charges","63% of total billed charges",472.92,15.3,,378.34,,,0,"percent of total billed charges","15.3% of total billed charges",18609.86,100,,,,,0,"fee schedule",EAPG,2132.79,69,,,,,0,"fee schedule","69% of total billed charges",3091,100,,2472.80,,,0,"percent of total billed charges","100% of total billed charges",31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3091,100,,2472.80,,,0,"percent of total billed charges","100% of total billed charges",31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3091,100,,2472.80,,,0,"percent of total billed charges","100% of total billed charges",31672.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",119619.3,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18609.86,100,,,,,0,"fee schedule",EAPG,31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31273.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18982.06,100,,,,,0,"fee schedule",EAPG,24192.82,100,,,,,0,"fee schedule",EAPG,31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1165.31,37.7,,932.25,,,0,"percent of total billed charges","37.70% of total billed charges",31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2410.98,78,,1928.78,,,0,"percent of total billed charges","78% of total billed charges",31988.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2553.17,82.6,,2042.54,,,0,"percent of total billed charges","82.6% of total billed charges",18609.86,100,,,,,0,"fee schedule",EAPG,31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2553.17,82.6,,2042.54,,,0,"percent of total billed charges","82.6% of total billed charges",31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18770.39,100,,,,,0,"fee schedule",EAPG,3091,100,,2472.80,,,0,"percent of total billed charges","100% of total billed charges",472.92,119619.3,
"62005 Elevation of depressed skull fracture; compo",7962728,CDM,521,RC,62005,CPT,OUTPATIENT,,,6882,4473.3,,6056.16,88,,4844.93,,,0,"percent of total billed charges","88% of total billed charges",6882,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6882,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,6882,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4335.66,63,,3468.53,,,0,"percent of total billed charges","63% of total billed charges",1052.95,15.3,,842.36,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,4748.58,69,,,,,0,"fee schedule","69% of total billed charges",6882,100,,5505.60,,,0,"percent of total billed charges","100% of total billed charges",6882,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6882,100,,5505.60,,,0,"percent of total billed charges","100% of total billed charges",6882,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6882,100,,5505.60,,,0,"percent of total billed charges","100% of total billed charges",6882,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6882,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,6882,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6882,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6882,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,6882,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2594.51,37.7,,2075.61,,,0,"percent of total billed charges","37.70% of total billed charges",6882,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6882,100,,,,,0,"fee schedule","100% of CMS fee schedule",5367.96,78,,4294.37,,,0,"percent of total billed charges","78% of total billed charges",6882,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5684.53,82.6,,4547.62,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",6882,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5684.53,82.6,,4547.62,,,0,"percent of total billed charges","82.6% of total billed charges",6882,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,6882,100,,5505.60,,,0,"percent of total billed charges","100% of total billed charges",1052.95,6882,
"62000 Elevation of depressed skull fracture; simpl",7963163,CDM,521,RC,62000,CPT,OUTPATIENT,,,4689,3047.85,,4126.32,88,,3301.06,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5772.23,100,,,,,0,"fee schedule",EAPG,4689,100,,3751.20,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",5945.4,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2954.07,63,,2363.26,,,0,"percent of total billed charges","63% of total billed charges",717.42,15.3,,573.94,,,0,"percent of total billed charges","15.3% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,3235.41,69,,,,,0,"fee schedule","69% of total billed charges",4689,100,,3751.20,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4689,100,,3751.20,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4689,100,,3751.20,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5772.23,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5887.68,100,,,,,0,"fee schedule",EAPG,7503.9,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1767.75,37.7,,1414.20,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3657.42,78,,2925.94,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3873.11,82.6,,3098.49,,,0,"percent of total billed charges","82.6% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3873.11,82.6,,3098.49,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5932.76,100,,,,,0,"fee schedule",EAPG,4689,100,,3751.20,,,0,"percent of total billed charges","100% of total billed charges",717.42,11116.67,
"62010 Elevation of depressed skull fracture; with",7962043,CDM,521,RC,62010,CPT,OUTPATIENT,,,8758,5692.7,,7707.04,88,,6165.63,,,0,"percent of total billed charges","88% of total billed charges",8758,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8758,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,8758,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5517.54,63,,4414.03,,,0,"percent of total billed charges","63% of total billed charges",1339.97,15.3,,1071.98,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,6043.02,69,,,,,0,"fee schedule","69% of total billed charges",8758,100,,7006.40,,,0,"percent of total billed charges","100% of total billed charges",8758,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8758,100,,7006.40,,,0,"percent of total billed charges","100% of total billed charges",8758,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8758,100,,7006.40,,,0,"percent of total billed charges","100% of total billed charges",8758,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8758,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,8758,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8758,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8758,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,8758,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3301.77,37.7,,2641.42,,,0,"percent of total billed charges","37.70% of total billed charges",8758,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8758,100,,,,,0,"fee schedule","100% of CMS fee schedule",6831.24,78,,5464.99,,,0,"percent of total billed charges","78% of total billed charges",8758,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7234.11,82.6,,5787.29,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",8758,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7234.11,82.6,,5787.29,,,0,"percent of total billed charges","82.6% of total billed charges",8758,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,8758,100,,7006.40,,,0,"percent of total billed charges","100% of total billed charges",1339.97,8758,
"62100 Craniotomy for repair of dural/cerebrospinal",7962044,CDM,521,RC,62100,CPT,OUTPATIENT,,,9565,6217.25,,8417.2,88,,6733.76,,,0,"percent of total billed charges","88% of total billed charges",9565,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9565,175,,,,,0,"fee schedule","175% of CMS fee schedule",3575.03,100,,,,,0,"fee schedule",EAPG,9565,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6025.95,63,,4820.76,,,0,"percent of total billed charges","63% of total billed charges",1463.45,15.3,,1170.76,,,0,"percent of total billed charges","15.3% of total billed charges",3470.9,100,,,,,0,"fee schedule",EAPG,6599.85,69,,,,,0,"fee schedule","69% of total billed charges",9565,100,,7652.00,,,0,"percent of total billed charges","100% of total billed charges",9565,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9565,100,,7652.00,,,0,"percent of total billed charges","100% of total billed charges",9565,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9565,100,,7652.00,,,0,"percent of total billed charges","100% of total billed charges",9565,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9565,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3470.9,100,,,,,0,"fee schedule",EAPG,9565,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9565,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9565,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3540.32,100,,,,,0,"fee schedule",EAPG,4512.18,100,,,,,0,"fee schedule",EAPG,9565,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3606.01,37.7,,2884.81,,,0,"percent of total billed charges","37.70% of total billed charges",9565,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9565,100,,,,,0,"fee schedule","100% of CMS fee schedule",7460.7,78,,5968.56,,,0,"percent of total billed charges","78% of total billed charges",9565,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7900.69,82.6,,6320.55,,,0,"percent of total billed charges","82.6% of total billed charges",3470.9,100,,,,,0,"fee schedule","100% of WA fee schedule",9565,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7900.69,82.6,,6320.55,,,0,"percent of total billed charges","82.6% of total billed charges",9565,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3631.43,100,,,,,0,"fee schedule",EAPG,9565,100,,7652.00,,,0,"percent of total billed charges","100% of total billed charges",1463.45,9565,
"62148 Incision and retrieval of subcutaneous crani",7962045,CDM,521,RC,62148,CPT,OUTPATIENT,,,919,597.35,,808.72,88,,646.98,,,0,"percent of total billed charges","88% of total billed charges",919,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,919,100,,735.20,,,0,"percent of total billed charges","100% of total billed charges",919,175,,,,,0,"fee schedule","175% of CMS fee schedule",5945.4,100,,,,,0,"fee schedule",EAPG,919,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",578.97,63,,463.18,,,0,"percent of total billed charges","63% of total billed charges",140.61,15.3,,112.49,,,0,"percent of total billed charges","15.3% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,634.11,69,,,,,0,"fee schedule","69% of total billed charges",919,100,,735.20,,,0,"percent of total billed charges","100% of total billed charges",919,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",919,100,,735.20,,,0,"percent of total billed charges","100% of total billed charges",919,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",919,100,,735.20,,,0,"percent of total billed charges","100% of total billed charges",919,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",919,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,919,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",919,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",919,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5887.68,100,,,,,0,"fee schedule",EAPG,7503.9,100,,,,,0,"fee schedule",EAPG,919,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",346.46,37.7,,277.17,,,0,"percent of total billed charges","37.70% of total billed charges",919,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",919,100,,,,,0,"fee schedule","100% of CMS fee schedule",716.82,78,,573.46,,,0,"percent of total billed charges","78% of total billed charges",919,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",759.09,82.6,,607.27,,,0,"percent of total billed charges","82.6% of total billed charges",5772.23,100,,,,,0,"fee schedule","100% of WA fee schedule",919,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",759.09,82.6,,607.27,,,0,"percent of total billed charges","82.6% of total billed charges",919,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5932.76,100,,,,,0,"fee schedule",EAPG,919,100,,735.20,,,0,"percent of total billed charges","100% of total billed charges",140.61,7503.9,
"62147 Cranioplasty with autograft (includes obtain",7962200,CDM,521,RC,62147,CPT,OUTPATIENT,,,8644,5618.6,,7606.72,88,,6085.38,,,0,"percent of total billed charges","88% of total billed charges",8644,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8644,175,,,,,0,"fee schedule","175% of CMS fee schedule",5945.4,100,,,,,0,"fee schedule",EAPG,8644,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5445.72,63,,4356.58,,,0,"percent of total billed charges","63% of total billed charges",1322.53,15.3,,1058.02,,,0,"percent of total billed charges","15.3% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,5964.36,69,,,,,0,"fee schedule","69% of total billed charges",8644,100,,6915.20,,,0,"percent of total billed charges","100% of total billed charges",8644,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8644,100,,6915.20,,,0,"percent of total billed charges","100% of total billed charges",8644,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8644,100,,6915.20,,,0,"percent of total billed charges","100% of total billed charges",8644,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8644,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,8644,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8644,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8644,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5887.68,100,,,,,0,"fee schedule",EAPG,7503.9,100,,,,,0,"fee schedule",EAPG,8644,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3258.79,37.7,,2607.03,,,0,"percent of total billed charges","37.70% of total billed charges",8644,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8644,100,,,,,0,"fee schedule","100% of CMS fee schedule",6742.32,78,,5393.86,,,0,"percent of total billed charges","78% of total billed charges",8644,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7139.94,82.6,,5711.95,,,0,"percent of total billed charges","82.6% of total billed charges",5772.23,100,,,,,0,"fee schedule","100% of WA fee schedule",8644,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7139.94,82.6,,5711.95,,,0,"percent of total billed charges","82.6% of total billed charges",8644,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5932.76,100,,,,,0,"fee schedule",EAPG,8644,100,,6915.20,,,0,"percent of total billed charges","100% of total billed charges",1322.53,8644,
"62146 Cranioplasty with autograft (includes obtain",7962459,CDM,521,RC,62146,CPT,OUTPATIENT,,,7250,4712.5,,6380,88,,5104.00,,,0,"percent of total billed charges","88% of total billed charges",7250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7250,175,,,,,0,"fee schedule","175% of CMS fee schedule",5945.4,100,,,,,0,"fee schedule",EAPG,7250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4567.5,63,,3654.00,,,0,"percent of total billed charges","63% of total billed charges",1109.25,15.3,,887.40,,,0,"percent of total billed charges","15.3% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,5002.5,69,,,,,0,"fee schedule","69% of total billed charges",7250,100,,5800.00,,,0,"percent of total billed charges","100% of total billed charges",7250,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7250,100,,5800.00,,,0,"percent of total billed charges","100% of total billed charges",7250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7250,100,,5800.00,,,0,"percent of total billed charges","100% of total billed charges",7250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,7250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5887.68,100,,,,,0,"fee schedule",EAPG,7503.9,100,,,,,0,"fee schedule",EAPG,7250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2733.25,37.7,,2186.60,,,0,"percent of total billed charges","37.70% of total billed charges",7250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7250,100,,,,,0,"fee schedule","100% of CMS fee schedule",5655,78,,4524.00,,,0,"percent of total billed charges","78% of total billed charges",7250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5988.5,82.6,,4790.80,,,0,"percent of total billed charges","82.6% of total billed charges",5772.23,100,,,,,0,"fee schedule","100% of WA fee schedule",7250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5988.5,82.6,,4790.80,,,0,"percent of total billed charges","82.6% of total billed charges",7250,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5932.76,100,,,,,0,"fee schedule",EAPG,7250,100,,5800.00,,,0,"percent of total billed charges","100% of total billed charges",1109.25,7503.9,
"62145 Cranioplasty for skull defect with reparativ",7963092,CDM,521,RC,62145,CPT,OUTPATIENT,,,8447,5490.55,,7433.36,88,,5946.69,,,0,"percent of total billed charges","88% of total billed charges",8447,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8447,175,,,,,0,"fee schedule","175% of CMS fee schedule",5945.4,100,,,,,0,"fee schedule",EAPG,8447,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5321.61,63,,4257.29,,,0,"percent of total billed charges","63% of total billed charges",1292.39,15.3,,1033.91,,,0,"percent of total billed charges","15.3% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,5828.43,69,,,,,0,"fee schedule","69% of total billed charges",8447,100,,6757.60,,,0,"percent of total billed charges","100% of total billed charges",8447,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8447,100,,6757.60,,,0,"percent of total billed charges","100% of total billed charges",8447,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8447,100,,6757.60,,,0,"percent of total billed charges","100% of total billed charges",8447,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8447,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,8447,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8447,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8447,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5887.68,100,,,,,0,"fee schedule",EAPG,7503.9,100,,,,,0,"fee schedule",EAPG,8447,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3184.52,37.7,,2547.62,,,0,"percent of total billed charges","37.70% of total billed charges",8447,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8447,100,,,,,0,"fee schedule","100% of CMS fee schedule",6588.66,78,,5270.93,,,0,"percent of total billed charges","78% of total billed charges",8447,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6977.22,82.6,,5581.78,,,0,"percent of total billed charges","82.6% of total billed charges",5772.23,100,,,,,0,"fee schedule","100% of WA fee schedule",8447,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6977.22,82.6,,5581.78,,,0,"percent of total billed charges","82.6% of total billed charges",8447,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5932.76,100,,,,,0,"fee schedule",EAPG,8447,100,,6757.60,,,0,"percent of total billed charges","100% of total billed charges",1292.39,8447,
"62141 Cranioplasty for skull defect; larger than 5",7963184,CDM,521,RC,62141,CPT,OUTPATIENT,,,6778,4405.7,,5964.64,88,,4771.71,,,0,"percent of total billed charges","88% of total billed charges",6778,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6778,175,,,,,0,"fee schedule","175% of CMS fee schedule",5945.4,100,,,,,0,"fee schedule",EAPG,6778,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4270.14,63,,3416.11,,,0,"percent of total billed charges","63% of total billed charges",1037.03,15.3,,829.62,,,0,"percent of total billed charges","15.3% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,4676.82,69,,,,,0,"fee schedule","69% of total billed charges",6778,100,,5422.40,,,0,"percent of total billed charges","100% of total billed charges",6778,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6778,100,,5422.40,,,0,"percent of total billed charges","100% of total billed charges",6778,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6778,100,,5422.40,,,0,"percent of total billed charges","100% of total billed charges",6778,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6778,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,6778,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6778,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6778,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5887.68,100,,,,,0,"fee schedule",EAPG,7503.9,100,,,,,0,"fee schedule",EAPG,6778,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2555.31,37.7,,2044.25,,,0,"percent of total billed charges","37.70% of total billed charges",6778,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6778,100,,,,,0,"fee schedule","100% of CMS fee schedule",5286.84,78,,4229.47,,,0,"percent of total billed charges","78% of total billed charges",6778,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5598.63,82.6,,4478.90,,,0,"percent of total billed charges","82.6% of total billed charges",5772.23,100,,,,,0,"fee schedule","100% of WA fee schedule",6778,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5598.63,82.6,,4478.90,,,0,"percent of total billed charges","82.6% of total billed charges",6778,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5932.76,100,,,,,0,"fee schedule",EAPG,6778,100,,5422.40,,,0,"percent of total billed charges","100% of total billed charges",1037.03,7503.9,
"62143 Replacement of bone flap or prosthetic plate",7963270,CDM,521,RC,62143,CPT,OUTPATIENT,,,5995,3896.75,,5275.6,88,,4220.48,,,0,"percent of total billed charges","88% of total billed charges",5995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5995,175,,,,,0,"fee schedule","175% of CMS fee schedule",5945.4,100,,,,,0,"fee schedule",EAPG,5995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3776.85,63,,3021.48,,,0,"percent of total billed charges","63% of total billed charges",917.24,15.3,,733.79,,,0,"percent of total billed charges","15.3% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,4136.55,69,,,,,0,"fee schedule","69% of total billed charges",5995,100,,4796.00,,,0,"percent of total billed charges","100% of total billed charges",5995,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5995,100,,4796.00,,,0,"percent of total billed charges","100% of total billed charges",5995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5995,100,,4796.00,,,0,"percent of total billed charges","100% of total billed charges",5995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,5995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5887.68,100,,,,,0,"fee schedule",EAPG,7503.9,100,,,,,0,"fee schedule",EAPG,5995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2260.12,37.7,,1808.10,,,0,"percent of total billed charges","37.70% of total billed charges",5995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5995,100,,,,,0,"fee schedule","100% of CMS fee schedule",4676.1,78,,3740.88,,,0,"percent of total billed charges","78% of total billed charges",5995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4951.87,82.6,,3961.50,,,0,"percent of total billed charges","82.6% of total billed charges",5772.23,100,,,,,0,"fee schedule","100% of WA fee schedule",5995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4951.87,82.6,,3961.50,,,0,"percent of total billed charges","82.6% of total billed charges",5995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5932.76,100,,,,,0,"fee schedule",EAPG,5995,100,,4796.00,,,0,"percent of total billed charges","100% of total billed charges",917.24,7503.9,
"62140 Cranioplasty for skull defect; up to 5 cm di",7963349,CDM,521,RC,62140,CPT,OUTPATIENT,,,6084,3954.6,,5353.92,88,,4283.14,,,0,"percent of total billed charges","88% of total billed charges",6084,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6084,175,,,,,0,"fee schedule","175% of CMS fee schedule",5945.4,100,,,,,0,"fee schedule",EAPG,6084,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3832.92,63,,3066.34,,,0,"percent of total billed charges","63% of total billed charges",930.85,15.3,,744.68,,,0,"percent of total billed charges","15.3% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,4197.96,69,,,,,0,"fee schedule","69% of total billed charges",6084,100,,4867.20,,,0,"percent of total billed charges","100% of total billed charges",6084,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6084,100,,4867.20,,,0,"percent of total billed charges","100% of total billed charges",6084,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6084,100,,4867.20,,,0,"percent of total billed charges","100% of total billed charges",6084,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6084,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,6084,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6084,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6084,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5887.68,100,,,,,0,"fee schedule",EAPG,7503.9,100,,,,,0,"fee schedule",EAPG,6084,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2293.67,37.7,,1834.94,,,0,"percent of total billed charges","37.70% of total billed charges",6084,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6084,100,,,,,0,"fee schedule","100% of CMS fee schedule",4745.52,78,,3796.42,,,0,"percent of total billed charges","78% of total billed charges",6084,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5025.38,82.6,,4020.30,,,0,"percent of total billed charges","82.6% of total billed charges",5772.23,100,,,,,0,"fee schedule","100% of WA fee schedule",6084,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5025.38,82.6,,4020.30,,,0,"percent of total billed charges","82.6% of total billed charges",6084,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5932.76,100,,,,,0,"fee schedule",EAPG,6084,100,,4867.20,,,0,"percent of total billed charges","100% of total billed charges",930.85,7503.9,
"62142 Removal of bone flap or prosthetic plate of",7963419,CDM,521,RC,62142,CPT,OUTPATIENT,,,4889,3177.85,,4302.32,88,,3441.86,,,0,"percent of total billed charges","88% of total billed charges",4889,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",4889,175,,,,,0,"fee schedule","175% of CMS fee schedule",5945.4,100,,,,,0,"fee schedule",EAPG,4889,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3080.07,63,,2464.06,,,0,"percent of total billed charges","63% of total billed charges",748.02,15.3,,598.42,,,0,"percent of total billed charges","15.3% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,3373.41,69,,,,,0,"fee schedule","69% of total billed charges",4889,100,,3911.20,,,0,"percent of total billed charges","100% of total billed charges",4889,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4889,100,,3911.20,,,0,"percent of total billed charges","100% of total billed charges",4889,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4889,100,,3911.20,,,0,"percent of total billed charges","100% of total billed charges",4889,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4889,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,4889,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4889,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4889,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5887.68,100,,,,,0,"fee schedule",EAPG,7503.9,100,,,,,0,"fee schedule",EAPG,4889,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1843.15,37.7,,1474.52,,,0,"percent of total billed charges","37.70% of total billed charges",4889,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4889,100,,,,,0,"fee schedule","100% of CMS fee schedule",3813.42,78,,3050.74,,,0,"percent of total billed charges","78% of total billed charges",4889,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4038.31,82.6,,3230.65,,,0,"percent of total billed charges","82.6% of total billed charges",5772.23,100,,,,,0,"fee schedule","100% of WA fee schedule",4889,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4038.31,82.6,,3230.65,,,0,"percent of total billed charges","82.6% of total billed charges",4889,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5932.76,100,,,,,0,"fee schedule",EAPG,4889,100,,3911.20,,,0,"percent of total billed charges","100% of total billed charges",748.02,7503.9,
"62160 Neuroendoscopy, intracranial, for placement",7962046,CDM,521,RC,62160,CPT,OUTPATIENT,,,1153,749.45,,1014.64,88,,811.71,,,0,"percent of total billed charges","88% of total billed charges",576.5,50,,461.20,,,0,"percent of total billed charges","50% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,1153,100,,922.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5945.4,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",726.39,63,,581.11,,,0,"percent of total billed charges","63% of total billed charges",176.41,15.3,,141.13,,,0,"percent of total billed charges","15.3% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,795.57,69,,,,,0,"fee schedule","69% of total billed charges",1153,100,,922.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1153,100,,922.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1153,100,,922.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",713.13,61.85,,570.50,,,0,"percent of total billed charges","61.5% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,576.5,50,,461.20,,,0,"percent of total billed charges","50% of total billed charges",371.27,32.2,,297.02,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5887.68,100,,,,,0,"fee schedule",EAPG,7503.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",434.68,37.7,,347.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",899.34,78,,719.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",952.38,82.6,,761.90,,,0,"percent of total billed charges","82.6% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,576.5,50,,461.20,,,0,"percent of total billed charges","50% of total billed charges",952.38,82.6,,761.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5932.76,100,,,,,0,"fee schedule",EAPG,1153,100,,922.40,,,0,"percent of total billed charges","100% of total billed charges",176.41,7503.9,
"62161 Neuroendoscopy, intracranial; with dissectio",7962047,CDM,521,RC,62161,CPT,OUTPATIENT,,,8225,5346.25,,7238,88,,5790.40,,,0,"percent of total billed charges","88% of total billed charges",8225,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8225,175,,,,,0,"fee schedule","175% of CMS fee schedule",5945.4,100,,,,,0,"fee schedule",EAPG,8225,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5181.75,63,,4145.40,,,0,"percent of total billed charges","63% of total billed charges",1258.43,15.3,,1006.74,,,0,"percent of total billed charges","15.3% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,5675.25,69,,,,,0,"fee schedule","69% of total billed charges",8225,100,,6580.00,,,0,"percent of total billed charges","100% of total billed charges",8225,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8225,100,,6580.00,,,0,"percent of total billed charges","100% of total billed charges",8225,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8225,100,,6580.00,,,0,"percent of total billed charges","100% of total billed charges",8225,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8225,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,8225,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8225,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8225,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5887.68,100,,,,,0,"fee schedule",EAPG,7503.9,100,,,,,0,"fee schedule",EAPG,8225,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3100.83,37.7,,2480.66,,,0,"percent of total billed charges","37.70% of total billed charges",8225,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8225,100,,,,,0,"fee schedule","100% of CMS fee schedule",6415.5,78,,5132.40,,,0,"percent of total billed charges","78% of total billed charges",8225,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6793.85,82.6,,5435.08,,,0,"percent of total billed charges","82.6% of total billed charges",5772.23,100,,,,,0,"fee schedule","100% of WA fee schedule",8225,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6793.85,82.6,,5435.08,,,0,"percent of total billed charges","82.6% of total billed charges",8225,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5932.76,100,,,,,0,"fee schedule",EAPG,8225,100,,6580.00,,,0,"percent of total billed charges","100% of total billed charges",1258.43,8225,
"62162 Neuroendoscopy, intracranial; with fenestrat",7962048,CDM,521,RC,62162,CPT,OUTPATIENT,,,5367,3488.55,,4722.96,88,,3778.37,,,0,"percent of total billed charges","88% of total billed charges",5367,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5367,175,,,,,0,"fee schedule","175% of CMS fee schedule",5945.4,100,,,,,0,"fee schedule",EAPG,5367,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3381.21,63,,2704.97,,,0,"percent of total billed charges","63% of total billed charges",821.15,15.3,,656.92,,,0,"percent of total billed charges","15.3% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,3703.23,69,,,,,0,"fee schedule","69% of total billed charges",5367,100,,4293.60,,,0,"percent of total billed charges","100% of total billed charges",5367,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5367,100,,4293.60,,,0,"percent of total billed charges","100% of total billed charges",5367,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5367,100,,4293.60,,,0,"percent of total billed charges","100% of total billed charges",5367,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5367,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,5367,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5367,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5367,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5887.68,100,,,,,0,"fee schedule",EAPG,7503.9,100,,,,,0,"fee schedule",EAPG,5367,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2023.36,37.7,,1618.69,,,0,"percent of total billed charges","37.70% of total billed charges",5367,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5367,100,,,,,0,"fee schedule","100% of CMS fee schedule",4186.26,78,,3349.01,,,0,"percent of total billed charges","78% of total billed charges",5367,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4433.14,82.6,,3546.51,,,0,"percent of total billed charges","82.6% of total billed charges",5772.23,100,,,,,0,"fee schedule","100% of WA fee schedule",5367,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4433.14,82.6,,3546.51,,,0,"percent of total billed charges","82.6% of total billed charges",5367,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5932.76,100,,,,,0,"fee schedule",EAPG,5367,100,,4293.60,,,0,"percent of total billed charges","100% of total billed charges",821.15,7503.9,
"62164 Neuroendoscopy, intracranial; with excision",7962049,CDM,521,RC,62164,CPT,OUTPATIENT,,,11418,7421.7,,10047.84,88,,8038.27,,,0,"percent of total billed charges","88% of total billed charges",11418,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",11418,175,,,,,0,"fee schedule","175% of CMS fee schedule",5945.4,100,,,,,0,"fee schedule",EAPG,11418,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7193.34,63,,5754.67,,,0,"percent of total billed charges","63% of total billed charges",1746.95,15.3,,1397.56,,,0,"percent of total billed charges","15.3% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,7878.42,69,,,,,0,"fee schedule","69% of total billed charges",11418,100,,9134.40,,,0,"percent of total billed charges","100% of total billed charges",11418,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11418,100,,9134.40,,,0,"percent of total billed charges","100% of total billed charges",11418,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11418,100,,9134.40,,,0,"percent of total billed charges","100% of total billed charges",11418,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11418,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,11418,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11418,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",11418,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5887.68,100,,,,,0,"fee schedule",EAPG,7503.9,100,,,,,0,"fee schedule",EAPG,11418,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4304.59,37.7,,3443.67,,,0,"percent of total billed charges","37.70% of total billed charges",11418,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",11418,100,,,,,0,"fee schedule","100% of CMS fee schedule",8906.04,78,,7124.83,,,0,"percent of total billed charges","78% of total billed charges",11418,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9431.27,82.6,,7545.02,,,0,"percent of total billed charges","82.6% of total billed charges",5772.23,100,,,,,0,"fee schedule","100% of WA fee schedule",11418,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9431.27,82.6,,7545.02,,,0,"percent of total billed charges","82.6% of total billed charges",11418,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5932.76,100,,,,,0,"fee schedule",EAPG,11418,100,,9134.40,,,0,"percent of total billed charges","100% of total billed charges",1746.95,11418,
"62165 Neuroendoscopy, intracranial; with excision",7962153,CDM,521,RC,62165,CPT,OUTPATIENT,,,9902,6436.3,,8713.76,88,,6971.01,,,0,"percent of total billed charges","88% of total billed charges",9902,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9902,175,,,,,0,"fee schedule","175% of CMS fee schedule",5945.4,100,,,,,0,"fee schedule",EAPG,9902,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6238.26,63,,4990.61,,,0,"percent of total billed charges","63% of total billed charges",1515.01,15.3,,1212.01,,,0,"percent of total billed charges","15.3% of total billed charges",5772.23,100,,,,,0,"fee schedule",EAPG,6832.38,69,,,,,0,"fee schedule","69% of total billed charges",9902,100,,7921.60,,,0,"percent of total billed charges","100% of total billed charges",9902,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9902,100,,7921.60,,,0,"percent of total billed charges","100% of total billed charges",9902,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9902,100,,7921.60,,,0,"percent of total billed charges","100% of total billed charges",9902,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9902,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5772.23,100,,,,,0,"fee schedule",EAPG,9902,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9902,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9902,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5887.68,100,,,,,0,"fee schedule",EAPG,7503.9,100,,,,,0,"fee schedule",EAPG,9902,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3733.05,37.7,,2986.44,,,0,"percent of total billed charges","37.70% of total billed charges",9902,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9902,100,,,,,0,"fee schedule","100% of CMS fee schedule",7723.56,78,,6178.85,,,0,"percent of total billed charges","78% of total billed charges",9902,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8179.05,82.6,,6543.24,,,0,"percent of total billed charges","82.6% of total billed charges",5772.23,100,,,,,0,"fee schedule","100% of WA fee schedule",9902,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8179.05,82.6,,6543.24,,,0,"percent of total billed charges","82.6% of total billed charges",9902,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5932.76,100,,,,,0,"fee schedule",EAPG,9902,100,,7921.60,,,0,"percent of total billed charges","100% of total billed charges",1515.01,9902,
"62192 Creation of shunt; subarachnoid/subdural-per",7962518,CDM,521,RC,62192,CPT,OUTPATIENT,,,5657,3677.05,,4978.16,88,,3982.53,,,0,"percent of total billed charges","88% of total billed charges",5657,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5043.02,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5657,175,,,,,0,"fee schedule","175% of CMS fee schedule",5194.31,100,,,,,0,"fee schedule",EAPG,5657,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3563.91,63,,2851.13,,,0,"percent of total billed charges","63% of total billed charges",865.52,15.3,,692.42,,,0,"percent of total billed charges","15.3% of total billed charges",5043.02,100,,,,,0,"fee schedule",EAPG,3903.33,69,,,,,0,"fee schedule","69% of total billed charges",5657,100,,4525.60,,,0,"percent of total billed charges","100% of total billed charges",5657,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5657,100,,4525.60,,,0,"percent of total billed charges","100% of total billed charges",5657,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5657,100,,4525.60,,,0,"percent of total billed charges","100% of total billed charges",5657,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5657,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5043.02,100,,,,,0,"fee schedule",EAPG,5657,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5657,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5657,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5143.88,100,,,,,0,"fee schedule",EAPG,6555.92,100,,,,,0,"fee schedule",EAPG,5657,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2132.69,37.7,,1706.15,,,0,"percent of total billed charges","37.70% of total billed charges",5657,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5657,100,,,,,0,"fee schedule","100% of CMS fee schedule",4412.46,78,,3529.97,,,0,"percent of total billed charges","78% of total billed charges",5657,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4672.68,82.6,,3738.14,,,0,"percent of total billed charges","82.6% of total billed charges",5043.02,100,,,,,0,"fee schedule","100% of WA fee schedule",5657,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4672.68,82.6,,3738.14,,,0,"percent of total billed charges","82.6% of total billed charges",5657,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5203.55,100,,,,,0,"fee schedule",EAPG,5657,100,,4525.60,,,0,"percent of total billed charges","100% of total billed charges",865.52,6555.92,
"62190 Creation of shunt; subarachnoid/subdural-atr",7962797,CDM,521,RC,62190,CPT,OUTPATIENT,,,5164,3356.6,,4544.32,88,,3635.46,,,0,"percent of total billed charges","88% of total billed charges",5164,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5043.02,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5164,175,,,,,0,"fee schedule","175% of CMS fee schedule",5194.31,100,,,,,0,"fee schedule",EAPG,5164,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3253.32,63,,2602.66,,,0,"percent of total billed charges","63% of total billed charges",790.09,15.3,,632.07,,,0,"percent of total billed charges","15.3% of total billed charges",5043.02,100,,,,,0,"fee schedule",EAPG,3563.16,69,,,,,0,"fee schedule","69% of total billed charges",5164,100,,4131.20,,,0,"percent of total billed charges","100% of total billed charges",5164,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5164,100,,4131.20,,,0,"percent of total billed charges","100% of total billed charges",5164,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5164,100,,4131.20,,,0,"percent of total billed charges","100% of total billed charges",5164,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5164,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5043.02,100,,,,,0,"fee schedule",EAPG,5164,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5164,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5164,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5143.88,100,,,,,0,"fee schedule",EAPG,6555.92,100,,,,,0,"fee schedule",EAPG,5164,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1946.83,37.7,,1557.46,,,0,"percent of total billed charges","37.70% of total billed charges",5164,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5164,100,,,,,0,"fee schedule","100% of CMS fee schedule",4027.92,78,,3222.34,,,0,"percent of total billed charges","78% of total billed charges",5164,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4265.46,82.6,,3412.37,,,0,"percent of total billed charges","82.6% of total billed charges",5043.02,100,,,,,0,"fee schedule","100% of WA fee schedule",5164,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4265.46,82.6,,3412.37,,,0,"percent of total billed charges","82.6% of total billed charges",5164,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5203.55,100,,,,,0,"fee schedule",EAPG,5164,100,,4131.20,,,0,"percent of total billed charges","100% of total billed charges",790.09,6555.92,
"62194 Replacement or irrigation, subarachnoid/subd",7963211,CDM,521,RC,62194,CPT,OUTPATIENT,,,2044,1328.6,,1798.72,88,,1438.98,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,2044,100,,1635.20,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1287.72,63,,1030.18,,,0,"percent of total billed charges","63% of total billed charges",312.73,15.3,,250.18,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,1410.36,69,,,,,0,"fee schedule","69% of total billed charges",2044,100,,1635.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2044,100,,1635.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2044,100,,1635.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",770.59,37.7,,616.47,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1594.32,78,,1275.46,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1688.34,82.6,,1350.67,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1688.34,82.6,,1350.67,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",931.2,100,,,,,0,"fee schedule",EAPG,2044,100,,1635.20,,,0,"percent of total billed charges","100% of total billed charges",312.73,7127.26,
"62201 Ventriculocisternostomy, third ventricle; st",7962542,CDM,521,RC,62201,CPT,OUTPATIENT,,,6683,4343.95,,5881.04,88,,4704.83,,,0,"percent of total billed charges","88% of total billed charges",6683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5043.02,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6683,175,,,,,0,"fee schedule","175% of CMS fee schedule",5194.31,100,,,,,0,"fee schedule",EAPG,6683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4210.29,63,,3368.23,,,0,"percent of total billed charges","63% of total billed charges",1022.5,15.3,,818.00,,,0,"percent of total billed charges","15.3% of total billed charges",5043.02,100,,,,,0,"fee schedule",EAPG,4611.27,69,,,,,0,"fee schedule","69% of total billed charges",6683,100,,5346.40,,,0,"percent of total billed charges","100% of total billed charges",6683,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6683,100,,5346.40,,,0,"percent of total billed charges","100% of total billed charges",6683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6683,100,,5346.40,,,0,"percent of total billed charges","100% of total billed charges",6683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5043.02,100,,,,,0,"fee schedule",EAPG,6683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5143.88,100,,,,,0,"fee schedule",EAPG,6555.92,100,,,,,0,"fee schedule",EAPG,6683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2519.49,37.7,,2015.59,,,0,"percent of total billed charges","37.70% of total billed charges",6683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6683,100,,,,,0,"fee schedule","100% of CMS fee schedule",5212.74,78,,4170.19,,,0,"percent of total billed charges","78% of total billed charges",6683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5520.16,82.6,,4416.13,,,0,"percent of total billed charges","82.6% of total billed charges",5043.02,100,,,,,0,"fee schedule","100% of WA fee schedule",6683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5520.16,82.6,,4416.13,,,0,"percent of total billed charges","82.6% of total billed charges",6683,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5203.55,100,,,,,0,"fee schedule",EAPG,6683,100,,5346.40,,,0,"percent of total billed charges","100% of total billed charges",1022.5,6683,
"62200 Ventriculocisternostomy, third ventricle;",7963533,CDM,521,RC,62200,CPT,OUTPATIENT,,,8272,5376.8,,7279.36,88,,5823.49,,,0,"percent of total billed charges","88% of total billed charges",8272,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5043.02,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8272,175,,,,,0,"fee schedule","175% of CMS fee schedule",5194.31,100,,,,,0,"fee schedule",EAPG,8272,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5211.36,63,,4169.09,,,0,"percent of total billed charges","63% of total billed charges",1265.62,15.3,,1012.50,,,0,"percent of total billed charges","15.3% of total billed charges",5043.02,100,,,,,0,"fee schedule",EAPG,5707.68,69,,,,,0,"fee schedule","69% of total billed charges",8272,100,,6617.60,,,0,"percent of total billed charges","100% of total billed charges",8272,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8272,100,,6617.60,,,0,"percent of total billed charges","100% of total billed charges",8272,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8272,100,,6617.60,,,0,"percent of total billed charges","100% of total billed charges",8272,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8272,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5043.02,100,,,,,0,"fee schedule",EAPG,8272,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8272,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8272,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5143.88,100,,,,,0,"fee schedule",EAPG,6555.92,100,,,,,0,"fee schedule",EAPG,8272,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3118.54,37.7,,2494.83,,,0,"percent of total billed charges","37.70% of total billed charges",8272,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8272,100,,,,,0,"fee schedule","100% of CMS fee schedule",6452.16,78,,5161.73,,,0,"percent of total billed charges","78% of total billed charges",8272,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6832.67,82.6,,5466.14,,,0,"percent of total billed charges","82.6% of total billed charges",5043.02,100,,,,,0,"fee schedule","100% of WA fee schedule",8272,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6832.67,82.6,,5466.14,,,0,"percent of total billed charges","82.6% of total billed charges",8272,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5203.55,100,,,,,0,"fee schedule",EAPG,8272,100,,6617.60,,,0,"percent of total billed charges","100% of total billed charges",1265.62,8272,
"62223 Creation of shunt; ventriculo-peritoneal, -p",7962949,CDM,521,RC,62223,CPT,OUTPATIENT,,,6443,4187.95,,5669.84,88,,4535.87,,,0,"percent of total billed charges","88% of total billed charges",6443,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5043.02,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6443,175,,,,,0,"fee schedule","175% of CMS fee schedule",5194.31,100,,,,,0,"fee schedule",EAPG,6443,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4059.09,63,,3247.27,,,0,"percent of total billed charges","63% of total billed charges",985.78,15.3,,788.62,,,0,"percent of total billed charges","15.3% of total billed charges",5043.02,100,,,,,0,"fee schedule",EAPG,4445.67,69,,,,,0,"fee schedule","69% of total billed charges",6443,100,,5154.40,,,0,"percent of total billed charges","100% of total billed charges",6443,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6443,100,,5154.40,,,0,"percent of total billed charges","100% of total billed charges",6443,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6443,100,,5154.40,,,0,"percent of total billed charges","100% of total billed charges",6443,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6443,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5043.02,100,,,,,0,"fee schedule",EAPG,6443,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6443,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6443,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5143.88,100,,,,,0,"fee schedule",EAPG,6555.92,100,,,,,0,"fee schedule",EAPG,6443,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2429.01,37.7,,1943.21,,,0,"percent of total billed charges","37.70% of total billed charges",6443,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6443,100,,,,,0,"fee schedule","100% of CMS fee schedule",5025.54,78,,4020.43,,,0,"percent of total billed charges","78% of total billed charges",6443,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5321.92,82.6,,4257.54,,,0,"percent of total billed charges","82.6% of total billed charges",5043.02,100,,,,,0,"fee schedule","100% of WA fee schedule",6443,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5321.92,82.6,,4257.54,,,0,"percent of total billed charges","82.6% of total billed charges",6443,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5203.55,100,,,,,0,"fee schedule",EAPG,6443,100,,5154.40,,,0,"percent of total billed charges","100% of total billed charges",985.78,6555.92,
"62220 Creation of shunt; ventriculo-atrial, -jugul",7963130,CDM,521,RC,62220,CPT,OUTPATIENT,,,5951,3868.15,,5236.88,88,,4189.50,,,0,"percent of total billed charges","88% of total billed charges",5951,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5043.02,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5951,175,,,,,0,"fee schedule","175% of CMS fee schedule",5194.31,100,,,,,0,"fee schedule",EAPG,5951,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3749.13,63,,2999.30,,,0,"percent of total billed charges","63% of total billed charges",910.5,15.3,,728.40,,,0,"percent of total billed charges","15.3% of total billed charges",5043.02,100,,,,,0,"fee schedule",EAPG,4106.19,69,,,,,0,"fee schedule","69% of total billed charges",5951,100,,4760.80,,,0,"percent of total billed charges","100% of total billed charges",5951,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5951,100,,4760.80,,,0,"percent of total billed charges","100% of total billed charges",5951,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5951,100,,4760.80,,,0,"percent of total billed charges","100% of total billed charges",5951,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5951,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5043.02,100,,,,,0,"fee schedule",EAPG,5951,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5951,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5951,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5143.88,100,,,,,0,"fee schedule",EAPG,6555.92,100,,,,,0,"fee schedule",EAPG,5951,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2243.53,37.7,,1794.82,,,0,"percent of total billed charges","37.70% of total billed charges",5951,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5951,100,,,,,0,"fee schedule","100% of CMS fee schedule",4641.78,78,,3713.42,,,0,"percent of total billed charges","78% of total billed charges",5951,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4915.53,82.6,,3932.42,,,0,"percent of total billed charges","82.6% of total billed charges",5043.02,100,,,,,0,"fee schedule","100% of WA fee schedule",5951,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4915.53,82.6,,3932.42,,,0,"percent of total billed charges","82.6% of total billed charges",5951,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5203.55,100,,,,,0,"fee schedule",EAPG,5951,100,,4760.80,,,0,"percent of total billed charges","100% of total billed charges",910.5,6555.92,
"62225 Replacement or irrigation, ventricular cathe",7963458,CDM,521,RC,62225,CPT,OUTPATIENT,,,2383,1548.95,,2097.04,88,,1677.63,,,0,"percent of total billed charges","88% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5043.02,100,,,,,0,"fee schedule",EAPG,2383,100,,1906.40,,,0,"percent of total billed charges","100% of total billed charges",11890.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",5194.31,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1501.29,63,,1201.03,,,0,"percent of total billed charges","63% of total billed charges",364.6,15.3,,291.68,,,0,"percent of total billed charges","15.3% of total billed charges",5043.02,100,,,,,0,"fee schedule",EAPG,1644.27,69,,,,,0,"fee schedule","69% of total billed charges",2383,100,,1906.40,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2383,100,,1906.40,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2383,100,,1906.40,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",23157.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5043.02,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6054.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5143.88,100,,,,,0,"fee schedule",EAPG,6555.92,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",898.39,37.7,,718.71,,,0,"percent of total billed charges","37.70% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1858.74,78,,1486.99,,,0,"percent of total billed charges","78% of total billed charges",6862.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1968.36,82.6,,1574.69,,,0,"percent of total billed charges","82.6% of total billed charges",5043.02,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1968.36,82.6,,1574.69,,,0,"percent of total billed charges","82.6% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5203.55,100,,,,,0,"fee schedule",EAPG,2383,100,,1906.40,,,0,"percent of total billed charges","100% of total billed charges",364.6,23157.6,
"62230 Replacement or revision of cerebrospinal flu",7962151,CDM,521,RC,62230,CPT,OUTPATIENT,,,4859,3158.35,,4275.92,88,,3420.74,,,0,"percent of total billed charges","88% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5043.02,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",11890.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",5194.31,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3061.17,63,,2448.94,,,0,"percent of total billed charges","63% of total billed charges",743.43,15.3,,594.74,,,0,"percent of total billed charges","15.3% of total billed charges",5043.02,100,,,,,0,"fee schedule",EAPG,3352.71,69,,,,,0,"fee schedule","69% of total billed charges",4859,100,,3887.20,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4859,100,,3887.20,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4859,100,,3887.20,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",23157.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5043.02,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6054.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5143.88,100,,,,,0,"fee schedule",EAPG,6555.92,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1831.84,37.7,,1465.47,,,0,"percent of total billed charges","37.70% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3790.02,78,,3032.02,,,0,"percent of total billed charges","78% of total billed charges",6862.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4013.53,82.6,,3210.82,,,0,"percent of total billed charges","82.6% of total billed charges",5043.02,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4013.53,82.6,,3210.82,,,0,"percent of total billed charges","82.6% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5203.55,100,,,,,0,"fee schedule",EAPG,4859,100,,3887.20,,,0,"percent of total billed charges","100% of total billed charges",743.43,23157.6,
"62258 Removal of complete cerebrospinal fluid shun",7962050,CDM,521,RC,62258,CPT,OUTPATIENT,,,6024,3915.6,,5301.12,88,,4240.90,,,0,"percent of total billed charges","88% of total billed charges",6024,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5043.02,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6024,175,,,,,0,"fee schedule","175% of CMS fee schedule",5194.31,100,,,,,0,"fee schedule",EAPG,6024,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3795.12,63,,3036.10,,,0,"percent of total billed charges","63% of total billed charges",921.67,15.3,,737.34,,,0,"percent of total billed charges","15.3% of total billed charges",5043.02,100,,,,,0,"fee schedule",EAPG,4156.56,69,,,,,0,"fee schedule","69% of total billed charges",6024,100,,4819.20,,,0,"percent of total billed charges","100% of total billed charges",6024,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6024,100,,4819.20,,,0,"percent of total billed charges","100% of total billed charges",6024,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6024,100,,4819.20,,,0,"percent of total billed charges","100% of total billed charges",6024,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6024,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5043.02,100,,,,,0,"fee schedule",EAPG,6024,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6024,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6024,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5143.88,100,,,,,0,"fee schedule",EAPG,6555.92,100,,,,,0,"fee schedule",EAPG,6024,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2271.05,37.7,,1816.84,,,0,"percent of total billed charges","37.70% of total billed charges",6024,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6024,100,,,,,0,"fee schedule","100% of CMS fee schedule",4698.72,78,,3758.98,,,0,"percent of total billed charges","78% of total billed charges",6024,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4975.82,82.6,,3980.66,,,0,"percent of total billed charges","82.6% of total billed charges",5043.02,100,,,,,0,"fee schedule","100% of WA fee schedule",6024,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4975.82,82.6,,3980.66,,,0,"percent of total billed charges","82.6% of total billed charges",6024,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5203.55,100,,,,,0,"fee schedule",EAPG,6024,100,,4819.20,,,0,"percent of total billed charges","100% of total billed charges",921.67,6555.92,
"62256 Removal of complete cerebrospinal fluid shun",7962729,CDM,521,RC,62256,CPT,OUTPATIENT,,,3111,2022.15,,2737.68,88,,2190.14,,,0,"percent of total billed charges","88% of total billed charges",3111,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5043.02,100,,,,,0,"fee schedule",EAPG,3111,100,,2488.80,,,0,"percent of total billed charges","100% of total billed charges",3111,175,,,,,0,"fee schedule","175% of CMS fee schedule",5194.31,100,,,,,0,"fee schedule",EAPG,3111,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1959.93,63,,1567.94,,,0,"percent of total billed charges","63% of total billed charges",475.98,15.3,,380.78,,,0,"percent of total billed charges","15.3% of total billed charges",5043.02,100,,,,,0,"fee schedule",EAPG,2146.59,69,,,,,0,"fee schedule","69% of total billed charges",3111,100,,2488.80,,,0,"percent of total billed charges","100% of total billed charges",3111,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3111,100,,2488.80,,,0,"percent of total billed charges","100% of total billed charges",3111,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3111,100,,2488.80,,,0,"percent of total billed charges","100% of total billed charges",3111,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3111,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5043.02,100,,,,,0,"fee schedule",EAPG,3111,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3111,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3111,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5143.88,100,,,,,0,"fee schedule",EAPG,6555.92,100,,,,,0,"fee schedule",EAPG,3111,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1172.85,37.7,,938.28,,,0,"percent of total billed charges","37.70% of total billed charges",3111,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3111,100,,,,,0,"fee schedule","100% of CMS fee schedule",2426.58,78,,1941.26,,,0,"percent of total billed charges","78% of total billed charges",3111,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2569.69,82.6,,2055.75,,,0,"percent of total billed charges","82.6% of total billed charges",5043.02,100,,,,,0,"fee schedule","100% of WA fee schedule",3111,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2569.69,82.6,,2055.75,,,0,"percent of total billed charges","82.6% of total billed charges",3111,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5203.55,100,,,,,0,"fee schedule",EAPG,3111,100,,2488.80,,,0,"percent of total billed charges","100% of total billed charges",475.98,6555.92,
"62252 Reprogramming of programmable cerebrospinal",7963420,CDM,521,RC,62252,CPT,OUTPATIENT,,,320,208,,281.6,88,,225.28,,,0,"percent of total billed charges","88% of total billed charges",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",533.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.74,100,,,,,0,"fee schedule",EAPG,304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",201.6,63,,161.28,,,0,"percent of total billed charges","63% of total billed charges",48.96,15.3,,39.17,,,0,"percent of total billed charges","15.3% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,220.8,69,,,,,0,"fee schedule","69% of total billed charges",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",304.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",1106.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.4,100,,,,,0,"fee schedule",EAPG,45.11,100,,,,,0,"fee schedule",EAPG,304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",120.64,37.7,,96.51,,,0,"percent of total billed charges","37.70% of total billed charges",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",249.6,78,,199.68,,,0,"percent of total billed charges","78% of total billed charges",307.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",264.32,82.6,,211.46,,,0,"percent of total billed charges","82.6% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",264.32,82.6,,211.46,,,0,"percent of total billed charges","82.6% of total billed charges",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",195.23,100,,,,,0,"fee schedule",EAPG,320,100,,256.00,,,0,"percent of total billed charges","100% of total billed charges",34.7,1106.9,
"62268 Percutaneous aspiration, spinal cord cyst or",7963319,CDM,521,RC,62268,CPT,OUTPATIENT,,,2269,1474.85,,1996.72,88,,1597.38,,,0,"percent of total billed charges","88% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,2269,100,,1815.20,,,0,"percent of total billed charges","100% of total billed charges",1626.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1429.47,63,,1143.58,,,0,"percent of total billed charges","63% of total billed charges",347.16,15.3,,277.73,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,1565.61,69,,,,,0,"fee schedule","69% of total billed charges",2269,100,,1815.20,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2269,100,,1815.20,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2269,100,,1815.20,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3341.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",855.41,37.7,,684.33,,,0,"percent of total billed charges","37.70% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1769.82,78,,1415.86,,,0,"percent of total billed charges","78% of total billed charges",938.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1874.19,82.6,,1499.35,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1874.19,82.6,,1499.35,,,0,"percent of total billed charges","82.6% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",931.2,100,,,,,0,"fee schedule",EAPG,2269,100,,1815.20,,,0,"percent of total billed charges","100% of total billed charges",347.16,3341.26,
"62269 Biopsy of spinal cord, percutaneous needle",7963552,CDM,521,RC,62269,CPT,OUTPATIENT,,,1948,1266.2,,1714.24,88,,1371.39,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1948,100,,1558.40,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1227.24,63,,981.79,,,0,"percent of total billed charges","63% of total billed charges",298.04,15.3,,238.43,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,1344.12,69,,,,,0,"fee schedule","69% of total billed charges",1948,100,,1558.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1948,100,,1558.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1948,100,,1558.40,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",734.4,37.7,,587.52,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1519.44,78,,1215.55,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1609.05,82.6,,1287.24,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1609.05,82.6,,1287.24,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",931.2,100,,,,,0,"fee schedule",EAPG,1948,100,,1558.40,,,0,"percent of total billed charges","100% of total billed charges",298.04,5715.97,
"62272 Spinal puncture, therapeutic, for drainage o",7961879,CDM,521,RC,62272,CPT,OUTPATIENT,,,435,282.75,,382.8,88,,306.24,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,435,100,,348.00,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",274.05,63,,219.24,,,0,"percent of total billed charges","63% of total billed charges",66.56,15.3,,53.25,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,300.15,69,,,,,0,"fee schedule","69% of total billed charges",435,100,,348.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",435,100,,348.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",435,100,,348.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",164,37.7,,131.20,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",339.3,78,,271.44,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",359.31,82.6,,287.45,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",359.31,82.6,,287.45,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",931.2,100,,,,,0,"fee schedule",EAPG,435,100,,348.00,,,0,"percent of total billed charges","100% of total billed charges",66.56,2578.03,
"62273 Injection, epidural, of blood or clot patch",7963498,CDM,521,RC,62273,CPT,OUTPATIENT,,,735,477.75,,646.8,88,,517.44,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,735,100,,588.00,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",463.05,63,,370.44,,,0,"percent of total billed charges","63% of total billed charges",112.46,15.3,,89.97,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,507.15,69,,,,,0,"fee schedule","69% of total billed charges",735,100,,588.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735,100,,588.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735,100,,588.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",277.1,37.7,,221.68,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",573.3,78,,458.64,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",607.11,82.6,,485.69,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",607.11,82.6,,485.69,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",931.2,100,,,,,0,"fee schedule",EAPG,735,100,,588.00,,,0,"percent of total billed charges","100% of total billed charges",112.46,2578.03,
"62270 Spinal puncture, lumbar, diagnostic",7963685,CDM,521,RC,62270,CPT,OUTPATIENT,,,519,337.35,,456.72,88,,365.38,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,519,100,,415.20,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",326.97,63,,261.58,,,0,"percent of total billed charges","63% of total billed charges",79.41,15.3,,63.53,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,358.11,69,,,,,0,"fee schedule","69% of total billed charges",519,100,,415.20,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",519,100,,415.20,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",519,100,,415.20,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",195.66,37.7,,156.53,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",404.82,78,,323.86,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",428.69,82.6,,342.95,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",428.69,82.6,,342.95,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",931.2,100,,,,,0,"fee schedule",EAPG,519,100,,415.20,,,0,"percent of total billed charges","100% of total billed charges",79.41,2578.03,
"62280 Injection/infusion of neurolytic substance (",7962118,CDM,521,RC,62280,CPT,OUTPATIENT,,,779,506.35,,685.52,88,,548.42,,,0,"percent of total billed charges","88% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,779,100,,623.20,,,0,"percent of total billed charges","100% of total billed charges",1626.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",490.77,63,,392.62,,,0,"percent of total billed charges","63% of total billed charges",119.19,15.3,,95.35,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,537.51,69,,,,,0,"fee schedule","69% of total billed charges",779,100,,623.20,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",779,100,,623.20,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",779,100,,623.20,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3341.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",293.68,37.7,,234.94,,,0,"percent of total billed charges","37.70% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",607.62,78,,486.10,,,0,"percent of total billed charges","78% of total billed charges",938.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.45,82.6,,514.76,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",643.45,82.6,,514.76,,,0,"percent of total billed charges","82.6% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",931.2,100,,,,,0,"fee schedule",EAPG,779,100,,623.20,,,0,"percent of total billed charges","100% of total billed charges",119.19,3341.26,
"62281 Injection/infusion of neurolytic substance;",7962686,CDM,521,RC,62281,CPT,OUTPATIENT,,,1123,729.95,,988.24,88,,790.59,,,0,"percent of total billed charges","88% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1123,100,,898.40,,,0,"percent of total billed charges","100% of total billed charges",1626.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",707.49,63,,565.99,,,0,"percent of total billed charges","63% of total billed charges",171.82,15.3,,137.46,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,774.87,69,,,,,0,"fee schedule","69% of total billed charges",1123,100,,898.40,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1123,100,,898.40,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1123,100,,898.40,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3341.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",423.37,37.7,,338.70,,,0,"percent of total billed charges","37.70% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",875.94,78,,700.75,,,0,"percent of total billed charges","78% of total billed charges",938.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",927.6,82.6,,742.08,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",927.6,82.6,,742.08,,,0,"percent of total billed charges","82.6% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",931.2,100,,,,,0,"fee schedule",EAPG,1123,100,,898.40,,,0,"percent of total billed charges","100% of total billed charges",171.82,3341.26,
"62287 Decompression procedure, percutaneous, singl",7962753,CDM,521,RC,62287,CPT,OUTPATIENT,,,3945,2564.25,,3471.6,88,,2777.28,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,3945,100,,3156.00,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2485.35,63,,1988.28,,,0,"percent of total billed charges","63% of total billed charges",603.59,15.3,,482.87,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,2722.05,69,,,,,0,"fee schedule","69% of total billed charges",3945,100,,3156.00,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3945,100,,3156.00,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3945,100,,3156.00,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1487.27,37.7,,1189.82,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3077.1,78,,2461.68,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3258.57,82.6,,2606.86,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3258.57,82.6,,2606.86,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,3945,100,,3156.00,,,0,"percent of total billed charges","100% of total billed charges",603.59,7127.26,
"62284 Injection procedure for myelography and/or c",7962833,CDM,521,RC,62284,CPT,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.05,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.76,61.85,,132.61,,,0,"percent of total billed charges","61.5% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",86.3,32.2,,69.04,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",278.32,100,,,,,0,"fee schedule",EAPG,354.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,134,50,,107.20,,,0,"percent of total billed charges","50% of total billed charges",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",433.4,100,,,,,0,"fee schedule",EAPG,268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,433.4,
"62291 Injection procedure for discography, each le",7962857,CDM,521,RC,62291,CPT,OUTPATIENT,,,1199,779.35,,1055.12,88,,844.10,,,0,"percent of total billed charges","88% of total billed charges",599.5,50,,479.60,,,0,"percent of total billed charges","50% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,1199,100,,959.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.05,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",755.37,63,,604.30,,,0,"percent of total billed charges","63% of total billed charges",183.45,15.3,,146.76,,,0,"percent of total billed charges","15.3% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,827.31,69,,,,,0,"fee schedule","69% of total billed charges",1199,100,,959.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1199,100,,959.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1199,100,,959.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",741.58,61.85,,593.26,,,0,"percent of total billed charges","61.5% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,599.5,50,,479.60,,,0,"percent of total billed charges","50% of total billed charges",386.08,32.2,,308.86,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",278.32,100,,,,,0,"fee schedule",EAPG,354.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",452.02,37.7,,361.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",935.22,78,,748.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",990.37,82.6,,792.30,,,0,"percent of total billed charges","82.6% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,599.5,50,,479.60,,,0,"percent of total billed charges","50% of total billed charges",990.37,82.6,,792.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",433.4,100,,,,,0,"fee schedule",EAPG,1199,100,,959.20,,,0,"percent of total billed charges","100% of total billed charges",183.45,1199,
"62290 Injection procedure for discography, each le",7963261,CDM,521,RC,62290,CPT,OUTPATIENT,,,1365,887.25,,1201.2,88,,960.96,,,0,"percent of total billed charges","88% of total billed charges",682.5,50,,546.00,,,0,"percent of total billed charges","50% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,1365,100,,1092.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.05,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",859.95,63,,687.96,,,0,"percent of total billed charges","63% of total billed charges",208.85,15.3,,167.08,,,0,"percent of total billed charges","15.3% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,941.85,69,,,,,0,"fee schedule","69% of total billed charges",1365,100,,1092.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1365,100,,1092.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1365,100,,1092.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",844.25,61.85,,675.40,,,0,"percent of total billed charges","61.5% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,682.5,50,,546.00,,,0,"percent of total billed charges","50% of total billed charges",439.53,32.2,,351.62,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",278.32,100,,,,,0,"fee schedule",EAPG,354.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",514.61,37.7,,411.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1064.7,78,,851.76,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1127.49,82.6,,901.99,,,0,"percent of total billed charges","82.6% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,682.5,50,,546.00,,,0,"percent of total billed charges","50% of total billed charges",1127.49,82.6,,901.99,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",433.4,100,,,,,0,"fee schedule",EAPG,1365,100,,1092.00,,,0,"percent of total billed charges","100% of total billed charges",208.85,1365,
"62311 Injection single lumbar or sacral",7904741,CDM,521,RC,62322,CPT,OUTPATIENT,,,799,519.35,,703.12,88,,562.50,,,0,"percent of total billed charges","88% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,799,100,,639.20,,,0,"percent of total billed charges","100% of total billed charges",1626.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",503.37,63,,402.70,,,0,"percent of total billed charges","63% of total billed charges",122.25,15.3,,97.80,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,551.31,69,,,,,0,"fee schedule","69% of total billed charges",799,100,,639.20,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",799,100,,639.20,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",799,100,,639.20,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",301.22,37.7,,240.98,,,0,"percent of total billed charges","37.70% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",623.22,78,,498.58,,,0,"percent of total billed charges","78% of total billed charges",938.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",659.97,82.6,,527.98,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",659.97,82.6,,527.98,,,0,"percent of total billed charges","82.6% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",931.2,100,,,,,0,"fee schedule",EAPG,799,100,,639.20,,,0,"percent of total billed charges","100% of total billed charges",122.25,2578.03,
"62310 Injection(s), of diagnostic or therapeutic s",7963240,CDM,521,RC,,,OUTPATIENT,,,890,578.5,,783.2,88,,626.56,,,0,"percent of total billed charges","88% of total billed charges",445,50,,356.00,,,0,"percent of total billed charges","50% of total billed charges",149.52,16.8,,119.62,,,0,"percent of total billed charges","16.8% of total billed charges",890,100,,712.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",154.01,17.304,,123.21,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",560.7,63,,448.56,,,0,"percent of total billed charges","63% of total billed charges",136.17,15.3,,108.94,,,0,"percent of total billed charges","15.3% of total billed charges",149.52,16.8,,119.62,,,0,"percent of total billed charges","16.8% of total billed charges",614.1,69,,,,,0,"fee schedule","69% of total billed charges",890,100,,712.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",890,100,,712.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",890,100,,712.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",550.47,61.85,,440.38,,,0,"percent of total billed charges","61.5% of total billed charges",149.52,16.8,,119.62,,,0,"percent of total billed charges","16.8% of total billed charges",445,50,,356.00,,,0,"percent of total billed charges","50% of total billed charges",286.58,32.2,,229.26,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",152.51,17.136,,122.01,,,0,"percent of total billed charges","17.136% of total billed charges",194.38,21.84,,155.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",335.53,37.7,,268.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",694.2,78,,555.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",735.14,82.6,,588.11,,,0,"percent of total billed charges","82.6% of total billed charges",149.52,16.8,,119.62,,,0,"percent of total billed charges","16.8% of total billed charges",445,50,,356.00,,,0,"percent of total billed charges","50% of total billed charges",735.14,82.6,,588.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",890,100,,712.00,,,0,"percent of total billed charges","100% of total billed charges",136.17,890,
"62318 inject spine w/cath crv/thrc",7963769,CDM,521,RC,,,OUTPATIENT,,,957,622.05,,842.16,88,,673.73,,,0,"percent of total billed charges","88% of total billed charges",478.5,50,,382.80,,,0,"percent of total billed charges","50% of total billed charges",160.78,16.8,,128.62,,,0,"percent of total billed charges","16.8% of total billed charges",957,100,,765.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.6,17.304,,132.48,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",602.91,63,,482.33,,,0,"percent of total billed charges","63% of total billed charges",146.42,15.3,,117.14,,,0,"percent of total billed charges","15.3% of total billed charges",160.78,16.8,,128.62,,,0,"percent of total billed charges","16.8% of total billed charges",660.33,69,,,,,0,"fee schedule","69% of total billed charges",957,100,,765.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",957,100,,765.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",957,100,,765.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",591.9,61.85,,473.52,,,0,"percent of total billed charges","61.5% of total billed charges",160.78,16.8,,128.62,,,0,"percent of total billed charges","16.8% of total billed charges",478.5,50,,382.80,,,0,"percent of total billed charges","50% of total billed charges",308.15,32.2,,246.52,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",163.99,17.136,,131.19,,,0,"percent of total billed charges","17.136% of total billed charges",209.01,21.84,,167.21,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",360.79,37.7,,288.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",746.46,78,,597.17,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",790.48,82.6,,632.38,,,0,"percent of total billed charges","82.6% of total billed charges",160.78,16.8,,128.62,,,0,"percent of total billed charges","16.8% of total billed charges",478.5,50,,382.80,,,0,"percent of total billed charges","50% of total billed charges",790.48,82.6,,632.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",957,100,,765.60,,,0,"percent of total billed charges","100% of total billed charges",146.42,957,
"62319 inject spine w/cath lmb/scrl",7963770,CDM,521,RC,,,OUTPATIENT,,,861,559.65,,757.68,88,,606.14,,,0,"percent of total billed charges","88% of total billed charges",430.5,50,,344.40,,,0,"percent of total billed charges","50% of total billed charges",144.65,16.8,,115.72,,,0,"percent of total billed charges","16.8% of total billed charges",861,100,,688.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",148.99,17.304,,119.19,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",542.43,63,,433.94,,,0,"percent of total billed charges","63% of total billed charges",131.73,15.3,,105.38,,,0,"percent of total billed charges","15.3% of total billed charges",144.65,16.8,,115.72,,,0,"percent of total billed charges","16.8% of total billed charges",594.09,69,,,,,0,"fee schedule","69% of total billed charges",861,100,,688.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",861,100,,688.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",861,100,,688.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",532.53,61.85,,426.02,,,0,"percent of total billed charges","61.5% of total billed charges",144.65,16.8,,115.72,,,0,"percent of total billed charges","16.8% of total billed charges",430.5,50,,344.40,,,0,"percent of total billed charges","50% of total billed charges",277.24,32.2,,221.79,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",147.54,17.136,,118.03,,,0,"percent of total billed charges","17.136% of total billed charges",188.04,21.84,,150.43,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",324.6,37.7,,259.68,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",671.58,78,,537.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",711.19,82.6,,568.95,,,0,"percent of total billed charges","82.6% of total billed charges",144.65,16.8,,115.72,,,0,"percent of total billed charges","16.8% of total billed charges",430.5,50,,344.40,,,0,"percent of total billed charges","50% of total billed charges",711.19,82.6,,568.95,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",861,100,,688.80,,,0,"percent of total billed charges","100% of total billed charges",131.73,861,
"62350 Implantation, revision or repositioning of t",7962210,CDM,521,RC,62350,CPT,OUTPATIENT,,,2282,1483.3,,2008.16,88,,1606.53,,,0,"percent of total billed charges","88% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,2282,100,,1825.60,,,0,"percent of total billed charges","100% of total billed charges",11890.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1437.66,63,,1150.13,,,0,"percent of total billed charges","63% of total billed charges",349.15,15.3,,279.32,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,1574.58,69,,,,,0,"fee schedule","69% of total billed charges",2282,100,,1825.60,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2282,100,,1825.60,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2282,100,,1825.60,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",23157.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6054.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",860.31,37.7,,688.25,,,0,"percent of total billed charges","37.70% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1779.96,78,,1423.97,,,0,"percent of total billed charges","78% of total billed charges",6862.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1884.93,82.6,,1507.94,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1884.93,82.6,,1507.94,,,0,"percent of total billed charges","82.6% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,2282,100,,1825.60,,,0,"percent of total billed charges","100% of total billed charges",349.15,23157.6,
"62351 Implantation, revision or repositioning of t",7962211,CDM,521,RC,62351,CPT,OUTPATIENT,,,3827,2487.55,,3367.76,88,,2694.21,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9236.61,100,,,,,0,"fee schedule",EAPG,3827,100,,3061.60,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2411.01,63,,1928.81,,,0,"percent of total billed charges","63% of total billed charges",585.53,15.3,,468.42,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,2640.63,69,,,,,0,"fee schedule","69% of total billed charges",3827,100,,3061.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3827,100,,3061.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3827,100,,3061.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9236.61,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1442.78,37.7,,1154.22,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2985.06,78,,2388.05,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3161.1,82.6,,2528.88,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3161.1,82.6,,2528.88,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9397.14,100,,,,,0,"fee schedule",EAPG,3827,100,,3061.60,,,0,"percent of total billed charges","100% of total billed charges",585.53,25451.55,
"62355 Removal of previously implanted intrathecal",7962954,CDM,521,RC,62355,CPT,OUTPATIENT,,,1564,1016.6,,1376.32,88,,1101.06,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1564,100,,1251.20,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",985.32,63,,788.26,,,0,"percent of total billed charges","63% of total billed charges",239.29,15.3,,191.43,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,1079.16,69,,,,,0,"fee schedule","69% of total billed charges",1564,100,,1251.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1564,100,,1251.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1564,100,,1251.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",589.63,37.7,,471.70,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1219.92,78,,975.94,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1291.86,82.6,,1033.49,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1291.86,82.6,,1033.49,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",931.2,100,,,,,0,"fee schedule",EAPG,1564,100,,1251.20,,,0,"percent of total billed charges","100% of total billed charges",239.29,7127.26,
"62365 Removal of subq reservoir or pump, previousl",7961708,CDM,521,RC,62365,CPT,OUTPATIENT,,,1516,985.4,,1334.08,88,,1067.26,,,0,"percent of total billed charges","88% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,1516,100,,1212.80,,,0,"percent of total billed charges","100% of total billed charges",11890.25,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",955.08,63,,764.06,,,0,"percent of total billed charges","63% of total billed charges",231.95,15.3,,185.56,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,1046.04,69,,,,,0,"fee schedule","69% of total billed charges",1516,100,,1212.80,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1516,100,,1212.80,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1516,100,,1212.80,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",23157.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6054.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",571.53,37.7,,457.22,,,0,"percent of total billed charges","37.70% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1182.48,78,,945.98,,,0,"percent of total billed charges","78% of total billed charges",6862.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1252.22,82.6,,1001.78,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1252.22,82.6,,1001.78,,,0,"percent of total billed charges","82.6% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,1516,100,,1212.80,,,0,"percent of total billed charges","100% of total billed charges",231.95,23157.61,
"62360 Implantation or replacement of device for in",7962154,CDM,521,RC,62360,CPT,OUTPATIENT,,,1530,994.5,,1346.4,88,,1077.12,,,0,"percent of total billed charges","88% of total billed charges",18190.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",257.04,16.8,,205.63,,,0,"percent of total billed charges","16.8% of total billed charges",1530,100,,1224.00,,,0,"percent of total billed charges","100% of total billed charges",31833.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",264.75,17.304,,211.80,,,0,"percent of total billed charges","17.304% of total billed charges",18190.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",963.9,63,,771.12,,,0,"percent of total billed charges","63% of total billed charges",234.09,15.3,,187.27,,,0,"percent of total billed charges","15.3% of total billed charges",257.04,16.8,,205.63,,,0,"percent of total billed charges","16.8% of total billed charges",1055.7,69,,,,,0,"fee schedule","69% of total billed charges",1530,100,,1224.00,,,0,"percent of total billed charges","100% of total billed charges",18190.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530,100,,1224.00,,,0,"percent of total billed charges","100% of total billed charges",18190.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1530,100,,1224.00,,,0,"percent of total billed charges","100% of total billed charges",18190.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",69192.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",257.04,16.8,,205.63,,,0,"percent of total billed charges","16.8% of total billed charges",18190.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18089.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",18190.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",262.18,17.136,,209.74,,,0,"percent of total billed charges","17.136% of total billed charges",334.15,21.84,,267.32,,,0,"percent of total billed charges","21.84% of total billed charges",18190.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",576.81,37.7,,461.45,,,0,"percent of total billed charges","37.70% of total billed charges",18190.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",18190.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1193.4,78,,954.72,,,0,"percent of total billed charges","78% of total billed charges",18372.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1263.78,82.6,,1011.02,,,0,"percent of total billed charges","82.6% of total billed charges",257.04,16.8,,205.63,,,0,"percent of total billed charges","16.8% of total billed charges",18190.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1263.78,82.6,,1011.02,,,0,"percent of total billed charges","82.6% of total billed charges",18190.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"case rate","pays based on per visit rate",1530,100,,1224.00,,,0,"percent of total billed charges","100% of total billed charges",160.53,69192.63,
"62362 Implantation or replacement of device for in",7962508,CDM,521,RC,62362,CPT,OUTPATIENT,,,2252,1463.8,,1981.76,88,,1585.41,,,0,"percent of total billed charges","88% of total billed charges",18190.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",378.34,16.8,,302.67,,,0,"percent of total billed charges","16.8% of total billed charges",2252,100,,1801.60,,,0,"percent of total billed charges","100% of total billed charges",31833.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",389.69,17.304,,311.75,,,0,"percent of total billed charges","17.304% of total billed charges",18190.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1418.76,63,,1135.01,,,0,"percent of total billed charges","63% of total billed charges",344.56,15.3,,275.65,,,0,"percent of total billed charges","15.3% of total billed charges",378.34,16.8,,302.67,,,0,"percent of total billed charges","16.8% of total billed charges",1553.88,69,,,,,0,"fee schedule","69% of total billed charges",2252,100,,1801.60,,,0,"percent of total billed charges","100% of total billed charges",18190.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2252,100,,1801.60,,,0,"percent of total billed charges","100% of total billed charges",18190.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2252,100,,1801.60,,,0,"percent of total billed charges","100% of total billed charges",18190.34,100,,,,,0,"fee schedule","100% of CMS fee schedule",69192.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",378.34,16.8,,302.67,,,0,"percent of total billed charges","16.8% of total billed charges",18190.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18089.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",18190.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",385.9,17.136,,308.72,,,0,"percent of total billed charges","17.136% of total billed charges",491.84,21.84,,393.47,,,0,"percent of total billed charges","21.84% of total billed charges",18190.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",849,37.7,,679.20,,,0,"percent of total billed charges","37.70% of total billed charges",18190.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",18190.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1756.56,78,,1405.25,,,0,"percent of total billed charges","78% of total billed charges",18372.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1860.15,82.6,,1488.12,,,0,"percent of total billed charges","82.6% of total billed charges",378.34,16.8,,302.67,,,0,"percent of total billed charges","16.8% of total billed charges",18190.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1860.15,82.6,,1488.12,,,0,"percent of total billed charges","82.6% of total billed charges",18190.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"case rate","pays based on per visit rate",2252,100,,1801.60,,,0,"percent of total billed charges","100% of total billed charges",160.53,69192.63,
"62367 Baclofen analysis; w/o reprogramming or refi",7963470,CDM,521,RC,62367,CPT,OUTPATIENT,,,163,105.95,,143.44,88,,114.75,,,0,"percent of total billed charges","88% of total billed charges",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.02,100,,,,,0,"fee schedule",EAPG,163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",533.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",135.99,100,,,,,0,"fee schedule",EAPG,304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.69,63,,82.15,,,0,"percent of total billed charges","63% of total billed charges",24.94,15.3,,19.95,,,0,"percent of total billed charges","15.3% of total billed charges",132.02,100,,,,,0,"fee schedule",EAPG,112.47,69,,,,,0,"fee schedule","69% of total billed charges",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",304.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",1106.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.02,100,,,,,0,"fee schedule",EAPG,304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",134.67,100,,,,,0,"fee schedule",EAPG,171.63,100,,,,,0,"fee schedule",EAPG,304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",61.45,37.7,,49.16,,,0,"percent of total billed charges","37.70% of total billed charges",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",127.14,78,,101.71,,,0,"percent of total billed charges","78% of total billed charges",307.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",134.64,82.6,,107.71,,,0,"percent of total billed charges","82.6% of total billed charges",132.02,100,,,,,0,"fee schedule",EAPG,304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",134.64,82.6,,107.71,,,0,"percent of total billed charges","82.6% of total billed charges",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",292.55,100,,,,,0,"fee schedule",EAPG,163,100,,130.40,,,0,"percent of total billed charges","100% of total billed charges",24.94,1106.9,
"62368 Baclofen analysis; w/ reprogramming only",7963589,CDM,521,RC,62368,CPT,OUTPATIENT,,,241,156.65,,212.08,88,,169.66,,,0,"percent of total billed charges","88% of total billed charges",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.02,100,,,,,0,"fee schedule",EAPG,241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",533.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",135.99,100,,,,,0,"fee schedule",EAPG,304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.83,63,,121.46,,,0,"percent of total billed charges","63% of total billed charges",36.87,15.3,,29.50,,,0,"percent of total billed charges","15.3% of total billed charges",132.02,100,,,,,0,"fee schedule",EAPG,166.29,69,,,,,0,"fee schedule","69% of total billed charges",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",304.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",1106.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.02,100,,,,,0,"fee schedule",EAPG,304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",134.67,100,,,,,0,"fee schedule",EAPG,171.63,100,,,,,0,"fee schedule",EAPG,304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",90.86,37.7,,72.69,,,0,"percent of total billed charges","37.70% of total billed charges",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",187.98,78,,150.38,,,0,"percent of total billed charges","78% of total billed charges",307.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.07,82.6,,159.26,,,0,"percent of total billed charges","82.6% of total billed charges",132.02,100,,,,,0,"fee schedule",EAPG,304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.07,82.6,,159.26,,,0,"percent of total billed charges","82.6% of total billed charges",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",292.55,100,,,,,0,"fee schedule",EAPG,241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",36.87,1106.9,
"63005 Laminectomy w/exploration/decompression spin",7961546,CDM,521,RC,63005,CPT,OUTPATIENT,,,5685,3695.25,,5002.8,88,,4002.24,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3581.55,63,,2865.24,,,0,"percent of total billed charges","63% of total billed charges",869.81,15.3,,695.85,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,3922.65,69,,,,,0,"fee schedule","69% of total billed charges",5685,100,,4548.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5685,100,,4548.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5685,100,,4548.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2143.25,37.7,,1714.60,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4434.3,78,,3547.44,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4695.81,82.6,,3756.65,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4695.81,82.6,,3756.65,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,5685,100,,4548.00,,,0,"percent of total billed charges","100% of total billed charges",869.81,25451.55,
"63001 Laminectomy w/exploration/decompression spin",7962303,CDM,521,RC,63001,CPT,OUTPATIENT,,,4526,2941.9,,3982.88,88,,3186.30,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,4526,100,,3620.80,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2851.38,63,,2281.10,,,0,"percent of total billed charges","63% of total billed charges",692.48,15.3,,553.98,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,3122.94,69,,,,,0,"fee schedule","69% of total billed charges",4526,100,,3620.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4526,100,,3620.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4526,100,,3620.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1706.3,37.7,,1365.04,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3530.28,78,,2824.22,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3738.48,82.6,,2990.78,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3738.48,82.6,,2990.78,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,4526,100,,3620.80,,,0,"percent of total billed charges","100% of total billed charges",692.48,25451.55,
"63003 Laminectomy w/exploration/decompression spin",7962347,CDM,521,RC,63003,CPT,OUTPATIENT,,,5120,3328,,4505.6,88,,3604.48,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3225.6,63,,2580.48,,,0,"percent of total billed charges","63% of total billed charges",783.36,15.3,,626.69,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,3532.8,69,,,,,0,"fee schedule","69% of total billed charges",5120,100,,4096.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5120,100,,4096.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5120,100,,4096.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1930.24,37.7,,1544.19,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3993.6,78,,3194.88,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4229.12,82.6,,3383.30,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4229.12,82.6,,3383.30,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,5120,100,,4096.00,,,0,"percent of total billed charges","100% of total billed charges",783.36,25451.55,
"63012 Laminectomy w/removal of abnormal facets w/d",7961631,CDM,521,RC,63012,CPT,OUTPATIENT,,,6571,4271.15,,5782.48,88,,4625.98,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4139.73,63,,3311.78,,,0,"percent of total billed charges","63% of total billed charges",1005.36,15.3,,804.29,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,4533.99,69,,,,,0,"fee schedule","69% of total billed charges",6571,100,,5256.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6571,100,,5256.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6571,100,,5256.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2477.27,37.7,,1981.82,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5125.38,78,,4100.30,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5427.65,82.6,,4342.12,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5427.65,82.6,,4342.12,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,6571,100,,5256.80,,,0,"percent of total billed charges","100% of total billed charges",1005.36,25451.55,
"63017 Laminectomy w/exploration,decompression,spin",7961632,CDM,521,RC,63017,CPT,OUTPATIENT,,,6614,4299.1,,5820.32,88,,4656.26,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4166.82,63,,3333.46,,,0,"percent of total billed charges","63% of total billed charges",1011.94,15.3,,809.55,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,4563.66,69,,,,,0,"fee schedule","69% of total billed charges",6614,100,,5291.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6614,100,,5291.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6614,100,,5291.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2493.48,37.7,,1994.78,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5158.92,78,,4127.14,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5463.16,82.6,,4370.53,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5463.16,82.6,,4370.53,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,6614,100,,5291.20,,,0,"percent of total billed charges","100% of total billed charges",1011.94,25451.55,
"63016 Laminectomy w/exploration,decompression of s",7961709,CDM,521,RC,63016,CPT,OUTPATIENT,,,5804,3772.6,,5107.52,88,,4086.02,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3656.52,63,,2925.22,,,0,"percent of total billed charges","63% of total billed charges",888.01,15.3,,710.41,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,4004.76,69,,,,,0,"fee schedule","69% of total billed charges",5804,100,,4643.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5804,100,,4643.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5804,100,,4643.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2188.11,37.7,,1750.49,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4527.12,78,,3621.70,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4794.1,82.6,,3835.28,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4794.1,82.6,,3835.28,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,5804,100,,4643.20,,,0,"percent of total billed charges","100% of total billed charges",888.01,25451.55,
"63015 Laminectomy w/exploration,decompression spin",7961835,CDM,521,RC,63015,CPT,OUTPATIENT,,,7322,4759.3,,6443.36,88,,5154.69,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4612.86,63,,3690.29,,,0,"percent of total billed charges","63% of total billed charges",1120.27,15.3,,896.22,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,5052.18,69,,,,,0,"fee schedule","69% of total billed charges",7322,100,,5857.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7322,100,,5857.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7322,100,,5857.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2760.39,37.7,,2208.31,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5711.16,78,,4568.93,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6047.97,82.6,,4838.38,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6047.97,82.6,,4838.38,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,7322,100,,5857.60,,,0,"percent of total billed charges","100% of total billed charges",1120.27,25451.55,
"63011 Laminectomy w/exploration/decompression spin",7962348,CDM,521,RC,63011,CPT,OUTPATIENT,,,5019,3262.35,,4416.72,88,,3533.38,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3161.97,63,,2529.58,,,0,"percent of total billed charges","63% of total billed charges",767.91,15.3,,614.33,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,3463.11,69,,,,,0,"fee schedule","69% of total billed charges",5019,100,,4015.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5019,100,,4015.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5019,100,,4015.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1892.16,37.7,,1513.73,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3914.82,78,,3131.86,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4145.69,82.6,,3316.55,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4145.69,82.6,,3316.55,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,5019,100,,4015.20,,,0,"percent of total billed charges","100% of total billed charges",767.91,25451.55,
"63020 Laminotomy,w/decomp of nerve root/s; 1 inter",7963154,CDM,521,RC,63020,CPT,OUTPATIENT,,,6992,4544.8,,6152.96,88,,4922.37,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4404.96,63,,3523.97,,,0,"percent of total billed charges","63% of total billed charges",1069.78,15.3,,855.82,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,4824.48,69,,,,,0,"fee schedule","69% of total billed charges",6992,100,,5593.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6992,100,,5593.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6992,100,,5593.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2635.98,37.7,,2108.78,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5453.76,78,,4363.01,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5775.39,82.6,,4620.31,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5775.39,82.6,,4620.31,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,6992,100,,5593.60,,,0,"percent of total billed charges","100% of total billed charges",1069.78,25451.55,
"63035 Laminotomy,w/decomp of nerve root/s; each ad",7962384,CDM,521,RC,63035,CPT,OUTPATIENT,,,1555,1010.75,,1368.4,88,,1094.72,,,0,"percent of total billed charges","88% of total billed charges",777.5,50,,622.00,,,0,"percent of total billed charges","50% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,1555,100,,1244.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4318.67,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",979.65,63,,783.72,,,0,"percent of total billed charges","63% of total billed charges",237.92,15.3,,190.34,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,1072.95,69,,,,,0,"fee schedule","69% of total billed charges",1555,100,,1244.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1555,100,,1244.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1555,100,,1244.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",961.77,61.85,,769.42,,,0,"percent of total billed charges","61.5% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,777.5,50,,622.00,,,0,"percent of total billed charges","50% of total billed charges",500.71,32.2,,400.57,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",586.24,37.7,,468.99,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1212.9,78,,970.32,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1284.43,82.6,,1027.54,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,777.5,50,,622.00,,,0,"percent of total billed charges","50% of total billed charges",1284.43,82.6,,1027.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4353.41,100,,,,,0,"fee schedule",EAPG,1555,100,,1244.00,,,0,"percent of total billed charges","100% of total billed charges",237.92,5450.75,
"63030 Laminotomy,w/decomp of nerve root/s; 1 inter",7963204,CDM,521,RC,63030,CPT,OUTPATIENT,,,6169,4009.85,,5428.72,88,,4342.98,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3886.47,63,,3109.18,,,0,"percent of total billed charges","63% of total billed charges",943.86,15.3,,755.09,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,4256.61,69,,,,,0,"fee schedule","69% of total billed charges",6169,100,,4935.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6169,100,,4935.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6169,100,,4935.20,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2325.71,37.7,,1860.57,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4811.82,78,,3849.46,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5095.59,82.6,,4076.47,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5095.59,82.6,,4076.47,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,6169,100,,4935.20,,,0,"percent of total billed charges","100% of total billed charges",943.86,25451.55,
"63043 Laminotomy,w/decomp nerve root/s,reexplorati",7961547,CDM,521,RC,63043,CPT,OUTPATIENT,,,1377,895.05,,1211.76,88,,969.41,,,0,"percent of total billed charges","88% of total billed charges",688.5,50,,550.80,,,0,"percent of total billed charges","50% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,1377,100,,1101.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4318.67,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",867.51,63,,694.01,,,0,"percent of total billed charges","63% of total billed charges",210.68,15.3,,168.54,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,950.13,69,,,,,0,"fee schedule","69% of total billed charges",1377,100,,1101.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1377,100,,1101.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1377,100,,1101.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",851.67,61.85,,681.34,,,0,"percent of total billed charges","61.5% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,688.5,50,,550.80,,,0,"percent of total billed charges","50% of total billed charges",443.39,32.2,,354.71,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",519.13,37.7,,415.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1074.06,78,,859.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1137.4,82.6,,909.92,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,688.5,50,,550.80,,,0,"percent of total billed charges","50% of total billed charges",1137.4,82.6,,909.92,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4353.41,100,,,,,0,"fee schedule",EAPG,1377,100,,1101.60,,,0,"percent of total billed charges","100% of total billed charges",210.68,5450.75,
"63044 Laminotomy,w/decomp of nerve root/s,reexplor",7961548,CDM,521,RC,63044,CPT,OUTPATIENT,,,1811,1177.15,,1593.68,88,,1274.94,,,0,"percent of total billed charges","88% of total billed charges",905.5,50,,724.40,,,0,"percent of total billed charges","50% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,1811,100,,1448.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9513.71,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1140.93,63,,912.74,,,0,"percent of total billed charges","63% of total billed charges",277.08,15.3,,221.66,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,1249.59,69,,,,,0,"fee schedule","69% of total billed charges",1811,100,,1448.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1811,100,,1448.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1811,100,,1448.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1120.1,61.85,,896.08,,,0,"percent of total billed charges","61.5% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,905.5,50,,724.40,,,0,"percent of total billed charges","50% of total billed charges",583.14,32.2,,466.51,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",682.75,37.7,,546.20,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1412.58,78,,1130.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1495.89,82.6,,1196.71,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,905.5,50,,724.40,,,0,"percent of total billed charges","50% of total billed charges",1495.89,82.6,,1196.71,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9397.14,100,,,,,0,"fee schedule",EAPG,1811,100,,1448.80,,,0,"percent of total billed charges","100% of total billed charges",277.08,12007.59,
"63048 Laminectomy,w/decomp spinal cord, single ver",7961710,CDM,521,RC,63048,CPT,OUTPATIENT,,,1479,961.35,,1301.52,88,,1041.22,,,0,"percent of total billed charges","88% of total billed charges",739.5,50,,591.60,,,0,"percent of total billed charges","50% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,1479,100,,1183.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4318.67,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",931.77,63,,745.42,,,0,"percent of total billed charges","63% of total billed charges",226.29,15.3,,181.03,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,1020.51,69,,,,,0,"fee schedule","69% of total billed charges",1479,100,,1183.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1479,100,,1183.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1479,100,,1183.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",914.76,61.85,,731.81,,,0,"percent of total billed charges","61.5% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,739.5,50,,591.60,,,0,"percent of total billed charges","50% of total billed charges",476.24,32.2,,380.99,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",557.58,37.7,,446.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1153.62,78,,922.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1221.65,82.6,,977.32,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,739.5,50,,591.60,,,0,"percent of total billed charges","50% of total billed charges",1221.65,82.6,,977.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4353.41,100,,,,,0,"fee schedule",EAPG,1479,100,,1183.20,,,0,"percent of total billed charges","100% of total billed charges",226.29,5450.75,
"63045 Laminectomy, w/decompression spinal cord,ner",7961941,CDM,521,RC,63045,CPT,OUTPATIENT,,,7576,4924.4,,6666.88,88,,5333.50,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4772.88,63,,3818.30,,,0,"percent of total billed charges","63% of total billed charges",1159.13,15.3,,927.30,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,5227.44,69,,,,,0,"fee schedule","69% of total billed charges",7576,100,,6060.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7576,100,,6060.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7576,100,,6060.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2856.15,37.7,,2284.92,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5909.28,78,,4727.42,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6257.78,82.6,,5006.22,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6257.78,82.6,,5006.22,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,7576,100,,6060.80,,,0,"percent of total billed charges","100% of total billed charges",1159.13,25451.55,
"63046 Laminectomy, w/decompression spinal cord,ner",7961942,CDM,521,RC,63046,CPT,OUTPATIENT,,,5897,3833.05,,5189.36,88,,4151.49,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3715.11,63,,2972.09,,,0,"percent of total billed charges","63% of total billed charges",902.24,15.3,,721.79,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,4068.93,69,,,,,0,"fee schedule","69% of total billed charges",5897,100,,4717.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5897,100,,4717.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5897,100,,4717.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2223.17,37.7,,1778.54,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4599.66,78,,3679.73,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4870.92,82.6,,3896.74,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4870.92,82.6,,3896.74,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,5897,100,,4717.60,,,0,"percent of total billed charges","100% of total billed charges",902.24,25451.55,
"63047 Laminectomy, w/decompression spinal cord,ner",7962262,CDM,521,RC,63047,CPT,OUTPATIENT,,,7005,4553.25,,6164.4,88,,4931.52,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4413.15,63,,3530.52,,,0,"percent of total billed charges","63% of total billed charges",1071.77,15.3,,857.42,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,4833.45,69,,,,,0,"fee schedule","69% of total billed charges",7005,100,,5604.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7005,100,,5604.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7005,100,,5604.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2640.89,37.7,,2112.71,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5463.9,78,,4371.12,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5786.13,82.6,,4628.90,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5786.13,82.6,,4628.90,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,7005,100,,5604.00,,,0,"percent of total billed charges","100% of total billed charges",1071.77,25451.55,
"63040 Laminotomy,w/decomp of nerve root/s, reexplo",7962509,CDM,521,RC,63040,CPT,OUTPATIENT,,,4902,3186.3,,4313.76,88,,3451.01,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3088.26,63,,2470.61,,,0,"percent of total billed charges","63% of total billed charges",750.01,15.3,,600.01,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,3382.38,69,,,,,0,"fee schedule","69% of total billed charges",4902,100,,3921.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4902,100,,3921.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4902,100,,3921.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1848.05,37.7,,1478.44,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3823.56,78,,3058.85,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4049.05,82.6,,3239.24,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4049.05,82.6,,3239.24,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,4902,100,,3921.60,,,0,"percent of total billed charges","100% of total billed charges",750.01,25451.55,
"63042 Laminotomy,w/decomp of nerve root/s,reexplor",7962648,CDM,521,RC,63042,CPT,OUTPATIENT,,,7381,4797.65,,6495.28,88,,5196.22,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4650.03,63,,3720.02,,,0,"percent of total billed charges","63% of total billed charges",1129.29,15.3,,903.43,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,5092.89,69,,,,,0,"fee schedule","69% of total billed charges",7381,100,,5904.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7381,100,,5904.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7381,100,,5904.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2782.64,37.7,,2226.11,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5757.18,78,,4605.74,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6096.71,82.6,,4877.37,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6096.71,82.6,,4877.37,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,7381,100,,5904.80,,,0,"percent of total billed charges","100% of total billed charges",1129.29,25451.55,
"63057 Transpedicular approach w/decomp of spinal c",7961633,CDM,521,RC,63057,CPT,OUTPATIENT,,,2243,1457.95,,1973.84,88,,1579.07,,,0,"percent of total billed charges","88% of total billed charges",1121.5,50,,897.20,,,0,"percent of total billed charges","50% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,2243,100,,1794.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4318.67,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1413.09,63,,1130.47,,,0,"percent of total billed charges","63% of total billed charges",343.18,15.3,,274.54,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,1547.67,69,,,,,0,"fee schedule","69% of total billed charges",2243,100,,1794.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2243,100,,1794.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2243,100,,1794.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1387.3,61.85,,1109.84,,,0,"percent of total billed charges","61.5% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,1121.5,50,,897.20,,,0,"percent of total billed charges","50% of total billed charges",722.25,32.2,,577.80,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",845.61,37.7,,676.49,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1749.54,78,,1399.63,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1852.72,82.6,,1482.18,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,1121.5,50,,897.20,,,0,"percent of total billed charges","50% of total billed charges",1852.72,82.6,,1482.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4353.41,100,,,,,0,"fee schedule",EAPG,2243,100,,1794.40,,,0,"percent of total billed charges","100% of total billed charges",343.18,5450.75,
"63055 Transpedicular approach with decomp of spina",7962611,CDM,521,RC,63055,CPT,OUTPATIENT,,,6557,4262.05,,5770.16,88,,4616.13,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4130.91,63,,3304.73,,,0,"percent of total billed charges","63% of total billed charges",1003.22,15.3,,802.58,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,4524.33,69,,,,,0,"fee schedule","69% of total billed charges",6557,100,,5245.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6557,100,,5245.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6557,100,,5245.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2471.99,37.7,,1977.59,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5114.46,78,,4091.57,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5416.08,82.6,,4332.86,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5416.08,82.6,,4332.86,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,6557,100,,5245.60,,,0,"percent of total billed charges","100% of total billed charges",1003.22,25451.55,
"63056 Transpedicular approach with decomp of spina",7962687,CDM,521,RC,63056,CPT,OUTPATIENT,,,7327,4762.55,,6447.76,88,,5158.21,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4616.01,63,,3692.81,,,0,"percent of total billed charges","63% of total billed charges",1121.03,15.3,,896.82,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,5055.63,69,,,,,0,"fee schedule","69% of total billed charges",7327,100,,5861.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7327,100,,5861.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7327,100,,5861.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2762.28,37.7,,2209.82,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5715.06,78,,4572.05,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6052.1,82.6,,4841.68,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6052.1,82.6,,4841.68,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,7327,100,,5861.60,,,0,"percent of total billed charges","100% of total billed charges",1121.03,25451.55,
"63051 Laminoplasty, cervical, w/decomp spinal cord",7962913,CDM,521,RC,63051,CPT,OUTPATIENT,,,6102,3966.3,,5369.76,88,,4295.81,,,0,"percent of total billed charges","88% of total billed charges",6102,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6102,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,6102,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3844.26,63,,3075.41,,,0,"percent of total billed charges","63% of total billed charges",933.61,15.3,,746.89,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,4210.38,69,,,,,0,"fee schedule","69% of total billed charges",6102,100,,4881.60,,,0,"percent of total billed charges","100% of total billed charges",6102,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6102,100,,4881.60,,,0,"percent of total billed charges","100% of total billed charges",6102,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6102,100,,4881.60,,,0,"percent of total billed charges","100% of total billed charges",6102,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6102,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,6102,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6102,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6102,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,6102,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2300.45,37.7,,1840.36,,,0,"percent of total billed charges","37.70% of total billed charges",6102,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6102,100,,,,,0,"fee schedule","100% of CMS fee schedule",4759.56,78,,3807.65,,,0,"percent of total billed charges","78% of total billed charges",6102,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5040.25,82.6,,4032.20,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,6102,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5040.25,82.6,,4032.20,,,0,"percent of total billed charges","82.6% of total billed charges",6102,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9397.14,100,,,,,0,"fee schedule",EAPG,6102,100,,4881.60,,,0,"percent of total billed charges","100% of total billed charges",933.61,12007.59,
"63066 Costovertebral approach w/decomp of spinal c",7962194,CDM,521,RC,63066,CPT,OUTPATIENT,,,1879,1221.35,,1653.52,88,,1322.82,,,0,"percent of total billed charges","88% of total billed charges",939.5,50,,751.60,,,0,"percent of total billed charges","50% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,1879,100,,1503.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4318.67,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1183.77,63,,947.02,,,0,"percent of total billed charges","63% of total billed charges",287.49,15.3,,229.99,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,1296.51,69,,,,,0,"fee schedule","69% of total billed charges",1879,100,,1503.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1879,100,,1503.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1879,100,,1503.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1162.16,61.85,,929.73,,,0,"percent of total billed charges","61.5% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,939.5,50,,751.60,,,0,"percent of total billed charges","50% of total billed charges",605.04,32.2,,484.03,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",708.38,37.7,,566.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1465.62,78,,1172.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1552.05,82.6,,1241.64,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,939.5,50,,751.60,,,0,"percent of total billed charges","50% of total billed charges",1552.05,82.6,,1241.64,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4353.41,100,,,,,0,"fee schedule",EAPG,1879,100,,1503.20,,,0,"percent of total billed charges","100% of total billed charges",287.49,5450.75,
"63064 Costovertebral approach w/decomp of spinal c",7962263,CDM,521,RC,63064,CPT,OUTPATIENT,,,6985,4540.25,,6146.8,88,,4917.44,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4400.55,63,,3520.44,,,0,"percent of total billed charges","63% of total billed charges",1068.71,15.3,,854.97,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,4819.65,69,,,,,0,"fee schedule","69% of total billed charges",6985,100,,5588.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6985,100,,5588.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6985,100,,5588.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2633.35,37.7,,2106.68,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5448.3,78,,4358.64,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5769.61,82.6,,4615.69,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5769.61,82.6,,4615.69,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,6985,100,,5588.00,,,0,"percent of total billed charges","100% of total billed charges",1068.71,25451.55,
"63076 Discectomy,anterior,w/decomp of spinal cord,",7961549,CDM,521,RC,63076,CPT,OUTPATIENT,,,1806,1173.9,,1589.28,88,,1271.42,,,0,"percent of total billed charges","88% of total billed charges",903,50,,722.40,,,0,"percent of total billed charges","50% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,1806,100,,1444.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9513.71,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1137.78,63,,910.22,,,0,"percent of total billed charges","63% of total billed charges",276.32,15.3,,221.06,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,1246.14,69,,,,,0,"fee schedule","69% of total billed charges",1806,100,,1444.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1806,100,,1444.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1806,100,,1444.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1117.01,61.85,,893.61,,,0,"percent of total billed charges","61.5% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,903,50,,722.40,,,0,"percent of total billed charges","50% of total billed charges",581.53,32.2,,465.22,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",680.86,37.7,,544.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1408.68,78,,1126.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1491.76,82.6,,1193.41,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,903,50,,722.40,,,0,"percent of total billed charges","50% of total billed charges",1491.76,82.6,,1193.41,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",9397.14,100,,,,,0,"fee schedule",EAPG,1806,100,,1444.80,,,0,"percent of total billed charges","100% of total billed charges",276.32,12007.59,
"63077 Discectomy,anterior,w/decomp of spinal cord,",7961550,CDM,521,RC,63077,CPT,OUTPATIENT,,,5985,3890.25,,5266.8,88,,4213.44,,,0,"percent of total billed charges","88% of total billed charges",5985,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4192.88,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5985,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,5985,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3770.55,63,,3016.44,,,0,"percent of total billed charges","63% of total billed charges",915.71,15.3,,732.57,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,4129.65,69,,,,,0,"fee schedule","69% of total billed charges",5985,100,,4788.00,,,0,"percent of total billed charges","100% of total billed charges",5985,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5985,100,,4788.00,,,0,"percent of total billed charges","100% of total billed charges",5985,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5985,100,,4788.00,,,0,"percent of total billed charges","100% of total billed charges",5985,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5985,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4192.88,100,,,,,0,"fee schedule",EAPG,5985,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5985,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5985,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,5985,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2256.35,37.7,,1805.08,,,0,"percent of total billed charges","37.70% of total billed charges",5985,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5985,100,,,,,0,"fee schedule","100% of CMS fee schedule",4668.3,78,,3734.64,,,0,"percent of total billed charges","78% of total billed charges",5985,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4943.61,82.6,,3954.89,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule","100% of WA fee schedule",5985,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4943.61,82.6,,3954.89,,,0,"percent of total billed charges","82.6% of total billed charges",5985,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4353.41,100,,,,,0,"fee schedule",EAPG,5985,100,,4788.00,,,0,"percent of total billed charges","100% of total billed charges",915.71,5985,
"63075 Discectomy,anterior,w/decomp of spinal cord,",7961634,CDM,521,RC,63075,CPT,OUTPATIENT,,,6986,4540.9,,6147.68,88,,4918.14,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9236.61,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4401.18,63,,3520.94,,,0,"percent of total billed charges","63% of total billed charges",1068.86,15.3,,855.09,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,4820.34,69,,,,,0,"fee schedule","69% of total billed charges",6986,100,,5588.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6986,100,,5588.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6986,100,,5588.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9236.61,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2633.72,37.7,,2106.98,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5449.08,78,,4359.26,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5770.44,82.6,,4616.35,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5770.44,82.6,,4616.35,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9397.14,100,,,,,0,"fee schedule",EAPG,6986,100,,5588.80,,,0,"percent of total billed charges","100% of total billed charges",1068.86,25451.55,
"63082 Vertebral corpectomy,partial/complete,anteri",7961635,CDM,521,RC,63082,CPT,OUTPATIENT,,,1910,1241.5,,1680.8,88,,1344.64,,,0,"percent of total billed charges","88% of total billed charges",1910,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,1910,100,,1528.00,,,0,"percent of total billed charges","100% of total billed charges",1910,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,1910,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1203.3,63,,962.64,,,0,"percent of total billed charges","63% of total billed charges",292.23,15.3,,233.78,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,1317.9,69,,,,,0,"fee schedule","69% of total billed charges",1910,100,,1528.00,,,0,"percent of total billed charges","100% of total billed charges",1910,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1910,100,,1528.00,,,0,"percent of total billed charges","100% of total billed charges",1910,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1910,100,,1528.00,,,0,"percent of total billed charges","100% of total billed charges",1910,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1910,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,1910,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1910,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1910,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,1910,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",720.07,37.7,,576.06,,,0,"percent of total billed charges","37.70% of total billed charges",1910,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1910,100,,,,,0,"fee schedule","100% of CMS fee schedule",1489.8,78,,1191.84,,,0,"percent of total billed charges","78% of total billed charges",1910,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1577.66,82.6,,1262.13,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",1910,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1577.66,82.6,,1262.13,,,0,"percent of total billed charges","82.6% of total billed charges",1910,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,1910,100,,1528.00,,,0,"percent of total billed charges","100% of total billed charges",292.23,15382.15,
"63086 Vertebral corpectomy,partial/complete,anteri",7961636,CDM,521,RC,63086,CPT,OUTPATIENT,,,1899,1234.35,,1671.12,88,,1336.90,,,0,"percent of total billed charges","88% of total billed charges",1899,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,1899,100,,1519.20,,,0,"percent of total billed charges","100% of total billed charges",1899,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,1899,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1196.37,63,,957.10,,,0,"percent of total billed charges","63% of total billed charges",290.55,15.3,,232.44,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,1310.31,69,,,,,0,"fee schedule","69% of total billed charges",1899,100,,1519.20,,,0,"percent of total billed charges","100% of total billed charges",1899,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1899,100,,1519.20,,,0,"percent of total billed charges","100% of total billed charges",1899,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1899,100,,1519.20,,,0,"percent of total billed charges","100% of total billed charges",1899,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1899,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,1899,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1899,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1899,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,1899,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",715.92,37.7,,572.74,,,0,"percent of total billed charges","37.70% of total billed charges",1899,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1899,100,,,,,0,"fee schedule","100% of CMS fee schedule",1481.22,78,,1184.98,,,0,"percent of total billed charges","78% of total billed charges",1899,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1568.57,82.6,,1254.86,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",1899,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1568.57,82.6,,1254.86,,,0,"percent of total billed charges","82.6% of total billed charges",1899,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,1899,100,,1519.20,,,0,"percent of total billed charges","100% of total billed charges",290.55,15382.15,
"63081 Vertebral corpectomy,partial/complete,anteri",7961776,CDM,521,RC,63081,CPT,OUTPATIENT,,,8988,5842.2,,7909.44,88,,6327.55,,,0,"percent of total billed charges","88% of total billed charges",8988,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8988,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,8988,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5662.44,63,,4529.95,,,0,"percent of total billed charges","63% of total billed charges",1375.16,15.3,,1100.13,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,6201.72,69,,,,,0,"fee schedule","69% of total billed charges",8988,100,,7190.40,,,0,"percent of total billed charges","100% of total billed charges",8988,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8988,100,,7190.40,,,0,"percent of total billed charges","100% of total billed charges",8988,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8988,100,,7190.40,,,0,"percent of total billed charges","100% of total billed charges",8988,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8988,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,8988,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8988,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8988,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,8988,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3388.48,37.7,,2710.78,,,0,"percent of total billed charges","37.70% of total billed charges",8988,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8988,100,,,,,0,"fee schedule","100% of CMS fee schedule",7010.64,78,,5608.51,,,0,"percent of total billed charges","78% of total billed charges",8988,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7424.09,82.6,,5939.27,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule","100% of WA fee schedule",8988,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7424.09,82.6,,5939.27,,,0,"percent of total billed charges","82.6% of total billed charges",8988,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9397.14,100,,,,,0,"fee schedule",EAPG,8988,100,,7190.40,,,0,"percent of total billed charges","100% of total billed charges",1375.16,12007.59,
"63085 Vertebral corpectomy,partial/complete,anteri",7961777,CDM,521,RC,63085,CPT,OUTPATIENT,,,7501,4875.65,,6600.88,88,,5280.70,,,0,"percent of total billed charges","88% of total billed charges",7501,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7501,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,7501,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4725.63,63,,3780.50,,,0,"percent of total billed charges","63% of total billed charges",1147.65,15.3,,918.12,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,5175.69,69,,,,,0,"fee schedule","69% of total billed charges",7501,100,,6000.80,,,0,"percent of total billed charges","100% of total billed charges",7501,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7501,100,,6000.80,,,0,"percent of total billed charges","100% of total billed charges",7501,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7501,100,,6000.80,,,0,"percent of total billed charges","100% of total billed charges",7501,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7501,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,7501,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7501,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7501,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,7501,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2827.88,37.7,,2262.30,,,0,"percent of total billed charges","37.70% of total billed charges",7501,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7501,100,,,,,0,"fee schedule","100% of CMS fee schedule",5850.78,78,,4680.62,,,0,"percent of total billed charges","78% of total billed charges",7501,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6195.83,82.6,,4956.66,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",7501,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6195.83,82.6,,4956.66,,,0,"percent of total billed charges","82.6% of total billed charges",7501,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,7501,100,,6000.80,,,0,"percent of total billed charges","100% of total billed charges",1147.65,15382.15,
"63088 Vertebral corpectomy,partial/complete,thorac",7961880,CDM,521,RC,63088,CPT,OUTPATIENT,,,1995,1296.75,,1755.6,88,,1404.48,,,0,"percent of total billed charges","88% of total billed charges",1995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,1995,100,,1596.00,,,0,"percent of total billed charges","100% of total billed charges",1995,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,1995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1256.85,63,,1005.48,,,0,"percent of total billed charges","63% of total billed charges",305.24,15.3,,244.19,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,1376.55,69,,,,,0,"fee schedule","69% of total billed charges",1995,100,,1596.00,,,0,"percent of total billed charges","100% of total billed charges",1995,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1995,100,,1596.00,,,0,"percent of total billed charges","100% of total billed charges",1995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1995,100,,1596.00,,,0,"percent of total billed charges","100% of total billed charges",1995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,1995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,1995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",752.12,37.7,,601.70,,,0,"percent of total billed charges","37.70% of total billed charges",1995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1995,100,,,,,0,"fee schedule","100% of CMS fee schedule",1556.1,78,,1244.88,,,0,"percent of total billed charges","78% of total billed charges",1995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1647.87,82.6,,1318.30,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",1995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1647.87,82.6,,1318.30,,,0,"percent of total billed charges","82.6% of total billed charges",1995,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,1995,100,,1596.00,,,0,"percent of total billed charges","100% of total billed charges",305.24,15382.15,
"63087 Vertebral corpectomy,partial/complete,thorac",7961943,CDM,521,RC,63087,CPT,OUTPATIENT,,,9693,6300.45,,8529.84,88,,6823.87,,,0,"percent of total billed charges","88% of total billed charges",9693,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9693,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,9693,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6106.59,63,,4885.27,,,0,"percent of total billed charges","63% of total billed charges",1483.03,15.3,,1186.42,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,6688.17,69,,,,,0,"fee schedule","69% of total billed charges",9693,100,,7754.40,,,0,"percent of total billed charges","100% of total billed charges",9693,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9693,100,,7754.40,,,0,"percent of total billed charges","100% of total billed charges",9693,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9693,100,,7754.40,,,0,"percent of total billed charges","100% of total billed charges",9693,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9693,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,9693,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9693,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9693,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,9693,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3654.26,37.7,,2923.41,,,0,"percent of total billed charges","37.70% of total billed charges",9693,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9693,100,,,,,0,"fee schedule","100% of CMS fee schedule",7560.54,78,,6048.43,,,0,"percent of total billed charges","78% of total billed charges",9693,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8006.42,82.6,,6405.14,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",9693,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8006.42,82.6,,6405.14,,,0,"percent of total billed charges","82.6% of total billed charges",9693,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,9693,100,,7754.40,,,0,"percent of total billed charges","100% of total billed charges",1483.03,15382.15,
"63091 Vertebral corpectomy,partial/complete,trans/",7961551,CDM,521,RC,63091,CPT,OUTPATIENT,,,1719,1117.35,,1512.72,88,,1210.18,,,0,"percent of total billed charges","88% of total billed charges",1719,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,1719,100,,1375.20,,,0,"percent of total billed charges","100% of total billed charges",1719,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,1719,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1082.97,63,,866.38,,,0,"percent of total billed charges","63% of total billed charges",263.01,15.3,,210.41,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,1186.11,69,,,,,0,"fee schedule","69% of total billed charges",1719,100,,1375.20,,,0,"percent of total billed charges","100% of total billed charges",1719,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1719,100,,1375.20,,,0,"percent of total billed charges","100% of total billed charges",1719,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1719,100,,1375.20,,,0,"percent of total billed charges","100% of total billed charges",1719,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1719,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,1719,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1719,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1719,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,1719,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",648.06,37.7,,518.45,,,0,"percent of total billed charges","37.70% of total billed charges",1719,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1719,100,,,,,0,"fee schedule","100% of CMS fee schedule",1340.82,78,,1072.66,,,0,"percent of total billed charges","78% of total billed charges",1719,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1419.89,82.6,,1135.91,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",1719,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1419.89,82.6,,1135.91,,,0,"percent of total billed charges","82.6% of total billed charges",1719,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,1719,100,,1375.20,,,0,"percent of total billed charges","100% of total billed charges",263.01,15382.15,
"63090 Vertebral corpectomy,partial/complete,trans/",7961637,CDM,521,RC,63090,CPT,OUTPATIENT,,,7699,5004.35,,6775.12,88,,5420.10,,,0,"percent of total billed charges","88% of total billed charges",7699,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7699,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,7699,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4850.37,63,,3880.30,,,0,"percent of total billed charges","63% of total billed charges",1177.95,15.3,,942.36,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,5312.31,69,,,,,0,"fee schedule","69% of total billed charges",7699,100,,6159.20,,,0,"percent of total billed charges","100% of total billed charges",7699,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7699,100,,6159.20,,,0,"percent of total billed charges","100% of total billed charges",7699,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7699,100,,6159.20,,,0,"percent of total billed charges","100% of total billed charges",7699,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7699,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,7699,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7699,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7699,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,7699,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2902.52,37.7,,2322.02,,,0,"percent of total billed charges","37.70% of total billed charges",7699,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7699,100,,,,,0,"fee schedule","100% of CMS fee schedule",6005.22,78,,4804.18,,,0,"percent of total billed charges","78% of total billed charges",7699,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6359.37,82.6,,5087.50,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",7699,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6359.37,82.6,,5087.50,,,0,"percent of total billed charges","82.6% of total billed charges",7699,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,7699,100,,6159.20,,,0,"percent of total billed charges","100% of total billed charges",1177.95,15382.15,
"63102 Vertebral corpectomy (vertebral body resecti",7962051,CDM,521,RC,63102,CPT,OUTPATIENT,,,7488,4867.2,,6589.44,88,,5271.55,,,0,"percent of total billed charges","88% of total billed charges",7488,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7488,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,7488,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4717.44,63,,3773.95,,,0,"percent of total billed charges","63% of total billed charges",1145.66,15.3,,916.53,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,5166.72,69,,,,,0,"fee schedule","69% of total billed charges",7488,100,,5990.40,,,0,"percent of total billed charges","100% of total billed charges",7488,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7488,100,,5990.40,,,0,"percent of total billed charges","100% of total billed charges",7488,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7488,100,,5990.40,,,0,"percent of total billed charges","100% of total billed charges",7488,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7488,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,7488,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7488,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7488,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,7488,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2822.98,37.7,,2258.38,,,0,"percent of total billed charges","37.70% of total billed charges",7488,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7488,100,,,,,0,"fee schedule","100% of CMS fee schedule",5840.64,78,,4672.51,,,0,"percent of total billed charges","78% of total billed charges",7488,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6185.09,82.6,,4948.07,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",7488,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6185.09,82.6,,4948.07,,,0,"percent of total billed charges","82.6% of total billed charges",7488,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,7488,100,,5990.40,,,0,"percent of total billed charges","100% of total billed charges",1145.66,15382.15,
"63101 Vertebral Corpectomy",7963903,CDM,521,RC,63101,CPT,OUTPATIENT,,,7606,4943.9,,6693.28,88,,5354.62,,,0,"percent of total billed charges","88% of total billed charges",7606,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7606,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,7606,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4791.78,63,,3833.42,,,0,"percent of total billed charges","63% of total billed charges",1163.72,15.3,,930.98,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,5248.14,69,,,,,0,"fee schedule","69% of total billed charges",7606,100,,6084.80,,,0,"percent of total billed charges","100% of total billed charges",7606,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7606,100,,6084.80,,,0,"percent of total billed charges","100% of total billed charges",7606,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7606,100,,6084.80,,,0,"percent of total billed charges","100% of total billed charges",7606,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7606,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,7606,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7606,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7606,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,7606,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2867.46,37.7,,2293.97,,,0,"percent of total billed charges","37.70% of total billed charges",7606,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7606,100,,,,,0,"fee schedule","100% of CMS fee schedule",5932.68,78,,4746.14,,,0,"percent of total billed charges","78% of total billed charges",7606,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6282.56,82.6,,5026.05,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",7606,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6282.56,82.6,,5026.05,,,0,"percent of total billed charges","82.6% of total billed charges",7606,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,7606,100,,6084.80,,,0,"percent of total billed charges","100% of total billed charges",1163.72,15382.15,
"63173 Laminectomy with drainage of intramedullary",7962052,CDM,521,RC,63173,CPT,OUTPATIENT,,,6214,4039.1,,5468.32,88,,4374.66,,,0,"percent of total billed charges","88% of total billed charges",6214,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6214,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,6214,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3914.82,63,,3131.86,,,0,"percent of total billed charges","63% of total billed charges",950.74,15.3,,760.59,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,4287.66,69,,,,,0,"fee schedule","69% of total billed charges",6214,100,,4971.20,,,0,"percent of total billed charges","100% of total billed charges",6214,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6214,100,,4971.20,,,0,"percent of total billed charges","100% of total billed charges",6214,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6214,100,,4971.20,,,0,"percent of total billed charges","100% of total billed charges",6214,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6214,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,6214,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6214,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6214,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,6214,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2342.68,37.7,,1874.14,,,0,"percent of total billed charges","37.70% of total billed charges",6214,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6214,100,,,,,0,"fee schedule","100% of CMS fee schedule",4846.92,78,,3877.54,,,0,"percent of total billed charges","78% of total billed charges",6214,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5132.76,82.6,,4106.21,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",6214,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5132.76,82.6,,4106.21,,,0,"percent of total billed charges","82.6% of total billed charges",6214,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,6214,100,,4971.20,,,0,"percent of total billed charges","100% of total billed charges",950.74,15382.15,
"63172 Laminectomy with drainage of intramedullary",7962541,CDM,521,RC,63172,CPT,OUTPATIENT,,,5445,3539.25,,4791.6,88,,3833.28,,,0,"percent of total billed charges","88% of total billed charges",5445,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4192.88,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5445,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,5445,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3430.35,63,,2744.28,,,0,"percent of total billed charges","63% of total billed charges",833.09,15.3,,666.47,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,3757.05,69,,,,,0,"fee schedule","69% of total billed charges",5445,100,,4356.00,,,0,"percent of total billed charges","100% of total billed charges",5445,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5445,100,,4356.00,,,0,"percent of total billed charges","100% of total billed charges",5445,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5445,100,,4356.00,,,0,"percent of total billed charges","100% of total billed charges",5445,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5445,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4192.88,100,,,,,0,"fee schedule",EAPG,5445,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5445,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5445,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,5445,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2052.77,37.7,,1642.22,,,0,"percent of total billed charges","37.70% of total billed charges",5445,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5445,100,,,,,0,"fee schedule","100% of CMS fee schedule",4247.1,78,,3397.68,,,0,"percent of total billed charges","78% of total billed charges",5445,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4497.57,82.6,,3598.06,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule","100% of WA fee schedule",5445,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4497.57,82.6,,3598.06,,,0,"percent of total billed charges","82.6% of total billed charges",5445,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4353.41,100,,,,,0,"fee schedule",EAPG,5445,100,,4356.00,,,0,"percent of total billed charges","100% of total billed charges",833.09,5450.75,
"63185 Laminectomy with rhizotomy; 1 or 2 segments",7963530,CDM,521,RC,63185,CPT,OUTPATIENT,,,834,542.1,,733.92,88,,587.14,,,0,"percent of total billed charges","88% of total billed charges",834,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4192.88,100,,,,,0,"fee schedule",EAPG,834,100,,667.20,,,0,"percent of total billed charges","100% of total billed charges",834,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,834,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",525.42,63,,420.34,,,0,"percent of total billed charges","63% of total billed charges",127.6,15.3,,102.08,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,575.46,69,,,,,0,"fee schedule","69% of total billed charges",834,100,,667.20,,,0,"percent of total billed charges","100% of total billed charges",834,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",834,100,,667.20,,,0,"percent of total billed charges","100% of total billed charges",834,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",834,100,,667.20,,,0,"percent of total billed charges","100% of total billed charges",834,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",834,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4192.88,100,,,,,0,"fee schedule",EAPG,834,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",834,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",834,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,834,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",314.42,37.7,,251.54,,,0,"percent of total billed charges","37.70% of total billed charges",834,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",834,100,,,,,0,"fee schedule","100% of CMS fee schedule",650.52,78,,520.42,,,0,"percent of total billed charges","78% of total billed charges",834,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",688.88,82.6,,551.10,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule","100% of WA fee schedule",834,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",688.88,82.6,,551.10,,,0,"percent of total billed charges","82.6% of total billed charges",834,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4353.41,100,,,,,0,"fee schedule",EAPG,834,100,,667.20,,,0,"percent of total billed charges","100% of total billed charges",127.6,5450.75,
"63190 Laminectomy with rhizotomy; more than 2 segm",7963402,CDM,521,RC,63190,CPT,OUTPATIENT,,,6039,3925.35,,5314.32,88,,4251.46,,,0,"percent of total billed charges","88% of total billed charges",6039,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4192.88,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6039,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,6039,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3804.57,63,,3043.66,,,0,"percent of total billed charges","63% of total billed charges",923.97,15.3,,739.18,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,4166.91,69,,,,,0,"fee schedule","69% of total billed charges",6039,100,,4831.20,,,0,"percent of total billed charges","100% of total billed charges",6039,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6039,100,,4831.20,,,0,"percent of total billed charges","100% of total billed charges",6039,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6039,100,,4831.20,,,0,"percent of total billed charges","100% of total billed charges",6039,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6039,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4192.88,100,,,,,0,"fee schedule",EAPG,6039,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6039,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6039,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,6039,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2276.7,37.7,,1821.36,,,0,"percent of total billed charges","37.70% of total billed charges",6039,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6039,100,,,,,0,"fee schedule","100% of CMS fee schedule",4710.42,78,,3768.34,,,0,"percent of total billed charges","78% of total billed charges",6039,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4988.21,82.6,,3990.57,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule","100% of WA fee schedule",6039,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4988.21,82.6,,3990.57,,,0,"percent of total billed charges","82.6% of total billed charges",6039,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4353.41,100,,,,,0,"fee schedule",EAPG,6039,100,,4831.20,,,0,"percent of total billed charges","100% of total billed charges",923.97,6039,
"63200 Laminectomy, with release of tethered spinal",7963205,CDM,521,RC,63200,CPT,OUTPATIENT,,,7495,4871.75,,6595.6,88,,5276.48,,,0,"percent of total billed charges","88% of total billed charges",7495,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7495,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,7495,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4721.85,63,,3777.48,,,0,"percent of total billed charges","63% of total billed charges",1146.74,15.3,,917.39,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,5171.55,69,,,,,0,"fee schedule","69% of total billed charges",7495,100,,5996.00,,,0,"percent of total billed charges","100% of total billed charges",7495,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7495,100,,5996.00,,,0,"percent of total billed charges","100% of total billed charges",7495,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7495,100,,5996.00,,,0,"percent of total billed charges","100% of total billed charges",7495,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7495,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,7495,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7495,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7495,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,7495,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2825.62,37.7,,2260.50,,,0,"percent of total billed charges","37.70% of total billed charges",7495,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7495,100,,,,,0,"fee schedule","100% of CMS fee schedule",5846.1,78,,4676.88,,,0,"percent of total billed charges","78% of total billed charges",7495,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6190.87,82.6,,4952.70,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule","100% of WA fee schedule",7495,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6190.87,82.6,,4952.70,,,0,"percent of total billed charges","82.6% of total billed charges",7495,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9397.14,100,,,,,0,"fee schedule",EAPG,7495,100,,5996.00,,,0,"percent of total billed charges","100% of total billed charges",1146.74,12007.59,
"63251 Laminectomy for excision or occlusion of art",7961714,CDM,521,RC,63251,CPT,OUTPATIENT,,,9552,6208.8,,8405.76,88,,6724.61,,,0,"percent of total billed charges","88% of total billed charges",9552,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9552,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,9552,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6017.76,63,,4814.21,,,0,"percent of total billed charges","63% of total billed charges",1461.46,15.3,,1169.17,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,6590.88,69,,,,,0,"fee schedule","69% of total billed charges",9552,100,,7641.60,,,0,"percent of total billed charges","100% of total billed charges",9552,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9552,100,,7641.60,,,0,"percent of total billed charges","100% of total billed charges",9552,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9552,100,,7641.60,,,0,"percent of total billed charges","100% of total billed charges",9552,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9552,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,9552,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9552,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9552,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,9552,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3601.1,37.7,,2880.88,,,0,"percent of total billed charges","37.70% of total billed charges",9552,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9552,100,,,,,0,"fee schedule","100% of CMS fee schedule",7450.56,78,,5960.45,,,0,"percent of total billed charges","78% of total billed charges",9552,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7889.95,82.6,,6311.96,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",9552,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7889.95,82.6,,6311.96,,,0,"percent of total billed charges","82.6% of total billed charges",9552,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,9552,100,,7641.60,,,0,"percent of total billed charges","100% of total billed charges",1461.46,15382.15,
"63250 Laminectomy for excision or occlusion of art",7962053,CDM,521,RC,63250,CPT,OUTPATIENT,,,11032,7170.8,,9708.16,88,,7766.53,,,0,"percent of total billed charges","88% of total billed charges",11032,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",11032,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,11032,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6950.16,63,,5560.13,,,0,"percent of total billed charges","63% of total billed charges",1687.9,15.3,,1350.32,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,7612.08,69,,,,,0,"fee schedule","69% of total billed charges",11032,100,,8825.60,,,0,"percent of total billed charges","100% of total billed charges",11032,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11032,100,,8825.60,,,0,"percent of total billed charges","100% of total billed charges",11032,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11032,100,,8825.60,,,0,"percent of total billed charges","100% of total billed charges",11032,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11032,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,11032,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11032,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",11032,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,11032,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4159.06,37.7,,3327.25,,,0,"percent of total billed charges","37.70% of total billed charges",11032,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",11032,100,,,,,0,"fee schedule","100% of CMS fee schedule",8604.96,78,,6883.97,,,0,"percent of total billed charges","78% of total billed charges",11032,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9112.43,82.6,,7289.94,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",11032,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9112.43,82.6,,7289.94,,,0,"percent of total billed charges","82.6% of total billed charges",11032,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,11032,100,,8825.60,,,0,"percent of total billed charges","100% of total billed charges",1687.9,15382.15,
"63252 Laminectomy for excision or occlusion of art",7962054,CDM,521,RC,63252,CPT,OUTPATIENT,,,12773,8302.45,,11240.24,88,,8992.19,,,0,"percent of total billed charges","88% of total billed charges",12773,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12773,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,12773,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8046.99,63,,6437.59,,,0,"percent of total billed charges","63% of total billed charges",1954.27,15.3,,1563.42,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,8813.37,69,,,,,0,"fee schedule","69% of total billed charges",12773,100,,10218.40,,,0,"percent of total billed charges","100% of total billed charges",12773,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12773,100,,10218.40,,,0,"percent of total billed charges","100% of total billed charges",12773,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12773,100,,10218.40,,,0,"percent of total billed charges","100% of total billed charges",12773,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12773,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,12773,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12773,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",12773,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,12773,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4815.42,37.7,,3852.34,,,0,"percent of total billed charges","37.70% of total billed charges",12773,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",12773,100,,,,,0,"fee schedule","100% of CMS fee schedule",9962.94,78,,7970.35,,,0,"percent of total billed charges","78% of total billed charges",12773,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10550.5,82.6,,8440.40,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",12773,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10550.5,82.6,,8440.40,,,0,"percent of total billed charges","82.6% of total billed charges",12773,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,12773,100,,10218.40,,,0,"percent of total billed charges","100% of total billed charges",1954.27,15382.15,
"63265 Laminectomy for excision or evacuation of in",7962426,CDM,521,RC,63265,CPT,OUTPATIENT,,,9450,6142.5,,8316,88,,6652.80,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5953.5,63,,4762.80,,,0,"percent of total billed charges","63% of total billed charges",1445.85,15.3,,1156.68,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,6520.5,69,,,,,0,"fee schedule","69% of total billed charges",9450,100,,7560.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9450,100,,7560.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9450,100,,7560.00,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3562.65,37.7,,2850.12,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7371,78,,5896.80,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7805.7,82.6,,6244.56,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule","100% of WA fee schedule",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7805.7,82.6,,6244.56,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,9450,100,,7560.00,,,0,"percent of total billed charges","100% of total billed charges",1445.85,25451.55,
"63266 Laminectomy for excision or evacuation of in",7962427,CDM,521,RC,63266,CPT,OUTPATIENT,,,8871,5766.15,,7806.48,88,,6245.18,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5588.73,63,,4470.98,,,0,"percent of total billed charges","63% of total billed charges",1357.26,15.3,,1085.81,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,6120.99,69,,,,,0,"fee schedule","69% of total billed charges",8871,100,,7096.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8871,100,,7096.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8871,100,,7096.80,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3344.37,37.7,,2675.50,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6919.38,78,,5535.50,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7327.45,82.6,,5861.96,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule","100% of WA fee schedule",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7327.45,82.6,,5861.96,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,8871,100,,7096.80,,,0,"percent of total billed charges","100% of total billed charges",1357.26,25451.55,
"63267 Laminectomy for excision or evacuation of in",7962482,CDM,521,RC,63267,CPT,OUTPATIENT,,,7507,4879.55,,6606.16,88,,5284.93,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4729.41,63,,3783.53,,,0,"percent of total billed charges","63% of total billed charges",1148.57,15.3,,918.86,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,5179.83,69,,,,,0,"fee schedule","69% of total billed charges",7507,100,,6005.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7507,100,,6005.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7507,100,,6005.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2830.14,37.7,,2264.11,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5855.46,78,,4684.37,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6200.78,82.6,,4960.62,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6200.78,82.6,,4960.62,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,7507,100,,6005.60,,,0,"percent of total billed charges","100% of total billed charges",1148.57,25451.55,
"63268 Laminectomy for excision or evacuation of in",7962483,CDM,521,RC,63268,CPT,OUTPATIENT,,,6767,4398.55,,5954.96,88,,4763.97,,,0,"percent of total billed charges","88% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12769.53,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4263.21,63,,3410.57,,,0,"percent of total billed charges","63% of total billed charges",1035.35,15.3,,828.28,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,4669.23,69,,,,,0,"fee schedule","69% of total billed charges",6767,100,,5413.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6767,100,,5413.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6767,100,,5413.60,,,0,"percent of total billed charges","100% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",25451.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4192.88,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6654,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2551.16,37.7,,2040.93,,,0,"percent of total billed charges","37.70% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5278.26,78,,4222.61,,,0,"percent of total billed charges","78% of total billed charges",7369.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5589.54,82.6,,4471.63,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule","100% of WA fee schedule",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5589.54,82.6,,4471.63,,,0,"percent of total billed charges","82.6% of total billed charges",7296.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4353.41,100,,,,,0,"fee schedule",EAPG,6767,100,,5413.60,,,0,"percent of total billed charges","100% of total billed charges",1035.35,25451.55,
"63271 Laminectomy for excision of intraspinal lesi",7961944,CDM,521,RC,63271,CPT,OUTPATIENT,,,9642,6267.3,,8484.96,88,,6787.97,,,0,"percent of total billed charges","88% of total billed charges",9642,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9642,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,9642,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6074.46,63,,4859.57,,,0,"percent of total billed charges","63% of total billed charges",1475.23,15.3,,1180.18,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,6652.98,69,,,,,0,"fee schedule","69% of total billed charges",9642,100,,7713.60,,,0,"percent of total billed charges","100% of total billed charges",9642,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9642,100,,7713.60,,,0,"percent of total billed charges","100% of total billed charges",9642,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9642,100,,7713.60,,,0,"percent of total billed charges","100% of total billed charges",9642,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9642,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,9642,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9642,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9642,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,9642,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3635.03,37.7,,2908.02,,,0,"percent of total billed charges","37.70% of total billed charges",9642,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9642,100,,,,,0,"fee schedule","100% of CMS fee schedule",7520.76,78,,6016.61,,,0,"percent of total billed charges","78% of total billed charges",9642,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7964.29,82.6,,6371.43,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",9642,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7964.29,82.6,,6371.43,,,0,"percent of total billed charges","82.6% of total billed charges",9642,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,9642,100,,7713.60,,,0,"percent of total billed charges","100% of total billed charges",1475.23,15382.15,
"63270 Laminectomy for excision of intraspinal lesi",7962055,CDM,521,RC,63270,CPT,OUTPATIENT,,,9992,6494.8,,8792.96,88,,7034.37,,,0,"percent of total billed charges","88% of total billed charges",9992,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9992,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,9992,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6294.96,63,,5035.97,,,0,"percent of total billed charges","63% of total billed charges",1528.78,15.3,,1223.02,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,6894.48,69,,,,,0,"fee schedule","69% of total billed charges",9992,100,,7993.60,,,0,"percent of total billed charges","100% of total billed charges",9992,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9992,100,,7993.60,,,0,"percent of total billed charges","100% of total billed charges",9992,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9992,100,,7993.60,,,0,"percent of total billed charges","100% of total billed charges",9992,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9992,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,9992,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9992,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9992,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,9992,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3766.98,37.7,,3013.58,,,0,"percent of total billed charges","37.70% of total billed charges",9992,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9992,100,,,,,0,"fee schedule","100% of CMS fee schedule",7793.76,78,,6235.01,,,0,"percent of total billed charges","78% of total billed charges",9992,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8253.39,82.6,,6602.71,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule","100% of WA fee schedule",9992,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8253.39,82.6,,6602.71,,,0,"percent of total billed charges","82.6% of total billed charges",9992,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9397.14,100,,,,,0,"fee schedule",EAPG,9992,100,,7993.60,,,0,"percent of total billed charges","100% of total billed charges",1528.78,12007.59,
"63272 Laminectomy for excision of intraspinal lesi",7962264,CDM,521,RC,63272,CPT,OUTPATIENT,,,10889,7077.85,,9582.32,88,,7665.86,,,0,"percent of total billed charges","88% of total billed charges",10889,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",10889,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,10889,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6860.07,63,,5488.06,,,0,"percent of total billed charges","63% of total billed charges",1666.02,15.3,,1332.82,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,7513.41,69,,,,,0,"fee schedule","69% of total billed charges",10889,100,,8711.20,,,0,"percent of total billed charges","100% of total billed charges",10889,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10889,100,,8711.20,,,0,"percent of total billed charges","100% of total billed charges",10889,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10889,100,,8711.20,,,0,"percent of total billed charges","100% of total billed charges",10889,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10889,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,10889,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10889,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10889,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,10889,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4105.15,37.7,,3284.12,,,0,"percent of total billed charges","37.70% of total billed charges",10889,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10889,100,,,,,0,"fee schedule","100% of CMS fee schedule",8493.42,78,,6794.74,,,0,"percent of total billed charges","78% of total billed charges",10889,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8994.31,82.6,,7195.45,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule","100% of WA fee schedule",10889,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8994.31,82.6,,7195.45,,,0,"percent of total billed charges","82.6% of total billed charges",10889,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9397.14,100,,,,,0,"fee schedule",EAPG,10889,100,,8711.20,,,0,"percent of total billed charges","100% of total billed charges",1666.02,12007.59,
"63273 Laminectomy for excision of intraspinal lesi",7962271,CDM,521,RC,63273,CPT,OUTPATIENT,,,9181,5967.65,,8079.28,88,,6463.42,,,0,"percent of total billed charges","88% of total billed charges",9181,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9181,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,9181,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5784.03,63,,4627.22,,,0,"percent of total billed charges","63% of total billed charges",1404.69,15.3,,1123.75,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,6334.89,69,,,,,0,"fee schedule","69% of total billed charges",9181,100,,7344.80,,,0,"percent of total billed charges","100% of total billed charges",9181,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9181,100,,7344.80,,,0,"percent of total billed charges","100% of total billed charges",9181,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9181,100,,7344.80,,,0,"percent of total billed charges","100% of total billed charges",9181,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9181,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,9181,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9181,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9181,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,9181,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3461.24,37.7,,2768.99,,,0,"percent of total billed charges","37.70% of total billed charges",9181,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9181,100,,,,,0,"fee schedule","100% of CMS fee schedule",7161.18,78,,5728.94,,,0,"percent of total billed charges","78% of total billed charges",9181,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7583.51,82.6,,6066.81,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule","100% of WA fee schedule",9181,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7583.51,82.6,,6066.81,,,0,"percent of total billed charges","82.6% of total billed charges",9181,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9397.14,100,,,,,0,"fee schedule",EAPG,9181,100,,7344.80,,,0,"percent of total billed charges","100% of total billed charges",1404.69,12007.59,
"63275 Laminectomy for biopsy/excision of intraspin",7962569,CDM,521,RC,63275,CPT,OUTPATIENT,,,10431,6780.15,,9179.28,88,,7343.42,,,0,"percent of total billed charges","88% of total billed charges",10431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",10431,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,10431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6571.53,63,,5257.22,,,0,"percent of total billed charges","63% of total billed charges",1595.94,15.3,,1276.75,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,7197.39,69,,,,,0,"fee schedule","69% of total billed charges",10431,100,,8344.80,,,0,"percent of total billed charges","100% of total billed charges",10431,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10431,100,,8344.80,,,0,"percent of total billed charges","100% of total billed charges",10431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10431,100,,8344.80,,,0,"percent of total billed charges","100% of total billed charges",10431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,10431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,10431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3932.49,37.7,,3145.99,,,0,"percent of total billed charges","37.70% of total billed charges",10431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10431,100,,,,,0,"fee schedule","100% of CMS fee schedule",8136.18,78,,6508.94,,,0,"percent of total billed charges","78% of total billed charges",10431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8616.01,82.6,,6892.81,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",10431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8616.01,82.6,,6892.81,,,0,"percent of total billed charges","82.6% of total billed charges",10431,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,10431,100,,8344.80,,,0,"percent of total billed charges","100% of total billed charges",1595.94,15382.15,
"63276 Laminectomy for biopsy/excision of intraspin",7962570,CDM,521,RC,63276,CPT,OUTPATIENT,,,10307,6699.55,,9070.16,88,,7256.13,,,0,"percent of total billed charges","88% of total billed charges",10307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",10307,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,10307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6493.41,63,,5194.73,,,0,"percent of total billed charges","63% of total billed charges",1576.97,15.3,,1261.58,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,7111.83,69,,,,,0,"fee schedule","69% of total billed charges",10307,100,,8245.60,,,0,"percent of total billed charges","100% of total billed charges",10307,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10307,100,,8245.60,,,0,"percent of total billed charges","100% of total billed charges",10307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10307,100,,8245.60,,,0,"percent of total billed charges","100% of total billed charges",10307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,10307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,10307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3885.74,37.7,,3108.59,,,0,"percent of total billed charges","37.70% of total billed charges",10307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10307,100,,,,,0,"fee schedule","100% of CMS fee schedule",8039.46,78,,6431.57,,,0,"percent of total billed charges","78% of total billed charges",10307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8513.58,82.6,,6810.86,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",10307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8513.58,82.6,,6810.86,,,0,"percent of total billed charges","82.6% of total billed charges",10307,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,10307,100,,8245.60,,,0,"percent of total billed charges","100% of total billed charges",1576.97,15382.15,
"63277 Laminectomy for biopsy/excision of intraspin",7962649,CDM,521,RC,63277,CPT,OUTPATIENT,,,10040,6526,,8835.2,88,,7068.16,,,0,"percent of total billed charges","88% of total billed charges",10040,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",10040,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,10040,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6325.2,63,,5060.16,,,0,"percent of total billed charges","63% of total billed charges",1536.12,15.3,,1228.90,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,6927.6,69,,,,,0,"fee schedule","69% of total billed charges",10040,100,,8032.00,,,0,"percent of total billed charges","100% of total billed charges",10040,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10040,100,,8032.00,,,0,"percent of total billed charges","100% of total billed charges",10040,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10040,100,,8032.00,,,0,"percent of total billed charges","100% of total billed charges",10040,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10040,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,10040,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10040,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10040,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,10040,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3785.08,37.7,,3028.06,,,0,"percent of total billed charges","37.70% of total billed charges",10040,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10040,100,,,,,0,"fee schedule","100% of CMS fee schedule",7831.2,78,,6264.96,,,0,"percent of total billed charges","78% of total billed charges",10040,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8293.04,82.6,,6634.43,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",10040,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8293.04,82.6,,6634.43,,,0,"percent of total billed charges","82.6% of total billed charges",10040,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,10040,100,,8032.00,,,0,"percent of total billed charges","100% of total billed charges",1536.12,15382.15,
"63278 Laminectomy for biopsy/excision of intraspin",7962656,CDM,521,RC,63278,CPT,OUTPATIENT,,,8163,5305.95,,7183.44,88,,5746.75,,,0,"percent of total billed charges","88% of total billed charges",8163,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8163,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,8163,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5142.69,63,,4114.15,,,0,"percent of total billed charges","63% of total billed charges",1248.94,15.3,,999.15,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,5632.47,69,,,,,0,"fee schedule","69% of total billed charges",8163,100,,6530.40,,,0,"percent of total billed charges","100% of total billed charges",8163,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8163,100,,6530.40,,,0,"percent of total billed charges","100% of total billed charges",8163,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8163,100,,6530.40,,,0,"percent of total billed charges","100% of total billed charges",8163,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8163,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,8163,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8163,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8163,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,8163,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3077.45,37.7,,2461.96,,,0,"percent of total billed charges","37.70% of total billed charges",8163,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8163,100,,,,,0,"fee schedule","100% of CMS fee schedule",6367.14,78,,5093.71,,,0,"percent of total billed charges","78% of total billed charges",8163,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6742.64,82.6,,5394.11,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",8163,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6742.64,82.6,,5394.11,,,0,"percent of total billed charges","82.6% of total billed charges",8163,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,8163,100,,6530.40,,,0,"percent of total billed charges","100% of total billed charges",1248.94,15382.15,
"63287 Laminectomy, biopsy/excision of intraspinal",7961552,CDM,521,RC,63287,CPT,OUTPATIENT,,,13585,8830.25,,11954.8,88,,9563.84,,,0,"percent of total billed charges","88% of total billed charges",13585,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",13585,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,13585,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8558.55,63,,6846.84,,,0,"percent of total billed charges","63% of total billed charges",2078.51,15.3,,1662.81,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,9373.65,69,,,,,0,"fee schedule","69% of total billed charges",13585,100,,10868.00,,,0,"percent of total billed charges","100% of total billed charges",13585,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13585,100,,10868.00,,,0,"percent of total billed charges","100% of total billed charges",13585,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13585,100,,10868.00,,,0,"percent of total billed charges","100% of total billed charges",13585,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13585,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,13585,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13585,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",13585,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,13585,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5121.55,37.7,,4097.24,,,0,"percent of total billed charges","37.70% of total billed charges",13585,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",13585,100,,,,,0,"fee schedule","100% of CMS fee schedule",10596.3,78,,8477.04,,,0,"percent of total billed charges","78% of total billed charges",13585,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11221.21,82.6,,8976.97,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",13585,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11221.21,82.6,,8976.97,,,0,"percent of total billed charges","82.6% of total billed charges",13585,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,13585,100,,10868.00,,,0,"percent of total billed charges","100% of total billed charges",2078.51,15382.15,
"63280 Laminectomy for biopsy/excision of intraspin",7961638,CDM,521,RC,63280,CPT,OUTPATIENT,,,12295,7991.75,,10819.6,88,,8655.68,,,0,"percent of total billed charges","88% of total billed charges",12295,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12295,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,12295,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7745.85,63,,6196.68,,,0,"percent of total billed charges","63% of total billed charges",1881.14,15.3,,1504.91,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,8483.55,69,,,,,0,"fee schedule","69% of total billed charges",12295,100,,9836.00,,,0,"percent of total billed charges","100% of total billed charges",12295,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12295,100,,9836.00,,,0,"percent of total billed charges","100% of total billed charges",12295,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12295,100,,9836.00,,,0,"percent of total billed charges","100% of total billed charges",12295,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12295,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,12295,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12295,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",12295,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,12295,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4635.22,37.7,,3708.18,,,0,"percent of total billed charges","37.70% of total billed charges",12295,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",12295,100,,,,,0,"fee schedule","100% of CMS fee schedule",9590.1,78,,7672.08,,,0,"percent of total billed charges","78% of total billed charges",12295,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10155.67,82.6,,8124.54,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",12295,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10155.67,82.6,,8124.54,,,0,"percent of total billed charges","82.6% of total billed charges",12295,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,12295,100,,9836.00,,,0,"percent of total billed charges","100% of total billed charges",1881.14,15382.15,
"63281 Laminectomy for biopsy/excision of intraspin",7961639,CDM,521,RC,63281,CPT,OUTPATIENT,,,12129,7883.85,,10673.52,88,,8538.82,,,0,"percent of total billed charges","88% of total billed charges",12129,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12129,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,12129,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7641.27,63,,6113.02,,,0,"percent of total billed charges","63% of total billed charges",1855.74,15.3,,1484.59,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,8369.01,69,,,,,0,"fee schedule","69% of total billed charges",12129,100,,9703.20,,,0,"percent of total billed charges","100% of total billed charges",12129,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12129,100,,9703.20,,,0,"percent of total billed charges","100% of total billed charges",12129,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12129,100,,9703.20,,,0,"percent of total billed charges","100% of total billed charges",12129,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12129,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,12129,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12129,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",12129,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,12129,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4572.63,37.7,,3658.10,,,0,"percent of total billed charges","37.70% of total billed charges",12129,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",12129,100,,,,,0,"fee schedule","100% of CMS fee schedule",9460.62,78,,7568.50,,,0,"percent of total billed charges","78% of total billed charges",12129,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10018.55,82.6,,8014.84,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",12129,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10018.55,82.6,,8014.84,,,0,"percent of total billed charges","82.6% of total billed charges",12129,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,12129,100,,9703.20,,,0,"percent of total billed charges","100% of total billed charges",1855.74,15382.15,
"63286 Laminectomy for biopsy/excision of intraspin",7961640,CDM,521,RC,63286,CPT,OUTPATIENT,,,13394,8706.1,,11786.72,88,,9429.38,,,0,"percent of total billed charges","88% of total billed charges",13394,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",13394,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,13394,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8438.22,63,,6750.58,,,0,"percent of total billed charges","63% of total billed charges",2049.28,15.3,,1639.42,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,9241.86,69,,,,,0,"fee schedule","69% of total billed charges",13394,100,,10715.20,,,0,"percent of total billed charges","100% of total billed charges",13394,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13394,100,,10715.20,,,0,"percent of total billed charges","100% of total billed charges",13394,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13394,100,,10715.20,,,0,"percent of total billed charges","100% of total billed charges",13394,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13394,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,13394,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13394,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",13394,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,13394,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5049.54,37.7,,4039.63,,,0,"percent of total billed charges","37.70% of total billed charges",13394,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",13394,100,,,,,0,"fee schedule","100% of CMS fee schedule",10447.32,78,,8357.86,,,0,"percent of total billed charges","78% of total billed charges",13394,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11063.44,82.6,,8850.75,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",13394,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11063.44,82.6,,8850.75,,,0,"percent of total billed charges","82.6% of total billed charges",13394,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,13394,100,,10715.20,,,0,"percent of total billed charges","100% of total billed charges",2049.28,15382.15,
"63285 Laminectomy for biopsy/excision of intraspin",7961645,CDM,521,RC,63285,CPT,OUTPATIENT,,,13267,8623.55,,11674.96,88,,9339.97,,,0,"percent of total billed charges","88% of total billed charges",13267,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",13267,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,13267,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8358.21,63,,6686.57,,,0,"percent of total billed charges","63% of total billed charges",2029.85,15.3,,1623.88,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,9154.23,69,,,,,0,"fee schedule","69% of total billed charges",13267,100,,10613.60,,,0,"percent of total billed charges","100% of total billed charges",13267,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13267,100,,10613.60,,,0,"percent of total billed charges","100% of total billed charges",13267,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13267,100,,10613.60,,,0,"percent of total billed charges","100% of total billed charges",13267,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13267,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,13267,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",13267,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",13267,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,13267,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5001.66,37.7,,4001.33,,,0,"percent of total billed charges","37.70% of total billed charges",13267,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",13267,100,,,,,0,"fee schedule","100% of CMS fee schedule",10348.26,78,,8278.61,,,0,"percent of total billed charges","78% of total billed charges",13267,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10958.54,82.6,,8766.83,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",13267,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10958.54,82.6,,8766.83,,,0,"percent of total billed charges","82.6% of total billed charges",13267,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,13267,100,,10613.60,,,0,"percent of total billed charges","100% of total billed charges",2029.85,15382.15,
"63282 Laminectomy for biopsy/excision of intraspin",7961778,CDM,521,RC,63282,CPT,OUTPATIENT,,,12327,8012.55,,10847.76,88,,8678.21,,,0,"percent of total billed charges","88% of total billed charges",12327,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",12327,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,12327,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7766.01,63,,6212.81,,,0,"percent of total billed charges","63% of total billed charges",1886.03,15.3,,1508.82,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,8505.63,69,,,,,0,"fee schedule","69% of total billed charges",12327,100,,9861.60,,,0,"percent of total billed charges","100% of total billed charges",12327,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12327,100,,9861.60,,,0,"percent of total billed charges","100% of total billed charges",12327,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12327,100,,9861.60,,,0,"percent of total billed charges","100% of total billed charges",12327,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12327,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,12327,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12327,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",12327,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,12327,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4647.28,37.7,,3717.82,,,0,"percent of total billed charges","37.70% of total billed charges",12327,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",12327,100,,,,,0,"fee schedule","100% of CMS fee schedule",9615.06,78,,7692.05,,,0,"percent of total billed charges","78% of total billed charges",12327,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10182.1,82.6,,8145.68,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule","100% of WA fee schedule",12327,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10182.1,82.6,,8145.68,,,0,"percent of total billed charges","82.6% of total billed charges",12327,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9397.14,100,,,,,0,"fee schedule",EAPG,12327,100,,9861.60,,,0,"percent of total billed charges","100% of total billed charges",1886.03,12327,
"63283 Laminectomy for biopsy/excision of intraspin",7962583,CDM,521,RC,63283,CPT,OUTPATIENT,,,9438,6134.7,,8305.44,88,,6644.35,,,0,"percent of total billed charges","88% of total billed charges",9438,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",9438,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,9438,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5945.94,63,,4756.75,,,0,"percent of total billed charges","63% of total billed charges",1444.01,15.3,,1155.21,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,6512.22,69,,,,,0,"fee schedule","69% of total billed charges",9438,100,,7550.40,,,0,"percent of total billed charges","100% of total billed charges",9438,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9438,100,,7550.40,,,0,"percent of total billed charges","100% of total billed charges",9438,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9438,100,,7550.40,,,0,"percent of total billed charges","100% of total billed charges",9438,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9438,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,9438,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9438,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9438,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,9438,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3558.13,37.7,,2846.50,,,0,"percent of total billed charges","37.70% of total billed charges",9438,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",9438,100,,,,,0,"fee schedule","100% of CMS fee schedule",7361.64,78,,5889.31,,,0,"percent of total billed charges","78% of total billed charges",9438,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7795.79,82.6,,6236.63,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",9438,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7795.79,82.6,,6236.63,,,0,"percent of total billed charges","82.6% of total billed charges",9438,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,9438,100,,7550.40,,,0,"percent of total billed charges","100% of total billed charges",1444.01,15382.15,
"63290 Laminectomy for biopsy/excision of intraspin",7961553,CDM,521,RC,63290,CPT,OUTPATIENT,,,10689,6947.85,,9406.32,88,,7525.06,,,0,"percent of total billed charges","88% of total billed charges",10689,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",10689,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,10689,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6734.07,63,,5387.26,,,0,"percent of total billed charges","63% of total billed charges",1635.42,15.3,,1308.34,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,7375.41,69,,,,,0,"fee schedule","69% of total billed charges",10689,100,,8551.20,,,0,"percent of total billed charges","100% of total billed charges",10689,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10689,100,,8551.20,,,0,"percent of total billed charges","100% of total billed charges",10689,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10689,100,,8551.20,,,0,"percent of total billed charges","100% of total billed charges",10689,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10689,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,10689,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",10689,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10689,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,10689,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",4029.75,37.7,,3223.80,,,0,"percent of total billed charges","37.70% of total billed charges",10689,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",10689,100,,,,,0,"fee schedule","100% of CMS fee schedule",8337.42,78,,6669.94,,,0,"percent of total billed charges","78% of total billed charges",10689,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8829.11,82.6,,7063.29,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",10689,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8829.11,82.6,,7063.29,,,0,"percent of total billed charges","82.6% of total billed charges",10689,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,10689,100,,8551.20,,,0,"percent of total billed charges","100% of total billed charges",1635.42,15382.15,
"63308 Vertebral corpectomy (vertebral body resecti",7962212,CDM,521,RC,63308,CPT,OUTPATIENT,,,2437,1584.05,,2144.56,88,,1715.65,,,0,"percent of total billed charges","88% of total billed charges",2437,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,2437,100,,1949.60,,,0,"percent of total billed charges","100% of total billed charges",2437,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,2437,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1535.31,63,,1228.25,,,0,"percent of total billed charges","63% of total billed charges",372.86,15.3,,298.29,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,1681.53,69,,,,,0,"fee schedule","69% of total billed charges",2437,100,,1949.60,,,0,"percent of total billed charges","100% of total billed charges",2437,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2437,100,,1949.60,,,0,"percent of total billed charges","100% of total billed charges",2437,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2437,100,,1949.60,,,0,"percent of total billed charges","100% of total billed charges",2437,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2437,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,2437,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2437,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2437,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,2437,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",918.75,37.7,,735.00,,,0,"percent of total billed charges","37.70% of total billed charges",2437,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2437,100,,,,,0,"fee schedule","100% of CMS fee schedule",1900.86,78,,1520.69,,,0,"percent of total billed charges","78% of total billed charges",2437,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2012.96,82.6,,1610.37,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",2437,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2012.96,82.6,,1610.37,,,0,"percent of total billed charges","82.6% of total billed charges",2437,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,2437,100,,1949.60,,,0,"percent of total billed charges","100% of total billed charges",372.86,15382.15,
"63300 Vertebral corpectomy (vertebral body resecti",7962220,CDM,521,RC,63300,CPT,OUTPATIENT,,,7745,5034.25,,6815.6,88,,5452.48,,,0,"percent of total billed charges","88% of total billed charges",7745,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7745,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,7745,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4879.35,63,,3903.48,,,0,"percent of total billed charges","63% of total billed charges",1184.99,15.3,,947.99,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,5344.05,69,,,,,0,"fee schedule","69% of total billed charges",7745,100,,6196.00,,,0,"percent of total billed charges","100% of total billed charges",7745,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7745,100,,6196.00,,,0,"percent of total billed charges","100% of total billed charges",7745,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7745,100,,6196.00,,,0,"percent of total billed charges","100% of total billed charges",7745,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7745,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,7745,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7745,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7745,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,7745,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2919.87,37.7,,2335.90,,,0,"percent of total billed charges","37.70% of total billed charges",7745,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7745,100,,,,,0,"fee schedule","100% of CMS fee schedule",6041.1,78,,4832.88,,,0,"percent of total billed charges","78% of total billed charges",7745,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6397.37,82.6,,5117.90,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",7745,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6397.37,82.6,,5117.90,,,0,"percent of total billed charges","82.6% of total billed charges",7745,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,7745,100,,6196.00,,,0,"percent of total billed charges","100% of total billed charges",1184.99,15382.15,
"63304 Vertebral corpectomy (vertebral body resecti",7962221,CDM,521,RC,63304,CPT,OUTPATIENT,,,8150,5297.5,,7172,88,,5737.60,,,0,"percent of total billed charges","88% of total billed charges",8150,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",8150,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,8150,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5134.5,63,,4107.60,,,0,"percent of total billed charges","63% of total billed charges",1246.95,15.3,,997.56,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,5623.5,69,,,,,0,"fee schedule","69% of total billed charges",8150,100,,6520.00,,,0,"percent of total billed charges","100% of total billed charges",8150,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8150,100,,6520.00,,,0,"percent of total billed charges","100% of total billed charges",8150,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8150,100,,6520.00,,,0,"percent of total billed charges","100% of total billed charges",8150,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8150,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,8150,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",8150,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8150,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,8150,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3072.55,37.7,,2458.04,,,0,"percent of total billed charges","37.70% of total billed charges",8150,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",8150,100,,,,,0,"fee schedule","100% of CMS fee schedule",6357,78,,5085.60,,,0,"percent of total billed charges","78% of total billed charges",8150,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6731.9,82.6,,5385.52,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",8150,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6731.9,82.6,,5385.52,,,0,"percent of total billed charges","82.6% of total billed charges",8150,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,8150,100,,6520.00,,,0,"percent of total billed charges","100% of total billed charges",1246.95,15382.15,
"63301 Vertebral corpectomy,partial/complete,excisi",7962349,CDM,521,RC,63301,CPT,OUTPATIENT,,,7645,4969.25,,6727.6,88,,5382.08,,,0,"percent of total billed charges","88% of total billed charges",7645,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7645,175,,,,,0,"fee schedule","175% of CMS fee schedule",12187.4,100,,,,,0,"fee schedule",EAPG,7645,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4816.35,63,,3853.08,,,0,"percent of total billed charges","63% of total billed charges",1169.69,15.3,,935.75,,,0,"percent of total billed charges","15.3% of total billed charges",11832.42,100,,,,,0,"fee schedule",EAPG,5275.05,69,,,,,0,"fee schedule","69% of total billed charges",7645,100,,6116.00,,,0,"percent of total billed charges","100% of total billed charges",7645,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7645,100,,6116.00,,,0,"percent of total billed charges","100% of total billed charges",7645,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7645,100,,6116.00,,,0,"percent of total billed charges","100% of total billed charges",7645,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7645,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11832.42,100,,,,,0,"fee schedule",EAPG,7645,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7645,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7645,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",12069.07,100,,,,,0,"fee schedule",EAPG,15382.15,100,,,,,0,"fee schedule",EAPG,7645,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2882.17,37.7,,2305.74,,,0,"percent of total billed charges","37.70% of total billed charges",7645,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7645,100,,,,,0,"fee schedule","100% of CMS fee schedule",5963.1,78,,4770.48,,,0,"percent of total billed charges","78% of total billed charges",7645,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6314.77,82.6,,5051.82,,,0,"percent of total billed charges","82.6% of total billed charges",11832.42,100,,,,,0,"fee schedule","100% of WA fee schedule",7645,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6314.77,82.6,,5051.82,,,0,"percent of total billed charges","82.6% of total billed charges",7645,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",11992.95,100,,,,,0,"fee schedule",EAPG,7645,100,,6116.00,,,0,"percent of total billed charges","100% of total billed charges",1169.69,15382.15,
"63655 Laminectomy for implantation of neurostimula",7962428,CDM,521,RC,63655,CPT,OUTPATIENT,,,4814,3129.1,,4236.32,88,,3389.06,,,0,"percent of total billed charges","88% of total billed charges",22312.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18609.86,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",39046.44,175,,,,,0,"fee schedule","175% of CMS fee schedule",19168.16,100,,,,,0,"fee schedule",EAPG,22312.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3032.82,63,,2426.26,,,0,"percent of total billed charges","63% of total billed charges",736.54,15.3,,589.23,,,0,"percent of total billed charges","15.3% of total billed charges",18609.86,100,,,,,0,"fee schedule",EAPG,3321.66,69,,,,,0,"fee schedule","69% of total billed charges",4814,100,,3851.20,,,0,"percent of total billed charges","100% of total billed charges",22312.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4814,100,,3851.20,,,0,"percent of total billed charges","100% of total billed charges",22312.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4814,100,,3851.20,,,0,"percent of total billed charges","100% of total billed charges",22312.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",83199.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18609.86,100,,,,,0,"fee schedule",EAPG,22312.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",21751.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",22312.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18982.06,100,,,,,0,"fee schedule",EAPG,24192.82,100,,,,,0,"fee schedule",EAPG,22312.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1814.88,37.7,,1451.90,,,0,"percent of total billed charges","37.70% of total billed charges",22312.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",22312.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3754.92,78,,3003.94,,,0,"percent of total billed charges","78% of total billed charges",22535.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3976.36,82.6,,3181.09,,,0,"percent of total billed charges","82.6% of total billed charges",18609.86,100,,,,,0,"fee schedule",EAPG,22312.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3976.36,82.6,,3181.09,,,0,"percent of total billed charges","82.6% of total billed charges",22312.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18770.39,100,,,,,0,"fee schedule",EAPG,4814,100,,3851.20,,,0,"percent of total billed charges","100% of total billed charges",736.54,83199.76,
"63650 Percutaneous implantation of neurostimulator",7962824,CDM,521,RC,63650,CPT,OUTPATIENT,,,3232,2100.8,,2844.16,88,,2275.33,,,0,"percent of total billed charges","88% of total billed charges",6975.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5344.89,100,,,,,0,"fee schedule",EAPG,3232,100,,2585.60,,,0,"percent of total billed charges","100% of total billed charges",12207.43,175,,,,,0,"fee schedule","175% of CMS fee schedule",5505.24,100,,,,,0,"fee schedule",EAPG,6975.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2036.16,63,,1628.93,,,0,"percent of total billed charges","63% of total billed charges",494.5,15.3,,395.60,,,0,"percent of total billed charges","15.3% of total billed charges",5344.89,100,,,,,0,"fee schedule",EAPG,2230.08,69,,,,,0,"fee schedule","69% of total billed charges",3232,100,,2585.60,,,0,"percent of total billed charges","100% of total billed charges",6975.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3232,100,,2585.60,,,0,"percent of total billed charges","100% of total billed charges",6975.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3232,100,,2585.60,,,0,"percent of total billed charges","100% of total billed charges",6975.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",25027.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5344.89,100,,,,,0,"fee schedule",EAPG,6975.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6543.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6975.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5451.79,100,,,,,0,"fee schedule",EAPG,6948.36,100,,,,,0,"fee schedule",EAPG,6975.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1218.46,37.7,,974.77,,,0,"percent of total billed charges","37.70% of total billed charges",6975.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6975.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2520.96,78,,2016.77,,,0,"percent of total billed charges","78% of total billed charges",7045.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2669.63,82.6,,2135.70,,,0,"percent of total billed charges","82.6% of total billed charges",5344.89,100,,,,,0,"fee schedule",EAPG,6975.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2669.63,82.6,,2135.70,,,0,"percent of total billed charges","82.6% of total billed charges",6975.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5505.42,100,,,,,0,"fee schedule",EAPG,3232,100,,2585.60,,,0,"percent of total billed charges","100% of total billed charges",494.5,25027.96,
"63660 removrevisin spin neurostim",7963786,CDM,521,RC,63660,CPT,OUTPATIENT,,,2752,1788.8,,2421.76,88,,1937.41,,,0,"percent of total billed charges","88% of total billed charges",1376,50,,1100.80,,,0,"percent of total billed charges","50% of total billed charges",462.34,16.8,,369.87,,,0,"percent of total billed charges","16.8% of total billed charges",2752,100,,2201.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",476.21,17.304,,380.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1733.76,63,,1387.01,,,0,"percent of total billed charges","63% of total billed charges",421.06,15.3,,336.85,,,0,"percent of total billed charges","15.3% of total billed charges",462.34,16.8,,369.87,,,0,"percent of total billed charges","16.8% of total billed charges",1898.88,69,,,,,0,"fee schedule","69% of total billed charges",2752,100,,2201.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2752,100,,2201.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2752,100,,2201.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1702.11,61.85,,1361.69,,,0,"percent of total billed charges","61.5% of total billed charges",462.34,16.8,,369.87,,,0,"percent of total billed charges","16.8% of total billed charges",1376,50,,1100.80,,,0,"percent of total billed charges","50% of total billed charges",886.14,32.2,,708.91,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",471.58,17.136,,377.26,,,0,"percent of total billed charges","17.136% of total billed charges",601.04,21.84,,480.83,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1037.5,37.7,,830.00,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2146.56,78,,1717.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",2273.15,82.6,,1818.52,,,0,"percent of total billed charges","82.6% of total billed charges",462.34,16.8,,369.87,,,0,"percent of total billed charges","16.8% of total billed charges",1376,50,,1100.80,,,0,"percent of total billed charges","50% of total billed charges",2273.15,82.6,,1818.52,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",2752,100,,2201.60,,,0,"percent of total billed charges","100% of total billed charges",160.53,2752,
"63685 Insert/replace spinal neurostimulator pulse",7961881,CDM,521,RC,63685,CPT,OUTPATIENT,,,2890,1878.5,,2543.2,88,,2034.56,,,0,"percent of total billed charges","88% of total billed charges",31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18609.86,100,,,,,0,"fee schedule",EAPG,2890,100,,2312.00,,,0,"percent of total billed charges","100% of total billed charges",55426.2,175,,,,,0,"fee schedule","175% of CMS fee schedule",19168.16,100,,,,,0,"fee schedule",EAPG,31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1820.7,63,,1456.56,,,0,"percent of total billed charges","63% of total billed charges",442.17,15.3,,353.74,,,0,"percent of total billed charges","15.3% of total billed charges",18609.86,100,,,,,0,"fee schedule",EAPG,1994.1,69,,,,,0,"fee schedule","69% of total billed charges",2890,100,,2312.00,,,0,"percent of total billed charges","100% of total billed charges",31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2890,100,,2312.00,,,0,"percent of total billed charges","100% of total billed charges",31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2890,100,,2312.00,,,0,"percent of total billed charges","100% of total billed charges",31672.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",119619.3,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18609.86,100,,,,,0,"fee schedule",EAPG,31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31273.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18982.06,100,,,,,0,"fee schedule",EAPG,24192.82,100,,,,,0,"fee schedule",EAPG,31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1089.53,37.7,,871.62,,,0,"percent of total billed charges","37.70% of total billed charges",31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2254.2,78,,1803.36,,,0,"percent of total billed charges","78% of total billed charges",31988.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2387.14,82.6,,1909.71,,,0,"percent of total billed charges","82.6% of total billed charges",18609.86,100,,,,,0,"fee schedule",EAPG,31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2387.14,82.6,,1909.71,,,0,"percent of total billed charges","82.6% of total billed charges",31672.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18770.39,100,,,,,0,"fee schedule",EAPG,2890,100,,2312.00,,,0,"percent of total billed charges","100% of total billed charges",442.17,119619.3,
"63688 Revision or removal of implanted spinal neur",7962385,CDM,521,RC,63688,CPT,OUTPATIENT,,,2491,1619.15,,2192.08,88,,1753.66,,,0,"percent of total billed charges","88% of total billed charges",3470.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.79,100,,,,,0,"fee schedule",EAPG,2491,100,,1992.80,,,0,"percent of total billed charges","100% of total billed charges",6073.28,175,,,,,0,"fee schedule","175% of CMS fee schedule",3483.24,100,,,,,0,"fee schedule",EAPG,3470.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1569.33,63,,1255.46,,,0,"percent of total billed charges","63% of total billed charges",381.12,15.3,,304.90,,,0,"percent of total billed charges","15.3% of total billed charges",3381.79,100,,,,,0,"fee schedule",EAPG,1718.79,69,,,,,0,"fee schedule","69% of total billed charges",2491,100,,1992.80,,,0,"percent of total billed charges","100% of total billed charges",3470.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2491,100,,1992.80,,,0,"percent of total billed charges","100% of total billed charges",3470.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2491,100,,1992.80,,,0,"percent of total billed charges","100% of total billed charges",3470.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",13306,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.79,100,,,,,0,"fee schedule",EAPG,3470.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3478.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3470.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3449.42,100,,,,,0,"fee schedule",EAPG,4396.32,100,,,,,0,"fee schedule",EAPG,3470.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",939.11,37.7,,751.29,,,0,"percent of total billed charges","37.70% of total billed charges",3470.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3470.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1942.98,78,,1554.38,,,0,"percent of total billed charges","78% of total billed charges",3505.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2057.57,82.6,,1646.06,,,0,"percent of total billed charges","82.6% of total billed charges",3381.79,100,,,,,0,"fee schedule",EAPG,3470.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2057.57,82.6,,1646.06,,,0,"percent of total billed charges","82.6% of total billed charges",3470.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3542.32,100,,,,,0,"fee schedule",EAPG,2491,100,,1992.80,,,0,"percent of total billed charges","100% of total billed charges",381.12,13306,
"63709 Repair of dural/cerebrospinal fluid leak or",7962510,CDM,521,RC,63709,CPT,OUTPATIENT,,,7888,5127.2,,6941.44,88,,5553.15,,,0,"percent of total billed charges","88% of total billed charges",7888,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7888,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,7888,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4969.44,63,,3975.55,,,0,"percent of total billed charges","63% of total billed charges",1206.86,15.3,,965.49,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,5442.72,69,,,,,0,"fee schedule","69% of total billed charges",7888,100,,6310.40,,,0,"percent of total billed charges","100% of total billed charges",7888,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7888,100,,6310.40,,,0,"percent of total billed charges","100% of total billed charges",7888,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7888,100,,6310.40,,,0,"percent of total billed charges","100% of total billed charges",7888,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7888,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,7888,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7888,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7888,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,7888,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2973.78,37.7,,2379.02,,,0,"percent of total billed charges","37.70% of total billed charges",7888,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7888,100,,,,,0,"fee schedule","100% of CMS fee schedule",6152.64,78,,4922.11,,,0,"percent of total billed charges","78% of total billed charges",7888,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6515.49,82.6,,5212.39,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule","100% of WA fee schedule",7888,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6515.49,82.6,,5212.39,,,0,"percent of total billed charges","82.6% of total billed charges",7888,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9397.14,100,,,,,0,"fee schedule",EAPG,7888,100,,6310.40,,,0,"percent of total billed charges","100% of total billed charges",1206.86,12007.59,
"63707 Repair of dural/cerebrospinal fluid leak, no",7962914,CDM,521,RC,63707,CPT,OUTPATIENT,,,5660,3679,,4980.8,88,,3984.64,,,0,"percent of total billed charges","88% of total billed charges",5660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4192.88,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",5660,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,5660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3565.8,63,,2852.64,,,0,"percent of total billed charges","63% of total billed charges",865.98,15.3,,692.78,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,3905.4,69,,,,,0,"fee schedule","69% of total billed charges",5660,100,,4528.00,,,0,"percent of total billed charges","100% of total billed charges",5660,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5660,100,,4528.00,,,0,"percent of total billed charges","100% of total billed charges",5660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5660,100,,4528.00,,,0,"percent of total billed charges","100% of total billed charges",5660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4192.88,100,,,,,0,"fee schedule",EAPG,5660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,5660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2133.82,37.7,,1707.06,,,0,"percent of total billed charges","37.70% of total billed charges",5660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",5660,100,,,,,0,"fee schedule","100% of CMS fee schedule",4414.8,78,,3531.84,,,0,"percent of total billed charges","78% of total billed charges",5660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4675.16,82.6,,3740.13,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,5660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4675.16,82.6,,3740.13,,,0,"percent of total billed charges","82.6% of total billed charges",5660,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4353.41,100,,,,,0,"fee schedule",EAPG,5660,100,,4528.00,,,0,"percent of total billed charges","100% of total billed charges",865.98,5660,
"63702 Repair of meningocele; larger than 5 cm diam",7963403,CDM,521,RC,63702,CPT,OUTPATIENT,,,7686,4995.9,,6763.68,88,,5410.94,,,0,"percent of total billed charges","88% of total billed charges",7686,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4192.88,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7686,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,7686,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4842.18,63,,3873.74,,,0,"percent of total billed charges","63% of total billed charges",1175.96,15.3,,940.77,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,5303.34,69,,,,,0,"fee schedule","69% of total billed charges",7686,100,,6148.80,,,0,"percent of total billed charges","100% of total billed charges",7686,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7686,100,,6148.80,,,0,"percent of total billed charges","100% of total billed charges",7686,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7686,100,,6148.80,,,0,"percent of total billed charges","100% of total billed charges",7686,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7686,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4192.88,100,,,,,0,"fee schedule",EAPG,7686,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7686,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7686,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,7686,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2897.62,37.7,,2318.10,,,0,"percent of total billed charges","37.70% of total billed charges",7686,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7686,100,,,,,0,"fee schedule","100% of CMS fee schedule",5995.08,78,,4796.06,,,0,"percent of total billed charges","78% of total billed charges",7686,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6348.64,82.6,,5078.91,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule","100% of WA fee schedule",7686,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6348.64,82.6,,5078.91,,,0,"percent of total billed charges","82.6% of total billed charges",7686,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4353.41,100,,,,,0,"fee schedule",EAPG,7686,100,,6148.80,,,0,"percent of total billed charges","100% of total billed charges",1175.96,7686,
"63700 Repair of meningocele; less than 5 cm diamet",7963437,CDM,521,RC,63700,CPT,OUTPATIENT,,,6821,4433.65,,6002.48,88,,4801.98,,,0,"percent of total billed charges","88% of total billed charges",6821,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4192.88,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6821,175,,,,,0,"fee schedule","175% of CMS fee schedule",4318.67,100,,,,,0,"fee schedule",EAPG,6821,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4297.23,63,,3437.78,,,0,"percent of total billed charges","63% of total billed charges",1043.61,15.3,,834.89,,,0,"percent of total billed charges","15.3% of total billed charges",4192.88,100,,,,,0,"fee schedule",EAPG,4706.49,69,,,,,0,"fee schedule","69% of total billed charges",6821,100,,5456.80,,,0,"percent of total billed charges","100% of total billed charges",6821,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6821,100,,5456.80,,,0,"percent of total billed charges","100% of total billed charges",6821,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6821,100,,5456.80,,,0,"percent of total billed charges","100% of total billed charges",6821,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6821,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4192.88,100,,,,,0,"fee schedule",EAPG,6821,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6821,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6821,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4276.74,100,,,,,0,"fee schedule",EAPG,5450.75,100,,,,,0,"fee schedule",EAPG,6821,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2571.52,37.7,,2057.22,,,0,"percent of total billed charges","37.70% of total billed charges",6821,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6821,100,,,,,0,"fee schedule","100% of CMS fee schedule",5320.38,78,,4256.30,,,0,"percent of total billed charges","78% of total billed charges",6821,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5634.15,82.6,,4507.32,,,0,"percent of total billed charges","82.6% of total billed charges",4192.88,100,,,,,0,"fee schedule","100% of WA fee schedule",6821,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5634.15,82.6,,4507.32,,,0,"percent of total billed charges","82.6% of total billed charges",6821,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4353.41,100,,,,,0,"fee schedule",EAPG,6821,100,,5456.80,,,0,"percent of total billed charges","100% of total billed charges",1043.61,6821,
"63710 Dural graft, spinal",7963909,CDM,521,RC,63710,CPT,OUTPATIENT,,,7071,4596.15,,6222.48,88,,4977.98,,,0,"percent of total billed charges","88% of total billed charges",7071,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",7071,175,,,,,0,"fee schedule","175% of CMS fee schedule",9513.71,100,,,,,0,"fee schedule",EAPG,7071,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4454.73,63,,3563.78,,,0,"percent of total billed charges","63% of total billed charges",1081.86,15.3,,865.49,,,0,"percent of total billed charges","15.3% of total billed charges",9236.61,100,,,,,0,"fee schedule",EAPG,4878.99,69,,,,,0,"fee schedule","69% of total billed charges",7071,100,,5656.80,,,0,"percent of total billed charges","100% of total billed charges",7071,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7071,100,,5656.80,,,0,"percent of total billed charges","100% of total billed charges",7071,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7071,100,,5656.80,,,0,"percent of total billed charges","100% of total billed charges",7071,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7071,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9236.61,100,,,,,0,"fee schedule",EAPG,7071,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7071,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7071,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9421.34,100,,,,,0,"fee schedule",EAPG,12007.59,100,,,,,0,"fee schedule",EAPG,7071,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2665.77,37.7,,2132.62,,,0,"percent of total billed charges","37.70% of total billed charges",7071,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",7071,100,,,,,0,"fee schedule","100% of CMS fee schedule",5515.38,78,,4412.30,,,0,"percent of total billed charges","78% of total billed charges",7071,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5840.65,82.6,,4672.52,,,0,"percent of total billed charges","82.6% of total billed charges",9236.61,100,,,,,0,"fee schedule","100% of WA fee schedule",7071,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5840.65,82.6,,4672.52,,,0,"percent of total billed charges","82.6% of total billed charges",7071,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",9397.14,100,,,,,0,"fee schedule",EAPG,7071,100,,5656.80,,,0,"percent of total billed charges","100% of total billed charges",1081.86,12007.59,
"63740 Creation of shunt, lumbar, subarachnoid-peri",7961646,CDM,521,RC,63740,CPT,OUTPATIENT,,,6057,3937.05,,5330.16,88,,4264.13,,,0,"percent of total billed charges","88% of total billed charges",6057,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5043.02,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",6057,175,,,,,0,"fee schedule","175% of CMS fee schedule",5194.31,100,,,,,0,"fee schedule",EAPG,6057,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3815.91,63,,3052.73,,,0,"percent of total billed charges","63% of total billed charges",926.72,15.3,,741.38,,,0,"percent of total billed charges","15.3% of total billed charges",5043.02,100,,,,,0,"fee schedule",EAPG,4179.33,69,,,,,0,"fee schedule","69% of total billed charges",6057,100,,4845.60,,,0,"percent of total billed charges","100% of total billed charges",6057,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6057,100,,4845.60,,,0,"percent of total billed charges","100% of total billed charges",6057,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6057,100,,4845.60,,,0,"percent of total billed charges","100% of total billed charges",6057,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6057,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5043.02,100,,,,,0,"fee schedule",EAPG,6057,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",6057,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6057,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5143.88,100,,,,,0,"fee schedule",EAPG,6555.92,100,,,,,0,"fee schedule",EAPG,6057,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2283.49,37.7,,1826.79,,,0,"percent of total billed charges","37.70% of total billed charges",6057,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",6057,100,,,,,0,"fee schedule","100% of CMS fee schedule",4724.46,78,,3779.57,,,0,"percent of total billed charges","78% of total billed charges",6057,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5003.08,82.6,,4002.46,,,0,"percent of total billed charges","82.6% of total billed charges",5043.02,100,,,,,0,"fee schedule","100% of WA fee schedule",6057,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5003.08,82.6,,4002.46,,,0,"percent of total billed charges","82.6% of total billed charges",6057,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",5203.55,100,,,,,0,"fee schedule",EAPG,6057,100,,4845.60,,,0,"percent of total billed charges","100% of total billed charges",926.72,6555.92,
"63741 Creation of shunt, lumbar, subarachnoid-peri",7962213,CDM,521,RC,63741,CPT,OUTPATIENT,,,2913,1893.45,,2563.44,88,,2050.75,,,0,"percent of total billed charges","88% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5043.02,100,,,,,0,"fee schedule",EAPG,2913,100,,2330.40,,,0,"percent of total billed charges","100% of total billed charges",11890.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",5194.31,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1835.19,63,,1468.15,,,0,"percent of total billed charges","63% of total billed charges",445.69,15.3,,356.55,,,0,"percent of total billed charges","15.3% of total billed charges",5043.02,100,,,,,0,"fee schedule",EAPG,2009.97,69,,,,,0,"fee schedule","69% of total billed charges",2913,100,,2330.40,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2913,100,,2330.40,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2913,100,,2330.40,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",23157.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5043.02,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6054.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5143.88,100,,,,,0,"fee schedule",EAPG,6555.92,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1098.2,37.7,,878.56,,,0,"percent of total billed charges","37.70% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2272.14,78,,1817.71,,,0,"percent of total billed charges","78% of total billed charges",6862.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2406.14,82.6,,1924.91,,,0,"percent of total billed charges","82.6% of total billed charges",5043.02,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2406.14,82.6,,1924.91,,,0,"percent of total billed charges","82.6% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5203.55,100,,,,,0,"fee schedule",EAPG,2913,100,,2330.40,,,0,"percent of total billed charges","100% of total billed charges",445.69,23157.6,
"63746 Removal of entire lumbosubarachnoid shunt sy",7962896,CDM,521,RC,63746,CPT,OUTPATIENT,,,2543,1652.95,,2237.84,88,,1790.27,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,2543,100,,2034.40,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",1276.43,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1602.09,63,,1281.67,,,0,"percent of total billed charges","63% of total billed charges",389.08,15.3,,311.26,,,0,"percent of total billed charges","15.3% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,1754.67,69,,,,,0,"fee schedule","69% of total billed charges",2543,100,,2034.40,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2543,100,,2034.40,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2543,100,,2034.40,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1264.04,100,,,,,0,"fee schedule",EAPG,1611.03,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",958.71,37.7,,766.97,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1983.54,78,,1586.83,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2100.52,82.6,,1680.42,,,0,"percent of total billed charges","82.6% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2100.52,82.6,,1680.42,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1399.78,100,,,,,0,"fee schedule",EAPG,2543,100,,2034.40,,,0,"percent of total billed charges","100% of total billed charges",389.08,7127.26,
"63744 Replacement, irrigation or revision of lumbo",7963061,CDM,521,RC,63744,CPT,OUTPATIENT,,,3610,2346.5,,3176.8,88,,2541.44,,,0,"percent of total billed charges","88% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5043.02,100,,,,,0,"fee schedule",EAPG,3610,100,,2888.00,,,0,"percent of total billed charges","100% of total billed charges",11890.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",5194.31,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2274.3,63,,1819.44,,,0,"percent of total billed charges","63% of total billed charges",552.33,15.3,,441.86,,,0,"percent of total billed charges","15.3% of total billed charges",5043.02,100,,,,,0,"fee schedule",EAPG,2490.9,69,,,,,0,"fee schedule","69% of total billed charges",3610,100,,2888.00,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3610,100,,2888.00,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3610,100,,2888.00,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",23157.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5043.02,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6054.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5143.88,100,,,,,0,"fee schedule",EAPG,6555.92,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1360.97,37.7,,1088.78,,,0,"percent of total billed charges","37.70% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2815.8,78,,2252.64,,,0,"percent of total billed charges","78% of total billed charges",6862.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2981.86,82.6,,2385.49,,,0,"percent of total billed charges","82.6% of total billed charges",5043.02,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2981.86,82.6,,2385.49,,,0,"percent of total billed charges","82.6% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5203.55,100,,,,,0,"fee schedule",EAPG,3610,100,,2888.00,,,0,"percent of total billed charges","100% of total billed charges",552.33,23157.6,
"64400 Injection, anesthetic agent; trigeminal nerv",7903319,CDM,521,RC,64400,CPT,OUTPATIENT,,,297,193.05,,261.36,88,,209.09,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,297,100,,237.60,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",187.11,63,,149.69,,,0,"percent of total billed charges","63% of total billed charges",45.44,15.3,,36.35,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,204.93,69,,,,,0,"fee schedule","69% of total billed charges",297,100,,237.60,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297,100,,237.60,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297,100,,237.60,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",111.97,37.7,,89.58,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",231.66,78,,185.33,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",245.32,82.6,,196.26,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",245.32,82.6,,196.26,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",552.74,100,,,,,0,"fee schedule",EAPG,297,100,,237.60,,,0,"percent of total billed charges","100% of total billed charges",45.44,1061,
"64405 Injection greater occipital nerve",7904742,CDM,521,RC,64405,CPT,OUTPATIENT,,,179,116.35,,157.52,88,,126.02,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,179,100,,143.20,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",112.77,63,,90.22,,,0,"percent of total billed charges","63% of total billed charges",27.39,15.3,,21.91,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,123.51,69,,,,,0,"fee schedule","69% of total billed charges",179,100,,143.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",179,100,,143.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",179,100,,143.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",67.48,37.7,,53.98,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",139.62,78,,111.70,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.85,82.6,,118.28,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.85,82.6,,118.28,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",552.74,100,,,,,0,"fee schedule",EAPG,179,100,,143.20,,,0,"percent of total billed charges","100% of total billed charges",27.39,1061,
"64402 Injection, anesthetic agent; facial nerve",7963571,CDM,521,RC,64999,CPT,OUTPATIENT,,,248,161.2,,218.24,88,,174.59,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",156.24,63,,124.99,,,0,"percent of total billed charges","63% of total billed charges",37.94,15.3,,30.35,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,171.12,69,,,,,0,"fee schedule","69% of total billed charges",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",93.5,37.7,,74.80,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",193.44,78,,154.75,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",204.85,82.6,,163.88,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",204.85,82.6,,163.88,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",552.74,100,,,,,0,"fee schedule",EAPG,248,100,,198.40,,,0,"percent of total billed charges","100% of total billed charges",37.94,1061,
"64416 Injection, anesthetic agent; brachial plexus",7962148,CDM,521,RC,64416,CPT,OUTPATIENT,,,778,505.7,,684.64,88,,547.71,,,0,"percent of total billed charges","88% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,778,100,,622.40,,,0,"percent of total billed charges","100% of total billed charges",1626.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",1076.46,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",490.14,63,,392.11,,,0,"percent of total billed charges","63% of total billed charges",119.03,15.3,,95.22,,,0,"percent of total billed charges","15.3% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,536.82,69,,,,,0,"fee schedule","69% of total billed charges",778,100,,622.40,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",778,100,,622.40,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",778,100,,622.40,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3341.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1066.01,100,,,,,0,"fee schedule",EAPG,1358.64,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",293.31,37.7,,234.65,,,0,"percent of total billed charges","37.70% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",606.84,78,,485.47,,,0,"percent of total billed charges","78% of total billed charges",938.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",642.63,82.6,,514.10,,,0,"percent of total billed charges","82.6% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",642.63,82.6,,514.10,,,0,"percent of total billed charges","82.6% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1205.64,100,,,,,0,"fee schedule",EAPG,778,100,,622.40,,,0,"percent of total billed charges","100% of total billed charges",119.03,3341.26,
"64415 Injection, anesthetic agent; brachial plexus",7963338,CDM,521,RC,64415,CPT,OUTPATIENT,,,682,443.3,,600.16,88,,480.13,,,0,"percent of total billed charges","88% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,682,100,,545.60,,,0,"percent of total billed charges","100% of total billed charges",1626.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",1076.46,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",429.66,63,,343.73,,,0,"percent of total billed charges","63% of total billed charges",104.35,15.3,,83.48,,,0,"percent of total billed charges","15.3% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,470.58,69,,,,,0,"fee schedule","69% of total billed charges",682,100,,545.60,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",682,100,,545.60,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",682,100,,545.60,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3341.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1066.01,100,,,,,0,"fee schedule",EAPG,1358.64,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",257.11,37.7,,205.69,,,0,"percent of total billed charges","37.70% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",531.96,78,,425.57,,,0,"percent of total billed charges","78% of total billed charges",938.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",563.33,82.6,,450.66,,,0,"percent of total billed charges","82.6% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",563.33,82.6,,450.66,,,0,"percent of total billed charges","82.6% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1205.64,100,,,,,0,"fee schedule",EAPG,682,100,,545.60,,,0,"percent of total billed charges","100% of total billed charges",104.35,3341.26,
"64418 Injection, anesthetic agent; suprascapular n",7963432,CDM,521,RC,64418,CPT,OUTPATIENT,,,356,231.4,,313.28,88,,250.62,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.28,63,,179.42,,,0,"percent of total billed charges","63% of total billed charges",54.47,15.3,,43.58,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,245.64,69,,,,,0,"fee schedule","69% of total billed charges",356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",134.21,37.7,,107.37,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.68,78,,222.14,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.06,82.6,,235.25,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.06,82.6,,235.25,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",552.74,100,,,,,0,"fee schedule",EAPG,356,100,,284.80,,,0,"percent of total billed charges","100% of total billed charges",54.47,2578.03,
"64413 Injection, anesthetic agent; cervical plexus",7963516,CDM,521,RC,64999,CPT,OUTPATIENT,,,423,274.95,,372.24,88,,297.79,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,423,100,,338.40,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",266.49,63,,213.19,,,0,"percent of total billed charges","63% of total billed charges",64.72,15.3,,51.78,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,291.87,69,,,,,0,"fee schedule","69% of total billed charges",423,100,,338.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",423,100,,338.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",423,100,,338.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.47,37.7,,127.58,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",329.94,78,,263.95,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",349.4,82.6,,279.52,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",349.4,82.6,,279.52,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",552.74,100,,,,,0,"fee schedule",EAPG,423,100,,338.40,,,0,"percent of total billed charges","100% of total billed charges",64.72,1061,
"64417 Injection, anesthetic agent; axillary nerve",7963531,CDM,521,RC,64417,CPT,OUTPATIENT,,,696,452.4,,612.48,88,,489.98,,,0,"percent of total billed charges","88% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,696,100,,556.80,,,0,"percent of total billed charges","100% of total billed charges",1626.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",438.48,63,,350.78,,,0,"percent of total billed charges","63% of total billed charges",106.49,15.3,,85.19,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,480.24,69,,,,,0,"fee schedule","69% of total billed charges",696,100,,556.80,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",696,100,,556.80,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",696,100,,556.80,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3341.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",262.39,37.7,,209.91,,,0,"percent of total billed charges","37.70% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",542.88,78,,434.30,,,0,"percent of total billed charges","78% of total billed charges",938.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",574.9,82.6,,459.92,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",574.9,82.6,,459.92,,,0,"percent of total billed charges","82.6% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",552.74,100,,,,,0,"fee schedule",EAPG,696,100,,556.80,,,0,"percent of total billed charges","100% of total billed charges",106.49,3341.26,
"64420 Intercostal nerve injection single",7904743,CDM,521,RC,64420,CPT,OUTPATIENT,,,389,252.85,,342.32,88,,273.86,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,389,100,,311.20,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",245.07,63,,196.06,,,0,"percent of total billed charges","63% of total billed charges",59.52,15.3,,47.62,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,268.41,69,,,,,0,"fee schedule","69% of total billed charges",389,100,,311.20,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",389,100,,311.20,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",389,100,,311.20,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",146.65,37.7,,117.32,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",303.42,78,,242.74,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",321.31,82.6,,257.05,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",321.31,82.6,,257.05,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",552.74,100,,,,,0,"fee schedule",EAPG,389,100,,311.20,,,0,"percent of total billed charges","100% of total billed charges",59.52,2578.03,
"64425 Inguinal nerve injection",7904744,CDM,521,RC,64425,CPT,OUTPATIENT,,,456,296.4,,401.28,88,,321.02,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,456,100,,364.80,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287.28,63,,229.82,,,0,"percent of total billed charges","63% of total billed charges",69.77,15.3,,55.82,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,314.64,69,,,,,0,"fee schedule","69% of total billed charges",456,100,,364.80,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",456,100,,364.80,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",456,100,,364.80,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",171.91,37.7,,137.53,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.68,78,,284.54,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",376.66,82.6,,301.33,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",376.66,82.6,,301.33,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",552.74,100,,,,,0,"fee schedule",EAPG,456,100,,364.80,,,0,"percent of total billed charges","100% of total billed charges",69.77,2578.03,
"64421 Injection, anesthetic agent; intercostal ner",7962721,CDM,521,RC,64421,CPT,OUTPATIENT,,,589,382.85,,518.32,88,,414.66,,,0,"percent of total billed charges","88% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,589,100,,471.20,,,0,"percent of total billed charges","100% of total billed charges",1626.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",1076.46,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",371.07,63,,296.86,,,0,"percent of total billed charges","63% of total billed charges",90.12,15.3,,72.10,,,0,"percent of total billed charges","15.3% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,406.41,69,,,,,0,"fee schedule","69% of total billed charges",589,100,,471.20,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",589,100,,471.20,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",589,100,,471.20,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3341.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1066.01,100,,,,,0,"fee schedule",EAPG,1358.64,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",222.05,37.7,,177.64,,,0,"percent of total billed charges","37.70% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",459.42,78,,367.54,,,0,"percent of total billed charges","78% of total billed charges",938.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",486.51,82.6,,389.21,,,0,"percent of total billed charges","82.6% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",486.51,82.6,,389.21,,,0,"percent of total billed charges","82.6% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1205.64,100,,,,,0,"fee schedule",EAPG,589,100,,471.20,,,0,"percent of total billed charges","100% of total billed charges",90.12,3341.26,
"64435 Injection, anesthetic agent; paracervical (u",7963206,CDM,521,RC,64435,CPT,OUTPATIENT,,,133,86.45,,117.04,88,,93.63,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,133,100,,106.40,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",83.79,63,,67.03,,,0,"percent of total billed charges","63% of total billed charges",20.35,15.3,,16.28,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,91.77,69,,,,,0,"fee schedule","69% of total billed charges",133,100,,106.40,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",133,100,,106.40,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",133,100,,106.40,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",50.14,37.7,,40.11,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",103.74,78,,82.99,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.86,82.6,,87.89,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.86,82.6,,87.89,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",552.74,100,,,,,0,"fee schedule",EAPG,133,100,,106.40,,,0,"percent of total billed charges","100% of total billed charges",20.35,2578.03,
"64430 Injection, anesthetic agent; pudendal nerve",7963528,CDM,521,RC,64430,CPT,OUTPATIENT,,,437,284.05,,384.56,88,,307.65,,,0,"percent of total billed charges","88% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,437,100,,349.60,,,0,"percent of total billed charges","100% of total billed charges",1626.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",1076.46,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",275.31,63,,220.25,,,0,"percent of total billed charges","63% of total billed charges",66.86,15.3,,53.49,,,0,"percent of total billed charges","15.3% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,301.53,69,,,,,0,"fee schedule","69% of total billed charges",437,100,,349.60,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",437,100,,349.60,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",437,100,,349.60,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3341.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1066.01,100,,,,,0,"fee schedule",EAPG,1358.64,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",164.75,37.7,,131.80,,,0,"percent of total billed charges","37.70% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",340.86,78,,272.69,,,0,"percent of total billed charges","78% of total billed charges",938.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",360.96,82.6,,288.77,,,0,"percent of total billed charges","82.6% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",360.96,82.6,,288.77,,,0,"percent of total billed charges","82.6% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1205.64,100,,,,,0,"fee schedule",EAPG,437,100,,349.60,,,0,"percent of total billed charges","100% of total billed charges",66.86,3341.26,
"64447 Injection, anesthetic agent",7904745,CDM,521,RC,64447,CPT,OUTPATIENT,,,187,121.55,,164.56,88,,131.65,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,187,100,,149.60,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",1076.46,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",117.81,63,,94.25,,,0,"percent of total billed charges","63% of total billed charges",28.61,15.3,,22.89,,,0,"percent of total billed charges","15.3% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,129.03,69,,,,,0,"fee schedule","69% of total billed charges",187,100,,149.60,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",187,100,,149.60,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",187,100,,149.60,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1066.01,100,,,,,0,"fee schedule",EAPG,1358.64,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",70.5,37.7,,56.40,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",145.86,78,,116.69,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.46,82.6,,123.57,,,0,"percent of total billed charges","82.6% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.46,82.6,,123.57,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1205.64,100,,,,,0,"fee schedule",EAPG,187,100,,149.60,,,0,"percent of total billed charges","100% of total billed charges",28.61,2578.03,
"64448 Injection, anesthetic agent; femoral nerve,",7962056,CDM,521,RC,64448,CPT,OUTPATIENT,,,585,380.25,,514.8,88,,411.84,,,0,"percent of total billed charges","88% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,585,100,,468.00,,,0,"percent of total billed charges","100% of total billed charges",1626.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",1076.46,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",368.55,63,,294.84,,,0,"percent of total billed charges","63% of total billed charges",89.51,15.3,,71.61,,,0,"percent of total billed charges","15.3% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,403.65,69,,,,,0,"fee schedule","69% of total billed charges",585,100,,468.00,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",585,100,,468.00,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",585,100,,468.00,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3341.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1066.01,100,,,,,0,"fee schedule",EAPG,1358.64,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",220.55,37.7,,176.44,,,0,"percent of total billed charges","37.70% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",456.3,78,,365.04,,,0,"percent of total billed charges","78% of total billed charges",938.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",483.21,82.6,,386.57,,,0,"percent of total billed charges","82.6% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",483.21,82.6,,386.57,,,0,"percent of total billed charges","82.6% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1205.64,100,,,,,0,"fee schedule",EAPG,585,100,,468.00,,,0,"percent of total billed charges","100% of total billed charges",89.51,3341.26,
"64445 Injection, anesthetic agent; sciatic nerve,",7963399,CDM,521,RC,64445,CPT,OUTPATIENT,,,420,273,,369.6,88,,295.68,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,420,100,,336.00,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",264.6,63,,211.68,,,0,"percent of total billed charges","63% of total billed charges",64.26,15.3,,51.41,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,289.8,69,,,,,0,"fee schedule","69% of total billed charges",420,100,,336.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420,100,,336.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420,100,,336.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",158.34,37.7,,126.67,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327.6,78,,262.08,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",346.92,82.6,,277.54,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",346.92,82.6,,277.54,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",552.74,100,,,,,0,"fee schedule",EAPG,420,100,,336.00,,,0,"percent of total billed charges","100% of total billed charges",64.26,2578.03,
"64447 Injection anesthetic agent and/or steroid, f",9610726,CDM,521,RC,64447,CPT,OUTPATIENT,,,187,121.55,,164.56,88,,131.65,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,187,100,,149.60,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",1076.46,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",117.81,63,,94.25,,,0,"percent of total billed charges","63% of total billed charges",28.61,15.3,,22.89,,,0,"percent of total billed charges","15.3% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,129.03,69,,,,,0,"fee schedule","69% of total billed charges",187,100,,149.60,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",187,100,,149.60,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",187,100,,149.60,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1066.01,100,,,,,0,"fee schedule",EAPG,1358.64,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",70.5,37.7,,56.40,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",145.86,78,,116.69,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.46,82.6,,123.57,,,0,"percent of total billed charges","82.6% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.46,82.6,,123.57,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1205.64,100,,,,,0,"fee schedule",EAPG,187,100,,149.60,,,0,"percent of total billed charges","100% of total billed charges",28.61,2578.03,
"64450 Injection, anesthetic agent",7904710,CDM,521,RC,64450,CPT,OUTPATIENT,,,145,94.25,,127.6,88,,102.08,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.35,63,,73.08,,,0,"percent of total billed charges","63% of total billed charges",22.19,15.3,,17.75,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,100.05,69,,,,,0,"fee schedule","69% of total billed charges",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",54.67,37.7,,43.74,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",113.1,78,,90.48,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",119.77,82.6,,95.82,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",119.77,82.6,,95.82,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",552.74,100,,,,,0,"fee schedule",EAPG,145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",22.19,2578.03,
"64450: Injection(s), Anesthetic Agent(s) And/Or St",13175391,CDM,521,RC,64450,CPT,OUTPATIENT,,,145,94.25,,127.6,88,,102.08,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.35,63,,73.08,,,0,"percent of total billed charges","63% of total billed charges",22.19,15.3,,17.75,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,100.05,69,,,,,0,"fee schedule","69% of total billed charges",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",54.67,37.7,,43.74,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",113.1,78,,90.48,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",119.77,82.6,,95.82,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",119.77,82.6,,95.82,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",552.74,100,,,,,0,"fee schedule",EAPG,145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",22.19,2578.03,
"64479 Inj, anesthetic agent/steroid, transforamina",7961779,CDM,521,RC,64479,CPT,OUTPATIENT,,,1101,715.65,,968.88,88,,775.10,,,0,"percent of total billed charges","88% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,1101,100,,880.80,,,0,"percent of total billed charges","100% of total billed charges",1626.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",693.63,63,,554.90,,,0,"percent of total billed charges","63% of total billed charges",168.45,15.3,,134.76,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,759.69,69,,,,,0,"fee schedule","69% of total billed charges",1101,100,,880.80,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101,100,,880.80,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101,100,,880.80,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3341.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",415.08,37.7,,332.06,,,0,"percent of total billed charges","37.70% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.78,78,,687.02,,,0,"percent of total billed charges","78% of total billed charges",938.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",909.43,82.6,,727.54,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",909.43,82.6,,727.54,,,0,"percent of total billed charges","82.6% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",931.2,100,,,,,0,"fee schedule",EAPG,1101,100,,880.80,,,0,"percent of total billed charges","100% of total billed charges",168.45,3341.26,
"64480 Inj, anesthetic agent/steroid, transforamina",7961641,CDM,521,RC,64480,CPT,OUTPATIENT,,,750,487.5,,660,88,,528.00,,,0,"percent of total billed charges","88% of total billed charges",375,50,,300.00,,,0,"percent of total billed charges","50% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,750,100,,600.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",793.79,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",472.5,63,,378.00,,,0,"percent of total billed charges","63% of total billed charges",114.75,15.3,,91.80,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,517.5,69,,,,,0,"fee schedule","69% of total billed charges",750,100,,600.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",750,100,,600.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",750,100,,600.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",463.88,61.85,,371.10,,,0,"percent of total billed charges","61.5% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,375,50,,300.00,,,0,"percent of total billed charges","50% of total billed charges",241.5,32.2,,193.20,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",282.75,37.7,,226.20,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",585,78,,468.00,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",619.5,82.6,,495.60,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,375,50,,300.00,,,0,"percent of total billed charges","50% of total billed charges",619.5,82.6,,495.60,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",931.2,100,,,,,0,"fee schedule",EAPG,750,100,,600.00,,,0,"percent of total billed charges","100% of total billed charges",114.75,1001.87,
"64484 Injection Transforaminal Epidural - addition",7963339,CDM,521,RC,64484,CPT,OUTPATIENT,,,270,175.5,,237.6,88,,190.08,,,0,"percent of total billed charges","88% of total billed charges",135,50,,108.00,,,0,"percent of total billed charges","50% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",793.79,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",170.1,63,,136.08,,,0,"percent of total billed charges","63% of total billed charges",41.31,15.3,,33.05,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,186.3,69,,,,,0,"fee schedule","69% of total billed charges",270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",167,61.85,,133.60,,,0,"percent of total billed charges","61.5% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,135,50,,108.00,,,0,"percent of total billed charges","50% of total billed charges",86.94,32.2,,69.55,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.79,37.7,,81.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",210.6,78,,168.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.02,82.6,,178.42,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,135,50,,108.00,,,0,"percent of total billed charges","50% of total billed charges",223.02,82.6,,178.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",931.2,100,,,,,0,"fee schedule",EAPG,270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",41.31,1001.87,
"64483 Injection Transforaminal Epidural - single l",7963433,CDM,521,RC,64483,CPT,OUTPATIENT,,,295,191.75,,259.6,88,,207.68,,,0,"percent of total billed charges","88% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,295,100,,236.00,,,0,"percent of total billed charges","100% of total billed charges",1626.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",185.85,63,,148.68,,,0,"percent of total billed charges","63% of total billed charges",45.14,15.3,,36.11,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,203.55,69,,,,,0,"fee schedule","69% of total billed charges",295,100,,236.00,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",295,100,,236.00,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",295,100,,236.00,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3341.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",111.22,37.7,,88.98,,,0,"percent of total billed charges","37.70% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",230.1,78,,184.08,,,0,"percent of total billed charges","78% of total billed charges",938.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",243.67,82.6,,194.94,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",243.67,82.6,,194.94,,,0,"percent of total billed charges","82.6% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",931.2,100,,,,,0,"fee schedule",EAPG,295,100,,236.00,,,0,"percent of total billed charges","100% of total billed charges",45.14,3341.26,
"64492 Injection Paravertebral Facet Joint - cervic",7963084,CDM,521,RC,64492,CPT,OUTPATIENT,,,269,174.85,,236.72,88,,189.38,,,0,"percent of total billed charges","88% of total billed charges",134.5,50,,107.60,,,0,"percent of total billed charges","50% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",793.79,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",169.47,63,,135.58,,,0,"percent of total billed charges","63% of total billed charges",41.16,15.3,,32.93,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,185.61,69,,,,,0,"fee schedule","69% of total billed charges",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.38,61.85,,133.10,,,0,"percent of total billed charges","61.5% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,134.5,50,,107.60,,,0,"percent of total billed charges","50% of total billed charges",86.62,32.2,,69.30,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.41,37.7,,81.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.82,78,,167.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",222.19,82.6,,177.75,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,134.5,50,,107.60,,,0,"percent of total billed charges","50% of total billed charges",222.19,82.6,,177.75,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",931.2,100,,,,,0,"fee schedule",EAPG,269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",41.16,1001.87,
"64495 Injection Paravertebral Facet Joint - lumbar",7963085,CDM,521,RC,64495,CPT,OUTPATIENT,,,241,156.65,,212.08,88,,169.66,,,0,"percent of total billed charges","88% of total billed charges",120.5,50,,96.40,,,0,"percent of total billed charges","50% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",793.79,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",151.83,63,,121.46,,,0,"percent of total billed charges","63% of total billed charges",36.87,15.3,,29.50,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,166.29,69,,,,,0,"fee schedule","69% of total billed charges",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",149.06,61.85,,119.25,,,0,"percent of total billed charges","61.5% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,120.5,50,,96.40,,,0,"percent of total billed charges","50% of total billed charges",77.6,32.2,,62.08,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",90.86,37.7,,72.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",187.98,78,,150.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",199.07,82.6,,159.26,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,120.5,50,,96.40,,,0,"percent of total billed charges","50% of total billed charges",199.07,82.6,,159.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",931.2,100,,,,,0,"fee schedule",EAPG,241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",36.87,1001.87,
"64490 Injection Paravertebral Facet Joint - cervic",7963393,CDM,521,RC,64490,CPT,OUTPATIENT,,,538,349.7,,473.44,88,,378.75,,,0,"percent of total billed charges","88% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,538,100,,430.40,,,0,"percent of total billed charges","100% of total billed charges",1626.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.94,63,,271.15,,,0,"percent of total billed charges","63% of total billed charges",82.31,15.3,,65.85,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,371.22,69,,,,,0,"fee schedule","69% of total billed charges",538,100,,430.40,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",538,100,,430.40,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",538,100,,430.40,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3341.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",202.83,37.7,,162.26,,,0,"percent of total billed charges","37.70% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",419.64,78,,335.71,,,0,"percent of total billed charges","78% of total billed charges",938.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",444.39,82.6,,355.51,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",444.39,82.6,,355.51,,,0,"percent of total billed charges","82.6% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",931.2,100,,,,,0,"fee schedule",EAPG,538,100,,430.40,,,0,"percent of total billed charges","100% of total billed charges",82.31,3341.26,
"64491 Injection Paravertebral Facet Joint - cervic",7963394,CDM,521,RC,64491,CPT,OUTPATIENT,,,266,172.9,,234.08,88,,187.26,,,0,"percent of total billed charges","88% of total billed charges",133,50,,106.40,,,0,"percent of total billed charges","50% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",793.79,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",167.58,63,,134.06,,,0,"percent of total billed charges","63% of total billed charges",40.7,15.3,,32.56,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,183.54,69,,,,,0,"fee schedule","69% of total billed charges",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",164.52,61.85,,131.62,,,0,"percent of total billed charges","61.5% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,133,50,,106.40,,,0,"percent of total billed charges","50% of total billed charges",85.65,32.2,,68.52,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",100.28,37.7,,80.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",207.48,78,,165.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",219.72,82.6,,175.78,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,133,50,,106.40,,,0,"percent of total billed charges","50% of total billed charges",219.72,82.6,,175.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",931.2,100,,,,,0,"fee schedule",EAPG,266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",40.7,1001.87,
"64493 Injection Paravertebral Facet Joint - lumbar",7963395,CDM,521,RC,64493,CPT,OUTPATIENT,,,487,316.55,,428.56,88,,342.85,,,0,"percent of total billed charges","88% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,487,100,,389.60,,,0,"percent of total billed charges","100% of total billed charges",1626.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",306.81,63,,245.45,,,0,"percent of total billed charges","63% of total billed charges",74.51,15.3,,59.61,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,336.03,69,,,,,0,"fee schedule","69% of total billed charges",487,100,,389.60,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",487,100,,389.60,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",487,100,,389.60,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3341.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",183.6,37.7,,146.88,,,0,"percent of total billed charges","37.70% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",379.86,78,,303.89,,,0,"percent of total billed charges","78% of total billed charges",938.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.26,82.6,,321.81,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.26,82.6,,321.81,,,0,"percent of total billed charges","82.6% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",931.2,100,,,,,0,"fee schedule",EAPG,487,100,,389.60,,,0,"percent of total billed charges","100% of total billed charges",74.51,3341.26,
"64494 Injection Paravertebral Facet Joint - lumbar",7963396,CDM,521,RC,64494,CPT,OUTPATIENT,,,238,154.7,,209.44,88,,167.55,,,0,"percent of total billed charges","88% of total billed charges",119,50,,95.20,,,0,"percent of total billed charges","50% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",793.79,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",149.94,63,,119.95,,,0,"percent of total billed charges","63% of total billed charges",36.41,15.3,,29.13,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,164.22,69,,,,,0,"fee schedule","69% of total billed charges",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",147.2,61.85,,117.76,,,0,"percent of total billed charges","61.5% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,119,50,,95.20,,,0,"percent of total billed charges","50% of total billed charges",76.64,32.2,,61.31,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",89.73,37.7,,71.78,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",185.64,78,,148.51,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",196.59,82.6,,157.27,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,119,50,,95.20,,,0,"percent of total billed charges","50% of total billed charges",196.59,82.6,,157.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",931.2,100,,,,,0,"fee schedule",EAPG,238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",36.41,1001.87,
"64510 Injection, anesthetic agent; stellate gangli",7962865,CDM,521,RC,64510,CPT,OUTPATIENT,,,623,404.95,,548.24,88,,438.59,,,0,"percent of total billed charges","88% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,623,100,,498.40,,,0,"percent of total billed charges","100% of total billed charges",1626.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",1076.46,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.49,63,,313.99,,,0,"percent of total billed charges","63% of total billed charges",95.32,15.3,,76.26,,,0,"percent of total billed charges","15.3% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,429.87,69,,,,,0,"fee schedule","69% of total billed charges",623,100,,498.40,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",623,100,,498.40,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",623,100,,498.40,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3341.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1066.01,100,,,,,0,"fee schedule",EAPG,1358.64,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",234.87,37.7,,187.90,,,0,"percent of total billed charges","37.70% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",485.94,78,,388.75,,,0,"percent of total billed charges","78% of total billed charges",938.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",514.6,82.6,,411.68,,,0,"percent of total billed charges","82.6% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",514.6,82.6,,411.68,,,0,"percent of total billed charges","82.6% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1205.64,100,,,,,0,"fee schedule",EAPG,623,100,,498.40,,,0,"percent of total billed charges","100% of total billed charges",95.32,3341.26,
"64520 Injection, anesthetic agent; lumbar or thora",7962650,CDM,521,RC,64520,CPT,OUTPATIENT,,,849,551.85,,747.12,88,,597.70,,,0,"percent of total billed charges","88% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,849,100,,679.20,,,0,"percent of total billed charges","100% of total billed charges",1626.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",793.79,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",534.87,63,,427.90,,,0,"percent of total billed charges","63% of total billed charges",129.9,15.3,,103.92,,,0,"percent of total billed charges","15.3% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,585.81,69,,,,,0,"fee schedule","69% of total billed charges",849,100,,679.20,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",849,100,,679.20,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",849,100,,679.20,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3341.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",770.67,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",786.08,100,,,,,0,"fee schedule",EAPG,1001.87,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.07,37.7,,256.06,,,0,"percent of total billed charges","37.70% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",662.22,78,,529.78,,,0,"percent of total billed charges","78% of total billed charges",938.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",701.27,82.6,,561.02,,,0,"percent of total billed charges","82.6% of total billed charges",770.67,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",701.27,82.6,,561.02,,,0,"percent of total billed charges","82.6% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",931.2,100,,,,,0,"fee schedule",EAPG,849,100,,679.20,,,0,"percent of total billed charges","100% of total billed charges",129.9,3341.26,
"64566 Posterior tibial neurostimulation, percutane",8165595,CDM,521,RC,64566,CPT,OUTPATIENT,,,437,284.05,,384.56,88,,307.65,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,437,100,,349.60,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",275.31,63,,220.25,,,0,"percent of total billed charges","63% of total billed charges",66.86,15.3,,53.49,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,301.53,69,,,,,0,"fee schedule","69% of total billed charges",437,100,,349.60,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",437,100,,349.60,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",437,100,,349.60,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",164.75,37.7,,131.80,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",340.86,78,,272.69,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",360.96,82.6,,288.77,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule","100% of WA fee schedule",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",360.96,82.6,,288.77,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",552.74,100,,,,,0,"fee schedule",EAPG,437,100,,349.60,,,0,"percent of total billed charges","100% of total billed charges",66.86,1061,
"64595 Revision or removal of peripheral or gastric",7961945,CDM,521,RC,64595,CPT,OUTPATIENT,,,456,296.4,,401.28,88,,321.02,,,0,"percent of total billed charges","88% of total billed charges",3470.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.79,100,,,,,0,"fee schedule",EAPG,456,100,,364.80,,,0,"percent of total billed charges","100% of total billed charges",6073.28,175,,,,,0,"fee schedule","175% of CMS fee schedule",3483.24,100,,,,,0,"fee schedule",EAPG,3470.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287.28,63,,229.82,,,0,"percent of total billed charges","63% of total billed charges",69.77,15.3,,55.82,,,0,"percent of total billed charges","15.3% of total billed charges",3381.79,100,,,,,0,"fee schedule",EAPG,314.64,69,,,,,0,"fee schedule","69% of total billed charges",456,100,,364.80,,,0,"percent of total billed charges","100% of total billed charges",3470.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",456,100,,364.80,,,0,"percent of total billed charges","100% of total billed charges",3470.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",456,100,,364.80,,,0,"percent of total billed charges","100% of total billed charges",3470.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",13306,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3381.79,100,,,,,0,"fee schedule",EAPG,3470.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3478.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3470.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3449.42,100,,,,,0,"fee schedule",EAPG,4396.32,100,,,,,0,"fee schedule",EAPG,3470.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",171.91,37.7,,137.53,,,0,"percent of total billed charges","37.70% of total billed charges",3470.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3470.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.68,78,,284.54,,,0,"percent of total billed charges","78% of total billed charges",3505.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",376.66,82.6,,301.33,,,0,"percent of total billed charges","82.6% of total billed charges",3381.79,100,,,,,0,"fee schedule",EAPG,3470.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",376.66,82.6,,301.33,,,0,"percent of total billed charges","82.6% of total billed charges",3470.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3542.32,100,,,,,0,"fee schedule",EAPG,456,100,,364.80,,,0,"percent of total billed charges","100% of total billed charges",69.77,13306,
"64600 Destruction,neurolytic agent, trigeminal ner",7961554,CDM,521,RC,64600,CPT,OUTPATIENT,,,1094,711.1,,962.72,88,,770.18,,,0,"percent of total billed charges","88% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,1094,100,,875.20,,,0,"percent of total billed charges","100% of total billed charges",1626.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",1076.46,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",689.22,63,,551.38,,,0,"percent of total billed charges","63% of total billed charges",167.38,15.3,,133.90,,,0,"percent of total billed charges","15.3% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,754.86,69,,,,,0,"fee schedule","69% of total billed charges",1094,100,,875.20,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1094,100,,875.20,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1094,100,,875.20,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3341.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1066.01,100,,,,,0,"fee schedule",EAPG,1358.64,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",412.44,37.7,,329.95,,,0,"percent of total billed charges","37.70% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",853.32,78,,682.66,,,0,"percent of total billed charges","78% of total billed charges",938.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.64,82.6,,722.91,,,0,"percent of total billed charges","82.6% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",903.64,82.6,,722.91,,,0,"percent of total billed charges","82.6% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1205.64,100,,,,,0,"fee schedule",EAPG,1094,100,,875.20,,,0,"percent of total billed charges","100% of total billed charges",167.38,3341.26,
"64605 Destruction by neurolytic agent, trigeminal",7962227,CDM,521,RC,64605,CPT,OUTPATIENT,,,956,621.4,,841.28,88,,673.02,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,956,100,,764.80,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",1076.46,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",602.28,63,,481.82,,,0,"percent of total billed charges","63% of total billed charges",146.27,15.3,,117.02,,,0,"percent of total billed charges","15.3% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,659.64,69,,,,,0,"fee schedule","69% of total billed charges",956,100,,764.80,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",956,100,,764.80,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",956,100,,764.80,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1066.01,100,,,,,0,"fee schedule",EAPG,1358.64,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",360.41,37.7,,288.33,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",745.68,78,,596.54,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",789.66,82.6,,631.73,,,0,"percent of total billed charges","82.6% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",789.66,82.6,,631.73,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1205.64,100,,,,,0,"fee schedule",EAPG,956,100,,764.80,,,0,"percent of total billed charges","100% of total billed charges",146.27,7127.26,
"64612 Injection of facial nerve",7904750,CDM,521,RC,64612,CPT,OUTPATIENT,,,373,242.45,,328.24,88,,262.59,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,373,100,,298.40,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.99,63,,187.99,,,0,"percent of total billed charges","63% of total billed charges",57.07,15.3,,45.66,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,257.37,69,,,,,0,"fee schedule","69% of total billed charges",373,100,,298.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",373,100,,298.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",373,100,,298.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",140.62,37.7,,112.50,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",290.94,78,,232.75,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",308.1,82.6,,246.48,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",308.1,82.6,,246.48,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",552.74,100,,,,,0,"fee schedule",EAPG,373,100,,298.40,,,0,"percent of total billed charges","100% of total billed charges",57.07,1061,
"64614 Chemodenervation of muscle ext/trk",7904751,CDM,521,RC,64614,CPT,OUTPATIENT,,,544,353.6,,478.72,88,,382.98,,,0,"percent of total billed charges","88% of total billed charges",272,50,,217.60,,,0,"percent of total billed charges","50% of total billed charges",91.39,16.8,,73.11,,,0,"percent of total billed charges","16.8% of total billed charges",544,100,,435.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",94.13,17.304,,75.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",342.72,63,,274.18,,,0,"percent of total billed charges","63% of total billed charges",83.23,15.3,,66.58,,,0,"percent of total billed charges","15.3% of total billed charges",91.39,16.8,,73.11,,,0,"percent of total billed charges","16.8% of total billed charges",375.36,69,,,,,0,"fee schedule","69% of total billed charges",544,100,,435.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",544,100,,435.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",544,100,,435.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336.46,61.85,,269.17,,,0,"percent of total billed charges","61.5% of total billed charges",91.39,16.8,,73.11,,,0,"percent of total billed charges","16.8% of total billed charges",272,50,,217.60,,,0,"percent of total billed charges","50% of total billed charges",175.17,32.2,,140.14,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",93.22,17.136,,74.58,,,0,"percent of total billed charges","17.136% of total billed charges",118.81,21.84,,95.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",205.09,37.7,,164.07,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",424.32,78,,339.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",449.34,82.6,,359.47,,,0,"percent of total billed charges","82.6% of total billed charges",91.39,16.8,,73.11,,,0,"percent of total billed charges","16.8% of total billed charges",272,50,,217.60,,,0,"percent of total billed charges","50% of total billed charges",449.34,82.6,,359.47,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",544,100,,435.20,,,0,"percent of total billed charges","100% of total billed charges",83.23,544,
"64615 Chemodenervation of muscle(s); migraine or h",7904752,CDM,521,RC,64615,CPT,OUTPATIENT,,,416,270.4,,366.08,88,,292.86,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,416,100,,332.80,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",262.08,63,,209.66,,,0,"percent of total billed charges","63% of total billed charges",63.65,15.3,,50.92,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,287.04,69,,,,,0,"fee schedule","69% of total billed charges",416,100,,332.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",416,100,,332.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",416,100,,332.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",156.83,37.7,,125.46,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",324.48,78,,259.58,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",343.62,82.6,,274.90,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",343.62,82.6,,274.90,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",552.74,100,,,,,0,"fee schedule",EAPG,416,100,,332.80,,,0,"percent of total billed charges","100% of total billed charges",63.65,1061,
"64616 Botox neck",7904753,CDM,521,RC,64616,CPT,OUTPATIENT,,,303,196.95,,266.64,88,,213.31,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,303,100,,242.40,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.89,63,,152.71,,,0,"percent of total billed charges","63% of total billed charges",46.36,15.3,,37.09,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,209.07,69,,,,,0,"fee schedule","69% of total billed charges",303,100,,242.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",303,100,,242.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",303,100,,242.40,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",114.23,37.7,,91.38,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",236.34,78,,189.07,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.28,82.6,,200.22,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.28,82.6,,200.22,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",552.74,100,,,,,0,"fee schedule",EAPG,303,100,,242.40,,,0,"percent of total billed charges","100% of total billed charges",46.36,1061,
"64610 Destruction,neurolytic agent,trigeminal nerv",7961780,CDM,521,RC,64610,CPT,OUTPATIENT,,,797,518.05,,701.36,88,,561.09,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,797,100,,637.60,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",1076.46,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",502.11,63,,401.69,,,0,"percent of total billed charges","63% of total billed charges",121.94,15.3,,97.55,,,0,"percent of total billed charges","15.3% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,549.93,69,,,,,0,"fee schedule","69% of total billed charges",797,100,,637.60,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",797,100,,637.60,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",797,100,,637.60,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1066.01,100,,,,,0,"fee schedule",EAPG,1358.64,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",300.47,37.7,,240.38,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",621.66,78,,497.33,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.32,82.6,,526.66,,,0,"percent of total billed charges","82.6% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",658.32,82.6,,526.66,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1205.64,100,,,,,0,"fee schedule",EAPG,797,100,,637.60,,,0,"percent of total billed charges","100% of total billed charges",121.94,7127.26,
"64613 destroy nerve, neck muscle",7963820,CDM,521,RC,64613,CPT,OUTPATIENT,,,435,282.75,,382.8,88,,306.24,,,0,"percent of total billed charges","88% of total billed charges",217.5,50,,174.00,,,0,"percent of total billed charges","50% of total billed charges",73.08,16.8,,58.46,,,0,"percent of total billed charges","16.8% of total billed charges",435,100,,348.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.27,17.304,,60.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",274.05,63,,219.24,,,0,"percent of total billed charges","63% of total billed charges",66.56,15.3,,53.25,,,0,"percent of total billed charges","15.3% of total billed charges",73.08,16.8,,58.46,,,0,"percent of total billed charges","16.8% of total billed charges",300.15,69,,,,,0,"fee schedule","69% of total billed charges",435,100,,348.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",435,100,,348.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",435,100,,348.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",269.05,61.85,,215.24,,,0,"percent of total billed charges","61.5% of total billed charges",73.08,16.8,,58.46,,,0,"percent of total billed charges","16.8% of total billed charges",217.5,50,,174.00,,,0,"percent of total billed charges","50% of total billed charges",140.07,32.2,,112.06,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",74.54,17.136,,59.63,,,0,"percent of total billed charges","17.136% of total billed charges",95,21.84,,76.00,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",164,37.7,,131.20,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",339.3,78,,271.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",359.31,82.6,,287.45,,,0,"percent of total billed charges","82.6% of total billed charges",73.08,16.8,,58.46,,,0,"percent of total billed charges","16.8% of total billed charges",217.5,50,,174.00,,,0,"percent of total billed charges","50% of total billed charges",359.31,82.6,,287.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",435,100,,348.00,,,0,"percent of total billed charges","100% of total billed charges",66.56,435,
"64620 Destruction by neurolytic agent, intercostal",7963350,CDM,521,RC,64620,CPT,OUTPATIENT,,,930,604.5,,818.4,88,,654.72,,,0,"percent of total billed charges","88% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,930,100,,744.00,,,0,"percent of total billed charges","100% of total billed charges",1626.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",1076.46,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",585.9,63,,468.72,,,0,"percent of total billed charges","63% of total billed charges",142.29,15.3,,113.83,,,0,"percent of total billed charges","15.3% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,641.7,69,,,,,0,"fee schedule","69% of total billed charges",930,100,,744.00,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",930,100,,744.00,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",930,100,,744.00,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3341.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1066.01,100,,,,,0,"fee schedule",EAPG,1358.64,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",350.61,37.7,,280.49,,,0,"percent of total billed charges","37.70% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",725.4,78,,580.32,,,0,"percent of total billed charges","78% of total billed charges",938.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",768.18,82.6,,614.54,,,0,"percent of total billed charges","82.6% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",768.18,82.6,,614.54,,,0,"percent of total billed charges","82.6% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1205.64,100,,,,,0,"fee schedule",EAPG,930,100,,744.00,,,0,"percent of total billed charges","100% of total billed charges",142.29,3341.26,
"64622 destr paravertebrl nerve l/s",7963758,CDM,521,RC,64622,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",,,,,,,0,other,"not separately reimbursment",160.53,160.53,
"64623 destr paravertebral n add-on",7963759,CDM,521,RC,64623,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",,,,,,,0,other,"not separately reimbursment",160.53,160.53,
"64626 destr paravertebrl nerve c/t",7963760,CDM,521,RC,64626,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",,,,,,,0,other,"not separately reimbursment",160.53,160.53,
"64627 destr paravertebral n add-on",7963761,CDM,521,RC,64627,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",,,,,,,0,other,"not separately reimbursment",160.53,160.53,
"64634 Destruction,neurolytic,paravertebral facet j",7961836,CDM,521,RC,64634,CPT,OUTPATIENT,,,535,347.75,,470.8,88,,376.64,,,0,"percent of total billed charges","88% of total billed charges",267.5,50,,214.00,,,0,"percent of total billed charges","50% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.97,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",337.05,63,,269.64,,,0,"percent of total billed charges","63% of total billed charges",81.86,15.3,,65.49,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,369.15,69,,,,,0,"fee schedule","69% of total billed charges",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",330.9,61.85,,264.72,,,0,"percent of total billed charges","61.5% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,267.5,50,,214.00,,,0,"percent of total billed charges","50% of total billed charges",172.27,32.2,,137.82,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",201.7,37.7,,161.36,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",417.3,78,,333.84,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",441.91,82.6,,353.53,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,267.5,50,,214.00,,,0,"percent of total billed charges","50% of total billed charges",441.91,82.6,,353.53,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",552.74,100,,,,,0,"fee schedule",EAPG,535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",81.86,552.74,
"64636 Destruction,neurolytic,paravertebral facet j",7961946,CDM,521,RC,64636,CPT,OUTPATIENT,,,482,313.3,,424.16,88,,339.33,,,0,"percent of total billed charges","88% of total billed charges",241,50,,192.80,,,0,"percent of total billed charges","50% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,482,100,,385.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1076.46,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",303.66,63,,242.93,,,0,"percent of total billed charges","63% of total billed charges",73.75,15.3,,59.00,,,0,"percent of total billed charges","15.3% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,332.58,69,,,,,0,"fee schedule","69% of total billed charges",482,100,,385.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",482,100,,385.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",482,100,,385.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.12,61.85,,238.50,,,0,"percent of total billed charges","61.5% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,241,50,,192.80,,,0,"percent of total billed charges","50% of total billed charges",155.2,32.2,,124.16,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1066.01,100,,,,,0,"fee schedule",EAPG,1358.64,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",181.71,37.7,,145.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",375.96,78,,300.77,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",398.13,82.6,,318.50,,,0,"percent of total billed charges","82.6% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,241,50,,192.80,,,0,"percent of total billed charges","50% of total billed charges",398.13,82.6,,318.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1205.64,100,,,,,0,"fee schedule",EAPG,482,100,,385.60,,,0,"percent of total billed charges","100% of total billed charges",73.75,1358.64,
"64633 Destruction,neurolytic,paravertebral facet j",7962195,CDM,521,RC,64633,CPT,OUTPATIENT,,,1167,758.55,,1026.96,88,,821.57,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,1167,100,,933.60,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",1076.46,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",735.21,63,,588.17,,,0,"percent of total billed charges","63% of total billed charges",178.55,15.3,,142.84,,,0,"percent of total billed charges","15.3% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,805.23,69,,,,,0,"fee schedule","69% of total billed charges",1167,100,,933.60,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1167,100,,933.60,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1167,100,,933.60,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1066.01,100,,,,,0,"fee schedule",EAPG,1358.64,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",439.96,37.7,,351.97,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",910.26,78,,728.21,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",963.94,82.6,,771.15,,,0,"percent of total billed charges","82.6% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",963.94,82.6,,771.15,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1205.64,100,,,,,0,"fee schedule",EAPG,1167,100,,933.60,,,0,"percent of total billed charges","100% of total billed charges",178.55,7127.26,
"64635 Destruction,neurolytic,paravertebral facet j",7962265,CDM,521,RC,64635,CPT,OUTPATIENT,,,1146,744.9,,1008.48,88,,806.78,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,1146,100,,916.80,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",1076.46,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",721.98,63,,577.58,,,0,"percent of total billed charges","63% of total billed charges",175.34,15.3,,140.27,,,0,"percent of total billed charges","15.3% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,790.74,69,,,,,0,"fee schedule","69% of total billed charges",1146,100,,916.80,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1146,100,,916.80,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1146,100,,916.80,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1066.01,100,,,,,0,"fee schedule",EAPG,1358.64,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",432.04,37.7,,345.63,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",893.88,78,,715.10,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",946.6,82.6,,757.28,,,0,"percent of total billed charges","82.6% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",946.6,82.6,,757.28,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1205.64,100,,,,,0,"fee schedule",EAPG,1146,100,,916.80,,,0,"percent of total billed charges","100% of total billed charges",175.34,7127.26,
"64632 Destruction by neurolytic agent; plantar com",7963090,CDM,521,RC,64632,CPT,OUTPATIENT,,,271,176.15,,238.48,88,,190.78,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,271,100,,216.80,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",170.73,63,,136.58,,,0,"percent of total billed charges","63% of total billed charges",41.46,15.3,,33.17,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,186.99,69,,,,,0,"fee schedule","69% of total billed charges",271,100,,216.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",271,100,,216.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",271,100,,216.80,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",102.17,37.7,,81.74,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",211.38,78,,169.10,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",223.85,82.6,,179.08,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",223.85,82.6,,179.08,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",552.74,100,,,,,0,"fee schedule",EAPG,271,100,,216.80,,,0,"percent of total billed charges","100% of total billed charges",41.46,1061,
"64642 Chemodenervation of one extremity; 1-4 muscl",7904754,CDM,521,RC,64642,CPT,OUTPATIENT,,,406,263.9,,357.28,88,,285.82,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,406,100,,324.80,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.78,63,,204.62,,,0,"percent of total billed charges","63% of total billed charges",62.12,15.3,,49.70,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,280.14,69,,,,,0,"fee schedule","69% of total billed charges",406,100,,324.80,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",406,100,,324.80,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",406,100,,324.80,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",153.06,37.7,,122.45,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",316.68,78,,253.34,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.36,82.6,,268.29,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.36,82.6,,268.29,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",552.74,100,,,,,0,"fee schedule",EAPG,406,100,,324.80,,,0,"percent of total billed charges","100% of total billed charges",62.12,2578.03,
"64643 Chemodenervation of one extremity; each addi",7904755,CDM,521,RC,64643,CPT,OUTPATIENT,,,267,173.55,,234.96,88,,187.97,,,0,"percent of total billed charges","88% of total billed charges",133.5,50,,106.80,,,0,"percent of total billed charges","50% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.97,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",168.21,63,,134.57,,,0,"percent of total billed charges","63% of total billed charges",40.85,15.3,,32.68,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,184.23,69,,,,,0,"fee schedule","69% of total billed charges",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.14,61.85,,132.11,,,0,"percent of total billed charges","61.5% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,133.5,50,,106.80,,,0,"percent of total billed charges","50% of total billed charges",85.97,32.2,,68.78,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",100.66,37.7,,80.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",208.26,78,,166.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",220.54,82.6,,176.43,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,133.5,50,,106.80,,,0,"percent of total billed charges","50% of total billed charges",220.54,82.6,,176.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",552.74,100,,,,,0,"fee schedule",EAPG,267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",40.85,552.74,
"64644 Chemodenervation of one extremity; 5 or more",7904756,CDM,521,RC,64644,CPT,OUTPATIENT,,,465,302.25,,409.2,88,,327.36,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,465,100,,372.00,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",292.95,63,,234.36,,,0,"percent of total billed charges","63% of total billed charges",71.15,15.3,,56.92,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,320.85,69,,,,,0,"fee schedule","69% of total billed charges",465,100,,372.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465,100,,372.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465,100,,372.00,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",175.31,37.7,,140.25,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",362.7,78,,290.16,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",384.09,82.6,,307.27,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",384.09,82.6,,307.27,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",552.74,100,,,,,0,"fee schedule",EAPG,465,100,,372.00,,,0,"percent of total billed charges","100% of total billed charges",71.15,2578.03,
"64645 Chemodenervation of one extremity; each addi",7904757,CDM,521,RC,64645,CPT,OUTPATIENT,,,327,212.55,,287.76,88,,230.21,,,0,"percent of total billed charges","88% of total billed charges",163.5,50,,130.80,,,0,"percent of total billed charges","50% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.97,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",206.01,63,,164.81,,,0,"percent of total billed charges","63% of total billed charges",50.03,15.3,,40.02,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,225.63,69,,,,,0,"fee schedule","69% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.25,61.85,,161.80,,,0,"percent of total billed charges","61.5% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,163.5,50,,130.80,,,0,"percent of total billed charges","50% of total billed charges",105.29,32.2,,84.23,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",255.06,78,,204.05,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,163.5,50,,130.80,,,0,"percent of total billed charges","50% of total billed charges",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",552.74,100,,,,,0,"fee schedule",EAPG,327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",50.03,552.74,
"64646 Chemodenervation of trunk muscle(s); 1-5 mus",7904758,CDM,521,RC,64646,CPT,OUTPATIENT,,,437,284.05,,384.56,88,,307.65,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,437,100,,349.60,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",275.31,63,,220.25,,,0,"percent of total billed charges","63% of total billed charges",66.86,15.3,,53.49,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,301.53,69,,,,,0,"fee schedule","69% of total billed charges",437,100,,349.60,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",437,100,,349.60,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",437,100,,349.60,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",164.75,37.7,,131.80,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",340.86,78,,272.69,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",360.96,82.6,,288.77,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",360.96,82.6,,288.77,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",552.74,100,,,,,0,"fee schedule",EAPG,437,100,,349.60,,,0,"percent of total billed charges","100% of total billed charges",66.86,2578.03,
"64647 Chemodenervation of extremity or trunk muscl",7904759,CDM,521,RC,64647,CPT,OUTPATIENT,,,506,328.9,,445.28,88,,356.22,,,0,"percent of total billed charges","88% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",1234.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",318.78,63,,255.02,,,0,"percent of total billed charges","63% of total billed charges",77.42,15.3,,61.94,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,349.14,69,,,,,0,"fee schedule","69% of total billed charges",506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",2578.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",673.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",190.76,37.7,,152.61,,,0,"percent of total billed charges","37.70% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394.68,78,,315.74,,,0,"percent of total billed charges","78% of total billed charges",712.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",417.96,82.6,,334.37,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",417.96,82.6,,334.37,,,0,"percent of total billed charges","82.6% of total billed charges",705.35,100,,,,,0,"fee schedule","100% of CMS OPPS rate",552.74,100,,,,,0,"fee schedule",EAPG,506,100,,404.80,,,0,"percent of total billed charges","100% of total billed charges",77.42,2578.03,
"64640 Destruction by neurolytic agent; other perip",7962977,CDM,521,RC,64640,CPT,OUTPATIENT,,,418,271.7,,367.84,88,,294.27,,,0,"percent of total billed charges","88% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",1626.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",1076.46,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",263.34,63,,210.67,,,0,"percent of total billed charges","63% of total billed charges",63.95,15.3,,51.16,,,0,"percent of total billed charges","15.3% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,288.42,69,,,,,0,"fee schedule","69% of total billed charges",418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",3341.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1045.11,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",873.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1066.01,100,,,,,0,"fee schedule",EAPG,1358.64,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",157.59,37.7,,126.07,,,0,"percent of total billed charges","37.70% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",326.04,78,,260.83,,,0,"percent of total billed charges","78% of total billed charges",938.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.27,82.6,,276.22,,,0,"percent of total billed charges","82.6% of total billed charges",1045.11,100,,,,,0,"fee schedule",EAPG,929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.27,82.6,,276.22,,,0,"percent of total billed charges","82.6% of total billed charges",929.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1205.64,100,,,,,0,"fee schedule",EAPG,418,100,,334.40,,,0,"percent of total billed charges","100% of total billed charges",63.95,3341.26,
"64650 Chemodenervation of eccrine glands",7904760,CDM,521,RC,64650,CPT,OUTPATIENT,,,84,54.6,,73.92,88,,59.14,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,84,100,,67.20,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.92,63,,42.34,,,0,"percent of total billed charges","63% of total billed charges",12.85,15.3,,10.28,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,57.96,69,,,,,0,"fee schedule","69% of total billed charges",84,100,,67.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",84,100,,67.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",84,100,,67.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",31.67,37.7,,25.34,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.52,78,,52.42,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",69.38,82.6,,55.50,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",69.38,82.6,,55.50,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",552.74,100,,,,,0,"fee schedule",EAPG,84,100,,67.20,,,0,"percent of total billed charges","100% of total billed charges",12.85,1061,
"64708 Neuroplasty, major peripheral nerve, arm or",7962651,CDM,521,RC,64708,CPT,OUTPATIENT,,,1971,1281.15,,1734.48,88,,1387.58,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1971,100,,1576.80,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",1276.43,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1241.73,63,,993.38,,,0,"percent of total billed charges","63% of total billed charges",301.56,15.3,,241.25,,,0,"percent of total billed charges","15.3% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,1359.99,69,,,,,0,"fee schedule","69% of total billed charges",1971,100,,1576.80,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1971,100,,1576.80,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1971,100,,1576.80,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1264.04,100,,,,,0,"fee schedule",EAPG,1611.03,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",743.07,37.7,,594.46,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1537.38,78,,1229.90,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1628.05,82.6,,1302.44,,,0,"percent of total billed charges","82.6% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1628.05,82.6,,1302.44,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1399.78,100,,,,,0,"fee schedule",EAPG,1971,100,,1576.80,,,0,"percent of total billed charges","100% of total billed charges",301.56,7127.26,
"64702 Neuroplasty; digital, 1 or both, same digit",7963529,CDM,521,RC,64702,CPT,OUTPATIENT,,,1028,668.2,,904.64,88,,723.71,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1028,100,,822.40,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",1276.43,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",647.64,63,,518.11,,,0,"percent of total billed charges","63% of total billed charges",157.28,15.3,,125.82,,,0,"percent of total billed charges","15.3% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,709.32,69,,,,,0,"fee schedule","69% of total billed charges",1028,100,,822.40,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1028,100,,822.40,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1028,100,,822.40,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1264.04,100,,,,,0,"fee schedule",EAPG,1611.03,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",387.56,37.7,,310.05,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",801.84,78,,641.47,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",849.13,82.6,,679.30,,,0,"percent of total billed charges","82.6% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",849.13,82.6,,679.30,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1399.78,100,,,,,0,"fee schedule",EAPG,1028,100,,822.40,,,0,"percent of total billed charges","100% of total billed charges",157.28,7127.26,
"64704 Neuroplasty; nerve of hand or foot",7963695,CDM,521,RC,64704,CPT,OUTPATIENT,,,949,616.85,,835.12,88,,668.10,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,949,100,,759.20,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",1276.43,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",597.87,63,,478.30,,,0,"percent of total billed charges","63% of total billed charges",145.2,15.3,,116.16,,,0,"percent of total billed charges","15.3% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,654.81,69,,,,,0,"fee schedule","69% of total billed charges",949,100,,759.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",949,100,,759.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",949,100,,759.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1264.04,100,,,,,0,"fee schedule",EAPG,1611.03,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",357.77,37.7,,286.22,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",740.22,78,,592.18,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",783.87,82.6,,627.10,,,0,"percent of total billed charges","82.6% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",783.87,82.6,,627.10,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1399.78,100,,,,,0,"fee schedule",EAPG,949,100,,759.20,,,0,"percent of total billed charges","100% of total billed charges",145.2,7127.26,
"64713 Neuroplasty, major peripheral nerve, arm or",7962759,CDM,521,RC,64713,CPT,OUTPATIENT,,,2116,1375.4,,1862.08,88,,1489.66,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,2116,100,,1692.80,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",4372.58,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1333.08,63,,1066.46,,,0,"percent of total billed charges","63% of total billed charges",323.75,15.3,,259.00,,,0,"percent of total billed charges","15.3% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,1460.04,69,,,,,0,"fee schedule","69% of total billed charges",2116,100,,1692.80,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2116,100,,1692.80,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2116,100,,1692.80,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4330.13,100,,,,,0,"fee schedule",EAPG,5518.79,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",797.73,37.7,,638.18,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1650.48,78,,1320.38,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1747.82,82.6,,1398.26,,,0,"percent of total billed charges","82.6% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1747.82,82.6,,1398.26,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4405.75,100,,,,,0,"fee schedule",EAPG,2116,100,,1692.80,,,0,"percent of total billed charges","100% of total billed charges",323.75,7127.26,
"64712 Neuroplasty, major peripheral nerve, arm or",7962897,CDM,521,RC,64712,CPT,OUTPATIENT,,,1653,1074.45,,1454.64,88,,1163.71,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",4372.58,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1041.39,63,,833.11,,,0,"percent of total billed charges","63% of total billed charges",252.91,15.3,,202.33,,,0,"percent of total billed charges","15.3% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,1140.57,69,,,,,0,"fee schedule","69% of total billed charges",1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4330.13,100,,,,,0,"fee schedule",EAPG,5518.79,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",623.18,37.7,,498.54,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1289.34,78,,1031.47,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1365.38,82.6,,1092.30,,,0,"percent of total billed charges","82.6% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1365.38,82.6,,1092.30,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4405.75,100,,,,,0,"fee schedule",EAPG,1653,100,,1322.40,,,0,"percent of total billed charges","100% of total billed charges",252.91,7127.26,
"64716 Neuroplasty and/or transposition; cranial ne",7963164,CDM,521,RC,64716,CPT,OUTPATIENT,,,1317,856.05,,1158.96,88,,927.17,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,1317,100,,1053.60,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",4372.58,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",829.71,63,,663.77,,,0,"percent of total billed charges","63% of total billed charges",201.5,15.3,,161.20,,,0,"percent of total billed charges","15.3% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,908.73,69,,,,,0,"fee schedule","69% of total billed charges",1317,100,,1053.60,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1317,100,,1053.60,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1317,100,,1053.60,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4330.13,100,,,,,0,"fee schedule",EAPG,5518.79,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",496.51,37.7,,397.21,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1027.26,78,,821.81,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1087.84,82.6,,870.27,,,0,"percent of total billed charges","82.6% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1087.84,82.6,,870.27,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4405.75,100,,,,,0,"fee schedule",EAPG,1317,100,,1053.60,,,0,"percent of total billed charges","100% of total billed charges",201.5,7127.26,
"64718 Neuroplasty and/or transposition; ulnar nerv",7963292,CDM,521,RC,64718,CPT,OUTPATIENT,,,1964,1276.6,,1728.32,88,,1382.66,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1964,100,,1571.20,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",1276.43,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1237.32,63,,989.86,,,0,"percent of total billed charges","63% of total billed charges",300.49,15.3,,240.39,,,0,"percent of total billed charges","15.3% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,1355.16,69,,,,,0,"fee schedule","69% of total billed charges",1964,100,,1571.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1964,100,,1571.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1964,100,,1571.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1264.04,100,,,,,0,"fee schedule",EAPG,1611.03,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",740.43,37.7,,592.34,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1531.92,78,,1225.54,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1622.26,82.6,,1297.81,,,0,"percent of total billed charges","82.6% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1622.26,82.6,,1297.81,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1399.78,100,,,,,0,"fee schedule",EAPG,1964,100,,1571.20,,,0,"percent of total billed charges","100% of total billed charges",300.49,7127.26,
"64719 Neuroplasty and/or transposition; ulnar nerv",7963293,CDM,521,RC,64719,CPT,OUTPATIENT,,,1499,974.35,,1319.12,88,,1055.30,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1499,100,,1199.20,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",1276.43,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",944.37,63,,755.50,,,0,"percent of total billed charges","63% of total billed charges",229.35,15.3,,183.48,,,0,"percent of total billed charges","15.3% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,1034.31,69,,,,,0,"fee schedule","69% of total billed charges",1499,100,,1199.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1499,100,,1199.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1499,100,,1199.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1264.04,100,,,,,0,"fee schedule",EAPG,1611.03,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",565.12,37.7,,452.10,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1169.22,78,,935.38,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1238.17,82.6,,990.54,,,0,"percent of total billed charges","82.6% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1238.17,82.6,,990.54,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1399.78,100,,,,,0,"fee schedule",EAPG,1499,100,,1199.20,,,0,"percent of total billed charges","100% of total billed charges",229.35,7127.26,
"64727 Internal neurolysis, requiring use of operat",7962108,CDM,521,RC,64727,CPT,OUTPATIENT,,,1056,686.4,,929.28,88,,743.42,,,0,"percent of total billed charges","88% of total billed charges",528,50,,422.40,,,0,"percent of total billed charges","50% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4372.58,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",665.28,63,,532.22,,,0,"percent of total billed charges","63% of total billed charges",161.57,15.3,,129.26,,,0,"percent of total billed charges","15.3% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,728.64,69,,,,,0,"fee schedule","69% of total billed charges",1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",653.14,61.85,,522.51,,,0,"percent of total billed charges","61.5% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,528,50,,422.40,,,0,"percent of total billed charges","50% of total billed charges",340.03,32.2,,272.02,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4330.13,100,,,,,0,"fee schedule",EAPG,5518.79,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",398.11,37.7,,318.49,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",823.68,78,,658.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",872.26,82.6,,697.81,,,0,"percent of total billed charges","82.6% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,528,50,,422.40,,,0,"percent of total billed charges","50% of total billed charges",872.26,82.6,,697.81,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4405.75,100,,,,,0,"fee schedule",EAPG,1056,100,,844.80,,,0,"percent of total billed charges","100% of total billed charges",161.57,5518.79,
"64721 Neuroplasty and/or transposition; median ner",7963035,CDM,521,RC,64721,CPT,OUTPATIENT,,,1492,969.8,,1312.96,88,,1050.37,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1492,100,,1193.60,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",1276.43,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",939.96,63,,751.97,,,0,"percent of total billed charges","63% of total billed charges",228.28,15.3,,182.62,,,0,"percent of total billed charges","15.3% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,1029.48,69,,,,,0,"fee schedule","69% of total billed charges",1492,100,,1193.60,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1492,100,,1193.60,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1492,100,,1193.60,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1264.04,100,,,,,0,"fee schedule",EAPG,1611.03,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",562.48,37.7,,449.98,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1163.76,78,,931.01,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1232.39,82.6,,985.91,,,0,"percent of total billed charges","82.6% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1232.39,82.6,,985.91,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1399.78,100,,,,,0,"fee schedule",EAPG,1492,100,,1193.60,,,0,"percent of total billed charges","100% of total billed charges",228.28,7127.26,
"64722 Decompression; unspecified nerve(s) (specify",7963491,CDM,521,RC,64722,CPT,OUTPATIENT,,,554,360.1,,487.52,88,,390.02,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,554,100,,443.20,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",1276.43,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",349.02,63,,279.22,,,0,"percent of total billed charges","63% of total billed charges",84.76,15.3,,67.81,,,0,"percent of total billed charges","15.3% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,382.26,69,,,,,0,"fee schedule","69% of total billed charges",554,100,,443.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554,100,,443.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554,100,,443.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1264.04,100,,,,,0,"fee schedule",EAPG,1611.03,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",208.86,37.7,,167.09,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",432.12,78,,345.70,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",457.6,82.6,,366.08,,,0,"percent of total billed charges","82.6% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",457.6,82.6,,366.08,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1399.78,100,,,,,0,"fee schedule",EAPG,554,100,,443.20,,,0,"percent of total billed charges","100% of total billed charges",84.76,7127.26,
"64738 Transection or avulsion of; inferior alveola",7962955,CDM,521,RC,64738,CPT,OUTPATIENT,,,1319,857.35,,1160.72,88,,928.58,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1319,100,,1055.20,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",1276.43,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",830.97,63,,664.78,,,0,"percent of total billed charges","63% of total billed charges",201.81,15.3,,161.45,,,0,"percent of total billed charges","15.3% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,910.11,69,,,,,0,"fee schedule","69% of total billed charges",1319,100,,1055.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1319,100,,1055.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1319,100,,1055.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1264.04,100,,,,,0,"fee schedule",EAPG,1611.03,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",497.26,37.7,,397.81,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1028.82,78,,823.06,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1089.49,82.6,,871.59,,,0,"percent of total billed charges","82.6% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1089.49,82.6,,871.59,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1399.78,100,,,,,0,"fee schedule",EAPG,1319,100,,1055.20,,,0,"percent of total billed charges","100% of total billed charges",201.81,7127.26,
"64734 Transection or avulsion of; infraorbital ner",7963438,CDM,521,RC,64734,CPT,OUTPATIENT,,,1159,753.35,,1019.92,88,,815.94,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1159,100,,927.20,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",1276.43,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",730.17,63,,584.14,,,0,"percent of total billed charges","63% of total billed charges",177.33,15.3,,141.86,,,0,"percent of total billed charges","15.3% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,799.71,69,,,,,0,"fee schedule","69% of total billed charges",1159,100,,927.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1159,100,,927.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1159,100,,927.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1264.04,100,,,,,0,"fee schedule",EAPG,1611.03,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",436.94,37.7,,349.55,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",904.02,78,,723.22,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",957.33,82.6,,765.86,,,0,"percent of total billed charges","82.6% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",957.33,82.6,,765.86,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1399.78,100,,,,,0,"fee schedule",EAPG,1159,100,,927.20,,,0,"percent of total billed charges","100% of total billed charges",177.33,7127.26,
"64732 Transection or avulsion of; supraorbital ner",7963475,CDM,521,RC,64732,CPT,OUTPATIENT,,,1030,669.5,,906.4,88,,725.12,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",1276.43,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",648.9,63,,519.12,,,0,"percent of total billed charges","63% of total billed charges",157.59,15.3,,126.07,,,0,"percent of total billed charges","15.3% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,710.7,69,,,,,0,"fee schedule","69% of total billed charges",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1264.04,100,,,,,0,"fee schedule",EAPG,1611.03,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",388.31,37.7,,310.65,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",803.4,78,,642.72,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",850.78,82.6,,680.62,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1399.78,100,,,,,0,"fee schedule",EAPG,1030,100,,824.00,,,0,"percent of total billed charges","100% of total billed charges",157.59,7127.26,
"64736 Transection or avulsion of; mental nerve",7963554,CDM,521,RC,64736,CPT,OUTPATIENT,,,1101,715.65,,968.88,88,,775.10,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1101,100,,880.80,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",1276.43,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",693.63,63,,554.90,,,0,"percent of total billed charges","63% of total billed charges",168.45,15.3,,134.76,,,0,"percent of total billed charges","15.3% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,759.69,69,,,,,0,"fee schedule","69% of total billed charges",1101,100,,880.80,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101,100,,880.80,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1101,100,,880.80,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1264.04,100,,,,,0,"fee schedule",EAPG,1611.03,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",415.08,37.7,,332.06,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",858.78,78,,687.02,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",909.43,82.6,,727.54,,,0,"percent of total billed charges","82.6% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",909.43,82.6,,727.54,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1399.78,100,,,,,0,"fee schedule",EAPG,1101,100,,880.80,,,0,"percent of total billed charges","100% of total billed charges",168.45,7127.26,
"64742 Transection or avulsion of; facial nerve, di",7962898,CDM,521,RC,64742,CPT,OUTPATIENT,,,1630,1059.5,,1434.4,88,,1147.52,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1630,100,,1304.00,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",1276.43,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1026.9,63,,821.52,,,0,"percent of total billed charges","63% of total billed charges",249.39,15.3,,199.51,,,0,"percent of total billed charges","15.3% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,1124.7,69,,,,,0,"fee schedule","69% of total billed charges",1630,100,,1304.00,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1630,100,,1304.00,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1630,100,,1304.00,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1264.04,100,,,,,0,"fee schedule",EAPG,1611.03,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",614.51,37.7,,491.61,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1271.4,78,,1017.12,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1346.38,82.6,,1077.10,,,0,"percent of total billed charges","82.6% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1346.38,82.6,,1077.10,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1399.78,100,,,,,0,"fee schedule",EAPG,1630,100,,1304.00,,,0,"percent of total billed charges","100% of total billed charges",249.39,7127.26,
"64744 Transection or avulsion of; greater occipita",7963373,CDM,521,RC,64744,CPT,OUTPATIENT,,,1186,770.9,,1043.68,88,,834.94,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,1186,100,,948.80,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",4372.58,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",747.18,63,,597.74,,,0,"percent of total billed charges","63% of total billed charges",181.46,15.3,,145.17,,,0,"percent of total billed charges","15.3% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,818.34,69,,,,,0,"fee schedule","69% of total billed charges",1186,100,,948.80,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1186,100,,948.80,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1186,100,,948.80,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4330.13,100,,,,,0,"fee schedule",EAPG,5518.79,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",447.12,37.7,,357.70,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",925.08,78,,740.06,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",979.64,82.6,,783.71,,,0,"percent of total billed charges","82.6% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",979.64,82.6,,783.71,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4405.75,100,,,,,0,"fee schedule",EAPG,1186,100,,948.80,,,0,"percent of total billed charges","100% of total billed charges",181.46,7127.26,
"64740 Transection or avulsion of; lingual nerve",7963572,CDM,521,RC,64740,CPT,OUTPATIENT,,,1569,1019.85,,1380.72,88,,1104.58,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1569,100,,1255.20,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",1276.43,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.47,63,,790.78,,,0,"percent of total billed charges","63% of total billed charges",240.06,15.3,,192.05,,,0,"percent of total billed charges","15.3% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,1082.61,69,,,,,0,"fee schedule","69% of total billed charges",1569,100,,1255.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1569,100,,1255.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1569,100,,1255.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1264.04,100,,,,,0,"fee schedule",EAPG,1611.03,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",591.51,37.7,,473.21,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1223.82,78,,979.06,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1295.99,82.6,,1036.79,,,0,"percent of total billed charges","82.6% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1295.99,82.6,,1036.79,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1399.78,100,,,,,0,"fee schedule",EAPG,1569,100,,1255.20,,,0,"percent of total billed charges","100% of total billed charges",240.06,7127.26,
"64774 Excision of neuroma; cutaneous nerve, surgic",7963086,CDM,521,RC,64774,CPT,OUTPATIENT,,,1099,714.35,,967.12,88,,773.70,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1099,100,,879.20,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",1276.43,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",692.37,63,,553.90,,,0,"percent of total billed charges","63% of total billed charges",168.15,15.3,,134.52,,,0,"percent of total billed charges","15.3% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,758.31,69,,,,,0,"fee schedule","69% of total billed charges",1099,100,,879.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1099,100,,879.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1099,100,,879.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1264.04,100,,,,,0,"fee schedule",EAPG,1611.03,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",414.32,37.7,,331.46,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",857.22,78,,685.78,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.77,82.6,,726.22,,,0,"percent of total billed charges","82.6% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",907.77,82.6,,726.22,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1399.78,100,,,,,0,"fee schedule",EAPG,1099,100,,879.20,,,0,"percent of total billed charges","100% of total billed charges",168.15,7127.26,
"64771 Transection or avulsion of other cranial ner",7963131,CDM,521,RC,64771,CPT,OUTPATIENT,,,1688,1097.2,,1485.44,88,,1188.35,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,1688,100,,1350.40,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",4372.58,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1063.44,63,,850.75,,,0,"percent of total billed charges","63% of total billed charges",258.26,15.3,,206.61,,,0,"percent of total billed charges","15.3% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,1164.72,69,,,,,0,"fee schedule","69% of total billed charges",1688,100,,1350.40,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1688,100,,1350.40,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1688,100,,1350.40,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4330.13,100,,,,,0,"fee schedule",EAPG,5518.79,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",636.38,37.7,,509.10,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1316.64,78,,1053.31,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1394.29,82.6,,1115.43,,,0,"percent of total billed charges","82.6% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1394.29,82.6,,1115.43,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4405.75,100,,,,,0,"fee schedule",EAPG,1688,100,,1350.40,,,0,"percent of total billed charges","100% of total billed charges",258.26,7127.26,
"64783 Excision of neuroma; hand or foot, each addi",7962057,CDM,521,RC,64783,CPT,OUTPATIENT,,,873,567.45,,768.24,88,,614.59,,,0,"percent of total billed charges","88% of total billed charges",436.5,50,,349.20,,,0,"percent of total billed charges","50% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,873,100,,698.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1276.43,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",549.99,63,,439.99,,,0,"percent of total billed charges","63% of total billed charges",133.57,15.3,,106.86,,,0,"percent of total billed charges","15.3% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,602.37,69,,,,,0,"fee schedule","69% of total billed charges",873,100,,698.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",873,100,,698.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",873,100,,698.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.95,61.85,,431.96,,,0,"percent of total billed charges","61.5% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,436.5,50,,349.20,,,0,"percent of total billed charges","50% of total billed charges",281.11,32.2,,224.89,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1264.04,100,,,,,0,"fee schedule",EAPG,1611.03,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",329.12,37.7,,263.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",680.94,78,,544.75,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",721.1,82.6,,576.88,,,0,"percent of total billed charges","82.6% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,436.5,50,,349.20,,,0,"percent of total billed charges","50% of total billed charges",721.1,82.6,,576.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1399.78,100,,,,,0,"fee schedule",EAPG,873,100,,698.40,,,0,"percent of total billed charges","100% of total billed charges",133.57,1611.03,
"64784 Excision of neuroma; major peripheral nerve,",7963155,CDM,521,RC,64784,CPT,OUTPATIENT,,,2069,1344.85,,1820.72,88,,1456.58,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,2069,100,,1655.20,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",1276.43,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1303.47,63,,1042.78,,,0,"percent of total billed charges","63% of total billed charges",316.56,15.3,,253.25,,,0,"percent of total billed charges","15.3% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,1427.61,69,,,,,0,"fee schedule","69% of total billed charges",2069,100,,1655.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2069,100,,1655.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2069,100,,1655.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1264.04,100,,,,,0,"fee schedule",EAPG,1611.03,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",780.01,37.7,,624.01,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1613.82,78,,1291.06,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1708.99,82.6,,1367.19,,,0,"percent of total billed charges","82.6% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1708.99,82.6,,1367.19,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1399.78,100,,,,,0,"fee schedule",EAPG,2069,100,,1655.20,,,0,"percent of total billed charges","100% of total billed charges",316.56,7127.26,
"64788 Excision of neurofibroma or neurolemmoma; cu",7963207,CDM,521,RC,64788,CPT,OUTPATIENT,,,1014,659.1,,892.32,88,,713.86,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1014,100,,811.20,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",1276.43,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",638.82,63,,511.06,,,0,"percent of total billed charges","63% of total billed charges",155.14,15.3,,124.11,,,0,"percent of total billed charges","15.3% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,699.66,69,,,,,0,"fee schedule","69% of total billed charges",1014,100,,811.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1014,100,,811.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1014,100,,811.20,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1264.04,100,,,,,0,"fee schedule",EAPG,1611.03,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",382.28,37.7,,305.82,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",790.92,78,,632.74,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",837.56,82.6,,670.05,,,0,"percent of total billed charges","82.6% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",837.56,82.6,,670.05,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1399.78,100,,,,,0,"fee schedule",EAPG,1014,100,,811.20,,,0,"percent of total billed charges","100% of total billed charges",155.14,7127.26,
"64782 Excision of neuroma; hand or foot, except di",7963263,CDM,521,RC,64782,CPT,OUTPATIENT,,,1682,1093.3,,1480.16,88,,1184.13,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1682,100,,1345.60,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",1276.43,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1059.66,63,,847.73,,,0,"percent of total billed charges","63% of total billed charges",257.35,15.3,,205.88,,,0,"percent of total billed charges","15.3% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,1160.58,69,,,,,0,"fee schedule","69% of total billed charges",1682,100,,1345.60,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1682,100,,1345.60,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1682,100,,1345.60,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1264.04,100,,,,,0,"fee schedule",EAPG,1611.03,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",634.11,37.7,,507.29,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1311.96,78,,1049.57,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1389.33,82.6,,1111.46,,,0,"percent of total billed charges","82.6% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1389.33,82.6,,1111.46,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1399.78,100,,,,,0,"fee schedule",EAPG,1682,100,,1345.60,,,0,"percent of total billed charges","100% of total billed charges",257.35,7127.26,
"64792 Excision of neurofibroma or neurolemmoma; ex",7962489,CDM,521,RC,64792,CPT,OUTPATIENT,,,3022,1964.3,,2659.36,88,,2127.49,,,0,"percent of total billed charges","88% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,3022,100,,2417.60,,,0,"percent of total billed charges","100% of total billed charges",11890.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",4372.58,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1903.86,63,,1523.09,,,0,"percent of total billed charges","63% of total billed charges",462.37,15.3,,369.90,,,0,"percent of total billed charges","15.3% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,2085.18,69,,,,,0,"fee schedule","69% of total billed charges",3022,100,,2417.60,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3022,100,,2417.60,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3022,100,,2417.60,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",23157.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6054.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4330.13,100,,,,,0,"fee schedule",EAPG,5518.79,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1139.29,37.7,,911.43,,,0,"percent of total billed charges","37.70% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2357.16,78,,1885.73,,,0,"percent of total billed charges","78% of total billed charges",6862.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2496.17,82.6,,1996.94,,,0,"percent of total billed charges","82.6% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2496.17,82.6,,1996.94,,,0,"percent of total billed charges","82.6% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4405.75,100,,,,,0,"fee schedule",EAPG,3022,100,,2417.60,,,0,"percent of total billed charges","100% of total billed charges",462.37,23157.6,
"64790 Excision of neurofibroma or neurolemmoma; ma",7963007,CDM,521,RC,64790,CPT,OUTPATIENT,,,2383,1548.95,,2097.04,88,,1677.63,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,2383,100,,1906.40,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",4372.58,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1501.29,63,,1201.03,,,0,"percent of total billed charges","63% of total billed charges",364.6,15.3,,291.68,,,0,"percent of total billed charges","15.3% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,1644.27,69,,,,,0,"fee schedule","69% of total billed charges",2383,100,,1906.40,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2383,100,,1906.40,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2383,100,,1906.40,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4330.13,100,,,,,0,"fee schedule",EAPG,5518.79,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",898.39,37.7,,718.71,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1858.74,78,,1486.99,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1968.36,82.6,,1574.69,,,0,"percent of total billed charges","82.6% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1968.36,82.6,,1574.69,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4405.75,100,,,,,0,"fee schedule",EAPG,2383,100,,1906.40,,,0,"percent of total billed charges","100% of total billed charges",364.6,7127.26,
"64795 Biopsy of nerve",7963923,CDM,521,RC,64795,CPT,OUTPATIENT,,,950,617.5,,836,88,,668.80,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,950,100,,760.00,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",1276.43,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",598.5,63,,478.80,,,0,"percent of total billed charges","63% of total billed charges",145.35,15.3,,116.28,,,0,"percent of total billed charges","15.3% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,655.5,69,,,,,0,"fee schedule","69% of total billed charges",950,100,,760.00,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",950,100,,760.00,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",950,100,,760.00,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1264.04,100,,,,,0,"fee schedule",EAPG,1611.03,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",358.15,37.7,,286.52,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",741,78,,592.80,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",784.7,82.6,,627.76,,,0,"percent of total billed charges","82.6% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",784.7,82.6,,627.76,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1399.78,100,,,,,0,"fee schedule",EAPG,950,100,,760.00,,,0,"percent of total billed charges","100% of total billed charges",145.35,7127.26,
"64804 Sympathectomy, cervicothoracic",7963724,CDM,521,RC,64804,CPT,OUTPATIENT,,,2977,1935.05,,2619.76,88,,2095.81,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,2977,100,,2381.60,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",4372.58,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1875.51,63,,1500.41,,,0,"percent of total billed charges","63% of total billed charges",455.48,15.3,,364.38,,,0,"percent of total billed charges","15.3% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,2054.13,69,,,,,0,"fee schedule","69% of total billed charges",2977,100,,2381.60,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2977,100,,2381.60,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2977,100,,2381.60,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4330.13,100,,,,,0,"fee schedule",EAPG,5518.79,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1122.33,37.7,,897.86,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2322.06,78,,1857.65,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2459,82.6,,1967.20,,,0,"percent of total billed charges","82.6% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2459,82.6,,1967.20,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4405.75,100,,,,,0,"fee schedule",EAPG,2977,100,,2381.60,,,0,"percent of total billed charges","100% of total billed charges",455.48,7127.26,
"64809 Sympathectomy, thoracolumbar",7963779,CDM,521,RC,64809,CPT,OUTPATIENT,,,2939,1910.35,,2586.32,88,,2069.06,,,0,"percent of total billed charges","88% of total billed charges",2939,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4245.22,100,,,,,0,"fee schedule",EAPG,2939,100,,2351.20,,,0,"percent of total billed charges","100% of total billed charges",2939,175,,,,,0,"fee schedule","175% of CMS fee schedule",4372.58,100,,,,,0,"fee schedule",EAPG,2939,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1851.57,63,,1481.26,,,0,"percent of total billed charges","63% of total billed charges",449.67,15.3,,359.74,,,0,"percent of total billed charges","15.3% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,2027.91,69,,,,,0,"fee schedule","69% of total billed charges",2939,100,,2351.20,,,0,"percent of total billed charges","100% of total billed charges",2939,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2939,100,,2351.20,,,0,"percent of total billed charges","100% of total billed charges",2939,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2939,100,,2351.20,,,0,"percent of total billed charges","100% of total billed charges",2939,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2939,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4245.22,100,,,,,0,"fee schedule",EAPG,2939,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2939,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2939,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4330.13,100,,,,,0,"fee schedule",EAPG,5518.79,100,,,,,0,"fee schedule",EAPG,2939,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1108,37.7,,886.40,,,0,"percent of total billed charges","37.70% of total billed charges",2939,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2939,100,,,,,0,"fee schedule","100% of CMS fee schedule",2292.42,78,,1833.94,,,0,"percent of total billed charges","78% of total billed charges",2939,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2427.61,82.6,,1942.09,,,0,"percent of total billed charges","82.6% of total billed charges",4245.22,100,,,,,0,"fee schedule","100% of WA fee schedule",2939,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2427.61,82.6,,1942.09,,,0,"percent of total billed charges","82.6% of total billed charges",2939,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4405.75,100,,,,,0,"fee schedule",EAPG,2939,100,,2351.20,,,0,"percent of total billed charges","100% of total billed charges",449.67,5518.79,
"64802 Sympathectomy, cervical",7963857,CDM,521,RC,64802,CPT,OUTPATIENT,,,1977,1285.05,,1739.76,88,,1391.81,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1977,100,,1581.60,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",1276.43,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1245.51,63,,996.41,,,0,"percent of total billed charges","63% of total billed charges",302.48,15.3,,241.98,,,0,"percent of total billed charges","15.3% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,1364.13,69,,,,,0,"fee schedule","69% of total billed charges",1977,100,,1581.60,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1977,100,,1581.60,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1977,100,,1581.60,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1264.04,100,,,,,0,"fee schedule",EAPG,1611.03,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",745.33,37.7,,596.26,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1542.06,78,,1233.65,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1633,82.6,,1306.40,,,0,"percent of total billed charges","82.6% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1633,82.6,,1306.40,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1399.78,100,,,,,0,"fee schedule",EAPG,1977,100,,1581.60,,,0,"percent of total billed charges","100% of total billed charges",302.48,7127.26,
"64818 Sympathectomy, lumbar",7963893,CDM,521,RC,64818,CPT,OUTPATIENT,,,2073,1347.45,,1824.24,88,,1459.39,,,0,"percent of total billed charges","88% of total billed charges",2073,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4245.22,100,,,,,0,"fee schedule",EAPG,2073,100,,1658.40,,,0,"percent of total billed charges","100% of total billed charges",2073,175,,,,,0,"fee schedule","175% of CMS fee schedule",4372.58,100,,,,,0,"fee schedule",EAPG,2073,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1305.99,63,,1044.79,,,0,"percent of total billed charges","63% of total billed charges",317.17,15.3,,253.74,,,0,"percent of total billed charges","15.3% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,1430.37,69,,,,,0,"fee schedule","69% of total billed charges",2073,100,,1658.40,,,0,"percent of total billed charges","100% of total billed charges",2073,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2073,100,,1658.40,,,0,"percent of total billed charges","100% of total billed charges",2073,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2073,100,,1658.40,,,0,"percent of total billed charges","100% of total billed charges",2073,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2073,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4245.22,100,,,,,0,"fee schedule",EAPG,2073,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2073,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2073,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4330.13,100,,,,,0,"fee schedule",EAPG,5518.79,100,,,,,0,"fee schedule",EAPG,2073,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",781.52,37.7,,625.22,,,0,"percent of total billed charges","37.70% of total billed charges",2073,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",2073,100,,,,,0,"fee schedule","100% of CMS fee schedule",1616.94,78,,1293.55,,,0,"percent of total billed charges","78% of total billed charges",2073,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1712.3,82.6,,1369.84,,,0,"percent of total billed charges","82.6% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,2073,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1712.3,82.6,,1369.84,,,0,"percent of total billed charges","82.6% of total billed charges",2073,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4405.75,100,,,,,0,"fee schedule",EAPG,2073,100,,1658.40,,,0,"percent of total billed charges","100% of total billed charges",317.17,5518.79,
"64832 Suture of digital nerve, hand or foot; each",7962894,CDM,521,RC,64832,CPT,OUTPATIENT,,,1095,711.75,,963.6,88,,770.88,,,0,"percent of total billed charges","88% of total billed charges",547.5,50,,438.00,,,0,"percent of total billed charges","50% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,1095,100,,876.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4372.58,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",689.85,63,,551.88,,,0,"percent of total billed charges","63% of total billed charges",167.54,15.3,,134.03,,,0,"percent of total billed charges","15.3% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,755.55,69,,,,,0,"fee schedule","69% of total billed charges",1095,100,,876.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1095,100,,876.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1095,100,,876.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",677.26,61.85,,541.81,,,0,"percent of total billed charges","61.5% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,547.5,50,,438.00,,,0,"percent of total billed charges","50% of total billed charges",352.59,32.2,,282.07,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4330.13,100,,,,,0,"fee schedule",EAPG,5518.79,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",412.82,37.7,,330.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",854.1,78,,683.28,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",904.47,82.6,,723.58,,,0,"percent of total billed charges","82.6% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,547.5,50,,438.00,,,0,"percent of total billed charges","50% of total billed charges",904.47,82.6,,723.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4405.75,100,,,,,0,"fee schedule",EAPG,1095,100,,876.00,,,0,"percent of total billed charges","100% of total billed charges",167.54,5518.79,
"64834 Suture of 1 nerve; hand or foot, common sens",7963311,CDM,521,RC,64834,CPT,OUTPATIENT,,,2105,1368.25,,1852.4,88,,1481.92,,,0,"percent of total billed charges","88% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,2105,100,,1684.00,,,0,"percent of total billed charges","100% of total billed charges",11890.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",4372.58,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1326.15,63,,1060.92,,,0,"percent of total billed charges","63% of total billed charges",322.07,15.3,,257.66,,,0,"percent of total billed charges","15.3% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,1452.45,69,,,,,0,"fee schedule","69% of total billed charges",2105,100,,1684.00,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2105,100,,1684.00,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2105,100,,1684.00,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",23157.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6054.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4330.13,100,,,,,0,"fee schedule",EAPG,5518.79,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",793.59,37.7,,634.87,,,0,"percent of total billed charges","37.70% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1641.9,78,,1313.52,,,0,"percent of total billed charges","78% of total billed charges",6862.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1738.73,82.6,,1390.98,,,0,"percent of total billed charges","82.6% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1738.73,82.6,,1390.98,,,0,"percent of total billed charges","82.6% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4405.75,100,,,,,0,"fee schedule",EAPG,2105,100,,1684.00,,,0,"percent of total billed charges","100% of total billed charges",322.07,23157.6,
"64831 Suture of digital nerve, hand or foot; 1 ner",7963471,CDM,521,RC,64831,CPT,OUTPATIENT,,,2073,1347.45,,1824.24,88,,1459.39,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,2073,100,,1658.40,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",1276.43,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1305.99,63,,1044.79,,,0,"percent of total billed charges","63% of total billed charges",317.17,15.3,,253.74,,,0,"percent of total billed charges","15.3% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,1430.37,69,,,,,0,"fee schedule","69% of total billed charges",2073,100,,1658.40,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2073,100,,1658.40,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2073,100,,1658.40,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1264.04,100,,,,,0,"fee schedule",EAPG,1611.03,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",781.52,37.7,,625.22,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1616.94,78,,1293.55,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1712.3,82.6,,1369.84,,,0,"percent of total billed charges","82.6% of total billed charges",1239.25,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1712.3,82.6,,1369.84,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1399.78,100,,,,,0,"fee schedule",EAPG,2073,100,,1658.40,,,0,"percent of total billed charges","100% of total billed charges",317.17,7127.26,
"64837 Suture of each additional nerve, hand or foo",7963492,CDM,521,RC,64837,CPT,OUTPATIENT,,,1470,955.5,,1293.6,88,,1034.88,,,0,"percent of total billed charges","88% of total billed charges",735,50,,588.00,,,0,"percent of total billed charges","50% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,1470,100,,1176.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4372.58,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",926.1,63,,740.88,,,0,"percent of total billed charges","63% of total billed charges",224.91,15.3,,179.93,,,0,"percent of total billed charges","15.3% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,1014.3,69,,,,,0,"fee schedule","69% of total billed charges",1470,100,,1176.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1470,100,,1176.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1470,100,,1176.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",909.2,61.85,,727.36,,,0,"percent of total billed charges","61.5% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,735,50,,588.00,,,0,"percent of total billed charges","50% of total billed charges",473.34,32.2,,378.67,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4330.13,100,,,,,0,"fee schedule",EAPG,5518.79,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",554.19,37.7,,443.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1146.6,78,,917.28,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1214.22,82.6,,971.38,,,0,"percent of total billed charges","82.6% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,735,50,,588.00,,,0,"percent of total billed charges","50% of total billed charges",1214.22,82.6,,971.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4405.75,100,,,,,0,"fee schedule",EAPG,1470,100,,1176.00,,,0,"percent of total billed charges","100% of total billed charges",224.91,5518.79,
"64835 Suture of 1 nerve; median motor thenar",7963632,CDM,521,RC,64835,CPT,OUTPATIENT,,,2341,1521.65,,2060.08,88,,1648.06,,,0,"percent of total billed charges","88% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,2341,100,,1872.80,,,0,"percent of total billed charges","100% of total billed charges",11890.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",4372.58,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1474.83,63,,1179.86,,,0,"percent of total billed charges","63% of total billed charges",358.17,15.3,,286.54,,,0,"percent of total billed charges","15.3% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,1615.29,69,,,,,0,"fee schedule","69% of total billed charges",2341,100,,1872.80,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2341,100,,1872.80,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2341,100,,1872.80,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",23157.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6054.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4330.13,100,,,,,0,"fee schedule",EAPG,5518.79,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",882.56,37.7,,706.05,,,0,"percent of total billed charges","37.70% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1825.98,78,,1460.78,,,0,"percent of total billed charges","78% of total billed charges",6862.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1933.67,82.6,,1546.94,,,0,"percent of total billed charges","82.6% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1933.67,82.6,,1546.94,,,0,"percent of total billed charges","82.6% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4405.75,100,,,,,0,"fee schedule",EAPG,2341,100,,1872.80,,,0,"percent of total billed charges","100% of total billed charges",358.17,23157.6,
"64836 Suture of 1 nerve; ulnar motor",7963739,CDM,521,RC,64836,CPT,OUTPATIENT,,,2342,1522.3,,2060.96,88,,1648.77,,,0,"percent of total billed charges","88% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,2342,100,,1873.60,,,0,"percent of total billed charges","100% of total billed charges",11890.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",4372.58,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1475.46,63,,1180.37,,,0,"percent of total billed charges","63% of total billed charges",358.33,15.3,,286.66,,,0,"percent of total billed charges","15.3% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,1615.98,69,,,,,0,"fee schedule","69% of total billed charges",2342,100,,1873.60,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2342,100,,1873.60,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2342,100,,1873.60,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",23157.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6054.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4330.13,100,,,,,0,"fee schedule",EAPG,5518.79,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",882.93,37.7,,706.34,,,0,"percent of total billed charges","37.70% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1826.76,78,,1461.41,,,0,"percent of total billed charges","78% of total billed charges",6862.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1934.49,82.6,,1547.59,,,0,"percent of total billed charges","82.6% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1934.49,82.6,,1547.59,,,0,"percent of total billed charges","82.6% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4405.75,100,,,,,0,"fee schedule",EAPG,2342,100,,1873.60,,,0,"percent of total billed charges","100% of total billed charges",358.33,23157.6,
"64840 Suture of posterior tibial nerve",7963700,CDM,521,RC,64840,CPT,OUTPATIENT,,,4595,2986.75,,4043.6,88,,3234.88,,,0,"percent of total billed charges","88% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,4595,100,,3676.00,,,0,"percent of total billed charges","100% of total billed charges",11890.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",4372.58,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2894.85,63,,2315.88,,,0,"percent of total billed charges","63% of total billed charges",703.04,15.3,,562.43,,,0,"percent of total billed charges","15.3% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,3170.55,69,,,,,0,"fee schedule","69% of total billed charges",4595,100,,3676.00,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4595,100,,3676.00,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4595,100,,3676.00,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",23157.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6054.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4330.13,100,,,,,0,"fee schedule",EAPG,5518.79,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1732.32,37.7,,1385.86,,,0,"percent of total billed charges","37.70% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3584.1,78,,2867.28,,,0,"percent of total billed charges","78% of total billed charges",6862.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3795.47,82.6,,3036.38,,,0,"percent of total billed charges","82.6% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3795.47,82.6,,3036.38,,,0,"percent of total billed charges","82.6% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4405.75,100,,,,,0,"fee schedule",EAPG,4595,100,,3676.00,,,0,"percent of total billed charges","100% of total billed charges",703.04,23157.6,
"64856 Suture of major peripheral nerve, arm or leg",7962304,CDM,521,RC,64856,CPT,OUTPATIENT,,,2907,1889.55,,2558.16,88,,2046.53,,,0,"percent of total billed charges","88% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,2907,100,,2325.60,,,0,"percent of total billed charges","100% of total billed charges",11890.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",4372.58,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1831.41,63,,1465.13,,,0,"percent of total billed charges","63% of total billed charges",444.77,15.3,,355.82,,,0,"percent of total billed charges","15.3% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,2005.83,69,,,,,0,"fee schedule","69% of total billed charges",2907,100,,2325.60,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2907,100,,2325.60,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2907,100,,2325.60,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",23157.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6054.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4330.13,100,,,,,0,"fee schedule",EAPG,5518.79,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1095.94,37.7,,876.75,,,0,"percent of total billed charges","37.70% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2267.46,78,,1813.97,,,0,"percent of total billed charges","78% of total billed charges",6862.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2401.18,82.6,,1920.94,,,0,"percent of total billed charges","82.6% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2401.18,82.6,,1920.94,,,0,"percent of total billed charges","82.6% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4405.75,100,,,,,0,"fee schedule",EAPG,2907,100,,2325.60,,,0,"percent of total billed charges","100% of total billed charges",444.77,23157.6,
"64857 Suture of major peripheral nerve, arm or leg",7962386,CDM,521,RC,64857,CPT,OUTPATIENT,,,3048,1981.2,,2682.24,88,,2145.79,,,0,"percent of total billed charges","88% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,3048,100,,2438.40,,,0,"percent of total billed charges","100% of total billed charges",11890.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",4372.58,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1920.24,63,,1536.19,,,0,"percent of total billed charges","63% of total billed charges",466.34,15.3,,373.07,,,0,"percent of total billed charges","15.3% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,2103.12,69,,,,,0,"fee schedule","69% of total billed charges",3048,100,,2438.40,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3048,100,,2438.40,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3048,100,,2438.40,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",23157.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6054.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4330.13,100,,,,,0,"fee schedule",EAPG,5518.79,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1149.1,37.7,,919.28,,,0,"percent of total billed charges","37.70% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2377.44,78,,1901.95,,,0,"percent of total billed charges","78% of total billed charges",6862.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.65,82.6,,2014.12,,,0,"percent of total billed charges","82.6% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.65,82.6,,2014.12,,,0,"percent of total billed charges","82.6% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4405.75,100,,,,,0,"fee schedule",EAPG,3048,100,,2438.40,,,0,"percent of total billed charges","100% of total billed charges",466.34,23157.6,
"64859 Suture of each additional major peripheral n",7963434,CDM,521,RC,64859,CPT,OUTPATIENT,,,839,545.35,,738.32,88,,590.66,,,0,"percent of total billed charges","88% of total billed charges",419.5,50,,335.60,,,0,"percent of total billed charges","50% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,839,100,,671.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4372.58,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",528.57,63,,422.86,,,0,"percent of total billed charges","63% of total billed charges",128.37,15.3,,102.70,,,0,"percent of total billed charges","15.3% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,578.91,69,,,,,0,"fee schedule","69% of total billed charges",839,100,,671.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",839,100,,671.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",839,100,,671.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",518.92,61.85,,415.14,,,0,"percent of total billed charges","61.5% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,419.5,50,,335.60,,,0,"percent of total billed charges","50% of total billed charges",270.16,32.2,,216.13,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4330.13,100,,,,,0,"fee schedule",EAPG,5518.79,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",316.3,37.7,,253.04,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",654.42,78,,523.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",693.01,82.6,,554.41,,,0,"percent of total billed charges","82.6% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,419.5,50,,335.60,,,0,"percent of total billed charges","50% of total billed charges",693.01,82.6,,554.41,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",4405.75,100,,,,,0,"fee schedule",EAPG,839,100,,671.20,,,0,"percent of total billed charges","100% of total billed charges",128.37,5518.79,
"64858 Suture of sciatic nerve",7963872,CDM,521,RC,64858,CPT,OUTPATIENT,,,3551,2308.15,,3124.88,88,,2499.90,,,0,"percent of total billed charges","88% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,3551,100,,2840.80,,,0,"percent of total billed charges","100% of total billed charges",3446.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",4372.58,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2237.13,63,,1789.70,,,0,"percent of total billed charges","63% of total billed charges",543.3,15.3,,434.64,,,0,"percent of total billed charges","15.3% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,2450.19,69,,,,,0,"fee schedule","69% of total billed charges",3551,100,,2840.80,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3551,100,,2840.80,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3551,100,,2840.80,,,0,"percent of total billed charges","100% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",7127.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1863.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4330.13,100,,,,,0,"fee schedule",EAPG,5518.79,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1338.73,37.7,,1070.98,,,0,"percent of total billed charges","37.70% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2769.78,78,,2215.82,,,0,"percent of total billed charges","78% of total billed charges",1989.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2933.13,82.6,,2346.50,,,0,"percent of total billed charges","82.6% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2933.13,82.6,,2346.50,,,0,"percent of total billed charges","82.6% of total billed charges",1969.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4405.75,100,,,,,0,"fee schedule",EAPG,3551,100,,2840.80,,,0,"percent of total billed charges","100% of total billed charges",543.3,7127.26,
"64864 Suture of facial nerve; extracranial",7963664,CDM,521,RC,64864,CPT,OUTPATIENT,,,3602,2341.3,,3169.76,88,,2535.81,,,0,"percent of total billed charges","88% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,3602,100,,2881.60,,,0,"percent of total billed charges","100% of total billed charges",11890.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",4372.58,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2269.26,63,,1815.41,,,0,"percent of total billed charges","63% of total billed charges",551.11,15.3,,440.89,,,0,"percent of total billed charges","15.3% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,2485.38,69,,,,,0,"fee schedule","69% of total billed charges",3602,100,,2881.60,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3602,100,,2881.60,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3602,100,,2881.60,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",23157.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6054.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4330.13,100,,,,,0,"fee schedule",EAPG,5518.79,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1357.95,37.7,,1086.36,,,0,"percent of total billed charges","37.70% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2809.56,78,,2247.65,,,0,"percent of total billed charges","78% of total billed charges",6862.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2975.25,82.6,,2380.20,,,0,"percent of total billed charges","82.6% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2975.25,82.6,,2380.20,,,0,"percent of total billed charges","82.6% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4405.75,100,,,,,0,"fee schedule",EAPG,3602,100,,2881.60,,,0,"percent of total billed charges","100% of total billed charges",551.11,23157.6,
"64866 Anastomosis; facial-spinal accessory",7963666,CDM,521,RC,64866,CPT,OUTPATIENT,,,3406,2213.9,,2997.28,88,,2397.82,,,0,"percent of total billed charges","88% of total billed charges",3406,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4245.22,100,,,,,0,"fee schedule",EAPG,3406,100,,2724.80,,,0,"percent of total billed charges","100% of total billed charges",3406,175,,,,,0,"fee schedule","175% of CMS fee schedule",4372.58,100,,,,,0,"fee schedule",EAPG,3406,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2145.78,63,,1716.62,,,0,"percent of total billed charges","63% of total billed charges",521.12,15.3,,416.90,,,0,"percent of total billed charges","15.3% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,2350.14,69,,,,,0,"fee schedule","69% of total billed charges",3406,100,,2724.80,,,0,"percent of total billed charges","100% of total billed charges",3406,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3406,100,,2724.80,,,0,"percent of total billed charges","100% of total billed charges",3406,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3406,100,,2724.80,,,0,"percent of total billed charges","100% of total billed charges",3406,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3406,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4245.22,100,,,,,0,"fee schedule",EAPG,3406,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3406,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3406,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4330.13,100,,,,,0,"fee schedule",EAPG,5518.79,100,,,,,0,"fee schedule",EAPG,3406,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1284.06,37.7,,1027.25,,,0,"percent of total billed charges","37.70% of total billed charges",3406,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3406,100,,,,,0,"fee schedule","100% of CMS fee schedule",2656.68,78,,2125.34,,,0,"percent of total billed charges","78% of total billed charges",3406,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2813.36,82.6,,2250.69,,,0,"percent of total billed charges","82.6% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,3406,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2813.36,82.6,,2250.69,,,0,"percent of total billed charges","82.6% of total billed charges",3406,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4405.75,100,,,,,0,"fee schedule",EAPG,3406,100,,2724.80,,,0,"percent of total billed charges","100% of total billed charges",521.12,5518.79,
"64868 Anastomosis; facial-hypoglossal",7963730,CDM,521,RC,64868,CPT,OUTPATIENT,,,3478,2260.7,,3060.64,88,,2448.51,,,0,"percent of total billed charges","88% of total billed charges",3478,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4245.22,100,,,,,0,"fee schedule",EAPG,3478,100,,2782.40,,,0,"percent of total billed charges","100% of total billed charges",3478,175,,,,,0,"fee schedule","175% of CMS fee schedule",4372.58,100,,,,,0,"fee schedule",EAPG,3478,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2191.14,63,,1752.91,,,0,"percent of total billed charges","63% of total billed charges",532.13,15.3,,425.70,,,0,"percent of total billed charges","15.3% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,2399.82,69,,,,,0,"fee schedule","69% of total billed charges",3478,100,,2782.40,,,0,"percent of total billed charges","100% of total billed charges",3478,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3478,100,,2782.40,,,0,"percent of total billed charges","100% of total billed charges",3478,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3478,100,,2782.40,,,0,"percent of total billed charges","100% of total billed charges",3478,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3478,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4245.22,100,,,,,0,"fee schedule",EAPG,3478,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3478,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3478,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4330.13,100,,,,,0,"fee schedule",EAPG,5518.79,100,,,,,0,"fee schedule",EAPG,3478,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1311.21,37.7,,1048.97,,,0,"percent of total billed charges","37.70% of total billed charges",3478,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3478,100,,,,,0,"fee schedule","100% of CMS fee schedule",2712.84,78,,2170.27,,,0,"percent of total billed charges","78% of total billed charges",3478,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2872.83,82.6,,2298.26,,,0,"percent of total billed charges","82.6% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,3478,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2872.83,82.6,,2298.26,,,0,"percent of total billed charges","82.6% of total billed charges",3478,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",4405.75,100,,,,,0,"fee schedule",EAPG,3478,100,,2782.40,,,0,"percent of total billed charges","100% of total billed charges",532.13,5518.79,
"64885 Nerve graft, head or neck; up to 4 cm in len",7963455,CDM,521,RC,64885,CPT,OUTPATIENT,,,3514,2284.1,,3092.32,88,,2473.86,,,0,"percent of total billed charges","88% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,3514,100,,2811.20,,,0,"percent of total billed charges","100% of total billed charges",11890.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",4372.58,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2213.82,63,,1771.06,,,0,"percent of total billed charges","63% of total billed charges",537.64,15.3,,430.11,,,0,"percent of total billed charges","15.3% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,2424.66,69,,,,,0,"fee schedule","69% of total billed charges",3514,100,,2811.20,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3514,100,,2811.20,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3514,100,,2811.20,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",23157.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6054.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4330.13,100,,,,,0,"fee schedule",EAPG,5518.79,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1324.78,37.7,,1059.82,,,0,"percent of total billed charges","37.70% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2740.92,78,,2192.74,,,0,"percent of total billed charges","78% of total billed charges",6862.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2902.56,82.6,,2322.05,,,0,"percent of total billed charges","82.6% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2902.56,82.6,,2322.05,,,0,"percent of total billed charges","82.6% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4405.75,100,,,,,0,"fee schedule",EAPG,3514,100,,2811.20,,,0,"percent of total billed charges","100% of total billed charges",537.64,23157.6,
"64897 Nerve graft (includes obtaining graft), mult",7962228,CDM,521,RC,64897,CPT,OUTPATIENT,,,3733,2426.45,,3285.04,88,,2628.03,,,0,"percent of total billed charges","88% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,3733,100,,2986.40,,,0,"percent of total billed charges","100% of total billed charges",11890.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",4372.58,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2351.79,63,,1881.43,,,0,"percent of total billed charges","63% of total billed charges",571.15,15.3,,456.92,,,0,"percent of total billed charges","15.3% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,2575.77,69,,,,,0,"fee schedule","69% of total billed charges",3733,100,,2986.40,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3733,100,,2986.40,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3733,100,,2986.40,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",23157.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6054.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4330.13,100,,,,,0,"fee schedule",EAPG,5518.79,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1407.34,37.7,,1125.87,,,0,"percent of total billed charges","37.70% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2911.74,78,,2329.39,,,0,"percent of total billed charges","78% of total billed charges",6862.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.46,82.6,,2466.77,,,0,"percent of total billed charges","82.6% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3083.46,82.6,,2466.77,,,0,"percent of total billed charges","82.6% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4405.75,100,,,,,0,"fee schedule",EAPG,3733,100,,2986.40,,,0,"percent of total billed charges","100% of total billed charges",571.15,23157.6,
"64898 Nerve graft, multiple strands (cable), arm o",7962754,CDM,521,RC,64898,CPT,OUTPATIENT,,,4017,2611.05,,3534.96,88,,2827.97,,,0,"percent of total billed charges","88% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",11890.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",4372.58,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2530.71,63,,2024.57,,,0,"percent of total billed charges","63% of total billed charges",614.6,15.3,,491.68,,,0,"percent of total billed charges","15.3% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,2771.73,69,,,,,0,"fee schedule","69% of total billed charges",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",23157.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6054.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4330.13,100,,,,,0,"fee schedule",EAPG,5518.79,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1514.41,37.7,,1211.53,,,0,"percent of total billed charges","37.70% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3133.26,78,,2506.61,,,0,"percent of total billed charges","78% of total billed charges",6862.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3318.04,82.6,,2654.43,,,0,"percent of total billed charges","82.6% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4405.75,100,,,,,0,"fee schedule",EAPG,4017,100,,3213.60,,,0,"percent of total billed charges","100% of total billed charges",614.6,23157.6,
"64895 Nerve graft, multiple strands (cable), hand",7962825,CDM,521,RC,64895,CPT,OUTPATIENT,,,3644,2368.6,,3206.72,88,,2565.38,,,0,"percent of total billed charges","88% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,3644,100,,2915.20,,,0,"percent of total billed charges","100% of total billed charges",11890.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",4372.58,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2295.72,63,,1836.58,,,0,"percent of total billed charges","63% of total billed charges",557.53,15.3,,446.02,,,0,"percent of total billed charges","15.3% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,2514.36,69,,,,,0,"fee schedule","69% of total billed charges",3644,100,,2915.20,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3644,100,,2915.20,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3644,100,,2915.20,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",23157.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6054.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4330.13,100,,,,,0,"fee schedule",EAPG,5518.79,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1373.79,37.7,,1099.03,,,0,"percent of total billed charges","37.70% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2842.32,78,,2273.86,,,0,"percent of total billed charges","78% of total billed charges",6862.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3009.94,82.6,,2407.95,,,0,"percent of total billed charges","82.6% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3009.94,82.6,,2407.95,,,0,"percent of total billed charges","82.6% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4405.75,100,,,,,0,"fee schedule",EAPG,3644,100,,2915.20,,,0,"percent of total billed charges","100% of total billed charges",557.53,23157.6,
"64890 Nerve graft, single strand, hand or foot; up",7963156,CDM,521,RC,64890,CPT,OUTPATIENT,,,3164,2056.6,,2784.32,88,,2227.46,,,0,"percent of total billed charges","88% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,3164,100,,2531.20,,,0,"percent of total billed charges","100% of total billed charges",11890.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",4372.58,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1993.32,63,,1594.66,,,0,"percent of total billed charges","63% of total billed charges",484.09,15.3,,387.27,,,0,"percent of total billed charges","15.3% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,2183.16,69,,,,,0,"fee schedule","69% of total billed charges",3164,100,,2531.20,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3164,100,,2531.20,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3164,100,,2531.20,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",23157.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6054.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4330.13,100,,,,,0,"fee schedule",EAPG,5518.79,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1192.83,37.7,,954.26,,,0,"percent of total billed charges","37.70% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2467.92,78,,1974.34,,,0,"percent of total billed charges","78% of total billed charges",6862.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2613.46,82.6,,2090.77,,,0,"percent of total billed charges","82.6% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2613.46,82.6,,2090.77,,,0,"percent of total billed charges","82.6% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4405.75,100,,,,,0,"fee schedule",EAPG,3164,100,,2531.20,,,0,"percent of total billed charges","100% of total billed charges",484.09,23157.6,
"64892 Nerve graft, single strand, arm or leg; up t",7963208,CDM,521,RC,64892,CPT,OUTPATIENT,,,2962,1925.3,,2606.56,88,,2085.25,,,0,"percent of total billed charges","88% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,2962,100,,2369.60,,,0,"percent of total billed charges","100% of total billed charges",11890.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",4372.58,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1866.06,63,,1492.85,,,0,"percent of total billed charges","63% of total billed charges",453.19,15.3,,362.55,,,0,"percent of total billed charges","15.3% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,2043.78,69,,,,,0,"fee schedule","69% of total billed charges",2962,100,,2369.60,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2962,100,,2369.60,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2962,100,,2369.60,,,0,"percent of total billed charges","100% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",23157.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4245.22,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6054.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4330.13,100,,,,,0,"fee schedule",EAPG,5518.79,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1116.67,37.7,,893.34,,,0,"percent of total billed charges","37.70% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2310.36,78,,1848.29,,,0,"percent of total billed charges","78% of total billed charges",6862.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2446.61,82.6,,1957.29,,,0,"percent of total billed charges","82.6% of total billed charges",4245.22,100,,,,,0,"fee schedule",EAPG,6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2446.61,82.6,,1957.29,,,0,"percent of total billed charges","82.6% of total billed charges",6794.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4405.75,100,,,,,0,"fee schedule",EAPG,2962,100,,2369.60,,,0,"percent of total billed charges","100% of total billed charges",453.19,23157.6,
"64999 Unlisted procedure, nervous system",7963696,CDM,521,RC,64999,CPT,OUTPATIENT,,,589,382.85,,518.32,88,,414.66,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,589,100,,471.20,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",403.97,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",371.07,63,,296.86,,,0,"percent of total billed charges","63% of total billed charges",90.12,15.3,,72.10,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,406.41,69,,,,,0,"fee schedule","69% of total billed charges",589,100,,471.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",589,100,,471.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",589,100,,471.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",222.05,37.7,,177.64,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",459.42,78,,367.54,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",486.51,82.6,,389.21,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",486.51,82.6,,389.21,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",552.74,100,,,,,0,"fee schedule",EAPG,589,100,,471.20,,,0,"percent of total billed charges","100% of total billed charges",90.12,1061,
"65205 Removal of foreign body, external eye; super",7904711,CDM,521,RC,65205,CPT,OUTPATIENT,,,103,66.95,,90.64,88,,72.51,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.54,100,,,,,0,"fee schedule",EAPG,103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",67.51,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.89,63,,51.91,,,0,"percent of total billed charges","63% of total billed charges",15.76,15.3,,12.61,,,0,"percent of total billed charges","15.3% of total billed charges",65.54,100,,,,,0,"fee schedule",EAPG,71.07,69,,,,,0,"fee schedule","69% of total billed charges",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.54,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.85,100,,,,,0,"fee schedule",EAPG,85.21,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.83,37.7,,31.06,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.34,78,,64.27,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",65.54,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.08,82.6,,68.06,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",226.07,100,,,,,0,"fee schedule",EAPG,103,100,,82.40,,,0,"percent of total billed charges","100% of total billed charges",15.76,454.8,
"65210 Removal of foreign body, external eye; embed",7904712,CDM,521,RC,65210,CPT,OUTPATIENT,,,126,81.9,,110.88,88,,88.70,,,0,"percent of total billed charges","88% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.54,100,,,,,0,"fee schedule",EAPG,126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",711.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",67.51,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",79.38,63,,63.50,,,0,"percent of total billed charges","63% of total billed charges",19.28,15.3,,15.42,,,0,"percent of total billed charges","15.3% of total billed charges",65.54,100,,,,,0,"fee schedule",EAPG,86.94,69,,,,,0,"fee schedule","69% of total billed charges",126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",1097.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.54,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.85,100,,,,,0,"fee schedule",EAPG,85.21,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",47.5,37.7,,38.00,,,0,"percent of total billed charges","37.70% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",98.28,78,,78.62,,,0,"percent of total billed charges","78% of total billed charges",410.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",104.08,82.6,,83.26,,,0,"percent of total billed charges","82.6% of total billed charges",65.54,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",104.08,82.6,,83.26,,,0,"percent of total billed charges","82.6% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",226.07,100,,,,,0,"fee schedule",EAPG,126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",19.28,1097.77,
"65220 Removal of foreign body external eye; cornea",7903286,CDM,521,RC,65220,CPT,OUTPATIENT,,,104,67.6,,91.52,88,,73.22,,,0,"percent of total billed charges","88% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.54,100,,,,,0,"fee schedule",EAPG,104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",711.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",67.51,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.52,63,,52.42,,,0,"percent of total billed charges","63% of total billed charges",15.91,15.3,,12.73,,,0,"percent of total billed charges","15.3% of total billed charges",65.54,100,,,,,0,"fee schedule",EAPG,71.76,69,,,,,0,"fee schedule","69% of total billed charges",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS fee schedule",1097.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.54,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.85,100,,,,,0,"fee schedule",EAPG,85.21,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",39.21,37.7,,31.37,,,0,"percent of total billed charges","37.70% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",81.12,78,,64.90,,,0,"percent of total billed charges","78% of total billed charges",410.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.9,82.6,,68.72,,,0,"percent of total billed charges","82.6% of total billed charges",65.54,100,,,,,0,"fee schedule",EAPG,406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.9,82.6,,68.72,,,0,"percent of total billed charges","82.6% of total billed charges",406.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",226.07,100,,,,,0,"fee schedule",EAPG,104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",15.91,1097.77,
"65222 Removal, corneal, foreign body, external eye",7904713,CDM,521,RC,65222,CPT,OUTPATIENT,,,123,79.95,,108.24,88,,86.59,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.54,100,,,,,0,"fee schedule",EAPG,123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",67.51,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.49,63,,61.99,,,0,"percent of total billed charges","63% of total billed charges",18.82,15.3,,15.06,,,0,"percent of total billed charges","15.3% of total billed charges",65.54,100,,,,,0,"fee schedule",EAPG,84.87,69,,,,,0,"fee schedule","69% of total billed charges",123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.54,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.85,100,,,,,0,"fee schedule",EAPG,85.21,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",46.37,37.7,,37.10,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",95.94,78,,76.75,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.6,82.6,,81.28,,,0,"percent of total billed charges","82.6% of total billed charges",65.54,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.6,82.6,,81.28,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",226.07,100,,,,,0,"fee schedule",EAPG,123,100,,98.40,,,0,"percent of total billed charges","100% of total billed charges",18.82,454.8,
"67405 Orbitotomy without bone flap (frontal or tra",7961947,CDM,521,RC,67405,CPT,OUTPATIENT,,,1438,934.7,,1265.44,88,,1012.35,,,0,"percent of total billed charges","88% of total billed charges",2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2513.96,100,,,,,0,"fee schedule",EAPG,1438,100,,1150.40,,,0,"percent of total billed charges","100% of total billed charges",4171.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",2589.38,100,,,,,0,"fee schedule",EAPG,2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",905.94,63,,724.75,,,0,"percent of total billed charges","63% of total billed charges",220.01,15.3,,176.01,,,0,"percent of total billed charges","15.3% of total billed charges",2513.96,100,,,,,0,"fee schedule",EAPG,992.22,69,,,,,0,"fee schedule","69% of total billed charges",1438,100,,1150.40,,,0,"percent of total billed charges","100% of total billed charges",2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1438,100,,1150.40,,,0,"percent of total billed charges","100% of total billed charges",2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1438,100,,1150.40,,,0,"percent of total billed charges","100% of total billed charges",2383.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",8134.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2513.96,100,,,,,0,"fee schedule",EAPG,2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2126.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2564.24,100,,,,,0,"fee schedule",EAPG,3268.15,100,,,,,0,"fee schedule",EAPG,2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",542.13,37.7,,433.70,,,0,"percent of total billed charges","37.70% of total billed charges",2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1121.64,78,,897.31,,,0,"percent of total billed charges","78% of total billed charges",2407.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1187.79,82.6,,950.23,,,0,"percent of total billed charges","82.6% of total billed charges",2513.96,100,,,,,0,"fee schedule",EAPG,2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1187.79,82.6,,950.23,,,0,"percent of total billed charges","82.6% of total billed charges",2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2674.49,100,,,,,0,"fee schedule",EAPG,1438,100,,1150.40,,,0,"percent of total billed charges","100% of total billed charges",220.01,8134.6,
"67700 Incision procedures on the eyelids",7904714,CDM,521,RC,67700,CPT,OUTPATIENT,,,381,247.65,,335.28,88,,268.22,,,0,"percent of total billed charges","88% of total billed charges",297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.94,100,,,,,0,"fee schedule",EAPG,381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",519.97,175,,,,,0,"fee schedule","175% of CMS fee schedule",292.46,100,,,,,0,"fee schedule",EAPG,297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",240.03,63,,192.02,,,0,"percent of total billed charges","63% of total billed charges",58.29,15.3,,46.63,,,0,"percent of total billed charges","15.3% of total billed charges",283.94,100,,,,,0,"fee schedule",EAPG,262.89,69,,,,,0,"fee schedule","69% of total billed charges",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",297.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.94,100,,,,,0,"fee schedule",EAPG,297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.62,100,,,,,0,"fee schedule",EAPG,369.12,100,,,,,0,"fee schedule",EAPG,297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",143.64,37.7,,114.91,,,0,"percent of total billed charges","37.70% of total billed charges",297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.18,78,,237.74,,,0,"percent of total billed charges","78% of total billed charges",300.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",314.71,82.6,,251.77,,,0,"percent of total billed charges","82.6% of total billed charges",283.94,100,,,,,0,"fee schedule",EAPG,297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",314.71,82.6,,251.77,,,0,"percent of total billed charges","82.6% of total billed charges",297.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",444.47,100,,,,,0,"fee schedule",EAPG,381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",58.29,1061.45,
"67840 Excision lesion eyellid w/o closure",7898839,CDM,521,RC,67840,CPT,OUTPATIENT,,,558,362.7,,491.04,88,,392.83,,,0,"percent of total billed charges","88% of total billed charges",1032.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1208.03,100,,,,,0,"fee schedule",EAPG,558,100,,446.40,,,0,"percent of total billed charges","100% of total billed charges",1807.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",1244.27,100,,,,,0,"fee schedule",EAPG,1032.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",351.54,63,,281.23,,,0,"percent of total billed charges","63% of total billed charges",85.37,15.3,,68.30,,,0,"percent of total billed charges","15.3% of total billed charges",1208.03,100,,,,,0,"fee schedule",EAPG,385.02,69,,,,,0,"fee schedule","69% of total billed charges",558,100,,446.40,,,0,"percent of total billed charges","100% of total billed charges",1032.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",558,100,,446.40,,,0,"percent of total billed charges","100% of total billed charges",1032.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",558,100,,446.40,,,0,"percent of total billed charges","100% of total billed charges",1032.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",3288.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1208.03,100,,,,,0,"fee schedule",EAPG,1032.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1032.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1232.19,100,,,,,0,"fee schedule",EAPG,1570.44,100,,,,,0,"fee schedule",EAPG,1032.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",210.37,37.7,,168.30,,,0,"percent of total billed charges","37.70% of total billed charges",1032.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1032.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",435.24,78,,348.19,,,0,"percent of total billed charges","78% of total billed charges",1042.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460.91,82.6,,368.73,,,0,"percent of total billed charges","82.6% of total billed charges",1208.03,100,,,,,0,"fee schedule",EAPG,1032.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460.91,82.6,,368.73,,,0,"percent of total billed charges","82.6% of total billed charges",1032.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1368.56,100,,,,,0,"fee schedule",EAPG,558,100,,446.40,,,0,"percent of total billed charges","100% of total billed charges",85.37,3288.78,
"67906 Repair of blepharoptosis; superior rectus te",7962058,CDM,521,RC,67906,CPT,OUTPATIENT,,,1093,710.45,,961.84,88,,769.47,,,0,"percent of total billed charges","88% of total billed charges",3943.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1491.52,100,,,,,0,"fee schedule",EAPG,1093,100,,874.40,,,0,"percent of total billed charges","100% of total billed charges",6901.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",1536.26,100,,,,,0,"fee schedule",EAPG,3943.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",688.59,63,,550.87,,,0,"percent of total billed charges","63% of total billed charges",167.23,15.3,,133.78,,,0,"percent of total billed charges","15.3% of total billed charges",1491.52,100,,,,,0,"fee schedule",EAPG,754.17,69,,,,,0,"fee schedule","69% of total billed charges",1093,100,,874.40,,,0,"percent of total billed charges","100% of total billed charges",3943.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1093,100,,874.40,,,0,"percent of total billed charges","100% of total billed charges",3943.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1093,100,,874.40,,,0,"percent of total billed charges","100% of total billed charges",3943.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",13428.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1491.52,100,,,,,0,"fee schedule",EAPG,3943.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3510.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3943.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1521.35,100,,,,,0,"fee schedule",EAPG,1938.98,100,,,,,0,"fee schedule",EAPG,3943.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",412.06,37.7,,329.65,,,0,"percent of total billed charges","37.70% of total billed charges",3943.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3943.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",852.54,78,,682.03,,,0,"percent of total billed charges","78% of total billed charges",3982.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",902.82,82.6,,722.26,,,0,"percent of total billed charges","82.6% of total billed charges",1491.52,100,,,,,0,"fee schedule",EAPG,3943.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",902.82,82.6,,722.26,,,0,"percent of total billed charges","82.6% of total billed charges",3943.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1652.05,100,,,,,0,"fee schedule",EAPG,1093,100,,874.40,,,0,"percent of total billed charges","100% of total billed charges",167.23,13428.49,
"67904 Repair of blepharoptosis; (tarso) levator re",7962305,CDM,521,RC,67904,CPT,OUTPATIENT,,,1284,834.6,,1129.92,88,,903.94,,,0,"percent of total billed charges","88% of total billed charges",2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1491.52,100,,,,,0,"fee schedule",EAPG,1284,100,,1027.20,,,0,"percent of total billed charges","100% of total billed charges",4171.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1536.26,100,,,,,0,"fee schedule",EAPG,2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",808.92,63,,647.14,,,0,"percent of total billed charges","63% of total billed charges",196.45,15.3,,157.16,,,0,"percent of total billed charges","15.3% of total billed charges",1491.52,100,,,,,0,"fee schedule",EAPG,885.96,69,,,,,0,"fee schedule","69% of total billed charges",1284,100,,1027.20,,,0,"percent of total billed charges","100% of total billed charges",2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1284,100,,1027.20,,,0,"percent of total billed charges","100% of total billed charges",2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1284,100,,1027.20,,,0,"percent of total billed charges","100% of total billed charges",2383.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",8134.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1491.52,100,,,,,0,"fee schedule",EAPG,2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2126.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1521.35,100,,,,,0,"fee schedule",EAPG,1938.98,100,,,,,0,"fee schedule",EAPG,2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",484.07,37.7,,387.26,,,0,"percent of total billed charges","37.70% of total billed charges",2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1001.52,78,,801.22,,,0,"percent of total billed charges","78% of total billed charges",2407.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1060.58,82.6,,848.46,,,0,"percent of total billed charges","82.6% of total billed charges",1491.52,100,,,,,0,"fee schedule",EAPG,2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1060.58,82.6,,848.46,,,0,"percent of total billed charges","82.6% of total billed charges",2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1652.05,100,,,,,0,"fee schedule",EAPG,1284,100,,1027.20,,,0,"percent of total billed charges","100% of total billed charges",196.45,8134.6,
"67900 Repair of brow ptosis (supraciliary, mid-for",7962826,CDM,521,RC,67900,CPT,OUTPATIENT,,,1095,711.75,,963.6,88,,770.88,,,0,"percent of total billed charges","88% of total billed charges",2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1491.52,100,,,,,0,"fee schedule",EAPG,1095,100,,876.00,,,0,"percent of total billed charges","100% of total billed charges",4171.03,175,,,,,0,"fee schedule","175% of CMS fee schedule",1536.26,100,,,,,0,"fee schedule",EAPG,2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",689.85,63,,551.88,,,0,"percent of total billed charges","63% of total billed charges",167.54,15.3,,134.03,,,0,"percent of total billed charges","15.3% of total billed charges",1491.52,100,,,,,0,"fee schedule",EAPG,755.55,69,,,,,0,"fee schedule","69% of total billed charges",1095,100,,876.00,,,0,"percent of total billed charges","100% of total billed charges",2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1095,100,,876.00,,,0,"percent of total billed charges","100% of total billed charges",2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1095,100,,876.00,,,0,"percent of total billed charges","100% of total billed charges",2383.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",8134.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1491.52,100,,,,,0,"fee schedule",EAPG,2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2126.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1521.35,100,,,,,0,"fee schedule",EAPG,1938.98,100,,,,,0,"fee schedule",EAPG,2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",412.82,37.7,,330.26,,,0,"percent of total billed charges","37.70% of total billed charges",2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",854.1,78,,683.28,,,0,"percent of total billed charges","78% of total billed charges",2407.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",904.47,82.6,,723.58,,,0,"percent of total billed charges","82.6% of total billed charges",1491.52,100,,,,,0,"fee schedule",EAPG,2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",904.47,82.6,,723.58,,,0,"percent of total billed charges","82.6% of total billed charges",2383.44,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1652.05,100,,,,,0,"fee schedule",EAPG,1095,100,,876.00,,,0,"percent of total billed charges","100% of total billed charges",167.54,8134.6,
"68020 Incision of conjunctiva, drainage of cyst",7963567,CDM,521,RC,68020,CPT,OUTPATIENT,,,236,153.4,,207.68,88,,166.14,,,0,"percent of total billed charges","88% of total billed charges",1032.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1208.03,100,,,,,0,"fee schedule",EAPG,236,100,,188.80,,,0,"percent of total billed charges","100% of total billed charges",1807.13,175,,,,,0,"fee schedule","175% of CMS fee schedule",1244.27,100,,,,,0,"fee schedule",EAPG,1032.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.68,63,,118.94,,,0,"percent of total billed charges","63% of total billed charges",36.11,15.3,,28.89,,,0,"percent of total billed charges","15.3% of total billed charges",1208.03,100,,,,,0,"fee schedule",EAPG,162.84,69,,,,,0,"fee schedule","69% of total billed charges",236,100,,188.80,,,0,"percent of total billed charges","100% of total billed charges",1032.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",236,100,,188.80,,,0,"percent of total billed charges","100% of total billed charges",1032.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",236,100,,188.80,,,0,"percent of total billed charges","100% of total billed charges",1032.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",3288.78,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1208.03,100,,,,,0,"fee schedule",EAPG,1032.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",859.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1032.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1232.19,100,,,,,0,"fee schedule",EAPG,1570.44,100,,,,,0,"fee schedule",EAPG,1032.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",88.97,37.7,,71.18,,,0,"percent of total billed charges","37.70% of total billed charges",1032.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1032.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",184.08,78,,147.26,,,0,"percent of total billed charges","78% of total billed charges",1042.96,100,,,,,0,"fee schedule","100% of CMS OPPS rate",194.94,82.6,,155.95,,,0,"percent of total billed charges","82.6% of total billed charges",1208.03,100,,,,,0,"fee schedule",EAPG,1032.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",194.94,82.6,,155.95,,,0,"percent of total billed charges","82.6% of total billed charges",1032.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1368.56,100,,,,,0,"fee schedule",EAPG,236,100,,188.80,,,0,"percent of total billed charges","100% of total billed charges",36.11,3288.78,
"69000 Drainage external ear abcess simple",7898861,CDM,521,RC,69000,CPT,OUTPATIENT,,,557,362.05,,490.16,88,,392.13,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,557,100,,445.60,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",350.91,63,,280.73,,,0,"percent of total billed charges","63% of total billed charges",85.22,15.3,,68.18,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,384.33,69,,,,,0,"fee schedule","69% of total billed charges",557,100,,445.60,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",557,100,,445.60,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",557,100,,445.60,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",209.99,37.7,,167.99,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",434.46,78,,347.57,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460.08,82.6,,368.06,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",460.08,82.6,,368.06,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.63,100,,,,,0,"fee schedule",EAPG,557,100,,445.60,,,0,"percent of total billed charges","100% of total billed charges",85.22,2526.76,
"69005 Drain external ear lesion",7898862,CDM,521,RC,69005,CPT,OUTPATIENT,,,462,300.3,,406.56,88,,325.25,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,462,100,,369.60,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",291.06,63,,232.85,,,0,"percent of total billed charges","63% of total billed charges",70.69,15.3,,56.55,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,318.78,69,,,,,0,"fee schedule","69% of total billed charges",462,100,,369.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462,100,,369.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462,100,,369.60,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",174.17,37.7,,139.34,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",360.36,78,,288.29,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",381.61,82.6,,305.29,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",381.61,82.6,,305.29,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.24,100,,,,,0,"fee schedule",EAPG,462,100,,369.60,,,0,"percent of total billed charges","100% of total billed charges",70.69,5715.97,
"69020 Drain external auditory canal absc",7898863,CDM,521,RC,69020,CPT,OUTPATIENT,,,318,206.7,,279.84,88,,223.87,,,0,"percent of total billed charges","88% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,318,100,,254.40,,,0,"percent of total billed charges","100% of total billed charges",1255.83,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200.34,63,,160.27,,,0,"percent of total billed charges","63% of total billed charges",48.65,15.3,,38.92,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,219.42,69,,,,,0,"fee schedule","69% of total billed charges",318,100,,254.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",318,100,,254.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",318,100,,254.40,,,0,"percent of total billed charges","100% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2526.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",660.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",119.89,37.7,,95.91,,,0,"percent of total billed charges","37.70% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",248.04,78,,198.43,,,0,"percent of total billed charges","78% of total billed charges",724.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",262.67,82.6,,210.14,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",262.67,82.6,,210.14,,,0,"percent of total billed charges","82.6% of total billed charges",717.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.63,100,,,,,0,"fee schedule",EAPG,318,100,,254.40,,,0,"percent of total billed charges","100% of total billed charges",48.65,2526.76,
"69090 Ear piercing",7963931,CDM,521,RC,69090,CPT,OUTPATIENT,,,77,50.05,,67.76,88,,54.21,,,0,"percent of total billed charges","88% of total billed charges",38.5,50,,30.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",48.51,63,,38.81,,,0,"percent of total billed charges","63% of total billed charges",11.78,15.3,,9.42,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.13,69,,,,,0,"fee schedule","69% of total billed charges",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.62,61.85,,38.10,,,0,"percent of total billed charges","61.5% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.5,50,,30.80,,,0,"percent of total billed charges","50% of total billed charges",24.79,32.2,,19.83,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.03,37.7,,23.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",60.06,78,,48.05,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.6,82.6,,50.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.5,50,,30.80,,,0,"percent of total billed charges","50% of total billed charges",63.6,82.6,,50.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",11.78,160.53,
"69100 Biopsy of external ear",7898864,CDM,521,RC,69100,CPT,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",435.98,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",859.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",251.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.63,100,,,,,0,"fee schedule",EAPG,206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",31.52,859.63,
"69105 Biopsy of external auditory canal",7898865,CDM,521,RC,69105,CPT,OUTPATIENT,,,359,233.35,,315.92,88,,252.74,,,0,"percent of total billed charges","88% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,359,100,,287.20,,,0,"percent of total billed charges","100% of total billed charges",2722.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",226.17,63,,180.94,,,0,"percent of total billed charges","63% of total billed charges",54.93,15.3,,43.94,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,247.71,69,,,,,0,"fee schedule","69% of total billed charges",359,100,,287.20,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",359,100,,287.20,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",359,100,,287.20,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",5495.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1436.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",135.34,37.7,,108.27,,,0,"percent of total billed charges","37.70% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.02,78,,224.02,,,0,"percent of total billed charges","78% of total billed charges",1571.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.53,82.6,,237.22,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.53,82.6,,237.22,,,0,"percent of total billed charges","82.6% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.24,100,,,,,0,"fee schedule",EAPG,359,100,,287.20,,,0,"percent of total billed charges","100% of total billed charges",54.93,5495.75,
"69110 Excision ext ear, partial simple repair",7898866,CDM,521,RC,69110,CPT,OUTPATIENT,,,985,640.25,,866.8,88,,693.44,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620.58,100,,,,,0,"fee schedule",EAPG,985,100,,788.00,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",2699.2,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",620.55,63,,496.44,,,0,"percent of total billed charges","63% of total billed charges",150.71,15.3,,120.57,,,0,"percent of total billed charges","15.3% of total billed charges",2620.58,100,,,,,0,"fee schedule",EAPG,679.65,69,,,,,0,"fee schedule","69% of total billed charges",985,100,,788.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",985,100,,788.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",985,100,,788.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620.58,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2672.99,100,,,,,0,"fee schedule",EAPG,3406.75,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",371.35,37.7,,297.08,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",768.3,78,,614.64,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",813.61,82.6,,650.89,,,0,"percent of total billed charges","82.6% of total billed charges",2620.58,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",813.61,82.6,,650.89,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2781.11,100,,,,,0,"fee schedule",EAPG,985,100,,788.00,,,0,"percent of total billed charges","100% of total billed charges",150.71,9628.23,
"69145 Excision of lesion ear",7898867,CDM,521,RC,69145,CPT,OUTPATIENT,,,545,354.25,,479.6,88,,383.68,,,0,"percent of total billed charges","88% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620.58,100,,,,,0,"fee schedule",EAPG,545,100,,436.00,,,0,"percent of total billed charges","100% of total billed charges",5071.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",2699.2,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",343.35,63,,274.68,,,0,"percent of total billed charges","63% of total billed charges",83.39,15.3,,66.71,,,0,"percent of total billed charges","15.3% of total billed charges",2620.58,100,,,,,0,"fee schedule",EAPG,376.05,69,,,,,0,"fee schedule","69% of total billed charges",545,100,,436.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",545,100,,436.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",545,100,,436.00,,,0,"percent of total billed charges","100% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS fee schedule",9628.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620.58,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2517.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2672.99,100,,,,,0,"fee schedule",EAPG,3406.75,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",205.47,37.7,,164.38,,,0,"percent of total billed charges","37.70% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",425.1,78,,340.08,,,0,"percent of total billed charges","78% of total billed charges",2927.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",450.17,82.6,,360.14,,,0,"percent of total billed charges","82.6% of total billed charges",2620.58,100,,,,,0,"fee schedule",EAPG,2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",450.17,82.6,,360.14,,,0,"percent of total billed charges","82.6% of total billed charges",2898.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2781.11,100,,,,,0,"fee schedule",EAPG,545,100,,436.00,,,0,"percent of total billed charges","100% of total billed charges",83.39,9628.23,
"69200 Foreign body removal ear canal w/o anset",7898868,CDM,521,RC,69200,CPT,OUTPATIENT,,,375,243.75,,330,88,,264.00,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",63,16.8,,50.40,,,0,"percent of total billed charges","16.8% of total billed charges",375,100,,300.00,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",64.89,17.304,,51.91,,,0,"percent of total billed charges","17.304% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",236.25,63,,189.00,,,0,"percent of total billed charges","63% of total billed charges",57.38,15.3,,45.90,,,0,"percent of total billed charges","15.3% of total billed charges",63,16.8,,50.40,,,0,"percent of total billed charges","16.8% of total billed charges",258.75,69,,,,,0,"fee schedule","69% of total billed charges",375,100,,300.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",375,100,,300.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",375,100,,300.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",63,16.8,,50.40,,,0,"percent of total billed charges","16.8% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.26,17.136,,51.41,,,0,"percent of total billed charges","17.136% of total billed charges",81.9,21.84,,65.52,,,0,"percent of total billed charges","21.84% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",141.38,37.7,,113.10,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",292.5,78,,234.00,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.75,82.6,,247.80,,,0,"percent of total billed charges","82.6% of total billed charges",63,16.8,,50.40,,,0,"percent of total billed charges","16.8% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.75,82.6,,247.80,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"case rate","pays based on per visit rate",375,100,,300.00,,,0,"percent of total billed charges","100% of total billed charges",57.38,454.8,
"69209 Unilateral earwash",7898869,CDM,521,RC,69209,CPT,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"case rate","pays based on per visit rate",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,226.12,
"69205 Removal foreign body from external auditory",7962688,CDM,521,RC,69205,CPT,OUTPATIENT,,,225,146.25,,198,88,,158.40,,,0,"percent of total billed charges","88% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,225,100,,180.00,,,0,"percent of total billed charges","100% of total billed charges",2893.89,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",141.75,63,,113.40,,,0,"percent of total billed charges","63% of total billed charges",34.43,15.3,,27.54,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,155.25,69,,,,,0,"fee schedule","69% of total billed charges",225,100,,180.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",225,100,,180.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",225,100,,180.00,,,0,"percent of total billed charges","100% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS fee schedule",5715.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1494.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",84.83,37.7,,67.86,,,0,"percent of total billed charges","37.70% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",175.5,78,,140.40,,,0,"percent of total billed charges","78% of total billed charges",1670.18,100,,,,,0,"fee schedule","100% of CMS OPPS rate",185.85,82.6,,148.68,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",185.85,82.6,,148.68,,,0,"percent of total billed charges","82.6% of total billed charges",1653.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.24,100,,,,,0,"fee schedule",EAPG,225,100,,180.00,,,0,"percent of total billed charges","100% of total billed charges",34.43,5715.97,
"69200 Removal foreign body from external auditory",8213636,CDM,521,RC,69200,CPT,OUTPATIENT,,,375,243.75,,330,88,,264.00,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",63,16.8,,50.40,,,0,"percent of total billed charges","16.8% of total billed charges",375,100,,300.00,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",64.89,17.304,,51.91,,,0,"percent of total billed charges","17.304% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",236.25,63,,189.00,,,0,"percent of total billed charges","63% of total billed charges",57.38,15.3,,45.90,,,0,"percent of total billed charges","15.3% of total billed charges",63,16.8,,50.40,,,0,"percent of total billed charges","16.8% of total billed charges",258.75,69,,,,,0,"fee schedule","69% of total billed charges",375,100,,300.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",375,100,,300.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",375,100,,300.00,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",63,16.8,,50.40,,,0,"percent of total billed charges","16.8% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.26,17.136,,51.41,,,0,"percent of total billed charges","17.136% of total billed charges",81.9,21.84,,65.52,,,0,"percent of total billed charges","21.84% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",141.38,37.7,,113.10,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",292.5,78,,234.00,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.75,82.6,,247.80,,,0,"percent of total billed charges","82.6% of total billed charges",63,16.8,,50.40,,,0,"percent of total billed charges","16.8% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.75,82.6,,247.80,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"case rate","pays based on per visit rate",375,100,,300.00,,,0,"percent of total billed charges","100% of total billed charges",57.38,454.8,
"69209 Removal impacted cerumen using irrigation/la",8213637,CDM,521,RC,69209,CPT,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.23,17.304,,4.98,,,0,"percent of total billed charges","17.304% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6.17,17.136,,4.94,,,0,"percent of total billed charges","17.136% of total billed charges",7.86,21.84,,6.29,,,0,"percent of total billed charges","21.84% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.05,16.8,,4.84,,,0,"percent of total billed charges","16.8% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"case rate","pays based on per visit rate",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,226.12,
"69210 Removal of ear wax instrumentation",7898870,CDM,521,RC,69210,CPT,OUTPATIENT,,,150,97.5,,132,88,,105.60,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",25.2,16.8,,20.16,,,0,"percent of total billed charges","16.8% of total billed charges",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.96,17.304,,20.77,,,0,"percent of total billed charges","17.304% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",94.5,63,,75.60,,,0,"percent of total billed charges","63% of total billed charges",22.95,15.3,,18.36,,,0,"percent of total billed charges","15.3% of total billed charges",25.2,16.8,,20.16,,,0,"percent of total billed charges","16.8% of total billed charges",103.5,69,,,,,0,"fee schedule","69% of total billed charges",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",25.2,16.8,,20.16,,,0,"percent of total billed charges","16.8% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",25.7,17.136,,20.56,,,0,"percent of total billed charges","17.136% of total billed charges",32.76,21.84,,26.21,,,0,"percent of total billed charges","21.84% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",117,78,,93.60,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",25.2,16.8,,20.16,,,0,"percent of total billed charges","16.8% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"case rate","pays based on per visit rate",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",22.95,226.12,
"69210 Removal impacted cerumen requiring instrumen",8213638,CDM,521,RC,69210,CPT,OUTPATIENT,,,150,97.5,,132,88,,105.60,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",25.2,16.8,,20.16,,,0,"percent of total billed charges","16.8% of total billed charges",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",25.96,17.304,,20.77,,,0,"percent of total billed charges","17.304% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",94.5,63,,75.60,,,0,"percent of total billed charges","63% of total billed charges",22.95,15.3,,18.36,,,0,"percent of total billed charges","15.3% of total billed charges",25.2,16.8,,20.16,,,0,"percent of total billed charges","16.8% of total billed charges",103.5,69,,,,,0,"fee schedule","69% of total billed charges",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",25.2,16.8,,20.16,,,0,"percent of total billed charges","16.8% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",25.7,17.136,,20.56,,,0,"percent of total billed charges","17.136% of total billed charges",32.76,21.84,,26.21,,,0,"percent of total billed charges","21.84% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",56.55,37.7,,45.24,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",117,78,,93.60,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",25.2,16.8,,20.16,,,0,"percent of total billed charges","16.8% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.9,82.6,,99.12,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"case rate","pays based on per visit rate",150,100,,120.00,,,0,"percent of total billed charges","100% of total billed charges",22.95,226.12,
"69220 Clean out mastoid, simple",7898871,CDM,521,RC,69220,CPT,OUTPATIENT,,,79,51.35,,69.52,88,,55.62,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",49.77,63,,39.82,,,0,"percent of total billed charges","63% of total billed charges",12.09,15.3,,9.67,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,54.51,69,,,,,0,"fee schedule","69% of total billed charges",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",29.78,37.7,,23.82,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.62,78,,49.30,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.25,82.6,,52.20,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.25,82.6,,52.20,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.63,100,,,,,0,"fee schedule",EAPG,79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",12.09,729.42,
"69222 Clean out mastoid, complex",7898872,CDM,521,RC,69222,CPT,OUTPATIENT,,,308,200.2,,271.04,88,,216.83,,,0,"percent of total billed charges","88% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,308,100,,246.40,,,0,"percent of total billed charges","100% of total billed charges",982.07,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",194.04,63,,155.23,,,0,"percent of total billed charges","63% of total billed charges",47.12,15.3,,37.70,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,212.52,69,,,,,0,"fee schedule","69% of total billed charges",308,100,,246.40,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",308,100,,246.40,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",308,100,,246.40,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",1837.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",480.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",116.12,37.7,,92.90,,,0,"percent of total billed charges","37.70% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",240.24,78,,192.19,,,0,"percent of total billed charges","78% of total billed charges",566.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",254.41,82.6,,203.53,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",254.41,82.6,,203.53,,,0,"percent of total billed charges","82.6% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.24,100,,,,,0,"fee schedule",EAPG,308,100,,246.40,,,0,"percent of total billed charges","100% of total billed charges",47.12,1837.71,
"69310 Reconstruction of external auditory canal (m",7963264,CDM,521,RC,69310,CPT,OUTPATIENT,,,2388,1552.2,,2101.44,88,,1681.15,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4116.84,100,,,,,0,"fee schedule",EAPG,2388,100,,1910.40,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4240.34,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1504.44,63,,1203.55,,,0,"percent of total billed charges","63% of total billed charges",365.36,15.3,,292.29,,,0,"percent of total billed charges","15.3% of total billed charges",4116.84,100,,,,,0,"fee schedule",EAPG,1647.72,69,,,,,0,"fee schedule","69% of total billed charges",2388,100,,1910.40,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2388,100,,1910.40,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2388,100,,1910.40,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4116.84,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4199.17,100,,,,,0,"fee schedule",EAPG,5351.89,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",900.28,37.7,,720.22,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1862.64,78,,1490.11,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1972.49,82.6,,1577.99,,,0,"percent of total billed charges","82.6% of total billed charges",4116.84,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1972.49,82.6,,1577.99,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4277.37,100,,,,,0,"fee schedule",EAPG,2388,100,,1910.40,,,0,"percent of total billed charges","100% of total billed charges",365.36,20662.24,
"69420 Incision of eardrum",7898873,CDM,521,RC,69420,CPT,OUTPATIENT,,,367,238.55,,322.96,88,,258.37,,,0,"percent of total billed charges","88% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,367,100,,293.60,,,0,"percent of total billed charges","100% of total billed charges",435.98,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",231.21,63,,184.97,,,0,"percent of total billed charges","63% of total billed charges",56.15,15.3,,44.92,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,253.23,69,,,,,0,"fee schedule","69% of total billed charges",367,100,,293.60,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367,100,,293.60,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367,100,,293.60,,,0,"percent of total billed charges","100% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",859.63,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",138.36,37.7,,110.69,,,0,"percent of total billed charges","37.70% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",286.26,78,,229.01,,,0,"percent of total billed charges","78% of total billed charges",251.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",303.14,82.6,,242.51,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",303.14,82.6,,242.51,,,0,"percent of total billed charges","82.6% of total billed charges",249.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.63,100,,,,,0,"fee schedule",EAPG,367,100,,293.60,,,0,"percent of total billed charges","100% of total billed charges",56.15,859.63,
"69421 Myringotomy including aspiration and/or eust",7961555,CDM,521,RC,69421,CPT,OUTPATIENT,,,381,247.65,,335.28,88,,268.22,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",240.03,63,,192.02,,,0,"percent of total billed charges","63% of total billed charges",58.29,15.3,,46.63,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,262.89,69,,,,,0,"fee schedule","69% of total billed charges",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",143.64,37.7,,114.91,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.18,78,,237.74,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",314.71,82.6,,251.77,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",314.71,82.6,,251.77,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.24,100,,,,,0,"fee schedule",EAPG,381,100,,304.80,,,0,"percent of total billed charges","100% of total billed charges",58.29,11116.67,
"69424 Ventilating tube removal requiring general a",7963312,CDM,521,RC,69424,CPT,OUTPATIENT,,,131,85.15,,115.28,88,,92.22,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",5746.8,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",82.53,63,,66.02,,,0,"percent of total billed charges","63% of total billed charges",20.04,15.3,,16.03,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,90.39,69,,,,,0,"fee schedule","69% of total billed charges",131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",49.39,37.7,,39.51,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.18,78,,81.74,,,0,"percent of total billed charges","78% of total billed charges",3316.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.21,82.6,,86.57,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.21,82.6,,86.57,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.24,100,,,,,0,"fee schedule",EAPG,131,100,,104.80,,,0,"percent of total billed charges","100% of total billed charges",20.04,11116.67,
"69433 Create eardrum",7898874,CDM,521,RC,69433,CPT,OUTPATIENT,,,428,278.2,,376.64,88,,301.31,,,0,"percent of total billed charges","88% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,428,100,,342.40,,,0,"percent of total billed charges","100% of total billed charges",982.07,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",269.64,63,,215.71,,,0,"percent of total billed charges","63% of total billed charges",65.48,15.3,,52.38,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,295.32,69,,,,,0,"fee schedule","69% of total billed charges",428,100,,342.40,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",428,100,,342.40,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",428,100,,342.40,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",1837.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",480.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",161.36,37.7,,129.09,,,0,"percent of total billed charges","37.70% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",333.84,78,,267.07,,,0,"percent of total billed charges","78% of total billed charges",566.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",353.53,82.6,,282.82,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",353.53,82.6,,282.82,,,0,"percent of total billed charges","82.6% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.63,100,,,,,0,"fee schedule",EAPG,428,100,,342.40,,,0,"percent of total billed charges","100% of total billed charges",65.48,1837.71,
"69436 Tympanostomy (requiring insertion of ventila",7962689,CDM,521,RC,69436,CPT,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",2722.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",5495.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1436.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",1571.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.24,100,,,,,0,"fee schedule",EAPG,361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,5495.75,
"69440 Middle ear exploration through postauricular",7962944,CDM,521,RC,69440,CPT,OUTPATIENT,,,1539,1000.35,,1354.32,88,,1083.46,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620.58,100,,,,,0,"fee schedule",EAPG,1539,100,,1231.20,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",2699.2,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",969.57,63,,775.66,,,0,"percent of total billed charges","63% of total billed charges",235.47,15.3,,188.38,,,0,"percent of total billed charges","15.3% of total billed charges",2620.58,100,,,,,0,"fee schedule",EAPG,1061.91,69,,,,,0,"fee schedule","69% of total billed charges",1539,100,,1231.20,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1539,100,,1231.20,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1539,100,,1231.20,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620.58,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2672.99,100,,,,,0,"fee schedule",EAPG,3406.75,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",580.2,37.7,,464.16,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1200.42,78,,960.34,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1271.21,82.6,,1016.97,,,0,"percent of total billed charges","82.6% of total billed charges",2620.58,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1271.21,82.6,,1016.97,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2781.11,100,,,,,0,"fee schedule",EAPG,1539,100,,1231.20,,,0,"percent of total billed charges","100% of total billed charges",235.47,11116.67,
"69450 Tympanolysis, transcanal",7963860,CDM,521,RC,69450,CPT,OUTPATIENT,,,1174,763.1,,1033.12,88,,826.50,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620.58,100,,,,,0,"fee schedule",EAPG,1174,100,,939.20,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",2699.2,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",739.62,63,,591.70,,,0,"percent of total billed charges","63% of total billed charges",179.62,15.3,,143.70,,,0,"percent of total billed charges","15.3% of total billed charges",2620.58,100,,,,,0,"fee schedule",EAPG,810.06,69,,,,,0,"fee schedule","69% of total billed charges",1174,100,,939.20,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1174,100,,939.20,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1174,100,,939.20,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620.58,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2672.99,100,,,,,0,"fee schedule",EAPG,3406.75,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",442.6,37.7,,354.08,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",915.72,78,,732.58,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",969.72,82.6,,775.78,,,0,"percent of total billed charges","82.6% of total billed charges",2620.58,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",969.72,82.6,,775.78,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2781.11,100,,,,,0,"fee schedule",EAPG,1174,100,,939.20,,,0,"percent of total billed charges","100% of total billed charges",179.62,11116.67,
"69505 Mastoidectomy; modified radical",7963731,CDM,521,RC,69505,CPT,OUTPATIENT,,,1963,1275.95,,1727.44,88,,1381.95,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3143.02,100,,,,,0,"fee schedule",EAPG,1963,100,,1570.40,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",3237.31,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1236.69,63,,989.35,,,0,"percent of total billed charges","63% of total billed charges",300.34,15.3,,240.27,,,0,"percent of total billed charges","15.3% of total billed charges",3143.02,100,,,,,0,"fee schedule",EAPG,1354.47,69,,,,,0,"fee schedule","69% of total billed charges",1963,100,,1570.40,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1963,100,,1570.40,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1963,100,,1570.40,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3143.02,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3205.88,100,,,,,0,"fee schedule",EAPG,4085.92,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",740.05,37.7,,592.04,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1531.14,78,,1224.91,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1621.44,82.6,,1297.15,,,0,"percent of total billed charges","82.6% of total billed charges",3143.02,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1621.44,82.6,,1297.15,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3303.55,100,,,,,0,"fee schedule",EAPG,1963,100,,1570.40,,,0,"percent of total billed charges","100% of total billed charges",300.34,20662.24,
"69511 Mastoidectomy; radical",7963883,CDM,521,RC,69511,CPT,OUTPATIENT,,,2706,1758.9,,2381.28,88,,1905.02,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4116.84,100,,,,,0,"fee schedule",EAPG,2706,100,,2164.80,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4240.34,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1704.78,63,,1363.82,,,0,"percent of total billed charges","63% of total billed charges",414.02,15.3,,331.22,,,0,"percent of total billed charges","15.3% of total billed charges",4116.84,100,,,,,0,"fee schedule",EAPG,1867.14,69,,,,,0,"fee schedule","69% of total billed charges",2706,100,,2164.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2706,100,,2164.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2706,100,,2164.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4116.84,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4199.17,100,,,,,0,"fee schedule",EAPG,5351.89,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1020.16,37.7,,816.13,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2110.68,78,,1688.54,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2235.16,82.6,,1788.13,,,0,"percent of total billed charges","82.6% of total billed charges",4116.84,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2235.16,82.6,,1788.13,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4277.37,100,,,,,0,"fee schedule",EAPG,2706,100,,2164.80,,,0,"percent of total billed charges","100% of total billed charges",414.02,20662.24,
"69540 Remove ear lesion",7898875,CDM,521,RC,69540,CPT,OUTPATIENT,,,261,169.65,,229.68,88,,183.74,,,0,"percent of total billed charges","88% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,261,100,,208.80,,,0,"percent of total billed charges","100% of total billed charges",2722.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",164.43,63,,131.54,,,0,"percent of total billed charges","63% of total billed charges",39.93,15.3,,31.94,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,180.09,69,,,,,0,"fee schedule","69% of total billed charges",261,100,,208.80,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",261,100,,208.80,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",261,100,,208.80,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",5495.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1436.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",98.4,37.7,,78.72,,,0,"percent of total billed charges","37.70% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",203.58,78,,162.86,,,0,"percent of total billed charges","78% of total billed charges",1571.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",215.59,82.6,,172.47,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",215.59,82.6,,172.47,,,0,"percent of total billed charges","82.6% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.24,100,,,,,0,"fee schedule",EAPG,261,100,,208.80,,,0,"percent of total billed charges","100% of total billed charges",39.93,5495.75,
"69602 Revision mastoidectomy; resulting in modifie",7962915,CDM,521,RC,69602,CPT,OUTPATIENT,,,2726,1771.9,,2398.88,88,,1919.10,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4116.84,100,,,,,0,"fee schedule",EAPG,2726,100,,2180.80,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4240.34,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1717.38,63,,1373.90,,,0,"percent of total billed charges","63% of total billed charges",417.08,15.3,,333.66,,,0,"percent of total billed charges","15.3% of total billed charges",4116.84,100,,,,,0,"fee schedule",EAPG,1880.94,69,,,,,0,"fee schedule","69% of total billed charges",2726,100,,2180.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2726,100,,2180.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2726,100,,2180.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4116.84,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4199.17,100,,,,,0,"fee schedule",EAPG,5351.89,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1027.7,37.7,,822.16,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2126.28,78,,1701.02,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2251.68,82.6,,1801.34,,,0,"percent of total billed charges","82.6% of total billed charges",4116.84,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2251.68,82.6,,1801.34,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4277.37,100,,,,,0,"fee schedule",EAPG,2726,100,,2180.80,,,0,"percent of total billed charges","100% of total billed charges",417.08,20662.24,
"69610 Repair eardrum tympanic membrane",7898876,CDM,521,RC,69610,CPT,OUTPATIENT,,,774,503.1,,681.12,88,,544.90,,,0,"percent of total billed charges","88% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,774,100,,619.20,,,0,"percent of total billed charges","100% of total billed charges",2722.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",487.62,63,,390.10,,,0,"percent of total billed charges","63% of total billed charges",118.42,15.3,,94.74,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,534.06,69,,,,,0,"fee schedule","69% of total billed charges",774,100,,619.20,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",774,100,,619.20,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",774,100,,619.20,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",5495.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1436.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",291.8,37.7,,233.44,,,0,"percent of total billed charges","37.70% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",603.72,78,,482.98,,,0,"percent of total billed charges","78% of total billed charges",1571.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",639.32,82.6,,511.46,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",639.32,82.6,,511.46,,,0,"percent of total billed charges","82.6% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.24,100,,,,,0,"fee schedule",EAPG,774,100,,619.20,,,0,"percent of total billed charges","100% of total billed charges",118.42,5495.75,
"69620 Myringoplasty (surgery confined to drumhead",7963157,CDM,521,RC,69620,CPT,OUTPATIENT,,,1015,659.75,,893.2,88,,714.56,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620.58,100,,,,,0,"fee schedule",EAPG,1015,100,,812.00,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",2699.2,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",639.45,63,,511.56,,,0,"percent of total billed charges","63% of total billed charges",155.3,15.3,,124.24,,,0,"percent of total billed charges","15.3% of total billed charges",2620.58,100,,,,,0,"fee schedule",EAPG,700.35,69,,,,,0,"fee schedule","69% of total billed charges",1015,100,,812.00,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1015,100,,812.00,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1015,100,,812.00,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620.58,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2672.99,100,,,,,0,"fee schedule",EAPG,3406.75,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",382.66,37.7,,306.13,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",791.7,78,,633.36,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",838.39,82.6,,670.71,,,0,"percent of total billed charges","82.6% of total billed charges",2620.58,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",838.39,82.6,,670.71,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2781.11,100,,,,,0,"fee schedule",EAPG,1015,100,,812.00,,,0,"percent of total billed charges","100% of total billed charges",155.3,11116.67,
"69631 Tympanoplasty w/o mastoidectomy, initial or",7961711,CDM,521,RC,69631,CPT,OUTPATIENT,,,1942,1262.3,,1708.96,88,,1367.17,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3143.02,100,,,,,0,"fee schedule",EAPG,1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",3237.31,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1223.46,63,,978.77,,,0,"percent of total billed charges","63% of total billed charges",297.13,15.3,,237.70,,,0,"percent of total billed charges","15.3% of total billed charges",3143.02,100,,,,,0,"fee schedule",EAPG,1339.98,69,,,,,0,"fee schedule","69% of total billed charges",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3143.02,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3205.88,100,,,,,0,"fee schedule",EAPG,4085.92,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",732.13,37.7,,585.70,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1514.76,78,,1211.81,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",3143.02,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1604.09,82.6,,1283.27,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3303.55,100,,,,,0,"fee schedule",EAPG,1942,100,,1553.60,,,0,"percent of total billed charges","100% of total billed charges",297.13,20662.24,
"69632 Tympanoplasty w/o mastoidectomy, initial or",7961837,CDM,521,RC,69632,CPT,OUTPATIENT,,,2231,1450.15,,1963.28,88,,1570.62,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4116.84,100,,,,,0,"fee schedule",EAPG,2231,100,,1784.80,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4240.34,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1405.53,63,,1124.42,,,0,"percent of total billed charges","63% of total billed charges",341.34,15.3,,273.07,,,0,"percent of total billed charges","15.3% of total billed charges",4116.84,100,,,,,0,"fee schedule",EAPG,1539.39,69,,,,,0,"fee schedule","69% of total billed charges",2231,100,,1784.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2231,100,,1784.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2231,100,,1784.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4116.84,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4199.17,100,,,,,0,"fee schedule",EAPG,5351.89,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",841.09,37.7,,672.87,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1740.18,78,,1392.14,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1842.81,82.6,,1474.25,,,0,"percent of total billed charges","82.6% of total billed charges",4116.84,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1842.81,82.6,,1474.25,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4277.37,100,,,,,0,"fee schedule",EAPG,2231,100,,1784.80,,,0,"percent of total billed charges","100% of total billed charges",341.34,20662.24,
"69636 Tympanoplasty with antrotomy or mastoidotomy",7962453,CDM,521,RC,69636,CPT,OUTPATIENT,,,2864,1861.6,,2520.32,88,,2016.26,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4116.84,100,,,,,0,"fee schedule",EAPG,2864,100,,2291.20,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4240.34,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1804.32,63,,1443.46,,,0,"percent of total billed charges","63% of total billed charges",438.19,15.3,,350.55,,,0,"percent of total billed charges","15.3% of total billed charges",4116.84,100,,,,,0,"fee schedule",EAPG,1976.16,69,,,,,0,"fee schedule","69% of total billed charges",2864,100,,2291.20,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2864,100,,2291.20,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2864,100,,2291.20,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4116.84,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4199.17,100,,,,,0,"fee schedule",EAPG,5351.89,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1079.73,37.7,,863.78,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2233.92,78,,1787.14,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2365.66,82.6,,1892.53,,,0,"percent of total billed charges","82.6% of total billed charges",4116.84,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2365.66,82.6,,1892.53,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4277.37,100,,,,,0,"fee schedule",EAPG,2864,100,,2291.20,,,0,"percent of total billed charges","100% of total billed charges",438.19,20662.24,
"69633 Tympanoplasty w/o mastoidectomy, initial or",7962858,CDM,521,RC,69633,CPT,OUTPATIENT,,,2296,1492.4,,2020.48,88,,1616.38,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4116.84,100,,,,,0,"fee schedule",EAPG,2296,100,,1836.80,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4240.34,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1446.48,63,,1157.18,,,0,"percent of total billed charges","63% of total billed charges",351.29,15.3,,281.03,,,0,"percent of total billed charges","15.3% of total billed charges",4116.84,100,,,,,0,"fee schedule",EAPG,1584.24,69,,,,,0,"fee schedule","69% of total billed charges",2296,100,,1836.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2296,100,,1836.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2296,100,,1836.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4116.84,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4199.17,100,,,,,0,"fee schedule",EAPG,5351.89,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",865.59,37.7,,692.47,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1790.88,78,,1432.70,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1896.5,82.6,,1517.20,,,0,"percent of total billed charges","82.6% of total billed charges",4116.84,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1896.5,82.6,,1517.20,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4277.37,100,,,,,0,"fee schedule",EAPG,2296,100,,1836.80,,,0,"percent of total billed charges","100% of total billed charges",351.29,20662.24,
"69637 Tympanoplasty with antrotomy or mastoidotomy",7963087,CDM,521,RC,69637,CPT,OUTPATIENT,,,3012,1957.8,,2650.56,88,,2120.45,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4116.84,100,,,,,0,"fee schedule",EAPG,3012,100,,2409.60,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4240.34,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1897.56,63,,1518.05,,,0,"percent of total billed charges","63% of total billed charges",460.84,15.3,,368.67,,,0,"percent of total billed charges","15.3% of total billed charges",4116.84,100,,,,,0,"fee schedule",EAPG,2078.28,69,,,,,0,"fee schedule","69% of total billed charges",3012,100,,2409.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3012,100,,2409.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3012,100,,2409.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4116.84,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4199.17,100,,,,,0,"fee schedule",EAPG,5351.89,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1135.52,37.7,,908.42,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2349.36,78,,1879.49,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2487.91,82.6,,1990.33,,,0,"percent of total billed charges","82.6% of total billed charges",4116.84,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2487.91,82.6,,1990.33,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4277.37,100,,,,,0,"fee schedule",EAPG,3012,100,,2409.60,,,0,"percent of total billed charges","100% of total billed charges",460.84,20662.24,
"69646 Tympanoplasty, w/ mastoidectomy; radical or",7962196,CDM,521,RC,69646,CPT,OUTPATIENT,,,3395,2206.75,,2987.6,88,,2390.08,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4116.84,100,,,,,0,"fee schedule",EAPG,3395,100,,2716.00,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4240.34,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2138.85,63,,1711.08,,,0,"percent of total billed charges","63% of total billed charges",519.44,15.3,,415.55,,,0,"percent of total billed charges","15.3% of total billed charges",4116.84,100,,,,,0,"fee schedule",EAPG,2342.55,69,,,,,0,"fee schedule","69% of total billed charges",3395,100,,2716.00,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3395,100,,2716.00,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3395,100,,2716.00,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4116.84,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4199.17,100,,,,,0,"fee schedule",EAPG,5351.89,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1279.92,37.7,,1023.94,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2648.1,78,,2118.48,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2804.27,82.6,,2243.42,,,0,"percent of total billed charges","82.6% of total billed charges",4116.84,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2804.27,82.6,,2243.42,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4277.37,100,,,,,0,"fee schedule",EAPG,3395,100,,2716.00,,,0,"percent of total billed charges","100% of total billed charges",519.44,20662.24,
"69643 Tympanoplasty, w/ mastoidectomy; w/ intact w",7962387,CDM,521,RC,69643,CPT,OUTPATIENT,,,2628,1708.2,,2312.64,88,,1850.11,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4116.84,100,,,,,0,"fee schedule",EAPG,2628,100,,2102.40,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4240.34,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1655.64,63,,1324.51,,,0,"percent of total billed charges","63% of total billed charges",402.08,15.3,,321.66,,,0,"percent of total billed charges","15.3% of total billed charges",4116.84,100,,,,,0,"fee schedule",EAPG,1813.32,69,,,,,0,"fee schedule","69% of total billed charges",2628,100,,2102.40,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2628,100,,2102.40,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2628,100,,2102.40,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4116.84,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4199.17,100,,,,,0,"fee schedule",EAPG,5351.89,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",990.76,37.7,,792.61,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2049.84,78,,1639.87,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2170.73,82.6,,1736.58,,,0,"percent of total billed charges","82.6% of total billed charges",4116.84,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2170.73,82.6,,1736.58,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4277.37,100,,,,,0,"fee schedule",EAPG,2628,100,,2102.40,,,0,"percent of total billed charges","100% of total billed charges",402.08,20662.24,
"69641 Tympanoplasty, w/ mastoidectomy; w/o ossicul",7962916,CDM,521,RC,69641,CPT,OUTPATIENT,,,2307,1499.55,,2030.16,88,,1624.13,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4116.84,100,,,,,0,"fee schedule",EAPG,2307,100,,1845.60,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4240.34,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1453.41,63,,1162.73,,,0,"percent of total billed charges","63% of total billed charges",352.97,15.3,,282.38,,,0,"percent of total billed charges","15.3% of total billed charges",4116.84,100,,,,,0,"fee schedule",EAPG,1591.83,69,,,,,0,"fee schedule","69% of total billed charges",2307,100,,1845.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2307,100,,1845.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2307,100,,1845.60,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4116.84,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4199.17,100,,,,,0,"fee schedule",EAPG,5351.89,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",869.74,37.7,,695.79,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1799.46,78,,1439.57,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1905.58,82.6,,1524.46,,,0,"percent of total billed charges","82.6% of total billed charges",4116.84,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1905.58,82.6,,1524.46,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4277.37,100,,,,,0,"fee schedule",EAPG,2307,100,,1845.60,,,0,"percent of total billed charges","100% of total billed charges",352.97,20662.24,
"69660 Stapedectomy, w/reestablishment continuity,",7962755,CDM,521,RC,69660,CPT,OUTPATIENT,,,2004,1302.6,,1763.52,88,,1410.82,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3143.02,100,,,,,0,"fee schedule",EAPG,2004,100,,1603.20,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",3237.31,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1262.52,63,,1010.02,,,0,"percent of total billed charges","63% of total billed charges",306.61,15.3,,245.29,,,0,"percent of total billed charges","15.3% of total billed charges",3143.02,100,,,,,0,"fee schedule",EAPG,1382.76,69,,,,,0,"fee schedule","69% of total billed charges",2004,100,,1603.20,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2004,100,,1603.20,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2004,100,,1603.20,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3143.02,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3205.88,100,,,,,0,"fee schedule",EAPG,4085.92,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",755.51,37.7,,604.41,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1563.12,78,,1250.50,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1655.3,82.6,,1324.24,,,0,"percent of total billed charges","82.6% of total billed charges",3143.02,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1655.3,82.6,,1324.24,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3303.55,100,,,,,0,"fee schedule",EAPG,2004,100,,1603.20,,,0,"percent of total billed charges","100% of total billed charges",306.61,20662.24,
"69700 Closure postauricular fistula, mastoid (sepa",7963093,CDM,521,RC,69700,CPT,OUTPATIENT,,,2128,1383.2,,1872.64,88,,1498.11,,,0,"percent of total billed charges","88% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620.58,100,,,,,0,"fee schedule",EAPG,2128,100,,1702.40,,,0,"percent of total billed charges","100% of total billed charges",2722.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",2699.2,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1340.64,63,,1072.51,,,0,"percent of total billed charges","63% of total billed charges",325.58,15.3,,260.46,,,0,"percent of total billed charges","15.3% of total billed charges",2620.58,100,,,,,0,"fee schedule",EAPG,1468.32,69,,,,,0,"fee schedule","69% of total billed charges",2128,100,,1702.40,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2128,100,,1702.40,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2128,100,,1702.40,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",5495.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2620.58,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1436.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2672.99,100,,,,,0,"fee schedule",EAPG,3406.75,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",802.26,37.7,,641.81,,,0,"percent of total billed charges","37.70% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1659.84,78,,1327.87,,,0,"percent of total billed charges","78% of total billed charges",1571.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1757.73,82.6,,1406.18,,,0,"percent of total billed charges","82.6% of total billed charges",2620.58,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1757.73,82.6,,1406.18,,,0,"percent of total billed charges","82.6% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2781.11,100,,,,,0,"fee schedule",EAPG,2128,100,,1702.40,,,0,"percent of total billed charges","100% of total billed charges",325.58,5495.75,
"69720 Decompression facial nerve, intratemporal; l",7962730,CDM,521,RC,69720,CPT,OUTPATIENT,,,5231,3400.15,,4603.28,88,,3682.62,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4044.53,100,,,,,0,"fee schedule",EAPG,4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",4165.86,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3295.53,63,,2636.42,,,0,"percent of total billed charges","63% of total billed charges",800.34,15.3,,640.27,,,0,"percent of total billed charges","15.3% of total billed charges",4044.53,100,,,,,0,"fee schedule",EAPG,3609.39,69,,,,,0,"fee schedule","69% of total billed charges",5231,100,,4184.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5231,100,,4184.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5231,100,,4184.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4044.53,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4125.42,100,,,,,0,"fee schedule",EAPG,5257.89,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1972.09,37.7,,1577.67,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4080.18,78,,3264.14,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4320.81,82.6,,3456.65,,,0,"percent of total billed charges","82.6% of total billed charges",4044.53,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4320.81,82.6,,3456.65,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",4205.06,100,,,,,0,"fee schedule",EAPG,5231,100,,4184.80,,,0,"percent of total billed charges","100% of total billed charges",800.34,20662.24,
"69801 Incise inner ear",7898877,CDM,521,RC,69801,CPT,OUTPATIENT,,,500,325,,440,88,,352.00,,,0,"percent of total billed charges","88% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,500,100,,400.00,,,0,"percent of total billed charges","100% of total billed charges",2722.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",315,63,,252.00,,,0,"percent of total billed charges","63% of total billed charges",76.5,15.3,,61.20,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,345,69,,,,,0,"fee schedule","69% of total billed charges",500,100,,400.00,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",500,100,,400.00,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",500,100,,400.00,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",5495.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1436.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",188.5,37.7,,150.80,,,0,"percent of total billed charges","37.70% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",390,78,,312.00,,,0,"percent of total billed charges","78% of total billed charges",1571.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",413,82.6,,330.40,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",413,82.6,,330.40,,,0,"percent of total billed charges","82.6% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.24,100,,,,,0,"fee schedule",EAPG,500,100,,400.00,,,0,"percent of total billed charges","100% of total billed charges",76.5,5495.75,
"69990 Microsurgical techniques, requiring use of o",7903320,CDM,521,RC,69990,CPT,OUTPATIENT,,,1090,708.5,,959.2,88,,767.36,,,0,"percent of total billed charges","88% of total billed charges",545,50,,436.00,,,0,"percent of total billed charges","50% of total billed charges",183.12,16.8,,146.50,,,0,"percent of total billed charges","16.8% of total billed charges",1090,100,,872.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",188.61,17.304,,150.89,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",686.7,63,,549.36,,,0,"percent of total billed charges","63% of total billed charges",166.77,15.3,,133.42,,,0,"percent of total billed charges","15.3% of total billed charges",183.12,16.8,,146.50,,,0,"percent of total billed charges","16.8% of total billed charges",752.1,69,,,,,0,"fee schedule","69% of total billed charges",1090,100,,872.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1090,100,,872.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1090,100,,872.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.17,61.85,,539.34,,,0,"percent of total billed charges","61.5% of total billed charges",183.12,16.8,,146.50,,,0,"percent of total billed charges","16.8% of total billed charges",545,50,,436.00,,,0,"percent of total billed charges","50% of total billed charges",350.98,32.2,,280.78,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",186.78,17.136,,149.42,,,0,"percent of total billed charges","17.136% of total billed charges",238.06,21.84,,190.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",410.93,37.7,,328.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",850.2,78,,680.16,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",900.34,82.6,,720.27,,,0,"percent of total billed charges","82.6% of total billed charges",183.12,16.8,,146.50,,,0,"percent of total billed charges","16.8% of total billed charges",545,50,,436.00,,,0,"percent of total billed charges","50% of total billed charges",900.34,82.6,,720.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",1090,100,,872.00,,,0,"percent of total billed charges","100% of total billed charges",160.53,1090,
"75822 Venography, extremity, bilateral, radiologic",7903361,CDM,521,RC,75822,CPT,OUTPATIENT,,,288,187.2,,253.44,88,,202.75,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.06,100,,,,,0,"fee schedule",EAPG,288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",781.83,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",181.44,63,,145.15,,,0,"percent of total billed charges","63% of total billed charges",44.06,15.3,,35.25,,,0,"percent of total billed charges","15.3% of total billed charges",759.06,100,,,,,0,"fee schedule",EAPG,198.72,69,,,,,0,"fee schedule","69% of total billed charges",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.06,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",774.24,100,,,,,0,"fee schedule",EAPG,986.78,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",108.58,37.7,,86.86,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",224.64,78,,179.71,,,0,"percent of total billed charges","78% of total billed charges",1649.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",237.89,82.6,,190.31,,,0,"percent of total billed charges","82.6% of total billed charges",759.06,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",237.89,82.6,,190.31,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",919.59,100,,,,,0,"fee schedule",EAPG,288,100,,230.40,,,0,"percent of total billed charges","100% of total billed charges",44.06,5712.48,
"75827 Venography, caval, superior, with serialogra",7903362,CDM,521,RC,75827,CPT,OUTPATIENT,,,202,131.3,,177.76,88,,142.21,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.06,100,,,,,0,"fee schedule",EAPG,202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",781.83,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",127.26,63,,101.81,,,0,"percent of total billed charges","63% of total billed charges",30.91,15.3,,24.73,,,0,"percent of total billed charges","15.3% of total billed charges",759.06,100,,,,,0,"fee schedule",EAPG,139.38,69,,,,,0,"fee schedule","69% of total billed charges",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",759.06,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",774.24,100,,,,,0,"fee schedule",EAPG,986.78,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",76.15,37.7,,60.92,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",157.56,78,,126.05,,,0,"percent of total billed charges","78% of total billed charges",1649.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",166.85,82.6,,133.48,,,0,"percent of total billed charges","82.6% of total billed charges",759.06,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",166.85,82.6,,133.48,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",919.59,100,,,,,0,"fee schedule",EAPG,202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",30.91,5712.48,
"76000 Fluoroscopy, up to 1 hour physician or other",7903363,CDM,521,RC,76000,CPT,OUTPATIENT,,,157,102.05,,138.16,88,,110.53,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,157,100,,125.60,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.02,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",98.91,63,,79.13,,,0,"percent of total billed charges","63% of total billed charges",24.02,15.3,,19.22,,,0,"percent of total billed charges","15.3% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,108.33,69,,,,,0,"fee schedule","69% of total billed charges",157,100,,125.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",157,100,,125.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",157,100,,125.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.76,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",110.94,100,,,,,0,"fee schedule",EAPG,141.39,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",59.19,37.7,,47.35,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.46,78,,97.97,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",129.68,82.6,,103.74,,,0,"percent of total billed charges","82.6% of total billed charges",108.76,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",129.68,82.6,,103.74,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",269.29,100,,,,,0,"fee schedule",EAPG,157,100,,125.60,,,0,"percent of total billed charges","100% of total billed charges",24.02,934.9,
"77002 Fluoroscopic guidance for needle placement",7903364,CDM,521,RC,77002,CPT,OUTPATIENT,,,236,153.4,,207.68,88,,166.14,,,0,"percent of total billed charges","88% of total billed charges",118,50,,94.40,,,0,"percent of total billed charges","50% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,236,100,,188.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",148.68,63,,118.94,,,0,"percent of total billed charges","63% of total billed charges",36.11,15.3,,28.89,,,0,"percent of total billed charges","15.3% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,162.84,69,,,,,0,"fee schedule","69% of total billed charges",236,100,,188.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",236,100,,188.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",236,100,,188.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",145.97,61.85,,116.78,,,0,"percent of total billed charges","61.5% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,118,50,,94.40,,,0,"percent of total billed charges","50% of total billed charges",75.99,32.2,,60.79,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",165.21,100,,,,,0,"fee schedule",EAPG,210.57,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",88.97,37.7,,71.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",184.08,78,,147.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.94,82.6,,155.95,,,0,"percent of total billed charges","82.6% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,118,50,,94.40,,,0,"percent of total billed charges","50% of total billed charges",194.94,82.6,,155.95,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",322.5,100,,,,,0,"fee schedule",EAPG,236,100,,188.80,,,0,"percent of total billed charges","100% of total billed charges",36.11,322.5,
"77003 Fluoroscopic guidance and localization of ne",7903366,CDM,521,RC,77003,CPT,OUTPATIENT,,,102,66.3,,89.76,88,,71.81,,,0,"percent of total billed charges","88% of total billed charges",51,50,,40.80,,,0,"percent of total billed charges","50% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",64.26,63,,51.41,,,0,"percent of total billed charges","63% of total billed charges",15.61,15.3,,12.49,,,0,"percent of total billed charges","15.3% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,70.38,69,,,,,0,"fee schedule","69% of total billed charges",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.09,61.85,,50.47,,,0,"percent of total billed charges","61.5% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,51,50,,40.80,,,0,"percent of total billed charges","50% of total billed charges",32.84,32.2,,26.27,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",165.21,100,,,,,0,"fee schedule",EAPG,210.57,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.45,37.7,,30.76,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",79.56,78,,63.65,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.25,82.6,,67.40,,,0,"percent of total billed charges","82.6% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,51,50,,40.80,,,0,"percent of total billed charges","50% of total billed charges",84.25,82.6,,67.40,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",322.5,100,,,,,0,"fee schedule",EAPG,102,100,,81.60,,,0,"percent of total billed charges","100% of total billed charges",15.61,322.5,
"77001 Fluor Guide Ven Plac/Replace/Rem",8169533,CDM,521,RC,77001,CPT,OUTPATIENT,,,479,311.35,,421.52,88,,337.22,,,0,"percent of total billed charges","88% of total billed charges",239.5,50,,191.60,,,0,"percent of total billed charges","50% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,479,100,,383.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",301.77,63,,241.42,,,0,"percent of total billed charges","63% of total billed charges",73.29,15.3,,58.63,,,0,"percent of total billed charges","15.3% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,330.51,69,,,,,0,"fee schedule","69% of total billed charges",479,100,,383.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",479,100,,383.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",479,100,,383.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",296.26,61.85,,237.01,,,0,"percent of total billed charges","61.5% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,239.5,50,,191.60,,,0,"percent of total billed charges","50% of total billed charges",154.24,32.2,,123.39,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",165.21,100,,,,,0,"fee schedule",EAPG,210.57,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",180.58,37.7,,144.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",373.62,78,,298.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",395.65,82.6,,316.52,,,0,"percent of total billed charges","82.6% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,239.5,50,,191.60,,,0,"percent of total billed charges","50% of total billed charges",395.65,82.6,,316.52,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",322.5,100,,,,,0,"fee schedule",EAPG,479,100,,383.20,,,0,"percent of total billed charges","100% of total billed charges",73.29,479,
"82075 Breath Alcohol Test",8489726,CDM,521,RC,82075,CPT,OUTPATIENT,,,43,27.95,,37.84,88,,30.27,,,0,"percent of total billed charges","88% of total billed charges",30,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",52.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",7.44,17.304,,5.95,,,0,"percent of total billed charges","17.304% of total billed charges",30,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.09,63,,21.67,,,0,"percent of total billed charges","63% of total billed charges",6.58,15.3,,5.26,,,0,"percent of total billed charges","15.3% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",29.67,69,,,,,0,"fee schedule","69% of total billed charges",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",30,100,,,,,0,"fee schedule","100% of CMS fee schedule",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",30,100,,,,,0,"fee schedule","100% of CMS fee schedule",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",30,100,,,,,0,"fee schedule","100% of CMS fee schedule",114.75,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,,,,0,"fee schedule","100% of CMS fee schedule",30,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",30,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.37,17.136,,5.90,,,0,"percent of total billed charges","17.136% of total billed charges",9.39,21.84,,7.51,,,0,"percent of total billed charges","21.84% of total billed charges",30,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",16.21,37.7,,12.97,,,0,"percent of total billed charges","37.70% of total billed charges",30,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",30,100,,,,,0,"fee schedule","100% of CMS fee schedule",33.54,78,,26.83,,,0,"percent of total billed charges","78% of total billed charges",30.3,101,,,,,0,"fee schedule","101% of CMS fee schedule ",35.52,82.6,,28.42,,,0,"percent of total billed charges","82.6% of total billed charges",7.22,16.8,,5.78,,,0,"percent of total billed charges","16.8% of total billed charges",30,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.52,82.6,,28.42,,,0,"percent of total billed charges","82.6% of total billed charges",30,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.53,100,,,,,0,"case rate","pays based on per visit rate",43,100,,34.40,,,0,"percent of total billed charges","100% of total billed charges",6.58,160.53,
"87880 Rapid Strep POC",1019780,CDM,300,RC,87880,CPT,OUTPATIENT,,,64,41.6,,56.32,88,,45.06,,,0,"percent of total billed charges","88% of total billed charges",16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",28.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.68,100,,,,,0,"fee schedule",EAPG,16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.32,63,,32.26,,,0,"percent of total billed charges","63% of total billed charges",9.79,15.3,,7.83,,,0,"percent of total billed charges","15.3% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,44.16,69,,,,,0,"fee schedule","69% of total billed charges",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",63.22,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.53,100,,,,,0,"fee schedule","100% of LI fee schedule",4.81,100,,,,,0,"fee schedule",EAPG,16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.62,100,,,,,0,"fee schedule",EAPG,8.44,100,,,,,0,"fee schedule",EAPG,16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.13,37.7,,19.30,,,0,"percent of total billed charges","37.7% of total billed charges",24.13,37.7,,19.30,,,0,"percent of total billed charges","37.70% of total billed charges",16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.7,33.9,,17.36,,,0,"percent of total billed charges","33.9% of total billed charges",16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.92,78,,39.94,,,0,"percent of total billed charges","78% of total billed charges",16.69,101,,,,,0,"fee schedule","101% of CMS fee schedule ",52.86,82.6,,42.29,,,0,"percent of total billed charges","82.6% of total billed charges",6.49,100,,,,,0,"fee schedule",EAPG,16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.86,82.6,,42.29,,,0,"percent of total billed charges","82.6% of total billed charges",16.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.49,100,,,,,0,"fee schedule",EAPG,64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",4.81,64,
"90785 Interactive complexity",7963884,CDM,521,RC,90785,CPT,OUTPATIENT,,,32,20.8,,28.16,88,,22.53,,,0,"percent of total billed charges","88% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",109.19,100,,,,,0,"fee schedule",EAPG,32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.46,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",20.16,63,,16.13,,,0,"percent of total billed charges","63% of total billed charges",4.9,15.3,,3.92,,,0,"percent of total billed charges","15.3% of total billed charges",109.19,100,,,,,0,"fee schedule",EAPG,22.08,69,,,,,0,"fee schedule","69% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.79,61.85,,15.83,,,0,"percent of total billed charges","61.5% of total billed charges",109.19,100,,,,,0,"fee schedule",EAPG,16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",10.3,32.2,,8.24,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",111.37,100,,,,,0,"fee schedule",EAPG,141.94,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.96,78,,19.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",109.19,100,,,,,0,"fee schedule","100% of WA fee schedule",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",269.72,100,,,,,0,"fee schedule",EAPG,32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",4.9,269.72,
"90791 Psychiatric diagnostic evaluation",7963711,CDM,521,RC,90791,CPT,OUTPATIENT,,,281,182.65,,247.28,88,,197.82,,,0,"percent of total billed charges","88% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",236.74,100,,,,,0,"fee schedule",EAPG,281,100,,224.80,,,0,"percent of total billed charges","100% of total billed charges",284.58,175,,,,,0,"fee schedule","175% of CMS fee schedule",243.84,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.03,63,,141.62,,,0,"percent of total billed charges","63% of total billed charges",42.99,15.3,,34.39,,,0,"percent of total billed charges","15.3% of total billed charges",236.74,100,,,,,0,"fee schedule",EAPG,193.89,69,,,,,0,"fee schedule","69% of total billed charges",281,100,,224.80,,,0,"percent of total billed charges","100% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",281,100,,224.80,,,0,"percent of total billed charges","100% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",281,100,,224.80,,,0,"percent of total billed charges","100% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",542.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",236.74,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",141.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",241.48,100,,,,,0,"fee schedule",EAPG,307.76,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",105.94,37.7,,84.75,,,0,"percent of total billed charges","37.70% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",219.18,78,,175.34,,,0,"percent of total billed charges","78% of total billed charges",164.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",232.11,82.6,,185.69,,,0,"percent of total billed charges","82.6% of total billed charges",236.74,100,,,,,0,"fee schedule","100% of WA fee schedule",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",232.11,82.6,,185.69,,,0,"percent of total billed charges","82.6% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397.27,100,,,,,0,"fee schedule",EAPG,281,100,,224.80,,,0,"percent of total billed charges","100% of total billed charges",42.99,542.87,
"90832 Psych follow up 20-30 minutes",7898881,CDM,521,RC,90832,CPT,OUTPATIENT,,,138,89.7,,121.44,88,,97.15,,,0,"percent of total billed charges","88% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.19,100,,,,,0,"fee schedule",EAPG,138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",284.58,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.46,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",86.94,63,,69.55,,,0,"percent of total billed charges","63% of total billed charges",21.11,15.3,,16.89,,,0,"percent of total billed charges","15.3% of total billed charges",109.19,100,,,,,0,"fee schedule",EAPG,95.22,69,,,,,0,"fee schedule","69% of total billed charges",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",542.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.19,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",141.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.37,100,,,,,0,"fee schedule",EAPG,141.94,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",52.03,37.7,,41.62,,,0,"percent of total billed charges","37.70% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107.64,78,,86.11,,,0,"percent of total billed charges","78% of total billed charges",164.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",113.99,82.6,,91.19,,,0,"percent of total billed charges","82.6% of total billed charges",109.19,100,,,,,0,"fee schedule","100% of WA fee schedule",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",113.99,82.6,,91.19,,,0,"percent of total billed charges","82.6% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",269.72,100,,,,,0,"fee schedule",EAPG,138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",21.11,542.87,
"90833 Psytx pt & fam w/ E&M 30 min",7898882,CDM,521,RC,90833,CPT,OUTPATIENT,,,143,92.95,,125.84,88,,100.67,,,0,"percent of total billed charges","88% of total billed charges",71.5,50,,57.20,,,0,"percent of total billed charges","50% of total billed charges",109.19,100,,,,,0,"fee schedule",EAPG,143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.46,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",90.09,63,,72.07,,,0,"percent of total billed charges","63% of total billed charges",21.88,15.3,,17.50,,,0,"percent of total billed charges","15.3% of total billed charges",109.19,100,,,,,0,"fee schedule",EAPG,98.67,69,,,,,0,"fee schedule","69% of total billed charges",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",88.45,61.85,,70.76,,,0,"percent of total billed charges","61.5% of total billed charges",109.19,100,,,,,0,"fee schedule",EAPG,71.5,50,,57.20,,,0,"percent of total billed charges","50% of total billed charges",46.05,32.2,,36.84,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",111.37,100,,,,,0,"fee schedule",EAPG,141.94,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",53.91,37.7,,43.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",111.54,78,,89.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",109.19,100,,,,,0,"fee schedule","100% of WA fee schedule",71.5,50,,57.20,,,0,"percent of total billed charges","50% of total billed charges",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",269.72,100,,,,,0,"fee schedule",EAPG,143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",21.88,269.72,
"90834 Psych follow up 45-50 minutes",7898883,CDM,521,RC,90834,CPT,OUTPATIENT,,,185,120.25,,162.8,88,,130.24,,,0,"percent of total billed charges","88% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",131.69,100,,,,,0,"fee schedule",EAPG,185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",284.58,175,,,,,0,"fee schedule","175% of CMS fee schedule",135.64,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",116.55,63,,93.24,,,0,"percent of total billed charges","63% of total billed charges",28.31,15.3,,22.65,,,0,"percent of total billed charges","15.3% of total billed charges",131.69,100,,,,,0,"fee schedule",EAPG,127.65,69,,,,,0,"fee schedule","69% of total billed charges",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",542.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",131.69,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",141.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",134.32,100,,,,,0,"fee schedule",EAPG,171.19,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",69.75,37.7,,55.80,,,0,"percent of total billed charges","37.70% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",144.3,78,,115.44,,,0,"percent of total billed charges","78% of total billed charges",164.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",152.81,82.6,,122.25,,,0,"percent of total billed charges","82.6% of total billed charges",131.69,100,,,,,0,"fee schedule","100% of WA fee schedule",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",152.81,82.6,,122.25,,,0,"percent of total billed charges","82.6% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",292.22,100,,,,,0,"fee schedule",EAPG,185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",28.31,542.87,
"90836 Psytx pt & fam w/ E&M 45 min",7898884,CDM,521,RC,90836,CPT,OUTPATIENT,,,228,148.2,,200.64,88,,160.51,,,0,"percent of total billed charges","88% of total billed charges",114,50,,91.20,,,0,"percent of total billed charges","50% of total billed charges",131.69,100,,,,,0,"fee schedule",EAPG,228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",135.64,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",143.64,63,,114.91,,,0,"percent of total billed charges","63% of total billed charges",34.88,15.3,,27.90,,,0,"percent of total billed charges","15.3% of total billed charges",131.69,100,,,,,0,"fee schedule",EAPG,157.32,69,,,,,0,"fee schedule","69% of total billed charges",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",141.02,61.85,,112.82,,,0,"percent of total billed charges","61.5% of total billed charges",131.69,100,,,,,0,"fee schedule",EAPG,114,50,,91.20,,,0,"percent of total billed charges","50% of total billed charges",73.42,32.2,,58.74,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",134.32,100,,,,,0,"fee schedule",EAPG,171.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",85.96,37.7,,68.77,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",177.84,78,,142.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",188.33,82.6,,150.66,,,0,"percent of total billed charges","82.6% of total billed charges",131.69,100,,,,,0,"fee schedule","100% of WA fee schedule",114,50,,91.20,,,0,"percent of total billed charges","50% of total billed charges",188.33,82.6,,150.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.22,100,,,,,0,"fee schedule",EAPG,228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",34.88,292.22,
"90837 Psych Follow Up 60 Minutes",7898885,CDM,521,RC,90837,CPT,OUTPATIENT,,,271,176.15,,238.48,88,,190.78,,,0,"percent of total billed charges","88% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",131.69,100,,,,,0,"fee schedule",EAPG,271,100,,216.80,,,0,"percent of total billed charges","100% of total billed charges",284.58,175,,,,,0,"fee schedule","175% of CMS fee schedule",135.64,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",170.73,63,,136.58,,,0,"percent of total billed charges","63% of total billed charges",41.46,15.3,,33.17,,,0,"percent of total billed charges","15.3% of total billed charges",131.69,100,,,,,0,"fee schedule",EAPG,186.99,69,,,,,0,"fee schedule","69% of total billed charges",271,100,,216.80,,,0,"percent of total billed charges","100% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",271,100,,216.80,,,0,"percent of total billed charges","100% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",271,100,,216.80,,,0,"percent of total billed charges","100% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",542.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",131.69,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",141.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",134.32,100,,,,,0,"fee schedule",EAPG,171.19,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",102.17,37.7,,81.74,,,0,"percent of total billed charges","37.70% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",211.38,78,,169.10,,,0,"percent of total billed charges","78% of total billed charges",164.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",223.85,82.6,,179.08,,,0,"percent of total billed charges","82.6% of total billed charges",131.69,100,,,,,0,"fee schedule","100% of WA fee schedule",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",223.85,82.6,,179.08,,,0,"percent of total billed charges","82.6% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",292.22,100,,,,,0,"fee schedule",EAPG,271,100,,216.80,,,0,"percent of total billed charges","100% of total billed charges",41.46,542.87,
"90838 Psytx pt & fam w/ E&M 60 min",7898886,CDM,521,RC,90838,CPT,OUTPATIENT,,,234,152.1,,205.92,88,,164.74,,,0,"percent of total billed charges","88% of total billed charges",117,50,,93.60,,,0,"percent of total billed charges","50% of total billed charges",131.69,100,,,,,0,"fee schedule",EAPG,234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",135.64,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",147.42,63,,117.94,,,0,"percent of total billed charges","63% of total billed charges",35.8,15.3,,28.64,,,0,"percent of total billed charges","15.3% of total billed charges",131.69,100,,,,,0,"fee schedule",EAPG,161.46,69,,,,,0,"fee schedule","69% of total billed charges",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",144.73,61.85,,115.78,,,0,"percent of total billed charges","61.5% of total billed charges",131.69,100,,,,,0,"fee schedule",EAPG,117,50,,93.60,,,0,"percent of total billed charges","50% of total billed charges",75.35,32.2,,60.28,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",134.32,100,,,,,0,"fee schedule",EAPG,171.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",88.22,37.7,,70.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",182.52,78,,146.02,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",193.28,82.6,,154.62,,,0,"percent of total billed charges","82.6% of total billed charges",131.69,100,,,,,0,"fee schedule","100% of WA fee schedule",117,50,,93.60,,,0,"percent of total billed charges","50% of total billed charges",193.28,82.6,,154.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.22,100,,,,,0,"fee schedule",EAPG,234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",35.8,292.22,
"90839 Psytx crisis initial 60 minutes",7898887,CDM,521,RC,90839,CPT,OUTPATIENT,,,286,185.9,,251.68,88,,201.34,,,0,"percent of total billed charges","88% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",131.69,100,,,,,0,"fee schedule",EAPG,286,100,,228.80,,,0,"percent of total billed charges","100% of total billed charges",284.58,175,,,,,0,"fee schedule","175% of CMS fee schedule",135.64,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180.18,63,,144.14,,,0,"percent of total billed charges","63% of total billed charges",43.76,15.3,,35.01,,,0,"percent of total billed charges","15.3% of total billed charges",131.69,100,,,,,0,"fee schedule",EAPG,197.34,69,,,,,0,"fee schedule","69% of total billed charges",286,100,,228.80,,,0,"percent of total billed charges","100% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",286,100,,228.80,,,0,"percent of total billed charges","100% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",286,100,,228.80,,,0,"percent of total billed charges","100% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",542.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",131.69,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",141.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",134.32,100,,,,,0,"fee schedule",EAPG,171.19,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",107.82,37.7,,86.26,,,0,"percent of total billed charges","37.70% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",223.08,78,,178.46,,,0,"percent of total billed charges","78% of total billed charges",164.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",236.24,82.6,,188.99,,,0,"percent of total billed charges","82.6% of total billed charges",131.69,100,,,,,0,"fee schedule","100% of WA fee schedule",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",236.24,82.6,,188.99,,,0,"percent of total billed charges","82.6% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",292.22,100,,,,,0,"fee schedule",EAPG,286,100,,228.80,,,0,"percent of total billed charges","100% of total billed charges",43.76,542.87,
"90840 Psytx crisis each additional 30 minutes",7898888,CDM,521,RC,90840,CPT,OUTPATIENT,,,138,89.7,,121.44,88,,97.15,,,0,"percent of total billed charges","88% of total billed charges",69,50,,55.20,,,0,"percent of total billed charges","50% of total billed charges",131.69,100,,,,,0,"fee schedule",EAPG,138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",135.64,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",86.94,63,,69.55,,,0,"percent of total billed charges","63% of total billed charges",21.11,15.3,,16.89,,,0,"percent of total billed charges","15.3% of total billed charges",131.69,100,,,,,0,"fee schedule",EAPG,95.22,69,,,,,0,"fee schedule","69% of total billed charges",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.35,61.85,,68.28,,,0,"percent of total billed charges","61.5% of total billed charges",131.69,100,,,,,0,"fee schedule",EAPG,69,50,,55.20,,,0,"percent of total billed charges","50% of total billed charges",44.44,32.2,,35.55,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",134.32,100,,,,,0,"fee schedule",EAPG,171.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",52.03,37.7,,41.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",107.64,78,,86.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.99,82.6,,91.19,,,0,"percent of total billed charges","82.6% of total billed charges",131.69,100,,,,,0,"fee schedule","100% of WA fee schedule",69,50,,55.20,,,0,"percent of total billed charges","50% of total billed charges",113.99,82.6,,91.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",292.22,100,,,,,0,"fee schedule",EAPG,138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",21.11,292.22,
"90846 Family psychotherapy w/o pt 50 min",7898889,CDM,521,RC,90846,CPT,OUTPATIENT,,,222,144.3,,195.36,88,,156.29,,,0,"percent of total billed charges","88% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",135.93,100,,,,,0,"fee schedule",EAPG,222,100,,177.60,,,0,"percent of total billed charges","100% of total billed charges",284.58,175,,,,,0,"fee schedule","175% of CMS fee schedule",140.01,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",139.86,63,,111.89,,,0,"percent of total billed charges","63% of total billed charges",33.97,15.3,,27.18,,,0,"percent of total billed charges","15.3% of total billed charges",135.93,100,,,,,0,"fee schedule",EAPG,153.18,69,,,,,0,"fee schedule","69% of total billed charges",222,100,,177.60,,,0,"percent of total billed charges","100% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",222,100,,177.60,,,0,"percent of total billed charges","100% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",222,100,,177.60,,,0,"percent of total billed charges","100% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",542.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",135.93,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",141.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",138.65,100,,,,,0,"fee schedule",EAPG,176.71,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",83.69,37.7,,66.95,,,0,"percent of total billed charges","37.70% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.16,78,,138.53,,,0,"percent of total billed charges","78% of total billed charges",164.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",183.37,82.6,,146.70,,,0,"percent of total billed charges","82.6% of total billed charges",135.93,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",183.37,82.6,,146.70,,,0,"percent of total billed charges","82.6% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.46,100,,,,,0,"fee schedule",EAPG,222,100,,177.60,,,0,"percent of total billed charges","100% of total billed charges",33.97,542.87,
"90847 Family psychotherapy",7898890,CDM,521,RC,90847,CPT,OUTPATIENT,,,228,148.2,,200.64,88,,160.51,,,0,"percent of total billed charges","88% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",135.93,100,,,,,0,"fee schedule",EAPG,228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",284.58,175,,,,,0,"fee schedule","175% of CMS fee schedule",140.01,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",143.64,63,,114.91,,,0,"percent of total billed charges","63% of total billed charges",34.88,15.3,,27.90,,,0,"percent of total billed charges","15.3% of total billed charges",135.93,100,,,,,0,"fee schedule",EAPG,157.32,69,,,,,0,"fee schedule","69% of total billed charges",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",542.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",135.93,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",141.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",138.65,100,,,,,0,"fee schedule",EAPG,176.71,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",85.96,37.7,,68.77,,,0,"percent of total billed charges","37.70% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",177.84,78,,142.27,,,0,"percent of total billed charges","78% of total billed charges",164.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",188.33,82.6,,150.66,,,0,"percent of total billed charges","82.6% of total billed charges",135.93,100,,,,,0,"fee schedule","100% of WA fee schedule",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",188.33,82.6,,150.66,,,0,"percent of total billed charges","82.6% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",296.46,100,,,,,0,"fee schedule",EAPG,228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",34.88,542.87,
"90849 Multiple family group psytx",7898891,CDM,521,RC,90849,CPT,OUTPATIENT,,,74,48.1,,65.12,88,,52.10,,,0,"percent of total billed charges","88% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",192.85,100,,,,,0,"fee schedule",EAPG,74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",284.58,175,,,,,0,"fee schedule","175% of CMS fee schedule",198.63,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.62,63,,37.30,,,0,"percent of total billed charges","63% of total billed charges",11.32,15.3,,9.06,,,0,"percent of total billed charges","15.3% of total billed charges",192.85,100,,,,,0,"fee schedule",EAPG,51.06,69,,,,,0,"fee schedule","69% of total billed charges",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",542.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",192.85,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",141.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",196.71,100,,,,,0,"fee schedule",EAPG,250.71,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",27.9,37.7,,22.32,,,0,"percent of total billed charges","37.70% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",57.72,78,,46.18,,,0,"percent of total billed charges","78% of total billed charges",164.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.12,82.6,,48.90,,,0,"percent of total billed charges","82.6% of total billed charges",192.85,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.12,82.6,,48.90,,,0,"percent of total billed charges","82.6% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",353.38,100,,,,,0,"fee schedule",EAPG,74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",11.32,542.87,
"90845 Psychoanalysis",7963926,CDM,521,RC,90845,CPT,OUTPATIENT,,,197,128.05,,173.36,88,,138.69,,,0,"percent of total billed charges","88% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",131.69,100,,,,,0,"fee schedule",EAPG,197,100,,157.60,,,0,"percent of total billed charges","100% of total billed charges",284.58,175,,,,,0,"fee schedule","175% of CMS fee schedule",135.64,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.11,63,,99.29,,,0,"percent of total billed charges","63% of total billed charges",30.14,15.3,,24.11,,,0,"percent of total billed charges","15.3% of total billed charges",131.69,100,,,,,0,"fee schedule",EAPG,135.93,69,,,,,0,"fee schedule","69% of total billed charges",197,100,,157.60,,,0,"percent of total billed charges","100% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",197,100,,157.60,,,0,"percent of total billed charges","100% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",197,100,,157.60,,,0,"percent of total billed charges","100% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",542.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",131.69,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",141.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",134.32,100,,,,,0,"fee schedule",EAPG,171.19,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",74.27,37.7,,59.42,,,0,"percent of total billed charges","37.70% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",153.66,78,,122.93,,,0,"percent of total billed charges","78% of total billed charges",164.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",162.72,82.6,,130.18,,,0,"percent of total billed charges","82.6% of total billed charges",131.69,100,,,,,0,"fee schedule","100% of WA fee schedule",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",162.72,82.6,,130.18,,,0,"percent of total billed charges","82.6% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",292.22,100,,,,,0,"fee schedule",EAPG,197,100,,157.60,,,0,"percent of total billed charges","100% of total billed charges",30.14,542.87,
"90865 Narcosynthesis for psychiatric diagnostic an",7962920,CDM,521,RC,90865,CPT,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",236.74,100,,,,,0,"fee schedule",EAPG,361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",284.58,175,,,,,0,"fee schedule","175% of CMS fee schedule",243.84,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",236.74,100,,,,,0,"fee schedule",EAPG,249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",542.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",236.74,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",141.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",241.48,100,,,,,0,"fee schedule",EAPG,307.76,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",164.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",236.74,100,,,,,0,"fee schedule",EAPG,162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",162.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397.27,100,,,,,0,"fee schedule",EAPG,361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,542.87,
"90867 tcranial magn stim tx plan",7963828,CDM,521,RC,90867,CPT,OUTPATIENT,,,266,172.9,,234.08,88,,187.26,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",439.72,100,,,,,0,"fee schedule",EAPG,266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",452.91,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",167.58,63,,134.06,,,0,"percent of total billed charges","63% of total billed charges",40.7,15.3,,32.56,,,0,"percent of total billed charges","15.3% of total billed charges",439.72,100,,,,,0,"fee schedule",EAPG,183.54,69,,,,,0,"fee schedule","69% of total billed charges",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",439.72,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",448.51,100,,,,,0,"fee schedule",EAPG,571.64,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",100.28,37.7,,80.22,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",207.48,78,,165.98,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",219.72,82.6,,175.78,,,0,"percent of total billed charges","82.6% of total billed charges",439.72,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",219.72,82.6,,175.78,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",600.25,100,,,,,0,"fee schedule",EAPG,266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",40.7,1074.33,
"90870 Electroconvulsive therapy (includes necessar",7963210,CDM,521,RC,90870,CPT,OUTPATIENT,,,382,248.3,,336.16,88,,268.93,,,0,"percent of total billed charges","88% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",439.72,100,,,,,0,"fee schedule",EAPG,382,100,,305.60,,,0,"percent of total billed charges","100% of total billed charges",956.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",452.91,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",240.66,63,,192.53,,,0,"percent of total billed charges","63% of total billed charges",58.45,15.3,,46.76,,,0,"percent of total billed charges","15.3% of total billed charges",439.72,100,,,,,0,"fee schedule",EAPG,263.58,69,,,,,0,"fee schedule","69% of total billed charges",382,100,,305.60,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",382,100,,305.60,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",382,100,,305.60,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1981.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",439.72,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",518.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",448.51,100,,,,,0,"fee schedule",EAPG,571.64,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",144.01,37.7,,115.21,,,0,"percent of total billed charges","37.70% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",297.96,78,,238.37,,,0,"percent of total billed charges","78% of total billed charges",552.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",315.53,82.6,,252.42,,,0,"percent of total billed charges","82.6% of total billed charges",439.72,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",315.53,82.6,,252.42,,,0,"percent of total billed charges","82.6% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",600.25,100,,,,,0,"fee schedule",EAPG,382,100,,305.60,,,0,"percent of total billed charges","100% of total billed charges",58.45,1981.61,
"90875 phychophysiological therapy 30 mins",7963667,CDM,521,RC,90875,CPT,OUTPATIENT,,,228,148.2,,200.64,88,,160.51,,,0,"percent of total billed charges","88% of total billed charges",114,50,,91.20,,,0,"percent of total billed charges","50% of total billed charges",143.95,100,,,,,0,"fee schedule",EAPG,228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",148.27,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",143.64,63,,114.91,,,0,"percent of total billed charges","63% of total billed charges",34.88,15.3,,27.90,,,0,"percent of total billed charges","15.3% of total billed charges",143.95,100,,,,,0,"fee schedule",EAPG,157.32,69,,,,,0,"fee schedule","69% of total billed charges",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",141.02,61.85,,112.82,,,0,"percent of total billed charges","61.5% of total billed charges",143.95,100,,,,,0,"fee schedule",EAPG,114,50,,91.20,,,0,"percent of total billed charges","50% of total billed charges",73.42,32.2,,58.74,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",146.83,100,,,,,0,"fee schedule",EAPG,187.14,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",85.96,37.7,,68.77,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",177.84,78,,142.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",188.33,82.6,,150.66,,,0,"percent of total billed charges","82.6% of total billed charges",143.95,100,,,,,0,"fee schedule","100% of WA fee schedule",114,50,,91.20,,,0,"percent of total billed charges","50% of total billed charges",188.33,82.6,,150.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",304.48,100,,,,,0,"fee schedule",EAPG,228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",34.88,304.48,
"90876 psychophysiological therapy 45 mins",7963668,CDM,521,RC,90876,CPT,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",143.95,100,,,,,0,"fee schedule",EAPG,361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",148.27,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",143.95,100,,,,,0,"fee schedule",EAPG,249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.28,61.85,,178.62,,,0,"percent of total billed charges","61.5% of total billed charges",143.95,100,,,,,0,"fee schedule",EAPG,180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",116.24,32.2,,92.99,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",146.83,100,,,,,0,"fee schedule",EAPG,187.14,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",143.95,100,,,,,0,"fee schedule","100% of WA fee schedule",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",298.19,82.6,,238.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",304.48,100,,,,,0,"fee schedule",EAPG,361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,361,
"90887 Consultation with family",7898893,CDM,521,RC,90887,CPT,OUTPATIENT,,,138,89.7,,121.44,88,,97.15,,,0,"percent of total billed charges","88% of total billed charges",69,50,,55.20,,,0,"percent of total billed charges","50% of total billed charges",135.93,100,,,,,0,"fee schedule",EAPG,138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",140.01,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",86.94,63,,69.55,,,0,"percent of total billed charges","63% of total billed charges",21.11,15.3,,16.89,,,0,"percent of total billed charges","15.3% of total billed charges",135.93,100,,,,,0,"fee schedule",EAPG,95.22,69,,,,,0,"fee schedule","69% of total billed charges",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",85.35,61.85,,68.28,,,0,"percent of total billed charges","61.5% of total billed charges",135.93,100,,,,,0,"fee schedule",EAPG,69,50,,55.20,,,0,"percent of total billed charges","50% of total billed charges",44.44,32.2,,35.55,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",138.65,100,,,,,0,"fee schedule",EAPG,176.71,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",52.03,37.7,,41.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",107.64,78,,86.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.99,82.6,,91.19,,,0,"percent of total billed charges","82.6% of total billed charges",135.93,100,,,,,0,"fee schedule","100% of WA fee schedule",69,50,,55.20,,,0,"percent of total billed charges","50% of total billed charges",113.99,82.6,,91.19,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",296.46,100,,,,,0,"fee schedule",EAPG,138,100,,110.40,,,0,"percent of total billed charges","100% of total billed charges",21.11,296.46,
"90882 Environmental intervention for med mgmt with",7962454,CDM,521,RC,90882,CPT,OUTPATIENT,,,165,107.25,,145.2,88,,116.16,,,0,"percent of total billed charges","88% of total billed charges",82.5,50,,66.00,,,0,"percent of total billed charges","50% of total billed charges",60.54,100,,,,,0,"fee schedule",EAPG,165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.36,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",103.95,63,,83.16,,,0,"percent of total billed charges","63% of total billed charges",25.25,15.3,,20.20,,,0,"percent of total billed charges","15.3% of total billed charges",60.54,100,,,,,0,"fee schedule",EAPG,113.85,69,,,,,0,"fee schedule","69% of total billed charges",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",102.05,61.85,,81.64,,,0,"percent of total billed charges","61.5% of total billed charges",60.54,100,,,,,0,"fee schedule",EAPG,82.5,50,,66.00,,,0,"percent of total billed charges","50% of total billed charges",53.13,32.2,,42.50,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",61.75,100,,,,,0,"fee schedule",EAPG,78.71,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",62.21,37.7,,49.77,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",128.7,78,,102.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.29,82.6,,109.03,,,0,"percent of total billed charges","82.6% of total billed charges",60.54,100,,,,,0,"fee schedule","100% of WA fee schedule",82.5,50,,66.00,,,0,"percent of total billed charges","50% of total billed charges",136.29,82.6,,109.03,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.07,100,,,,,0,"fee schedule",EAPG,165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",25.25,221.07,
"90889 Preparation of psychiatric report for status",7962571,CDM,521,RC,90889,CPT,OUTPATIENT,,,69,44.85,,60.72,88,,48.58,,,0,"percent of total billed charges","88% of total billed charges",34.5,50,,27.60,,,0,"percent of total billed charges","50% of total billed charges",60.54,100,,,,,0,"fee schedule",EAPG,69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.36,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",43.47,63,,34.78,,,0,"percent of total billed charges","63% of total billed charges",10.56,15.3,,8.45,,,0,"percent of total billed charges","15.3% of total billed charges",60.54,100,,,,,0,"fee schedule",EAPG,47.61,69,,,,,0,"fee schedule","69% of total billed charges",69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.68,61.85,,34.14,,,0,"percent of total billed charges","61.5% of total billed charges",60.54,100,,,,,0,"fee schedule",EAPG,34.5,50,,27.60,,,0,"percent of total billed charges","50% of total billed charges",22.22,32.2,,17.78,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",61.75,100,,,,,0,"fee schedule",EAPG,78.71,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.01,37.7,,20.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",53.82,78,,43.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.99,82.6,,45.59,,,0,"percent of total billed charges","82.6% of total billed charges",60.54,100,,,,,0,"fee schedule","100% of WA fee schedule",34.5,50,,27.60,,,0,"percent of total billed charges","50% of total billed charges",56.99,82.6,,45.59,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.07,100,,,,,0,"fee schedule",EAPG,69,100,,55.20,,,0,"percent of total billed charges","100% of total billed charges",10.56,221.07,
"90885 Psychiatric evaluation of records for medica",7962978,CDM,521,RC,90885,CPT,OUTPATIENT,,,106,68.9,,93.28,88,,74.62,,,0,"percent of total billed charges","88% of total billed charges",53,50,,42.40,,,0,"percent of total billed charges","50% of total billed charges",60.54,100,,,,,0,"fee schedule",EAPG,106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.36,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",66.78,63,,53.42,,,0,"percent of total billed charges","63% of total billed charges",16.22,15.3,,12.98,,,0,"percent of total billed charges","15.3% of total billed charges",60.54,100,,,,,0,"fee schedule",EAPG,73.14,69,,,,,0,"fee schedule","69% of total billed charges",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",65.56,61.85,,52.45,,,0,"percent of total billed charges","61.5% of total billed charges",60.54,100,,,,,0,"fee schedule",EAPG,53,50,,42.40,,,0,"percent of total billed charges","50% of total billed charges",34.13,32.2,,27.30,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",61.75,100,,,,,0,"fee schedule",EAPG,78.71,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39.96,37.7,,31.97,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",82.68,78,,66.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.56,82.6,,70.05,,,0,"percent of total billed charges","82.6% of total billed charges",60.54,100,,,,,0,"fee schedule","100% of WA fee schedule",53,50,,42.40,,,0,"percent of total billed charges","50% of total billed charges",87.56,82.6,,70.05,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.07,100,,,,,0,"fee schedule",EAPG,106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",16.22,221.07,
"90880 Hypnotherapy",7963934,CDM,521,RC,90880,CPT,OUTPATIENT,,,217,141.05,,190.96,88,,152.77,,,0,"percent of total billed charges","88% of total billed charges",90.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.19,100,,,,,0,"fee schedule",EAPG,217,100,,173.60,,,0,"percent of total billed charges","100% of total billed charges",159.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.46,100,,,,,0,"fee schedule",EAPG,90.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",136.71,63,,109.37,,,0,"percent of total billed charges","63% of total billed charges",33.2,15.3,,26.56,,,0,"percent of total billed charges","15.3% of total billed charges",109.19,100,,,,,0,"fee schedule",EAPG,149.73,69,,,,,0,"fee schedule","69% of total billed charges",217,100,,173.60,,,0,"percent of total billed charges","100% of total billed charges",90.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",217,100,,173.60,,,0,"percent of total billed charges","100% of total billed charges",90.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",217,100,,173.60,,,0,"percent of total billed charges","100% of total billed charges",90.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",304.15,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.19,100,,,,,0,"fee schedule",EAPG,90.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",79.51,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",90.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.37,100,,,,,0,"fee schedule",EAPG,141.94,100,,,,,0,"fee schedule",EAPG,90.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",81.81,37.7,,65.45,,,0,"percent of total billed charges","37.70% of total billed charges",90.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",90.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.26,78,,135.41,,,0,"percent of total billed charges","78% of total billed charges",91.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",179.24,82.6,,143.39,,,0,"percent of total billed charges","82.6% of total billed charges",109.19,100,,,,,0,"fee schedule","100% of WA fee schedule",90.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",179.24,82.6,,143.39,,,0,"percent of total billed charges","82.6% of total billed charges",90.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",269.72,100,,,,,0,"fee schedule",EAPG,217,100,,173.60,,,0,"percent of total billed charges","100% of total billed charges",33.2,304.15,
"90899 Unlisted psychiatric service or procedure",7963568,CDM,521,RC,90899,CPT,OUTPATIENT,,,160,104,,140.8,88,,112.64,,,0,"percent of total billed charges","88% of total billed charges",29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.19,100,,,,,0,"fee schedule",EAPG,160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",51.21,175,,,,,0,"fee schedule","175% of CMS fee schedule",112.46,100,,,,,0,"fee schedule",EAPG,29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.8,63,,80.64,,,0,"percent of total billed charges","63% of total billed charges",24.48,15.3,,19.58,,,0,"percent of total billed charges","15.3% of total billed charges",109.19,100,,,,,0,"fee schedule",EAPG,110.4,69,,,,,0,"fee schedule","69% of total billed charges",160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",29.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",106.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.19,100,,,,,0,"fee schedule",EAPG,29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",27.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.37,100,,,,,0,"fee schedule",EAPG,141.94,100,,,,,0,"fee schedule",EAPG,29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",60.32,37.7,,48.26,,,0,"percent of total billed charges","37.70% of total billed charges",29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.8,78,,99.84,,,0,"percent of total billed charges","78% of total billed charges",29.55,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.16,82.6,,105.73,,,0,"percent of total billed charges","82.6% of total billed charges",109.19,100,,,,,0,"fee schedule","100% of WA fee schedule",29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.16,82.6,,105.73,,,0,"percent of total billed charges","82.6% of total billed charges",29.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",269.72,100,,,,,0,"fee schedule",EAPG,160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",24.48,269.72,
"90901 Biofeedback training, any method",7898894,CDM,521,RC,90901,CPT,OUTPATIENT,,,79,51.35,,69.52,88,,55.62,,,0,"percent of total billed charges","88% of total billed charges",19.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",143.95,100,,,,,0,"fee schedule",EAPG,79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",32.88,175,,,,,0,"fee schedule","175% of CMS fee schedule",148.27,100,,,,,0,"fee schedule",EAPG,19.12,100,,,,,0,"fee schedule","100% of CMS fee sv",49.77,63,,39.82,,,0,"percent of total billed charges","63% of total billed charges",12.09,15.3,,9.67,,,0,"percent of total billed charges","15.3% of total billed charges",143.95,100,,,,,0,"fee schedule",EAPG,54.51,69,,,,,0,"fee schedule","69% of total billed charges",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of CMS fee schedule",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",19.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",19.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",75.62,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",143.95,100,,,,,0,"fee schedule",EAPG,19.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.86,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",19.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",146.83,100,,,,,0,"fee schedule",EAPG,187.14,100,,,,,0,"fee schedule",EAPG,19.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",29.78,37.7,,23.82,,,0,"percent of total billed charges","37.70% of total billed charges",19.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",19.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",61.62,78,,49.30,,,0,"percent of total billed charges","78% of total billed charges",19.31,101,,,,,0,"fee schedule","101% of CMS fee schedule ",65.25,82.6,,52.20,,,0,"percent of total billed charges","82.6% of total billed charges",143.95,100,,,,,0,"fee schedule","100% of WA fee schedule",19.12,100,,,,,0,"fee schedule","100% of CMS fee schedule",65.25,82.6,,52.20,,,0,"percent of total billed charges","82.6% of total billed charges",19.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",304.48,100,,,,,0,"fee schedule",EAPG,79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",12.09,304.48,
"90935 Hemodialysis procedure w/ single eval by a p",7961959,CDM,521,RC,90935,CPT,OUTPATIENT,,,153,99.45,,134.64,88,,107.71,,,0,"percent of total billed charges","88% of total billed charges",712.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",689.5,100,,,,,0,"fee schedule",EAPG,153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",1247.3,175,,,,,0,"fee schedule","175% of CMS fee schedule",710.19,100,,,,,0,"fee schedule",EAPG,712.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",96.39,63,,77.11,,,0,"percent of total billed charges","63% of total billed charges",23.41,15.3,,18.73,,,0,"percent of total billed charges","15.3% of total billed charges",689.5,100,,,,,0,"fee schedule",EAPG,105.57,69,,,,,0,"fee schedule","69% of total billed charges",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",712.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",712.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",712.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",2658.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",689.5,100,,,,,0,"fee schedule",EAPG,712.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",694.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",712.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",703.29,100,,,,,0,"fee schedule",EAPG,896.36,100,,,,,0,"fee schedule",EAPG,712.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",57.68,37.7,,46.14,,,0,"percent of total billed charges","37.70% of total billed charges",712.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",712.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",119.34,78,,95.47,,,0,"percent of total billed charges","78% of total billed charges",719.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",126.38,82.6,,101.10,,,0,"percent of total billed charges","82.6% of total billed charges",689.5,100,,,,,0,"fee schedule",EAPG,712.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",126.38,82.6,,101.10,,,0,"percent of total billed charges","82.6% of total billed charges",712.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",850.03,100,,,,,0,"fee schedule",EAPG,153,100,,122.40,,,0,"percent of total billed charges","100% of total billed charges",23.41,2658.27,
"90937 Hemodialysis procedure requiring repeated ev",7963400,CDM,521,RC,90937,CPT,OUTPATIENT,,,221,143.65,,194.48,88,,155.58,,,0,"percent of total billed charges","88% of total billed charges",110.5,50,,88.40,,,0,"percent of total billed charges","50% of total billed charges",689.5,100,,,,,0,"fee schedule",EAPG,221,100,,176.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",710.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",139.23,63,,111.38,,,0,"percent of total billed charges","63% of total billed charges",33.81,15.3,,27.05,,,0,"percent of total billed charges","15.3% of total billed charges",689.5,100,,,,,0,"fee schedule",EAPG,152.49,69,,,,,0,"fee schedule","69% of total billed charges",221,100,,176.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",221,100,,176.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",221,100,,176.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.69,61.85,,109.35,,,0,"percent of total billed charges","61.5% of total billed charges",689.5,100,,,,,0,"fee schedule",EAPG,110.5,50,,88.40,,,0,"percent of total billed charges","50% of total billed charges",71.16,32.2,,56.93,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",703.29,100,,,,,0,"fee schedule",EAPG,896.36,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",83.32,37.7,,66.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",172.38,78,,137.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",182.55,82.6,,146.04,,,0,"percent of total billed charges","82.6% of total billed charges",689.5,100,,,,,0,"fee schedule","100% of WA fee schedule",110.5,50,,88.40,,,0,"percent of total billed charges","50% of total billed charges",182.55,82.6,,146.04,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",850.03,100,,,,,0,"fee schedule",EAPG,221,100,,176.80,,,0,"percent of total billed charges","100% of total billed charges",33.81,896.36,
"90945 dialysis one evaluation",7963863,CDM,521,RC,90945,CPT,OUTPATIENT,,,182,118.3,,160.16,88,,128.13,,,0,"percent of total billed charges","88% of total billed charges",451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",689.5,100,,,,,0,"fee schedule",EAPG,182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",790.56,175,,,,,0,"fee schedule","175% of CMS fee schedule",710.19,100,,,,,0,"fee schedule",EAPG,451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",114.66,63,,91.73,,,0,"percent of total billed charges","63% of total billed charges",27.85,15.3,,22.28,,,0,"percent of total billed charges","15.3% of total billed charges",689.5,100,,,,,0,"fee schedule",EAPG,125.58,69,,,,,0,"fee schedule","69% of total billed charges",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",451.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",1477.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",689.5,100,,,,,0,"fee schedule",EAPG,451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",386.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",703.29,100,,,,,0,"fee schedule",EAPG,896.36,100,,,,,0,"fee schedule",EAPG,451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",68.61,37.7,,54.89,,,0,"percent of total billed charges","37.70% of total billed charges",451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",141.96,78,,113.57,,,0,"percent of total billed charges","78% of total billed charges",456.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.33,82.6,,120.26,,,0,"percent of total billed charges","82.6% of total billed charges",689.5,100,,,,,0,"fee schedule",EAPG,451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.33,82.6,,120.26,,,0,"percent of total billed charges","82.6% of total billed charges",451.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",850.03,100,,,,,0,"fee schedule",EAPG,182,100,,145.60,,,0,"percent of total billed charges","100% of total billed charges",27.85,1477.69,
"90947 dialysis repeated eval",7963879,CDM,521,RC,90947,CPT,OUTPATIENT,,,264,171.6,,232.32,88,,185.86,,,0,"percent of total billed charges","88% of total billed charges",132,50,,105.60,,,0,"percent of total billed charges","50% of total billed charges",689.5,100,,,,,0,"fee schedule",EAPG,264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",710.19,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",166.32,63,,133.06,,,0,"percent of total billed charges","63% of total billed charges",40.39,15.3,,32.31,,,0,"percent of total billed charges","15.3% of total billed charges",689.5,100,,,,,0,"fee schedule",EAPG,182.16,69,,,,,0,"fee schedule","69% of total billed charges",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",163.28,61.85,,130.62,,,0,"percent of total billed charges","61.5% of total billed charges",689.5,100,,,,,0,"fee schedule",EAPG,132,50,,105.60,,,0,"percent of total billed charges","50% of total billed charges",85.01,32.2,,68.01,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",703.29,100,,,,,0,"fee schedule",EAPG,896.36,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",99.53,37.7,,79.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",205.92,78,,164.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",218.06,82.6,,174.45,,,0,"percent of total billed charges","82.6% of total billed charges",689.5,100,,,,,0,"fee schedule","100% of WA fee schedule",132,50,,105.60,,,0,"percent of total billed charges","50% of total billed charges",218.06,82.6,,174.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",850.03,100,,,,,0,"fee schedule",EAPG,264,100,,211.20,,,0,"percent of total billed charges","100% of total billed charges",40.39,896.36,
"90965 esrd home pt serv per full month 12-19",7963612,CDM,521,RC,90965,CPT,OUTPATIENT,,,1072,696.8,,943.36,88,,754.69,,,0,"percent of total billed charges","88% of total billed charges",536,50,,428.80,,,0,"percent of total billed charges","50% of total billed charges",541.17,100,,,,,0,"fee schedule",EAPG,1072,100,,857.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",557.41,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",675.36,63,,540.29,,,0,"percent of total billed charges","63% of total billed charges",164.02,15.3,,131.22,,,0,"percent of total billed charges","15.3% of total billed charges",541.17,100,,,,,0,"fee schedule",EAPG,739.68,69,,,,,0,"fee schedule","69% of total billed charges",1072,100,,857.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1072,100,,857.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1072,100,,857.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",663.03,61.85,,530.42,,,0,"percent of total billed charges","61.5% of total billed charges",541.17,100,,,,,0,"fee schedule",EAPG,536,50,,428.80,,,0,"percent of total billed charges","50% of total billed charges",345.18,32.2,,276.14,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",551.99,100,,,,,0,"fee schedule",EAPG,703.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",404.14,37.7,,323.31,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",836.16,78,,668.93,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",885.47,82.6,,708.38,,,0,"percent of total billed charges","82.6% of total billed charges",541.17,100,,,,,0,"fee schedule","100% of WA fee schedule",536,50,,428.80,,,0,"percent of total billed charges","50% of total billed charges",885.47,82.6,,708.38,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",701.7,100,,,,,0,"fee schedule",EAPG,1072,100,,857.60,,,0,"percent of total billed charges","100% of total billed charges",164.02,1072,
"90966 esrd home pt services per month 20 yrs",7963613,CDM,521,RC,90966,CPT,OUTPATIENT,,,567,368.55,,498.96,88,,399.17,,,0,"percent of total billed charges","88% of total billed charges",283.5,50,,226.80,,,0,"percent of total billed charges","50% of total billed charges",541.17,100,,,,,0,"fee schedule",EAPG,567,100,,453.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",557.41,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",357.21,63,,285.77,,,0,"percent of total billed charges","63% of total billed charges",86.75,15.3,,69.40,,,0,"percent of total billed charges","15.3% of total billed charges",541.17,100,,,,,0,"fee schedule",EAPG,391.23,69,,,,,0,"fee schedule","69% of total billed charges",567,100,,453.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",567,100,,453.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",567,100,,453.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",350.69,61.85,,280.55,,,0,"percent of total billed charges","61.5% of total billed charges",541.17,100,,,,,0,"fee schedule",EAPG,283.5,50,,226.80,,,0,"percent of total billed charges","50% of total billed charges",182.57,32.2,,146.06,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",551.99,100,,,,,0,"fee schedule",EAPG,703.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",213.76,37.7,,171.01,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",442.26,78,,353.81,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",468.34,82.6,,374.67,,,0,"percent of total billed charges","82.6% of total billed charges",541.17,100,,,,,0,"fee schedule","100% of WA fee schedule",283.5,50,,226.80,,,0,"percent of total billed charges","50% of total billed charges",468.34,82.6,,374.67,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",701.7,100,,,,,0,"fee schedule",EAPG,567,100,,453.60,,,0,"percent of total billed charges","100% of total billed charges",86.75,703.52,
"90962 esrd serv 1 visit 20yrs and older",7963699,CDM,521,RC,90962,CPT,OUTPATIENT,,,438,284.7,,385.44,88,,308.35,,,0,"percent of total billed charges","88% of total billed charges",219,50,,175.20,,,0,"percent of total billed charges","50% of total billed charges",541.17,100,,,,,0,"fee schedule",EAPG,438,100,,350.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",557.41,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",275.94,63,,220.75,,,0,"percent of total billed charges","63% of total billed charges",67.01,15.3,,53.61,,,0,"percent of total billed charges","15.3% of total billed charges",541.17,100,,,,,0,"fee schedule",EAPG,302.22,69,,,,,0,"fee schedule","69% of total billed charges",438,100,,350.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",438,100,,350.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",438,100,,350.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",270.9,61.85,,216.72,,,0,"percent of total billed charges","61.5% of total billed charges",541.17,100,,,,,0,"fee schedule",EAPG,219,50,,175.20,,,0,"percent of total billed charges","50% of total billed charges",141.04,32.2,,112.83,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",551.99,100,,,,,0,"fee schedule",EAPG,703.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",165.13,37.7,,132.10,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",341.64,78,,273.31,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",361.79,82.6,,289.43,,,0,"percent of total billed charges","82.6% of total billed charges",541.17,100,,,,,0,"fee schedule","100% of WA fee schedule",219,50,,175.20,,,0,"percent of total billed charges","50% of total billed charges",361.79,82.6,,289.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",701.7,100,,,,,0,"fee schedule",EAPG,438,100,,350.40,,,0,"percent of total billed charges","100% of total billed charges",67.01,703.52,
"90960 esrd srv 4 visits p mo 20+",7963826,CDM,521,RC,90960,CPT,OUTPATIENT,,,604,392.6,,531.52,88,,425.22,,,0,"percent of total billed charges","88% of total billed charges",302,50,,241.60,,,0,"percent of total billed charges","50% of total billed charges",541.17,100,,,,,0,"fee schedule",EAPG,604,100,,483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",557.41,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",380.52,63,,304.42,,,0,"percent of total billed charges","63% of total billed charges",92.41,15.3,,73.93,,,0,"percent of total billed charges","15.3% of total billed charges",541.17,100,,,,,0,"fee schedule",EAPG,416.76,69,,,,,0,"fee schedule","69% of total billed charges",604,100,,483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",604,100,,483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",604,100,,483.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",373.57,61.85,,298.86,,,0,"percent of total billed charges","61.5% of total billed charges",541.17,100,,,,,0,"fee schedule",EAPG,302,50,,241.60,,,0,"percent of total billed charges","50% of total billed charges",194.49,32.2,,155.59,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",551.99,100,,,,,0,"fee schedule",EAPG,703.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",227.71,37.7,,182.17,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",471.12,78,,376.90,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",498.9,82.6,,399.12,,,0,"percent of total billed charges","82.6% of total billed charges",541.17,100,,,,,0,"fee schedule","100% of WA fee schedule",302,50,,241.60,,,0,"percent of total billed charges","50% of total billed charges",498.9,82.6,,399.12,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",701.7,100,,,,,0,"fee schedule",EAPG,604,100,,483.20,,,0,"percent of total billed charges","100% of total billed charges",92.41,703.52,
"90961 esrd srv 2-3 vsts p mo 20+",7963827,CDM,521,RC,90961,CPT,OUTPATIENT,,,508,330.2,,447.04,88,,357.63,,,0,"percent of total billed charges","88% of total billed charges",254,50,,203.20,,,0,"percent of total billed charges","50% of total billed charges",541.17,100,,,,,0,"fee schedule",EAPG,508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",557.41,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",320.04,63,,256.03,,,0,"percent of total billed charges","63% of total billed charges",77.72,15.3,,62.18,,,0,"percent of total billed charges","15.3% of total billed charges",541.17,100,,,,,0,"fee schedule",EAPG,350.52,69,,,,,0,"fee schedule","69% of total billed charges",508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",314.2,61.85,,251.36,,,0,"percent of total billed charges","61.5% of total billed charges",541.17,100,,,,,0,"fee schedule",EAPG,254,50,,203.20,,,0,"percent of total billed charges","50% of total billed charges",163.58,32.2,,130.86,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",551.99,100,,,,,0,"fee schedule",EAPG,703.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",191.52,37.7,,153.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",396.24,78,,316.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",419.61,82.6,,335.69,,,0,"percent of total billed charges","82.6% of total billed charges",541.17,100,,,,,0,"fee schedule","100% of WA fee schedule",254,50,,203.20,,,0,"percent of total billed charges","50% of total billed charges",419.61,82.6,,335.69,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",701.7,100,,,,,0,"fee schedule",EAPG,508,100,,406.40,,,0,"percent of total billed charges","100% of total billed charges",77.72,703.52,
"92014 Eye exam comprehensive established patient",7898900,CDM,521,RC,92014,CPT,OUTPATIENT,,,185,120.25,,162.8,88,,130.24,,,0,"percent of total billed charges","88% of total billed charges",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",235.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",116.55,63,,93.24,,,0,"percent of total billed charges","63% of total billed charges",28.31,15.3,,22.65,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",127.65,69,,,,,0,"fee schedule","69% of total billed charges",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",134.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",482.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",126.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",69.75,37.7,,55.80,,,0,"percent of total billed charges","37.70% of total billed charges",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",144.3,78,,115.44,,,0,"percent of total billed charges","78% of total billed charges",136.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",152.81,82.6,,122.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",152.81,82.6,,122.25,,,0,"percent of total billed charges","82.6% of total billed charges",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"case rate","pays based on per visit rate",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",28.31,482.38,
"92081 Visual field exam LTD",7898904,CDM,521,RC,92081,CPT,OUTPATIENT,,,84,54.6,,73.92,88,,59.14,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.54,100,,,,,0,"fee schedule",EAPG,84,100,,67.20,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",67.51,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.92,63,,42.34,,,0,"percent of total billed charges","63% of total billed charges",12.85,15.3,,10.28,,,0,"percent of total billed charges","15.3% of total billed charges",65.54,100,,,,,0,"fee schedule",EAPG,57.96,69,,,,,0,"fee schedule","69% of total billed charges",84,100,,67.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",84,100,,67.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",84,100,,67.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.54,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.85,100,,,,,0,"fee schedule",EAPG,85.21,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",31.67,37.7,,25.34,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.52,78,,52.42,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",69.38,82.6,,55.50,,,0,"percent of total billed charges","82.6% of total billed charges",65.54,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",69.38,82.6,,55.50,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",226.07,100,,,,,0,"fee schedule",EAPG,84,100,,67.20,,,0,"percent of total billed charges","100% of total billed charges",12.85,226.12,
"92100 Eye-Glaucoma Check Serial Tonometry w/ inter",7962690,CDM,521,RC,92100,CPT,OUTPATIENT,,,191,124.15,,168.08,88,,134.46,,,0,"percent of total billed charges","88% of total billed charges",95.5,50,,76.40,,,0,"percent of total billed charges","50% of total billed charges",65.54,100,,,,,0,"fee schedule",EAPG,191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.51,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",120.33,63,,96.26,,,0,"percent of total billed charges","63% of total billed charges",29.22,15.3,,23.38,,,0,"percent of total billed charges","15.3% of total billed charges",65.54,100,,,,,0,"fee schedule",EAPG,131.79,69,,,,,0,"fee schedule","69% of total billed charges",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",118.13,61.85,,94.50,,,0,"percent of total billed charges","61.5% of total billed charges",65.54,100,,,,,0,"fee schedule",EAPG,95.5,50,,76.40,,,0,"percent of total billed charges","50% of total billed charges",61.5,32.2,,49.20,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",66.85,100,,,,,0,"fee schedule",EAPG,85.21,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",72.01,37.7,,57.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",148.98,78,,119.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.77,82.6,,126.22,,,0,"percent of total billed charges","82.6% of total billed charges",65.54,100,,,,,0,"fee schedule",EAPG,95.5,50,,76.40,,,0,"percent of total billed charges","50% of total billed charges",157.77,82.6,,126.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",226.07,100,,,,,0,"fee schedule",EAPG,191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",29.22,226.07,
"92502 Otolaryngologic examination under general an",7963340,CDM,521,RC,92502,CPT,OUTPATIENT,,,198,128.7,,174.24,88,,139.39,,,0,"percent of total billed charges","88% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",982.07,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.74,63,,99.79,,,0,"percent of total billed charges","63% of total billed charges",30.29,15.3,,24.23,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,136.62,69,,,,,0,"fee schedule","69% of total billed charges",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",1837.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",480.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",74.65,37.7,,59.72,,,0,"percent of total billed charges","37.70% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.44,78,,123.55,,,0,"percent of total billed charges","78% of total billed charges",566.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",163.55,82.6,,130.84,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",163.55,82.6,,130.84,,,0,"percent of total billed charges","82.6% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.63,100,,,,,0,"fee schedule",EAPG,198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",30.29,1837.71,
"92504 Binocular microscopy (separate diagnostic pr",7963341,CDM,521,RC,92504,CPT,OUTPATIENT,,,71,46.15,,62.48,88,,49.98,,,0,"percent of total billed charges","88% of total billed charges",35.5,50,,28.40,,,0,"percent of total billed charges","50% of total billed charges",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.29,17.304,,9.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.73,63,,35.78,,,0,"percent of total billed charges","63% of total billed charges",10.86,15.3,,8.69,,,0,"percent of total billed charges","15.3% of total billed charges",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",48.99,69,,,,,0,"fee schedule","69% of total billed charges",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.91,61.85,,35.13,,,0,"percent of total billed charges","61.5% of total billed charges",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",35.5,50,,28.40,,,0,"percent of total billed charges","50% of total billed charges",22.86,32.2,,18.29,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.17,17.136,,9.74,,,0,"percent of total billed charges","17.136% of total billed charges",15.51,21.84,,12.41,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.77,37.7,,21.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",55.38,78,,44.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.65,82.6,,46.92,,,0,"percent of total billed charges","82.6% of total billed charges",11.93,16.8,,9.54,,,0,"percent of total billed charges","16.8% of total billed charges",35.5,50,,28.40,,,0,"percent of total billed charges","50% of total billed charges",58.65,82.6,,46.92,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",10.86,160.53,
"92506 auditory function test",7963875,CDM,521,RC,92506,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",47.5,50,,38.00,,,0,"percent of total billed charges","50% of total billed charges",15.96,16.8,,12.77,,,0,"percent of total billed charges","16.8% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.44,17.304,,13.15,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",15.96,16.8,,12.77,,,0,"percent of total billed charges","16.8% of total billed charges",65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.76,61.85,,47.01,,,0,"percent of total billed charges","61.5% of total billed charges",15.96,16.8,,12.77,,,0,"percent of total billed charges","16.8% of total billed charges",47.5,50,,38.00,,,0,"percent of total billed charges","50% of total billed charges",30.59,32.2,,24.47,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.28,17.136,,13.02,,,0,"percent of total billed charges","17.136% of total billed charges",20.75,21.84,,16.60,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",15.96,16.8,,12.77,,,0,"percent of total billed charges","16.8% of total billed charges",47.5,50,,38.00,,,0,"percent of total billed charges","50% of total billed charges",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,160.53,
"92511 Nasopharyngoscopy with endoscope",7903317,CDM,521,RC,92511,CPT,OUTPATIENT,,,344,223.6,,302.72,88,,242.18,,,0,"percent of total billed charges","88% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",353.55,175,,,,,0,"fee schedule","175% of CMS fee schedule",103.1,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,63,,173.38,,,0,"percent of total billed charges","63% of total billed charges",52.63,15.3,,42.10,,,0,"percent of total billed charges","15.3% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,237.36,69,,,,,0,"fee schedule","69% of total billed charges",344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS fee schedule",667.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.1,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",174.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.1,100,,,,,0,"fee schedule",EAPG,130.13,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",129.69,37.7,,103.75,,,0,"percent of total billed charges","37.70% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",268.32,78,,214.66,,,0,"percent of total billed charges","78% of total billed charges",204.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.14,82.6,,227.31,,,0,"percent of total billed charges","82.6% of total billed charges",100.1,100,,,,,0,"fee schedule",EAPG,202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.14,82.6,,227.31,,,0,"percent of total billed charges","82.6% of total billed charges",202.03,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.63,100,,,,,0,"fee schedule",EAPG,344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",52.63,667.83,
"92550 Tympanometry and reflex threshold",7901073,CDM,521,RC,92550,CPT,OUTPATIENT,,,39,25.35,,34.32,88,,27.46,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",75.82,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.57,63,,19.66,,,0,"percent of total billed charges","63% of total billed charges",5.97,15.3,,4.78,,,0,"percent of total billed charges","15.3% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,26.91,69,,,,,0,"fee schedule","69% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75.09,100,,,,,0,"fee schedule",EAPG,95.7,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",30.42,78,,24.34,,,0,"percent of total billed charges","78% of total billed charges",160.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.14,100,,,,,0,"fee schedule",EAPG,39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",5.97,566.92,
"92551 Hearing screen greater than 3 yrs",7901074,CDM,521,RC,92551,CPT,OUTPATIENT,,,38,24.7,,33.44,88,,26.75,,,0,"percent of total billed charges","88% of total billed charges",19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.11,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",23.94,63,,19.15,,,0,"percent of total billed charges","63% of total billed charges",5.81,15.3,,4.65,,,0,"percent of total billed charges","15.3% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,26.22,69,,,,,0,"fee schedule","69% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.5,61.85,,18.80,,,0,"percent of total billed charges","61.5% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",12.24,32.2,,9.79,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",31.8,100,,,,,0,"fee schedule",EAPG,40.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.33,37.7,,11.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.64,78,,23.71,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.71,100,,,,,0,"fee schedule",EAPG,38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",5.81,191.71,
"92552 Pure tone audiometry (threshold); air only",7903322,CDM,521,RC,92552,CPT,OUTPATIENT,,,56,36.4,,49.28,88,,39.42,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.18,100,,,,,0,"fee schedule",EAPG,56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",32.11,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.28,63,,28.22,,,0,"percent of total billed charges","63% of total billed charges",8.57,15.3,,6.86,,,0,"percent of total billed charges","15.3% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,38.64,69,,,,,0,"fee schedule","69% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.18,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.8,100,,,,,0,"fee schedule",EAPG,40.53,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",21.11,37.7,,16.89,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",43.68,78,,34.94,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191.71,100,,,,,0,"fee schedule",EAPG,56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",8.57,454.8,
"92557 Comprehensive audiometry threshold evaluatio",7962895,CDM,521,RC,92557,CPT,OUTPATIENT,,,98,63.7,,86.24,88,,68.99,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",75.82,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.74,63,,49.39,,,0,"percent of total billed charges","63% of total billed charges",14.99,15.3,,11.99,,,0,"percent of total billed charges","15.3% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,67.62,69,,,,,0,"fee schedule","69% of total billed charges",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75.09,100,,,,,0,"fee schedule",EAPG,95.7,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",36.95,37.7,,29.56,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",76.44,78,,61.15,,,0,"percent of total billed charges","78% of total billed charges",160.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.95,82.6,,64.76,,,0,"percent of total billed charges","82.6% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.95,82.6,,64.76,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.14,100,,,,,0,"fee schedule",EAPG,98,100,,78.40,,,0,"percent of total billed charges","100% of total billed charges",14.99,566.92,
"92556 Speech audiometry threshold; with speech rec",7963342,CDM,521,RC,92556,CPT,OUTPATIENT,,,55,35.75,,48.4,88,,38.72,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.18,100,,,,,0,"fee schedule",EAPG,55,100,,44.00,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",32.11,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.65,63,,27.72,,,0,"percent of total billed charges","63% of total billed charges",8.42,15.3,,6.74,,,0,"percent of total billed charges","15.3% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,37.95,69,,,,,0,"fee schedule","69% of total billed charges",55,100,,44.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",55,100,,44.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",55,100,,44.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.18,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.8,100,,,,,0,"fee schedule",EAPG,40.53,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",20.74,37.7,,16.59,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42.9,78,,34.32,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",45.43,82.6,,36.34,,,0,"percent of total billed charges","82.6% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",45.43,82.6,,36.34,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191.71,100,,,,,0,"fee schedule",EAPG,55,100,,44.00,,,0,"percent of total billed charges","100% of total billed charges",8.42,226.12,
"92553 Pure tone audiometry (threshold); air and bo",7963472,CDM,521,RC,92553,CPT,OUTPATIENT,,,63,40.95,,55.44,88,,44.35,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",75.82,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.69,63,,31.75,,,0,"percent of total billed charges","63% of total billed charges",9.64,15.3,,7.71,,,0,"percent of total billed charges","15.3% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,43.47,69,,,,,0,"fee schedule","69% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75.09,100,,,,,0,"fee schedule",EAPG,95.7,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",23.75,37.7,,19.00,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",49.14,78,,39.31,,,0,"percent of total billed charges","78% of total billed charges",160.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.04,82.6,,41.63,,,0,"percent of total billed charges","82.6% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.04,82.6,,41.63,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.14,100,,,,,0,"fee schedule",EAPG,63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",9.64,566.92,
"92555 Speech audiometry threshold;",7963780,CDM,521,RC,92555,CPT,OUTPATIENT,,,46,29.9,,40.48,88,,32.38,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.18,100,,,,,0,"fee schedule",EAPG,46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",32.11,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",28.98,63,,23.18,,,0,"percent of total billed charges","63% of total billed charges",7.04,15.3,,5.63,,,0,"percent of total billed charges","15.3% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,31.74,69,,,,,0,"fee schedule","69% of total billed charges",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.18,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.8,100,,,,,0,"fee schedule",EAPG,40.53,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",17.34,37.7,,13.87,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.88,78,,28.70,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38,82.6,,30.40,,,0,"percent of total billed charges","82.6% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38,82.6,,30.40,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191.71,100,,,,,0,"fee schedule",EAPG,46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",7.04,191.71,
"92568 Acoustic reflex testing, threshold",7963686,CDM,521,RC,92568,CPT,OUTPATIENT,,,39,25.35,,34.32,88,,27.46,,,0,"percent of total billed charges","88% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.18,100,,,,,0,"fee schedule",EAPG,39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",71.58,175,,,,,0,"fee schedule","175% of CMS fee schedule",32.11,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.57,63,,19.66,,,0,"percent of total billed charges","63% of total billed charges",5.97,15.3,,4.78,,,0,"percent of total billed charges","15.3% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,26.91,69,,,,,0,"fee schedule","69% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.18,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.8,100,,,,,0,"fee schedule",EAPG,40.53,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.70% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",30.42,78,,24.34,,,0,"percent of total billed charges","78% of total billed charges",41.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191.71,100,,,,,0,"fee schedule",EAPG,39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",5.97,191.71,
"92567 Tympanometry (impedance testing)",7963720,CDM,521,RC,92567,CPT,OUTPATIENT,,,44,28.6,,38.72,88,,30.98,,,0,"percent of total billed charges","88% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.18,100,,,,,0,"fee schedule",EAPG,44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",71.58,175,,,,,0,"fee schedule","175% of CMS fee schedule",32.11,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",27.72,63,,22.18,,,0,"percent of total billed charges","63% of total billed charges",6.73,15.3,,5.38,,,0,"percent of total billed charges","15.3% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,30.36,69,,,,,0,"fee schedule","69% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.18,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.8,100,,,,,0,"fee schedule",EAPG,40.53,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",16.59,37.7,,13.27,,,0,"percent of total billed charges","37.70% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.32,78,,27.46,,,0,"percent of total billed charges","78% of total billed charges",41.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",40.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191.71,100,,,,,0,"fee schedule",EAPG,44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",6.73,191.71,
"92565 Stenger test, pure tone",7963873,CDM,521,RC,92565,CPT,OUTPATIENT,,,39,25.35,,34.32,88,,27.46,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.18,100,,,,,0,"fee schedule",EAPG,39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",32.11,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.57,63,,19.66,,,0,"percent of total billed charges","63% of total billed charges",5.97,15.3,,4.78,,,0,"percent of total billed charges","15.3% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,26.91,69,,,,,0,"fee schedule","69% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",137.47,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.18,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.8,100,,,,,0,"fee schedule",EAPG,40.53,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",30.42,78,,24.34,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",31.18,100,,,,,0,"fee schedule","100% of WA fee schedule",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191.71,100,,,,,0,"fee schedule",EAPG,39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",5.97,191.71,
"92579 Visual reinforcement audiometry (VRA)",7963651,CDM,521,RC,92579,CPT,OUTPATIENT,,,95,61.75,,83.6,88,,66.88,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",75.82,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.85,63,,47.88,,,0,"percent of total billed charges","63% of total billed charges",14.54,15.3,,11.63,,,0,"percent of total billed charges","15.3% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,65.55,69,,,,,0,"fee schedule","69% of total billed charges",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75.09,100,,,,,0,"fee schedule",EAPG,95.7,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",35.82,37.7,,28.66,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.1,78,,59.28,,,0,"percent of total billed charges","78% of total billed charges",160.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",78.47,82.6,,62.78,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.14,100,,,,,0,"fee schedule",EAPG,95,100,,76.00,,,0,"percent of total billed charges","100% of total billed charges",14.54,566.92,
"92570 acoustic immittance testing",7963798,CDM,521,RC,92570,CPT,OUTPATIENT,,,79,51.35,,69.52,88,,55.62,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",75.82,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",49.77,63,,39.82,,,0,"percent of total billed charges","63% of total billed charges",12.09,15.3,,9.67,,,0,"percent of total billed charges","15.3% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,54.51,69,,,,,0,"fee schedule","69% of total billed charges",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75.09,100,,,,,0,"fee schedule",EAPG,95.7,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",29.78,37.7,,23.82,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.62,78,,49.30,,,0,"percent of total billed charges","78% of total billed charges",160.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.25,82.6,,52.20,,,0,"percent of total billed charges","82.6% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.25,82.6,,52.20,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.14,100,,,,,0,"fee schedule",EAPG,79,100,,63.20,,,0,"percent of total billed charges","100% of total billed charges",12.09,566.92,
"92577 Stenger test, speech",7963900,CDM,521,RC,92577,CPT,OUTPATIENT,,,38,24.7,,33.44,88,,26.75,,,0,"percent of total billed charges","88% of total billed charges",546.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",956.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",75.82,100,,,,,0,"fee schedule",EAPG,546.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.94,63,,19.15,,,0,"percent of total billed charges","63% of total billed charges",5.81,15.3,,4.65,,,0,"percent of total billed charges","15.3% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,26.22,69,,,,,0,"fee schedule","69% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",546.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",546.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",546.68,100,,,,,0,"fee schedule","100% of CMS fee schedule",1981.62,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,546.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",518.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",546.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75.09,100,,,,,0,"fee schedule",EAPG,95.7,100,,,,,0,"fee schedule",EAPG,546.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",14.33,37.7,,11.46,,,0,"percent of total billed charges","37.70% of total billed charges",546.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",546.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.64,78,,23.71,,,0,"percent of total billed charges","78% of total billed charges",552.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",73.61,100,,,,,0,"fee schedule","100% of WA fee schedule",546.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",546.68,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.14,100,,,,,0,"fee schedule",EAPG,38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",5.81,1981.62,
"92588 Evoked otoacoustic emissions; comprehensive",7961781,CDM,521,RC,92588,CPT,OUTPATIENT,,,81,52.65,,71.28,88,,57.02,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",75.82,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.03,63,,40.82,,,0,"percent of total billed charges","63% of total billed charges",12.39,15.3,,9.91,,,0,"percent of total billed charges","15.3% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,55.89,69,,,,,0,"fee schedule","69% of total billed charges",81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75.09,100,,,,,0,"fee schedule",EAPG,95.7,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",30.54,37.7,,24.43,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",63.18,78,,50.54,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.91,82.6,,53.53,,,0,"percent of total billed charges","82.6% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.91,82.6,,53.53,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.14,100,,,,,0,"fee schedule",EAPG,81,100,,64.80,,,0,"percent of total billed charges","100% of total billed charges",12.39,1074.33,
"92585 Evoked response audiometry and/or testing of",7962266,CDM,521,RC,,,OUTPATIENT,,,367,238.55,,322.96,88,,258.37,,,0,"percent of total billed charges","88% of total billed charges",183.5,50,,146.80,,,0,"percent of total billed charges","50% of total billed charges",61.66,16.8,,49.33,,,0,"percent of total billed charges","16.8% of total billed charges",367,100,,293.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.51,17.304,,50.81,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.21,63,,184.97,,,0,"percent of total billed charges","63% of total billed charges",56.15,15.3,,44.92,,,0,"percent of total billed charges","15.3% of total billed charges",61.66,16.8,,49.33,,,0,"percent of total billed charges","16.8% of total billed charges",253.23,69,,,,,0,"fee schedule","69% of total billed charges",367,100,,293.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",367,100,,293.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",367,100,,293.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",226.99,61.85,,181.59,,,0,"percent of total billed charges","61.5% of total billed charges",61.66,16.8,,49.33,,,0,"percent of total billed charges","16.8% of total billed charges",183.5,50,,146.80,,,0,"percent of total billed charges","50% of total billed charges",118.17,32.2,,94.54,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",62.89,17.136,,50.31,,,0,"percent of total billed charges","17.136% of total billed charges",80.15,21.84,,64.12,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",138.36,37.7,,110.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",286.26,78,,229.01,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",303.14,82.6,,242.51,,,0,"percent of total billed charges","82.6% of total billed charges",61.66,16.8,,49.33,,,0,"percent of total billed charges","16.8% of total billed charges",183.5,50,,146.80,,,0,"percent of total billed charges","50% of total billed charges",303.14,82.6,,242.51,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",367,100,,293.60,,,0,"percent of total billed charges","100% of total billed charges",56.15,367,
"92587 Evoked otoacoustic emissions; limited evalua",7962484,CDM,521,RC,92587,CPT,OUTPATIENT,,,93,60.45,,81.84,88,,65.47,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",75.82,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",58.59,63,,46.87,,,0,"percent of total billed charges","63% of total billed charges",14.23,15.3,,11.38,,,0,"percent of total billed charges","15.3% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,64.17,69,,,,,0,"fee schedule","69% of total billed charges",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75.09,100,,,,,0,"fee schedule",EAPG,95.7,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",35.06,37.7,,28.05,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",72.54,78,,58.03,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",76.82,82.6,,61.46,,,0,"percent of total billed charges","82.6% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",76.82,82.6,,61.46,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.14,100,,,,,0,"fee schedule",EAPG,93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",14.23,1074.33,
"92582 Conditioning play audiometry",7963781,CDM,521,RC,92582,CPT,OUTPATIENT,,,88,57.2,,77.44,88,,61.95,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",75.82,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",55.44,63,,44.35,,,0,"percent of total billed charges","63% of total billed charges",13.46,15.3,,10.77,,,0,"percent of total billed charges","15.3% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,60.72,69,,,,,0,"fee schedule","69% of total billed charges",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.61,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75.09,100,,,,,0,"fee schedule",EAPG,95.7,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",33.18,37.7,,26.54,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",68.64,78,,54.91,,,0,"percent of total billed charges","78% of total billed charges",160.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",73.61,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234.14,100,,,,,0,"fee schedule",EAPG,88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",13.46,566.92,
"92583 Select picture audiometry",7963850,CDM,521,RC,92583,CPT,OUTPATIENT,,,88,57.2,,77.44,88,,61.95,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.18,100,,,,,0,"fee schedule",EAPG,88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",32.11,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",55.44,63,,44.35,,,0,"percent of total billed charges","63% of total billed charges",13.46,15.3,,10.77,,,0,"percent of total billed charges","15.3% of total billed charges",31.18,100,,,,,0,"fee schedule",EAPG,60.72,69,,,,,0,"fee schedule","69% of total billed charges",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.18,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.8,100,,,,,0,"fee schedule",EAPG,40.53,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",33.18,37.7,,26.54,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",68.64,78,,54.91,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",31.18,100,,,,,0,"fee schedule","100% of WA fee schedule",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191.71,100,,,,,0,"fee schedule",EAPG,88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",13.46,226.12,
"92924 Atherectomy, with coronary angioplasty when",7961642,CDM,521,RC,92924,CPT,OUTPATIENT,,,1934,1257.1,,1701.92,88,,1361.54,,,0,"percent of total billed charges","88% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7748.35,100,,,,,0,"fee schedule",EAPG,1934,100,,1547.20,,,0,"percent of total billed charges","100% of total billed charges",19636.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",7980.8,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1218.42,63,,974.74,,,0,"percent of total billed charges","63% of total billed charges",295.9,15.3,,236.72,,,0,"percent of total billed charges","15.3% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,1334.46,69,,,,,0,"fee schedule","69% of total billed charges",1934,100,,1547.20,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1934,100,,1547.20,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1934,100,,1547.20,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",40799.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7748.35,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10666.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7903.32,100,,,,,0,"fee schedule",EAPG,10072.86,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",729.12,37.7,,583.30,,,0,"percent of total billed charges","37.70% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1508.52,78,,1206.82,,,0,"percent of total billed charges","78% of total billed charges",11332.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1597.48,82.6,,1277.98,,,0,"percent of total billed charges","82.6% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1597.48,82.6,,1277.98,,,0,"percent of total billed charges","82.6% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7908.88,100,,,,,0,"fee schedule",EAPG,1934,100,,1547.20,,,0,"percent of total billed charges","100% of total billed charges",295.9,40799.76,
"92928 Stent(s) placement, w/ angioplasty when perf",7961882,CDM,521,RC,92928,CPT,OUTPATIENT,,,1738,1129.7,,1529.44,88,,1223.55,,,0,"percent of total billed charges","88% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7748.35,100,,,,,0,"fee schedule",EAPG,1738,100,,1390.40,,,0,"percent of total billed charges","100% of total billed charges",19636.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",7980.8,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1094.94,63,,875.95,,,0,"percent of total billed charges","63% of total billed charges",265.91,15.3,,212.73,,,0,"percent of total billed charges","15.3% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,1199.22,69,,,,,0,"fee schedule","69% of total billed charges",1738,100,,1390.40,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1738,100,,1390.40,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1738,100,,1390.40,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",40799.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7748.35,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10666.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7903.32,100,,,,,0,"fee schedule",EAPG,10072.86,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",655.23,37.7,,524.18,,,0,"percent of total billed charges","37.70% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1355.64,78,,1084.51,,,0,"percent of total billed charges","78% of total billed charges",11332.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1435.59,82.6,,1148.47,,,0,"percent of total billed charges","82.6% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1435.59,82.6,,1148.47,,,0,"percent of total billed charges","82.6% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7908.88,100,,,,,0,"fee schedule",EAPG,1738,100,,1390.40,,,0,"percent of total billed charges","100% of total billed charges",265.91,40799.76,
"92920 Angioplasty; single major coronary artery or",7963370,CDM,521,RC,92920,CPT,OUTPATIENT,,,1565,1017.25,,1377.2,88,,1101.76,,,0,"percent of total billed charges","88% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7748.35,100,,,,,0,"fee schedule",EAPG,1565,100,,1252.00,,,0,"percent of total billed charges","100% of total billed charges",10202.1,175,,,,,0,"fee schedule","175% of CMS fee schedule",7980.8,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",985.95,63,,788.76,,,0,"percent of total billed charges","63% of total billed charges",239.45,15.3,,191.56,,,0,"percent of total billed charges","15.3% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,1079.85,69,,,,,0,"fee schedule","69% of total billed charges",1565,100,,1252.00,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1565,100,,1252.00,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1565,100,,1252.00,,,0,"percent of total billed charges","100% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",20137.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7748.35,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5264.65,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7903.32,100,,,,,0,"fee schedule",EAPG,10072.86,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",590.01,37.7,,472.01,,,0,"percent of total billed charges","37.70% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1220.7,78,,976.56,,,0,"percent of total billed charges","78% of total billed charges",5888.05,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1292.69,82.6,,1034.15,,,0,"percent of total billed charges","82.6% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1292.69,82.6,,1034.15,,,0,"percent of total billed charges","82.6% of total billed charges",5829.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7908.88,100,,,,,0,"fee schedule",EAPG,1565,100,,1252.00,,,0,"percent of total billed charges","100% of total billed charges",239.45,20137.31,
"92937 Revascularization of/through coronary artery",7961883,CDM,521,RC,92937,CPT,OUTPATIENT,,,1736,1128.4,,1527.68,88,,1222.14,,,0,"percent of total billed charges","88% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7748.35,100,,,,,0,"fee schedule",EAPG,1736,100,,1388.80,,,0,"percent of total billed charges","100% of total billed charges",19636.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",7980.8,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1093.68,63,,874.94,,,0,"percent of total billed charges","63% of total billed charges",265.61,15.3,,212.49,,,0,"percent of total billed charges","15.3% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,1197.84,69,,,,,0,"fee schedule","69% of total billed charges",1736,100,,1388.80,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1736,100,,1388.80,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1736,100,,1388.80,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",40799.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7748.35,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10666.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7903.32,100,,,,,0,"fee schedule",EAPG,10072.86,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",654.47,37.7,,523.58,,,0,"percent of total billed charges","37.70% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1354.08,78,,1083.26,,,0,"percent of total billed charges","78% of total billed charges",11332.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1433.94,82.6,,1147.15,,,0,"percent of total billed charges","82.6% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1433.94,82.6,,1147.15,,,0,"percent of total billed charges","82.6% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7908.88,100,,,,,0,"fee schedule",EAPG,1736,100,,1388.80,,,0,"percent of total billed charges","100% of total billed charges",265.61,40799.76,
"92933 Atherectomy, w/ stent, w/ coronary angioplas",7962267,CDM,521,RC,92933,CPT,OUTPATIENT,,,1944,1263.6,,1710.72,88,,1368.58,,,0,"percent of total billed charges","88% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7748.35,100,,,,,0,"fee schedule",EAPG,1944,100,,1555.20,,,0,"percent of total billed charges","100% of total billed charges",31299.05,175,,,,,0,"fee schedule","175% of CMS fee schedule",7980.8,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1224.72,63,,979.78,,,0,"percent of total billed charges","63% of total billed charges",297.43,15.3,,237.94,,,0,"percent of total billed charges","15.3% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,1341.36,69,,,,,0,"fee schedule","69% of total billed charges",1944,100,,1555.20,,,0,"percent of total billed charges","100% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1944,100,,1555.20,,,0,"percent of total billed charges","100% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1944,100,,1555.20,,,0,"percent of total billed charges","100% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS fee schedule",65260.52,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7748.35,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17061.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7903.32,100,,,,,0,"fee schedule",EAPG,10072.86,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",732.89,37.7,,586.31,,,0,"percent of total billed charges","37.70% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1516.32,78,,1213.06,,,0,"percent of total billed charges","78% of total billed charges",18064.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1605.74,82.6,,1284.59,,,0,"percent of total billed charges","82.6% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1605.74,82.6,,1284.59,,,0,"percent of total billed charges","82.6% of total billed charges",17885.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7908.88,100,,,,,0,"fee schedule",EAPG,1944,100,,1555.20,,,0,"percent of total billed charges","100% of total billed charges",297.43,65260.52,
"92941 Revascularization acute sub/total occlusion",7961644,CDM,521,RC,92941,CPT,OUTPATIENT,,,1948,1266.2,,1714.24,88,,1371.39,,,0,"percent of total billed charges","88% of total billed charges",1948,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7748.35,100,,,,,0,"fee schedule",EAPG,1948,100,,1558.40,,,0,"percent of total billed charges","100% of total billed charges",1948,175,,,,,0,"fee schedule","175% of CMS fee schedule",7980.8,100,,,,,0,"fee schedule",EAPG,1948,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1227.24,63,,981.79,,,0,"percent of total billed charges","63% of total billed charges",298.04,15.3,,238.43,,,0,"percent of total billed charges","15.3% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,1344.12,69,,,,,0,"fee schedule","69% of total billed charges",1948,100,,1558.40,,,0,"percent of total billed charges","100% of total billed charges",1948,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1948,100,,1558.40,,,0,"percent of total billed charges","100% of total billed charges",1948,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1948,100,,1558.40,,,0,"percent of total billed charges","100% of total billed charges",1948,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1948,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7748.35,100,,,,,0,"fee schedule",EAPG,1948,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1948,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1948,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7903.32,100,,,,,0,"fee schedule",EAPG,10072.86,100,,,,,0,"fee schedule",EAPG,1948,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",734.4,37.7,,587.52,,,0,"percent of total billed charges","37.70% of total billed charges",1948,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1948,100,,,,,0,"fee schedule","100% of CMS fee schedule",1519.44,78,,1215.55,,,0,"percent of total billed charges","78% of total billed charges",1948,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1609.05,82.6,,1287.24,,,0,"percent of total billed charges","82.6% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,1948,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",1609.05,82.6,,1287.24,,,0,"percent of total billed charges","82.6% of total billed charges",1948,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",7908.88,100,,,,,0,"fee schedule",EAPG,1948,100,,1558.40,,,0,"percent of total billed charges","100% of total billed charges",298.04,10072.86,
"92943 Revascularization chronic total occlusion; s",7963234,CDM,521,RC,92943,CPT,OUTPATIENT,,,1948,1266.2,,1714.24,88,,1371.39,,,0,"percent of total billed charges","88% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7748.35,100,,,,,0,"fee schedule",EAPG,1948,100,,1558.40,,,0,"percent of total billed charges","100% of total billed charges",19636.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",7980.8,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1227.24,63,,981.79,,,0,"percent of total billed charges","63% of total billed charges",298.04,15.3,,238.43,,,0,"percent of total billed charges","15.3% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,1344.12,69,,,,,0,"fee schedule","69% of total billed charges",1948,100,,1558.40,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1948,100,,1558.40,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1948,100,,1558.40,,,0,"percent of total billed charges","100% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",40799.76,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7748.35,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10666.6,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7903.32,100,,,,,0,"fee schedule",EAPG,10072.86,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",734.4,37.7,,587.52,,,0,"percent of total billed charges","37.70% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1519.44,78,,1215.55,,,0,"percent of total billed charges","78% of total billed charges",11332.97,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1609.05,82.6,,1287.24,,,0,"percent of total billed charges","82.6% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1609.05,82.6,,1287.24,,,0,"percent of total billed charges","82.6% of total billed charges",11220.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",7908.88,100,,,,,0,"fee schedule",EAPG,1948,100,,1558.40,,,0,"percent of total billed charges","100% of total billed charges",298.04,40799.76,
"92953 Temporary transcutaneous pacing",7963732,CDM,521,RC,92953,CPT,OUTPATIENT,,,33,21.45,,29.04,88,,23.23,,,0,"percent of total billed charges","88% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",582.08,100,,,,,0,"fee schedule",EAPG,33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",1161.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",599.54,100,,,,,0,"fee schedule",EAPG,663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",20.79,63,,16.63,,,0,"percent of total billed charges","63% of total billed charges",5.05,15.3,,4.04,,,0,"percent of total billed charges","15.3% of total billed charges",582.08,100,,,,,0,"fee schedule",EAPG,22.77,69,,,,,0,"fee schedule","69% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",2282.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",582.08,100,,,,,0,"fee schedule",EAPG,663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",596.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.72,100,,,,,0,"fee schedule",EAPG,756.7,100,,,,,0,"fee schedule",EAPG,663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",12.44,37.7,,9.95,,,0,"percent of total billed charges","37.70% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",25.74,78,,20.59,,,0,"percent of total billed charges","78% of total billed charges",670.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",582.08,100,,,,,0,"fee schedule",EAPG,663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",742.61,100,,,,,0,"fee schedule",EAPG,33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",5.05,2282.77,
"92950 Cardiopulmonary resuscitation",7963750,CDM,521,RC,92950,CPT,OUTPATIENT,,,870,565.5,,765.6,88,,612.48,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818.62,100,,,,,0,"fee schedule",EAPG,870,100,,696.00,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",843.18,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",548.1,63,,438.48,,,0,"percent of total billed charges","63% of total billed charges",133.11,15.3,,106.49,,,0,"percent of total billed charges","15.3% of total billed charges",818.62,100,,,,,0,"fee schedule",EAPG,600.3,69,,,,,0,"fee schedule","69% of total billed charges",870,100,,696.00,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",870,100,,696.00,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",870,100,,696.00,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",818.62,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",834.99,100,,,,,0,"fee schedule",EAPG,1064.21,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",327.99,37.7,,262.39,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",678.6,78,,542.88,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",718.62,82.6,,574.90,,,0,"percent of total billed charges","82.6% of total billed charges",818.62,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",718.62,82.6,,574.90,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",979.15,100,,,,,0,"fee schedule",EAPG,870,100,,696.00,,,0,"percent of total billed charges","100% of total billed charges",133.11,1074.33,
"92961 Cardioversion, elective, electrical conversi",7961723,CDM,521,RC,92961,CPT,OUTPATIENT,,,716,465.4,,630.08,88,,504.06,,,0,"percent of total billed charges","88% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",582.08,100,,,,,0,"fee schedule",EAPG,716,100,,572.80,,,0,"percent of total billed charges","100% of total billed charges",1161.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",599.54,100,,,,,0,"fee schedule",EAPG,663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",451.08,63,,360.86,,,0,"percent of total billed charges","63% of total billed charges",109.55,15.3,,87.64,,,0,"percent of total billed charges","15.3% of total billed charges",582.08,100,,,,,0,"fee schedule",EAPG,494.04,69,,,,,0,"fee schedule","69% of total billed charges",716,100,,572.80,,,0,"percent of total billed charges","100% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",716,100,,572.80,,,0,"percent of total billed charges","100% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",716,100,,572.80,,,0,"percent of total billed charges","100% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",2282.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",582.08,100,,,,,0,"fee schedule",EAPG,663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",596.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.72,100,,,,,0,"fee schedule",EAPG,756.7,100,,,,,0,"fee schedule",EAPG,663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",269.93,37.7,,215.94,,,0,"percent of total billed charges","37.70% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",558.48,78,,446.78,,,0,"percent of total billed charges","78% of total billed charges",670.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591.42,82.6,,473.14,,,0,"percent of total billed charges","82.6% of total billed charges",582.08,100,,,,,0,"fee schedule",EAPG,663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",591.42,82.6,,473.14,,,0,"percent of total billed charges","82.6% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",742.61,100,,,,,0,"fee schedule",EAPG,716,100,,572.80,,,0,"percent of total billed charges","100% of total billed charges",109.55,2282.77,
"92960 Cardioversion, elective, electrical conversi",7962827,CDM,521,RC,92960,CPT,OUTPATIENT,,,642,417.3,,564.96,88,,451.97,,,0,"percent of total billed charges","88% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",582.08,100,,,,,0,"fee schedule",EAPG,642,100,,513.60,,,0,"percent of total billed charges","100% of total billed charges",1161.67,175,,,,,0,"fee schedule","175% of CMS fee schedule",599.54,100,,,,,0,"fee schedule",EAPG,663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",404.46,63,,323.57,,,0,"percent of total billed charges","63% of total billed charges",98.23,15.3,,78.58,,,0,"percent of total billed charges","15.3% of total billed charges",582.08,100,,,,,0,"fee schedule",EAPG,442.98,69,,,,,0,"fee schedule","69% of total billed charges",642,100,,513.60,,,0,"percent of total billed charges","100% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",642,100,,513.60,,,0,"percent of total billed charges","100% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",642,100,,513.60,,,0,"percent of total billed charges","100% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",2282.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",582.08,100,,,,,0,"fee schedule",EAPG,663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",596.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",593.72,100,,,,,0,"fee schedule",EAPG,756.7,100,,,,,0,"fee schedule",EAPG,663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",242.03,37.7,,193.62,,,0,"percent of total billed charges","37.70% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",500.76,78,,400.61,,,0,"percent of total billed charges","78% of total billed charges",670.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",530.29,82.6,,424.23,,,0,"percent of total billed charges","82.6% of total billed charges",582.08,100,,,,,0,"fee schedule",EAPG,663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",530.29,82.6,,424.23,,,0,"percent of total billed charges","82.6% of total billed charges",663.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",742.61,100,,,,,0,"fee schedule",EAPG,642,100,,513.60,,,0,"percent of total billed charges","100% of total billed charges",98.23,2282.77,
"92973 Percutaneous transluminal coronary thrombect",7963180,CDM,521,RC,92973,CPT,OUTPATIENT,,,529,343.85,,465.52,88,,372.42,,,0,"percent of total billed charges","88% of total billed charges",264.5,50,,211.60,,,0,"percent of total billed charges","50% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,529,100,,423.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7980.8,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",333.27,63,,266.62,,,0,"percent of total billed charges","63% of total billed charges",80.94,15.3,,64.75,,,0,"percent of total billed charges","15.3% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,365.01,69,,,,,0,"fee schedule","69% of total billed charges",529,100,,423.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",529,100,,423.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",529,100,,423.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",327.19,61.85,,261.75,,,0,"percent of total billed charges","61.5% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,264.5,50,,211.60,,,0,"percent of total billed charges","50% of total billed charges",170.34,32.2,,136.27,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7903.32,100,,,,,0,"fee schedule",EAPG,10072.86,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",199.43,37.7,,159.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",412.62,78,,330.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",436.95,82.6,,349.56,,,0,"percent of total billed charges","82.6% of total billed charges",7748.35,100,,,,,0,"fee schedule",EAPG,264.5,50,,211.60,,,0,"percent of total billed charges","50% of total billed charges",436.95,82.6,,349.56,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",7908.88,100,,,,,0,"fee schedule",EAPG,529,100,,423.20,,,0,"percent of total billed charges","100% of total billed charges",80.94,10072.86,
"92970 Cardioassist-method of circulatory assist; i",7963374,CDM,521,RC,92970,CPT,OUTPATIENT,,,516,335.4,,454.08,88,,363.26,,,0,"percent of total billed charges","88% of total billed charges",516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3222.02,100,,,,,0,"fee schedule",EAPG,516,100,,412.80,,,0,"percent of total billed charges","100% of total billed charges",516,175,,,,,0,"fee schedule","175% of CMS fee schedule",3318.68,100,,,,,0,"fee schedule",EAPG,516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",325.08,63,,260.06,,,0,"percent of total billed charges","63% of total billed charges",78.95,15.3,,63.16,,,0,"percent of total billed charges","15.3% of total billed charges",3222.02,100,,,,,0,"fee schedule",EAPG,356.04,69,,,,,0,"fee schedule","69% of total billed charges",516,100,,412.80,,,0,"percent of total billed charges","100% of total billed charges",516,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",516,100,,412.80,,,0,"percent of total billed charges","100% of total billed charges",516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",516,100,,412.80,,,0,"percent of total billed charges","100% of total billed charges",516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3222.02,100,,,,,0,"fee schedule",EAPG,516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3286.46,100,,,,,0,"fee schedule",EAPG,4188.63,100,,,,,0,"fee schedule",EAPG,516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",194.53,37.7,,155.62,,,0,"percent of total billed charges","37.70% of total billed charges",516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",516,100,,,,,0,"fee schedule","100% of CMS fee schedule",402.48,78,,321.98,,,0,"percent of total billed charges","78% of total billed charges",516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",426.22,82.6,,340.98,,,0,"percent of total billed charges","82.6% of total billed charges",3222.02,100,,,,,0,"fee schedule","100% of WA fee schedule",516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",426.22,82.6,,340.98,,,0,"percent of total billed charges","82.6% of total billed charges",516,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3382.55,100,,,,,0,"fee schedule",EAPG,516,100,,412.80,,,0,"percent of total billed charges","100% of total billed charges",78.95,4188.63,
"92971 Cardioassist-method of circulatory assist; e",7963375,CDM,521,RC,92971,CPT,OUTPATIENT,,,278,180.7,,244.64,88,,195.71,,,0,"percent of total billed charges","88% of total billed charges",278,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",582.08,100,,,,,0,"fee schedule",EAPG,278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",278,175,,,,,0,"fee schedule","175% of CMS fee schedule",599.54,100,,,,,0,"fee schedule",EAPG,278,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",175.14,63,,140.11,,,0,"percent of total billed charges","63% of total billed charges",42.53,15.3,,34.02,,,0,"percent of total billed charges","15.3% of total billed charges",582.08,100,,,,,0,"fee schedule",EAPG,191.82,69,,,,,0,"fee schedule","69% of total billed charges",278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",278,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",278,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",278,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",278,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",582.08,100,,,,,0,"fee schedule",EAPG,278,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",278,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",278,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",593.72,100,,,,,0,"fee schedule",EAPG,756.7,100,,,,,0,"fee schedule",EAPG,278,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",104.81,37.7,,83.85,,,0,"percent of total billed charges","37.70% of total billed charges",278,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",278,100,,,,,0,"fee schedule","100% of CMS fee schedule",216.84,78,,173.47,,,0,"percent of total billed charges","78% of total billed charges",278,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",229.63,82.6,,183.70,,,0,"percent of total billed charges","82.6% of total billed charges",582.08,100,,,,,0,"fee schedule","100% of WA fee schedule",278,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",229.63,82.6,,183.70,,,0,"percent of total billed charges","82.6% of total billed charges",278,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",742.61,100,,,,,0,"fee schedule",EAPG,278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",42.53,756.7,
"92979 Intravascular ultrasound; each additional ve",7963435,CDM,521,RC,92979,CPT,OUTPATIENT,,,238,154.7,,209.44,88,,167.55,,,0,"percent of total billed charges","88% of total billed charges",119,50,,95.20,,,0,"percent of total billed charges","50% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",149.94,63,,119.95,,,0,"percent of total billed charges","63% of total billed charges",36.41,15.3,,29.13,,,0,"percent of total billed charges","15.3% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,164.22,69,,,,,0,"fee schedule","69% of total billed charges",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",147.2,61.85,,117.76,,,0,"percent of total billed charges","61.5% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,119,50,,95.20,,,0,"percent of total billed charges","50% of total billed charges",76.64,32.2,,61.31,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",165.21,100,,,,,0,"fee schedule",EAPG,210.57,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",89.73,37.7,,71.78,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",185.64,78,,148.51,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",196.59,82.6,,157.27,,,0,"percent of total billed charges","82.6% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,119,50,,95.20,,,0,"percent of total billed charges","50% of total billed charges",196.59,82.6,,157.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",322.5,100,,,,,0,"fee schedule",EAPG,238,100,,190.40,,,0,"percent of total billed charges","100% of total billed charges",36.41,322.5,
"92978 Intravascular ultrasound; initial vessel",7963590,CDM,521,RC,92978,CPT,OUTPATIENT,,,296,192.4,,260.48,88,,208.38,,,0,"percent of total billed charges","88% of total billed charges",148,50,,118.40,,,0,"percent of total billed charges","50% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,296,100,,236.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",186.48,63,,149.18,,,0,"percent of total billed charges","63% of total billed charges",45.29,15.3,,36.23,,,0,"percent of total billed charges","15.3% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,204.24,69,,,,,0,"fee schedule","69% of total billed charges",296,100,,236.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",296,100,,236.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",296,100,,236.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.08,61.85,,146.46,,,0,"percent of total billed charges","61.5% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,148,50,,118.40,,,0,"percent of total billed charges","50% of total billed charges",95.31,32.2,,76.25,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",165.21,100,,,,,0,"fee schedule",EAPG,210.57,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",111.59,37.7,,89.27,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",230.88,78,,184.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",244.5,82.6,,195.60,,,0,"percent of total billed charges","82.6% of total billed charges",161.97,100,,,,,0,"fee schedule",EAPG,148,50,,118.40,,,0,"percent of total billed charges","50% of total billed charges",244.5,82.6,,195.60,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",322.5,100,,,,,0,"fee schedule",EAPG,296,100,,236.80,,,0,"percent of total billed charges","100% of total billed charges",45.29,322.5,
"92974 cath place cardio brachytx",7963830,CDM,521,RC,92974,CPT,OUTPATIENT,,,484,314.6,,425.92,88,,340.74,,,0,"percent of total billed charges","88% of total billed charges",242,50,,193.60,,,0,"percent of total billed charges","50% of total billed charges",81.31,16.8,,65.05,,,0,"percent of total billed charges","16.8% of total billed charges",484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",83.75,17.304,,67.00,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",304.92,63,,243.94,,,0,"percent of total billed charges","63% of total billed charges",74.05,15.3,,59.24,,,0,"percent of total billed charges","15.3% of total billed charges",81.31,16.8,,65.05,,,0,"percent of total billed charges","16.8% of total billed charges",333.96,69,,,,,0,"fee schedule","69% of total billed charges",484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",299.35,61.85,,239.48,,,0,"percent of total billed charges","61.5% of total billed charges",81.31,16.8,,65.05,,,0,"percent of total billed charges","16.8% of total billed charges",242,50,,193.60,,,0,"percent of total billed charges","50% of total billed charges",155.85,32.2,,124.68,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",82.94,17.136,,66.35,,,0,"percent of total billed charges","17.136% of total billed charges",105.71,21.84,,84.57,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",182.47,37.7,,145.98,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",377.52,78,,302.02,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",399.78,82.6,,319.82,,,0,"percent of total billed charges","82.6% of total billed charges",81.31,16.8,,65.05,,,0,"percent of total billed charges","16.8% of total billed charges",242,50,,193.60,,,0,"percent of total billed charges","50% of total billed charges",399.78,82.6,,319.82,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",74.05,484,
"92980 insert intracoronary stent",7963821,CDM,521,RC,92980,CPT,OUTPATIENT,,,2412,1567.8,,2122.56,88,,1698.05,,,0,"percent of total billed charges","88% of total billed charges",1206,50,,964.80,,,0,"percent of total billed charges","50% of total billed charges",405.22,16.8,,324.18,,,0,"percent of total billed charges","16.8% of total billed charges",2412,100,,1929.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.37,17.304,,333.90,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1519.56,63,,1215.65,,,0,"percent of total billed charges","63% of total billed charges",369.04,15.3,,295.23,,,0,"percent of total billed charges","15.3% of total billed charges",405.22,16.8,,324.18,,,0,"percent of total billed charges","16.8% of total billed charges",1664.28,69,,,,,0,"fee schedule","69% of total billed charges",2412,100,,1929.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2412,100,,1929.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2412,100,,1929.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1491.82,61.85,,1193.46,,,0,"percent of total billed charges","61.5% of total billed charges",405.22,16.8,,324.18,,,0,"percent of total billed charges","16.8% of total billed charges",1206,50,,964.80,,,0,"percent of total billed charges","50% of total billed charges",776.66,32.2,,621.33,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",413.32,17.136,,330.66,,,0,"percent of total billed charges","17.136% of total billed charges",526.78,21.84,,421.42,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",909.32,37.7,,727.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1881.36,78,,1505.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1992.31,82.6,,1593.85,,,0,"percent of total billed charges","82.6% of total billed charges",405.22,16.8,,324.18,,,0,"percent of total billed charges","16.8% of total billed charges",1206,50,,964.80,,,0,"percent of total billed charges","50% of total billed charges",1992.31,82.6,,1593.85,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",2412,100,,1929.60,,,0,"percent of total billed charges","100% of total billed charges",160.53,2412,
"92981 insert intracoronary stent",7963822,CDM,521,RC,92981,CPT,OUTPATIENT,,,672,436.8,,591.36,88,,473.09,,,0,"percent of total billed charges","88% of total billed charges",336,50,,268.80,,,0,"percent of total billed charges","50% of total billed charges",112.9,16.8,,90.32,,,0,"percent of total billed charges","16.8% of total billed charges",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",116.28,17.304,,93.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",423.36,63,,338.69,,,0,"percent of total billed charges","63% of total billed charges",102.82,15.3,,82.26,,,0,"percent of total billed charges","15.3% of total billed charges",112.9,16.8,,90.32,,,0,"percent of total billed charges","16.8% of total billed charges",463.68,69,,,,,0,"fee schedule","69% of total billed charges",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",415.63,61.85,,332.50,,,0,"percent of total billed charges","61.5% of total billed charges",112.9,16.8,,90.32,,,0,"percent of total billed charges","16.8% of total billed charges",336,50,,268.80,,,0,"percent of total billed charges","50% of total billed charges",216.38,32.2,,173.10,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",115.15,17.136,,92.12,,,0,"percent of total billed charges","17.136% of total billed charges",146.76,21.84,,117.41,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",253.34,37.7,,202.67,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",524.16,78,,419.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",555.07,82.6,,444.06,,,0,"percent of total billed charges","82.6% of total billed charges",112.9,16.8,,90.32,,,0,"percent of total billed charges","16.8% of total billed charges",336,50,,268.80,,,0,"percent of total billed charges","50% of total billed charges",555.07,82.6,,444.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",672,100,,537.60,,,0,"percent of total billed charges","100% of total billed charges",102.82,672,
"92982 coronary artery dilation",7963853,CDM,521,RC,92982,CPT,OUTPATIENT,,,1789,1162.85,,1574.32,88,,1259.46,,,0,"percent of total billed charges","88% of total billed charges",894.5,50,,715.60,,,0,"percent of total billed charges","50% of total billed charges",300.55,16.8,,240.44,,,0,"percent of total billed charges","16.8% of total billed charges",1789,100,,1431.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309.57,17.304,,247.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1127.07,63,,901.66,,,0,"percent of total billed charges","63% of total billed charges",273.72,15.3,,218.98,,,0,"percent of total billed charges","15.3% of total billed charges",300.55,16.8,,240.44,,,0,"percent of total billed charges","16.8% of total billed charges",1234.41,69,,,,,0,"fee schedule","69% of total billed charges",1789,100,,1431.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1789,100,,1431.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1789,100,,1431.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1106.5,61.85,,885.20,,,0,"percent of total billed charges","61.5% of total billed charges",300.55,16.8,,240.44,,,0,"percent of total billed charges","16.8% of total billed charges",894.5,50,,715.60,,,0,"percent of total billed charges","50% of total billed charges",576.06,32.2,,460.85,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",306.56,17.136,,245.25,,,0,"percent of total billed charges","17.136% of total billed charges",390.72,21.84,,312.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",674.45,37.7,,539.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1395.42,78,,1116.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",1477.71,82.6,,1182.17,,,0,"percent of total billed charges","82.6% of total billed charges",300.55,16.8,,240.44,,,0,"percent of total billed charges","16.8% of total billed charges",894.5,50,,715.60,,,0,"percent of total billed charges","50% of total billed charges",1477.71,82.6,,1182.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",1789,100,,1431.20,,,0,"percent of total billed charges","100% of total billed charges",160.53,1789,
"92984 coronary artery dilation",7963854,CDM,521,RC,92984,CPT,OUTPATIENT,,,480,312,,422.4,88,,337.92,,,0,"percent of total billed charges","88% of total billed charges",240,50,,192.00,,,0,"percent of total billed charges","50% of total billed charges",80.64,16.8,,64.51,,,0,"percent of total billed charges","16.8% of total billed charges",480,100,,384.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",83.06,17.304,,66.45,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",302.4,63,,241.92,,,0,"percent of total billed charges","63% of total billed charges",73.44,15.3,,58.75,,,0,"percent of total billed charges","15.3% of total billed charges",80.64,16.8,,64.51,,,0,"percent of total billed charges","16.8% of total billed charges",331.2,69,,,,,0,"fee schedule","69% of total billed charges",480,100,,384.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",480,100,,384.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",480,100,,384.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",296.88,61.85,,237.50,,,0,"percent of total billed charges","61.5% of total billed charges",80.64,16.8,,64.51,,,0,"percent of total billed charges","16.8% of total billed charges",240,50,,192.00,,,0,"percent of total billed charges","50% of total billed charges",154.56,32.2,,123.65,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",82.25,17.136,,65.80,,,0,"percent of total billed charges","17.136% of total billed charges",104.83,21.84,,83.86,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",180.96,37.7,,144.77,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",374.4,78,,299.52,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",396.48,82.6,,317.18,,,0,"percent of total billed charges","82.6% of total billed charges",80.64,16.8,,64.51,,,0,"percent of total billed charges","16.8% of total billed charges",240,50,,192.00,,,0,"percent of total billed charges","50% of total billed charges",396.48,82.6,,317.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",480,100,,384.00,,,0,"percent of total billed charges","100% of total billed charges",73.44,480,
"93000 EKG w/ 12Plus leads,Tracing/Interp/Report",7963609,CDM,730,RC,93000,CPT,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.47,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.07,61.85,,23.26,,,0,"percent of total billed charges","61.5% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",15.13,32.2,,12.10,,,0,"percent of total billed charges","32.2% of total billed charges",17.6,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",24.23,100,,,,,0,"fee schedule",EAPG,30.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.7% of total billed charges",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.93,33.9,,12.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",23.76,100,,,,,0,"fee schedule","100% of WA fee schedule",23.5,50,,18.80,,,0,"percent of total billed charges","50% of total billed charges",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.76,100,,,,,0,"fee schedule",EAPG,47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"93005 EKG w/ 12 plus leads Tracing Only",7963741,CDM,730,RC,93005,CPT,OUTPATIENT,,,32,20.8,,28.16,88,,22.53,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",24.47,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",20.16,63,,16.13,,,0,"percent of total billed charges","63% of total billed charges",4.9,15.3,,3.92,,,0,"percent of total billed charges","15.3% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,22.08,69,,,,,0,"fee schedule","69% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17.6,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.23,100,,,,,0,"fee schedule",EAPG,30.89,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.7% of total billed charges",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10.85,33.9,,8.68,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.96,78,,19.97,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",4.9,226.12,
"93016 Cardiovascular stress test; supervision only",7903335,CDM,730,RC,93016,CPT,OUTPATIENT,,,66,42.9,,58.08,88,,46.46,,,0,"percent of total billed charges","88% of total billed charges",33,50,,26.40,,,0,"percent of total billed charges","50% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",41.58,63,,33.26,,,0,"percent of total billed charges","63% of total billed charges",10.1,15.3,,8.08,,,0,"percent of total billed charges","15.3% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,45.54,69,,,,,0,"fee schedule","69% of total billed charges",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.82,61.85,,32.66,,,0,"percent of total billed charges","61.5% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,33,50,,26.40,,,0,"percent of total billed charges","50% of total billed charges",21.25,32.2,,17.00,,,0,"percent of total billed charges","32.2% of total billed charges",111.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",154.01,100,,,,,0,"fee schedule",EAPG,196.29,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",24.88,37.7,,19.90,,,0,"percent of total billed charges","37.7% of total billed charges",24.88,37.7,,19.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.37,33.9,,17.90,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.48,78,,41.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",54.52,82.6,,43.62,,,0,"percent of total billed charges","82.6% of total billed charges",150.99,100,,,,,0,"fee schedule","100% of WA fee schedule",33,50,,26.40,,,0,"percent of total billed charges","50% of total billed charges",54.52,82.6,,43.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",150.99,100,,,,,0,"fee schedule",EAPG,66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",10.1,196.29,
"93018 Cardiovascular stress test; interpretation a",7903336,CDM,730,RC,93018,CPT,OUTPATIENT,,,44,28.6,,38.72,88,,30.98,,,0,"percent of total billed charges","88% of total billed charges",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",27.72,63,,22.18,,,0,"percent of total billed charges","63% of total billed charges",6.73,15.3,,5.38,,,0,"percent of total billed charges","15.3% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,30.36,69,,,,,0,"fee schedule","69% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.21,61.85,,21.77,,,0,"percent of total billed charges","61.5% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",14.17,32.2,,11.34,,,0,"percent of total billed charges","32.2% of total billed charges",111.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",154.01,100,,,,,0,"fee schedule",EAPG,196.29,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",16.59,37.7,,13.27,,,0,"percent of total billed charges","37.7% of total billed charges",16.59,37.7,,13.27,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.92,33.9,,11.94,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.32,78,,27.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",150.99,100,,,,,0,"fee schedule","100% of WA fee schedule",22,50,,17.60,,,0,"percent of total billed charges","50% of total billed charges",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",150.99,100,,,,,0,"fee schedule",EAPG,44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",6.73,196.29,
"93015 Cardiovascular stress test, complete; with s",7962455,CDM,730,RC,93015,CPT,OUTPATIENT,,,266,172.9,,234.08,88,,187.26,,,0,"percent of total billed charges","88% of total billed charges",133,50,,106.40,,,0,"percent of total billed charges","50% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",167.58,63,,134.06,,,0,"percent of total billed charges","63% of total billed charges",40.7,15.3,,32.56,,,0,"percent of total billed charges","15.3% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,183.54,69,,,,,0,"fee schedule","69% of total billed charges",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",164.52,61.85,,131.62,,,0,"percent of total billed charges","61.5% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,133,50,,106.40,,,0,"percent of total billed charges","50% of total billed charges",85.65,32.2,,68.52,,,0,"percent of total billed charges","32.2% of total billed charges",111.84,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",154.01,100,,,,,0,"fee schedule",EAPG,196.29,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",100.28,37.7,,80.22,,,0,"percent of total billed charges","37.7% of total billed charges",100.28,37.7,,80.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.17,33.9,,72.14,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.48,78,,165.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",219.72,82.6,,175.78,,,0,"percent of total billed charges","82.6% of total billed charges",150.99,100,,,,,0,"fee schedule","100% of WA fee schedule",133,50,,106.40,,,0,"percent of total billed charges","50% of total billed charges",219.72,82.6,,175.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",150.99,100,,,,,0,"fee schedule",EAPG,266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",40.7,266,
"93017 Cardiovascular stress test; tracing only, wi",7962652,CDM,730,RC,93017,CPT,OUTPATIENT,,,152,98.8,,133.76,88,,107.01,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.99,100,,,,,0,"fee schedule",EAPG,152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",560.25,175,,,,,0,"fee schedule","175% of CMS fee schedule",155.52,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",95.76,63,,76.61,,,0,"percent of total billed charges","63% of total billed charges",23.26,15.3,,18.61,,,0,"percent of total billed charges","15.3% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,104.88,69,,,,,0,"fee schedule","69% of total billed charges",152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.99,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.84,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.01,100,,,,,0,"fee schedule",EAPG,196.29,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",57.3,37.7,,45.84,,,0,"percent of total billed charges","37.7% of total billed charges",57.3,37.7,,45.84,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",51.53,33.9,,41.22,,,0,"percent of total billed charges","33.9% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.56,78,,94.85,,,0,"percent of total billed charges","78% of total billed charges",323.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.55,82.6,,100.44,,,0,"percent of total billed charges","82.6% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.55,82.6,,100.44,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.99,100,,,,,0,"fee schedule",EAPG,152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",23.26,1074.33,
"93010 EKG w/ 12+ leads; Interp/Report Only",7963665,CDM,730,RC,93010,CPT,OUTPATIENT,,,26,16.9,,22.88,88,,18.30,,,0,"percent of total billed charges","88% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.47,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",16.38,63,,13.10,,,0,"percent of total billed charges","63% of total billed charges",3.98,15.3,,3.18,,,0,"percent of total billed charges","15.3% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,17.94,69,,,,,0,"fee schedule","69% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.08,61.85,,12.86,,,0,"percent of total billed charges","61.5% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",8.37,32.2,,6.70,,,0,"percent of total billed charges","32.2% of total billed charges",17.6,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",24.23,100,,,,,0,"fee schedule",EAPG,30.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",9.8,37.7,,7.84,,,0,"percent of total billed charges","37.7% of total billed charges",9.8,37.7,,7.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.81,33.9,,7.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.28,78,,16.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",23.76,100,,,,,0,"fee schedule","100% of WA fee schedule",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",21.48,82.6,,17.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.76,100,,,,,0,"fee schedule",EAPG,26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",3.98,30.89,
"93041 Rhythm ECG, 1-3 leads; tracing only without",7962859,CDM,730,RC,93041,CPT,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",24.47,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17.6,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.23,100,,,,,0,"fee schedule",EAPG,30.89,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.7% of total billed charges",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.42,33.9,,4.34,,,0,"percent of total billed charges","33.9% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,226.12,
"93040 Rhythm ECG, 1-3 leads; with interpretation a",7963314,CDM,730,RC,93040,CPT,OUTPATIENT,,,38,24.7,,33.44,88,,26.75,,,0,"percent of total billed charges","88% of total billed charges",19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.47,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",23.94,63,,19.15,,,0,"percent of total billed charges","63% of total billed charges",5.81,15.3,,4.65,,,0,"percent of total billed charges","15.3% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,26.22,69,,,,,0,"fee schedule","69% of total billed charges",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.5,61.85,,18.80,,,0,"percent of total billed charges","61.5% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",12.24,32.2,,9.79,,,0,"percent of total billed charges","32.2% of total billed charges",17.6,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",24.23,100,,,,,0,"fee schedule",EAPG,30.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",14.33,37.7,,11.46,,,0,"percent of total billed charges","37.7% of total billed charges",14.33,37.7,,11.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.88,33.9,,10.30,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.64,78,,23.71,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",23.76,100,,,,,0,"fee schedule","100% of WA fee schedule",19,50,,15.20,,,0,"percent of total billed charges","50% of total billed charges",31.39,82.6,,25.11,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.76,100,,,,,0,"fee schedule",EAPG,38,100,,30.40,,,0,"percent of total billed charges","100% of total billed charges",5.81,38,
"93042 Rhythm ECG, 1-3 leads; interpretation and re",7963315,CDM,730,RC,93042,CPT,OUTPATIENT,,,22,14.3,,19.36,88,,15.49,,,0,"percent of total billed charges","88% of total billed charges",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.47,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",13.86,63,,11.09,,,0,"percent of total billed charges","63% of total billed charges",3.37,15.3,,2.70,,,0,"percent of total billed charges","15.3% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,15.18,69,,,,,0,"fee schedule","69% of total billed charges",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.61,61.85,,10.89,,,0,"percent of total billed charges","61.5% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",7.08,32.2,,5.66,,,0,"percent of total billed charges","32.2% of total billed charges",17.6,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",24.23,100,,,,,0,"fee schedule",EAPG,30.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",8.29,37.7,,6.63,,,0,"percent of total billed charges","37.7% of total billed charges",8.29,37.7,,6.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.46,33.9,,5.97,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.16,78,,13.73,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",23.76,100,,,,,0,"fee schedule","100% of WA fee schedule",11,50,,8.80,,,0,"percent of total billed charges","50% of total billed charges",18.17,82.6,,14.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.76,100,,,,,0,"fee schedule",EAPG,22,100,,17.60,,,0,"percent of total billed charges","100% of total billed charges",3.37,30.89,
"93224 Holter ECG Monitor, up to 48 hr, w/ scan, in",7963121,CDM,521,RC,93224,CPT,OUTPATIENT,,,293,190.45,,257.84,88,,206.27,,,0,"percent of total billed charges","88% of total billed charges",146.5,50,,117.20,,,0,"percent of total billed charges","50% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,293,100,,234.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",184.59,63,,147.67,,,0,"percent of total billed charges","63% of total billed charges",44.83,15.3,,35.86,,,0,"percent of total billed charges","15.3% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,202.17,69,,,,,0,"fee schedule","69% of total billed charges",293,100,,234.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",293,100,,234.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",293,100,,234.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.22,61.85,,144.98,,,0,"percent of total billed charges","61.5% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,146.5,50,,117.20,,,0,"percent of total billed charges","50% of total billed charges",94.35,32.2,,75.48,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",62.75,100,,,,,0,"fee schedule",EAPG,79.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",110.46,37.7,,88.37,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",228.54,78,,182.83,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",242.02,82.6,,193.62,,,0,"percent of total billed charges","82.6% of total billed charges",61.52,100,,,,,0,"fee schedule","100% of WA fee schedule",146.5,50,,117.20,,,0,"percent of total billed charges","50% of total billed charges",242.02,82.6,,193.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",222.05,100,,,,,0,"fee schedule",EAPG,293,100,,234.40,,,0,"percent of total billed charges","100% of total billed charges",44.83,293,
"93226 Holter ECG Monitor, up to 48 hr, scanning an",7963122,CDM,521,RC,93226,CPT,OUTPATIENT,,,129,83.85,,113.52,88,,90.82,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.52,100,,,,,0,"fee schedule",EAPG,129,100,,103.20,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",63.37,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",81.27,63,,65.02,,,0,"percent of total billed charges","63% of total billed charges",19.74,15.3,,15.79,,,0,"percent of total billed charges","15.3% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,89.01,69,,,,,0,"fee schedule","69% of total billed charges",129,100,,103.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",129,100,,103.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",129,100,,103.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.52,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",62.75,100,,,,,0,"fee schedule",EAPG,79.98,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",48.63,37.7,,38.90,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.62,78,,80.50,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",106.55,82.6,,85.24,,,0,"percent of total billed charges","82.6% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",106.55,82.6,,85.24,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",222.05,100,,,,,0,"fee schedule",EAPG,129,100,,103.20,,,0,"percent of total billed charges","100% of total billed charges",19.74,454.8,
"93228 Holter ECG Monitor, up to 30 days, review an",7963343,CDM,521,RC,93228,CPT,OUTPATIENT,,,75,48.75,,66,88,,52.80,,,0,"percent of total billed charges","88% of total billed charges",37.5,50,,30.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47.25,63,,37.80,,,0,"percent of total billed charges","63% of total billed charges",11.48,15.3,,9.18,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.75,69,,,,,0,"fee schedule","69% of total billed charges",75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.39,61.85,,37.11,,,0,"percent of total billed charges","61.5% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.5,50,,30.00,,,0,"percent of total billed charges","50% of total billed charges",24.15,32.2,,19.32,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.28,37.7,,22.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",58.5,78,,46.80,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.95,82.6,,49.56,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.5,50,,30.00,,,0,"percent of total billed charges","50% of total billed charges",61.95,82.6,,49.56,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",75,100,,60.00,,,0,"percent of total billed charges","100% of total billed charges",11.48,160.53,
"93225 Holter ECG Monitor, up to 48 hr, recording o",7963457,CDM,521,RC,93225,CPT,OUTPATIENT,,,87,56.55,,76.56,88,,61.25,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.52,100,,,,,0,"fee schedule",EAPG,87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",63.37,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",54.81,63,,43.85,,,0,"percent of total billed charges","63% of total billed charges",13.31,15.3,,10.65,,,0,"percent of total billed charges","15.3% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,60.03,69,,,,,0,"fee schedule","69% of total billed charges",87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.52,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",62.75,100,,,,,0,"fee schedule",EAPG,79.98,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",32.8,37.7,,26.24,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",67.86,78,,54.29,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",71.86,82.6,,57.49,,,0,"percent of total billed charges","82.6% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",71.86,82.6,,57.49,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",222.05,100,,,,,0,"fee schedule",EAPG,87,100,,69.60,,,0,"percent of total billed charges","100% of total billed charges",13.31,454.8,
"93227 Holter ECG Monitor, up to 48 hr, interp",7963610,CDM,521,RC,93227,CPT,OUTPATIENT,,,77,50.05,,67.76,88,,54.21,,,0,"percent of total billed charges","88% of total billed charges",38.5,50,,30.80,,,0,"percent of total billed charges","50% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",48.51,63,,38.81,,,0,"percent of total billed charges","63% of total billed charges",11.78,15.3,,9.42,,,0,"percent of total billed charges","15.3% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,53.13,69,,,,,0,"fee schedule","69% of total billed charges",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.62,61.85,,38.10,,,0,"percent of total billed charges","61.5% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,38.5,50,,30.80,,,0,"percent of total billed charges","50% of total billed charges",24.79,32.2,,19.83,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",62.75,100,,,,,0,"fee schedule",EAPG,79.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.03,37.7,,23.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",60.06,78,,48.05,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.6,82.6,,50.88,,,0,"percent of total billed charges","82.6% of total billed charges",61.52,100,,,,,0,"fee schedule","100% of WA fee schedule",38.5,50,,30.80,,,0,"percent of total billed charges","50% of total billed charges",63.6,82.6,,50.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",222.05,100,,,,,0,"fee schedule",EAPG,77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",11.78,222.05,
"93229 remote 30 day ecg tech supp",7963792,CDM,521,RC,93229,CPT,OUTPATIENT,,,2054,1335.1,,1807.52,88,,1446.02,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",2054,100,,1643.20,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1294.02,63,,1035.22,,,0,"percent of total billed charges","63% of total billed charges",314.26,15.3,,251.41,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",1417.26,69,,,,,0,"fee schedule","69% of total billed charges",2054,100,,1643.20,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054,100,,1643.20,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2054,100,,1643.20,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",774.36,37.7,,619.49,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1602.12,78,,1281.70,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1696.6,82.6,,1357.28,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1696.6,82.6,,1357.28,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"case rate","pays based on per visit rate",2054,100,,1643.20,,,0,"percent of total billed charges","100% of total billed charges",148.21,2054,
"93241 Ext EKG 48 hr -7 days, record, scan, A/R",10142557,CDM,521,RC,93241,CPT,OUTPATIENT,,,241,156.65,,212.08,88,,169.66,,,0,"percent of total billed charges","88% of total billed charges",120.5,50,,96.40,,,0,"percent of total billed charges","50% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",151.83,63,,121.46,,,0,"percent of total billed charges","63% of total billed charges",36.87,15.3,,29.50,,,0,"percent of total billed charges","15.3% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,166.29,69,,,,,0,"fee schedule","69% of total billed charges",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",149.06,61.85,,119.25,,,0,"percent of total billed charges","61.5% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,120.5,50,,96.40,,,0,"percent of total billed charges","50% of total billed charges",77.6,32.2,,62.08,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",62.75,100,,,,,0,"fee schedule",EAPG,79.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",90.86,37.7,,72.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",187.98,78,,150.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",199.07,82.6,,159.26,,,0,"percent of total billed charges","82.6% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,120.5,50,,96.40,,,0,"percent of total billed charges","50% of total billed charges",199.07,82.6,,159.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",222.05,100,,,,,0,"fee schedule",EAPG,241,100,,192.80,,,0,"percent of total billed charges","100% of total billed charges",36.87,241,
"93245- Ext EKG  7 - 15 days, record, scan, A/R",10142559,CDM,521,RC,93245,CPT,OUTPATIENT,,,414,269.1,,364.32,88,,291.46,,,0,"percent of total billed charges","88% of total billed charges",207,50,,165.60,,,0,"percent of total billed charges","50% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,414,100,,331.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",260.82,63,,208.66,,,0,"percent of total billed charges","63% of total billed charges",63.34,15.3,,50.67,,,0,"percent of total billed charges","15.3% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,285.66,69,,,,,0,"fee schedule","69% of total billed charges",414,100,,331.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414,100,,331.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",414,100,,331.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",256.06,61.85,,204.85,,,0,"percent of total billed charges","61.5% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,207,50,,165.60,,,0,"percent of total billed charges","50% of total billed charges",133.31,32.2,,106.65,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",62.75,100,,,,,0,"fee schedule",EAPG,79.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156.08,37.7,,124.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",322.92,78,,258.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",341.96,82.6,,273.57,,,0,"percent of total billed charges","82.6% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,207,50,,165.60,,,0,"percent of total billed charges","50% of total billed charges",341.96,82.6,,273.57,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",222.05,100,,,,,0,"fee schedule",EAPG,414,100,,331.20,,,0,"percent of total billed charges","100% of total billed charges",61.52,414,
"93268 External patient and, when performed, auto a",7961559,CDM,521,RC,93268,CPT,OUTPATIENT,,,705,458.25,,620.4,88,,496.32,,,0,"percent of total billed charges","88% of total billed charges",352.5,50,,282.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",705,100,,564.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",444.15,63,,355.32,,,0,"percent of total billed charges","63% of total billed charges",107.87,15.3,,86.30,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",486.45,69,,,,,0,"fee schedule","69% of total billed charges",705,100,,564.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",705,100,,564.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",705,100,,564.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",436.04,61.85,,348.83,,,0,"percent of total billed charges","61.5% of total billed charges",,,,,,,0,other,"not separately reimbursment",352.5,50,,282.00,,,0,"percent of total billed charges","50% of total billed charges",227.01,32.2,,181.61,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",265.79,37.7,,212.63,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",549.9,78,,439.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",582.33,82.6,,465.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",352.5,50,,282.00,,,0,"percent of total billed charges","50% of total billed charges",582.33,82.6,,465.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",705,100,,564.00,,,0,"percent of total billed charges","100% of total billed charges",107.87,705,
"93270 External patient and, when performed, auto a",7961560,CDM,521,RC,93270,CPT,OUTPATIENT,,,37,24.05,,32.56,88,,26.05,,,0,"percent of total billed charges","88% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",67.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",6.4,17.304,,5.12,,,0,"percent of total billed charges","17.304% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.31,63,,18.65,,,0,"percent of total billed charges","63% of total billed charges",5.66,15.3,,4.53,,,0,"percent of total billed charges","15.3% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",25.53,69,,,,,0,"fee schedule","69% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6.34,17.136,,5.07,,,0,"percent of total billed charges","17.136% of total billed charges",8.08,21.84,,6.46,,,0,"percent of total billed charges","21.84% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13.95,37.7,,11.16,,,0,"percent of total billed charges","37.70% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",28.86,78,,23.09,,,0,"percent of total billed charges","78% of total billed charges",38.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"case rate","pays based on per visit rate",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",5.66,160.53,
"93271 External patient and, when performed, auto a",7961561,CDM,521,RC,93271,CPT,OUTPATIENT,,,595,386.75,,523.6,88,,418.88,,,0,"percent of total billed charges","88% of total billed charges",98.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.96,16.8,,79.97,,,0,"percent of total billed charges","16.8% of total billed charges",595,100,,476.00,,,0,"percent of total billed charges","100% of total billed charges",172.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.96,17.304,,82.37,,,0,"percent of total billed charges","17.304% of total billed charges",98.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",374.85,63,,299.88,,,0,"percent of total billed charges","63% of total billed charges",91.04,15.3,,72.83,,,0,"percent of total billed charges","15.3% of total billed charges",99.96,16.8,,79.97,,,0,"percent of total billed charges","16.8% of total billed charges",410.55,69,,,,,0,"fee schedule","69% of total billed charges",595,100,,476.00,,,0,"percent of total billed charges","100% of total billed charges",98.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",595,100,,476.00,,,0,"percent of total billed charges","100% of total billed charges",98.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",595,100,,476.00,,,0,"percent of total billed charges","100% of total billed charges",98.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",407.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.96,16.8,,79.97,,,0,"percent of total billed charges","16.8% of total billed charges",98.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",106.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",98.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.96,17.136,,81.57,,,0,"percent of total billed charges","17.136% of total billed charges",129.95,21.84,,103.96,,,0,"percent of total billed charges","21.84% of total billed charges",98.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",224.32,37.7,,179.46,,,0,"percent of total billed charges","37.70% of total billed charges",98.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",98.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",464.1,78,,371.28,,,0,"percent of total billed charges","78% of total billed charges",99.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",491.47,82.6,,393.18,,,0,"percent of total billed charges","82.6% of total billed charges",99.96,16.8,,79.97,,,0,"percent of total billed charges","16.8% of total billed charges",98.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",491.47,82.6,,393.18,,,0,"percent of total billed charges","82.6% of total billed charges",98.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"case rate","pays based on per visit rate",595,100,,476.00,,,0,"percent of total billed charges","100% of total billed charges",91.04,595,
"93272 External patient and, when performed, auto a",7961562,CDM,521,RC,93272,CPT,OUTPATIENT,,,73,47.45,,64.24,88,,51.39,,,0,"percent of total billed charges","88% of total billed charges",36.5,50,,29.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",45.99,63,,36.79,,,0,"percent of total billed charges","63% of total billed charges",11.17,15.3,,8.94,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.37,69,,,,,0,"fee schedule","69% of total billed charges",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.15,61.85,,36.12,,,0,"percent of total billed charges","61.5% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.5,50,,29.20,,,0,"percent of total billed charges","50% of total billed charges",23.51,32.2,,18.81,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",27.52,37.7,,22.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",56.94,78,,45.55,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.5,50,,29.20,,,0,"percent of total billed charges","50% of total billed charges",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",11.17,160.53,
"93279 Programming device evaluation (in person); s",7962788,CDM,521,RC,93279,CPT,OUTPATIENT,,,149,96.85,,131.12,88,,104.90,,,0,"percent of total billed charges","88% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,149,100,,119.20,,,0,"percent of total billed charges","100% of total billed charges",67.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.74,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",93.87,63,,75.10,,,0,"percent of total billed charges","63% of total billed charges",22.8,15.3,,18.24,,,0,"percent of total billed charges","15.3% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,102.81,69,,,,,0,"fee schedule","69% of total billed charges",149,100,,119.20,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",149,100,,119.20,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",149,100,,119.20,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.4,100,,,,,0,"fee schedule",EAPG,45.11,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",56.17,37.7,,44.94,,,0,"percent of total billed charges","37.70% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",116.22,78,,92.98,,,0,"percent of total billed charges","78% of total billed charges",38.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.07,82.6,,98.46,,,0,"percent of total billed charges","82.6% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.07,82.6,,98.46,,,0,"percent of total billed charges","82.6% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",195.23,100,,,,,0,"fee schedule",EAPG,149,100,,119.20,,,0,"percent of total billed charges","100% of total billed charges",22.8,195.23,
"93288 Interrogation device evaluation (in person)",7961647,CDM,521,RC,93288,CPT,OUTPATIENT,,,112,72.8,,98.56,88,,78.85,,,0,"percent of total billed charges","88% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",67.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.74,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",70.56,63,,56.45,,,0,"percent of total billed charges","63% of total billed charges",17.14,15.3,,13.71,,,0,"percent of total billed charges","15.3% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,77.28,69,,,,,0,"fee schedule","69% of total billed charges",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.4,100,,,,,0,"fee schedule",EAPG,45.11,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",42.22,37.7,,33.78,,,0,"percent of total billed charges","37.70% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",87.36,78,,69.89,,,0,"percent of total billed charges","78% of total billed charges",38.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.51,82.6,,74.01,,,0,"percent of total billed charges","82.6% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.51,82.6,,74.01,,,0,"percent of total billed charges","82.6% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",195.23,100,,,,,0,"fee schedule",EAPG,112,100,,89.60,,,0,"percent of total billed charges","100% of total billed charges",17.14,195.23,
"93284 Programming device evaluation;  multiple lea",7961838,CDM,521,RC,93284,CPT,OUTPATIENT,,,266,172.9,,234.08,88,,187.26,,,0,"percent of total billed charges","88% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",67.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.74,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",167.58,63,,134.06,,,0,"percent of total billed charges","63% of total billed charges",40.7,15.3,,32.56,,,0,"percent of total billed charges","15.3% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,183.54,69,,,,,0,"fee schedule","69% of total billed charges",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.4,100,,,,,0,"fee schedule",EAPG,45.11,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",100.28,37.7,,80.22,,,0,"percent of total billed charges","37.70% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",207.48,78,,165.98,,,0,"percent of total billed charges","78% of total billed charges",38.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",219.72,82.6,,175.78,,,0,"percent of total billed charges","82.6% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",219.72,82.6,,175.78,,,0,"percent of total billed charges","82.6% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",195.23,100,,,,,0,"fee schedule",EAPG,266,100,,212.80,,,0,"percent of total billed charges","100% of total billed charges",34.7,266,
"93287 Peri-procedural device evaluation; single, d",7961839,CDM,521,RC,93287,CPT,OUTPATIENT,,,101,65.65,,88.88,88,,71.10,,,0,"percent of total billed charges","88% of total billed charges",50.5,50,,40.40,,,0,"percent of total billed charges","50% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.74,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",63.63,63,,50.90,,,0,"percent of total billed charges","63% of total billed charges",15.45,15.3,,12.36,,,0,"percent of total billed charges","15.3% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,69.69,69,,,,,0,"fee schedule","69% of total billed charges",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,61.85,,49.98,,,0,"percent of total billed charges","61.5% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,50.5,50,,40.40,,,0,"percent of total billed charges","50% of total billed charges",32.52,32.2,,26.02,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.4,100,,,,,0,"fee schedule",EAPG,45.11,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.08,37.7,,30.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",78.78,78,,63.02,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",83.43,82.6,,66.74,,,0,"percent of total billed charges","82.6% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,50.5,50,,40.40,,,0,"percent of total billed charges","50% of total billed charges",83.43,82.6,,66.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",195.23,100,,,,,0,"fee schedule",EAPG,101,100,,80.80,,,0,"percent of total billed charges","100% of total billed charges",15.45,195.23,
"93289 Interrogation device eval; single, dual, or",7961840,CDM,521,RC,93289,CPT,OUTPATIENT,,,193,125.45,,169.84,88,,135.87,,,0,"percent of total billed charges","88% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",67.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.74,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",121.59,63,,97.27,,,0,"percent of total billed charges","63% of total billed charges",29.53,15.3,,23.62,,,0,"percent of total billed charges","15.3% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,133.17,69,,,,,0,"fee schedule","69% of total billed charges",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.4,100,,,,,0,"fee schedule",EAPG,45.11,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",72.76,37.7,,58.21,,,0,"percent of total billed charges","37.70% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.54,78,,120.43,,,0,"percent of total billed charges","78% of total billed charges",38.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",159.42,82.6,,127.54,,,0,"percent of total billed charges","82.6% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",159.42,82.6,,127.54,,,0,"percent of total billed charges","82.6% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",195.23,100,,,,,0,"fee schedule",EAPG,193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",29.53,195.23,
"93282 Programming device evaluation; single lead t",7962197,CDM,521,RC,93282,CPT,OUTPATIENT,,,185,120.25,,162.8,88,,130.24,,,0,"percent of total billed charges","88% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",67.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.74,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",116.55,63,,93.24,,,0,"percent of total billed charges","63% of total billed charges",28.31,15.3,,22.65,,,0,"percent of total billed charges","15.3% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,127.65,69,,,,,0,"fee schedule","69% of total billed charges",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.4,100,,,,,0,"fee schedule",EAPG,45.11,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",69.75,37.7,,55.80,,,0,"percent of total billed charges","37.70% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",144.3,78,,115.44,,,0,"percent of total billed charges","78% of total billed charges",38.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",152.81,82.6,,122.25,,,0,"percent of total billed charges","82.6% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",152.81,82.6,,122.25,,,0,"percent of total billed charges","82.6% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",195.23,100,,,,,0,"fee schedule",EAPG,185,100,,148.00,,,0,"percent of total billed charges","100% of total billed charges",28.31,195.23,
"93283 Programming device evaluation; dual lead tra",7962306,CDM,521,RC,93283,CPT,OUTPATIENT,,,239,155.35,,210.32,88,,168.26,,,0,"percent of total billed charges","88% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",67.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.74,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.57,63,,120.46,,,0,"percent of total billed charges","63% of total billed charges",36.57,15.3,,29.26,,,0,"percent of total billed charges","15.3% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,164.91,69,,,,,0,"fee schedule","69% of total billed charges",239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.4,100,,,,,0,"fee schedule",EAPG,45.11,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",90.1,37.7,,72.08,,,0,"percent of total billed charges","37.70% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",186.42,78,,149.14,,,0,"percent of total billed charges","78% of total billed charges",38.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",197.41,82.6,,157.93,,,0,"percent of total billed charges","82.6% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",197.41,82.6,,157.93,,,0,"percent of total billed charges","82.6% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",195.23,100,,,,,0,"fee schedule",EAPG,239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",34.7,239,
"93286 Peri-procedural device evaluation; single, d",7962429,CDM,521,RC,93286,CPT,OUTPATIENT,,,76,49.4,,66.88,88,,53.50,,,0,"percent of total billed charges","88% of total billed charges",38,50,,30.40,,,0,"percent of total billed charges","50% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.74,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",47.88,63,,38.30,,,0,"percent of total billed charges","63% of total billed charges",11.63,15.3,,9.30,,,0,"percent of total billed charges","15.3% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,52.44,69,,,,,0,"fee schedule","69% of total billed charges",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.01,61.85,,37.61,,,0,"percent of total billed charges","61.5% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,38,50,,30.40,,,0,"percent of total billed charges","50% of total billed charges",24.47,32.2,,19.58,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.4,100,,,,,0,"fee schedule",EAPG,45.11,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.65,37.7,,22.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",59.28,78,,47.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.78,82.6,,50.22,,,0,"percent of total billed charges","82.6% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,38,50,,30.40,,,0,"percent of total billed charges","50% of total billed charges",62.78,82.6,,50.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",195.23,100,,,,,0,"fee schedule",EAPG,76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",11.63,195.23,
"93285 Programming device evaluation (in person); i",7962653,CDM,521,RC,93285,CPT,OUTPATIENT,,,125,81.25,,110,88,,88.00,,,0,"percent of total billed charges","88% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",67.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.74,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",78.75,63,,63.00,,,0,"percent of total billed charges","63% of total billed charges",19.13,15.3,,15.30,,,0,"percent of total billed charges","15.3% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,86.25,69,,,,,0,"fee schedule","69% of total billed charges",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.4,100,,,,,0,"fee schedule",EAPG,45.11,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",47.13,37.7,,37.70,,,0,"percent of total billed charges","37.70% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",97.5,78,,78.00,,,0,"percent of total billed charges","78% of total billed charges",38.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",103.25,82.6,,82.60,,,0,"percent of total billed charges","82.6% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",103.25,82.6,,82.60,,,0,"percent of total billed charges","82.6% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",195.23,100,,,,,0,"fee schedule",EAPG,125,100,,100.00,,,0,"percent of total billed charges","100% of total billed charges",19.13,195.23,
"93281 Programming device evaluation (in person); m",7962722,CDM,521,RC,93281,CPT,OUTPATIENT,,,202,131.3,,177.76,88,,142.21,,,0,"percent of total billed charges","88% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",67.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.74,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",127.26,63,,101.81,,,0,"percent of total billed charges","63% of total billed charges",30.91,15.3,,24.73,,,0,"percent of total billed charges","15.3% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,139.38,69,,,,,0,"fee schedule","69% of total billed charges",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.4,100,,,,,0,"fee schedule",EAPG,45.11,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",76.15,37.7,,60.92,,,0,"percent of total billed charges","37.70% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",157.56,78,,126.05,,,0,"percent of total billed charges","78% of total billed charges",38.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",166.85,82.6,,133.48,,,0,"percent of total billed charges","82.6% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",166.85,82.6,,133.48,,,0,"percent of total billed charges","82.6% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",195.23,100,,,,,0,"fee schedule",EAPG,202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",30.91,202,
"93280 Programming device evaluation (in person) d",7962860,CDM,521,RC,93280,CPT,OUTPATIENT,,,174,113.1,,153.12,88,,122.50,,,0,"percent of total billed charges","88% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,174,100,,139.20,,,0,"percent of total billed charges","100% of total billed charges",67.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.74,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.62,63,,87.70,,,0,"percent of total billed charges","63% of total billed charges",26.62,15.3,,21.30,,,0,"percent of total billed charges","15.3% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,120.06,69,,,,,0,"fee schedule","69% of total billed charges",174,100,,139.20,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",174,100,,139.20,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",174,100,,139.20,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.4,100,,,,,0,"fee schedule",EAPG,45.11,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",65.6,37.7,,52.48,,,0,"percent of total billed charges","37.70% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",135.72,78,,108.58,,,0,"percent of total billed charges","78% of total billed charges",38.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",143.72,82.6,,114.98,,,0,"percent of total billed charges","82.6% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",143.72,82.6,,114.98,,,0,"percent of total billed charges","82.6% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",195.23,100,,,,,0,"fee schedule",EAPG,174,100,,139.20,,,0,"percent of total billed charges","100% of total billed charges",26.62,195.23,
"93299 Interrogation device eval, up to 30 days; im",7961563,CDM,521,RC,,,OUTPATIENT,,,85,55.25,,74.8,88,,59.84,,,0,"percent of total billed charges","88% of total billed charges",42.5,50,,34.00,,,0,"percent of total billed charges","50% of total billed charges",14.28,16.8,,11.42,,,0,"percent of total billed charges","16.8% of total billed charges",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.71,17.304,,11.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.55,63,,42.84,,,0,"percent of total billed charges","63% of total billed charges",13.01,15.3,,10.41,,,0,"percent of total billed charges","15.3% of total billed charges",14.28,16.8,,11.42,,,0,"percent of total billed charges","16.8% of total billed charges",58.65,69,,,,,0,"fee schedule","69% of total billed charges",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.57,61.85,,42.06,,,0,"percent of total billed charges","61.5% of total billed charges",14.28,16.8,,11.42,,,0,"percent of total billed charges","16.8% of total billed charges",42.5,50,,34.00,,,0,"percent of total billed charges","50% of total billed charges",27.37,32.2,,21.90,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.57,17.136,,11.66,,,0,"percent of total billed charges","17.136% of total billed charges",18.56,21.84,,14.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",32.05,37.7,,25.64,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",66.3,78,,53.04,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.21,82.6,,56.17,,,0,"percent of total billed charges","82.6% of total billed charges",14.28,16.8,,11.42,,,0,"percent of total billed charges","16.8% of total billed charges",42.5,50,,34.00,,,0,"percent of total billed charges","50% of total billed charges",70.21,82.6,,56.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",13.01,160.53,
"93293 Transtelephonic rhythm strip pacemaker evalu",7961648,CDM,521,RC,93293,CPT,OUTPATIENT,,,161,104.65,,141.68,88,,113.34,,,0,"percent of total billed charges","88% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,161,100,,128.80,,,0,"percent of total billed charges","100% of total billed charges",67.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.74,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.43,63,,81.14,,,0,"percent of total billed charges","63% of total billed charges",24.63,15.3,,19.70,,,0,"percent of total billed charges","15.3% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,111.09,69,,,,,0,"fee schedule","69% of total billed charges",161,100,,128.80,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",161,100,,128.80,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",161,100,,128.80,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.4,100,,,,,0,"fee schedule",EAPG,45.11,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",60.7,37.7,,48.56,,,0,"percent of total billed charges","37.70% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.58,78,,100.46,,,0,"percent of total billed charges","78% of total billed charges",38.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.99,82.6,,106.39,,,0,"percent of total billed charges","82.6% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.99,82.6,,106.39,,,0,"percent of total billed charges","82.6% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",195.23,100,,,,,0,"fee schedule",EAPG,161,100,,128.80,,,0,"percent of total billed charges","100% of total billed charges",24.63,195.23,
"93295 Interrogation device eval remote, up to 90 d",7961649,CDM,521,RC,93295,CPT,OUTPATIENT,,,191,124.15,,168.08,88,,134.46,,,0,"percent of total billed charges","88% of total billed charges",95.5,50,,76.40,,,0,"percent of total billed charges","50% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.74,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",120.33,63,,96.26,,,0,"percent of total billed charges","63% of total billed charges",29.22,15.3,,23.38,,,0,"percent of total billed charges","15.3% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,131.79,69,,,,,0,"fee schedule","69% of total billed charges",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",118.13,61.85,,94.50,,,0,"percent of total billed charges","61.5% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,95.5,50,,76.40,,,0,"percent of total billed charges","50% of total billed charges",61.5,32.2,,49.20,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.4,100,,,,,0,"fee schedule",EAPG,45.11,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",72.01,37.7,,57.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",148.98,78,,119.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.77,82.6,,126.22,,,0,"percent of total billed charges","82.6% of total billed charges",34.7,100,,,,,0,"fee schedule","100% of WA fee schedule",95.5,50,,76.40,,,0,"percent of total billed charges","50% of total billed charges",157.77,82.6,,126.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",195.23,100,,,,,0,"fee schedule",EAPG,191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",29.22,195.23,
"93291 Interrogation device evaluation; loop record",7961785,CDM,521,RC,93291,CPT,OUTPATIENT,,,107,69.55,,94.16,88,,75.33,,,0,"percent of total billed charges","88% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",53.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.74,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",67.41,63,,53.93,,,0,"percent of total billed charges","63% of total billed charges",16.37,15.3,,13.10,,,0,"percent of total billed charges","15.3% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,73.83,69,,,,,0,"fee schedule","69% of total billed charges",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.22,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.4,100,,,,,0,"fee schedule",EAPG,45.11,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",40.34,37.7,,32.27,,,0,"percent of total billed charges","37.70% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",83.46,78,,66.77,,,0,"percent of total billed charges","78% of total billed charges",30.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",88.38,82.6,,70.70,,,0,"percent of total billed charges","82.6% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",88.38,82.6,,70.70,,,0,"percent of total billed charges","82.6% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",195.23,100,,,,,0,"fee schedule",EAPG,107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",16.37,195.23,
"93298 Interrogation device eval, (remote) up to 30",7961786,CDM,521,RC,93298,CPT,OUTPATIENT,,,77,50.05,,67.76,88,,54.21,,,0,"percent of total billed charges","88% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",67.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",48.51,63,,38.81,,,0,"percent of total billed charges","63% of total billed charges",11.78,15.3,,9.42,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.13,69,,,,,0,"fee schedule","69% of total billed charges",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",47.62,61.85,,38.10,,,0,"percent of total billed charges","61.5% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.79,32.2,,19.83,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",29.03,37.7,,23.22,,,0,"percent of total billed charges","37.70% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60.06,78,,48.05,,,0,"percent of total billed charges","78% of total billed charges",38.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",63.6,82.6,,50.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",63.6,82.6,,50.88,,,0,"percent of total billed charges","82.6% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"case rate","pays based on per visit rate",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",11.78,160.53,
"93296 Interrogation device eval, up to 90 days si",7961841,CDM,521,RC,93296,CPT,OUTPATIENT,,,88,57.2,,77.44,88,,61.95,,,0,"percent of total billed charges","88% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",67.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.74,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",55.44,63,,44.35,,,0,"percent of total billed charges","63% of total billed charges",13.46,15.3,,10.77,,,0,"percent of total billed charges","15.3% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,60.72,69,,,,,0,"fee schedule","69% of total billed charges",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.4,100,,,,,0,"fee schedule",EAPG,45.11,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",33.18,37.7,,26.54,,,0,"percent of total billed charges","37.70% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",68.64,78,,54.91,,,0,"percent of total billed charges","78% of total billed charges",38.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",195.23,100,,,,,0,"fee schedule",EAPG,88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",13.46,195.23,
"93294 Interrogation device evaluation, up to 90 da",7961949,CDM,521,RC,93294,CPT,OUTPATIENT,,,97,63.05,,85.36,88,,68.29,,,0,"percent of total billed charges","88% of total billed charges",48.5,50,,38.80,,,0,"percent of total billed charges","50% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.74,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",61.11,63,,48.89,,,0,"percent of total billed charges","63% of total billed charges",14.84,15.3,,11.87,,,0,"percent of total billed charges","15.3% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,66.93,69,,,,,0,"fee schedule","69% of total billed charges",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.99,61.85,,47.99,,,0,"percent of total billed charges","61.5% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,48.5,50,,38.80,,,0,"percent of total billed charges","50% of total billed charges",31.23,32.2,,24.98,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.4,100,,,,,0,"fee schedule",EAPG,45.11,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.57,37.7,,29.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.66,78,,60.53,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.12,82.6,,64.10,,,0,"percent of total billed charges","82.6% of total billed charges",34.7,100,,,,,0,"fee schedule","100% of WA fee schedule",48.5,50,,38.80,,,0,"percent of total billed charges","50% of total billed charges",80.12,82.6,,64.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",195.23,100,,,,,0,"fee schedule",EAPG,97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",14.84,195.23,
"93290 Interrogation device evaluation; cardiovascu",7963055,CDM,521,RC,93290,CPT,OUTPATIENT,,,90,58.5,,79.2,88,,63.36,,,0,"percent of total billed charges","88% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",67.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.74,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",56.7,63,,45.36,,,0,"percent of total billed charges","63% of total billed charges",13.77,15.3,,11.02,,,0,"percent of total billed charges","15.3% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,62.1,69,,,,,0,"fee schedule","69% of total billed charges",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.4,100,,,,,0,"fee schedule",EAPG,45.11,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",33.93,37.7,,27.14,,,0,"percent of total billed charges","37.70% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",70.2,78,,56.16,,,0,"percent of total billed charges","78% of total billed charges",38.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.34,82.6,,59.47,,,0,"percent of total billed charges","82.6% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.34,82.6,,59.47,,,0,"percent of total billed charges","82.6% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",195.23,100,,,,,0,"fee schedule",EAPG,90,100,,72.00,,,0,"percent of total billed charges","100% of total billed charges",13.77,195.23,
"93297 icm device interrogat remote",7963762,CDM,521,RC,93297,CPT,OUTPATIENT,,,74,48.1,,65.12,88,,52.10,,,0,"percent of total billed charges","88% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",67.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.62,63,,37.30,,,0,"percent of total billed charges","63% of total billed charges",11.32,15.3,,9.06,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.06,69,,,,,0,"fee schedule","69% of total billed charges",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",45.77,61.85,,36.62,,,0,"percent of total billed charges","61.5% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.83,32.2,,19.06,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",27.9,37.7,,22.32,,,0,"percent of total billed charges","37.70% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",57.72,78,,46.18,,,0,"percent of total billed charges","78% of total billed charges",38.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.12,82.6,,48.90,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.12,82.6,,48.90,,,0,"percent of total billed charges","82.6% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"case rate","pays based on per visit rate",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",11.32,160.53,
"93292 wcd device interrogate",7963876,CDM,521,RC,93292,CPT,OUTPATIENT,,,97,63.05,,85.36,88,,68.29,,,0,"percent of total billed charges","88% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",67.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.74,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.11,63,,48.89,,,0,"percent of total billed charges","63% of total billed charges",14.84,15.3,,11.87,,,0,"percent of total billed charges","15.3% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,66.93,69,,,,,0,"fee schedule","69% of total billed charges",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",150.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.7,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.4,100,,,,,0,"fee schedule",EAPG,45.11,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",36.57,37.7,,29.26,,,0,"percent of total billed charges","37.70% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75.66,78,,60.53,,,0,"percent of total billed charges","78% of total billed charges",38.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.12,82.6,,64.10,,,0,"percent of total billed charges","82.6% of total billed charges",34.7,100,,,,,0,"fee schedule",EAPG,38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",80.12,82.6,,64.10,,,0,"percent of total billed charges","82.6% of total billed charges",38.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",195.23,100,,,,,0,"fee schedule",EAPG,97,100,,77.60,,,0,"percent of total billed charges","100% of total billed charges",14.84,195.23,
"93306 Echo, transthoracic, w/ image, includes M-mo",7961715,CDM,521,RC,93306,CPT,OUTPATIENT,,,677,440.05,,595.76,88,,476.61,,,0,"percent of total billed charges","88% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,677,100,,541.60,,,0,"percent of total billed charges","100% of total billed charges",984.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",430.64,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.51,63,,341.21,,,0,"percent of total billed charges","63% of total billed charges",103.58,15.3,,82.86,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,467.13,69,,,,,0,"fee schedule","69% of total billed charges",677,100,,541.60,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",677,100,,541.60,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",677,100,,541.60,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1961.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",255.23,37.7,,204.18,,,0,"percent of total billed charges","37.70% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",528.06,78,,422.45,,,0,"percent of total billed charges","78% of total billed charges",568.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",559.2,82.6,,447.36,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",559.2,82.6,,447.36,,,0,"percent of total billed charges","82.6% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",578.63,100,,,,,0,"fee schedule",EAPG,677,100,,541.60,,,0,"percent of total billed charges","100% of total billed charges",103.58,1961.75,
"93304 Transthoracic echocardiography for congenita",7961787,CDM,521,RC,93304,CPT,OUTPATIENT,,,107,69.55,,94.16,88,,75.33,,,0,"percent of total billed charges","88% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",984.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",430.64,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",67.41,63,,53.93,,,0,"percent of total billed charges","63% of total billed charges",16.37,15.3,,13.10,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,73.83,69,,,,,0,"fee schedule","69% of total billed charges",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1961.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",40.34,37.7,,32.27,,,0,"percent of total billed charges","37.70% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",83.46,78,,66.77,,,0,"percent of total billed charges","78% of total billed charges",568.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",88.38,82.6,,70.70,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",88.38,82.6,,70.70,,,0,"percent of total billed charges","82.6% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",578.63,100,,,,,0,"fee schedule",EAPG,107,100,,85.60,,,0,"percent of total billed charges","100% of total billed charges",16.37,1961.75,
"93307 Echo, transthoracic, real-time with image, i",7961885,CDM,521,RC,93307,CPT,OUTPATIENT,,,135,87.75,,118.8,88,,95.04,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,135,100,,108.00,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",430.64,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",85.05,63,,68.04,,,0,"percent of total billed charges","63% of total billed charges",20.66,15.3,,16.53,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,93.15,69,,,,,0,"fee schedule","69% of total billed charges",135,100,,108.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",135,100,,108.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",135,100,,108.00,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",50.9,37.7,,40.72,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",105.3,78,,84.24,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.51,82.6,,89.21,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.51,82.6,,89.21,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",578.63,100,,,,,0,"fee schedule",EAPG,135,100,,108.00,,,0,"percent of total billed charges","100% of total billed charges",20.66,934.9,
"93308 Echo, transthoracic, w/ image, includes M-mo",7962691,CDM,521,RC,93308,CPT,OUTPATIENT,,,76,49.4,,66.88,88,,53.50,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",430.64,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.88,63,,38.30,,,0,"percent of total billed charges","63% of total billed charges",11.63,15.3,,9.30,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,52.44,69,,,,,0,"fee schedule","69% of total billed charges",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",28.65,37.7,,22.92,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.28,78,,47.42,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",62.78,82.6,,50.22,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",62.78,82.6,,50.22,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",578.63,100,,,,,0,"fee schedule",EAPG,76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",11.63,934.9,
"93303 Transthoracic echocardiography for congenita",7962731,CDM,521,RC,93303,CPT,OUTPATIENT,,,188,122.2,,165.44,88,,132.35,,,0,"percent of total billed charges","88% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,188,100,,150.40,,,0,"percent of total billed charges","100% of total billed charges",984.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",430.64,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.44,63,,94.75,,,0,"percent of total billed charges","63% of total billed charges",28.76,15.3,,23.01,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,129.72,69,,,,,0,"fee schedule","69% of total billed charges",188,100,,150.40,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",188,100,,150.40,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",188,100,,150.40,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1961.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",70.88,37.7,,56.70,,,0,"percent of total billed charges","37.70% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",146.64,78,,117.31,,,0,"percent of total billed charges","78% of total billed charges",568.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",155.29,82.6,,124.23,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",155.29,82.6,,124.23,,,0,"percent of total billed charges","82.6% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",578.63,100,,,,,0,"fee schedule",EAPG,188,100,,150.40,,,0,"percent of total billed charges","100% of total billed charges",28.76,1961.75,
"93316 Transesophageal echo for congenital cardiac",7961450,CDM,521,RC,93316,CPT,OUTPATIENT,,,143,92.95,,125.84,88,,100.67,,,0,"percent of total billed charges","88% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",984.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",430.64,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",90.09,63,,72.07,,,0,"percent of total billed charges","63% of total billed charges",21.88,15.3,,17.50,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,98.67,69,,,,,0,"fee schedule","69% of total billed charges",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1961.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",53.91,37.7,,43.13,,,0,"percent of total billed charges","37.70% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.54,78,,89.23,,,0,"percent of total billed charges","78% of total billed charges",568.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.12,82.6,,94.50,,,0,"percent of total billed charges","82.6% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",578.63,100,,,,,0,"fee schedule",EAPG,143,100,,114.40,,,0,"percent of total billed charges","100% of total billed charges",21.88,1961.75,
"93314 Echo, transesophageal, w/ image (w/ or w/o M",7961650,CDM,521,RC,93314,CPT,OUTPATIENT,,,178,115.7,,156.64,88,,125.31,,,0,"percent of total billed charges","88% of total billed charges",89,50,,71.20,,,0,"percent of total billed charges","50% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,178,100,,142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",430.64,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",112.14,63,,89.71,,,0,"percent of total billed charges","63% of total billed charges",27.23,15.3,,21.78,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,122.82,69,,,,,0,"fee schedule","69% of total billed charges",178,100,,142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178,100,,142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",178,100,,142.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",110.09,61.85,,88.07,,,0,"percent of total billed charges","61.5% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,89,50,,71.20,,,0,"percent of total billed charges","50% of total billed charges",57.32,32.2,,45.86,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",67.11,37.7,,53.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",138.84,78,,111.07,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",147.03,82.6,,117.62,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,89,50,,71.20,,,0,"percent of total billed charges","50% of total billed charges",147.03,82.6,,117.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",578.63,100,,,,,0,"fee schedule",EAPG,178,100,,142.40,,,0,"percent of total billed charges","100% of total billed charges",27.23,578.63,
"93313 Echo, transesophageal, w/ image (w/ or w/o M",7961788,CDM,521,RC,93313,CPT,OUTPATIENT,,,298,193.7,,262.24,88,,209.79,,,0,"percent of total billed charges","88% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,298,100,,238.40,,,0,"percent of total billed charges","100% of total billed charges",984.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",430.64,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",187.74,63,,150.19,,,0,"percent of total billed charges","63% of total billed charges",45.59,15.3,,36.47,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,205.62,69,,,,,0,"fee schedule","69% of total billed charges",298,100,,238.40,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298,100,,238.40,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",298,100,,238.40,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1961.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",112.35,37.7,,89.88,,,0,"percent of total billed charges","37.70% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",232.44,78,,185.95,,,0,"percent of total billed charges","78% of total billed charges",568.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",246.15,82.6,,196.92,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",246.15,82.6,,196.92,,,0,"percent of total billed charges","82.6% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",578.63,100,,,,,0,"fee schedule",EAPG,298,100,,238.40,,,0,"percent of total billed charges","100% of total billed charges",45.59,1961.75,
"93312 Echo, transesophageal, w/ image (w/ or w/o M",7962430,CDM,521,RC,93312,CPT,OUTPATIENT,,,311,202.15,,273.68,88,,218.94,,,0,"percent of total billed charges","88% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,311,100,,248.80,,,0,"percent of total billed charges","100% of total billed charges",984.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",430.64,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",195.93,63,,156.74,,,0,"percent of total billed charges","63% of total billed charges",47.58,15.3,,38.06,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,214.59,69,,,,,0,"fee schedule","69% of total billed charges",311,100,,248.80,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",311,100,,248.80,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",311,100,,248.80,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1961.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",117.25,37.7,,93.80,,,0,"percent of total billed charges","37.70% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",242.58,78,,194.06,,,0,"percent of total billed charges","78% of total billed charges",568.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.89,82.6,,205.51,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.89,82.6,,205.51,,,0,"percent of total billed charges","82.6% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",578.63,100,,,,,0,"fee schedule",EAPG,311,100,,248.80,,,0,"percent of total billed charges","100% of total billed charges",47.58,1961.75,
"93318 Echo transesophageal intraop",7963767,CDM,521,RC,93318,CPT,OUTPATIENT,,,324,210.6,,285.12,88,,228.10,,,0,"percent of total billed charges","88% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,324,100,,259.20,,,0,"percent of total billed charges","100% of total billed charges",984.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",430.64,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",204.12,63,,163.30,,,0,"percent of total billed charges","63% of total billed charges",49.57,15.3,,39.66,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,223.56,69,,,,,0,"fee schedule","69% of total billed charges",324,100,,259.20,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",324,100,,259.20,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",324,100,,259.20,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1961.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",122.15,37.7,,97.72,,,0,"percent of total billed charges","37.70% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.72,78,,202.18,,,0,"percent of total billed charges","78% of total billed charges",568.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.62,82.6,,214.10,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267.62,82.6,,214.10,,,0,"percent of total billed charges","82.6% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",578.63,100,,,,,0,"fee schedule",EAPG,324,100,,259.20,,,0,"percent of total billed charges","100% of total billed charges",49.57,1961.75,
"93315 echo transesophageal",7963898,CDM,521,RC,93315,CPT,OUTPATIENT,,,411,267.15,,361.68,88,,289.34,,,0,"percent of total billed charges","88% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,411,100,,328.80,,,0,"percent of total billed charges","100% of total billed charges",984.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",430.64,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",258.93,63,,207.14,,,0,"percent of total billed charges","63% of total billed charges",62.88,15.3,,50.30,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,283.59,69,,,,,0,"fee schedule","69% of total billed charges",411,100,,328.80,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",411,100,,328.80,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",411,100,,328.80,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1961.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",154.95,37.7,,123.96,,,0,"percent of total billed charges","37.70% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320.58,78,,256.46,,,0,"percent of total billed charges","78% of total billed charges",568.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",339.49,82.6,,271.59,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",339.49,82.6,,271.59,,,0,"percent of total billed charges","82.6% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",578.63,100,,,,,0,"fee schedule",EAPG,411,100,,328.80,,,0,"percent of total billed charges","100% of total billed charges",62.88,1961.75,
"93317 echo transesophageal",7963899,CDM,521,RC,93317,CPT,OUTPATIENT,,,269,174.85,,236.72,88,,189.38,,,0,"percent of total billed charges","88% of total billed charges",134.5,50,,107.60,,,0,"percent of total billed charges","50% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",430.64,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",169.47,63,,135.58,,,0,"percent of total billed charges","63% of total billed charges",41.16,15.3,,32.93,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,185.61,69,,,,,0,"fee schedule","69% of total billed charges",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",166.38,61.85,,133.10,,,0,"percent of total billed charges","61.5% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,134.5,50,,107.60,,,0,"percent of total billed charges","50% of total billed charges",86.62,32.2,,69.30,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.41,37.7,,81.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.82,78,,167.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",222.19,82.6,,177.75,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,134.5,50,,107.60,,,0,"percent of total billed charges","50% of total billed charges",222.19,82.6,,177.75,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",578.63,100,,,,,0,"fee schedule",EAPG,269,100,,215.20,,,0,"percent of total billed charges","100% of total billed charges",41.16,578.63,
"93320 Doppler echocardiography, pulsed wave and/or",7961716,CDM,521,RC,93320,CPT,OUTPATIENT,,,56,36.4,,49.28,88,,39.42,,,0,"percent of total billed charges","88% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",430.64,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",35.28,63,,28.22,,,0,"percent of total billed charges","63% of total billed charges",8.57,15.3,,6.86,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,38.64,69,,,,,0,"fee schedule","69% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.64,61.85,,27.71,,,0,"percent of total billed charges","61.5% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",18.03,32.2,,14.42,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.11,37.7,,16.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.68,78,,34.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",578.63,100,,,,,0,"fee schedule",EAPG,56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",8.57,578.63,
"93321 Doppler echo, pulsed wave and/or cont wave w",7961717,CDM,521,RC,93321,CPT,OUTPATIENT,,,23,14.95,,20.24,88,,16.19,,,0,"percent of total billed charges","88% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",430.64,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",14.49,63,,11.59,,,0,"percent of total billed charges","63% of total billed charges",3.52,15.3,,2.82,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,15.87,69,,,,,0,"fee schedule","69% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.23,61.85,,11.38,,,0,"percent of total billed charges","61.5% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",7.41,32.2,,5.93,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.94,78,,14.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",578.63,100,,,,,0,"fee schedule",EAPG,23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",3.52,578.63,
"93325 Doppler echocardiography color flow velocity",7963344,CDM,521,RC,93325,CPT,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",102.64,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.8,61.85,,5.44,,,0,"percent of total billed charges","61.5% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",260.18,100,,,,,0,"fee schedule",EAPG,11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,260.18,
"93351 Echo, trans, w/image, M-mode, stress test, i",7961564,CDM,521,RC,93351,CPT,OUTPATIENT,,,256,166.4,,225.28,88,,180.22,,,0,"percent of total billed charges","88% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",984.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",430.64,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",161.28,63,,129.02,,,0,"percent of total billed charges","63% of total billed charges",39.17,15.3,,31.34,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,176.64,69,,,,,0,"fee schedule","69% of total billed charges",256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1961.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",96.51,37.7,,77.21,,,0,"percent of total billed charges","37.70% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.68,78,,159.74,,,0,"percent of total billed charges","78% of total billed charges",568.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",211.46,82.6,,169.17,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",211.46,82.6,,169.17,,,0,"percent of total billed charges","82.6% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",578.63,100,,,,,0,"fee schedule",EAPG,256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",39.17,1961.75,
"93350 Echo, transthoracic, w/ image, M-mode, stres",7962198,CDM,521,RC,93350,CPT,OUTPATIENT,,,213,138.45,,187.44,88,,149.95,,,0,"percent of total billed charges","88% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",984.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",430.64,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",134.19,63,,107.35,,,0,"percent of total billed charges","63% of total billed charges",32.59,15.3,,26.07,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,146.97,69,,,,,0,"fee schedule","69% of total billed charges",213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1961.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",512.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",80.3,37.7,,64.24,,,0,"percent of total billed charges","37.70% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",166.14,78,,132.91,,,0,"percent of total billed charges","78% of total billed charges",568.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",175.94,82.6,,140.75,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",175.94,82.6,,140.75,,,0,"percent of total billed charges","82.6% of total billed charges",562.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",578.63,100,,,,,0,"fee schedule",EAPG,213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",32.59,1961.75,
"93352 Use of echocardiographic contrast agent duri",7962828,CDM,521,RC,93352,CPT,OUTPATIENT,,,110,71.5,,96.8,88,,77.44,,,0,"percent of total billed charges","88% of total billed charges",55,50,,44.00,,,0,"percent of total billed charges","50% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",430.64,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",69.3,63,,55.44,,,0,"percent of total billed charges","63% of total billed charges",16.83,15.3,,13.46,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,75.9,69,,,,,0,"fee schedule","69% of total billed charges",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.04,61.85,,54.43,,,0,"percent of total billed charges","61.5% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,55,50,,44.00,,,0,"percent of total billed charges","50% of total billed charges",35.42,32.2,,28.34,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.47,37.7,,33.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",85.8,78,,68.64,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.86,82.6,,72.69,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,55,50,,44.00,,,0,"percent of total billed charges","50% of total billed charges",90.86,82.6,,72.69,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",578.63,100,,,,,0,"fee schedule",EAPG,110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",16.83,578.63,
"93355 echo transesophageal (tee)",7963825,CDM,521,RC,93355,CPT,OUTPATIENT,,,488,317.2,,429.44,88,,343.55,,,0,"percent of total billed charges","88% of total billed charges",244,50,,195.20,,,0,"percent of total billed charges","50% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,488,100,,390.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",430.64,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",307.44,63,,245.95,,,0,"percent of total billed charges","63% of total billed charges",74.66,15.3,,59.73,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,336.72,69,,,,,0,"fee schedule","69% of total billed charges",488,100,,390.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",488,100,,390.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",488,100,,390.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",301.83,61.85,,241.46,,,0,"percent of total billed charges","61.5% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,244,50,,195.20,,,0,"percent of total billed charges","50% of total billed charges",157.14,32.2,,125.71,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",183.98,37.7,,147.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",380.64,78,,304.51,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.09,82.6,,322.47,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,244,50,,195.20,,,0,"percent of total billed charges","50% of total billed charges",403.09,82.6,,322.47,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",578.63,100,,,,,0,"fee schedule",EAPG,488,100,,390.40,,,0,"percent of total billed charges","100% of total billed charges",74.66,578.63,
"93457 Cath placement w/ injects for coronary angio",7961718,CDM,521,RC,93457,CPT,OUTPATIENT,,,1068,694.2,,939.84,88,,751.87,,,0,"percent of total billed charges","88% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,1068,100,,854.40,,,0,"percent of total billed charges","100% of total billed charges",5816.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",2184.59,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",672.84,63,,538.27,,,0,"percent of total billed charges","63% of total billed charges",163.4,15.3,,130.72,,,0,"percent of total billed charges","15.3% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,736.92,69,,,,,0,"fee schedule","69% of total billed charges",1068,100,,854.40,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1068,100,,854.40,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1068,100,,854.40,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",11777.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3079.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2163.38,100,,,,,0,"fee schedule",EAPG,2757.26,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",402.64,37.7,,322.11,,,0,"percent of total billed charges","37.70% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",833.04,78,,666.43,,,0,"percent of total billed charges","78% of total billed charges",3356.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",882.17,82.6,,705.74,,,0,"percent of total billed charges","82.6% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",882.17,82.6,,705.74,,,0,"percent of total billed charges","82.6% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2281.49,100,,,,,0,"fee schedule",EAPG,1068,100,,854.40,,,0,"percent of total billed charges","100% of total billed charges",163.4,11777.36,
"93458 Cath placement w/ injection(s) for coronary",7961719,CDM,521,RC,93458,CPT,OUTPATIENT,,,908,590.2,,799.04,88,,639.23,,,0,"percent of total billed charges","88% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,908,100,,726.40,,,0,"percent of total billed charges","100% of total billed charges",5816.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",2184.59,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",572.04,63,,457.63,,,0,"percent of total billed charges","63% of total billed charges",138.92,15.3,,111.14,,,0,"percent of total billed charges","15.3% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,626.52,69,,,,,0,"fee schedule","69% of total billed charges",908,100,,726.40,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",908,100,,726.40,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",908,100,,726.40,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",11777.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3079.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2163.38,100,,,,,0,"fee schedule",EAPG,2757.26,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",342.32,37.7,,273.86,,,0,"percent of total billed charges","37.70% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",708.24,78,,566.59,,,0,"percent of total billed charges","78% of total billed charges",3356.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",750.01,82.6,,600.01,,,0,"percent of total billed charges","82.6% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",750.01,82.6,,600.01,,,0,"percent of total billed charges","82.6% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2281.49,100,,,,,0,"fee schedule",EAPG,908,100,,726.40,,,0,"percent of total billed charges","100% of total billed charges",138.92,11777.36,
"93459 Cath placement w/ injection for coronary ang",7961720,CDM,521,RC,93459,CPT,OUTPATIENT,,,1024,665.6,,901.12,88,,720.90,,,0,"percent of total billed charges","88% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,1024,100,,819.20,,,0,"percent of total billed charges","100% of total billed charges",5816.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",2184.59,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",645.12,63,,516.10,,,0,"percent of total billed charges","63% of total billed charges",156.67,15.3,,125.34,,,0,"percent of total billed charges","15.3% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,706.56,69,,,,,0,"fee schedule","69% of total billed charges",1024,100,,819.20,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1024,100,,819.20,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1024,100,,819.20,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",11777.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3079.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2163.38,100,,,,,0,"fee schedule",EAPG,2757.26,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",386.05,37.7,,308.84,,,0,"percent of total billed charges","37.70% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",798.72,78,,638.98,,,0,"percent of total billed charges","78% of total billed charges",3356.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",845.82,82.6,,676.66,,,0,"percent of total billed charges","82.6% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",845.82,82.6,,676.66,,,0,"percent of total billed charges","82.6% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2281.49,100,,,,,0,"fee schedule",EAPG,1024,100,,819.20,,,0,"percent of total billed charges","100% of total billed charges",156.67,11777.36,
"93455 Cath placement, w/ inj(s) for coronary angio",7961790,CDM,521,RC,93455,CPT,OUTPATIENT,,,860,559,,756.8,88,,605.44,,,0,"percent of total billed charges","88% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,860,100,,688.00,,,0,"percent of total billed charges","100% of total billed charges",5816.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",2184.59,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",541.8,63,,433.44,,,0,"percent of total billed charges","63% of total billed charges",131.58,15.3,,105.26,,,0,"percent of total billed charges","15.3% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,593.4,69,,,,,0,"fee schedule","69% of total billed charges",860,100,,688.00,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",860,100,,688.00,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",860,100,,688.00,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",11777.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3079.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2163.38,100,,,,,0,"fee schedule",EAPG,2757.26,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",324.22,37.7,,259.38,,,0,"percent of total billed charges","37.70% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",670.8,78,,536.64,,,0,"percent of total billed charges","78% of total billed charges",3356.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",710.36,82.6,,568.29,,,0,"percent of total billed charges","82.6% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",710.36,82.6,,568.29,,,0,"percent of total billed charges","82.6% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2281.49,100,,,,,0,"fee schedule",EAPG,860,100,,688.00,,,0,"percent of total billed charges","100% of total billed charges",131.58,11777.36,
"93451 Right heart cath w/ measurement(s) of oxygen",7961844,CDM,521,RC,93451,CPT,OUTPATIENT,,,422,274.3,,371.36,88,,297.09,,,0,"percent of total billed charges","88% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",5816.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",2184.59,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.86,63,,212.69,,,0,"percent of total billed charges","63% of total billed charges",64.57,15.3,,51.66,,,0,"percent of total billed charges","15.3% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,291.18,69,,,,,0,"fee schedule","69% of total billed charges",422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",11777.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3079.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2163.38,100,,,,,0,"fee schedule",EAPG,2757.26,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.09,37.7,,127.27,,,0,"percent of total billed charges","37.70% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",329.16,78,,263.33,,,0,"percent of total billed charges","78% of total billed charges",3356.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.57,82.6,,278.86,,,0,"percent of total billed charges","82.6% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",348.57,82.6,,278.86,,,0,"percent of total billed charges","82.6% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2281.49,100,,,,,0,"fee schedule",EAPG,422,100,,337.60,,,0,"percent of total billed charges","100% of total billed charges",64.57,11777.36,
"93456 Cath placement w/  injection(s) for coronary",7961845,CDM,521,RC,93456,CPT,OUTPATIENT,,,953,619.45,,838.64,88,,670.91,,,0,"percent of total billed charges","88% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,953,100,,762.40,,,0,"percent of total billed charges","100% of total billed charges",5816.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",2184.59,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",600.39,63,,480.31,,,0,"percent of total billed charges","63% of total billed charges",145.81,15.3,,116.65,,,0,"percent of total billed charges","15.3% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,657.57,69,,,,,0,"fee schedule","69% of total billed charges",953,100,,762.40,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",953,100,,762.40,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",953,100,,762.40,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",11777.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3079.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2163.38,100,,,,,0,"fee schedule",EAPG,2757.26,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",359.28,37.7,,287.42,,,0,"percent of total billed charges","37.70% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",743.34,78,,594.67,,,0,"percent of total billed charges","78% of total billed charges",3356.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",787.18,82.6,,629.74,,,0,"percent of total billed charges","82.6% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",787.18,82.6,,629.74,,,0,"percent of total billed charges","82.6% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2281.49,100,,,,,0,"fee schedule",EAPG,953,100,,762.40,,,0,"percent of total billed charges","100% of total billed charges",145.81,11777.36,
"93453 Combined R&L heart cath including intraproce",7961950,CDM,521,RC,93453,CPT,OUTPATIENT,,,968,629.2,,851.84,88,,681.47,,,0,"percent of total billed charges","88% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,968,100,,774.40,,,0,"percent of total billed charges","100% of total billed charges",5816.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",2184.59,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",609.84,63,,487.87,,,0,"percent of total billed charges","63% of total billed charges",148.1,15.3,,118.48,,,0,"percent of total billed charges","15.3% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,667.92,69,,,,,0,"fee schedule","69% of total billed charges",968,100,,774.40,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",968,100,,774.40,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",968,100,,774.40,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",11777.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3079.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2163.38,100,,,,,0,"fee schedule",EAPG,2757.26,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",364.94,37.7,,291.95,,,0,"percent of total billed charges","37.70% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",755.04,78,,604.03,,,0,"percent of total billed charges","78% of total billed charges",3356.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",799.57,82.6,,639.66,,,0,"percent of total billed charges","82.6% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",799.57,82.6,,639.66,,,0,"percent of total billed charges","82.6% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2281.49,100,,,,,0,"fee schedule",EAPG,968,100,,774.40,,,0,"percent of total billed charges","100% of total billed charges",148.1,11777.36,
"93454 Cathnplacement in coronary artery(s), intra",7962456,CDM,521,RC,93454,CPT,OUTPATIENT,,,744,483.6,,654.72,88,,523.78,,,0,"percent of total billed charges","88% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,744,100,,595.20,,,0,"percent of total billed charges","100% of total billed charges",5816.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",2184.59,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",468.72,63,,374.98,,,0,"percent of total billed charges","63% of total billed charges",113.83,15.3,,91.06,,,0,"percent of total billed charges","15.3% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,513.36,69,,,,,0,"fee schedule","69% of total billed charges",744,100,,595.20,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",744,100,,595.20,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",744,100,,595.20,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",11777.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3079.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2163.38,100,,,,,0,"fee schedule",EAPG,2757.26,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",280.49,37.7,,224.39,,,0,"percent of total billed charges","37.70% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",580.32,78,,464.26,,,0,"percent of total billed charges","78% of total billed charges",3356.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",614.54,82.6,,491.63,,,0,"percent of total billed charges","82.6% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",614.54,82.6,,491.63,,,0,"percent of total billed charges","82.6% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2281.49,100,,,,,0,"fee schedule",EAPG,744,100,,595.20,,,0,"percent of total billed charges","100% of total billed charges",113.83,11777.36,
"93452 left hrt cath w/ventrclgrphy",7963772,CDM,521,RC,93452,CPT,OUTPATIENT,,,740,481,,651.2,88,,520.96,,,0,"percent of total billed charges","88% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,740,100,,592.00,,,0,"percent of total billed charges","100% of total billed charges",5816.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",2184.59,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",466.2,63,,372.96,,,0,"percent of total billed charges","63% of total billed charges",113.22,15.3,,90.58,,,0,"percent of total billed charges","15.3% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,510.6,69,,,,,0,"fee schedule","69% of total billed charges",740,100,,592.00,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",740,100,,592.00,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",740,100,,592.00,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",11777.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3079.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2163.38,100,,,,,0,"fee schedule",EAPG,2757.26,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",278.98,37.7,,223.18,,,0,"percent of total billed charges","37.70% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",577.2,78,,461.76,,,0,"percent of total billed charges","78% of total billed charges",3356.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",611.24,82.6,,488.99,,,0,"percent of total billed charges","82.6% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",611.24,82.6,,488.99,,,0,"percent of total billed charges","82.6% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2281.49,100,,,,,0,"fee schedule",EAPG,740,100,,592.00,,,0,"percent of total billed charges","100% of total billed charges",113.22,11777.36,
"93461 Cath w/ inject for coronary R&L heart cath f",7961651,CDM,521,RC,93461,CPT,OUTPATIENT,,,1258,817.7,,1107.04,88,,885.63,,,0,"percent of total billed charges","88% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,1258,100,,1006.40,,,0,"percent of total billed charges","100% of total billed charges",5816.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",2184.59,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",792.54,63,,634.03,,,0,"percent of total billed charges","63% of total billed charges",192.47,15.3,,153.98,,,0,"percent of total billed charges","15.3% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,868.02,69,,,,,0,"fee schedule","69% of total billed charges",1258,100,,1006.40,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1258,100,,1006.40,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1258,100,,1006.40,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",11777.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3079.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2163.38,100,,,,,0,"fee schedule",EAPG,2757.26,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",474.27,37.7,,379.42,,,0,"percent of total billed charges","37.70% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",981.24,78,,784.99,,,0,"percent of total billed charges","78% of total billed charges",3356.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1039.11,82.6,,831.29,,,0,"percent of total billed charges","82.6% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1039.11,82.6,,831.29,,,0,"percent of total billed charges","82.6% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2281.49,100,,,,,0,"fee schedule",EAPG,1258,100,,1006.40,,,0,"percent of total billed charges","100% of total billed charges",192.47,11777.36,
"93463 Pharmacologic agent admin w/ assessing hemod",7962307,CDM,521,RC,93463,CPT,OUTPATIENT,,,358,232.7,,315.04,88,,252.03,,,0,"percent of total billed charges","88% of total billed charges",179,50,,143.20,,,0,"percent of total billed charges","50% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,358,100,,286.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",41,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",225.54,63,,180.43,,,0,"percent of total billed charges","63% of total billed charges",54.77,15.3,,43.82,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,247.02,69,,,,,0,"fee schedule","69% of total billed charges",358,100,,286.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",358,100,,286.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",358,100,,286.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.42,61.85,,177.14,,,0,"percent of total billed charges","61.5% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,179,50,,143.20,,,0,"percent of total billed charges","50% of total billed charges",115.28,32.2,,92.22,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",134.97,37.7,,107.98,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",279.24,78,,223.39,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",295.71,82.6,,236.57,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule","100% of WA fee schedule",179,50,,143.20,,,0,"percent of total billed charges","50% of total billed charges",295.71,82.6,,236.57,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",200.33,100,,,,,0,"fee schedule",EAPG,358,100,,286.40,,,0,"percent of total billed charges","100% of total billed charges",39.8,358,
"93460 Cath for coronary angiography w/injection; R",7962612,CDM,521,RC,93460,CPT,OUTPATIENT,,,1139,740.35,,1002.32,88,,801.86,,,0,"percent of total billed charges","88% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,1139,100,,911.20,,,0,"percent of total billed charges","100% of total billed charges",5816.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",2184.59,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",717.57,63,,574.06,,,0,"percent of total billed charges","63% of total billed charges",174.27,15.3,,139.42,,,0,"percent of total billed charges","15.3% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,785.91,69,,,,,0,"fee schedule","69% of total billed charges",1139,100,,911.20,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1139,100,,911.20,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1139,100,,911.20,,,0,"percent of total billed charges","100% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",11777.36,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2120.96,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3079.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2163.38,100,,,,,0,"fee schedule",EAPG,2757.26,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",429.4,37.7,,343.52,,,0,"percent of total billed charges","37.70% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",888.42,78,,710.74,,,0,"percent of total billed charges","78% of total billed charges",3356.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",940.81,82.6,,752.65,,,0,"percent of total billed charges","82.6% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",940.81,82.6,,752.65,,,0,"percent of total billed charges","82.6% of total billed charges",3323.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2281.49,100,,,,,0,"fee schedule",EAPG,1139,100,,911.20,,,0,"percent of total billed charges","100% of total billed charges",174.27,11777.36,
"93464 Exercise w/ Hemodynamic meas",7963800,CDM,521,RC,93464,CPT,OUTPATIENT,,,270,175.5,,237.6,88,,190.08,,,0,"percent of total billed charges","88% of total billed charges",135,50,,108.00,,,0,"percent of total billed charges","50% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",170.1,63,,136.08,,,0,"percent of total billed charges","63% of total billed charges",41.31,15.3,,33.05,,,0,"percent of total billed charges","15.3% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,186.3,69,,,,,0,"fee schedule","69% of total billed charges",270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",167,61.85,,133.60,,,0,"percent of total billed charges","61.5% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,135,50,,108.00,,,0,"percent of total billed charges","50% of total billed charges",86.94,32.2,,69.55,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",154.01,100,,,,,0,"fee schedule",EAPG,196.29,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.79,37.7,,81.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",210.6,78,,168.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.02,82.6,,178.42,,,0,"percent of total billed charges","82.6% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,135,50,,108.00,,,0,"percent of total billed charges","50% of total billed charges",223.02,82.6,,178.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",311.52,100,,,,,0,"fee schedule",EAPG,270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",41.31,311.52,
"93462 l hrt cath trnsptl puncture",7963804,CDM,521,RC,93462,CPT,OUTPATIENT,,,679,441.35,,597.52,88,,478.02,,,0,"percent of total billed charges","88% of total billed charges",339.5,50,,271.60,,,0,"percent of total billed charges","50% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2184.59,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",427.77,63,,342.22,,,0,"percent of total billed charges","63% of total billed charges",103.89,15.3,,83.11,,,0,"percent of total billed charges","15.3% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,468.51,69,,,,,0,"fee schedule","69% of total billed charges",679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",419.96,61.85,,335.97,,,0,"percent of total billed charges","61.5% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,339.5,50,,271.60,,,0,"percent of total billed charges","50% of total billed charges",218.64,32.2,,174.91,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2163.38,100,,,,,0,"fee schedule",EAPG,2757.26,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",255.98,37.7,,204.78,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",529.62,78,,423.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",560.85,82.6,,448.68,,,0,"percent of total billed charges","82.6% of total billed charges",2120.96,100,,,,,0,"fee schedule",EAPG,339.5,50,,271.60,,,0,"percent of total billed charges","50% of total billed charges",560.85,82.6,,448.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",2281.49,100,,,,,0,"fee schedule",EAPG,679,100,,543.20,,,0,"percent of total billed charges","100% of total billed charges",103.89,2757.26,
"93503 Insertion and placement of flow directed cat",7961890,CDM,521,RC,93503,CPT,OUTPATIENT,,,783,508.95,,689.04,88,,551.23,,,0,"percent of total billed charges","88% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,783,100,,626.40,,,0,"percent of total billed charges","100% of total billed charges",2858.63,175,,,,,0,"fee schedule","175% of CMS fee schedule",1043.63,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",493.29,63,,394.63,,,0,"percent of total billed charges","63% of total billed charges",119.8,15.3,,95.84,,,0,"percent of total billed charges","15.3% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,540.27,69,,,,,0,"fee schedule","69% of total billed charges",783,100,,626.40,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",783,100,,626.40,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",783,100,,626.40,,,0,"percent of total billed charges","100% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS fee schedule",5712.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.23,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1493.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033.49,100,,,,,0,"fee schedule",EAPG,1317.2,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",295.19,37.7,,236.15,,,0,"percent of total billed charges","37.70% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",610.74,78,,488.59,,,0,"percent of total billed charges","78% of total billed charges",1649.83,100,,,,,0,"fee schedule","100% of CMS OPPS rate",646.76,82.6,,517.41,,,0,"percent of total billed charges","82.6% of total billed charges",1013.23,100,,,,,0,"fee schedule",EAPG,1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",646.76,82.6,,517.41,,,0,"percent of total billed charges","82.6% of total billed charges",1633.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1173.76,100,,,,,0,"fee schedule",EAPG,783,100,,626.40,,,0,"percent of total billed charges","100% of total billed charges",119.8,5712.48,
"93561 Indicator dilution studies, w/ arterial and/",7961891,CDM,521,RC,93598,CPT,OUTPATIENT,,,73,47.45,,64.24,88,,51.39,,,0,"percent of total billed charges","88% of total billed charges",36.5,50,,29.20,,,0,"percent of total billed charges","50% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.05,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",45.99,63,,36.79,,,0,"percent of total billed charges","63% of total billed charges",11.17,15.3,,8.94,,,0,"percent of total billed charges","15.3% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,50.37,69,,,,,0,"fee schedule","69% of total billed charges",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.15,61.85,,36.12,,,0,"percent of total billed charges","61.5% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,36.5,50,,29.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",278.32,100,,,,,0,"fee schedule",EAPG,354.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",27.52,37.7,,22.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",56.94,78,,45.55,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,36.5,50,,29.20,,,0,"percent of total billed charges","50% of total billed charges",60.3,82.6,,48.24,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",433.4,100,,,,,0,"fee schedule",EAPG,73,100,,58.40,,,0,"percent of total billed charges","100% of total billed charges",11.17,433.4,
"93562 Indicator dilution studies, venous cath; sub",7962457,CDM,521,RC,93598,CPT,OUTPATIENT,,,23,14.95,,20.24,88,,16.19,,,0,"percent of total billed charges","88% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.05,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",14.49,63,,11.59,,,0,"percent of total billed charges","63% of total billed charges",3.52,15.3,,2.82,,,0,"percent of total billed charges","15.3% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,15.87,69,,,,,0,"fee schedule","69% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.23,61.85,,11.38,,,0,"percent of total billed charges","61.5% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",278.32,100,,,,,0,"fee schedule",EAPG,354.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.94,78,,14.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",433.4,100,,,,,0,"fee schedule",EAPG,23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",3.52,433.4,
"93567 Injection during cardiac cath; for supravalv",7963123,CDM,521,RC,93567,CPT,OUTPATIENT,,,162,105.3,,142.56,88,,114.05,,,0,"percent of total billed charges","88% of total billed charges",81,50,,64.80,,,0,"percent of total billed charges","50% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,162,100,,129.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.05,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",102.06,63,,81.65,,,0,"percent of total billed charges","63% of total billed charges",24.79,15.3,,19.83,,,0,"percent of total billed charges","15.3% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,111.78,69,,,,,0,"fee schedule","69% of total billed charges",162,100,,129.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162,100,,129.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",162,100,,129.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",100.2,61.85,,80.16,,,0,"percent of total billed charges","61.5% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,81,50,,64.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",278.32,100,,,,,0,"fee schedule",EAPG,354.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",61.07,37.7,,48.86,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",126.36,78,,101.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",133.81,82.6,,107.05,,,0,"percent of total billed charges","82.6% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,81,50,,64.80,,,0,"percent of total billed charges","50% of total billed charges",133.81,82.6,,107.05,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",433.4,100,,,,,0,"fee schedule",EAPG,162,100,,129.60,,,0,"percent of total billed charges","100% of total billed charges",24.79,433.4,
"93568 Injection during cardiac cath; for pulmonary",7963235,CDM,521,RC,93568,CPT,OUTPATIENT,,,148,96.2,,130.24,88,,104.19,,,0,"percent of total billed charges","88% of total billed charges",74,50,,59.20,,,0,"percent of total billed charges","50% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,148,100,,118.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.05,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",93.24,63,,74.59,,,0,"percent of total billed charges","63% of total billed charges",22.64,15.3,,18.11,,,0,"percent of total billed charges","15.3% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,102.12,69,,,,,0,"fee schedule","69% of total billed charges",148,100,,118.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",148,100,,118.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",148,100,,118.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.54,61.85,,73.23,,,0,"percent of total billed charges","61.5% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,74,50,,59.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",278.32,100,,,,,0,"fee schedule",EAPG,354.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",55.8,37.7,,44.64,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",115.44,78,,92.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",122.25,82.6,,97.80,,,0,"percent of total billed charges","82.6% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,74,50,,59.20,,,0,"percent of total billed charges","50% of total billed charges",122.25,82.6,,97.80,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",433.4,100,,,,,0,"fee schedule",EAPG,148,100,,118.40,,,0,"percent of total billed charges","100% of total billed charges",22.64,433.4,
"93564 inject hrt congntl art/grft",7963793,CDM,521,RC,93564,CPT,OUTPATIENT,,,191,124.15,,168.08,88,,134.46,,,0,"percent of total billed charges","88% of total billed charges",95.5,50,,76.40,,,0,"percent of total billed charges","50% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.05,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",120.33,63,,96.26,,,0,"percent of total billed charges","63% of total billed charges",29.22,15.3,,23.38,,,0,"percent of total billed charges","15.3% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,131.79,69,,,,,0,"fee schedule","69% of total billed charges",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",118.13,61.85,,94.50,,,0,"percent of total billed charges","61.5% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,95.5,50,,76.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",278.32,100,,,,,0,"fee schedule",EAPG,354.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",72.01,37.7,,57.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",148.98,78,,119.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.77,82.6,,126.22,,,0,"percent of total billed charges","82.6% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,95.5,50,,76.40,,,0,"percent of total billed charges","50% of total billed charges",157.77,82.6,,126.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",433.4,100,,,,,0,"fee schedule",EAPG,191,100,,152.80,,,0,"percent of total billed charges","100% of total billed charges",29.22,433.4,
"93563 inject congenital card cath",7963794,CDM,521,RC,93563,CPT,OUTPATIENT,,,186,120.9,,163.68,88,,130.94,,,0,"percent of total billed charges","88% of total billed charges",93,50,,74.40,,,0,"percent of total billed charges","50% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.05,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",117.18,63,,93.74,,,0,"percent of total billed charges","63% of total billed charges",28.46,15.3,,22.77,,,0,"percent of total billed charges","15.3% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,128.34,69,,,,,0,"fee schedule","69% of total billed charges",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",115.04,61.85,,92.03,,,0,"percent of total billed charges","61.5% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,93,50,,74.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",278.32,100,,,,,0,"fee schedule",EAPG,354.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",70.12,37.7,,56.10,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",145.08,78,,116.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",153.64,82.6,,122.91,,,0,"percent of total billed charges","82.6% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,93,50,,74.40,,,0,"percent of total billed charges","50% of total billed charges",153.64,82.6,,122.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",433.4,100,,,,,0,"fee schedule",EAPG,186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",28.46,433.4,
"93566 inject r ventr/atrial angio",7963795,CDM,521,RC,93566,CPT,OUTPATIENT,,,144,93.6,,126.72,88,,101.38,,,0,"percent of total billed charges","88% of total billed charges",72,50,,57.60,,,0,"percent of total billed charges","50% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.05,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",90.72,63,,72.58,,,0,"percent of total billed charges","63% of total billed charges",22.03,15.3,,17.62,,,0,"percent of total billed charges","15.3% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,99.36,69,,,,,0,"fee schedule","69% of total billed charges",144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.06,61.85,,71.25,,,0,"percent of total billed charges","61.5% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,72,50,,57.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",278.32,100,,,,,0,"fee schedule",EAPG,354.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",54.29,37.7,,43.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",112.32,78,,89.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",118.94,82.6,,95.15,,,0,"percent of total billed charges","82.6% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,72,50,,57.60,,,0,"percent of total billed charges","50% of total billed charges",118.94,82.6,,95.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",433.4,100,,,,,0,"fee schedule",EAPG,144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",22.03,433.4,
"93565 inject l ventr/atrial angio",7963796,CDM,521,RC,93565,CPT,OUTPATIENT,,,144,93.6,,126.72,88,,101.38,,,0,"percent of total billed charges","88% of total billed charges",72,50,,57.60,,,0,"percent of total billed charges","50% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.05,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",90.72,63,,72.58,,,0,"percent of total billed charges","63% of total billed charges",22.03,15.3,,17.62,,,0,"percent of total billed charges","15.3% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,99.36,69,,,,,0,"fee schedule","69% of total billed charges",144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",89.06,61.85,,71.25,,,0,"percent of total billed charges","61.5% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,72,50,,57.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",278.32,100,,,,,0,"fee schedule",EAPG,354.73,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",54.29,37.7,,43.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",112.32,78,,89.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",118.94,82.6,,95.15,,,0,"percent of total billed charges","82.6% of total billed charges",272.87,100,,,,,0,"fee schedule",EAPG,72,50,,57.60,,,0,"percent of total billed charges","50% of total billed charges",118.94,82.6,,95.15,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",433.4,100,,,,,0,"fee schedule",EAPG,144,100,,115.20,,,0,"percent of total billed charges","100% of total billed charges",22.03,433.4,
"93571 Intravascular Doppler velocity and/or pressu",7961892,CDM,521,RC,93571,CPT,OUTPATIENT,,,267,173.55,,234.96,88,,187.97,,,0,"percent of total billed charges","88% of total billed charges",133.5,50,,106.80,,,0,"percent of total billed charges","50% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1694.66,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",168.21,63,,134.57,,,0,"percent of total billed charges","63% of total billed charges",40.85,15.3,,32.68,,,0,"percent of total billed charges","15.3% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,184.23,69,,,,,0,"fee schedule","69% of total billed charges",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.14,61.85,,132.11,,,0,"percent of total billed charges","61.5% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,133.5,50,,106.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1678.2,100,,,,,0,"fee schedule",EAPG,2138.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",100.66,37.7,,80.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",208.26,78,,166.61,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",220.54,82.6,,176.43,,,0,"percent of total billed charges","82.6% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,133.5,50,,106.80,,,0,"percent of total billed charges","50% of total billed charges",220.54,82.6,,176.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1805.83,100,,,,,0,"fee schedule",EAPG,267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",40.85,2138.89,
"93572 Intravascular Doppler velocity and/or pressu",7962431,CDM,521,RC,93572,CPT,OUTPATIENT,,,213,138.45,,187.44,88,,149.95,,,0,"percent of total billed charges","88% of total billed charges",106.5,50,,85.20,,,0,"percent of total billed charges","50% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1694.66,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",134.19,63,,107.35,,,0,"percent of total billed charges","63% of total billed charges",32.59,15.3,,26.07,,,0,"percent of total billed charges","15.3% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,146.97,69,,,,,0,"fee schedule","69% of total billed charges",213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",131.74,61.85,,105.39,,,0,"percent of total billed charges","61.5% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,106.5,50,,85.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1678.2,100,,,,,0,"fee schedule",EAPG,2138.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",80.3,37.7,,64.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",166.14,78,,132.91,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",175.94,82.6,,140.75,,,0,"percent of total billed charges","82.6% of total billed charges",1645.3,100,,,,,0,"fee schedule",EAPG,106.5,50,,85.20,,,0,"percent of total billed charges","50% of total billed charges",175.94,82.6,,140.75,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1805.83,100,,,,,0,"fee schedule",EAPG,213,100,,170.40,,,0,"percent of total billed charges","100% of total billed charges",32.59,2138.89,
"93603 Right ventricular recording",7963813,CDM,521,RC,93603,CPT,OUTPATIENT,,,340,221,,299.2,88,,239.36,,,0,"percent of total billed charges","88% of total billed charges",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",2124.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",5750.89,100,,,,,0,"fee schedule",EAPG,1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",214.2,63,,171.36,,,0,"percent of total billed charges","63% of total billed charges",52.02,15.3,,41.62,,,0,"percent of total billed charges","15.3% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,234.6,69,,,,,0,"fee schedule","69% of total billed charges",340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",1213.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",4520.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1181.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5695.05,100,,,,,0,"fee schedule",EAPG,7258.4,100,,,,,0,"fee schedule",EAPG,1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",128.18,37.7,,102.54,,,0,"percent of total billed charges","37.70% of total billed charges",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.2,78,,212.16,,,0,"percent of total billed charges","78% of total billed charges",1226.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.84,82.6,,224.67,,,0,"percent of total billed charges","82.6% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.84,82.6,,224.67,,,0,"percent of total billed charges","82.6% of total billed charges",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5743.92,100,,,,,0,"fee schedule",EAPG,340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",52.02,7258.4,
"93600 Bundle of His recording",7963874,CDM,521,RC,93600,CPT,OUTPATIENT,,,340,221,,299.2,88,,239.36,,,0,"percent of total billed charges","88% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",13330.21,175,,,,,0,"fee schedule","175% of CMS fee schedule",5750.89,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",214.2,63,,171.36,,,0,"percent of total billed charges","63% of total billed charges",52.02,15.3,,41.62,,,0,"percent of total billed charges","15.3% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,234.6,69,,,,,0,"fee schedule","69% of total billed charges",340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",24694.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6455.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5695.05,100,,,,,0,"fee schedule",EAPG,7258.4,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",128.18,37.7,,102.54,,,0,"percent of total billed charges","37.70% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.2,78,,212.16,,,0,"percent of total billed charges","78% of total billed charges",7693.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.84,82.6,,224.67,,,0,"percent of total billed charges","82.6% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.84,82.6,,224.67,,,0,"percent of total billed charges","82.6% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5743.92,100,,,,,0,"fee schedule",EAPG,340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",52.02,24694.01,
"93609 map tachycardia add-on",7963877,CDM,521,RC,93609,CPT,OUTPATIENT,,,804,522.6,,707.52,88,,566.02,,,0,"percent of total billed charges","88% of total billed charges",402,50,,321.60,,,0,"percent of total billed charges","50% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,804,100,,643.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15166.32,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",506.52,63,,405.22,,,0,"percent of total billed charges","63% of total billed charges",123.01,15.3,,98.41,,,0,"percent of total billed charges","15.3% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,554.76,69,,,,,0,"fee schedule","69% of total billed charges",804,100,,643.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",804,100,,643.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",804,100,,643.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",497.27,61.85,,397.82,,,0,"percent of total billed charges","61.5% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,402,50,,321.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15019.08,100,,,,,0,"fee schedule",EAPG,19141.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",303.11,37.7,,242.49,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",627.12,78,,501.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",664.1,82.6,,531.28,,,0,"percent of total billed charges","82.6% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,402,50,,321.60,,,0,"percent of total billed charges","50% of total billed charges",664.1,82.6,,531.28,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",14885.12,100,,,,,0,"fee schedule",EAPG,804,100,,643.20,,,0,"percent of total billed charges","100% of total billed charges",123.01,19141.96,
"93602 Intra-atrial recording",7963881,CDM,521,RC,93602,CPT,OUTPATIENT,,,340,221,,299.2,88,,239.36,,,0,"percent of total billed charges","88% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",13330.21,175,,,,,0,"fee schedule","175% of CMS fee schedule",5750.89,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",214.2,63,,171.36,,,0,"percent of total billed charges","63% of total billed charges",52.02,15.3,,41.62,,,0,"percent of total billed charges","15.3% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,234.6,69,,,,,0,"fee schedule","69% of total billed charges",340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",24694.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6455.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5695.05,100,,,,,0,"fee schedule",EAPG,7258.4,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",128.18,37.7,,102.54,,,0,"percent of total billed charges","37.70% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",265.2,78,,212.16,,,0,"percent of total billed charges","78% of total billed charges",7693.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.84,82.6,,224.67,,,0,"percent of total billed charges","82.6% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.84,82.6,,224.67,,,0,"percent of total billed charges","82.6% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5743.92,100,,,,,0,"fee schedule",EAPG,340,100,,272.00,,,0,"percent of total billed charges","100% of total billed charges",52.02,24694.01,
"93615 Esophageal recording of atrial electrogram w",7962272,CDM,521,RC,93615,CPT,OUTPATIENT,,,145,94.25,,127.6,88,,102.08,,,0,"percent of total billed charges","88% of total billed charges",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",2124.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",5750.89,100,,,,,0,"fee schedule",EAPG,1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.35,63,,73.08,,,0,"percent of total billed charges","63% of total billed charges",22.19,15.3,,17.75,,,0,"percent of total billed charges","15.3% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,100.05,69,,,,,0,"fee schedule","69% of total billed charges",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",1213.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",4520.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1181.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5695.05,100,,,,,0,"fee schedule",EAPG,7258.4,100,,,,,0,"fee schedule",EAPG,1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",54.67,37.7,,43.74,,,0,"percent of total billed charges","37.70% of total billed charges",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",113.1,78,,90.48,,,0,"percent of total billed charges","78% of total billed charges",1226.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",119.77,82.6,,95.82,,,0,"percent of total billed charges","82.6% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",119.77,82.6,,95.82,,,0,"percent of total billed charges","82.6% of total billed charges",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5743.92,100,,,,,0,"fee schedule",EAPG,145,100,,116.00,,,0,"percent of total billed charges","100% of total billed charges",22.19,7258.4,
"93616 Esophageal recording of atrial electrogram w",7962274,CDM,521,RC,93616,CPT,OUTPATIENT,,,196,127.4,,172.48,88,,137.98,,,0,"percent of total billed charges","88% of total billed charges",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",2124.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",5750.89,100,,,,,0,"fee schedule",EAPG,1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.48,63,,98.78,,,0,"percent of total billed charges","63% of total billed charges",29.99,15.3,,23.99,,,0,"percent of total billed charges","15.3% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,135.24,69,,,,,0,"fee schedule","69% of total billed charges",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",1213.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",4520.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1181.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5695.05,100,,,,,0,"fee schedule",EAPG,7258.4,100,,,,,0,"fee schedule",EAPG,1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",73.89,37.7,,59.11,,,0,"percent of total billed charges","37.70% of total billed charges",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",152.88,78,,122.30,,,0,"percent of total billed charges","78% of total billed charges",1226.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",161.9,82.6,,129.52,,,0,"percent of total billed charges","82.6% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",161.9,82.6,,129.52,,,0,"percent of total billed charges","82.6% of total billed charges",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5743.92,100,,,,,0,"fee schedule",EAPG,196,100,,156.80,,,0,"percent of total billed charges","100% of total billed charges",29.99,7258.4,
"93613 Intracardiac electrophysiologic 3-dimensiona",7963296,CDM,521,RC,93613,CPT,OUTPATIENT,,,858,557.7,,755.04,88,,604.03,,,0,"percent of total billed charges","88% of total billed charges",429,50,,343.20,,,0,"percent of total billed charges","50% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,858,100,,686.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5750.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",540.54,63,,432.43,,,0,"percent of total billed charges","63% of total billed charges",131.27,15.3,,105.02,,,0,"percent of total billed charges","15.3% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,592.02,69,,,,,0,"fee schedule","69% of total billed charges",858,100,,686.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",858,100,,686.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",858,100,,686.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",530.67,61.85,,424.54,,,0,"percent of total billed charges","61.5% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,429,50,,343.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5695.05,100,,,,,0,"fee schedule",EAPG,7258.4,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",323.47,37.7,,258.78,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",669.24,78,,535.39,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",708.71,82.6,,566.97,,,0,"percent of total billed charges","82.6% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,429,50,,343.20,,,0,"percent of total billed charges","50% of total billed charges",708.71,82.6,,566.97,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5743.92,100,,,,,0,"fee schedule",EAPG,858,100,,686.40,,,0,"percent of total billed charges","100% of total billed charges",131.27,7258.4,
"93618 Induction of arrhythmia by electrical pacing",7963496,CDM,521,RC,93618,CPT,OUTPATIENT,,,684,444.6,,601.92,88,,481.54,,,0,"percent of total billed charges","88% of total billed charges",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,684,100,,547.20,,,0,"percent of total billed charges","100% of total billed charges",2124.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",5750.89,100,,,,,0,"fee schedule",EAPG,1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",430.92,63,,344.74,,,0,"percent of total billed charges","63% of total billed charges",104.65,15.3,,83.72,,,0,"percent of total billed charges","15.3% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,471.96,69,,,,,0,"fee schedule","69% of total billed charges",684,100,,547.20,,,0,"percent of total billed charges","100% of total billed charges",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",684,100,,547.20,,,0,"percent of total billed charges","100% of total billed charges",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",684,100,,547.20,,,0,"percent of total billed charges","100% of total billed charges",1213.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",4520.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1181.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5695.05,100,,,,,0,"fee schedule",EAPG,7258.4,100,,,,,0,"fee schedule",EAPG,1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",257.87,37.7,,206.30,,,0,"percent of total billed charges","37.70% of total billed charges",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",533.52,78,,426.82,,,0,"percent of total billed charges","78% of total billed charges",1226.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",564.98,82.6,,451.98,,,0,"percent of total billed charges","82.6% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",564.98,82.6,,451.98,,,0,"percent of total billed charges","82.6% of total billed charges",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5743.92,100,,,,,0,"fee schedule",EAPG,684,100,,547.20,,,0,"percent of total billed charges","100% of total billed charges",104.65,7258.4,
"93619 electrophysiology evaluation",7963763,CDM,521,RC,93619,CPT,OUTPATIENT,,,1181,767.65,,1039.28,88,,831.42,,,0,"percent of total billed charges","88% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,1181,100,,944.80,,,0,"percent of total billed charges","100% of total billed charges",13330.21,175,,,,,0,"fee schedule","175% of CMS fee schedule",5750.89,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",744.03,63,,595.22,,,0,"percent of total billed charges","63% of total billed charges",180.69,15.3,,144.55,,,0,"percent of total billed charges","15.3% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,814.89,69,,,,,0,"fee schedule","69% of total billed charges",1181,100,,944.80,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1181,100,,944.80,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1181,100,,944.80,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",24694.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6455.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5695.05,100,,,,,0,"fee schedule",EAPG,7258.4,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",445.24,37.7,,356.19,,,0,"percent of total billed charges","37.70% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",921.18,78,,736.94,,,0,"percent of total billed charges","78% of total billed charges",7693.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",975.51,82.6,,780.41,,,0,"percent of total billed charges","82.6% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",975.51,82.6,,780.41,,,0,"percent of total billed charges","82.6% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5743.92,100,,,,,0,"fee schedule",EAPG,1181,100,,944.80,,,0,"percent of total billed charges","100% of total billed charges",180.69,24694.01,
"93612 Intraventricular pacing",7963866,CDM,521,RC,93612,CPT,OUTPATIENT,,,482,313.3,,424.16,88,,339.33,,,0,"percent of total billed charges","88% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,482,100,,385.60,,,0,"percent of total billed charges","100% of total billed charges",13330.21,175,,,,,0,"fee schedule","175% of CMS fee schedule",5750.89,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",303.66,63,,242.93,,,0,"percent of total billed charges","63% of total billed charges",73.75,15.3,,59.00,,,0,"percent of total billed charges","15.3% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,332.58,69,,,,,0,"fee schedule","69% of total billed charges",482,100,,385.60,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",482,100,,385.60,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",482,100,,385.60,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",24694.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6455.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5695.05,100,,,,,0,"fee schedule",EAPG,7258.4,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",181.71,37.7,,145.37,,,0,"percent of total billed charges","37.70% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",375.96,78,,300.77,,,0,"percent of total billed charges","78% of total billed charges",7693.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",398.13,82.6,,318.50,,,0,"percent of total billed charges","82.6% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",398.13,82.6,,318.50,,,0,"percent of total billed charges","82.6% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5743.92,100,,,,,0,"fee schedule",EAPG,482,100,,385.60,,,0,"percent of total billed charges","100% of total billed charges",73.75,24694.01,
"93610 Intra-atrial pacing",7963910,CDM,521,RC,93610,CPT,OUTPATIENT,,,484,314.6,,425.92,88,,340.74,,,0,"percent of total billed charges","88% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",13330.21,175,,,,,0,"fee schedule","175% of CMS fee schedule",5750.89,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",304.92,63,,243.94,,,0,"percent of total billed charges","63% of total billed charges",74.05,15.3,,59.24,,,0,"percent of total billed charges","15.3% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,333.96,69,,,,,0,"fee schedule","69% of total billed charges",484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",24694.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6455.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5695.05,100,,,,,0,"fee schedule",EAPG,7258.4,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",182.47,37.7,,145.98,,,0,"percent of total billed charges","37.70% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",377.52,78,,302.02,,,0,"percent of total billed charges","78% of total billed charges",7693.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",399.78,82.6,,319.82,,,0,"percent of total billed charges","82.6% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",399.78,82.6,,319.82,,,0,"percent of total billed charges","82.6% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5743.92,100,,,,,0,"fee schedule",EAPG,484,100,,387.20,,,0,"percent of total billed charges","100% of total billed charges",74.05,24694.01,
"93623 Programmed stimulation and pacing after intr",7962950,CDM,521,RC,93623,CPT,OUTPATIENT,,,459,298.35,,403.92,88,,323.14,,,0,"percent of total billed charges","88% of total billed charges",229.5,50,,183.60,,,0,"percent of total billed charges","50% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,459,100,,367.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5750.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",289.17,63,,231.34,,,0,"percent of total billed charges","63% of total billed charges",70.23,15.3,,56.18,,,0,"percent of total billed charges","15.3% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,316.71,69,,,,,0,"fee schedule","69% of total billed charges",459,100,,367.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",459,100,,367.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",459,100,,367.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",283.89,61.85,,227.11,,,0,"percent of total billed charges","61.5% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,229.5,50,,183.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5695.05,100,,,,,0,"fee schedule",EAPG,7258.4,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",173.04,37.7,,138.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",358.02,78,,286.42,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",379.13,82.6,,303.30,,,0,"percent of total billed charges","82.6% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,229.5,50,,183.60,,,0,"percent of total billed charges","50% of total billed charges",379.13,82.6,,303.30,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5743.92,100,,,,,0,"fee schedule",EAPG,459,100,,367.20,,,0,"percent of total billed charges","100% of total billed charges",70.23,7258.4,
"93620 electrophysiology evaluation",7963764,CDM,521,RC,93620,CPT,OUTPATIENT,,,1866,1212.9,,1642.08,88,,1313.66,,,0,"percent of total billed charges","88% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,1866,100,,1492.80,,,0,"percent of total billed charges","100% of total billed charges",13330.21,175,,,,,0,"fee schedule","175% of CMS fee schedule",5750.89,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1175.58,63,,940.46,,,0,"percent of total billed charges","63% of total billed charges",285.5,15.3,,228.40,,,0,"percent of total billed charges","15.3% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,1287.54,69,,,,,0,"fee schedule","69% of total billed charges",1866,100,,1492.80,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1866,100,,1492.80,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1866,100,,1492.80,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",24694.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6455.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5695.05,100,,,,,0,"fee schedule",EAPG,7258.4,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",703.48,37.7,,562.78,,,0,"percent of total billed charges","37.70% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1455.48,78,,1164.38,,,0,"percent of total billed charges","78% of total billed charges",7693.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1541.32,82.6,,1233.06,,,0,"percent of total billed charges","82.6% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1541.32,82.6,,1233.06,,,0,"percent of total billed charges","82.6% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5743.92,100,,,,,0,"fee schedule",EAPG,1866,100,,1492.80,,,0,"percent of total billed charges","100% of total billed charges",285.5,24694.01,
"93621 electrophysiology evaluation",7963765,CDM,521,RC,93621,CPT,OUTPATIENT,,,339,220.35,,298.32,88,,238.66,,,0,"percent of total billed charges","88% of total billed charges",169.5,50,,135.60,,,0,"percent of total billed charges","50% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5750.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",213.57,63,,170.86,,,0,"percent of total billed charges","63% of total billed charges",51.87,15.3,,41.50,,,0,"percent of total billed charges","15.3% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,233.91,69,,,,,0,"fee schedule","69% of total billed charges",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",209.67,61.85,,167.74,,,0,"percent of total billed charges","61.5% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,169.5,50,,135.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5695.05,100,,,,,0,"fee schedule",EAPG,7258.4,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",127.8,37.7,,102.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",264.42,78,,211.54,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",280.01,82.6,,224.01,,,0,"percent of total billed charges","82.6% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,169.5,50,,135.60,,,0,"percent of total billed charges","50% of total billed charges",280.01,82.6,,224.01,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5743.92,100,,,,,0,"fee schedule",EAPG,339,100,,271.20,,,0,"percent of total billed charges","100% of total billed charges",51.87,7258.4,
"93622 electrophysiology evaluation",7963766,CDM,521,RC,93622,CPT,OUTPATIENT,,,499,324.35,,439.12,88,,351.30,,,0,"percent of total billed charges","88% of total billed charges",249.5,50,,199.60,,,0,"percent of total billed charges","50% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,499,100,,399.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5750.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",314.37,63,,251.50,,,0,"percent of total billed charges","63% of total billed charges",76.35,15.3,,61.08,,,0,"percent of total billed charges","15.3% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,344.31,69,,,,,0,"fee schedule","69% of total billed charges",499,100,,399.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",499,100,,399.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",499,100,,399.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",308.63,61.85,,246.90,,,0,"percent of total billed charges","61.5% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,249.5,50,,199.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5695.05,100,,,,,0,"fee schedule",EAPG,7258.4,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",188.12,37.7,,150.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",389.22,78,,311.38,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.17,82.6,,329.74,,,0,"percent of total billed charges","82.6% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,249.5,50,,199.60,,,0,"percent of total billed charges","50% of total billed charges",412.17,82.6,,329.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5743.92,100,,,,,0,"fee schedule",EAPG,499,100,,399.20,,,0,"percent of total billed charges","100% of total billed charges",76.35,7258.4,
"93624 electrophysiologic study",7963856,CDM,521,RC,93624,CPT,OUTPATIENT,,,777,505.05,,683.76,88,,547.01,,,0,"percent of total billed charges","88% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,777,100,,621.60,,,0,"percent of total billed charges","100% of total billed charges",13330.21,175,,,,,0,"fee schedule","175% of CMS fee schedule",5750.89,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",489.51,63,,391.61,,,0,"percent of total billed charges","63% of total billed charges",118.88,15.3,,95.10,,,0,"percent of total billed charges","15.3% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,536.13,69,,,,,0,"fee schedule","69% of total billed charges",777,100,,621.60,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",777,100,,621.60,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",777,100,,621.60,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",24694.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6455.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5695.05,100,,,,,0,"fee schedule",EAPG,7258.4,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",292.93,37.7,,234.34,,,0,"percent of total billed charges","37.70% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",606.06,78,,484.85,,,0,"percent of total billed charges","78% of total billed charges",7693.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",641.8,82.6,,513.44,,,0,"percent of total billed charges","82.6% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",641.8,82.6,,513.44,,,0,"percent of total billed charges","82.6% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5743.92,100,,,,,0,"fee schedule",EAPG,777,100,,621.60,,,0,"percent of total billed charges","100% of total billed charges",118.88,24694.01,
"93631 heart pacing mapping",7963897,CDM,521,RC,93631,CPT,OUTPATIENT,,,1191,774.15,,1048.08,88,,838.46,,,0,"percent of total billed charges","88% of total billed charges",595.5,50,,476.40,,,0,"percent of total billed charges","50% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,1191,100,,952.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5750.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",750.33,63,,600.26,,,0,"percent of total billed charges","63% of total billed charges",182.22,15.3,,145.78,,,0,"percent of total billed charges","15.3% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,821.79,69,,,,,0,"fee schedule","69% of total billed charges",1191,100,,952.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1191,100,,952.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1191,100,,952.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",736.63,61.85,,589.30,,,0,"percent of total billed charges","61.5% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,595.5,50,,476.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5695.05,100,,,,,0,"fee schedule",EAPG,7258.4,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",449.01,37.7,,359.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",928.98,78,,743.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",983.77,82.6,,787.02,,,0,"percent of total billed charges","82.6% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,595.5,50,,476.40,,,0,"percent of total billed charges","50% of total billed charges",983.77,82.6,,787.02,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5743.92,100,,,,,0,"fee schedule",EAPG,1191,100,,952.80,,,0,"percent of total billed charges","100% of total billed charges",182.22,7258.4,
"93642 Electrophy eval of cardioverter-defibr (thre",7961652,CDM,521,RC,93642,CPT,OUTPATIENT,,,1111,722.15,,977.68,88,,782.14,,,0,"percent of total billed charges","88% of total billed charges",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,1111,100,,888.80,,,0,"percent of total billed charges","100% of total billed charges",2124.31,175,,,,,0,"fee schedule","175% of CMS fee schedule",5750.89,100,,,,,0,"fee schedule",EAPG,1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",699.93,63,,559.94,,,0,"percent of total billed charges","63% of total billed charges",169.98,15.3,,135.98,,,0,"percent of total billed charges","15.3% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,766.59,69,,,,,0,"fee schedule","69% of total billed charges",1111,100,,888.80,,,0,"percent of total billed charges","100% of total billed charges",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1111,100,,888.80,,,0,"percent of total billed charges","100% of total billed charges",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1111,100,,888.80,,,0,"percent of total billed charges","100% of total billed charges",1213.89,100,,,,,0,"fee schedule","100% of CMS fee schedule",4520.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5583.39,100,,,,,0,"fee schedule",EAPG,1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1181.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5695.05,100,,,,,0,"fee schedule",EAPG,7258.4,100,,,,,0,"fee schedule",EAPG,1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",418.85,37.7,,335.08,,,0,"percent of total billed charges","37.70% of total billed charges",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",866.58,78,,693.26,,,0,"percent of total billed charges","78% of total billed charges",1226.02,100,,,,,0,"fee schedule","100% of CMS OPPS rate",917.69,82.6,,734.15,,,0,"percent of total billed charges","82.6% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",917.69,82.6,,734.15,,,0,"percent of total billed charges","82.6% of total billed charges",1213.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5743.92,100,,,,,0,"fee schedule",EAPG,1111,100,,888.80,,,0,"percent of total billed charges","100% of total billed charges",169.98,7258.4,
"93641 Electrophy eval of single or dual chamber pa",7961791,CDM,521,RC,93641,CPT,OUTPATIENT,,,954,620.1,,839.52,88,,671.62,,,0,"percent of total billed charges","88% of total billed charges",477,50,,381.60,,,0,"percent of total billed charges","50% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,954,100,,763.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5750.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",601.02,63,,480.82,,,0,"percent of total billed charges","63% of total billed charges",145.96,15.3,,116.77,,,0,"percent of total billed charges","15.3% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,658.26,69,,,,,0,"fee schedule","69% of total billed charges",954,100,,763.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",954,100,,763.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",954,100,,763.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",590.05,61.85,,472.04,,,0,"percent of total billed charges","61.5% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,477,50,,381.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5695.05,100,,,,,0,"fee schedule",EAPG,7258.4,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",359.66,37.7,,287.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",744.12,78,,595.30,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",788,82.6,,630.40,,,0,"percent of total billed charges","82.6% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,477,50,,381.60,,,0,"percent of total billed charges","50% of total billed charges",788,82.6,,630.40,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5743.92,100,,,,,0,"fee schedule",EAPG,954,100,,763.20,,,0,"percent of total billed charges","100% of total billed charges",145.96,7258.4,
"93640 Electrophysiologic eval of single or dual ch",7961893,CDM,521,RC,93640,CPT,OUTPATIENT,,,565,367.25,,497.2,88,,397.76,,,0,"percent of total billed charges","88% of total billed charges",282.5,50,,226.00,,,0,"percent of total billed charges","50% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,565,100,,452.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5750.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",355.95,63,,284.76,,,0,"percent of total billed charges","63% of total billed charges",86.45,15.3,,69.16,,,0,"percent of total billed charges","15.3% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,389.85,69,,,,,0,"fee schedule","69% of total billed charges",565,100,,452.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",565,100,,452.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",565,100,,452.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",349.45,61.85,,279.56,,,0,"percent of total billed charges","61.5% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,282.5,50,,226.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5695.05,100,,,,,0,"fee schedule",EAPG,7258.4,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",213.01,37.7,,170.41,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",440.7,78,,352.56,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",466.69,82.6,,373.35,,,0,"percent of total billed charges","82.6% of total billed charges",5583.39,100,,,,,0,"fee schedule",EAPG,282.5,50,,226.00,,,0,"percent of total billed charges","50% of total billed charges",466.69,82.6,,373.35,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",5743.92,100,,,,,0,"fee schedule",EAPG,565,100,,452.00,,,0,"percent of total billed charges","100% of total billed charges",86.45,7258.4,
"93653 Comp electrophy eval w/ insertion of cath w/",7961565,CDM,521,RC,93653,CPT,OUTPATIENT,,,2367,1538.55,,2082.96,88,,1666.37,,,0,"percent of total billed charges","88% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14724.59,100,,,,,0,"fee schedule",EAPG,2367,100,,1893.60,,,0,"percent of total billed charges","100% of total billed charges",42392.95,175,,,,,0,"fee schedule","175% of CMS fee schedule",15166.32,100,,,,,0,"fee schedule",EAPG,24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1491.21,63,,1192.97,,,0,"percent of total billed charges","63% of total billed charges",362.15,15.3,,289.72,,,0,"percent of total billed charges","15.3% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,1633.23,69,,,,,0,"fee schedule","69% of total billed charges",2367,100,,1893.60,,,0,"percent of total billed charges","100% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2367,100,,1893.60,,,0,"percent of total billed charges","100% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2367,100,,1893.60,,,0,"percent of total billed charges","100% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",87199.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14724.59,100,,,,,0,"fee schedule",EAPG,24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22797.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15019.08,100,,,,,0,"fee schedule",EAPG,19141.96,100,,,,,0,"fee schedule",EAPG,24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",892.36,37.7,,713.89,,,0,"percent of total billed charges","37.70% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1846.26,78,,1477.01,,,0,"percent of total billed charges","78% of total billed charges",24466.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.14,82.6,,1564.11,,,0,"percent of total billed charges","82.6% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1955.14,82.6,,1564.11,,,0,"percent of total billed charges","82.6% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14885.12,100,,,,,0,"fee schedule",EAPG,2367,100,,1893.60,,,0,"percent of total billed charges","100% of total billed charges",362.15,87199.85,
"93656 Comp electrophys eval including transseptal",7961846,CDM,521,RC,93656,CPT,OUTPATIENT,,,3160,2054,,2780.8,88,,2224.64,,,0,"percent of total billed charges","88% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14724.59,100,,,,,0,"fee schedule",EAPG,3160,100,,2528.00,,,0,"percent of total billed charges","100% of total billed charges",42392.95,175,,,,,0,"fee schedule","175% of CMS fee schedule",15166.32,100,,,,,0,"fee schedule",EAPG,24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1990.8,63,,1592.64,,,0,"percent of total billed charges","63% of total billed charges",483.48,15.3,,386.78,,,0,"percent of total billed charges","15.3% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,2180.4,69,,,,,0,"fee schedule","69% of total billed charges",3160,100,,2528.00,,,0,"percent of total billed charges","100% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3160,100,,2528.00,,,0,"percent of total billed charges","100% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3160,100,,2528.00,,,0,"percent of total billed charges","100% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",87199.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14724.59,100,,,,,0,"fee schedule",EAPG,24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22797.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15019.08,100,,,,,0,"fee schedule",EAPG,19141.96,100,,,,,0,"fee schedule",EAPG,24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1191.32,37.7,,953.06,,,0,"percent of total billed charges","37.70% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2464.8,78,,1971.84,,,0,"percent of total billed charges","78% of total billed charges",24466.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2610.16,82.6,,2088.13,,,0,"percent of total billed charges","82.6% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2610.16,82.6,,2088.13,,,0,"percent of total billed charges","82.6% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14885.12,100,,,,,0,"fee schedule",EAPG,3160,100,,2528.00,,,0,"percent of total billed charges","100% of total billed charges",483.48,87199.85,
"93657 Additional linear or focal intracardiac cath",7962309,CDM,521,RC,93657,CPT,OUTPATIENT,,,1186,770.9,,1043.68,88,,834.94,,,0,"percent of total billed charges","88% of total billed charges",593,50,,474.40,,,0,"percent of total billed charges","50% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,1186,100,,948.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15166.32,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",747.18,63,,597.74,,,0,"percent of total billed charges","63% of total billed charges",181.46,15.3,,145.17,,,0,"percent of total billed charges","15.3% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,818.34,69,,,,,0,"fee schedule","69% of total billed charges",1186,100,,948.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1186,100,,948.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1186,100,,948.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",733.54,61.85,,586.83,,,0,"percent of total billed charges","61.5% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,593,50,,474.40,,,0,"percent of total billed charges","50% of total billed charges",381.89,32.2,,305.51,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15019.08,100,,,,,0,"fee schedule",EAPG,19141.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",447.12,37.7,,357.70,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",925.08,78,,740.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",979.64,82.6,,783.71,,,0,"percent of total billed charges","82.6% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,593,50,,474.40,,,0,"percent of total billed charges","50% of total billed charges",979.64,82.6,,783.71,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",14885.12,100,,,,,0,"fee schedule",EAPG,1186,100,,948.80,,,0,"percent of total billed charges","100% of total billed charges",181.46,19141.96,
"93654 Comp electro eval w/ insertion of cath; w/ i",7962945,CDM,521,RC,93654,CPT,OUTPATIENT,,,3159,2053.35,,2779.92,88,,2223.94,,,0,"percent of total billed charges","88% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14724.59,100,,,,,0,"fee schedule",EAPG,3159,100,,2527.20,,,0,"percent of total billed charges","100% of total billed charges",42392.95,175,,,,,0,"fee schedule","175% of CMS fee schedule",15166.32,100,,,,,0,"fee schedule",EAPG,24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1990.17,63,,1592.14,,,0,"percent of total billed charges","63% of total billed charges",483.33,15.3,,386.66,,,0,"percent of total billed charges","15.3% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,2179.71,69,,,,,0,"fee schedule","69% of total billed charges",3159,100,,2527.20,,,0,"percent of total billed charges","100% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3159,100,,2527.20,,,0,"percent of total billed charges","100% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3159,100,,2527.20,,,0,"percent of total billed charges","100% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",87199.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14724.59,100,,,,,0,"fee schedule",EAPG,24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22797.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15019.08,100,,,,,0,"fee schedule",EAPG,19141.96,100,,,,,0,"fee schedule",EAPG,24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1190.94,37.7,,952.75,,,0,"percent of total billed charges","37.70% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2464.02,78,,1971.22,,,0,"percent of total billed charges","78% of total billed charges",24466.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2609.33,82.6,,2087.46,,,0,"percent of total billed charges","82.6% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2609.33,82.6,,2087.46,,,0,"percent of total billed charges","82.6% of total billed charges",24224.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14885.12,100,,,,,0,"fee schedule",EAPG,3159,100,,2527.20,,,0,"percent of total billed charges","100% of total billed charges",483.33,87199.85,
"93655 Intracardiac cath ablation of a discrete mec",7963008,CDM,521,RC,93655,CPT,OUTPATIENT,,,1183,768.95,,1041.04,88,,832.83,,,0,"percent of total billed charges","88% of total billed charges",591.5,50,,473.20,,,0,"percent of total billed charges","50% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,1183,100,,946.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15166.32,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",745.29,63,,596.23,,,0,"percent of total billed charges","63% of total billed charges",181,15.3,,144.80,,,0,"percent of total billed charges","15.3% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,816.27,69,,,,,0,"fee schedule","69% of total billed charges",1183,100,,946.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1183,100,,946.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1183,100,,946.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",731.69,61.85,,585.35,,,0,"percent of total billed charges","61.5% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,591.5,50,,473.20,,,0,"percent of total billed charges","50% of total billed charges",380.93,32.2,,304.74,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15019.08,100,,,,,0,"fee schedule",EAPG,19141.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",445.99,37.7,,356.79,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",922.74,78,,738.19,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",977.16,82.6,,781.73,,,0,"percent of total billed charges","82.6% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,591.5,50,,473.20,,,0,"percent of total billed charges","50% of total billed charges",977.16,82.6,,781.73,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",14885.12,100,,,,,0,"fee schedule",EAPG,1183,100,,946.40,,,0,"percent of total billed charges","100% of total billed charges",181,19141.96,
"93650 ablate heart dysrhythm focus",7963771,CDM,521,RC,93650,CPT,OUTPATIENT,,,1903,1236.95,,1674.64,88,,1339.71,,,0,"percent of total billed charges","88% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14724.59,100,,,,,0,"fee schedule",EAPG,1903,100,,1522.40,,,0,"percent of total billed charges","100% of total billed charges",13330.21,175,,,,,0,"fee schedule","175% of CMS fee schedule",15166.32,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1198.89,63,,959.11,,,0,"percent of total billed charges","63% of total billed charges",291.16,15.3,,232.93,,,0,"percent of total billed charges","15.3% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,1313.07,69,,,,,0,"fee schedule","69% of total billed charges",1903,100,,1522.40,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1903,100,,1522.40,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1903,100,,1522.40,,,0,"percent of total billed charges","100% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS fee schedule",24694.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14724.59,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6455.95,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15019.08,100,,,,,0,"fee schedule",EAPG,19141.96,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",717.43,37.7,,573.94,,,0,"percent of total billed charges","37.70% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1484.34,78,,1187.47,,,0,"percent of total billed charges","78% of total billed charges",7693.43,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.88,82.6,,1257.50,,,0,"percent of total billed charges","82.6% of total billed charges",14724.59,100,,,,,0,"fee schedule",EAPG,7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1571.88,82.6,,1257.50,,,0,"percent of total billed charges","82.6% of total billed charges",7617.27,100,,,,,0,"fee schedule","100% of CMS OPPS rate",14885.12,100,,,,,0,"fee schedule",EAPG,1903,100,,1522.40,,,0,"percent of total billed charges","100% of total billed charges",291.16,24694.01,
"93660 eval of cardiovascular function w/ tilt tabl",7961449,CDM,521,RC,93660,CPT,OUTPATIENT,,,276,179.4,,242.88,88,,194.30,,,0,"percent of total billed charges","88% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.99,100,,,,,0,"fee schedule",EAPG,276,100,,220.80,,,0,"percent of total billed charges","100% of total billed charges",956.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",155.52,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.88,63,,139.10,,,0,"percent of total billed charges","63% of total billed charges",42.23,15.3,,33.78,,,0,"percent of total billed charges","15.3% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,190.44,69,,,,,0,"fee schedule","69% of total billed charges",276,100,,220.80,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",276,100,,220.80,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",276,100,,220.80,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1981.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.99,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",518.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.01,100,,,,,0,"fee schedule",EAPG,196.29,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",104.05,37.7,,83.24,,,0,"percent of total billed charges","37.70% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",215.28,78,,172.22,,,0,"percent of total billed charges","78% of total billed charges",552.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",227.98,82.6,,182.38,,,0,"percent of total billed charges","82.6% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",227.98,82.6,,182.38,,,0,"percent of total billed charges","82.6% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",311.52,100,,,,,0,"fee schedule",EAPG,276,100,,220.80,,,0,"percent of total billed charges","100% of total billed charges",42.23,1981.61,
"93662 intracardiac ecg (ice)",7963880,CDM,521,RC,93662,CPT,OUTPATIENT,,,417,271.05,,366.96,88,,293.57,,,0,"percent of total billed charges","88% of total billed charges",208.5,50,,166.80,,,0,"percent of total billed charges","50% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,417,100,,333.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",430.64,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",262.71,63,,210.17,,,0,"percent of total billed charges","63% of total billed charges",63.8,15.3,,51.04,,,0,"percent of total billed charges","15.3% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,287.73,69,,,,,0,"fee schedule","69% of total billed charges",417,100,,333.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417,100,,333.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417,100,,333.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",257.91,61.85,,206.33,,,0,"percent of total billed charges","61.5% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,208.5,50,,166.80,,,0,"percent of total billed charges","50% of total billed charges",134.27,32.2,,107.42,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",426.46,100,,,,,0,"fee schedule",EAPG,543.53,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",157.21,37.7,,125.77,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",325.26,78,,260.21,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",344.44,82.6,,275.55,,,0,"percent of total billed charges","82.6% of total billed charges",418.1,100,,,,,0,"fee schedule",EAPG,208.5,50,,166.80,,,0,"percent of total billed charges","50% of total billed charges",344.44,82.6,,275.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",578.63,100,,,,,0,"fee schedule",EAPG,417,100,,333.60,,,0,"percent of total billed charges","100% of total billed charges",63.8,578.63,
"93724 Electronic analysis of antitachycardia pacem",7963265,CDM,521,RC,93724,CPT,OUTPATIENT,,,711,462.15,,625.68,88,,500.54,,,0,"percent of total billed charges","88% of total billed charges",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.02,100,,,,,0,"fee schedule",EAPG,711,100,,568.80,,,0,"percent of total billed charges","100% of total billed charges",533.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",135.99,100,,,,,0,"fee schedule",EAPG,304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",447.93,63,,358.34,,,0,"percent of total billed charges","63% of total billed charges",108.78,15.3,,87.02,,,0,"percent of total billed charges","15.3% of total billed charges",132.02,100,,,,,0,"fee schedule",EAPG,490.59,69,,,,,0,"fee schedule","69% of total billed charges",711,100,,568.80,,,0,"percent of total billed charges","100% of total billed charges",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",711,100,,568.80,,,0,"percent of total billed charges","100% of total billed charges",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",711,100,,568.80,,,0,"percent of total billed charges","100% of total billed charges",304.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",1106.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.02,100,,,,,0,"fee schedule",EAPG,304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",134.67,100,,,,,0,"fee schedule",EAPG,171.63,100,,,,,0,"fee schedule",EAPG,304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",268.05,37.7,,214.44,,,0,"percent of total billed charges","37.70% of total billed charges",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",554.58,78,,443.66,,,0,"percent of total billed charges","78% of total billed charges",307.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",587.29,82.6,,469.83,,,0,"percent of total billed charges","82.6% of total billed charges",132.02,100,,,,,0,"fee schedule",EAPG,304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",587.29,82.6,,469.83,,,0,"percent of total billed charges","82.6% of total billed charges",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",292.55,100,,,,,0,"fee schedule",EAPG,711,100,,568.80,,,0,"percent of total billed charges","100% of total billed charges",108.78,1106.9,
"93745 set-up cardiovert-defibrill",7963791,CDM,521,RC,93745,CPT,OUTPATIENT,,,49,31.85,,43.12,88,,34.50,,,0,"percent of total billed charges","88% of total billed charges",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.52,100,,,,,0,"fee schedule",EAPG,49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",533.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",63.37,100,,,,,0,"fee schedule",EAPG,304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",30.87,63,,24.70,,,0,"percent of total billed charges","63% of total billed charges",7.5,15.3,,6.00,,,0,"percent of total billed charges","15.3% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,33.81,69,,,,,0,"fee schedule","69% of total billed charges",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",304.64,100,,,,,0,"fee schedule","100% of CMS fee schedule",1106.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.52,100,,,,,0,"fee schedule",EAPG,304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",289.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",62.75,100,,,,,0,"fee schedule",EAPG,79.98,100,,,,,0,"fee schedule",EAPG,304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",18.47,37.7,,14.78,,,0,"percent of total billed charges","37.70% of total billed charges",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.22,78,,30.58,,,0,"percent of total billed charges","78% of total billed charges",307.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.47,82.6,,32.38,,,0,"percent of total billed charges","82.6% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.47,82.6,,32.38,,,0,"percent of total billed charges","82.6% of total billed charges",304.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",222.05,100,,,,,0,"fee schedule",EAPG,49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",7.5,1106.9,
"93770 Determination of venous pressure",7963722,CDM,521,RC,93770,CPT,OUTPATIENT,,,24,15.6,,21.12,88,,16.90,,,0,"percent of total billed charges","88% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",15.12,63,,12.10,,,0,"percent of total billed charges","63% of total billed charges",3.67,15.3,,2.94,,,0,"percent of total billed charges","15.3% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,16.56,69,,,,,0,"fee schedule","69% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.84,61.85,,11.87,,,0,"percent of total billed charges","61.5% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",7.73,32.2,,6.18,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",62.75,100,,,,,0,"fee schedule",EAPG,79.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.05,37.7,,7.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.72,78,,14.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",222.05,100,,,,,0,"fee schedule",EAPG,24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,222.05,
"93784 Amb BP, utilizing a system such as magnetic",7961653,CDM,521,RC,93784,CPT,OUTPATIENT,,,174,113.1,,153.12,88,,122.50,,,0,"percent of total billed charges","88% of total billed charges",87,50,,69.60,,,0,"percent of total billed charges","50% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,174,100,,139.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",109.62,63,,87.70,,,0,"percent of total billed charges","63% of total billed charges",26.62,15.3,,21.30,,,0,"percent of total billed charges","15.3% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,120.06,69,,,,,0,"fee schedule","69% of total billed charges",174,100,,139.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",174,100,,139.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",174,100,,139.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",107.62,61.85,,86.10,,,0,"percent of total billed charges","61.5% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,87,50,,69.60,,,0,"percent of total billed charges","50% of total billed charges",56.03,32.2,,44.82,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",62.75,100,,,,,0,"fee schedule",EAPG,79.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",65.6,37.7,,52.48,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",135.72,78,,108.58,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",143.72,82.6,,114.98,,,0,"percent of total billed charges","82.6% of total billed charges",61.52,100,,,,,0,"fee schedule","100% of WA fee schedule",87,50,,69.60,,,0,"percent of total billed charges","50% of total billed charges",143.72,82.6,,114.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",222.05,100,,,,,0,"fee schedule",EAPG,174,100,,139.20,,,0,"percent of total billed charges","100% of total billed charges",26.62,222.05,
"93786 ambulatory bp recording",7963864,CDM,521,RC,93786,CPT,OUTPATIENT,,,94,61.1,,82.72,88,,66.18,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.52,100,,,,,0,"fee schedule",EAPG,94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",63.37,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.22,63,,47.38,,,0,"percent of total billed charges","63% of total billed charges",14.38,15.3,,11.50,,,0,"percent of total billed charges","15.3% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,64.86,69,,,,,0,"fee schedule","69% of total billed charges",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.52,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",62.75,100,,,,,0,"fee schedule",EAPG,79.98,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",35.44,37.7,,28.35,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.32,78,,58.66,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",77.64,82.6,,62.11,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",222.05,100,,,,,0,"fee schedule",EAPG,94,100,,75.20,,,0,"percent of total billed charges","100% of total billed charges",14.38,454.8,
"93788 ambulatory bp analysis",7963878,CDM,521,RC,93788,CPT,OUTPATIENT,,,27,17.55,,23.76,88,,19.01,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.52,100,,,,,0,"fee schedule",EAPG,27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",63.37,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17.01,63,,13.61,,,0,"percent of total billed charges","63% of total billed charges",4.13,15.3,,3.30,,,0,"percent of total billed charges","15.3% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,18.63,69,,,,,0,"fee schedule","69% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.52,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",62.75,100,,,,,0,"fee schedule",EAPG,79.98,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10.18,37.7,,8.14,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",21.06,78,,16.85,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22.3,82.6,,17.84,,,0,"percent of total billed charges","82.6% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22.3,82.6,,17.84,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",222.05,100,,,,,0,"fee schedule",EAPG,27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",4.13,454.8,
"93799 Unlisted cardiovascular service or procedure",7963513,CDM,521,RC,93799,CPT,OUTPATIENT,,,78,50.7,,68.64,88,,54.91,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",24.47,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",49.14,63,,39.31,,,0,"percent of total billed charges","63% of total billed charges",11.93,15.3,,9.54,,,0,"percent of total billed charges","15.3% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,53.82,69,,,,,0,"fee schedule","69% of total billed charges",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.76,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.23,100,,,,,0,"fee schedule",EAPG,30.89,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",29.41,37.7,,23.53,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60.84,78,,48.67,,,0,"percent of total billed charges","78% of total billed charges",160.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",64.43,82.6,,51.54,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",184.29,100,,,,,0,"fee schedule",EAPG,78,100,,62.40,,,0,"percent of total billed charges","100% of total billed charges",11.93,566.91,
"93790 review/report bp recording",7963829,CDM,521,RC,93790,CPT,OUTPATIENT,,,56,36.4,,49.28,88,,39.42,,,0,"percent of total billed charges","88% of total billed charges",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",35.28,63,,28.22,,,0,"percent of total billed charges","63% of total billed charges",8.57,15.3,,6.86,,,0,"percent of total billed charges","15.3% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,38.64,69,,,,,0,"fee schedule","69% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.64,61.85,,27.71,,,0,"percent of total billed charges","61.5% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",18.03,32.2,,14.42,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",62.75,100,,,,,0,"fee schedule",EAPG,79.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.11,37.7,,16.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.68,78,,34.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",61.52,100,,,,,0,"fee schedule","100% of WA fee schedule",28,50,,22.40,,,0,"percent of total billed charges","50% of total billed charges",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",222.05,100,,,,,0,"fee schedule",EAPG,56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",8.57,222.05,
"93798 cardiac rehab/monitor",7963886,CDM,521,RC,93798,CPT,OUTPATIENT,,,74,48.1,,65.12,88,,52.10,,,0,"percent of total billed charges","88% of total billed charges",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15.18,100,,,,,0,"fee schedule","100% of WA fee schedule",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",235.85,175,,,,,0,"fee schedule","175% of CMS fee schedule",15.18,100,,,,,0,"fee schedule","100% of WA fee schedule",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.62,63,,37.30,,,0,"percent of total billed charges","63% of total billed charges",11.32,15.3,,9.06,,,0,"percent of total billed charges","15.3% of total billed charges",15.18,100,,,,,0,"fee schedule","100% of WA fee schedule",51.06,69,,,,,0,"fee schedule","69% of total billed charges",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",134.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",471.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15.18,100,,,,,0,"fee schedule","100% of WA fee schedule",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15.48,102,,,,,0,"fee schedule","102% of WA fee schedule",19.73,130,,,,,0,"fee schedule","130% of WA fee schedule",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",27.9,37.7,,22.32,,,0,"percent of total billed charges","37.70% of total billed charges",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",57.72,78,,46.18,,,0,"percent of total billed charges","78% of total billed charges",136.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.12,82.6,,48.90,,,0,"percent of total billed charges","82.6% of total billed charges",15.18,100,,,,,0,"fee schedule","100% of WA fee schedule",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.12,82.6,,48.90,,,0,"percent of total billed charges","82.6% of total billed charges",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"case rate","pays based on per visit rate",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",11.32,471.48,
"93797 cardiac rehab",7963930,CDM,521,RC,93797,CPT,OUTPATIENT,,,49,31.85,,43.12,88,,34.50,,,0,"percent of total billed charges","88% of total billed charges",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9.87,100,,,,,0,"fee schedule","100% of WA fee schedule",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",235.85,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.87,100,,,,,0,"fee schedule","100% of WA fee schedule",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",30.87,63,,24.70,,,0,"percent of total billed charges","63% of total billed charges",7.5,15.3,,6.00,,,0,"percent of total billed charges","15.3% of total billed charges",9.87,100,,,,,0,"fee schedule","100% of WA fee schedule",33.81,69,,,,,0,"fee schedule","69% of total billed charges",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",134.77,100,,,,,0,"fee schedule","100% of CMS fee schedule",471.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9.87,100,,,,,0,"fee schedule","100% of WA fee schedule",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10.07,102,,,,,0,"fee schedule","102% of WA fee schedule",12.83,130,,,,,0,"fee schedule","130% of WA fee schedule",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",18.47,37.7,,14.78,,,0,"percent of total billed charges","37.70% of total billed charges",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.22,78,,30.58,,,0,"percent of total billed charges","78% of total billed charges",136.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.47,82.6,,32.38,,,0,"percent of total billed charges","82.6% of total billed charges",9.87,100,,,,,0,"fee schedule","100% of WA fee schedule",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.47,82.6,,32.38,,,0,"percent of total billed charges","82.6% of total billed charges",134.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"case rate","pays based on per visit rate",49,100,,39.20,,,0,"percent of total billed charges","100% of total billed charges",7.5,471.48,
"93886 Transcranial Doppler study of the intracrani",7962792,CDM,521,RC,93886,CPT,OUTPATIENT,,,586,380.9,,515.68,88,,412.54,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",155.82,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",369.18,63,,295.34,,,0,"percent of total billed charges","63% of total billed charges",89.66,15.3,,71.73,,,0,"percent of total billed charges","15.3% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,404.34,69,,,,,0,"fee schedule","69% of total billed charges",586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.31,100,,,,,0,"fee schedule",EAPG,196.67,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",220.92,37.7,,176.74,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",457.08,78,,365.66,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",484.04,82.6,,387.23,,,0,"percent of total billed charges","82.6% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",484.04,82.6,,387.23,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",311.81,100,,,,,0,"fee schedule",EAPG,586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",89.66,934.9,
"93888 Transcranial Doppler study of the intracrani",7962794,CDM,521,RC,93888,CPT,OUTPATIENT,,,278,180.7,,244.64,88,,195.71,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",175.14,63,,140.11,,,0,"percent of total billed charges","63% of total billed charges",42.53,15.3,,34.02,,,0,"percent of total billed charges","15.3% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,191.82,69,,,,,0,"fee schedule","69% of total billed charges",278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",104.81,37.7,,83.85,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.84,78,,173.47,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.63,82.6,,183.70,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229.63,82.6,,183.70,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.18,100,,,,,0,"fee schedule",EAPG,278,100,,222.40,,,0,"percent of total billed charges","100% of total billed charges",42.53,442.69,
"93882 Duplex scan of extracranial arteries; unilat",7962979,CDM,521,RC,93882,CPT,OUTPATIENT,,,509,330.85,,447.92,88,,358.34,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320.67,63,,256.54,,,0,"percent of total billed charges","63% of total billed charges",77.88,15.3,,62.30,,,0,"percent of total billed charges","15.3% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,351.21,69,,,,,0,"fee schedule","69% of total billed charges",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",191.89,37.7,,153.51,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397.02,78,,317.62,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.43,82.6,,336.34,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",420.43,82.6,,336.34,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.18,100,,,,,0,"fee schedule",EAPG,509,100,,407.20,,,0,"percent of total billed charges","100% of total billed charges",77.88,509,
"93880 Duplex scan of extracranial arteries; comple",7963056,CDM,521,RC,93880,CPT,OUTPATIENT,,,537,349.05,,472.56,88,,378.05,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",155.82,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.31,63,,270.65,,,0,"percent of total billed charges","63% of total billed charges",82.16,15.3,,65.73,,,0,"percent of total billed charges","15.3% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,370.53,69,,,,,0,"fee schedule","69% of total billed charges",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.31,100,,,,,0,"fee schedule",EAPG,196.67,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",202.45,37.7,,161.96,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",418.86,78,,335.09,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.56,82.6,,354.85,,,0,"percent of total billed charges","82.6% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",443.56,82.6,,354.85,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",311.81,100,,,,,0,"fee schedule",EAPG,537,100,,429.60,,,0,"percent of total billed charges","100% of total billed charges",82.16,934.9,
"93892 tcd emboli detect w/o inj",7963840,CDM,521,RC,93892,CPT,OUTPATIENT,,,451,293.15,,396.88,88,,317.50,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,451,100,,360.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",155.82,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.13,63,,227.30,,,0,"percent of total billed charges","63% of total billed charges",69,15.3,,55.20,,,0,"percent of total billed charges","15.3% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,311.19,69,,,,,0,"fee schedule","69% of total billed charges",451,100,,360.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",451,100,,360.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",451,100,,360.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.31,100,,,,,0,"fee schedule",EAPG,196.67,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",170.03,37.7,,136.02,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",351.78,78,,281.42,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",372.53,82.6,,298.02,,,0,"percent of total billed charges","82.6% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",372.53,82.6,,298.02,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",311.81,100,,,,,0,"fee schedule",EAPG,451,100,,360.80,,,0,"percent of total billed charges","100% of total billed charges",69,451,
"93893 tcd emboli detect w/inj",7963865,CDM,521,RC,93893,CPT,OUTPATIENT,,,452,293.8,,397.76,88,,318.21,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,452,100,,361.60,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.76,63,,227.81,,,0,"percent of total billed charges","63% of total billed charges",69.16,15.3,,55.33,,,0,"percent of total billed charges","15.3% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,311.88,69,,,,,0,"fee schedule","69% of total billed charges",452,100,,361.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",452,100,,361.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",452,100,,361.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",170.4,37.7,,136.32,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",352.56,78,,282.05,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",373.35,82.6,,298.68,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",373.35,82.6,,298.68,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.18,100,,,,,0,"fee schedule",EAPG,452,100,,361.60,,,0,"percent of total billed charges","100% of total billed charges",69.16,452,
"93923 Segmental pressure arm/leg bilat scr",7901080,CDM,521,RC,93923,CPT,OUTPATIENT,,,478,310.7,,420.64,88,,336.51,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.99,100,,,,,0,"fee schedule",EAPG,478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",155.52,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",301.14,63,,240.91,,,0,"percent of total billed charges","63% of total billed charges",73.13,15.3,,58.50,,,0,"percent of total billed charges","15.3% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,329.82,69,,,,,0,"fee schedule","69% of total billed charges",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.99,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.01,100,,,,,0,"fee schedule",EAPG,196.29,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",180.21,37.7,,144.17,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",372.84,78,,298.27,,,0,"percent of total billed charges","78% of total billed charges",160.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394.83,82.6,,315.86,,,0,"percent of total billed charges","82.6% of total billed charges",150.99,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394.83,82.6,,315.86,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",311.52,100,,,,,0,"fee schedule",EAPG,478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",73.13,566.91,
"93922 Non-invasive upper/lower ext arteri",7904796,CDM,521,RC,93922,CPT,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.18,100,,,,,0,"fee schedule",EAPG,309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,454.8,
"93924 Noninvasive phys studies of lower extremity",7961566,CDM,521,RC,93924,CPT,OUTPATIENT,,,600,390,,528,88,,422.40,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,600,100,,480.00,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",378,63,,302.40,,,0,"percent of total billed charges","63% of total billed charges",91.8,15.3,,73.44,,,0,"percent of total billed charges","15.3% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,414,69,,,,,0,"fee schedule","69% of total billed charges",600,100,,480.00,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",600,100,,480.00,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",600,100,,480.00,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",226.2,37.7,,180.96,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",468,78,,374.40,,,0,"percent of total billed charges","78% of total billed charges",160.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",495.6,82.6,,396.48,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",495.6,82.6,,396.48,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.18,100,,,,,0,"fee schedule",EAPG,600,100,,480.00,,,0,"percent of total billed charges","100% of total billed charges",91.8,1074.33,
"93926 Duplex scan of lower extremity arteries or a",7961567,CDM,521,RC,93926,CPT,OUTPATIENT,,,342,222.3,,300.96,88,,240.77,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,342,100,,273.60,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",215.46,63,,172.37,,,0,"percent of total billed charges","63% of total billed charges",52.33,15.3,,41.86,,,0,"percent of total billed charges","15.3% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,235.98,69,,,,,0,"fee schedule","69% of total billed charges",342,100,,273.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342,100,,273.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342,100,,273.60,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",128.93,37.7,,103.14,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",266.76,78,,213.41,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",282.49,82.6,,225.99,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",282.49,82.6,,225.99,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.18,100,,,,,0,"fee schedule",EAPG,342,100,,273.60,,,0,"percent of total billed charges","100% of total billed charges",52.33,442.69,
"93925 Duplex scan of lower extremity arteries or a",7961792,CDM,521,RC,93925,CPT,OUTPATIENT,,,533,346.45,,469.04,88,,375.23,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,533,100,,426.40,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",155.82,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.79,63,,268.63,,,0,"percent of total billed charges","63% of total billed charges",81.55,15.3,,65.24,,,0,"percent of total billed charges","15.3% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,367.77,69,,,,,0,"fee schedule","69% of total billed charges",533,100,,426.40,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",533,100,,426.40,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",533,100,,426.40,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.31,100,,,,,0,"fee schedule",EAPG,196.67,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",200.94,37.7,,160.75,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",415.74,78,,332.59,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",440.26,82.6,,352.21,,,0,"percent of total billed charges","82.6% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",440.26,82.6,,352.21,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",311.81,100,,,,,0,"fee schedule",EAPG,533,100,,426.40,,,0,"percent of total billed charges","100% of total billed charges",81.55,934.9,
"93931 Duplex scan of upper extremity arteries or a",7961568,CDM,521,RC,93931,CPT,OUTPATIENT,,,468,304.2,,411.84,88,,329.47,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,468,100,,374.40,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",294.84,63,,235.87,,,0,"percent of total billed charges","63% of total billed charges",71.6,15.3,,57.28,,,0,"percent of total billed charges","15.3% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,322.92,69,,,,,0,"fee schedule","69% of total billed charges",468,100,,374.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",468,100,,374.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",468,100,,374.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",176.44,37.7,,141.15,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",365.04,78,,292.03,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",386.57,82.6,,309.26,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",386.57,82.6,,309.26,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.18,100,,,,,0,"fee schedule",EAPG,468,100,,374.40,,,0,"percent of total billed charges","100% of total billed charges",71.6,468,
"93930 Duplex scan of upper extremity arteries or a",7961793,CDM,521,RC,93930,CPT,OUTPATIENT,,,684,444.6,,601.92,88,,481.54,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,684,100,,547.20,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",430.92,63,,344.74,,,0,"percent of total billed charges","63% of total billed charges",104.65,15.3,,83.72,,,0,"percent of total billed charges","15.3% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,471.96,69,,,,,0,"fee schedule","69% of total billed charges",684,100,,547.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",684,100,,547.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",684,100,,547.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",257.87,37.7,,206.30,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",533.52,78,,426.82,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",564.98,82.6,,451.98,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",564.98,82.6,,451.98,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.18,100,,,,,0,"fee schedule",EAPG,684,100,,547.20,,,0,"percent of total billed charges","100% of total billed charges",99.65,934.9,
"93965 extremity study",7963921,CDM,521,RC,,,OUTPATIENT,,,376,244.4,,330.88,88,,264.70,,,0,"percent of total billed charges","88% of total billed charges",188,50,,150.40,,,0,"percent of total billed charges","50% of total billed charges",63.17,16.8,,50.54,,,0,"percent of total billed charges","16.8% of total billed charges",376,100,,300.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",65.06,17.304,,52.05,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",236.88,63,,189.50,,,0,"percent of total billed charges","63% of total billed charges",57.53,15.3,,46.02,,,0,"percent of total billed charges","15.3% of total billed charges",63.17,16.8,,50.54,,,0,"percent of total billed charges","16.8% of total billed charges",259.44,69,,,,,0,"fee schedule","69% of total billed charges",376,100,,300.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",376,100,,300.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",376,100,,300.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",232.56,61.85,,186.05,,,0,"percent of total billed charges","61.5% of total billed charges",63.17,16.8,,50.54,,,0,"percent of total billed charges","16.8% of total billed charges",188,50,,150.40,,,0,"percent of total billed charges","50% of total billed charges",121.07,32.2,,96.86,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",64.43,17.136,,51.54,,,0,"percent of total billed charges","17.136% of total billed charges",82.12,21.84,,65.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",141.75,37.7,,113.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",293.28,78,,234.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",310.58,82.6,,248.46,,,0,"percent of total billed charges","82.6% of total billed charges",63.17,16.8,,50.54,,,0,"percent of total billed charges","16.8% of total billed charges",188,50,,150.40,,,0,"percent of total billed charges","50% of total billed charges",310.58,82.6,,248.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",376,100,,300.80,,,0,"percent of total billed charges","100% of total billed charges",57.53,376,
"93978 Duplex scan of aorta, inferior vena cava, il",7961654,CDM,521,RC,93978,CPT,OUTPATIENT,,,544,353.6,,478.72,88,,382.98,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,544,100,,435.20,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",155.82,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",342.72,63,,274.18,,,0,"percent of total billed charges","63% of total billed charges",83.23,15.3,,66.58,,,0,"percent of total billed charges","15.3% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,375.36,69,,,,,0,"fee schedule","69% of total billed charges",544,100,,435.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",544,100,,435.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",544,100,,435.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.31,100,,,,,0,"fee schedule",EAPG,196.67,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",205.09,37.7,,164.07,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",424.32,78,,339.46,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.34,82.6,,359.47,,,0,"percent of total billed charges","82.6% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",449.34,82.6,,359.47,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",311.81,100,,,,,0,"fee schedule",EAPG,544,100,,435.20,,,0,"percent of total billed charges","100% of total billed charges",83.23,934.9,
"93979 Duplex scan of aorta, inferior vena cava, il",7961721,CDM,521,RC,93979,CPT,OUTPATIENT,,,349,226.85,,307.12,88,,245.70,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,349,100,,279.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",219.87,63,,175.90,,,0,"percent of total billed charges","63% of total billed charges",53.4,15.3,,42.72,,,0,"percent of total billed charges","15.3% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,240.81,69,,,,,0,"fee schedule","69% of total billed charges",349,100,,279.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",349,100,,279.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",349,100,,279.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",131.57,37.7,,105.26,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.22,78,,217.78,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",288.27,82.6,,230.62,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",288.27,82.6,,230.62,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.18,100,,,,,0,"fee schedule",EAPG,349,100,,279.20,,,0,"percent of total billed charges","100% of total billed charges",53.4,442.69,
"93975 Duplex scan of arterial inflow and venous ou",7962980,CDM,521,RC,93975,CPT,OUTPATIENT,,,709,460.85,,623.92,88,,499.14,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,709,100,,567.20,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",155.82,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",446.67,63,,357.34,,,0,"percent of total billed charges","63% of total billed charges",108.48,15.3,,86.78,,,0,"percent of total billed charges","15.3% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,489.21,69,,,,,0,"fee schedule","69% of total billed charges",709,100,,567.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",709,100,,567.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",709,100,,567.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.31,100,,,,,0,"fee schedule",EAPG,196.67,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",267.29,37.7,,213.83,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",553.02,78,,442.42,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",585.63,82.6,,468.50,,,0,"percent of total billed charges","82.6% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",585.63,82.6,,468.50,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",311.81,100,,,,,0,"fee schedule",EAPG,709,100,,567.20,,,0,"percent of total billed charges","100% of total billed charges",108.48,934.9,
"93976 Duplex scan of arterial inflow & venous outf",7963057,CDM,521,RC,93976,CPT,OUTPATIENT,,,623,404.95,,548.24,88,,438.59,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,623,100,,498.40,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",155.82,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",392.49,63,,313.99,,,0,"percent of total billed charges","63% of total billed charges",95.32,15.3,,76.26,,,0,"percent of total billed charges","15.3% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,429.87,69,,,,,0,"fee schedule","69% of total billed charges",623,100,,498.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",623,100,,498.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",623,100,,498.40,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.31,100,,,,,0,"fee schedule",EAPG,196.67,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",234.87,37.7,,187.90,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",485.94,78,,388.75,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",514.6,82.6,,411.68,,,0,"percent of total billed charges","82.6% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",514.6,82.6,,411.68,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",311.81,100,,,,,0,"fee schedule",EAPG,623,100,,498.40,,,0,"percent of total billed charges","100% of total billed charges",95.32,623,
"93971 Duplex scan of extremity veins; unilateral o",7963158,CDM,521,RC,93971,CPT,OUTPATIENT,,,349,226.85,,307.12,88,,245.70,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,349,100,,279.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",219.87,63,,175.90,,,0,"percent of total billed charges","63% of total billed charges",53.4,15.3,,42.72,,,0,"percent of total billed charges","15.3% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,240.81,69,,,,,0,"fee schedule","69% of total billed charges",349,100,,279.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",349,100,,279.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",349,100,,279.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",131.57,37.7,,105.26,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.22,78,,217.78,,,0,"percent of total billed charges","78% of total billed charges",113.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",288.27,82.6,,230.62,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",288.27,82.6,,230.62,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.18,100,,,,,0,"fee schedule",EAPG,349,100,,279.20,,,0,"percent of total billed charges","100% of total billed charges",53.4,442.69,
"93970 Duplex scan of extremity veins; complete bil",7963236,CDM,521,RC,93970,CPT,OUTPATIENT,,,549,356.85,,483.12,88,,386.50,,,0,"percent of total billed charges","88% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",437.37,175,,,,,0,"fee schedule","175% of CMS fee schedule",155.82,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.87,63,,276.70,,,0,"percent of total billed charges","63% of total billed charges",84,15.3,,67.20,,,0,"percent of total billed charges","15.3% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,378.81,69,,,,,0,"fee schedule","69% of total billed charges",549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS fee schedule",934.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151.28,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.31,100,,,,,0,"fee schedule",EAPG,196.67,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",206.97,37.7,,165.58,,,0,"percent of total billed charges","37.70% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",428.22,78,,342.58,,,0,"percent of total billed charges","78% of total billed charges",252.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",453.47,82.6,,362.78,,,0,"percent of total billed charges","82.6% of total billed charges",151.28,100,,,,,0,"fee schedule",EAPG,249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",453.47,82.6,,362.78,,,0,"percent of total billed charges","82.6% of total billed charges",249.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",311.81,100,,,,,0,"fee schedule",EAPG,549,100,,439.20,,,0,"percent of total billed charges","100% of total billed charges",84,934.9,
"93990 Duplex scan of hemodialysis access",7963697,CDM,521,RC,93990,CPT,OUTPATIENT,,,579,376.35,,509.52,88,,407.62,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,579,100,,463.20,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",102.64,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",364.77,63,,291.82,,,0,"percent of total billed charges","63% of total billed charges",88.59,15.3,,70.87,,,0,"percent of total billed charges","15.3% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,399.51,69,,,,,0,"fee schedule","69% of total billed charges",579,100,,463.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579,100,,463.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",579,100,,463.20,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",101.64,100,,,,,0,"fee schedule",EAPG,129.55,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",218.28,37.7,,174.62,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",451.62,78,,361.30,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",478.25,82.6,,382.60,,,0,"percent of total billed charges","82.6% of total billed charges",99.65,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",478.25,82.6,,382.60,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",260.18,100,,,,,0,"fee schedule",EAPG,579,100,,463.20,,,0,"percent of total billed charges","100% of total billed charges",88.59,579,
"94010 Spirometry tech",7901082,CDM,521,RC,94010,CPT,OUTPATIENT,,,67,43.55,,58.96,88,,47.17,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",48.3,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42.21,63,,33.77,,,0,"percent of total billed charges","63% of total billed charges",10.25,15.3,,8.20,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,46.23,69,,,,,0,"fee schedule","69% of total billed charges",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",25.26,37.7,,20.21,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.26,78,,41.81,,,0,"percent of total billed charges","78% of total billed charges",160.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",55.34,82.6,,44.27,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",55.34,82.6,,44.27,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",207.42,100,,,,,0,"fee schedule",EAPG,67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",10.25,566.92,
"94060 Spirometry with bronchodilator tech",7901083,CDM,521,RC,94060,CPT,OUTPATIENT,,,180,117,,158.4,88,,126.72,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.19,100,,,,,0,"fee schedule",EAPG,180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",94.95,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",113.4,63,,90.72,,,0,"percent of total billed charges","63% of total billed charges",27.54,15.3,,22.03,,,0,"percent of total billed charges","15.3% of total billed charges",92.19,100,,,,,0,"fee schedule",EAPG,124.2,69,,,,,0,"fee schedule","69% of total billed charges",180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.19,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",94.03,100,,,,,0,"fee schedule",EAPG,119.84,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",67.86,37.7,,54.29,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",140.4,78,,112.32,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.68,82.6,,118.94,,,0,"percent of total billed charges","82.6% of total billed charges",92.19,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.68,82.6,,118.94,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.72,100,,,,,0,"fee schedule",EAPG,180,100,,144.00,,,0,"percent of total billed charges","100% of total billed charges",27.54,1074.33,
"94070 Bronchospasm provocation evaluation, multipl",7962756,CDM,521,RC,94070,CPT,OUTPATIENT,,,179,116.35,,157.52,88,,126.02,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.19,100,,,,,0,"fee schedule",EAPG,179,100,,143.20,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",94.95,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",112.77,63,,90.22,,,0,"percent of total billed charges","63% of total billed charges",27.39,15.3,,21.91,,,0,"percent of total billed charges","15.3% of total billed charges",92.19,100,,,,,0,"fee schedule",EAPG,123.51,69,,,,,0,"fee schedule","69% of total billed charges",179,100,,143.20,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",179,100,,143.20,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",179,100,,143.20,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.19,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",94.03,100,,,,,0,"fee schedule",EAPG,119.84,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",67.48,37.7,,53.98,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",139.62,78,,111.70,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.85,82.6,,118.28,,,0,"percent of total billed charges","82.6% of total billed charges",92.19,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.85,82.6,,118.28,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.72,100,,,,,0,"fee schedule",EAPG,179,100,,143.20,,,0,"percent of total billed charges","100% of total billed charges",27.39,1074.33,
"94150 Vital capacity, total",7963894,CDM,521,RC,94150,CPT,OUTPATIENT,,,46,29.9,,40.48,88,,32.38,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",48.3,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",28.98,63,,23.18,,,0,"percent of total billed charges","63% of total billed charges",7.04,15.3,,5.63,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,31.74,69,,,,,0,"fee schedule","69% of total billed charges",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",17.34,37.7,,13.87,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.88,78,,28.70,,,0,"percent of total billed charges","78% of total billed charges",160.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38,82.6,,30.40,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38,82.6,,30.40,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",207.42,100,,,,,0,"fee schedule",EAPG,46,100,,36.80,,,0,"percent of total billed charges","100% of total billed charges",7.04,566.92,
"94200 Maximum breathing capacity, maximal voluntar",7903360,CDM,521,RC,94200,CPT,OUTPATIENT,,,74,48.1,,65.12,88,,52.10,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",48.3,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.62,63,,37.30,,,0,"percent of total billed charges","63% of total billed charges",11.32,15.3,,9.06,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,51.06,69,,,,,0,"fee schedule","69% of total billed charges",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",27.9,37.7,,22.32,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",57.72,78,,46.18,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.12,82.6,,48.90,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.12,82.6,,48.90,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",207.42,100,,,,,0,"fee schedule",EAPG,74,100,,59.20,,,0,"percent of total billed charges","100% of total billed charges",11.32,226.12,
"94375 Respiratory flow volume loop",7963782,CDM,521,RC,94375,CPT,OUTPATIENT,,,115,74.75,,101.2,88,,80.96,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.19,100,,,,,0,"fee schedule",EAPG,115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",560.25,175,,,,,0,"fee schedule","175% of CMS fee schedule",94.95,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",72.45,63,,57.96,,,0,"percent of total billed charges","63% of total billed charges",17.6,15.3,,14.08,,,0,"percent of total billed charges","15.3% of total billed charges",92.19,100,,,,,0,"fee schedule",EAPG,79.35,69,,,,,0,"fee schedule","69% of total billed charges",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.19,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",94.03,100,,,,,0,"fee schedule",EAPG,119.84,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",43.36,37.7,,34.69,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",89.7,78,,71.76,,,0,"percent of total billed charges","78% of total billed charges",323.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",94.99,82.6,,75.99,,,0,"percent of total billed charges","82.6% of total billed charges",92.19,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",94.99,82.6,,75.99,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.72,100,,,,,0,"fee schedule",EAPG,115,100,,92.00,,,0,"percent of total billed charges","100% of total billed charges",17.6,1074.33,
"94618 Pulmonary stress testing (eg, 6-minute walk",9747260,CDM,521,RC,94618,CPT,OUTPATIENT,,,533,346.45,,469.04,88,,375.23,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,533,100,,426.40,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",48.3,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",335.79,63,,268.63,,,0,"percent of total billed charges","63% of total billed charges",81.55,15.3,,65.24,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,367.77,69,,,,,0,"fee schedule","69% of total billed charges",533,100,,426.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",533,100,,426.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",533,100,,426.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",200.94,37.7,,160.75,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",415.74,78,,332.59,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",440.26,82.6,,352.21,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",440.26,82.6,,352.21,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",207.42,100,,,,,0,"fee schedule",EAPG,533,100,,426.40,,,0,"percent of total billed charges","100% of total billed charges",46.89,533,
"94644 Continuous inhalation treatment w/ aerosol m",7961960,CDM,521,RC,94644,CPT,OUTPATIENT,,,132,85.8,,116.16,88,,92.93,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",48.3,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",83.16,63,,66.53,,,0,"percent of total billed charges","63% of total billed charges",20.2,15.3,,16.16,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,91.08,69,,,,,0,"fee schedule","69% of total billed charges",132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",49.76,37.7,,39.81,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.96,78,,82.37,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.03,82.6,,87.22,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.03,82.6,,87.22,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",207.42,100,,,,,0,"fee schedule",EAPG,132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",20.2,454.8,
"94645 cbt each addl hour",7963912,CDM,521,RC,94645,CPT,OUTPATIENT,,,42,27.3,,36.96,88,,29.57,,,0,"percent of total billed charges","88% of total billed charges",21,50,,16.80,,,0,"percent of total billed charges","50% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",26.46,63,,21.17,,,0,"percent of total billed charges","63% of total billed charges",6.43,15.3,,5.14,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,28.98,69,,,,,0,"fee schedule","69% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.98,61.85,,20.78,,,0,"percent of total billed charges","61.5% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,21,50,,16.80,,,0,"percent of total billed charges","50% of total billed charges",13.52,32.2,,10.82,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",32.76,78,,26.21,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,21,50,,16.80,,,0,"percent of total billed charges","50% of total billed charges",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",207.42,100,,,,,0,"fee schedule",EAPG,42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",6.43,207.42,
"94660 POS airway pressure CPAP",7901086,CDM,521,RC,94660,CPT,OUTPATIENT,,,84,54.6,,73.92,88,,59.14,,,0,"percent of total billed charges","88% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.78,100,,,,,0,"fee schedule",EAPG,84,100,,67.20,,,0,"percent of total billed charges","100% of total billed charges",380.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",115.13,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.92,63,,42.34,,,0,"percent of total billed charges","63% of total billed charges",12.85,15.3,,10.28,,,0,"percent of total billed charges","15.3% of total billed charges",111.78,100,,,,,0,"fee schedule",EAPG,57.96,69,,,,,0,"fee schedule","69% of total billed charges",84,100,,67.20,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",84,100,,67.20,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",84,100,,67.20,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",763.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",111.78,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",114.01,100,,,,,0,"fee schedule",EAPG,145.31,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",31.67,37.7,,25.34,,,0,"percent of total billed charges","37.70% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.52,78,,52.42,,,0,"percent of total billed charges","78% of total billed charges",219.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",69.38,82.6,,55.50,,,0,"percent of total billed charges","82.6% of total billed charges",111.78,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",69.38,82.6,,55.50,,,0,"percent of total billed charges","82.6% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.31,100,,,,,0,"fee schedule",EAPG,84,100,,67.20,,,0,"percent of total billed charges","100% of total billed charges",12.85,763.26,
"94664  Demonstration and/or evaluation of patient",7901087,CDM,521,RC,94664,CPT,OUTPATIENT,,,50,32.5,,44,88,,35.20,,,0,"percent of total billed charges","88% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",380.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",48.3,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",31.5,63,,25.20,,,0,"percent of total billed charges","63% of total billed charges",7.65,15.3,,6.12,,,0,"percent of total billed charges","15.3% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,34.5,69,,,,,0,"fee schedule","69% of total billed charges",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",763.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.89,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",18.85,37.7,,15.08,,,0,"percent of total billed charges","37.70% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39,78,,31.20,,,0,"percent of total billed charges","78% of total billed charges",219.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",46.89,100,,,,,0,"fee schedule",EAPG,217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",41.3,82.6,,33.04,,,0,"percent of total billed charges","82.6% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",207.42,100,,,,,0,"fee schedule",EAPG,50,100,,40.00,,,0,"percent of total billed charges","100% of total billed charges",7.65,763.26,
"94726 Plethysmography for determination of lung vo",7962981,CDM,521,RC,94726,CPT,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.19,100,,,,,0,"fee schedule",EAPG,20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",560.25,175,,,,,0,"fee schedule","175% of CMS fee schedule",94.95,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",92.19,100,,,,,0,"fee schedule",EAPG,13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.19,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",94.03,100,,,,,0,"fee schedule",EAPG,119.84,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",323.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",92.19,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.72,100,,,,,0,"fee schedule",EAPG,20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,1074.33,
"94761 Noninvasive ear or pulse oximetry for oxygen",7962488,CDM,521,RC,94761,CPT,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.66,61.85,,6.93,,,0,"percent of total billed charges","61.5% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",11.56,82.6,,9.25,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,160.53,
"94760 Noninvasive ear or pulse oximetry for oxygen",7962576,CDM,521,RC,94760,CPT,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.57,61.85,,4.46,,,0,"percent of total billed charges","61.5% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,160.53,
"94799 Unlisted pulmonary service or procedure",7963593,CDM,521,RC,94799,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",48.3,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47.83,100,,,,,0,"fee schedule",EAPG,60.96,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",207.42,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",46.89,207.42,
"95004 Allergy skin testing, PRICK",7901088,CDM,521,RC,95004,CPT,OUTPATIENT,,,21,13.65,,18.48,88,,14.78,,,0,"percent of total billed charges","88% of total billed charges",1066.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",1866.21,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.63,17.304,,2.90,,,0,"percent of total billed charges","17.304% of total billed charges",1066.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13.23,63,,10.58,,,0,"percent of total billed charges","63% of total billed charges",3.21,15.3,,2.57,,,0,"percent of total billed charges","15.3% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",14.49,69,,,,,0,"fee schedule","69% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",1066.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",1066.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",1066.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",3736.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",1066.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",976.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1066.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3.6,17.136,,2.88,,,0,"percent of total billed charges","17.136% of total billed charges",4.59,21.84,,3.67,,,0,"percent of total billed charges","21.84% of total billed charges",1066.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7.92,37.7,,6.34,,,0,"percent of total billed charges","37.70% of total billed charges",1066.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1066.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16.38,78,,13.10,,,0,"percent of total billed charges","78% of total billed charges",1077.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",3.53,16.8,,2.82,,,0,"percent of total billed charges","16.8% of total billed charges",1066.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",1066.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"case rate","pays based on per visit rate",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",3.21,3736.79,
"95024 Allergy testing intradermal",7901090,CDM,521,RC,95024,CPT,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.34,100,,,,,0,"fee schedule",EAPG,15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",39.49,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",38.34,100,,,,,0,"fee schedule",EAPG,10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.34,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.1,100,,,,,0,"fee schedule",EAPG,49.84,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",38.34,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",12.39,82.6,,9.91,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",198.87,100,,,,,0,"fee schedule",EAPG,15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,226.12,
"95027 intradermal allergy skin test",7963743,CDM,521,RC,95027,CPT,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.34,100,,,,,0,"fee schedule",EAPG,13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",53.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",39.49,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",38.34,100,,,,,0,"fee schedule",EAPG,8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.22,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.34,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.1,100,,,,,0,"fee schedule",EAPG,49.84,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",30.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",38.34,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10.74,82.6,,8.59,,,0,"percent of total billed charges","82.6% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",198.87,100,,,,,0,"fee schedule",EAPG,13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,198.87,
"95125 Services for allergen immunotherapy, w/ prov",7961655,CDM,521,RC,95125,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.55,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.34,100,,,,,0,"fee schedule",EAPG,27.2,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",181.45,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",20.92,181.45,
"95120 Services for allergen immunotherapy, w/ prov",7961894,CDM,521,RC,95120,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.55,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.34,100,,,,,0,"fee schedule",EAPG,27.2,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.92,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",181.45,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",20.92,181.45,
"95165 Anitgen therapy services",7901091,CDM,521,RC,95165,CPT,OUTPATIENT,,,39,25.35,,34.32,88,,27.46,,,0,"percent of total billed charges","88% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",20.92,100,,,,,0,"fee schedule",EAPG,39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",84.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",21.55,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.57,63,,19.66,,,0,"percent of total billed charges","63% of total billed charges",5.97,15.3,,4.78,,,0,"percent of total billed charges","15.3% of total billed charges",20.92,100,,,,,0,"fee schedule",EAPG,26.91,69,,,,,0,"fee schedule","69% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",20.92,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",21.34,100,,,,,0,"fee schedule",EAPG,27.2,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.70% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",30.42,78,,24.34,,,0,"percent of total billed charges","78% of total billed charges",48.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",20.92,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",181.45,100,,,,,0,"fee schedule",EAPG,39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",5.97,181.45,
"95250 Ambulatory continuous glucose monitoring of",7961656,CDM,521,RC,95250,CPT,OUTPATIENT,,,510,331.5,,448.8,88,,359.04,,,0,"percent of total billed charges","88% of total billed charges",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.52,100,,,,,0,"fee schedule",EAPG,510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",235.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",63.37,100,,,,,0,"fee schedule",EAPG,134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",321.3,63,,257.04,,,0,"percent of total billed charges","63% of total billed charges",78.03,15.3,,62.42,,,0,"percent of total billed charges","15.3% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,351.9,69,,,,,0,"fee schedule","69% of total billed charges",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",134.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",482.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.52,100,,,,,0,"fee schedule",EAPG,134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",126.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",62.75,100,,,,,0,"fee schedule",EAPG,79.98,100,,,,,0,"fee schedule",EAPG,134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",192.27,37.7,,153.82,,,0,"percent of total billed charges","37.70% of total billed charges",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397.8,78,,318.24,,,0,"percent of total billed charges","78% of total billed charges",136.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",421.26,82.6,,337.01,,,0,"percent of total billed charges","82.6% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",421.26,82.6,,337.01,,,0,"percent of total billed charges","82.6% of total billed charges",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",222.05,100,,,,,0,"fee schedule",EAPG,510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",61.52,510,
"95251 Ambulatory continuous glucose monitoring for",7961795,CDM,521,RC,95251,CPT,OUTPATIENT,,,77,50.05,,67.76,88,,54.21,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.52,100,,,,,0,"fee schedule",EAPG,77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.37,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",48.51,63,,38.81,,,0,"percent of total billed charges","63% of total billed charges",11.78,15.3,,9.42,,,0,"percent of total billed charges","15.3% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,53.13,69,,,,,0,"fee schedule","69% of total billed charges",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",61.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",62.75,100,,,,,0,"fee schedule",EAPG,79.98,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.03,37.7,,23.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",60.06,78,,48.05,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.6,82.6,,50.88,,,0,"percent of total billed charges","82.6% of total billed charges",61.52,100,,,,,0,"fee schedule","100% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",63.6,82.6,,50.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",222.05,100,,,,,0,"fee schedule",EAPG,77,100,,61.60,,,0,"percent of total billed charges","100% of total billed charges",11.78,222.05,
"95782 polysom <6yrs 4/>parameters",7963799,CDM,521,RC,95782,CPT,OUTPATIENT,,,226,146.9,,198.88,88,,159.10,,,0,"percent of total billed charges","88% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.53,100,,,,,0,"fee schedule",EAPG,226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",1866.21,175,,,,,0,"fee schedule","175% of CMS fee schedule",707.12,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",142.38,63,,113.90,,,0,"percent of total billed charges","63% of total billed charges",34.58,15.3,,27.66,,,0,"percent of total billed charges","15.3% of total billed charges",686.53,100,,,,,0,"fee schedule",EAPG,155.94,69,,,,,0,"fee schedule","69% of total billed charges",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",3736.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.53,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",976.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",700.26,100,,,,,0,"fee schedule",EAPG,892.49,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",85.2,37.7,,68.16,,,0,"percent of total billed charges","37.70% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",176.28,78,,141.02,,,0,"percent of total billed charges","78% of total billed charges",1077.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",186.68,82.6,,149.34,,,0,"percent of total billed charges","82.6% of total billed charges",686.53,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",186.68,82.6,,149.34,,,0,"percent of total billed charges","82.6% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",847.06,100,,,,,0,"fee schedule",EAPG,226,100,,180.80,,,0,"percent of total billed charges","100% of total billed charges",34.58,3736.79,
"95783 polysom <6yrs cpap/bilvl",7963855,CDM,521,RC,95783,CPT,OUTPATIENT,,,275,178.75,,242,88,,193.60,,,0,"percent of total billed charges","88% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.53,100,,,,,0,"fee schedule",EAPG,275,100,,220.00,,,0,"percent of total billed charges","100% of total billed charges",1866.21,175,,,,,0,"fee schedule","175% of CMS fee schedule",707.12,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.25,63,,138.60,,,0,"percent of total billed charges","63% of total billed charges",42.08,15.3,,33.66,,,0,"percent of total billed charges","15.3% of total billed charges",686.53,100,,,,,0,"fee schedule",EAPG,189.75,69,,,,,0,"fee schedule","69% of total billed charges",275,100,,220.00,,,0,"percent of total billed charges","100% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",275,100,,220.00,,,0,"percent of total billed charges","100% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",275,100,,220.00,,,0,"percent of total billed charges","100% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",3736.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.53,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",976.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",700.26,100,,,,,0,"fee schedule",EAPG,892.49,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",103.68,37.7,,82.94,,,0,"percent of total billed charges","37.70% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",214.5,78,,171.60,,,0,"percent of total billed charges","78% of total billed charges",1077.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",227.15,82.6,,181.72,,,0,"percent of total billed charges","82.6% of total billed charges",686.53,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",227.15,82.6,,181.72,,,0,"percent of total billed charges","82.6% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",847.06,100,,,,,0,"fee schedule",EAPG,275,100,,220.00,,,0,"percent of total billed charges","100% of total billed charges",42.08,3736.79,
"95805 Multiple sleep latency or maintenance of wak",7961895,CDM,521,RC,95805,CPT,OUTPATIENT,,,116,75.4,,102.08,88,,81.66,,,0,"percent of total billed charges","88% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.53,100,,,,,0,"fee schedule",EAPG,116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",956.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",707.12,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.08,63,,58.46,,,0,"percent of total billed charges","63% of total billed charges",17.75,15.3,,14.20,,,0,"percent of total billed charges","15.3% of total billed charges",686.53,100,,,,,0,"fee schedule",EAPG,80.04,69,,,,,0,"fee schedule","69% of total billed charges",116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1981.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.53,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",518.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",700.26,100,,,,,0,"fee schedule",EAPG,892.49,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",43.73,37.7,,34.98,,,0,"percent of total billed charges","37.70% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",90.48,78,,72.38,,,0,"percent of total billed charges","78% of total billed charges",552.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",95.82,82.6,,76.66,,,0,"percent of total billed charges","82.6% of total billed charges",686.53,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",95.82,82.6,,76.66,,,0,"percent of total billed charges","82.6% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",847.06,100,,,,,0,"fee schedule",EAPG,116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",17.75,1981.61,
"95806 Sleep study, unattended, simultaneous record",7962460,CDM,521,RC,95806,CPT,OUTPATIENT,,,116,75.4,,102.08,88,,81.66,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",127.33,100,,,,,0,"fee schedule",EAPG,116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",131.15,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",73.08,63,,58.46,,,0,"percent of total billed charges","63% of total billed charges",17.75,15.3,,14.20,,,0,"percent of total billed charges","15.3% of total billed charges",127.33,100,,,,,0,"fee schedule",EAPG,80.04,69,,,,,0,"fee schedule","69% of total billed charges",116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",127.33,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",129.88,100,,,,,0,"fee schedule",EAPG,165.54,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",43.73,37.7,,34.98,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",90.48,78,,72.38,,,0,"percent of total billed charges","78% of total billed charges",160.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",95.82,82.6,,76.66,,,0,"percent of total billed charges","82.6% of total billed charges",127.33,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",95.82,82.6,,76.66,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287.86,100,,,,,0,"fee schedule",EAPG,116,100,,92.80,,,0,"percent of total billed charges","100% of total billed charges",17.75,566.91,
"95803 actigraphy testing",7963911,CDM,521,RC,95803,CPT,OUTPATIENT,,,84,54.6,,73.92,88,,59.14,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.52,100,,,,,0,"fee schedule",EAPG,84,100,,67.20,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",63.37,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.92,63,,42.34,,,0,"percent of total billed charges","63% of total billed charges",12.85,15.3,,10.28,,,0,"percent of total billed charges","15.3% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,57.96,69,,,,,0,"fee schedule","69% of total billed charges",84,100,,67.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",84,100,,67.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",84,100,,67.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",61.52,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",62.75,100,,,,,0,"fee schedule",EAPG,79.98,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",31.67,37.7,,25.34,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.52,78,,52.42,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",69.38,82.6,,55.50,,,0,"percent of total billed charges","82.6% of total billed charges",61.52,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",69.38,82.6,,55.50,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",222.05,100,,,,,0,"fee schedule",EAPG,84,100,,67.20,,,0,"percent of total billed charges","100% of total billed charges",12.85,226.12,
"95811 Polysomnography; 6 yrs or older, w/ C-Pap th",7961847,CDM,521,RC,95811,CPT,OUTPATIENT,,,244,158.6,,214.72,88,,171.78,,,0,"percent of total billed charges","88% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.53,100,,,,,0,"fee schedule",EAPG,244,100,,195.20,,,0,"percent of total billed charges","100% of total billed charges",1866.21,175,,,,,0,"fee schedule","175% of CMS fee schedule",707.12,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",153.72,63,,122.98,,,0,"percent of total billed charges","63% of total billed charges",37.33,15.3,,29.86,,,0,"percent of total billed charges","15.3% of total billed charges",686.53,100,,,,,0,"fee schedule",EAPG,168.36,69,,,,,0,"fee schedule","69% of total billed charges",244,100,,195.20,,,0,"percent of total billed charges","100% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244,100,,195.20,,,0,"percent of total billed charges","100% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",244,100,,195.20,,,0,"percent of total billed charges","100% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",3736.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.53,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",976.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",700.26,100,,,,,0,"fee schedule",EAPG,892.49,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",91.99,37.7,,73.59,,,0,"percent of total billed charges","37.70% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.32,78,,152.26,,,0,"percent of total billed charges","78% of total billed charges",1077.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",201.54,82.6,,161.23,,,0,"percent of total billed charges","82.6% of total billed charges",686.53,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",201.54,82.6,,161.23,,,0,"percent of total billed charges","82.6% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",847.06,100,,,,,0,"fee schedule",EAPG,244,100,,195.20,,,0,"percent of total billed charges","100% of total billed charges",37.33,3736.79,
"95813 Electroencephalogram (EEG) extended monitori",7962917,CDM,521,RC,95813,CPT,OUTPATIENT,,,253,164.45,,222.64,88,,178.11,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",456.39,100,,,,,0,"fee schedule",EAPG,253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",470.08,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",38.71,15.3,,30.97,,,0,"percent of total billed charges","15.3% of total billed charges",456.39,100,,,,,0,"fee schedule",EAPG,174.57,69,,,,,0,"fee schedule","69% of total billed charges",253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",456.39,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465.52,100,,,,,0,"fee schedule",EAPG,593.31,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",95.38,37.7,,76.30,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",197.34,78,,157.87,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",208.98,82.6,,167.18,,,0,"percent of total billed charges","82.6% of total billed charges",456.39,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",208.98,82.6,,167.18,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.92,100,,,,,0,"fee schedule",EAPG,253,100,,202.40,,,0,"percent of total billed charges","100% of total billed charges",38.71,1074.33,
"95810 Polysomnography; age 6 years or older, atten",7962982,CDM,521,RC,95810,CPT,OUTPATIENT,,,234,152.1,,205.92,88,,164.74,,,0,"percent of total billed charges","88% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.53,100,,,,,0,"fee schedule",EAPG,234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",1866.21,175,,,,,0,"fee schedule","175% of CMS fee schedule",707.12,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",147.42,63,,117.94,,,0,"percent of total billed charges","63% of total billed charges",35.8,15.3,,28.64,,,0,"percent of total billed charges","15.3% of total billed charges",686.53,100,,,,,0,"fee schedule",EAPG,161.46,69,,,,,0,"fee schedule","69% of total billed charges",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",3736.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",686.53,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",976.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",700.26,100,,,,,0,"fee schedule",EAPG,892.49,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",88.22,37.7,,70.58,,,0,"percent of total billed charges","37.70% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",182.52,78,,146.02,,,0,"percent of total billed charges","78% of total billed charges",1077.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",193.28,82.6,,154.62,,,0,"percent of total billed charges","82.6% of total billed charges",686.53,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",193.28,82.6,,154.62,,,0,"percent of total billed charges","82.6% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",847.06,100,,,,,0,"fee schedule",EAPG,234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",35.8,3736.79,
"95816 Electroencephalogram (EEG); including record",7963009,CDM,521,RC,95816,CPT,OUTPATIENT,,,995,646.75,,875.6,88,,700.48,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287.75,100,,,,,0,"fee schedule",EAPG,995,100,,796.00,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",296.39,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",626.85,63,,501.48,,,0,"percent of total billed charges","63% of total billed charges",152.24,15.3,,121.79,,,0,"percent of total billed charges","15.3% of total billed charges",287.75,100,,,,,0,"fee schedule",EAPG,686.55,69,,,,,0,"fee schedule","69% of total billed charges",995,100,,796.00,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",995,100,,796.00,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",995,100,,796.00,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287.75,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",293.51,100,,,,,0,"fee schedule",EAPG,374.08,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",375.12,37.7,,300.10,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",776.1,78,,620.88,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",821.87,82.6,,657.50,,,0,"percent of total billed charges","82.6% of total billed charges",287.75,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",821.87,82.6,,657.50,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",448.28,100,,,,,0,"fee schedule",EAPG,995,100,,796.00,,,0,"percent of total billed charges","100% of total billed charges",152.24,1074.33,
"95819 Electroencephalogram (EEG); including record",7963010,CDM,521,RC,95819,CPT,OUTPATIENT,,,158,102.7,,139.04,88,,111.23,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287.75,100,,,,,0,"fee schedule",EAPG,158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",296.39,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.54,63,,79.63,,,0,"percent of total billed charges","63% of total billed charges",24.17,15.3,,19.34,,,0,"percent of total billed charges","15.3% of total billed charges",287.75,100,,,,,0,"fee schedule",EAPG,109.02,69,,,,,0,"fee schedule","69% of total billed charges",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287.75,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",293.51,100,,,,,0,"fee schedule",EAPG,374.08,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",59.57,37.7,,47.66,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.24,78,,98.59,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",130.51,82.6,,104.41,,,0,"percent of total billed charges","82.6% of total billed charges",287.75,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",130.51,82.6,,104.41,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",448.28,100,,,,,0,"fee schedule",EAPG,158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",24.17,1074.33,
"95812 Electroencephalogram (EEG) extended monitori",7963088,CDM,521,RC,95812,CPT,OUTPATIENT,,,158,102.7,,139.04,88,,111.23,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",456.39,100,,,,,0,"fee schedule",EAPG,158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",470.08,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",24.17,15.3,,19.34,,,0,"percent of total billed charges","15.3% of total billed charges",456.39,100,,,,,0,"fee schedule",EAPG,109.02,69,,,,,0,"fee schedule","69% of total billed charges",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",456.39,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465.52,100,,,,,0,"fee schedule",EAPG,593.31,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",59.57,37.7,,47.66,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.24,78,,98.59,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",130.51,82.6,,104.41,,,0,"percent of total billed charges","82.6% of total billed charges",456.39,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",130.51,82.6,,104.41,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",616.92,100,,,,,0,"fee schedule",EAPG,158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",24.17,1074.33,
"95822 Electroencephalogram (EEG); recording in com",7963159,CDM,521,RC,95822,CPT,OUTPATIENT,,,158,102.7,,139.04,88,,111.23,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287.75,100,,,,,0,"fee schedule",EAPG,158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",296.39,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",24.17,15.3,,19.34,,,0,"percent of total billed charges","15.3% of total billed charges",287.75,100,,,,,0,"fee schedule",EAPG,109.02,69,,,,,0,"fee schedule","69% of total billed charges",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287.75,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",293.51,100,,,,,0,"fee schedule",EAPG,374.08,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",59.57,37.7,,47.66,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.24,78,,98.59,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",130.51,82.6,,104.41,,,0,"percent of total billed charges","82.6% of total billed charges",287.75,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",130.51,82.6,,104.41,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",448.28,100,,,,,0,"fee schedule",EAPG,158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",24.17,1074.33,
"95857 Cholinesterase inhibitor challenge test for",7963089,CDM,521,RC,95857,CPT,OUTPATIENT,,,148,96.2,,130.24,88,,104.19,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,148,100,,118.40,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",126.58,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",93.24,63,,74.59,,,0,"percent of total billed charges","63% of total billed charges",22.64,15.3,,18.11,,,0,"percent of total billed charges","15.3% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,102.12,69,,,,,0,"fee schedule","69% of total billed charges",148,100,,118.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148,100,,118.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148,100,,118.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.35,100,,,,,0,"fee schedule",EAPG,159.77,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",55.8,37.7,,44.64,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.44,78,,92.35,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.25,82.6,,97.80,,,0,"percent of total billed charges","82.6% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.25,82.6,,97.80,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.43,100,,,,,0,"fee schedule",EAPG,148,100,,118.40,,,0,"percent of total billed charges","100% of total billed charges",22.64,1074.33,
"95851 Range of Motion Measurements",7963783,CDM,521,RC,95851,CPT,OUTPATIENT,,,32,20.8,,28.16,88,,22.53,,,0,"percent of total billed charges","88% of total billed charges",7.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",13.2,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.54,17.304,,4.43,,,0,"percent of total billed charges","17.304% of total billed charges",7.7,100,,,,,0,"fee schedule","100% of CMS fee sv",20.16,63,,16.13,,,0,"percent of total billed charges","63% of total billed charges",4.9,15.3,,3.92,,,0,"percent of total billed charges","15.3% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",22.08,69,,,,,0,"fee schedule","69% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",7.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",7.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",7.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.11,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",7.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.59,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",7.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.48,17.136,,4.38,,,0,"percent of total billed charges","17.136% of total billed charges",6.99,21.84,,5.59,,,0,"percent of total billed charges","21.84% of total billed charges",7.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.70% of total billed charges",7.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",7.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.96,78,,19.97,,,0,"percent of total billed charges","78% of total billed charges",7.78,101,,,,,0,"fee schedule","101% of CMS fee schedule ",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",7.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",7.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.53,100,,,,,0,"case rate","pays based on per visit rate",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",4.9,160.53,
"95861 Needle electromyography; 2 extremities with",7962512,CDM,521,RC,95861,CPT,OUTPATIENT,,,411,267.15,,361.68,88,,289.34,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,411,100,,328.80,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",126.58,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.88,15.3,,50.30,,,0,"percent of total billed charges","15.3% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,283.59,69,,,,,0,"fee schedule","69% of total billed charges",411,100,,328.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",411,100,,328.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",411,100,,328.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.35,100,,,,,0,"fee schedule",EAPG,159.77,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",154.95,37.7,,123.96,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320.58,78,,256.46,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",339.49,82.6,,271.59,,,0,"percent of total billed charges","82.6% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",339.49,82.6,,271.59,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.43,100,,,,,0,"fee schedule",EAPG,411,100,,328.80,,,0,"percent of total billed charges","100% of total billed charges",62.88,454.8,
"95863 Needle electromyography; 3 extremities with",7962513,CDM,521,RC,95863,CPT,OUTPATIENT,,,496,322.4,,436.48,88,,349.18,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,496,100,,396.80,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",126.58,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",75.89,15.3,,60.71,,,0,"percent of total billed charges","15.3% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,342.24,69,,,,,0,"fee schedule","69% of total billed charges",496,100,,396.80,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",496,100,,396.80,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",496,100,,396.80,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.35,100,,,,,0,"fee schedule",EAPG,159.77,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",186.99,37.7,,149.59,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",386.88,78,,309.50,,,0,"percent of total billed charges","78% of total billed charges",160.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.7,82.6,,327.76,,,0,"percent of total billed charges","82.6% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.7,82.6,,327.76,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.43,100,,,,,0,"fee schedule",EAPG,496,100,,396.80,,,0,"percent of total billed charges","100% of total billed charges",75.89,566.91,
"95864 Needle electromyography; 4 extremities with",7962514,CDM,521,RC,95864,CPT,OUTPATIENT,,,538,349.7,,473.44,88,,378.75,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,538,100,,430.40,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",126.58,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",82.31,15.3,,65.85,,,0,"percent of total billed charges","15.3% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,371.22,69,,,,,0,"fee schedule","69% of total billed charges",538,100,,430.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",538,100,,430.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",538,100,,430.40,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.35,100,,,,,0,"fee schedule",EAPG,159.77,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",202.83,37.7,,162.26,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",419.64,78,,335.71,,,0,"percent of total billed charges","78% of total billed charges",160.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",444.39,82.6,,355.51,,,0,"percent of total billed charges","82.6% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",444.39,82.6,,355.51,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.43,100,,,,,0,"fee schedule",EAPG,538,100,,430.40,,,0,"percent of total billed charges","100% of total billed charges",82.31,566.91,
"95860 Needle electromyography; 1 extremity with or",7962577,CDM,521,RC,95860,CPT,OUTPATIENT,,,283,183.95,,249.04,88,,199.23,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,283,100,,226.40,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",126.58,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",43.3,15.3,,34.64,,,0,"percent of total billed charges","15.3% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,195.27,69,,,,,0,"fee schedule","69% of total billed charges",283,100,,226.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283,100,,226.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283,100,,226.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.35,100,,,,,0,"fee schedule",EAPG,159.77,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",106.69,37.7,,85.35,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",220.74,78,,176.59,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",233.76,82.6,,187.01,,,0,"percent of total billed charges","82.6% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",233.76,82.6,,187.01,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.43,100,,,,,0,"fee schedule",EAPG,283,100,,226.40,,,0,"percent of total billed charges","100% of total billed charges",43.3,454.8,
"95869 Needle electromyography; thoracic paraspinal",7962693,CDM,521,RC,95869,CPT,OUTPATIENT,,,202,131.3,,177.76,88,,142.21,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",560.25,175,,,,,0,"fee schedule","175% of CMS fee schedule",126.58,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",30.91,15.3,,24.73,,,0,"percent of total billed charges","15.3% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,139.38,69,,,,,0,"fee schedule","69% of total billed charges",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.35,100,,,,,0,"fee schedule",EAPG,159.77,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",76.15,37.7,,60.92,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",157.56,78,,126.05,,,0,"percent of total billed charges","78% of total billed charges",323.34,100,,,,,0,"fee schedule","100% of CMS OPPS rate",166.85,82.6,,133.48,,,0,"percent of total billed charges","82.6% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",166.85,82.6,,133.48,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.43,100,,,,,0,"fee schedule",EAPG,202,100,,161.60,,,0,"percent of total billed charges","100% of total billed charges",30.91,566.92,
"95867 Needle electromyography; cranial nerve suppl",7962861,CDM,521,RC,95867,CPT,OUTPATIENT,,,270,175.5,,237.6,88,,190.08,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",126.58,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",41.31,15.3,,33.05,,,0,"percent of total billed charges","15.3% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,186.3,69,,,,,0,"fee schedule","69% of total billed charges",270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.35,100,,,,,0,"fee schedule",EAPG,159.77,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",101.79,37.7,,81.43,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",210.6,78,,168.48,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",223.02,82.6,,178.42,,,0,"percent of total billed charges","82.6% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",223.02,82.6,,178.42,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.43,100,,,,,0,"fee schedule",EAPG,270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",41.31,1074.33,
"95868 Needle electromyography; cranial nerve suppl",7962946,CDM,521,RC,95868,CPT,OUTPATIENT,,,362,235.3,,318.56,88,,254.85,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,362,100,,289.60,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",126.58,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",55.39,15.3,,44.31,,,0,"percent of total billed charges","15.3% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,249.78,69,,,,,0,"fee schedule","69% of total billed charges",362,100,,289.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",362,100,,289.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",362,100,,289.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.35,100,,,,,0,"fee schedule",EAPG,159.77,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",136.47,37.7,,109.18,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",282.36,78,,225.89,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",299.01,82.6,,239.21,,,0,"percent of total billed charges","82.6% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",299.01,82.6,,239.21,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.43,100,,,,,0,"fee schedule",EAPG,362,100,,289.60,,,0,"percent of total billed charges","100% of total billed charges",55.39,1074.33,
"95874 Needle electromyography for guidance in conj",7962727,CDM,521,RC,95874,CPT,OUTPATIENT,,,186,120.9,,163.68,88,,130.94,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",392.21,100,,,,,0,"fee schedule",EAPG,186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.97,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.46,15.3,,22.77,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,128.34,69,,,,,0,"fee schedule","69% of total billed charges",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",392.21,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",70.12,37.7,,56.10,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",145.08,78,,116.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",153.64,82.6,,122.91,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",153.64,82.6,,122.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",552.74,100,,,,,0,"fee schedule",EAPG,186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",28.46,552.74,
"95873 Electrical stimulation for guidance in conju",7962793,CDM,521,RC,95873,CPT,OUTPATIENT,,,198,128.7,,174.24,88,,139.39,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",392.21,100,,,,,0,"fee schedule",EAPG,198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.97,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",124.74,63,,99.79,,,0,"percent of total billed charges","63% of total billed charges",30.29,15.3,,24.23,,,0,"percent of total billed charges","15.3% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,136.62,69,,,,,0,"fee schedule","69% of total billed charges",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",392.21,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",400.05,100,,,,,0,"fee schedule",EAPG,509.87,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",74.65,37.7,,59.72,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",154.44,78,,123.55,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",163.55,82.6,,130.84,,,0,"percent of total billed charges","82.6% of total billed charges",392.21,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",163.55,82.6,,130.84,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",552.74,100,,,,,0,"fee schedule",EAPG,198,100,,158.40,,,0,"percent of total billed charges","100% of total billed charges",30.29,552.74,
"95870 Needle electromyography; limited study",7963633,CDM,521,RC,95870,CPT,OUTPATIENT,,,193,125.45,,169.84,88,,135.87,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",126.58,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",29.53,15.3,,23.62,,,0,"percent of total billed charges","15.3% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,133.17,69,,,,,0,"fee schedule","69% of total billed charges",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.35,100,,,,,0,"fee schedule",EAPG,159.77,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",72.76,37.7,,58.21,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",150.54,78,,120.43,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",159.42,82.6,,127.54,,,0,"percent of total billed charges","82.6% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",159.42,82.6,,127.54,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.43,100,,,,,0,"fee schedule",EAPG,193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",29.53,454.8,
"95886 Needle electromyography, each extremity; com",7962789,CDM,521,RC,95886,CPT,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",122.9,100,,,,,0,"fee schedule",EAPG,258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.58,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",122.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",125.35,100,,,,,0,"fee schedule",EAPG,159.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",283.43,100,,,,,0,"fee schedule",EAPG,258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,283.43,
"95885 Needle electromyography, each extremity; lim",7963436,CDM,521,RC,95885,CPT,OUTPATIENT,,,165,107.25,,145.2,88,,116.16,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",122.9,100,,,,,0,"fee schedule",EAPG,165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.58,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25.25,15.3,,20.20,,,0,"percent of total billed charges","15.3% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,113.85,69,,,,,0,"fee schedule","69% of total billed charges",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",122.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",125.35,100,,,,,0,"fee schedule",EAPG,159.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",62.21,37.7,,49.77,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",128.7,78,,102.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.29,82.6,,109.03,,,0,"percent of total billed charges","82.6% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",136.29,82.6,,109.03,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",283.43,100,,,,,0,"fee schedule",EAPG,165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",25.25,283.43,
"95887 Needle electromyography, non-extremity",7963634,CDM,521,RC,95887,CPT,OUTPATIENT,,,231,150.15,,203.28,88,,162.62,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",122.9,100,,,,,0,"fee schedule",EAPG,231,100,,184.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.58,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.34,15.3,,28.27,,,0,"percent of total billed charges","15.3% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,159.39,69,,,,,0,"fee schedule","69% of total billed charges",231,100,,184.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231,100,,184.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",231,100,,184.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",122.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",125.35,100,,,,,0,"fee schedule",EAPG,159.77,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",87.09,37.7,,69.67,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",180.18,78,,144.14,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",190.81,82.6,,152.65,,,0,"percent of total billed charges","82.6% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",190.81,82.6,,152.65,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",283.43,100,,,,,0,"fee schedule",EAPG,231,100,,184.80,,,0,"percent of total billed charges","100% of total billed charges",35.34,283.43,
"95907 Nerve conduction 1-2 studies",7901095,CDM,521,RC,95907,CPT,OUTPATIENT,,,279,181.35,,245.52,88,,196.42,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",126.58,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",42.69,15.3,,34.15,,,0,"percent of total billed charges","15.3% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,192.51,69,,,,,0,"fee schedule","69% of total billed charges",279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.35,100,,,,,0,"fee schedule",EAPG,159.77,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",105.18,37.7,,84.14,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",217.62,78,,174.10,,,0,"percent of total billed charges","78% of total billed charges",160.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",230.45,82.6,,184.36,,,0,"percent of total billed charges","82.6% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",230.45,82.6,,184.36,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.43,100,,,,,0,"fee schedule",EAPG,279,100,,223.20,,,0,"percent of total billed charges","100% of total billed charges",42.69,566.91,
"95908 Nerve conduction 3-4 studies",7901096,CDM,521,RC,95908,CPT,OUTPATIENT,,,344,223.6,,302.72,88,,242.18,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",126.58,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",52.63,15.3,,42.10,,,0,"percent of total billed charges","15.3% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,237.36,69,,,,,0,"fee schedule","69% of total billed charges",344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.35,100,,,,,0,"fee schedule",EAPG,159.77,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",129.69,37.7,,103.75,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",268.32,78,,214.66,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.14,82.6,,227.31,,,0,"percent of total billed charges","82.6% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.14,82.6,,227.31,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.43,100,,,,,0,"fee schedule",EAPG,344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",52.63,1074.33,
"95909 Nerve conduction 5-6 studies",7901097,CDM,521,RC,95909,CPT,OUTPATIENT,,,411,267.15,,361.68,88,,289.34,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,411,100,,328.80,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",126.58,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.88,15.3,,50.30,,,0,"percent of total billed charges","15.3% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,283.59,69,,,,,0,"fee schedule","69% of total billed charges",411,100,,328.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",411,100,,328.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",411,100,,328.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.35,100,,,,,0,"fee schedule",EAPG,159.77,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",154.95,37.7,,123.96,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",320.58,78,,256.46,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",339.49,82.6,,271.59,,,0,"percent of total billed charges","82.6% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",339.49,82.6,,271.59,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.43,100,,,,,0,"fee schedule",EAPG,411,100,,328.80,,,0,"percent of total billed charges","100% of total billed charges",62.88,1074.33,
"95900 motor nerve conduction test",7963787,CDM,521,RC,95900,CPT,OUTPATIENT,,,190,123.5,,167.2,88,,133.76,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.92,16.8,,25.54,,,0,"percent of total billed charges","16.8% of total billed charges",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.88,17.304,,26.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",119.7,63,,95.76,,,0,"percent of total billed charges","63% of total billed charges",29.07,15.3,,23.26,,,0,"percent of total billed charges","15.3% of total billed charges",31.92,16.8,,25.54,,,0,"percent of total billed charges","16.8% of total billed charges",131.1,69,,,,,0,"fee schedule","69% of total billed charges",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",31.92,16.8,,25.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",32.56,17.136,,26.05,,,0,"percent of total billed charges","17.136% of total billed charges",41.5,21.84,,33.20,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",71.63,37.7,,57.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",148.2,78,,118.56,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.94,82.6,,125.55,,,0,"percent of total billed charges","82.6% of total billed charges",31.92,16.8,,25.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",156.94,82.6,,125.55,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",190,100,,152.00,,,0,"percent of total billed charges","100% of total billed charges",29.07,190,
"95910 Nerve conduction 7-8 studies",7901098,CDM,521,RC,95910,CPT,OUTPATIENT,,,541,351.65,,476.08,88,,380.86,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,541,100,,432.80,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",126.58,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",82.77,15.3,,66.22,,,0,"percent of total billed charges","15.3% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,373.29,69,,,,,0,"fee schedule","69% of total billed charges",541,100,,432.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",541,100,,432.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",541,100,,432.80,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.35,100,,,,,0,"fee schedule",EAPG,159.77,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",203.96,37.7,,163.17,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",421.98,78,,337.58,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",446.87,82.6,,357.50,,,0,"percent of total billed charges","82.6% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",446.87,82.6,,357.50,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.43,100,,,,,0,"fee schedule",EAPG,541,100,,432.80,,,0,"percent of total billed charges","100% of total billed charges",82.77,1074.33,
"95911 Nerve conduction 9-10 studies",7901099,CDM,521,RC,95911,CPT,OUTPATIENT,,,655,425.75,,576.4,88,,461.12,,,0,"percent of total billed charges","88% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,655,100,,524.00,,,0,"percent of total billed charges","100% of total billed charges",956.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",126.58,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",100.22,15.3,,80.18,,,0,"percent of total billed charges","15.3% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,451.95,69,,,,,0,"fee schedule","69% of total billed charges",655,100,,524.00,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",655,100,,524.00,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",655,100,,524.00,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1981.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",518.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.35,100,,,,,0,"fee schedule",EAPG,159.77,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",246.94,37.7,,197.55,,,0,"percent of total billed charges","37.70% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",510.9,78,,408.72,,,0,"percent of total billed charges","78% of total billed charges",552.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",541.03,82.6,,432.82,,,0,"percent of total billed charges","82.6% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",541.03,82.6,,432.82,,,0,"percent of total billed charges","82.6% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.43,100,,,,,0,"fee schedule",EAPG,655,100,,524.00,,,0,"percent of total billed charges","100% of total billed charges",100.22,1981.61,
"95912 Nerve conduction 11-12 studies",7901100,CDM,521,RC,95912,CPT,OUTPATIENT,,,766,497.9,,674.08,88,,539.26,,,0,"percent of total billed charges","88% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,766,100,,612.80,,,0,"percent of total billed charges","100% of total billed charges",956.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",126.58,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",117.2,15.3,,93.76,,,0,"percent of total billed charges","15.3% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,528.54,69,,,,,0,"fee schedule","69% of total billed charges",766,100,,612.80,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",766,100,,612.80,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",766,100,,612.80,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1981.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",518.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.35,100,,,,,0,"fee schedule",EAPG,159.77,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",288.78,37.7,,231.02,,,0,"percent of total billed charges","37.70% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",597.48,78,,477.98,,,0,"percent of total billed charges","78% of total billed charges",552.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",632.72,82.6,,506.18,,,0,"percent of total billed charges","82.6% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",632.72,82.6,,506.18,,,0,"percent of total billed charges","82.6% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.43,100,,,,,0,"fee schedule",EAPG,766,100,,612.80,,,0,"percent of total billed charges","100% of total billed charges",117.2,1981.61,
"95913 Nerve conduction > 13 studies",7901101,CDM,521,RC,95913,CPT,OUTPATIENT,,,888,577.2,,781.44,88,,625.15,,,0,"percent of total billed charges","88% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,888,100,,710.40,,,0,"percent of total billed charges","100% of total billed charges",956.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",126.58,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",135.86,15.3,,108.69,,,0,"percent of total billed charges","15.3% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,612.72,69,,,,,0,"fee schedule","69% of total billed charges",888,100,,710.40,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",888,100,,710.40,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",888,100,,710.40,,,0,"percent of total billed charges","100% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS fee schedule",1981.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",518.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.35,100,,,,,0,"fee schedule",EAPG,159.77,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",334.78,37.7,,267.82,,,0,"percent of total billed charges","37.70% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",692.64,78,,554.11,,,0,"percent of total billed charges","78% of total billed charges",552.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",733.49,82.6,,586.79,,,0,"percent of total billed charges","82.6% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",733.49,82.6,,586.79,,,0,"percent of total billed charges","82.6% of total billed charges",546.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.43,100,,,,,0,"fee schedule",EAPG,888,100,,710.40,,,0,"percent of total billed charges","100% of total billed charges",122.9,1981.61,
"95927 Short-latency somatosensory evoked potential",7962757,CDM,521,RC,95927,CPT,OUTPATIENT,,,483,313.95,,425.04,88,,340.03,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,483,100,,386.40,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",126.58,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",73.9,15.3,,59.12,,,0,"percent of total billed charges","15.3% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,333.27,69,,,,,0,"fee schedule","69% of total billed charges",483,100,,386.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",483,100,,386.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",483,100,,386.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.35,100,,,,,0,"fee schedule",EAPG,159.77,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",182.09,37.7,,145.67,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",376.74,78,,301.39,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",398.96,82.6,,319.17,,,0,"percent of total billed charges","82.6% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",398.96,82.6,,319.17,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.43,100,,,,,0,"fee schedule",EAPG,483,100,,386.40,,,0,"percent of total billed charges","100% of total billed charges",73.9,1074.33,
"95926 Short-latency somatosensory evoked potential",7962947,CDM,521,RC,95926,CPT,OUTPATIENT,,,478,310.7,,420.64,88,,336.51,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",126.58,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",73.13,15.3,,58.50,,,0,"percent of total billed charges","15.3% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,329.82,69,,,,,0,"fee schedule","69% of total billed charges",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.35,100,,,,,0,"fee schedule",EAPG,159.77,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",180.21,37.7,,144.17,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",372.84,78,,298.27,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394.83,82.6,,315.86,,,0,"percent of total billed charges","82.6% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",394.83,82.6,,315.86,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.43,100,,,,,0,"fee schedule",EAPG,478,100,,382.40,,,0,"percent of total billed charges","100% of total billed charges",73.13,1074.33,
"95925 Short-latency somatosensory testing; 1+ nerv",7963473,CDM,521,RC,95925,CPT,OUTPATIENT,,,492,319.8,,432.96,88,,346.37,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",126.58,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",75.28,15.3,,60.22,,,0,"percent of total billed charges","15.3% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,339.48,69,,,,,0,"fee schedule","69% of total billed charges",492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.35,100,,,,,0,"fee schedule",EAPG,159.77,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",185.48,37.7,,148.38,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",383.76,78,,307.01,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",406.39,82.6,,325.11,,,0,"percent of total billed charges","82.6% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",406.39,82.6,,325.11,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.43,100,,,,,0,"fee schedule",EAPG,492,100,,393.60,,,0,"percent of total billed charges","100% of total billed charges",75.28,1074.33,
"95930 Visual evoked potential (VEP) testing centra",7962392,CDM,521,RC,95930,CPT,OUTPATIENT,,,448,291.2,,394.24,88,,315.39,,,0,"percent of total billed charges","88% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,448,100,,358.40,,,0,"percent of total billed charges","100% of total billed charges",560.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",126.58,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",68.54,15.3,,54.83,,,0,"percent of total billed charges","15.3% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,309.12,69,,,,,0,"fee schedule","69% of total billed charges",448,100,,358.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",448,100,,358.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",448,100,,358.40,,,0,"percent of total billed charges","100% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",1074.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",280.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.35,100,,,,,0,"fee schedule",EAPG,159.77,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",168.9,37.7,,135.12,,,0,"percent of total billed charges","37.70% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",349.44,78,,279.55,,,0,"percent of total billed charges","78% of total billed charges",323.33,100,,,,,0,"fee schedule","100% of CMS OPPS rate",370.05,82.6,,296.04,,,0,"percent of total billed charges","82.6% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",370.05,82.6,,296.04,,,0,"percent of total billed charges","82.6% of total billed charges",320.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.43,100,,,,,0,"fee schedule",EAPG,448,100,,358.40,,,0,"percent of total billed charges","100% of total billed charges",68.54,1074.33,
"95933 Orbicularis oculi (blink) reflex, by electro",7963058,CDM,521,RC,95933,CPT,OUTPATIENT,,,239,155.35,,210.32,88,,168.26,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.54,100,,,,,0,"fee schedule",EAPG,239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",67.51,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",36.57,15.3,,29.26,,,0,"percent of total billed charges","15.3% of total billed charges",65.54,100,,,,,0,"fee schedule",EAPG,164.91,69,,,,,0,"fee schedule","69% of total billed charges",239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.54,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",66.85,100,,,,,0,"fee schedule",EAPG,85.21,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",90.1,37.7,,72.08,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",186.42,78,,149.14,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",197.41,82.6,,157.93,,,0,"percent of total billed charges","82.6% of total billed charges",65.54,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",197.41,82.6,,157.93,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",226.07,100,,,,,0,"fee schedule",EAPG,239,100,,191.20,,,0,"percent of total billed charges","100% of total billed charges",36.57,239,
"95937 Neuromuscular junction testing, each nerve,",7963237,CDM,521,RC,95937,CPT,OUTPATIENT,,,205,133.25,,180.4,88,,144.32,,,0,"percent of total billed charges","88% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,205,100,,164.00,,,0,"percent of total billed charges","100% of total billed charges",278.81,175,,,,,0,"fee schedule","175% of CMS fee schedule",126.58,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",31.37,15.3,,25.10,,,0,"percent of total billed charges","15.3% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,141.45,69,,,,,0,"fee schedule","69% of total billed charges",205,100,,164.00,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",205,100,,164.00,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",205,100,,164.00,,,0,"percent of total billed charges","100% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS fee schedule",566.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.9,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",148.21,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",125.35,100,,,,,0,"fee schedule",EAPG,159.77,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",77.29,37.7,,61.83,,,0,"percent of total billed charges","37.70% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",159.9,78,,127.92,,,0,"percent of total billed charges","78% of total billed charges",160.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.33,82.6,,135.46,,,0,"percent of total billed charges","82.6% of total billed charges",122.9,100,,,,,0,"fee schedule",EAPG,159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.33,82.6,,135.46,,,0,"percent of total billed charges","82.6% of total billed charges",159.32,100,,,,,0,"fee schedule","100% of CMS OPPS rate",283.43,100,,,,,0,"fee schedule",EAPG,205,100,,164.00,,,0,"percent of total billed charges","100% of total billed charges",31.37,566.91,
"95934 h-reflex test",7963928,CDM,521,RC,95934,CPT,OUTPATIENT,,,181,117.65,,159.28,88,,127.42,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.41,16.8,,24.33,,,0,"percent of total billed charges","16.8% of total billed charges",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.32,17.304,,25.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.03,63,,91.22,,,0,"percent of total billed charges","63% of total billed charges",27.69,15.3,,22.15,,,0,"percent of total billed charges","15.3% of total billed charges",30.41,16.8,,24.33,,,0,"percent of total billed charges","16.8% of total billed charges",124.89,69,,,,,0,"fee schedule","69% of total billed charges",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.41,16.8,,24.33,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",31.02,17.136,,24.82,,,0,"percent of total billed charges","17.136% of total billed charges",39.53,21.84,,31.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",68.24,37.7,,54.59,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",141.18,78,,112.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",149.51,82.6,,119.61,,,0,"percent of total billed charges","82.6% of total billed charges",30.41,16.8,,24.33,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",149.51,82.6,,119.61,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",181,100,,144.80,,,0,"percent of total billed charges","100% of total billed charges",27.69,181,
"95936 h-reflex test",7963929,CDM,521,RC,95936,CPT,OUTPATIENT,,,146,94.9,,128.48,88,,102.78,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.53,16.8,,19.62,,,0,"percent of total billed charges","16.8% of total billed charges",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.26,17.304,,20.21,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",91.98,63,,73.58,,,0,"percent of total billed charges","63% of total billed charges",22.34,15.3,,17.87,,,0,"percent of total billed charges","15.3% of total billed charges",24.53,16.8,,19.62,,,0,"percent of total billed charges","16.8% of total billed charges",100.74,69,,,,,0,"fee schedule","69% of total billed charges",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.53,16.8,,19.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25.02,17.136,,20.02,,,0,"percent of total billed charges","17.136% of total billed charges",31.89,21.84,,25.51,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",55.04,37.7,,44.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",113.88,78,,91.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",120.6,82.6,,96.48,,,0,"percent of total billed charges","82.6% of total billed charges",24.53,16.8,,19.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",120.6,82.6,,96.48,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",146,100,,116.80,,,0,"percent of total billed charges","100% of total billed charges",22.34,160.53,
"95961 electrode stimulation brain",7963789,CDM,521,RC,95961,CPT,OUTPATIENT,,,441,286.65,,388.08,88,,310.46,,,0,"percent of total billed charges","88% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287.75,100,,,,,0,"fee schedule",EAPG,441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",1866.21,175,,,,,0,"fee schedule","175% of CMS fee schedule",296.39,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.83,63,,222.26,,,0,"percent of total billed charges","63% of total billed charges",67.47,15.3,,53.98,,,0,"percent of total billed charges","15.3% of total billed charges",287.75,100,,,,,0,"fee schedule",EAPG,304.29,69,,,,,0,"fee schedule","69% of total billed charges",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",3736.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",287.75,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",976.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",293.51,100,,,,,0,"fee schedule",EAPG,374.08,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",166.26,37.7,,133.01,,,0,"percent of total billed charges","37.70% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",343.98,78,,275.18,,,0,"percent of total billed charges","78% of total billed charges",1077.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",364.27,82.6,,291.42,,,0,"percent of total billed charges","82.6% of total billed charges",287.75,100,,,,,0,"fee schedule",EAPG,1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",364.27,82.6,,291.42,,,0,"percent of total billed charges","82.6% of total billed charges",1066.4,100,,,,,0,"fee schedule","100% of CMS OPPS rate",448.28,100,,,,,0,"fee schedule",EAPG,441,100,,352.80,,,0,"percent of total billed charges","100% of total billed charges",67.47,3736.79,
"95962 electrode stim brain add-on",7963790,CDM,521,RC,95962,CPT,OUTPATIENT,,,473,307.45,,416.24,88,,332.99,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",287.75,100,,,,,0,"fee schedule",EAPG,473,100,,378.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",296.39,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",297.99,63,,238.39,,,0,"percent of total billed charges","63% of total billed charges",72.37,15.3,,57.90,,,0,"percent of total billed charges","15.3% of total billed charges",287.75,100,,,,,0,"fee schedule",EAPG,326.37,69,,,,,0,"fee schedule","69% of total billed charges",473,100,,378.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",473,100,,378.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",473,100,,378.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",287.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",293.51,100,,,,,0,"fee schedule",EAPG,374.08,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",178.32,37.7,,142.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",368.94,78,,295.15,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",390.7,82.6,,312.56,,,0,"percent of total billed charges","82.6% of total billed charges",287.75,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",390.7,82.6,,312.56,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",448.28,100,,,,,0,"fee schedule",EAPG,473,100,,378.40,,,0,"percent of total billed charges","100% of total billed charges",72.37,473,
"95972 Analysis neurostimulator 1st hour",7903112,CDM,521,RC,95972,CPT,OUTPATIENT,,,317,206.05,,278.96,88,,223.17,,,0,"percent of total billed charges","88% of total billed charges",98.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.02,100,,,,,0,"fee schedule",EAPG,317,100,,253.60,,,0,"percent of total billed charges","100% of total billed charges",172.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",135.99,100,,,,,0,"fee schedule",EAPG,98.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.71,63,,159.77,,,0,"percent of total billed charges","63% of total billed charges",48.5,15.3,,38.80,,,0,"percent of total billed charges","15.3% of total billed charges",132.02,100,,,,,0,"fee schedule",EAPG,218.73,69,,,,,0,"fee schedule","69% of total billed charges",317,100,,253.60,,,0,"percent of total billed charges","100% of total billed charges",98.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",317,100,,253.60,,,0,"percent of total billed charges","100% of total billed charges",98.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",317,100,,253.60,,,0,"percent of total billed charges","100% of total billed charges",98.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",407.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.02,100,,,,,0,"fee schedule",EAPG,98.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",106.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",98.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",134.67,100,,,,,0,"fee schedule",EAPG,171.63,100,,,,,0,"fee schedule",EAPG,98.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",119.51,37.7,,95.61,,,0,"percent of total billed charges","37.70% of total billed charges",98.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",98.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",247.26,78,,197.81,,,0,"percent of total billed charges","78% of total billed charges",99.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",261.84,82.6,,209.47,,,0,"percent of total billed charges","82.6% of total billed charges",132.02,100,,,,,0,"fee schedule",EAPG,98.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",261.84,82.6,,209.47,,,0,"percent of total billed charges","82.6% of total billed charges",98.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",292.55,100,,,,,0,"fee schedule",EAPG,317,100,,253.60,,,0,"percent of total billed charges","100% of total billed charges",48.5,407.5,
"95992 Canalith repositioning",7903113,CDM,521,RC,95992,CPT,OUTPATIENT,,,104,67.6,,91.52,88,,73.22,,,0,"percent of total billed charges","88% of total billed charges",35.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",61.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.83,100,,,,,0,"fee schedule",EAPG,35.63,100,,,,,0,"fee schedule","100% of CMS fee sv",65.52,63,,52.42,,,0,"percent of total billed charges","63% of total billed charges",15.91,15.3,,12.73,,,0,"percent of total billed charges","15.3% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,71.76,69,,,,,0,"fee schedule","69% of total billed charges",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",35.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",35.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",35.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",141.95,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,35.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.15,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",35.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.48,100,,,,,0,"fee schedule",EAPG,45.23,100,,,,,0,"fee schedule",EAPG,35.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",39.21,37.7,,31.37,,,0,"percent of total billed charges","37.70% of total billed charges",35.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",35.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.12,78,,64.90,,,0,"percent of total billed charges","78% of total billed charges",35.99,101,,,,,0,"fee schedule","101% of CMS fee schedule ",85.9,82.6,,68.72,,,0,"percent of total billed charges","82.6% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,35.63,100,,,,,0,"fee schedule","100% of CMS fee schedule",85.9,82.6,,68.72,,,0,"percent of total billed charges","82.6% of total billed charges",35.66,100,,,,,0,"fee schedule","100% of CMS fee schedule",195.32,100,,,,,0,"fee schedule",EAPG,104,100,,83.20,,,0,"percent of total billed charges","100% of total billed charges",15.91,195.32,
"95991 Refilling and maintenance of implantable pum",7962657,CDM,521,RC,95991,CPT,OUTPATIENT,,,344,223.6,,302.72,88,,242.18,,,0,"percent of total billed charges","88% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",528.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.72,63,,173.38,,,0,"percent of total billed charges","63% of total billed charges",52.63,15.3,,42.10,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,237.36,69,,,,,0,"fee schedule","69% of total billed charges",344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS fee schedule",1061,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",277.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",129.69,37.7,,103.75,,,0,"percent of total billed charges","37.70% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",268.32,78,,214.66,,,0,"percent of total billed charges","78% of total billed charges",305.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.14,82.6,,227.31,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",284.14,82.6,,227.31,,,0,"percent of total billed charges","82.6% of total billed charges",302.08,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200.33,100,,,,,0,"fee schedule",EAPG,344,100,,275.20,,,0,"percent of total billed charges","100% of total billed charges",39.8,1061,
"95990 Refilling and maintenance of implantable pum",7963160,CDM,521,RC,95990,CPT,OUTPATIENT,,,254,165.1,,223.52,88,,178.82,,,0,"percent of total billed charges","88% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",604.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.02,63,,128.02,,,0,"percent of total billed charges","63% of total billed charges",38.86,15.3,,31.09,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,175.26,69,,,,,0,"fee schedule","69% of total billed charges",254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",1262.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",95.76,37.7,,76.61,,,0,"percent of total billed charges","37.70% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",198.12,78,,158.50,,,0,"percent of total billed charges","78% of total billed charges",348.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",209.8,82.6,,167.84,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",209.8,82.6,,167.84,,,0,"percent of total billed charges","82.6% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200.33,100,,,,,0,"fee schedule",EAPG,254,100,,203.20,,,0,"percent of total billed charges","100% of total billed charges",38.86,1262.42,
"96110 Developmental screening",7903114,CDM,521,RC,96110,CPT,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",521.69,100,,,,,0,"fee schedule",EAPG,20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",537.34,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",521.69,100,,,,,0,"fee schedule",EAPG,13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",521.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",532.13,100,,,,,0,"fee schedule",EAPG,678.2,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",521.69,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",682.22,100,,,,,0,"fee schedule",EAPG,20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,682.22,
"96360 IV infusion, hydration; initial, 31 minutes",7963316,CDM,521,RC,96360,CPT,OUTPATIENT,,,170,110.5,,149.6,88,,119.68,,,0,"percent of total billed charges","88% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",382.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",281.17,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",26.01,15.3,,20.81,,,0,"percent of total billed charges","15.3% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,117.3,69,,,,,0,"fee schedule","69% of total billed charges",170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",826.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278.44,100,,,,,0,"fee schedule",EAPG,354.88,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",64.09,37.7,,51.27,,,0,"percent of total billed charges","37.70% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.6,78,,106.08,,,0,"percent of total billed charges","78% of total billed charges",220.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",140.42,82.6,,112.34,,,0,"percent of total billed charges","82.6% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",140.42,82.6,,112.34,,,0,"percent of total billed charges","82.6% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",433.51,100,,,,,0,"fee schedule",EAPG,170,100,,136.00,,,0,"percent of total billed charges","100% of total billed charges",26.01,826.71,
"96361 IV infusion, hydration; each additional hour",7963514,CDM,521,RC,96361,CPT,OUTPATIENT,,,45,29.25,,39.6,88,,31.68,,,0,"percent of total billed charges","88% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",84.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",475.9,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",6.89,15.3,,5.51,,,0,"percent of total billed charges","15.3% of total billed charges",462.04,100,,,,,0,"fee schedule",EAPG,31.05,69,,,,,0,"fee schedule","69% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",471.28,100,,,,,0,"fee schedule",EAPG,600.65,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",16.97,37.7,,13.58,,,0,"percent of total billed charges","37.70% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.1,78,,28.08,,,0,"percent of total billed charges","78% of total billed charges",48.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",462.04,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",622.57,100,,,,,0,"fee schedule",EAPG,45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",6.89,622.57,
"96374 Therapeutic, prophylactic, or diagnostic inj",7961657,CDM,521,RC,96374,CPT,OUTPATIENT,,,156,101.4,,137.28,88,,109.82,,,0,"percent of total billed charges","88% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",382.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",23.87,15.3,,19.10,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,107.64,69,,,,,0,"fee schedule","69% of total billed charges",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",826.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",58.81,37.7,,47.05,,,0,"percent of total billed charges","37.70% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",121.68,78,,97.34,,,0,"percent of total billed charges","78% of total billed charges",220.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",128.86,82.6,,103.09,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",128.86,82.6,,103.09,,,0,"percent of total billed charges","82.6% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200.33,100,,,,,0,"fee schedule",EAPG,156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",23.87,826.71,
"96375 Therapeutic, prophylactic, or diagnostic inj",7961848,CDM,521,RC,96375,CPT,OUTPATIENT,,,67,43.55,,58.96,88,,47.17,,,0,"percent of total billed charges","88% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",84.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",10.25,15.3,,8.20,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,46.23,69,,,,,0,"fee schedule","69% of total billed charges",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",25.26,37.7,,20.21,,,0,"percent of total billed charges","37.70% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52.26,78,,41.81,,,0,"percent of total billed charges","78% of total billed charges",48.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",55.34,82.6,,44.27,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",55.34,82.6,,44.27,,,0,"percent of total billed charges","82.6% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200.33,100,,,,,0,"fee schedule",EAPG,67,100,,53.60,,,0,"percent of total billed charges","100% of total billed charges",10.25,200.33,
"96376 Therapeutic, prophylactic, or diagnostic inj",8092745,CDM,521,RC,96376,CPT,OUTPATIENT,,,136,88.4,,119.68,88,,95.74,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.8,100,,,,,0,"fee schedule",EAPG,136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",41,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.81,15.3,,16.65,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,93.84,69,,,,,0,"fee schedule","69% of total billed charges",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39.8,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",51.27,37.7,,41.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",106.08,78,,84.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.34,82.6,,89.87,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",112.34,82.6,,89.87,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",200.33,100,,,,,0,"fee schedule",EAPG,136,100,,108.80,,,0,"percent of total billed charges","100% of total billed charges",20.81,200.33,
"96402 Chemo hormone antineopl SUBQ/IM",7903116,CDM,521,RC,96402,CPT,OUTPATIENT,,,156,101.4,,137.28,88,,109.82,,,0,"percent of total billed charges","88% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",98.28,63,,78.62,,,0,"percent of total billed charges","63% of total billed charges",23.87,15.3,,19.10,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,107.64,69,,,,,0,"fee schedule","69% of total billed charges",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",58.81,37.7,,47.05,,,0,"percent of total billed charges","37.70% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",121.68,78,,97.34,,,0,"percent of total billed charges","78% of total billed charges",72.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",128.86,82.6,,103.09,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",128.86,82.6,,103.09,,,0,"percent of total billed charges","82.6% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200.33,100,,,,,0,"fee schedule",EAPG,156,100,,124.80,,,0,"percent of total billed charges","100% of total billed charges",23.87,251.75,
"96401 Chemotherapy admin, subcutaneous or intramus",7962515,CDM,521,RC,96401,CPT,OUTPATIENT,,,160,104,,140.8,88,,112.64,,,0,"percent of total billed charges","88% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.8,63,,80.64,,,0,"percent of total billed charges","63% of total billed charges",24.48,15.3,,19.58,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,110.4,69,,,,,0,"fee schedule","69% of total billed charges",160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",60.32,37.7,,48.26,,,0,"percent of total billed charges","37.70% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.8,78,,99.84,,,0,"percent of total billed charges","78% of total billed charges",72.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.16,82.6,,105.73,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132.16,82.6,,105.73,,,0,"percent of total billed charges","82.6% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200.33,100,,,,,0,"fee schedule",EAPG,160,100,,128.00,,,0,"percent of total billed charges","100% of total billed charges",24.48,251.75,
"96405 Chemo Adm:Intralesional 1-7 Les",8169535,CDM,521,RC,96405,CPT,OUTPATIENT,,,397,258.05,,349.36,88,,279.49,,,0,"percent of total billed charges","88% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,397,100,,317.60,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.11,63,,200.09,,,0,"percent of total billed charges","63% of total billed charges",60.74,15.3,,48.59,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,273.93,69,,,,,0,"fee schedule","69% of total billed charges",397,100,,317.60,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397,100,,317.60,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397,100,,317.60,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",149.67,37.7,,119.74,,,0,"percent of total billed charges","37.70% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",309.66,78,,247.73,,,0,"percent of total billed charges","78% of total billed charges",72.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327.92,82.6,,262.34,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",327.92,82.6,,262.34,,,0,"percent of total billed charges","82.6% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200.33,100,,,,,0,"fee schedule",EAPG,397,100,,317.60,,,0,"percent of total billed charges","100% of total billed charges",39.8,397,
"96406 Chemo Adm: Intralesional >7 lesions",8169536,CDM,521,RC,96406,CPT,OUTPATIENT,,,564,366.6,,496.32,88,,397.06,,,0,"percent of total billed charges","88% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",382.57,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",355.32,63,,284.26,,,0,"percent of total billed charges","63% of total billed charges",86.29,15.3,,69.03,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,389.16,69,,,,,0,"fee schedule","69% of total billed charges",564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",826.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",212.63,37.7,,170.10,,,0,"percent of total billed charges","37.70% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",439.92,78,,351.94,,,0,"percent of total billed charges","78% of total billed charges",220.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465.86,82.6,,372.69,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",465.86,82.6,,372.69,,,0,"percent of total billed charges","82.6% of total billed charges",218.61,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200.33,100,,,,,0,"fee schedule",EAPG,564,100,,451.20,,,0,"percent of total billed charges","100% of total billed charges",39.8,826.71,
"96409 IV push Technique sgl/init drug",8169537,CDM,521,RC,96409,CPT,OUTPATIENT,,,535,347.75,,470.8,88,,376.64,,,0,"percent of total billed charges","88% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",604.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",337.05,63,,269.64,,,0,"percent of total billed charges","63% of total billed charges",81.86,15.3,,65.49,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,369.15,69,,,,,0,"fee schedule","69% of total billed charges",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",826.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",216.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",201.7,37.7,,161.36,,,0,"percent of total billed charges","37.70% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",417.3,78,,333.84,,,0,"percent of total billed charges","78% of total billed charges",348.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.91,82.6,,353.53,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",441.91,82.6,,353.53,,,0,"percent of total billed charges","82.6% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200.33,100,,,,,0,"fee schedule",EAPG,535,100,,428.00,,,0,"percent of total billed charges","100% of total billed charges",39.8,826.71,
"96411 IV push Technique ea add'd drug",8169538,CDM,521,RC,96411,CPT,OUTPATIENT,,,303,196.95,,266.64,88,,213.31,,,0,"percent of total billed charges","88% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,303,100,,242.40,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.89,63,,152.71,,,0,"percent of total billed charges","63% of total billed charges",46.36,15.3,,37.09,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,209.07,69,,,,,0,"fee schedule","69% of total billed charges",303,100,,242.40,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",303,100,,242.40,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",303,100,,242.40,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",114.23,37.7,,91.38,,,0,"percent of total billed charges","37.70% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",236.34,78,,189.07,,,0,"percent of total billed charges","78% of total billed charges",72.56,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.28,82.6,,200.22,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.28,82.6,,200.22,,,0,"percent of total billed charges","82.6% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200.33,100,,,,,0,"fee schedule",EAPG,303,100,,242.40,,,0,"percent of total billed charges","100% of total billed charges",39.8,303,
"96413 Chemo Adm IV inf 1 hr SGL Init",8169540,CDM,521,RC,96413,CPT,OUTPATIENT,,,653,424.45,,574.64,88,,459.71,,,0,"percent of total billed charges","88% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,653,100,,522.40,,,0,"percent of total billed charges","100% of total billed charges",604.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",281.17,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",411.39,63,,329.11,,,0,"percent of total billed charges","63% of total billed charges",99.91,15.3,,79.93,,,0,"percent of total billed charges","15.3% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,450.57,69,,,,,0,"fee schedule","69% of total billed charges",653,100,,522.40,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",653,100,,522.40,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",653,100,,522.40,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",1262.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278.44,100,,,,,0,"fee schedule",EAPG,354.88,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",246.18,37.7,,196.94,,,0,"percent of total billed charges","37.70% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",509.34,78,,407.47,,,0,"percent of total billed charges","78% of total billed charges",348.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",539.38,82.6,,431.50,,,0,"percent of total billed charges","82.6% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",539.38,82.6,,431.50,,,0,"percent of total billed charges","82.6% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",433.51,100,,,,,0,"fee schedule",EAPG,653,100,,522.40,,,0,"percent of total billed charges","100% of total billed charges",99.91,1262.42,
"96415 Chemo Adm IV inf Ea ADD'l Hr",8169541,CDM,521,RC,96415,CPT,OUTPATIENT,,,137,89.05,,120.56,88,,96.45,,,0,"percent of total billed charges","88% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,137,100,,109.60,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",475.9,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",86.31,63,,69.05,,,0,"percent of total billed charges","63% of total billed charges",20.96,15.3,,16.77,,,0,"percent of total billed charges","15.3% of total billed charges",462.04,100,,,,,0,"fee schedule",EAPG,94.53,69,,,,,0,"fee schedule","69% of total billed charges",137,100,,109.60,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",137,100,,109.60,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",137,100,,109.60,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",471.28,100,,,,,0,"fee schedule",EAPG,600.65,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",51.65,37.7,,41.32,,,0,"percent of total billed charges","37.70% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",106.86,78,,85.49,,,0,"percent of total billed charges","78% of total billed charges",72.56,100,,,,,0,"fee schedule","100% of CMS OPPS rate",113.16,82.6,,90.53,,,0,"percent of total billed charges","82.6% of total billed charges",462.04,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",113.16,82.6,,90.53,,,0,"percent of total billed charges","82.6% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",622.57,100,,,,,0,"fee schedule",EAPG,137,100,,109.60,,,0,"percent of total billed charges","100% of total billed charges",20.96,622.57,
"96416 Int or prolong chem >8hr w pump",8169542,CDM,521,RC,96416,CPT,OUTPATIENT,,,680,442,,598.4,88,,478.72,,,0,"percent of total billed charges","88% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,680,100,,544.00,,,0,"percent of total billed charges","100% of total billed charges",604.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",475.9,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",428.4,63,,342.72,,,0,"percent of total billed charges","63% of total billed charges",104.04,15.3,,83.23,,,0,"percent of total billed charges","15.3% of total billed charges",462.04,100,,,,,0,"fee schedule",EAPG,469.2,69,,,,,0,"fee schedule","69% of total billed charges",680,100,,544.00,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",680,100,,544.00,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",680,100,,544.00,,,0,"percent of total billed charges","100% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",1262.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",471.28,100,,,,,0,"fee schedule",EAPG,600.65,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",256.36,37.7,,205.09,,,0,"percent of total billed charges","37.70% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",530.4,78,,424.32,,,0,"percent of total billed charges","78% of total billed charges",348.87,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.68,82.6,,449.34,,,0,"percent of total billed charges","82.6% of total billed charges",462.04,100,,,,,0,"fee schedule",EAPG,345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.68,82.6,,449.34,,,0,"percent of total billed charges","82.6% of total billed charges",345.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",622.57,100,,,,,0,"fee schedule",EAPG,680,100,,544.00,,,0,"percent of total billed charges","100% of total billed charges",104.04,1262.42,
"96417 Ea add'l seq inf dif drug/1 hr",8169544,CDM,521,RC,96417,CPT,OUTPATIENT,,,303,196.95,,266.64,88,,213.31,,,0,"percent of total billed charges","88% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,303,100,,242.40,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",281.17,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.89,63,,152.71,,,0,"percent of total billed charges","63% of total billed charges",46.36,15.3,,37.09,,,0,"percent of total billed charges","15.3% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,209.07,69,,,,,0,"fee schedule","69% of total billed charges",303,100,,242.40,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",303,100,,242.40,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",303,100,,242.40,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278.44,100,,,,,0,"fee schedule",EAPG,354.88,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",114.23,37.7,,91.38,,,0,"percent of total billed charges","37.70% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",236.34,78,,189.07,,,0,"percent of total billed charges","78% of total billed charges",72.56,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.28,82.6,,200.22,,,0,"percent of total billed charges","82.6% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",250.28,82.6,,200.22,,,0,"percent of total billed charges","82.6% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",433.51,100,,,,,0,"fee schedule",EAPG,303,100,,242.40,,,0,"percent of total billed charges","100% of total billed charges",46.36,433.51,
"96523 Irrigate implanted venous access (Clinic)",7903117,CDM,521,RC,96523,CPT,OUTPATIENT,,,57,37.05,,50.16,88,,40.13,,,0,"percent of total billed charges","88% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",109.18,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",8.72,15.3,,6.98,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,39.33,69,,,,,0,"fee schedule","69% of total billed charges",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",226.12,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",21.49,37.7,,17.19,,,0,"percent of total billed charges","37.70% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",44.46,78,,35.57,,,0,"percent of total billed charges","78% of total billed charges",63.01,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.08,82.6,,37.66,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.08,82.6,,37.66,,,0,"percent of total billed charges","82.6% of total billed charges",62.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200.33,100,,,,,0,"fee schedule",EAPG,57,100,,45.60,,,0,"percent of total billed charges","100% of total billed charges",8.72,226.12,
"96920 Laser treatment for inflammatory skin diseas",7961889,CDM,521,RC,96920,CPT,OUTPATIENT,,,517,336.05,,454.96,88,,363.97,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,517,100,,413.60,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",413.49,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",325.71,63,,260.57,,,0,"percent of total billed charges","63% of total billed charges",79.1,15.3,,63.28,,,0,"percent of total billed charges","15.3% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,356.73,69,,,,,0,"fee schedule","69% of total billed charges",517,100,,413.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",517,100,,413.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",517,100,,413.60,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",401.45,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",409.47,100,,,,,0,"fee schedule",EAPG,521.88,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",194.91,37.7,,155.93,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",403.26,78,,322.61,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",427.04,82.6,,341.63,,,0,"percent of total billed charges","82.6% of total billed charges",401.45,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",427.04,82.6,,341.63,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",561.98,100,,,,,0,"fee schedule",EAPG,517,100,,413.60,,,0,"percent of total billed charges","100% of total billed charges",79.1,729.42,
"96999 Unlisted special dermatological service or p",7963346,CDM,521,RC,96999,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",147.32,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",151.74,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",147.32,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",147.32,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",150.27,100,,,,,0,"fee schedule",EAPG,191.52,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",147.32,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",307.85,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",147.32,307.85,
"97010 Application of a modality to 1 or more areas",7963036,CDM,521,RC,97010,CPT,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",6.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.1,100,,,,,0,"fee schedule",EAPG,36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",10.96,175,,,,,0,"fee schedule","175% of CMS fee schedule",29.97,100,,,,,0,"fee schedule",EAPG,6.43,100,,,,,0,"fee schedule","100% of CMS fee sv",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",29.1,100,,,,,0,"fee schedule",EAPG,24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",6.26,100,,,,,0,"fee schedule","100% of CMS fee schedule",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",6.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",6.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",23.87,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",29.1,100,,,,,0,"fee schedule",EAPG,6.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.29,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",6.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.68,100,,,,,0,"fee schedule",EAPG,37.83,100,,,,,0,"fee schedule",EAPG,6.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",6.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",6.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",6.49,101,,,,,0,"fee schedule","101% of CMS fee schedule ",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",29.1,100,,,,,0,"fee schedule",EAPG,6.43,100,,,,,0,"fee schedule","100% of CMS fee schedule",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",6.44,100,,,,,0,"fee schedule","100% of CMS fee schedule",189.63,100,,,,,0,"fee schedule",EAPG,36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,189.63,
"97035 Application of a modality to 1 or more areas",7962732,CDM,521,RC,97035,CPT,OUTPATIENT,,,44,28.6,,38.72,88,,30.98,,,0,"percent of total billed charges","88% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",24.61,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee sv",27.72,63,,22.18,,,0,"percent of total billed charges","63% of total billed charges",6.73,15.3,,5.38,,,0,"percent of total billed charges","15.3% of total billed charges",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",30.36,69,,,,,0,"fee schedule","69% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",14.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",56.07,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.98,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.71,102,,,,,0,"fee schedule","102% of WA fee schedule",11.1,130,,,,,0,"fee schedule","130% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",16.59,37.7,,13.27,,,0,"percent of total billed charges","37.70% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.32,78,,27.46,,,0,"percent of total billed charges","78% of total billed charges",14.37,101,,,,,0,"fee schedule","101% of CMS fee schedule ",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",8.54,100,,,,,0,"fee schedule","100% of WA fee schedule",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",14.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.53,100,,,,,0,"case rate","pays based on per visit rate",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",6.73,160.53,
"97597 Debride open wound 1st 20 sq cm",7903351,CDM,521,RC,97597,CPT,OUTPATIENT,,,139,90.35,,122.32,88,,97.86,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",87.57,63,,70.06,,,0,"percent of total billed charges","63% of total billed charges",21.27,15.3,,17.02,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,95.91,69,,,,,0,"fee schedule","69% of total billed charges",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.41,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",52.4,37.7,,41.92,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",108.42,78,,86.74,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",114.81,82.6,,91.85,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",114.81,82.6,,91.85,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",328.93,100,,,,,0,"fee schedule",EAPG,139,100,,111.20,,,0,"percent of total billed charges","100% of total billed charges",21.27,729.41,
"97598 Debride open wound each additional 20 sq cm",7903355,CDM,521,RC,97598,CPT,OUTPATIENT,,,165,107.25,,145.2,88,,116.16,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",903.83,100,,,,,0,"fee schedule",EAPG,165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",930.95,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",103.95,63,,83.16,,,0,"percent of total billed charges","63% of total billed charges",25.25,15.3,,20.20,,,0,"percent of total billed charges","15.3% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,113.85,69,,,,,0,"fee schedule","69% of total billed charges",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",903.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",921.91,100,,,,,0,"fee schedule",EAPG,1174.99,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",62.21,37.7,,49.77,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",128.7,78,,102.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.29,82.6,,109.03,,,0,"percent of total billed charges","82.6% of total billed charges",903.83,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",136.29,82.6,,109.03,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1064.36,100,,,,,0,"fee schedule",EAPG,165,100,,132.00,,,0,"percent of total billed charges","100% of total billed charges",25.25,1174.99,
"97602 Nonselective debridement per session",7903356,CDM,521,RC,97602,CPT,OUTPATIENT,,,56,36.4,,49.28,88,,39.42,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.28,63,,28.22,,,0,"percent of total billed charges","63% of total billed charges",8.57,15.3,,6.86,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,38.64,69,,,,,0,"fee schedule","69% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",21.11,37.7,,16.89,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",43.68,78,,34.94,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.26,100,,,,,0,"fee schedule",EAPG,56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",8.57,729.42,
"97605 Negative pressure wound therapy < 50 sq cm",7903357,CDM,521,RC,97605,CPT,OUTPATIENT,,,151,98.15,,132.88,88,,106.30,,,0,"percent of total billed charges","88% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",357.34,175,,,,,0,"fee schedule","175% of CMS fee schedule",173.46,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",95.13,63,,76.10,,,0,"percent of total billed charges","63% of total billed charges",23.1,15.3,,18.48,,,0,"percent of total billed charges","15.3% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,104.19,69,,,,,0,"fee schedule","69% of total billed charges",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS fee schedule",729.42,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",190.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",171.77,100,,,,,0,"fee schedule",EAPG,218.93,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",56.93,37.7,,45.54,,,0,"percent of total billed charges","37.70% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",117.78,78,,94.22,,,0,"percent of total billed charges","78% of total billed charges",206.23,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.73,82.6,,99.78,,,0,"percent of total billed charges","82.6% of total billed charges",168.4,100,,,,,0,"fee schedule",EAPG,204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",124.73,82.6,,99.78,,,0,"percent of total billed charges","82.6% of total billed charges",204.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",328.93,100,,,,,0,"fee schedule",EAPG,151,100,,120.80,,,0,"percent of total billed charges","100% of total billed charges",23.1,729.42,
"97606 Negative pressure wound therapy > 50 sq cm",7903358,CDM,521,RC,97606,CPT,OUTPATIENT,,,169,109.85,,148.72,88,,118.98,,,0,"percent of total billed charges","88% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",711.73,175,,,,,0,"fee schedule","175% of CMS fee schedule",348.89,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",106.47,63,,85.18,,,0,"percent of total billed charges","63% of total billed charges",25.86,15.3,,20.69,,,0,"percent of total billed charges","15.3% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,116.61,69,,,,,0,"fee schedule","69% of total billed charges",169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS fee schedule",1404.98,100,,,,,0,"fee schedule","100% of CMS OPPS rate",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",367.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",345.5,100,,,,,0,"fee schedule",EAPG,440.34,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",63.71,37.7,,50.97,,,0,"percent of total billed charges","37.70% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",131.82,78,,105.46,,,0,"percent of total billed charges","78% of total billed charges",410.77,100,,,,,0,"fee schedule","100% of CMS OPPS rate",139.59,82.6,,111.67,,,0,"percent of total billed charges","82.6% of total billed charges",338.73,100,,,,,0,"fee schedule",EAPG,406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",139.59,82.6,,111.67,,,0,"percent of total billed charges","82.6% of total billed charges",406.7,100,,,,,0,"fee schedule","100% of CMS OPPS rate",499.26,100,,,,,0,"fee schedule",EAPG,169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",25.86,1404.98,
"97750 Physical medicine and rehabilitation tests a",7903365,CDM,521,RC,97750,CPT,OUTPATIENT,,,106,68.9,,93.28,88,,74.62,,,0,"percent of total billed charges","88% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",60.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee sv",66.78,63,,53.42,,,0,"percent of total billed charges","63% of total billed charges",16.22,15.3,,12.98,,,0,"percent of total billed charges","15.3% of total billed charges",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",73.14,69,,,,,0,"fee schedule","69% of total billed charges",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",34.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",132.38,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.12,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.52,102,,,,,0,"fee schedule","102% of WA fee schedule",26.16,130,,,,,0,"fee schedule","130% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",39.96,37.7,,31.97,,,0,"percent of total billed charges","37.70% of total billed charges",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.68,78,,66.14,,,0,"percent of total billed charges","78% of total billed charges",35.08,101,,,,,0,"fee schedule","101% of CMS fee schedule ",87.56,82.6,,70.05,,,0,"percent of total billed charges","82.6% of total billed charges",20.12,100,,,,,0,"fee schedule","100% of WA fee schedule",34.73,100,,,,,0,"fee schedule","100% of CMS fee schedule",87.56,82.6,,70.05,,,0,"percent of total billed charges","82.6% of total billed charges",34.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.53,100,,,,,0,"case rate","pays based on per visit rate",106,100,,84.80,,,0,"percent of total billed charges","100% of total billed charges",16.22,160.53,
"98925 Osteopathic manipulation 1-2 regions",7903369,CDM,521,RC,98925,CPT,OUTPATIENT,,,91,59.15,,80.08,88,,64.06,,,0,"percent of total billed charges","88% of total billed charges",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18.22,100,,,,,0,"fee schedule","100% of WA fee schedule",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",46.3,175,,,,,0,"fee schedule","175% of CMS fee schedule",18.22,100,,,,,0,"fee schedule","100% of WA fee schedule",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",57.33,63,,45.86,,,0,"percent of total billed charges","63% of total billed charges",13.92,15.3,,11.14,,,0,"percent of total billed charges","15.3% of total billed charges",18.22,100,,,,,0,"fee schedule","100% of WA fee schedule",62.79,69,,,,,0,"fee schedule","69% of total billed charges",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",26.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18.22,100,,,,,0,"fee schedule","100% of WA fee schedule",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",28.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18.58,102,,,,,0,"fee schedule","102% of WA fee schedule",23.69,130,,,,,0,"fee schedule","130% of WA fee schedule",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",34.31,37.7,,27.45,,,0,"percent of total billed charges","37.70% of total billed charges",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",70.98,78,,56.78,,,0,"percent of total billed charges","78% of total billed charges",26.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75.17,82.6,,60.14,,,0,"percent of total billed charges","82.6% of total billed charges",18.22,100,,,,,0,"fee schedule","100% of WA fee schedule",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",75.17,82.6,,60.14,,,0,"percent of total billed charges","82.6% of total billed charges",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"case rate","pays based on per visit rate",91,100,,72.80,,,0,"percent of total billed charges","100% of total billed charges",13.92,160.53,
"98926 Osteopathic manipulation 3-4 regions",7903371,CDM,521,RC,98926,CPT,OUTPATIENT,,,129,83.85,,113.52,88,,90.82,,,0,"percent of total billed charges","88% of total billed charges",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.19,100,,,,,0,"fee schedule","100% of WA fee schedule",129,100,,103.20,,,0,"percent of total billed charges","100% of total billed charges",46.3,175,,,,,0,"fee schedule","175% of CMS fee schedule",26.19,100,,,,,0,"fee schedule","100% of WA fee schedule",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",81.27,63,,65.02,,,0,"percent of total billed charges","63% of total billed charges",19.74,15.3,,15.79,,,0,"percent of total billed charges","15.3% of total billed charges",26.19,100,,,,,0,"fee schedule","100% of WA fee schedule",89.01,69,,,,,0,"fee schedule","69% of total billed charges",129,100,,103.20,,,0,"percent of total billed charges","100% of total billed charges",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",129,100,,103.20,,,0,"percent of total billed charges","100% of total billed charges",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",129,100,,103.20,,,0,"percent of total billed charges","100% of total billed charges",26.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.19,100,,,,,0,"fee schedule","100% of WA fee schedule",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",28.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.71,102,,,,,0,"fee schedule","102% of WA fee schedule",34.05,130,,,,,0,"fee schedule","130% of WA fee schedule",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",48.63,37.7,,38.90,,,0,"percent of total billed charges","37.70% of total billed charges",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",100.62,78,,80.50,,,0,"percent of total billed charges","78% of total billed charges",26.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",106.55,82.6,,85.24,,,0,"percent of total billed charges","82.6% of total billed charges",26.19,100,,,,,0,"fee schedule","100% of WA fee schedule",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",106.55,82.6,,85.24,,,0,"percent of total billed charges","82.6% of total billed charges",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"case rate","pays based on per visit rate",129,100,,103.20,,,0,"percent of total billed charges","100% of total billed charges",19.74,160.53,
"98927 Osteopathic manipulation 5-6 regions",7903372,CDM,521,RC,98927,CPT,OUTPATIENT,,,169,109.85,,148.72,88,,118.98,,,0,"percent of total billed charges","88% of total billed charges",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33.78,100,,,,,0,"fee schedule","100% of WA fee schedule",169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",46.3,175,,,,,0,"fee schedule","175% of CMS fee schedule",33.78,100,,,,,0,"fee schedule","100% of WA fee schedule",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",106.47,63,,85.18,,,0,"percent of total billed charges","63% of total billed charges",25.86,15.3,,20.69,,,0,"percent of total billed charges","15.3% of total billed charges",33.78,100,,,,,0,"fee schedule","100% of WA fee schedule",116.61,69,,,,,0,"fee schedule","69% of total billed charges",169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",26.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",33.78,100,,,,,0,"fee schedule","100% of WA fee schedule",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",28.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.46,102,,,,,0,"fee schedule","102% of WA fee schedule",43.91,130,,,,,0,"fee schedule","130% of WA fee schedule",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",63.71,37.7,,50.97,,,0,"percent of total billed charges","37.70% of total billed charges",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",131.82,78,,105.46,,,0,"percent of total billed charges","78% of total billed charges",26.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",139.59,82.6,,111.67,,,0,"percent of total billed charges","82.6% of total billed charges",33.78,100,,,,,0,"fee schedule","100% of WA fee schedule",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",139.59,82.6,,111.67,,,0,"percent of total billed charges","82.6% of total billed charges",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"case rate","pays based on per visit rate",169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",25.86,169,
"98928 Osteopathic manipulation 7-8 regions",7903373,CDM,521,RC,98928,CPT,OUTPATIENT,,,206,133.9,,181.28,88,,145.02,,,0,"percent of total billed charges","88% of total billed charges",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",41.57,100,,,,,0,"fee schedule","100% of WA fee schedule",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",46.3,175,,,,,0,"fee schedule","175% of CMS fee schedule",41.57,100,,,,,0,"fee schedule","100% of WA fee schedule",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",129.78,63,,103.82,,,0,"percent of total billed charges","63% of total billed charges",31.52,15.3,,25.22,,,0,"percent of total billed charges","15.3% of total billed charges",41.57,100,,,,,0,"fee schedule","100% of WA fee schedule",142.14,69,,,,,0,"fee schedule","69% of total billed charges",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",26.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",41.57,100,,,,,0,"fee schedule","100% of WA fee schedule",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",28.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42.4,102,,,,,0,"fee schedule","102% of WA fee schedule",54.04,130,,,,,0,"fee schedule","130% of WA fee schedule",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",77.66,37.7,,62.13,,,0,"percent of total billed charges","37.70% of total billed charges",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.68,78,,128.54,,,0,"percent of total billed charges","78% of total billed charges",26.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",41.57,100,,,,,0,"fee schedule","100% of WA fee schedule",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",170.16,82.6,,136.13,,,0,"percent of total billed charges","82.6% of total billed charges",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"case rate","pays based on per visit rate",206,100,,164.80,,,0,"percent of total billed charges","100% of total billed charges",26.46,206,
"98929 Osteopathic manipulation 9-10 region",7903375,CDM,521,RC,98929,CPT,OUTPATIENT,,,245,159.25,,215.6,88,,172.48,,,0,"percent of total billed charges","88% of total billed charges",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",48.78,100,,,,,0,"fee schedule","100% of WA fee schedule",245,100,,196.00,,,0,"percent of total billed charges","100% of total billed charges",46.3,175,,,,,0,"fee schedule","175% of CMS fee schedule",48.78,100,,,,,0,"fee schedule","100% of WA fee schedule",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",154.35,63,,123.48,,,0,"percent of total billed charges","63% of total billed charges",37.49,15.3,,29.99,,,0,"percent of total billed charges","15.3% of total billed charges",48.78,100,,,,,0,"fee schedule","100% of WA fee schedule",169.05,69,,,,,0,"fee schedule","69% of total billed charges",245,100,,196.00,,,0,"percent of total billed charges","100% of total billed charges",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",245,100,,196.00,,,0,"percent of total billed charges","100% of total billed charges",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",245,100,,196.00,,,0,"percent of total billed charges","100% of total billed charges",26.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",107.86,100,,,,,0,"fee schedule","100% of CMS OPPS rate",48.78,100,,,,,0,"fee schedule","100% of WA fee schedule",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",28.19,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",49.76,102,,,,,0,"fee schedule","102% of WA fee schedule",63.41,130,,,,,0,"fee schedule","130% of WA fee schedule",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",92.37,37.7,,73.90,,,0,"percent of total billed charges","37.70% of total billed charges",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",191.1,78,,152.88,,,0,"percent of total billed charges","78% of total billed charges",26.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.37,82.6,,161.90,,,0,"percent of total billed charges","82.6% of total billed charges",48.78,100,,,,,0,"fee schedule","100% of WA fee schedule",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",202.37,82.6,,161.90,,,0,"percent of total billed charges","82.6% of total billed charges",26.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"case rate","pays based on per visit rate",245,100,,196.00,,,0,"percent of total billed charges","100% of total billed charges",26.46,245,
"29440 Adding walker to previously applied cast",7903265,CDM,521,RC,29440,CPT,OUTPATIENT,,,119,77.35,,104.72,88,,83.78,,,0,"percent of total billed charges","88% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",281.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",174.75,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.97,63,,59.98,,,0,"percent of total billed charges","63% of total billed charges",18.21,15.3,,14.57,,,0,"percent of total billed charges","15.3% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,82.11,69,,,,,0,"fee schedule","69% of total billed charges",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",573.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",149.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.06,100,,,,,0,"fee schedule",EAPG,220.57,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",44.86,37.7,,35.89,,,0,"percent of total billed charges","37.70% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",92.82,78,,74.26,,,0,"percent of total billed charges","78% of total billed charges",162.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",98.29,82.6,,78.63,,,0,"percent of total billed charges","82.6% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.19,100,,,,,0,"fee schedule",EAPG,119,100,,95.20,,,0,"percent of total billed charges","100% of total billed charges",18.21,573.54,
"29086 Application, cast; finger (eg, contracture)",7903147,CDM,521,RC,29086,CPT,OUTPATIENT,,,132,85.8,,116.16,88,,92.93,,,0,"percent of total billed charges","88% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",281.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",174.75,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",83.16,63,,66.53,,,0,"percent of total billed charges","63% of total billed charges",20.2,15.3,,16.16,,,0,"percent of total billed charges","15.3% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,91.08,69,,,,,0,"fee schedule","69% of total billed charges",132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",573.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",149.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.06,100,,,,,0,"fee schedule",EAPG,220.57,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",49.76,37.7,,39.81,,,0,"percent of total billed charges","37.70% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",102.96,78,,82.37,,,0,"percent of total billed charges","78% of total billed charges",162.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.03,82.6,,87.22,,,0,"percent of total billed charges","82.6% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.03,82.6,,87.22,,,0,"percent of total billed charges","82.6% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.19,100,,,,,0,"fee schedule",EAPG,132,100,,105.60,,,0,"percent of total billed charges","100% of total billed charges",20.2,573.54,
"29105 Application of long arm splint (shoulder to",7903148,CDM,521,RC,29105,CPT,OUTPATIENT,,,158,102.7,,139.04,88,,111.23,,,0,"percent of total billed charges","88% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",281.24,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.34,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",99.54,63,,79.63,,,0,"percent of total billed charges","63% of total billed charges",24.17,15.3,,19.34,,,0,"percent of total billed charges","15.3% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,109.02,69,,,,,0,"fee schedule","69% of total billed charges",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",573.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",149.94,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.94,100,,,,,0,"fee schedule",EAPG,50.91,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",59.57,37.7,,47.66,,,0,"percent of total billed charges","37.70% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",123.24,78,,98.59,,,0,"percent of total billed charges","78% of total billed charges",162.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",130.51,82.6,,104.41,,,0,"percent of total billed charges","82.6% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",130.51,82.6,,104.41,,,0,"percent of total billed charges","82.6% of total billed charges",160.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.69,100,,,,,0,"fee schedule",EAPG,158,100,,126.40,,,0,"percent of total billed charges","100% of total billed charges",24.17,573.54,
"29355 Application of long leg cast (thigh to toes)",7903262,CDM,521,RC,29355,CPT,OUTPATIENT,,,347,225.55,,305.36,88,,244.29,,,0,"percent of total billed charges","88% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",479.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",174.75,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.61,63,,174.89,,,0,"percent of total billed charges","63% of total billed charges",53.09,15.3,,42.47,,,0,"percent of total billed charges","15.3% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,239.43,69,,,,,0,"fee schedule","69% of total billed charges",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",979.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.06,100,,,,,0,"fee schedule",EAPG,220.57,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.82,37.7,,104.66,,,0,"percent of total billed charges","37.70% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",270.66,78,,216.53,,,0,"percent of total billed charges","78% of total billed charges",276.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",286.62,82.6,,229.30,,,0,"percent of total billed charges","82.6% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",286.62,82.6,,229.30,,,0,"percent of total billed charges","82.6% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.19,100,,,,,0,"fee schedule",EAPG,347,100,,277.60,,,0,"percent of total billed charges","100% of total billed charges",53.09,979.75,
"29425 Application of short leg cast (below knee to",7903264,CDM,521,RC,29425,CPT,OUTPATIENT,,,276,179.4,,242.88,88,,194.30,,,0,"percent of total billed charges","88% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,276,100,,220.80,,,0,"percent of total billed charges","100% of total billed charges",479.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",174.75,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.88,63,,139.10,,,0,"percent of total billed charges","63% of total billed charges",42.23,15.3,,33.78,,,0,"percent of total billed charges","15.3% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,190.44,69,,,,,0,"fee schedule","69% of total billed charges",276,100,,220.80,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",276,100,,220.80,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",276,100,,220.80,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",979.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.06,100,,,,,0,"fee schedule",EAPG,220.57,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",104.05,37.7,,83.24,,,0,"percent of total billed charges","37.70% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",215.28,78,,172.22,,,0,"percent of total billed charges","78% of total billed charges",276.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",227.98,82.6,,182.38,,,0,"percent of total billed charges","82.6% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",227.98,82.6,,182.38,,,0,"percent of total billed charges","82.6% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.19,100,,,,,0,"fee schedule",EAPG,276,100,,220.80,,,0,"percent of total billed charges","100% of total billed charges",42.23,979.75,
"29445 Application of rigid total contact leg cast",7903266,CDM,521,RC,29445,CPT,OUTPATIENT,,,516,335.4,,454.08,88,,363.26,,,0,"percent of total billed charges","88% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,516,100,,412.80,,,0,"percent of total billed charges","100% of total billed charges",479.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",174.75,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",325.08,63,,260.06,,,0,"percent of total billed charges","63% of total billed charges",78.95,15.3,,63.16,,,0,"percent of total billed charges","15.3% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,356.04,69,,,,,0,"fee schedule","69% of total billed charges",516,100,,412.80,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",516,100,,412.80,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",516,100,,412.80,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",979.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.06,100,,,,,0,"fee schedule",EAPG,220.57,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",194.53,37.7,,155.62,,,0,"percent of total billed charges","37.70% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.48,78,,321.98,,,0,"percent of total billed charges","78% of total billed charges",276.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.22,82.6,,340.98,,,0,"percent of total billed charges","82.6% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",426.22,82.6,,340.98,,,0,"percent of total billed charges","82.6% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.19,100,,,,,0,"fee schedule",EAPG,516,100,,412.80,,,0,"percent of total billed charges","100% of total billed charges",78.95,979.75,
"30100 Biopsy, intranasal",7903272,CDM,521,RC,30100,CPT,OUTPATIENT,,,267,173.55,,234.96,88,,187.97,,,0,"percent of total billed charges","88% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",2722.09,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",168.21,63,,134.57,,,0,"percent of total billed charges","63% of total billed charges",40.85,15.3,,32.68,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,184.23,69,,,,,0,"fee schedule","69% of total billed charges",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS fee schedule",5495.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1436.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",100.66,37.7,,80.53,,,0,"percent of total billed charges","37.70% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",208.26,78,,166.61,,,0,"percent of total billed charges","78% of total billed charges",1571.04,100,,,,,0,"fee schedule","100% of CMS OPPS rate",220.54,82.6,,176.43,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",220.54,82.6,,176.43,,,0,"percent of total billed charges","82.6% of total billed charges",1555.49,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.24,100,,,,,0,"fee schedule",EAPG,267,100,,213.60,,,0,"percent of total billed charges","100% of total billed charges",40.85,5495.75,
"28270 Capsulotomy; metatarsophalangeal joint, with",7903248,CDM,521,RC,28270,CPT,OUTPATIENT,,,1064,691.6,,936.32,88,,749.06,,,0,"percent of total billed charges","88% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,1064,100,,851.20,,,0,"percent of total billed charges","100% of total billed charges",5777.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2001.8,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",670.32,63,,536.26,,,0,"percent of total billed charges","63% of total billed charges",162.79,15.3,,130.23,,,0,"percent of total billed charges","15.3% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,734.16,69,,,,,0,"fee schedule","69% of total billed charges",1064,100,,851.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1064,100,,851.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1064,100,,851.20,,,0,"percent of total billed charges","100% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",11498.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",3006.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1982.36,100,,,,,0,"fee schedule",EAPG,2526.54,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",401.13,37.7,,320.90,,,0,"percent of total billed charges","37.70% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",829.92,78,,663.94,,,0,"percent of total billed charges","78% of total billed charges",3334.46,100,,,,,0,"fee schedule","100% of CMS OPPS rate",878.86,82.6,,703.09,,,0,"percent of total billed charges","82.6% of total billed charges",1943.49,100,,,,,0,"fee schedule",EAPG,3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",878.86,82.6,,703.09,,,0,"percent of total billed charges","82.6% of total billed charges",3301.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2104.02,100,,,,,0,"fee schedule",EAPG,1064,100,,851.20,,,0,"percent of total billed charges","100% of total billed charges",162.79,11498.59,
"27750 Closed treatment of tibial shaft fracture; w",7903142,CDM,521,RC,27750,CPT,OUTPATIENT,,,1227,797.55,,1079.76,88,,863.81,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,1227,100,,981.60,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",773.01,63,,618.41,,,0,"percent of total billed charges","63% of total billed charges",187.73,15.3,,150.18,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,846.63,69,,,,,0,"fee schedule","69% of total billed charges",1227,100,,981.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1227,100,,981.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1227,100,,981.60,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",462.58,37.7,,370.06,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",957.06,78,,765.65,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.5,82.6,,810.80,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1013.5,82.6,,810.80,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,1227,100,,981.60,,,0,"percent of total billed charges","100% of total billed charges",187.73,1227,
"21320 Closed treatment of nasal bone fracture; wit",7903190,CDM,521,RC,21320,CPT,OUTPATIENT,,,485,315.25,,426.8,88,,341.44,,,0,"percent of total billed charges","88% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,485,100,,388.00,,,0,"percent of total billed charges","100% of total billed charges",5746.79,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",305.55,63,,244.44,,,0,"percent of total billed charges","63% of total billed charges",74.21,15.3,,59.37,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,334.65,69,,,,,0,"fee schedule","69% of total billed charges",485,100,,388.00,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",485,100,,388.00,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",485,100,,388.00,,,0,"percent of total billed charges","100% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS fee schedule",11116.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2906.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",182.85,37.7,,146.28,,,0,"percent of total billed charges","37.70% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",378.3,78,,302.64,,,0,"percent of total billed charges","78% of total billed charges",3316.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.61,82.6,,320.49,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.61,82.6,,320.49,,,0,"percent of total billed charges","82.6% of total billed charges",3283.88,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,485,100,,388.00,,,0,"percent of total billed charges","100% of total billed charges",74.21,11116.67,
"27780 Closed treatment of proximal fibula or shaft",7903241,CDM,521,RC,27780,CPT,OUTPATIENT,,,769,499.85,,676.72,88,,541.38,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,769,100,,615.20,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",484.47,63,,387.58,,,0,"percent of total billed charges","63% of total billed charges",117.66,15.3,,94.13,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,530.61,69,,,,,0,"fee schedule","69% of total billed charges",769,100,,615.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",769,100,,615.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",769,100,,615.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",289.91,37.7,,231.93,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",599.82,78,,479.86,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",635.19,82.6,,508.15,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",635.19,82.6,,508.15,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,769,100,,615.20,,,0,"percent of total billed charges","100% of total billed charges",117.66,837.64,
"27808 Closed treatment of bimalleolar ankle fractu",7903243,CDM,521,RC,27808,CPT,OUTPATIENT,,,639,415.35,,562.32,88,,449.86,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,639,100,,511.20,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",402.57,63,,322.06,,,0,"percent of total billed charges","63% of total billed charges",97.77,15.3,,78.22,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,440.91,69,,,,,0,"fee schedule","69% of total billed charges",639,100,,511.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",639,100,,511.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",639,100,,511.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.9,37.7,,192.72,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",498.42,78,,398.74,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",527.81,82.6,,422.25,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",527.81,82.6,,422.25,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,639,100,,511.20,,,0,"percent of total billed charges","100% of total billed charges",97.77,837.64,
"28660 Closed treatment of interphalangeal joint di",7903284,CDM,521,RC,28660,CPT,OUTPATIENT,,,229,148.85,,201.52,88,,161.22,,,0,"percent of total billed charges","88% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,229,100,,183.20,,,0,"percent of total billed charges","100% of total billed charges",420.92,175,,,,,0,"fee schedule","175% of CMS fee schedule",412.25,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",144.27,63,,115.42,,,0,"percent of total billed charges","63% of total billed charges",35.04,15.3,,28.03,,,0,"percent of total billed charges","15.3% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,158.01,69,,,,,0,"fee schedule","69% of total billed charges",229,100,,183.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229,100,,183.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",229,100,,183.20,,,0,"percent of total billed charges","100% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS fee schedule",837.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",218.99,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",408.25,100,,,,,0,"fee schedule",EAPG,520.32,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",86.33,37.7,,69.06,,,0,"percent of total billed charges","37.70% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",178.62,78,,142.90,,,0,"percent of total billed charges","78% of total billed charges",242.92,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.15,82.6,,151.32,,,0,"percent of total billed charges","82.6% of total billed charges",400.24,100,,,,,0,"fee schedule",EAPG,240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",189.15,82.6,,151.32,,,0,"percent of total billed charges","82.6% of total billed charges",240.53,100,,,,,0,"fee schedule","100% of CMS OPPS rate",560.77,100,,,,,0,"fee schedule",EAPG,229,100,,183.20,,,0,"percent of total billed charges","100% of total billed charges",35.04,837.64,
"30020 Drainage abscess or hematoma, nasal septum",7903271,CDM,521,RC,30020,CPT,OUTPATIENT,,,611,397.15,,537.68,88,,430.14,,,0,"percent of total billed charges","88% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,611,100,,488.80,,,0,"percent of total billed charges","100% of total billed charges",982.07,175,,,,,0,"fee schedule","175% of CMS fee schedule",852.54,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",384.93,63,,307.94,,,0,"percent of total billed charges","63% of total billed charges",93.48,15.3,,74.78,,,0,"percent of total billed charges","15.3% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,421.59,69,,,,,0,"fee schedule","69% of total billed charges",611,100,,488.80,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",611,100,,488.80,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",611,100,,488.80,,,0,"percent of total billed charges","100% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",1837.71,100,,,,,0,"fee schedule","100% of CMS OPPS rate",827.71,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",480.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",844.26,100,,,,,0,"fee schedule",EAPG,1076.02,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",230.35,37.7,,184.28,,,0,"percent of total billed charges","37.70% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",476.58,78,,381.26,,,0,"percent of total billed charges","78% of total billed charges",566.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",504.69,82.6,,403.75,,,0,"percent of total billed charges","82.6% of total billed charges",827.71,100,,,,,0,"fee schedule",EAPG,561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",504.69,82.6,,403.75,,,0,"percent of total billed charges","82.6% of total billed charges",561.17,100,,,,,0,"fee schedule","100% of CMS OPPS rate",988.24,100,,,,,0,"fee schedule",EAPG,611,100,,488.80,,,0,"percent of total billed charges","100% of total billed charges",93.48,1837.71,
"G0102 Prostate cancer screening; digital rectal ex",7903300,CDM,521,RC,,,OUTPATIENT,,,59,38.35,,51.92,88,,41.54,,,0,"percent of total billed charges","88% of total billed charges",29.5,50,,23.60,,,0,"percent of total billed charges","50% of total billed charges",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.21,17.304,,8.17,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.17,63,,29.74,,,0,"percent of total billed charges","63% of total billed charges",9.03,15.3,,7.22,,,0,"percent of total billed charges","15.3% of total billed charges",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",40.71,69,,,,,0,"fee schedule","69% of total billed charges",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",29.5,50,,23.60,,,0,"percent of total billed charges","50% of total billed charges",19,32.2,,15.20,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.11,17.136,,8.09,,,0,"percent of total billed charges","17.136% of total billed charges",12.89,21.84,,10.31,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.24,37.7,,17.79,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.02,78,,36.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",48.73,82.6,,38.98,,,0,"percent of total billed charges","82.6% of total billed charges",9.91,16.8,,7.93,,,0,"percent of total billed charges","16.8% of total billed charges",29.5,50,,23.60,,,0,"percent of total billed charges","50% of total billed charges",48.73,82.6,,38.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",59,100,,47.20,,,0,"percent of total billed charges","100% of total billed charges",9.03,160.53,
"G0101 Breast and pelvic exam",7903425,CDM,521,RC,,,OUTPATIENT,,,110,71.5,,96.8,88,,77.44,,,0,"percent of total billed charges","88% of total billed charges",55,50,,44.00,,,0,"percent of total billed charges","50% of total billed charges",18.48,16.8,,14.78,,,0,"percent of total billed charges","16.8% of total billed charges",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.03,17.304,,15.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.3,63,,55.44,,,0,"percent of total billed charges","63% of total billed charges",16.83,15.3,,13.46,,,0,"percent of total billed charges","15.3% of total billed charges",18.48,16.8,,14.78,,,0,"percent of total billed charges","16.8% of total billed charges",75.9,69,,,,,0,"fee schedule","69% of total billed charges",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.48,16.8,,14.78,,,0,"percent of total billed charges","16.8% of total billed charges",55,50,,44.00,,,0,"percent of total billed charges","50% of total billed charges",35.42,32.2,,28.34,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.85,17.136,,15.08,,,0,"percent of total billed charges","17.136% of total billed charges",24.02,21.84,,19.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.47,37.7,,33.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",85.8,78,,68.64,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",90.86,82.6,,72.69,,,0,"percent of total billed charges","82.6% of total billed charges",18.48,16.8,,14.78,,,0,"percent of total billed charges","16.8% of total billed charges",55,50,,44.00,,,0,"percent of total billed charges","50% of total billed charges",90.86,82.6,,72.69,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",110,100,,88.00,,,0,"percent of total billed charges","100% of total billed charges",16.83,160.53,
"G0104 Colorectal cancer screening; flexible sigmoi",7903428,CDM,521,RC,,,OUTPATIENT,,,409,265.85,,359.92,88,,287.94,,,0,"percent of total billed charges","88% of total billed charges",204.5,50,,163.60,,,0,"percent of total billed charges","50% of total billed charges",68.71,16.8,,54.97,,,0,"percent of total billed charges","16.8% of total billed charges",409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",70.77,17.304,,56.62,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",257.67,63,,206.14,,,0,"percent of total billed charges","63% of total billed charges",62.58,15.3,,50.06,,,0,"percent of total billed charges","15.3% of total billed charges",68.71,16.8,,54.97,,,0,"percent of total billed charges","16.8% of total billed charges",282.21,69,,,,,0,"fee schedule","69% of total billed charges",409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",68.71,16.8,,54.97,,,0,"percent of total billed charges","16.8% of total billed charges",204.5,50,,163.60,,,0,"percent of total billed charges","50% of total billed charges",131.7,32.2,,105.36,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",70.09,17.136,,56.07,,,0,"percent of total billed charges","17.136% of total billed charges",89.33,21.84,,71.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",154.19,37.7,,123.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",319.02,78,,255.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.83,82.6,,270.26,,,0,"percent of total billed charges","82.6% of total billed charges",68.71,16.8,,54.97,,,0,"percent of total billed charges","16.8% of total billed charges",204.5,50,,163.60,,,0,"percent of total billed charges","50% of total billed charges",337.83,82.6,,270.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",409,100,,327.20,,,0,"percent of total billed charges","100% of total billed charges",62.58,409,
"G0105 Colonoscopy; High Risk",8165596,CDM,521,RC,,,OUTPATIENT,,,586,380.9,,515.68,88,,412.54,,,0,"percent of total billed charges","88% of total billed charges",293,50,,234.40,,,0,"percent of total billed charges","50% of total billed charges",98.45,16.8,,78.76,,,0,"percent of total billed charges","16.8% of total billed charges",586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.4,17.304,,81.12,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",369.18,63,,295.34,,,0,"percent of total billed charges","63% of total billed charges",89.66,15.3,,71.73,,,0,"percent of total billed charges","15.3% of total billed charges",98.45,16.8,,78.76,,,0,"percent of total billed charges","16.8% of total billed charges",404.34,69,,,,,0,"fee schedule","69% of total billed charges",586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",98.45,16.8,,78.76,,,0,"percent of total billed charges","16.8% of total billed charges",293,50,,234.40,,,0,"percent of total billed charges","50% of total billed charges",188.69,32.2,,150.95,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",100.42,17.136,,80.34,,,0,"percent of total billed charges","17.136% of total billed charges",127.98,21.84,,102.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",220.92,37.7,,176.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",457.08,78,,365.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",484.04,82.6,,387.23,,,0,"percent of total billed charges","82.6% of total billed charges",98.45,16.8,,78.76,,,0,"percent of total billed charges","16.8% of total billed charges",293,50,,234.40,,,0,"percent of total billed charges","50% of total billed charges",484.04,82.6,,387.23,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",89.66,586,
"G0127 Trim dystrophic nail(s)",7903426,CDM,521,RC,,,OUTPATIENT,,,66,42.9,,58.08,88,,46.46,,,0,"percent of total billed charges","88% of total billed charges",33,50,,26.40,,,0,"percent of total billed charges","50% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.42,17.304,,9.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",41.58,63,,33.26,,,0,"percent of total billed charges","63% of total billed charges",10.1,15.3,,8.08,,,0,"percent of total billed charges","15.3% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",45.54,69,,,,,0,"fee schedule","69% of total billed charges",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",33,50,,26.40,,,0,"percent of total billed charges","50% of total billed charges",21.25,32.2,,17.00,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",11.31,17.136,,9.05,,,0,"percent of total billed charges","17.136% of total billed charges",14.41,21.84,,11.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.88,37.7,,19.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",51.48,78,,41.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",54.52,82.6,,43.62,,,0,"percent of total billed charges","82.6% of total billed charges",11.09,16.8,,8.87,,,0,"percent of total billed charges","16.8% of total billed charges",33,50,,26.40,,,0,"percent of total billed charges","50% of total billed charges",54.52,82.6,,43.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",66,100,,52.80,,,0,"percent of total billed charges","100% of total billed charges",10.1,160.53,
"G0121 Colorectal Cancer Screen",8165597,CDM,521,RC,,,OUTPATIENT,,,586,380.9,,515.68,88,,412.54,,,0,"percent of total billed charges","88% of total billed charges",293,50,,234.40,,,0,"percent of total billed charges","50% of total billed charges",98.45,16.8,,78.76,,,0,"percent of total billed charges","16.8% of total billed charges",586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.4,17.304,,81.12,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",369.18,63,,295.34,,,0,"percent of total billed charges","63% of total billed charges",89.66,15.3,,71.73,,,0,"percent of total billed charges","15.3% of total billed charges",98.45,16.8,,78.76,,,0,"percent of total billed charges","16.8% of total billed charges",404.34,69,,,,,0,"fee schedule","69% of total billed charges",586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",98.45,16.8,,78.76,,,0,"percent of total billed charges","16.8% of total billed charges",293,50,,234.40,,,0,"percent of total billed charges","50% of total billed charges",188.69,32.2,,150.95,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",100.42,17.136,,80.34,,,0,"percent of total billed charges","17.136% of total billed charges",127.98,21.84,,102.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",220.92,37.7,,176.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",457.08,78,,365.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",484.04,82.6,,387.23,,,0,"percent of total billed charges","82.6% of total billed charges",98.45,16.8,,78.76,,,0,"percent of total billed charges","16.8% of total billed charges",293,50,,234.40,,,0,"percent of total billed charges","50% of total billed charges",484.04,82.6,,387.23,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",586,100,,468.80,,,0,"percent of total billed charges","100% of total billed charges",89.66,586,
"G0245 Initial physician eval & management of patie",8529955,CDM,940,RC,,,OUTPATIENT,,,401,260.65,,352.88,88,,282.30,,,0,"percent of total billed charges","88% of total billed charges",200.5,50,,160.40,,,0,"percent of total billed charges","50% of total billed charges",67.37,16.8,,53.90,,,0,"percent of total billed charges","16.8% of total billed charges",401,100,,320.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.39,17.304,,55.51,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.63,63,,202.10,,,0,"percent of total billed charges","63% of total billed charges",61.35,15.3,,49.08,,,0,"percent of total billed charges","15.3% of total billed charges",67.37,16.8,,53.90,,,0,"percent of total billed charges","16.8% of total billed charges",276.69,69,,,,,0,"fee schedule","69% of total billed charges",401,100,,320.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",401,100,,320.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",401,100,,320.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",67.37,16.8,,53.90,,,0,"percent of total billed charges","16.8% of total billed charges",200.5,50,,160.40,,,0,"percent of total billed charges","50% of total billed charges",129.12,32.2,,103.30,,,0,"percent of total billed charges","32.2% of total billed charges",67.37,16.8,,53.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.72,17.136,,54.98,,,0,"percent of total billed charges","17.136% of total billed charges",87.58,21.84,,70.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.18,37.7,,120.94,,,0,"percent of total billed charges","37.7% of total billed charges",151.18,37.7,,120.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",135.94,33.9,,108.75,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",312.78,78,,250.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.23,82.6,,264.98,,,0,"percent of total billed charges","82.6% of total billed charges",67.37,16.8,,53.90,,,0,"percent of total billed charges","16.8% of total billed charges",200.5,50,,160.40,,,0,"percent of total billed charges","50% of total billed charges",331.23,82.6,,264.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.37,16.8,,53.90,,,0,"percent of total billed charges","16.8% of total billed charges",401,100,,320.80,,,0,"percent of total billed charges","100% of total billed charges",61.35,401,
"G0247 Routine foot care by physician of a diabetic",8529958,CDM,940,RC,,,OUTPATIENT,,,671,436.15,,590.48,88,,472.38,,,0,"percent of total billed charges","88% of total billed charges",335.5,50,,268.40,,,0,"percent of total billed charges","50% of total billed charges",112.73,16.8,,90.18,,,0,"percent of total billed charges","16.8% of total billed charges",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",116.11,17.304,,92.89,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",422.73,63,,338.18,,,0,"percent of total billed charges","63% of total billed charges",102.66,15.3,,82.13,,,0,"percent of total billed charges","15.3% of total billed charges",112.73,16.8,,90.18,,,0,"percent of total billed charges","16.8% of total billed charges",462.99,69,,,,,0,"fee schedule","69% of total billed charges",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",112.73,16.8,,90.18,,,0,"percent of total billed charges","16.8% of total billed charges",335.5,50,,268.40,,,0,"percent of total billed charges","50% of total billed charges",216.06,32.2,,172.85,,,0,"percent of total billed charges","32.2% of total billed charges",112.73,16.8,,90.18,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",114.98,17.136,,91.98,,,0,"percent of total billed charges","17.136% of total billed charges",146.55,21.84,,117.24,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.97,37.7,,202.38,,,0,"percent of total billed charges","37.7% of total billed charges",252.97,37.7,,202.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.47,33.9,,181.98,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",523.38,78,,418.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",554.25,82.6,,443.40,,,0,"percent of total billed charges","82.6% of total billed charges",112.73,16.8,,90.18,,,0,"percent of total billed charges","16.8% of total billed charges",335.5,50,,268.40,,,0,"percent of total billed charges","50% of total billed charges",554.25,82.6,,443.40,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",112.73,16.8,,90.18,,,0,"percent of total billed charges","16.8% of total billed charges",671,100,,536.80,,,0,"percent of total billed charges","100% of total billed charges",102.66,671,
"G0246 F/U EVAL DIABETIC PT W/LOPS",8882868,CDM,940,RC,,,OUTPATIENT,,,401,260.65,,352.88,88,,282.30,,,0,"percent of total billed charges","88% of total billed charges",200.5,50,,160.40,,,0,"percent of total billed charges","50% of total billed charges",67.37,16.8,,53.90,,,0,"percent of total billed charges","16.8% of total billed charges",401,100,,320.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",69.39,17.304,,55.51,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",252.63,63,,202.10,,,0,"percent of total billed charges","63% of total billed charges",61.35,15.3,,49.08,,,0,"percent of total billed charges","15.3% of total billed charges",67.37,16.8,,53.90,,,0,"percent of total billed charges","16.8% of total billed charges",276.69,69,,,,,0,"fee schedule","69% of total billed charges",401,100,,320.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",401,100,,320.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",401,100,,320.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",67.37,16.8,,53.90,,,0,"percent of total billed charges","16.8% of total billed charges",200.5,50,,160.40,,,0,"percent of total billed charges","50% of total billed charges",129.12,32.2,,103.30,,,0,"percent of total billed charges","32.2% of total billed charges",67.37,16.8,,53.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",68.72,17.136,,54.98,,,0,"percent of total billed charges","17.136% of total billed charges",87.58,21.84,,70.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",151.18,37.7,,120.94,,,0,"percent of total billed charges","37.7% of total billed charges",151.18,37.7,,120.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",135.94,33.9,,108.75,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",312.78,78,,250.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",331.23,82.6,,264.98,,,0,"percent of total billed charges","82.6% of total billed charges",67.37,16.8,,53.90,,,0,"percent of total billed charges","16.8% of total billed charges",200.5,50,,160.40,,,0,"percent of total billed charges","50% of total billed charges",331.23,82.6,,264.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",67.37,16.8,,53.90,,,0,"percent of total billed charges","16.8% of total billed charges",401,100,,320.80,,,0,"percent of total billed charges","100% of total billed charges",61.35,401,
"G0402 Welcome to Medicare visit",7903427,CDM,521,RC,,,OUTPATIENT,,,457,297.05,,402.16,88,,321.73,,,0,"percent of total billed charges","88% of total billed charges",228.5,50,,182.80,,,0,"percent of total billed charges","50% of total billed charges",76.78,16.8,,61.42,,,0,"percent of total billed charges","16.8% of total billed charges",457,100,,365.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.08,17.304,,63.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",287.91,63,,230.33,,,0,"percent of total billed charges","63% of total billed charges",69.92,15.3,,55.94,,,0,"percent of total billed charges","15.3% of total billed charges",76.78,16.8,,61.42,,,0,"percent of total billed charges","16.8% of total billed charges",315.33,69,,,,,0,"fee schedule","69% of total billed charges",457,100,,365.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",457,100,,365.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",457,100,,365.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",76.78,16.8,,61.42,,,0,"percent of total billed charges","16.8% of total billed charges",228.5,50,,182.80,,,0,"percent of total billed charges","50% of total billed charges",147.15,32.2,,117.72,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",78.31,17.136,,62.65,,,0,"percent of total billed charges","17.136% of total billed charges",99.81,21.84,,79.85,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",172.29,37.7,,137.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",356.46,78,,285.17,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",377.48,82.6,,301.98,,,0,"percent of total billed charges","82.6% of total billed charges",76.78,16.8,,61.42,,,0,"percent of total billed charges","16.8% of total billed charges",228.5,50,,182.80,,,0,"percent of total billed charges","50% of total billed charges",377.48,82.6,,301.98,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",457,100,,365.60,,,0,"percent of total billed charges","100% of total billed charges",69.92,457,
"G0438 Initial annual wellness visit; includes a pe",7903303,CDM,521,RC,,,OUTPATIENT,,,488,317.2,,429.44,88,,343.55,,,0,"percent of total billed charges","88% of total billed charges",244,50,,195.20,,,0,"percent of total billed charges","50% of total billed charges",81.98,16.8,,65.58,,,0,"percent of total billed charges","16.8% of total billed charges",488,100,,390.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.44,17.304,,67.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",307.44,63,,245.95,,,0,"percent of total billed charges","63% of total billed charges",74.66,15.3,,59.73,,,0,"percent of total billed charges","15.3% of total billed charges",81.98,16.8,,65.58,,,0,"percent of total billed charges","16.8% of total billed charges",336.72,69,,,,,0,"fee schedule","69% of total billed charges",488,100,,390.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",488,100,,390.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",488,100,,390.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",81.98,16.8,,65.58,,,0,"percent of total billed charges","16.8% of total billed charges",244,50,,195.20,,,0,"percent of total billed charges","50% of total billed charges",157.14,32.2,,125.71,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",83.62,17.136,,66.90,,,0,"percent of total billed charges","17.136% of total billed charges",106.58,21.84,,85.26,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",183.98,37.7,,147.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",380.64,78,,304.51,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.09,82.6,,322.47,,,0,"percent of total billed charges","82.6% of total billed charges",81.98,16.8,,65.58,,,0,"percent of total billed charges","16.8% of total billed charges",244,50,,195.20,,,0,"percent of total billed charges","50% of total billed charges",403.09,82.6,,322.47,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",488,100,,390.40,,,0,"percent of total billed charges","100% of total billed charges",74.66,488,
"G0439 Subsequent annual wellness visit, includes a",7903304,CDM,521,RC,,,OUTPATIENT,,,327,212.55,,287.76,88,,230.21,,,0,"percent of total billed charges","88% of total billed charges",163.5,50,,130.80,,,0,"percent of total billed charges","50% of total billed charges",54.94,16.8,,43.95,,,0,"percent of total billed charges","16.8% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.58,17.304,,45.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.01,63,,164.81,,,0,"percent of total billed charges","63% of total billed charges",50.03,15.3,,40.02,,,0,"percent of total billed charges","15.3% of total billed charges",54.94,16.8,,43.95,,,0,"percent of total billed charges","16.8% of total billed charges",225.63,69,,,,,0,"fee schedule","69% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",54.94,16.8,,43.95,,,0,"percent of total billed charges","16.8% of total billed charges",163.5,50,,130.80,,,0,"percent of total billed charges","50% of total billed charges",105.29,32.2,,84.23,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",56.03,17.136,,44.82,,,0,"percent of total billed charges","17.136% of total billed charges",71.42,21.84,,57.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",255.06,78,,204.05,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",54.94,16.8,,43.95,,,0,"percent of total billed charges","16.8% of total billed charges",163.5,50,,130.80,,,0,"percent of total billed charges","50% of total billed charges",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",50.03,327,
"G0439 Telehealth Annual Wellness Visit FFS - Subse",12894261,CDM,521,RC,,,OUTPATIENT,,,327,212.55,,287.76,88,,230.21,,,0,"percent of total billed charges","88% of total billed charges",163.5,50,,130.80,,,0,"percent of total billed charges","50% of total billed charges",54.94,16.8,,43.95,,,0,"percent of total billed charges","16.8% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56.58,17.304,,45.26,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",206.01,63,,164.81,,,0,"percent of total billed charges","63% of total billed charges",50.03,15.3,,40.02,,,0,"percent of total billed charges","15.3% of total billed charges",54.94,16.8,,43.95,,,0,"percent of total billed charges","16.8% of total billed charges",225.63,69,,,,,0,"fee schedule","69% of total billed charges",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",54.94,16.8,,43.95,,,0,"percent of total billed charges","16.8% of total billed charges",163.5,50,,130.80,,,0,"percent of total billed charges","50% of total billed charges",105.29,32.2,,84.23,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",56.03,17.136,,44.82,,,0,"percent of total billed charges","17.136% of total billed charges",71.42,21.84,,57.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",123.28,37.7,,98.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",255.06,78,,204.05,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",54.94,16.8,,43.95,,,0,"percent of total billed charges","16.8% of total billed charges",163.5,50,,130.80,,,0,"percent of total billed charges","50% of total billed charges",270.1,82.6,,216.08,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",327,100,,261.60,,,0,"percent of total billed charges","100% of total billed charges",50.03,327,
"G0438 Telehealth Annual Wellness Visit FFS - Initi",12896460,CDM,521,RC,,,OUTPATIENT,,,488,317.2,,429.44,88,,343.55,,,0,"percent of total billed charges","88% of total billed charges",244,50,,195.20,,,0,"percent of total billed charges","50% of total billed charges",81.98,16.8,,65.58,,,0,"percent of total billed charges","16.8% of total billed charges",488,100,,390.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",84.44,17.304,,67.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",307.44,63,,245.95,,,0,"percent of total billed charges","63% of total billed charges",74.66,15.3,,59.73,,,0,"percent of total billed charges","15.3% of total billed charges",81.98,16.8,,65.58,,,0,"percent of total billed charges","16.8% of total billed charges",336.72,69,,,,,0,"fee schedule","69% of total billed charges",488,100,,390.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",488,100,,390.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",488,100,,390.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",81.98,16.8,,65.58,,,0,"percent of total billed charges","16.8% of total billed charges",244,50,,195.20,,,0,"percent of total billed charges","50% of total billed charges",157.14,32.2,,125.71,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",83.62,17.136,,66.90,,,0,"percent of total billed charges","17.136% of total billed charges",106.58,21.84,,85.26,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",183.98,37.7,,147.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",380.64,78,,304.51,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",403.09,82.6,,322.47,,,0,"percent of total billed charges","82.6% of total billed charges",81.98,16.8,,65.58,,,0,"percent of total billed charges","16.8% of total billed charges",244,50,,195.20,,,0,"percent of total billed charges","50% of total billed charges",403.09,82.6,,322.47,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",488,100,,390.40,,,0,"percent of total billed charges","100% of total billed charges",74.66,488,
"G0444 Annual depression screening, 15 minutes, med",7903313,CDM,521,RC,,,OUTPATIENT,,,54,35.1,,47.52,88,,38.02,,,0,"percent of total billed charges","88% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.34,17.304,,7.47,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.02,63,,27.22,,,0,"percent of total billed charges","63% of total billed charges",8.26,15.3,,6.61,,,0,"percent of total billed charges","15.3% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",37.26,69,,,,,0,"fee schedule","69% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",17.39,32.2,,13.91,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.25,17.136,,7.40,,,0,"percent of total billed charges","17.136% of total billed charges",11.79,21.84,,9.43,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.36,37.7,,16.29,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",42.12,78,,33.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.6,82.6,,35.68,,,0,"percent of total billed charges","82.6% of total billed charges",9.07,16.8,,7.26,,,0,"percent of total billed charges","16.8% of total billed charges",27,50,,21.60,,,0,"percent of total billed charges","50% of total billed charges",44.6,82.6,,35.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",8.26,160.53,
"G0447 Face-to-face behavioral counseling for obesi",7903318,CDM,521,RC,,,OUTPATIENT,,,60,39,,52.8,88,,42.24,,,0,"percent of total billed charges","88% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.38,17.304,,8.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.8,63,,30.24,,,0,"percent of total billed charges","63% of total billed charges",9.18,15.3,,7.34,,,0,"percent of total billed charges","15.3% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",41.4,69,,,,,0,"fee schedule","69% of total billed charges",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",19.32,32.2,,15.46,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.28,17.136,,8.22,,,0,"percent of total billed charges","17.136% of total billed charges",13.1,21.84,,10.48,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",22.62,37.7,,18.10,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.8,78,,37.44,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.56,82.6,,39.65,,,0,"percent of total billed charges","82.6% of total billed charges",10.08,16.8,,8.06,,,0,"percent of total billed charges","16.8% of total billed charges",30,50,,24.00,,,0,"percent of total billed charges","50% of total billed charges",49.56,82.6,,39.65,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",60,100,,48.00,,,0,"percent of total billed charges","100% of total billed charges",9.18,160.53,
"21235 Graft; ear cartilage, autogenous, to nose or",7903188,CDM,521,RC,21235,CPT,OUTPATIENT,,,1251,813.15,,1100.88,88,,880.70,,,0,"percent of total billed charges","88% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2697.98,100,,,,,0,"fee schedule",EAPG,1251,100,,1000.80,,,0,"percent of total billed charges","100% of total billed charges",10452.87,175,,,,,0,"fee schedule","175% of CMS fee schedule",2778.92,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",788.13,63,,630.50,,,0,"percent of total billed charges","63% of total billed charges",191.4,15.3,,153.12,,,0,"percent of total billed charges","15.3% of total billed charges",2697.98,100,,,,,0,"fee schedule",EAPG,863.19,69,,,,,0,"fee schedule","69% of total billed charges",1251,100,,1000.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1251,100,,1000.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1251,100,,1000.80,,,0,"percent of total billed charges","100% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS fee schedule",20662.24,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2697.98,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5401.89,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2751.94,100,,,,,0,"fee schedule",EAPG,3507.38,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",471.63,37.7,,377.30,,,0,"percent of total billed charges","37.70% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",975.78,78,,780.62,,,0,"percent of total billed charges","78% of total billed charges",6032.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033.33,82.6,,826.66,,,0,"percent of total billed charges","82.6% of total billed charges",2697.98,100,,,,,0,"fee schedule",EAPG,5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1033.33,82.6,,826.66,,,0,"percent of total billed charges","82.6% of total billed charges",5973.07,100,,,,,0,"fee schedule","100% of CMS OPPS rate",2858.51,100,,,,,0,"fee schedule",EAPG,1251,100,,1000.80,,,0,"percent of total billed charges","100% of total billed charges",191.4,20662.24,
"Hematocrit POC",1019800,CDM,300,RC,85014,CPT,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",4.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.23,100,,,,,0,"fee schedule",EAPG,2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.06,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.37,100,,,,,0,"fee schedule","100% of LI fee schedule",3.76,100,,,,,0,"fee schedule",EAPG,2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.18,100,,,,,0,"fee schedule",EAPG,6.61,100,,,,,0,"fee schedule",EAPG,2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.7% of total billed charges",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",6.78,33.9,,5.42,,,0,"percent of total billed charges","33.9% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",2.39,101,,,,,0,"fee schedule","101% of CMS fee schedule ",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",5.08,100,,,,,0,"fee schedule",EAPG,2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.52,82.6,,13.22,,,0,"percent of total billed charges","82.6% of total billed charges",2.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.08,100,,,,,0,"fee schedule",EAPG,20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",2.37,20,
"Hemoglobin A1c POC",1019765,CDM,300,RC,83036,CPT,OUTPATIENT,,,64,41.6,,56.32,88,,45.06,,,0,"percent of total billed charges","88% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",16.99,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",40.32,63,,32.26,,,0,"percent of total billed charges","63% of total billed charges",9.79,15.3,,7.83,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,44.16,69,,,,,0,"fee schedule","69% of total billed charges",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.14,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.71,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",24.13,37.7,,19.30,,,0,"percent of total billed charges","37.7% of total billed charges",24.13,37.7,,19.30,,,0,"percent of total billed charges","37.70% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.7,33.9,,17.36,,,0,"percent of total billed charges","33.9% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",49.92,78,,39.94,,,0,"percent of total billed charges","78% of total billed charges",9.8,101,,,,,0,"fee schedule","101% of CMS fee schedule ",52.86,82.6,,42.29,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.86,82.6,,42.29,,,0,"percent of total billed charges","82.6% of total billed charges",9.71,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,64,100,,51.20,,,0,"percent of total billed charges","100% of total billed charges",3.25,64,
"Hemoccult POC",7945822,CDM,300,RC,82270,CPT,OUTPATIENT,,,27,17.55,,23.76,88,,19.01,,,0,"percent of total billed charges","88% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",7.66,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.53,100,,,,,0,"fee schedule",EAPG,4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",17.01,63,,13.61,,,0,"percent of total billed charges","63% of total billed charges",4.13,15.3,,3.30,,,0,"percent of total billed charges","15.3% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,18.63,69,,,,,0,"fee schedule","69% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.75,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.38,100,,,,,0,"fee schedule","100% of LI fee schedule",3.25,100,,,,,0,"fee schedule",EAPG,4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.48,100,,,,,0,"fee schedule",EAPG,5.71,100,,,,,0,"fee schedule",EAPG,4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.18,37.7,,8.14,,,0,"percent of total billed charges","37.7% of total billed charges",10.18,37.7,,8.14,,,0,"percent of total billed charges","37.70% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.15,33.9,,7.32,,,0,"percent of total billed charges","33.9% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.06,78,,16.85,,,0,"percent of total billed charges","78% of total billed charges",4.42,101,,,,,0,"fee schedule","101% of CMS fee schedule ",22.3,82.6,,17.84,,,0,"percent of total billed charges","82.6% of total billed charges",4.39,100,,,,,0,"fee schedule",EAPG,4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.3,82.6,,17.84,,,0,"percent of total billed charges","82.6% of total billed charges",4.38,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.39,100,,,,,0,"fee schedule",EAPG,27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",3.25,27,
"31237 Nasal/sinus endoscopy, surgical; with biopsy",7903283,CDM,521,RC,31237,CPT,OUTPATIENT,,,642,417.3,,564.96,88,,451.97,,,0,"percent of total billed charges","88% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.64,100,,,,,0,"fee schedule",EAPG,642,100,,513.60,,,0,"percent of total billed charges","100% of total billed charges",3029.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",1806.25,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",404.46,63,,323.57,,,0,"percent of total billed charges","63% of total billed charges",98.23,15.3,,78.58,,,0,"percent of total billed charges","15.3% of total billed charges",1753.64,100,,,,,0,"fee schedule",EAPG,442.98,69,,,,,0,"fee schedule","69% of total billed charges",642,100,,513.60,,,0,"percent of total billed charges","100% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",642,100,,513.60,,,0,"percent of total billed charges","100% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",642,100,,513.60,,,0,"percent of total billed charges","100% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",6079.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1753.64,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1589.31,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1788.71,100,,,,,0,"fee schedule",EAPG,2279.73,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",242.03,37.7,,193.62,,,0,"percent of total billed charges","37.70% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",500.76,78,,400.61,,,0,"percent of total billed charges","78% of total billed charges",1748.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",530.29,82.6,,424.23,,,0,"percent of total billed charges","82.6% of total billed charges",1753.64,100,,,,,0,"fee schedule",EAPG,1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",530.29,82.6,,424.23,,,0,"percent of total billed charges","82.6% of total billed charges",1731.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",1914.17,100,,,,,0,"fee schedule",EAPG,642,100,,513.60,,,0,"percent of total billed charges","100% of total billed charges",98.23,6079.13,
"PPD Administration (TB Screen) POC",1019775,CDM,300,RC,86580,CPT,OUTPATIENT,,,70,45.5,,61.6,88,,49.28,,,0,"percent of total billed charges","88% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9.39,100,,,,,0,"fee schedule",EAPG,70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",53.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",44.1,63,,35.28,,,0,"percent of total billed charges","63% of total billed charges",10.71,15.3,,8.57,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,48.3,69,,,,,0,"fee schedule","69% of total billed charges",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.22,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9.39,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6.96,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.39,37.7,,21.11,,,0,"percent of total billed charges","37.7% of total billed charges",26.39,37.7,,21.11,,,0,"percent of total billed charges","37.70% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.73,33.9,,18.98,,,0,"percent of total billed charges","33.9% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",54.6,78,,43.68,,,0,"percent of total billed charges","78% of total billed charges",30.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",57.82,82.6,,46.26,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",57.82,82.6,,46.26,,,0,"percent of total billed charges","82.6% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9.39,100,,,,,0,"fee schedule",EAPG,70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,100.22,
"PT/INR POC.",7945824,CDM,300,RC,85610,CPT,OUTPATIENT,,,24,15.6,,21.12,88,,16.90,,,0,"percent of total billed charges","88% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",7.5,175,,,,,0,"fee schedule","175% of CMS fee schedule",3.45,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.12,63,,12.10,,,0,"percent of total billed charges","63% of total billed charges",3.67,15.3,,2.94,,,0,"percent of total billed charges","15.3% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,16.56,69,,,,,0,"fee schedule","69% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",16.4,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.29,100,,,,,0,"fee schedule","100% of LI fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.41,100,,,,,0,"fee schedule",EAPG,4.35,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.05,37.7,,7.24,,,0,"percent of total billed charges","37.7% of total billed charges",9.05,37.7,,7.24,,,0,"percent of total billed charges","37.70% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.14,33.9,,6.51,,,0,"percent of total billed charges","33.9% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.72,78,,14.98,,,0,"percent of total billed charges","78% of total billed charges",4.33,101,,,,,0,"fee schedule","101% of CMS fee schedule ",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",3.35,100,,,,,0,"fee schedule",EAPG,4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",4.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.35,100,,,,,0,"fee schedule",EAPG,24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",2.48,24,
"Patient?s Own Medication Used - AST",11560607,CDM,521,RC,,,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",,,,,,,0,other,"not separately reimbursment",160.53,160.53,
"29705 Removal or bivalving; full arm or full leg c",7903156,CDM,521,RC,29705,CPT,OUTPATIENT,,,140,91,,123.2,88,,98.56,,,0,"percent of total billed charges","88% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",479.35,175,,,,,0,"fee schedule","175% of CMS fee schedule",174.75,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",88.2,63,,70.56,,,0,"percent of total billed charges","63% of total billed charges",21.42,15.3,,17.14,,,0,"percent of total billed charges","15.3% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,96.6,69,,,,,0,"fee schedule","69% of total billed charges",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS fee schedule",979.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",169.66,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",256.14,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",173.06,100,,,,,0,"fee schedule",EAPG,220.57,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",52.78,37.7,,42.22,,,0,"percent of total billed charges","37.70% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",109.2,78,,87.36,,,0,"percent of total billed charges","78% of total billed charges",276.64,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.64,82.6,,92.51,,,0,"percent of total billed charges","82.6% of total billed charges",169.66,100,,,,,0,"fee schedule",EAPG,273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.64,82.6,,92.51,,,0,"percent of total billed charges","82.6% of total billed charges",273.91,100,,,,,0,"fee schedule","100% of CMS OPPS rate",330.19,100,,,,,0,"fee schedule",EAPG,140,100,,112.00,,,0,"percent of total billed charges","100% of total billed charges",21.42,979.75,
"29530 Strapping; knee",7903268,CDM,521,RC,29530,CPT,OUTPATIENT,,,96,62.4,,84.48,88,,67.58,,,0,"percent of total billed charges","88% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",40.34,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",60.48,63,,48.38,,,0,"percent of total billed charges","63% of total billed charges",14.69,15.3,,11.75,,,0,"percent of total billed charges","15.3% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,66.24,69,,,,,0,"fee schedule","69% of total billed charges",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.8,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.16,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.94,100,,,,,0,"fee schedule",EAPG,50.91,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",36.19,37.7,,28.95,,,0,"percent of total billed charges","37.70% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",74.88,78,,59.90,,,0,"percent of total billed charges","78% of total billed charges",131.59,100,,,,,0,"fee schedule","100% of CMS OPPS rate",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",39.16,100,,,,,0,"fee schedule",EAPG,130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",79.3,82.6,,63.44,,,0,"percent of total billed charges","82.6% of total billed charges",130.29,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.69,100,,,,,0,"fee schedule",EAPG,96,100,,76.80,,,0,"percent of total billed charges","100% of total billed charges",14.69,454.8,
"Urine Microscopy POC",3808345,CDM,300,RC,81001,CPT,OUTPATIENT,,,33,21.45,,29.04,88,,23.23,,,0,"percent of total billed charges","88% of total billed charges",3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",5.54,175,,,,,0,"fee schedule","175% of CMS fee schedule",2.55,100,,,,,0,"fee schedule",EAPG,3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",20.79,63,,16.63,,,0,"percent of total billed charges","63% of total billed charges",5.05,15.3,,4.04,,,0,"percent of total billed charges","15.3% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,22.77,69,,,,,0,"fee schedule","69% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.12,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.17,100,,,,,0,"fee schedule","100% of LI fee schedule",1.83,100,,,,,0,"fee schedule",EAPG,3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.52,100,,,,,0,"fee schedule",EAPG,3.22,100,,,,,0,"fee schedule",EAPG,3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",12.44,37.7,,9.95,,,0,"percent of total billed charges","37.7% of total billed charges",12.44,37.7,,9.95,,,0,"percent of total billed charges","37.70% of total billed charges",3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.19,33.9,,8.95,,,0,"percent of total billed charges","33.9% of total billed charges",3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",25.74,78,,20.59,,,0,"percent of total billed charges","78% of total billed charges",3.2,101,,,,,0,"fee schedule","101% of CMS fee schedule ",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.26,82.6,,21.81,,,0,"percent of total billed charges","82.6% of total billed charges",3.17,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",1.83,33,
"electrocardiogram w/ 12+ leads; Tracing/Interp/Rep",8592006,CDM,730,RC,93000,CPT,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.76,100,,,,,0,"fee schedule",EAPG,47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.47,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",23.76,100,,,,,0,"fee schedule",EAPG,32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.76,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.6,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",24.23,100,,,,,0,"fee schedule",EAPG,30.89,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.7% of total billed charges",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.93,33.9,,12.74,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",23.76,100,,,,,0,"fee schedule","100% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.76,100,,,,,0,"fee schedule",EAPG,47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,47,
"1026M ATTENDING PHYSICIAN FINAL REPORT",8152807,CDM,521,RC,1026M,CPT,OUTPATIENT,,,28,18.2,,24.64,88,,19.71,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.64,63,,14.11,,,0,"percent of total billed charges","63% of total billed charges",4.28,15.3,,3.42,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.32,69,,,,,0,"fee schedule","69% of total billed charges",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.56,37.7,,8.45,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.84,78,,17.47,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.13,82.6,,18.50,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",28,100,,22.40,,,0,"percent of total billed charges","100% of total billed charges",4.28,160.53,
"1027M LOSS OF EARNINGS POWER FOR",8152808,CDM,521,RC,1027M,CPT,OUTPATIENT,,,25,16.25,,22,88,,17.60,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.75,63,,12.60,,,0,"percent of total billed charges","63% of total billed charges",3.83,15.3,,3.06,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.25,69,,,,,0,"fee schedule","69% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.43,37.7,,7.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.5,78,,15.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.65,82.6,,16.52,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",3.83,160.53,
"1028M JOB ANALYSIS ADDITIONAL",8152809,CDM,521,RC,1028M,CPT,OUTPATIENT,,,42,27.3,,36.96,88,,29.57,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.46,63,,21.17,,,0,"percent of total billed charges","63% of total billed charges",6.43,15.3,,5.14,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.98,69,,,,,0,"fee schedule","69% of total billed charges",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.83,37.7,,12.66,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",32.76,78,,26.21,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.69,82.6,,27.75,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",42,100,,33.60,,,0,"percent of total billed charges","100% of total billed charges",6.43,160.53,
"1038M JOB ANALYSIS FIRST",8152810,CDM,521,RC,1038M,CPT,OUTPATIENT,,,56,36.4,,49.28,88,,39.42,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.28,63,,28.22,,,0,"percent of total billed charges","63% of total billed charges",8.57,15.3,,6.86,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.64,69,,,,,0,"fee schedule","69% of total billed charges",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.11,37.7,,16.89,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.68,78,,34.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",46.26,82.6,,37.01,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",56,100,,44.80,,,0,"percent of total billed charges","100% of total billed charges",8.57,160.53,
"1040M RPT OF INJURY",8152811,CDM,521,RC,1040M,CPT,OUTPATIENT,,,65,42.25,,57.2,88,,45.76,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",40.95,63,,32.76,,,0,"percent of total billed charges","63% of total billed charges",9.95,15.3,,7.96,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.85,69,,,,,0,"fee schedule","69% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.51,37.7,,19.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.7,78,,40.56,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",53.69,82.6,,42.95,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",9.95,160.53,
"1041M L&I RE-OPEN CLAIM",8152812,CDM,521,RC,1041M,CPT,OUTPATIENT,,,63,40.95,,55.44,88,,44.35,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39.69,63,,31.75,,,0,"percent of total billed charges","63% of total billed charges",9.64,15.3,,7.71,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.47,69,,,,,0,"fee schedule","69% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.75,37.7,,19.00,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",49.14,78,,39.31,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.04,82.6,,41.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",52.04,82.6,,41.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",9.64,160.53,
"1048M ESTIMATE OF PHYSICIAN CAP L&I",8152813,CDM,521,RC,1048M,CPT,OUTPATIENT,,,24,15.6,,21.12,88,,16.90,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.12,63,,12.10,,,0,"percent of total billed charges","63% of total billed charges",3.67,15.3,,2.94,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.56,69,,,,,0,"fee schedule","69% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",9.05,37.7,,7.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.72,78,,14.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",19.82,82.6,,15.86,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,160.53,
"1055M OCCUPATIONAL HX FORM",8152814,CDM,521,RC,1055M,CPT,OUTPATIENT,,,234,152.1,,205.92,88,,164.74,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",147.42,63,,117.94,,,0,"percent of total billed charges","63% of total billed charges",35.8,15.3,,28.64,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",161.46,69,,,,,0,"fee schedule","69% of total billed charges",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",88.22,37.7,,70.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",182.52,78,,146.02,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",193.28,82.6,,154.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",193.28,82.6,,154.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",35.8,234,
"1056M PHYSICIANS SUPPLEMENTAL RPT",8152815,CDM,521,RC,1056M,CPT,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.22,82.6,,10.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,160.53,
"1057M OPIOID PROGRESS RPT SUPP",8152816,CDM,521,RC,1057M,CPT,OUTPATIENT,,,32,20.8,,28.16,88,,22.53,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.16,63,,16.13,,,0,"percent of total billed charges","63% of total billed charges",4.9,15.3,,3.92,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.08,69,,,,,0,"fee schedule","69% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.96,78,,19.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",4.9,160.53,
"1063M IME REVIEW",8152817,CDM,521,RC,1063M,CPT,OUTPATIENT,,,48,31.2,,42.24,88,,33.79,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.24,63,,24.19,,,0,"percent of total billed charges","63% of total billed charges",7.34,15.3,,5.87,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.12,69,,,,,0,"fee schedule","69% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",18.1,37.7,,14.48,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",37.44,78,,29.95,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.65,82.6,,31.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39.65,82.6,,31.72,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",7.34,160.53,
"1065M ATTENDING DOCTOR IME REVIEW WRITTEN REPO",8152818,CDM,521,RC,1065M,CPT,OUTPATIENT,,,32,20.8,,28.16,88,,22.53,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.16,63,,16.13,,,0,"percent of total billed charges","63% of total billed charges",4.9,15.3,,3.92,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.08,69,,,,,0,"fee schedule","69% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.96,78,,19.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.43,82.6,,21.14,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",4.9,160.53,
"1068M IMPEDIMENTS TO RETURN TO WORK",8153048,CDM,521,RC,1068M,CPT,OUTPATIENT,,,164,106.6,,144.32,88,,115.46,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",103.32,63,,82.66,,,0,"percent of total billed charges","63% of total billed charges",25.09,15.3,,20.07,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.16,69,,,,,0,"fee schedule","69% of total billed charges",164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",61.83,37.7,,49.46,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",127.92,78,,102.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",135.46,82.6,,108.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",135.46,82.6,,108.37,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",164,100,,131.20,,,0,"percent of total billed charges","100% of total billed charges",25.09,164,
"1069M COHE WORK STATUS ACTIVITY RX",8154197,CDM,521,RC,1069M,CPT,OUTPATIENT,,,54,35.1,,47.52,88,,38.02,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.02,63,,27.22,,,0,"percent of total billed charges","63% of total billed charges",8.26,15.3,,6.61,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",37.26,69,,,,,0,"fee schedule","69% of total billed charges",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.36,37.7,,16.29,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",42.12,78,,33.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.6,82.6,,35.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",44.6,82.6,,35.68,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",54,100,,43.20,,,0,"percent of total billed charges","100% of total billed charges",8.26,160.53,
"1071M INCENTIVE PAY",8154878,CDM,521,RC,1071M,CPT,OUTPATIENT,,,117,76.05,,102.96,88,,82.37,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",73.71,63,,58.97,,,0,"percent of total billed charges","63% of total billed charges",17.9,15.3,,14.32,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",80.73,69,,,,,0,"fee schedule","69% of total billed charges",117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",44.11,37.7,,35.29,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",91.26,78,,73.01,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",96.64,82.6,,77.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",96.64,82.6,,77.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",117,100,,93.60,,,0,"percent of total billed charges","100% of total billed charges",17.9,160.53,
"1073M ACTIVITY PRESCRIPTION FORM",8154879,CDM,521,RC,1073M,CPT,OUTPATIENT,,,63,40.95,,55.44,88,,44.35,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",39.69,63,,31.75,,,0,"percent of total billed charges","63% of total billed charges",9.64,15.3,,7.71,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",43.47,69,,,,,0,"fee schedule","69% of total billed charges",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23.75,37.7,,19.00,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",49.14,78,,39.31,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.04,82.6,,41.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",52.04,82.6,,41.63,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",63,100,,50.40,,,0,"percent of total billed charges","100% of total billed charges",9.64,160.53,
"1074M PHYSICAL CAPACITIES EVAL",8154880,CDM,521,RC,1074M,CPT,OUTPATIENT,,,34,22.1,,29.92,88,,23.94,,,0,"percent of total billed charges","88% of total billed charges",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.42,63,,17.14,,,0,"percent of total billed charges","63% of total billed charges",5.2,15.3,,4.16,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.46,69,,,,,0,"fee schedule","69% of total billed charges",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.03,61.85,,16.82,,,0,"percent of total billed charges","61.5% of total billed charges",,,,,,,0,other,"not separately reimbursment",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",10.95,32.2,,8.76,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",12.82,37.7,,10.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.52,78,,21.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",17,50,,13.60,,,0,"percent of total billed charges","50% of total billed charges",28.08,82.6,,22.46,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",34,100,,27.20,,,0,"percent of total billed charges","100% of total billed charges",5.2,160.53,
"1075M FRI TRACKING SHEET",8154881,CDM,521,RC,1075M,CPT,OUTPATIENT,,,40,26,,35.2,88,,28.16,,,0,"percent of total billed charges","88% of total billed charges",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",25.2,63,,20.16,,,0,"percent of total billed charges","63% of total billed charges",6.12,15.3,,4.90,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.6,69,,,,,0,"fee schedule","69% of total billed charges",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.74,61.85,,19.79,,,0,"percent of total billed charges","61.5% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",12.88,32.2,,10.30,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.08,37.7,,12.06,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",31.2,78,,24.96,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,50,,16.00,,,0,"percent of total billed charges","50% of total billed charges",33.04,82.6,,26.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",40,100,,32.00,,,0,"percent of total billed charges","100% of total billed charges",6.12,160.53,
"1076M OPIOID REQUEST FOR SUBACUTE PAIN",8160736,CDM,521,RC,1076M,CPT,OUTPATIENT,,,39,25.35,,34.32,88,,27.46,,,0,"percent of total billed charges","88% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.57,63,,19.66,,,0,"percent of total billed charges","63% of total billed charges",5.97,15.3,,4.78,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.91,69,,,,,0,"fee schedule","69% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.12,61.85,,19.30,,,0,"percent of total billed charges","61.5% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",12.56,32.2,,10.05,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.42,78,,24.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",5.97,160.53,
"1077M OPIOID REQ FOR SUBACUTE PAIN W/DOCUMENTATION",8160737,CDM,521,RC,1077M,CPT,OUTPATIENT,,,72,46.8,,63.36,88,,50.69,,,0,"percent of total billed charges","88% of total billed charges",36,50,,28.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",45.36,63,,36.29,,,0,"percent of total billed charges","63% of total billed charges",11.02,15.3,,8.82,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.68,69,,,,,0,"fee schedule","69% of total billed charges",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.53,61.85,,35.62,,,0,"percent of total billed charges","61.5% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,50,,28.80,,,0,"percent of total billed charges","50% of total billed charges",23.18,32.2,,18.54,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",27.14,37.7,,21.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",56.16,78,,44.93,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",59.47,82.6,,47.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",36,50,,28.80,,,0,"percent of total billed charges","50% of total billed charges",59.47,82.6,,47.58,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",11.02,160.53,
"1078M OPIOID REQUEST FOR CHRONIC PAIN",8160738,CDM,521,RC,1078M,CPT,OUTPATIENT,,,39,25.35,,34.32,88,,27.46,,,0,"percent of total billed charges","88% of total billed charges",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",24.57,63,,19.66,,,0,"percent of total billed charges","63% of total billed charges",5.97,15.3,,4.78,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",26.91,69,,,,,0,"fee schedule","69% of total billed charges",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.12,61.85,,19.30,,,0,"percent of total billed charges","61.5% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",12.56,32.2,,10.05,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",14.7,37.7,,11.76,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.42,78,,24.34,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.5,50,,15.60,,,0,"percent of total billed charges","50% of total billed charges",32.21,82.6,,25.77,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",39,100,,31.20,,,0,"percent of total billed charges","100% of total billed charges",5.97,160.53,
"1191M IME EXPANDED",8164696,CDM,521,RC,1191M,CPT,OUTPATIENT,,,675,438.75,,594,88,,475.20,,,0,"percent of total billed charges","88% of total billed charges",337.5,50,,270.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",675,100,,540.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",425.25,63,,340.20,,,0,"percent of total billed charges","63% of total billed charges",103.28,15.3,,82.62,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",465.75,69,,,,,0,"fee schedule","69% of total billed charges",675,100,,540.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",675,100,,540.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",675,100,,540.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",417.49,61.85,,333.99,,,0,"percent of total billed charges","61.5% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.5,50,,270.00,,,0,"percent of total billed charges","50% of total billed charges",217.35,32.2,,173.88,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",254.48,37.7,,203.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",526.5,78,,421.20,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",557.55,82.6,,446.04,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",337.5,50,,270.00,,,0,"percent of total billed charges","50% of total billed charges",557.55,82.6,,446.04,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",675,100,,540.00,,,0,"percent of total billed charges","100% of total billed charges",103.28,675,
"1192M IME DETAILED",8164697,CDM,521,RC,1192M,CPT,OUTPATIENT,,,816,530.4,,718.08,88,,574.46,,,0,"percent of total billed charges","88% of total billed charges",408,50,,326.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",816,100,,652.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",514.08,63,,411.26,,,0,"percent of total billed charges","63% of total billed charges",124.85,15.3,,99.88,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",563.04,69,,,,,0,"fee schedule","69% of total billed charges",816,100,,652.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",816,100,,652.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",816,100,,652.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",504.7,61.85,,403.76,,,0,"percent of total billed charges","61.5% of total billed charges",,,,,,,0,other,"not separately reimbursment",408,50,,326.40,,,0,"percent of total billed charges","50% of total billed charges",262.75,32.2,,210.20,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",307.63,37.7,,246.10,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",636.48,78,,509.18,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",674.02,82.6,,539.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",408,50,,326.40,,,0,"percent of total billed charges","50% of total billed charges",674.02,82.6,,539.22,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",816,100,,652.80,,,0,"percent of total billed charges","100% of total billed charges",124.85,816,
"1198M IMPAIR RATE ADDENDUM PER 30",8164698,CDM,521,RC,1198M,CPT,OUTPATIENT,,,152,98.8,,133.76,88,,107.01,,,0,"percent of total billed charges","88% of total billed charges",76,50,,60.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",95.76,63,,76.61,,,0,"percent of total billed charges","63% of total billed charges",23.26,15.3,,18.61,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.88,69,,,,,0,"fee schedule","69% of total billed charges",152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",94.01,61.85,,75.21,,,0,"percent of total billed charges","61.5% of total billed charges",,,,,,,0,other,"not separately reimbursment",76,50,,60.80,,,0,"percent of total billed charges","50% of total billed charges",48.94,32.2,,39.15,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",57.3,37.7,,45.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",118.56,78,,94.85,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",125.55,82.6,,100.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",76,50,,60.80,,,0,"percent of total billed charges","50% of total billed charges",125.55,82.6,,100.44,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",152,100,,121.60,,,0,"percent of total billed charges","100% of total billed charges",23.26,160.53,
"96136 Psych or neuropsych test administration and",8768521,CDM,521,RC,96136,CPT,OUTPATIENT,,,76,49.4,,66.88,88,,53.50,,,0,"percent of total billed charges","88% of total billed charges",130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",521.69,100,,,,,0,"fee schedule",EAPG,76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",228,175,,,,,0,"fee schedule","175% of CMS fee schedule",537.34,100,,,,,0,"fee schedule",EAPG,130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47.88,63,,38.30,,,0,"percent of total billed charges","63% of total billed charges",11.63,15.3,,9.30,,,0,"percent of total billed charges","15.3% of total billed charges",521.69,100,,,,,0,"fee schedule",EAPG,52.44,69,,,,,0,"fee schedule","69% of total billed charges",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",130.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",454.79,100,,,,,0,"fee schedule","100% of CMS OPPS rate",521.69,100,,,,,0,"fee schedule",EAPG,130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",118.9,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",532.13,100,,,,,0,"fee schedule",EAPG,678.2,100,,,,,0,"fee schedule",EAPG,130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",28.65,37.7,,22.92,,,0,"percent of total billed charges","37.70% of total billed charges",130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.28,78,,47.42,,,0,"percent of total billed charges","78% of total billed charges",131.58,100,,,,,0,"fee schedule","100% of CMS OPPS rate",62.78,82.6,,50.22,,,0,"percent of total billed charges","82.6% of total billed charges",521.69,100,,,,,0,"fee schedule",EAPG,130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",62.78,82.6,,50.22,,,0,"percent of total billed charges","82.6% of total billed charges",130.28,100,,,,,0,"fee schedule","100% of CMS OPPS rate",682.22,100,,,,,0,"fee schedule",EAPG,76,100,,60.80,,,0,"percent of total billed charges","100% of total billed charges",11.63,682.22,
"96368 Intravenous infusion, for therapy, prophylax",8092741,CDM,521,RC,96368,CPT,OUTPATIENT,,,197,128.05,,173.36,88,,138.69,,,0,"percent of total billed charges","88% of total billed charges",98.5,50,,78.80,,,0,"percent of total billed charges","50% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,197,100,,157.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.17,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",30.14,15.3,,24.11,,,0,"percent of total billed charges","15.3% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,135.93,69,,,,,0,"fee schedule","69% of total billed charges",197,100,,157.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",197,100,,157.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",197,100,,157.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",121.84,61.85,,97.47,,,0,"percent of total billed charges","61.5% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,98.5,50,,78.80,,,0,"percent of total billed charges","50% of total billed charges",63.43,32.2,,50.74,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",278.44,100,,,,,0,"fee schedule",EAPG,354.88,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",74.27,37.7,,59.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",153.66,78,,122.93,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.72,82.6,,130.18,,,0,"percent of total billed charges","82.6% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,98.5,50,,78.80,,,0,"percent of total billed charges","50% of total billed charges",162.72,82.6,,130.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",433.51,100,,,,,0,"fee schedule",EAPG,197,100,,157.60,,,0,"percent of total billed charges","100% of total billed charges",30.14,433.51,
"96367 Intravenous infusion, for therapy, prophylax",8092744,CDM,521,RC,96367,CPT,OUTPATIENT,,,157,102.05,,138.16,88,,110.53,,,0,"percent of total billed charges","88% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,157,100,,125.60,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",281.17,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",24.02,15.3,,19.22,,,0,"percent of total billed charges","15.3% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,108.33,69,,,,,0,"fee schedule","69% of total billed charges",157,100,,125.60,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",157,100,,125.60,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",157,100,,125.60,,,0,"percent of total billed charges","100% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.74,100,,,,,0,"fee schedule","100% of CMS OPPS rate",272.98,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",278.44,100,,,,,0,"fee schedule",EAPG,354.88,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",59.19,37.7,,47.35,,,0,"percent of total billed charges","37.70% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",122.46,78,,97.97,,,0,"percent of total billed charges","78% of total billed charges",72.56,100,,,,,0,"fee schedule","100% of CMS OPPS rate",129.68,82.6,,103.74,,,0,"percent of total billed charges","82.6% of total billed charges",272.98,100,,,,,0,"fee schedule",EAPG,71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",129.68,82.6,,103.74,,,0,"percent of total billed charges","82.6% of total billed charges",71.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",433.51,100,,,,,0,"fee schedule",EAPG,157,100,,125.60,,,0,"percent of total billed charges","100% of total billed charges",24.02,433.51,
"97537 Community/work reintegration training; each",7963969,CDM,521,RC,97537,CPT,OUTPATIENT,,,85,55.25,,74.8,88,,59.84,,,0,"percent of total billed charges","88% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",56.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee sv",53.55,63,,42.84,,,0,"percent of total billed charges","63% of total billed charges",13.01,15.3,,10.41,,,0,"percent of total billed charges","15.3% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",58.65,69,,,,,0,"fee schedule","69% of total billed charges",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",32.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",124.24,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.75,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.17,102,,,,,0,"fee schedule","102% of WA fee schedule",24.43,130,,,,,0,"fee schedule","130% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",32.05,37.7,,25.64,,,0,"percent of total billed charges","37.70% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",66.3,78,,53.04,,,0,"percent of total billed charges","78% of total billed charges",32.6,101,,,,,0,"fee schedule","101% of CMS fee schedule ",70.21,82.6,,56.17,,,0,"percent of total billed charges","82.6% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",70.21,82.6,,56.17,,,0,"percent of total billed charges","82.6% of total billed charges",32.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.53,100,,,,,0,"case rate","pays based on per visit rate",85,100,,68.00,,,0,"percent of total billed charges","100% of total billed charges",13.01,160.53,
"97535 Self-care/home management training; each 15",7963975,CDM,521,RC,97535,CPT,OUTPATIENT,,,99,64.35,,87.12,88,,69.70,,,0,"percent of total billed charges","88% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",58.07,175,,,,,0,"fee schedule","175% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee sv",62.37,63,,49.90,,,0,"percent of total billed charges","63% of total billed charges",15.15,15.3,,12.12,,,0,"percent of total billed charges","15.3% of total billed charges",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",68.31,69,,,,,0,"fee schedule","69% of total billed charges",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",33.18,100,,,,,0,"fee schedule","100% of CMS fee schedule",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",129.71,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.77,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.75,102,,,,,0,"fee schedule","102% of WA fee schedule",25.17,130,,,,,0,"fee schedule","130% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",37.32,37.7,,29.86,,,0,"percent of total billed charges","37.70% of total billed charges",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",77.22,78,,61.78,,,0,"percent of total billed charges","78% of total billed charges",33.68,101,,,,,0,"fee schedule","101% of CMS fee schedule ",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",19.36,100,,,,,0,"fee schedule","100% of WA fee schedule",33.35,100,,,,,0,"fee schedule","100% of CMS fee schedule",81.77,82.6,,65.42,,,0,"percent of total billed charges","82.6% of total billed charges",33.36,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.53,100,,,,,0,"case rate","pays based on per visit rate",99,100,,79.20,,,0,"percent of total billed charges","100% of total billed charges",15.15,160.53,
"97542 Wheelchair management (eg, assessment, fitti",7963946,CDM,521,RC,97542,CPT,OUTPATIENT,,,88,57.2,,77.44,88,,61.95,,,0,"percent of total billed charges","88% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",56.19,175,,,,,0,"fee schedule","175% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee sv",55.44,63,,44.35,,,0,"percent of total billed charges","63% of total billed charges",13.46,15.3,,10.77,,,0,"percent of total billed charges","15.3% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",60.72,69,,,,,0,"fee schedule","69% of total billed charges",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",32.11,100,,,,,0,"fee schedule","100% of CMS fee schedule",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",125.57,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.75,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.17,102,,,,,0,"fee schedule","102% of WA fee schedule",24.43,130,,,,,0,"fee schedule","130% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",33.18,37.7,,26.54,,,0,"percent of total billed charges","37.70% of total billed charges",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.64,78,,54.91,,,0,"percent of total billed charges","78% of total billed charges",32.6,101,,,,,0,"fee schedule","101% of CMS fee schedule ",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",32.28,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",32.29,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.53,100,,,,,0,"case rate","pays based on per visit rate",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",13.46,160.53,
"97763 Orthotic/prosthetic subsequent mgt, each 15",8209107,CDM,521,RC,97763,CPT,OUTPATIENT,,,200,130,,176,88,,140.80,,,0,"percent of total billed charges","88% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",93.77,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.83,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee sv",126,63,,100.80,,,0,"percent of total billed charges","63% of total billed charges",30.6,15.3,,24.48,,,0,"percent of total billed charges","15.3% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,138,69,,,,,0,"fee schedule","69% of total billed charges",200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",53.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",212.21,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",34.79,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",52.67,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",35.48,100,,,,,0,"fee schedule",EAPG,45.23,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",75.4,37.7,,60.32,,,0,"percent of total billed charges","37.70% of total billed charges",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",156,78,,124.80,,,0,"percent of total billed charges","78% of total billed charges",54.28,101,,,,,0,"fee schedule","101% of CMS fee schedule ",165.2,82.6,,132.16,,,0,"percent of total billed charges","82.6% of total billed charges",34.79,100,,,,,0,"fee schedule",EAPG,53.74,100,,,,,0,"fee schedule","100% of CMS fee schedule",165.2,82.6,,132.16,,,0,"percent of total billed charges","82.6% of total billed charges",53.75,100,,,,,0,"fee schedule","100% of CMS fee schedule",195.32,100,,,,,0,"fee schedule",EAPG,200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",30.6,212.21,
"97802 Medical nutrition therapy initial assessmen",7963944,CDM,521,RC,97802,CPT,OUTPATIENT,,,100,65,,88,88,,70.40,,,0,"percent of total billed charges","88% of total billed charges",32.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.64,100,,,,,0,"fee schedule","100% of WA fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",56.11,175,,,,,0,"fee schedule","175% of CMS fee schedule",21.64,100,,,,,0,"fee schedule","100% of WA fee schedule",32.22,100,,,,,0,"fee schedule","100% of CMS fee sv",63,63,,50.40,,,0,"percent of total billed charges","63% of total billed charges",15.3,15.3,,12.24,,,0,"percent of total billed charges","15.3% of total billed charges",21.64,100,,,,,0,"fee schedule","100% of WA fee schedule",69,69,,,,,0,"fee schedule","69% of total billed charges",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",32.06,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",32.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",32.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",126.84,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",21.64,100,,,,,0,"fee schedule","100% of WA fee schedule",32.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",31.72,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",32.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.07,102,,,,,0,"fee schedule","102% of WA fee schedule",28.13,130,,,,,0,"fee schedule","130% of WA fee schedule",32.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",37.7,37.7,,30.16,,,0,"percent of total billed charges","37.70% of total billed charges",32.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",32.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",78,78,,62.40,,,0,"percent of total billed charges","78% of total billed charges",32.54,101,,,,,0,"fee schedule","101% of CMS fee schedule ",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",21.64,100,,,,,0,"fee schedule","100% of WA fee schedule",32.22,100,,,,,0,"fee schedule","100% of CMS fee schedule",82.6,82.6,,66.08,,,0,"percent of total billed charges","82.6% of total billed charges",32.23,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.53,100,,,,,0,"case rate","pays based on per visit rate",100,100,,80.00,,,0,"percent of total billed charges","100% of total billed charges",15.3,160.53,
"97804 Medical nutrition therapy; group (2 or more",7963945,CDM,521,RC,97804,CPT,OUTPATIENT,,,44,28.6,,38.72,88,,30.98,,,0,"percent of total billed charges","88% of total billed charges",15.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.87,100,,,,,0,"fee schedule","100% of WA fee schedule",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",26.95,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.87,100,,,,,0,"fee schedule","100% of WA fee schedule",15.57,100,,,,,0,"fee schedule","100% of CMS fee sv",27.72,63,,22.18,,,0,"percent of total billed charges","63% of total billed charges",6.73,15.3,,5.38,,,0,"percent of total billed charges","15.3% of total billed charges",9.87,100,,,,,0,"fee schedule","100% of WA fee schedule",30.36,69,,,,,0,"fee schedule","69% of total billed charges",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",15.4,100,,,,,0,"fee schedule","100% of CMS fee schedule",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",15.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",15.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.05,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",9.87,100,,,,,0,"fee schedule","100% of WA fee schedule",15.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",15.32,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",15.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",10.07,102,,,,,0,"fee schedule","102% of WA fee schedule",12.83,130,,,,,0,"fee schedule","130% of WA fee schedule",15.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",16.59,37.7,,13.27,,,0,"percent of total billed charges","37.70% of total billed charges",15.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",15.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",34.32,78,,27.46,,,0,"percent of total billed charges","78% of total billed charges",15.73,101,,,,,0,"fee schedule","101% of CMS fee schedule ",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",9.87,100,,,,,0,"fee schedule","100% of WA fee schedule",15.57,100,,,,,0,"fee schedule","100% of CMS fee schedule",36.34,82.6,,29.07,,,0,"percent of total billed charges","82.6% of total billed charges",15.58,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.53,100,,,,,0,"case rate","pays based on per visit rate",44,100,,35.20,,,0,"percent of total billed charges","100% of total billed charges",6.73,160.53,
"97803 Medical nutrition therapy; re-assessment and",7963947,CDM,521,RC,97803,CPT,OUTPATIENT,,,88,57.2,,77.44,88,,61.95,,,0,"percent of total billed charges","88% of total billed charges",27.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",47.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",27.46,100,,,,,0,"fee schedule","100% of CMS fee sv",55.44,63,,44.35,,,0,"percent of total billed charges","63% of total billed charges",13.46,15.3,,10.77,,,0,"percent of total billed charges","15.3% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",60.72,69,,,,,0,"fee schedule","69% of total billed charges",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",27.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",27.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",27.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",108.06,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",27.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.04,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",27.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",19.17,102,,,,,0,"fee schedule","102% of WA fee schedule",24.43,130,,,,,0,"fee schedule","130% of WA fee schedule",27.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",33.18,37.7,,26.54,,,0,"percent of total billed charges","37.70% of total billed charges",27.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",27.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",68.64,78,,54.91,,,0,"percent of total billed charges","78% of total billed charges",27.73,101,,,,,0,"fee schedule","101% of CMS fee schedule ",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",18.79,100,,,,,0,"fee schedule","100% of WA fee schedule",27.46,100,,,,,0,"fee schedule","100% of CMS fee schedule",72.69,82.6,,58.15,,,0,"percent of total billed charges","82.6% of total billed charges",27.47,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.53,100,,,,,0,"case rate","pays based on per visit rate",88,100,,70.40,,,0,"percent of total billed charges","100% of total billed charges",13.46,160.53,
"98967 Telephone assessment/management by nonphysic",7963939,CDM,521,RC,98967,CPT,OUTPATIENT,,,48,31.2,,42.24,88,,33.79,,,0,"percent of total billed charges","88% of total billed charges",22.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",38.17,175,,,,,0,"fee schedule","175% of CMS fee schedule",8.31,17.304,,6.65,,,0,"percent of total billed charges","17.304% of total billed charges",22.14,100,,,,,0,"fee schedule","100% of CMS fee sv",30.24,63,,24.19,,,0,"percent of total billed charges","63% of total billed charges",7.34,15.3,,5.87,,,0,"percent of total billed charges","15.3% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",33.12,69,,,,,0,"fee schedule","69% of total billed charges",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",21.81,100,,,,,0,"fee schedule","100% of CMS fee schedule",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",22.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",22.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",96.39,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",22.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.86,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",22.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.23,17.136,,6.58,,,0,"percent of total billed charges","17.136% of total billed charges",10.48,21.84,,8.38,,,0,"percent of total billed charges","21.84% of total billed charges",22.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",18.1,37.7,,14.48,,,0,"percent of total billed charges","37.70% of total billed charges",22.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",22.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",37.44,78,,29.95,,,0,"percent of total billed charges","78% of total billed charges",22.36,101,,,,,0,"fee schedule","101% of CMS fee schedule ",39.65,82.6,,31.72,,,0,"percent of total billed charges","82.6% of total billed charges",8.06,16.8,,6.45,,,0,"percent of total billed charges","16.8% of total billed charges",22.14,100,,,,,0,"fee schedule","100% of CMS fee schedule",39.65,82.6,,31.72,,,0,"percent of total billed charges","82.6% of total billed charges",22.15,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.53,100,,,,,0,"case rate","pays based on per visit rate",48,100,,38.40,,,0,"percent of total billed charges","100% of total billed charges",7.34,160.53,
"98966 Telephone assessment/management; est pt/pare",7963950,CDM,521,RC,98966,CPT,OUTPATIENT,,,27,17.55,,23.76,88,,19.01,,,0,"percent of total billed charges","88% of total billed charges",11.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",19.69,175,,,,,0,"fee schedule","175% of CMS fee schedule",4.67,17.304,,3.74,,,0,"percent of total billed charges","17.304% of total billed charges",11.41,100,,,,,0,"fee schedule","100% of CMS fee sv",17.01,63,,13.61,,,0,"percent of total billed charges","63% of total billed charges",4.13,15.3,,3.30,,,0,"percent of total billed charges","15.3% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",18.63,69,,,,,0,"fee schedule","69% of total billed charges",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",11.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",11.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",11.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",48.88,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",11.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.26,100,,,,,0,"fee schedule","100% of LI fee schedule",,,,,,,0,other,"not separately reimbursment",11.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.63,17.136,,3.70,,,0,"percent of total billed charges","17.136% of total billed charges",5.9,21.84,,4.72,,,0,"percent of total billed charges","21.84% of total billed charges",11.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",10.18,37.7,,8.14,,,0,"percent of total billed charges","37.70% of total billed charges",11.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",11.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",21.06,78,,16.85,,,0,"percent of total billed charges","78% of total billed charges",11.52,101,,,,,0,"fee schedule","101% of CMS fee schedule ",22.3,82.6,,17.84,,,0,"percent of total billed charges","82.6% of total billed charges",4.54,16.8,,3.63,,,0,"percent of total billed charges","16.8% of total billed charges",11.41,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.3,82.6,,17.84,,,0,"percent of total billed charges","82.6% of total billed charges",11.42,100,,,,,0,"fee schedule","100% of CMS fee schedule",160.53,100,,,,,0,"case rate","pays based on per visit rate",27,100,,21.60,,,0,"percent of total billed charges","100% of total billed charges",4.13,160.53,
"99024 Postoperative follow up visit",7947787,CDM,521,RC,99024,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",,,,,,,0,other,"not separately reimbursment",160.53,160.53,
"99080 Special reports, insurance forms, ect",7947786,CDM,521,RC,99080,CPT,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",29.61,63,,23.69,,,0,"percent of total billed charges","63% of total billed charges",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,160.53,
"99205 New patient visit- level 5",7947780,CDM,521,RC,99205,CPT,OUTPATIENT,,,380,247,,334.4,88,,267.52,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.84,16.8,,51.07,,,0,"percent of total billed charges","16.8% of total billed charges",380,100,,304.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",65.76,17.304,,52.61,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",239.4,63,,191.52,,,0,"percent of total billed charges","63% of total billed charges",58.14,15.3,,46.51,,,0,"percent of total billed charges","15.3% of total billed charges",63.84,16.8,,51.07,,,0,"percent of total billed charges","16.8% of total billed charges",262.2,69,,,,,0,"fee schedule","69% of total billed charges",380,100,,304.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",380,100,,304.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",380,100,,304.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",63.84,16.8,,51.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",65.12,17.136,,52.10,,,0,"percent of total billed charges","17.136% of total billed charges",82.99,21.84,,66.39,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",143.26,37.7,,114.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",296.4,78,,237.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.88,82.6,,251.10,,,0,"percent of total billed charges","82.6% of total billed charges",63.84,16.8,,51.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",313.88,82.6,,251.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",380,100,,304.00,,,0,"percent of total billed charges","100% of total billed charges",58.14,380,
"99204 New patient visit- level 4",7947781,CDM,521,RC,99204,CPT,OUTPATIENT,,,304,197.6,,267.52,88,,214.02,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.07,16.8,,40.86,,,0,"percent of total billed charges","16.8% of total billed charges",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",52.6,17.304,,42.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",191.52,63,,153.22,,,0,"percent of total billed charges","63% of total billed charges",46.51,15.3,,37.21,,,0,"percent of total billed charges","15.3% of total billed charges",51.07,16.8,,40.86,,,0,"percent of total billed charges","16.8% of total billed charges",209.76,69,,,,,0,"fee schedule","69% of total billed charges",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",51.07,16.8,,40.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",52.09,17.136,,41.67,,,0,"percent of total billed charges","17.136% of total billed charges",66.39,21.84,,53.11,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",114.61,37.7,,91.69,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",237.12,78,,189.70,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",251.1,82.6,,200.88,,,0,"percent of total billed charges","82.6% of total billed charges",51.07,16.8,,40.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",251.1,82.6,,200.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",304,100,,243.20,,,0,"percent of total billed charges","100% of total billed charges",46.51,304,
"99203 New patient visit- level 3",7947783,CDM,521,RC,99203,CPT,OUTPATIENT,,,309,200.85,,271.92,88,,217.54,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",53.47,17.304,,42.78,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.67,63,,155.74,,,0,"percent of total billed charges","63% of total billed charges",47.28,15.3,,37.82,,,0,"percent of total billed charges","15.3% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",213.21,69,,,,,0,"fee schedule","69% of total billed charges",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",52.95,17.136,,42.36,,,0,"percent of total billed charges","17.136% of total billed charges",67.49,21.84,,53.99,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",116.49,37.7,,93.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",241.02,78,,192.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",51.91,16.8,,41.53,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",255.23,82.6,,204.18,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",309,100,,247.20,,,0,"percent of total billed charges","100% of total billed charges",47.28,309,
"99202 New patient visit- level 2",7947784,CDM,521,RC,99202,CPT,OUTPATIENT,,,212,137.8,,186.56,88,,149.25,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.62,16.8,,28.50,,,0,"percent of total billed charges","16.8% of total billed charges",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",36.68,17.304,,29.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",133.56,63,,106.85,,,0,"percent of total billed charges","63% of total billed charges",32.44,15.3,,25.95,,,0,"percent of total billed charges","15.3% of total billed charges",35.62,16.8,,28.50,,,0,"percent of total billed charges","16.8% of total billed charges",146.28,69,,,,,0,"fee schedule","69% of total billed charges",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.62,16.8,,28.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",36.33,17.136,,29.06,,,0,"percent of total billed charges","17.136% of total billed charges",46.3,21.84,,37.04,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",79.92,37.7,,63.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",165.36,78,,132.29,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",175.11,82.6,,140.09,,,0,"percent of total billed charges","82.6% of total billed charges",35.62,16.8,,28.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",175.11,82.6,,140.09,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",212,100,,169.60,,,0,"percent of total billed charges","100% of total billed charges",32.44,212,
"99215 Established patient visit- level 5",7947775,CDM,521,RC,99215,CPT,OUTPATIENT,,,268,174.2,,235.84,88,,188.67,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",46.37,17.304,,37.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",168.84,63,,135.07,,,0,"percent of total billed charges","63% of total billed charges",41,15.3,,32.80,,,0,"percent of total billed charges","15.3% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",184.92,69,,,,,0,"fee schedule","69% of total billed charges",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",45.92,17.136,,36.74,,,0,"percent of total billed charges","17.136% of total billed charges",58.53,21.84,,46.82,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.04,37.7,,80.83,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",209.04,78,,167.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",45.02,16.8,,36.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",221.37,82.6,,177.10,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",268,100,,214.40,,,0,"percent of total billed charges","100% of total billed charges",41,268,
"99214 Established patient visit- level 4",7947776,CDM,521,RC,99214,CPT,OUTPATIENT,,,200,130,,176,88,,140.80,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",33.6,16.8,,26.88,,,0,"percent of total billed charges","16.8% of total billed charges",200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.61,17.304,,27.69,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",126,63,,100.80,,,0,"percent of total billed charges","63% of total billed charges",30.6,15.3,,24.48,,,0,"percent of total billed charges","15.3% of total billed charges",33.6,16.8,,26.88,,,0,"percent of total billed charges","16.8% of total billed charges",138,69,,,,,0,"fee schedule","69% of total billed charges",200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",33.6,16.8,,26.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.27,17.136,,27.42,,,0,"percent of total billed charges","17.136% of total billed charges",43.68,21.84,,34.94,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",75.4,37.7,,60.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",156,78,,124.80,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.2,82.6,,132.16,,,0,"percent of total billed charges","82.6% of total billed charges",33.6,16.8,,26.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",165.2,82.6,,132.16,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",200,100,,160.00,,,0,"percent of total billed charges","100% of total billed charges",30.6,200,
"99213 Established patient visit- level 3",7947777,CDM,521,RC,99213,CPT,OUTPATIENT,,,207,134.55,,182.16,88,,145.73,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.78,16.8,,27.82,,,0,"percent of total billed charges","16.8% of total billed charges",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.82,17.304,,28.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",130.41,63,,104.33,,,0,"percent of total billed charges","63% of total billed charges",31.67,15.3,,25.34,,,0,"percent of total billed charges","15.3% of total billed charges",34.78,16.8,,27.82,,,0,"percent of total billed charges","16.8% of total billed charges",142.83,69,,,,,0,"fee schedule","69% of total billed charges",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.78,16.8,,27.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.47,17.136,,28.38,,,0,"percent of total billed charges","17.136% of total billed charges",45.21,21.84,,36.17,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",78.04,37.7,,62.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",161.46,78,,129.17,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.98,82.6,,136.78,,,0,"percent of total billed charges","82.6% of total billed charges",34.78,16.8,,27.82,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",170.98,82.6,,136.78,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",207,100,,165.60,,,0,"percent of total billed charges","100% of total billed charges",31.67,207,
"99212 Established patient visit- level 2",7947778,CDM,521,RC,99212,CPT,OUTPATIENT,,,126,81.9,,110.88,88,,88.70,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.17,16.8,,16.94,,,0,"percent of total billed charges","16.8% of total billed charges",126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.8,17.304,,17.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.38,63,,63.50,,,0,"percent of total billed charges","63% of total billed charges",19.28,15.3,,15.42,,,0,"percent of total billed charges","15.3% of total billed charges",21.17,16.8,,16.94,,,0,"percent of total billed charges","16.8% of total billed charges",86.94,69,,,,,0,"fee schedule","69% of total billed charges",126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.17,16.8,,16.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.59,17.136,,17.27,,,0,"percent of total billed charges","17.136% of total billed charges",27.52,21.84,,22.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47.5,37.7,,38.00,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",98.28,78,,78.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.08,82.6,,83.26,,,0,"percent of total billed charges","82.6% of total billed charges",21.17,16.8,,16.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.08,82.6,,83.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",19.28,160.53,
"99211 Established patient MC/MA- level 1",7947779,CDM,521,RC,99211,CPT,OUTPATIENT,,,37,24.05,,32.56,88,,26.05,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.4,17.304,,5.12,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.31,63,,18.65,,,0,"percent of total billed charges","63% of total billed charges",5.66,15.3,,4.53,,,0,"percent of total billed charges","15.3% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",25.53,69,,,,,0,"fee schedule","69% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.34,17.136,,5.07,,,0,"percent of total billed charges","17.136% of total billed charges",8.08,21.84,,6.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.95,37.7,,11.16,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.86,78,,23.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.56,82.6,,24.45,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",5.66,160.53,
"99223 Initial inpatient or observation hospital ca",7947772,CDM,521,RC,99223,CPT,OUTPATIENT,,,570,370.5,,501.6,88,,401.28,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",570,100,,456.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",359.1,63,,287.28,,,0,"percent of total billed charges","63% of total billed charges",87.21,15.3,,69.77,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",393.3,69,,,,,0,"fee schedule","69% of total billed charges",570,100,,456.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",570,100,,456.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",570,100,,456.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",214.89,37.7,,171.91,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",444.6,78,,355.68,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",470.82,82.6,,376.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",470.82,82.6,,376.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",570,100,,456.00,,,0,"percent of total billed charges","100% of total billed charges",87.21,570,
"99222 Initial inpatient or observation hospital ca",7947773,CDM,521,RC,99222,CPT,OUTPATIENT,,,388,252.2,,341.44,88,,273.15,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",244.44,63,,195.55,,,0,"percent of total billed charges","63% of total billed charges",59.36,15.3,,47.49,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",267.72,69,,,,,0,"fee schedule","69% of total billed charges",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",146.28,37.7,,117.02,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",302.64,78,,242.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",320.49,82.6,,256.39,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",320.49,82.6,,256.39,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",388,100,,310.40,,,0,"percent of total billed charges","100% of total billed charges",59.36,388,
"99221 Initial inpatient or observation hospital ca",7947774,CDM,521,RC,99221,CPT,OUTPATIENT,,,286,185.9,,251.68,88,,201.34,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",286,100,,228.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",180.18,63,,144.14,,,0,"percent of total billed charges","63% of total billed charges",43.76,15.3,,35.01,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",197.34,69,,,,,0,"fee schedule","69% of total billed charges",286,100,,228.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",286,100,,228.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",286,100,,228.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",107.82,37.7,,86.26,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",223.08,78,,178.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",236.24,82.6,,188.99,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",236.24,82.6,,188.99,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",286,100,,228.80,,,0,"percent of total billed charges","100% of total billed charges",43.76,286,
"99244 Office Consultation, Level 4",7964061,CDM,521,RC,99244,CPT,OUTPATIENT,,,222,144.3,,195.36,88,,156.29,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",222,100,,177.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",139.86,63,,111.89,,,0,"percent of total billed charges","63% of total billed charges",33.97,15.3,,27.18,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",153.18,69,,,,,0,"fee schedule","69% of total billed charges",222,100,,177.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",222,100,,177.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",222,100,,177.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",83.69,37.7,,66.95,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",173.16,78,,138.53,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",183.37,82.6,,146.70,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",183.37,82.6,,146.70,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",222,100,,177.60,,,0,"percent of total billed charges","100% of total billed charges",33.97,222,
"99385 Initial Comp Preventive Med 18 to 39 years N",1025766,CDM,521,RC,99385,CPT,OUTPATIENT,,,256,166.4,,225.28,88,,180.22,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",161.28,63,,129.02,,,0,"percent of total billed charges","63% of total billed charges",39.17,15.3,,31.34,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",176.64,69,,,,,0,"fee schedule","69% of total billed charges",256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",96.51,37.7,,77.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",199.68,78,,159.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.46,82.6,,169.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",211.46,82.6,,169.17,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",256,100,,204.80,,,0,"percent of total billed charges","100% of total billed charges",39.17,256,
"99386 Initial Comp Preventive Med 40 to 64 years N",1025767,CDM,521,RC,99386,CPT,OUTPATIENT,,,328,213.2,,288.64,88,,230.91,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",206.64,63,,165.31,,,0,"percent of total billed charges","63% of total billed charges",50.18,15.3,,40.14,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",226.32,69,,,,,0,"fee schedule","69% of total billed charges",328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",123.66,37.7,,98.93,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",255.84,78,,204.67,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",270.93,82.6,,216.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",270.93,82.6,,216.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",328,100,,262.40,,,0,"percent of total billed charges","100% of total billed charges",50.18,328,
"99383 Initial Comp Preventive Med 5 to 11 years Ne",1025768,CDM,521,RC,99383,CPT,OUTPATIENT,,,234,152.1,,205.92,88,,164.74,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",147.42,63,,117.94,,,0,"percent of total billed charges","63% of total billed charges",35.8,15.3,,28.64,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",161.46,69,,,,,0,"fee schedule","69% of total billed charges",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",88.22,37.7,,70.58,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",182.52,78,,146.02,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",193.28,82.6,,154.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",193.28,82.6,,154.62,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",234,100,,187.20,,,0,"percent of total billed charges","100% of total billed charges",35.8,234,
"99384 Initial Comp Preventive Med 12 to 17 years N",1065765,CDM,521,RC,99384,CPT,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",213.11,82.6,,170.49,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"99382 Initial Comp Preventive Med 1 to 4 years New",1065766,CDM,521,RC,99382,CPT,OUTPATIENT,,,228,148.2,,200.64,88,,160.51,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",143.64,63,,114.91,,,0,"percent of total billed charges","63% of total billed charges",34.88,15.3,,27.90,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",157.32,69,,,,,0,"fee schedule","69% of total billed charges",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",85.96,37.7,,68.77,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",177.84,78,,142.27,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",188.33,82.6,,150.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",188.33,82.6,,150.66,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",228,100,,182.40,,,0,"percent of total billed charges","100% of total billed charges",34.88,228,
"99381 Preventive exam < 1 year new pt",7947760,CDM,521,RC,99381,CPT,OUTPATIENT,,,211,137.15,,185.68,88,,148.54,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",132.93,63,,106.34,,,0,"percent of total billed charges","63% of total billed charges",32.28,15.3,,25.82,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",145.59,69,,,,,0,"fee schedule","69% of total billed charges",211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",79.55,37.7,,63.64,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",164.58,78,,131.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",174.29,82.6,,139.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",174.29,82.6,,139.43,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",211,100,,168.80,,,0,"percent of total billed charges","100% of total billed charges",32.28,211,
"99391 Periodic Comp Preventive Med less than 1 yea",1025770,CDM,521,RC,99391,CPT,OUTPATIENT,,,173,112.45,,152.24,88,,121.79,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",108.99,63,,87.19,,,0,"percent of total billed charges","63% of total billed charges",26.47,15.3,,21.18,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",119.37,69,,,,,0,"fee schedule","69% of total billed charges",173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",65.22,37.7,,52.18,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",134.94,78,,107.95,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.9,82.6,,114.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",142.9,82.6,,114.32,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",173,100,,138.40,,,0,"percent of total billed charges","100% of total billed charges",26.47,173,
"99394 Periodic Comp Preventive Med 12 to 17 years",1025771,CDM,521,RC,99394,CPT,OUTPATIENT,,,235,152.75,,206.8,88,,165.44,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",235,100,,188.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",148.05,63,,118.44,,,0,"percent of total billed charges","63% of total billed charges",35.96,15.3,,28.77,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.15,69,,,,,0,"fee schedule","69% of total billed charges",235,100,,188.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",235,100,,188.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",235,100,,188.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",88.6,37.7,,70.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",183.3,78,,146.64,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",194.11,82.6,,155.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",194.11,82.6,,155.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",235,100,,188.00,,,0,"percent of total billed charges","100% of total billed charges",35.96,235,
"99392 Periodic Comp Preventive Med 1 to 4 years Es",1025772,CDM,521,RC,99392,CPT,OUTPATIENT,,,186,120.9,,163.68,88,,130.94,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",117.18,63,,93.74,,,0,"percent of total billed charges","63% of total billed charges",28.46,15.3,,22.77,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",128.34,69,,,,,0,"fee schedule","69% of total billed charges",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",70.12,37.7,,56.10,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",145.08,78,,116.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",153.64,82.6,,122.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",153.64,82.6,,122.91,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",186,100,,148.80,,,0,"percent of total billed charges","100% of total billed charges",28.46,186,
"99395 Periodic Comp Preventive Med 18 to 39 years",1025773,CDM,521,RC,99395,CPT,OUTPATIENT,,,246,159.9,,216.48,88,,173.18,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",154.98,63,,123.98,,,0,"percent of total billed charges","63% of total billed charges",37.64,15.3,,30.11,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",169.74,69,,,,,0,"fee schedule","69% of total billed charges",246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",92.74,37.7,,74.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",191.88,78,,153.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",203.2,82.6,,162.56,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",203.2,82.6,,162.56,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",246,100,,196.80,,,0,"percent of total billed charges","100% of total billed charges",37.64,246,
"99396 Periodic Comp Preventive Med 40 to 64 years",1025774,CDM,521,RC,99396,CPT,OUTPATIENT,,,270,175.5,,237.6,88,,190.08,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",170.1,63,,136.08,,,0,"percent of total billed charges","63% of total billed charges",41.31,15.3,,33.05,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",186.3,69,,,,,0,"fee schedule","69% of total billed charges",270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",101.79,37.7,,81.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",210.6,78,,168.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",223.02,82.6,,178.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",223.02,82.6,,178.42,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",270,100,,216.00,,,0,"percent of total billed charges","100% of total billed charges",41.31,270,
"99393 Periodic Comp Preventive Med 5 to 11 years E",1025775,CDM,521,RC,99393,CPT,OUTPATIENT,,,193,125.45,,169.84,88,,135.87,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",121.59,63,,97.27,,,0,"percent of total billed charges","63% of total billed charges",29.53,15.3,,23.62,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",133.17,69,,,,,0,"fee schedule","69% of total billed charges",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",72.76,37.7,,58.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",150.54,78,,120.43,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",159.42,82.6,,127.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",159.42,82.6,,127.54,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",193,100,,154.40,,,0,"percent of total billed charges","100% of total billed charges",29.53,193,
"99397 Periodic Comp Preventive Med 65+ years Est",1025776,CDM,521,RC,99397,CPT,OUTPATIENT,,,287,186.55,,252.56,88,,202.05,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",180.81,63,,144.65,,,0,"percent of total billed charges","63% of total billed charges",43.91,15.3,,35.13,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",198.03,69,,,,,0,"fee schedule","69% of total billed charges",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",108.2,37.7,,86.56,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",223.86,78,,179.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",237.06,82.6,,189.65,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",287,100,,229.60,,,0,"percent of total billed charges","100% of total billed charges",43.91,287,
"99417 Prolonged services per charge for each addit",10676393,CDM,521,RC,99417,CPT,OUTPATIENT,,,294,191.1,,258.72,88,,206.98,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",185.22,63,,148.18,,,0,"percent of total billed charges","63% of total billed charges",44.98,15.3,,35.98,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",202.86,69,,,,,0,"fee schedule","69% of total billed charges",294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",110.84,37.7,,88.67,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",229.32,78,,183.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",242.84,82.6,,194.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",242.84,82.6,,194.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",294,100,,235.20,,,0,"percent of total billed charges","100% of total billed charges",44.98,294,
"99456 Work related/medical disability evaluation s",7947745,CDM,521,RC,99456,CPT,OUTPATIENT,,,510,331.5,,448.8,88,,359.04,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",321.3,63,,257.04,,,0,"percent of total billed charges","63% of total billed charges",78.03,15.3,,62.42,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",351.9,69,,,,,0,"fee schedule","69% of total billed charges",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",192.27,37.7,,153.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",397.8,78,,318.24,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",421.26,82.6,,337.01,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",421.26,82.6,,337.01,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",510,100,,408.00,,,0,"percent of total billed charges","100% of total billed charges",78.03,510,
"99496 Transitional care management service- high",7947742,CDM,521,RC,99496,CPT,OUTPATIENT,,,675,438.75,,594,88,,475.20,,,0,"percent of total billed charges","88% of total billed charges",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",93.36,100,,,,,0,"fee schedule",EAPG,675,100,,540.00,,,0,"percent of total billed charges","100% of total billed charges",235.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",96.16,100,,,,,0,"fee schedule",EAPG,134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",425.25,63,,340.20,,,0,"percent of total billed charges","63% of total billed charges",103.28,15.3,,82.62,,,0,"percent of total billed charges","15.3% of total billed charges",93.36,100,,,,,0,"fee schedule",EAPG,465.75,69,,,,,0,"fee schedule","69% of total billed charges",675,100,,540.00,,,0,"percent of total billed charges","100% of total billed charges",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",675,100,,540.00,,,0,"percent of total billed charges","100% of total billed charges",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",675,100,,540.00,,,0,"percent of total billed charges","100% of total billed charges",134.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",482.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",93.36,100,,,,,0,"fee schedule",EAPG,134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",126.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",95.22,100,,,,,0,"fee schedule",EAPG,121.36,100,,,,,0,"fee schedule",EAPG,134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",254.48,37.7,,203.58,,,0,"percent of total billed charges","37.70% of total billed charges",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",526.5,78,,421.20,,,0,"percent of total billed charges","78% of total billed charges",136.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",557.55,82.6,,446.04,,,0,"percent of total billed charges","82.6% of total billed charges",93.36,100,,,,,0,"fee schedule","100% of WA fee schedule",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",557.55,82.6,,446.04,,,0,"percent of total billed charges","82.6% of total billed charges",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",253.89,100,,,,,0,"fee schedule",EAPG,675,100,,540.00,,,0,"percent of total billed charges","100% of total billed charges",93.36,675,
"99495 Transitional care management service- modera",7947743,CDM,521,RC,99495,CPT,OUTPATIENT,,,481,312.65,,423.28,88,,338.62,,,0,"percent of total billed charges","88% of total billed charges",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",93.36,100,,,,,0,"fee schedule",EAPG,481,100,,384.80,,,0,"percent of total billed charges","100% of total billed charges",235.94,175,,,,,0,"fee schedule","175% of CMS fee schedule",96.16,100,,,,,0,"fee schedule",EAPG,134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",303.03,63,,242.42,,,0,"percent of total billed charges","63% of total billed charges",73.59,15.3,,58.87,,,0,"percent of total billed charges","15.3% of total billed charges",93.36,100,,,,,0,"fee schedule",EAPG,331.89,69,,,,,0,"fee schedule","69% of total billed charges",481,100,,384.80,,,0,"percent of total billed charges","100% of total billed charges",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",481,100,,384.80,,,0,"percent of total billed charges","100% of total billed charges",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",481,100,,384.80,,,0,"percent of total billed charges","100% of total billed charges",134.82,100,,,,,0,"fee schedule","100% of CMS fee schedule",482.38,100,,,,,0,"fee schedule","100% of CMS OPPS rate",93.36,100,,,,,0,"fee schedule",EAPG,134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",126.11,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",95.22,100,,,,,0,"fee schedule",EAPG,121.36,100,,,,,0,"fee schedule",EAPG,134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",181.34,37.7,,145.07,,,0,"percent of total billed charges","37.70% of total billed charges",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",375.18,78,,300.14,,,0,"percent of total billed charges","78% of total billed charges",136.16,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397.31,82.6,,317.85,,,0,"percent of total billed charges","82.6% of total billed charges",93.36,100,,,,,0,"fee schedule","100% of WA fee schedule",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",397.31,82.6,,317.85,,,0,"percent of total billed charges","82.6% of total billed charges",134.82,100,,,,,0,"fee schedule","100% of CMS OPPS rate",253.89,100,,,,,0,"fee schedule",EAPG,481,100,,384.80,,,0,"percent of total billed charges","100% of total billed charges",73.59,482.38,
"99498 Advance care planning; each additional 30 mi",7947768,CDM,521,RC,99498,CPT,OUTPATIENT,,,215,139.75,,189.2,88,,151.36,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",93.36,100,,,,,0,"fee schedule",EAPG,215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",96.16,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",135.45,63,,108.36,,,0,"percent of total billed charges","63% of total billed charges",32.9,15.3,,26.32,,,0,"percent of total billed charges","15.3% of total billed charges",93.36,100,,,,,0,"fee schedule",EAPG,148.35,69,,,,,0,"fee schedule","69% of total billed charges",215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",93.36,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",95.22,100,,,,,0,"fee schedule",EAPG,121.36,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",81.06,37.7,,64.85,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",167.7,78,,134.16,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",177.59,82.6,,142.07,,,0,"percent of total billed charges","82.6% of total billed charges",93.36,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",177.59,82.6,,142.07,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",253.89,100,,,,,0,"fee schedule",EAPG,215,100,,172.00,,,0,"percent of total billed charges","100% of total billed charges",32.9,253.89,
"99991 ob visit  no charge",7964090,CDM,521,RC,99991,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",,,,,,,0,other,"not separately reimbursment",160.53,160.53,
"99998 no charge consult",7964097,CDM,521,RC,99998,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",,,,,,,0,other,"not separately reimbursment",160.53,160.53,
"99201 New patient visit- level 1",7947785,CDM,521,RC,99211,CPT,OUTPATIENT,,,126,81.9,,110.88,88,,88.70,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.17,16.8,,16.94,,,0,"percent of total billed charges","16.8% of total billed charges",126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21.8,17.304,,17.44,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",79.38,63,,63.50,,,0,"percent of total billed charges","63% of total billed charges",19.28,15.3,,15.42,,,0,"percent of total billed charges","15.3% of total billed charges",21.17,16.8,,16.94,,,0,"percent of total billed charges","16.8% of total billed charges",86.94,69,,,,,0,"fee schedule","69% of total billed charges",126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.17,16.8,,16.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.59,17.136,,17.27,,,0,"percent of total billed charges","17.136% of total billed charges",27.52,21.84,,22.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47.5,37.7,,38.00,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",98.28,78,,78.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.08,82.6,,83.26,,,0,"percent of total billed charges","82.6% of total billed charges",21.17,16.8,,16.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",104.08,82.6,,83.26,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",126,100,,100.80,,,0,"percent of total billed charges","100% of total billed charges",19.28,160.53,
"G0108 Diabetes management treatment, per 30 minute",8485476,CDM,521,RC,,,OUTPATIENT,,,157,102.05,,138.16,88,,110.53,,,0,"percent of total billed charges","88% of total billed charges",78.5,50,,62.80,,,0,"percent of total billed charges","50% of total billed charges",26.38,16.8,,21.10,,,0,"percent of total billed charges","16.8% of total billed charges",157,100,,125.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.17,17.304,,21.74,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",98.91,63,,79.13,,,0,"percent of total billed charges","63% of total billed charges",24.02,15.3,,19.22,,,0,"percent of total billed charges","15.3% of total billed charges",26.38,16.8,,21.10,,,0,"percent of total billed charges","16.8% of total billed charges",108.33,69,,,,,0,"fee schedule","69% of total billed charges",157,100,,125.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",157,100,,125.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",157,100,,125.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.38,16.8,,21.10,,,0,"percent of total billed charges","16.8% of total billed charges",78.5,50,,62.80,,,0,"percent of total billed charges","50% of total billed charges",50.55,32.2,,40.44,,,0,"percent of total billed charges","32.2% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",26.9,17.136,,21.52,,,0,"percent of total billed charges","17.136% of total billed charges",34.29,21.84,,27.43,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",59.19,37.7,,47.35,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",122.46,78,,97.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",129.68,82.6,,103.74,,,0,"percent of total billed charges","82.6% of total billed charges",26.38,16.8,,21.10,,,0,"percent of total billed charges","16.8% of total billed charges",78.5,50,,62.80,,,0,"percent of total billed charges","50% of total billed charges",129.68,82.6,,103.74,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",157,100,,125.60,,,0,"percent of total billed charges","100% of total billed charges",24.02,160.53,
"G2211 Visit Complexity add",13670484,CDM,521,RC,G2211,CPT,OUTPATIENT,,,61,39.65,,53.68,88,,42.94,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",38.43,63,,30.74,,,0,"percent of total billed charges","63% of total billed charges",9.33,15.3,,7.46,,,0,"percent of total billed charges","15.3% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.09,69,,,,,0,"fee schedule","69% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",23,37.7,,18.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",47.58,78,,38.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.39,82.6,,40.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",50.39,82.6,,40.31,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",160.53,100,,,,,0,"case rate","pays based on per visit rate",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",9.33,160.53,
"94640 Aerosol treatment",7922193,CDM,521,RC,94640,CPT,OUTPATIENT,,,52,33.8,,45.76,88,,36.61,,,0,"percent of total billed charges","88% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",380.7,175,,,,,0,"fee schedule","175% of CMS fee schedule",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",32.76,63,,26.21,,,0,"percent of total billed charges","63% of total billed charges",7.96,15.3,,6.37,,,0,"percent of total billed charges","15.3% of total billed charges",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",35.88,69,,,,,0,"fee schedule","69% of total billed charges",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS fee schedule",763.26,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.61,102,,,,,0,"fee schedule","102% of WA fee schedule",7.15,130,,,,,0,"fee schedule","130% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",19.6,37.7,,15.68,,,0,"percent of total billed charges","37.70% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.56,78,,32.45,,,0,"percent of total billed charges","78% of total billed charges",219.72,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",5.5,100,,,,,0,"fee schedule","100% of WA fee schedule",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42.95,82.6,,34.36,,,0,"percent of total billed charges","82.6% of total billed charges",217.54,100,,,,,0,"fee schedule","100% of CMS OPPS rate",160.53,100,,,,,0,"case rate","pays based on per visit rate",52,100,,41.60,,,0,"percent of total billed charges","100% of total billed charges",5.5,763.26,
"95115 Allergy injection; single POC",7903331,CDM,521,RC,95115,CPT,OUTPATIENT,,,30,19.5,,26.4,88,,21.12,,,0,"percent of total billed charges","88% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",20.92,100,,,,,0,"fee schedule",EAPG,30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",84.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",21.55,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",18.9,63,,15.12,,,0,"percent of total billed charges","63% of total billed charges",4.59,15.3,,3.67,,,0,"percent of total billed charges","15.3% of total billed charges",20.92,100,,,,,0,"fee schedule",EAPG,20.7,69,,,,,0,"fee schedule","69% of total billed charges",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",20.92,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",21.34,100,,,,,0,"fee schedule",EAPG,27.2,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",11.31,37.7,,9.05,,,0,"percent of total billed charges","37.70% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.4,78,,18.72,,,0,"percent of total billed charges","78% of total billed charges",48.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",20.92,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",24.78,82.6,,19.82,,,0,"percent of total billed charges","82.6% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",181.45,100,,,,,0,"fee schedule",EAPG,30,100,,24.00,,,0,"percent of total billed charges","100% of total billed charges",4.59,181.45,
"95117 Allergy injection; multiple POC",7903332,CDM,521,RC,95117,CPT,OUTPATIENT,,,36,23.4,,31.68,88,,25.34,,,0,"percent of total billed charges","88% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",20.92,100,,,,,0,"fee schedule",EAPG,36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",84.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",21.55,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",22.68,63,,18.14,,,0,"percent of total billed charges","63% of total billed charges",5.51,15.3,,4.41,,,0,"percent of total billed charges","15.3% of total billed charges",20.92,100,,,,,0,"fee schedule",EAPG,24.84,69,,,,,0,"fee schedule","69% of total billed charges",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",20.92,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",21.34,100,,,,,0,"fee schedule",EAPG,27.2,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",13.57,37.7,,10.86,,,0,"percent of total billed charges","37.70% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",28.08,78,,22.46,,,0,"percent of total billed charges","78% of total billed charges",48.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",20.92,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",29.74,82.6,,23.79,,,0,"percent of total billed charges","82.6% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",181.45,100,,,,,0,"fee schedule",EAPG,36,100,,28.80,,,0,"percent of total billed charges","100% of total billed charges",5.51,181.45,
"96366 IV infusion, for therapy, prophylaxis, or di",8169645,CDM,521,RC,96366,CPT,OUTPATIENT,,,72,46.8,,63.36,88,,50.69,,,0,"percent of total billed charges","88% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",84.78,175,,,,,0,"fee schedule","175% of CMS fee schedule",475.9,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",11.02,15.3,,8.82,,,0,"percent of total billed charges","15.3% of total billed charges",462.04,100,,,,,0,"fee schedule",EAPG,49.68,69,,,,,0,"fee schedule","69% of total billed charges",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS fee schedule",162.5,100,,,,,0,"fee schedule","100% of CMS OPPS rate",462.04,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",42.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",471.28,100,,,,,0,"fee schedule",EAPG,600.65,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",27.14,37.7,,21.71,,,0,"percent of total billed charges","37.70% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",56.16,78,,44.93,,,0,"percent of total billed charges","78% of total billed charges",48.93,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.47,82.6,,47.58,,,0,"percent of total billed charges","82.6% of total billed charges",462.04,100,,,,,0,"fee schedule",EAPG,48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",59.47,82.6,,47.58,,,0,"percent of total billed charges","82.6% of total billed charges",48.45,100,,,,,0,"fee schedule","100% of CMS OPPS rate",622.57,100,,,,,0,"fee schedule",EAPG,72,100,,57.60,,,0,"percent of total billed charges","100% of total billed charges",11.02,622.57,
"96372 Therapeutic; prophylactic, or diagnostic inj",7903115,CDM,521,RC,96372,CPT,OUTPATIENT,,,47,30.55,,41.36,88,,33.09,,,0,"percent of total billed charges","88% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",41,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",7.19,15.3,,5.75,,,0,"percent of total billed charges","15.3% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,32.43,69,,,,,0,"fee schedule","69% of total billed charges",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",39.8,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",40.6,100,,,,,0,"fee schedule",EAPG,51.74,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",17.72,37.7,,14.18,,,0,"percent of total billed charges","37.70% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",36.66,78,,29.33,,,0,"percent of total billed charges","78% of total billed charges",72.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",39.8,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",38.82,82.6,,31.06,,,0,"percent of total billed charges","82.6% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",200.33,100,,,,,0,"fee schedule",EAPG,47,100,,37.60,,,0,"percent of total billed charges","100% of total billed charges",7.19,251.75,
"Epipen (epinephrine injection) Charge",10727303,CDM,636,RC,,,OUTPATIENT,,,361,234.65,,317.68,88,,254.14,,,0,"percent of total billed charges","88% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.47,17.304,,49.98,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",227.43,63,,181.94,,,0,"percent of total billed charges","63% of total billed charges",55.23,15.3,,44.18,,,0,"percent of total billed charges","15.3% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",249.09,69,,,,,0,"fee schedule","69% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",116.24,32.2,,92.99,,,0,"percent of total billed charges","32.2% of total billed charges",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",61.86,17.136,,49.49,,,0,"percent of total billed charges","17.136% of total billed charges",78.84,21.84,,63.07,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.7% of total billed charges",136.1,37.7,,108.88,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",122.38,33.9,,97.90,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",281.58,78,,225.26,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",180.5,50,,144.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",60.65,16.8,,48.52,,,0,"percent of total billed charges","16.8% of total billed charges",361,100,,288.80,,,0,"percent of total billed charges","100% of total billed charges",55.23,361,
"J0171 Adrenalin, epinephrine injection 0.1mg",7906891,CDM,636,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.7% of total billed charges",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.68,33.9,,0.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"J0290 Ampicillin injection",7906892,CDM,636,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.7% of total billed charges",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.37,33.9,,1.90,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"J0558 Injection, penicillin g benzathine and penic",7922202,CDM,636,RC,,,OUTPATIENT,,,23,14.95,,20.24,88,,16.19,,,0,"percent of total billed charges","88% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.98,17.304,,3.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.49,63,,11.59,,,0,"percent of total billed charges","63% of total billed charges",3.52,15.3,,2.82,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",15.87,69,,,,,0,"fee schedule","69% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",7.41,32.2,,5.93,,,0,"percent of total billed charges","32.2% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.94,17.136,,3.15,,,0,"percent of total billed charges","17.136% of total billed charges",5.02,21.84,,4.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.7% of total billed charges",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.8,33.9,,6.24,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.94,78,,14.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",3.52,23,
"J0561 Injection, penicillin g benzathine, 100,000",7906929,CDM,636,RC,,,OUTPATIENT,,,51,33.15,,44.88,88,,35.90,,,0,"percent of total billed charges","88% of total billed charges",25.5,50,,20.40,,,0,"percent of total billed charges","50% of total billed charges",8.57,16.8,,6.86,,,0,"percent of total billed charges","16.8% of total billed charges",51,100,,40.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.83,17.304,,7.06,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",32.13,63,,25.70,,,0,"percent of total billed charges","63% of total billed charges",7.8,15.3,,6.24,,,0,"percent of total billed charges","15.3% of total billed charges",8.57,16.8,,6.86,,,0,"percent of total billed charges","16.8% of total billed charges",35.19,69,,,,,0,"fee schedule","69% of total billed charges",51,100,,40.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",51,100,,40.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",51,100,,40.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.57,16.8,,6.86,,,0,"percent of total billed charges","16.8% of total billed charges",25.5,50,,20.40,,,0,"percent of total billed charges","50% of total billed charges",16.42,32.2,,13.14,,,0,"percent of total billed charges","32.2% of total billed charges",8.57,16.8,,6.86,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.74,17.136,,6.99,,,0,"percent of total billed charges","17.136% of total billed charges",11.14,21.84,,8.91,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.23,37.7,,15.38,,,0,"percent of total billed charges","37.7% of total billed charges",19.23,37.7,,15.38,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.29,33.9,,13.83,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",39.78,78,,31.82,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.57,16.8,,6.86,,,0,"percent of total billed charges","16.8% of total billed charges",25.5,50,,20.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.57,16.8,,6.86,,,0,"percent of total billed charges","16.8% of total billed charges",51,100,,40.80,,,0,"percent of total billed charges","100% of total billed charges",7.8,51,
"J0588- Injection, incobotulinumtoxin A, 1 unit",7964121,CDM,636,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.7% of total billed charges",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.05,33.9,,2.44,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"J0670 inj mepivacaine hcl/10 ml",7964147,CDM,636,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.7% of total billed charges",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.03,33.9,,1.62,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"J0696 Injection, ceftriaxone sodium, per 250 mg",7906896,CDM,636,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.7% of total billed charges",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.78,33.9,,5.42,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"J0690 Injection, cefazolin sodium",7922197,CDM,636,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.7% of total billed charges",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.37,33.9,,1.90,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"J0697 sterile cefuroxime injection 750 mg",7964125,CDM,636,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.7% of total billed charges",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.73,33.9,,2.98,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"J0694 cefoxitin sodium injection",7964142,CDM,636,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.7% of total billed charges",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.42,33.9,,4.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"J0696 Injection, ceftriaxone sodium, per 250 mg, 5",10217808,CDM,636,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.7% of total billed charges",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.78,33.9,,5.42,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"J0696 Injection, ceftriaxone sodium, per 250 mg, 1",10217809,CDM,636,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.7% of total billed charges",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.78,33.9,,5.42,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"J0696 Injection, ceftriaxone sodium, per 250 mg, 2",14747436,CDM,636,RC,,,OUTPATIENT,,,20,13,,17.6,88,,14.08,,,0,"percent of total billed charges","88% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.46,17.304,,2.77,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.6,63,,10.08,,,0,"percent of total billed charges","63% of total billed charges",3.06,15.3,,2.45,,,0,"percent of total billed charges","15.3% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",13.8,69,,,,,0,"fee schedule","69% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",6.44,32.2,,5.15,,,0,"percent of total billed charges","32.2% of total billed charges",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.43,17.136,,2.74,,,0,"percent of total billed charges","17.136% of total billed charges",4.37,21.84,,3.50,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.7% of total billed charges",7.54,37.7,,6.03,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.78,33.9,,5.42,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.6,78,,12.48,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",10,50,,8.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.36,16.8,,2.69,,,0,"percent of total billed charges","16.8% of total billed charges",20,100,,16.00,,,0,"percent of total billed charges","100% of total billed charges",3.06,20,
"J0702 Betamethasone injection, per 3mg",7906894,CDM,636,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.7% of total billed charges",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.07,33.9,,3.26,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"J0780 Injection, prochlorperazine",7922203,CDM,636,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.7% of total billed charges",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.03,33.9,,1.62,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"J0795 corticorelin ovine triflutal",7964130,CDM,636,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.7% of total billed charges",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.03,33.9,,1.62,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"J0834  Cosyntropin Cortrosyn Injection",9705594,CDM,636,RC,,,OUTPATIENT,,,247,160.55,,217.36,88,,173.89,,,0,"percent of total billed charges","88% of total billed charges",123.5,50,,98.80,,,0,"percent of total billed charges","50% of total billed charges",41.5,16.8,,33.20,,,0,"percent of total billed charges","16.8% of total billed charges",247,100,,197.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.74,17.304,,34.19,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",155.61,63,,124.49,,,0,"percent of total billed charges","63% of total billed charges",37.79,15.3,,30.23,,,0,"percent of total billed charges","15.3% of total billed charges",41.5,16.8,,33.20,,,0,"percent of total billed charges","16.8% of total billed charges",170.43,69,,,,,0,"fee schedule","69% of total billed charges",247,100,,197.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",247,100,,197.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",247,100,,197.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.5,16.8,,33.20,,,0,"percent of total billed charges","16.8% of total billed charges",123.5,50,,98.80,,,0,"percent of total billed charges","50% of total billed charges",79.53,32.2,,63.62,,,0,"percent of total billed charges","32.2% of total billed charges",41.5,16.8,,33.20,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",42.33,17.136,,33.86,,,0,"percent of total billed charges","17.136% of total billed charges",53.94,21.84,,43.15,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",93.12,37.7,,74.50,,,0,"percent of total billed charges","37.7% of total billed charges",93.12,37.7,,74.50,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",83.73,33.9,,66.98,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",192.66,78,,154.13,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.5,16.8,,33.20,,,0,"percent of total billed charges","16.8% of total billed charges",123.5,50,,98.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",41.5,16.8,,33.20,,,0,"percent of total billed charges","16.8% of total billed charges",247,100,,197.60,,,0,"percent of total billed charges","100% of total billed charges",37.79,247,
"J0885 Injection, epoetin alfa, (for non-esrd use),",7906910,CDM,636,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.7% of total billed charges",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.09,33.9,,4.07,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"J0897 Injection, denosumab, 1 mg",7906900,CDM,636,RC,,,OUTPATIENT,,,61,39.65,,53.68,88,,42.94,,,0,"percent of total billed charges","88% of total billed charges",30.5,50,,24.40,,,0,"percent of total billed charges","50% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.56,17.304,,8.45,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",38.43,63,,30.74,,,0,"percent of total billed charges","63% of total billed charges",9.33,15.3,,7.46,,,0,"percent of total billed charges","15.3% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",42.09,69,,,,,0,"fee schedule","69% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",30.5,50,,24.40,,,0,"percent of total billed charges","50% of total billed charges",19.64,32.2,,15.71,,,0,"percent of total billed charges","32.2% of total billed charges",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.45,17.136,,8.36,,,0,"percent of total billed charges","17.136% of total billed charges",13.32,21.84,,10.66,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,37.7,,18.40,,,0,"percent of total billed charges","37.7% of total billed charges",23,37.7,,18.40,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.68,33.9,,16.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",47.58,78,,38.06,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",30.5,50,,24.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.25,16.8,,8.20,,,0,"percent of total billed charges","16.8% of total billed charges",61,100,,48.80,,,0,"percent of total billed charges","100% of total billed charges",9.33,61,
"J1000 Injection, depo-estradiol cypionate, up to 5",7906911,CDM,636,RC,,,OUTPATIENT,,,26,16.9,,22.88,88,,18.30,,,0,"percent of total billed charges","88% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.5,17.304,,3.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.38,63,,13.10,,,0,"percent of total billed charges","63% of total billed charges",3.98,15.3,,3.18,,,0,"percent of total billed charges","15.3% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",17.94,69,,,,,0,"fee schedule","69% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",8.37,32.2,,6.70,,,0,"percent of total billed charges","32.2% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.46,17.136,,3.57,,,0,"percent of total billed charges","17.136% of total billed charges",5.68,21.84,,4.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.8,37.7,,7.84,,,0,"percent of total billed charges","37.7% of total billed charges",9.8,37.7,,7.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.81,33.9,,7.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.28,78,,16.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",3.98,26,
"J1010 Injection, methylprednisolone acetate, 1 mg",7906903,CDM,636,RC,,,OUTPATIENT,,,24,15.6,,21.12,88,,16.90,,,0,"percent of total billed charges","88% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.15,17.304,,3.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.12,63,,12.10,,,0,"percent of total billed charges","63% of total billed charges",3.67,15.3,,2.94,,,0,"percent of total billed charges","15.3% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",16.56,69,,,,,0,"fee schedule","69% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",7.73,32.2,,6.18,,,0,"percent of total billed charges","32.2% of total billed charges",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.11,17.136,,3.29,,,0,"percent of total billed charges","17.136% of total billed charges",5.24,21.84,,4.19,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.05,37.7,,7.24,,,0,"percent of total billed charges","37.7% of total billed charges",9.05,37.7,,7.24,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.14,33.9,,6.51,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.72,78,,14.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",12,50,,9.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.03,16.8,,3.22,,,0,"percent of total billed charges","16.8% of total billed charges",24,100,,19.20,,,0,"percent of total billed charges","100% of total billed charges",3.67,24,
"J1010 Injection, methylprednisolone acetate, 20 mg",14727904,CDM,636,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.7% of total billed charges",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.1,33.9,,4.88,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"J1010 Injection, methylprednisolone acetate, 40 mg",14727905,CDM,636,RC,,,OUTPATIENT,,,18,11.7,,15.84,88,,12.67,,,0,"percent of total billed charges","88% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.11,17.304,,2.49,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.34,63,,9.07,,,0,"percent of total billed charges","63% of total billed charges",2.75,15.3,,2.20,,,0,"percent of total billed charges","15.3% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",12.42,69,,,,,0,"fee schedule","69% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",5.8,32.2,,4.64,,,0,"percent of total billed charges","32.2% of total billed charges",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.08,17.136,,2.46,,,0,"percent of total billed charges","17.136% of total billed charges",3.93,21.84,,3.14,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.7% of total billed charges",6.79,37.7,,5.43,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.1,33.9,,4.88,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.04,78,,11.23,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",9,50,,7.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,16.8,,2.42,,,0,"percent of total billed charges","16.8% of total billed charges",18,100,,14.40,,,0,"percent of total billed charges","100% of total billed charges",2.75,18,
"J1010 Injection, methylprednisolone acetate, 80 mg",14727906,CDM,636,RC,,,OUTPATIENT,,,19,12.35,,16.72,88,,13.38,,,0,"percent of total billed charges","88% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.29,17.304,,2.63,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.97,63,,9.58,,,0,"percent of total billed charges","63% of total billed charges",2.91,15.3,,2.33,,,0,"percent of total billed charges","15.3% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",13.11,69,,,,,0,"fee schedule","69% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",6.12,32.2,,4.90,,,0,"percent of total billed charges","32.2% of total billed charges",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.26,17.136,,2.61,,,0,"percent of total billed charges","17.136% of total billed charges",4.15,21.84,,3.32,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.7% of total billed charges",7.16,37.7,,5.73,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.44,33.9,,5.15,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.82,78,,11.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",9.5,50,,7.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.19,16.8,,2.55,,,0,"percent of total billed charges","16.8% of total billed charges",19,100,,15.20,,,0,"percent of total billed charges","100% of total billed charges",2.91,19,
"J1020 Injection, methylprednisolone acetate, 20 mg",7964118,CDM,636,RC,,,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",2.25,32.2,,1.80,,,0,"percent of total billed charges","32.2% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.7% of total billed charges",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.37,33.9,,1.90,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",3.5,50,,2.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"J1030 Injection, methylprednisolone acetate, 40 mg",7906905,CDM,636,RC,,,OUTPATIENT,,,13,8.45,,11.44,88,,9.15,,,0,"percent of total billed charges","88% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.25,17.304,,1.80,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.19,63,,6.55,,,0,"percent of total billed charges","63% of total billed charges",1.99,15.3,,1.59,,,0,"percent of total billed charges","15.3% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",8.97,69,,,,,0,"fee schedule","69% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",4.19,32.2,,3.35,,,0,"percent of total billed charges","32.2% of total billed charges",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.23,17.136,,1.78,,,0,"percent of total billed charges","17.136% of total billed charges",2.84,21.84,,2.27,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.7% of total billed charges",4.9,37.7,,3.92,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,33.9,,3.53,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.14,78,,8.11,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",6.5,50,,5.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.18,16.8,,1.74,,,0,"percent of total billed charges","16.8% of total billed charges",13,100,,10.40,,,0,"percent of total billed charges","100% of total billed charges",1.99,13,
"J1050 Injection, medroxyprogesterone acetate 1mg",7906904,CDM,636,RC,,,OUTPATIENT,,,80,52,,70.4,88,,56.32,,,0,"percent of total billed charges","88% of total billed charges",40,50,,32.00,,,0,"percent of total billed charges","50% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.84,17.304,,11.07,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.4,63,,40.32,,,0,"percent of total billed charges","63% of total billed charges",12.24,15.3,,9.79,,,0,"percent of total billed charges","15.3% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",55.2,69,,,,,0,"fee schedule","69% of total billed charges",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",40,50,,32.00,,,0,"percent of total billed charges","50% of total billed charges",25.76,32.2,,20.61,,,0,"percent of total billed charges","32.2% of total billed charges",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.71,17.136,,10.97,,,0,"percent of total billed charges","17.136% of total billed charges",17.47,21.84,,13.98,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",30.16,37.7,,24.13,,,0,"percent of total billed charges","37.7% of total billed charges",30.16,37.7,,24.13,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",27.12,33.9,,21.70,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",62.4,78,,49.92,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",40,50,,32.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",13.44,16.8,,10.75,,,0,"percent of total billed charges","16.8% of total billed charges",80,100,,64.00,,,0,"percent of total billed charges","100% of total billed charges",12.24,80,
"J1071 Injection, testosterone cypionate 1mg",7906934,CDM,636,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.7% of total billed charges",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,33.9,,0.27,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"J1100 Injection, dexamethasone sodium phos 1mg",7906906,CDM,636,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.7% of total billed charges",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.7,33.9,,1.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"J1110 Injection, dihydroergotamine mesylate, per 1",7906907,CDM,636,RC,,,OUTPATIENT,,,65,42.25,,57.2,88,,45.76,,,0,"percent of total billed charges","88% of total billed charges",32.5,50,,26.00,,,0,"percent of total billed charges","50% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.25,17.304,,9.00,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.95,63,,32.76,,,0,"percent of total billed charges","63% of total billed charges",9.95,15.3,,7.96,,,0,"percent of total billed charges","15.3% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",44.85,69,,,,,0,"fee schedule","69% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",32.5,50,,26.00,,,0,"percent of total billed charges","50% of total billed charges",20.93,32.2,,16.74,,,0,"percent of total billed charges","32.2% of total billed charges",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.14,17.136,,8.91,,,0,"percent of total billed charges","17.136% of total billed charges",14.2,21.84,,11.36,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.51,37.7,,19.61,,,0,"percent of total billed charges","37.7% of total billed charges",24.51,37.7,,19.61,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.04,33.9,,17.63,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",50.7,78,,40.56,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",32.5,50,,26.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",10.92,16.8,,8.74,,,0,"percent of total billed charges","16.8% of total billed charges",65,100,,52.00,,,0,"percent of total billed charges","100% of total billed charges",9.95,65,
"J1170 Injection, hydromorphone, up to 4 mg",7906914,CDM,636,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.7% of total billed charges",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.02,33.9,,0.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"J1200 Diphenhydramine hcJ l inj up to 50mg",7906893,CDM,636,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.7% of total billed charges",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.03,33.9,,1.62,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"J1240 dimenhydrinate injection",7964151,CDM,636,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.7% of total billed charges",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.71,33.9,,2.17,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"J1380 Injection, estradiol valerate, up to 10 mg",7906901,CDM,636,RC,,,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.77,17.304,,2.22,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",5.15,32.2,,4.12,,,0,"percent of total billed charges","32.2% of total billed charges",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.74,17.136,,2.19,,,0,"percent of total billed charges","17.136% of total billed charges",3.49,21.84,,2.79,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.7% of total billed charges",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.42,33.9,,4.34,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",8,50,,6.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.69,16.8,,2.15,,,0,"percent of total billed charges","16.8% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,16,
"J1435 injection estrone per 1 mg",7964143,CDM,636,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.7% of total billed charges",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.07,33.9,,3.26,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"J1460 Injection, gamma globulin, intramuscular, 1",7964114,CDM,636,RC,,,OUTPATIENT,,,26,16.9,,22.88,88,,18.30,,,0,"percent of total billed charges","88% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.5,17.304,,3.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.38,63,,13.10,,,0,"percent of total billed charges","63% of total billed charges",3.98,15.3,,3.18,,,0,"percent of total billed charges","15.3% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",17.94,69,,,,,0,"fee schedule","69% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",8.37,32.2,,6.70,,,0,"percent of total billed charges","32.2% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.46,17.136,,3.57,,,0,"percent of total billed charges","17.136% of total billed charges",5.68,21.84,,4.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.8,37.7,,7.84,,,0,"percent of total billed charges","37.7% of total billed charges",9.8,37.7,,7.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.81,33.9,,7.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.28,78,,16.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",3.98,26,
"J1560 gamma globulin > 10 cc inj",7964144,CDM,636,RC,,,OUTPATIENT,,,169,109.85,,148.72,88,,118.98,,,0,"percent of total billed charges","88% of total billed charges",84.5,50,,67.60,,,0,"percent of total billed charges","50% of total billed charges",28.39,16.8,,22.71,,,0,"percent of total billed charges","16.8% of total billed charges",169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29.24,17.304,,23.39,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",106.47,63,,85.18,,,0,"percent of total billed charges","63% of total billed charges",25.86,15.3,,20.69,,,0,"percent of total billed charges","15.3% of total billed charges",28.39,16.8,,22.71,,,0,"percent of total billed charges","16.8% of total billed charges",116.61,69,,,,,0,"fee schedule","69% of total billed charges",169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.39,16.8,,22.71,,,0,"percent of total billed charges","16.8% of total billed charges",84.5,50,,67.60,,,0,"percent of total billed charges","50% of total billed charges",54.42,32.2,,43.54,,,0,"percent of total billed charges","32.2% of total billed charges",28.39,16.8,,22.71,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.96,17.136,,23.17,,,0,"percent of total billed charges","17.136% of total billed charges",36.91,21.84,,29.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",63.71,37.7,,50.97,,,0,"percent of total billed charges","37.7% of total billed charges",63.71,37.7,,50.97,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.29,33.9,,45.83,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",131.82,78,,105.46,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.39,16.8,,22.71,,,0,"percent of total billed charges","16.8% of total billed charges",84.5,50,,67.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",28.39,16.8,,22.71,,,0,"percent of total billed charges","16.8% of total billed charges",169,100,,135.20,,,0,"percent of total billed charges","100% of total billed charges",25.86,169,
"J1580 Medication; garamycin, gentamicin, up to 80",7964115,CDM,636,RC,J1580,CPT,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.7% of total billed charges",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.71,33.9,,2.17,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"J1600 Injection, gold sodium thiomalate, up to 50",7964116,CDM,636,RC,,,OUTPATIENT,,,25,16.25,,22,88,,17.60,,,0,"percent of total billed charges","88% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,17.304,,3.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.75,63,,12.60,,,0,"percent of total billed charges","63% of total billed charges",3.83,15.3,,3.06,,,0,"percent of total billed charges","15.3% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",17.25,69,,,,,0,"fee schedule","69% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",8.05,32.2,,6.44,,,0,"percent of total billed charges","32.2% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.28,17.136,,3.42,,,0,"percent of total billed charges","17.136% of total billed charges",5.46,21.84,,4.37,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.43,37.7,,7.54,,,0,"percent of total billed charges","37.7% of total billed charges",9.43,37.7,,7.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.48,33.9,,6.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.5,78,,15.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",3.83,25,
"J1610 Injection, glucagon hydrochloride",7922200,CDM,636,RC,,,OUTPATIENT,,,120,78,,105.6,88,,84.48,,,0,"percent of total billed charges","88% of total billed charges",60,50,,48.00,,,0,"percent of total billed charges","50% of total billed charges",20.16,16.8,,16.13,,,0,"percent of total billed charges","16.8% of total billed charges",120,100,,96.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.76,17.304,,16.61,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.6,63,,60.48,,,0,"percent of total billed charges","63% of total billed charges",18.36,15.3,,14.69,,,0,"percent of total billed charges","15.3% of total billed charges",20.16,16.8,,16.13,,,0,"percent of total billed charges","16.8% of total billed charges",82.8,69,,,,,0,"fee schedule","69% of total billed charges",120,100,,96.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",120,100,,96.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",120,100,,96.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.16,16.8,,16.13,,,0,"percent of total billed charges","16.8% of total billed charges",60,50,,48.00,,,0,"percent of total billed charges","50% of total billed charges",38.64,32.2,,30.91,,,0,"percent of total billed charges","32.2% of total billed charges",20.16,16.8,,16.13,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.56,17.136,,16.45,,,0,"percent of total billed charges","17.136% of total billed charges",26.21,21.84,,20.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",45.24,37.7,,36.19,,,0,"percent of total billed charges","37.7% of total billed charges",45.24,37.7,,36.19,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",40.68,33.9,,32.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",93.6,78,,74.88,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.16,16.8,,16.13,,,0,"percent of total billed charges","16.8% of total billed charges",60,50,,48.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",20.16,16.8,,16.13,,,0,"percent of total billed charges","16.8% of total billed charges",120,100,,96.00,,,0,"percent of total billed charges","100% of total billed charges",18.36,120,
"J1630 haloperidol injection 5mg",7964149,CDM,636,RC,J1630,CPT,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.7% of total billed charges",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.36,33.9,,1.09,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"J1642 Injection, heparin sodium",7964139,CDM,636,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.7% of total billed charges",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.02,33.9,,0.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"J1650 Injection, enoxaparin sodium, 10 mg",7906908,CDM,636,RC,,,OUTPATIENT,,,26,16.9,,22.88,88,,18.30,,,0,"percent of total billed charges","88% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.5,17.304,,3.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.38,63,,13.10,,,0,"percent of total billed charges","63% of total billed charges",3.98,15.3,,3.18,,,0,"percent of total billed charges","15.3% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",17.94,69,,,,,0,"fee schedule","69% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",8.37,32.2,,6.70,,,0,"percent of total billed charges","32.2% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.46,17.136,,3.57,,,0,"percent of total billed charges","17.136% of total billed charges",5.68,21.84,,4.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.8,37.7,,7.84,,,0,"percent of total billed charges","37.7% of total billed charges",9.8,37.7,,7.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.81,33.9,,7.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.28,78,,16.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",3.98,26,
"J1670 Injection, tetanus immune up to 250 unit",7906935,CDM,636,RC,,,OUTPATIENT,,,420,273,,369.6,88,,295.68,,,0,"percent of total billed charges","88% of total billed charges",210,50,,168.00,,,0,"percent of total billed charges","50% of total billed charges",70.56,16.8,,56.45,,,0,"percent of total billed charges","16.8% of total billed charges",420,100,,336.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",72.68,17.304,,58.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",264.6,63,,211.68,,,0,"percent of total billed charges","63% of total billed charges",64.26,15.3,,51.41,,,0,"percent of total billed charges","15.3% of total billed charges",70.56,16.8,,56.45,,,0,"percent of total billed charges","16.8% of total billed charges",289.8,69,,,,,0,"fee schedule","69% of total billed charges",420,100,,336.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",420,100,,336.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",420,100,,336.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",70.56,16.8,,56.45,,,0,"percent of total billed charges","16.8% of total billed charges",210,50,,168.00,,,0,"percent of total billed charges","50% of total billed charges",135.24,32.2,,108.19,,,0,"percent of total billed charges","32.2% of total billed charges",70.56,16.8,,56.45,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",71.97,17.136,,57.58,,,0,"percent of total billed charges","17.136% of total billed charges",91.73,21.84,,73.38,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",158.34,37.7,,126.67,,,0,"percent of total billed charges","37.7% of total billed charges",158.34,37.7,,126.67,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",142.38,33.9,,113.90,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",327.6,78,,262.08,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",70.56,16.8,,56.45,,,0,"percent of total billed charges","16.8% of total billed charges",210,50,,168.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",70.56,16.8,,56.45,,,0,"percent of total billed charges","16.8% of total billed charges",420,100,,336.00,,,0,"percent of total billed charges","100% of total billed charges",64.26,420,
"J1720 Injection, hydrocortisone sodium succinate,",7964112,CDM,636,RC,J1720,CPT,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.7% of total billed charges",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.37,33.9,,1.90,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"J1726 Injection, hydroxyprogesterone caproate, (ma",8604744,CDM,636,RC,,,OUTPATIENT,,,1057,687.05,,930.16,88,,744.13,,,0,"percent of total billed charges","88% of total billed charges",528.5,50,,422.80,,,0,"percent of total billed charges","50% of total billed charges",177.58,16.8,,142.06,,,0,"percent of total billed charges","16.8% of total billed charges",1057,100,,845.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",182.9,17.304,,146.32,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",665.91,63,,532.73,,,0,"percent of total billed charges","63% of total billed charges",161.72,15.3,,129.38,,,0,"percent of total billed charges","15.3% of total billed charges",177.58,16.8,,142.06,,,0,"percent of total billed charges","16.8% of total billed charges",729.33,69,,,,,0,"fee schedule","69% of total billed charges",1057,100,,845.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1057,100,,845.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1057,100,,845.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",177.58,16.8,,142.06,,,0,"percent of total billed charges","16.8% of total billed charges",528.5,50,,422.80,,,0,"percent of total billed charges","50% of total billed charges",340.35,32.2,,272.28,,,0,"percent of total billed charges","32.2% of total billed charges",177.58,16.8,,142.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",181.13,17.136,,144.90,,,0,"percent of total billed charges","17.136% of total billed charges",230.85,21.84,,184.68,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",398.49,37.7,,318.79,,,0,"percent of total billed charges","37.7% of total billed charges",398.49,37.7,,318.79,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",358.32,33.9,,286.66,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",824.46,78,,659.57,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",177.58,16.8,,142.06,,,0,"percent of total billed charges","16.8% of total billed charges",528.5,50,,422.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",177.58,16.8,,142.06,,,0,"percent of total billed charges","16.8% of total billed charges",1057,100,,845.60,,,0,"percent of total billed charges","100% of total billed charges",161.72,1057,
"J1740 Injection, ibandronate sodium, 1 mg",7964126,CDM,636,RC,,,OUTPATIENT,,,336,218.4,,295.68,88,,236.54,,,0,"percent of total billed charges","88% of total billed charges",168,50,,134.40,,,0,"percent of total billed charges","50% of total billed charges",56.45,16.8,,45.16,,,0,"percent of total billed charges","16.8% of total billed charges",336,100,,268.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.14,17.304,,46.51,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",211.68,63,,169.34,,,0,"percent of total billed charges","63% of total billed charges",51.41,15.3,,41.13,,,0,"percent of total billed charges","15.3% of total billed charges",56.45,16.8,,45.16,,,0,"percent of total billed charges","16.8% of total billed charges",231.84,69,,,,,0,"fee schedule","69% of total billed charges",336,100,,268.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336,100,,268.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",336,100,,268.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",56.45,16.8,,45.16,,,0,"percent of total billed charges","16.8% of total billed charges",168,50,,134.40,,,0,"percent of total billed charges","50% of total billed charges",108.19,32.2,,86.55,,,0,"percent of total billed charges","32.2% of total billed charges",56.45,16.8,,45.16,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",57.58,17.136,,46.06,,,0,"percent of total billed charges","17.136% of total billed charges",73.38,21.84,,58.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",126.67,37.7,,101.34,,,0,"percent of total billed charges","37.7% of total billed charges",126.67,37.7,,101.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",113.9,33.9,,91.12,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",262.08,78,,209.66,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",56.45,16.8,,45.16,,,0,"percent of total billed charges","16.8% of total billed charges",168,50,,134.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",56.45,16.8,,45.16,,,0,"percent of total billed charges","16.8% of total billed charges",336,100,,268.80,,,0,"percent of total billed charges","100% of total billed charges",51.41,336,
"J1750 Injection, iron dextran, 50 mg",7964128,CDM,636,RC,J1750,CPT,OUTPATIENT,,,16,10.4,,14.08,88,,11.26,,,0,"percent of total billed charges","88% of total billed charges",17.3,100,,,,,0,"fee schedule","100% of CMS OPPS rate",82.95,100,,,,,0,"fee schedule",EAPG,16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",30.29,175,,,,,0,"fee schedule","175% of CMS fee schedule",85.44,100,,,,,0,"fee schedule",EAPG,17.3,100,,,,,0,"fee schedule","100% of CMS OPPS rate",10.08,63,,8.06,,,0,"percent of total billed charges","63% of total billed charges",2.45,15.3,,1.96,,,0,"percent of total billed charges","15.3% of total billed charges",82.95,100,,,,,0,"fee schedule",EAPG,11.04,69,,,,,0,"fee schedule","69% of total billed charges",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",17.3,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",17.3,100,,,,,0,"fee schedule","100% of CMS OPPS rate",16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",17.3,100,,,,,0,"fee schedule","100% of CMS fee schedule",60.39,100,,,,,0,"fee schedule","100% of CMS OPPS rate",82.95,100,,,,,0,"fee schedule",EAPG,17.3,100,,,,,0,"fee schedule","100% of CMS OPPS rate",15.84,100,,,,,0,"fee schedule","100% of CMS OPPS rate",55.86,100,,,,,0,"fee schedule",EAPG,17.3,100,,,,,0,"fee schedule","100% of CMS OPPS rate",84.61,100,,,,,0,"fee schedule",EAPG,107.83,100,,,,,0,"fee schedule",EAPG,17.3,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.7% of total billed charges",6.03,37.7,,4.82,,,0,"percent of total billed charges","37.70% of total billed charges",17.3,100,,,,,0,"fee schedule","100% of CMS OPPS rate",5.42,33.9,,4.34,,,0,"percent of total billed charges","33.9% of total billed charges",17.3,100,,,,,0,"fee schedule","100% of CMS OPPS rate",12.48,78,,9.98,,,0,"percent of total billed charges","78% of total billed charges",17.48,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",82.95,100,,,,,0,"fee schedule",EAPG,17.3,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",17.3,100,,,,,0,"fee schedule","100% of CMS OPPS rate",82.95,100,,,,,0,"fee schedule",EAPG,16,100,,12.80,,,0,"percent of total billed charges","100% of total billed charges",2.45,107.83,
"J1790 droperidol injection",7964159,CDM,636,RC,J1790,CPT,OUTPATIENT,,,4,2.6,,3.52,88,,2.82,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.304,,0.55,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.52,63,,2.02,,,0,"percent of total billed charges","63% of total billed charges",0.61,15.3,,0.49,,,0,"percent of total billed charges","15.3% of total billed charges",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",2.76,69,,,,,0,"fee schedule","69% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.69,17.136,,0.55,,,0,"percent of total billed charges","17.136% of total billed charges",0.87,21.84,,0.70,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.7% of total billed charges",1.51,37.7,,1.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.36,33.9,,1.09,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.12,78,,2.50,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.67,16.8,,0.54,,,0,"percent of total billed charges","16.8% of total billed charges",4,100,,3.20,,,0,"percent of total billed charges","100% of total billed charges",0.61,4,
"J1815 Injection, insulin, per 5 units",7964161,CDM,636,RC,,,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,17.304,,1.25,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",2.9,32.2,,2.32,,,0,"percent of total billed charges","32.2% of total billed charges",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.54,17.136,,1.23,,,0,"percent of total billed charges","17.136% of total billed charges",1.97,21.84,,1.58,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.7% of total billed charges",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.05,33.9,,2.44,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",4.5,50,,3.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.51,16.8,,1.21,,,0,"percent of total billed charges","16.8% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"J1885 Injection, ketorolac tromethamine per 15 mg",7906936,CDM,636,RC,,,OUTPATIENT,,,25,16.25,,22,88,,17.60,,,0,"percent of total billed charges","88% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,17.304,,3.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.75,63,,12.60,,,0,"percent of total billed charges","63% of total billed charges",3.83,15.3,,3.06,,,0,"percent of total billed charges","15.3% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",17.25,69,,,,,0,"fee schedule","69% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",8.05,32.2,,6.44,,,0,"percent of total billed charges","32.2% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.28,17.136,,3.42,,,0,"percent of total billed charges","17.136% of total billed charges",5.46,21.84,,4.37,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.43,37.7,,7.54,,,0,"percent of total billed charges","37.7% of total billed charges",9.43,37.7,,7.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.48,33.9,,6.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.5,78,,15.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",3.83,25,
"J1938 Injection furosemide, 1 mg",14727048,CDM,636,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.7% of total billed charges",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,33.9,,0.27,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"J1940 Injection, furosemide, up to 20 mg",7906912,CDM,636,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.7% of total billed charges",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.09,33.9,,4.07,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"J2175 Injection, meperidine hydrochloride, per 100",7906922,CDM,636,RC,,,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",4.51,32.2,,3.61,,,0,"percent of total billed charges","32.2% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.7% of total billed charges",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.75,33.9,,3.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",7,50,,5.60,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"J2180 meperidine/promethazine inj",7964140,CDM,636,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.7% of total billed charges",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.71,33.9,,2.17,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"J2250 inj midazolam hydrochloride",7964141,CDM,636,RC,J2250,CPT,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.7% of total billed charges",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.37,33.9,,1.90,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"J2270 Injection, morphine sulfate",7906926,CDM,636,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.7% of total billed charges",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.03,33.9,,1.62,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"J2310 Injection, naloxone hydrochloride",7922201,CDM,636,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.7% of total billed charges",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.73,33.9,,2.98,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"J2360 orphenadrine injection up to 60mg",7964155,CDM,636,RC,J2360,CPT,OUTPATIENT,,,29,18.85,,25.52,88,,20.42,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.02,17.304,,4.02,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",18.27,63,,14.62,,,0,"percent of total billed charges","63% of total billed charges",4.44,15.3,,3.55,,,0,"percent of total billed charges","15.3% of total billed charges",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",20.01,69,,,,,0,"fee schedule","69% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.97,17.136,,3.98,,,0,"percent of total billed charges","17.136% of total billed charges",6.33,21.84,,5.06,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.93,37.7,,8.74,,,0,"percent of total billed charges","37.7% of total billed charges",10.93,37.7,,8.74,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.83,33.9,,7.86,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.62,78,,18.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.87,16.8,,3.90,,,0,"percent of total billed charges","16.8% of total billed charges",29,100,,23.20,,,0,"percent of total billed charges","100% of total billed charges",4.44,29,
"J2405 Injection, ondansetron hydrochloride 1mg",7906928,CDM,636,RC,,,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",0.64,32.2,,0.51,,,0,"percent of total billed charges","32.2% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.7% of total billed charges",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.68,33.9,,0.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1,50,,0.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"J2680 Injection, fluphenazine decanoate, up to 25",7964117,CDM,636,RC,,,OUTPATIENT,,,33,21.45,,29.04,88,,23.23,,,0,"percent of total billed charges","88% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.71,17.304,,4.57,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.79,63,,16.63,,,0,"percent of total billed charges","63% of total billed charges",5.05,15.3,,4.04,,,0,"percent of total billed charges","15.3% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",22.77,69,,,,,0,"fee schedule","69% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",10.63,32.2,,8.50,,,0,"percent of total billed charges","32.2% of total billed charges",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.65,17.136,,4.52,,,0,"percent of total billed charges","17.136% of total billed charges",7.21,21.84,,5.77,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.44,37.7,,9.95,,,0,"percent of total billed charges","37.7% of total billed charges",12.44,37.7,,9.95,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.19,33.9,,8.95,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",25.74,78,,20.59,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",16.5,50,,13.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.54,16.8,,4.43,,,0,"percent of total billed charges","16.8% of total billed charges",33,100,,26.40,,,0,"percent of total billed charges","100% of total billed charges",5.05,33,
"J2725 inj protirelin per 250 mcg",7964145,CDM,636,RC,,,OUTPATIENT,,,37,24.05,,32.56,88,,26.05,,,0,"percent of total billed charges","88% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.4,17.304,,5.12,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",23.31,63,,18.65,,,0,"percent of total billed charges","63% of total billed charges",5.66,15.3,,4.53,,,0,"percent of total billed charges","15.3% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",25.53,69,,,,,0,"fee schedule","69% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",11.91,32.2,,9.53,,,0,"percent of total billed charges","32.2% of total billed charges",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.34,17.136,,5.07,,,0,"percent of total billed charges","17.136% of total billed charges",8.08,21.84,,6.46,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",13.95,37.7,,11.16,,,0,"percent of total billed charges","37.7% of total billed charges",13.95,37.7,,11.16,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.54,33.9,,10.03,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",28.86,78,,23.09,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",18.5,50,,14.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.22,16.8,,4.98,,,0,"percent of total billed charges","16.8% of total billed charges",37,100,,29.60,,,0,"percent of total billed charges","100% of total billed charges",5.66,37,
"J2765 Injection, metoclopramide hcl, up to 10 mg",7906923,CDM,636,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.7% of total billed charges",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.03,33.9,,1.62,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"J2790 Injection, rho d immune globulin, human",7906931,CDM,636,RC,,,OUTPATIENT,,,130,84.5,,114.4,88,,91.52,,,0,"percent of total billed charges","88% of total billed charges",65,50,,52.00,,,0,"percent of total billed charges","50% of total billed charges",21.84,16.8,,17.47,,,0,"percent of total billed charges","16.8% of total billed charges",130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.5,17.304,,18.00,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",81.9,63,,65.52,,,0,"percent of total billed charges","63% of total billed charges",19.89,15.3,,15.91,,,0,"percent of total billed charges","15.3% of total billed charges",21.84,16.8,,17.47,,,0,"percent of total billed charges","16.8% of total billed charges",89.7,69,,,,,0,"fee schedule","69% of total billed charges",130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.84,16.8,,17.47,,,0,"percent of total billed charges","16.8% of total billed charges",65,50,,52.00,,,0,"percent of total billed charges","50% of total billed charges",41.86,32.2,,33.49,,,0,"percent of total billed charges","32.2% of total billed charges",21.84,16.8,,17.47,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",22.28,17.136,,17.82,,,0,"percent of total billed charges","17.136% of total billed charges",28.39,21.84,,22.71,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",49.01,37.7,,39.21,,,0,"percent of total billed charges","37.7% of total billed charges",49.01,37.7,,39.21,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.07,33.9,,35.26,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",101.4,78,,81.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.84,16.8,,17.47,,,0,"percent of total billed charges","16.8% of total billed charges",65,50,,52.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",21.84,16.8,,17.47,,,0,"percent of total billed charges","16.8% of total billed charges",130,100,,104.00,,,0,"percent of total billed charges","100% of total billed charges",19.89,130,
"J2919 Methylprednisolone injection up to 125 mg",7906933,CDM,636,RC,,,OUTPATIENT,,,15,9.75,,13.2,88,,10.56,,,0,"percent of total billed charges","88% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.6,17.304,,2.08,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.45,63,,7.56,,,0,"percent of total billed charges","63% of total billed charges",2.3,15.3,,1.84,,,0,"percent of total billed charges","15.3% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",10.35,69,,,,,0,"fee schedule","69% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",4.83,32.2,,3.86,,,0,"percent of total billed charges","32.2% of total billed charges",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.57,17.136,,2.06,,,0,"percent of total billed charges","17.136% of total billed charges",3.28,21.84,,2.62,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.7% of total billed charges",5.66,37.7,,4.53,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.09,33.9,,4.07,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",11.7,78,,9.36,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",7.5,50,,6.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.52,16.8,,2.02,,,0,"percent of total billed charges","16.8% of total billed charges",15,100,,12.00,,,0,"percent of total billed charges","100% of total billed charges",2.3,15,
"J3030 Injection, sumatriptan succinate, 6 mg",7906917,CDM,636,RC,,,OUTPATIENT,,,93,60.45,,81.84,88,,65.47,,,0,"percent of total billed charges","88% of total billed charges",46.5,50,,37.20,,,0,"percent of total billed charges","50% of total billed charges",15.62,16.8,,12.50,,,0,"percent of total billed charges","16.8% of total billed charges",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.09,17.304,,12.87,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",58.59,63,,46.87,,,0,"percent of total billed charges","63% of total billed charges",14.23,15.3,,11.38,,,0,"percent of total billed charges","15.3% of total billed charges",15.62,16.8,,12.50,,,0,"percent of total billed charges","16.8% of total billed charges",64.17,69,,,,,0,"fee schedule","69% of total billed charges",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.62,16.8,,12.50,,,0,"percent of total billed charges","16.8% of total billed charges",46.5,50,,37.20,,,0,"percent of total billed charges","50% of total billed charges",29.95,32.2,,23.96,,,0,"percent of total billed charges","32.2% of total billed charges",15.62,16.8,,12.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.94,17.136,,12.75,,,0,"percent of total billed charges","17.136% of total billed charges",20.31,21.84,,16.25,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.06,37.7,,28.05,,,0,"percent of total billed charges","37.7% of total billed charges",35.06,37.7,,28.05,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",31.53,33.9,,25.22,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",72.54,78,,58.03,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.62,16.8,,12.50,,,0,"percent of total billed charges","16.8% of total billed charges",46.5,50,,37.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",15.62,16.8,,12.50,,,0,"percent of total billed charges","16.8% of total billed charges",93,100,,74.40,,,0,"percent of total billed charges","100% of total billed charges",14.23,93,
"J3111 Romosozumab syringe 210mg/3.34ml dose",9449518,CDM,636,RC,,,OUTPATIENT,,,6056,3936.4,,5329.28,88,,4263.42,,,0,"percent of total billed charges","88% of total billed charges",3028,50,,2422.40,,,0,"percent of total billed charges","50% of total billed charges",1017.41,16.8,,813.93,,,0,"percent of total billed charges","16.8% of total billed charges",4695,100,,3756.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1047.93,17.304,,838.34,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3815.28,63,,3052.22,,,0,"percent of total billed charges","63% of total billed charges",926.57,15.3,,741.26,,,0,"percent of total billed charges","15.3% of total billed charges",1017.41,16.8,,813.93,,,0,"percent of total billed charges","16.8% of total billed charges",4178.64,69,,,,,0,"fee schedule","69% of total billed charges",6056,100,,4844.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6056,100,,4844.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6056,100,,4844.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1017.41,16.8,,813.93,,,0,"percent of total billed charges","16.8% of total billed charges",3028,50,,2422.40,,,0,"percent of total billed charges","50% of total billed charges",1950.03,32.2,,1560.02,,,0,"percent of total billed charges","32.2% of total billed charges",1017.41,16.8,,813.93,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1037.76,17.136,,830.21,,,0,"percent of total billed charges","17.136% of total billed charges",1322.63,21.84,,1058.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2283.11,37.7,,1826.49,,,0,"percent of total billed charges","37.7% of total billed charges",2283.11,37.7,,1826.49,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2052.98,33.9,,1642.38,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4723.68,78,,3778.94,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1017.41,16.8,,813.93,,,0,"percent of total billed charges","16.8% of total billed charges",3028,50,,2422.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1017.41,16.8,,813.93,,,0,"percent of total billed charges","16.8% of total billed charges",6056,100,,4844.80,,,0,"percent of total billed charges","100% of total billed charges",926.57,6056,
"J3250 trimethobenzamide hcl inj",7964150,CDM,636,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.7% of total billed charges",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.71,33.9,,2.17,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"J3301 Injection, triamcinolone acetonide, 10 mg",7906918,CDM,636,RC,,,OUTPATIENT,,,32,20.8,,28.16,88,,22.53,,,0,"percent of total billed charges","88% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.54,17.304,,4.43,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.16,63,,16.13,,,0,"percent of total billed charges","63% of total billed charges",4.9,15.3,,3.92,,,0,"percent of total billed charges","15.3% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",22.08,69,,,,,0,"fee schedule","69% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",10.3,32.2,,8.24,,,0,"percent of total billed charges","32.2% of total billed charges",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.48,17.136,,4.38,,,0,"percent of total billed charges","17.136% of total billed charges",6.99,21.84,,5.59,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.7% of total billed charges",12.06,37.7,,9.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.85,33.9,,8.68,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",24.96,78,,19.97,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",16,50,,12.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",5.38,16.8,,4.30,,,0,"percent of total billed charges","16.8% of total billed charges",32,100,,25.60,,,0,"percent of total billed charges","100% of total billed charges",4.9,32,
"J3360 Injection, diazepam",7922199,CDM,636,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.7% of total billed charges",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.71,33.9,,2.17,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"J3370 vancomycin hcl injection 500mg",7964127,CDM,636,RC,J3370,CPT,OUTPATIENT,,,14,9.1,,12.32,88,,9.86,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.42,17.304,,1.94,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.82,63,,7.06,,,0,"percent of total billed charges","63% of total billed charges",2.14,15.3,,1.71,,,0,"percent of total billed charges","15.3% of total billed charges",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",9.66,69,,,,,0,"fee schedule","69% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.4,17.136,,1.92,,,0,"percent of total billed charges","17.136% of total billed charges",3.06,21.84,,2.45,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.7% of total billed charges",5.28,37.7,,4.22,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.75,33.9,,3.80,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",10.92,78,,8.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.35,16.8,,1.88,,,0,"percent of total billed charges","16.8% of total billed charges",14,100,,11.20,,,0,"percent of total billed charges","100% of total billed charges",2.14,14,
"J3410 Injection, hydroxyzine hcl, up to 25 mg",7906916,CDM,636,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.7% of total billed charges",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.03,33.9,,1.62,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"J3411 Injection, thiamine hcl",7908272,CDM,636,RC,,,OUTPATIENT,,,26,16.9,,22.88,88,,18.30,,,0,"percent of total billed charges","88% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.5,17.304,,3.60,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",16.38,63,,13.10,,,0,"percent of total billed charges","63% of total billed charges",3.98,15.3,,3.18,,,0,"percent of total billed charges","15.3% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",17.94,69,,,,,0,"fee schedule","69% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",8.37,32.2,,6.70,,,0,"percent of total billed charges","32.2% of total billed charges",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.46,17.136,,3.57,,,0,"percent of total billed charges","17.136% of total billed charges",5.68,21.84,,4.54,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.8,37.7,,7.84,,,0,"percent of total billed charges","37.7% of total billed charges",9.8,37.7,,7.84,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.81,33.9,,7.05,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",20.28,78,,16.22,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",13,50,,10.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.37,16.8,,3.50,,,0,"percent of total billed charges","16.8% of total billed charges",26,100,,20.80,,,0,"percent of total billed charges","100% of total billed charges",3.98,26,
"J3420 Injection, vitamin b-12 cyanocobalamin, up t",7906897,CDM,636,RC,,,OUTPATIENT,,,23,14.95,,20.24,88,,16.19,,,0,"percent of total billed charges","88% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.98,17.304,,3.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.49,63,,11.59,,,0,"percent of total billed charges","63% of total billed charges",3.52,15.3,,2.82,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",15.87,69,,,,,0,"fee schedule","69% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",7.41,32.2,,5.93,,,0,"percent of total billed charges","32.2% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.94,17.136,,3.15,,,0,"percent of total billed charges","17.136% of total billed charges",5.02,21.84,,4.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.7% of total billed charges",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.8,33.9,,6.24,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.94,78,,14.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",3.52,23,
"J3430 Injection, phytonadione (vitamin k)",7908267,CDM,636,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.7% of total billed charges",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.71,33.9,,2.17,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"J3490 Injection, Sodium Bicarbonate, 1 Vial",7964124,CDM,636,RC,,,OUTPATIENT,,,12,7.8,,10.56,88,,8.45,,,0,"percent of total billed charges","88% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.08,17.304,,1.66,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.56,63,,6.05,,,0,"percent of total billed charges","63% of total billed charges",1.84,15.3,,1.47,,,0,"percent of total billed charges","15.3% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",8.28,69,,,,,0,"fee schedule","69% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",3.86,32.2,,3.09,,,0,"percent of total billed charges","32.2% of total billed charges",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.06,17.136,,1.65,,,0,"percent of total billed charges","17.136% of total billed charges",2.62,21.84,,2.10,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.7% of total billed charges",4.52,37.7,,3.62,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.07,33.9,,3.26,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.36,78,,7.49,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",6,50,,4.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",2.02,16.8,,1.62,,,0,"percent of total billed charges","16.8% of total billed charges",12,100,,9.60,,,0,"percent of total billed charges","100% of total billed charges",1.84,12,
"J7030 Infusion, normal saline solution , 1000 cc",7964119,CDM,636,RC,J7030,CPT,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.7% of total billed charges",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.37,33.9,,1.90,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"J7040 Infusion, normal saline solution, sterile (5",7964111,CDM,636,RC,J7040,CPT,OUTPATIENT,,,2,1.3,,1.76,88,,1.41,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.35,17.304,,0.28,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.26,63,,1.01,,,0,"percent of total billed charges","63% of total billed charges",0.31,15.3,,0.25,,,0,"percent of total billed charges","15.3% of total billed charges",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",1.38,69,,,,,0,"fee schedule","69% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,17.136,,0.27,,,0,"percent of total billed charges","17.136% of total billed charges",0.44,21.84,,0.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.7% of total billed charges",0.75,37.7,,0.60,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.68,33.9,,0.54,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.56,78,,1.25,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.34,16.8,,0.27,,,0,"percent of total billed charges","16.8% of total billed charges",2,100,,1.60,,,0,"percent of total billed charges","100% of total billed charges",0.31,2,
"J7050 Infusion, normal saline solution , 250 cc",7964120,CDM,636,RC,J7050,CPT,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.7% of total billed charges",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.37,33.9,,1.90,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"J7060 5% dextrose/water",7922198,CDM,636,RC,,,OUTPATIENT,,,25,16.25,,22,88,,17.60,,,0,"percent of total billed charges","88% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.33,17.304,,3.46,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",15.75,63,,12.60,,,0,"percent of total billed charges","63% of total billed charges",3.83,15.3,,3.06,,,0,"percent of total billed charges","15.3% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",17.25,69,,,,,0,"fee schedule","69% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",8.05,32.2,,6.44,,,0,"percent of total billed charges","32.2% of total billed charges",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.28,17.136,,3.42,,,0,"percent of total billed charges","17.136% of total billed charges",5.46,21.84,,4.37,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.43,37.7,,7.54,,,0,"percent of total billed charges","37.7% of total billed charges",9.43,37.7,,7.54,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.48,33.9,,6.78,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",19.5,78,,15.60,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",12.5,50,,10.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.2,16.8,,3.36,,,0,"percent of total billed charges","16.8% of total billed charges",25,100,,20.00,,,0,"percent of total billed charges","100% of total billed charges",3.83,25,
"J7070 Infusion, d5w, 1000 cc",7964157,CDM,636,RC,J7070,CPT,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.7% of total billed charges",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.37,33.9,,1.90,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"J7120 Ringers lactate infusion, up to 1000 cc",7964122,CDM,636,RC,J7120,CPT,OUTPATIENT,,,7,4.55,,6.16,88,,4.93,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.21,17.304,,0.97,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.41,63,,3.53,,,0,"percent of total billed charges","63% of total billed charges",1.07,15.3,,0.86,,,0,"percent of total billed charges","15.3% of total billed charges",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",4.83,69,,,,,0,"fee schedule","69% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.2,17.136,,0.96,,,0,"percent of total billed charges","17.136% of total billed charges",1.53,21.84,,1.22,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.7% of total billed charges",2.64,37.7,,2.11,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.37,33.9,,1.90,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.46,78,,4.37,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.18,16.8,,0.94,,,0,"percent of total billed charges","16.8% of total billed charges",7,100,,5.60,,,0,"percent of total billed charges","100% of total billed charges",1.07,7,
"J7298 Levonorgestrel-releasing intrauterine contra",7906925,CDM,636,RC,,,OUTPATIENT,,,1362,885.3,,1198.56,88,,958.85,,,0,"percent of total billed charges","88% of total billed charges",681,50,,544.80,,,0,"percent of total billed charges","50% of total billed charges",228.82,16.8,,183.06,,,0,"percent of total billed charges","16.8% of total billed charges",1362,100,,1089.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",235.68,17.304,,188.54,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",858.06,63,,686.45,,,0,"percent of total billed charges","63% of total billed charges",208.39,15.3,,166.71,,,0,"percent of total billed charges","15.3% of total billed charges",228.82,16.8,,183.06,,,0,"percent of total billed charges","16.8% of total billed charges",939.78,69,,,,,0,"fee schedule","69% of total billed charges",1362,100,,1089.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1362,100,,1089.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1362,100,,1089.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",228.82,16.8,,183.06,,,0,"percent of total billed charges","16.8% of total billed charges",681,50,,544.80,,,0,"percent of total billed charges","50% of total billed charges",438.56,32.2,,350.85,,,0,"percent of total billed charges","32.2% of total billed charges",228.82,16.8,,183.06,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",233.39,17.136,,186.71,,,0,"percent of total billed charges","17.136% of total billed charges",297.46,21.84,,237.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",513.47,37.7,,410.78,,,0,"percent of total billed charges","37.7% of total billed charges",513.47,37.7,,410.78,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",461.72,33.9,,369.38,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1062.36,78,,849.89,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",228.82,16.8,,183.06,,,0,"percent of total billed charges","16.8% of total billed charges",681,50,,544.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",228.82,16.8,,183.06,,,0,"percent of total billed charges","16.8% of total billed charges",1362,100,,1089.60,,,0,"percent of total billed charges","100% of total billed charges",208.39,1362,
"J7307 Etonogestrel (contraceptive) implant system",7906927,CDM,636,RC,,,OUTPATIENT,,,1350,877.5,,1188,88,,950.40,,,0,"percent of total billed charges","88% of total billed charges",675,50,,540.00,,,0,"percent of total billed charges","50% of total billed charges",226.8,16.8,,181.44,,,0,"percent of total billed charges","16.8% of total billed charges",1350,100,,1080.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",233.6,17.304,,186.88,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",850.5,63,,680.40,,,0,"percent of total billed charges","63% of total billed charges",206.55,15.3,,165.24,,,0,"percent of total billed charges","15.3% of total billed charges",226.8,16.8,,181.44,,,0,"percent of total billed charges","16.8% of total billed charges",931.5,69,,,,,0,"fee schedule","69% of total billed charges",1350,100,,1080.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1350,100,,1080.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1350,100,,1080.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",226.8,16.8,,181.44,,,0,"percent of total billed charges","16.8% of total billed charges",675,50,,540.00,,,0,"percent of total billed charges","50% of total billed charges",434.7,32.2,,347.76,,,0,"percent of total billed charges","32.2% of total billed charges",226.8,16.8,,181.44,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",231.34,17.136,,185.07,,,0,"percent of total billed charges","17.136% of total billed charges",294.84,21.84,,235.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",508.95,37.7,,407.16,,,0,"percent of total billed charges","37.7% of total billed charges",508.95,37.7,,407.16,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",457.65,33.9,,366.12,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",1053,78,,842.40,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",226.8,16.8,,181.44,,,0,"percent of total billed charges","16.8% of total billed charges",675,50,,540.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",226.8,16.8,,181.44,,,0,"percent of total billed charges","16.8% of total billed charges",1350,100,,1080.00,,,0,"percent of total billed charges","100% of total billed charges",206.55,1350,
"J7301 Levonorgestrel-releasing intrauterine contra",7906932,CDM,636,RC,,,OUTPATIENT,,,857,557.05,,754.16,88,,603.33,,,0,"percent of total billed charges","88% of total billed charges",428.5,50,,342.80,,,0,"percent of total billed charges","50% of total billed charges",143.98,16.8,,115.18,,,0,"percent of total billed charges","16.8% of total billed charges",857,100,,685.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",148.3,17.304,,118.64,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",539.91,63,,431.93,,,0,"percent of total billed charges","63% of total billed charges",131.12,15.3,,104.90,,,0,"percent of total billed charges","15.3% of total billed charges",143.98,16.8,,115.18,,,0,"percent of total billed charges","16.8% of total billed charges",591.33,69,,,,,0,"fee schedule","69% of total billed charges",857,100,,685.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",857,100,,685.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",857,100,,685.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",143.98,16.8,,115.18,,,0,"percent of total billed charges","16.8% of total billed charges",428.5,50,,342.80,,,0,"percent of total billed charges","50% of total billed charges",275.95,32.2,,220.76,,,0,"percent of total billed charges","32.2% of total billed charges",143.98,16.8,,115.18,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",146.86,17.136,,117.49,,,0,"percent of total billed charges","17.136% of total billed charges",187.17,21.84,,149.74,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",323.09,37.7,,258.47,,,0,"percent of total billed charges","37.7% of total billed charges",323.09,37.7,,258.47,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",290.52,33.9,,232.42,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",668.46,78,,534.77,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",143.98,16.8,,115.18,,,0,"percent of total billed charges","16.8% of total billed charges",428.5,50,,342.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",143.98,16.8,,115.18,,,0,"percent of total billed charges","16.8% of total billed charges",857,100,,685.60,,,0,"percent of total billed charges","100% of total billed charges",131.12,857,
"J7300 Intrauterine copper contraceptive",7908266,CDM,636,RC,,,OUTPATIENT,,,1093,710.45,,961.84,88,,769.47,,,0,"percent of total billed charges","88% of total billed charges",546.5,50,,437.20,,,0,"percent of total billed charges","50% of total billed charges",183.62,16.8,,146.90,,,0,"percent of total billed charges","16.8% of total billed charges",1093,100,,874.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",189.13,17.304,,151.30,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",688.59,63,,550.87,,,0,"percent of total billed charges","63% of total billed charges",167.23,15.3,,133.78,,,0,"percent of total billed charges","15.3% of total billed charges",183.62,16.8,,146.90,,,0,"percent of total billed charges","16.8% of total billed charges",754.17,69,,,,,0,"fee schedule","69% of total billed charges",1093,100,,874.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1093,100,,874.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1093,100,,874.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",183.62,16.8,,146.90,,,0,"percent of total billed charges","16.8% of total billed charges",546.5,50,,437.20,,,0,"percent of total billed charges","50% of total billed charges",351.95,32.2,,281.56,,,0,"percent of total billed charges","32.2% of total billed charges",183.62,16.8,,146.90,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",187.3,17.136,,149.84,,,0,"percent of total billed charges","17.136% of total billed charges",238.71,21.84,,190.97,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",412.06,37.7,,329.65,,,0,"percent of total billed charges","37.7% of total billed charges",412.06,37.7,,329.65,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",370.53,33.9,,296.42,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",852.54,78,,682.03,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",183.62,16.8,,146.90,,,0,"percent of total billed charges","16.8% of total billed charges",546.5,50,,437.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",183.62,16.8,,146.90,,,0,"percent of total billed charges","16.8% of total billed charges",1093,100,,874.40,,,0,"percent of total billed charges","100% of total billed charges",167.23,1093,
"J7325 Hyaluronan or derivative, synvisc or synvisc",7922204,CDM,636,RC,,,OUTPATIENT,,,23,14.95,,20.24,88,,16.19,,,0,"percent of total billed charges","88% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.98,17.304,,3.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.49,63,,11.59,,,0,"percent of total billed charges","63% of total billed charges",3.52,15.3,,2.82,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",15.87,69,,,,,0,"fee schedule","69% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",7.41,32.2,,5.93,,,0,"percent of total billed charges","32.2% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.94,17.136,,3.15,,,0,"percent of total billed charges","17.136% of total billed charges",5.02,21.84,,4.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.7% of total billed charges",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.8,33.9,,6.24,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.94,78,,14.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",3.52,23,
"J7321 Injection, Hyaluronan or derivative, hyalgan",7964108,CDM,636,RC,,,OUTPATIENT,,,258,167.7,,227.04,88,,181.63,,,0,"percent of total billed charges","88% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.64,17.304,,35.71,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",162.54,63,,130.03,,,0,"percent of total billed charges","63% of total billed charges",39.47,15.3,,31.58,,,0,"percent of total billed charges","15.3% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",178.02,69,,,,,0,"fee schedule","69% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",83.08,32.2,,66.46,,,0,"percent of total billed charges","32.2% of total billed charges",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",44.21,17.136,,35.37,,,0,"percent of total billed charges","17.136% of total billed charges",56.35,21.84,,45.08,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.7% of total billed charges",97.27,37.7,,77.82,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",87.46,33.9,,69.97,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",201.24,78,,160.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",129,50,,103.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",43.34,16.8,,34.67,,,0,"percent of total billed charges","16.8% of total billed charges",258,100,,206.40,,,0,"percent of total billed charges","100% of total billed charges",39.47,258,
"J7320 Injection, Hylan G-F 20, intra-articular, 16",7964113,CDM,636,RC,,,OUTPATIENT,,,5,3.25,,4.4,88,,3.52,,,0,"percent of total billed charges","88% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.87,17.304,,0.70,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.15,63,,2.52,,,0,"percent of total billed charges","63% of total billed charges",0.77,15.3,,0.62,,,0,"percent of total billed charges","15.3% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",3.45,69,,,,,0,"fee schedule","69% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",1.61,32.2,,1.29,,,0,"percent of total billed charges","32.2% of total billed charges",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.86,17.136,,0.69,,,0,"percent of total billed charges","17.136% of total billed charges",1.09,21.84,,0.87,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.7% of total billed charges",1.89,37.7,,1.51,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.7,33.9,,1.36,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.9,78,,3.12,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",2.5,50,,2.00,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.84,16.8,,0.67,,,0,"percent of total billed charges","16.8% of total billed charges",5,100,,4.00,,,0,"percent of total billed charges","100% of total billed charges",0.77,5,
"J7323 Hyaluronan or derivative, euflexxa, for intr",8020089,CDM,636,RC,,,OUTPATIENT,,,437,284.05,,384.56,88,,307.65,,,0,"percent of total billed charges","88% of total billed charges",218.5,50,,174.80,,,0,"percent of total billed charges","50% of total billed charges",73.42,16.8,,58.74,,,0,"percent of total billed charges","16.8% of total billed charges",437,100,,349.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",75.62,17.304,,60.50,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",275.31,63,,220.25,,,0,"percent of total billed charges","63% of total billed charges",66.86,15.3,,53.49,,,0,"percent of total billed charges","15.3% of total billed charges",73.42,16.8,,58.74,,,0,"percent of total billed charges","16.8% of total billed charges",301.53,69,,,,,0,"fee schedule","69% of total billed charges",437,100,,349.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",437,100,,349.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",437,100,,349.60,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",73.42,16.8,,58.74,,,0,"percent of total billed charges","16.8% of total billed charges",218.5,50,,174.80,,,0,"percent of total billed charges","50% of total billed charges",140.71,32.2,,112.57,,,0,"percent of total billed charges","32.2% of total billed charges",73.42,16.8,,58.74,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",74.88,17.136,,59.90,,,0,"percent of total billed charges","17.136% of total billed charges",95.44,21.84,,76.35,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",164.75,37.7,,131.80,,,0,"percent of total billed charges","37.7% of total billed charges",164.75,37.7,,131.80,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",148.14,33.9,,118.51,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",340.86,78,,272.69,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",73.42,16.8,,58.74,,,0,"percent of total billed charges","16.8% of total billed charges",218.5,50,,174.80,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",73.42,16.8,,58.74,,,0,"percent of total billed charges","16.8% of total billed charges",437,100,,349.60,,,0,"percent of total billed charges","100% of total billed charges",66.86,437,
"J7325 Hyaluronan or derivative, Synvisc or Synvisc",10110944,CDM,636,RC,,,OUTPATIENT,,,23,14.95,,20.24,88,,16.19,,,0,"percent of total billed charges","88% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.98,17.304,,3.18,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",14.49,63,,11.59,,,0,"percent of total billed charges","63% of total billed charges",3.52,15.3,,2.82,,,0,"percent of total billed charges","15.3% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",15.87,69,,,,,0,"fee schedule","69% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",7.41,32.2,,5.93,,,0,"percent of total billed charges","32.2% of total billed charges",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.94,17.136,,3.15,,,0,"percent of total billed charges","17.136% of total billed charges",5.02,21.84,,4.02,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.7% of total billed charges",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",7.8,33.9,,6.24,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.94,78,,14.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",11.5,50,,9.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.86,16.8,,3.09,,,0,"percent of total billed charges","16.8% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",3.52,23,
"J7613 Albuterol, inhalation solution 1mg",7922195,CDM,636,RC,,,OUTPATIENT,,,1,0.65,,0.88,88,,0.70,,,0,"percent of total billed charges","88% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.304,,0.14,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.63,63,,0.50,,,0,"percent of total billed charges","63% of total billed charges",0.15,15.3,,0.12,,,0,"percent of total billed charges","15.3% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.69,69,,,,,0,"fee schedule","69% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",0.32,32.2,,0.26,,,0,"percent of total billed charges","32.2% of total billed charges",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.17,17.136,,0.14,,,0,"percent of total billed charges","17.136% of total billed charges",0.22,21.84,,0.18,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.7% of total billed charges",0.38,37.7,,0.30,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.34,33.9,,0.27,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.78,78,,0.62,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",0.5,50,,0.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.17,16.8,,0.14,,,0,"percent of total billed charges","16.8% of total billed charges",1,100,,0.80,,,0,"percent of total billed charges","100% of total billed charges",0.15,1,
"J7620 Albuterol, up to 2.5 mg and ipratropium brom",7964107,CDM,636,RC,,,OUTPATIENT,,,6,3.9,,5.28,88,,4.22,,,0,"percent of total billed charges","88% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.04,17.304,,0.83,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",3.78,63,,3.02,,,0,"percent of total billed charges","63% of total billed charges",0.92,15.3,,0.74,,,0,"percent of total billed charges","15.3% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",4.14,69,,,,,0,"fee schedule","69% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",1.93,32.2,,1.54,,,0,"percent of total billed charges","32.2% of total billed charges",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.03,17.136,,0.82,,,0,"percent of total billed charges","17.136% of total billed charges",1.31,21.84,,1.05,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.7% of total billed charges",2.26,37.7,,1.81,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.03,33.9,,1.62,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",4.68,78,,3.74,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",3,50,,2.40,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.01,16.8,,0.81,,,0,"percent of total billed charges","16.8% of total billed charges",6,100,,4.80,,,0,"percent of total billed charges","100% of total billed charges",0.92,6,
"J7626 budesonide non-comp unit",7964152,CDM,250,RC,,,OUTPATIENT,,,11,7.15,,9.68,88,,7.74,,,0,"percent of total billed charges","88% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.9,17.304,,1.52,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.93,63,,5.54,,,0,"percent of total billed charges","63% of total billed charges",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",3.54,32.2,,2.83,,,0,"percent of total billed charges","32.2% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.88,17.136,,1.50,,,0,"percent of total billed charges","17.136% of total billed charges",2.4,21.84,,1.92,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",5.5,50,,4.40,,,0,"percent of total billed charges","50% of total billed charges",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.85,16.8,,1.48,,,0,"percent of total billed charges","16.8% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.68,11,
"J7644 Ipratropium bromide non-comp",7964136,CDM,250,RC,,,OUTPATIENT,,,8,5.2,,7.04,88,,5.63,,,0,"percent of total billed charges","88% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.38,17.304,,1.10,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",5.04,63,,4.03,,,0,"percent of total billed charges","63% of total billed charges",1.22,15.3,,0.98,,,0,"percent of total billed charges","15.3% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",5.52,69,,,,,0,"fee schedule","69% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",2.58,32.2,,2.06,,,0,"percent of total billed charges","32.2% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.37,17.136,,1.10,,,0,"percent of total billed charges","17.136% of total billed charges",1.75,21.84,,1.40,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",3.02,37.7,,2.42,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",6.24,78,,4.99,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",4,50,,3.20,,,0,"percent of total billed charges","50% of total billed charges",6.61,82.6,,5.29,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.34,16.8,,1.07,,,0,"percent of total billed charges","16.8% of total billed charges",8,100,,6.40,,,0,"percent of total billed charges","100% of total billed charges",1.22,8,
"J8499 oral prescrip drug non chemo",7964137,CDM,636,RC,,,OUTPATIENT,,,3,1.95,,2.64,88,,2.11,,,0,"percent of total billed charges","88% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.52,17.304,,0.42,,,0,"percent of total billed charges","17.304% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.89,63,,1.51,,,0,"percent of total billed charges","63% of total billed charges",0.46,15.3,,0.37,,,0,"percent of total billed charges","15.3% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",2.07,69,,,,,0,"fee schedule","69% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",0.97,32.2,,0.78,,,0,"percent of total billed charges","32.2% of total billed charges",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",,,,,,,0,other,"not separately reimbursment",0.51,17.136,,0.41,,,0,"percent of total billed charges","17.136% of total billed charges",0.66,21.84,,0.53,,,0,"percent of total billed charges","21.84% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.7% of total billed charges",1.13,37.7,,0.90,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",1.02,33.9,,0.82,,,0,"percent of total billed charges","33.9% of total billed charges",,,,,,,0,other,"not separately reimbursment",2.34,78,,1.87,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",1.5,50,,1.20,,,0,"percent of total billed charges","50% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",0.5,16.8,,0.40,,,0,"percent of total billed charges","16.8% of total billed charges",3,100,,2.40,,,0,"percent of total billed charges","100% of total billed charges",0.46,3,
"VFC 90471 Immunization Admin Perc/ID/Subq/IM; 1 Va",5230197,CDM,521,RC,90471,CPT,OUTPATIENT,,,45,29.25,,39.6,88,,31.68,,,0,"percent of total billed charges","88% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.67,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",28.35,63,,22.68,,,0,"percent of total billed charges","63% of total billed charges",6.89,15.3,,5.51,,,0,"percent of total billed charges","15.3% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,31.05,69,,,,,0,"fee schedule","69% of total billed charges",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.33,100,,,,,0,"fee schedule",EAPG,45.03,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",16.97,37.7,,13.58,,,0,"percent of total billed charges","37.70% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.1,78,,28.08,,,0,"percent of total billed charges","78% of total billed charges",72.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",37.17,82.6,,29.74,,,0,"percent of total billed charges","82.6% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",195.17,100,,,,,0,"fee schedule",EAPG,45,100,,36.00,,,0,"percent of total billed charges","100% of total billed charges",6.89,251.75,
"VFC 90472 Immunization Admin Perc/ID/Subq/IM; Each",5230198,CDM,521,RC,90472,CPT,OUTPATIENT,,,23,14.95,,20.24,88,,16.19,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.64,100,,,,,0,"fee schedule",EAPG,23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.67,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",14.49,63,,11.59,,,0,"percent of total billed charges","63% of total billed charges",3.52,15.3,,2.82,,,0,"percent of total billed charges","15.3% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,15.87,69,,,,,0,"fee schedule","69% of total billed charges",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.64,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.33,100,,,,,0,"fee schedule",EAPG,45.03,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",8.67,37.7,,6.94,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",17.94,78,,14.35,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",19,82.6,,15.20,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",195.17,100,,,,,0,"fee schedule",EAPG,23,100,,18.40,,,0,"percent of total billed charges","100% of total billed charges",3.52,195.17,
"VFC 90473 Immunization Admin Intranasal/Oral; 1 Va",5230199,CDM,521,RC,90473,CPT,OUTPATIENT,,,71,46.15,,62.48,88,,49.98,,,0,"percent of total billed charges","88% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",125.74,175,,,,,0,"fee schedule","175% of CMS fee schedule",35.67,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",44.73,63,,35.78,,,0,"percent of total billed charges","63% of total billed charges",10.86,15.3,,8.69,,,0,"percent of total billed charges","15.3% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,48.99,69,,,,,0,"fee schedule","69% of total billed charges",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS fee schedule",251.75,100,,,,,0,"fee schedule","100% of CMS OPPS rate",34.64,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",65.81,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",35.33,100,,,,,0,"fee schedule",EAPG,45.03,100,,,,,0,"fee schedule",EAPG,71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",26.77,37.7,,21.42,,,0,"percent of total billed charges","37.70% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",55.38,78,,44.30,,,0,"percent of total billed charges","78% of total billed charges",72.57,100,,,,,0,"fee schedule","100% of CMS OPPS rate",58.65,82.6,,46.92,,,0,"percent of total billed charges","82.6% of total billed charges",34.64,100,,,,,0,"fee schedule","100% of WA fee schedule",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",58.65,82.6,,46.92,,,0,"percent of total billed charges","82.6% of total billed charges",71.85,100,,,,,0,"fee schedule","100% of CMS OPPS rate",195.17,100,,,,,0,"fee schedule",EAPG,71,100,,56.80,,,0,"percent of total billed charges","100% of total billed charges",10.86,251.75,
"VFC 90474 Immunization Admin Intranasal/Oral; Each",5230200,CDM,521,RC,90474,CPT,OUTPATIENT,,,21,13.65,,18.48,88,,14.78,,,0,"percent of total billed charges","88% of total billed charges",,,,,,,0,other,"not separately reimbursment",34.64,100,,,,,0,"fee schedule",EAPG,21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",35.67,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",13.23,63,,10.58,,,0,"percent of total billed charges","63% of total billed charges",3.21,15.3,,2.57,,,0,"percent of total billed charges","15.3% of total billed charges",34.64,100,,,,,0,"fee schedule",EAPG,14.49,69,,,,,0,"fee schedule","69% of total billed charges",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",34.64,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",35.33,100,,,,,0,"fee schedule",EAPG,45.03,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",7.92,37.7,,6.34,,,0,"percent of total billed charges","37.70% of total billed charges",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",16.38,78,,13.10,,,0,"percent of total billed charges","78% of total billed charges",,,,,,,0,other,"not separately reimbursment",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",34.64,100,,,,,0,"fee schedule","100% of WA fee schedule",,,,,,,0,other,"not separately reimbursment",17.35,82.6,,13.88,,,0,"percent of total billed charges","82.6% of total billed charges",,,,,,,0,other,"not separately reimbursment",195.17,100,,,,,0,"fee schedule",EAPG,21,100,,16.80,,,0,"percent of total billed charges","100% of total billed charges",3.21,195.17,
"81003 Urine Dipstick POC",607619,CDM,300,RC,81003,CPT,OUTPATIENT,,,9,5.85,,7.92,88,,6.34,,,0,"percent of total billed charges","88% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",3.93,175,,,,,0,"fee schedule","175% of CMS fee schedule",2.55,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",5.67,63,,4.54,,,0,"percent of total billed charges","63% of total billed charges",1.38,15.3,,1.10,,,0,"percent of total billed charges","15.3% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,6.21,69,,,,,0,"fee schedule","69% of total billed charges",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.6,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.25,100,,,,,0,"fee schedule","100% of LI fee schedule",1.83,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.52,100,,,,,0,"fee schedule",EAPG,3.22,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.7% of total billed charges",3.39,37.7,,2.71,,,0,"percent of total billed charges","37.70% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.05,33.9,,2.44,,,0,"percent of total billed charges","33.9% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.02,78,,5.62,,,0,"percent of total billed charges","78% of total billed charges",2.27,101,,,,,0,"fee schedule","101% of CMS fee schedule ",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",7.43,82.6,,5.94,,,0,"percent of total billed charges","82.6% of total billed charges",2.25,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,9,100,,7.20,,,0,"percent of total billed charges","100% of total billed charges",1.38,9,
"Urine Pregnancy Test POC",607621,CDM,300,RC,81025,CPT,OUTPATIENT,,,35,22.75,,30.8,88,,24.64,,,0,"percent of total billed charges","88% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",15.06,175,,,,,0,"fee schedule","175% of CMS fee schedule",2.55,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",22.05,63,,17.64,,,0,"percent of total billed charges","63% of total billed charges",5.36,15.3,,4.29,,,0,"percent of total billed charges","15.3% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,24.15,69,,,,,0,"fee schedule","69% of total billed charges",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",32.93,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.61,100,,,,,0,"fee schedule","100% of LI fee schedule",1.83,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.52,100,,,,,0,"fee schedule",EAPG,3.22,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",13.2,37.7,,10.56,,,0,"percent of total billed charges","37.7% of total billed charges",13.2,37.7,,10.56,,,0,"percent of total billed charges","37.70% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.87,33.9,,9.50,,,0,"percent of total billed charges","33.9% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",27.3,78,,21.84,,,0,"percent of total billed charges","78% of total billed charges",8.69,101,,,,,0,"fee schedule","101% of CMS fee schedule ",28.91,82.6,,23.13,,,0,"percent of total billed charges","82.6% of total billed charges",2.48,100,,,,,0,"fee schedule",EAPG,8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",28.91,82.6,,23.13,,,0,"percent of total billed charges","82.6% of total billed charges",8.61,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.48,100,,,,,0,"fee schedule",EAPG,35,100,,28.00,,,0,"percent of total billed charges","100% of total billed charges",1.83,35,
"36415 Collection of venous blood by venipuncture",7963546,CDM,300,RC,36415,CPT,OUTPATIENT,,,11,7.15,,,,,,,,0,other,"not separately reimbursment",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.1,100,,,,,0,"fee schedule",EAPG,11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",15.45,175,,,,,0,"fee schedule","175% of CMS fee schedule",2.16,100,,,,,0,"fee schedule",EAPG,8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",,,,,,,0,other,"not separately reimbursment",1.68,15.3,,1.34,,,0,"percent of total billed charges","15.3% of total billed charges",2.1,100,,,,,0,"fee schedule",EAPG,7.59,69,,,,,0,"fee schedule","69% of total billed charges",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",11.47,382.5,,,,,0,"fee schedule","382.5% of CMS fee schedule",2.1,100,,,,,0,"fee schedule",EAPG,8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.83,100,,,,,0,"fee schedule","100% of LI fee schedule",1.55,100,,,,,0,"fee schedule",EAPG,8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.14,100,,,,,0,"fee schedule",EAPG,2.73,100,,,,,0,"fee schedule",EAPG,8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.7% of total billed charges",4.15,37.7,,3.32,,,0,"percent of total billed charges","37.70% of total billed charges",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",3.73,33.9,,2.98,,,0,"percent of total billed charges","33.9% of total billed charges",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",8.58,78,,6.86,,,0,"percent of total billed charges","78% of total billed charges",8.91,101,,,,,0,"fee schedule","101% of CMS fee schedule ",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",2.1,100,,,,,0,"fee schedule",EAPG,8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",9.09,82.6,,7.27,,,0,"percent of total billed charges","82.6% of total billed charges",8.83,100,,,,,0,"fee schedule","100% of CMS fee schedule",2.1,100,,,,,0,"fee schedule",EAPG,11,100,,8.80,,,0,"percent of total billed charges","100% of total billed charges",1.55,15.45,
"59514 CESAREAN DELIVERY ONLY",7939681,CDM,521,RC,59514,CPT,OUTPATIENT,,,3180,2067,,2798.4,88,,2238.72,,,0,"percent of total billed charges","88% of total billed charges",3180,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2349.1,100,,,,,0,"fee schedule",EAPG,3180,100,,2544.00,,,0,"percent of total billed charges","100% of total billed charges",3180,175,,,,,0,"fee schedule","175% of CMS fee schedule",2419.57,100,,,,,0,"fee schedule",EAPG,3180,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2003.4,63,,1602.72,,,0,"percent of total billed charges","63% of total billed charges",486.54,15.3,,389.23,,,0,"percent of total billed charges","15.3% of total billed charges",2349.1,100,,,,,0,"fee schedule",EAPG,2194.2,69,,,,,0,"fee schedule","69% of total billed charges",3180,100,,2544.00,,,0,"percent of total billed charges","100% of total billed charges",3180,100,,,,,0,"fee schedule ","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3180,100,,2544.00,,,0,"percent of total billed charges","100% of total billed charges",3180,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3180,100,,2544.00,,,0,"percent of total billed charges","100% of total billed charges",3180,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3180,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2349.1,100,,,,,0,"fee schedule",EAPG,3180,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",3180,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3180,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2396.08,100,,,,,0,"fee schedule",EAPG,3053.83,100,,,,,0,"fee schedule",EAPG,3180,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",1198.86,37.7,,959.09,,,0,"percent of total billed charges","37.70% of total billed charges",3180,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",,,,,,,0,other,"not separately reimbursment",3180,100,,,,,0,"fee schedule","100% of CMS fee schedule",2480.4,78,,1984.32,,,0,"percent of total billed charges","78% of total billed charges",3180,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2626.68,82.6,,2101.34,,,0,"percent of total billed charges","82.6% of total billed charges",2349.1,100,,,,,0,"fee schedule","100% of WA fee schedule",3180,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2626.68,82.6,,2101.34,,,0,"percent of total billed charges","82.6% of total billed charges",3180,100,,,,,0,"fee schedule","Pays at line item charges due to Status Indicator C on the CMS APC fee schedule",2509.63,100,,,,,0,"fee schedule",EAPG,3180,100,,2544.00,,,0,"percent of total billed charges","100% of total billed charges",486.54,3180,
"76815 OB US LIMITED FETUS(S)",8271235,CDM,521,RC,76815,CPT,OUTPATIENT,,,316,205.4,,278.08,88,,222.46,,,0,"percent of total billed charges","88% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.6,100,,,,,0,"fee schedule",EAPG,316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",196.23,175,,,,,0,"fee schedule","175% of CMS fee schedule",94.35,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",199.08,63,,159.26,,,0,"percent of total billed charges","63% of total billed charges",48.35,15.3,,38.68,,,0,"percent of total billed charges","15.3% of total billed charges",91.6,100,,,,,0,"fee schedule",EAPG,218.04,69,,,,,0,"fee schedule","69% of total billed charges",316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS fee schedule",442.69,100,,,,,0,"fee schedule","100% of CMS OPPS rate",91.6,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",115.73,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",93.43,100,,,,,0,"fee schedule",EAPG,119.08,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",119.13,37.7,,95.30,,,0,"percent of total billed charges","37.70% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",,,,,,,0,other,"not separately reimbursment",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",246.48,78,,197.18,,,0,"percent of total billed charges","78% of total billed charges",113.25,100,,,,,0,"fee schedule","100% of CMS OPPS rate",261.02,82.6,,208.82,,,0,"percent of total billed charges","82.6% of total billed charges",91.6,100,,,,,0,"fee schedule",EAPG,112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",261.02,82.6,,208.82,,,0,"percent of total billed charges","82.6% of total billed charges",112.13,100,,,,,0,"fee schedule","100% of CMS OPPS rate",252.13,100,,,,,0,"fee schedule",EAPG,316,100,,252.80,,,0,"percent of total billed charges","100% of total billed charges",48.35,442.69,
"Miscellaneous Supply",8388433,CDM,521,RC,52310,CPT,OUTPATIENT,,,,,,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1405.94,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1448.12,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1405.94,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1405.94,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1434.06,100,,,,,0,"fee schedule",EAPG,1827.72,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1405.94,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",,,,,,,0,other,"not separately reimbursment",1566.47,100,,,,,0,"fee schedule",EAPG,,,,,,,0,other,"not separately reimbursment",1405.94,1827.72,
"PPD ADMINISTRATION POC",2562303,CDM,300,RC,86580,CPT,OUTPATIENT,,,70,45.5,,61.6,88,,49.28,,,0,"percent of total billed charges","88% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9.39,100,,,,,0,"fee schedule",EAPG,70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",53.14,175,,,,,0,"fee schedule","175% of CMS fee schedule",9.67,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",44.1,63,,35.28,,,0,"percent of total billed charges","63% of total billed charges",10.71,15.3,,8.57,,,0,"percent of total billed charges","15.3% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,48.3,69,,,,,0,"fee schedule","69% of total billed charges",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS fee schedule",100.22,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9.39,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.2,100,,,,,0,"fee schedule","100% of CMS OPPS rate",6.96,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9.58,100,,,,,0,"fee schedule",EAPG,12.21,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",26.39,37.7,,21.11,,,0,"percent of total billed charges","37.7% of total billed charges",26.39,37.7,,21.11,,,0,"percent of total billed charges","37.70% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",23.73,33.9,,18.98,,,0,"percent of total billed charges","33.9% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",54.6,78,,43.68,,,0,"percent of total billed charges","78% of total billed charges",30.67,100,,,,,0,"fee schedule","100% of CMS OPPS rate",57.82,82.6,,46.26,,,0,"percent of total billed charges","82.6% of total billed charges",9.39,100,,,,,0,"fee schedule",EAPG,30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",57.82,82.6,,46.26,,,0,"percent of total billed charges","82.6% of total billed charges",30.37,100,,,,,0,"fee schedule","100% of CMS OPPS rate",9.39,100,,,,,0,"fee schedule",EAPG,70,100,,56.00,,,0,"percent of total billed charges","100% of total billed charges",6.96,100.22,
"HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC",1,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",27372.44,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,27372.44,
"HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC",2,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",30386.48,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,30386.48,
"ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES",3,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",25467.58,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,25467.58,
"TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES",4,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",18319.64,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",18319.64,49216.52,
"LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT",5,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20982.8,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,20982.8,
"LIVER TRANSPLANT WITHOUT MCC",6,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",18565.96,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,18565.96,
"LUNG TRANSPLANT",7,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17481.44,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,17481.44,
"SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT",8,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17613.23,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,17613.23,
"PANCREAS TRANSPLANT",10,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14741.91,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,14741.91,
"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC",11,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12687.14,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,12687.14,
"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC",12,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13563.89,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,13563.89,
"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC",13,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12470.31,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,12470.31,
"ALLOGENEIC BONE MARROW TRANSPLANT",14,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11954.22,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,11954.22,
"AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC",16,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10909.42,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,10909.42,
"AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC",17,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10909.42,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,10909.42,
"CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES",18,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",86229.89,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",86229.89,86229.89,
"SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS",19,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20731.25,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20731.25,20731.25,
"INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC",20,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",25613.44,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",25613.44,49216.52,
"INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC",21,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",33999.74,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",33999.74,49216.52,
"INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC",22,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",33362.41,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,33362.41,
"CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR ANTINEOPLASTIC IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR",23,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",22355.26,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",22355.26,49216.52,
"CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC",24,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",27967.17,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,27967.17,
"CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC",25,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19558.12,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,19558.12,
"CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC",26,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",28337.95,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",28337.95,49216.52,
"CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC",27,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",23346.11,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",23346.11,49216.52,
"SPINAL PROCEDURES WITH MCC",28,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17701.98,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,17701.98,
"SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS",29,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20998.09,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20998.09,49216.52,
"SPINAL PROCEDURES WITHOUT CC/MCC",30,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",26703.75,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,26703.75,
"VENTRICULAR SHUNT PROCEDURES WITH MCC",31,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16929.81,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,16929.81,
"VENTRICULAR SHUNT PROCEDURES WITH CC",32,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",22964.29,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,22964.29,
"VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC",33,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15573.35,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,15573.35,
"CAROTID ARTERY STENT PROCEDURES WITH MCC",34,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",23896.49,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,23896.49,
"CAROTID ARTERY STENT PROCEDURES WITH CC",35,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",22066,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,22066,
"CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC",36,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17351.49,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,17351.49,
"EXTRACRANIAL PROCEDURES WITH MCC",37,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19831.99,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,19831.99,
"EXTRACRANIAL PROCEDURES WITH CC",38,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15352.64,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,15352.64,
"EXTRACRANIAL PROCEDURES WITHOUT CC/MCC",39,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10949.04,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,10949.04,
"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC",40,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15835.46,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15835.46,49216.52,
"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR",41,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16466,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,16466,
"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC",42,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20868.9,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,20868.9,
"SPINAL DISORDERS AND INJURIES WITH CC/MCC",52,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13328.16,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,13328.16,
"SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC",53,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10892.94,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",46462.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10892.94,46462.4,
"NERVOUS SYSTEM NEOPLASMS WITH MCC",54,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10604.78,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10604.78,
"NERVOUS SYSTEM NEOPLASMS WITHOUT MCC",55,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9966.22,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",46462.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9966.22,46462.4,
"DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC",56,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",11486.41,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",46462.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",975.82,46462.4,
"DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC",57,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",10327.32,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",975.82,10327.32,
"MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC",58,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10151.59,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",46462.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10151.59,46462.4,
"MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC",59,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9493.64,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",46462.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9493.64,46462.4,
"MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC",60,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9226.55,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9226.55,
"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC",61,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16809.79,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,16809.79,
"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC",62,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17381.45,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,17381.45,
"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC",63,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19455.45,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,19455.45,
"INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC",64,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12813.86,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,12813.86,
"INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS",65,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10450.04,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10450.04,
"INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC",66,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6597.25,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,6597.25,
"PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC",67,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12360.52,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,12360.52,
"PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC",68,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8358.12,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8358.12,
"TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC",69,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7664.33,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,7664.33,
"OTHER CEREBROVASCULAR DISORDERS WITH MCC",70,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11199.16,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11199.16,
"OTHER CEREBROVASCULAR DISORDERS WITH CC",71,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9262.76,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9262.76,
"OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC",72,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10245.91,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10245.91,
"CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC",73,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11168.27,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",46462.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11168.27,46462.4,
"CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC",74,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10550.8,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10550.8,
"VIRAL MENINGITIS WITH CC/MCC",75,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10395.18,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10395.18,
"VIRAL MENINGITIS WITHOUT CC/MCC",76,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7810.86,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,7810.86,
"NONTRAUMATIC STUPOR AND COMA WITH MCC",80,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",994.41,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",994.41,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",994.41,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",12976.34,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",994.41,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",994.41,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",994.41,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",994.41,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",994.41,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",994.41,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",994.41,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",994.41,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",994.41,12976.34,
"NONTRAUMATIC STUPOR AND COMA WITHOUT MCC",81,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",994.41,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",994.41,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",994.41,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",9350.96,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",994.41,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",994.41,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",994.41,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",994.41,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",994.41,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",994.41,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",994.41,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",994.41,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",994.41,9350.96,
"TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC",82,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14575.04,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,14575.04,
"TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC",83,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11832.74,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11832.74,
"TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC",84,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12607.77,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,12607.77,
"TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC",85,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14223.78,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,14223.78,
"TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC",86,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12638.89,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,12638.89,
"TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC",87,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8503.98,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8503.98,
"CONCUSSION WITH MCC",88,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12265.29,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,12265.29,
"CONCUSSION WITH CC",89,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13241.33,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,13241.33,
"CONCUSSION WITHOUT CC/MCC",90,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8970.34,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8970.34,
"OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC",91,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11446.11,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11446.11,
"OTHER DISORDERS OF NERVOUS SYSTEM WITH CC",92,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9846.46,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9846.46,
"OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC",93,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10133.38,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10133.38,
"BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC",94,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13201.3,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,13201.3,
"BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC",95,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12479.34,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,12479.34,
"BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC",96,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11408.95,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11408.95,
"NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC",97,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12034.38,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,12034.38,
"NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC",98,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10881.36,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",46462.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10881.36,46462.4,
"NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC",99,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9745.11,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9745.11,
"SEIZURES WITH MCC",100,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12970.96,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,12970.96,
"SEIZURES WITHOUT MCC",101,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9698.36,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9698.36,
"HEADACHES WITH MCC",102,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11205.03,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11205.03,
"HEADACHES WITHOUT MCC",103,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10543.92,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10543.92,
"ORBITAL PROCEDURES WITH CC/MCC",113,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15357.48,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,15357.48,
"ORBITAL PROCEDURES WITHOUT CC/MCC",114,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16886.22,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16886.22,49216.52,
"EXTRAOCULAR PROCEDURES EXCEPT ORBIT",115,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12171.88,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,12171.88,
"INTRAOCULAR PROCEDURES WITH CC/MCC",116,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12854.9,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,12854.9,
"INTRAOCULAR PROCEDURES WITHOUT CC/MCC",117,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16428.35,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,16428.35,
"ACUTE MAJOR EYE INFECTIONS WITH CC/MCC",121,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8995.9,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8995.9,
"ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC",122,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7938.02,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,7938.02,
"NEUROLOGICAL EYE DISORDERS",123,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11021.69,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11021.69,
"OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT",124,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11192.61,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11192.61,
"OTHER DISORDERS OF THE EYE WITHOUT MCC",125,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9981.93,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9981.93,
"SINUS AND MASTOID PROCEDURES WITH CC/MCC",135,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20091.75,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20091.75,49216.52,
"SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC",136,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9011.6,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9011.6,49216.52,
"MOUTH PROCEDURES WITH CC/MCC",137,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12740.38,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12740.38,49216.52,
"MOUTH PROCEDURES WITHOUT CC/MCC",138,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8307.26,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,8307.26,
"SALIVARY GLAND PROCEDURES",139,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14246.46,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14246.46,49216.52,
"MAJOR HEAD AND NECK PROCEDURES WITH MCC",140,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15537.71,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",43954.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15537.71,43954.52,
"MAJOR HEAD AND NECK PROCEDURES WITH CC",141,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19238.74,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",43954.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19238.74,43954.52,
"MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC",142,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14825.82,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14825.82,14825.82,
"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC",143,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15441.51,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",43954.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15441.51,43954.52,
"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC",144,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17792.01,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17792.01,17792.01,
"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC",145,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11717.68,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",43954.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11717.68,43954.52,
"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC",146,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10300.25,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10300.25,
"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC",147,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10164.63,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10164.63,
"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC",148,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12196.52,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,12196.52,
DYSEQUILIBRIUM,149,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7146.14,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,7146.14,
"EPISTAXIS WITH MCC",150,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10511.62,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10511.62,
"EPISTAXIS WITHOUT MCC",151,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10084.96,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10084.96,
"OTITIS MEDIA AND URI WITH MCC",152,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10689.34,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10689.34,
"OTITIS MEDIA AND URI WITHOUT MCC",153,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9615.19,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9615.19,
"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC",154,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10800.42,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10800.42,
"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC",155,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9732.4,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9732.4,
"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC",156,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8985.97,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8985.97,
"DENTAL AND ORAL DISEASES WITH MCC",157,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11168.44,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11168.44,
"DENTAL AND ORAL DISEASES WITH CC",158,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9649.12,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9649.12,
"DENTAL AND ORAL DISEASES WITHOUT CC/MCC",159,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6479.22,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,6479.22,
"MAJOR CHEST PROCEDURES WITH MCC",163,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19955.16,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,19955.16,
"MAJOR CHEST PROCEDURES WITH CC",164,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20977.4,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,20977.4,
"MAJOR CHEST PROCEDURES WITHOUT CC/MCC",165,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",25722.76,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,25722.76,
"OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC",166,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14786.83,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,14786.83,
"OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC",167,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15408.35,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,15408.35,
"OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC",168,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13009.3,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,13009.3,
"ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM",173,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",22130.78,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",22130.78,22130.78,
"PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE",175,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10628.83,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10628.83,
"PULMONARY EMBOLISM WITHOUT MCC",176,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9783.12,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9783.12,
"RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC",177,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10616.51,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10616.51,
"RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC",178,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8876.6,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8876.6,
"RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC",179,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8789.55,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8789.55,
"RESPIRATORY NEOPLASMS WITH MCC",180,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10424.85,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10424.85,
"RESPIRATORY NEOPLASMS WITH CC",181,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10225.31,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10225.31,
"RESPIRATORY NEOPLASMS WITHOUT CC/MCC",182,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9500.04,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9500.04,
"MAJOR CHEST TRAUMA WITH MCC",183,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10301.52,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10301.52,
"MAJOR CHEST TRAUMA WITH CC",184,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10094.03,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10094.03,
"MAJOR CHEST TRAUMA WITHOUT CC/MCC",185,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9888.68,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9888.68,
"PLEURAL EFFUSION WITH MCC",186,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10154.97,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10154.97,
"PLEURAL EFFUSION WITH CC",187,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9560.49,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9560.49,
"PLEURAL EFFUSION WITHOUT CC/MCC",188,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9343.58,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9343.58,
"PULMONARY EDEMA AND RESPIRATORY FAILURE",189,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10133.38,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10133.38,
"CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC",190,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9330.7,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9330.7,
"CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC",191,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9052.23,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9052.23,
"CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC",192,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8798.16,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8798.16,
"SIMPLE PNEUMONIA AND PLEURISY WITH MCC",193,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9547.54,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9547.54,
"SIMPLE PNEUMONIA AND PLEURISY WITH CC",194,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8453.39,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8453.39,
"SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC",195,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7830.34,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,7830.34,
"INTERSTITIAL LUNG DISEASE WITH MCC",196,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11135.67,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11135.67,
"INTERSTITIAL LUNG DISEASE WITH CC",197,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9902.08,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",46462.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9902.08,46462.4,
"INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC",198,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10668.01,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10668.01,
"PNEUMOTHORAX WITH MCC",199,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10423.02,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10423.02,
"PNEUMOTHORAX WITH CC",200,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9688.96,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9688.96,
"PNEUMOTHORAX WITHOUT CC/MCC",201,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20565.25,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9239.64,100,,,,,0,"case rate","100% of CMS IPPS rate",20565.25,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20565.25,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",46462.4,100,,,,,0,"case rate","100% of WA base rate",20565.25,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",20565.25,100,,,,,0,"case rate","100% of WA base rate",26734.83,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20565.25,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20565.25,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",9239.64,46462.4,
"BRONCHITIS AND ASTHMA WITH CC/MCC",202,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",25796.18,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9505,100,,,,,0,"case rate","100% of CMS IPPS rate",25796.18,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",25796.18,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",25796.18,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",25796.18,100,,,,,0,"case rate","100% of WA base rate",33535.03,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",25796.18,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",25796.18,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,33535.03,
"BRONCHITIS AND ASTHMA WITHOUT CC/MCC",203,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",33359.62,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9526.09,100,,,,,0,"case rate","100% of CMS IPPS rate",33359.62,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",33359.62,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",46462.4,100,,,,,0,"case rate","100% of WA base rate",33359.62,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",33359.62,100,,,,,0,"case rate","100% of WA base rate",43367.51,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",33359.62,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",33359.62,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",9526.09,46462.4,
"RESPIRATORY SIGNS AND SYMPTOMS",204,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",55180.33,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11280.78,100,,,,,0,"case rate","100% of CMS IPPS rate",55180.33,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",55180.33,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",55180.33,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",55180.33,100,,,,,0,"case rate","100% of WA base rate",71734.43,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",55180.33,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",55180.33,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,71734.43,
"OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC",205,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11581.09,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11581.09,
"OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC",206,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10957.43,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10957.43,
"RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS",207,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15536.52,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,15536.52,
"RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS",208,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15885.1,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,15885.1,
"COMPLEX AORTIC ARCH PROCEDURES",209,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,3184,
"CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES",212,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",24306.61,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",24805.35,100,,,,,0,"case rate","100% of CMS IPPS rate",24306.61,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",24306.61,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",24306.61,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",24306.61,100,,,,,0,"case rate","100% of WA base rate",31598.59,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",24306.61,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",24306.61,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",24306.61,31598.59,
"ENDOVASCULAR ABDOMINAL AORTA WITH ILIAC BRANCH PROCEDURES",213,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",37700.59,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,100,,,,,0,"case rate","100% of CMS IPPS rate",37700.59,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",37700.59,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",37700.59,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",37700.59,100,,,,,0,"case rate","100% of WA base rate",49010.76,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",37700.59,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",37700.59,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",3184,49010.76,
"OTHER HEART ASSIST SYSTEM IMPLANT",215,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",57659.54,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,57659.54,
"CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC",216,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",26111.79,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,26111.79,
"CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC",217,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",35239.28,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,35239.28,
"CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC",218,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",71302.87,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,71302.87,
"CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC",219,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",26116.47,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,26116.47,
"CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC",220,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",26960.99,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",26960.99,49216.52,
"CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC",221,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11901.02,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",43169,100,,,,,0,"case rate","100% of CMS IPPS rate",11901.02,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11901.02,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",11901.02,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",11901.02,100,,,,,0,"case rate","100% of WA base rate",15471.33,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11901.02,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11901.02,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,43169,
"OTHER CARDIOTHORACIC PROCEDURES WITH MCC",228,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",22664.7,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",22664.7,49216.52,
"OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC",229,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",38139.3,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",38139.3,49216.52,
"CORONARY BYPASS WITH PTCA WITH MCC",231,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14517.17,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",21631.52,100,,,,,0,"case rate","100% of CMS IPPS rate",14517.17,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14517.17,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",14517.17,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",14517.17,100,,,,,0,"case rate","100% of WA base rate",18872.32,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14517.17,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14517.17,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,21631.52,
"CORONARY BYPASS WITH PTCA WITHOUT MCC",232,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19916.48,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",22532.67,100,,,,,0,"case rate","100% of CMS IPPS rate",19916.48,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19916.48,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",19916.48,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",19916.48,100,,,,,0,"case rate","100% of WA base rate",25891.43,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19916.48,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19916.48,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,25891.43,
"CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC",233,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",35453.96,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19870.34,100,,,,,0,"case rate","100% of CMS IPPS rate",35453.96,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",35453.96,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",35453.96,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",35453.96,100,,,,,0,"case rate","100% of WA base rate",46090.15,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",35453.96,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",35453.96,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,46090.15,
"CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC",234,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",55839.84,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",18473.72,100,,,,,0,"case rate","100% of CMS IPPS rate",55839.84,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",55839.84,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",55839.84,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",55839.84,100,,,,,0,"case rate","100% of WA base rate",72591.8,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",55839.84,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",55839.84,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,72591.8,
"CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC",235,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20900.09,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,20900.09,
"CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC",236,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20058.29,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,20058.29,
"AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC",239,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12245.85,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,12245.85,
"AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC",240,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11078.25,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,11078.25,
"AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC",241,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8436.43,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9093.08,100,,,,,0,"case rate","100% of CMS IPPS rate",8436.43,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8436.43,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",8436.43,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",8436.43,100,,,,,0,"case rate","100% of WA base rate",10967.36,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8436.43,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8436.43,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",8436.43,49216.52,
"PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC",242,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11541.62,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19893.08,100,,,,,0,"case rate","100% of CMS IPPS rate",11541.62,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11541.62,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",11541.62,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",11541.62,100,,,,,0,"case rate","100% of WA base rate",15004.1,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11541.62,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11541.62,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,19893.08,
"PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC",243,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",21215.35,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",22609.5,100,,,,,0,"case rate","100% of CMS IPPS rate",21215.35,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",21215.35,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",21215.35,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",21215.35,100,,,,,0,"case rate","100% of WA base rate",27579.95,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",21215.35,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",21215.35,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,27579.95,
"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC",244,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",38762.83,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",25079.83,100,,,,,0,"case rate","100% of CMS IPPS rate",38762.83,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",38762.83,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",38762.83,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",38762.83,100,,,,,0,"case rate","100% of WA base rate",50391.68,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",38762.83,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",38762.83,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,50391.68,
"AICD GENERATOR PROCEDURES",245,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",30337.2,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,30337.2,
"PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC",250,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20507.52,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,20507.52,
"PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC",251,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15227.89,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15227.89,49216.52,
"OTHER VASCULAR PROCEDURES WITH MCC",252,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17554.4,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,17554.4,
"OTHER VASCULAR PROCEDURES WITH CC",253,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19326.6,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19326.6,49216.52,
"OTHER VASCULAR PROCEDURES WITHOUT CC/MCC",254,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16650.02,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16650.02,49216.52,
"UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC",255,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11298.88,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,11298.88,
"UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC",256,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9440.74,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,9440.74,
"UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC",257,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10188.9,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,10188.9,
"CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC",258,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16244.83,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,16244.83,
"CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC",259,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",22389.87,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,22389.87,
"CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC",260,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16743.5,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,16743.5,
"CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC",261,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12356.55,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",18057.75,100,,,,,0,"case rate","100% of CMS IPPS rate",12356.55,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12356.55,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",12356.55,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",12356.55,100,,,,,0,"case rate","100% of WA base rate",16063.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12356.55,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12356.55,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,18057.75,
"CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC",262,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15584.28,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15788.3,100,,,,,0,"case rate","100% of CMS IPPS rate",15584.28,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15584.28,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",15584.28,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",15584.28,100,,,,,0,"case rate","100% of WA base rate",20259.56,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15584.28,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15584.28,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,20259.56,
"VEIN LIGATION AND STRIPPING",263,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",23404.83,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",18484.51,100,,,,,0,"case rate","100% of CMS IPPS rate",23404.83,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",23404.83,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",23404.83,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",23404.83,100,,,,,0,"case rate","100% of WA base rate",30426.28,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",23404.83,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",23404.83,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,30426.28,
"OTHER CIRCULATORY SYSTEM O.R. PROCEDURES",264,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",47128.97,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13626.32,100,,,,,0,"case rate","100% of CMS IPPS rate",47128.97,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",47128.97,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",47128.97,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",47128.97,100,,,,,0,"case rate","100% of WA base rate",61267.66,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",47128.97,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",47128.97,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,61267.66,
"AICD LEAD PROCEDURES",265,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",24814.55,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,24814.55,
"ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC",266,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",69158.74,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",69158.74,69158.74,
"ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC",267,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",46830.4,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",46830.4,46830.4,
"AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC",268,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",32888.85,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",32888.85,32888.85,
"AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC",269,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",39905.93,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",39905.93,39905.93,
"OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC",270,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",22746.57,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",22746.57,22746.57,
"OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC",271,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15493.31,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",26891.1,100,,,,,0,"case rate","100% of CMS IPPS rate",15493.31,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15493.31,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15493.31,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",15493.31,100,,,,,0,"case rate","100% of WA base rate",20141.31,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15493.31,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15493.31,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",15493.31,26891.1,
"OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC",272,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19164.29,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",23409.44,100,,,,,0,"case rate","100% of CMS IPPS rate",19164.29,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19164.29,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19164.29,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",19164.29,100,,,,,0,"case rate","100% of WA base rate",24913.57,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19164.29,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19164.29,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",19164.29,24913.57,
"PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC",273,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",30038.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",32996.13,100,,,,,0,"case rate","100% of CMS IPPS rate",30038.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",30038.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",30038.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",30038.88,100,,,,,0,"case rate","100% of WA base rate",39050.54,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",30038.88,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",30038.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",30038.88,39050.54,
"PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC",274,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",56400.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",31098.72,100,,,,,0,"case rate","100% of CMS IPPS rate",56400.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",56400.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",56400.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",56400.52,100,,,,,0,"case rate","100% of WA base rate",73320.68,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",56400.52,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",56400.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",31098.72,73320.68,
"CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC",275,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",24403.21,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",24403.21,24403.21,
"CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR",276,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",28835.36,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",28835.36,28835.36,
"CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC",277,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",41719.92,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",41719.92,41719.92,
"ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC",278,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20063.44,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20063.44,20063.44,
"ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC",279,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",29722.22,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",29722.22,29722.22,
"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC",280,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11139.55,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11139.55,
"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC",281,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10951.44,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10951.44,
"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC",282,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6890.89,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,6890.89,
"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC",283,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17735.21,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",46462.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17735.21,46462.4,
"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC",284,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7098.16,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,7098.16,
"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC",285,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",4689.57,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,4689.57,
"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC",286,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11491.74,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11491.74,
"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC",287,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14827.19,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,14827.19,
"ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC",288,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10087.47,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10087.47,
"ACUTE AND SUBACUTE ENDOCARDITIS WITH CC",289,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8341.18,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8341.18,
"ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC",290,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8432.42,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8432.42,
"HEART FAILURE AND SHOCK WITH MCC",291,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",18201.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9477.16,100,,,,,0,"case rate","100% of CMS IPPS rate",18201.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",18201.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",18201.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",18201.88,100,,,,,0,"case rate","100% of WA base rate",23662.45,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",18201.88,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",18201.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,23662.45,
"HEART FAILURE AND SHOCK WITH CC",292,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",18201.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8218.97,100,,,,,0,"case rate","100% of CMS IPPS rate",18201.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",18201.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",18201.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",18201.88,100,,,,,0,"case rate","100% of WA base rate",23662.45,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",18201.88,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",18201.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,23662.45,
"HEART FAILURE AND SHOCK WITHOUT CC/MCC",293,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",24667.14,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7697.36,100,,,,,0,"case rate","100% of CMS IPPS rate",24667.14,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",24667.14,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",24667.14,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",24667.14,100,,,,,0,"case rate","100% of WA base rate",32067.28,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",24667.14,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",24667.14,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,32067.28,
"CARDIAC ARREST, UNEXPLAINED WITH MCC",296,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15384.31,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,15384.31,
"CARDIAC ARREST, UNEXPLAINED WITH CC",297,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6991.65,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,6991.65,
"CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC",298,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",4211.68,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,4211.68,
"PERIPHERAL VASCULAR DISORDERS WITH MCC",299,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11343.91,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11343.91,
"PERIPHERAL VASCULAR DISORDERS WITH CC",300,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9908.64,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9908.64,
"PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC",301,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17986.7,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9730.34,100,,,,,0,"case rate","100% of CMS IPPS rate",17986.7,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17986.7,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",17986.7,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",17986.7,100,,,,,0,"case rate","100% of WA base rate",23382.7,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17986.7,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17986.7,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,23382.7,
"ATHEROSCLEROSIS WITH MCC",302,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",25715.91,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11526.51,100,,,,,0,"case rate","100% of CMS IPPS rate",25715.91,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",25715.91,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",25715.91,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",25715.91,100,,,,,0,"case rate","100% of WA base rate",33430.69,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",25715.91,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",25715.91,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,33430.69,
"ATHEROSCLEROSIS WITHOUT MCC",303,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",36002.46,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6315.13,100,,,,,0,"case rate","100% of CMS IPPS rate",36002.46,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",36002.46,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",36002.46,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",36002.46,100,,,,,0,"case rate","100% of WA base rate",46803.2,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",36002.46,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",36002.46,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,46803.2,
"HYPERTENSION WITH MCC",304,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",50758.85,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10670.13,100,,,,,0,"case rate","100% of CMS IPPS rate",50758.85,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",50758.85,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",46462.4,100,,,,,0,"case rate","100% of WA base rate",50758.85,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",50758.85,100,,,,,0,"case rate","100% of WA base rate",65986.51,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",50758.85,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",50758.85,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",10670.13,65986.51,
"HYPERTENSION WITHOUT MCC",305,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10329.41,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",46462.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10329.41,46462.4,
"CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC",306,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11343.95,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11343.95,
"CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC",307,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12334.35,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,12334.35,
"CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC",308,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10179.1,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",46462.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10179.1,46462.4,
"CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC",309,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9321.05,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",46462.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9321.05,46462.4,
"CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC",310,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5306.59,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,5306.59,
"ANGINA PECTORIS",311,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6698.97,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,6698.97,
"SYNCOPE AND COLLAPSE",312,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10808.02,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",46462.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10808.02,46462.4,
"CHEST PAIN",313,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6943.67,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",46462.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6943.67,46462.4,
"OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC",314,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12299.53,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",46462.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12299.53,46462.4,
"OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC",315,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10313.57,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",46462.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10313.57,46462.4,
"OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC",316,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6647.15,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",46462.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6647.15,46462.4,
"CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION",317,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",43954.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,43954.52,
"PERCUTANEOUS CORONARY ATHERECTOMY WITHOUT INTRALUMINAL DEVICE",318,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,3184,
"OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC",319,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16522.42,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16522.42,16522.42,
"OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC",320,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",30515.28,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",43954.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",30515.28,43954.52,
"PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES",321,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",21778.12,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",43954.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",21778.12,43954.52,
"PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC",322,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17497.35,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",43954.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17497.35,43954.52,
"CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC",323,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",25909.2,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",43954.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",25909.2,43954.52,
"CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC",324,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",37156.55,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",43954.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",37156.55,43954.52,
"CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE",325,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",28194.11,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",43954.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",28194.11,43954.52,
"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC",326,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16246.03,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16246.03,49216.52,
"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC",327,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17973.79,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,17973.79,
"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC",328,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",21896.7,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,21896.7,
"MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC",329,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13544.75,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,13544.75,
"MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC",330,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13936.33,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,13936.33,
"MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC",331,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17190.55,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,17190.55,
"RECTAL RESECTION WITH MCC",332,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16317.4,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,16317.4,
"RECTAL RESECTION WITH CC",333,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17104.18,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,17104.18,
"RECTAL RESECTION WITHOUT CC/MCC",334,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20090.27,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,20090.27,
"PERITONEAL ADHESIOLYSIS WITH MCC",335,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11829.55,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,11829.55,
"PERITONEAL ADHESIOLYSIS WITH CC",336,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11223.59,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,11223.59,
"PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC",337,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13461.99,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,13461.99,
"MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC",344,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12137.02,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12137.02,49216.52,
"MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC",345,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11087.7,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,11087.7,
"MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC",346,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13240.42,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13240.42,49216.52,
"ANAL AND STOMAL PROCEDURES WITH MCC",347,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13104.19,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13104.19,49216.52,
"ANAL AND STOMAL PROCEDURES WITH CC",348,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12085.39,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,12085.39,
"ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC",349,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9363.78,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9363.78,49216.52,
"INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC",350,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14100.24,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,14100.24,
"INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC",351,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14449.59,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14449.59,49216.52,
"INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC",352,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10641.96,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,10641.96,
"HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC",353,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14514.61,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,14514.61,
"HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC",354,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14985.46,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,14985.46,
"HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC",355,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13075.51,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,13075.51,
"OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC",356,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15996.78,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,15996.78,
"OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC",357,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14373.06,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,14373.06,
"OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC",358,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14752.12,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,14752.12,
"PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITH MCC",359,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,3184,
"PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITHOUT MCC",360,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,3184,
"MAJOR ESOPHAGEAL DISORDERS WITH MCC",368,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11323.28,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11323.28,
"MAJOR ESOPHAGEAL DISORDERS WITH CC",369,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9483.73,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9483.73,
"MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC",370,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7136.55,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,7136.55,
"MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC",371,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9492.98,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9492.98,
"MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC",372,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8109.66,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8109.66,
"MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC",373,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7366.64,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,7366.64,
"DIGESTIVE MALIGNANCY WITH MCC",374,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10790.36,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10790.36,
"DIGESTIVE MALIGNANCY WITH CC",375,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9582.41,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9582.41,
"DIGESTIVE MALIGNANCY WITHOUT CC/MCC",376,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11157.23,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11157.23,
"GASTROINTESTINAL HEMORRHAGE WITH MCC",377,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11453.15,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11453.15,
"GASTROINTESTINAL HEMORRHAGE WITH CC",378,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9766.08,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9766.08,
"GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC",379,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6076.19,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,6076.19,
"COMPLICATED PEPTIC ULCER WITH MCC",380,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11218.68,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",46462.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11218.68,46462.4,
"COMPLICATED PEPTIC ULCER WITH CC",381,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9652.98,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",46462.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9652.98,46462.4,
"COMPLICATED PEPTIC ULCER WITHOUT CC/MCC",382,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9081.41,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9081.41,
"UNCOMPLICATED PEPTIC ULCER WITH MCC",383,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10592.47,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",46462.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10592.47,46462.4,
"UNCOMPLICATED PEPTIC ULCER WITHOUT MCC",384,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10083.86,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",46462.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10083.86,46462.4,
"INFLAMMATORY BOWEL DISEASE WITH MCC",385,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9021.58,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9021.58,
"INFLAMMATORY BOWEL DISEASE WITH CC",386,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8226.59,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8226.59,
"INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC",387,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7877.55,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,7877.55,
"GASTROINTESTINAL OBSTRUCTION WITH MCC",388,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9298.52,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9298.52,
"GASTROINTESTINAL OBSTRUCTION WITH CC",389,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7642.25,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,7642.25,
"GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC",390,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6996.74,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,6996.74,
"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC",391,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9664.43,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9664.43,
"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC",392,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9046.34,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9046.34,
"OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC",393,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10843.03,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10843.03,
"OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC",394,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9300.51,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9300.51,
"OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC",395,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8876.3,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8876.3,
"APPENDIX PROCEDURES WITH MCC",397,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12681.4,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12681.4,12681.4,
"APPENDIX PROCEDURES WITH CC",398,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14521.63,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14521.63,14521.63,
"APPENDIX PROCEDURES WITHOUT CC/MCC",399,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10681.31,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10681.31,10681.31,
"SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL",402,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12792.48,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,100,,,,,0,"case rate","100% of CMS IPPS rate",12792.48,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12792.48,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12792.48,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",12792.48,100,,,,,0,"case rate","100% of WA base rate",16630.22,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12792.48,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12792.48,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",3184,16630.22,
"PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC",405,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",18645.14,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,18645.14,
"PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC",406,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17685.63,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,17685.63,
"PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC",407,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19350.93,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,19350.93,
"BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC",408,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14287.29,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,14287.29,
"BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC",409,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12249.29,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,12249.29,
"BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC",410,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13654.24,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,13654.24,
"CHOLECYSTECTOMY WITH C.D.E. WITH MCC",411,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7210.96,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14548.04,100,,,,,0,"case rate","100% of CMS IPPS rate",7210.96,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7210.96,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",7210.96,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",7210.96,100,,,,,0,"case rate","100% of WA base rate",9374.25,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7210.96,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7210.96,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,14548.04,
"CHOLECYSTECTOMY WITH C.D.E. WITH CC",412,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8063.03,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13383.15,100,,,,,0,"case rate","100% of CMS IPPS rate",8063.03,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8063.03,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",8063.03,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",8063.03,100,,,,,0,"case rate","100% of WA base rate",10481.94,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8063.03,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8063.03,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,13383.15,
"CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC",413,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10768.54,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15520.84,100,,,,,0,"case rate","100% of CMS IPPS rate",10768.54,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10768.54,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",10768.54,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",10768.54,100,,,,,0,"case rate","100% of WA base rate",13999.11,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10768.54,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10768.54,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,15520.84,
"CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC",414,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16872.13,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13353.09,100,,,,,0,"case rate","100% of CMS IPPS rate",16872.13,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16872.13,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",16872.13,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",16872.13,100,,,,,0,"case rate","100% of WA base rate",21933.77,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16872.13,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16872.13,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,21933.77,
"CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC",415,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12639.85,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,12639.85,
"CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC",416,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13768.89,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,13768.89,
"LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC",417,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13617.31,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,13617.31,
"LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC",418,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14260.53,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,14260.53,
"LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC",419,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16436.7,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,16436.7,
"HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC",420,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14176.1,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,14176.1,
"HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC",421,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6204.65,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14475.28,100,,,,,0,"case rate","100% of CMS IPPS rate",6204.65,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6204.65,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",6204.65,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",6204.65,100,,,,,0,"case rate","100% of WA base rate",8066.05,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6204.65,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6204.65,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,14475.28,
"HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC",422,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7443.62,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16247.95,100,,,,,0,"case rate","100% of CMS IPPS rate",7443.62,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7443.62,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",7443.62,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",7443.62,100,,,,,0,"case rate","100% of WA base rate",9676.71,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7443.62,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7443.62,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,16247.95,
"OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC",423,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11282.75,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13899.63,100,,,,,0,"case rate","100% of CMS IPPS rate",11282.75,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11282.75,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",11282.75,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",11282.75,100,,,,,0,"case rate","100% of WA base rate",14667.58,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11282.75,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11282.75,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,14667.58,
"OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC",424,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",23761.16,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12263.1,100,,,,,0,"case rate","100% of CMS IPPS rate",23761.16,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",23761.16,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",23761.16,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",23761.16,100,,,,,0,"case rate","100% of WA base rate",30889.5,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",23761.16,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",23761.16,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",12263.1,49216.52,
"OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC",425,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17736.73,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,17736.73,
"MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE",426,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,3184,
"MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC",427,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,3184,
"MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC",428,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,3184,
"COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC",429,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,3184,
"COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC",430,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,3184,
"CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC",432,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10824.01,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11256.7,100,,,,,0,"case rate","100% of CMS IPPS rate",10824.01,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10824.01,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",10824.01,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",10824.01,100,,,,,0,"case rate","100% of WA base rate",14071.22,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10824.01,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10824.01,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,14071.22,
"CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC",433,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16757.55,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8994.07,100,,,,,0,"case rate","100% of CMS IPPS rate",16757.55,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16757.55,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",16757.55,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",16757.55,100,,,,,0,"case rate","100% of WA base rate",21784.81,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16757.55,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16757.55,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,21784.81,
"CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC",434,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",32350.44,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9177.89,100,,,,,0,"case rate","100% of CMS IPPS rate",32350.44,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",32350.44,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",32350.44,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",32350.44,100,,,,,0,"case rate","100% of WA base rate",42055.57,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",32350.44,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",32350.44,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,42055.57,
"MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC",435,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10555,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10555,
"MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC",436,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9602.11,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9602.11,
"MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC",437,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10402.48,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10402.48,
"DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC",438,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10008.63,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10008.63,
"DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC",439,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8206.5,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8206.5,
"DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC",440,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7705.17,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,7705.17,
"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC",441,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7587.97,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10964.63,100,,,,,0,"case rate","100% of CMS IPPS rate",7587.97,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7587.97,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",7587.97,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",7587.97,100,,,,,0,"case rate","100% of WA base rate",9864.36,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7587.97,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7587.97,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,10964.63,
"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC",442,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10022.18,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8559.93,100,,,,,0,"case rate","100% of CMS IPPS rate",10022.18,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10022.18,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",10022.18,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",10022.18,100,,,,,0,"case rate","100% of WA base rate",13028.83,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10022.18,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10022.18,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,13028.83,
"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC",443,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14205.24,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8572.83,100,,,,,0,"case rate","100% of CMS IPPS rate",14205.24,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14205.24,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",14205.24,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",14205.24,100,,,,,0,"case rate","100% of WA base rate",18466.82,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14205.24,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14205.24,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,18466.82,
"DISORDERS OF THE BILIARY TRACT WITH MCC",444,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19667.79,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10448.12,100,,,,,0,"case rate","100% of CMS IPPS rate",19667.79,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19667.79,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",19667.79,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",19667.79,100,,,,,0,"case rate","100% of WA base rate",25568.13,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19667.79,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19667.79,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,25568.13,
"DISORDERS OF THE BILIARY TRACT WITH CC",445,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10428.93,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10428.93,
"DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC",446,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10487.99,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10487.99,
"MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE",447,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,3184,
"MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC",448,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,3184,
"SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE",450,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,3184,
"SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC",451,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6740.68,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,100,,,,,0,"case rate","100% of CMS IPPS rate",6740.68,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6740.68,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6740.68,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",6740.68,100,,,,,0,"case rate","100% of WA base rate",8762.89,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6740.68,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6740.68,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",3184,8762.89,
"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC",456,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",24026.29,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,24026.29,
"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC",457,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",34979.15,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,34979.15,
"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC",458,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",50168.63,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,50168.63,
"BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC",461,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6704.33,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",27646.62,100,,,,,0,"case rate","100% of CMS IPPS rate",6704.33,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6704.33,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",6704.33,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",6704.33,100,,,,,0,"case rate","100% of WA base rate",8715.63,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6704.33,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6704.33,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",6704.33,49216.52,
"BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC",462,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7809.63,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",37245.13,100,,,,,0,"case rate","100% of CMS IPPS rate",7809.63,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7809.63,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",7809.63,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",7809.63,100,,,,,0,"case rate","100% of WA base rate",10152.51,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7809.63,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7809.63,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,37245.13,
"WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC",463,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10299.79,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15528.25,100,,,,,0,"case rate","100% of CMS IPPS rate",10299.79,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10299.79,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",10299.79,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",10299.79,100,,,,,0,"case rate","100% of WA base rate",13389.72,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10299.79,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10299.79,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,15528.25,
"WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC",464,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",18487.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15709.87,100,,,,,0,"case rate","100% of CMS IPPS rate",18487.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",18487.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",18487.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",18487.88,100,,,,,0,"case rate","100% of WA base rate",24034.25,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",18487.88,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",18487.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,24034.25,
"WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC",465,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",25646,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,25646,
"REVISION OF HIP OR KNEE REPLACEMENT WITH MCC",466,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",21029.84,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",21029.84,49216.52,
"REVISION OF HIP OR KNEE REPLACEMENT WITH CC",467,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",33454.53,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,33454.53,
"REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC",468,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",25617.48,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",25617.48,49216.52,
"MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT",469,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",27388.08,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,27388.08,
"MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC",470,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",18056.79,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,18056.79,
"CERVICAL SPINAL FUSION WITH MCC",471,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5915.27,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19944.81,100,,,,,0,"case rate","100% of CMS IPPS rate",5915.27,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5915.27,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",5915.27,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5915.27,100,,,,,0,"case rate","100% of WA base rate",7689.85,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5915.27,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5915.27,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,19944.81,
"CERVICAL SPINAL FUSION WITH CC",472,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6554.54,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",34032.02,100,,,,,0,"case rate","100% of CMS IPPS rate",6554.54,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6554.54,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",6554.54,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",6554.54,100,,,,,0,"case rate","100% of WA base rate",8520.9,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6554.54,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6554.54,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,34032.02,
"CERVICAL SPINAL FUSION WITHOUT CC/MCC",473,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8472.05,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",23611.92,100,,,,,0,"case rate","100% of CMS IPPS rate",8472.05,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8472.05,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",8472.05,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",8472.05,100,,,,,0,"case rate","100% of WA base rate",11013.66,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8472.05,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8472.05,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,23611.92,
"AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC",474,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15657.53,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12144.02,100,,,,,0,"case rate","100% of CMS IPPS rate",15657.53,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15657.53,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",15657.53,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",15657.53,100,,,,,0,"case rate","100% of WA base rate",20354.8,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15657.53,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15657.53,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,20354.8,
"AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC",475,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10831.86,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,10831.86,
"AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC",476,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13552.24,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,13552.24,
"BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC",477,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11021.22,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,11021.22,
"BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC",478,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13196.53,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,13196.53,
"BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC",479,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16260.86,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,16260.86,
"HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC",480,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13475.07,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,13475.07,
"HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC",481,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5951.62,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13575.5,100,,,,,0,"case rate","100% of CMS IPPS rate",5951.62,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5951.62,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",5951.62,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5951.62,100,,,,,0,"case rate","100% of WA base rate",7737.11,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5951.62,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5951.62,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,13575.5,
"HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC",482,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6802.38,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14750.6,100,,,,,0,"case rate","100% of CMS IPPS rate",6802.38,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6802.38,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",6802.38,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",6802.38,100,,,,,0,"case rate","100% of WA base rate",8843.1,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6802.38,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6802.38,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,14750.6,
"MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES",483,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9777.39,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",23838.38,100,,,,,0,"case rate","100% of CMS IPPS rate",9777.39,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9777.39,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",9777.39,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",9777.39,100,,,,,0,"case rate","100% of WA base rate",12710.61,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9777.39,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9777.39,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",9777.39,49216.52,
"KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC",485,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11289.01,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,11289.01,
"KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC",486,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11336.26,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,11336.26,
"KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC",487,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12354.05,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,12354.05,
"KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC",488,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20912,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,20912,
"KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC",489,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11876.97,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,11876.97,
"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC",492,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17475.48,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15101.05,100,,,,,0,"case rate","100% of CMS IPPS rate",17475.48,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17475.48,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",17475.48,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",17475.48,100,,,,,0,"case rate","100% of WA base rate",22718.12,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17475.48,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17475.48,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,22718.12,
"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC",493,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",23105.07,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16461.94,100,,,,,0,"case rate","100% of CMS IPPS rate",23105.07,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",23105.07,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",23105.07,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",23105.07,100,,,,,0,"case rate","100% of WA base rate",30036.59,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",23105.07,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",23105.07,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,30036.59,
"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC",494,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",37312.75,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19929.83,100,,,,,0,"case rate","100% of CMS IPPS rate",37312.75,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",37312.75,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",37312.75,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",37312.75,100,,,,,0,"case rate","100% of WA base rate",48506.58,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",37312.75,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",37312.75,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,48506.58,
"LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC",495,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14941.39,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,14941.39,
"LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC",496,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17880.05,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,17880.05,
"LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC",497,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13697.33,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,13697.33,
"LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC",498,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13186.92,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,13186.92,
"LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC",499,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12376.92,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,12376.92,
"SOFT TISSUE PROCEDURES WITH MCC",500,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12283.39,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,12283.39,
"SOFT TISSUE PROCEDURES WITH CC",501,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6084.15,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12187.15,100,,,,,0,"case rate","100% of CMS IPPS rate",6084.15,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6084.15,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",6084.15,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",6084.15,100,,,,,0,"case rate","100% of WA base rate",7909.39,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6084.15,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6084.15,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,12187.15,
"SOFT TISSUE PROCEDURES WITHOUT CC/MCC",502,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11028.68,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17306.59,100,,,,,0,"case rate","100% of CMS IPPS rate",11028.68,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11028.68,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",11028.68,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",11028.68,100,,,,,0,"case rate","100% of WA base rate",14337.28,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11028.68,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11028.68,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,17306.59,
"FOOT PROCEDURES WITH MCC",503,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19287.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10576.24,100,,,,,0,"case rate","100% of CMS IPPS rate",19287.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19287.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",19287.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",19287.4,100,,,,,0,"case rate","100% of WA base rate",25073.62,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19287.4,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19287.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,25073.62,
"FOOT PROCEDURES WITH CC",504,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",39103.82,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12429.94,100,,,,,0,"case rate","100% of CMS IPPS rate",39103.82,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",39103.82,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",39103.82,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",39103.82,100,,,,,0,"case rate","100% of WA base rate",50834.97,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",39103.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",39103.82,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,50834.97,
"FOOT PROCEDURES WITHOUT CC/MCC",505,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12275.92,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,12275.92,
"MAJOR THUMB OR JOINT PROCEDURES",506,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10526.33,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,10526.33,
"MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC",507,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12784.87,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,12784.87,
"MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC",508,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15877.69,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,15877.69,
"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC",510,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15356.99,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,15356.99,
"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC",511,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",4337.01,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16881.62,100,,,,,0,"case rate","100% of CMS IPPS rate",4337.01,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",4337.01,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",4337.01,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",4337.01,100,,,,,0,"case rate","100% of WA base rate",5638.11,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",4337.01,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",4337.01,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",4337.01,16881.62,
"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC",512,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6538.48,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",21117.31,100,,,,,0,"case rate","100% of CMS IPPS rate",6538.48,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6538.48,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",6538.48,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",6538.48,100,,,,,0,"case rate","100% of WA base rate",8500.02,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6538.48,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6538.48,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,21117.31,
"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC",513,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12314.18,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11666.34,100,,,,,0,"case rate","100% of CMS IPPS rate",12314.18,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12314.18,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",12314.18,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",12314.18,100,,,,,0,"case rate","100% of WA base rate",16008.44,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12314.18,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12314.18,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,16008.44,
"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC",514,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",21358.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12492.79,100,,,,,0,"case rate","100% of CMS IPPS rate",21358.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",21358.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",21358.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",21358.88,100,,,,,0,"case rate","100% of WA base rate",27766.55,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",21358.88,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",21358.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,27766.55,
"OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC",515,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13384.3,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,13384.3,
"OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC",516,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15064.24,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,15064.24,
"OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC",517,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",18704.69,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,18704.69,
"BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR",518,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19468.15,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19468.15,19468.15,
"BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC",519,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17710.02,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17710.02,17710.02,
"BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC",520,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13736.67,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13736.67,13736.67,
"HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC",521,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5537.62,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13902.75,100,,,,,0,"case rate","100% of CMS IPPS rate",5537.62,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5537.62,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5537.62,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5537.62,100,,,,,0,"case rate","100% of WA base rate",7198.91,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5537.62,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5537.62,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5537.62,13902.75,
"HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC",522,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6222.8,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15201.5,100,,,,,0,"case rate","100% of CMS IPPS rate",6222.8,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6222.8,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6222.8,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",6222.8,100,,,,,0,"case rate","100% of WA base rate",8089.65,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6222.8,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6222.8,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",6222.8,15201.5,
"FRACTURES OF FEMUR WITH MCC",533,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8197.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11182.08,100,,,,,0,"case rate","100% of CMS IPPS rate",8197.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8197.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",8197.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",8197.52,100,,,,,0,"case rate","100% of WA base rate",10656.77,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8197.52,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8197.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,11182.08,
"FRACTURES OF FEMUR WITHOUT MCC",534,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20473.48,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8040.79,100,,,,,0,"case rate","100% of CMS IPPS rate",20473.48,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20473.48,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",20473.48,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",20473.48,100,,,,,0,"case rate","100% of WA base rate",26615.53,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20473.48,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20473.48,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,26615.53,
"FRACTURES OF HIP AND PELVIS WITH MCC",535,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9571.64,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9571.64,
"FRACTURES OF HIP AND PELVIS WITHOUT MCC",536,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8092.51,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8092.51,
"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC",537,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9279.33,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9279.33,
"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC",538,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9278.9,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9278.9,
"OSTEOMYELITIS WITH MCC",539,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9067.76,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9067.76,
"OSTEOMYELITIS WITH CC",540,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8898.23,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8898.23,
"OSTEOMYELITIS WITHOUT CC/MCC",541,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5477.07,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8516.28,100,,,,,0,"case rate","100% of CMS IPPS rate",5477.07,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5477.07,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",5477.07,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5477.07,100,,,,,0,"case rate","100% of WA base rate",7120.19,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5477.07,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5477.07,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,8516.28,
"PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC",542,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6436.75,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10096.28,100,,,,,0,"case rate","100% of CMS IPPS rate",6436.75,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6436.75,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",6436.75,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",6436.75,100,,,,,0,"case rate","100% of WA base rate",8367.77,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6436.75,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6436.75,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,10096.28,
"PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC",543,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7939.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8971.16,100,,,,,0,"case rate","100% of CMS IPPS rate",7939.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7939.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",7939.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",7939.52,100,,,,,0,"case rate","100% of WA base rate",10321.37,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7939.52,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7939.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,10321.37,
"PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC",544,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14933.57,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8498,100,,,,,0,"case rate","100% of CMS IPPS rate",14933.57,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14933.57,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",14933.57,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",14933.57,100,,,,,0,"case rate","100% of WA base rate",19413.64,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14933.57,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14933.57,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,19413.64,
"CONNECTIVE TISSUE DISORDERS WITH MCC",545,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12374.87,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,12374.87,
"CONNECTIVE TISSUE DISORDERS WITH CC",546,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10154.54,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10154.54,
"CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC",547,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9756.73,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9756.73,
"SEPTIC ARTHRITIS WITH MCC",548,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8909.66,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8909.66,
"SEPTIC ARTHRITIS WITH CC",549,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8903.61,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8903.61,
"SEPTIC ARTHRITIS WITHOUT CC/MCC",550,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9140.69,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9140.69,
"MEDICAL BACK PROBLEMS WITH MCC",551,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6601.58,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10650.93,100,,,,,0,"case rate","100% of CMS IPPS rate",6601.58,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6601.58,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",6601.58,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",6601.58,100,,,,,0,"case rate","100% of WA base rate",8582.05,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6601.58,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6601.58,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,10650.93,
"MEDICAL BACK PROBLEMS WITHOUT MCC",552,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8979.26,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9592.36,100,,,,,0,"case rate","100% of CMS IPPS rate",8979.26,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8979.26,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",8979.26,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",8979.26,100,,,,,0,"case rate","100% of WA base rate",11673.04,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8979.26,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8979.26,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,11673.04,
"BONE DISEASES AND ARTHROPATHIES WITH MCC",553,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13651.57,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9489.51,100,,,,,0,"case rate","100% of CMS IPPS rate",13651.57,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13651.57,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",13651.57,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",13651.57,100,,,,,0,"case rate","100% of WA base rate",17747.04,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13651.57,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13651.57,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,17747.04,
"BONE DISEASES AND ARTHROPATHIES WITHOUT MCC",554,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",27609.49,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8449.28,100,,,,,0,"case rate","100% of CMS IPPS rate",27609.49,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",27609.49,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",27609.49,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",27609.49,100,,,,,0,"case rate","100% of WA base rate",35892.34,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",27609.49,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",27609.49,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,35892.34,
"SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC",555,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10598.53,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10598.53,
"SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC",556,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9493.13,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9493.13,
"TENDONITIS, MYOSITIS AND BURSITIS WITH MCC",557,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9535.57,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9535.57,
"TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC",558,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8157.22,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8157.22,
"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC",559,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10445.53,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10445.53,
"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC",560,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8808.35,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8808.35,
"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC",561,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5987.78,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8021.57,100,,,,,0,"case rate","100% of CMS IPPS rate",5987.78,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5987.78,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",5987.78,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5987.78,100,,,,,0,"case rate","100% of WA base rate",7784.11,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5987.78,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5987.78,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,8021.57,
"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC",562,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8616.69,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10677.54,100,,,,,0,"case rate","100% of CMS IPPS rate",8616.69,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8616.69,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",8616.69,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",8616.69,100,,,,,0,"case rate","100% of WA base rate",11201.69,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8616.69,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8616.69,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,11201.69,
"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC",563,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13738.39,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9208.05,100,,,,,0,"case rate","100% of CMS IPPS rate",13738.39,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13738.39,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",13738.39,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",13738.39,100,,,,,0,"case rate","100% of WA base rate",17859.91,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13738.39,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13738.39,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,17859.91,
"OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC",564,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",25755.49,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9367.5,100,,,,,0,"case rate","100% of CMS IPPS rate",25755.49,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",25755.49,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",25755.49,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",25755.49,100,,,,,0,"case rate","100% of WA base rate",33482.13,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",25755.49,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",25755.49,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,33482.13,
"OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC",565,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8718.4,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8718.4,
"OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC",566,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9393.65,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9393.65,
"SKIN DEBRIDEMENT WITH MCC",570,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10648.64,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,10648.64,
"SKIN DEBRIDEMENT WITH CC",571,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5983.9,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9940.09,100,,,,,0,"case rate","100% of CMS IPPS rate",5983.9,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5983.9,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",5983.9,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5983.9,100,,,,,0,"case rate","100% of WA base rate",7779.07,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5983.9,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5983.9,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,9940.09,
"SKIN DEBRIDEMENT WITHOUT CC/MCC",572,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8263.8,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11312.69,100,,,,,0,"case rate","100% of CMS IPPS rate",8263.8,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8263.8,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",8263.8,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",8263.8,100,,,,,0,"case rate","100% of WA base rate",10742.94,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8263.8,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8263.8,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,11312.69,
"SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC",573,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11543.18,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14793.94,100,,,,,0,"case rate","100% of CMS IPPS rate",11543.18,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11543.18,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",11543.18,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",11543.18,100,,,,,0,"case rate","100% of WA base rate",15006.14,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11543.18,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11543.18,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,15006.14,
"SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC",574,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",22275.93,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11956.85,100,,,,,0,"case rate","100% of CMS IPPS rate",22275.93,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",22275.93,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",22275.93,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",22275.93,100,,,,,0,"case rate","100% of WA base rate",28958.71,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",22275.93,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",22275.93,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,28958.71,
"SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC",575,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12804.4,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,12804.4,
"SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC",576,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17404.8,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,17404.8,
"SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC",577,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17735.42,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,17735.42,
"SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC",578,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",18545.23,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,18545.23,
"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC",579,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12495.49,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,12495.49,
"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC",580,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11971.7,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,11971.7,
"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC",581,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7671.59,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",18461.33,100,,,,,0,"case rate","100% of CMS IPPS rate",7671.59,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7671.59,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",7671.59,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",7671.59,100,,,,,0,"case rate","100% of WA base rate",9973.07,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7671.59,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7671.59,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,18461.33,
"MASTECTOMY FOR MALIGNANCY WITH CC/MCC",582,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10274.87,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19196.99,100,,,,,0,"case rate","100% of CMS IPPS rate",10274.87,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10274.87,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",10274.87,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",10274.87,100,,,,,0,"case rate","100% of WA base rate",13357.34,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10274.87,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10274.87,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,19196.99,
"MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC",583,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13329.15,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14604.15,100,,,,,0,"case rate","100% of CMS IPPS rate",13329.15,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13329.15,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",13329.15,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",13329.15,100,,,,,0,"case rate","100% of WA base rate",17327.9,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13329.15,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13329.15,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,17327.9,
"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC",584,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19800.46,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16583.58,100,,,,,0,"case rate","100% of CMS IPPS rate",19800.46,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19800.46,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",19800.46,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",19800.46,100,,,,,0,"case rate","100% of WA base rate",25740.6,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19800.46,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19800.46,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,25740.6,
"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC",585,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",22035.91,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,22035.91,
"SKIN ULCERS WITH MCC",592,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9282.58,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10374.1,100,,,,,0,"case rate","100% of CMS IPPS rate",9282.58,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9282.58,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",9282.58,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",9282.58,100,,,,,0,"case rate","100% of WA base rate",12067.36,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9282.58,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9282.58,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,12067.36,
"SKIN ULCERS WITH CC",593,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13543.14,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8293,100,,,,,0,"case rate","100% of CMS IPPS rate",13543.14,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13543.14,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",13543.14,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",13543.14,100,,,,,0,"case rate","100% of WA base rate",17606.08,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13543.14,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13543.14,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,17606.08,
"SKIN ULCERS WITHOUT CC/MCC",594,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",21153.76,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7312.15,100,,,,,0,"case rate","100% of CMS IPPS rate",21153.76,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",21153.76,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",21153.76,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",21153.76,100,,,,,0,"case rate","100% of WA base rate",27499.89,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",21153.76,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",21153.76,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,27499.89,
"MAJOR SKIN DISORDERS WITH MCC",595,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11595.17,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11595.17,
"MAJOR SKIN DISORDERS WITHOUT MCC",596,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8543.26,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8543.26,
"MALIGNANT BREAST DISORDERS WITH MCC",597,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9599,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9599,
"MALIGNANT BREAST DISORDERS WITH CC",598,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10457.9,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10457.9,
"MALIGNANT BREAST DISORDERS WITHOUT CC/MCC",599,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6168.57,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,6168.57,
"NON-MALIGNANT BREAST DISORDERS WITH CC/MCC",600,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8946.09,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8946.09,
"NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC",601,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7169.36,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,7169.36,
"CELLULITIS WITH MCC",602,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9309.16,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9309.16,
"CELLULITIS WITHOUT MCC",603,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8215.72,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8215.72,
"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC",604,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11410.65,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11410.65,
"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC",605,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10062.51,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10062.51,
"MINOR SKIN DISORDERS WITH MCC",606,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10375.46,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10375.46,
"MINOR SKIN DISORDERS WITHOUT MCC",607,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8869.68,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8869.68,
"ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC",614,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",24015.59,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,24015.59,
"ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC",615,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14116.68,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,14116.68,
"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC",616,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11393.43,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,11393.43,
"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC",617,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10022.77,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,10022.77,
"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC",618,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7961.25,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,7961.25,
"O.R. PROCEDURES FOR OBESITY WITH MCC",619,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",29807.1,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,29807.1,
"O.R. PROCEDURES FOR OBESITY WITH CC",620,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15566.63,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,15566.63,
"O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC",621,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14560.01,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,14560.01,
"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC",622,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12236.82,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,12236.82,
"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC",623,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9923.33,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,9923.33,
"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC",624,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12340.09,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,12340.09,
"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC",625,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",18281.63,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,18281.63,
"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC",626,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14316.27,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,14316.27,
"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC",627,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11860.66,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,11860.66,
"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC",628,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13758.27,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,13758.27,
"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC",629,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10506.69,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,10506.69,
"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC",630,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13398.89,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,13398.89,
"DIABETES WITH MCC",637,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10430.61,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10430.61,
"DIABETES WITH CC",638,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8630.64,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8630.64,
"DIABETES WITHOUT CC/MCC",639,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5973.51,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,5973.51,
"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC",640,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10517.22,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10517.22,
"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC",641,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8651.9,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8651.9,
"INBORN AND OTHER DISORDERS OF METABOLISM",642,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11724.81,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11724.81,
"ENDOCRINE DISORDERS WITH MCC",643,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9471.83,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9471.83,
"ENDOCRINE DISORDERS WITH CC",644,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8989.48,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8989.48,
"ENDOCRINE DISORDERS WITHOUT CC/MCC",645,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8424.92,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8424.92,
"KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC",650,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20551.43,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20551.43,20551.43,
"KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC",651,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",18437.11,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",43954.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",18437.11,43954.52,
"KIDNEY TRANSPLANT",652,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20114.11,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,20114.11,
"MAJOR BLADDER PROCEDURES WITH MCC",653,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15430.37,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,15430.37,
"MAJOR BLADDER PROCEDURES WITH CC",654,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14869.27,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,14869.27,
"MAJOR BLADDER PROCEDURES WITHOUT CC/MCC",655,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",18387.68,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,18387.68,
"KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC",656,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17710.83,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,17710.83,
"KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC",657,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20419.55,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,20419.55,
"KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC",658,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14205.92,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,14205.92,
"KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC",659,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12849.87,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,12849.87,
"KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC",660,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13360.61,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,13360.61,
"KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC",661,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10060.45,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,10060.45,
"MINOR BLADDER PROCEDURES WITH MCC",662,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11981.81,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,11981.81,
"MINOR BLADDER PROCEDURES WITH CC",663,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12000.48,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,12000.48,
"MINOR BLADDER PROCEDURES WITHOUT CC/MCC",664,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10187.11,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,10187.11,
"PROSTATECTOMY WITH MCC",665,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11256.84,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,11256.84,
"PROSTATECTOMY WITH CC",666,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13733.48,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,13733.48,
"PROSTATECTOMY WITHOUT CC/MCC",667,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10071.96,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,10071.96,
"TRANSURETHRAL PROCEDURES WITH MCC",668,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11267.3,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,11267.3,
"TRANSURETHRAL PROCEDURES WITH CC",669,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11940.02,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,11940.02,
"TRANSURETHRAL PROCEDURES WITHOUT CC/MCC",670,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9237.11,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,9237.11,
"URETHRAL PROCEDURES WITH CC/MCC",671,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11733.85,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,11733.85,
"URETHRAL PROCEDURES WITHOUT CC/MCC",672,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8854.23,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,8854.23,
"OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC",673,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10236.35,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,10236.35,
"OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC",674,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12468.87,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,12468.87,
"OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC",675,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15749.02,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,15749.02,
"RENAL FAILURE WITH MCC",682,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9819.33,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9819.33,
"RENAL FAILURE WITH CC",683,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8644.08,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8644.08,
"RENAL FAILURE WITHOUT CC/MCC",684,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7962.5,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,7962.5,
"KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC",686,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9991.07,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9991.07,
"KIDNEY AND URINARY TRACT NEOPLASMS WITH CC",687,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9403.78,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9403.78,
"KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC",688,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7493.52,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,7493.52,
"KIDNEY AND URINARY TRACT INFECTIONS WITH MCC",689,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8897.01,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8897.01,
"KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC",690,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8296.08,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8296.08,
"URINARY STONES WITH MCC",693,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10729.59,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10729.59,
"URINARY STONES WITHOUT MCC",694,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10729.7,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10729.7,
"KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC",695,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9564.01,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9564.01,
"KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC",696,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8662.68,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8662.68,
"URETHRAL STRICTURE",697,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12324.59,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,12324.59,
"OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC",698,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9922.26,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9922.26,
"OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC",699,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9183.37,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9183.37,
"OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC",700,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9268.43,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9268.43,
"MAJOR MALE PELVIC PROCEDURES WITH CC/MCC",707,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",25672.35,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,25672.35,
"MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC",708,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13995.77,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,13995.77,
"PENIS PROCEDURES WITH CC/MCC",709,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14885.5,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,14885.5,
"PENIS PROCEDURES WITHOUT CC/MCC",710,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11844.34,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11844.34,49216.52,
"TESTES PROCEDURES WITH CC/MCC",711,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13002.99,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",49216.52,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13002.99,49216.52,
"TESTES PROCEDURES WITHOUT CC/MCC",712,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16291.27,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,16291.27,
"TRANSURETHRAL PROSTATECTOMY WITH CC/MCC",713,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16705.1,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,16705.1,
"TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC",714,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9197.77,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,9197.77,
"OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC",715,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11768.43,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,11768.43,
"OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC",716,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13647.43,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,13647.43,
"OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC",717,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15356.7,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,15356.7,
"OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC",718,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11282.98,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,11282.98,
"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC",722,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10794.35,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10794.35,
"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC",723,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9434.84,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9434.84,
"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",724,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7767.96,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",46462.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7767.96,46462.4,
"BENIGN PROSTATIC HYPERTROPHY WITH MCC",725,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9159.75,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9159.75,
"BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC",726,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8767.15,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8767.15,
"INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC",727,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10370.08,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10370.08,
"INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC",728,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7942.51,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,7942.51,
"OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC",729,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9322.67,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9322.67,
"OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC",730,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5964.87,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,5964.87,
"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC",734,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",39551.67,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20857.87,100,,,,,0,"case rate","100% of CMS IPPS rate",39551.67,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",39551.67,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",39551.67,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",39551.67,100,,,,,0,"case rate","100% of WA base rate",51417.17,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",39551.67,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",39551.67,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,51417.17,
"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC",735,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12092.88,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,12092.88,
"UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC",736,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14920.63,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,14920.63,
"UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC",737,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15357.23,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,15357.23,
"UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC",738,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17856.41,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,17856.41,
"UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC",739,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16266.57,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,16266.57,
"UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC",740,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19053.39,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,19053.39,
"UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC",741,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12468.08,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,12468.08,
"UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC",742,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",18999.01,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,18999.01,
"UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC",743,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11150.55,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,11150.55,
"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC",744,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12042.34,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,12042.34,
"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC",745,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9940.5,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,9940.5,
"VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC",746,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16083.86,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,16083.86,
"VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC",747,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8513.57,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,8513.57,
"FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES",748,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13481.42,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,13481.42,
"OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC",749,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13672.67,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,13672.67,
"OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC",750,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13050.56,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,13050.56,
"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC",754,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10456.82,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10456.82,
"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC",755,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9758.23,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9758.23,
"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",756,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9497.16,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9497.16,
"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC",757,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8945.87,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8945.87,
"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC",758,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8164.28,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8164.28,
"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",759,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7154.93,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,7154.93,
"MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC",760,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10234.13,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10234.13,
"MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC",761,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5811.34,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,5811.34,
"VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C",768,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2382,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2382,5262,
"POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES",769,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15873.5,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,15873.5,
"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",770,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10949.04,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,10949.04,
"POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES",776,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8970.59,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8970.59,
"ABORTION WITHOUT D&C",779,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11865.45,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11865.45,
"CESAREAN SECTION WITH STERILIZATION WITH MCC",783,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11088.39,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11088.39,11088.39,
"CESAREAN SECTION WITH STERILIZATION WITH CC",784,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9510.26,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9510.26,9510.26,
"CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC",785,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9975.62,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9975.62,9975.62,
"CESAREAN SECTION WITHOUT STERILIZATION WITH MCC",786,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11991.57,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11991.57,11991.57,
"CESAREAN SECTION WITHOUT STERILIZATION WITH CC",787,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9169.41,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9169.41,9169.41,
"CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC",788,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8487.5,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8487.5,8487.5,
"NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY",789,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17458.96,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,17458.96,
"EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE",790,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9649.77,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9649.77,
"PREMATURITY WITH MAJOR PROBLEMS",791,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8869.52,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8869.52,
"PREMATURITY WITHOUT MAJOR PROBLEMS",792,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8276.55,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8276.55,
"FULL TERM NEONATE WITH MAJOR PROBLEMS",793,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",25782.41,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,25782.41,
"NEONATE WITH OTHER SIGNIFICANT PROBLEMS",794,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12615.07,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,12615.07,
"NORMAL NEWBORN",795,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",1873.08,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",1873.08,2507.88,
"VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC",796,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14080.31,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14080.31,14080.31,
"VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC",797,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12465.2,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12465.2,12465.2,
"VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC",798,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10153.4,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10153.4,10153.4,
"SPLENIC PROCEDURES WITH MCC",799,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19810.14,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,19810.14,
"SPLENIC PROCEDURES WITH CC",800,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",18435.44,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,18435.44,
"SPLENIC PROCEDURES WITHOUT CC/MCC",801,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20608.75,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,20608.75,
"OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC",802,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13013.33,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,13013.33,
"OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC",803,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13716.37,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,13716.37,
"OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC",804,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11615,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,11615,
"VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC",805,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10365.74,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10365.74,10365.74,
"VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC",806,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9346.09,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9346.09,9346.09,
"VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC",807,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6278.66,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6278.66,6278.66,
"MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC",808,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11895.96,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11895.96,
"MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC",809,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10197.73,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10197.73,
"MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC",810,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11567.02,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11567.02,
"RED BLOOD CELL DISORDERS WITH MCC",811,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10920.77,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10920.77,
"RED BLOOD CELL DISORDERS WITHOUT MCC",812,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9260.48,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",46462.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9260.48,46462.4,
"COAGULATION DISORDERS",813,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12474.8,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",46462.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12474.8,46462.4,
"RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC",814,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12252.75,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,12252.75,
"RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC",815,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9540.34,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",46462.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9540.34,46462.4,
"RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC",816,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9735.83,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9735.83,
"OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC",817,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15456.41,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15456.41,15456.41,
"OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC",818,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14683.13,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14683.13,14683.13,
"OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC",819,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8705.49,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8705.49,8705.49,
"LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC",820,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15682.2,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,15682.2,
"LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC",821,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5273.15,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",18359.34,100,,,,,0,"case rate","100% of CMS IPPS rate",5273.15,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5273.15,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",5273.15,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5273.15,100,,,,,0,"case rate","100% of WA base rate",6855.09,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5273.15,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5273.15,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,18359.34,
"LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC",822,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6432.86,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11887.52,100,,,,,0,"case rate","100% of CMS IPPS rate",6432.86,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6432.86,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",6432.86,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",6432.86,100,,,,,0,"case rate","100% of WA base rate",8362.72,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6432.86,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6432.86,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,11887.52,
"LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC",823,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9862.43,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12342.92,100,,,,,0,"case rate","100% of CMS IPPS rate",9862.43,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9862.43,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",9862.43,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",9862.43,100,,,,,0,"case rate","100% of WA base rate",12821.16,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9862.43,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9862.43,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,12821.16,
"LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC",824,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",22942.99,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12856.15,100,,,,,0,"case rate","100% of CMS IPPS rate",22942.99,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",22942.99,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",22942.99,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",22942.99,100,,,,,0,"case rate","100% of WA base rate",29825.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",22942.99,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",22942.99,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,29825.88,
"LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC",825,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16898.56,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,16898.56,
"MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC",826,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14038.31,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,14038.31,
"MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC",827,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16270.14,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,16270.14,
"MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC",828,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19676.6,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,19676.6,
"MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC",829,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15131.93,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,15131.93,
"MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CC/MCC",830,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",21675.99,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,21675.99,
"OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC",831,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8550.04,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8550.04,8550.04,
"OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC",832,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8168.04,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8168.04,8168.04,
"OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC",833,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",4911.23,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",4911.23,4911.23,
"ACUTE LEUKEMIA WITH MCC",834,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17147.24,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,17147.24,
"ACUTE LEUKEMIA WITH CC",835,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14626.27,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,14626.27,
"ACUTE LEUKEMIA WITHOUT CC/MCC",836,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14361.61,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,14361.61,
"CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC",837,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13166.63,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,13166.63,
"CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT",838,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10808.79,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10808.79,
"CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC",839,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9618.88,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9618.88,
"LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC",840,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13428.1,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,13428.1,
"LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC",841,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11614.85,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11614.85,
"LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC",842,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11807.51,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11807.51,
"OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC",843,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9919.07,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",46462.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9919.07,46462.4,
"OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC",844,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9003.64,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",46462.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9003.64,46462.4,
"OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC",845,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10374.48,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10374.48,
"CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC",846,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11726.31,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11726.31,
"CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC",847,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8950.85,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8950.85,
"CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC",848,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8097.96,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8097.96,
RADIOTHERAPY,849,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10470.27,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10470.27,
"ACUTE LEUKEMIA WITH OTHER PROCEDURES",850,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,3184,
"INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC",853,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14991.65,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,14991.65,
"INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC",854,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11735.14,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,11735.14,
"INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC",855,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14845.88,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,14845.88,
"POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC",856,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13857.04,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,13857.04,
"POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC",857,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11385.65,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,11385.65,
"POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC",858,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11195.91,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,11195.91,
"POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC",862,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10397.55,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10397.55,
"POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC",863,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8513.63,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8513.63,
"FEVER AND INFLAMMATORY CONDITIONS",864,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9412.61,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9412.61,
"VIRAL ILLNESS WITH MCC",865,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11802.36,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11802.36,
"VIRAL ILLNESS WITHOUT MCC",866,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9784.72,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9784.72,
"OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC",867,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11154.28,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11154.28,
"OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC",868,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9190.99,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9190.99,
"OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC",869,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8284.95,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8284.95,
"SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS",870,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15664.5,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,15664.5,
"SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC",871,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11647.98,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11647.98,
"SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC",872,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8471.07,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8471.07,
"O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS",876,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",1133.81,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",1133.81,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",1133.81,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",14516.54,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",1133.81,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",1133.81,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",1133.81,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",1133.81,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",1133.81,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",1133.81,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",1133.81,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",1133.81,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",1133.81,14516.54,
"ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION",880,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",9814.65,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",975.82,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",975.82,9814.65,
"DEPRESSIVE NEUROSES",881,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",920.06,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",920.06,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",920.06,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",6524.08,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",920.06,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",920.06,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",920.06,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",920.06,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",920.06,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",920.06,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",920.06,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",920.06,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",920.06,6524.08,
"NEUROSES EXCEPT DEPRESSIVE",882,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",7953.11,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",947.94,7953.11,
"DISORDERS OF PERSONALITY AND IMPULSE CONTROL",883,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",9308.45,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",947.94,9308.45,
"ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY",884,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",957.23,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",957.23,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",957.23,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",10761.2,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",957.23,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",957.23,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",957.23,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",957.23,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",957.23,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",957.23,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",957.23,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",957.23,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",957.23,10761.2,
PSYCHOSES,885,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",929.35,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",929.35,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",929.35,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",6051.68,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",929.35,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",929.35,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",929.35,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",929.35,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",929.35,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",929.35,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",929.35,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",929.35,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",929.35,6051.68,
"BEHAVIORAL AND DEVELOPMENTAL DISORDERS",886,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",920.06,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",920.06,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",920.06,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",10524.52,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",920.06,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",920.06,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",920.06,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",920.06,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",920.06,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",920.06,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",920.06,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",920.06,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",920.06,10524.52,
"OTHER MENTAL DISORDER DIAGNOSES",887,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",855.01,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",855.01,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",855.01,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",11302.34,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",855.01,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",855.01,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",855.01,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",855.01,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",855.01,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",855.01,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",855.01,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",855.01,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",855.01,11302.34,
"ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA",894,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",901.47,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",901.47,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",58515.47,100,,,,,0,"case rate","100% of WA base rate",901.47,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",7875.57,100,,,,,0,"case rate","100% of CMS IPPS rate",58515.47,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",901.47,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",58515.47,100,,,,,0,"case rate","100% of WA base rate",901.47,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",2507.88,100,,,,,0,"case rate","100% of WA base rate",58515.47,100,,,,,0,"case rate","100% of WA base rate",901.47,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",58515.47,100,,,,,0,"case rate","100% of WA base rate",76070.11,100,,,,,0,"case rate","100% of WA base rate",901.47,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",901.47,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",901.47,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",58515.47,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",901.47,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",901.47,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",58515.47,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",901.47,76070.11,
"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY",895,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",6093.97,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",947.94,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",947.94,6093.97,
"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC",896,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",817.83,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",817.83,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",817.83,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",10664.15,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",817.83,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",817.83,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",817.83,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",817.83,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",817.83,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",817.83,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",817.83,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",817.83,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",817.83,10664.15,
"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC",897,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",817.83,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",817.83,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",817.83,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",7463.94,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",817.83,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",817.83,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",817.83,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",817.83,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",817.83,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",817.83,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",817.83,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",817.83,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",817.83,7463.94,
"WOUND DEBRIDEMENTS FOR INJURIES WITH MCC",901,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13691.07,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,13691.07,
"WOUND DEBRIDEMENTS FOR INJURIES WITH CC",902,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12057.05,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,12057.05,
"WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC",903,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13746.27,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,13746.27,
"SKIN GRAFTS FOR INJURIES WITH CC/MCC",904,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13391.36,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,13391.36,
"SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC",905,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15721.23,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,15721.23,
"HAND PROCEDURES FOR INJURIES",906,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",16927.34,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,16927.34,
"OTHER O.R. PROCEDURES FOR INJURIES WITH MCC",907,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15518.4,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,15518.4,
"OTHER O.R. PROCEDURES FOR INJURIES WITH CC",908,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15592.98,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,15592.98,
"OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC",909,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",18592.94,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,18592.94,
"TRAUMATIC INJURY WITH MCC",913,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",35015.95,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11322.02,100,,,,,0,"case rate","100% of CMS IPPS rate",35015.95,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",35015.95,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",35015.95,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",35015.95,100,,,,,0,"case rate","100% of WA base rate",45520.73,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",35015.95,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",35015.95,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,45520.73,
"TRAUMATIC INJURY WITHOUT MCC",914,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",58829.62,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10050.33,100,,,,,0,"case rate","100% of CMS IPPS rate",58829.62,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",58829.62,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",58829.62,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",58829.62,100,,,,,0,"case rate","100% of WA base rate",76478.51,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",58829.62,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",58829.62,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,76478.51,
"ALLERGIC REACTIONS WITH MCC",915,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13802.68,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,13802.68,
"ALLERGIC REACTIONS WITHOUT MCC",916,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6321.84,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,6321.84,
"POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC",917,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12090.2,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,12090.2,
"POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC",918,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9913.44,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9913.44,
"COMPLICATIONS OF TREATMENT WITH MCC",919,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11938.51,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11938.51,
"COMPLICATIONS OF TREATMENT WITH CC",920,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10262.43,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,10262.43,
"COMPLICATIONS OF TREATMENT WITHOUT CC/MCC",921,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12355.13,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9565.84,100,,,,,0,"case rate","100% of CMS IPPS rate",12355.13,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12355.13,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",12355.13,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",12355.13,100,,,,,0,"case rate","100% of WA base rate",16061.66,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12355.13,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12355.13,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,16061.66,
"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC",922,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15741.55,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11681.9,100,,,,,0,"case rate","100% of CMS IPPS rate",15741.55,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15741.55,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",15741.55,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",15741.55,100,,,,,0,"case rate","100% of WA base rate",20464.02,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15741.55,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15741.55,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,20464.02,
"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC",923,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",24724.36,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",10040.06,100,,,,,0,"case rate","100% of CMS IPPS rate",24724.36,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",24724.36,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",24724.36,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",24724.36,100,,,,,0,"case rate","100% of WA base rate",32141.67,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",24724.36,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",24724.36,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,32141.67,
"EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT",927,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",31617.26,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,31617.26,
"FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC",928,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15936.35,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,15936.35,
"FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC",929,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15689.46,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,15689.46,
"EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT",933,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",33571.24,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,33571.24,
"FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY",934,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",13690.66,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,13690.66,
"NON-EXTENSIVE BURNS",935,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14689.8,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,14689.8,
"O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC",939,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14692.39,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,14692.39,
"O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC",940,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20790.69,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,20790.69,
"O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC",941,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17810.18,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,17810.18,
"REHABILITATION WITH CC/MCC",945,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8520.68,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8520.68,
"REHABILITATION WITHOUT CC/MCC",946,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8098.22,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8098.22,
"SIGNS AND SYMPTOMS WITH MCC",947,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9738.12,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9738.12,
"SIGNS AND SYMPTOMS WITHOUT MCC",948,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8868.92,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,8868.92,
"AFTERCARE WITH CC/MCC",949,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6778.92,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,6778.92,
"AFTERCARE WITHOUT CC/MCC",950,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6236.08,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",46462.4,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",6236.08,46462.4,
"OTHER FACTORS INFLUENCING HEALTH STATUS",951,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7014.06,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5661.64,100,,,,,0,"case rate","100% of CMS IPPS rate",7014.06,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7014.06,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",46462.4,100,,,,,0,"case rate","100% of WA base rate",7014.06,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",7014.06,100,,,,,0,"case rate","100% of WA base rate",9118.28,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7014.06,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7014.06,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5661.64,46462.4,
"CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA",955,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19923.26,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,19923.26,
"LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA",956,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",18007.36,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,18007.36,
"OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC",957,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",21245.84,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,21245.84,
"OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC",958,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17642.68,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,17642.68,
"OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC",959,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",19184.93,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,19184.93,
"OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC",963,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14576.86,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,14576.86,
"OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC",964,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11079.69,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11079.69,
"OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC",965,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11007.38,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11007.38,
"HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC",969,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15456.91,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,15456.91,
"HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC",970,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11536.31,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,11536.31,
"HIV WITH MAJOR RELATED CONDITION WITH MCC",974,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",23635.91,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12168.15,100,,,,,0,"case rate","100% of CMS IPPS rate",23635.91,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",23635.91,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",23635.91,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",23635.91,100,,,,,0,"case rate","100% of WA base rate",30726.69,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",23635.91,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",23635.91,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",2507.88,30726.69,
"HIV WITH MAJOR RELATED CONDITION WITH CC",975,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",9127.13,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,9127.13,
"HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC",976,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",7849.84,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,7849.84,
"HIV WITH OR WITHOUT OTHER RELATED CONDITION",977,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11324.08,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",2507.88,11324.08,
"EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC",981,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8535.11,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15685.82,100,,,,,0,"case rate","100% of CMS IPPS rate",8535.11,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8535.11,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",8535.11,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",8535.11,100,,,,,0,"case rate","100% of WA base rate",11095.64,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8535.11,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",8535.11,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,15685.82,
"EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC",982,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12063.78,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",17455.36,100,,,,,0,"case rate","100% of CMS IPPS rate",12063.78,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12063.78,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",12063.78,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",12063.78,100,,,,,0,"case rate","100% of WA base rate",15682.91,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12063.78,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",12063.78,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,17455.36,
"EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC",983,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20719.28,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",15691.38,100,,,,,0,"case rate","100% of CMS IPPS rate",20719.28,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20719.28,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",20719.28,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",20719.28,100,,,,,0,"case rate","100% of WA base rate",26935.06,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20719.28,100,MS-DRG,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",20719.28,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",5262,26935.06,
"NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC",987,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11854.69,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,11854.69,
"NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC",988,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",11631.72,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,11631.72,
"NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC",989,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",14136.22,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,100,,,,,0,"case rate","100% of WA base rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",5262,14136.22,
"PRINCIPAL DIAGNOSIS INVALID AS DISCHARGE DIAGNOSIS",998,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,3184,
UNGROUPABLE,999,CDM,100,RC,,,Inpatient,,,,,,,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,100,,,,,0,"case rate","100% of CMS IPPS rate",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",,,,,,,0,"other ","not separately reimbursment",3184,3184,